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HomeMy WebLinkAbout038-1067-30-000 a O 6q Ui ~C O d; 0.' O I f O O O O N C N E - Y . U C O cn O m Q~ E E M O N N C -O O ~ 7 E ~ .N Y 'd d_ O O U N 7 O a 'O O N (n 0 W C. N O C - Z O N I C - ~ U C N ro - o> c Lt. O.'- N O O N N E Q U o~ v F a~ U N o > O Z W d m O ~ ~ II li h N i O Z d' III li U M ~ N N Y~ Y U O O N C co N N O 0 • ~ 'O -C SO N O 0 04 O Z Z Z C) N rnll d ° i R E _E N M N io Y ~i n. CL C = - m O O N ~ ~ C ~n < 75 U-) Cn Cn O O O •'v ~ ~ a a a a N U) o 7 O U) E N tq ~ U i~ rn rn o o v o o E " o m p_ v N N N ~j _N d d Q > lV O N O e~ M~ N 00 3 W N C O a~ Q) (n O C) c0 r rO ~ co L c a rn o O cep ca Y c N p o V v _ N N C N a w 0) a Q M cp ;a L N O E U • y'',' O fn U) O N Z i5 U) # ,._T+ £ N (D CL ~ :3 a r E L s c Q 0 a 2 0 in 0 0. -0 0 Q) co 0 v n p 6q b9 O n.^^V G c NN A Q C N a) 75 O O N y y N C Ory 'O 'O w .L.• .0 'O p a N C O N L 'O N c c E.. 3~ N m ti .O > N N CM ~ OO C C-Z6 0 3 L "O (L) d N N O O U 4I N o E m~~y 3 L E a~i ca o a m 3 0 ~o pf6 nc2a~oa) c Z ~wc~w O w E ° m'° o° ° NLrn m N C C U N > O O Z E C to > V Co N C 0 fA U N N Y N O 0 (lu 4) D a N y O = O U co O> .O O U) NC C O N v 0 =°-c Q) 0 0- w 0 c NLH ~ 0= co - S in N 70 E m cn -r L r 3° y z Y E C ~ a°i ao° N m O C 3: Q) C Z> > c U U N O O- ° N E y t o 0° q- ° a .~0 2(U (D o U a3occ LL o aN a am~~ o L 2 -0- ~'a a) M 0 0° in o c o ° c ~ ~a aYLE L OO w V m _0 c 3 5 C N N N N 01 7 U 7 o N Q 1°.S 3 ML o N° U w 3(h aw E c 3 3 m v o z y 00 W 0 ` O z d d N U) a m o z d ° C 00 ~ m 2 C to F- ~ m O c E U O o j (D m N N (n L C M O O i • ~ d . O c c O Z H Z O O o O Q Z O N N i O Cl) (D C C O - a LO a M L ° N Cl) N N i U > L a ❑ a cz m (n Z > 'O I- I- F- 3 ° O O O d CO co •ti ~ a a a CL Q 1, :i 3 rn rn N o v) a) m U1 U Z m _m } Z M I~ IpV O O NI O O N \ N OI N N a, I-Z i ^1 0 0 o -o n m Q ~ (p L ~ C, i O N d' ~ ar Q } Z 0~ N O ° N N N C ~ N C O0 3 O 01 E N (0 O_ O CQ 0 O N U w6 3 C C O O O ~ L O C L C x 0 0 0 r';t U U c O E C m N N V O O W O - C O 7 N .r 3 N N C p L N00 c ; -OO E m O • iii', N O U N M N o d O m U (71 y O N Fr Q' M O - Y Z d O ~ CL zt a v • ce CL d .2 `v a r`i•y E C C = U a m o c u Parcel 038-1067-30-000 10/31/2007 04:36 , PAGE 1 OF 1 F 1 Alt. Parcel 16.31.18.288C 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - FEDERAL HOME LOAN MORTGAGE CORPORATION FEDERAL HOME LOAN MORTGAGE CORPORATION 5000 PLANO PKWY CARROLLTON TX 75006 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 2124 104TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 16 T31N R18W 2A IN SE SW LOT 1 OF Block/Condo Bldg: CSM IN VOL II PAGE 309 Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 16-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 04/26/2007 849250 QC 04/26/2007 849249 SD 09/27/2002 692081 1992/82 WD 12/17/1999 615702 1479/31 QC more... 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 30,000 133,100 163,100 NO Totals for 2007: General Property 2.000 30,000 133,100 163,100 Woodland 0.000 0 0 Totals for 2006: General Property 2.000 30,000 133,100 163,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 110 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF STAR PRAIRIE COMPUTER NUMBER 038-1067-30-000 Parcel Number 16.31.18.2880 OWNER NAME: First ANDREW W & AMANDA L Last DAY PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 2124 104TH ST SECTION 16 TOWN 31N RANGE 18W %160 1/440 Line Description Line Description TOTAL ACREAGE 2.000 PLAT LOT BILK 01 SEC 16 T31 N R18W 2A IN SE SW 15 02 LOT 1 OF CSM IN VOL II PAGE 16 03 309 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, 177-Valuations, F8-History, F10-Exit I • FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP 'Sf~r SECTION ,L,T . y j N-R ZZ W A' A 4 d4 -~t ADDRESS - rnMzyrre~ Sq-U ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW RVRRYTHTNn--WTTHTN 100 PERT OP /O 1 C.N ~ qs F3 /~axce~ ys~~.";J r N 1~s u sE lv ~I INDICATE NORTH AR~OW L BENCHMARK:Elevation and description. Alternate benchmark SEPTIC TANK: Manufacturer: -Liquid cap. Rings used:(,-LManhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front , Side,(, Rear Ft. From nearest prop. line:Front , Side, Rear_./ Ft. 11C No. of feet from: Well , Building: , /w (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE r^ ss • t PUMP CHAMBER Manufacturer: Liquid Capacit : ~885 , Pump Model: YZ o!ZZi,Z, Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type:_4, ,Location- Distance from nearest prop. line: Front-, Side, RearLtFt. p,S~ Distance from: Well y~ Building SOIL ABSORPTION SYSTEM - Bed:_ Trench: Seepage Pit: Width: Length -~42 Number of Lines:_,QZArea Built-2.,L- Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side,, Rear Ft.,Z No. feet from well:_. No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: ' Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: ~ -11) PLUMBER ON JOB : LICENSE NUMBER: 7 ~-9 6/90:cj LOCATION: STAR PRARIE 16.31.18.288C NE, SW 104TH ST., LOT 1 Wisconsin Department o Industry, PRIVATE SWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 175652 Permit Holder's Name: ❑ City ❑ Village EXTown of: State Plan ID No.: SHILTZ, KEN STAR PRAIRIE CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: Q Gs-r- 038-1067-30-000 TANK INFORMATION ELEVATION DATA A92003109 /1Z Z TYPE MANUFACTURER CAPACITY STATION BS HI FS ELE Septic u1e_e>s U,,tC . rd~ ~d Benchmark '-32 r ' i Dosing 06171. . S Aeratio Bldg. Sewer Holding St/I/ Inlet TANK SETBACK INFORMATION St/ F/Outlet Ito- Vntto TANK TO P/ L WELL BLDG. qe Intake ROAD Dt Inlet ~ Septic a3/ NA Dt Bottom /Q< ti NA W4adff / Man. Dosing '1640 >13-0 I,14 Aeration NA Dist. Pipe ,oz~~;ey 10-5 x'I1 Holding Bot. System y , ~7 110yd«PUMP /S INFORMATION Final Grade Manufacturer Demand I° / 71, Model Number W4/GPM TDH Lift Lrictio Syste Z_ TDH Ft oss H ~r Forcemain Length ,2~j Dia. " Dist. To Well (Q SOIL ABSORPTION SYSTEM BED/TRENCH Width Length v;2 t No. Of Trenches PIT its a. Liquid Depth DIMENSIONS V DIMENSIONS SYSTEM TO P I L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER Mode Num er: INFORMATION Type O / } .1 System: o1~td OR UNIT DISTRIBUTION SYSTEM WewWer / Manifold Distribution Pipe(s) ;r „ x Hole Size x Hole Spacing Vent To Air Intake j q It Length sL Dia- Length Dia. Spacing k- k4 1 2- L( SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over ,i p xx Depth Of f/ xx Seed /S Px2~ulch Bed / ene1~ Edges z,, , /d Topsoil ~p es E] No es ❑ No Bed / Tse"ek Center r'll COMMENTS: (Include code discrepancies, persons present, etc.) _ &,13 " / c) e, lC . [ . OH~if CT'r ' L~2d/7~ lc~~ 1 Plan revision required? ❑ Yes to J Use other side for additional information. /J Q,3 SBD-6710 (R 05/91) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SANIT Y PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 2.7i 8% x 11 inches in size. ❑ i'ievisio?Itfo vious a IIcation -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMA ON - PLEASE PRINT ALL INFORMATION. (7~ PROPE OWNER RPR RTYLOCATION S N,R E(or)W PROPERTY WNER' fTl ING ADDRESS BLOCK # CI STATE ZIP CO PHONE NUMBE SUBDIVISION NAME OR CSM NUMBER Zi II. TYPE OF BUILDING: (Check one) 11 State Owned E3 VILLLLAGE NEAREST ROAD- ISQ JOWN OF j ❑ Public 1 or 2 Fam. Dwelling~#of bedroo 2j?_ PARCEL TAX NUMERO ,`/T III. BUILDING USE: (If building type is public, check all that apply) _30 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 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 ryryonly one in line A. Check line B if applicable) A) 1. ® New 2. XN1 Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ® Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE ft.) (Gals/day/sq. ft.) (Min. rich) ELEVATION REQUIRED (sq. ft.) PROPOSED AREA /J Feet AJA? Feet VII. TANK CAPACITY Site in gallons Total of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber S VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installati of the onsite sewage system shown on the attached plans. Plumbe s Name Print '.1 Plumber' Si atu : ( to MP/MPRSW No.: Business Phone Number: Plu a 's Address St et, City, S te, Zip Code): IX. COUNTYIDEPAR MENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater [Gate issued Iss ' Agent Signatur o Stamps) Approved El Owner Given Initial Surcharge Fee) 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 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 adn°iinistrator 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 insta!!ed. 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 fil,' 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) s!6 ®40728 WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design a mound system for a ~j The site characteristics are: Y, Depth to groundwater or bedrock in. ! J Y' Landslope yi h t Percolation rate min.tin. f Distance from dose chamber to distribution system_ ft. Elevation difference between aump and distribution system 42,!q ft. t Step 1. WASTEWATER LOAD gal.' • Step 2. SIZE THE ABSORPTION AREA A) Area required = 300y,,l-' sq. ft. B) Bed or trench length (B) ft. C) Bed or trench width (A) ft. t. D) Trench spicing (C) _ Wastewater load .24 coal/ft2/day ft. tre is ~fi s t3 Step 3. MOUND HEIGHT. A) Fill depth (D) ft. 6) Fill depth (E) D + slope (Ar p) ft. C) Bed or trench depth (F) _ s t. D) Cap and topsoil depth (G) ft. E) Cap a top oil depth (H) a S"" ft. Zi~;n ?~~p UE~ to Step 4. MOUND LENGTH A) End slope (K) D + E + F + H x 3 _2 ft. C--2 f7,s"~ f . t 1, s` x 3 11 • »s B) Total mound length (L) = B + 2(K) e ft. Step 5. MOUND WIDTH ' Al) Upslope correction factor lop A2) Upslope width (J) (D + F + G)(3)(factor) B1) Downslope correction factor = B2) Downslope width (I) _ (E + F + G)(3 (fact r) _ ft. C C1) Total me)und width (W) for bed = J + A + It•~C ~ 3 t ~ ~ `l=mss 7 C2) Total mound width (W) for trenches i J + + (no. trenches -1)(c) + A + I ft. R Step 6. BASAL AREA I A) Infiltrative capacity of natural soil gal./ft2/4ay B) Basal area required - wastewater flow natural soil inf ltrative, capacity sq. ft. 7,5 C1) Basal area available for bed for sloping sites a C2) Bas are avail le for trench for sloping sites = j B W • (J + A,) 4L sq tes B x W . ft. C3) Basal area available for trench or bed for level = sq. ft. License Da to } i Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. 2) Hole spacing = in. ..~C.~ { 3) Distribution pipe length W. 4:,-r 4) Distribution pipe diameter = in. 5) Spacing between distribution pipes in. 6) Distance from sidewall to distribution pipe in. 78) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe 2) Flow per pipe lJ ~,~~s r x,17 AA,4 GPM 7C) SIZE MANIFOLD 1) Manifold is central/ _ end ' 2) Manifold length = ft. 3) Number of distribution lines = j~ 4) Manifold diameter in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate = S~ GPM e 2) Force main diameter in, 3) Friction loss = ft. 1E) TOTAL DYNAMIC HEAD 1) Vertical lift ft. 2) Friction loss =ft. 3) System head 2.5 ft. ft. T al dynamic head ft. gg Date; :~r~.=9,42 1 - 'et) PUMP SELECTION 1) Pump selected will discharge GPM at "jS ft. total dynamic head. 2) Pump /model and manufacturer I.' 7G) DOSE VOLUME 1) 10 times vo d volu of distribution lines gal./cycle 2 Dail wastewa er 'v 1 me - 4 doses/24 hrs. gal./cycle Y ,3©D~~ / ; 04s~s/a 3) Minimum dose volume a 159 gal./cycle 7H) DOSE CHAMBER • 1) Minimum capacity required a S`rso- ?SO~~~ gal. /,.tJrJxa ~/~k~5 ~C1QG'1~ J ii i Q2/ ~a Date:- sit A--lA 1 41- 14 "T 14 `d O SV ` x . k a F-M ~A I _ i a'JG i _ I I Page__~, Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand H G ~ r • s s• Topsoil-~ F ~31 E D Force Main Plowed Layer $ Slope Bed of ]I"-2Y' _ ~1 2 Aggregate z Cross Section of a Mound System Using D1-;2-< Ft. A Bed For The Absorption Area E Ft. F 3 Ft. A Ft. G D Ft. B_ Ft. Signed: K Ft. L~Ft. License # : J R' 3 Ft Ft. I 9 Date : It SCNN ,GE nM. ^ 41 ` N'. Alterna` of- Forc~as I v J Observation Pipe K - B i A Forc Main - W ' - ------------IBed Distribution Pipe of ~"-2§" Aggregate ObsWvation I Pipe Permanent Markers-i Plan View of Mound Using a Bed-For-the Absorption Area • ti P494 Of, Perforated Pipe Oetolt S N`~z D -u AMyw Pptoroted , . RC End GM PVC Pipe . l r On Bottom • S~ e PVC Fo►se Wier .,7 PVC Manifold Pico , . Oistrip•tlion Alternate Potation Of i piN Force Man Lost Hole Should as West To gr4 Call Eed cop Distribution Pipe Layout P c~~2 Ft. RFr Sr x Inches' Y 12 Inches Signed: Hole Diameter Inch Lateral " 4 Inch(es) License Number: Manifold " ~-;aches Date: Force Main " 3 inches f of- holes/pipe Invert Elevation of Lateral5jax ft. _ 1D~•t5~ I b • 1 w r N ~ ~r,& a F'-~_ 4.) Al 4 rl 4)c Ak~ 54 44 I 0 44 0 O c 4 G h w-w~ 44 W - OO O A) N ~ 43 QI U, N m a N 0 VO ~I O d' .r4 V N U ~ U r ti y ~SA ti b w 100 d' rj+ u d ~ cn a c~ b a ..ny - PAGE pF-.LQ PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP S 4%.I. VENT PIPE 7T WEAT14EK PROOF APPROVED LOCKING JUNCTION BOX, MANHOLE COVER ~ 25' FRAM DOOR, WINDOW OR FRESH 12"MIU. AIR INTAKE GRADE H0 MIIJ. , IB' MIN. COIJDUIT - le•nIN. wt~ S. I INLETPROVIDE AIRTIbHT SEAL I .III APPROVED JOIWT A t ~M I ((I APPROVED JOINTS W/C.2. PIPE SON ' I I I( W/C.I. PIPE EXTENDING 3' jG`' I^q I i I EXTENDING 3' ONTO SOLID. SOIL ALARM ONTO SOLID SOIL OFF 0I - - RISER EXIT PERMITTED ONLY IF-IrANK MANUFACTURER HAS SUCH APPROVAL SPEGIFICATIOMS EPTIC AND _ oSE TAMM MANUFACTURER. wE~~s IJUMBER OF DOSES: PER DA3 TANK LIZE :G LLONS DOSE VOLUME: l y~ GALLONS ALARM MANUFACTURER: CAPACITIES'•As IAICHES OR •..:S;2:Z GALLONS `MODEL LIUMBER: 8 a2 IWCAES OR -7 GALLONS --SWITCH TYPE: C=.-.rAQ INCHES OR 0~ GALLOIJS DUMP MANUFACTLIRFR: D=:INCHES OR Zd CALLOUS MODEL NUMBER: NOTE' PUMP AND ALARM ARE TO BE SWITCH TYPE: INSTALLED ON SEPARATE CIRCUITS PUMP DISCHARGE. RATE GPM f.//S VERTICAL.DIfFERENCE bETWEEN PUMP OFF AND OISTRIBUTION PIPE.•.42Q- FEET + MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET + FEET OF FORCE MAIN X _Ll~LF/oo FLFRICTION FACTOR-4_G__ FEET TOTAL DYNAMIC. HEAD FEET n ~ IIJTEKIJAL DIMEIJS ONL OF TAIJK: LENGTH ;WIDTH ;LIQUID DEPTH LICEMSE DUMBER. Performance Submersible Effluent Curves Pumps METERS FEET 90 25 80 MODEL 3885 SIZE 3/4" Solids t] WE15H 70 p X 20 WE10HP~S/ 60 - WE07H 15 50 l'> .S 1S v ib 40 WE05H 10 30 WE03M 20 WE03L 10 0 0 0 10 20 30 40 5a 60 70 80 90 100 110 120 GPM I U-LCr. tE.'t,~dC~y I 0 10 "*e'p''aX 30 m'/h CAPACITY ir1~' yN [RGOULDS PUMPS, INC. SBe--A FALLS NEW YORK 13148 -1 METERS FEET 120 MODEL 3885 35 110 WE15HH SIZE 3/4" Solids 30 100 90 25 80 70 X 20 a 60 0 50 WE05HH 15 40 10 30 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 0 10 20 30 mm~n, CAPACITY 01985 Goulds Pumps, Inc. Effective July, 1985 C3885 DILHR SUIL AND ITE EVALUATION REPORT in accord with ILHR 83.05. Wis. Adm. Code COUNTY Aaach 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. A dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE SZ PROPERTY ONNER: PROPERTY LOCATION GOVT. LOT n 1/4 501/4,S l& T 3 N.R g' W PROPERTY NE -'S MAILING ADDRESS LOT 8 BLOCK N SUED. NAME OR CSM I CI STATE, C/ ZIP CODE ~HO~NMBER []CITY CIVIL E N NEAREST ROAD (J New Construction Use [ J Residential / Number of bedrooms j J Replacement ( J Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/It2 Absorption area required bed, ft2 trench, 112 Maximum design loading rate bed, gpd$ trench, gpd/ft2 Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system ooNVENTI MOU INGRoUNLDPfiKSURE AT-GRADE TEM IN FILL HOLDING TANK U= Unsuitable for W stem D S 911 1 0 p U D S 0'U [IS CI S pv- cis au- SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Consistence Baadary Roots Bed Trerct' Ground dL r7" ~l {YI S 1,,. elev. ft. 32-E Z rn5 12 Depth to f 'n. rEc~ limiting factor Remark's: Boring # j .•:pik a r 2<8 Ground - elev. Depth to - - limiting factor _ Remarks: CST N e Print _ Phone: Add ss: Si nat Dal T Number: -P%► 'WisconsinDepartment of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Divisior..pf 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 Lla'Z 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 PROPE OWNER: PROPERTY LOCATION GOVT. LOT 114 1/4,S T Al E (a PROPERTY OWNFR':S MAILING ADDRESS LOT BL K # SU NAME OR CSM # C1,7, STATE ZI CODE PHONE NUMBER r-ICITY_LJVILLAGE OWN NEAREST f& [ ] New Construction Use (X[ Residential / Number of bedrooms 9 [ ] Addition to existing building (a(] Replacement ( ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate 29bed, gpd/ft2.Z.-2 trench, gpd/ft2 Absorption area required as'D bed, ft2,=Oyb_ trench, ft2 Maximum design loading rate ~ 9 bed, gpd/ft2.L.~7 trench, gpd/ft2 Recommended infiltration surface elevation(s) . ft (as referred to site plan benchmark) Additional design /site nsiderations Parent material - Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S S U WS ❑ U ❑ S 14U ❑ S ( U ❑ S f~ U ❑ S Nil SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. S Cont Color Gr. Sz. Sh. Bed Trertdi 0- L-Z 'VA' Ls I x Ground eley. ft. _ Depth to limiting fact Remarks: Boring # I o- Ground - ! f elev. Z. ft Depth to limiting factor Remarks: V~~r CST Name:-Please Print Phone: Address: Signature: Date: CST Num - PROPERTY OWNER i✓ J ,~fs SOIL DESCRIPTION REPORT Page+jof PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BondEry Roots GPD/ft in. Munsell Qu. Sz. Pont Color Gr. Sz. Sh. Bed Trench ILI` Ground 49j,-4 elev. , -&Zft Depth to limiting factor .-?7,• Remarks: Boring # Ground elev. ft. Depth to limiting ` factor Remarks: Boring # • Ground elev. it Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05192) V I I I I I I I I ! 1! i CAI I~ I SsAe 1-71 I X- ( i II Iii _ !III III -TI I 6 i .10 ! i i I ---II I _ I i 1 i i Wiscohsin Department of Industry, SOIL AND SITE EVALUATION REPORT Pap -,Lof Labor and Human Relations Division of Safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPE OWNER: PROPERTY LOCATION GOVT. LOT 1/4 1/4,S T_ q ,NA E (or& PROPERTY OWNfR':S MAILING ADDRESS LOT BL K # ST NAME OR CSM # } Cl STATE ZI CODE PHONE NUMBER ITY ri, ILLAGE OWN NEAREST O [ ] New Construction Use [S4 Residential I Number of bedrooms [ ] Addition to existing building j,(] Replacement [ j Public or commercial describe SS Code derived daily flow er gpd Recommended design loading rate } bed, gpd/ft'_' Itch, gpd/ft2 Absorption area required aso bed, ft2 erioTi jt2,.~ Maximu design loading rate bed, gpd/f:2 trench, gpd/ft2 Recommended infiltration surface elevatio ) 99 9 It (as referred to site plan benchmark) Additional design / site nsiderations Parent material. Zkjz - Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT GRADE SYSTEM IN FlLL HOLDING TANK U = Unsuitable fors stem ❑ S ®U WS ❑ U ❑ S [9) U ❑ S QI U ❑ S fA U ❑ S ® U SOIL DESCRIPTION REPORT GPD/ft Borin Depth Dominant Color Mottles Texture Structure Consistence Boring # Horizon in. Munsell Qu. S Cont. Color Gr. Sz. Sh. Bound3y Roots Bed Tmnch uas Ground _ -4~5- Al A~'l C11 d f, 'A A1,10 A1,10 1eley. ft• - Aff Depth to limiting facto Remarks: Boring # 1114 OU2,J;L 4-j ,s G Ground 4vd.C A1,00 i Ado Depth to limiting factor „ Remarks: CST Name:-Please Print Phone: Address: /J Signature: Date: CST Numbs 4;2 -49 4' ' PROPERTY OWNER ' 4/ ¢ SOIL DESCRIPTION REPORT PARCEL I.D. Page of Boring # Horizon Depth Dominant Color Mottles Structure 'GPD/ft in. Munsell Qu. Sz. Pont Color Texture Consistence Bounck3y Roots Gr. Sz. Sh. Bed mrich 3 Ground elev. ~ SQL ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor FT LLJ Remarks: Boring # 4 ' Ground elev. ft. Depth to limiting _ factor F4- 1 17 i Remarks: Boring # 7~A \~xi Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) _ I I I I I j l ) I I I - I I I , ` _ sl ~ ~ 5- 1V I T f I i___ I I 7 ' I I I 1~ 1 , ® A* _I T-T } _ I r SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ADDRESS: Xa ~L FIRE NO: LOCATION:~1/4, _SuI_1/4, SEC.T 2 N-R__L!:~ W, TOWN OF: ST. CROIX COUNTY ,r SUBDIVISION: LOT NO. -.2-'4 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:- D -Z I' DATE : St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 ST. CROIX COUNTY WISCONSIN t ' =Y ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 July 31, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: A second onsite investigation of the Kenneth Shilts property, located in the NE1/4 of the SW1/4, Sec.16, T31N, R18W, Town of Star Prarie, St. Croix County, WI., has been conducted with the assistance of Kim O'Connell, CST# 2344. This onsite revealed suitable soil for onsite sewage disposal to a depth of 21" while meeting the requirments of the A + 4" rule. This site should be suitable for a replacement mound septic system having 15" of sand fill. Should you have any questions, please feel free to contact this office. VSilnce ely, K. Thompson Assistant Zoning Administrator cc: file - 1 STC-100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording Owner of property Location of property_JZ- 1/4 _.,~AL1/4, Section _ T3 N-R.1~W Township Mailing addres Address of site Subdivision name Lot no. Other homes on property? yes___2~_NO Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes .XNo Volume and Page Number as recorded. with the Register of Dee s . 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 ( ) the owner(s) of property described in this informatio warranty deed recorded in the office of the County Register of Deeds as Document No., and that I (we) own the proposed site for the sewage disposal system orr Ie(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. c I Signature o applicant Co-appl cant Date of Signature 4Da of S gnature it DOCUMENT NO. STATE BAR OF WISCONSIN FORM 3-1982 THIS SPACE RESERVED FOR RECORDING DATA QUIT CLAIM.DEED 4 85 P 9 dr% 11 VOL 959 , 482- St. Croix County REGISTERS OFFICE ST. CROIX CO, %M Recd for Record - quit-clalmsto Kenneth E. Shilts and Barbara C. Shilts.as JUL. 16 1992 -survivorship marital property at 1:10 P. M the following described real estate in St. Croix County, Re(~isterofDnds State of Wisconsin: RETURN TO I Tax Parcel No: A parcel of land located in the SE 1/4 of the SW 1/4 of Sec. 16, T31N,, R18W more particularly described as follows: Lot 1 of the CSM recorded October 14, 1976, in Vol. 2, page 309, document no. 336027, St. Croix County Register of Deeds office. EXEMPT This is not homestead property. (is) (is not) / q Dated this day of _75-Lc L Y j 19--y-1i (SEAL) l /,<'li~ ~~i/- ~9 G ~C~r 7~r✓ (SEAL) Richard B. Peterson, Chairman St. Croix County Board of Supervisors (SEAL) t, n~""'"'i (SEAL) Sue E. Nelson St Croix County Clerk AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ss. S t Croix County. ll t17 authenticated this day of 19 P son Ily came t3etore me this day of ~~19~ the above named Richard B. Peterson and Sue E. Nelson TITLE: MEMBERSTATE BAR OF WISCONSIN (If not, to me known-to be the pars n s who executed the authorized by § 706.06, Wis. Slats.) foregoin lnstrtl 'nt-and nowledgle the same. - Gl724~C~~ THIS INSTRUMENT WAS DRAFTED BY CrPgn3: r A- Timmerman MajFy, -Er** YAVe Stb ,gyp asurer !LX1 County, Wis. C'nrnnrai-i nn Counsel.St. Croix County Nota- ~St „ 6 (Signatures may be authenticated or acknowledged. Both My~rallsl,ol~ Is ,per#'[ia~nent. -(If not, stale expiration are not necessary.) date ~9h L ~ 19~.) 'Names of persons signing in any capacity should be lypea or pr,nlea oelow their signatures `SB3 NTF 0023 STATE BAR OF WISCONSIN " OUIT CLAIM DEED FORM No 3- 1982 Nelco Tax Forms, P.O. Box 10208. Green Bay. WI 54307.0208