Loading...
HomeMy WebLinkAbout002-1019-30-000 Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 'p~ ntL~~cc.~~~ TOWNSHIP SEC. T,_,2~ N-R W ADDRESS.& aL ST. CROIX COUNTY, WISCONSIN AL SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i L 7~ i ys' r A,r3* 25d 1~-?o "4 So: ,Cm INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer:j9 CA&IAL',j _Liquid Capacity: jeBry Number of rings used: Tank manhole cover elwation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side Rear, O _ feet From nearest-property line Front,O Side, Rear, O feet Number of feet from: well f0 , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE 1 PUMP CHAMBER Manufacturer: i Liquid Capacity: ' Pump Model: ?jjj Pump/Siphon Manufacturer: Pump Size Elevation of inlet: 5 ~ Bottom of tank elevation: Pump off switch elevation: /R Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: 4-412-1 Number of feet from nearest property line: Front, O Side, Rear, © Ft. Number of feet from well: AZZ Number of feet from building:_ (Include distances on plot plan). SOIL ABSORPTION SYSTEM " AdUA0 Bed: Trench: A Width: Length: Number of Lines: Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, Y Side, O Rear,©Ft. Y Number of feet from well: ;I Zo Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: i>f D~s~7s 'J 41Z License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION J IHpISQty,.IVI 5707 JVV'4,5W4, ec.9,T29-R16 SftePlanI. Number: Town of Hammond E] CONVENTIONAL El ALTERATIVE Co. Rd. E ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound 10,~W6X47W 7K NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Vickie Anderson 2316 Co. Rd. E Baldwin, BENCH MARK (Permanent referent oint) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: To o~ rarIS arrY~ev sstw--'s 0v . v Name of lumber: MP/MPRSW No.: 7ou : Sanitary Permit Number: Calvin Powers Jr. 1563 SEPTICTANK/HOLDING TANK: M NUFACTURER: LIQUID ITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER ff PROVIDED. PROVIDED: OW r c-ei PW1AC1S D:CAPAC qI -Oci 6 0YES ❑IN 21 YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑ YES © NO '7 l~ T ❑ YES ❑ NEARES T 3 3 5/ > / z U 2 Q / DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: e ((-5 0 YES ❑ NO W ~Q 31 L ~s Ou L OYES ❑ NO d YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE. AIRINLE : PUMP ON AND OFF R71 YES ❑ NO NEAREST -1110- 1,3q >1-_ 3 ,3 SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN / the soil is dry enough to continue.) .7 CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: N0. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE Dill R.. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW OYES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: I/ EDGES: ~ d 0 8 " G / 1YES NO LEI YES ❑ NO ES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: rye, \ FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST 110- t 2 ~P Sketch System ohRetain in county file for audit. ^ Reverse Side. - SIGNAT RE: - T SBD-6710 (R. 06/88) r rL.HR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COM STATE SANITARY PERMIT .ich complete plans..(to the county copy only) for the system, on paper not less than A x 11 inches in size. ❑ / Cf ~'n C~ C~ Checkk if re''v1sion to p evious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. Cl ~Q PROPER OWNER PROPERTY LOCATION L2 N, or PROPE TY OWNER' MAILI G ADDRESS LOT # BLOCK # C , ST ZIP CODE PHONE NUMBER SUBDIVISION NAME O CSM NUMBER II. TYPE OF BUILDING: (Check one) ❑ State Owned VILLAGE NEA T ROA ❑ Public W1 or 2 Fam. Dwelling-# of bedrooms NVU FAKL;hL TAX I` III. BUILDING USE: (If building type Is public, check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 1120 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. ® Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously Issued. Permit # Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution 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 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION Feet - Feet VII. TANK CAPACITY Site INFORMATION in allons Total Prefab. Fiber- Exper. New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Hol in Tank JX F1 I F1 Lift Pump Tank/Siphon Chamber FeIA VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation o the onsite 2 wage system shown on the attached plans. Plumb 'S N e (Print, • Plu r'a ign re: No S s) MP/MPRSW No.: Business Phone Number: 3 umb 's Addre (treet, City, State, Zip Code : COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater \pproved ❑ Owner Given initial charge Fee) ate ssue Issuin Agent Signatu (No Sta IIZZ Adverse Determination f gy INDITIONS OF APPROVAUREASONS FOR DISAPPROVAL: •merly PIIr87) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber APPLICATION FOR SANITARY PERHIT RTC-100 This application form In to ba conplntod In full and llgnad by the ovner(s) of the property being developed, My lnadoquacles will only result In delays of the pzrrAlt Issuance. -Should thlts development be Intended for resell by ovner/contractorj(spec house), then a second form should be ratalnod and completed when the property Is sold and submitted to thia a I f I c a v I t h the appropriate deed recording. Oyntr of property Location of property _1/4 1/4, Section ~_,i,l•RY T o vn s h l p Kalling address Address of ■lts s lubdlvlslon nacre , Lot number Prevlous ovner of property _~,~4~,~•6-~ Total ■1=e of parcel Date parcel was created Are all cornars and lot lin,s Identifiable? __Yes __}(o Ia this property being developed for resale (spec house)? Yes xo Yoln►.a ~ h and page Humber ZA/P-c As recorded wlth the Reglster of Deeds. { L n ( }1 APPLICATION - A VAARANTT DYID which Includes aDOcUHYHTHLMDRR, VOOLrXz A ~ NDDPA02 XLrXIIR, and the BIAL OP Till RROISTRR OO DRRDS. In addition, a cartllled survey, if available, would be helpful so as to avoid delays of the reviewing process. if the dead description teterencaa to a Cettlfled Survey Hap, the Cattlfled survey Hap shall also be required. PROPERTY OVIII R CERTIPICATIoH I(ve) cartlfy that all etatementn on this form are true to the best of ay (our) Anovladgel that I (we) am (Are) the owner(s) of the property described In I h I a Intormatlon form, by virtue of a wnrranty Rd t co dad In the Dtfice of the county Register of Deeds As Document }(o. Presently own the proposed site for tho newage diaposal, aenl and that I (va) obtalntd an eeaement, to run with the above delbadatro(ortI Iwo) hays construction of said nystsm, and the same has been duly recorded Inythetaofflce of the oyn t R qla er of Deeds, as Document Ho. 41" vo algnetvte of owner , elgnature oL Co-ovner (1L App11cable) Date at etgnatura Date oL 9lgnature VOL 70 PAGE 36j Docu,MENT NO. STATE BAR OF WISCONSIN FORM 11-1982 THIS SPACE RESERVED FOR RECORDING DATA LAND CONTRACT 3A* Individual and Corporate 9789 $2.r0,,000'~IS USED FOR FINANCED ALL N o ItERN NON-CONSUMER ACT TRANSACTIONS) Contract, by and between Mar_};ai c_ t `I' . Rhone i;• Co., WIS. a--singl-----Petsorl---------- 's.exx)rd 6k s 20th (`Vendor", tj:1Y of Nov. &D, 1984 David A Anderson and V ic.k is whether one or more) and - - ~ 11:45 A t'j2ai% A. Andc_rsc2n,---husband and__w:ife as ~c~_irll en¢tl s- Q ("Purchaser", whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full per- €gEaR•a6?Area formance of this contract by Purchaser, the following property, together with the rents, profits, fixtures and other appurtenant interests (all called the "Property"), in______________________________St Croix----_------__---_ County, State of Wisconsin: RETURN TO ! MENOMONIE FARMERS CRELIT UNION Part of the Southwest Quarter of the BOX. 126 _BALDWIN WI_ 54002 Southwest Quarter (SW4 of SW4) of Section Nine (9), Township Twenty-nine North (T29N), Range Sixteen West (R1.6W) Tax Parcel No. described as follows: Lot one (1) of Cert:if_ied Survey Map filed May 5, 1983 .in Volume page 1280. This is_--not___ homestead property. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at a place d c . s _i gn a t e.. _ by V e n d o r ' the sum of 4 _-_-9_Us_--_0 _:-0 0 in the following manner: (a) $__10 000_-_0 0 at the execution of this Contract; and (b) the balance of $___3y00 . 00 , together with interest from date hereof on the balance outstanding from time to time at the rate of____ tc n ( 10) _ per cent per annum until paid in full, as follows: monthly payments of $342 25 commencing the first day of December, 1984, and on the first day of each month thereafter. Provided, however, the entire outstanding balance shall be paid in full on or before the__f y e (5) y ~W§: _ fr:om---da-te hereof, tt9 (-t-he--maturity-date). Following any default in payment, interest shall accrue at the rate of % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Pureh-aser,-unless-ereused-bp -Vender, agrees to-pay -monthly-to- Vendor -amou-n#s-s-lf-fieient-te- pay-reasonaWy antici- -paW(.t annual-taxes, spee-ial assessments_fir-eancLregiiire(Lins_urwwe-px-eminms-when di e_To the extent received-w-Vender, *endor- agrees- to- apply-payments-te -these-obligataens -when- due- Such -amounts-r-ecei-ved-by_.the_ Vendor-for-payment oL taxes, assessments -a-n& insu-rance will-be-deposited-late -an -escr-ow-f-uad- er-trustoe-account,-but- shall _not_bear- interest .unless .other-seise -required _hyJaw- Payments shall be applied first to interest on the unpaid balance at the rate specified and then to pril}fipal. Any amount ma be J a rt u a 1' y 1 o y prepaid without premium or fee upon principal at any time after_______________________ 19----- (61t) -thertr mar her no- prepayment -of- rincipal-without-permission -of -VEmior.* In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been t~ •saan)eu3is aiagl molaq : alep pajuud ao pad cl aq plnogs Alp9dea Aug u[ Butuels suosaad Io sauisHo ~y - - - (•Aaessaaau lou aae y~l ylog 'pa2palmou~o13 ao palsatluayln13 ail Aum saanlru3ts) tluatdxa alrls 'lou 3I)'luauumaad st UOISSiwwoo S uo •sl, 'klunoo------------------- XTox,[)----![a---- a?Ignd AiujoH -----------------ZOOS------- :7M ruTNipTieg' (1 -------------------------------------------guttTuxaM a.uaxg v )jZ)Pw.In,)-,)w • d SPwc)q L , ~AB ❑31dVii❑ SVM 1N3Wr12l1SN1 StHl 1 / am13s aql a Imc;Lt ar ur`3uaiuna3s to8aao C ~ agl pa}n9axa, oym ' S uosaad Dill ail of umou)l am o; (slelS __s?AA `90.906 Aq paztaoglne Sr, ' - ---'lou 3I) - y . iQISI`IOOSIAA .30 2Idfi sZvZS 2IagNiaIAT a'IS,LL -s Ya T' llV` • tJ 2T217TA pile uoS.IOWIV - y' - P 'id p,TAPC[ a4uoy2i - J, '1 ~ TPW opaumu-4&ogr aql g6T 77gWOAON 30 ST stgl am aao;aq amra Allruosaa(I 61 ' ;o dep' stgl Palratluaglns 1 S SS NISAIOOSIAA ,d0 alvis iNar11lt)crarx Aommlov 11IoIZv31.L ffH1f1 ' iIO--,'.I7pud d 01In? - (,itias)---- -J- ailc)iI21 .~.IPW iI<)S.Iapiad • V p? nPQ 11vas ;P, 3 p - - - - - - - - still PalBQ bg IagwaA0N (•;oaaag luawil9ln3 ut apaw aq of Paep aql ;o uo,lnoaxa aql ut utof of saaa2s pu13 Slaadoad loafgns aql ut slg8ta pralsawog asealoa of maaaq sutof uopuaaptsuoa algenlse s ao; aopuaA ;o asnods aq3 Alaadoad aql ;o aaumo ue IOU ;I) •aasugaand pus aopuaA ;o suAtss13 puu saossaaans 'saeL3r;uasoadai lia8al 'sitaq aql ;o slgauaq aql of ainut puu uodn ~utputq aq llegs lasaluoo still ;o swaal l1v •aasugaand jo llnrr,tap aotad ao luanbasgns iaglo Sur 5uwum inogltm llnu;ap dun antrm Auw aopuaA •lasaluoo still uo apsm sluawArd paaaptsuoa aq 11ugs aasugaand :i(l aprw os sluamdud llu puu os op of slit; aopuaA aa;Juallaoytl aql of Slpaatp sluawAud vans Aur a3lrm Sum aasugaand •lasaluoo stgl aapun anp uagl slunowu aql }o luautAud Alawtl saxew aasugaand paptnoad 'Agaaagl paanaas alou Aus aapun ao (aasrgaand Aq paluux2 a2u~1aow Aur .1o; ldaaxa) laualuoo stgl ;o alup aql uo Alaadoad agl lsutuAu dutpurlslno a;JuAlaow Wlo aapun anp uagm sluawdud Us al[ew llugs aopuaA •amlou lnogltm uotldo s,aopuaA lu 'lln; ut algedud pup anpAlolutpammt awoaaq llegs lasaluoo stgl aapun olgeArd aaueleq dutpurlslno aatlua aql 'luasuoa ualltam s,aopuaA lnogltm aaurAanuoa .lo a[rS 'aa;SUral gans due jo Juana aq ul •aasugaand jo ssaupalgaput us aoj Sltanaas se Aalos laualuoo still aapun lsaaalut s,aasrgaand ;o luatu dust ao adpald r st padanuoa lsaaalut aql ao 1[n; ut pied )sat} st laealuoJ still aapun algrSud aaurlrq Yutpuslslno ail) xoglta ssalun aopuaA ;o luasuoa ualltam aotad agl lnogltm (Arm iaglo Aur ut ao assal waal-2uol 'uotldo Aq so lasaluoo still aapun slg2ta s,aasegaand ;o Aur ;o luamu8tssu Aq) Alaadoad aql ut lsaaalut algeltnba ao lydal Sue Aanuoa ao llas '.Lajsural IOU llrgs aasrgaand •laaatp [[rqs lanoa aql su patlddr pue plaq aq llsgs palaalloa os uagm slgoad pur `sansst 'sluaa gans pur 'uotlas gans ;o Sauapuad at[l 2utanp Alaadoad aqi ;o slgoid pule 'sansst `sluaa aql laalloa of'lsaaalut psalsawoq 2utpnlaut `Alaadoad aql ;o aantaaaa a ;o luawlutoddu agl of sluasuoa aasrgaand `laraluoo still ;o aansolaaao; jo uotlar Sue ;o Aauapuad aql 2utanp ao luawaouamwoa aq1 uodfl •luauLlpnf Aur ut papnlaut aq [lugs puu 'paaana -ut se 'aasugaand Aq ptud pur ludtautad of pappr aq Mails aauaptna all?l 10 sasuadxa pur mel Aq pal?q!yoad lou lualxo aul of (lou ao paluqu aaglagm) aapunaaaq Apautaa Aur aaaqua of paaanaut aopuaA 3o s0a3 sSauaollu elquuosuaa 2wpnlaut sasuadxa pur Slsoa llu pur uotlyd?l?1 ut pansand uagm put: 11 aopuaA uodn 2utputq aq Aluo hugs satpamaa .Suto2aao,I aql 30 Aur. ;o Impala up 'aopuaA ,Io suollar ao sluautalrls uallta-'t ao [eao Aur ~utpurlsgltmlol~l anogr (:.t) to (tt) '(t) aapun uotlar Sur ;o Aauapuad aq ,dutanp slt}oad ao sansst 'sluaa Aur palloa of polutoddr aantaaaa r anrt{ pur Alaadoad aql ;o uotssassod woa3 palaafa aasrgaand anuq Sum aopuaA (n) puu :luuatJtuxtsut st aasegaand 3o lsaaalut a[qultnba aql 3l uotlas alltl-lamb u ut alltl uo pnolaesulasaluoo stgl anoma.t put,. pua us is lasaluoo stgl aarlaap Arm aopuaA (nt) ao :3oatagl uotlaod Auu ao aatad aartlaind ptttdun aatlua agl ao; mrl lu ans Arm aopuaA ao !Aauatat;ap Auu ao; algml aq Ilrgs aasugaand puu alus letatpnf is pauotlanr aq Ilrgs Alaadoad aql Juana tlatgm in 'aapunaaaq anp slunowe aaglo pus llnr,Iap ;o alsp aqq uo laa;Sa ut aaua aql jr, uoaaagl lsaaalut gltm 'aaurlrq 2utpuulslno aatlua aql 3o luatuA-ed lln.T pue alutpamwt ladmoa of lasaluoo still ;o aauswao;aad at,ltaads aoj ans Sum aopuaA ao (waapaa of sltg3 aasugaand ;t Alaadoad aq ao; Ieluaa se pur pealuoo still llf3ln3 of aanltr; aoj sadewrp paluptnbtl su palta;aoj: aq 11egs aasugaand Aq ptrd A[snotnaad slunowu [Iu Juana gatgm ut) aapunaaaq anp slunowe aaglo pue alup gans uo laa;;a ut alsa agl lr llnrlap 3o al-ep aql woa,l uoaaagl lsaaalut gllm `aaurlrq luipui-IsIno aatluo agl .to luatuS-ed lln3 s,aasegoand uodn pauotltpuoa aq of uotldtuapaa ;o Altnba Aur gltm aansolaaao) lat.ils gdnoagl Nauq Slaado.td aql aanoaaa pulp Sliadoad aql ut lsaaalut pur alltl 'slgJ?a s,aasuyaand pur lasaluoo still 01su1 tu101 'uotldo stq lr 'Sum aopuaA (t) :Al?nba ut ao mrl Aq paptnoad asogl of uotltppu ut (mrl Aq paptnoad suotlrltwil Aur of laafgns) satpamaa pur slg2ta 2utmollo; aql anrq os[u llsgs aopuaA Puu'(santrm Agaaaq aasugaand yatym) aatlou lnogltm pule uotldo s,aopuaA lu 1111n3 ut algsSrd pur anp Alalrtpawwt awoaaq llrgs lasaluoa still aapun aausluq Autpuulslno aatlua agl uagl ' (peut pat;tlaaa Aq paltrw ao Alluuosaad p3a0n1lap) aopuaA Aq;oaiagl aatlou ualltam 2utmollo3 sA13p ';o pot.tad r .to; sanutluoa gatgm aasugaand ;o uotlr$tlclo aaglo Sue ;o aourmao;aad ut llnulap r ;o Juana 341 ut (q) ao alrp anp pat;taods aql Aut motto; sSrp --'6 F--- ;o potaad 13 ao; sanutluoa gatgm lsaaalut ao Isdmutad Aur ;o luatuSed agl ut llne;ap s Io Juana agl ut (u) pue aauassa aql ;o st amtl lrgl saaa2v aasrgaand - :ldaaxa pue 'aasegaand ;o llne3ap ao Jas agl Sq palsaaa saoueagmnaua ao suatl Sur ldaaxa 'saDusaqurnaua pur sua?l 1113 ;o Iuala pus aaa,I 'Slaadoad aql ;o 'aldwts aa; ut 'paa(I Alusaasb a 'aasrgoand aql of aaetlap pur alnaaxa 'pu13wap uo 11M aopuaA 'pagtaads anoge aauuma aql ut pule samtl aql lg pamao;aad AIIn; aq llrgs suotl?Puoa I?s pule pt13d AIInT aq llrgs sAauotu aaglo pup lsaaalut gltm amid asrgaand aql asea ut l13gl saaz2v aopuaA •Alaadoad aql Autlaa•I;e suotlsln8aa pun saouumpao 'smel 1113 gltm Aldtuoa of puu 'pealuoo stgl ;o uatl aql of aotaadns suatl woa; aaa; Alaadoad aql •daa)I of 'atudaa pus uotltpuoa algelueual pool ut Slaadoad aql dawi of 'Slaadoad agl uo pall?wiuoo aq of alsrm molls sou alS13m ltuiwoa of IOU sluruanoa aasegaand a1q?sea; Allratwouoaa aq of atudaa ao uotleaolsaa aql swaap aopuaA aql paptno.d 'pa2uurep Slaadoad aql ;o atudaa ao uotlraolsoa oil patlddu aq 1I1Lgs Spaaaoad aausansut 19utltam ut aaa2r astmaaglo aopuaA puu aasrgaand ssalufl aopuaA pue satusdmoa aausansut of 13SOI ;o aatlou antB Alldwoid 11egs aasugaand •aopuaA gltm paltsodap aq 1113gs. Slaadoad agl 2uta9no3 sa?a?lod ilia ;o Ieut2tao aql '2utl?am ut saaa2s astmaaglo aopuaA ssalun 'pup, lsaaalut s,aopuaA aql ;o Done; ut asnsla paspurls Dill utrluoa uegl l[rgs satatlod aqy •anp uagm suintmaad aausansut agl Aed hugs aasugaand •laraluoo still $ ;o aapun pa mns mo agl ut aourle 'q aqlaopuaA Sq aaom lunowia u13 ut 92eaan03 annbaa lou 1legs aopuaA T P A -61 q P .I n~ u 'i' T T n j panoaddr saaansut g2noagl 'aousansut-oa lnogltm 'aainbaa Arm aopuaA er spauzaq aaglo gans pus sltaad 03raanoa papual -xa 'aag Sq pauotseaoo aArurep .10 ssol lsutu5r paansut Slaadoad aql uo sluamaeoadmt aql daa)l Ilggs aasrgaand •luawSed qans 2utmogs eldtaaaa pu13m0p uo aopuaA of aaetlaP of pus l? ut ;saaalut s,aopuaA uodn ao Slaadoad a l uo palnal sluamssasse us saxul 1113 anp uagm A-ad of sastmoad aasrgaand T i p Xed ! IQn "anp il.')gM s:)XP) V86 t ct•l 1I:)," PLl7.Ind •S?0-1 IPd ~Tl01)Mm I().id (moq :)n P. t{ S:-)xP.-1 .)•l P) Sa IP.'-).I VR61 IVNIDIHO w < m mZ z a _ o w J O Q W (lj T J y U < v~i= co Z U °a a m U a¢ w~ aU a~ °ox na x IN O Oa 3t- < z ¢O r y Z ZO aQ a co cc 11 z _ cr) w X ¢ w rt w ¢ ¢ a ~ Q r - , ~ . _ p z (r z w ~ X z w ~ 2- ~i O T O Q W W Q m - Q Q d a o ~r ¢ Q ma as Li u d w w~ aU 'n +n ¢ z O x ¢ W L..1 a z y cn U cn°a a` cv o 0 r, w¢ ¢O ¢ Q a 5 m z 0 cU J C: z > carn a O ..T " ui - z a O W c, w W o a a N m 0 a. Q < J a > a U) cna wO¢ Q m > w = ¢ W U co (ir C7 w z t O> n j, a a o w o ~ W~ O J r o-o m o U O Z F- I,'! r a w W as ~a wa Z a C J w ¢~i!z OF-SW¢ a co LL z w Y~l a l'..v, ! 1C'IJ ll Ij1~+tt X rr w°- xn,~Nlr- -rr-ter! W ,ti w N T - F-T < vain Q 3 z s ' f- w U) w W •.i. h Z ^ e N Lo uj n ¢ LL LL liJrl Q a ao (,iG', ftj W z c nC - F- w a Q r_„.. I.- C w ['j a: cr < u G'.• r w ° r-O r7 f! I l! a o :a N w CC! Lfi t) i sr ¢ ¢ v -.i Z Li oo mN Q > ~ G:: - ~ r.l w o W F^ yam] ] < < < W Y u) 0 > N ¢ U o LL O O ri -4 z N W r (L D C"j If'; 0 En cc w tJ o a L: Q a C) W a co ir`• it • u i _J"Y r rLsG;r+ u7=z a cv~ ti.. Cl . .r < t l y W t^ .J U) C w Q r. y U w 7 w w w F- 0 O , w F-¢w¢U~¢w¢ 1-. C![:++i,,'t < Q w p, v:uw -j 0 0 Q J .r C t F c)l F- (n 0 z 2 C+: L J~ QZ UF- p m Q 2 M Z J W F- ❑ W w ❑ 0- W Q w Q T1 m a Ow wU V~w } p x w F- ' Z O~ w0 Z J ZM ~ Z U ~ a c c tt°, Z O Q LLu ?o a o a m Q m w r r._ LL i W Q rti U't i Cn O x F 0 LL W Z Q w J C7 Z m Q F- Z O o o❑ z O LL m to Y F- Q IL LU z V) cf) o a W = V a WJ }N d ~Z U U a U a: I CL a: w Qt- w Ucc Uw W O aW aW U ~0 ZX Wm W JJ >0 QX Z¢ Z~ ❑ m O 00 wQ a= a22 w~ ¢O UQw W U in ' C7r- inU FAQ 0 0'L 3F- ~w ~ (n t_t Q w J:j : Z l H mQ Z r t J U Q Z U _ Lli a: LU i m O Vs tom' w c/) p =i L y U IL W vi w Q :o w r- S 4. Q ❑ H m w W U m F OC Q 4 :t"t w f- LL V U m LLJ Lo U) LLI U Q ci zv ID CO <Z = q _ Q CID u > T i f CL T 1.r. 1~'1 n Z CL ` : ®U U) a w U w ~O w 7i U> i : << w m tl. Z t? xQ _t O _ d U r ¢ w cUii • . U z a r- w > = > ❑ F- _ m z U 0 u w w LLI _ T O cr F- p Q cUiir F- w m cri x cr a i:K -M 3 F- C7 L') D r~ - Y z ~ p ~i a _ U m n. p fir. ❑ ~t a i; i ED Lu a- in o cri cr ST C- 105 r r SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County z t7 a OWNER/BUYER ROUTE/BOX NUMBER Fire Number CITY/ STATE Z l PROPERTY LOCATION:_St4l_k, Sam/ Section, T~ N, R__,/Z_W, I Town of St. Croix County, Subdivision Lot number . Improper use and maintenance of your septic system could result in its premature failure to handle wastes.. Proper maintenance con- I sists 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 treat- ment 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 I/WE, the undersigned, have read the above requirements and agree 1 N to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. 17 `~/~1!`~y' I V SIGNED ~ v DA'rE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPARTMENT OF INDUSTRY, REPORT ON SOIL BORINGS INDUS ~ AND SAFETY & BUILDINGSi tABM AND PERCOLATION TESTS ( DIVISION! HUMAN RELATIONS P.O. BOX 7969 r (ILHR 83.09(1) &:Chapter 145) 0' AISON, WI 53707 LOCATI SECTION: TOWNSHIP/MUN(CIPALITY:. LOT NO.: BLK. NO.: SUBDIVISION NAME: 4SW 4 ~r2 N~R (or) W Baldwin q COUNTY: OWNER'S BC,~}QAME: MA ING DDR S : n/a . n/a n a USE rn Rd NO. BE R : CO DATES BSERVATIONS MADE E! esidence TON: PROF1. 3 n/a ' • ❑New ~eplace 8-8-90 . ' 8-10-90 RATING: S- Site suitable for system U- Site unsuitable for system i MIT ONVENTL011 IN-GROUS K:OMMENDEDSYSTEM optios au os~u as® u os if Percolation Tests are NOT required DESIGN RATE: under s. ILHR 83.09(5)(b), Indicate: n/a If any portion of the tested area is in the Floodplain, Indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WIT ICKNESS, 2LOR, TEXTURE, AND DEPTH NUMBER DE ELEVATION OBSERVED ES I HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 3.41 96.06' !"none 1.08 .75bl.1. .33bn.sil. .33bn.mot. sil. 2.00bn.mot.s. B-2 3.50 96.06 none 1.25 1.00bl.1. .25bn.sil. .25bn.mot. sil. 2.00bn.mot. B_3 r3-. 0 94.66 none 1.25 1.00bl.1. .25bn.si1. 2.25bn.mot. s.l. . B- dec' PERCOLATION TESTS TEST DEPTIi WATER IN RULE TEST TIME NUMBER AFTER SWELLING INTERVAL-MIN. DROP IN WATER LEVEL-INCHES a.' 1 1.67 none I p RATE MINUTES 30 7 8 PER INCH P• 2 1.67 none 5 8 5/8 48 P• none 30 5. 8 9/16 9/16 53 P. 7/8 7/8 3 P- P. o PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the h zontal f land 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, ori- SYSTEM ELEVATION 97.98 ~IIr- ~ --r-- - - %_4 (ooh El J_ p-j - a3 ' I r I 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 that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print Gary L. Steel . TESTS WERE COMPLETED ON: • • . I ADDRESS: 8-10_90 i 1554 200th. Ave., New Richmond; Wi. 54017 CERTIFICATION NUMBER: PHON NUMBER(optional): i 2298 15- 4 -6200 CST SIGNAT DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. I DILHR•SBD-6395 (R. 10/83) j . OVER - - ST. CROIX COUNTY rY `F ri~ y WISCONSIN lA,r 4^. : ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 715 386-4680 Sept. 14, 1990 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Vickie Anderson property located at the SW 1/4 of the SW 1/4 of Section 9, T29N-R16W, Town of Baldwin, St. Croix County revealed suitable soils at a depth of 13" below which seasonable high ground water was noted. An additional 11 inches of sand should make this site suitable for a mound. Should you have any questions, please feel free to contact this office. Sin6erely, A. . ~Imes K. Thompson "Assistant Zoning Administrator cj WORKSHEET - MOUND SYSTEM DESIGN tJ S`1/~a2 S 40 5 PROBLEM: Deeign a mound system fora site characteristics are: Depth to groundwater or bedrock ttr.,oxe- Landslope X Percolation rate , min./in. Distance from dose chamber to distribution system_ ft. Elevation difference between aump and distribution system ft. Step 1. WASTEWATER LOAD gal i i Step 2. SIZE THE ABSORPTION AREA A) Area required ft. s y B) Brad or trench length (8) ft. = r;. C) Bed or trench width (A) ft. D) Trench spacing (C) Wastewater load .24 (oal/f*z/day BB = ft, r r a e+ Step 3. MOUND HEIGHT A) Fill depth (D) _ j ft. B) Fill depth (E) D + slope (A)'f'p) ft, gat CD3 (s~1;1,9) C) Bed or trench depth (F) _ ft, D) Cap and topsoil depth (G) ft. aE) C p n topsoil depth (H) ft. ate: ~i ACIC Step MOUND LENGTH S90-405'92 A) End slope (K) _ CDR/ + F + H x 3 ft. IS, 4~2 "Y -S X ~11YJI B) Total mound length (L) B + 2(K) _ • (/,3 ~(I3 7) - 90, Step 5. MOUND WIDTH Al) Upslope correction factor r~ A2) Upslope width (J) (D + F + G)(3)(factor) _ .3_ ft. B1) Downslope correction factor ■ B2) Downslope width (I) _ (E + F + G)(3)(faetor) ft. (a r-, -as;- x(3)00) =>~aa?9 Cl) Total mound width (W) for bed = J + A + I = ft. i ' C2) Total mound width (W) for trenches ■ : j + ~ + (no. trenches -1)(c) + A + I = ft. Step 6. BASAL AREA A) Infiltrative capacity of natural soil _,Zzgal./ft2/0ay B) Basal area required = wastewater flow natural soil infiltrative ca acity, = sq. ft. , S6,0 Cl) Basal area available for bed for sloping sites = B x (A + I) _ sq. ft. C2) Bas are -avail le for trench for sloping sites = B W (J + A 1 ■ l~sq. ft. 'F .JJ sxr5~? = C3 Basal area available for trench or bed for level s tes = B x W = sq. ft. Sign: _ d-9--4 License 1\7u:,. vate:-- 9-z-.21- 9110~> Step 7. DISTRIBUTION SYSTEM ~,Jls 41A SIZE D ~ ~ Q-~05`?~~ ISTRIBUTION SYSTEM 9 1) Hole size = in. 2) Hole spacing = in. 3) Distribution pipe length = Aaee Fr 4) Distribution pipe diameter = I in. 5) Spacing, between distribution pipes iv,,otc 6) Distance from sidewall to distribution pipe in. 1B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe = 2) Flow per pipe GPM 7C) SIZE MANIFOLD 1) Manifold is , central/ end 2) Manifold length a ft. 3) Number of distribution lines = 4) Manifold diameter 3 in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate GPM 2) Force main diameter in. 3~8 1' r~ 3) Friction loss - ~eae ~ 13G8° ft. 7E) TOTA4 DYNAMIC HEAD 1) Vertical lift = ft. 2) Friction loss = f ft. 3) System head 2.5 ft. _ ft. 4' Total dynamic head A'-1 ft. LicersE: /S'~3 D at, o, 0 i' CL 1F) PUMP SELECTION S 9 O- 4 u 6 4 1) Pump selected will discharge GPM at .rte ft. total dynamic head. 2) Pump model and manufacturer S 7G) DOSE VOLUME 1) 10 times void volume of distribution lines 1 gal./cycle IaxGo%~ 'i = ~a 2) Daily wastew ter vpl me doses/24 hrs. _ g gal./cycle 3) Minimum dose volume = / /sdgal./cycle 7H) DOSE CHAMBER 1) Minimum capacity required = Ge~11~ gal. ,sz~o_ 7.5~ yam./ 1-16-11je- Sign: Licunse ::u:~f-i~ Date I i i i ~ .t a3/~a gym. sw / s~/y, s,~ ~ ~ ~~r✓~c'/~~/ 1#14?ociAl,0 0 v' R 4 IM. "NS tic, zs 'F+-, tr Lrvj uw~ is i c1r~~>rr,, 36 78 Page A 0f,~3 Straw, Marsh Hay, Or n~ 02 Synthetic Covering 40 a+ Distribution Pipe Medium Sand H Topsoil 'o ' .L123.a SS.^lLV1Ji as .•1 E r t3 ` I! % Slope Trench 'Of 2 Plowed s Aggreg Layer la o4 i i~~+ i 4~ iaLy Undisturbed A80 D Ft. r~~jphE,d~ Soil Ft. Cross Section sing F A-"~ Ft. 2 Trdnches or The Absorption Area G-1, Ft. A - Ft. H_ Ft. 13 Ft. Signed: - C ~ Ft. License Number: K 1Z Ft. -17 Date: L Ft. JZ,3 Ft. Alternate Position of Force Main I_j S Ft. W Ft, L J A ~r_" ^ - _ - - - --_i K C _ ' Force 'r W Observation Permanent Main VPipes Markers - Distribution Trench Of % - 2 1 Pipe 2 2 Aggregate Mound Using .3t Trenches For Absorption Area q r y p . '44yf 1R A N • M a 40 5 9, w m S90 A FA fD . A s ~ A ~y M ft. 1d Ft ~ C (D ' N y • _ .wry (A rr ~ b co O s It (.v m o cr d A E TE $~JV' GE SYS ° G~EI rt v f IHY, LAruI) hi r Karr, r .5.~. a q~ i A~ ¢ & i r s " h T i r ~~~~~5 ~~'Paga Q" ` pYE ,r tr'; a3io. J , 1' C~ d Pre Detail . ire 8...__. ~ _ k~•.~A En... d.V(ow '@ • EM Cop PV'C Pipta a<„ h- i; tice r HoN~' Lototed On B tt` r } ' d Ike E u a 4ma y $pocUd t .fit . L>r C, Y • PVC force Moor w ~ r ~ as yVR~,*~~ ~r r r'4 7r PVC ` } MoNta4'tPipe k,' _7.~ r=; , Di~trtp dio/l Alternate Pp~Ition of A a it"' : ^a pip* E Torei Miin r tt tXl { ' Last Moto mould Be r, ,~r t ~k #text To EnQ r ya _ , Cop ~.r~ ,~i.: End Cop g oi~tri eution Pip•' lajout p ~ Ft:V #e R ~ ; ~A b T W S F' U y YS .Y; . . Inches } Signed; Ho1`e Dia'meter' ;Inch Lateral " ''Inth(e License Number: Manifold' M Orate: Force Main ~3 ~.;In~ch~,3 of holes/pi pe ' Invert El vat a ion ;of Latr:ral s~~ Ft. m y. ;e e, ' y. ewe PIMP CHAMBER CROSS P GE SECTION AND SPECIFICATIOIJS OF VENT CAP 'I"C. I. VENT PIPE WCATHEK PROOF APPROVED LOCKING -7 ZV FROM DOOR, JUUCTION BOX MANHOLE COVER WINDOW OR FRESH 12"MILT. AIR INTAKE I GRADE 1 y" MIIJ. COIJDUIT • 51 \ i.tiona ill APPROVED JOINT ~r+ vim' W/C.I. PIPE A A £ 1 t~1~ I I V I I APPROVED JOINT EXTENDIAIC. 3' ONTO 501.10 SGl;.` E•//C.I. PIPE e M~,, 1i:~~~ ~ ~,S ALARM EXTEUOING ONTO SOLID Sol 4) I M. _ PUMP--,., p OFF r CONCRETE BLOCK RISER EXIT PERM17fED OIJL`J IF TAUK MANUFACTURER HAS SUCH APPROVAL SEPTIC AMC) SPEC lFICAT Zj TAMKS MANUFACTURER: /Vii.. CUMBER OF DOSES: PER pAy 6L.AR/1 MANUFACTURER: GALLOIJS DOSE VOLUME C x vir INCLUD!!! : ....C-FLOW: MODEL UUMBER' GALLONS SWITCH TYPE: • • , CAPACITIES: A. IIUCHES OR f,~ ' u PUMP MANUFACTURER: -Z B= INCHES OR ' G?I L~l li MODEL NUMBER: ~1~1^C3 1I L = I I A C=y INCHES OR ,(2 GAL' M~ SWITCH TYPE: D-_INCHES ORGALLONS PUMP DISCHAR`E ~ IJOTE: PUMP ANO ALARM ARE TO DC RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE 6z,~NEEA! PUMP OFF AND DISTRIBUTION PIPE., FEET f MIN11'1UM NETWORK SUPPLY PRESSURE . . • • • . . . • • 104-0- 'f' FEET OF FORGE MAIN X 2.5 FEET FT _ ioorT.FRICTIOM FACTOR.. FEET 1 TOTAL OUIJAMIC HEAD FEET r IIJTERIJA{,,, RIMEIJSI OF TAAIK: LEIJC,TH ~-•~,,e~-~ . ;WIDTH ;LIQUID DEPTH SIGNED LICEWSE DUMBER: -117- DATE:,e 1 (a yi yft r. ~ S~11y+1 •hY.fi„`~.A~'iN}. } i ~(J" ' ,t~rf. x Gt1LDS ,S:UDMEl3SiBLE v~>rk-,9•~ . 4 ,t S.EIAGE AID EFFLUENT PUMPS , 0311 LIST DISC. GO P + 115 V Effluent Pte... 1/2" solidi 256:50 172.10 1 V W311 2/3'H t]PFP0311 142 i Submersible . xy, i " ; 5 pI ; MOD 0 r r ,.1x1.1 -~,ya•,1 :Efflent;Pump Y - 1+1ETYAS FE[T SIZE % SOLIDS 1 ` 25 o ati , rs , +~~XCCk rj 20 e1t1 i~ ts~ is ~S a~ . tr 4 1 I , lY' i s'• c 10 t r f . O 1+fA~+i °Yt °•;k~t ' s r C CO , 6 12 16 ZO 24" 26 32 36 40 Y• . 1 1 OPM ! ' 0 24 0.0 71 m41: IrAPAC(TY G: , ry Performance Curve 3885:I;r '~r VArrM tact 1 ` 90 MODEL SIZE 3/4" Solid + =r t SEa es . , ~ 70 rt [!rt x't31!~~ r 20 1f yN,=~_ b tE WEC 'WE06M 1o W(• WE03L- Yr . 30 'Y •=t T-r- m---r 7171 1 1 O►Y ~h >1 jf~ to m 00 60 40 70 N i0 100 110. 170 1 CAIAC"T 5 LIST DISC. " COLR,tE03111. 142 HE0311L 1/3 HP 115 V tw H, 3/41 solids ' 91.55 329.3S • vh "A " O3lrR.'EO311M. 112 wE0311M 1/3 !P 115 V. Mod H 3%4" solids 491 .55 329.35 ' t y} *As4°r r it<~P4SFS Alf. PACE FM pMraM1CE Ate SPE=ICKTICNS. '.:OJIJPStrA11N 14I WE0511H 1/2 HP 115 V High H 374" .1o11ds 704;25 471775. , rr. r 011P6'E0712t► 142 FtE0712H 3/4'HP 230 V' High H3:. 3/4" is ids E443.65 565.25' fir r y G~ •1 ~!3?'$? t ly►1E.• 10/88 DEBT 30 PAGE 01u y.; r t'a t • PETITION FOR VARIANCE APPLI~AON Wisconsin Department of Indust', Labor and Human Relations OFFICE E ONLY Safety and Buildings Division OFFICE USE ONLY Amount Paid 201 East Washington Avenue, P.O. Box 7969 Petition No. Madison Wisconsin 53707 ceipt No. 608/266-3151 E-Number Tame of Owner/Petitioner Building or Project Agent, J - L n~~r SO►~ AMC. ~F-t ~A1 ~t L~ [U I'n W8 r5 Company Tenant Name, if any Street & Number S3 42 *2 Street b Number Location, Street & Number City State Zip Code City State Zip Code C'ty r County Telephone Number C --N002 Telephone Number Plan Number, if known Name/ o1f Contac erson 1. The rule being petitioned reads as follows: (cite specific rule number and lanquaqe) JLIH9 83.2-3 (QCC . H R lip 3 l t r r~1 g~ z - i h ere. s~ ► 1 I 3 ~ ~i I - . o~ T ~4 ~ ~ C~ i~ 'S+ t9 r 9'1..~ 111 +tt ~ ~ . ~ 2.-_~J he rule being petitioned cannot be entirely satisfied because: 1 ~t --i - ~ Y► G S C> V', ~ ~ C~ ~7 ~3 h t V~ q V- a S e ► @ ~ ~ b y A hs D ~ { l1 • /17 ,5 to c,-A Sb LA The following alternative(s) and supporting information are proposed as a means of providing an equivalent degrE health, safety or welfare as addressed by the rule- / 10,11 O~ .S4hd rit e A d t~Q l o b Dro9es e - LA 5,C- ~ t -e- :Vt, 't 11 '0 uA r% V-% Please attach any pictures, plans, sketches or required position statements. VERIFICATION BY OWNER - PETITION IS VALID ONLY IF NOTARIZED AND ACCOMPANIED BY REVIEW FEE See Section Ind 69.15 for complete fee information Note: Petitioner must be the owner of the building or project. Tenants, agents, designers, contractors, attorneys, etc. may not sign petition unless a Power of Attorney is submitted with the Petition for Variance Application. Vickie A. Anderson , being duly sworn, I state as petitioner that I have read the foregoi (NAME OF PETITIONER, Please type/print) petition, that I believe it to be true and I have significant ownership rights in the subject building or project. 11 I~ Subscribed and sworn to before me this date: 10/4/90 _ Signature of Petitioner A A 2 2 1 , r MnnnnnnnnnnnMnnnnnnnnnnnnnnnnnnna cv-,- l_ V ~~titi, Yn~,My,nc.om9i,S,s~P~'„4xQ1 res • 5---~~~--= ~A -1 Notary Public < NOTARY PUBLIC- < SB-8(R.09/88) I 5 RAMSEY COUNTY '0iA 7~ y My 'orom, cxpires Nov. 18, 191+- PETITION FOR VARXANCE APPLICATION Wisconsin Department of Industry, Labor and Human Relations OFFICE USE ONLY Safety and Buildings Division OFFICE USE ONLY Amount Paid 201 East Washington Avenue, P.O. Box 7969 Petition No. _ Madison, Wisconsin 53707 ceipt No. 608/266-3151 E-Number Name of Owner/Pe itioner Building or Project Agent, AEsiineer+nq ' r 1, ~ -P rAd e-Y, Soh Q Y-,\ 2 v~o wt r5 h- Company Tenant Name, if any Street & Number k PC, P F1.3 Street b Number Location, Street & Number City State Zip Code City State Zip Code C(}~,ty County T~ellephone Number .1~ V VN w h X Cvoi I (r p~ 51J Telephone Number Plan Number, if known Name of Contac erson I C I ve 1. The rule being petitioned reads as follows: (cite specific rule number and lanquaqe) I LHP- g 8 .'Z 3 ~i~~cl L-fi R rll~ 3 1,( 7h 4ft -'~It 3 yI) CI~1 K- i - ' ~I<iv q ° f Ara T I q-,. m- M S ZiJAZ44 A/ C- dnJ V, e-rt se~ e a*+ am oJWqXV,!= 1A 4a~IA C" , 2. •The rule being petitioned cannot be entirely satisfied because: - ~D-~. v v s o V\ 1 1, 61 e~ st a r. ~ +n A n. ~ 5 s ~A b V I h e YY~ I► n. The following alternative(s) and supporting information are proposed as a means of providing an equivalent degrE health, safety or welfare as addressed by the rule- / - d e U S. o-~ .sQ nd lam t k>z ! D 3 --Ck A SI -t--1&_ im tit) L ! 1 ~r ~ Gti ~ ~ S ?~'-t n ~ '~`t~v~►~_ ak~ ~i~.C'~~ Will d ~i ~i.c.r - %0 4 e~n1-r a r *-k t%-- Note: Please attach any pictures, plans, sketches or required position statements. VERIFICATION BY OWNER - PETITION IS VALID ONLY IF NOTARIZED AND ACCOMPANIED BY REVIEW FEE See Section Ind 69.15 for complete fee information Note: Petitioner must be the owner of the building or project. Tenants, agents, designers, contractors, attorneys.. etc. may not sign petition unless a Power of Attorney is submitted with the Petition for Variance Application. Vickie A. Anderson , being duly sworn, I state as petitioner that I have read the foregoi (NAME OF PETITIONER, Please type/print) petition, that I believe it to be true and I have significant ownership rights in the subject building or project. / I l / I Subscribed and sworn to before me this date: 10/4/90 Signature of Petitioner 2 r S V C~ a~/ nmrAQ AMAMMM~ j C_ l_ b ~.lti.- rn~yn,CA•~7.$.~lp!!,.SxRlres5 Dim h4ARVIN Notary Public < 'd~s'_j?. 1^~ ' NOTARY PUBLIC-MIPiNESOTA RAMSEY COUNTY SB-8(R.09/88) E.. o A _9- My -'ortim. Expires Nov. 18. 1993 w. t;...r.v3 TMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS TRY, DIVISION BOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 7969 N WI 53707 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: TOWNSHIP/~ LOT -NO. NO.JSUBD_IVISION NAME: SW ~4 SW ~ 9 /T2 9N/R 16E(or)W Baldwin n/a n/a n/a COUNTY: OWNER'S/ ME: MAILING ADDRESS: St. Croix Vickie Anderson 2310 Co. Rd. #E, Baldwin, Wi. 54002 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: ❑ PROFILE DE CR TIONS: PERCOLATION TESTS: Residence 3 n/a NewReplace 8-8-90 8-10-90 RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-G ROUND-PRESSURE: Tos YSTEM-IN-FILNK: RECOMMENDED SYSTEM:(optional) ❑ s HU 9 S ❑ S ~U eu S ~U mound with variance If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: n/a Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 54 SaC2 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, f LEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 3.41 96.06 none 1.Q9 .75bl.1. .34bn.sil. .33bn. mot.sil.2.00b . B-2 3.50 96.06 none 1.25 .83bl.1. .42bn.sil. .25bn.mot. sil. 2.00bn.mot.s. . B-3 3.50 94.66 none 1.25 .83bl.1. .42bn.sil. 2.25bn.mot. s.l. B- B- B- decimal' PERCOLATION TESTS DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES DUCMES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER PER INCH 1.67 none 30 7/8 5/8 5/8 48 1.67 none 30 5/8 9/16 9/16 53 LP2 -i.67 none 30 1 7/8 7/8 34 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. SYSTEM ELEVATION 97.98 ~ ..t7 E s 3 . - - - 3 C9 0 3 E E P. ~a_ 0 Z a ` 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 that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: Gary L. Steel 8-10-90 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional) 1554 200th. Ave., New Richmond, Wi. 54017 2298 1/1 1715-?16-6200 CST SIGNA DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - owl Q~ TZ Cam!,' ~ e to C~ossQ i2$ jt, L St - ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 = (71S ) 386-4680 Oct. 3, 1990 Jerry Swim LaCrosse Regional Office 2226 Rose St. LaCrosse, WI 54603 Dear Jerry: Enclosed is a copy of my field notes regarding the Vicki Anderson property. It is my feeling that this site is suitable for an onsite sewage disposal system. This system would have to be a mound which would require a variance due to a depth of suitable soil of 13". As my notes show, the site would meet the minimum requirements of the A+4" rule. If I can be of any further help in this matter please contact me at the St. Croix Co. Zoning Department at 386-46890. Since ely, mm es K. Thompson Assistant Zoning Administrator cj State of Wisconsin ` Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION I CIA 'VIN PillwFIRS JR. W_ t; 216 RE: Plan Number: 590--40522 rsr, I:t . _:1. ;~?t lE)• c P(- 1"V t> ui.Z. Ci.. ~G2..3.i._ rt^ r'' ..f'f.::. i-ar h ~•t.3t;S,.}'.V~,. .i. T:;.'. i'~~, ~ fN T'':?I-:- _ t„il~r~,`. _ ' I _!'•.C. . Qi! '<f'F-. a~..f, :E,r ~ ;e ;'iC :.ti. t: ,.F i;ti J _..^•F' x't The F l ,i,7 c~f S f.t{,~ 1 ?5 _ F _ ''3 i. CA gp 5i t. e. 'F. !en s v . E'S'C- 1) !'?ii?P" T}: :^.tt iOI"'_'`` :7 r'^ :t •a'1 F UrJ'..l"' U: .adF}`S 5 ~i .~:F• W c~' ke,y,r tiC14',niSt UC'P T" 1 1!) 1'f)g.'zl f3 ~:7 , a' ~.l= :.51 t.!•', b v 3 , 20lyllgGccf <%OUIV7 2 129 SBD-6423 (R. 08/88) State of Wisconsin ` Department of Industry, Labor and, Human Relations SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue OC tUf)eP 24, 1990 P.O. Box 7969 Madison, Wisconsin 53707 i i Vickie Anderson 2310 County Road L Baldwin, WI 54002 Man I.D. `jo. S90-40522-P Dear M;s. Anderson: Re: Vickie Anderson - Residence Orsi te Seviage Systeo ai"s d,D,2a,156 Town of Baldwin, St. Croix County, :I Your petition for variance to section IL11R 83.23 (1)(r), !Jsconsin A&iinistrative Code, has bee; reviLawed. The rule being petition requires a riound systeca site to have a r,tinillmn of 24 inches of suitable natural soil. The variance requested was to install a replacelient rlo uncl system on a site with 13 inches of suitable natural soil. The following corrrments were mane in tire petition anaiysis: _ 1 In revi e:ri_ny . Ue peti ti or;, it vvas noted inat the request was .sir.i.l ar_. to _ other petitions accepted by tnis depart,nent Under petition numbers S89-03304, S39-0331,0j, and S90-00,0172. 2. based on the precedent estaolishet by the previous petitions, this petition for variance is tieing uroc(~ssed as perirsitteo by Wisconsin Statute Section 101.02 (u)(g). Depart~ental Action: Approval. . SBD-6928 (R. 10/87) DEF~''TMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDOSTRY, _ DIVISION LABOR AND P.O. BOX 7969 PERCOLATION TESTS (115) MADISON, W153707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK. NO. SUBDIVISION NAME: ~ SW ~ 9 /T 2 H/Rl (or) W Baldwin In/a n/a n /a COUNTY: OWNER'S/SAME: MA LING ADDRESS: USE DATES BSERVATIONS MADE rNO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PER OLATION TESTS: I ONesidence 3 n/a 0 New ffl~heplace 18-8-90 8-10-90 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN_ -GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) ❑S 0U [gS ❑U ❑S QU ❑S ®U ❑S [a m If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: n/a Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS 54 IC9 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WI ICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPT ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 3.41 96.06 none 1.08 .75bl.1. .33bn.sil. .33bn.mot. sil. 2.00bn.mot.s. . B 2 3.50 96.06 none 1.25 1.00bl.l. .25bn.sil. .25bn.mot. sil. 2.00bn.mot. .1. B-3 3.50 94.66 none 1.25 1.00bl.1. .25bn.sil. 2.25bn.mot. s.l. B- B- B- ec' ' PERCOLATION TESTS d TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IIIXi X AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER D PER INCH p-1 1.67 none 30 7/8 5/8 5/8 48 p-2 1.67 none 30 5/8 9/16 9/16 53 P-3 1.67. none 30 71 7/8 7/8 3 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. 'j E SYSTEM ELEVATION 97.98 : 3 E _ T E t 3 L= I E ~,r.~rws~ ~ rNc-Y4, S ~ oG E E E 1_ w 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): TESTS WERE COMPLETED ON: Gary L. Steel 8-10-90 NE NUMBER (optional): ADDRESS: CERTIFICATION NUMBER: M-246-6200 1554 200th. Ave., New Richmond, Wi. 54017 2298 CST SIGNAT A~~ "&ALZ RIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. -SBD-6395 (R. 10/83) - OVER -