Loading...
HomeMy WebLinkAbout010-1068-70-100 m R 7 2 j Co & , / 2 0 \ § 0 . oN }j A 0) � $ §\ % � $ \2C.4 £ 02 \ a) D 2 amin 2 2 \f\ \ k -70.2 LL / §2 § 3 g °§C � « % 2 } \ ' k\ 8 OD / \ IL 0 )\ § B 2 z% t ® k0 CL 2 z / 4") E E o @ = E E a f w g7 § \ E ) / § �0 0 0 k k E r \ . B Q 2 } % � t � C n ) E . \ \ 0 D © ° / _ E j } \ 0 o o o 2 a a a 7 IL c R koB ? 88 ; U e / § 0 = E Q I � 7 R ) f t m o o o e § E 3 $ $ 2 § \ C'4 / \ ƒ ) � � a 2 7 ) c � 2 \ % 2 £ t = E \ a § 2 ; y Wiscortsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. 363970 Permit Holder's Name: ❑ City ❑ Village ❑ T wn of: State Plan ID No.: Bouton, Steve Emerald Township 3iq o r f :Tr wr, /D,4 CST BM Elev.:- Insp.BM Elev.: BM Description: Parcel Tax No.: �, a 1 LT ,p ' -Flan L = p✓'L P,` 010-1068-70-000 TANK INFORMATION ELEVATION DATA .2?.3a-/(0r 5//9 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Imp o Benchmar ( p aD 3.20 �o3.2d (vD Dosing K Alt. BM Aeration Bldg.Sewer9 Holding St/Ht Inlet 240 CIO. 6� TANK SETBACK INFORMATION St/Ht Outlet --- TANK TO P/L WELL BLDG. Ai Intake ROAD Dt Inlet Septic Z ` NA Dt Bottom Dosing }Z� / NA Header/Mant"d Aeration NA Dist. Pipe Holding ----` _ Bot.System 6 S� )o (, bz- r PUMP/SIPHON INFORMATION Final Grade l b + ) qA anufacturer Demand St cover p• odel Number I-' GPM 04) TDH Lift o Lrictionl Z� Systemz TDH l�,nFt oss Forcemain Length Dia. Head a Dist.To Well SOIL ABSORPTION SYSTEM ( Z•43 — 4 `�� �z- c SW/ RENCH Width Length No.Of PIT No.Of Pits Inside ici epth DIMEN 4- 1 � DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM ILEAC Manufacturer: SETBACK C MBER INFORMATION Type O y System: I 33 OR UNIT a Num er: Z DISTRIBUTION SYSTEM T ` = 2,.o 3 Header/Manif V Distribution Pipe(s)r u x Hole Size x Hole Spa g -Vent To Air Intake Length ia. Length Dia. Z Spacing IN 11 1r 9 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies,persons present,etc.) •t5 3'`/ ' ? `(s— `1 • Lf' (�(�+ - > � ��—►� Insp tion#1: 08 o 60 Inspection#2: CI?/Z3/CD Location: 1369 230th,reet,Bad 5 002 (SE 1/4 SW 1/4 28 T30N R16W)-283016419 n n 1.) Alt BM Description= ��0 Goz,. ) 2.) Bldg sewer length= J -amount of cover. ' '3. (S * �o ' 3.) contour.= 1 Plan revision required? ❑ Yes b4 No Use other side for additional informatlon. 02- 2- C1 SBD-6710(R.3/97) �Die i) I _ 4 Inspector's Signature Cert.No. INST� CTIONS 4 1. A sanitary permit is valid for two(2)year `'% �L,A 2. Your sanitary permit maybe renewed bo *their tion ate,ATM a time of renewal any new criteria in the Wisconsin Administrative Code will be appti�able + . _}► ° 3. All revisions to this permit must be appro ed by thepe �issbing �F irity. 4. Changes in ownership or plumber requires"i�ry Permit Tr r6s%ei.,Renewal Form(SBD-6399)to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained `P15 septic tanks)must be pumped by a lice"nsed"purY�per 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 and Buildings Division, 608-266-3151. ' 'w To be complete and accurate this sanitary permit application must include: I. Property ewner's name and mailingvddress. 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 on 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 for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/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 anc\specifications not smaller than 8 112 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; frictionless; 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 practiceswhich can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings Division SANITARY PE ATION 201 W.Washington Avenue 14sconsin P O Box 7302 Department of Commerce In accord wi 1 s. I? Madison,WI 53707-7302 • Attach complete plans(to the county copy only) \e s"I ape ess Count than 81/2 x 11 inches in size. -II��CC�� 'T • See reverse side for instructions for completin app%gii a State Sanitary Permit Number 3�3 7 7d Personal information you provide may be used for secondary p s Y COX Cry ❑Check it revision to previous application [Privacy Law,s. 15.04(1)(m)]. State Plan I.D.Number I. APPLICATION INFORMATION- PJLEAS5 P ^115RA 16a 3 D Propert er ro rty Location .�,1)Q ia�6v► va,S �� Tae ,N,R 4 E(or)\AP Property-0 Mail dress a lot Number Block Number City,State. Zip e `hon r division Name or CSM Number ❑ It Nearest Road II. TYPE IL ING: (check one) ❑ State Owned �' S ❑ Vil age Public 1 or 2 Family Dwelling-No.of bedroom Town OF6W40 a III Parcel Tax Number(s) . BUILDING USE: (If building type is public,check all that apply) �f , 4 a (J 1 ❑ Apartment/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 box on line A. Check box on line B,if applicable) A) 1 , New 2. ❑ Replacement 3_ ❑ Replacement of 4_ ❑ Reconnection of 5, ❑ Repair of an m ________System _____________ Tank Only______________ ExlstingSystem _________Exlstingsystem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑Seepage Bed 21,6 Mound 30❑Specify Type 41 ❑Holding Tank 12❑Seepage Trench 22❑In-Ground Pressure i r 42❑Pit Privy 13❑Seepage Pit 43❑Vault Privy 14❑System-In-Fill Iz - a L X.S TAI r 3 VI. ABSORPTION SYSTEM INFORMATION: 1.Gallons Per Day 2. Absorp.Area 3. Absorp.Area 4. Loading Rate 15. Perc. Rate 6. System Elev. 7. Final Grade �S / Required(sq.ft Pro osed(sq.ft.) (Galstday/sq.ft.) (Min./inch) / Elevation d ,/ *V' �7e,/ �� A • b Feet Feet Capacit VII. TANK in gallons Total #of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic or Holding Tank GAO i �0 ❑ ❑ ❑ ❑ ❑ i Pu Tank/Siphon Chamber OQ `— (,OV 1:1 El ❑ ❑ ❑ ❑ . RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage s em shown on the attached plans. Plumber's Name:(Print) mber's S nature: m s) MPRS Business Phone Number: �/J11. s ,! c_ ;� 7 Plumber's Address(Street,Ci*State,Zjplede): IX. COUNTY/DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee (Includes Groundwater D ate ssue 11ssuigentS' nature(No Stamps) Approved Surcharge fee) C/ �►--�� pp []Owner Given Initial / Adverse Determination 3 S b Ad X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: rr,a✓N�4�� SBD-6398(R.4199) DISTRIBUTION: Original to County,One copy To: Safety&Buildings Division,Owner,Plumber I Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD#:(608)264-8777 A www.commerce.state.wi.us Department of Commerce Tommy G.Thompson,Governor Brenda J.Blanchard,Secretary May 31,2000 . CUST ID No.221471 ATTN:POWTS INSPECTOR ZONING OFFICE DENNIS J GILLE "` ' A f ST CROIX COUNTY SPIA 372 140TH ST r. , - - 1101 CARMICHAEL RD AMERY WI 54001 �, . .% HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/31/2002 Identificato ers Transaction ID N 319014 Site ID No.193007 SITE• Please refer to both identification numbers, Site ID: 193007, Steve Bouton Proposed Residence above,in all correspondence with the agency. St.Croix County,Town of Emerald SETA,SW1/4,S28,T30N,R16W FOR: Description:Three Bedroom Mound System Object Type:POWT System Regulated Object ID No.:665651 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED.The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19,Wis. Stats. • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis. Stats. • The well must be a minimum of 25 feet from any POWTS tank,and a minimum of 50 feet from the absorption area. CAUTION:Wis.stats 145.135(2)(b)indicates that the approval of a sanitary permit is based on regulations in force on the date of approval.The effective date of COMM 83 revisions is expected to be July 1,2000. Thus depending on the type of system and your design,this plan approval may not be eligible for sanitary permit approval if submitted to the issuing agency on or after July 1,2000. Note:There is a otD ential for a law suit that may delay the effective date of the code so this status may or may not change. A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. DENNIS J GILLE Page 2 5/31/00 Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. Sincerely, s DATE RECEIVED 05/23/2000 FEE REQUIRED$ 180.00 FEE RECEIVED$ 180.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer-Integrated Services (608)-785-9348, Mon.-Fri.7:15 AM to 4:00 PM jswim @commerce.state.wi.us WiSMART cede:7633 MOUND SYSTEM DESIGN Residential Application INDEX AND TITLE SHEET 0 4 !� o0 Protect STEVE BOUTON �A Owner STEVE BOUTON 4 • Address PO BOX 932 HUDSON WI 54016 Legal Description SE SW S 28 T 30 NR 16 W Township EMERALD County ST. CROIX Subdivision Name Lot No. Parcel ID Number Plan Transaction Number Index and title sheet Page 1 P.0,Vq T.S. Mound calculations Page 2 G011dttloliall ' Mound drawings Page 3 Roy Pres. dist. calcs. and laterals Page 4 TDH and pump tank drawing Page 5 FL-OT- PLAID PAGFS� pfPAR7MENT oY AND BUILDINGS D► N F ESpONDENCE SEE G0 Designer DENNIS GILLS License Number 2214.71 Signature ?am:Ar Phone No. 715-268-6637 Date 5-16-00 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s.145.10,Wis.Slats. Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. SBD-10462-E(R.05198) Pagel of $ MOUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch- ounds Metric Residential or commercial? R (r or c) (y or n) L-� Replacement system? Creviced bedrock site? n (y or n) Slope 7 % Wastewater flow rate 450 gpd 1703 Lpd Depth to limiting factor 26 in 66.0 cm In situ soil infiltration rate 0.3 gpd/ft2 12.2 Lpd/m2 Contour line elevation 100.6 ft 30.66 m Use standard fill depths? x OR Design depth? in cm Place X in box to use standard depths(24 and A+4 inclusive)OR specify design fill depth. Center or end manifold (c ore) Hole diameter r 0.25 1 in n*m )Ai r n'Al 0.219, n 75 ft�A1 nr!1'31'1 inrh nnN Lateral spacing 0.00 ft Use 0 lateral spacing for trenches. Estimated hole space 4.00 ft Not a final calculation. Number of laterals Pump tank elevation 90 ft Outside bottom of tank. Forcemain length 60.0 ft Forcemain diameter 2.0 in 1.5,2,3 or 4 inch only. 2.067 in Actual I.D. HOLE DIAMETER CONVERSIONS 118 =0.125 114=0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5/32=0.156 9/32=0.281 Estimated daily flow 450 gpd 1703 JLpd 3/16=0.188 5/16=0.313 7132=0.219 Absorption cell Design load rate&area 1.2 gpdW 375.0 ft' 34.84 m2 Linear loading rate (LLR) 4.79 gpd/ft 59.4 Lpd/m Design width (A) 4.00 ft 1.22 m Cell length (B) 94.0 ft 28.65 m Depth of cell (F) 10.0 in 25.4 cm Sand filter Upslope fill depth (D) 12.0 in 30.5 cm Downslope fill depth (E) 15.4 in 39.1 cm Basal area required (gpd/infiltration rate) 1500.0 ft2 139.35 m2 Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.5 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 10.43 ft 3.18 m Up slope toe length (J) 7.00 ft 2.13 m Down slope toe length (1) 12.00 ft 3.66 m Basal adjustment made. Total mound length (L) 114.86 ft 35.01 m Total mound width (W) 23.00 ft 7.01 m Project: STEVE BOUTON Transaction Number: Page 2 of MOUND PLAN VIEW observation pipes(typical) J 23 ft ... A A= 4.00 ft 1.22 m 7.01 m B= 94.0 ft 28.65 m B J = 7.00 ft 2.13m I K I = 12.00 ft 3.66 m K= 10.43 ft Ljj8j m _ 114.86 ft 35.01 m typ. obs. pipe (anchored securely) I= down slope dimension ] = absorption cell (AxB) J= up slope dimension = plowed area (LxW) K= end slope dimension JU 6°(152 mm) T MOUND CROSS SECTION subsoil cap D= 30.5 cm lateral topsoil G H E= 15.4 in 39.1 cm invert 102.10 ft---- _ _____ F= 10.0 in 25.4 cm elev. 31.12 m F G = 12.0 in 30.5 cm ASTM C33 H = 18.0 in L 45.7 cm D Sand Fill Sys. 101.60 ft elev. 30.97 m 100.60 ft contour 30.66 m elev. 7 % ---.�, slope D= upslope fill depth plowed layer E= downslope fill depth Note: Absorption cell media will consist F= absorption cell depth of aggregate and pipe with laterals G = subsoil +topsoil depth at cell wall centered across AxB media. The cell H = subsoil +topsoil depth at cell center media is covered with geotextile fabric. Designer notes: Project: STEVE BOUTON Transaction Number: Page 3 of PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch-pounds Metric Width (A) 1 4 ift 1 1.22 Irn Length (B) 94.0 Jft L 28.65 Irn Lateral specifications Number laterals 1 Holestlateral 23 holes Lateral length (P) 91.67 ft 27.94 m Hole diameter 0.250 in 6.35 mm Lat. dis. rate 26.80 gpm 1.69 Us Sys. dis. rate 'z� gpm 1.69 Us Hole spacing (X) 50 in 127.0 cm Lateral diameter Pipe diameter Design options Design choice Designer must t in(25 mm) Place X in red X" one choice 1 114 in(32 mm) box of chosen from the options 1 1/2 in(40 mm) diameter. provided. 2 in(50 mm) X X 3 in(75 mm) X Manifold diameter Pipe diameter Design options Design choice Designer must 1 in(25 mm) 'X" one choice 1 114 in(32 mm) None required. from the options 1 112 in(40 mm) No choice necessary. provided. 2 in(50 mm) 3 in(75 mm) 4 in(100 mm) Distribution system contains: 1 Lateral(s) LATERAL DIAGRAM - END CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. Laterals centered over the A&8 dimension end cap P -----�! Last hole dirilled neat to end cap I I Laterals&force main a►PVC Sch+40 Hole---•drilled on the bottom of the lateral (per COMM Table 84.30-5) equaliy spaced i =permanent end marker Inch-pounds Metric Lateral length (P) 91.67 ft 27.94 m Lateral spacing (S) 0.00 ft 0.00 m Hole spacing (X) 50 in 127.0 cm Manifold length 0 ft 0.00 m Hole diameter 0.250 in 6.4 ]mm Lateral diameter 2.00 in 50 m Forcemain diameter 2.00 in 50 mm Project: STEVE BOUTON Transaction Number: Page 4 of �' TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft 0.76 m Vertical lift 11.40 ft �,�I loo, 3.47 m Are laterals the highest point in the Friction loss 0.76 ft�. 1 0.23 m system?Yes^x°here. Total dynamic head 14.66 4.47 m if no,what is the highest elevation Dose Volume downstream of pump? Dose is > 10 times lateral volume Forcemain drain Lateral void volume 16.0 gal 60.6 L back to tank?("x"one) Minimum dose 160.0 gal 605.7 L x Yes Drain back 10.5 gal 39.7 L No Dose volume 170.5 gal 645.4 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3)WAC. approved manhole cover with weather proof warning label and locking device grade levels junction box —� disconnect ade levels connect -- y aftemate 4"vent pipe electric as per NEC 300 and E— outlet Comm 16.28 WAC location 18"(46 cm)min. wall of pump &— approved chamber or outlet joint combination tank A Provide 1/4"weep hole or anti- alarm on siphon device as necessary pump on B Grade levels pump 90.7 ft C -pump tank manhole=4"(10 cm) Off elev. 27.6 m minimum above finished grade JE]D -vent=12"(30.5 cm)minimum above finished grade 90.0 ft Pump tank elevation 3"(75 mm)of bedding under tank 27.4 m bottom of tank Tank manufacturer HUFFCUTT Pump tank capacity 15 gal/in Pump tank volume 600 gal Pump manufacturer IZOELLER Inches Gallons Pump model number 198 o A 21.6 324.5 .N B 2 30.0 c Alarm manufacturer ILEVEL ALARM E C 11.4 170.5 Alarm model number JDLV o D 5 75.0 Project: STEVE BOUTON Transaction Number: Page 5 of loo" 1 IRP 7* z -El 9-0y,- v- — — La 7 -- sT' S ro a�ev 3 PAR 3o S 1 30 FEB-29-00 T IE 03:47 PM JN LARSON FAX NO, 1 7115 386 3746 P. 03 HEAD CAPACITY CURVE MODEL 46981? ".4 25 — \ �.�,. 1• .3 'ij8 O 10 2 �- 5 0 U.S. GALLONS _ 10-_ 20 1 30 40 LITERS I /` EO 160 240 o FL W PER MINUTE TO TAI GYNAMIG HEAWFLOWP£A MINUTE ( l Ef FLUENT ANDDEWATENING t2 i l CAPACRY [^ �. HEAD UNITSWIN PIEPBET 1AIMRS GALS LTRS ET 72 273 ! j to 3 20 610 25 95 j c 61 231 16 4 57 45 170 I LOGY�VSIIVB 23• SKI 10: CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and • Variable level float smxrhes are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available with • Double piggyback variable level float switches are avail::tble or without alarm switches. for variable level long cycle controls. s�Lrci iott GUIDE 1. Integral float operated 2 role 1•ecttanical switch,no exlernat control required. Standard all models -Weight 39 lbs.•%M.P. 2 Single piggyback variable level i!oat switch or double piggyback Variable IUvei• Controt Selection float switch,Refer to FM047? nI - Olbs•Ph Mode Am s simpletl Duplex� 3 Mechanicai alternator 10-0072 or 10-0075 1 1 Auto 9.4 1 or 1 8 7 - 4. See FM0712.ror correct mode?or Eleclr;ca'Altem3tur.E-Pak. N 9.4 2 r 6 3 ur 4 S 5 '5 Contra?switch 10.0226 Used as a control aetivolor, specify duplox(3)Cr(4) float system 0 1 ' Aulo 43 1 or i 8 7 6. Four(4)t,oie,1-Pak,junrl,on D�; for 0r� i Non 4.7 2 or 2 b ti 3 or 4 8 Sy simplex o!duplex operation,10-£002, 7 1 wo(2)hole.1.Pak,for watertight connection Of sf>Iice CAUTION For lMonrtationanaddittanal Zoeller Products relertoataloponCombinatanStertar,FMOStn,Ppgyluek All insiattatia,i of cont,ols,protection devices and wiring rhould be done by a qualified VarhblsLevelSwitclte5,FM04'7;Ebcktc9lAllttmater,FM04A6;Mechanise!Alemetor,fiNO/85;Sump! licensedetnetrlctan. All Electrical and sately codes sltuutdbafoliovredineivainglhanwst sewage Basins,FM0487;aid Single Phase Simplex PUMPContralrAlaml SyateTr.FhQ732 rocent Natlona!Eiactric code(N[ ?and the 0ccvpatioral Salcly and Health Act(0814A). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAN,r0: P.O.BOX'6347 �� la,i& 3,4Y 40?6t Pun R a.t1r;;1u!urerl:o! . j SHIP TO: 3r>as erne Run Aoa+? /� �r 0 l.outs4o,KY 402f 1.1961 Qeilit e d4 vs sehz..f IFUS PlJMP !D (5021 778-2131-I(siv)926-PUvp FAX(502)77 W4 Wisconsin'bepartment of Commerce SOIL AND SITE EVALUATION D10slon of Safety and Buildings Page / of, Bureau of Integrated Services in accordance with s. 1LHR 63.09, Wis. Adm. (.:cde Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County Include,but not limited to: vertical and horizontal reference point(BM),direction and percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel f.p. APPLICANT INFORMATION- Please print all information. A®vlev�ea �y' gate Personal infomTation you provide may be used jor secondary purposes{Privacy Law,s.15:04(t)(m)), Property qwner Property Location Govt.Lot SC VOS&,! 1/4.S:28' T,3 0 ,N,R 16 E(or,<9 Property Owner's Mailing Address Lot# Block# r ubd.Name or CSM# City State Zip Code Phone Number ❑ } Nearest R city Village. [� Town tur se©i4 0iS" )38'I-� 1 .230 S — Now Construction Use: ❑Residential/Number of bedrooms ,� _ Addition to existing buiiding ._ [] Replacement ❑Public or commercial-Describe: Code derived daily flow yS'o gpd Recommended design loading rate, , . :.,. -_bed,gpd/fe - ?- trench,gpd/92 Absorption area required i�7S� bed,ft2 3 _—trench,ft2 Maximum design loading rate_1' bed,gpd/1'12—Z7._trench,gpd/tt2 Recommended infiltration surface elevation(s)_�L�o' __ _ �it(as reterred to site plan benchmark) Additional design/site 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 for system ❑S v1 s El 91 ❑s u ❑s �'sl v ❑s Q-u ❑s C'ru SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles e:; Structure GPD/ft2 Texture afisistenca Boundary Roots in. Munseli Qu.Sz.Cont, Color Gr, Sz.5h. Bed , Trench Ground V 3/y Sr[ I PA ire�.�' 'zw � 12 '317syR3/ fly -&fs Sre �. Depth to limiting a for in. Remarks: °- Boring 12 31, P- tl-w3 Ground �091 a t Depth to limiting M f dor in. Remarks: Signature Telephone No. CST Name (Please Print) pate CST Number Address 777 14k S7- A2�r .i SSIo®( Sy s c z lY7 PROP RTY,uwNeR ____,_; SOIL DESCRIPTION REPORT Page Z of !_ .y' PAR1rEL I.D.# Boring# Horizon Depth Dominant Cotr Mottles Texture Structure Consistence Boundary Roots 2 in. Munse Qu.Sz.Cant Color Gr.Sz.Sh. Bed .Trer>ch 3 t MS// -- c4 IFA W ow& .3 Ground 3 to --- timiling , r n. Remarks: 8oring# . I Ground elev. Depth to it. lkw*v factor in. Remarks: Horizon Depth Dominant Color Mottles Structure In. Munseti Qu.Sz.Copt Color Texture Gr.Sz.Sh. Consistence Boundary Roots Bed Trench Boring# E3 Ground elev. !t. Depth to 11mitin8 factor in. Remarks: Boring# 13 Ground elev. h. Depth to limiting factor in. Remarks: SBD-8330(R.07/W) S' SEv`S SOT © mez IoF 7 ire Ave ` . P�" ion ' . 2' 99.6 Z. s �r i 1 J r SOIL DESCRIPTION REPORT PROPERTY OWNER Page Z�, ef�y�� PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 g Texture Consistence Boundary Roots in. Munsefl Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench ,SyrPs CL aw 2 ;3 Ground 3 S'a?(o ,-M3JY Z I v./ 2 ; ft jo �. Rely F1 Depth to limiting fagtor I olio in. i i Remarks: Boring# 13 Ground elev. ft. , Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/112 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench Boring# ; Ground elev. ft. Depth to limiting factor in' Remarks: Boring# E3 Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330(R.07/96) 1 wiscons=.n department of Commerce SOIL AND SITE EVALUATION Division of 9�afety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR 83.09,Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 xx 1hes in size. Plan must County c include,but not limited to: vertical and horizont*r64epc@ -t ,direction and B� percent slope,scale or dimensions,north arr k*ih 9i to a to nearest road. parcel I.D.# 2^ t pp APPLICANT INFORMATION- lam' a prir>fi► atl Reviewed by� Date Personal information you provide may be use for ondipi rposes(Privacy Law,'"5A4(1)(m)). �. Propertyawner Property Location 7 / /�+ �-A ST uNLY + Govt.Lot �� 1/4�&, 1/4,S.�$t T.3 ,N,R 10 E(or% Property Owner's Mailing Address ,7 6+ Zdtifl�90FIF)C i Lot# Block# Subd.Name or CSM# d /al Z_ City r State Zip Code e r ❑ City Village ❑ Town Nearest Ro bar Ej New Construction Use: ❑Residential/Number of bedrooms Addition to existing building ❑ Replacement ❑Public or commercial-Describe: Code derived daily flow yso gpd Recommended design loading rate ,� bed,gpd/ft2 -_Z trench,gpd/f12 Absorption area required 7S' bed,ft2 31X tren/ch,ft 2 Maximum design loading rate - bed,gpd/fl2_Z__7,trench,gpd/ft2 Recommended infiltration surface elevaion(s) ft(as referred to site plan benchmark) Additional design/site derati ns 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 for system I EIS ® U e1 s ❑ U ❑s ®.u I ❑s En-u I [--Is C-U ❑S 2YU SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench CZ Ir AP Ground Z fv-x 7'S,W V I/ .� SiL fA blici ctw f" 62 i ft 4-1 y _3j 7 SYR3/y F W-5-/4, s.c zM Depth to limiting fa or Remarks: Boring# , 1 0- ?1.3 W215711 c 9 Z ` 3. >3 s ccs8 aw ,2 Ground Is /c BPS 1& Q lom1 ft. Depth to limiting factor 01-2—_in. Remarks: CST Name (Please Print) �, Signature Telephone No. Address _ Date CST Number Z_ T SY'00 6 -o a ZzIy7l -7 +z- �e . ! I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 5 1 r oj: �)o Mailing Address Property Address _ a J U (Verification required from Planning Department for new construction)_ City/State G�.k� 6,T sYOO Z Parcel Identification Number LEGAL DESCRIPTION Property Location Sw -r/., Al 4) r/., Sec. -a T_,Jt)N-R_.L/_W, Town of zAlgyl Subdivision -- . Lot # Certified Survey Map # Volume . Page # Warranty Deed # &)-I I �;- , Volume 2- Page # 3 Spec house ❑ yes IF no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastcr plumber,journeyman plumber,restrictedplumber or a licensedpumper verifying that(1)the on-site wastewaterdisposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 full of sludge. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expirati n date. /�' / / QG SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I(we)certify that all statements on this form are true to the best of my (our) knowledge. I(we)am(are)the owner(s) of the property described above,b o_ f`warranty deed recorded in Register of Deeds Office. �> /-, /2l/ ov IGNATURE OF APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed d 1529PAGE533 • 627125 STATE BAR OF WISCONSIN FORM 2- 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTEER OF DEED This Deed,made between Dean J.Wink and Shelley A.Wink, RECEIVED FOR RECORD husband and wife, 07-27-2000 9:30 AM WARRANTY DEED EXEMPT # Grantor, and Steve Bouton CERT COPY FEE: COPY FEE: TRANSFER FEE: 60.00 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor,for a valuable consideration,conveys to Grantee the following described real estate in St.Croix County, State of Wisconsin(if more space is needed,please attach addendum): Recording Area SW1/4 NW1/4,Sec.28-T30N-R16W, St.Croix County,Wisconsin. Name anV urn Address �`� �.I!'�' :NA OGLA ND ZRZ, Es1_reerl & Oglan(I P-0- Box 359 Hudson, WI 54016 010-1068-70-000 Parcel Identification Number(PIN) This is not homestead property. (K) (is not) Exceptions to warranties: Easements,restrictions and rights-of-way of record,if any. Dated this 75-W day of July 2000 Voa./) I- I )') L�a_ * * Dean J.Wink * * elley A. It Wink AUTHENTICATION ACKNOWLEDGMENT Signature(s) Dean J.Wink and Shelley A.Wink,husband and STATE OF WISCONSIN ) wife, )ss. County ) authenticated this-day of July 2000 VZZAI? Personally came before me this day of the above named * Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s)who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson,WI 54016 My Commission is permanent.(If not,state expiration date: (Signatures may be authenticated or acknowledged.Both are not necessary.) f ) *Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals company,Fond du Lac,Wl STATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORM No.2-1999