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HomeMy WebLinkAbout038-1133-70-000 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT R OWNER ~~C///2OWNSHIP SECTION_,:&,'- T_~/ N-R--W ADDRESS /~d`~ / ST. CROIX COUNTY, WISCONSIN r-- SUBDIVISION -LOT ----LOT SIZE PLAN VIEW SHOW EV YTHING WI HIN 100 FEET OF SYSTEM 1( Q~ 1 1 6 r 16 7~ INDI TE NORTH ARROW BENCHMARK: Elevation and description: ` 1 Alternate benchmark G SEPTIC TANK:Manufacturer: Liquid Cap. d° ,]r'inal grade elev: .off LManhole cover elev:j~Gt (v Rings used:, Tank inlet elev.: Tank outlet elev.: .27 No. of feet from nearest road:Front , Side, Rear Ft.L / From nearest prop. line:Front Side , Rear__,,~_Ft. Gto ~r No. of feet from: Well //9 Building: //o (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE v Asa • t I J i PUMP CHAMBER 3 Manufacturer: /'lee .e 1(5 Liquid Capacity: Pump Model: d.e//-Pump/Siphon Manufact.: Pump Size Elevation of inlet: 9"5- ? Bottom of tank elevation 3 Pump on elev.: Pump off elev.: ~ lions/cycle: mom' Alarm: Man.: Switch Type: ~--z ft Location-/ Distance from nearest prop. line: Front_, Side_, Rear'XFt. ~m Distance from: Well Building //,;2 T SOIL ABSORPTION SYSTEM Bed: X Trench: Seepage Pit: Width: ~Length _ 4 ~ Number of Lines:,.2_Area Built s~ / Exist. Grade Elev.;ZZ-6-5' Proposed Final Grade Elev. Fill depth to top of pipe: go. feet from nearest prop. line:Front. Side , Rear Ft.~F No. feet from well: ,L/ No. feet from building HOLDING TANK / O 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: la ' / PLUMBER ON JOB: LICENSE NUMBER: 6/90.:cj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS ►LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 SEQ,SEQ,Sec.32,T31-'R18 DCONVENTIONAL ❑ALTERNATIV State Plan I.D. Number: ( Town of Star Prairie El Holding Tank ❑In-Ground Pressure 04ound 100th St. NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: IN PE TION DATE: 7 / / _ Z71---#T- Morris Constantineau 1804 100th St., New Richmond, WI o9 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: F. PT.' ELEVCST REF. PT. ELE Name of Plumber MPIMPRSW No. Cnun1Y_ Sanitary Permit Number: Byron Bird Jr. - 3318 St, Croix_ 149061 3.29 SEPTIC TANK/HOLDING TAN i MANUFACTURER LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLE _ WARNING LABEL LOCKING COVER ~l /J cep r7 PROVIDED / PROVIDED Val' LCY L~ i G L ~J ~%t b /,SI. a/ / DYES L`~INO DYES LJNO BEDDING. V.LA I pIA.: VENT MA11 H WATER NUMBER OF ROAD: PROPERTY WELL BUILDING. VENT TO FRESH CCJJ ALARM FEET FROM LINE i C1 ) AIR I DYES 1! NO 5 DYES NEAREST 4b (6 J 1 DOSING CHAMBER: o- r,St/ i-in . 24 6, CD I MANUFACTURER BEDDING. ILIOUR)CAPACITY POW, Mom I. PUMP. SlfF'*R7f11 MANUE ACTUHEH WAR RING LABEL LOCKING COVER r 7 lROVIDED PROVIDED: s EJ'YES ONO e? old T, -c r G7E 15_S DNO E~V_ES ❑NO GALLONS PER CYCLE: fuVIP ANDCONTR SOPERATIONAL NUMBER OF JIHOP ERVY WELL BUILDING V NTTOFRE H (DIFFERENCE BETWEEN FEET FROM LINE t~ IR INLET / PUMP ON AND OFF) YES ONO NEAREST 30 SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing I N(ii It IDIAMF TE H / MATE HIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until MAINE the soil is dry enough to continue.) 3 & CONVENTIONAL SYSTEM: W IOTH LENGTH NO. OF DISIH PIPE SPACiN(, COVER JINSIDE DIA -PITS LIQUID BED/TRENCH THENCHFS NIATEHIAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH Ulslli PIPE OISTH PIPE DISTR. PIPE MATERIAL NO OISTN PROPERTY WELL BUILDING VENT TO H BE LOW PI ABOVECOVER EI EV INti I ELEV ENO PIPES FEET FROM At JL.M T L NEAREST===:::±.j- a. ar OL5« / 03~V / ?.ds MOUND SYSTEM:' 3,/S o'r G7~ f/SA An6 Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTE and furrows thrown upslope: t mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. VES ONO _ SOIL COVER TEXTURE [1111111ANINI ANM~AHKEI'iis 7111VAIIIINVVELLS ~VLJ/V~ `4~4' S L Ft4 ES DNO EYES DNO DEPTH OVER TRENCH 771T H OVER TRENCH HE11 DEPTH OF TOPSOIL S(IDDF II SEE UFD MULCHED CENTER /t GES L7 Y ❑NO NO DYES. ID-N0 ES ❑ PRESSURIZED DISTRIBUTION SYSTEM: /r 7Z '6w/ ~ r = ff"' WIDTH LENGTH NO. OF LATERAL SPACING [HAVE L DEPTH HE LOW PIP( FILL DEPTH ABOVE COVER BED/TRENCH i 1 THENCHES / DIMENSIONS ~ (D~1 MANIFOLD PUMP MANIFOLD OISTR. PIPE MANIFOLD MATERIAL NO UISIH DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEV. ELEV~/ IA 'I ELEV. / PIPES DIA : n 5~r~ 7 %C DISTRIBUTION d d ,/)D• P INFORMATION.... HOLE SIZEAT HOLE SPACING DRILLED CORRECT L Y COVER MA TEHIA PVERTIICAL LIFT CORR~~% NDS~TO APPR I_?5'ES ❑NO DYES ~5~1J N NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: PERMANENT MARKERS: OBSERVATION WELL : / LINE: FEET F L7 /'~f(~ r.Z~ 39 ~/F LEES 0 YE5 ❑ NO NEAREST M ~IG®' ~~C(~ / ~7 f NO _ ~ " - ' F:~l ✓.5. ~o ' d~~~ , r,~ ~~~--mac Sketch System on et 'n in county file for audit. Reverse Side. SIGNAT RE: JTITLE. ')ILHR SBD 6710 (R. 01/82) C ~ DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code ~~Re STATE SANITARY PER # Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 8% x 11 inches in size. ceck rt p vious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. r 07 PROPERTY OWNER 1 PROPERTY LOCATION 402 y,,.-~ ~.Z "IS a Y. S T , N, R E (Or PROPER OWNER'S MA ING ADDRESS LOT # BLOCK # 0 0 CITY, TAT ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ~G dwv r III. TYPE OF BUILDING: (Check one) ❑ State Owned VILLLLAGE r cr NEARES T ROADO ❑ Public ~-1 or 2 Fam. Dwelling- # of bedroom PARCEL TA N -fit 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 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. %Replacement 3. ❑ Replacement of 4.E] 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 ~D ~ ! Feet Z 2Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STA EMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Cme (Print): t Plumber' ignature: (No Stamps 7/MPRSW No.: Business Phone Number: ddress (Street, City, to , Zip Code). Plum r 01 d tom / 4 e ov IX. CO NTY/D PARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (I crudes Groundwater a e Issued Issui g gent Signature (No Stamps) Surcharge Fee) Approved ❑ Owner Given Initial 15 j1AVA&L 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 / APPLICATION FOR SANITARY PERMIT 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 ,09 E Location of Property Section T N-R._I;F- W Township Mailing Address d 0' v S 7 _w % / 'Eva, d Address of Site = Subdivision Name Lot Number ~_1 f Previous Owner of Property Total Size of Parcel ~d,C_- 4-a 701~ZO .4uz5 ( /.35lFU Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume 311- and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume. and page number, and 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPFRTV OWNER CERTIFICATION I (We) ce4ti6y that att statements on thiz borcm cute tltue to the but ob my (oun) knowledge; that I (we) am (ane) the ownen(s) ob the pnopehty dan bed in .thi.6 inbonmation bonm, by viAtue ob a waxtanty deed %econded in the Obbice ob the County Reg.i step o6 Dees as Document No. and that I (We) pnu entt own the proposed s.cte bon the sewage d4Apos~ , • (on 1 (we) have obtained an easement, to nun w.cth the above dmchibed pnopenty, bon the consttuction ob said system, and the same has been duty neconded in the Obb.ice ob the County Register ob Deeds, as Document No. A 7~/ey/d ) IL . Y_0~ - j / , SIGNATURE OF OWNER SIGNATUkE OF CO-OWNER (IF APPLICABLE) D E SIGN D DATE SIGNED z rn r y STC - 105 r a • a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z r~ a ~j OWNER/BUYER ROUTE/BOX NUMBER ~(1 ~ d 0( Fire Number a .CITY/STATE ZIP PROPERTY LOCATION: .S~ SSe ion , T~N, R_ W, Town of ~ /,9 ~F}, 1 & , St. Croix County, Subdivision 0/4- , Lot" number.4-4-. I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- 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. - H E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- tid ment of Natural Resources. Certification form must be completed I ..a rotnrnarl to the St. Croix_County__Zoning Office within 30 days tNDOS DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS N •INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 76 N WI 53707 HUI~IIAN RELATIONS (ILHR 83.0911)& Chapter 145) LOCATION: SECTION: OWNSHIP MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: NI COUNTY: MAILING ADDRESS: Ur n c L. . r d~~<. L ~rn • Lim % 5r k/,- Pr) USE DATES OBSERVATIONS MADE - G" NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS]PERCOLATION TESTS: Residence 7 - ❑ New Replace © , RATING: S= Site suitable for system U= Site unsuitable for system i :k + 'r CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYST ❑ M:(optional) S [34U ~ S ❑uT E] S [Zu ❑ S ❑ S .emu If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Q Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- amw s/ a q - 3a ~n `syr d~ 91L -34? 241 ~5'0"P- B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P_ / QZ z~ l b P p_ Off- 71, P- P- P- a PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale is 1•l b are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation a al ngs and the di d percent of land slope. SYSTEM ELEVATION r < < V bo w a ~y T N o / p~a►^Gf r r p c~tc~c 6 J~ f giforec I, the undersigned, hereby certify that the soil tests reported on this fo were made by me i accord with the pr cedures 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: ADDRESS: * CERTIFICATION NUMBER: HONE NUMBER (optional): / CST SIGN URE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP 4"C.I. VENT PIPE f r7 WEATHER PROOF APPROVED LOCKING 7 JUNCTION BOX MANHOLE COVER 25' FROM DOOR, %N11 r" g i..4 WINDOW OR FRESH IMIIJ. AiF; INTAKE I GRADE y" MIN. 18" MII.I. COIJDUIT-- t8"MIN. atj i L ROVIDE INLET FRO ?AIRTIG$ jt- SEAL APPROVED JOINT A I I I APPROVED ,lO1NTS W/C.I. PIPE W/C.I. PIPE I III EXTENDING 3' EXTENDING 3' ALARM ONTO SOLID SOIL OIJTO SOLID SOIL B Ili ',Iu ' I . ON C I I ELEV. FT. E C02 fj-jF: t-'Oiv~EII' p OFF D CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCAPPROVAL 5PECIFICATIOUS c,.2 SEPTIC f DOSE TANKS MANUFACTURER: g- e '7~~--- ~JUMBE O DD/OSES: -PER DAy TANK SIZE: QO GALLONS D0SEME d3' ALARM MANUFACTURER: INCLUDING BACKFLOW: .14PO GALLONS ~ 3.1 CAPACITIES: A= 2-9 INCHES OR GALLONS MODEL NUMBER: _ Z,;19 c SWITCH TYPE: e g= INCHESOR GALLONS PUMP MANUFACTURER: j/ C, INCHES OR .1-2~ GALLONS MODEL NUMBER: D= - INCHES OR GALLONS SWITCH TYPE: m NOTE: PUMP AND ALARM ARE TO BE INSTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE PM VERTICAL DIFFEREKICE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET + MINIMUM NETWORK SUPPLY PRESS RE . . . . 2.5 FEET + j,'rOFEET OF FORCE MAIN X FYo,,FRICTION FACTOR.. 2.5 FEET S 91- 20 2 2 2 TOTAL DYNAMIC. HEAD = FEET INTERNAL DIMEMSIONS of TANK: LENGTH -~z-;WIDTH --~;LIQUID DEPTH F LICENSE "NUMBER: DATE: SIGNED: f Page - Of _ Perforated Pipe Detail End View )Perforated End Cop) \e i T PVC Pipe 1 a~~p0 ape o\s~a Holes Located On Bottom, S Are Equally Spaced S P PVC Force Main .7 P PVC Manifold Pipe Alternate Position Of Distribution Pipe Force Main Last Hole Should Be Next To End Cap End Cap ~ Distribution Pipe Layout P Ft. R S X Inches Y Inches Signed: Hole Diameter Inch Lateral Inch(es) License Number: Manifold Inches Date: Force Main Inches # of holes/pipe Invert Elevation of Laterals Ft. 1 Straw, Marsh Hay, Or • Synthetic Covering Distribution Pipe Medium Sand • G Topsoil F E ~S D 3 ~ . u % Slope Bed Of 2 - 2 %2 Force Main Plowed Aggregate From Pump Layer 1 1 :DNS D Cross,Section Of A Mound System Using A Bed For The-Absorption Area F = tic~; PONZ)EN vE G - ~ A 6 Ft. H -3 Signed: - - - - - - - - License Numb IL Ft. J Ft. Date: K ,(.!2 Ft. Alternate Position L Ft. of Force Main WFt. Observation Pipe " K 01 Force Main ~o 6 W !o --j--------------- From Purf - Distribution Bed Of 22 %2M Pipe Aggregate 1 Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area .9~ 891=20222 i, • 40 YLV 1 r LAN PROJECT i k #764t*6RESS r'P'-RS 1 /4 S_, ,1/a/S j?3T / N/RA%W TOWN rc~ COUNTY Byron Bird Jr. 318 D E BEDROOMa, CLASS PERC J.~ CON NTIO AL IN-GROU ESSURE CONVENTIONAL LIFT MOUND HOLDING TANK SEPTIC TANK SIZE IFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA ' ERC RATE BED SIZEa i L Benchmark V.R.P. Assume Elevation 100' Location of Benchmark -!!5 g Q 4 s * H.R.P. - doc-or C3 Borehole Q Well Scale = Feet 0 Perc Hole System Elevation ~J 9 I 0NEWITE vet"~ :uE SYSTEM S'v iVi Vi ~"lCtJO.nfr.~ SEE CGPPESPONDENCE ' Qb A, 1v fl I ~ `1 was ( 70 n~ c y.( S91-20222 7 y a- iPTPONAL WORKSHEET 13 /gg/ 6s 1. MOUND SYSTEM ~ IN GROUND PRESSURE SYSTEM-Continued- I 1. Wastewater Load, Total Daily Flow= _.140 gal. 10. Force Main: Use section d 63.15 (3) Wis. Minimum Dosing Rate = / g . Diameter = in Adm. Code anQ PROVIDE A DETAILED 71 LIST OF SIZING ON PLANS. I/ 11. Total Dynamic Head; = 2. Depth to Limiting Factor 0 ft. System Head 2.5 ft. = ft. 3. Landslope = % Vertical Lift = Friction Loss = ft. 4. Distance from Dose Chamber to ft. Distribution System = ft. TDH = 5. Elevation Difference Between 12. Pump Selection: Pump and Distribution System = ft. Pump will di harge at least a gPm 6. Absorption Area Sizing: at ft. total dynamic head. Area Required = `J sq. ft. Pump model anal manufacturer: Bed or Trench Length (B) _eZ- ft. ' Bed or Trench Width (A) ft. 13. Dose Volume: Trench Spacing (C) ft. 10 Times Void Volume of f;Z 7. Mound Height: Distribution Lines= gal. Fill Depth (D) = ft. Daily Wastewater Volume T Fill Depth Downslope (E) ft. 4 Doses In 24 hrs. Bed or Trench Depth (F) ____,L ft. Backflow = = Cap and Topsoil Depth (G) = ft. Minimum Dose gal. Cap and Topsoil Depth (H) = ft. 14. Dose Chamber: gal 8. Mound Length: Volume = • End Slope (K) _ ft. Total Mound Length (L) _ a ft. 111. CONVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: 1. Wastewater Load, Total Daily Flow = gal. Upslope Correction Factor = Use section H 63.15 (3) (c), Wis. Upslope Width (1) = ft. Adm. Code and PROVIDE DETAILED Downslope Correction Factor = LIST OF SIZING ON PLANS. Downslope Width (1) ft. 2. Required Septic Tank Capacity = gal. Total Mound Width (W) = ft. 3. Percolation Rate = min./in. 10. Basal Area: 4. Absorption Area Sizing: Infiltrative Capacity of • Refer to Table 2 in chapter H 63 Natural Soil = s aC gal./sq.ft./day and PROVIDE A DETAILED LIST OF Basal Area Required = -7 CIO sq. ft. SIZING ON PLANS. sq. Basal Area Available = Fsii--~~yfJJ-• sq. ft. Required Area = ft. ft. 11. If Standard Tables from Chapter Length = ft. H 63 are Used, Indicate Table No. Width ft. 12. For the Distribution Network, Use Numbers 5-14 in Section 11. Number of Trenches Trench Spacing = ft. 11. IN-GROUND PRESSURE SYSTEM A' 5. Distribution System: 1. Depth to Limiting Factor _ ft. Lateral Length = ft. 2. Landslope = _ a % Number of Laterals= 3. Percolation Rate = min./in. Lateral Spacing = in. 4. Proposed System Elevation = ft. Distance from Sidewall to Pipe = in. 5. Wastewater Load, Total Daily Flow: gal System Elevation = ft. Use section H 63.15 (3) (c), Wis. Adm. Code and PROVIDE A DETAILED IV. SYSTEM-IN-FILL LIST OF SIZING ON PLANS. '''J~~i/~~ Fill in All Items from Section III Required Septic Tank Capacity = L•) V gal. 6. Absorption Area Sizing: V. SEPTIC TANK Percolation Rate = min./in. 1. Capacity = gal. Area Required =1n~ sq. ft. 2. Manufacturer: " System Length _ 'A _L ft. 3. Show Site Constructed Tank Details on Plan System Width = - ft. 7. Distribution Pipe Sizing: VI. DOSING TANK gal. Hole Size = in. 1. Capacity = Ft. 2. Manufacturer: Hole Spacing = Lateral Length - it. ;1, Pump Manutadurer: Laleral Size 4. Pump Model: Lateral Spacing ° I'L 5. Operating Head= ft. Distance Ironn Sidew.dl•to Pipe in. 0. Flow Rate= gPm• 8. Distribution Pipe Discharge Rate: 7. Show Site Constructed Tank Details on Plans Number of Flules Per Pipe low Per Pipe:. gpnt. VII. HOLDING TANK 1. Capacity = gal. 9. Manifold Siring: rype (canter or end) C2itJ` 2. Manulacturer: Length = ft. 3. Show Site Constructed Tank Details on Plans Diameter in. -SHOW ALL INFORMATION ON PLANS- 20222 OILHR SBD•6761 (R.03/82) S'91 OPTIONAL, WORKSHEET j~ 1. MOUND SYSTEM I. IN GROUND PRESSURE 5YSTEM•Continued• : 1. Wastewater Load, Total Daily Flow= gal. 10. Force Main: a Use section H 63.15 (3) (c), Wis. Minimum Dosing RAW Adm. Code anQ PROVIDE A DETAILED Diameter LIST OF SIZING ON PLANS. 11. Total Dynamic Head: 2. Depth to Limiting Factor= ft. System Head = 2.S 6 + 3. Landslope = % Vertical Lift 4. Distance from Dose Chamber to Friction Loss = tt+ Distribution System = ft. TDH = ' 5. Elevation Difference Between 12. Pump Selection: I ' Pump and Distribution System = ft. Pu=W harp #t least vZ ~ 4pm 6. Absorption Area Sizing: at . foul dynamic head.. Area Required = . iL sq. ft. Pump model an manufuturer: .0-0 Bed or Trench Length (B) _ --1s ft. Bed or Trench Width (A) _ ft. 13. Dose Volume: Trench Spacing (C) ft. 10 Times Void Volume 06 7. Mound Height: Distribution Linesli C -.r ({il ) Fill Depth (D) = ft. Daily Wastewater Volume+ ~ r14 l Fill Depth Downslope (E) 4 Doses in 2 hrs. a Bed or Trench Depth (F) _ -~e ft. Backflow .-s> )lilt r i''.• Cap and Topsoil Depth (G) ft. Minimum Dose fall Cap and Topsoil Depth (H) = ft. 14. Dose Chamber: 8. Mound Length: Volume = ,1;12.. gal End Slope (K) _ ft. t; Total Mound Length (L) _ ....(L.tL ft. III. CONVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: 1. Wastewater Load, Total Daily flow; gal• r Upslope Correction Factor = Use section H 63.15 (3) (c), Wis. Upslope Width (j) = ft. Adm. Code and PROVIDE DETAILED Downslope Correction Factor = LIST OF SIZING ON PLANS. Downslope Width (1) _ ft. 2. Required Septic Tank Capacity gal. Total Mound Width (W) _ ft. 3. Percolation Rau 10. Basal Area: 4. Absorption Area Sizing: Infiltrative Capacity of Refer to Table 2 in chapter H 63 Natural Soil = j • gal./sq.ft./day, and PROVIDE A DETAILED LIST OF Basal Area Required = sq. ft. SIZING ON PLANS. Basal Area Available = sq. ft. Required Area = ft, 11. If Standard Tables from Chapter Length H 63 are Used, Indicate Table No. da Width 12. For the Distribution Network, Use Numbers 5=14 In Section 11. Number of Trenches Trench Spacing= fit 11. IN-GROUND PRESSURE SYSTEM 'r 5. Distribution System: 1. Depth to Limiting Factor ft. Lateral Length = fL 2. Landslope , % Number of Laterals= 3. Percolation Rate = min./in. Lateral Spacing = In.. 4. Proposed System Elevation = ft. Distance from Sidewall to Pipes In. ' 5. Wastewater Load, Total Daily Flow: gal. System Elevation ft. Use section H 63.15 (3) (c), Wis. Adm. Code and PROVIDE A DETAILED IV. SYSTEM-IN-FILL LIST OF SIZING ON PLANS. Fill in All Items from Section 111 Required Septic Tank Capacity 0 gal. 6. Absorption Area Sizing: V. SEPTIC TANK Percolation Rau = 7- min./in. 1. Capacity = gil• Area Required Z2;Fj2 sq. ft. 2. Manufacturer: System Length = f AIL ft. 3. Show Site Constructed Tank Details on Plan System Width = & . ft. 7. Distribution Pipe Sizing: VI. DOSING TANK Hole Size = in. 1. Capacity = gal. Hole Spacing = fl. 2. Manufacturer: Lateral Length It. 3. Pump Manulaclurer: LalerA Size in. 4. Pump Model: I..ttur.d Spacing S. Operating Head= ft. Uislance Iroro Sidowall•,U Pipe /..y in. 6. Flow Rate= # ' 8. Distribution PIIN: Discharge Rme: 7, Show Situ Constructod Tank Details on Plans Y Number of tlolos Per Pipe low Per Pipe Spnt, VII. HOLDING TANK 9. Manifold Suing: 1. Capacity = gal• y 'type (center or unit) - CBn l` 2. Manufacturer: Length = ft. 3. Show Situ Constructod Tank Detailson Platlli R+ Diameter = in. -SHOW ALL INFORMATION ON PLANS- x 2 0 2 2 2 DILHR SOD-6761 (R.03/82) HEAD /CAPACITY CURVE TDH W S91-20222 90 TOTAL OYMAMC 11EAa'CA►ACITT PGR m1M11TE ErnuEtn eta atyATttrtto 26 9ER1E• 51.51.59 h tO1.gf 1{! 199 5 't-- _ - EFFLUENT AND DEWATERING ►1 oAL c,A► ciAL cuu ciA~ W •1 i1 SEWAGE AND DEWATERING 10 51 >9 e1 s1 % 24 ` , a 19 u w •o eo ~ 29 • s? s9 We 56 •0 49 96 71 Sl SY i ( I 90 IS q 20 ODEt-'- L --i- -+---1- - w % 163 _ pock J• 5 ae ee M MODEL 165' TOTAL OYu►rco+c•rran►awwee we1woa am oett•►ilwa w•11a u/ m 1•e 999 =99 16 FT Oft _ ! ! s 109 too 1~0 no 000 ?2 95 1 j ! 1s 20 a St 143 14 20 • a. 123 79 >w. I i ao eo 11 12 ' 1S a L N MODEL s u~ : ^ . + + t so - tt 10 L..r. ! I Lock lhlvs 10 21 29 54 S' SJ t~ 1 9 MODELS g 137, 139 R ' _ _ M~ DEL j 6 OOE 204 MO EL % MODELS 2 53 57-T 1 M DE MO EL 59 97 207 -d it LITERS 80 160 240 320 400 480 5~0 FLOW PER MINUTE C gUREAI! 3M ON Mfhn Lww Aunbcams of . l Box 1047 ntu PO. QlZZlF,ff A9. ou (SQ2)~ Kentucky ~oQte ~ouwurr 'amwps 9,#z-.r /937 ' r ra,1 Approved God t~' , 4" C . I . Vent Pipe Minimum iI /Final Grade L._ f Approved Joint 18" Minimum f- e SPECIFICATIONS j f I - Manu acturer• Approved Joint Tank Size: w/ C.I. Pipe a ons Extending 3" NUMBER New Existing Onto Solid Soil NUMBER OF BEDROOMS: ,9zrz-- GALLONS PER DAY:-1Q 3" of Bedding Under Tank Owner's Name: Address: v o n Legal 'scription: r c ,utQ~ w, 0~7 Count tunicipal ty: Vw PLUMBER/DESIGNER Signature: License Number: Date: 891-20222 r Y Page Of Perforated Pipe Detail Perforated End Cap) PVC Pipe gas 2 Holes Located On Bottom, S Are Equally Spaced A P \\\`~-t PVC Force Main .7 Q PVC Manifold Pipe Distribution Alternate Position Of Pipe Force Main Last Hole Should Be Next To End Cap End Cap Distribution Pipe Layout P C Ft. R S X T eat Ys Hole Diameter Inch Signed: Lateral _ Inch(es) License Numbe Manifold " a2 Inches Date: Force Main_ Inches # of holes/pipe Invert Elevation of Laterals-./O/.,,;Ft. 891m20222 SAFETY & BUILDINGS DIVISION Tommy G. Thompson _ Governor Gerald Whitburn Secretary State of Wisconsin Department of Industry, Labor and Human Relations May 21, 1991 209 West First Street P.O. Box 754 Hayward, Wisconsin 54843 BYRON BIRD, JR. Owner: MORRIS CONSTANTINEAU. ROUTE 4 BOX 6 1804 - 100TH STREET AMERY WI 54001 NEW RICHMOND WI 54017 RE: Plan Number S91-20222 Project: CONSTANTINEAU, MORRIS - RES. County: ST CROIX Location: SE,SE,32,31,18W Fee Received: 80.00 STAR PRAIRIE Date Received: 5/15/91 This letter is to acknowledge receipt of the Plumbing Plans which you submitted to the Office of Division Codes and Application, Section of Private Sewage. We cannot however, process your submittal until we receive: - A corrected copy of the county onsite with the correct legal description. Please retain one copy of this letter for reference and return the other with the materials requested. Your Plans will be processed within 15 days by the Section of Private Sewage following receipt of the requested items. Petitions or plans submitted to this office which require additional information will be held 90 working days for receipt of the information. If, after 90 days, response to this letter has not been received, your plans will be returned. If you find it necessary to contact us regarding your submittal, please call us at (715) 634-4804 and refer to the plan number as shown above. Sincerely, e~ JOE MCGAVER Section of Private Sewage Division of Safety and Buildings cc: MORRIS CONSTANTINEAU X Private Sewage Consultant SBD-14231 R. 07/90i r I SAFETY & BUILDINGS DIVISION Tommy G. Thompson Governor Gerald Whitburd Secretary V State of Wisconsin Department of Industry, Labor and Human Relations May 21, 1991 209 West First Street P.O. Box 754 Hayward, Wisconsin 54843 BYRON BIRD, JR. Owner: MORRIS CONSTANTINEAU ROUTE 4 BOX 6 1804 - TOOTH STREET AMERY WI 54001 NEW RICHMOND WI 54017 RE: Plan Number SQI-20222 Project: CONSTANTINEAU, MORRIS - RES. County: ST CROIX Location: SE,SE,32,31,18W Fee Received: 80.00 STAR PRAIRIE Date Received: 5/15/91 This letter is to acknowledge receipt of the Plumbing Plans which you submitted to the Office of Division Codes and Application, Section of Private Sewage. We cannot however, process your submittal until we receive: - A corrected copy of the county onsite with the correct legal description. Please retain one copy of this letter for reference and return the other with the materials requested. Your Plans will be processed within 15 days by the Section of Private Sewage following receipt of the requested items. Petitions or plans submitted to this office which require additional information will be held 90 working days for receipt of the information. If, after 90 days, response to this letter has not been received, your plans will be returned. If you find it necessary to contact us regarding your submittal, please call us at (715) 634-4804 and refer to the plan number as shown above. Sincerely, JOE MCGAVER Section of Private Sewage Division of Safety and Buildings cc: MORRIS CONSTANTINEAU X Private Sewage Consultant I { 4?.: SBD-6423 4 R. 071801 k ST. CROIX COUNTY WISCONSIN " n f'' yy ZONING OFFICE 333 ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 May 20, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Morris Constanteneau property, located in the SE 1/4 of the SE 1/4 of Section 32, T31N-R18W, Town of Star Prairie, St. Croix County, revealed suitable soils at a depth of 30" requiring 12 " of sand fill for a mound. Should you have any questions, please feel free to contact this office. Sinc ely, James K. ompson Assis nt Zoning Administrator cj ~t. ST. CROIX COUNTY WISCONSIN YtT s h!^+~Y ZONING OFFICE ST. CROIX COUNTY COURTHOUSE - 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 May 13, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Morris Constanteneau property, located at the SE 1/4 of the SW 1/4 of Section 32, T31N-R18W, Town of Star Prairie, St. Croix county, revealed 30 inches of suitable soils requiring 12 inches of sand fill for a mound system. Should you have any questions, please feel free to contact this office. Sincerely, James K. Th on Assistant Zoning Administrator cj DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON WI 3707 HUMAN RELATIONS (ILHR 83.0911)& Chapter 145) LOCATION: SECTION: u OWNSHIP UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: s ~ J& t\ ( I y r COUNTY: JMAILING ADDRESS: USE DATES OBSERVATIONS MADE - v1 NO. BEDRMS.: ICOMMER IAL DESCRIPTION: PR IONS: - rt:HCOLATION TESTS: Residence ❑New Replace zz- 2z -//,;7 Jc RATING: S= Site suitable for system U= Site unsuitable for system ~l XCi r~ •r' G't1. CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: TIS TEM-IN-FILLHOLDING TANK: RECOMMENDED SYST M:(optional) os s❑u osIZU EA I ❑sZU F rcolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the r s. ILHR 83.09(5)(b), indicate: 0. I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. I HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B o--/a!6 / 5//.-z S a &I -r- 30 46-7 / 2 f~r-rc 40 .9, yon spa B- SS~3/mod- -2 y 135 y -y,S/8» /s'Y' ys1 y~o B- '0 rno Ad4 B- B- B- ~11(_ PERCOLATION TESTS ES TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD ~e re: P_ v a b' P- P- P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scal st e . cribe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevatio a '$I I hp, 'rection and percent. of land slope. aY SYSTEM ELEVATION - I lun) - 4 . L/ I t ~a , 17 i /,-4 , 75 ' i 4v W i r 1 41 e- 0 6 41 J~A. f y I, the undersigned, hereby certify that the soil tests reported on this foi were made by me i accord wit the pfdcedures 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: ADDRESS: CERTIFICATION NUMBER: JPHONE NUMBER (optional): 71 e o CST SIGN URE: a DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 0 0 W m A O H U M O O E-4 to M O U a .-i cs ~ ti o to .1 U W -4 M N .--I a 00 m O N vn co .1 to -4 m F o E-+ U o a ao 7t W A N z E-+ H m o z ~ ~ o z z w w rn ~ o O ~ ~ ao H U E-4 Ey E-4 E~ M C, U U to z z z z a w ti a a o o F E~ E~ U U va ~ a M M 0 N 10 O i E S 40 S A G E ST. CROIX COUNTY OOURTHaTSE 911 Fourth Street Hudson, WI 54016 DATE To TO_ Date ~1 Timms L7 Q ~zJ P FT of cju'r Phone T Are' CLEP/ ICNED Number CALLED 1.0 SE PL Extensio WANT E yaU EASE Cq n knit******* S Ta SEE y~V WlLL CALL LC RETURNED URGENT gGAtN 3IVED, M~SSa9e o yDUR CALL > /s.. Operator n~ x reord, 2 00 RECYCLE PAPER ~ C,'~4D~.7 f,V4PS: ~e'D4E4'~ GO4D4'J G04D,0'a G~JPtTa G'QAD4, GO4C~~ G~OD4, G~40~J G~494~ ST. CROIX COUNTY y WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 r (715) 386-4680 May 20, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Morris Constanteneau property, located in the SE 1/4 of the SE 1/4 of Section 32, T31N-R18W, Town of Star Prairie, St. Croix County, revealed suitable soils at a depth of 30" requiring 12" of sand fill for a mound. Should you have any questions, please feel free to contact this office. Sinc ely, James K. omPson ` m,Q.... Assis nt Zoning Administrator cj