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HomeMy WebLinkAbout002-1010-60-000 1 a o o ~ I I ~ ~ y I c 0 I e I °o I N o I ~ I I I I ~ N I T ayi I o z U. co O_ ' C U R O v a I O Cl) oO E Z d a~i a m N I o I ozd' ~ I N z :!t z E a a> I I~I c • N I' a~ I ~i c O 2 Z Z I N z m N E y R I C .7, O O i La d N O Nooa ~ d~ z °o IL al 0 00 z a ~y c o o o N a N J U ~'I v rn rn } CO a 5; C, CD w E ~ I Q o o a L ml c a o m N Q rn 2 04 N m ¢zin co ~1 R ^i _ y N 1V ~ O O { N C L O O R r- C14 LO O fn (D C N U a 00 00 V O O cD O C E C m Lo C cc) M CD I- co yr F~ N '30 N co - ~ C N r, N co of O E R V • O O m Q O z z Cn 1cO ~ ,iCi V C~ a I v~ d C a oat a a • CL m .2 d E = c r, r A tia~ ';oinc~ 02108/2006 02:07 PM Parcel 002-1010-60-000 PAGE 1 OF 1 Alt. Parcel M 05.29.16.75A 002 - TOWN OF BALDWIN Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BOLDT, GARY A & CHERYL R GARY A & CHERYL R BOLDT 1113 220TH ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1113 220TH ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 6.610 Plat: N/A-NOT AVAILABLE SEC 5 T29N R1 6W SW SW LOT 1 OF CSM 2/363 Block/Condo Bldg: TOWN BALDWIN Tract(s): (Sec-Twn-Rng 401/4 1601/4) 05-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 09/17/1999 610511 1457/097 WD 07/23/1997 959/465 07/23/1997 871/258 07/23/1997 869/582 2005 SUMMARY Bill Fair Market Value: Assessed with: 86632 164,300 Valuations: Last Changed: 06/05/2000 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.610 13,700 91,800 105,500 NO Totals for 2005: General Property 6.610 13,700 91,800 105,500 Woodland 0.000 0 0 Totals for 2004: General Property 6.610 13,700 91,800 105,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 510 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 45.00 Special Assessments Special Charges Delinquent Charges 0.00 0.00 Total 45.00 _ ± f L,~ -e~-4 ) ~4? d~ DBPARTMWT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION ADISON 53 07c State Plan I.D. Number: SSW 4,S~1 ,~.5,T29-Rl6 (If assigned) Town of Baldwin El CONVENTIONAL ❑ ALTERATIVE ❑ Holding Tank El In-Ground Pressure Mound 110th Ave, NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Stan Anderson 11113 220th St. Baldwin WI 54002 n o - BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST RE T. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:/ Joe Stang 6646 St. ix 128758 SEPTIC TANK/ i 9_ ANK OU T V.: WARNING LABEL LOCKING COVE MANUFACTURER: LIQUID CAPACITY: TANK INLE E ISE n ~I / PROVIDED: PROVIDED: ~ r00 Sir✓ o?, 07 • Q YES ❑ NO F-1 YES 56 NO BEDDING: V dT DIA.: V-QW MATL.: HIGH WATE NUMBER OF ROAD: PROP v! WEL BUILDING: VENT T FRESH ~%.O, C~..~. ALARM: FEET FROM ~ N / AIR INLET: ~ NO CL[$ DYES NO NEAREST 56 DYES Al 43',2& erg' "SLocfC - t~ RX DOSING CHAMBER: - J r h Crvrrre,✓ %n& / 03 MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPMCI-MANUF G LA EL LOCKING COVER 7ED P ROVIDED: YES NO Q S ❑ NO YES ❑ NO GALLONS PER CYCLE: FUMPANDCONTRO S OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDI G: VENT TO FRESH : ► (DIFFERENCE BETWEEN ~w FEET FROM LINE f AIR INL T: PUMP ON AND OFF 0 ❑ NO NEAREST ~lSd >50 -.0 D SOIL ABSORPTION SYSTEM. Check the s II 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 4( the soil is dry enough to continue.) Soft CONVENTIONAL SYST BED/TRENCH _ LENGTH: NO. OF E SPACING: COVER INSIDE Dix: # PITS: LIQ-7 U TRENCHES: MATERIAL: PIT D H: DIMENSI GRAVE EPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DIS MBER OF PROPERTY WELL: BUILDING: NT TO FRESH BELO PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FE LINE: AIR INLET: NEAREST M UND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slopgg and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL C VER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; 6 YES ❑ NO Eff S ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH BED ~DEPTTHSOF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: to Z„ t. & ❑ YES L.d O ES ❑ NO DYES ❑ NO oFPRESSURIZED DISTRIBUTION SYSTE of = d / P BED/TRENCH WIDTH: LENGTH: O.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: I RENCHES: DIMENSIONS S S LID MANIFOLD PUMP O MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: I ELEV.: ELEV.: / DIA.: II ELEV.: PIPES: DIA.: I)I ELEVATION AND /CZ, 73 Z A 2- --sr-L o pv(✓ DISTRIBUTION HOLE SIZE: HO E SPACING: DRILLED CORRECTLY: (D COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION AP D PLANS Tp,39 /f A-V L?5'ES ❑ NO CL/ 3 ❑ YES 1~1115 1.2.4e ENTS:fIs PERMANENT MARKERS: OBSERVATION W LS: NUMBER OF ROPERTY WELL: BUILDING: FEET FROM LIN / s II~ EjIES ❑ NO ES ❑ NO EAR T~f~. • Q, . 4 u uss L c o(_ of .1 / +o-p OT W ei , p . ® v)Ce X1-.46 P? T 3, / /1?o n Ce Ct1 'r i,'aAfe -t af &CU4&,C 7-b 00 Sketch System on etain in county file for audit. Reverse Side. SIGN URE: TITLE: SBD-6710 (R. 06/88) Form S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER J 4 07 ~~)O'~°rSG~'1 TOWNSHIP ae l ~4/~•`t SEC. 5^ T N-R!~ (O W ADDRESS ST. CROIX COUNTY, WISCONSIN t s SUBDIVISION ('l LOT 1 /4" LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•IHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1 4 1-ia k S 4/le// I ~ i INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used f3o 7`t-- Elevation of vertical reference point: jo Proposed slope at site: SEPTIC TANK: Manufacturer: Ci k/ GS"Cer-Liquid Capacity: d do Number of rings used: IV_ Tank manhole cover elevation: Tank Inlet Elevation: S^ Tank Outlet Elevation: q i , gd Number of feet from nearest Road: Front, Side,ORear, 0 feet .From nearest property line Front 10Side,(Dlear,O ~(J feet r Number of feet from: well / 20 , building: / 9 / (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: m Id ye S4(:'"ON Liquid Capacity: S V ► Pump Model: n/ Pump/Siphon Manufacturer: Gc //C Pump Size 1/Z Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: 91,44 Gallons per cycle: Alarm Manufacturer: -51 f~ L tGC-t T n Alarm Switch Type: Number of feet from nearest property line: Front, 'S`ide, ORear, Ft.) Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Lenith: S~ Number of Lines: Area Built Fill depth to top of pipe: Number of feet from nearest property line: Front, 01S ide, O Rear, Opt. Number of feet from well: q 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 box0 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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: 3/84:mj x {may SANITARY PERMIT APPLICATION u 0~HR In accord with ILHR 83.05, Wis. Adm. Code CouN . e.. o..... e. STATE SANITARY PERMI # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑'tA e 8% x 11 inches in size. k if v; to vious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. Q PROPERTY OWNER PROPERTY LOCATION tQ P1 14 S %4 '/4, S T , N, R 1(Q E (or) W PROPERTY OWNER'S MAILIINJJ DDRESS LOT BLOCKAl 11 V , 4- CITY, , STATE ZIP CODE PHONE NUMBER SUBDIVI ION NAME OR CSM NUMBER ~341~wi"~lvG IS' -353 N/ 4- , 1O Rr 4 II. TYPE OF BUILDING: (Check one) El State Owned VILLAGE g4 lw r. NEARES1 ❑ Public 1 or 2 Fam. Dwelling- # of bedrooms3 AR TAX NUMBER(S) Ill. BUILDING USE: (If building type is public, check all that apply) 4 ®D on 1~ j0 40 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 80 Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Off ice/Factory 13 ❑ Other: Specify` IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 0 New 2. X Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.E] 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 300 Specify Type 41 ❑ Holding Tank 12 El Seepage Trench 22 LJ 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 L` s U 3 7 S 7 S~ 1, Z 3 p 7 17, Feet )l 4~ . t-10 Feet CAPACITY VII. TANK Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION Manufacturer's Name Con- Steel Plastic New lExisting Gallons Tanks Concrete structed glass App' I Tank Tanks I Gov s fc.~eh Septic Tank or Holdin Tank GOO" d W S Lift Pump Tank/Si hon Chamber 7 S'7~ Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumb 's Signature: ( tamps) AAPIMPRSW No.: Business Phone Number: o E. St 4 n O-C G G l S- L 1~ .2G G Plumber's Address (Street, Ci State, Zip Code 10'e k/oo AL/ IX. C NTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued =nggentnature (No Sta s Approved F-1 Owner Given Initial Surcharge Fee) ~ ac Adverse Determination pt) X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS .r : +l 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to :3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the " State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'/z x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences, friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - - - - - - - - - - - - - - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigadoris and establishment of standards. SBD-6398 (R.11/88) c 41 a . 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 p3rmit Issuance. -Should thin development be Intended Lot resale by owner/conttactot,(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 Eyt n 19n d e 2 SO ✓1 - Sw 1/1 9w 1/40 Section T__1_V_R-L_V Location of property Township Sq 1-1 IS Mallln address g w~ Address of site s/,)I- Q _ lubdivislon name CJ14 Lot number (4 Ptavlous owner of property 1s c n C 4 0?GS M A C Total also of parcel„_,_,_. Date paccal was created Are all cornets and lot lines Identifiable? ~,_Yes 0 Is this pcopetty being developed for resale tepee house)? an Yalu" and Page Number as recorded with the Register of Deeds. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INCLUDE WITH THIS APPLICATION THE FOLLOWINGi A WARRANTY DEED which Includes a DOCUMENT NUMBER, VOLUME AND PADS NVMaER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a cettlfiad survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description teferencas to a Ceitilled Survey Nap, the Csttlfled4Survey Map shall also be required. - PROPERTY OWNER CERTIFICATION I(we) certify that`all statements on this form are true to the best of my (our) knowledge; that I (we) am (ate) the owner(s) of the property described In this Information form, by virtue of a warranty deed recorded In the Office of the County Registet of Deeds as Document No. LLB f(k4l 36 ; and that I (we) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to tun with the above described property, for the construction of sold system, and the same has been duly recorded in the office of • count Re lstet of Deeds, as Document No. 1-15 • natut of owner Signature of Co-owner (If Applicable) =T-R 3 7- 9o Date of Signature Date of Signature 114 7' w ` x:41 a N._ Doman, f a 6ti ~F nge aissou ' o wrari................ N{ --•4S' t~.:» .4~ . 8 ~caatnq►a and warrants to StarileX_ ` r ldfiY..M.- lUidsrson,~ 1t. lrols9 as- -survvorsp•_"X _ r : , - Mr i4s" g described real estate in ..._..$x,...!CraiZ_ Cam„ Ten Prjiw W..'' - Ptrt> Vf Southwest Quarter. of tthw"t,. o toc, 41 4-g. *f AO--on Five (5), 'Towp414V` t j Z 1 i i 110 Lot $dn (16) Nest, disc=bl f{ L Qor!"',e 1 v ~ #f rd Survey Map fileQ.Me+} 2; 1971, in 'Volusw _Ihv: ; paQ+ 363. . i a homestead property. vy 4 ExcqWon to 'r'"tea` EasenRnts and restrictions of record. t _Y is 111241d this dap otr__..... Y • . (SEAL)-A..a4M`7~?1 . Glenda N. Boslga Ki' . . . , - ........(SEAL) 9 e Y 4 i ? AUTBaNTICATION AC=NORLTIO.61[N111t' 8ignature(a) STATE OF WISCONSIN tai . Grp X........ CVA3kV. authenticated this day of 19 Personally came before no . Kay•-....... ' Glenda- _ N.:•Bosnan, t•~h[ 9 • -Mr- Kooinan • . m . ; TITLE: MEMBER STATE BAR OF WISCONSIN r authorized by § 706.06. Wis. States.) to me krrovrn to be the i t peraw fo THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack ( . . . Baldwin, WT 5400 N APP Nie (Signatures may be authenticated or aeknovdedge~;^ wk; V * is Mrma are not necessary.)Y Aaee; y T.; *Namas of Dersons Riming In Soy eapatitV. shmid biv'uv q f t `~nlm. th'ir aQnah'I" QARMANTT DEED 4 e ar W<sm" > _ AN& N SEPTIC TANK MAINTENANCE AGREEMENT a St. Croix County ~ a OWNER/BUYER StG' v2' a h de. ?S~vt w O p ROUTE/BOX NUMBER 3' Fire. Number J I~ CITY/ STATE w (.r/~' S ZIP PROPERTY LOCATION:'_', Si✓ Section St. Croix County, Town of GA /w SubdivisioLot number ry 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 if needed, by a licen's'ed' 's'ept'ic tank pumper. What you put into the system can al ect the-function of the-septic-tank as a treat- ment-stage in the waste disposal system. St. Croix County residents-may £breplacement elto£racfailinggsystem~ a maximum of 60% of the cost o wh c 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 's' s~tem_s agree to keep their system properly maintained. The property owner agrees to submit to St.. Croix County Zoning a certification form, signed by the owner and by a mater 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. y I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, asset by the Wisconsin Depart- went of Natural Resources. Certification form must be completed v and returned to the St. Croix County Zoning Office within 30 days of the three year expiration.date.j I> SIGNED G~ ~ DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. DEPA TMENLOF KLKVK I ON WIL UUKI14bb AIIIJ DIVISIL►I INDUS RY, P.O. BOX L,AB,OI AND PERCOLATION TESTS (115) MADISON WI fi190t HUMA RELATIONS , 3J (ILHR 83.0911) & Chapter 145) A L AT ON: SECTION: TOWNSHIP/ OT NO.:8LK. NO.: SUBDIVISION 6(WAA S /T~9N/R/(E1o►W 3hL_°``',^' _ COUNTY: MAILIN ADDR S: sr C 40 /if 4 r14-wP,+ ;30 SA4, -V _ R + 1 3 h c w.'-4J , wI; USE -2 3 _ - DATES OBSERVATIONS MADE NO. BEDR : COMMERCIAL O RI TION:~ jaFILE DESCRIFTIONS: FER~NIF~T Res once 3 ❑New Replace ~/'17R44 90 410Al 9' /G~rO SAS d5 :5,- 5 Sy FREE=oo S i L r I- FIATIN : S= Site suitable for system U- Site unsuit le for system ONVE 1 NAt_: MOUND: - IN-GROUNO-PRESSU)RE. SYSTEM-IN•FILL OLDING TANK RECOMMENDED SYSTEM:loptional) El ©U Ea S Oil ❑ S ©U 0 S ®U 0 S ©U o n o sy5-rel--4 o,Ij If Pa lation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s ILHR 83.09151(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS =-v b we- tAh 4+. BOR1631 TOTAL P H T R U DWATER•INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND E`EN [if NUMBE DEPTH IN, ELEVATION OBSERV D TO BEDROCK -IF OBSERVED (SEE ABBRV. ON BACK.) r 83 B~-sy Cev'l3t.y 1, r.S~ .G)' Li.Q3j Sy Blo( t-y B- ,3,0 l ) S' L-4 9,a'$y Sty 1"0' Qfocky rN-j SI - 3,0 ' u f: y CEN SE R~tt- ~N . s 1 w/ ) . B- d1 s 0 Q - t,-Y Mors B-Z -5,0, [3 'K- IvhH r. S. '15' PL'+ry I?. JI'j-Sy, 51 /f uE,j st 5 y, ,.j . D ' oe. 0.N 51 w/ , d r s r. r~ -wt . tt~e- S y N o rs B- Dr QN ~0A"A T`S Gl. Rloc/ry '5Y A 33 10~,1,_.G4 -y-~N• 31otkq fI' . ,33'L,(/3,.,:. B- yr(~, fe01' .2r0 _1 5y. A/a ele y fill 2L. U ' R-A- It a eleA.k-g-e- B w~_. 1 s 1' 6 T' . o R- 6y . MD f S PERCOLATION TESTS DEPTH WATER IN HOLE TEST TIME DROP 1 WATER LEVEL-INCHES RATE MINUI FS - NUMB R INCHES AFTER SWELLING INTERVAL-MIN. p€c i n i___ PERt o PER INCH 30 P. 2- P- -1 - - - PLOT PLAN- Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what afa the h.)i :ontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and rercrri of land lope. T vo SYSTEM ELEVATION i I - 5E E L_OT Lrl~.~ 'k 0 E P- 6: I I I ; i I, the ndersigned, hereby certify that the soil tests reported no tars form were made by me in accord with the procedures and methods specified in the Wisror-ii~ AdminYistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print H&RffSEPTIC PLUMBING CO. - - ' TESTS WERE COMPLETED ON: - 655 O'NEIL RD., HUDSON, WIS. 54016 f) P Q l l_ 9 - g d -----AOBERT ULBRIGHT _ ADDR SS: CERTIFICATION NUMBER: PHONE NUMB ERfortional WIS. MASTER PLUMBER LIC. NO. 3307 M-PA.S. 2- y p Z 13,10G - 141 .S_- MINN- WTALLER A DESIGNER LIC. NO. 00663 - - - - CST SIGNATURE: ~ DISTRIBUTION: Original and one copy to Local Authority, Property Owner an,l Soil Tester. l _I . B3 3-9 /.P 3 W J 98 ,~31 13i Pv 3 f3tDRH 30 _ 30 3 Z - so - zP ` I f I(i5 r-1W ~ SYST joPT~~ T I VEIpTI«L Re F, PT i S 13 6 Tro.11 1 OwE 5 1_. P~z of S LA TE- 5,' 0 1',0 G- Ar N .Cca copoe n o F I t-~p ~t E ~ 61avwrLO-J ° /00.0 1 i ~ Ex• sn~G well HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., HUDSON, WIS. 54016 ROBERT ULBRIGHT C s i -ri Z Y,f'1 i i WM. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. MINN, PISTALLER A DESIGNER LIC. NO. 00663 -c,4IE: 30 PLOT PLAN t~ State of Wisconsin ` Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION Western Regional Office 2226 Rose Street LaCrosse, Wisconsin 54603 WEGERER SOIL TESTING & DESIGN Owner: STAN ANDERSON P.O. BOX 74 1160 10TH AVENUE RIVER FALLS, WI 54022 BALDWIN, WI 54002 I~ RE: Plan Number: S90-40276 Date Approved: June 12, 1990 Gallons Per Day: 450 Date Received: June 11, 1990 Project Name: ANDERSON, STAN - RESIDENCE Location: SW,SW,5,29,16W Town of BALDWIN County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sincerely, GERARD M. SWIM Section of Private Sewage Division of Safety and Buildings 4PP039/0009n/20 cc: STAN ANDERSON X Private Sewage Consultant SBD-6423 (R. 08/88) • Page 1 of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE 22~/YOF THE SW I/Y OF SECTION S , T Zq N, R1- W, TOWN OF L p" I r.3 , sT: C_!Cz-_z 1X COUNTY, WISCONSIN . INDEX PAGE 1 of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR \ \ b O 1 O `t)t tl\v t.. ~f~L~WlI~wl wf 3Z f' 6 S9® PREPARED BY 't,001111118%, e yes WF -CDEFcEFC SC) X a TEST I h!G p+ t AND tW ERER nES X C3 I`+.e ERk..p I ~E 0 D-915P 6LLSWORTH, s WAS. S 0 P P.O. p•E4k 74 421 N. MAIN 5T. fit. GIVER ELLS, Wl 54022 ES I G14 715-425-0165 %N•eese Job # 90 100 PLOT PLAN page Z of Scale 1"=Y01 Z, U N 13-1 C 8.3 IJ° ~ C1 ti t J At J ;LLI ~s/ ~tZ•c6 1`~fliN ~ ~ ~ SY gT EM t-~~se 3 E gON AG V7 y s,~:, ~Ng1T Z ~ G L-'"Xt S17a G Z-rrv ~ - ' " ~ U FAA~REIA~IONS To BE A-3t~►.~ooN ~ A R 0 is3US~p L►;60R A tS P ~l ~ w. R N OEFA tfl. A SEE ~~f~tS I. r J r O Q ~ ouT'1~1.1 NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( 2 required) 3. Install 4" observation pipes with approved caps. ( z. required) 4. Septic tank to be 1z!~0 o gallon capacity manufactured by ~ ~ pw s`~~ ~R.~ ~ n sr 5. Bench Mark ~L~ app o' o~v ~orfi~►~1 O~ S~D1~G HT +VO~ZT}lw~ ST cAR1u ei~ W: H~~sa 6. Divert surface water around mound to prevent ponding at the uphill side. SHOP uNCOwiPAC.l S~~w OR hARSN li" iSTFLI$U-nllil PIPE oR t'CpPR~U~.O S`-tFJTHETIC COVERItJG i poi G->= i.~~ I APPl2o-~J2A f~ED1aH SftrvD N G loPSo~~ o y BEU ~L. ~GI .9~ Z °/p SLOPE L. pV C FORCE . L~ A 1_t.2_ _ TAEy CL~: of ~/z 2~~Z~~!'i~R~~ATa E-fzo'YI i~I~M P 6`' $EWW PIPE - 2" OVER P+ P6 n t, E \ 1 FT. .~~M C.C~ASS S`~CT1O5 FT. II NG,E CJ`(S N t.S -T. \~E S L1 4 O GPD/L1~.FT'• A 5 F~. p }3 __)S VT. ~)MPN PT LP~,pR P~ S~~L ~NGS• 3 `d FT- OF ~N~ P4 K ) O FT pC°~`R p~ R~~ \~h NC L 9 S r_T• 87' ~ t AR \c ER pJC ~1S'T'Z.lec~TfotJ P1pE VC 0 W s TAT OP OS1TL cSBSERVATvoN PIPE ~F1+'-~~-HOt~ PIPE SECI~R~-Y~ S K aG~~E~ATe ~ - L - pL:t4N V \ ~.yJ PER-FORATl=~ Al PE-_De-AlL PEP.FOR.ATE~ _ E-PUC PIPE E1sD C,PYD ~~s °-~~STA~.~. {~CtZHANE7.~T HRR\tb""R AT EQZ) OF X11 CH L)ITL'ti2AL ~+D CAP. Q No, ES LOC-ATLM OlZ Z07-TOM of + - _ Pl.nE R+.~D IkR.E E"'q~~1AL1.Y SPAC,~a , t 4--FORCE H 1~ 1 IJ Svc LATER,At5 ~B-s(tl~S P,T CJv ly~wcp Pi NC E LltST MOLE ~?ExT Tb Eub CAP 4 ZJ~S~2.\$t~T101~1 PIPE LA4DUT - _ ~ I i AGE SY ~~M P. 36-Z F-T. 6 ~NSiTE EEW x co~~~~ a Z 9 0 Y \ R pNU t RE~Ai►OWg ALE toiAnETC-x~ ~ r~ . S }UslRY , l kGO 5 Ll cl- , L Z N, CI NggjV,EN~ y p F~OR,CE tl Fl iu " z +N p SCE of 1t(.mLE:vp) FE IL SEE Etj- N. of LA A Ls tiro • 4 0 r-T: a, PVAcE ! sT HOLE 1 U" FRom TEL' w)?H Su cC-e-Eb)M G HOLES AT Z 8 J JJl1RU~lS . - - LN%-r l-bL & -M pt~ AjExr To -THE E,ND CR P• ' PUMP CHAMBER CROSS SECTION AA10 SPECIFICATIONS, S OF ~o VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING , JUIJCTION BOX MAWHOLE COVER WITH ? 25' FROM DOOR, wRRNIN 6 >r+~BEL WINDOW OR FRESH It'MIfJ. AIR INTAKE. I GRADE I 9 8,66 I H' MIN. la' MIW. COWDUIT IMLET jpof OYIDE L I III - OR I III APPROVED JOINT A 4A~,4NS I I' APPROVED JOINTS W/C.Z. PIPE ~r~0 CS ( III W/C.I. PIPE ORPVC CAB p ALARM EXTENDIM(p 3' OWTO 601-10 Oil. b ,~'~S~SR oN 10 EN N ©F I I 7601~RSM Ati5 :aOENCE I I oN E ~4A PUMP I I OFF ELEV."FT. 0 CL-86 Sp CONCRETE 5LOCK --FRISER EXIT PERMITTED OWLy IF TANK MANUFACTURER HAS SUCH APPROVAL 3'•ApPl2aVE0 6E001 NG SPECIFICATIOKIS DOSE K MANUFACTURCIt: i'11p~JES'Z'~'I~ PCZEchsT NUMBER OF DOES: 3 ' S PER 0Ay TANK SIZE: ~Sp GALLONS DOSE VOLUME S,S, Z~ SYS s INCLUDIM& GACKFLOW: GALLONS ALARM MANUFACTURER: MODEL AIUMISER: 10 l ~`Iw CAPACITIES: A= Z3 INCHES OR 3S~' p GALLONS SWITCH TYPE: g=_-INCHESOR 3b.S GQLLOLJS PUMP MANUFACTURER: C = 9 INCHES OR -!~GALLOLJS MODEL NUM6ER: D= %.8 INCHES OR 'L-)y--7 GALLONS SWITCH TUPE: MOTE: PUMP AND ALARM ARE TO OE MIIJIMUM DISCHARGE RATE 3-)`y GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE CETWEEU PUMP OFF AUO..DISTRIbUTIOM PIPE.. \2140 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . 2.50 FEET + bD FEET OF FORCE MAIN X 133FYoftFRICTIOU FACTOR.. ''42 FEET Y - TOTAL OyWAMIC HEAD = 1-6"3O FEET D1 F11`9 ~TE1Z ~7 y IAITERNAL DIMLWSWWN OF TANK: LEW&TH ;WIDTH jLIQUID DEPTH sz" ,aoTTbim ~42tsA 35 Z,(~ . z31 = 1 S . Z~ c,R /truces As P {4 -m pt 1J U FA C-"V [t~12 = G f~ 1, / / Aj C. H M • 2 TOTAL DYNAMIC HEAD FEET/ HEAD CAPACITY. CURVE METERS MODEL 137-139 SERIES CAPACITY GALLONS/LITERS 30 HEAD CAPAC TY UNITS/ IAIN 8 FEET METERS GAL LT RS 25 5 1.52 104 394 10 3.05 79 300. _ 15 4.57 64 242 6-26-- 20 6.10 36 136 25 7.62 8 30 c lb.3o 26 7,92 0 0 15 F 4 31.4 Y 10 2 5 0 110 U S 10 20 30 40 50 60 70 80, 90 100 GALLON LITERSI 80 160 240 3 0 400 0 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Three phase pumps are available in 200/208V or • Mercury float switches are available for controlling. 230V. single and three phase systems. • Electrical alternators, for duplex systems, are • Double piggyback mercury float switches are avail- available and supplied with an alarm. able for variable level long cycle controls. • Mechanical alternators, for duplex systems, are • Long cords: are available in lengths of 15 - 25 - available with or without alarm switches. 35 - 50 feet. • Combination' starters are available. • Simplex and duplex basins are available. SINGLE AND THREE PHASE UNITS 137 Series 13 eries cad Cord Cord Iron Volts-Phase Wt H.P. Amps Length Bronze Vohs-Phase Wt H.P. Amps Length M137 115-1 Ph Automatic 47 1/2 10.4 10 ft. M139 115-1 Ph Automatic 51 1/2 10.4 10 ft. N137 115-l Ph Non-Auto. 47 1/2 10.4 15 ft. N139 115-1 Ph Non-Auto. 51 1/2 10.4: 15 ft. D137 230-1 Ph Automatic 47 1/2 5.2 10 ft. D139 230-1Ph Automatic 51 1/2 5.2 10 ft. E137 230-1 Ph Non-Auto. 47 1/2 5.2 15 ft. E139 230-1 Ph Non-Auto. 51 1/2 5.2 15 ft. H137 200/208-1 Ph Automatic 47 1/2 8.4 10 ft. H139 200/208-1 Ph Automatic 51 1/2 8.4 10 ft. 1137 200/208-1 Ph Non-Auto. 47 1/2 8.4 15 ft. 1139 200/208-1 Ph Non-Auto. 51 1/2 8.4 15 ft. Three phase units require a control switch to operate an external magnetic or All installation of controls, protection devices and wiring should be done by a combination starter. licensed and qualified electrician. All electrical and safety codesshould be followed For information on additional Zoeller products refer to catalog on Combination in addition to the most recent National Electric Code (NEC) and the Occupational Starter, FM-514; Piggyback Mercury Float Switches, FM-477; Electrical Alternator, Safety and Health Act (OSHA). FM-486; Mechanical Alternator, FM-495; Alarm Package, FM-513; and Sump/ Sewage Basins, FM-487. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is an engineered/design part of every Zoeller pump. 3280 Old MIR= Lane Manufacturers of . ZZELLE/~ ZZ_ Po. Box 16947 Louklru/e, Kentucky 40216 ® (502) 778-2731 QUAL/TY PUMPB ~NCE a ST. CROIX COUNTY -r WISCONSIN a .M 4} Y ZONING OFFICE ST. CROIX COUNTY COURTHOUSE n,I P ^ h ~y 911 FOURTH STREET • HUDSON, WI 54016 PUILK (715) 386-4680 April 18, 1990 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Glenda Bosman property, located at the SW4 of the SW4 of Section 5, T29N-R16W, Town of Baldwin, St. Croix County, revealed suitable soils at a depth of 2 feet below which seasonable high ground water was noted. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator cj