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008-1083-50-000
-0 CD ~ o a~ I a p 69 I o c I c ,r RL o I ~ I e ~ I 0 N a I N j ~ O ,Q g I d O I a) ' ~ f0 I y O P f3 a~ y 'o z ~ I C _ 7 c E I C U. O_ SO I 3 - I M a (D z v, o z € m co N H u) _O O Z t~ V ~ r d Z d c z H r CD z I 72 I ~~ww 2 Cl) (D I J = c I t O 0 Z z O N z 0 N E y N ` Z CL 1 0. C', 1 y m i N CD i ooa .nom U) U) U) E Z N J = O 4. U O z •N aaa = c v) c W J V W o z r ce) 00 m N N I 65 O E co ml y C 9 y a) O) .y+ r C d N d Q cn Q ~ t"r O O to h 0 00 !i ~ H C I 'a E 04 CD ~ M o a3 N G C C d 0 0 1 O C r i ~ Y € N N V ~O a0 m c, S O 2 d O n ap Li O a0 n y N H C y I ab N O co co O to E O R U 0) Cc . O O N W fn O Z N %5 Z 'd U3 r.+ I €a EL E L• a • as a m. j d d c `Iri E ` c c to) IL t 4 Parcel 008-1083-50-000 11/29/2006 11:06 AM PAGE 1OF1 Alt. Parcel 29.28.16.443A 008 - TOWN OF EAU GALLE 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 - WETLI, ROBERT G & VICKY L ROBERT G & VICKY L WETLI 120 222ND ST BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 120 222ND ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 25.390 Plat: N/A-NOT AVAILABLE SEC 29 T28N R16W PT SW SW BEING LOT 2 OF Block/Condo Bldg: CSM 9/2598 25.39 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 29-28N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 784/75 07/23/1997 582/612 07/03/1997 1249/508 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/11/2000 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 24,800 187,600 212,400 NO PRODUCTIVE FORST LANDS G6 23.390 24,000 0 24,000 NO Totals for 2006: General Property 25.390 48,800 187,600 236,400 Woodland 0.000 0 0 Totals for 2005: General Property 25.390 48,800 187,600 236,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 513 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 192.00 Special Assessments Special Charges Delinquent Charges Total 192.00 0.00 0.00 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER I(aQ,~ &~4(?14r TOWNSHIP z a- a, SECTION T ~qT N-R W ADDRESS WOoCT ~j!!~° (,Gf/S. ST. CROIX COUNTY, WISCONSIN V 0p SUBDIVISION - LOT - LOT SIZE - II ~ i PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM f i I~ k I a/ )UOC~, 7E0 1 L ~ INDICATE NORTH ARROW i BENCHMAR.K:Elevation and description:~Wj no / wet 04 a('(rGSS rof Alternate benchmark DAP SEPTIC TANK:Manufacturer: t ,gS4L'M Liquid Cap. Rings used:0Manhole cover elevA, Final grade elev: , Tank inlet elev.: Z Tank outlet elev.:- / No. of feet from nearest road:Front/7J, side; Rea From nearest prop. line:Front 1//y/S SidecOO ; Rear4"Ft. I ~ No. of feet from. Well Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE i~ PUMP CHAMBER n Manufacturer : //~~C- WVS /efP J feCCASI-l Liquid capacity: g Pump Mode rS~ ump/Siphon Manufact.: - Pump Size Elevation of inlet: Bottom of tank elevation f l Pump on elev.: K 7 Pump off elev.:AJv( Gallons/cycle : Alarm: Man.:S. ~A" rb Switch Type: OerCUP11 Location Distance from nearest prop. line: Front/ Side-, Rear- Ft. - / - - Distance from: We11~Q~t D wQ/ Building SOIL ABSORPTION SYSTEM Bed: X Trench: Seepage Pit: Width: _Length_Number of Lines: Area Built Exist. Grade Elev. Proposed Final Grade Elev. . t Fill depth t o top of 1 pipe: r o m0017 Oda No. feet from nearest prop. line: Front, SidecU); Rea--'~O)-~Ft. i No. feet from well:)06f No. feet from building /~o (oel( yep HOLDING TANK Manufacturer: Capacity: No, of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE : W rdl", - PLUMBER ON JOB:- LICENSE NUMBER: 3~~h 6/90:cj ~ ao3c~ DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING '%~L-"OR R HUMAN RELATIONS DIVISION P.O. 8617969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: SW 4i SW 4, Sec . 29 ,T28-R16 ❑ CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Eau Galle El El Holding Tank In-Ground Pressure ac~l Mound 3 - 9911d qf- NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: .S BENCH (Permanent reference point) DESCRWIF F EN FROM PLAN: R W. PT. E `CS RE .15T. ELE . I ~s /y.. e s Name of Plumber MP/MPRSW No.: County: Sanitary Permit Number: Crni_x --128790 SEPTIC TANK/HOLDING TAN S Y = 7 PV_ ANK OUTLET EL WARNING LABEL LOCKING COV MANUFACTURER: LIQUID CAPACITY: TANK INLET EL t i a ~7 2 / PRO IDED: PROVIDED: d3 YES ❑ NO El YES NO BEDDIN IA. MATL.: HIGH WATE N BER OF ROAD: PROPERTY' I WEL/L~ BUILDING: VENT T FRESH Q .y ALARM: FEET FROM LLNE 7 m~ ( ~3 J / ~ AIR INLET: Y1 C. ; ❑ YES NO ❑ YES NEAREST /O (~'!S - ~ DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHO" UFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES NO t~Y rn / N(YES ❑ NO YES ❑ NO _ TO 4A L,) GALLONS PER CYCLE: UMP AND ;Z~ ERATIONAL: UMBER OF PROPERTY ~WELM BUILDI VENT LE FRESH INE: ! f AIR T: (DIFFERENCE BETWEEN FEET FROM I L~_/10 7_15 L-22 PUMP ON AND OFF) I NO NEAREST LENGTH: DIAMETER: : I MATERIAL AND MARKING SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE : or excavation. (If soil can be rolled into a wire, construction shall ce~se II / P the soil is dry enough to continue.) - G~ , L~~ MAIN CONVENTIONAL SYSTEM: Z°Q. o/< WIDTH L N0. OF IS R. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH ES: MATERIAL: PIT DEPTH: DIMENSIO GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERI STR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO F SH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPE LINE: AIR INL T NEAREST 111111 MOUND SYSTEM• a, ~ -5,_J .C ;1 = , Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW S C14-( vV-- meets the criteria for medium sand. ELEVATIONS MEASURED. Y ES ❑NO Lj,,oScr.-S X SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; YES ED NO YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES O ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: 2,/ _ ed1 1601 WIDTH: LENGTH: NO OF LATERAL SPACING: GRAVE DEPTH BELOW PIPE: FILL DEPTH ABOVE ER: BED/TRENCH / TRENCHES: / r DIMENSIONS 63 cf~ I MANIFOLD PUMP MANIFOLD DISTR. PIPq MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE/~ DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: EL / DIA.: Of ELEV.: PIPES: DIA.: ELEVATION AND p!/ C Y G DISTRIBUTION o~. ~~•O T ~ l~.U~ ~ 'I HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT C RESPO PS O INFORMATION I it AP ED PLANS WI./Zr r _ I(O-V 1/3, ,7~ YES ❑ NO ~ ' ❑ YES O de,rOf { PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WEL . BUILDING COMMENTS: FEET FROM LINE: / XYES ❑ NO jqj YES ❑ NO INEAREST---* 4"'7,_(o L.44~-t.2,Lt L arc J..C'e ;a.,~,c` , aL~~;c T,C~ J~ - / ain in count ile for audit. Sketch System on Reverse Side. SIGNAT E: T; SBD-6710 : (R. 06/88) SANITARY PERMIT APPLICATION a-OILR In accord with ILHR 83.05, Wis. Adm. Code cou . STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / /J~ Cl 8% x 11 inches in size. cn.kcl?f'elon o previous application -See reverse side for instructions for completing this application. STATE N I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION S''7"4tS&.) %Sif) Y4, S JP~ T of N, R 16 E (or)(0 PRO RTY OWN R'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: (Check one) ❑ State Owned 13 VILLAGE : NEAREST ROAD ,S-fret7' ^ Q ❑ Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms R EL AX NUMB R() le ~v_ !01 (~2 Q III. BUILDING USE: (If building type is public, check all that apply) /I d J 1 ❑ Apt/Condo 2 ❑Assembl Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility y Hall 6 El 3 ❑ .nin CamP9round 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dl 9 40 Church/School 80 Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. LXI New 2. ❑ Replacement 3.E1 Replacement of 4.E1 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 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE ~V REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gal day/sq. ft.) (Min -~'f nch) ELEVATION V .~9"7r &7Y_ x j /V/1 Feet 10,3& U5 U Feet VII. TANK CAPACITY Site in allons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete glass App. Tanks Tanks strutted Septic Tank or Wakillnotirnk El F1 F] I L1 Ll ✓1 Lift Pump Tank/Si hon Chamber s 172dwe't Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu b 's Signatur o S s) 140PMPRSW No.: Business Phone Number: 7 Plumber's Address (Street, City State Zip Code): rte/ ^y r c! T /c7 IX. C NTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing A ent Sign a (No Sta ) ep~ Approved I ❑ Owner Given initial Surcharge Fee) a Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be 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, and holding tanks for this system. Check experimental pump/siphon 9 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% 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 v volume; elevation differences; friction loss, • pump performance curve; pump model and manufacturer D) cross , p p pump ) oss section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) 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 tot tesali by owner/contractor,(spee 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. - - - - - - - - - - - - - - - - - --r r--------r -r-r-•-r---------- Owner -----N---~---•• of property - Y ( acC sy 4-a Ck C, v Location of property IL-fill r.z..-..-.-1/4• Section ? T 28 .~'R~Y Township Ea k G n ~l Mailing address ~5 It ® o Address of site Z 0 ` , a '01 'Y G subdivision name Lot number Previous owner of peopertyl!r ~5 , g v ~C S c~ t~ Total alga of parcel 2 7 acr Date parcel was created 7 `1 ` -~-9 Ats all corners and lot lines ldentitlable? ✓ an __J(0 Is this property being developed tot tesala tspea houss)Tso =U o V019NO 7 YLIind Page Number a$ recorded with the Register of Deeds. r rrr --r INCLUDE rrr-----~----•• WITH THIS APPLICATION THE POLLOWIM A WARRAXTY DRRD which includes a DOCUMENT NUMBER, VOLUMS AND PADS NU111SR, and the SRAL OF THi REMOTER OF DRIDS. In addition, a certified survey, it available, would be helpful so as to avoid delays of the reviewing pprocess. It the deed description references to a Cestlfled survey Map, the Cettitled Survey Map shall also be required. PROPERTY OWNER CERTIFICATION E(ve) certify that all statements on this form are true to the best of my (outl knovledge/ that t (vg) am (ate) the owner(s) of the properly described In lhls ln[ocmotlon form, by virtue of a warranty deed recorded In the office of the County Register of Deeds as Document No. `t7 7 0 1/ 5-. c and that I (Wei presently own the proposed site for the sewage disposal system (at 1 (wel have obtained an easement, to tun with the above described property, tot the conetcuctlon of sold system, and the same has been duly recorded In the office of the County Register of Deeds, as Document No. 6qy %~'iCtt~ ~yLG~ Signature of owner SL n DA44;cj tur of Co-owner it Applicable) - ~1 go 7 o Data of Signature Date o S1 atute eseesiosyi- of ? _ p rp, 9rATN BAS OP wlSOONUK FORK i - 21011111 WANSrsasa see > WAMAN" ODD " `yam 7 Oscar B. Berkseth, KL-GISTERS OPl1~.'~ d. m.d. hetwe.a Qs+~sr...l~trksRth1.-lox--Rana~ld.---- ST. CROIX CO, WIL :.TDey..~ti .At<fornuc..ia_.F6t ..srtd..Gecli+~ Must for Reao~d Nd1 ~j„ Granter. 00y itxiill►l..rid6it. :a i_......IClaius..S.tadw..aWor-. Joyra.Stadw-,..husband.and..... ...........idita,..asJaint.•tenants. with..ripht..of...surv1.vor.ship,. . Grantee, b. Tbd the said Granter, for a valuable eoneidoration...... „ T.r tx-ffxR.1hau~land..and..rtallQQ.-Dollars *CTUAR TO eesegs is (rests On tepowlas described real estate in _ . St . - . Croix.. ' Gsuty, State of Wisooasin: b: Net Welf,of Southwest Quarter (WJ of S111) of Section 29, . Te1p 26 flbrth of Range 16 Most, EXCEPT North Half of t QYN'ter of Southwest Quarter of Section 29. Tax Pared No:...... ('ZING the following described parcel: That certain parcel of land located 38 tho Southwest Quarter of Southwest Quarter of Section 29, Town 28 North Range 1 -'f Mart, Town of Eau Gallo, St. Croix County, Wisconsin, more fully described as follarls..° Ilpiuaing at a point on the South line of said Section 29 a distance of 4794.75 feet (fit of.tM southeast corner of said Section 29; thence go West a distance of 420.40 , feet; thence Worth a distance of 518.57; thence East a distance of 420.00 feet; ,thaw Sot1tA a distance of 518.57 feet to the point of begining, the abose•described parcel T , staining 5.0 acres, more or less, including the South 35 feet thereof presently - for Tom Road. i Said real estate is subject to that certain right of way easewent for rural electric'', r, line to the St. Croix County Electric Cooperative, a cooperative association, recorded ice Volme M. page 136, in the office of the Register of Deeds for St. Croix Co4*ty,_• { . 4, Wscatsin. ; s' Ibis dead is in consuniation of the land contract dated May 17, 1977, recorded Octobes 17, 1173 in Vol. 582 of Records, page 612, Document No. 352425 between the parties Migrate. A 'Ale is.... not.... homestead property. lie) (lo slot) 149adw with all and siasular the bereditaments and appurtenances thereunto belonging; ArA Oscar..8arkseth and Cecl.i.a.•Berkseth . . . . . . _ waresb that w We is Nom. Indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. Dated this day of May 19 .87 * 1 F. ..(SEwL) ✓ !!r! SEAL) Oscar Berkseth; by tal~eerks*th, hi=72- i.n..Ffct { ' (SEAL) ~ (SEAL) ~ - Ceclia Berkseth I AUTRUNTICATION ACRNOWLED011 MUT i s` O • of._Oonald Berkseth .as Attorney y STATE OF WISCONSIN in Fact for Oscar Berkseth, and Ceclia sepke"k w ---County. this of 19 7- ' day May 8. Personals cams before me this ................dsip et i 19........ w eboes now" =~r rs - i - t Robert R. Gavic TITLE: MZKBER STATE BAR OF WISCONSIN ; (If not . by 1 706.06, Wis. States.) touring instto be rument and acknowledge the tams. go fo Ef THIS INSTRUMENT WAS ORArTEO BY ROBERT R. GAVIC l~ttorney atZaw Spr4ng--Na41ey-,--W4--64767-------------------•--- Notary Public . ' (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (if not, eoradba !i are not ner,,:ary,). date: •IfAM al.ee.asfs slaying is any eapacity should be typed or Printed below their signatures. ' sea gas of WUM1489M N 1 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County r a OWNER/~~R. cc IAA` S4 4 C. k e✓ C ROUTE/BOX NUMBER Fire Number d rr a CITY/ STATE EC l G LV 6 At 41i zip (9l~ Z r* 0 PROPERTY LOCATION: ~k, S V✓k, Section ,-q • T IV N, R_ W, Town of-Tow" rn ~u le St. Croix County, Subdivision cat Lot number IV 9 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 aTfect t e-.unct on o, the septic tank as a treat- ment-stage in the waste disposal system. St. Croix County residents may be eligible to recieve 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 .s . ys't. ems 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. H I/WE, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as.-set by the Wisconsin Depart- W meet of Natural Resources. Certification form must be completed •d and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE 7- St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR P.O. BO HUMAN NDLATIONS PERCOLATION TESTS (115) MADISON W 7969 (H63.090) & Chapter 145.045) LOCATION: S SECTION: ITOWNSHI LOT NO.: BLK. NO.: SUBDIVISION NAME: w '/w 1/ zq /Tzg N/R 01\(or) (or) w EAy G AL.L.e COUNTY: OWNER'S Ski 0tftS NAME: MAILING ADDRESS: SA -CRoI Y, KO T E 11~* (Woody.' Ll_ . We SV A2c3 USE DATES OBSERVATIONS MADE NO. BEDRMS,: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: ®Residence L_ New ❑Replace z9 87 - o RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) os©u as©u oSA asIEu ❑sau ~"4L_ If Percolation Tests are NOT required DESIGN ~~Rt~``ATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: blol_ Floodplain, indicate Floodplain elevation: 'Vt. PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 0- • 7'6( s.Lfs f•i -z•?i ~jJl S;l FC1*V6 30-3,S On sl B- I S.a' ~6•~ 15$ I.o -i.c 1,4, ~.~.3.0 8"st #A** 1.4.~3s zoco,.I.•. cd B- Z 77. ' 'q,-A •So d-~S $Cs.Lh. eS- 3.3 yG a'/i6, As ! SG . 13/ sa4s, /.o-/•S 8,.s..L GF-0-h. B- -T 3 . 3 A, S-- 2 3 Src >1 /N edf Ff 91-1 No L"k els 1 Q..S 81 5,4-h . r /•I - /.B a." Sl Its Fr ^10-h B- 3.q ' ESL.p 1 No 1,0 •S- I.2 L,4._I9L s L. / Lf - '3. E3" s/ Mecl rul. d- . 31?1 s,L-<s /o -1.7 .8+r S.l F«efr B- 61 .3-/. c14-46"S; ~3,k- 4s l3...,.sds a WL.+ B- F-Ro 1,3 o - - re lay'.r Z 4s • ~ s-1.8 tz"c eo6 r ~ F.,,.fs -1.3 14 PERCOLATION TESTS EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH d id NaT park- P__ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale o distances Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION N~ '4 4 ~ E ~ I I I E.. q.. _ t _....J . . _ 6 tN -7 _R ,~yl r cO f r w F r ?b 0j. t, = q. Q LOA. 'At t I`C .I I i 77 w.. a I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COM• ETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): S r, i N G LSE W e 416-1 301 Z/-E- 778-5'68 CS NATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - I INSTRUCTIONS FOR COMPL.ET.-I.- FORM 115 - SBD - 6395 To be and accurate soil test, your rel: include: 1. Ce _c. iption; 2_ " r,t clew F ~dicate whether ?sidence or commercial 3, >f I or cornrno i, ir. nned; 4. Is :emr.,.. Y,. 5. ibi-v i `in : I,. A SITE IL S,=ITABLE FOR I°IG TANK ONLY IF ALL S ARE RULEE UT BASED ON SOIL CONDITIC 6. ,.he abbe ^,liat.i 'is shown here for vlTiting profile descr iptio =tnd completing the plot plan; 7_ A LEGIBLF ~ r ac°urately locating your test locations. sawing to scale is preferred. A Sheet may ' sired; B. A sm your b ic. rk no ve,tical elevation returer ale clearly shown, an ~ ~re, permanent; 9 all apps . 1 vs as to dates, narnes, a >od plain data, per exernp- >propriai,, plan, elevation) does m place N.A. in the api--l ;ox; a y i, address and your t An rWmber; and as required. ALL TESTS MUST BE FiLED'"VITH THE iTY WIT 9 DAYS OF COMPILE ABBREVIATIONS FOR CERTI, 3011- T r 3S s =s r Symbols 1 are Irock Ca LS Li 'i€ Sand HGVV - Hicth ~-i! _ Prep; Perc; i nd - VveI! is I Sand Loam E' - I Bn _ Gy Gray cl Y _ Yellow Clay Loam R - Red Loam neat - Mottles v~,/ with sic S. ri - - p - P1 ri HWIL H Jh rt ~I textures disposal BM - I VRP Vern Point TAO Ti -.t to DEPARTMENT OF REPORT ON SOIL BORINGS. AND SAFETY & BUILDINGS INDUSTRY, , DIVISION LABOR AND cc P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (11J) ~ A ~A~60N, WI 53707 (H63.09(1) & Chapter 145.045) 0, 5z 0 r' L~ LOCATION- TOWNSHIP O O.. L K. NO.: SUBDIVISION NAME: s w I 1/ 29 /TZa N/R, /0 (or) W .EAR C,4449 Nc- rJa Ne_ COUNTY: OWNERS S NAME: MAILING ADDRESS: 1,LNMLS -T Pi CKE R R o WooJv ► LLB , I.~ l -svox8 USE DATES OBSE RVATI DNS, MADE NO.BEDRMS : COMM R A DES RIPTIO I R STS: ®Residence 7 Na 54New ❑Replace Z?~B7 RATING: S- Site suitable for system U- Site unsuitable for system CONVENTIONAL ©U . IM193OUNDS: E~ I p~i OUND-PRESSURg ©U ❑ D L H E] ING T U : RECOMMEN~SYSTEM: I("3 (optional) r❑ S RAW If Percolation Tests are NOT required DESIGN RATE: I if any portion of the tested area is in the under s.1-163.09(5)(b), indicate: ' Floodplain, indicate Floodplain elevation: /fa. PROFILE DESCRIPTIONS BORING TOTAL DEPTH T GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. EI-EVATION OBSERVED HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) p ' g Sit ~J 2 - ,Z • L i~ 3r, c B- I ' 1 ~p r~ • g_ S L-•(-c ~a( S i I , 3. 2 - 3. 1l Ii.. sc G F/c ~rr.*S Q_ ,8 131 s.Y 'h ,~+3 lol.-t e•o •s-~. s, FF 21 - 3,Q L.vc ae xv'e B- L s.8- 3 - Ps jrnds O- S ai s,L-!•-s a1 - 3.0 s oL 113- 3 ?.o 101-1 6-'1,s dk B r-L/a o / 0- -7 8/ si z fs•j t - 2 - 2 C, mo qg.qq B- $ S. 01 0--7 a? AA J" 0.1 z . 7- -?.I Z e-4 -sil .4'e..T n s B- 1 TESTS I TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. -PERIOD Al 132 FERIOD3 INCH P- o 9 / 9 P- 14-3 e -30 6 P- S- P- P- P- _ LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate kale o distance Describe what are the hori- ntal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent f land slope. YSTEM ELEVATION - c IIN TN ~ S _ 2 r ~p p , 9 1~ 7► - - OC. the undersigned, hereby certify that lb d on this form were made by me in accord with the procedures and methods specified in the Wisconsin dministrative Code, and that the data recd location of the tests are correct to the best of my knowledge and belief: AME (print): TESTS WERE COMPLETED ON: DDRESS>n CERTIFICATIO NUMBER: PHONE NUMBER (optional); ,o`Z r ~.-i l~ . W ! .a Y 76~ .3D ~1 ; /S= 77f-5'59 coo CST.SI URE: . ~.t==....~. ISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ILHR-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 SBD - 6395 To be a complete; and accurate soil t(,st, your report must inclucle: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedroorns or commercial use planned; A. Is this a new or, replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS Alit= RIJI_FD OUT RASFl) ON SOIL. CONDITIONS; 6. PI [ ASL ww the ~abbicvi,aliuiis "llm,111 hale foi wriiirm piotilo oct.c6pnons and complrtintl Lhoplotplatt;. 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale, is preferred. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are perrnanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp-j-, tion, if ,appr'opri'ate; 10. If the information (Such as flood plain, elevation) does riot apply, place N.A. in the appropriate box; 11. Sign the form and place your ce.ane nt address and your certification nurnber; 12. Make legible copies and distribute as wquired. ALL SOIL TESTS MUST BE FILED WITH 'THE LOCAL AU'I 1-10 it-I Y WI-1 HIN 30 DAY,',' OF COMPIA-TION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR Bedrock cob Cobble (3 - 10") SS Sandstone gr Gravel (under 3") LS Limestone "s Sand IIGW High Gtotandwatel cs Coarse Sam] Perc Percolation Rate t i. need s - M-diurn ! r+md W Well fs {inr .`;,~r~l f;ltlr; Bui!clirut ti I. L~r,r~aay:>ur~l > G~n,rt~~i lla.~u sl - Sandy Lc>eam Less Tlaan `I Loam Bn _ 13. o "rI r 'siI Silt Loam 131 Black Silt C;y Gray cl Clay Loam Y Yellow scl Sandy Clay Loam R - Red sicl - Silty Clay Loern mot Mottles sr, Sanely Clay wr . \vilh sic - Silty Clay fff few, fine, faint `c Clay cc - common, coarse pl Peat mm Maray, rrx;dium rn - Muck d - distinct p - prominent HWL High water level, Six general soil textures surface water for lictuid waste disposal BM - Bench Mark VRP Vertical Reference Point TO THE OWNER: This soil test report is the first step in securirig a sanitary„permit. The county or, tthe, Department may request:,,:: , verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sevvace~; system and a permit a iplfcation must be se.rbrnitted to the approFmate local authority ,J E in order to obtain a permit. The sanitary perrnif moist be obtained and posted prior to the start of any construction. i i IT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION P.O. BOX 76 PERCOLATION TESTS (115) MADISON W153707 CATIONS (H63.090) & Chapter 145.045) SECTION: TOWNSHIP/ +W: LOT NO.: BLK. NO.: SUBDIVISION NAME: S1/4 2 /T N/Q " /0+",`or) W LT4//L~ Na II~a. OWN R'S Ny4M~: MAILING ADDRESS: OIL DA ES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: R LA ION TESTS: idence Z w /a New ❑ Replace J~ Z?- 87 TING: S= Site suitable for system U= Site unsuitable for system 'NVENTIONAL: MOUND: IN-GROUNDPRESSUR_ : S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) 1 DU ❑S a ❑S ~U ❑S ®U ❑S ~ avne... If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5) (b), indicate: Na- Floodplain, indicate Floodplain elevation: ry 0. PROFILE DESCRIPTIONS BORING TOTAL DE r PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- NO &ftts.02.s-3.3 dk eft Ls/3r- 4/.2- 4.9 o - - 7 BL Ls 'SS r 2.0- 3.ti dw Yv,a 4 / B- 2- 98.1+ NO i.s8 .1-2.0 Wcg,, ) -04-8 '~•8-c.z .r~..fyFs O- - 7 Bkt- i x'8 3 'Vj►, vne d i t • ~i.4- ~ tk gn B- 3 5.9 ~ 13.44 NO 1.33 •7- l,8 ~5 r f Fm ItM r Fs i"6 ! f3.•SCL C Mew !43 s.7 L.•J~ B.I B- 1 S 7 ~1~•5l No •'la .~-~.6 G S( FF~`~?.r-3.8 Fs M a,& B- s 6-•7 el Ls 4% V.2 - s• cL /hets C s. gS•39 NO 1.33 .7_ I.A a" LS 3.!- 3.o /3., sc C FFnr':6 r 94.5 0 , 92- 0- •s f1 s~L •s-~.~, sit /•i-,'.t •8"P.r C ^~o+• X- e,eac B- 7 y. •93 s -Z• s4-3. 4-s- y. & PERCOLATION TESTS Gly/c L4tanAs• TEST DEPTH WATER IN HOLE TEST TIME DROP N WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERT D2 PERIOD PER INCH P- P- 1 P_ P- O P- E~x P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale o distances Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ~0. fl ~ I I t i t 3 I _ Sal i x - 1 E ~ I i i ~ I I 4^^ t y~.Yo~►sti 7--- s T _ _ 1 4- J_ -I i y / ; y -O I gel L J' r , E 3dj 3 t__ -__t......_..,L... r ;e4 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the'r6 do e s specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledg ~ I e# NAME (print): TESTS WERE COMPLETED ON: o-•- M 29 - l ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): t r 4 ~aU.. 1 5 7 b ID41 `115-778-8 9 C SI NATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6335 T ;ornplete and .ail test, your rust include: gal descriptiI. ion must cle indicate whether nis is a residence or cornme tJM number of ~ is or commercial use planned; 4, a nevv or ror lr, ;tern. 5. L malete the su ig boxes. 1"E IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEM RULED OL, , --DON SOIL. CC ITIONS; 6. PL in ns shown hi Por vvritincg E iPtions r: u1 co,l I plot plan; r. n accurately locating yo ions. D eferrec9. A rlesi I rdevatic perm as to dates, names,d p;.3i .,~st e np- 1'v I: flood pl-ri~r, ,in-i} dr; . place N_. N, i ite box; 11. r r cur and your:rn number, 12 (istribut( yuiiol, ALL ~L TESTS MUST BE ITH THE. L 30 DAYS OF (,OMPLE" JI4TIC OR CERTIFIED SOIL TEST- 1 Textures t rt t ols 10") rock 10`°} nor e ( ,der 3"} I I_" .estoner High tar , ci Per~colatiuf ) i Nell I` - _ rrr *s1 - -,rn c t , Br; - Loam Eft si- Gy -c L y - -r Loarn R ay Loarn mot _ ay tr roll H'vvtL - Hi,,) c,r l t~xtrares ~''sposal BM - VRP- 1 L TO THE OWNER: 7 in sec a sanh.ary I' lit. U `y or _ C guest r p r rn r sr~ r DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOA BOX HUM N REDLATIONS PERCOLATION TESTS (115) MADISON WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: S SECTION: TOWNSHIP/MUNICIPALITY: I OT NO.: BLK. NO.: SUBDIVISION NAME: ' W 1/ W 1/ 29 /T z8 N/R Ib $ (or) W E 99A GA"~ N&__ 1401. ,,4 COUNTY: OWNER'S NAME: AILING ADDRESS: S Ro Wolldy'LLI' W1 TV049 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILED S RIPTIONS: PERCOLATION TESTS: Residence Z QNew ❑Replace ►Jo` -29- B 1 - v - RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSUR_E: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑S ©U EIS DU ❑S CCU ❑S CCU EIS ©U Nonce 7 If Percolation Tests are NOT required DESIGN RAT,,Err: If any portion of the tested area is in the rr under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: 1Y0. 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.) 0-•s 8/s.~-(S r f•5-~.3 S+~sl/FS 9r ~w,~~ B- SI / 103.1(0 ~0 16'1 •S-I•S 8l ~~ll a.3-'r~' r3"~sc% ca.+ia.n~~d ,I Q_ .7 Bls.lls 1.5 -~•o sac i:y..eFa ioi s4 hol C-3 '0 C_ B- 4.2" ? x-1 ap - .z•y s.,. SZ f'~.Yr.fs n - S -61 s-lh B-4 1.2- 10 4.l6 No 1.0 sc C B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER1003 PER INCH P- P- P- P-_ P- P PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale o distance Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION as 'Y` ~ S 1 E I TN i 1 1087 , , 1, the undersigned, hereby certify that the soil tests repor•te~-on'fh'is form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (pri TESTS WER COMPLETED ON: ol4a& QLEKQAX,% - 2 - ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): z. ~F R G V A~.~.E W t 54~ 30 11 S -`T7 -5 C RE- DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER - i e INSTRUCTIONS FOR COMPLET ORM 115 - SBD - 6595 Tc 1d acct Est, your it include: 2, ether this is a residence car e:ornmer- t,+ i =rcial rise 0anned; 4, c~~3~rrt 5. y c A SITE IS SUITABLE FOR A 11 G TANK ONLY IF ALL OTH' S ARE RUL BASED ON SOIL CONI TIONS; (f. PL ;b' evictior, ~re for writing profile "ions and completing they plot plan; 7. i_ iiagrar !y locating your test 1- . ~.ns. Drawing to scale is preferred. A I if n,' U ~P~tc! )('e P CI( , and are permanent; b,-=x(,,s as adds plain e -cols-atiori -st exemp- ~r+ :tiorl) does r,-, lace N,i~.,,~ the api box; ar;i your c - :on 11unlb('1 +`~striE luired. ALL `.STS MUST BE F11 'TH THE AL . TY VVITHIN 3C 'F COMPLETI 'VIAT, CERTIF~-_ -I L TEST. d Textures ~/rnbols - -r 10") BR co 10"1 SS ter) e gr 3") 1 H is - L -Cf :n 's[ rrr sr - _ Gy y ->am R Liam mot - ~r W/ sic f f f p1. - rnrn ~n d P H IN L - xtures sal BM I if R P R TOT a . Ert a T= r` De ray rerluest he nrivatr3 1 order to j r f MOUND SYSTEM S89-40447 FOR l~la~ s Sfi~~ ~ LOCATED IN THE SCE OF THE Sw OF SECTION T CWN , R Iwo TOWN OF Q(~ COUNTY, WISCONSIN INDEX PACE 1 of 7 TITLE SHEET PAGE 2 of 7 WORKSHEET PAGE 5 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 DOSE CHAMBER PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR DENNIS HEWITT RR2, MAIDEN ROCK, WISCONSIN; 54750 PREPARED BY DENNIS HEWITT RR2, MAIDEN ROCK, WISCONSIN 54750 MPRS LIS. NO. 3186 aeTIONAL WORKSHEET 1. MOUND SYSTEM r) II. IN-GROUND PRESSURE SYSTEM-Contlnued- 1. Wastewater Load, Total Daily Flow gal. 10. Force Main: Use section H 63.15 (3) (c), Wis. Minimum Dosing Rate = gpm. Adm. Code and PROVIDE A DETAILED Diameter = _ in. LIST OF SIZING ON PLANS. , 11. Total Dynamic Head: g 2. Depth to Limiting Factor = ft. System Head = 5 ft. 3. Landslope = % Vertical Lift = ft. ft. 4. Distance from Dose Chamber to Friction Loss =,q - Distribution System = ft. TD" = per'-~ 0 ~X ft. S. Elevation Difference Between / 12. Pump Selection: Pump and Distribution System = 0< ft. Pump tscharge at least gpm 6. Absorption Area Sizing: at ft. total dynamic hea S M Area Required = 7 ~ sq. ft. Pump model and manufacturer: rr/ ft. ~ t Bed or Trench Length (B) _ Bed or Trench Width (A) = ft. 13. Dose Volume: Trench Spacing (C) 10 Times Void Volume of ^J' Tj 7. Mound Height: Distribution Lines=_ gal. Fill Depth (D) ft. Daily Wastewater Volume r ` = - J al. Fill Depth Downslope (E) = ft. XDoses in 24 hrs. 7 Bed or Trench Depth (F) = ft. Backflow = 75 _c? X • to al. Cap and Topsoil Depth (G) = ft. Minimum Dose = al. Cap and Topsoil Depth (H) = ft. 14. Dose Chamber: 8. Mound Length: f~ Volume gal. End Slope (K) ft. Total Mound Length (L) ft. III. 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 (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 Rate = min./in. 10. Basal Area: 4. Absorption Area Sizing: Infiltrative Capacity of Refer to Table 2 in chapter H 63 Natural Soil = 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 = sq. ft. 11. If Standard Tables from Chapter /J Length = ft. H 63 are Used, Indicate Table No. J~ 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 n 5. Distribution System: 1. Depth to Limiting Factor = 410 ft. Lateral Length = ft. 2. Landslope - - % Number of Laterals = 3. Percolation Rate = min./in. Lateral Spacing = in. 4. Proposed System Elevation = ft. Distance from Sidewall to Pipe = in. er Load Total Daily Flow: gal. System Elevation ft. 5. Wastewat = 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 III Required Septic Tank Capacity = 111YSL gal. 6. Absorption Area Sizing: 2 V. SEPTIC TANK Percolation Rate = J min./in. 1. Capacity = Q -fv v gal. Area Required = sq. ft. 2. Manufacturer: fln System Length = ft. 3. Show Site Constructed Tank Details on Plan System Width = ft. 7. Distribution Pipe Sizing: VI. DOSING TANK ~~D Hole Size = in. 1. Capacity - gal. / r Hole Spacing = ,ft. 2. Manufacturer: 5 Lateral Length • 20 ft. 3. Pump Manufacturer: Lateral Size - , &I in. 4. Pump Model: Lateral Spacing; ft. 5. Operating Head= ft. Uisl.utce from Sidt+wall•lu I'ipe ran ill. 6. Flow Rate= gpm• H. Distribution Pipe Discharge Rale: 7. Show She Constructed Tank Details on Plans Number oI' itoles Per Pipe I low Per I'sl'e KPnt, VII. HOLDING TANK 9. Manifold Sizing: 1. Capacity = gal. I Ype (conger or end) 2. Manufacturer: Length = It. 3. Show Site Constructed Tank Details on Plans Diameter = In. -SHOW ALL INFORMATION ON PLANS- DILHR SBD-6761 (R.03/82) C.) PAGE 3 OF 7 PLOT PLAN SIGNED LISCENSE NO. N RTH DATE r sc~oes~e~ we/l ~.r~a, i Nyasa /Vp~,~ ~r ~ vealay 0 ~H. A 00C~ v 0,6 T vP, S•T. ONSITE SEWAGE SYSTEM 750 (font itaona #e s X63 ~o A Ism r% urlorROVt:u cp DEPARTMENT OF INDUSTRY. LABOR AND HUMAN RELATIONS ISION OF F A BUIWINGS SEE CORRESPONDENCE { NOTES 1. ELEVATIONS SHOWN ARE GROUND ELEVATIONS. 2. INSTALL PERMANENT MARKERS AT END OF EACH LATERAL. (-T REQUIRED 3. INSTALL 4" OBSERVATION PIPES WITH CAPS. ( a REQUIRED rr 4. PUMP CHAMBER TO BE 7,~~ GALLONS MANUFACTURED BY L S7~rn /rPC~s~ 5. SEPTIC TANK TO BE )oov GALLONS MANUFACTURED BY ~p~fP~n ~e C~S7 6. BENCH MARK ELEVATION IS Q DESCRIPTION OF B. M. 1faf'/ cl/red 01 9 /h eow*rf #A 7. OTHER NOTES Page: Of 7 Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand _ H G Topsoil F 3 D ONSITE SEW N / ContlitionaNj Slope in Plowed Bed Of i - 2 i Force Ma A No Aggregate From Pump Layer IPP-'R 0 V * E, jr) DEPARTMENT OF iN DUSTRY, LABOR AND HUMAN RELATIONS ISION OF Si+E`=1' A B~UIL~{NGS E Cross Section Of A Mound System Using ~ SEE CORRESPONDENCE A Bed For The Absorption Area F Signed: A Ft. H B ~ Ft. License Number: I Ft. Date: 00~ glgf/ J Ft. K ~Ft. L _~Ft. Force Main W o? ' Ft. L J Observation Pipe---,,,\ B K A Io i T Distribution Bed Of i"- 2 i Pipe Aggregate Aggregate I Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area page '6 Of Perforated Pipe Detail 0 it End View )Perforated End Cap) r' T PVC Pipe i `ore /e Holes Located On Bottom, Are Equally Spaced S\ e e- / PVC \ Manifold Pipe Position Of Distribution Force Main From Pump Pipe i Last Hole Should Be Next To End Cap End Cap Distribution Pipe Layout P R . S -y X . Jr r 7a Y Signed: Hole Diameter Inch Lateral Inch es ) License Number: ~D Manifold Inches Date: oe-f Iv-r-4,3 Force Main Inches ONSITE SEWAGE SYSTEM UeS l a4 of a Conaldionally ( APv%R0'rvUj fol. DEPARTMENT OF 1NL~J'•HY, LABOR AND HUMAN RELATIONS ISION OF SA AND UIL151NGS sys-~~m ~ ~v. )o lea SEE CORRESPONDENCE r a PAGE OF- PUMP CHAMBER CROSS SECTIOIJ AMID SPECIFICATIOIJS VENT CAP 4'C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING 25FROM DOOR. JUMCTIOAJ BOX MANHOLE COVER l e - (,(~/(,tJQ f n I ~tb ~Gtt7 WIMDOW OR FRESHI2"NIIU. i AIR IMTAKE 16 1.6 I GRADE I I-T40tIA1. I / 411 IB'MIIJ. COUDUIT 18"hllN. 11~ IMLET ONSITESEYVAGE~ VE'A L I III TIF APPROVED JOIAIT 'A` (f on 0 n f`k' I III APPROVED JOINT W/C.I. PIPE I III W/C.I. PIPE EXTENDIIJG 3' I II ALARM EXTENDING 3' ONTO SOLID SOIL DVO"D I II ONTO SOLID 5011 5 A R t: DEPA Th4ENT OF INDUSTRY, LABOR AND HUMAN RELATIONS T I ON C X TUN OF L!'~'LDWGS • I I Q~~ I ELEV. • r FT. SEE CORRESPONDENCE PUMP ~ pFF - D CONCRETE BLOCK 3" APPRo RISER EXIT PERMITTED C+IJLy IF TA►JK MAAIUFACTURER HAS SUCH APPROVAL BEOOIN(- SEPTIC E 5 P E C, I F I C AT I OM S DOSE IJU ) S~C'~~ reCeS MBER OF DOSES: PER OAy TANKS MAMUFACTURER:(('~ U W TAMK 51ZE: GAL-LOIJS DOSE VOLUME ALARM MAMUFACTLIKER: I' INCLUDING BACKFLOW: / GALLONS MODEL-WUMBER*. 261 14I^ CAPACITIES: A= ~SLINCHES OR :.3~GALLOWS SWITCH TYPE' _ r r B = INCHES OR GALLONS PUMP MAMUFACTURER. c m _ C=- INCHES OR GALLONS MODEL HUMBER: S(F, D= INCHES OR CA46GALLONS SWITCH TYPE: /nc°myrV MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE 4 _GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEU PUMP OFF AND PISTRIBUTION PIPE.. FEET f7,r0 3S + MIIjMIM''UM NETWORK SUPPLY PRESSURE . , . . . 2.5ly FEET / + FEET OF FORCE MAIN X S(! XIODft.FRICTION FACTOR..FEET TOTAL Dy1JAMIC. HEAD = FEET ci IMTERNAL DIMLWSIOMS OF TAUK: LENGTH ;WIDTH ;LIQUID DEPTH 51GNE D: bpllnw-~ y LICEOSE IJUMBER: 310 DATE: 1 - ~ / TOTAL HEAD IN FEET -~--~~-•~NNN N N -P O co O N -P W co O N -P m O O _ U1 N - O n ul o Cl) N > Cl) n ° 00, D ~ O o - O O r-. C r Wo r ~ N rn ~ _ m o CD m o0 M y ~ r av ~ ~ rn Z C C c 1 o O m 't7 N C U1 cn N O N O N -p O O N W -A• CJi M '-J W c0 TOTAL HEAD IN METERS K3068 State of Wisconsin ` Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION Office of Division Codes and Application 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 DENNIS HEWITT Owner: KLAUS STACKER ROUTE 2 ROUTE 1 MAIDEN ROCK, WI 54750 WOODVILLE, WI 54028 RE: Plan Number: SSO-40447 Date Approved: November 2, 1989 Gallons Per Day: 450 Date Received: October 30, 1989 Project Name: STACKER, KLAUS - RESIDENCE Location: SW,SW,29,28,16W Town of EAU GALLE 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: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 266-6952. Sincerely, Please Note: For future submissions, Plans drawn in pencil are unacceptable and will be d L returned to you. GERARD M. SWIM Section of Private Sewage Division of Safety and Buildings cc: KLAUS STACKER X Private Sewage Consultant SBD-6423 (R. 08/88)