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Parcel 022-1091-60-000 09/20/2005 09:51 AM
PAGE 1 OF 1
Alt. Parcel 31.28.18.P496A 022 - TOWN OF KINNICKINNIC
Current ' k 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 - BROWN, ANNEXED * 4/09/03
ANNEXED * 4/09/03 BROWN
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 0.400 Plat: N/A-NOT AVAILABLE
SEC 31 T28N R1 8W PT SE SE COM ON E LN OF Block/Condo Bldg:
W 1/2 SE SE 120'N OF S LN: TH W 120'
N24DEG W 100' TO CL HWY M, ELY ON CL TO Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
E LN W 1/2, S 160' TO POB ANNEXED 4/9/03 31-28N-18W SE SE
N KA 276-1107-80-000 (971)
Notes: Parcel History:
Date Doc # Vol/Page Type
04/09/2003 716542 2200/012 AX
07/23/1997 917/446
07/23/1997 859/565
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 04/05/2004
Description Class Acres Land Improve Total State Reason
Totals for 2005:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 0 0 00
Woodland 0.000 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
DIVISION
LABOR & HUMAN RELATIONS ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
P.pO BOX 7969
S 4 State Plan I.D. Number:
Mp ISON X537 ec. 31 , T28-Rl8 El CONVENTIONAL ❑ ALTERATIVE (If assigned) j
Town r of Kinnickin,jc
LJ Holding Tank ❑ In-Ground Pressure Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: _T,• JAS
~
Ann Dusek Rt. 2 River Falls, WI 54022 ~'//d
IF DIFFERENT FROM PLAN: REF. PT. ELEV.: ST R . P 7
BENCH MARK (Permanent reference point) DESCRIBE ,3
.7,.3' ,
f0_11r. k
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Thomas Wan 3231 St. Croix 128716
SEPTIC TANK/HOLDING TANK. f73 5 f or"kee ' 6D,88
MANUFACTURER: LIQUID CAPACITY: TANK INLET EL ANK OUTLET ELEVV.: WARM G ABEL LOCKING OJRG,
f J 97, 97 YES NO ❑ YES NO
V1~ vJt~ ro 'GS
BEDDING: `W.W DIA.: VE +T MAT L.: HIGH WATER NUMBER OF ROAD: PROPERTY WEL BUILDING: VENT TO FRESH
~,o, C O. ALARM: FEET FROM LINE: r AIRI L T:
EYES NO Y C~ EYES NO NEAREST
DOSIN Gdf CHAMBE o V ? LOCKING MANUFACTURER: BED (QUID CAPACITY: PUMP MODEL: PUMP/BfPMAN MANUFACTURER: W
PROVIDED: ARNING LABEL pROVIDED:OVER
q k ' ✓ l (~S ES ❑ NO YES ❑ NO
tom/ - ❑ YES 506N0 7~ PROPERTY WELL BUILDI VENT TO FRESH
GALLONS PER CYCLE: PUMP AND CONTRO S OPERATIONAL: NUMBER OF LINE: AIR INLET:
(DIFFERENCE BETWEEN FEET FROM > z)(41
PUMP ON AND OFF YES ❑ NO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.)
CONY 7ELEV. WIDTH: NO. OF PIPE SPACI NG: COVER INSIDE DIA.: # PITS: LIQUID
/TRENCH TRENCHES: L: DEPTH:
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTRNUMBER F PROPERTY WELL: BUILDING: VEN TTOFR
BELOW PIPES: ABOVE COVER: : ELEV. END: PIPES: FEET FROM LINE: AIR INLET:
NEAREST -00-
MOUND SYSTEM:
Mound site plowed perpendicular, to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unstop `Y mound systems to make certain that it ON REVERSE SIDE. SHOW
EYES dN0' meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE: ` PERMANENT MARKERS: OBSERVATION WELLS;
L) `O I~Y1 dV Q,~ yl 5 I 5;,, S ❑ NO ES ❑ NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED:
CENTER: EDGES: /i aV91 ❑ YES - ~21CJ0 f ES ❑ NO ,i r
~5 ❑ NO
u
PRESSURIZED DISTRIBUTION SYSTEM: l~'' F3c cv>~. o~ >n I0? .(o
WIDTH: LENGTH: NO. OF L TERAL SPACING: GRAVEL DEPTH BELOW P PE: FILL DEPTH ABOVE COVER: 10 11
BED/TRENCH / TRENCHES: / / p
DIMENSIONS (P 7
MANIFOLD PUMP MANIF LD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING:
ELEV.: f ELEV. f DIA.: f ELEV.: PIPES: DIA.: (~d~
ELEVATION AND JOL), 0 Qt~' '`7G~.,C~(l a '1z - ~U
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY COVER MATERIAL: VERTICAL LIFT COR 4 ONDS TO y9t
INFORMATION 1 11 to AP OVED PLANS ,
2
Ca ES No EYE ✓S•S.0
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WjEL, BUIL G:
COMMENTS: FEET FROM LINE:
-r
L_rI~TtJ El NO 'DYES ❑ NO NEAREST
r
/S vv2 C-LC (~CZ f~.C / CO Z I~ ' i1 - / ( C/ ~t ? C Gti.C ~C.t~t i JC yy fJ p j( , .
.9,49
/ tain in county file for audit.
Sketch System one-~C-C_ 7, +b,
Reverse Side. SIGNATURE: TITLE:
SBD-6710 (R. 06/88)
DILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code 77/.
STATE SANITARY PERM T
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 0 7
8% x 11 inches in size. c f revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. ('990 11 U
PROPE TY OWNER PROPERTY LOCATION
11 L F'/aT e %,S 3 ( T.V,N,R I~ E(or W
PROPP OWNER'S MAILING ADDRESS LOT # BLOCK #
STATE- eir 1~~Llo lm< S ; ZIP CODE PHONE NUMBER SUBDIVISION NAME OR S ,NUMBER
II. TYPE OF BUILDING: (Check one) ❑ State Owned ❑ VILLLAGE ' NEAREST O
❑ Public ❑ 1 or 2 Fam. Dwelling-#~ of bedrooms ~ fEl TOWN OF:
AR E TA NUMB R() T
111. BUILDING USE: (If building type is public, check all that apply) I v 196 A
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 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. ❑ 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 F1 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 q. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
® 'I Feet Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App
Tanks Tanks structed
r7- rree t, 9.
Septic Tank or Holdin Tank G!
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Business Phone Number:
Plumber's Name (Print): Plum ignature: (No Stamps) MP PRSW
Plumber' Addr (Street, City, State, Zip Code):
ecj- La `J4~df~C/
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fso (Includes Groundwater a e ssue Issui Agent Signature (No Stamps)
Approved F1 Owner Given Initial Surcharge Fee)
Adverse etermination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety a Buildings Division, Owner, Plumber
s
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 4he 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, 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% 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 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 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 e
Location of property 1/4 1/4, Section TO~-N-R AP"W
A I
Township r i~iLM114
Mailing address O`
Address of site 15AA-Q
Subdivision name
Lot number
Previous owner of property
Total size of parcel ,2 hrp(3
Date parcel was created IBC' l d
Are all corners and lot lines identifiable? A' Yes No
Is this property being developed for resale (spec house)? Yes _ 0
Volume 05 and Page Number M 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 references to a Certified Survey Map, the Certified Survey
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 (are) the owner(s) of the property described in
this information form, by virtue of a warranty deed orded in the Office of
the County Register of Deeds as Document No. ; and that I (We)
presently own the proposed site for the sewage disposal ee il system (or I (we) have
obtained an easement, to run with the above described property, for the
construction of said system, and the same has been dul ecorded in the Office
of the County Register of Deeds, as Document No.
Signature of Owner Signature of Co-Owner (If Applicable)
M A6
Date f Si nature Date of Signature
FORM 339-WARRANTY DEED-TO JOINT TENANTS. (Section 230,45 Wisconsin Statutm „ urv ~++<<
Jl111
This Indenture, blade this 29th _day of December A. 1)., 1')72
between Robert J. Finger and Bette E. Finger, husband and wife,
parties of the first part,
and Thomas J. Dusek and Ann L. Dusek, husband and wife,
as joint tenants, parties of tilt, second Dart.
Witnesseth, That the said parties of the first part, for and in consideration of the sum of
.Eighteen Thousand Seven Hundred Fifty and.00/100 ($18,750,00) Dollars-------------------
to. them in hand paid by the said parties of the second part, the receipt whereof is hereby confes,cd and
acknowledged, have given, granted, bargained, sold, remised, released, aliened, conveced and conlirnted, and by
these presents do give, grant, hargain, sell, remise, release, alien, convey and confirm unto the quid pxlrties of
the second part, in joint tenancy, their hairs and assigns forever, the following descriht•d real estate, ,iluatcd in the
County of. - St..Croix and State of Wisconsin, to-wit:
Part of SE4 of SE4 of Section 31-28-18, described as follows:
Commencing on E line of W-z of SE4 of SE4 120 feet N of S line of
Section 31; W parallel with said S line 120 feet; N 240 W 100 feet,
more or less, to centerline of County Trunk Highway "M"; Ely on
said centerline to E line of Wz of SE4 of SE4; S on said E line
160 feet, more or less, to place of beginning.
;T''A1, St't
LEE
Together, with all and singular the hereditaments and appurtenances thereunto belonging or in any wise
appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said part_les - of the first
part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and their
hereditaments and appurtenances.
To have and to hold the said premises as above described with the hereditaments and appurtenances, 'unto
the said parties of the second part, in joint tenancy, and not as tenants in common, and to their respective heirs and
assigns FOREVER. n c~~ry
BOOK 493 PA A3 1
z
a
ST C- 105 r
a
H
SEPTIC TANK MAINTENANCE AGREEMENT o
St. Croix County
d
6WNER z
Alk
UYER ,~~,t~ ~
ROUTE/BOX NUMBER /C `2!P_ Fire Number
'5'VD a)
CITY/STATE ~!U(i4 ~`GCl J L[// . ZIP
PROPERTY LOCATION: Section l T i-l R (U- W,
Town of l2~ElC C~fb1121C~ St. Croix County,
Subdivision Lot number
Improper use and maintenance of your septic system could result in I
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 I!
the system can affect the function of the septic tank as a treat-
ment stage in the waste disposal system.
St. Croix.County residents may be eligible to receive a grant for
a maximum of 60% of the cost of replacement of a failing system,
which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration.
0
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- ►d
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
SIGNED n
DATE .G D
St. Croix County Zoning Office
P.O. Box 98-
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
ftPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, G DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 7969
HUMAN RELATIONS
9111 & Chapter 145.045)
LOCATION: SECTION: MUNICIPAL T LOT NO.:BLK. NO.: SUBDIVISION NAME:
1k B/4 /T,9tN/W'E (a (det ~ S
OUN Y: NER UYER'S NA E: MAILING ADDRESS:
(fit' a tk)er Falls 1~1t. Aoaa
USE DATES OBSERVATIONS MADE
NO.BEDRMS,: ICOMMERCIAL DESCRIP ION: PROFILE DESCRI IONS: R TIO TESTS:
I ~esidence ~ ❑ New Replace
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECO ENDE SYSTEM: (optional)
EIS 15A ES OU OS ®U OS U ❑S ®U
If Percolation Tests are NOT required DESIGN RATE:
If any portion of the tested area is in the ~y
under s.H63.09(5)(b), indicate: 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- t
60 a. n t" 4, cx~ B n / er o e
B- u • Ino G; 6
B- fill tN 1 ~i ! r
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD I PERIOD 2 P PER INCH
P- I 3\1 0 30 F 75A 37
P .30
1rl /
P- A
37
P-_
P-
P
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION h 3 , p
i ~
-
airy
v1 -
I~.
S a a-r4x 9j,,
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 : too, TESTS WERE COMP FD~O 90
ADORE CERTI TIO N MBBEJR, PHONE NUMBER opt nal):
IG RE:
CST SJ
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 - 6395
To and accurate sail test, your report must include:
1. r~ scription;
2. Th ust clearly indicate whether this is are i or commercial project;
1 IVIAXI er of bedrooms or commercial use planner`,
4. Is t ',s cement sy-,
5. Com,, 'lity rating s. A SITE IS SUITABLE ?R A HOLDING TANK ONLY IF ALL
OTHER ARE RULEC JT BASED ON SOIL CC -IONS;
6. PLEASE r. nations sh i here for writing profile descriptions and completing the plot plan;
1. ';'u A lram ac 'y locating Your test locations. I- ving to scale is preferred. A
-mark and v I elevation rr~~ference point are; c:; -)wn, arr' permanent;
3. )ropriate boxes i, . ~3 dates, nar.7es, food pla I .o _ t exemp-
10. : i jSUCl1 as tloo(l "'ai:i, elevation) de, ~ r >Iy, plar" a the appw --riate box;
11. w _ wi place your currc address and yor ..ion nur
12. ~i, b, copies and distii = - required. ALL 1IL TESTS 1ST BE Fi - ITH THE
I _ L)THORITY WITHIN , DAYS OF COMPLETION.
-REVIATIONS FOR CERTIFIED SOIL TESTERS
s and T as _ Symbols
st _ over 10") BR Bedrock
cob - {3 - 10-1 SS - Sandstone
gr )under 3") LS Limestor
' - Nigh C= r)cs a. S-Ind - Percu-t,
coed :s S nd W Well
I's - d E34dg E' . ldincl
Is - and j - t -n
`sl iy Loam < - I -arl
"1 Bn
Isil - t.irr: BI
si Gy
- y Loam Y "llow
`y Clay Loan-) R -
- i Clay Loam mot -
_ iy Clay ,pal
C:'ay fff
mm :'.an7
- Muck d
p
I-WL' - I' In ,
- ' 'l >s
Vfxrt ~
Tt
t t a Tir , core C y rest
n
c. fiined a,~,, ~t
s r Li S 3 t T281t 1 9 u
S4. CrOt>4 Co
cow ~ ~
~ rep sysKe-N b~
eD A.s peg, tLAR s3.o3(z)
~w,o,,•~t, ;,Sooc al SIP
3E TiC. a wl n~ rhn el,a-,ben
INJ
IREM/►tti➢ vN~~STU►z1b:_., 1 / .
n 0 VS 3SCDe*Lt ncin
L V
'1- \ / rs P o n+
Aerc- Farce)
I'
SF. Go n,_,.
S. P,1..
gJ y,~~ SYSTEM
nditio
APPRO - VED
NS
R r, ,0
INM6Tpy. LABOR ACLU NUM
OEPARI ME 1~f
OE SAS
3a~1 .
r ~I
Page - Of -
A
Straw, Marsh Hay, Or
Synthetic Coverinq~
- Distribution Pipe
vedlum Sand
T404611 F
E D
1 L A~Ir _s V
olt
tape
0 -god Of 2 % Force Main
z t Plowed
O1Cstggreqate From Pump Layer
R ~ GS ~
1.1 I
pLp~tM Cross Section Of A Mound System Usin E 13
g -79"
A Bed For The Absorption Area G 1
A g Ft. H i.S~
Signed: /
B 4 Ft.
License Number: I Ia. Ft.
Date: 01 Ft.
K1_Ft.
Alternate Position L t,-7 Ft.
. of
Force Main W Ft.
L
Observation Pipe
B K
'ot
.
of
I
Force Main
W From Pump
Distribution Bed Of 2
' Pipe z 2
1 Aggregate
Observation Pipe Permanent Markers
Y
Plan View Of Mound Using A Bed For The Absorption Area
i
Page _ Of _
I
Perforated Pipe Detail
n
End View
Perforated
End Cap( i" PVC Pipe
Holes Located On Bottom,
S Are Equally Spaced
A
PVC Force Main SC Ndl~ IE~Z"
'i"KE NON e FoLA .
To
Q
Distribution
Pipe '
Lost Hole Should Be
Nest To End Cop
Distribution Pipe Layout P y S Ft.
R
S 3,
X Inches
1 Y Inches Y= 3Co"
Signed: Hole Diameter y Inch
License Number: Lateral It L Inch(es)
Manifold 2.. Inches
Date: Force Main " r Inches
ON SITE GE1r11AGE SYSTEM . ; i # of= holes/Pipe (o
i.i. r Invert Elevation of Laterals l0 Ft.
~.,•C~Ota;~ttt~~'lGl ~ .
A R 0 V E D '
DCAARI~11EiJ F MUSTRY, LAbJti MD HIJW;vN EL' G
SAFE
1
PAGE OF
PUMP CHAMBER CROSS SECTIOU AND SPECIFICATIOUS
VEIJT CAP
H°C.I. VENT PIPE
WEATHER PROOF APPROVED LOCKIAIf"
- rF JUMCTIOLI BOX MANHOLE COVER
23' FROM DOOR.
WINDOW OR FRESH IL Mill.
AIR INTAKE
GRADE
I Y" MIFJ.
COIJDUIT
11
INLET
t ONSIT E AIR H*SEAL
t
APPROVED JOINT {f•.,.. "t~,~y. f ( III APPROVED JOINTS
. ~ e~ er {..Q I { I I W/C.I. PIPE
L,Tr Jrr}+~ -c' I I I { n` e I 1 ExTEmmuc. 31
ONTO SOLID SOIL, ' II ONTO SOLID SOIL
B 111~t~1• ~~4N1V~~ I
5 I I om
0 1N'Jlys>RY . ► w N . (
q p PORA 't pH OF { .
ELEV. FY
.z~~ OFF
c(I
D gE
CONCRETE BLOCK
RISER EXIT PERMITr'ED OIJL4 IF TAMK MANUFACTURSIt HAS SUCH APPROVAL
SEPTIC E SPEC.IF(CATIOUS
DOSE
TAWKS MAUUFACTURER: t j1~W~~ ~r~CQ`S 1 WMBER OF DOSES: -PER DA!d
TAWK SIZE: 7 50 GALLOMS, DOSE VOLUME Sv t s' 74 71/
ALARM MANUFACTURER: I`all h GSGsLI~ INJCLUDIAIG BACKFLcOW= ,411 -GALLOWS
MODEL AIUMBER: CAPACITIES: A= INCHES OF. 313~zGALLONS
SWITCH TYPE: g = IWCHES OR 3953 GALLONS
PUMP MANUFACTURCR: C=_sLINLHES ORZ2(01LCALLOUS 40 MODEL UUMBER: D= IMCHES OR 1.77_ GALLOWS
SWITCH TYPE: NOTE: PUMP AND ALARM ARE TO BE
MIMIMUM DISCHARGE RATE 37. Ll GPM QINSTALLED OU SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET
+ MIAIIMUM AIETWORK SUPPLY PRESSURE 2.5< FEET ~I
+ S FEET OF FORCE MAIM X L^U~ IF/00 nFRICTIOU FACTOR.._Q 5 FEET
TOTAL OSUAMIC. HEAD = /1'3 5 FEET
1UTERMAL DIM WSIONS OF TAWK: LENGTH v 7 ;WIDTH ;LIQUID DEPTH
1 ED.
S Gf\I LICEIJSE 1JUMBER: DATE.
. a>j
State of Wisconsin \ Department of Industry, Labor and Human Relations
SAFETY & BUILDINGS DIVISION
July 18, 1990
Western Regional Office
2226 Rose Street
LaCrosse, Wisconsin 54603
THOMAS WANG Owner: ANN DUSEK
ROUTE 4 BOX 382 B ROUTE 2
RIVER FALLS, WI 54022 RIVER FALLS, WI 54022
RE: Plan Number S90-40379
Project: DUSEK,ANN - RESIDENCE County: ST CROIX
Location: SE,SE,31,28,18W Fee Received: 80.00
KINNICKINNIC Date Received: 7/17/90
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 cross section of a mound system using a bed for the absorption area.
The current cross section shows a trench design.
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
(608) 785-9348 and refer to the plan number as shown above.
Sincerely,
GERARD M. SWIM
Section of Private Sewage
Division of Safety and Buildings
4PP039/000ln/15 COMP: 11
ELEM: 12
cc: ANN DUSEK X Private Sewage Consultant
SBD-6423 (R. 08/88)
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
THOMAS WANG Owner: ANN DUSEK
ROUTE 4 BOX 382 B ROUTE 2
RIVER FALLS, WI 54022 RIVER FALLS, WI 54022
RE: Plan Number: S90-40379 Date Approved: July 20, 1990
Gallons Per Day: 450 Date Received: July 20, 1990
Project Name: DUSEK,ANN - RESIDENCE Location: SE,SE,31,28,18W
Town of KINNICKINNIC 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/26
cc: ANN DUSEK X Private Sewage Consultant
SBD-6423 (R. 08/88)
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
L 911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
July 13, 1990
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
Dear Sir:
An on site investigation for the Ann Dusach property,
located at the SW 1/4 of the SW 1/4 of Section 32,T28N-R18W, Town
of Kinnickinnic, St. Croix County, revealed suitable soils at a
depth of 38 inches 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.
(]Since ely,
es K. Thompson
Assistant Zoning Administrator
cj
JUL-20-' 90 FR I 14:07 I D : SAFETY,. AND BUILDINGS TEL N0 : 608/785-9330 #565 P02 - ° -
~ C ' ~ N ~ ~ ~1 y `3 c c. 3 t X2.8 ~I 1$ t~.n)
K~rtir~i r- l< nr.k'c. pcJttiS~,~p S-~r0►~c l,b
~ywh ~ 1t ~ -
aban~.on f.~; Pti5 Pf~t ILHR #~~',~z~
3 be„4roor,
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swto
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o,er~ patc,c~ ...1
i'
AG5 SYSTEM
oNSI'rr Sew QQ
Condiao A PPROVED
AND HU R r,~o~s
L
OEPARTM
c &CC t anm
W.0
JUL-20-'90 FRI 14:08 ID:SAFETY AND BUILDINGS TEL N0:608i785-9330 4565 P03
Page Of
Straw. Marsh Hay, Or
Synthetic Covering
1 Distribution Pipe
Mialum Sand
T-00tbil G
• ti~+a F
VH pG
top$
CIO -god Of 2 Force Main Plowed
~~~,p'[td►'~g4regt$te From Pump Layer
Cross' Section Of A Mound System Using E (3
t 6EE 4~E A Bed For The Absorption Area F .-7 1
+ G
Signed;
B- Ft.
License Number; Ft.
Dat@: z ..7/~~ J ~ Ft.
K 1. Ft.
Alternate Position L_ Ft.
of
Force' Mein W Ft.
L
Observation Pipe-..,.,
• p ".."r"" K
Force Main
W From Pv mp
Distribution Bed Of Zr-- 2 `1.
' pipe
I Aggregate
Observation Pipe Permanent Mqrkers
k
Plan View Of Mound Using A Bed For The Absorption Area
JUL-20-190 FRI 14:08 ID,,SAFETY AND BUILDINGS TEL NO:608/785-9330 #565 P04
Of
- - page
Perforoled Pipe befell
view
t►erroratea
' end Coo PVC Floe
Holo• Located On Bottom,
Ars Sou911r ioe~e0
PVC Force Main KO GE; r 1~o TKe w4,tAtFvtt>.
Qietrilwlion '
~+ve
Lost We !hand Se
Neat To Lnd Cop
Distribution PIPS LaYout
- p y 5 Ft.
R
5 _
X Inches
• Y „ Inches Yr- 3w"
• Hole Diameter Inch
Signed: Lateral Inch(es)
License Humber: _ Manifold Inches
Date, Farce Main Inches
of,,'holes/pipe.
ON SITE SEWAGE SYSTEM
n~Lrt If Invert Elevation of Laterals ~p Ft.
on cU0 i
APPROVED'
CEPOI&Ci INDUSTAY, U WA AND HUMAN 01~
SAFE
SEE C-CRAWOND N slur:••;:~1•
Ll- VU r : L r i~E f-Y F ' I~1 rU I LD i NGS 'PEL NCB : 608 /785-9338 #565 P05
FAGK Or
PLUMP GHAMD~R CROSS SCCTION A?jQ SPECIEICATIOAIS_
VEWT CAP
4*C.=. VE1UT PIPC
WCATNCR f ROOF APPROVED LOCKtAiG
JUNCTIOLI &Ox MANHOLC COVER
? t3' FRCM DOOR, I>!'Mlli.
WjWDOW OR rRcSH
AIR INTAKE
GKADE 5: I 4' MIM,
I
IAILf T } }i 5I~e ~~W *~?'"A~ * ~~'ISRAL 1 III
~ ON 1 I I
r1,.i: r. I
APPROVED JOINY r;: , ► I AP►RQVRD JoWTs
• most- COI (I1 W/C.. PIPE
■Irr i
.
L:;'tLr~OS~711 iYTCtlmuci 3'
31
01JT0 bOL10 8pil. ONTO 30LID TOIL
e )P AND ~ tM1•►G'~ I
R
~ I ow
C IUD'
LLCV.~ FT.
OFF
01
.
CONCRETE OLOCK
RI9c}R EXIT PCKAMCD OULU IF TAWK MANUPAGTI.IR¢K H/-s SUCH APPROVAL
SEPTIC BPECIPL'L TIOI~IS
DOSE ,UKS MAIJUFACTUR6R: IJUMBER OF 003E3 : PER bAd
TA
TA14K 91X[: ~ GALLOWS DOSE VOLUME 1 SO f 'S. ELI 77
ALARM !"1AWUFACTIMIt: INCLUDING OAtKFLOW: X 5 GALLON'S
MODLL MUMB>ER: CAPACITIES: A*IUCHCSOR 31 GALLONS
sWiTCH TStIC: Iy a r'r Ificli js Olt W 99 GALLONS 16
P_ MAAIUFACPUKER: C ~ IUCH1Gs OR 1-1(*- GALLOWS
MODEL UUMS%K* 0- 10 _LiLr..IISGHE3 OR l-J _ 4ALLON~i
SWITCH TUPC: 'NOTE: PUMP AWO ALARM ARE TO SE ~
MWIMUM DISCHARGE RATE GPM INSTALL90 ON SEPARATE CIRCUITS
VEKTICAL I)IFFiRCNCE DETWCCU PUMP OFF AMD 013TRIbUTIOU PIPE.. &0 FCKT
+ MII.IIMLIM WI<TWORK SUPPLY PRESSURE o . . Is . . ,,.$15 FEET
+ 3 FEET OF FORCE MAIN k ^-~^:.t/lec~FRICTIGIJ pAcroR._ ..g 5 FZET
TOTAL D511AMIG HEAD = 1/3.5 I' LET
~ 7sl tj ~l ~ 3
IIaTER4m. CIM wstows OF rAQK; LEKICPTH MIDTH U2111D DEFT"
SIGurm LICENSE . LIWASER: DATE:
4.. 3