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HomeMy WebLinkAbout036-1093-10-000 ~ 0 3 °o I 3 °o I h ti 0 (A O ~ M 0> I ~ I M a Oq a I $ I O O H 6 m I ~ I I ~ I o Y I O O. L o c o aE I tl) U to N N y d y 00 T z c z c _ O 7 N 7 f0 ~ C I LL O L U. O 01~ c 3 = .o E ¢ w ¢ w I n Z r O Y p0 O ` ° M w a m II a m I M F- Z I O I C (7 O z a ~ Y y avi Z' a v c v c Z v~ F- r c E i o y 2 m ww c, •9 I C' ~+V v D N N c C N O • L IV 7 L ~ N vi O 10i a z z O a z z I i ~ I ~ N I N I z I li R N I CD c c _ o m °a o U) oCL U) am o m c v) a` v> m ' ~ E a Cf) U') v ~ j V~ rrr a co CL IL IL EO30O ° m Lo00 N I 4.; L U U 1~ a ° ° U) V 3 (D 3rnrn Z N N O N O O O c (D crn m rn o co a~ rn ti y c 2 v m (A 2~ d . m I 0) 0) O O w0 ~i' y C N p V E N -e c E O O O C U y C C 'O N N t, M LO H 0 c co y c y c 3 -CIO C, O c N 'Z: Z c~ N E~ N - •D n aD v c_ w ~ M A N co O p U ct O fO N O O O R U • O M fn ¢ N co Z N S F- r O Z_ Z ~ O d t0 Ii EL m 4 • o d .2 m a m *fti ti " FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SECTION T N-R / Z W ADDRESS ~f %?C~ ~fl ST. CROIX COUNTI, WISCONSIN do n 5 y SUBDIVISION LOT -LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM / 644 5 ire INDICATE NORTH ARROW r BENCHKARK: Elevation and description: /~f . Go rvFe i asi-f ,45 Alternate benchmark SEPTIC TANK:Manufacturer:1 /ao~ Liquid Cap. Rings used:-/-Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front, Side , Rear Ft. o-v From nearest prop. line:Front , Side5G , Rear Ft. No. of feet from: Well S I , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE r PUMP CHAMBER 57'. Manufacturer: u 5 Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front, Side_, Rear-Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: X Trench: Seepage Pit: Width: Length Number of Lines: Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front_,Z, Side , Rear Ft--i-ell" No. feet from wel / No. feet from building 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: PLUMBER ON JOB : LICENSE NUMBER: 3 6/90:cj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: NE,-,NE4,Sec.36,T31-R17 e e.ar7r)' v%► (If assigned) Town of Stanton CONVENTIONAL ❑ ALTERATIVE ❑ Holding Tank On Ground Pressure El mound NATAE O PERMIT HOLDER: ADDRESS OF PERMI OLDER: INSPECTION DATE: Rt: FK. d /B (Permanen reference point) DESCRIBE IF DIF E E FROM L REF. ELEV. CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: S PTIC TANK/HOLDING TANK: 6. pS "a. wc.-,c = , T 2 7 U Cam, -r MANUFACTURER: LIQUID CAPACI : TANK INLE - TANK OUTLET ELEV.: WARNING LABEL KING COVE / / PROVIDED: PROVIDED: 1 9-5) YES ❑ NO E] YES NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO RESH ALARM: FEET FROM LINE , AIR I ET: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST -41110- DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: pump/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO El YES ❑ NO ❑ YES El NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: 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.) I f CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: I TO VENT LE FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINrnE: AIR INLET: >Ieo NEAREST MOUND SYSTEM: 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 ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO COMMENTS' PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑ YES ❑ NO~f ❑ YES ❑/NO NEAREST-~ -.1 Zf~ cl 's? Cr O ._X1J IC<- q 57- .16 ( cy C, Y. on. et in county file for audit. Reverse Side. SIGN URE: TITLE: SBD-6710 (R. 06/88) DrLHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY C .o..~ .,.v,.,..,..,,~.,,e. AR PE -Attach complete plans (to the county copy only) for the system, on paper not less than STATE SANIT7 8% x 11 inches in size. ❑ /h.??if revision tRMJ o previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION '/a T N,R E(o PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE G ZIP CO PHONE NUMBER s9~ SUBDIVISION NAME OR CSM NUMBER ~ , /Js O 3~~ II. TYPE OF BUILDING: (Check one) El State Owned VILLLLAGE NEAREST ROAD ❑ Public 1 or 2 Fam. Dwelling# of bedrooms A OWL 'T Ax NuM R( ) lp ~~~lo III. BUILDING USE: (If building type is public, check all that apply) 3,6 1 ❑ Apt/Condo li /N r in Home 10 El Outdoor Recreational Facili 2❑ Assembly Hall 6❑ Medical Facl tyu s g ty 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) 1.0 New 2. ❑ Replacement 3. ❑ Replacement of 4. N 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 J'I`B-' 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 4.1-L70ADIfIG RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE L~ REQUIRE . ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION Feet . Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App INFORMATION Tanks Tanks structed 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. Plumber's Name (Print): Plumb ignature: (No Stamps) MP/MPRSW No.: Business Phone Number: t do P^a/^' $ ~G'l Plu Address (Street, City, State, Zip Code): IX. NTY/DEPARTMENT USE ONLY Ile, ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e asue Issuing en 'nature (No S m Approved El Owner Given Initial / Surcharge Fee) / r✓~'Y` Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/86) 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 kind/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. Vlll. 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; G) 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 rinonitoring groundwater, (Iraund- 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 inadequaoies 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 ~~s~„~e q \ o Location of Property It IV ly, Section , T 3 I N - R W Township J T 0, v` Mailing Address N 7 „ (0 4 46 A • w Subdivision Name Lot Number Previous Owner of Property Le-elene~~, Total Size of Parcel S~G2 Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes _ X No Volume 1761e;Z _ and Page Number Z-0-4!!-f as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed i 2. Land Contract 3.• Other recordings filed with the Register of Deeds Office 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 Nap, the the Certified Survey Map shall also be required. PROPERTV OWNER CERTIFICATION I (We) eekti6y that att b.ta.temen A on thi,d 6onm a,%e VLu.e to the beb•t o6 my (oun) h.nowtedge; that I (we) am (ahe ) the owner (d) o6 the pnopen ty deaCAi.bed in th.i.6 .in6oAmati.on 6onm, by vi tue o6 a wmAanty deed heeonded in the 066ice o6 the County RegiA teh o6 Veedb a6 Document No. ; and that I (we) pneb en tey own the pnopoe ed 6 to bon the d ewag pob s yd.tem (o4 I (we) have obtained an eabement, to hun with the above de cAibed pupehty, bon the conztAuction o6 eaid dyb.tem, and the dame ha6 been duty uconded in the 066.tee o6 the County Reg,ie,ten o6 Ueed6, as Document No. AIG Z35e2- sa-WA~~-- - NATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED 19911.3 4 WS::rvtt W',N.-r.ANTY DEED BOOK ~62PASk J ®V This Indenture, made this 1st day of December . 19 86 , between Federal Land Bank of St. Paul . a corporation, organized under the Laws of the United States, with a post office address of P .O. Box 199, Hi er Fa 1 1 s, WT 54022 party of the first part, and James W. Dalton and Clea E. Dalton whose post office address is Rt. 4, Box 157B, New Richmond Share of Wisconsin pan ies of the second, WITNESSET11, That the said party of tire first Part, for al,d in consideration of the sum oPne DOLLAR and other valuable consideration To it paid by the said parr i%S of the second part, the receipt whereof is hereby acknowledged, does Grant, Bargain, Sell and Convey unto the said part ies of the second part, their heirs, successors and assigns forever, the following described real estate, situated in the County of St Croix and State t Wisconsin to-wit: See Attachment A for legal description EXEMPT FROM R.E. TRANSFER FEE (2) subject to all existing easements and rights of way; also subject to all taxes on said premises for the year 19_85 and following years; also subject to all unpaid parts and installments of special assessments on said premises which have fallen due, or will fall due hereafter. 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 party 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 part ies of the se- coed part, and to-1bai theirs, successors and assigns FOREVER. AND THE SAID parry of the first part, for itself and its successors, does covenant, grant, bargain and agree to and with the said part leS of the second part, t.hP i r heirs, successors and assigns, that the above bargained premises, in the quiet and peaceable possession of the said part ies of the second part, theirheirs, successors and assigns, against all and every person or persons lawfully claiming the whole or any part thereof, by, through or under said party of the first part, and none other, it will forever WARRANT and DEFEND. IN WITNESS WHEREOF, the said party of the first part, has caused these presents to be executed in its corporate name by its duly authorized of- ficers, and its corporate seal to be hereunto affixed the day and year first above written. In Presence of.• THE FEDERAL D BANK OF SAI PAUL By _ c Thomas E. Hass, DiPectorJ of Acq. ProPet"i-i( Name nde Federal Land Bank Association "of N7 Gti s&=i n BAN rActing as Attorney-in-fact for the Federal Land Bank of Saint Pau! or., .•V, c'.Z CORPORATE t v.' v 0. Production Credit Association e y of SEAL By; . 05140 5186 ;rl~e0'°ueo~eee1\~\~: , ~~c►. Ptllll. State of L~ 1 U t,~S (1,. 1 BOOK NA',c Q ss. County of 771e foregoing instrument was acknowledged before me on Daft by of the Federal Land Bank Association Name 7lrte 1 I• Of as attorne in a n behalf of 6 d 4LanOBahk.of saint Paul. r My commission expires 11/22/86 Nwary tYb l < ` S a3 ^^J V St. Croix 7~'•1SL0,1?Slcl~ t County State • • 5 P State of 1 ss. County of 1 77te foregoing instrument was acknowledged before me on Dare by of the Production Credit Association of Name 77de on behalf of said corporation. My commission expires _ Nowry Public County Slate Drafted By: ~1- P.~ dF /1/or ~~wt3 ~•JSCanS'iit/ v 0 o, A o C• o, 121- Ln o Q CI4 • A W -IN 01, w U) 0 z A ~ v v A~ ~ O o V ~ U •ts O w C4 Ir rL; O . ~f10'r ~~~PAGE ATTACHMENT A I ,PARCEL NO. 1: (That part of the NW}.of Section 36 described as follows: ;Beginning at the Wi corner of Section 36, thence N 89° !54'24" E along the South line of the NWI, 2627.87 feet, thence N 00°40'.32" W along the East, line of the Ni, 2024.55 feet, thence S 87°36152" W, 458.14.feet,'thence S 16°10136" W,-66.79 feet, thence S 81°50'48" W, 391.18 feet, thence S 75°29118" W, 5$2.18 feet, thence S 33° 36122" W, 189.94 feet, thence S 3°12'38" E, 266.13 feet, thence S 73°57158" W, 132.49 feet, thence S 1018145" E, 220.96 feet, thence S 81033109" W, 630.19 feet, thence S 63°55'47" W, 130.06 feet, thence S 37°46'14" W, 50.17 feet, thence S 7°20'13" W 233.20 feet, thence S 76° 10130" W, 111.22 feet, thence S 21°59126" W, 178.90 feet to the West line of the NW} of said Section 36, thence S 1°26'53" E along the West line of, the NW}, 449.70 feet to the point of beginning. All in Section 36, Township 31 North, Range 17 West. Together with an easement described as follows: A strip of land 33 feet in width either side of a line described as follows: Commencing at the NE corner of the NW} of Section 36, thence West 660 feet, more or less, to the center of an existing driveway, this being the point of beginning, thence South 690 feet and there terminating. All in Section 36, Township 31 North, Range 17 West. PARCEL NO. 2: The NE of Section 36, Township 31 North, Range 17 West, except beginning at the NW corner of the NW}NEI, thence East 600 feet, thence South 225 feet to the center line of the Willow River, thence along the center line of said river in a SW'ly direction to the West line of the NWINE}, thence North along the West line 400 feet to the place of beginning, also except the North 629 feet of the East 346 feet of the NEI, as set forth in a land icontract recorded in Volume 619, page 206. Subject to existing highways, easements, and rights-of-way of record. UX 'T or-,~s ~'S J es W. Dalton CI )--a E. Dalton x- fi z N H r STC - 105 r H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z C1 a H OWNER/BUYER L7V'~ ROUTE/BOX NU ER Fire Number/l/ .CITY/ STATE Nee ~%%Cl wd_ W i 5• ZIP S q O 17 PROPERTY LOCATION: M_k, )_F k, Section 3 ~j TN, R_j1_W, Town of q~ St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners o.f all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H 0 E z I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with rx, the standards set forth, herein, as set by the Wisconsin Depart- b 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 DATE .St. Croix County Zoning Office P. 0. Box 98> Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. .IvT.oF REPORT ON SOIL BORINGS AND Y- SAFETY & BUILDINGS ND PERCOLATION DIVISION rfUMAN RELATIONS TESTS (115) P.O. BOX 7969 MADISON, WI 53707 3707 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT :BLK. NO.: SUBDIVISION NAME: /T- N/R/7 E (or A? COUNTY: OWNER'S BUYER'S NAME: S (7 r MAILING ADDRE S S 1SE / !C~ r NO. BEDRMS.: COMMERCIAL DE R TON: DATES OBSERVATI NS MADE Residence PROF1 ONew Replace a S' ESTS: a IATING: S= Site suitable for system U= Site unsuitable for system ZONVENTIONAL: ND: IN-GGROUNDPRESSURE:S STEM-IN-FILL r[jj_1 TANK: RECOMMENDED SYSTEM:(optional) S DU ©S ❑U OS ®U BU f I Percolation Tests are NOT required DESIGN RATE: nder s.H63.09(5)(b), indicate: If any portion of the lot is in the Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS JMBER DEPTH IN. ELEVATION OBSERVED E URING TOTAL PTH TO ROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR:: AND DEPTH HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) a 96'e 9 9S, s-~ a 4- 9e"2 jp oc~ PERCOLATION TESTS EST DEPTH WATER IN HOLE TEST TIME ~ VIBER INCHES AFTER SWELLING INTERVAL-MIN. DROP IN WATER LEVEL-INCHES TE MINUTES V 1P Rt D t P RI D PER INCH A I VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the III 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 d slop. N)TEM ELEVATION 9y' q j' /y . _ a R .r• t AeJA x, jar , EL7__ T1W en ....,ads v ~+f tf' , d~ r J. r % z i dersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin trative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief, print): I JTOEESTS r WERE COMPLETED ON: IFIC ION NUMBER: PHONE NUMBER optional): IG RE: TION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. D-6395 (N. 03/81) I • FLU 1 rLAN PPOJEtT .1a ~s alr~ ADDRESS f-2// 2~v/Crclj`n' 1/4 1!4/S~A/T ~YN/R /7W TOWN o COU Y _ Gro S~ 0/7 MPRS Byron Bird Jr. 3318 DAffE BEDROOM CLASS PERC CONVENTIONAL- IN-GR PRESSURE, CONVENT NAL LIFT MOUND HOLDING TANK SEPTIC TANK SIZE .f LIFT TANK SIZE DOSE TANK SIZE Da-- HOLDING TANK SIZE ABSORPTION AREA PERC RATE/ BED SIZE Benchmark V.R.P. Assume Elevation 100' Location of Benchmark 7 o o l/ * H.R.P. ❑ Borehole Q Well Scale = Feet 0 Perc Hole System Elevation F Q 6-41 0 ?5 8 ah. 1 V I I 1 v V a y , 64J su ti ST. CROIX COUNTY WISCONSIN ' ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 July 11, 1990 Charlotte Croes • Town of Stanton, Clerk 2264 200th St. New Richmond, WI 54017 Dear Ms. Croes: The septic system on the property of James Dalton, located at the NW; of the NE4 of Section 36, T31N-R17W, Town of Stanton was replaced May 28, 1982. At the time of the inspection the septic system met all current state requirements, therefore a building permit can be issued for this site.. Should you have any questions regarding this matter, feel free to contact this office, Sincerely, Thomas C. Nelson Zoning Administrator cj Parcel 036-1093-10-000 06i30i2006 09:26 AM PAGE 1 OF 1 Alt. Parcel 36.31.17.561A 036 - TOWN OF STANTON 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 - DALTON, MICHAEL J & MARK J MICHAEL J & MARK J DALTON 1759 HWY 64 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1759 HWY 64 SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 35.000 Plat: N/A-NOT AVAILABLE SEC 36 T31 N R1 7W 35A NE NE EXC E 346' OF Block/Condo Bldg: N 629' Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-31 N-1 7W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1069/443 WD 07/23/1997 874/316 LC 07/23/1997 762/100 07/23/1997 726/65 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/27/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 33.000 5,000 0 5,000 NO OTHER G7 2.000 17,000 255,500 272,500 NO Totals for 2006: General Property 35.000 22,000 255,500 277,500 Woodland 0.000 0 0 I Totals for 2005: General Property 35.000 22,000 255,500 277,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 129 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 L V / l vv.e flusen/: ti St G~tw L Fa '117-5 U S.9- CIJ 5 J ` - Poy Tacobso~ v Cp h ovnt Cr/oovs May qb O U.4 /59.73 C_-_n ~U 2z6 eye N~0 ~ D a 7& V1) 17._75 ~ltl dQ~ Ua~ 4 4 (Tohnsori s 0 Cx~ : i aa 235 5w Bo u„~ 4F ue do "COO z~ F 9i ca H /'Q '9Q ° .e,~e. b Av . ~ aas: Q ® W'~ U RO6erY`f/ C l0 S en~a zie /er- Leo j 0 9, .C the tl~ 4u s.a9 Ma yot ,pchacd a-0 Fyn a /p yyo F/oyd a~~. 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'kxx La✓o/s 9 y S V hn R ,Ee `,i~ = es o H- a t¢/ 4 p F f3acb. L¢mer5 5 a C , o K umm Q ^ /Posernar[ T.re, 9a = 160 ° 7/ 72/ 40 pro. y o rte. ri~ „ 1o Q' bV ~ 4~ Bo l(r°:~0 C Ea~ r4o C7i//s w r✓ca/ / • ~o a O A ° Q u~ 60 Q ry a .259. / tl d 3 f V On R_a-C_ 64 v U °V• ° (TZ w~ G J 117 112 4 K umm ri s . Qa t edcrson .2o cn 7R s f Jas. c'~y. 9//on ~ancois /9 (Tahcr Wa/sh `9✓ J Cody 'eta T ,ear/ L. (San 2 • ~ 'Oizo /20 ~ cjohnson We//s 9-a o Kro Per( NE (51CV-7 it Ta es F °RICH OND~ 0 /O 8'`3 tc it 9c1ss /bo Q~$ Denn/s L 917srn _ a Nancy Cody ~ 240./8 0 c!i vex ® 2¢0 3 4 /as v e 'e 9d Ca/ ,.r. f Ph //.s ° 2 ff N vC • ' • 1°7 o//nn CL ✓ fUi vian_ F Harvo 0 h &9,72 19s D M, 240 /'7ai~r .9 Yr crson Powers K gp y d Chr.sf-er>sen Rich Bet /tea Tc¢r~sei- b :o -sB /20 9 . o, /6o f'U/rich `Z Yq s c O R /y sr vE. a 67 • fb f2rs tR °l /aBrr~sr u ti 9 7 s e May R Trarse se C/are e ~C man K G OS 90 /zo . O o ®/98s oc;E dMP b/s,r c •I SEE PAGEaP 43 SEE PAGE 45 cSt Croix ouriy Ws Your Family Hair SKOGLUND OIL CO. Care Center Phone: 246-4767 The Country Greenery 140we 66 New Richmond, Wisconsin 54017 }{A.h, DeOigltm APPLE RIVER LARGE TREE TRANSPLANTING OIL CO. For All Your Garden Shrubs and PHONE: 246-6080 Phone: 247-3332 Landscaping Needs 324 North Knowles Avenue Somerset, Wisconsin New Richmond, Wisconsin 54017 Bulk Farm Delivery 1 MILE SOUTH HIGHWAY 65 A FULL SERVICE SALON Gas - Fuel Oil - Diesel NEW RICHMOND, WISCONSIN MILL - s AS BUILT SANITARY SYSTEM REPORT OWNER/1'tlf" _ TOWNSHIP el ll _SEC ..5 e T31N-R& ADDRESS -/i ST. CROIX COUNTY, WISCONSIN. A C✓ G2 SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 VEUTHING WITHIN 00 FEET OF SYSTEM l I di++a H:eo#hl A ro SC LE BENCHMARK: (Permanent reference Point) Describe: Y4- D11, Elevation of vertical reference point: Slope at site: SEPTIC TANK: Manufacturer: c►- Liquid Capacity: &t Number of rings on cover : Ian k manhole cover elevat on Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: zl Number of gallons 'Number of gal. pump set or a cycle /6-3 gallons; tota c ac ty o distribution lines gallon: size o pump head; gallon per minute a horsepower/ ran name of pump and model number • `T Type of warning ev ce HOLDING TANK: Manufacturer` Number of gallons Elevation of manhole cover Type of warning device' SEEPAGE PIT SIZE: Number of-pits eet iameter feet liquid depth seepage pit'in et pipe-elevation bottom of seepage p1t E: evation feet. lj leagtht/A tile depth 2 SEEPAGE BED SIZE: number of lines width SEEPAGE TRENCH: width length PERCOLATION RATE -AREA REQUIRED BU T - AREA INSPECTOR DATED PLUMBER ON J B . LICENSE NUMBER d DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOFt& HWAN RELATIONS PRIVATE SEWAGE SYSTEMS bIVISION P.O. BOX 7969 BUREAU OF PLUMBING r MADISON, WI 53707 ❑ALTERNATIVE State Plan l.D.Number A CONVENTIONAL : IIf assi nedl El Holding Tank El In-Ground Pressure El Mound . NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION DATE: BENCH MARK (Permanent reference point) DESCR BE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.. ST T~r~ Name of Plumber: MP/MPRSW No.. County: Sanitary Permit Number: SEPTIC TANK/HOLDING TANK: 4 I MANUFACTURER: LIQUID CAPACITY: TANK INLET ELE V.. TANK OUTLET ELEV. WARNING LABEL ILO.CK NG COPROVIDED: PRVID J 1 +r`, j C, v 7. i7 ,~P DYES ❑NO O BEDDING: VEN f-D fA.. VENT MATL.. HIGH WAT R NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENTTOFRESH ALARM FEET FROM LINE:n AIR INLET: YES ❑NO ( ❑YEUNO NEAREST ZD©t J`S { 7Sf ZO D.JA OSING CHAMBER: D, Co Z MANUFACTURER BEDDING. LIQUID CAPACITY. PMODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL %LOCK :11N, G C OVER `'7 PROV DEDED: YES ❑NO S0~ i 2-7 / C_..0c i YES ❑NO ES ❑NO GALLONS PER CYC E: PUMP AND CONTROLS OPERATIONAL NUMBER OF PR OPERTV WELL BUILDING VENT TO FRESH FEET FROM LINE AIR INLET: (DIFFERENCE BETWEEN z S f 7 Sf PUMP ON AND OFF) 1 DYES Nn NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of pipwi "NGTH - uIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction sh I ce.; until FORCE the soil is dry enough to continue.) MA N CONVENTIONAL SYSTEM: 1 1-1 _ WI IDTH: LENGTH... NO. F /IDSTP. PPE SPACI COVER INSIUE DIA.'. #PITS: LIQUID DEPTH. BED/TRENCH THE CHES MATERIAL: I_P1_T DIMENSIONS P J . 1- vcL _Lrl n FILL DEPTH DISTR. PIPE DISTR. P P ISTR. IPE TERIAL: NO. DISTR. NUMBER OF PROPERTY WELL. BUILDING: V NT TO FRESH BELOW PIPES ABOVE COVER ELEV. INLET ELEV. E D4 _ PIPES' FEET FROM LINE: AIR INLET: NEAREST f _ _ _ MOUND SYSTEM: Mound site plowed perpen, icular to slope eck th texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslo e~: m and systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ets the criteria for medium sand. TIONS MEASURED. DYES NO SOIL .`OVER. TEXTURE. PERMANENT MARKERS: OBSERVATION WELLS. DYES ❑NO DYES ONO DEPTH OVER TRENCH;BED DEPT OVE T ENCH/BED IDEP H OF TOPSOI L. DED SEEDED. JMULCHED: CENTER EDG S. ` NO DYES ❑ NO DYES ❑ NO ❑ PRESSU_RIZED DISTRIBUTION SYS M: V1, I V, , . r.YES 6, r NIDTH. LENGTH. NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FI DEPTH ABOVE COVER. BED/TRENCH DIMENSIONS (5 11, 1 24 Sa TRENCHES: 6 MAN/IFOLq"- ELEV. DIA IFOLD DI T WIPE. MANIFO MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: 5 PIPES DIA.: LE.: ELEV. , I 5 I V ~j I Qv C. ELEVATION AND I DISTRIBUTION I VERTICAL LIFT CORRESPONDS TO APPROVED HOLE SIZE HOLE SPACING. DRILLED CORRECTLY COVER MATERIAL: INFORMATION PLANS: f 14 1.5 31 YES ❑NO ~ lX1YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF 'P OP :RTV WELL: BUILDING: y, S FEET FROM LINE YES El NO YES El NO NEAREST = I I J ° I Z a;ryLt ~,(o~ zi, 10.611 Sketch System on Retain in ounty file for audit. Reverse Side. DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND, PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/Z x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Property Owner: Mailing Address: , C ~e Prope ty Location: City, Village o owns i County: Sy 6~, 1V W '/a/~ '/4S 41T,11 NCR E (or %~h S'Te Q Lot Number: 131k No.: Subdivision Na e: Nearest Road, Lake or Landmark: State Plan I.D. Number: (If si d TYPE OF BUILDING A-ARM D C,4 C' Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: 1 or 2 Family *State Approval Required. PA) (IJr_ ' Cr TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT 4Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER r MANUFACTURER:Q A-1 h~ /l C ` EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ New 0• Replacement Experimental/ Seepage Bed El Seepage Pit _ Z/ d2 j Alternative (specify) , C C s r!A Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Rep rt (If other than present owner): Private ❑ Joint ❑ Public ak 1, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. am f Plumber: Sign re: ^ MP/MPRSW No.: Phone Number: mb dress: / - Nam f Designer. ,X?)" I - Z COUNTY/DEPARTMENT USE ONLY Signa r of Issuing Age Fee--e: Date: APPROVED Sanitary Permit Number: & O ❑ DISAPPROVED L42 4~ Q Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (R.07/81) 3 . R" RECEIVED ..1. v e~ y yd " 1982 •~Q VLUMBItIG SECTION Q o 441 ~ a 'Ir i~ 41 41 a 1 'AN i • PAGE OF gal ® y 2 1982 :PLGMGI1dG SECTION CROSS SECrtG-OM OF A BED SYSTEM SOIL FILL Z" OF AGGREGATE DISTKIV3UTlOK1 PIPE APPROVED SUMTHETIC COVE r MATERIAL OR 9" OF STRAW OR MARSH HAy ° -'/2" A G G R. EGAT E. CJ l~ ° to OF %2 2 ELEV. OF~ FEETli `20171 ' DISTRIBUTIO►J PIPE TO BE AT LEAST WCHES BELOW ORIGIMAL &RADE A1JD AT LEAST20 IAICHES SUT 1.10 MORE TRAM 42. IAICHES BELOW FIKIAL GRADE MAXIMUM 'DEPTH OF EXCAVATIOLI FROM ORIGIIJAL GRADE WILL BE IAICHES i MINIMUM DEPTH OF EXCAVATIOM FROM ORIGIWAL GRADE WILL. BE INCHES SIGHED: 0 LICEIJSE UUMBL /,,e'~/ a! ` DATE* i < Page _ Of Perforated Pipe Detail 21 1982 End View Perforated / NG L~dN End Cop \e PVC Pipe S J at~ot`oe Holes Located On Bottom, W / S Are Equally Spaced S \ ~ P PVC Force Main 2 w From Pump ~Q PVC Manifold Pipe R7 Alternate Position Of Distribution Force Main From Pump Pipe Last Hole Should Be Next To End Cap 1 End Cap Distribution Pipe Layout P R~ S X ,~'f Hole Diameter Inch r Signed: -)"7 Lateral Ifs Inch(es) License Numbe • rl,'/- ~ 3Dy ~"P4onifold Z~" Inches ~Irk Date: aZ~. Force Main Inches J to L ?TIONAL WORKSHEET MOUND SYSTEM I1. IN-GROUND PRESSURE SYSTEWILontinued- 1. Wastewater Load, Total Dally Flow- gal 'h. 10. Force Main: Use section H 63.15 (3) (c), Wis. <y Minimum Dosing Rate = gpm• Adm. Code and PROVIDE A DETAILED el Diameter = in. LIST OF SIZING ON PLANS. 11. Total Dynamic Head: , - - 2.5 ft. Ystem Head : 2. Depth to Limiting Factor S 3. Landslope = 96 , Vertical Lift = ---U-S_ f 4. Distance from Dose Chamber to Friction Loss = Distribution System ft. TDi l = t• S. Elevation Difference Between 12. Pump Selection: Pump and Distribution System = ft. Pum w I scharge at least 6. Absorption Area Sizing: j at ft. total dynamic he Area Required = sq. ft.' Pump model and manufacturer: Bed or Trench Length (B) _ ft. Bed or Trench Width (A) _ ft.' 13. Dose Volume: Trench Spacirig'1C) _ ft. 10 Times Void Volume of 7. Mound Height: Distribution Lines 31 A gal. fC. Daily Wastewater Volume F111 Depth (D) _ 4 Doses In 24 hrs. _ 15-0 gal. Fill Depth Downslope (E) _ ft. Bed or Trench Depth (F) = ft. Backflow = /Q•M%Bal. Cap and Topsoil Depth (G) = ft. II 1-R Minimum Dose = fo3 n gal. Cap and Topsoil Depth (H) ® ft. Dose Chamber: 8. Mound Length: Volume = ?DDgal. End Slope (K) = ft. Total Mound Length (L) = ft. I8E ~'ENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: Q~M~n `y,~,~~G • Wastewater Load, Total Daily Flow = gal. Upsiope 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.QRequired Area = sq. ft. 11. If Standard Tables from Chapter A O • ~-ength = ft. H 63 are Used, Indicate Table No. Width = ft. 12. For the Distribution. Network, Use Numbers 5.14 in Section Number of Trenches = Trench Spacing = ft. 1. IN-GROUND PRESSURE SYSTEM S. Distribution System: 1. Depth to Limiting Factor = ft. Lateral Length = ft. 2. Landslope = % Number of Laterals = 3. Percolation Rate = ~r11n./In. Lateral Spacing = in. 4. Proposed System Elevation = jtjft. Distance from Sidewall to Pipe = in. 5. Wastewater Load, Total Daily Flow: 00 gal. System Elevation = ft. Use section H 63.15 (3) (c), Wis. Adm. Code and PROVIDE A DETAILED IV. SYSTEM-IN-FILL LIST OF SIZING ON PLANS. Fill in All Items from Section III Required Septic Tank Capacity = .1 620 gal. 6. Absorption Area Sizing: V. SEPTIC TANK Percolation Rate = 204 min./in. 1. Capacity = dj2a gal. Area Required = fS -3 .1 sq. ft 2. Manufacturer: System Length = ft.~ 3. Show Site Constructed Tank Details on Plan System Width = ft•i~ 7. Distribution Pipe Sizing- VI. DOSING TANK :O Hole She = In. 1. Capacity = g e. ft. 2. Manufacturer: Hole Spacing = Lateral Length ft. I. Pump Manulaclure~ ~-ss Lateral $iiu in. 4. Pump Model: 0.1- . - I't. S. Operating Head= ft. 1..11c1-.11 Spacing Distance 11-0111 Sidewall•t11 I'il+c In. 6. Flow Rate= Spm• 8. Dlslrihullon Pipe Discharge Rale: 7. Show Site Constructed Tank Details on Plans Numhur of Holes Per Pipe Flow 1101 Pipe Kpnl, V11. HOLDING TANK 1). M.milold SI/Ing: 1. Capacity = gal. I ype (wntur or und) C' Q.,7 7e r 2. Manufacturer: Length = J-7 0 ft. 3. Show Site Constructed Tank Details on Plans Diameter In. -SHOW ALL INFORMATION ON PLANS- )ILHR SBD-6761 (R.03/82) t~ PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS RECEIVED .---VENT CAP I }v i' C.I. VENT PIPE kUlABING SECTION _ WEATHER PROOF APPROVED LO ING JUNCTION BOX MANHOLE COVER 25' FROM DOOR, •IINDOW OR FRESH IZ"MIU. I ,IR INTAKE GRADE I ti" MIN. i IB"MIN. COIJDUIT-- 18"MIN. INLET PROVIDE I - K7 _ AIRTIGHT SEAL I I i I ~ V PPRO`JEU JOINT A j` I III APPROVED JOINTS J/C:'i. PIPE • G~,/ I III W/C.I. PIPE XTENDING 31 , ~~QI II ALAR EXTENDIAI(. 3 )NTO SOLID SGIL ONTO SOLID SOIL i~ OFF D poo L7 CONCRETE BLOCK Y J~h RISER EXIT PERMITTED OAJL-d IF TANK MANUFACTURER HAS SUCH APPROVAL SPECIFICATIONS. TANKpS MANUFACTURER: r„ 14.516"L (A.5 / , 17)II641 3MBER OF DOSES: PER DAy TAIJK :,IZE : '9SOD GALLONS DOSE VOLUME: GALLONS ALARM MANUFACTURER: CAPACITIES: A=/ INCHES OR Off' CALLOUS MODEL NUMBER: _ Jr B=a_INCHES OR GALLOAIS SWITCH TYPE: ' C= 7•SINCHES OR GAL MOMS ('LIMP MANS Tl_1RfR: ~ [ZARjor" D=_ INCHES OR CALLOUS 7 :7 Z NOTE: PUMP AND ALARM ARE TO BE MouEL NUMBER: ,r SWITCH TYPE: _ J~ INSTALLED ON SEPARATE CIRCUITS PUMP DISCHARGE RATE A //O - _GPM Tar 1 I VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET -I- MINIMUM NETWORK SUPPLY PRESSURE . , . , • . . , , , • 2.5 FEET -F FEET OF FORCE MAIN X -k~--FYOFT.FRICTIOIJ FACTOR..- .a FEET TOTAL DYNAMIC HEAD = FEET / 3* 3 110TERAIAL DIMEWSIOAIS OF TANK: LENGTH -~_;WIDTH ;LIQUID DEPTH 117 11 r „~l 51GAIED: LICEMSE IJUM ER: 0 DATE: "fit 0-~ TOTAL DYNAMIC HEAD FEET-METERS HEAD CAPACITY CURVE CAPACITY GALLONS-LITERS MODEL 277 287 297 10 SEWAGE PUMPS FT. M. GAL. LTRS. GAL. LTRS. GAL. LTRS. 30' 5' 1.52 109 412 128 484 170 643 10' 3.04 80 303 103 390 145 549 15' 4.57 44 167 67 254 119 450 8 s H 25' 20' 6.10 16 81 34 129 89 337 Q 25' 7.62 5 19 52 197 W 3019.14 17 64 W 20' ao W I 15, v MODEL 4 297 2 , O J 101 R iO F 2 Isk, 5' , V-2 MODEL 287 U.S. G LLON$ 20 40 80 80 100 120 140 160 180 LITERS 80 160 240 320 400 l- 480 560 640 720 FLOW PER MINUTE r RECEIVED CONSULT FACTORY FOR SPECIAL APPLICATIONS r „ C), 1982 is 3 phase 230V or 460V unit with or without pilot a High water alarms available. switch available. a Long cycleounits availablelTAPANlex" 00ex is Magnetic starters, disconnect switches and units for all voltages in single phase or three combination starters are available. phase. e Electrical and mechanical alternators for duplex systems available with mercury float switches. E. SINGLE PHASE UNITS Model* H.P. Volts Amps Wt. Model" H.P. Volts Amps Wt. 277 Automatic K 115 10.0 85 tbs. 287 Automatic % 115 11.6 87 tbs. D277 Automatic Y2 230 5.0 85 lbs. D287 Automatic 230 5.8 87 tbs N277 Non-Automatic % 115 10.0 85 tbs. N287 Non-Automatic 1. 115 11.6 87 tbs. E277 Non-Automatic '/a 230 5.0 85 tbs. E287 Non-Automatic 'Y. 230 5.8 87 The D297 Automatic 1 230 89 90 Ibs. E297 Non-Automatic 1 230 8.9 90 tbs. 208 V IPH AVAILABLE Automatic single phase % H.P. units are di- Automatic 3 phase units have a pilot level Consult NEC and Local Code tor,proper in- rectly controlled by float switch, % and 1 switch included and enclosed in switch cap stallation of controls, protection devices H.P. are controlled by float switch through a to control an external magnetic controller. and wiring. magnetic contactor enclosed in switch cap. Pilot switch is 230V maximum. •2" Discharge Shipped Unless 3" Requested "You Get More for Your Dollar - When You Buy a Zoeller" RESERVE POWERED DESIGN OELLEI~ Engineered purposely to pump less than design characteristics permit in order to 3280 Old Millers Lane Louisville, a safety factor for unusual conditions. Kentucky 40216 15021 772-2584 FM 387-0778 Qcuu~r ff,~ Smear ~AV . , ZffZLE/Q' O. 3280 Old Millers Lane Louisville, Kentucky 40216 (502).772-2584 COMPARE THESE FEATURES • Vortex Impeller Design "WASTE MATE" • Float operated, submersible (NEMA 6) mechanical switch. SUBMERSIBLE • Durable cast construction. Cast iron SEWAGE PUMP switch cap, motor shell, pump housing, base and impeller. No sheet metal parts to rust or corrode O R D EWATE R I N G PUMP . • stainless steel screws, bolts, float rod, "277-287-297" SERIES handle, guard, and arm and seal assembly. 2" OR 3" FLANGED DISCHARGE • Nine foot UL-appro%". ire neoprene cord & plug. - • Thermal protected. , • Oil filled motor- hermetically sealed. • All models are available with 3-phase motor. • 60 cycle, 1650 RPM. • Carbon and ceramic shaft seal. • Sleeve bearing running in bath of oil. • All models pass 2-inch solids (sphere). • All models are available in 2" or 3" discharge. *Amp Pump Mfg. Assoc. SPMA specification is On point-18", off point-5". Number Major width-l6". • Height-20". sc-2225 All Models SIMPLEX AND DUPLEX RECEWED SYSTEMS AVAILABLE PACKAGED SYSTEMS ~ 198 AVAILABLE PLUMBING SECTI N OfLLEf' O. ~o 3280 Old Millers Lane Louisville, Kentucky 40116 (502) 112.2584 ALL MODELS AVAILABLE • Automatic or Non-Automatic • 1 H.P., 1 Ph., 230V only • 2" or 3" Discharge • %z,'/.,)or 1 H.P., 3 Ph., 230V or 460V Msnufsctures of 0 % or Y: H. P., 1 Ph., 115V or 230V • Passes 2" Solids 9 State of Wisconsin Department of Ind sin r~L nd an Relations { l~iy/ I Aease. ply to: lY & BU'j~ NGS DIVISION Bureau of PI ` g 53707 - f~ r= Plan Identification Number L .J Re. PRIVATE SEWAGE SYSTEM ONLY- A The Bureau of Plumbing has reviewed plans, site survey information and installation details for the construction of an alternative private sewage system to be installed at the above-mentioned location. The plans and specifications were prepared by J / and received for r f approval on i The soil and site evaluation was conducted by The site meets the soil and site requirements specified in chapter H 63, Wisconsin Administrative Code, for the use of s The proposed system is fora Wastes from the building will discharge to a - ` gallon capacity septic tank which will discharge to arm ( 2 gallon capacity pump chamber from which a pump having a capacity of gallons per minute against a total dynamic head of feet will discharge through a inch diameter pipe to the soil absorption system. It is of utmost importance that the system be installed in complete accord with the plans and installation details and the conditions of-z approval contained in this letter. The licensed plumber responsible for the installation shall notify the county inspector when the installation of the system will commence so that the county inspector shall be able to inspect this installation. The installer shall not deviate from this approval and shall follow the directions or orders issued by the appropriate local or state authorities. In accord with ch. 145, Statutes, and ch. H 63, Wis. Adm. Code, the plans and specifications are approved contingent upon compliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep one set of plans bearing the stamp of approval of this department at the construction site. If the installation of this system has not commenced within two years from the date of this letter, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination oversight, construction or any damage that may result in or after installation and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on ch. H 63, Wis. Adm. Code, requirements. It shall be necessary to obtain and fulfill the permit requirements of the county in which this installation is to be constructed. Failure to obtain county permits will automatically void this acceptance. cc: OWS By: County Other Enclosures mes Sargent, B erector DILHR-SBD-6159 (R. 7/81) r .,9BUI31378 (9/81) (Plb 100a) STATE OF WISCONSIN DILHR -Detach And Return Upper DIVISION OF SAFETY & BUILDINGS Portion Of This Form With BUREAU OF PLUMBING 201 E. WASHINGTON AVE. RM 178 Any Return Correspondence P.O. BOX 7969 MADISON, WI 53707 / 608-266-3815 DATE:- t / .z PROJECT: oox / fN PLAN ID. I DETACH HERE PROJECT NAME At -"'S4f, * 0fe PLAN ID. # O 7 Z This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the required fee is $ AG?_-?- 4' 461, 7 Fee Received is $ ~D - E Underpayment - Please submit the additional fee. ❑ Overpayment - Refund forthcoming. Plan accepted for review, ❑ Plans being returned. No fee has been remitted. Plans submitted with no fees will be ❑ Additional information required. SEE BELOW. held in abeyance. 1. Plan Submission ❑ Complete data relative to anticipated use of bldg. ❑ Additional information shall be submitted in duplicate un- ❑ 2 copies of PLB 60 enclosed. less specifically noted. ❑ Deed restriction required (1 copy). ❑ Plans not clear, legible or permanent. ❑ Condominium declaration. (1 copy) ❑ All information submitted shall be signed, dated and sealed or stamped in accord with Section H 63.08(2)(a) Wisconsin Administrative Code. ❑ Affidavit enclosed. IV. Holding Tanks ❑ Profile of holding tank showing vent, manhole alarm and manufacturer if precast. Complete construction details if II. Pressurize Distribution Systems (Mound or In Ground Pressure) site constructed. ❑ Application for use of an alternative system signed by owner ❑ Holding tank agreement signed by owner and local unit of and notarized. (1 copy) government (sample enclosed). ❑ County onsite required (1 copy). ❑ Design calculations ❑ Reason for installing holding tank. Soil test or statement for pressurize distribution. ❑ Soil boring & percolation from county (1 copy). test data. % ❑ Plot plan showing location of holding tank with lateral dist- ❑ Cross section of system. ❑ Pipe lateral layout. ances to any building, wells, water service piping, water ❑ Plan view of system. ❑ Plot plan. course, lot lines, swimming pools, all weather service road, ❑ Verification of Exception Status Form by County. (1 copy) Etc. Provide benchmark with elevation reference point. III. Private Sewage Disposal Systems V. Lift Pump ❑ Ground slope with 2' contours in entire area of soil absorp- ❑ Calculations for total lift pump discharge, head and gallons tion system extending 25' on all sides. pumped per cycle. ❑ Elevation of permanent reference point (benchmark). ❑ Size, length & depth of force main. ❑ Location of area suitable for replacement system - provide ❑ Detail & model of pump or automatic siphons including soil data. size, pump curves, drawdown and average flow rate GPM. ❑ Plot plan showing lot size and all lateral distances from ❑ Cross section of lift pump tank showing pump(s) or sewage disposal system to buildings, lot lines, well, water siphon(s). course, swimming pools, water service piping, Etc. ❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. VI. Systems In Fill (Fill must be placed prior to plan submission) ❑ Construction detail and cross-section of soil absorption ❑ Total area filled (fill to extend 20' beyond edge of trench system. before side slope begin). ❑ Soil boring and percolation test on 115 completed by cer- ❑ Depth and type of fill. tified soil tester 0 Copy). ❑ Copy of onsite report by county or district staff. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS I DIVISION DUSTY,. p,BOR AND C P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOT.:BLK. NO.: SUBDIVISION NAME: D&V 4~ /T3 N/R17 E (orffl COUNTY: OWNER'S BUYER'S NAME: MAILING ADDR SS: t Lvi r Ad v i USE DATES OBSERVATI NS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: DESCRIPTIONS: JPERCOLATION STS: Cg 790FILE F Residence ! . &Z ❑New Replace I / G+ _ L ~ Or ~7 ~ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: ND: IN-GROUND-PRESSURE: ISYSTEM-1 N-F I LL HOLD I NG TANK: RECOMMENDED SYSTEM: (optional) ❑S[M S©U MS DU El SZJU 0S RU m - t If Percolation Tests are NOT required DESIGN RATE: SYS EM ELEV. If any portion of the lot is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: 4O f PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. GHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) e B- 9'9 74,,3 y „ W .s 011W k4 Z.,a" F4.w ~QI.V B- 9 96-v ~s-r~ a y B-.3 19R 9s- (Sb " a a a Qp B- -37 B- ACT ~VFO i~ W81 ~-j ION/NO PERCOLATION TESTS , 'AY TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES E MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. P RIOD 1 PERIOD 2 P PER INCH _30 ! I / (,P 17 A0 J//A. P- P- y of st ~ / / S 7 Cie P- No I YZ 4010 P-. P- P- PLAN VIEW: 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 slop. SYSTEM ELEVATION Q AC~ 6 (ks._ _ ,...Se f r„ /O i s ~ 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. I NAME (print): TESTS WERE COMPLETED ON: t ~ ADDRESS; CERTIFICATION NUMBER: PHONE NUMBER optional): 4G CST SIG RE: DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395(N.03/81) C°y