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HomeMy WebLinkAbout014-1054-60-000 � - . 0 / ? \ ° ? m n { J to m � )i to e 2 z z \» r m o o f { 2 0 4% ;°@ *- » > > \ & , \ \ Q « \ c m o g ° . . Q 2 K K k(% i / 2 §\ 9 E E@ 2 G @@ R K E e $ « « ci ¥ \ a 8 (A ] ° E ` \ \ E t 7 / � _ § \ 0 \/ ƒ\ . : ® z k G \ \ � \ \ \ \ ` ( CL 0 0 3 o v m / - 7 \ R —E] § D 3 ` S ; Cl) z § I o 9 , CL C ƒ , & [ N) , \ . \ g 2 r M \ ƒ \ m 0 f { q 2 z 6 �$ Rte± § 2 \ k § a \ C\\ . /M/ \\ � . }} (� ) . s( { ai y , f � _{ \ � . \ � I ■ o ) e CD o \ \ \ 7 Parcel #: 014 - 1054 -60 -000 04/25/2008 04:08 PM PAGE 1 OF 1 Alt. Parcel #: 26.31.15.406 014 - TOWN OF FOREST 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 - ANDERSON, MITCHELL N & JENNIFER L MITCHELL N & JENNIFER L ANDERSON 1977 CTY RD P GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description 1977 CTY RD P SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 39.640 Plat: N/A -NOT AVAILABLE SEC 26 T31 RI 5W NW NW EXC E 12' OF W Block/Condo Bldg: 45' FOR HWY R/W Tract(s): (Sec- Twn -Rng 40114 160 114) 26 -31 N-1 5W Notes: Parcel History: Date Doc # Vol /Page Type 06/03/2004 764720 2588/132 WD 04/11/2000 621007 1501/511 WD 07/23/1997 974/280 07/23/1997 903/596 more 2008 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 10/18/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 15,000 101,500 116,500 NO AGRICULTURAL G4 10.000 1,500 0 1,500 NO UNDEVELOPED G5 27.640 27,600 0 27,600 NO Totals for 2008: General Property 39.640 44,100 101,500 145,600 Woodland 0.000 0 0 Totals for 2007: General Property 39.640 44,100 101,500 145,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 105 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y: Safety and Buildings Division Count INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: -f ^ 0 / -� Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)( m)1. / 0 Permit Holder's Name: ❑ City ❑ Village ❑ jown of: State Plan ID No.: IPSO 6/, s/p n :r Insp. M Elev.: BM Description: Parcel Tax No.: (7p,D 1 1 C;D 5 0 4-1054-60-000 TANK INFORMATION ELE ION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � v� P �C�S� — WO A S Benchmark / /0 /.O ' Dp • D Dosing Alt. BM si g3.22 Aeration Bldg. Sewer $• `� �- 2 -0 3` Holding St /Ht Inlet d �p, TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. vent to ROAD Dt Inlet ^ Air Intake Septic >Sb' NA Dt Bottom Dosing > 5-0 ' tt [ t -�, 8 2 NA Header / Man. Aeration NA Dist. Pipe 9 I z_ If Holding Bot. System s `' PUMP/ SIPHON INFORMATION Final Grade Manufacturer 5 S errand q3. zZ ` Model Number qo L} "IPM fl 1 o` iE:' ift q.*S Friction �� Syste 5 TDH ((.j 2Ft [ Forcernzin Length Dia. Fi t " Dist. To Well S AL ABSORPTION SYSTEM 1 Width Length No OfTtemekp PIT No. f Pits inside Dia. I Liquid pth DIMEN I N a DIMENSION f' SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIN Manu rer: SETBACK CRAM INFORMATION Type O � Modelr: System: lVt >5D t'112 NIT DISTRIBUTION SYSTEM Header / M 'fold Distribution Pipe(s) r 4 x V e Size x Hole Spacing Vent To Air Intake Length Dia. 2 Length 5') Dia. 2 Spacing a 3(0 '( SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No t wp COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1• fXc /d+/ 00 Inspection #2:c-- � Location: 1977 County Road P, Glenwood City, WI 54013 (NW 1/4 1/4 26 T31N R15W 26.31.15.406 1.) Alt BM Description= �'^"+ti � e--"' 5-0 1 C^4tA" + Z j 2.) Bldg sewer length = [ I }` 4 2 11 - f- -amount of cover = > ( .5 6019 l , l ✓- 3.) contour = 91.5 C 5 L-A - � R • J at" im = I) Ey evisl e" s � ,; l �° Imp i �"�: g` ' Plan o requlr ❑ Yes .4 No 01- 24 JA Us t s or addit*o al infor Z 10 (R.3 /9� , 3- � Date / n Inspector's Signature / �C t,, No 1. l 8 + +r• tot K �eoc vj, w a. ( )ap n (J as Pa*" 4yk"ees a tMS4►. f'f,,M.(aa�; a E r° :838Wf1N ilNU3d /kHVi[NVS H313NS aNV S1N3WWO3 IVNowaav vCi'Gr'Z SANITARY PERMIT AP"iLJt Mfii Bureau safety and Buildings Division of Building Water Systems <, D 201 E. Washington Ave. In accord with ILHR 83.05 Wfs. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the sys4err) on Jz- 4ourtfl than 8 112 x 11 inches in size. j i r t r t4 ; jn�C �h p _ ck ,5 nitar P • See reverse side for instructions for completing this appllciaatian p" sT � r' P ermit Number O 2 C*QX The information you provide may be used by other government agency progr`a(rps, 0 0(* y if revision to previous application (Privacy Law, s. 15.04 (1) (m)]: : '' . Z0 W#$0 ,, • Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL IN '`ca Property Owner Name r_ p8r y o v4, S T3 , N, Rj E (o Property Owner's Mailing Address Lot Number Block Number e Ci J State Zip Code or Phone Number Subdivision Name C ULU4 ber e 4� LY613 21 s� s� II. TYPE F BUILDIN (check one) ❑State Owned El Cit Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms 3 ❑ own of C + III BUILDING USE (If building type is public, check all that apply) Parcel TaxNumber(s) 4-0 1 ❑ Apartment / Condo / `T I L IO� © y 2 E] Assembly Hall 6 El 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 box on line A. Check box on line B, if applicable) A) 1 ❑ New 2. g 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 i ued. Per it Number Date Issued V. TYPE OF SYSTEM: (Check only one) gr Non - Pressurized Distribution Pre ur"ized Distribution Experimental Other 11 []Seepage Bed 21,9Mound e ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure —V r 42 ❑ Pit Privy 13 ❑ Seepage Pit ?!.� t ` 7 �®L 43 ❑ Vault Privy 14 ❑ System -In -Fill" VI. ABSORPTION EM INFORM ON: q3,� y� a✓ 1. Gallons Per Day 2, Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System V. 7. Final Grade �\ Required (sq. ft.) Proposed (sq. ft.) (Gals/day/s . ft.) (Min. /inch) Elevation Y v Z Feet Feet TANK Capacity Site VII• INFORMATION in a llo n Total # of Manufacturer's Name Prefab. Con Steel Fiber Plastic Exper. New Existin Gallons Tanks concrete strutted glass App. Tanks Tanks Septic Tank or Holding Tank 1 4 1 &4> /yJ /0We:LS Tv ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 1 A) e— ❑ 1 ❑ 1 ❑ I ❑ VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's N ame: (Print) Plumber' Signa are: (No Stamps) MP /MPRSW No.: Business Phone Number: Plumb is Address (Street, ity, S te, Zip Code : IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) A roved Surcharge Fee) pp ❑ Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divuio , 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 a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 1 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 and 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. IL 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 on 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 for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed ar)d tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanl<,s 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. ::omplete plans �r not small, 8 112 x 1 1 Ir;� hr�, must he suhmi'ted to the county. The plans must inOuue the foilovvin( t.l f 4ot plan, drawn _o scale or witf cornF)iete clicoensions, lo(ation of holding tank(s), septic ri� ,. �r i'�znk;; buildinc�scv = >��;yefis, s� ��,�; , _� s r� ice; streanuand lakes; pump or siphon s �:� A aF sorption <, =ms: replacemer ��; z�� u I cation of the building served Va?IOn ! I£ _ atloi a for purlp and iio rrols dose vo,umel alE =r_ f'hc loss, p c p Y' ,: c ' 3, pump manufa - )tore - , D) cross section {� , of �., ;absorption system if rc- a .a.rt;; E) ac 1, 1:.. r<� 1.1 S torm and L) all sizing information. _ u�, � .� :_, _ 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 contamination investigations and establishment of standards. Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 Vksconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary June 05, 2000 CUST ID No.227618 ATTN: POWTS INSPECTOR ZONING OFFICE TOM GUSTUM ST CROIX COUNTY SPIA N13450 937TH ST 1101 CARMICHAEL RD NEW AUBURN WI 54757 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/05/2002 Identificati Transaction ID N . 3195 SITE: Site ID No. 19320 TRISHA LEMKE - RESIDENCE Please refer to both identification numbers, ST CROIX County, Town of FOREST above, in all correspondence with the agency. 1977 CTY HWY P, GLENWOOD CITY 54013 NW1 /4, NW1 /4, S26, T3 IN, RI 5W FOR: Description: MOUND SYSTEM Object Type: POWT System Regulated Object ID No.: 666245 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. CAUTION: Wis. Stats. 145.135(2)(b)., indicates that the approval of a sanitary permit is based on regulations in force on the date of approval. The effective date of COMM 83 revisions is expected to be July 1, 2000. Thus, depending on the type of system and your design, this plan approval may not be eligible for sanitary permit approval if submitted to the issuing agency on or after July 1, 2000. Note: There is a otp ential for a lawsuit that may delay the effective date of the code so this status may or may not change. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. n Sincerely, r� DATE RECEIVED 05/25/2000 f FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 P ER E P L , P TS LAN REVIEWER II BALANCE DUE $ 0.00 Integrated Services (608)266-2889,M-' , 0745 - 1630 HRS PEPAGEL @COMMERCE.STATE.WI.US WiSMART;code: 7633. cc: TRISHA LEMKE RECEIVED A10UND Sly �XIES - MAY 2 5 2000 Residential Application pp rcatron SAFETY & BLDGS. DIV. INDEX AND TITLE SHEET Project 3 Bedroom.Nound Owner Trisha2mke I Address 1977 County Hwy P Glenwood City WI 54013 Legal Description NVV NW S 26 T 31 N R 15 W Township Forest County St. Croix Subdivision Name N/A Lot No. N/A Parcel ID Number 014- 1D54�0-II00 Plan Transaction Number P.O,W TS. Index and title sheet Page 1 F Mound calculations Page 2 ConditionQ'll y Mound drawings Page 3 A 1 Q Pres. dist. calcs. and laterals .Page 4 DEP MW D. TDH and pump tprr�c-dtavving Page 5 DM f S a f i �,A o Rc Plot Plan Page 6 U!L iNG$ Pump curve Page 7 ` SEE CORRESPO Designer Thos Gustum License Number D1201 Signature �c Phone No. 715 -658 -1344 Date 5/20/2000 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. Stats. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. SBD- 10462 -E (R.05198) Page 1 of 7 Shef40 Performance & Dimensional Data 40 30 SHEF40 W 20 IL 1�AL 0 10 20 30 40 50 60 70 P 3 -7/8" 6-5/8"(168.27) (98.42) 5"(127) LAII dimensions in inches. (Metric for international use). 2. Component dimensions may (98.4 2) vary ± 1/8 inch. Mot for construction purpose unless certified. 3-7/8" DISCHARGE (98.42) 1 -1/2" NPT 4. Dimensions and weights are approximate. FLOAT SWITCH 5.We reserve the right to make revisions to our product and their specifications without notice. 11 -3/8 IFL190 HYDROMATIC (288.92) 10- 3/16" (258.76) PENTAIR PUMP GROUP f 3 -5/8" 2" (50.8) (92.07) � 1 • r � i Performance Data pump Characteristics 1 111 tiM / Ud1 5,b Maud Nw" OVUM OVUM Aataalatk IAWds 0SP33A1 033A2 I1P Nw"ww 1/3 St 16 FaN WW AaI's 7.8 4.6 M41w Type Spik.r QAAL 1750 F • rbasa A 1 VdIaN 11S 230 Nwt: 60 c u 20 30 60 60 Dimon 1atww"Ont CAPACITY-1I.S. G.P.M. 1amwawa 140 °F Anlbi6nt Total NoW (14t) 4 8 1 16 44 ZS NEMA � 8 GSM 1/ N' 60 • SS 48 39 Z8 *dedw Gass F 0 *d wp Sin 1•i /r N� s.as "'"s" 5 />'' Di ensional Data ' ti Ufa %W* SO NS. 0 00 ' F 3- 7/9 sa/• Peww W 1• /3, Sr Slaw MiA l0' SQ (2rt.1 40' St4. Yd 1. Al&manY„ 4-1 /4 1.1/2 NPT 2. (wPo as"M{ Materials of Constructs imin "�' t. Steal 3.y� 4. ��wl. Adwi% s. rwnM���w Natty Now" Cut 'VM Cedq� UN %W F a- Cw6.a /t wft* Uftsw Sid 10dr. kuS s Sh6hSS St.d * k6a6 s-,/4 11 -3/4 ® PUMP Sb * Raw BA 16wi,y ■ ON aww &W! Sho NOW IaM t e&* ' 00 cast Ina ai teawl Stww"S Sled PUMP OFF AURORA /MTDROMATIC Pumps, Inc. N 1840 8anoy Road, Ashland, Ohio 44805 (419) 289.3042 n lvQ e 70 F 7 ; I 4 • i --i Z4 - i c ; r � , _ �I_ r i <� loe I t -t— - -- - J. / A.t S/ J o� I a i R3 I m � 8a rCJ 1 _ AROUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch - pounds Metric Residential or commercial? r (r or c) (y or n) L.�.� Replacement system? Creviced bedrock site? n (y or n) Slope 10 % Wastewater flow rate 450 gpd 1703 Lpd Depth to limiting factor 12 in 30.5 cm In situ soil infiltration rate 0.5 gpd /ft 20.4 Lpd/m Contour line elevation 92.5 ft 28.19 m Use standard fill depths? I x OR Design depth? r.- -y in cm Place X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth. Center or end manifold c or e> Hole diameter r in 0.121, or 0.3 3188, o 0.25, 0.281, or 0.313 inch only. Lateral spacing 4.00 ft Use 0 lateral spacing for trenches. Estimated hole space 3.00 ft Not a final calculation. Number of laterals 2 Pump tank elevation 85 ft Outside bottom of tank. Forcemain length 50.0 ft Forcemain diameter 2.0 in 1.5, 2 3 or 4 inch only. 2.067 in Actual I.D. HOLE DIAMETER CONVERSIONS 118 =0.125 1/4 = 0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5/32=0.156 9/32=0.281 Estimated daily flow 1 450 gpd 1703 Lpd 3116=0.188 5116=0.313 7/32 = 0.219 Absorption cell Design load rate & area 1.2 gpde 375.0 ft 34.84 m Linear loading rate (LLR) 8.33 gpd/ft 1:03.3 Lpd/m Design width (A) 7.00 ft 2.13 m Cell length (B) -54:4 16.A& - rn Depth of cell (F) j-D fin 25.4 cm Sarfln ter Upslope fill depth (D) 24.0 in 6 - 10 -- 1 cm Downslope fill depth (E) 32.4 in 82.3 cm Basal area required (gpd/infiltration rate) 900.0 ft 1 83.61 JM2 Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.5 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 14.05 ft 4.28 m Up slope toe length (J) 8.80 ft 2.68 m Down slope toe length (1) 19.40 ft 5.91 m Total mound length (L) 82.10 ft 25.02 m Total mound width {W) 35.24 ft 10.73 m „315E&oomldbund Transaction Number: Page 2 of 7 observation pipes (typical) J 35.2 ft A = 7.00 ft 2.13 m 10.73 m A B - 54:0 ft 16.46 m W B J= 8.80 ft 2.68 m I K I= 19.40 ft 5.91 m K = 14.05 ft 4.28 m L _ 1 8210 ft 25.02 m typ. obs. pipe (anchored securely) I = down slope dimension = absorption cell (AxB) J = up slope dimension =plowed area (LxW) K = end slope dimension T H 6" (152 mm) T MOUNp GROSS SECTION H subsoil cap D = 24.0 in 61.0 cm lateral topsoil c E = 32.4 in 82.3 cm invert 95.00 ft _ _ F = 10.0 in 25.4 cm elev. 28.96 m ? F G = 12.0 in 30.5 cm AS TM C33 H = 18.0 in LIMcm Sand Fill E Sys. 94.50 ft W y elev. 28.80 m 92.50 ft contour 28.T9 m elev. 10 % slope D = upslope fill depth- ploviedlayer E = downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = subsoit- +_topsoil-depth at cell wall centered across AxB media. The cell H = subsoil + top it depth at cell center media is covered with geotextile fabric. Deep chisel plowIng to break up top layer Project: 3 Bed,oc�rrtiMacmd Transaction Number: Page 3 of 7 P44MURE DIS' RUBU-TIOR CALCULATIONS Absorption cen Inch ounds Metric Width (A) 7 ft F 2.13 m Length (B) 54.0 ft 16:46 m Lateral specifications Number laterals 2 Holestlateral 1.8 holes Lateral length (P) 51.00 ft 15.54 m Hole diameter 0.250 in 6.35 mm Lat. dis. rate 20.97, gpm 1.32 Us Sys. dis. rate _ 74 7 1W.77 . gpm 2.65 Us Hole spacing (X) 36 in 91.4 cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) Place X in red X' one choice 1 1/4 in (32 mm) box of chosen from the options 1 112 in (40 mm) x diameter. provided. 2 in (50 -mm) x x 3 in (75 mm) I Ma diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) 'X" one choice 1 1/4 in (32 mm) Place X in red from -the options 1 1/2 in (40-mm) x box of chosen provided. 2 in (50 mm) x x diameter 3 in (75 mm) x 4 in (IM Trim) x Distribution system contains: 2 Lateral(s) LATERAL DIAGRAM - END CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. L aterals centered over- the - A fx B dimension Last hate drilled next to end cap en `l cap P • =Fori.Demain cal I+ X �l l Holes drilled on the bottom of the lateral $ equally spaced • tion uiatee or cross t o maniFold at any point. Laterals & Force main of PVC Sch 40 o = permanent end marker (per COMM Table- 84.34 -5) Inch-pounds Metric Lateral length (P) 51.00 ft 15.54 m Lateral spacing (S) 4.00 ft 1.22 m Hole spacing (X) 36 in 91.4 cm Manifold length 4.00 I ft 1.22 m Hole diameter 0.250 in 6.4 mm Lateral diameter 2.00 lin 50' mm Forcemain diameter 2.00 lin 50 mm Project: Bob Jensorr Transaction Number: Page 4 of 7 J Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code AC.E. Soil &Site Evaluations Attach complete site plan on paper not less than 8'/2 x 11 inches in size. Plan must County include, but not limited to vertical and horizontal reference point (BM) direction and St. Croix percent slope, scale or dimemsiors, north arrow, and location and distance to nearest road. Parcel I.D.# w. APPLICANT INFORMATION - P /ea$e(ptht all inform'Wion. 014- 1054 - 60-000 Personal information you provide may be used for, pdary purposes (Privacy Law; s. 15.04 (1) (m)). Fjeviewed BY Date Property Owner 1 Property Location R. Steinber er Buyer: Trisha emke Govt. Lot NW 1/4 NW 1/4 S 26 T 31 N,R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1977 County H . P City State Zip Code Phggeer City [ ] Village ❑Town Nearest Road Glenwood City WI 4013 =wc i ,I Forest County Hwy. P ❑ New Construction Use: z Resrdential,/Number olbbdrooms 3 ❑Addition to existing building ❑ Replacement ❑ Public &cammerciaLdekdbe Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpolft .6 trench, gpd/ft Basal area required 900 bed, ft 750 trench,� Maximum designLgpg rate 5 9polft .6 trench, gpolft Recommended infiltration surface elevations) 9 12" above 9-140'. 6e . g3 .5v — . s h s ( as re err to site an benchmark) Additional design / site considerations A y lacemeen - mound requiri g " 24" A sand lift. Additional sand will be needed to overcome 3-4" swale stemar ti Parentmateria ll loess over glacial till Flood lain elevation, if a licable NA ft for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank table for system I L] s M u ❑ S U ❑ S u ❑ S® u [IS ®U 71 s® u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD 1ft Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 1 0 -9 Olyr3 /2 None sil 2fsbk mvfr as 2f &m 0.5 0.6 2 9 -15 10yr3/3 None sil 2fsbk mvfr gs 2fin,lc 0.5 0.6 Ground 3 15 -20 10yr4 /3 None sil 2fsbk mfr cw 1f &m 0.5 0.6 elev 92.51'ft 4 20 -39 1Oyr4/3 m2d7.5yr5/8 sit lfsbk mfr - if 0.2 0.3 Depth to limiting factor Remarks: 2 1 0 -7 Olyr3 /2 None sil 2fsbk mvfr as 2f &m 0.5 0.6 2 7 -15 10yr3/3 None sil 2fsbk mvfr gs 2fin,lc 0.5 0.6 Ground 3 15- 3 1Oyr4 /3 m2d7.5yr5/8 sit 2fsbk mfr cw if &m 0.5 0.6 elev 92.98'ft 4 23 -42 10yr4 /3 m3d7.5yr5/8 scl lcfsbk mfr - if 0.2 0.3 Depth to limiting factor Remarks: CST Name (Please Print) Signature. Telephone No. James K. Thompson 715- 248 -7767 Address A-C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, Wl 54020 3/13/00 3602 1181 3 (� 3 Ow �cfa�d 5fe /7WYI/t)&AY,, 5ec.25 /3 1., 1977 do. �d. !� ,Q, 45 ► J, n -or s f, ■ So; / Ol�ser�a�on �Ler�cvicec ✓C �/, fit. Crb;x sYo /,3 Q 3.25' B y er: EXi "n dnet; ■ U i �/l4 �em�•c � S� Q c o: - M CI? omo.0: 5q 7,T) Aban4b r as pt/' cAdQ • J 66-�SE.¢le�a£fapo�' �_ -- Abanc56naspe�Ccde. ■ bui ld%n_q Sews ^ = y4.0� ' -- —� V Ex; 3 bdr'wt. koust;. e Poke 8 Uit Shed ■ vl �okndabroQ l�3 B2 9iso'c�,�k• Bat-n ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer - Mailing Address f 9 77 Property Address t J, (Verification required from Planning Depa nt for new construction) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location %, %4, Secg,_.-�, T LN•R w, Town of Subdivision , Lot # Certified Survey Map # . Volume j Page # . Warranty Deed # �;c�2 l 6,0 `7 , Volume � 1 , Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system i recess the septic tank is less than 1/3 full of sludge. condition and/or 2 after inspection and pumping f necessary), is in proper operating P P S{ P � � �g {) � Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da ear expiration date. / 1 ao S GNATURE OF 57 ATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the 'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATUJRE OK AP CANT DATE t * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * *•'' ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 1501 ?AGE 511 ' STATE BAR OF WISCONSIN FORM 2.1998 6 21 O C? 7 Document Number WARRAN DEED KATHLEEN H. WALSH '('y REGISTER OF DEEDS This Deed, made between Richard W. Steinber¢er and Donnette M ST. CROIX CO., WI Steinbereer, husband and wife RECEIVED FOR RECORD Grantor, 04 -11 -2000 8:00 AM conveys and warrants to Joseph E. 5 ne nd Tr a Lemke both si�l_1 gle persons VAWANTY DEED Grantee. EXEMPT N Grantor, for a valuable consideration, conveys and warrants to Grantee the CERT COPY FEE: following described real estate in _St. Croix County, State of Wisconsin COPY FEE: "Property"): (The TRANSFER FEE: 429.00 RECORDING FEE: i o- . 00 Recording Area Name and Return Address CITIZENS STATE BANK 1602 N Broadway Menomonie, WI 54751 otatasa -6o Parcel Identification Number (PIN) This is homestead property. NW IA of NW !4 of Section 26, Township 31 North, Range 15 West, St. Croix County, Wisconsin. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 6th day of April. 2000. ` richard W. Stemberger * onnette M. Stemberger ACKNOWLEDGMENT STATE OF WISCONSIN ) AunIlEN17CATION ) as. Signatu S t. C r o iobunty ) res) Personally came before me this day of April, 2000, authenticated this day of April, 2000, the above named Richard W Steinberrer and Don are M Steinhere_er. husband and wife '_ me known to be the * Krishna Ogland person(s) who executed the foregoing instrument and acknowledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) Notary b Ic, St of ' consin THIS INSTRUMENT WAS DRAFTED BY My Commission is permanent. (If not, state expiration date: Attorney Kristioa Ogland January ? 5 ?004 Hudson, WI 54016 ( Signamnsmaybe authenticated or acknowledged. BotharenotneemIaty.) NANCY GLAUS Notary Public State of Wisconsin I -Names of persons signing in any capacity should be typed or printed below djoir signmres WARRANTY DEED STATE BAR OF WISCONSIN FORM N.. S - 191E INFORMATION PROFESSIONALS COMPANY FONDOULAC.%M 8068552041