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016-1067-60-100
' n cnO n~nO 3 ~ o C .d. ~ C '~" ~ 3 A 3 O ~ O -p O ~ O ~ '~ ~ ID ~ ry . ~D 'O C ~ ~ i ~ ~ 0 ' N it 3 ^~ 3 ~: '~ cn ~ T. Z ~ ~ D ~_ -{ ~, Z o D ', ~ I' ~ o ~ ~; m o ~ ra ~ ~ ~ ~ v, ~ ~ a , j ~ ~ ~ m ~ i a 3~ a m ~ N . ~ N -1 m tin ~ w ~ N '' F j~ ~ (O ~ " N O > O W 3 y ~ W O ', p .~ p v Q. ~" 0 ° O ~ ~ ~ N _ a A v 0 o ~~', ~ ~ ~ ~ '~ o ~ ~ o D ° m cn ~ a o .Z 3 0 •z f o I 3 N N N i Q° 7 N N N QO ~ O O ~ y ~ ~ y ~ ~ ~ A to a a 0 A N G a m p~ Z CD V W ~, Z O) N O O ~ N N ~ H ~ j j ~ ~ ' N N ~ O N O N ~ ai N ~ p p W N ~ ~ N :: 3 O C .. Q C ~p I C ~p I ' ~ N. n. O O O 0.. ~ I a O O O .CD.. ~ , I ' ... ? , I ? ~ .Zl '0 ~ c < ~ 7 ~ 'D ~ ~ ~ j '.. I ~ I on ~°c ~ ai ai c~n o l m c aiaiai o ' o ' D N _~' ~ ~ ~ ~ O ~ o w ~ ~ O _C °o. o ~ O O I m e y ~ ~ N ~ y _ N .o . ~ n ' ,~ ~ f~D .~. N .' m a ~ _ 00 ~ .. ~ ~ A ~ ~ ~ N ~ ~ C I < ~ ~ C < N N A ~ O o ~'' D D o ~'' I i '> D D ' ~ O ~ O ~ I m m ~ I ~ i i ~ c - c I w ~ I m -L ~ > ~ > ~ ~ A Z i, ~ N N ~ ~ K ~ ~ ~ 7 .. ' O Z -1 w W ~ W ~ m W o o, ~ 3 { o, -, ~ 3 I ~ a z ° ~: I $ rt cn ' ~ o 3 3 ~ m !!_ cn ~ !~ .ZJ !~ .Z1 ~ ~ n 0 I I ' 0 '' W j W d ' I ~ ~ . y m ~ I 'v ,i Q -o v D 3 ' CD Q ~~ c .~. 3 ' N O fD fD C a 7 fD ~ O Q Q C 7 G C O a ~ T~ I m c m° w c 3 ~ < T~ ~ M O cc (D ~ < O I N O '6 ~ ~ to fD . N s 3a >> I ~ j ~ ~~ o ff I r. . c~ o o> x ~ I o i o. o ° o 7 fD N I I p ~ N . O - _ ~ N 7 O i Y N O_ C ~ O ~ ~ O O ~ t9 ~ W p p ~ I ~ _ u ~ Wisconsin Department of Commerce ~ ~~ ~ ~ ~ D~~ ~ ~`~~ ,~.__ ATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: Anderson, Ga & Carol City Village X Township Glenwood Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~. ~l ~ W ~ 1 (, IXrO Dosing ~~~ ~~~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic i 1 Dosing ~ S-o' ~ > 51D ~ D' Aeration Holding PUMP/SIPHON INFORMAT ON Manufacturer Demand GPM Model Number „ ,/~ `w~ TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist, to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: $t. CrOiX Sanitary Per No: ~ ~. 47 State Plan I o: Parcel Tax No: 016-1067-60-100 STATION BS HI FS ELEV. BencS `k ~,~ ~ ~~ Alt. BMA Bldg. Sewe O f ~lb•ZL SUHt Inlet ~ ~ ~Z ~ b l ~ 'T SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BED/TRENCH DIMENSIONS Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid De th SETBACK INFORMATION SYSTEM TO P!L BLDG WELL LAKElSTREAM LEACHING CHAMBER OR Ma urer. Type Of System: ~ gip' > ~-5' UNIT Model Nu~r: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to A take Pipe(s) Length Dia Length Dia Spacing 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 Bedl1'rench Center Bed/Trench Edges Topsoil ~ Yes [] No ~] Yes J No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~~/~~~- Location: 1226 280th Street Glenwood City, WI 54013 (NE 1/4 SE 1/4 1 T30N R15W) Lot 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = 3.) Contour = Plan revision Required? fj Yes No Use other side for additional informat' n. SBD-6710 (R.3/97) ,,~ . ~~ c~.c.uar m ,~..,.5E- ~'-- ~a e•,~.,Q. rK ~ ~K ~ ~--- - - t Date Insepctor's Signature Inspection #2: T'-7-~ /~el No~3S30.15.472A Q ~Jtir'~ ~~ « 1. ~%~`~- Cert. . , -+ - --••••_•--•p•r•,•vaa,v~~ ~ ST.CROIXCOUt~fCVWI8CC~18lN in aCCOrtt with 15_p4 gt. Crpix County 5anltary Ordinance Personal irrfortnation you ¢ravide may be used for seconds put ZpNINt3 OFFII:I! (Pr~+aoy t-aW $ 16 04(1)(m)j rY poses ST. GROIX COUN'T`Y GOVERNfi~NT CE 1101 Carrhichasl Road ~- 2 9 -O'L ~~~ Hudson, V~fl 54018.7710 (115)388.4680 FaX (115 386.4$86 Atiaeh complete plans for thq s stern on Raper net lees than 8-1l2 x a 1 inches in size. en Peir;m_~~'i n s, s-p Check If revisi c o ~,ou.~~^,~ AU"u 2 2 2 ZONINGOFFf arvu Blpdt umber .~~~~ Phonp Numer ubdlvision Name or C61N Number 171 I'^ H e ~• . ! _ ,ps. 1 ar 2 Familp OweBing - No, of her ^ PuDBc/GOrnmercial (descrlpe ;lee); d State-own®ei Nearest Road Check k~ox on line B if appiigble) ~ 1.^ Repair • I~ Recpnnection ' ` Non umhp -W n5 . p Rejuvenation src4 Tax Numbar(;a Sanltatian ~. / Bj V. T 1 P~nit Num~pr 1 5tatp SanPta permit was Rrevivusly Issued / ~ ~' ~ ?~ ~ ype of POWT S t / Da1te i66ued 1 Z ~ ~ ~ ~~ ys r3m: (Check all that appiy~ ~ ~ -~„Z ^ Naa-pressuri2ad lrhground ,~ ^ ^ ,~ Pressurized Itt•ground ~ ~ Mound C7 sand Filter d Holding Tank ^ Cona:rueted Wetland ', Di At e ' rsaVTreatrmm~t Area tnformatictn: . [~ Single Pass ^ Aerobic Trgsttrnent Unlt q Recirculating Cj prpp Ling ^ Otltpr . OeslAn Plow iaod) 2 n;~~...e~ ~.__ _ _. eRwreG IProppsed ~ ~ , ~._ (Gafs Id l ". ~ °"'•"°°""'~'~ n, system Elevation 7. : II . sq.ft.) aY (t~lin,/inch) 9~ ~ EI apalcty in t3allons New Exisling otel # of Qatlons Tanks Atanutactur4r Pratab 91t@ Con- 8t+esl f r- 7'dnks Tarim Concrete str~ted grass ra n ^ ^ u ^ D ^ 'a ti, Responsriblllty Statement ^ the undersigned, assume rosponsibAity for rgpairlreconne^+cUoR~rs(uvenaUynlinslatlation of non• lumbi Sor thl: PpWTS crown ~-SS is trot roquired tpr terralitt repair or the instaNaGon et rtan.pputri anilation system, p ~ O,t ~ attached Bans. A lu~ber's Namg Vii) r Plumharssir..n~ .__ _.__ _. w ,,. ,... ~ , - ~._... ~pCl-E-e) ,.. ,.. - Disaptxoved Sanitd~~ Permit Fee Approved Owner Glven Initibl Adverse Dais Issued lsau Agent Slgnamre (No stamps) Determl++ation ' ~, S• ~ 2~t ,~,Z K, C.olnd~lUon9 of Apprgyal/gaa onb for DisapproyaL 'f f~ Ie Is1.~S a~.~tt,Ot.,+n.S~ ~ ~.- dlGebKw2 •~- ,nta~ ~,P„v,,_ -~.s ~1.t4~ Nq.A.t,r,,~ ~ s~"+-~ W4st.. ' / GP.ae-~~`- tNw+ta..~ ~.....,0~ h.0.eyrc~CJM,~ -~ ~ Too~j :~~:a;.~toz I?~ ~~:~ ~.s A~g~ sec cat x~a o~r:~x amt zoirzieo FROM ROGERS PLUMBING FAX N0. 715 235 0867 Aug. 27 2002 12:56PM P2 ~---~ ~. C r` ~~~ . ~ . e I Y 1 v ~ I ~ ~-~^~ .~.~. -- J .7~ 1 L , ', 1 {G~ ~ O ; _ w ~ ~ ~ 3S f -~- ~ ~ i ,~ © ~ i ~~ \ 9~~~ - . Cs FROM : ROGERS PLUMBING FAX N0. 715 235 0867 Aug. 27 2002 12:56PM P1 R O GERS P.L UMB.~NG, xNC. N4563 320TH STREET . ME.NOMOME, WI 54751 ,PHONE: (7'YS) 235-1132 FAX.• (7X S) 235-086T F'ax Cover Sheet Date: ~- ~ ~' ~ ~_ o To: v Company: Fax #: _ ~/5"~~ ~~~(~ Re: F~ages: ~ Comments FROM ROGERS PLUMBING F FAX N0. 715 235 0867 Aug. 26 2002 08:24AM P1 Ro~E~s ~.~r~~~~~vc, .zrv~. .N4563 320T'r ST1?EET ME~VONIONIE, ~I 54751 1~'1SCONE: (71 S) 235-I I32 ~'AX.• (7ZS~ 235 0867 fax Cover Sheet Date: ~- Z~o'~r~...~ To; Company: Fax#: ~~~-~~(4-~~ Re: ;t.~ 1~11~UQ C~ ~ ~~ r _ ~ ,~ Pages: rnmmantc• ~C u~~u ~ m. y~ ~u <rta..l ,~U G ~Sc~ ,~ -,~~.~ ~~ t1N~I1M~Mw (- I.'~~''7 To: ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 Phone: (715)386-4680 Fax (715)386-4686 From: ~~ (, Fax: ~LS -~ Z~~ -- Pages: Phone: ~s'- _ 7i3 ~r- f ~ 3 2 Date: / ~ , ~(J~ Z Re: CC: ^ Urgent ^ For Review ^ Please Comment ^ Please Reply ^ Please Recycle • Comments: M~ -t~s f~~-p1•.. ,,,,~ ~- ~b TL.-.S S ~ V' ~~C ~S ~ _pe ~S ~~-~ C~~ ~~~~~ s~ /~ .~~/3/ _. GSTEM I4A P, DEP ARTl~E NT OF iND LABdR AND ,~ nnn~~., .:. __ Z~' ~. ~ - - ~~ ~~~,~~ ~~ l ~ ~ s-~ to ~ ? 1 `~' ~ti I -- ~s,~ ,3,` h~ ,~; /55 ~ -~. .. ~~~ SEE ~~~~~~a ~ ~ ~,~I~ 7~~ r-~ ~~~ y ~~ ~z ~~ ~f7o~9o a ~~~s Q . ~-n ~ .i,-~ k ~M~ ~.~ FROM ROGERS PL~JMBING, FAX N0. 715 235 0867 Aug. 26 2002 08:25AM P2 ROGERS PLUMBING, INC. N4563 320TM STREET MENOMONIE, WI 54751 PFIONE (715) 235-1132 FAX (715) 235-0887 August 23, 2002 RE: Well and septic inspection for Gary 8 Carol Anderson Site Address: 1226 280`h Street, Glenwood City An inspection was done at 1226 280`h Street for Gary ~ Carol Anderson. There is a Septic Tank and Pump Tank with manhole and cover. The tank has less than 1/3 sludge level and appears to be in good condition. At the time of inspection there appeared to be no evidence of failure. The inspection of this septic system was based upon a surtace inspection of said system, and did not involve any excavation or chemical analysis. Accordingly, there is the possibility of hidden defects not discovered by this inspection. This does not in any way warrant or guarantee the continued proper operation of this system. ft is also recommended that the system should be pumped as per required by the state. Therefore the prolonged life of this system may be dependent upon proper maintenance of system. New Wisconsin code requires a filter, this would be advised but not required, to be added to pump tank discharge. Respectfully, Michael R ers Rogers Plumbing, Inc. MR/jw ~ - 08!22;02 THLT 09:'53 FAX 715 78i3 4656 ST CRX CO ZONING WISCpnSinQ2p~rtMentpf)ndustry, PRIVATE SEWAGE SYSTEM Latlo'-dnd.1lunten RYelations Safety and BuildingsDivisian INSPECTION REPORT re.reew r ~arene..~~~i--.^iF ~ ~~ ~ ~Q ~ uS1~TACH TO PERMIT} a~r~s~r.nr+~mrvn~r~wrryr~ 280th Road Permit Hdldar's Namd: ^ [ity Vi age Town of: (pax Anderson Glenwood CSY B ew,: Insp. ,rev,: BM DescripUOn; ~7 ~-~~ TANK IN FORMATION TYP£ MANUFACTURER 4gPPSITY fepti~ fi ~, fl L..~ ~f r n lLi C.U4 • ~i (rlX~c<~ r, Dosing ~ : _ -~_, ~; i AerB Holding TONK SFTRO!'MC INPfiRMOTIPtiN (_ I _l TANKTQ PIL WELL BLL)G. Aelntake RQAD Septic ~. ~ I } r ~~! NA Dosing ~.~Q~ ~~ ~ ' NA Aera ' •- NA Holding PUMP!-SIPN~$N INFORMATION Manufacturer ;~'~~ Demand Model Number ~~ ~ GPM TDH Lift Z `ri~#ip ~~~; S~+stQrn gp TDH ~ ~ Ft ForCemain Length~~l Did. ~rl pist,ToWeil~!(fj}+ S0ILA65ORPTlON SYSTEM r~oo1 Lounty: St. Croix anitary erlrllt C.: Z4~233 State P an ID No.. S9G-fllo?5 ParC Tax No.: oa.6-xc6~-6ol-00 ELEVATION DATA ~DJ3/19r ~~,~' ~TATI4N ~5 HI FS FI Fl! !leinlnnmk ~ rJ-/ ~ ,r~/~~ r -r. , e ~ ~-~ `. , G'J./Dr Bldg, Sewer St! Ht Inlet r v ~ ~~ ' tiT1Yt f.L.iti4t Dt Inlet ~, , z.T, ,~.~' D B~'CtCrr~' "~~ ! ' .SG H eder /Man. ~. y~' ~ Dist. Pipe BOt. System p ~~ ~ Final Grade . ~. C_c~'A~ ~~ ! lid TREN Width I Length ~ Np. pf T n es W No. 4f Pits Ineido Dia. Liquid Depth N I N ~ I M -~. SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM( LEACHI Manu acturer: IWF4kMAt14N vr+~ System: ' x r ~~ ~ ~Q 7 (,~ CHAMBER ~ ~ QR UNIT s,,, , „„ D15TRISUTION SYSTEM Leng#h l~~pl pia. ~ ,str'Langth p~/ Dia. ~ Specing ~ ~+ " Hp~ ize x Hole~Sp~acing Ve~ o Ai~ntake r N ~ 1 501E DOVER x Pressure Systems Only xx Mound Or At-Grade Systems Qnly Dopth Qver ~ r+ Depth Over 11 r~ xK Depth 4f ,~ KK e~eded/sodded S xr< Mulched ~ 9ed 115~eneF-Center I 8edl~Edges ~ ~. ~ ($ rdp6oil , ~, L~~_. ^ Np~ ^ No ~ COMMENTS: (Include code discrepancies, persons present, etc.) ~~.,lar G~~ t~G;C laf rc~77,"•. r"~•~!G ~ ~, ~~l s.sy i '!~ ,C~ u.~r-~ mac, • : C~t•-~,~.,.~~.'r .r. 4G' ~,~ ~.::... ~ ~`i'~ ,. ,,~, .-. `~ "- -~•-~ ~ -, f'' ~U Plan r@visi0rl required? ^ Yes [~•fAo Use other side for additional in#ormatfon. (a SBb-6710 (it 05!41) Date Inspector's 5ignatare Cert No. 08/22/02 THtT D9:S3 FAX 715 986 4686 Mate o~ wieoanain July 9, 1990 Gary Anderson 1270 Lokhorst Baldwin, WI 54042 Dear Mr. Anderson: Re: Gary Anderson - Residence Onsite Sewage S~rstem NE,SE,31,30,15E Town of Glenwood, 5t. Croix County, YI 207 E. Weehington AvOnue P.G. Box 7868 Medieon, Wlsconsirr 5870'I Petition Na. 590-011675-P The petition for a variance requested to Section ILNR 83.23 {1)(d) and (2){c) 1.b. of the Wisconsin Administrat~'ve Code was considered on June 29, 1990. The petition has been approved. The rules require that a mound systen site have a minimum 24 inches of suitable natural soil and trenches in mound systems shall be 2 to 4 feet in width . The variance requested was to install a replacement mound system on a site with 9 inches of suitable natural soil and using a single 5 feet wide absorption area. All of the data and statements submit'tcd on behalf of the petitioner were considered. This variance is specific to the subject petition and cannot be use for any additional modifications. c rely, 'idlia ~rl ~ t ~ ~'+'ti Airector~ Office of Division ~~ Codes and~App~ ication (608) 266..30$0 NM:PeP:3601g ~~~ L~r4Y ,~~nskY, Privat® SewA~R Gnn5ult~nt ~ Distrir# 6f Chippawe Falls ihanas nelson, toning Administrator - St. Croix county Lyle J. hers, Plumber ST CRX CO ZONING ~l002 department of Industry, Labor and Human Relations SAFETY a BUILDINGS GIVI810N 6BO-cc¢a (n. ioMr! 08/22/Z682 19:58 'r'152354d41 GREAT AMERICAN HOMES PAGE 03 (h = ~~ ~. Z ~~t•i a °~ °~is f U = ~ ~ d j ~~ 4 [~ N ~ ~ ~ AT A,K - - - - - - - - - - - 4 1 I I 1 i I ~~ f ` t I I I I I ~~ I I ~~ i I I i i i I j i t ~-- --, I ~- -! ~ i i ~ ! I ! J I I I I I~ I I I I I I I i i I I I I ~ ~ i = t ~ I ~ I ~ ~ I ........... . ~.............j_ ~............. i::::;::;:::::~: i..r..,..~..i .~..~ ...:.............~. I i'I;Ili1 ! I I { I i I I y I I I - ~ I __, _ ; i L ~ I I .~l¢e,~ ~-- -~ l i ~ ~ ~ I ± ~ ~ I ~ a,~ ,, I I • ---•--- I ~ ~ r : 1 ~g i t A'~ I ~ I I ~ ~ ~ I ' I I ~ I N ~..~._, I I I ~. ~ I I ~--~-~- ~,~ .~ ~ 3 a I . i ~ I s i I ~ ~ 3 I I ~ I ~ I ~ ~ I I ''n''` ( ~ ~ r ___ _..,.. ...~~~____..r ~-.. b I I ~ I i t I ~°`~ I ' I p I I I I I I ~ I ~ I ,q,Y ~ I ~ I ~. _ J ~ ~~ ~~ ~~ t I ~~ ~~ s~ ~' ~~ ~,~ ~ l I e~ 9 ~~ ~~ I I i- _' - J ~ I g~~ ~ ~ ~a€ ~ I ~ I ~ ~~ ~ ~ ~~ 3 i I I ~~ I j ~ ~ ~~ ~~ ~~ -~~ I ~~ ~~ ~~ I b `~ ~ ~~ (6S i ~~~~ ~~~ b ~~~~ ~~~~ l i ~ ~^ pp ~ ~~~~ I i ~ I I I I I ~ ---------- -J ~ 08/2212002 10:58 715235A841 C;REAT AMERICAN HC1M19E5 PAGE 02 dVAOY dlydd ~ pxaq+~;. Jd00IC7 3r01YdR~l.11 dpy,~~ Q dWN900~d01 ~ 1 ~i g ~ b a ~I ~ ~ a ~ ~i p ~ ~ ~ ~~ ~ O ~ n ~, d • 1i, ~ .~ ~ j o .~ u oacmv1 j c~t,rnr ~% i ~ ~ 4 1~ -~ i .-~-- A C ~ 48 ~ a i i b ~ }' 9 1 ~ t. \ ~ d I~R ~ i ~ vl g ~ ,, d ~ ti. 1 ~ ~ '1 ~~ W h: k~ !_ii:~n~:i~ ' ~ ~ ~ O ,•Y' ~ ~ 1 ~ ~~~ ;• ~y ~~ ~ _ a ~ ~ ~~ ~ ~ ~ ~ ~~ ~ E ~ ffi z~ ....._~ ...._.. I 3s ~ ~ r~x~ ~ _._ L.~ _ JL _ J r ~ x r:r:: a~ ,i .. ! ws .~.~...•....--~--~ Pd1Y A~,+t If $~ 1 ~~~ ~ ! 1 ~~~ ~~~ G i ~ ~~~ ~ ~~ • f ~ ~I dN4100 J ?•,9t 1 Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM Labot and~luman Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMA~~ONF., 31, 30, ](S~'"fACH TO PERMIT) 280th Road Permit Holder's Name: ^ City ^ Village [~ Town of: Gar Anderson Glenwood CST BM Elev.: Insp. BM Elev.: BM Description: /G11. ~~ ~ Gv, as ~ ~ ~ ~-~ t_.-. TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~ ~,{J~S ~~,~r') FC~~• G'~. ~, Dosing ~~-~. S Aera ' n Holding TANK SETBACK INFORMATION U TANK TO P/ L WELL BLDG. vent to Air Intake ROAD Septic > U~ 7 ~'J~- ~7 ~~i 7 NA Dosing ~/~~ ~ a~r NA Aeratia+~~ ~~- NA Holding PUMP /~HBN INFORMATION Manufacturer ` e_~ Demand Model Number rte, ~ ~ GPM TDH Lift 2 Frictio 35 System Fi ~ TDH p,~ Ft Forcemain Length~~l Dia. 31I Dist. TO Well ~/Q~7 SOIL A6SORPTION SYSTEM~1 County: St. Croix Sanitary Permit No.: 149233 State Plan ID No.: S90-01675 Parcel Tax No.: 016-1067-601-00 ELEVATION DATA ~D~3I j9i STATION BS HI FS ELEV. Benchmark D ~ ~ ~~~ r T ~"-~ c-... ~~ /d Bldg. Sewer St1Ht Inlet S-' ~a ` St/Ht Outlet ~ ~~ ~,~' Dt Inlet ~ z7~ .~ ~ Dt Bottorr~l'~tk ,z ,s(, Hea2ler /Man. 3 . ~{ ~ 3~ Dist. Pipe 3.33 ~ ~ . ~ yL~ ~M1 ~ , Bot. System o a' ~ Final Grade ~° - H~- Cc.;~w' > 32 J. BIB TRENCH Width ~ Length ~ No. Of T enches PIT No. Of Pits Inside Dia. Liquid Depth DIM N I N S DI SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHIN Manufacturer: SETBACK INFORMATION TypeO 1 r / CHAMBER Mo e System: ~~ , ~ 7 ~ OR UNIT DISTRIBUTION SYSTEM +}esdes/ Mani~fpld ~t Di ~ h Distribution Pipe(s) ~ „ 7r ~ acin Dia ~ S L th ' x Ho ie Size /~ x Hole Spaaing ~ Vent To Air I take 7 a. Lengt _c:~~_ p g eng . ~ r SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ~+~ ~~ Depth Over !~ ~, r$ xx Depth Of ,~ l ~ xx Seeded /Sodded ^ N es xx Mulched ~}-1'E!'' ^ No Bed /~rtneFrtenter ' O Bed /~ceadtiEdges / - Topsoi ~ _ COMMENTS: (Include code discrepancies, persons present, etc.) t t,/..-~ <.r ~;~! ~ t 4E ~~ ~~•, ~,,•~ - /, ~/ ' .. - - . ~-. .> _ ~ a ~J 9 9 9g - 9~ ~ 9~ s~~ ~c5 ~.~ ~~ ~" ~~~ Plan revision required? ^ Yes L~'No Use other side for additional information. ~(v A SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ~-~ _ _ CONITORY PERMIT OPP1 1[_OTIIt~N ~' ~ILf"'~Fi -- -- -- - - -- - - - -- ----- - - -- - -- -- - - - - - - _~~,,,,,,_„a In accord with ILHR 83.05, Wis. Adm. Code couNTY ,_ ~ 1 ~ D 1, STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ~ S/ 9 ~ 3 3 8'h x 11 inches in size. ^ Check if revision to previous application -See reverse Slde for InStrUCtIOr1S for COmpleting thlS appllCatlOn. STATE PLAN I.D. NUMBER i. APPLICANT iNFORMATK)N -PLEASE PRINT ALL INFORMATION. S 9D - O / !0 7 S' PROPER OWNER '~ PyRp~RTY LOCATION R S~ E (or~l S l L~ N IUD '! ~1 ~ '/ ~ - , , . a, a PROPERTY OWNER' MAILING ADDRESS LOT # ~~ ~ BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ~/gZ C-71GL1/~ ! ~ II. TYPE OF BUILDIN (Check one) CITY ~ NEAREST AD ^ Stat@ OWned ^ VILLAGE ~ Lc:71 )a~JJ :~ ~~ _ . ^ Public 1 or 2 Fam. Dwelling-~ Of bedrooms AR ELTAX N MBER( ) III. BUILDING USE: (If building type is public, check all that apply) ~ ~ ~ ~ _ _CJ~ 1 ^ AptlCondo 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 ~ 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 (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./i/nch) q/ 7E+,LEVATION .~~ 3 c ~ ~`o ~ ~, ~~~ fo l (~~ ]Feet d ' ~ Feet VII. TANK CAPACITY in allons Total # of f ' N M t Prefab. Site Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks ame urer s anu ac oncret glass App Tanks Tanks structed Se tic Tank or Holdfn Tank f~C~ ~ ~ ~+ tac.J~-$ '~7CsJ Lift Pum TankfSi hon Chamber ` ~- .SZ G,ti E '~ c_1.~ C' ~!J G VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system show on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) P/ PRSW No.: Business Phone Number: ~~ ~ ~/ ~~ ~ ~ C ' -` ~ ~ -JGV ity, fate, Zip C e Plum 's Address (Street, C ` d ~~G ~~1C 7 ~ ~C G: L~/CSC-ter C IX. COUNTY/DEPARTMENT USE O Y ^ Disapproved Senile Permit Fee (Includes Groundwater uroharge Fee) ' a e ssue Issuing Agent ignature (No Stamps) ~ , ' Approved ^ Owner Given Initial ~ C ~ S ~ ~ /~, ,~ ~ _ (~ J /V ~~ Advers D rminati n 7 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety S Buildings Division, Owner, Plumber INSTRIJCTION~ 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. Ali revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sa~,nitary Permit Transfer/Renewal Form (BBD 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. tf you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, fi08-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one anti 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 inform:~tion 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 a!/ 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 m~~st 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, dra~Nn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tsinks; 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 f~~rm; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surch~irges (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. SBb-6398 (R.11/88) ` 4w 1 _ .,~ ~' ~ ~ ~~~ ~~~~~~~r /~ ~ cif STEM .. ~~ P E DEPARTMENT OF iND ,, . ~ tA84R ANA ~ ~ ~ _ D!V!S! F~7Y B S R ~ ~ _ _. _ 220 - _ ~ --- - __._ . ~. h~ 1 -u -- 3 ~..../-~-- ~ ~ ~~ ,,~ ~~a ,~ . ~~ a , ~~~~ ~--- 3 ~, ~ `; ~ iY;.~ ` I.;G 0" ~r, .___ , d~ 2b ~ `~ ~ ~~~ .mss ~ ,-,. ~ i _. ___~ . _ _ _ . _ ___ . _ _ , . _ __ _ _ _ _ I I I~ ~ I'~I °~ ~~ ( s ~ ~ - ~ 1 s ~ 5 o~y-~ ~ ~~ ~~ ~z.~ c/zo~yo l+Ce SEE s,a _ 1:~~s ,~ ,~,~~ ~~ ~ Sys, <~ ~~ /~ 5~ S rf~~~' ~~o~ State of wISC0I1Slll ` Department of Industry, Labor and Human Relations 2 Y ~~ PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION Office of Division Codes and Application 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 LYLE'S PLUMBING & REPAIR ROUTE 2, BOX 4lA BOYCEVILLE, WI 54725 Owner:)' GARY ANDERSON 1270 LOKHORST BALDWIN, WI 54002 RE: Plan Number: S90-01675 Date Approved: July 12, 1990 Gallons Per Day: 450 Date Received: June 26, 1990 Project Name: ANDERSON, GARY - RESIDENCE ~ Location: NE,SE,31,30,15E Town of GLENWOOD 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 appr®val is for the following c®mponents •nly: - REPLACEMENT PETITI®N - REPLACEMENT M®UNR Inquiries concerning this approval may be made by calling (608) 266-2889. Sincer , ~// Lam. PAGE L Section of Private Sewage Division of Safety and Buildings PPP013/0009n/ 9 cc: GARY ANDERSON ^Private Sewage Consultant County _UW--SSWMP _Plumbing Consultant Owner Plumber Environmental Health SBD-6423 (R. 08/88) • ., 'i"C.I. VEAlT PIPC ~ 2S' FROM DOOR, WIA100W OR FRE5H AIR IIJT/1KE ' ' ' PAGE ..__. 0 F PUMP CHAMBER CROSS SfCTI01J AA1Q SPECIFICATIOAIS ' VElJT CAP JUW 'f'IOAI sOX~~ ~APPROVCC LOCKINIG MANHOLC COVRR IL'MIU. ' GRADE 1 18"MIN. 0~5~~ I IuLET APPROVED JOINT W/C.I. PIPE ~ CXTEMDIAI4 ~'C~~~ 01JT0 SOL10 EVIL L L E V:.._.._._. F T. ' ~~~•~O v~,~Q. ~ I I I I ,~.~~0~ 1 ~AIQUIT ~-'- l \~ 'i' MIAJ. ,/l ~___ 1D_nlu•: PROVIDE ( AIRTIGHT SEAL { ~ I ~__ -7 ,O~ Q 5Q I {'~ APPROVEL ~ ~ I I W/c.=. rl O t; j~ ~ ~ r ®1 ~~ ~ `~ I 1 I ` A4.ARM EXTEWOIA! ~~ S 1(. ONTO S04 i . ~ ~ 1 { ou C ~~ I I PUMP--~ --~ ~ OFF D COAICRETE ~IOLK ,r .. - , ~~ . L 1 ~„-•~. ' ~ R15CR EXIT PE:RMi1T1rD OIJL~ IF 7AWK MAIJUFAtTUR{`R NAS SUCH APPROVAL 'J wPPiLc 6CC ~ ~ + SPCGIFICAT1~1~15 ~~ ~-,~ ~~~`~ __;. ~ ~'~ ~>~ ~~ sEPTIc E DOSE ~~~ ~,/~ r~~ IJUMBER OF DOSES: PER DAy T^WK MAIJUFACTURCR: TANK 51ZC: ~-~0 LLOAJS DOSE VOLUM~-~G ~ ~~~ ' ALARM MAAIUFACTURER: ~ IIUCLUD1AICs 6ACKFLOW~` =" ~ GAI MOO¢4. LIUMBtR: CAPACITIES: A CHCS OR -~~~~* GAt SWITCH TyPC: ..=~ ~.__..._ D = Z IUfCMEi OR .1.YS~_ GAl PUMP MAUUFACTURCR: ~~~- ~~ C • ~r~ IIJGHES OR ~ I .°GAI MODEL IJUM9ER: X37 0~ A~~~~INCHES OR ~ GA SWITCH TYPE: uoIE: PUMP. AtJO Al-ARM ARE TO OC MIIJIMUM DISCHARGE RATE ~~• GPM WSYALLED OW SEPARATC CIRCWT; VERTICAL DIFFCRCIJCE DETWCEIJ PUMP Off A1J0 DISTR4BUT10-J PIPE.. ~ FEET ~- MINIMUM AJE1'WORK SUPPLY PRE55URE .. 2•`' FC.ET T~ • Za FC1rT OF FCIRCC MAIIJ X~''~ F~oi>:FR-c'rtorJ FJ-GTOR.. 'ZZ FEET, ' ..._ TOTAL OyWAMIC HEAD = ~~ T`'- FEET SIJTERAlA1. OIMELfS10WL Of TA1.IK: l.EA1CaTH_ ;WIDTH ~~4.14V10 DEPTH UAT E: 91GNE0: ''• ~ - .I~'._.-.... LICEtJSE 1JUMDER: ~~?~~1~ ~~~ ONS~ S~A~E SYS~ •. DEp ARTA4ENT' Q F IN DlVt ST ' '~~©~ AN U a Page ._ Of Perforoled Plo• ~etoll FE p N~'J TlD~ End Cop ~OKI r ~Du1rOn Pips lots MOI• Should B• Neat To End Gop ~~/ End Cop P~rtmolad PVC Pips Signed: License Number: m~ ~~~~ Date: ~ ~~ ~qd Q SE~~RRESp cNCE End Vuw Holaa located On Bollom, ',~ Ar• Erruol~y Spoted ~r /" 'Q , 't~~ Mot ~, k . i{i ' ' ,~`~, • ~ Allerna4• Poattlon OL. Fort• Moin Fram Pump P ~~ R ~~' S r f! X _S~ v ~.L~~> bole Diameter ~ Inch Lateral ~~ Z Inch(es) Manifold 2 .Inches Force Main 3 Inches ' `1~ Oiclribulion Pipe loyoul r ~~ Straw Marsh Hay, Or '~ Synthetic Covering M~dlum Sand ~~ ti 3 Li~~ , ~,110c~ RE ~Oa~ ~~` P Bed 0 f !~~- 2 :2 `i • A r e A qq ~~ pE 0 ,r S UtipPR~ ,~ S _,r NCE Page ~ Of Distribution Pipe I G ~~ D b Force Moin Plowed From Pump Layer ~4Rr~~. Cross Section Of A Mound System Using S A Bed For The Absorption Area A ~ Ft. B ~~ Ft. I ~Ft . ~_ J / / Ft. K ~ 7 Ft. L ~ Ft. D z,zs ' E ~ ~ y F .7S G 1 N ~~ - I~,~>! X30-0165 WFt.~~~~.(,"~~ ~ ~ Observation Pipe--~ .~~ ~~ ~ K Distribution Bed Of %~- 2 %~ • 2 2 Pipe ~ Aggregate i Observation Pipe Permanent Markers Signed: t i cense Number : ~~ ~~~ ~ Date : ~ ~p ~q~ Alternate Position of Force Main L Plan View Of Mound Using A Bed For The Absorption Areo .i CAPACITY ~~~ ~~ 3 ~ 1• ' -. 2i h 2i EFFLUENT 2~ W 24 20 p 9• Q w 1e ca ~ 1a Z p t2 F > 10 Q F e e 4 2 and g DEWATERING = 2. U 2l .. Q ~ tE D "~ id O ~, 12 10 ...~ s SEWAGE and ~ ~ ~ _ ~ 1 ~ `~ ~ DEWATER/NG b 4 2 ~~o 1,b _ 105 I - -" 100- - - ~ f 80 ;. ~- ,. 65 _ {-- Caa ~~ - ~ ~--. ~ ~ ~- ~ MODEL 7S MO DEL 1BY 18 5 70 85' 60 55 _ 5 ,~ MO DEL 1 83 MODEL> ' 4S 10~ _ 40 , 3S _ ,. 30 EL MODEL zs 19 138 18S MODEL 15 .MODEL 161 7 10 MODEL 5 53, 55, _ _ 57, Sq I 4 10 2D --F 3Q 40 5Q 60l 70 80 ------4---- ---1- 80 .,100 j110 --~ 9 a ,.4 ~"~'K, ~''`"} -• ,.! } '.3~;~ 80 +50 240 J40 400 ~ ~ r. ~LOw PEA ~arNUre ~~ "~~~ -~~: ~~3 ~~';~ Y1 ~'~' ~,~ -~f ` .. ~, ,~~; Dfllf/P ,~* `. ____.; 3TC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER _~~ /~~ ~,tfnr~.se.~ ROUTE/BOX NUMBER /.~ f~ ..C(A~L I~orLS~ FIRE N0. CITY/STATE ~14z r2s~ix~~ [.(J [3 ZIP PROPERTY LOCATION: C 1/4 S ~ 1/4, Section ~_, T~_N, R__,/ ~ W, Town of ~~i~rJuJd©~_ _ , St. Croix County, Subdivision ~/' A , Lot No. 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 SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a !lAXIMU!! of $3000 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 verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), 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. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix unty Zoning Office within 30 days of the three year expiration date. ~ ~ n u SI k, DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 59016 (715) 386-4680 Sign, Date, and Return to above address i 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 Location of property ~~~ 1/9 ~~ " 1/9, Section ~ ~ , T-~~ N-R~W Township ~~~~'c'~~~~?~ Mailing address /~ > ~~ `~~'"~ r- r ~ ~~ Address of site .~ ~'C~ ~ ~` c~, c s Subdivision name /Tlfa Lot number Previous owner of pro Total size of parcel Date parcel was created ~~~7 ~~v Ate all corners and lot lines identifiable? a,C' Yes No Is this property being developed for resale (spec house)? Yes ~_No Volume ~y and Page Number ~ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DSSD which includes a DOCUMENT NUMBBR, VOLUMB AND FAGS NUMBER, and the BBAL OF THS RBGISTBR OF DBBDS. 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 Hap shall also be required. ---------------------------- PROPERTY OWNER CERTIFICATION I(We) certify that all statements an this foam 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 recorded in the Office of the County Register of Deeds as Document No. ~~Zz,p ; and that I (We) presently own-the proposed. site for the sewage disposal system (or I (we) have obtained an easemenk, to 'tun with the above described property, for the construction of said system, and the same has bee~G dfuly recorded in the Office of thef~ounty~e~gts,~r of„Deeds, as Document No. l fO,,Z /7S ). x ~_ ~ ~_. Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 Gary Anderson 1270 Lokhorst Baldwin, WI 54002 Petition No. S90-01675-P Dear Mr. Anderson: Re: Gary Anderson - Residence Onsite Sewage System NE,SE,31,30,15E Town of Glenwood, St. Croix County, WI The petition for a variance requested to section ILHR 83.23 (1)(d) and (2)(c) l.b. of the Wisconsin Administrative Code was considered on June 29, 1990. The petition has been approved. The rules require that a mound system site have a minimum 24 inches of suitable natural soil and trenches in mound systems shall be 2 to 4 feet in width. The variance requested was to install a replacement mound system on a site with 9 inches of suitable natural soil and using a single 5 feet wide absorption area. All of the data and statements submitted on behalf of the petitioner were considered. This variance is specific to the subjec t petition and cannot be used~for any additional modifications. ly, 'Richard ~fe`ye`r~,`~rc?fit~--`' Director, Office of Division Codes and Application (608) 266-3080 RM:PEP:3601g cc: Leroy Jansky, Private Sewage Consultant - District 6, Chippewa Falls Thomas Nelson, Zoning Administrator - St. Croix County Lyle J. N~yers, Plumber SBD6926 (R. 10/87) ~. DEPARTMIiNT OF , INQ.USTRY,~ LABOR AND HUMAN RELATIONS REPORT ON SOIL BORINGS AND PERCOLATION TESTS (115) (H63.0911) & Chapter 145.045) SAFETY & BUILDINGS DIVISION P.O. BOX 7969 MADISON, WI 53707 LOCATION: ~ '/~S~a SECTION: 3 / N R O NSHIP UNICIPALITY: to wooD LOT NO.: BLK. NO.: SUBDIV SION NAME: COUNTY: OWNER' 'S MAILING ADDRESS: Sl 1~' o T ~ S y o0 I ICF R id NO. BEDRMS: "'~ COMMERCIAL DESCRIPTION: ~~FF lace YLiRe ^N es ence ~~ p ew RATING: S= Site suitable for system U= Site unsuitable for system DATES OBSERVATIONS MADE PROFI E DESCRIPTIONS: ER ATION TESTS: S 3>- 9'O v-31.9'a ICO ~ENTIONAL: M~~. ~~ IN-GROUND ~1.1Y RE: SYSTEM-IN-FILL HO~LDING TA K: RECOMMENDED SYSTEM:loptional) If Percolation Tests are NOT required DESIGN RAT I If any portion of the tested area is in the A~~ under s.H63.09(511b), indicate: Floodplain, indicate Floodplain elevation: /[/ PROFILE DESCRIPTIONS BORING TOTAL D PTH TOGROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, EL EVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) +~ B- w ~ *sa~-6v R .vse tIw ~e pmf~,yyo r B-3 9'~3 ,~~ ~ ,~ _ w '~~ B~L~se w ~ - B- 8 9 , ~ ~ ~ '~ ,~ '`~~ o - 6~d' ,i~w~se W cc~ o,rdrgro 0 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP N WAT RLEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD2 R PER INCH P_ / o ~ ~ 3 P- 3 © ~ s ~ P- (~ ~ 3 3 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 horn aontal 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 ~6, 3 r_ _ .~__. _ ~ S __ O = ~ --~~~ R __i ~_ . ~! = ~1; ~ l0 6~~ '~~ 1 ~ . , ~.. /.7~7 V ~. ~~ ~ _ r,.. . ~.T T ~ ,; E ' 3 E '- ..~. .a,~~ t ~ ~ ~ w ~ _ ,~.._.... ~_ E t i ,- i ~ ~u~. ; ~- 2o ro ~ ~ - ---- E oio'+~ 8~ sr ~ -~+--~--~--- . - ___ ~ _ _~ TN t[f^' 'lints ITRUCT!(~NS FOR ~~L.ET~~" ,FORM 11 - R3 - 6395 To ~ a co~nplet~ ut acs ~rra~te soil to ,~o inclr~de: 1. C~ ,legal c'_ 2. ~ ~ =ctior~ mi -arly indicate ~ ~ ~hisis a residence or r;oir~rnerriai ~~ra 3. N!A> ~ ~-umber of ;==~drooms or ca ~ ' i~se planned, 4. (s ? 1 ~r a"Qnlacenient syste~7~; 5, Cony i~.at~ility rating `r~oxes. ~ `'~. ~`<E3L.E FOR A HOLDING TANK. C3NI.Y IE ALL 01 Hl~ ARE Rt)LED OUT ' i L CONDITIONS; ~. :~zv~._:tians shaven ~ ~r~file descriptions and con~~l~ ng ~, , ~_in, c '., _ =n accural" ~~; ~, ast locations. Drawing i. A ~",;, i desired; .~.~d vertic:.l ~>oir~t are clearly she Vii. ~e~~;s as to ,:es, flood plain d ~ calatiar7 tE .t ~a- t:, IO. if ; 7n~1 plai~~, _s ~: ahK~lY, 131,x,-„ '~. ~„~ a;~~rc?prcate box, '11. Sig t' ° f =r~ nt ~ fiication ~tun~, " ; 32. ;L'la' ~i.tribute as , ~ J i SOIL TESTS `JST I3 E=ILEC? ~'Ut3°l-i THE LOCA _ ,' IN 30 DAY ' Ct t"lt7N. • Soil Sr'F e~' ~n~i Tcxti3res C}ther Symbols - ~~,t~ RR - .~ z~~ is +` -- ~€ 3`1 I_S - L" ~ 1~ cs - C ~. -- P ;F rTi E3 Ci S -- ~, ', Is -- ~, Sa3td ;> -- G er ~ ~ tan °~I - l.t}am ~ - [ Z"~;n~ -- [ R~~ -- - `~It Loam L~l - E3'a:'; si - S'' Ciy ._ $fil - ;:~ ;. '.i~J Clay Loam ~ - Ri;.,~ ~ sid - `' ~"ty Cfay Loart7 z~~ot - Monies ~ sc S<n~t4y Clay vvl -- ivitl~ ~;c - Sil_.r Clay fff fete, fire, ~._nt `c -- ~' ~ cc - eo3nr~ ~- pt - (" ~ rsrm - C~:1any, mi "_ ar.. ni -- ~ d -- distinct ~~ __. "€~ r>mir~ent H~~~L - vva" . I ." , Six genPra~ soil textures ~,,+ lace ~~a~ " i for li~i.i .:~ disl~osai FPM --~ t3 ~~at Mark 4'RF' - Vertical Referer~r, l°; ` ..~ 3 ~' .-- ~r t'C} T!-!F OVlIIU Ra E ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 38b-4680 June 22, 1990 Divison of Safety and Building Bureau of Plumbing P.O. Box 7969 riadison, WI 53707 Dear Sir: An on site investigation for the Gary Anderson property, located at the NE4 of the SE4 of Section 31, T30N-R15W, Town of Glenwood, St. Croix County, revealed suitable soils at a depth of 9" below which seasonable high ground water was noted. Using the A+4" rule (A horizon=5"+y." to mottling) should make this site suitable for an on site disposal, with 27" of sand fill beneath the proposed mound. Should you have any questions, please feel free to contact this office. inc rely, mes K. Thompson Assistant Zoning Administrator cj I _ - _____ ~ r State of Wisconsin ` Department of Industry, Labor and Human Relations ('K 1 ~tJ11~~' :~~tt{J~',ia. ~'f ~~~~ !~i'~'N1JV `!~ SAFETY & BUILDINGS DIVISION : 1 ~, P :? ., 1 i ~i :;i: .~.tt' .i1 i:( .1litl ~ .i 6, ~ )F; , «:~ .. ' i tl ~ I t f 1 !! ,. i'I iiI'"t„.@~. ~ C; i:4' ., t, „.!ii ~ ...t i ir:f; 'tt i`I ' ,~,i h f ' i , ,.+1; {'~. '~ri3Tl NlH:Itlf'C . ~41.1 i7~ f3!1 .> i `. t~ .•I _e y i ~. -il _ _ _ ~ 4-1 ~ ~ ii f~.j=, 1)i _ t ,.: ~~ 11.2 i _ ,'.1 ~ ! ., alit'.. ,. ~'! ~~ fjCt~f . r ~,~„',, i~ v~tsh~~~ . 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SBD-6423 (R. 08/88) r _ __T r k.f' t~.~ o~ Wisconsin Department of Industry, Labor and Human Relations ~ SAFETY & BUILDINGS DIVISION J ~ { ~ -~ J t, V 201 E. Washington Avenue ~ P.O. Box 7969 Madison, Wisconsin 53707 ~~%v LU+;riOrSt ~~1 ct~ri i-i , b~ I S~~ti1L ;-'L~t.i Lion I.G. ~~~-~l ~7~-i~ .; ' t;.- near ~r. i~n~.~r?r aUii: t~;: !"nary ncLrsor - :;es~:iosic __ ___ vrlsite cwa~e.,yster; , 'ion;°r~i cf i:,-l~r~~~1OO,:, :~t. CrGir. ~;uf.~rity, :~T ~tiie r;t?tition nor a variance rec;u~steci to s~:c~;i~n ILIi~ ~3.2~ (1 ),<~) anci {~)~L"~ '1.i.1. Uf 1:~iC ~15CUi15'lli 1~>,G!;'.111i5i:railVC ~,L7::!^ t~ld5 CGnS'1uCrCC: Un ~LlnE~2y, ~. ~`.i`yi. Tu ~lGtii:i'.:~il :ias Gt'_Gn u~~~;rUV'(S. 7i1E? 1^i„'~f,'°> Y;LC~U7Y'C ~,riilt c: ~i':JUCiii ,`i;~51,.t.'T~i S i r;U i13VE: i1"};i1Cii1"i:Alii G r 711C:1E'S Uf siai %a~.i l ~ natural sui 1 arc: '~I"enc~ies i n i~a~Suric 5yster:is sr;«'i 1 ~+_ ~' t~~ 1 fret i n iri u~~i . iiie Vc1!"1aliC~: r/,:iU~.'~3f;~:'i.t .adS ~CG 1nSi,ti1~ i~ i"t_~I+:Ct'~>i'ls~;, ;GUiiQ S;~S.f,';:i;~ Ufa d S1~@ i~i~i ~ )%iCsii:.'5 Ut sl,iita~lc iiuf:l.irGl `aijil i3.rll USiri~ ~ 51;;~1~ ~ f"Er't~, o~1c!(: t',:%sii:r"~)t1~J11 iirt'.ta. t;ll Uf i;iiC' ::~z~c~ csilc~ stat~:~+ica[its SU:~;'i12;t`~.i Gr"c b~'~lizli Gi" tits r/eT,1w1UF1er r1Cre c~Ylsiucrt~o. ~6~ii; variurice is s~4citic ~.~~ tii~~ subject ~;etition anu cannot t,e iiSCGCi tUr' Clrrjr 4il;2ii.fCSilul :.:;JuiflC~tl'un5. _ 9 '~i. inccr~°i.Y, 1 i ,~ t t ~;i ~iic~r c. ~i~i2yer~,` l;.ru;ii t~'~i.~° ;t ~~, ~lrt':(..~.cGY'~ '.s~7'lYC U'f 4,lViS'>Vi' i,v'G+;:S arit+ .`ir?(?~1CuL7l;)ri CC: LcrDy JciriSKy, Pr iVat£' ~.~.'4aa J.'. i'.UiiSal i.~filt - ?.1 5tY'1CC i ~ ~ISi ~~C'.t?,-ltt ~~~ ~ S T~lol,ias ~vt:1lsGri, Guriri~: t~r,~:;ir~isi=rotor - ~-4.. ,:rUi: ~ount.y SBD-6928 (R. 10/87)