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HomeMy WebLinkAbout018-1011-10-000 f~tn0~ T+~n d m o ~1 ~ C I ~ ~ ~ ~ °- ~ O I n a3i o m vy, o °~ m ', w rn °> ~ ~• = ~ i ~ ~_ ~ fl- A ~ p ~ y fmn ~ p ? O ~ v M ~ CO cp p. N N p d tG N y O~ ~ ~ r .may ` ` 1 p p°p ~ lD f~ 01 Cyi C (D I ~ ~ O p '° R A'I O Ut .p O j 7 fll ~'' g 9 O 0 ~1 !~ ~ ~ C v ! O "`t' chi I ~ v D ~ a I o ~ ~ a ~ a I ° w ° ° I ~ o O c o d I ~ ~ Q m o m '', _ I ~ m °° 3 y c c 3 ~ ~ 3 ~ °- 0 OOOa' '•' ~• o ~ c ~~~~ l m tv~ `~ n °~ <o~ ~ y y ~ ~vv i ~ I ~ " ~0_'~~ "'I ~ ~ ~ d ~ n ~ a a y I Z ~ z~z o ~; a ~ p _? ~ ~ s ~ h. I ~ ~ o~ ~ C 7~C N ~ - ~f w ~ a f 0 = ~ i p 2 e~D I .-. N ~ ~ ,Q„. I n m 'a ~: A z o v I ~ I i Z ~ rn W ~ m ~ a z ~ a ~ I B ~ ~ ~ q! ~ ~ ~ ~ ~ (mod d d X. f// ~- fD a o I ~ ~~~ ~ ~ w ~ ~ a oa ° o o ~ a o ~ ~ p, fD y W y 7C N I I a ~. O ~ p .Sys s ~ N y fi y 7 fD j ~ f1~ X I A N O O7 ~ ~ ~ 7 ? tp ~ pyj '; C I N N O f7 I O I ~ o~c ~ U1 ~ N y fD N fD Q O a ~ ~ 7 I A I ~ o ~ ~j a °p I ~ ao v A I o ~ ° ! ~ ~ ~., Wisconsin Department of Commerce PRIVATE 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)]. 'ermit Holder's Name: City Village X Township Kerber, Robert Hammond Townshi :ST BM Elev: Insp. BM Elev: BM Description: a !oo c T- •~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic IL k; b-H~ ~(,~ Q.~ f! ~ DU W -W Z(o os~ ~~° h•e.~ d Op Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ S~ Z,°s~ 7 ~ ~ •~~ (~ SO floo Dosing yy~~ >F'"~C/ ~ ~~• 30 ~ a~ ~D(j Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~ `` Demand -E~.~~•t ~r-- GPM Model Number ~ ~ ~3 TDH Lift Friction Loss System Head TDH Ft Forcemain Length~vr Dia. Z~ Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. OfTrenchf DIMENSIONS S St dy l S f (3~ SETBACK SYSTEM TO C P/L B`LDG INFORMATION Tvpe Of DISTRIBUTION SYSTEM ELEVATION DATA County: St. CI'DIX Sanitary Permit No: 395274 State Plan ID No: Parcel Tax No: 018-1011-10-000 STATION BS HI FS ELEV. Benchmark 3.8 t v~• 10~ Alt. BM Bldg. Sewer ~ ~ 9 S- ZS SUHt Inlet ~•$C ~ S• St/Ht Outlet I , (8 ~ y, to ~" 13tiinle~ ~ ~ ~ ~ 9.21 . ~ Zt%1 owl- 9'•~`~ ~~'~ Header/Man. Dist. Pipe q,~ 4 3 .o ~- Bot. System ~:~ •a,~ ~ Final Grade ~~- q~•i St Cover Div I l 1~vrl. ~ 9'`~ ~ ~ ~~ ~H ~ /o•~ ~ 3•yl DT' a n s:' ~~•~ fKl ~b v.y q - PIT DI NS O No. f Pits Inside Dia. Liquid Depth Jr~.~,l .,a~~~z a• ~ a~•3 ~3•aw'I 'rloa I ~`'~sl Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake ~ I rr y" Pipe(s) ,~i T Jl ~ t i i ~SZ~. Length Dia a Spac ng Length D SOIL COVER v Drnccuru Cvc4omc Anly YY Mnund Or Ot.Grade SVStemS Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedffrench Center BedlTrench Edges Topsoil ^ Yes ^ No ^ Yes ^ No I~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: tr / ~ / ~~ Inspection #2: / / Location: 1527 Co. Road E Hammond, WI 54015 (NE 1/4 NW 1/4 6 T29N R17W) NA Lot NA Parc~el/No: 08.29.17.85D 1.) Alt BM Description = ~~ 7~ ~~^ ~"`~~~/~ t/va•~S ~ ~ Q ,a~ "D,~,~"t ~;. T-~e~'~ 2.) Bldg sewer length = LD " .ect,,~- -F'm~'` -~ `G ~s 7~~ ~bt t1~+/ ~~~C ,1p.~. ~jP~d~ lr.""'_ - amount of cover = ~L 1 kG~s r C S~ ~•~~' S rOv~i i3 ~Tr~P,•, '~ ~ ~ V~~.• ~ !o 'S ~ ~ j , C~ ti V ~ ~ ue - 1?1 ~~~..¢ ~ 4 ~ U rad! ~ ~exrs-f 7~ SD t 1 wlit• r~jJr o r e~ q.4 8 le'i`''`"' -- Plan revision Required? ^ Yes ^ No ~ ~ ~ ,` r77 Use other side for additional information. Date Insepctor's Signature SBD-6710 (R.3/97) (" 1 G~ / 7 ~~ ~c Safety & Buildings Division Sanita Permit A lication 1"3' PP 201 W. Washington Ave. PO Box 7302 ' - In accord with Comm 83.21, Wis. Adm. Code Madison, WI 53707-7302 ry,,,r,N, ~,,,~ ,~ ,,~ ~~,,,~,~,,,~~,,,, Personal information you provide may be used for secondary purposes (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach com fete fans to the coun co onl for the s stem, on a er not less than 8-1/2 x 11 inches in size. Coun State Sanitary Permit Number () Check if revision to previous application State Plan I. D. Number -~t-~ C.tte~c 3qs a = - I. A lication Information -Please Print all Information Location: Property Owner Name Property Location [[~~ ` a b z w ~ R ~, ~ ~E, ~ ~ t- b ~ r N~.1 /4 {U ~t 1 /4, S W T ~ ,N, R i ) W Property Owner's Mailing Address Lot Number Block Number ~ ~ ~ ct~ , Rd ~ ~. ~ R ~~.. City, State Zip Code Phone Number Subdivision Name or CSM Number ~. -~, wl ~ ~ d w x' ~y v / S (~ ~~ > a y I~ -- ~ `~ ~ l~ '~"'1.~.:~ ~ ~ c~-A.~ II T e of Building: (check one) ~ il D N 2 F lli f B d O City 0 Village y o. o rooms: or am we ng - e )oC.Town of D Public/Commercial (describe use): NR m m~ n d D State-owned - III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road C i7 A) 1. ^ New System 2. replacement 3. ^ Replacement of 4. ^ Addition to Parcel Tax Number(s) S stem Tank Onl Existin S stem c5 % ~ ~' % a % ~ -- ~ - G n rr B) ~ A Sanitary Permit was reviously issued Permit Number A~ ~ n r Ne ' • it~ ` ~ b s Date Issued ~ ~ + IV. Type of POWT System: (Check all that ap ly) t:Q. 1~--(0'p ~ Non-pressurized In-ground ~ .~~ ~ ^ Mound ^ Sand Filter ^ Constructed Wetland ~ ' C ~""''"(p ~ ^ Holding Tank ^ Single Pass ^ Drip Line ~ ^ Pressurized In-ground ^ At-grade / 1 Aerobic Treatment Unit ^ Recirculating ^ Other: 3 5 x St V Dis ersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application S. Percolation Rate yst ation 7. Final Grade Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) /~ 93•'1 ~; Elevation %~-~t~ o ~~ R~3 rn:-w.~s, VI Tank Capacity in Total # of Manufacturer Prefab Site S Fiber- Plastic Information Gallons Gallons Tanks Con- on- glass New Existing Crete structed Tanks Tanks >~, ^ ^ ^ ^ p. ~p ~~ ~~r~rr l ~. VII Responsibility Statement I, the undersi ned, assume res onsibili for installation of the POWTS shown on the attached ]ans. Plumber's Name (print) Plumber's Signature (no stamps): MP/MPRS No. Business Phone Number Plumber's Address (Street, Ciry, State, Zip Code) VIII County/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issui Agent Signature (No stamps) Approved ^ Owner Given Initial Adverse Surc g e2 f~ r Determination ~ ~ G. ~ ~ ~ IX. Conditions of Approval /Reasons for Disapproval: ~ 36 u b.~ I ~p I a. 7'0 ~ n ~uo~ ~ ~ ak Q `~C.En~'t ~ ~ 2 Q `p ~ ~ 't ' ~i t `~'t 6W ~ ~ S~Xd , ~~l ~~ 3- c~~s. L _ .~... Can- .x~ i-[ 5 V1A+~~ CB+~iQ'*'1~ G., ~D,q, rW . ~; ~, ~ ,r 1 r , *~ ~ r ~~ - "~ .p `~, x U )) i ~ ~? ~ 7 'rh }.~ .+y~ ~J ~. •1 ' i X~ Maiden Rock. WI 1~800,'i25,B466 Portage, WI i-800-362~'?'EEO Fond du lac, WI i-800841-b937 ~o~~~~ n Website.__www.w~eserco__crete.com __ ,o r ~C.1-F ~ ,O -o ~. W ~`~ w W m~ Q t i ~ w~ ~ .. ,-~ -~ ~ ~ ~ \ ~ i ~ ~~ ,,~ ~ ~~ ~ `. ~,, r !_ ~`* ~. l ~~ ~.~ t I} .~ -~ ~~Ek ~ - .. - - - _ .~ a {~ '" .,~ ; / ~~~ T ,:. t-`T "~ ~ -~ ~ / ~ ~ / ;~;i ~.., w ~ ~~ - ~ ~ ,~ ~ is h ~ ~ ,~ 1 1 ~~~ ~' ~~ r r.: r ~ ;, ~, f ; I, ~. ~ ; .~`~ ~ ~ ~ ~ ~ a x7. ' a! ` ~~1 i ~~~~ / f ,~ ~~'- tY '.~ ''C- , .~ ~ ~ ~ /lr _ ~ f .~~ ~ # ~,, r.a_._ ~ ... ''yr r ,~ '. ~~,=, ;~ ~~ ~.~ e s ~ r F~ ~~ ,. ~~~ ~~ .gyp L L N G ~ ~_ R '~ • i~ ~ G ' :.., ~ ~' ~ '~ ~ ~ ~ a ~ o ~~ .~,~ o r : ~ ~~ ~~ W € IIy a~ Z w v -~ ~ _ ~ a 3 °'~ .,.~ . - t z c3, ~° ~ ~ ~' 0 4 ~~ L C+p ~ I I `~ ~ ~ ~ ~ 0., a f i ~ b (~ ~ i X.'" ~ ~ + t N ~ ~ f O ~ ~ -r~---:---- ~ UA ~ --- - _ '~/"'~"' (~~un~~ut.ui~~rr Lip: Ic:: ~---------- -- ---~--- '~'h' . _-- -- - _ _ __ __ - rue: '~ ~ ~ R ~ ~ E ~ am~,na~.~ ~ ; 5yo 15 <'n~rl.rJ L3, _. , ~~- _ 1_. _ ~; ~ `~ Maiden Rock. WI i-800-325-8456 - Portage, WI 1-800.362-~'E20 ~~JJ ~ ~-~ Fond du lac, WI 1,800641,6837 ~Tf. ,A. ~u,~ ~ ~ ~ O000O~1~E _ .... Website: www.wieserconcrete.corn . ~.. b ~ +- _i~-e-~` ,.~ ~ ~._ . _ ~.,__.~ .,__~m- -,~~, ~: -~O m' h 1 ~ ~ i .M a i Q e ~-,:'-'~) ~.,, ~ ~ dC~N tom` y. ~ ' ~ x - ray I ` _ i "' C ~: r ~r' ';; ~ ~ / ~ ~ .:, •~ s . ~ ~- ~, . ._ ._~ . .~ ./ ~ , ~. o ~ ~ _r~ _ ,~ { ,~ ,, J ~' ~. ~.' 9fi • i e~J ~~ ~"ta 4.s ~. ~ ~` / t ~. /'~' ) ~T~ . ~~ ~- r ~ Q ~ ~ °~ ~. Y~ ~ ' ~f t 4 ~ ~, V :x / J, / ~ ~ / /f , Syr fl~ ti ~ ~~ M ~O ~ 4 / !ll~~~ ""' e ~Y~; - ;s ~~ ., ~ ~ 4 { t •'' ~+ r--'~ pp - ~ o '~ ~r ,. ~~t-Name. ~ ~- w C~~mputuliun5 [3)~: lc: ~ ~ f~_._... ,. ,~~ ~ ! 1 f~ e ~ ~.a..rYi'v'tY1.Li~'1"~p~' t ~~fl 1'S" (~hc~•kc~ B~ : ,31);ric: ~ ~ ' ~,is~ Shc~i" ~f: ___-- r _~ C. - 1""~- . ""~-- z~ ., .. . Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT Page / of Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must. , County $ 7: C/C~O~•X include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. fig' ~~/~ ' ~~ • ~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all infoi'7flation. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). , ~0, Property Owner ~ Ro/3ERT ~ ~~•T~{• /~~~~~~ Property LocatioGGn L G t NL ,~J''..'' /" ~ ~ Z~ ~~ ovt. o 1/4 4 S T N R i~(or) W Property Owner's Mailing Address ~ S i'1 wry R~• ~ Lot # s. 3 Block # ~s Subd. Name or CSM# ~ ,y~E-,-sj, !3 a~.~os - City State Zip Code Phone Number ^ City ^ Villa a ®Town Nearest Road ^ New Construction Use: ~ Residential /Number of bedrooms Code derived design flow rate t~ QT, GPD [Replacement ^ Pu~,bli~c or commercial -Describe: Parent material ~ O~SS oyF:~C SR.VD y ]~f~~~.s Flood Plain elevation if applicable IV~ ft. General comments '~.~t~ .S'GY L ~}'/0,/~l/~~if T/ O.t/ /P/¢'~' Of f' ~PD /`~ 2' R[.t~Q,N, and recommendations: per,! Boring # ^ Boring / ~ Pit Ground surface elev. ~ ~• ~ ~ ft. Depth to limiting factor ~~ in. Solt Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 i o•~S iarr~ 3iy ~~P~v s~ ~,~,, ,r ~S ~S z f • s • ~ ~syed ~ ` ~~ ~s - ? • ~• z /D S ~-- s /f ,/~ S cS - • S l ~.~o ~s L 83• sz Boring # Boring _ Z ~it Ground surface elev. ~~ ~ ft. Depth to limiting factor ~~ in. Soil licaflon Rate APP Horizon Depth Dominant Color Redox Descdption Texture Structure Consistence Boundary Roots GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 7•S ~--- SG r-~•f 92. a _____--_ '~3.9Z q . q 2 ~muen[ ~ i = esvvs ~ ov ~ ccu mgiu ana i ~~ Hsu _~ i 5u mg/l. ' tttiuent iFZ =taws < 3[) mg/L and 7 55 < 30 mg/t. CST Name (Please Print) Signature . - CST Number Ro ~eT- 2(G„~ ~ i~ T- ~--~- z 2,1i 37 S Address Dat-e'Ev/a'luation Cond^ucted TSelephone Num~be/r 1 tlhrirhf & ASSOCiateB /~'K~/L) ~ • OS do / ~i/ ~ ~~ •(/( ~~ Private Sewage 655 O'Nell Rd. Hudson, Wis. 54016 Property Owner ~' ~~/~ Q/~ • ~Q~/. /D . Q~~ ParcellD # © Boring # ^ Boring ~ L Pit Ground surface elev. ~~ • ft. Depth to limiting factor ~ [ ~ i~ I Boring # ^ Boring --J ^ Pit Horizon Depth Dominant In• Munsell Ground surface elev. ry, :olor Redox Description Texture Qu. Sz. Cont. Color Z 3. Page of Depth to limiting factor in. Structure Consistence Boundary Roots Gr. Sz. Sh. Soil •EH#1 ~ 'Eff#2 ~ Boring # ^ Boring ^ Pita Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bounda Roots Sal Application Ra in. Munsell Qu. Sz. Cont. Color ry GPD/ft2 Gr. Sz. Sh. •Eff#1 ~ •Eff#2 'Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 =BODY < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SB0.8730 (R.6/00) . ~, . D 6C" i ~, ~ ~ `~~ 1 ,~ ~ ~ ~ c `~- ~ ~ ' ~ ~.~~C,,, // 1c ~ ~ / i~ I~ ~/ // ~i 1i ~~ /~ ~/ ~ ~` _ ~ ~~ ~1 ~1 / / /, ~ / ~~~ / - / ~ ~ ~' n= ,L i i ~ _ ~ ~ ~~~ ~ ~ ~ ~ ~ ~e ~- (~ ~ o ~ rn i ~ o~ O ~ ,~ ~ d c ~^ V ~ (`~ W 1 \1 11 v ~ ~ ~_ Q ~ o ~~ ° ~ d ~ ~ ~ ~ ~ n i~ ~ ~~ ~T m `~ o O r. ,e~ y, ~° ~ ~ _"~fi FY s ~'v C 4'~,t~. VENT PIPE sir ` ;;;s~ , 25~ FROM -0OOR .~ WINOOW OR FRESH ~ ." R~INTAKE DE A1 G R A p~ t ~r ~ +• ~ + 7 ~ CIL~V • ~ w"' r _ ,'~ ~ Il~s.~• `'~,~ -~ P: 18° MIN. ,' i.. ~_ ,~ ELEVATION ' ~' ~ ..~, . .._ APPROVED •JOINT-~ WITN C.I. PIPE EXTENDIl16 3' ONTO SOLID SOIL ELEV. ~^'~ FT, v ~..~ rcyd , . .~ V JUNCTiO~N 80X 12" MIN. 1 I GRADk 1 • r Coj~DU1T ~--' ~: ~•._ .O•y O.I. I'~: •t• ' PROVIDE AIRTIGHT SEAL A '• B ,~, C PUMP ~_1 ~ 0 C~~:'~i~RETE BLOCK APPROVED LOCKING MANHOLE COVER AND WARNING LABEL 4° MIN. ~, i r _ •~ IB"MIN. II ~` V ~1 ;;i II .~,: APPROVED JOI II •:• WITH C.I. PIP ;•~AlAR1A ra EXTENDING D .: ONTO SOL1O S SON :: .. OFF'' :: ~o '~ ~~ '~ T~9,NK BEDDING •-_-_~ .,••., ~•; •<. ~. :.: ~. :..: ~; .. .,-.: •- :~~ ... , ~ '~- ELEV. _ CJ e, ~ ~ ~ z'~_,~~, jE RISER EXIT PERMITTED ONLY P~ YANK MANUFACTURER HAS SUCH APPROVAL ` _ ' Dpi' SE TANK ''~ " ~ ~ MANUFACTURER r~ ".,z~io.-a. NUN1BEFt OF DOSES PER DAY ` TANK SIDE (GAL __1~~~' ~.~ DOSE VOLUME ^ ~ ~'` ..+~L.A_.RM_= IidCLUDING BACKFLOIn' / ~~ ~ GAL ' MANUFACTURER S~ ~ CAPACITIES ~, MpIJEL NUMBER 1 ~~y3 i c y' A ~ 9. ~" INCHES OR ~ ~ `~ GAI, ~x~ ~. " ++ y~ ~ S~ H TYPE -~~~,....~~~ C .y ~; NIANtJF,ACTURER `~~. ;~ ~ ~ ~~-~ ~ ` " s MQDEL NUMBER ~~~ NOTES Pump ~.nd alarm are to be +~ K t f ' ,~ St~YTCH TYPE ,e3 -~1~ ;~I installed on separate .circuits. M k • 4 Y°;. .. . INIMUM-DISCHA RATE ~c7 GPM _ ~ .v~~1 ~ , , ~';~ .~~....~_. VERTICAL DIFFERENCE BETWEEN PUN'P OFF ATvTD DISTRIBUTION PIPE ~ ~~ FEET' t- # MINIMI?M NETWORK SUPPLY PRESSURE nt~• --~~-FEET a ~.. F ~ .{= ~ ~~ FEET OF FORCE MAIN X ~ ~ ~~Z FT/200 FT - ..~.~~.r~. ~~ ` ` - FRICTION F'~CTOR 1 ~ y y FEET ,`='~ ~' ._ - 4~~ - TOTAL DYNAMIC HEAD .. ~. W FEAT ~" ~ ~ TALK SPECS " i EACH 1; INCH OF DEPTH EQUALS ~~ ~ t~ G~'lL .. ` ~., INTERNAL DIP~.ENSIONU Or TANK: ~'`+ .~ `~ ~ LENGTH n~h ~ y ~•, c3•t7 ~2 ¢ rIDTH ~- ~ r ~ LIQUID DE t~TH ~ j,S t' PUP..P CH_!~~3ER CROSS SECTIOTV A:11D SPECK ICATIUNS ~~~ _ ~: ,. ;;~ . :a:. ~, w w ( o` Q ti U 4 0 a 0 ~~ ~~ ~ Q U.S. GALLONS 10 20 30 40 50 LITERS 80 1 b0 0 FLOW PER MINUTE ooses~ . CONSULT FACTORY - FOR SPECIAL ARPLICATIONS ~- • Variable level Float Switches available. ~~ • Variable level long cycle systems available. ~ • Available with special cord lengths of 15', 25', 35' and 50'. ' ~ Alarm~systems available. Duplex systems available. ~~ -:~E:; ,~. ° g'. J.. ,.. StngleSaal _ Control Selection Listings Model ' Volts-Ph Mode Amps _ Simpler Duplex CSA 1 UL~ _ M53155 & M57159 r N53- f558N~~1159 1 ?5 1 115 1 Auto Non ~ 8:0 _ 8.0 _ 1 or 1 & 7 --- 2or2&6 3or4& 5_ Y Y -- Y Y_ 9N53 t t 115 Auto 8.0 _ - Y Y '.BLAST 657 ___ 115 1 230 _ 1 - Auto i - Auto- 8.0 - 4.0 _ I - _ __• _ -~~ _ N Y Y _ Y D53/55&D57159 230 1 Auto _ 4.0 1 or 1& 7 -- Y Y E53155 R E57/59 230 1 Non 4.0 2 or 2& 6 3 or 4& 5 Y Y ~- - Ft. -- Model Meters - "`>3/55/57/59,~ Gal. Ltrs. 5 1 .52 43 1 63 10 3.05 34 129 15 4.57 19 72 Lock Valve: 19.25 ft . (5.9m) •-I .S 15/16',- -6 5i ~7 _~i .- ~ -. 4 5j8 ~ 1~2 I I ~~ ~ _ - ~ -~. f ;- ~ ~. ~ i ~ ,,,,~ ~~o i~,5 i i 1 __-- S i ,i t, ~~ - --_~. 4 x!16 ~~ 1 i 3 3j 32 --- SEI.>~C~tlON hlSiDf= SK858 1. Integral float operated mechanical switch, no external control required. 2. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. 4. See FM0712 for correct model of Electrical Alternator. 5. Variable level control switch 10-0225 used as a control activator, with Electrical Alternator (3) or (4) float system. 6. Four (4) hole J-Pak, junction box, forwatertight connection orwired-in simplex or 2 pump operation, P/N 10-0002. '~? • Single piggybacdc switch included. 7. Two (2) hole J-Pak, junction box for watertight wnnection or splice, PIN 10-0003. `~ ~ --- ., I CpU?`QN...1 a ForinfomiatianOnaddi6onalZoellerproductsrefertocatalogonPiggybackVariableLevel FloatSwitches, FM0477 k~.t ~ + ~ ! . » ~ n ,!ti s ntec~:i;>n devices and winno ;Kould b~~ done by a Guaiified ~ FJectttit;alAltenlStpr,FM0486;MechanicalAlternator,FM0495;Sump/SewageBasins,FM0487; and Single Phase ,~ e~`r~. ;L::._tnca±andsafetyccdessl.~~c+.~,followad~ocl;,dl~glhPmost ~`'. Simplex Pump ControllAlarm Systems, FM0732. ray. fi unn:, f • ~,~r;c t' ~a1e {NEC:) aid the Occupatianal Safety and Health Ac? (OSHA). s~ , For unusual conditions a reserve safety factor is engineered ilito the design of every Zoeller pump. - ~' MAIL T0: P.O. BOX 16347 '~ lr L,~ - 7 ~ ~. ~ r z Louisville, KV 40256-0347 Manufacturersof. . '' a SHIP T0: 3649 Cane Run Road a, ~ i l' ~ + ® Louisville, KY 40211-1961 ~ y w ,/ /- (502) 778-2731. 1(800) 928-PUMP Q!/.OL/rr PUMPS ~NCE ~~,~~ hfgel:!/www.zoe//er.com - ~~ ~ ~~,Y,~ `~ FAX(502) 774 362 ~' ©Copytight 1999 Zoeller Co. All rights reserved. Y' ~~ ~ h ;4 ~~ ~~ ,I~ ~.,~,~ ©~ { ~ ~ • ~~, ~ ~ ~ ~n f I ~ '~. -Z e ~: .~'' ~ l~ 3 ~11 ~ l '~ . i ~• r t ~ ~~ ~ ~ ~~~ ~v7 4 ~ , ~ ' ~' ~ ,~ ~ ~ ~~ ^i ~ ~ ' ~6 .~ f ,,.~, ~. ~ ~ ~ ~r' ~~ ~' ~,# - , ~~ f ~~ i i I a~ 6 t! (~\/] 7 F d b 4 --.t c _ _ _ ... _.. _ _.. ~, ~' , ~ ~ ~P~-..~" f~. ~~ Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Desian Specifications .Sanitary Permit Number Number of Bedrooms Design Flow -Peak (gpd) fo pn Estimated Flow -Average (gpd) ofl Septic Tank Capacity (gal) ~ 4- Soil Absorption Component Size (ft2) j~~' 1 Zt30 Z Type of Wastewater Domestic Tahlp 9~ Snil Ah~erntien Component -Limits of Reliable Operation • -r- -.- Septic Tank Component Soil Absorption Compon nt Design Flow -Peak (gpd) ~~ 121s Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 a.~~ (z'! ~ ~,Q,~- Tab le 3: Maintenance Scneauie Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se and outlet filter shall be assessed at least once every 3 years by inspection. T outlet filter hall be cleaned as necessary to ensure Roper operation. The filter cartridges o be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the r, ~~ Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treafinenf or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. ~~k~ R•r~ ~ rv~ p-~.~i~~ ~ f ~ ^~ V ~~ v 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT ~i i AND ~`" OWNERSHIP CERTIFICATION FORM P~ ag2 S~ ~ ,~ ~%~ ~~ er uyer Mailing Address / ~ ~ ~ ~ ~ R ~ ~ ~' Properly Address (Verification required from Planning Department for new construction) t~ ~ Parcel Identification Number City/State LEGAL DESCRIPTION 0 18 -IO!/ -10 - o00 Cod . z 4 . t ~-, 8sd~ properly Location ~ '/s, N ~ '/s, Sec. b , TAN-R~Z_W, Town of 1-~ Subdivision .Lot # Certified Survey Map # ~~`~`1 1 ~~ ,Volume -'-- ..Page # Warranty Deed # ~~ ~ `~ ~ ~ .Volume / ~~' ~ .Page # a ° 1 Spec house ^ yes ~ no Lot lines identifiable ~1 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 masterplumber, journeymanplumber, restrictedplumber or a licensedpumperverifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 days of the year a iration date. / f~ / D SIGNA 'OF APPLICANT DATE 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 th roperty descn'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ ~ j /~Q '~ SIGNATURE O PLICANT DATE ****** ****** 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 DOCUMENT NU, WARRANTY DEED t~ ~ J:3Ota: t roe ~!T~~~acEbC14 } ~' THIS DEED, made between Robert F. Kerber and Rita A. Kerber, his wife, as joint tenants, Grantor, and Robert F. Kerber and Rita A. Kerber Revocable Trust, Grantee, "~ WITNESSETH, That the said Grantor, for a valuable consideration of ~ one dollar and other valuavle consideration conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: Part of the North 1/2 of the Northwest 1/4 of Section 6, Township 29 North, Range 17 West, described as follows: Commencing at the Northwest corner of said Sectior. 6; the~)ce East on North line of said Section 6, t 162.0 feet to Place of Beginning; thence East on said North line 339.76 feet; thence South 1°37' East ti79.3 feet; thence West 339.76 feet; thence North t"37' West on West line of said Northeast l/4 of the Northwest 1/4 679.3 feet to the Place of Beginning. ~FEE~--•- #• CJ~lrlVli' f This is h.;:neste: d property. ~U /~- . .~_ RcGl37c~~ 3 C.=,- 1996 OCT 4 at 10:00 A.r~ ; P.c' .. , RECORDI,YG INFORMATION NP.ME AND RETURN ADDRESS Bakke Norman, S.C. 900 Maln Street Baldwin, WI 54002 018-1011-10 (Parcel Identification Number) Together with all and singular the hereditaments and appurtenances thereunto belonging: and Grantor warrvtts that the title is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, highways, utility rights and reservations of record, and will warrant and defend the same. Dated this Z-~ day of _ October 1996 -,~'~-`~ f. i,tXi (SEAL) • Robert F. Kerber ~ ~~ ~ p~ t-' •_-~~~c.t~-L~ (SEAL) • Rita A. Kerber AUTHENTICATION Signature(s) of Robert F. Keixr and Rita A. Kerber authenticated thi _ ay of be 1996 • Thomas R. Schumacher LD. N10149g6 (SEAL) s s STATE OF WISCONSIN ST. CROIX COUNTY ACKNOWLEDGEMENT } s5. } Personally came before me this !9 ,the above named TITLE MEMBER STATE BAR OF WISCONSIN (lf not, authorized hY Si 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY: BAKKE NORMAN, S.C. BALDWIN,WISCONSIN executed the foregoing instrument and acknowledged the same. a Notary Public, a 4 day of .i County, Wisconsin i 4~ °~` `r ~. i:~. ki ~ ~.T. •-..~~ f~ ~' .~ 'Names of persons signing in sny capacity should be typed or printed below their My Commission is permanent. of not, state expiration date: signatures, 19^) ~. ~ \ i - ~ 01999 Clnad Cartor/®Il¢a. fnc. 3EE PnhE 50 E E • Nsr6 Lame • =1, ~, ° 4 O pK x NSP6 • NSr6 NSP6 • NSP6 •.. ~R keJeawn~ QUam z 36.5 3'~ N bb • 190.5 Ri<naed Reuben ~ Thor & Karen ~ ~ ~ r l.txdus EROl 3R.5 a.M1- 152 Carrie & o ~ 3s.5 1585 ~ Ir 221.42. • William am Rnberl Jacobson m q • Aune z E ,~ Sam & Hilda ~ • 3o.z ~• x aZ & Constance Michael & Dawn ~ t)prrick Tmst U ~ ~ ~ ~~ ~ Morrow Goodin samm ^ gq~; oar ~:~.;~~ Post Georgics Marshall 77.5 7g 78.5 ,.~ A 158.5 0, ~~ eWl~ g Mmmx o,yx Fsm ` ~ : ~" • '~ ao Sammy • ~ ~ Sam & Clara Linda Lake 5unke XI. Ken N ~ Roger 176 9 Jean ~ ~ T Randolp Morrow ~ y 415.9 Nelson Fam Tr Paul mamas Gar & June Robert acobson ~ ~` ~ & senora 16o H; "~~;;,, Robert & Nancy • ~p [nc ~ Lindquist Stafsholt • J 40 € ~ Bnu9m Bushnell a• 4o BB 180 k GF 186.1 oan ~rmm 160 s • • • • • Lake . a 6 77.7 J9hnso : ~ na ~„ C CqV • 6 _ s.s R ~ Nels & fS0 40 John p~ ~a •N'~ a • • ~ m Ronald & Geraldine ~ ms's r6omas 315.5 trek • ~ Maroney etal 120 • a I.e n arxn~ 70.1 • Frank 120 ~ .. Ha -James Hawkins St ^ ~ 150 & Trull 160 Donald & Nancy an;,;,n 1° ~'artes Roxakt & • Robert & q0 ~x s 5""'°'a H~~ m • Elhom• • e~Reb"~ca ceralaine eo NinaCripe Vrieze ~rtsusan 63 ~ 7 a etal • ~ • P&MIR Frank 80 1 Roger & • Farms 1 Gausman ~ 33 Vernon 64.1 ~ Karl & Roxanne 80 •~Iler "~~`° T f"tet°'" Barbara Inc t9nise xar Kenneth Katharine . & Thom son Nelson - . ~ Chevalier aa<o Frederick 1 Donald P 175 100 McNellis '~ Roberts LJlferts $0z & Helen 217.1 56 59.5 ;T 78'1 Trustee ~vv • Clenn& Kuebker Ott 266.7 ., Sandfott • u' Richard . ~ " • Family Dorothy Sather 40 165 • ~ '° • • wRP & I-estrud 0 222.4 9• Brooks 180.65 Tru$t 80 • sl oo l0 3.z B I I 11e ~s.an rraw ^ Dana r&P t4 E 74.4 ~ 77.8 Dwayne 66 John& William 80 ~ r°mmY Hv '~ Nelson Gerald & ~ s acobson 39.1 39.s • Paul s>i.~ ''I 68.4 70.6 >; Carolyn Dalton ~ 309.6 Hawkins BOnte J rles & • Veronica sm u E9rv to a z ^ tto ~ ~ Patricia 69.4 • lure dr Parma 155.5 z (~I$ 120 s Ronald & Kusilek 7g.g Mary Rebecca Melby Y Donald & Nan S Ile e 105 GlYa r Dine Bonte 131.8 Hawluns cY Pace Y 200 140 s0 • r EAom • • D6 w.ua • 69.5 „ BOPF • ~ 115.8 z6 Kc Robert & Bernard walw<e m.7 155.1 Trost a Roger ohn . Duane & Lorna s 59.9 RicbaM I .x an ohnson 117.8 & Carol ~`cai • >, c ~ • wd & June Rivard Lewis rP5 0 lss.7 cY J BO t1o Gillis ~ ~ P`F" • Lindquist 235 'K F ~ °s V Richard ~ xat W ikkerink ga ", ° ~ g xoue 85 Fauns ~ o • E c ll .' s Holle Farms 8 ~ ~ Farms Inc • Inc ~ a~x,e~mar 76 s m ; a 3. 3 Ho11e Inc • S-'8 < s•~ O • • 363 , 3 4 1 P • ~ ^ r'3 ~ • u ~ 12 R&M S t • 4 .p^. L&1 • Willem k Kar ; 56 4 s• b o ` 4o • Robert F H9.5 q0• John& rolyn Rebma Yang T&t. ~ Wynveen 88.12 R er June G ~ 153.9 Ri~am Battler - Da^~n Thom p ~ Mary Rodne 72.1 R ton • ,a etal 4D Pin ~ & Thompson dquu ,a ~~ s.a~er z 36.9 - I o u ors ~ s~ 3 .o $ ~ ~ Duane ~ s't'ar F Richard ar xaa,ryn wYnvee" ge'S ~ml«n Thomas M Emmett & Janet Donald a o & Loma v S H .- <' M ~ Hone a • Webb 120 • 158.9 & E' 4a O1P1n °~ 7o Humbird c ~ 115 m ~ eo g lotmson y~ O'Connell Trust ~ o Lewis •~~^r o ~ cd ~ ~9.7o.s t~'n •40 110.9 Rode ~ U • 4 ytner Land • E u ~ 2? o • k R F Qr 142 MaaerK Paul & rA s 7g 1 Corpi~tion ~ c 3 m Ken-Rich ~ Gregory ; ~ Brian & l~n ^ Joseph & t] 1/P 71.9 Dolores St Croix • $ Farms Inc Ramberg Kent ~ Dohmen Katlileen .~ ~ Et~l ~ R„m Ford ~~5 Central Shelley )o~~n ~ f v ~ k~x o'coruunl a school 136.5 144.2 Wynveen 155.4 65 z ~ _ a^^^r~l Paul & Dolores Rr s to DisMCt za.z ultua y 3 78.5 s ~ _ Tn M.9 Ford • 149.2 51 147 r xl M • Iu~Beason • 12 u 9z a _ p - TT F t )•.. _ 5m • • G ~ • Kemetn k ~ • ,^,~ • • ,k? r ~ e •' 8: $+ Dom-Hof eamru sax .4Fn. Richard • Gillis Fames ~a -' • Francis wRe a0.naers i++. fi Inc Nrsaare Inc 121.4 ~s' ~o Russell ~ 117 i~~lle '"< ado ~9' °i•r' 293.3 Wmv~ 3 ~ ~ y ns st ~ •wanam 101 Marvin & Esther Trust ear ~ ~ ^~+e^,1-'~' RR 1~ 4~ 154.6 ~ 67.6 SkER Riles Res 329 w. Amos ~ to : s „ Fem 5x.65 PP • 113.8 and ~ s tse a SchnltZ 80 na RW 5 11 'IS >. RE Im+ '0.9 s.9 William Jr Jean ?: Burnell . Ken-Rich Kr..rr6 s " oe Fam, 152.3 149 2 j.a a & Hello ]acobson = ~ H A M M~0 N D Holman Farms 1nC 53 Irc Hueg etal Q B A L D W I N f ~_,• s - 75 ~ dJ Q Erling & Murray William Sr & Clara s~.a~ • )awes & Dolores e S 158 ~ • ~ Lestmd Foersler m 4o aau-~ ° ~ • • ~~ n o ~^ Hawkins• • • • sm r. (7 ~'7 s.r- Tn d •• or + • m 4Qn~ •• r St Croix ~, • • • ' • o 3ti.6 Neal 99.6 ~ • 73.4 Electric Co-op Rnnra^R Leroy Dennis ar~n on De Farm S avke tyJJ1tC o •40 167.3 a: Ter; J 39.R BY amegan ifl 'tC!C• 79.5 Olson ~ FOersrer 120 Inc • Dom-Hof Francis k 76.6 Bobbie ~ ~15r1. onmres 136.1 tw Herman r- George Glen 80 John & Joann 80 ~ 90.1 [nc 154.5 121.7 Rlrke Hawkins Rirkrnre 4r Delores P ardner Mohn Ronningen 94.4 40 elal ~ • • Heinbuch Tr .+e Dean <~~'• Llo d Ja`"`s narn~ Ruuna Lewis & June d 5' 118.79 Kautz A&M Family ~ ~ 155 Gertrude Cory & Malys T Bruce ere o Famny Hie Geurkink Karsten & Jennifer llawkirss Eugene d 40 • g ry Tmsl Trust KkG r to • „ Neuendorf & J l.aock I. Mueller IP - Fami am.~a MoB F,,,,, ma ~~ ~~ Bjersredt q9 `' F al.~snn srevm6 Ken-Rich 100.2 Trust Wayne ~; 74.5 a Tel 160 3S s .~ 40 0 41 z • He;wu<n 159.2 • Farms Inc 114.8 155 Loock • • w • • ~ 80 35.2 ~ • o• ~ ~ ^ ~ RA 9 <c 2100 ~ 1500 1600 1700 xae 1800 SEE PAQE I $ 1900 2000 ANDERSON EXCAVATING, ~. ~ _ INC. 52 YEARS OF SERVICE & Apple Farm FREE ESTIMATES Highway 63 & I-94 Baldwin, Wisconsin ` WE WILL MOVE THE EARTH FOR YOU! (715) 684-2856 OFFICE: 715-684-21'14 •APPLES FROM YOUR HOMETOWN ORCHARD Joe: 715-684-2949 120 Hwy 12 E. - L4WN & GARDEN CENTER • GIFT SHOP & MUSEUM Cotton: 715-684-2510 P.O. Box 104 wE ARE OPEN FROM MARCH-DECEMBER FAX: 715-684-2848 Baldwin, WI 54002 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the Bi.cr residence located at : N~ 1~, ~1/,, Sec. b T~_N, R /7 W, Town of ~ St. Croix County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced / ! - I ~ ' o Did flow back occur from absorption system? Yes ~ No line. Approximate volume or lengCh of time: ~ gallons Capacity: / 0 d ~ Construction: Prefab Concrete Steel Other Manufacturer (if known): (~ Age of Tank ( i f known) : ~ ° (if no, skip next minutes W 4~Q~`~ ~ !.~ a, C ~ '~ r l~ ~, C, ice, 1 ~ ! l ~ E: (Signature) (Name) Please Print (Title) (License Number) (Date) ~~~~e~ Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my knowledge, will conform to the .requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over outlet baffle). ~, ~,.wi / <° Signature tR~o..~-~'1~ Name (~.~ a ~'~~ ~- ~ ~ , MP/MPRS as z ZGa gib'- ~~z~~, 17~~IJ