Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
018-1020-70-000
f o(Ao 0V)0 3 - V n tz r� j Z O? v fA Z O v V O Cl O ryl y p W 3 N tD m cn acv � ° p o S. o W a ^ o `m I�C� y 3. o Dc \O1 I 7 Si c °° I d C A 'O Cy lV cn Z D ,� a o cn Z D ° CO t U D y a m cQ D y a o C M W - 0 m W c 0 ° o 3 0 °' � N CL I m W O CL O w y N N m C lV 3 1 3 g n+ • 3 o o o a l Z o o o 3 �V 0 0 CD CL Z Z, 3 "'`' 3 v)0rn D r n o q; < Q -0 o o� co M I p { j 3 d CT 7 .. j 42 7 .. 3 Z r =r -0 p D o 3 D o w 2 o m F a ° 0 a o v m 3 Q M a E w m I M :3 m Z m -4 to O O N y "— M O Q A Z O c a v +7 a n O j W N O W v m w 0o a °'3,z X o o° o N C C 7 O y y ' < f° a D a U) { w Mk,- omd��o a � yoc ° �� ?a � m rn ° 6 'c c ° a = ,' o o�°: 0 3 ' = 3 v; o w c { < o `G O � O — 7 N.l< � CD 7 CD :3 CD m o o a �w3 a 3° °° °Cn > m oa = m << 3 m m 01 a CD O n a W G -4 O m L C, fi S p O fD (O p aO wu+ n m s� a a EL CD y v° vv n ao. o m ` b N d a m O c co °—m -.4 o -0 l a m N _w o a o w _ O j O O @ N a� 'c w °cl m Mom i t -w Cr N' O< O y p C. a CD ' I n 0 c � (�D = 0 , V ? aO � v c � N CD a 'a o lo< A 0 o b < fD ft in o c N v o: a, a Parcel #: 018 - 1020 -70 -000 12/07/2004 07:47 AM PAGE 1 OF 1 Alt. Parcel #: 10.29.17.156A 018 - TOWN OF HAMMOND Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " = Current Owner BRENT & TONIA BUERKLE BUERKLE, BRENT & TONIA 1848 CTY RD E HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ' 1848 CTY RD E SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: (, � lat: N/A -NOT AVAILABLE SEC 10 T29N R17W 10A PRT SE SW THE S Block/Condo Bldg: 592' OF THE E 736' Tract(s): (Sec- Twn -Rng 401/4 1601/4) 10- 29N -17W Notes: Parcel History: Date Doc # Vol /Page Type 08/20/2003 736639 2382/560 WD 12/04/2002 700815 2067/493 WD 01/29/1998 571987 1291/338 WD 07/23/1997 959/383 more 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 159,400 Valuations Last Changed: 07/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 29,000 96,000 125,000 NO UNDEVELOPED G5 7.000 6,100 0 6,100 NO Totals for 2004: General Property 10.000 35,100 96,000 131,100 Woodland 0.000 0 0 Totals for 2003: General Property 10.000 41,100 96,000 137,100 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch #: 159 Specials: User Special Code Category Amount 010- GARBAGE SPECIAL ASSESSMENT 60.00 Special Assessments Special Charges Delinquent Charges Total 60.00 0.00 0.00 wis ZONING DEPARTMENT 1 - ST. CROIX COUNTY GOVERNMENT CENTER ` many sound, 1101 Carmichael Road Hudson, WI 54016 -7710 ,�... Phone: (715)386 -4680 Fax (715)386 -4686 January 21, 2004 Dave Dalton PO Box 366 Hammond, WI 54015 RE: Certified Survey Map - Town of Hammond Dear Mr. Dalton: The St. Croix County Zoning Office received a certified survey map application for a land division in the Town of Hammond on November 13, 2002. This application was req uest conditionally approved on November 2 6, l il no longer Janu d dividing as one to withdraw thus application in which y ou stated the land w owner is purchasing the entire parcel. At this time we are able to refund $250 in park fees, but cannot refund the review fees. The park fees will be refunded to you shortly. Additionally, the $10,000 septic escrow will be returned to the party who submitted the fees, Burnett Title Company at 1501 W 80 Bloomington, MN 55431. You will need to contact their office for further details of dispersal of the funds. If we can be of any further assistance, or if you have any questions, please feel free to call our office. Sinc , Jon Sonnentag Zoning Technician /jh cc: Burnett Title Company Town of Hammond File HA M MON D T 29 N. R . 17 W A A SEE PAGE 45 / xs.n . gr..ce. r, 4 Thor lie" s W h lm. • �`,. /ibrre M Wi /ey Ca.-/ L• ti C h 4¢ren No ei/ a/ �'�f Js.s r, NE .J .nth r h ue ass. -A 4 Hie /kerns., G P V A \ •9ur�e w L. � tl Si/.r2 / /9s.s .Baricf /ss iy �^ �V� Ao /79s • 74 fay /ses �,Q iai 17cr rQu6crP \1r �Q /for! N�rrea! /ys sv ��Da� / Co. �yyd� //pn . 4ca✓ sor7 do T / bo USNNEL iL //aro /d, 06 f e; zoo , Ruth do ,, �/ �� • ' . Zoo me r 2'3d s �� i Johnson `l Bo C � � h Kathervne � � cS rid Ler ¢ �c 4 nd� scr� 4o Jo � �• h C Thomas Ua;, p �®0 U /fens Jos t M • do tl ,� Poweis �D� h r Dona/a/ r • os / r�n . D 3 p; • �. / /e7 Ja..,es N a/ /ace EV /6o Nan Sch i"lcrfor/ W H/eiss Eemicc //ro d i7 3zo �i'it c 80 • 80 0 ...� Cjausmnn N Louse � /7T /,brie /G Car � • izo � iJ9 • N a M BC /� Tfior.e0 Kenneth � U��rf`T Uohnson • e o/ CO \ � y h 6J C � R Robots Z Jzo Lo /¢ .acs � ��•� �OD ,F nc C' Tho.n awcrS /79 . i ! /e.� s �P000a // ; �a V Q o� i0 f � C /arrnce f ©/h ,o p ,j lime j PowertsB • tSal/i • 1 � „� `� •s // d nefa -J[tz AA u/G Evan, JOOn M a /q //ayh S Ch. -isfia sexc'obson f� • o ••s 14. 7A50 q q /eo bo /•rB.Z• h.F O y tl .De D r � Bo ens 4 /2 Kent m . • • • ✓,7 • Loma f .byd 3 •Quiae // $e!f ¢ry W /vsn s cTudith w one rx !oe tl />/o/ er oo /r>)an yrs✓e se's h 07 //aw /ey He /cC D "a,74 F G /en f LCwi r '� 4o V `'� ®O • dO rnmc 4 �P e Lewis .Dorot/7r/ '° b , Puss, ftG E.J 4 fh L. cTwsct Pro u^aff�er L/eibr tp 'j E� /a .'/ .iJe.F'oy /lfCfib Connc // /sc.a. Bo �•o Tu�nci - • Q J 4 '�o:3� ffcsac /�.� • o �� xs "°s8nts Bo e.6 /bo vo /zo /oe A" /s f ca;• Hci6r7 F 0 H • /3abcf \ C C C� a. a p \ pp iwwisPmt/ \ tr. ` /�( / C TUMGr' �� V a d 70 do eta/ Q V Q -Iz= 4S.7 • D Pp „ C `i, � Tehnsor/ , R <<` : [: 's•• v !f/C. h C C m Pau/ /swot b r : •. t Conr'- Ford D /t/ J '° r A/o:s.Ecri% p \ ,cssss €i ........i '.'.iii €€ • I N {S/ % /�aPn S rG.7CGJ W 'C r^ • �1 s •: : � GE/ 7 Ci J C Je%in R. KM fo •� us.• rPussc // .0 C ° Tuixr�cr ,pc/cird .�, IrT Be de� IJoornin'Q� /. Ro iso �� ' - l 3 M� /t/ynveen 4 • o,v. Frrzne / n tl�� f�vi7sen � €s.oh/>?It7�n /o � � isb �� eies •� WM s R /� €4 vG .R. ®o fo 38 L e Sera/d S s • :: ,G� a .Pir/rard. ,t en D a /`- :- €'s :':.�: isJ Susan g j - ®o / r s is yo /•na n .oclsrsor/ � - s�z h zOcP /cr PGo ,d aU . �z Pa3 . B/4. V' �¢n7Gs fi! 6 0 - 9/6er/6 j Evan,•.EEEEEEEristianEEE f!e /en S / /aTJ Oyer 3y.S o \. 7P9 -- Loi Tirr/s Z U�Q floe/ Hanson Leaf�vde �c°rss e.2z/.son r •'a ti b :: �Q6sf • • • /BO fo .cgs azs _ _ �P ✓..see/ • • Gene 4 9 //c ♦ J • O / • Ih ke y � /00 yud ey eo a �' rd • Q �� M w� Ken Q•ch G its 'C � nG f,Bef�y ®or��i• s hn � ♦ �n� g� l alt m, Inc. qo �rerer ° b tl 'J ` Al . hsS. p .� a /so k'enna th r ,� �'� .4h JmnesS y7 Ton _ • c %�vs clean ef4/ �Q �G o .Doornin 9z9/ Fa i-.>s, MUM • /,zo' ,• r/a2rp/ orsPev /,! Ea ne 3 /.LS7 C Q� 7' Lewis //t Pefc s i o. z /za c' son l R C tl C 4 9 � 9 0� r 0, Jucn h V ,� CO /bo h!G.f/ccb rrE • 7 �.E.Se Faun, Ix• \ �1' yM, `l .� /i49 4 � •t • //f CSti97 oc or4/ a ub / IrP[., Re v /97¢ SEE PAGE LOG CABIN ammond , otel S/EBOLD REALTY () ar & Cafe, Inc. ON AND OFF SALE LIQUOR FARMS BUSINESSES "Stop and See Donnie" ON AND OFF SALE RESORTS - HOMES DANCING SHELDON O. SIEBOLD - BROKER PHONE: 796 -2237 EVERY SATURDAY PHONE: 796 - 2391- HAMMOND, WISCONSIN Hammond, Wisconsin 54015 PHONE: 796 -2330 HAMMOND, WISCONSIN A "ij ✓ 1 320 . � sr. CERTIFIED SURVEY MAP PART OF THE SEI /4 OF THE SWI /4 OF SECTION 10. T29N. R17W. TOWN OF HAMMOND. ST. CROIX COUNTY WISCONSIN SCALE 1' 200' BEARINGS REFERENCED TO THE NI /4 COR. SOUTH LINE 3WI/4 SEC, 10 SEC. 10 0 100 300 ASSUMED 889'41'57'E UNPLATTED LANDS h m N 89 ' 57'W 738.00' r ° p22Ec,tn� LEGEND 217.800 SF. 210.289 SF. ' sotr. '�w SET 3/4` X 18' IRON PIN 5.00 AC. 4.83 AC. WT. 1.50 LBS /FT. LESS ROAD R -O -W to ` 9 MONUMENT ALUMINUM $ r xe9.41 soe.aa• ❑ , • ❑ in ® g'3 FOUND I• STEEL MARKER • '0 n LOT 2 g� � $n c I �U 217,800 SF. fs17UG ❑ ZF- al n , 5.00 AC. Mvou b in 201.023 SF. ' $ ttftrrrr 1 p a 4,61 AC. LOT 1 LESS ROAD R -O o ROADWAY f - ( n w y • C— y M ACK L 1NL' _ _ • 00 V U e T �\. G0l I 3 W �1.\ g1►1,W\ yH re 3J.00' •49 736.00' 0 33 .00• 33.09' ...... ; ........... ... S°!:3!............. 227.62' � �� ; ' p� ��� • 306 36' 227.E2' g . • '••......i e'���` S 59' 41 :57 E .... ...... �..: . a,. 1`. .. .. .............. . ' , � , S a n d $ SOUTH L I N E SWI /4 SEC. 10 C. T • H. • E • UNPLATTED LANDS I. LYLE L. ELLIOTT. REGISTERED LAND SURVEYOR 5 -1300 DO HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS MAP IS A TRUE AND CORRECT REPRESENTATION OF PART OF THE 3EI /4 OF THE SWI /4 OF SECTION 10. T29N. R17W. TOWN OF HAMMOND ST. CROIX COUNTY. WISCONSIN AND MORE PARTICULARLY DESCRIBED AS FOLLOWS; BEGINNING AT THE SOUTH QUARTER CORNER SAID SECTION 10. THENCE NOO ALONG THE EAST LINE OF THE SOUTHWEST QUARTER 592.00 FEET: THENCE N89 736.00 FEET. THENCE S00 592.00 FEET TO THE SOUTH LINE SOUTHWEST QUARTER SAID SECTION 10: THENCE S89 ALONG SAID SOUTH LINE 736.00 FEET TO THE POINT OF BEGINNING: SAID PARCEL CONTAINS 10.00 ACRES MORE OR LESS. INCLUDING COUNTY HIGHWAY E RIGHT -OF -WAY. THIS PARCEL IS SUBJECT TO ANY EASEMENTS OR RESTRICTINS OF RECORD. i HEREBY CERTIFY THAT 1 HAVE FULLY COMPLIED WITH THE PROVISIONS OF SECTION 236.34 OF THE WISCOSNIN REVISED STATUTES AND THE ORDINANCE OF THE TOWN OF HAMMOND. AND ST. CROIX COUNTY IN SURVEYING AND MAPPING SAME, EACH PARCEL SHOWN ON THIS MAP 18 SUBJECT TO STATE, COUNTY AND TOWNSHIP LAWS. RULES AND REGULATIONS I.l... WETLANDS, MINIMUM LOT SIZE. ACCESS TO PARCEL ETC.? BEFORE PURCHASING OR DEVELOPING ANY PARCEL CONTACT THE ST. CROIX COUNTY ZONING OFFICE AND THE APPROPRIATE TOWN BOARD FOR ADVICE. PRIOR TO CONSTRUCTION AN EROSION CONTROL PLAN MUST BE SUBMITTED TO THE COUNTY PLANNING AND ZONING OFFICE ON EACH LOT THIS SURVEY WAS MADE AT THE REQUEST OF DAVE DALTON 1848 CTY RD. E HAMMOND. Wt. 54015 I -715- 796 -2715 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 4 0 GENERAL INFOSRMATION (ATTACH TO PERMIT) State Plan ID Personal information you provide may be used fors a urposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: / City Village X Township Parcel Tax No: Dalto a Nom` Hammond Township 018- 1020 -70 -000 M Elev: Insp. BM lev: BM Des ion: TANK INFORMATION ELEVATION DAT TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size I x Hole Spacing Vent to Air Intake Pipe(s) Length Dia I Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of ded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil x 10 Yes 1 No [] Yes, No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1848 Cty Rd E Hammond, WI 54015 (SE 1/4 SW 114 10 T28N R17W) NA Lot Parcel No: 10.29.17.156A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes M No �^ Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. A Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 c`✓e AnsconSI n Madison, WI 53707 - 7162 Site Address Dep artment of Commerce 940 E E j ' &AMe ` Sanitary Permit Application S anitary P`errrmit Number to S-f In accord with Cotton 83.21, Wis. Adm. Code, personal information you provide T may be used for secondazy purposes Privacy law, s15.04(1 m ❑ Check if Revision I. Application Information - Please Print All Information Ste Plan I.D. Number 4 S —T o'„ ►� Property Owner's Name ®c � d C D 1 Number d l �W [�G Y G &(T o Zo — 50 - tJt3'D 6 15_ fA Property Owner's Mailing Address 1 003 Pr rty Location V 5 S 'I�GG� IA; S /Gr T . N, R , o City, State Zip Code P one NuTbff,, X LOUN T Lot umber Block Number N ZONING OFFfCE Subdivision Name CSM Number J'Y�IS �S'ly1 X t H. Type of Building (check all that apply) ❑City ' lot 2 Family Dwelling - Number of Bedrooms ❑Vflla e g ❑ Public /Commercial - Describe Use 9 ' Township � 4 y ❑ State Owned l tt n Nearest Roa r l y I x 5D I MOU.VNOQ III. Type of Permit: (Check onl ox on line A (numbering scheme for internal use). Complete line B if applicable) V A ' 1 ❑New Replacement System 3 ❑Replacement of 6 ❑Addition to" For County use. 3 p c S stem Tank Only ExistingS stem O B • ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued 9 a i C � IV. Type of Permit: (Check all that apply) (numbering scheme is for internal use) 44 ❑ Non - Pressurized In- Ground 20Mound 47 ❑ Sand Filter 50 U Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line , 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other q/ V. Dispersal/Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade j Required Proposed Rate(Gals. /Days /Sq.Ft.) (Min./lnch) Elevation 1 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing ' Tanks Tanks Septic or Holding Tank _ 6 -A Dosing Chamber 7 SZ , e - VII. Responsibility Statement- I, the undersigned, assume responsibility for tion of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature & AIPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) � !r VIII. Coon /De artment Use Only < Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) El Owner Given Initial Adverse . .> .•� � f ._ �'� � Determination �• IX. Condition of pproval/Reasons f r Disapproval {ta - ,4 tl ' s +µw-E- tie ta+�. fat s fn� V A (tact plete County only) for the system on pa not than 8� Inches in size . - / / ' Q '�L_. � /-�•, f9.0� iMD- '►.t,t� �. S 5 e�(Rc,l) O > (� t� � o c M M d j v\ n G 3 o ol "14 Fri 93 r 261 T N w � � \ d N � o, a. �l °o o Y LON qA °a , °0 0 o h} �► `C kA c IA w V N N " � o r Z E v1 3, c d 3 m n �► � .� Mai ^ O .1 w s �� a 0 3 3 � a g a � A O V p Y � 0� � ; O 1 4� 1 �p •• Q V1 H a V lb y A r N `1. =r O nfi \ 5 a 'ate c d 0 a. N v a %Cc Safety and Buildings 4003 N KINNEY COULEE RD FFR\. C D LA CROSSE WI 54601 -1831 : TDD #: (608) 264 -8777 ,scons1 www.commerce.state.wi.us /sb www.wisconsin.gov Department of Commerce Scott McCallum, Governor j Philip Edw. Albert, Secretary October 17, 2002 CUST ID No.267341 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES 10/17/2004 Identification Numbers Transaction ID No. 795579 SITE: Site ID No. 651681 David Dalton Please refer to both identification numbers, CTH E above, in all correspondence with the agency. Town of Hammond St Croix County SE 1 /4, S W 1 /4, S 10, T29N, R 17 W FOR: GeLC�, -i Description: Re - connect;nn to an Fxicting ound System sized per capita for approximately 5 people - (380 gpd) —, Object Type: POWT System Regulated Object ID No.: 874602 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. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Per Comm 83.26(2)(a), the mound system can not be put into operation until the local governmental unit or the department has had an opportunity to inspect the system in accordance with Comm 83.26, Wis. Adm. Code. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7) - 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. Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. P.O.W.T.S. Conditionally APPRn ARTHUR L WEGERER Page 2 10/17/02 Owner Responsibilities Continued: • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Gj4J Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswim @commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 VUL 104r- PAGE 4!. PER CAPITA OCCUPANCY 6 8 3 4 6 3 'Document Number Document Title KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 07 -03 -2002 12:50 PH MISCELLANEOUS TO WHOI•I ,IT MAY CONCERN EXEMPT # REC FEE: 11.00 The existing POWTS owned by David Dalton and located in the TRANS FEE SEk of the SW` of Section 10, T29N, R17W, Town of Hammond COPY FEE St.Croix County, Wisconsin was installed in August of 1992 CERT COPY FEE: in accordance with plan approval No. S92- 01681. PAGES: 1 The- 5 5 p e-r `l K 75&' & 4 dc-- slE yy o �-/ ire 51c yy Recording Area Name and Return Address The absorption area is 380 sq.ft. and "based on the code now in David Dalton effect (1.0 gpd /sq ft loading rate for fill) is suitable 1848 County "E" for 380 - .gal /day of effluent. Hammond, WI 54015 COFIM 83.4:3(3)(a) states that the estimated daily flow is assumed to be 100 ga 1 /dap per bedroom based on.2 persons per bedroom which 50 gal /day per person. The .design flow is then SOgpd % - 150X = 75 gal/day person. 018 - 1020 -70 -000 The mound is code compliant for up to - 5.persons in the dwelling (380 -75 =5) as per Collm 83.43(3)(b) based.on per capita occupancy. Parcel identification Number (PIN) COMM 83.22(2)(a)3 requires that when the design is not based on the number of bedrooms in the dwelling, the design condition (per capita occupancy, maximum.5 persons) be recorded with the deed to the property, Owners) Name(s) (Print) Ownees Signature(s) Sub - bed and swom to me on tNs date: t a06 Todays Date • 1 /' J � w l t � '1�1lGtJ`Tl"L • I . Na Public Signature ,�� ���• �Ca��l�evt � /sir Drafted by Arthur L. Wegerer L f- ca commission Expiration u� O J <...y AX s This information must be completed by submitter. documen N s ' address and PIN (if required). Other information such as the granting clauses, legal description, etc. may be placed on this t 1V e document or may be placed on additional pages of the document. Note: Use of this cover page adds one page to your document and $2.00 to the recording fee Wisconsin Statutes, 59.43(2m) WRDA 2/99 215-32 (2199) .. TITLE SHEET Page of FOUND SYSTEM FOR A BEDROOM RESIDENCE VV/ S FE\z5o1V S M :'<. This plan has been prepared in accordance with portions of the Mound Component Manual SBD -10572 (R.6 and portions of the Pressure Distribution Manual SBD10573 (R.6/99) and with the requirements in effect at the time of approval and installation in 1992. The septic tank and pump tanks will be replaced. The mound component will remain place with no modification. LOCATED IN THE S E ' 1 /4 OF THE S UJ 1 /4 OF SECTION l0 T Z N,R 17, W TOWN OF }-j- y.1 ST C-MU( COUNTY, WISCONSIN. INDEX q� �c PAGE 1 of 7 TITLE SHEET oC J' PAGE 2 Of 7 SYSTEM MAI1AGEir1ENT PLAN PAGE 3 of 7 PLOT PLAN �A v O PAGE 4 of 7 PLAN PAGE 5 of 7 DISTRIBUTION O PIPE �LAYOUT � PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION VO PAGE 7 of 7 PUMP PERFORMANCE CURVE k PREPARED FOR PREPARED BY kIEGERER SQ I L . TEST I [VG AND. DIES � Gai'V S1ERV = CE P.O. Box 74 421 N , Main St. ���,,�+otcr►o�oe � River Falls, WI 540221,�$'�� Phone 715 -425 -0165 4 Fax 715 -425- 6864� A347r -;JR L Wt.IF'4F:R year D y 61iy1" RTH 3 DEPARTMENT OF COMMERCE (VISION 0 AFETY AND BUILDINGS j G t: 0 SEE CORRES ONDENCE JOB NO. (D) -C)3- Mound System Management Plan Page Z of — 7 Pursuant to Comm 83.54, Wis. Adm. Code . Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be asses ensure proper operation e filter car - Wdge should y not be removed unless provisions on made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the 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 sludge and scum 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 a triennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System N6 trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L 8005, 150 mg/L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. istribution system is provided with a flushing point at the end of each lateral, and it ' each � lateral be flushed of accu�when ve 18 m ure test is performed it should be re mp ared to the initial tese o e ermi curred and if orifice cleaning is uir ution wit hin the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] arid local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump 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 a tank or component. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repalred or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at 11 - 38 6- Y 80 S c 2U lX The system installer at The tank manufacturer at `— buri _9 - Z S /O M I L�TtTRJV The effluent filter manufacturer at S Z.t�CA3TT- The pump manufacturer at — 630 , gZp , y8.� - PLOT PLAN Scale 1 "= UO' Page 3 of IV 7 N T�� 1t`llb OF y y PoC O 3 �DR�1 r / r 4 o/ -J S- G6 ES`fLmO Jr l X. v�1C'L l ' 'xksnrv(S �o SOT �4? a Z7 / BM k-C - "C� -:SAO -O'. 0►.J:_1 �P : "OF- T�'Z- C.'1�ftUA1�_�::h�_. = -^ - -_ - - -- 1 S i-- OhJ_.ET�I �7'._S`�'r' - l'�Clt�1•c _1'- �f11u1�-pL� .._�AU�� -- ,� 8` at'►1-� 0 y h� j -h NOTES: _ 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be 1 000 /650 gallon capacity manufactured by M 1 ►RJJ T. w C. Z 4. Bench marks S -- Z S. Divert surface water around system to prevent ponding at the uphill side. F Page Approved Synthetic Covering �STr -t c 33 Distribution Pipe Medium Sand Topsoil F Elev. q8 -� E p 3 , „ b y % Slope Bed Of 2- 2 %2 Force Main Plowed Aggregate From Pump Layer D Z, 0 Ft. E Z.Z Ft. Cross Section Of A Mound System Using F o: 8 Ft. A Bed For The Absorption Area G t•o Ft. A Ft. H l -S Ft. Linear Loading Rate= S- 9ZGPD /LN FT B --) G Ft. Design Loading Rate= 0. /SQ FT I )L Ft J ) O Ft. K ) Ft. L I O f3 Ft. W Z Ft. L. Observation Pipe — __ _._._-- _----- __�____ — = 0 1 A P W o----------------------------------- - - - -- Force Main �, Distribution B ed Of 2 2 \,— Pipe Aggregate Observation Pipe Permanent Markers (Anchor securely) C�apN G) Plan View Of Mound Using A Bed For The Absorption Area Distribution Pipe Layout Pdce S of -� • ��CtSTlly G� • c I Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. end en each :al with a us Ions o S° o th e. T e/ e ends t�e � II r . 'de c" s r e aIy Lateral Manifold Lateral Lencth - lam -Lt?•N V \ - -- P r� Pna�ro`b - ►fq-j 1 w/ S u C cs,� Ft, Hole Diameter ) /Y Inch S - Ft, Lateral " 1 / "Z inch(es) X ` Inches - Vto LE Spf Manifold " 2 Inches Force Main " Inches I of holes /pipe / 6 Invert Elevation of.Laterals Ft. 1� X Ii - 1= 1 't. z. 3�_y� r Combination Septic; and PUMP CHAMBER CROSS SECTION AMD SPECIFICATIONS ' PAGE OF 7 • -YEU7 CAP WEATHER PROOF JUIJCTIOU BOX . ti C.I. VENT PIPC APPROVED LOCKING 1 10' FROM DOOR, &WHOLE COYER ;v I V :ittJ00W OR FRESH 1 u'ARtaIUG LA,g�C. uasp�olJ � tPE cosaputr - 1, JJFnTz-:nrar terP ALR WTAKE s tj SIRD LL 0 '13 I • C' �YD E I NL ET PROVIDE AtRTtGHT SEAL I I (( V @ �rrFL�S •n, I I l I ( Approved sfll�. r_wlm� _A A +(( Approved joint 1q/joint w/ PVC pipe ALARM PVC pipe - I I I ( I ow C � CLCY. I PUMP -� --J OFF COUCKETE LSZrsU $ 3. op BLOCK RISER EXIT PERMITTED OAJL L IF TAwK MA HAS SUCH APPROVAL • �6irpD SE DDI t N4 SEPTIC f SPECIFICATIOUS DOSE TAUKS MA 1 �LJL WUM5ER OF DOSES: �• PER OAS TA 1J K SIZE lb(A) / CALLOUS DOSE VOLU r ALARM tSAIJU FACT URCR: S - S , kZIA�C`n2_p 21,9yQ S I.MCLUDING 6ACKFI.OW MODEL IJUMBER: - J () I tjL- CAPACITIES: A - 18 (� - - INCHES OR O 3 SWITCH TJPC: GALLO►1s W1 `L'1ZL°LFi2 -� INCHES'OR 3 � G{ LLOUS PUMP 1'�AIJUFAGTUREA: GOV` -�S C z -? WCHES OR 1 C \ CALLOUS MODEL WUMHER: 3$� t'POS D . 1 INCHES OR $, GALLOMS SWITCH TVPE: MOTE: PU11P AUD ALgRM rTT TO 6C MINIMUM DISCKARGE • RATE 3� GPM INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFERENCE 15ETWEEAJ PUMP OFF AtID..DrSTRtBUTIOtJ PtPE.. L1 -S� FEET + KIWIMUM METWORK SUPPLJ PRESSURE , ; , , , . , , , , , 3_zS FLET C�• Sx l. 3) ♦ �3� FEET OF FORCE MAIM X Z•g3 0 ftFRICTIOU FEET TOTAL 0!AJAMIC. HEAD = Z ! ^ FEET As per manufacturer 1 `1 . o gal /in. Liquid depth Goulds Submersible Effluent Pump i 38 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron SpeClfically designed for the stainless steel grade turbine oil for for efficient heat transfer, , following uses: • Capable of running lubrication and efficient strength, and durability. •Effluent systems dry without damage to heat transfer. ■Motor Cover: Thermoplas= • Homes components. tic cover with integral handle Available for automatic and • Farms Motor: and float switch attachment •Heavy duty sum • EPO4 Single hose: 0.4 HP, manual operation. Automatic p g p models include Mechanical Points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and -; ■ Power Cable: Severe duty RPM, built in overload with • Dewatering rated`oil and water resistant. automatic reset. preset at the factory. + EP05 Single phase: 0.5 HP, , 4 ■ Bearings: Upper and lower SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump EPO4 built in overload with construction ■ EPO4 . Impeller: Thermo- .r Solids handlmg capablhty automatic reset plastic Semi -o en desl n . ' r �r 4 maximum. * -` ` r "v • Power cordl0 foot P 9 AGENCY LISTING #'� r • with pump out vanes for Capacities. up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP- Canadian Standards Association II pptal heads: up to 24 feet. with three prong grounding M EP05 Impeller: Thermo - .� `« pischarge Size: 1 NPT. plug. Optional 20 foot p (CSA listed model numbers y M g plastic enclosed design for end in " to or model *.-Mechanical seal: carbon- length, SJTW with . /ceramic= stationary, hree prong grounding plug improved performance.. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged thermoplastic design Temp rovides erature , �`� P 9 P 1 04 F (40 C) continuous :. superior strength and ° ° 140 °F (60 °C) intermittent. " corrosion resistance. • Fasteners: 300 series `` M FEET stainless steel 10 *'Capable of running i G; dry without damage to 9 30 5 components. i Pump: EP05 a I 25 • Solids handling capability: c 7 25 °°'/4° maximum -.a W •Capacities up to 60 GPM. 6 20 • Total heads: up to 31 feet. • Discharge size: 11h" NPT. . z 5 �.� • Mechanical sea[ carbon-- c 15 rotary/ceramic- stationary, j BUNA -N elastomers. a E o PO * Temp erature: , * 0 3 10 104oF (40oC) continuous - Poa 140 F (60 intermittent 2 K'r 5 1 1 - �/ o 0 10," 20 30 40, ;, 50 `GPM 0 2 4 6 8 10 12 m /h CAPACITY rt < 0 1995 Goulds Pumps Inc. FHArtwe Ua, taoS PLOT PLAN / Page 3 of 7 /scale 1"=L10 ' N Ij M O . 1 3 IS' �O ►JOT COMt�R•21 o� ► r�l 1 32� \� h • ,1 N0T C_ = J -L 1 S O. Sov�' N wT... �. g►�z G fir:: L�kU v 5 N" -�. _. l g l"0 ... S • 3 labs -vi X U"P -j c E 0 er-- tewft ':C A►" 1 N-Z L,L fit. 7 ca►'ir{tuwl 41 �� L- aco�SE D1wG. o ST. STPiM T' A?_ MW COU — CT" - T orr W Iz e _ 1 AJS ° i +. LeE: ,iV IC Z., -"�Cl` Sg�1ZC '`'l�'l Jrt; 1's �U �.��1r"ti•Pt� �J tN �- � V �t�'`: , _ " �/�Z..�« 'tom c�t�7or� or— �3o'n•I �� , f-o� coD� cor ipLZ , . r y Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County NZ-0 lx i Attach complete site plan on paper not less t ns �ce, ust include, but not limited to: vertical and horizo (BMt , nd Parcel I.D. P�.��IN 6 percent slope, scale or dimensions, north arrd distarest road. Revie d by Date Please print all l � Q Personal information you provide may be used forrivacy s. 15.04 (?,) (m)) 2003 Property Owner C � Property Evocation D 1 /4S W 1/4 S 1 D T 2 N R E (o W Property Owner's Mailing Address Lot Block # Subd. Name or CSM# ! S 4.S e0u>j i L1 y - ��TLr )v�osiE esm City State Zip Code Phon rti 7 City ❑ Village 4 Town Nearest Road S�LUt (ZtS ? �W11tilU►vz> ❑ New Construction Use: Residential i Number of bedrooms 3 Code derived design flow rate q S GPD Replacement ❑ Public or commercial - Describe: Parent material S t_`r 1 6 V LTL G LA-Gt A-f- Tl. Lt- Flood Plain elevation if applicable General comments and recommendations: W 1`Rl W ,C- So' 3�1STN - U SQ W Co le: 1. ) t " U Z Z. OF - 3 a Boring # I ❑7 Boring tom! Pit - Ground surface elev. )i O ft. Depth to limiting factor _ 1\ 4 in. j� - Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I 'Eff#2 L L Z 6 - 1 U1R -3(L 3 N-1 - 1•S , 1rLYl6 F -1 Boring # F] Boring ® pit Ground surface eiev. 11. 0 ft. Depth to limiting factor Z� Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Ef1#2 o -e -L - st( 143 b>, vn'vr -s Z $ Zo IoYIL 9L6 '3 Z` ,A -c. YA 6- e-S - s • 8 3 Zp 3"1 `� SY2i�l6 �!'� �•SY25�S 510-1 c3bk rn`�1- - •'�- .3 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S CST Number Arthur L. Wegerer �, O t - p 3 ' 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. 1--lain St. River Falls, WI 54022 1 - 715 -425 -0165 s Property Owner _ �D�t L`t p N Parcel ID # _ !� kJ Z> ) A/ 6 Page Z of 3 Boring # Borin ❑ e ® Pit Ground surface elev. Q�- � ft. Depth to limiting factor � a in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu: Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 O — 1tnR 3LZ — s? 1 Z.`f ►�`FV Iv`� -S -g3 Z `g sbk rn �F►, c S - 5 - rd �SLiR- V 6 -S Lt 1ZSL� F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/11 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # [] Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ' Effluent #1 = BOD, > 30 < 220 mg /L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 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. SB D 4330 (P-6MO) r PLOT PLAN Page 3 of 3 Scale l' =y0 CA j O . .r � ^ I j 1 3Z� 1S' �o Nor cuMC�R•e� � p� UI�TU -13 � ' 71k S Li 1 �l BLDG _ 1 a2 � o 'T2L�"C -• V BM�� - Z - a'v. Q � J �� �z - �-�. toy. � � -�, - ��rr��► �" � QS= ____��SE StDti✓� ___ _ a S71 - sTPTl e m N cou - I 1 - 715- 425 -0165 220254 01--03 -- CST Signature Date Telephone Ito. CST No. Job NO. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 ,��Onsn www.commerce.state.wi.us /sb www.wisconsin.gov Department of Commerce � Scott McCallum, Governor Sr Philip Edw. Albert, Secretary October 17, 2002 CUST ID No.267341 ATTN. PO WTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/17/2004 Identific e Transaction I o. 79558 SITE: Site ID No. 65 David Dalton Please refer to both identification numbers, 1848 CTH E above, in all correspondence with the agency. Town of Hammond St Croix County SE 1/4, SW 1/4, S10, T29N, RI 7W FOR: Description: Proposed Mound System for an Existing Three Bedroom Residence Object Type: POWT System Regulated Object ID No.: 874603 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. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of See. 145.20(2)(d), Wis. Stats. • The existing tanks must be inspected for structural soundness, size and baffles /effluent filter where required, and must be brought into conformance with the requirements of chapter Comm 83, Wis. Adm. Code. If a tank does not comply, a state - approved tank shall be installed. • Comm 83.22(7) - 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. Note: The total dynamic head shall be revised to 20.45 feet due to the fact that the GAG Sim/Tech filter requires and additional .5 ft. to function correctly. Owner Responsibilities: • Comm 83.52(l)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a h &Q- ANIt'Mard. Conditionally ARTHUR L WEGERER Page 2 10/17/02 Owner Responsibilities Continued: • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. • In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892 , Mon - Fri, 7:15 am - 4:00 pm WSMART code: 7633 jswim@commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 I TITLE SHEET Page ` of - 7 FOUND SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD -1057 P and the Pressure Distribution Manual SBD - 10573 -P Ctz - b lga� CtZ- 6199 LOCATED IN THE St; 1/4 OF THE SW 1/4 OF SECTION 10 , T Z°t N, R 1'7 W, TOWN OF l'� P�'M�"'IOU� ST C°_1ZU lx COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT A PAGE 3 of 7 PLOT PLAN �j rk PAGE 4 of 7 PLAN VIEW -CROSS SECTION '0X PAGE 5 of 7 DISTRIBUTION PIPE LAYOU� PAGE 6 of 7 PUMPING CHAMBER CROSS SE D O PAGE 7 of 7 PUMP PERFORMANCE CURVE nn v" v PREPARED FOR _ 1 ►^'l l'�10►vD , w l S 4.0 l 5 PREPARED BY WEGEt:;.'EFZ SCI I L TEST I NG AND . DES I CCtV S1_=F2V I CE P.O. Box 74 421 N.Main St. t 1110 1 tea River Falls, WI 54022 Phone 715- 425 -0165 Fax 715 - 425 -6864 3 : •••'` `•,� • AM"JR. 1. ' � WfGENtR U•!315 P FLbssv:.RTN, i W G 'O 9 DEPARTMENT Of COMMERCE S I DIVISION OLAAFETY AND BUILDINGS SEE CORRES NDENCE JOB NO. Mound System Management Plan page Z of Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The sbptic tank shall be maintained by an individual certified to service septic tanks under s. 281.48 Sl ats. ats. The contents of the septic tank shall be disposed of in accordance wi NR 113, Wis. Adm. Code. J ae o erating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet cite hall be s cleaned as necessary to gnsure oroogL erati n. The filter cartridge should not 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 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 sludge and scum 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 a triennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation: If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Dlstrlbutlon S tem Nd trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quallty Into the mound system may not exceed 220 mg /L BOD5, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual (SB0- 10572 -P (R. 6/99)] arid local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump 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 a tank or component. Contlnaency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component falls to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at 1S— 3$ 6 — X1680 ST. t•_ Ro tx The system installer at ►JOT' krupwtJ ' The tank manufacturer at l — $oo -32S -8qS l v t �^ct The effluent filter manufacturer at L�l GAG S1 M TEC The pump manufacturer at / PLOT PLAN Page 3 of 7 /Scale 1 " =y 0 ' (.n � m • �7 N 0� f a �� o I _ � ► 3 otx O�sruW_13 ► e.7. 1 11 yn/ 111 e Q ti �b _ � J c� F_ R'b US M t s Tv _ " � �'zwl X wxLL ---- Opu C 0 c�� - cam -- t_.L��►�, '` _ Pl.� �' t3y� N-z &L- 44 0 L'y j ST. SZPT]C TV-AL MW C oU 1 A 1 N S`11ft'f`t`LLA tti 14 I Z , 'T Rr AJ W n_u Ttrz: 1 u Cltm -t (ulz W Q- - mC)uetl To 1� Lo fl6ove VOt N `Tup- CCwDtT?Uyv c) 'T -S .roP_ coDO. c-owtC��_iN , . Page 4 Yn Ap roved Sy Covering - _ P ASTH C33 Distribution Pipe Medium Sand �-� - H - „ tG Topsoil v. i OZ - -- F Elev. - 3 3 E �i. % Slope Distribution Cell of - Force Main Plowed z" to 2 z" Aggregate From Pump Layer p /.Sy Ft. E Z.?-O Ft. CROSS SECTION OF A MOUND SYSTEM F o - Ft. G Q. S Ft. A Ft. F. 1 0 Ft. Linear Loading Rate =Q.O GPD /LN FT 6 S 0 Ft. Design Loading Rate =b.39 GPD /SQ FT j I y Ft. J q Ft. K 1 Z Ft. _A!t t one ;t;nn L - 74 Ft. for n _._ W 3 Z Ft. }..._ L f Observation Pipe g - � K Ao- �-- - -� - - - - -- --- - - - - -------- - - - - -- --- - -- d7 - �L _ _ _ _ _ orce Main so :� W_ �:Vlstribution 1 2 Pipe Cell of Z to � aggregate Observation Pipe (anchbr Secure PLAN VIEW'OF A MOUND SYSTEM Distribution Pipe Layout Page S of 7 Place the holes at the bottom of the distribution • equal ribution pipes at a q spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of Iona turn or 45 fitting to a point within si inches of the final grade. Terminate the ends of the laterals with a valve, threaded cap or threaded plug. Provide access from final grade for the valve, threaded can or threaded plug. T `t P Ct� � . �,ZDS S . S�C`t711►y PVC Fb� PUC Lateral Manifold Lateral ............. X x x x x12 xa x x x x 'Lateral Lenoth — Lateral Length — p Distribution Line IT • P �� `-- r�cc sflX — - o rmjiFOt.a S o -- P Ft. Hole Diameter I /Y� Inch = -- S 3 Ft. Lateral J Inches) X Z3 Inches Manifold " Z• Inches .Force Main " 2 Indies #of holes /pipe !3 Invert Elevation of.Laterals L3kO.gI PUMP CHAMBER CROSS SECTIOM ARID SPECIFICATIONS ' PAGE E; OF lb VENT CAP '1 "C.T- VENT PIPE f r WEATHER PROOF APPROVED LOCKING MANHOLE 10' FRO 000R, 7 JU)JCT10N BOX ' COVER WITH WARNING LABEL i2'MttJ. WINDOW OR FRESH AIR INTAKE i GRADE 1 y' AIM. COIJDUIT �- - 19'MIIJ. INLET • PROVIDE • 7 AIRTIGHT SEAL I I ( I I V APPROVED JOIIJT/ - A Tank construction shall comply I APPROVED JOUJTS with COMM 83.15 and COMM 83.20 1 1 ALARIA � A ON C - CLEV. 00 FT. __� S`r [_ - LI�Q pump—,, OFF D ��• ) 'Z,00 ' COMCP DLOCK 3" ApPf2oVED - RISER EXIT PERMITfEO OIJLy IF TANK MAJJUFAGTUR>~R HAS SUCH APPROVAL, SPECIFICATIOUS DOSE 'rA FJ AS MA►IUFACTURER: CS)" C.�37t IJUMDER OF DOSES: L/ PER DAU TANK SIZE: GALLOWS DOSE VOLUME z AL ARM _I_MIUFACTiJRER: L�1;L. P-L Izi L`O INCLUDING 6 ACKFLOW: �34ab GALLONS MODEL MUMBCR: �' L V • - CAPACITIES: A = � � _IMCHES OR Q. 6 ' 1 GALLONS SWITCH TUFF — �F� 9 a Z IIJCHES OR 3,R 5 GALLOWS PUMP MAMUFACTURCR: C= tAICHES OR �3y'6 CALLOUS MODEL NUA I5ER: 3 g� OS D= �? INCHESOR �' GALLOIJS SWITCH TYPE: - MOTE: PUMP ARID ALARM ARE TO bC MIMIMUM DISCHARGE RATE 3 _ GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE OETWGCN PUMP OFF AWD..DISTRMUTIOW PIPE... - ==L: FEET , + MIAIIPIUM ' NETWORK SUPPLY PRESSURE -. , .. 6'S� FEET + b S FEET OF FORCE MAIN X Z = — o rI FRICT1ou FACTOR. 3 ' 61 FEET _� -- -- - -- - - _ :E CORRESPONDEX :_ TOTAL OtIWAMIC. HEAP - \" S - FEET — - - As per .'manufacturer - z. :a, gal /in. Liquid depth 39_ Goulds Submersible ^ 1 Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. dry without damage to heat transfer. ■ Motor Cover: Thermo las- •Effluent systems components. P Homes Motor: Available far automatic and tic cover with integral handle • Farms manual operation. Automatic and float switch attachment e Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical Points. 115 or 230 V, 60 Hz, 1550 Float Switch assembled and duty • Water transfer RPM, ■Power Cable: Severe du built in overload with : preset at the factory. Dring _ - , rated oil and water resistant ewate automatic reset. ■ Bearings: Upper and lower'-, ' SPECIFICATIONS EP( Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: PO4 built in overload with construction p' ■ EPO4 Impeller: Thermo - -% Solids handling capability automatic reset. plastic Semi -open design g � x �� , 4 ,.maximum ;r Power cord: 10 foot AGENCY LISTING - J & Ca aciities. u , to 55 GPM. standard le 16/3 SJTO with pump out vanes for k .. P p g mechanical seal protection. SA• Canadian Standards Associ ation * " Qtal heads: up to 24 feet. with three prong grounding Discharge size: l' /z " NPT. plug. Options{ 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers 3 s4 Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for g end in "F" or "AC ".) rotary /ceramic- stationary, three prong grounding plug Improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged •,Temperature: thermoplastic design provides continuous superior strength and Y 140 °F (60 °C) intermittent. _ corrosion resistance. Fasteners: 300 series METERS FEET stainless steel. 10- •`Capable of running dry without damage to s 30 s s" components. Pump: EP05 $ s I w as • Solids handling capability: c 25 :3/4' maximum. w 7 •. Capacities: up to 60 GPM. s , • Total heads: up to 31 feet. 6 20 o Discharge size: NPT. z 5 Mechanical seal: carbon- 0 15 rotary/ceramic - stationary, 4 BUNA -N elastomers. 1 JE • Temperature: ° 3 10 % ,._1 (40 0 C) continuous 140 °F (60 °C) intermittent 2 Epp r t' 5 1 '. 0 00 10 - 20 30 40_ , 50 GPM 4 L -L r. 0 2 4 6 8 10 12 m /h CAPACITY r r 1995 Goulds Pumps, Inc. Effective Ma 1995 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer `L Mailing Address AF ` ��' /�'� - Property Address (Verification required from Planning Department for new construction} City /State Parcel Identification Number - ---- I. &rA . D iCRIPUQN � t/ r � 1 N -R ' a t � awn of ��� Property Location � /4, � v Sec le .aL Subdivision , Lot # Certified Survey Map # , Volume `'— , Page # Warranty Deed # 4T 9 8 T . Volume 1 1 — , Pa e # Spec house 0 yes Z no Lot lines identinablej�'yes Q no SYJ137►_+[ rrrsETT NA_NC 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, journeymenplumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/Or (2) aflter inspection and pumping (if necessary), the septic tank is leas than 113 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 C OM!ner ce and the Department of Natural Resources, State of Wisconsin. Certification sorting that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 34 days of the three year expiration date. .�l/ Icy ' DAI SIGNATURE OF APPLICANT OWEA CERTIFICATION I (we) certify that all statements on this form are true to the best of ray (our) knowledge. I (we) am (are) the oumer(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. I. DATE SIGNATURE OF APPLICANT waw * ** A information that is mis- represented may result in the sanitary per-nit being revoked by the Zoning Department. "* Include wltb this applieatlon: 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 4 1 by t Vc 1291"U338 571981 STATE BAR OF WISCONSIN FORM 1 — 1982 WARRANTY DEED DOCUMENT NO. This Deed, made between J J. SCHMELZER, a single Ri'gIST R'S OFFICE person ST. C ROIX CO„ Wt an d DAVID A. DALTON, a le sin g Grantor, , ,IAN 2 8 1998 person 1:00 P M . c•atttee, Ra tw a•a Witnesseth, Tim the said Gnmwr, far a,juable oxLSid. conveys to Grantee the following described real estate in St. Croix THIS SPACE RESEAvEo FOR RECORDING DATA County. State of Wisconsin: ANO RETURN ADDRESS NA A5'7 C. ek x' 1 n. 018 - 1020 -70 y;. PARCEL IDENTIFICATION NUMBER South 592 feet of East 736 feet of SE -1/4 of SW -1/4 of Section 10, Township 29 North, Range 17 West, St. Croix County, Wisconsin. *9 TRANSFER This _ f st not, homestead property. (is) (15 not) Together with all and singular the hereditsments and appurtenances thereunto belonging; And Tnhn .T, Schmal7ar warrants that the title is good, indefeasible in fe: simple and free and clear of encumbrances except None and will warrant and defend the same. Dated this 26th d January 98 19 (SEAL) i�,.ay��_•�,e./�,�� (SEAL) . John J. Schmelzer BY: Frank Sutherland, Temporary Guardiard (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of *V1w_4=s*x)t Minnesot u. Washington County authenticated this day of _ , 19 Personally came before me this 26th 4 day of January 19 rite above named Frank Sutherland _ TITLE: MEMBER STATE BAR OF WISCONSIN (If trot, authorized by §706.06, Wis. Slats.) to the known to be the person who executed the foregoing instnur cnt and acknowledge the same THIS INSTRUMENT WAS DRAFTED BY Attorney Barry C. Lund MUDGE, PORTER, LUNDEEN b SEGUI , ���► -� S. /'7ea�, n - 2 10 2-00 Qome °: Hudsna, wiftronxin 540 public, Washington N�rlr Countym% Minn. (Signatures may be authenticated or acknowlydnrd V�.: AAAAwr...AdkAA.A , I. .,.n,....,... nr N 2 lt! o yo C:3 ui O1 / Z !MS � . SL . £0>:S M.1S.' Ol'IILi� C4 Fj CL 00 • �V c z LAI 0 0 °z 1.-0 cl " ZO O ZvIn [� o- w3�t A N J o K �. ift 2 ea CO q g Q Z Q 1 = -► . p So Lo p c� 2 a F - w O _- ►- Z I, LL m z eo. � y Xm a x 0 ]l -� -h Mz W{• 00 % W Z r i AS BUILT SANITARY SYSTEM REPORT OWNE _l n / A << A /h'i'm' Z E - TOWNSHIP SECTION f( T ;� N - f _ ADDRESS / `� �� `�' y ` ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM F 103 �s�1 3s s k �--- INDICATE NORTH ARRO 0. I.G BENCHMARK: Elevation and description , o o Ito Alternate benchmark zip .�`°��- - ��' /,'(��v SEPTIC TANR:Manufacturer: �W� ,. & K C� -Ca Liquid Cap. cR Rings used:--O cover elev: /01,O 'Final grade elev: f Tank inlet elev.: /OQ. 2 ' Tank outlet elev.: 9 9.5''y f Q Al ► No. of feet from nearest road:Front , Side Rear Ft. 3 ��� S / PUMP CHAMBER Manufacturer: .E7 r' © ( (f .Liquid Capacity: 10 Pump Model: Pump iphon Manufact.: lvilgh Pump Size f' Elevation of inlet: O Bottom of tank elevation �. Pump on elev.: r /Pump off elev.:.ZGallons /cycle Alarm: Man.: /,r E4 A�a " Sfwitch Type: Xr cu � - Location .c• i Distance from nearest prop. line: Front_, Side_,, Rear!!Ft. � 5/ Distance from: Well � � � Building 9 SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length Number of Lines: Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front Side , Rear Ft. No. feet from well: No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well building nearest road Alarm Manufacturer: INSPECTOR: DATE: PLUMBER ON JOB: LICENSE NUMBER: 6 /90:cj IQCATIRN: HAM n OjJD 10.29.17.156A SE SW, HWY. E sconsin e{Tartmento ustry, PRIVATE SEWAGE SYSTEM county: 'Labor and Hpman Relations Safety and Buildings Division INSPECTION REPORT ST., CR X (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 175641 Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: DONATH BERNICE R HAMMOND CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: /0j 1 p Itttcr- L L 018- 1020 -70 -000 TANK INFORMATION ELEVATION DATA A9200300 i TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r Benchmark lo& lo/,G(- /00• Dosing `13�Ef) — y% /61,'/� ins Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St /Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic 0 77 `� 5` / 3 � NA Dt Bottom Dosing 5 l / a NA Header / Man. c>?. T �/ S , G z Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number (� (' r t�ti ti` 1 GPM DH Lift Lrictiort System TDH /� Ft Fi Forcemain Length Dia.e Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 -11 DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type Of 1 / l S� ��� OR UNIT Mo el Number: System: QAi �5 N DISTRIBUTION SYSTEM Header / Manifold a` Distribution Pipe(s) 1 / x Hole Sze x Hole Spacing Vent To Air Int Dia. Length I— Dia. Spacing i ake Length 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 Q�Yes ❑ No EfYes ❑ No ,COMMENTS (Include code discrepancies, persons present, etc.) '7 3 -y Plan revision required? ` ❑ Yes ❑ NQ �y Use other side for additional information. 7 �` SBD -6710 (R 05/91) Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: - 1� , e_ , < m y s v f' V l c i� r REP,T131' HAMMOND ST. CROIX COUNTY ZONING PAGE 1 09 08:19 REQUESTS FOR INSPECTION WORK SHEETS FOR: 8/24/92 AREA: MJ Activity: A9200300 8/24/92 Type: MOUND Status: PENDING Constr: Address: HAMMOND 10.29.17.156A,SE,SW, HWY. E Parcel: 018 - 1020 -70 -000 Occ: Use: Description: 175641 Applicant: DONATH, BERNICE R Phone: Owner: DONATH, BERNICE R Phone: Contractor: NECHVILLE, HENRY Phone: 749 -3322 -------------------------------------------------------------------------------- Inspection Request Information..... Requestor: NECHVILLE, HENRY Phone: Req Time: 11:08 Comments: Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION -------------------------------------------------------------------------------- Inspection History..... Item: 00012 FINAL INSPECTION a -- SANITARY PERMIT APPLICATION g&HR' In accord with ILHR 83.05, Wis. Adm. Code COUN STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ f 5 �P CA 8% X 11 inches in size. Check if revision to pre ious application - See reverse side for instructions for comp leting this p g S STATE PLAN I.D. NUM ER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PRO RTY OWNER / PROPERTY LOCATION EF At i C �o/V c� P /i F_ Y, S 4L) %, S T , N, R E (or PROPERTY OWNER'S AILING ADDRESS LOT # BLOCK # /88 w E F.1 01 cka4, CITY TATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER s'yo Al II. TYPE OF BUILDING (Check one �/ ) ❑ state Owned CITY NEAREST ROAD ILLAGE : El Public L 1 or 2 Fam. Dwelling -# of bedrooms PAR EL X NUMBS () �7�- III. BUILDING USE: (if building type is public, check all that apply) #0�o ~ d ZT' , s r 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 11 ❑ Restaurant/Bar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Office /Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check onl ne 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 Pressu ed 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. /inch) , ELEVATION SC) 3 90 1 A / .d Feet 00 Feet VII TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name C oncrete Con- Steel glass App Ta r Tanks st A Septic Tank or Holding Tank 00 Lift Pump Tank/Siphon Chamber '7S0 C.1J C"�.Sf l Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's t Name (Print): Plumber's Signature: (No Stamps) M /MPRSW No.: Business Phone Number: C u .� �$ S 7 —332 lumbers AAdress (Street, City, State, Zip e). 7 R w v PZ ,q IX. COUNTY /DEPARTMENT USE ONLY Disapproved I Sanitary Permit Fee (includes Groundwater PiRe 15sueo gent Sign re Stamps) Approved Surcharge Fee) _ ❑ Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS t 1. A sanitary;permit is valid for two (2) years. 2. You# sanitaYy may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3 ; All revisions to this permit must be approved by the permit issuing authority. 4 "CFiaAbes 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 main The septic tank(s) must be pumped by'a licensed pumper whenever necessary, usually.every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608- 266 -3815. To be complete and accurate this sanitary permit appligation 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. It. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in #1 -7. VII. Tank information. Fill in the capacity of every new and /or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County /Department Use Only. X. County /Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect - groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD -6398 (8.11/88) f r �c o b a �' a �A C . Ili -%0 11 ` 1 2 d of O C C .» 1 m O � O O °. 1 o. a O `. � ro t °wa LA N G1 O r- 4, b N 4A m ° a CA v' • N N - O V N O 3 3 tvt N ... cl A g tit Io , A N O m CL ,n 4b y O VS co kA vi 10 w I 2t, c ° �� e ✓' N tb N >. d v o z ��C -0 d Q o a a os� G y `. to r p o g �N IImo�. Q d 7 A Q jj !,,^� W -p 1 r a M 3 I M Do 144 N a no y to ro \ 1 ,� �.c kA as i In LA I tA h cl to Zia r. G IM O I , A ^ � a t V � (, f� 0 ° m r 1 \ ro W CL =N 2 , a .« Oo Y o A o f* a (, W - �. a (� o 0 1 M 3 rn3 �o � t q q k d A _ z � A, N A v c 1 IC. A °' °o O '� 3 I 3 i C. CL PIP rx� Y W N w ton !4 0 z 3 at a L N 0 . . o 0 kA °s 0 1 A O r N %.A 0 ►, -�, b jt C m N V d {A 4 1 LA 1 ID+ �c Q ` C � Y: log co O fD -+ -- m a lb y o m d w w CL 2 A z " A o , SA a ^ Y �" �. :3 d g C - 0 1A r► N O 1 x a f� o 0 w _ J I V 10 n s N 0 HOMESiTE SEPTIC PLUMBING CO. 605 O'NEIL RD., HUDSON, WIS. 54016 — ROBERT ULBRIGHT c s r W -7yeZ N{S. M? "TER PLUMBi:R LIC. NO. 3307 M.P.R.S. HtNI l. 1" ( :Fq& DESIGNER LIC. NO. 00663 i a wci� �WS� v c* , er Rif 19 r.) iS T0 off' p lz AJ vr A 3 r:6 � It UgTI` = / U 2. 2 � o = Ex�srw6- q,P•r�F F /EI/.FT /o•v s' roP of sr-yrpiE 1 sysrt-H co t'dL, 010 54,0714 74AIe i 5 . 95.30 i 8 -. �Y -& s g\ t 13 1� } S j zp, .11 p ' 1 � _ Q zs' 95.35 9G.zs j (l � r a I..L.H.1? 83.08(2) ----- .--- - - - -.. PROJECT INDEX SHEET Owner: T` F'Ni c€ o cif /�. %/5 — - 7 96 — 2 3 o Address �g /i =c�, y .. }/` -ter zrc�r� �/s . 5'4161f1 Site Location: /0 s 4--) Se c . /D , T ? , v , , / 7 /-'J' eV U OF ST c�Po�X Cdvv�y . Project Description: 6- C.Ou - 7i �. icy- 'Gr ✓.r � 7iC.. � ffsr �� . sow /s i Page l . PLOT PLAT! V I LWS s Page 2. MOUND CROSS SECTION & SYSTEM PLAN VIEWS Page 3. PIPE LATER LAYOUT Page 4. DOSING CHAMBER CROSS SECTION s o Page 5. PUMP PERFROMANCE SPECS 2 . jL 6QI PLUMBER: RECEIVE //Z e JUN .l G M92 OFF' i c 1PC ... . / s--- T 2 ... G � G PL-o =PL-AO HOMESITE SEPTIC PLUMBING CO. 65 O'NEIL RD., HUDSON, WIS. 54016 ROEERT ULBRIGHT C © NIS. M `'7 PLUMBER LIC. NO. 3307 M.P.R.S. DESIGNER LIC. NO. 0M 3 ' '� N �o o, o i D IUD sys7 A- 4.1 I'dt, y" sv 9 ' O � -ttr? S'3 03 C�-� � Y� C .r PV a.� I Dili 25 NL 4,0 75 0 6-" �� w. � r i r� t r' r 1 f r 7 1) uGTRY, LA I' , k "N;D tIU rA1J R ELATIONS a 95' SEE COkRESP IN DENCE t , j 0 �`111 h / 3 l ti y 9s. as Zy" ! Prior To Ploi -Ang Installer will carefully shift or orient mound position ( toe line and area under bed aggregare) so ground elevations across slope are as uniform as possible. Suggested elevations (staked on i cif-0 T.Ti rt, 1.a11- T3,4 ,rte �� Page .— Of . Straw, Marsh Hay, Or Synthetic Covering Distributiod Pipe Medium Sand H Topsoil -1I -- 3 b _ - y',e Slope . Bed Of Z 2 %2 Force Main ' Plowed £�99ESTE1� �1 ovtip '1�N. fo,P.' -� l.c� 2r 9G • 0 Aggregate Y 7D�" G�:vE' FyEV.iTiD.v D z.0 Ft. 1S; 3© Ft. Cross Section Of A Mound System Using A Bed For The Absorption Area `1 Ft. G 40 Ft. A Ft. H A5 Ft. Signed: g 76 Ft. � License Number: K Ft. I � - Date: L Ft. /aa 3 y% j / Ft. Position I IV Ft. of Force Main W Ft. Observation Pipe, I --------------- ' I - -------------- --- ------ ---- --- --- - -- C - - j w LB Distribution Of %-- 2 2 2 Pipe. Aggregate % Observation Pipe manent Markers r- �UG EM 4 f Plan View Of Mound T g�, fdr ption Area Page 3 Of 3 r U/ Pnrforofed Pipe Detoll rA 7 F, V11 v.Aj � VI) U47 ' 19A-) Lil Vitw End Cop � //� PVC Pipe I oar Q s� Holes Located on Bottom, Are Equally Spaced ¢ d TO r It 5 PA lti C Munilul] Pip. Dlslriouliori Hole Should Be Ntkl To End Mq�iulD %' Dislribulion Pipu Layout P 7y Ft. R 3, o F Y „ X Inches y 14100 Inches Signed: Hole Diameter �y Inch Lateral z Inches) License Number: _ Manifold 2 - Inches Date: Force Main °' -2 ' Inches # of'' holes /pipe /G Invert Elevation of Laterals S Ft. u 7'/0,0 .01 n �,E't t k;) Tt J. 4' 'j 4 f l 72 J Q Q ,tit wv • ;' lJ ��. f ' P 7 /� / 13 UT /(,,) 1) /V( .P(C i`? K sN A PLiMP CHAMBER CROS5 SECTION AMD SPECIFICATIOUS �� � f of mac; VEMT CAP 4 "C.I. VENT PIPE I WCATHEK PROOF APPROVED LOCKING JUMCTIOU BOX MANHOLE COVER > 25' FROM DOOR, 12 "MIIJ. WUIDOW OR FRESH I AIR INTAKE ppgr ��^T /ON GRADE COWDU►T L -- INLET PROVIDE I - -- AIRTIGHT SEAL I I �y 10 ` APPROVED JOIAIT A 1 05 1 96 K I I I ( APPitOVI D JOINTS w/C.I. PIPE I �A �n� I III W /C.l. PIPE LXTENDING S' 0� I I ALARM EXTEAIDIIJG 3' our0 SOLID soli, e ��,75 I II , ONTO SOLID SOIL � I 1 _T ow I E.l E _ FT. PUMP OFF r D j, 4 '! AN k 1 I BLOCK . l iO,J C V� �" -RISER EXIT PERMITTED OWLS IF TAWk MANUFACTURER HAS SUCH APPRO''VAL SEPTIC E SPCC.IFICATIDKJS DOSE E f G'pv��G ea- t TANKS MAWUFACTURER: EJUMBER OF DOSES: - PEK bAH TA WK SIZE: 7S� GALLOQS DOSE VOLUME IrO Glv� r7� Grs INCLUDING BACKFL.OW: / GALLONS ALARM MANUFACTURER. /3 MODEL HUMBER: �' �"' V CAPACITIES: A= � CD INCHES OKI � GALLONS SWITCH TYPE: "'t'"CORy Floyt 7 $ = pp INCHES 0 `�� GALLONS PUMP MANUFACTURER: p a l C= 0.3 IIJCH£S O j63 GALLO MODEL NUMBER: / � -FORH r-y # / / D= 12,. INCHES O� y a GALLONS SWITCH TYPE: 1> SSya,46e M£OCVRy F/ NOTE: PUMP AMD ALARM ARE Td d E MIMIMUM DISCHARGE RATE J /0 GPM np INSTALLED ON SEPARAll: CIKCUITS VERTICAL DIFFEREMCE BETWEEM PUMP OFF AND DISTRIBUTION PIPE.. d � FEET ���iWS� .� +'MINIMUM NETWORK SUPPLY PRESSURE . . , . , .. . , . . 2 . 5 FEET EACtA_ �;� o� tP1vL - O FEET OF FORCE MAIN X '�' 6 F oo FLF RICTION FACTOR.. Z'` FEET �Ur l 9 TOTAL Dy10AMIC HEAD = 1 3-Y FEET ��� 10TERNAL DIME:IJSIONS OF TAUK: LEA1G ;WIDTH - ;LIQUID DEFtH 9 1 N I.- J HEADI 2 � ^APA 3 2 %Alf^ ITY 32 110 r 105 CURV 195 ! 28 90 28 85 EFFLUENT 24 80 MODEL and Q 75 MODEL-189 I ' DEWATERING = 22 70 165 n 2 20 65- Q Z 18 60 55 _ ` Q 18 ODEL 163 MODEL F- 14 45 188 12 40. 35 4 10 MODEL „ 30 MODEL 137,139 ; . 185 r SEWAGE and 6 25 D WATERING 6 MODEL t{ 15 .MODEL 161 4 7, A t 2 MODEL , C ti 5 53, 55, iu 57.59 0 GALLONS 10 20 30 40 50 60 70 80 80 100 110 LITERS 0 80 160 240 320 400 75 FLOW PER MINUTE 70 85 I6 60- � — MODEL Q 285 W 1 55 V 50 a 14 MODEL 284 - p 12 40 Q 35 MODEL G 10 283 MOpEI —� - - -- 30 MODEL - - - - `, l 8 20 282 - - ` 15 I j MODEL - _ _ oE«E� 267,268 - I 0 3280 Oki M/llem Lane GALLONS 10 20 30 40 50 60 70 80 1 90 100 110 120 130 140 151 160 170 180 180 P.O. Box 16347 ` Louisville, Kentucky 40216' 4 LITERS 0 80 160 240 320 400 480 560 640 720 (502) 778-2731 j FLOW PER MINUTE r 1 r ` 97 Cast Iron 8 V eddi CAPACITY ' \ MEAD UNITS /MIN • Automatic or Non - Automatic. F..1 Meters Gal. Ltrs. 5 1.52 57 216 + 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 I -------------------- ------------- - - - - -- - -- -- - - - -C, - - -- -- -- - - -- --( �qa V Owner of property Location of property 1/9 5W0 1/9, Section , T - R A W Township 1 Mailing address 7T 8 2 A A Address of site 1 ' l 14 (uJ Subdivision name Iq Lot number 0 3o PAt ay 0 Previous owner of property ty Total size of parcel Date parcel was created . 1? 7 T Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes N0 A Volume " and Page Number � & as re with the Register of Deeds. -------------------- - - - - -- - - - - -- - - - -- ------------------------ - - - - -- - - - - -- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warrant ded in the Office of y •eco the County Register of Deeds as Document No. ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has bee ul r rded in the Office of the County Register of Deeds, as Document No. ). 'x 3s�, n D SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Office of Division Codes and Application 201 East Washington Avenue P.O. Box 7969 s Madison, Wisconsin 53707 BOB ULBRICHT Owner: BERNICE DONATH 655 O'NEIL RD 1848 HWY E HUDSON WI 54016 HAMMOND WI 54014 RE: Plan Neer: S92-01681 Date Approved: June 12, 1992 Gallons Per Day: 450 Date Received: June 12, 1992 Project Name: DONATH, BERNICE - RESIDENCE Location: SE,SW,10,29,17W Town of HAMMOND 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,,wnship or county shall be obtained prior to construction. The licensed plumber 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 F 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 B2 for general plumbing or in Chapters 50 -64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT MOUND Inquiries concerning this approval may be made by calling (608) 266 -3937. SBD 64291R.0"11 i SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations BOB ULBRICHT t o Page 2 Si erely, JAMES QUINLAN Section of Private Sewage Division of Safety and Buildings PPP012 /0009n/ 5 cc: BERNICE DONATH i Private Sewage Consultant _County _UW -SSWMP Plumbing Consultant Owner Plumber ^ Environmental Health i SBD 6423 iR. 01/011 STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER /BUYER -en. do D crr `'h�"0 ROUTE /BOX NUMBER 1 A i `G G� C FIRE NO. CITY /STATE 0.vy�.m -� toti , ZIP y _ PROPERTY LOCATION: 5 1/4 C 1/4, Section l� , T2_E_N, R 17 W, Town of 14 , St. Croix County, Subdivision Lot No. Al #9, 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 MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation p rior to Jul 1 1978. St. p y , 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 lumber or a licensed pumper verifying that the on-site P P P Y 9 1 () to 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 County Zoning Office within 30 days of the three year expiration date. X SIGNED D DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386 -4680 Sign, Date, and Return to above address ST. CROIX COUNTY WISCONSIN a A ZONING OFFICE ST. CROIX COUNTY COURTHOUSE ' r 911 FOURTH STREET • HUDSON, WI 54016 (715) 386 -4680 June 4, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite investigation of the Bernice Donath property, located in the SE 1/4 of the SW 1/4 of Sec. 11, T29N -R17W, Town of Hammond, St. Croix County has been conducted. This onsite revealed suitable soils at a depth of 12" below which seasonally saturated soil conditions were observed. This site does meet the requirements of the A +4 rule and is therefore suitable fore a replacement mound requiring 24" of sand fill. Should you have any questions, please feel free to contact this office. in erely, ames K. Thompson Assistant Zoning Administrator cj L e COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 �4,j 715- 962 -3121 800 - 962 - 5227 ST. CROIX ZONINo REPORT NO.: 23934/01 PAGE ST. CROIX C"TY REPORT DATE. 6/10/92 COURTHOUSE DATE RECEIVED: 6/09/92 HUDSON, WI 54016 ATTNt THOMAS C. NELSON OWNER: Bernice Dona +h LOCATION: 1848 Cty Rd. E, Hammond COLLECTOR: M# Jenkins DATE COLLECTED: 6 -08 -92 TIME COLLECTED: 11100am SOURCE OF SAMPLE: Kitchen faucet :DATE ANALYZED :6 -09 -92 TIME ANALYZEDt2t00pm COLIFORM: 0 /100 mt INTERPRETATION: BacteriologicaLLy SAFE NITRATE -Nt 3 ppm Above 10 ppm exceeds the recommended Public Drinking Water Standard. Corrected Report 6 -26 -92 Jn 8 91 i T N "MMICIAM Pam Gane �' N s i Lab No. 19 "F Z APProved by: THAN" Detectable Le-' 410ES SINCE 1952 TO � CQ ERCIAL TESTING LABORATORY, INC. r , "5.14 Main Street, P.O. Box 526` Colfax,-Wisconsin 54730 k4j 715 - 962 -3121 -leis& 800 - 962 - 5227 F ST. CROIX ZONING REPORT NO.'. 23934/01 PAGE i ST. CROIX COUNTY REPORT DATE: 6/10/92 E COURTHOUSE DATE RELEIVED: 6/09/9 2 HUDSON, WI 44016 ATTN2 THOMAS C, NELSON f OWNE�R2 Bernice Donath LOCATION. 1848Cty Rd. E, Hammond COLLECTOR. M. Jenkins DATE COLLECTEM 6 -08 -92 € TIME COLLECTED*# 11:00am F SLLItCE OF SAMPLU Kitchen faucet DATE ANALYZED26 -09 -92 TIME ANALfYZED:2S00pm COLIFORM2 0 /100 Jni INTERPRETATION: Bacteriologically SAFE NITRATE -N: ppm Abo" 10 pPm exceeds the recommended Pubtic Drinking Water Standard, At , N c zo m ?, 4 r ; c LAB TECHNICIAN' Pam Gane <, °' In O .NOBVEpO fry A i WI Approved Lab No. 19 l Means ''LESS THAN" De#ec #able level Approved byt �'� ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 �n. l i f �,�- ST. CROIX COUNTY ZONING OFFICE g St. Croix County Courthouse G, 911 4th Street Hudson, WI 54016 Telephone - (715)386 -4680 The St. Croix County Zoning Of f ice of f ers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion 2L this form is essential H,Q that #Jg ,rooerty can hi located Please provide the following nformation, enclose appropriate g fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be dome as soon as possible after fee and form are received. WATER TESTING--------------------- - - - - -- -FEE: $ 35.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $185.00 (For VOC'S) SEPTIC SYSTEM INSPECTION ----------------- FEE:. $25.00 (Determines if system is properly functioning at. of inspection) ,'� PROPERTY OWNER'S NAME : 1 J 2r" h i C e 60 h e t PROP . ADDRESS: S Pi C CITY 1 " ryL 0 n Legal Description /4 of the 1/4 of Section T 2 N - R_)j Town of Lot Number Subdivis • FIRE NUMBER S�'t -� g LOCK DQK NUMBER Color of house Realty sign by house? If so, list firm: PLEASE INCLUDE, IF AT ALL POSSIBLE, A KAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case', please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: Telephone Number REPORT TO 'BE SEN TO: f O . t S QtX4 CLOSING DATE: - Z Signature