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018-2001-09-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safiety and Building Div,sion INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Thielen, Barr Hammond Townshi CST BM Elev: 00~~ Insp. BM Elev: ~p~~o BM Descript' ~" ~(~ ~jrV1,~'I TANK INFORMATION " ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing 1 }~ d Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL ~~ BLDG. Vent to Air Intake ROAD Septic ~ j / v~ ~ j r s Dosing 2 ~ / r~ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer n s,~l 3d -~ TDH Li ~ / Fnctio Lo~, r, System Head TD~ I , ~ (Ft r '~It" r Forcemain Len th ~ Dia. 2N ist. to W@I~ ~ _ 1 1~ SOIL ABSORPT ON SYSTEM ~ /~ G' county: St. Croix Sanitary Permit No: 429981 0 State Plan ID ~~ Parcel Tax No: /~~\ 11 Secti n/Town/Range ap No: 14.29.17. i j7n ~ ~G STATION HI FS ELEV. Benchmark _,,.,y~ ` AItAIt. BM • ~ t~U Bldg. Sewer 63 ~rY b - , S t Inlet ~~ / S,`n %% SUHt Outlet ~- ~~- Dt Inlet ~ f i ` Dt Bottom 1, f~9U• r ,/ P~ ' 2 (U J Header/Man. -~. /a6~. Dist. Pipt o ~ ~ 2 ~3•Z /a?t~o,3 Bot. System 3.9 3-~ r Final Grade S~ ii9~ g-~ ~~~9.~ -to / - ~ ~,c~ r v BEDn'RENCH DIMENSIONS W idth r Length r / No. Qf rench ~s 1 PIT DIMENSI(~A}S No. Of Pits Inside Dia. Liquid Depth ~ ~ ~ ( jI_ 1 a- SETBACK SYSTEM TO P/L BLDG WE L LAKE/STREAM L CHING Manufacturer: INFORMATION ~ A ER OR Type ~[ $ry I ste ~ ny / ~ / D Model Number; J ]r/ ~ h ~ ( DISTRIBUTION SYSTEM ro~ ~.0`t.(J HeaderlManifold j ~ !jd ~ Distribution Pipe s) ~~ ~ Z ~ ~ .~~ x Hole S1ize Hol~e}Spacing ~ ~ 7 Ve/nt~,to Air Intake ~ Len th Dia 9 - 9 P q Len th Dia S acin LF~ ((J 7 qZ SOIL COVER r x Pressure Systems Only xx Mound Or At-Grade Systems Only 6~~11~ ~ ~ Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ ~~ ~ ~ Bed/Trench Edges Topsoil - [] Yes [ ~ No [=J~ Yes~~ No Y COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /~ Location: 634 193rd St Hammond, WI 54015 (NE 1/4 SW 1/4 14 T29N R17W) NA Lot 9 ~ Parcel N` o: 1_~T~ 1.) Alt BM Description = 5T'~Y C~1v j~/J~~ C~,~~~ ~~,~~'~- ! Q~ ~ ,~~!^1~ / ~ ~ _ J G~ 2.) Bldg sewer length =~~ 7 ~- ~, n ~~ ^,~"'~/,n, z / `f _,,/ -amount of cover =. ~ j l ~`~ l~ ~K!(G~~ ~'~/~~'~'LdL~~-' G~ ~ 7 0/ Ir ~- ~5~~ Plan revision Required? ; ; Yes ~ o ~ 6 i Use other side for additional information. ___ 3_ ~ _~~?'t!+'~-~J L~ S - _ _ J SBD-6710 (R.3/97) Date Insepctor's Sign ture Cert. No. ~~ ~~5 Safety and Buildings Division County ` ~ i 201 W. Washington Ave.. P.O. Box 7082 5 I C a-O I x ~scons~n Madison, WI 53707 - 7082 Saottary a m (to be filled is by Co.) De artment of Commerce (608) 261.6546 l a ~ ~' oG Sanitary Permit Applies ~ State Plan LD. Number In accord with Comm 83.21, Wis. Adm. Code, personal inf ion y~i[ ~ I V E D ~(o`C~D ~ _" Trgtts ac~ie+~ / ~. # may be used for secondary purposes Privacy Law, s I .04(1 xm) ject dress (if different thm mailing address) I. Application lnformauoa-PleasePrtntAllIoformatioa MAY 1 4 2003 ~. '~ + ~ 63 ~ 93 S . Owner's Name C~ ~~ e ] ST. CROIX COUNTY I # Lot # Block # ~~ ~~ ~f l ZONING OFFICE Property Owner's fling Addrrras pe rty Loc a ti P ro on ~~ ~ + / , , ~ ~ ~ J~tJ Ci State ty Zi C d ~y e Y., %., Scetion . p o e Phone Number ~ ~ ~ ~J ~'`~ I~E~ trck one) R// E T~N W II. Type of Bttil erg (check all that apply) ~ ~,,,~,„~ ; or i or 2 Family Dwelling -Number of B .r Subdivisia~ilNa~me, CSM Number d ° ~~~ ^ Pttblit/Comatacial-Describe Use ~- g. O ~ L~S 1r L° $ 6 /~1 ^ State Owned -Describe Use C I 0 ~ X ~ o r fhou~~ c.QQ,Q ~ ~.D ~ = 12~ t ~. D ^City ^Village ownsbip of~M D~ III. T ype of Permit: (Check only one box oa line A. Complete line B ii applicable) ~ ~~~ i /~ , A' ~ New S ystem ^ Replacement System ^ Treatmeat/Flolding Tank Replacement Only ^ er odificaaon to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner N. of POW'I'S S em: Check all that a dE. ^ Nat -Pressurized In-Ground )~ Mamd > 24 in. of suitable soil Mound < 24 in, of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized la-Ground ^ Holding Tank ^ Peat Filta~ ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recireulatin Synthetic Media Filter ^ I.eachirtg Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (ex lain) V. Dis reatment Area Information: Design Flow (gpd) lktign Soil Appliation Ratc(gpds~ Dbperasl Area Required (sf) Dispersal Area Proposed (sf) System Elevation Gov 6 vv 6av >~ ~?. 9 VI. Tank Info Capacity is Totbl Number Manufacturer Prefab Site Stool Fiber Plastic Gallats Gallons of Units Coacrcte Constructed Glass New Fxistittg Taala Ta^ks Septic or Hoid'wg Ta^k rn~ tYd~ l ~ s Aerobic Trewawl Uait lbsi^g Clutaber VII. Responsibility Statement- I, the undersigned, assntne respoasibiUty for fns WTS shows oa the attached picas. Plum 's Name (Print) ~ Plum 's grtature f ' /MFRS ~ ~yd Business Phone Number yak-~~'d' s y i Plumber's Address (Sheet, City, State, Zip ) aa~ e ~ 6 ~~ 7 ' ~ ~ ~1 Y v~r 0 , S l VIR. Coun /D artment Use Oat Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date issued Issuing Agent Signature o Stamps) ^ Owner Given Reason for Denial SnrchazgeFee) ~ 32S/~ jS2QD _ IX. Conditions otApproval/Reasoaa for Disapproval ~. v~ t.~Jt:~Sf" v~. Sys w.ud~ ~ thQaO .~-~•.. o.~t~ S . S•~~ -- .~v~~.a~.~ a-° ,~C E ,t..a..~~` -r-7 ~ ~i ~ ' .- ' f c.. r9~ -net9.w ~,.st~: ~ ~ ~ 'M~ .~ P~;~.t-~-~. iJ w ^ eomprea pw^s lto tre cw^ty •^ry) tar roe systew •^ paper rat less taa^ arrj i 1 r r^caes t^ stse SBD-6398 (R. U8/U2) ,~w.aQ 1 1 PLOT PLAN Scale 1"= yo' Page 3of 7 r•' ~{ LOr l_lrJ~ ~Tt ll~~i'`.~ ~ ~ ~ ~z U ~ ~ 2.1 \~ ~ i ~~°` <~~ ~~~ % ~ ~\S~` , ~ -cam ~ \ ~a.RA ~ I .~ 4~Z~- C ~g'j'(Zv~~ ~ NoT cur-t ~ ~-e. T` ~ \ ~ ~ ~ ~.`x~° T'~g ~1~ ~ ~ ~ 1~ ' ~ \~ 6 ~\~ ~ ~ 7 ~ , ~; ~~ "\ j ~" - yea- ~ ~ p. ~„ ~~ \ \ S, , Q __- ~ - V 6 - ~lq~O ,.~r - `'. -.~ f ~~ ~) BD2-~ ~ lZ i ~ ~~ - - ~ 1'1vMC , a~ !~-`~ - ~p JC S-f 7;~ ~ 1 S Or ~~~ PVC ~\ ~ . O O L,oT t..11^~~' t .. -~~-it=-1 =_EZ: ,-i l_q 8 : S_g'::pN o ~ ~?~i=c• PVC"1?~p~' wYF~~~~S T, d ---- _ - NOTES: _ 1. Elevations shown are existing ground elevations unless otherw' 2. Install 4" observation pipes with approved ca s.. 2 ise noted. 3. Septic tank to.. be ~~-00 !So p ~ required) . .• o gallon ca ac:ity manufactured by 4. $ench marks = S ''v1 w H-.lf~o~ ~13NZ 1=i~.~Z , vU~ 5. Divert surface water around system to prevent pondin at g the uphill side. ' , Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT rn accoraance wan c,omm n~, vvis. r+am. ~.uae t 1 t P - County cJT lan mus Inches In size. Attach complete site plan on paper not lass than 8 112 x include, but not 14mlted to: vertical and horizontal reference point (BM), direction and paw( I,p, percent slope, scale or tlimenslons, north arrow, and location and distance to nearest road. Q 1 ~ ~ ! 0 Please print all Information. R awed by Pe~nonul Intom;aoon yov provioe may be used for secondary purpwos (Privacy L.~w, a. 15.0 { r) (m)). Property0wnor Property Location V t Pk IZ AND N TH iEl_~N 114 S W V4 S~ 4 T ~' N R 1'7 Ej(r W AI E. Property Owner's Maiiing Address Lot # Block # 5utx1. Name or CSM# ZCI ~" L~~E N~ ~ FOJ2~ST `RI D~~ EST'!}T~ City Slate Zip Code phone Number [] City ^ Vllage Town Nearest Road ~i ~~ N-13 ~ Ss4~-l I c 763)7$l~-~y8 D c r. ~. ~ New Construction Use: I~Residential / Number of bedrooms ~~ ^ Replacement ^ pubNc or commerdal - Desaibe:._ Parent material ___~~_ General comments and recommerdatlons: MO V-JJD S~ST'EM /•~ r ~.A O.y [.DA~t~JG T2JtT~. D t~ ^,~ EvJ F•kb L{~r IA MOV ~ yam Code derived design How rate _____ ~Q~. ___ -- - • Flood Flain elevation ii applicable ~-,_..~fl:~__ F-'/l.1- .; ~~1f~ }~.E 1~ ~ _. __ ~_----__- GPD ------- .-.- H• Q g Boring # ~ Boring p;t Ground surface elev.119Y_ zo ft. Deplh to limitlng factor ~n. SOU licalion Rata Horizon Depth Dominant Cofor tion Redox Descri Texture Structure Consistence Boundary Rools GP D/f4 In. Munself p Qu. Sz. Cont. Color Gr. Sz. Sh, •Eff#1 ~Eff#2 i D- o ~z - sl t v~ . s o.:s ov 3~ az stl If -~sbK - _m O.z p.~ ~~------~ -- 1 - - I-`~ ^ E1or,ng ~ i Boring # t~l J pit t;rount: sunece elev. ___~,_ n. Ueptn to amtnng raaor __`_ ~n• SoU A {tcauon Rato Horizon Depth Dominant t;olor Radox Description Texture Structure Consistence Boundary Roots GPD/ff in. Mansell Qu. Sz. Cant. Color Gt. Sz. Sh. 'Eff#i 'Eft#2 1 i I 'Effluent #1 = BOD, > 30 < 220 mglL and TSS >30 < 150 mgrL ' Eftlvent #2 ~BOD~ < 30 mg/L and TSS < 30 mgn. CST Name (Please Prtni) gnatura CST Number h1A Y ~o Ha~.L~sTEr{ ^~ ZzyB~ Address Date valuation nducted Telephone Number Wgfl15 ~4tJ+hAVe,~~UE-~FAu-S}_WT" 5422 0~/-//-D3 L7+5~ ylb-1~7S ~ ,r E 1 ` ~ ~ ~ ~ ~~ __ _. .,,, , ~, ~ ~ ~ p.,87o .,,a. Q~4 V ~r ` 4 _ l ~ EL Itq$. ~~ _ ... O $ a B~ ~ 1' $ c p~PE I ~.. 1 ~ ! ..~ g~ ,;,,1; ~ :,,, ' ~ ~ 4 `R,borr~ ~, ,~ ., pVE ~~ pM5 E ~.- {1~n,57 ~ ~` '® 11G~ IN CoiGo wV ' E ` Z.. F'' REv~p ~, , `. . , oq-l~-oz j,. ~ .~; Q~ - . ; ~ - - \ 04-11-0 . .. ~ \ ~ ~Z- .-- ~~ F~ ~ - ~ ~, e ~ ~ ,~_ ~ ~ ~ . ~ ~~ ~~ ~ ~ 2 ..~ ~ -~'~ ' , , / J • ~~ ~1 C • ,, r .__ r \• `\A`-J1J\ r f ' 8 ~.9 ~ _ -~ \ - ~~ 1yf~ ~ ~ ~ 1 .. ~ \ .. ` ` ~/ \• '. ~ ~ ~' 8 _ ~` ~ . ~\ . 1 ~ \ J ~ ~~ ` /~ 1\ fZ'1~1~ R17u J ~ ~ /~~ ' 1 ~ , YVlsoonsln Oepartrnent orCommerce SOIL EVALUATION REPORT Paye _~_ of _. Divfslan of Sa(ety and 8uifdings In accordance with Comm 85, Vvlc. Adm. Code Coun ~,D^, V Anacl+ complete site plan on paper not less than 8 1/2 x 1 t Inchos h elze. Plan must ~ r~ ~^~.lL Include, bur not limited to: vertical end horizontal reference point (8M), direction end P~ t lJ percent stops, scale or 0lmans{ons, norlh avow, and location and dlslance to naarae't road. ~ PGNOINo Please print al! in/ormetlon. Reviewed by Date Panon~~ Inlorm~rbn you prOv10• May D~ vuQ rer gCOndsry pvrpof/f (Privacy lrrw, t. 1 SAS (11 tmll. ropvty Owner -_- _'._'_7 e_.,._.... ~ _--•'-- Ak u-A _ NE 1Id'S~ 1/4 Sly T ,zq N R ~? N Property Owner's Mallln(l Address ~ ~ • ! col M Block p Subd. Marne Or CSM/I l(l ~ W, o,~t t5t oN s->< , _ 9 -- or~~5r Rty~~ FSTRTE:.S j Clty State Zip Code Phone Numbar~ [] Ctty ^ ~/Illege ~J Town Nearest Road R~~E~2 FAt.,is wr Syo2 ('1s5 ~tzb-48o H~ ,~,~ ~ e.rlt E Mew Conshvctlon User Retadentlal / Number o(bedrooms __,_~ Code derived des n flow rate , +4 ~a0__~_._-__ ~~ Q Replacement ^ Publ~ or cArrvnetUel • Describe: i1 Parent material ` ~_ ~ Flood Plsln elevation it a NCablf ~}.•7 ~ !.~_°~_ (-, ~ - - Ganeral comments and recommendations: /V~p~p 5~j5T~M IAA 5l~ND F -LL. 1 O,y WlltafNfo RR~E ._ l~ ~ V v 1 n9 ~, /J~ R ~ Boti p ~ oOr1Rg Grnunrt enrt~~. via., t (Q4 q~ a ..__.~ ._ „_~.,_ _ . .__ •-s/_ __ .:.__ ~.~,..._..-,-..m, __._ ~--- il li t S i R Horizon Depth Dominant Color Redox Descrlptfon Toxiure Structure Consistence Boundary Roots o cel on a e GP in. Munsel 0u. Sz. Cont. Color Gr. Sz. Sh. 'Eftgt 'Etfit2 1 0-3 3/z -- ~- ds cb ~co o. 5 Z 3- 0 3 --- L d si-l .~. 0.5 p. ~ S 3~ 3 ~ 4 I s M d.s -- ,, ~~ goring x ^ Boring r.e Orrwnd suAwer. ainv u n__.._ ._ ~. ___~_ __r..... _.....,.,, .aw,,. --~_V.__ "•. ~ Sop carton Rate Norizon Depth Dominant Color Redox Descripllon 7exlure Structure Conslalence Boundary Roots GPDItP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EttNt 'Et'fM2 C~ PAGe z.. . ~~.--- . _. _ ..~a -- --- - - - --a -- - -- ••'v• a,•• . ••.., -s+ = .au mgrs - emuent rrz ^ aoo < 30 rrogll and TSS < 30 mgrt C5T' Name (Please Print] SlQnature CST Number ~ aH~t_s~ n ~ Address ~ Date Evaiuarion Conducted Takptwne Number W9a?5 69~~"~AVe,, RtUER,~^US WI 5`fo22 1 Oq- -0 ~i5 ~-lzb-17..5 R~~~SED; O~i-1~'-OZ,, Property tJwner J ~ w~ ~,~~ Parod Ip q _ ~ ~.~~~.N.~._.._...._., p°go'~~.~ of _~'ES-2 ff ~--~ ~~ ~'-~4 ~ S~ ~ Plt round surfsrA elev. ~__ _`. h. Depth to ilmltk-g factor _ ~ ~r !n ~t lutlon Rete Horizon Oepth Dominant Cdtx edox DesVlpllan Texhue Structure Gonatate ndary Roots GPO/ff In. Munaed t. Color Gr. Sz. Stt. 'Eftat 'EMr2 S 0-In o i/z ~-- -m v{tr -ta a5 0,8 2-• 10-5 Y y ~- ~ 1 5 . Z A 3 3 ~y~ ,~ ~ 0. Z 0.3 y 3 ~. v 3! 1 GS I r -w, 0, 2 5' vt4~ n~2p Sbit -' O.Z 0. - S t_ I lw ,~f r 70 LJ BoAng C~p'1' 4~ ~ Pit Ground suAacw elev. ~,~i1Z0 h. Oepth Io limiting lector 5~ In. Shc katlOn Rate l Redox Deatrlptltxt Texture Structure Conslalence Boundary Roots GPO/fl' Horizon Depth In. or Dominant Co Munsey Qu. Sz. Cant. Color Gr. Sz. Sh. 'Etfp1 'Efrg2 1 ~In. ,~~•/~ --- L 0.S -co S 0, L 12-t$ v ~ '" SI 2~ ~5 0~~1 3 Sq-ZS SO `S y Ong p U Borirg Grow urfaa elev. ~~ „, Depth to limiting la ~- I^• goy Ifcefton Rate 't' Y~ ~ wt ~ {w r.ty{~n pepth pominantCobr Aeeaiptbn Texture 5t Conatslenoe Boundary Roota -Eftat Pa~EfMf2 In. Mtunsey Cau. SL .Color . Sh. 1 a-S to rt~z -" L -{-m ~ fr ,5 Y 5~,~ ,~~ ~ St _ _m ,t or3 2{,. '.~ y y~ ~ ~ I b i O,t 0, 3 • Efiusnt pt • 1300r > 30 ~ 220 rnpll. and TSS a30 = ti50 rngfl ' EfiueM x2 ^ BODr: 3t) mglL end TSS , 30 myl The Uaparimenl of Commerce is an equal opportunity service provider end employer. If you need aasiatance to access servieea or need material in rn rlternate format, please contact the department at 608.2t~h-3151 or'i'TY tSpR-2W•8777. ssarrso ta,vool ~~ ~~ ~~~c~t nl f'.-1 ~sT ~ ~ o~y 9 c.,•.y.a. 1 T l~l ~d'• ~LO't . , -- ,----- _ ~ I ~ ~~,yo ., ~ x ~ , _ ~ ~ P-8 . ~ ~ ~a ~ ~~ ~ G1 ~~ ~ ~o o~ Svc. ~ ~~ . ~ g~ . ~~ 8 ~, sic. ~4 ~ ~ g~ ~Q'ArSoJE '. ` 1 C1~! - c.~ouN~ kr c~ ~ ~ i • ~ • ~ , Lt/1.10, , rc, l 19Sd ~ ~ ~ ~ Fj/1'~!E - SPA KE ~~ ` y .-.~- Z GONTOI~.tZ .~ -~ - ` ~ ` - - E~--llq~.57 --~ ~ 11CL' t of 640 ~l.,grt0 Lrr ~9K r . 1 ` ~ ~ REv~p • . _ . Aq_14-OZ~ ~k °~ ~ , , ~ ~ ~, ~ --- ... ` \ .: , ~. -_2 ~~ ..~ ~`, _ . ., ~ o \ V c ` ~/X~ ) O ` . ,\ ~y ` ` ~ J \ . ~ \ I ~~`~ ~~ ~ / ,,~ S. F. ~ J ~ ~a ~ , • _.. _ ~ ~ __ ___ ___ _ .-_ o- ~. ,: _._- -~'" J ~ ~/ _ ` ~ - 1 _ J," ! J - \ .~ ~C~ ~~ . ~ ~ ~ \ \ , ~~ s_...#., , YVisoonsin Department of Cammeroe 50i~ EVALUATION R foORY ~ag®_~_.- °f 2= Division of Safety and Bulldlrgs ! In accordance with Comm 85, Wis. Adm. ode ~ ~,- ~ °~~'~- _ Attach complete site plan on paper not less than 8 1!2 x 11 Inches in slzo. Plan mint include, but not limited to: vertical end horizontal reference point (BM), dlredlon and Parcel LD. percent slopo, scale or dimensions. north arrow, and tocaUon and distance to neare~t road. Q I g ~ ~ 0 ~ ~~~ Oa Reviewed by Date Please print aft information. Personal ~nfortnxiion you provitle may bowed for fetondary purposos (nrlvrcy Uw, ~. 15At (~1) (ml). Property Owner Prop Location N~ t!4 SNJ tl4 S l4 T 29 N R 1' % r W ~ ~1~p ~ ~ ~ tI~L~ Lot p Block # 5ubd Name or CSMti Property Owner's Mailing Address ~~~~.5 .Zpl qp-w~ L'~i~ n1>~ " q Foi~sT "RI ~;ty State Zip Code phone Number ^ Ci (] Village Town Nearest Road ~3LA~r~~, (M-S )ss434 i ('7~3 )'7q~-9~tgio Q C.r fF. ~ (~ D~ GPD New Construdlon Use: l~Residential t Number of bedrooms _~ ,-,r Co a derived design flow rate _r . ._._.- - ^ Replacement J Pubile or cammerclsl - Desatbe:.__._ ~ --- -- "' FM I~ m elevallon ii applipoie .~:.fl~-- - fl' Parent material __~~_ ~ ~~~~ ~~ Goneral comments r and recommendations: ry~D 11~JOD SySZFM /•~ ~ irf w r7.y LoAOtNG T2R'T~ ~ ~ Bodng ' Boring q ~ Ground surface elev. ft. Pit lj~.~.Z~ Depth 9 ~___ In. o limltln factor Sop lication Rate Horizon Depth Dominant Color Redox Descr{ptlon Texture S cture Consistence Boundary Gpaft* Roots ~Ef[#t ~Eft#2 In. Mussel{ Qu. Sz. Cont. Color Gr' Sz. Sh. - D - d o Z!~- -. ~sll ,S O.K 5i I ~ S O. L ~ _ ~ 3 ._.- m. _ . ~ cz .. ~ , ti r .,,,. ~wr .__..~ ~ I d~- m 0.2 0 . ~ Boring qC Boring q ,~ C^ N 1 n :M~ ittlr Sil: r.'~.~A AIw\i. ~ 1 1 • Jl/ !i Dep^1 !e !Imttlng factor Z.S ln• Soil .~coiicauori RoR Horizcn r Depth { in. - _ Dominant Color Munsell Redox Description Qu. 5z. Cont. Color Texture G trudure . Sz. Sh. Consistence Boundary Roots -... GPDlItT ~Eft#1 ~Eftft2 z 5-(3 io tc~IZ - 5~ a .s 5- tc314 c s~ ~ ~ _ ~ .~ .,.rv~ _S O- otG. 5 3 ~ ~k ~~ ~. _._ ~ __ ~ 1 ._ ~ 1. I~ _ .._ ...-.. ~ ..,. , -- -_~ Toc . 7A .WWII cmumn rr ~ - oyvL av ~ ~~ n,y.~ o _ .... ,..y. ,. I - -- . - - CST Number CST Name (Please .Print) ignature _ ZZ ~ N1 .~ 0 Fi 0 tr t+ Srt-E _ Date Evaluatlon Conducted Telephone Number Address W9g75 b9o++•AVE, RIVE FAU-S WI~ 54022 4~/~//'~3 (,"lt5 y2b-1'i7.5 I~Ut~~ v-T-u-v-~ .. _`. ~ EsT , ~ Pd~~?` 'mot' 9 V"' i _... .. - ~~ ~I p_g~o g$, , .,,a. ~ ` ~ ~ • . ~~-1 ~ 44 4'x"1 ~` ~ ~f R~ ~ 4 ~ `Q (~ ~ i ~ 1 ~ A~o~E ~- ,, ~, ~ ~ ~` j i '® II -~ • ~ ` ~ '~ oy- Z1-o3 r i i \ „ ~ ~ '~ }' ~ \ "~ ~ . .._ j ~ ~ ~ ~ ~ \ \ \ i ~o /l.l J~ \' ~ ~ J \ ~. ~. ~1 1.2.'' Z fiJ J J 1 ... _.. ... ~ I ~ 0 ~Z c ~. _. ~-- ~\ . .:~-- ~~~ ~-° ~ ---- .. ~ ~ ~ . ,~ ~ ~ ~ j ~ ~ '\ ~.~ ~~ ~ ~ ~ ~\ ~ X 8 i ~ '\ J 1~ ~ ..I ~. ~~ ; ~~ 'f21~1~ K1'1•J `. ~ ~ r ~~ ~~a/IF~!'•i=i~:-~ lit: -= 1~1`a~_~~F~=;tia _~:. ;, a; Y il~•''~~I,I dI ~~ ~' ~z ~.~~ ~ti ~, q ~D ~~ ~ ~.~~ •~i `\ bo N o Y C u*-t t7 +~-e T-,~ \ 5 a t~ .> ~ 9 'rte 4~ p a,% 3 ~3Qa,.~ ~ G ~ ~, ~~ ~~ \~~ ~''` 1'~','~' ~Q 11gb ~ 17Y ~~ ~ ~'~~ 1~ u`T} ~i5' , ~01~.w G t 3 11.l~~ ~ -~~ ~~r .1 ~~ 0 °a ;~ ~~ t L '``~ ~~. - kZ- . t t q 8 . S q ' p~ o • q `T~-t PVC T~ ~ 1~' W/ FP.rTC~`4'SO_S T. ~ -~~ Z.. ~ C'-L. , t S a 6.8 ~' o ~a ~ ~ L t•~E- +, 4 • q ' ~$ v u ~ G i?~-,.i~D ! n1:.712.~~ . NOTES : ~ I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( required). 3. Septic tank to be gallon capa~ity manufactured by 4. $ench mark• 5. Divert surface Water around system to ~_;i iIL TE_~TIh•I! PLOT PLAl~ Scale 1" `~o ~ .~--•-. ~.. t ~ ~I ~ . ~ ' Page -3 of ~ -_-__ ~f ut ~ v7 ~, ~ ~ ~ '~ ~ T p ~ V'~ l- -k`-~? ~ ~--a I\; rX4•A y~~ l ~Q~7.J~n 7J~ ~p1J ~ • ~S-~,u J ~ ~, \ ~ a. o ` ~,,,,.-, ~- yti ~-i, O I v ~~ . ~ ~ v~r-s r. o ~ \ ~ revent ponding at the uphill side. I isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Jim Doyle, Governor Secretary May 08, 2003 CUST ID No.220254 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/08/2005 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Barry & Jolene Thielen County Hwy E Town of Hammond St Croix County NE1/4, SW1/4, S14, T29N, R17W Subdivision: Forest Ridge Estates -lot 9 FOR: Description: Proposed Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 901904 MAY 1 2 ?443 ST. CRO/X ZONING o 0 CE ~, Identification Numbers Transaction ID No. 864901 Site ID No. 658687 Please refer to both identification numbers, above, in all correspondence with the- agency. 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. • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product 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. • 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 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. C~.'~:".T.. Cc~~i~~~~~~~c~, ARTHUR L WEGERER Owner Responsibilities: Page 2 5/8/03 • 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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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 maybe 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, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm jswim@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 ,, L TITLE SHEET Page ~ of 7 I~OUPdD SYSTEi~1 FOR A _ ~ BEDROOrI RESIDENCE This plan has been prepared in accordance ~~rith the Mound Component Manual SBD-10691-P and the Pressure Distribution P•Ianual SBD-10706-P (N.Ol/O1) (N.O1/O1) LOCATED ICI THE N~ 1 /4 OF THE Sby 1 /4 OF SECTION ~ ~ , T ~-°! N,R » W TOWid OF l`1~'AW1-'~1vnJ~ ~ S7'_ ~~ ~x COUNTY, WISCOPdSIN. '~T _~1 of t=int-SST [Zt,DGE ~T~fi~s INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEr1 I~IAt~AGEi~1ENT PLAid PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIE~7-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUc•IPING CHAIiBER CROSS SECTION PAGE 7 of 7 PUriP PERFORi•1ANCE CURVE PREPARED FOR ~A~~`f ~~ ~L~~ ~ `T1t1~~t~1N RECEIVED - zot a o ~-,.a. ~-~~ N MAY - ~ 2003 ~~~L , 1~1ty . ss~f3~1 S~FE~Y & BLDGS D1V~ PREPARED BY WEGEFCER SOIL - TEST S iVG AND . ' DES = G;V S~RV S CE P.O. Box 74 421 i1.Iiain St. ~~~~ River Falls, T~~I 54022 Phone 715-425-0165 ~~~,~'~~~~~~ Fax 715-425-6864 ~v'.•y ••.L'~ ~~•LRfA DF=ihN 6LL;iN=pgTh t~) '~w`•~~1/~ ~~ ~ ka, DEPARTMENT OF Cf3t~,~f,^,EF~iCE DIVISiGN OF SAFETY AND BUILDINGS __ JOB N0. v3-~0 sE~ co~zki=s~ ~~~~vcc Mound System Management Plan Page Z. of 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, Stats. 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 assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. 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 pgrsonnel 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 S tem No 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 scsne 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. 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 - -6f99j] arid local or state rules pertaining to system maintenance and maintenance reporting. ~ BD ' -1 D ba l - P 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. Contingency 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 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 _~,~5~-3g-~p_,l~~j:~Q S`r'i-~e~1X .,The system installer 'at ~1. LS - ZS = ~4S~i wf~vt~ The tank manufacturer at ~uL~ `.3_Z.S ~ ~l[S 1.U l L``S L"R ` The effluent filter manufacturer at _ -~~~ ~ Z.;2.~ ~ S-l ~Z, Z~~ The e-pump manufacturer at. U 30-~ w- ~[~' ~ g ~C)111..L~S PLOT PLAN • ,Page 3of 7 • Scale 1"= `{o' ,~ ,~ g U`T`1•'V h~ U ~ Cat L r , cur UN~ ~. ~,~ ,~ ' ~ ~ ~z = ~ ~ ~p„~T to v'tt ' ~B .QA ~ ~'Z.`- Ng•~L. ,s ~ ,~-z ~ . - V ~_ .~ ._ • t1.°~b - ~. ±~ ~~ ~ ~ ~ _ ~ 1Z~~~ ~~ - c~ 'C" ~~ ~c ~ ~ 2~Q '~ ~, 0 6 T Ll~~ ~-~ Lu L c3w-tt-1 =~-s:tlab;s~`:rev._~~q~T~r=c-PVC~T?~~~~"wlF~~~~-s T. 4 d~'"I`~° L -__ tTL__-_11 of 6_ ~D'_~~-~ S P [ E~:.~- _~~ ~ ! iPr3 ~V ~ G tZG~ -11J-.. 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 tZ-o0 laoo gallon ca acity manufactured by • W~Q~SL~Z CC1U`c-R~C~ ~iyL~ ~~/~ ~'7 'w/R-l~oc~ Z~R~Z Ficr~iZ . 4 . $ench marks ' S~`• -~S3UU ~ ~. Divert surface water around system to prevent ponding at the uphill side. ~~ S'o~ ~1'~ ~v c ' - ~' Page ~~.Or 7 P_pprc~ ec Sirn thetic Coverinc ASTi~f C33 " Medium Sand -» Tcpsail ~ , ~~' ~~ -- istribufion Fipe I~ F E?ev. ~ ~.~,q.9 o °a Slope ~~ Distribution Cell of ~ Force Main Flowed z" to 2 Z" Aggregate From Pump Laker D ~ .p Fi. F ~ Ft. CROSS SECTION Or A MOUVD SYSTEM F p_8 Fb, G 6_ S Ft. A. 1 o Ft. ~ FI ~-O Ft. Linear L r a-• ~ g • oadi__c ~`e=1vA G-D/~,~ rT ~~ F~• Desicn Loadinc :awe=p•~(~GL/s4 ;T i 1 S Ft. J -7 Ft. ' K ~_ Ft. uteri°,~ ~~--~w^s'-~i~m L ~ B Ft. -aT-- ~r-ca.~tai.r~. ~ tv 3 2 Ft. L - I ~} -Observation Pipe ~r----------------- ~------- ---=-- -- •~ ' A a-~----/68--- --------- -------------- ----- ~-r~ ----, ~----- _ ~, Force Main w ~------ _ ------=---=----! L ~~ ~~ :~ Distribution ~ Cell of Z" to 2 2" Pipe . ' aggregate Observation. Pipe • ' ' - PLAiv VIEW OF A MOUND SYSTEI4 •• Distribution Pipe Layout Page S of ~ • Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of Iong turn or 4~ ° fitting to a point within six inches of the final made. Terminate the ends of the laterals with a valve,.threaded cap or . threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. ' ~_ ~~,cc~.ss sox:_ T`-t P 1 Ct~ L ~,~5 S S'~~~p ~ PVC, Later[-, C- fvfar~ifold PV C ~---Lateral !~- L•PrN V \EW --- o._ _ ' F r~~~~ ~- ~ct~s _~oX - -~ a- -- ---0 PVC wec, n~ i a-- - ~a P Zq Ft. ~ ~ Hole Diameter ~~~ Inch S 3.33Ft, - ~ Lateral 1 ~ Inches) . X Z~ Inches Manifold " Z Inches ' -~ ~ Force Main " ~ Inches # of holes/pipe 1 S - Invert Elevation of.Laterals~ZD o 3~t. . .. __ ~ ~ Combination Sept~c~Tank and •, PUMP CHAMBER CRO55 SECT(OtJ AruD SPEClF1CATIauS' PAGE ~ OF -1 • ..-- -VEUT CAP ~- WEATHER Pit00f • JIJIJCTIOIJ 80X . '1~C.Z. VEA17 PIPC ~ APPROVED LOCKIfJG ~ lO ~ FROM OOOR. MANHOLE COVER cvl-~ti :/tA100W OR FRFSH ~ wA(ttJ1UG Lt~6EC.. ~3P~ptJ PIPE A~UJTAKE ~ coraputr -v /R•tCzll s ~ a.np ~ ~ s •• ~ i • _ ._ ~ ~R~~ ~ • `__ ~ le•Miu. ~~; • UJLET `" PROVIDE I __ __ . ~, _ •• ~,'~~ AIRTIGHT SEAL ~ I I e~1=rLt ~ ~ I+~ Approved zt~8~t ~~~ °~ I ICI Approved joint w/ ~ _L$00 ~ ~~I joint w/ PVC pipe ALARM PVC pipe 6 !I I) I 1 ~ i ou c -~ I 11819 ~ I CLEV. fT ~ __~ PUMP -~ OFF c~~ D ~Z-`.V . ~~g 1.0t~ t ~' ~C BLOGKTE ~- RISER EXIT PERMUTED O-JLy IF TAUK MAL;L'FACTUR]`R HAS , SUCH APPROVAL~3,•AAPRosFp BF.DO t rv 4 SEPTIC E yip ~.~~ SPECIFICATIOt~1S DOSE ~ l~C) - ~ R TA-,!K MAlJUFACTURCR: ~ ~ ~~? ~ N C,2~ t"L~ jJ~~yER OF DOSES: S ' PER CJA„ TA1JK SIZC: 1`wO ~SOO GALL0IJS DCSE VOLUME z cI ALAR1+1 MAUUFACTURLR: S'~'_C~L.~c`1~20 S-!S`~•ts INCLUp1A7G OACKrLDW:_ ~~`i,b (,AILON: C10DEL -JUMSER: ~Q ~ ~v _ CAPACITIES: A= ~ ~ pJCHES OR yOb- 3cALL0us SWITCH TyPC: ~ ~-~Q-~ c ~ 8 = ~ IIJCHES'OR ~~ "tl'IS G(~LLOI~IS PUMP MAJJUFACTURCR: C~UL'DS C: .6 ~ IZAICHES OR ~1.~y•6 CALLOUS MODEL 1JUM6ER: ED'S ~"; p= q 1Z ~~ ~, 3 I`A~ICpH~E(S~(O~R ~ GALLOAJS SWITCH TYPE:-~ ~Ze~-~___ uOTE: PUriP AU~~ARM ARC TO 6C~~ MIAtIMUM DISGtiARGERATE-~6..°I GPK ItVSTAlLEO OA1 SEPARATE CIRCUITS VERTICAL piFFEREfJCE DETWCEU PUMP OFf AUD..DISTRIBUTIOIJ PIPE..' s1 FEET t~j ~~ + MltJlhlUM i~-ETWORK SUPPLY PRESSURE . ,~ , b.SO 'F1rET ~.Ok ~.3, -F l~ O FEET OF FORCE MAIN X ~~ $ S F~c FCFRtCTtou FACTOR.. ~'~'S FEET ; d Z z9.6 ~ y TOTAL OyWAMiC HEAD = ~ FEET As er >zanufacturer 2Z,2 +~ P _ ~ gal/in. Liquid depth 3 ~, . . uou~as - ~ " ~ Submers~b~~ ---,. Effluen# Pump 1~°-~ ~ =J cr ~ r~ u 3885 APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • .Hospitals • Industry • Effluent systems SPECIFICATIONS Pump '• Solids handling capabilities: '3/a" maximum. -~ • Discharge size: 2"NPT. • Capacities: up to 128 GPM. • Total heads:. up to 123 feet .TDH • Overload protection must be provided in starter unit. • Shaft: threaded, 400 series stainless steel. • Bearings: ball bearings upper and lower. • Power card: 20 foot standard length (optional lengths available). Single phase: •'/a and''/z HP -16/3 SJTO . with 115 V or 230 V three prong plug. • 3/4-1 YZ HP -14/3 STO with bare leads. Three phase: ' •'/~-1 Yz HP -14/4 STO with bare leads. On CSA listed models - 20 foot length SJTW and STW are standard. smooth operation. Silicon bronze impeller available as an option. ^ Casing:.Cast iron volute type for maximum efficiency. 2" NPT discharge adaptable for slide rail systems. ^ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces. Stainless steel metal parts, BUNA-N elastomers. ^ Shaft: Corrosion-resistant stainless steel. Threaded design. Locknut on three phase models to guard against component damage on accidental reverse rotation. ^ Motor: Fully submerged in high-grade turbine oil for lubrication and efficient heat transfer. ^ Designed for Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, can be operated continuously without damage. ^ Bearings: Upper and lower heavy duty ball bearing construction. e Pou+er Cable: Severe duty rated, oil and water resistant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. ^ 0-ring: Assures positive sealing against contaminants and oil leakage. • Mechanical seal: silicon ca~bitle-rotary seat/silicon . FEATURES carbide-stationary seat 300 , ` series stainless steel metal ^ Impeller: Cast iron, semi- parts, BUNA-N elastomers. .open, non-clog with pump- ,- • Temperature: out vanes for mechanical seal 104°F (40°C) continuous protection. Balanced for 140°F (60°C) intermittent. • Fasteners: 300 series MARS Feer stainless steel. so _ _ - • Capable of running dry z5 ao w , without damage to e, - components. 70 v i 20 i el l Motor ::, a o . Single phase:: - _ s I I , `` • '/ H P, .115 V, 200 V, 230 V, ~ 5a 0 ' . ', 60 Hz '1750 RPM;'h HP i 5 Z " , , 115 V, 60 Hz 3500 RPM; 'o ao w , s ''/ HP =1% H , 230 V eo H .. z ., P , "' 60 Hz, 3500 RPM _ ° ;10 s° , .. : • B i .: t 5. . uilt-inyoverload with ; - EO ' ' ' w '' automatic reset `20 i ` 5 ~ ClassB Insulation ~l , ' 4 ~1 hree phase :~ ~~~r a ~ G I ; .. r ~ ~. sa.!~z HP=~'~HP 200/230/ '"max; o i , ; ' o Y~, 460`60 Hz,~3500'RPM }~'` ~~ ' •t s ' '~` ' ,o ~. 10 : , 20 ~;30 ~ ' ~3 Cla s B Insulation ~ ~~ ~ -' -° r .x. ';Y y~. ®1995 Goulds-Pumps, Inc. - .~~SGPM - s Fr AGENCY LISTINGS SP Canadian standards Association ~L Underwriters Laboratories SERIES: 3885 slzE:'/.'SOLIDS RPM: VARIOUS .. 1 , ~ s i ~ ~~-~ i ,I { _ <.: k ~ +"_ ? t;. I ~ ` . 40 50 , ` 60 '70 80 -90 ' ~ 100 ; 11d ' 120 130GPM CAPACfTY - - Effective May, 1995 -63885 11 ST CROIX COUNTY SCPT[C TANK MAIN'IL'NANCC AGRLeML'NT AND OWN~RSH(P C~RT[FICATION FORM Owncr/13uyc~ Mailing Ad ®~ ~ ~ ,-~ Pacrcl Idcnt,ifieation Number Propafy L.ocat.ion /V c~ ~,~ %<, Soc.1~ T ~-(N R~W, a~. II13d1`(LSLOIl ~y~ 3rd ~~ ""~~ - D o o p l0'- Town o J Lot # :__,~__. Ccrfi~ed Strrvep Map # ' Volumc ~ .page # Warranty Deed # _ ~ / ~ ~ ,,29' .Volume ~ ~ ~ .page # ~ ~-v Spcc ~.ousc D ycs ~no Lot lines id,cati£able~(yes ^. no S'YS"IF.i~I~N1f,3N'~'F„N~4NG"E • ImpacopctaseiOi~of~~P~sY~m~aI~dr~altmi~s ~.:. . oc~asists of P~fa~to handlcwastcs.Propcr caa sffcdSyc a of tlLe tam ~~ truce ~ ~ if aACdcd bq ~Tuorasodpampct. ~~ What you put.iuLo tip system ~c taaiti as.a teatmcat stage 3a II~c viasGe ty~. .. Tba giopaty ov~uac agrees t+o tulnaiit"tA St. ~ ~ =,oaort forms, sigaod hY tlae owner and hY: ~p~'~7°Pz~Lodplumbcrori~Y~~(i) ~on~itc~aas~waLcrdirpOUlcpstcm P~ ~ioa and/or (~) aRcr inspoction ~ I'~PmS.C~{y). ~ ccptictxnk~is Icss fan U3 full of shsdge. . ~+ ~ Isavo~trad tip abv~ aad agree too aria tip pciratc scRragG disposal sysu;m wiffi ~ti~ standards . ~ fot~, ~.3rs td bq tfac Dgtttimcat of and the Dcpu4mait of Natural Stafc of Wi9oousin... t~xfiificati~on that Y~ uP~ sY~ has tiocu maintainod musi be ooazpktod and n-b~d tp the SL Qvix.County Zoning Oflicc within 30 drys of tlbc tlztec yar rxpintian, date. SIQ1A OF APPLIC1lNT Q .3 /l3/ T~ DATE OWNER• G"E~2'I,'IRICA.~ON I (~) oat~fy that all stag ou this form ate true to the best of my (our) knowiodgc. I (we) atn (arc) the owner(s) of ~ property dcsrz~cd abo~te, by vittxtc of a warranty decd recorded is Register of Deods Ofliec. ~. ,r SiGISA ~ OF APPI;ICANT OJ / ~jQ/ ~ ~ DATE ssssss Any infotmatiozi that is naffs-ieprescutod may result in the sanitary Knit bci~ ncvokcd by the Zoning DepactmcuL "• • • • •• Iadudc ~rt(h thLr application: a staa~{,od waasm(y flood Gram the Register of Doods o~cc a copy of the certified ecuvcy map if aef'ctrncc is tnadc iu the waccanty dcod ~ 03~ -"~-o- Doer )'LEGAL D~SCR~'Z'XON _ ~©- o~~. J 217 ~' S20 STATE BAR OF WISCONSIN FORM 2 • 1999 Document Number WARRANTY DEED This Deed, made between E. W. Homes, Inc., a Wisconsin Corporation, Grantor, and Barry M. Thielen amd Jolene M. Thielen, husband and wife, Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 9 Plat of Forest Ridge Estates in the Town of Hammond, St. Croix ounty, Wisconsin. 1 .~ ~ i ~ ~~ KATHLEEN H. WALSH kEGISTER GF UEEUS ST. CROIX CD. , WI kECEIVEU FOR kECORD 03/19/2003 08:30AM WARRANTY UEEU tXENF'T REC FEE: 11.00 TRANS FEE: 123.00 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address ~/=~ ~ Part of 018-1030-4U-000, 018-1030-50-000 and 018-1029-90-000 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this I - I day of March p~} (is not) 2003 E. W. Homes, [ ~~ + By, Mark B. Syl a, Prc ' ent ____ r AUTHENTICATION Signature(s) E. W. Homes, Inc., a Wisconsin Corporation, by dlark B. Sylla, President, authenticate thi ~~ of March 2003 + Kristina OQland + ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. County ) Personally came before me this day of the above named TITLE: MEMBER STATE BAR OF WISCONSIN -'- to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) Tli1S 1NSTIZUMENT WAS DRAFTED BY + Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ') • Names of persons signing in any capacity must be typed or printed below their signature. ~nrormation Prorese~onais company, Forty a~ tao. wi 80055-2021 WARRANTY DEED STATE BAR OF WISCONSIN FORA1 No. 2 - 1999 r! c ~o t l~HS $ C -----~ N O WEST UNE OF Sg+ E W ------ -- --39&i -- bo k ~ ~ ~ n \ ~ -- ~ -----$ W~ Z I .- - ----- °s°-°' ---~~- ~ ~ W ~ I % 31 W 464.01 / 3 I Y31' E 484.01' m ~ ~ I -- -- - 248 31' ~ ~ ` . ~ ~ ~--~ -- X ~,~ I ~ I N U I I I I ~ ~~~ I I Y ~ ~-~ ~if I ~ A I i ~..~ - ~I ~~ ~ ~; I I ~ Q t (uri 6 I I I ~ ~ EI O~ In ~ I ~I ~ o ~~; I ~ I zI I I I I i ~ I I ~ I I I I ~ I ~ i I I S 00'21'03 E 131235' ~n ~~ ~z~ o~o NUS --I ~ -- 726_00' vii _ _ _226.00' I I I I I -- 1963.1 I I ~ I ~ I I ~ I I II Y I I ~ ~ I ~ I ~ M H ~ s- - - 1 - - - 1. 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