HomeMy WebLinkAbout002-1027-40-000 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING
LABOR&HUMAN RELATIONS DIVISION
P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION
MADISON,WI 53707 State Plan I.D.Number:
SW,. SW, 13, 29, 16W [ CONVENTIONAL I ALTERATIVE If assigned)
S�89 - 00947
Tom of Baldwin I I Holding Tank I I In-Ground Pressure IX I Mound
Lg E:OFW//n/tIT HOLDER: ADDRESS OF PERMIT HOLDER: I7 SPEtTIN D ,r')
Bernard Sturgul R. R. 1 Ca IX/"'ll
BEN H MARK(Permanent reference�inpoint)point) IF DIFFERENTFROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.:
)
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Joe Stung 6646 St. Croix 119483
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
❑YES ❑NO ❑YES ❑NO
BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH
ALARM: FEET FROM LINE: AIR INLET:
❑YES ❑NO ❑YES ❑NO NEAREST--
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
a/� PROVIDED: PROVIDED:
(5-14.a ❑YES /NO ❑YES ❑NO ❑YES ❑NO
GALLONS PER CYCLE: PUMP AND CONTRO_S OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET:
PUMP ON AND OFF) ❑YES ❑NO NEAREST-*
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN
the soil is dry enough to continue.)
CONVENTIONAL SYSTEM:
BED/TRENCH WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID
TRENCHES: MATERIAL: PIT DEPTH:
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW PIPES: ABOVE COVER: ELEV.INLET: ELEV.END: PIPES: FEET FROM LINE: AIR INLET:
NEAREST•--*
MOUND SYSTEM:
Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW
❑YES ❑NO meets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑YES ❑NO ❑YES ❑NO
DEPTH OVER TRENCH/BED' DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED:
CENTER: EDGES:
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER:
DIMENSIONS TRENCHES:
MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING:
ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
DISTRIBUTION HOLE SIZE HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑YES ❑NO ❑YES ❑NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING:
FEET FROM LINE:
❑YES ❑NO ❑YES '❑NO NEAREST--O•
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u; 51;_)y9J")
054* / i°
0)1/4.) CI)r,, 4'6 ." .
Sketch System on Retain in county file for audit.
Reverse Side. SIGNATURE: TITLE:
SBD-6710(R.06/88) Zoning Administrator
Tom C. Nelson
DILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05,Wis.Adm.Code CouNTY
stc'ro1 tx
—Attach complete plans(to the county copy only)for the system,on paper not less than STATE SANITARY PERMIT#❑ J/
8%x 11 inches in size. { y �j
—See reverse side for instructions for completing this application. Check i revision to previous application
I. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. STATE PLAN I.D.NUMBER
PRO TY OWNER Cl -0�9 /y
PROPERTY LOCATION 7
.d.4 A C/ t - IA 1 l+/'/a S Ws, S I
PRODTY`OOWNER'SMAILINGADDRESS 3 T 29 N, R ,��• W
i LOT# BLOCK
CITY,STATE 't ��/yt
ZIP CODE PHONE NUMBER SUBth t8ION NA.MF OR CSM NUMBER
14leC4,1/� 14-/•'S 5 y"2 $l I( 74' ) L4.-?4ft:
II. TYPE OF BUILDING• ck one) ❑ IN CITY
State Owned O VILLAGE / NEAREST ROAD•❑ Public L`�-.:l or 2 Fam. Dwellin
no . , ` • • ��4 �e �"I C/0 r A /¢j,/
9-#of bedrooms ld i.14 ft:nom aguy' L(
II. BUILDING USE: (If building type is public,check all that apply)
1 ❑ Apt/Condo I✓<-, e e S'7 ,
2 0 Assembly Hall 6 0 Medical Facili /Nursin
3 ❑ Campground 7 ❑ g Home 10 ❑ Outdoor Recreational Facility
Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park
5 ❑ Hotel/Motel 12 0 Service Station/Car Wash
9 ❑ Office/Factory 13 ❑ Other: Specify
TYPE OF ERMIT: (Check only one in line A. Check line B if applicable)
L° New 2. ❑Replacement 3.
System C)Replacement of 4. CI Reconnection of 5.❑ Repair of an
System Tank Only Existing System
El Da a y A Sanitary Permit was previously issued. Permit# _ Existing System
te Issued
PE OF SYSTEM: (Check only one)
Pressurized Distribution Pressuri Distribution Experimental
Other
Seepage Bed 21 Mound 30 ❑ Specify T e
1 Seepage Trench 22 ❑ In-Ground yP 41 ❑ Holding Tank
I Seepage Pit Pressure 42 ❑ Pit Privy
System-In-Fill 43 ❑ Vault Privy
RPTION SYSTEM INFORMATION:
S PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC.RATE
REQU RE (sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) 6. SYSTEM ELEV. 7. FINAL GRADE
ge,0 lie)pw L U / ELEVATION
CAPACITY I; G /O 2 'S Feet /G 4,0 Feet
ATION in gallons Total
New istin Gallons Tanks Manufacturer's Name Prefab. Co� Steel Fiber- Exper.
Tanks Tanks oncrete structed glass Plastic A
PP•
olding Tank /(j (!tl IN./e- .k 1 ❑
iphon Chamber .� 4a 00 I t ❑ ❑ ❑ ❑ ❑
SIBILITY STATEMENT
led,assume responsibility for installation of the onsite sewage system shown on the attached plans.
print): Plumb is Signature:(N mps)
I PRSW No.: Business Phone Number:
tee Ag • 64 eio ( 7/r ) 6 fis :IUG
!Street, ,State,Zip Code
0 e. Woc d u,'ll e r,t1 , 3-1-/ 2 ?
''ARTMENT USE ONLY
)isapproved Sanitqy Permit Fee(Includes Groundwater
)caner Given Initial Surcharge Fee) *a e ssue. Issuing Agent Signature(No Stamps
dverseDet=rmin=tion L/� ' ��� .� .ZSf i, il, 7, . ,
F APPROVAL/REASONS FOR DISAPPROVAL:
/
(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety&Buildings Division,Owner,Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at 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. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained.
2 t 3 ed. The septic tank(s) must be pumped by a licensed
pumper whenever necessary,
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 application must include:
I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one 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 land ma ion. Fill in'shname. Indicate prefab orand/or
s to constructed list the
material. Complete for all
tanks and manufacture
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR. appropriate prefix (e.g.
VIII. Responsibility statement. Installing plumber is to fill in name, li canion former with app ro p
MP, etc.), address and phone number. Plumber must sign app
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 unn county. he
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, loco
holding tank(s), septic n (so other building wells; mains/water
strem s and la kes; pmp orsP hnks; 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;nufacturer;oD) c o;sselevation
section of the soeSabsor'ption syson loss;
m p
performance curve; pump model and pump
required by the county; E) soil test dataoha 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(R.11/88)
1
APPLICATION FOR SANITARY PERMIT
S T C - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development be intended for resale by owner/contractor, ("spec
house"), then a second form should be retained and completed when the property is
sold and submitted to this office with the appropriate deed recording.
Owner of Property B e R n /9-,Pd Ct Lilt k I
Location of Property S w k 54✓ 14, Section 3 , T N-R W
Township a4 /C�w,�y •
Mailing Address W 6 u d fr, 7/2
•
Address of Site ,S�
•
Subdivision Name// N /� •
Lot Number N (4
Previous Owner of Property i9(;°l c°�
ert
P Di Z-„e/C4,-0.cJ
Total Size of Parcel 'j/J
Date Parcel was Created
Are all corners and lot lines identifiable? v Yes No
Is this property being developed for resale (spec house) ? Yes No
&o,e p
Volume y0 = 3
and Page Number umberD,p 3 as recorded 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 refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
I (We) ceh ti.6 y that at statement on th.i a 6onm ante t&ue to the best o 6 my (oun)
hnowtedge; that 1 (we) am (ante) the ownvt(s) o6 the phope.nty des c.n i.bed in .th.i s
A.n6okmatton 6onm, by viAtue o6 a wan Cant deed n.ec ded in the O66.ice o6 the
County Registek o6 Deus a. Document No. S ; and that I (We) pnesentty
own the proposed sate 60A. the sewage • pos .6y4 em (on. I (we) have obtained an
easement, to nun wWt the above deschibed pn.openty, bon the constAucti,on o6 said
system, and the same has been duty n.econded in the ()Agee o6 the County Register. 06
Deeds, a& Vocwnent No. 1 .
SIGNATURE OP OWNER SI URE OF CO-OWNER (IF A LICABLE)
DATE SIGNED DATE SIGNED
V
■
DOCUMENT NO. STATE BAR OF WISCONSIN–FORM 1
WARRANTY DEED
3 Q 9 95 4 THIS SPACE RESERVED FOR RECORDING DATA ri
ii
THIS DEED, made between Rachel Erickson also known as ilt.GISTERS OFFICE 1!
• Rachel 0. Erickson, a womb 9T. CROIX CO., wls•
111
Rec'd for Record this_ 1st_
2 i
and Bernard A. Sturgul and Judy Sturgul.,_ husband and day of May A.D.19 Z ,I
wife and as joint tenants, at 813.9 Ais M.
Grantee, f
W i t n e e se t h, That the said Grantor for a valuable consideration o Re er f vri!
One dollar and other valuable oonsideratinn
conveys to Grantee the following described real estate in St. Croix County, RETURN TO
State of Wisconsin:
•
Southwest Quarter of Southwest Quarter (SW/ of SW-1) Tax Key # --
Section 13, Town 29 North, Range 16 West. This is homestead property.
N TRANSFER
1 P $1 71.4.0
FEE
1
I Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining;
And _ _ Rachel Erickson
IA
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances.except _ ____
and will warrant and defend the same.
•
E _• at Spring Valley,Wisconsin this e day of __. ------ 19 72 '
■
I //SEA DIN PRE E.CE OF - �G/ �i /1 SEAL. � 1(__ (SEAL)/
111 .1d Rachel Erickson
-- ( — — — — (SEAL)
Robert R. Gavic 1/
l Lee ' (SEAL) ,
IBarbara Rudesill
(SEAL) ,
(
1 .
il
it Signatures of
j ailthenticated this day of , 119_
1
Title: Member State Bar of Wisconsin or Other Party
Authorized under Sec. 706.06 viz.
•
• STATE OF WISCONSIN
Pierce )} ss. i / ````�,,.,„,,,,,,,,,
County.
Personally came before me, this_ ay of `�•�� �` ••%••19 , `�y l.
the above named Rachel Erieks / �P.•']�
-- 4.•'f U D' '+
_ _ Q. , J - v
to me known to be the person who executed the foregoing instrument a,d a 5w,.::-,/ same./ »�•
v
• V � i
This instrument was drafted by ,,, ,,``� I:
Robert R. Gavic',„%i so.
Gavic, Richardson and Skow Pierce •��•i•""t"'"mil ~ ,I
Notary Public traUnty,Wis• j
The use of witnesses is optional, My Commission( (Is) permanent
li
• 11111111s•11r4/////.ra
Names of persons signing in any capacity should be typed or prinr low t1 '. 1 matures.
umpangl
WARRANTY DEED–STATE BAR OF WISCONSIN, FORM "'•°e
.
z
H
a
STC - 105
• a
H
SEPTIC TANK MAINTENANCE AGREEMENT o
St . Croix County z
OWNER/BUYER 13tRnAed StUI (.4 / tri
ROUTE/BOX NUMBER (p )7j /a 4j.' ', Fire Number (P lO
CITY/STATE 1.J O 0 1. ; Z IP J y0 ,
PROPERTY LOCATION : S W 1, S U/ 1, Section ) 3 , T N , R W,
Town of 134 (lwitki , St . Croix County ,
Subdivision N/' , Lot number /qg .
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes . Proper maintenance con-
sists 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 treat-
ment stage in the waste disposal system.
St . Croix . County residents may be eligible to receive a grant for
a maximum of 60% of the cost of replacement of a failing system,
which was in operation prior to July 1 , 1978 . St . Croix County
accepted this program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained .
The property owner agrees to submit to St . Croix County Zoning a
certification form, signed by the owner and by a master plumber ,
journeyman plumber , restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping ( if nec-
essary) , 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 cn
to maintain the private sewage disposal system in accordance with
H
the standards set forth, herein, as set by the Wisconsin Depart- ro
ment 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 .
SIGNED ✓J _ � , _. <. I4,c)
St . Croix County Zoning Office
P .O. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign , date and return to above address .
• . s-,Nc p- L oF_ 6. -
S 89' 00947
PEA-FoRP.TEn A!PE DE'rAIL
PERFORATES
'F-SzVC CAPE
t't�a cJty
,r -'� .~ • \►J •TALL PER I )E7JT MAR.ItER.
AT EtJQ OF EA CN LAT ''I.AL
QUO_tAP_
Q
., l40t-ES Wc.A7i�0_CN::BtiTt°pFI or
+ _P1.R RUD A�R:E- ��uNLLY SPAC,at,
It , +
Q/ 1144 ......4
< \--pvc.---LATERALS • — R CE 'h1N--.
_ F R )-i F?uViP
P�[cE _A T__ltOLF
T_?EXT TO_E 315--CJlP-
.�,;.ISA
IS
�(l G'�S
0`°�`C�Sv'P 418 FT.
a NAM•
pN Y 4�G � .
Niv
Ica 1 / N I
of 0)."4 ! - - t
���'P''
'0 p`. SO40 .may hQnE Z iN'II�� cNpEN
-* $p FOR.Ce.t-1 pos., i8 • 2. wt.
/ /
C�• OF: HvLE$/P1 PE ,3
11JV.ELEV.OF INTE"P.ALS i 02.'80 VT.
P\-=P Ce 1ST-iiOLE 2.3'1 FR WI TeE PO1-nt SU Cc.E'ED11A)G HDLEs ii-7- U 6"i J.l•TE Uih-C:S:--
t_I1,ST t-bLE 1D la E A e-x-r To 'WE Eav b CA-P.
v
•
PLOT PLAN
• ��' a.
Scale 1"=SOt �=
,�-II •
9 _ 00 9 4 7 __ _ � 1� ►JOT DISTt1RB OR
.�1 �hFncr 11Y1s /NR. --A
LP —� ■
1e'
1■N ._^ -- 3)1 ii Z
8.6 I
SIM t* I �_ -- �j+► e,./0 4101.1 5'10
�'
S- a.13
Z iAl"'
or be
!;x 1 s'n-Lc I O /
ouTFit-�■-
\ 1 a ,111414\346 1*1
O*`gyp\.\o 91E Gd
U.
tit ' S�
t QlR
M
rsARpt _.
\ ,.,c.•
V) \
of
1flEcv*
: 4 o(\ 7c\s r, s�mc'Mutt. ' ti s
To 13 PftiupaufaD \,i t)U S E 3
9
1 i s wire_ cobe T
1S' P/►
I
— -- -
i ,
0, ) Mil42 - 9cOT� ROE .
,v-
NOTES
1. Elevations shown are existing ground elevations unless otherwise noted.
2 . Install cast iron pipe 3t onto undisturbed soil both sides of each tank.
3 . Install permanent markers at end of each lateral. ( Z required)
4- Install 4" observation pipe with approved cap. ( •z required)
5 . Septic tank to be 1000 gallon capacity as manufactured by
Ct..) S '- L r=.E t-c s .
6. Bench Mark- Elevation 8Y-1 1 - E�- too.o' 0)u :"x z"
2_ '
7. j 1u ET SuRFP,'� :•.)A-c'R P,R'JL:►., • 1--)-... 1..) -7 PR \)ENT :1►JD11JG RT UPHILL SIAM.
411. } •
' 4f' 'i!fs t
•
S89 .600947 �p.,-�� "s of 6
S'IOF LINCOr1PACTL"D SIRAW OR his‘RSIA 1}F-/ 61S'TT-113(S IIIJ PIPE EL. lt.3Z_Z3
CSR nil)PRO\J 0 S`-1 I.ITHETIC COV ER 11J G
ApPRovez 'f iss:wall $n-1• ) _
TOPSOIL ,3 - p F :7,11 i k,.. aE0 GL, 10 Z.3
E .
5 % SLOpE '?'3C. FORCE n R 1 N
.Ori Pvw1P
BEO OF ilia-Z1/Z ric.. REesRTL
6'1 BELOW P,Pa.- 2"ovER AI PE D -2-.0 Pr.
E 2 . Z F-.
, ► F O•& Pr.
C1`' �.,C�fJ S SECT? J13 G o PT.
H 1. 5 F=r,
S4:111°°9‘4140000j p A y Fl.
ONE $ loo FT.
1‘, FT: �� . E`x.'t'EIN�eD 2'Fri-RTti�Z
liNL)17t65'''
1 I To 'Ptzov1AQ AAQ)T10)-1AL‘,,lill d fr Fr. ads R L AREA ,
\�'" O�S N�G X 13 FT,
i0 ..l L \ 6 Fr.
/,,A odi; W 3o Pr.
QvC F GE tii9ir3 — .
pRO n )P\
PERHAIJI�T r1ARlc R
p lC 1,1S11Z1a„T101J
T •
i.. . PIpE.
A
P� 6REGATE
0
W CSEvA'r t PIPE
14---- g .
K
I ' .E f2
, I_ l'k 1..
PLAN N\,VJ
:?r
• y A .• i, t
t' alb
•
II �
•
P\6E oF
Submersible MODEL: 3871
SIZE: 3/4" SOLIDS
Effluent Pump RPM: 1550
HP: 0.4
S 89 - 00 9 4 7
METERS FEET
8
25
7-
mai 6 20
2 5- -
15
>-
0 4
3 113
0
10 .4
2-
5
1 "
—
0- 00 10 20 30 40 50 GPM
0 2 4 6 8 10 12 m3/h
CAPACITY
M GOULDS PUMPS, INS,
Effective October,1988
0 1988 Goulds Pumps,Inc. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE PRINTED IN U.S.A.
State of Wisconsin Department of Industry, Labor and Human Relations
PRIVATE SEWAGE PLAN APPROVAL SAFETY&BUILDINGS DIVISION
Office of Division Codes and Application
201 East Washington Avenue
P.O. Box 7969
Madison, Wisconsin 53707
WEGERER SOIL TESTING & DESIGN Owner: BERNARD STURGUL
P.O. BOX 74 2610 90TH AVENUE
RIVER FALLS, WI 54022 WOODVILLE, WI 54028
RE: Plan Number: S89-00947 Date Approved: May 17, 1989
Gallons Per Day: 450 Date Received: May 8, 1989
Project Name: STURGUL, BERNARD -- RESIDENCE Location:
Town of BALDWIN County: ST CROIX
Fees Received (Priority Review) : 260.00
The plumbing plans and specifications for this project have been reviewed for
compliance with applicable code requirements. This approval is based on Chapter
145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are
stamped 'conditionally approved' . This approval is contingent upon compliance with
any stipulations shown on the plans. All items that are noted must be corrected.
All permits required by the city, village, township or county shall be obtained
prior to construction. The licensed plumber responsible for this installation
shall keep one set of plans with the department' s approval stamp at the
construction site. The installer shall notify the appropriate inspector when
inspections can be made.
This approval will expire two years from the date approved or if a sanitary
permit is obtained, it will expire the day the initial sanitary permit expires .
The Section of Private Sewage has reviewed these plans for private sewage system code
requirements only. These plans have not been reviewed for the code requirements
set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the
Wisconsin Administrative code.
This approval is for the following components only:
-- NEW PETITION
— NEW MOUND
Inquiries concerning this approval may be made by calling (608) 266-8230.
_
bi
SBD-6423 (R.08/88)
t�
ft ;140_,A State of Wisconsin \ Department of Industry, Labor and Human Relations
SAFETY&BUILDINGS DIVISION
WEGERER SOIL TESTING & DESIGN
Page 2
Sincerely,
1;3-1.-4--%.4-41/4
KENN TH STIEMKE <1:ke-11"144-17---)
Section of Private Sewage .
Division of Safety and Buildings
PPP016/0009n/ 5
cc: BERNARD STURGUL
__ Private Sewage Consultant _ County _ UW—SSWMP Plumbing Consultant
Owner Plumber Environmental Health
1
1
SBD-6423 (R.08/88)
y A `Y�#"� t3�A
I , " ;1 `i State of Wisconsin \ Department of Industry, Labor and Human Relations r= 1 1 SAFETY&BUILDINGS DIVISION
=.. May 18, 1 989 201 E.Washington Avenue
P.O.Box 7969
Madison,Wisconsin 53707
Bernard Sturgul
2610 90th Avenue
s Woodville, WI 54028
Petition No. S89-00947-P
Dear Mr. Sturgul :
Re: Bernard Sturgul - Residence
Onsite Sewage System
SW,SW,13,29,16W
Town of Baldwin, St. Croix County, WI
Section 145.24 (1 ), Wisconsin Statutes, and s. ILHR 83.09 (2) (b), Wisconsin
Administrative Code, allow the owner to petition the department for a variance
to the installation for a onsite sewage system to replace an existing onsite
sewage system at a site which is not in full compliance with the siting
standards in the administrative rule. The system design proposed should
protect the waters of the state from contamination. If this system becomes a
failing system or contaminates the waters of the state, this variance shall be
rescinded.
The petition for a variance requested to s. ILHR 83.23 (1 ) (d) of the Wis.
Adm. Code was considered on May 12, 1989. The petition has been approved.
The rule requires a mound system site to have a minimum of 24 inches of
suitable natural soil .
The variance requested was to install a replacement mound system on 'a site
with 13 inches of suitable natural soil .
All of the data and statements submitted on behalf of the petitioner were
considered. This variance is specific to the subject petition and cannot be
used for any additional modifications.
Sincerely,
rt/ 4 'd t(ta )//
Richard Meyer, Architect ;` ,
Director, Office of DiviS/idn
Codes and Application
(608) 266-3080
Rr1:KS:2428i
SBD-6928(R.10/87)
Page 1 of 6
MOUND SYSTEM
A 3 BEDROOMRRESIDENCE 0 0
LOCATED IN THE S 1/y OF THE S,___ OF SECTION 13 , T 2-9 N, R I(, W,
TOWN OF 1 Iv , ST. cR-o ix COUNTY, WISCONSIN.
INDEX
PAGE 1 of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
PAGE 3 of 6 PLAN VIEW-CROSS SECTION
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE
PREPARED FOR
FIER1.1/N926 STURG V L
2-‘3/ 0 90121` /NUE.
1tibO •V1LL�. , Lv, 517102-b
PREPARED BY S* •••" ''•• 1,1%,
ti•
j ARTHUR L. ft 1
WECERER
WEcEFcEFc SQ I L TEST I N� ® D-915P
Sl • ELLSWORTH, •
AND A wrs ? 4F
DESICh1 SEFc ' ICE or
F.O. BOX 74 421 N. MAIN ST. 4P0 o®�fti oopoo s-
RIVER FALLS, NI 54022 H� S, l c18•7
715-425-0165
Job # S9-39
A
( I'
State of Wisconsin Department of Industry, Labor and Human Relations
{, ; , SAFETY&BUILDINGS DIVISION
i- i..1, n 3;.9Fy044,r-Y ,>,', 1 11,.i'.D,'J `
.
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.,o��- ,.
SBD-6423 (R.08/88) -.�
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t �y
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i) State of Wisconsin \ Department of Industry, Labor and Human Relations
SAFETY&BUILDINGS DIVISION
•
SBD-6423 (R.08/88)
tip
41 Ci State of Wisconsin \ Department of Industry, Labor and Human Relations
SAFETY&BUILDINGS DIVISION
May 18, 1989 201 E.Washington Avenue
P.O.Box 7969
Madison,Wisconsin 53707
Bernard Sturgul
2610 90th Avenue
Woodville, WI 54028
Petition No. S89-00947-P
Dear Mr. Sturgul :
Re: Bernard Sturgul - Residence
Onsite Sewage System
SW,SW,13,29,16W
Town of Baldwin, St. Croix County, WI
Section 145.24 (1 ), Wisconsin Statutes, and s. ILHR 83.09 (2) (b), Wisconsin
Administrative Code, allow the owner to petition the department for a variance
to the installation for a onsite sewage system to replace an existing onsite
sewage system at a site which is not in full compliance with the siting
standards in the administrative rule. The system design proposed should
protect the waters of the state from contamination. If this system becomes a
failing system or contaminates the waters of the state, this variance shall be
rescinded.
The petition for a variance requested to s. ILHR 83.23 (1 ) (d) of the Wis.
Adm. Code was considered on May 12, 1989. The petition has been approved.
The rule requires a mound system site to have a minimum of 24 inches of
suitable natural soil .
The variance requested was to install a replacement mound system on a site
with 13 inches of suitable natural soil .
All of the data and statements submitted on behalf of the petitioner were
considered. This variance is specific to the subject petition and cannot be
used for any additional modifications.
St erely,
,0(
01(
Richard Meyer, Architect
Director, Office of Divii n
Codes and Application
(608) 266-3080
RM:KS:2428i
SBD-6928(R.'0/87)
-- .,1 .....,
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A ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
o - ..��t"ii'��" 4 � ST.CROIX COUNTY COURTHOUSE
;,: w ----— �. 911 FOURTH STREET • HUDSON,WI 54016
(715)386-4680
May 4, 1989
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
Dear Sir:
An on site investigation for the Bernard Sturgul property, located in the
SW4 of the SWk of Section 13, T29N-R16W, Town of Baldwin, St. Croix County,
revealed suitable soils at a depth of 13 inches, below which seasonable
high groundwater was noted.
This site should be suitable for a mound system.
Should you have any questions, please feel free to contact this office.
Sincerely,
t'h-3 C�-o (2 4 L ca'1/�"S
Thaws C. Nelson
Zoning Administrator
TCN:rms
T ON SOIL BORINGS AND SAFETY & BUILDINGS
LEPAMENt. OF REPOR DIVISION
DUSTRY, P.O. BOX 7969
HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707
HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145)
OWNSHIP UNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME:
LOCATION: SECTION: �)p,��Dw f N .,_ ,�... "~
Sw '/ sw1/ \3 /Tz,4N/R 1 E (o 1:,‘.J'Ili'Ili COUNTY: ( WNER 2 BUYER'S NAME: MAILING ADDRESS: 10 90
_ woODVIL_L-E, J1 SVO2 3
ST' •Z�\� � �` �� BTU G DATES OBSERVATIONS MADE
USE LE DESCRIPTIONS: PERCOLATION TESTS: I
NO.BEDRMS.: COMMERCIAL DESCRIPTION: ❑New �-Replace I 1PROFI
I
esidence - PN -
RATING:S=Site suitable for system U=Site unsuitable for system
o.0 S rT-% W Z8-8 9 W--( '71) 1..1 Est.S o by
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional)
S Du c s _u c s Eu n s Zu .�s ___Al ov>� "3 0' x. 1•..(o
Surr,P03k--e. LA-)11-1"i UKIZI PlPJC 131-F'PRoVEi� I
DESIGN RATE: I If any portion of the tested area is in the `
IIf Percolation Tests are NOT required
1 'V
under s. ILHR 83.09(5)(b),indicate: 1V Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
\ y1 99.E 1J(!)n.)a, Z3 SLT� P/V6E Z. of
B z -2:7 R-I.S f. ) 3 _
3 30 q L.9 ? 11
B y 33 R s.-1 11
S L0 99.9 18
B- 6 36 X1$ ,8 - 13
—1 -z.S \op.$ ,. 8
B- ' 1-10 \ l . ) 1 e"E, l?NcE 3 of
9 ■S 1oZ.O '• 8
B- lO 3g \OI. I 1)3
\\ 18 ci$.6 1 U
3-7 goo.0 B- \z
I0 ■OZ.S K.30'-1E )'/ PERCOLATION TESTS RATE MINUTES
TEST DEPTH WATER IN HOLE TEST TIME
DROP IN WATER LEVEL-INCHES PER INCH
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD PERIOD 3
\'3 �0 30 _ 1I/)6 - 5/g 9/8 —
S
P- 1 30 S/g 51 b
P- 3 ZO 13n4, 3/y 13//b 37
P- 3 \': 3� .5 is 9/46 9)/‘ 53
P. S \3 t/ I 15//1,, 3 Z
P. , 13 3 0 1 B 1/— I/-Z 64
P- 6
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PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings the direction and percent
of land slope. 1.. \. Z.•3 / `?/tC�e-6 3
SYSTEM ELEVATION C+-nu . 7.: o F S f\)v��
0"4 3- I- E'4. 100.0' 01.) lY/ f
11,11
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I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print): TESTS WERE COMPLETED ON:
AIZ`1- UAZ
L. w •G :e S - 2- 89
ADDRESS: - ' t X 7 CERTIFICATION NUMBER: PHONE NUMBER(optional):
1 IULR h ILLS) [lOt SL(0 .2-Z. S-A, --)tS-1-I2S- 0/ b5
CST SIGNATU E:
DISTRIBUTION: Original and one copy to Local Authority,
Property Owner and Soil Tester. Pl'NGE 1 of
DILHR-SBD-6395 (ft 10/83) —OVER -
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SOD DESCRIPTION FORM
(Attach Soil Prof ilc Location Map On a Suparate Sheet)
CLIENT: -.6 E.Z11Z 1]
STU\--Q., L) L LINEAR LOADING RATE:
PURPOSE: EN pal-C.))N' )1313 FOR SO/ (- fl‘-/IS Ufa PT?U)3 SYS EY-1 SLOPE: S °/O
DESCRIPTION BY: 9�THvc�
L_ . LAJGG�z-E``sf� ASPECT: 1� 1 0_ _ _
DATE
Lf- -as- gci CURRENT LAND USE: -i\STU
COUNTY/STATE: ST'
c-?-O 151 C. UU ...Yr-I , i VEGETATIVE COVER: Z-A-SS
LOT DESCRIPTION: 9T, of SLA.)//v-Sw//v- S s )3, 1-194.1/ R./6w DRAINAGE CLASS: Sc'`'-2 T POORL-y apizA/i,J6-0
LOCATION:
�lw K OF -�>\L w I N GALLONS PER SQ. FT. PER DAY: -DES t<51-.1 ZJCTT 0 .2-Z
SOIL SERIES: �Rs�)41`
PARENT MATERIAL(s)/DEPTH:
PtiYSI flAPliL' SAIL CIASSIEICAIION: —
HORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS ' PM .BOUNDARY REMARKS
(in.) (noist) Gr. Sz. Shp.
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OTHER SITE FEATURES/NOTES: nn
C.l�. i i l'1/61&_1-i ' s-Z-$-`j 5-'6
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LIMITING FACTORS/DEPTH:
Signature Date CST #
•
HORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PH BOUNDARY REMARKS
(in.) (moist) Gr. Sz. Shp. COATINGS
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OTHER SITE FEATURES/NOTES:
Signature Date CST #
LIMITING FACTORS/DEPTH: