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HomeMy WebLinkAbout012-1025-80-000 . GO \ j 2 4 ® 0 \ � m ¢ \ � \ � � W � ƒ \ � m � $ z U. 7 k � » \ E 7 \ 2 n $ � / j \ 0 z \ % j _ / $ a ■ § § z :!t . t m e t 2 f r ® D E ,� _ ON \ B < < \ 3 z z � \ \ « � . 2 « ) E $ ~ I _ © - B j L \ / / k m " S ° . o � < g 2 2 } ƒ ) 7 (D \ \ § k ° • k ; z IL a. CL \ o B M (01, ° U) -j U / } § § ; » \ / § \ (D ) [ a ~ < t e J z n t � ■ 0 - \ § ® # = It 6 0 ® \ 8 ƒ c S o § \ \ \ \ \ r [ i k 7 / \ % \ \ ; 3 ) { f / / - w \ k 3 \ 2 o ) _ ) / 2 ± m 2 ( kIL — , : " a » E k ° § k 0 a 3 2 k v Parcel #: 012-1025-80-000 02/01/2006 04:06 PM PAGE 1 OF 1 - Alt. Parcel#: 09.30.17.140 012-TOWN OF ERIN PRAIRIE Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner %WILHELM BORGSTROM O-BORGSTROM, ELEANORE M ELEANORE M BORGSTROM 5310 W 137TH ST SAVAGE MN 55378 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1612 CTY RD T SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 09 T30N R1 7W SE SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 09-30N-17W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 886/141 07/23/1997 532/584 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 104732 Use Value Assessment Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 45,000 127,000 172,000 NO AGRICULTURAL G4 35.000 5,700 0 5,700 NO UNDEVELOPED G5 2.000 200 0 200 NO Totals for 2005: General Property 40.000 50,900 127,000 177,900 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 13,100 85,700 98,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 130 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPARTMENT OF INnl1STR^ INSPE TION 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: SE4►SE4iS9,T30N-R17W FE/CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Erin Prairie ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound PE L R: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Marvin Kirschbaum Route 3 Ne wRichmond WI 54017 1- f? BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF. T.ELEV.: CST REF.PT.ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Calvin Powers Jr. 1563 St Croix 119510 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV: TANK OUTLET ELEV: WARNING LABEL LOCKING COVER w / o PROVIDED: PROVIDED: C ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: I BUILDING: VENT TO FRESH /� ALARM: FEET FROM LINV AIR 1N� ❑YES ❑NO C El YES F-1 NO NEAREST--- ? f v d•�� DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: P PUMP/SIPHON MANU ACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: � "0 a445 YES ❑NO (� V .�'�7l� (� ES ❑NO ❑YES NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LIN ' �y �� AIR I ET: PUMP ON AND OFF L ES ❑NO NEAREST� /� L/ SOIL ABSORPTION SYSTEM. Check fhe soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: I MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN 3 the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: k PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS 1 GRAVEL DEPTH FILL DEPTH DISTR.PIPE I DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF 1PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET:I ELEV.END: PIPES: FEET FROM LINE: AIR INLET: T�� MOUND SYSTEM: NEARES 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 TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; YES ❑NO YES ❑NO DEPTH OVER TRENCH/BED I DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: f EDGES: J / � ''S ❑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: 91,�� TRENCHES: DIMENSIONS J MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEVATION AND ELEV.: ELEV.: DIA.:� ELEV.: PIPES:' DA., �J DISTRIBUTION HOLE SIZE: HOLE SING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION .2V APPROVED rP�yLA�NS YES ❑NO IL`I YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY I WELL: BUILDING: FEET FROM LINE• YES ❑NO K]YES ❑NO NEAREST—� Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710(R.06/88) Zoning Administrator 4— SANITARY PERMIT APPLICATION :10'ILHR In accord with ILHR 83.05,Wis.Adm.Code couNTY`,� swnn�s l 0 J �s�eww `J � - STATE SANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than 1 1 9 S/D 8%x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. ST TE PLAN I.D.NUMBER I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. S g'O 8 IROP TY OWNER PROPERTY LOCATION AVA) s 5 '/4 '/a, S 3 , N, R (or W RTY OWNER'S AILING ADDRESS LOT# BLOCK# STAT ZIP C0 9E PHONE NUMBER SUBDIVISI N NAME OR CSM NUMBER 11. TYPE OF BUILDING: (Check one) CI NEAREST AD ❑Stat @OWft @d ❑,VILLAGE -r' ❑ Public 4�1 or 2 Fam.Dwelling-�#of bedrooms PARCEL TAX NUMBER(b) III. BUILDING USE: (If building type is public,check all that apply) 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/C Wa 5 ❑ Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. 9 Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 W Mound 30 1:1 SpecifyType 41 El HoldingTank 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 13.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 Feet Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Expp. INFORMATION New !sting Gallons Tanks Manufacturer's Name Concrete Con- Steel glace Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's ame(Pri Plu er's Signatu o ) MP/MPRSW No.: Business Phone Number: 1- Plu b 's Address(Stree City,State ip Code): IX. COUNTY/DEPARTMENT USE ONLY Disapproved S tary Permit Fee(Includes Groundwater a e ssue I ing Agent Signature(No Sta s) Surcharge Fee) Approved ❑ Owner Given Initia M �j�/a Adverse Determination W / n M . 41L—� X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly Pib-67)(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. 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 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. 11. 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; (Jose 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 . L 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) + APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property Location of property 1/9 _1/9, Section _, T O N-RW Townshiplt�Olj� /rte/, ,__ Mailing address .� Address of site Subdivision name Lot number Previous owner of property Total size of parcel Date parcel was created _ / , 7 7 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes _No Volume -Sa D and Page Number / 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 BEAL 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 warranty, end p r corded in the Office of the County Register of Deeds as Document No. °� .6 0 ; 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 been duly recorded in the Office of the County Register of Deeds, as Document No. ) . PL/1" Signature of Owner Signature of Co-Owner (If Applicable) Date of Signature Date of Signature DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 3707 HUMAN RELATIONS (1-163.090)&Chapter 145.045) LOCATION: SECTION: pp TOWNSHIP/MWA4GWALITY: LOT .:BLK.NO.: SUBDIVISION NAME: N/R, t (or COUNTY: O NER'S-BUYE S NAME: MAI ING ADDRES S e USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMM ERCI L DESCRIPTION: PROFILE DESC IPTIONS: PERCOLATION TESTS: ®Residence ❑New Replace I &— 21-9f RATING:S=Site suitable for system U=Site unsuitable for system ICEIS ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING fil RECOMMENDED SYSTEM:(optional) ®U ®S ❑U DS ©U OS ©U DS OG�✓D I f Percolation Tests are NOT require DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING OTA D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH t1j, ELEVATION OBSERVED EST. IGH T TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- B- / _ B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER I4£I-FE9^ AFTERSWELLING INTERVAL.-MIN. PERIOD 1 PERI 1)2 PER1,90 PERINCH P- f P-, r� P- 47 AIAA&& -310 Y-2 P-_ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION AI /` IRY ............. ..._ ....._ _,.� _._... ____., ,.,._... 3._., 111 _.. {....^ �...... ..F._ .,-- ....._..�....�._ ,... ._,_..,_g.... 4i✓/�-3„�A/GY� lJ .ff�"- b-.__ .. ,-._ t.___,� .6� ._ _ 'F ---Y- '- .,..-... ......�............_����C,• _ • '` _. ' _ r -. ---[ N ......., �.p } 1 I,the undersigned, hereby certify that the soil tests reported on his form were made by me in accord with the procladures#4 jethods sp 3cified 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 belie . CIS' NAME nn TESTS WERE COMPLETED ON: ADDR CERTIFICATION NUMBER: PHONE NUMBER(optional): CS TUBE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — _�_ mew INSTRUCTIONS FOR COMPLETING FORM 115 - S ® - 6395 To be a cornplete and accurate sail test,your report most include: 1. complete legal description; P, Tire use section must clearly indicate whether this is a residence or commercial project, 1 MAXIMUM number of bedroorns or commercial use I)lanned; 4. Is this a new or replacement system; E. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately Iccatint your test locations. Drawing to scale is preferred, A >eparate shoet may be used if desired; S_ Make scare your benchmark and vertical elevatioei reference point are clearly shown,and are permanent; 0, cc plete all apf.iropri<ate boxes as to Mates, rarari s,addresses, flood plain data, percolation test exemp- *icr3 , ii approlarrate; 10. if th(e information lsuch as flood plain,elevation)does riot apply, place N.A. in the appropriate box; 1 1. Sign the form and place your cur rerr't address acrd your-certification number; l`. Make legible copses and distribute as required. ALL SOIL TESTS MUST BE FILED V ITH THE LOCAL AUTH RITY kVITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS eri1 Separates and Textures Other Symbols Stone (over 10") EAR — Bedrock coma cobble r3- 10") SS — Sandstone ir- __ Gravel iomJ r 3",l l_S - L,,rest one — Sarad HGVJ — High G10undwate1- s Coarse Sand Prrc Percolation Rate rued M(iium Stmd VV ,r e§ -- Fine Sand Bldg _ B iildmg k Loamy S.)nd Greater Than `cl - Sandy Loam < - Less Than a-: Loam Bn ._ Brrr,r,,i s.€ - Silt Loam BI -. (3 rck si Silt Gy - Gray lei - 'Clay Loarra Y '`ellovv s i Sandv flay Loam R Fled sicl Silty Clay t-ohnn Tarot Tir?tt es s Sandy 'Clay w/ ... �v�`h Sic ._ Silty Clay fit fm v, hna, Nair; — Clay r.c i a!rrr;or" i 0 a,s€, i7➢rT3 — many, rT[C?€`ttLirn distinct P - prominent HVttL — High water level, Six general soil texttmes Surface vvater" for liquid waste disposal BM -- Bench Mark VRP __ Vertical Reference Point y TO THE OWNER: This soil test report is the first stet, in securing a sanitary permit. The county or,the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and ra permit application must be submitted to the appropriate local authority in order to obiain a permit. The sanitary permit rnust be obtained and posted prior to the start of any construction, STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER t T ROUTE/BOX NUMBER - FIRE NO. CITY/STATE I A4 ZIP PROPERTY LOCATION: 1/4 X1/4, Section , T N, R_,ie To of / M120k , St. Croix County, ivision ,(i�L - , Lot No. . Impr use and maintence of your septic system could result in its premature fail 4', ,o_hanAle wastes. Proper maintenance consists of pumping out the septic tan k'. ve 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 prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their ,,.systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after Inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein as set b the Wisconsin y 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. /J ) S I GNED)&1:114.I"'-. .1d 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 � w State Of Wisconsin ` Department of Industry, Labor and Human Relations SAFETY&BUILDINGS DIVISION N: RF: Plan Number". son 04 + • o I f 1+ SBD-6423 (R.08/88) State of Wisconsin \ Department of Industry, Labor and Human Relations SAFETY&BUILDINGS DIVISION J y df i 5 SBD-6423 (R.08/88) -- - -- --------------- l State of Wisconsin \ Department of Industry, Labor and Human Relations SAFETY&BUILDINGS DIVISION November 7, 1988 `` 201 E.Washington Avenue P.O.Box 7969 Madison,Wisconsin 53707 Marvin Kirschbaum Route 1 , Box 641 New Richmond, WI 54017 Petition No. S88-04801-P tear fir, Kirschbaum: Re: Marv* Kirschbaum Residence Onsite Sewage System SE,SE,9,30,17W Town of Erin Prairie, St. Croix County, WI Section 145.24 (1 ), Wisconsin Statutes, and s. ILFiR 83.09 (k) (,-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 November 1 , 1988. The petition has been conditionally approved. The condition being that in the event of failure, the mound system shall be replaced with a holding tank or other off-lot system. The rule requires that a mound system have a riiniraum of 24 inches of suitable natural soil . The variance requested was to install a replacement mound system on a site with,2l inches of suitable natural soil . All of the data and statements submitted on behalf of the petition were considered. This variance is specific to the subject petit i0 r atop e used for any additional modifications. Sincerely, b Rich rid Beyer, Architect I Director, Office of Uivi /io, Codes and Application -% (608) 266-3080 i Rti:PEP:0970g cc: Leroy Jansky, Private Sewage Consultant - District 6, Chippewa Falls Thomas Nelson, Zoning Administrator - St. Croix County Calvin Powers, Jr. , Plumber SBD-6928(R.10/87) ST. CROIX COUNTY WISCONSIN 1 4• {' 1 ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,WI 54016 (715)386-4680 October 21, 1988 Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Marvin Kirschbaum property located in the SE 1/4 of the SE 1/4 of Section 9, T30N-R17W, Town of Erin Prairie, St. Croix County, revealed suitable soils at a depth of 1.75 feet, below which high groundwat er was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, 1 k C) G/a �- /V.t a-0t-% Thomas C. Nelson Zoning Administrator TCN:rms A ` u ` .._..--- --- S88 - 04 RECEIVED r woo 11988 GA, b W .'� OFFICE Apps , 1i4il5cOt'in�7"rtment of Industry; Office of Divison Codes and anon Labor bred 4uman Relations ONSITE SEWAGE SYSTEMS OnsiteSewa ss H l S 10 Illuildings Division 7-E.-W 1ingto�lAVe t�`'41 t �: y ,�a ` P1 AN An APPROVAL APPUc on l o.Box 7 9,Mar ian,vr�r)3iro7 x fl $ft)266 b815 "" 5R1t CF1O>IeS: Please fill in all applicable data antl submit this form with plans. Plans will not be reviewed until alkfees art recew The rover"siI of this form describes most of,�the required plan information Further requirements maybe cootairlect th 1�ie Wisconsin Ptuettbing tjode,riiihich can be purchased from the department of Administration,Document Sales and Distribution,Z02 South't'hhdmtorl Ave.,�P.*.Box 781 Madison,W153707,Telephone(608)266-3358. Plan Limber Previously Assigned 1. PROJECT' INFORMA7104(Type o r print�tearly� ltd 04 5 bmittin arty(Plans eturned 461 same) Project ame dress„�P. -Box#or Rural Route Project Y;pss or Legal Description Az j1 J Gty r illage State , Zip Cotfe City ❑ County Village E] of ` e ephc rie No.(include area code) Town sin Nam OWr►Qf Telephone No (include area code) Telephone No.(include area code feet Cess,P.O.Box#or Rural"Route Street A4dre st,P.O.Box#or Rural Route 5. pity or tJelage State Zip Code City Villag State Zip Code m"bh'Ai W A�'ION FOR: Cf Experim*ntal Mound System []Holding tank '• Q Construction [,I,Large System Q Conventional Gravity System ' Q 4�qurtdwater Monit�bnng x r s ,T ( dielrisit5n dradi talon For Var►anca S stem m)Wzeplacement Q At [3 Pressunrled System ❑ Sys#em in Flood Plain(attach SBD-6698) 0 fi>6hEr Alternatives Rf.COWIPLITATIOI+IS (include taxistirlg tanks) FEE SUBMITTED FOR OF610E US fllli1li€£Aii�CN£CKS PAYABLE TO,SAfIY I$BUILfNGS Dtti!MSIQf�I. z' ` 1,500 gallonseptictenk $ 50.0 Ib` 1;501- 2,500 gallon septic tank $ 60,90 2;50 t- 5,000 gallon septic tsnk $ 80.00 t n s t. 5,001- 9,000 gallon septic tank $100-00 e r 9,001 - 15,000 gallon septic tank $150.00 -- Over 15,000 gallon septic tank $250.00 t�r1' +E 9 $ 30,00 500 1,000 gallon dose cMamber ft S lwQ01- 2,000 gallon dose ct3arrI $ 50-00 n ,7. i g ' 4,000 gallon dose chamber $ 70.00 j. 4,001- 3,000 gallon dose chamber $ 90.00 k,` 8,001'- 12,000 gallon dose chamber $110.00 — 1, Over 12,000 gallon dose clamber $150.00 ;i m.' 150- 5,000 gallon holding tank $ 30.00 n. 51001- 10,000 gallon holding tank $ 55.40 Over 10,000 gallon holding tank $100 0 --�-- p. Revisions $ 20.00 q. Groundwater Monitoring-Per Site $ 32.00 (other than a proposed subdlvislor) r. Petition For Variance: Setback $ 25j00 ...... Site Evaluaition , d Subtotal: / s s. Priority Plan Review: Enter same amount as Subtotal ' Total Fee: ( �X! SBD 6748(R.OA'd8) NOTE:Fev a pursuant to Was Adm Code,Chapter lnd 9,at:d OVER are ioct to r hange ant,ually ST. CROIX COUNTY � k WISCONSIN ZONING OFFICE ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET 0 HUDSON,WI 54016 (715)386-4680 October 21, 1988 Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Marvin Kirschbaum property located in the SE 1/4 of the SE 1/4 of Section 9, T30N-R17W, Town of Erin Prairie, St. Croix County, revealed suitable soils at a depth of 1.75 feet, below which high groundwat er was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator s8 - o:4go1 TCN:rms ar I ETITION FOR VARIANCE WISCONSIN DEPARTMENT OF OFFICE USE ONLY OF A RULE IN THE INDUSTRY,LABOR AND HUMAN RELATIONS Petition No. WISCONSIN ADMINISTRATIVE CODE DIVISION OF SAFETY&BUILDINGS E—Number P.O. BOX 7969,MADISON,W1 53707 �ompanv a Building Occupancy or Use Agent, 1 Esc hB4 u Y� �,. ?l�T— - &V > Tenant Name,if any Street&No. fV6m4?- RE 3 B StSRSL&No. Building Locatio Street No City State&Zip City State&Zip City I County Phone uy " Phone Plan Number(s) Name of Contact P#Irson 3'k IF KNOWN _ 1. Rule '=t"�5.- 61 3- "7 31/206f the Wisc>:insin Adminstrative code cannot be entirely satisfied because: J —.,7 ——— a ..�' cyt.ac.._ ----------- --------------- ------------------------- QF Rt4<Iz,IJ �*! 2. 1 n lieu of complying exactly with the rule,the following alternative is proposed as a means of providing an equivalent degree of safety: "- '! °- �_s e+`1-r, ups _ h R-S Y 64 _ 5-'t' .A_ LA"S 4{ -'-J obi_ 7�Jt._ /I 7`0 ___ ————— - - — ----- ——————— --- ------ -- -------- — 3.Supporting arguments are: _ - s _�s___ a.�__ KisJ?l�«�-- !ale ►-, --�.2d _/ eLh__.s_/Vv __107{4e A__-_ ��1zI_1alol� _)n�>t�l __A41--_�,►s��— 1�� n� aH� _ �� �,k,¢ blimp _ VERIFICATION BY OWNER -PETITION IS VALID ONLY IF NOTARIZED For Fee Information See ILHR 69.15 or Contact The Department at (608)•267-7843 MOTE: Petitioner must be building owner. Tenants, agents, designers, contractors,attorneys,etc. may not sign petition unless a Power of Attorney is submitted with the Petition, being duly sworn, 1 state as petitioner;that I have read (NAME of PETITIONER Please type/print) the foregoing petition,that I believe it to be true and I have significant ownership rights in the subject building. (� S 8 - 04 8 0 1,L* OFFICE USE ONLY g,ewra of owns. Date Received Amount Paid Receipt No. Subscribed and sworn to me this date: /6),W County,Wisconsin. .i�to�ll Department Action Notary '-J=`--„- Office of The Secretar,' Date My commission expires:._. . SB-8 (R. 12/84) REPORT ON SAIL BORINGS AND SAFETY&BUILDINGS E1tARTMENT OF DIVISION (NtUST R Y, LABOR AND G P.O. BOX 7969 L L BOR RELATIONS PERCOLATION TESTS (115) MADISON,W163 (1-163.090)& Chapter 145.045) L. f ,: � ' E T ION: TOWNSHIPlM6IWb6EPACiTY: OT,/10.:BLK.NO,: SUBD VISION NAME: / NA (or / 1611 _ COUNTY: NER'S BUYlt AME- M I I G ADDHhb *� s e DATES OBSERVATIONS MADE NO.BEDR O M I DESCRIPTION: E S: OUResidence ❑New ®Replace RATING:S=Site suRable for system U-Site unsuitable for system O��Tf®�, M��,a� ►N_C,D� Q� . SQ� ©�L H0�1NG TANK:RECOMMENDED SYSTEMaoptionall If Percolation Tests are NOT require-& ESIGN RAT E^ If any portion of the tested area is in the under s,H63.09(5)(b),indicate: Fioodplain indicate Floodplain elevation: PROFILE DESCRIPTIONS B WG TA P N H TO ,R UD ATER-INCHES CHARAC E OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED ST.HIG H S TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B� B-" > / - " o% C� PERCOLATION TESTS icGr TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V INCHES RATE MINUTES NUMBER IfrGIIE9, AFTERSWELLING INTERVAL-MIN. PERIOD 1 PER1002 Q2 PER INCH 1­7 A14 vo P- ` P* p, .3' P. P. P� PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances,Describe,what &to the horn =ontel and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent' of land slope. i SYSTEM ELEVATION pla�el� .co t Ai T tN M 1 t.,.. { 1 + I I C l/ a 3L� I 1,the undersigned,hereby certify that the soil tests reported on Ithis form were made by me in accord with the pro�ce�dures�t ethods sp cified 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 befiel. 15 NA V, rin TESTS WERE COMPLETED ON: r A DR��� : I �r CERTIFICATION NUMBER: PHONE NUMBER(optional): �N f �'/�f 7 ,CS PTURE: a DISTRIBUTION:Or and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 Ifi.02/82) —OVFR -- ,,.... .....,..,... .....w-. _.._ ,.„,...... -..,.:-..,.,,y..,...._ .....,.................,.....r..,.,,.T.,e,,,,>.. ..,,,�,,,,,,-......_ -._”' ,"�yw+."„�-•*""''^ -^^..-^far �#,Ai."'e'°R'°'-P '` DESIGN MOUND SYSj t L A)f- A n a mound s yste* for a /4'-'s RT i a h characteri!WCS are, x Q un tier or w�Tf vt ' lanasiope 41 hrcOlati" s cot ► d� ctw** a a rlfstribt ion system F s� aindistribue► sys �ena et� a rff t q,. " w „ < R iz `MME A#so PTION nwd ©1� =trench zl- ' ) orb xC°nch 04 ( �. �� ��, 6 ati �, * ��w +_ s�. S ,z q � ®��h`••.S ti��r�• �y� z � �� y"�- <4 •24 gal/ft/d}y. ' 3. MOUND,IiEjgHT ft A) Fill depth (o) - 1 th E w p + slope A 8) Fi l dip 13 Pe C) i d o trench derp !,h , SO i " ' f y` E p topsoi t�� tth' t 'r } ,'�� "v R (Q� �}1•. t Lj aq.n.uL " R Step 4. MOUND LENGTH ; k A) End slo" (K) • D + E1 + F '+ N x 3 • ft. M/ 4 V1 B) Tota l mound l en dh (L) B + 2(K) l Step 5. MOUND WIDTH Al) Upslope correction factor = ©©pp A2) Vpslope width (J) (D + F + G)(3)(factor) r ft. -.I-,S3 j (3). BU 0 slope correction factor = 82) Downslope width (1) - (E + f + G)(s)(factor) * fit. IB • C0 Total wound .,width (W) for bed - J + A + I C2) Total mound width (W) for trenches � . l x + + (no. trrenches -1)(c) + + .I ■ .30,3 IL (C) Step 6. BASAL AREA _ 1� A) Infiltrative capacity of natural soil �.n Y,. B) Basal #rea required • wastewater flow r natural soil nf1'ltrativ ca city = sq. ft. C0 Basal area available for bed for sloping sites B x (A + I) sq; ft. C2) BasoJ,areq, avai le for trench for sloping sites /STS e w 4 (j + --6gjmZL sq. ft. C?V Basal area available for trench or bed for level $i sBxW ■ sq:, ft. sic;n:2, Licanse T :u f S _ 8 8 04 8 Date. / x ?3, 7�5'�X ,3p,3 - ��3 t � d � c 4. �fR'•hT- 7 5te8r DISTRIBUT1ON SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 44/ n. 1) Hate size . 2) Hole spacing 3) Distri buti on pipe length tw;r�e 'T i( 4) Distribution pipe diameter w 2 in. 6) Spacing between distribution pipes 6') Distance from sidewall to distribution pipe no 7B) DISTRIBUTION PIPE DISCHARGE RATEft. 1) Number of holes per pipe - 2) Flow per pipe ' A 7C) SIZE MANIFOLD " 1) Manifold is � central/ end 2) Manifold length • ft. 3) - Number of distribution l i nes 4) Manifold diameter ■ in. � ' r 7D) SIZE FORCE MAIN r �. � GPM Minimum dosing rate ' 2) farce main diameter �601f in. Rfi 3) Friction loss' - ©o F 7E) TOTA4 DYNAMIC HEAD RECEIVED 1) Vertical lift ft. 2) Friction loss c„-; 1.Q� n;�ri�l�N ft. ` ft.`� � 3) System head 2.5 ft. • s 4) Total dynamic head ft. � ,al{�ia 2 ra. 0 4' 8 9, S8 8 L �J SO : dd 7F) PUMP SLLECTION ' 1) Plump selected will discharge GPM at ft. total dynamic head. 2) Pump model and manufacturer J` yl'I_ nc� WE prr 7G) DOSE r'VOLUME 1) 10 times Oid voI of di i buti on lines * ga /COX G�� h . 2) Daily was ewater vol `e: = doses/2 4 s R 11,12E2790 /4yd e * 3) Minimum dose volume /cyc1 VC 7H) DOSE ,CHAMBER 1) Minimu" cap, ity required 9a1• 1 . , RECEIVED NOV 1 1988 ^/OFFICE OF Di41SION r Ao � '► .! , A�/3 lYtin� Jf�Cr�, i✓� I1 Ar S*i'1 t � J -4 /l�L�,O _/���1.11 o arJE G'�•"� ye AA 011 c fl:�411 , 3 S88 - 04801 � ;. s s ��.� y cry?►�.... �°k °'�s�.�,� ,. .:,,y ag .i6 ' g �s�„ b . ., ,, v �-� �- z � . a �- . .fir�-. ryr �"`�.., � � ti. ';� '` % . �,,;�� , �-... :.�.�� M. ,, �� �� -� �� � � ',�) �:q }i .�S �� tg .C1R.F � i . �, �1� (2 # 1 4•'- F S� owl Marshlay. Or ir OT Snthet�+c Coiernq }. a^ �� DisrbufOn '•!� z r Medium S and.` _...... . G T0ps0i1j _ Y, . , ,.. .—.,•s^' rte i �•4 � t�t¢weEk � Sao 01 -2 , Isar C�e M� �• V A�gra4e" � p Ft� +! �� b ,, Crp�as Section: d# A Mound Sytter+n Usir►q A F' : A For ,lr Absorption Arbo n Ft 3 r. gqfN��kk� s� ♦ .T IWO 4 ids •} Alternate Position I _ Ft, s � � of Sri Ft � �. k FQrGe Ma W P. rl �. 3 " Dter ItriUt'00- �. . PCPs ' AoIrw at ' Obsary 'lion Pigs- Permonent Mq�rksrs.' �7 A t�'• " Plan View Of Iour i Using A eed For The Absorption Area ��. Al g. , �•� �� � '�k�,�. .r �. � . ;�,�� S r- u �� fti , •,�, . . A P494 s le Perforated Pipe Detail. view )POrforroled cad cop PVC Pipe • Holes LeceN4 On Bottom, t Are tiloody Spec#0 F Q w D'S ibr tK>d 19 . r , M1 Lail Hole Should Be 7 Neal To End Cop DitiriD� ulion�PipLoyoul P " X 4 Inches A4��Ic Signed Hole Diameter � _ Inch Lateral License Number; S-Tem Force Main osslTt z5r # of hales/pipe Invert Elevation of Laterals-A& Ft. s i , 5 Pa +9 mf 83 rE"i S C SPa ,r a TTI Al ct �a to to to r+ .� .,._ r. 0 -� -� R K !-.- :3 O r L.q M :3 L4 Ct R; a s,� a v' tr a � r a w -ay r.. r Ilk A PAGE 9 OF_Z PUMP CHAMBER CROSS SECTION AND SPECIFICATIQUS t+InresaePn moarrr�sarma-ap r�"s� �i��l�N✓ �.SG�+-�,�'eM VCIJT CAP Nk/✓ /i'�NiY,o.�r0 11/J,� M'C.X. VENT PIPE WEATHER PROOF APPROVED LOCKIIMG Syd1� JUUCTIOM 90X MANHOLE COVER 25' FROM DOOR, WINDOW OR FRESH IE"MIU. AIR INTAKE k I GRADE If r-"f COWDUIT ttili_.ET , R G I. OXAHTESEA vie I II ---- r drotk APPROVED JOINTS APPROVED JOINT C A W/C.T. PIPF. 1J f 41< < a, �sl �`�t .t:r, ,;�� ( (I I W/C.T. PIPE CXTCNDfM(- 3' a a�I^ s 'YW ( I I ALARM EXTEAIDING 3' ,va ONTO 601.10 SC!;. t ONTO SOLID SOIL U I ON k ' �, CCy1,1PUMP�., J OFF CONCRETE BLOCK F SER EXITS PERMITTED OMLy IF TANK MANUFACTURER HAS SUCH -APPROVAL SPECIFICATIONS S88 - 04 v 0 1 SEPTIC AND � D!'�5E TAtJKS MAWUFACTURER: .11ll� .� !� s,, s NUMBER OF DOSES: PER PA4 TAWK SIZE: �. � GALLOUS DOSE VOLUME 1-71 ALARM MAMUFACTLIKER: � „�n_, ,? yaj��l �cl IAICLUO!':" C%.C':RLOW: GA1.L�ONS MODEL WUtABER:_ZZY2 CAPACITIE : A= IGNE5 OR GALLONS SWITCk TYPE: � L,tIT.;'' s 1 B= NES OR GALLONS PUMP MANUFACTURER: N. C= ES OR .Zs`rGAL01�15� MODEL NUMBER: 3 4,N D w�INCHES ORIV GALLO►JS SWITCH TYPE: OTE: PUMP AMD ALARM ARE TO BE PUMP DISCHARCIE RATE GPM INSTALLED pN SEPARATE IRCUITS VERTICAL DIFFEREMC.9 ei9-wCCU PUMP OFF ARID OISTRIBUTIOM PIPE.. FEET Q + M7IrMI'MUM METWORK SUPPLY PRESSURE✓. . . . . . , 2.5 FEET ♦ �r ._,FEET OF FORCE MAIM X ..,.FJoartFRICTIOM FAcYaR..—Lle -__ FEET OFnP,+%j IQT';n�a , S TOTAL DYNAMIC. HEAD = Y FEET C!� eo IUTERWAI.. DIMEW61OWS OF AUK: L.ENCvTH ;WIDTH ....;LIQUID DEPTH / SIGIJED:�. LICEAISE AJUMBER:�lP--� DATE: � p. z ;" abmersible Effluent., P '� a 140 z a 3 wYM a t 120 Y 100 yA 80 60,; 1�rp d s � WP 40 c WPMO3,1h H.P. } y „ MINI 3 WK3,1/3 H.P. 60 4 l so'{ 0 20 4 C �� G palls pof MIMI!! nr c lzl 888 ° 04801 TH.P. ofow Na VOW P11 .x' 4. WpppltE 1t5 94' WPB it! E /760 Yo - WPO317E 230 10 41 WPHO9111 80 WPt10512E 23Q h _ 230 3� WPHO@32E _ 30 t; WPHOS9�E `WPM0T12E 23Q � �♦ 04 t q 5 64 WPHOT334 � 1♦ K.. ,1l 9,60; w HIWE �rr� wPf„ E' 133 WpM1512E _• + WpH1532E 20M230 11:3 460 WPH1694E 133 292 1 A WPHM1512E 10 !.2 WPHHt532E 20d230 30 8 f W MH15UE 460 .i �7 $PECIFICAT�O+'15 ARE SU9.1 GT TO CHANGE MdT ND