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HomeMy WebLinkAbout030-1060-95-000 v, p °� "' a o � I o I N ery is � I c ti I I CD a Z c U. c O II 0 � y I 3 Z " E c g z NcoLU am o o z a 0 a, w o fA IZ- Z N M 0 0 z z O N 0 ' z E N N N O c LO An z C\l �I .0 a = oil z Al io aaa CL c N co co rn rn Z 0 N N . O Q O O m C � a I ai co co z co•p d Q Z I O o M f_T C o o r d O m H c c a ( l V N t co co oN O N U FN M C H 7 C _ t6 • ��y Cl) N U) U O Z N z z Sr U) EL L: a • ea C m d c E 0 Parcel #: 030-1060-95-000 01/13/2006 11:34 AM PAGE 1 OF 1 Alt.Parcel M 23.30.19.216 030-TOWN OF SAINT JOSEPH 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 O-CONDON, ROSELLEN M TRUST ROSELLEN M TRUST CONDON 1241 O'RYAN TR N STILLWATER MN 55082-1891 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description '734 143RD AVE SC 5432 SCH D OF SOMERSET SP 8040 BASS LAKE REHAB DIST SP 1700 WITC Legal Description: Acres: 2.020 Plat: N/A-NOT AVAILABLE SEC 23 T30N R1 9W PT OF GL 8 PREVIOUSLY Block/Condo Bldg: KNOWN AS P206B LOT 1 OF CSM 5/1203 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 23-30N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/21/2000 626759 1528/174 QC 07/23/1997 827/289 07/23/1997 790/456 07/23/1997 774/137 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 83634 309,100 Valuations: Last Changed: 09/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.020 177,200 103,900 281,100 NO Totals for 2005: General Property 2.020 177,200 103,900 281,100 Woodland 0.000 0 0 Totals for 2004: General Property 2.020 177,200 103,900 281,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount 040-OTHER ASSM'T SPECIAL ASSESSMENT 507.89 Special Assessments Special Charges Delinquent Charges Total 507.89 0.00 0.00 Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER �NDOti TOWNSHIP S f. S SEC. Z3 T N-R W ADDRESS ! �/ ST. CROIX COUNTY, WISCONSIN Y-7( .-10 5, SUBDIVISION lr oU' L� '/ a LOT - LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•IHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I I i I i i I INDICATE NORTH ARROW Top dF �f v,PvEyo.PS •'#10,v BENCHMARK: Describe the vertical reference point used ?T P. O� / o • LOf G��A Elevation of vertical reference point: e' 0 Proposed slope at site: �o GJ i'x-SeA Con ,Qo TtAJk /2-5-a SEPTIC TANK: Manufacturer: CGAJ4-1 1� Liquid Capacity: 7ro pU.k h !LA . Number of rings used: ank manhole cover elevation: 6 Tank Inlet Elevation: / 3. 08 Tank Outlet Elevation: �'� ' 76 t Number Af feet from nearest Road: Front,©Sideo Rear, O LD feet From nearest property line Front,OSide,ORear,© 70 feet. Number of feet from: 6re11- / L building: �J (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE i PUMP CHAMBER Gv Manufacturer: Y Liquid Capacity: Pump Model: ZlJ4 11En 2Pu p/S3,pheik Manufacturer: Pump Size Elevation of inlet: Z2. Bottom of tank elevation: �O s �J� Pump off switch elevation: O /• Gallons per cycle: < 7 Z-• Alarm Manufacturer: G�� e to / Alarm Switch Type: /�'l f R Gtr Number of feet from nearest property line: Front, O Side, O Rear, Ft. /4-10 Number of feet from well: • 13Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: X Trench: i r Width: Length: J Number of Lines: Area Built: Fill depth to top of pipe: Z Number of feet from nearest property .line: Front, O Side, O Rear,®It S15- Number of feet from well: Number of feet from building: 31 ' (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Liquid depth: Bott of seepage pit elevation: Area Built: Has either a drop box O Zone istribution box O been used on any of the above soil absorbtion sytems? (Ch k ). HOLDING TANK Manufacturer: Capacity: Number of rings sed: Elevation of bottom of tank: Elevation inlet: Number f feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Plumber Inspector: I P on ,j ob: Dated: License Number: HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD.,HUDSON,WIS.54016 ROBERT ULBRIGHT WIS.MASTER PLUMBER LIC.NO.3307 M.P.R.S. 3/84:mj MINN.INSTALLER&DESIGNER LIC.NO.00663 i 1s 4 Q�SS 0 F<1•ST1`3I �cll 3 j3�a So► �� COP 00.&) A C�' ,Aff- r , wog 57 K lE d / - 2 0 1 / fi I 13 / 1 S T- co►�G° t y�e`NT a l IC , Th SEP ' I v � I M 1 1 1 1 1 1 1 I VLS 0 CIO 'ISO pum 70 � PowEQ 1 ��olE 1 1 I 1 l /0 S/o PE • iv',c So a- D sN S-x'ir�A HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD.,HUDSON,WIS.54016 ROBERT ULBRIGNT VS.MASTER PLUMBER LIC.NO.3307M.P.R.S. MINN.INSTALLER 6 DESIGNER LIC.NO.00863 JOATIDAf 1116 7e44 i --- -- 7- 11 - 15,Pf P • Top 5 Of All I 1VTcYPl/5 = fG hone hvy'ex '015�4,00-J57 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.B(;X 7969 BUREAU OF PLUMBING MADISON,WI 53707 MADISON, SN,WI 53 SW -R19W ❑CONVENTIONAL El ALTERNATIVE State Plan1.0.Numbat- Town of St. Joseph ❑Holding Tank ❑In-Ground Pressure ❑Mound 7-02069 Bass Lake A 4a NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECT O D E: 99 Larry & Rosellen Condon 2089 Inglehardt, St. Paul MN 55104 '��'�� 1 BENCH MARK(Permanent reference pomtl DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.. Name of Plumber IMPIMPRSW No.: Counsy Sanitary Permit Number: Robert Ulbricht 3307 St. Croix 106083 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET EL EV_ WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. ❑YES ❑NO ❑YES ❑NO BEDDING. VENT DIA.. VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING. IVIN TTUFRESH ALARM FROM LINE AIR INLT DYES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER JBIDDING ILIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED'. PROVIDED: YES -]NO DYES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AN D CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES 0 N NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAME ILH MATERIAL AND MARKING or excavation. (if soil can be rolled into a wire,construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH'. LENGTH NO.OF DISTR.PIPE SPACING COVER JINSIDE DIA =PITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH UISTH.PIPF 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 slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES ❑NO SOIL COVER JTFXTURE PERMANENT MARKERS OBSERVATION WE LLS ❑YES ❑NO ❑YES ENO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEOEO MULCHED CENTER EDGES. EYES ❑NO ❑YES ❑NO ❑YES El NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR,PIPE MANIFOLD MATERIAL NO DISTR DISTR.PIPE DISTRIBUTION PIPE MATE HIAL&MARK IN(; ELEV.' ELEV.. DIA. ELEV.. PIPES DIA.: ELEVATION AND DISTRIBUTION VERTI INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANSCAL LIFT CORRESPONDS TO APPROVED ❑YES 0 N DYES ❑NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS. NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE DYES El NO DYES E:1 NO NEAREST— Sketch System on Retain in county file for audit. Reverse Side. SIGNAT URE. TITLE. DILHR SBD 6710(R.01/82) Zoning Administrator I � DIL R SANITARY PERMIT APPLICATION C��.Y�/` X In accord with ILHR 83.05,Wis.Adm.Code -�•����^� STATE SANITARY PERMIT# l UG d8' –Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. F7 —�20 –See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES NO PROPERTY OWNE Pggo�PERTY LOCATION c OS611" CovpO�✓ j� S �3 T f N, R l E (or W PROPEi Y OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME `^w I Ink Dr r s� 37� l� P61- .5 SCI Y,STATE �J ZIP CODE PHONE NUMBER 0 CITY (( �D,LAKE OR LFRdBM�4R14+ SSIO G ❑ VILLAGE: . „ft�lT' S e-A..'me- II. TYPE OF BUILDING OR USE SERVED: 3 =ubric�(/ Number of Bedrooms if 1 or 2 Family R Specify): Y III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a.19� New b.❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a. ❑Conventional b. ❑Alternative c. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy eX Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. /O X ,S'O T�See a e Bed b. ❑seepage e Trench c. ❑See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): of l> 375' J m S Feet 9 Private -]Joint ❑ Public CAPACITY VI. TANK ##of Prefab. Site in allons Total Manufacturer's Name Con- Steel Fiber- Plastic Exper. INFORMATION New xistin Gallons Tanks Concrete glass App. Tanks Tanks ,v structed Septic Tank or Holding Tank X o El ❑ Lift Pump Tank/Siphon Chamber CQ.tJ .0 ❑ I ❑ Lj VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Sig ature:(No Stamps) MPfMPRSW No.: Business Phone Number: 0_7 �l 3 �� Plumber's Address(Street,City,State,Zip Code): Name of Designer: If lhle ep Vlll. SOIL TEST INFORMATION Certified Soil Tester(CST)Name HOMESITE SEPTfe,PtUMBINO CO. CST## 655 O'NEIL RD.,HUDSON,WIS.54016 ;L Y CST's ADDRESS(Street,City,State,Zip Code) Phone Number:[ NIS.MAST�Ii PLUMBER LIC.NQ; 7 M.P.R.^ �� pf� rj�� ,Ira:iNSTALL98&DESIGNER L .NO . 3 Q(p d IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S nitary Permit Fee Groundwater Date Issuing Agent Signature(No Stamps) MA Approved El Owner Given Initial ` Surcharge Fee Adverse Determination 0100 as& X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber I INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO-THE APPLICANT:. 1. This 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_appiicable; 3. -All revisions to this permit must'be approved by the45ermit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of.syStem;,or ty0e of system; 4. `Changes in,'ownershp"or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained'The septic tank(s) should be pumped by a licensed pumper•whenever'necaasary, usually every'2 id years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 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 where the system is to be ` installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in #1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Departmeri't Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8V2 x 11 inches must be submitted to the county. The plans must include the followings 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; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and.pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. ---------------.->—------------------------------—-------------------------—---------------------------------------------------r--------------------------- r . GROUNDWATER SURCHARGE On May 4,1984;1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection.law. This change,in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground 9r included the creation of surcharges (fees) for a number o` regulated practices which Wisco in's a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried •reasllf@ is used in your building is returned to the groundwater through your soil absorption u system or the disposal site used by your holding tank pumper. a The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) 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 Location of Property SE` S W 14, Section Z 3 , T 3 v N-R W Township TO St 7q Mailing Address 6 8 0 Address of Site Subdivision Name �'s� 3 c 40 4 V0 o 3 Lot Number ( , Previous Owner of Property . pL wo+ Total Size of Parcel 2 , 0 2 cot l� Date Parcel was Created S cpT - Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes /< No Volume 7 !F0 and Page Number 57 9" as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and pa&e 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPFRTY OWNER CERTIFICATION I (We) ceAtiby that att statement6 on thivs bonm ane true to the but ob my (oun) knowledge; that I (we) am (ahe) the owneA(,$) o6 the pnopeh ty da ch ib ed in this s inbolrmation bonm, by vixtue ob a wa4Aawty deed neconded in the Obbice ob the County Regi6teA o6 Deeda ass Document No. YZjF:' ; and that I (We) pnez enemy own the pnopo.bed site bon the sewage dizpozat dy,6t (on I (we) have obtained an easement, to nun with the above deiscAibed ptopenty, bon the comtnucti.on ob said system, and the .tame has been duty tecotded in the Obbd.ce ob the County Regizten ob Veeds, ab Document No. ) . SI&AIBU OF WNER SIGNATURE OF CO-OWNER IF APPLICABLE) ) /�/�-7 '` DATE SIGNED DATE SIGNED Mi�•...111�.. .a.«».» ..Y...+...w.:.w. Y .•.................. ....... >.a. '•....«. ......... .« ........«..................w.»«•.M• 1.w'.ii.a.w...F+r+�,•:.w....w4..,.ala..«»»....«...».«..... ..«................. ....... + ...,....'.'.�"r-' '�4� r «.........�... «... ..........«. ........................... IK�MAIf k «wi.+....i.....w+Y..r... ............... ......................................... F h w .. .. t ......................o...�. . =- ,�►�'�. �woars �osd as sty bl�,.. .. ,- #! ► Of f. JbNfh. , al* 1 ♦ l& Fµt I of dw f�oRth in vest acivm sf of Ulna of to O t�1at Mtsq Osad Ox. lb. ao; .ihte '161 ftp,In* in this of`.i aa of the ftosteae'�a�- J `'k: its Im y� # Y EXE -M MIMs k .t ... Auuat..... .. , ........ Aobert E. Si stab- �..�.►: . ...... --=.. ..-....... &U..R...UVI A i..................... •'VO#M SGAI ON •otNowLt ISttssll�"; BTATS OF WWWNM ........... .........»....»........y ».... -., `. . .. ---•- 4 MM 1�ra•tr M� -•----------+�•--- >,� ��� N H a , . STC - 105 r _ a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d ep a OWN ER/-BVTt-1t- 13)R_ Lrl� �NJ���✓ hI ROUTE/BOX NUMBER aog? ,16Le4AkJ_ 4,/ Fire Number CITY/STATE 5�• I�JL /'!%")")1�z p "! ZIP 155b PROPERTY LOCATION: 3L, 3 14, Section _� 3 T ?6 N, R—W, Town of S�r �aSEP l5� St . Croix County, Subdivision CSAl '77f_176 Lot number zo 3 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 m_ y 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 uirement 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. Ho E I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- 'b 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 . SIGNE DATE St . Croix County Zoning Office P.O. Box 98z. Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address . State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGN APPROVAL SAFETY&BUILDINGS DIVISION _E PLAN Bureau of Plumbing 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 HOMESITE SEPTIC PLUMBING CO. Owner: DR. LARRY & MRS. ROSELLEN CONDON ROBERT ULBRICHT RT. 3, O'NEIL RD. 2089 I:GL.EHARDT HUDSON WI 54016 ST. PAUL MN 55104 RE: Plan Number: 87-02069---S Date Approved: April 13, 1987 Gallons Per Day: 600 Date Received: April 13, 1987 Project Name: CONDON,DR. LARRY & ROSELL.E.N Location: SE,SW,23,T,30, 19W Town of ST. JOSEPH County: ST CROIX Fees Received (Priority Review) : 160.00 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 Bureau of Plumbing 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 54-64 of the Wisconsin Administrative code. This approval is for the following components only: — NEW MOUND Inquiries concerning this approval may, be made by calling (608) 266-3937. Sincerely, t )AMES QUINL.AN R Bureau of Plumbing Safety and Buildings Division PPP012/0009w/28 cc DR. LARRY & MRS. ROSELL.EN CONDON Private Sewage Consultant _ County UW—SSWMP Plumbing Consultant Owner Plumber Environmental Health DILHRSSD-6423 (N.04/81) PROJECT INDEX SHEET . I OWNER: ��. VARIR MR5 . i�oSelljOl COAj DOr.I r ADDRESS: 2ogj TCTL-E hARDr Asit. Mid SS�o/ SITE LOCATION: �. -Se-I -4,4-L SZ3, r3o a, R !q w 0 t ACRE p4pr 0+ 4k)01T. 10t 0 y TDwwi o F ST 70 S tr p ti-- PROJECT DESCRIPTION: oA3 c brX 0000 ry ZoA.2i' A19J-t►'AJi STle4 r0l4. '1'� �UttSvN� Cow Mb:D 5o s ARC v y QLC Bur SFASomA it y SATUPATED . 4 S EIS o m L � 4u4w w Y I)A L-y E'STIA4 ATE-0 WAST t 1: )o WS ARE' 600 �� 5 PAGE 1 . ,PLOT PLAN VIEWS PAGE 2 . MOUND CROSS SECTION & SYSTEM PLAN VIEWS PAGE 3. PIPE LATERAL LAYOUT PAGE 4. DOSING OR SIPHON CHAMBER CROSS SECTIONS PAGE 5 . PUMP PERFORMANCE SPECS OR SIPHON SPECS PLUMBER: HOMESI1E SEPTIC PLUMB1Kiat SITE EV.AZUATER/ DESIGNER RT.3 O'NEIL RD.,HUDSON,VA&51016 ROBERT ULBRICHT • M&MASTER PLUMKR LIC.NO. 3307 M.P.R.>l: rluMtSI IL SEPTIC PLUMBINU C41 MINN.INSTALLER&DESIGNER LIC.NO.OM RT.3 O'NEIL RD.,HUDSON,NAS.54ill ROBERT ULBRICHT . 9 / °JiS MASTER PLUM9ER LIC.NO.3307 MAIM '!N !NTTALLER B�� fifi3 SIGNER LIC.NO.00 DATE: �./1, ` SIGNATURE: RECEIVED 31987 x APR law pLUMn, PLOT PL.AA3 V I E W S ' 1 • � /3A�,f'/ioE- ,�o,PEs ��,'� = Pieo PoSeD roe i-;at a f NOUND e,4 le- Per �T cvES T LOT GiwE '' Ieo� C� L o r i / cs,Y 3 7?V 7lr A& ?� . 1 so 3 �r. 0 4 1 t � • 1 ; t � � 1 1 t ` t t 1, t Peg soiL rESr 1 i ' VeRT: Rr f. $3 �} -F----- Top o f 00 D � M O STAte AppRootO COMSWAt1Q`tJ peFc*s r 'iti' SePT�c pump ChAmW INTe£wT�w / 0 oaD �/ ffar v MANU4AcTUQEQ P G�%�sep l'ouc�Pe�>E / �c •� f'Rdovc TS, zn MAMW &Cle LUiS . o� RECEIVED �s APR 13 1987 LUMBlNC*r.U7SAU L 4 E•E � �� � I 0 ��_ i n Page L Of .S Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand SYSTCH H = G lP 'TOJ Topsoil _J E p 3 (v % Slope Bed Of iN (Force Main Plowed Aggregate Layer D Ft. Cross Section 'Of A Mound System Using E C Ft. A Bed For The Absorption Area F . 75 Ft. G / Ft. A /° Ft. H h S Ft. Signed: B S0 Ft. License Number: K /O Ft. Date: L 70 Ft. g Ft. /f Ft. W -32- Ft. Observation Pipe---,,,,, J 13 yK AL---------------------- -----------------------I (•----- -------------- ----------------------•I Force Main W ° — ------- ------- ' M Distribution Bed •Of i Pipe. Aggregate Observation Pipe Permanent Markers PVC C&P990 57EeL RODS Plan View Of Mound UsirA9'p� Fo , l'he Absorption Area r P11 i i• +* " 4ha ORMTOW Op jjju-T) a ' �JLIWN Or SAFw 1' ►�ti b�i;LU`I�� -� y --pro �'- S Ct3Ri�Et� Cl=fv F RECEIVED A PR 131997 PLUM9!t! �• �.'r_at.j. Plge3 Of✓� J,tsT h1o% SET u�OR�ytiT pv,��Nb �P�9r� Doww Perforated Pipe Detail / 0 End view Perforatea End Cop °.� PVC P Pe -A �s�° Holes Located On Bottom, S Are Equally Spaced S P PVC Force Main PVC Manifold Pipe ror,4 L_ Alternate Position Of Pipe ibuti0n D�S Force Main 3" SCA- 40 P jr yy" pt. -c+• 5R�1Dt£A3r Last Hole Should Be SLOPCp BACK rO ?ONp CbAHQ . Neat To End Cop End Cop Distribution Pipe Layout P � -5 Ft R w �T S 3 Fr X InchPS p{ 1 ,� Y Inches a Hole Diameter Al Inch -' Lateral / Inch(es) Manifold 2 Inches x� 3 Force Main " Inches i # of holes/pipe /D � x �,L � r Invert Elevation of Laterals 6.0 Ft. s mj)1,eoc k s ys` rAj a lev>A-rido q 5. 5 'oisTRs,l3uroo,aJ I'S /1RG E d TOTAL Di STR i Q 0T)00 P S Ch AV- �'Are- = 7Z pN1 CQ 14T&P415 Tor..+L . Voi D Vok vA4� )CoR f RECEIVED APR 13 1987 PLUMt*:�' Q ! PAGE _L CF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP y'C.I. VENT PIPE WEATHER PROOF APPROVED LOCKIWrp 25' FROM DOOR, JUNCTION BOX MAWHOLE COVER r---T- WINDOW OR FRESH I Vim IU. AIR INTAKE GRADE I IEV, �l0• I 'I"MIN. it COIJDUIT -- 18"MIAI. �� IAILET PROVIDE I ----- v-AIRT14"T-3EAL APPROVED. JOINT A a I I I APPROVED JOINTS W/G.13. PIPE I III W(C.I. PIPE EXTENDING 3' jr I I ALARM EXTEIJDING 3' 01JT0. SOLID SOIL B � y- I ONTO SOLID SOIL ` ^ ON k P OFF Nhb E /o 1 Z CONCRETE BLOCK gg,2S RISER EXIT PERMIWED OWL1 IF TAWK MANUFACTURER HAS SUCH APPROVAL n GDHt3i�>,T�o,j s epri�/ (o0 S4. TOT*L1 I$O S'45 . SEPTIC E Furlp chAmBE� SPECIFI'CATIOAIS DOSE. bll:sca Co,ucRETr ?Pop. y TANKS MANUFACTURER: IJUMBER OF DO ES: PER DAU �ZSO sEprt� �Zy ,.�s TAIJK SIZE: 7Sb PvH P G I14H GALLOWS DOSE VOLUME y ALARM MMJUFACTURE.R: L I:uEL• AlAkm 66 INCLUDING BACKFLOW: GALLONS MODEL NUMBER: 3)• V`I— CAPACITIES: A= 2(o MICgES OR GALLONS SWITCH TYPE: M ER-CU R Y DOE B= y INCHES OR 3 E GALLONS PUMP MANUFACTURER: ZotIIel2 Co - C,: // INCHES OR 192- GALLONS MODEL MUMBER: 2-4 00 Y2_ 14 P I\S V;-j- D s r0 INCHES OR 1-4'0 GALLONS SWITCH TYPE: P11�1Jy 8A(,K WkUA1 00<A NOTE: PUMP AMID ALARM ARE TO BE MINIMUM DISCHARGE RATE 72" GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AUD DISTRIBUTION PIPE.. �' FEET SANK 'sp�G s ♦ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2.5 FEET 44 Gf!v � " i�-3 A S ♦ FEET OF FORCE MAIN X I'0 g F loomFRICTIOU FACTOR. '� FEET -_ TOTAL DYNAMIC HEAD = �' FEET IAITERNAL OIMEWStONE OF TAIJK: LENfsTH ;WIDTH _ .. LIQUID DEPTH SIGNED: LICENSE MUMBER: DATE: RECEIVED APR 13 1987 PLUMBIN0, r1.1^EAU fAGNf' o� TDH EAD r' CAPACITY CURVE Ch Ir w W W 2 W 100 TOTAL DYNAMIC MEADICAPACITII PER MINUTE 30 EFFLUENT AND DEWATERIND 95 SERIES .591 97 137.139 1 183 1 1" F{ M QAL LTRS LTRS LTRS LTRS LTRS 28 ------------ 5 1,52 163 249 394 231 231 80 EFFLUENT AND DEWATERING to 3.05 129 219 300 231 231 14. 457 ,1 72 183 242 227 227 26- 85 SEWAGE AND DEWATERING 20 610 — 1a 138 223 227 ` 25 -7-62- _ 30 216 223 30 w 9 14 __ 208 220 80 ` /0, 12�9 —� n 172 , 205 \ 60 1524 125 191 \ . 75 a0 r t62y- ? 1 57 181 � 70 21.34 . '�•:' at• 111 22 �\ 24 3e 63. 70 MODEL\\ MODEL Lock Valve- 19 24.5' 26' 20 163 \ 16.51 TOTAL OVNAMIC MEADICAPACITV PER MINUTE 65 \ SEWAOE AND DEWATERING ` SERIES 207 299 792 m 2W FT, M QA1.' LTRS LTRS LTRS LTRS LTRS 18 \ �` 5 ,sz i ,409 308 1 492 RW 881 \ 10 30 273 380 598 ?1•' 16- 55 \\ 15 4,57 20 76 4� 163 238 SIt 20 6 t_0 30 125 401 - so. 26 762 2M88 1 30 9 14 163 292 14 45 \ \ 1 35 ,os7 227 171 \ 1 15: t372 106 LN 12 40 \ 1 15 24 _ Ib 1 MODEL Lock Valve ,e z, zb 35 53 10 35 ` I 293 t, l 30 MODELS 11 8 25 137 139 1 6 20 --- MODEL 284 4 15 I MODEL MODEL 282 �"j 10 268 \ I `2 MODELS ,• S 53, 55, MODEL MODEL 0 57, 59 97 267 U.S. GALS. 10 20 30 40 50 60 70 80 90 100 10 1Zp Y LITERS 80 160 240 320 400 480 560 640 650 E FLOW PER MINUTE 3280 Old Millen;Lane Manufacturers of. . . ` ZZ7Z-ZZfAff O. Louisville, lucky 40216 Box 16347 O (502) 778-2 31 Q���,rr Pa,�Pe smew lav 8 RECEIVED APR 1 3 1987 ,' 1 .�+ nr rrrP.1 � PLUMW S 5'uv,u f?-��-, aj/.v7E,2 TE'f T C'U,uDtT�D�S � +I, 33° F, F V S T' ° `DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.09(1)&Chapter 145.045) 'PART' Of 6-OiiT (,pt- 8 LOCATION:, SECTION: WOWNSHIP/MWIAGIPAbI Y: OT NO.:BLK.NO.: SUBDIVISION NAME:.s6 1/ 1/ a 3 /To N/R/Y' E (o sT To f-P If— i PY �G vol jzo3 COUNTY: OWM£i`'S BUYER'S NAME: MAILINU ADDRESS: 17t? �Gk- 4)er 54- ?A0 ;4 itiAJI. USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: F S: A STS: Residence New ❑Replace Z 7— �9 0004.ary ov Sild- RATING:S=Site suitable for system U-Site unsuitable for system ,!J• 3 7�'iQ 7 ONVENTIONAL: MOUND: IN-GROUND-PRESSURE:S 'STEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:loptional) D ®U ©S ❑U 0 ©U EIS ❑U [IS ©U ND A3 s Y S'7`e,-, If Percolation Tests are NOT required DES'7�SIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate:14S- Floodplain,indicate Floodplain elevation: SGS jy .4,vT/(ra PROFILE DESCRIPTIONS /Al 'jE-G,H,F( f+' BORING TOTAL DEPTH TO GROU NDWATER-IN CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH pELEVATION OBSERVED EST.HIG HE TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B- / 7,0 9� ��� -5,D r �, �,� S 15 col: Br, • 1. io' 8�• s a �'s� /.d'y 'G�P4y HRu f-F. ORfr. HOTS 4r 3. 5 C/4 AM C 14y 104•+ 84,0,0&0 w rte. 6-rt4y B- /'L S-rRAT�tt of 5,�.,D N�'al .�tsr. OQ-HD TS. • •-fl' AC. a- 5 , /,1S ' W-�y OLDexy •LS 00,4 5V B-2, �0.0 9y..s y -5,0 yQ sal •66' dt. Sl so &A s,p ' 904Y sil w M SHADC DR 1401'S AT •d' puDD/ (�J.e *' B_ wr t Fr, g /,S • p�t!aw �ouef� r , G7' 8a •CosaA-9 B-3 &,o f /a •O8 �— 3' 7 S /.G • no ht.1 . ,awe• S 2 • 1 7 es SILT �sa/ ,►,,, _ (ct OR.mafS — C04T14%AaS B- o O I" PERCOLATION TESTS EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 ERIQD 2 RAI PER INCH P_ � 2 /0 � is fi G 7 P- P- ,s 2- 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. DOG kISA U D /NT�F4CE ; F f SYSTEM ELEVATION I 1 ....._ ._ 1 ... T tel n - - - — --- I I tN -C ROV Fit ------ 70 k �� D _ I ► cis oa tl 6 T - Ad !4- - 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: HUMESIIL$tPT(C PLUMOU CO. ,t8 - T V) ADDRESS: ROBERT ULBRICHT F�732CATION NUMBER: PH;NUM % optionall: "S MASTER PLUMBER LIC.N0, 3307 M.P.R.S pp 2•- J� V(XW- �+ CST GNATUR DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) -OVER — REPORT ON SOIL BORINGS & PERCOLATION TESTS 115 PLOT PLAN Pr o 'ec t I D 'D C AJ � - 1.4/e�C,. L r* a Q ��R R o �o '3�-ss o Y HOMESUE SEPTIC PIUMWNG 0a LEGEND At 9O'NEII RD.,MOWN,MNS SIT ANENT UU)ROT • = Ba c kh o e t-i t s ♦ ` f ODE E/E(/h T.,oM s MS.MASTER PLUMPER UC.NQ 3307 AI P Itt X w Perc Locations Ail;'Sq. MINN.JMSTAUER i DESIGNER LIC.W.WU 30 Q = Existing Well C.S.T. 2482 = Vertical Reference Point t TOP OF SVeUr`yoP's " p1tA 04 Ad. DoT- hae Elevation of Vertical Reference Point i 00 . FT -r0k411v(r l pow t - Lot Line /"/BOU �.lR.t'Ev w/ fu►yy�D 1� f�ac e i•� ( t.J EST Lp T 1..!N!!' 3yo � r 0 2 . 02 AC-P- S � Hour- O f FlevRrw►J, 94'30 / Icua: , pRopoSeD ToE yid C --p'9 , Of M OVA)D• / 1 1 B2 i 1 • 3s ARek_ t POP) 'PRGpoSAV I RM i w poll C'410 I � 15E�Soo+►� , • i 75 0 � V 'SAS S 4 AtE