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HomeMy WebLinkAbout032-2006-10-100 w / Q \ c GO } % § � » fir = _ § ~ % ( Q 7 D a g77 § � 622 § $_ ƒ JCL . aE>#aag Q � � � 0L � 000 o« k §\k/ƒ/ 2 � o , m= occ ) ) f ƒ/ § r� k 2 E5§) Vkf / /% 0 >2 « \ ƒ/C)cc f CD \ / : A § « Z : k k . . § 7 a 2 § � § z 2 ) z E 2 (Y)I e e � -� B / ) § U z m k = E { § / U.) CL \ r o_ \ k & � � ) m \ k / k k k \\ ZL � } 3 2 2 2 CL k \ k k \ ! ) \ \ j 2 \ Co / § E / / o I § V G a t f a a LO % 2 # » m A % ; 2 / K 2 I ) E n _ Q § § / 2 . ¥ c S £ E _E_ E 10 (D � o § \ I c - a q k k / E $ § o f \ a a a - § G CO j o z ) / z 2 \ . 2 2 § a L : " a » ca E § a § 2 J a 2 o J 0 Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP 1�411tQ^�-e-�-- SEC. SIb N-RI ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE —� PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM t4' 9A • s INDICATE NORTH ARROW BENC Describe the vertical reference point used to csa�i n y A7166-r- 0-�- � Elevation of vertical reference point: Proposed slope at site: Oil : li SEPTIC TANK: Manufacturer: Zf Z 1�5 Liquid Capacity: Number of rings used: AYPI�Tank manhole cover elevation: �. Tank Inlet Elevation: Tank Outlet Elevation: l $� Number of feet from nearest Road.: Front �Side Rear O 1--112140 / �eet i From nearest property line Front,OSide,ORear,O ,JQ feet Number of feet from: well building: eZoD ' I E ° 1' (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SFR RRVRRSF. STD-P PUMP CHAMBER Manufacturer: /`%y Liquid Capacity: Pump Model: �,� Pump/Siphon Manufacturer: Pump Size Elevation of inlet: q6 Bottom of tank elevation: Pump off switch elevation: - ! Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest _ property line: Front, O Side, Rear,0 Ft. Number of feet from well: Number of feet from building: �O (Include distances on plot plan). SOIL ABSORPTION SYSTEM � �. 5�e e � � ,� Bed: Trench: Width: Lenith: old/ Number of Lines: Area Built:- l Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, ®Rear,0 Ft . c�/ Number of feet from ay '� well: 01 Number of feet from building: is (Include dist nces on plot plan). j D SEEPAGE PIT !f �, J Size: Number of pits: « Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: s Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of 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: Inspector: Dated: Plumber on job: License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 NW'4,S8'4,S1,T30N-R19W IXYCONVENTIONAL El ALTERNATIVE State Plan LD.Nurn I Town 0j S. SUmQliJset El Holding Tank ❑ In-Ground Pressure El Mound (It assigned) 85th StAee NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECT10 D T Robert Pete&6on Route 4, Box 212, New Richmond, wI 5401 J BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: - CST REF,PL ELEV.. Name of Plumber: MP/MPRSW No.. County. Sanitary Permit Number: B non &Ad It. 3318 St. Cno.ix 112797 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET E LEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATT HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING: VENT TO FRESH ALARM FEET FROM; LINE AIR INLET. ❑YES ❑NO ❑YES ONO NEAREST DOSING CHAMBER: MANUFACTURER 7ING. LIQUID C:APACI iv PUMPMODEI. JPIIMP:SIPHON MANUI ACTUHFEi WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: S ❑NO ❑YES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENT TO E FRESH (DIFFERENCE BETWEEN FEET'FROM NE AIR INLET. PUMP ON AND OFF) 1-1 YES El NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing I 1 7TH JUIAMF TEH MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH ILINGTH IISTH. PIPE SPACIN(; COVER :INSIDE OIA PITS LIQUID BED/TRENCH THE NCHES MATERIAL' PIT DEPTH DIMENSIONS RAVEL DEPH FILL DEPTH JD�STR PIPE DH PIPE DISTR PIPE MATERIAL NO DISTH NUMBER OF PROPERTY WELL BUILDING. VENT TO FRESH BELOW IPES ABOVE COVER E EV INLE f ELEV.END PIPES FEET FROM IL INE AIR INLET: NEAREST--�r 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. ❑YES NO SOIL COVER TEXTURE jP1HMAN1 NT MAHKIHS OBSERVATION WELLS _ ❑YES 1:1 NO DYES 1:1 NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED DEPTH OF TOPSOIL SODDED SFE DED MULCHED CENTER EDGES 1:1 YES, El NO ❑YES CN0 ❑YES El NO PRESSURIZED DISTRIBUTION SYSTEM: EL/TR NCF'I :WIDTH LENGTH TR EOOCHES. LATERAL SPACING GHAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER DIMENSIONS I.MANIFOLD PUMP MANIFOLD DISTR.PIPE JMANIIOID MATERIAL NO DISTH DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEV.. ELEV. DIA. ELEV. PIPES DI A.. ELEVATION AND DISTRIBUTION HOLE SIZE HOLE SPACING CHILLED COHHFCT I v COVER MATE HIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS DYES NO 1:1 YES El NO COMMENTS: PERMANENT MARKERS. OBSERVATION WELLS: INUMBEFI OF- ',, PROPERTY WELL: BUILDING: FEET FROM LINE: EYES ❑NO ❑YES ❑NO NEAFIIs`ST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE-. TITLE Zoning Admin.t� taton DILHR SBD 6710(R.01/82) — SANITARY PERMIT APPLICATION COUNTY DILHR In accord with ILHR 83.05,Wis.Adm. Code :j5/7 Gr o STATE SA ITARY PERMIT## i/ ayQ .y –Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%z x 11 inches in size. –See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION. FOR VARIANCE 1:1 YES-N NO PROPERTY O R PROPERTY LOCATION �/_-er.5 52e2 Ayw'/a /a, S T , N, R E(or) PROPERTY OWNER'S MAILING ADDRESS J,OT NUM ER BLOCK NUMBER SUBDIVISI(N NAME c4)/,ra CITY,16TATE ZIP CODE PHONE NUMBER f CITY EAR ST ROAD,L KE O LANDMAR D VILLAGE . L II. TYPE OF BUILDING OR USE SERVED: 03.2, - 606 7!0/D _V TOWN OF�Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. 14 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. El Alternative c. El Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a.X seepage Bed b. ❑seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 15.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): Z4 CZ I 1018--V4et Private ❑Joint ❑ Public APACI VI. TANK C ## Prefab. Site in allons Total of Pre . Fiber-Manufacturer's Name Con- Steel Plastic Exper. INFORMATION New xisting Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank gO en e Lift Pump Tank/Siphon Chamber VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Pl�Ryee' Name(Print): Plumber' gnature:(No Stamps) MP/MPRSW No.: Business Phone Number: r2 r1r / Q'761�[ Plumb s Address(Street, 'ty,State,Zip Code): Name of D ' er: -0-0, VIII. SOIL T ST INFORMATION Certified Soil Tester(CST)Nam CST## may CST's ADDRESS( eet,City,State,Zip Code) Phone Number: er ( 7,00�> /Z C IX. CO NT /DEPARTMENT USE ONLY p ❑ Disapproved Sapitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial ]j Irly rcharge Fee Adverse Determination L ��— u l�l ✓J 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 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 applicable; 3. All revisions to this permit must be approved by the permit 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 type of system; 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.. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 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 owners name and mailing address. Provide the legal description where the system is to be installed; 11. 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 Lepair; 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/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 81/2 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; 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. ----------------------------------------------------------------------------------------------------------------------------------------------------------- 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 $teT included the creation of surcharges (fees) for a number of regulated practices which Wisco can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried r �stre is used in your building is returned to the groundwater through your soil absorption o 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 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 ,,..;�,��'71 J al_ ar�� Location of property N W 1/4 S 1/4, Section , T__N-R L'� W Township Mailing address / Address of site �7�� -r`-elf, L 0 Subdivision name Lot number Previous owner of property �cSS� Total size of parcel 3. /0 Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes iXNo Volume 'Ka 3 and Page Number ;1A -7 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 references to a Certified Survey Map, the Certified Survey Map shall also be required. I ------------------------------------------------------------------------------- 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 deed recprded in the Office of the County Register of Deeds as Document No. a 4/16 0 y . 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. ) . a /y� Signature of Owner Signature of Co-Owner (If Applicable) 7 Date of Signature Date of Signature DOCUMENT No. STATE BA$ OF WISCONSIN FORK 1—IM THIS NACa RaaaRTaD /DR RtCDR11M4 DATA WARRANTY DEED I 441604 a o This Deed, made between .Itu:sc.l.l .1?, _Petersatn...and. ""STERS Ofa Pauline 1 . Peterson. hushanci and wife . ..... ST. CROIX 00.0 WISI► Nbc'd. far Qxcwd Ns 22nd Grantor, Sept. A.D. 19 88 and Robert .1. I eter on and Mann M. Peterson, day gf husband and wife, as survivorship marital 8:30 A.-os, property Grantee, emo"of Witnesseth, That the said Grantor, for a valuable consideration . com•e.Ns to Grantee the following described real estate in tit . Croix RErt RN TO County, State of Wisconsin: Lot 1 of the Cert i f icd Survey [clap recordecl i in Volume " of Certified tilll'l•,,N, Nap. on Pale 202�azParcelNo: as Document No. 1-111 hcinv, a hart of the Northwest 1/ 1 of the Southc:l,t 1 ;4 of Section 1 , Township 30 North , Range 1i) hest . Exempt No. 8 This is not homestead proprrt� (is) (is not) Together with all and sinK:;lar the here..•.,wtnts and :,ppurtenances t}ereuntu b6or..I;Ittg: And warrants that the title is go.,d, m,ir:c;,alf;, ;n ,:n:l,!t ar„i :r— a:,.I cl,;u nt, an,e3 .-Xetpt and will warrant anti defend 0:e >,.;:..• Dated this I, �c nfcmhcr l� ti3 ISEALr Russell D. Peter�l ;: iSEAI.I • Pauline 1 . Pctcr<1,;; AUTHENTICATION ACKNOWLEDGM }:NT Signaurg,(sl (�i R11-; l and !'sill i nc I authenticated this TITLE: MEMBER ST.ATK R>I., :} '. lrf4t!\\\\.0\\\ , . , , . s1f9T�lr1RJ1�A4��\i�Wig VA R% . :�,•t .V Lt„i rl..• I 'n' I'Ic r i t e . WARRANT” DEED •I .,I _ ,rl xl ..,\.I♦ I,. , „ , i,. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ,//lei^ c� /t°.��/'<�� ROUTE/BOX NUMBER FIRE NO. CITY/STATEz�eco'f /?/we"I' lam/ ZIP PROPERTY LOCATION: AZ,.(�).114 5 4�f_ 1/4, Section ,�, T 30N, R_W, Town of , St. Croix County, Subdivision .,Q,e. / , Lot No. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation 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 by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. S I G N E D DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS -INDUSTRY, G DIVISION LABOR AND, PERCOLATION TESTS (115) MADISON,WI 53707 P.O. BOX 7969 HUMAN RELATIONS (H63.09(1)& Chapter 145.045) LOCATION: SE TION. TOWNSHIPrIVl�4': LOT NO.:BLK.NO.: SUBDIVISION NAME: NW 11,CE 1/4 1 /T30 III/It9X�r)W Somerset` n/a n/a I n/a COUNTY: S BUYER'S NAME: MAILING ADDRESS: St. Croix Robert & Diann Peterson IR.R.24, Box 212, New Richmud, , Wi, 54017 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATF11N TE TS: Residence 3 n/a FRNew ❑Replace 7_8-88 n/a RATING:S=Site suitable for system Um Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) CA S S ❑U EIS ®U Di ❑U IEISRU ❑S EU conventional If Percolation Tests are NOT required DESIGN RATE: Q If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Iclass2 Floodplain,indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 27 BxC2 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH QQ ELEVATION OBSERVED EST.HIGWE—ST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B-1 7.59 105.65 none >7.59 .75bl.1. 1.17bn.sil. 5.67bn.l.s. B-Z 1 6.59 105.36 none >6.59 .92bl.1. 1.42bn.sil. 4.25bn.s.l. B-3 6.50 105.91 none >6.50 .83bl.1. 1.00bn.sil. 4.67bn.l.s. B-4 6.92 105.01 none >6.92 .92bl.1. 1.17bn.sil. 4.82bn.l.s. B-5 6.25 105.34 none >6.25 1.08bl.1. .67bn.sil. 4.50bn.s.1. 13- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. P IOD t P ERI D 2 PERIOD 3 PER INCH P- p.see de-sigr rate P- P-. P_ 1P- 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 102.01 i - , TN �'. . L`1_ L 601._.._ qo - 1,the undersigned, hereby certify that the soil tests reported on this form were made by a 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: Gary L. Steel 7-8-88 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 988 N. shore dr. , New Richmond, Wi. 54017 2298 1315- 46-6200 CST SIG RE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBO-6395 (R.02/82) —OVER — PLOT PLAN PRO,fE­CT _o�e�^� ,���Pf-�Y� ADDRESS A f7/� 1/45� 1/4/S / lT�fl N/R/�W TOWN _ �a� fC0 NTY ro yoil MPRS Byron Bird Jr. 3318 DATE BEDROOM__,VCLASS PERC__2-/7— CONVENTIONAL IN-GRO PRESSURE CONVENTIONAL LIFTX MOUND__ HOLDING TANK SEPTIC TANK SIZE ®�z� - LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA > PERC RATE _BED SIZE ► Benchmark V.R.P. Assume_ Elevation 100' / Location of Benchmark wfee * -H.R.P. C3 Borehole Wep Scale = Feet O Perc Hole i system Elevation ; Al TYPAR COVERING t 26 12' 3' 4 6'- 0 3' 0 Sewer Rock �ro 1 6' 12' �nr � LT O (/ ;4q 13 goy PAGE , pLIMP 'CMAM6ER CR CT OSS SEIQN AND SPECIFICATIOUS Ott vckIT CAP SENT PIPE 1n/CAT'I�ER PRQOF APPROVED LOCKING .� ROM,,DOOR, JU 3CT'IOAS Box MAWHOLE COVER M 'A witildow OR FRESH "�Illl ti ti f a. 4"MIIJ. woul I IA f $n a :S ti !�*!'STN♦+.. + $ �, z', 'A ' x a k I LET mil ', „• I I _ ___ AIRTIGHT SEAL ..... I II� I I } AS1►i� O�1Et3'iJbiN7 A.. �r I I`� APPROVED JOINT PIPE .,�, /c.i. �ae I<XT NDIfJG 3' I I( ALARM EXTEUDI'AICs 3� Cl1�1TG1 SOLID so1L � I 't , o+JTO sauD sol � t I ON n �r #ry ,I�111 b t FT Pk1MP-. r _J OFF �t � ,+s " • � i t° S.t, + std+�a�i i i+y RISEFCt it' PERMI)TIZI) WL4 AF 'IAfJR MAAIUFACTURCR HAS SUCH APPROVAL ..' CI Ft T14h1 c ,-DOS F t /U'` � �� �✓�-C/j MAAiLiFACTi IR `{.' I.IUMBER CAF DOSES: PER DAJ . 1 I,i Xa Y� _ f' i � r TAt►�K .+SEIZE� � ' �" ��r�►#�t�C►1J� DOSE uOLUME ' A N MAklUF CT:1 LNCLUDII�ICi BACKFkGW: Q GAL4OTJS ` ;CIAPAC1TtES• A- INCHES OR GALLONS B n 1 ,.INCHES oft GJ►LLOIJS fit.. . »,.; ,t• 't P } ,1C14A]tJi`ll '1"LtRE 13 "7 G INCHES OR ALLOWS . ` `MODEL I1JIUA'�EK D Y �-w.-- _ s �. �...,....,. _.�� INCHES OR .L�._... GA tLQ Al S � ,5'WI`I'CN OTEI PUMP AMD ALARM ARE TO 5E ` .MI1JIMUM bil CAAP�3 '-R ''t,..: ,. �..,c M* INSTALLED OIJ SEPARATE CIRCUITS .1I>�I TtCAL DIFFEKEUCE.DETWECU, PUMP DISTRIBUTION PIPE... FECT t- -! 1�tOulMUM' ►a£TWdRK SUPPLN PKES%U, : .`. . . „ . . ;. FEET FEET b[ FORCE f 1AIN + �; ,, �a FRfG"fld»3 FAt-roe. FEET 4 N41►'Al.. 0l /1/�M1IC.' HEAD = FEET q' IiJTEft IUAL D{Mr;WSsIdWS ©P� TAWIC LEI�1&T•H ? i1+►IIDTI� .. .2..��.�LIQI.IID DEPTH r . iGNE Q: LICEIJ$E fJUM�ER: 3� UATEa�