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HomeMy WebLinkAbout032-2087-95-000 \ o \ § � - o ® \ ° o E % o % j jZa % k§ t22 ¢ 2®4. / \Mo � §ffa � � $ EjEk7 E k SE §\ $ 7 . 0 � r $ IE / � 0 o2 ° w \ \ \Cl) LL stria < -0 CLm k y � % � � j \ 0 f , � z ' � « / / } S � B z :!t \ t z : ® } m e » k 2 e � � � } � .� ) j m 0 / k © z C c k £ D ) L / � ) ) \ LO § k ] \ R w � / \ k \ E 5 } \ E k \ \\ : � o§ co � z \ / ® D \ kk \ ® o I / co 2 \ 3 c a J ¥ _ o § o CO 0 ® ■ @ § ° a = § @ \ \ \ k a ) 2 S §_ \ o § 2 ^ @ k / k \ \ ° f } - \ / 3 § / o ) j 2 } . $ . � E 75 k § ■ Q v m 2 o U) v � . - � ' SHPT• Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER�� /" � �� TOWNSHIP ✓&-AF SSE l SEC. T N-R W A - = ADDRESS ST. CROIX COUNTY, WISCONSIN i SUBDIVISION LOT LOT SIZE 0 S PLAN VIEW h Distances and dimensions to meet requirements of I•IHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ,ka S� HOMEBITE SEPNUDWN WIS.A16 666 O'NEIL RD ROSERT ULBRIGMI 37 M 0.6 MASTER R 0E G R +„NN,INSTALLER 6 DE8K3NER LTG.NO INDICATE NORTH ARROW , BENCHMARK: Describe the vertical reference point used /tee Elevation of vertical reference point: Proposed slope at site: �6 CO”? 00 - 7'o a/c SEPTIC TANK: Manufacturer: CDw 4C 7r.G_ Liquid Capacity: k' Number of rings used: Z Tank manhole cover elevation: �� • ��j sf Tank Inlet Elevation:: /9� ��, LL ' Tank Outlet Elevation: � � ✓.S� 'V D 4e, CP Number of feet from nearest Road: Front,O Side,©Rear, O �1' ` feet 'Ve From neareat property line Front,OSide,O Rear,0 / feet W-cL VOT D/(i 1ffD TO +.,. Number of feet from: well , building: ✓ y s (Include this information of the above lot plan)(P P )( 2 reference dimensions to septic tank) -" ` CFF DVIYVUCV CTnV £9900.011.011 83NDIM V 8311d1SNI'NNIYV •S'V01 LOSE'ON'011 d381Nflld d31SM'SIN, mId9V118380d 91095'SIM'NOSaf1H"ad 113N,0 999 '00 DNIBW(lld 0I1d3S 311MOH :aagmnN asuaoTZ :qo� uo aagwnTd p D� , � G�/� •PaJBQ S � � :aoaoadsul :aaan3oe3nueH maeTy ` :peoa 3saaeau moa3 gaa3 3o aagmn . :$uTPTTnq moa3 3993 3o aagmn :TTOA maz; laa3 3o aagmn •33 O 'aeag O `aPTS O `�uoa3 :auTT A349doad 1sa au moa; �aa3 ;o aagmnN :3aTuT 3o uoT3enaTa :Nuel 3o wolloq 30 uoTIena :pasn sauTa 3o aagmnN eC�Toed.0 :aaanjoe3nuey� XXVI ONIQ'I0H •(auo xaag0) LSma4As uoT3gaosge TTos anoge ag3 3o Aug pasn uaaq oxoq uoTingTa3sTp ao O xoq doap a aag4Ta seH :3TTng eaad :uoTlenaTa 3Td 92edaas 3o mo3gog :g3dap PTnbTI :aalameTQ :slTd 3o aagmnN :azTg yid a9ddaas •(ueTd loTd uo s8oue3sTP apnToul) :$uTPTTnq moa3 3aa3 3o aagmnH :TTBm moa3 i9a3 3o aagmnN t • 141 O`aeag 0 '9PTSO `luoaa :auTT Aiaadoad 3saaeou moa3 3aa3 3o aagmnN j Y ' :adTd 3o dol o3 g3daP Ma :1TTnq eaay :sauT7 3ov aagmnN D tgjI2ua7 / p :g1PTM GI •pail S c7ev'r1 o kY Kaisxs N oiydaosav zios •(ueTd 3oTd uo saoueasTp apnTouI) —Z S :$uTPTTnq woa3 jaa3 3o aagmnp O,-Y :TT9m moa3 39a3 3o aagmnN 'i.�� •13 O`aeag O OPTS O `luoa3 :auTT Alaadoad lsaaeau moa3 39a3 3o aagmnN c a :adAy go3TMSeTV G✓X/i ���7 .aaan�oe3nueyl maeTd Z Z/ :aTOAD aad suoTTeO SG j�,J :uoT3snaTa g33TAS 33o dmnd :uoTlenaTa �Iue3 3o w03:10g / :3aTuT 3o uoT3en9Td l N Z azTg dmnd — �� �OZ :aaanloe3nuvH uogdTS/dmnd •TapoN dwn j 0 9 .A1TaedeO pTnbT'I � aane;nusl� ' t' �✓ S'�/� U219MO dWnd f �ht 0 o S ,, a/r✓6'� C1��D� Lo PL,4�j 70.E �►►'//�!� Scp la i yv �f' I 610 cot r 54.40 TG p Q L DS r i Zp/ r � r t q# 8 r; �WMTroNS i s ysrE•�, 49 0, o TopS OF p►f V3 = loo, S,? , cal Top of 2" &t45T*7fl �4,&�iFOLD = /0 a•62 ® 11 T, PT . ' go 4)oAA of Puy 61A Ul 5 ' 70 HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD.,HUDSON,WIS.54016 f ROBERT ULBRIGHT VS.MASTER PLUMBER LIC.NO.3307 M.P.R.S. VNN.INSTALLER&DESIGNER LIC.NO.00663 x , g, a DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS I L ON HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMB DIVISING W.O..O.BOX BOX 7969 MADISON,WI 53707 State PI NW�,SW�, S14,T30N-R20W CONVENTIONAL ❑ALTERNATIVE (if ass,gnediD.Number . Town of Somerset ❑Holding Tank ❑ In-Ground Pressure Mound S88-01447 NAME OF PERMIT HOLDER'. ADDRESS OF PERMIT HOLDER: INSPECTiON0bAIIrE7. Tom Miller P.O. Box 470 AC 612 Stillwater MN 55082 - 13-gg BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: [7ELEV.. Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number Robert Ulbricht I3307 St. Croix 112647 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. ❑YES ❑NO [—]YES ONO BEDDING: VENT DIA. VENT MAT L.. HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING (VENT TO FRESH ALARM. FEET FROM L, E: AIR INLET ❑YES ❑NO DYES 1-1 NO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY JPUMP MODEL. PUMP/SIPHON MANUFACTURER WARNING LABEL ILOCKING COVER PROVIDED: PROVIDED: DYES ONO ❑YES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING JVENTTOFHIS" LINE AIR INLET (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) ❑YES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER 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: LENGTH NO.OF DISTR.PIPE SPACING COVER JINS1111 DIA =PITS LIQUID BED/TRENCH TRENCHES MATERIAL. PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH IDISTR PIPF DISTR.PIPE DISTR.PIPE MA-TERIAL. NO.DISTR. NUMBER OF PROPERTY WELL BUILDING VENT TO FHE SFI 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 ONO OIL COVER ITEXTURE PERMANENT MARKERS O11SIHIIATIIIN WELLS OYES ❑NO OYES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES. DYES ONO DYES 0 N OYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING GRAVEL DEPTH BELOW Pit FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE IMAN11OLDMATIRIAL NO DISTR DISTR.PIPE DISTHIBU T ION PIPE MATERIAL&MAHKIN(; ELEV.. ELEV. DIA. ELEV.. PIPES DIA.. ELEVATION AND DISTRIBUTION HOLE SIZE HOLE SPACING: DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS DYES 0 N DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PR OPE RTV WELL: B FEET FROM LINE: DYES ❑NO ❑YES ❑NO NEAREST - Sketch System on Retain in count y file for audit. Reverse i eve se S de. SIGNATURE. TITLE. Zoning Administrator DILHR SBD 6710(R.01/82) DILH R SANITARY PERMIT APPLICATION COON Y�; In accord with ILHR 83.05,Wis.Adm.Code S. �,9.;,��•,,,�,,.� STATE SANITARY PERMIT# –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. 5 dd — 611+ –See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES NO PROPS TY OWNER P OPERTY LOCATION M .1Q11/� W 114: l l '/4, S T 30, N, R 20 E(o W Pj40PERTY OWNER'S MAILING ADDRESS LOS( BER BLOCK NUMBER ES�UBDIVISIONNPME /, 6 c'7 V I\ lI�CITY,STATE ZIP CODE PHONE NUMBER CITY EST ROAD,LAKE OR LA®- �/ Z 3 f) VILLAGE:II. TYPE OF BUILDING OR USE SERVED: (O Aa44 � b Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): (-b� 11111. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. 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 e.K Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a.06 Seepage Bed b. ❑seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Mites per inch): REQUIRED(Square Feet): PROPOSED(Square Feet):L400 . /?33 v Feet Private ❑Joint ❑ Public VI. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks .. structed Septic Tank or Holding Tank ❑ ❑ Lift Pump Tank/Siphon Chamber K, ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumb 's Signature:(No Stamps) MPHY PRSW No.: Business Phone Number: Q . 2tL,a12iC4ir /L�• 30 711 Plumber's Address(Street,City,State,Zip Code): Name Designer: 6S6S-,57 /,) E1L 2D - f"` VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name MOMESME SEPTIC FttJMBING CO. CST# ^� 655 O'NEIL RD.,HUDSON,WIS.54016 Z td CST's ADDRESS(Street,City,State,Zip Code) WIS.MASTER PLUMBER LIC.NO.3307 M.P.R.S. Phone Number: MINN.INSTALLER 8 DESIGNER LIC.N0.00663 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) L?�J y� rcharge Fee Approved ❑ Owner Given Initial ,,ll �T�� Adverse Determination 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 J ,--.TQ 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 approv ed-by the'`p rmit issuing authority. A new peicmit may be needed. "T' 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: S' I. Prcaerty 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; Vl. 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 informatiqn: 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 8Y2_�_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. This1egislation is more commonly known as the groundwater protection law fk" change in-stptutes'was the result of over 2 years of steady negotiatiori'ariby4blic debate T)'ie,groundwater bill Ground�atel' included the creation of surcharges (fees)`for a'numbet of regulated practices which Wiscor4in 15 a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasur'e 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. 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) DEPARTMENT OF tNDUSTI3Y, REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS ' LABOR AND DIVISION P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (115) �p� / MADISON WI 537Q7 (1-163.090)&Chapter 145.045) IVW TI '/ '/ s ION. N/POE(or)W TOWN Si YYIP tFTY. �y Apo.eLI7C.No.. s�°►yJ o°"'�o"" s COUNTY: 'S BUYER'S NAME: I—M—A1-CIFYG—AD—DR--FS—S: Two S t 4 c�01 x TO 1--,( 'M i I left d. �o 5 70 S:Y/cd� TAR /�'1 so7.�Rs USE jd,t� N0.BEDR IS.: COM, ER AL DES RIPTION: DATES OBSERVATIONS MADE Residence 3 Z �JXXNew ED Replace P S: PERCOLATIO rte" �7 404? MARC-IL S s 33 `(lfi I3 044/>I',v si/f /DA,4( RATING:S=Site suitable for system U=Site unsuitable for system ' r5—NIENTIONAL: MOUND: INGROS STEM-IN-FILL HODING ANK:RECOMMENDED SYSTEM:(optionalS XC�U ®S C]U ❑S ®U ❑S DU ❑S DU .yov.�h If Percolation Tests are NOT required DESIGN RATE: ; under s.H63.09(5)(b),indicate: L�^s $ S If any portion of the tested area is in the Floodplain,indicate Floodplain elevation: r PROFILE DESCRIPTIONS *v aCC/r1044 'r7 BORING TOTAL PTH TO R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED ES . GHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) f f; B-/ yo /03,y� .3. o s�� Ts, ��, -9r %�,�y Phtly) 4 D' 007-8,4- Stct�. w i" B- Fi�IFC'f S-6AJ E' Q P . B-,?- y3 /alr 9G ytp 3. 2 � a . S' rs. s' P4A�y as. sr i o• ��cc�y5 rtKC AV4 l '!'j B- 9y. ftl-A- S w lye. r '3.s ' � B- 3 G•O /p/ S/ 7.4 s �3 o Cr S Y to i 60- S f N -r--'F- • A?41t C B- �3 ; A/ 7 6Y-8,J. DEa.ISE S -2 ' A/-7r0,V* � S5a-*Ic r I&cNTio T of pzoev Icy, "' o>= -fear S ,up fiNe -Qa . Si l Nod PERCOLATION TESTS TEST DEPTH WATER IN HOLE EST TIME DROP IN WATER LEVEL-IN HES NUMBER INCHES AFTERSWELLING NTERVAL-MIN. RATE MINUTES ; P. P I P I PER INCH ' P- P- y 1 •.'SO P P' 0 Z. // 13 / I. i P — PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what ere 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. Si M1>1 R O Ck SYSTEM ELEVATION i N VEST o I 't �'sTRI'R�TIp,J pl pE /O y 30 i -r- i ( { I r 1 ' I I I . , t -- r- - I F' 1,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: o HOMESITE 6 5 O'NEIL RD.,HUDSON,W S.54016 ADDRESS: ROBERT ULBRIGHT CERTIFIC TION NUMBER: PHONE/NUM��,€ER ptionall: WIS.MASTER PLUMBER LIC.N0.3307 M.P.R.S. 2yT2-- Sol �s V hr;NN.INSTAL CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority,Proper ry Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) --UV ER — r`� REPORT ON SOIL BoRIN &S PERCOLATION TESTS 115- PLor PAN PRoTEcT 17. D. DA rE A4,P z HOMESITE TESTING CO. RT.3, O'NEIL ROAD BOB ULL'Riui iIUIySoN, wls. ...- 54016 :... Cs r, ss-02 Yf2- 0� PROPOSED HOUSE mos r CIE Fr. o f Aen F�POM A<< TEST �,PEgS, PRo posE o WELL M vsr LIE ,SO FT Ot Ib0/PE F�POH ALG TEST AiPE/1 S, • = AAce#4C Afr,f 0 = 405XIA16- WELL x ` �EQG /OC�►�/ONf a &AJD Rd9ERED owe, 54mel- Bowr5 r = yoeiz . BM _ VfRriiAL &ACRZAICE Pour :yVAPE ick-wrovs T sw• moo? �o,PN � LEGEND el"Arow of 1/01. &,,0. �1,' �o o• o ' C l- Turi v 40 6- �0o 5CAL-E DY' vim It) 3z gy Fr I PRoposE0 , 1 KE5ITE I I /00 ,�gDOos E� W1EII 1 , 3G . f' o 14 4 PROJECT INDEX SHEET S88 g _ '7 ' x OWNER: -fom I%// k 61j- - 3 y vo,? r< ADDRESS: PO. /3 0)c H 7 a Sail WAT-rk' /I/4,,/-A/, SITE '2JOCATYON: Nw% sw % S.tz. • I + T 3,n J R�-a w� To wN a f • S FiesE7- PROJECT DESCRIPTION: S-F.Gc.p t'1L Co uz T )( , SGf( Qd RiAJG-S 'R le VeA L 5 i4E- i S s'EAS oA-)464/ sh-ruAA*e .. (a.f 2.3 fl-) . DA I L Y A U tA.� co A S 4-L -Va w 0 , MaOab Sy 54- ,.- is RoPosE4,�) PAGE 1 . PLOT PLAN VIEWS PAGE 2. MOUND CROSS SECTION & SYST--,M PT&N VIE`9S PAGE 3.. PIPE LATERAT, T,AYOUT PAGE 4. DOSING OR SIPHON 0HfJ-1B7R CROSS S7,CTIONS PAGE 5 . PUMP PER F ORPtiiANC ' SP13 CS OR SIPHON SPECS PLUMBER: SITP, EVALUAT?R or DESIGNER HOMESITE SEPTIC PLUMBING CO. HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD.,HUDSON,WIS.54018 655 O'NEIL RD.,HUDSON,WIS.54016 ROBERT ULBRIGNT ROBERT ULBRIGHT WIS.MASTER PLUMBER LIC.NO.3307 M.P.R.S. �41 vIS.MASTER PLUMBER LIC.N0.3307 M.P.R.S. NN:INSTALLER&DESIGNER LIC.N0.00863 IM4.INSTALLER&DESIGNER LIC.NO.00663 A D E•Tom. SIGNATURE s I RECEIVED • RAY i 31998 OFFICE OF DIV ICN- CODES AND AP I s Y 44 SEr I p i ' T'.P of PIPE �p iS 100. 0 oRRO well of f6Po o it CAT S y CoHf3iaRnoa � Sf/Itt APPRoUEO • i000�e,Q S-2pfr'c�Soa 5-C Pomp you E ; (-- is 3.. F PcE F t-v ATI'V xj S 5. 77 ouT- Z 33 00 , , tta�L�� 3 (3EoR� tS T1,,, iT G yS 1 Ism C'EVA 1 t•0 /V DrO �l OG *•����`, ,�` �.,,a v / S ljs sw lot pa A) So- lo 4- �iA tip, 131988 C+ OFFICE OF pl . = J3gctY� 40,PFs COPES AtJD Pit 0 ,, 9 HOMESITE SEPTIC PLUMBING CO.. PLOT P L A N 655 O'NEIL RD.,HUDSON,US.U0116 T yy�Z ROBERT ULBRIGHT WIS.MASTER PLUMBER LIC.NO.3W M.P.R.S, UNN.INSTALLER 6 DESIGNER LIC.NO.00663 • 4v 04 Page Of Synthetic Covering Distribution Pipe Medium Sand S y STEM - H � £/EwFT►•N Topsoil == S8g 0-1447 Page 3 Of S fog V'�����R►�� a DR^fN r Perforated Pipe Detail 0 End View Perforated Eno Cop ;�+ PVC Pipe 'off• • Holes Located On Bottom, lY a Are Equally Spaced • S S Q .7 PVC Monifold Pipe Alternate Position Of Distribution Force Main Pipe Lost Hole Should Be Next To End Cop End Cop Distribution P' jyzdyout P Ft ��P � .� �,, ', •� F��,P� X 30 Inches cot-, Inches � " a 10 Hole Diameter Yq Inch Signed: y' g �� Lateral Inches) "' c� �E License Number: `'. Manifold Z- Inches Date: Force Main 3 Inches # of hol es/pi pe � Invert Elevation of Laterals SFt. 5,4 ND oc sl57" QZvgTleAj /00. 0 Fr- (117 1 o toe s 7 R .S o ,,�.... , � RECD E - � NAY 13 1988 of OFFICE '' CODES AND F�,aI•,;�r•,, ,�;J of 5 SPecs ; �IF F J p\yGS SEP P CROSS SECTION AND SPECIFICATIONS n� PROOF 4" CI VE E 12 MIN . ABOVE GRADE & ✓!'WEATHER >_ 25 ' OM OOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE . WITH CONDUIT MANHOLE ,.COVER W/ PADLOCK & FINISHED GRADE 4" CI RISER WARNING LABEL 6�� MIN . r 4" MIN. ABOVE G ADE _ 18'" IN. 6" MAX. INLJE GAS- WATER TIGHT SEALS � TIGHT i v A SEAL APPROVED 4" BAFFLE i ; ALM JOINTS W/ CI CI B i PIPE 3 ' ONTO 3 ' „ yZs -F- , ON SOLID SOIL SOL C ,SOIPUMP OFF ELEV .95,75 FT. - - OFF * RISER EXIT PERMITTED ONLY Js,Z 5 D IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK -lA ak CONCRETE PAD Sep S' SPECIFICATIONS SEPTIC / DOSE �01�5�2 C'a,��'f-c � f/ 1�2•sJ�� TANK MANUFACTURER: HkipE� -P-O C!c C41S NUMBER DOSES PER DAY: TANK SIZES : SEPTIC ��� GAL. DOSE VOLUME INCLUDING DOSE 500 GAL. 25 ' FLOWBACK: �2?.— GAL. ALARM MANUFACTURER: Lr--OF-( A(AAM CAPACITIES: A X308.5 INCHES = -360 GAL. MODEL NUMBER: t77 V, L 2 = Za GAL. SWITCH TYPE: MgP R cuY FIOAr- B = 2 INCHES PUMP `MANUFACTURER: 2n Ell X12-- C = 4-S INCHES = GAL. MODEL NUMBER G 7 ` Z �'�- D = SWITCH TYPE: pi6-6y R/4CK tNERcuity FloATf 6 INCHES = `� GAL. REQUIRED DISCHARGE RATE 7Y GPM PUMP, & ALARM WIRING AS PER ILHR 16 . 23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . y75 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . . FEET + _2-5 FEET FORCEMAIN ;A 4AA FT/100 FT. FRICTION FACTOR . _ • _� FEET G� I TOTAL DYNAMIC HEAD I� INTERNAL DIMENSIONn OF PU K: LENGTH 3(P WIDTH 7 / ; DIAMETER ON%S014 d4QUID DEPTH .7 OFFIGE DFPpPL%CPj 00 SIGNED: _ r�pD�s � DATE: LICENSE NUMBER: 1, t � � W W W HEAD/ LL CANDJASCITY ? ,� CURVE h ,95 95 28 so- 26 j 85 � I EFFLUENT 24 eo MODEL p 75 MODEL 189 and DEWATERING =22 70 ,65 V 20 65 Q � > l9 O 55 It 16 MODEL so 1I MODEL kit � 14 45 1BB � 01 12 •0 Q ' r 10 MODEL (J MODEL 137,139 10 Jr SEWAGE and ° 25 DEWATERING 6 20 MODEL ,5 MODEL 161 4 97 \ 1! 2 MODEL Cis u¢i uWi 5 53,55, W 57,$9 i 0 GALLONS 10 20 30 40 50 SO 70 SO 90 100 110 24 LITERS 0 80 180 240 320 400 75 FLOW PER MINUTE 70 20 � 18 80_ MODEL- — p 295 W 55 tirr. z Is- 50 R E Q14 45 MODEL 12 49_ 294 - -- - -fi- F-- MAY 13 1988 35 MODEL -__. -� -- -- -- Q 293 1 C -�10 MODEL - _I- OFFIC- + ° 25 - — - - CODES MODEL 6 20- 282 + — - • 15 - - - 10 -MODEL 3i • 2 267,2 is I Li 3260 Ofd U NM Lens 0 P.O.ear 16347 GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 180 LoubvlNs•Kenftvc 40216 Zoeller builds the most complete line of dewatering, sewage, SEWAGE and DEWATERING pumps "26r and "268" Cast Iron S6/fes s Automatic or Non-Automatic. CAPACITY • ,,2 H.P.,1 Ph., 115V or 230V. NEAR UNITS/MIN is Non-clogging vortex impeller design. Feet Meters Gat. Ltrs. s Passes 2 inch solids(sphere). 5 1.52 129 464 • 267 series features a 2"NPT discharge. 10 3.05 89 337 If 268 series features a 2" female - 3" male com- 15 4.57 so 189 bination NPT discharge as part of the pump. 20 6.10 10 39 • Float operated, submersible (NEMA 6) mech- Lock valve: 21s anical switch. • Automatic reset thermal overload protection. cenodian srand8rda L Assoc Approval • Stainless steel screws,bolts,handle,guard,arm listed S available and seal assembly. 266-state of • Switch case,motor and pump housing,base and Wisconsin approved impeller are of cast iron. 8C-2225 M266 Pictured N267,non-automatic,available packaged with a piggyback mercury ••••a• float Switch. NOTE No UL listing for 200.208V/1 Ph Mercury float switches are available for N268. pumps �n ST. CROIX COUNTY r WISCONSIN 1r ZONING OFFICE r 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 March 4, 1988 I Division of Safety and Buildings Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir : An on site investigation for the Tom Miller property located in the NW 1/4 of the SW 1/4 of Section 14, T30N-R20W, Town of Somerset, revealed suitable soils at a depth of 2. 3 feet, below which high goundwater 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, 0 . I /rc., Thomas C. Nelson Zoning Administrator rc 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 deedsrecording. ---------------------------------- -------------------- Owner of property `/ 170 / A Location of property/ `V-1/4 1/4, Section , T 340 N-R M W Township Mailing address e , /30x 4y? Address of site y� Subdivision name ! "v�N Lot number 7 S 7 W 7 Previous owner of property Total size of parcel 2 '1 dd 6te S Date parcel was created OAX_ Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes No Volume 2?and Page Number 20 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. -------------------------------------------------------------------- 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 r coded in the Office of the County Register of Deeds as Document No. ; 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 Registe of Deeds, as Document No. �) • Signature of Owner Signature of Co-Owner (If Applicable) Date o 3igna ure Date of Signature I Rte, o- f. Z !F wow .k: A^ `4 r `� �✓� eR s .._t Lq j Y. OWn No. 356331 s. rocordod on April 19, 1979, in the SR. flit corntP,•liioc000la, In volme 3 of Survey Nos, •"P F 40 pummmt tots 2 mW 3 Section 14 Township 30 North, ,.� !t. am" clowtr, Niscoaia. � "g X 3 Ak t Tboo E. Novicki a.� J M. Novicki Nti����, N'TATNOR1 HnINUMA IAMM OQlllly. M .1t...� POUN0 681mosnrtN late r Aeril .t�.d1... Thorns t. reYicki i iaL Y_ Yertwkt husband and rite _ N us M�Iw11�M Mt ll�d lb . �`Mi ,Mwaf�.! Nr�wMra�wlsMaMwwM�Mrw�w l Ml r wwws�waw TITLE t� lisr 6204 n'rm SUN r Mt or 4dMWft $& ft* Mv Oawoom N PwweIML Ma"* I I 3.q �PPV�K: Na���MI����1�M N�1IM MAD ONM'�IMM. { +Ai f S T C - 105 alt SEPTIC TANK MAINTENANCE AGREEMENT ►°+ .. 'i St . Croix County t � ! OWNER/BUYER ROUTE/BOX NUMBER `� /� y7t/ Fire Number { ' CITY/STATE I�f�jj2(i[� �s �IP ,r h PROPERTY LOCATION : 14 �w �y, Section / , T,70 N, R iii Town of s/ ' �/ 6V�� St . Croix County, Subdivision y Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper maintenance con- sists of pumping out the septic tank every three years or sooner , if needed, by a licensed septic tank pumper. What you pUt into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix. County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St . Croix County Zoning a certification form, signed by the owner and by a master plumber, ,journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary) , the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. o l I/WE, the undersigned; have read the above requirements and' agree N to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- ro ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Off:Lge within 30 days of the three year expiration date. SIGNED Z `I k. DATE St . Croix County Zoning Office ] P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign , date and return to above address . ► t� ,