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HomeMy WebLinkAbout042-1041-50-000 ~ I O O 6 h C II O y o -0zd ' O ; m `.y w m � a�a� N a m E o c0 0 �L CC y aEi 0 o T t 0 D7� a - � w- d o cm E 0i 3 Ew N w TY y N U'- a z E z 22 a) o• I C moor LL C LL C N o 3 O °�E' 3 Ez� � E ¢ w � a 0v°',r O � I I T `) 3 ° v z E 00 :: 00 OZi 'O d N d d L H z a CO a m I o I o Z d c v o o - d Z c c Z to H .= �' E 1 c E v N CL a� N C O N I • C O C C O C Q Z F Z Z F- Z w N _ z y � 7 � N O R .. H 0 CL CL y y d O r N d N O j j Cl)n z n z z •N aaa aaa y CL o c m fq J U a�i z m CO 0) 0 Z Wft*l N N N O O LO 0 LO O O ml c c co ta c 4. C y (D 0) 4) i'. W 'p d Q S <n Yy! 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CROIX COUNTY, WISCONSIN f SUBDIVISION LOT � LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM S i c-e'�-w.��� r/�cv...� n r 5� Ge•„K.✓ .,yp Gor.-��... .'z!o• 7 — r /far-tom� p �et.._n,.. � c�- I/�.•i q, ----e�rrnn ,,qq. B � w , v n o2ppO� lr � f lzlde 73/ I OD too ! ! i i 6 CQ E 4 ARROW .Z BENCHMARK: escribe the vertical refe nce point used ~ A _ /00.,00 Elevation f vertical reference point: AP-0,06AITroposed slope at site: _,?A SEPTIC TANK: Manufacturer: Liquid Capacity: -at , Number of rings used: Q Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front 10 Sid�40 Rear, (zy-- feet From nearest property line Front 10Side,bRear,O / 13 / feet Number of feet from: well — � building: - , '� (Include this information of th above plot plan)( 2 reference dimensions to, septic tank) �- II SEE REVERSE SIDS PUMP CHAMBER Manufacturer: r,&Pw Liquid Capacity: p0 Pump Model: Pump/Siphon Manufacturer: o `� '/ Pump Size Elevation of inlet: ]° _' g Bottom of tank elevation: Pump off switch elevation: �. Gallons per cycle: 4, A nufact rer: Alarm Switch Type: ��� _� �=a,i,p✓ Numb r of feet from ne rest property line Front, O Side, ear,0 Ft. 00 Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: s'� S Width: �� Length: 3/ Number of Lines: Area Built: /S g � 5— Fill depth to top of pipe: 3� v4.G _3-V Number of feet from nearest property line: ���....////Front, Side, Rear,O Vt ._�/ t� �S q Number of feet from well: J y' 1 rs , Number of feet from"building: (Include distances on plot plan). j SEEPAGE PIT 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: 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, OFt. 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 R.O.BOX 7969 BUREAU OF PLUMBING MADISON WI 53707 NW ,SE ,S15,T29N—R18W YM CONVENTIONAL 1:1 ALTERNATIVE I Stf ate Pianl.D.Number: U assigned) Town of Warren ❑Holding Tank ❑ In-Ground Pressure ❑Mound S88-00814 HWY 65 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Ted Gulich Route 1, Rober ts, WI 54023 _S. BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT.ELEV.. Name of Plumber: MP/MPRSW No.. County. Sanitary Permit Number: Henry Nechville 3258 St. Croix 106085 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET E LEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. DYES ❑NO DYES ❑NO BEDDING: VENT DIA, I VENT MATT HIGH WATER NUMBER OF ROAD. PROPERTY WELL. BUILDING: VENT TO FRESH ALARM FEET FROM LINE. AIR INLET. ❑YES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER. =EINO LIQUID CAPACITY PUMP MODEL PUMP;SIPHON MANUf ACTUREH WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: ❑YES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET. PUMP ON AND OFF) ❑YES 1:1 NO NEAREST" SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing I I N(.TH IIIIAMI TE11 111ATI HIAL AND MARKING; or excavation. (If soil can be rolled into a wire,construction shall cease until FORGE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH IN0,01"',HH NC IDIST11 PIPE SPA(:INC MATERIAL' :=III DIA SPITS DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH j)!S7V1 P IP. E DISTH PIPE DISTR.PIPE MATERIAL NO DIS7H NUMBER{JF PROPERTY WELL BUILDING. VENT TO FRESH I I BELOW PIPES ABOVE COVER EE .INLE f ELEV.END PIPES '' LINE AIR INLET: FEET FROM NEAREST--i► MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. 1:1 YES ❑NO SOIL COVER TEXTURE PE HMANI NT MAHKE HS �JSEHVATIIIN WELLS _ EYES 1:1 NO _DYES 1:1 NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BEU DEPTH(71 TOPSOIL S(IOOFD JSEEDFD MULCHED CENTER EDGES DYES. ❑NO DYES 0 N ❑YES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: '.BED/TRENCH WIDTH. LENGTH TR EOOCH ES. LATERAL SPACING (]RAVEL DEPTH RE LOW PIPI- FILL DEPTH ABOVE COVER DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO DISTR DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING >=LEVATfOhI AND i'.ELEV.. ELEV.' CIA. ELEV. PIPES DIA DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ❑NO El YES NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑YES 1:1 NO ❑YES ❑NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE TITLE Zoning Administrator DILHR SBD 6710 (R.01/82) SANITARY PERMIT APPLICATION COUNTY /� =Zam HR In accord with ILHR 83.05,Wis.Adm.Code 0—Rol --�- STATES/ANITARYpPERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBEJI 8%x 11 inches in size. Q,66 J?/IS -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ® NO PROPERTY OWNE PROPERTY LOCATION ,41af Sc %, S I S T , N, R iE E(or W PRO R f OWNER'S MAILING ADDRESS LOT, M ER BLOCK U ER SUBDI) 10 E CITY, TE ZIP CODE g PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK SSoO� js, ❑ VILLAGE: II. TYPE OF BUILDING OR USE SERVED: & /_C�L/ LCJ`a�ts, � 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. 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 inspectedand 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;-6-onventional SYEM: (Check only one in#1 and only one in#2) 1. a. b. ❑Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tan k V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. El Seepage Bed b. LT See a e Trench c. ❑Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVA ION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): �,�y -40 &✓ 9eet� rivate ❑Joint 1:1 Public CAPACITY VI. TANK Site in gallons Total #of Manufacturer's Name Prefab. Fiber- Plastic Exper. INFORMATION New Con- Steel xisting Gallons Tanks Concrete glass App. Tanks_JoTanks structed Septic Tank or Holding Tank eoo + Lift Pump Tank/Siphon Chamber '✓ I I /'Fee !/ i 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 Signature:(No Stamps) MP/MPRSW No.: Business Phone Number: Plumber's Address(Street,City,State,Zip Co ): Nam f Designer: A 50 91 Vlll. SOIL TEST INFORMATION Certified Soil Teste0.etc, ame CST# a V% CST's DRESS( y,State,Zi C e) Phone Number: / C -39' `°8 IS IX. COUNTY/DEPA TMENT USE ONLY ❑ Disapproved S Hilary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved El Owner Given Initial y O,1 harge Fee �Q Adverse Determination U s 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 syste!:i, 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: 1. Property owler's name and mailing address Provide the legal description where the system is tc be installed; 11. Type of building or use served: K 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; Ill. 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; Vill. 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 8'/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale orrrith 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 biil (wound later included the creation of surcharges (fees) for a number of regulated practices which Wisco, in`s can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasut'e is used in your building is returned tc the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. a Tie nor,:es r.ollected through these surcharges are credited to the groundwater fund adminis- terec by 'he Department of Natural R-=sources. These funds are used for monitoring ground.- t ate , gr}ur,Jwater contamination in�estigations and establishment of standards. Oroundwat :r, _ i''s worth protecting. SBD-6398(R.03/86) ► x � !�b:s��t'.Ia ��i8Wf11d a m 711 r ft6� d " ?'�� , -- - - - - -- - - - --- - - rn A x a �^ + m b lA + 2x h o i c N r �'_ O� rn m 70 IA rn m � o O• .� o o n, M 3 "1 rn p p tit, ` rt `� �v oc � ol✓ � NJ 1p- a, ~� c w� o � ► e � y 'o o M � o Z- v' ! C RV to 4 �" H rn T t Cl "- a N € ,� �► o o r : ri "s m a ob Zf op a� a 1 0 IT z Of s Q c- - ---------- n V C + oy1� 0 s�j '�nry .31�1S 1'Ea I.L. . 93.08 (2) PROJECT INDEX SHEET OWNER: -rep �.�r.a . GvlcG, rtev �l��aU.- ADDRESS: V-+-1 !�w y Co S o at-RTS , w I'S 5 4 0 2. 3 SITE LOCATION: (� ,¢GI,L Pvcf/' % Ni fee No � i 04EOu C�L't�'t�^1 o F Sr+hT Nwy. Ges 7t- S. Rwy. 12— IVwll56%y Sac - 151T)- fA) , Plew PROJECT DESCRIPTION: °w'v Po H"R. ewlt- G, W111 VtpANv kl's Rvc,kI pARts 54rel Pole- RI sj,x yd ' w r i'� 4u .4 vo,t�oAv < sy'� To , ) N curl/ P � ) pegofr� SERE New AooiTioa vim q REST Q/M , 3 3 f /a 0R De4i.#1S . P S J /p T�v c/ E�Ps ECQe,rtRP40-f5 110 i ES pc Vs op�R 1TC �o %LLp , 13u+ DO 1j 0'r oec-v P y I'f- ' s s��.� A, PR 1V ATE o I g S�liJq�,e f"11 /iG y S0i/ Aoi , //S �rat�f �c':=ve,1/ �•t f Soi/s /3iE�E' ,96S�&-o� r^faa1js l DAD elV� Dis-�RI607-4Ow TOTAL hkir,y G-'ASTeIOAR 1/30d*As SySTcr1 TLA%a VIED 1-01A' P'EQCl!QeD A$SORP+ION APtj i PAGE 1 . JLOT PLAN VIEWS Std C PAGE 2. NaWa CROSS SECTION & TAT1 Z T1TTfT__T..1.TT1T.1T T 1Tf/1TTT PAGE 3 . DOSING OR SIPHON CHAMBER CROSS SECTIONS a PAGE �. PUMP PERPORMANCE SPECS OR SIPHON SPECS PLUMBER: �E�Ry �Ec,{,�vi1�� SITE EV.ALUATER/ DESIGNER P-4 . / Nwy (05 HC7MESITE SEPTIC PLUMBING CO. � PO B��.f-s if/,f W2-3 655 O'NEIL RD.,HUDSON,WIS,$4016 ROBERT ULSM014T -715 - WIS.MASTER PLUMBER LIC.NO.3V M.P.R.S. MINN:INSTAttE#k d@S'MIR VC:NO.00663 DATE: 14hed I —1fd? G .S•T• Z'��2,— SI GNATURE: .�►J AI' ". 41983 P5 . 2 0f9-- -1+- +4, � 0Cp ( (4 I'G(ti TREAJUgS Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12" Above Final Grade r„)i541Ed 32-” Above Pipe — 4" Cast Iron � -ro Final Grade Vent Pipe � 11my Or Synthetic Covering O Min. 2++ Aggregate Over Pipe 0 Distribution Tee V Pipe —� 0 0 0 0 0 , (� lot of PIPE 16.0 O Aggregate re ate 99 9 o Perforated Pipe Below � •v� S YJ rCr/ Beneath Pipe , o 0 r • Coupling Terminating At SYBU14m Of System r o �'�,i' "Pe-le 501,L TES'(' , J. iok ►� ` `x , , * RELATIONS ) rit.)sr'�. f C iJt 77 I'e..r pEFAR i N '.k V Ji"• ,, � GVSSiU,a Ut' .. V SEE C.Gf=fFi�:cn01�t3 W .. T Y P+*«L � HES /ow F R �Q T��ticti�s • • o THE L l � v Fresh Air Inlets And Observation Pipe O L Approved Vent Cap kk Minimum 12" Above Final Grade �i�✓i"Sfr�D , Above Pi 4++ Cast Iron 3 — y Pipe Vent Pipe To Final Grade SNy=Or Synthetic Covering �I¢ Min. 2" Aggregate T ' Te or Pi PE Distribution Over Pipe Tee RECEIVED Pipe 0 0 0 0 0 4 y P s Aggregate o Pe r f o'pLIql1 kE� kl? SyST Beneath Pipe 0 Coupling Terminating At �ER Bottom Of System �S yo PA&e PAGE OF F PUMP CHAMBER CROSS SECTIOU AMID SPECIFICATIONS j . i VEWT CAP y"C.T. VENT PIPE OF APPROVED LOCKIWG WEATHER PRO y� t JUWCTIEK PROOF COVER 2' L5' FROM DOOR. .12"MIU. WINDOW OR FRESH I AIR INTAKE I mApel q7 Q GRADE I 4"MIW. 19"MIU. r, _ a18 0 MIN. .S \ IWLET � r,< 94dRTIGHr IONS APPROVED JOINTS APPROVED JOINT A G.'% �' I I i W/C.I. PIPE � W/C.I. PIPE %t��2.��,,rF `•" EXTENDIUG 3' EXTENDIWG 3' Z ONTO SOLID SOIL � C3E;f c 1 I PVJTO SOLID SOIL e i I oW 1 O C q IN �o . ELEV. g �0 PUMP—� __ OFF COAICRETE BLOCK C g0•� KISCR EXIT PERMITTED OIJLH IF TAWK MAWUFACTURER HAS SUCH APPROVAL _ SPECIFIGATIOt�1S 0AIt / WAS�"� roAD SEPTIC E " DOSE 61 eR e!ONC`t f-4— I.WMBER OF DOSES: Z PER DAy ! T_AWKS MAWUFACTURER: ,�p TAWK SIZE: GALLOWS DOSE VOLUME ��$ �` ' ZG 3 -- ALARM MAI,IUFACTURER: �6 LEUeI f>•�itRM IIJCLUDIWG SACKFLOW: GALLONS - CAPACITIES: A= INCHES OR 3� CALLOUS MODEL WUMBER: SWITCH TYPE: OA B= Z INCHES OR GALLOWS C: IMCHES OR ZG'3 CALLOUS PUMP MAIJUFACTURER: MODEL WUMBER: yj' D- / —INCHES OR y�O GALLOWS SWITCH TYPE: ER LVR` f I0A_+ 3 DOTE: PUMP AMD ALARM ARE TO BE INSTALLED OW SEPARATE CIRCUITS MIAIIMUM DISCHARGE RATE sa _GPM 1 VERTICAL DIFFEREUCE BETWEEM PUMP OFF AUD D13TRIBUTIOM PIPE.. T S FEET J?,Vle f,4 + MIWIMUM METWORK SUPPLY PRESSURL�E�/. . . . . . . . . . . FEET "A ♦ /30 FEET OF FORCE MAIM X S� F/oo,FRICTIOM FACTOR.. ' Z5 FEET TOTAL Oy1JAMIE HEAD = FEET O - SI yam „ IMTERIJAL. DIMEWSIOWS OF TAAIK: LENGTH ;WIDTH LIQUID DEPTH 91GUED: LICEOSE IJUMBER' DATE: fj 130 6f 3 40 WEIVE0 lr poi 4IX4 �o40) = y� u,Ds ANR 13 0 HEAD/ rn W Q W F W LL 115 I 34 CAPACITY 110 32 105 - CURVE 30 100 — 95 28 90 I 26 85 EFFLUENT 24 80 MODELI and a 75 MODEL 189 DEWATERING = 22 70 165 -- U � 6S a > 18 5s 16 MODEL O 163 MODEL t- 14 45 188 12 40 -- 35 10 MODEL 137,139 MODEL SEWAGE and 6 '� DEWATERING 6 K MODEL 15 MODEL 181 4 87 10 a W 2 MODEL H 5 53,55, w 57.5R 0 i T. . i i GALLONS 10 20 30 40 60 6011 70 80 90 10'0 110 24 75 LITERS 0 80 160 240 320 400 22 FLOW PER MINUTE 70 20 is so- — - --- - ODEL- -- -- — 295 W 55 = 16 - t- U 50 _._ Z 14 45 MODEL �- 294 p 12 �- -- a 35- MODEL 293 -- - -- - -- --t—._ F -> 10 Q 30 MODEL _....' ~ 284 -- 8 25 MODEL 1 6 20 - - - 282 - I - - - - 15 10 F_ MODEL OELLE/P O. 2 5 267,268 0 3280 OM NMI=Lane GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 X130 140 150 160 170 180 190 P0.BOX 16317 LouloWNe, Kentucky 4111216 \ / LITERS 0 80 160 240 320 400 480 560 640 720 (52) 776'2731 N' FLOW PER MINUTE i Zoeller builds the most complete line of dewatering, sewage, SEWAGE and DEW4TERING pumps .,� I "26r and "268" Cast Iron Sodas .1 I I 0 Automatic or Non-Automatic. • 'h H.P.,1 Ph., 115V Or 230V. HEAD CAPACITY • Non-clogging vortex impeller design. �^l+ UNITS/MIN • Passes 2 inch solids(sphere). RE:Ci1,..I v 001 ' Molars Gal. Ltrs. 52 128 464 • 267 series features a 2"NPT discharge. i{I 3 05 99 337 • 268 series features a 2" female -3""Male'com-AH - 4.57 50 189 bination NPT discharge as part of the pump. 20 6,10 1 10 36 • Float operated, submersible (NEMA 6) r 21 5• apical switch. "��.'�P�`��x�ir � ��" 4`�� • Automatic reset thermal overload protection. Canadian standards • Stainless steel screws, bolts,handle,guard,arm listed C Assoc Approval �o available and seal assembly. • Switch case,motor and pump housing,base and M Wisconsin approved 266-state of /y impeller are of cast iron. M268 Pictured N267,non-automatic,available packaged with a piggyback mercury N�N� SC 2225 float switch. NOTE No UL listing for 200-208Vi 1 Ph Mercury float switches are available/or N268. pumps INDUSTRY," OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS LABOR AND C DIVISION HUMAN,RELATIONS PERCOLATION TESTS f 11 k 5, PA I c� MADISON WI 969 (H63.09(1)&Chapter 145.045) 2. Nw ��5 '/ Is /T i9 N/R ICE(or w TOWN � p��y; OT NO.•BLK NO.: SUBDIVISION NAME: COUNTY: W M : (T a IMAILING ADDRESS: Sfi•CRo1iC T�� G�/i'�G� Gam, TRWIA/49-1 14. 1 Hwy. Cos Ponears Cats S.Fv23 us E SST/N6- 13L,06-, DATES OBSERVATIONS MADE ❑Residence I PTI O PROFILE DESCRIPTIONS: PIIIOLAT19N TESTS: TRVC& PA -' XNew ❑Replace APRiI S 14ry ,gpQ;l 6 7tc� wA EkouSB' �a�R,;eF /b .RuGNfR 2 M. t:c)„ya fC 5 ) Z 5 ecR a roor IQ ILL-s 1 144,t f l b oa p p�fi,v i�E•vck. I ,. RATING:S*Site suitable for system U-Site unsuitable for system O RA%•4Jf ONVE : MOUND: IN-G S 4 -FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) ®s au as ❑u as ❑u os ©u as ou . TRENUAs - w,•-� pop Qox�s EA If Percolation Teats are NOT required DESIGN RAT S t o W a E: [Floodplain,any portion of the tested area is in the under s.H63.09(51(b1,indicate: C/A S-S indicate Floodplain elevation: ' 5G$ O SgTTiQ S%/ PROFILE DESCRIPTIONS to 'DEB-i�A44L Fr. BORING TOTAL DEPTH TO R UN Nl1MBER DEPTH IN, ELEVATION DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH 9-SERVED E K�_, H ENS TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B. / �, o' 9 ,15 7�— > .7S' ins . '!z'Al-dj . /S cct�K s , .67• o,P. 4euRk S �, Q /.5 ae -p4_5, 1.33' "-$a . R1 O&k-y sl 3.3 ' f,N,e +4A.1 s ' r �- t l . -7` � )S k BIaAN s S!, S�S''Q - G1.�'xL G (/u,gec A3.o s ►Z. 3 5 O H m S t'Ai '/o Yw F P +,jN -fI 10ore S.Pit 3, R o, /' B-v 51' i ' s 3.33 T N '►�+� .$ B- �•�� �/` , , O l,o /r-y s/, 1.33 Y 3> c w e0uR!R AI r �I B'S to �� do � > � Q I 3 I r?It" s�'/� I,GG Ba. S (.,i' 0 C.Kt f N . S tM 0, PERCOLATION TESTS { TEST DEPTH WATER IN HOLE TEST TIME DR 1 WATER L V I H S RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. p 1 P r R 10 E2 2 PER INCH I .6 a 2 a Z G 13 , 3 P. I�. P- Z l P- P . r,. 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- ik to ta slope. all 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 +� �FrGt1 -TRIEA)a-ts C3) = ?a. 0 p SYSTEM ELEVATION �ol,,� TR fVC g s ( 3) = 9S f _ " r ; A4 } - �- 'flayo2 t,!?I�iN5 - __ I 3 I ? R loon v,��►,,Ivs , - - �- r. ._.. _._._.�._ --1.__+_ --- _. X S o� A J , t-- i I -- ' . 0 S f L !S _ LTA 1f „% ��- s o ' - r s o s = 1,#w 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 date recorded and the location of the tests are correct to the best of my knowledge and belief, i AM (print): HOMESITE SEPTIC PL TESTS WERE COMPLETED ON: e v. IN%O'NEIL RD.,HUDSON,WIS.54016 7 j ADDRESS: d! CERTIF�A ION NUMBER: PHONE NUMBER(optional): WIS.MASTER PLUMBER LIC.N0.3307 M.P.R.S. CST SIGNATURE: '/', r -± I E DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. f' ) OfLHR-SBO.6395 (R.02/82) -OVER - ' sr-rTF . o -q W w � fl'OC & Z w3 V U. Nom* C 23 o �' j, 'a • Qk W . Q� c4 W h i C O CO 'yam cr a _ (Yl `N OL V a Q ` v � A i w V4 iu 0 uL EA 0 �a o IN l '2 T4 w W Cl- W 1 .Q • IX N l W o- awe 1- N Z O Q Z u uL as 0 -.i 1 Ot �n u G p h A' ¢ in 1 ¢ V a w ----- - -- -- -- - - -- 1 pWr. Q e n u 11 . x cn H a 9TC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT 0 St . Croix County x ty a ��J H OWNER/BUYER �� ��yO M ROUTE/BOX NUMBER T/ �T w �i S` Fire Number .CITY/STATE ZIP '�',� �_ PROPERTY LOCATION: Al.tl IL, 36, Section T 29 N . R.j W, Town of ).o'14 , St . Croix County , Subdivision SAM , 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 pdt 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. 0 I/WE, the undersigned , have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- ho ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Offkge within 30 days of the three year expiration date. SIGNED p 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. 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 S�--h;, Section / S , T 5, N-R /8 W Township Mailing Address Tj ZZ w Address of Bite Subdivision Name . Lot Number Previous Owner of Property j2 .4t4_t4_& p Z,, _I_. Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? Z---___Yes No Is this property being developed for resale (spec house) ? Yes �� No Volume 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 Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I We) ceAU6y that aCC statements on thi-6 oAm ane th.ue to the but o6 my (ouh) hnowtedge; that I (we) am (ahe) .the owne�c(�s� o6 the pnopenty deAcAi.bed in thin in6oAmaLi.on 6ovn, by v.ihtue o6 a wa Aanty deed kecohded in the 06 ice o6 the Cc utty RepAteA o6 Deeds as Document No. ;, 7 �; and that I lWe) pne�sentty CROW the pnopoa¢d b i,te bon the sewage di�spo�s dy6 em (orc I (we) have obtained an eaeement, to nun with the above d6chi•bed pnopektq, bon the conAtnucti.on o6 eaid eyste n, and the came hae been duty keeakded Zn the 066ice o6 the County Regi4teA o6 Veeda, Uocwnent No. ) , SIGNATURE Op OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED { � :� p...r.wj�}+Me.'xll �H«e ..'.YfM•...«wrww.w..i.•-we �� �p Xi+..,Ye».u..w*�..«e.».r•�.:«. r.�»..x.-.. ....s«.....:ti......+..�s,...»........, :......-... .«. .•.... _ ...... Gwr�er.S r a� mribtJi-Ltti!hate in. ..... ...t7.L-.—Ll.lJX............ .... .. N" lop � ` d Tax Kay This it. .».» latnd located .in the Sk of Section 15-29-18. Town of Mir diCwfAed as follows: The N 370 feet of the E 700 feet of the W a ;N°1 e�cgptitig that portion currently dedicated for right-of-rMd► d TM* Highway 065 Parcel containinq S acres vore or legit. am or t �ky d y, X p d .• +� Robert E. ',row* � ............ c ! Julie Am r r � du a Jim � 5f/.r� - -i^+ --s4'w.yy'.� r .. »..»pnr i 8 e...�r�F/y� .s:3u•��� M Y�Cl7iCYb3�ti+e`[u�►u+R roiltaallrL� ••• ,.°���- }, Tyy