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HomeMy WebLinkAbout036-1086-50-000 . . j 2 a cc \ ) 2 §_ AI{x % % Ecm t3 kkk5 cL\ \ \ a0\ ® §2t0 E.2 : > ¥ e � 7/ \ � \ / Ioe@ oe�- @ E]\Q e LL 2-0 / cc + E - ) & e § � n \ \ \ a m . n E � § z \ « 9 50 $ 7 : E 2 � - � } � , c � c CD a 0 § 7 2 � g � � { � ° > j � ~ ) 2 * C,6 k b \ E 0) Lo _ - E 2§ k j \ k k K FL 0- ) - £ E a a a a ) \ \ § \ § \ \ o , z Q E g } E \ \ \ » / c a � k k J ƒ Cl) i � � � ■ ] ° L \ _ \ co & E a = o 6 c c S £ 8 8 E ° 2 \ ) S S § 2 k ® - / a c 40. a 2 § C'S . $ z z f \ § 4 a \ \ } \ c z k k k 2 \ � E . % E 2 ( 0 § f . E c ; c , � k J 0 , PUMP CHAMBER Manufacturer:Z"- Liquid Capacity: Pump Model: h)P4 Z4,, Pump/Siphon Manufacturer: Pump Size �y 7S Elevation of inlet: Bottom of tank elevation: Ij Pump off switch elevation: Gallons per cycle: -,452���- Alarm Manufacturer: . / o�s Alarm Switch Type: Number of feet from nearest property line: Front, O Side, Rear Ft.1 Number of feet from well: / Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM /7)64r,f),Q -- Bed: Trench: ^ 0 Width: Length: Number of Lines: Area Built i Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side,Rear, Ft . � Number of feet from well: / Number of feet from building: ff I r (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop O box O or distribution box 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, 0Ft. Number of feet from well: Number of feet from building: h Number of feet from nearest road: Alarm Manufacturer: //0 Yy+ a.#7 /y Inspector• Dated: Plumber on job: License Number: 3/84:mj T Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. T-=�N-R W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM poaOD I .3' { I R � 7f�� S � t E �4 INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference (point: �j���lL_ Proposed slope at site: SEPTIC TANK: Manufacturer: J , Liquid Capacity: 4z Number of rings used: Tank manhole cover elevation: s 3 9 5 • g v �n �JL? /•�' Tank Inlet Elevation:l0-8,(� •b Tank Outlet Elevation: Number of feet from nearest Road.: Front,®Side 0 Rear, O J, feet ' From nearest property line : . ' Front,0Side,0 Rear,0 .1 r feet J ,/ Number of feet from: well —_�^L_, building: .3 'Y (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE 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 SWI,4,SW',4,S33,T31N—R17W ❑CONVENTIONAL (ALTERNATIVE State Plan l.D.Number: (H a�aig-�b2637-S Town of Stanton ❑Holding Tank ❑In-Ground Pressure U Mound 7 CTY K NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION D E: ! 1 Rick G. Powers Route'4, Box 40J, New Richmond, WI 54 17 (0— 3 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.: Name of Plumber: IMP/MPRSW No.: County: Sanitary Permit Number: Calvin Powers Jr. 1563 St. Croix 92535 SEPTIC TANK/HOLDING TANK: WARNING LAS MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.'. PROVIDED: L PROVIDED:OVER DYES ❑NO DYES ONO BEDDING: VENT DIA.: VENT MATL.: HIGH WA ER NUMBER OF ROAD: PROPERTY WELL: BUILDING:IV AIR INLET RESH ALARM: FEET FROM LINE: DYES ONO ❑YES ❑NO INEAR,EST DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY: PUMP MODE L: PUMP/SIPHON MANUFACTURER: gWAR ROVID QED PROVIDED OVER ❑YES ONO ❑YES El ❑YES_0 NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF WELL BUILDING. VENT TO FRESH AIR INLET(DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTHMATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) L MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH: TRENCHES: DISTR.PIPE SPACING COVER INSIDE CIA 1Y PITS LIQUII MATERIAL: PIT DIMENSIONS GRAVEL DEPTH FILL DEPTH UISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL. BUILDING: V NT 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 1:1 NO PERMANENT MARKERS OBSERVATION WELLS SOIL COVER TEXTURE. DYES ❑NO EY ES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED SEEDED MULCHED CENTER. EDGES. DYE S ENO DY ES ❑NO EYES ❑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 MATERIAL a,MARKING ELEV.V.. ELEV.: DIA.: ELE V.. PIPES DIA.. ELEVATION AND DISTRIBUTION VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION HOLE SIZE HOLE SPACING: DRILLED CORRECTLY COVER MATERIAL. PLANS ❑YES ❑NO 1:1 YES ONO COMMENTS: PERMANENT MARKERS: OBSERVA 7Y E S WELLS: NUMBER OF LRnOEERTV WELL: BUILDING. FEET FROM ❑YES ❑NO NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. TITLE.. SIGNATURE: Zoning Administrator DILHR SBD 6710(R.01/82) 7 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: I'. 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; II!. 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/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% 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 I result of over 2 years of steady negotiation and public debate. The groundwater bill Ground�ivte[ -- included the creation of surcharges (fees) for a number of regulated practices which Wisco intS ° can effect groundwater. The surcharge took effect on July 1, 1984. Al of the water that buried! treasure iS. used in your building is returned to the groundwater through your soil absorption o f system or the disposal site used by your holding tank pumper. a T!-ye rnonies collected through these surcharges are credited to the groundwater fund adminis- ° k.-rec. by the Department of Natural Resource°s. These funds are uses for monitoring groucd- t a,at� g,nundwvier contamination investigations and establishment of standards Groundwater, s vac.-tl protec;ng. o-s; 18 riR.03/8W DILHF-� SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis.Adm. Code Rd X �. ...v�... �.,o. 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. 97— 6V 617Z —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES K NO PROP TY I Ow 2j2 PROPERTY LOCATION '/ /a, S 3 T,f , N, R 17 E (or)(9 PRO R Y OWNER'S MAILING ADDRESS LOT NU BER BLOCK UMBER SUBDIVISI N NAME Cl STA ZIP CODE PHONE NUMBER CITY NEARE f#OAD, E OR LA DMARK ❑ VILLAGE : ) O!✓ 11 II. TYPE OF BUILDING OR USE SERVED: Ite. C81 (0 Number of Bedrooms if 1 or 2 Family 3 OR Ll Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. 4 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.X 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. ❑ seepage Bed b. ®Seepage Trench c. ❑seepage 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): 3 5 °? Feet Eg Private ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons 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 Ho ldin Tank -- S Lift Pump Tank/Siphon Chamber ) I f 1 ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's NameJ nn t): PI ber's Sign re: tamps) MP/MPRSW No.: Business Phone Number: Plumber's Address(Street,City,State,Zip Code): Name of Designer: t Vill. SOIL TEST INFORMATION Certifi oil Tester ST)N e CST# CS ESS(Street,City,State,Zip Cod ) Phone Number: O IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial `� S h'aargee^Fee `10 Adverse Determination ��w,©� �.�. ^ 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 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 �Zes Location of Property A�� S rv , Section ��, T�_N-R_22_ W Township Mailing Address Afl 7 Address of Site /S . Subdivision Name Lot Number A//,,f Previous Owner of property Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes _ No Volume' = and Page Number 2-l 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) ceAtiby that a.0 Statements on this 6onm arse tAue to the best o6 my (om) knowledge; that 1 (we) am (ane) the owneA(z) o6 the pnope&ty de�scA bed in thi.6 .insoAmation Jonm, by viAtue o6 a wain anty de econded in the 066ice ob the County Register o6 Deeds ass Document No. t 2 5_ ; and that I (we) pnesent.ey own the pnopob ed site bon the sewage dis'pozat system (on I (we) have obtained an easement, to nun with the above de�schibed pnopenty, bon the con,6tnuction o6 said .system, and the same has been duty %ecmded in the 046ice o6 the County Regi.6ten ob Deeds, as ocument No. ) . r SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED 1,1 A ���� S CO DEED J I THIS SPACE RESERVED FOR RECORDING DATA ' DOCUMENT No. � STATE BAR OF WISCONSIN FORM 1—1982;1 RE-GIST ERS OFFICE 424551 ND� 71 ++r{, 221 i J�. CR��i; CO., W��: �M fF. yi Rec'd. for RFcord this 15th This Deed, made between ....Daniel an _B1t x 7 y _- icy of April A.D. 19 Casey, husband and wife. _as survivorship 11.00 A M4 --..... ..marital..pr _ tYs................................................................. ..................... •---•---------•-••--•-------•-------•--•-------------------•----------------, Grantor, ,I 7, and....... RickieQ. Powers .and _Deboh--A t--Pow. a- M DeMl.. ... _ _husband and wife. as sureo -_ -_ _,__ __ Y -------marital-.property'------------ ------------------------------ --------------•------ I ..--••--------------•-•--•-----------•-•---.....-•--------•---------------------------------------, Grantee, II Witnesseth, That the said Grantor, for a valuable consideration...... 11 -------------One_ dollar and-_Q.ther--v luable...consideration...........- 1; RETURN TO conveys to Grantee the following described real estate in ._-_-at:I -Cr.p:,X-.-_-...._ ;, Bank of New Richmond County, State of Wisconsin: ;'!, New Richmond, Wisconsin 54017 ' Tax Parcel No- ----------------------------------- i, The West 300 feet of the SEk of the SWk of Section 33-31-17. N Subject to recorded easements, reservations, and rights of way. -4•t FED; This -•-----is not _ homestead property. ---------- - (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And Daniel- J. Casey and Bett Case�' ... ------- ---- --- ----- ---- --• -- --------�'.. _ ........ ...... ------. ----------------------- -------------------.............. warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except i no exceptions and will warrant and defend the same. Dated this ----------------- .................... day of .................... Apr i.1-----•------•-----•--------- ........- 19..87.-. ---------------------------------(SEAL) --------------- - -------- --------- _ --------(SEAL) Daniel Casey - -----•----------------------•-------....----------------------------.(SEAL) --- -•------•------- ----...(SEAL) Be Case * ------------------------------- AUTHENTICATION ACKNOWLEDGMENT Signature(s) Daniel J. Casey and Betty STATE OF WISCONSIN I� Casey SS. �I .....•----------------------------------------------------------------•--------- 1� --------------------------------------County. authen�ted_ h is �?v�day _-----April 19 87 personally came before me this ................day of • ----------•--•----------------------------r 19.------. the above named .......................... Eric J. undell TITLE: MEMBER STATE BAR OF WISCONSIN ---------------------------:----------------------------------------•----------- (If not, --------------------------------------------- . authorized by § 706.06, Wis. Stats.) to me known to be the person ............ who executed the f! foregoing instrument and acknowledge the same. �! THIS INSTRUMENT WAS DRAFTED BY •'� Eric J. Lundell, Box 157 = -------------- ------------------- - e h --- ... No----- Public – – County, Wis. '! New Richmond, Wisconsin 54017 •-------------------------------------------------- ----------- (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: ......................................................... 19-•••----•) 'I •Names of persons signing in any capacity should be typed or printed below their signatures. STATE BAR OF WISCONSIN H.GMillercomp" FORM No. 1-1982 Stock No. 13001 H • z H a STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d a OWNER/BUYER ROUTE/BOX NUMBER , 5l/j 1 Fire Number- .CITY/STATE.CITY/STATE XL OAhd tA1 ZIP-,T'�/ 7 PROPERTY LOCATION: JQL ,fu r 'k, Section;33 , T., R W, Town of SIA.V,6a , St . Croix County, Subdivision 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 6O% 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 . H 0 E I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x 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:,ce within 30 days of the three year expiration date. SIGNED 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 . ST. CROIX COUNTY :4t :;M WISCONSIN ZONING OFFICE 798-2239(HAMMOND) 425-8383 (RIVER FALLS) HAMMOND, WI 54015 April 20, 1987 Division of Safety and Plumbing Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir : An on site investigation for the Rick G. Powers property located In the SW 1/4 of the SW 1/4 of Section 33, T31N-R17W, Town of Stanton, St. Croix County, revealed suitable soils at a depth of 2. 1 feet, below which seasonable high ground water 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, ()w)1.t 0 l - 111,c -a c I('C_. Thomas C. Nelson Zoning Administrator CIO rc RECEtVE� APR2907 WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status fo an Alternative Private Sewage System In the County of fit. Croix Location SW 1/49 SW 1/4, Sec. 33 T 31 N. R 17 W Town Stanton Street Address Rt. 4, Box 40J, New Richmond, WI Lot No. , Block Subdivision Landowner's Name: Rick G. Powers The application for this site is for: 0 new construction use. replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: 1.X1 to have one of the first five approvals guaranteed for this year. This is numher 59 - 04 - 8 of those applications. (Use one of the first five quota numbers-Issued-to you.) ]one of the applications needing a quota number. The quota number assigned to this application is - []for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. F.1for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. LJ for an application on file prior to February 1, 1980. ( ]for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: 0a failing conventional soil absorption system. 0 a holding tank that: was installed and in use prior to February 1, 1980. ❑a privy that was installed and in use prior to February 1, 1980. RECEIVED If this is a REPLACEMENT SYSTEM USE and the Jot meets the criteria 14�Rai 9 � conventional private sewage system, check here. PLUNt � I certify that the above information is true and accurate to est f my knowledge. Name Thomas C. Nelson Si re ounty Official) Title Zoning Administrator, St. Croix County Date April 20, 1987 DILHR-SBD-6158 (R 12/82) STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING S P.O. BOX 7969 - MADI ON WI, , 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Township/Municipality: SW 341 SW ;4 IS 33 IT 31 N/R 17 JK�6E�W Town of Stanton Street Address: Subdivision: County: Rpute 4, Box 40J, New Richmond, WI 54017 n/a St. Croix Landowners Name: Mailing Address: Rick G. Powers Rt. 4, Box 40J, New Richmond, WL 54017 I (We) , the undersigned , hereby make application for an alternative system on the above-described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted , I agree m to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and-date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation, If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and. further agree to give the buyer a copy of this application. ' The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of ppT cant,' Date R29 07 STATE OF WISCONSIN Subscribed and sworn to befa me + SS. COUNTY OFVZ4.e1Z This 1101 day of 19 a /. XY�01� Notary Pu4, c, State of Wisconsin O DILHR-SBD-6413 (N. 05/81) My Commission Expires: l t Lb WORKSHEET - M AD SYSTEM DESIGN ✓!'LK L / v't s PROBLEM: Design a mound system for ac �n____ : The site characteristics are: Depth to groundwater or bedrock in. Landslope % Percolation rate (mss' min./in. Distance from dose chamber to distribution system ft. Elevation difference between pump and distribution system ft. Step 1. WASTEWATER LOAD • /S"Oe►�� 3 = gal Step 2. SIZE THE ABSORPTION AREA A) Area required • ` 5 09 g� / � rK;/ sq• ft. B) Bed or trench length (B) ft. C) Bed or trench width (A) _ .. ft. 0) Trench spacing (C) Wastewater load .24 gal/ft2/da ft. r . y B = trenches Step 3. MOUND HEIGHT A) Fill depth (D) _ _,,,1,,_„ ft. B) Fill -depth (E) D + % slope(A)t" ft- o C Bed or trench depth F _ - ' p ) D) Cap and topsoil depth (G) a _,��,,, ft. E) Cap topsoil depth (H) - RECEIVE— ft• ign: ?' `"`° APR 2 91987 hiconso PLUMBING BUREAU 2 A • P ' Y S 4. MOUND LENOTH A) End slope (K) _ D + E 1 + F + H x 3 ■ ft. B) Total mound length (L) B + 2(K) ,r ft. Ste S. MOUND WIDTH Al) Upslope correction factor = . A2) Upslope width (J) _ (D + F + G)(3)(factor) _ ft-. 81) Downslope correction factor • ( „ 62) Downslope width (1) (E + F + G)(3)(factor) -'z�Ft. Aa x kitty C1) total mound width (W) for bed- • J + A + I ft.. ' C2) Total mound width (W) for trenches J + + (no. trenches -1)(c) + A + I • St" 6. BASAL AREA *k A) Infiltrative capacity of natural-soil .x 9a1./fi de z H 8) $bsal area required wastewater flow i natural soil infiltrative c pacify F C1) Basal area available for bed for sloping sites = B x (A + I) _ sq. ft. C2) bas are avai ble for trench for sloping sites Bk ,W o, J + A n ft. (O'er 7` ` 7 / CX Basal area available for trench or bed for level to = B x M1 = pq« ft. RECE License 1'u:,- Date r. else'A Step 7. DISTRIBUTION SYSTEM 1A) SIZE DISTRIBUTION SYSTEM Vv 1) Hole size = in. 2) Hole spacing in. 3) Distribution pipe length W. . r 4) Distribution pipe diameter 1,6 _ in• 5) Spacing between distribution pipes r 6) Distance from sidewall to distribution pipe = M in. 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe _. .. 2) Flow per pipe .L .. GPM 7C) SIZE MANIFOLD 1) Manifold is central/ end 2) Manifold length ■ ft. 3) -Num')er of distribution lines a ._.. 4) Man fold diameter : M, in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate GPM 2) Force main diameter in. 3) Friction LOSS ft. 1E) TOTAL DYNAMIC HEAD y1) Vertical lift = y_, ft. 2) Friction loss _ " `� �' ,.e ,fsQ,� ft. 3) System head 2.5 ft. _ ft. r DO Total dynamic head / ft. RECEIVED Licer so• is APR 2 9197 t�� J °ilk) a 1D li lc�o .3 ii w G ??9so, at Va Ji ,a. iy DLPi:�Tt�t�, 15&�-3 t PO - S `V � �,2W Straw. Marsh Hay. Or Synthetic Covering Medium Sand Distribution Pipe Topsoil H " c zxcsc�sastir sssas ms F ` D Force Main 96 Slope Tranch Of �- 2%2 Plowed -Aggregate Layer Undisturbed D _L Ft. Soil E Ft.' Cross Section Of A Mowed System Using F ; Fit. t 2.Trenches For The Absorption Area G• / Ft. A Ft. H ,S: Ft. B3_ Ft. Signed: G Ft. License Number: /56_3 K _lc2_c�_ Ft. SSW-.� — _ Ft. Date: . � J _$...._: Ft. Alternate Position of Force Main Ft. W ,�9.3 Ft. L J t •' K C T - rc-f W tJbseVi,,nn° Permanent Main kers ------- -- - -- - _V Distribution Trend► 0f 2 - 2 '2 t Pipe Aggregate RE EIVED k APR 9 W7 Mound Using 3 Trenches For Absorption Area la0 w � I U` i l7 rt 0 to C� m rt � o N M► rt b C � m to FA rt to tD ro --=�-------- -- -- W Pt �o cam, o O � r•r• _ r M U _ •'• Pat' ►fit "71 +" H. (D O '.1 (Fl ,t) fn , a RECEIVES r. 8'7 -• O 6 w APR 2 9 IZY 1 a w . a a L Page 4k` � x'S N elcliMmoo 14S le Perforated Pipe Detail .Ind View )Perforated Ead cap PVC Pipe t'folee Located On Bottom, S Are Equally Spaced S Q PVC Force Mairr ` w PVC ' Manifold Pipe Orsttih•rlion Alternate Position Of v Pipe Force Main Last Hole Should,'- Neal To End ,.Cap Ff�a y End Gap J i4iytion pfpe 4; atop€ ' V{i, a f * r ?Z DF©1`iRTi�1�1iJT _ R to �� r j;/�"�i�? ,?l�r�t.f-�-L-,-ice:;�f-•` � X ; Inches EE= CORRESPG G- Y Li Inches Signed: Hole Diameter --, _ Inch Lateral Inches) License Number: /S C,3 Manifold " Inches Date: Force Main " .3 Inchij3 N of hol eslpi pel(, Invert Elevation of Late Ft. APR 2 9 IM7 PAGE _L OF_)Z2_ PUMP CHAMBER CROSS SECTION AND SPECIFICATIOAIS � � /0.)ews VCWT CAP /✓,ryJ �4�/No/�b �� '1' C.I. VENT PIPC Iv�7 WEATHER PROOF APPROVED LOCKING JUNCTION BOX MAWHOLE COVER _. 23' FROM DOpR, ' WINDOW OR FRESH I2"MIU. AIR INTAKE GRADE --\ i CONDUIT ----____-- IB°MIAI. \ — --�— — — 11� - fA1L.ET _ _PROVIDE 'A1RT*HT SEAL I III APPROVED JOINT A I III APPROVED JOINTS W/C.I. PIPF I III W/C.I. PIPE EXTENDING 3' I II ALARM EXTENDING 3' INTO SQ1.10 SG `. ' T r a. I I ONTO SOLID SOIL U PARI IIE l I I 1 _.. -.. OFF D CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SPECIFICATIONS SEPTIC AND f DGSE TANKS MANUFACTURER: Icm)i4 r�k=,u T )S NUMBER OF DOSES:— PER pAy TANK SIZE : 616 GALLONS DOSE VOLUME �} ALARM MANUFACTURER: INCLUV!'!L ZAC!;FLOW: / �✓. GALLONS MODEL WUMBER: CAPACITIES: A= 7 INCHES OR 3&7 GALLONS SWITCH TyPf:. 1l).2L(A - �, g INCHES OR `����/.R GALLONS PUMP MANUFACTURER: C=INCHES OR / t, GALLONS MODEL NUMBER. . I � .� !r ' D- INCHES OR .Q GALLONS SWITCH TYPE: 0 £ NOTE: PUMP AMD ALARM ARE TO BE PUMP DISCHAR4E RATE - ��� GpM INSTALLED ON SEPARATE CIRCUITS `s VERTICAL DIFFERENCE Bil9WEEN PUMP OFF AND DISTRIBUTION PIPE.. _&0 FEET + MIIAJIIMUM NETWORK SUPPLY PRESSURE��. . . , . " . . . , . 2.5 FEET + .0 FEET OF FORCE MAIN X �F/oorr.FRICTION FACTOR.. l•0-9 FEET RECEIVED TOTAL OyNAMIC HEAD = ET , ? q Ailz-K 60" APd2 9 p7 INTERAIAL QIMEWSIONS OF TANK: LENGTH ;WIDTH _..;LIQUID DEPTH -•.17 SIGNED: �' LICENSE HUMBER: /� 2 D ATE: -117- Model. Submersible Effluent PUMPS 140 120 lLA , yy s a 100 yi0• 3' 0 W LL 80 u wph75,>•h O wph10, 3 1 h!p 0 60 .Hp 40 WI `N.P WPMOV/3 H.P. 20 ' WP03.'/3 H.P. iP. 20 40 60 80 100 120 0 Capacity—Gallons Pe Minute + _ --- - - - — mall. wI ( Vora Phw Amps P soltdr (�+ Orox No_ WPMWI 115 9.4 WPM0311E 1750 � �' WP0312E 230 10 47 WPM03t?E _16A�� • WPH0511E 115 WPHU5112E 230 80 5 WP 32E - 17 3 a 2081 � 230 30 WPH0534E 460 WPH0712E 230 tm 90 4 WPH0732E 208/230 208/230 30 5. 734E ' 2.7 7 WPH0 118 3450 % 1__ WPH1032E 206/230 30 6 4 t WPH1034E 480 3.2 _ WPHt512E 230 1m 13.3 WPH1532E 2067230 9.2 30 4.6 ` WPH1534E 460 8 l h WPHH1512E 230 to 13.3 / WPHH1532E 206/230 9.2 r PHH7534E e60 46 W R �� SPECIFICATIONS ARE SUBJECT 10 CHANGE WITHOUT NO ICE 1 NDUS TMY�I' � REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS I t` NDt1STRY, �+ DIVISION LABOR AND PERCOLATION TESTS (115) Mails O. BOX 3;0; HUMAN RELATIONS (H63.09(1)& Chapter 145.045) L IO ION: SHIP/ OT NO.:BLK O.: SUB (VISION NAME: (A.) — /T'1 N/R!?I(or,W y� ' rti/ COUNTY: 0 R'S M ING A DRESS:e-P S i�'9 DATES OBSERVATIONS MADE �y NO.BEDRMS.: COMMERCIAL S R PTIO I TESTS: IL11Residence New ❑Replace I` (�s 6 —S) L _ RATING:S-Site suitable for system U+Site unsuitable for system _r 017 G V' TI I L: UND: IN-GROUND-PR T IN-FIL H LDING TANK:RECOMMENDED SYSTEM:(optional) 10s SDU _._0sp CD S.�1U DSMU_. c?yow— 1f Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the j under s.H63.08(5)(b),indicate: Q I Floodplain,indicate Floodplain elevation: P- PROFILE DESCRIPTIONS BORING TOTAL P H T GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH ELEVATION pBSERVE HIGHEST TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) s i � ! rl s f — , h A3 e.S d 91, on -2, 7 q, o 0 0 6 01a,/j , �--z,1r3,7s, W"L S..o 104 0 a e- 3 2.I- 3.z 4 1 0 �• 1 31/ • 7 - 2.3 6n s,/ 2. -- ,S v J B- PERCOLATION TESTS VESI _eeMTH WATER IN HOLE TEST TIME DROP IN W R LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERV\L:MIN. �PE OD t PEI��D 2_ 3 P R INCH l 7. P , U�� r P. U ) , PLOTPLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontai;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 z . of land slope. SYSTEM ELEVATION z / . 7 'SGf ! r.is REC E VED 0. . .- IT H1' !9 . ._ APR 2 N 1-FS 3�PLUMBIN , PURFAU S� 3 -- joc — } c / iYf.E ,ts I Kit i I L6�nTY eya. -- --- 1,the undersigned, hereby certify that the soil testa 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. NA riot : TESTS WFRE COMPLETED ON: AD"ESSI: CERTIFICATION NUMBER: PHONE NUMBER(optional): a s^ t , C IGN URE: (dl.tiJ't DISTRIBU'"t?f: ' iii i'3i ST. CROIX COUNTY WISCONSIN ZONING OFFICE 796-2239 (HAMMOND) 425-8363(RIVER FALLS) -- - - HAMMOND, WI 54015 April 20, 1987 Division of Safety and Plumbing Bureau of Plumbing P . O. Box 7969 Madison, WI 53707 Dear Sir : An on site investigation for the Rick G. Powers property located in the SW 1/4 of the SW 1/4 of Section 33, T31N-R17W, Town of Stanton, St. Croix County, revealed suitable soils at a depth of 2 . 1 feet, below which seasonable high ground water 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, T6"6w 0 A,��&-)n/rc- Thomas C. Nelson Zoning Administrator rc WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status fob an Alternative Private Sewage System In the County of t. cro x Location SW 1/4, SW . 1/4, Sec. 33 T 31 N, R 17 W Town Stanton Street Address Rt. 4, Box 40J, New Richmond, WI Lot No. Block _, Subdivision Landowner's Name: Rick G. Powers The application for this site is for: 0 new construction use. ❑replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: I.x1to have one of the first five approvals guaranteed for this year. This is number 59 - 04 - 8 of those applications. (Use one of the first five quota numiersissue7lo you.) �. ]one of the applications needing a quota number. The quota number assigned to this application is - - for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. F.1 for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. [._.,for an application on file prior to February 1, 1980. (_]for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ❑a failing conventional soil absorption system. U a holding tank that was installed and in use prior to February 1, 1980. ❑a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the Jot meets the criteria for a conventional private sewage system, check here.R I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. Nelson Si re County Off cial Title Zoning Administrator, St. Croix County Date April 20, 1987 BILHR-SBD-6158 (R 12/82) STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Township/Municipality: SW kJ SW kJS 33 T 31 N/R 17 KWXW Town of Stanton Street Address: Subdivision: County: Route 4, Box 40J, New Richmond, WI 54017 n/a St. Croix Landowners Name: Mailing Address: Rick G. Powers Rt. 4, Boat 40J, New Richmond, WI 54017 I (We) , the undersigned , hereby make application for an alternative system on the above—described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted , I agree to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have-been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. r The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19_, Notary Public, State of Wisconsin My Commission Expires: DILHR-SBD-6413 (N. 05/81)_