HomeMy WebLinkAbout020-1331-40-000 i
f isconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
afety an'aBuildings Division INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Pe rsonal inf you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 370373
Permit Holder's Name: ❑ City ❑ Village ❑ T n of: State Plan ID No.:
LaCasse Custom Homes, Hudson Township
CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.:
b U 0 020 - 1331 -40 -000
TANK INFORMATION E DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. �/
Septic Z ��� Benchmark D D`�/ Q�
Dosing S6 Alt. BM - �✓ S
v
A Bldg. Sewer
Ing St /Ht Inlet CA 3,3:�
TANK SETBACK INFORMATION St/ Ht Outlet
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic Z NA Dt Bottom (-'
Dosing NA Header /Man. &
Dist. Pipe
Hol Bot. System p '� Q - s �
PUMP/ SIPHON INFORMATION �/ ("0 Final Grade
Manufacturer 1� Demand St cover
Model Number as I GPM 3 OJ /0J90 j ob l�
TDH Lift FrictiorL Syste 2S TDH Ft s
L oss Head
Forcemain Length o Dia. Z °' Dist. To well
SOIL ABSORPTION SYSTEM �, S + t("
BED/TRENCH Width Len th No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIM ENSIONS S DIME
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEA anufacturer:
SETBACK CHAN...ER
INFORMATION TypeO t + / Moe r:
System: % UNIT
DISTRIBUTION SYSTEM g ; /oY -/
Header/Manifold Distribution Pipe(s) 7 x Hole $ire x Hole pacing Vent To Air Intake
Length Dia. Z !/ Length Dia. �/ / Spacing J ( ?, C� `—
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes [] No
COMMENTS: (Include code discrepancies, persons present, etc.) � o
Inspection # 1: / (/ o� 1 /tW lnspec ion # : _S } / 0
Location: 715 Waldroff Farm Road, Hudson, W1 54016 (SW 1/4 NW 1/4 23 T29N R19W) - 2329191738 Evergreen Estates
-Lot 14 ( � �cr
1.) Alt BM Description =''�� CI,utncQdf6v1 Cis S
2.) Bldg sewer length = D� on v t�fn, Ci ✓� �� —'s /,cccd l� �rJ
- amount of cover = > `fZ ` ,on (��� /° < �4 (�
l()
C! y �°� `
an revision required? ❑ Yes ❑ No
Use other side for additional information. 1F1 I I
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No-
Y_
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
,
I
t
� 1
CAL [-'I
(S Li F Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application PO Box 7302
84 sconsin Personal information you provide may be used for second p urposes Madison, WI 53707 -7302
Department of p
p commerce [privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not
state owned.)
Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size.
Coun State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. D. Num er My S 1
2p! • 0_& 3 c 3T3 3X883
I. Application Information - Please Print all Informat Location:
Property Owner Name Property Location
a 1/4 N&?14, S T N, (or) W
Property Owner's Mailing Address Lot Number Block Number
5
City, State Zip Code Phone Number Subdivision Name or CSM Number
1Z J4
II. Type of Building: (check one) as g ; y ❑ City
1 or 2 Family Dwelling - No. of Bedrooms :_•+ec s ` '��' ❑ Village
❑ Public /Commercial (describe use):_ / �:rt` �i , f$Town of
❑ State -Owned
Nearest R
a,
1 l 7 eery
S X YAW
CSL�CJ� - Tom- < `. u�ltJV ` /. P ND
III. Type of Permit: (Check only one box on line A. Check box on,lint B.if applicablp: ' ,' 3. 9 °► . 1 38
A) 1. New 2. ❑ Replacement 3. ❑ Replacement of '�4�:; ! ! ' j '�" 1 5. 6. ❑ Addition to
S stem System Tank Only �'` —:_. �? .� Existing System
$) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply) •iE
❑ Non - pressurized In- ground Mound ❑ Sand Filter ❑ Constructed Wetland
❑ Pressurized In- ground Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -gr , a ❑ Aerobic Tr atment nit ❑ Recirculating ❑ Other:
of 99 •0 D„ : o.s` WEosH
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation
Vso yso y s - o s
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
�S — 000 ❑ ❑ 0 ❑
. C. — DSO ccr– �" ❑ ❑ ❑ 1 ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS show n the attached plans.
Plumber's Name (print) Plumbe Signatur (no stamp ): RS No. Business Phone Number
Plumber Address (Street, C' , State, Zip Code) 0
IX. County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps)
Approved ❑ Owner Given Initial Adverse Surge Fee) ,
Determination 3aE. M
X. Conditions of Approval /Reasons for Disapproval:
AR '-Alx�k C,0&0-- _ -
Le.,&�—W S t� .
c as w..
SBD -6398 (R 07/00)
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
Tlivisconsin www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
September 30, 2000
CUST ID N 2 7 41 T
o. 6 3 ATfN• POWTS INSPECTOR
O
ARTHUR L WEGERER
WEGERER SOIL TESTING & DESIGN ZONING OFFICE
421 N MAIN ST ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
;Ictat bets ..
PLAN APPROVAL EXPIRES: 09/30/2002
Transaction ID N 437 3
Site ID No. 161428
SITE: Please reft10 both . #1 mf c t rs,
Site ID: 161428, Richard La Casse etc m
St. Croix County, Town of Hudson '
SWl /4, NW1 /4, S23, T29N, R19W ^ F r
Subdivision: Evergreen Estates - lot 14 i<U
FOR: U 5 t
Description: Three Bedroom Mound System - Revision
Object Type: POWT System Regulated Object ID No.: 428886 _—
` ST CROIX 1;
COUNTY
t. ?0N1NGOFFICE
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Cock
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The a rove will
become an addendum to the plans previously approved. All other portions of the installation s the
original approval. The following conditions shall be met during construction or installation and prior to occupancy or
use:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P
(R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems"
SBD- 10573 -P (R.6/99).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the
owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the
mound component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
P p J
• An effluent filter is required. Maintenance information must be given to the owner of the tank explaining that
periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84
product approval conditions.
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
IF • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(4), Wis. Stats.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
[ W
ARTHUR L WEGERER Page 2 9/30/00
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely, DATE RECEIVED 09/19/2000
FEE REQUIRED $ 60.00
FEE RECEIVED $ 60.00
Gerard M. Swim BALANCE DUE $ 0.00
POWTS Plan Reviewer - Integrated Services
(608)- 789 -7892, Mon. - Fri. 7:15 AM to 4:00 PM
jswim @commerce.state.wi.us
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 2648777
isconsin www .commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
September 30, 2000
CUST ID No.267341 ATTIC• POWTS INSPECTOR
ARTHUR L WEGERER
WEGERER SOIL TESTING & DESIGN ZONING OFFICE
421 N MAIN ST ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 09/30/2002
Irinitif zatibn dtigiles.... ...'. ,
Transaction ID No. 437883
Site ID No. 12
SITE: T PleSe'sr
Site ID: 161428, Richard La Casse above;;
St. Croix County, Town of Hudson NECDVE0
SWI /4, NWI /4, S23, T29N, R19W
Subdivision: Evergreen Estates - lot 14 `, T j 2000 �• ::: j
FOR: ST CROIX
Description: Three Bedroom Mound System - Revision COUNTY
Object Type: POWT System Regulated Object ID No.: 428886 ZON OFFICE
The submittal described above has been reviewed for conformance with applicable Wisconsin mistrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The approved changes will
become an addendum to the plans previously approved. All other portions of the installation shall conform to the
original approval. The following conditions shall be met during construction or installation and prior to occupancy or
use:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P
(R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems"
SBD - 10573 -P (R.6/99).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health
hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the
owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the
mound component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
• An effluent filter is required. Maintenance information must be given to the owner of the tank explaining that
periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84
product approval conditions.
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19 Wis. Stats.
q ,
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation /operation.
ARTHUR L WEGERER Page 2 9/30/00
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely, DATE RECEIVED 09/19/2000
Cq(t�O FEE REQUIRED $ 60.00
FEE RECEIVED $ 60.00
Gerard M. Swim BALANCE DUE $ 0.00
POWTS Plan Reviewer - Integrated Services
(608)- 789 -7892, Mon. - Fri. 7:15 AM to 4:00 PM
jswim@commerce.state.wi.us
TITLE SHEET Page: 1 of - 7
MOUND SYSTEM
FOR
A .3 BEDROOM RESIDENCE
This plan has been prepared in accordance with the Mound Component
Manual SBD- 10572 -P and the Pressure Distribution Manual SBD- 10573 -P
LOCATED IN THE Sti l1/4 OF THE NW 1/4 OF SECTION Z.3 ,T" �9 N,R Z 9 W,
TOWN OF �Sp� S� Cl�w\X COUNTY, WISCONSIN.
wr I y o p= EN t�ZG >z015Q S s
INDEX
PAGE 1 of 7 TITLE SHEET
PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN
PAGE 3 of 7 PLOT PLAN
PAGE 4 of 7 PLAN VIEW -CROSS SECTION
PAGE 5 of 7 DISTRIBUTION PIPE.LAYOUT
PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION -
PAGE 7 of 7 PUMP PERFORMANCE CURVE
PREPARED FOR
at
FCF
_ _ L � r�ss� ec�s`r�►� 1- {-o►^ -c � 4
A so
PREPARED BY
WEG :F�EF� SOIL TEST = NG
AND .
P.O. Box 74 421 N .Main St. �
River Falls, WI 54022 �►
Phone 715 - 425 -0165 a .�f `C ..sly
Fax 715- 425 -6864
ART.4UF L •
WEGEREIR
D815
ELLSWORTH.
W5.
• ti
� •, 0 0114t IN 6 4 S I G N S
d L
M �,CRGE
ANT o f CQ j 0\1A GS
ENL�
C0 RR�SPO JOB NO.
Mound System Management Plan page Z- of - 7
Pursuant to Comm 83.54, Wis. Adm. Code
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the
septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The aperating condition of the septic tank and
outlet filter shall be assessed at least once every 3 years by inspection. The outl filte shall be cleaned as necessary t o
ensur roper operati The filter cartridge should not be removed unless provisions are made to retain solids in the tank that
may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if
the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of
the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise
the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in
the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required.
However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and
Buildings Division.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to
verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound
shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic
(other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the
infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather
installations (October - February) dictate that the mound be heavily mulched for frost protection.
Influent quality into the mound system may not exceed 220 mg /L BODS, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may
not exceed maximum design flow specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each
lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be
compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is
required to maintain equal distribution within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,
and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its'
component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance
reporting.
` No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and
pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access
openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed
unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall
be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be
immediately repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired
or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions on the operation or maintenance of this system should be
directed to the County Zoning office at - .lS-- -LI580 or to the
licensed plumber who installed the system.
PLOT PLAN
Page 3 of �
Scale 1 "= SO'
� , L l`t Qu
i
/ ✓ SJGg+� �u _
,
3 �
LO + O'F
5 Do ►.� T
4 0 ( - \ �PA t-T oR
car-
4 A C-1
8F C.
9.4.5'
8.
tru-L-
NOTES: 8
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved caps. ( Z required).
3. Septic tank to be 1 000 165 gallon capacity manufactured by
4. Bench mark Ln .10u. p' pU I k l ��l F. Fi Lb CORJ 'Z
. Divert surface water around system to prevent ponding at the uphill side.
Pace Or
Approved Synthetic Covering
ASTH C33 Distribution Pipe
Medium. Sand
Topsoil F G Elev. �q.S
3
E "
-
b
% Slope
Distribution Cell of Force Main Plowed
2" to 2'z Aggregate From Pump Layer
D p, 50 Ft.
E O - SS Ft.
CROSS SECTION OF A MOUND SYSTEM F O•$ Ft.
G 0, S Ft.
A 14.5 Ft. H 1 • � Ft.
Linear Loading Rate= q—S GPD /LN FT B 10 0 Ft.
Design Loading Rate= o ZGPD /SQ FT I l5 Ft.
J Ft.
K - 7 Ft.
L 11.4 Ft.
W 18 Ft.
I
l
- Observation Pipe
8 � K
C3--- __ -- -- - - -- -- - - -_ -_ ______ BOX
A �-- '�6 H "— 0 _
W ------- - - - - -- -- - - - - -- ---- - - - - -- 1 Force Main
Distribufiion Cell of Z" to 2 %"
x
Pipe aggregate
n
Observatio Pipe
(Anchor securely)
PLAN VIEW OF A MOUND SYSTEM
Distribution Pipe Layout Page 5 of
Place the holes at the bottom of the distribution pipes
at equal spacing. Remove all burrs from the pipe and holes.
Extend the end of each lateral up with the use of long turn or 45° fitting to a point within six
inches of the foal grade. Terminate the ends of the laterals with a vahve threaded cap or
threaded I Provide e access from a valve"
� final grade for ,threaded cap or threaded ploQ t ..
C. Fvc S vc
Lateral Manifold Lateral
x x x x x!Z x!2 x x x I x
Lateral Length — Lateral Length —
Oistribuden Line
P --� FicES.s Sox
S I.ORCEr �+ Rf�
a-- --
P L4 q Ft, Hole Diameter 1 /b Inch -
S 3 Ft. Lateral " l " Y Inches)
X Z-Y Inches Manifold " _.• Inches
Force Main " 2 Inches
l of holes /pipe ZS
Invert Elevation of- Laterals loo-o Ft.
_ - Combination Se
ptc:Tank and
PUMP CHAMBER CROS5 SECTION AND SPECIFICATIONS' PAGE G OF 7.
1 •
-VENT CAP WEATHER PROOF
JUUCTIOIJ BOX .
ti C.I. VEUT PIPE APPROVED LOCKIIJ6
1 10' FROM DOOR, MAIJHOLE COVER AJ11M
, ,iaJ0OWOR FRESH 1 w'ARNII.JG LI401:L `
u-13P IoW S'tPE
ALP, J cor.�DU�r
� r. MIIJ.
� �. 16 lrll rl.
+ -; PROVIDE I
IRILET AIRTIGHT SEAL I I
- •n I
Approved zt�8�t �� A ' i I Approved
0
int
point Ta/ I II � • w/
PVC ALARM PVC pipe
pipe
I
C,
ou
CLEY. 13 F T. PUMP —_J
OFF
D COLIC
• • COIJCRETE .
• .�� � 6 0� � DLOLK
- RISER EXIT PERMITTED C)NLy IF TANK MAMUFACTURER HAS SUCH APPROVAL
Br<OD I u4
SEPTIC F SPEC.IFICATIOMS
DOSE
TA MA►IUFACTURCR: F'T��JbV�S1ERJ� p T WMHEft OF DOSES: ' S PER DA.V
TAWK SIZE. GALLOWS L �S� GALLONS DOSE VOLUME t
ALARM MAUUFACTURER: S.S'. � `("I2p SV37 q -5 INCLUDING BACKFLOW: "Cl GA ILON,�
MODEL WUMBEK: CAPACITIES: A= IAICHES OR 3 S GALLOU3
SWITCH TYPE:
8 = _ � IUCHES'OR 21k4 G(►LLONS
PUMP PkANUFACTURCK: �6`l1LD S C= -7- IUCHES OR ` GALLONS
MODEL NUMBER: • •388 S 1^JE�OS p= IASCHES OR ls� GALLONS
SWITCH TYPE:
MOTE: PUMP A�10 ALARM ARE = 6
MWIMUM DISCHARGE RATE GPM INSTALLED bIJ SEPARATE CIRCUITS
VERTICAL DIFFERENCE 15ETWIEU PUMP OFF AUO- .DI5TRIBUTION PIPE.. L 3 '� S FEET
+ MINIMUM NETWORK SUPPL'J PRESSURE , .(�' FEET
+- 11 O FEET OF FORCE MAIN , , 100F LFRICT1OU FACTOR.. 3 '$ FEET
TOTAL 0y1JAMIC HEAD = Z3' 3 FEET
As per manufacturer 1 gal /in. Liquid depth
uouias
Submersible
Effluent Pump
3885
� n
ElThwnl hwiV , ' )�
APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously
Specifically designed for the be provided in starter unit. bronze impeller available as without damage.
following uses: • Shaft: threaded, 400 series an option. ■ Bearings: Upper and
• Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing
• Farms • Bearings: ball bearings type for maximum efficiency. construction.
• upper and lower. g p ■ Power Cable: S d
Trailer courts •Power cord: 0 foot 2" NPT discharge adaptable aeevere u �,
2
• Motels for slide rail systems. rated, oil and water resistant.
• Schools standard length (optional m Mechanical Seal: SILICON Epoxy seal on motor end
• Hospitals lengths available). CARBIDE VS. SILICON provides secondary moisture
• Industry Single phase: P ry
•Effluents stems ' Y3 and'/ HP —16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket
Y Stainless steel metal parts, damage and to prevent oil
with 115 V or 230 V three gUNA -N elastomers. wicking.
prong plug. g•
SPECIFICATIONS
• % -1'/2 HP —14/3 STO with ■ Shaft: Corrosion - resistant ■ 0 -ring: Assures positive
Pump bare leads. stainless steel. Threaded sealing against contaminants
• Solids handling capabilities: Three phase: design. Locknut on three and oil leakage.
W maximum. •'/2 -1'/2 HP —14/4 STO phase models to guard
• Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS
• Capacities: up to 128 GPM. listed models — 20 foot on accidental reverse rotation.
• Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in SA Canadian Standards Association
TDH. are standard. high -grade turbine oil for
• Mechanical seal: silicon lubrication and efficient heat Underwriters Laboratories
carbide -rotary seat /silicon FEATURES
transfer. O
carbide- stationary seat, 300 ■ Designed for Continuous
series stainless steel metal o Impeller: Cast iron, semi- 0 P P Operation: Pump ratin gs are
parts, BUNA -N elastomers. open, non -clog with pump-
• Temp erature: out vanes for mechanical sea{
within the motor manufacturer's
p recommended working limits,
104 °F (40 °C) continuous Protection. Balanced for
140 °F (60 °C) intermittent.
• METERS FEET .
Fasteners: 300 series
90
stainless steel. SERIES: 3885
• Capable of running dry 25 80• SIZE:,�'SOLIDS
- without damage to "`E'$" RPM: VARIOUS
—► SGPM
components. 70• wE1oH I SFT -
Motor a 20 6 i
W
0
i
{
Single phase:
9 P - -
E0 - i
• % HP, 115 V, 200 V, 230 V i
60 Hz '' /2 1750 RPM; HP < 1s so
115 V, 60 Hz, 3500 RPM o a — { I ' i
WE05H N, 1 I
'/2 HP —1'/ HP, 230 V,
60 Hz, 3500 RPM. o i 30
• Built -in overload with
auto weo
20
automat reset. i
• Class B insulation. 5
Three'phase: 10
•' /2 HP -1 % HP 200/230/ o o f i ' ! I !
460 V , 60 Hz, 3500 RPM. 0 10 20 30 40 50 60 70 80 90 100 110 120 130GPM
• Class B insulation. o io zo 30 mom
CAPACITY
®1995 Goulds Pumps, Inc. Effective May, 1995
11 B3885
U ,
Wisconsin Department of Industry SOIL AND SITE EVALUATION
Labor and Human Relations Page / of
Division of Safety and Buildings in accordance With s. ILHR 83.09, Wis.
Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size. Plan must County n
Include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Parcel I.D. #
.uDi�
PE 6—
APPLICANT INFORMATION - Please print all information Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
G 23
2
� � I �v 9 q
�(f � /�V A�N/� CD/p Govt. Lot .Sl.� 1/4/v 1/4,S T ,N,R � / E (or) (0
Property Owner's Mailing Address F S T Lot # j §FcZR Subd. Name or CSM#
33 Z H i NNr =sock $r Ti ��� L G-- . /� � vERCriP�E�v ES7
City State Zip Code Phone Number Nearest Road 10/. /2
5 ' 6 r- PAU L- 1-t INS � 510 (Co 1 Z) 227_ - S S SS � CiV � Village own cGM A�!-l. _ y /,> Z)
CAS
New Construction Use: Residential / Number of bedrooms — Addition to existing building
❑ Replacement ySo -
El Public or commercial - Describe:
Code derived daily low O / —5
trench, 9Pd Recommended design loading rate bed, gpdM trench, gpdHt
Absorption area required i�� bed, f it S trrench, It Maximum design loading rate "-- bed, gpd/ft ` 3 trench, gpd/ft
Recommended Infiltration surface etevadon(s) SEA / f ' 3 It (as referred to site plan benchmark)
Additional design /site con ations !r 7 =- ,eECP c - 4f6E 5 ! `L� r7 1-fo u-w L, S y,'T -
Parent material 5 C5 8 ' Pi /0 r I S}T ",15" lew 1s Flood plain elevation, If applicable
S = Suitable for system Conventional �Mound In- Ground ,P._resss re AT Gradde/ e System in Fill Holding Tank
U = Unsuitable for system ❑ S L"J S❑ U ❑ S L'1 U ❑ S B U ❑ S B ❑ S
SOIL DESCRIPTION REPORT t C'
Boring # Horizon Depth Dominant Color Mottles Structure GPD/112
In. Munsell cu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed ,Trench
0 /o Ye 2 �o �,y / fsb c �.► �.e c s / . �(:. S
Z 13-26 lo ye 313 f S,4,t 19� c 5 L(. ' . Sr,
Ground J? 3 YR 3/y ��� /f 1C/ CS �' S
elev.
y9.Ott. Y io YX t1 21s llm e d es . 7:. tF
Depth to ( S Di S C �- • 7 '
limiting
factor
/0 Y/t
Remarks:
Boring #
Z L - / /0 313 rL 11 it �� e5
-18 0 3 �� /ICs 444 4-- Y�e
Ground I N / t 1 - Depth to limiting /Q ,e u S O l �� 4 7 '
factor
In. Remarks:
CST Name (Please Print) Signature Telephone No.
RO ?,f L 4 R i CST" �t� 71,5'• 3 gG P/ S.S
Address to
Da CST Number
Assoc iates 11411• /3� / f�� G'ST Z ye.
Private Sewage Consultants
655 O'Neil Rd.
Hudson, Wis. 54016
PROPERTY OWNER SOIL DESCRIPTION REPORT 2 3
Page of
PARCEL 1.131 E S T A'e's
Boring # Horizon Depth Dominant Color Mottles Structure 2
In. Munseil Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed ; Trench
J l 1� AO Y2 Z12-
Ground
Ztt. 3 /o re 5 1' 3 5& / 7 s64k
c
io 3/ SCL /�sl�i� /Ysr ,�, , z , • 3
Depth to �� I✓
limiting
factor
Remarks:
Boring #
Ground
elev.
ft
Depth to
limiting
factor
(n.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots
(n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # ,
Ground
elev.
tt.
Depth to
limiting
factor Lil
tn. Remarks:
Boring #
Ground
elev.
Depth to
limiting
factor
In ' Remarks:
SBOW -8330 (R. 08/95)
'J
LOT
I Goy
� v
X1.76
L3
- 2 0
C)
1
go
3� 20
S Ply 88Sr6O r
5v�r',�5
/d- " 77%/ Boa.
�5
B�
su�v�
ST C1tOIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /Buyer LRC.4dSe 46 -
/4&n
Mailing Address 5 Z G 4. A
Property Address M 6�
(Verification required tionl Planning Dc al n it for new construction) f
City /Stale tk 1A I .SeAd . Parcel Idenliiication Number Qcg 1331- L �t�
LEGAL DESCRIPTION
Property Location 6LO '/4, "'' /,, Sec. , 1' -lt -LW, 'Ibwn of
Subdivision L <r — i &I . Lot It
Certified Survey Map It , Voluutc , Page U
Warranty Deed It '/' 0c ) , Volume S Page i t
Spec house ly ❑ no Lot lines identifiable 10 ❑ no
SYSTEM MAINTENANCE
Lnproper use and niain(enanceof your septic systeni could result in its premature failure to handle wastes. Propermaintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a lrealnrcut stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
utaster plumber, jounieyrnan plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by „tiie Department of Commerce and (lie Department of Natural Resources, Slate of Wisconsin. Certification
stating that your septic system has been maintained roust be completed and returned to the St. Croix County Zoning Office within 30
days of a car liiration dale.
j y i We .
SIGNA O PLICANf DATE
OWNER CEWFIFICATION
I (we) certify that all statements on this forn► are titre to the best of my (our) knowledge. I (we) am (are) the owners) of
t , y descri d ab e, by virtue of a warranty deed recorded in Register of Deeds Office. I X1
SIMiATU RE OF Af PLI DATE
*** * ** Any information prat is mis represented inay result in the sanitary permit being revoked by the Zoning Department. * * * * **
** Include with this Application: a stamped warranty deed from (lie Register of Deeds office
a copy of the certified survey map if reference is made In the warranty deed
10L 1415PAcF?53
6ocuMENT NO. WARRANTY DEED
- STATE BAR OF WISCONSIN FORM 2-1982 KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
j;o�rpq�rAtion. n
a o pqra�ti
....... ". r
.H. ..�. . on .... . ---------- 0A-►1-1999 600 AN
.............. .............................................................. I...... ..... . 1... 11
.. ... .. . ...... NARRANTY DEEP
.. ..... .. .. ... ..... EMT
Ii ........... '* ...... --------- ------ ' CERT COPY FEE:
c onvi-yo and wars-nots to .. Hqpc;;_.IPc_. a Wi.$ponpjf ........ .. COPY FEE;
..'icurporation. . TRANSFER FEE: 96.70 .................... .. ...... ........ RECORDING FEE: 10-00
.... ...... I. ..................................................... ............... ... . ..............- •...... PAGES;
... ........ ..
. ...... ....... I ........ ........................ ... I ................... . .... ..... ............
............. ........................... .... .......... ... I ... ....
...... .......... . �
. .. ........................................ I... .........
..... ..... ..... I .................................... ... I ................. ..................... 01
the following described rc:%I estate in ....... 5t...Cr.QA)I, .. ........................
State of Wisconsin:
Tax Parcel No,4.A�7.OA_YA.
Lot 14 Eve t
Es
Town ' of roix county, Wisconsin
; r2en
s o n ,
This .......j ..not- ..- __...._ homestead property.
Xbo (is not)
Exception to warranties: Easements, restrictions, reservations, and rights-of-way of record, if any
Dated this .. ..... .......... ........... . ......... day of ........ ..March ................ 19.99....
.... . I ...... ....... ..................................... (SEAL) LA D.CORPORATION . .............. (SEAL)
. P .. .................... I ........
................................ ........................ .-.by:. . .................
Austin J. Baillon, Its President
.................... __ .................................... (Sh:AL) ...... I ...... I .......................................... (SEAL)
• ....................... ..................................... ............. I ................................. ........
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) ............................. ............................... STATE OF VaUM&ISM MINNESOTI
......................... ------- .............................................. Ramw ................... ........ County.
nuilienticated this ._. .....day oi ........................ ...... Personally came before me this _13f:tL ..... day of
Jlqr0 ......................•..•....... 10.99. the abovo named
------- .................................................................... Austin J. BdillonPre5ident of
............................ t. _.-- .........__.......__....... I._..............
....................................................................... ....... ........................................
TITLE: MEMBER STATE BAR OF WISCONSIN ..........................................................................
(It not . ............................................................ ........... I ............................................... .................
authorized by § 708.00. Wis. Stats.) - to me known to be the person ............ who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
............................ ......
................................................................................
-i.9 R ...
................................................................................ Notnry Public ......... filg�aw -
(Signatures may be authenticated or acknowledged. Both
M Commission in permanent.(If not, 611 ex i�irla- .6
are not necessary•) date: )AT4ftcy..
•N.mca of P " nlanlnx In y -o-ity .1 Od he typed or aria led hrlmr t1l.j,
LOT 2 `� °
p. LOT 3 Li
(THL) ° W � '
° (�
3.01 ACRES m 3.01 ACRES 0 M 3•
131,112 SO. FT. 131,116 SO. FT. 131
Sg I 6°
N8q °12 'C , O "yy 208.
0 -, .
'5 T O `�— 4 5 8.93 '
84 °1 2'00 „
E 458
231.07' .93'
(4
FT, /
a
"
2.10 ACHF S LOT 13
,t
91 , L
976 SCE FT. . a `' W
2.10 ACRES cp
4 91,476 SQ. FT. "� � 2
0 92
/ � n
16
�. 3
241.23' _ 239.30
' S89 ° E 480.53'
LOT 15
2.16 ACRES
�p sue'
94,174 SQ. FT, n LOT 1 i
° 2. 14 ACRES p'
n t�v
93,212 SO. FT. S r� ti
v
i
LOT 16
IFi6. /H' 330.00' 18
2.08 ACRES
90,432 SO. FT. S89 "E 516.78' y,, �