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HomeMy WebLinkAbout024-1035-95-000 p ova M a o ti ~ I c E o " 0 d E L aNi r aL 3 C u U ~ ~ 3 m 0 y E atOO a rn oY I o ~ aci L ~ ~ p U E [r om0n ao~ (D ; v Z rn o 75 Li c O U C O t0 3 Q' C, ; w a 0 y p 0 Q a z M z Z " o Z a m M H (n _ O N C C7 N O Z a a a :3 c N H - N E o ~ww E C `o N N O O co C L /0 f0 co" O z6 N 2zz 0-Q Z , M d .C p~ N d O a C, LO d N d N j In a L U z j FN- co FN- =3 a UL LLaaa CL N a 2 co to O fn co 00 yr tq -1 U rn rn } co 0 o o o O N N j O O° N E C - w.. MM N C d r, (O 0 (D (D O F- O y ~ O 00 Q N_- U N O Lo O fM V ~ f0 . p O O i.i N C.9 Y o = a N N N M N N c 0 C W r C _ C CJ co w O V! 7 Z w a O r (O cc 1 N O a0.. 7 Z' C N e- r o M a Y o Z N Fo- co V " E m a a `MV ~ v 'c c d c rw ~ _1 A U d 0 ai U LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF PLEASANT VALLEY COMPUTER NUMBER 024-1035-95-000 Parcel Number 30.28.17.231A OWNER NAME: First GREGORY S & SUZANNE D Last KOEh- PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 165 150TH ST SECTION 30 TOWN 28N RANGE 17W 1/4160 '/440 Line Description Line Description TOTAL ACREAGE 21.805 PLAT LOT BLK 01 SEC 30 T28N R17W PT OF SW NW 15 02 LOT 1 CSM 5/1213 TOWNSHIP 16 03 PLEASANT VALLEY. 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit I~ ~ I l O O O 3 0 o ry c C ~ o° I I N d OD I c 0 00 O N C Z Q~ LL ° 0 U N ° c Q - ! M Z E 00 CL m M CO N O Z V d r fn F- r N E E `o 04 C 3 0 c m m ~ O I M d W E ! ` R L O d L N C N d O o C G a a V Z >0 LO ! r t2 P a a ~ _ C;Oaaaa. a U- • 3 O to ! N ap '00 } v1 J U I rn rn ID o N ~(o a = O L ) N CD .2) 2 Q 1- {n Lo U) U) 9 Q N CD 10 ~I o N, N ce) 1- L.7 4) V 17 a) " w tx, Gi r z co N ~N o ° a S? 0 Y r-- O z° = IO SQ w 'a' 46 Q d d j U CL CL ,C c „ O ~1 A L)a.~ 0 U)0 41 8'~c G a l 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 ❑CONVENTIONALALTERNATIVE State Plan 1) . D. Number: ❑ Holding Tank El In-Ground Pressure INymound (If assigned 8601833 NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER LIO~~T ~j„r Cy B ~7 Greg Koehler Rt. 1, Box 281, River Falls, WI 54022 7 V BENCH MARK (Permanent reference pomO DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. T. ELEV.: SW NW, Section 30, T28N-R17W, Town of Pleasant Valley Narne of Plumber. MNnJCnuly Sanitary Permit NumberRobert Ulbricht 7 St. Croix 79199 SEPTIC TANK/HOLDING TANK: MANUFACTURER . LIQUID CAPACITY. ]TANK INLET ELEVTANK OUTLET ELE V W ARNIG LAREL LOCKING COVER h t h W PROVI ED ARM G PROVIED1 d 0 0 0• pq 1 I V• 0 X7YES ❑NO ❑YES NO J BEDDING: VENT DIA.. VENT MATt HIGH WATER NUMBER DF ROAD: PROPERTY W UILDINGJVENTTOFRESH FEET FROM 9 ALARM LIN AIR INLET❑YES NO ❑YES NO NEAREST 25 -4 OC _ ` DOSING CHAMBER: MANUFACTURER. 171 G ITY PUMP M()DEt JPUMPSIPHON MANUF ACTUFIER WARNING LABEL LOCKING COVER ~pj)_ . PRR(DE DPROVIDED Wk ES ®NO ~So M a&- 3r` a~ C~v l/ YES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PH OPERTV WELL BUILDING JV(DIFFERENCE BETWEEN ~~y/ FEET FROM LINE AIR INLET' PUMP ON AND OFF) 7.- 1-11q L(YES ❑N0 NEAREST--0-1DO-1 11 B, SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE I, JDIAMETER +r 1111TIRIALANDMAHKING } 1 . or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN `-^I the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH' JLENGTH NO. OF DISTR PIPE SPACING COVER NSIrE DIA GPI TS LIQUID T RENCHFS MATERIAL: PI -r DEPTH. DIMENSIONS GR~.~'LL D'_P T!{ FILL DEPTH DISTR PIP[ DISTR PIPE DISTR PIPE 7,pr M lea.- NO DISTR NUMBER OF PROPERTY WELL. BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER EL EV. INLEI ELEV. END PIPES FEET FROM LINE AIR INLET. NEAREST -s 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- ❑YES ❑NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE P[HMANI N+ MAHKEHS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BEU DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES ❑YES. ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH NO.OF LATERAL SPACING GHAVEL DEPTH BF LOW PIPE FILL DEPTH ABOVE COVER. BED/TRENCH } V TRENCHES DIMENSIONS r 3 Z' ` i MANIFOLD PUMP MANIFOLD DIST P E MANIFOLD MATERIAL NO DISTR I STR PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV DIA ELEI .10 ~ PIPES J~D IA.'. ELEVATION AND ©11 J~ 0795 ' f ( /E DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING CHILLED COHHECI t.Y COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED 3D PLANS YES ❑NO _ YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPFRT1j~ WELL: BUILDING: ~I FEET FROM uN %YES ❑NO %YES ❑NO NEAREST l0 0 r Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. ~ TITLE r//~~ DILHR SBD 6710 (R. 01/82) Fo rm - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. 3y T ,r, 2 - l /d, A'4~ NR W ADDRESS ST. CROIX COUNTY, WISCONSIN -7' A SUBDIVISION LO IZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE NORTH ARROW lop OF cau /Sb 7-- BENCHMARK: Describe the vertical reference point used 16 Fr fie IAA 141-6-Ow-1K A•i'rIPr~ S•%(~-,v Elevation of vertical reference point: /-00' 0 Proposed slope at site: 0 CD SEPTIC TANK: Manufacturer: /,O16-slx Liquid Capacity: /&TV &-'g / Number of rings used: ti~'y nom'/~ Tank manhole cover elevation: 112- 0 Co Tank Inlet Elevation: d J /Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side,Q Rear, O 1L-s feet From nearest property line Front,0 Side,O Rear, O d 0E/Q 2,00 feet Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Oljsz - G Liquid Capacity: Pump Model: 14'l/Ek J "Pomp/Siphon Manufacturer: Pump Size ono in a Bottom of tank elevation. /N or s1AAo v~l 41o" • X I Du7 7 Pump off switch elevation: y ~c<?g Gallons per cycle:,&~IQOx 7 Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, © Rear, Ft.Z Number of feet from well: Ile ' / Number of feet from building: 33 (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: 13i-1~i R3 Width: ' Length: 7a / Number of Lines: Area Built: 5 FT Fill depth to top of pipe. Number of feet from nearest property line: Front, O Side, O Rear,O ht 2LS Number of feet from well: Z Y0 0 Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of s: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box 0 been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings us Elevation of bottom of tank: Elevation o nlet: 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: Q{/ Plumber on job: License Number: HOMESITE SEPTIC; PLUMNIND CO, ItT I O'NEIL RD., HUDSON, WIS. 54016 ROBERT ULBRICW vIRS• MASTER PLUM KR LIC, NO, 33D7 M.RR,& 3/84:mj MINN. INSTALLER & DESIGNER LIC: NO, 00663 ~ D 1 L HqR Safety and Buildings Division PLAN APPROVAL Bureau of Plumbing P.O Box 7969 ❑ General Plumbing Plans Madison, WI 53707 Private Sewage Plans 6 7 Telephone: (608)266-3815 ` c(i i1,, Pcr D,iv PRIORITY PLAN REVIEW ONLY Plan Kc~ it"w f ce K~ c~ ieecl s l(,~ C, . co Pelitinn I w V,irilnr(, Ice kec `h Project Name Project Location - Street No. or Legal Description cl, -0, tsj uJI so, Q, 'F. County ❑ City ❑ Village Town of: I X Y The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped "conditionally approved". This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be, obtained, prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. ❑ FOR GENERAL PLUMBING PLANS: 3a 3b 3c 3d 3e 3f 3g This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. 7 FOR PRIVATE SEWAGE PLANS: (1) (2~'O (34) (4a) (4b) (6) (7) This approval will expire two years from the daft ,Oved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Bureau of Plumbing has reviewed these plans for plumbing and/or private sewage code requirements only. All other system reviews must be submitted to the Bureau of Buildings and Structures. Comments: By: James Sargent Bureau Director f i If Questions Plans Approved By: Date A,&rove/d: Contact y z cc: Private Sewage Consultant ❑ "Plumbing Consultant ❑ Environmental Health County ❑ Local PI ❑ Facilities Need Analysis Section ❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture DILHR-SBD-6099 (R. 01/85) ❑ Owner ❑ Other ~ DILHR .o. PLAN APPROVAL Safety and Buildings Division ~„r., Bureau of Plumbing P.O Box 7969 ❑ General Plumbing Plans Madison, WI 53707 Private Sewage Plans Telephone: (608)266-3815 Klan IdeIt ifi(aticm r-, C;allcxu !'Er L~av t € PRIORITY PLAN REVIEW ONLY - Plan Review f ee Received Petition I or Variance Foe Re,(- Project Name Project Location - Street No. or Legal Description 1 \ \ 11 City 1:1 Village X Town of: County Y The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped "conditionally approved". This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. ❑ FUR GENERAL PLUMBING PLANS: 3a 3b 3c 3d 3e 3f 3g This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. X FOR PRIVATE SEWAGE PLANS: (1) (2 3a)tY b) (4a) (4b) (6) (7) This approval will expire two years from the dat oved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Bureau of Plumbing has reviewed these plans for plumbing and/or private sewage code requirements only. All other system reviews must be submitted to the Bureau of Buildings and Structures. Comments: By: y~ James Sargent Bureau Director If Questions Plans Approved By: Date A prov Contact _ cc: Private Sewage Consultant ❑ L01umbing Consultant ❑ Environmental Health County ❑ Local PI ❑ Facilities Need Analysis Section ❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture DILHR-SBD-6099 (R. 01/85) ❑ Owner ❑ Other r PROJECT Ta\?D-;X SHEET OWNER : 'SV F ~C oEA &4 ADDRESS: zoo/ ~ivs~~ ~~//f ~iS• S~o I.2._ SITE T,OCATION: y u . PROJECT DESCRIPTION: sT. Croix c~✓ s• 'oew Awa- owly W-c4loo !yr6 S;445 Xs C I. SwnwOlhli ~gloj&sejp. S6113 C ~o zo b -rAjC Ho aaD s ys~ w ;d,e. At 3. s r ~ Act, AWCOZ- IS -.2 0 4c4e -s PAGE 1. PLOT PT,AN VIEWS PAGE 2. MOUND CROSS SLCTIOIT & SYSTEM PT 111 VIEWS PAG7 3. PIPE LATERAL LAYOUT PAGE 4. `7?63 f}-$R SIPHON CH!IMBr,R CROSS S CTIONS P AG.1 5. S OR S IPIIr'N SPECS PLUMBER : SIT?-, EVALUAT-lM or DESIGNER HOMESITE SEPTIC PLUCOING CO. RT. 3 O'NEIL RD.: HUDSON, WIS. 54016 HOMESITE SEPTIC PLUOBING CO. ROBERT ULBRICHT RT. 3 O'NEIL RD., HUDSON, WIS, 54016 WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.& ROBERT ULBRICHT MINN. INSTALLER & DESIGNER LIC. NO.906fi3 WIS. MASTER PLUMBER LIC. NO. 3307 KFR& (,-.INN. INSTALLER & DESIGNER LIC. NO.00663 SIGNATURE 8601833 MAY 51986 PLUMBING SECTION jo-a.77 4w) Slf&IC 74AAK 4)1ESE~Q COwC. RiVVD. ` ~ 3 ~eDRM Fkwf ~s• 3 /~,P+o~ias~ ' ~ cviF.s~-,e ~o.~r. fiPop• WEB/ ~//.S p t A"s ~J 5; 2,E • Goo v O A JM 5 R \~0 lfyu'. S OF 0 Of ' i03,90' "/03.8 ou, I T• ~PE~• l~f' s~% 70r- / ~ oo dfT 1 ~ f . ,aAc~rHaE i3o,~~s o' F,c rs'ri~ls Scf1~c 30 RECHVED 860183t3 MAY 51986 PLUMBING SECTION f I o ?LOT ?LAN VIEWS `~PA~e t I Page _ Of _ Straw, Marsh Hay, Or Synthetic Covering ya Pe Distribution Pipe Awc~ Medium Sand F - H G Topsoil ~ I 3 E - D ~4- (o % Slope Bed Of Force Main Plowed Aggregate Layer D 1 Ft. Cross Section Of A Mound System Using E 1-5 Ft. A Bed For The Absorption Area F - 75 Ft. O~t~Q G ► Ft. A 8 Ft. H I S Ft. B 117 Ft. oks PN K /0 Ft. L 6 7 Ft. OF S AGE J Ft. `I 13 Ft. Force Main/ W Z f Ft. L F j Observation Pipe--,\ 8 K W (o ----------------------•I Distribution Bed Of iN Pipe Aggregate . I Observation Pipe Permanent Markers y" CA f FtD ( ue- $-1 EE I 12oDS Plan View Of Mound Using A Bed For The Absorption Area 8601833 RECEIVED M AY rtUMBING SECTION I Pale Of SEr u~ lflyAr ~oR j1,4cv u,6- f//,WVtr 0A) pv,~iNb ~,P~9io Oown/ Perforated Pipe Oetoil 0 End View )Perforolea / End Cop PVC Pape 1. Jo~,anoc~e O~5 Holes Located On Bottoms S Are Equally Spaced S \ P X / / PVC MonifoId Pipe Distribution Pipe Force Main 51,d0,VFJ2, Vito Last Hole Should Be -t-0040,OS Sf phoa 4A* . Nest To End Cop End Cop Distribution Pipe Layout P X2.7 Ft. ,00 00 S 3z E~P~~oNS X 30 Inches MP Y Z/ ` Inches ~ Hole Diameter Inch Qs~ Lateral / Inch(es) 0 Manifold " Z- Inches Force Main Y Inches # of holes/pipe /0 RECEIVED Invert Elevation of Laterals 10YO Ft. MAY 5 386 sm o/,eo c k s ysrrn Lc le ►wo z /°3.5 pLUMBING SECTION 11-VAT100 S Tom' Soi I TEST" ~DjST(ei(30T,00 PipEE DLSCAAR2_ ~4.`I.2 .02•S iS 1Z .M T,,- Aj -Di-SC-(,A1ejA- Wte -POP, (-e ""CS ~S 72.. • M To+,Q_ PS Io>h0 IS ~D ~`p TiMATED Phil-Y Iv~STE NO. of S e ~,e~uQpe~- 17°SES i S M lNi M uM s ~ sf~ = z z5~ ~s . 8 6- 018 3 SIPHON TANK D STATE ~9-Pi°~'ovfv GU/EScA° wiS . i \ st~tio,.i TO PPROD M of aQ. a.Q-. ►w T~1.v~ CAP -Pf of To I 411 Cast Iron I Hub I 24" dia Co v.Prt., • l 4o1,tov0 /o C&471 Wo :I1~• \ NOTES: All reinforcement Grade 40 steel and 6x6 - 10 y°C'T • welded wire mesh li 2. Concrete compressive strength 4000 psi minimum cs. i-U f 3. Inlet: 4" Cast Iron Hub Discharge: 4" Cast Iron Hub 3• 4. Siphon: Miller 3" 4• Automatic Siphon 4" C.I. Vent. i water in 5. Storage: 21.47 gal/in 13+ 6. Discharge: 279 gal/dis- Low water line charge 4Z• l 04; tea- 2114 13• H1~/~✓ y'' pdc 84'D►A. S/oho pew y ci, fo Mouut~ . 3 /r• ,~~raro Ec ~"d o 5 iNVEer S~ p P~~ ~•~EV,~riov Lw~L tiev's z f~ 8 6 018'3 I '00 MAY 51986 PLUMBING SECTION a ~ J Y 4 I 1 THE MILLER 3", 40, 51, 6", 8" Standard Design Single Sewage Siphons -1I ~ o ' • ,v HIGH WATER LINE yyy(~ ' t'. .D• :•.•p V .P •Q. T-Y r A ° o D C ti 4 •o o . LOW WATER LINE 8 na c A E ` U_ Reducer, discharge pipe, and back vent and overflow, are not furnished or sold by Rex - ' PFT Division. Vitrified the p : P pipe and fittings are generally o a.•° used for this purpose. • { Approximate Dimensions in Inches and Average Weights in Pounds Diameter of Siphon , , , , v, , , , , , A 3 4 5 6 8 Drawing Depth D 13 .17 23 30 35 Diameter of Discharge Head C 4 4 6 8 8 Diameter of Bell B 10 12 15 19 21 Invert Below Floor E 4'/a 5'/z 7% 10 9 Depth of Trap ...........y F 13 14'A 23 30% 40 Width of Trap G 8-3/8 11 14 16 25-5/8 Height Above Floor . H 7'/e 11.3/4 9% 11 16 Invert to Discharge=D+E+K J 20 25% 33% 44 47 Bottom of Bell to Floor K 3 3 3 4 3 Center of Trap to End of Discharge Ell L 12% 14% 17 19 25 Diameter of Carrier S 4 4-6 6-8 8-10 8-12 Average Discharge Rate GAM 727~) 165 328 474 950 Maximum Discharge Rate G,P.M......... X96 227 422 604 1400 Minimum Discharge Rate G.P.M...:..%... 48 102 234 340 500 j Shipping Weight in Pounds r , , , 60 150 210 300 800 i Detail Drawing 1 F 373 374.2 375 376 378.2A Note:-Two single Siphons of this type set side by side in the same tank will alternate,.See page 4~ for description of operation. The draft "D" will be 1" to 2" less in this case. Siphons listed • here are carried in stock'and can be shipped promptly on receipt of order and payment. The draft depth "D" may be reduced in certain cases by special air piping. Contact the manufac dr for these special applications. ' 8601833 RECEIVED MAY 5106 PLUMBING SECTION ~,~Fa%evs ow.vE.e : G/~',v ,1f~•~so,~ RTMENT OF REPORT ON SOIL BORINGS AND STRY, SAFETY & BUILDINGS OR AND DIVISION ~IUMAN RELATIONS PERCOLATION TESTS 115) P.O. BOX 7969 y (H63,090) & Chapter 145.045) MADISON, WI 53707 LOCATION: SECTION: TOWNSHIP V4 -30 1T2.8 N R~7E (o LOT NO.:BLK. NO.: SUBDIVISION NAME: W COUNTY: ONER'S/'S NAME: MAILING ADDRESS: S1. C,(di~( /Sox z f/ /f :UP 1R//s 'I . Sf~o a Z - USE Lo I NO, BEDRMS,: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE -IReplace /4- / X.1400 Residence 3 ,N` New PROFILE DESCRIP IpN~S: P QSG S qZ sins s>=~so~A~~ w~ r RATING: Site suitable for system U= Site unsuitable for system f}S $ 7y S 3 _ ~ CONVENTI ONAL: MOUND IN-GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(opttioonnal) c,i o S ©u © S ou o S ou OS ©u ❑ S au 1-X4V-V41* oV:!~Y. e'00'07Y ~0/ If Percolation Tests are NOT required DESIGN RATE: under s.H63.09(5)(b), indicate: GrG~-S s If any portion of the tested area is in the Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS ~+F sof/s wsrp~c pvoD/ C4,II 4S Sr104W,v-- BORING TOTAL tiT Nb Aio'rri-e alb.. o J~~+u1A . NUMBER DEPTH IN, ELEVATION DEPT H TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- / 3.75 /03.18 3. So 2 • ?S ' 1 j 9y 3, / fi a0- rN-.0- s , 79 N 5 v~cO.Q~ 47-- of • ? S /-O , - 9v ~SriN© -S S/ B- M I 'X w idy-v 11t77111-Q ,f'i:~-4v,1y/ T4F2:I 191! 3. S . 01 B-Z 3•56 /03.0 f S/ nAX,&X w_e'F AT- -2.,P' 3j - Titn/ B- Sr1-S,}.vD 04iX w/ 1 CWUA- Sr•a¢ewAl Scr-p;f " u B-j 3 -S4 ~ 161-1,90P .3. /6 " _2 -Sa A6 Go ~ $ 1 s IAJ Q+ a-r 1;2. S /O 7,/V S/ rvi $idQecas B- Sve~° AT 3. iG F*; tv~~~3lTiouS 0'F jiG SrTf'S PERCOLATION TESTS %N lavrpsQ -/c3o j,~ S/. TEST DEPTH, WATER IN HOLE TEST TIME NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 DROP IN W PER ODE- EL-INCHES PERIOD RAPER IINCH ES P- P- P- l DA! /0 A • : ee --r74 P- P Z /0A. FL PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. iN a4,f r = / o ge 0 J*T'. SYSTEM ELEVATION ysTE-9 T: oa - ~ 1 -7, l a3 . SD T J1J__ _~JyCy~L Ate. a _z f/~ ~j>OA1S _ 1 4111, 7 ~,r E 14 T ~ osee~' 3 0 ;I s /oG~y~r'e°Af APPRO'V t~ Titus -This test at Ytort~. T - for a -onv,E septic ~T. h lanat(on. - exp 'iT Ip - a Ar se f. 30 P1- O fflclAy _ FTC *c r~ , _ i i ! 3 f t 3 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin - Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): RT. 30'NEIL RD.: HUDSON, WIS. 54016 a a ! TESTSR~OMPLETED let IV 1 ADDRESS: RT UL$RICHT f~ 2 / WIS. MASTER PLUMBER LIC. NO. 3 .O , CERTIFICATI NUMBER: PHONE NUMBER (optional VINN. INSTALLER & DESIGNER LIC. NU. OO ' +tll sS`=OL K _ CST SIGNATURE: 2k--~ aci STRIBUTION: Original and one copy to Local Authority, Prop t ner and Soil 4R-SBD-6395 (R. 02/82) ONLY IF ALL id completing the p:. rg to scale is pr+ per colati( the apes, FILED WITI- ti r: C m I rTt I 9 ti o ~ 'r m ` m fA lA N D o N 0 ~ma r ` ~Am o 3 -o 9AO 0) 0 00 3 o (13 (n o ' -0 o~m• vamm°o~ H m m N m~ o N ~ C A t w o =w m (D A m m 7C m w w Jai w, . wo N m (n a (n 3 C.) CD CD O'D ~1 r o w o `0 o m=r O C. wow ~>>w~ A o~3oa 3° c `c c c=' N c s w ' F 0 7D m w A (D c < CD CO) cr 0~ CD cn o 0 D CC-i n a w A o d m' O m 0!n CD 0n'vww~' C CA ' a, N < ow N• Z `dam ~ w CD m ID 0 =r CD ? CL. m A 3 CD M 0a D "I ova ID o m wa ? ?c w0 0 m :3 ET vi w a CD =r a (a CA a c 3 o co 0) 0) - (n A 0) o C m v ~ CD o CL (D =r (D ui m (n n 1 A w a(in w< (CD p~ w0~ c ochV, ~D CL f c cr0 E .~m: w a CD = a a m (a 3 rT1 M a - Q CO°~ Q3.~,oN. =No oc mm-3 0 e m0C G~(o0 0 v,70m0 z o CL C: a 2 a~ 3 O c m a o o M a~ Mo3 \3 :3 CA. 0 < 0 0 wlsconsln - APPLICATION FOR SANITARY PERMIT S~ C AO/ COUNTY ~DILHR (PLB 67) UNIFORM SANITARY PERMIT # OEPRRTTEnT OF InOUSTRV, LRBOR 6 HUMRn RELRTIOnS I Z 1?^ 2 -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/zx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAI I G ADDRESS eAF-ey- lae_ 1-3,9,Y 22-PI PROPERTY LOCATION etT1, 5,A) 1/4'VR)1/4, S 30 , T2~ N, R 17,0'(or) W TOWNOF: ?'E_ASy4uT VA kJ I It! LOT NUMBER BLOCK NUMBER SU IVISION NAME bdI l/ NEAREST ROAD,gyLAKE S- T, STTE PLAN 9 UMBER TYPE OF BUILDING OR USE SERVED •4~ C _ C-- 01 1 or 2 Family Number of Bedrooms: JD Public (Specify): THIS PERMIT IS FOR A: KNew System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-F' ❑ In-Ground Pressure ❑ S/6'all 11" y El Pit Privy ❑ Existing, For Which A Previous Is On File, Per issued ❑ An Existing System That Has Been Inspecte s Compliant As Far As Soil Conditions. Total of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Ch er Holding Tank capacit * Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ~ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity ldVV 12'O"O Trtp/Siphon Chamber Manufacturer: lcnE f_, PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): T 3/~ Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumbe Signature: Mff`MPRSW No.: Phone Numbef~: p RT. 3 O'NEIL RD., HUDSON, WIS. 54016 334 7 (715) 3J G _ of Plumber's W. rI TER PLUMBER LIC. NO. 3307 M.P.R.S. Name of Designer: U M1.INN. IN$TALLER & DESIGNER LIC.. NO. 00663 . jI~A I C COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved 6 %~~d [_v El Owner Given Initial Approved Adverse Determination Reason for DiOpprovaK C/ Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. H Z cn H Y ST C- 105 r" r 9 H SEPTIC TANK MAINTENANCE AGREEMENT H 0 St. Croix County z 9 X01 OWNER/t-d-%ER H -1yLR4 tz] ROUTE/BOX NUMBER,//./ jag-~ Fire Number CITY/STATE O`/U~ w7 JZZ ZIP PROPERTY LOCATIOJ& 1 14, Section 30 T2or N, R/7 W, Town of &'V7- 11'I6/+1 , St. Croix County, S u b d i v i s i o n 20 _/_14~45 hot --rrae~-- - 1 Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing sy 'm.' 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. y 0 I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- ►~u ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED 16 'A' 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 U/ e6 `1: Location of Property 54V 14 ;4, Section 1?6 , T N-R ! W Township /f4 (5, I'V Mailing Address IJOX 2~ Address of Site Subdivision Name Lot Number Z 2f'e-LS Previous Owner of Property Total Size of Parcel 120 ,or Date Parcel was Created - 4a. Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume 7/ U~ 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 pa&ee 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) cvtti.by that att btatement3 on thi.6 bonm cute true to the best ob my (oun) knowtedg e; that I (we) am (au) the owneA (,s) o6 the pro peat y dens nib ed in this inbonmation bonm, by vi tue ob a waiAanty deed neconded in the Obb.i.ce ob the County Registers ob Deeda ad Document No. 410 1 U -7 and that I (We) pne3entey own the pnopod ed z to bon the z ewag e d,vs pops z y em (on I (we) have obtained an ea6ement, to nun with the above descAibed pnopehty, bon the construction ob .said by6tem, and the same h" been duty neconded in the Obbice ob the County Register ob Deeds, ad Document No. SIGNATURE ER SIGN URE OF CO-OWNER (IF APPLICABLE) DATE S GNED DATE SIGNED ST. CROIX COUNTY y~ WISCONSIN `L*~z ZONING OFFICE l z s~ > ~I 796-2239 (HAMMOND) 425-8383 (RIVER FALLS) HAMMOND, WI 54015 May 1, 1986 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Greg Koehler property, located at the SW!4 of the NWT of Section 30, T28N-R17W, Town of Pleasant Valley, St. Croix County, revealed suitable soils at a depth of 2.50 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincerel Thomas C. Nelson Assistant Zoning Administrator mj 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/NXMXXW~ SW NW ~4 S 30 T 28 N/R 17 EXSX?V Pleasant Valley St. Croix Street Address: Subdivision: County: Landowners Name: Mailing Address: Greg Koehler Rt. 1, Box 281, River Falls, QI 54022 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. 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 DILHR-SBD-6413 (N. 05/81) My Commission Expires: 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 for an Alternative Private Sewage System In the County of St. Croix Location sw 1/4, Nw 1/4, Sec. 30 T 28 N, R 17 XWD4 W Town Pleasant Valley Street Address Lot No. Block Subdivision Landowner's Name: Greg Koehler The application for this site is for: ® new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: 61 to have one of the first five approvals guaranteed for this year. This is numher 59 - 04 - of those applications. (Use one of the first five quota numbers issued to you.) 1. lone 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. D 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. El 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 .0 I certify that the above information is true and accurate to the best of my knowledge. 000, Name Thomas C. Nelson Si ure County Official Title Assistant zoning Administrator Date May 1, 1986 DILHR-SBD-6158 (R 12/82) Parcel 024-1035-95-000 10/16/2006 04:02 PM PAGE 1 OF 1 Alt. Parcel # 30.28.17.231A 024 - TOWN OF PLEASANT VALLEY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - KOEHLER, GREGORY S GREGORY S KOEHLER 165 150TH ST RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 165 150TH ST SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH j i Legal Description: Acres: 21.805 Plat: N/A-NOT AVAILABLE SEC 30 T28N R17W PT OF SW NW LOT 1 CSM Block/Condo Bldg: 5/1213 TOWNSHIP PLEASANT VALLEY. Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-28N-17W Notes: Parcel History: Date Doc # Vol/Page - Type 08/24/2004 772517 1 WD 07/23/1997 718/64 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/03/2 05 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 42,600 148,400 191,000 NO AGRICULTURAL G4 15.000 1,300 0 1,300 NO AGRICULTURAL FOREST G5M 1.800 1,400 0 1,400 NO Totals for 2006: General Property 21.800 45,300 148,400 193,700 Woodland 0.000 0 0 Totals for 2005: General Property 21.800 45,300 148,400 193,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 221 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 , 4 P r CLRTIFTED SURVFY MAP JOHN MAULS NW COR. SEC.30,T2PN, Part. of the ,3ou.thwPgt 1/11 of the Northwest 1/11 of Section R 17 w, (COUNTY SURVEYOR'S MONUMENT) 30s Townrghip PP Nor-I;hr Ra.nrrn 17 West,, Town of Plr> z^.-".rit Valley, St. Croix County, Wisconsin. * Indicates 1" iron pipe found ti N o Indicates 1" x 24" iron pipe weighing 1.13 l.b-/l:i_n.. a VARIABLE WIDTH TOWN ROAD ft. <lr t r`_' 73.61 UNPLATTED LANDS N LINE S W 1/4 NW I/4 sage 9' 51" 102 0 6 9 2, 0 9 if 0 P M 33- 3.0 300 _ 661 , 84 330 0' ,o 89° 36 14 W 102 5.14 N \ 69 ° g C I A d rn m I 23 4 M 0 ( W r/ j m~ ~ N M ~ M M CO m O S 89° 36' 14 " E 361.48' QI it z 69e 2 a N 2 ° JI . I N - p~0 p o ( N I rn 1tl- 0 W l ° - LOT 1 21.805 ACRES LOT 2 17.000 ACRES 1- N 949,821 SQ. FT. wl M ~ ~ N 740,507 SQ. FT. ~I od -oI~ N ET = 19.730 ACRES NET = 16,490ACRES p~ 859 0 f~r .,449SO.FT. 718, 283 SO. FT. z WI ° I~ W 0 co 0 LOT I NOT TO BE USED AS A BUILDABLE :N i aal rNnZ d LOT AT THIS TIME M N - M OQ CP .r" ° V \ °N N 2 00 Iz i 1 N W M d ~ I I M d' o ~ 3 z ( 0 3 o z z I f 4y d J 0° - 3 I m 3 33.00' 9°/ cn 713.30" 643, 00' N 890 14' 53"W 1389,30' 1/4 COR.SEC. 30, 0 100 200 300 400 500 600 W 28 N, R17W, ~ _ - E/W 1/4 LINE :OUNTY _ URVEYOR'S UNPLATTED LANDS AONUMENT) ALL BEARINGS REF. TO THE WEST LINE OF THE N WI/4 OF SEC. 30, T28 N, R17w, ASSUMED NOO°03'32"E THIS INSTRUMENT DRAFTED BY LAURENCE W. MURPHY \a~n,mnmm~rrhn N / SCALE 1" : 200' flo L. VV ~A MURPIly / it r I V= F rALLS, c' Vol. pale 1a~ James I, Murphy wl"XII. Cer+,ified Survey Maps Rofri +ered Land Surveyor roix County, Wisconsin (DESC,RTPTTON ON REVajSE) 0 cn0l 3y -0 0 M CC c d C M C C 1 y n Yy T 1 d (D 'S O K O z O -4 O O N P. v O ? CD CD y F•I fD <D co rn ^ CD W N a O° O j 1 °O n m CD ° S O m m w c ° D ° p H cn ° m (n D a cn .lrl. 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