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HomeMy WebLinkAbout032-2075-20-000 n y 0 3-0 n r~ f C 01 p d r/1 M 3 d a m 3 v o ° 3 W N • C Z L N v (D O ON fD N L N A O N (n o V CL CD CD N 0 (D co O n N U1 O O O Ca I 3 O D N N cn p cn O v C 3 o (1~ O Q1 cy CD CD cx :-4t C) N hLi o 00 co 0 n r ti (A Q -4 ~ °c y 0 a tv cn -0 -0 P no! o~ a,ao icv i m = r'3= 0, y N co C~ A -o 1 v M o = N C 7 4~ O I Z ' I O O D D c 00 a CD Q Oy w m CD N Z O W N O O X m A G 7 a (roD E (D V O I- 4 W O CA) A rr~1 p• Z N F'• P~ `4 1-1 rt O c 3 .°r. O p N C,) 00 oo ¢ U) C 41 Ul W t In m 1-• n p V f0 w v sc =.oo~ a CD a o E p-, D 3 m c CL cn co 3 a~ o o a In o o. w N oQ pp x N to a ' l rn 0 3 ( co , Cc, o H H °D y a -4 3 a) 14 f0 O CL CD ~ Q CD En CD F' U 3 CD r y _ N ^ i Fj \ rt O r• m r• a M w rt ra o t CD w 69 0 v a, -0 HEAD TDH D , It CAPACITY CA RV E , rn IlI W TOTAL DYNAMIC HEADICAPACITY PER MINUTE EFFLUENT AND DEWATERING 00 137-139 163 165 51-59 30 SERIES 5 L 3-55-TRS 97 LTRS LTRS LTRS LTRS M TRS 394 1 23 95 231 J Lr2 163 248 300 231 231 ;a 129 72 2 11604 227 28 EFFLUENT AND DEWATERING 242 227 90 136 223 227 ` 104 30 216 223 26 85 \ SEWAGE AND DEWATERING 25; 7 , 206 220 \ g0: 5 14 ' 172 206 ` 10' 12 1a 125 191 AO \ 50 15 24 A 57 161 24 80 1829 114 7` 70 21.34 53 5 \ \ 24.38 26, r• 87' 22 24.5' Lock Valve: 19 70 MODEL MODEL TOTAL DYNAMIC HEADICAPACITY PER MINUTE \ 165 SEWAGE AND DEWAAT2 RING 264 293 20 CG 163 \ SERIES 267 268 LT RS LTRS 1 LTRS \ \ M LTRS LTRS 386 492 681 ; i. p \ g t 52 ,y a08 - 273 360 598 18 ` 1p 305 227 238 511 C \ - 15 4 57 76 130 125 401 55 2fl 610 - a 288 16 CA \ 25 7 62 _ _ 163 292 5V \ 3Q- 9.14 227 V = 35. 10.67 _ 174 14 \ 40 12.19 41~ 106 45 46 13.72 45 \ 4: 1524 ' 26' 35' 53 12 40 MODEL Lock valve. 19 21 293 10 35 \ 30 \I MODELS ` 8 2b _ 137 139 MODEL 284 6 20 MODEL 4 15 DEL 282 MO ~ . ~ 10 268 2 MODELS 5 53, 55, MODEL MODEL 57,59 97 267 0 40 50 00 ?0 AO 90 ;10010 120 U.S. GALS. 10 2() 30 561'' 320 400 48© LITERS 640 650 _ ...W, 80 160 240 FLOW PER MINUTE Manufacturers of . 3280 Old Millers Lane P.O. Box 16347 p a ` OELLER O Louisv111e, Kentucky 40216 ,0ua[/TY PUMPS ,fi;NCE I,73a7 (502) 778-2731 Z 8 1`lil'Jl ~ ~ ^ l~J'J No 'TRY" OF SAFETY & BUILDINGS REPORT ON SOIL BORINGS AND LABOR AND PERCOLATION TESTS (115 DIVISION HUMAN RELATIONS ) P.O. BOX 7969 0'C GpG'T• /'07""j (H63.090) & Chapter 145.045) MADISON, WI 53707 LOCATION:✓(' SE TI ON: OWNSHIP/MtiiVTCipprL?Ty: OT NO.: BLK NO.: SUBDIVISION NAME: 101 Y /T 3o N/R i o E (o ► W SOMEAr.6 7"' / evi 4) 3 P~ . 7~Z p COUNTY: OWNER'S BUYER'S NAME: MAILIN ADDRESS: ST. C,eo/X 7EF~ , fa1~~ ~J~ O USE ,SoZ ~3 //,v 00 1A' fP/`~~voo!? /%v. SS//~ DATES OBSERVATIONS MADE NO. BEDRMS.: COMMER. IAL :DESCR::IPTION: PR FI D R Residence New ❑Replace ,r ONS: A I N TESTS: 1171 21 J 01P 61 RATING: S= Site suitable for system U= Site unsuitable for system '?3 ~ CONVENTIONAL: MOUND: IN -GROUND-PRESSURE : SYSTEM-IN-FILL OLDING TA NK: RECOMMENDED SYSTEM: (optional) 0 [IS ©U ©S ❑U _ EIS 5A EIS ®U DS DU ~m~~D If Percolation Tests are NOT required DESIGN RATE: y under s.H63.09(5)(b►, indicate: CG/~SS~_ If any portion of the tested area is in the Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS -'AI ZEC• F7-. BORING TOTAL D PTH TO GROUNDWATER-IN' CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. IGHES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) s-Z D /0?•2~- y~ So eti X-1 ~,.1 G~e~ 4~ i d7 'Z~ ate,. s: .u. y Bs.3 $ /cy, If _ s • sr o s ~ FT..,, E- R• R' . ~j 14 9ifCA of 800P #1`3 uA/.J0 7"/C',tp o'6,e,41 wET) `s'/ t✓o L.MESrdv~ B- + 0 (!vv E P", ept- o f 4,14 ,e;~ Z 3 13-IV Or /OZ -3z, 0 • 7s' ~,f"B.v oc , , ` Z . Q ' ~f•EriF S UDD/e WET (o • 0'- /irl E ST 10 si B~ S 102 •16 3 7 " 3 767" ~'f S;, . S •O~f'BN. S.' 2. p ' Q.,~ky B.u- 3• !3N . f~NF 5 ' oc E ~ PERCOLATION TESTS \ TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES ~O NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERT D 1 PERIOD R PER INCH P_ / Z p 4 i 4 O P- P- 2- 1i - _13 T. 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. s/4N'0/P_OGk iNfEi2 f ACE : 103, S "T SYSTEM ELEVATION NVE07- tLeVATwJ: /Df!Zs E r - , t _ i t I l 41 TIT 1 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): HOMESITE SEPTIC PLUMBING CO. TESTS WERE OMPLETED ON: 161.3 O'NEIL RD., HUD50N, WIS. 54016 -If N ADDRESS: ROBERT WRICHT CERTIFICATION NUMBER: PHONE NUMBER(optional)-n W13. MASTER PLUMBER UC. N0.3301 M.P,R.3 Z y 00 L- 3~6 - 1~ y 0 CST S NATURE: "LC.GI / , k DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. C DILHR-SBD-6395 (R. 02/82) - OVER - V s _ REPORT ON SOIL BORINGS & PERCOLATION TESTS 115 PLOT PLAN * Pfi-Oj e c t• I . D . T e F F 17; cv LEGTI~ID HOMESIIE SEPHC PLUM%M _ lit a WNEIL NO., NUDBON, M& 51016 ROBERT ULSRICHT 0 = Ba c kh o e _T i t s WIS. MASTER ►LUMIER LIC. Na 3307 M.P.RIE MINN. INSTAUER A DESIGNER LIC. 40. mu X = Perc Locations Q = C.S.T. 2482 Existing Well Vertical Reference Point ;TOP 8!~ /y NPi~IDyvD ~T ,S'U LoT ~O,ctlvE,~ V.evation of Vertical Reference Point X00. 0 jT. Lot Line N1' SCALE : / = 3 d vR~S 6y 1y .By°fi V► x Ps ,~/ev y o~E 9a IP9 ) 1n yon p 6Y /ol , 3o' ' $3 1 62, - - 3o QZ fl!/oiD Tlis Zr~v~ r~lT/E- LQE lu ~ . 'ri'~oU.vD eUE~ Fo s ~E SoO.ywA Lo y~~ FT LIMESTONE MOaF,vTt r ~,~.~rE G E _ z cn , y y STC - 105 r r a ' H SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County z C$ a OWNER/BUYER J Z...1" 1 ~v;✓ L ROUTE/BOX NUMBER Fire Number CITY/STATE S l- ZIP PROPERTY LOCATION: 14, Section , T N, R W, Town of 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, _1zN if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 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- b 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. A SIGNED DATE & - ~ t✓ St. Croix County Zoning Office HOMESITE SEPTIC PLUMBING CO. P . 0 . Box 9&. RT. 3 O'NEIL RD., HUDSON, WIS. 54016 Hammond, WI 54015 RpBERTUIBRICH; NO. 715-796-2239 or 715-425-8363 MINNWIS. . MASTER IN$TAI LERM& DESILIC, GNER L C3 N0 0066 'i Sign, date and return to above address. HOMESITE SEPTIC PLUMBING CO. AT. 3 O'NEIL RD.; HUDSON: WIS. 54016 APPLICATION FOR SANITARY PERMIT ROBERT ULBRICH4 WIS. MASTER PLUM6ER LIC. NO. 3307 M.P.R.1 S T C - 100 MINN, INSTALLER & DESIGNER LIC. NO. 0060 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 j r Ly" Z Location of Property 1V s 10 34, Section T_D _N-R 20 W Township a _(e F_ Mailing Address S D ~l i.,s c cr c/'3L In Address of Site ,gl, ~i:~;/ f~✓z Subdivision Name C'S Ub ~f CQ Lot Number Previous Owner of Property Jy Jl n ~ ;j Total Size of Parcel / y L S 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 yZ0 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) eeAti6y that aQ..Q. statements on thi.6 6onm ane tAue to the best ob my (oun) knowtedge; that I (we) am (ahe) the owneA(s) ob the pnopenty descAi.bed in this .in6onmati.on 6ohm, by viAtue ob a wat,%anty de d ne onded in the 046i.ee o6 the County Register o6 Deeds as Document No. D D ; and that I (We) pnesent2y own the proposed site {Ion the sewage di~spos system (on I (we) have obtained an easement, to nun with the above desehibed pnope&ty, bon the constnucti.on of 6a.id system, and the same has been duty seconded in the 066ice ob the County Regi6ten o6 Deeds, as Document No. J. SI URE OFF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) GI - s DATE 'SIGNED DATE SIGNED ST. CROIX COUNTY WISCONSIN ZONING OFFICE 796-2239 (HAMMOND) 425-8383 (RIVER FALLS) HAMMOND, WI 54015 October 24, 1986 Division of Safety and Building Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Jeff Howe property, located at the NW1/4 of the SW1/4 of Section 14, T30N-R20W, Town of Somerset, St. Croix County, revealed suitable soils at a depth of 3.75 feet, below which seasonable high groundwater was noted. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Assistant Zoning Administrator TCN/mj WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 1969, MADISON, WISCONSIN 53101 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location NW 1/4, Sw 1/4, Sec. 14 , T 3o N, R 20 fxXXM) W Town 0rj~3ftV Somerset Street Address Lot No. Block Subdivision Landowner's Name: Jeff Howe The application for this site is for: Dnew construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: [.1 to have one of the first five approvals guaranteed for this year. This is number - of those applications. (Use one of the first five quota num ers-i ea-Fo-you.) [.xione of the applications needing a quota number. The quota number assigned to this application is 59 - 20 - 7 . for one additional homesite on a farm to he occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. []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. ❑ 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. Name Thomas C. Nelson Sig+~ature (County Official Title Assistant Zoning Administrator Date October 24, 1986 DILHR-SBD-6158 (R 12/82) ' Parcel 032-2075-20-000 01/26/2006 03:17 PM PAGE 1 OF 1 Alt. Parcel 14.30.20.786G 032 - TOWN OF SOMERSET 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 THOMAS F & SANDRALEE L ROSE O - ROSE, THOMAS F & SANDRALEE L 1531 TWIN SPRINGS RD HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1531 TWIN SPRINGS RD SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 1.940 Plat: N/A-NOT AVAILABLE SEC 14 T30N R20W 1.94A LOT 1 CSM 4/1146 Block/Condo Bldg: WHICH INCLUDES LOTS 70,71 & 72 OF TWIN SPRINGS ADD ASSESS WITH P866, 867, & 868 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 14-30N-20W Notes: Parcel History: Date Doc # Vol/Page Type 12/01/1997 569251 1280/59 WD 07123/1997 1219/538 QC 07/23/1997 934/01 07/23/1997 756/420 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 78120 204,300 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.940 31,000 133,400 164,400 NO Totals for 2005: General Property 1.940 31,000 133,400 164,400 Woodland 0.000 0 0 Totals for 2004: General Property 1.940 31,000 133,400 164,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 542 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 - C - 104 14 R AS BUILT SANITARY SYSTEM RE S T OWNER ~S J~~F ,1pflJ~c- PORT Foy rr TOWNSHIP SQ"~~A~;~'~7--- ~ ~ ,gyp ADDRESSt SEC. j ~~)C JCQ~ T -_N-R z U W ST, CROIX COUNTY, WISCONSIN - s ~fnS a SUBDIVISION CSM Up~' 3 ri 7k LOT LOT SIZE P~Rb X L/ PLAN VIEW Distances and dimensions to meet requirements of ILI1R 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM C~ Tibjs /0 3 M~ °f -FI, - 910. / y . '79 ' I 3 4. y0 ~ ' O 3 " fc{ Qp 17 / f y,, 13' 2 (3~oeM 17, I~ rcz /fir o r ~ X588 'ONi 0Uk ~k 33 GOOF /c, Pr. _ 30 \r, sa !O~ INDICATE NORTH ARROW L, BENCHMARK: Describe the vertical reference sF r P,pF +4r Elevation of vertical reference Point used CO RNEQ Point: /o 62, Q ' Proposed slope at site: SEPTIC TANK: Manufacturer: WlESe,'~) - Tank Capacity: t7 ~rc_Q Number of rings 2 - used: Tank manhole cover elevation: /03, / Tank Inlet Elevation; 99, 7 ~ ' ~q Tank Outlet Elevation: Number of feet from nearest Road: Front, From 0 Side,O Rear, O nearest property line Front '050., O Rear ,O /2Q Q , Number of feet from: well ( feet 11 e _above p_, building: /.3 (Include this information of thlot plan)( ~ • td 4S56 444 Liquid Capacity' Asa N Manufacturer: pump Size Z P pump/Siphon Manufacturer: gs. / pump Model: 137 'f Bottom of tank elevation: / Elevation of inlet: ~.L_--~-------' ~ f cle: 6• /C7 .gallons per cy pump off switch elevation: tyEP(UP Alarm Switch TYPeo l20 Manufacturer: !r SO Alarm O Side, (D Rear, 0 ~ line: Front, Number of feet from nearest property well : ~ , / Number of feet from , Number of feet from building: . . (Include distances on Plot plan) 3St_ i M u,u SOIL ABSORPTION SYSTEM Trench: Bed : (P Area Built: r y 7 Number of Lines Width 8 : Length:` of pipe: Z w ~ST3 3 ~ Fill. depth to top Side, O Rear,O pt Number of feet from nearest property line: ~r~ Front / Number of feet from well: , /00 Number of feet from building: (Include distance~*.on Plot Plan). SEEPAGE PIT Diameter: Number of pits: Size:.. ottom of seepage pit elevation: Liquid depth: Area Built: t of the above soil Has either rop box O or distribution box O been used on any absorbtion sytems? (Check one). HOLDING TANK Capacity: Manufacturer: - Elevation of bottom of tank: Number of rings used: Elevation of ' et: Front, O Side, O Rear, OFt. Number of feet from nearest property line: Number of feet from well: Number of feet from building: Number. of feet from nearest road: Alarm Manufacturer: Inspector: plumber on job: Dated: License Number: ,UMESITE SEPTIC PLUMb1W G0. 21 3 U'NEII RD.: HUDSON; WIS. 54016 ROBERT ULBRICHT -;to Yfll PLUMBER LIC. NO.3307 MIR& ~1i.ER 6ESIGNER LIC. N0.00663 3/84:mj Y 1 Form S T C - 104 i AS BUILT SANITARY SYSTEM REPORT ~t R. A4 utFF 110wE- OWNER TOWNSHIP $ E RSeT- SEC. T 3 O N-R Z d W ADDRESS ST. CROIX COUNTY, WISCONSIN q I LGSM Vol 3 r SUBDIVISION 7,F 2--' LOT LOT SIZE A P~ y ~„S 1 PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM C L. 3e~ , /0 ToedS o.,c 1474 /s = /o yo P Um 10 t.F r f r 3" s ' yo' ~ EF+c~E . j ii is 3S So. INDICATE NORTH ARROW -rep or- 1 Pepe *r { BENCHMARK: Describe the vertical reference point used SF- lOT CGR,4EQ . i Elevation of vertical reference point: - cl, 0 Proposed slope at site: SEPTIC TANK: Manufacturer: wIESE-R Liquid Capacity: t Number of rings used: Z' Tank manhole cover elevation: ,0 3• (i Tank Inlet Elevation: 997/ Tank Outlet Elevation: / Sy Number of feet from nearest Road: (~q i Front ,@Side 0 Rear, O 1/ feet From nearest property line Front,OSide,ORear,O / 2 0 feet ` er of feet from: well , building: 13 i ...rude this information of the ab nlant~ r r PUMP CHAMBER - n ~~.0 GarJC Manufacturer: i~S~/~ • Liquid Capacity: 0 Zo IIJ^, Pump Size Pump Model: 137 Pump/Siphon Manufacturer: /c J` 7 Bottom of tank elevation: 15 Elevation of inlet: 7 s~ pump off switch elevation: / • Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: SO Number of feet from nearest property line: Front, O Side, O Rear, Q Ft•l Number'of feet from well: / Number of feet from building: (Include distances on plot plan). 3~ SOIL ABSORPTION SYSTEM M 6 uN ~ I~hS*L- A-k Bed: Trench: 8 / Length: 7 Number of Lines: Area Built: Width: Fill depth to top of pipe: 1 weir. Number of feet from nearest property line: Front, O Side, O Rearso It. 3 Number of feet from well: ~ ~0 0 Number of feet from building: (Include distanco.on plot plan). SEEPAGE PIT 4 Size:%. Number of pits: Diameter: Liquid depth: ttom of seepage pit elevation: Area Built: Has either rop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check-one). { HOLDING TANK ; ManufactuIrings Capacity: Number of used: Elevation of bottom of tank: Elevation et: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. =1 Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Plumber on job: Dated: License Number: tUMESITE SEPTIC PUN IM CO. Q1 3 VNEIL RD., HUDSON, VAS. 54016 ROBERT ULBRICHT ' AR PLUMBER UC. NO. 3307 M. *1 %U ER & DESIGNER UC. NO.006fi3 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION BUREAU OF PLUMBING MADISON, WI 53707 ❑CONVENTIONAL ALTERNA~TyIVE state Plan l.D. Number. ❑ Holding Tank ❑ In-Ground Pressure RPWound (If asst [96-08813 NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION DATE: Jeff Howe 502 Bellwood, Maplewood, MN 55117 t7:Y 7 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: NW SW, Section 14, T30N-R20W, Town of Somerset Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Robert Ulbricht 3307 St. Croix 88427 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL ILOCK:NGCOVER PROVIDEDNO DPROVDED:YES ONO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER DYES O NUMBER OF ROAD: PROPERTY WELL: BUILDING: 1-17-ENT TO FRESH ALARM. FEET FROM LINE: AIR INLET. DYES ONO DYES ONO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED DYES ONO DYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM I LINE AIR INLET' PUMP ON AND OFF) OYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing =FORCE LENG TH DIAMETER MATERIAD MARKING or excavation, (lf soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH NO OF DISTR. PIPE SPACING COVER NSIUE DIA 1141 PITS LIQUID DIMENSIONS TRENCHES: MATERIAL: PIT DEPTH GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPE&. ABOVE COVER: ELEV. INLET. ELEV. END. PIPES: LINE. AIR INLET. FEET FROM NEAREST--► MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES ONO meets the criteria for medium sand. TIONS MEASURED. OIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS L.EP'TH OVER TRENCH/BED DEPTH OVER TRENCH/BE DYES ONO DYES O NO D pEPTH OF TOPSOIL. SODDED. SEEDED MULCHED R. EDG ES: DYES ONO DYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRNO.EOFNCHES FELEV. AL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER : DIMENSIONS MANIFOLD PUMP MANIFOLD PIPE MANIFOLD MATERIAL: NO. DISTH DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.: ELEV.: CIA PIPES DIAELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLEDCORRECOVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS YES ONO COMMENTS: PERMANENT MARKERSD: OBSERVATION WE LLS: D YES ONO NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE DYES ONO DYES NO NEAREST Sketch System on Reverse Side Retain in county file for audit. . SIGNATURE: TITLE DILHR SBD 6710 (R. 01/82) E .7 SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code 5-1 SANITARY PERMIT Y? Y-21 91 -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. 61 - ab /3 -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES NO PROPERTY OWNER / PROPERTY LOCATION /6GVc'- Nw'/4 540 %4, S / T 34, N, R 14 E (or W PROPERTY OWNER'S MAILING ADDRESS , 1, v LOT NUMBER BLOCK NUMBER SUBDIVISION NAME 5'a y de/lwoop / es roe, y (e CITY STATE ZIP CO PHONE NUMBER E:I CITY NEAREST ROAD, 6AKre Aft LAMIIM4RK LAGE P el -V ors 15'6_//7 1(612- 777' L13pl ❑ VIL OWN OF, 1 II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR 11 Pub is (Specify): 6clu III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. ~ New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3.7 An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 1. a. ❑ Conventional b. ❑ Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy en Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ seepage Bed b. ❑ seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): i U z 7r 3 163,5 Feet ~rivate ❑ Joint F-1 Public VI. TANK CAPACITY Site in gallons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New xisting Gallons Tanks Concrete glass App. Tanks Tanks structed Septic Tank or Holding Tank ❑ ❑ ❑ ❑ Lift Pump Tank/Si hon Chamber 757 ❑ ❑ ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MWMPRSW No.: Business Phone Number: AlSa7 _ _7M1V 1e_11T 3307 3 t6JPl? Plumber's Address (Street, City, State, Zip Code): Name of Designer: VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name _ ML CST # NT 0 Q VII, RD., HUDSON; WIS, 54016 CST's ADDRESS (Street, City, State, Zip Code) NHS MITI? ROW.T OR NO, 3507 M,R.R,S. Phone Number: E I 'N R LIC. NO. 00663 IX. COUNTY/DEPARTMENT USE ONLY MINN, INSTALLER ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuin Agent Signature (No Stamps) Approved ❑ Owner Given Initial S~ch„g~ e Adverse Determination o 4 ~z ~M, a X. COMMENTS/REASONS FOR DISAPPROVAL: I SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT T 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; I 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. !f yoU have ugstions concernincg yo.',w privat : 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 musz include 1. Property owner's nary e and mailing address. Provide the legal description where the system is to be installed; ll. Type of building or use served: If public is checked, indicate :ype of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; Vi. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; Vill. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale 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 result of over 2 years of steady negotiation and public debate. The groundwater bill Groundwater - included the creation of surcharges (,fees) for a number of regulated practices which Wiscon"" n's can effect groundwater. The surcharge took effecf on July 1, 1984. AIi of the water that ~J buried (;r,.asure ' is used in your building is returned to the groundwater through your soil absorption 'o ` system or the disposal site used by your bolding tank pumper. The monies collected throuW th`;se .,zrci:ar des are credited to the groundwater fund adm. nis- ° tered by the Department of Natural R >source These funds are used for monitoring n ound- ~4 water, groundwater contamination in,estigat'nns and establishment of standards Crol,ndlgat::: ~ it's worth protecting. SBD-6398 (8.03/86) 3.o i I• PROJECT IND,X SHEET OWNER #owe ADDRESS: 5'0 2. BeAW00D liq?q F6vool7, .5v~~~7 SITE LOCATION: 407L 7) 6- 7~Z *W yy sway .mac.~y r 3a,~ yaw Tower Of 5'0111E:RSer ST, neoia( (s5) PROJECT DESCRIPTION: atw Cp.vST~Uc T~o.v ~~u,U~/ S4i L 7E STS /ND%Gi! T~ D So i/S /J~P+~' SEr}SONhI.L~/ SATv~PAT~ To avi f 3, 7~" of Su.~F•f GE', 5011S 40016 14"oy/%t/C3/E; NIOduG~te a jjEv~°d0~ f/D~YE~v ilk /~E" /~fo~l~L~ o.~ ~o f Lo 7. t4 1`'149 4)-v,0 5"y STe.-j <~ovv tt/ ,e~GD.uft f~vp~ Tii'xv, /57 PAGE 1. PLOT PLAN VIEWS . PAGE 2. MOUND CROSS SECTION & SYSTEM P!,AN VIEWS PAGE 3. PIPE LATERAL LAYOUT PAGE 4. DOSING OR SIPHON CHAMBER CROSS SECTIONS PAGE 5 .1,4 PUIti1P PER F ORTiANC E SPECS OR SIPHON SPECS 088 Is PLUMBER: SITE EVALUATI1t or DESIGNER HOMtSITE SEPTIC PLUMBING CO. RT. 3O'NEIL RD., HUDSON, WIS. 54016 140thilTE OPTIC PLUMBING CO. ROBERT ULBRICK RT. 3 O'NEIL RD., HUDSON, WIS. 54016 WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.& ROBERT ULBRICH4 MINN, INSTALLER & DESIGNER LIC. NO. 00663 MS. MASTER PLUMBER X. NO. 3307 M.P.R.& MINN. INSTALLER & DESIGNER LIC. N0.006663 e~ DATE: SIGNATURE s Yt' , J' ~:.I 11.- ~,NJ 0 AI;"f lY~ PLOT PLAN o I.D;. `FF `J't /lam I,:CGT,'T1D L o t' .4,!5>f-( Of 6- S 3 6z Alo,v S Rl7 2 7,S' A~~ Ba.ckhoe ''its = • Perc Locations = X Existing Well = Q Vertical Reference Point T0~ D~r /y "Pik ~oAvp gT S.`U, /ar a ,PN Elevation of Vertical Reference Point X00. Q fT. -Lot Line PROPOSEv O ~ scAL~: / = 3 0 q Q Z ie" ~ - HIE /1 DTi9tE .s PP,POVEO A ~s So. It I - 3 f~ $ O ~ t - •To chAHa~R ~tN -may • i l 35 1 pu" 8ING i j ~U fo i UAT~ l EUV1SLON OF SAF A J3~ BUf GI 30' Q~ f~!/oiD 7,4,;r -41 ~ Tb X44 Sow y a w►~.. 17 F r S~PT1 c T,uK CO/►J$i. )AMA/ SEpTic P~ti~ 4y.t.N~ TA^K - Lial£ITO.+E MONkME.vTl . (,(JiESER COoc etfiE Pp 0D R+. 2 fi w y. 10 M,+inCN'POCK &JIS• SY7so 7!5'CoN7-Z3 Page of S~ Synthetic Covering Distribution Pipe Medium Sand s Y MM Topsoil G Etev~T~w J i F /0 3 S 3 E / % Slope Bed Of~ Force Main Plowed Aggregate Layer D Ft. Cross Section Of A Mound System Using E 2- Ft. A Bed For The Absorption Area F '75 Ft. G Ft. g A Ft. H A S Ft. B y7 Ft. n 3w :b7.' v L 4 4 1 Y K /o Ft. i 77 :r 67 Ft. Ft. sift Ft. Force Main W Ft. Observation Pipe B K A I.---------------------- W to ----------------------•I Distribution Bed Of 2 Pipe Aggregate Observation Pipe Permanent Markers y Ii PING G t0;4F,7 STEEL ,PO~$ . i Plan View Of Mound Using A Bed For The Absorption Area Page 3 01 ser uPie yti~ p~,~i vb ~~P~9io DOWN Perforated Pipe Detail ~0 End View \ Perforated End Cop) ) Al- PVC Pape 1 ~a~~oo~occe • Ors` Holes Located On Bottom. S Are Equally Spaced \ P S i P / PVC Manifold Pipe \ Distribution ' 'Pipe Force Main 3 a Sela~(. yp PUL Lost Hole Should Be i Next To End Cop End Cop Distribution Pipe Layout P ZZ: 2 Ft. R G/ s 22- A f X JO Inches Y -2-1 Inches ' Hole Diameter Inch a N t I+itii~"v~RELA1tt3NS Lateral 11 / Inch( es) f OiVISi N OF SAFETY ,-.Nu BUILDINGS Manifold " Z- Inches Force Main 11 3 SEE C0FjRvj ©t~ED~ ~ Inches # of holes/pipe /0 Invert Elevation of Laterals /W Ft. /03.S S4Vj)1e0c,k s ysTeh E {evATO,3 7t?f q L !~%STiPi/S fiD A) jeo Ce 1i4T6AIS 72 -I r Oe /ijn f1 A I ' U"Y"', 3 t PAGE OF PUMP CHAMBER CROS5 SECTION AND SPECIFICATIONS wEh~ /s~G1G~G TGLVvfbw ,~D x. VENT CAPS, Co,✓DU'f 4"C.I. VENT PIPE APPROVED LOCKING MANHOLE COVER 25' FROM DOOR, WINDOW OR FRESH 12"MIU. I s AIR INTAKE /p3,a GRADE I 4"MIN. 11J T - 15" MILL. INLET PROVIDE I L,^,.s~. AIRTIGHT SEA1 APPROVED JOINT A / I h 1 I APPROVED JOINTS W/C.I. PIPE Pam, I W/C.I. PIPE EXTENDING 3' EXTENDING 3' IL D 0 ~il:~ ALA,ItNb;9 ONTO SOLID SOIL B I I ONTO SOLID SOIL J / Ian S ELAI ELEV. FT-- 'I', k6f F i ~O-flbm of • / CONCRETE BLOCK fAA) r p~A; G«~ RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC ~14' tw) 5PECI/FI•GATIous DOSE 60/ES&R ~OtiGt,~T-G. ~3 TAWKS MANUFACTURER: NUMBER OF DOSES: PER DA-4 /100 j -C = Go) )L l✓~0 V IS . ?obit, TANK 51ZE : uM G ti ~ hBE 5 DOSE VOLUME ZS' ~~s• ALARM MANUFACTURER: INCLUDIAIG SACKFLOW: ' GALLONS MODEL 1JUMBER:L~'~'L CAPACITIES: A= INCNES OR 3 GALLONS SWITCH TYPE: 0,1/,,- • v, 4-. maelgA B= 2- INCHES OR - '~8 ~Ai-LOMS PUMP MANUFACTURER: C= 13 INCHES OR UALLOWS MODEL NUMBER: /37 l,# C D= /Z INCHES OR GALLONS SWITCH TYPE: TS NOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE 7✓C- GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. S-0 FEET P(JA Gh.0f/vCK0 + MINIMUM NETWORK SUPPLY PRESSURE . , , , 2.5 FEET + 7-57 FEET OF FORCE MAIN X / O Fyo F,FRICTION FACTOR.. d / FEET yillS . TOTAL DYNAMIC HEAD = "3 FEET 7 7 INTERNAL. DIMENSIONS OF TANK: LENGTHt_;WIDTH~ V ;LIQUID DEPTH -53 SIGNED: LICEMSE DUMBER: DATE: yo/4P l/OG v y4r -f o 7Ser dF 3 „sue yD toac = S~ls 6111 L, 86 a r t/ r.