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HomeMy WebLinkAbout040-1133-50-000 n Cl) p C v n d .r y ~ O O 10 O L n 7 ~ C1 a K a G ~ ~ C rte. m O1 D 3 " A7 • a~i a m w o ° CVO ccnn A tC o iJ ° 3 CD CD 00 N C fD Z L Ul CO N CD CD a N N ` W ! O F N CA O 0 0) cn° c ro co o CD o o e cn G7 3 y y N! O C l~ G C w0 A -o w (n D a R ~d n z E m (a O W a cD A (D fop [r1 CD CL 0 CL Z W ca 3 O o CD co V fD W H O C, 0 H :4 rt H 'J L to OD co cn (a co 0 r rt v W tOii co co) o C W ~O E ."Y ID 3 Q N N H (D O j ,O.• z O O O CL 4 ° =H z Cc 0- N = CCD tiv ` m m w to d1 N CD N l0 O ID A N o 0 p~ D D c rn ` I o• ~ a I N m ~ • Z m c ` I W y \ l 1~ F- 3 ~.D M Z CD W -2~ N O O_ A z m O rOt Uo w m A G Q) o r z N ci, o w w M M ° rt Ln CD (D CL ::t z O r. m N W A W O d c a n I m c F3 Z a cn a y O I ~ N N I o 0 a I a o b (D do N O O ti Parcel 040-1133-50-000 01/26/2006 03:58 PM PAGE 1 OF 2 Alt. Parcel 35.28.19.556C 040 - TOWN OF TROY 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 - HANSEN, WILLIAM F & KAREN M WILLIAM F & KAREN M HANSEN 32 PINE RIDGE TERR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.842 Plat: N/A-NOT AVAILABLE SEC 35 T28N R19W NE SE BEGIN S LN 813'W Block/Condo Bldg: E LN NE SE TH N 350' TO POB:TH N 160 FT W 501.7' TH S 160' TH E 503' TO POB ALSO Tract(s): (Sec-Twn-Rng 40 1/4 160 114) KNOWN AS LOT 1 CSM 6/1645 35-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 11/05/1997 568053 1275/96 WD 07/23/1997 994/387 WD 07/23/1997 894/390 07/23/1997 894/389 more 2005 SUMMARY Bill Fair Market Value: Assessed with: 103093 266,200 Valuations: Last Changed: 07121/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.842 47,500 208,700 256,200 NO Totals for 2005: General Property 1.842 47,500 208,700 256,200 Woodland 0.000 0 0 Totals for 2004: General Property 1.842 47,500 208,700 256,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 143 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1133-50-000 01/26/2006 PAGE 03:58 PM 2 OF 2 Parcel History: cont. 07/23/1997 C740/)89 SAFETY & BUILDINGS DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON WI 63707 ❑ CONVENTIONAL )ddrALTERNATIVE State Plea I.D. Number: (If e9el~Red) Holding Tank ❑ In-Ground Pressure ❑ Mound 1 9605687 - NAME OF PERMIT HOLDER' DDRESS OF PERMIT HOLDER_ INSPECTION DATE. James Greske A403 Wasson Lane, River Falls, WI 54022 /0-da -,?6-//, `3 0 BENCH MARK (Permanent reference paint) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. NE SE Section 35, T28N-R19W, Town of Troy, Lot #1 Name of Plumber: JMPIMPFISW No.. IC,~nty Sanitary Permit Number: Tom Wan 3231 St. Croix 79219 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV. WARNING LABEL LOCKING COVER ,I 1040 PROVIDED: PROVIDED (i P 1 000 (d?~•S ( ' YES ❑NO ❑ YES IAJNO BEDDING: VENT DIA.. VENT MATL HIGH WATER NUMBER OF ROAD: PR PERT WELL. BUILDING: VENT TO FRESH . ET C ALARM FEET FROM LINE AIRINLET ❑YES NO ❑YES NO NEAREST T /V DOSING CHAMBER: MANUFACTURER. JBEDDING. LIQUID CAPACITY PUMP MODE L. JPUMP; SIPHON MANUF IIHEH WARNING LABEL LOCKING COVER yyyy~~1l PROVIDED PROVIDED: i" I W QlIYES ❑NO ti~YES ❑NO YES ❑NO GALLONS PER CYC E: PUMP AND CONTROLS OPERATIONAL NUMBER OF PN OPE HTV WELL BUILDING VENT TO FRESH (DIFFERENCE BET EEN FEET FROM NE AIR INLET PUMP ON AND OFF) YES ❑NO _ N ok L.~0 SOIL ABSORPTION SYSTEM. Check the soil moisture at t depth of plowing i u iii AMETEH MATE HInI AND MARKING lit or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH LENGTH NO OF UISTN PIPE SPACING COVER INSIDE f11A -PITS ILIOUID BED/TRENCH THENCHFS MATERIAL: PIT DEPTH. DIMENSIONS ,P-,'LL D(PTII FILL DEPT H DISTH PIPE DISTH PIPE DISTR.PIPE MATERIAL NO DISTH NUMBER OF PROPERTY WELL BUILDING. VENT TO FRESH BELOW PIPES ABOVE COVER EI EV. INLE f 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 OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ES ❑NO SOIL COVER XTURE III HMANI NT MAHKE HS OBSEHVATION WELLS IRYES ❑NO YES ❑NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED Df PTH OF TO 1PSt1IL $t1ODL U SEE DEO MULCHED CENTER EDGES / E © ❑ YES. NO YES O NNO KYES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO.OF LATERAL SPACING [HAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH DIMENSIONS TRENCHES: J MANIFOLD PUMP MANIFOLD DISTR. PIPE MNO DISTH DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING ELEV.'. ELEV. DIA. ELEV ELEVATION AND .t7 10.2. ID / I , PIPES DIA 140 DISTRIBUTION 02.17 ie~• I ~l HOLE SIZE HOLE 93-11 P, SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED. INFORMATION I/ PLANS Orr YES ❑NO DYES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINDA,( ~y YES ❑NO XYES ❑NO _ NEAREST Gc g.q3 lei -I Sketch System on R ain in county file for auditll Reverse Side. SIGNATURE. ~ TITL DILHR SBD 6710 (R. 01/82) =-==MEMO HR SANITARY PERMIT APPLICATION COU In accord with ILHR 83.05, Wis. Adm. Code S ATE SANITARY PERMIT r/ 2/ 9 -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8'/z x 11 inches in size. oy 17 -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 / ~ ~i c (1 G-Lls ~''/a 3!'%, S .3S' T N, R E (o W PROPERTY OWNER'S MAILING ADDRESS LOT ~C/ (.~-~1 SS6~'l !sec h NUMBER BLOCK NUMBER SUBDIVISION NAME CIT~(`STATE ZIP ODE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LANDMARK J,/ V dQ, 2 a ~ ( I E] VILLAGE : ~..D 10 lp & TOWN 11./ TYPE OF BUILDING OR USE SERVED: I Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable) 1. a. New b. E1 Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in ##2) 1. a. ❑ Conventional bX Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e.54 Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. See a e 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): PROPOsSEj~D (Square Feet): C 4 J ! Feet ❑ Private ❑ Joint ❑ Public 9F, 733 VI. TANK CAPACITY Site in gallons Total of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank 0~ /v~S rP~ S ® El El ❑ El El Lift Pump Tank/Si hon Chamber 10 ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plum Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: A* -3,95/ `ldS' T~1I~Q S ~ Z ~ i~ 4 L6-.q I Plumber's Address (Street, ,City, St to Zip Code : Nam f esigner: Av a Jj r (j) 14 ,V Sya~~ VIII. SOIL TEST INFORMATION Certified Soil ester (CST) Name CST 9 l g #a0 Phone Number: CST's AD RE~$ (Street, Ci y, State, ip Code A P IX. COUNTY/DEPARTM T USE ONLY X ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (N tamps) Approved ❑ Owner Given Initial 0 S rchiarge Fee Adverse Determination ~~90__ 1 A. j I X. COMMENTS/REASONS FOR DISAPPROVAL: 17-77 SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber I INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3,years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; 11. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; 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; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use"by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater b'11 Groundwater - included the creation of surcharges (fees) for a number of regulated practices which Wiscor#,sin's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasure is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater find admirds 4i -1 tare by the Department of Natural Resources. These funds are used for monitoring ground eater, groundwater contamination it -estigations and establishment of standards Groundvvats i s worilw protecting. °•5D {,3a f .03/86) 01/26/2006 03:54 PM Parcel 040-1134-50-000 PAGE 1 OF 2 Alt. Parcel 35.28.19.556) 040 - TOWN OF TROY ST. CROIX COUNTY, WISCONSIN Current X Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: TOwner(s), O = Current Owner, C = Current Co-Owner ER, JERRY P & BETTY L TR JERRY P & BETTY L TR SATHER 111 SYLLA ST RIVER FALLS WI 54022 * =Primary Districts: SC = School SP = Special Property Address(es): Type Dist # Description "PINE RIDGE TERR SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.835 Plat: N/A-NOT AVAILABLE SEC 35 T28N R19W PT NE SE COM 990 FT N Block/Condo Bldg: OF SW COR NE SE TH E 49 Tract(s): (Sec-Twn-Rn9 40 1/4 160 1/4) W 500.5 FT,TH N 320 TO OB EXC THE S1/2 OF ABOVE DESC PARCEL(THE-SV WAS SOLD 35-28N-19W TO AN ADJ LAND OWNE 940/135) Notes: Parcel History: Date Doc # Vol/Page Type 04/01/2005 791110 2775/513 QC 05 2775 04/01/2005 7791109 0/115/200 1 659126 1738/951 WD 91109 11 07/23/1997 960/533 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 103103 218,500 Last Changed: 07/21/2004 Valuations: Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.835 46,000 164,300 210,300 NO Totals for 2005: General Property 1.835 46,000 164,300 210,300 Woodland 0.000 0 Totals for 2004: General Property 1.835 46,000 164,300 210,300 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 108 Specials: Category Amount User Special Code Special Assessments Special Charges 00 Delinquent Charges 00 Total 0.00 01/26/2006 03:54 PM Parcel 040-1134-50-000 PAGE 2 OF 2 Parcel History: cont. 07/23/1997 940/135 07/23/1997 717/281 07/23/1997 465/170 H z cn H a r ST C- 105 r' a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d a H Czf OWNER/BUYER ROUTE/BOX NUMB R Fire Number CITY/STATE ZIPS PROPERTY LOCATION:', 1, 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, 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 H three year expiration. o E z I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- 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 DATE St. Croix County Zoning Office P. 0. `Box 994: Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property Location of Property h:, Section 3e , T P~ N - R W Township ( Q Mailing Address 7 3 SB j1 1 LA4 . <51 yo ~ Subdivision Name Lot Number Previous Owner of Property 1.. Total Size of Parcel 3 4 Date Parcel was Created Are all corners and lot lines dentifiable? Yes No Is this property being developed for resale (spec house) ? Yes _ No Volume _ W01 and Page Number N as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3.• Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) eeAti.by that at t statements on this Bohm ane true to the beat ob my (oun) hnowtedge; that I (we) am (ahe) the ownea (d) o6 the pnopent y des eh i.bed in th.iA in6onmati,on bonm, by vixtue ob a waAAanty deed xeecconded in the Obbice ob the County RegiAten ob Deed6 as Document No. ; and that I (we) pheaent,ty own the p!coposed A to bon the s age po-.6EZ76 stem (on I (we) have obtained an easement, to hun with the above de cA bed pnopenty, bon the conatn.ucti.on ob said system, and the same has been duty neconded in the Ojbzee ob the County Reg"ten ob Deeds, as Document No. GNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED State of Wisconsin ` Department of Industry, Labor and Human Relations r s t t:y:r~ SAFETY & BUILDINGS DIVISION 8 t,,.i r JA, , s~ I DILHR-SBD-6423 (N. 04/81) ST. CROIX COUNTY WISCONSIN 6, ,r A ROOM, nt, ZONING OFFICE k r ' 796-2239 (HAMMOND) ~t 425-8363 (RIVER FALLS) HAMMOND, WI 54015 August 25, 1986 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the James and Gail Greske property, located at the NEl/4 of the SE1/4 of Section 35, T28N-R19W, Town of Troy, revealed suitable soils at a depth of 3.0 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. Sincerely, Thomas C. Nelson Assistant Zoning Administrator TCN/mj • ATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS ST DIVISION OF SAFE 9a BUILDINGS MADISON, WI, RE53707 PLUMBING P.O. BO APPLICATION FOR THE USE OF AN ALTERMATIVE SYSTEM Township/Municipality: Location: St. Croix NE 1 SE T 28 N/ R-- 19 Tro County: S 35 Subdivision: Street Address: Mailing Address: Landowners Name: , James and Gail Greske 304 N. Winter, River Falls WI 54022 the undersigned, hereby make application for an alternative system on I a . the e above-described premises. I recognize that the abov~opalmisegranted~ I suited for a conventional private sewage system. If app f royal a ree to have the system installed in conformance with the Bureau's app of plans and specifications. further understand that an alternative system is more comp eedein nature than I a conventional private sewage system and as such will requirailed inspection during construction and monitoring after the ysteis put ngtcounty use. I agree to permit both county officials charged with meinist ito have sons sanitary ordinances and Bureau employes or othreasonableztime for the purpose access to the above described premises at any ng of the of inspection the construction of t ontactr the proper county•officialh to agree to either personally or by my agen arrange the time and date to begin construction of the system. the I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system approved, Bureau will send the applicant a letter of approval authorizes have been construction of the alternative system after all necessary permits 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 applicat. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. This day of COUNTY OF Notary Public, State of Wisconsin My Commission Expires: . LABOR AND HUMAN RELATIONS WISCONSIN DEPARTMENT OF INDUSTRY, DIVISION OF SA~9G9 &MADISONNGWISCONSIN OF PLUMBING P.O. BOX , Verification of Exception Status for an Alternative Private Sewage System In the County of st Cro' SE 1/4, Sec. 35 T 28 N, R 9 X ) W Location NE 1/4, Town %A#ITVVJxX Troy Street Address Lot No. Block Subdivision • Landowner's Name: James and Gail Greske 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: those approvals ~.1 to have one of the first five number - - of applications. numb-re s ssueT-fo you.) 1. one of the applications needing a quota number. The quota number assigned to this application is 59 - 11 - 7 . ❑ for one additional homesite on a farm to be 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. [jfor an application on file prior to February 1, 1980. (_lfor 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. 0 a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the Jot meets the criteria for a conventional private sewage system, check here. ❑ I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. Nelson $1 Ure County Official Date August 25, 1986 Title Assistant Zoning Administrator un cnn_ai rn /R 19/R71 State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN _APPROVAL SAFETY & BUILDINGS DIVISION Bureau of Plumbing 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 THOMAS WANG RE: Plan Number: 86-05687-S Gallons Per Day: 450 1009 1/2 WEST MAPLE Date Approved: September 10, 1986 RIVER FALLS WI 54022 Date Received: 8/27/86 Project Name: GRESKE, JAMES & GAIL RES. Location: NE,SE,35,28,19W Town of TROY County: ST CROIX 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. This approval will expire two years from the date approved 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 private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 266-9374. Sincerely, ANTHONY T FEDERSPILL. Bureau of Plumbing Safety and Buildings Division PPP022/0009w/15 cc: Private Sewage Consultant 'County _ UW-SSWMP _Plumbing Consultant _XOwner __plumber _____Environmental Health DILHR-SBD-6423 (N. 04/81) S~-. Cco ~ ~.o, l.J 1 . g A e r e os C-a 39 I Ile i v lam- ~ . _Q 1~7 d I. 1O C d2 Pt ~ f 27 S ` 5 !•5 63 11 4flou I ( Zy 3 6 0'r SLJ PL S~aKe tA T'\ ~ X31 {.,UMING S~ti t : ~~C ~ TIONS " i 1if 0 3N1,~iE! REIA V AP ~EppRTMENT OF, MfbusTw D BUI UI DIVISION OF Sp,~ EN AN4~GS ° a.s_ e ~r. ASV. a-is-.•~V: .as. JV SEE CO Page i Of _ Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand G Topsoil =rr____~=r=_ F D 3 % Slope Bed Of 2y- 2 Force Main Plowed Aggregate From Pump Layer D I Cross Section Of A Mound System Using E 13 A Bed For The Absorption Area F 75 G A ~ Ft. H 1.5 Signed: B q 7 Ft. License Number: -7,931 I 11 Ft. Date: J $ Ft. K 10 Ft. Alternate Position L G-7 Ft. of Force Main W ~-g Ft. L J Observation Pipe-, A I♦--------------------- -------=--------=------I W I------j---------------------------------------- Force Main ° - - - - - - - - - - - - f-r *;ftiftrn Pump ~Distrlbut,igxa tfdQ 212N:. P .'e. ate ' I Condit Observation Pipe a M Q AN0 Y "I 1P/if~TNic L .g 12 7 19 86- GiVS f CL9 Plan View Of Mound Usirtg ed Fer-~ Absorption Area i Page _ Of _ Perforated Pipe Detail 0 End View )Perforoled End Cap i~ PVC Pipe it • a~ Moles Located On Bottom, S Are Equally Spaced \ S i X~ Q • PVC Force Main ♦ 4 From Pump P .7 / PVC Manifold Pipe Alternate Position Of OUif VDU) ~a/ Pips Force Man From Pump Last Mole Should Be Neal To End Cop End Cop Distribution Pipe Layout P Z3 R Co L4 S x Y zl 7. Signed: Hole Diametery f~/ Inch 331 License Number: Lateral ( Inch(es) Manifold ~ Inches Date: For~,;1?•?t?a:ik _-7~ Inches -+oe PLUMBIN ~oy~itior~a~i~ 0 AND i SEE C PAGE OF v{' ' PUMP CHAMBER CR05S SECTION AI`ID -SPECIFIC ATIOUS VENT CAP 40C.I. VENT PIPC WEATHER PROOF APPROVED LOCKING ZS' JUNCTION BOX MANHOLLE COVER ~ FROM DOOR. I2•MIIJ. WIKIDOW OR FRESH I AIR INTAKE I GRADE I I `i~ MIN. r ID' MIN. couDUIT le•MIN.\ 11~ PROVIDE :j PLUMDi"T SEAL APPROVED JOINT A eonbiOi2al q APPROVED JOINTS W/C.I. PIPE 4 I Ih W/C.I. PIPE EXTENDING 3' r ° ~ - ' I I [1. ALARM EXTENDING 3' ONTO SOLID SOIL B I ONTO SOLID SOIL c i`tJSF.a'~ c,30 6,t ,1 k"JPJ!AJ>J RE II 3JI C Cr z r-Y AN 1~DINGS I ON CLEV. J~ F? C, E. E Off r D CONCRETE BLOCK Mw. 3 1Nu} RISER EXIT PERMITTED ONLY IF TAIJK MANUFACTURCR HAS SUCH APPROVAL, gi viLD t CD 1N(q SEPTIC E SPECIFICATIOUS D05E M n TAWAs MAWUFACTURER: HUMBER OF DOSES: -PER DA!d TANK 51ZE: -7S O GALLONS DOSE VOLUME 5,SZ 4 I(PO ."7 ALARM MANUFACTURER: INCLUDIIJG BACKFLOW: I (D 40 GALLONS 0 MODEL NUMBCK: S CAPACITIES: A= 3 INCHES OR GALLONS SWITCH TYPE: 15 = Z INCHES OR GALLONS PUMP MANUFACTURCR: w C 2 INCHES OR (V2 CALLOUS MODEL NUMBER: 020S 3 S 97 D= INCHES ORIJ~ GALLONS SWITCH TYPE: MOTE: PUMP. AWD ALARM ARE TO BE MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET k rrc,,~p t MINIMUM NETWORK 5UPPL`! PRESSURTEC....... . ?•5_ FEET ♦ ~ FEET OF FORCC MAIN X •9-'2 F/ r ;I Ioo fCFRICTION FACTOR.. • FEET A~j' '7 ! ~1 c~.~ TOTAL DtJWAMIC. HEAD = I S FEET INTERNAL DIM WSIONS OF TANK: LENGTH ;WIDTH ._.=-.;LIQUID DEPTH 51GUED: -f-~-=- LICENSE MUMBER:_ DATE:" 4 Model 3887 Bulletin CUM ~ Sewage Pump July, 1983 • For Homes GOULDS • Farms • Trailer courts • Model 3887 • Motels (Supersedes Model 3882) • Schools Sewage PmffP • Sewage systems Submersible • Hospitals Sewage Pump • Industry - anywhere waste or drainage must be disposed of quickly, Pump Specifications quietly and efficiently. Discharge Size 2" NPT Impeller Non-clog, semi open, cast iron threaded to shaft with ejector vanes on back side for seal PERFORMANCE RATING protection. Casing wS0571B Cast iron volute type for maximum efficiency. Series 4-Bolt construction. No. WS05126 WS07128 WS7012B WS10128H - ► WS0532B WS0732B WS1032B WS10328H Series 300 Stainless Steel Fasteners WS0534B WS0734B WS1034B WS1034BH for corrosion resistance. HP ► '/2 34 1 Mechanical Seal RPM ► 1750 3500 Ceramic vs. Carbon sealing faces, stainless 5 150 170 180 190 steel spring and Buna N elastomers. Maximum Temperature 3 10 126 154 168 170 160°F. B 15 94 125 152 150 Capable of Running Dry LL 20 56 90 121 128 I without damage to components. d 25 17 49 81 107 30 14 40 86 ` 35 10 64 , Motor Specifications M 40 43 _ Motor Fully Submerged 45 24 in high grade turbine oil for permanent lub- 50 4 rication of bearings and mechanical seal and efficient heat dissipation. Motor sealed from environment by rugged cast iron enclosure. Bearings Heavy-duty all ball bearing construction. Stainless Steel Shaft PERFORMANCE CURVE Series 300 stainless steel for corrosion resistance. Threaded shaft. Single Phase Units All single phase units have built-in thermal overload protection with automatic reset. 50 Q ~T w ~F~l7fUR Three Phase Uni 3 n Overload protect t r i (s O I c .4URVE or 460 Volts. fi kA 40 w Power Cord LL x lp ar Water and oil resistant. Epoxy seal on motor end acts as a secondary moisture barrier in 30 T N 4' case of damage to outer jacketing. Corrosion 'PI p resistant gland nut. _ 'alp-W Single phase units: 15' of 16/3 SJTO with U 20 n Or`Sery~ i 3-prong grounding plug. yP W~ Q g n0 Three phase units. 15 of4'jllT.O, bare Z Serf- r ended leads. ` x• ~r v t.t I 1986 _J 10 4 o F 20 40 60 80 100 120 140 160 180 SPECIFICATIONS ARE SUBJECT CAPACITY - GALLONS PER MINUTE TO CHANGE WITHOUT NOTICE. r. w7~1 BQR1~~7 AND SAFE'f1~&BUILI]Ei ' RT DIVISION MAN RELATIONS f` PERCOLATION TESTS (115 P O. POX 7969 1 MADISON, W1637,07 (H63.09(1) & Chapter 145,046) ATION.- SECT] p T HIPIMUNICIPALITY: OT O.:BLKNQ. SUBDIVISI N A lid A N Y: As. JCO TI DATES OBSERVATIONS MADE tM ,t eve. ~Residena PQNew []Replace / u RATING: S• Site suitable for system Un Site unsuitable for system NULN-VENTIO ( N MOU - IN c 'L OLDING TANK: RECD MENDED YSTEM:(optionalI LEI El IRIS "70S Ou 10 MU rOS NU I If Percolation Tests are NOT required --]DESIGN RATE: If any portion of the tested area is in the t1lKfar s.H63.09{lil(b), indicate: A • [Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL H T GROUNDWATER-1 NCH ES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE AND 'RES NUMBERPTH IN, ELEVATION B E D EST. T TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) DEPTH c 00.06 O ..C ►00 /,00 b rSi /,4c~ b~ si 14~1 B.Ob ; rt LAI Cr w ^at 41 ~;as -,10 /40 Ae 'i OTE_ TESTB , ,Ea WATER IN 7 TEST~nVE~W17DROP IN WA ES H AFT SW L G'JNTERVAL~Mft y. RI 11,T77-1 and Yt~ow to f of Forculaslan• 30{! ,hRr P 1 thll, 1'lons pf rsuitabJp.wll lndlc.u ardi Pow tleY►tr c tr l} atettgp t Z1I and jr{? plPr} +Slt'l ~Mavati4n ai all bwlnpt 1111r, A DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, c DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 76 HUMAN RELATIONS N WI 53707 (H63.090) & Chapter 145.045) LOCATION: SECTION: TO HIP MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: E 1/45P/4 35 /TcPrN/R E (or S 1 COUNTY- OWNER'S BUYER' NAME: MAILING ADDRESS: au to USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL ESCRIPTION: PROFI DESCRIPTIONS: PER LATION TEST : Residence ? New ❑ Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECD MENDED YSTEM:(optional) ❑S ©U JS ❑U ❑S ©U ❑S (x7U ❑S ®U If Percolation Tests are NOT required DESIGN RATE: I If an I}~ L any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: --ff. X. I PROFILE DESCRIPTIONS BORING TOTAL IELEVATION DEPTH TO GROUNDWATER-1 C NHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) oo It B- S°,~o o.nb lone el, b is,i /.6o fly) S. l ~s'o if s 0.66 B- 1; a o B- a ;50 79,0D No hC ,dD 33~'1sr oP.60#RSl /lc~ at 413,-600 - 6- lfi SQ B- 3 s,So /oo.ob N6kie ~,b0 1.~3 Bf /"v .67 sf B- M o fi a~ 3.00 PERCOLATI N TESTS TEST DEPTH. WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIO 1 PERIOD 2 PERIOD PER INCH P- a U P- P__ P- P- 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. ,P. SYSTEM ELEVATION AV, oo e1 u trees on E I f fo @ r14 i Sl`aK~° - E Jp 0. 00 V I r E A r _ Q P4 - e ~e~` .r>bbo►~~~n'~►~ s . o ;E ~,Pe;Le _ r~ a S,1,J ~a P; 33 4 N I I E i E 3 i 3 3 € E E E E E 1 ~ P3 g 3 3 e' r F E F E 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 • TESTS RE COMPLETED ON: ,f a s 4 / 6 k' ADDRESS: CERTIFICA ON NU BER: PHON NUM ER(optional): kle i ver- - l1 ors ~yas CST ATURE: " 11BUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. i-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR OL PL T1 a FORM 115 - S BD - 6395 To be a complete and urate soil te_", , ,wort mcsst include: 1. Complete legal de, 2. The use section must rly indicate v is is a residence or commer 1 MAXIMUM nurnk c iroorns or c planned; 4& Is w or i it system, 5. --boxes, A T 4JITABLE FOR A HOLDING TANK ONLY IF ALL _ED OUT F SOIL CONDITIONS; . PL' i is shown he i Ong P' e descriptic is and completing the plat plan; 7. MAK -arn accura : r atio s. j' I to scale is preferred. A es i red ; 3, ovr, resti{ - point ar- shown, an e permanent; 9. Cc p as to a, flood pig late, per - it exernp- ti( 10, plain, E } a iy, , & )riate box, 11. «)ur current ;at 12. ~!;stribute IL TF _S - F '-ED WITH THE L t `'ITHIN 30 DAY o, )N. "IATIONS FOR CERTIFIED SOIL TESTERS Textures C st 1 CI") cob gr - der 3") I - L Id )rs s an an y )any r P n E go, a~ vSal , Point F f orC i ay 1 st C Sr to kr traR.