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HomeMy WebLinkAbout022-1080-95-000 St. Croix SPORTSMANS CLUB RIVER FALLS Municipality: TOWN OF KINNICKINNIC BOX 336 Permit Number: 49435 RIVER FALLS WI 54022 Parcel Number: 022108095000 Alt Parcel Number: 28.28.18.4408 Site Address: 1130 RIFLE RANGE RD SHED Components Component Manufacturer Description Last Next Status Schedule Service Service Septic Tank Septic Tank 08/02/2013 08/02/2016 Current 36 Conventional Bed - Seepage Bed - Seepage 08/02/2013 08/02/2016 Current 36 Drainfield Maintenance History Service Date Maintenance Name Gallons Pumped 01/01/2004 Not Available 0 08/20/2009 Not Available 0 08/02/2013 Not Available 0 Notes Date Text 7/4/1776 12:00:00 AM ADDITIONAL NOTES: 15 acres - outdoor sports facility with 1200 gal. septic tank to 18' x 67' bed MIGRATED ON: 09/04/2015 'No data found for Notices, Violations I IS / DEPARTMENT OF REPORT ON SOIL BORINGS AND ~ ' . "`4 - UILDINGS INDUSTRY, krHQS~0 DIVISION LABOR ANM 76 PERCOLATION TESTS (115) OI 53707 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) FE l6 198 LOCATION: SECTION: TOWNSHIP/MUNICIPALITY: LOTNO.:BLK. O' SUBDI NAME: sc 1/4 0/4 z8 /Tz8N/RVa[ (or W ~4 \C.V, \NU~c ~jI~, COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: ST.CFzo\X USE DATES OBSERVATION NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: ❑ Residence N/ O\CDOOR SPOPCZS~QhC.\4\t`Q El New Replace I Z _ \ 4 _ (a) j\- Q I A RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE:'SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ~S ❑U ~JS ❑U XS ❑U gS ❑U ❑S XU CoNVEtJT\Oua~ ~Et7 If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the t under s.1163.09(5)(b), indicate: C-SS D... Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-0111111111111111111116 CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH Ill, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- ~ ,.3 a`o.`~ NINE ~ •9Z, V DK dN \S TS; \.gZVDY.Ru\s} I•oQN\s~ Z.`b3CiwrFed S' ,1c3'L+cs.,rcS. . ~ ~3' V OvC C3W \S "Cis .~e1VDT. \3H \i ~ .qZ.• $N\i 1 B- Z 5. , NOt~~c 7 S 43 ,g3'VPKQ~a\sTi•f .b1'Vpr.\~sw\s j •~3C3N \S ~ B- 3 ~ . a ~~p . NONE 1 . Z5' ~3..r Mtd. S ~ 3.2.ZL-! QN rnea , S . B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- P- 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. QO"TOT-N p~ 8 d R15 s0\L 9Z •15 / 9e (PC-, _ C11 oAh, s~wa Z_ ll/ SYSTEM ELEVATION ~ P o ~ X , I Al E A g a 0 AV ,nom~ M %.rf\. CON.ChSaTE u:wz - RSSVw.EO a.F.@V. m0 .im_oil. I~ 5~11TP~~lic RRE ~8 / ' rS~LSO HS~P Q I~ Z45# fi~~\tat~ N j__, EXFSZ~tafe. P0.W`tS o F3vtLplt rj, Ta ~i. Ci T C"), UJI S ►.q~ 04 t_oca-t oN J q 5 Q - - Sc.A~~ 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 WERE COMPLETED ON: AR'7 R L. WAG R,E Z- \4-84- ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 1~4 RT 4 Qox Z-Zto EL>_SWOR~H w\ s~~~\ S_llo 1\5-425-0 CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - r Who N; ...U,„ i£°G AWN! 1~,r SO, a, ; o wur Sol t~= you- • pon rnuot KW E_ _ i,:° e _t cio ly rtn;I,car , 1'1,3}-f< i, I r ...a '.:-esi£.; ~ J n ,am >r!' L1'i o{'3C t,)=.e.> or G~'2Y~ r , _'i(i t,t SF? Ec nt a of T(.t~la4-?'!-el ,gt e.r[„€,#y r_<tt =ref s; 3 `k !t, ~HER S),'SI"EP,,i!SjARF RULED JUT BASED ON SOIL (,~()!',!DITIONS; LASE use the abbiz,-imici f `ihov,.t , hEEc fiat wr big prufdo G _c;5}5A 7fi and t;omM eAung Me pI`y pl,e +,tAKE A LEG TL d=_ ,r"a a_. iMAt1 Ii,L,rin,, y'mq "r'.;: d„Cs.,i.ons. DiavPIE'y to scales !5 prefe-tre(j yo€i° s_ L t.au 1 and aar6:?,_ wn"dCa,= atu, h, 's C) dotes, u~ P? fcqn and Irhus you 'v,it t t tt rtlt.{f i a B col"VP A s. „ „s. Lmna Warm sand Pac P.001 WOW SW VY VVel; Fine Sand Bkfq HVIdt, t , nj en£ r n t Law Bi ~r S a Clay Low- inut NW WAY Clay 50y 0401y, r, H ,r"'•, so Am 004"; wt w& 3o .o! in th h aid h P.nr, :0 PAW c n to O 3 0 m o d v c 1 3 --I S v~ Z O A ,ZJ N O e t• co S 3 C A ((D 7 N N C N W 90 z EL Z2- co s A i N 0) W N N A O N) pi 0 C) _ o ° O (D 0 j N O N C C a (n { Cn m ~ a I ~ 3 n I o ~ O ~ oo ~ I A { IV CA 0 a 7 x r, H 06 r! cr 71 < r, < W CG b ri (D 9d :n. ~ ~ ~ O (D r -7 O Z O O O W j C r~ ? C) 0,3 D Z /5.. rt r `a 1r q cA cn Vf A ion r m q 5', T t„ a) IP" fu ?A = w n r r N 3 0 Q. "J :1 { f r~ I Z M Z } CO I D a j N O y Q I (U N T f'1 I j CD , a ~ ~y ra ! ~ I ~ N tv o c to M. ~-OC I C (D N i> LI w C1 a m fn V•f F+. N ;T7 Z M I 7 o y J- N. f 0 n A C) n O M N N En --i r W CD M co N0 CD F C , r. Q Z A T C) O F 3 J I I N ~ A 00 ` O ` I y fb C D O. I a a I ~ U I S~ S V S L` N 2 A N CD ~ n N I c a I ~ a N CD O o o u Parcel 022-1080-95-000 01'30/2007 04:23 PM PAGE 1 OF 1 Alt. Parcel 28.28.18.440B 022 - TOWN OF KINNICKINNIC 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 SPORTSMAN'S CLUB RIVER FALLS O - RIVER FALLS, SPORTSMAN'S CLUB BOX 336 RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 15.000 Plat: N;A-NOT AVAILABLE SEC 28 T28N R18W 15A IN SE NW COM SW COR Block/Condo Bldg: SE NW, TH E 495' TH N 1320' TH W 495' TH S 1320' TO POB Tract(s): (Sec-Twn-Rng 40 114 160 V4) 28-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07!2311997 2006 SUMMARY Bill Fair Market Value: Assessed with: 179409 142,100 Valuations: Last Changed: 0811112005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 15.000 100,000 31.200 131,200 NO Totals for 2006: General Property 15.000 100,000 31,200 131,200 Woodland 0.000 0 0 Totals for 2005: General Property 15.000 100,000 31,200 131,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Fo r:o - S T C- 1 04 AS BUILT SANITARY SYSTEM REPORT OWNER i T _ /e, Ta i TOWNSHIP r r n SEC. T N-R r f W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION l LOT LOT SIZE Pi.AN VIEW distances and dimi~nL;iuns to meet rcquirements of it 63 SHOW HVERYTHINC WITHIN 100 FEET OF SYSTEM w1J rao~ .:c I r> \ { t. . I GI~ G~ 3 i ~r INDICATE NORTH ARROW BENCHMAM: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TA1NK: MAnufacturer: Liquid Capacity: a Numbir of r-ngs used: Tank manhole cover elevation: Tank Inlet ;11evation: r ~ 9 Tank Outlet Elevation: Numbs r or f,:et from nearest Road: Front, Side ,0 Rear, 0, fact From .earost property Front-,OSide Rcar,O feet Number of feet from: well building: i  (Include this information of Lhe above plot plan)( ? reference dimensions to scE)Lic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Punip Model: Pump/Siphon Manufacturer: - Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: _ A Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Ft. Number of feet from nearest property line: Front, 0Side, O Rear, 0 Number of feet from well: Number of feet fru:❑ building: ___T (Include disLances on plot plan). SOIL ABSORBT I ON SYSTEM Bud: Tree . J! - Width Length Fill depth to top of pipe: Number of feet from nearest property line: Front, 0 Side, O Rear,O Ft .1! Number of feet from well: Number of feet from building: _ (Include disLanccs on plot plan). SEL•'PAGL PIT Size: f Number of pits: Diameter: Liquid depth: - Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been u~~d on any of trlr above soil absorbtion sytews? (Check one) HOLDING TANK Manufacturer: j' Capacity: Number of rings used: _ Elevation of bottom of tank: Elevation of inlet: Number of tent from nearest property line: Fruit t, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: / Bared: - Plumber on job:J License Number: (  3/84:raj -)EP.,',Rrr,tEr.r OF lr,DUSTRO. INSPECTION REPORT FOR SAFETY E BUILOIr` .AHUR 0. HU a 969 RELA r lorvs N PRIVATE SEWAGE SYSTEMS P BOX 7969 DIVISIO MADISON, WI E-707 BUREAU OF PLUMBING X){CONVENTIONAL ALTERNATIVF S: r;>Inn I l; M1,m e.. I - ~ III J.bpr.~:l u Holding Tank In-Ground Pressure L Mound 8400642 COMMERCIAL F FEgti7lT 40: FR 7allDLRF Fr.1 HO_UER INSPECTION DA'F River Fills Rifle Club Rifle Range Rd, River Falls, WI -17 _ i J;/ •n 0 FFr,ZH rr'AFik ~ F•~nll UE SCE aE IF IiIF FEFIFN I H':r•1 FL'. •.I - RIFF Pt. ELEG CST qEr PT ELEv SE. NW, Section 28, T28N-R18W, Town of Kinnirkinnic qq>,MaF S:•: r.--_ - Sa -ne•, Pv~rr I N..rrne- E. F. Grove 5569 St. Croix 49435 I SEPTIC TANK/HOLDING TANK: _ r IFA~TLHER LIUUIJ-_lP.1CITv rave: r'LET ELE'J. TA141111I LLT ELE'v 1111A,114 . Nt_ LATE I LOCKINC, r-l:ViH F 4.1 J. DFD PRCVID CJ YES ❑NO LIYES ~INO =~NO VFNT WAIL -IIII%%TFH NUMBER OF PR-_PERrv WLLIL D1r~G VENT T1RF:~FEET FROM -7 AIR INLET 1 OYES YES .NO NEAREST J INE~ I d0 I Z DOSING CHAMBER: 1+fYL Fn;;TI,!FFF'. RN DUI'.G _11]IJi(: ~IiPA.:ITY >Elr/P r,'^L'EL f't IrAV:SIVH^v MAr~LF:.('I, 1V4ARING NLABEL LCCKINGCOVER PR OV TOED PEIU`JIUED _ I I~IYES ENO C1YES LJNO YES No GALLONS PER CYCLE: >LIMPANDC00.TFI0L,r E ATr NA NUMBER OF PRDPFFrv VOIF BU LDIN; vENT roFHE::.' I(tJIFFERENCE BETWEEN FEET FROM L11%E AIR Iv_FT [PUMP ON AND OFF) _-YES ~.NO NEAREST SOIL ABSORPTION SYSTEM.Check:heso,Imoatureatthe depth of plowing l r. TI• DI-%1--T 11 '--AILRIALA+ioWA7KVC or excavation ;If s l can be rolled into a wire, corstruction mall cease until FORCE the snit a :rv enough to continue.; MAIN CONVENTIONAL SYSTEM: BED/TRENCH ,,ITH LENGTH - - No or vlvE sPaclv:, r.vE a msIDE Dln - aPlr - I'PT" DIMENSIONS I 6 7 FE '~"HFS EH.A! PIT _ "'PT" '1Ha":I i t l I.1~ rlLl DFPTU Jt$Tn PPF .'1'$T r PIFE DISTR PIPE FOATFRIAL n VgOPEgTV ,o SIR ' NUMBER OF wE. L uulLDr~b Nr TO FRESH "ET Y ~/J EIPrs FEET FROM NEA REST L NE .7 , Z Z IR?L' f f " y r~ MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and fill thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- YE$ NO meets the criteria for medium sand. TIONS MEASURED, h IrI ; COIL COVER r xrOR,E - ' TI AAgKEFS , Al LLS LJ - _ ❑FPTH OVER THEN,: H - it ES NO YES NO I: DIL SO DDF E DFr' I_7IEF / A7J~CtiFU YES NU ❑YES_ (INO OYES Ll NO PRESSURIZED DISTRIBUTION SYSTEM: ! BED/TRENCH vIC 1 N F'.:, nl No OF LATFRAI_ PAf id , GR :EL DE PT_ Bf l Y 4V- :ILL CEPTHAROVFI. I ; I ~rFENCI Es DIMENSIONS I . " r.ra NIF;:LU PVr,1P rrayit :)LC ;TIT OFL htANIF OLC MATERIAL NCB 'II T11 L'TSTf+ PIPE OISTq I BU T'Or.PIPE %-_Tl III.:; r..'., =1.E',' ELE'v. DIA FV VIPES DIA ELEVATION AND DISTRIBUTION INFORMATION MULE SIZE HOLE Sr. ACIVb I: III L LEC CgRR ECTL r _ COVER MATFRIAL VERTICAL _IFT _DRRIF- C 'cl ::F~H'. FC PLANS L- ^YES 17, NO DYES ❑NO COMMENTS: PERMANENT AIARKERS_ ~9SE RVA- ION WFL. S NUMBER OF PFOPE'1t r rYE LL BLILCING FEET FROM Fir.F E5 V:1 _YES ]NO NEAREST J Sketch Syr.-er-, o'T Retain in county file for auclt. Reverse Side. t~M1A1URE - / _'_E D I L H R SRFi r;110 (R-01'871/'-J' APPLICATION FOR SANITARY PERMIT D6CQqrmErr Dc (PLB 67) "46 COUNTY 13ILHR UNIFoRrvl SANITARY PERMIT # - InOl1SlgV,IgBOR 1. HUmgrl gElq TlOns 3,5 -Attach complete plans in accord ,with s. H 63.05, Wis. Adm. Code for the system, o- paper not less than 8i_x I I inches in size. -See reverse side for instructions for completiny this application. PLEASE PRINT PROPERTY OWNER NIAIUNG ADDRESS f' L-6 e CLwff Jya r-, Ea I PRU FRTY LOCA I WIN CITY S.jfEs~ E T 114 /NY /4.S T2 , N, R E (or v a LOT NUMBER JBLOCK NUMBFH Sl!RDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER 114 11114 *4 1 ~?Y42Q 064z TYPE OF BUILDING OR USE SERVED /T.~v~ 1 or 2 Family Number of Becirojms. ICI Pul;liC (Specify): THIS PERMIT IS FOR A: K IVew System Tank Replacement _ Repair ReplacemuriL Soil Absorption System Revision Privy Alternate System Recurwuct'on - Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. LeH5eepaye Bed Seepage Tench - Seepage Pit U Holdin,t Tank System-In Fill In-Ground Pressure Vault Privy C Pit Privy U Existing, For Which A Previous Permit Is On File, Permit # issued An Existing System That Has Been Inspected Arid Is Compliant As Far As Soil Conditions. Tctal #cif Prefab Slue Steel F1be1Lrlas5 Plast c Tanks Concrete Constructed Septic Tank Capac ty _ift Pump Tanl phon Chamber Holding Tank capaci-y rvlanufacturEr: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: Mound In-Ground Pressure Total s`roF Prefab. Si-e Steel F berglas; Plastic -Gallons Tank: Conc ,atc Constructed S~!Irtiu Tank Capacity Lift Pump,Siphon Chwnber rvtanufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AHEA INATFR SUPPLY: (Nimutes p('.r inch): RECLARED ISeuan• F>et}: PROPOSCD (Spuare FeeO: d/« S 5 --a- vw ja %xp b _jn~P'rivate Jo nt n Public I, the undersigned, hereby assume responsihility for installation of the pr ate sewage system shown on the attached plans. Name of Plumber I;Printj Signature MP?MPRSIN Nu.' Phcne Number: .~T fi' ~ ( SST b Piumber's Address: Name of Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issu ng Agert Fee: Date _ pp~ ~ Disapproved / Gr, / ~C'f 3 d T IV Approve] ] Owner Given Initial Adverse Determination Reason fcr Disapprova Alternate coursels) of Action Available: DILHR SPn 6308 tR -E2; DISTRIBJTION: Ongiral to Cowity, Un r Cory To, B ireau cf alumbing, C,mer, Plimher 1 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 descr ptio• , plea>e c'rcle th., appropriate •nu•-icipal government r.nit, i,;vhether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked ir'dicate type of use (i.e. 10 unit apartment, 30 seat restaurant, eI.c.); 3. Complete the block for conventional or alternate system dependiny 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 oy code and the nurnber of square feet to he installed; 5. (;omplete the sec-ion on ,vate• supply, 6. PRINT the name of the master ,flu-nhe, or master plumber restrictee who ,ar,ll 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 husiness phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ov.,nership or plumber recuires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply ::ill void the sanitary permit. 9. This permit may he -ene,.ved, and at the time of renewal any new criteria in the Wis. Adm. Code vvill he applicable. 10. A rew permit vvill be needed if them is a change in, estimated wastewater floe,,, (number of bedrooms, etc.), location of the system, depth of the syst?rn, type of s; stern. 11. All -evisi,,ms :o this pe n it must be 313:111Dved :r; the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertica elevation reference points that are permanen- and clearly shown. 14. Piping detail including pine site, separating distances, distances hetween beds ' app-opria*,e, tank locations, effluent lire from tank(s) T-) system, builc:iny se~;er a'id ve- 15. hu prrn`it rnl alit, t may rpcgi_ilre a crass ;ec.T,on drawing of the affluent r:ispnsal 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 purnper 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. ~ s • 6 /Ar N. MAIN STREET KOZEL, WEGERER ~Lj C R FALLS, WI 54022 & ASSOCIATES, Inc. 9~~~. Oyu >9V (71 425-9381 ENGINEERING SURVEYING ®Af yC 8sr (7~ 425-6118 ATTT•I: DATE r3--ZZ- y Z K E ARE ENCLOSING,? DES SLR ` E -COVER, THE FOLLOWING I'iO S t lNumber of Cosies' Descri-otion - SENT TO YOU FOR THE FOLLOWING REASONS:. O FOR APPROVAL ❑ AP'PROVED AS SJEb.I'TTF.D ❑ NOT APPROVED lll~-kR YOUR USE Q APPROVED AS NOTFD ❑RETURN CO?I E S ❑ FOR R--:VIEW AND COMMENT OINPORMATION DESIRED VERY TRULY YOU?S , KOZEL, WEGERER.8 ASSOCIATES,INC• y 19 Departrient of Industry, Labor and iiuran Relations Division of Safety & Buildings ' 1 L H R Bureau of F lumb i ng i P.O. Box 7969 Madison, WI 53707 Li - - - 7el. (608) 266-3815 i, 4'-S l' Cyr/SIC` 1N ALL CORRESPONDENCE ZA REFER TO PLAN 77 IDENTIFICATION NO. r~ • NAME -QF, PROJECT y?RIVAT SEWAGE ONLY - [7 GENERAL PLUMBING PLANS C0 Fee Received: 10 CA IONS ^ Priority Plan Review Only ~jITY OR TOWN COUNTY, Lxamination of plumbing plans and specifications for this project has been completed. In accord witn Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon compliance with the stipulations shown on the plans. Please review your code for the requirements of each code section noted. The licensed plumber responsible for this installation shall keep at the construction site one set of plans bearing the department's stamp of approval. The installer shall also notify the appropriate inspector of weep required,' inspections are to be made. In +h^ P-Lant ; rSt->>> j+;^^ h hp nun Within twi@ yea;:s 4-iqF;R this dyt-f-, ru1L) r ova i w i i i - - Pi i V In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions or examination oversight, and reserves the right to order changes or additions i^ necessary. This approval is based on Wisconsin Administrative Code requirements. I- shall be necessary to obtain and fulfill the permit requirements of the city, village, township or county in which this installation is to he grade. Failure to obtain local permits will, automatically void this dP rovdl. Sincerely, ~t-l-', !c?~' CC~f-~G7L Tt s Gp provGl is val:d for James Sarg t. YCCIM Or it ~•,^il be until 'l the exo,' a!bn date of tl:e initi:,; Bureau Dire or oar~i,ary pE.,,,;;t 'PLANS REVIEWED BY: - - DATE: - 1 cc: DP - OWS Owner H & R & Rec. San. Section Plumber Bur. of Health Fac. & Services County Other D''-'lSBD-099 (R. 05/82) r . H lg, T:DV11 OF -(7 ~ X _C(:U1,.TY, 1AT' SC1, S I I TN'DEX PAGE 1 OF 4 TTT'LF, SuEET PAGE; 2 OF' 4 P,C)JECT DATA PA GE 3 OF 4 F LUT P LA Pd PAGE 4 OF 4 P--kN VIEVI-CFCSS SECTION FIEPAP,FD FCFL: S P REPy F-ll fiY r;0ZT 7 1, y ;F, F~ FC?' 74, 421 Ii . IP s 'rFJT r 1 n l r E C T TL T LS T :IS A^ILITY I S USED AS A SE0CT=iJG .:IC1FATED A'T1EI`DAI'tiCE GF 50 PECrLE. "TEFL. AFB; iIC '!:I-- i 'CILII'IES A?.D TWC F~,il'SS 6~=1C' AP.E FF:ESE'Iv~`~,Y ZED FCr F1,AlvS TC "'STALL "WC Il'DC7'i ~A` USE, IS CC-:N"S=D', HED TT'? BE C%r SFC:r:~S t Tj SEF 10 `iAlaK "^.1, CIjI-A`i'10 '':S -r - ~t'L•. SS _ Lc=.'S F~,H DAY - 250 GALLO'.S FE ; D"", 50 GA LLONS PiI_dl:4-6i1 SEPTIC TAN' -TaQU,Il-H-. ICJC GALLChS ,-T S A ]?00 GAT,?,r- r TANK It= P= !NSTAL1, r- ILA I rp r7 r", FEB F LCT P?~G.'' - - - - Loc.q` i ~..M . c t,ucRC-Ze r mud . 4i~ Svrr~to ~_Fv. •OO . ~ ALSO ~.RP~ 1wt~.~n~.,., r.-_.a cam= \'c3•. C\ 1~ E vE: F-•~= \ y© 40 -RO a - 10IAS ( I ` aR AND H DM~ ' • sip C) l ~R,vc 5 ~E C ` ( ; ~ I To P_,E REMOVE _ ~j 95 0 I o I \ If 3 I , I I \ G 0 FF B j ~f i9ti EY -tJWYA_ 5~c.~ a5 NO~ V Elev,-ti oils shown are exist.in ; ground elevations unless othei, e noted. 2. Install cast iron pipe 31 onto undisturbed soil on both sides of septic tank. 3 . S=ptic tank to be 1200 ~,allon capacity as m.anufactu_-ed by Wi : -F_r Con- cre_c Prcducts, I•'.a_cden Rock, ttiiscorsin. 5S SECTIC11, (7F A :----D SYSTEM YA (-E - !4" ;:ast Trnn Vern. FiF:e 1211 Alove Finished CrOde C 4 T1 ?VS s tri buti on Pipe S of 1 F1 11 ` l 2" r)f A9,v.reEate Aj A ppi -ved Synthetic y ~i C~~' l^ M1n t e7'l a l or _u fi __e~, , _ o 'Ji!cc)mF;-cted %1~ 1 ~ c I X71 r~'. v m ~n O !"-2'u AE' Eat e Feet ~ottem Per= orated Pipe To Of Bed. j STKB'JT'I0N PIFF 'O BE AT 1,EAST INCHES BELO'r, ORIGINAL GRADE AND AT 1FAST 20 IJ,;7_:r_:C rUT :;Cl FINAL GRADE. MAJ:i _J; ~r '0 EXCAZ'ATION FRO?: ORIGINAL G}~-:M ~ti'TLL Br 1IOCH c . W1,11 ~DEP OF EXCAVATION FROM: ORIGINAL CFA D vTLL BE 2~ INCRES. L'~ N o0 ~pNs 0.Y' Ern' OF BED ,NOD'S F~ N FEB ~ `1 vQf tir e: ~ y J 4" Ferforated PVC TDistributi crn 6' Pipe. 6 , 4VVPVC From Septic ~K-- 4 t Cast Iron Vent Pipe Tank In' Solid 'Wall ?VC T - - - - - - - - Header Pipe • i PROJECT DETAIL DATA SHEET !E OF 3L:SINF~S R1 FLG _ C L c~--------- - - ~7-e-jzc,x C.c:• SC RI PI I'ON TB C- i.k_~ 67~;'r y9~ c.r S 1 k, fZ Fig C . _E •\`lt' Z F7) tL LC- L- ' •'r ,r,~' '^<< I VLt IAti!GE A-Z) C Li _i,n SVL Z, Z - TMCT, ~.Gc t- 7 ADCR=SS 'bC~Y- 7Y YZ/ i`1 Y-)`AMj '~'T• Fc.(S,ZIP SY~ 2 c:I b y L~°CK ~LrOprla~e U1 di nc l:saQ°_'s) ~.r d fill in, t ~l il';lrmatlon requested opposite each usage listed. F ;ase ccrsult Sectier H 62.20. Existinc building New buildinq Addition 4:)artmerts and-condominiums . . . . 'Nirrber of bedrooms Assembly hall . . . . . . . . . . . Seating capacity Ear . . . . . . . . . . . Seatina_ capacity = of meals served a GOet? i no a? 1 ey Number of 1 apes ( ) With bar ( (-arpgrcund and camping resorts Number of sewered sites Number of unsewered sites U Total number of sites ( ) Carrps . . • . . • • • • • • • • • ( ) Dav use only Number of persons - ( ) Day and night Number of persuAW-- Day Catchbasin . . . . . . . . . . . . . Number ' Church ( ) No kitchen Number of persons ( ) lI i th kitchen Number of cersons Dance hall . . . . . . . . . . . Number of persons i Dining hall . . . . . . . . . . . . Number of meal-s served daily Doo kernels . . . . . . . . . . . . Number of enclosures Drive-in restaurant . . . . . . . . Irside seating capacity Car-service Number of car sUaces ( Dump station . . . . . . . . . . . . Number of dump stations f ) Employees ( total of all shifts) Number of employees Hotel ( Motel ( Cottages . . . . Number of units with 2 persons ner writ _ Number of units with 4 persons per unit "edical and der.tzl office bldo_s. Number of doctors, nurses, medical staff Number of office personnel Number of patierts -:obile pomp park . . . . . . . . . Number of sites 1 Nursinc hems Nunber o beds } Parks . . . . Number of Dersons ( ) Toilets ( ) Showers Restaurant . . . . . j / -5fcapacity 1 ( } Dishwasher and/or disposal ( ) 2~1-,-Jour service ! Retail store gR 1984- . Total rumber of customers } Schools . . . . . . Number of classrooms P1ezl s ( ) Sho Hers Self service a'i y,CTY.& 8L.p~s. r i Total runber of machines I Service statitn Number of cars served daily 1 Swinmirg pool bathho.ise . . . . Nunber of persons _ ✓OT!'`P (Spcc fy) -sip-ttTS 1=fiCJc! -~~C` ~~~~z c•~_ S CCF~"_ETE OTHER SIDE ---esent irldica..e wrether f ll:;l~in~ fac it ties ar-e - Floor drain yes no suer of drains Food waste c_rinder ves nc Di shwasher Yes no Autnmatic clot`~es asher yes - no ;amber of clothes ,.ushers - 3. Sept is tank capacity - Z~ '•iolding tank capacity ~ Je 7at1 F-a rlU1 4. ~F FP GE k'C -LS: total square feet - - icth of tenches length of trerches d«r`.h tre i:hPs _ _ _ - number of are feet. \ZC`C width 1` ' C=PF BAD;. t:,tal ou _ r " t G r lPnoth of hed 7 - depth Z ----,~c~ - SEEPAG F,I~S: ~ota1 square feet outside diameter - - - ciepth below inlet - - - fetal depth from tc:) to bottom of pit _ FO-- DEPARTMENTAL USE ONLY Signature of person canpleting fcrm: EL, L.2~C1=fir g 19-;S'C. i,F-;c . Address yZf 1C!: i ~1~1.c~ ST 1LIt:t~-r- FA- us Zip- J yt~ 7-'z T e i epnor e Number Sat.c ZS Flo ori c N, SA t OF Qki SAFETY pLtyCE MMMMMMMI Department of Industry, Labor and Human Relations --~~Division of Safety & Buildings DILHR Bureau of Plumbing .I P.O. Box 7969 pEPC~aTmenT oc - I UUSTRV.LHF3 IHU.W4nFWLAT1 S Madison, WI 53707 1. (608) 266-3815 CORRESPONDENCE Kc:, 7JL-- (4 )e I - v v 4- S CD -7 py9 FER TO PLAN ~I IFICATION NO. R NAME PROJECT 4 ► F/L g,#RI T SEWAGE ONLY - GENERAL PLUMBING PLANS Fee Received: LOCATION 'Priority Plan Review Only OTY OR OWN COUNTY. Examination of plumbing plans and specifi-catjons for this project has been completed. In accord witn Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon compliance with the stipulations shown on the plans. Please review your code for the requirements of each code section noted. The licensed plumber responsible for this installation shall keep at the construction site one set of plans bearing the department's stamp of approval. The installer shall also notify the a;_ inspections are to be made. !4i tho f-yent lnctd11atinn 13a$ app..roya__l -wi.I-1---be. void .=atr rr 3 p► ,vii slla l i oe b€ort. In granting this approval, the Division of safety and Buildings does noi, hula itself liable for any defects in plans or specifications, plan omissions or examination oversight, and reserves the right to order changes or additions 7f necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit requirements of the city, village, township or county in which this installation is to be made. Failure to obtain local permits will automatically void this approval. Sincerely, I'riva-te Scvdage systerns Only. ~ This approval is valid for tvio yr,~JY't~~fi7L yaars or vAH be vaiid Mtil James SargEkt_ the g:+,^i' i'ts' of the iniMl Bureau Dire or LAN REVIEWED BY: DATE: _1K -1 A cc: DP - OWS Owner H & R & Rec. San. Section Plumber Bur. of Health Fac. & Services County Other DILHR SBD-6099 (R. 05/82) SBD 6678 19/81) (Plb 1008) STATE OF WISCONSIN DILHR Detach And Return Upper 1~ 8 DIVISION OF SAFETY & BUILDINGS Portion Of This Form With 6\ BUREAU OF PLUMBING 201 E. WASHINGTON AVE. RM 178 Any Return Corresponden P.O. BOX 7969 l MADISON, WI 53707 lpy~ 2 ~S, 608-266-3'L~ . Qic fC tg¢ ~i DATE: f~CE v PROJECT: NW, 28, 28,1 Kinnickinni, i i~UY'l,il i~ I a ~:l P" PLAN ID. # DETACH HERE PROJECT NAME PLAN ID. # This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the required fee is $ _ Fee Received is $ ❑ Underpayment - Please submit the additional fee. ❑ Overpayment - Refund forthcoming. ❑ Plan accepted for review. ❑ Plans being returned. ❑ No fee has been remitted. Plans submitted with no fees will be ❑ Additional information required. SEE BELOW. held in abeyance. 1. Plan Submission L Complete data relative to anticipated use of bldg. LJ Additional information shall be submitted in duplicate un- ❑ 2 copies of PLB 60 enclosed. less specifically noted. D Deed restriction required (1 copy). LI Plans not clear, legible or permanent. ❑ Condominium declaration. (1 cony) All information submitted shall be signed, dated and scaled or stamped in accord with Section H 63.08(2)(x) Wisconsin Administrative Code. Affidavit enclosed. IV. Holding Tanks ❑ Profile of holding tank showing vent, manhole alarm and manufacturer if precast. Complete construction details if 11. Pressurize Distrihution Systems (Mound or In Ground Pressure) site constructed. C Application for use of an alternative system signed by owner ❑ Holding tank agreement signed by owner and local unit of and notarized. (1 copy) government (sample enclosed). L County onsite required (1 copy). F Design calculations ❑ Reason for installing holding tank. Soil test or statement for pressurize distribution. ❑ Soil boring & percolation from county (1 copy). test data. ❑ Plot plan showing location of holding tank with lateral dist- Cross section of system. n Pipe lateral layout. ances to any building, wells, water service piping, wa er Plan view of system. C Plot plan. course, lot lines, swimming pools, all weather service road, ❑ Verification of Exception Status Form by County. (1 copy) Etc. Provide benchmark with elevation reference point. I11. Private Sewage Disposal Systems V. Lift Pump n Ground slope with 2' contours in entire area of soil absorp- ❑ Calculations for total lift pump discharge, head and gallons tion system extending 25' on all sides. pumped per cycle. f J Elevation of permanent reference point (benchmark). ❑ Size, length & depth of force main. ~l Location of area suitable for replacement system - provide Detail & model of pump or automatic siphons including soil data. size, pump curves, drawdown and average flow rate GPM. L1 Plot plan showing lot size and all lateral distances from LL Cross section of lift pump tank showing pump(s) or sewage disposal system to buildings, lot lines, well, water siphon(s). course, swimming pools, water service piping, Etc. ❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. VI. Systems In Fill (Fill must be placed prior to plan submission) ❑ Construction detail and cross-section of soil absorption ❑ Total area filled (fill to extend 20' beyond edge of trench system. before side slope begin). ❑ Soil boring and percolation test on 115 completed by cer- Depth and type of fill. titied soil tester (1 Copy). r J Copy of onsite report by county or district staff. ~ ry . . c ~ +v cii t i t a~i ,.~vl3 `~ij noo Department of Industry Labor and Human Relations Safety & Buildings 0:31 L H R ureau of Box 7969 P.O. Box 7969 i rrvw ~,c r-r+n,rE n, oc ` l . a, N..: r.. r • , w n , K,., . + n X 9 9 ~ F j G i s o n , WI 5 3 7 0 7 . F _ T' (608) 266-3815 1,9 CORRESPONDENCE FER TO PLAN TIFICATION NO. z DAME PROJECT _ ~.?R DATE SEWAGE ONLY - GENERAL PLUMBING PLANS- C1 Fee Received: LOCATION Priority Plan Review Only 1 I 1-Y OR ; OWN -I, COUNTY , h Ili l~ icki 1.1 N iC -S ~ of x t=xarnination of plumbing plans and specifications for this project has been completed. In accord witn Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon compliance with the stipulations shown on the plans. Please review your code for the requirements of each code section noted. The licensed plumber responsible for this installation shall keep at the construction site one set of plans bearing the department's stamp of approval. The installer shall also notify the appropriate inspector of wner required inspections are to be made. 'n thre cvan* inet~~~~}inn h ~t „n .within twg yca~ arc frryi this `i Q'at crrT7 ~G-G, In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions or examination oversight, and reserves the right to order changes or additions if necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit requirements of the city, village, township or county in which this installation is to be 111a0e. Failure to obtain local permits will automatically void this approval. Sincerely, For Privite C-evvage Systoms 0: !y. Th,;, approval is valid for te.c jr-~,1. l~r GAL vears or be „ames Sar t_ 4 until 9~_ tr,t' e :piratior~ d^te of the iniii<i; Bureau Dire or sun:: per;,;;t. TLANS REVIEWED BY: DATE: 7 cc: DOwner H & R & Rec. San. Section Plumber Bur. of Health Fdc. & Services Other DILHR SBD-6099 (R. 05182) A pS -FDIC:. S Sm, 1 FR (.,F SECTION L8 -,T ? r'' S - C1001 y' "~'~TR' TY ':~1'TJC~'SI'. . ~ - - - ~ - - PACE 2 OF 4 PROJECT DATA PACE 3 CF 4 PLOT PLAN 4 C 4 F TAN VIEW-CROSS SECTTOI'; F~~i l:: JLr (r.: r F ti. V 994 KUM, WKSEER AND ASSMATES,INC. D 0 . 74, 421 N . i,-A1 S=^rLE'-- RIVER FALLS, WISCUS I - , 54022 415 All ~ L ^=?IS HACTT,ITY IS USED AS A S CC -T- NC, ?AIN*GE I`_' TICI:A'!' 'D ATTEi;L1AI~CF OF 50 PLCi-'LE. EFE ARE i~C1 KTT v. l TG~ i :.._Sw ^7V I. SEA rCR n m ~T PR l~1 LIl ~.".S AND r7- 1VrC i lT1S F -1'~ CLUI P1L,r;S Tc 1-:- / T _i ~C',",S A NUJ A 1r..."E 1-;SE 11Z rrpJSIT11'C S-IFTIC TAI'S:. CALCULATIOPS ;O PERSONS X 5 GALLO.S F DAB' = 250 CALL(:)P:S FER DAY 75C GALLOP%'S .,,I1'~SEPTIC TAKK PEQliITIED: 1000 GALLOP S A 1200 GALLG°,: SEPTIC T 1I.T T,T, _ Ii; STALLED. D.--AINFTELD CALCULATIONS ?c AiLl,,] 1 50 PEPSCINS X -C-Q5 = 871 SQ' tTE FF- ':lam' JTF!D. I 8.rrt . c o.,x_a.ETE ~ LAq . F / \ ~u PLAIN j ZR CO q', - - j10Ns N~ , ~ OF 5 COIR \ , ' TO BE KE~hOVE 01 Y Lo 95 a y \ , 0 - FEB1984 Eye -NV) Y&- sec.`- qs NO 1•,!)TES Elevations shown are existing hro-ird elevations unless otherwise noted. 2. Install cast iron pipe 3' onto undisturbed soil on both sldcs of septic tank. 3. Sf-,t.tic tank to be 1200 rallor, capacity as manufactu--ed by Vieser Con- i'C'Cltl; S~ ?•2id,n } ock, Wiscoi`sin. 'c car r`; C D SYS7EPd F A CE Cr- Ott 5 T,"':)T7 VOrl~ n 4 t. 12" Abozre Fir~isl.ed Grade Soi 1 11 - - Of Aureate Cover 1.1AAtel-ial or of U.1con-acted Of2" Ar.ate'ti^!'~ aw Or riPrsh r 4) Perforated Pipe To Bottom 01 Bed. CSTItiBJ T'IOPd PIPE TO BE AT LEAST _ ~ TNC- ES BELO4 OHIGTNAL GRADE AND AT FAST 20 INCHES BUT 1~0 ]MORE THAI: 42 INCuJS BELOW FIFA L CTtADE. F r X;;AVATTON FRCS : ORIGI';c i_, (;F'.D w,TLL BE 11 _TNC ES. MTN t ! OF OF EXCAVATION FRQ,i OR1GII:AI, TL.DE VII LL BE _ ~z~_INC?_ES. Una r-P` ~N- -Bw of BVD h1 l s. aF ~~°;~oE FE ~~v~ 0 6 E E B iy 4" Perforated PVC Tii stri' it,i cn Pi tie. i ti - ( 411PVC Fro-n S pt,i c Cast Iron Vent Pipe Tank 31 - 4" Solid :4a 11 PVC - - - - - ?reader Pipe PROJECT DETAIL J?1`A SHEET t C, l's:'`ESS i-=I'\ L u` ~'►I'+E CL' - - rx carc„x .7-GAL DESCRI°TICN il-i(7 1,.` A c` C`;, 2l$i v y c,= _,t ~e Zr i 2r. ti', 1VCVc F~,U' ~?,IF-P-C'Lk-L INJ DD E~:S Z1F1C CE IUt12 r7<<iS,l- ~l.ZIP St/C1ZZ i-2A 7-- ZJl"~~Z ~tZIP ~VC, -2--Z C -eck a~.prcpr-.ate bui Id~ ng usaoe's) and f - i ' _ i i l in t, i~ r," ;rr- atic r ~~.~~ec u c~, e r~~ch usage listed. ?lease consult Section H 62.20. E>J(t.ir o building New building A d tics 1 L-,-i-L-ents and condominiums . . . Number of bedrooms i Hs,emb_y hall . . . . . . . . . . . Seating capacity 1 Par Seating capacity - of meals served Qok•rl i nc a i e. . . . . . . . . . . . .dumber of lanes (J) 1Ji th bar (o~ Caiiporcund and camping resorts NUmher of sewered sites Number of ursewered sites Total number of sites Camps . . . . . . . . . . . . ( ) Day use only }Dumber of persons Day and night Number of perso~5 i ) Catchbasin . . . . . . . . . . . . . Number Church . . . . . . . . . ( ) No kitchen Nu.:ber of persons ( ) With kitchen !Dumber of persons ( ) Dance hall . . . . . . . . . . . . . Number of persons ( ) Diring hall . . . . . . . . . . . . Number of meals served daily Doc kernels . . . . . . . . . . . . Number of enclosures Drive-in restaurant . . . . . . . . Inside seating capacity Car-sereice Nurnber of c Duna station . . . . . . . . . Number of dump stations Employees ( total cf al' shifts) Number of employees Hotel ( ) Mote, ( ) Cottages "dumber of units with 2 persons per unit ';umber of units with 4 perscrs per unit _ Pledical and dental office hl des. ^,umber of doctors, nurses, medical staff NUTter of office personnel Plumber of Datierts b e none na r :s er o= sites Nursing hcr-res Number of heds ( ) Parks . . . . . . . Number of persons ( ) Toilets ( ) Shc::ers i Restaurant . . . . . RE _jzf-~ing capacity ( ) Dish-,.rasher and/or disposal? Mq ( ) 24-Hour service Retail store . . . . . R .2 r9 Total number of customers Schools ,q~ Nu fiber of classrooms Meals ( ) Shc;rers i ) Service service statitin r~n~~1~~TV,g OlV.• Nun;blr nof bcarof served machines dail y Swimming poc' bathhouse . . . . Number of persons _ 0 THER SpeCifS') ~,L;r_.h;=i irTS t 117y - - 3~~ COP'PLETF OTHER S-CE veS no Cr r{r..a-. Food ,jaste eft"1nG°r yes no - er yes _ no ✓ Di5'nt,ld5 h J°S f~i „ „r~IF'Nr Q- c1u~nF,S ,vc hit Septic tan's: capac'iy Septic lding tank caracity ~ _~.nF r;_ nr. acturer ~ ~-.tc r~=- 1 t~c•1~~ cr --=r= '.,c',dth of tre- ches - length of trenches depth of Tenches - - - - CC-'F EEC tnta' Sq 1ar e feet. C-~ width Y ! l math of h°d - - - c eptn E F A GE ] 1- to-,al square feet nuts'de diame`-t r neuth be i ow inlet - - tto~al deutF from top to bottom cf pit E^ "-PJTAL USE ~pJ~y F , r. r AP, i i._ Sinnature o` person comF~ictinc form: Z I I~ C`rti 1 T~ LL Z 1 p _ S V G, Tel ecnor e n:)er C16Y- pt~~glt~~ CoNjitionalf(I Y~~;~ OPy t:0 Nora-- S1~~E ~ CE r. S.~CO