Loading...
HomeMy WebLinkAbout022-1093-20-000 I c~ f i c w o ~ v ~ v co 3 O 0 o m v o A CD N N t ? 3 Q C fD ~ 3 ~ IJ _N ~ girl cD co .p Q. z a W N W N O CD 00 to C. m NO N N N N R O-0 p 7 (D 0 O O O O A O o cn O O _ _ Z7 y 7 N O o N C W =O C/) < D a 00 -ti N W C G c (D C) 3 a0 ° n n cn ` j o "ftot o w C N O OO D 00 0 :Z, N O c m rt o+ (D Q o z O O O rn r H N v_ ° n J U) CL v 1 x y c~i~ m ~1 CP CD v a O 00 4- 0 CD A) -a 90 (N N W C A_ A N Q O } j W r N 3 Z (D N~ z (D O 0 D c o A a d O rt i i _ I CD N 1 ~ ~ ~ lVyy f O C (OD N r Oo W m Q y v' H H Z n CD p N Cam] z Z m C~ 00 f` I v n A GZj r. 00 U W rxi. n W .v III m N C z 00 1 G ~ Frt., I a C) 3 03 1 N D A W N N 0 f, n CL a CD m a O 3 m c z c 0 o CD m 0 m y CL R- o :3 y A I ~ I A N lv O O V A O N "A, A K3 O O C a °o a ~ Parcel 022-1093-20-000 01/25/2007 10:40 AM t PAGE 1 OF 1 Alt. Parcel M 32.28.18.P505C 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 KEVIN R ELLERTSON O - ELLERTSON, KEVIN R 1038 CTY RD M RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1038 CTY RD M SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.000 Plat: N/A-NOT AVAILABLE SEC 32 T28N R18W PRT NE SW COM 7.07'N & Block/Condo Bldg: 585.2'E OF SW COR ON CENLINE OF HWY, TH NELY 220.47'TH NWLY 194.55', TH SLY 220' Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) TH SELY 180.07' TO POB EXC HWY 32-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 01/30/2002 669779 1826/270 QC 07123/1997 746/206 2006 SUMMARY Bill M Fair Market Value: Assessed with: 179544 250,200 Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 20,000 211,000 231,000 NO Totals for 2006: General Property 1.000 20,000 211,000 231,000 Woodland 0.000 0 0 Totals for 2005: General Property 1.000 20,000 211,000 231,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 131 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 022-1093-10-000 01/25/2007 10:36 AM PAGE 1 OF f". Alt. Parcel 32.28.18.P505B 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 O - WITTIG, DAVID M & AMANDA L DAVID M & AMANDA L WITTIG 1046 CTY RD M RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1046 CTY RD M SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 32 T28N R18W PT NE SW, BEGIN CEN SEC Block/Condo Bldg: 32, TH W 279' SODEG E 95.9' S56DEG E 56' S16DEG W 56' TO CL HWY; NELY ON CL TO E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) LN. N-POB 316/525 32-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 870/479 07/23/1997 316/525 2006 SUMMARY Bill Fair Market Value: Assessed with: 179543 171,300 Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 40,000 118,100 158,100 NO Totals for 2006: General Property 2.000 40,000 118,100 158,100 Woodland 0.000 0 0 Totals for 2005: General Property 2.000 40,000 118,100 158,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 208 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form- S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER Jack R . Helmer TOWNSHIP Kinnickinnic SEC. 32 T 28 N-R 18 W ADDRESS Rt- 2 ST. CROIX COUNTY, WISCONSIN River Falls, WI 4022 , SUBDIVISION _ _ LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM l t S Hu- '1!r - i r S X - P 5/I' 3 ~vrv-r X X x x ! Ffr' ~FFNCr LEM"2 EL 95, To P c F INDICATE NORTH ARROW BENCHMARK; Describe the vertical reference point used BM#1 EL 100.0' on bottom of siding Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer.: Wieser Liquid Capacity: 1000 Gallon Number of rings used: Tank manhole cover elevation: 96.12 Tank Inlet Elevation:-89.86 Tank Outlet Elevation: 89.65 Number of feet from nearest Road: Front,O Side,o Rear, O ^ feet From nearest property line Front,0 Side,0 Rear O feet Number of feet from: well building. (Include this information of the above lot p plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Wieser _ Liquid Capacity: 750'Gallon pump Size Pump Model: SS 4 Pump/Siphon Manufacturer: F E Myers P "y Elevation of inlet: Bottom of tank elevation: ~ 'J~,j Gallons per cycle: 117 Pump off switch elevation: Alarm Switch Type: N.O. Alarm Manufacturer: S.J. Electroc Number of feet from nearest property line: Front, O Side, O Rear, Ft. - Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: 4 X' umber of Lines: Area Built: 900' Width:! r Length-7 3 4 Fill depthi to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear, 0Irt Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Number of pits: Diameter: Size: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box 0 been used on any of the above soil absorbtion sy;ems? (Check one). N 0 HOLDING TANK Capacity: Manufacturer: Number of rings used: Elevation of bottom of tank: ~.T..~- Elevation of inlet: O Side, O Rear, 0Ft. Number of feet from naarest property line: Front, Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Plumber on job: Paul R. C dd Dated: License Number: MPRSW2739 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & H:JMAN RELATIONS ' ' PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 XCONVENTIONAL ❑ALTERNATIVE SIWt PlanLD.N.mber. (If assign O Holding Tank 1:1 In-Ground Pressure E IM and ed) NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECTI N DA E i Jack R. Helmer R. R. 2 , River Falls , WI 54022 BENCH MARK (Perm anent reference polntl DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: JCST REF. PT. ELEV. NE SW, Section 32, T28N-R18W, Town of Kinnickinnic Name of Plumber. MP/MPRSW No.. County. Sanitary Permit Number_ Paul Cudd 2739 St. Croix 64843 SEPTIC TANK/HOLDING TANK: ' MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED PROVIDED YES ONO OYES ONO BEDDING: V T DIA.: VENT MATL. HIGH WATER NUMBER OF ROAD. PROPERTY WELL. BUILDING. JVENT TO FRESH ALARM FEET FROM LINE- AIR INLET: YES ONO' OYES ONO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER ° ONO PROVIDED: PROVIDED. YES ONO OYES ONO GALLONS PIER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERT WELL BUILDING (DIFFERENCE BETWEEN ) FEET FROM LINE I AIR INLET PUMP ON AND OFF) ! EYES ONO NEAREST 1101 SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LEN(,TH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH J LENGTH NO OF DISTR PIPE SPACING COVE INSIDE DIA -PITS ILIOUID L / TREN j L PIT DEPTH DIMENSIONS ) L' Cl? GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR PIP DISTR. PIPE MATERIAL'. NO. DISTR. NUMBER OF PROPERTY WELL. BUILDING'. VENT TO FRESH BELOW PIPES ABOVE COVER ELEV. INLET ELEV. END PIPES. FEET FROM I LINE: / AIR INLET. NEAREST-r 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- O YES O NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEx TURF PERMANENT MARKERS JOBSERVATION WELLS OYES ONO OYES ONO DEPTH OVER TRENCH BED FffEPTH OVER TRENC H; BFU DEPTH OF TOPSOIL SODDED SEEDED MULCHEDCENTER GES EYES ONO OYES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE M . NO. DISTR. JD~STRPIPE DISTRIBUTION PIPE MATERIAL 8 M ARKING ELEVELEVDIAELEVPIPESDA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS OYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL. BUILDING. FEET FROM LINE. DYES ONO OYES ONO NEAREST p Sketch System on Retain in county file for audit. Reverse Side. GNATURE. ITITLE. DILHR SBD 6710 (R. 01/82) 1' LVIsconslnv , APPLICATION FOR SANITARY PERMIT ILHR< (PLB 67) St. Croix -COUNTY T ,LROF I"DUSTgYLR UNIFORM SANITARY PERMIT # - nOUS BOg 6 HUTRn RELRTIOnS k-113 -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8%2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS Jack R. Helmer Rt. 2, River Falls, WI 54022 PROPERTY LOCATION NE 1/4 SW 1/4, S 32 , T28 N, R 18 Kinnickinnic W TOWN OF: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NFAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER C . T . H, nM" TYPE OF BUILDING OR USE SERVED (xd 1 or 2 Farnily Number of Bedrooms. 3 Puhlic (Spurily). THIS PERMIT IS FOR A: New System La Tank Replacement L1 Repair EX) Replacement Soil Absorption System (TreneheFS) Revision Privy L_1 Alternate System Reconnection Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. F-1 Seepage Bed X]~ Seepage Trench L) Seepage Pit LJ Holding Tank D System-In-Fill F-1 In-Ground Pressure L_] Vault Privy L) Pit Privy I Existing, For Which A Previous Permit Is On File, Permit # sued Cl An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Gallons Tanks Concrete Constructed Steel Fiberglass Plastic Septic Tank Capacity 1000 1 X Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: Wieser Concrete Products IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: L-) Mound In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): , Class 3 900 9d0 & Private ~ Joint D Public 1, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): Ign ture: X MPRSW No. Phone Number: Paul R. Cudd 2739 (71_`,) ~5-2W4t~ Pltunber's Address: me of D urner. Rt. 5, Box 364, River Falls,,Wl 54022 Arthur Wegerer (576) COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: 7 ~ 1 Disapproved ~ a P ~C~ ❑ Owner Given Initial A ~~(~LC pproved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR SBD-6398 (R. 5/82) DISTRIBUTION: original to County, One Copy To, Bureau of Plumbing, Owner, Plumber I INDUSTRY' DEPARTMENT OF. SAFETY & BUILDINGS NDUS RE-PORT ON SOIL BORINGS AND DIVISION LABOR AND P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (115 DISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: - - N•' ` OWNSHIP/ UNICIPALITY: LOT N ~ LK. N` E: (or 'VII COUNTY: OWNER'S UYER'S NAME:}~I~ - - S-.r` ~~IJ~•~,`. MAILING ADDRESS: , Star l~ . - - _ - - f,>r,~r~ `~'G 'j•'^ USE NO. BEDRMS.: COMMERCIAL DESCRIPTION: DATE fS ~RVATIONS MA4 .Residence PROFIL RJP COLATION TESTS: • ❑ New Replace J RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING T COMMENDED SYSTEM:(optional) DT. If Percolation Tests are NOT required DESIGN RATE: under s.H63.09(5)(b►, indicate: ~J If any portion of the tested area is in the Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-FRk#~S- CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTU A NUMBER DEPTH#At ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) RE, ND DEPTH B 1~~-._ ~;a;.;~ _'7.'~ ~1•C~';-. TS 'I 'i5; _-LL, `S w~S~o7~ ol= ~2~ C $f B), y 6' LT2h -Fs -70 ~S r-lIX w~wLRlFrLy B -7~.~ _ \o S31si1Ts ri 'Gr-Y,l..zs'LTA>,slw/ 0ob B_ 7.1 iV ~t a rn 2, O ) @ T S ~A7 n B S,3`tBh 1 S 0 as Bh S 1) W , B- 1.1' Bn ~,S B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. RATE MINUTES ` PERIOD 1 PERIOD 2 PERIOD 3 PER INCH - 3'J \Si';e P_ D 3 b -7/g wig 3 P- P_rj 3 7`' 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. QD ) , y0 i SYSTEM ELEVATION I _ we ice, v .,hN r"I bk I ELF is --C~TTtJ 1 1 , I , qF JS t_ hJ fC~ v~ F C. i ~So • i ~95~ 83 .i s 5t;=i~~_C 1F o I D(L~ QIE'Lt_ ~ ci'tAtyirb qr CL .2 S- 1 k ay TAI• t 3 Z C+ o SO o - T - - - - 84 I - - I° 6 u / s •~o~°~S n _.p S Z~j'vn 6 _ 2, - 2O - 3 , NE_ 11 3 IBM ~Z 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: --'~~U'K 111'T~~ ADDRESS: ~CERTIFICATION NUMBER: PHONE NUMBER (optional): CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - + , r LEV I`s,x vr. o "A d=waw no Oyu VM, &A. 4. °Mi rE 3 t. , R t f Erli is Yr 't ik tin new Cr rt€~z r Ti\ VS r r ,fir ,E kt_, ' L= h_; e. ,1I as _ shown hem f ow rA ig t e fle d >r K, a€,. ld wrats Q w! m k s l e 3t T a p t a I rF,tY a6s.I -`I ff r. tsr 4 " r= ate « ~>s t r€~ 4t t t r ) ti MOWS. .ii ~ ~f 1 i3.,~ sr ~ arv t M n ja.,~- A ~alq art a<r-tP C3 _ 1 s - O.-.,_ t , "i" rr ~i ~d pb rtsa'~ xP 1; too t in t3 ' t,Si.. ,r~ Fi On ~ -,r: tea"?- as ; 3ssZ3 ;`i--~i, 4~ _ H ism 0'0 t)3c3 M y63 w 0 a rf it< sUEia, uS- "w'; k:3i#? , R Bva Smd, Sax -1 f t ( Coon ~„~s<}sa 1. r .ij• t w'- Loony Son! .c= R Gn La= US i .a., o M, - "as$n .?t9 a r s" 1 n, c, a3~ ,3i,-Or`. t~~$, atilr Von: k'? a % ~ . ' A- 1 T r" e t S no s ' k h3F` .rFa't, tv 11 v 1" N CO) m w 1 _ K c cnw~~ w .y. ~cti^'30 44 O~ N a 0 n 0 m j 0 W Cr --x Sw Z c 0 C° ° 3 co t1n w N c M w D D CD y 70 a cD CD ~a pp m _ ~ N yi (D M ODD A~- n W~ o CD 2) W CD CD CL cc ~3CD ~(D - =M, \ OA CD c1 O 0 O M CO ~D n C o~° ~owo a rM > o 3 C `c C_ c c Z~ o~3oa0 w w c~ Q•° o p ---g? a,-`~wwz 0a;~ 0 .~0am CD O w co m c n X 1 0 CD Cn c co to Q O I U) o -1 N.C C D w " `O' o L/ o CL B) o Q ~m N~uwi ChCDy c V1 w ? w C n (p Z D CD -1 C O O Q cD° 3 0 m ~MCD ?cz c (D 0 CL 0 v,wa cDN0M 3CD QyWM(DD~ cn V ° w w C m o a° m' CD (h (D n O a Co w° cr m co p~ woc on=cco D i nai n:E, ccn C c ° C m = n o m Q ao~ aaaa~o a) Ch 0 C: M <-•fDCD~3 CA ao o(a a o w e° m o o a o w -im c m m § a w°- ~ CL aCD 003 ~v o FA a ~ o< o m o C Hh 3 . 0 5 PLOT PLA2v' r i-~ Location of building Served Dosing chamber Septic tank Vertical/horizontal reference r -;t I`_'a Building sewer System elevation is v~ Effluent system Well Replacement system area Property lines w/in 50' of syst_'m Di stri hution boxes Scale = \1~ 1 or di men s, d Pump and "oriel No, Vertical L1ft Size Force 1.la' on L'>ss ~ D. H. Vol. Dist. Pi De GaI. ? i' iI a1 . Der Cv ie Place check mark in appropriate box, indicating item is sho4m on plot plan blow: ~ \.S-T, \ f sir ' fir,-I EL I 111STAlL tppp ' G4F^ .ArJ C, ~ ~a~{-~ Cy TAN l r / ~ B~ 1/JSThII. 1S0~A Io \ 3c/, Z' r W1LS y~2 c-0:JC ~ it i 52 ~J r s X x s' L z Y E~ 95-3wa i To? of 7-_L. , - CHc?l.c ~pX By the granting or approving of the above plan, or upon the event of a subsequer:- permit being issued,St.Croix County and the St.Croix,County Zoning Administrator, not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or 87 te Installation, r s si ,na re 1c_e11se No. Dare - Li L C ~~~_~7wR . :~i ~ CAS r 38 ' " i i I PUMP CHAMBER CROSS SECTIOQ ANJD SPECIFICATIONS VEIJT CAP y„ C.I. V E tJT PIPE - ( r~YPROVcD LG WEATHER PROOF 25' FRCM DOOR, JUA1CT101J BOX MANHOLE COVE-P. WI►JDOW OR FRESH I2"MIU. A,I 1NTAKE I GRADE Ilk" y E LEVJ y" NO. I IS"MIS: ` COFJDUIT PROVIDE - I - ! AIRTIGHT SEAL I I i I AF RGVED JOINT A I I I APPROVED C'NTS .v/C.1. PIPE I III W/C.2. PIPE EXTENDIIIG 3' I II ALARM EXTF_MDIUG 3' OJJTO SOLID SOIL B I III OJTO SOLID SOIL I I I Ou C I I FT.-- - PUMP--- OFF D CCKJCRETE BLOCK KISER EXIT PERMIT ED GiJL-- IF -7 Qy, r ,ALiJ=ACT~ae R HAS SU H APPROVAL - -9TH`{-_ S PE C 11= i CAT10 N S DOSE AUKS MAO U FACT U R. E. Je?;jJUMBER OF DOSES: PER DAU TAMK SIZE: s O GALLOMS DOSE VOLUME ALARM MAMUFACTURER: S,S• ~LE`~p SYS"e') S INCLUDIAIG BACKFLOW: 9 GA! `-Ot~S MODEL JJUMBER: tC~ 1 W • CAPACITIES: A= INCHES OR 3u~ GALLOU5 SWITCH TYPE: -Z WCHES OR GALLOIJS B= PUMP -,AMUFACTURER: ~`"~`~~~ZS C= Q IIJCHES OR CALLOUS MODEL MUMBER. S S D = INCHES OR G.ALLDUS 5'v417CH TS PE: M j1J:- ~L UOTE: PUMP AJJD ALARM ARE TO BE MIIJIMUI''1 DISCHARGE RATE ~Z GPM INSTALLED OU SEPARATE CIRCJITS VERTICAL DiFFEREKICE BETWEEU PUMP OFF AAJD 015TRIEUTIOU PIPE.. 9 33 FEET T MIUIMUM NETWORK SUPPLY PRESSURE . . . . . , . . . . = FEET - FEET OF FORCE MAIN X ~Y F oFTFRICTIOAJ FACTOR__ C>- FEET TOTAL D''JMAMIC HEAD = 9'S3 FEET IIJTERNAL DIME_QSIONS OF TANK: LENGTH - ;WIDTH ;LIQUID DEPTH = 3.J~/)C 39.~5_Z= _ oI_ Jr.3- Z3) _ _ 1.4~ >AL/)n. 'A IvIol C}7 UD t-- (D LO -,I- CY) N o O -T T - I T 1- T T i - 1-- - --7--~ -T--f- -T ---T--r- - _ T - - N CD - - - - o N - (D N O ! L N O - - - - - - - - O to OD - ~~J - - CD UJ o 0. T- , - - - - - Lf) cp (y) rc CC CD 0 JU LLJ N + . I C) r -J p C') Q U LO 11 00, C\j CD Co 0 ~ - - --1_ o Q N 0 LO 0 0 N LO O L_ O (D N O CEO CO "j N O CO CD N- C\l N N N N T-- I T- T- T-- H Vi H I ST C- 105 a r r a SEPTIC TANK MAINTENANCE AGREEMENT y St. Croix County 0 z t7 OWNER/BUYER H - + rn ROUTE/BOX NUMBER Zx 2 Fire Number QQ CITY/STATE l UEe i4LLS ` c^~42 i t ZIP J PROPERTY LOCATION: "0/1~ Z, SW 4, Section 32_ , T- N, .n W, Town of K1Nmr.I KutC.- , 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 three year expiration. H 0 I/WE, the undersigned, have read the above requirements and agree z 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 Zoni Office within 30 days of the three year expiration date. SIGNED a s~' St. Croix County Zoning Office DAT P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. APPLICATION FOR SANITARY PERMIT S T C - 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 ~~qGk d► U) A IA a A eL hit No n Location of Property ~_it S w h, Section 3 Z- P T ~ N - R----W-- Township i N j G t t•(ti/! C._ _ Mailing Address Rio U T F Z TspJc -Z - t Ur-k .,:Fl9 LL S LJ ' - ~ S"~{ o z z,.. Subdivision Name Lot Number Previous Owner of Property /V Pq V4 S O -,v Total Size of Parcel ©NZ #4C E 2.,- Date Parcel was Created CMG 7- Z (0 l R 5 / Are all corners and lot lines identifiable? - Yes No Is this property being developed for resale (spec house) ? Yes No .~1 Volume and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract •r. 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) eeXU6 y that att,a,ta temen to on .thin 6o, %m ane .tAu.e to the but o6 my knowledge; that 1 (we) am (ane) the owneh.(6) o6 the phopeh,ty de cA bedint JUA ) in6o4mati,on 6o4m, by v4 tue o6 a waA.a.nty deed %eco4ded in the 066ice o6 the County RegiAteK o6 Deedd ae Document No. ; and that I (we) pees en tty own the pno pos ed 6ite bon the s swage pod s ys.tem (oa I (we) have obtained an easement, to A.un with the above deeehi.bed pnopeAty, bon the constAucti.on o6 said system, and the same has been duty 4eco4ded in the 066ice o6 the County Reg" ten o6 Deeds, ad Document No. ) NATURE OF 0 R SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED Sar . PF : mi ~P G,'~ - H63.05 PLOT PLAN r Show: fr f ~ 1,oCati on o1 biI Id ng s e r V e d ! ~ Dnsinc chi ,M k_'r Septic tank Vertical/horizontal reference t Building sewer System elevation is a,- - Effluent system Well Replacement system area Prop-rty lines w/in 50` of svs-1-.- ✓ Distribution boxes Scale or arm_ s-_:- c Pump and controls: = S L/ - t?=r. 6 e 1 No. V rt r-al Li _ t Size Force llai_n J \ G rrtc'A on IOss T. D. H. VcD st. -:-~-e Gal. D~r T-, . Gal. Der Cycle Place check mar}: in appropriate _r~cx, indicating item is shown on plot plan below: ~ LS-T ; ! U1 c.... 3s . E { - EXtS[. bZ2Y wtn- - l~S~<i. ~Sc~~~ P~ L11'oF 9"mac * Sj u Y 30 ~ U v Sx L rs x Z x EL_ 9s-3•o+-~ I: By the granting or approving of the above plan, or upon the event of a subsequent permit being i ssued,St.Croix County and the St.CroixCounty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage tt at may rr,sui t in or a-f ter installation. - f•s~~7 Cry i !~OFJ I / VE~1T P s v,.. ~ 5~ t 1 Puc - - - - 15 0 33' p L1N~P CHFER, Cr?OSS S=CTION AI`JD SPECIFIC.ATIOUS VC►JT CAP '"C-I. VENT PIPE WEATHER PROOF APPROVED LGCKItJG JUNCTIOIJ BOX f"Af~HOLE COVER > 25' FROM DOOR, `,,J!NDOW OR FRESH 12"MIU. f;iF; INTAKE - GRADE I~ L_~7v. 5 J I i y' M i t 1. ~1G COKjDUIT V T \ - - - , - - _-5 fIJIET EL; V.•`tV PROVIDE AIRTIGHT SEAL APFROVED JOIN, A I III APPROVED C!fuTS /C.S. PIPE I III W/C.I. PIPE w' EXTENDING 3' I II ALARM EXTEIJD!NG 3' GUTO SOLID SOIL 8 I II ONTO SOLID SOIL I I I oN c I I F-LEV. FT. I PUMP OFF D CONCRETE BLOCK - RISER EXIT PERMITi-ED G►JL`J IF 70JK !v jA Li-P=TURER HAS SUCH APPRCVAL SPEC.IFICATIOtJS DOSE TA_ I.1 KS MANUFACTURER: ~~~`~`J'-~=3`J=TSI.IUMBER OF DOSES: PER DAB TAIJK SIZE: JO GALLONS DOSE VOLUME ALARM MANUFACTURER: S S `LEA-'~ 0 S"~ I `I'1 S INCLuDIUG BACKFLOW: GA's!-DNS MODEL ►JUMBER: CAPACITIES: A= INCHES OR Jul GALL CL- SWITCH TYPE: B = -7 INCHES OR GALLONS PI tivT MANUFACTURER: C = l~ IMr- HES O R ,ALLOIJS MODEL NUMBER: SS D=_~ I~? IAICHES OR _'_CA_+S SWITCH TUPE: {n7-- r.l NOTE: PUMP. A1JD ALARM ARE TO BE MIN{MUP1 DISCHARGE RATE SS GPM INSTALLED ON SEPARATE CIRC I VEEKTICAL DIFFERENCE 6ETWEEU PUMP OFF AND DISTRIBUTION PIPE.. 7-E'S FEET + MIMIMUM NETWORK SUPPLH PRESSURE . . . . . . . . . . . FEET } 4D_ FEET OF FORCE MAIN X S; Fjp FTFRICTION FACTOR.- FEET TOTAL 0'3MAMIC. HEAD = FEET 1PIl»~~7z-_R X9.5 _ r INTERt1AL DiME►JSIO►JS OF TAIJK: LENGTH - ;WIDTH -LIQUID DEFTH'9,1- M 00 r-- Co LO c!" C~ N r CD v` CV 0 0 C\j 00 N ~n - - ° M. .a (D Lr) co - 'T- Lo ~ cfl r CD CC L CD - - - Nt LC) cy o r~ t j N ! 0 C\J I C) C co - - - - ° (0 C) Ili Qc) 0 0 CD I - - - - N - - Lo i o - - o (D N CD Co CD N CD 00 Co Nt N N CV CV CV T-- r- r T- r C-w-j e ' s n ame H63.05 PLOT PLASH `dhow. Location of building served Dosing chain!.-,?r L Septic tank Vertical-/horizon---al Building sewer System: elevatJ on is _J I Effluent system Well Replacement system area r Pro.r_ _y i nes ~'a/in 50' of sys: Distribution boxes i1 Scale or dimensi_on~ Pump and controls: S L" " 5 MLr. & M=odel No. Vertical Lift Size Force T=aro T 7t! ion T. D. H. Vol r_ - - . D_ st Piy Cal. _ r Gal per Cycle Place check mark in appropriate box, indicating item is shown on plot plan helow: i VJ ESL Z V x Jh bu t!) Cam. I ~J'J. ~1 7v I 1 k,.~SZ't.l 1. Copp i ~ L"~~^ GRL.w\cS r` 03 =X~ST. 02Y w~1.L - - 1~~S~R~I ~So Ctrs 4 ~.?~°F 3 Svc ~i 7 Lg k ? I By the granting or approving of the above plan, or upon the event of a subsequent permit being issued,St.Croix County and theSt.CroixCounty Zoning Administrator, do not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or of installation. ~7,* f -P=urr, ~ I - - - - - - - S , ~I , S2 - ~f hN cz~ i i 38 J L ~ K _ i h L- 9~3. 1 0 . ~ISl v~T.4,J p - _^Ross `;CTIrJ` Ak!p SPE Clr (CATIONS -VENT CAP ' C.I. VENT PIPE WEATHER PROOF _All"FROV-D LOCKIt•JG M',IJ~IOLE Co'~FR JUNG I IOU BOX 25' FROM DOOR, ,OIJDOW OR FRESH 12••MI►J. lfJ TAKE GRADE - T `I. MIN. CONDUIT ` _ - _ - I8"MIN. 1~1a - INLET PROVIDE 1 ' ----=J AIRTIGHT SEAL J I II~ APPROVED JOINT A I I I APPROVED o UTS W/C.T. PIPE I I I W/C.I. PIPE EXTENDING 3' I III ALARM EXTENDING 3' C1JTO SOLID SDIL B I III ONTO SOLID SOIL I I ON C I I ELEV. FL + PUMP _-J OFF D ~L~? 6 CONCRETE BLOCK RISER EXIT PERMI TIED GULy IF TAUK r~' -ACT!_R~R HAS SUCH APPROVAL stP~+ f 5PEGIFICATIDU S D05E _1A►.1KS MANUFACTURER: OF DOSES: PER DA4 TANK SIZE: SO GALLONS DOSE VOLUME t ALARM MANUFACTURER: S-S• ~LE~~.p `6'/S INCLUDIMG BACKFLOW: __GA= ONS MODEL NUMBER: •W • CAPACITIES: A= 1u INCHES OR 3'?`~ LL Ok5 SWITCH TJPE: B= Z INCHES OR GALLOK35 Piit lP MANUFACTURER: 1 S C - ~~u IIJCH- S OR ~y GALLOWS - MODEL NUMBER: _ S S C= INCHES OR SWITCH T~JPE: IJOTE: - PUMP AND ALARM ARE TO 5Z. MINIMUM DISCHARGE RATE SS -GPM IN5TALLED ON SEPARATE CIRCui_v VERTICAL DIFFERENCE BETWEEN PUMP OFF AND D15TRIBUTION PIPE.. - FEET + MINIMUM NETWORK SUPPLY PRESSURE FEET FEET OF FORCE MAIN Y, O 10 F o,FT.FRICTIOU FACTOR.- 0_33 FEET TOTAL DYNAMIC HEAD = g. FEET tl INTERNAL DIME~JSiOQG OF TANK: L EIJGTH =-;WIDTH ;LI~uIO DEPTH _ ~ 3i