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HomeMy WebLinkAbout026-1011-70-003 c U) O c d o d 2. 0 3 a co v • 00 a) =F 3 m s w m 91 C) 0 a Z CD 3 (n Ul L N n O CFD a v O -0 n ° 7 O L, C 0 ti 3 m m O w y m _ vo cn o D a a 3 a C-n o m 0' 0 7~1 o rn can o c o R =3 ? z O ~rl + R f cn cn-l N o - a (o Q O O o t1 ~ ~p 1; f ~ o in m ip ~ vi cn chi D ~r -p T A cn O N 01 N o D D o O pn N N O I III F a• O O 1 ~ N Oc m V't c -p - w ~ C -i (n W Z p Z z fZ A z C.i O C7 00 (n ~ W A (o W m o b n ° Z 3 0 ;w z co 3 m N t- I N C) D c 1 m o 3 O T = O N C n o~ z a oN o cfl cD n> N N CD 0 3 N O O N O 8 7 (D S O. p C p 3 0 e C T1 7 i CL i ~ O N O V C N X N O A o ti CD `0 0 O Oo `a Parcel 026-1011-70-003 05/27/2005 05:35 PM PAGE 1 OF 1 Alt. Parcel 4.30.18.41 D 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner GRUBISH, D R & S,&G C & V JAMESON D R & S,&G C & V JAMESON GRUBISH 1169 HWY 64 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1169 HWY 64 SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.000 Plat: N/A-NOT AVAILABLE SEC 4 T30N R18W 1A SW NE LOT 1 OF CSM Block/Condo Bldg: 5/1471 EZ-U-1464/084 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1239/523 LC 07/23/1997 735/598 07/23/1997 699/611 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/19/2002 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 1.000 45,000 229,400 274,400 NO Totals for 2005: General Property 1.000 45,000 229,400 274,400 Woodland 0.000 0 0 Totals for 2004: General Property 1.000 45,000 229,400 274,400 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 DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS 'LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 ❑ CONVENTIONAL U ALTERNATIVE state Plan I D N-1- ( I t assign 1d LJ Holding Tank ❑ In-Ground Pressure ❑ Mound 8500264 NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER: INSPECT N D `TE. r Mich.aet A. Pam- R. R. , Someuex, W1 54025 ' BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. RIO. PT. ELEV.: CST REF. PT. ELEV. SW NE, Section 4, T30N-R18W, Town a4 Richmond, Lvt#1 Name of Plumber. MP/MPHSW No. County Sanitary Permit Number: Cat Powers 1563 St. Cn.oix 58935 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PR IVIDED. EYES ENO EYES ENO BEDDING: VENT CIA VENT MA FL. HIGH WATE NUMBER OF ROAD. PROPERTY WELL: BUILDING. (VENT TO FRESH ALARM FEET FROM LINE AIR INLET DYES ENO EYES ENO NEAREST 7~ DOSING CHAMBER: MANU F,QCTURFR. BEDDING. LIQUID CAPACI iv PUMP MODEL JIUMP,SIPHON MANUF AC7UREH WARNING LABEL LOCKING COVER PROVIDED. PROVIDED. EYES NO EYES ENO DYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PHOPERTV WELL BUILDING I VENT TO FRESH (DIFFERENCE BETWEEN _ FEET FROM LINE AIR INLET PUMP ON AND OFF) DYES L-1NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moistureat thedepth of plowing LENGTH IMAMITER 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: WIDTH LENGTH NO. OF DISTR. PIPE SPACING COVER J INSIDE DIA. -PITS LIQUID BED/TRENCH TRENcRES MATERIAL PIT DEPTH. DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL NO. DISTR NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH BE LOW PIPS ABOVE COVER ELEV. INLET ELEV. END PIPES LINE: AIR INLET: FEET FROM NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM 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. YES NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS C_JYES ENO EYES ENO DEPTH OVER TRENCH: BED DEPTH OVER TRENCH: BED DEPTH OF TOPSOI L. SQODED SEEDED MULCHED. CENTER EDGES. EYES ENO EYES ENO EYES ENO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTHIBUTION PIPE MATERIAL & MARKING. E LEV.. ELE~/,.'t DIA. ELEV. PIPES. DIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ! EYES ENO EYES ENO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE YES ❑ NO DYES ❑ NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE DILHR SBD 6710 (R. 01/82) _v_.- Safety and Buildings Division DIL.HR PLAN APPROVAL Bureau of Plumbing P.O Box 7%9 a a., m~„AE......, ❑ General Plumbing Plans Madison, WI 53707 ❑ Private Sewage Plans Telephone: (608)266-3815 OFFICE USE ONLY Plan Identification No. ©r+ Gallons Per Day IZ~ PRIORITY PLAN REVIEW ONLY Plan Review Petition For Modification Project Name Project Location - Street No. or Legal Description County ❑ City ❑ Village ❑ Town of: The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped "conditionally approved". This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. ❑ FOR GENERAL PLUMBING PLANS: This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. ❑ FOR PRIVATE SEWAGE PLANS: This approval will expire two years from the date approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. Comments: By: James Sargent Bureau Director If Questions Plans Approved By: Date Approved: Contact cc: ❑ OWS Q' DPS ❑ H&R & Rec. San. Section ❑ County ❑ Local PI ❑ Facilities Need Analysis Section ❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture DILHR-SBD-6099 (R. 01;84) ❑ Owner ❑ Other wlsconsln APPLICATION FOR SANITARY PERMIT :x DILHR (PLB 67 COUNTY oEPRRTMEnTOC UNIFORM SANITARY PERMIT # - InO STRV,LRBOR&HumRn RELRTIOnS _ -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 MAIYN ADDRESS PROPERTY LOCATION CITY- : A/ V+Lt-AGE: ' 1/4_ 1/4, S N, R (or TOWN OF: LOT NUMBER BLOCK N MBER JSUBDIVISIO~ NAME NEAREST ROAD, LAKE OR LANDMARK ST TE PLAN I.D. NUMBER R TYPE OF BUILDING OR USE SERVED % 1 or 2 Family Number of Bedrooms: Public (Specify): r THIS PERMIT IS FOR A: r-0 26.r X New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ 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 Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber n Manufacturer. PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of ivate sewage system shown on the attached plans. Na of Plumber (Prin / Si to MP/MPRSW No.: Phone Number: I ~S Plumber' Address: / Name of Designe COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved / ❑ Owner Given Initial ~ Approved Adverse Determination Reason for Disapproval: 9 ~ Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber 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. - n-r~- -f- - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property 1 1 I IC /1 Q j~ 1 4-kt Location of Property It. Section , T (1 N- R W Township lC~Lr►~-~f Mailing Address • ^ rYl`~ Lt +l t S j Q Subdivision Name,- , Lot Number Previous Owner of Property Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes_ No Volume 11511 and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: Warranty Deed 2. Land In ract 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. PROPERTV OWNER CERTIFICATION I (We) eenti6y that aft 6-tatement6 on .th,i.,s 4o4m ane tAue to the be6-t o6 my (ouA) knowledge; that I (we) am (cute) the ownen(6) o6 the pnopeAty de,6c ibed in .th,i.6 in6o4mattl on 6oAm, by viAt e o6 a wa4Aa.nty deed %e o4ded in the 066ice o6 the County RegiAteA o4 Deed6 a6 Document No. 0 ; and that I (we) pnee entt y own the pnopob ed 6ite 6oh the 6 ewage pob 6 ys-tem (o4 I (we) have obtained an easement, to n.un with the above de6enibed pnopexty, bon the conb.tAu.ction o6 baid 6y6.tem, and the same has been duty Aeeon.ded in the 066iee o6 the County Re "'t, 06 Deed6, a6 Document No. ) SIG ATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) X c4f h J/ l DATE SIGNED DATE SIGNED H H a S T C 105 r" r a SEPTIC TANK MAINTENANCE AGREEMENT H 0 St. Croix County z a OWNER/BUYER _CIZj S ROUTE/BOX NUMBER K~ Fire Number CITY/STATE 5 6 _VN_ t~ v"~ 7.IP PROPERTY LOCATION: Section, T>C N, R W, tl Town of fr/ChV7I G' St. Croix County, Subdivision Lot number 1. I 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 to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- b ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. 9~ ~ \I `SIGNED DATE ,1/7 41 St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 P.O. BOX 76 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATI UN.I SECTIpN:T T j/ Q OWNSHIP/MUNtCTFALITY: LOT NO.: BLK. N SUBDIVISION NAME: COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BED COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: ❑Residence ' New ❑Replace t - _ Jf ~I ~ RATING: S= Site suitable for system U= Site unsuitable for system ; -cm CONVENTI N L: M : IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ❑s u ❑u ❑ s ❑u ❑s u ❑s ❑u If Percolation Tests are NOT require DESIGN RATE: If any portion of the tested area is in the under s.H63.09(51(bl, indicate: Floodplain, indicate Floodplain elevation: T'L PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH iro, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- B- B' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER t>S AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD 2 PERIOD 3 PER INCH 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 horJ zontal and vertical elevation reference points and show their location o th pl t plan. Show the surface elevation at all borings and the direction and percent of land slope. V~ /7~i~~I(u~ ~ SYSTEM ELEVATION r . € f , r E i L f f. - --~-L1 - 1 1 3 - I, the undersigned, hereby certify that the soil tests reporte on this form were made by me in accord with the procedures and methods specifie in the isconsin Administrative Code, and that the data recorded and NAME.4print): ) TESTS WERE COMPLETE ON: A ESCERTIFICATION NUMBER: PHONE NUMB R(optional): CST SI ATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ?il_ 7r'-S D-`95 (R. 02/82) - OVER y, s... a a a . . t`a li: t a, . .tt,_ C . zf,Hv )n Uhc b.. _ S x" i1 I, h, e e f o, , t~ I., r".i Ez~t t t ca, i l Ji Sd" ,siu a .Fa„,~ 1, t rte?-".. N .3 rt taa; t t 1 'aa: f, -per i c J x- 3 ~ a e - t, a u Ea s ~ i z 1 s-e t ~ o ` Z p) ~ > O E Q. O c c-0 c 3 E -6 U -ca L•' N o v W' C W N ~H- ~ O° c p U) E L- CD _ Nt~ Co 0) >1 o~ c7~ o " '01 - - 0 0 U c voi ~ c0 ~ uj 3 :3 03 L E (~bJ cv)=m :30 I >o,cn o.- o \ H fit-- N rn~ tt= o CD m ~ G V N- O O E E (D t c 4) c a Q E G W m ~ ° 3: 0 :3 ° w N 3 rn IL N co CcU.- 'aN70 Q m S t C ca 0 r- 0 cc ~ N 0 o ai (D cn C: (D CD a) uo Q 3~ca w~~ vi o 0 (n m CL ,0 U ca cb~ c(C C O 3 o L O) :3 0 cr. O D U- L- ` O N (7 0 75 Q (1) fn O > 0 CM .0 U) U L- a) L cti O C'a O O N c i - N r ~ iO Cfj u 0 3 cZ >.=3 ~Z.c O-DO 5 O w ,n c =3 E r c c L Cad O L O ca O c C C,i O 0),- 7 o O U Z- E J~ ~L=~~- ULNO >1 cn (D a- ca cn -0 Q) _ co CIS ca w a) O C) - O o) Z U ~3:M O 3:~ N0Oa rn e. ° 13 N O N a) C a U ° t Z MY~coMO=3 on U.. a o" L W 2- co V V ~Y E N 3 C O i U c c i c0 cn y m O E N cn CO w F- 3= N cc J N C C yy~ ,;~y 46 0 Po~ FJ \ „1 > z Z- Z. 7 i ~V EN JJ i~ 32 -~2 fog nIA~ Flo<<~d i i -2n D PI b. # 60 •1/78 PROJECT DETAIL DATA SHEET NAME OF BUSINESS LEGAL DESCRIPTION 44 zel MAILING ADDRESS /I )J-Z I P ARCHITECT, ENGINEER, (~J)Zj ADDRESS PLUMBER 0R DESIGNER A, L TELEPHONE NUMBER 7fS S-/_ ~Sr 1. Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. 0()264 A Existing building New building Addition ` ( ) Apartments and condominiums . . . . Number of bedrooms ( ) Assembly hall . . . . . . . . . . . Seating capacity ( ) Bar . . . . . . . . . . . . . . . . Seating capacity # of meals served ( ) Bowling alley . . . . . . . . . . . Number of lanes ( ) With bar ( ) Campground and camping resorts . . . Number of sewered sites Number of unsewered sites Total number of sites ( ) Camps . . . • • • • • • • • . • . . ( ) Day use only Number of persons ( ) Day and night Number of persons ( ) Catchbasin . . . . . . . . . . . . . Number ( ) Church . . . . . . . . . . . . . ( ) No kitchen Number of persons ( ) With kitchen Number of persons ( ) Dance hall Number of persona ( ) Dining hall . . . . . . . . . . . . Number of meals served daily ( ) Dog kennels . . . . . • • • . . . . Number of enclosures ( ) Drive-in restaurant . . . . . . . . Inside seating capacity Car-service Number of car spaces ( Dump station . . . Number of dump stations Employees ( total of all shifts) Number of employees ,~3 ( ) Hotel ( ) Motel ( ) Cottages . . . . Number of units with 2 persons per unit Number of units with 4 persons per unit ( ) Medical and dental office bldgs. Number of doctors, nurses, medical staff Number of office personnel Number of patients ( ) Mobile home parks . . . . . . . . . Number of sites ( ) Nursing homes . . . . . . . . . . . Number of beds ( ) Parks . . . . . . . . . . . . . . Number of persons ( ) Toilets ( ) Showers ( ) Restaurant . . . . . . . . . . . . . Seating capacity ( ) Dishwasher and/or disposal? ( ) 24-Hour service (f Retail store . . . . . . . . . . . . Total number of customers ( ) Schools Number of classrooms Meals ( ) Showers ( ) Self service laundry . . . . . . . . Total number of machines ( ) Service station . . . . . . . . . . Number of cars served daily ( ) Swimming pool bathhouse . . . . . . Number of persons ( ) OTHER . . . (Specify) . . . . . . COMPLETE OTHER SIDE 2. Indicate whether the following facilities are present. Floor drain yes no Number of drains Food waste grinder yes no X Dishwasher yes no Automatic clothes washer yes no Number of clothes washers 3. Septic tank capacity D ,j Holding tank capacity Septic or holding tank manufacturer ,y,-s)F,~s ~,,Z - /aa 4. SEEPAGE TRENCHES: total square feet width of trenches /yirkt,,10 length of trenches depth number of trenches %0 SEEPAGE BEDS: total square feet width length of bed depth SEEPAGE PITS: total square feet outside diameter depth below inlet total depth from top to bottom of pit Sign re of pe son c mple ing form: FOR DEPARTMENTAL USE ONLY Address y j Zi / Telephone Number Date F WORKSHEET - MOUND SYSTEM DESIGN i PROBLEM: 8_tO0264 1 Design a mound system fora The site characteristics are_ Depth to groundwater or bedrock in. Landslope Percolation rate Q~ min./in. Distance from dose chamber to distribution system ft. Elevation difference between pump and distribution system q ft. Step 1. WASTEWATER LOAD -gal. Step 2. SIZE THE ABSORPTION AREA A) Area required = - / q /a_~/,fir/~~,y sq. ft. B) Bed or trench length (B) _ ft. C) Bed or trench width (A) a ft. D) Trench spacing (C) _ Wastewater load .24 gal/ft2/da B = ft. # trenc es y C' Step 3, MOUND HEIGHT A) Fill depth (D) _ _L ft. B) Fill depth (E) = D + % slope (A) ft. I y 3 C) Bed or trench depth (F) ft. D) Cap and topsoil depth (G) = ft. E) Cap and topsoil depth (H) = / ft. ,}.Idlld 4~ of ly t Step 4. MOUND LENGTH A) End slope (K) = CD + E + F + H x 3 x:99 ft. 2 B) Total mound length (L) = B + 2(K) _ ft. Step 5. MOUND WIDTH Al) Upslope correction factor A2) Upslope width (J) _ (D + F + G)(3)(factor) _ t -ft z~g Bl) Downslope correction factor = B2) Downslope width (I) _ (E + F + Gj(3)(factor) /.D(, 4- % 3 f C1) Total mound width (W) for bed = J + A + I ft. 3 x( l C2) Total mound width (W) for trenches = J + A + (no. trenches -1)(c) + A + I ft. 500264 Step 6. BASAL AREA A) Infiltrative capacity of natural soil =2gal./ft2/day B) Basal area required = wastewater flow natural soil infiltr tive c city sq. ft. Cl) /00 Basal area available for bed for sloping sites = B x (A + I) _ sq. ft. C2) Basal area available for trench for sloping sites = B X W j J+ A = sq. ft. C3) Basal area available for trench or bed for level sites B x W = sq. ft. 'Ole _.w:, C - ~S,3 ~s` ~ s Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. 2) Hole spacing in. 3) Distribution pipe length = ~in. 4) Distribution pipe diameter = in. 5) Spacing between distribution pipes = in. 6) Distance from sidewall to distribution pipe in. I 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe 2) Flow per pipe_ GPM 7C) SIZE MANIFOLD 1) Manifold is _ central/ end 2) Manifold length = ft. ~ 3) Number of distribution lines 4) Manifold diameter = in. a 7D) SIZE FORCE MAIN -A 264 i 1) Minimum dosing rate GPM 2) Force main diameter = J in. 3) Friction loss 7E) TOTAL DYNAMIC HEAD 1) Vertical lift = ft. 2) Friction loss = ft. 3) System head 2.5 ft. = S ft. 4) Total dynamic head ft. 7F) PUMP SELECTION 1) Pump selected will discharge) _ GPM at ft. total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME 1) 10 times vo) d volume of distribution lines a -J% gal./cycle oal) 2) Daily wastewater vol me 4 doses./24 hrs. _ gal./cycle 3) Minimum dose volume gal./cycle 7H) DOSE CHAMBER 1) Minimum capacity required gal. ` 62-6 Page 10 Straw, Marsh Hay, Or Synthetic Covering 4 Medium Sand Dist ribution.i. pipe Topsail sssrrssssss is-sa aaass~ru za. 0 3 E % Slope Trench Of 2 i Force.Main Plowed Aggregate From Pump Layer t' Undisturbed p r Soil E i Cross Section Of A Mound System Using F , z 3' Trenches For The Absorption Area G A Ft. H A gc Ft. Signed: l Ft. License Number: ,Z= J Ft.~ K ' Ft. 0 6 . Date : " _1 ? n`~~ A Alternate Position of Force Main C ~r Force ..•4'~~ . , s~ t_.. - - - ~ _ - - - - _ - - - - - - - • Main From Observation Permanent1 Pump Pipes Markers Disfributlon _ Trench Of % - 2 2 i Pipe Aggregate Mound Using 3 Trenches For Absor Area 1 j D- y I 0 0 K h ® 4,- i ~ _ _ - vH 11~ ~ ~Y J \nI vv) ~c0 t ' i i v O q ( r V U`;i`s?' , LP,30R Niu FIL, r ; 'RELATIONS . i t)Y is D ~ UfLDI(v G S t;' E CORRESRONDENCF-, j i~= a PIP- LAY Ci Distribution Lines ~diameter PVC ,T- - Lnd Cad.. , J TIONS \ 1`Ltii is i ,:~R AND HUMAN RELA rActs h ll`.r SAFE AidD 6 lLDiNGS C' ,,R--_ pCNDENCE /'diameter holes at bottom of DiDe ~YG/S i i diameter PVC oo Force i:ain l~ eft. long, diameter PVC t7 e- C-14P Po,)Ze I, ::O Scale 1114r 61-vs ' ~ PUMP CHAMBER CROS5 SECTION AND SPECIFICATIONS PAGE- pF r VENT c%P(d/V•~c"'-cC/~4%/'ae J 4"C.I, VENT PIPE WEATHER PROOF APPROVED LOCKING 25' FRCM DOOR, JUNCTION BOX MANHOLE COVER``rµ/a~.✓s.v~ WINDOW OR FRESH 12"MIU. AIR INTAKE GRADE I L - - I B"`M I IJ . COIJDUIT 8"MIN. \ 11~ I(\J I_.F= PROVIDE t~'ONIRTISHT SEAL ( I I E! I II APPRO'✓EC A APPRDVED .01I T5 PIPE' EXTENCIAJC• 3' y ED I I I W/ C. I. PIPE OFJTO S4:.ID Sc,,,. B l z~~:' t f I II ALARM OIJXTTO EIJ SDIUOLIGD SDIL. JEPAit 11, E-,1'i 0 LAS 2 AND DIN S RElAT1Uil C CC'Jl l I S •FE AND oN I I F, ,r . IE1CE _ I +t _ J E I SEE C_ °:~PUMP OFF D CONCRETE BLOCK RISER EXIT PERMITTED OIJLy IF TANK MANUFACTURER HAS SUCH A~P Pg?%\AN Ty- SPCC.IFICATIOPJS SL TIC AND ,O LOSE TANKS MANUFACTURER: i~ `1UMBER OF DOSES: _-_LL-___-___PER QAy TANK LIZE : - GALLONS r DOSE VOLUME ALARM MANUFACTURER: 1 f ~rnfC«-f JL INCLUDING BACKFLOW: GALLONS MODEL QUMBER:=-,/•~/ CAPACITIES: A- - / - 3S- INCHES OR _-r GALLOWS SWITCH TyPC; = h 5= INCHES OR GALLONS PUMP MANUFACTURER: t/ C = INCHES OR :Q GALLONS MODEL NUMBER: C D= INCHES OR GALLONS SWITCH TYPE: NOTE: PUMP AND ALARM ARE TO BE PUMP D15CHAR`E RATE GpM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEREAICE Bt"&'?WECAI PUMP OFF AND DISTRIBUTION PIPE., FEET + MtAIIMUM NETWORK SUPPLY PRESSURE , 2.5 • - FEET ~ _z Z11 + FEET OF FORCE MAIN X =---FjoFT.FKICTIOU FACTOR.. FEET -7-/< TC)TAL DYNAMIC. HEAD = FEET IUTERNAL. DIME WS10 F TANK: LENGTH --6~ ,WIDTH • LI ulo I r Q DEPTH SIGIJED: LICEKISE NUMBER: I. ~ / ~ DATE:,L-~~ i . Model 3870 Submersible Effluent pumps 140 r f a 120 "all p.ND HUMA~d RELATIONS too INDU`S' UILDINGS . D' OF r Np-NCE f v 80 i a d I IyP _u £ 757, I A4 c •A 70 0 60 F- I ~yP O> ~ I ~ GYP -40 05 -y. WP 20, 3;-'h-H.P!- 0 20 40 L- - 60 i 80 100 120 Capacity - Gallons Pei/Minute l \ HP. Order No. MWb Max. YVL A^rpe RPM Shcb (tbs.) WPO31IE WPMWPO -t1E 115 9.4 K WP-0312E 1750 - 56 WPMp312E 230 10 4.7 WPHM11E 115 ^ T ` WPHO512E 230 - ~ S4 8.0 WPHO532E 208!230 3.4 60 WPH0534E X60 30 1.7 WPH0712E :?30 lm 9.0 WPH0732E YO1i/230 5.4 WPHO734E 460 30 2.7 WPM1012E 1.'30 10 11.6 70 1 WPH1032E 20EE 3450 30 6. WPH7034E 480 3.2 2 WPHt512E 230 =1 33 WPM 1532E 20%/230 92 8 iK WF'M15UE 460 4.6 WPHH1512E 150 230 10 13.3 WPHM1532E 2081230 92 Ill WPHHt534E 4450 4.6 SPECiFICATIO1,S ARE SUBJEC=T TO CMAn1GE WITHOUT NOTICE 3 d ST.CROIX COUNTY t s ,.x WISCONSI N i~ 4 ~ r y yv ~A ZONING OFFICE 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, W1 54015 January 3, 1985 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site inspection was done on the Mike Faust property located in the SA of the NE14 of Section 4, T30N-R18W, Town of Richmond, St. Croix County, revealing no plysical limitations in the soil profile to a depth of 6 feet. However, because of the slow rate of permeability, it is recommended by this office that a mound system be installed utilizing the trench system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Thomas C. Nelson Assistant Zoning Administrator TCN:mj WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location SW 1/4, NE 1/4, Sec. 4 T 30 N, R _L& k{,&QW W Town iiyr Richmond Street Address Lot No. Block Subdivision Landowner's Name: Mike Faust The application for this site is for: x❑ new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: F to have one of the first five approvals guaranteed for this; year. This is number 59 - 01 - 6 of those applications. (Use one of the first five quota num ers 'issue -d you.) ]one of the applications needing a quota number. The quota number assigned to this application is - - for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. F Ifor 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. I_._, for an application on file prior to February 1, 1980. L_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. ❑ 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 Si gett u r e County Official Title Assistant Zoning Administrator Date January 3, 1985 DILHR-SBD-6158 (R 12/82) STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Townshipmay1w SW ~4 NE ~4 S 4 T 30 N/R 18 KhU~W Richmond St. Croix Street Address: Subdivision: County: Landowners Name: Mailing Address: Mike Faust Somerset, WI 54025 I (We), the undersigned, hereby make application for an alternative system on the above-described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19 Notary Public, State of Wisconsin DILHR-SBD-6413 (N. 05/81) My Commission Expires: