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Parcel 028-1042-40-000 01/23/2006 04:28 PM
PAGE 1 OF 1
Alt. Parcel 35.28.17.265B 028 - TOWN OF RUSH RIVER
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
CRAIG R & PATTY JO BAKKE O - BAKKE, CRAIG R & PATTY JO
1943 4TH AVE
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 21.000 Plat: N/A-NOT AVAILABLE
SEC 35 T28N R1 7W PT N1/2 OF THE SW1/4 Block/Condo Bldg:
INC PARCEL 265D
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
35-28N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/24/2002 684953 1933/156 WD
09/14/1998 587029 1357/049 AF
09/14/1998 587028 1357/047 LC
07/23/1997 859/138
more...
2005 SUMMARY Bill Fair Market Value: Assessed with:
83049 Use Value Assessment
Valuations: Last Changed: 08/30/2005
Description Class Acres Land improve Total State Reason
RESIDENTIAL G1 3.000 35,000 165,400 200,400 NO 05
AGRICULTURAL G4 10.000 1,400 0 1,400 NO 00
UNDEVELOPED G5 1.000 100 ~ 0 100 NO
AGRICULTURAL FOREST G5M 7.000 12,300 0 12,300 NO 05
Totals for 2005:
General Property 21.000 48,800 165,400 214,200
Woodland 0.000 0 0
Totals for 2004:
General Property 21.000 20,700 104,500 125,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 214
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 028-1042-50-100 01/23/2006 04:30 PM
PAGE 1 OF 1
Alt. Parcel 35.28.17.265D 028 - TOWN OF RUSH RIVER
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
CRAIG R & PATTY JO BAKKE O - BAKKE, CRAIG R & PATTY JO
1943 4TH AVE
BALDWIN WI 54002
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description ` 18,43 4TH AVE
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 2.590 Plat: N/A-NOT AVAILABLE
SEC 35 T28N R1 7W PT OF NE 1/4 SW 1/4 AS Block/Condo Bldg:
DESCRIBED IN 711/273 & INC LYING E OF
CTR LN OF FIRST ST OF PLAT NEW Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
CENTERVILLE; EXC W 485FT; & EXC HWY & 35-28N-17W
EXC PREVIOUSLY CONVEYED TO PURCHASER
ASSESSED W/028-1042-40
Notes: Parcel History:
Date Doc # Vol/Page Type
09/14/1998 587028 1357/047 LC
07/23/1997 711/273
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/13/1998
Description Class Acres Land Improve Total State Reason
Totals for 2005:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 0 0 0
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
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER i - / TOWNSHIP T,-Q8- N-R~W
ADDRESS ST. CROIX COUNTY, WISCON
10,14
C~l
SUBDIVISION t LOT LOT 1SI~7.+'., `rte
PLAN VIEW
Distances and dimensions to meet requirements of 'MR, 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
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c~ f
i
t ~,R P
~ of orq,
INDICATE NORTH ARROW
i
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point: / r Proposed slope at site:
SEPTIC TANK: Manufacturer: rjL)_)-, j, Li uid Capacity: <<~ q C)o
Number of rings used: Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front,Q Side,O Rear, O feet
From nearest property line Front, 0Side 10Rear ,0 feet
Y
Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER
Manufacturer: Liquid Capacity:
V- -c Mti t L
Pump Model: p, Pump/Siphon Manufacturer: Pump Size 5-
-T
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer:_ Alarm Switch Type:
Number of feet from nearest property line: Front,?ZIN ~N Side, O Rear, Ft. 1U
Number of feet from well: I a)ol~
Number of feet: from building: ,rte
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM i'~~C(. yr
Bed: A Trench:
Width: Lenth: Number of Lines: Area Built:
Fill depth to top of pipe:
Number of feet from nearest property line: Front, 0 Side, Rear,01?t. 2
Number of feet from well:
Number of feet from building:
i
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution box O been used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, O Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector: J(2
Dated: Plumber on job:e o m 1-P°
License Number : j l;(
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR
LABOR & HUMAN RELATIONS SAFETY & BUILDINGS
P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION
MADISON, WI 53707 BUREAU OF PLUMBING
E:1 CONVENTIONAL Iq ALTERNATIVE STare PIan I7DN-b,,
❑ Holding Tank ❑ In-Ground Pressure n a sgMound 85017NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER INSPECTION DATE
Craig Bakke Baldwin, WI 54002
BENCH MARK (Permanent reference 1-11 DESCRIBE IF DIFFERENT FROM PLAN
NE SW, Section 35, T28N-R17W, Town of Rush River REF. PT. ELEV. CST FEE PT ELEV
Name of Plummer
MP/MPHSW Nu Co~~nty Sa n,Tary Permit Nu miner.
Bennie Helgeson 3215 St, Croix 69634
SEPTIC TANK/HOLDING TANK:
MANUFACTIJfi _
r LIQUID CAPACITY IAtiK INI ET FLEV TANK OUTLET ELE WARNING LABEL LOCKING COVER
PROVIDED PROVIDE D
BEDDING vENr DIA. VENT MAT L HIC,R warF FI ( OYES O NO O YES ONO
01 ALARM NUMBER OF ZROADPROPERTY WELL. BOI LDING VENT TO FRESH
L_~ YES ~ . O FEET FROM LINE / IaIR INLET
YES _ NO NEARESTI ~1/
DOSING CHAMBER:
MANUFACTUHFR 7BEDDING L IOU D"APA(IV AG LABEL LOCKING COVER
y~ J PROVIDED
I / ES NO a~ YYY / ONO /iYES ONO
GALLONS PER CYCLE: PUMPANOCONTROLSOPEHATTONAL UMBER OF jtVsAD
BUILDIN(, VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM AIR INLET
PUMP ON AND OFF) OYES ONO NEAREST--SOIL ABSORPTION SYSTEM. C eck the soil moistureat tKe depth of plowing 1 AIIE I AND MAHKIN(,
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 LENGTH No of nlsn+ Nn f SPAT
T "(IIFS rrar-;iuE ulA =PIr; DEPTH
DIMENSIONS ArfRlnl_I PIT DEPTH
GRAVEL DEPTH FILL DEPTH DI STH PIPE UISTH PIPE DISTR. PIPE MATERIAL NO UISiR
BELOLN PIPES ABOVECOVER EIFV INLFI FLEV INEI NUMBER OF~ =PROPERTY WELL BUILDING VENT TO FRESH
1 PE FEET FROM AIR INLET
JNE~REST_~
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-
YES ONO meets the criteria for medium sand. TIONS MEASURED.
O
SOIL COVER TExrLJRE
PFRMANTNI nnnHx,flls ors FRVAnoNwELLs
OFPTHOVEH rHENCH BEO JDEPTHOVFH nTENCH BFU 1-1YES ONO OYES LCHED ONO
CENTER j PTrI"F T(JPSl 1IL ScIITDEI) SEF UFI) MU
EDGES
OYES. ONO OYES ONO OYES ONO
PRESSURIZED DISTRIBUTION SYSTEM:
W
BEDITRENCH IDTH LENGTH NO.OF LATFHAL SPACIN(; GRAVEL UEP TH BF L(IlN NIVI - FILL DEPTH ABOVE CO VEH
TRENCHES
FDIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR.PI PE M A N I F O L IJ M A T E H I AL NO I)ISTH f;ISTH PIPE DISTRIBUTI ON PIPE MATER IAL&MARK ING
ELEVATION AND FLEV E{ V , DIA ELFV PIPES oIA
DISTRIBUTION !
INFORMATION HULE SIZE HOLE SPACING `RILLEOCOHHFCI I CO VER MATER IAL
VEH I flAL LIFT CORHE SPONDS TO APPROVED
Pt ANS
YES ONO
OYES" ONO
COMMENTS; PERMANENT MARKERS: OBSERVATION WELLS NUMFBER ROM OF LINE PROPERTY WELL. BUILDING.
FEET
OYES NO _ YES i _ NO _ NEAREST- -
Sketch System on Retain in county file for audit.
Reverse Side. y
SIGNATURE. - TITLE' -
DILHR SBD 6710 (R. 01/82)
M Wisconsin 'M APPLICATION FOR SANITARY PERMIT
DILHR P COUNTY
ml~~ p6PRRT7-nEnT OF LB 67) UNIFORM SANITARY PERMIT #
- InpUSTR V,LRBOR6 HUTRn RELRTIpnS
1 1 69, .
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/zx l l inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
%
PROPERTY OWNER ) i MAfLI AJJ RESS
PROPE Y LOCH ION CITY:
14)1/4, S T,28- N, R / 'Sdyr) W Td
WIN 0 -5 /7
C,[ c~Zi-
LOT NU qER BLOCK NPMBER SUBDIVISION KLAME -TrqFAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
TYPE OF BUILDING OR USE SERVED 6 ~a ~d
~y1 or 2 Family Number of Bedrooms. Public (Specify):
THIS PERMIT IS FOR A:
XNew 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
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
Septic Tank Capacity ~r
Lift Pump/Siphon Chamber
Manufacturer.
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
D X Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name o71) mber (Print): Ile,
SMP/MPRSW No.: Phone Number:
r
Plumber's Address: Ll Poo- Name of Designer:
<zq
°S f i, r .G/ dc.
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: at e:
t ❑ Disapproved
l L ix j[D
El Owner Given Initial
ix 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
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 description, please circle the appropriate municipal government unit, (whether this is in
a city, village or town);
2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant,
etc.) ;
3. Complete the block for conventional or alternate system depending 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 by code and the number of
square feet to be installed;
5. Complete the section on water supply;
6. PRINT the name of the master plumber or master plumber restricted who will 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 business phone number in the blank provided, if there is a problem or question this will speed review of the
permit;
8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation.
Failure to comply will void the sanitary permit.
9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable.
10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system,
depth of the system, type of system.
11. All revisions to this permit must be approved by the permit issuing authority.
12. A complete plan including a plot plan, drawn to scale or with complete dimensions.
13. Horizontal and vertical elevation reference points that are permanent and clearly shown.
14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s)
to system, building sewer and vent observation pipe(s).
15. The permit issuing agent may require a cross section drawing of the effluent disposal 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 pumper 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.
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
Location of Property Section T N _ R / W
Township
Mailing Address
Subdivision Name
Lot Number >>qq -
Previous Owner of Property 1C ~ k lc~ - -
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 k No
Volume and Page Number -~2 as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
1. Warranty Deed
2. Land Contract
3.• Other recordings filed with the Register of Deeds Office
In addition, a certified survey, if available, would be helpful so as to avoid delays
of the reviewing process. If the deed description references to a Certified Survey
Map, the the Certified Survey Map shall also be required.
PROPERTY OWNER CERTIFICATION
I (We) ee4ti..6y that aU statements on th,i,s 6onm ahe t&ue to the but o6 my (ouh)
knowledge; that I (we) am (are) the ownen(s) o6 the pnopehty ducAi.bed in .th,iA
in6o4mati,on 60nm, by viAtue o6 a =,,a. deed neeonded in the 066ice o6 the
County Reg•ie•ten o6 Deeds as Document No, and that I (we)
pnesentey own the proposed site bon the ewage po6 6 yb-tem (on I (we) have
obtained an easement, to nun with the above duni.bed pnopenty, bon the
eon,6t4uc.ti,on o6 eai.d 6y4tem, and the dame has been duty neeonded in the 066ice
o j the County Reg.i,s.ten o6 Deeds, ab Document No.
SIGNA RE OF OWNER SIGNA CO-OWNER (IF APPLICABLE)
DATE SIGNED DATE SIGNED
H
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STC - 105 r
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SEPTIC TANK MAINTENANCE AGREEMENT H
St. Croix County °
z
r7
OWNER/ BUYER l ,~C'A'~CI c~._ L ~ H
r~
ROUTE/BOX NUMBER~1 2 Fire Number
CITY / S T A T E Z I P
PROPERTY LOCATION:~~./ Section 2Z- , T~,~ N, R l7 W
/y;~ ,I
Town of oaS),2, K\\) , 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
to maintain the private sewage disposal system in accordance with x
the standards set forth, herein, as set by the Wisconsin Depart- v
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
SIGNED
DATE-
St. Croix County Zoning Office
P.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, DIVISION
LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969
f-VUNLAN RELATIONS 1 / MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: S7TTII TOWNSHIP/N40 tfe AT7TY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
V 1/4$ T N/R r W COUNTY: BUYER'S NAME: MAILING ADDRESS:
`USE < f 4'/
NO. BEDRMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE
Residence QNew PROFILE DESCRIPTIONS. PERCOLATION TESTS:
❑ Replace
RATING: S= Site suitable for system U= Site unsuitable for system L`7 c* ~Y i ! < ~i C
CONVENTIO~VL:M ZOU D:OUN soPRESS uUSYSTos EM-IN-F ®u LHOLDIN TTANK: RECOM /M0 6j
END DSYSTEM:(optional)
os os auk ❑ os ou
1
[under Percolation Tests are NOT required DESIGN RATE:
If any portion of the tested area is in the f
s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: 7
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
4 r f' F'L s. s 1
46 '06 Ai A- '-PrQ e+q.
Al c,t
fill B- rs
is ,4 d A, 5 * c t- -
B y .3•.`I' /l ~c 01S:!~5 .s'.4AF..-s:
B 7 G-smss,' / 6 ' f3., If anJ. 4,
D R,, Se- zI A 'n 'h'C
B /M./Ts 7 ;~rP., S,/1L S CCU
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. RATE MINUTES
PERIODI PERIOD2 PERIOD3 PER INCH
P_
P- f--
P- -
P-
Rk n I:~Y our
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.
SYSTEM ELEVATION l y
, y
7 e.a. ✓ / ~i"f /r Y \
- -w
iAL-
4___4
,
- _ r
_ ~ TN
BORING TOTAL DEPTH TO GROUNDWATER-INCHEc
NUMBER DEPTH IN, ELEVATION : IARACTER OF SOIL vu,"(F; %OLOR ;SURE, A,1 D rr I
OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
5;/ Ty SIr L
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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): l/ le4
TESTS WERE COMPLETED:
ADDRESS: ~
/ CERTIFICATION NUMBER: PHONE NUMBER (optional):
/ f J') S
22 y CST SYIGNTURE: ~ -
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
Dl!._HR-SBD-6395 (R. 02/82) OVER
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Safety and Buildings Division
PLAN APPROVAL Bureau of Plumbing
D I L H R P.O Box 7969
Madison, WI 53707
❑ General Plumbing Plans Telephone: (608)266-3815
❑ Private Sewage Plans
OFFICE USE ONLY
E ?y Plan Identification No.
Gallons Per Day eal
s
PRIORITY PLAN REVIEW ONLY
Plan Review
Petition For Modification
Project Location - Street No. or Legal Description
Project Name
Count
❑ City ❑ Village El Town of:
The plumbing plans and specifications for this project have been reviewed forcom The pplliance with apppedble cditi Wally quirementpproveds. approval is
based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Cod req
the is contingent upon compliance with any stipulations shown on the lnThellicensed plumber responsible for th is insdtal alt onrshall keeprond bset of
city, village, township or county shall be obtained prior to construction. 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 Sargent7
Bureau Director
Date AppIf Questions Plans Approved By: roved: ♦ `
cc: ❑ OWS ❑ DPS ❑ H&R & Rec. San. Section
❑ County ❑ Local PI ❑ Facilities Need Analysis Secticr
❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture
Owner ❑ Other
DILHR-SBD-6099 (R. 01/84)
ST. CROIX COUNTY
WI S C 0 N S I N
ZONING OFFICE
796-2239 (HAMMOND)
425-8363 (RIVER FALLS)
HAMMOND, WI 54015
May 7, 1985
Division of Safety and Building
Bureau of Plumbing
P. 0. Box 7969
Madison, WI 53707
RE: Craig Bakke report, state plan 85-01794
Dear Sir:
An on site investigation for the Craig Bakke property located in the
NEB of the SW34 of Section 35, T28N-R17W, Town of Rush River, St. Croix
County, revealed suitable soils within the system area. B#2 at a depth
of 2.2 feet, B#3 at a depth of 2.6 feet, and B#8 at a depth of 2.5 feet,
below which seasonable high ground water was noted.
This site should be suitable for a mound system.
Should you have any further questions, please feel free to contact this
office.
Thomas C. Nelson
Assistant Zoning Administrator
TCN:mj
k
x
ST. CROI X COUNTY
WI S C 0 N S I N
ZONING OFFICE
= - 796-2239 (HAMMOND)
425-8363 (RIVER FALLS)
HAMMOND, WI 54015
April 24, 1985
Division of Safety and Building
Bureau of Plumbing
P. 0. Box 7969
Madison, WI 53707
Dear Sir:
An on site investigation for the Craig Bakke property located in
the NEB of the SW-4 of Section 35, T28N-R17W, Town of Rush River,
St. Croix Croix County revealed suitable soils at a depth of 1.3 feet:,
below which seasonable high ground water was noted.
This site should be suitable for a mound system.
Should you have any questions, please feel free to contact this
office.
Sincerely,
0 11)
Q bin" L"
Thomas C. Nelson
Assistant Zoning Administrator
mj j
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: Towns hip
NE 14 SW ~ S 35 T 28 N/R 17 ~¢~W Rush River
Street Address: St.. Croix
Subdivision: County:
Landowners Name: Mailing Address:
Craig Bakke Baldwin, WI 54002
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:
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 NE 1/4, sW 1/4, Sec. 35 T 28 N, R 17 Axe=) W
Town XKX2KMft4TM3A X Rush River Street Address
Lot No. Block Subdivision
Landowner's Name: Craig Bakke
The application for this site is for:
® new construction use.
❑ replacement system use.
If this is NEW CONSTRUCTION USE, the alternative private sewage system is:
kA to have one of the first five approvals guaranteed for this year. This is
number 59 - 03 - 6 of those applications. (Use one of the first five
quota num ers-issued to 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 for an individual lot for which a sanitary permit was issued but was later
ruled unsuitable due to new or changed soil criteria established by the,
department.
[_,.]for an application on file prior to February 1, 1980.
L]for a lot that meets the criteria for a conventional private sewage system.
If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is
replacing:
❑ a failing conventional soil absorption system.
Fla 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 ure
County Official
Title Assistant Zoning Administrator Date April 24, 1985
DILHR-SBD-6158 (R 12/82)
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H:ELGESON TRUCKING. INC.
N Spring Valley', Wis~~~>~~sv7 54767
APR 2 2 11
e I
Oct/ Nay z
Ott
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P S r i S I T L~t'~, .;?J RELATION!
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:eds. ! CC i t
Page Of
Straw Marsh Hay, Or
Synthetic Covering
Medium Sand Distribution Pipe
Topsoil - - H = ~o
---._1 i F
3 E D
J % Slope
Bed Of
2 2 Force Main Plowed
Aggregate From Pump
Layer
DEPA;, )F € IDU, i !_h AND iivl5 OF 1F ;~D 1Lu1~tiUS
D ' Ft.
Cross".-Section Of A Mound System Using E
Ft.
A Bed For The Absorption Area F Ft.
G Ft.
Signed: A ) Ft. H -fir C _ Ft.
License Number: Ft.
Date: K Ft.
7 Ft.
HELGE SON TRUCKING, MCy. Alternate Position J S~ Ft.
Spring Valley, 11V'.isconsiA 54767 of T ' . Ft.
APR 2 3 1985 Force Main W Ft.
Observation Pipe
Force Main
Distribution i
Pi --'~Bed Of z - 2 L
Pe
Aggregate
Observation Pipe
CvJ Permanent Markers
Plan View of Mound Using A Bed For The Absorption Area
0`
Page
~yr n \
~J
b A.
Porfcirated Pipe Oetoll
End View
Perforated j
PVC Pipe
End Cupf .
rG0 Holes Located On Bottom,
Are Equally Spaced
~I R. I
1<{v~e l`72r Lei {rca
411S l'~c~~L rn ~r~C~Ccir
PVC Force Main /
F,om. Pump
Y/
~Momfold~Pipe
j7-_
Alternate Position C'
Cslribot~on
Pi e Force Main From Pump
~ v
` -J
Lact Hole Should Be
Next To End Cop 't
End Co C;stribt~llon ripe i..oyout
R
S
X
yyl Y _
Hole Diameter Inch
' r1 Signed: - Lateral Inch
License Number: Manifold 11 Inches
-
Date: %C _ Force Main Inches
HELGESON TRUCKING. INC.
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F, 8-
' Spring Volley'. Wisconsin 54767 i L
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tied: t t- J i9 5 A./~4%F '✓7i'v ~YGV'~7i7~7/'/
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PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS PAGE OF
-
VEIJT CAP A r~~
H"C.Z. VENT PIPE 7`I/oe J t
WEATHER PKOOF APPROVED LOCKIAJG
25' FRCM DOOR, JUNCTION BOX MANHOLE COVER`-VV/G,,,,' A/ 1
WINDOW OR FRESH 12"MIU.
AIR INTAKE
GRADE
~ I
~ 4" MIAJ
----L.__
CONDUIT
IMLET PROVIDE 11,
AIRTIGHT SEAL ~
APPROVED JOINT A
W/C.I. PIPE Cs ~ ~G' 1., f I APPROVED JONTS
EXTENDING 3' W/C.T. PIPE
OWTO SOLID SOIL ALARM EXTENDING
8 ONTO SOLID SOIL
ME-NI OF LA33N AND HUNT/
C 'DIv;' iQF SAFETY AND BUILD ; I ON
SEE CORR -S~;~~- Pt~NkP--~--J
OFF
D CONCRETE BLOCK
IJ85))
RISER EXIT PERM1TfED GUL9 IF TANK MAIJUFACTURE.R HAS SUCH APPROVAL
` J -
SEPTIC AND L~=~~/ I C SPECIFIGATI~t~1S ,
DOSE TANKS MANUFACTURER: OL) i S r
_ WMBER OF DOSES: PER DAJ
TA"K. :,IZE: GALLOUS 4
DOSE VOLUME: GALLOK15
ALARM MANUFACTURER: _t0 Srcw, C
t CAPACITIES: A= A IIJCHES OR GALLOtJS
MODEL NUMBER: /1/2/ /4 L
B= INCHES OR GALLONS
SWITCH TYPE: r
PLIMP MANUFACTURER: _ INCHES OR GAl LOIJS
INCHES OR GALLONS
MODEL AJUMBER. "I
M NOTE: PUMP AND ALARM ARE TO BE
SWITCH TYPE: IUSTALLED ON SEPARATE CIRCUITS
PUMP DISCHARGE RATE LY -GPfA
VERTICAL DIFFERENCE BETWEEM PUMP OFF AND DISTRIBUTION PIPE.,
+ MIILIIMUM NETWORK SUPPLY PRESSURE , FEET
2.5 FEET
:a-S.L FEET OF FORCE MAIN X Fy
;FEET ~~C~~ OUP 1~ ,~n,>
IOOFTFRICTIOU FACTOR..
-21
R
TOTAL 09MAMIC HEAD ~ Q
`:~4Sti~ P
FEET
INTERNAL, DIMEMSIONS OF TANK: LENGTH
;WIDTH - LIQUID DEPTH .
SIGP.IED:
V e ' LICEMSE DUMBER: _„_J
SAT E:
ri
-HYDR-0-MRTIC SECTION 210
PUMPS DIMENSIONAL DRAWINGS
& PERFORMANCE DATA
MODEL: SP40A SUBMERSIBLE SEWAGE PUMP-MAX. SOLIDS 11/4" SPHERE-1750 RPM
TOTAL - it. No. 213.3 703
HEAD
°/,o HP MOTOR
IN FT.
24
22
20
18 -
16
14 -
12
- j - - - - - - FULL LOAD
8 - AMPS AT1 (b 115V.
- - - { _ 9.4, AT 230 V. 4.7 r
6
- - TT _ FULL LOAD
4 AMPS AT 3 6 230 V.
2.72, AT 460 V. 1.36 -
2 -
OL
o 20 40 60 80 100 120 140 160 180
U.S. GALLONS PER MINUTE
492
MODEL: SP40A
~.p0~i s R~{'iTlr'... 4 69/16 ~l
i J U61 "
`B
! a1 " j", !
l)
SP o. 0
51/8 O 515/16
O
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O~
4
O
111/a -51/6
2 STD. PIPE
45/16 Owner-Criag Bakke
Plb.-Bennie Helgesen
MPRS 3215
HELGESON TRUCKING, I= 9 4
Spring Valley. Wisconsin 54767
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