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HomeMy WebLinkAbout030-1029-80-000 0 m f m° c d `+1 0 3 w nl. ~ a T^ 1 Q) ' V 3 >v 3 - cn -1 z z ° ° 0W `C • N O N !n O W 7 C- N ICI co CD O 7 3 , N O Cn N O Z d (b p O N 1 tA\ _ co = - co tU N N N O :3 u Co (D x O C CD n O W O R O r. 3 7 y O O o C N C p O G =d w 9 co D a 0 n1. rl Z m co m~ o q m t.0 v rn :3 OD CL Q b O O C a = o o :3 W N (D p Z 3 o "It O Z~ 0 ri 0 N N d l\~ (D N V < N CD to n r N ~ p H N 00 CC) fn O C j < rr U til ~ U, CD l~l 00 z O O OC C O. ~ -D * c C G O < N z 3 N N P C) W D v v v v o ~ A D en C7 M CAD o H v = a d ~ r a - N d N O D D o O 0o m O t+l CD o tv y y I t~l v N ~ 00 Z D In o ,,0 W CD n cn CD En cn (D z A Z 0 (n ;o b rt =h A z O o ri H. v (D 0 O ';:j O z J (D CO U1 (D N ~I W < CND b W z 0 3 a A O ' z cD m z CD A W D CL O T z a o m N ~ A A A A N A N O O CT A O CD , o O CD o 00 f- ti 01/23/2006 04:59 PM Parcel 030-1029-80-000 PAGE 1 OF 1 Alt. Parcel 07.29.19.1081 030 - TOWN OF SAINT JOSEPH ST. CROIX COUNTY, WISCONSIN Current X 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 - HANSON, KEITH A & VICKI L KEITH A & VICKI L HANSON 1091 GOLDEN OAKS DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1091 GOLDEN OAKS DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 5.050 Plat: N/A-NOT AVAILABLE SEC 7 T29N R19W NW NE & IN NE NW LOT 23 Block/Condo Bldg: IN CSM 1/86 Tract(s): (Sec•,Twn-Rng 40 1/4 160 1/4) 07-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 716/569 2005 SUMMARY Bill Fair Market Value: Assessed with: 83365 266,400 Last Changed: 07/07/2004 Valuations: Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.050 100,100 142,200 242,300 NO Totals for 2005: General Property 5.050 100,1000 142.,200 242,3000 Woodland 0.000 Totals for 2004: General Property 5.050 100,100 142,200 242,3000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 206 Specials: Category Amount User Special Code Special Assessments Special Charges Delinquent Charges 00 0.00 0.00 Total Form-STC- 10-- AS BUILT SANITARY SYSTEM REPORT OWNER ! = - TOWNSHIP 6L 61' - SEC. T=ar LN-R~W ,Q ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to equirements of I1HR 83 SHOW LVER%YTHI G WIT HIN 100 FEET OF SYSTEM r tai r F V ✓ yiiDua~.1 i INDICATE NORTH RROW Ile BENCHMARK: Describe the vertical reference point used 4z ~J Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: 'quid Capacity: / - Number of rings used: 4/ Tank manhole cover elevation: - Tank Inlet Elevation: 5 Tank Outlet Elevation: Number of feet from nearest Road: Front 10 Side,yRear, 0- ~ feet From nearest property line Front,O Side„© Rear, O feet Number of feet from: well building: _'D? (Include this information of the above plot plan)( 2 reference dime"fisions to septic tank) SEE REVERSE SIDE A PUMP CHAMBER Manufacturer: 4 - Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: ) Pump Size - -17 Elevation of inlet: ' !C ~ Bottom of tank elevation: / Pump off switch elevation: 7 Gallons per cycle: / Alarm Manufacturer: 61f-'Alarm Switch Type: a Number of feet from nearest property line: Front, Side, O Rear, p Ft,L Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM P elll/110 Bed: Trench: Width: Length: ' Number of Lines: Area Built -46 Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, © Rear,O Vt. _ Number of feet from well: ' Number of feet from building: (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: Dated:L Plumber on job: License Number: 3/84:mj 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 statePlan D N tuber: ❑ CONVENTIONAL M ALTERNATIVE y~ (I1 assigned) D Holding Tank ❑ In-Ground Pressure M Mound 85-04066 NAME OF PERMIT HOLDER. ADDR ES$ OF PERMIT HOLDER: INSPECTION DATE Keith Hanson Box 209A, Hudson, WI 54016 „,Z ° 95 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV. NW NE, Section 7, T29N-R19W, Town of St. Joseph, Lot# 23 Name v( Plumber_ MP/MPRSW No. County Sanitary Permit Number_ Cal Powers 1563 St. Croix 69608 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET EI,E V.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COV R ti .,:f PROVIDED- PROVID D. f 11 /O 7.5 ES ❑NO ❑ YES ❑NO BEDDING: VENT DIA. VENT MATL. HIGH WA ER NUMBER OF ROAD PROPERTY WELL: BUILDING- ENT TO FRESH JALARM 7 / FEET FROM J J L ~y / 13 IV LET DYES NO ( DYES NO NEAREST DOSING CHAMBER: MANUF CTURER BE DUING: LIQUID CAPACITY PUMP MODEL Pl1 iSIPHON MANUFACTURER.. WARNING LABEL LOCKING COVER PHOy1DED. P IDED. DYESNO ~j I / 4 YES ❑NO F YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH LIN AIR LET (DIFFERENCE BETWEEN ~i FEET FROM .5` Y PUMP ON AND OFF) J YES ❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing JLENG111 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: WIDTH. LENGTH NO. OF DISTR. IPE SP6;C G COVER INSIDE DIA. #PITS LIQUID BED/TRENCH TRENCHES '1 AT ER IA L: PIT DEPTH. DIMENSIONS GRAVEL DEPTH FILL DEPTH JDISTF PIPE DISTR. PIPE DISTR I AT I No. DISTR. NUMBER OF PR OPERTV WELL. BUILDING. VENT TO FRESH BELOW PIPES ABOVE COVER ELEV. INLE i ELEV. END'. PIPES FEET FROM ,LINE. AIR INLET. NEAREST ((J(J (/I✓1 MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. KY ES ❑NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS u YES ❑NO SJYES ❑NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH~BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED. CENTER / EDGES. Q . S DYES NO YES ❑NO YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH. NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH F TRENCHES: f DIMENSIONS P -d MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. IDISTR PIP DISTRIBUTION PIPE MATERIAL & MARKING. ELEV. EL V DIA 2 ELEV PIPES DIA ELEVATION AND C, J 37 J, i:? 7 DISTRIBUTION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIA VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS t.f ~ YES L-~'1',/ES ❑NO WEL BUILDING. COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS : T- NUMBER OF PROPERTY L FEET FROM uN YES ❑ NO YES ❑ NO NEAREST &lo - 13 93 j O;,- cr it V '~5 7C Sketch System on~ Retain in county file for audit. Reverse Side. SIGNATURE TITLE,. r DILHR S B D 6710 (R. 01/82) a Mm"Mmm"'iiiir Wisconsin ~ ~ 1 L APPLICATION FOR SANITARY PERMIT HR oERRRTTEnTOC (PLB 67) COUNTY - In UUSTgy, LRBCIq 6 HUTgn RELRTIOnS UNIFORM SANITARY PERMIT -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system on a , L -See reverse side for instructions for completing this application. PLEASE PRINT p per not less than 8/zx 11 inches in size. PROP Ty OVV ER \I~ MAILING ADDRESS PROPERTY LOCATIONSa Y~ l~ CITY: /Z (N 1/445 1/4, S Ta q N, R ~(Or) W LOT NUMBER BLOCK NUMBER SUBDIVISION NAME TOWN OF: - EARES ATVDMARK N STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms: ❑ Public (Specify): THIS PERMIT IS FOR A: New System ❑ Replacement Soil Absorption System Tank Replacement ❑ Repair Alternate System ~ Revision ❑ Privy Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench System-In-Fill ❑ Seepage Pit ❑ Holding Tank ❑ In-Ground Pressure ❑ Vault Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # ❑ Pit Privy ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions, issued Total # of Prefab. Gallons Tanks Site Septic Tank Capacity Concr Constructed Steel Fiberglass Plastic Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COi TE THIS BLOC Mound ❑ In-Ground Pressure Total #ot Prefab. Gallons Tanks Site Septic Tank Capacity Concrete Constructed Steel Fiberglass Plastic Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA (Minutes per inch): REQUIRED ABSORPTION AREA (Square Feet): PROPOSED (Square Feet): WATER SUPPLY: L/~ Private ❑ Joint ❑ Public 1, the undersigned, hereby assume responsibility for installatio of the private sewage system shown on the attached plans. Name Plumber,(Pri Sig ure: tl I l11 1n 0 we r5 MP/MPRSW No.: Phone Number: Plumb Address: I C ()~S ) Y4- N~J a~~G`yyy~ /I S Name Or Designer: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: t Fee: Date: ,~I ~ ~ ti~ ❑ Disapproved Reason for Disapproval: ❑ Owner Given Initial XApproved pproval; Adverse Determination 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. i e size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) 14. Piping detail including p p 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 ecessa must be properly maintained. Have a licensed pumper clean your septic tank whenever DI State of W scoly every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, Safety and Buildings Division PLAN APPROVAL Bureau of Plumbing D' L H R P.O Box 7969 N,......,a,..,..,,, ❑ General Plumbing Plans Madison, WI 53707 ❑ Private Sewage Plans Telephone: (608)266-3815 OFFICE USE ONLY YG'~ Plan Identification No. • ► 19, Gallons Per Day ht.. . r - PRIORITY PLAN REVIEW ONLY Plan Review Petition For Modification $ Project Name Project Location - Street No. or Legal Description County ❑ City El Village 1-1 Town of: The plumbing plans and specifications for this project have been reviewed for compliance with ap i b e c is 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 ❑ DPS ❑ H&R & Rec. San. Section ❑ County ❑ Local PI ❑ Facilities Need Analysis Section ❑ UW-SSWMP ❑ Plumber ❑ Department of Agriculture DaHR-sBQ-6099 (R. 011/84) ❑ Owner ❑ Other ~•s~~~ lr~.c, s-~J/G WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design a mound system for a / The site characteristics are. Depth to groundwater or bedrock ~7_ in. Landslope X Percolation rate min./in. Distance from dose chamber to distribution system ft. Elevation difference between puirp and distribution system / S ft. Step 1. WASTEWATER LOAD 3 _ p gal. Step 2. SIZE THE ABSORPTION AREA A) Area required - B) Bed or trench length (B) _ ft. C) Bed or trench width (A) ft. D) Trench spacing (C) _ Wastewater load .24 gal/ft2/day B = # trenc yes C ft. Step 3. MOUND HEIGHT A) Fill depth (D) ft. B) Fill depth (E) - D + % slope (A) a f t. I t(, 03X C) Bed or trench depth (F) _ ft. D) Cap and topsoil depth,(G) ft. E) Cap and topsoil depth (H) ft. Step 4. MOUND LENGTH A) End slope (K) _ (DR + E1 + F + H x 3 ft. 2 / , B) Total mound ength (L) = B + 2(K) ft. Step 5. MOUND WIDTH Al) Upslope correction factor A2) Upslope width (J) _ (D + F + G)(3)(factor) = 7,R ft. = 7,77 Bl) Downslope correction factor = /gyp B2) Downslope width (I) _ (E + F + G)(3)(factor) _ ft. Cl) Total mound width (W) for bed J + A + I ft. 78 ~'t 9.9.3 a 7S C2) Total mound width (W) for trenches = J + A + (no. trenches -1)(c) + 2 + I ft. Step 6. BASAL AREA A) Infiltrative capacity of natural soil gal./ft2/day B) Basal area required = wastewater flow natural soil infiltrative capacity = sq. ft. SDI , 749~~~r~.~y Cl) Basal area available for bed for sloping sites = B x (A + I) _ ~sq. ft. 4;~, s'X(~,r 9,9s~= 99~ s~ C2) Basal area available for trench for sloping sites = B W = J + A sq. ft. T C3) Basal area-available for trench. or bed for level sites - B x W = sq. ft. rye ~Sw i 5 ~'~:r (o - 17 WSJ 1 t Step DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. 2) Hole spacing = 3) Distribution pipe length = in. 4) Distribution pipe diameter .1~ in. 5) Spacing between distribution pipes in. 6) Distance from sidewall to distribution pipe = lg_ in. 7B) DISTRIBUTION PIPE DISCHARGE RATE 1)' Number if holes per pipe 2) Flow per pipe_ GPM 7C) SIZE MANIFOLD 1) Manifold is _ central/ end 2) Manifold length a_ ft. 3) Number of distribution lines 4) Manifold diameter in. 7D) SIZE FORCE MAIN 1 1 1) Minimum dosing rate = GPM 2) Force main-diameter = ~ in. ; 3) Friction loss ft. 7E) TOTAL DYNAMIC HEAD 1) Vertical lift = 11157 ft. 2) Friction loss ft. 3) System head 2.5 ft. ft. 4) Total dynamic head = ft. IyJP~SuJ 1 SF,,s rdir~E ~-/7-d'S' yPf 7F) PUMP SELECTION 1) Pump selected will discharge -7~ GPM at f.~ ft. total dynamic head. 2) Pump model and manufacturer i - d~h 7G) DOSE VOLUME 1) 10 times void volume of distribution lines gal./cycle /,j l ,09-~ X y,r.3o04-) _ 2) Daily wastewater volume . 4 doses/24 hrs. j ~ gal./cycle 3) Minimum dose volume gal./cycle ef . /779 7H) DOSE CHAMBER 1) Minimum capacity required 7,sD,i gal.6/1WV ~/f-LUuJ 0' CJ'~JE~C1• ~C IYI~~SG~ ~ S'~? ~~~./rsrr'otr N)d/~~ /,ls~c7To?gisJ~/9~J ll w, nn /~uaso"J G~Jr= ~S`5~vr/v ~~'i JT" 'JOsr/~l / y~i9TE [o ' 17 ~7,~ at .3~~Gt Irl~4,~1 ICA t. q V it ~..~Y✓..~ .--r I".t ItC /80 /Ok1•J ~d.~/J _ ~ Page Of Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand _ H _ G Topsoil F E D 3 ' 3 % Slope Bed Of 2r- 2 %2 Force Main Plowed ~ Layer Aggregate D Ft. Cross Section Of A Mound System Using E 1./9 Ft. r ~ `A Bed For The Absorption Area F 3 Ft. e.,:..i: i.. A _ Ft. H Ft. Signed: BFt. U6` License Number: K /n,3 Ft. L Ft. Date: 7- ~ J 7 R, Ft. Alternate Position Ft, of 4 Force Main W' Ft. 7 L4 L r_14Observation Pipe i3 K ----------------------4I Force Main r r Distribution Bed Of i - 2 %2 Pipe Aggregate t I N ~ , Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area 7 of I ' i 1 I'I LrI I f i j I I I ~ , t„ I. I t I W' . f V 7 f I •/T~/ ~~t.~1sa~J Page Of Perforated Pipe Detail n End Vier Perforated End Cop °l A0 PVC Pipe cos Holes Located On Bottom, ~Md.So S Are Equally Spaced R S P VC Force Main Q PVC Manifold Pipe Alternate Position Of Distribution Force Main Pipe Last Hole Should Nest To End Cap End Cap Distribution Pipe Layout P 32r-2rFt. R 3_ S_ X Inches i_5" = Y . Inches Hole. Diameter Inch Signed: ou- Lateral Inch(es) License Number: 1 ~l3 Manifold Q_ Inches Force Main Inches Date: # of holes/pipe /Ae_ • e F. Invert Elevation of Laterals2Z _Z Ft. _ e PAGE _2- OF~ PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VEUT CAP `I' C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUAJCTION BOX MAIJHOLE COVER - 25' FROM ODOR, WINDOW OR FRESH 12°MIU. AIR INTAKE I GRADE 41 I 4-L7"MIAJ. COQDUIT IN I_J7 7- PROVID€ I ~ AIRTIGHT SEAL APFR.O`✓ED JOINA s~ I III APPROVED JOINTS WlC.I. PIPF r F r?, ~"'a F" I I I W/C.I. PIPE EXTENDING. 3' ~t~ I I I. ALARM EXTENDIUG 3' ONTO SOLID SC' ~ ONro soup solL ~;~E.,.✓ I I o rJ C PUMP __j i1 OFF ~ D CONCRETE BLOCK RISER EXIT PERMI1rED O►JLy IF TAUK MAIUUFACTURER HAS SUCH' APPROVAL SPECIFICATIOUS SEPTIC AND DOSE TAIJKS MANUFACTURER: ~.)Eoc ti~ "/1 1" ~n qtr HUMBER OF DOSES: PER DAB TANK ;,IZE : GALLONS DOSE VOLUME 17S ALARM MANUFACTURER: 2_~. L~ _zen .4uSj A.- S_ ~e INCLUDING BACKFLOW: _ GALLONS MODEL NUMBER: - /,gCAPACITIES: A=oa WCHESOR -12YGALLDMS SWITCH TYPE: . = B=INCHES OR 3,19 GALLO►JS PUMP MAMUFACTURER: < p C=~I-!~L WCHES Oft MI-9 GALLOUS MODEL NUMBER: ,739 ,?D - D- _ INCHES OR ~ GALLONS SWITCH TYPE: L. NOTE: PUMP AND ALARM ARE TO BE PUMP DISCHAR`E KATC GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE B '?WrLLJ PUMP OFF AND DISTRIBUTION PIPE.. ZN-S_7 FEET + MIAJIMUM NETWORK SUPPLY PRESSURE . 2.5 FEET + 17R FEET OF FORCE MAIN X L~L.S_FYoiTFRICTIO&J FACTOR.. F, v; 77~Z2 -7 I~1 = TOTAL DyUAMIC HEAD = FEET y INTERIJAL D,MEUSIOJU TANK: LENGTH ;WIDTH ;LIQUID DEPTH _ SIGIJED: - LICENSE "UMBER. zlcl DATE:2S -117- i • -Model 3870 Submersible Effluent Pumps 140 - i 1 120 3 100 I ~t tr 1~ ` . ;;is f 80 pEF '-wG - - 75 7~ s~E s0?,RESr a 195 E -L ~ Wp 70 ! o~ h! - A 16" wP -40 OS h. - WP 03, 'h-H P. - - 20 _w 3; 'h-H.P i - 0 20 40 60 + 80 100 120 Capacity - Gallons PerMinute bmp Y1fl MP. Order No. VoRs Phase Artpe RPM Shcds (IDs-) WPO311 E WPM031IE 115 9.4 WPO312E 1750 56 230 10 ♦.7 WPMM12E WPHO51IE 115 K WPHO512E 230 8.0 WPHO532E 208/230 30 3A 60 WPH05UE 460 1.7 WPH0712E 230 10 9.D WPH0732E 208/230 5.4 30 WPH0734E 460 2.7 70 - WPH1012E 230 10 11.6 3450 t WPH1032E 2081230 30 64 WPH1034E 460 3.2 WPH1512E 230 10 13.3 C, WPH1532E 206/230 92 Q [ 1 X W PH 1534E 460 4.6 80 8 WPHH1512E 230 10 133 r WPHH1532E 208/230 92 360 l WPHH1534E 460 4.6 SPECIFICATIONS ARE SUBJECT TO CkIANGE WITHOUT NOTICE.. - 3 APPLICA`1 10N FOI: SAN iTA!ZY I T S T C _ 100 signed by the owner(s) of the in fui-1 and s of the permit only result in delays !'his application form is to be completed inadequacies will actor, (~~si'c• r developed. Any owner/contra • property being, intended issuance. for resale by is development be when the property Should this retained and completed should be ret deed recording. • house~l), then a second form -01 appropriate this office with the d and submitted to - - - - - - - - - - - - - - _ - R W T N Omer of property Sect ion Location of Property _1`~-` - Mil; ng Address - 3 C Subdivision Name I.ot Number T-1 Iej Previous Owner of property i'~,tal Size of Parcel - No U,{te 'Parcel was Created Yes ___Yes No Arc all corners and 1 of lines identifiable? _ ~ being developed for resale (spec house) of Deeds t. his !,r,!erty ~ 1 s . ~'~~f and Page. Number as recorded with the Register V.> 1 i!mc ONF OF nir FOLLOWING : INCLUDE WITH THIS n3'PLICATION~ _ Warranty Deed il,zd Contract- of Deeds office with the Register Ys filed avoid delays Or_l,<+r recording,- would be helpful so as to addition' ferences to a Certified Survey a certified survey, if available, If the deed description „ re (o the reviewing process. shall also be required. - - - I - - - - - - - - - - - - - - - - - - - - - M,11,, the the Certified Survey Map loon ) - - - - - - PROPERT`/ OG NFR CERTIFICATION - - o"Lm aAe tAue to the. be At m ~nyzhi~ that o a s temen 0v' .i.h 0 th----mare els the 7 l•~tlc 1 cen,ti Ud own.eA(~ 1 1~ the Ofi ce 06 tbia t 1 lwe. ) am l aAC) the eeonded tin av~,t ;ed n 7 1 (we) have fznvwl cdgc, vv_tue. 0{ a WI) and, - We) h (0n. 1 ,n{~0nma_ttion onm, by Decd cup ocumcn. sy em l 0n the. Cvu.n y R~,ov,;teA 0 > on he. - bed ~nopC,)aY the O~i~~ ee own the pnopOAed A i to - n eeonded in ~o n.un ,the. above. de~~ and the. samc h.as been, duXy ) ,,f~-tcune.d an cant/said,AyAtcm, evnlsthuctio 0 en 0~ viced~, a~ ocume.nt No. the. County Rcg / -OWNER (IF APPLICABLE) SIGNATURE OF CO -~1_GNATURF OF OWNER DATE SIGNED ED 1)~'r!,SGN H z H a r ST C- 105 r" a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z c7 a llII ~1 H OWNER/BUYER K el/n I ~g,\ ROUTE/BOX NUMBER ^ R Lox aocj Ar Fire Number_ CITY / S T A T E 1 A L & g k , ( Z . : t a ~ WY C Z I P PROPERTY LOCATION: /V,r-~ 14, Section, T~N, R W, I I Town of~ ~65~~Ph St. Croix County, Subdivision , Lot number o_• I Improper use and maintenance of your septic system could result in I its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic•tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to H three year expiration. E z I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- '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. X SIGNED yip ~~~~~udbt~ y DATE Gc~J^ 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. IN INDUSTRY, 0:+= REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS NDUSTRY, LABOR AND PERCOLATION TESTS 115) DIVISION P.O. BOX 7969 HUMAN RELATIONS ` J MADISON, WI 53707 (H63.090) & Chapter 145.045) [LOCATION: SECTION: T ,E Nr HIP/MUNI PALITY: LOT NO.:BLKO.: SUBDIVISIN NAME: / /T N/R (o9 - UNTY: OWN R'S BUYER'S A E: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCI L DESCRIPTION: PROFILE DESCRIPTIONS: 1PERCOLATION TESTS: Residence ? XNew ❑Replace I RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUN~`D: IN-GROUND M TANK: RE OMM DED SYSTEM: (optional) DS ~iESSURE:ISYSTEM-IN-FILLHOLE)IffU KU El S ZU DS ©U F Percolation Tests are NOT required DESIGN RATE: EFodplain, n y portion of the tested area is in the der s.H63.09(5)(b), indicate: indicate Floodplain elevation: PROFILE DESCRIPTIONS 7 BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH tN. OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- B- B- i B_ LB- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER LAIC+tES AFTERSWELLING INTERVAL-MIN. PERIOD1 PERIOD2 PE RI D PER INCH P- - l 3 P- AIOAIA- P- P- P P- PLOT PLAN: Show locations of percolation tests, soul 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 ~ -_~blG T.~srs t - _ scif,9ai~% - - - - - - - - - 90 - - - IN 7 I, the undersigned, hereby certify that 2dedand p rted on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the da~ : I cation of the tes ts are correct to the best f my knowledge and belief. NAME,(print : TESTS WERE COMPLETED ON: ADDRE CERTIFICATION NUMBER: PHONE NUMBER( optional): r , ,CAJ C rGN#1TURI DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - L- k ST. CROIX COUNTY WISCONSIN ZONING OFFICE 796-2239 (HAMMOND) - - ^j 425-8363 (RIVER FALLS) HAMMOND, WI 54015 June 25, 1985 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Keith Hanson property located at the NW4 of the NE4 of Section 7, T29N-R19W, Town of St. Joseph, St. Croix County, revealed suitable soils at a depth of 2.2 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Assistant Zoning Administrator mj 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: Township/Nooft ob . NE IT S 7 T 29 N/R19 & kV St. Jose h St. Cno-i.x Street Address: Subdivision: County: Landowners Name: Mailing Address: Keith Hanson 614 - 8th St. N. North Hudson WI 54016 I (Me), 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. 34gnature 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 1969, MADISON, WISCONSIN 53101 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location NW 1/4, NE 1/4, Sec. 7 T 29 N, R 19 kL W Town btx?%1ja 9yX St. Joseph Street Address Lot No. , Block Subdivision Landowner's Name: Keith Hanson The application for this site is for: fflnew construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: to have one of the first five approvals guaranteed for this year. This is number - - of those applications. quota num ers ssueT-to you.) (Use one of the first five ]one of the applications needing a quota number. The quota number assigned to this application is 59 - 10 - 6 for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. LI 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. Lla 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 lot meets the criteria for a conventional private sewage system, check here. 0 I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. Nelson ure County Official Sige-er Title AssistantZoning Administrator Date June 25, 1985 DILHR-SBD-6158 (R 12/82) ST. CROIX COUNTY WISCONSIN A; ZONING OFFICE 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 June 25, 1985 4, J Division of Safety and Building Bureau of Plumbing 7 P. 0. Box 7969 Madison, WT 53707 Dear Sir: An on site investigation for the Keith Hanson property located at the NW4 of the NE-14 of Section 7, T29N-1t19W, Town of St. Joseph, St. Croix County, revealed suitable soils at a depth of 2.2 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Assistant Zoning Administrator mj 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 1,ocation: Township/~)C~ ~ C NE S 7 T 29 N/R19 MCK)IW St. Joseph St. C1toiX street Address: Subdivision: County: Landowners Name: Mailing Address: Keith Hanson 614 - 8th St. N. North Hudson WI 54016 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. Sd,gnature 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 NW 1/4, NE 1/4, Sec. 7 T 29 N, R 19 llEk W Town WMM743"14"X St. Joseph Street Address Lot No. Block Subdivision Landowner's Name: Keith Hanson The application for this site is for: 0 new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: -Ito have one of the first five approvals guaranteed for this year. This is numher - - of those applications. (Use one of the first five quota num ersTued to you.) ]one of the applications needing a quota number. The quota number assigned to this application is 59 - 10 - 6 . ]for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. ]for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. [Afor an application on file prior to February 1, 1980. (__]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. ❑ 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. E] I certify that the above information is true and accurate to the best of my knowledge. Thomas C. Nelson $j ure Name Official Title AssistantZoning Administrator Date June 25, 1985 DILHR-SBD-6158 (R 12/82) 0 Z i O c _ a > 0 " c cu E c O c c cu a Ew0 c~ C°3 (D E c 'a CTJ 'a =3 C :4 y (D cn O) V O O a) co 0 p o C 0-0 O ~ a) > C 0) O U m H Y~c OIL w i O _N 3._ 0 vi (7~~ w 3: 0 ca -0 C a) cti C a! O ~3 oa0 E L- 10 co C-) Q m w 0 o 0 c_ _ (D 0 CU tU C V N N n 'C O y C a) 10 0 W = HccO m co a) E D a N 3 ~3 0 ° ` c c U cc c c U (D _ CU a) co LLJ 0~03~ L- a) Q Q c y cm w 0 w ai N a) (D E a) t U O • Z Q ~ f U ca t w m IL Q 3 cc 3 H- cn ca z m CO ante a)60 3 O 30° crn u0CD = co .r v.. O a t rn _C) U U R1 - U : O 0 U) 0 (D Q CL a~co co Ncr c C a) C: w v O .O c`v c J 3cZ scow 0 E O mZ E O RS C c-C O O cu O m o « C C C) (D co O 0 0 U v E U Y 0) C - CD 0) 0 N a) O a) d . w 'It cc CU Y co CU ~ rnc~~a3. 0pc~ .0 $ FR 3 (n U) . a) cn a) O a c O O a) C d a) w 0 a tl3mi o >,Y cn °'O'~ E c t z c O CD i i O Cl) C a) (D 3 `O n 0Ecvvic7n ~ - 3.~ m m CO) e = 0 DEPART,vl I F INDUSTRY, REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS LABOR AND P.O. BOX 7969 PERCOLATION TESTS ( / 115l DIVISION HUMAN RELATIONS (H63.09(1) & Chapter 145.045) ` MADISON, WI 53707 [LO CATION: SECTIONT WNSHIP/MUNI IPALITY: LOT NOBLK. O.: SUBDIVISION NAME: 14 - 1/4 ~ (o t~kSr N / p` UNTY: OWN R'S/BUYER'S A E: MAILING ADDRESS: f W-4 2 SO, 1) USE DATES OBSERVATIONS MADE NO, ~V~~~~~XNewEJ~R, (PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence place !I RATING: S= Site suitable f or system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTE -IN-FILLHOLDING TANK: RE OMM DIED SYSTEM: (optional) EIS [ZU ®S JU OS ©U OS ZU ❑S ©U If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(bl, indicate: Floodplain, indicate Floodplain elevation: 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.) B- B_ , ell B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER LUG+tES AFTERSWELLING INTERVAL-MIN. PERIODt PERIOD2 PERIODS PER INCH P- P- 19 AlkA14_ 1.36 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, SYSTEM ELEVATION X r CJ _ ~ e ~S ~ 3 as ( i - f - t i I, the undersigned, hereby certify that 2dedand p rted on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the da~ I cation of the tests are correct to th best f my knowledge and belief. NAME-(print TESTS WERE COMPLETED ON: :ADDRE CERTIFICATION NUMBER: PHONE NUMBER (optional): z C S G TUR I DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DI LHR-SBD-6395 (R. 02/82) - OVER - wia kJ s:,...iut s nu use i?, 4Xi1's:'I(._;,`c°i t,t9mE;P t t' t ,i c3t r? 4 r t;E'r t tz,E.tCi € use TAP S, A . >C~~ 1) fir S[.. iL CO, iis.~I F 4C)"'J s;. "t s.,, ,slu ar~TS 13 w} f.C?rnp (,[In - - ~ iilg lc. scan, is d,f,,,d i. A ? a_GI 1 E may he uss, id s. ci".~~~ t.10 t%£.` 7"si €.r; ptt tilt ,4CEb c.,,,;ep -1 ~Jd, :atFd e7P tl t'Cr.r,,flC', Ii; f. 4th t7 .r ,o i 3i6. „s Ef<t'. as PeF COIX 3OTI ;('S~ (.'7C!'t' p, fl w 'I k nla,.lmn is ,food t,# ~,Vatio 3) dow',9 Z!0[, 1, p l,s,l, N ° §,t t,y s cf#. o . e iaie F ;1 a ;;ri # i'.:.a;'. Y.:mm' £}td 3"en, and y'ou£ t E; ~1- t s ,r. ttt .,3i 3") S I! CoFuse sand, pe,r ~'v, I~ S, , =y ,r i6 s, test e .c ,'W ..(ir..,r vt"G Fa c. of !''he may n,que~,t s3 , Ie.o° li?E