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HomeMy WebLinkAbout032-2092-10-000 0 w O ~ v n d _1 0 d f c 3 "0 3 ID 'a A v d CD 3 T ~r m D 3 0 m 3 d z d_ N cn (D N C `^l W (D OJ N CO 7 p N N a (0 r C 1 7 p N (p - CO O 'p 0 7 6 (D O O O O C fD n p O cn 3 0 - o °o N N ~ 0 O ~ d d c `J (n < D ip ~a C/) • 1~1, (D (f] N N 7 G S ~p - i_ w rn C Ic, 0 co co C::, can N O c d (D H D !mil ((DD ~t ( z 0 0 0 * 'Y • Cn o E rt d v (D N W O - v o v O'\ Z I a O ro ~ O N~ ~ r Oo C lJi~ CD_ H N (77 z z o N N z cu m C ff~~ D m N t- V j m O CYI\ a N I~~VVijl _0 C V \ (D iU F•~ Oo C CD 7 O LT1 H H w (D ~ r r r' z (D 7 -i Vl U~ O N a A Z C ~ r-+ n i z U' O H rn r., m A C 3 cn o U) m 7 rt O rt Z w a G7 ca _0 (D O• a A Z C m O 3 a 70 rt w rt 3 m (p y z (D ~ D v a U) w ~ Q) 0 3 m c p o a (D D n N ' m a m` y y I a I ~ I a t I F n,l N N O O a ~ A (D D'AQ V o O Ol O (D ^1 ti Parcel 032-2092-10-000 02/22/2006 04:35 PM PAGE 1 OF 1 Alt. Parcel 24.31.19.900 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - ARMSTRONG, SHIRLEY J SHIRLEY J ARMSTRONG 759 205TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 759 205TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 4.000 Plat: 2046-HANSEN'S TURTLE LAKE HILLS 1ST LOT 1 BLK 1 HANSEN'S TURTLE LAKE HILL Block/Condo Bldg: 01 LOT 01 1ST ADD Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 24-31 N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1213/598 TI 07/23/1997 701/180 2005 SUMMARY Bill Fair Market Value: Assessed with: 78197 383,900 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.000 63,500 245,500 309,000 NO Totals for 2005: General Property 4.000 63,500 245,500 309,000 Woodland 0.000 0 0 Totals for 2004: General Property 4.000 63,500 245,500 309,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 104 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 LABOR & H(JIVIAN RELATIONS SAFETY & BUILDINGS P.O. bOx 79, PRIVATE SEWAGE SYSTEMS DIVISION MADISON, VVI 53707 BUREAU OF PLUMBING ❑CONVENTIONAL ALTERNATIVE NgZ:77 ❑ Holding Tank XRRIn-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE. Donald Armstronjq~ 2661 Martin Way, BENCH MAR White Bear Lake, MN55110 -1-3 _Y5 K (Permanent reference point) DESCRIBE IF DIF FEHENT FROM PLAN REF. PT. ELEV.: CST REF. PT. ELEV NW SE, Section 24, T31N-R19W, Town of Somerset, Lot#I,TurtleLakeHills Name <tf Plum her. MP/MPRSW N,, Coumy_ Sanitary Permit Number: Gar L Steel 3254 St. Croix 64875 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID CAPACITY. TANK INLET FLEV.. TANK OUTLET ELEV. WARNING LABEL LOCKING COVER i. ( 3 1 m %j C.I' t PROVID ED. PROVIDED. aeoDING LINO ❑YES VENT DIA y VENT MATL HIGH WATER E~N O ALARM NUMBER OF ROAD: PROPERTY ❑YES WELL. BUILDING. VENT TO FRESH ❑YES ❑NO FEET FROM uNE (AIR INLET ❑YES ❑NO NEAREST '~J DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER FLfti.J ❑YE, 1 f[ ` \l f P OVIDED PROVIDED !NO U':•.' J rl V J ❑NO GALLONS PER CYCLE: PUMP ANDC YES ONraoLSOPERArIONAL YES ❑NO (DIFFERENCE BETWEEN NUMBER OF PROPERTY WELL BUILDING VENT-E.IF I. PUMP ON AND OFF) FEET FROM NE AIR INLET c;,: ❑YES ❑NO NEAREST J I SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing ENCr/f DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH. LENGTH NO. OF DISTR. PIPE SPACING COVER+ DIMENSIONS TRENCHES . MATERIAL : PIT INSIDE DIA uPITS LIQUID DEPTH. GRAVEL DEPTH FILL DEPTH DISTH PIPF DISTR. PIPE DISTR. PIPE MATERIAL. . BELOW PIPES ABOVE COVER. ELEV. INLET ELEV. END NO DISTR NUMBER OF PR OP ERTV WELL. BUILDING: VENT TO FRESH PIPES FEET FROM LINE AIR INLET. MOUND SYSTEM: Mound site plowed perpendicular to slope and furrows thrown Upslope: Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ❑YES ❑NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARK ERS. OBSERVATION WELLS DEPTH OVER TRENCH.' BED DEPTH OVER TRENCH, I ❑YES ❑NO ❑YES ❑NO CENTER EDGES DEPTH OF TOPSOIL SODDED NO SEEDED MULCHED ❑ ❑YES ❑ PRESSURIZED DISTRIBUTION SYSTEM: ❑YES NO ❑YES ❑NO FBED/TRETION NCH WIDTH LENGTH NO. OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE Cr `e TRENCHES „ F FILL DEPTH ABOVE COVER NSIONS ( MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTIONI MATERIAL & MARKING AND ELEV ELEV r CIA ELEV PIPES ` Dln [DISTRIBUTION `tw INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY' COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED l PLANS u`tJ YES ❑NO COMMENTS: PERM AN ENTMARK E RS: jUlbt,"VATIONWELLS YES Y ❑NO NUMBER OF PROPERTY WELL BUILDING ❑YES ❑ NO FEET FROM LINV DYES ❑NO NEAREST Sketch System on Reverse Side. Retain in county file for audit. SIGNATURE. - -~r,~; TITLE. DILHR SBD 6710 (R. 01/82) Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER {T ' i! is Ir I !C'_,Lf _ TOWNSHIP; SEC. T 1 f N-R W ADDRESS ST. CROIX COUNTY, WISCONSIN LOTS LOT SIZE SUBDIVISION~„-,,,:~,,,~,~f~/ ~ , PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ('r F 1 0~ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used TT - Elevation of vertical reference point ~Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: 11Je)c i Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation J,'~% Tank Outlet Elevation: Number of feet from nearest Road: Front, Side,0 Rear, O feet From nearest property line Front, 0Side, QRear, 0 feet IC- Number of feet from: well building: ' (Include this information of th above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity. Pump Model: Pump/Siphon Manufacturer: ! (cM Pump Size Elevation of inlet: l Bottom of tank elevation: Pump off switch elevation: `f Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: fNumber of feet from nearest property line: Front, O Side, Rear, 0 Ft.,1U,"K Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Lenith: Number of Lines: Area Built:.' Fill depth to top of pipe: Number of feet from nearest property line: Front, n Side, O Rear, O Ft.(, 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 Bu' t: Ha/eit r a dro p box O or distribution box O been used on any of the above soil abon 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: i Dated: Plumber on job:~~?`-~. ~r License Number: 3/84:mj E1n07- consln A PPLICATION FOR SANITARY PERMIT ~ILHR COUNTY (PLB 67) UNIFORM SANITARY PERMIT # 17, USTR V,LRBOR 6MUTRn RELPTIOns -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 PBL-PERTY OWNER f MAILING ADDRESS ~J L m ESL a n ul {'1 i dg inn -~-~/~u PROPERTY LOCATION C-F`F~: 114-56- 1/4, S T.31, N, R : (or) W TOWN OF, D m LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEARES ROAD LAKE OR LANDMARK STATE PLAN I.D. NUMBER /r t Ob'"I% - cgs U / v S 17 TYPE OF BUILDING OR USE SERVED Ill 1 or 2 Family Number of Bedrooms. 3 ❑ Public (Specify): THIS PERMIT IS FOR A: 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 Steel Fiberglass Plastic Gallons Tanks Concrete Constructed 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 ~d d Lift Pump/Siphon Chamber SQ C-) Manufacturer: S S 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 installati of the private sewage system shown on the attached plans. yfmber (Print): Signat 7F7MPRSW No.: Phone Number: Name Plum Ad ess: Name of Designer: COUNTY/ DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved ~f1 C O J ❑ Owner Given Initial 6- l r~ Approved 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. Ir W) r o R I P ' oo i o ' ~ ~ r Na laSE i ~ yS A~orav~~~ i Io00 . X) Lh pvrb~ 5 ,~1,~ . vow - ~i ;S~oNS g FIND ~PUOR U~LDINOS SEE coR~ES~O~DENCE PLAN APPROVAL Bu-au ofPlubng Division ®IL~.H P.O Box 7969 ❑ General Plumbing Plans Madison, WI 53707 Private Sewage Plans Telephone: (608)266-3815 r- OFFICE USE ONLY Plan Identification No. 6 / e e / Gallons Per Day I 7~v NI e- w_ t-~ I C 1-1 , ij C W,, k5-xe 7 PRIORITY PLAN REVIEW ONLY Plan Review $ 16 c. Petition For Modification $ Project Name Project Location - Street No. or Legal Description N 6-1 /1 S-fray./ re s all V~ 56 a 4/ ~3 % 19 W County ❑ City ❑ Village Town of: 5 G Me N 1 / S r"; , 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 )i plans with the department's approval stamp made. ❑ FOR GENERAL PLUMBING PLANS This approval will expire two years from the date approved below. If construction has not commenced betore the expiration date, new plan approval must be obtained. FOR PRIVATE SEWAGE PLANS: b (J 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 * c cc: OWS ❑ DPS ❑ H&R & Rec. San. Section County ❑ Local PI ❑ Facilities Need Analysis Sect;. ❑ UW-SSWMP ❑ Plumber ❑ Department of Agricultw- DILHR-SBD-6099 (R. 01/84) ❑ Owner ❑ Other L71LHR STATE OF WISCONSIN DILHR D,'VISION OF SAFETY & REAU OF PLUMBING BUILDINGS PRIVATE SEWAGE SYSTEMS BU 201 E. Washington Avenue, Rm 178 PLAN APPROVAL APPLICATION P.O. Box 7968, Madison, WI 53707 608-2663815 INSTRUCTIONS: Please fill in all applicable data and submit this form with plans. Plans will not be reviewed until all fees are received. The back side of this form describes required plan information. Plumbing codes can be purchased from the Department of Administration, Document Sales, 202 South Thornton Ave., Madison, Wisconsin 53703, Telephone (608) 266.3358. 1. PROJECT INFORMATION (Type or print clearly) Name of Sub itting Party (Plans returned to same) Project Name l' , / 11 ...Zrj - rv V -,y7 cf prk.1Scw ~ Street & No. Project Location - Street & No. or Legal Descri tion au y~ E City State Zip Code ❑ City County y ❑ Village _ Town S 'o S ,4 v✓ 0 Designer Telephone No. (Include Area Code) / 51' Z 41 (e C~ Z 00 2. THIS APPLICATION IS FOR A: C~ ❑ New Mound System (3) ❑ Holding Tank (2) ❑ New Pressurized System on site not suitable ❑ Petition For Modification (6) for conventional (3) ❑ Replacement Mound (4) ❑ Replacement Pressurized System on site not ❑ System in Fill (1) suitable for conventional (4) ❑ System in Flood Fringe (1). Pressurized System on site suitable for ❑ Groundwater Monitoring (7) conventional (1) ❑ Conventional, System Public Building (1) 3. FEE COMPUTATIONS (Include existing tanks) 4. FEE SUBMITTED FOR OFFICE USE Sa ~p.oo 3a. 750- 1,500 gallon septic tank - 390 4a. 3b. 1,501 2,500 gallon septic tank - 40.00 4b. 3c. 2,501 4,000 gallon septic tank - 55.00 4c.i~~G6~r`3 3d. 4,001 8,000 gallon septic tank - 70.00 4d. _ 3e. 8,001 - 12,000 gallon septic tank - 85.00 4e.''` i) J 3f. Over 12,000 gallon septic tank - 100.00 4f. 3g. 500- 1,000 gallon pump chamber - 30.00 49. '20 3h. 1,001 - 2,000 gallon pump chamber - 35.00 4h. 3i. 2,001 4,000 gallon pump chamber - 50.00 4i. 3j. 4,001 8,000 gallon pump chamber - 65.00 4j. 3k. 8,001 - 12,000 gallon pump chamber - 80.00 4k. 31. Over 12,000 gallon pump chamber - 95.00 41. 3m. 500 - 5,000 gallon holding tank - 30.00 4m. 3n. 5,001 - 10,000 gallon holding tank - 40.00 4n. 3o. Over 10,000 gallon holding tank - 50.00 4o. 3p. Groundwater Monitoring - 32.00 4p. Subtotal O 3q. Priority plan review: (walk through) 4q. Submittal of plans in person, by appointment, with double fee 3r. Petition for Modification Setback - 20.00 4r. Site evaluation - 50.00 Total Fee COMMENTS: DILHR SBD-6748 (R. 5/82) CID -OVER- ST. CROI X COUNTY q rryr ~ WI SC0 N S I N ZONING OFFICE - 796-2239 (HAMMOND) 425-8363 (R I V E R F A L LS) HAMMOND, WI 54015 Wisconsin Dept. of Ind. Labotc 9 human Reeations RWag, 76ir"ng Madison, w.%s. 53707 To Whom it May Concern: An ons-c to inspection was conducted on 10130185 on the Donatd AAra6t .ong pttopetcty, toeated in the NW-SE% Section 24 T31N R19W Township os SomVcs et. The soV-s evatuati.on shows suitabte soit.6 to a depth of 5.75 feet. These souies wound be suctabte jots an in-ground pne,ssutce system. Due to the timited area on the above desnibed pnopenty. The above described system wound be most apptcopiate. RECEIVED Sincetceey, [:VAR 2 9 1985 PLUMBING BUREAU Thomas C. Neeson, Ass'.t. Zoning Adminzittatotc 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, SE 1/4, Sec. 24 T 31 N, R 19 XF46~ W Town W)9&fbXf0iWx Somerset Street Address Lot No. 1 , Block , Subdivision Hanson's Turtle Lake Hille Landowner's Name: Donald Armstrong 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: I 1 to have one of the first five approvals guaranteed for this year. This is number - - of those applications. (Use one of the first five quota num ers issued to you.) i_ ]one of the applications needing a quota number. The quota number assigned to this application is - - D for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. " 1.;o ]for an individual lot for which a sanitary permit was issued but was i4t[WiI G ruled unsuitable due to new or changed soil criteria established by the department. I.-]for an application on file prior to February 1, 1980. k?dfor 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 lot 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 March 28, 1985 DILHR-SBD-6158 (R 12/82) DEPAR DUS l"MENTOF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND P.O. BOX 769 HUMAN RFLATIONS PERCOLATION TESTS (115). MADISON WI 53707 (H63.090) & Chapter 145.045) iLOCATION: SECTION, TOT NO..BLK. NO.: SUBDIVISION NAME: N Vj '/S :Z4 /T3 N/R/ 9L(or) W COUNTY: 6WRNr§xUy I-: AI S5-//D /yJ USE DAT S OBSERVATIONS MADE DESCRIPTION] S: 1 Residence 3 /0 Q W New ❑ Replsce /Q -13 p ^ p RATING: S- Site suitable for system U- Site unsuitable for system C7 ' ~CONVENTIONAL:~S ©U MOUND: ❑U tNG S ❑U ❑S 0UL ❑SG[RTAN U R_YECOMENDED NM~nNOSLtMYSTEM d.foptN►^~'~S/~/1"~ ( If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the hinder s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH R NDWATER-INCHES CHARACTER OF S IL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER ELEVATION BSERV O EST. GPTS-T TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 06 B- 613.: 7 fZ- A 2b A~) 4~ i i, ~~I. 3-en C .5, 'A"e's, 61sk- 'e"A. c2a B- Z y' 103 A)a lu 5 I8 en S,~.. 2, MS. L°S l7, L U) B- 3 03's= xk~ f0 _ 7 Z d ~~i.s: t_ / 3~g . s, 3 33 . c° , S. 2 019 L B O z 9~ 100 /J' (o L S 1, gJ~ ' G° S, d9 "es,. Ns, I + , 11. tgn-S,A. 2 2;,, Aso 612 13- -52 103- WO A)6 t, es an, B- I" PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PER PERI0133 PER INCH P. P- P- AAP BG~O 'r" P zz -;r _5 ~fe P- .S /P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or dista what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all bori gi an Ft- ction and percent of land slope. IQ~ SYSTEM ELEVATION_ /oo c~'~ l! L. L PL BI _ G ; .__T - ►v t t I i 831 V I1 I I~ I , L j... qjo t I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. !NAME print': TESTS WERE COMPLETED ON: v Z. S ,o~ -&o -8 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): ~ ® S i7 z 2 y~ is-Z~G -zoo CST SIGNATU DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-S80.6396 (R. 02/82) -OVER TIONAL WORKSHEET I. OUND SYSTEM 11. IN-GROUND PRESSURE SYSTEM-Continued- i Wastewater Load, Total Daily Flow = 10. Force Main: Use section H 63.15 (3) (c), Wis. Minimum Dosing Rate = gpm. Adm. Code and PROVIDE A DETAILED Diameter in. LIST OF SIZING ON PLANS. 11. Total Dynamic Head: - 2. De h to Limiting Factor = ft. System Head = 25 ft. 3. Land ope = % Vertical Lift = '2 / ft. 4. Distan from Dose Chamber to Friction Loss = ft. Distr ution System = ft. TDH = ft. 5. Elevation ifference Between 12. Pump Selection: Pump an Distribution System = ft. Pump wit discharge at least gpm 6. Absorption A a Sizing: at ft. total dynamic head. Area Requir = sq. ft. Pump rrlody }nd manufacturer. C d to Bed or Trench ength (8) = ft. tom. , / G Bed or Trench dth (A) = ft. 13. Dose Volume: Trench Spacing ( ft. 10 Times void Volume of M0,01 7, Mound Height: Distribution Lines = .gal. Fill Depth (D) = ft. Daily Wastewater Volume r Fill Depth Downslope ft. _?,,#Doses In 24 hrs. _ /5o gal. Bed or Trench Depth (F ft. Backflow =,I ~y gal. Cap and Topsoil Dept ( ft. Minimum Dose = 19'#71 9 Bal. Cap and Topsoil De h (H) ft. 14. Dose Chamber? t C,C) 8. Mound Length: Volume = t gai. End Slope (K) = ft. Total Mound L gth (L) = ft. I. CONVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: 1. Wastewater Load, Total Daily Flow = gal. Upslope Cor ection Factor = Use section H 63.15 (3) (c), Wis. Upslope W dth = ft. Adm. Code and PROVIDE DETAILED Downslo a Correction Factor = LIST OF SIZING ON PLANS. Downs pe Width (1) = ft. 2. Re ired Septic Tank Capacity = gal. Total ound Width (W) = ft. 3. Perco ion Rate= min./in. 10. Basal ea: 4. Absorpti Area Sizing: I Itrative Capacity of Refer to able 2 in chapter H atural Soil = gal./sq.ft./day and PROV E A DETAIL LIST OF Basal Area Required - sq. ft. SIZING ON P NS. {tom (~'%i Basal Area Available = sq. ft. Required Area = sq. rt. 11. If Standard Tables from Chapter Length = r.q i R t) rl H 63 are Used, Indicate Table No. Width = f~ For the Distribution Network, Use Numbers 5-14 in Section I. Number of Tre ches = ft. Trench Spac g = BING B ri it. IN-GROUND PRESSURE SYSTEM 5. Distribution stem: 1. Depth to Limiting Factor = D P) L ft. Lateral ength = ft. 2. Landslopd 2 % Nu er of Laterals= 3. Percolation Rate = I&I min./in. L ral Spacing = in, 4, Proposed System Elevation = 71 0- ft. Istance from Sidewali to Pipe = in. 5. Wastewater Load, Total Daily Flow: 5~L7 gal. System Elevation = ft. Use section H 63.15 (3) (c), Wis. Adm. Code and PROVIDE A DETAILED IV. STEM-IN-FILL LIST OF SIZING ON PLANS. Fill in All Items from Section 111 Required Septic Tank Capacity = gal, 6. Absorption Area Sizing: V. SEPTIC TANK Percolation Rate = min./in. 1. Capacity = gal. Area Required = sq. ft. 2. Manufacturer: Y ));-g S 0-0 N A System Length = ft. 3. Show Site Constructed Tank Details on Plan System Width = R, ft. 7. Distribution Pipe Sizing: VI. DOSING TANK Hole Sire - _ in. 1. Capacity = gal. Hole Spacing = ft. 2., Manuracturer: Lateral Length - ft. J. Pump Mdnufacturer: t 01 I.dter.tl Sire in. 4. Pump Model: L.uerdl Spicing rt. 5. Operating Head= ft. Distance from Sidewdll4u 11 b. Flow Rate= "z gpm. 8. Dlsirlbuliun Pipe Dhchdrge hate: ` 7. Show Site Constructed Tank Details on Plans Number of Itoles I'el Pipe Ilow 1101I'llm Rpm. V HOI.UING'IANK 'l. Manilold Siting: i. ap Ira 1. i ype (cuntcl o1 und) 2. Minulacturer. Length = It, t0 Constructed Tank Details on Plans Diameter in. -SHOW ALL INFORMATION ON PLANS- DILHR SBD-6761 (R.03/82) PAGE OF / b- ,-,c r vxI 4 'tp0. E l.i N E 2 8. p,v,c.y4o Mov ms".'.old dV)441 o rl CROSS SECTIO WOF A BED SYSTEM P- P~.: lu t l1 I (1ti i. ; 10 ' SOIL FILL DI TRIBUTIOM PIPE j APPROVED SyAITHETIC COVER '"MATERIAL 2" OF AGGREGATE OR MARSH HAy 4 0 FAGGREGATE E8 ELEV. OF/_Q_ FEET_..,. DISTRIBUTIOW PIPE TO BE AT LEAST 44dCHEtiS BELOW ORIGIMAL GRADE ARID AT LEAST20 IAICHES BUT 1.10 MORE THAN H2 IWCHES BELOW FIIJAL GRADE 26 ~ MAXIMUM DEPTH OF EXCAVATIOAI FROM ORIGINAL GRADE WILL BE IBS MINIMUM DEPTH OF EXCAVATIOM FROM ORIGIQAL GRADE WILL BE lad&"S SIGME LICEMSE DUMBER: DATE: ~1 Page _ Of _ Perforated Pipe Detoll 0 End View )Perforated End Cap . PVC Pipe tCr"~oe '%oc Holes Located On Bottom, S Are Equally Spaced PVC Force Main PVC Manifold Pipe - ,ti E.I 4~ Alternate P aljt ~„('~;#I*1r' Q"IIC?i Distribution Pipe Force Main Last ole Should Be Next To End Cap C,r End Cap Distribution Pipe Layout P 76 Ft. mnK~nir~Okl R S S X 4!6o Inches 4226 q100 I/ Y Signed: Hole Diameter , Inch Lateral Inch(es) License Number: Manifold Inches Date: Force Main _ Inches # of hales/pipe PLUr tali / AlumS Invert Elevation of Laterals 00 Ft. 3 Xa6 i 4 <3 Ya f f-1 FWD ; a.-,.,~ AN!? HUMAN REIA~Ot~ "O DINGS 'SEE CORRESPO;' PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VEAIT CAP ~1}(.ij~•"ce f y"C.I. VEKIT PIPE WEATHER PROOF APPROVED LOCKING / ' JUNCTION BOX MANHOLE COVER ?_5' FROM DOOR, WINDOW OR FRESH 12"MIU. AIR INTAKE GRADE I y" MIKJ. CONDUIT 18"MIN. INLET PROVIDE I AIRTIGHT SEAL I I i I I I APPROVED JOINT A I III APPROVED JOINTS W/C.T. PIPE I III W/C.I. PIPE EXTEIJDtNG 3' €'I r I I I EXTENDING 3' ALARM ONTO SOLID SOIL B I 1 ( ONTO SOLID SOIL . _ I I ow C ELEV. FT. ~ PUMP OFF D CONCRETE BLOCK SCI~c 6'tf D £3 (u:i RISER EXIT PERMITTED ONLY IF TAMV MANUFACTURER HAS SUCH APPROVAL ~t SEPTIC E SPECIFI'GATIOAIS DOSE TANKS MANUFACTURER. 0661<5 rnra-1 f 4 4. IJUMBER OF DOSES: PER DA4 TANK SIZE: Rion GALLONS DOSE VOLUME ~j~/ ALARM MANUFACTURER: ~v1 MC INCLUDING 5ACKFLOW: /q~ / 7,el GALLONS MODEL NUMBER: lit A CAPACITIES: A=INCHES OR 817 GALLONS SWITCH TYPE: MC NC U,'V g=INCHES OR 9ZGALLOKIS PUMP MANUFACTURER: O, , vLAA_ C=INCHES ORS L'_""GALLONS MODEL NUMBER: D-2INCHES 0 (22 TGALLONS SWITCH TYPE: NOTE: PUMP ARID ALARM ARE TO BE MINIMUM DISCHARGE RATE~~GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET + MI,A IM'UM NETWORK SUPPLY PRESSUR~T,,E//. . . . . . . . 2.5 FEET 2 2 , Zc(,e cfAl/9/1. + /.3C7 FEET OF FORCE MAIN X ~~S,LF/oo,,FRICTION FACTOR.._,2_~_ FEET LlrX R 7 X TOTAL OtIWAMIC HEAD = 2~ 11CE. ET 231 INTERNAL DIMFwS NS OF TAK1K: I~ H _ ;WIDTH ;LIQUID DEPTH it p as c<) SIGN LICENSE ).!UMBER: -3'3'5 el DATE: '2 .a U. vs ~ W M del 3870 u °-n rsib!e Effluent Ptarhps 120 a' '1 7r'`z-.~ rP t00 fCifyS '''S',e► ANA H'J . a,ii RE'-AT C1~aS ~ ,..mot L1al:,i pr CE 1 'gyp _ h , r bhp 1 O 10 's If 6G p r' ~s "AR BUREAU WPM03. % H.P. 20 WP 03, % H.P. µ y 0 20 40 60 80 100 120 Capatcty - Gallons Par Mt 9tv AWL WL O:rMy NO. v P►sw~ Am" RPM t~WIM 1 1 Ile i1Al;;'^ t I E 115 0.4 1750 WtA 1~ 230 10 . 4.7 a... _ VVpM~ l1+ 2~ WPhW@ 1 E., 115 r 7 WPH0512E 230 8.0 60 WPH063ZE 208/230 3.4 i WPH0634E'46p 30 1.7 VA"712E 230 10 9.0 WPH0732E 206230 5.4 WPH0734E 480 2.7 ~E 5 _ WPH1012E 230 10 11.6 3450.. 70 1 WPH1032E 208/230 6.4 { WPH1034E 460 30 3.2 WPHIS12E 230 10 13.3 WPHI"E 206/230 92 WPH1SNE 460 30 4.6 6o WPHH1512E 230 10 13.3 WPHH1532E 2081230 9.2 30 WPHH1S34E •460 4.6 SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE 3 . r ~Y1 ~a 's 5 1~;y o l ® -1057 fiEt;illiE7 r (G ~i/o PLUMPING BUpy j! 1 # ~,~p C~~bfr l _ll r.. r urelau ofPlu b' ngs Division ®Il`LHR PLAN APPROVAL BSaf an P.O Box 7%9 ❑ General Plumbing Plans Madison, WI 53707 ❑ Private Sewage Plans Telephone: (608)266-3815 OFFICE USE ONLY Plan Identification No. ® Gallons Per Day 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 expii,afon mite, 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: e. N C B o o rT'I Y' ~ z 00 James Sargent Bureau Director If Questions Plans Approved B ~ Y: Date Approved: Contact cc: ❑ OWS ❑ 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 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, SE 1/4, Sec. 24 T 31 N, R 19 Xf-x~6F4 W Town dV4QWFd Somerset Street Address Lot No. 1 , Block , Subdivision Hanson's Turtle Lake Hille Landowner's Name: Donald Armstrong 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: to have one of the first five approvals guaranteed for this year. This is number - - of those applications. (Use one of the first five quota num ers i s e3 to you.) ]one of the applications needing a quota number. The quota number assigned to this application is - - D 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. [.J for 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. 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.n I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. Nelson Si 9wrt ure County Official Title Assistant Zoning Administrator Date March 28, 1985 DILHR-SBD-6158 (R 12182) ST. CROI X COUNTY 3 a WI SC 0 x N S I N ZONING OFFICE 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 WiZcon6in Dept, o~ Ind. Laboh 9 human Retations Ou .&ag0O67~Jrbing Mad,L6on, wis. 53707 To whom it May Concelc.n: An onvs.cte inspection ways conducted on 10130185 on the Donatd Atauttong pupelcty, .-ocated in the NW-St:% Section 24 T31N R19W Townahip o6 Someuet. The aoits evaiu.at on shows suitabZe so.c E6 to a depth o6 5.75 Beet. These .souits woued be 4uitabte Son an in-ground p,%usune .6ystem. Due to the t m,ited area on the above deschibed pnopeAty. The above descAibed system woued be most appnopiate. Sincenety, Thoma6 C. Net6on, As.6't. Zoning Adminsittation v v ~ m x ~ a m "Co N g am csw' H o o ~ p w w cn C 3 C(aca O 7 CD '0 O ' c m CD a CD N N Q yy~ 7 > CD to CL 0 0 CD =3 CD CD :E CD - CD 0 w D m m U1 `G Q w r CD 'm (D CM m oho " A 3 a c~ w 0 CD o w o 0 p O c p 3-"c oc3oa00 p'z c~ Q=3 = =r 2. CD (o -2 CD1-O V n 'm v, N ~ Q CD m o Dc -m O R= w n n CCU c ca w m m 0 Q m O= CL N C oNCD =miow0)(n Z N N cwico p D =r Q) 90 CD q (D n Jr m Cl. CD 3mmCD ~a D m o =)r ~ m "ma a-~'? °c w ° QU,m mcn~aca~ Cl) M vi a acmgCD C m m CD CL m m ic m ai ~ ° m n !s Mme w 3. m cr w = 6`. Oao moOo D cn0c C~3mvi w a m-.0Nw !~7 a O N c C o Caw O m wow m -'=mNv a s aQ CCDD Qa * acv,' =.c l< to w E m 3 n m n C G) cp a O y. m A N p 7 d a0 7 Ofa C --rm C CD C CD O v w a=3 poi o,om !fa am moo' X13 m v 3 a o m Ui o z 0 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, ~ DIVISION LABOR AND PERCOLATION TESTS (115) MADISON, WI 3909 P.O. BOX 76 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: I P/}PAgt }-TY: LOTO.:SUBDIVISIONNAME: c 1/4 .2 /T~ N/R/ °y~,(or) ]_TTOWNNSH S ,C,~XE~/i/s COUNTY: O~fPdER`3fBUY y~~ MAILING ADDRESS:) j ~J Jd_ ER'S xm's E. USE ~G 6 1~ 7i Y~ r€, ~4 r- oZ4 m . DAT S OBSERVATIONS MADE NO. BEDRMS.: CDESCRIPTION: PROFILE DESCRIPTIONS: 1PERCOLATION TESTS: .Residence ~ ~ New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (opt- al) 0s ou Zs ❑u I. 3S au ❑s ®u ❑s Cu ~m.~ '~ct,p,►~~ klot Ej63 tion Tests are NOT required DESIGN RATE: [Ffloodplain, an / y portion of the tested area is in the .09(5)(b), indicate: U indicate Floodplain elevation: ~~•In~ i PROFILE DESCR IPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF S IL W H THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- ~7 1-7 2 7 7S , 9a c33 /7 B- ►v ti 6,/., m,S. s,L u) YYi64 5'0 33 tN~I 3 3 3 08 n S' C', ? Jam, d,~ ~l B Q zR~ o ruck ~p 9z ~.,.z d9 13.1.5, B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD3 PER INCH P- P- P- 'AA074 &g,-0fi;rn e 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 A t N. IZ )'04' to mj r \ i E t ) ~ i act 83, 4 3 N i Fc . t1 ~o ) I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: -&e5? -P~Z ADDRESS: ~D CERTIFICATION NUMBER: PHONE NUMBER (optional): z z~~ ~PZ-00 CST SIGNATU OSf ' DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DI I-HR-SBD-6395 (R. 02/82) - 01/Er