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HomeMy WebLinkAbout038-1136-40-100 0 to O m m o C7 `r1 O y c m 7 O CD n (D 'B H~ CD C r. 3 it 0 zy N c O o cD w a° 00 CD d N 0) N mZ =3 :3 T L. n fl. 61 N W L. N ~ r.S j CD 0 7 Q (D 0) O NO p (D CD C- P n N O W' K 3 5 y 3 °o p N N (D .3. tii C N O !l~~1i w U N CL a N N W U C p p N Iwy CD F~ L OD lz ::z (n A S Q a d N W W (D cn o c 1z, CD O O O C-4 :T T H F c to cn co 3 0 3 v (D v v _v C } O N A N O_ \ rn O lj C i d_ (D o- PJ f~ D) N cn H N D 3 m Q a ~ O Cl) z 9 o z z p D D o tt7' m O o l~l • m CD a d I ~ Z 'D ON i D r~ Oo ` ( c Co In w (o I C~ oo ° CD N `JJ U, O co w o s n Z °p z cn p z o o a r 00 hl cn E W v ~ w n C v rt a CD CD CD z a K H, 0 3 vim, d N z E'O n w N LI) c' ~ a ca H Q Q o ~ v c z a 0 (D N fi a A S A A I N A N I O O a A O 'T7 b N bq a N EA O r Cb p ((D ~y O a. r Fo rm - S T C - 104 w AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC.T,_L_N-R_ W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION j2 LOT LOT SIZE PLAN VIEW Distances and dimensions to mPpr ron o cements of H 63 7- SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM F s 3~~ c~~s r tax a~~,%,J Q ~ 311 8S' INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: ~Proposed slope at site: s SEPTIC TANK: Manufacturer: Capacity: 11P10 Number of rings used: - Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: 9/,, 9 Number of feet from nearest Road: Front,~ Side 10 Rear, O Jc~T1 feet rte,, From nearest property line Front,OSide,~Rear,O feet Number of feet from: well building: (Include this iiiformation of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE r i f1 PUMP CHAMBER Manufacturer: iquid Capacity: `(I hl~ Pump Model: Pump/Siphon Manufacturer: Pump Size / Elevation of inlet: Bottom ol. tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: - Alarm Switch Type: j Number of feet from nearest property line: Front, ~Side,(7~Rear , Ft.// Number of feet from well: z / Number of feet from building: (Include distances on plot plan). SOIL ABSORBTION SYSTEM 10),vo"Op Bed: Trench: ` 1S- Width: ~r Length: Number of Lines: Area Built:,iz /'Fill depth to top of pipe: z _ Number of feet from nearest property line: Front, O Side , Rear, O Ft Number of feet from well: Number of feet from building: 7 (Include distances on plot plan). SEEPAGE P!'! Size: td u,1~< iirn,C,=r° 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: i Inspector Dated: Plumber on job: License Number: ~!H4:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR 'AFFTY & BUILDING LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 ❑ CONVENTIONAL XIALTERNATIVE StatePIa, D_Numoe, (If assign edl ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound 8502421 NAME OF PERMIT HOLDER. ADDRESS Or PERMIT HOLDER'. INSPECTION DATE. Jim Hermansen I R. R. 1, Somerset, WI 54025-~~~ BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.- CST REF. PT_ ELEV. NW14 SW4, Section 33, T31N-R18W, Town of Star Prairie Name of Plumber. MP/MPHSW No Coi~niy Sanitary Permit Number. Cal Powers, Jr. 1563 St. Croix 64906 SEPTIC TANK/HOLDING TANK: MANUFACTURER LIQUID CAPACITY. TANK INLET ELE V.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: 9a YES ❑NO DYES ❑NO BEDDING: VENT DIVA.: VENT MATL. HIGH WATE NUMBER OF ROAD: PROPERTYBUILDING JVENT TO FRESH ALARM LINE [ELL ALETS 'Z FEET FROM 5 YES ❑NO DYES ❑NO__~NEAREST DOSING CHAMBER: IMA ACTUR ER J I BEDDING. LIQUID CAPACITY PUMP MODEL JPUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER / /J PROVIDED PROVIDED. YES ❑NO YES ❑NO •(Jr$' DYES ❑NO C~ D 1&)0 71 GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL IBUILDIrW, VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE ~t~.r Ala INLE PUMP ON AND OFF) YES ❑NO NEAREST J (f 3 SOIL ABSORPTION SYSTEM. Check the soil moisture at t e c1tpth of plowing Nc,nl 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. PIPE SPACING COVER INSIDE DIA -PITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH DIMENSIONS NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH GRAVFL DEPTH FILL DEPTH IDISTH PIPF DISTR PIPE DISTR. PIPE MATERIAL. NO DI7NEARF4ZT_---B~1 BE LOW PI PFS ABOVE COVER ELEV. INLE f ELEV. IN. PIPES FEET FROM LINE. AIR INLET. MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. YES ❑NO ISO IL COVE 24T"e TUNE PERMANENT MARKERS OBSERVATION WELLS ^1-~J YES ❑NO YES ❑NO DEPTH OVER TRENCH BED DEPTH OVER TRENCHBED DEPTH OF TOPSOIL SODDED SEEDED MULCHED ICFNT EH EDGES. .1 ~p2 Lo DYES NO YES ❑NO YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH LENGTH NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE ~COV ER. BED/TRENCH TRENCHES / DIMENSIONS 1/V ",5 / / r ;o r _f_ J MANIFOLD PUMP MANIFOLD DISTR PIPE MANIFOLD MATERIAL. PIPS OEDISTR DIATR. PIPE( DISTRIBU 155 PIPE MATERIAL & MARKING ELEV.. ELEV. DIA (I ELEV ELEVATION AND ~J/1,5 DISTRIBUTION , HOL SI E HOLE SPACING DRILLED CORRECTLY COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS YES ❑NOi YES ❑NO COMMENTS: PF RMANENT MARKERS: OBSERVATION WELLS: NUMBER OF OP RTV WELL: BUILDING'. FEET FROM LINE YES ❑ NO YES ❑ NO NEAREST f Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE TITLE DILHR SBD 6710 (R. 01/82) WMCCInsin APPLICATION FOR SANITARY PERMIT . ILHR COUNTY (PLB 67) oe~ragrmEnroc UNIF R 1n0USr O M SANITARY PERMIT # qY, LIiBOq 6 MUmgn qE 1gT10n5 ~ I 940 4-' -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 81/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPF,RTY OWN MAI ADDRESS PROP RTY LOCATION CTrr: Nh) 1/4S 1/4, S3 , T,?/ N. R lif ~(or rowoF: LOT NUMBER BLOCK UMBER SUBDIVISION NAME NEARE T ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER X -f TYPE OF BUILDING OR USE SERVED / 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: X New S e ❑ 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 7Ta CK: Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons nksConcrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: • PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installatiorfo~the private sewage system shown on the attached plans. Nam Of lumber (P t): Signature; MP/MPRSW No.: Phone Number: Plumber' ddress: Name of Design r: COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fe Date: ❑ Disapproved L,/ O 15 ly ❑ Owner Given Initial GG (D Approved Adverse Determination Reason for Disapproval: 8502421 RECEIVED Alternate course(s) of Action Available: F,';: aY 2 2 1985 PLUh1F3iN:; L' %ttHU DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber Parcel 038-1136-40-100 01i24i2006 09:45 AM PAGE 1 OF 2 Alt. Parcel 33.31.18.556B 038 - TOWN OF STAR PRAIRIE 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 JAMES C & MICHELE F TR HERMANSEN O - HERMANSEN, JAMES C & MICHELE F TR 1829 100TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1829 100TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 21.300 Plat: N/A-NOT AVAILABLE SEC 33 T31 N R18W NW SW COM W1/4 COR SEC Block/Condo Bldg: 33 S 1 DEG E 810.55' TO POB, S 711.75', N 89 DEG E 1242.94'N 711.75 FT S 89 DEG Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) W 1242.94'-POB ASSESS WITH P557B 33-31N-18W Notes: Parcel History: Date Doc # Vol/Page Type 11/12/1999 613718 1470/226 QC 11/12/1999 613716 1470/214 QC 07/23/1997 1233/433 QC 07/23/1997 760/103 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 119862 461,700 Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 32,000 373,500 405,500 NO 05 UNDEVELOPED G5 19.300 48,300 0 48,300 NO Totals for 2005: General Property 21.300 80,300 373,500 453,800 Woodland 0.000 0 0 Totals for 2004: General Property 21.300 80,300 365,200 445,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 131 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel M 038-1136-40-100 01/24/2006 09:45 AM PAGE 2OF2 Parcel History: cont. 07/23/1997 752/424 07/23/1997 714/115 REINSTRA, VAN DYK & NEEDHAM, S. ATTORNEYS AT LAW 201 S. KNOWLES AVENUE P. O. e0x 127 ~'-7 NEW RICHMOND, WI 54017-0127 k'`~~ L. R. REINSTRA HENDRIK \N. VAN DYKE ~ TELEPHONE SCOTT R. NEEDHAM (715) 246-6806 June 20, 1985 Mr. Harold Barber Zoning Administrator St. Croix County Hammond, WI 54015 Dear Harold: Enclosed please find recorded copy of land contract between Straub and Hermansen. It is my understanding that Mr, and Mrs. Hermansen have applied for a permit to install a mound system on this property. This copy of the land contract is being provided to you for your records. If you have any questions, please call. Very truly yours, r REI ' TRA, VAN DYK & NEEDHAM S.C. t Sco t R. Needham SRN:fvn Enc. Safety and Buildings Division DILHR PLAN APPROVAL Bureau of Plumbing P.O Box 7%9 ❑ General Plumbing Pla w- Madison, WI 53707 n i4'PV u., INU " 11p'u ❑ Private Sewage Platt-(, Telephone: (608)266-3815 J~ OFFICE USE ONLY j0 Gf Plan Identification No. t X G C- Gallons Per Day t° KO tf V Y PRIORITY PLAN REVIEW ONLY Plan Review Petition For Modification Project Name Project Location - Street No. or Legal Description County ❑ City ❑ Village ❑ Town of: The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped "conditionally approved". This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. ❑ FOR GENERAL PLUMBING PLANS: This approval will expire two years from the date approved below. If construction has not commenced before the expiration date, new plan approval must be obtained. ❑ FOR PRIVATE SEWAGE PLANS: This approval will expire two years from the date approved below or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. Comments: By: ' James Sargent Bureau Director If Questions Plans Approved By: Date Approved: Contact cc: ❑ OWS ❑ 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 SBD 6678 (R. 08/83) (Plb 100a) (Wis Stats. S. 145.02) STATE OF WISCONSIN DILHR Detach And Return Upper DIVISION OF SAFETY & BUILDINGS Portion Of This Form With BUREAU OF PLUMBING 201 E. WASHINGTON AVE. RM 141 Any Return Correspondenc 6 7 `-7 P.O. BOX 7969 MADISON, WI 53707 608-266-3815 DATE: atpR~'~~~ w~ PROJECT: ice/ I - _ c ~ j.2~ 2~, r 4a PLAN ID. # DETACH HERE PROJECT NAME PLAN ID. # This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the required fee is $ Fee Received is $ ❑ Plan accepted for review. ❑ Underpayment- Please submit additional fee. Plans will be held in abeyance. ❑ Plans being returned. ❑ Overpayment-Refund forthcoming. ❑ Additional information required. SEE BELOW. ❑ No fee has been remitted. Plans will be held in abeyance. 1. Plan Submission ❑ Soil boring and percolation test data on 115 completed ❑ Additional information shall be submitted in duplicate unless by Certified Soil Tester. (1 copy) specifically noted. ❑ Petition For Modification signed by county, owner and ❑ Plans not clear, legible or permanent. notarized. (1 copy) ❑ All information submitted shall be signed, dated and sealed or ❑ Complete data relative to anticipated use of building. stamped in accord with Section ILHR 83.08 (2) (a) Wisconsin ❑ Deed restriction required. (1 copy) Administrative Code. ❑ Affidavit enclosed. ❑ Condominium declaration- (1 copy) ❑ Plot plan showing location of land parcel (distance from nearest road intersection, etc.), lot size and all distances from IV. Holding Tanks private sewage system to buildings, lot lines, well, water- ❑ Holding tank profile showing vent, manhole, alarm, course, swimming pools, water service piping, all weather ser- and manufacturer if state approved. Complete vice road, etc. Show benchmark with permanent elevation. construction details if site constructed. ❑ Holding tank agreement signed by owner and local II. Pressure Distribution Systems (Mound or Inground Pressure) unit of government (sample enclosed). ❑ Application for Use of an Alternative System signed by owner ❑ Reason for installing holding tank. Statement from and notarized. (1 copy) county or soil boring and percolation test data on ❑ County onsite required. (1 copy) ❑ Design calculations. 115 completed by CST, showing that a soil absorption system ❑ Soil boring and percolation test data on 115 completed by cannot be installed on the land parcel. Certified Soil Tester. (1 copy) ❑ Affidavit for all-weather service road (enclosed). ❑ Cross section of system. ❑ Pipe lateral layout. ❑ Plan view of system. V. Dosing Information ❑ Verification fo Exception Status Form by county. (1 copy) ❑ Calculations for total dynamic head and gallons pumped per cycle. III. Private Sewage Systems ❑ Size, length and depth of force main. ❑ Ground slope with 2' contours in entire area of soil absorption ❑ Detail and model of pump or automatic siphon, including system extending 25' minimum on all sides. size, pump curves, drawdown, and average flow rate (GPM). ❑ Location of area suitable for replacement system - provide soil ❑ Cross section of dosing tank showing pump(s) or siphon(s). data. ❑ Construction details of septic, holding or dose tank if site VI. Systems in Fill (Fill must be placed prior to plan submission.) constructed, or tank manufacturer if state approved. ❑ Total area filled (fill to extend 20' beyond edge ❑ Construction details and cross section of soil absorption of trench before side slopes begin.) system. ❑ Depth and type of fill. ❑ Copy of signed onsite report by county or district staff. 4 d/kl Sri st e 33 r3//J ~t°/8' } WORKSHEET - MOUND SYSTEM DESIGN RECEIVELr MAY 2 2 1985 PROBLEM: PWA3c;.N;=::; ``BEAU Design a mound system for a The site characteristics are: Depth to groundwater or bedrock Landslope % Percolation rate min./in. Distance from dose chamber to distribution systems ft. Elevation difference between pump and distribution system ft. Step 1. WASTEWATER LOAD J,S-pX Sri gal . Step 2. SIZE THE ABSORPTION AREA A) Area required B) Bed or trench length (B) _ 4 3_ ft. C) Bed or trench width (A) _ ft. D) Trench spacing (C) _ Wastewater load .24 gal/ft2/day , B = ft. trenc es _ ;nc- 850242 Step 3. MOUND HEIGHT A) Fill depth (D) ft. B) Fill depth (E),- D+ % slope (A)BC ~ ft. / f(0/./ Slog X fr t 15Wr>=/;3s8 C) Bed or trench depth (F) 193 ft. D) Cap and topsoil depth (G) ft. E) Cap and topsoil depth (H) f, ft. ~'IPX°Skl 1563 ,O~r/= - S- 7 ` ~S . ~ ~/~~Ea of • t Step 4. MOUND LENGTH A) End slope (K) _ CD + E1 + F + H x 3 ft. 6) Total mound length (L) = B + 2(K) = ft. Step 5. MOUND WIDTH Al) Upslope correction factor A2) Upslope width (J) = (D + F + G)(3)(factor) B1) Downslope correction factor Z.o B2) Downsl oPe width (I ) _ (E + F + G)(3)(factor) ft./ ~.X t,93f r)(3)(~a~), 9, 8sJ n~, Cl) Total mound width (W) for bed J + A + I ft.'6~~~"~ 10 C2) Total mound width (W) for trenches = J+q+ ~ (no. trenches -1)(c) + q + I ft. 3 ~ 2 g1.2Y 7Ta 3G,oc RECEIVED MAY 22 1985 .Step 6. BASAL AREA PLUMSI (,a taU A) Infiltrative capacity of natural soil gal./ft2/day 01 24 2 B) Basal area required = wastewater flow 8 /I natural soil infiltrative capj~cit = IS7S. sq. ft. JuJ ar.J~~ .J~ ~SO~.+~ ' • ~'i/gt~1f r-~~ ~ /875- fyl~iS~ C1) Basal area available for,bed for sloping sites = B x (A + I) _ sq. ft. , r2M5 S - -SAS C2) Basal area avail ble for trench for sloping sites = B P ,W #-(J + A _ /L2Vsq.. f t. aG:aG _ /L Sy. 3F C3) Basal area available for trench or bed for level sites - B x W = sq. ft. ~ y 8~ f F ` t Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = A in. 2) Hole spacing = in. 3) Distribution pipe length ":r 4) Distribution pipe diameter = in. 5) Spacing between distribution pipes ice. 6) Distance from sidewall to distribution pipe in, 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe 2) Flow per pipe GPM 7C) SIZE MANIFOLD 1) Manifold is central/ _ end 2) Manifold length = ft. 3) Number of distribution lines 4) Manifold diameter= in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate = _ GPM 2) Force main diameter in. ~Jj o~E,Qs~~ 3) Friction loss = ft. 7E) TOTAL DYNAMIC HEAD 8 5 0 2 4 1) Vertical lift = RECEIVED ft. 2) Friction loss = ft. 1-,1AY 22 1985 3) System head 2.5 ft. ft. PLUM INC, ' 'FiLAU 4) Total dynamic head = ft. 7F) PUMP SELECTION 1) Pump selected will discharge Z Z GPM atc22 ft. total dynamic head. 2) Pump model and manufacturer J~~ AYO ZIJ a~0 ~o%t 7G) DOSE VOLUME 1) 10 times Void volume of distribution lines a gal./cycle /0 40 V Y 1/ 3O,.-)s- = 2) Daily wastewater volume : 4 do /24 hrs. _ gal./cycle 3) Minimum dose volume gal./cycle 7341 ,aeA.;j aoc,r 7H) DOSE CHAMBER 1) Minimum capacity required gal. 04.1,doJ RECEIVED MAY 2 2 1985 PLUMBIN^ 'REAU fSr~J l',9GE S/ dF / ~~ou.Jp SIZE - S ee T(.dK- /ooo y,4 ,C7itr.E S- 7 - ~ l t.`~, l~ l~0 6 c,. > 4- vse ~.n t i-cJ Ld L I- L tr, r, RECEIVED CC HAY 22 1985 PLUR`fBINC, 9, EAU PLUMBING /,rte 1 , r 850 1 v=fit B 0 1, DEPARTMENT OF %DUSTRY, LACIOR ANO HUMAN RELATIONS ipL ISION OF SAFE AND BUILDit G SEE CORRESPONDENCE I.L/o9 7 sa , " 330 yB' je~ I - 1098 a~ E~ //0's ~/o os S L r..,: ~.w..n..w'+r... ..ter.. s..«: n+w^yw ..rr , - Page P~q Straw, Marsh Hay, Or , Synthetic Covering Y { Distribution Pipe Medium Sand ' Topsoil H a ..=R+.,,... z.. F E + D % Slope Trench 0f 2 2~ Force Main Plowed • Aggregate From Pump Layer Undisturbed D --~--.i Soil E Cross Section Of A Mound Sysfem Using F 3' Trenches For The Absorption Area G _ I , ~ t A_ Ft. H` B Ft. i . Signed: I 14~.Y( Ft. a 2" ~ r ~r License Number: J n'~y Ft. : RECE►Y~p r ~ Date: 5;---1- K Ft. ; . IIAY Alternate Position of Force Main PLUK W Ft. 4AU ~r s y r ' Y N tf 4~ Ric 1 Force Main From ; 5 Observation Permanent Pump i; Pipe: Markers t t Distribution Trench Of 2• Pipe l Aggregate Z,f Mound Using 3 Trenches For Absorption Area . ~ ~ ► ~ ~ 7 of q C Lr) J / i 1 4:~4 r7l irz~~ 85024 - _ ! 1 RECEIVED j o 2 2 1985 z t ! I i ' w n w Page g Of Perforated Pipe Detail n End View )Perforated End Cap PVC Pipe Holes Located On Bottom, • S Are Equally Spaced S PVC Force Main -7 Q PVC Manifold Pipe Distribution Alternate Position Of Pipe Force Main 8502421 Lost Hole Should Be Next To End Cap End Cop Distribution Pipe Layout P_3j=2~ Ft. RECEIVED S 1 ~ t, Ay 22 1985 S - PLUA IENIC X Inches kttiU Y _Z-5- Inches Signed: Hole Diameter Inch Lateral Inch(es) License Number: Manifold Inches Date: sr Force Main _ 3 Inches PLUMBING # of holes/pipe t, Invert Elevation of Laterals-&.-4& Ft. - APPROVED DEPARTMENT OF INDUSTRY, LABDR AND HRELATIONS DIVISION OF S TY AND BUlr.CJ't.' SEE CORRESPONDENCE PAGE OF PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS VENT CAP 4 C.2. VENT PIPE WEATHER PROOF APPROVED LOCKING 25' FROM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH 12"MIu. AIR INTAKE I GRADE I - y i MIN. I8"MIN. CONDUIT \ - 15"mIE1. 11~ - ImI_.F: PROVIDE I AIRTIGHT SEAL I III ` ' APPROVED JOIN.r' I I I V W/C.I. PIPE. A ~L~~~~ I III APPROVED JOINTS EXTENDIIIC• 3' I I I W/C.I. PIPE ONTO 501.10 SC'! . B ~d~ I I I ALARM EXTENDING 3' !!lLLL~~~ I I I ONTO SOLID SDIL 0 rl;it . l 1 Oki 1t'~~3US s RY , t3t11Lt7it~~` I 9~l O OE4ARY~,Eh + DSION Of SAFE ADD ` P - - F REIVEG D OF 'L SPON~ENC HAY 42 1985 $~E C~~ CONCRETE BLOCK U 1191 C, V, 'READ RISER EXIT PERMITTED ONLY IF TANK MANUFACTURI=R HAS SUCH APPROVAL SPECIFICATIOkis SEPTIC AMID DOSE TANKS MANUFACTURER: ,Oc r~F / /-J NUMBER OF DOSES: PER DA-,j TANK ;,IZE: GALLONS DOSE VOLUME ALARM MANUFACTURER: i~r n 5 57_,r Ci INCLUDING BACKFLOW: ZSK I GALLONS MODEL NUMBER: CAPACITIES: A- ~f~ -~G-..1L_INCHES OR ,~GALLOAIS SWITCH TyP¢: ~ B PUMP MANUFACTURER: INCHES OR GALLONS NUMBER: C / INCHES Oft- GALLONS MODEL DINCHES OR J3~ ~ SWITCH TYPE: _ J00 r, GALLONS NOTE: PUMP AND ALARM ARE TO BE PUMP DISCHAR`E RATE GPM INISTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE B -?wrEu PUMP OFF AMC) DISTRIBUTION PIPE., FEET + MINIMUM NETWORK SUPPLY PRESSURE , 2.5 . FEET + ~ FEET OF FORCE MAIM X _F~ Ioo Fr.FRICTION FACTOR..,;. FEET i~ TOTAL DYNAMIC HEAD = G: FEET IIJTEitNAL DIMEtJ51 t OF TANK: LENGTH _lOl~ t ' LI(~UID DEPTH SIGNED: LICEIJSE NUMBER: DATE: -117- ' .C . 'i. P.. - Model 3870' Submersible Effluent Pumps. 120 r ~A s 3 ' 100 o - I 80 i 4 = k'A E S 7~ c A I o wp 70 ~ 60 ' 7 y I h 1p O (t'p WP 03, Y, H P. 20 -VII 3,-Y:-H.P' - - I 0 20 40 - 120 Capsdty - Gab i 80 100 ~ftc 85 0 24 2 1 V"Ay 4; 2 1995 H.P. Order No. Votb Max. wt Ph- M+Pe RPM So114 (IOS.) WPO311 E WPM 31IE 115 K 9.4 WP0312E 1750 56 230 10 4.7 WPM012E _ WPH0511E 115 WP 12E 230 8.0 WPHO532E 208/230 3A 60 WPH0534E 460 30 1.7 WPH0712E 230 10 9D i1. WPHO732E 2081230 5.4 WPH0734E 460 30 2.7 WPH1012E 230 10 11.6 _ 70• 1 345Q WPH1032E 30 64 - WPH1034E 460 3.2 WPH1512E 230 10 13.3 WPH1532E 208/230 92 8 1 Sy W PH t 534E 460 46 WPHH1512E 230 10 13.3 l H A ( WPH1S32E 208/230 9.2 30 ~(J WPHHtS34E 460 4.6 SPECIFICATIONS ARE SUBJECT TO C 4MGE WITHOUT NOTICE 3 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISP.O. BOX ON W 53707 HUMAN RELATIONS (H63.0917) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/ ITY: LOT NO.:BLK. O.: SUBDIVISION NAME: N/R 8E (or COUNTY: OWN R'S BU ER'S NAME: MAI G ADDRESS: 7 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DES RIPTIONS: PER LATION TESTS: Residence ~ New ❑Replace I r _ ~ Ste) - RATING: S= Site suitable for system U= Site unsuitable for system 1,141v 9 r OSENTIAL: MOUND: DU IN-GR~OUNaP® URE: SYSTEM-I®ILLp❑LDING®NK: RECOMMENDED SYSTEM: (opti nal) ~~~III[(([((~~~,,,JJJJJJ J If Percolation Tests are NOT required ESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: ID Floodplain, indicate Floodplain elevation: ` LI PROFILE DESCRIPTIONS l BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH MN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- - > - - Ma .5 i~212 B- B- - B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD t PERIOD2 PER D PER INCH P / /s 7 P 7 s s 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 he plot plan. Show the surface elevation at all borings and the direction and percent of land slope. RECEIVED 8 5 0 2 4 2 1 SYSTEM ELEVATION 11 _ -----I'~- ~ 2 X98 5 _ - 1 i 3&0 - - 1 I T ~ ( 1, the undersigned, hereby certify that the s i es s reported on this form were made y me in accor wit the procedures and methods spe " 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. NAM (print): TESTS WERE COMPLETED ON: 7 A RESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): CST ATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ntl IIR ShD-6395 (R.0?/82) -OVER - v r v x m x ~ ~ m v fD =-V 30 ro CID, ID ~oaaCD°' l~f O co - 0 3 =r =r z c• ~ ~ ~ _7 ~ C ~ N 7C' ~ IA ~j o p -0 cc S m -0 0 cD ca Q A x Ti N m ° O O O .N. 8 yi (D 2) co w W cD CD ai a A O (D c ° ca 3Sc- -3 ZCD -cam (n~CDwwu, w CD o (n - ca D < tea, v l'o. M CD c) 0' c: (n ° n O D C n CD =r '0 " - 06 CL CL w m ° a m w p m =yN yMww c Cl) CA w cD CD ( z D (D -i ° o CD 3 c s a D CL 0) =r 0 m OL (a v rn'~ww a 171 s > ~(n c oaCD o n,(a w ° a-M _ m - ,Y m -i N ° ° U) 0 - - - co a aof v,cccfw G) w 3 w CD o m N 0 m aaa 0.0 _ iD a-.- l< Ca CD cD n C G) Ca = l< . D cD 3 m n a° O o ca O• C w ? c (p Q = C a ? C O w fD C (D~; ~a3 o0o3 o ° ~ ° aCD 3a 3 m O < ca CD O ~Q O z ~o 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, SW 1/4, Sec. 33 T 31 N, R 18 EXU4 W Town S~kKijX Star Prairie Street Address Lot No. Block Subdivision Strand Landowner's Name: Jim Hermanson The application for this site is for: [anew 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 number - - 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 59 - 07 - 6 for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. [.1for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. [I for an application on file prior to February 1, 1980. L]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. L1 a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the Jot meets the criteria for a conventional private sewage system, check here. ❑ I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. Nelson Si ure County Official Title Assistant Zoning Administrator Date May 24, 1985 DILHR-SBD-6158 (R 12182) SBD 6678 (R. 08/83) (Plb 100a) (Wis Stalls. S. 145.02) STATE OF WISCONSIN DILHR Detach And Return Upper DIVISION OF SAFETY & BUILDINGS Portion Of This Form With BUREAU OF PLUMBING 201 E. WASHINGTON AVE. RM 141 Any Return Correspondence P.O. BOX 7969 ~w R s se C~ MADISON, WI 53707 608-266-3815 DATE: PROJECT: J fT[.i T wi 3 3~ 71 e- e- v e- r J Pre. , r- #'e QQ3 Qo x .2 of S-f. Grv,x New 64J1 s Rio/~ ~ PLAN ID.# 0 2~'2 DETACH HERE PROJECT NAME er.~. a v, s J1 h. _ ,Q S PLAN ID. # S'~ 2 5 ? This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the required fee is $ ~E o e v Fee Received is $ 4 ~`d ❑ Plan accepted for review. ❑ Underpayment- Please submit additional fee. Plans will be held in abeyance. ❑ Plans being returned. ❑ Overpayment - Refund forthcoming. Additional information required. SEE BELOW. ❑ No fee has been remitted. Plans will be held i abeyance. D 1. Plan Submission ❑ Soil boring and percolation test data on 115 completed ❑ Additional information shall be submitted in duplicate unless by Certified Soil Tester. (1 copy) specifically noted. ❑ Petition For Modification signed by county, owner and ❑ Plans not clear, legible or permanent. notarized. (1 copy) ❑ All information submitted shall be signed, dated and sealed or ❑ Complete data relative to anticipated use of buildir ; stamped in accord with Section ILHR 83.08 (2) (a) Wisconsin ❑ Deed restriction required. (1 copy) Administrative Code. ❑ Affidavit enclosed. ❑ Condominium declaration. (1 copy) ❑ Plot plan showing location of land parcel (distance from nearest road intersection, etc.), lot size and all distances from IV. Holding Tanks private sewage system to buildings, lot lines, well, water- ❑ Holding tank profile showing vent, manhole, alarm, course, swimming pools, water service piping, all weather ser- and manufacturer if state approved. Complete vice road, etc. Show benchmark with permanent elevation. construction details if site constructed. ❑ Holding tank agreement signed by owner and local 11. Pressure Distribution Systems (Mound or Inground Pressure) unit of government (sample enclosed). ❑ Application for Use of an Alternative System signed by owner ❑ Reason for installing holding tank. Statement from and notarized. (1 copy) county or soil boring and percolation test data on ❑ County onsite required. (1 copy) ❑ Design calculations. 115 completed by CST, showing that a soil absorption system ❑ Soil boring and percolation test data on 115 completed by cannot be installed on the land parcel. Certified Soil Tester. (1 copy) ❑ Affidavit for all-weather service road (enclosed). ❑ Cross section of system. ❑ Pipe lateral layout. ❑ Plan view of system. V. Dosing Information Verification to Exception Status Form by county. It copy) ❑ Calculations for total dynamic head and gallons pumped per cycle. III. Private Sewage Systems ❑ Size, length and depth of force main. ❑ Ground slope with 2' contours in entire area of soil absorption ❑ Detail and model of pump or automatic siphon, including system extending 25' minimum on all sides. size, pump curves, drawdown, and average flow rate (GPM). ❑ Location of area suitable for replacement system - provide soil ❑ Cross section of dosing tank showing pump(s) or siphon(s). data. ❑ Construction details of septic, holding or dose tank if site VI. Systems in Fill (Fill must be placed prior to plan submission.) constructed, or tank manufacturer if state approved. ❑ Total area filled (fill to extend 20' beyond edge ❑ Construction details and cross section of soil absorption of trench before side slopes begin.) system. ❑ Depth and type of fill. ❑ Copy of signed onsite report by county or district staff. i"} J ST. CR01 X COUNTY £W WI SC O N S I N ZONING OFFICE , 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 May 13, 1985 State of Wisconsin, DILHR Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: Having reviewed the back hoe pits on the Jim Hermansen property located in the NW4 of the SW4 of Section 33, T31N-R18W, Town of Star Prairie, St. Croix County, there is no physical perimeter that may indicate high groundwater or bedrock, although it was revealed that there was a dense, reddish brown, sandy loam, which had the potential of restricting ground water flow as tested by the certified soil tester. It did indeed, reveal slow permeability, and therefore, it is recommended that a mound system be installed utilizing trench systems. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, 0n 4 9~~~Thomas C. Nelson Assistant Zoning Administrator mj I INDUSTRY, ENT OF SAFETY & BUILDINGS NDUS REPORT ON SOIL BORINGS AND LABOR AND P.O. BOX 7969 PERCOLATION TESTS 1151 DIVISION HUMAN RELATIONS / (H63.09(1) & Chapter 145.045) MADISON, WI 53707 LOCATION: SECTION: TOWNSHIP/ ITY: LOT NO.: BILK. O.: SUBDIVISION NAME: 1 1/ /T N/R (or COUNTY: OWN R'S/BU ER 'S NAME: MAI NG ADDRESS: USE Q NO. BEDRMS.: COMMERCIAL DESCRIPTION: A New OBSERVATIONS MADE Residence ~VNew ❑Replace PROFILE DESCRIPTIONS: PERCOLATION TESTS: RATING: S= Site suitable for system U= Site unsuitable for system 2 CONVENTIO AL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:(opti nal) ❑s ~u s ❑u ❑s ®U as ©u ❑s r~u If Percolation Tests are NOT required DESIGN RATE: under s.H63.09(5)(b), indicate: If any portion of the tested area is in the Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 1%, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- - s- B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. RATE MINUTES PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P ~ ~r 7 P- P- S 7~ 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 he plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION _ _e3 I f I , E TN I j I Fe, I, the undersigned, hereby certify that the s i tests re'P"" on this orm were made by me in accorl wit" to procedures a dfinr thhoods spe ' 'e lithe Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAM (print): J j C_ TESTS WERE COMPLETED ON: /CERTIFICATION NUMBER: PHONE NUMBER(optional): CST ATURE:.,, x DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. 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