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HomeMy WebLinkAbout006-1083-10-100 rY o I 3 0 N y N ~ a N ~ I n O O N N i d I N N O III'... 9 Z C LL c0 3 a E U Q. c7 r II ~ W W E 0 Z I y y C,3 F- Z c co r, w a m O c C7 co V_ O Z c U w r = N -P 0 a~i Z a li' 2 c Z cn F r N c E QI E co N n 7 7 N ~ N U N ~ O p d U _ c O U O E a O Z H Z p N Z ro- III R E N is m ! d - Y co a a R c \l U') N d " N U _Q O i. Cl) D CL E w U) n Z r j I~ H F N - -U) O Z .^w ~aaa n 'i a g m in J V E m rn aNi W r !Z } ""MIA v N Co N 00 = O co o o Q) d D Lo O O O C) N a L4 E O O '1 O m O III U U N d~ W O L+ O N C C O C U 0) G CV 3 c` (n cVO ii t O 000 p H LL C fa C ~ N r.- z W O r C -O N N Z C pp E - 0.0 c6 c+0 2 O m o ~ U II > O N • O O M U Z N= fn e~ E d •O Y E coo « R I' d 7 EL d .w U O 7I, 3 r O A Uam OrnU Parcel 006-1083-20-000 01/24/2007 01:51 PM PAGE 1 OF 1 Alt. Parcel M 36.31.16.552B 006 - TOWN OF CYLON 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 - KONSELA, ALBERT J & DIANE M ALBERT J & DIANE M KONSELA 2585 HWY 63/64 EMERALD WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 2585 HWY 63/64 SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE SEC 36 T31 N R16W 2A IN NE NE LOT 1 CSM Block/Condo Bldg: 5/1360 Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 36-31N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 817/96 07/23/1997 816/302 07/23/1997 678/542 2006 SUMMARY Bill M Fair Market Value: Assessed with: 144804 229,100 Valuations: Last Changed: 09/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 15,000 180,100 195,100 NO Totals for 2006: General Property 2.000 15,000 180,100 195,100 Woodland 0.000 0 0 Totals for 2005: General Property 2.000 15,000 180,100 195,1000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch M 512 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 '76Z 6 rM,& Form S T C 10AS BUILT SANITARY SYSTEM R1~FC' ~ 7A . OWNER f TOWNSHIP / ' 4`!M T .N-R~W ADDRESS ST. CROIX COUNTY, WISC(rj SIN T SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 5 nr;~f H N p0-'y`0 M 0A7 ~/j¢NC A/ A' -7 F >t I ~ r ` ' INDICATE NORTH ARROW ~ri1` r e BENCHMARK: Describe the vertical reference point used ~L" ('ea1VE'I't C F A/c Ci.S r Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: k /14; KS Liquid Capacity: Number of rings used: 0 -5 Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: %1,-113 Number of feet from nearest Road: Front,0 Side 10 Rear, o feet / From nearest property line Front, 0Side,QRear, 0 feet i 1 Number of feet from: well building: i 6 (Include this information of the above plot plan)( 2 reference dimensions to septic tzink) PUMP CHAMBER T Manufacturer: Liquid Capacity:{ Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: y /I AN Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: S Alarm Switch Type: Number of feet from nearest property line: Front,CSide,@ Rear , Ft.~ Number of feet from well: Number of feet from building:. (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Number of Lines: Width: Len$th:~T Area Built: / l-' ri Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, Rear, 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 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: _ Plumber on job: License Number: ~ 3/84:mj wlsconsln APPLICATION FOR SANITARY PERMIT 1~'N [COUNTY ®1 L H R (PLB 67) UNIFORM SANITARY PERMIT # OEPRATMEnT OF - InOUSTRV,LPBOR 6HUTPn FIELGiTlOnS - -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/zx 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT ~ N U J PROtBR ER MAILING ADDRESS PROPTION ~~/4. S 3 , T N, R /E ! (orLOT BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, AKE OR LAND~M/ARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED ❑ Public (Specify): )6 1 or 2 Family Number of Bedrooms: THIS PERMIT IS FOR A: ❑ Repair ❑ New System ❑ Tank Replacement ❑ ❑ Privy Replacement Soil Absorption System Revision ❑ Petition for Modification ❑ Reconnection Alternate System IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Holding Tank Seepage Trench ❑ Seepage Pit D Seepage Bed Y 'Seepage Vault Privy ❑ Pit Privy ELI System-In-Fill El In-Ground Pressure issued ❑ Existing, For Which A Previous Permit Is On File, Permit # ❑ 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 O© Lift Pump Tank/Siphon Chamber 0 Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): o-d 9Q() Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attach Nod: plans. Number: i Name of Plumber (Print): Signature- 'S 9 ~ Name of Designer: Plumber's Address: v COUNTY/ DEPARTMENT USE ONLY El Disapproved Signature of Issuing Agent: Fee: Date: I~ Owner Given Initial d/ XApproved Adverse Determination tiGt~ • Reason for isapproval: I 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 ti o LlMt, (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. SAFETY & BUILDINGS DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR DIVISION LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING P.O. BOX 7969 MADISON, WI '63701 ~yy,, SL~'I.ONVENTIONAL ALTERNATIVE ' ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound INSPECTION DATE. NAME OF PERMIT HOLDER : ADDRESS OF PERMIT HOLDER. q X. Rivard R. R. 1, Emerald, WZ -mow/ csT REF PT ETEEV . Francis X REF. PT. ELEV. BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN - NE NE, Section 36, T31N-R16W, Town of Cylon Sanitary Permi[ Number MP/MPRSW Na. County. 5 /,'-t(~ Na,°" °(PI°,nbe, 5690 St . Croix 7 Gale Smith OUID CAPACITYTANK ILET ELEVTANK OUTLEELEVWARNINLABEL LOCKMANUF ACTURER PO I D E PRO SEPTIC TANK/HOLDING TANK: D: V UC I YES LINO O LINO PR OP ERTV WELL. BUILDING: VENT TO FRESH ' ROAD: : VENT MATL HIGH WATER NUMBER OF LINE AIR INLET VENT DIA C BEDDING: > , ALARM F EET FROM /V/Ij( ( DYES LINO NEAREST DYES NO : DOSING CHAMBER; PUMPiSIPH ON N1ANU AC1lIHEH WARNING LABEL LOCKING COVER ( ROVIDED . P OV I DED M[NUFAC!!lNNN ER BEDDING. LIQUIDCAPAC PUMP MODEL r DES ONO I6j 0., ~"w-s 1' ES ❑ N O DYES ND PH OP ERTV WELL' BUILDING. IVAERNI TOE FRESH PUMP AND CONTROLS OPER ATIONAL. UMBER OF LINE INL GALLONS PER CYCLE: FEET FROM (DIFFERENCE BETWEEN O FN(;TH oInMETER MATERIAL AND MARKmG PUMPONAND FF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE L or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) -PITS LIQUID CONVENTIONAL SYSTEM: INSIDE DIA DEPTH WIDTH. LENGTH NO. OF DISTR. PIPE SPACING COVER PIT' BED/TRENCH ~l TRENCHES ~1/4 FRESH AIERNITNLTOET. DIMENSIONS ❑ PROPERTY WELL BUILDING VENT LINE. Q GRAVEL DEPTH FILL DEPTH UISTH PIPF DISTR. PIPE DISTR. PIPE MATERIAL. PIOED rR. FNUM EETBFROM „ Z g J BELOW PIPE' ABOVE covER ELEV INLFr ELEV END Z 2 NEAREST r MOUND SYSTEM: PROV I DE A DIAG RAM OF SYSTEM Mound site plowed perpendicular to slope Check the texture of the fill material for REVERSE and furrows thrown upslope: mound systems to make certain that it O ONE MEAS SIDE. SHOW ELEVA- meets the criteria for medium sand. RED. DYES LINO PERMANENT MARKERS OBSERVATION WELLS SOIL COVER TEXTURE DYES ONO DYES LINO MuLCHFD SODDED 5 ED DEPTH OVER TRENCH. BED DEPTH °VER TRENCH BED OFPTH OF TOPSOIL. DYES DND DYES DND CENTER EGES DYES 1:1 r FILL DEPTH ABOVE COVER. PRESSURIZED DISTRIBUTION SYSTEM: LATERALSPACING GRAVE D r BELO. PIPE W IDTH. LENGTH NO. OF - BED/TRENCH TRENCHES, DIMENSIONS MANIFOLD PUMP MANIFOL DISTR. PIPE DISTR PIPE DISTR IBUTION PIPE MATERIAL & MARKING FLEV ELEV DIA ELEV. P PES MANIF. L M ER N O. D IST - DIA D I.. ELEVATION AND f veRTICAL 111- 1 CORRESPONDS TO APPROVED INFORMATION ION FORMATION DRI LEDCORRECTLV C ER MATERIA 1 PLANS HOLE SIZE HOLE SPACING L % DYES LINO DYES PROPERTY WELL. BUILDING. ❑N PERMANENT OBSERVATION WELLS: NUMBER OF LINE. MARKERS: FEET FROM COMMENTS: DYES LINO ❑YES LINO NEAREST <3 -7, << S Retain _ii~county file for audit. Sketch System on TITLE. ,i' Reverse Side. s URE DILHR SBD6710 (R. 01/82) - APPLICATION FOR SANITARY PERMIT S T C - 1.00 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor.,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property R,4x a is R/ VARa Location of Property' N.1L, Section T s~ N - R 1-!~ W _fe Township Mailing Address /Qf Subdivision Name Lot Number Previous Owner of Property f3 ad />Nde/l s'o /V e9iti~f~ yqy crs, `T'otal. Size of Parcel A.6Rc° q Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No volume and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION 1 (We.) eehti. y that aU statements on this Bohm cute thu.e to the best o~ my (ours) knowledge; that I (we) am (arse) the owners (,s) oA the pnopeAty dacni,bed in this tnAon.mati,on ~mm, by viAtue oA a waAAanty deed neeonded in the 046ice o{ the County Reg-isteh oA Deeds ass Document No. , I ; and that I (we) ptment.2y own the pnoposed site {ion the Sewage Po'-6ystem (on I (we) have obtained an easement, to nun with the above described pnopexty, ion the. cons u .i,on oA sa~,d sys , d the same has been duty neeonded in the O~~ice eds, as Document No. ) *TE' gReg E OF O-OWNS IF PLICABLE) SIG TUR /7 1 / DATE SIGNED r FORM NO. 985•A M C M.II•r (prp,rry~ 8 Stock No. 26273 CERTIFIED SURVEY MAP NO. 1360 Part of the NE 1/4 of the NE 1/4 of Section 36, Town 31 North, Range 16 West, Town of Cyl on, County of St. Croix, State of Wisconsin, described in Volume _5 of Certified Survey Maps, Page 1360 as Certified Survey Number 1360 UNH'_ATTED LANDS CTI r NORTH LINE, NE I/4,SEC.36,T31 N-R.16W. C" p u u u n - 2637.73= 230.71' ~ -699.21'-- N I/4 COR. 1~ inl o NE CORNER. SEC.36, N89°44' 34"E SEC.36,T.31NsR.16W. T.31 N.- R.16w--- - 230.71' SCALE: 1"- IOU C 0 50 100 150 200 :r w cn i Z LEGEND ;y aNi 2 LOT 1 0 fr Q m v :y O SET 3/4"X24" ROUND IRON Q? N Ut 87,119SQ. FT ROD WEIGHING 1.502LBS./L.F, ~ m t 2.00 ACRES ± I\; I ;rr, g 1 I&I SET 2" IRON PIPE WITH rn a• ALUMINUM CAP ~o ! :p BEARING REFERENCED TO TA NORTH EXISTING LINE OF THE NE QUARTER OF SECTION BUILDING 36,T31 N.-R.16W. ASSUMED AS S89°50'21"W _,_.1 9 FILED APPROVED I OCT 171983 \ 230.71' A~;JA"aESI O' CONNELL , IN; S 89° 44' 34" W otsta •t mO T 0 51983 Crotx tml-fr UNPLATTED LANDW W- ST. CROIX COUNTY • L~0.1PxE►!fNSIYf PARKS PIANN!NG SURVEYOR'S CERTIFICATE AND ZONING COMMITTEE I, Leon R. Herrick, Registered Land Surveyor, hereby certify that I have surveyed, divided and mapped a part of the NE 1/4 of the NE 1/4 of Section 36, Town 31 North, Range 16 West, Town of Cylon, County of St. Croix, State of Wisconsin, more particularly described as follows: Commencing at the Northeast corner of said Section 36; .-Thence S 89° 50' 21" W, 699.21 feet; Thence S 00' 15' 26" E, 48.55 feet to the point of beginning; Thence continuing S 00° 15' 26" E, 377.62 feet; Thence S 89° 44' 34" 1.1, 230.71 feet; Thence N 00° 15' 26" 1-1, 377.62 feet; Thence N 89' 44' 34" E, 230.71 feet to the point of beginning. Said parcel contains 87,119 square feet (more or less) 2.0 acres (more or less). That I have made such survey, land division and plat at the direction of Francis Rivard, purchaser of the property, now presently owned by Ray C. Anderson. This plat is a correct representation of the boundaries of the land surveyed and the division thereof made. That I have fully complied with. the provisions of Chapter 236 of the Wisconsin Statutes and the subdivision regulations of the County of St. Croix, in surveying, dividing and mapping the same. This survey is subject to existing easements. Dated this 13'eday of 1983. • 4,.•*•"'s,., C0/V LEON R. : * s eONR. HERRIC , Regi ste e Land Surveyor S-81303 } - MENOMONIE, Wis. E SHEET 1 OF 1 # Volume 5 Pa.ee 1360 • ~/,~•SURVE~~~~++ I N cl~ y ST C- 105 r r SEPTIC TANK MAINTENANCE AGREEMENT H St. Croix County V. 0 H OWNN:R BUYER R_ 11,4 Rey' ROUTE/BOX NUMBER Fire Number C IT Y / S T A T E M 7X ,4 10~ ~i! - 1. III PROPERTY LOCATION:_ IV,9!5 ~ 1'4, Section T_~/ _N, Town of Al - St. Croix County, SubdivisLot number I Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant I-or a maximum of. 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 F. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- c ment of Natural Resources. Certification f r must be co ted and returned to.the St. Croix County Zo 'ng Office w"th' 0 days of the three year expiration date. _ / SICNED W C DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. o Z L O ` E i O C N CRI •r► CL EO O a O L' O C: , :3 0 t C U Co O D• la) (D ego N O O O C O U U a.1 N O L O U N V faA ` O O L- cn o .6 O O'D c 0-0 O cd 3 E Z (D c c CD :3 U) cc (1) 0 0 V ~ ~ ~ ~ N c m - v) (1)O =U) ° ~Qo cc cc cc (n .ccmc~a E o W m -03Uj~ °ccW -0 r- IL v) cc ~a0•.m ~0 co M - Cc 0 (n 0 010 F- 3 ~~tU0~ E CO m r LL Cts C F- O cc ca r- S. Q Z co '2 4- " ca U) 0 U) c 0 3l ~A N ~ c rn° coo°0 ca r O 3 Oa .c~.°' o~ cc - C.) 0 t5 N. . Q - :3 4) 75 U) cA p O -0 > i O O Ict cd C U i O 0) Cc C: c(D C° N r? O CC co ca cts c3ca>+: LZ.c O -0 O > p O U :3 E C :3 O O U CO O~ C C O L C C O 0 O '0" OOi.- :3 O O U O L C D t O t5 CD C cn (D (D Cl. 'It cc M rn c a aV •-3v~W. vUi°>s ° O N N C a N y O c = C O O1 I_ E C>, LO) Y i a- =3 O i to v a,. LL a _ E O N C O D U Y 3 C O i. N c N i N m D OEN~nvi H:33= w N C J N G DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX 76 HUMAN RELATIONS N, WI 53707 • (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/ Y: LOT NO.: BLK. NO. SUBDIVISION NAME: N/RE ( C)W Y/ cey COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO: BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS: LN Residence 5= 1:1 New Replace l k = 5> RATING: S= Site suitable for system U= Site unsuitable for system ECOkNjVEN~Tl OINGU17U~F_Ts PURE:SYSTEM-IN-Fi TANK: RECOMMENDED SYSTEM:(optional) UOS ~RU _ /V 2 If Percolation Test s are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ® OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- Nel B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD( PERIOD2 PERIOD3 PER INCH J -I P- ~ j. P_ ^ C 3~ ii 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 N Ce 1!4 i I He N l tt'~ Al uF .S `,fitIN,, 3 a _ r 4 f 3 9~' ~ . • her ~ - 14 3 t J~ , 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: C ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): C9' cs t. t` 1, CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - ,mplete and ac",; r , Li 's C. C, MAX S,a~ c El t, C, za{ .t,`4 ~It C'Sasi Cff ii; a to ?t S 'str>3, , ;e i., s lr. rl >.e. S17 E a~, wsU1 ! 5~4 A ath?n s. i vv ncl sca1i p fw i3G"L is 1 , 1°ht, P, Pi E A L s G, I " 1. F t c t$r ~a :7t !fi Fe A ~.ar; €5 t y c.= 4.ir t 5t c, cl,!si rt;E ; POW, }F3 ~'s ,,F . } 3 > t „.1?~ - ,,t_,, ; Baud plaid data, pofct}tatilln t, N, A, it h =.i _ , t fv r „ iIj f c r r , : e a yfa}.a t.' t o , ~ <_L,3S i E „ rl t?i. ,9;"E`ll tteFf 13% IR', np~ _ err t E , Pf,rc Pine S:vld B, (!,I Bo~J,Iil _ iJv € 1 ` i { t, _ ~tr,.•az ,stria'` v r ; F SCI F-a YDR-O- r` RTIC PUMPS DIMENSIONAL DRAWINGS & PERFORMANCE DATA MODEL: OSP33 SUBMERSIBLE SUMP PUMP -MAX. SOLIDS SPHERE -1750 RPM i TOTAL - - Lit. No. 113.5 348 HEAD - I r- - - ;r-r- IN FT 3/,o HP MOTOR j 24 22 ti i _-4 } - t - 20 Y - C 18 16 i 14 12 10 8 a FULL LOAD AMPS AT 115 V. -r- - 6.5 2 0 HH+4 10 20 30 40 50 60 U.S. GALLONS PER MINUTE MODEL: OSP33 319 4 7 43/8 O 50F 0 5'/4 94 4 11/4 STD. 25/16 PIPE THD. 43/8 NOTE: CASTING DIM. MAY VARY ± 1/8 PAGE pF,- PUMP CHAMBER CKOSS SECTION A~JD SPECIFICAFIOk.IS i"- -VEIli IF CAP 4"C..L. VENT PIPE WF Al IaF K F'KOOF ~ APPROVED LUCKING OX - MAFJHOLE COVER JUAJCI ION BOY,---- - 25' FRCM DCOR, WINDOW OK F-RLSH 12 MIU. AIW INTAKE I GRADf_ I _ IB°MIQ. COIJDUIT- - - - INL_E: i PROVIDE - AIRTIGHT SEAL_ I I ( I I / APPKO'JED JC,I,JT A I III APPRC)VED -jCG` W/C.I. Ptpv.. I III W/C.l. PIPE E7RENUING I II ALARM EXTENDIUV O►JTO S(JLID l. B I I I ONTO SOLID I ON L. I I i PUMP - OFF O COFJCKETL bLOCK- - - - - - KISER E)(11 PERMITIED ONLY IF TANK MAUUFACTUREF< HAS SUCH APPROVAL ,S P E C I F I C A T I Q LJ S =PTIC AND I )SE TANKS, MALIUFACTUREK: FJUMBER C.IF DUSL.`,: lAC`JK .,IIE (:AL.L()115 DOSE VOLUME: AI_AKM MA►1UFACI IJREK. _-IKJC.HES OK ~~O _ vAi l 0' MCi0 EL K)UMEl,EK: __IkJC.HLSUK 5H/Il"CH TJPE: UR GALL I'I1F`,\I' MWHI Ar I tIRi t: ML I t L F.)UMF l- KC NO-I-L: 1'UMP /\MU ALAK.M AM. TC: P,f - IAIS1 ALLLD GU SE.F'ARATE (:,RC U I T S PUMP UI'DLriAR(,L KA-I L VL-KT I T A L . DiFFcI LHU bE I WLE.k.I PLIMI' CI F AIJD 01,13 KIt~UT-ION I'II'L-.. -4:~,C Ef:i c + MI"IMIIM, NEIWOK,. "UPPL(J PKL uKE . . . . . . . _t'om`/~ FEET t /~0 FEE I CJ FvKI"E MAIN k??~ __F isi,FIFKtCttoll FA(.To-)R--,a 41- FEE I TOIAL_ UJNAMII_. HLAp 9,_~7_ FEET c~ L i /r ~NIiJc2OV.4 L I iFUS+c►+~s of rAAM. 1-r~Fli?Cr~t-- O t~tWrlt 44WAIlD Q~Pi/F Smith Plumbing PHONE (715) 265-4838 ILif- 'as~f -7-`31 lzl GLENWOOD CITY, WISCONSIN 54013 se-p Terri erg arc r 35r i lol /46 ice, p 19.0 r i i - a Q3 p.3' - pr I - - 0 4ol