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Wisconsin Department of industry,
PLB-1 INSPECTION REPORT Labor & Human Relations
Safety & Buildings Division
Bureau of Plumbing
Name o remises Date an No.
County Sanitary Permit
Master Plumber Firm Name dress
Jou-rneyma4-P;4mb~er Address
Owner Address
T '
I
ma...~«t®~......~.«.. .-.....n. e...,e-.....,.®.~. ~..®~.~.e .s~T-.... P-.~« „~.®.,.ame .e.._.
q 0 A T iT.E
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D.I.L.H.R.
Mit.
Chippewa Falls, Mll 54729
.
~P _ , w .....V_...._.. . .(TI 5)'7'23-`878'6
Discussed with signature
( )See Attached.
DILHR-SBD-6192 (R.10/82) Signature o Dist. um Wq----up. on-Site as a Spec .a is
Inspector Local Inspector Plumber or Responsible Party ;Owner
Parcel 020-1039-10-000 01/20/2005 11:24 AM
PAGE 1 OF 1
Alt. Parcel 18.29.19.164A 020 - TOWN OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* FEIA, LON L & BRIGITTE J
LON L & BRIGITTE J FEIA
1080 LAKEVIEW TR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1080 LAKEVIEW TR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 19.310 Plat: N/A-NOT AVAILABLE
SEC 18 T29N R19W E 1/2 OF NE SW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
18-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
06/09/1998 580604 1-330/084 WD
07/23/1997 831/132
v
2004 SUMMARY Bill Fair Market Value: Assessed with:
47904 413,300
Valuations: Last Changed: 10/26/2001
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.000 59,700 240,200 299,900 NO
PRODUCTIVE FORST LANC G6 13.310 19,800 0 19,800 NO
MANAGED FOREST LAND-( W8 5.000 22,500 0 22,500 NO
Totals for 2004:
General Property 14.310 79,500 240,200 319,700
Woodland 5.000 22,500 22,500
Totals for 2003:
General Property 14.310 79,500 240,200 319,700
Woodland 5.000 22,500 22,500
Lottery Credit: Claim Count: 0 Certification Date: Batch 121
Specials:
User Special Code Category Amount
018-RECYCLING SPECIAL ASSESSMENT 27.00
001-WATER SPECIAL ASSESSMENT 0.00
Special Assessments Special Charges Delinquent Charges
Total 27.00 0.00 0.00
Parcel 020-1039-00-000 01/20/2005 11:31 AM
PAGE 1 OF 1
Alt. Parcel 18.29.19.163A 020 - TOWN OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* FEIA, LON L & BRIGITTE J
LON L & BRIGITTE J FEIA
1080 LAKEVIEW TR
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE
SEC 18 T29N R19W S 1/2 OF SE1/4 NW1/4 Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
18-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
06/09/1998 580604 1330/084 WD
07/23/1997 831/133
07/23/1997 831/132
2004 SUMMARY Bill Fair Market Value: Assessed with:
47902 0
Valuations: Last Changed: 10/26/2001
Description Class Acres Land Improve Total State Reason
MANAGED FOREST LAND-( W8 20.000 90,000 0 90,000 NO
Totals for 2004:
General Property 0.000 0 0 0
Woodland 20.000 90,000 90,000
Totals for 2003:
General Property 0.000 0 0 0
Woodland 20.000 90,000 90,000
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
001-WATER SPECIAL ASSESSMENT 0.00
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
01/20/2005 11:33 AM
PAGE 1 OF 1
Parcel 020-1039-82-000 020 - TOWN OF HUDSON
ST. CROIX COUNTY, WISCONSIN
Alt. Parcel 18.29.19.168 1/2 B
Current X Sales Area Application # Permit # Permit Type
Creation Date Historical Date M0 # 0
Owner(s): Current Owner
Tax Address: ' FEIA, LON L & BRIGITTE J
LON L & BRIGITTE J FEIA
1080 LAKEVIEW TR
HUDSON WI 54016
* =Primary
SC = School SP = Special Property Address(es):
Districts:
Type Dist # Description
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Acres: 4.240 Plat: N/A-NOT AVAILABLE
Legal Description: Block/Condo Bldg:
SEC 18 T29N R19W NW SE PRT N OF WILLOW Sec-Twn-Rng 40 1/4 160 114)
RIVER VOL 252, PAGE 252 Tract(s):
18-29N-19W
Parcel History: Type
Notes: Date Doc # Vol/Page
WD
06/09/1998 580604 183101084
07/23/1997 252/252
07/23/1997
Fair Market Value: Assessed with:
2004 SUMMARY Bill
47912 0
Last Changed: 10/26/2001
Valuations: Land Improve Total State Reason
Description Class Acres 8,600 0 8,600 NO
MANAGED FOREST LAND-C W8 4.240
Totals for 2004: 0.000 0 0 0
General Property 4 240 8,600
Woodland 8,600
for 2003: 0
Totals 0.000 0 0 8,600
General Property
Woodland 4.240 8,600
Batch
Claim Count: 0 Certification Date:
Lottery Credit:
Specials: Amount
Category 0.00
User Special Code SPECIAL ASSESSMENT
001-WATER
Special Charges Delinquent Cha 0 00
Special Assessments
O00 0.00
Total
PUMP CHAMBER
Manufacturer:
Liquid Capacity:
~L
Pump Model: I
Pump/Siphon Manufacturer: ~~✓J~~
Elevation of inlet: Pump size
Bottom of tank elevation:
Pump off switch elevation:
Gallons per cycle:
Alarm Manufacturer:
Alarm Switch Type;
Number of
fret from nearest property line:
Front, O Side, O Rear,
Number of feet from well: It.
Number of feet from building: ,
l
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: j
Length: Number of Lines;
Fill depth to top of pipe: D - - Area Built:5
Number of feet from nearest
property line: Front,
Number o O Side, Rear, O Ft
of feet from well:
Number of feet from building:
(Include distances on
plot plan).
SEEPAGE PIT
Size:
Number of pits.
Liquid depth:
Bottom of seepage pit elevation:
Area Built:
Has either a drop box 0 or distribution box
absorbtion sytems? been used on any of the above soil
(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 ORear, 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
r Dorm - S T-C X44.
AS BUILT SANITARY SYS`1'EM REPORT f
V~~4P IVcU~r;r- SEC. ~T7_N-R ~ W
OWNER
ST. CROIX COUNTY, WISCONSIN
ADDRESS NV~~
ke,
LOT LOT SIZE
SUBDIVISION
PLAN VIEW
Distances and dimensions to meet requirements of H 63 a
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
Baja,
Q-7
i
i
Clu.,.vw
wwT
ro' ,
i
INDICATE NORTH ARROW
<Fr (~10J~~1
BENCHMARK: Describe the vertical reference point used
Proposed slope at site:
Elevation Of vertical refere ice point : SEPTIC TANI:: Manufacturer: Liquid Capacity: j00
-
Tank manhole cover elevation:
rings used:
Number of
Tank Inlet Elevation: Tank Outlet Elevation:
j~ v feet
Number of feet from neari,st Road: Front10 Side10 Rear,
~ tnz> feet
0
}?rpm nearest property line Front,o Side,0 Rear,
n , building:
Number of feet from: well r~-
nclude this information of the above plot plan)( 2 reference dimensions to septic tar
SEE REVFIRSF SIDE
(I
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
DIVISION
LABOR NUM.AM.RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING
P.L. BOX 7969 ,
MADISG`w, WI 53707 State Plan I.D. Ncmben
U CONVENTIONAL ❑ALTERNAT(VE of ass9
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
Fl i\
INSPECTION DATE-
NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER'.
R. R. 5, Riveuide Dn.N.Hudaan, W1 '5
Steve ContLo y ~5T REF PT EL~~
Jt . ELEV.
BENCH MARK (Permanent reference point) DESCRIBE IF IFFERENT FROM PLAN RE . PT
N N. Hudson NE% SWJ4 o~ Sec ion 13, 29N-R19G1, ViPgage v~ G A
Sanitary Permit Number'.
MP/MPRSW No
R CO~"ty 49496
Name PWmbar. - 3224 St. ctoix
vgetc Timm
SEPTIC TANK/HOLDING TANK:
MANUFACTURER LIQUID CAPACITY. TANK INLET ELEV. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
. PROVIDED: PROVIDED
Z YES LINO ❑YES LINO
ROAD : PROPERTY WELL: BUILDING VENT TO FRESH
NUMBER OF LINE, AIR INLET.
BEDDING: VENT DIA.: VENT MATL HIGH WATER
' ALARM / /,n ) ( }h ] /
❑YES LINO J`'1 I ❑YES LINO NEARESTOM / l f V~ J
DOSING CHAMBER:
MANUFACTURER BEDDING PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER
LIQUID CAPACITY PUMP MODEL PROVIDED: PROVIDED'.
(r ZOLS)~ p ~~uL
l'' V ❑YES NO ~nYES LINO ❑YES NO
A
RINLOTRESH
L' PROPERTY WELL BUILDING IVEN
GALLONS PER CYCLE: PUMPANOCONTROLSOPERATIONAL NUMBER OF LINE
(DIFFERENCE BETWEEN FEET FROM ~Q 5 J ~fj ;J
PUMP ON AND OFF) IV—- LINO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LL N(~TI{ DIAMFI ER MATERIAL AND L MARKING excavation. (If soil can be rolled into a wire,
construction shall cease until MAIN J
the soil is dry enough to continue.)
ID
INSIDE DI.
CONVENTIONAL SYSTEM: A aPl7s LDIEQUPT R
WIDTH LENGTH NO. OF DISTR. PIPE SPACING ryIgTEFyRiIAL' PIT
BED/TRENCH - TRENCHES
DIMENSIONS PROPERTY WELL BUILDING VENT TO FRESH
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL NO. DI rR. NUMBER OF LINE. AIR INLET.
PIPES FEET FROM
BELOW PPES ABOVE COVER ELEV. INLFT ELEV. END' 1✓~ f✓J/
I
Z 2 / J NEAREST
MOUND SYSTEM:
M:nd nd site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
afurrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
meets the criteria for medium sand. TIONS MEASURED.
❑YES NO oBSERVAnoNwEUs
PERMANENT MARKER S.
SOIOVER T ExTURE
❑YES LINO ❑YES LINO
' SEEDED. MULCHED.
SODDED
DEPTH OVER TRENCH: BED FDP TH O VER TR ENCHBEU DEPTH OF TOPSOIL
NTER ES
❑YES LI NO ❑YES LINO ❑YES LINO
PRESSURIZED DISTRIBUTION SYSTEM: FILL DEPTH ABOVE COVER
WIDTH LENGTH IN OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPF.
BED/TRENCH TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL' NO. DISTR. DD IISATR. PIPE DISFHIBUT ION PIPE MATERIAL & MARKING
PIPES
ELEV.. ELEV. DIA.. ELE V.
ELEVATION AND
DISTRIBUI ION COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
HOLE SIZE HOLE SPACING DRILLED CORRECTLY PLANS.
INFORMATION ❑YES LINO
❑YES LINO
COMMENTS: PROPERTY WELL BUILDING'.
PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF LINE:
FROM
❑YES LINO ❑YES FEET LINO NEAREST
5 'L r
y V~ Ly - Vr S ~ ~c LGt P Ic"
I /U
4 ts3
'E. 71
13 0
Re n in county file for audit.
stem on
TITLE:
le. SIGNATURE
'710 (R. 01 /82)
WISCOfl9In APPLICATION FOR SANITARY PERMIT ,j
L1L_3S!/ (PLB 67) COUNTY
UNIFORM SANITARY PERMIT #
'EnT OF -
InOU inouR;T TRY,LR LRBO
~OR6NUTRn RELRTIOnS ~j
-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 comp tiny this application. PLEASE PRINT
PROPERTY OWNER MAILING ADDRESS r
PROPERTY LOCATION CITY.
rr
c`1/4501/4, S 3', TZ , N. R 1~SE (or)(!p!<) TOWN O E
_E_LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NAREST ROAD, LAKE OR LANDMARK STATE PLAN II.D. NUMBER
J
TYPE OF BUILDING OR USE SERVED
❑ 1 or 2 Family Number of Bedrooms. ❑ Public (Specify): / r
THIS PERMIT IS FOR A:
Tank Replacement ❑ Repair
❑ New System
❑
i~Replacement Soil Absorption System ❑ Revision Privy
El Petition for Modification
Alternate System ❑ Reconnection
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
5C Seepage Bed ❑ Seepage Trench El Seepage Pit El Holding Tank
❑ ❑
System-In-Fill ❑ In-Ground Pressure Vault Privy Pit Privy
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
Lift Pump Tank/Siphon Chamber C7 'C }
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):
<CJ _L"j Private ❑ Joint Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Si naturB• MP/MPRSW No.: Phone Number:
Name of Plumber (Print): 9
F<' ; ~i,~ s ame of signer:
Plumb " s Addres -
i
COUNTY/DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date: ❑ Disapproved
Owner Given Initial
? -A 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
r
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 he 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.
v..
!Ill AN RE LF i ) ti n ~ ~d sy W .t a t ~ ~ F'.U t C'X ;c
(H63.09(1) & Clial,ter 745.045)
),'Alin - - r
l 1~'l
i _ YEF1 S NAF E (l „I L ,..i l,UUI+c -
- - -
(011",: tF .IF ! ! t _ DATES O'SS RVATIO'VS ^1A~) - - - -
f;IF'rl -
i ilrleni e v^J.t (;F I I
S~'F r' I IONS
.
,T!N S°' Site _ _ ----I
smt for ystern U= Site ur,surtab fot s
s s rn f
~i'.dE_NT16 Jr l T.
IN GRO IVr31',',= -,;:2 TEP -I! l~ IULDIN .
-js - s C_~ - C s Cpl _j S E-1 u ,
F30FILE DESCHIPTI0,NS
- -
LING TOT -
_ `R DEPTH ter Tt=P FH TO C riOU~ )FR I CN CHAF,ACf-ER-UF SOIL V11 rt ~i~ ~coc COL Ot 1 E}:Tl p LE F1:~
-
_-0 SE---VtJ Fa F.'IICFIES TO O K O F I<,)
- -
~ 5 :RVF[ 1) S: 3V O E ~C i LA
F . K e I" Yr,
L J - J - - -
{
a L
,
F PERCOLATION TESTS
TEST DEPTH VV~\ IFR IN HOLE TEST T I 1
N'U.'IJBER fES AFTER SPELLING INTERVA ER
1P.). DROP IN V.'ATER LEVEL IItiCH -y RA)r S
- U T
-
--L-40 r I G r' - ---P
-'LOT PLAN: Shoe; loot n, of percolation tests, soil horings and the dimensions of suitahlu soil areas. Indict tr s 'r er u::stances. D?; In ,.r art! the h
u;tal and vertical elevatl~~, reference points and shovv their location on the plot plan. Shovv the surface eleiatic p
la id slope. borings and tht d and oarcent
_ ~ ff
S S T Edit ELEVA T ION
rj C-.
th•• undersigned, hereby certify that the soil tests reported on this form were mada by me in accord with ti,e procechrtes and riethodS speaJ ,,ct m _:in
idrninistrative Code, and that the data recorded and the location of the te the 1ti'iscon
sts are correct to the bast of my l;nrn led,ue and belief.
r: f: C
_ f J - ~ i'L E:1 LU OV, E: Is
7
L E)RFSS: - J s 4 -z:),
i~_ tt tt, r4 CERTIFICATION NUPAE3ER: PRONE NUiVBLFj(option al):
CST IGNATURE:
IBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester,
i t_S50-5395 IR- 02130 --OVER -
APPLICATION FOR SANITARY PERMIT
S T C - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development be intended for resale by owner/contractor,("spec
house1°), 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 'T~-- /
Location of Property ~,d- 4 "/,I 40 Section , T r N - R W
Township
Mailing Address Vt'{GSipC C) ;?-i,JE iti~0
Subdivision Name./
Lot Number
Previous Owner of Property i\Oc m •:.•i r< ) ,
Total Size of Parcel
±1
Date Parcel was Created
Are all corners and lot lines identifiable? Yes No QOM t2.f=~'
s j FL. V n .f a 3
Is this property being developed for resale (spec house) ? Yes y No
Volume .1 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
I (We) eeAti6y that a.U a.tatementb on this 4ohm ah.e tAue to the best o6 my (owe.)
knowledge; that I (we) am (ane) the ownele (s) o~ the pnopefety deg ni.bed in -this
in6onma ion ~oAm, by vi4tue of a wa4 arty deed &eeoaded in the 066ice o6 the
County RegizteA 06 Deeds as Document No. 7 h 4-(, o and that I (we)
pnesentty own the puposed site bore the sewage pos system (ore I (we) have
obtained an casement, to nun w.'-th the above descAi.bed pa.ope&ty, 4m the
constAucti,on o~ said system, and the same has been duly neeoa.ded in the 066ice
o6 the Countl RegizteA o6 Deeds, as Document No. ) .
SIGNATURE 01? OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
L
DATE SIGNED DATE SIGNED
C"
1' c - 1 0 )
TANK HA I N'l't~i :1f1CF: At~1, I':Lt1LN I'
St l;rU i r: l;uuuI y
C IC
IV 1~ iru Nt~mt:rr _
t<r!U'L'F;/L'UX P+U^1111;1<
i
/ t m} N, l: i W,
It
I
LL)ci N
i
5L CF C) CouuLy,
Lot ILL Ill bLr f C
' I
I
,CL-nt t_~,u1J r~•~ult iti
~i
tl ut
t 1 i t j~ i~ l) p d r s C' <1 t~ _~I L i t t~ t. i l~ C~ 1' t~~ 1 C r 111 it 1- n t L' (lit 1. c C U 1 l-
its, preIll atIt tc`i;tllIt re to IlLiIL~ w:a..t_L_=s. t
si;tt5 ul puutpftt~, uLt L tt?~, aeptr~ LBllk eVCry Cttr<E' yea CS ur ;;uL)lier,
it ueecied, by i tL Ltt_~LL► = -1,L is Lauk P uwliL lJllat yuu put into
rifts ayaCen, Cau ~ti 1uCL tht+ Itill ct UI LIB
Hi ._,ir aCage Ln Liter waste Lli:;l~usal systeut-
tit Croix Cuuut y ~usidenra wu1 l>~, ul ii il,iz
't Hl axilit it lit of 60 01 ttte cost of Icplacu,ueut ul a 1ai11.ny, 5ystca+,
;t. Croix Cuurtty
which waa -Lit u1,L+raLion priur to 1lily 1 19/t)
CC1),ted this prc,graill Lit August , 1 1980, wi, h C11 C rt- (lui r ~ Ill unL that
u c. t o f a l l u L: w s y 6t u ill s ,i I' to keep thutr sysretuts properly
w,tiuL IIit ed.--
i h 1) r U l) e r t y 0 %-j 11 L A I t'_ t: -i L i, ll l,- til i L Lip S L L o L X L. U LL it L y a It l n r :i
rcLi tiuu rural, sigut•.d Ly the uwucI and by a master pluIli beI
.icense~er V e t
u i-
jurne y uiatt pluuil,ur, reSLI ICd pILttit1) e r o t- a l d p u m p
fyln}; t hat (1) the ort - Si.Lct w rit water (.1 is1) us:ll. system is in 1) ropL_r
operating coedit ton and (2 <i Lur LIt spectiC.)u and puutptng (if it ec
essary), the SC ptiC tank is leas than 1/3 I:uil of sludge and scum.
Certification l- L,rtn w ill be scnL a1) pruxiIli ateiy 30 days priur to
three year expiration.
I/WF:, the undersigned, 11aVt- reaLl LIt e a b o V C ruyLI=irelit ents 3 11d agree
to Illai.ritaiii thu private sewage disposal Sy SI- :m in aCC0UdLA nCe with
-c
the standards L furth, Itcrein, as set by the Wisconsin Depart - t
ill citt of Natural resources. Certcatiu,i Ioflit Ili ust be completed
artd returned to the St. Croix County 7.uuii,pg Office within 30 days
of the three year expiration (I atL~.
S 1 C N E 1) / _ _ - )
u AT t _ - - - - - 7 - -
St. C'oix County Zoning Off-tce
P.O. iox 95
Hauunolad, WI 51101.5
715-7 16-2239 or 715-425-8363
Sign, date anti return t_u abuvi; a(I dress
^ JOB , ✓
ROHL & TIMM EXCAVATING SHEET NO. OF
310 Arch Street , r r
HUDSON, WIS. 54016 CALCULATED BY k i• DATE
(715) 386-8664
CHECKED BY D7 ME
F
SCALE
4`°•, `
mw
3 w: r
~ CPS
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06
Cp
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PRODUCT 204-1 Inc, Grotan. Mess. 01471.
FM 411
1082
~U4L.~TY PUMPS SiYCF IN39 O
c
3280 Old Millers Lane
P.O. Box 16347 . Louisville, Kentucky 40216
(502) 778-2731
COMPARE THESE FEATURES
• Vortex Impeller Design. "137" Cast Iron Series
• Float operated, submersible (NEMA 6) "139„ Bronze Series
mechanical switch.
• Durable cast construction. Cast C`W switch case, motor and pump housing, F L
base and impeller. u sheet metal
MATE"
parts to rust or corrode.
• Stainless steel screws, bolts, float rod,
handle, guard, and arm and seal FOR SEPTIC TANK SYSTEMS
assembly.
• Bronze units available. EFFLUENT
• UL-listed 3-wire neoprene cord
and plug. OR DEWATERING PUMP
10 ft. standard for automatic.
15 ft. standard for non-automatic. SUBMERSIBLE
Automatic reset thermal overload 11/2" NPT DISCHARGE
protection.
• Oil filled motor-hermetically sealed. SPA
• Carbon and ceramic shaft. Lerntie;f
• Maximum temperature for effluent or
dewatering -130° F. - 54°C.
r•ru•
IFC-- Z qft
• 60 cycles, 1725 RPM.
Passes 5/e inch solids (sphere). sump a sewage Pump
Mfg. Assoc.
• No screens to clog. SSPMA Specification
L Number
• 1112" NPT Discharge. 197 Series sczzzs
e~ 199 Sarin SB1115
• On point-93/4".
• Off point-3". LISTED
• Major width -113/4". its
i W ' i• Height-13".
SIMPLEX AND DUPLEX
SYSTEMS AVAILABLE
PACKAGED SYSTEMS
AVAILABLE
VARIABLE LEVEL CONTROL
SYSTEMS AVAILABLE
6F r DESIGNED FOR
L HEAVY DUTY
EFFLUENT APPLICATION
3280 Old Millers Lane MODELS AVAILABLE
P. O. Box 16347
Louisville, Kentucky 40216 Automatic or Non-Automatic
(502) 7782731 • H.P., 1 Ph., 115V, 200-208V or 230V
• '%1 H.P., 3 Ph., 200-208V or 230V
• Canadian Standards Assoc.
Manufacturers of Approval available
d • LA Los Angeles code
ZWITY /I&W.9 SNCE lffl g Approval available Vortex Type Impeller
V,
w
w
• HEAD CAPACITY CURVE METAERSYNAMIC HEAD FEET/
MODEL 137-139 SERIES CAPACITY GALLONS/LITERS
30 CAPACITY
HEAD UNITS/ MIN
g FEET METERS GAL LT RS
25 5 1.52 104 394
i 10 3.05 79 300
_ 15 4.57 64 242
6 2Q- - 20 6.10 36 136
Z 25 7.62 8 30
a
0 26 7.92 0 0
a ~15
4 I
10
2
0
U.S. 10 20 30 40 50 60 70 80 90 160 110
GALLONS
LITERSI 80 160 240 320 400
0 FLOW PER MINUTE
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Three phase pumps are available in 200/208V or • Mercury float switches are available for controlling
230V. single and three phase systems.
• Electrical alternators, for duplex systems, are • Double piggyback mercury float switches are avail-
available and supplied with an alarm. able for variable level long cycle controls.
• M9chanical alternators, for duplex systems, are • Long cords are available in lengths of 15 -25 -
available with or without alarm switches. 35 - 50 feet.
is Combination starters are available. • Over 1301F. (54°C.) special quotation required.
SINGLE AND THREE PHASE UNITS
137 Series 139 Series
Cast Cord Cord
Iron Volts-Phase Wt. H.P. Amps Length Bronze Volts-Phase Wt. H.P. Amps Length
M137 115-1Ph Automatic 47 112 104 10 ft. M139 115-1Ph Automatic 51 1/2 10.4 10 ft.
N137 115-l Ph Non-Auto. 47 112 10.4 15 ft. N139 115-l Ph Non-Auto. 51 1/2 10.4 15 ft.
D137 230-1Ph Automatic 47 1/2 5.2 10 ft. D139 230-1 Ph Automatic 51 112 5.2 10 ft.
E137 230-l Ph Non-Auto. 47 112 5.2 15 ft. E139 230-1Ph Non-Auto. 51 112 5.2 15 ft.
F137 230-3Ph Non-Auto. 47 1/2 3.4 15 ft. F139 230-3Ph NgrrAuto.. S1 1!2 4 15
H137 200/208-1 Ph Automatic 47 112 8.4 10 ft. H19
39
200/208-1 Ph Automatic 51 1/2 8.4 10 ft.
1137 200/208-1 Ph Non-Auto. 47 112 8.4 15 ft. 1139 200/208-1 Ph Non-Auto. 51 112 8.4 15 ft.
J137 200/208-3Ph Non-Auto. 47 1/2 4.2 15 ft. J:13 200/20873P Non- w; tq. 1 1/
Three phase units require a control switch to operate an external magnetic or All installation of controls, protection devices and wiring should be done by a
combination starter. licensed and qualified electrician. All electrical and safety codes should be followed
For information on additional Zoeller products refer to catalog on Combination in addition to the most recent National Electric Code (NEC) and the Occupational
Starter, FM-514; Piggyback Mercury Float Switches, FM-477; Electrical Alternator, Safety and Health Act (OSHA).
FM-486; Mechanical Alternator, FM-495; Alarm Package, FM-513; and Sump/
Sewage Basins, FM-487.
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is an engineered/design part of every Zoeller pump.
aass" 3280 Old Millem Lane Manufacturers of
ZZMZZ1j-f O. Loo i Ble, Kentucky 40216
(502) 778-2731 Q~.~.rr PUMPS S;vcf /93.9 N
PAGE t OF
CroSS Jec~turl pS A 16r1) S S~en-l
fresh Al, lnlett And Obserrotlon Plpe
-i•' Approved Vent Cop
Mlnlmuwt II' Above
FI„UI ~uU•
I
I
20- 4 2' Above Pips ii 4" Cost Iron
To final Grade.-- Vent Pips
9
_ Mwih Hop Or SynlhNk Curd ln{~_
rm 2" AUU~~Uale -
Orer Pipe
Olurlb.I I'l,
Pipe 0 1,-- Tao c
6` AppisOolo
Beneeln pip. 0 Perloroled pipe below
i ~0 I (;OwMing Terminollny At
• " dollom 01 System
701-
SOIL FILL
D15TRIBUTIOf.1 PIPE
APPROVED S'JJJTIIETIC COVc
~fu OF r~r~ OR `i OF STRA`,
r4 /~6G'IR GI~1TE OR tAAKSN HAy
jr~ ~~W 1 SOP/2c^.~/zaAGGRCGATE
r
DISTRIf5UT1(D1J PIPE TO PIE AT LEAST IUCHE5 BELOW ORIGIAIAL GRADE
AQU AT LEASTIO WCHES BUT LIO MORE, THAKI H2 IKICHES BELOW FIKJAL GRADE
MAXIMUM MPTH OF CXCAVATioij r oM OR16 lAL fWK WILL BE INCHES
PUt4)#''%UM Mprii OF EXCA\IATIOM MOM ~tt,tMq~ (,949E WILL ?SC ~ IJ INCHES
r .
r
LIC-EUSE W/tAlB/ER:
DATE : < 1_ rf (a t_I
lin
I )r I RlL.N F OF SAFETY & BUILDINGS
INDUSTRY,
ORT ON SOIL WRINGS AND
LABOR AND DIVISION
909
HUMAN RELATIONS PERCOLATION TESTS (115) MAD P.O. ISON, BUWIX 7
53707
(H63.0.9 (1) & Chapter 145.045)
LOCATIOfV SECTION: NICIPALI TY: LOT NO. BLK. NO: SUBDIVISION NAME
M E '/45w~/ /v /T~`) N/R /'9 E ( v ps4 r. t r~.
COUNTY: (,~WN,I FL S BUYER'S NAME - - - MA A.
-
_ ILING Ap(7RESS:
u Z I V e e.:"' l os D uLt 4- N o. 4'j P s ~aN, ,'AA, ZXO /G
DATES OBSERVATIONS MA'bE
NO.BEnRMti,: COIVIPJIERCIA( DESCRIPTION: PROFIL `DESC)RPTIONS: R OL TION fcST`
L/Residence r-
_ I New Replace
a U r ~ $ c~c~ l G,. -
RATING: S= Site suitable for system U= Site unsuitable for system
CO J ENTIONAL: MOUND: IN_-GRO N[1F'RESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOi11MENDED SYSTEM:(optionall--
_ s au Las _ - 's ouIos zu Qs Zj CUA'1V. 8ED
If Percolation Tests are NOT required OESIGN RATE: if the
under s.H63.09(5) (b), indicate: q LFlnodPIjm, any portion of the tested area is in the
+r' indicate Flocarplain elev hon: ,
PROFILE DESCRIPTIONS
BORING TOTAt_ 7,c
UDEP) r t3Ui1N^J'rAl
NliitihBER t~EPTHt# ;L WITH iH;Ct;RESS, COLOR, IU.+;'E, APP
`.LEV.4!!Oi~ OBSERVED, E T FiII,I)kST~ TU BEDROCK IF OBSERVED (SEE ABBRV. ON BACK,) ,D ut'rF,
ij(_ t-;:~o' ~sN tL ~•so~ 8~,; ien Y c~,
B- l 31 ~`~I^~ 7► 7, 5-
-3
S
t 5 -w-_ co ar S=mar PQ~T < 3..
B-
5 , , so ' 8r~ r2 n
P_ $.~5 703.4 > 8 Y
B- -
B- - ~ 703 36
y > o, 3S ' g 1.3 s ' 5" L ; -5s' 5^4 V-0- 4 ~1" C~5
CB_
D ELI M i4 t_ - - _ - -
FMS T PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INLI 1
NUMBER S AFTERSWELLING INTERVAL-MIN. pEg19p j_-___ a pER1oD 2--_-_ zn RAP FIfi' !NCHE~ ~ ya€V
P- Z Z.761
h l aN - - 7CZ' S3
- - - - 7Gl ~i`'
P- 3,10 ' r~l E Z
P_ 3 in3
LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of sui!ab!e soil areas. Indicates;c*1R eut adtl,tances. Describe whit are the hog
ntal and vertical elevation reference points and show their location on the plot plan. Show the surface elevatir,ni at ailll borings and the direct(: ~ and percent
f land slope.
YSTEM ELEVATION 704• 7t
E PSTT'Ac~,F4 EIC> P P,4,L,,J I t~ 1 4
- J'
lee
the Undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods slretd7 ed in the bVisconsin
ministrative Code, and that the data recorded and the location of the tests are correct to the best of my F:nowlecige and belief.
P.1E (print):
_ ~TFSTS V"ERF COMP! ETEF) r) ! - -
URCSS.
t . r (Ei f If ICA7ION NUMBER: PHONE NUMBER (option al)
CST SIGNATURE: -
STRIBUTION: Original and on,! copy to Local Awhottty, Property Owner and Soil l+stcr,
' W'3-SBD-6395 7R, 02i82)
- OVER k