HomeMy WebLinkAbout036-1078-70-000
C !n O g -0 0 d _1
m
m A 0' v
v v' # c
CD 1 LI fD
CD 3 _ ~ ~ ` 1l
I ~ O
O A j O
n O N O W N Cl)
•
m 3 O o9 'm w *I
CD- z Q. N C.li CD p L OJ h
°
N d fl! N W N O ~'1 n
i CD C)
O v cr T:) n CA Z i~ x ° c CD 7 CD n o A~ O
co z
(D b 7J m m ° a ,
~l (D N
a°WO V
N
O H. 3 O
d~~ H -I- m w W n 0 c
w N D C/) a
Z ON
s., y (D In H CD !r
O O O
•
z
F' b c o U
0 Sr CD
a) 3 v v v 3 c
a- cn
C7 (D V ' ° O m
(D Cr
(D 0
< o 3 d
rt cn°
U) w a 4~' N
C) o O
Z
1 o z :i z v
n Cp 00 r-3 H cn - D CD
w w p w t~ Co O
E o' =r !r
.
(D CD
cn t ~J EEn
m `D
p o
r-h r S m
r N n CD O -i cn
W in o
N•
f rr O o
J (D i _ -i
1
w
(D 03 'a m
m CD
a g :at Z
p Cl)
o
N <
O I' ?
.D
W p~
n
(D
d
O C
O _
N C
z o
o
cD
N
I ~
I y
a
I
N
O
i
N
O
O
a
I A
0 A
CD ha ~A
to O q
o (D
6 C
Parcel 036-1078-70-000 07/20/2006 04:44 PM
PAGE 1 OF 1
Alt. Parcel 31.31.17.487C 036 - TOWN OF STANTON
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 - BOBLIT, GERALD E
GERALD E BOBLIT
1430 181ST AVE
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ` 1430 181 ST AVE
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 0.690 Plat: N/A-NOT AVAILABLE
SEC 31 T31 N R1 7W SE SW.69AC COM SW COR Block/Condo Bldg:
LOT 1 HOOK'S ADD. S89DEG W 149.70' ON N
LN VERN LAIN DR. EXTENDED W TH N 190'N Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
80DEG E 151.63'S 213.20' POB 682/616 31-31N-17W
Notes: Parcel History:
Date Doc # Vol/Page Type
08/03/2000 627554 1531/583 WD
06/13/2000 624797 1519/111 QC
07/23/1997 682/616
07/11/1989 449589 845/440 LC
2006 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/06/2003
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.690 22,000 128,000 150,000 NO
Totals for 2006:
General Property 0.690 22,000 128,000 150,000
Woodland 0.000 0 0
Totals for 2005:
General Property 0.690 22,000 128,000 150,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 124
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
AS BUILT SANITARY SYS'T'EM REPORT
r '
OWNER `t r tom, TOWNSHIP,`~r~sy,_ SEC.}~TN-R/2 W
ADDRESSfZ.44 ST. CROIX COUNTY, WISCONSIN.
mew./21 e' t'I. C-r~c
SUBDIVISION - LOT - LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H63
SHOW EVERYTHING WITHIN 1.00 FEET OF SYSTEM
r
! i
i
L~
f'P
.L•
I di at N r h ffw
BENCHMARK: (Permanent reference Point) Describe: -/i`~/117
f
Elevation of vertical reference point: Slope at site: G2 Z is
SEPTIC TANK: Manufacturer: Liquid Capacity:%~~/
Number of rings on cover c~ Tank manhole cover elevation:
`l'ank Inlet Elevation: Tank Outlet Elevation:
PUMP CHAMBER
Manufacturer: _ Number of gallons
Number of &,alpump set for a cycle gallons; Total capacity of
distribAx'lon lines ---gallon: size of pump head;
galloal per minute horsepower ;brand name of pump
model number
an
pe~of warning device _
HOLDING T Manufacturer Number of gallons
Ele tion of manhole cover
T pe of warning device _
SEEPAGE T SIZE; Number of pits feet diameter
f t liquid depth seepage pit inlet pipe-elevation
bottom o.f. seepage pit elevation feet.
SEEPAG D SIZE: number of lines _ width length tile depth
SEEPAGE TRENCH(O-Lidth_ length -5c'
PERCOLATION RATE _8 AREA REQUIRED -~6r5 AREA AS BUILT<,'Co
INSPECTOR
PLUMBER ON JOB. u1
DATEDC) ~ .~=3 - T,
LICENSE NUMBER m-~i ~Jl~ j 3~5
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS
F.O. BOX 7969 PRIVATE SEWAGE SYSTEMS
DIVISION
MADISON,'W,! 537D7 BUREAU OF PLUMBING
CRCONVENTIONAL ❑ALTERNATIVE E77
❑ Holding Tank ❑ In-Ground Pressure Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER.
INSPECTION DATE:
Glen Hansen RR#3, New Richmond, WI J - ''f Y3 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN
REF. PT. ELEV.: CST REE PT. ELE V
SE SW, Section 31, T31N-R17W, Town of Stanton
Name of Plumt~er. MP/MPRSW No. County Sanitary Permit Number:
Gary Steel 3254 St. Croix 43675
SEPTIC TANK/HOLDING TANK:
MANUFACTURER LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING OVE
PR VI ED PROVI
✓"r2 7 fL%~ 4~ a~. JC~~.. JZ ES ❑NO Y ❑NO
BEDDING: VENT DIA.: VENT MAT: HIGH WATER NUMBER OF + ROAD: PROPERTY j WELL BUILDING: VENT TO FRESH
/ ALARM FEET FROM LINE lA1R NLET
❑YES NJ C C ❑ ❑NO NEAREST
DOSING CHAMBER:
MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANtiIF AC 1RER
WARNING LABEL LOCKING COVER
/.F PROVIDED: PROVIDED:
❑YES ❑NO j ❑YES ❑NO ❑YES ❑NO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERA IONA MBER OF PROPERTY WELL BUILDING. VENT TO FRESH
(DIFFERENCE BETWEEN EET FROM LINE IAIR INLET'
PUMP ON AND OFF) ❑YES ❑NO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of`plowing LLNCITH DIAMETER MATERIAL AND MARKwG
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 COy~ R INSIDE DIA -PITS LIQUID
TRENCHES
DIMENSIONS / '7 NvAr RI PIT _ DEPTH
GRAVEL DEPTH FILL DEPTH DISTR IPF DISTR. PIP ISTR. PIPE MATERIAL NO. STR NUMBER OF PROPERTY WELL. BUILDING VENTTO FRESH
BELOW PIPES ABOVE COVER ELECV INLET ELEV N PIPE LINE'
AIR ET.
l 1k Q~ , ~j FEET FROM l
NEARES► 1
MOUND SYSTEM: LiM
Mound site plowed0irpendicular 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-
❑ YES ❑NO meets the criteria for medium sand. TIONS MEASURED.
SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS
❑YES ❑No ❑YES ❑NO
DEPTH OVER TRENCH BED DEPTH OVER TRENCHBED DEPTH OF TOPSOIL SODDED SEEDED MULCHED
CENTER EDGES.
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH ENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER
TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL MARKING
ELEV. ELEV.. DIA ELEV.. PIPES DIA.:
ELEVATION AND
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
❑YES ❑NO r ❑YES ❑NO
COMMENTS: PERMANENT MARKERS. J~SBSERVATION WELLS. ~IUM BER OF PROPERTY rL[
BUILDING.
BEET FROM LINE,
❑ YES ❑ NO ❑ YES ❑ N G' NEAREST
r
L-7
Sketch System on in in county file for audit.
Reverse Side.
SIGNATURE TITLE _
DILHR SBD 6710 (R. 01/82) ~ 1"
. wlsconsln APPLICATION FOR SANITARY PERMIT
COUNTY
(r DILHR
~ OEPgRTTEnT OF (PLB 67)
InOUSTRV, LRBOR 6 HUMAn RELRTIOnS UNIFORM SANITARY PERMIT #
7~
~V
-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
PROPERTY OWNER MAILING ADDRESS
PROPERTY LOCATION ? t A), G! 5 4,IU/
C-fT-14
SC1/4501/4,S, ,T R ) ~II1°OE
IN, 1~,(Or) W TOWN OF LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
TYPE OF BUILDING OR USE SERVED
1 or 2 Family Number of Bedrooms. ❑ Public (Specify):
THIS PERMIT IS FOR A:
❑ New System ❑ 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
J 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 0
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
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
'0 - i0 Z
i 0 6) ❑ Private ' Jloint ❑ Public
I, the undersigned, hereby assume responsibility for installati n of the private sewage system shown on the attached plans.
Name Plumber (Print): Signature :t /MPRSW No.: Phone Number:
Plumber's Addre s: Name of Designer:
COUNTY/ DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date:
G~j ~7 ❑ Disapproved
-t-? ❑ Owner Given Initial
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.
UL'AH-(MLN I W REPORT ON SOIL BORINGS AND ' ` `U ` 1
INI:)~STHY, UIVI SIOIv
I' U box 7JUJ
LABOH AND
HUMAN fiELAI ION: PERCOLATION TESTS 115 IVIADISUN, WI 631W
W63.09(1) to Ch'sp ur 145.U4b)
LOCATION S0 IION I i1UVIV:;l11P/MtI1Vrt LYl4tY1 Y L U 1 NU ~I-F, NU [MIDIVIjION NAML
COUNTY: OWNLH'Sllttll~tilL NAMC PnAII-INC ADDf1E s - - -
_ ~ -11 ~.1LYL~L r). <1 -Y,' J k- l1 r L)' c `JLI 1 ~~1 J
USE DA YES OHSL VIVA I EONS MADE
NO.HkUHM;. TOMMLIWI)kI DESCHIPIION fiiofILE131" P-11 NS PEHCOLATIONTLSTS
~~Hnu innl n I 1 Nuvv lAFiupluw `J
HA rING: S- Sit. aurtaWa It syatum U-- Stlu una u,lahlu to, ayalum
CONVENTIONAL MOUND IN GHUl1Nl)t'Itl `;l1HE:I,Y;TFM IIV 1-11 I~HOLDINC TANK HECOMMLNULU SYSI M:(upuuu„I)
:u
r DU Ns 1_ju _As C JU i_7 ys r-IS U 1
>r:.=f:C1_~LC.._ LLG t Y'CY1 ' Y1.L f1 Cl L'tc r l it r~ t~..k.
I11 I'MCUluuun leala aiu NOI ,u4u u ud I.IL IL,N ItA IL
_ 71 iuly pus lic,~n lhU to i I aila is in lhia
uc of
l-u-tldtl~l Y.=NU J.Uyl bllo) u L
Ulu Fluutlpl un, uulicatu 1 luodplaui uluvalwn
PHOIALE DESCHIPTIONS
BORING T01AL. - ) I' II l U (VIII L 11 I)vvA I I II INt'NFS CHARACTER OF SOH WITH 1-1-IICtUV1-.SS, COLOI-I, TEXTURE, AND DEPTH
NUMHEFI ULPIII IN LLLVA I 10N L_
_ IVEQ L i1~~IICiH 'I TU IIEDHUCK IF OHStftVl U IkL AUHItV ON BACK 1
d-
Ot PLHCOLATION TESTS
TESL I,LPTN WA1 EH IN 1101 E TEST TIML DROP IN WATfII I fVFI INCIIF'.`. _ RATE. MINUTES
NUMHLLI +Ni;Ht+,- AFYLI'iSWLt-LING IN7EltVAL MIN -_f.'L1 LS2L L-- PL11!S2L~2-- PLf11t)r)_ PER INCH
P
I
PLOT PLAN. Shuuv lut.dlwna ul putUulahun lush, awl bu,utea wul 11,,: thnurn4un14 ul aw lahlu u,il a,ua;. ha i,:dlu saalu ui ulawncua. UU54-11VU vuhat did 111U h0ii
tontul and varticdl uluvdtlun iulnronl;u pollee and shuuu 01011 lucauun un ll,u plot I.,Idn_ Shuvv u,U 4uifacu tlUVauun at all buullya and ulu dlrucLlon dnd percunl
ul land slopu-
SYSTEM ELEVATION
I I lI I i
l
1, the Undulslyoud, huteby culllty that lhu 4011 teSla lupus tad un tnia lutoi vvuro mauU iiy nw ,n accun.l uvlth IhU prucudutua dud ntuthUda apuclfied ut lhu WgGU41a111
Adttumhuauve Cude, and tlldt lhu duln lucurund and the lucauun u) like tests are correct Lo the bunt of my knuvvludyu and buhut
NAME (pnnt) I LS IS WLHL COMPL L I L D ON
AUDRE S CkHI IFICAI ION IVUMI:IL H I HONE- NUMHLH(upuunal):
.-r Wc~ - 1, z o a
(";I I(,NJ U -
DE41HIULli ON. Uiiywal unu una,.upy to 1 u,.il Auu~,a uY. I'i uli~~iy i)vu nci .,nd Soil IU;lui
L)IL_HR-SHU b3t)',, (lt U2/61) UVkR
EpA`Rt(MENT OF REPORT ON SOIL BORINGS RE~E~~E ES BUILDING
INDUSTRY, i'sAt3 DIVISION
` LABOR AND JAN ~ O. BOX 7969
h3UMAN"RELATIONS PERCOLATION TESTS (115 20N►N~ MA N, WI 53707
(H63.09(1) & Chapter 145.045) OFE~(E
LOCATION SECTION 0WNSIIIP MUNICIPALITY k0l IVO BI '~1~1 `LIBUIVISIOE.
COUNT - OWNER'S/BUYER'S NAME jMAIIING ADDRESS
~,v ~
t
USE DATES OBSERVATIONS MADE
NO. BEDRMS COMMERCIAL DESCRIPTION PROFILE DESCRIPTIONS PERCOLATION TESTS;
EAR.1,dence-NewHcpl,ce
13 _
RATING: S= Site suitable for system U= Stte unsuitable for system
CONVENTIONAL MOUND - r-GHOUNf>PHF SURE~YSTEM IN 1 III IIOI.IIING TANK HECOMMENDLD SYSIEM:(opilonal)
o s ❑u ❑ s ~u s ~u El s ru 1_a s cu 1__
It Percolation Tests are NOT to wired DESIGN RATE:
4 ff any portion of the tested area is in the
under 0163.09(b)(1)), Indicate Floociplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS E Za ,5-14:?
BOHING 1t)fAl )L.PIH 10 (iliOl)NUWATEH INCHES CHARACTER OF SOIL WITH THICKNESS, COLON, TE X1011F, AND DEPTH
NUMBER DEPIII IN, LLEVA I ION OBSLIT ED EST. HIGHEST TO BEDNOCK IF OBSERVED (SEE ABBItV. ON BACK.)
B I c e , v /o 4.
sv
B Z `'7 y. 0 n/ 3
B-
B-
B
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVELINCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIQD_Z_ _ pERIOD2 P_RIZS P R IN
P r - - - -
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 hon-
zontal and vertical elevation referance points and show their' location cm I'l- elan. Show the surf-."it, , at all borings and the direction and percent
of land slope. Ylr,~i)r~/)J.A
SYSTEM ELEVATION
p 4s~ ►~m rz urnt- r 34-6f, --Zn--a^y 441- Ot"
Oz; o t--w-vri 0 a 4 f r
J Tq1 j
dW+3 3 f
FowF r {,t~It
1, the undersigned, hereby certify that the soil tests reported on this form were made by me to accord with the procedures and methods specified to the Wisconsin
Administrative Code, and that file data recorded and the location of the tests are correct to the best of my knowledge and ballet.
jNAME (pri TESTS WERE COMPLETED ON:
ADORES CEfIFIFICALION NUMBER: PHONE NUMB Ell (opt iuiial):
- J~~ C1 Y L~ _ ' - yCLF ~ ZILZ 17.1 ~~4 r ~✓X = 11
~C:Sf 'I(, 1FUIJI
V 4/ 17
U
co J
~~.3 a
r~ ~ z
i
~p i2 J c f< ~ g ~ ~ ~ (14- ►2 C,
`k'~C
State of Wisconsin ` Department of Industry, Labor and Human Relations
ti
SAFETY & BUILDINGS DIVISION
,oFi r o `st q
AUK
1 1 East
P.D. Box
cr v. 'la
• a .:Y~` ~~''2*~ f " r' r }:y rte.
of Stirstor" St.
ski+ *rioq da't.e9 A tte-,4i iF 4,!;, } tt'r v ti % s z £ .a,
-ranted t* allow the i AsW Il tt i n of a conventional sy5 trr
"ni% apprt vi1 is for t ;tepo to d :l d_3 s
if the v.esigp and size of s ste . All ot; r criteria in chapter 1L4R Pi, Wis.
°
Code, ~ s t b4: -*,*t at tf of q;4rmit )S%V-,ar
lti~r31'# }";.'Cr y*r fit''a „ Y^ .r-s>>a.r.°s `E , f`
ii M' i°pt.:t^''4
==,)f rc Ku}rat of local omii are: s permit t i st t i t ion as pr pi- s .
to fi.~Mll
,A4t ira11 y vrsi f this ap rold l .
y of r operational or or ncr..r•, t
' v l r an
ri*c i t of approval by t is art ww r
`is Jett r• io no way rplin =w<is " t.
DILHR-SBD-6423 (N. 04/81)
• State of Wisconsin ` Department of Industry, Labor and Human Relations
SAFETY & BUILDINGS DIVISION
3f 3t I for an.' ripfects in pl4:os or Sp iflc.ations' plan tmi"'-slorls,
r' 1++~~'yltj!non sS~3gtw~t~~'§s'i-gy, ,f,.a~ "putt i9,~} or any a~ f~~ that $r~"yi~f~~ in or 1 stAl 4 xL anti S esi#9}~es V) right t , Qef. ifq 4yz"t l
{ Y . S i~ '3 as a3
would change. or If water is wwstrvi~--j
.P.S.S.
DILHR-SBD-6423 (N. 04/81)
SBD 6678 (9/81) (Plb 100a) 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 178
Any Return Correspondence P.O. BOX 7969
MADISON, WI 53707
608-266-3815 81 DATE: ~ /'9 PROJECT:
i
AuG VE
119 3 1
q al, J
I6 Stan;
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 $
❑ Underpayment - Please submit the additional fee. ❑ Overpayment - Refund forthcoming.
❑ Plan accepted for review. ❑ Plans being returned.
❑ No fee has been remitted. Plans submitted with no fees will be ❑ Additional information required. SEE BELOW.
held in abeyance.
1. Plan Submission ❑ Complete data relative to anticipated use of bldg.
❑ Additional information shall be submitted in duplicate un- ❑ 2 copies of PLB 60 enclosed.
less specifically noted. ❑ Deed restriction required (1 copy).
❑ Plans not clear, legible or permanent. ❑ Condominium declaration. (1 copy)
❑ All information submitted shall be signed, dated and sealed
or stamped in accord with Section H 63.08(2)(a) Wisconsin IV Holding Tanks
Administrative Code. ❑ Affidavit enclosed.
❑ Profile of holding tank showing vent, manhole alarm and
manufacturer if precast. Complete construction details if
II. Pressurize Distribution Systems (Mound or In Ground Pressure) site constructed.
❑ Application for use of an alternative system signed by owner ❑ Holding tank agreement signed by owner and local unit of
and notarized. (1 copy) government (sample enclosed).
❑ County onsite required (1 copy). ❑ Design calculations ❑ Reason for installing holding tank. Soil test or statement
for pressurize distribution. ❑ Soil boring & percolation from county (1 copy).
test data. ❑ Plot plan showing location of holding tank with lateral dist-
❑ Cross section of system. ❑ Pipe lateral layout. ances to any building, wells, water service piping, water
❑ Plan view of system. ❑ Plot plan. course, lot lines, swimming pools, all weather service road,
❑ Verification of Exception Status Form by County. (1 copy) Etc. Provide benchmark with elevation reference point.
III. Private Sewage Disposal Systems V. Lift Pump
❑ Ground slope with 2' contours in entire area of soil absorp- ❑ Calculations for total lift pump discharge, head and gallons
tion system extending 25' on all sides. pumped per cycle.
❑ Elevation of permanent reference point (benchmark). ❑ Size, length & depth of force main.
❑ Location of area suitable for replacement system - provide ❑ Detail & model of pump or automatic siphons including
soil data. size, pump curves, drawdown and average flow rate GPM.
❑ Plot plan showing lot size and all lateral distances from ❑ Cross section of lift pump tank showing pump(s) or
sewage disposal system to buildings, lot lines, well, water siphon(s).
course, swimming pools, water service piping, Etc.
❑ Construction detail of septic, holding or lift pump tank if
site constructed or tank manufacturer if precast. Vl. Systems In Fill (Fill must be placed prior to plan submission)
❑ Construction detail and cross-section of soil absorption ❑ Total area filled (fill to extend 20' beyond edge of trench
system. before side slope begin).
❑ Soil boring and percolation test on 115 completed by cer- ❑ Depth and type of fill.
tified soil tester (1 Copy). ❑ Copy of onsite report by county or district staff.
k
ST. CROI X COUNTY
$ z WI S C 0 N S I N
Firrca~l~ ZONING OFFICE
f ° r
796-2239 (HAMMOND)
425-8363 (RIVER FALLS)
HAMMOND, WI 54015
July 1, 1983
Division of Safety and Building
Bureau of Plumbing
P. 0. Box 7969
Madison, WI 53707
RE: Glen Hanson property
Location: SE14 of SWZ of Section 31, T31N-R17W, Town
of Stanton, St. Croix County
Dear sirs:
An on site inspection of the above described property
revealed mottled soil conditions at 35 inches. During
the monitoring period, observations were made on several
occasions revealing no evidence of ground water.
Should you have any questions regarding this matter please
contact this office.
Sincerely,
Thomas C. Nelson
Assistant Zoning Administrator
TCN:mj
46
t~ .
. REc~~vEO -
C.0 JAN 181983 ~
ZONING
S, OFFICE /r
-~546M-l S, jl 2,
pff,
y N J ~ /tea ~~~r9~ ..5~ ~ ~s ~ s s b~'~-✓
S6,
'z 9y
DEPARTMENT OF REPORT ON SOIL BORINGS Rlmv[C~A~ & BUILDINGS
DIVISION
INDUSTRY,
• LABOR AND PERCOLATION TESTS (11 JAN 181983 P.O. BOX 7969
HUMAN RELATIONS ZONING M ON, WI 53707
(1-163.090) & Chapter 145.045)
LOCATIONSECTION: OWNSHIP/ UNICIPALITY: LOT NO.: NO.: S ISIO E:
.S r: 1/41,\ 1/a / /TJ I N/R /1 (or) W
COUNT OWNER'S BUYER'S NAME: MAILING ADDRESS:
64 /0
DATES OBSERVATIONS MADE
USE
NO. BEDRMS,: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PER OLATION TESTS:
i „ ; l s(>
(Residence - - ❑ New N Replace
RATING: S= Site suitable for system U= Site unsuitable for system
-
CONVENTIONAL: MOUND: IfV-GROUND PR-ESSURE: SYSTEM-IN-FILI_HOLDfNG TANK: RECOMMENDED SYSTEM: (optional)
DS ❑U EIS ❑u EIS 1A ❑S ❑U ❑S ❑U
f Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
FI
under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN5ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
, >-JYzo
B- ,
ti
,U
B- Z .3
B-3 .7 "61 L. 4- 5 5. In Moo. m .S
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERI D PER INCH
P_
P- -
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
b3 ~E~ft^ - S,C _C~'Urn~r CEP r ~-ry 44- Off)
1 Ill
f ( +r
N
V~ OW-3
ztV
pv w r odi
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.
N TESTS WERE COMPLETED ON:
AME (g in /
- CERTIFICATION NUMBER: PHONE NUMBER optional
ADDRESS YE:
r
State of Wisconsin ` Department of Industry, Labor and Human Relations
July 27, 1983 SAFETY & BUILDINGS DIVISION
Bureau of Plumbing
201 East Washington Avenue
P.O. Box 7969
Madison, Wisconsin 53707
Mr. Gary L. Steel
988 North Shore Drive
New Richmond, Wisconsin 54017
Plan Identification No. 83-03945-M
Dear Mr. Steel:
Re: Hanson, Glen - Property
Groundwater Monitoring
SE,SW,31,31,17W
Town of Stanton, St. Croix County, WI
Groundwater monitoring data submitted in accord with section ILHR 83.09
(7) (a), Wisconsin Administrative Code, has been reviewed. Approval is hereby
granted to allow the installation of a conventional system.
This approval is for the depth to groundwater only and does not include review
of the design and size of system. All other criteria in chapter ILHR 83, Wis.
Adm. Code, must be met at the time of permit issuance by the local authority.
This approval is subject to the following conditions:
1. That any locally concerned authorities having the responsibility o!
enforcement of local ordinances permit the installation as proposed.
2. It shall be necessary to fulfill all permit requirements of the city,
village, township or county. Failure to obtain such permits will
automatically void this approval.
3. In the event that this approval creates liquid waste problems at ground
level or any other operational or maintenance problems occur, the
provisions necessary to resolve these problems shall be commenced upon
receipt of approval by this department.
4. This letter in no way relinquishes the use of soil mottling to determine
the depth to high groundwater on any other parcel or any other portion of
the parcel than that described herein.
DLLHR-SBD-6423 (N. 04/81)
•
State of Wisconsin Department of Industry, Labor and Human Relations
Mr. Gary L. Steel SAFETY & BUILDINGS DIVISION
Page 2
July 27, 1983
In granting this approval, the Division of Safety and Buildings does not hold
itself liable for any defects in plans or specifications, plan omissions,
examination oversight, construction or any damage that may result in or after
installation and reserves the right to order changes or additions should
conditions arise making this necessary.
This approval shall remain valid unless the site is altered in such a way that
the depth to groundwater would change, or if water is observed within the
critical depth for system operation for seven consecutive days.
Sincerely,
Edmund M. Drozd, C.P.S.S.
Soil Scientist
Section of Private Sewage and Platting
EMD:jdh
cc: Leroy Jansky, On-Site Waste Specialist - District 6, Chippewa Falls
Harold C. Barber, Zoning Administrator - St. Croix County
Glen Hanson, Owner
DILHR-SBD-6423 (N. 04/81)