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HomeMy WebLinkAbout040-1083-85-100 O y ~ c d 0 m 1 7 3 e4 dCD n CD 3 O o Cl) o ~ d r=n O co p A • (D 3 fD W n K N ICI ? j Q O O 00 C: (CD Z N V m -i 1. o N D 0, ° N ? W w ° n C) 0 0 _ z o co 3 VI A O U3 O l~~1 ~ ~ V O O C lr1 cn 7 7y d I ~ C~ i `r1 O W N• 7~ C CD O 0 G G C T n m cQ m (n CL a N p (D w t~ = m w < t-I (D V C)+ c n (D S. (D U; O ° ° C td CD (D N• I- DC CD 0 co (D ! n ~ b rt N m oo aWO ~1 In _ 1~+r1 W w T N 0 CD "WA f~ co C Z O O O (D y ry~• ~ N ai can o Z vvoc~ 1 rt` a. m I C N o 0 A N (n N 00 3 H d 41 Q A J Z N o D D o O m O a = 0 CL y ~3 CD • O N t 7 ~J 9 co m :F- 0 (D G F-h r~ Z CD z J (D H CrJ A ri W ti C] A Z (D PV 0 ri (D C = \ ri Iv Z N ca M CD m rn (o Z a ~ A 0 Ff - M cC y < (D A W N N d N ~c c (n a (D - CD a = O C co Z 3 s Oo 0 5 (D < N N (D = O 6 W N V ((DD CD S ,n fi N C 0 A ~ C OOQ0 b N ((DD 00 n 3. _.(D N z Z Q CD N N (D 0p V 53 O O N a O ti O (D = DO Oho A O (D y O Parcel 040-1083-85-100 12/27/2005 01:54 PM PAGE 1 OF 1 Alt. Parcel 21.28.19.328D-10 040 - TOWN OF TROY 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 MARK B & VALERIE SYLLA O - SYLLA, MARK B & VALERIE 523 WESTRIDGE CIR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 247 TOWNSVALLEY RD SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.340 Plat: 1944-CSM 07/1944 SEC 21 T28N R19W SW NW NE SW NW SE 2.340 Block/Condo Bldg: LOT 1 ACRES LOT 1 CSM 7/1944 ASLO PT SE NW,NW SE & NE SW DESC AS COM W1/4 COR SEC 21; Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) TH N 88 DEG E 2207.56'POB;TH N 25 DEG W 21-28N-19W 1210.19';TH N 89 DEG E 36.48';TH N 25 DEG W 21.31';TH N 88 DEG E 944.78' TH S more... Notes: Parcel History: Date Doc # Vol/Page Type 07/17/2002 684394 1928/650 LC 03/21/2002 674165 1858/173 WD 2005 SUMMARY Bill Fair Market Value: Assessed with: 102688 169,400 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.340 52,000 111,000 163,000 NO Totals for 2005: General Property 2.340 52,000 111,000 163,000 Woodland 0.000 0 0 Totals for 2004: General Property 2.340 52,000 111,000 163,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 DEPARTMENT OF ' APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PL13 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/z x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Prop x Owner: Mailing Address: Property cation: _ nor Township: County: ~,''%S YT ZE N,R E (or W Lot Number: Blk No.: Subdivision Name: Nea st Road, Lake or Landmark: State Plan I_D. Number: (If assigne~j, TYPE OF BUILDING Number of Public' ❑ Variance' ❑ Other (specify)' ti Bedrooms: 1 or 2 Family State Approval Required. e . TOTAL NUMBER PREFAB POURED-IN NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE STEEL FIBERGLASS INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY , X47 HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER l MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ NeW Replacement Experimental El Seepage Bed El Seepage Pit S ❑ Alternative (specify) El Seepage Trench Water Supply: Owger' Name as Liste~ on Soil Test Report (If other than present owned; rivate ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the pi,,', sewage system tnuwn on the attached plans. Name of Plumber: Signatur ~ MP/MPRSW No,: Phone Number: 1 / LIL Plumber's Address: : 1 Name of Designer: COUNTY/ DEPARTMENT USE ONLY Sign re of Issuing A Ant: Date: APPROVED Sanitary Permit Number: l - 3 U ❑ DISAPPROVED ~J~3 7 Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (R.07/81) Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP / SEC. TN-R_YW ~ 7 ADDRESS 1jj` lc /f' ST. CROIX COUNTY, WISCONSIN 24' SUBDIVISION LOT - LOT SIZE - PLAN VIEW Distances and dimensions to meet requirements of I1HR, 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM l L O INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used .1151- Elevation of vertical reference point: lo- d Proposed slope at site: - SEPTIC TANK: Manufacturer: f1L1« Liquid Capacity: /'-4,C) Number of rings used: Z21 Tank manhole cover elevation: % Tank Inlet Elevation:. Tank Outlet Elevation: C y Number of feet from nearest Road: Front,O Side Q Rear, O o feet From nearest property line Front,O Side,O Rear, O feet Number of feet from: well building: O (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: C) Pump Model: Pump/Siphon Manufacturer: 7z Pump Size r7` Elevation of inlet: S _ , o Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: f 1d Alarm Manufacturer: S' 17/``~ Ze_Alarm Switch Type: ~12~~ Number of feet from nearest property line: Front, O Side, O Rear Ft.l 0 Number of feet from well: e-7- Number of feet from building: Ft (Include distances on plot plan). SOIL ABSORPTION SYSTEM f-// &-.& Bed: X Trench: Width: C+' ` Len the Number of Lines: Area Built: Fill depth to top of pipe: I/ " Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft Number of feet from well: Number of feet from building: 1 (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: 3Z DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION MADISON, WI 53707 BUREAU OF PLUMBING ❑CONVENTIONAL EXALTERNATIVE State PlanLD.No mber ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound 9 9 8 NAME OF PERMIT HOLDER . ADDRESS OF PERMIT HOLDER: INSPECTION DATE. clos RR Box 64, River Falls WI BENCH MARK IPermanem reference poind DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST REF. PT. ELEV NE SW, Sec. 21, T28N-R19W, Town of Troy Name of Plumber. MP/MPRSW No.. County- Sanitary Permit Number: William Schumaker 6382 St. Croix 38537 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLE"'I~ T EjV, : TANK 83 OUTLE E EV.: WARNI YNG LABEL LOCKING • ~ T_y P OVE PRO v IV/ u 7ES S ❑ N O S ❑ N O BEDDING: VENT DIA.. VENT MAT L.. HIGH WATER NUMBER {vim Grp YR OF ROAD: ~ PROPERTY WELL. BUILDING. V T TO F ESH f( ALARM FEET FR`M f75 / LAIR N ❑YES NO ❑Y NO NEAREST L / J/ p~ r DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER INGCOVER 7-5- PARNIDIEDLABEL LOCKING ROV D ~y- ❑YES ❑NO YES ❑NO YES ❑NO GA LONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN C 2 FEET FROM LIy~ fF i +ti R I L PUMP ON AND OFF) YES ❑ NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LE°NGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue.) MAIN C CONVENTIONAL SYSTEM: BED/TRENCH WIDTH. LENGTH NO. OF DIS PIPES ACIN COVER INSIDE DIA &PITS LIQUID DIMENSIONS TRENCHES MATERIAL. PIT DEPTH 11 GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DIST . PI E TERIAL NO. DISTR. NUMBER OF PRO PERTV WELL. BUILDING. VENT TO FRESH BELOW PIPETS ABOVE COVER. ELEV. INLET ELEV. END PIPES LINE: FEET FROM ' AIR INLET. NEAREST------w-1 MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- Y ES ❑ NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS DEPTH OVER TRENCEBED DEPTH ovEa rRENCHeED YES ❑NO YES ❑NO CENTER DEPTH OF TOPSOIL SODDED SEEDED MULCHED EDGES ( ❑YES ❑NO ❑YES ❑NIn ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH W'DTH LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER TRENCHES. DIMENSIONS Jr MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL'. NO. DISTR DISTR. PIPE DISTRIBUTION PIPE MAT ..ERIAL & MARKING ELEV.. ELEV.'. DIA E V PIPES DIA.: I~,-' ELEVATION AND ~ DISTRIBUTION 7 f HOLE $I HOLE SPACING DRIL LEDCORRE CTLY IN Z,1 , FORMATION COVER MAT IAL VERTICAL LIFT CORRESPONDS TO APPROVED 1A/ 6-0- Or YES L+~lIYES ❑NO YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS UM : NBER OF PROPERTY WELL BUILDING. FEET FROM LI E YES ❑NO YES ❑NO NEAREST ( 1~C1 i Sketch System on Ret iT Count file for audit. Reverse Side. y SIGNATURr TITLE. DILHR SBD 6710 R. 01/82) t,!ru~~D S`'S 1'~N FOR Gh~.`7 ~uc~os 2 0 v1-t 3 t3 x Z J U ETL F-_~ L- -LS , Lxj S yo -L LOCATED IN THE M'-//y OF THE Sk-~/iyOF SECTION Z) , T -2,b N, R 19 W, TC~ L`Y CT . C R o t >C C O':3It T Y, w S C 0?' S T N o C Ji' OF Pk. GE 1 of 7 TITLE SHEET PAGE 2 of 7 WORKSHEET PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PA GE 6 of 7 DOSE CHM3ER Pk.r or ; PLTMP PERFORKMI-CE CURVE R 1 ~}o LST S?~Z ~ c~vJ , 1 i.3 C . PR.EPA RED BY i:OZEL, vEGERER AND ASSOCIATES 421 NORTH ?k ZN STREET r _V__TR _Fk.?,LS, W, e 54022 yQvae,pit 4 •`+~5 C 0 /V CHUR;._ES M ° ! 77QC?/C \ a r ET rc cS„Rr P Kam- ~ _ SYSTEM-Continuec- II. IN ~ROJN'D r,'N D SY51 E M LAS Ea 10. Force MaMl L~• c •..-lrr Loa7c:a: Deily Flow= osin Rate - N a. t- d Minimum D E Z Us: srcl,or. H C•i.1S (3) (c), Wis. r Diameter Abm. Code end PROVIDE A DETAILED 71 Total Dynamic Head: LIST OF SIZ!NG ON PLAN'S. Z. 1 System Head = 2-5 f; _ S Depth to LimitinE Factor = ft. {t_ 5 Vertical Lift g Landslope f" Friction toss = e, Distance from Dose Chamber to t~0 ft. TDri = $ t,. Distribution System = 12 pump Selection: 5. Elevation Difference Between i4 S Pump will discharge at least Z3' 7 gt'm' Pump and Distribution System = ft. \R sift. total dynamic head. _ at 5z`-p 6 ,t•wrption Area Sizing: JAS F M~ _ sq. ft. Pump model and manufacturer. _-t2 Reouired = ~S - u - - E td or T -I R Length (8) o, T•r FWrdth iA - _ 8 ft 13. Dose Volume.: - 10 Times Void Votumc nct 5cac.n D!siribution I- me! Height \•O ft. Gai'!\ ltiaste~ater Volume Fii: Depth (D,• _ - - - y ft. 4 Doses in 24 hrs. - 29 • S Fil; Depth Downslope (Ej = - b • f t. ) q 2- B e d or Depth (F) Back flow = = _ ci, ft. M i n i m u m D ose r a p and Topsoil Depth (G, N Cap and Topsoil Depth (H) = Y' S ft. 14. Dose Chamber: -~50 a Volume = g.. E. Mound Length: `p End Slope (K) = ft. 6-7 ft {{I, C VENTIONAL PRIVATE SEWAGE SYSTEM % T o,a; Mound Length (L) _ ~a 1. 'astewater Load, Total Daily Flow = r Wiath EIS se section H 63.15 (3) (c), Wis. of t Correction Factor = g ft A Code and PROVIDE DETAILED t,_ width Oj = LIST F SIZING ON PLANS. / wn~one Correction Factor = ft. 2. Required Se tic Tank Capacity opt Width (Ir = Zs _ m!n.-;!n ft 3. Percolation Ra '!wt,= - !bond Widtn t Ahsorpuon Area ing: / Rerer to Table 2 m, cnanter H 63/ a_wt Car.ac t. o' • ~ gal ;s4 4' %o a, and PROY'!DE A. Dr AILED,~IST OF Soil = - PLANS sc ft. SIZING ON Area 'n eouued = - = 5C _ ~"4 L-' SC f:. ReG U!reG .C.rea j ~ engtr = -.darc -ab,es from -napte- _ d = \ f H c, are Used, Ind at. Ta'n!e No. - Numoer o' , renCne5 - \ For th Distribution Network, Use Numbers 5-14 in Section IL ench 5nac!Ft = t` s D!strioutioe System ,ti GROUND PRESSURE SYSTEM Lateral r Sx's h = ft t t. Depth to Limiting Factor= Nuntoer of Laterals = Landsiope = Lateral Spacing = m. Fercoiatron Ratt = mi,^,.Jin. p = .o :.Csed S ystem Eievation = _ ft. /Distance from Side wall to Prpe _LI ~p Fa! System Elevation = ft. tv. Ater Loac. Tota! Dail. F low: st stcuon H 63.15 (3) (c ; W'is. 1!'. .SYSTEM-IN-FILL c.~~rr Coo; and PROVIDE A. DETAILED ~ Fill in Atl Items from Section III ;-!S-, OF 5!Z!NG ON PLANS. eouired Septic Tank Capaclls = - g 'S gal' V SEPTIC TANK C. ,c,-ption Area Sizing: S3 0 gal. min./in. 1. Capacity = n ~RyI~ULTS - Percolation: Rate = ~~\'C'~~ C°-o►~1 Area Reouired = 3-?S sq. ft. 2. Manufacturer: svstem Length = 4-1 ft. 3. Show Site Constructed Tank Details on Plan System Width = 8 ft. Vt. DOSING TANK SEF~F- PPIuL 6 OF ~ ~ SC P!siribution Pipe Sizing: ~ gal 1. Capacity = Hole Size -(10- h 2. Manufacturer _ Hole 5pacinti;= 1-mcral Lcnglh - 22.5 It. 3. Pump Manulacturer. t_.ut•r.rl Siic I I/v in. 4. Pump Model: 5 It. 5. Operating Head= ft. I .uc•r.rl S11,16119 1$ gpm. in. 0. Flow Ralc= I>itit.u,u• 110111 Si,Icwell In Pil,c - } . DioTibirtion Pipe Di,chaigv R•rlc- i. Shoff Site Constructed Tank Details on Plans Number of Ilolus Pet Pipr S NK I low c! I'lPV S gs kl m. Vll. HOI_ P 1. Capacity = gal. y M,milol~ Shin(;: I vtu (u•ntt•r or und) 2. Manula S It ow Site Constructed Tank Details on Plans Lrn~lh = ~ ni,~ri: lc, = In. S iOW ALL I`;p ,)kMA T ION' Or PL.ANS- PLOT PLC N ~Yio~SE i _~X.1ST. Si~?7C ~f-~IT (moo ~ RE~LACE~~ I \ k C;2AVEL b12~ V~ny9o9 ~ ~ Fa~~ gn &HRP 905 P 1S0 oP FvC r~oRCE WrOV LrtwN s3_ 93 5~ NoT Vt r 7 N ~J~ t~ ~c t S11r3 b OuTFt L L 21 (_y LItiE - O\S.^.~u►~~CT' 3': ~ 3i NT S~?'nC TS``3.ir. j 1(y N~ 3,Rr~~ w 5 Ir ~oTE = T~ 1 E f~ E`S T 1--*3R o pE,-;>-7 4e L/Av G S pr~p~ox 1 M .y Z So ` NNOOZT'H ar S I- E. N OTES 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install cast iron pipe 3t onto undisturbed soil both sides of each tank. 3. Install, permanent markers at end of each lateral. ( q required) 4. Install 4" observation pipe with approved cap. ( Z required) 5. Septic tank to be -\ooo gallon capacity as manufactured by VJ I ES~R Gt» ^ 2~T~. P fZCiD V CTS 6. Bench Mark- Elevation ~oo.oo' o i o~_oF_v~ooD_FB-CEFoST ATFE-~C-F= cMZ-~J _ -7, `bo }JUT 'N)tSTQZB -MF PRE'A wi~Ti►N -ZS 'OF 7tiE Z)Ok-) k~SLZPP'C. 51DE of T11E Y~U~vD. Or C}'nif,EilC ng~ Disiribuiron Fipe Medium Sond - - Topsoil ~ ,t _ _ ! 1cwE C ~C O~ or tV Oar PCver r r O 71 Li ~00~ e OOi E > c -qT Cross Seciion Of A ,found Sy siem Using FT A Bed For The Absorption Area C c> iT Ft. H S TT ~h F t. ~c I. r L r ipe ~ i- - i Observoiion P y 1 - 1 s ~ -J 21 c- d c ~ Uis i rbui ion Plpe AOOr e g0, E Obser~otion Pipe Permoneni Morkers Plan View Of Mound Using A Bed For The Absorption Arec Fertorofed Pipe Detail' rot y I, 1. _r !!l!~~~~ ~t>JSTt.LL pcri~.ANElJi Kra? ~ gT_C~D OF =AC-H l-ATEHpL i =IVZ Enr Em Lop O-Of ITT. S S '~T• Y. lib l h . ! bC--> tv, . D;ameler _Oy inch L erai 11lY inch(es) *'«n i ofd Z inches Force M air Z 1 nches r ~•r TT T ~I ~ T \,/E !J-1 PI?C /rFrP.OVED LOCP.IDJG - WCATNEF, FROOF /,hlJHOLE CGVER JUUC-TIDU 5DX r` RGN~ DOOR, ICmIU. OR r P.E51 I tJ T P, V. E I - GRADL I -I i 1 IVJLET 8~•S~, AIRTIGHT SEAL I III I`\\~//J I I III j-,PPRGVEC ??ROVED JowT A I II w/C.7 FIPz i I I 1 ~XTEt!D!U PIPE II 1 ~ f ALARM lJDIU!~ f `~)-ZZ 01JT0 SO' S'!- E - Ofi 1--- C . I Tpl, I j I - -E~' gam. O ~ F U ~ I i I I _I ! 1 RISER EXIT PLF~Mi7fLD GIJLJ IF T% tJK r-,,Q,.JFAC T URER HAS S!JG}y J FPROVAL SPECIF)CATIDUS =_FT1C A. 1, C ~PO UL IJU^,BER OF DDSCS. PLP. DAy K c r .'J A T'F S ~1Z.__v~ r- - - l y Z ~%-IJF, -''ZE--_-- ~sC) GALL01J5 DDSs VOLUME C, I- O tJ s S.S, cL~CT~Zo SY57>a+"'IS ckPACI T IES: I~JLar: DF. _?31 Gat,DIJ NOr,EL !1l N',BER= - No 6= z- IUCNES OR GALLOUS c- ~.(o ItJCN~s nF, 14Z GR~L nus sw!TCt: TyPt=: - ,a Hc5 DP, uF.L' OfJ CT ~ N t !',A)JU AURER: r - t1C JIBE SS FJO T L- PuM- Awl, ARE TO BE It.JSTaLLED O►: SEPARATL CIRCUITS SWITCH TYPE - ~~'1 ~ GIJ ETI C - PllMP D!SCHARC~E PATE - Z6-- GPM . VERTICAL DIFt CF,Et,)CE 6-T\,IEE►J PUN,F OFF •AIJD DIS7P,!gUTiOIJ PIPE-- 14•5 FEET - N,!►JIN:UM ►JETWORK SUFPLy PRESSURE _ - 2.5 - - - FE=LT " F T- + l 0 - FL ET OF FORCE r-1A ItJ X -_9a /DFIFRICTIOU FACTOR___-~' S FEET TOTAL C,9JAMIC HI`AD = FLET 1)JT E R tJA DIME I,_'SIOti!5 COf TAQK- LF_f\JGTH ;WIDTH ~c ) LIQUID DEPTH L4 _ z31 - _ ZI 7 GA L / /~J. 3 "~-_TT»ar. a'•~~F - IC•-~ 3 J~ - PRGE 2 of G u~ 6 i'°i AFA. U@ i w F F- C 1 NNNN N-~0-) 000N4-1-- pCbON-P 0) CD O 01 N O O O L 0 o m D I ~ ~ O I Oo 0 O n U) N U) UI o r o p o ~ M Z w (n (n 'Yl O m m CD rn ~ C O z z Cn c - q cn o m M O C: N cn O Un N p N O O N O o -L N w .t-' Cn ~ ~ M (-O W. H. Hobbs Supply Ca. Plumbing & Hcoting Division TOTAL HEAD IN METERS Distributors Eau Claire, Wisconsin 54701 ToL,., 335-5151_ DEPARTMENT OF REPORT ON SOIL BORINGS AND INGS LABOR AND G HUMAN RELATIONS ION PERCOLATION TESTS (115) ro ~ . B 3707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MU.pLJ.6J-gAt--I--FY: LOT NO.: BLK. NO.: VISION NAME: '/a /T = N/R E (A, COUNTY: OWNER'S/B1c+Y-ER4S NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence ❑New Replace - l~- 5 1 1_ J S- I _!Z RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) ES ou os ou o s ou E Is ou EIS ou z„ A If Percolation Tests are NOT required DESIGN RATE: LF'loodplain, an y portion of the tested area is in the under s.H63.09(5)(b), indicate: ' indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-ItUP,MPEB CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH t#i, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1 ( ! ` '7 . ' ~}n S f I ^J~ t> j B' ' 1`•~ ?`.~.i - - TaYC. t'( 7%'i 9o-L. - c~• 6 ~ I-. S Qty B- Z Z. 6' 93.9' ~otv~ 0.6' Dk 6y Bn si l Ts ;0. 3' 8n s Lan sc1 ; d 3' `C Zan C~ o• L S 01Z o.9'a1~GyGnsilTs; I.o'~nsil; 5-1 3.6 3.Z ►~o,vt? B- 3 9 o. S' LS G B- pVC c ;I TS f o•9Via ; J ~ a.7'T; , ~ a R B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IiVfk#f=S AFTER SWELLING INTERVAL -MIN. PERIODi PERIOD2 PERIOO3 PERINCH P P- Z 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-EL F.. _ . _ . Q. _17L ~ - C3 5.~,.5G la~ Y.l c E t 6 r I A Lt?r._V Ot- -4,J -12 ~sL~s • I ~ ~n _ (S52 /ti U kTl, 7 8M ; I ~,1 ,9 0 E 3 ; 3 _ u~ r a d33F {L ) a ~°i>4T.SAf~ E PZ PI 1 I ~ _ ~V _ 3 a- : 3 i ; : ~ i2 s rte 7 E I 3 _ i 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: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional)-. 93IS! CST S~(VATWE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER TKOHi'03' OR NIP FT 1 qty, fvr. b --T m- u ,a ap W:£ 'WW f tax p lr t tt,~ t x}, t .iu} t'~E ` 3 ✓f jlit.G i 'p 13~ i; if FE F) "V r i h ROUND cC~K 51c; _ 45 r..ca h' C (i i o' Cc N"' r.: jai J r fir' Lc zc. ir. Wl~ n'!amctcr - E I A.IL ED - namit Head am;~C oor and i 2OV!CiE A D 11. otal D~ ^ c ft IS i OF S1Z!NG ON ?LA.NS z , S•strm Hcad = 41. ` f t. - 1 Dr; in L, Lirn Zinc Fdcto, = - A 1 ft L andsiopc = S Vertical Litt = - ft = - F 4, Distance from Dolt Chamner to _ 1 C3 ft. - cep ft_ rDl; Dis:rihutior System = Seirction: c Efr.atior: Di`itrenct 3etween 12. Pump _ and Distribution System ft. Pump will discharge at Ieact z3• y RPrr' = 14 S at 1ro,°y ft. totai dynamic head. so Pump mnoel anc mn,nu`eiciurer. Mme' .S - A^ o ri,o^ Area Siting: 3-15 z r 2a, De bc-nsiont (Et p. -1 :t 1 41 7 . .c c 1-r Tes Depth (F)= - het, , O.F = - ~ o ft r< Ca: a-d I ot`soil Depth (G) Can and ? oL-soil Dcpth (H) ga' V - E, Mound L engih: oiumc End Slope (K) 10 _ _ ft. i ENTIONAL PRIVATE SEWAGE SYSTEM ice? ft, 111. \CTN~V Mound Length (L) Cr,a' t+ astrwaicr Load,Tota! Daily FioH = sr section H 63.15 (c) W'is. nc PROVIDE DETAILED CorrtnlDr "acto = Q Art;- Cnor c , +idt~ = F SIZING O LISTU, N PLANS. fL 2. F.rcured Se:itlc ;ant. Capacity r ✓c le, Ic Ir; (I / ^a'-eirt . _:e^,c.;nc e A^so ,or Arear.nc KZ a near- iCTenit au~e Ca aut. o` ~L: an: n0ViDE t it Er, 0= r a u ,ol, _ - 71 N:. ON P -N \ nc,e Art2 nrovueC - - - nf... cc _ r 5.: ~arlel 1mir do to Ls c inol t ahlr No k _ f c„`i n- D-ctrihution Network, i_, se Num:.,ers j-lt In Scction It. nt o n-: RESSURE SYSTEty \ vr9tr in L ImiunF r acioi a J.~V r Nur, t e• of Laitrais - : 1J _ Ir anc op. _ . Lalera! SpaLmF = r Cl Inr'. Rate - min./ir,. _ r ~r ft. ,6 istancc from Sii+sFtetl to Plnc _ ;~C fit: SvclC~... EIe4 IIGr_ • I i • ..rr Too i eill F inw _ ga!. Svsttrr: Llrizilorl rcvcTEN.•-IN-FILL 1 . it nc "r nC'D_ DET AI?-ED Fi!; it All liemctrom 5tcilor 11) -tS l Or S'iZ!NG ON PLANS. / ro i ed Septic Tani Czoacits ga;. - V• SEPTIC TANK f . A^soroiion Area Sizing: Capacity gal Fucoiation Rate= r _ Ar:a.------Lrrc M 11 F.. Area RequircC = " fL. Snov' Sot Consiructec Tank De,aiis on Plan System Length = Svsirrn Width = ft_ _ Vt. DOSING IAN1 - D~;ribuiion Fipe Suing: 1. Ca- acid = gal Hnic S'vc = In rf - - HOFC Spacink = - 1, ump h°.~n, !tc,u e Lalcral Lrnkih 3. - LJII'I atlnc Head= - - Rom 1~ tit i.. 4u~ F.dt:= w ? Tani; Details on Plans L?Lilli,uiiun Plhl Dig,:h.ukc F<.Ilc• Sho r S NuliIhr of Iinlr, I'ct I'Ipl' - - 5 kiln. VII. 111, 1 iuµ I'cl Pi!u INK 1. Capacity = gal. y M,,;,itnlJ Siiinp: I 2. M.Inu'dLL' . - S 1t _ 1 Site Cor.struclcd Tank Derails on Plans t C Il j; I I . - r,;amrtc, _ In. -SHON' ALL INFO MAT ION ON PLANS- i, is /i 1 k i ~ 130 ;cf L ➢V C FARCE nMN'. so- P n 4 " M" JV O 1 r, S 1. Elevations shc-*%-n are existing ground elevations ullles5 other- ise noted. 2. Install cast iron pipe 3' onto undisturbed soi: beth sides Of each tank. 3. Install permanent markers at end of each literal. (_y reauired) 4. Install 4T' observation pipe Kith approved cap. ( Z required) Septic tank to be =Npoo gallon capacity asailufactur ed by - 6. Bench Nark- Elevation ~oc.o of.~ ~:oFwoop= c 33TFF~?~~ Lac }JOT ~tSTv~E i c 1rtR"F Lv~' IN ZS ~P_T)IF t~iStAA~ SIDE of 7?fc 1'~o~D. OWNER. TOWNSHIP ,A, r, .a SEC. T ~ ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE - PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 2i A -3 ~ ~ mN INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: /,T,' Proposed slope at site: SEPTIC TANK: Manufacturer: Gam/ L Liquid Capacity: / lic, Number of rings used: y Tank manhole cover elevation: Y f Tank Inlet Elevation: Tank Outlet Elevation: i~~ Manufacturer: Liquid Capacity: Pump Model: pump/Siphon Manufacturer: Pump Size Elevation of inlet: 4~5 /Q Bottom of tank elevation: 75~~ l' Pump off switch elevation: c?,~ / Gallons per cycle: / 4l,/ Alarm Manufacturer: .S ✓ / ~N< .Te,Alarm Switch Type: - i Number of feet from nearest property line: Front, O Side, O Rear, © Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: "X} Trench: Width: x" Length: y~7 ` Number of Lines: Area Built:.3 Fill depth to top of pipe: / T " Number of feet from nearest property line: Front, O Side, O Rear,0 Ft. Number of feet from well: Number of feet from building: "l " (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: E?e arirnent of industry, Labor & Hurniaie «e::r;ons Division of Safety & Bidgs. +V I-it-(>nS1n Bureau of Pit.-robing Platting& Fire Protection P.O. Box7969 Madison WI. 53707 Tel. 608-266-3815 IN ALL CORRESPONDENCE t r, f' ~Ci % t' r S OC , REFER TO PLAN IDENTIFI%:ATION NO. 1 NAME F PROJECT TYPE,O~.F/ APP AL `R` 'r AND NO / Cj I`Y 11r1 iYViv l.ll ON I Y S{ ATE ~ Llr 7: I ,u%a iJn of plumr)inf 3''i,. ..:Ti•!_':liinc -0" thy- Chapter 14 , Wisconsin Statutes and Wisconsin Administrative Cooe, :r'_ ar, e F ipo,ov-c unu-nT upon com phance with the stipulations indicated on the plans. Please rev e.vr v:)u' (C:Oi if". }J '•r r G bai:'1 ' cnl' "t, Dn n0it'.L. -..i, arch te(% professional engineer, registered designer, ovvne, o' "a~ -O' >r - th : on ;ruction site one sei of r!Faring the stamp of approval of the department. and Buildings does not hold itself .ialbie -or and, ci_«ct.S in pianS or specifications, plan OmEi.stons, examination iod sesert'es the righl to order changes or arJdlUOns SnoUlCl COnOltlor- arise T.aKlni7 This necessary, Thi: ODrinval is ti^ a )ri W .,_onsi., A. 'etiv` Code _ ,Unto, It chal`; he necessary t .f-in er)Cdf fulfill the permit rehtfire.- ilrculi ui UDC Gily, v~.ru.K:• sr; v ~.a ~ ' matically void this accepta.i_x. Private Sewage Syst .ms Sincerely, i his aPPTOVui i S ii2i!d t0; t,`.-0 ye rS or it WlI; LE vai1~_i Ulltl! trl~ .G.n~ .:~t!L rl 1 ' L r James Sargent-Bureau Director PLANS /"EWED BY: i DATE: / l ~f~f s~✓~r~---J c DP5-01MOwner DI LHR Local PI Plumber H & R (2) E1LSui Mfp. Rep. Bur. of Health F .c. £t S--ices R?c. & Env- Sdrvtres qy =-{z("gip. r; hr1e39 Cn'. 05/fi0} -c--Td 7 SLO -ZT ~8 N R 19 W, - T1,~ ~~`_y o Tr ~yo SECTION 1 -1 - ti-.i 4T C-I-, C) I Y, V It 1 J, L, T F -k GE 2 of 7 WORK SHEE Pis GE 3 of 7 PLOT 1 1 `e P_►. GE_ 1, of 7 PLkN VIEW -CROSS SECTION Gr of 7 DISTRIBIITI Oh PIPE ? kYGUT DOSE C r i_y=h -~71 1 ~t f F r ~w ~ mss . ~ ~ y c c o ~ e f Ar o~ C 0 N c.<<<< r t C'r=qL~S 0 I _ c - t b e _ D ,r 4 c e ~ 1 e t _ CJb:Ct.. .~3 `-p g J -3 , State of Wisconsin Departme ustry, Labor and Human Relations DATE: 7-- - A SAFETY & BUILDINGS DIVISION 2' Bureau of Plumbing ~983 4 201 E. Washington Avenue '`/CF P.O. Box 7969 TO: / Madison, Wisconsin 53707 Plan Identification No.j~' Re: 2-- Irv The Bureau of Plumbing has received a request to review some minor changes to the above-mentioned plans. Those changes have been approved as indicated below. The approved changes will become an addendum to the plans previously approved, All other portions of the installation shall conform to the original approval. Sincerely, lan Zpprovals Section of Private Sewage and Platting cc: On-Site Waste Specialist County 04/81) ;lon pipe Sond - - n c - -7:7- i c r' C - L 1 rt T S ^ f,A.,ound System US Inc Gross Sec ilo l ~f r C y.~7 -~T wed For The AbSOrpilon r.`rec f-C rt' i - , ~ I 1 of r 4) Dn pipe - E i ~ObServoiion ripe -err.+c",~n1 IJ,orkers C)l t, Bed For The fit- C'' ion ,r;reo t' :Ort I- i 2 S -~7, S -12.5 P 17 S TL. L L j T _ .I OF = A U, LhT K AL' i c v )nch _ i~ t 11~y inch(es) )ncnes i l' may)