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HomeMy WebLinkAbout028-1038-80-000 n y p m-0 o d p C O v f C .r 3 CD co~ m I A7 3 U) Z W N r ;L7 N 0 n 07 O N p N A C ~I N << • S 3 0 0 N N w I~ (D (D 0 a) m O 3 O o O 1 cn G) (D N N d O O -D Q 7 `Z w w o O 0 O 0 c A7 w O O r* O w., N_ N c I. j o Q N oo O C D a s N cfl (n O 3 m c 3 O 2! N ONM M w cc (0 3 r N N N co O N „p C a Q z 0 0 0 m O O O M !mil =i O E A_ a N fn (n (D L_rn~1 CD 3 o. m m v v of ~r d - y O C 7 0- 0- N N Z 0 c D D o v O N • CD n <D 0 c w m a ~ CD O N E ZZ m j T n p z A' O M < V W V O. " w Z p _ A Z7 O (n v 3 m ;o zt m a w m O CD a 3 CD 0 CD w c Z3 T 5' a m m 0 Z a 0 CO 5' m vm m cic) N m a t c d ~ 7 7 A CL d (D O_ M a b ~ m n S N 'p ~ Q Z Q (D F t <n N N j O N n N O ~p O O O a E» O ° cv 00 CL y m o ~ o m a d `il :3 o 3 C v 3' 2. 4k v .1 o M m 01 ^ 3 \ 1 A I ~ Q ? K J °N eC • (n -y -I Z r'A O m O N ~l 7 3 CD 7 ~ N~ ICI (D 0 z C) 00 a Dt J) O_ N N W 00 Q O (DD j co 3 3 N p °O C co O C cn G D o- m W a cf) s CD CD CL C) 0 (M c\ 5 3 O C ° ° :r CD co co 3 (n z O O O o a . r-3 N y m \ fl O cn N m ~ D po eQ CD 0 tr N j A d. w N ~C1. i~~ o Q D D o C a !r • W 3 Z Z (D p A Z .n. V o G~ J a co Z 3 O (n m N _ `1\\ a A W N 0 V o D 3 v a (D n. CD _ c T CL v C Z 3 o CD N N 9 a N v a. CL a b CL v I N C Z N N tv O O A O A < ~ OAq O C I C) ~ I ti AS BUILT SANITARY SYSTEM REPORT ~-e.e_ e~~.rar` - F-•vtit fig. r 2d ` %~j~~`` r-T, OWNER 'r TOWNSHIP SEC '1'i 'N- tl!iW ADDRESS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE ,~fL PLAN VIEW Distances and dimensions tb meet requirements of H63 VF.EUTHING WITHIN 100 FEET OF SYSTEM ~I II ' r 0- - - - h- d1 a e a th Arrow -1 SC - G i _ ( - BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: J SEPTIC TANK: Manufacturer: - Liquid Capacity: Number of rings on cover : Tan manhole cover elevation: Tank Inlet Elevation; Tank Outlet Elevation; PUMP CHAMBER Manufacturer: - Number of gallons Number of gal. pump set or a cycle gallons; totalcapacity- oT distribution lines 44 gallon: size pump ' head; gallon per minute horsepower bran name of pump and model number Type of warning device HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE: -Number o pits --feet iameter feet liquid depth seepage pit in et pipe-elevation-- bottom of seepage pf-t7 eva on feet. SEEPAGE BED SIZE: number of lines width leitgth_ tile depth SEEPAGE TRENCH: width _ length _ PERCOLATION RATE AR AREQUIRED ",,AREA AS BUILT _ INSPECTOR DATED - PLUMBER ON JOB - ! LICENSE NUMBER DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION BUREAU OF PLUMBING MADISON, WI 53707 ❑CONVENTIONAL ❑ALTERNATIVE state Planl D. Number (Ir assigned) ❑ Holding Tank ❑ In-Ground Pressure Mound NAME OF F IT HOLDER. ADDRESS OF PE MIT HOLDER: INSPECTION DATE. _ A ON 8 CH ARK ( ent .efe e _ Intl DES IBE IF DIFFERENT FR PLAN: REF. PT. ELEV.: CST REP PT ELEV N ne of Plu ber. MP/MPRSW No.. Count Sanitary Permit Number. SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV. WARNING LABEL LOCKIN C PROVIDED . PROVI D~ (jo BEDDING. VENT DIA.. VENT MATL. HIGH WATER YES ❑ NO Y S 6 NO NUMBER OF ROAD: JPROPERTY WELL. BUILDING. ALARM EC FEET FROM - LINE IAE / YES ENO EYES ENO NEAREST. 1~1 f I DOSING CHAMBER: MANUFACTURER BEDDING. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: EYES ENO~© EYES ENO NYES ENO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONA t NUMBER OF PROPERTY WELL BUILDING VENT TOFRESH (DIFFERENCE BETWEEN FEET FROM LI"E I AIR INLET' PUMP ON AND OFF) YES ENO NEAREST SOILABSORPTION SYSTEM. Check thesoilmoisture atthedepthofplowing FORCE rh l )IAraFTFR MATERIAL AfND~MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN S^ ~ 040 the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH NO OF Sr PIPE SPACING COVER NSIUF Din -PITS LIQUID THEN ES. MATERIAL'. PIT DEPTH: DIMENSIONS GRAVEL DCF'T 1{ FILL DEPTH DISTr}• PF CIS PIPE IS PIPE MATERIAL: NO. DISIH .PROPERTY WELL. BUILDING. VENT TO FRESH BELOwPIPFS ABOVE COVER E~e LEr'E 4-EN PIPES NUMBER OF AIR INLET' f FEET FROM LINE. NEAREST MOUND SYSTEM: _ Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- E YES NO meets the criteria for medium sand. TIONS MEASURED. E SOIL COVER TEXTURE PERM}A~NENT MARKERS OBSEH NATION WELLS kJ YES ENO YES ENO DEPTH OVER FRENCH BED DEPTH OVER TRENCH. BED DEPTH OF TOPSOIL. SODDED SEEDED MULCHED CENTER EDGES I t!/ L I I/Z EYES I~NO EYES_NO EYES ~NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH wo LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER rRENCaiEs DIMENSIONS MANIF i)1 D PUMP MANIFOLD DISTR PIPE MANIFOLD MATERIAL NO DISTR DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV. - ELEV. DIA. ELEV. PIPES DIA ELEVATION AND 1 DISTRIBUTION INFpRMATION MOLL SIIF HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS YES ENO YES ENO COMMENTS: PERMANENT MARKERS OBSERVATION WELLS: NUMBER OF IPROPERTV WELL BUILDING ' FEET FROM uNE N YES ENO DYES ENO NEAREST--)P-j Sketch System on Retajn in county file for audit. Reverse Side. SIGNATUREj TITLE .vA DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8Y2 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. The owners copy or a legible reproduction of the soil test report must be included. Property Owner: Mailing Address: 2 -S > T f Property Location: ownship: f~ ` } County: S iT f N/ R 7 (or). .S l Lot Number: Blk,N/o.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: ~1' (If assigned) TYPE OF BUILDING Number of Public* ❑ Variance* ❑ Other (specify)* Bedrooms: 1 or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE STEEL FIBERGLASS INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA r (Minutes per inch): PROPOSED (Square feet): ~u New Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit --~.e- ❑ Alternative (specify) Z9 C> ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for ins Lion of the private sewage system shown on the attached plans. I Name of Plumber: ignature: MP/MPRSW No.: Phone Number: ve-oc e~ Plumb dress: !Name signer: COUNTY/DEPARTMENT USE ONLY S' n to of Issuin Agen Fee: Date: Sanitary Permit Number: APPROVED U ~C~ ❑ DISAPPROVED 191 - ~_j~ eason 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 cour+ty prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DP_I4R-SBD-6398 (N.03/81) State of Wisconsin ` Department of Industry, Labor and Human Relations Please Reply to: SAFETY & BUILDINGS DIVISION -1 Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Plan Identification Number _ L, = r Re: PRIVATE SE TEM ONLY- _t 0 7987 ho The Bureau of Plumbing has reviewed plans, site survey information and installation details for the c "s "rW6ip1ternative private sewage system to be installed at the above-mentioned location. The plans and specifications were prepared by ` and received for approval on The soil and site evaluation was conducted by The site meets the soil and site requirements specified in chapter H 63, Wisconsin Administrative Code, for the use of The proposed system is for a Wastes from the building will discharge to a -gallon capacity septic tank which will discharge to agallon capacity pump chamber from which a pump having a capacity of gallons per minute against a total dynamic head of feet will discharge through a -inch diameter pipe to the soil absorption system. It is of utmost importance that the system be installed in complete accord with the plans and installation details and the conditions of approval contained in this letter. The licensed plumber responsible for the installation shall notify the county inspector when the installation of the system will commence so that the county inspector shall be able to inspect this installation. The installer shall not deviate from this approval and shall follow the directions or orders issued by the appropriate local or state authorities. In accord with ch. 145, Statutes, and ch. H 63, Wis. Adm. Code, the plans and specifications are approved contingent upon compliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep one set of plans bearing the stamp of approval of this department at the construction site. If the installation of this system has not commenced within two years from the date of this letter, this approval shall become void and new application shall be made for approval of these plans before work may commence. 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 is based on ch. H 63, Wis. Adm. Code, requirements. It shall be necessary to obtain and fulfill the permit requirements of the county in which this installation is to be constructed. Failure to obtain county permits will automatically void this acceptance. cc: OWS County BY Other Enclosures 7 DILHR-SBD-6159(R. 7/81) mes Sargent, B (rector DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BULIDINGS LABOR & HUMAN RELATIONS ALTERNATIVE PRIVATE DIVISION P.O. BOX 7969 SEWAGE SYSTEMS BUREAU OF PLUMBING MADI,20^✓, Votl 53707 ❑ Mound ❑ Pressure Distribution NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: PLAN ID NUMBER: BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.. CST REF. PT. ELEV.: SEPTIC TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.:i'i PROPERTY LINE: WELL: BUILDING: DOSING CHAMBER: MANUFACTURER: LIQUID CAPACITY: PUMP MODEL PUMP MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED. PROM DED. ❑ YES ❑ NO ❑ YES ❑ NO GALLON PER CYCLE PUMP AND CONTROLS OPERATIONAL: QfL PROPERTY WELL: BUILDING: VENT TO FRESH DIFFERENCE BETWEEN} LINE: AIR INLET PUMP ON AND OFF ❑ YES ❑ NO h1EA6i, "a~, SOIL ABSORPTION SYSTEM: Check the soil moisture at the depth of plowing or excavation. (If soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue.) Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM and furrows thrown upslope: mound systems to make certain that it OF SYSTEM. SHOW El YES NO meets the criteria for medium sand. ELEVATIONS MEASURED. ❑ DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO. OF SPACING CENTER LENGTH: DIAMETER: MATERIAL AND MARKING: p~ TRENCHES: TO CENTER: AAy'„j €?liulE4.%0' M~4tM1 MANIFOLD: PUMP: MANIFOLD PIPE MATERIAL AND MARKING- NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: - DIA.: PIPES: DIA.. Eilm f ij6C^ HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: DEPTH OF GRAVEL OVER PIPES: VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. ❑ YES ❑ NO ❑ YES ❑ NO SOIL COVER: TEXTURE. DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED: JSEEUED, MULCHED. CENTER- EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO COMMENTS: SIGNATURE: FITLE: DILHR-SBD-6227 (R. 05/81) Parcel 028-1038-80-000 12/22/2005 04:46 PM PAGE 1 OF 1 Alt. Parcel 27.28.17.238 028 - TOWN OF RUSH RIVER 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 BARBARA J BERG O - BERG, BARBARA J 139 185TH ST HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 139 185TH ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 27 T28N R17W NW SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 27-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 800/264 2005 SUMMARY Bill Fair Market Value: Assessed with: 83006 Use Value Assessment Valuations: Last Changed: 08/30/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 30,000 173,100 203,100 NO 05 AGRICULTURAL G4 17.500 3,100 0 3,100 NO 05 UNDEVELOPED G5 0.500 100 0 100 NO Totals for 2005: General Property 20.000 33,200 173,100 206,300 Woodland 0.000 0 0 Totals for 2004: General Property 20.000 14,800 98,600 113,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 220 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 c~ - DEPARTMENT OF !IVDL+ST REPORT ON SOIL BORINGS AND I S N IV[ f LABOR AND HUMAN RELATIONS PERCOLATION TESTS (115) - 1 % 18~~~4x - N, WI Q curylN6 LOCgTION: PE u ) TOWNSHIP/ nrr 'L,1 V- ,?n/I~ Y: LOT NO.: B LK. NO.: SUB ON N COUNTY: UYER'S NAME: qV/S I (7{f~r~dc L4ON ,,ix7 ~r S ~E USE NO. BEDRMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE ILE r<Residence I R F R ONS: ER LA ION TESTS: ❑ New Replace f RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) DS DU xS DU DS DU DS ❑U ❑S DU If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V. under s.H63.09(5)(b1, indicate: If any portion of the lot is in the VA- Floodplain, indicate Floodplain elevation: I + /~Sla' PROFILE DESCRIPTIONS 5a,(., m4e BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED 1 EST. IGHES,IT TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- ' , ~ 1 V _+,L YV9 y l O it If 1q 51 5~- B-3 7,2- g'lo 37 5, IC-39 it .5 L_ 18 7 ;U11 _/1 B- B~ PERCOLATION TESTS TEST -P-TH WA ERIN HOLT- TEST TIME - NUM ER INCH S AFTERSWELLLING INTERVAL-MIN. DROP IN WATER LEVEL-INCHES PERIOD ,1 RATE MINUTES PERIO 2 PERIOD PER INCH P_ 1Z P- .a P- 3 ,a /V 0 P-~ P- P- PLAN VIEW: 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 slop. SYSTEM ELEVATION 6 0-,vklj e-," 14o os- CZ 91W e_ 10 0,& 4'6 433 4,4 Svpb TK _ . _w 4-- A at! is 63 r Q I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative 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: qj/ ADDRESS: / ( ) _I - f t CERTIFICATION NUMBER: PHONE NUMBER optional): Q.5 CS I URE: DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 IN. 03/81) WISCONSIN DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATION PRQTF(T!ON DIVISION OF SAFPOST &OFFICE BOX~79BUREAU OF PLUMBING, 69, MADISON, WISCONSIN 53701 Verification of Exception Status for an Alternative Private St'wa~)t'y,t,}rr In the County of St. Croix Location NW 1/4 _ SE 1/4 S 27 T 28 N, R 17 _ ?o00 W Town or Municipality Rush River Street Address R.R. 1, Hammond, WI 54015 Lot No. Block Subdivision Landowner's Name: _C~ary-A-y-ons__-- The application for this site is to serve a: ❑ new construction use. 0 replacement system use. If this is a NEW CONSTRUCTION USE, the alternative private sewage system is to be included as: ❑ part of the 3%/5% limitation. This is number of the applications made through this office. one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. ❑ an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. ❑ a lot that meets the site criteria for a conventional private sewage system. If this a REPLACEMENT SYSTEM USE, the mound is replacing: ❑,a failing conventional soil absorption system. ❑ a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. 1 (ertify that the above information is true and accurate to the best of my knowledge. Name l homas C. Nelson Signat _ Assistant Zoning Administrator Date October 14, 1981 r,;LRlt-m- 6158 (11.7/80) ~ - f l1 ST. CROI X COUNTY WI SC O N S I N ZONING OF F ICE 196-2239 ~:f f HAMMOND, WI 54015 October 14, 1981 Division of Safety and Butl.dings Bureau of Plumbing P.O. Box 7969 Madison, W1 53707 Dear Sir: An on site investigation for the Gary Lyons property located at the NW-14 of the SEA Sect Lon 27, 1128N-R17W, Rush River township fn St. Cr.olx County, revealed suitable so11s at a depth of 27 inches, below wIiii ti seasonable high ground water was rioted. '[`his site should be suitable for a mound system. Should you have any questions, please feel. Iree to contact this office. Yours truly, Thomas C. Nelson Assistant Zoning Ad m[ii lstrato r TCN:al •Plb 100a 12/78 Detach And Return y G r . Mate of Wisconsin Upper ` G Dl~/ISON OF HEALTH - Portion Of This Form With = z r SE TION OF PLUMBING C:ZND F1 E PROTECTION SYSTEMS Any Return Correspondence 4v1A1 ADDRESS: P.O. BOX 309 DI SON, WISCONSIN 53701 608-266-3815 DATE: PROJECT: 4, SE4, Sec. 2. -win of Rush Riv 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 plan review fee required is $ ❑ Plan accepted for review. Fee received is $ Fee is being returned because of ❑ Overpayment ❑ Underpayment. Providing one of the two catagories above is checked, remit correct fee in one payment. ❑ No fee has been remitted. Plans submitted with no fees will be held in abeyance. ❑ Plans being returned. ❑ Additional information required. SEE BELOW. 1. Plan Submission ❑ Additional information shall be submitted in triplicate unless specifically noted. ❑ Plans not clear, legible or permanent. ❑ All information submitted shall be signed, sealed or stamped in accord with Section H 62.25(2) (a) Wisconsin Administrative Code. ❑ Affidavit enclosed. 11. Alternate sewage Disposal Systems (Mound Systems) ❑ PLB 108 (Application for use of an alternate system). ❑ County onsite required (1 copy). ❑ Design calculations for pressurized distribution ❑ Cross section of mound. ❑ Pipe lateral layout. ❑ Plan view of alternate. 111. Private Sewage Disposal Systems ❑ Ground slope with 2' contours in entire area of soil absorption system extending 25' on all sides. ❑ Elevation of permanent reference point (benchmark). ❑ Location of area suitable for replacement system - provide soil test data. ❑ Plot plan showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, lot lines, well, watercourse, etc. ❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. ❑ Construction detail and cross-section of soil absorption system. ❑ Soil boring and percolation test on EH 115 completed by certifiedsoil tester (1 copy). ❑ Complete data relative to anticipated use of bldg. ❑ 3 copies of PLB 60 enclosed. ❑ Deed restriction required (1 copy). IV. Holding Tanks ❑ Profile of holding tank. ❑ Holding tank agreement signed by owner and local unit of government (sample enclosed). ❑ Reason for installing holding tank soil test or statement from county (1 copy). V. Lift Pump 1-1 Calculations for total lift pump discharge, head and gallons pumped per cycle. Size, length & depth of force main. Detail & mode! of pump or automatic siphons including size, pump curves, drawdown and average flow rate GPM. Li Cross section of lift pump tank showing pump(s) or siphon(s). V!, S yarns In Fill (Fill must be placed prior to plan submission) Total area filled (fill to extend 20' beyond edge of trench before side slope begin). FI Depth and type of fill. 1 Copy of onsite report by county or district plumbing supervisor. i_-sgth of tine fill has been in place. n tip ~9 f fa + " i -f LV e w s,' I 3 41 ft " Ct) a,, El w A ~ I 40 P ry ~ 1 -.1Z ~C1 ~ -fl W J'" r- El p n A x a 7` 1 n Iv RECE.' VED CU .I f; i r 41 3 o: I i I I 61~ I~ I oQ I~_I p I I~ I ~ C I _ 13 Z ~a I Z I 0 Il o° I D A N tip. l 4-w I I t 3 C- u -tj II"I - ~j~, D I I Z oo -D sl. I Cry ♦ o \ Q0. I t VI I -r- 4-- w -t -IC . i o ~ rr I ' IT A, Z. D `w 7G Du Do 0o 2 ft IV Q. VZ i- -t f L L-a P n' ' ~~-DS► \ A co, Z o n A A z' c IT, t Z» CIO e r.. ¢ _-Poll CJ ' d i 4 k < E o I ` _ L C n p ~"e ~ j 6 f Q 14 + Z t f t t t + ~ i ' ~ p Its + s 00 w L w CA - a. L 12- "s (0 7_ a, A 0 ~ ~ C C3 T z ti IN 'D P f_ £ n IA t c to - o D + r~ W WK\ ~ <a o0 j A (Aj I-A 11 . ITC i- u Il~'~Ft l ~ r q 7 CA Ali E I y ~ ~c ~i { l ' e . 74 f pp ~ ~ p 3 I L4 06 n Zb, .b a i c~ W 0 1 a d ~X ~ c I ~ P IG y J rn., ~w 3~`s is ~ ~ d {tttt la4, x. lit r~ ~ s (4 ~ 3Y } 7) 7) ti tY- c~ HYDR-o- rTlRTIC H_82 PUMPS 28 24 - W 20 533 LL 2 16 [ SV?s = 12 J ~8 0 4 did SUBMERSIBLE 0 5 10 15 20 25 30 35 40 45 U.S. GALLONS PER MINUTE SUMP Head-Capacity: SV25 and SV33 Submersible Sump Pumps Max. Solids 3/4" Sphere; 4 Pole, 60 Hz PUMPS 28 24 _S ii 2050-- z 0 16 12 O e H 4 0 10 20 30 40 50 60 U.S. GALLONS PER MINUTE Head-Capacity: SP33 and SP25 Submersible Sump Pumps Max. Solids SP33, 3/4" & SP25,1/4 Spheres; 115 Volts, 60 Hz., 1750 RPM 140 120 100 HIGH, HEAD _ ,o EFFLUENT a 60 S~OOH - 0 40 PUMPS ~ 20 SPA 0 20 40 60, 80 100 120 140 U.S. GALLONS PER MINUTE Head-Capacity: SP50H, SP100H and SKH150 High Head Effluent Pumps Max. Solids SP50H, SP?00H & SKH150, 3/4" Spheres; 115 Volts, 60 Hz., 3450 RPM