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HomeMy WebLinkAbout030-2030-30-000 o y °-0' o -1 CD ID CD 'a :z (D n c l^l 3 xt 3 1 3 - o I S w fJ~ N A O -O 0 0 N W = w 3 • zy- ° r- A O O_ O tp CAJ X Z O O O N .Z Q m 00 ~ N N o ` 1 W m W - o o C N C O O N 0 ? A W 00 m m (D 3 1' o C o o c -0 o o .r 3 _ m o m > > o O N N < O C3 ~ C fD O cn D a Q N 0 w W 5S C 0. A : O ` w (wP (O (O A 0 r (D O cr co N N 3 O rT 0 0 0 00 O O O i o d~ 3 v o _o Ao cn m R rn co v 4o o 0 m (D ° H z z ~ v 0 w N I CL O 0 _ O = 7 3 N o -I Cn J a A Z (D V t^v^, A ~ j On W 1 Cl) W N co v o 3 Z (n t~ 0 m o 0 O 1 _ N A O J N \c O O Q O Q 0-O O v C a m Z N O N Sv t J C O O r Q ~ N O F ~ O O O ~ x A o b b N ti A v (A O 0 0 o (D o 0- AS ISU I KT SANITARY SYSTEM REPORT t)WNER ' TOWNSHIP SEC. /Q to ~ADDRLSS ST. CROIX COATY, WISCONSI 9 a -.v SURU fV-[SLON LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM t r f- r, t Al J i I I it - -TT ii ae N r h rrc w I) f BENCHMARK: (Permanent r.efer.encc Point) Describe: Elevation of vertical reference point: /W -Slope at site: SRPTIC TANK: Manufacturer: T_ic1uTd Capa"city: Number of rings on cover- nk manhole cover elevation,, Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer: Number of gallons_ _ to Total Number of gal. pump "c_ far L1, l capacity of distribution lines gallon: of pump,<< head; },allon per minute- w ; horsepower_ _ ;brand name of pump and model number 'T'ype of warning device HOLDING TANK: Manufacturer - Number of gallons Elevation of manhole cover ; Type of warning device SEEPAGE PIT SIZE; _ Number of pits feet diameter feet liquid depth seepage pit inlet pipe-elevation - bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines-_ width- length-%h) -tile depth SEEPACE TRENCH: width - length__ PERCOLATION RATE AREA REQUIRED AREA AS BUILT _ INSPECTOR PLUMBER ON J0B - - LICENSE NUMBER 2y I DEPART'r1',1i'JT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING' I.HiBOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS Dlvlslo P.O. BOX /969 BUREAU OF PLUMBING, MADISON, WI 53707 ❑CONVENTIONAL ❑ALTERNATIVE IS,,,, Plant,DD../N~",ber (I1 ass; V~+ El Holding Tank In-Ground Pressure El Mound G'O/I1/y! C'/ L NAM OF PERMIT HOLDER. ADDR S OF ERMIT HOLDER: INSPECTION DATE. NCH MARK Permanent re erence point) D •CRIBE IF DIFFERE OM AN. REF. PT. ELEV.: CST REF. PT. ELEV. me 0 Plumber_ JMPIMPRSW INIV County Sanitary Permit Number_ SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLEI ELE V.. TANK OUTLET ELEV. WARNING LABEL LOCKING CO R PR VIDED. PROVI tD. ❑NO C'YES FfA16 Aa` BE DDING. VENT OI A.. VENT MATL HIGH WATER NUMBER OF ROAD PROPERTY WELL. BUILDING )VENT TO FRESH : ALARM FEET FROM Llrye) AIR INLET 3 ❑YESNO ❑YES LINO NEAREST-- _ DOSING CHAMBER: _ MANU FJ1CTREER BEDDING. LIQUID CAPACITY FPU7PM DEL PU MP/SIPHON MANUFACTURER WARNING LABEL LOCROKING COVER OIDEIEDYES LINO YES LINO YES NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PR OPERTM WELL BUILDING VENT T FRESH . LINE, AIR~IN LET ROM FEET BETWEEN F PUMP ON AND OFF) YES LINO _ NEAREST SOIL ABSORPTION SYSTEM. Checkthesoilmoisture atthe epthofplowing 'vl;l~, uln^.9FrER MArERIALANOMARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE [ - MAIN the soil is dry enough to continue.) H JNOOF PAPE SPACING OVER INSIOE DIA ITS LIQUID LENGT CONVENTIONAL SYSTEM: FNEARE BED/TRENCH TRENCMATERIAL PIT DEPTHDIMENSIONS 'p", I)PIPE DISTR ERIALNODISTR MBER OF ROPERTY ELLBUILDINGVENT TO FRESH BFInwPIPES ABOVE ILer ELEV END PIPES TFROM uNF AIR INLET ST MOUND SYSTEM: 7 Mound site plowed perpendicular to slope Check the tq ture /akeum e fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound sysa s to ain_ float' it ON REVERSE SIDE. SHOW ELEVA- meets thi'c terlA fsand. TIONS MEASURED. ❑YES LINO OBSERVATION COVER TEXTURE y PERMANENT MARKERS WELLS LINO I ❑YES LINO -]YES DEPTH OVER TRENCH BED DEPTH OVER TRENCH: BED V)EP„TH OF .O OIL. SODDED SEEDED MULCHED. CFNTEH EDGES ❑YES LINO ❑YES LINO ❑YES LINO PRESSURIZED DISTRIBUTION SYSTEM: ~VI DEH LENDTH NFILL DEPTH ABOVE COVER. OF LATERAL SPACIN PIPE . G. GRAVEL DEPTH B FLOW BED/TRENCH .w . rRENCHEs DIMENSIONS J - NI F OLD PUMP MANIFOLD DISTR PIPE MANIFOLD MATERIAL. NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING FLEV. ELEV DIA. - ELEV fq'fy~ PIPES DIA, P J ELEVATION AND DISTRIBUTION vERncAL urr coRRESPONOS To APPROVeo INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL - - PLANS _r YES LINO ❑YES NO COMMENTS: P RM ANE NT MARKER OBSERVATION WELLS NUMBER OF PROPERTY WELL: BU DING. FEET FROM uNE ❑YES NO ❑YES NO NEAREST- r 1 ( r Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE. DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY,' FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLI3 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8% 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: Property Location: City, Village or Township: County: 5 iJ '/a S '/.S G ZIT 3C~ NC R Z I- (or) Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake Landmark: State Plan I.D. Number: ~i (If assigned►)Sz OL: TYPE OF BUILDING Number of Public* ❑ Variance* ❑ Other (specify)* Bedrooms: ❑ 1 or 2 Family *State Approval Required. N a TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY 24h 1 X HOLDING TANK CAPACITY rd A LIFT PUMP TANK/SIPHON CHAMBER f 7~{r Y, MANUFACTURER: l~l Ei' C,Irc s'✓. EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): lA New ❑ Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit JAlternative (specify) Z S c, ❑ Seepage Trench am s 1 , 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 installation of the private sewage system shown on the attached plans. Na of Plumber. Signature=----,;, ~ MP/MPR W No.: Phone Number: Plu 's Address: /l Name of Designer: 16 COUNTY/DEPARTMENT USE ONLY ,Sig a re of IsWing A qnt: Fee: Date: j APPROVED Sanitary Permit Number: L V DISAPPROVED eason for Disapproval: Alternate course(s) of Action Available: J Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to i:r- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (N.03/81) PROJECT DETAIL DATA SHEET NAME OF BUSINESS ~~~1;~Yv ~D 0 Ll C~ LEGAL DESCRIPTION /cJ o f-he Too OWNER MAILING ADDRESS 1117, ZIP-jJUf2 ARCWTECT, ENGINEER, ;lam ADDRESS zA) /0~qi(~// .~Gr~ (PL BE OR DESIGNER s 3 ZIP ~J TELEPHONE NUMBER aJ ~~6 1. Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. Existing building 9 g New building 1S to ~ Addition %ake,i a40111 ( ) Apartments and condominiums . . . . Number of bedrooms ( ) Assembly hall . . . . . . . . . . Seating capacity ( ) Bar . . . . . . . . Seating capacity # of meals served ( ) Bowling alley . . . . . . . . . . . Number of lanes ( ) With bar ( ) Campground and camping resorts . . . Number of sewered sites Number of unsewered sites ( ) Total number of sites Camps ( ) Day use only Number of persons ( ) Catchbasin ( ) Day and night Number of persons ( ) Number Church . . ( ) No kitchen Number of persons ( ) Dance hall ( ) With kitchen Number of persons Number of persons ( ) Dining hall . . . . . . . . . . . Number of meals served daily cn ( Dog kennels . . . . . . . . . . . . Number of enclosures a ( Drive-in restaurant . . . . . . . . Inside seating capacity r-ri Car-service Number of car spaces co ( ) Dump station . . . . . . . . . Number of dump stations O Employees ( total of all shifts) Number of employees F 154 ( ) Hotel ( ) Motel ( ) Cottages . . . . Number of units with ersons p per u i t ~ _-¢ti Number of units with 4 persons per uirit ( ) Medical and dental office bldgs. Number of doctors, nurses, medical sTaff Number of office personnel Number of patients ( ) Mobile home parks . . . . . . . . . Number of sites ( ) Nursing homes . . . . . . . . . . . Number of beds ( ) Parks . . . . . . . , . . Number of persons ( ) Restaurant ) Toilets ( } Showers . . . . . Seating capacity ( ) Dishwasher and/or disposal? ( ) 24-Hour service Retail store . Total number of customers 1 Schools . . . Number of classrooms Meals ( ) Showers ( ) Self service laundry . . . . . . . . Total number of machines (No Service station . . . . . Number of cars served daily oU ( ) Swimming pool bathhouse . . . . . . Number of persons ( ) OTHER . . . (Specify) . . . . . . . COMPLETE OTHER SIDE 6 ; \ t rig u~ - ~2 uagwnN auogda Lai s 7 uPPV 12 .llNO 3Sf1 1d1N3W1dtId3Q b03 :w.Aoj 6ULPLdwoo uos.Aad jo ajn;eu6~S q~d jo wo44oq o4 do; wojj 44dap Le404 PLUL mOLaq g4dap aa4aweip ap~sjno paj aaenbs Le404 :SlId 30Vd33S g4dap Q~ paq ,}o 446uaL q;p~M paj aaenbs Le404 :SQ39 39dd33S sagouaj4 jo jagwnu g4dap sagouaJ4 Jo 446ual sagouaa4 jo g4p~M pal aaenbs Le404 : SPON3bl 3SVd33S 't ..Aaan4oejnuew jue4 6u Lp loq .AO o L jdaS ~4pedeo jue4 6uPLOH o0o k4}oedeo jue4 OigdaS suagseM sa44OLD jo jagwnN ou sad' J agseM s044OLo opewoiny x ou sak jagseMgsLQ X ou sad aapULj 6 alseM pooj z SULPJp jo jagwnN ou sak uLe.Ap AOOLJ • quasaid aje SO Lq ~ L PPP 6u LMO L LOJ a44 JaglagM a4eO ipu l 'Z E xpert Corp()i,i;;,),, I is iur(!i, of Puinp1m) Products LM EXPERT SEWAGE EJECTOR t - PUMPS INFORMATION SHEET 1. What is the purpose of To , i,or ptiml,;, Residential sewage ejector punii.., hp m lt~, .,i ire nitr~n nr~c,,, i y where lavatories, wash basin,;, etc. are located below the existing rrw~ r liiw- I lllut-ii1 .111r1 ~.ew;icle burn llli .e sources must then be pumped up to the sewer line for disposal. Other appiu:atiuns hir ihes;e pumps include lifting effluent from a septic tank system, removal of liquids from f1wdi ncl (kwm (I Iwo 1; if- ~itull;, ;u,rl il, :1J, ~Il,xili;Iry purnp in flood control systems. These pumps handle solids as vv(,ll ns liclrri+i 2. How does the Expert sew:ule ej("ct„r l)uu)l) work- Our pump is fully automatic:. The wt )tot. swig 11, .~~~i e!er tiic ,1! ( i)owt, :i0 w; ,ne l,rotected inside a sealed corro- sion resistant stainless steel c;tse. The r.,cse rien,,.t n,; a flu;tt, tlnuwnq Ilie n)otor ON and OFF as the liquid level demands. The pump switches on it aippmx. 1 end off at 4 f heft are no external floats, actuators, wires, or switches which could her,onur fouled by fuleign ul)jec.ts. O,u bump on/off levels are preset at the factory. 3. How reliable is the pw-p- Our motor features a float ,;witcii px,)ven th ini()h continuous million cycle, tests and over 25 years of suc- cessful field operation. 4. How long is the w;,irt w, I), Our sewage elector pumps ar(: vv :i ili,ited lot rom ')l ,Ilill,:Ii,)n_ Cr, m;(,te details of our warranty are included on every carton iiw ,~,I tlu: Id l).i. I 1 ,,1, , Jwr,i;,. 5. What horsepower pun)l) do we nec~i' In most cases, if the vertical fist no n)orf ih,,i ur , I,; In ;,:i? 0 is sufficient. If the vertical rise is over 15' but is no muse 11,X1 (,W ly) luW)I), n~c~il~~l ~.•1"l, is racornn,endod. 6. Is electrical wiring u 82004S Our pumps are furnished v -ith a three prong (rounded plug to l`~c't r t aiq nst the possihtlity of electrical shock. No additional wiring is neccr,s;u hnt l;le:I<:e ,c:st.it loc,~l 7. How are these fnnnl)s u,:;!,~Il, c± Complete instructions are included in the instnill i'f-n sheet lorI, a.i-l with the porn)). Very simply, the pump is tvpi.:Jlly pl<,c-d in ;r;) 1 diainct-r x 30" deep sewage basin which should be Typical Submersible Sewage ,it Ili(! Inwe:;t )quint in the dr;iinage area. (When raw sewage is emptied Ejector Installation into the basin, a gastight cover is required crud there must be a vent pipe from th,, h;)sin tci the vent stack.) The pijinf, in the basin is connected to a 2" (or, in 3'') discharge ptpf.. A check valve is then installed to prevent ev:;);te lii)n) [ellnnin.1 to the h;i,;w once the pump is shut off. F) Oow, thr, nnn have thermal (overload 7 ® t I protection. Yes, all r)ur sewage ejectors have thern)al overload protection to prevent motor h.rn fut. 9. Wh,It nu)intenance is rc~c)uired? Our i)un'•~s should givt! yot, yc,.Irs of service with reasonable care. The basin ;in,l int;tke <,rcu ';hould he chocked regularly if the effluent is extremely dirty or gre;tsy. Also, n;) foreign objects, such as rags, sanitary napkins, etc. should be f lushcd into he system since this may ''lock" the impeller and cause the pump to heconw c loc)ged. Also, the pump should be checked periodically for sludge huild up under Mid ;wound the case which could prevent the case from settling ;Intl lurninq off Performance jGallons Per Minute) Head (Lift) Model 310 Model 342 60 --------120 l~ ~0 114 1 5 :30 90 U 50 14 cno.to d Expert 1754 North Paulina Street Manufacturer,; of Chicago, Illinois 60622 Water Disposal Products Corporation 312-486-5110 EXPERT SEWAGE EJECTORS - MODELS 342 & 343 MOTOR:''-2HP, 115 or 230 volts, 1725 rpm, 7.2 amps, 590 watts, locked rotor 26.5 amps, cord acts as a breather tube (see hole in 3 prong plug). ® PUMP: DISCHARGE TAPPED FOR 2" or 3" NPT pipe, Height 20", weight 56 lbs, Heavy cast iron pump housings. Screenless intake to allow passage of solids and stringy materials. All vital working parts are enclosed to insure a clean design, and eliminate "hang-ups" caused that can be caused by projecting mechanisms. Stainless steel motor cover and fasteners are Tr , used to insure maximum corrosion resistance. Thermal protection eliminates motor burn out. 342 3' Ball bearing easily carries pump thrust. The capacitor start reduces energy requirements. t _ I T1 r l r 1 ~1.: -r i~} } 1- 7 ' ~ y i.t i tip,. ~ r 111 4-- 44 T1 7 25 i ' -r a r +I 1 - I } } + ' 20 iI- - I r 1 ;r r r HEAD it, 1 I _ t r ! FEET 15 ,1 1 t t ~I I i } 1 t i j r f ' f-r~ _ l i I 1 t r,,. } it- r t - 10 t-T 741 T1 -t- j~ t 1- t} i t' ~1 t i r{ -1- T I 1_ a tt$ r ntj T T- rte; } 1{t r 5 r-~ r -r- t L- 10 20 30 40 50 60 70 80 90 100 110 120 GALLONS PER MINUTE (GPM) i u r Sl IN x - N i ~£Y 1 x z m vv 00 z 'C ~ I ~ vo ' I 30' o m g 2 5 01 I"O.6 i ~I ~ N p O o` N F II r~ r Z 17 01, sm I F Z m i P m IPA IU OOD~ Z ~ ( h v G--- a 3 b 1 O O /I (n - r jl I o„ 01- G~ ~ \ o J ` W ~ F \ o w C IGI v 74, Cl% n\ 1 v G) T N MFR lonn v\ rte' CIO c a U c -C- 1 -t 1 t1` LA (r) (A Ct c o o C lk- i g. ~ P ~y v- \ l~ J~ 1 L 1% ~`1 4 l c..~ s -Al k7 8 _ q WORKSHEET -PRESSURE DISTRIBUTION NETWORK DESIGN l6 PROBLEM , /U CC y ian, a j /e Design a pressure distribution network for a bedroom home. The site characterisitics are Depth of groundwater or bedrock _ in. Landslope Percolation rate min./in. Distance from dose chamber to distribution system Elevation difference between pump and distribution system ft. Step 1. ESTIMATE WASTEWATER LOAD Step 2. SIZE THE ABSORPTION AREA A) Area required ' R) Select length 70 C) Width is D) I will use a CeOlre/ manifold. tep 3. SIZE DISTRIBUTION PIPES A) Hole size I will use is in. g) Hole spacing I will use is y i$. C) Lateral length is ft. D) Lateral size in. Step 4. DISTRIBUTION PIPE DISCHARGE RATE step 5. SIZE MANIFOLD A) Manifold length /51 ft.. B) Number of distribution pipes = g C) Manifold diameter .3 in. Step 6. SIZE THE FORCE MAIN A) System discharge rate Yd B.) Force main diameter J C) Friction loss will be 3 ft./100 ft. Step 7. TOTAL DYNAMIC HEAD A) Vertical lift boa 35' ft. B) Friction loss e ft. O) TDH = ~1e Sy Step B. SELECT A PUMP ~p ::Jl,n, Step 9. DOSE CHAMBER SIZE i-7 66 Step 10. DOSE VOLIUUME Step 6. SIZE THE FORCE MAIN A) System discharge rate Yo 1n1r', B.) Force main diameter 3 C) Friction loss will be 3 ft. /100 ft. Step 7. TOTAL DYNAMIC HEAD A) Vertical lift (Ua 35' ft. B)- Friction loss e 6 ft. C D) TDH = - yc 5 ft. Step H. SELECT A PUMP* 4 Step 9. DOSE CHAMBER SIZE Step 10. DOSE VOLUME *1 331 Rev. 9/7$ / EH 115 n REPORT ON SOIL BORINGS AND PERCOLATION TESTS CO WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES 0~T ^Z, P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION:-~w/4 ST 1 -Y-E'/4, Section,T-~N,Re2LQfo(or)~Township or Municipality U~ 4,4,1 7d Lot No. , Block No. County ! w c Subdivision Name Owner's/Buyers Name: Or x 01,/ co . QrC ; / OCR '00W OF Mailing Address: el- S"ao Gy -f -E2~Aikw 4LO4/~T ,l', TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL x EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT >C ALTERNATE SYSTEM x OTHER DATES OBSERVATIONS MADE: SOIL BORINGS /0' IT-1 & PERCOLATION TESTS 10-171P/ SOIL MAP SHEET NAME OF SOIL MAP UNIT St B t~rhi tdlt -SOAdAll /o4,11 PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE BOLE AFTER INTERVAL MIN,'IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- / see B~r~z Ag-49 /o P- r~ e e Ot 2-~ /NCO -3 P-3 e- m B-3 S"' d P- S'/'' e 6-ne A+La 83 dZ y A10 .212- v2 ' 12P- S" V " a Bor / 0 -3 y/ Y / P-6 160-1 5,e e- 15ote A4 A16 3'4- -3 -3 f SOIL BORING TES TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES / B- 7 " diale ! " 1'/i 3 "S1 d ~i r &-ij 34e 'f'(- r r co-4 B- 2 Ai Qy' Ortl~ `7 w „SL C-,- F eo , S* /rr t CG - 81 4,,3 2 g.: 3 ?46 A/1 A, I e- t! 'f 1-5" 3 -r sx- Cri , eol, -S4 Ct- COb B- F1 113- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location. a~c) square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy 3 c~`/~s+r S'e°~ Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 4rm Z01 Lu Z 76 13- res S Q S/ C03 93 BS' s'_, a S T o Per Cs s' o P/ P3 O O ray ~6 T a T OrA.,. P 4t P~z ps, y t m_ .00404 J4) ec ~Ii4, kJesr Q.M. F,C.=/~v'- ~ N E ~ o p ~ ~ s I 8 3 C, f 3 e -4 - - /o Y V ~ BY m E,c .s t<; C ~s'14G. F, as k, 6, s-/,m e4, /0;' arvp')s~ o ase Pr P -4- toe/ t wore wit / %y,"'.L / D / [ S Msilt t44 /l 3 .~?C` I, the underslgend, hereby de4y 1hat`ests reArt~ 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 location of test holes are correct to the best of my knowledge and belief. Name (print) .QNW,s r` 0I e,,C.1W Certification No. CS'r e ~2 Address 111L aa,&eZ )LJe, 44-14/JCI.-- I' ) .Name of installer if known 1 Copy A -Local Authority CST Signatur ~I i 't 0, F . wt p i +'a AVt.t. N ,J 898g 17,so•• F- . Nff f A n4 ~~1 -y4 4-0 . t. ) h l fj, i , rc it $ 44 } t 1, I I I I I 142 r r r t x i %T. 4i M I1 , kv l r O J / r O Pr D SITE PLAN INEXLE I' O' EH 115 Rev.9/78 RF RT ON SOIL BORINGS AND PERCOLATIO TESTS WISCO V DEPARTMENT OF IIEALTH AND SOCIAWERVICES 1 P.O. BOX 309, MADISON, WISCONSIN 53701 D S Yosep~i ~w~ ` LOCATION:-:W Sect ionc~ ,T~N,R,_Qfb(o,)~Iownship or Municipality y'~~~~Ge 7O~ Lot No. , Block No. County r ~rOtcX ub ivlslon ame r Owner's/Buyers Name: c Mailing o to Address:~~ ,c"1 TYPE OF OCCUPANCY: Residence_ _No. of Bedroorns_____ COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM X POTHER DATES OBSERVATIONS MADE: SOIL BORINGS /01 IS_PERCOLATION TESTS -,/77 / SOIL MAP SHEET_ _-NAME OF SOIL MAP UNIT r r~isJr d f SA PERCOLATION TESTS TEST HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- DEPTH CHARACTER OF SOIL. SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER INCHES THICKNESS IN INCHES 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 - ~L3/ I/ ~o F/O 6 61 P- l EIP4 See acre D.9'A 14 J U2 If P- -3 Q A4 [,9 3) s" .2 ' -3 P- S 1 Se e- or a o y 15( P-6 0r, S' 'y o 3 3'L 3' 3' SOIL BORING TESTS TEST TOTAI_ DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B-- 1&le 7 9~~ 3 "SC dGr C~v~~ 3~ Sf~t + CD . 4 6*- B- Y ' O,t l ~ "1"$ t 2- /U 3 9 ,,ae- B 6 N I, r C`O CSI' C'C9 a' + B- i PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the locatI a square feet of suitable area:, Indicate number of square feet of absorption area needed for building type and occupancy x '/OA' SK° ~Q Indicate scale or distance Give horizontal and vertical reference points. indicate slope. /gre4 _ . { Z01 Lac 0- sT C3 8 93 13S-OT 0 joy s' p a T 0 P1 P3 0 - Par c5 _ ArtA A1.7_ _ ~ ~ ~ Oz-A.;,. F%~.~/~~A 11I „~t ,''s DI'!7~t~ F• c+ I ~ n I A4 4- /6' ~bo~ ` oZ y°lo SIQw~ Wes Tf` + i % G rr1 Ge 4 r ¢A ~ ~ O 1 (_yA 0AJ ~ 51-4.8 A /I dc, N 4R.M.Fl /o0• B 3 C- : /o,/.S' A QY C-1. /p y' I ; l ~t y~rn~lv.S10~+.JC~'S~It/9h 1~~. /0;' ='/ao / s 44 GI!_ t i._ ! . , 3 ~Q- f3'Ar P~,R~a~1N Ce~e.L? L1 !prt ~ti,cy z S 0'!'14slil'ittests I, the undersigend, hereeby re re ort rt~ 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 location of test holes are correct to the best of my knowledge and belief. Name (print) ft Certification No. CSC l-S1 !_L--01''` / G -L- Address_ /Old ~.9Li1 t c!c', ca 1 °°s , S~ll~_ Name of installer if known- CST Signatu Copy A -Local Authority r t WISCONSIN DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING, PLATTING & FIRE PROTECTION POST OFFICE BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location SW 1/4 SE 1/4 S 22 T 30 N, R 20 9~ W Town or Municipality St. Joseph (Houlton)Street Address Stillwater, MN X5082 Lot No. Block Subdivision Landowner's Name: .--St. Croix Oil Compan~_ The application for this site is to serve a: ❑ new construction use. © replacement system use. If this is a NEW CONSTRUCTION USE, the alternative private sewage system is to be inkluded 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. E] a lot that meets the site criteria for a conventional private sewage system. If this a REPLACEMENT SYSTEM USE, the mound is replacing: Q 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. I certify that the above information is true and accurate to the best of my knowledge. Name ~hQmas Nelson _ _ Siynatur Title Assistant Zoning Administrator Date November 12, 1981 DILHR-SBD- 6158 (9.7/80) ST. CRO1 X COUNTY .xr y;r 4 W1 SC0 N S I N f 1 y l r jJ ,!s K ZONING OFFICE 796-2239 HAMMOND, WI 54015 November 12, 1981 Division of Safety and Buildings Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the St. Croix Oil Company which is located in the SW4 of the SE-4 of Section 22, T30N-R20W, St. Joseph Township in St. Croix County, revealed suitable soils at a depth of greater than 70 inches. Due to the fact that there is limited area, this site is suitable for an in-ground pressure sys- tem. Should you have any questions, please feel free to contact this office. Yours truly, Thomas C. Nelson Assistant Zoning Administrator TCN:sl ,678 (9/81) (Plb 100a) STATE OF WISCONSIN DILHR atach '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 DATE: PROJECT: 1 :.4,SE,12,30,20:, , . X111 Houltvr,,%' Arcii Str< MA`s' g 1982 ZON1N6 PLAN ID. # OFf~~ DETACH HERE PROJECT NAME PLAN ID. # v 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 0 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 Administrative Code. ❑ Affidavit enclosed. IV. Holding Tanks ❑ 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, p 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. VI. 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. SBD 6678 (9/81) (Plb 100a) STATE OF WISCONSIN DI LHR Detach And Return Upper DIVISION OF SAFETY & BUILDINGS P 9 ! BUREAU OF PLUMBING Portion Of This Form Wit 201 E. WASHINGTON AVE. RM 178 Any Return Correspond ce pi rF Iti~F~~ P.O. BOX 7969 / MADISON, WI 53707 MA1 1382 ~ N 608-266-3815 DATE: / ZGiui,,6 f` PROJECT: OFFICE FIE:- "E 5 ?_2 5 JO cj ArCti SLr, 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 Administrative Code. ❑ Affidavit enclosed. IV. Holding Tanks ❑ Profile of holding tank showing vent, manhole alarm and manufacturer if precast. Complete construction details if ll. 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. I II. 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. VI. 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 0 Copy). ❑ Copy of onsite report by county or district staff. 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 fin. Re: PRIVATE SEWAGE SYSTEM ONLY- The Bureau of Plumbing has reviewed plans, site survey information and installation details for the construction of an alternative 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 a -gallon 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 By: County Other Enclosures DI LHR-SBD-61 59 (R. 7/81) mes Sargent, B erector At your request we have examined the abstract of title No. 13,626 to land in St. Croix County, Wisconsin All that part of the SWJ of the SEJ of Section 22, T30N, R20W, St. Joseph Twp., St. Croix Co., Wisconsin, described as follows: Commenein at a county monument located at the southwest corner of SWJ of SE4 of Sec. 22, T30N, R20W, St. Croix Co., Wisconsin; thence northerly along the West line of said SWJ of SEJ of Sec. 22 on an assumed bearing of Due North, for 881.8 feet to the(p`Sint of begin- ning of this description; thence continuing Due NortIT along said West line of SWJ of SEJ for 195.0 feet; thence South 87044140" East for 64.02 feet; thence South 75019110" East for 69.4 feet; thence North 89039130" East for 88 95 feet; thence South 0001100" West for 175.8 feet; thence North 89x54'00" West for 220.0 feet to the point of beginning. Containing 0.93 acres, more or less, subject to the right-of-way of Wisconsin Highway No. 64 and 35. 1 1 i i i ti R~ ~ ~e f F . 9b FLEA 2 5 n2 0(1)0Kv0 C7 r~ m o co ~1 S m a 3 ID 0. d (D \ 1 I 3 - w z z N Z N A C7 N ee ~1 3 y 0 0 0 }rJl CD d d CD O A X p O fJ 4. (D (D N w N N O h ^ w 7 (D (D ~ w O 1 N a 0 N C7 A O o Ca cn C N N 5 O A O CL d O M SI tan y 7 7 o O c < O O N u> Z D tD a N m cfl D (n a C. CD O W 3 CD z 3 O 00 N= N O C .r C T -0 'D z O O O ' `lNil ° c v I * -4 ~7 _ c tin vii ai - m c O Q v 0 A (D o to 7 7 y N 90 tD tD tS d y O I 3 y c N 7 c9 d .3. N Z N z z v o D D O rn N J C O O N, • ( a Cc ~ co m' to 0 Z ? a rn O ? Z CO'1 A Z O 0 7 CL ` ~ ° o N z , 3 ;u O ^ co N 3 m o to z CD A CD F I I C-) D S CL O a 0 _ ~ o CD W C 0 o a C m 3 a. m m ~ i 7 A O `D N CL 't n N kli N 7 tv ' O - O p N 7 3 hq O 0 tv E9 0 o O y O i .l Parcel 030-2030-30-000 07/28/2006 12:36 PM PAGE 1 OF 1 Alt. Parcel 22.30.20.4441 030 - TOWN OF SAINT JOSEPH 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 - FINA OIL & CHEMICAL, % TWIN CITIES STORES INC % TWIN CITIES STORES INC FINA OIL & CHEMICAL 2020 SILVER BELL RD #23 EAGAN MN 55122 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 1421 HWY 35/64 SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 0.720 Plat: N/A-NOT AVAILABLE SEC 22 T30N R20W SW SE COM SW COR SW SE Block/Condo Bldg: TH N 1076.8 FT TH S 88DEG E 64.02 FT TH S 76DEG E.58 FT -POB OF PARCEL TO BE Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) DESC & TO ITS INTER WITH E LN PARCEL 22-30N-20W TAKEN FOR HWY AS DESC IN 433/332 & 333 TH CONT S 76DEG E 68.82 FT TH N 88DEG E more... Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1097/558 LE 07/23/1997 674/46 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 0.720 108,800 240,000 348,800 NO Totals for 2006: General Property 0.720 108,800 240,000 348,800 Woodland 0.000 0 0 Totals for 2005: General Property 0.720 108,800 240,000 348,800 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 Parcel 030-2030-10-000 07/28/2006 12:35 PM PAGE 1 OF 1 Alt. Parcel 22.30.20.444G 030 - TOWN OF SAINT JOSEPH 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 - ST CROIX, MEADOWS INC/A MINN CORP MEADOWS INCA MINN CORP ST CROIX PO BOX 185 COTTAGE GROVE MN 55016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1415 HWY 35/64 SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 37.980 Plat: N/A-NOT AVAILABLE SEC 22 T30N R20W SW SE EXC P444H & I Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-30N-20W Notes: Parcel History: Date Doc # Vol/Page Type 08/23/1999 609058 1450/586 WD 07/23/1997 925/367 07/23/1997 923/230 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 9.980 71,100 813,500 884,600 NO UNDEVELOPED G5 8.000 45,100 0 45,100 NO PRODUCTIVE FORST LANDS G6 20.000 344,100 0 344,100 NO Totals for 2006: General Property 37.980 460,300 813,500 1,273,800 Woodland 0.000 0 0 Totals for 2005: General Property 37.980 460,300 813,500 1,273,800 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 I 1