HomeMy WebLinkAbout038-1148-80-000
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Parcel 038-1148-80-000 09/20/2005 09:39 AM
PAGE 1 OF 1
Alt. Parcel 17.31.18.652 038 - TOWN OF STAR PRAIRIE
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 - GLOCKZIN, LARRY C & DEBRA L
LARRY C & DEBRA L GLOCKZIN
115 RIVER ST
HUDSON WI 54016
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 960 BRAVE DR
SC 5432 SCH D OF SOMERSET
SP 8050 SQUAW LAKE RHAB & MANAGE
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: 2617-WIGWAM SHORES
SEC 17 T31 N R1 8W LOT 1 BLOCK E WIGWAM Block/Condo Bldg: E LOT 01
SHORES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-31 N-1 8W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 872/482
07/23/1997 798/594
07/23/1997 707/130
2005 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 53,100 0 53,100 NO
Totals for 2005:
General Property 0.000 53,100 0 53,100
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 53,100 0 53,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
i
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969 BUREAU OF PLUMBING
MADISON, WI 53707
El CONVENTIONAL ❑ALTERNATIVE stataPlanLD.Number:
❑ Holding Tank of a ne)
g (A In-Ground Pressure ❑ Mound
NAME OF PERMIT HOLDS ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
1 L< Is:) Cl
BENCH MA K
(Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV..
U TS i 0 18 ti-) AR(-LA.(-
Name Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
c:~ C q
SEPTIC TANK OLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL ILOCKING COVER
PROVIDED: PROVIDED:
DYES ONO DYES ONO
BEDDING: VENT DIA.. VENT MATE.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH
ALARM FEET FROM LINE: AIR INLET
DYES ONO DYES ONO NEAREST
DOSING CHAMBER:
MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
DYES ONO DYES ❑NO DYES ❑NO
GALLONS PER CYCLE: PUMP AND CONTROL OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING jvENTTTVRn,1
(DIFFERENCE BETWEEN FEET FROM LINE AIR INLET
PUMP ON AND OFF) DYES DNO NEAREST
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING
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 INU OF DISTR. PIPE SPACING COVER INSIDE CIA *PITS LIQUID
TRENCHES MATERIAL: PIT DEPTH
DIMENSIONS
GRAVEL DEPTH FILL DEPTH (LIST If P'P' DISTR. PIPE ISTR. PIP MATERIAL . NO. DISTR. NUMBER OF R E TY WELL. BUILDING. VENT TO FRESH
BELOW PIPES. ABOVE COVER. ELEV. INLET ELEV. END PIPES FEET FROM LINE. AIR INLET.
NEAREST
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-
DYES O NO meets the criteria for medium sand. TIONS MEASURED.
SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS
DYES ONO DYES ONO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED
CENTER EDGES.
DYES ❑NO DYES ONO DYES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER
TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO UISTH DISTR. PI DISTRIBUTION PIPE MATERIAL & MARKING
ELEVATION AND ELEV. ELEV.. CIA ELEV. PIPES DIAJ
'
DISTRIBUTION
INFORMATION HOLE SI/F HOLE SPACING DRILLED COHHECTLV COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
DYES ONO DYES ❑NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER OF PROPERTY WELL
BUILDING.
FEET FROM LINE
DYES LINO [DYES L7 NO _ NEAREST
Sketch System on Retain in county file for audit.
Reverse Side.
SIGNATURE TI LE
,DILHR SBD 6710 (R. 01/82)
DEPARTMENT OF APPLICATION
INDUSTRY, FOR SANITARY SAFETY & BUILDINGS
LABOR AND PERMIT DIVISION
HUMAN RELATIONS P.O. BOX 7969
(PLB 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. A legible reproduction of the soil test report or the owner's copy must be
included.
Property Owner:
Mailing Address:
6
Pro Location: ^
/ City, Village To ship: County:
n %1 t~4S iT NiR f (or) W
Lot Number: Blk No.: Sub .division Name: e '
Nearest Road, Lake or Landmark: State Plan I.D. Number:
(if assigned
~~C'
Oln A.
TYPE OF BUILDING CT
❑ Public* ❑ Variance* ❑ Other (specify)* Number of
[$~1 or 2 Family *State A Bedrooms:
pproval Required.
TOTAL NUMBER PREFAB POURED-IN
GALLONS OFTANKS CONCRETE PLACE STEEL FIBERGLASS NEW REPLACE- OTHER
SEPTIC TANK CAPACITY INSTALLATION MENT (Specify)
L
HOLDING TANK CAPACITY
LIFT PUMP TANK/SIPHON CHAMBER CIC,2
MANUFACTURER: L_
EFFLUENT DISPOSAL SYSTEM
PERCOLATION RATE ABSORPTION AREA
(Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit
Alternative (specify) r+Cf~g-►~,.55=c~r ❑ Seepage Trench
I
Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): J
Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name o lumber: Signature:
MP/MPRSW No.: Phone Number:
CO srz
Plumber's Addr s:
Name of Designer:
F.
COUNTY/DEPARTMENT USE ONLY
Sig at re of Issuing gent: Fee:
Date: Sanitary Permit Number:
1 p"~ Y APPROVED
DISAPPROVED
OCX. ❑ `i
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)
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STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS
DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING
P.O. BOX 7969 - MADISON, WI, 53707
APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM
Location: Townshipp Municipality:
~(A) 4S l 'J IT N/R ~C1 A(or)W M7,f?r i~F~IE_
r~
Street Address: Subdivision: County:
7' ~X,
Landowners Name: Mailing Address:
I-L - A E. , J~'li r~/l, s5o 3
I (We), the undersigned, hereby make application for an alternative system on
the above-described premises. I recognize that the above premises are not
suited for a conventional private sewage system. If approval is granted,
a ree to have the system installed in conformance with the Bureau's appr val
of plans and specifications.`
I further understand that an alternative system is more complex in nature than
a conventional private sewage system and as such will require detailed
inspection during construction and monitoring after the system is put into
use. I agree to permit both county officials charged with administering county
sanitary ordinances and Bureau employes or other authorized persons to have
access to the above described premises at any reasonable time for the purpose
of inspection the construction of or monitoring of the system. I further agree
to either personally or by my agent contact the proper county official to
arrange the time and date to. begin construction of the system.
I understand that this application does not permit me (the applicant) or my
agent (the contractor) to begin installation. If the system is approved, the
Bureau will send the applicant a letter of approval which authorizes
construction of the alternative system after all necessary permits have been
obtained.
I agree to give notice to any subsequent buyer that an application for an
alternative system has been made and if installed, that the premises are served
by an alternative system and further agree to give the buyer a copy of this
application.
The Bureau accepts this application subject to this understanding and subject
to all the conditions and obligations set out in this application.
(y~
Sign ture of Applicant Date
A~~_
STATE OF [ O0,NSTN'- Subscribed and sworn to before me
SS.
COUNTY This 4- _day of
~NC/ v '}6~'_ rtN !t5 [ii,q 4~ / s41F CY".ji-~.1 .7
-
Notary Public, State of -Wisconsin
My coy .i swn expires Dec. 1 A, 1985
DILHR-SBD-6413 (N. 05/81) My Commission Expires:, _-.r
QIL at
DIVISION OF Arr ter Wlat; SAFETY [ BUILDINGS
PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING
a , o 201 E. Washington Avenue, Rm 178
PLAN APPROVAL APPLICATION P.O. Box 7969, Madison, WI 53707 ;
608-266-3815
INSTRUCTIONS: Please fill in all applicable data and submit this form with plans. Plans will not be reviewed until all fees are received.
The back side of this form describes required plan information. Plumbing codes can be purchased from the Department of Administration,
Document Sales, 202 South Thornton Ave., Madison, Wisconsin 53703, Telephone (608) 266-3358.
1. PROJECT INFORMATION (Type or print clearly)
Name of S mitting Party (Plans returned to same) Pro•ect Name
Street & No. Project Location - Street & No. or Legal Description
City State Zip Code ❑ City County
}
ki 164, 1~ ❑ Village /
G~ Kl /2Z'97 d ~i J c5~ G7/ Town c?
Designer Telephone No. (Include Area Code)
11J a ,lv~ao
2. THIS APPLICATION IS FOR A:
❑ New Mound System (3) ❑ Holding Tank (2)
New Pressurized System on site not suitable ❑ Petition For Modification (6)
for conventional (3) ❑ Replacement Mound (4)
❑ Replacement Pressurized System on site not ❑ System in Fill (1)
suitable for conventional (4) ❑ System in Flood Fringe (1
❑ Pressurized System on site suitable for ❑ Groundwater Monitoring (7)
conventional (1 )
❑ Conventional System - Public Building (1)
3. FEE COMPUTATIONS (Include existing tanks) 4. FEE SUBMITTED FOR OFFICE USE
3a. 750- 1,500 gallon septic tank - 30.00 4a.
3b. 1,501 - 2,500 gallon septic tank - 40.00 4b.
3c. 2,501 4,000 gallon septic tank - 55.00 4c.
3d. 4,001 8,000 gallon septic tank - 70.00 4d.
3e. 8,001 12,000 gallon septic tank - 85.b0 4e.
3f. Over 12,000 gallon septic tank - 100.00 4f.
3g. 500- 1,000 gallon pump chamber - 30.00 4g.~? CEO
3h. 1,001 - 2,000 gallon pump chamber - 35.00 4h.
3i. 2,001 4,000 gallon pump chamber - 50.00 4i.
3j. 4,001 8,000 gallon pump chamber - 65.00 4j.
3k. 8,001 12,000 gallon pump chamber' - 80.00 4k.
31. Over 12,000 gallon pump chamber - 95.00 41.
3m. 500 - 5,000 gallon holding tank - 30.00 4m.
3n. 5,001 - 10,000 gallon holding tank - 40.00 4n.
3o. Over 10,000 gallon holding tank - 50.00 4o.
3p. Groundwater Monitoring - 32.00 4p.
Subtotal lo, 00
3q. Priority plan review: (walk through) 4q.
Submittal of plans in person,
by appointment, with double fee
3r. Petition for Modification
Setback - 20.00 4r.
Site evaluation - 50.00
Total Fee
COMMENTS:
,)II. HR S13n-8748 IR. 5!82.).---_--__.-__ ' -OVER-
♦ 1
it
S1. CROI X COUNIV
ZONING OFFICE /96-2139
HAMMOND, WI 54015
r
Division of Safety and Buildings
Bureau of Plwiibing
P.O. Box 7969
Madison, WT, 53707
Dear Sir:
An on site iflvesti6atiun for the Jim Belmonte property
located at the SW of the NE Section 17
T31N-R18W, Star Prairteir► St. Croix County, rr.vealud
suitable soils at a depLh of inches, below which
seasonable high ground water was noted.
This site should be suitable for an in-ground Pressure
BysLeW.
Shuuld you have arty yueations, Please: feel free' to
contact this offAe.
Yuur' Lruly,
Thuuiab C. Nc 1 bun
Ansiu Ldnl-
TLN a l
1
WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS
DIVISION"OF SAFETY & BUILDINGS, BUREAU OF PLUMBING
POST BOX 7969, MADISON, WISCONSIN 53707
Verification of Exception Status for an Alternative Private Sewage System
In the County of t. Croix
Location SW 1/4 NE 1/4 Sec. 17 T 31 R 18 8'- (or) W
Town or Municipality Star Prairie Street Address 85 Quality Ave.
Lot No. 1 , Block E , Subdivision Wigwam Shores
Landowner's Name: Jim Belmonte
The application for this site is to serve a:
Q new construction use.
❑ replacement system use.
If this is a NEW CONSTRUCTION USE, the alternative private sewage system is to
be included as:
Q one of the 25 needing a quota number. This is number 59-10-3 of the
applications made through this office.
❑ for one additional homesite on a farm to be occupied by a parent, child,
grandchild, sibling, niece, nephew, or first cousin.
❑ for 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.
❑ an application on file prior to February 1, 1980.
❑ a lot that meets the site%criteria for a conventional private sewage
system.
❑ one of the first five approvals guaranteed for this year. This is
number of those applications. (Use one of the first
five quota numbers issue to you.)
If this is 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.
❑ a lot that meets the site criteria for a conventional private sewage
system.
I certify that the above information is true and ac urate to the best of my
knowledge.
Name Harold C. Barber Signatu ;
ounty 0 ficia
Title Zoning Administrator Date December 3, 1982
DILHR-SBD-6158 (R 6/82)
LDINGS
r~ r>F.R rMr:iv r ()F REPORT ON SOIL BORINGS AND SAF F1'Y RI 13U1IVSI N
UN
INDUSTRY, P.O. BOX 7969
LABOR AND r BOX 7
HUMAN RELATIONS PERCOLATION TESTS (115) MADISON, WI 53707
« (H63.090) & Chapter 145.045)
LO A 1 N: ;U- S TON:T OWNSHI /MUNICIPALITY: OT NO.: BLK. NO,: SUBDIVISION NAME:
1/4 x1/4 J,7 /T~3i N/R/F),E (or) W f ,4Y' or #q 1,4 L^ ((J 15 4)6-.Yl 6 h arFs
55
COUNTY: OW ER'S BUYER'S NAME: MAT-LING ADDRESS:
DATES OBSERVATIONS MADE
USE
NO, BEDRMS.. COMMER A D S Al ION: COE
FU ~ S:
C $esidence New EE: Replace 0 , Lr z ~Z - gZ
~I~ 7
7
RATING: S- Site suitable for system U= Site unsuitable for system
ONVENTI NAL: MOU D: IN-GROUND-PRESSUR S E -IN-FIILLTHOLDING TANK: RECO_MMENDED SYSTEM: (optional)
S ®U S ❑ u ~S ❑ U 0 S U 1 EIS ,®U
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s.H63.09(5)(b), indicate: Floodplain, indicate FloodPlain elevation:
PROFILE DESCRIPTIONS 10A/7,02
BORING TOTAL P H T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. I S TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- '7~i"
B- 33" --90 'n ?d /7.,q r, S; 1,
)L- I 4
o L
B-mo j6-''~n,S. G.
B c7ov 0 E 6,"13n.5,
B 0 !~v C- 80" n
B-
PERCOLATION TESTS
U E S
T DEPTH WATER IN HOLE TEST TIME DROP WATER V I HES RAT PE E R M I INNCN
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. P I
P_ I .74M ~0 r
3,i~
P- z a'Iy -3~ 3
P - 1
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-
xontai 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
-1C OIL
EL. ~=z Ioi
3 = )ov - aa, ~ gar 8-4
~
P -1
Q 10• -4-s 4: ,Ohl . a~ p 3
4' ~ r F
1
s-
_ tit 2 Q ~-2
4-o 6
v ~Lo t vy,
w
aA P"I~ +-0 4~ o S t_~c
4,a I&J 10 Mt F
1- 00 4t, 6r-- 6
q 4 J8, tq V+6 r f n 5 1) a4 d or SEwk
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 Sprint) TESTS WERE COMPLETED ON:
- = CERTIFICATION NUMBER: PHONE NUMBERIoptional):
ADDRESS: ~~-07 - (o Lao
CST SIGN E- ,Q
t
..,,M«,.,:..•s ........w+.rw.•„ro,m,..,.w, ,.,~.>x.. ,.,-....,.+1.w,e,,,r:.-..,n, ,y.,~Wwrv,.. .
j?TIONAL WORKSHEET
I.\MOUND SYSTEM II. IN-GROUND PRESSURE SYSTEM-Continued-
1. Wastewater Load, Total Daily flow = gal. 10. Force Main: ca
\ Minimum Dosing Rate = ~z. e gpm
Use section H 63.15 (3) (c), W is.
Adm. Code and PROVIDE A DETAILED Diameter in.
\ LIST OF SIZING ON PLANS. 11. Total Dynamic Head:
2. 'h to Limiting Factor ft. System Head = 2.5 ft.
3. La dslope % Vertical Lift = -~a ft.
4. Dist'aince from Dose Chamber to Friction Loss = ft.
DisVibution System ft. TDH = ` ft.
5. Elevation Difference Between 12. Pump Selection:
Pump`apd Distribution System ft. PUMP will discharge at least 7z gpm
6. Absorption'rea Sizing: at 9(9 ft. total dynamic head.
.'c'
Area Required = sq. ft. Pump model and manufacturer
Bed or Trench Length (B) = ft{ 3H h? i - W t20 S
Bed or Trencli'<<Width (A) = ft. 13. Dose Volume:
Trench Spacing`(C) = ft. 10 Times Void Volume of
7. Mound Height: Distribution Lines = gal.
Fill Depth (D) = ft. Daily Wastewater Volume T•
Fill Depth Downslop ( = ft. 4 Doses In 24 hrs. gal.
Bed or Trench Depth ) = ft. Backflow = f gal.
Cap and Topsoil Dep, ) = ft. Minimum Dose = 0 gal.
Cap and Topsoil 130th (H = ft. 14. Dose Chamber:
8. Mound Length: i' Volume = ;C) ->C gal.
End Slope (K) ft.
Total Mound length (L) = ft, III. CONVENTIONAL PRIVATE SEWAGE SYSTEM
9. Mound Width: 1.\ Wastewater Load, Total Daily Flow = gal.
Upslope Corrrection Factor = Use section H 63.15 (3) (c), Wis.
Upslope Width (j) = ft. Adm. Code and PROVIDE DETAILED
Downsigpe Correction Factor = LIST OF SIZING ON PLANS.
Downytope Width (I) = ft. 2. Required,$eptic Tank Capacity = gal.
Total 'Mound Width (W) ft. 3. Percolation ijate = % min./in.
10. Basal Area: 4. Absorption Ar Sizing:
Infiltrative Capacity of Refer to Tabl in chapter H 63- '
.Natural Soil = gal./sq.ft./day and PROVIDE A`~ETAILED LIST OF
/Basal Area Required = sq. ft. SIZING ON PLANS
Basal Area Available = sq. ft. Required Area = sq. ft.
11. If Standard Tables from Chapter Length = i!^ ft.
H 63 are Used, Indicate Table No. Width = ft.
12. For the Distribution Network, Use Numbers 5-14 in Sectionll. Number of Tr/ches=
Trench Spa g = ft.
11. IN-GROUND PRESSURE SYSTEM 5. Distributlon ystem:
1. Depth to Limiting Factor = /_V) k ft. Later#f-ength = ft.
2. Landslope o 0--o- % Nu er of Laterals=
T_
3. Percolation Rate min./in, teral Spacing = in.
4. Proposed System Elevation = ft. Distance from Sidewall to Pie:=1 in.
5. Wastewater Load, Total Daily Flow: -500 gal. System Elevation = ~~`a ' ft.
Use section H 63.15 (3) (c), Wis.
Adm. Code and PROVIDE A DETAILED IV. SYSTEM-IN-FILL r
LIST OF SIZING ON PLANS. Fill in All Items from Section I f
Required Septic Tank Capacity = 1000 gal.
s? t,
t,
6. Absorption Area Sizing: V. SEPTIC TANK s i .
Percolation Rate 15
= min./in. 1. Capacity OCR gal.
Area Required = ' sq. ft. 2. Manufacturer: FKS i~C r'1C~MF tE ~t,l_ f
System Length = C- 3 ft. 3. Show Site Constructed Tank Details on Plan
System Width = _ 6 ft.
7. Distribution Pipe Sizing: VI. DOSING TANK
Hole Sire = 2/L in. 1. Capacity = 11 0d gal.
Hole Spacing = -3 fl. 2. Manufacturer: (.lJ F 1~5 N(Yr~ Erb 4 € F'd + S
Lateral Length ~L It, 1. Pump Manufacturer:. nu Icj
Literal St/l` /'/z in. 4. Pump Model: -3 e - ) p o -5
1.•11cral Spacing ~13 It. 5. Operating Head= 56 ft.
Disiallee from Sidt-wall to Pipc in. Flow Rate= Rpm.
8. Distribution Pipe Discharge Rate: 7. Show Site Constructed Tank Details on Plans
Number of I lures Per Pipe
I low Per Nov 18,4 gpln. VII... HOLDING 'I ANK
Manilold Sizing: 1. Capacity
I ype ((enter or end) n F V^ 2. M nut (Aurer
Lcngih 3_ a onstructed Tank Details on Plans
Diameter In.
-SHOW ALL INFORMATION ON PLANS-
Dl[ HR SBD-6761 (R.03/82) \
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431
1 ZnSp~a~-ion PFP~
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' OAG E. OF
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CROSS SECTIOm OF A BED 3, STEM
~Y
V /
r,•
SOI FILL Z" OF AGGREGATE
D15TRIBUTIOki PIPE--j /~jkPPplQ\/EU 5%3MTHETIC COVER
, MATERIAL OR 4" 8 1- R 064
°
lo10F%Q-2'Iz AGGR GATE ,
ELZV. OF1_Sg _ FEET,
DISTRIBUT►OM PIPE TO BE AT LEAST I lKiCHES BELOW OPIG1NAL GRADE
AkID AT LEAST 20 INCHES BUT NO MORE THAKI HZ INCITES BELOW FIKIAL GRADE
MAXIMUM UEPl'il OF E.Y.CAVATIOA] FROM ORIGIMAL GRADE WILL 6E IAIGHES
MINIMUM DEP1 H OF EXCAVAI IOU FROM OKIGIWAL GRADE WILL. BE 24'ac INCHES
S16►JED
'
LIGEtiISE A101ABEFt: 8~ x
F
1 Z t~
DATE:
Page u I
Perforated Pipe Detail
End View
Perforated
End Cap PVC Pipe
1.
re
Holes Located On Bottom,
W V` Are Equally Spaced
S
` R
P Force Main
Fr Pump
l
Ma ' old Pipe ,
/P
Alternate Position Of
ribution / Force Main From Pump
Pipe
Last Hole Should Be
Next To End Cap
5~ x
End Cop Distribution Pips Layout P 2
R
t, S
X
r1 ~ Y
Hole Diameter Inch
Signed:
Lateral l yz Inch(es)
License Number: r Manifold 2 Inches
Date: _ ~-7 - Force Main 3 Inches
WAGE OF
PUMP CHAMBER CROSS SECTION AA1D SPECIFICATIONS +
VENT CAP
`l**C.i. VF-Ut PIPE WEATHER P ROOF APPROVED LOCKING
JUNCTIOA! BOX MANHOLE COVER
25' FROM DGGR, 12°MINJ. '
WI►JDOW GK FRESH
Alf?, IAITAKE
GRADE i y" MIN.
18" -
COIJDUIT ~T-
18"MIAI.
PROVIDE I
I<ILE T AIRTIGHT SEAL i I(~ V
~ I
I APPROVED .lO1NTS
APPROVED JOINT A W~C,=. PIPE
W/C.T. PIPE I III EXTEUDIUG 3'
EXTENDINJG 3' ALARM
I ONTO SOLID SOIL
O*1TO SOLID SOIL t.)
I I Ow
`PUMP OFF
30
CONJCRETE BLOCK
RISER EXIT PERMITTED GIJL9 IF TAUK MANUFACTURER HAS SUCH APPROVAL
k
SPECIFICATIOUS
SEPTIC ANU J Z
DOSE TANKS MANUFACTURER: 4 W5 f) Y) WMBEK OF DOSES: PER DAy
TANJK ' IZE : 900 GALLONJS DOSE VOLUME: GALL0?JS
ALARM MANlUFACTURER: yc1✓< f''^+" ' CAPACITIES: A= iNGHES OR 2r 7, GALLONS
MODEL ►JUMBER: IAICHES OK GALLONS
SWITCH TYPE: C=INCHES OR I 33, 7 GALLONJ5
D~~Z, -_IULNES OR2,67,552 GALLOA.IS
I'_IIM_ P MAIllItAf.'lilKL`K:
- MC I+F L MLIMBE.R'. ~ plc? NOTE: PUMP AND ALARM ARE TO BE
IMSTALLED OW SEPARATE CIRCUITS
1
PUMP DIS(JIARGL KARL GPM
VI.KT ICAL_ DIF Ir tI,'LAKE BL-f WE.F_AJ f'I.IMI' OFF AUD DISTRIBUTIOKI PI►'E-. .Ccz~-- FEET
+ MIfUIMUM tJETWORK $UPPLJ PRESSUKE . . . . . . . . . 2.5 FEET
22,2~i~, /xn+
FEEL OF FURCE MA1N 1 X 1,[-F~oFr.FRICTIOF! FACTOR.. FEET ,Xzx 9A~- jj
TOTAL mimAMIG+ HEAD = R'FEET
IIJTERIUAL DIMLWSIONS OF TAIJK: LE#f~fiN ( ;WIDTH -;LIQUID DEPTH
-49
IMF nJ~ E kiUMBFR. - DATE:
-
'xwwwMV, n a:e' .x . . . ........wm n.m.;uv ..Hr.:M ...rv.. a r.A..w a- ~ , ,,.n.r.~m .e'n+.'.~....•n,n+Mevc.
Gallons Per Minute Model
WP -3881 WPO51 Ls,
' Series No. ► ' WP0512S \1881
WP0534S Submersible
"P ► Sewage
P~ 21
RPM ► 1750
Pumps
V 5 160
Z y 10 133
E 3 15 90:
° 20 - 50 1XI
ILL
25 20 t~
F°- b
30 0 x
G x ,VL 5 ~ .?L ,n • Y t k SW ,,2
t
t Y,Jr a er
k Liquid passages provide true full diameter solids handling capabilities as
advertised. Epoxy seal on power cable acts as secondary barrier to liquid
intrusion if cable jacketing is damaged. Rugged cast iron construction.
High efficiency full volute casing.
%
WP3881 Max. a.
Series HP Volts Phase RPM Solids i Amps Wt.
WP0511S '2 115 1 1750 1'/2 13 60
t WPO512S ! 12 230 1 1750 11/2 6.5 60
WP0532S /2 230 3 1750 1'/2 22 60 " I
-WP0534S /2 460 3 1750 11/2 1.1 60 s - '
CSA Listing Pending „
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t- - -ti
i. . I I ' I. I k
t
0 20 40 60 80 100 120 140
Capacity 1-t1-7
-Gallons Per Minute ~f
,t
SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE.
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Wisconsin Department of Industry,
PLB-1 INSPECTION REPORT Labor & Human Relations
Safety & Buildings Division
Bureau of Plumbing, Platting & Fire Protection
Name o remises Date an No.
Street city County Sanitary Permit
Master Plumber Firm Name dress
Journeyman Plumber Address
Owner Address
.............~ae«www~+..ew.o..«~.....LV.2 ».T n...........^"~'^...~..a..~« ..~,.....m~...nw..mm e«.A..o...»»..<~..o:,.a+..+,...,~..........o........
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Tiscussed wit-h- re
( )See Attached.
DILHR-SBD-6192(N.09/80) Signature o is Plumbing - up. On-Site Waste Specialist
White-Inspector Yellow-Local Inspector Pink-Plumber or Responsible Party Green-Owner
WISCONSIN DEPARIMENI OF INDUSTRY, LABOR AND HUMAN RELATIONS
DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING
POST BOX 7969, MADISON, WISCONSIN 53707
Verification of Exception Status for an Alternative Private Sewage System
In the County of S t . Croix
Location - sw 1 j4 NE 1 j4 Sec. 17 T 31 R 18
L~ (o r ) W
Town or Municipality star Prairie Street Address 85 Quality Ave.
Lot No. 1 Block
' , SUbd1V1Si0n Wigwam Shores
Landowner's Name: Jim Belmonte
The application for this site is to serve a:
O new construction use.
❑ replacement system use.
If this is a NEW CONSTRUCTION USE, the alternative private sewage system is to
be included as:
Done of the 25 needin a 59-10-3
applications made thrroughuthisnoffice. This is number of the
❑ for one additional homesite on a farm to be occupied by a parent, child
grandchild, sibling, niece, nephew, or first cousin. '
for 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.
U an application on file prior to February 1, 1980.
[]a lot that meets the site criteria for J coiivr~~ttf: of cry-+!Vi 0.«, ;,ewayf
system. i
L_.Ione of the first fiv,-
number ~~~a"~s~.~~:~. ;t„ ~.r:a~~ .Yi~ak !his ~s
five to those applications. (Use one of the first
quota numbers issue to you.)
If this is 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 Februar 1
y 1980.
❑ a privy that was installed and in use prior to February I, 1980.
na lot that meets the site criteria for a conventional private: sewa e
system. g
1 certify that the above information is true and ac urat- ~;n UIC r,._- - or my
knowledge.
ri trotd
a
`ounty (jff;ri11 _ ar'i ~~~,c ..._1~ ;
STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS
DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING
P.O. BOX 7969 - MADISON, WI, 53707
APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM
Location: Township Municipality:
,S6-) 1-4 4~S l % T N/R 6 '(or)W
Street Address: Subdivision: County:
_S1 ,Q~ e / X,
Landowners Name: Mailing Address: C/
I (We), the undersigned, hereby make application for an alternative system on
the above-described premises. I recognize that the above premises are not
suited for a conventional private sewage system. If approval is granted, I
agree to have the system installed in conformance with the Bureau's approval
of plans and specifications.
I further understand that an alternative system is more complex in nature than
a conventional private sewage system and as such will require detailed
inspection during construction and monitoring after the system is put into
use. I agree to permit both county officials charged with administering county
sanitary ordinances and Bureau employes or other authorized persons to have
access to the above described premises at any reasonable time for the purpose
of inspection the construction of or monitoring of the system. I further agree
to either personally or by my agent contact the proper county official to
arrange the time and date to. begin construction of the system.
I understand that this application does not permit me (the applicant) or my
agent (the contractor) to begin installation. If the system is approved, the
Bureau will send the applicant a letter of approval which authorizes
construction of the alternative system after all necessary permits have been
obtained.
I agree to give notice to any subsequent buyer that an application for an
alternative system has been made and if installed, that the premises are served
by an alternative system and further agree to give the buyer a copy of this
application.
The Bureau accepts this application subject to this understanding and subject
to all the conditions and obligations set out in this application.
Jl_
Signhture of Applicant Date
STATE OF WfRt NSI1V_- Subscribed and sworn to before me
SS.
OF,bY ' %/,ll ; l 6
COUNTY This 'r day of f C~ yi >Cf l ,
G; A D W. TANK:
- ;n7
Notary Public, State of-Wisconsin
. `.o~rvly
My can n :i4r excit es Der
. 14, 1955 4.0
My Commission Expires : _ r'~;' COY J _
DILHR-SBD-6413 (N. 05/81)
DEPAR•T(~iENT OF REPORT ON SOIL BORINGS AND SAFETY & BD UIIVLDIISINGS
ON
`INDUSTRY,-
P.O. BOX 76
LA$OR AND PERCOLATION TESTS (115) MADISON WI 3707
HUMAN RELATIONS
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: OWNSHI /MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
CL_
'/4 '/4 1'7 /T~ / N/R/ (or) W A ay
COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS:
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE OE IPTIONSON TESTS:
New ❑Replace _ ~
~esidenc Q
RATING: S=Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: rYSTEM-IN-Flional)
❑ S ❑~U S ❑U I ["S ❑U El S
GN RATE: I If any portion of the tested area is in the
If Percolation Tests are NOT required DESI
under s.H63.09(5)(b), indicate: Floodplain indicate Floodplain elevation:
PROFILE DESCRIPTIONS _ /';v) e2
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- c7 C!' T JtJ /,L)C)/~ f7 / /J,~f•S. ~~O ~i/1 S k)C V7
B 7 oc~ /U
F .,15,,,„ 53A3,46, , rnr/.SI 1
B-9 rJN
B
B ,0 /00 to 80'' S,k, 6, 5, a R;'J3n,S„C.
B-
PERCOLATION TESTS
ETEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATER INCH ES
INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3
141
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
E
62
961 8-4 f,
00
s 5~y a P-, 3 07
13 s~oP 'S 'W I`a4s4jqKL
fit, tiff r___.T H
loo
u t31~ ~Po1-0 4 9 8-° or X18 w ka 15
4_
01 r7
0), 1- a K
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
ministrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
1E (print): TESTS WERE COMPLETED ON:
12 -3-8Z_
HESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
?SST SIGN E: Q
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CIA
ST. CROI X COUNTY
WI SC O N S I N
ZONING OFFICE 796-22 9
HAMMOND, WI 54015
Division or Safety and Buildings
Bureau of Plumbing
P.O. Box 7969
Madison, Wl 53707
Dear Sir:
An on site investigation for the Jim Belmonte property
located at the SW of the NE Section 17
T31N-R18W, Star Prairie in St. Croix County, revealed
suitable soils at a depth of inches, below which
seasonable high ground water was noted.
This site should be suitable for an in-ground pressure
system.
Should you have any questions, please feel free to
contact this office.
Your, truly,
Thomas C. Nelson
Assistant Zoning Administrator
TCN:sl