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HomeMy WebLinkAbout002-1022-40-100 0 vn 0 C v 0 d O M O a y v m o , 3_ , a~ QOj 0 v o N p rn m m m o o `C • CD 1 :y 3 co a N N 0-( W o ~l Ut d z n y A (D :E' O co c cD O ? N 1 CD M En N CL = O O-0 O 7 ro o O o rn ~ ro o ~ W ~ ~ m m o 0 00 O CO N CD m a a o -p :3 to co =r CL C) o 0 N O W W d ~ 0 r en P "a T M 0) cat C/) z O O O n 3 E N N ON 3 ~f cn CD y Er ~ v o N o' O m I ro :3 -D R° ro ~r 0 CD croi N I o N 7 O ro ~ N N z ° z~ o w D a 0 o s a l~l O (D A • (D 00 O C 77 (.J N O '.I a 3 m z m i p O C A~~ n A z 0 m m ) a. D o. I cn N W m o O. , t z o 3 ~ x O FF z 3 m os N x ` CD A (wl N O ro O N N CL 3 CD T ro ~ T O C A O C O Q 7 m d CD a°on (D CD C. w : O 3 s CL x (D =r Z N ~ O O N O O c O A 0 A :3 il~ 6Q ~tl ro Hi 0 .41 O N b C:) CL Parcel 002-1022-40-100 12/20/2005 04:13 PM PAGE 1 OF 2 Alt. Parcel 11.29.16.1556 002 - TOWN OF BALDWIN 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 - SPILMAN, TIFFANY M TIFFANY M SPILMAN C - SPILMAN, WALTER D WALTER D SPILMAN,ET AL C - SPILMAN, FAYE E 1068 260TH ST C - SCHMIDT, JOSEPH T BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description " 1068 260TH ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 11 T29N R16W SE NE 20 AC W1/2 OF SE Block/Condo Bldg: NE Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 06/07/2005 796875 2816/450 WD 04/25/2002 677237 1878/348 WD 02/01/1999 596756 1399/577 WD 07/23/1997 1242/133 more... 2005 SUMMARY Bill Fair Market Value: Assessed with: 86751 Use Value Assessment Valuations: Last Changed: 05/18/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.500 7,500 49,100 56,600 NO AGRICULTURAL G4 3.000 300 0 300 NO UNDEVELOPED G5 3.000 900 0 900 NO AGRICULTURAL FOREST G5M 12.500 4,400 0 4,400 NO I Totals for 2005: General Property 20.000 13,100 49,100 62,200 Woodland 0.000 0 0 Totals for 2004: General Property 20.000 17,500 49,100 66,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 516 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 45.00 Special Assessments Special Charges Delinquent Charges Total 45.00 0.00 0.00 Parcel M 002-1022-40-100 12/20/2005 04:13 PM PAGE 2OF2 Parcel History: cont. 07/23/1997 873/2 07/23/1997 4 7 Parcel 002-1023-40-000 12/20/2005 04:04 PM PAGE 1 OF 1 Alt. Parcel 11.29.16.164 002 - TOWN OF BALDWIN 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 - MALCEIN, GLENN & JOAN GLENN & JOAN MALCEIN C - PO BOX 162 PO BOX 162 1058 CTY RD D WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 22.000 Plat: N/A-NOT AVAILABLE SEC 11 T29N R1 6W NE SE EXC PT DESC IN WD Block/Condo Bldg: 1508/375 NOT A COMPLETE DESCRIPTION Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-29N-16W NE SE Notes: Parcel History: Date Doc # Vol/Page Type 12/12/2002 702104 2079/58 AC 05/05/2000 622522 1508/375 WD 08/04/1998 584374 1345/510 MD 2005 SUMMARY Bill M Fair Market Value: Assessed with: 86768 Use Value Assessment Valuations: Last Changed: 06/28/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 21.000 2,100 0 2,100 NO UNDEVELOPED G5 1.000 100 0 100 NO Totals for 2005: General Property 22.000 2,200 0 2,200 Woodland 0.000 0 0 Totals for 2004: General Property 22.000 2,200 0 2,200 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 002-1024-50-000 12/20/2005 04:03 PM PAGE 1 OF 1 Alt. Parcel 12.29.16.171A 002 - TOWN OF BALDWIN 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 GLENN MALCEIN O - MALCEIN, GLENN PO BOX 162 WOODVILLE WI 54028 ~I Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 1058 CTY RD D SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC I Legal Description: Acres: 33.980 Plat: N/A-NOT AVAILABLE SEC 12 T29N R16W SE NE EXC CSM 4/928 & Block/Condo Bldg: EXC WD-1147/629 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1147/629 WD 07/23/1997 718/588 2005 SUMMARY Bill Fair Market Value: Assessed with: 86777 Use Value Assessment Valuations: Last Changed: 05/18/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 17.680 1,800 0 1,800 NO UNDEVELOPED G5 1.000 100 0 100 NO AGRICULTURAL FOREST G5M 12.300 3,000 0 3,000 NO OTHER G7 3.000 4,800 183,600 188,400 NO Totals for 2005: General Property 33.980 9,700 183,600 193,300 Woodland 0.000 0 0 Totals for 2004: General Property 33.980 12,700 183,600 196,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 510 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 45.00 Special Assessments Special Charges Delinquent Charges Total 45.00 0.00 0.00 BALDWIN T•29N--R.16W 33 47 ' ' SEE f a e. 6 n~~, ~ / s ra/o Edwa ~d Roy 9. ~sr a OQ ~o~° •Ka s !Irene daa/ •v^/e tfe~ sEo'wa.d Ron ,P s Tant PINE ~Q 3z5 >s >s 76. b7 W.iia > Kd lea ne ` U • ffoydin/~ .tl /gY a>~ Esahenbac /z,~ mrons Q L. ~ l h i.y Ch'~9/.'ce Edw F~/ori Bo ~ r x a(9~pz • o ~ ~ U ~ rG oofa~~ e~daa Euye.,e F is.r ~sz • i n ` p'C a 74s .,v. ci: 6 Sand a E 9de/cede f3 fha/ % /63• !/eenendaa/ 80 ~ ~ a r ° A° vi A /ho /3s B R be t • .3 0 Utl a ~ ~ °0• //an CSon-iece e/ n /6° Shic/ey 6 T se h Q C ° • E eanoc h eobe .nou 'f ~ ~c.a /m3.z f ,8ctt~t 80 ~ Q1 ~ ~ ' i o w 9/mos ~ ° ~ C 0 t a dQi` f iPob e~Y• 2e~.ben urf9en V ~ p ,C ~ ° C 4- C a a~1 76.35 v %E of y ° e f Hare a 4 Do oth_y /vo o ' d 1 1^ h ~ 4o afdn D o~nin.E Q l (~C tl IJe%~a n✓ • NNA ~-Jv O ~Q~LA ~ t 4 ~ © ✓i//e Ba 73.3 'l~ ~ .Ba,-i',QU/f C C h 5 4° ~r 4 O a ° se ~srth d~ Psy/i s 3 • /so LA. d ~acco// A • 40 ~ • ~.L~ . ~~o°n Ken fJiF iToan ~Ei /een Q.~ ~ Docofh • wed E/3 oho /zo Haas :xas Ci-on,E E en Q /IRS /09 o~ an s • D°9/as mt- s/eohen e° 99 ~ \ / an 36 kvi/ N-a- (/eenenQO' o. 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U p Sly 6 G S n/e he rro• 3 /40 u 79 ~ ~ ~ ~ B s Cl~ 0 OKas e Neison e V \ 7 f v9 5• • v✓eS,PayF//a 1.,~ s/~~ad M fh G/ayd Jarnrs f ,e y 7 v( .39 F taco/ 63 /a be 9 W C ~l mod/ M /ton o F ed¢ rL 9 /~huc Z O/sed izo pensen Alas/ BB Ov /OO/en~ q L -r heS /b C 9S S 60 ,6cenne cS um B c5'f ,ga.: PL_ C /968 .Poe,Ff P 6/s .r e, • ^ VIOL E1T ocd a n .Prv/979 7a- ,a,-as ,is.s 40 HB/e- stead ~o •~o° s •5oax CaPec SEE PAGE 2/ E~•s Woodville ALUMINUM CASTINGS FR WS SERVICE Dental ALUMINUM FLAG POLES PUMP REPAIR AND 'N Center All Sizes ~ NEW INSTALLATION RIEHM We Sell TRW - Redo Frank W. Keeler Submersible Pumps D.D.S. FOUNDRY j Woodville, Wisconsin 698-2410 Phone: 698-2959 54028 ' WOODVILLE, WISCONSIN 54028 698-2915 Woodville, Wisconsin L ,7 L AS BUILT SANITARY SYSTEM REPORT OWNER_ C>-16 / MAL Ce/ 41 TOWNSHIP,R,A,[ e& W SEC. &_T,- -R ADDRESS~ ST. CRO17~ COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 EVERYTHING WITHIN 100 FEET OF SYSTEM H NG 1W, I y e e ~ v ~ I di a e ox`th Arrow BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: /N Weg Slope at site: s D,~se SEPTIC TANK: Manufacturer:-IV le se Liquid Capacity: Number of rings on cover : M#Alt- nhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation PUMP CHAMBER Manufacturer: ~v;e,se, S Number of gallons d _ Number of gal. pump set or a cycle _ gallons; total capacity O distribution lines gallon: size o pump head; gallon per minute horsepower ran name of pump and model number is M,0,ACZ S, ; Type of warning d ice L AX 9 4- ' HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE: Number o pits feet diameter feet liquid dept seepage pit in eft pipe-elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines wi th lerrgth the depth___ SEEPAGE TRENCH: width length /Z.6 PERCOLATION RATE AREA REQUIRED AREA AS BUILT_ INSPECTOR DATED PLUMBER ON JOB LICENSE NUMBER 'EH 115 • WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH ~c9 P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS _ 10lu 3< LOCATION: S6'14, M114, Section _LL_, TA--N, R & )00 W, Township or- ~ y`• ~ .FFj~F _ Lot No. , Block No. , - County Subdivision Name Owner's Name: GO c"N /~'1.4F1 C COON aI Rf t c- cl'I 1ze L, ti' Mailing Address: TYPE OF OCCUPANCY: Residence - No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW /l ADDITION REPLACEMENT PERCOLATION TESTS DATES OBSERVATIONS MADE: SOIL BORINGS '0 " yl SOIL MAP SHEET - ~ SOI L TYPE Al NF R,4 yye- 81 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 HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P_ -2 2- 4/0 2C7 IV- F0 P _3 1-3 xe SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- S :2 'r Y/ ~-S~ el ;7 B- ~1 7 G PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy. M0 a H P, SSA S`Tf? Al Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. 8 ►vG~N q7r % 5 d - !V i e i l t k r N i I I I - T I - - ~t I i _ _ ._S~'~-.~~'--~_._Gv_~~.-.~~l~L►_~C~~C`'-t~li 1 ~._i_v}--`"_'y---~'"`_ _ i I _-I`___~~~ - ! , - Iflflf I ~ t k E t 1 ~ ~ - t ( t; - 1 I I t i { I i I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) , -A,4 l° S IM Certification No. Address 1sC3 Name of installer if known CST Signature 't'~PY A f..~ Cil AUT11~xR TY Plb.n^, WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES ` Division of Health Section of Plumbing & Fire Protection Systems ti ON-SITE WASTE DISPOSAL INSPECTION REPORT Name of Premises Street City County Master Plumber Address Owner Address ❑ County Permits ❑ Appropriate State Permits Type of Building: ❑ Public ❑ Single Family or Duplex CHECK APPROPRIATE BOX FOR VIOLATION TYPE OF TREATMENT SYSTEM ❑ Building Sewer ❑ Conventional Soil Absorption System ❑ Septic Tank ❑ Conventional System-in-fill ❑ Holding Tank ❑ Alternate Mound System ❑ Seepage Bed ❑ Holding Tank ❑ Seepage Trench ❑ Seepage Pit ❑ Experimental System BRIEF, FACTUAL COMMENTS AND SKETCH: F . , s F ? , a t - - - - - - - - - - - - - - - a _ 1 e b # s 1 1 o w , , s t d , r ~ ° i ,:r w_e.~. -..a _ E t a e _ _ Pte. . ~ . Fmm, . _ _ . 3 i ~ r , , , ......._a.,,_ ~ma , f s 3 s ~ a t ~w < E ; a . i a E 3 _ e a - - - - - - - - - - - - - - - - - - - - - - - - - - i ° F E , . . s , E , s E , , F _ . t_ ❑ SEE ATTACHED DISCUSSED WITH PLUMBER ( ) Yes ( ) No SIGNATURE (Voluntary) DATE OF INSPECTION j Signature of Inspector fl White - Inspector Yellow - Local Inspector Pink - Plumber or Responsible Party r D[LIR-SBD-6227 (R.9180) (PLB.106) Plan Identification No. Construction Inspection of Alternate Design Sewage Disposal Systems I .Wisconsin Department of Industry, labor and Human Relations Bureau of Plumbing. Platting and Fire Protection Owner's Name ( 1 I~ Mailing Address A. Site Investigation at onset of construction 1. Name of Installer" 2. County ~a,.; 'Inspector iDated 3. Package` 4. Preliminary onsito made by tO Date b`~ ) ' f 5. Depth to limiting factor (50% unconsolidated rock or estimated ground r water level) ' 6. Percolation rate r>_~ 7. County installation permit number 8. Are percolation and soil boring holes evident? Yes No 9. Is system located in area of soil tests? Yes. No 10. Is system located in area shown on state approved plans? Yes aX, No 11. Ground slope in area of system "f 12. Site data is correct as presented by C_S.T. and system designer? Yes IX No B. Inspection of Construction l: Disposal site plowed and properly prepared? Yes No 2. Disposal site conditions wet or damp? Wet Damp Dry 3. Type of fill material 4. Depth of fi l l (1' Minimum) i/) Ji- 5. Is a crawler type tractor used? Yes No a. Blade Bucket 6. Has site been driven on by any vehicles? Yes No,.` If yes, explain 7: Trench width as indicated on approved plans? Yes No ` I 8. Trench spacing as indicated on' approved plans? Yes 9. Have 'trench bottoms been properly leveled? Yes No 10. Trench length•and number as shown on approved plans? Yes No 11. Distribution piping proper diameter? Yes No 12. Holes in distribution piping properly sized? Yes No 13. Holes in distribution piping properly spaced? Yes No 14. Holes in distribution piping in a straight line? Yes No 15. Distribution. holes drilled straight into piping? Yes No 16. Depth of gravel below distribution piping )7. Depth of gravel above distribution piping '2- 18. Thickness of marsh hay covering 7~'1 19. Permanent marker at end of each trench 20. Depth of fill over center of system 1 - 21. Depth of fill over outer trenches l•.~. 22. Side slopes 1 L~~ 2 3 . Type of f i l l used above trenches 1 24. Depth of top soil it 25. Seeded7 Yes ! No If no, has mulch been placed over mound? Yes No C. Pumping Chamber 1. Diameter of inlet- _ 2. Diameter of outlet rg I 3. Head 4. Size of pump tank gallons 5. Draw down or gallons pumped per cycle 6. Manufacturer and type of pump same as that indicated on approved a plans? Yes No If no, indicate Mfg. an d. Model f of pump used. 7. Quick disconnect provided? Yes No 2 8. Diameter of manhole 9. lieight of manhole above finished grade _ 10. Diameter of vent H. Height of vent above finished grade 12. Pump tank locateq.as shown on approved pIans7 Yes . No D. Septic Tank 1. Properly installed? Yes No COMMENTS ti c J aft'cs~`d? 4j 1, the undersigned, hereby certify that the questions were answered on the basis of my personal inspection or knowledge of the construction of this alternate system and further that all data and answers _re.corded,- on this form are correct and to the best of my knowledge anJ-be/lie C ~y Na;re: I~~cr,4s r7cl5ar S.i rig , Title: a _ m } - WE HAVE INCLUDED TWO COPIES OF THIS FORM FOR COMPLETION BY YOUR OFFICE. WHEN INSPECTION OF CONSTRUCTION IS COMPLETE, ONE COMPLETED FORM SHALL BE RETURNED TO THIS OFFICE WITHIN TEN (10) DAYS AFTER YOUR FINAL INSPECTION OF THIS ALTERNATE SYSTEM. Date received by Bureau of Plumbing, Platting and Fire Protection 3 I:I PORT OF INS VICrION IN I) IVIOUAI_ SIUTA(;t SvSFIM Sani farm/ I'e"im4 i State Scpt t c'~' - Tow yiAh 4)_ -St. c1lo< x Cuun tit i l i nvr ~ ' Section -I_o-t N slit) di-v<3-i an IK---- I' I I C LANK L' q ~4'anb Nurnbe~r. cr carri.~aii tmo_n.tb C - a _ fi 1 Olooi: We P1'~.~~~ Bu~..Pd"<.n 17"0 of o, re - l High.waten +iM P I NG CHAMBER - gaUone :Pump Manuhac..tuh.e.n. ModeX Numbet OING TANK rc _ gakQanb Numbers oA CompaAtmcvrtA Pu mpe'r AQahm Sy,6tem ti tavitlc (nom: Weft, Bui, ding____ _12$ e~!ape. Highwaten [ON SITE 1~'l Tl, e I. H4 ghwa to ~r 0Wl'7ION SITE DIMENSIONS (v (Ith otn.ench _ t Requ~~red an.ea ~t l.cng tlr o 6 each. tine_ - _At Depth o A h.och befow tike. i n Nnmbc~r o6. , ine. - Depth oA rcoc-h oven tike. .i-n Tota. P.en.gth o6 tine.e At Depth u6 t_Ue be.how gnade in Di A Lance between tine.b_ ~ _At ~tope o6 the:nch___-- in. pe-~r 100 6t li,tae abhonption.ane.a At Type r,A Coven: Pape~u on etnaw it O 1 MI NS IONS Nilymbell u6 Gravel ahround pt-tr yeb na <Ic (I.<".amete.n 6t Depth befow I ,4(0' ai)Aortption an.ea~ 6t A a ltequi.hed -6t cl C11I? 6v TITI-r ~~1;~~vI a DATE 198 I C 1 1 U DATE 19 k A,,:oN I I: I:r.7EC, TION • y; oa ` County State Permit # PLB-67 State Conty County Permit # Permit and Application for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: <<~~eN Al4Lee®`N 15r2 4✓aoafv;44 e- " B. LOCATION: S,=Section T2YN, RZ~lz E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Township 04 X 1A-,1,V C. TYPE OF OCCUPANCY: *Commercial *Industrial "Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons 7/ D. SEPTIC TANK CAPACITY /04 0 Total gallons No. of tanks f T HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement )e Lift Pump Tank or Siphon Chamber 404 Total gallons Prefab concrete XPoured-in-Place -Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate- Total Absorb Area 77~ sq. ft. New Replacement X Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth ile depth (top)1aNo. of Trenches Seepage Bed: Length Width Depth Tile depth (top) No. of Lines Seepage Pit: Inside diameter. Liquid Depth No. of Seepage Pits Percent slope of land- 1>41 Distance from critical slope WATER SUPPLY: Private A Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME S f° S-M C.S.T. # and other information obtained from (owner/builder). Plumber's Signature MP/MPRSW# Phone Plumber's Address ~ PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. 4 g p r r ...e:.. . ..e..~ s. .m . . ..i m a ..e.», ,,me . i... e n. m ...k...,.. e m ea. a m _ _ m t i = E r e,,.~. ...m 4 . _,~~,.e .i ...®.m. :...m..- _ ~.q.. s Pis e .«,a.m a..._ ....r.., ,me. _ a_ m... g...... i ~ t 3 E k € .az _ e tee.. m ..m.. ~ . . . t i E F E E ~ L f } Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application Fees Paid: State County D ' Permit Issued/fkItT£ed (date) Issuing Agent Name c ',,oection Yes No State Valid# Date Recd *y (whit copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 State of Wisconsin ` Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION Bureau of Plumbing, Platting & Fire Protection P.O. Box 7969 TO: Madison, WI 53707 Plan Identification No. Gentlemen: Re: ~Z t The Bureau of Plumbing, Platting and Fire Protection 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 an s to requirements specified in c . N , Wis. Adm. 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 absorptIo-` 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 con- tained 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 instal- lation. The installer shall not deviate from this approval and shall follow the directions or orders issued by the appropriate local or state authorities. DILRH-SBD-6159 (N.7/80) V `Zat ar.* a~€;. 'S e is. Adm. Code plans aCt6 "Cificati ns are approved contingent upon compliance with the stipralatior ~1 cated on the plans. Please review your code for the requirements of code section noted. 4`h architect, professional engineer. registered designer, owner or plumbing ntract r shall keep one set of f depart rat at the construction sltl of the installation of this system :a re couw;e nced i hin to years frog; the date of this latter, this approval shall become void and new applicatic shall b made for approval of these plans before work tray commence. in granting this approval, the Division of Safety and Buildings doses not ,old itself liable for any defects in plans or specifications, playa omissions, ,examination over°s ight, construction or any damage that may result in or after irsstai lat i n and reserves the right j-)r-'U l i C X-: ;iitions, arise king this necessary his approval is based on ch. H t", r equ ir nm r ts. it slat i ;;e necessary t obtain and fulfill the Permit requirements of the carat, ,Erich this installation is be c nstrvcta acv r"o obta;,r) county -er .its Sri t P , a 5- aka )c= t cap Plb 1.00a.12/78,, Detach. And Return Upper State of Wisconsin DIVISON OF HEALTH Portion Of This Form With SECTION OF PLUMBING Correspondence AND FIRE PROTECTION SYSTEMS Any Return Correspondence MAIL ADDRESS: P.O. BOX 309 MADISON, WISCONSIN 53701 608-266-3815 DATE: PROJECT: yif, r\)F-- ,sec.\~~ ~`i PLAN ID. # i 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 $ 1 ❑ Plan accepted for review. Fee received is $ Fee is being returned because of ❑ Overpayment ❑ Underpayment. ~'JT Providing one of the two catagories above is checked, remit correct fee in one payment. e~w No fee has been remitted. Plans submitted with no fees will be held in abeyance. L l~"`1II El Plans being returned. ❑9 ❑ 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. I11. 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 certified soil 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 ❑ Calculations for total lift pump discharge, head and gallons pumped per cycle. ❑ Size, length & depth of force main. F_7 Detail & model of pump or automatic siphons including size, pump curves, drawdown and average flow rate GPM. ❑ Cross section of lift pump tank showing pump(s) or siphon(s). VI. Systems In Fill (Fill must be placed prior to plan submission) 0 Total area filled (fill to extend 20' beyond edge of trench before side slope begin). ❑ Depth and type of fill. ,--J Copy of onsite report by county or district plumbing supervisor. r_! L.e qth of time fill has been in place. ST. CROI X COUNTY , WI SC0 N S I N a ZONING OFFICE 796-2239 i HAMMOND, WI 54015 December 10, 1980 Gale Smith R,R, 2 Glenwood City, WI 54013 Dear Gale: We can not accept these ER115 forms because in- dividual bore holes do not have vertical eleva- tions. As required by H 63, each bore hole must have vertical elevations as referenced by the bench mark. These should be taken at the surface of the bore hole excavation. Should you have any questions, please feel free to contact this office. Yours truly, Thomas C. Nelson TCN:sl Enclosure RE: Rott Malcein ' + r WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design -a mound system for a z Wpq- The site characteristics are: ~tp Depth to groundwater or bedrock 3C)_ in. 30 Landslope % -2 Percolation rate 7 ra'C min./in.>60 Distance from dose chamber to distribution system ft. q 6 Elevation difference between pump and distribution system ft. 7 Step 1. WASTEWATER LOAD = /4216- gal. y6`0 Step 2. SIZE THE ABSORPTION AREA /v so - 75 A) Area required = -1 - sq. ft. 3 B) Beni or trench. length (B) ft. /0- 3~ C) Bed or tren width (A) ft. D) Trench spacinq (C) _ Jr Wastewater load .24 gal/ft2/day B = Z ft. trenches .2 q -73 Step 3. MOUND HEIGHT A) Fill depth (D) - ft. B) Fill depth (E) - D + % slope (A) - ' 6 ft. C) Bed or trench depth (F) ft., D) Cap and topsoil depth (G) = ft. i E) Cap and topsoil depth (H) ft. IA Lee 10 80-05596 zn th Plumbing PHONE (715) 265-4838 GLENWOOD CITY, WISCONSIN 54013 i i . -7 5 0Vim: i7Yr r'/: r~ ~v jc r 4ll y ty f \MIR, R 9' k N ` 14G r' V " f r tit ° rk i 559 6 Smz th Plumbing PHONE (715) 265-4838 GLENWOOD CITY, WISCONSIN 54013 K - f 4 ..,....y...,..,.,..,:.....-».,...5..~.,G~.~. .J -j ~y. / l.. l'f t.~l jtf` ,lam f ~'n n`J' r'~.,`Gi ~ i•N.~' Y f f i ' 1 f„F Step 4. MOUND LENGTH I A) End slope (K) D + E1 + F + H x 3 Zz~ ft. A% B) Total mound length (L) a B + 2(K) _ ft. 93-(' Step 5, MOUND WIDTH Al) Upslope correction factor = X8`1 "gq- A2) Upslope width (J) _ (D + F + G)(3)(factor) _ L ft. ? } Cl r, 8 t- 3X. 9-5) B1) Downslope correction factor = Ll Y B2) Downslope width (I) - (E + F + G)(3)(factor) ■ / ft. Cl) Total mound width (W) for bed = J + A +.I ft. 1 C2) Total mound width (W) for trenches = J + A + (no. trenches -1)(c) + A + I p 67 ft. 7i +2 1- Step 6, BASAL AREA ' A) Infiltrative capacity of natural soil gal./ft2/day ) Bas,-.1 _"'-ta e c E:d WdSLt'Water d lOW a ~d ~ s v . natural soil Infiltrative capacity = sq. ft. Chi) Basal area available for bed for sloping sites = B x (A + I) ■ sq. ft. C2) Ba rea avail ble for trench for sloping sites BX-f- `J + A ■ y`1~~IUsq. ft. f C/ j j9 63( C3) Basal area available for trench or bed for level sites B x W = sq. ft. 7F) PUMP SELECTION f G,~ 1) Pump selected will discha qet/,-(„ GPM at ~W-ft. total dynamic head. S D 2) Pump model and manufacturer 13 z cs c r L o. V 7G) DOSE VOLUME 1) 10 times void volume of distribution lines gal./cycle 2 Daily wastewater volume 4 doses/24 hrs. ..1.x,3 gal./cycle 7O 3) Minimum dose volume = • gal./cycle lk w 7H) DOSE CHAMBER 1) Minimum capacity required = ,coo. gal. 3w 4 .2 00 V ~'!d 161~W'IAIUANVnnt i . r Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size Z-y in, 2) Hole spacing 4 in. 3) Distribution pipe length = in. 3 0 4) Distribution pipe diameter in. ~ 5) Spacing between distribution pipes = .2()l in. J-~ 6 Distance from sidewall to distribution pipe ~oz = 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe = g 2) Flow per pipe GPM 1C) SIZE MANIFOLD 1) Manifold is central/ end r 2) Manifold length = ~O ft. 1 5 3) Number of distribution lines 4) Manifold diameter = ,3 in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate a GPM 2) Force main diameter = in. 3) Friction loss = ft. 7E) TOTAL DYNAMIC HEAD 1,) Vertical lift = ft. 2) Friction loss = ft. 3) System head 2.5 ft. _ S ft. 4) Total dynamic head -'ft. l~ 6~ FM 411-0380 ' \QU•4L/TYPUMPS ,;NEE /9.~9,/ /Ar~ZZ q ~O 3280 Old Millers Lane Louisville, Kentucky 40216 (502) 778-2731 COMPARE THESE FEATURES Mode/ "137" Cast Iron Vortex Impeller Design Float operated, submersible (NEMA 6) "139" Bronze mechanical switch. Durable cast construction. Cast switch cap, motor shell, pump housing, base and impeller. No sheet metal LUV W I A' I parts to rust or corrode. Stainless steel screws, bolts, float rod, handle, guard, and arm and seal FOR SEPTIC TANK SYSTEMS assembly. EFFLUENT Bronze units available. 10 foot UL-approved 3-wire neoprene OR DEWATERING PUMP cord & plug. Automatic reset thermal overload SUBMERSIBLE protection. 11/2" NPT DISCHARGE Oil filled motor- hermetically sealed. Carbon and ceramic shaft seal. 60 cycles, 1725 RPM PAM Passes % inch solids (sphere). No screens to clog. 11/2" NPT Discharge. On point - 93/4 Sump Pump Mfg. Assoc. Off point - 3". SPMANumbeication 137 & D137 SC2225 Major width - 113/4". 1 39 & D139 SB1115 Height - 13". Weight - 45 lb. SIMPLEX AND DUPLEX SYSTEMS AVAILABLE PACKAGED SYSTEMS AVAILABLE der ~ x c''h" r ' ~ R 4T". VARIABLE LEVEL CONTROL SYSTEMS AVAILABLE W17 DESIGNED FOR l e HEAVY DUTY 3280 old Millers Lane EFFLUENT APPLICATION Louisville, Kentucky 40216 (502) 778-2731 u a "P Automatic or Non-Automatic 1/2 H.P., 1 Ph., 115V or 230V Manufactures of `QUAL/TYPUMPS Aver /9J9 Vortex Type Impeller CAI w f- TOTAL DYNAMIC HEAD FEET/ 2 LL HEAD CAPACITY CURVE METERS MODEL 137 CAPACITY GALLONS/LITERS 30- CAPACITY HEAD UNITS/ MIN 8 FEET METERS GAL LT RS 25- 5 1.52 104 394 W 10 3.05 79 300 15 4.57 64 242 a 6 20 20 6.10 36 136 Z 25 7.62 8 30 0 26 7.92 0 0 a 15 0 4- 10 2- 5'- U.S. GALLONS 10 20 30 40 50 60 70 80 90 160 110 LITERS 80 160 240 320 400 • 0 FLOW PER MINUTE • Electrical alternators for duplex systems • High water alarms available. available with mercury float switches. . Mechanical alternators available for • Minimum recommended basin size duplex systems. Simplex - 18" x 30" Duplex - 36" x 36" Caution: Maximum temp. effluent or dewatering - 160 degrees. • Long cords available Zoeller can provide complete packaged systems or combination of components including controls, pumps, polyethylene or fiberglass basins. Cast Iron Model Ph. H. P. Volts Amps Wt. Bronze Model Ph. H.P. Volts Amps Wt. 137 Automatic 1 1/2 115 10.4 491bs. 139 Automatic 1 1/2 115 10.4 49 lbs. D137 Automatic 1 1/2 230 5.2 491bs. D139 Automatic 1 1/2 230 5.2 49 lbs. N137 Non-Automatic 1 1/2 115 10.4 49 lbs. N139 Non-Automatic 1 112 115 10.4 491bs. E137 Non-Automatic 1 1/2 230 5.2 49 lbs. E139 Non-Automatic 1 1/2 230 5.2 491bs. You Buy a Zoel RESERVE POWERED DESIGN Engineered purposely to pump less than design characteristics permit in order to 3280 Old Millers Lane allow a safety factor for unusual conditions. Louisville, Kentucky 40216 (502) 778-2731 ~ J 3280 Old Millers Lane Louisville, Kentucky 40216 (502) 778-2731 ("GIVIPAHE THESE FEATURES Mode/ "57" Cast Iron • Vortex Impeller Design. • Float operated, submersible (NEMA 6) ""59 " Bronze mechanical switch. • Durable cast construction. Cast switch cap, motor shell, pump housing, base and impeller. No sheet metal : parts to rust or corrode. • Bronze units available. DEWATERING • Stainless steel screws & switch arm. OR • No screens to clog. • Water tight neoprene "0" ring CLEAR EFFLUENT PUMP between motor and pump housing. • Automatic reset thermal overload SUBMERSIBLE protection. 11/2" NPT DISCHARGE • Oil filled motor- hermetically sealed. • Entire unit pressure tested after P assembly.„ • Carbon and ceramic shaft seal. T • Easily serviced - can be completely disassembled in field. Sump Pump Mfg. Assoc. • Safety protected by UL 3-wire cord I SPMA Specification and plug. II 57 &ND57b SC-2225 ~'r{',""""`>• 111 59 & D59 SB-1115 • Use for pumping water up to 1601 F.-_= Over 1600 F special quotation required. • Passes 1/2-inch solids (sphere). • 11/2" NPT Discharge. • On point - 71/2". • Off point-3". Major width - 91/2". • Height - 91/2". • Weight - 25#. COMPLETELY SUBMERSIBLE HERMETICALLY SEALED Water tight - dust tight. Permanently"` y oiled bearings. VARIABLE LEVEL CONTROL SYSTEMS AVAILABLE 27 O 3280 Old Millers Lane Louisville. Kentucky 40216 (502) 778-2731 MODELS AVAILABLE` • Automatic or Non-Automatic Manufactures of. • 115V or 230v . O QUALITY LIMPS / SNCE 1939 VORTEX TYPE IMPELLER N Cr w TOTAL DYNAMIC HEAD FEET/ ME T LRS HEAD CAPACITY CURVE CAPACITY GALLONS/ LITERS . MODEL 57 CAPACITY - 25 - HEAD UNITS/MIN FEET METERS GAL LTRS 5 1.52 43 163 6_20- 10 3.05 34 129 0 15 4.57 19 72 Q w = 19.25 5.87 0 O C2 15 - - - f Z 4 r 0 Q 10 - 0 F- 2 5 0 US GALLONS 5 10 15 20 25 30 35 40 45 LITERS 40 80 120 160 0 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • High temperature units available - 1801 Maximum. • Variable level control Systems available. • Factory Wired "W" Series available for longer cycles. SINGLE PHASE UNITS Cast Iron Model Ph. Volts Amps Wt. Bronze Model Ph. Volts Amps wt. 57 Automatic 1 115 7.7 24Ibs. 59 Automatic 1 115 7.7 24Ibs. 557 Automatic 1 230 3.8 24Ibs. D59 Automatic 1 230 3.8 24Ibs. N57 Non-Automatic 1 115 7.7 24Ibs. N59 Non-Automatic 1 115 7.7 24Ibs. E57 Non-Automatic 1 230 3.8 24Ibs. E59 Non-Automatic 1 230 3.8 24Ibs. "You Get /'►/tore for Your Lollar- When You Buy a Zoeller" RESERVE POWERED DESIGN ~C Engineered purposely to pump less than 7.3W47 -ZZZ- 1' design characteristics permit in order to 3280 Old Millers Lane allow a safety factor for unusual conditions. Louisville, Kentucky 40216 (502) 778-2731