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Home My WebLink About018-1078-80-000 n~q. O c v n 0 3 v 71 o c 3 m ^ 3 x \ 1 ~ Q N L 2 W 0 0 O m 0 O W O O p7 6) `C O\ Q Z Q N CD CD 3 CD 0 ~ v O CD- N N NO W N N d C, 000 C) CO -10 0 CD (D co I? c C) 00 c CD (n 0 M D 0 3 in m CD ~ 0 in I 00 0. a 0) (D Ln a n v (n Z D (D CD (Cl O (n d `G -n CD W Q 3 O ° CD r) CD 1 CD v, C c 3 n o c ^o• 3 N L O O O rr D O W (n v a 3 N +'o cwn c ~ M cr, m Q 0 =r CD :3 co C CD CD N 7 N N 3 m ZI CD N Z z o O D D m m O vi CD c h 00 (D N. • CD (D CD =1 a ly,~ I w m o o a , z M M n A Z O I iv ~ n Z N rn 00 v (o CD z 3 a °o z J y m (D I ~ rn m m O a 3 CD o CD x. o U) = 7 c Z O W O co (D (n O~ CD N N C.) fi O 7 R (D C7 CD C ti O 4V U) N 3 N O O a A ~ w Q CD 0~ N O w CD * y~ o (D y ti 'EPA RTMENT OF INDUSTRY, INSPECT IUN KtPUK I VUM SAFETY & BUILDINGS ABO.R & HUMAN RELATIONS ALTERNATIVE PRIVATE DIVISIOk 0. BC1Xl7963 SEWAGE SYSTEMS LIREAU OF PLUM ING 4ADiXN, WI 53707 C1 Mound f Pressure Distribution 8~>63b MLA )F EHMIT"i`UL1 I AODH E SS OF PE. I iOLOEH INSI I L; UN 11 IT PI AN IIf NLIM if II -h. IE 1 ARK IP.11-l1~l 11 r~taf u~~f:~Pf'IifH l/F SL Ii1BE IF UII VI I4 NI FIIOMP AN 1111 1'I I I I V t",I III I 1'1 t I1 v EPTIC TANK: _ nANUF ACTURE H. LIQUID CAPACI I V TANK INLI. I Ll tV TANK OL/11 E I L I F V N ~'IC -...gym PIII )P111 CV I.INI Wf I.I 111111 IfINf. N AH F E ROM 2- -NIN6 )OSING CHAMBER: W AM LIQUID CAPACITY PUMP MODEL. PUMP MANUF ACl IIRE R. WAFT 1_ABFI J,IIIf N(i C CTV EH H VIDE DIIOV OLD NO IYES NO - _ - / GALLON PER CYCLE PUMP AND CONTNOISOPEHA nONAL Y LL UILO~AIII INII I II11 Sn ILI DIFFERENCE BETWEEN FEES- FROM N~ , ---ter. PUMP ON AND OFF YES I_J NO Iy#siST SOIL ABSORPTION SYSTEM: Check the soil moisture at the depth of plowing of excavation. (If soil can be rolled into a wire, construction ,,hall cease until the soil is dry enough to continue.) Mound site plowed perpendicular to slope Check the texture. of," the fill material for PROVIDE A DIAGRAM and furrows thrown upslope: mound systems to make certain that it OF SYSTEM. SHOW meets the criteria fo medium sand. El YES C7 NO ELEVATIONS MEASURED. MSTRIBUTION SYSTEM: WIDTH LENGTH: NO.OF SPACING CENiEH IFNGTH. OIAMLI ER MAT F HIAL AND MAIiK IN(; 110pl!NCH, TRENCHES TO CENT I~~}Mi~f~lk MANIFOLD PUMP. MANIFOLD PIPE MATERIAL AND MAHKINU NO. DISTR. DISTH. PIPE DISTH IBUT ION PIPE MAIEHIAL & MAHKINf. DIA.. j PIPES. DIA. HOLE SIZE. HOLE SPACING. DRILLED CORRECTLY DEPTH OF GRAVEL OVER PIPES. VERTICAL LIFT CORRESPONDS TO APPHOVt D PLANS U YES CJ NO L-1 YES Ll NO SOIL COVER: TEXTURE ! - % - UFP TH OVER TRENCH/BED DEPTH OVER TRENCH/ ED DEPTH OF TOPSOI SODD SEEDED MULCHED CENIEH EDGES r ❑ YE FEj NO I~ YES NO L_I YES F-I NO COMMENTS: X !111 NH-SBD-6227 (R. O5I61) R1 P011'I' 01" }NSPFCTION - INDIVIDIIAI. SEWAG'k SY;;'I HM Sanitary Perini it State Sept ic O W NS 5 t. C r c, i a i i n i v NAM?J'O LOC Sect ion'l,ot Subdivn I?:P`1'iC TANK Siz" gallons Number of compartments Distance from: Well Buildinl,. l27. slope }}i_ghwater PUMP-1 NG CHAMBER Size gallons Pump Manufacturer Mode]_ Number HOLDINC 'PANIC Size gallons Number of Compartments Pumper_ Alarm System Distance from: We11 - Bui.lding_-__ 12% slope If ighwater ABSORPTION SITE Bed Distance from: Well Bu.lding_-____ 1'2% slope Il.i.ghwater ABSORPTION SITE DIMENSIONS Width of trench ft Required area It, Length of each line ft Depth of rock below the in Number of lines Depth of rock over the in. Total length of lines ft Depth of ti.le below grade in Dist~ince I)etwee lines ft Slope of. trench in. per 100 1 't'otal ahsort1) ti_on area ft 'T'ype of Cover:--- I) IT 1)IM FN SiON S Number of pits _ _ Gravel around pit; yep n, Outside diameter ft Depth below inlet fr 1 Total absorption area ft Area required ft INSPECTED BY TITLE APPROVED DATE 1-98 REJECTED DATE 198 REASON FOR REJECTION 'DEPARTMENT OF APPLICATION SAFETY & BUILDING INDUSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 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: Ir; V /V D C c'_ ~ la /t :Yr. ~ /4 Cj J i ✓.i LL/I fi 4 C f1 Property Location: p ~y Cor Township: County: G~ t/4 tV15%S -3(e iT l N/R J I &(or) /r-/tern •1rj()A-) 41 ~ ~ . CRLA ~ x Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: C 7R V : (Ifassi TYPE OF BUILDING ~f~ Number of ❑ Public* ❑ Variance* E:1 Other (specify)* ce s Bedrooms: 1 or 2 Family *State Approval Required. 5-/" 6 oNC o F eSc f i/t.~K5 ~4 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS EW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY (eno X HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: LL EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ New Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit O / ❑ Alternative (specify) )I oRe5 S 4oe ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (if other than present owner): 54 Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. MP/MPRSW No.: honeNumber: Name of Plumber: 1SiV6_a_ture. • P Plumber' Address: Name of Designer: gL ~c l.~ L~t 5 Sc1c~ Z G ✓~E f fc COUNTY/DEPARTMENT USE ONLY igna re of Issue g ge l Fee/: C~ EI Da/te: n A~APPROVED Sanitary Permit Number: ❑ DISAPPROVED 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 (N.03/81) 4 De- /0-00 $~,1p4 1 ` _.14e.mvv. 6"/YIRtn! _+e r-Ace wrtf New AF'ic' ~e m sM-X C'oRn~~ra /~ov5e t n / 4- A4 e IQ + bu nt K, a"'~ 9z C q3 ~/lti'~~1- '7-,C" /.~e< uSe,I W - ~~r err 8-4 r rr C srs c 3 42 New/ o 0 co (.kq L k ~'1 y' f~~ 't 1~✓ C'_ ~p J+' c.'~_1 A t/~? ~ !~:-oZS~-#OE-~S'~-~ Aa I - - PAX - Qss ~ 3 GM Akliti i N Al `Sew i I aS i e- C)f C, vl Ua# '30 z 'CAS, ti , 1 ' I ~ ,r. f~;,. ! `lam < ff° r p (Aa f A L I i - 3 L-l f j All. UJ~ 41 c o _ j < ! ('b N b U c; W 70 i rl s ! ; RECEIVED , n x x 93. A tJ G 3 1981 x 0-1 ck) ~j i y 40 Lo A- lx~ }y . I r E d t da k AD U, 1 f o ~s o e-I 01 Y s ~ 7 3 f ~ i ~ ~ t + s sJ ' i Vi E. r' ct, o ¢ - R. S.Y':F l- O °v U h OL R *v 1 f ` J 0.. It > ~ tj \ ! C) r 71 r 1 0 IZ v ~ t----+---- 4 _ :34t c€ orb 4 66! J n kI N 14- ~S1 t m • v - z J u ' % • t + 4 ao 1` + z' j A F3 -6 th f g 1~ D `e t~ pC' :z p y oco C , - N Colo 31 4-- A --T v A- 11 Ii D < 7 { AUG 3 i O .h bra r PLUMBING SECTION 3 % } G4 ~ l ~ ~1 z' co ~ rt. 24 ~ 20 SDK 'W - SO W LL 16 z 8V40 c 12 W S J 6 F 0 4 0 16 32 48 64 80 96 112 U.S. GALLONS PER MINUTE - - SOLIDS Head-Capacity: SV40 and SVK50 Submersible Residential Sump Pumps Max. Solids SV40,11/2" & SVK50, 2" Spheres; 4 Pole, 60 Hz. HANDLING 32 SUBMERSIBLE W 28 l 24 SPA EWA = 20 A S GE ° = 1s" Sp40 12i q & EFFLUENT 0 8 F, Mhii.. - PUMPS 4 0 20 40 60 80 100 120 140 160 U.S. GALLONS PER MINUTE Head-Capacity: SP40A and SP50A Submersible Sump Pumps Max. Solids SP40A,11/4" & SP50A,11/2" Spheres; 115 Volts, 60 Hz., 1750 RPM 40 36 le 28 SKy00 K~5 324 9 20 i 16 SK6 12 g_,e 4 0 20 40 60 80 100 120 140 160 U.S. GALLONS PER MINUTE NG SE lx. Head-Capacity: SK60, SK75 and SK100 Submersible Sewage Pumps Max. Solids 2" Sphere, 1750 RPM HYDR-D-MRTIC PUMPS A Division of Wylain, Inc. Post Office Box 327, 419/289 3042 "r Claremont 8 Baney Roads, Ashland, Ohio 44805 H-82 In Gmdc Wylain Canada Ltd. U"., 126 Eut Dr., Brampton, Ontario LeT iC2 y R Co z77 State of Wisconsin ` Department of Indu ~ 'y, L*or arr HUman Relations ~Mo RMase.R~ply to: '-SAFETY & BUILDINGS DIVISION BWr ~tbWt)% Ping P9 Madison, WI 53707 ~mk Plan Identification Number 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 County By. Other c e~,iYy~f.~/ - -C Enclosures DILHR-SBD-6159 (R. 7/81) mes Sargent, B =rector Pub 100. 12/n • p- State of Wisconsin oetech AMd Return Upper DIVISON OF HEALTH Portion Of This Form With SECTION OF PLUMBING AND FIRE PROTECTION SYSTEMS Any Return Correspondence MAIL ADDRESS: P.O. BOX 309 MADISON, WISCONSIN 53701 608-266-3815 DATE: PROJECT: sib, NE-4, Sec. 1.. PLAN ID. # DETACH HERE PROJECT NAME PLAN ID. # This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the plan review fee required is $ ❑ Plan accepted for review. Fee received is $ 't Fee is being returned because of ❑ Overpayment ❑ Underpayment. Jrj Providing one of the two catagories above is checked, remit correct fee in one payment. `+F t r ❑ No fee has been remitted. Plans submitted with no fees will be held in abeyance. `'+FyC~,~ Plans being returned. ❑ Additional information required. SEE BELOW. - 1. Plan Submission ❑ Additional information shall be submitted in triplicate unless specifically noted. ❑ Plans not clear, legible or permanent. ❑ All information submitted shall be signed, sealed or stamped in accord with Section H 62.25(2)(a) Wisconsin Administrative Code. ❑ Affidavit enclosed. ll. Alternate sewage Disposal Systems (Mound Systems) ❑ PLB 108 (Application for use of analternate system). ❑ County onsite required (1 copy). ❑ Design calculations for pressurized distribution ❑ Cross section of mound. ❑ Pipe lateral layout. ❑ Plan view of alternate. 111. Private Sewage Disposal Systems ❑ Ground slope with 2' contours in entire area of soil absorption system extending 25' on all sides. ❑ Elevation of permanent reference point (benchmark). ❑ Location of area suitable for replacement system - provide soil test data. ❑ Plot plan showing lot size and all lateral distances from sewage disposal system or holding tank to bldgs, lot lines, well, watercourse, etc. ❑ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. ❑ Construction detail and cross-section of soil absorption system. ❑ Soil boring and percolation test on EH 115 completed by certifiedsoil tester (1 copy). ❑ Complete data relative to anticipated use of bldg. ❑ 3 copies of PLB 60 enclosed. ❑ Deed restriction required (1 copy). IV. Holding Tanks ❑ Profile of holding t'-o!- El Holding tank agreement signed _)y owner and local unit of government (sample enclosed). ❑ Reason for installing holding to r-k soil test or statement from county (1 copy). V. Lift Pump L.J Calcul :;ic ns for total lift p,_Imp 'ischare d acid gallons pumped oe r ✓r ! ❑ Size, lenylh & depth of force m-iin. ❑ Detail & model of pump or automatic siphons including size, primp curves, drawdown and average flow rate GPM. Cross section ,,,f hft purnp tank ,I wi:i 5 -,4)-honk). Vl. Systems In Fill (Fi: j)lac~.^i -i'm tc i :-_i mlcsion) J'Fotai area fillet; (ili to extend 20' beyond edge of trench before side slave begin). Death and type of fill. Copv of onsite report by county )r d~ . n s=~r. CS ~:~F irn~ h:-J: n r~1Ce. Plb.'t -A WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES D.11.I--1•.R. Division of Health Leroy jansky O.W.S. Section of Plumbing & Fire Protection Systems 13 E. Spruce Street Chippewa Falls, Wl 54729 ON-SITE WASTE DISPOSAL INSPECTION REPdIt'h5) 723-8786 Name of Premises Street City County Master Plumber Address Owner Address _ ❑ County Permits 0 ~ ❑ Appropriate State Permits CT Type of Building: El Public _ _ ❑Single Family or Duplex CHECK APPROPRIATE BOX FOR VIOL TYPE OF TREATMENT SYSTEM 1:1 Building Sewer i ~ ❑ Conventional Soil Absorption Syster El Septic Tank: El Conventional System-in-fill 1-1 Holding Tank ❑ Alternate Mound System F1 Seepage Bed El Holding Tank F-1 Seepage Trench ❑ Seepage Pit 1:1 Experimental System BRIEF, FACTUAL COMMENTS AND SKETCH- f E , } F E E # , E a _ s- w'~ - a ~ ~ ~ r G a } I 2` E , 'r 1 , 41 1 ~ ~ j, 'ter 1 I~_ t 3 o ;t 3 -a rW P ~ i 3 : awl°...«.- a , E , ` E ~ t t i 3 E i i s _ _ ee e , e r ° z f ~ { s I } ~I E E ' + a a ry_. E , s , s I , P r r i a ~ t € , B E , E - r ~ E o i f ~ a v t n } F ❑SEE ATTACHED DISCUSSED WITH PLUMBER ( ) Yes ( ) No SIGNATURE (Voluntary) DATE OF INSPECTION Signature of Inspector L "'bite - Inspector Yellow - Local Inspector Pink - Plumber or Responsible Party DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFZ:c,i~ BUILDINGS 4NDUSTR / . 'DIVISION LABOR AND PERCOLATION TESTS (115 C~~ P:O•BOX 7969 HUMAN RELATIONS o1SON, WI 53707 IP/MUNICPA IK J~ Y• LOT =0c ~SUBDI NANFE, LOCAL O~~ 4 SECTION /T~ / JRor) kOWNSH NIG= COUNTY: OWN/ER'S BUYER'S NAME: MAILI ADDRESS: f ~~Qdlx fJOiv- ~l~Rms lr AL.c~W/ (,tJ/S USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: R D R TONS]PERCOLATIONfESTS: Residence ❑New L~Replace I RATING: S= Site suitable for system U= Site unsuitable for system / J d / !I CONVENTIONAL: MOUND: IfV-G O ~Cf RE:SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) E JS au []S ❑u If Percolation Tests are NOT required DESIGN RATE: SYSTEM EL V. I If any portion of the lot is in the under s.H63.09(5) (b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B 61%r l1')o ~i AT O ~r 5j& 0-if / 8 rr ,r $i. . 54, B- T T9 If er rr /a „ If ~r, ~l ogrl 13- 7A 106 U 1, 0'7, B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIO 2 PERIOD PER INCH P_ q / D P- /r O / V r " /Z O P_ Ty r rr tr P_ PLAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop, r / rf/ /~d /~}C,2GS SYSTEM ELEVATION Gv,ZL"S~~t 3 arJ 4 / - /+0 j E. ve-A of flwus+W eLJn X . 4*1.a - cja, ~RHde ~~N.r •(Pvm p%.,~ I I 14RG9. t f w , I g e3 o"Z of t t f3 -3 - a / 1, A' 5- go-ill A 6e- TANK q.~.. At q _ phi - -a= - ay aid TAN 14 83-3 , 'F;pL To he Removc-Pi4,~ p I U A, I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: 7- 14-Sl ADDRESS: CERTIFICATION NU'~yBER: PHONE NUMBER optional): Aid / Lc~~ s 5'`~ _ 6,9 33 7j;p ST JLGAI)VURE: DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILW-SBD-6395 (N. 03/81) PIti.100a 12/78 Detach A, d Return Upper State of Wisconsin DIVISON OF HEALTH Portion Of T 1 his C form 'AI ■ ith SECTION OF PLUMBING AND FIRE PROTECTION SYSTEMS Any Return Correspondence MAIL ADDRESS: P.O. BOX 309 MADISON, WISCONSIN 53701 608-266-3815 DATE: PROJECT: ~i:rirtai~ve "d'4, N04, Sec. L PLAN ID. # DETACH HERE PROJECT NAME PLAN ID. # This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the plan review fee required is $ ❑ Plan accepted for review. Fee received is $ Fee is being returned because of ❑ Overpayment ❑ Underpayment. Providing one of the two catagories above is checked, remit correct fee in one payment. ❑ No fee has been remitted. Plans submitted with no fees will be held in abeyance. ❑ Plans being returned. ❑ Additional information required. SEE BELOW. 1. Plan Submission ❑ Additional information shall be submitted in triplicate unless specifically noted. ❑ Plans not clear, legible or permanent. ❑ All information submitted shall be signed, sealed or stamped in accord with Section H 62.25(2)(a) Wisconsin Administrative Code. ❑ Affidavit enclosed. 11. Alternate sewage Disposal Systems (Mound Systems) ❑ PLB 108 (Application for use of an alternate system). ❑ County onsite required (1 copy). ❑ Design calculations for pressurized distribution ❑ Cross section of mound. ❑ Pipe lateral layout. ❑ Plan view of alternate. 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 cyc"e. ❑ Size, length & depth of force main. ❑ Detail & model of pump or automatic siphons including size, pump curves, drayiclovvn and average flow rate GPM. ❑ Cross section of lift pump tank showing pump(s) or siphon(s). V3. Systems In Fill (Fill must be placed prior to plan submission) ❑ i otal area filled (fill to extend 20' beyond edge of trench before side slope begin). ❑ Depth and type of fill. D Copy of onsite report by county or dis _c_t plurr,5*ng supervisor. t m fill has been in place. n y O E-0 n d r_ O c m O co v1 c 3 I sk ~ I 3 !I~ ~ ~ I ~ Q Z Z N Z o o, S P) C) ~ O O N O N C 7 3 N W 00 C y O„ 3 O O v P. cn 3 3 N ~ ~ CD a o Q N N n vii o D o CL O_ N 7 00 Mr. o O CO) a cn o O y cn z D a n e~ n D N Q `C d W o o n 0 O C-- ° ° 2 Z (o - n CC) co a ~ 'D M O O O Y• c Q I I j Nv ~v ~ v o W m ~ cw n aQ H cn ~ n CD . CD N m (D N z z -0 Q D D O N I ~ C • N !~r O N T1 m Q- '0 C (D O R d p Z CD ~ ~ Cs W W .0 C N O) CD CC) O 1 n z 3 A O z J 3 m g N Z (D A O m m D CL Ir 3 CD 0 Z c m - o m z CL n. a o (D m v v m N = Sr CD Z ~ I N a N O O a I A O O EA O ti 4., p N a 0 L ti Parcel 018-1078-80-000 07/26/2006 10:47 AM PAGE 1 OF 1 Alt. Parcel 36.29.17.549A 018 - TOWN OF HAMMOND 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 - JON DE FARM INC JON DE FARM INC 2061 30TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ' 2065 CTY RD J SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 39.770 Plat: N/A-NOT AVAILABLE SEC 36 T29N R1 7W NW NE EXC S 100' OF N Block/Condo Bldg: 133' OF E 75' OF W 116.5' 39.77AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/24/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 30.270 3,800 0 3,800 NO UNDEVELOPED G5 0.500 50 0 50 NO AGRICULTURAL FOREST G5M 3.000 3,000 0 3,000 NO OTHER G7 6.000 25,000 183,000 208,000 NO Totals for 2006: General Property 39.770 31,850 183,000 214,850 Woodland 0.000 0 0 Totals for 2005: General Property 39.770 31,850 183,000 214,850 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 018-1078-70-000 07/26/2006 10:47 AM PAGE 1 OF 1 Alt. Parcel 36.29.17.548 018 - TOWN OF HAMMOND 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 - JON DE FARM INC JON DE FARM INC 2061 30TH AVE BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 19.500 Plat: N/A-NOT AVAILABLE SEC 36 T29N R17W W1/2 OF NE NE FRL 19.5A Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 19.000 2,300 0 2,300 NO UNDEVELOPED G5 0.500 50 0 50 NO Totals for 2006: General Property 19.500 2,350 0 2,350 Woodland 0.000 0 0 Totals for 2005: General Property 19.500 2,350 0 2,350 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