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HomeMy WebLinkAbout012-1010-60-000 0 cn o C~ cn 0 K T 0 o d F 0 m f c 41 o G i4 m A (D (D v a c c J: S 2 Im Z 2 s o r 2 m o o C N N ` N O N W C', - N O_ O O Cl) (D Q o ,C; N O O O. n n 7 O n C T O 'ter ~A\ r. CD W O Co aC v v o N N N OD 3 r G O W O ID q Q Q CD < Q ~O - O O 4 CD 0 Vt - n 0 O Py y fNJI M W O O Q @~~1 C7 N fD 0p D1 C CD ~ !Y p_ v CD a a a o o D a CO 0 O7 _ S N O O p O 0, (:7) (D n t^ Cn (D 00 O O v O co H c 0 0 0< O O O o r ~ui 4 6 Cl) Cl) N 3 N L) N N _ 9 CD D N to N O Cn ~p O O Z cn CD S° !7 'O (D CD 0 7 3 m (D CD v - s m - CD- (D 3 :D 0 3 N (D o D 0 o n D o O CL :D :3 ti a m m m (D (D cn o-. cn m ~ (D CD G CD CD W m OL co co Q m In (D m -i C O p Z 0 U) c c .z z o cJ n n cn ~ W W Cl) m W o _ Z O 3 3 ~O A 0 0 v 3 3 N y a N n A O p O O G _ N O m 0C) m ooa n' n x o o n o a a N o - cc - x cc a' Cc co C O T - 7 T y G) C ~ fJ C 0 O CD CN C G N G -0 0- ~n . (D cD ~ CD (D N (D 10 0 C, N O N N CD OCD 0 = (D y 3 C N m 0- O 0 A v 0 n O (D 8 9 w W N ti q CD cc A O CD n n. N CAD N CD 0 O ~ O ~ N O 0 (D C-1 C 7c cz, 7 W r. O X G ~G 't ti N CC ~(r jq N G n 0 CL O n APPLICA ION FOR SANITILRY PERMIT f or ! ST ILA;TION OF A SEPTIC TANK (Sec. 144.03, Wis. Stats.) A. OWNER OF PROPERTY Name Address (Street, Cit ,Zip Co ) B. LOCATION OF PROPERTY WHERE SEPTIC TANK IS TO BE INST:~LLED Check 1. _ City Mail address County one: 2. Village ~w TJO 07 3. Town / -7 e, 'C el , C. TNSTGT"TRP. Give license number held: Wisconsin Restricted Licensed Sewer PlumhAr J 71jz7 Servi(-es Name Address D. SPECIFICATIONS OF SEPTIC TANK Size in gallons:(check one) 1. ! 1,000 gal. 56 -4 4,000 gal. 2. _ 1,500 gall 6. _ 5,000 gal. 3. 2,000 gal. 7. If over 5,000 gal., give capacity. 4. 3,000 gal4 Materials: 1. Prefab concrete 2. -4 Poured concrete 3._ Steel E. TYPE OF 0 C CUPI.N CY 1. Single family residence 3. miL Commercial establishment 2. Multiple family residence 4. Industrial establishment F. APPROXIMATE NUMBER OF PERSONS jSERVED DAILY ~ S ~ G. PERCOLi TION TEST MADE 1, Yes 2. No Date By whom ' : x<c -c v He EGx.~ (To be completed by County Clerk) Date application is filed and fee paid Permit issued (date) Permit Number County Clerk 4 J Percolation Rate Minimum Iibsorption Brea in Square Feet per Bedroom Minutes Required Normal With With With Both For Water to Fall Plumbing Garbage 1,utomatic Grinder and One Inch Fixtures Grinder Washer Automatic Washer 2 50 65 75 85 3 60 75 85 100 4 70 85 95 115 5 75 9o 105 125 5 - 10 100 120 135 165 10 - 15 115 140 160 190 15 - 30 150 180 205 250 30 45 180 215 245 300 45 - 60 200 240 275 330 60 - 90 240 290 325 400 AS BUILT SANITARY SYSTEM REPORT ;'rR 2? 6L u3~j f , TOWNSHIP SEC. T N, R rW ADDRESS , ST. CROIX COUNTY, WISCONSIN. ",DIVISION , LOT LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 02.0 aim. . 'TIC TANK(S) 2 MFGR CONCRETE STEEL NO. of rings on cover - Depth DRY WELL "TCHES NO. of width length area no. of lines width _ len th ' g / area C . depth to top of pipe 40 L X ;REGATE RATE AREA REQUIRED AREA AS BUILT k. claimer: The inspection of this system by St. Croix County does not imply complete % aliance with State Administrative Codes. There are other areas that it is not possible j' inspect at this point of construction. St. Croix County assumes no liability for tem operation. However, if failure is noted the County will make every effort to ormine cause of failure. .ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. 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Q) 0) 4J 10 :3 0 y 0 W -C co P O G O a() •.G•1 $4 aG) 0 41 0 P W a>) CO •G •,Gd -C .cc r- a) 3 G p a) OC G E v u a+ w 11 En 00 m 4 u m E O P4 3 W 3 1-4 E E E m m 11 p ca co O n m H ,-a N Cl) Vto 60 NAME OF BUSINESS LOCATION street or high-4ay city or to n ,hid county - I J 01,714ER nailing address • j ARCHITECT OR ENGINEER Address PLUMBER Address _ 1:, Check appropriate building usages) and fill in the information requested opposite each usage listed: Existing building- New building Addition ;r If addition to exist>_no building attach detailed r-,arco for each, y~ Restaurant or dining room . . . . Sc,,,tins cap,-caity (10 sq.ft./poraon) l`P (4 F7 is . VA O Hotel ( ) Hotel ( ) Cotta; es }iu'aber of unit s: F,-)ruler 2 persons/Unit 4 poraona/imit - TOTAL M-13.".n 0:' MUTS Bar or coc`_;Lnil lounge . . . . . Sc!t{:ng oapaoity (10 rZ.ft./par an) Nurair. or retirwmcnt how3 My bor of beds hobilo hc:]o par:: . 1ru:bor of units - dop-n~',-at - nond--pz:nd:.nt ( ) Service station . . . . . . . . nw-box of care served (eD6J,1 ) ( ) Sohool . 2har_ber of elr~-sorae:as Meals sorvcd Yes-- No~ Shcaor3 provided Yos No Feotory or offiec build3.rZ . . . 1u bor of poroono (total all shifts) 11() residenoo . . . t'unbor of brdiocros _ ti:V Uthor - specify (,.-lam: t'a}.,(- 2. Indieato S+h):h+r or not th3 follc:rinZ facilities are connected: Food wasto grind3r . . . Yes AIo Dish,-rashor . . . . . . . YesNo Auto;_,atio clotheo fr3 Mr Yes No ~ s. Fill in the tppropriato information for the follc:ring as indicator?: _ 1 C Septic try asd-acity lapped P c Nor=.1 septic tpSk eap% ity rc;uircd 5Vd inervano for KG or KI - Total eoptio taza% eapaoity r::quirwd Peroolation test rosults - Ai it-CH P!F OL.M i i?ST F7,11OF.1 5 "';P Soepagg tronah bottom area pla-ua,3d lancer feet depth Seepage pit planned outside dinioter depth balc:9 inl,,t ✓ dopth SeepoZe tr;;nah bottc3 rrca rcquirad -9 width linear Poet SoopccLgo pit rsquirod , eutsido di."-niter depth br,lon inlet Signature of person completing for: STATE BOARD OF HEALTH, PLUMPING DIVISION 1 P. 0. Box 309, Madison, Wisconsin 53701 Address: Approved: r,A^rJ 4.1 Date D Date 0 cc: William Holland Donald Kinyon, DPS, District 97 Richard Evjen, Arch. Hotels & Rest. - 2 Lawrence Hawkins .'Harold C. Barber KLPOKT Of INSPt CI ION - INDIV100AI SI WAGE SySTLM Savi~ ta'trt Phm~ Ice t<<t Stpttic-_131 NAME Towvibhlf"p ti t. Cto i x Ct,ml tr/ Locattiovic,,-- 11 c- ion Lol Subd:(v4A_,I01r S( PTIC TANK Paz -t z e y a k o vtb N u rn b e fc u( n o m p a it 1` rri e vt to z D-tA ta.nce. ~~iom: Alekf-----1 ttiu_t 4'dt vr~) - / /a- --l2 A~ ope_ HLgGtwa -te/r PUMPING G---C- I (A M-8-E. R. titi zc~~~ _gakl ovr/s Pump Maviu jae;tu1te~l Model Numbe.lc 1 IIOI_U1NG TANK -7 ~0 tiI_ze ya('eovt'~ Nu 1b ~,j CanripanImvpi t4 O P u_ m p e lt- % a h Yl ( A e-YYI D<a tavtc w: rl~tlh~~,ar~; AI:,SORPTION SITL !>ed r I~vtcrt D('! tavtce Oom: LUo ( l3cti i'di vi~ i''up~II<ghwa=tcI( At;SORPTION SI"rL DIMENSIONS W4",d-th o I-e- vtth Requ~~lcd all a 0 v h1 1-cogth of each ~~'vie Depth itj lock be~,ow e vi ~dumbc. t o{ 1'I teA J!~ 0 e1:)T11 o j waefz ove11 vi to P e vt r ah_ o h e,(' vt e ,5 X D e r fih a tie(, b c. _t~w ~r c . a d e. ~ _ a- „ 4-. b a vi c vb b t tw e t, vt ( 4 vi t S' 7 r 7 4 ' t7 ~ t. It E.vr <-Y t t.Vl. V/1 100 I b~f% .n ~P h-t t o r p (t Totae ab5owpt4_ovi aztea ~j Tyne of Covell: I'apeh o t~ta(4) PIT DIMENSIONS Numbe.lt. of pr.t4 Gdtavc anait vtd p~t6 vt~OuXb-ide di_ame-te.ll j.t De-p~-h bclow Tot(,((' a_b~son.p,ttiovt a~ca ()t Azt.ea nequ.in d (~T INSPECTED Icy T I T L r APPROVEO OAT(- 19 REJECTED UAY1, 19,k RIASON FOR REJEC~LON ij-1 0 N O 0 c ~ 3 (D 0• M D -0 7! ~..CD n c,D n m v u o o w CD M. ow `C • rn tD O_ O_ tD W CD W N 00 U' v m aWi cn W I V CD O 1 o 0 Q o CD < m CO C) CD CD a Cil 0 3 N 7 O C CD o a m (D a N m a a c~~ 7 Cn W O m = cn = o o 3 0- u c~ CD CD- a c (o cc CD CA CD o o y r o c 6 0 a rn V _ v v v n li °t ~y~~ • DQ o a +`1 cr CD CD (n (D Q. Q m Q =r su CD 3 N .Zl O Z) D Q m _ a z N z m z a O o D Q CD @~• A U) (D N C (D D N CD C1 n 3 j _ (D (n p :3 A Z CD (n c A Z O v C o' rn ~ w CWI m a 3 z 1 T O x Z V D A O m CD A D x O 3 x. O o o ° m N x o (c o' - (p W ill :3 T Cf) v C CD CS N O Q (D (D C "O C, (OCD N N (D CD fi 3 7 CD N A CD n Q O 3 CD- 0 3 V) (D CD V ~ C7 0 N ~ (D O c a ~ A DQ V p ~ b CD O ~ Parcel 012-1010-60-000 09/05/2006 03:30 PM PAGE 10F1 Alt. Parcel 03.30.17.39B 012 - TOWN OF ERIN 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 - KLANDERMAN, MATTHEW & ERIN MATTHEW & ERIN KLANDERMAN 1767 CTY RD T NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 1767 CTY RD T SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.980 Plat: N/A-NOT AVAILABLE SEC 03 T30N R17W 2A SW NW COM PT 260 FT Block/Condo Bldg: N OF 1/4 SEC POST BETW SEC 3 8 ,4, TH E 330 FT, N 298 FT W 330 FT, S ALG C HWY Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 198 FT TO POB EXC COM W1/4 COR SEC 3 N 03-30N-17W 260.11' S 89 DEG E 49.52' -POB S 89 DEG E 280.62'N 10.63'N 89 DEG W 280.62'S more... Notes: Parcel History: Date Doc # Vol/Page Type 01/12/2005 784809 2730/078 LC 12/03/1999 614933 1475/604 JUDG 01/23/1998 571678 1289/594 LC 07/23/1997 943/465 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.980 14,700 65,700 80,400 NO COMMERCIAL G2 1.000 15,000 62,700 77,700 NO Totals for 2006: General Property 1.980 29,700 128,400 158,1000 Woodland 0.000 0 Totals for 2005: General Property 1.980 29,700 128,400 158,1000 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges 00 Delinquent Charges 00 Total 0.00 REPORT ON INSPECTION OF SANITARY PERMIT # (1) Name and Address of Permit Holder Person/Persons at Site ,~2 Date of Inspection !1 Time of Inspection Name, reesss,/ License NO. !o ns a ing/ Plu~bpr 3 STALLATION Ct, S S OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: M DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute horsepower ; brand name of pump and model number Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO 8 HOLDING TANK: Manufacturer o ga ons construction ; depth to the cover ft; If septic tank is being used are baffles removed? YES ❑ NO; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? C] YES ❑ NO; Wired? ❑ YES ❑ N0; Locking device on cover? ❑ YES ❑ N0; Diameter of vent and material Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe-elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. ~(12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-SBD-6095 N.05/80 Signature of Inspector: Plb, t -A WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES Division of Health Section of Plumbing & Fire Protection Systems 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: 4 , , i I 4 = , , r_ a 3 e , 3 x t ~ Y 4 r ~ _ F € W t ~ # F Y a ~ . ~ _ ~ r # E , F ; a i r 3 # w F..e.~ t l € hm _ .........q_ 'c , ~ c-.....- _ .sue r . P r_, n, _ _ . ~ F I~ € s } .E.....>......`_.. _ .E _ _ .m„ ,q ~----ter p W4 E ~ t ` , s t 3 2 3 , t i , Q , ` - E , , k , E , i s® . m... _ . _ _ . } t E f , • % , , , 3 e i i ~ I I a b 4 a , j37 t ~ I a r E i y? ? # ❑ SEE ATTACHED DISCUSSED WITH PLUMBER ( ) Yes ( ) No SIGNATURE (Voluntary) DATE OF INSPECTION Signature of Inspector White - Inspector Yellow - Local Inspector Pink - Plumber or Responsible Party PLB 6 7 State and County State Permit # Permit Application County Per i # for Private Domestic Sewage Systems Count *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required 2- s'~ Off/ State Plan I.D. # O 0Q(0 .Z A. OWNER OF PROPERTY Mailing Address: B. LOCATION: .$"C*J % AV E , Section X , T_rON, R f Z a (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk#c/~cJ T % Village Township Llt/r, ?Jzm..; C. TYPE OF OCCUPANCY: *Commercial_ *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY 4' O. :,_;~,'3 Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement x Lift Pump Tank or Siphon Chamber./6", 1'r'~' Total gallons Prefab concrete _Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate * _L !Total Absorb Area sq. ft. New Replacement X Alternate (Specify) Seepage Trench: No. of Lineal t..Width Depth Tile depth (top) No. of Trenchs Seepage Bed: Length Width r i Depth z e- Tile depth (top) No. of Lines r Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land- Distance from critical slope WATER SUPPLY: Private 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, NAMEL R ,,f o'f C.S.T. # and other information obtained from (owner/builder). Plumber's Signature, MP/MPRSW# r< Phone # Plumber's Address a i L r/ 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. m ~ i gym. , m._.,..... E ` 3 , e e # E E r.e..a~. . ,ro. m . 1 i . i E ate,. E e Do Not Write in Space Below FOR COUNTY AND STATE DEP4TMENT USE O Date of Application „2 - ZFees Paid: State e_.County Date 7- Permit Issued/Rejected (date) Issuing Agent Name go_ ~ 4" , Inspection Yes ,&,No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1 /78 I State of Wisconsin ` Department of Industry, Labor and Human Relations Please Reply to Safety & Buildings Division Bureau of Plumbing, Platting & Fire Protection P.O. Box 7969 Madison, WI 53707 Telephone 608-266-3815 IN ALL CORRESPONDENCE REFER TO PLAN IDENTIFICATION NO. --NAME OF PROJECT TYPE OF APPROVAL STREET AND NO 7 # CITY OR TOWN COUNT . STATE ZIP OWNER N,~ e? Nw S i a ti• *4 a- l Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes, and Wisconsin Adminstrative Code, the plumbing 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 at the construction site one set of plans bearing the stamp of approval of the department. In the event installation of the plumbing improvements or system has not commenced within two years from this date, this approval shall become void and new application shall be made for approval of these plans before work may commence. yn granting this approval, the Safety & Buildings Division does not hold itself liable for any defects in plans or specifications, plan ommissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit requirements of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will automatically void this acceptance. Sincerely, PLANS REVIEWED BY: DAVE: . " `1 James Sargent/Bureau Director cc: bPS'OWS Owner DTLHR 116 c41 Pl Plumber H&R (2) untX Mfg. Rep Bur. of Health Fac. & Serv. ` Rec. & Env, Services D1LHR-SBD-6099 (N. 06/80) PIb 100a 12/78 Detach And Return Upper State of Wisconsin DIVISON OF HEALTH Portion bf This Form With SECTION OF PLUMBING Any Return Correspondence AND FIRE PROTECTION SYSTEMS MAIL ADDRESS: P.O. BOX 309 MADISON, WISCONSIN 53701 608-266-3815 DATE: PROJECT: t i I 1 I PLAN ID. # j 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. III. 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. ❑ 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) ❑ Total area filled (fill to extend 20' beyond edge of trench before side slope begin). ❑ Depth and type of fill. ❑ Copy of onsite report by county or district plumbing supervisor. ❑ Length of time fill has been in place. L Parcel 012-1009-80-100 09/05/2006 03:24 PM PAGE 10F1 Alt. Parcel 03.30.17.34A-10 012 - TOWN OF ERIN 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 - ELKIN, JOHN A & VICKIE L JOHN A & VICKIE L ELKIN 1753 CTY RD T NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC ~All Legal Description: j Acres: I 0.000 Plat: N/A-NOT AVAILABLE SEC 03 T30N R17WiPT SW NE SE NW, NE NJ., Block/Condo Bldg: COM W COR SEC 3~ S 88'E 2302.36FT TH N 00' E 211.06FT TO B; TH CONT N 00' E Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 1431.14FT;TH S 85 504.08FT; TH N 81/ 03-30N-17W SW NE E 328.75FT; TH S 42' 04.83 FT; T 65'E 225.58FT; TH N 81' 4 ; TH more... Notes: Parcel History: Date Doc # Vol/Page Type 03/27/2003 714843 2185/186 QC 1406/263 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 012-1010-70-050 Valuations: Last Changed: 04/16/2004 Description Class Acres Land Improve Total State Reason Totals for 2006: p 0 General Property 0.000 0 0 Woodland 0.000 0 Totals for 2005: 0 0 General Property 0.000 0 0 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch 215 Specials: User Special Code Category Amount Special Assessments Special Charges 00 Delinquent Charges 00 Total 0.00 Parcel 012-1009-90-000 09/05/2006 03:23 PM PAGE 1 OF 1 Alt. Parcel 03.30.17.35A 012 - TOWN OF ERIN 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 - OLSON, B DAVID & JUDITH C B DAVID & JUDITH C OLSON 491 B LAKEVIEW LA OSCEOLA WI 54020 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1753 CTY RD T SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 5.800 Plat: N/A-NOT AVAILABLE SEC 03 T30N R1 7W PT SW NE LYING N OF RR Block/Condo Bldg: EXC AS DESC IN WD-1280/148 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 03-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 12/02/1997 569282 1280/148 WD 07/23/1997 750/44 07/23/1997 711/374 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANDS G6 5.800 18,600 0 18,600 NO Totals for 2006: General Property 5.800 18,600 0 18,600 Woodland 0.000 0 0 Totals for 2005: General Property 5.800 18,600 0 18,600 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 CWA"YNA, NOVITZKE, BYRNES, GUST & WILLIAMS Attorneys-at-Law Telephone 715-268-8163 Box 847 Amery, Wisconsin 54001 MICHAEL B.CWAYNA DON PAUL NOVITZKE DANIEL M. BYRNES GERALD N. GUST OWEN R.WILLIAMS DAVID G. LEADHOLM DAVID M. ERSPAMER October 3, 1979 Law clerk JAYLUKE _ Investigator Mr. Harold Barber Zoning Administrator St. Croix County Hudson, WI 511016 Dear Mr. Barber: This letter will confirm the conference held between myself and yourself at the premises of the Red Rooster tavern at Jewett Mills. It is my understanding that Mrs. Sellent has until October 30, to apply for a septic tank permit and submit plans to the state in support thereof for the Red Rooster and that the completion date will be set for lst of July, 1980. It is my further understanding that you have issued a conditional permit, subject to completion of the septic system as above and that a renewal of this permit is conditioned upon completion. It is my further understanding that the perc test obtained by Alroy Soland may be permissable to use in support of the application for the state permit and we will be relying on this. I wish to thank you for your cooperation and understanding in assist- ing us in remedying a very difficult situation. Yours sincerely, CWAYNA, NOVITZKE, BYRNES, GUST & WILLIAMS Owen R. Williams ORWj b CWAYNA, NOVITZKE, BYRNES, GUST Et WILLIAMS Attorheys-at-Law Telephone 715-268-8163 Box 847 Amery, Wisconsin 54001 MICHAEL B. CWAYNA DON PAUL NOVITZKE DANIEL M. BYRNES GERALD N. GUST OWEN R.WILLIAMS DAVID G. LEADHOLM /J \ DAVID M. ERSPAMER 1X Law Clerk August 29, 1979 ' t q 1 JAY LUKE bS- i Investigator $j3 Lea\<\ C ~y f ~ Mr. Harold Barber Zoning Administrator St. Croix County Courthouse P. O. Box 418 Hudson, WI 54016 re: Fall v. Keating et al Dear Harold: As you are aware, I represent Beverly Fall Sellent concerning the Red Rooster foreclosure. Mr. and Mrs. Sellent are currently in possession of the Red Rooster and are aware that the sewage dis- posal system needs to be upgraded. Accordingly I would like to meet with you and the Sellents at a mutually convenient time so that we may set up a timetable acceptable to you for upgrading the septic system. I anticipate that this can be accomplished before spring, if you concur. As you are aware, Mr. and Mrs. Sellent have incurred substantial costs incident to the foreclosure and, money being in tight supply, are having a difficult time in maintaining the service which the Red Rooster provides to the New Richmond community. Accordingly would you please contact me or my secretary if I am out of the office and set up an appointment with myself at the Rooster so that we can attempt to work something out for the benefit of all concerned. Thanking you for the privilege of working with you again, I am, Yours sincerely, CWAYNA, NOVITZKE, BYRNES, GUST & WILLIAMS Owen R. Williams ORWj b cc: Mrs. Beverly Sellent a r. Y State of Wisconsin \ DEPARTMENT OF HEALTH AND SOCIAL SERVICES v DIVISION OF HEAL MAIL ADDRESS: P. O. !OA 309 MADISON. WISCONSIN 53701 July 23, 1979 IN REPLY PLEASE REFER TO 3550 Mormon Coulee Rd., Rm. 104 La Crosse, Wisconsin 54601 . tY ' R~cFIVE[) ~ JUL 241979 Y ZONING Mrs. Beverly .lent OFFICE , Route 3 • New Richmond, W ' Dear Mrs. Sellent: Re: Red Rooster Supper Club On July 17, 1979, I conducted a follow-upinspectiospof the sewage disposal system serving the Red Rooster. Results of that below. The seepage pit was full. Effluent had risen to the invert oof the f the fencet pipe. I noted also that the surface of the pile south was wet at two points, one being the hole I had marked with a stake on July 3, 1979, the other approximately 2 feet southwest of the marked hole, another apparent exit point. Liquid was ponded at both noted points and evidence of recent seepage was present on the surface. I dropped 2 green dye tablets in the seepage pit, flushed the toilet in the men's room a few times and requested your daughter to run the bar sink for a few minutes. After approximately 10 minutes I observed effluent moving through the seepage pit and into the outlet pipe. My next observation was at the noted points in the dirt pile located immediately south of the fence. Liquid was surfacing at those points and flowing across the dirt pile. Traces of green dye were present in the liquid showing that the surface seepage had originated in the seepage pit. With a shovel I located an outfall pipe directly under the fence. This pipe conveys sewage effluent from the seepage pit to the discharge point at the fence. It has apparently been there for several years since the end of the pipe is considerably corroded. The discharge of sewage effluents to ground surface is not an acceptable means of sewage disposal, therefore, the discharge will have to be abated. The septic tank and seepage pit presently serving iheibuildibothreinadequate to handle the discharge load placed upon the to age of the system and system size, which is too small. Proper procedure is to replace the present system. Based on the results of a site evaluation done in June of 1977, and on information supplied concerning use and capacity of the building, size of system required is 4,000 gallon capacity septic tank and 6,720 square feet of absorption area. Also, since maximum daily discharge exceeds 1,500 gallons, a ~ 9 chamber is required. s flrs. Beverly Sellent New Richmond, WI 54017 July 23, 1979 Page 2 Because both county and state licensing is involved at the establishment, I suggest you contact both licensing agencies to work out a schedule for correction and replacement. Feel free to contact me if you have any questions. Sincerely, James A. Sargent, Chief Section of Plumbing and Fire Protection Systems Dennis R. Sorenson On-site Waste SpecialisiC DRS:jd cc: James A. Sargent, Chief - Plumbing Section, Madison ~_..Harold C. Barber, Zoning Administrator, P. 0. Box 227, Hammond 54015 Robert B. Dempsey, R.S., Hotel and Restaurant Section, District 5/La Crosse Keith Krenz, R.S., Hotel and Restaurant Section, District 6/Eau Claire r"r t e , , 11A ,a PQ~nr~ J ~ : f February 25, 1980 ~ gild t /f N;~I Pc+wers Cement. Products RT 3 New Richmond, WI 54017 Plan Identification No. 80-08269 Gent iesman: Res Red Rooster Supper Club Sewage Disposal SW JAR RE 1/40 Sec. 30 T310W, 917W, Town of Erin Prairie, WI St. Croix County Examination of plumbing plans and specifications for the above ntioned project has been completed. in accord with Chapter 145, Wisconsin Statutes, and Chapter H 62, Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon compliance with the following stipulations Indicated on the plans and the following code section. Please review your code for the requirements of the coda section noted. i. H 62.20 (5) (c) - Dosing or pumping chamber - sizing and construction and pumping equipment. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one sect of plans bearing the stamp of approval of the department. In the event Installation of the plumbing Improvements or system has not commenced within two years from this date, this approval shall became void and new application shall be mode for approval of these plans before work may ice. In granting this approval, the Division of Health does not hold itself liable for any defects in plans or specifications, pion 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 arises making this necessary. { CAW Ann v pier rq ply" AM 1 Am antiAliolilail 66 IQ lot also* wdow wwc"3,11M lot t , f 11 . j r P i ` - =A';~+e~.f S '1 '3'-,~" 3%Y"t- aa~ t'3,.~ ^>z~~.Y ';,f4~~ •:~y,t ::~~i 'Y~ j3j sv v m y -010110101a hi": t f t z`H U 1 t~ 143 ,r q 3:ry r '~r'~' 2 0:1 2 : t~1'1. , K t~tt~ at:. ,~r?tea ^i:~ t ~x.'S~ +''4,:; . : z a i.•?a ' t;` „t .a i s ='i i1F!1~2=7 t., ;~sr:°j~ '~t~t i„y "a- - a - e r a„H ,S ' ` v•a` -~.i •y~ap f'j t all. auk man k - r + ~ ,,3 ; rtt'--, t t., *H3,•3.,: ~,iy ~E41 '^~'~a'~°. i •Z, • ..::may ! „sfi~k's ~ .'c kv? ~ ~t~.' ~=.z ~ s a,~gti.: ,s.^i,. ;-,~k7.sY~ a E i~ay~•+t 4#;a,r1•a~v~v'~ S~r,_}:~ ~ a a:;!~. F _ r • t`, aozi ~=3. iP.iz ~N~:.`~.:kv.~r~. y.t -rr,x4 :%.'7 , .i r~.~'=zJ'.s.' i.~i.r: i.;M_ :.f 1.y~Y.:.,, " r. w s - ' ~ ; ?''~r a'I 6 S x:,~ «,>.ft.' ~ ~ H s'b'~~~o ~ °4` t yr; Hi ' 1 Y_$ to a0luff l 1 ` 101-e a w , to ` € d y Y vsr:~ " s , r_ not LYw'i t'°:' } .a' *,y : d C:3v 11!"M s a :;':r" ,?&t B`.*a,hO A -110"K ss""` 1 00 00J.1010 !+.`sc-~,~el '~3'~»us ! `~s q~,••;]i ~ ,S:$"z„: .~r~ ri'1 i3 ;`.",~sz~~e~i 1y Sk~`i,"'., # " A n k Y':o , 01 .:wj3u"$w ~•f°t~ mH.31x;?~'`t+:3 ,R :x>: ~.qP~; ;ig•,9+.~` .iH `•~.'h."';.:) „l. 1 •F'~ .a?FrY y.,n' °4i; li~.'L: ONAnn -ills 1~%13140.0 111541 • _ INS 14, r Powers Cunt Products New Richmond, WI Page 2 February 25, 1980 TI Ms approval is based an Chapter H 62, Wisconsin Administrative Code, requirements. It shall be necessary to obtain and fulfill the permit requirerw,nts of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will automatically void this acceptance. Approved/issued By The Oepartrent of Realth and Social Services Division of Health By: Section of Plumbing and fire Protection Syster is JAS: KS: etas Enclosures cc: . Leroy Jansky, OWS - District 6, Eau Claire rber, Zoning Administrator, St, Croix County . Harold C. bay Mr. Foy K. Clary, R.S., Chief, Section of Hotels and Restaurants i 1 yt x 4 'P .v s 1 B ~ t`° ya .a _"has.°.i"~F :~'E A y, ale M R~ 3 .vt X 1 ~9~ fi~~a ~ ~ ; _ r tl~7"L r ti~#s~ t ray ,,°:r;.91 i ; ~3 ~'"S" : "X t ~ `