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022-1034-40-225
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BM Elev.: BM Description: Parcel Tax No.: L 100 1 1 cy-D M ' *► 1 2yT G S T) S 022 - 1033 -40 -000 TANK INFORMATION ELEVATION DATA 22- (U3 TYPE MANUFACTURER .1�� CAPACITY STATION BS HI FS ELEV. eptic 01 v" Benchmark Dosing bDo Alt. BM 1 tab V7_ I 0 S. Z.I Aeration Bldg. Sewer Holding St / 40 InletTP IOfo�4'S I� R-3 TANK SETBACK INFORMATION St/ 1%4 Outlet TANK TO P/ L WELL BLDG. Air I to ntake ROAD Dt Inlet Air Septic -} ;per -1.100 +JS2g. 41522 NA Dt Bottom 1 -116-V q 0 Dosing r U NA Header /AAeft. x!'7,9. Aeration --. — �- NA Dist. Pipe 9798 Holding — Bot. System 104 / .9 97 , ? j PUMP/ SIPHON INFORMATION s� 5L �� Final Grade jD /. /� 1A Manufacturer Demand St cover 'T� lob -� � So 9$ Model Number P D s '�GPM —, P _ g � ° �$.$'� z�� lc� (o q TDH I Lift l.55 Friction4 System>;. 4 TDHf,7� Ft 8 4e Forcemain Length IDo Dia. 0 t Dist. To Well • 1 � P ce- SOIL ABSORPTION SYSTEM -k4k, Zarv% - 6�t4a.. `U P BED RENC Width Length , No. Of Tr PIT No. Of Pits Inside Dia. Liquid Depth DIM I &. DIMENSIONS 0— — SETBACK SYSTEM TO P / L BLDG WELL LAKE / ST EAM LEACHING Manufacturer _ INFORMATION Type Of CHAMBER Model Number: System• r ,SO I I IY 4 /00 -1- SO/ OR UNIT DISTRIBUTION SYSTEM " Header / Manif,19 9 Distribution Pipe() IP x Hole Size x Hole Spacing Vent To Air Intake Length > Dia. Z Length : Dia. S IN Spacing �C 1 �� x t' SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Centers Bed /Trench Edges Topsoil Yes ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 0/ v/� Inspection #2: T Location: 465 Division Avenue, River Falls, WI (SE 1/4, NE 1/4, Section 12 T28N -RI 8W) - 12.28.18.P180A S) F� �kr • c�a11e�) t J�vPWA \ , Pa 44.-c veo 4ie 4ow K ° � CY.S �' SfiG k re4.c1 � a -) Ljll Y acl(i 5ev,/er5 rY 4e WUSr CAICI �ccse jharin WevA iA , 611pd curl WGcKli Vr'►a/ b `�' 161 �lVrtq,��r. � �� �Glr .'�►��' arc -�� }C 51c�p �a -1nI Cc�rh ��r - �ay�c�'k°a>. 004&AD,i3 we Ife '1 nS +0Qed .eb�sc.... . VISWA i5 V'e i �ui �eC( � /� -#- � fiar�t - C (eau p In `f avi k loca°f(� 1�.. 4 e c�-�aw 1C. Plan revision requ d? ❑ es 4 No Use other side for additional informi lon. [ 4 1 SBD -6710 (R.3/97) Date Inspe is Signature No. R , ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: E e � w g %., a .e KA a e. J1._ i e - r 1 E i A•� �/ /'�{ • I ii l �� 3 9 [ 5 d a. 9 - f ti E. � } f 3 � � d as �... � 3 g 2 , ..... A . ., ........,,,,$ e 1 1 Mao A L 3 4 _. .. .� ' , 1v1jAWVW _. i \ _ _ j ell "V a _1 ., eW.- "3. .� ®.,. g �. »-eP .,A.�. »� � ,e }, mg.A , ; _�_ �. �. �,, a � k.f.h., AA 7 t 9 e a s _.— _ —4--f- Mc 4_ — 4 —, w A fir 1 F .�.. .< d-..i .. 1 , Sr'fi` V ol 1 1 T : C f � � t . P . . m__�... VA _..,., ... _ ri t V1 V — ._ e_,_ S �. bt e A ¢ a.. m ....� �. _ .,. e. A n y . U e m Fes- .. k .. . #.,- Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 '"A Personal information you provide may be used for secondan purposes Madison, WI 53707 -730^ i Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if r state owner Attach com fete plans (to the county copy only) f the system. on paper not less than 8 -1/2 x 11 inches in size. County State antta Permit Number Check if revision to previous application State Plan umber s rc b x.. 5 I I. Application Information - Please Print all Information Location: Property // Owner Name Property Location 1/4 1/4, S 12 ToI[?,N, P,/ or Property Owner's Mailing Address Lot Number Block Number / 4/3 'i� S 7`e -e ,C e Y G c y City, State Zip Code Phone Number Subdivision Name or CSM Number /4.` oey e, - ( r-- II Type of Building: (check one) ❑ City ❑ 1 or 2 Family Dwelling — No. of Bedrooms 0 Village • Public /Commercial (describe use): j;jTown of • State -owned III Type of Pert -:it: (Check only one box on line A. Check box on line B if applicable) Nearest Road A) I. &New System 1 2. ❑ Replacement 1 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Numbers) System Tank Only Existing System © J D -4/0 $) Permit Number Dale Issued� EV A / Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line fill At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation G G ( S6 d �- � 7. VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks �L 1.2 �� l /Q V ❑ O ❑ E3 4)�� eoo t 13 13 0 VII Resp nsibility Statement I, the undersigned, assume res on ibility fer installation of the POWTS show the attached plans. Plumber's Name (print) Plumber's Signature (no stamps): MP PRS No. Business Phone Number M" `a �a7 ? Plumber's Address (Street, City, S Zip Code) t SGGU/ VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (I udes Groundwater Dat Iss d I • Age t S' at re (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Q' 2 a Determination (� IX. Con tions of Approval /Reasons for Disapproval: I r S2 P{ Akgn K `e �'�lU e� 1 ��� �� V M - � �i✓G(� A k.0 C CW at. c.Q U�' S . cse e c. ci c A led `tom &Q �S�t.�e ✓'d Ia.YJ- • SBD -6398 (R. 07/00) Y June 20, 2000 A permit was originally issued for a mound system on 10/4/99. The shed and house were placed on the mound site area and a new soil test was conducted. The new soil test indicated that a conventional system could work. A revision was therefore submitted to reflect the change in system type and location. During installation of this conventional system the plumbesfound that water was emerging from the subsurface within 4 ft. of the surface. It was determined that limiting factors in xhe surrounding area are creating a high volume of subsurface flow towards this tested area. Within this tested area, hard pan conditions were found and believed to be holding up the excess drainage that is converging on this location. Therefore it was decided that a contour line would be established in this area and mound plans would be submitted to the state. The county will require a revision and the plans from the state, but no fee will be assessed since the location is not changing. Everything must be complete within 2 years from the original permit, unless it is renewed during this time. Jon Sonnentag ntiuC�� Safety and Buildings 4003 N KINNEY COULEE RD E LA CROSSE WI 54601 -1831 N s st tewi.us www.commece Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary July 19, 2000 CUST ID No.267341 ATTN. POWTS INSPECTOR ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 I ON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/19/2002 Identification Numbers ti' nslaction ID No. 327841 !a ®Q Sit No. 176873 SITE• �} ! rO�X P refer to both identification numbers, Site ID: 176873, Bill Liddle S1 �1NTv a &ej in all correspondence with the agency. St. Croix County, Town of Kinnickinnic 'CNO�ovF SE 1/4, NE 1/4, S12, T28N, RI 8W FOR: '��� , ►_..`. - -1 y Description: Four Bedroom At -grade System Object Type: POWT System Regulated Object ID No.: 672211 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with both the "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Waste Treatment Systems" SBD- 10570 -P (R.6/99) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the At -grade component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be g iven to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary rmit must be obtained from the coup where this project is located in accordance with the �'Y county P J requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local 'inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. ARTHUR L WEGERER Page 2 7/19/00 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 06/30/2000 FEE REQUIRED $ 175.00 RECEIVED � FEE $ 180.00 Oerard Swim REFUND AMT $ 5.00 POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:15 AM to 4:00 PM Refunds of $25 or less will be jswim @commerce.state.wi.us made only on written request. WiSMART code: 7633 I I i Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 • 6 onsr►n www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary July 19, 2000 CUST ID No.267341 ATTN: POWTS INSPECTOR ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL �\ , �. ,�. n ide N o . 327841 bees PLAN APPROVAL EXPIRES: 07119/2002 RECEIVED Try section ID No. 327841 No. 176873 r t` leake refer to both identification numbers, SITE Site ID: 176873, Bill Liddle I - (1 w 'I ZUDO aboy in all correspondence with the agenc ST R- St. Croix County, Town of Kinnickinnic = !;OUNTV SETA, NEIA, S12, T28N, R18W ZONINGC�FFIGE ,': cV FOR: y ` /� `9 Description: Four Bedroom At -grade System Object Type: POWT System Regulated Object ID The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with both the "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Waste Treatment Systems" SBD- 10570 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the At -grade component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. ` ARTHUR L WEGERER Page 2 7/19/00 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, ` DATE RECEIVED 06/30/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 180.00 Oerard M. Swim REFUND AMT $ 5.00 POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:15 AM to 4:00 PM Refunds of $25 or less will be jswim @commerce.state.wi.us made only on written request. WiSMART code: 7633; TITLE SHEET Page of - 7 AT -GRADE SYSTEM FOR A `I BEDROOM RESIDENCE This plan has been prepared in accordance with the At -Grade Component Manual SBD- 10570 -P and the Pressure Distribution Manual SBD- 10573 -P LOCATED IN THE S !H 1 /4 OF THE N E 1 /4 OF SECTION 12 ,T Z iS' N, R 1� W, TOWN OF Yz_-L 1 PJ lC` z_jQ )Q VC gT • C LX COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR %A d e ll FLI U EIVL F-frLLS W ( S Ll p L Z O cp Q PREPARED BY �!I f+JEGE ER SL? I L AND. DES I CCU! SEF2V = CE P.O. Box 74 421 N.Main St. �M�M River Falls, WI 54022 l)IyS Phone 715- 425 -0165 Fax 715- 425 - 6864 �+s r euswCxirµ P Conditionally OMMERCE NT Of ' DEPART N DINGS • ,. �; _QO �' yVIS40N SA ET SEE CORRESPO D NCE JOB NO. 0 6 -1'78 SYSTEM.MANAGENENT Page' ? of 7 Management and maintenance of this system is critical to its proper operation and longevity. The system owner must be provided with a complete set of plans including the management section. GENERAL Proper functioning of any type of on -site waste disposal system is dependent on the amount of water entering the system and the quality of the water. The lower the volume of water and the lower the level of contaminants, the more efficient and longer lasting. the system will be. Typical system components include a septic tank to settle out and break down solids, an effluent filter at the septic tank outlet to filter out small particles, a pump tank with an effluent pump and controls and an absorption cell to dispose of the water in a manner which will protect the groundwater and public health. RECOMMENDATIONS 1. Install water saving devices when and where possible. 2. Repair any water leaks as soon as possible. 3. Do not pour greases, oils, chemicals such as paint or paint thinners into the system. 4. If you have a garbage disposal, use it sparingly. 5. Do not dispose of any paper products other than tissue into the system. 6. Try to avoid excessive flows of water in short periods of time. Spreading clothes washing throughout the week is recommended. MAINTENANCE 1. The septic tank should be inspected by a licensed pumper every three years or less and pumped if necessary to remove solids and scum. 2. The effluent filter must be cleaned periodically to remove any accumulated particles. It should be washed back into the septic at 6 month intervals or as per the manufacturer's recommendation. 3. Periodic inspections at the observation pipes should be made by the owner to determine if any ponding is taking place in the absorption cell. Also check for any seepage to the ground surface. If consistent ponding or seepage is noted, a licensed plumber should be contacted. 4. This sytem.contains an alarm which must be installed on a separate circuit from the pump. If the alarm activates, minimize water use and contact a licensed plumber immediately. CONTINGENCIES Monitoring of the volume and effluent quality may become necessary if problems develop. Monitoring must be done as per the requirements of .COMM 83.54(2). Pumping and disposal of wastewater by a licensed pumper may be necessary while analysis and repairs are made. 1. Failed mound systems may require removal and disposal of the existing sand fill and replacing it new sand or installing an aerobic pre- treatment unit to reduce or eliminate any clogging mat may be present. 2. In- ground soil absorption systems or at -grade systems may require the installation of an aerobic pre - treatment unit or replacement of the system. Additional site and soil evaluations may need to be done and additional plans may need to be,prepared and approved by the Safety and Buildings Division of the Department of Commerce. �� r�y �. ,:,� . i JUL -19 -00 WED 11:03 AM NELSEN WEBER SURVEYING,M 1 715 425 6864 P.02 PLOT PLAN Page -�Sof 7 Scale 1 "= y0 -J. %Lt�6 wl li ur�� e F 'T*V,{wrt Fo rt � o 4 z 00 , y> it a fq J � J y _- ��s.�Q.e, bars -Prr �N s-r ._z+���1 F� v�r► �r 0 9 •� L . br'1►1 I tom or- 1 ° pVC q Z" C'0QM) 4.5 Vi otL d" aNz,aw a P wY wt'4f5� °t�ovCwtF` g.b U"pvc auL.owG s.�cc� C�k�� OVT N,�2.E13 S�17or1 lo bo ` i �s•oF z j ..'�3..L,.IU - B�_��.:�`33 ,50�. t :_Sl �'' / � // ems, �- z , •� e.3 / ,L1 e� J SP.Itiz�_Z. °r,_P ovt�___. NOTES- I- Elevations shown are existing ground elevations unless otherw se rioted. wC 2. Install 4" observation pipes with approved caps. ( requi ed). 3. Septic tank to be Vz o gallon capacity manufactured by 1"1lOW���' PA ST" h1�Zft$ V::7 t TL-N- Pu y `IU � `750 (SPM M Lbwc?sTV 4. Bench mark s • Ste, ps3oy� /lfi In 5. Divert surface water around system to prevent ponding at the uphill side. JUL -19 -00 WED 11:04 AM NELSEN WEBER SURVEYING.M 1 715 425 6864 L T }5� B >5�, 5� r-�2� Ic T — Q 13 0mv ,,,eus - 6 R- b . �5 t/6 B Z/6 B 1/26 -- A R5 S f T .. z Fir C _ Linear Loading GPD /LN FT Design Loading Rate - GPD /SQ FT ion T _ N Dist ribut' Observation We ll ns��� :: Lateral Fabric a Soil ��=�. i - psi. - - -- , \�� - ��� /i \ \� \`•' ",, '�i:a 12 i�r,A' " /.. I 1� 1 11 f Cover '-5� A �2` C A =�2� 'S� f do Plan View and Crass Section of a Wisconsin At -grade Unit with Two Ab!50rption Areas With in a Single Unit on a SIcIping Site Distribution Pipe Layout Page S of 7 Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 45' fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valve;;,:threaded cap or . threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. 7` T Cf� L ��ZOSS S'�Z`i1V pvC 1puC P Lateral Manifold X x x x x2 I x2 x x x x Lateral Lenath — Lateral Lenqth — P Distribution Line 41 ps1.1 � F0 �o S W RCE • �=02�� Mrs P 3 S Ft. Hole Diameter (Inch S Z Ft. Lateral 1 /114 Inches) X 14 Inches Manifold Z Inches Force Main " Z Inches of holes /Pipe 1� Invert Elevation of Laterals Ft. • 1F�X x_66= ��- �S�X�= �1.`1.SZGPwI rnr.,f GF PUMP CHAM5ER CR055 SEC7 101I ANG SPECIFICATIM'S VE KIT CAP New pomt c4m k � f S 4 „ C. I. VEtuT PIPE 1065 L _T WEATHERPROOF APPROVED LOCKIAIG JUNCTIOAI BOX MA4vFi01_E COVER :� 25' FROM DOOR, WINDOW OR FRESH IZ "MILT. I AIR INTAKE � GRADE I 4" MIN. i CO►JDUIT \ __ _ _ __ 18 ° MIN. PROVIDE I - - - -- fA1LET AIRTIGHT SEAL_ I I A i i { I I E I i i i + ALARM D � 11 i 1 *APPROVED i i aN c JOINTS WITH i CLEV FT. APPROVED PIPE I 3' ONTO PUMP OFF p SOLID SOIL COMCRETE BLOCK RISER EXIT PERMITTED 0AJL9 IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC f SPEC.IFICATIOKIS DOSE ,y, e- 4 / TAMKS MA LIUFACTURER: 8. , ��we gtpe Ca-S �UMSER OF DOSES: 3 ' (( PER DAS TANK SIZE: Ed GALL OMS DOSE VOLUME ALARM MAIJUFACTUKE fin ** Ar"QPIGiy-m INICLUD)MG DACKFLOW: �� ^�-� GALLONS MODEL NUMBER: - 1L (/ CAPACITIES: A= IMCAES OF. GALLO0 SWITCH TSPE.: 5= c , WCHES OR GALLONS O PUMP MANUFACTURER: � �' G = tA1tkE5 OR 1st_ GALL01J5 MODEL NUMBER: 1 -:T - D- IMCHES OR GALLOME 5WITCH TSIPE: 1iey NOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE 2 6PM INSTALLED QN SEPhRATE CIRCUITS VERTICAL DIFFERERICE SETWECU PUMP OFF AND DISTRIBUTION P IPE.. FEET + MII.IIMUM NIE.TWORK SUPPLE PRESSURE .. . . . .. . . FEET + 1 FEET OF FORCE MAIN X ySf F Yg a FxFKICTIau FACTOR.. FEET TOTAL D'AlJAMIL HEAD = FEET INTERNAL. DIMEIJSIONZ OF TANK: LEkIGTH ;WIDTH - ;LIQUID DEPTH 3 1GNE D: �!!� l�� LICEMSE IJUMBER: ���t� DATE:�� s • . PUMP CHAMBER CROSS SECTION ARID SPECIFICATIONS' PAGE _L OF VEAIT CAP �lJc) ol2l00 'I ' C.1 VENT PIPE c � 0 WEATHER PROOF APPROVED LOCKING MANHOLE 10' FROM DOOR, JUNCTION BOX COVER WITH WARNING LABEL WINDOW OR FRESH It�MW. AIR INTAKE GRADE I I `1' MIN. COQnUIT -- ______ 18�MIN. ---- - - - - -- PROVIDE I — -- . INLET r—F AIRTIGHT SEAL I v APPROVED JOI A Tank construction shall c mplp I I APPROVED .JOINTS with COMM 83.15 and COMM 83.20 ALARM b I ) 11 . I 1 ON C I I -- _ 88 6� LLEK FT. PUMP --, —'� OFF 0 tri '38 lz� o C MCRETE DLOCK 3" APPROV RISER EXIT PERMITTED ONLY IF TANK MANUFACTURCIt HAS SUCH APPROVAL ucoING SPEGIFICATIOAIS 005E M t DVv 1�I P 1 TAUIK MA6lUFACTURCR: ��T" IJUMDEA Of DOSES: TANK bIZE: GALLONS DOSE VOLUME I t INCLUDING DACKFLOW: ` GALLONS ALARM .._PL4,NU CTURfrR: S .S. SAS S - - - -- - - - -- -- - - -�_�.. MODEL IJUMBCR: t0 I iAw CAPACITIES: A= Z- INCHES OR L A —c- GALLONS SWITCH TYPES Z INCHES OR sq � O G{ LLON5 PUMP MANUFACTURER: C, INCHES OR l.„Sb bGALLONS MODEL NUMBER: Ds D IZ INCHES OR W6.I GALLONS SWITCH TYPE: Y"1�Z �Z NOTE: PUMP AND ALARM ARE TO bE MINIMUM DISCHARGE R E � SZ GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEN UMP OFF AUO_DISTRIBUTIO M PIPE.. �� FEET t MIAJIAUM • NETWORK SUPP y PRESSURE ......... .. 3 - Z S FEET ♦ �S FEET OF FORCE MA X �'SS oo fLFRICTIOU FACTOR. O "�� FEET TOTAL OyIJAMIC. HEAD = '' FEET S As per . cturer • S 4 gal /in. Liquid depth � Z Goulds Submersible Effluent Pump 4 V LJ 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with integral handle • Farms Motor: manual operation. Automat" ic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■Bearings: Upper and lower RP 115 V, 60 Hz, 1550 RPM, SPECIFICATIONS • EP05 Single phase: , FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi -open design 3 /4" maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING --� • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. CO- canadian standards Association Total heads: up to 24 feet. with three prong grounding m EP05 Impeller: Thermo- • Discharge size: l' /z" NPT. plug. Optional 20 foot (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in 7" or "AC ".) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 j • Capable of running dry without damage to s 30 s components. I I, Pump: EP05 a U f o Solids handling capability: i 9 P tY� o 3 Y Q 1 /a maX1111Um. w • Capacities: up to 60 GPM. X s 20 • Total heads: up to 31 feet. • Discharge size:1 %* NPT. z 5 • Mechanical sea I .carbon - rotary/ceramic - stationary, ° 4 15 BUNA -N elastomers. I • Temperature: ° 3 10 104 °F (40 °C) continuous j e 140 °F (60 °C) intermittent. 2 5 1 - 1 0 00 10 20 30 40 50 GPM L -L 0 2 4 6 9 10 12 m °/h CAPACITY SAFETY AND BUILDINGS DIVISION 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 isconsin Department of Commerce \�t Tommy G. Thompson, Governor fi WZ William J. McCoshen, Secretary At -Grade System ons to Verification Report Are the soil and landscape features accurately reported on the Soil and Site Evaluation Form yes no If no, provide a further description by including an onsite report, which may consist of a soil profile report, or provide a brief explanation below. E, If yes, what other type of Private Owned Waste Treatment System (POWTS) could be used? IY l Z2 - 2COrD C unty Official Signature, Date 4 �b5 - 5 �c five ( SE A(F) 12 , Zq 18 K" 5, L90 I X Co UXl v Property Location B , L-L- LT- I.) bL-E Landowners Name SBD- 10513(N.11/96) FAX ST. CROIX COUNTY ZONING OFFICE 1101 Carmichael Road Hudson, WI 54016 (715) 386 -4680 DATE: fo - 2 2 -.2 WD TO: Fax Number. `f2 5 - Name: FROM: Fax Number. 386 -4686 Name: 6j2 '4 Number of Pages Including Cover Sheet: IF COMPLETE AND LEGIBLE INFORMATION IS NOT RECEIVED, PLEASE CONTACT: NAME: TELEPHONE NUMBER: Wimconsin Labor end Hum Relations use" SOIL AND SITE EVALUATION REPORT Page of Divisi of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x,1111�c a i0ize. Plan must include, but - Ste' not limited to vertical and horizontal reference po in `e r ,tf>�rv�p, ,,� ern and' /4 of.slope, scale or PARCEL I.D. # , dimensioned, north arrow, and location and distoo$ 4o dearest oad. O Z Z _ 10 a 3 - �[ u APPLICANT INFORMATION - PLEASE PRIM All p 0RTION R EWED BY DATE 5 _f_ PROPERTY OWNER: PROPERTY LOCATION � 1 /4,S I T Z-b ,N,R L Pj E or W L t s� 1/4 rvt Z PROPERTY OWNER':S MAILING ADDRESS • LOT # BLOCK # SUBD. NAME OR CSM # N S`r _��` �\���� :; OUNTY � _ CITY, STATE _ ZIP CODE AID E ITY ❑VILLAGE [MOWN ' NEAREST ROAD TZ P11l$ tJI S�I t�" 1 - '- ;3�' � 1 ' 1 L_)1\1AS16)\j el ( New Construction Use [x] Residential / Number of be rooms L i [) AdditiQn to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow boo gpd Recommended design loading rate - bed, gpd /ft 6 trench, gpd/ft Absorption area required \Z-00 bed, ft l Do O trench, ft Maximum design loading rate • S bed, gpd /ft • trench, gpd/ft Recommended infiltration surface elevation(s) °l 2 o It (as referred to site plan benchmark) Additional design/ site considerations QJQ PAIL Ll Parent material L b ZS3 n ULj'tz SP�I CNjTc S H Flood plain elevation, if applicable f-,l A It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESS AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ®S ❑ U E ❑ U ®S ❑ U URE OS ❑ U EI S ®U EIS O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bou iary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed JTrench x #� ;� I b -Z3 .1 p`�.2 31 Z — s i I Z�s� �t w,.�1� �-�, — • S • � � s t t Ztti, sl�k 1- ►�.�i- �S -� Ground - 3 L1 tz 3 /Y — G v- s u S 5 VK) elev. _ Q - $ It (4 $ -110 v3-t R V I( O S9 Depth to limiting factor u f z . a Lici �r .6o1�0 Remarks: Boring # o -Lq uti. ti 3 Lz w Z » Z ty IZ 31L — 2_V4 6 k �S --J -46 Ground L elev. ft 14 (F 2Z 1 S '� tz L Y -).S `I tLS 18 1 s ��-+ �,, ► - �'p NP Depth to limiting fa ctor Remarks: CST Name: - Please Print Phone: Arthur L. We erer 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River_Falls,WI. 54022 ' Signature: � � �_.� 6 Date: � CST Numbe 220 PROPERTYOWNER Lt -DDLZ SOIL DESCRIPTION REPORT Page?- of PARCELI.D.# OZ-Z._ 1 . 03 3 -40 , Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Gr. Sz. Sh. Consistence Roots Qu. Sz. Cont. Color Y Bed ITmrich 2 3 o -ly to�ttZ 31Z — si 1 Z`F vh.'�H cw _ ,s ,� Z lo 'tiZ 3l (o si l 2 vn sbk Ground 3 39 -fig S `12 31 G� ` g p S elev. q 6-9 rt. g -te, Y /(, s C�S� ►M 1 ,s i_.b Depth to , limiting factor 0(� 2, -;V i Remarks: Boring # k•M >,:;� o -ZZ y z / >:«::<::<:� >:�v 3 ulZ -luy l0 `2lZ V / 6 E' elev. i 0 0 -Z ft. i i Depth to limiting factor ? t W4 ` i : Remarks: Boring # 0 L (3 - %z Z — S i 1 Z� s b>z wt �►- el.v i ,> Z 3 Y 311. 3 3y -SZ �.SLirL — �S os9 Ground ; elev. 3� ft. y �/ i Depth to . limiting factor S'Z Remarks: 3oring # u Z.Z 1 b"l lZ 31 Z - S i I Z `F3 b 12 ►�' C �1 • S• 6 Z I u K Vz 316 - s i 7 L s : et ' ,round S lg V S �"'► - .1 j •� 1 ;lev. q - ).y ft. )epth to imiting actor Remarks: __ PROPERTY OWNER �-��� SOIL DESCRIPTION REPORT Page of L� PARCEUD.tt C Z 1033_40 i Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Consistence (Boundary Roots Bed ITmrch o `d 2 9! - S'r Z tin s bFr rn C- • S (� Ground e.ev. G>^ l S U S 9 n� c_ s — • l 8 0 1 6.1 ft, y D -103 lu`12 4/�6 �S U S g Yrr I _ • 5• : 6 Depth to limiting factor Remarks: Boring # - L 3 r Ground elev. ft. Depth to ` limiting factor i Remarks: Boring # Ground elev. ft. Depth to limiting factor i Remarks: 3oring # `r :,:;. )round !lev. ft. )epth to imiting actor Remarks: I _. PLOT PLAN Page y of SCALE 1 "= yl, ' Ll %D" Po LL %LLjG wl 8 P'RtR O " Fo 12 (3tr1k-_VL'S ►000`f � p � J PIT M eza�$ o ° of l i 4 ,3tit. a 6 9 3r �. _- _.Gt�l p 1N S " -fl lR• Li,Uwz:� _ - �_lOb•2..`__G.�_SPl1rz�._Z °[-- f7i3ouE - - - e � C:�•�c,� �0 —� -49 zz , ( 715 ) 425 -ni h5 CST Signature Date Signed Telephone No. CST # Safety and Bulldin' s 2226 ROSE ST LACROSSE WI 54603 -1905 TDD #: (608) 264 -8777 Viscons www.commercestate.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary November 15, 1999 CUST ID No.267341 _ ATTN: Plumbing INSPECTOR �3 WEGERER SOIL TESTING & DESIGN ��"' ° °, "'- - /; ICIPAL CLERK 421 N MAIN ST r ,, TOWN OF KINNICKINNIC PO BOX 74 /4. ",z 179 STATE ROAD 65 RIVER FALLS WI 54022 ' / �� RIVER FALLS WI 54022 -5714 RE: CONDITIONAL APPROVAL" Identification Numbers APPROVAL EXPIRES: 11/15/2001 } Transaction ID No. 274585 SITE: Site ID No. 176873 Site ID: 176873 Please'refer to both identification numbers, ST CROIX County, Town of KINNICKINNIC; T)1V016VE above, in all correspondence with the agency. SE 1/4, NE 1/4, S12, T28N, R18W BILL LIDDLE DIVISION AVE FOR: • Q Description: PIMS coy' ditt Object Type: Sanitary Drain & Vent System Regulated Object ID No.: 636350 1 1 ( Plan Type: New jtA %J C The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes �cP N of sAFE and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The installation of the Sanitary Private Interceptor Main Sewer(s). • This approval does not include the private sewage system. Plans for the private sewage system must be submitted and approved before beginning construction on this project. The following conditions shall be met during construction or installation and prior to occupancy or use: • Provide approved materials, as per s. 84.30, Wis Adm Code. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 11/04/1999 FEE REQUIRED $ 80.00 FEE RECEIVED $ 80.00 HERMAN J DELFOSSE , PLUMBING PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)789-5535, MON - FRI, 7:45 AM - 4:30 PM HDELFOSSE @COMMERCE.STATE.WI.US WiSMART code: 7657 cc: THOMAS L BRAUN, PLUMBING CONSULTANT, (715) 634 -3026, MON. 7:45 -4:30 Page 1 of '2 PRIVATE INTERCEPTOR MAIN SEWER FOR ftl tt� cy-t LPQ A, FUN2 LOCATED IN THE SE - 1 /4 OF THE "Z 1/4 OF SECTION I R lb W, TOWN OF \Z.INN �C�1�N 1e , ST � -1�1X COUNTY, WISCONSIN. INDEX PAGE 1 of 2 TITLE SHEET PAGE Z of 2 PLOT' PLAN - �Wv � � 4119,99 • sAFETr v IV& PREPARED FOR LPL 3q 2 G�E �5, wl S v0 Vz pally )VED COMMERCE r " In BUILDINGS PREPARED BY — 2 WEGER.EF2 E3 C3 S L TEST I NG,, "��`� + �'�� '® AND F.O. BOX 74 421 K. MIX ST. a w N J �J . RIVQ? FFALLS. NI 54022 1 ' eu.s. =� >ar►r, wrs. ZL5 -44 -016; .� _ Ip- JOB N0. g9 -2-86 PLOT PLAN Pa z of z SCALE 1 "= �I % Pc, �L 3LDG wl l�vr�� BoYi Fo)Z owri1`S l., el �� p�Zt� lO a D J �I r v- L 2 • g.5 j f � - �. .Z" o%Z- 6" 8m.ow I I y'pvc 3uLVa,..G S�C I C LL "tom oy j < -U38 �C -'PON _ o ���v C.►� o IL — - I Ct'e`PCt'►c�'25 - -3y :t:NF�t_'n2.q`tUYL ��s`r�l� I �� e a 3` 3' Bt'`_'1 �'I - �,�IAO C1:�_o►J _SPrr� -- __ Z ,b — GIZOIfi�D .1N. _ S" D l� _i tl)Oi1 _V OS_L_. ri . ,. SANITARY PERMIT s % c Y r; , ' COUNTY CJILHR S RENEWAL UNIF N EMIT #!` (PLB 67 -67-T) PERMIT RENEWAL DATE: PERMIT TRANSFER DATE: ORIGINAL PERMIT ISSUANCE DATE: STATE PLAN I.D. NUMBER: PROPERTY LOCATION: CITY: ,T � + N,R l� E (or TOWN OF: LOT NUMBER: BLOCK NUMBER: SUBDIVISION NAME: NEAREST ROAD, LAKE OR LAN MARK: PREVIOUS SANITARY PERMIT HOLDER (IF CHANGED): SANITARY PERMIT TRANSFERRED TO: NAME: SSG ATUR NAME: PHONE NUMBER: d'i (c ADDRESS: PHO E UM ER: ADDRES : cG !! �G.4 /� 1�) '�Y�7 7 � �, s c'c" " C. L 1< r 'r - 1, the undersigned, hereby assume responsibility for installation of the private sewage system that has previously been approved for this property. PLUMBER'S SIGNAT . RE: PREVIOUS PLUMBER'S NAME (IF CHANGED): PLUMBER'S ADDRESS: PREVIOUS PLUMBER'S ADDRESS: P PRSW NUMBER: PHONE NUMBER: MP /MPRSW NUMBER: PHONE NUMBER: 7�'9 ( ;/`1 a 7Cr 31 1 l 1 SIG TI}fJiE OF ISSUING AGENT: D T AP ROVED: DISTRIBUTION: Original - County 11 ice a&ff�d Copy - Bureau of Plumbing Copy - Owner DILHR -SBD -6399 ( /82) Copy - Plumber Safety and Buildings Division Aisconsin ITA PPUCATION 201 ox 7302ngton Avenue Department of Commerce In accord with ILHR x3.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. G o e' • See reverse side for instructions for completing this application State Sanitary Permit Number �S`313, Personal information you provide may be used for secondary purposes E] Check if revision previous app►' ition [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N Z� j gsl� �P Property Owner Name Property Location _Q, 1/4,v1' 1/4, S /;Z T fj' , N. R E (or W Property Owner's Mailing Address Lot Number Block Number l / G i'r:/ a lzo Ot , State Zip Code Phone Number Subdivision Name or CSM Number Vow 12 _Iflaa-3 II. TYPE OF BUILDING: (check one) ❑ State Owned It Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ro w a n O , III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) c..v. 16 / YD 1 ❑ Apartment / Condo d a2- 1 6 33 - , W 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box online B, if applicable) A) 1. jk New 2 ❑ Replacement 3 ❑ Replacement of 4 ❑ Reconnection of 5. C] Repair of an ------ System _ System Tank Only System __ Exlsting System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other` 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 []Holding Tank 12 [.Seepage Trench 22 ❑ In- Ground Pressure / r 42 ❑ Pit Privy 13 ❑ Seepage Pit o � SOD 43 ❑ Vault Privy 14 ❑ System -In -Fill au si, jk�,C✓ = A VI. ABSORPTION SYS EMI FOR TION- ? 1. Gallons Per Day 2. Absorp. Area 3. Abs r Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min_/inch) Elevation 4;do Q f rte.,- 9.4 d Feetl Feet VII TANK in gallon s Total # of r Prefab. Site Fiber Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Exist in structed Tanks Tanks p is Tank or k aZ dd '14d e s Te yy;i/ ® ❑ ❑ ❑ ❑ ❑ Li p Tank /Siphon Chamber I ❑ I ❑ ❑ 1 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signatu e: (No Stamps MPRSW No.: Business Phone Number: - Plumber's Address (Street, City, State, Zip Code): 6 7 C) S r- ® ep 90 .r✓ L.1 `old 1 G IX. COUNTY/ DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit a (Includes Groundwater ate ssue tss Ing gent Signatur (No Stamps) Approved ❑Owner Given Initial `yl °° Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date,.and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a`Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years.. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 - 3151. To be complete and accurate this sanitary permit application must include: (. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or- existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County t Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE ,r. 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. i ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGRBBMBNT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Maiitag, A&1= YS 97 ✓ / '�r �� �/ / l i I/ 1/ Q C L S G✓ (r..�r.�� Property Addrass (Vai icsdac ragcdcod than Plan * Depatt mt for naw cotattucdoaj atymate _____„ ._ Pa ca Ideadfieatlon Number Property Location .,5'�f y, � y Sec. 2 T 2—y. Town of Subdivision Lot # Uertitted Survey Map # volume . age # Wte unq Deed # volume Spec ham 0 yes ELno Lot lima ldaWftable C3 yea 0 3 Iaoparaaea rd YM odduafth, i2a 4 %&=fAl1adew"oee.Pmpecm&"== coodaa of pmm� oat f5e septiotasdcpvagrt5tee y� er s000eq b'aeededby a EOmaed What � pat ftrbo the system cm alga -64 Amon of 66 septic tact =. a or fa as *aeoadi�osat�yeoma. The, pub to eobmit iq St CN& 7AftD=ftV1Wa =loll a fsm, OPM by tlw aw= sad Aw a F1�o�ym:a�lamba� raddoledptm�erac�t lloea�edPmu�rt�it�ng t5al �1) tfre aa,dte �di�poat gaa� b Ia proper open oo�Itioa aaddoc {gj after fttsper�ioa wd pumpiag,(if , the iepdataatc•b I= tlaa In an of dwgL Ywc, do =dwsku"m mddw dw" =qGk==ft ofO m= sad . m tie m:f�c d o � the a�mdatds set AWN bmk set by dim Depaumeataa ddw bQ 6atyaOreyaeml usbaeoauiodedmastbe ofN�Ixeeoaocee ;S�toof�fifoomda.• ati� days' dm *M ya�r axplatioa date. eoa Oedandretumodtofhe St t:roix•Oomly Zoaicag OtSce wi9tin 30 SIGM APPLMANT DATE OR IMM90 oa tit fates am tw N the bast of my (=4 lwwwge. I (we) am (ere) ttm owna(s) of die PWpaW 4mdW abort by vWae of a wasrmty deed tece"M in RgOger of Doe& Offm c \ MONATU E R APPLICANT D D • •ao4i ft infalamatioa that tomb rapreeentedmay result In die udWy,p=Wt bciag t+avo Wd by the Zoning Dopartmam 40R0 ' •• Inelada with this apptleadoa: a stamped wum4ty dood ft M dio RA t' Of Daft oMae a copy of tha certlfted survey map if tdacnco is made In the wammy deed STATE BAR OF WISCONSIN FORM I - 1998 r=;. IL '9 C11 1 X WARRANTY DEED MIrHLtEN fl, IJALSH SfEk OF DEEDS URCII CO., 141 Document Number RECEIVED FOP, RECORD This Deed, made between Viola R. Liddle, 9:30 Am a single person WARRANTY DEED EXEMPT # Grantor, CERT COPY FEE: and William F. Liddle and Penny Lou Liddle, 'OPY FEE: husband and wife as survivorship marital ikANSFER FEE: 420.00 R HE: .0.00 property Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St - Croix - County. State of Wisconsin (the 'Property")! I Recording Area Name and Return Address Part of the Northeast Quarter of the Northeast Quarter (NE 1/4 of NE 1/4),i Edward F. Vlack part of the Southeast Quarter of the Northeast Quarter (SE 1/4 of NE 1/4), Davison & Vlack and part of the Northeast Quarter of the Southeast Quarter (NE 1/4 of 200 E. Elm St. SE 1/4), of Section 12, Township 28 North, Range 18 West, Town of River Falls, WI 54022 Kinnickinnic, St. Croix County, Wisconsin, described as follows: Beginning at the Northeast comer of the Northeast Quarter of the . Northeast Quarter (NE 1/4 of NE 1/4) of Section 12, T28N, RI 8W, 022-1 022-1033-10-000 034-40-000, 022-1033-40-000 thence go SOI 0 4'33"E 2639.89' (recorded as SO0'00'00 "E 2639.86) Parce4 Identification Number (PIN) along the East line of the Northeast Quarter of said Section 12; thence This i q n f homestead property. SO IQ 08'45"E 916.60' (recorded as SOO* 32'1 5"E 913.4 along the Wk (is not) .East line of the Southeast Quarter of said Section 12; thence 'S88 297.17' (recorded as S89*20'46"W 297.23'); thence S44'38'09"W 561.06' (recorded as S45'14'42"W 560.98'); thence S89*35'00"W 635,42' (recorded as N89*48'07"W); thence NOI * 1 1'13"W 1323.1 V along the West line of the Northeast Quarter of the Southeast Quarter (NE 1/4 of SE 1/4) of said Section 12; thence N01 *09'07"W 530.83' along the West line of the Southeast Quarter of the Northeast Quarter (SE 1/4 of NE 1/4) of said Section 12; thence S89*50'44"E 543.75' (recorded as S88'46'50"E 543.74); thence N00 '22'09"W 398.77' (recorded as NOO'42'33"E 398.61% thence N00 394.77' (recorded as N00 '42'33"E 394.63'); thence NOI 0 09'07"W 1322.66; thence S89 784.83' to the point of beginning, containing 90.2 acres, including right-of-way. Together with all appurtenant rights, title and Interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, reservations, and covenants, if any of record, and highway rights of way. Dated this 2 day of February 2000 (SEAL) (SEAL) Viola R. Liddle (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) Viola R. Liddle State of Wisconsin, County. authenti 2000 Personally came before me this day of j� the above named Edward F. Vlack TITLE! MEMBER STATE BAR OF WISCONSIN to (if not, me known to be the person who executed the foregoing authorized by §706.06, Wis. Stats.) instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Edward F. Vlack, Davison & Vlack Notary Public, State of Wisconsin River Falls, WI 54022 M commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) • Names of persons si in any capacit must be t or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Leo 81nk Co., MO. WARRANTY DEED FORM No. I - 1999 W."kiiii. Ws. , Safety and Buildings Division . 1 0 .4 consin SANITARY PERMIT A -k#E N 201 W. Washington Avenue P O Box 7302 ,,,; Department of Commerce In accord with Comm 83.0 ,i0.'AcEm.6o&.1 ! ; Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the s s ~', on of less..; unty than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this ap ion 4t _off Sanitary Permit Number Personal information y ou p rovide m 2 " _- ' 3 5�3 l 33 y p e ay be used for secondary purposes [Privacy Law, s. 15.04 (1) (m)). JA heck rf revision to us application U 1 to Plan LD. N er �/(� s I. APPLICATION INFORMATION - PLEASE PRINT AL RMJIi6N Property Owner Name ro y or r' ��, 1 4, S j T 2 , N, R/?' E (or) 10 Property�0� n s Mailln ess Lot er� Block Number V C $' City, State ; jJ Pa. r e Phone Number Subdivision Nam CSM Number II. TYPE OF 11111111 DIP (check one) State Owned It Nearest Road Public 1 or 2 Family Dwellin - No. ms To. F bedroo ,*,e�/«kr'.vu� G ' III BUILDING USE (If building type is public, check a at apply) Par ax Number(s) f U' � _ 0CP1 1 E] Apartment/ Condo - 2 E] Assembly Hall 6 E] Medical Facility/ rsin OM 10 El utdo Oor Recreational Facility 3 Q Campground 7 E] Merchandise: Sales airs 11 C] Restaurant/ Bar/ Dining 4 E] Church/School 8 E] Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line I Check bo n line B, if applicable) A) 1. (_New 2 Q Replacement 3_ Replacement 4_ Q Reconnection of 5. [] Repair of an _System -------- System __ __Tank Only_____ Existing System -------- Existing System B) ❑ A Sanitary Permit was previously is d. Permit Number Date Issued V. TYPE OF SYSTEM: (Check on / JKMound Non - Pressurized Distribution ized Distribution Ex tal Other 11 ❑ Seepage Bed Type 41 ❑ Holding Tank 12 ❑ Seepage Trench - Ground Pressure / 42 C Pit Privy 13 ❑ Seepage Pit C� 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM j RMATION: 1. Gallons Per Day 2. Abrea 3. Absorp. Area 4. Loading Rate 5. Perc. R 6. System Elev. 7. Final Grade equi. ft.) P oposed (sq. ft.) Is/day/sq. ft.) (Min. /inch Elevation _Dd r v- ��� eet OS• S Feet a acct VII. FORMATION (a nks g Fiber- Exper. Total # of Manufacturer's Name Prefab. Itn steel Gallons Tanks Concrete glass Plastic App w Ex Tanks istIn str ed eptic Tank,� Tenk (j �ap ✓c� ❑ ❑ I ❑ ❑ i umpTank d4 1'is ❑ El El El El VI SPONSIBILIT STATEMENT I, the undersigned, sume responsibility for installation of the onsite sewage system shown on th ttached plans. Plumber's Name: (Print) Plumber's Signature: o tamps) /MPRSW No.: Busin s Phone Number: /.'Q d -c � tx yl !.// ~ Q 7� d / Plumber's Address (Stretate, Zip ode): G- e1 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate I ssued Issui g Agent Signature (No Stamps) Approved I C] Owner Given Initial Surcharge Fee) , Adverse Determination ! G l X. CONDITI NS OF APPROVAL / REASONS FOR DISAPPROVAL: rJ��,L�q; __`cam -c Jr N'� iyt,{{�L r('Y�,ry I��' ?� ✓. G S �.l -5f'. ,Jeri SBD -6398 (R. 4199) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS r 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Arninistrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed"-pumpt%whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. - - ll. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer;_D) cross section of the soil absorption system if required by the County; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 416 included the creation of surcharges (fees) for a number of regulated practices v ich can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. r Safety and Buildings s 2226 ROSE LACROSSE WI 54603 -1905 05 TDD #: (608) 264 -8777 Visconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda I Blanchard, Secretary July 20, 1999 CUST ID No.267341 ATTN. POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 07/20/2001 Identification Numbers Transaction ID No. 236370 SITE: �\ �j'? S ID N o 116873 Site ID: 176873 mss/ re r both identificatior<nuimbers, St. Croix County, Town of Kinnickinnic .��el aV in a eQ espondence with the agency. SE1 /4, NEIA, S12, T28N, R18W 6' Facility: Facility: Bill Liddle Proposed Residence c 9 FOR: Z oNi vG� Ty \ , Description: FourBedroomM ound- System ` PP /CF Object Type: P ysfem Regulated Object ID No.: 86g The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • This approval does not include plans for the general plumbing systems or sewer piping leading to the septic/holding tank that may be required for this project. See section Comm 82.20, Wis. Adm. Code, to determine if plan submittal and approval is required. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 07/12/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)785-9348, Mon - Fri, 7:15 AM - 4:00 PM jswim @commerce.state.wi.us WAMA o R l i Page of 6 MOUND SYSTEM FOR A BEDROOM RESIDENCE LOCATED IN THE SE 1/4 OF THE NE 1/4 OF SECTION V?- ,T Ze N, R 16 W, TOWN OF COUNTY, WISCONSIN. INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT -PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR n �ly • o C 0 itt .. �1 U�Z I LS, i1J I E 4 0 l:z- (ft C 4p�N p1V�S� ENG� GQ � K �SP PREPARED BY WEE FEE EZER , SO I L TEST T NG AND. DES = GN SERV = CE F.O. BOX 74 421 K. KAIK ST. s RIVEF. FALLS. YI 54022 w �q c c GJ!5P 7IS-4L .-4ISJ ELLSNDRTH, WIS. OO ,JUL 1 2 1999 � ETY & D" ^'s DIV, JOB NO. q9 -� PLOT PLAN Page Z-- of � I 'r Scale 1"= SO ' >: fl- fl- W s i ciy"tWCr aR �.ftX 1 / I �tO tc 1C 0 n or z""ric. rz'". ' MIN.I�Zh Sw ttvs'Th�l_ ClkKlvovi`S J w /F1tOS r 3 LL 6 R'Rt R UltiM1 r0%L 4 C1 OwNtsR$ USA I- r1tt l - �• L00.0` ON Ip ° Htftf ' -31'4 PLC WIU", NOTES -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( 7 required) 4. Septic tank to beV I gallon capacity manufactured by W t StM CA)J cVjz:M oOucr_s 5. Bench Marks SEA fk3ove 6. Divert surface water around system to prevent .ponding at the uphill side. Page 3 Of Approved Synthetic Covering F�gTM C 33 Distribution Pipe Medium Sand Topsoil F Elev'. ► k�)q -(3 _J I E D - b `7 % Slope (Force Main Plowed Trench of k"-2k" From Pump Layer Aggregate Undisturbed D 1.p Ft. Soil E \-3S Ft. Cross Section Of A Mound System Using F b,a Ft. I Trench For The Absorption Area G N•a Ft. A S Ft. H I- S Ft. B trop Ft. I NS Ft. Linear Loading Rate= 6.Q) GPD /LN FT J 7 Ft. Design Loading Rate= 0. GPD /SQ FT K \\ Ft. L ZZ Ft. W Z Ft. L Force B K Mai� A - - - - -_— _ -- _ __ � S T W OPPus ►`iF Distribution Trench Of 2 - 2 2 ��►D Pipe Aggregate Permanent Markers Observation Markers Pipes (Anchor securely) Mound Using I Trench For Absorption Area Page L ) Of .� Perforated Pipe Detoll 0 End View Perforated End Cop.) �\cy" PVC Pipe once Install permanent at end of each lateral Holes Located On Bottom. Are Equally Spaced Q End Cap P �1. * S PVC Force Main DiSlrioution Pipe Lost Hole Should Be Next To End Cop Distribution Pipe Layout P y X qZ Inches Y 4Z Inches Hole Diameter � Inch Lateral 1 l i Z Inch (es ) Force Main Z Inches # of holes /pipe t4 Invert Elevation of Laterals -5 Ft. R � Place lst hole Zt from tee with succeeding holes at �Z intervals. Last hole to be next to the end cap. �I Combination c�Llu PUMP CHAMBER, CROSS SECTIOU AND SPECIFICATIONS PAGE S OF to -VET CAP WEATHER PROOF JUIJCTIOIJ 80X 'i'C.I. VENT PIPE APPROVED LOCKING lO' FROM ODOR, MAWHOLE COVER Pk- •.iIN00W OR FRESH wARIafIJ6 l.Pt6El.. ALP, IWTAKE cor�pu>tT tj b"MIN. I `, MIW. 18' Mlu. - 11� y�IiJSPtcTlo►J PIpie PROVIDE I – --- . IIJLET - TAIRTIGHT SEAL I III 1 II APPROVED JOIWT �AFF��S A I I I I APPROVED JOIWT: w /C. PIPF.OR Tank construction I III WIC I � PiPE� c I I I ALARM shall comply with "I I ILHI ('13.15 and 33.20 a I I I 1 I oIJ C I I $�.b 7 E. LCV. FL PuMP,_ -'� . OFF D COAICRETE BLOCK 3" XPPRo,; RISER EXIT PERMITTED OIJLJ IF TAWK MAUIJFACTURC.R HAS SUCH APPROVAL BEDDINr* SEPTIC f SPEGIFICATIDKJS DOSE " Ca�� P 20 y vQC4S WUMbER OF DOSES: -3-69 T AIJK MAIJUFACTURCR: PER D" TAWK :,IZC: `200 1-7SO &ALLOWS DOSE VOLUME r S. . �" - L�`rR0 S`iS"T}IS IMCLUDIIJ 5ACKFLOW: `a GALLONS ALARM MAIJUFACTURCR: — MODEL ►DUMBER: tb� �� CAPACITIES: A= Z S IIJCHESOK GALLONS SWITCH TtJPC: Y 5 = IIJCHES OR 3 � G( LLOUS PUMP MAIJUFACTURCK: C= ` INCHESOR 1a3 GALLONS MODEL LIUMBEK' 33 D= $ INCHES OR �Zq'� GALLONS SWITCH TYPE: 1uR M OTE: PUMP AM ALA RM ARE TOO 5L Z MINIMUM DISCHARGE RATE 3z.�� GPM IN5TALLED ON SEP CIRCUITS VERTICAL DIFFERENCE DETWEEU PUMP OFF AIJO..015TRIBUTIOU PIPE.. Ib'83 FEET t titim tUM METWORK SUPPLY PRESSURE 2.Sp FRET z. by F L . y tQP F E E T OF FORCE MAIN X YOfT_FRICTIOU FACTOR.. b FEET _ . TOTAL DtIUXMIC HEAD = 23 .4 p FEET Pump chamber DIAMETER IIJTERWAL. DIMEWSIOLI� OF TAWK: LEAIGTH ;WIDTH ;LIQUID DEPTH BOTTOM AREA - 231= GAL /INCH AS PER MANUFACTURER GAL /INCH ME Series MYM. 1/3 through 1 -1/2 HP Effluent Pumps Performance Curve CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 400 450 100 90 28 80 M 24 07 70 W W O� 20 LL 60 Z Z Q 50 MSS 115 W W = = J J Q 40. M�SO 12 O O H "'., 30 ZI 2 ,1 e 20 3 4 10 z..�6 0 O 0 10 20 30 40 50 60 70 80 90 100 110 120 130 CAPACITY GALLONS PER MINUTE M"Is e • 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3327 8192 Printed in U.S.A. Safety and Buildings `•: 2226 ROSE ST LA CROSSE WI 54603 -1905 _ sconsin TDD #: (608) 264 -8777 www.commerce.state.wi.us i Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary July 13, 1999 CUST ID No.267341 ATTN.• Plumbing INSPECTOR WEGERER SOIL TESTING & DESIGN MUNICIPAL CLERK 421 N MAIN ST TOWN OF KINNICKINNIC PO BOX 74 179 STATE ROAD 65 RIVER FALLS WI 54022 RIVER FALLS WI 54022 -5714 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 07/13/2001 Identification Numbers Transaction ID No. 236357 SITE: Site ID No. 176873 Site ID: 176873 Please refer to both identification numbers, ST CROIX County, Town of KINNICKINNIC above, in all correspondence with the agency._ SE 1/4, NE 1/4, S12, T28N, RI 8W Facility: BILL LIDDLE FOR: _._ Con ,, Descri ion: PIMS Object amtary Drain & Vent System Regulated Object ID No.: 480653 Plan Type: New 1AE FpA The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes qV S and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The installation of the Sanitary Private Interceptor Main Sewer(s). • This approval does not include the private sewage system. Plans for the private sewage system must be submitted and approved before beginning construction on this project. The following conditions shall be met during construction or installation and prior to occupancy or use: • Provide approved materials, as per s. 84.30, Wis Adm Code. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 07/12/1999 FEE REQUIRED $ 80.00 • FEE RECEIVED $ 80.00 HERMAN J DELFOSSE , PLUMBING PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)789-5535, MON - FRI, 7:45 AM - 4:30 PM HDELFOSSE @COMMERCE.STATE.WI.US WiM0090 cc: THOMAS L BRAUN, PLUMBING CONSULTANT, (715) 634 -3026, MON. 7:45 -4:30 ' Page 1 of '2 PRIVATE INTERCEPTOR MAIN SEWER FOR titJ LOCATED IN THE SIF 1/4 OF THE ML /4 OF SECTION 1 Z ,T 2.8 N, R W, TOWN OF COUNTY, WISCONSIN. INDEX PAGE 1 of 2 TITLE SHEET PAGE 2 of 2 PLOT PLAN PREPARED FOR 3lCl_. _ L�DD LE 1 X139 ST��L� �z�� lionally tOVED NT OF COMMERCE .AFETY % BUILDINGS PREPARED BY JRRES ONDENCE ®Cml03 L•.lEGEE�EE� SO I L- TE =BT = hiG � ®�C®Ns5 AND. �• .••.»..».... .'�i ARTHUR L F.O. BOX 74 421 K. KAIK ST. W D -915 P BUSWOHTH, RIVET FALLS. VI 54021 f Wis 7L5-425-010 '� G R ECEI V ED �SIGNE � J UL 12 1999 S 3 -`il "Ty & Cl!i""s DIV. 5 -Trim *T _ 9_�� PLOT PLIU4 Page Z— of scale 1"= SO The plumbing for this project uses an existing private sewage treatment system. Prior b the start of any ' Construction A review of that system is required to deter*** that it complies with current standards and �sy that it wil not be adverse affected ly ected by the proposed construction. cs 41 x - lllV S ^ t'Z lA1° i N � O aR �FO�� • l9A'OF Z r - ,", 'ys'aF v 3 4 PLC Hri1�l S'v _ 7 ltis'M�.L. CU�K1vou� -. J 2 Far% G EV4 eWN L. ""I"MI JU 6 � A"M �btiK wiz �- �wNL FIh) t 1!4 c4z�G� !: p2�D�e cti� y''�vC`wkF" f—t -03T Vie;'"M -T X5`7 ,� . �KR�+.Fa Sin :� i I WisconsinDeparunentofIndustry SOIL AND S EVALUATION REPORT Page of 3 Labor and Human Relations Divs!ar'srSafety & Buildings in accord with ILHR 83.05, Wi Adm. Code . 0. COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but- not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. o Z Z - L C3 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R DBY DATE U PROPERTY OWNER: V L O L R L.VD'D Lam, PROPERTY LOCATION '6Q $1� L Ll OA L 4AVFtt� S E 1/4 Ne- 1/4,S l Z T Ze ,N,R S E (or@W PROPERTY OWNER'.S MAILING ADDRESS. LOT # BLOCK # SUBD. NAME OR CSM # Lx-4.Y STS u_ t�o�z . - CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®TOWN M)w AREST ROAD CZw 1z tS �V 5 �� CZtS) €�63 tQv' \\Z kl , - I i�1 N 1.0 (� New Construction Use QQ Residential / Number of bedrooms [ ] AdditiQn to existing building j ] Replacement [ ] Public or commercial describe Code derived dairy flow b(�-D gpd Recommended design loading rate - bed, gpd /ft - 3 trench, gpW Absorption area required SM - bed, ft S O V trench, ft Maftum design loading rate ' S bed, gpd/ft - �- trench, gpdt t Recommended infiltration surface elevation(s) l Z yq -O It (as referred to site plan benchmark) Additional design / site considerations llWj ►vb W l `iv-s�� c�j . V Uk.) . \ Z" ovu S F-i LL Parent material Flood plain elevation, if applicable M f . It S = Suitable for system CONVENTIONAL I MOUND "ROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem 1 11 S [at 19S ❑ U ❑ S ®.0 ❑ S (aU [IS O U EIS ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rfierd ` - s - 1 Z �o -zq to�tcz 31to - sit i'Fs�k cS - Ground 3 Za 3 -S IZ 31y � S� v �►- - _ 3 , y elev. lz o.(3 fL 3 w 1z_L ��JCt 1/u jrn Depth to fit ANI limiting factor L(01 `' GROW � �0 Remarks: Boring # O —�.0 tib`'l,tZ- 3 l Z � SL1 Z`��� m`�+- CS �.`� • S .� 3 3- i •S `�t 3 l y -) .s Li YL S A, U - f 1 - Ground elev. %W3 ft Depth to limiting factor 4 Remarks: T Name. Please Print Phone: Arthur L. We erer 715 425 - 0165 to %rer Soil Testing & Design Service- P.O... Box 74 River .Falls,WI 54022 Sgnature: Date: CST Number:.: 220254 PROPERTY OWNER ��DL.E. SOIL DESCRIPTION REPORT Page_bf 3 PARCEL I.D. # C> ZZ — L O 3 3 — 4 d . Boring Horizon Depth Dominant Color Mottles Structure in. Munsell Qu. Sz. Cont. Color Texture ure Consistence Boundary Roots GPD /ft w} Gr. Sz. Sh. Bed Trench 3 0 -LO L�tiVz Li sL1 9�- »Z ►� CS ti � 5 `'''� � S • S . l Ground 3 31 - 1 4-9 Z -S `ttZ3ly �-1•T yR.s /g % 1 oVV yn 1� C - S 3 '� elev. \ off, -S ft. q9 -6D Lt -L, L w z �� .S �f 2 sib is o4 v Depth to 3 S Er 1V o ts5 3 f� $ limiting fact�or`, y LSTS �, � ?��1 cY✓ - • W� 1r�..s,.. e Remarks: Boring # Ground elev. 1 ft. Depth to limiting factor Remarks: Boring # i f ; Ground elev.� ft. Depth to , limiting factor i 1 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: _ Inn nonnin nc Inn\ PLOT PLAN Pa 3 of 3 SCALE 1 "= 50 ' -guy s Loy N � cbm ALT aR bj� � O�`'h1LSR -S USA y��Z — CC.. ��n• U1 1.l p� K r 1 k a • 11 j `tq ( 715 ) 42A -0165 14 00576 CST Signature Date Signed Telephone No. CST # WimcomsnoepartmentofIndustry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Division of Safety & Buildrgs in aCCQfBd,!Vith (LHR 83.05, Wis. Adm. Code COUNTY ,Attach complete site plan on paper not less than 81/2 z 11 inches in size. Plan must include, but- ST -- not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. C:�' 2 z — I APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION REVIEWED BY DATE . PROPERTY OWNER: \3 O LVpD Lam, PROPERTY LOCATION ' = 81 L10P 40VE 6T 'S E' 1/4 W 1 /4,S 12T ZS ,N,R 8 E(or@ PROPERTY OWNERS MAILING ADDRESS . LOT # FK # SUBD. NAME OR CSM # _ l �I.3 STS L� �2 . -- CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE ®TOWN NEAREST ROAD CL1U �1� FPfLLS U 5 �ozz h1S)4 � 'N — _ttv� �C �ir,ll�l tiLC . ��v lsto►� 1�Vt�. K New Construction Use M Residential / Number of bedrooms [ j Addition to existing building Replacement [ j Public or commercial describe - Code derived daily flow 6oD gpd Recommended design loading rate — bed, gpd1ft • trench, gpolft Absorption area required SM bed, ft S Ott trench, ft W)dmum design loading rate ' S bed, gpd/ft • trench, gpd1(t Recommended infiltration surface elevation(s) t py..0 ft (as referred to site plan benchmark) Additional design / site considerations M nu h-AD wl S' xVo r,' 1Vtau cty . Meru . Z` o T= St F t LL , Parent material UN UU. � 70_L— Flood plain elevation, if applicable tv fj . ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL. HOLDING TANK U = Unsuitable fors stem [I S (RU cg S C1 U O S au ❑ S ®.0 ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouxiary Roots GPD /ft +. in. Munsell Qu. Sz. Cons Color Gr. Sz. Sh. Bed rRench Ground 3 29 -� 3 - z . S K tZ 31 }c .S'` R 5�4� S� OWN elev. 1o fl.0 R EK� )Au Depth to lintiling lit Remarks: Boring # n j -�0 tib` lR- 3 lz SO r to -1 fZ_ 3 1f. _ si 1 3Nk y -y- cS - •S 6 j S LiR 5A, ht U` I,- Ground elev. 3 S E ti \3 t %1_o ft. Depth to imifing faC�tOr ti - -Remarks: TName— Please Print Pine' Arthur L. We erer 715- 425 -0165 . ,eg rer Soil Testing & Design Service- P.O.. .Box 74 River.Falls,WI 54022 Sgnature: Date: CST Number: vi= i/ti� 9`� -`� 5 -1- -419 220254 f PROPERTY OWNER SOIL DESCRIPTION REPORT Page Z'bf " PARCEL 1.1). # a _Z — L p 3 3 b Boring # Horizon Depth Dominant Color Mottles Structure in. Munsell Qu. Sz. Cont. Color Texture Consistence Bourtd ry Roots G P D /ft Gr. Sz. Sh. tp Bed Tn� 1 `t rZ 3 L 2 — s L 1 Z - 7- v►1 ►^ Ground 3 3 - q9 Z •S `t tL 3 I y elev. �-D , y R 1p •S ft. (l9 •S �t 2 S1 TS O►+� �,,V �I- • �` `-5 Depth to 3 S limiting 3 1 � _ rZ1 I factor ,� y 2 �S`1 S l��.r � ��� ty✓ -- W �r=.s.. �o Remarks: Boring # <z"�? { Ground f elev. ft. Depth to limiting factor r a Remarks: Boring # Ground ^` ' elev. +f K ax ft. AM Depth to limiting factor " x Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: _ inn oo�inrfl .�� PLOT P L-AN Pa 3 of 3 SCALE 1 "= 50 ' ,g' v� GgJ'C 3.3 / ex N � � � � � / O�'R► a r �R�ry 1 B.I � f wQo' r 1 j) • 2 �7 iJ � 7 Jim �4- P J � a n'tZt t2c�ow �vr2 �' NO'fLS �, I � M0 ON 1 "E+lGlf, 3 /c� PVC PIPS c 1Ary j}} i I � i I ` "�� S ' �_ c1 q t 71s 425-0165 I4 00576 CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buycr �ld`G Mailing Address 5 - / S� 1,Val l 4��s Property Address �` v a < z (Verification rcquir+cd from Planning Department for new consttuetioa) QVIState Parcel Identification Number LEGAL DESCRIPTION Property Location 54 Y4 Scc. ,1 � ? N -R�ff W, Town of _ if r),y �f • ` v v: ' G W /'�:fi , C.:� �a .i � , �.�, 1��/ Subdivision Lot # Cer ffied SmTey Map # Volume . Page # Wamaty Deed Volume 3 9l . Page # Spec house ❑ yes M no Lot fins identifiable ❑ yes JJK no YSZEM MARM - I � Cn p aasc:ad �y , ��o�1,dz�tmitsp . � .. � - tohandlewastGS.Froper consists of punwiag oat dc sgztic U* curry tie y� w oc woad if waded by 9 fi=sedp=per_ Wbit ym pat.imto the system can; affect&C fumctioa of &e septic U*a a frcatment stage m Su viaste .4stcm„ Tbe. FOP owner agana to scrbmit to St Croix Zoning Dcpartmcat iL cmff=lioa foam, signed by 8re owner and fir. a sterp 7 omaicYmaaplumlxr; tcstdctcdplumtbcrorabo= sodpampertraifying dit( I)&Coaaitcwastcwatordisposdsystc& is in. P b oaand ( or( 2 ) afterinspoctioz< mdpnmpiagCif ),¢=scpti,ctmk.isless than Wfall ofsludge. Uwe, the =dcrskucdlmt fund the above rogaiacuments and sg= to maiauin Su private sewage disposal system wiftt the s scl fob, law kvs sd by the ofoon= and fire DVut ned of Isaturxl Rmourom State of Wiwonsia.. Omocation 6 tatn 2 9 t6at You uPtic Systn bas ban maintained must be eomplctod and r+ctamed to to St.'Croix County Zoning Oice within 30 days of the d= year exp4atioa date, i' -- SIGNATU OF APPLICANT DATE OWNER CE 1 CNITON I (we) ectizfy that all sUkmeats on tbis form are true to flu best of my (Our) lmowledge. I (we) am (arc) the owacr(s) of PmPCdY 46 above, by virtue of a wuaaaty flood =oor&d in Register of Dads Office, SIGNATURE OF APPUC.ANT DATE «era « «s Avy infoamation that is mis-ctipatxcatcd may trsalt is the sanitary Permit being rovoked by the Zoning Depaatrnent. 00"" " Indnde with this APPlieatfon: a cumpcd w=aaty doed Emm the Register of Dads office a copy of the catifaod survey map if mfercnec is made in the warranty dcod WARRANTY DEED. - -To Husband and Wile as -rolnt Tenants FORM 399 (Revised) 2'71190 This Indenture, >�I this 27 day of _December - -_ in rile �rar of our Lord, one thousand nine hundred and _ sixty two- between .FTed -eri.c A - M:)" - . end -13- tty -- Manz. - husband- .a,nd._wif< <; .arid W liaai _L. Most a_singl - man, - part lcs of the first Bart, and _. Vern .P _ -. Lddle and Viola R. Liddle , - of ST. Croix _County, Wisconsin husband and n if,, as joint tenants, parties of the Second part. Witnesseth, "That the Said part ies of the lust Dart, for arld in consideration of the SLIM of - -- Forty Seven Thousand I'ivc 1lundr(,d ( $47,500,00) - - - -- to thCn] in 11:11),1 pail) by tit(- sail) parti,; ,I( th" „"'mill p, lit, the rcecipt tch(reof is hcrchv confesse,I ;(n,4 ackno(cle(I c,l, ha VC ljven, grantcd, h,11L�.linell, —M, relui ,crl, rl•le;l,e�l, .Iliencrl. nn�e�crl 111d cortlirmcd, and h% these , lu�i�c. r,u1i, h,lmain, sell, nnli"• . i(1,.1 <,•, ,(lien, (uncc� :Intl contirEn until the s.1id part lc; of t)te srcond pert, .1, joint tcnult�, rile follo(cin 6"f rihed re.11 e�U(fe, situ.itc,l in the ('ount�' of St, GrOiX ut,l State , :f v�iseon�in, tl, (� 11 f i'ho East Ono ilalt (E 1/2) of thl %'orthc(ist Qtt��rt��t .(,�C li4) the North -, o: ;t Quert(�r ( NE 1/ 1) of tho Soutl:� ;,t Ouoft�21 (SE I /zl), Soctior, Fwclve (12), Township Twenty Ei (jilt (2t1) orth, I:<�n�tc hi�lht�� W:!) W- st. Thy Northw,.st C�uattor (i �l is �]) •)nci ti�,� Nurth t),).� ti�31f (w 1i 2) of tip; Southwost Quart -1 (S \ ^: 1/ 1) (,f ;' , ctio;l (Y), Tow tllship `I'wr"r;ty Eight (2(;) Nortl:, I2�)u,, S ,n h7) .. t, ! f 6 r { I!1 Eli �i lh� h t,rlitlinl1 1111 ,I, � .�.t. n,ln, ill, r, I;nr�l I el�ni nr� .•I in .Ins (,i"• I 1, , tl� I t (lilt),~ ;ut :111 (!u � _(,Ile, li,;lit. tir!c, iutelc � (Clint � r �I�III nil , ' .,I I�,� ti, •wl III(' of the lint tint tither to I:t(. ure��uil - ,itLcr in pu�e�. ion or,l l r,lilr�. ,( I,rt ,.111d their hl 71 lh!,. n)ettts and , Eppurt( n:11u e -. To have and to hold t}�r s,til{ i -. , III th hll �ht,n I 1 . rn , It1�nErten.ulle�, ,;nt�l till• Said pantie, of the scconr! t,,u't, asjoint tcnaut�. i l i And the said Frederick 1\. Most and Betty Most, husband and wife; and William L. Most, a single man, hart ics (,f th" 1 -1 fur thCir lu�ir,, cvecli "lid admini'h.ttor,. (if with Iiw • lrutir•> ,�t thf c o' I f',..In�l t , auui kith Cllr -nr%ivor of them, hi, „r her heir, au(l .f <,i n;, that apt ilo 11il the cn I 111 ry l!u "l. I ,, I )% �lt .cll �ei he 1 1 -1- �i��_f iil����l, .i•; of i ::uin!, .� „� I�,f�r' :,;, „iui,� :rill i;ri�����.i,il�l� � -.; it�� .,f iiih�'ri� :uin� in the Li',� in I�� -i, i„'��. �n ;i; t thf •- ur.��.iu' fa. nt�l r'.�i 1� :�n� .�li ins in ,n�.<�- l�h.ue�cr, ��� :111d that (hc ahocc h;lr d lrr( in the yfWl anti l—accahlc of the said parties of the ,c(— p:,[t, :t, joint tenants, hi, or hf•r h( if anal a�,si�n >, .�� :fin -t all soul cvcl lwrsoll o;” 1)etsoti, Lmfullr clainlin ;; the h, ins jcu"t thereof, they gill forge: W.ARR.AV"I' AM) I)EFFIND. I In NNilness Whereof, thc ,.ild i f,f the (n,t !fart ha ve hereunto set their h„n�i nt�l sc :tf S thi- Z 7th d „f Dec(mihr A. 1 ).. 1 q tiitnt,l, tic :llf -d anal Iicl',(-I •-J .n Fr��dc�r1( i� Most i' l - Bc'tty_ N!0st johii Vv . Daviso J��anettc ]ca3s(,n � nh wI`;(;msiNi, P iercl, t'owl I v Personatlk calms' Leforc rill., thl- ?7th riat of _.------ Dcccm}aar A. D., 1) 6), f1w aho"c rnalrnetl Frederic A. Most and Betty Most, husband and wife; and Wilhair. L. %lost, a single man, I , ir, file knlMn to I the l,f 1 1 nf s echo c.Nf•( if T hy• foretinin,c in�truincnt and ackjim� lcrl,Qefl the saline. >.` JJ v John X. Davison THIS INSTRUMM - - -- - - - -- --� -- 1 � �- 1) RC; - "C1) a 0 1 " Pierce JO HN ` v ' i�.��r'.'3�td Notary I'ul,hc, �( ATTCRt;EY AT LAW S l RWfR f4,US, WISCONSIN 1lv ( ;Section 54.51 (1) of Nu Wisconsin Statutes provides that all plainly y Drintcd or Instruments to be recorded shall have derma rl �'nt . [, ewr. thereto the names of the grantors, ¢,rantees, wltnc -t —.4 and notary! G C' U p W / I, G CL toI di Ci N � i ry tn: v G 0 C i w f i 1'