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HomeMy WebLinkAbout022-1077-10-000 (2) 0(D 0 N0 ', 3d c tv �1 1 fD �1 mI m z C C \ 1 rf 3 C x _ O n d O a z ° -4 f n - d N 4 i O fD j V N ° o z a c� N p a c°o y `cn 0 a. c A • N C O C C y 1 N N n CD 7 O W N O� N Q 7 01 7 c .Z 7 j Q 7 f0 n A aCDc m ° CD C m lc°nc � c ° CD �mb � o o _ _ o _ �i ° y o w n° O c c cn < D �a °c rn z D a o f co CD w a ° m co D �' a :3 C m W m W CL CL 0 N 3 3 O O f OZ o c0 " Z O NO I n r vl rnrn� ° rnrnz y O Q CD ° z O O O N z 000 JE :3. � 3 cr CD cn O O 0 N I ' O O O N 1 p N m 3 d N 3 Im °A' W I CL 7 p 7 W M .. N z z z z 3 z z 9 o D D o I D D o { O O O S O. ° m ° m �• I I CD C . c { W W n Z m Z m -1 Cl) o 0 A Z z 0 N W C W m m c" M CD I CD � � z m � OD O A W W m, 9 �m m a a v o a _.° - 7 . —m _ R 7 D n m 7 T 7 �C m CL CL a CD C _. : _ CD CD 0 �oNa CD m ID° 0.0 o °• v U ° o - :3 o Et O N m N C 0 f0 . A m — o m e Q x CD m o m m 0 j K CD rn -p <. vi 5. a- 2 4 CD O O (D en C N _. 7 •O =r N N CD rm rn o" CD ;:W r- m 7 O CD O< O n °. ti K D m °.> m °a= ,co mad =w o n m o CD m a o w a N °` I I O O tv b CD m Dro a { o 0 0 10 ■ n @ g c • 2 � 6 c o Iƒ 0 °) E $% 2 a§ E o, Q M _ z E a w D / o CD E / m ; ; ) § § e n 2 . 0 2 CD ( ° 0 0 o § 0 > > = R ƒ i c 2 o o � k � �/i � z 0 7 § o cr CD T V .0 mn E . 0 0 0 £ •• . § ƒ § CO) § \ . K > \ 7 0 i G 0 � .. 0 > 2 0 \ 7 / � k = E m k d - � j 7 CL § R w T m 2 -4 0 CD CL ° M � j k %x U) CL x(( }2ƒ § ��+2£ \ CD 0 0 % � k\ / {� $ A c(D , m cn E lzi CK . ƒ ]o £ }EE t 3 ,EE q ±m CL 0 CL CD ■ 0 < § . f ? ~ . E n � 2 . � Wi6consin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix � Safety and Building Division INSPECTION REPORT Sanitary Permit No: 104 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: LeQue, Roger I Kinnickinnic, Town of 022- 1077 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 27.28.18.P429C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic g Benchmark Dosing Alt. BM Aeration � n - _ Bldg. Sewer Holding `1 f St/Ht Inlet St/Ht Outlet • f TANK SETBACK INFORMATION --tF1 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , N Dt Bottom Dosing 7 AJ Header /Man. Aeration } 35 32 3 Z ! Dist. Pipe of ' Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Fricti Loss Syste ad TDH Ft t • t z$ It/ A. Forcemain Length Dist. to Well f j�p � -� • -S� I � 2.9/0 SOIL ABSORPTION SYSTEM BEDITRENCH WidthLength No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/ BLD ELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of Syst • CHAMBER OR UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold IDistribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing 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 Center Bed/Trench Edges Topsoil 0 Yes 2 No [R Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 �r Inspection Location: 131 County Road JJ River Falls, WI 54022 (NE 1/4 SE 1/4 27 T28N R1 Pa 1.) Alt BM Description = ' " - - 4 s � 41 rliJ 2.) Bldg sewer length - amount of cover = 3. �Co tour = • IL l Plan revision Required? ❑ Yes XNo Use other side for additional information. f _ SBD -671 (R.3/97 a Date Insepctor's Signature Cert. No. r 0 r- � c1 = O C D K Z m 0 O m O �l m �' V x O o _0 W -� 6� m y d m 0 CD f1 m n < o S r '! m m n o 0 T r 0 c� o y 00 c r — - W m z 0 n m N �D z o C z N O W 0 M v, ;Um c c 0 ` C/) -n Z ;u o CD 0 0 zz z 21 O Z m 0 Z m �v m m E a 3 3- ma �� m m o m a CI- - < CD =Z �= 3� 3 my (` W �c n"° mm O0�' a�m o� g O m m m * �' mm ?_ �� I� O �� W� °-'O m m ma°' p << '�o fD C N ? flj Oy !f X X y j N n .0 00 n `Z n m N , y V � Ot D ;= d � m _ C 9 D d mD �dm y 3 m a vm a Q CL w mom o m Z n 0 0 m Zr Z N c 'DO m mom a D D� C m CA 0 CD Z Z +n Z i N_ �_ 0 0 3 7 5 7 r 12E��iNR , Mlt TINAV& Safety and Buildings Division County 201 W. Washington Ave., P.O. B 7 N Visea►nshi Madison, WI 53707 — 71 San Permit N (to be filled in by Co.) f C Dep artment o C (608) 266 -31 ST ���? C O D Sanitary Permit A PP lieatio State Plan LE( Number . - ff�� In accord with Comm 83.21, Wis. Adm. Code, t�� ! information y e �� O / —7 U / may be used for secondary purposes Privacy Law, sl5.t14(lX Project Address (if different bunt mailing address) I. Application Information — Please Print All Information GEX S� Property Owner's Name Parcel # Lot # Block # Q 6a If AhV �(�� S 2 _ 40 , 7- 41 - Property Owner's Mailing Address CO VN Property Locati n 3/ O Y 12P • T -T N� s� a� �� City, State '�+ '�, Section 1 q ) f //� W �• s �0 Z Pho / r 2- `u le 02 / T (circ N; R 1 E t IL Type of Building (check all that apply) K1 or 2 Family Dwelling — Number ofB Qm S_ L M o LGV y PP 1 lj CSMNumber Q Puhli_ rr' nmtr� mial rL 7 1 L r E' 1 2S . l / 1 /40 /- S , ❑city ❑Villagekownship of K1W"1 ri 1 AJ1 III. Type of Permit- (Check only one box on line A. Complete line B if applicable) A. ❑ New System ❑ Sys g Replacement Only her Modi Otfication Sy Replacement Gem ❑ Treatment/Holding Tank SEA ` ,io EwshnS A ys� r • B. [I Permit Renewal _ ❑ Permit Revision ❑ Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration' Plumber . Owner l - 7 Q 222 IV. Type of POWTS System Ch all that appl ❑ Non — Pressurized In -Ground ound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wedand ❑ Pressurized In- Ground ❑ Holding Tank I ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chambq ❑ Drip lane ❑ Gravel -less Pipe Q9Jher (explain) V. Dis ersalfTreatmeat Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass Tanks g Tanks �.y,�� se w T 10 (JU X icTreatment 'V. S ., Ewing Chamber �J gO VII. Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. _Pludiibees Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Plumber's Address (Street, City, Stale, Zip Code �• /� d (� Z' / Z. Lt��J . Sal VIII. nn /De artment Use Onl ppioved ❑ Disapproved Y Permit Fee ludes Groundwater Issued uing Agen Signature S ) Surcharge Fee) �dQ / t7Z/ -7/ D ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and uc L'tLj �� Qytrt, 7�`' dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained _ 1 as per applicable code /ordinances. Attach complete plans (to the County only or the aye on paper not less than SW a 11 inches in size SBD -6398 (R. 01/03) J le O 4 q ' 7v /V�w wing, M & F t P L ' ` ` 18'° -I gp oo 1 0 p p M4 fy ATE',e 18 1 Sc�Q. y0 h � y t prz C lv rR 7 ,4r E - n X/�v, /OO. 6 �aw fie I To .e�� aF a�id�►1'E �t'1> . (NO. GD GivE 1 M00AJP CEAh /7AV-111 - /0 9. /y Hof E 160/ pops �� Rig / " �A� /s c/ y , f �^ P!f fl ,c�OGk f ;TOTE APP�ov�D ' S44-P- /i OM 'fit 0lkX t�% f . E S of .SAS" trF, kf /G . D pil HOMESITE SEPTIC PLUMBING CO. 7 � j C /J RT. 3 O'NEIL RD., HUDSON MS. 54016 /Q Q Q ROBERT ULBRICK OR& MASTER PLUMBER Lit MINN. INSTALLER & DESIGNER O C. 33 O. 0060 LBRICHT & ASSOCIATES CO. 281210th Ave. • Spring Valley, Wl 54767 Reg. Designers of Engineering Systems Private Sewage Consultants 715- 772 -3442 PROJECT INDEX PLAN ID # DATE 2 - 7 0 - OWNER RoSck -4 �AAjAj 1 -0 00 C7 PHONE 7j5• / 'XS • x I ADDRESS 131 Cly RP cT T 1 V E2 f/fll LEGAL DESCRIPTION GO 7 C- M ,3��3�'/ ��� .S' ! 3S 3 N4 56;. • 21. n iy W . TOWN OF /li,vwi �'w.vl G COUNTY ST. CRor' ), CS TM • 'u l.t3 R t GGtT f J LOCAL AUTHORITY/ SUPERVISION S'? C 201 G1' ZO , J 1 AJ G-- PROJECT DESCRIPTION: Cl •�f S oV S yST��M t�JAS ( u -4 R y 74 1 l EO 070 h AND di SlF'��+ e %� Fwd, ob f G�¢ r�jp ,4190 CoOE_ COMP Ii A NT TORM - 21 n c1 �N 0 rs 'l"'u' f° R . f a't G) 6A A5 i lu G.. )V c � Fs s + o A p D t �6: X i ST fAXp-- -5epTtc T' 04 Pom � z W5 fi•G7� W10% + �- ZkOEFIC A. aoo Fi'LT� A'u � Lero 1AP,S9/'/4 IflAr 4PP12a E'D " u �}�rrTf ©N D��'lE', �� � p��, � %dv.¢ �/� • DAR r c o v �,e so vdf , Slbt DF Iiov cep ye p�ery 7' &i f1V&-.0T /egiM�e 6wpos -kr) iA) s po -t5 4e_.r 11W' aL'tA y4&'1;PF_S Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, Wl 54767 M R S 'ZZCe 3? s Pg.l INFILTRATOR SIZING WORKSHEET t Pg.2 SYSTEM PLOT PLAN Z 0 P9.3 CROSS SECTION OF 'SYSTEM, WITH ELEVATIONS. Pg.4 It It It H of P9.5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS P1.5 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG•7 (OPTIONAL) PUMP PERFORMANCE SPECS. The attached plans and specifications are based on "In- Ground Absorption Component Manual For Private Onsite Wastewater Troai -mon+. Cucfeame n (vorei nn 7 - n) fiRn -1 n 75 —p(wn1 /n1 _ w Ei► E ie eve O y �pME ' g &ODf awoob AaecA To A91? Al> -uj pn .h oa, D M&L Ig'y ti SE?4\T Q �rJ� ass s t D 9 's" , s�B• yo .3 Veer- Arz Sep gr Rw D mot' i00. 6 pD yti P11t7 To T s .. , ICAIJ Eats AAl or eft 10 Are gal Dr �.. ?� 'ep .._. Pty gyp. -3► � /// NO. Ld f GivE' 1 Moues!% TiG►Nf .� sr• 5cg /� 0 lops �� All / /Ar0 */s = o y a (� /T.tTE APP+�4v�D Mo v vP S4 Op ' freo.M 'PA o rkX t�% f' • I.Ut1FJ�tS °f SAS / ry cifyF,PitGS �l -v� S ysf��I ,,vfE,O��r C-V� HOMESITE SEPTIC PLUMBING CO. �P j l RT. 3 O'NEIL RD., HUDSON, WIS. 54011 `� Q ROBERT ULBRICK Q VW& MASTER PLUM ®ER LIC. NO. 3307 M.P.R.& MINN. INSTALLER & DESIGNER LIC. NO. 00663 n M O' o N p' n to O I 3 c t7 �1 �1. 1 ID 3 m m /\ C � i r N o � N 0 UT O O al C n 6� O 1 O m 0 O (DD C O N CJl O ° CD I 7 V N y 3 O c A W p CD 7 O c CD N p 3 c 7 N N rl Z CL N V CD N C. Z a (D N N 0. CD to ° M o CD � o N N co su m v N N A o V 1 V CD a CD m I O o O o � n � m CD m I �= n m � K) ° co 00 0 a 0 0 0 7 C j 3 7 N j 7 U) A O Q N C N C N n �p C7 CD n ! O a o O — a O 0 Z D a o <n D cn a co cfl y y a cfl D en a CD co p m cD m IW a W o 7 Q ?_ 03 N 3 O C ( p Q \ p lot ° a m a CO O i Cn O O O A O N N 0 c a I CD I CD I � � 000° —'—' rt 000 —' 000° —' °.: �• o Z (A (A ��I Cr � co o F K .1 0 3 Gov o~ �� vov =r �'�° q CD Vl O O _ fD N _ CD lD fB ? 7 Ln ' CD N I O O N I O CD CD N Cp m o m 3 m m 3 d w a Z 1 D CD a =+ D D D D o 0 a o g c 0 � a h• CD Ch o CD CD o c A CD CD M. fD CD c_ CD CD c c 1 CL I I CD a CD N O_ Z >_ >_ A Z C N C O N O �► I I 0 I Z � N a 3 a a a Z $ gr!L a N� M C OD CD { CD I D ? 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O fD a CD N —In y 7 _ < < 0_ N O CD CD C1 O O CD O N C7 l R k 0 Iv G y �_! y �+ N C m� fD Cg o . EF � 0 , Er o N O C o N 3 Cn y a A CN O O A CD CD DQ V t» O <n O CD 9 o g H O L C Q. y r ° c ,. O °c 3 �+ o d I BC CD V ' m O -I r N O o m o o a pl = a 3 °' _ °^ CO p 3 N N *.4 O CD N OD C a N V N C A Z n N N �� O 1 CD 3 CD W 5 j OD O CO ai 1 �` a m v, m CA `D CD D c0n c A 7 CD m o 0 CL O N N 3 0 O N N (7 0 to C t C 0 In Z D A �a 7 °�' u> < D ID a I � cn D N n m m CD u, C, C W n O W a CD = o CD = o o A 3 0 c_ O N CL CO CD 0 0 l o a coo N p CO) �+ rn m 0) 0) ',. 3 a m _ M (A � •O � y N O1 �1 • I � I "a . 9 000 1 0 0 0 0 3 o y N j o is '0 D O N - o T 0 G N .�. m A N N p CCD O Cp _ CD O lD CO C cr N 3 °—' N CD CL Z lv o O O D a O D D o CD o C �� CD CD a' C c m m c CL 1 CD c6 3 3 3 z CD C A (? 7 I � Z N V W e W 0 m w C. 3 a A Z o °o to y Z y Z m CD w C.0 f I I �v �_ a m o a ° -• cv ° °f m < "� C y i y. N N v C CD o 3 o a 3o CL o a c o.o co :3 m 3 m CD CD c o o o —' e n m �. B C.� a 0 m mo CD `c CG N o W N Uo CD n x j e CO 7c O om 9•CL N O CO.0p j q p c m m y : N CD C. o � O C I I J �-n m A O O O at CD m pp N 69 0 b9 0 �v O O E O * a O L O CL ti �1 ST. CROIX COUNTY WISCONSIN ZONING OFFICE r p n ST. CROIX COUNTY GOVERNMENT CENTER now 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 August 31, 1998 Roger and Ann LeQue 131 County JJ River Falls, WI 54022 RE: Bedroom addition, Town of Kinnickinnic, St. Croix County Dear Mr. and Mrs. LeQue: You have requested the Zoning Office to review your remodeling/addition project for compliance with the state sanitary code (COMM 83). When remodeling or adding onto a dwelling you are required to examine whether or not the construction involves an increase of wastewater. As I understand the project, you presently have 3,360 square feet of total living area and you are proposing another 168 square feet of living area. The proposed construction equals a 5% increase in the total living area. It is my understanding that the existing living room will be converted into a master bedroom, making the structure a four bedroom dwelling. Section 83.055 (3)(b)(2) states: Increased wastewater load in dwellings results from an increase in the number of bedrooms from construction of any addition or remodeling which exceeds 25% of the total gross area of the existing dwelling unit. Since you are adding another bedroom, the septic system will have to be evaluated to obtain a building permit. The septic system serving this structure was evaluated by Robert Ulbricht the week of August 17th, 1998. Mr. Ulbricht noted that the system was functioning properly at that time and indicated that there is room to expand or enlarge the mound in the event of a failure. The as -built report revealed that the septic system is sized for a three bedroom dwelling. Records of the sanitary permit are located in the Zoning Office. Before obtaining a building permit you must have an affidavit recorded with the register of deeds indicating that the septic system is undersized by one bedroom. Also indicate whether the mound can be enlarged or a replacement area is available. You shall provide the Zoning Office with a copy of the recorded affidavit prior to obtaining a building permit from the township. To prolong the life of the system, remember to have the septic tank pumped once every three years or when the tank becomes 1 /s full of sludge and scum. Other efforts to prolong the life of the system could be as simple as fixing or replacing plumbing fixtures with water conserving fixtures, reducing shower time, washing dishes when the dish washer is full, avoid using a garbage disposal, using a wash machine with a suds saver feature, etc. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Should you have any questions, please contact this office. Sincerely, Rod Eslinger V Assistant Zoning Administrator r VOL 135b PACEUND 586'98 2 . VI)WL.. • EXISTING SEPTIC SYSTEM AFFIDAVIT Document Number IC .. Name & Return Address . CROIX 00., W ST h, f K Sip 01998 �i ✓e��G� J (i \'�...e4 $'00 t of Parcel I.D. Number \ A� ur�Crr O ZONNGOFFICE The existing septic system which serves the dwelling being added on to must be verified by an acceptable soil report or be inspected by a licensed soil tester for compliance with high groundwater and /or bedrock separation requirements as set. forth in s- COMM Chapter 83.10 (2) WI. Adm. Code. The results of that inspection must be made available to this office. If the existing septic system meets these minimum requirements, and is properly functioning, an addition may be added to the dwelling without updating that system. This addition must not, however, encroach upon the required septic system setbacks as setforth in s. COMM 83.10 (1). Property Owner(s) e.- 3 X no Property Mailing Address: - 12)'ye- ' U✓1 5 -/0 Z Z. 2 - 2 Property Legal Description: Lot # CS Subdivi.si ' Sec . -�7 , T Z N -R_a_W, Town of Comments: The existing mound septic system was sized and installed for a three bedroom dwelling. Robert Ulbricht (ID # 226375) stated in an inspection report on August 25, 1998, that the septic system was functioning properly. He also noted there is room to expand the mound in the event of a failure. I, as the owner of the above described property, hereby affirm that the septic system serving this dwelling meets the above referenced state private sewage system codes. I realize that this addition may cause the existing septic system to become undersized for a dwelling of the resulting size, and I will make this information available to any future parties interested in purchasing this property. Signed: otary Public Subscribed and sworn to befo m e on this date: Date: ,J.. - -T Zoning Dep a . My, bomi(a:ssion expires: Approval: Date: UIBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 '� ' �rc� �i j� Raj van ers age Consultants nts 715- 386 -8185 VT •, d 57 GAr X J `T Le Xgw 4 4'� 5 /,f 7- �v� _ a,, ' "—f 37 S r•. t. 6 SLc � rip ncY�✓ C� , S� .> a �� ?c , N � max! ►.g pfd. t �- � ' 3 � Form -STC -104 e AS BUILT SANITARY SYSTEM REPORT OWNER LC Q V E TOWNSHIP SEC. Z T 1� N -R �/ W , , z #WY sJ ADDRESS ST. CROIX COUNTY, WISCONSIN 3 o OP 3 y SUBDIVISION (Ip/. .S -P6 , LOT LOT SIZE yQv�/tt 1,3S3 PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE NORTH ARROW -jb�0 C0 146e f gf Aeiv &wy BENCHMARK: Describe the vertical reference point used F r A A07. Elevation of vertical reference point: 0 '0 / Proposed slope at site: WEE,'f v /a �OnL'•PE7E PAP ,0uG SEPTIC TANK: Manufacturer: N,l v ��'Gti�o J/7 Liquid Capacity: �d� Number of rings used: Tank manhole cover elevation: 5 ^' Tank Inlet Elevation: �l Y �o / Tank Outlet Elevation: H ?o / o aUE� Number of feet from nearest N Road: Front,O Side G Rear, O / OQ feet 100 'y From nearest property line Front, O Side,© Rear, O feet Number of feet from: well 7 , building: 2 Z / (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER �� VG7s GU t=E CD.vG..l '(90 Q Manufacturer: Liquid Capacity: Pump Model: 2_67 Pump / ems. Manufacturer: Z G E Pump Size - Elevation of inlet: / Bottom of tank elevation: /0 3 -0 Pump off switch elevation: 1 Gallons per cycle: / (s F Alarm Manufacturer: � Alarm Switch Type: E RCv^_ N o Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: 75 Number of feet from building: 3 ( ' (Include distances on plot plan). SOIL ABSORPTION SYSTEM (/-yo owp) Bed: g * x y0 Trench: Width: 3 S Length: -7o — Number of Lines: Area Built: Fill depth to top of pipe: A) O Number of feet from nearest property line: Front, O Side, © Rear, O It. i Number of feet from well: /0 f Number of feet from building: 3y� (Include distances on plot plan). SEEPAGE PIT Size: Numbe its: Diameter: Liquid dep Bottom of seepage pit elevation: ea Built: Has either a drop box O or distribution box O been used on any of -above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Numbe rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector Dated: Plumber on job: License Number: HOML,sft SEPTIC PLUN;61N0 CO. RT. 3 O'WIL RD.: HUD -SON, WIS. 54016 ROBERT ULBRICH4 3/84 •mj WIS. MASTER PLUMBER, LIC. NO 3307 M.P.R.S. MINN. INSTALLER & DESIGNER LIC, NO. 00663 i ' ' J o L o y /ioME -i tle s OW oor (OLW �b 00 5&?4(c \T- U e I Qfi � X11 D� 9�✓ I8 Se p v /00. V 1ti �1 f•�o 7oE I i 7o fie - 10 . -, \ ?o .414 of POfd.#W AL . Gi ( /1 01 1 � c� Mo 0A�P v,#TiDNf ff 'Kr. Sc,4 - +1 o Toes e� All /" /A7b &/s = /o y 04? f4 113 /AIM&S s �D9 ♦ / V16 f' 191,4j(f� HOMESiiE SEPTIC PLUMBING CO. � I �C RT. 3 O'NEIL RD., HUDSON, WIS. 54016 /�} !• o ROBERT ULBRICH4 OC - 7 , ,n - 1 9 86 WIS. MASTER PLUMBER LIC. NO. 3307 M.P.RI / v a MINN. INSTALLER & DESIGNER LIC. NO, 00663 l i i -� SANITARY PERMIT APPLICATION Cou S T. �- x ILHR I n accord with ILHR 83.05, Wis. Adm. Code �� � �• •�.�. STATE SANITARY PERMIT # iG. a 2/ —Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLA I.D. NUMBER 0% x 11 itches in size. 8 V —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION FOR VARIANCE ❑ YES LIT9.NO PROPERTY OWNER PROPERTY LOCATION 3 �VAI `€ Ue �E' /a 5 '-%, S 7 -7 T �, N, R E (or PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME ,2t . Z TJ' CITY, Aj STE� �/ ZIP COo /e P HO� E NUMBE� CITY NEARE ROAD, LAKE OR LANDMARK ��� F � 5 0 VILLAGE II. TYPE OF BUILDING OR USE SERVED: ' Number of Bedrooms if 1 or 2 Family y OR ❑ Public (Specify): 111. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. K b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an ystem System Septic Tank Only an Existing System xisting stem 2. ❑ A Sanitary Permit was previously issued. Permit ## 7 ✓` O %? 7 Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner /building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in ##1 and only one in #2) 1. a. ❑ Conventional b. Alternative c. ❑ Experimental 2. a. ❑ System- b. ❑ Holding C. ❑ Pit Privy d. ❑ Vault Privy e.,K Mound f. ❑ IGP In -Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. LKSee a e Bed b. ❑ Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): 8 ' T'TJ 7 S 37 (0 /O Feet Wrivate ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons Total ## of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank x Lift Pump Tank/Siphon Chamber QD VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) ftilP /MPRSW No.: Business Phone Number: T. 7.4-5 R 1' CIO 330 - 7 715 06 ,Fl Plumber's dress (Street, Ci State, Zip Code): Name of Designer: • R-+ 3 V oA.) R I T Vlll. SOIL TEST INFORMATION Certified Soil Tester (CST) Name HOMESITE SEPTIC PLUMBING CO. CST # Of, 3VNEIL RD., HUMN, WIS, 54016 CST's ADDRESS (Street, City, State, Zip Code) Phone Number: MS. MASTER PLUMUR LIC, N0. 3307 MAR-3 IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sanit ry Permit Fee Groundwater ate Issuing Agent Signature (No Stamps) , V1 Approved ❑ Owner Given Initial ¢ o J'� Surc arge Fee pl Adverse Determination (/ °p (22� X. COMMENTS /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years, 6. if you have questions concerning your pn ' sewage syste, i, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 508 -266 -3815. To be complete and accurate this sanitary permit application mist include: I. Property owners name and mailing address. Provide the legal description where the system is to be installed; I!. Type of building or use served: If public is chucked, indicate +ype of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; Ill. Purpose of application: Check only one in 41. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1 -6; V!. Tank information: Fill in the capacity of every new and /or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift /siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County /Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'h 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; dosing or pumping chambers; 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. ---------------------------------------------------------- •-------------------- - - - - -- I ----------------------------------------------------------------------- GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the ! result of over 2 years of steady negotiation and public debate. The groundwater bi!i Groundwater - included the creation of surcharges (fees) for a number of regulated practices which Wiscor i'n`s a can effect groundwater. The surcharge took effec' on July 1, 1 984. All of the water that buried reasur. is used in your building is returned t +v, the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resource s. These funds are used for monitoring ground - t water, groundwater contamination investigations and establir,hmE nt of standards. GAroundwater, _ it's worth protecting. SBD -6398 (R.03/86) )EPARTMENT,OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS .ABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION '.O. BOX 7969 BUREAU OF PLUMBING AADISON,WI 53707 El CONVENTIONAL EXALTERNATIVE Slate Plan 1.0. Numher ❑ Holding Tank ❑ In- Ground Pressure Mou of IM018 NAME OF PERMIT HOLDER. J ADDRESS OF PERMIT HOLDER. INSPECTION DATE Roger Le Que Rt. 2, Hwy JJ, River Falls, WI 54022 BENCH MARK (Permanent reference twmtl DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST NET PI. ELEV NE SE, Section 27, T28N —R19W, Town of Kinnickinnic y.une nl Plumber. I MPIMPRSW No County ovary Permit Numinr: Robert Ulbricht 3307 St. Croix 79222 IEPTIC TANK /HOLDING TANK: MANUFACTURER LIQUID CAPACITY 1 1ANKINLETELEV. TANK OUT LET ELEV WARNING LABEL LOCKING COVEH PROVIDED PROVIUED e (e VYES ❑NO CJ YES LX O BEDDING VENT CIA, VENT MAIL. 1 1 11611 WA NUMBER OF ROAD: PROPERTY WELL BUILUING VEN iO CHFH ALARM FEET FRO / d'bf LINE Alit 1N�_ [DYES NO C DYES NO N T )OSING CHAMBER: _ h1ANtlf AC7UREH Bf DDING LIOUIU CAP A( ;11 `/ VUMI' M(IUEL PUMP SIPHON MANUI A :RV1tN WARNING LABEL LOCKING COVER .(✓ DYES p PRO CEO PROVIDEO J� �G. �OG��Z YES UNO ❑YES C O GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF LI HIV WT LI 111111 DINT. VENT TO I (DIFFERENCE BETWEEN /�/_ c� FEET FROM Llr �'Q /' —7 AIR INIFT PUMP ON AND OFF) 6 s YES ❑NO NEAREST —� ; 301L ABSORPTION SYSTEM. Check the soil moisture at thfi depth of plowing FORCE I f N J OIAMI II Il 41A I11n,u AND A1AHR1 Dr excavation. (if soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH NO OF Z'S'" PIPE SPACINI, COVER rNtil Dl Dla aPON t n)lIII) BED /TRENCH HENC"FS MATERIAL! PIT uTPTII DIMENSIONS (a tnV LUf H FIII UEP TH UItitH PB'I U15Tlt TRMATERIAL NO UI$1H NUMBER OF PRIIPERIV WELT. BUILUING VENT IOIRf :.n i"LOW PIPES ABOVE COVE" IIfV INIIt ELEV ENU -� PIPES FEET FROM .LINE A11i INLET NEARES - - ► MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. YES ❑NO OIL COVER I IFxIultt J PI 1110ANI N I MA14K I IIS nIA14VAIItINWIIIS ` _ YES ❑NO _ YES LINO Of PTII OVER THE NCH HE 1) Of PT" OVI It I RE NCH BE IlEPT1 /Of TUPSOIL SOIIU!D 5If UI Ir M11111 (.ri711 CFNIEH EDGES a S (/ DYES ONO N O YES [_)NO PRESSURIZED DISTRIBUTION SYSTEM: _ WIDTH LF NU T14 NO OF LAT ACING (rHAVfL Uf P711 BI LOW VIPI IIIL OF Pt11AF (:(1 BED /TRENCH � TRENCHES G( E /A /_ DIMENSIONS MANIFULU PIJM MANIC 1111) UI$IH PIPE MANIC (ILU MATEHIAI N�1 Dr5 It I)ISIH PIP' IIISTHIBIIII(INPII'1 NPIIIf1Al A4IAIIk IN4 ELEVATION AND EL� FLEy, CIA ELEV PIPES e DIA �� DISTRIBUTION � � s o / INFORMATION HOLE SlIf MULE SPACING UItILILI) C(rlilll Cll y COVFH MATERIAL Vlllrl(:Al l If T C)"Hf51'IrNUS TO APP11UVf 11 Ill ANN Y 5 ❑NO j V r Y ES QNO COMMENTS: r rERMANENT MARK J OBSERVATION WELLS: tN U MBER OF P WELL BUILUING ^— EET FROM L'� 1 0 - 9 ' ❑NO ES ❑NO YES EAR EST -!!!/ Sketch System on Re t in county file for audit. Reverse Side. SIfiNATURE 11 LE DILHR SBD 6710 (R.01/82) l State Of Wisconsin ` Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL SAFETY & BUILDINGS DIVISION Bureau of Plumbing 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 HOMESITYE SEPTIC PLUMBING CO. RE: Plan Number: 86- 07018 —S Gallons Per Day: RT. 3 O'NEIL RD Date Approved: September 12, 1986 HUDSON WI 54016 Date Received: 9/10/86 Project Name: LEQUE, ROGER Location: NE,SE,27,28N,19E Town of KINNICKINIC County: ST CROIX The plumbing plans and specifications for this project have been reviewed for ' compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the Pp department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. I The Bureau of Plumbing has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: •- NEW MOUND Inquiries concerning this approval may be made by calling (608) 266 -9374. Sincerely, ANTHONY T. FEDERSPILL Bureau of Plumbing Safety and Buildings Division PPP022 /0009w/13 cc: Private Sewage Consultant _County UW —SSWMP Plumbing Consultant Owner Plumber Environmental Health I DILHR -SBD -6423 (N. 04/81) -- T•�•H.R. 83.n8�� -) r PROJECT IND -'X SHEET OWNER: 'e � d vv GE" QoE ADDRESS: Cray V. a'J "ei ��f /�S &W , SyO SITE; LOCATION: y0$ I 1 tit S�i��'• T66u v OF �iviv�c��.�.v /'(, Mk St % .S,C 27 rz A.1 kv sr. C /X 6 l�0�JN * . PR('.JECT DESCRIPTION: I f i6ropy o cmykrJeE jc y k;, NEw CpaSTR�cT�oa u�,¢s ,QEfury i Sa ov �¢ 3 ����'/. /`/a•yF v 750371 s/ Al"u y A At i S PLvM � E . / I /.�.� WE-4 E R � 7FD 2 Y-,03 r'' SOIL j2eo�e Il$ locWiDl �pa,� (C.ST. k 3�Cel l'kD CA 5"0i1,S WERE 5 'ufT*IRle - l 2)0AiA3 -fp fZ CO.ut�� T � O-u h L T� E�l�. S . b a( J Of 40#f jk A 4%�udr 8G ftf?- t421C- T�eE'Gr WA.; Dis�vt� r`ie / v '� �) 6(t t -t-rl a S pRov tDe-r LaER-L- toeouC � Cx) so 11S A i2F A3 0+ S ug A - R IE f=bIz C6NVEV 4rov .+ L. SyS+eA4 . S EA' BELOW PAGE 1. PLOT PLAN VIEWS PAG� 2. MOUND CROSS SE('TT011 & SYSTT PT',kil VTE, PAGrc 3. PIPE LATER LAYOUT PAGE 4. DOSING OR S IPHY' i'I rT-T AMBER CROSS S :" T TONS PAGE 5 PUMP PER F ORIIAN('11 ) _, SPECS OR S I 'TT -' lTT SP*FX s � QQ- VQ� , PLUMBER: SIT -, EV 11LUATM or DESIGNER HOMESITE SEPTIC PLUMBING CO. RT. 3 O'NEIL RD., HUDSON, WIS 54010 ROBERT ULBRICK HOMESITE SEPTIC PLUMBING 00. WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.B. ht; A OVIL lb;, HUDSON' Wit. Moll MINN. INSTALLER & DESIGNER LIC. NO. DOW NOOK Wilcl# wit. WAR PLUM10 LIg: NO: w M0.41 MINN: INitALLP & U914 N Ut N0: toe DATE: '�' D sF_ p SIGNATURE' Z4 / PLUMQING G BU REAU T�� !�t-s �`�e��rvy �C1��✓ �Nf�� / /�'D, a�E�s 4 e' M0 V /.v ( *:0 Zl f -04- -F f . OS� Poo Ar ) � s Z , y 4 vsler'o, 4iv�v� 3 Si v E y C� 1.014 bol�e� � 4e- V.viceE�Jc�z� 13 y E /TES v row- (s •� l FT Sa o JS �UE(: E EAj �N TE R SE C T /OA3 / " /RO.v , NW G�1E5 T L o T L• Lot c o.P,uER �j l � I PLI � 3 .> T RE r tur DIVE I DEPART � �j��S10N ) P SfaFt � � 04•� � SEE CO J ESP ON DENC / 00.0 lo b. � = X06 •� j / I Fi 70DE lot o % boa • 13 j �. z 1 0 - 7. 9 g k4 aAJ 7 O p SEpr�c r. P4UMQ�N� io o o •-f Q Q c /�/�Ro�p �,PF�i+sr t�N(r ••��� o4 r,,,M c ex w E 11 i'?�4�c.vf/1cTu,Pt,p : 3 BED,PM ' �X ISXi O w�,Cs <oN�tfc fir. /MME i ��� / ill� ��h -v Nayg: Gu�/E,QS w: S . ss�oi7 v�vE,er�.vy S mots Hev , fra*p of oo -u r Ill 90 5, A,41/ (3z 4V54AACP ON Wtf IQ ODF - 1" 0 / v/oE,e r 44A, r Page — Of Synthetic Covering Distribution Pipe Medium Sand G s y trey Topsoil fl�vkT�w E , /� 10 % Slope Bed Of Jr Force Main Plowed Aggregate Layer D Ft. Cross Section_ Of.. ind System Using E AS Ft. F • 75 Ft. P ,3,B ed For The Absorption Area G / Ft. co A I? Ft. H / S Ft. � B 1 17 Ft. ;'" cLAf'i0N K lI Ft . DEPARThlti'iSt;] OF i SEE r 2-1 Ft. �e 35 Ft. e Main L Observation Pipe 8 \ K A I•---------------- - - - - -- ----------------- - - - - -I w l o ---- f --------- - - - - -- ------------------ - - ---I — - - - - - -- - - --- -- � r Distribution :Bed Of i Pipe Aggregate Observation Pipe Permanent Markers f � pdG G��f E� STEEL leDOS . Plan View Of Mound Using A Bed For The Absorption Area RECEIVED UMeJN(; 'BUR FAU Page ! Of _ SE-r vve tir pv,�iNb D�P9K� OowiV Perforated Pipe Detail � End view Perforotea �' End Cop) PVC Rpe I . • Joi000�oc OAS Holes Located On Bottom, S Are Equally Spaced S P X / PVC Monifold Pipe Distribution , ` 3' Pipe Ford Main N OTt •" AIL Last Mole Should Be �` � . Next To End Cap r End Cap -,) y J "r )p Aas t2 Ft. Distribution Pipe Layout P 2. 2- �E 2Z% rr. r i NOTI 2 ' R Cry S 32 13'Eceu4E5 X 30 InchPa� 15 Ner PLUMBING Y Inches Hole Diameter �y Inch } e Lateral _� Inches) a �� 'z; Z t4s; x4;,.!_nT'lons Manifold Inches DEPARTMENT OF !"till? TPY, LN... ` + "{ V t Div O ' �� SAFEiY 1�`dtj l3UlLGi ;u Force Main " 3 Inches # of holes /pipe /D ���r S EE R ES � X Ft. Invert Elevation of Laterals S ,tVvv / ,eO C k -SYSTEM L IEV T00 �DOF _' Voles Vd /E' `�oi2 S Q j 3 " sr.� 7C/ 0 = / f2.� eDrs TrejOUJ oa �t�� Dg's CA h RSA, Rai 12 /in „a . (� �2. 5 To4a_V - Zl - s TR 130t 'ATE' Fo t a 1 i N E5 RECEIV IJ- �#Il w . r _- P J 1 PLUMBING BUREAU PU h PAGE OF PUMP CHAMBER CROS5 SECTIOU AKID SPECIFICATIONS VIE KIT CAP 4 "C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTIOW BOX AWHOLE COVER 25' FROM DOOR, 12" t ��nir 1 "' WINDOW OR FRESH ( J / AIR INTAKE I 112 0 GRADE i y "MIIJ. COWDUIT �— — CCIE I/ INLET PROVIDE I ' =Lai PLIJOSiT APPROVED JOINT A ��P/�L 1 I I I ) APPROVED JOINTS W/C.I. PIPE W /C.I. PIPE EXTENDING 3' ALARM EXTEUDIWG 3' OWTO SOLID SOIL B hELATI I I ONTO SOLID SOIL C ON O DIV�u��,�d Ur SA "L LLEV FT MP - pFi PU Nab D pvi SIDE „ CONCRETE BLOCK RISER EXIT PERMITTED OWLy IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFI'CATIOAIS DOSE TANKS MANUFACTURER: WUMBER OF DOSES: PER DAIS TAWK SIZE: Y0 o GALLOWS DOSE VOLUME ALARM MANUFACTURER: LEv�L /� /j} �.( INCLUDING BACKIrLOW: GALLONS MODEL WUMBEK: 12 ' V(L - CAPACITIES: A = ''� INCHES OR 3 � G GALLONS SWITCH TYPE: S � C 7 �l0 /� 15 c 2 ' IIJCMES OR 35' GALLOLIS PUMP MANUFACTURER: Za � C: 's INCHES OR ��o/ GALLONS MODEL NUMBER: '2 X07 yZ H /IS' 04-r— D. 23 1 9 INCHES OR GALLOIJS SWITCH TYPE M�IN . M %vR�j� OTE: PUMP AND ALARM ARE TO BE MI AIIMUM DISCHARGE RATE 72 Gplik INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEKEUCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. ` FEET 'l,�iJK Sys + MIN IMUM NETWORK SUPPLY PRESSUR / .... ..... .. � FEET �- � �/. 7 -r• ♦ -So FEET OF FORCE MAIN X 1 " F �po;tFK1CT''1, - U FA YOR. 4 FEET TOTAL DtIWAMIC. HEAD 0 FEET 5'oU,uO '� D/ P. 5 �� IWTERWAL. DIMENSIONS OF TANK: LE ;WIDTH ;LIQUID DEPTH '77 i v. 91GNED: LICENSE WUMBER: DATE:_ /DO00�1 CTS q/�cv RIM 401 vo Cc� � S S YOB 7 PLU 19� MQING eURE S'WAGE and DEWATERING pumps J `267" Series • Automatic or Non - Automatic. • 1/2 H.P., 1 Ph., 115V or 230V • Thermal protected. • Cast iron and stainless steel construction. is Vortex impeller design. • 2" NPT discharge. 41W • Sleeve bearing running in bath of oil. • Switch case, motor and pump housing, base and impeller are of cast iron. • Passes 2 inch solids (sphere). U L listed �A Los Angeles code SP Canadian Slandards Assoc Approval available C Approval available, SC -2225 hl EAD ,� CAPACITY( CURVE 3 TDH , Q*' 0) UJI OO TOTAL DYNAMIC NEAOICAPACITY PER MINUTE 30 EFFLUENT AND DEWATERING 95 SERIES 53 -55 57 -59 97 137 -139 163 165 J M LTRS LTRS LTRS LTRS LTRS 28 1.52 163 248 394 231 231 90 EFFLUENT AND DEWATERING 3.05 _. 129 216 300 231 231 4.57 72 163 242 227 227 26 85 SEWAGE AND DEWATERING 610 104 , 36 223 227 \ 7.62 30 216 223 2 220 9.14 ^'y. 06 pA 172 206 V0 12,19 24 � 15,24 .. ,25 ,sl o 57 ,s1 ,� ,62J 75 — +�i - - � 114 2 2 24 38 53 70 MODEL \\ MODEL Lbck va lve 1 9' 24.5 2s' 66' er \ TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE 20 65, 163 - - -- ` 165 SEWAGE AND DEWATERING 262 284 ` SERIES 267 293 268 � M LTRS LTRS LTRS LTRS LTRS 1.52 406 366 492 681 } 55 1 % ` 1Q 3.05 227 273 360 598 i 4.57 ° 76 163 238 511 16- `� \ Va. 6.10 30 125 401 50 286 7 62 9.14 163 292 14 � , 0 ` 67 w 227 � 45 \ � , 2.19 .a�Y 174 t 106 \ IS "' 1372 ✓g 12 4O \ 45 \ MODEL Lock Valve: 18' 21' 26' 35' S3' 35 293 10 t 30 MODELS t 8 25 137 139 6 20 MODEL 284 4 15 MODEL MODEL \ i 282 ;: — 10 268 2 MODELS ,� 5 53, 55, IN ODEL MODEL 0 57,59 97 267 U.S. GALS. 10 Z0 30 401 50 .60 170 80 80 1 10 _121 r LITERS 80 160 240 320 400 480 560 EMOn 650 FLOW PER MINUTE `' ~P ............ 3280 Old Millers Lane Manufacturers Of ... Z 91 ZZI/ 1 TZ P.O. Box 16347 p Loulsvllle, Kentucky 40216 � p " (502) 778 -2731 QUA[ /TY PUMPS �NCE ��3�7 k ST. CROIX COUNTY WISCONSIN ZONING OFFICE "gin° • - �. �;;• 796 -2239 (HAMMOND) r ' 425 -8363 (RIVER FALLS) HAMMOND, WI 54015 September 4, 1986 Division of Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Roger Le Quie property, located at the NE1 /4 of the SE1 /4 of Section 27, T28N -R19W, Town of Kinnickinnic, St. Croix County revealed suitable soils at a depth of 2.8 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. , In discussing this situation with Leroy Janksy, Private Sewage Consultant for the State of Wisconsin, it is felt that that there is definite urgency since the owners have moved in, and this plan approval should receive high priority. Should you have any questions, please feel free to contact this office. Sincerely Thomas C. Nelson Assistant Zoning Administrator TCN /mj i r STATE OF WISCONSIN - DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS _ T DIVISION OF SAFETY & BUILDINGS - BU AU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN AL ERNATIVE SYSTEM Location: Township/ Municipality: NE 1 4 SE ]% I S 27 IT 28 N/R 19 X)W Kinnickinnic St. kroix Street Address: Subdivision: County: Landowners Name: Mailing Address: Roger Le Quie Hwy "JJ', River Falls, WI 54022 I (We), the undersigned, hereby make application for an alternative system on the above - described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such w 11 require detailed inspection during construction and monitoring afte the system is put into use. I agree to permit both county officials char ed with administering county sanitary ordinances and Bureau employes or other a thorized persons to have access to the above described premises at any reas nable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained. I agree to give notice to any subsequent buyer tha an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19 Notary Public, State of Wisconsin DILHR -SBD -6413 (N. 05 /81) My Commission Expires: WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location NE 1/4, SE 1/4, Sec. 27 T 28 N, R 19' *XW W Town lii{x!l13iijiij#jTlq Kinnlckinnic Street Address Lot No. Block Subdivision Landowner's Name Roger Le Quie The application for this site is for: B new construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: (.1to have one of the first five approvals guaranteed for this year. This is number - - of those applications. (Use one of the first five quota num ersT ea to you.) W one of the applications needing a quota number. The quota number assigned to this application is 59 - 13 - 7 . for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. [ 1for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. [._.for an application on file prior to February 1, 1980. (_]for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ❑ a failing conventional soil absorption system. [� a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the Jot meets the criteria for a conventional private sewage system, check here I certify that the above information is true and accurate to the best of my knowledge. � -,-- Name Thomas C. Nelson Si re .. County Official Title Assistant Zoning Administrator Date September 4, 1986 DILHR -SBD -6158 (R 12/82) DEeARTMENT REPORT ON SOIL BORINGS AND S AFETY & BUILDINGS INDUSTRY, . DIVISION LAROJR. AMD PERCOLATION TESTS ( P.O. BOX 7969 HU1MAN \ / MADISON, WI 53707 (H63.090) & Chapter 145.045) LOCATION: • SECTION: TOWNSHIP /MW4 fY: OT NO.: BLK. NO.: SUBDIVISION NAME: ?9 13,5' AvE `/ �/ 2, /T2?N/R19 E (o W A1Q / sf 1 1 3.0 f/ 1/0/ s COUNTY: OWNER'S B't1Y1lR`S NAME: MAILING ADDRESS: sr. 4 3AN-v LE QviF T-T f=,0 W/5 s50 USE DATES OBSERVATIONS MADE NO.BEDRMS.: I COMMERCIAL DESCRIPTION: IPROFI E DES RIPT ONS: PERCOLATION TESTS: I SAResidence ANew ❑ Replace I �— 2 Z - / 9j'� �— — 8 4 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND 'RESSURE: S STEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑ S [Nu ES ❑U ❑ $ ®U ❑ S OU ❑ S DU I /lIa o w 4y If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: I Floodplain, indicat Flo elevation: PROFILE DESCRIPTIONS ho ` eci• *c_ BORING TOTAL DEPTH TO GR UNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIG HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) ' /0120 � - d ' 3 ' a ' aNS��N _-6 5. ) • 33 511 � 5 ' Lf a % � , B- A ♦ % p .3d .u- ,j' • , ♦ B - �d /o 5. (yb *0_' 2- • 6 I,&. w4 i4 P,j; we &J IF ff. aR - Hats, pv�DlB'D ♦ � /. S '�' N . 5� • s BN . S • S �'P. S� 3. , j ' � w1 � bl ' QU B- 7 0/ r 3 S 3. 9 wET s W MAN Op • .4 0`� S . B -y �. �v7 I6 �2p� ��. D �I w ffi ND +s 1 /, 0 ' Ex�RtNC'L IeNsE" Ole• Sl L � / �/ &0 • � !�i' �• s i o ' 8.., s' /. S ' G/ 0,j - d,P, r; ♦ 2 75 B-.S (0.0 / �' � (1�I{'l 3iCTr f1aoLr 9AA/D w1i , * 4 L r i OAS 6 A iyo PERCOLATION TESTS AT 'lie TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOD PERIOD2 PERIOD PER INCH P- i /G G P- P- P P- P- -'! 6q C s V.d iN od d R t t t PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ,� S./,�o ,Qo � % f�F,f -cam ivu� fs D ( . ._ ... _ . � _ _ C4 I i!°c ti til `o cr vE! v '/ /�t ` r — _ ;_ . _._1 N _._ I i I z I sM�s i__a! A'_ . fix _ ''-C_', ` f l s ;� I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: HO O'NEIL RD.. HUDSON, WIS. 5 SEPTIC PLUMBING GO. TESTS �J 6 SEPT .3 / f e4 O' NEIL 40 ADDRESS: ROBERT ULBRICK Avy ERTIFICATION NUMBER: PHO E NUMB R(optional): MS. MASTER PLUMBER LIC. NO. 3307 m �TJ Z y� �-- Y� ` S SIGNATUR : Z& t cc cA e rn DISTRIBUTION: Original and one copy to Local Authority, Property 0 r nd Soil Te m. DILHR -SBD -6395 (R. 02/82) l -- L. INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report roust include; � 1 . Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3, MAXIMUM number of bedrooms or commercial use r)lanned; 4. Is this a new or replacernent system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL. CONDITIONS; 6. PLEASE use the abbreviations shown here for writi ng profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately loctrting your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; S. CVIake Spa,; your b :richmark and vertical elevation reference point are clearly shown, and are permanent; 9. Corrrplele all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- bon� if appropriate„ 10, V the information (such as flood plain, elevation) does riot apply, place N.A. in the appropriate box; 11, Sign the form and place your current address and your certification number; 12- Make legible copies and distribUle as rcoUired. ALL SOIL_ TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols St - Stomo {over 1f) ") BR -- Bedrock coi> - gobble (3 - 10") SS - Sandstone gr Gravel (under 3 ") LS - Limestone �s - Sand HGVV High Gromicivuater c coarse Sandi Perc. Percolation Rate WlOd s -- Medium Sand rr11 - -- V- , ,r I f <; _ Fir €r; Sand Bid() Buildincl Is - Loamy Sal 3 - -- Greater Than `sl Sandy Loam Less Than, � r - L >arn fan -Brown �sil Silt Loam BI - Black si Sill G Gray �ci - Clay Loam Y - Ye llo %v- sr,i _.. Sandy Clay Loarn R - Reo sicl -- Silty Clay Loam neot - Mottles ,.. , �,,. Sandy Clay w - vv t h ° is -- Silty Clay ftf f"w", tirle faint ,c Clay cc - cornnwcsrf i €aa s£ P1 ... Rcat Min - Many, med m m -- Muck d ._ distinct p -- prominent HWL - High vvator levef, Six general soil textures surface water for liquid waste disposal BM - Bench Mark VRP - Vertical Reference Point TO THE OWNER, This Soil test report 1s t hu first step in se curmq a sanrta_y permit, The county or the Department may request `Jf(" licatlon of his Sod test III the, field: J ;ifr to perlrel€. x:34 €e,irtg` & }.. A (,(M) JIe.te ,sE of plan "s for the private SV} lord tt£i a peml must be suhmi eed to rite ap Pd'oprSm t,;icaii authority in order to Tlt t; Sa[ csry` pe!'nlil rtt �, a �l� ohiaine ar?f�f pf )S CeCI 1)3"(Clr to 'tlid; Start Of ar'Yy f,LlrlSi € "liCt3ort, REPORT ON SOIL BORINGS & PERCOLATION TESTS 115 PLOT PLAN • Project I.D. �E- 7- 1,4 L (.� / V& W -- s LEGEND HOMESITE Sm FLWONG Ca IT. i O'NEII AD., HUDSON, M18. 5" ROBERT UUNKAT Ba c kh o e Tits VAS. MASTER /LUMBER IIC. Na 3357 M.►.0 Perc Locations K. II MIN 91"A i DESIGNER UC. Na we X = 2482 T S. . Q = Existing Well C. P . = Vertical Reference Point " P D F *064JAY Cul u6AT- S' ? p4hyS7q , Elevation of Vertical Reference Point "T Lot Line LW I) /,per NUJ I 0 SCALE: / �= 30 C A/ 3 M uoj o TES T A,0C+ �o� >rD vE�y u�ooDeO. �_ APP `h c/► Ef 6 L i. OAKS 3 Mll -PIES FAR 83 I •' 1_1t ;,, AREA of 7z' PRt t 0A p- �S1 179 /D � 9c Ue� ,PEf i a/Y � lob L /0]L �\` • \ 0 I 20 Fou 0A9 t i Tr p w i df�, Tiff E . i000 �• �B.>�dr�sT 3zr,l\ y SE�oTiG = /II �0 F 1401)764) - I m AREA B & - ins S ' DRM • o WF // I6 ,4/1 Du Tf4e S�pT/C 'jirivK //V 2- C-> �d 14 XJ21, X4 r7 0 3 7 — /�-ro- -D f014° �o uvf- vTav�� T,PE�uc�rS . DEPARTMENT OF REPORT ON SOIL BORINGS AND S AF E TY &BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) 1 P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (H63.090) & Chapter 145.045) LOCATzON: SECTI N: TOWNSHIP /MkiMFCff1+RtiTY: OT NO.: LK. NO.: SUBDIVISION NAME: 9 , 13S �vF �/ �/ Z /T21�N /R I i E (o W X •:4w c rl Aw • -c / s�! s COUNTY: OWNER' S NAME: MAI LING ADDRESS: 57 • CAN( 1 � 0 G !E R 1 AAf-V LE ni 0 /F //W y T J ' J� , uE e ref s co S s 2 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: �{, R F S: TES Residence J �.� JC�New ❑Replace I P-22. -/M q_�- if4'G ( 80 Re 3 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND - PRESSURE: S STEM -IN -FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) I EIS DU 0 s ❑u ❑ S ®U [ DU [:]S DU Ma�� o If Percolation Tests are NOT required re DESIGN RATE: G I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: I Floodpiain, indicate Floodplain elevation: PROFILE DESCRIPTIONS W - F+-. BORING TOTAL DEPTH TO GR UNDWATER- INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGWE TO BEDROCK IF OBS ERVED (SEE ABBRV. ON BACK.) A /./7' UN -6/ S"' .3a " , 5'a' %, •6 3 d -3 3 " 3 Sf PuDD)ED Wt'T . , P3 ' flr.1A w)..i�lE S /.a fraaf 64 Ry S wl-rt, ~A"4 L5 J,'6 O B- B �d , /05.06 ?� Z • 6 l.ux 10414 ��,A u.Exk�y VOW !„!� fff aQ-,�tatS, P�uul 0 B -•3 � o ' o/ yy . 3 ' S ' 3' S 9y F�' S 5'w,'S a�. s, .s �. s, s.s• :Nt �,.. . 107, /�� �0 33 w '0 fj• S, /. 3 cf. S, 2. rRy e 4M C -GAJ y f f M01-5 /, ' tx�RL?M 'c �ENSL' OR / �/ - 7S' ar . S i o' 3.v J' /. 6' G/ *j -dip. t, 2. 7S 1 B- J cD, 0 10 7 & 0 � � 6 GrP,} srL fioCr r ^up wli+. ftw 'D fST OA•- b A t M O S PERCOLATION TESTS A7 'Y,/ .?'G TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL -MIN. PERIOD PERIRD2 PER INCH P- l 37 Z N e , P- P_ P-3 kx 7 P_ — -X Et e t ULN /N esi&Rj4F i 7ARr5 ' PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori. zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION `� '�'��'D ,e i� fF��) / iutfs : /4 y', D Sf �C /.f N QT, ok 6'i.�. nF f•�,v - j tN 4 © Oar i i "V 7"'' i l izEw , ro14 44elw Spit D� /I�EGx T� �_._1� 1, the undersigned, hereby certify that the soil tests reported on this form were m ith the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are r the best owledge and belief. CP h NAME (print): W T ERE COMPLETED ON: HOMESITE SEPTIC PLUMBING CO. .. HUMN, Wt 54016 96 ADDRESS: ROBERT ULBRICHT 0 Td � T ATION NUMBER: PHO E NUMB R(optional): IMS. MASTER PLUMBER LIC. NO. 3307 M.P.R.3. P 2-- W 6 -e l e . UUOW NATUR ' DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. D I LHR-SBD-6395 (R. 02/82) - OVER - Il ' REP ORT ON SOIL BORINGS & PERCOLATION TESTS 115 PLOT PLAN Project I.D. kt' T /A LEGrND HOMES IE Saw FLUMWNG Ca -- IT. A WIER AD., H1ftK Va SW "KAT UUWJCHT • - . Ba c kh o e r i t s MS. MASTER KUMKR uC. Na 3W Atp" MINN.1NKAU.EA i DESIGNER UC. Na a" X = Perc Locations Q = Existing Well C.S.T. 2482 Po,'aT' = Vertical Reference Point : fa P O F Ppjot�yt culue - S } Ile Elevation of Vertical Reference Point 7- Lot Line fo"d LOT Cvif',v r SCALE: / = 30 i _ C N 0Tc 3 MouuD TEST ADC+ o "n � ohKS 3 Mh� ES F � G Li. 8 �R + 0 8 D' *A M GS 1, 3 z Gl EA 13 bf o I` �Z RR�� N� I Lim is _ � L OA ft 0A 3 096 t So 15 19, j ` ;pT 9V 30 16 1 So 9 b I s o Fouvp 1 re � Ou7LE'7� �f - Sp�iCf iv 7iPf E , r� JETiGY/ Ac RE�tDy i/S 5 f - / G a E /etr f (r,P D o Stp7 iC 0 1RTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDINGS JR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION BOX 7963` BUREAU OF PLUMBING ADISON.,WI 53707 ` .. RXCONVENTIONAL E:1 ALTERNATIVE State Plan I.D. Number (If assigned) ❑ Holding Tank ❑ In- Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDEq: INSPFC TI N DATE: Roger Leque 1321 Sycamore St., River Falls, WI BENCHMARK (Permanent reference point) DFSCRIBF IF DIFFERENT FROM PLAN: RFF, PT. FLEV.. CST REF. PT. ELEV.. NE SE, Section 27, T28N —R18W, Town of Kinnickinnic, Lot #1 Name of Plumber: MP; MPRSW No.: County: Sanitary Permit Number: Robert Ulbricht 3307 St. Croix 75037 SEPTIC TANK /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.'. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑IYES ONO ❑YES ONO BEDDING: VENT DIA.'. VENT MATL. HIGH WATCH NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM. FEET FRt111A'. LINE: AIR INLET: ❑YES ONO EYES LINO NEAREST DOSING CHAMBER: MANUFACTURER: J BIEDDING. LIQUID CAPACITY PUMP MODFI_ PUMP /SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: EYES ❑NO DYES ❑NO DYES ONO GALLONS PER CYCLE: 1 7ND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUILDING. I VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) EYES ❑NO NEARC SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN: CONVENTIONAL SYSTEM: WIDTH'. LENGTH TH NO. OF DISTR. PIPE SPACING. COVER J INSIDE CIA. JY PITS. LIQUID BEOtTRENCH TRENCHES I MATERIAL: PIT DEPTH: p GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR, PIPE MATERIAL: NO, DISTR NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER ELEV. INLET ELEV. END PIPES: FEET FROM LINE: AIR INLET. NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- DYES 7-1 NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS 1:1 YES NO ❑YES NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED. CENTER EDGES. OYES 1:1 NO 1:1 YES 1 NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER: BE{�1TtNCH TRENCHES: t 1MEN$ DNS , MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV. . ELEV. . DIA.. ELEV.: PIPES: DI A.: Izt,EV itJ141 AN 1iStFC >4 ( ATION , HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED 1 ,s PLANS. ❑YES E NO DYES El NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: PROP ERTV WELL: BUILDING: ( (� ❑YES - 1 NO OYES 0 N MEAPI R 7 � r Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: DILHR SBD 6710 (R. 01/82) r w wisconsin APPLICATION FOR SANITARY PERMIT � DILHR s '��°' � - C OUNTY � OEPRRTTnEI"IT OF (PCB 67) UNIFORM SANITARY PERMIT # On InOUSTRV,LR601 SMUmgn RELRTIOnS q rO 3 /\ — A3tach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8' /zx 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PROPER Y OWNE MAILING ADDRESS C A/VGe .NR • • .�•r,P •d Gf Qv iE' l3L/ SY�� iyo�2 ✓ S �[/ PROPERTY LOCATION GFFY NE SC 2"7 2� 1 ,��' 1/4 1/4, S , T , N, R 4 p E (or W TOWN OF: c LOT NUMBER I BLOCK NUMBER JqUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER OS A4 d� �,3 / Rio l . s P� • 3 3 C� T �" �4- . TYPE OF BUILDING OR USE SERVED - —L —/O— 1 or 2 Family Number of Bedrooms: [] Public (Specify): THIS PERMIT IS FOR A: K New System ❑ Tank Replacement ❑ Repair ❑ Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ❑ Seepage Bed ';�] Seepage Trench U Seepage Pit ❑ Holding Tank System -In -Fill ❑ In- Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity 0ZIZ n Lift Pump Tank /Siphon Chamber Holding Tank capacity Manufacturer: j�f' Q AXt 7 O/Q k91 IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In- Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump /Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA MATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): L PROPOSED (Square Feet): ? �� 7 ✓ Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): HOMESITE SEPTIC RM Ri"PRSW No.: Phone Number: RD.. HU SON: WIS 54011 330 ,2 (7 /S ) ?.06 " 8l Or Plumber's Address: ROBERT UL Name of Designer: �> 'pl& MASTER PLUMBER LIC. NO. 3307 M.P.R.S UESIGNiR 1 IC NQ 00%3 COUNTY /DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved / )+ ❑ Owner Given Initial l j ']` t/ Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR -SBD -6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber - 1 S INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: • T 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.) ; 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; r 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; u 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67 -T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority.� 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. HOMESITE SEPTIC NLU6d31NG CO. RT, 3 O'NEIL RD., HUDSON, WIS. 54016 ROBERT U LBRICHT APPLICATION FOR SANITARY PERMIT WN3, MASTER PLUMBER LIC, N0, 3307 M.P.R.S. iMNN. INSTALLER & DESIONER LIC: NO. 00663 STC -100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, ( "spec house "), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property A'e- P 14.1,e f x `� py/ 16F_ Location of Property 1 4 SE- 1 4, Section Z , T N -R W Township Mailing Address 3 2/ SYC.: -fro. 97 Address of Site T Subdivision Name ? o s� ✓ Z 3 Lot Number Previous Owner of property Total Size of parcel Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number � as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING A Warranty Deed which includes a Document number volume and Page number and the Seal of the Register of Deeds In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey required. Ma the Certified Survey Ma shall be Y P� y P q - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPFRTY OWNER CERTIFICATIO I (we) cen t i.6 y that att statements on this 6 onm ane t'liue to the best o6 my (oun ) know.Cedge; that 1 (we) am (ahe) the ownenGs) ob the pnopehty de�snibed in this inbonmation 6oAm, by vi tue o6 a wa Aanty deed neconded in the Oj6ice o6 the County RegiAten o6 Veedsass Document No. and that I (We) pne�sentty nwn the pupo.s ed site bon the sewage di s p ds �s yes em (on I (we) have obtained an easement, to nun with the above deschi.bed ptopelAty, bon the con.6tnucti.on o6 said .system, and the same has been duty %eco&ded in the 046.ice oA the County Reg-usteA o6 Deeds, as Document No. ). 4 SI URE OF 0 SIGNATURE OF CO -OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED ,IpC Cam. DOCUMENT NO. voL f M PACE 275 STATE BAR OF WISCONSIN — FORM 2 WARRANTY DEED .9Q THIS SPACE RESERVED FOR RECORDING DATA REGATIwRS OFFICE Kevin M. Radel and LaDonna M Radel husband ST. Croix CO., w%. and wife as ioint tenants and in his and her oN i right, Rec'd. for R=rd this 3rd Grantors day of May A.D. 158 conveys and warrants to Roger D _ LeQue and Ann M Leque qt 8 :30 A husband and wife joint-tenan •M' DM ft "_0 , I of Gra ntees- RETURN TO the following described real estate in _St C rni x County, State of Wisconsin: Tax Key No. Part of Nk of SEk of Section 27 -28 -18 described as follows: Lot 1 of Certified Survey Map filed October 6, 1983, in Volume 5, page 1353. Together with 66 foot roadway easement as shown on said Certified Survey Map, TRAN SFER $.- FEE This is no tahomestead property. *at (Is not) Exception to warranties: i Dated this day of (SEAL) �� (SEAL) • Kevin M. Radel (SEAL) SEAL) i • . LaDonna rq. Radel AUTHENTICATION ACKNOWLEDGEMENT Signatures authenticated this day of STATE OF WISCONSIN c5t /� -1 _. i.Y`Q t X County. Personally came before me, this day of i� TITLE: MEMBER STATE BAR OF WISCONSIN (If not, the above named t� j authorized by § 706.06, Wis. Slats.) _ki v IN., VA - e &de_ I AAcf ! } This instrument was drafted by 4 ,� R ussell E. Berg, Attorn �', v •. ,���; 125 North Main Street x River Fa WT 5 40 22 � .7 : G ! u tone known to be the person _:5L_ Who stFU nd k d d the same. (Signatures may be authenticated or acknowledge? 9¢th are not`' tr necessary.) •..ti ,'�. AC Notary Public $ - C.r n t *Names of persons signing In any capacity must be typed or printed below their signatures. My Commission is permanent. (If not WARRANTY DEED — STATE BAR OF WISCONSIN, FROM NO. 2 FIRED • J J OCT IW 1983 G7 O' CONNE Keo44� W Os�� tt $4 G-oy Ccwr . CERTIFIED SURVEY M4 LOCATED IN THE NE 1 /4 -SE 1/4 AND THE N W 1/4 -SE 114 OF S EC.27, T28 N , R 18 W, TOWN OF KINNICKINNIC, ST. CROIX CO., WI. APPROVED OWNE BY : MERLE NI RT.2 RIVER FALLS, WI.54022 T p 51983 - - - St. CROW COUNTY C T. H COI'APftb4f" IVE PARKS PtAW M G _—" AND 204mo COMMITtel ___�fi _ N4 038 w • O y A - 66 47' m 1 C o J Lo D r o h '- I o v x I 1 a a a to T r ' A z e m rZ m� Im oNlto m� ^' to �cr-o m �p �) ° 'V ° 'r 1f Z 2 O - �j �M mm �m� O p .�R1n1 i n nUD T, O w " u mt" •� u W zc n N n < O A n 3rn �a°o� IA xZ ioa Z � O a w a M . tr a v o w 2 yo inl w I �H Z mn tt� h1 p a � a ° 3 z o w o ITI UNPLAT of �m mzmz N N m N c Z vl w T EO LANDS 7 ( 8Di1U' -'�-, f N404/�56.. 379.. I o�,zaO rn (REC. AS 380.00') _ r I< � A 10 01 b U Q © b m N C m z ° a • • tD ` F D -< UD v f D n , 1 1. MV - a e a ro m :o �1 m o zv n n �► ^� to to Z I -C it Z I Azmmmm O rn m =o n y to J.� O m z I 'fo °p z z z z m F m x m rn 0 Do {� N t01- Y) Obi f ,, 0� m _ Lo V Q v -- v - °• U T • a 4 R1 1 /, .0 ro ro � � ma c N •tA :I . -i aanannn -1 :I O zzz 2Z Z m mm mw m z mmv y ^ym0 AN NA ONNpap m z AI m -N NN - N NN A 14 <<UI� t0 1- NNo Of N N� W'V-' N� wIV1 •� . NNm� S 4 ° 4/ X 56" W 410.35' 6 � p Ln =zyaz� S9 4!'56 "W Nw u. yn_ < �m m a (A ' ' y UNPLATTED N ro a ;O °1 w LAN X �` 3? mao =N °cNoz m ` m o m r EAST LINE OF THESE 1/4 V` ° SEC.27` TZ9N RIB W O A 'Z7 "W . . 2 ' NO 36 m 131 .80' 1301.20 • f wi v (REC. S 1320.60') N 0 " W 2619.04 (REC. 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MASTER PLUMBER LIC. NO. 3307 M,P.R.S r SEPTIC TANK MAINTENANCE AGREEME'WINSTAL19R&giglGNERLIC No, oaf 0 St. Croix County z OWNER /BUYER /e• M ROUTE /BOX NUMBER Z (/� /V �/!� Fire Number Z IP 7 A .CITY /STATE T'�� / S 2 I PROPERTY LOCATION: /�c s C, Section , T 1P N, R �a W, Town of / /;tw / !L St. Croix County, Subdivision W ; Lot number p� . i 3s� Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents m be eligible to receive a grant for a maximum of 6O% of the cost of replacement of a failing system, which was in operation prior-to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. yo I /WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart - �v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE 3 gr St. Croix County Zoning Office P.O. Box 984. Hammond, WI 54015 715 -796 -2239 or 715- 425 -8363 Sign, date and return to above address. v_ u = m O (n w ? 7 (D `< 0 7 V �. (D O (D n n (D 7 w Q O C O w w N w c � 7 3 C (D (D (Q (D 7 o (D -p d ° O ? s 0 :3 c, � o, � m O a p 0 w 0 -w (D 7 (D 0 N O N a w A _ y r an C, 60 D o (D c CO 7 woo 'o `c �, C: y. 3: z cc w w 1 m w w N o m o � o a`, 3 7 w N _ 8 D U w w C ; 1 c � 0 < tD (n c (o cT O (D u, o D c m u c n v = w n 0 0 c (D w = O (p ( - O C . N (p 7 � (n C m p (n cD N CD n w N (n Z Ch w ��' �w 7 A Z a CD 0 3 `� c (n D CD ° � � to m 7 d _ 7 O r- W ar: 7 > 7 L En CD CD o > swa ac0gm� C fTl v 3 `° ° - o m D -' 3 m m ~mom ��mQw _ a o No =cam a -� �V N. c -• c (o N In w d M . 01 n 73 c rn p : W m a 7 m W 7 a N 0 7 C �. (D 3 M O �• O c (p 7 O to -. O N O c n. 0 7 o (p D C - 1 (�D C (D a �0 7C =w ^o A+ X 0� o'O� M1 w a�. a 7 o . (,, 3 _(CD fn O N 'U Z i RTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS .jSTRY, DIVISION 3OR AND PERCOLATION TESTS (115 MADISON WI 7969 _ JIMAN RELATIONS • . (H63.090) & Chapter 145.045) LOCH ION: SECTION: TOWNSHIP /MUNICIPALITY: OT NO.: LK. NO.: SUBDIVISION NAME: COUNTY: 9 OWNER &th' -EFP6 NAME: MAILING ADDRESS: USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE A ION TESTS: esidence � iw ❑Replace I C� _ Z�a�"� —Z� —`} RATING: S= Site suitable for system U= Site unsuitable for system ` J CONVENTIONAL: MOUND: IN- GROUNDPRESSURE:S STEM -IN-FILOLDING TANK: RECOMMENDED SYSTEM: (optional) SS DU Ns ❑U IS 11U ❑ S sU L H 0 S KU 'z S' xCi s' Z�� HtcS If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, ind icate Floodplain elevation: I PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-1 MAWS CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH JW. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) .Z +Z B- z .Z. IQXJ — t- to •Z �V Czti s� '� i .4' 3N s fie-• Z. D B- 'b Z b •Z-� • `1'( -,s�, ;,3'aw w \s; L. 3'Sus. \' B- (o . Z 7 k-, Z ` S ,Z .Z ` aNS�j 2..3' B- lfl.Z_ ��•.j NIGc 7 b.Z� ��G y��� \•o "8�s:►� .Ss`�; \.Ssk; B_ PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER MdPFMF?± AFTER SWELLING INTERVAL -MIN. PE RIOD 1 PERIOD 2 P R PER INCH P_ 2 • t.�C��� 3 � s f , , / \ % z .. Z_ d P - '? z ,b ' . � = `� u 1 ` , I Y z 0 Cs10%Z Q� y - Z - yvk P -- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. TRE�C1� �" 9C.(1, S�.Ct2t7 \�( S01LSvQv�`( SYSTEM ELEVATION TREwxE a ©. aZ T ( f 5 1 ' ( ►- i -- 4 I � 1 I E j ( i E , c NbT ;kw� t .9_ -- ? a z , l • `s P• RAi \ ? P��YD I 3 W T O i tE Q-- GO d _. t RoP�R'�`t L��►t�j � `- - - � SC.'E�LE I — 317 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: [ P HONE NUMBER (optional): 4 Vs s ��lE� �R`�5 3 �Z.l� - Arzs -"13z� NATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) — OVER — J INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 " To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2 The use section must clearly indicate whether this is a residence or commercial project; ° 1 MAXIMUM number of bedrooms or comr: oicial use planned; 4. Is this a new or replacement syste€za; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 0. PLEASE use the abbreviations shown here for writing profile descriptions at)( completing the plot plan; 7. MAKE A LEGIBLE diagram accurately loaning y €aaar test locations. Drawing to s cale is preferred. A separate sheet may be used if desired; € , Make sure your benchmark and vertical elevation i eference point are clearly shown, and are permanent; P_ Complete all appropriate boxes as to datas, names, addresses, flood plain data, percolation test exemp- tion;, if appropriate; 10, If the information (such as flood plains, elevation) does not apply, place N.A. in the appropriate box; 1 1 . Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as rc�(ILJrerl. ALL. SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY kAJITHIN 30 DAYS OF COMPLFTION_ ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbois st - Stone (over 10 ") BR - Bedrock coh Cobble (3 - 10 ") SS Sandstone gr - Gravel (under 3 ") LS Limestone * s - Sand HGW - High Gtouncivvater cs - Coarse Sand t �Irc - Porcolatirn Rate reed s -- .,crtiumSar5d VV -- 'vu'eli is _.. Fine S.nci E3idg -. Building l - Loamy Sand > Greater thara - sl Sandy Loam Las ihd:; i s Lour) Br, Bro'% f si€ Siit Loam S silt Ciy - Gra 0 Clay Loam Y _ Yello v sci - San Clay Loam R -- Red sicl Silty Clay Loam n, C" - [ 1 IttiF's sc: - Saildv Clan .,f( C - Sits Clay ft -- fi ti t; I c - C1 y CC cra €tir,i r= c e -'a - Prat rrlm - klilny, r d tarn n, -- NA r ir d - d' c I't -- psornirrr €It H'AlL High ti,,at =cVIIl, Six goner al soli text.rre s wl'w": fer foi liquid -rest €a dkposal RM - Be Mrark 7H - Vert;cza Reter, Point TO THE OWNER: T , ; soil test report is thra first step it') s ,r urwg a >anit ar; pornsit. The county r)i the Departmew, may rettuest VLE,' €l:atlwl of this soil test S!t th� fiuld prior iii i.) {'t ,aEi: :Ss 71.'.i, ' A compleo4 et of p;,'s for the p7rivato Sy >iem -' and a pr, ni apfl liCeifi o 3' €?a.S> b(' SUI3., i,a �. =.d t(i the jpf)t opt# e. IOcat <'3u0mrity it', ord(t " to otkta`fl a The CUxt ii -iS V £3'!:'"ii3; must S,e orImmed arof Oos'".d Svl io it3 t1_ ) sty(rz of any co structi pf;c a , � ,S'aW Ur • &,r T fy °f ro ,uUt�'� o v Peop o wE(l �5 ` 1 1 p O, 'b3 � lv d� `v Fresh Air Inlets And Observation Pipe �/P���� d h �] 0 _ Approved Vent Cap C� Minimum 12 Above Final Grade N (d Z� Above Pipe _ 4" Cast Iron ' i o Final Grade Vent Pipe Marsh Hay Or Synthetic Covering Min. 2" Aggr Over Pipe Distributi Tee Spi 1 Pipe 0 0 0 , A gg re g at Perforated Pipe Below Beneath Pip Coupling Terminating At f5 Bottom Of System 1 O t 1 v fl V Fresh Air Inlets And Observation Pipe v � h O L Approved Vent Cap Minimum 12" Above Final Grade 9 4" Cast Iron Z " Above Pipe — Vent Pipe - To Final Grade Marsh Hay Or Synthetic Covering Min. 2 Aggregate Over Pipe ��5� Distributi Tee ��, Pipe 0 0 0 0 0 Aggregate Beneath Pipe o Perforated Pipe Below �( T o Coupling Cou lin Terminating Al Bottom Of System