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HomeMy WebLinkAbout022-1091-50-101 9partment of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix 'ding Division INSPECTION REPORT Sanitary Permit No: 463483 0 .cRAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: ,rsonal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name" Village X Township Parcel Tax No: Hanson, John & Alice I Kinnickinnic, Town of 022 - 1091 -50 -000 CST BM Elev: Insp. BM Elev: BM Descripti n: !� - 1 Section/Town /Range /Map No: t ` 4-� 1 �� 31.28.18.494A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / Benchmark Desix�g Alt. BM Aeration _ -- Bldg. Sewer Holding St/Ht Inlet 11 6 0 11 TANK SETBACK INFORMATION St/Ht Outlet #2— TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Wlet Septic -7 10 1 725 26/ Dt Bo m Dosing Header /Man. Aeration ( Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM F /63 Model r ber TDH L Friction Lo System Head H Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia Liquid Depth DIMENSIONS �- SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: `, INFORMATION CHAMBER OR Type Of System: NA- UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution 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 Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 948 Hanson Drive River Falls, WI 54022 (S 1/2 NE 1/4 31 T28N R18W) metes & bounds Lot Parcel No: 31.28.18.494A 1.) Alt BM Description kcni �S [ � ,, �� 2.) Bldg sewer length = - amount of cover = 7 116 Plan revision Required? I Yes 0 W Z I YJ Use other side for additional information. _ b5 _ _ _. _ _ _ _ � ____. Date Insep is Sign a Cert. No. SBD -6710 (R.3197) t u � ri „ a. Ft.. a.} 1 V N N c O N lf) C � _ . C J r O Vi = N IL co 4 > 1 �S j rn LW I • Safety and Buildings Division County c r 201 W. Washington Ave., P.O. Box 7162 5 4, CI (7 ' I r _ iscons�n Ma on, WI 53 it Number ( to be filled in by Co.) Departmerit of Commerce 8) 266- 51 REGEIV 3 Sanitary Permit App 'c Plan .D. Number . r In accord with Comm 83.21, Wis. Adm. Code, personal inform AY 0 N A may be used for secondary purposes Privacy Law, s15.04(1 ct A ress (if differs than mailing address) R SQi. I. Applic ation Information - Please Print All Information ZONING OFF 1 091 " o - /Cu Property Owner's Name Parce # Lot # Block # D a rti .s o !'./ 4Z i da_ . Property Owner's Mailing Address Pri� tion City, State ,3 ip Code Phone Numbbe /r �� 1 / 9 � Section / •1 �� Z T-%` �a i /J = `7p2c� - SD`s T 23 N; Rcle W Il. Type of Building (check all that apply) r� ` S � 1 or NumberofBedrooms TIN / Subdivision Name CSM Number Public/Commercial - Describe Use pp El State Owned - Describe Use Q)'1 8 1R S s }�/yi� ❑City ❑Villag ownship of �/!! it 11I. Type of Permit: (Check only one box on A. Complete line B if applicable) A. ❑ New System ❑ Replacement System Treatment/ Replacement Only ❑ Other Modification to Existing System T N K. B. El Permit Renewal El erm Pit Revision El Change of ❑ Permit Transfer to New fJ-, List Previous Permit Number and Date Issued Before Expiration Plumber Owner c /VW,S -- L1 ,<A/� j IV. T at a I e of POWTS System: Check all th) S /�(/ A'N - Pressurized In Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At - Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit 11 Recirculating Sand Filter Recirculating Synthetic Media Filter El Leaching Chamber El Drip Line El RC1 Gravel-less Pipe Other (explain) V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Requir s Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Pre a ate feel Fib Plastic Y v r Gallons Gallons of Units Concrete Constructed Glass New Ddsting Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit �"�' -'X _ b Dosing Chamber VII. Responsibility Statement- I, the undersigned, a responsibility for installation of the POWTS shown on the attached plans. Plumb 's ame (Print) Plumber's S' a MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip VIII. un /De artment Use Onl pproved ❑ Disapproved Sanitary Permit Fee (includes Groundwater DDaa Iss ed ssuing AgeSi 7� Fee) C ❑Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval -7 1 STEM OWNER: �5�e C Septic tank, effluent filter and dispersal cell must all be serviced / maintain w as per management plan provided by Dlumhar QHQ 2. All suck requirements must be maintained ,�, � //__ -- n as per applicable code /ordinances. GCS0"� / r �C Attach complete plans (to the County only) for the ste pq per not less 81� inches es In See Q ! � (/(1 ( ( / / J h ` G�t / t / TTiiII� SBD -6398 (R. 01/03) � b� �.�, U'"` o r - OT PLAN PROJECT John Hanson AD RESS 948 Hanson Drive River Falls Wi 54022 NW 1/4 SE 1 /45 31 /T _ 28 IV N/ 8 W TOWN Kinnickinnic COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/5/05 BEDROOM 3 CONVENTIONAL XXX IN -GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA ? # of chambers none BENCHMARK V.R.P. Top of DW Vent Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL H. R. P. Same as Benchmark SYSTEM ELEVATION 92.0' at Drainfield bottom Property Line Existing 3 Well Bedroom House 200' 30' AC 20' lkd1 35' �v 10 , To be Pumped and rem oved 0 , so' J ST� 50' 25' DW 3? Vent 50' 15' —0 20' 10 0% Slope B -1 To Hanson Drive to Property Line OT PLAN PROJECT John Hanson AD14RESS 948 Hanson Drive River Falls Wi 54022 NW 1/4 SE 1 /4S 31 /T 28 N/ 8 W TOWN Kinnickinnic COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/5/05 BEDROOM 3 CONVENTIONAL XXX IN -GROU / PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA ? # of chambers none IL BENCHMARK V.R.P. Top of DW Vent Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL H. R. P. Same as Benchmark SYSTEM ELEVATION 92.0 at Drainfield bottom Property Line Existing 3 Well Bedroom House 200' 30' 15' 20' Add, � T 35' 10 W 3 ' 0 D To be Pumped and rem oved ' 50' ST 50' 25' DW 3 Vent 50' 15' 20' 10' 0% Slope B -1 Hanson Drive ZT0 e t o Property Line ST. CROIX COUNTY WISCONSIN PLANNING & ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 May 18, 2005 John & Alice Hanson 948 Hanson Drive River Falls, WI 54022 RE: Remodelingibedroom addition, Town of Kinnickinnic Parcel # 022 - 1091 -50 -100 - Computer #31.28.18.494A Dear Mr. & Mrs. Hanson: You have requested the Zoning Office 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 planned modifications involve an increase in design wastewater flows to the Private On- site Wastewater Treatment System ( POWTS). I have reviewed your remodeling plans for the above residence. The project involves finishing one additional bedroom in the lower level of the structure. The septic system has an estimated design wastewater flow for three (3) bedrooms with a maximum occupancy of six (6) persons. There are currently two (2) occupants using the system, but the proposed project will increase the total number of bedrooms to four (4). The POWTS will become undersized for the number of finished bedrooms within the residence; however, current occupancy does not exceed the design wastewater flow for the existing POWTS. An Occupancy Affidavit is required to disclose the disparity between number of bedrooms and septic system sizing to any future owner(s) of the residence. This affidavit has been submitted to the St. Croix County Register of Deeds office for recording against the deed on May 18, 2005. The original system pre -dates any county records, but a recent inspection and soil test have confirmed that the existing drywell dispersal area is still functioning. The original septic tank and one of the two existing drywells will be abandoned per Comm 83.33. The replacement septic tank will include an effluent filter to improve the quality of wastewater being discharged and will be connected to the southerly portion of the existing system. To prolong the POWTS lifespan, the septic tank should be pumped at least once every three years or when the tank becomes 1/3 full of sludge and scum. In addition, water conservation measures should be implemented, for example repair /replacement of leaking plumbing fixtures, reducing shower time, running the dishwasher only when full, avoid using a garbage disposal, using a wash machine with a suds -saver feature, etc. The long -term function of your POWTS is dependent upon proper maintenance of the system. If this POWTS should fail at any time in the future, the system will need to be inspected by a licensed plumber or POWTS maintainer to determine if it requires replacement according to state code requirements in effect at that time. The proposed remodeling and room addition project must comply with all applicable building codes. Please contact the Building Inspector for the town of Somerset to obtain a building permit. Should you have any questions, please contact this office. Si , Pamela Quinn Zoning Specialist Cc: David Phillips, Kinnickinnic Building Inspector Permit file ST CROW COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer , Mailing Address Property Address (Verification required from Planning Department for new construction) City/State Parcel Identification Number c� 2 2 _ /Z f 150 l LEGAL DESCRIPTION I �/ — prop Location � /., /., Sec. . T N- RL._W, Town Subdivision --- . Lot # Certified Survey Map # /J A , Volume . . Page # � Deed # _ 4(0 1 Volume /> (s2 . Page # 1 Spec house ❑ yes Lot lines identifiably. ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days f the year expiration date. r oA OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of ;O LNA ty scribed above, by virtue of a warranty deed recorded in Register of Deeds Office. OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * « * ** «« Include with this application. a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. r filter is being installed in 2. Effluent filter is to be cleaned once a year. Please note: a large order to extend the maintenance interval of the filter: the ins actions pipes at the ends of in via p 3. Once every 3 years, cells are to be p the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5, The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan - -. {f stem fails, determine cause of failure, use �:ernate Ar`�d and install new Option #1. sy stem syst tested replacement area. chambers, removing biomat, ption # . install system at a lower elevation, by removing and install new system. O tion#3. No adequate area is suitable for replacement area, and system elevation P can nont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -45 St. Croix County Zoning 715 386 - 4680 Pumper Tom Mondor 715- 246 -5 Shaun Bird #226900 I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page —L of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County it r Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must 1 r include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). R Col Q� Property Owner j Property Location a Govt. Lot IU 1/4 �� 1 /4 S J T Z 7 3 N R E (o W Property Owner's Mailing A dress Lot # Block # I Subd. Name or CSM# • /', City State , Zip Code Phone Number ❑ City ❑ own Near st Road villa / - ❑ New Construction Us sidential / Number of bedrooms Code derived design flow rate '7Q GPD f Ej�eplacement ❑ Publil or commercial - Describe: Parent material © :7 Flood Plain elevation if applicable General comments and recommendations: fl Boring Boring # n9 2 Pit Ground surface elevz y ft. Depth to limiting factor /z !� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Ef1#2 1- S� F-1 Ong # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 1 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please print) nature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �� —ZJ�� 715 -246 -4516 r Property Owner _ Parcel ID # Page of F] Ong # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F __T I 1-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Ong # E] Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Effluent #1 = BOD_ > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SOW330(RAW) Parcel #: 022 - 1091 -50 -100 04/2812005 11:29 AM PAGE 1 OF 1 Alt. Parcel #: 31.28.18.494A 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 *_ Tax Address: Owner(s): - Current Owner � % JOYCE CONNOLLY, TRUSTEE * HANSON, JOHN L & ALICE JOHN L & ALICE HANSON 1434 S MAIN ST Q O RIVER FALLS WI 54022 U �l7 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 948 HANSON DR SC 4893 SCH D OF RIVER FALLS SP SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 6.870 Plat: N/A -NOT AVAILABLE SEC 31 T28N R18W PT NW SE THAT PT OF THE Block/Condo Bldg: N3/4 OF THE NW SE LYING SWLY OF HWY & INC DRIVEWAY AS DESC IN VOL 584 PAGES 94 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) n� & 95 31- 28N -18W NW SE S O Notes: Parcel History: Date Doc # Vol /Page Type 04,5-/ 1162/131 QC 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 12845 119,900 Valuations Last Changed: 05/11/2001 Description Class Acres Land Improve Total State Reason OTHER G7 6.870 20,000 70,300 90,300 NO Totals for 2004: General Property 6.870 20,000 70,300 90,300 Woodland 0.000 0 0 Totals for 2003: General Property 6.870 20,000 70,300 90,300 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch #: 117 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 .I „_,; State Ba of A',�con.in Fort. 3 QUIT C .41 DEF REGISTER'S OFFICE l ST. Croix CTY., WI '? Recd for Record Henson and Alice Hanson, husband `e, as survi.voT. ship_ marital- proper-ty F EB 16 1996 �aQa :�intia Y Neuberger,Susan_C Monicken_, t Connolly, _Lawrence J. Hanson,_A.11en L, rtd Ruth A. Hanson_, as tenants in common F6giSterofDeeds vi one- _sixth -- interest each - -_ -_ .S t T`+'S SPACE RESERVED FOR RECORDI N.. ^4'A icscnbed real e.tate in -- -- -- -- - —_ - - - -- Croix County NAME AND ^ETUR ADOREss 13 le � ago wr sucy ->`. t i 1 (Parcel Identification Number! i >: P i ttached Exhibit "A" for real estate description. j � �I 15 not homestead property. (XK'(i not) 31st day of _____ ._- December_. - -__ -- __ -- __ 19 9 5. -- -- - - - -- -- -- (SEAL) -><_ _ -4�yv - -- (SEAL) .J hn L. Hanson -- — — -- - ( SE - \L1 _ CLC�_ - L`k� - - -. (SEAL) I .Alice Hanson_ AUTHENTICATION ACKNOWLEDGMENT of John L. Hanson and STATE OF WISCONSIN Sti. Hanson _._ -_ _ County. J th 31st day lff December 19 95 Personally Lame before me this ._ _.�__ -_ __ _ day of t � the above named . _ Beskar__ - i -MBFR STATE BAR OF WISCONSIN _- _ _._ -- ------ ...-- .-------- . - -- -- -._ -. -__- _ red by §706.06, Wis. Stats.) to me known to he the person _ __._____ who executed the ioregoin¢ instrument and acknowledge the same. ', - IAEN T '.VA3 j)G A ' TED By Reskar, Attorney - vSKAR. BOLES & KRUEGER, S - - - - -- -- _- - -- nty. Wis. 1 t5 Mai S tre 4 0.. Box 1 ti$ Notary Puhlic -_ -__ _ _ Cou a is 4tl J 4 � � Nty commission is permanent. (If not, state ex iration date: as e aufhenu•:ate• or ac nos e ged Roth are not P 19 ! .�¢ m .::r. •.ap�4;n -h. a!d t" :.prd ,tr prmtvd M— thetr ..enalure.. 4M STATE R:%R Of- wtSCONSIN - M,cnos.n L Bunk Ga Inc. 1.OR%1 No 1 — 19N: P.L lwat,k ao Wis I EXHIBIT "A" :10%'Pa_1�? The S 1/2 of the NE 1/4 of Section 31, T28, R18, Commencing at the NW corner of the SE 1/4 of Section 31, T28, R18, running thence East along the North line of said SE 1/4 120 rods; thence South 55 rods; thence West 120 rods to the West line of said SE 1/4; thence North along said West line of said SE 1/4 to the place of . be innin g g Commencing at the SW corner of said SE 1/4 of Section 31, T 28, R18, thence North alo,ig the West line of said SE 1/4 100 rods; thence East 26 1/2 feet; thence South 100 rods to the South line of said II I SE 1/4; thence West along the said south line of said SE 1/4 26 1/2 feet to the place of beginning. i Commencing at a point 26 1/2 feet East and 95 rods North of the SW corner of the SE './4 of Section 31, T28, R18, running thence North 5 rods, thence East 5 rods, thence S Wly to the place of beginning. The West 3/4 of the SE 1/4 of Section 31, T28, R18, except that part sold to Walter Class described as follows: Com a Putlit 23 T, e E and 100 rocs and 6 feet N of the SW corner of the SE 1/4 of Section 31, T28, R18, and running thence S 100 rods and 6 feet to the section line, thence E along said section line 118 rods and 6 112 feet, more or less, to l owned by James Dunn, thence N 100 rods and 4 feet, thence Wly 118 rods and 6 1/2 feet, more or less, to the place of beginning. o Section 32 T28 R18 also a right The W 1 2 of the NW 14 f , , , ht of g way from the center of said section N 80 rods and thence W 80 rods as conveyed by deed of J. Brothwait and wife to Ellen Horstad. Conmencing at a point 80 rods E and 100 rods and 4 feet N of the SW corner of Section 32 T28, R18, running thence N 57 rods; thence W 120 rods, thence S 57 reds, thence E 120 rods to the place of beginning, also the right to travel over a strip of land 1 rods wide along the W line of said farm to the hwy. running E and W known as the County Road. A lying East of the S.T.H. 35/65 River Falls Bypass. AND E:{CEPT: A of land in Section 31, Township 28 North, Range 18 West in that part of the Northwest Quarter of the Southeast Quarter and the Southwest Quarter of the Northeast Quarter thereof described in Vol. 804 of Records, page 608 and recorded in the office of the Register of Deeds of said St. Croix County. Said parcel includes all land of the owner contained in the following described traverse: w' jai �'"1 �Ki : l _4c,�` 1 ""` :: �° 'X y .i'' •� �' f .� Y °Y 3' R• &vh{.L"4ea+wf4t�..$ [ `� F: Apo . .: y Commencing at the southwest corner of the Southeast Quarter of said Section 31; thence N 02 ° 09'5£3" E, 2423.07 feet to the point of beginning; thence N 39 ° 25'44" W, 296.81 feet; thence N 58 0 59 1 25" W, 887.19 f--et; thence N 32 ° 16'20" E, 270.00 feet; thence S 1 57 ° 43 1 40" E; 397.93 f -et; thence S 53 ° 22 1 29" E, 609.70 feet; thence S 60 ° 44'39" E, 325.50 feet; thence S 41 ° 03'14" E, 107.19 feet; thence S 29 ° 29'25 "E, 426.21 feet; thence S 19 0 48 1 03" E, 561.39 feet; thence S 14 0 25 1 17 11 E, 45.26 feet; thence N 87 W, 281.50 feet; i thence N 10 ° 53'30" W, 280.99 feet; thence N 33 ° 25'41" W, 280.48 feet; thence N 43 0 09'23" W, 367.05 feet; thence N 39 ° 25'44" W, 73.58 feet to the point of beginning. All bearings contained in the above described traverse are Grid Bearincis the W' - Syst --em-, ,.Central Zone. c j Containing 7.64 acres, more or less, exclusive of lands heretofore ! ased for highway right -of -way. St. Croix County, Wisconsin. I i i Safety and Buildings Division County RV 201 W. Washington Ave., P.O. Box 7162 �54 e� a l �sea�ns�n M on, WI 53 it Number (to be filled in by Co.) Department of Commerce s) 266 51 RECEIV D Sanitary Permit App 'e State Plan .D. Number f In accord with Comm 83.21, Wis. Adm. Code, personal inform ' AY U 9 N A may be used for secondary purposes Privacy Law, s1504 I Project (if differenf than mailing address) I. Application Information - Please Print All Information NTY SQinQ_ ZONING OFF E D 9 /" v1/ou Property Owner's Name Parse # Lot # Block # ez rL s' o /1✓ Property Owner's Mailing Address C/ Prr op � City, S 1p Code ._ , Section d Phone Numb / r �Sa Z �/� = Yac� — �SD�d? T �� N; RE W II. Type of Building (check all that apply) I or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number ❑ Public/Commercial - Describe Use se State Owned - Describe Use 01 3 9 ❑City ❑vin ownship of III. Type of Permit: (Check only one box on A. Complete line Rif applicable) `,' ❑ New System y ❑ Replacement System Treatmen Replacement Only El Other Modification to Existing System B• ❑Permit Renewal ❑ Permit Revision ❑ Change of ❑ T Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ����- el�/re%u,J IV. Type of POWTS S ystem: Check all that appW 9lon Pressurized In- Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe Other (explain) WEZL S V. Dis ersal/7'reatment Area Information: / Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Requ Dispersal Area Proposed (st) System E levat VI. Tank Info Capacity in Total Number Manufacturer Pre a t Fi Plastic Yv t Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, a responsibility for installation of the POWTS shown on the attached plans. Plumb r ?: ame (Print) Plumber / 's S' a NIP/MPRS Number t Business Phone Number Plumber's Addres /D s (Street, Cit St Zi VIII. Coun e artment Use Onl El Approved ❑ Disapproved i e ee cl Groundwater Date Issued Issuing Agent Signature (No Stamps) ) 11 Owner Given Reason for Denial Surcharge Fee IX. Conditions of Approval/Reasons for Disapproval STEM OWNER: " �� r Septic tank, effluent filter and S�/f�ry ��c�� �� yt,0 -- dispersal cell must all be serviced /maintained / as per mans ement lan provided by 40 2• All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County o ) fear the ay to a 81/t 211 Inches in ' SBD -6398 (R. 01/03) 7� 1 .k 0:1 i r TOTAL DYNAMIC IICAD /CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATER!NC MODEL 152/153 r MODEL 1h2 153 50 Feet MP.1P.rS Gai. Liters Gal. � Li ters 153 5 1.5 69 261 i 77 f 291 12 40 10 3.1 61 231 I 70 265 152 0 15 4.6 53 201 61 231 20 6.1 i 44 167 i 52 197 30 25 Feet 7.6 _i_3 129 I 42 159 30 9.1 i 23 1 87 33 125 — o 20 35 10.7 i -- i -- 22 85 1 11 1 42 4 • Lock Vo!ve- 38.0 Ft. (11 fm) 44.0 FL. (I 3.4m) 10 014M 0 20 40 60 80 100 GALLONS LITERS 0 80 160 240 320 3 27/x2 n 5/8 - - FLAW PER MINUTE I I � I 11 t j 3 27/32 a.1 of t—„ e14. t t�'t i� ��� r' i:4�. i'•' %��:5.,, '��•:�1•+s. {'i•1[,Y�� *�.9 — j • T enod doff ponois avaiabte. V ® 3 27/32 • Electrical allemators, fa duplex systems, are available and supplied wild an alarm. • Variable level control switches are available for controllO g single phase systems. 1 • Double piggyback variable level float svritctres are avallable for variabi ' Level rang and short cycle wntols I I • Sealed Qv* -Box available for oultim insGrilations. See FM1420. i • Over 130 °F. (54 °C.) special quoMon required. I i I +52153 Sem 12 1/8 I _T 1StH6! MO 8.4 I C00ro $eleclb i � I II mum I VO41-ft Mode Aerpg I N152 115 1 NM U 1 2or3 8N1 115 1 i Ado 85 ... _Indudd.- -.. _ E152 2 1 T Non 43 1 2or3 eE152 230 1 I Auto 43 kdxled 2or3 M153 115 1 Nan 1 5 t 2or3 aN153 115 1 A& 10.5 Included 2or3 i i: AW :i E153 230 1 Non 3 3 1 ZOO 1. p199lI� evel k w1able l MW WM:h or double ftybedc variable level float 6E153 230 1 Auld 5.3 krc 2ar3 61Miar. Refer 1D FL40477. I A CAUTION 2. See FW712 for correct rnodel of 58001111 Abmelor E -Pak '= ''y ' °• "P "` " 3. VW W$ level Control Poo 10-0225 used as a Cadrd acdwkx, WjUfy duplex (3) .. c . t' am: '.;Ina•• . ;6adu19 We Fros! r. .% °C" .. -n Act roSNa or (4) loaf system. RESERVE POWERED DE3'GN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. AMLTa P.O."111w ,. Lotdolk KY 402564W � SW TO. 3618 Cow Run RaW mod.. �,• ® L.an aft KY 40211 -1961 /Tl r+M+o �J/" /.7✓s7 r o FAx CGVR M4 7T6 273f • r 74. 928 PIAIIP PUMP f0. � (6o� >7sa624 . 43 Copyright 2001 ZoeW Co. All rights reserved. 6 MODEL 152.153.max