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HomeMy WebLinkAbout026-1026-20-000 0 m \ 2 k ) \ / k J .41 « 2 < _ c _ , < [ 7 ) � 0/ 2( 7 0 + 2 ;u f G �• / - £ { § m ] : § ? \ 2 \ \ Q } m [ \ / - 8 / / E t t ® ¥ \ \ r / P. 2 ( @ @ A 3 / > / ` E E § ! § £ � i g c a » 2 / V y 2 % / . @ \ - § ® / 1 / 2 § \ � [ w / > < @ m . \ / \ \ c (A E c CD ` z o f 0 0 0% \' % § 2 ƒ S § $ \ z g a E ■ ■ a > 2 0 ) ( o E ° : . � ■A. 2 § ¢ D e / r 4 \ -4 / 2 > >0 E / CL . a / E � k \ _ - \ ¥ z 7 0 \ Z w » C M \ k 0 A \ _ o \ z o / \ { G \ F/k 2 § / a 0 § � //£ })f % 0 \) °$ ® E - } \ / � [ \ 7 2 ƒ S i a 0 $ \ > C) * % § @ � \ / isconsin Department of Commerce PRIVATE SEWAGE SYSTEM C ounty: and Buildings Division Count : fet INSPECTION REPORT St. Croix aENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 363928 Permit Holder's Name: ❑ City ❑ Village ❑ T6wn of: State Plan ID No.: Germain, Edmund Richmond Township 5 3 / CST BM Elev.:. Insp. BM Elev.: BM Description: Parcel Tax No.: I M. 6 1 k "a1 ,1fie¢ 026 - 1026 -20 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic (,) t T Benchmark �, ! S Dosing C' t Alt. BM ) Aeration Bldg. Sewer Holding St /Ht Inlet 97. - R , TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet Air I Septic s too r Idp t NA Dt Bottom 3. Dosing > rov > fcor k �s ` NA Header/ Man. lo�� 5 •� °($..°/2 Aeration NA Dist. Pipe � 1 �a es Holding Bot. System G 5�8 R0 2Z PUMP/ SIPHON INFORMATION Final Grade Manufacturer G. L � �' Demand St cover CA Model Number D 3 t L 'k " GPM Cam) ,bb aq -8,D TDH Lift CO3 Friction O. , System 2 S TDH� 'Tx Ft �✓ H ead c Z. q 4 Forcemain Length ��� Dia. 2t� Dist. To Well SOIL A SORPTION SYSTEM BAD QREhLW Width Le I No. Of Trenches PIT No. Of Pits Inside Dia, Liquid Depth DIMENSIONS 1's DIMENSION SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHI Manuf r: SETBACK CHAMBER 6 INFORMATION Typeof M o e Number: System: M I�b z 15C> OR U YW DISTRIBUTION SYSTEM ( I � Header/Manifold AA h Distribution Pipg(s) It x Hole Size x Hole Spacing Vent To Air Intake Length kv— Dia. Dr Length � 2awia. O Spacing tr-f I Zy 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 discrepancies, persons present, etc.) Inspection #l: t0/ Z3/Q Ins ection #2: ° /Z ° Location: 1063 170th Avenue, New Richmond, WI 54017 (NW 1/4 NE 1/4 8 T30N R19W) - 083019104A ) 1.) Alt BM Description = �v�a... �a. do~ - 2.) Bldg sewer length = 6 S" - amount of cover = " 4Z" 54 3.) contour = 9:-- 2 - 5 ` S L . Plan revision required? ❑ Yes No Use other side for additional information. 5� SBD -6710 (R.3197) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: E } F 4... g -41-4 I f F i * Safety and Buildings Division 6 onsin S ANITARY PERMIT APPLICATION 201 Box Washington Avenue Department of Commerce In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for t tTess County ` than 8 1/2 x 11 inches in size. CC,(, • See reverse side for instructions for completing this a State San � PP errmit Nu ber Personal information you provide may be used for secondary purposes Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. S A„ A» 5 ate Plan I.D. Number I. APPLI ATION INFORMATION - PLEA E PRINT N �= �oS 3 Property n r Name j � erty Lo tion ii A Y\1 ,1/a, T3C7 ,N,RI �"�r)W Propert Owner's Mailin� Addres� �+� Y t ' . Block Number rr Q Cit State Zip Code Phone Number u -vision Name or CSM Number I V 2� ter\ _5 0 ( 'Z 6 - ----�- II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ It� Nearest R92 ❑ C.I age Public al or 2 Family Dwelling - No. of bedrooms 1 Town of 17 0 III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 Apartment/ Condo g, 30, IS. IoyA 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) Aj 1 ❑ New 2 rof Replacement 3 ❑ Replacement of 4 ❑ Reconnection of 5_ ❑ Repair of an ------ System !_�'_' System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 30 E] Specify Type 41 E] Holding Tank 12 E] Seepage Trench 22 In- Ground Pressure r 42 [] Pit Privy 13 E] Seepage Pit k 43 ❑ Vault Privy 14 E] System -In -Fill 8, 0 VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 550 —3 7-3 /, 7 c� � Feet /0.2 Feet VII. TANK Capacity in Cap Total # of , Site Fiber- INFORMATION g Gallons Tanks Manufacturers Name Conc Prefab. Con- steel glass Plastic App New Existin App anks Septic Tan or H@k6"9ier►k, Tanks T i ❑ ❑ ❑ ❑ ❑ 1 Pump Tan /Si ialia. r4a..W. W e r i .QS uS ❑ ❑ 1 ❑ 1 ❑ ❑ PONSIBILITY STATEMENT I, the undersigned, assume responsibility for ins tion of the onsite sewage system shown on the attached plans. Plumber's Name: (Pr ) Plu ber's Sign ture: No Stamps) MP /MPRSW No.: Business Phone Number: 153 '7�5 v Lis Plumber's Address (Street, City, State, Zi Code 1 ): c S �-e o c IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps) Surcharge Fee) [Approved F1 Owner Given Initial 3o�S d� Adverse Determination - 3 0 - Zal X. CONDITIONS OF APPROVAL REASONS FOR ISAPPROVAL: — RA-W 4BD -6398 (R. 4/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS , 1. A sanitary permit is valid for two (2) years.','_ > �� 2. Your sanitary permit may renewed before thte (ratior5- da'te� and at a time of renewal any new criteria in the Wisconsin Administrative Code will be appliEW =" -f 3. All revisions to this permit must be'approve y 1h(;,p41" iss rn4authority. 4. Changes - in owne4iq or phumbpr requires a Sasroar Permit Tianlfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation ` '' -: 5. Onsite sewage systems must be properly initatained., c tanks) must be" "pumped by a licensed pumper whenever _.. _ necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151 �- - - • -- - -• _.. __ To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. ,Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller thaQ 81/2 x 11 inches must be submitted to the county. The plansmust include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction Joss; pump performance curve, pump model and pump manufacturer D) cross section j of the soil absorption system if required by the county; E) soil test data on a 115 form; and'F) all sizing information. ----------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included thecreaii6n surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. 5: _ Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us • Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 07, 2000 CUST ID No.273085 ATTN. POWTS INSPECTOR CALVIN POWERS ZONING OFFICE POWERS EXCAVATING INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/07/2002 Identification Numbers Transaction ID No. 305131 Site ID No. 189198 SITE• Please refer to both identification numbers, Site ID: 189198 above, in all correspondence " with the agency. St. Croix County, Town of Richmond NW1 /4, NE1/4, S8, T30N, R18W Facility: Edmund J. Germain Existing Residence FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 655361 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The existing POWTS must be properly abandoned. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, c DATE RECEIVED 03/29/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 erard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 785 -9348, Mon. - Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us WiSMART code: 7633'' r PAGE ''uu OF ° I 1� MOUND SYSTEM FOR A _3BEDROOM RESIDENCE LOCATED IN THE AOF THE 1 /40F SECTION' ,T 3C N,RlyW, TOWN OF on , S COUNTY, WISCONSIN. INDEX PAGE lA OF 9 TITLE SHEET PAGE 1 OF 9 WORK SHEET PAGE 2 OF 9 WORK SHEET PAGE 3 OF 9 WORK SHEET PAGE 4 OF 9 WORK SHEET PAGE 5 OF 9 PLOT PLAN PAGE 6 OF 9 PLANVIEW CROSS SECTION PAGE 7 OF 9 DISTRIBUTION PIPE LAYOUT PAGE 8 OF 9 PUMP CHAMBER PAGE 9 OF 9 PUMP PERFORMANCE CURVE PREPARED FOR I o c-3 1 '7� (o-o- N -e- . -�', t�v 5 t 7 PREPARED BY POWERS EXCAVATING INC. P �II)y -3 — Ls -010 Go11 4l - Qo53 7 1969 185th AVE NEW RICHMOND, WISC. 54017 715 -246 -5135. =- I� WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: `� l Design a mound system fora U�d roo►;� - -- The site characteristics are: Depth to groundwater or _ may in. P Landslope Percolation rate Distance from dose chamber to distribution system_ ft. Elevation difference between oum A and distribution system .3 ft. 'Step 1. WASTEWATER LOAD = 3,�.9�r��1 IS - Y ^. gal.' Step 2. SIZE THE ABSORPTION AREA A Area required 4,50 ; 1. L 3 7.5 sq. ft. �s B) Bed or trench length (B) _ -5 375 � ft - C) Bed or tr-anch width (A) a 5 ft. , D.) TrcnGh' spcing..(.C) Wastewa er load .24 gal /ft /day S : ft. r r tre�c e� es Step 3. MOUND HEIGHT A) Fill depth (D) _ ft. B) Fill depth (E) = D + slope (A, f t. /+LO X5 h 2- C) Bed or trench depth (F) A ' ft. D) Cap and topsoil depth (G)`= • � ft. E) Cap and topsoil depth _ It -5 ft. •J _ 1 :... 4A for Step 4. MOUND LENGTH A) End slone (K) _ C D + E + F + H x 3 = /D'.3 ft. C 2 5, B) Total mound len�th (L) B + 2(K) e 9 ft. Step 5. MOUND WIDTH Al) Upslope correction factor 5/6rc. � 89 A2) Upslope width (J) n (D + F + C)(3)(factor) = - 2, , ft. Q x-83 + /)x 3 X ,89= 7,ss6 01) Downslope correction factor = 0y. 51. B2) Downslope width (1) _ (E + F + G)(3)(factor) _ /6' ft. +,83 +>3X 1,ly Cl) Total mound width (W) for bed = J + A + I _ ft. 6 + C2) Total mound width (W) for trenches J + + (no. trenches -1)(c) + A + I ft. Step 6. BASAL AREA A) Infiltrative capacity of natural soil g4l. /ft /day B) Basal area required = wastewater flow ' natural soil infiltrative• capacity ?SO sq. ft. , — C1) Basal area available for bed for sloping sites = 155 B x (A + I) _ sq:, ft. r j5<5 + /o,� 1135 C2) Bas are •avail le for trench for sloping sites = B W — �J + A 1 = sq. ft. C3) Basal area available fo'r trench or bed for level sites B x W = sq, ft. t (f )nu�� � 5w Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM in. 1) Hole size a� in. 2) Hole spacing ■ ..37 in. 3) Distribution pipe length /-I , - in. 4) Distribution pipe diameter 5) Spacing between distribution pipes A -- in. 6) Distance from sidewall to distribution pipe D in. 7B) DISTRIBUTION PIPE DISCHARGE RATE / 1) Number of holes per pipe 4 1Z 2 GPM 2) Flow per pipe 7C) SIZE MANIFOLD 1) Manifold is central / end © ft. 2) Manifold length a d �a Tic 3 - -- 3) Number of distribution lines --°-' in. 4) Manifold diameter R �3 7D) SIZE FORCE MAIN GPM 1) Minimum dosing rate 3 2) Force main diameter .15 ft. 3) Friction loss ' 7E) TOTAL, DYNAMIC HEAD ...3. ft. 1) Vertical lift " ,15 ft. 2) Friction loss R '-"- 40 ft. 3) System head 2.5 ft. •_ ko, t5 r ft. 4) Total dynamic head 7F) PUMP SELECTION 1) Pump selected will discharge „ GPM at ft. total dynamic head. 2) Pump model and manufacturer 3885 hft- 7G) DOSE VOLUME 1) 10 times void volume of distribution lines gal. /cycle 2) Daily wastewater volume . 4 doses /24 hrs. _ /,[�,5 gal. /cycle 3) Minimum dose volume = X5 /a3, -5 gal ./cycle 3ow,3� 11 7H) DOSE CHAMBER 1) Minimum capacity required = (vim gal. r 3 )- �. C 1- I I I _ f i I - I , I I OA 5 3 j I I : 1 : r i : : , : : I : 1 i l i� i I ! i j : : I i I , I ' I t ,I I ! I , I ' , : - -- + - - - -- -- - -- - - -� - - - -1 - - Page Straw, Marsh Hay, Or ' • Synthetic Covering }�STM C33 Distribution Pipe Medium Sand. j G % Slope Bed Of ;j %2 Gorce Main Plowed Aggregate Layer D Ft. • �� Z Cross Section Of A Mound System Using. E Ft. �A Bed For The Absorption Area F X83 Ft. G 1 Ft. A 5 Ft. H 45 Ft. B ?S , Ft. K lb3 Ft. L 95, 6 Ft. _v. J ?.to Ft.. Position I /D Ft. of - Force Main W a3 Ft. Observation Pipe --,,, A jo— - - -- -- - --- - - - -' I Distribution. \Bed Of -2 %? Pipe Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area w i 1 f �jer'�Mct %� P 7 9 i Perforated Pt�r Ditoit End View :End Cop PuforoUd PVC Pipe H041 Located On Dottom, Are Equally SpocId X. • � • Fi % ?' � • • •�'' P c. r. • . el l nos f ' Last Hoii �t'a o� k .... ._.. y .�: � • Knit To End Cop • ' r i Dictribulio • n Pips Layout P 37 Ft. R S X InchPc Y a r Inches -- - ry Hole Diameter _A Inch Lateral " /%Z lncli(e;) Manifold = Inches j - Force Main ` A of holes /pipe q Invert Elevation of Laterals 4qS Ft. :PTIC TANK E ' PUMP CA_AMBE CROSS SECTION AND bFLU wvuu�j }v"v 4" CI VENT PIPE 12" MIN, ABOVE GRADE 6 WEATHER PROOF' 25.' FROM.DOOR, WINDOW OR JUNCTION BOX APPROVED INTAKE- WITH CONDUIT MANHOLE COVER FRESH AIR I W/ PADLOCK 6 FINISHED GRADE 4" Cl RISER WARNING LABEL 6 MIN. _4 4 MIN- ABOVE G ADE 18 IN. 6" MAX. NLET !\ GAS- ' WATER TIGHT SEALS TIGHT i A SEAL % APPROVED ED 4" BAFFLE ;}_ ALM JOINTS W/ CI �I PIPE B ON PIPE 3' ONTO 3' ONTO _F_ SOLID SOIL SOLID C 1 ' n* RISER EXIT SOIL PUMP OFF ELEV .FT • '' -- Y OAF PERMITTED ONLY D IF.TANK . MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS °. SEPTIC / DOSE %�I�pO TANK MANUFACTURER: NUMBER 'DOSES PER DAY: T TANK SIZES SEPTIC ' ` (_M - 0 GAL. DOSE VOLUME INCLUDING s GAL. DOSE _�-- GAL. FLOWBACKs ALARM MANUFACTURER: CAPACITIES: A = � , INCHES = .3 GAL.. � MODEL NUMBER: o w B = 2 INCHES = 33 -a GAL SWITCH TYPE: _ -- PUMP MANUFACTURER: C = 8, , 3 INCHES = 133 GAL.- MODEL NUMBER: 311 I- D = 7 INCHES = /a 8 GAL. SWITCH TYPE: REQUIRED DISCHARGE RATE GPM PUMP 6 ALARM WIRING AS PER ILHR 16. 23 WAC PEET VERTICAL DIFFERENCE BETWEEN PUMP OFF.AND DISTRIBUTION PIPE .5 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . • • • . . EET + 30 FEET FORCEMAIN _ X FT /100 FT. FRICTION FACTOR'. '�- . TOTAL DYNAMIC HEAD � / x.,15 INTERNAL DIMENSIONS OF PUMP TANK: LENGTH-, WIDTH '�_i DIAMETER ,b c^• LIQUID DEPTH 3 . J S iMbltn� " V q S ._ Ji ll ' .. Goulds P0. �- a o� a Submersible Effluent Pump .3885 APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the • be provided in starter unit. bronze impeller available as without damage. Shaft: threaded 400 series an option. Bearings: Upper and following uses: g : pp • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing Farms • Bearings: ball bearings type for maximum efficiency. construction. • Trailer courts upper and lower. 2" NPT discharge adaptable ■ Power Cable: Severe duty • Motels • Power cord: 20 foot for slide rail systems. rated, oil and water resistant. • Schools standard length (optional m Mechanical Seal: SILICON Epoxy seal on motor end • Hospitals lengths available). CARBIDE VS. SILICON ry moisture Indust p provides seconda • Single phase: Industry •' /3 and' /: HP -16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket • Effluent systems Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three BUNA -N elastomers. wicking. pron 1 SPECIFICATIONS • 2 plug. P 14/3 STO with to Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. W maximum. •'/2 -1'/2 HP -14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models - 20 foot on accidental reverse rotation. SP Canadian Standards Association • Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in _ TDH. are standard. high -grade turbine oil for • U Underwriters Laboratories lubrication efficient heat . L Mechanical seal: silicon lub ation and e c O carbide -rotary seat/silicon FEATURES transfer. carbide- stationary seat, 300 ■ Designed for Continuous series stainless steel metal •impeller: Cast iron, semi- en Operation: Pump ratings are parts, BUNA -N elastomers. op, non -clog with pump- within the motor manufacturer's out vanes for mechanical seal • Temperature: protection. Balanced for recommended working limits, 104 *F (40 continuous 140 °F (60 °C) intermittent METERS FEET • Fasteners: 300 series 90 stainless steel. _ _ _ SERIES 3885 • Capable of runnin d 25 80 SIZE: 1r'SOLIDS " 9 rY RPM: VARIOUS without damage to + 5GPM components. z � FT e 20 ; R - _ _. Motor 60 Single phase: _ ... Eo • % HP, 115 V, 200 V, 230 V, '15 so I I 60 Hz, 1750 RPM; Y HP, -- 115 V, 60 Hz, 3500 RPM; 0 40 EO H '/2 HP- 1' /HP, 230 V a - - - - - - - 60 Hz, 3500 RPM. 0 10 30 w • Built -in overload with - • — — automatic reset. 20 P WEo3L 5 • Class B insulation. Three phase: t • '/2 HP -1'/2 HP 200/230/ 0 0 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 50 80 70 80 90 too 110 120 130GPM • Class B insulation. o i0 2 30 mo CAPACITY 01995 Goulds Pumps Effective May, 1995 B3885 f Wisconsin Department of Commerce SOIL AND SITE EVALUATION Divisibn of Safety and Buildings Page J_ of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than S 1/2 x 11 inches in size. Plan must County ^ Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Prop Owner Property Location " t� Govt. Lot l f tj 1/4 N f, 1/4,S S T 3tj ,N,R �b or) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 1 __ J%% fi v -e_. City State Zip Code Phone Number ❑ City tk village f' Town Nearest R d N e� wX of ( '715 G o S o 1 71) f 16L St ❑ New Construction Use: esidential / Number of bedrooms 3 Addition to existing building (� Replacement ❑ Public or commercial - Describe: Code derived daily flow #So_ gpd Recommended design loading rate S bed, gpd /f1 gpd /f1 Absorption area required 37S bed, ft2 3 trench, ft Maximum design loading rate i S bed, gpd /ft2 , �2_ trench, gpd/ft Recommended infiltration surface elevation( sp _ C�, •._��Q� 9q ft (as referred to site plan benchmark) Additional design /site c onsiderations © Parent material f t'� 4 10L c 1 ' r, I Ck r , S"t l I If Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S 91 U �D S ❑ U ❑ S Flu ❑ S ®U I ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT c Boren # Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary Roots .......................... in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench .......................... ........................... ' 0 -7 a M sbk, M�' s o- Ground 0 3y r S PYl 5 b< Y>1 �'r w C. / 15 li lev. . ft. y -'A 7.5 r G �� 7, �S 6 5 rn 51 <. ►�, Sr — – i y -5 Depth to limiting factor >34 in. Remarks: Boring # 010 l ow - j 1h A m 5 M S G 3 m ,.5 , 10 a a /o dl j 5 s 3 a13o Abv ri _516 m4 t w e I R 6 Ground y y - >-.3 6 r Sbk h1i"y w C_ ' ` elev S 6-YD 715' FaF 2•� nr.5�� Mfi -- s ft. Depth to limiting factor >36n. Remarks: CST Name (Please t) Sig atur Telephone No. ca�� w ��s -� s a ess Date CST Number cl SOIL DESCRIPTION REPORT �. 4 s PROPERTY OWNER 1Vl- a a � Page ';� of PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 . , .: .,.....,, sell Qu. Sz. Cont. r Texture Consistence Boundary Roots t Colo Gr. Sz. h $ � S Bed ,Trench h -- � ,� ►'n S bK Mfr S C o1M , s , (e /v r S s,/ m 5bk mfr SC (h^ ,5 ;,,6 Ground aD 7, S r y S / m 5 k• 1'�1 r C y,, S elev. ?I 5 r 7, S C` S S ) I'll Sh 1'Y1 y ,5 Depth to limiting factor Remarks: Boring # ..... .. '.< Ground elev. ft. , Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Structure PD /ft Texture Consistence Boundary Roots Bed , Trench in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boring # 39 Ground elev. — ft. ; Depth to limiting factor — in. Remarks: Boring # C 1 Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) i w c � � y N.E �S S 730 jD c - - - - - -- Q ac, t s r�c� - — -- - - - — - -- -- 1 1 - -- V i , i r, ; ; ; I i ��z.os37 - - - i I I I I ; I I i ; i T i I I I I � 1 I I I I i I i i 1 i } ; j : 1 . � Ir i I - -- I , ; l I I 1 t 1 I t I Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of' and Buildings Page J_ of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and 'S7 C percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 0 APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 6-3t 2&0 Prope Owner Property Location r/ Y- � ncsu nA Govt. Lot A)U) 1 /4Nf, 1 /4,S T 36 ,N,R lb Por) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 1 o p fiV _Q_ City State Zip Code Phone Number ❑City Village Town Nearest R d New of (7�5 a S a f\1 7a ,�- 161- St ❑ New Construction Use: esidential / Number of bedrooms 3 Addition to existing building N Replacement ❑ Public or commercial - Describe: Code derived daily flow #SO_ gpd Recommended design loading rate 5 bed, gpd/ft —, o trench, gpd /ft Absorption area required 37S bed, ft ,3 75 trench, ft \ Maximum design loading rate i S bed, gpd /ft2 gpd /ft Recommended infiltration surface elevation(sO ft (as referred to site plan benchmark) Additional design /site considerations Parent material Pd 4 )a► c f 4 I dr" -s-t (1i r(�_ Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system El S 9:1 U Io S ❑ U ❑ S ®U ❑ S 1Z U E] S © U ❑ S ® U SOIL DESCRIPTION REPORT Po -t-a7 A^^ -' Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 6 -7 /D / aMSbk m�i� sc 3M iS .6 7 k fs a r^ 5tik rn r { an\ '5 A. Ground o3y ,. 51 m 5bl< ►� �'r GuG / � . elev. 9ft. y 7.5 d c a . 1 7, S b s Depth to limiting factor >. Remarks: Boring # 0'10 O r j a m 5.bK mf 5 L m .5 a a /0 dl D r S l( a ~n ' bw 2 3 x1-30 >r s I m 5hk M4 i w C i �6 Ground 36 r S .6k Mi W C ,S elev 5 lo' � �� 5 F a F 2. h >r1 5` ► 4 f y r s T _ Depth to limiting factor Remarks: C Name (Please t) Sig atur Telephone No. C o,\v ; ,.. 1 t) w 42-rS `7 15 p2 �osl3s q ess Date CST Number f')j, S c�i 3 —? -DO 'S3 . ����« SOIL DESCRIPTION REPORT g of PROPERTY OWNER �_ Pa e PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Kn Sbk rn f a 0 •d0 /� �, S — 5, l m 5b k. m �r S c /•, -' , S ; , b Ground a 7,S" ry S /m S�k. P11�t C� y ,,S elev. ' 5" h S 5 ( th Sbk 1'Y1 y S Depth to limiting factor in. r Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # Ground elev. ft. Depth to , limiting factor ' Remarks: Boring # i , Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) `j30 - w -7W _A Ric M V-L 54 01-7 33 N U: -`fi X11 _ L Ali- O o ��2 ®537 N o� £ 198 ct Jai { 6D so I - VCROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND ( . 1 OWNER / SHIP CERTIFICATION FORM Owner/Buyer c1. uyer M till - Gr_> , h Mailing Address 1D 6 3 176 ""*\ A v �� i t�n� d-, St �/o Property Address SQ &V. ,� A (Verification required from Planning Department for new construction) � City /State N�. i Mo[A W`� Parcel Identification Number LEGAL DESCRIPTION Property Location N 10 4 , _tIS: '/4, Sec. , T-3,DN -R l K W, Town of Car. Subdivision �" _, Lot # Certified Survey Map # 2 Aa4 --, + , Volume , Page # `Warranty Deed # q 3 3- ,2 ? — ,Volume �' , Page # 2 Spec house ❑ yes W no Lot lines identifiable F yes ❑ 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 wastewater disposal 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. I/we, 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 of the three year ex pi ation date. 9 A 4 t6'4jj SIGNATURE OIVPPLICANT DATE OWNER CERTIFICATION 1 (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 the property described above, y virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF AJYLICANT DATE * * * * ** - h Zoning Department. * * * * ** An information that is mis re resented may result in the sanitary permit being revoked b the g p Y P Y rY P g Y ** 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 DOCUMENT NO. STATE BAR OF WISCONSIN FORM 5 — JM T961141 SPArg 411SANIV90 FOR 1111111COVID!1*0 DATA PERSONAL REPRESENTATIVE'S DEED 43,5*278 r + REGISTERI OFFICE ST aw Co., W1 Roed for Rscwd ... 0A ................................... . ................................. ........ .......... ------- --- ---- - ---------- ...... MAR I a 1 14bo ..............•.................................... as Personal Representative of the estate of ...... i D A.Y. id.. j ..... (lermain ....................................................... of 8:30 A #A ........................................................................................................ 0 ii ..................................................................................... .... ("Decedent"), i for a valuable consideration conveys, without warranty, to .............................. ........................ . ....................................... ...................................... I ................................ . ....................................... an --- undivided--one=half --- U/2.) ... imterest...ia—, Grantee, l VICTU0134 To ty, W following described real *state in ........ att .... C1:9-ig .................. C0un State of Wisconsin (hereinafter called the "Property") : Tax Parcel No: . A( —01P �� The Northeast Quarter of the Southwest Quarter (NE} Of SW-0 of Section Five (5) ; the fj Northe-ist Quarter (NE}) of Section Eight (8), EXCEPT the j-,ollaAng described parce Camencing at the Northeast corner of the Northwest Quarter of the Northeast Quarter (NW} of NEB); thence in a Westerly direction along the center line of the To Road, 210 feet; thence at right angles, South 240 feet; thence at right angles, East 210 feet; thence at right angles, North 240 feet back to the point of beginning, containing 1.15 ages, imore or less, all located in Totwnship Thirty (30) North, of Range Eighteen (18) West, St. Croix County, Wisconsin. 41, S at FES Personal Representative -by this deed does convey to Grantee all of the estate and interest In the Property which the Decedent bad immediately prior to Decedent's death, and all of the estate and interest in the Property which the Personal Representative has since acquired. Dated this ........................... 10 ---------------- d o f .......... p� -------------------------------------------------- 19- .................................................................... (SEAL) •----- •--- -- -- --- -••-- --- -- - --- - ------ °---- -- --- ---- ............. (SEAL) .................................................................. a . O. Ge C ...................... r�v-n --------------------------- Personal Representative Personal Reprementativo AUTHENTICATION ACKNOWLEDGMENT Si gna t ure ( s ) ... Germai-n ...................... STATE OF WISCONSIN .............. .. .. ..........................................._..•..._... I ...................... -------------------------------------- county. Ma c1v auth"cited thip Vmay of '4� Is-.?? Personally came before me this ................ day of 19 ........ the above named --- - -------- ------------- ------------------------------------- HY. - - - X--mt ..................................... . ......................................... • Hendrik W. V ....................... ............................... ------------------------------------ - -- TITLE: MEMBER STATE BAR OF WISCONSIN ................................................................................ (If not ............................................................ ............................................................................ authorized by 1706.06, Wis. State.) to me known to be the person ............ who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY ................................................................................ Reinstra, Van Dy)� S.C. .. ...... ............ .. . ....... . .... --- South --- Knowles Avenue . ..... Box ... I . 27 •........... ............................................................. -New --- R ichmond.,—WI ------ 54al7 ........................ Notary Public .....-_.. .._____..___.._................ .. County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: ......................................................... 19.. --- ---• sNamas of persons si"inff to any capacity should be typed or printed below their signatures. ` Kr-t STAT E BAR OF WNSIN MlWCW4MV FORK No. 5 — 1982 Stock No. 1300S .—a