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Home My WebLink About026-1173-41-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety andbufiding Division Sanitary Permit No: INSPECTION REPORT 463235 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may 6k# used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Winkler, James I Richmond Townshi CST BM Elev: Insp. BM Elev: Description: M Section /Town /Range /Map No: /M BM m 21.30.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � 3 � d� Benchmark •01 0� Dosing Alt. BM Aeration Bldg. Sewer /as Holding St/Ht Inlet 4 •�-1- ion --5 ,,11 TANK SETBACK INFORMATION SUHt Outlet lb Z. TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 15x Dt Bottom Dosing /i x / Header /Man. Aeration Dist. Pipe �` JQ 7 c� Holding Bot. System (• 1 �7 /6 �` 'OK PUMP /SIPHON INFORMATION Final Grade 3 0 /c7. 7 Manufacturer Demand St Cover , GP Model Nu TDH ft Friction Loss System Hea TDH Ft Forcemain Leng Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length o. Of Tren PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 , I - 5 g I `��1 \ SETBACK SYSTEM TO P/L DG WE v\ LAKE /STREAM LEACHING Manufacturers n INFORMATION CHAMBER OR i- Type Of System: a " i UNIT 0 h�+F��S–' "j— Z4} l� J,/4, Model Number:, / ^J (-r— DISTRIBUTION SYSTEM Header /Manifold Distributi°n� \ \ x Hole Size x Hole Sp Vent to Air Intake T Pipes) 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 I 'i No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: IZ / / 0 Inspection #2: I / Location: 1102 145th Avenue New Richmond, WI 54017 (NE 1/4 SE 1/4 21 T30N R18W) Waldroff Meadows IV Lot 41 Parcel No: 21.30.18. 1.) Alt BM Description 2.) Bldg sewer length = Sys�� _ 7�� we li. F c1c�. ( amount of cover Cl 1 A � Plan revision Required? Yes No [ �� Use other side for additiona mfori ation. -- Date Insep is Si ature Cert. No SBD -6710 (R.3/97) r Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 /\ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) fsconsfn (608) 266 -3151 q( 3 z 3 5 - Department of Commerce CEIVED State Plan In Sanitary Permit li atiRE In accord with Cotton 83.21, Wm Adm. nnation you pmvide ��e� (if diffetettt than mauling addn:ss) may be used for secondary purposes 15'0 U G� U 3 o n n 4 I I , ) 4 5 I. Application Information -please Print All Information 0 I COUNTY if Lot# Block N "En �.A- / property Owner's Name ( �-- property o MTing Address �,#' $critlOn City. State o ! Zip Code Phone Number �50 T2-VN: R o W Oft (check all West apply) _ Sub divi CSM N welling - Number of Bearoosag - �r h D.dR.Nrl / - Describe Use City- y of State Owned - Describe Use Type permit: (Check only one box on line A. Complete line B if applicable) A New system Replacement System Treatment/Holding Tank Replacement Only Other Modification to Edsting System Previous Permit Number and Date issued B. Permit Renewal Permit Revision Change of Permit Transfer to New �pp Before Expiration Plumber Owner 10,2 l_ or K IV, of POWTS S m: Check all that a 1) Sin Pass Sand Fit I u azed in Ground Mou nd _> 24 in. of suitable soil Mound < 24 in of suitable �" Fil constructed Wedand Pressurized In Holding Tank Peat Fitter Aerobic bu Synthrdc Media Filter Chamber Line Gravel -less Pi (ex lain) V. D' ecsal/I'reatment Area rmation: 2) X S Design Soil Application Raw(gpdsf) Disposal ( Dm A= posed (sO System Elevation Desi flow (gpd) D S O 3 S J� J prefab Site S Fiber VI. Tank Info Capadty in otal Number Manufacturer Glass Gallons t.,allons of Uai t,- 3��Za�e.Q A- -/CD Concrete Constructed New Existing ranks Tanks _ Septic or Hokfing Tank Aembic Treatment U-d Dosing Qsarnber . yII 'bility Statement - I, the ed, assume bility for;ffitapation of the pGVVTS shown on the a udgm lwne Nu7/ pl s Name (Print) Pi s Signature MP � � � � � � V .• � •/ "� �'�� Plu s Address (Stroet, City, Ste,� ) � � � ``S VIIL Co /De mulumt Use Od Date Issued Agent Signatam (No Stamps) Sanitary Permit Fee Cmncludes Groundwater Appmved Disc Surcharge Foe Given Reason for Denial n Z S O � JX. Conditions App SYSTEM OWNER: 1 1 Septic tank, effluent filter and l dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attub co®plete plats (to the County only) for the system on paper not mess than Ila 1 11 inches in stae PL LAN PROJECT James Winkler/Sandra Rudek RESS 8382 Foothill Rd. Cottaae Grove Mn 55016 NE 1/4 SE 1/4S ?1 /T 30 / 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 12/2/04 BEDROOM 3 CONVENTIONAL XXXX IN -GROU RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 BENCHMARK V.R.P. Top of Survey iron g ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 105.0/103.5'5.2' below qrade B.M. * property Line 116' 0 ' Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts 102' 108' 20% Slope Manual Version 2.0 110' 112' Vents 1 ell B -1 � I - 1. ,,w El BB r - 183 2 -3' X 69' Cells with >3' Spacing �^ 30 67' ST 20' Pro 3 A1t.B.M. Bedroom top of conduit @ 118.1 House Vent > 6„ Standard Biodiffuser Property Line of Cover Leaching Chamber with 3 1. 1 ft2 of Area 6' Long 11 " Grade at System Elevation 34" F, )Zj, �,v �- vj wo-I PL 9T PLAN M LVoc� PROJECT James Winkler /Sandra Rudek ADDRESS §8 82 Foothill Rd. Cottaae Grove Mn 55016 NE 1/4 SE 1/4S. 21 /T 30 / 18 TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 12/9/04 BEDROOM 3 CONVENTIONAL XXX IN-GROUNVPRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 653 # of chambers 21 BENCHMARK V.R.P. Top of Survey iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 103.5' 5' below qrade B. M. * Property Line 116' X Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts 102' 108' 20% Slope Manual Version 2.0 112' 110' Vent B -1 3'X 75' Cell B -3 183 ST 3' X 56' Cell 25' 30' Vent 67' B -2 is 20' inside of house Pro 3 Bedroom House Vent >6 „ Standard Biodiffuser Property Line of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long 11 " Grade at System Elevation 34" PL LAN PROJECT James Winkler /Sandra Rudek RESS 8382 Foothill Rd. Cottaae Grove Mn 55016 NE 1/4 SE 1/4S 21 /T 30 / 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 12/2/04 BEDROOM 3 CONVENTIONAL )00( IN -GROU RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 BENCHMARK V.R.P. Top of Survey iron g ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL H. R. P. Same as Benchmark 0 SYSTEM ELEVATION 105.0/103.5'5.2' below qrade B.M. * property Line 116' 0 ' Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts 102' 108' 20% Slope Manual Version 2.0 112' 110' Vents B -1 B -3 183 2 -3' X 69' Cells with >3' Spacing 30' roll 67' ST 20' 10' Pro 3 Alt. M. Bedroom top of conduit @ 118.1 House Vent >6 „ Standard Biodiffuser Property Line of Cover Leaching Chamber with 3 1. 1 ft2 of Area 6' Long 11 " Grade at System Elevation 34" t , Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. Croix Attach complete site plan on paper not less than 81 /2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Pending percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all i tlon. R viewed by Date Personal information you provide may be used for se ndary a Law, s. 15.04 (1) (m)). p(Q Property Owner ' 1"f Location David Waldrof Govt. Lot NE 1/4 SE 114 S 21 T 30 N R 18 E( Property Owner's Mailing Address „ e , t Block # Subd. Name or CSM# 398 River Ro c j (/� - Waldroff Meadows N City State Zip Code o �� fly [:]Yllage JATown Nearest Road Hudson WI 1 54016 ( 144th Avenue tl New Construction UseE] Residential / Number of bedrooms 3 to 4' Code derived design flow rate 450 to 600 GPD Replacement 0 Public or commercial - Describe: Parent material Loess over outwash sands Flood Plain elevation if applicable lslt� ft. General comments s with a large oeket of sicl, 2.5yr5/3, c2d5yr5 /8, dsh. Recommendation is to install system below this restriction. and recommendations: �---- 1❑ Boring # 11 Boring Q Pit Ground surface elev. 117.15 ft. Depth to limiting factor 14'4'8 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. 'Efr#1 "Eff#2 1 011 10yr3 /2 sil 2msbk dsh as 2f .6 .8 2 4 -14 7.5 4/4 sl I dsh cam if .4 .7 3 14 -48 7.5yr4/6* ' s/sicl* Osg/lmsbk dl/dsh cw - .2* .3* 4 48 -105 7.5yr4/6 - s Osg dl - - .7 1.6 21 2 Boring # n Boring 118.00 >105 Q 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/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -9 10yr3/2 sil 2msbk dsh as 2f .6 .8 2 9 -29 1 4/4 - sil imsbk dsh cw If A .b 3 29 -105 7.5yr4/6 s Osg dl - _ .7 1.6 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S' na CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432120th Street, New Richmond, Wl September 8, 2004 715- 246 -2454 i - Waldroff Meadows IV Pending 2 3 Pro Owner Parcel ID # Page of Property 3 Boring �Boring g 1_i pd Ground surfac:eelev. 104.00 ti. Depth to Gmfing factor 36 - 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. *Ef1#1 I *Eff#2 1 0 -24 10yr3 /3 - sit 2msbk dsh as 2f .6 .8 2 24 -36 1 4/4 - sit Imsbk dsh cw if .4 .6 �n 3 36 -50 10yr4/4 flf5yr5 /8 sit lmsbk dsh cam' - .4 .6 4 50 -102 7.5yr4/4 - s Osg dl - - .7 1.6 Boring # Boring F1 Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # H 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/IF 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/- and TSS a 30 mg& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SBD- 8330Ted (R.09/00) Waldroff Meadows IV Lot 41 Scale 1 "= 30' Cp N bti / 1 1V G �o IMP Q7 Ibv v� l 0 jvA pp ,bL • L too (3 .00' Z B3 Thomas Nelson ► 227387 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Eff luent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of 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 o cy Plan Option #1. If system fails, determine cause of failure, use c ` yrnate at" and install new tem i ested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation nt be lowered. Install holding 9 tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird #226900 ........... ....... .............. ............................. ........... .......... ......................... ............ ...... ...................... ................ ST CIROIN MAIN SUTTK TANK ITENKNiCE AGRITMENT ANI) ONVNIER`".�'HIP CRRITIFICATICY�N FIDIRIVI t ;, %I t ��:, :... .�.._.__,.:�..,!�>'t ?.� 5.... C.�! 1�,tf.2..�..,. /fir GY __Vz 011 Prop.: - ty (Verifica:klil required fioin Planning Department for new consInLct Lon) tate _ejam✓ Parcel Identification Nunib!r__,_. . . . ......... . ... Prop-! V 1,0 ;r;!. ' n A 1�, V".. Sec. 4 UnIjAed sviv"!.y NI.U.P H V UrIll 1 9 .............. spec, -louse 'f of Lines ideutifiallic yes 1 no Lmpro rR! v i sia and =imemance of your septic system could result in its premature failure to handle wastes. PrOper ilia 4MIelince consic" of purapi:v " out the septic taml- every three ye-us OU 500TICT, it IlCedrd by a licensed pumper. What you put into tit..'evstem can. 111-tot the .emu i';;6an of the soptic tank as a treatment stage in the waste disposal system, The owner aj:xees to submit to St Croix Zoning DepAutrucata, ccTfifi"tiQn foriu. $if ' ned by the. o'.1mer,and by a rtsfaictodpluWbor or liucnsedp=pervcrifyingdiet (1) the is in P-1 Per opox"t"I: tq condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 AtU OP`Iludge. I/we, ic have reac• the above requirements and agree to maintain the private sewage disposal system with the I , , amdards set fora s, hciivI,'1i.i_w*t by the Department of Couirrierce azd the *j)eprLrUncnt of NatwiLl Resources; State of'Wisconsin.' cer"OlAvati BUtin;!�'!Lb tyoiir.i,;tl ,tie system l�.as been maintainod must be completed and returnod to the St. (,'roix Zoning, OtT d-ays o r.hr eb:z -:c } it omriratin late• 6—A i T( DAIT GW I T , EF, 'I'l."MICATI ON I (we)! t'!" that all 11tatements on this form axe true to the best of my (our) Icnowledge. I (we) am (are) the of the p:r ;:5arty i:nd above, b y virtuo al"a wurant). deed recorded to Register ni DeccLe Office DATr . .... 11 J Any ir& that is riu's-repres may result in the sanitary permit being revoked by'•he Zoning llhi::ude with - 4 h Is applicati a*st4mped warranty dead from the Register of Deeds Off a copy of the certified sw t%Mp if reforence is made W the waninry deed U 2690 P 224 ?�g1Q13 f t STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX Co., MI This Deed, made between David J. Waldroff and Julie A. RECEIVED FOR RECORD Waldroff, husband and wife Grantor, 11/05/2004 10:45AII and James L. Winkler and Saundra Rudek, WARRANTY DEED Grantee. EXEMPT # Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 1 1.00 the following described real estate in St. Croix County, State of Wisconsin TRANS FEE: 149.70 ace is needed, please attach addendum): COPY FEE: Lot 41, aldroff Meadows 1V. St. Croix County, Wisconsin. CC FEE: PAGES: 1 Recording Area Name and Return Address Of0 3- 17 we 026- 1062 -60; 026- 1062 - 70:026- 1064 -40 026- 1060 -20: 026- 1060 -30: 0264060 -40: 026- 1062 -50 Parcel Identification Number (PIN' This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights - of - way of record, if any. Dated this �' day of November 2004 * * yid J. Waldroff - - -- -- -- - - -- ---- ----- - -- * * l ie droff AI AUTHENTICATION ACKNOWLEDGMENT Signature(s) —_ ^_ -- -- ^ _— STATE OF - - ... ..........._..................- / ,r �� r/ � ) ss. _......._.._... � / f X County ) authenticated this _ day of Ro D . G2we -_- ^ -J— -- Personally came before me this ` 30Gy of Notary __ November r , 2004 the above named ........ _..._.... ......................................... _.._..-- - - -• -- - - - ..._.........- •- - -• - -- _._... - - - - - - -- -- State of Wisconsin David J. Waldroff and Julie A. Waldroff, husband and wife * K ristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ ______ to me known to be the person(s) who executed the foregoing autborized by § 706.06, Wis. Stats.) instrumen d ac w e ged the same. THIS INSTRUMENT WAS DRAFTED BY _.._ ... _ ... _._ ............... ............. .... Attorn Kristin Og land Hudson, WI - N t• Public, State of My C i n i rm merit f not, state expi ation date: (Signatures may be authenticated or acknowledged. Both are not necessary.) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, WI STATE BAR OF WISCONSIN 800.655 -2021 WARRANTY DEED FORM No. 2 -1999 -., ---------------------- --------- - - - - -- ST.. . 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