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HomeMy WebLinkAbout026-1165-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: Y (ATTACH TO PERMIT) 463154 0 GENERAL INFORMATION 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: Dalstock LLC Richmond Township 6) 2-to - I X05 - 36 - OZ6 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: / DU /dt) G �' v 30.18. �Zg TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 4 g4- / Dosing- A- Alt. BM � Aeration Bldg. Sewer �- Holdin g St/Ht Inlet -`• St/Ht Outlet TANK SETBACK INFORMATION ' _z_ Z • Z TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ ` Septic / NA 1 42- 1 4Zi Dt Bottgm ` \ Dosing Header /Man. cv • (z Aeration Dist. Pipe Holding Bot. System - S e Ia n Final Grade 4 I PUMP /S10H<�W NFO' 'RMATION . Manufacturer Demaril St Cover GPM Z . C cl I Model Nunt7 T 1= riction Loss System H ?,, Ft 1 ti y. r' �• 1 Leng a. Dist. to Well Ll SOIL ABSORPTION SYSTEM DIMENSION 1 \ . Iyjdth / Length h No. Of T rench es PIT DIMENSIONS No. Of its Inside Di a. DIMENSIONS \ ' I �< SETBAC SEM TO P/L BLDG IWE LL LAKE /STREAM LEACHING Manufacturer: INFORMRI CHAMBER OR Of stem:. UNIT Model Number: j� �,., . fit C, I DISTRIB . ON SYSTEM j c' 4—o--,J� Header /Manito]0 �� Distributi x Hol Size x Hole S acing Vent to ' Intake `i- Pipigth Dia \ i Length 36 Dia Length � Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over TPI h Ov er xx Depth of xx Seeded /Sodded xx Mulc eh Bed/Trench Center Trench Edges ` Topsoil ` l Yes No Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1457 129th Street New Richmond, WI 54017 (N 1/2 SE 1/4 30 T30N R18W) Lundy Meadows Lot 30 Parcel No: 30.30.18. 1.) Alt BM Description = ` 2.) Bldg sewer length = 14 2 -' - amount of cover oSignA Plan revision Required? [ f Yes No Use other side for additional informs ion. SBD - 6710 (R.3/97) Date Inse Cert. No. * a _ w �. �� !� Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 i cansirt Madison, W 1 53707 - 7162 Sanitary Permit Number (to be felted in by Co.) Department of Commerce (608) 266 -3151 Sanitary Permit Applic RECEIVED Plan LD. Numbe In accord with Comm 83.21, Wis Ad personal info ou provide may be used for secondary s vary Law, ' I m) O O jest Address (if Jiff t than trailing address) L Application Information - Please Print All Information CROIXCOUNTY t s Name ZONING OF P Lot# Block# Sf_V 1 7 v 's Mailing Address Pioperty - 1 -2 Section -)�q Z Z- City, State tip Code Pho ne Number ,? Y 'role one) T N;A orW IL of Building (check all that apply) /�/ or Family Dwelling - Number of Bedrooms Subdivision Nam 117- Iv / /%' L M N Public/Cowmercial - Describe Use 2 State Owwd - Describe Use � 'D )51 - . CQ.I�S "7 City_ Village wnship of / III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A System Replacement System Treattnent/Holding Tank Replacement Only Other Modification to F.xi wW System B. Permit Renewal Permit Revision Change of Permit Transfer to New List Previous Pettit Number and late Issued Before Expiration Plumber Owner IV. of POIM System: (Check all that aii -Pressurized In -Ground Mound Z 24 in. of suitable soil Mound < 24 in. of suitable soil Ate Single Pass Sand Filter i Constructed Wetland Pressurized In -Ground Holding Tank Peat Filter Aerobic Treatment Unit Recirculating Filter Recavulathig Synthetic Media Filter g Chamber Drip Line Gravel -less Pi (ez lain) y' V. D' eatment Area I rtnation: ( b - F Desi � F low ��) Design Soil App f) Dispersal Arc& Retptired (sI) • . Dispersal Proposed (st) System ffievati . 3 � d -( . d� z 1- VL Tank Info Capacity in Number Man&facturer Prefab St teel r r Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Tanks Tanks Ad Septic or Hold;ag Tank Aerobic Treatment Unit A4 / Tlkiii Dosing Clamber VII. Responsibility Statement- 1, the a responsibility for Installation of the POWTS shown on the attached Plumber's Name (Pratt) Plumber' MPWRS Number Business Phone Number 2 smell 6 �������✓ Plumber's Addrcss �(S O Stat Tag Z /`' �� L ✓( J � �� � / VIII. CauntWDepartinent Use O nl y Appmv Disapproved Sanitary Permit Fee (includes Groundwater Date stnng Agee Srgn um ) Surcharge Fee) rV r 0 Owner Given Reason for Denial IX. Conditions of ApproyaMeasons for Disapproval 4 _ SYSTEM OWNER: &'G r� � epic tan , e vent filter and 4 dispersal cell must all be serviced / maintained j 3` S -2- �. / xz� � � ,44�og as per management plan provided b lumber. `'i ) 2. AFs requirements must be maintained as per applicable codelordinances vfG� LOT PLAN PROJECT Dalstock L.L.C. ADDRESS 1748 112th St. New Richmond Wi 54017 N 1> 2 SE 1 /4S 22 /T N/ 18 W TOWN Richmond COUNTY ST. CROIX 10/20/04 BEDROOM 4 MPRS Shaun Bird 226900 DATE CONVENTIONAL XXX IN -GR D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39 IL 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 91.5/91.3/91.1 5' below grade Alt. BM Top of 2" Pipe @ 100.2' Well is to meet all setbacks required by WDNR Pro 4 Bedroom 375' Property Line House Scale is 1" = 40' Plans Designed Using Conventional Powts 30' unless otherwise Manual Version 2.0 noted ST 3 -3' X 83' Cells with >3' Spacing 30' Al 1 ' Prope Lin B -1 90 -2 ` Ven t` &PLA1(,6 J; 45' 3- % Ar�2-t%!'� 0 7 U o 2 7srt�<- Slope / X 1 Vent >6 „ Sta Rind ffu aching Chamber g of Cover 233' with 3 1. 1 ft2 of Area Property 6' Long 11 " Line 34 „ rade a stem Elevation G t System 430' Property Line 67' Property Line PLOT PLAN PROJECT Dalstock L.L.C: ADDRESS 1748112th St. New Richmond Wi 54017 N 1: 2 SE 1 /4S 22 /T N/ 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/20/04 BEDROOM 4 CONVENTIONAL XXX IN -GR D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39 IL 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 91.5/91 5' below grade Alt. BM Top of 2" Pipe C) 100.2' Well is to meet all setbacks required by WDNR Pro 4 Bedroom 375' Property Line House Scale is 1" = 40' Plans Designed Using Conventional Powts 30' Unless otherwise Manual Version 2.0 noted ST 3 -3' X 83' Cells with >3' Spacing 30' Al M. — — --- 'I` 10' Property Linel B -1 90' -2, Vents 3 4 A -'6^ 6 �?.( A 45 B 3 _ Slop (4c> ' )C I ? 0 '7br>kC Vent > 6„ Standard B of Cover Leaching Chamber 233, with 3 1. 1 ft2 of Area Property 6' Long 11 Line Grade at System Elevation 34" 430' Property Line 67' Property Line ` Wisconsin DepartrnentofCommerce SOIL EVALUATION REPORT Page ( of Division of Safety and Buildings in accordanqe'with•Gomm 85 Wis, Adm�- -Code County r , Attach complete site plan on paper not less than 8 1/� x 11 inches in size. Plan must 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. RwieweZ Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Q Property Owner Property Location �` • /�� J 1/j Cam/ L �c� �� 41 Govt. Lot 1 i ,S 1 /4 S T N R E (o W Property Owner's Mai Address l Lot # Subd. Name of City §tate Zip Code Phone Number ❑ City ❑Village ;KT Nearest Road New Construction UsX Residential / Number of bedroom Code derived design flow rate -GPD ❑ Replacement Public or merciai - Describe: __ —__ - -- -- -- Parent material Flood Plain elevation if ap licable ,�� - z z ft. General comments ` / ' and recommendations: 7 j / - moo j [ /� �5'�/ / y/ J / 5 ��` ! � ` ✓ Boring ID # Boring Ground surface elev. - ,a'`'ft. Depth to limiting factor j V in. Pit Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff #1 •Eff#2 �---- s Boring It Boring r � ® / Pit Ground surface elev. J 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 Ak r l b� Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 150 ` Effluent #2 = BOD <_ 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 — ��. _ U 715- 246 -4516 Property Owner _ Parcel ID # Page of F31 Boring # ❑ Boring � s �j Pit Ground surface ele '` ft. Depth to limiting factor in Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/t in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 Eff#2 �Z S 2 1!9/6j a Boring # ❑ 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. Munselt Qu. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 ❑ Boring F] Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit M*Eff#I'EfW Application Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Effluent #1 = BOD_ > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 30 mg/L and TSS 5 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. Sa - 9730 (R.broo) Soil Test Plot Platy/ Project Name William Stock/Steve Dalton Sha Bir Address 1748 112th St. New Richmond Wi 54017 M #226900 Lot 30 Subdivision Lundy Meadows Date 8/11/03 N 1/2 SE 1/4S 22 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 91.5/91.1 *HRpSame as Benchmark Alt. BM Top of 2" Pipe @ 100.2' Please note: Installer must verify all lot lines and setbacks before installation. 375' Property Line Scale is 1 " = 40' unless otherwise Please Note: Tested area noted may not be suitable for desired building area. Check system location before excavating. Al M. 97' x J 10' Property Line B -1 90 96' 30' Poo 45' B-3 % lope 233' Property Line 430' Property Line 67' Property Line Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent 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 V ncy Plan If system fails, determine cause of failure, use c'rnate aria and install new tested 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 cannont be lowered. Install holding 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 COVNTY ST CROIX ENT' . E AGREEM EVA C SEPTIC -TAN D F ORM ` D�HIP CERTIFICATION F owne r/Buyer Mailing Address a mnent for new construction) -- Address 5 pplanning D Property (Z/erificatioa required ¢� parcel Identificatr °n Number city /State LEGAL DES' D I.T -R w, Town of �,., Sear .--- 1 Lot # 3 D. Pr operty _______ I,ocatxon Subdivision �`- Page # — �--- Volume e rtified Survey MaP # 3 9 Page # �? —...- C Z , Volume Warranty Deed # -7 � '� es D no Lot �� identifiab of sludge. �� ©no spec hour ee its premature failure to beadle wsstcs. Proper the N � tic system could result is P a licensed systeln lIaproper use and Ma pumpe1, What You F' SYS bAcm °e cry � years or sooacr, if seeded by system. iag out the septic tack tment stage in the waste disposal consists of pump as a tree ed by tJre owner and by s ctioa of the septic teak artmeat a Ce rtification form, sign ewaterdisposal system it to St. Croix Zoning can affect the fun that (1) the on - site vast to Zoning DeP r verifying tic teak.' 1!3 full The proper owner agrees or a licensed pu3n; the 3s less than lumbar, jouraeYmanplumber, rester °tedp n and Pump if necessar7'j� h septic ing (� masterp oporating condition sndlor (2) after system with the standards is in prop m a intain the private sewage d stat atioa emeats and agree to iZesourccs, State of VyiscansO � 30 as have read the above re4uir ed so St. Croix County' Zoning Uwe, the t of ��merce and th e Departar set forth, ass, as set by the Departm'� nta� amp O stem has stating a our septzCC P, *on date. , r % 4 —A) D �� days of Uj N a� 1QrPIAfViZE F APPLICANT owners) of _ J AJ I F l /� Gjv sl� w �' c. I (we) am (are) the WNER ICATI N a re true to the best of my (ours cc. p I {we ertify that all statements on a in Re aster of D bed ove, virtue of a warranty the property scribed DATI: TURF 4 errrtit being ievoked by the Zoning Department. 44444k AP PLICANT «« oraaation that is �- n pnscnted may result is the sanitary P . «4« ,pay utf aster of Deeds office derd deed from the Reg' cation: a stamped Warranty sna if reference is made in the warranty «« Include with this app li s copy of the certified survey P A U,• 2484P 300 J. Exterior siding and finish materials must terminate no higher than 16" above finish grade level. Exposed concrete masonry or poured concrete foundation systems must not be exposed more than 16" above grade. K. All gas and electric meters shall be located away from the dwelling side fronting the street and obscured from direct public view. Where these locations cannot be adhered to, a landscape buffer must be incorporated to obstruct the view of these meters. L. All basement egress window wells must be constructed with a timber retaining wall or a rri�tal window well. These egress wells must be earth retained and not left unfinished. 7. Setbacks Setbacks from streets, right of way, side and back lot lines shall adhere to existing ordinances and zoning requirements of the township of Richmond and the County of St. Croix. 8. Violation and Rights of Parties If any party violate or attempts to violate any of the covenants, conditions or restrictions herein provided, it shall be lawful for any party in interest in the above described lands to institute and prosecute proceedings at law in equity against the parties violating, or attempting to violate, either to prevent an anticipated violation, strkp a violation, or to recover damages for a violation. This Declaration may be amended or changed by a supplemental Declaration of Covenants that is signed b ers o CEO 0 Dalst , LLC ill Stock Steve Dalton Subscri d sworn to before me this '2 -�`Y`' o Mnb7e 003 i nd, Not Public WI ;' , pion is pe anent. This instrument drafted by: Attorney Kristina Ogland Estreen & Ogland Attorneys at Law 304 Locust Street Hudson, WI 54016 I _ r . U 29 39P Gay S fATF. UAR O) WISCONSIN FORM t .2000 KATHLEEN H, WALSH Y�ARR,4NTY HEED REGISTER OF DEF_'D'� DocumeniNumbcr ST. CRt)IX CO., M1 RECEIVED FOR RECORD This Deed, made between L. Lawrence Williamy and Virgina R. Williams, husband and wife and each in thrir own rieht Grantor, and ie/21/2003 0S:45An Dals(ock, ULC, a Wiscon3in limited liability company Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys to Grantee the following f described real estate in St. Croix County, Stale of Wiscon5in (the "Properry ") REC FEE: 11.00 (if more space is needed, please attach addendum) TRANS FEE: 3015. A0 The South One -half of the Northwest Quarter (S 'h of NW '/, of Section COPY FEE: Twenty -three (23), Township Thirty (30) North, Ranee Eighteen (18) West, CC FEE EXCFPT Lot One ()) of Certified Survey N1up recorded in Vol. 8 of PAGES: 1 Certified Survey Maps, Page 2305 as document number 465057; AND The North One -half of the Southeast Quarter (N 4; of SE ''' /) of Section Twenty -two (22), Township Thirty (30) North, Range Eighteen (I es . Virginia R. Williams loins in this deed for the sole purpose of conveying any kccording Area lnseresi she may h — in Ure sulij�ct ;Hoped) umlc the P Lx. of the State of Wisconsin. S'lo.c .nu R Sur❑ .Auurr�.N Robert J. Richardson Parcel Id numbers' Bakke Norman SC 026-1068 F O 000; 026 - 1068 -90- 000 026 - 1066 -00 026- 1066 -90 -000 5233 McKay Ave., P.O. Box 399 ;Spring Valley, W1 54767 l Tof,ethar � %ilh ;ill appurscn-ini r,6hi >, Bile end ,iucr.;ii $cc abovc farr•el k3twi(icaliun Numtxr This is not homesicau property (+ra (is not) Grantor warrants that the title to the Prop 1: y ,s good, indefeasible in fee simple and fret and clear of encumbrances except easements, restrictions and rights of way of record Dated this 1 Sth day of October 2003. L. Lawrence Williams _ Vir is R. Williams l AUTHENTICATION AC1(P,'Q'`'LEDG,ME,NT Sler,arve(s) L. Lawrence Williams and STATE OF WISCONSIN 1 Vir¢ina R. Williams ) ss. ) authenticated this 15th da f October 2003 County , Personally came before me this day of r 2003 the above named i ob rt J. Richardson TI LE. MEMBER STATE BAR OF WISCON�.i,v, (If not ___ (0 me know'n to be the oerson(s) who executed the foreL)oine authorized by 6706.06. �l'Ig. Scats,) instrument and acknowledeed the same. THIS INSTRUMENT WAS DRAFTED BY ROBERT J. RICHARDSOti' Bakke Norman SC SPRING vgLLEY. WI 54767 Notary Public. State 01 I My Commission is Dermancnl (If not, state cxwration dale ' (Signatures ma�� be aushcnucated or acl Hoth a;c not ncccsstry) Names ul persons Signing in any apueny inu5l he typcu 1 ) PL hcLlw (lieu signawre WARPANI) DLrD U t8W16S5•:Ult rwo nlourofonn co OTC rF. anR OF v ttC(i N. \\ ` A p 2 � o0 • `` °° LOT 4 — ~ ° \ 68,672 sq. ft. • IN \ 1.58 acres LOT28 • LOTS • 70, 000 sq ft. 89,892 sq. ft. • - v� 1 w 1.61 acres 2.06 acres 5 rn `'� o / - •- j o . Lr1 N • j � - • LOT 29 _ �— , 66' Joi, 91,250 sq. ft. - , a C12 Drivewc 2.09 acres ah 4 • • Easemet J. mss. a� . • - - � � •� - . , 5� ry LO T _WO .� 85,211 sq. ft. 1.98 acres 3 r � LOT31 � LOT32 •�° 81,269 sq. ft. to 86,861 sq ft. 1.87 acres 1.99 acres ZQ ° o� N �`�' o a 0. = 972.0' a h :� L. �q. ft. �. MB .:res �,� — 19765 Drainage £c — 1439.07 — "' ^ H W. E = 96t ;3.19' �, 67.19' 294.80' >➢6d.10 ~ 31� - 26SS.95' e of slopes goo o goo This permit E _U N P L A T_T_E D_ ! ugh o public r GRAPHIC SCALE TE n ": Thenorth lice ofLot 1 ofa CertiBe�d SurveyMap t' SCALE IN FEET: 1 inch = 100 feet worded m Volume 9 Page 2474 does not coincide with the north line Dusty and at size. Daces ofthe Southeast Qusrlff ofthe Southeast Qua throfmid Section 22. Ri & ofodters ma exist m this errs. Contact an attorne re intact the St. 8h Y Y gmukn8 r advice. rights, tide end ownrrs * in this arra . This Instrumt