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HomeMy WebLinkAbout026-1147-45-000 0 (A ° m - o tv k ) ( a 3 � � � � t � g m = . . X 0 2 7 0 & �j < \ / m E \ \ { ) ' # 0. ( \ ^ a ° /; � % i EI; 0 »$ ~3 � § °0 U) � J ° CD / § 0 CL } o o 3 o e ° A C ¥ G§®; Q / / \ \i n r cn # ® \ & % [ m T ; © Ei — Oro / \ { § § § 0 & \ 7 $ E R i 3 g E i N) 3 m E g E z .. & C: co 7 ƒ EN o [ § 0 § ƒ § � c / N z 3 11 -4 CO) 0 / } E R R E m m / \ CL 3 m o FF . z 3 00 z Cl) q / � [ ma=r �E @k § � J CL c F)mz % � \/$ \ _ 77 /3 \ 2/ § aE � /\ o @ . m § \ \( �} � CD CL . # Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Suilding Division • INSPECTION REPORT Sanitary Permit No: 453164 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: P.C. Collova Builders, Inc. I Richmond Township 026- 1147 -45 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: �� d 0 0 oS� 24.30.18.1103 TANK INFORMATION V tLEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / 6 '400-0 Dosing � j � � / Alt. BM S,r • ✓ Aeration BI �i /v�• r �Holding SUHt I TANK SETBACK INFORMATION St/Ht Outlet p 5 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic k-i 1 3s , Dt Bottom Dosing Header /Man. ,zs Aeration Dist. Pipe .', � 72 Holding Bot. System 10.4 PUMP /SIPHON INFORMATION Final Grads Manufacturer Demand St Cover �j / 3• GPM Model Number TDH Lift F JTDH Ft Forcemain ength Dia. Dist. to Well SOIL ABSORPTION SYSTEMS-/ - / 7 BED /TRENCH Width 3' Length No. Of Trenches rPITIMENSIONS o. Of Pits I ide Dia. Liquid Depth DIMENSIONS /05 S —:3 1 SETBACK SYSTEM TO P/L L BLDG WELL LAKE /STREAM LEACHING Man tl{rer : .,� IN Type f System: i CHAMBER O /O �+Z Model Number: DISTRIBUTION SYSTEM O� S Header /Manifold Distribution x Hole Size x Hole Spacing Vent t it I ake tri Pipe(s) n Z✓� / Length O Dia Length L bs Dia Spacing —y SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded j xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrep Gigs persons present, etc.) Inspection #1:— / Inspection #2: P A m 1407 146th Ave ll+�kunbrn (SW Location: 1/4 NW 1/4 T30N R18W Richmon s Lot 45 24. 0.18.1103 � Parcel No. 3 1.) Alt BM Description= S� •�v \ �/ 19. 2.) Bldg sewer length = � 1 �f wed— i - amount of cover - 7 Plan revision Required? Yes " No Use other side for additional information. I_ D ate Insepctor's Signat e Cert. No. SBD -6710 (R.3/97) PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 SW 1/4 NW 1/4S 24 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4/24/04 BEDROOM 3 CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SI HOLDING TANK SIZE LOAD RATE .3 ABSORPTION AREA 1586 # of cham rs 51 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100 Filte A -100 ❑ BOREHOLE WELL *H. R. P. Same as Benchmark O SYSTEM ELEVATION 100.8/100.6/100.4 4' below qrade 146th Ave Well is to meet all Plans Designed Using setbacks required by Conventional Powts WDNR Manual Version 2.0 Vent Aon Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area Pro 3 Bedroom Property House p y Line Grade at System Elevation 34" 30' 0 40' B -1 85, B -220, 0 ' Vents 3 -3' X 107' cells with >3' Spacing 5% B -3 35' 100' Slope B.M.* Alt. B.M. is top of survey iron @ Property Line 96.5' i I County Safety and Buildings Division - � 201 W. 'Washington Ave., P.O. Box 70$2 Sanitary permit Number (to be filled in by Co.) Madison, WI 53707 — 7082 �sconsin (608) 261 -6546 ` State Pla y LD. Number Dt? artment o m f Comerce ti / �" I Sanitary Permit App liea on mforntaaonyoupcovide in second with Comm 83.21, Wis. Adm Code• perso Project Address (if di teat than mailing address) m ay be used for secondary purposes Privacy 1 aW, s15.04{ 1)(m) information (`(� don Inform atio - Please Print A ll Info � t<w B # I. A tr B ac PP Parce l ix Lot l L Property Owne'a NA Uu )l f� J U / ll� /C{ /J PropertYLocation p — Addreaa erty Owae's mail dress r� L?X !CNING OFFi Prop �.E Z (� y� � Section Phone Number Zip Code 7 rcle ) City S, tau N; r W II, a of Building (check all that appl y) � � fff%� S— CSM N bar or 2 Family Dwocg - Number of Bedrooms C] lidCammercial- Describe Usc /� ❑City ls wnsbip of ?- . CELCS tc.J l Use 3 A i5" ❑ State Owned Desrnbe _ --- - --�- -- , III, Type of Permit: (Cheek only one box on line A. Complete line B if applicable) Other Modification to Existing System Replacement System ❑ W System Treatrnent/Holding Tank Replacement Only B. ❑ Permit Renewal ❑ Permit Revision C3 change of ❑ Peiatit Transfer to New Lis Previous Permit Number mad Date issued Plumber Owner Before Expiration IV. T of POWP3 3 tent: Cheek ali that a 1 ❑ Single Pass Sand Filter ❑ Non - Pressurized in -Ground ❑ Mound _> 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil 13 At Grade 0 C onstruc t e d Wetland 11 Pressurized !n uad 13 Holding Tank ❑Pot Fiber ❑Aerobic Tre>tnnent Unit ❑Recirculating Sand Filter liacirprlsttin Synthetic Media Filept.f. bin Ch ❑ Drip Line ❑ Gravel -less Pipe er (explain) Dls ersalfrreatmeat Area m atio 1 O Dis 1 Area ro System El V. evsti Design flow (gpd) Design Soil APplicatio e(gPdsf) Dispersal Area Required (sf) P ��� pr Manufae /n�uer/y� efab Site Steel Fiber Plastic YL Tank Info Capacity in Tonal Number Concrete Constructed Glass Gallons Gallons of Units New Existing Tauka Tanks Septic at Hoiding Talc Aerobic Tromment Unit Dosing Chamber VII. ReapoaslbiiU Statement- I, the uadersi a sume responsibility tar installation of th e e pO1VTS shown oa the attached plans. Mp/MPRS Nu be )business Phone um i Plumber's Name (Print) Plumber' re �� U� J _ . _ G t Y ! L Plumber's Address (Street, City. S Zi ode (i' / /, L VIII oun !D artment Use Onl Sanitary Permit Fee (in odes Groundwater sued ssuing Ag Si re ps Approved ❑ Disapproved Surcharge Fee) �Ja , d (/ �j ❑ Owner Given Reason for Denial � IX. Conditions of Approval/Reasons for Disapproval S Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. / 3 1 1P 2 . All setback requirements must be maintained sVst9� as per applicable code /ordinances. u to the County only) for tLe system p a kss mail 5172 s 11 l he% In ttaee Complete Plains t SBD -6398 (R. M8/02) a�J PL PT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 SW 1/4 NW 1/4s 24 /T 30 /R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 — DATE 4/24/04 BEDROOM 3 CONVENTIONAL XXX IN -GROUN RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1212 # of chambers 39 -� I BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H. R. P Same as Benchmark SYSTEM ELEVATION 100.8/100.6/100.4 4' below qrade 146th Ave Well is to meet all Plans Designed Using setbacks required by Conventional Powts WDNR Manual Version 2.0 tE Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area Pro 3 Bedroom Prope es House Lin Y 3 4 Grade at System Elevation 30' - lease note: if soils are found to have pockets T V I of massive sandy loam in the system area, the 2� ! o installer will upsize the system to a.3 loading rate and use 51 chambers 40 , B -1 gd - k Lz-, -r 85' 2 20' k� 0 ' 3-3'X 83' cells with >3' Sp g Vents , 5% B 3 35' 100 Slope C opy B.M.* Alt. B.M. is top of survey iron @ Property Line 96.5' PL YT PLAN PROJECT P.C. Collova Bldrs. Inc. / ADDRESS P.O. Box 489 Somerset Wi 54025 SW 1/4 NW 1/4S 24 /T VO/ /R 18 W TOWN Richmond COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 4/24/04 BEDROOM 3 CONVENTIONAL XXX IN -GROUN RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1212 # of chambers 39 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE WELL Q H.R.P. Same as Benchmark SYSTEM ELEVATION 100.8/100.6/100.4 4' below qrade 146th Ave Well is to meet all Plans Designed Using setbacks required b Conventional Powts 9 Y WDNR Manual Version 2.0 jL Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area Pro 3 Bedroom House Property Grade at System Elevation Line 34 30' lease note: if soils are found to have pockets T of massive sandy loam in the system area, the installer will upsize the system to a .3 loading rate and use 51 chambers 40' B -1 B -2 85' 20 0 ' 3 -3' X 83' cells with >3' Spacing Vents 0-411 9 5% B -3 35' 100' Slope B.M.* Alt. B.M. is top of survey iron C Property Line 96.5' ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT + _ ~ ST. CROIX COUNTY GOVERNMENT CENTER N N N ■ ■ .••. 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 Memo to File From: Pam Quinn Date. 4/27/2004 Re: Sandy loam structure misinterpretation on subdivision soil reports Recent soil on -site determinations have brought a problem to our attention. During these on- sites, boaings were excavated to confirm soil conditions where two conflicting soil reports had been submitted for zonifli department review. The soil profiles, evaluated by myself, Dave Fogerty, and Dave Steel (all certified soil testers) differed from the original soil reports in that massive ( structureless) sandy loams were encountered in horizons that were described as having either moderate, medium subangular blocky (2msbk) structure by Adam Schumaker or weak, medium granular structure (lmgr) by Shaun Bird. There apparently has been a misunderstanding between "structure" caused by handling samples of the soil during texturing versus the soil characteristics in situ. The soil, when chunks were taken out of the profile to hand texture, with pressure parted into "crumbs" that appeared at first to be subangular or granular in shape. However, these were not true peds that broke apart along planes of weakness, but fragments created by handling. The soil when observed in the horizon did not have distinct units of structure and should have been reported as "massive ". Added notation: on 4/23/04 Mark Iverson (Cedar Corp. certified professional soil scientist), Shaun Bird, and myself did an evaluation of soils on Lots 6 & 9, Richmond Meadows where the original soil report described the third horizon as sandy loam, "l mgr ". On Lot 6 we checked soil profiles within a POWTS distribution cell and then excavated a test pit on Lot 9. The sandy loams in question were a weak, coarse to very coarse subangular blocky structure, where planes of weakness were just discernible when peds were parted from the profile. The peds separated with very light pressure by soil tester. Sand coatings were observed on the ped faces in the Lot 9 soils, which supported the determination that some structure existed to allow water to move through the upper portion of the sandy loam horizon. However, below the weak - structured soil we found massive (structureless) sandy loams and the boundary between these horizons was irregular, which would mean a distribution cell could encounter alternating weak and massive sandy loam. Shaun said he would amend his soil reports with a memo recommending that any sandy loams he identified as "lmgr" or "2 mgr" be assigned a lower loading rate of 0.3 gpd/ft2 (see attached memo for Whitetail Meadows) to provide a larger dispersal area. Page Two — Soil Memo 4/27/04 Massive sandy loams have been assigned a soil application rate of 0.2 gpd/ft with the code changes in Comm 83.44 -2, effective as of 2/1/04. The application rates listed on the soil reports were higher due to the structure having been described as either weak or moderate, which affects the calculations for sizing of POWTS distribution cells. Obviously, one of the concerns is to make sure loading rates for the soils are not in error and allow undersized POWTS to be installed. For example, in December 2003, Lot 35 of Richmond Meadows subdivision had to have its loading rate reduced to 0.3 gpd/sq. ft. when the installer encountered massive sandy loam at the system elevation. The sandy loam horizon had been described on the soil report as "lmgr" with firm consistence. Leroy Jansky, Dept. of Commerce Regional Wastewater Specialist, has been consulted on this situation and advised the zoning department to require on -site verifications for any lots with this potential misinterpretation on the soil reports. All soil reports with sandy loam "1 or 2 mgr" as its structure will be required to use a design based on the current code's soil application rate for massive sandy loam @ 0.2 gpd/sq. ft. unless additional soil testing proves otherwise. Z Bird Plumbing Inc. 1008 192nd Ave New Richmond WI 54017 715- 246 -4516 Subject: Whitetail Meadows Soil Tests is To Whom it may concern: I Shaun Bird did the soil tests on this subdivision known as Whitetail Meadows in Richmond township. Aftbr a couple of installations, some of the soils were found to have a more weak structure than what was found in some of the borings. In order to protect home owners and contractors, it is my recommendation after discussing the issue with Pam Quinn from St. Croix County Zoning office that the systems be oversized using a.3 loading rate Instead of the original .4 rate. On the lots that were originally sized for a.5, I recommend using a.4, not the new .6 that the state has suggested. The soils are what the tests indicate but the large areas tested did not reveal some of the weaker structures that were found upon installations. If a installer can prove otherwise, that the weaker structures do not exist, then the installer should proceed with the soils that he /she believes are present. Shaun Bird CST #226900 z -d ds* = z z t►o sa Jdd ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 Memo to File From: Pam Quinn Date: 4/14/2004 '0S Re: Soil On -site Determinations for Lots 3 37 43 Richmond Meadows Subd. On April 8, 2004 on -site determinations of soil conditions at the above lots was performed to evaluate conflicting soil reports submitted by Adam Schumaker and Shaun Bird. At 11:00 a.m. the weather /lighting conditions were acceptable, with temp. 50 °F, clear and. These determinations were requested by the property owner, Orenzo Oevering and the plumber /permit applicant, Dave Fogerty, who were present during the test pit excavations. Additional test pits were located next to borings on the original soil reports to better compare soil conditions in the tested areas. On lot 32 (see attached description) the soil profile contained massive sandy loams at approximately 36 inches below grade, which does not conflict with the soil tester's recommendation for using an at -grade system. What it did reveal, however, is that both Adam and Shaun likely misinterpreted the structure of the sandy loams: Adam called the sandy loam horizon a "2msbk" and Shaun uses "lmgr ". There apparently has been a misunderstanding between "structure" caused by handling samples of the soil during texturing versus the soil characteristics in situ. The soil, when chunks were taken out of the profile to hand texture, parted easily into "crumbs" that appeared at first to be subangular or granular in shape. However, these were not true peds that broke apart along planes of weakness , but fragments created by handling. The soil when observed in the horizon did not have distinct units of structure and should have been reported as "massive ". Two test pits were evaluated on Lot 37, since the sanitary permit has already been issued. Due to the current house and well location, additional tested area will be required to meet setbacks to the POWTS. A pit closest to Shaun's B2 did have a sandy horizon as reported, but only to a depth of 60 ", then underlain by a massive sandy loam. Unfortunately, the boundary between the sands and sandy loam horizon was very irregular, with tongues of sandy loam much closer to grade than 60 ". The recommended loading rate for this site would need to be lowered to adjust for varying pore space at system elevation. I Lot 43 had conflicting reports, where Shaun's tested area (near the front of the lot) reported conditions allowing a conventional system and Adam's (closer to the rear of the lot) reported mottling at 32" with a mound system recommendation. Additional test pit B4 was excavated next to Shaun's B3 (see attached description) and massive sandy loams were encountered at 17 inches below grade. Weathered cobbles (break into smaller pieces upon disturbance) and oxidized iron deposits around individual gravel/cobbles were observed in the pit wall, but no mottling was identified to 68 ". Shaun's B3 description of sandy loam with "2mgr" structure starting at 18 ", then sandy loam "lmgr" from 36- 110 ". Again, I think there was a misinterpretation of texture after a sample had been handled. Leroy Jansky, Dept. of Commerce Regional Wastewater Specialist, has been consulted on this situation and advised the zoning department to require on -site verifications for any lots with this potential misinterpretation on the reports. Obviously, one of the concerns is to make sure loading rates for the soils are not in error and allow undersized POWTS to be installed. For example, in December 2003, Lot 35 had to have its loading rate reduced to 0.3 gpd/sq. ft. when the installer encountered massive sandy loam at the system elevation. The sandy loam horizon was described on the soil report as "lmgr" with firm consistence. The zoning department will have a note placed on all soil reports with this type of description as requiring a design using the current code's soil application rate for massive sandy loam @ 0.2 gpd/sq. ft. unless additional soil testing proves otherwise. R Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code �t County '�- Attach complete site plan on paper not less than 8 112 x 1 incF - i -" e: include, but not limited to: vertical and horizontal referen pointj i n ga j Parcel I.D. _ percent slope, scale or dimensions, north arrow, and I tion and distance to near t road.1 Please print all informs ion. ? weaved by Date Personal information you provide may be used for secondary p rposes jt'ii vacy Lew; 5. f5. ( (m)). _ Property ,O,kner Property Location /� // +� GoNtiLOt i 1/4 1J114 � i T N R' E (r} W Property Owner's Mailing Address J Lot # Block # Subd. Name or CSM# City State _ Zip Code Phone Number ❑ City ❑ village Wown Nearest Road New Construction Use>' ;rResidential /Number of bedrooms Code derived design flow rate ,s GPD ❑ Replacement ❑ Public or meraal - Describe: __.--- - - - - -- ,/1 ----- - - - - -- - -- Parent material L .2�c r/r-J Flood Plain eleva on if applicable General co and recommendations: ��� �✓ ( ^� / ��� 8 /��' / •..� ` / C'C.� E / I PJ Boring Bori a# Q Pit Ground surf ace elev. v it. Depth to limiting factor _� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure i Consistence Boundary Roots GPDt(f in. Munsell Qu. Sz. Cont. Color Gr. Sz. Si*. `Eff#1 •Eff#2 l ^ l t I 1 Boring ng # Pit Ground surface elev. & 1 4 Depth to limiting factor !n. Soil Application Rate izon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF or in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I 0- 3 /01/11 �^ 5 S 3 P�w ti� I Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ffluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ' 715- 246 -4516 3 Property Owner _ Parcel iD # _ Page of � Boring # ❑ Boring � Pit Ground surface elev. 7 ft. Depth to limiting *a _.r ?0 Soil Application Rate Horizon Depth Dominant Color Redox Description ! Texture Structure ::onsist' ce Boundary Roots GPDKf ? in. Munsell Qu. Sz. Cont. Color t Gr. Sz. Sh. 'Eff #1 'Eff#2 IZ-2� J4 a LA 2, S ' _ - Z I N i I i ! ! Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication 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 6 8 ! Boring D Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit SoilApplicati on Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/Pi= 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 130 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. SOD-8330 pt.6100> i Soil Test Plot Plan : Project Name P.C. Collova Bldrs. Inc. Sha r Address P.O. Box 489 Somerset Wi 54025 M #226900 Lot 4 5 Subdivision Richmond Meadows Date /28/03 S W 1 /4 N W 1 /4S 24 T 30 N /R W Township Richmond R Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 100.8/100.6/100.4 *HRpSame as Benchmark Alt. BM Top of survey iron @ 96.5' 146th Ave a� a 105' 85 B -2 20' B -1 0 ' 00 104' 35' 5 Slope B-3 FA 6 Property Line 6. %risconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County sf ; c ro 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. 7— VS =a9[j Please print all information. Rev' a Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner / Property Locati o Ri C � a r� IU e kori Govt. Mt� 1/4 /VW1 / S Zq T 3 Q N R I E (or) OW Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# R;Ck q� mea dows City State Zip Code Phone Number I ❑City ❑Village [4 Town Nearest Road L J& d ear C K, A N S 5 o (l 9 ocie o q & Rl C� o oa C(O �. 03 New Construction Use.Z Residential / Number of bedrooms 3 t Code derived design flow rate p — D ❑ Replacement ' ❑ Public or commercial - Describe: Parent material � Flood Plain elevation if applicable ft. General comments 1 x S f -e W� 2 J, Fe ' -- C: ) �c�/li �(¢� 1� � ) and recommendations: °Lo v { �� ST. CR % fie. shn�r� d-- O/tw G °�` _c F T1 Boring # ❑ Boring 7� Pit Ground surface elev. �, V 0 ft. Depth to limiting factor Cl a in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 0- 10,r Sh 2r �Uf , 2 II- LIo joy 3 1 10 - G6 6 z s G I F — S 1 L romp .5 cam- (31 �Q - q F] Boring # Boring Pit Ground surface elev. G , 0 ft. Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 0 -fo o, - 6K M� C S ( u s' g Z,-IS Lt v,, �r c S — S' ' 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 (Plea $e Print) h Signature CST Number C7 IVf - 3 0 Address / Date Evaluation Conducted Telephone Number 2ll tl Sr• Sa MP�SP� (,� S G25 - 9 -UU .Z C IS zU> `IG©,� SBD -8330 (Rn7 /00) Property Owner A W S O ✓) Parcel ID # Page 2 of 3 3 Boring # 0 Boring /�� ❑ G�'� pit Ground surface elev. -- �-0� -0 ft. Depth to limiting factor �V in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 - a — I I K c s F . s Z ro3 S( 6K A4 P r S( 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 /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 Ef1#2 ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft 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. SBD -8330 (R.07100) L PAGE _OF 3 NAME o n LOT# LEGAL DESCRIPTION —' X�) X ,S,? T -SO N,R, Z 9 E(or SCALE: I"= G � -- A BM I ELEVATION BM 1 DESCRIPTION 400 c)-[/ )- l p liC BM 2 ELEVATION qy yU BM 2 DESCRIPTION eG ` SYSTEM ELEVATION 7, f: ,SO _ ALTERNATE ELEVAT 16 CONTOUR ELEVATION �5 q v �o Z g \ c) 6' P 0 SIGNATURE DATE aZ a -I Z m Z m -AMN aC r%A 1 rltK11Vt MUKKA t N j 1496 140TH STREET N NEW RICHMOND, WI 54017 UNPLATTED LANDS 140TH STREET - OAS _ �A GA6 � CAS GAS G - •— 66 ' 375.00' \w o 437.36'\ m N N �� \ 00 2 85.92' — — _ _ Z 6 \6`S� \ 1 m (-4 0 Z � t o N07'15 Z -40 ii o � 33E ° j \ -N s— --�o— — — —gym r T — N J -- s r4 I / act i m _ :E m rn , rn N — 33 33 �o D� rrl J tr• J �1 W \ 0 ��1 ' \ OeW\ m Lr \ •� l'8� \ \ O � \C ` o. �. \ LT, rn w CD ta i c a - �r D� D C+' Z co 'b to i w - Ol v \ � \\ rnD�r \ 3 o o � \ �0� \ — DAN \ \\ A Cn \ f 0.0 (D \ v) y �! D , O \ i ��!► \s�..L O u� 996 �• w \ \ \ \ F \ \/ .1 \ O \ \ S O D \ AN \ 4 O �• c. \ '�\ Sp m \ `90 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer P. C. Collova Builders, Inc. Mailing Address P 0 Box 489 Somerset, WI 54025 Property Address H 6 - 7 - A v erification e ( required from Planning Department for n co g p nstruction) City/State l R , C m 1,,.)1 parcel Identification Number Oa(o - //Y - yS- LEGAL DESCRIPTION Property Location k)L,S % NU / Sec. 2.4 . T 36 N -R l Town of 4 Subdivision ► ('�►rr,r► m[l m E? qp�J S Lot # Y':5 Certified Survey Map # Volume , Page # Warranty Deed - 7 -7 5- (o y Volume a s �" , Page # �o�l� Spec house b� yes ❑ no Lot lines identifiable byes ❑ 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 masterplumber, 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 s em has been maintained must be completed and returned to the � � mp St Croix County Zoning Office within 30 r date. P. C. COLLOVA BUILDERS, INC. (715) 247 -2742 / / C,f S APPLICANT P.O. Box 489 SOMERSET, WISCONSIN 54025 DATE OWNER CERTIFICATION (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 sc bove, by virtue of a warranty deed recorded in Register of Deeds Office. P- C. COLLOVA BUILDERS, INC. (715) 247 -2742 S IG 14ACOP APPLICANT P.O. Box 489 SOMERSET, WISCONSIN 54025 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 decd Maintenance and Contingency Plan for a Septic System Maintenance Plan pumped once every 3 years. be um 1. Septic Tank is to p p 2. Effluent fitter 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 Contingency Plan Option #1. If system fails, determine cause of failure, use altemate area and install new ystem in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Opt1on #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 U 2 5 12 P 4 2 8 -7 t5,4 4S ffS 'D STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS This Deed, made between Hillvale Development Limited Liability RECEIVED FOR RECORD Partnership a Minnesota Limited Liability Partnership 02/19/2004 12:30PM Grantor, WARRANTY DEED and P.C. Collova Builders Inc. a Minnesota Corporation EXEMPT # 17 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 11.00 described real estate in St. Croix County, State of Wisconsin TRAYS FEE: the following tY, COPY FEE: (if more space is neede , nlease attach addendum): CC FEE: Lots 6, 7, 8, 9, 10, 45 46 Plat of Richmond Meadows in the Town of PAGES: 1 Richmond, St. Croix nty, Wisconsin. This deed is given in (partial)fulfillment of that certain Land Contract between the parties hereto dated January 20, 2003, recorded January 21 Recording Area 2003, in Vol. 2116, Page 009, as Doc. No. 706468. Name and Return Address FFc-S ZO ( Zacl 57' So 4o �-,,cL, W L q4 u 026 -1147- 010,026 - 1147 - 944,,026- 1147:4,A26- 114 - 1146 026_ -1147- 06,026- 1147 -07,026- 1147- 08.026- 1147 -0 Parcel Identification Number (PIN) This is not homestead property (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ,��_ day of February 1 2004 * * Hillvale Devel Limited Liability Partners AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF 4 /!v !J) ) ) ss. /erri�JS� -t/ County ) authenticated this day of - - Personally came before me this - l� day of February 2004 the above named MAPLE NE � ■ Hillvale Development Limited Liability Partnership, a BLS - -- - - -- - * My N -- F�suc. ON Minnesota Limited Liability Partnership by: - - - -- - -- - - - -- TITLE: MEMBER STATE BA ONSI EXPfREs ? ?005 (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY �- Attorney Kristina Ogland __ --------------- - - - - -- - - -- - - - -__ ----- - - -- - - - -_- - - -- Hudson, WI 54016 Notar y Public, State of My Commission is permanent. (If not, state expiration 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 ` WEST LINE OF THE NW 1/4 .,- 24, T.30 N., R.18 W. NOOOO rTED LANDS i 1 -140TH STREET �- 375.00' — � � "• � _ `'` '' � � 148.56, 437.36' No i - -- �\ _ r_' o 0 92 S00M01 33 W O c \ o 533 W ry � bZ cs O, o O M % Q ! g &i O rn - - - -- ---- �rn--------- Y--- - -__/ tI : RI N I , rn N ; \ ---- — - I 33' 33' �m \ �co I \ \� ! —14 m \ y —h \ \ 3�Ia \ y rt o oo •m�, �` \ rt � \`` \ 05,: \ $ \`�io S to Ln - n cs 237.53' — r I`00 , : 4 �Sa \ s\ t \ �• \ \ t – 4 57.58 1 – ? \ Ln 0 cn to w w O. O• s� O —�. \ D _ ? co Xv 7 0 A oo 0 0. �► ? \ rn 0 0\ O s , io D �u� SO S „ W 0. o CD °° 0 U , o tg M � I a 0 o H I � 1 I I i I I I I a I c z 0 i I LL c O 3 � I 1 I M O > z y O V p ° a m 04 M N F 0 Z CO H ;' E 2 1 D � I c I 3 � L_ O I O O Z Z � I O y g H � .. m c v m r c a w L m O E c G C d 3 3 a m m a a a �. a Q' m oUSj o Cl) J U ° z O N M � I N °° � _ m v m Q z (n a =w L i. I C O ° M 3 1 m ° m 5 V sw O E o o o w? o U E U co y O (D FBI M U M y O O N 2' d z z 0 CL a+ d c c � A U a ! '', O N V