HomeMy WebLinkAbout026-1130-23-000 Wisconsin De p artment of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 399416
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:
Casey, Michael Richmond Township 026 - 1130 -23 -000
CST BM Elev: Insp. BM Elev: BM Description:
92a Ir
TANK INFORMATION L ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosin Alt. BM
_-- - - - - -- 71 /o
Aeration „ems Bldg. Sewer
Holdi g t/ t Inlet � y� '61
(o
TANK SETBACK INFORMATION Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic �-� � ,(. ys r � , � Dt Bott
Dosing Header /Man.
Aeration '` Dist. Pipe c M 4 ?-?.3 4 9 1'
Holding Bot. System t, L 8rbf
Final Grade
PUMP /SIPHON INFORMATION A 70 �0. P3
er Demand St Cover
;06 tOz-
Model Number
TDH Lift Friction s Sys Head rDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS U S / 3
SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM L G Man fact er-
INFORMATION AMBER R i
Type Of System: _ Modey umber:
id, 41
DISTRIBUTION SYSTEM �pW
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
/ e/ Pipe(s) �/ r / ' 7
Length_ Dia Length y �. �S 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 [q] No ❑Yes O No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / /01 Inspection #2:
Location: 1392 141st Street New R'chmond, a WI 54017 (NW 1/4 NW 1/ 25 T30N R 8W) Red Pine C /_ Parcel No: 25.30.18.883
p t ,�„�,� q,�. y So •`l {� r / �GOrrv� l %X
1.) Alt BM Description = `�'� '/ 4 1 16
2.) Bldg sewer length = q' ✓ �r w' „� d w �O� c.�
N
- amount of cover =
3 .�e6seru Aj'i* . P";'es
Plai
n revision Required . ❑ Yes ] No
Use other side for additional information.
Date Insepctor's Si nature Cert. No.
SBD -6710 (R.3/97)
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1. The POWTS inspector shall verity the SOII con
2. Effluent filter to be installed and maintained per manufacturer's recommendations.
3. The finished floor elevation shall be 985.5 or higher. (See note on plat)
4. Well setbacks to be maintained per NR 811 & 812.
5. All setbacks to the system and residential structure must meet applicable code requirements.
6. Property is zoned Ag- residential — only one principal dwelling is allowed on this property.
7. Any filling and grading that will affect the capacity of the HWL retention area is prohibited.
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'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
Attach complete site plan on paper not less than B 1/2 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 yrtformation. Reviewed by. Da e
Personal information you provide may be used fopsecondary purpo(Privacy Law, s. 1'5.04 (1) (m)).
Property Owner prep" Location
Gb k t 1/4 1/4 S T N R r) W NW
nakwnnd Land Property Owner's Mailing Address Lot. #` I Block # I Subd. Name or CSM# na Red Pine Corner
City State Zip Code Phone Num ' 6 ICL ity ❑ Village Town Nearest Road
Spring Lake Par ,MN. 5 3 , �.•< ` j Richmond 140th. St.
IR New Construction Use: ] Residential / Numbed' ' jd,bJi _ Code derived design flow rate 6 0 0 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material glacial drift Flood Plain elevation if applicable na ft.
General comments
and recommendations:
trenches starting @ el. 97.80', spaced to code 3.50' below grade, stepping down
slope.
F— Boring # r] Boring 101.30 +85
i ® Pit Ground surface elev. ft. Depth to limiting factor in Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 - Eff#2
m 5 8
2 10 -2010 r 4/4 none sic 2msbk mfr gw 1m .4 .6
3 20 -657.5 r4 6 none is osg mvfr gw if .7 1.2
4 65-85 5yr4/4 none scl 2csbk mfr na na .4 .6
AD
al A
oring # El Boring
2 Pit Ground surface elev. _ 90 ft. Depth to limiting factor +90 in. Soil Application Rate
H zon 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
1 r3 3 none L 2msbk mfr gw 2m .5 ,8
2 8 -18 10yr4/4 non sil 2msbk mfr gw 1m .5 .8
18-447.5yr4/E none ms osg mvfr gw if .7 1.2
4 44-577 none sl 2msbk mfr gw na .5 .9
5 57 -72 7.5 4/6 none ms osq mvfr qw na .7 1.2
6 72 -90 5yr 4/4 none sl 2msbk mfi I na na .5 .9
` Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ent #2 = B < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature CST Number
Gary L. Steel C 02298
Address J Date Evaluatiog Conducted Telephone Number
1554 200th. Ave. New Richm ond, W 4017 11 -15 -2000 715 -246 -6200
I 5
I
Property Owner nakA, „a T.anrl n eV. Parcel ID # _pending Page 2 of
F- Boring # ❑Boring
3 Q Pit Ground surface elev. 98 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
3 20 -65 7 5 4
4 65-
F-1 Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
❑ 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 GPDAf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Etl'#2
Effluent #1 = BOD > 30:S 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 30 mg/- 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(P -&W)
STEELS SOIL SERVICE
Gary L. Steel Oakwood Land Development 1554 200th Ave.
CSTM2298 NW S25 t30N -R18W
New Richmond WI 54017
MPRSW -3254 town of Richmond (715) 246 -6200
lot #23 -Red Pine Corner
This soil evaluation was conducted to satisfy a zoning requirement, it may or may
not be suitable for your use. The location of the test may or may not be as shown
as permanent lot lines were not established at the time the test was conducted.
N
1 " =40
BM.= top of 1" pvc pipe@ el 100.00'"
Alt. BM.= top of 1" pvcpipe @ el. 101.80' r
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Gary L. 'Steel
11 -15 -2000
1
„ %,KA W LUNING 001
Private Onsite Wast"Ot Treatment System Management Plan
Septic Tank ank And Gravity 1n- Ground Soft Absorption Component
Pursuant to Comm 83.54 Wis. Adm, Code each pntvate Onsite Wester Treatment
System (POWTS) star include information and pmcwkms for mokgWnmg the system within
doe Pam of Comm 83 and 84, and tine editions of approval by
Or Vw go unit. The approved plans and permits far system are on 81e at the c>ounnty
zoning health department.
This managemwt plan Comp{ es with Cornet 8154. Wis. Adm. Code, and the kw-Ground
Soli Absorption Component Manual for Private Onsita Wastewater TreaimeM Systems SBD-
10567 -P (R,6W).
Tame 1: SYSUM
Sandmi Permit Wta
Near 9sdrr�orres
Desi Flog
Estinwted How - A
tic TaMc
M.
Sop We
- uvm of Wasf r Domestic
TaWs 2: Soil C • t.irrdta of RlNsblet
Design i=bW - Peek } Tank
Ma*nwn 1rM ww — Pw dcfe Size
MR* RKn ?20
Ma*ntxn TSS ) 454
Taibta 3. Mainbnence Salle
' Tarnk anti service once 3 Yom
Outlet Filter t once a year and dean at least once 3
Sal I rmped once every 3 years &
The septic tank shall be maintained by an individual wed to servwe septic tanks
. Adm. Code (Servicin
under s. 281.48, Stats. The contend of the septic tank shalt be d*xnW of in accordance with
N 113, Wis Septic or Holding Tanks, Pumping Chambers. Grease
Restroo tercep t s, Beds Seepage Pits, Seepage Trenches. Privies, or Portable
The operating condition of the septic tank and outlet filter shalt be assesaed at least
onoe every 3 years by inSpecopn. The outlet fter strap be deercd as necessary to ensure
Proper operation. The fdr Cartridge should not be removed unless provisions are made to
retain solid in the tank that may slough cuff the tiller when removed from its enclos If the
Management Plan for a Septic Tank and Soil Absorption Component
fine► is eoluipped with an alarm, the tamer shy be serviced If the Maim is act 4aied c orAlnuously.
Intermitter finer arms may irwhos6e surge bows or an impending oorttinuous alarm. The
septic tank shall have lls contents removed when the volume of scum and sludge in the tank
exceeds 113 the iquMd volume of the tank. if the conWft of the tardk are rat removed at the
time of an sssessrne nL mafenence personnel shall advice the owner of when the next service
needs to be performed to maintain less than modmum scum and sludge accumulation In the
tank.
Manhole risers, access risers and covers should be inspecseid for water lightness and
soundness. Access openi Vs used for service and assessment shall be seabd watertight upon
the completion of service. Any opening deemed unsound, defective. or subjed to failure must
be replaced. Exposed access openings greater VW 8-inches in dituroter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one shoWd odor a So pft a ogler &*m&nfJrd or holdig WA for
any tie"n t WROt being iM AW CoMpNOnoe will► OSM standards for
enterleg s Con~ • me adnoaphery WWI& Mr* septic or a 0MV
67 O"It of hoWhIS tank My c o M& leg'ISl gaol, and nocue of a
person *OW dte ilk WKW of fbe W* maybe Ofto or rlerpoaaAile.
Tank abandonment shall be in accordance with Comm 63.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
soil Absorption CornponeM
The sad absorption component serving this structure Is designed to accept domestic
wastewater from a residential facility. The lknhs of operation of this component are shown in
Table 2.
The longevity of a sod Wm ppbon compareni depends grieedy on Propel' and timety
rmwinlerwxvxe and system use within or below the &Tft of rsksble opaalton. Good water
an pradjoes by all occuparft and the filiation of water corrSSrvIng ikNy 9
fixtures are key factors in extending the useful We of this cornponerrt.
The spit absorption eompormrs operation must be assessed by inspection at least
once every three years. The won slate include recording the levels of pending, if any, in
the observation piles, and a visual hvoedian for any evidence of surfa m seeapage or discharge
from the component.. On deeply sloping sil s, ales of erosion should be idan ied and
reported to the OWrter for fair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the sole absorptlon Cornponert should be evaded particularly
during wlrter mmormths. The oonpocoon or removal of snow Covet over the component may lead
to hydraulic failure by freezing. Thin type of faire is usually temporary. tint is difficult or
rogue to repair until weather Condtions improve. in general. soil compaction over this
component vA, reduce diffusion of oxygen ktto the sod and dlspersal cell, wtbch may lead to
more intense, and earlier, organic dogging of the sal.
2
05/02!01 Wn 10:28 FAX 715 386 4686
ST Ctt1L CO ZOSVin
• Management
Plan for a Septic Tank and SOY Absorption CDmponent
Pkir" of deep-rooted trees and shrubs di �� �� y * ,trot
mrxnp neat be availed Sir" root intrusion into
tom.
3T. CRUD: ZUI� III u = 586
**
plumber = Calvin Powers - 246 -5135
Replacement site will be that soil tested area by
C3T
Replacement site must be left undisturbed, or
management/ contingency plan must be modified
and filed with the zoning office, outlining the
steps to be taken in event of septic system failure.
3
' ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer \
Mailing Address 3!4 ,,� � c 1�V�nc,�n �_ L�9� - �Q/ O /?'
Property Address S
(Verification required from Planning Department for new construction)
City /State nl�.cc�n�. �� ParceI Identification Number 11 30 - a 3 _0 00
LEGAL DESCRIPTION
Property Location $J_U_l ' /., �uJ ' /,, Sec. , T_aN -R�W, Town of _ n .
Subdivision _ P10 — , Lot # c:�
Certified Survey Map # . Volume , Page #
Warranty Deed # Volume , Page #
Spec house 0 yesA no Lot lines identifiable K yes O no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the three year expiration date.
A _ 1 IO
SIGNATURE OF APPLICAN' DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
SIGNATURE OF APPLICANT DATE
* * * * «* Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * *«
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
STATE BAR OF WISCONSIN FORM 1 - 1998 65914
WARRANTY DEED KATHLEEN H. DE E
REGISTER OF DEEDS DS
1 ^jlJo ST. CROIX, CO., WI
Document Number ' l P ACE RECEIVED FOR RECORD
This Deed, made between Oakwood Land Development Inc . 08-15 -2001 9:30 AN
WARRANTY DEED
EXEMPT 0
Grantor, CERT COPY FEE:
a single /y COPY FEE:
and Michael D. Casev,
{.14X\__ TRANSFER FEE: 104.10
RECORDING FEE: 10.00
PAGES: 1
Grantee.
Grantor, for a valuable consideration, conveys to Grantee the following
described real estate in St. Croix County, State of Wisconsi
(the "Property "): Recording Area
Name and Retum Addmss
M ha 1 D. sey
t 3 d Pi Co er
N Ch nd, 54 7
Q26-1130-23-000
Panel Idendtication Number (PIN)
This i t s n 1 o �s t pp homestead property
Lot 23, Red Pine Corner RETll�1Y W :?/ O '�1�(� l �
Burnet Title 1
Records of St. Croix County, Wisconsin. 7550 France Ave. S. �
First Floor
Abstract Property. Edina, MN 55435
ATTN: Post Closing Central
Together will all appurtenant rights, title and interests.
none
Grantor warrants that the title to the Property is good, indefeasable in simple fee and free and clear of encumbrances except
Dated this 15th _ _ day of June 2001
(SEAL) (SEAL)
Oakwood Band Development Inc.
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGEMENT
Signature(s) —
State Of Wisconsin,
} ss.
St. Croix County.
authenticated this day of Personally came before me this 15th day of
June 2001 the above named
Gr egorvS Peterson as President
AND :31NAT
TITLE: MEMBER STAIN to
(if not me know to be the person who executed the foregoing
authorized by § i . to s. ins n ment and acknowiedge the same.
THIS INSTRUMENT WAS DRAFTED BY tZ/ V)O, —
Coldwell Banker Burnet 01 -16264
1301 oulee R ad
Notary Public, State of isconsin
Hudson. WI 54016 My commission is perm' tit, (If not, state expiratt�n te:
( Signatures may be authenticated or acknowledged. Both are -- — — — -- )
not necessary.)
Names of perwns SiOlIng in any capacity must be typed or pfinwd below their Signature.
5 I A I E BAR Ur wlzC . SIN Wscnnsm Lega Blank Co.,lnc.
WARRANTY DEED FORM No. I - 1998 Milwaukee, WIS.
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