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HomeMy WebLinkAbout026-1141-17-000 WisfAnsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 399504 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- 1141 -17 -000 CST BM Elev: Insp. BM Elev: BM Description: �. �� Cn 3 / , � � - �>; :'S %ilk h'/�J I����' / /sr i ,�/� TANK INFORMATION ELEVATION DATA L r'r TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark y Dosing Alt. BM Aeration Bldg. Sewer a Holding / St/ t Inlet TANK SETBACK INFORMATION !t/ Ht Outlet 7, &Y 3c� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD e (-As r Septic Dosing Header /Man., X° q 7.0 S -- Aeration ,,.• Dist. Pipe' (_. _. � � � q Ic • 7 7 s Ntfi91 Holding Bot. System 12 - "ii i qy, 7, PUMP /SIPHON INFORMATION Final Grade L / ' Manufact r Demand_ t over GPM :� C /./v Model Number TDH Lift Friction Lo System Head TDH ,Ft Forcemain Len Dia. Dist. to W. SOIL ABSORPTION SYSTEM BED RENC Width / Length ' / No. Of Trenches PIT DIMENSION s Inside Dia. Liquid Depth DIMEN NS SETBACK SYSTEM TO )) P/L , BLDG IWELL LAKE /STREAM LEACHING Manuf�etur INFORMATION CHAMBER r1 fi ��Y�t -�Z i / (E'L ✓` }� ' Typ�,Of System: n j 67 / d l �-''� IT Model Number: •, r_* i DISTRIBUTION SYSTEIVf Header /Manifold Distribution / x Hole Size x Hole Spacing Vent to Air Intake Length Dia z Length i �` Dia Spacing Y'S SOIL COVER I x Pressure Systems Only xx Mound Or At - Grade Systems Only Dep "ve[. ,%21i Depth O Ed To p ver 1 XX Depth of xx Seeded /Sodded xx Mulched Be /Trench Center > tV t��. Be /Trench es soil �� ❑Yes [] No ❑Yes [] No COMMENT (Include code is persons present, etc.) Inspection #1: `/ / /? / Inspection #2: Location: 1198 121st Avenue New Richmond, WI 54017 (SW 1/4 SE 1/4 33 T30N R18W) Duck Escdpe Lot 17 Parcel No: 33.30.18.1021 1.) Alt BM Description = 5{ 1,4,'01j doo v - 5 jWri h t iz(C fYant 2.) Bldg sewer length ff { , {� vt 4 �Lh [Y rr - amount of cover = t d+� r• bS�'( V,'i1 - t,pn Plan revision Required? ❑ Yes Vo / Use other side for additional information. " a�'h� / ,ti, ��- yti y� �t 5 C Date / Insepctor's Signa re Cart. No. SBD -6710 R.3/97 / j I nJ A'I I fl J '7 5 � i L )C - V-Q,,n5 t &-V� 4 ck",V- LA- -5�4e-u, I C, ,Ai� Safety and Buildings Division Cry . 201 W. Washington Ave., P.O. Box 7162 p , isconsi►n Madison, WI 53707 - 7162 Site Addm-- �¢ — Department of Commerce ? Sanitary Perm • it N r Sanitary Permit Application 3 ��, In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Revision may be used for secondary Privacy Law, s15.04(1 m I. Application Information - Please Print All Information State Plan I.D. N umber Property Owner's Name ( � Parcel Number 3 3. 30 . 18 . 1 021 i Cp C... O� `f1`l7 Property J Owner's Mailing Address Property Location / 0,5 l� 51- if C -A; S 3T N, R City, State Zip Code Phone Number Lo N ber Block Number s Subdivision CSM Number �L�P� II. Type of Building (check all that apply) r , ❑City �Qr // 2 Family Dwelling - Number of Bedrooms fir" ys ` ❑V ge ❑ Public/Commercial - Describe Use r r � ownship ❑ State Owned � � i'. � �r � � = Barest Road ( 3)3 ' X - ?t III. Type of Permit: (Check only one box on line A (numb scheff Ar trt" Cb" lete line B if applicable) A. 1 ew 2 11 Replacement System 3 ❑ Replacement 6 11 Addi� n For use stem Tank Onl "Exist'" B. ErCbeck if Sanitary Permit Previously Issued Permit Number Date Issued Sb �0/ �b 399 IV. of Permit: (Check all that apply)(numbering scheme is for 4on - Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment U `t 49 ❑ RMirculating 30 ❑ Other Se i J v V. D' tmen Area Informa p • - el Design Flow (gpd) Dispersal Area Dispersal Area oil AWcaiion Percol lion Rate YSystem Elevation Final Grade Required sed 1U e(Gals./Days/Sq.Ft.) (Min./Inch) ` _5' Elevation 6 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Dosing Chamber .j VII. Responsibility Statement- I, the undersign ' , O time responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Phmnber's MP/MPRS Number Business Phone Num r Plumber's Address (Street, City, State, Zip /09b /92�r-0 oe-,i (2-,� ) r! VIII. Count /De artment Use Onl q Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse !r Determination' . ? Z 7dD IX Conditions of pproval/Reas for Disa V ® t ►sv� Ale s &tLs ` Attach complete plans (to the County only) for the tyrtem on paper not lea than 81/2 x 11 inches in size SBD -6398 (R. 05101) PLOT LAN PROJECT P.C. Collova Bu ilders itders Inc. RESS 705 County Rd E Hudson Wi 54016 SE 1/4 SE 1 /4S 33 /T 30 / w TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE /20/02 BEDROOM 3 CONVENTIONAL IN -G U PRESSURE CONVENTIONAL LIFT M HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 667 # of chambers 39 BENCHMARK V.R.P. Top of Lath ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL - H.R.P. Same as Benchmark SYSTEM ELEVATION 96.0/95.0 Alt. BM Base of Lath 96.3' Plans Designed Using Conventional Powts Manual Version 2.0 Vent Sidewinder High ALong 55 Capacity Leaching o Chamber ct 34„ Grade at System Elevation N 3 -3'X 82' Cells with >3' Spacing CZI �B.M. ( GJP5- 1 a� Vents B.M. I 0 EAU � Pro 3 Bedroom N House 30 ST 15' 4°Io — Slope 5 B -1 -3 Vents B -2 150' Town Road 150' PLOT LAN PROJECT P.C. Collova Builders Inc. RESS 705 Countv Rd E Hudson Wi 54016 SE , 1/4 SE 1/4S 33 /T 30 / W TOWN Richmond COUNTY ST. CROIX 2/20/02 3 f MPRS Shaun Bird 226900 DATE BEDROOM CONVENTIONAL IN -G U 7 4 d PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 667 # of chambers 39 BENCHMARK V.R.P. Top of Lath ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL 'H. R. P. Same as Benchmark SYSTEM ELEVATION 96.0/95.0 Alt. BM Base of Lath @ 96.3' Plans Designed Using Conventional Powts Manual Version 2.0 Vent der High > 12" Sidewinder a, of Cover C pac�ty g ° Chambe r 16" � L ong 6 Lon 34 }� Grade at System Elevation N 3 -3'X 82' Cells with >3' Spacing t B. M. Vents Pro 3 Bedroom N House 30' ST 15' 4 -- Slope 50 B -1 -3 Vents B -2 150' Town Road 150' ' vvrzconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Coun Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must ty 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 infonnation Re 'ewed by Date Personal infom�ation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m))., 2.2 2 Property Owner I Property Location ( < _ 1, b �`0 U�✓ t Govt. WIS 1/4J 1/4 S3,� 36 N R/Y E(o W Prope Owner's Mailing Ad ress Lot # Block # Subd. Name or CSM# X 07 i - ) City Stat Zip Code Phone Number ❑ City ❑ Village T wn Nearest Road s ( ) / ': -New Construction Uses Residential / Number of bedrooms Code derived design flow rate 4 -� GPD F1 Replacement ❑ Public or commercial - Describe: Parent material a Flood Plain elevation if applicable ft. General comments and recommendations: J chi � 0 !. Boring # ❑ Boring F pit Ground surface elev. .=L . ft. Depth to limiting factor __ C) in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz !l in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. �r 'Eff#1 'Eff#2 �h•o� F Boring # [] Boring 0 , ..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 'Eff#2 Z- Z`� Q is ---' vv -� - S j✓��� lL, - / 6 R3. ' Effluent #1 = BOD > 30 < 220 mg/L 90 TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST N (Please Print) Signature CST Number Address Date Evaluation Conducted Telephone Number SBD -8330 (R07 /00) f I Property Owner Parcel ID # Page of 3 Boring # ❑ Boring factor Depth to limiting De ft Ground surface elev. j . pg v 0 ❑ �' Pit �/ �� � 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 'Eff#2 2- — S F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rat 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 EJ 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/ftz 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.07/00) Soil Test Plot Plan Project Name P.C. Collova Builders Shaun Address 507 cty Rd E yf� Hudson Wi 54016 #226900 Lot 1 7 Subdivision Duck Pond Date 2/20/02 SE 1 /4 SE 1 /4S 33 T 30 N /R18 W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Lath System Elevation 96.0/95.0 *HRpSame as Benchmark Alt. BM Base of Lath @a 96.3' a� a a O M N ( 1- Alt. B. M. B.M. Q Pro 3 Bedroom N House 15' 4% 50' - Slope 99' B -2 100' 101' 150' i Town Road 150' It�B A-i 67 Sanitary ]Permit Application Safety & Buildings Division In accord with Comm 83 21, Wis. Adm. Code 201 W Was pp g oon Ave. �sC�n reverse side for instructions for completing this application Madison, WI 53707 -7302 +� >� you provide may be used for second u o Department of commerce Personal information y P y p ses Submit completed forth to eoun if not [Privacy Law, s. 15.U4(lxm)j (� p ry state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -112 x 1 I inches in size. Coun n State ,:. P i Number ❑ Check if rcvision to previous application State Plan t. D. Number I. App lication Information - Please Print all Information Location: Property Owaer Name / Property Location 1► ,l� aGJ ctoj Property Owner's Mailing Address \ Lot Number Block Numb City, State 'Lip odG` Pon r Subd v s on N ame or M Number �+ I1. ype of Building: (check one) L� x_ City 2 or 2 Family Dwelling - No. of Bedrooms : �►! O Village © blic /Commercial (describe use): S ,� o`"r' of ❑ State - Owned' ax Num r s ®_g– I /7 111. Type o P mit: (Check only one box on line A. Check box on line B if a plicable) 33 .3d / . !OZ A) 1. w 2. 0 Replacement 3. 0 Replacement of 4. 5. G. 0 Adjkrm to System System Tank Only Ex ngSystem t� B) • D ettnttNum�ber � Dpte A' Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) — QO , e�> on- pressurized In- ground 13 Mound C3 Sand Fitter E3 Constructed Wetl d ressurized In- ground ❑ Holding Tank O Single Psies ❑ Drip Line a ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑Other: V. Dis ersabTreatment Area Information: s ' I _ Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4, Soit Application 5. Percolation Rate 6. System Elevation f 7. Final e Required Proposed 11 Rate (Gals. /day /sq. ft.) (Min. /inch) Elevatlo V1I. Tank Capacity in Total # of Manufacturer Prefab Site Steel F' Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete struc e 'ranks Tanks Oflb ❑ ❑ ❑ ❑ 30 � o a ❑ ❑ VIII. Responsibility Statement 1, the undersigned, assume responsibility fbr instaVation of tki POWTS own on the attached Elans. unt sName (prim) P u 'er re s): MP /MP S No. Business ne Number 4 ff I 4 , t Plumber's Address (Street, City, State, Zlp l llpet>ly ? .4� L`C. County /Department Use Only Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Si re (No stamps KApproved 13 Owner Given Initial Adverse Surcharge Fee) eta Determination 4 22.5 9 X. Condi of AP lRessons f sa�p ) 8 l S �c-e- i� Co0+�.K .Q_ dC� � A e �e �- s� 4-o _ eo&(L 5Rn 5� d,`el , .,�IQ•.Ucto►�t" 5 liC� . PLOT LAN PROJECT P.C. Collova Builders Inc. A RESS 705 Countv Rd E Hudson Wi 54016 SE 1/4' SE 1 /4s 33 /T 30 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/7/01 BEDROOM 3 CONVENTIONAL IN -GRO D ESSURE CONVENTIONAL LIFT )00( HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE 630 gallons DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1125 # of chambers none BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL IH.R.P. Same as Benchmark SYSTEM ELEVATION 100.4/98.7 1 . 5 b e low q rad e 239' o p ert Line 80 ' ? Plans Designed Using 210' Conventional Powts Manual: Version 2.0 B.M. #2 J VENT 30' B.M. #1 12" GRAD TYPAR COVIIt1NG 12" 2' 0' 12„ 2.5' 2.5' u -2 2 - 94' Cells with >3' Spacing s' 6' s xocx Vents 2% Slope 15/Below;/ ,Qrade kn 0' B -1 60 5 inbo Tank 1 Pro 3 Bedroom House 121 st. Ave PLOT LAN 'PROJECT P.C. Collova Builders Inc. A RESS 705 Countv Rd E Hudson Wi 54016 SE 1/4 SE 1 /4s 33 /T 30 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/7/01 BEDROOM 3 CONVENTIONAL IN -GRO D ESSURE CONVENTIONAL LIFT )00( HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE 630 gallons DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1125 # of chambers none BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 100.4/98.7 1.5 below grade 239' o pert Line 80' ? Plans Designed Using 210' Conventional Powts Manual Version 2.0 B.M. #2 VENT 30' B.M. #1 12 " GRADE TYPAR COVERING 12" 2' 30' a" 12 „ 2.5' 2.s 2 -6' X 94' Cells >3' Spacing 5 , 6 , sE ROCK $2 Vents 2% a Slope 1:5' Below Grade B B -1 6 5' ; `Combo Tank ' Pro 3 Bedroom , House L�l 121 st. Ave * F i P S Cag S T ti A v" CZ VINT PIP= 12" MTN. ABOVE GRADE 6 WeAlwRokow It ?it FROM DoOR, wINaow OR JUNCTION X APPROVSD !R Ax0 ZNTAXZ WITH co v:T ""MOLAR govxR �'t Mt z WARNI LAIT4 • As`.N. �� wl M. 1 N" S N . C s. 1�►MSR� t, r. a. ,� •�� � M4M► WAT'CR Tx T SEALS GAR' ; +� T24MT F t� ----•* �� S ZA L a0 Neil Allif�l LM }t1[ r ON tX TO 3 3Q�i0 '� ' N �1WI.t0 lOtl SOIL . ,... PuMr or'F ELEV. FT. asl* n S " A.P OV SD s tool U sfl3ER TANK CONUCTE PAD P1" I x T N ssPTSC Doaw S aA TANK MAWFACWRICR M,It�SER Sts PER DAY R TIC CAL. DOSE VOLLAU INC CMM4 � 13A L• ro 3o GAL. IRAlRiF zz ss i A 2- MAE MoQ wv sae, R x Has 3 -- -- sAu MTLIP scut '1'lRPS i � "NorlrC'sifR C MOOM wan lots sawn "PC: 1 6. 13 REgUIRC13 019CHARAS: RAT& �� OIM PUt!! t ALARM WXRINA AR �i�R SLA1lt FRS CC me oirr RS sxwczN Pump Orr AND DIsTNt9UTIow P:P! . • MTIIIMS3M ME'iti101lK �WPPLY PsES3U1tE . • • . • . ' 4 ' " T. + FCZT FORC IN X. .- _FT /lOp TOTAL FR -■, rttT INTERNAL OLMEIMS OF PUMP TANK. LENGTH . 5 WID�TE+l�,,,,,, �?IAMFr�"CR LIQUID szcNt LICENSE NUMBER' ZZZ— Lf e�PAT Performance Data Pump Chalracteri ti U P /motor Ualt Sub IA Manuol Modals 5WZ3M1 W33If111 24 Autoratit Models SW2 5A1 S U 1/3 MP Horsepowel 1/4 1 is Full load Amps 8.6 10.4 � 1/4 HP Motor Type Shaded Pak (4 polo) R.Pdil1. 15 a e Phose 0 � i Yohage 115 Hertz 60 \(o, 10 30 40 r 511 00 operation CAPACITY -U.S G.P.K. r infertnitteat Temperature 120 0f Ambient Total Mead t' 4/6 8_10 12 14 16 18 20 24 24 NEMA Oesiga A 1/4 NP 41 36 33 29 26 23 18 12 6 0 Insulation Class A A 0 1 1/3 NP ^1 48 43 40 37 34 30 26 23 16 10 Discharge Size 1•1/2" NFT Solids Na"&q 1 /2" Di1'1'tensi al NO Unit Weight 30 life. 3 -1/2 --{• -- s -r/a »1 I, auArnen+aMAAwcAcs I Power Card 18/3, SJTW, 10 4-1/2 2. (ompo•w &ww Mw Noy (20r optloW) 1 I vary t i/e kh ! ! 1 1 /2 NF7 3. lint for roapromw purpose y I fE Materials of Construction 4. alfw4 and weiphtHan Handle _ __ Steel l 5 On/OH le,el edlupablr 3.1/1 d. W4 resat iile right to lu6skattag 00 Dleiectric 01 m•ke ravisians to our wodulk and (heir { Motor Housing Cast Iran spedtical ows *"j nolko Pu Cas1n Cast troa ` hM1echanlcal Seal Faces; Carlton /C k Shah Seal Seed Be Asia& test StftiiWe$ tW � ieUavl►ss l) PU "0 11.1/8 ttn !eY 16errae 10.1/8 ON 9 -t(2 Upw lla booze Skere 1004 ' OISC}tAHGE lours, Year st o2k RAMP slaty Strah>er /Base Pipslk ( r a•r /a a + PUMP I c fasteners OFF I I v, � � z W AUSOWHY®ROiMA'OC 106mps, Inc. 1840 Haney Rand, AshlanIcl, Ohio 44805 Y (419) 289 -3644 vy"isin Department of commerce SOIL EVALUATION REPORT Pte I of "2, Division of safety and Buildings in accordance with Comm 85, VA& gym. Code Attach complete site Plan otr p not less than 81/2 x 11 inctres in side. Plan must Counly include, but not limited to: vertical and twriz�l (BM), direc and Parcel I.D. percent slope, scale or dimensions. north a b nearest road. :1 . � w Reviewed by Date o/ PIBaSe nhf� (Prkotw"�r. s. 15.04 (1) (m))• Personal Womatlon Iron P PropertyOWner - - prop" Location Govt Lot S 114S E 114 S 3 T S o N R E (or) +V Lot# Block# Subd. Name or CSM# Property Owners Mailing Address C 7 CRUX 1 b5 �� r ; r,C?i INTY ` �1 D State ❑ citY ❑ lydlage ® Town Nearest Road ry Coda el GPD New Corlstrudion ties: (r� Residential 1 Number of be�oorrrs -3 " `/ Code derived design flow rate 5?3 4 ❑ Replacement ❑ Public or commercial - Describe: ,v /� fl. Parent material CL Flood Plain elevation if applicable General comments $ y Sfr m _ J -e V. P 9Y •� Go w = r' yS a and ins: f G {. ej CV . ❑ 5y Bori a # Soring Pit Ground surface elev. l 0 0 ft Depth to hmifag factor in. SON Rate Texture Structure Consistence Boundary Roots GPDM Horizon Depth Dominant Cob Redox Description �{y f1 •Eff#2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. -,Z I 33 12 23 ID �Lflg 3 3_S l I ) fr 31 — -- 2. 3 y 59 - 4 r C2 P - 7.5 Sets rrY (,{ �, g #❑ Boring 1 [ Pit Ground surface elev. 1(�O 3b R Depth to limiting fiord Rate Horizon Depth DominantColor Redox Description Texture Structure dance Boundary Roots GPI in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. � tf#2 -� �d r 3fz --` SiJ Z E't c 1v�' . . 2 1z- An ` 13 —' c 2 mfr �s 5 3 34,36 10 3/ • EtfWwd #1 = BOD > 30 < 220 mg& and TSS >30 < 150 mg1L ' Effluent #2 = BOD < 30 mg& and TSS _` 30 mg& CST Now (Please Print) S re 2 CST Number C{ Address Date Evaluation Canduc�ed Telephone Number 2 3 pap Property Owner CO Parcel ID # �C> (� a Boring# ❑ Bo" in. Rate ® Pit Ground sualaceelev. ,. v I Depth t o kniting factor Sal Redooc Descr n Texture Struck" Cow Banduy Roots GPD/W Horizon Depth Dmna>ent Gr. Sz Sh. 'Ef�1 'Efi#2 in. Munsell CKL Sz. Corti. Color 2 C_s ( v .5 8 p —/2 /p 3 3 A4 - 3 E96,-:&7 V 14 SL Z n�s bk rr 5 `3 El Bamg # ❑ somas ❑ Pit Ground SUdaoe elev. R Depth to lirrritirrg factor 7*Eff#1 n Rate Horizon Depth Dominant Redox Description Strrx3rue Consistence Boundary Roofs Di1l? in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh 'Eff#2 Boring # a � Ground surface elev. fL Depth to li nft* factor in- ❑ Pit Sail Rate Horizon Depth Dmr*wdCOlOr Redac Description Texture SWcture Consistence Boundary Roots GPD/ft? in. Mansell Ou. sz. Con. Color Gr. Sz. Sh. 'Etf#1 •Eff#2 • Eflhlent #1 = SOD > 30 220 mg& and TSS >30 150 mglL ' Efll m t 92 = BM, :s 30 rngIL and TSS _< 30 mglL The Department of Commerce is an equal opportunity service Provider and employer. Myou need assistance to access services or need material in an afternoe format, please contact the department at 609 -266 -3151 or TTY 608- 264 -8777. ssn -9730 (rt07M) r i PAGE_OF NAME 0 o 1 1 C U a LOT# 1 LEGAL DESCRIPTION SF - V4SQ/4 S 3 3T3o ,NR 1 S E (or)(so SCALE: I "= yo — BM I ELEVATION (0 o • 0 BM I DESCRIPTION o 1 pvc P p BM 2 ELEVATION 9$, S S < e 3 BM 2 DESCRIPTION -¢gyp a-C I ',Ofc. P: pe SYSTEM ELEVATION ? o q( o d 60�« 95 7d ALTERNATE ELEVATION yf 1 CONTOUR ELEVATION /0o • o 3 /0/.6 I C p 9-3 IGNATURE DATE Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent Miter 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 1. if system fails, determine cause of failure, use akemate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 Shaun Bird # 6900 FROM P C COLLOUR BLLRS, INC PHONE NO. : 7 549 5 Feb. 01 2001 07:3ZgM P1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FOR114 Owner/Buyer ev,e• N ' nb Address r 4•: v fi n Mailin Property Address (Verification required from Planning Department for new construction) ✓ city/S late Up4,JL%Oman& T Parccl Identification IIumber LEGAL D tESCRIPTIQN Property Location &P� /�, SE- , /;, Scc. �, — bN - I w, Tcwlt of Subdivision CIS(- Lot i€ --b C Suri -1 y " ,I::r, IM Volume " age ir Warranty Deed I (o — 3 13 Volume Page # i Spec Louse es ❑ t:a Lot dL-- yer AJQo SYSTEM MANNTENANCI improper ase and mainteuaccc of your septic system couid result is its grcnatnte.failure to pudic Basics. r roper maiutcaa= ratssfsts of ptunping out the septic tank every thrcc year or scener, if accdcd by a licensed vutnecr. wh you put into the syst_ -m can affect the fimcdon of the septic rank as a trea =ent stage in tltc W=C disposal system TIu property owner agrees to submit to St. Croix Zoning Deputmc: t a cettiucation form, signed by the own. and by a m sserplumbe=, joumeyntarrphuuber.,- wtr,cted plu=bcr or it 1kcnsed nu raper , e.^ifymg tLat (1) the on -site wastc-,vatcrdisposal system is in Fir openting cotaditlon at:d(oc (Z) attt: itispcctian and pursgiag (if ae -: ss^; ), the Septic tank is less than 113 full of shadge, I/wc, the uadersignod have read the above requirements and agirct to =intsia the private sewage disposal system with the standards set forth. he rein, as set by the Departm, -z t of Commerce and the Department of Natural Resources, State of wiscaasia Certification stating tt t ��ur septic system h" been naainuincd roust be completed and returned to tlsc St. Croix County Zoning Office within 30 3.iys of "t!x three ar expiation tc. TURF OF APPLICANT' LATE O YMA CERTIFICA I (we) Certify tut all statcm. =u an this form art true to the rest of ny (aur) knowledge. T (we) ant (are) die ownet(s) of the ptop�rCy ^ i weir a v ; by yi5ue of a wnrranry dzzd recorded in nrgister of Deeds Office. IL. SIGNATURE OF APPLICANT DATE Any information that is :nis epr_sented may result in the saaita Y ry pet:ttit bomb revoked by Ute Zoning Department. " "'• `• Include with this applleatlan: a stamped warranty decd from the Register of Deeds once a enpy of the cartified survey map if reference is glade in the warranty decd VOL 1520F 607 1 STATE BAR OF WISCONSIN FORM 2.1998 6 t -4 Z3 1$c-31 WARRANTY DEED KATHLEEN H. WALSH Ducument Number REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Kenneth L. Brown and Kathleen B. RECEIVED FOR RECORD Brown, Husband and Wife 04 -18 -2001 9:45 AN WARRANTY DEED Grantor, and P. C. Collova Builders, Inc. EXEMPT N CERT.COPY FEE: COPY FEE: ,IWIISFER FEE: 828.00 RECORDING FEE: 10.00 Grantee. R9leESr�, 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recording Area Name and Return Address That part of SE 1/4 SW 1/4 and SW 1/4 SE 1/4 Sec. 33— T30N-R] 8W described David J. Estreen as follows: Lots I, 2 and 3 of Certified Survey Map recorded in Vol. 13 of 304 Locust St. Hudson, WI 54016 Certified Survey Maps, page 3698 as Doc. No. 60759E St. Croix County, Wisconsin *60 026- 1096 -60- 000,026- 1096 -60 -200, 026 - 1096 -70 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Existing highways, easements & rights of way of record. Dated this �3�'_ day of April 2001 Z �Kenneth L. Brown * T Kathleen B. Brown AUTHENTICATION ACKNOWLEDGMENT STATE OF Wisconsin ) Signature(s) )SS. St. Croix County. ) Personally came before me this /3 day of authenticated this ! day of April 1 2001 the above named Kenneth L. Brown and Kathleen B. Brown TITLE: t AR OF WISCONSIN to nown to be the person(s) who executed the foregoing i in and acknowledge the same. Ittity 0605 Wis. Stats.) E f WAS DRAFTED BY Aft o��l • David J. Estreen 304 LdguSliSt:; Hudson, WI 54016 Notary Public, State of Wisconsin _T Commission is permanent. not, ex (SignatureS'fnay be authenticated or acknowledged. Both are not M y P expiration date: necessary.) 'Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR Or WISCONSIN FORM No. 2 • 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 500 - 6552021 NSHIP LAWS, RULES AND REGULATIONS (I.E. WETLANDS, MINIMUM LOT SIZE, ACCESS PARCEL, ETC.) BEFORE PURCHASING OR DEVELOPING ANY PARCEL OF LAND, TAOT THE ST. CROIX COUNTY ZONING OFFICE AND THE APPROPRIATE TOWN BOARD ADVICE. RAINAGE EASEMENT NOTE: )WNER OR RESIDENT SHALL DO ANYTHING WHICH WOULD INTERFERE WITH OR JGE THE OPERATION OF THE APPROVED COMPREHENSIVE WATER DRAINAGE AND EROSION PLAN FOR THIS PLAT. THIS INCLUDES BUT IS NOT LIMITED TO BUILDING �, OBSTRUCTING, ALTERING, FILLING, OR EXCAVATING OR PLANTING IN ANY POND MENTS, WATER DRAINAGE DITCHES, WATER RUNWAYS, WATER CULVERTS, BERMS 'RASS SEEDINGS. a, I 33'I EAST 1/4 CORNER, SECTION 33, T30N, R18W, FOUND 3" COUNTY o SURVEYORS MONUMENT J 45 5 35' 275-57' 5 57' 239.48' 33.00' i I Z I I I 0 I �_ o I I I I I o )T 19 LOT 18 LOT 17 im ��� I N ' E 6 ' 99 Sq. Ft. 119933 Sq. Ft. 121742 Sq. Ft.l I 44 Ac. 2.75 Ac. � 2.79 Ac. Ln I m c� 33' 33' D I N, cn rn I Ln I I 1 0 0 0 I Z \ I I b o l o DEDICATED TO — — — I m THE PUBLIC I co co cn -P co m 191.60' \ � -- -- - - - -- 233.72' J c? ( � \ O - -- — - - - - — — — N 89 W 425.32' .,� � m 121st AVENUE - - �' ° n 24 0 F T -- S 89'35'5E 425.32' `� Z AR 47.60' - -- 187.85' - - -- 189.87' — m L D O 3 - - -- _ m � 1 A`, T ,. , � � I _ �TI