HomeMy WebLinkAboutBevers Permit Application Materials_27249_SAINT JOSEPH_Town_23_030-1053-10-020_1416 RIDGE RUNrya
County
�. Safety and Buildings gs division St. Croix
.
201 W. Washing Box 7162
. ,�. ,; tin Av
if
3. 1, ='= '�`• P • ®• Sanitary Permit Number (to be filled in by Co.)
y; Madison,W162--
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Sanitary Permit Appllcatlor� State Transaction Number
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Na
is required prior to obtaining a sanitary permit. 'Note: Application forms for state-owned POWTS are submitted to
the Department of Safety and Professional Services. Personal information you provide may be used for secondaryProject Address (if different than mailing address)
purposes in accordance with the Privacy Law,,s. 15.04 1 m , Stats.
I. Application Information -- Please Print All Information Same
Property Owner's Name Parcel
Alessandra Bevers
030-I053-10-020
Property Owner's Mailing Address Property Location
p o
1416 Ridge Run
Govt. Lot 01
City, State Zip Code Phone Number ,
/4, 1/4, Section 23 .
New Richmond, WI 54017 612 877-23 73 (circle one)
II. Type of Building check all that apply) Lot # - T 30 N; R 19 W
YP � � g ( Pp Y)
❑ l or 2 Family Dwelling — Number of Bedrooms 01 Subdivision Name
Block #
0 Public/Commercial Describe Use Private Use Accessory Structure Na: CSM Vol. 29, P 6501
City of
❑ State Owned Describe Use CSM Number ❑ Village of
1065543 0 Town of St. Jose h
p
III. Type of Permit: (Check only one box on line A. Complete -line B if applicable
A. � New System ❑ Replacement System ❑ Treatment/Holding 1 " Y o ding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B •
❑ Permit Renewal
❑ Permit Revision
❑ Change of Plumber
Before Expiration
El Permit Transfer to New -List Previous Permit Number and Date Issued
Owner
IV. TYPe of POWTS System/Component/Device: (Check all that apply)
0 Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound >_ 24 in. of suitable soil El Mound < 241n. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain)
❑ Pretreatment Device (explain)
V. Dis ersal/Treatment Area Information: 20 Infiltrator Quick 4 Standard Plus chambers & 2 pair end _
ca s, Pol Lok PL 525 effluent filter
Design Flow (gpd)
150.0 Gpd
Design Soil Application Rate(gpdsf)
0.4 Gpd/Sq.
Dispersal Area Required (sf)
Dispersal Area Proposed (sf)
System Elevation
Ft.
375.00 sq. ft.
41040 sq . ft.
93.00'
VI. Tank Info
Capacity in
Total
# of
Manufacturer
Gallons
Gallons
Units
o
un•-'
New Tanks
Existing Tanks
o
Cn
CIS
Septic or Holding Tank
320
320
1
Wieser Concrete
X
Dosing Chamber
VII. Responsibility Statement- I, the un rsigned, ssume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
Plumb is Signature
MP/MPRS Number
Business Phone Number
James K. Thompson
Plumber's Address (Street, City, State, Zip Code)
MPRS 30021 715 248-7767
340 Paulson Lake Lane, Osceola, WI 54020
VIII. Coun /De artment Use Only
❑ Approved
❑ Disapproved
Permit Fee
Date Issued
Issuing Agent Signature
❑ Owner Given Reason for Denial
IX. Conditions of Approval/Reasons for Disapproval
Attach to complete plans for the system and submit to the County only on
paper not less than 8 1/2 x 11 inches in size
SBD-6398 (R. 11/11)
Conventional POWTS Index & Title Sheet
Project Name:
Bevers Accessory Structure Conventional POWTS
Owners Name:
Alessandra Bevers
R
Owner's address:
1416 Ridge Run, New Richmond, WI 54017
Site address:
Same
Project Location:
Subdivision:
lot 015. CSM Vol. 29, Pg, 6501, Doc. # 1065543
Legal Description: Gov't Lot 01, Sec. 23, T.30N.5 R. 19W., Tn. of St. Joseph, St. Croix Co. WI.
Parcel ID #:
030-1053-10.020
Page l Index and Title Sheet
Page 2 Site Plan
Page 3 Dispersal Cell Sizing Calculations
Page 4 Dispersal Cell Cross Section
Page 5 Infiltrator "Q-4" Chamber Specifications
Page 6 System Management Plan
Page 7 Septic Tank Cross Section
Page 8 Effluent Filter Specifications
Page 9 Septic Tank Maintenance Agreement
page 10 Certified Survey Map
page l 1 Warranty Deed
Attached: Soil Evaluation Report
Mater P1 er Re,
icted Service: James K. Thompson, DSPS Credential #30021
Signature:..'
C�
Date:-1,7
p
Page l Of 11
Design
pursuant to In -Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01)
Low
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Bevers Privat Use Accesso Structure Dispersal Cell Sizing Calculations R
l . (100 gallons estimated flow)(1.5 design factor) = 150.00 GDd desijzn flow
2. Infiltrative capacity of native soil _ 0.4 gpd/sq. ft.
3. Absorption area required: 3 75.00 sq. ft.
4. Absorption area as proposed: 410.40 sq. ft. (20 chambers + 2 pair end caps)
Infiltrator "Quick 4" 20.00 sq.ft. EISA per chamber, Infiltrator "Quick 4" end caps 5.20-s .ft EISA/ air
p sq.ft, p
375.00 sq. ft. - (2 pair endcaps)(5.20) = 364.60 sq. ft.
364.60 sq. ft./20.00 =18.23 chambers required
Number of trenches: _2 @ 10 chambers per trench (20 chambers total
9
Trench width: 2.83
Trench length: 43.00'
Trench spacing: 9.00' on center
Total system area w/ 6' trench spacing: 12.00'x 43.00'
IN -GROUND DOSED -GRAVITY DISPERSAL AREA
Stepped Elevation Trenches with Quick4 Standard-W Chambers
3-ft Trench (down -sizing credit)
s
----------------
i rrrnwv' W.f il+
Quick4 Plus Standard Ghamher;�y:w
1211
34 4811
EFFECTIVE LENGTH
Quick4 Plus All -in -one 12 Endcap
PRESSURIZED PIPE DRILL
POINTS LOCATIONS
(2 PLACES)
1811
fT
a kz� - 1 311
8" INVERT
33„
FRONT VIEW SIDE VIEW
Quick4 Plus All -in -One Periscope INFILTRATOR WATER TECHNOLOGIES, PLC (" INFILTRATOR")
Infiltrator Water Technologies, LLC STANDARD LIMITED Drainfield WARRANTY
(a) The structural integrity of each chamber, endcap, EZflow expanded polystyrene and/or other
accessory manufactured by Infiltrator („Units"), when installed and operated in a leachfield of an
QUICK4 PLUS ALL -IN -ONE PERISCOPE onsite septic system in accordance with Infiltrator's instructions, is warranted to the original pur-
(360° SWIVEL) chaser (" Holder") against defective materials and workmanship for one year from the date that the
septic permit is issued for the septic system containing the Units; provided, however, that if a septic
permit is not required by applicable law, the warranty period will begin upon the date that installa-
tion of the septic system commences. To exercise its warranty rights, Holder must notify Infiltrator
in writing at its Corporate Headquarters in Old Saybrook, Connecticut within fifteen (15) days of
the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be.
covered by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/
12.711 INVERT or installation of the Units.
(b) THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE
ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS, INCLUDING NO IMPLIED
WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
(c) This Limited Warranty shall!be void if any part of the chamber system is manufactured by anyone
other than Infiltrator. The Limited Warranty does not extend to incidental, consequential, special or
indirect damages. Infiltrator shall not be liable for penalties or liquidated damages, including loss of
production and profits, labor and materials, overhead costs; or other losses or expenses incurred by
6,, the Holder or any third party. Specifically excluded from Limited Warranty coverage. are damage to
the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units;
the Units being subjected to vehicle traffic or other conditions which are not permitted by the instal-
lation instructions; failure to maintain the minimum ground covers set forth in the installation instruc-
9 tions; the placement of improper materials into the system containing the Units; failure of the Units
or the septic system due to improper siting or improper sizing, excessive water usage, improper
grease disposal, or, improper operation; or any other event not caused by Infiltrator. This Limited
Warranty small be void if the Holder fails to comply with all of the terms set forth in this Limited
Warranty. Further, in no event shall infiltrator be responsible for any loss or damage to the Holder,
the Units, or any third party resulting from installation or shipment, or from any product liability
claims of Holder or any third party. For this Limited Warranty to apply, the Units must be installed in
accordance with all site conditions required by state and local codes; all other applicable laws; and
Infiltrator's installation instructions.
4 Business Park Road y g
(d) No representative of -Infiltrator has the authority to change or extend this Limited Warranty. No
P.O. Box 768 warranty applies to any party other than the original Holder. The above represents the Standard
Old Saybrook, CT 06475 Limited Warranty offered by Infiltrator. A limited number of states and counties have different war -
I NO F I LT AT
�, 860-577-7000 - Fax 860-577-7001 ranty requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters in
1-800-221 4436 Old Saybrook, Connecticut,, prior to such purchase, to obtain a copy of the applicable warranty, and
water technologies www.infiltratorwater.com should carefully read that warranty prior to the purchase of Units.
U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839.844 Canadian Patents: 1,329,959; 2,004.564 Other patents pending. R
Infiltrator, Equalizer, Quick4, and SideWinder are registered trademarks of Infiltrator Water Technologies. Infiltrator is a registered trademark in France. Infiltrator Water Technologies is a registered trademark in Mexico.
Contour, MicroLeaching, PolyTuff, ChamberSpacer, MultiPort, PosiLock, QuickCut, QuickPlay, SnapLock and StraightLock are trademarks of Infiltrator Water Technologies.
PolyLok is a trademark of PolyLok, Inc. TUF-TITE is a registered trademark of TUF-TITE, INC. Ultra -Rib is a trademark of IPEX Inc.
O 2016 Infiltrator Water Technologies, LLC. All rights reserved. Printed in U.S.A. PLUS05 0816
K!ME-Ramalm. 1t
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Conventional Septic System Management Plan
Pursuant to SPS 3 83.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code and shall ' be maintained
in accordance with component manual SBD-10705-P (N.01/01). All local and:/or state rules Y
pertainin to system
g
maintenance and maintenance reporting shall be complied with. Questions on the operation or maintenance of the system
should be directed to the installing plumber, Jim Thompson at (715) 248-7767 or the St. Croix County Zoning Department artment at
(715) 386-4680.
Septic Tank
Septic tank servicing mechanics comply with SPS 3 83.54(l)(e). Septic tank to be located within 150' of servi ce pad, i
wth
bottom of tank to be <_ 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be
assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in
the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR
113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are
not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be
needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to
ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank
that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be
serviced if the alarm is activated. Septic tank manholes risers, access risers, and covers should be inspected for water
tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of
service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access
openings greater
than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank.
No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank
abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS
component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If
g Y
such products are used, they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings
Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system
ys em should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface
within and above the system and will promote frost penetration during cold weather months. Cold weather installations . g er in tallations
(October -March) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 m /L FOG. Influent flow
g _ ow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ondin . Pondin levels shall
p g g be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiringadditional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component_shall be repaired or replaced p paced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil
absorption cell to bring the system into proper operating condition.
Pg. 6-of 11
W320-MR
TANK SPECIFICATIONS,
DIMENSIONS:
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WALL: 3"
Q-
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BOTTOM: 3"
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a
a
COVER: 4"
�-
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
50�
HEIGHT: 58 " O.D.
LENGTH: 50 O.D.
Air
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N
N
WIDTH: 50" O.D.
z
47 CAST -A -SEAL
BELOW INLET: 46 1 /2" O.D.
LIQUID LEVEL: 43"
WEIGHT: 3,880 LBS.
in
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4" CAST —A -SEAL
INLET AND OUTLET.
I (
4" CAST -A -SEAL BOOT OR EQUAL
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GASKET, CAST -A -SEAL BOOT OR EQUALLo
3
/
INLET AND OUTLET BAFFLE AND FILTER:
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WISCONSIN, SEE DETAIL 10
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OTHER STATES SEE CHAR
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LIQUID CAPACITY: 8.0 GAL/IN
a
FILTER OR BAFFLE
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TOP VIEW
WLo
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LOADING DESIGN: 8' 0" UNSATURATED SOIL
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LO
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INLET
-
- OUTLET
TANK CAN BE USED AS:
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SEPTIC/ HOLDING/ PUMP OR SIPHON
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00
Lo
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3
COVER: MIX DESIGN #8(N0 FIBER)
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TANK: MIX DESIGN #10 STRUCTURAL FIBER}
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CUSTOMIZED TANKS:
3
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
M
Q
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Q
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SIDE VIEW
N
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
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.SHEET N0.
/OF 1
Inc,
Innovations in Precast, Dr g %'' '` Zabel" r'
e Wastewater products A Division of PolAok Inc.
PL-525 Filter
The PL-525 Filter is rated for 10,000 GPD (gallons per day) Makin it one of the largest P �) g Best filters in its class. It has
525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off
y toff ball
installed with every filter. when the filter is removed for p temporarily cleaning, the ball will float u and to R
g orar�ly shut. off
the system so the effluent wont leave the tank.
Features,., " Filtration Slots:.
Rated for 10,000 GPD
(gallons per day).Alarm Switch
o
5 linear1/16". `.::.:::
(opti
onal)
feet of filtr � <�:...'`-:'�.:�..r.::
anon.
Accepts 4 and. 6 SCHTO 40 pipe. br:}}:• Accepts 1'r PVC
;. .
Extension Handle
Built in gas deflector.
Automatic shut-off ball when filter is removed..
Alarm. accessibility. Rated for
Accepts PVC extension handle.
' 1.0,000 GPD
PL-525 Instal.latio:n.
Ideal :for residential. and commercial. waste flows up to � 525 Linear t.
1.0,000 gallons per day (GPD). of 1/16
�;} :}V Filtration. Slots
a;Y;r as^r v:
f''� 1r.%':}:try:}•�;'•'r'L'^}}it•/b'r±..YYvt :. r
1. Locate }o- :<}Y<\ £ ♦ 4 r x
outlet of { >.: r�:t....::.,.}.::::
the the septic tank. ' ykYv,.Y-:yr ::::-:.. ...:k
r otr::'.yf•:;b:•r%%r•.••:fY.: r 'C•. ^.r,'v:,u _'
2. Remove the tank cover and pump tank if necessary"
� < � b �rrr • _
3 Accepts Orr
M
3. Glue the filter s
t0 the 4" „ e. �f `
housing or 6 outlet i�
SCHD 40 pipe
6 4r •Y r 'r
the filter is not centered under the access opening
use a
- • : xs<}}:}:bar
Polylok Extend. & Lok or piece of pipe to center filter.
4. Insert the P•L-525 filter into its housing. y: A::.::: ' .:--:} :::
5. Replace and secure the septic tank cover. :`-MENNEN.-
=++ to
}
NSF/ANS1 Standard 4
PL-525 Maintenance. -
The PL-525 Effluent Filters will operate efficiently for
}
several years under normal conditions before requiring
cleaning. It is recommended that the filter be cleaned
every time the tank is pumped, or at least every three
3
years. If the installed filter contains an optional alarm, y
the owner will be notified by an alarm when the filter
needs servicing. Servicing should be done by a certified 3
:"`: Gas Deflector
septic tank pumper or installer.
Automatic
1.. Locate the outlet of the septic tank. 4
Shut-COff Ball
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j
2. Remove tank cover and pump tank if necessary. 4
3. Do not use plumbing when filter is removed.
4. Pull PL-525 cartridge out of the housing.
5. Hose N} �-.:::;:.�:::�+ti:.::,- •:.sf. ;-l-�
off filter over the septic tank. Make sure all I
4 ... �.'+( rSbKr S ;`a'r`y':.::Y:x$-,r-✓.x:.:,r•. ..y?c ;!� }.;_Cr,+y;
solids fall lack into septic tank.
6. Insert the filter cartridge back into the housing making
r
sure the filter is properly aligned and completelyinserted. Outdoor Snilrt?� Alarm Extend Liiknl
Polylok, .babel & Best filters accept Easily installs R
7. Replace and secure septic tank cover. the SmartFilter@ switch and. alarm. into existing tans.
Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax 203
.284.85 14 www.polylok.corn
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Alessandra Bevers
Mailing Address 1416 Rid a Run Rd New
W 154017
Property r
Prop Y Same Address
(Verification required from Planning & Zoning Department for new construction.
City/State 03 0 1053-10-020
Parcel Identification Number
LEGAL DESCRIPTION
Gov't � Lot 01 2
Property � 3 3
p y Location /4 /4 Sec. St. Joseph T N W, Townof
CSM
Subdivision Plat: 01
_ ,Lot
10665543Ce Certified Survey Ma # 26 6501
Y p , Volume , page #
warranty Deed #1076702Na Na
(before 2007)Volume Page
Spec house Dyes Ono Lot lines identifiable es
❑Y ❑no
SYSTEM MAINTENANCE AND OWNER CERTIFICATI
ON
Improper use and maintenance of your septic system could result in its premature failure to ha
ndle andle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed- pumper. What you
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. p P Y p Into
responsibilities are specified' in § SPS. 383.52(l) and in Chapter 12 - S P Y m..Owner maintenance
p t. Croix County Sanitary ordinance.
The property owner agrees to submit to St. Croix County Planning& ZoningDepartment
owner and by a master plumber, journeyman lumber, restricted plumber p t a certification form, .signed by the
Y p p mber or a licensed pumper verifying that (1) the on -site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping if
less than 1 /3 full of sludge. P p p g ( necessary), the septic tank is
I/we, the undersigned have read the above requirements and agree to maintain the priv
ate sewage disposal system with the
standards set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural
State of Wisconsin. Certification stating .that your septic system has been maintain p a Resources, R
Y maintained must be completed and returned to the St. Croix
County Planning & Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of m /our knowledge. dge. I/we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
0
10 2s 19
SIGNATURE OF APPLICANT(S)
DATE
* * *Any information that is misrepresented may result in the sanitarypermit being revoked
p g by the Planning &Zoning Department.
Include with this application a recorded warranty deed from the Register of Deeds Office ce and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 04/12)
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CERTIFIED SURVEY
MAIDLL
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LOCATED IN PART OF THE SE1/4 OF THE SE1/4 AND IN PART OF GOVERNMENT LOT 1 0
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N ag d 4 OF SECTION 23, T30N, R19W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN. F•„ .
W 3 c PREPARED FOR: `" .
M I`- W . W rl j W
S Nt to a p OL N> N o o M COLLEEN SULLIVAN-GRAY r �CIS
� it u c n W � .. 1416 RIDGE RUN
LA IL N 0 � FA i W ui w NEW RICHMOND, WI 54017
1-1 W N W J 0 LL. Q
,� 5t�lt SMALL TRACT
m M U> N m; I W °' SURVEYOR: r�3 -,,, / 33'I.
W lu H DOUGLAS J. ZAHLER �/ S„ 30, ,. �'-�-APPROXIMATE NORTH LINE OF GOVERNMENT LOT 1 � I
pd W 'n DC AUTH CONSULTING & ASSOC. �f Ex 3• N00°ii'09"W
v 2920 ENLOE STREET SUITE 141 �?/ OHWM ELV.886.'� G SI'%�I� Z?• N89°42'42"E 478J9' 52.12' 33.00'
36.6fl` 442.19'
HUDSON, WI 54016
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A < 5 w ' N OF ter! ••av� . high water mark of a lake or 6 �1� '' -- % '�') /' 50.49' LET � juii w-
o� DOUGLA S J. navigable stream is subject to the ��6 =fir"' ���
w cn W e public trust in navigable waters that ,'' "y •� /'� e� ��� �'
w o c w HLER is established under article 1X, / +'V� a� �41
oy ¢ ; 5-2145 f section I, of the state constitution. �\ 3,?�s� ���®t f''-42
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W H U O LEGEND � ��`� ,��h � � 3.015 ACRES f TENNIS _� �.�-+ UJ
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w LU V � �� N21°11'40"E 55.76' "'� 1 COURT 1 c LU
FOUND ALUMINUM COUNTY Z' . _ , (`-� L------ vo �n w Vf
SECTION CORNER MONUMENT CC
o� WELL Z a
NORTH • FOUND 1 OUTSIDE DIAMETER IRON PIPE C o ( HIDDEN c �4Z�C �O � �ERIV:E
( o LL
M 3( OAK `r' Uv S 1'0 1 O 1IO
FOUND 1-1/4 OUTSIDE DIAMETER IRON PIPE cno °° e»1 __TRAIL RP �rVA_�,scALE: , 150 '�. z'{PRIVATE ROAD} GARAGE�r�
0
150 75 0 150 M FOUND 3/4"OUTSIDE DIAMETER IRON PIPE 41
316.78' 'y 370.03' 33 co
ELEVATIONS ARE REFERENCED SET 1 OUTSIDE DIAMETER BY 18" LONG IRON • • • 4-
TO NAVD 1988 (91) 0 PIPE, WEIGHING 1.13 LBS. PER LINEAR FOOT ` '`�,, 33.00' 283.78' 26.61' 343.42' + _o
S89"07'37" W 686.91' , „ 8.60' a�
N00 1109 W 33.02 rn
SOIL TEST BORING `331� CERTIFIED SURVEY MAP VOLUME 1, PAGE 238 85.71' a
FENCE LOT 1
— .— LOT 2 ( "'
LO
NOTE: ' ' o
ORDINAR
Y HIGH WATER MARK (OHWM) This lot is subject to the St. Croix County Floodplain, T-
Shorelond.and Riverway Zoning Overlay Districts. A land use
- - - - - - - - - - - 75-FOOT ORDINARY HIGH WATER MARK SETBACK
permit may be required ,for construction or grading activities.
°• °• BLUFFLINE _ 'Consult with the staff at the Community Development Office X
before any construction or grading on this lot. 0
------------------ 20-FOOT BLUFFLINE SETBACK THIS INSTRUMENT WAS DRAFTED BY DOUG ZAHLER JOB NO. 7786-0011 DATE: 4/26/18, REVISED 5/23/18 U
co
Document Number
1076702
BETH PABST
REGISTER OF DEEDS
State Bar of Wisconsin F'orrn 1-2003 ST. CROIX CO., Wt
WA.R UNITY DEED RECEIVED FOR RECORD
01/14/2019 11:51 AM
Document Name
THIS DEED,, made between Colleen M. Sullivan Cerra FKA ColleenM. Gra`
sLn le.
("Grantor," whether one or more)
EXEMPT#: 3
REC FEE 30.00
PAGES: 1
**The above recording information
verifies that this document has
been electronically recorded
and Alessandra J. Bevers & returned to the submitter
'Grantee," whether one or goers).
Grantor, for a valuable consideration, conveys to Grantee the following described. real
estate, together with the rents, profits, fixtures and -other appurtenant interests, in
Saint Croy County, State of Wisconsin ('Troperty") (if more space is Recording Area
needed, please attach addendum):
Name and Return Address
Part of Government Lot 1 of Section 23, T30N, R19w, Town of Sit. Joseph, St. Croix - Alessandra J. Bevers
County,Wisconsin, being Lot 1 of that Certified SurveyMa recorded in Volume 91.416 Ridge Run
p it�ni..e 29
of said maps, on Page 6501, as Document No. 1065543, St. Croix County Register of New Richmond, wi 54017
Deeds.
030-105-0-020
Parcel Identification Number (PIN)
This is not homestead property.
:. (is) (is not)
Grantor warrants that the title to the Property is good, indefeasible in. fee simple an
_ p d free and clear of encumbrancesexcept:
i
Dated _� B cat un. p p[�W��, ,pp����5 •j `
t Ta b'�S ) M b
IUS
lGii .�}�.�I
1..,. t: to .4 ublic-Minnes
ia
M.y t'-'lf M' t"'O D Ex "lore n q 61 3 `
f .J�. :' d 3 .9' ,}.. � .N ... ,• r ,ram r r i., �I f Ff{33 .'.. r 7 riiFh�f f 1 ;�•.d '.k
" r a,..(j r , . > { ^.: • �.. c eIS ^ ^t A ,
.r { 'M.w.^' '"• 4,,. i«...✓'ay..+`brt(r..JJIJAL�
!!!
* Colleen M. Sullivan Gray >* (SEAL)
(SEAL)
:. (SEAL)
AUTHENTICATIONACKNOWL
EDGMENT
Signatures)
STD.(� SOTA }
authenticated on iy Ij ss.
t COUNTY �
Personally cane befog
f * y e me on - 1
9
the above -named Colleen M. Sullivan• Gra i�A Colleen M. Gray
i TITLE: MEMBER STATE BAR. OF WISCONSIN - y �
(If not, , single.
to one known to be the person(s) who executed the foregoing
authorized by Wis. Stat. 706.06 g
§ ) instrument and acknowledged ed the same. g
3� g
Y "ttDRAFTER BY:
THIS. INSTRIaMIENT �...�.:.. .�.. �' ..:.: ,•�
Tim Hrubetz 4750 white Bear Lake Parkwa *Timothy Brubet2
White Bear bake Mai 55110 Notary Public, State of Minnesota My Commission (is permanent) (expires:
(Signatures may be authenticated or acknowledged. Both are not necessary.)� �
s
NOTE: THIS IS A. STANDARD FORM ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLYII �NTIFTED.
�' Y HEED 0 2003 STATE BAB. Off' wiSe[INSIN
* Type name below signatures. FORM NO.1-2003
St. Croix County 1076702. Page 1 of 1
Wisconsin Department of Safety and Professional Services
Division of Industry Services
Page.! of 3
SOIL EVALUATION REPORT
In accordance with SPS 385, Ws. Adm. Code
County
•
Attach complete site plan on paper not lessthan 81/2 x 11 inches in size. Plan must include
St. Croix
but not limited to: vertical and horizontal reference point (8M), direction and percent slope, 9
Parcel I.D.
scale or dimensions, north arrow, and location and, distance to nearest road.
030-1053-10-020
Rer #2552
Please print all information.
Reviewed by
Date
Personal information You r�ovide may - be used for seconda u p uses Priva
Law s. 15.04(l)m
Property Owner"
Alessandra
Property Location
p
Revers
Govt. Loi. ' S' SE '/a 5 _
23 T 30'N - R 19
E (or) W
Property Owner's Mailing Address
Lot #
Block f#
Subd. Name .or CSM#
141*6 Ridge Run
City
01
Na
CSM #1065546 Vol. 29 P . 6501
State Zip Code Phone Number---
[] City Village Town
Nearest Road
New Richmond WI 54017 612 877-2373
St. Joseph
t�
14o Ave.
New Construction Use: '
. Residential / Number.of bedrooms 0 Code derived -design flow r 150
.�ate GPD
[l Replacement [] Public or commercial -Describe:
Parent material Glacial till Flood Plan slay ' elevation if applicable Na ZL
R.
General comments and recommendations: Site suitable for in -ground POWTS with 0.4 gpd/sq. ft. loading rate: Recomm be = 93.001. O ended infi!#rative surface elevation #o
1 Boring # Boring
Pit Ground surface elev. 96 ft. Depth to limiting -factor 9Q in.
Redox Description Texture Structure
Qu. Az. Cont. Color Consistence Boundary
Soil Application Rate
GPD/ t2
Horizon .
Depth
In:
Dominant Color
Munsel!
Roots
Gr. Sz. Sh.
1
0-7
1Qyr3l3
none
sl fill
na
na
aw .
' 3vff
*Eff#1
0.0
*Eff#2
0.0
2
7-16
1 oyr5/3
none
sil
1 thin pl
mvfr
aw
1 vf,f
0.4
0.6
3
16-29
7.5yr416
none
scl
2%bic .
mfr
.cw
1 of
0.4
;
0.6
4
29-48
7.5yt4/6
none
Ivfs
Os g
i
aw
0.4
0.6
5
48-67
7.5yr414
none
sl
1 rnsbk
mfr
aw
-
0.4
0.7
6
-
67-84
7.5yr4/4
Wane
s
4sg
ml
aw
-
0.7
1.6
7
84-90
7.5yr4/4
none
s w/ s1
banding-
0sg
ml `
0.4
0.7
2 Boring # Boring w
Pit Ground surface elev. 9 ft, { Depth to limiting factor >7611 in.
Re dox Description Texture Structure Consistence' Boundary
Qu. Az. Cont. Color
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Roots
2
QPD/ tom
.
Gr. S�. S�h.
1
0�
1 0yr3/3
none
s1
2fgr
mvfr
*Eff#1
*Eff#2
aw
2vf,frn
0.6
1,0
2
.6-12
1Oyr5/4
none
sil
thin p1
'nf
as
1 VUm-
0.4
0.6
3
12-38
1 Oyr414
none
MCI
2 msbk
rrifi
cw
1 of f
0.4
00
4
38-42
1 0yr414
none
s1
1 msbk
mvfr
gw
0.4
0.7
5
42-76
1 Oyr4l4
none
fs.lfs.sl
Os 1 rn g, sbk
ml.rnvfr
-
0.4
0.7
Effluent #1 = BOD > 30 5 220 m /L And T'SS > 30 150
mL * Effluent #2 BDD > 30 s 220 m /L and TSS > 30
5150 m /L
CST Name (Please Print)
Signatur
James K. Thompson
CST Number
Address
ate Evaluation Conducted
30021
r
340 Paulson Lake Lane, Osceola, Wl 54020-5413
Telephone Number
'
,
.? 5 248.7767
SBD-8330 (R041/ 5)
❑ .
3 Boring # Boring Depth to limiting factor .>70" in.
Pit Around surface eiev.� ft. ep "� ....._.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence.
Boundary
Roots
W%J11 F-IjJFMOCALIVII I UIL0
GPD/Ftz
*Eff#1
*E ff#2
1,
-5
1.Oyr3/3
none
si
2fgr
m'vfr
cw
22f1 c
0.6
0.8
2
5.13
1Oyr5/4
none
sii
2%bk
mvfr
cw
2fmc
0.6
0.8
3
13-38
1Oyr4/4
none
sicl
2msbk
mfi
gw,
Ifmc
0.4
0.6
4
38-50
1.Oyr4/4
none
si
1 m&csbk
mfr
cw
1 f
04
0.7
5
. 50-70
1 oyr4/4
none
fs.lfs.sl
Osg,1 msbk.
mi.mvfr
-
0.4
0.7
❑ Boring #
[� Boring
d Pit Ground surface elev. fit. Depth to limiting factor in.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
ouli 11 Ituallon Kate
GPD/Ft2
*Eff#1
*Eff#2
-
R
Boring #
Boring
[] Pit Ground surface elev. it. Depth to limiting factor in.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Or. Sz. Sh.
'Consistence
Boundary
Roots
GPD/I~tl
Eff#1
rzff#2
* Effluent #1 _ BOD, > 30 5 220 mg/L and TSS > 30 150 mg/L * Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5150 m9 /L