Loading...
HomeMy WebLinkAbout030-1058-10-025 Wisconsi of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 514953 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Foster, Ronald St. Joseph, Town of 030 - 1058 -10 -025 CST BM Elev: Insp. BM Elev: BM Description: Sectionlrown /Range /Map No: q ► Ce 1 3 - 3 G r 23.30.19.203A25 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER .,/�9 CAPACITY STATION BS HI FS ELEV. Septic ( Benchmark v 'F D GST ( 10'5. Sg .�o 610Sit73 Alt. BM 7 ml5.1 Aeration Bldg. Sewer 2 , p Z Holding St/Ht Inlet Y-, I 3.5 �a1, y5 TANK SETBACK INFORMATION St/Ht Outlet 3 •� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic -7 � 3 -2 -7 6 _ Dt Bottom Dosing Header /Man. 5 O �� , Z Aeration Holding Dist. Pipe . � f OF . 5.s . A/ Bot. System (p.0 9 6 Z / . . 3 iC► Final Grade PUMP /SIPHON INFORMATION Z•CD Manufacturer Demand St Cover _� C 5 • q PM 1 Model Number TDH Lift Friction Loss System He TDH Ft Forcemain Length Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches _ n 1 PIT DIMENSIONS No. Of its Inside Dia. Liquid Depth DIMENSIONS 3 TO Z R cek� \ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: _ T � INFORMATION I CHAMBER OR ,{►.��• Type Of System: UNIT Model Number: 6040 -,4j DISTRIBUTION SYSTEM ��-- 7 — r ZO = �" � Header /Manifo }d Distribution x Hole Size x Hole Spacing Vent to Ai Intake /� Pipe(s) (� Length Dia / Length �- Dia \ Spacing � Z.r�,�1 t' SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only G Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench Center ti $ Bed/Trench Edges Topsoil ❑ Yes No FE Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 712 West Shore Dr' v a Somerset, WI 54025 (NE 1/4 SW 1/4 23 T30N R19W) I NA Lot 1 Fjarcel No: 23.30.19.203A25 �'1 vt.,— (� C- 2.) +- ° s a 1.) Alt BM Description = A o<<�'Y Or 2.) Bldg sewer length = 3 (0 , o • l �y �' - amount of cover = / � u G 41 God Plan revision Required? ❑ Yes No Ja �� ,3 7 Use other side for additional information. Date Insepcto s Signat 7 D t \ 5 Cert. N_ o. I 1+ SBD -6710 (R.3/97) C '�'�` Q ' �64a& Q4 /ZZ/� TUB 49:30 FAZ 716 316 4616 wMAd wMi.O� W . w, 7162 ` J' oeprUN� X91 P"' n eii�i) $ Snl � er „ a „bo� ,,rti.wt..at�i.fla.a +. a ! O AUG 0 l 2008 5 ST. CROX COUNTY w,L Uft s � T & _ 711%. e 8 tat El c f Z O:sF Celt �,✓ J (v fJ G '"` VLTjr 1'riit (�>k..l►►...Ns..IrA. c..�lNawsit Cdr O osal�fM�fa�asidrtias��"ns1 w 01�.pre..ac p T Tiilt � f.�arwiws ltiia NM s. Q 13 mown - Q a'"�'°terrr+ir � ttarfw tr>r lY N�01fYN= D Nd+M O Mo.a�24 ts diirll• Q w..+ <� . Ormtwj%,0jewd CI�e.�ri�a ies p f boaira�+vp+�"" ---- -- b- t ' �sr I1wa avrMa/(�1 een - VL u& cauffs i Od1w / Mrw IriM� ea7<M� « Tint Ou1�Cw�� if1Us)f'O�VI'ifb�ws� lidmltrdt � Vii. LOW p �� Y 13 wq5a p goialletDnii / 1 , 4r �+G,S i✓,J�,,.��. Ie x. caiMaj ,'[eol�lhl.....t�rin+..�r�.al , 3 j /.1�,��'fr•�'g 1. Septic tank, effluent fifter and dispersal cell must all be °er mainta� ✓N.o /� J as per management plan provided by plumber. 1 e d i rG 0 .. 1 j • 2. AN sstbecic t must bs .a werisu>t.a.�rr. yrnsadi.l�iltrer�i+4�i� -�7 r P T PLAN PROJECT Ron F oster ADDRESS 435 RiDlev Ave Maplewood Mn 55117 NE I14 SW 1 /4S 23 /T 30 /R 19 W TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/6/08 BEDROOM 3 CONVENTIONAL XXX IN -GROU RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 kk BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 98.7/97.7 4' below grade setbacks required by WDNR Alternate Benchmark To of 3/4" Top pipe @ 100.4 ' Plans Designed Using Conventional Powts Manual Version 2.0 281' Property Line 2 -3' X 65' cells with >3' spacing Pro 3 30 ' S 50' 20' jts Ve is Bedroom 15% ----� House 10. B -3 Slope 65' 10' Area of poor soils /inconsistent soils H M 0 , 102' 99' Ecopy Scale is 1" = 40' Vent 19 unless otherwise >6 „ Quick4 Standard -W noted of Cover Leaching Chamber with 20.0 ft2 of Area 4' Long 12" 5.8ft ^2 /pair of end caps 34" Grade at System Elevation West Shore Drive L•d dZL:L0 ZO Co AO 1301R T PLAN PROJECT Ron Foster ADDRESS 435 Riolev Ave Maplewood Mn 55117 NE 1/4 SW 1 /4s 23 /T 19, W TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/6/08 BEDROOM 3 CONVENTIONAL XXX IN -GROU RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 hk BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL #H.R.P. Same as Benchmark Well i5 to meet all SYSTEM ELEVATION 96.7197.7 4' below grade setbacks required by WDNR Alternate Benchmark Top of 3/4" pipe @ 100.4 Plans Designed Using Conventional Powts Manual Version 2.0 281' Property Line 2 -3' X 65' cells with >3' spacing Pro 3 30' S 50' 20' B NVents 15% m Bedroo B -3 Slope House 0' 5' Area of poor soils /inconsistent soils B I 10' 1. 0 ' B-2 102' 99' Scale is 1" = 40' vent 195' unless otherwise > 652 Quick4 Standard -W noted of Cover Leaching Chamber with 20.0 ft2 of Area 5.8ft ^2 /pair of end caps 4' Long 12" 4" Grade at System Elevation 3 West Shore Drive L•d dZ1:60 ZO £0 ^ON Wisconsin Department of Commerce SOIL EVALUATION REPORT Page Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code im County 4. a Attach complete site plan on paper not less than 8 1/2x 11 inches in si Ian st D include, but not limited to: vertical and horizontal reference point (BM), a arcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. evie d by ' Date Personal informs ou provide may used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 Property owner ` f Prop Locatio n c� V Govt. t 1/4 S A S Z T 1 R E (o W Property Owner's Mailing Address ,Lot # Block # S Name or CSM# s 0 2 ° I Eric k,L-CsYn Zal Z 3 a City State Zip C e Ph t N r GO N � City ❑ VII a own Nearest Road I L �5 11) 1( GRG� S° We s+ IkIr r New Construction UsesidenYial / Numbe of s S Code derived design flow rate GPD ❑ Replacement ❑ Pub' or commercial - Describe: Parent material Ft" Plain elevation if applicable , y ft. General oomments � � c�. � r1c �kk— - -- and recorrxnendations: . live / System Type D A—vv eae6 System Elevation I Boring # El Boring 7' Pit Ground surface elev /0- 1 / 1 ft. Depth to limiting factor � in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eif#1 •Etf#2 ,3 /z, L' , 2 — s — 7 fr q Boring # Eit oring / Ground surface elev. ft. Depth to limiting facdo / -/ in. Soil ADDliCafi0n 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 1 0 -9 0 ,I s G Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ture CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 017 Q �CJ 715- 246 -4516 I Property Owner _ ` ' Parcel ID t Page of Boring # Boring Ground surface elev. ' �ft. Depth to limiting factor /v in. Soil Application Rate ® it _... Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 - Z $ - 07 �7 1 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 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff 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 (RAMD) Property Owner_ '' ParrelID' ,w Page of Boling # Boring a it Ground surface elev. ft. . limiting , depth to miting factor in. {� Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff41 •Eff#2 J . 2 7 C r f( Boring # E] Boring E] 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/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I •Eff#2 F-1 Ong # E] Boring 11 Pit Ground surface elev. ft. Depth to limiting factor in. Soil icafion Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efl#1 - Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1150 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. SOD48330 (R.6N0) A , Soil Test Plot Plan Project Name Ron Foster Shaun Bird Address 435 Ripley Ave Maplewood Mn 55117 CSTM #2 00 Lot 1 Subdivision -------- Date 10/28/07 NE 1/4 S W 1/4S 23 T 30 N /R W Township St. Joseph ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 98.7/97.7' *HRPSame as Benchmark Alternate Benchmark Top of 3/4" pipe @ 100.4' 281' Property Line 20' B- 25' 15% 10' B -3 Slope 65' AtI.B.M. Area of poor soils /inconsistent soils 10 * B.M. 30' B -2 102' 99' 195' Scale is 1" = 40' unless otherwise noted West Shore Drive * 8 6 8 7 9 6 2 . 868796 KATHLEEN H. NAL$H REGISTER OF DEEDS CERTIFIED SURVEY MAP RECEIVED RECORD 02/12/2008 03:45PH CERTIFIED SURVEY MAP Located in part of Government Lot 7, Section 23, Township VOL: 23 PAGE: 5500 30 North, Flange 19 West, Town of St. Joseph, St. Croix REC FEE: 13.00 County, Wisconsin. COPY FEE: 3.00 PAGES: 2 BEARINGS ARE REFERENCED TO THE WEST LINE Of' THE SOUTHWEST QUARTER OF SECTION 23, TOWNSHIP 30 NORTH, RANGE 19 WEST WHICH IS ASSUMED TO BFAR SOO'53'32 "F. UNPLAT7F LANDS S89'30'29 "E 491.06' West 71 Corner ,Section 23- -30 -79 c al ` (Established from LOT I -� ,a �0 4 L ties) 1 TA AREA: ro 293,281 sq. ft. cv - 6.73 acres d:` "'+�h � •,r•.•.••••v /fl T ' i u >I LOT AREA EXCLUDING R -O -W: I1J �M J{ 261,537 sq. ft. a f.t.Ai <,_rJCE f. 6.00 acres — :i el r U 5 h V 14 1 W, � r .'q a) o s- ..s.s••• '4.' cn o Proposed 12' Utility Easement CD Southerly Right -of -Way of West Shore Drive '8 I Northerly Right -of -Way of West Share Drive - — — 233 .73' — 79.52< Y-') Angle Point WEST SHOf7E ON/l/E -- -- ..: - -- -- 1 -- — — 5 75'Sa S89'38'24"E c S.ri9 30'29 E nors Urlve n S89'30'29' L (�VPLs1 r7FI2. - $ -- 294.67 - - - -�-- 398.06 — 241.06 • t�� �P.O.B 13ASS LAKE Mf ADOWS Southwest Corner Section 23 -30 -79 (/ ouno' Aluminum County Monument) A special exception use permit is required for the disturbance of slopes 20% or greater not identified on the approved plat or CSM. This permit is applied for through the zoning office and is reviewed through a public hearing process by the St. Croix County Board of Adjustment. The lands included in this Certified Survey Map are within the Shoreland Zoning District. For additional information contact the St. Croix County Zoning Department., NOTE: The parcels shown on this map are subject '.o State, County and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. Lots may be subject to future special assessments for any upgrades and improvements to the road. LEGLNQ: - Section Corner Monument 150 0 150 YY of Record • Set 1" x 18" O.D. Iron Pipe weighing GRAPHIC SCALE 1.13 pounds per linear foot SCALE IN FEET: 1 inch = 150 feet o Found 1" O -O. Iron Pipe ........ Setback Line (50' from R -O -W) JOB # W1057SU259 -- Utility Easement (12' from R - O - W) Prepared by: EO con sulting gmu p, Inc. Prepared for and at the request of: Phone No. ('715) 246 -4319 Ronald Foster Fax No. (715) 246 -3830 435 Ripley Avenue P.O. Box 325 Maplewood, MN 55117 New Richmond, WI 54017 Drafted by L. Engen Sheet 1 of 2 1 of 2 Vol. 23 Page 5500 ST. CROIX COUN'T'Y SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer :� c�✓ -�2 Mailing Address r JZI Property Address (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number 6 30 0 LEGAL DESCRIPTION Property Location_' /4 zj '/4 , Sec. S , T So N R / W, Town of Subdivision , Lot # �. Certtified Survey Map # '� I , Volume , Page # D-D_ Warranty Deed # b CTO , Volume , Page # Spec house yes (3 Lot lines identifiable no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 wastewater disposal 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. I/we, 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we amlare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms �Z_ = �� C - 6 - 0 —y SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed (REV. 08105) Nov 04 02 06:26a P -1 cr Cld rrJ " J c k Td WbeS:90 8002 TI find Z£9£V6ZSTLT: 'ON xdd 3Nt saa-e UoOTIOD 3d: woS-A - 1 111111 IIIU IIIII IIIII IIIII 11111 IIII 111111 IIII 11N * 8 7 3 3 0 0 1 State Bar of Wisconsin Form. 2'2003 873300 WARRANTY DEED r x}300 JJVV KATHLEEN H. WALSH Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 04/22/2008 04:15PM THIS DEED, made between Allen W. Brakke and Patricia A. Brakke, husband and WARRANTY DEED wife EXEMPT t ( "Grantor," whether one or more), REC FEE: 11.00 and Ronald Foster and Patti Foster, husband and wife _ TRANS FEE: 195.00 PAGES: 1 ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrarits to'Grantee following described real estate, together with the rents, profits, fixtures and othge "appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property ") (if more space is �--•� �s needed, please attach addendum): t ?� 0 49:::�, That part of Government Lot 7, Section 23, Township 30 North, Range 19 West described as follows: Lot 1 of Certified Survey Map recorded in Volume 23 of kv Certified Survey Maps page 5500 as Document Number 868796. St. Croix County, Wisconsin. Part of 030- 1058 - 10-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated 1: a t_�03 . (SEAL) ,I ,c.y{.QJ.; ° -t (SEAL) * *Allen W..Brakke (SEAL) �G - (SEAL) * *Patricia A. Brakke AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF ) ss. ,C rp j X COUNTY ) TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me on ll (If not, the above -named Allen W. Brakke and Patricia A. Brakke, authorized by Wis. Stat. § 706 �Sy ) ; husband and wife O,••••"" "'•, to me known to be the person(s) who executed the foregoing THIS INSTRUMENT DRAFTED B ?'• 1 InstruMentand acknowledged the same. MONDA MA Attorney Kristina OQlan ha l)� i..JF•� �ini�- Hudson WI 54016 * _W/ Zczm . ........ y,�q� , N .r Notary Public, State of lV� C . 'wa` OF WISC��a` My Commission (is permanent) (expires: atltgIntltl ' (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED © 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. INFO -PRO— Legal Forms 800 - 655 -2021 www.infoprotorms.com 1 of 1 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent fifter 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 cy Plan e use altemate area and install new ption #1. system-fails, determine cause of failure, tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird #226900