Loading...
HomeMy WebLinkAbout030-2122-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420369 0 GENERALINFOR (ATTACH TO PERMIT) iI�ATION 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 St. Joseph Township 030 - 2122 - 40-000 CST BM Elev: Insp. BM Elev: BM Description: �(D 0 C) 1 T d s � / - Nr� to TANK INFORMATION 'ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark . I 100) ^ • lV ..�J Dosing Alt. BM y e �— lbd vG 4 11. - 9 Aeration Bldg. Sewer `1. 3 91 b Holding SUHt Inlet O 7 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing He r /Man. Q Aeration Dist. Pipe A 93•y Holding Bot. System b* i el a . -.1, D Final Grade PUMP /SIPHON INFORMATION Ik7 o�.I �'7• Manufacturer Demand Stir 4 -7 „I J' Model Num TDH Lift tion System Head TDH Ft Forcemain ngth Di . Dist. to Well OIL ABSORPTION SYSTEM BED/TRENCH Width Length , No. Of Trenches PIT DIMEN ONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS J (�/ 3 SETBACK SYSTEM TO P/L JBLDG WELL LAKE/STREAM an LEACHING Muf ure�r INFORMATION CHAMBER^ n�7 Type �f System: 3 } � ►LU UN Model Number: DISTRIBUTION SYSTEM AW ro)( ZD v� " - If h'" 3 J t rt Header /Manifold Distribution x Hole Size x Hole Spacin Vent to Air Int ke Pipes) t n ��,yy�����' Length Dia r 1� Length Dia v'Sp�cmg SOIL COV Tb x Pressure Systems Only xx Mound Or At - Grade Systems Only / 'Ak=P Depth Over ry Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil u Yes [] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: A / /� Inspection #2: Location: 801 West Shore Drive New Richmond, WI 54017 (NE 1/4 SE 1/4 23 T30N R19W) Bass Lake Me" adows rcel No: 23.30.99.994 1.) Alt BM Description = Sr. aA-5z 2.) Bldg sewer length = 4 - amount of cover -- Plan revision Required? [..,] Yes [ No Use other side for additional information. I SBD -6710 (R.3/97) Date Insepctor's ignature Cert. Safety and Buildings Division County / /J 201 W. Washington Ave., P.O. Box 7162 (� ISConS`>/f Madison, WI 53707 - 7162 Site Address Department of Commerce v- /i -v'z. 3 i / �b �,Ps L)2. Sanitary Permit Application Sam Permit Number ��//�� /_ f In accord with Comm 83.21, Wis. Adm. Code, personal information you provide �00 3 & Check if Revision my be used for secondary purposes Privacy I.aw, 05. 1 m I. Application Information - Please Print All Information State Plan I.D. Number Properly Owner's Na ` °' , r -� Parcel Number - CO&M,� t 030 �(o --06)6 Property Owner's Mailing Address (?, ` t perry Location , �9 d l 0110 ;S N,R Ll City, State Zip dxk G r Block Number �� Su division Name CSM Number 11,Type of Building (check all that aPpo Ocity or 2 Family Dwelling = Number of Bedriigms � 01tt71age 0 Public/Commercial - Describe Use p 4 ❑ State Owned .f/� x-71 /^ N.� Nteist Road e �A t, III. Type of Permit: (Check only offs bo* oif line A (numbering scheme for Internal use). ete I*e B if applicable) A. 2 0 Replacement *s1etti` 3 0 Replacement of 6 0 Additionlo For CouWase sum Tank Only Existing m B. ❑ Check if Sanitary Permit Previously, Issued Permit Number Date Issued IV. Tpe of Permit: (Check a' ii that applMnumbering scheme is for internal use) ��� ' A" 3A / n - Pressurized ha- Ground 210 Mound 47 0 Sand Filter 50 0 Constructed Wetland 22 0 Pressurized In -Ground 410 Holding Tank 48 0 Single Pass 510 Drip Line 45 0 At -Grade 46 0 Aerobic Treatment Unit 49 0 Recirculating 30 0 Other V. Dispersal/Treatment Area Information: Design Flow (go) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Requited % Proposed `/ Rate(Gais./Days/Sq.Ft.) (Min./inch) Elevation 9 33 � � 14, 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 Tactic Dosing Chamber VII. Responsibility Statement - I, the tmdersip respoadbility for installation of the POWTS shown on the attached plans. Plumb Name (Print) Phtmbe ' MP/MPRS Number Business Phone Number Plumber's Address (Street, City, Sta ) VIMUVC01m /De artment Use Onl Approved 0 Disapproved Sanitary Permit Fee (includes Groundwater Date Issued mg ent Signa o Stamps) Surcharge Fee) to ❑ Owner Given Initial Adverse �� O� 0 4 �iYl%t -r i Determination IX. Conditions of Approval/Reasons for Disapproval yrt.�n�e�L � �.�p ,�:.•�z��d— �.tez �o �;S,�a.U�...�e=�► _ A�o 36 iNes>t -• P /L,. lst Attach complete piaA (to the County Doll) for the em on paper nWku than 8 x 11 itches In dze SBD -6398 (R. 05101) J 44k PSys P PLAN PROJECT P.C. Collova Bidrs. Inc DDRESS P.O. Box 489 Somerset Wi 54025 NE 1/4 SE ' 1 /4s 23 /T 30 TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/6/02 BEDROOM 3 CONVENTIONAL X)OC IN -GR PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 30 IL BENCHMARK V.R.P. Top of Fence Post with Sign ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE (DWELL - H.R.P. Same as Benchmark B.M. Alt.B.M. SYSTEM ELEVATION 92.2/91.6 West Shore Drive nts / 5' 5' -3 to B- 0 45 3 i4.5 10 2s Pe 5' Pro 3 5 Bedroom Vb Rention area /067 B - b 1 S l 2 -3' X 94' Cells with >3' pacing 1~ a� a a� a > ndard Infiltrator a. V ching Chamber ° h 31.1 ft2 of Area at System Elevation Plans Designed Using Conventional Powts Manual Version 2.0 0' Proper Line 2�rs P PLAN PROJECT P.C. Collova B ldrs. Inc DDRESS P.O. Box 489 Somerset Wi 54025 NE 1/4 SE 1/4s 23 /T 30 / TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/6/02 BEDROOM 3 CONVENTIONAL XXX IN-GRF PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 30 IL BENCHMARK V.R.P. Top of Fence Post with Sign ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark B.M. Alt.B.M. SYSTEM ELEVATION 92.2/91.6 �� West Shore Drive �, l Vents Z5 5 15 5' -3 � '0V ro B- 0 .� 10% 45' � 17 ope 5' Pro 3 5 Bedroom T �+ 401 Rention area !ob B -1 1 2 -3' X 94' Cells with >3' Spacing a� rn in a� Vent ►� >6 „ Standard Infiltrator a, V of Cover Leaching Chamber with 3 1. 1 ft2 of Area 6' Lo 2" ng 3 4" Grade at System Elevation Plans Designed Using Conventional Powts Manual Version 2.0 0' Pro e Line 2�fS / OV.VV of IJ JL NOZ 01 1.5 W b9.1 / /1.015 C2 80.00 5216'06" N63'22'20 "W 70.48 72.98 7 80.00 13'08'21" N43'48'27.5 "W 18.31 18.35 6 80.00 39'07'45" N69 56'30.5 "W 53.58 54.63 M�l[PdlQ44C�D dQ ` - 1 6 3 WILL HAVE A JOINT "VtWAY EASEMENT OVER ----------------------- OWN 0E' WIDE ROADWAY 'ItMENT La (N8nj 33" W 639.237 — _ — N89*W23"W 639.12 0 ... ..`..... IS ... ....................... . ....................... yf 46-pt le rMENT GRANTED TO THE e }r {- 1 J08EPH FOR FUTURE LOT 3 k - - �� L�T 4 LOT 5 LOT � 1.407 ACRES 14 397 SO. FT.) I t130� ACR ES ) . m. (130, 2 C EFT.) 3.009 ACRE: EASEMENT (131,087 SO. F 3.002 ACRES $ MIN FFE - 925.0 MIN FFE = 925.0 (130,752 SO. FT.) Q„ `�0, ROAD EASEMENT \� MIN FFE - 927.5 ` ' - 923.0 � 1 1 .... • - " P ................... I................. ...................... EASEMENT H.W.L. = 925.5 �- - -�� �.RNUE(Privataro — ._._._._._._._._.— ._._._._._. - — — — — — — ad) ---- ----- (S89° 16%'E 1379.937 UH PU r�CED �[ = --- - - - - -- ---- LEGEND FOUND ALUMINUM COUNTY SECTION LU CORNER MONUMENT oc FOUND 1' IRON PIPE O 2' X 30' IRON PIPE SET WEIGHING 3.65 U3S. PER UNEAR FOOT ALL OTNM LOT CORN= AILS MONUMKM WITH A 1 X 44 IRON NM •w•A��A 1 I � A� Awl �� � A SAM ,Wisconsin Department of Commerce SOIL EVALUATION REPORT Pa / of Z Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code c County 1 ` Attach complete site plan on paper not less than 8 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. T percent slope, scale or dimensions, north arrow, and location and distance to nearest road. d �t o -� laa 1 l��O11d Please print all information. eview y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Q Property Owner Property Location C . v Govt. Lot 1/4 �1/4 S E ( ) W P Owners iling Addre J Lot # Block # Subd. Name or NW > D4 q O r City State, Zip Code Phone Number ti City ❑ Village own Nearest Road 9 New Construction Us . sidential / Number of bedrooms Code derived design flow rate J GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material QL.LT - , Flood Plain elevation if applicable General and recomrne n daft mmedations: r l., r a Ong # p Boring / /'�" Pit Ground surface el ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Ef1#1 •Eff#2 121 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor -�-�= in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i - Eff#1 'Eff#2 G S� -a •.S - ------ 2 L � r Effluent #1 = BOD > 30 220 mg1L and TSS >30 150 ` Effluent #2 = BOD 30 mg/L and TSS < 30 mg& CST - -S nnt (Please P) - - - < Address �j Date Evaluation Conducted Telephone Number / Property Owner Parcel ID Page of © Boring # ❑ Boring Pit Ground surface elev. + ft. Depth to limiting factor in. SoA -Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. n •81#1 •Eff#2 F-1 B oring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to liimiting factor in. Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 F B o ri ng # Boring a ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description. Texture Stricture Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef1#1 'Eff#2 Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mg& • Effluent #2 = BOD < 30 mgll- and TSS < 30 mg1L 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. sao4330 MM) I .2 Irm DOI CA s ................... ......................... \� I ! ( £Z N01103S 30 i7AMS 3Hl 30 3N!1 iS3M — _ — — •� G� c I I .d�'�L & M.vz.s�dooN �� — — — — — — — — — � \� � �.�sooN i M'K9 MAPUSMN -- - ------- 4E9M.5EZ5.00N -- \'- --- - - - I .9L'E84Z \ —� j ai Io I I m I I I 27, m � CO) i I v I �� 0o j A)0*9M 31WAZ9000S `^ ccD, i c r I loa w 1 I I i ��• / � O� 1 i I -� c I7 I . m m i s9'ves 3.5'f, I M _ I � I r I �� m� • I I I r i I� �j I I I V i I c I I �� ,tv'a5 3.ts ,9td80S looj I c \ aJ , ��I j x � ,l9'86Z �� � �� � � 2 cn ca -em m-6 &AOcOON 2D1 W. Washamgton Ave.. P.O. Box 7162 �scons�n .� -7162 She Addren De artment of Commerce 9 -o z 5 D/ / P Permit Nnmha erm�.t A lication zo 3& P 9 PP `� L � won yen Pm 0 Cheek if Revkion to aocard Ca®mn 83.21, wens. Aden. Code. Pte' � als. i be rased fm State Phan LD. Number L APPHemom Informadn - Please Print AN InfermatIM Number Ptopetiy Oamer'a A� -ooh ptgw y owner's Address 2002. Property Location , jq tL> Y Lot ds mo Nuatber Zip Code ' " F; Cray. State CE 11 Subdivision Name Number Gc> i fir" 7� s sY� sy 77 Type of BttittPm ( all mat apply) per, 2 Family Dweftg — Number of Bedrooms ovmw Dewrft Use r oo:: e Owned Nearest Road CP um� III. Type Permit: (Check en* one box an Noe A (Mn dmft scheme for me). Complete line B if a�ppBcable) A. 3 0 Replaameo< of 6 AdMm to For Como rase clew 2 0 Rapes TIsok Daft Iss+med B. ❑Check if Sashary Petmit Prevly Isa�ed Permit Number IV. Type of Peratit: (Check all mat applyxnombainB std is for ;ntWNIMt use) n G� nd 210 Wbund a7 0 send Fftr so 0 Drip walam Ito n 22 / Pcesamr5ud in Gmmd 410 Aoldmg Teak 48 0 Smgle Pass 510 D ' ✓ 46 0 Aerobic Ik atmmt Unit 490 R 30 0 otter �J 45 O Ac -Grade V. Area Iafm: Final Grade Area Dot Area Sob Pr to®Rate Required Design Flaw (gpd) Proposed Rm(CWsJDwjwlq Ft.) (ldia /1ac>a Etevau°° / '? 1 Sim Plastic TOW -Number Prefta-I VI. Tank Info C m GIMM of Theft Caocrete Comtnmeted ter F�b6Os Tanta sepmia Tmmx - �7Cst9 Daft CMmber Vm staftmtseat for b of sue Pown abown own the att elood Om s Name (Prim �� MPNumb" Bmumem Phone Nuwbw Phtdm es Address (Buret. Cray. fCl OQ �J VIII• Use O r* Date Issued Wan Agent MO Stumps) Samnrp Permit Fee Groandw� Apps 0 DbWpro`red SardwV Pee) 0 owner Given Imad Adverse I Determmatim IX. Condidow of ApWGVWMmom for Disapproval . PLOT P AN P,ROJEC r P.C. Collova Bldrs. Inc Ajo R SS P.O. Box 489 Somerset Wi 54025 Y NE 1/4 SE ' 1 /4s 23 /T 30 N/ 19 w TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8 BEDROOM 3 CONVENTIONAL )00C IN- GROUND SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 648 # of chambers 22 BENCHMARK V.R.P. Top of nail in elm tree ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 91.0/90.5 West Shore Drive K� B.M. #2 B.M. #1 Pro 3 Bedroom 30' 0' B -2 5' 40' u Vents Vents ' 0 , 140' 2 -3' X 69' Cells with >3' Spacing 70' 55' B -1 5% B-3. Slope u Vent Standard Infiltrator >6" Leaching Chamber Plans Designed Using o of Cover with 31.1 ft2 of Area Conventional Powts c Manual Version 2.0 6' Long 12" 3 4" Grade at System Elevation 220' Property Line PLOT P AN PdiOJEC' P.C. Collova Bldrs. Inc A R SS P.O. Box 489 Somerset Wi 54025 NE 1/4 SE 1/4s 23 /T 30 N/ 19 w TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE$ / 25/02 BEDROOM 3 CONVENTIONAL XXX IN- GROUND - SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 648 # of chambers 22 BENCHMARK V.R.P. Top of nail in elm tree ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL - H.R.P. Same as Benchmark SYSTEM ELEVATION 91.0/90.5 West Shore Drive B.M. #2 B.M. #1 Pro 3 Bedroom 30' 0 B -2 5 40' Vents Vents 0 , 140' 0 2 -3' X 69' Cells with >3' Spacing 70 ' lb- 55 ' z B -1 5% B-3_ �^ Slope ALong ent ►-a Standard Infiltrator Leaching Chamber Plans Designed Using o with 31.1 ft2 of Area Conventional Powts Manual Version 2.0 M 34" Grade at System Elevation 220' Property Line Wisconsin Department of Commerce SOIL EVALUATION REPORT Page Of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County � (• X Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan mutt 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 information. Re iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Q Z Property Owner Property Location Govt. Lot E 1.0 I4 SE 1/4 S Z3 T 36 N R I q E (ors Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# S � d� , qss m >:uCidw s City State Zip Code Phone Number ❑ City ❑ Village (D Town Nearest Road W k I S Y 1 LAY )KY - New Construction Use: ® Residential / Number of bedrooms - y Code derived design flow r :��!'S'a / GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material O V + (.Ja S h Flood Plain elevation if applicable General comments 5V,5fCn1 c GeV, 8 9 as r j J and recommendations: ST S7 O' ! �O[X Z ON WG ❑( Boring # ❑ Boring t 5 © Pit Ground surface elev. 93, 2 O 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 1 0 -/z to r - V4 — -, 4. C S ) -� •s .9 Z /Z -1$ is Yr 4113 - G.S �� n j tr -Crr e S — • 7 /. Z g - //o 10 L Y /<o M5 os >'v, — .7 / Z- 3 z 4 7L Y Fil Boring # Boring ❑ pit Ground surface elev. 9(1• 00 ft. Depth to limiting factor //s in. Soil Applicatio n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 3 Ze 7. s '//6 SrG / z.nsl� C 5 - `/ • �/ zo .,J * Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number ,a, rV. S U L wta -- - -- z.5 3 30 Address Date Evaluation Conducted Telephone Number Z// 4 S O A - o 7` / ell Sya eS (c - Z9' - 0 " 7,s$ - - 7- y/roa- f - 1 16 <• Property Owner C U 1(o V a Parcel ID # 1.,: `7 Page of Boring # ❑ Boring F F1 R pit Ground surface elev. 73.16 ft. Depth to limiting factor // d in. - go - il 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-/0 6 Y ray - SG z 6- o ,-y/3 - 4-5 ❑ 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 1 ❑Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit 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 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) PAGE OF 275_ NAME w I Io0 LOW LEGAL DESCRIPTIONt* ' /sue" /s,S 3o,N,R Iq E (or)O SCALE: 1 BM I ELEVATION I 00. 6 BM I DESCRIPTION na ( i ,, (. BM 2 ELEVATION lUU• y Z 3 BM 2 DESCRIPTION - 6a, I C ,\ • z� nn SYSTEM ELEVATION FS9 • U ° ^ ?C - ALTERNATE ELEVATION c( I • So CONTOUR ELEVATION N/ kl - ~ e S S kof � �g•z.. 93.00 B-3 S IGNATURE c� DA -Z dl 9 Z3,� Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter 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 alternate 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 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSIiIP CERTIFICATION FORM Owner /Buyer �- HoVA 6 1 J it S =N L Mailing Address • 6 c o n :, S Lzr— Property Address '� S hJ •� (VcriGcation required from Planning Department for new construction) City /State SEMQA',:�e- - ( ) Parcel Identification Number LEGAL DESCRIPTION Property Location ',: ��`, :, Sec. T i! -R W, Town of Subdivision �� 1 `4 �1tC1�0��L>.�`� I_ot it . Ccrtificd Sur-rev itiiap . VoillIlle Panic ;t Warrauty Decd # ( 3 Voiunic /7`) Pa-'c - 2 Spec llouscyyes ❑ t ;o Lot iincc iii ;ttit i;, no SYSTEM NIAINTENL ANCT! Improper use and maintcnanc: oC your static systcm could resuit in its prcnuturc ;aiiurc :o 1:andle %vastcs. :oper matntc.laIlcc consists of pumping out the septic tank cvcry three years or sooner, if accdcd by a iiccascd pumncr. What you put into tic systcm can affect the function of the static tank as a treatment stage in the waste disposal system. Tue property owner agrees to submit to St. Croix Zoning Dcpartn ;cat a cc :titication form, signed by tie owner and by a n:a sterplumber, journeyman piumbcr, restric:ed plumber or a liccascd pumncr verifying that (1) the on-site :vastc•watcrdisposal systcm is in proper operating condition and/or (2) after inspection and pumping (if reccssary), the septic tauk is Icss than 1/3 full of sludge. 1/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with tic standards set forth, herein, as sct by the Department of Commerce and the Department of Natural Resources, Slate of Wisconsin. Certification stating that your septic systcm has beta maintained must be comnlctcd and returned to the St. Croix County Zoning Office within 30 days e ,.- year expirat' n date. 2-1 NATURE OF APPLICANT DATE OWNER CIRTIFICATION I (we) certify that all statements on this form are true to the best of my (our) 1.�-towledge. I (wc) am (arc) the o .- nc:(s) of tie cry Z 3 iUed above, by virtue of a warranty deed recorded in Register of Deeds Office. �y O /z// U S AMRE 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 decd from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty decd r' 41574fu( 528 STATE BAR OF WISCONSIN FORM 7 - 1998 636669 TRUSTEE DEED KATI-ILFFN H. WALSH REGISTER OF DEEDS WCumrnr Numner ST. CROIX CO., WI RECEIVED FOR RECORD jjEI,F;N �,�p1�.SLYK;:L.� - ------ - -__ —_ -- - - - - -- 01 -11 -2001 11:30 AM ` - -- TRUSTEES DEED as Trustee of j EXEMPT If HELEN—E- VAN ST vl<f•• REVOCABLE TRUST CREATED BY REVOCABLE CERT COPY FEE: TRUST AGREEMENT DATED FEB RUARY 21 � 19 COPY FEE: '— -- - - - - - -- — -- TRANSFER FEE: 1275.00 - - - -- _— RECORDING FEE: 10.00 for a vahtable consideration conveys without warranty to PAGES: 1 P.C. CO LLOVA BUILDERS, INC. -- -- - ------- - - - - -- IIH or riu) A, ea Grantee. ...... _: .. _ the following described real estate In ST. CROIX County. . an Return Address / ,L " OD & CARI, S.C. State of Wisconsin: 2 OCUST STREET, BOX 1'25 PART OF GOVERNMENT LOT 7 OF SECTION 23, TOWNSHIP 30 NORTH,;; RANGE 19 WEST AND LOT 1, STEVENS AND SHIRLEY'S PLAT TN THE;; HU NN,, WI 54016 TOWN OF ST. JOSEPH, ST. CROIX COUNTY WISCONSIN DESCRIBED !I AS FOLLOWS: LOT 3 OF CERTIFIED SURVEY MAP FILED JULY 24, !' 1978 IN VOL. 3, PAGE 644, DOC. NO. 350360. 030- 1049- 70 -002 ` 030- 1060 -10 PART OF NElz OF SE' OF SECTION 22 AND PART OF GOVERNMENT LOT 7 OF SECTION 23, ALL IN TOWNSHIP 30 NORTH, RANGE 19 cel ldentificatiun Number (PIN) WEST, ST. CROIX COUNTY, WISCONSIN DESCRIBED AS FOLLOWS: LOT 4 F CERTIFIED SURVEY MAP FILED JULY 24, 1978 IN VOL. 3, PAGE 644, DOC, NO. 350360. PART OF NEZ OF SE - OF SECTION 22, 'TOWNSHIP 30 NORTH, RANGE 19 WEST, DESCRIBED AS FOLLOWS: COM14F.NCING AT THE SOUTHEAST CORNER OF SAID SECTION 22; THENCE NOO ° 32'43 "W ALONG THE EAST LINE OF SECTION 22, 1313.35 FEET TO A POINT TIIAT IS 16.5 FEET NORTH OF THE SOUTHEAST CORNER OF THE NEi;; OF THE SEtt OF SAID SECTION 22; THENCE N89 ° 47 1 00 "W, 16.5 FEET NORTH AND PARALLEL TO THE SOUTH LINE OF THE NEti OF THE SE' -4 OF SECTION 22, 309.00 FEET TO THE POINT OF I BEGINNING OF THIS DESCRIPTION; THENCE CONTINUING N89 ° 47'00 "W, 202.78 FEET TO THE SOUTHEASTi CORNER OF CERTIFIED SURVEY MAP AS RECORDED IN VOL. 2, PACE 595; THENCE NOO ° 32'43 "W ALONG THE EAST LINE OF SAID CERTIFIED SURVEY MAP 539.09 FEET T'0 THE SOUTHERLY RIGHT OF WAY' LINE OF A TOWN ROAD KNOWN AS SUNSET RIDGE; THENCE S89 ° 18'52 "E ALONG SAID SOUTHERLY TOWN ROAD RIGHT OF WAY, 202.81 FEET; THENCE S00 ° 32'43 "E, 537.44 FEET TO THE POINT OF BEGINNING. I' Dated this _� day of JANUARY 2001 - - - - - -- (SEAL) �'c C� <o t- ,y (SEAL) HELEN E. VAN SLYKE - -- - — •fnutee Truaee AUTHENTICATION ACKNOWLEDGMENT Signatulr(s) _J1EL N L•'. VAN SLY KE_____ - _ ----_.._-- State of Wisconsin, } ss. - - - -- _ County. JANUARY 20O 1 Personally came before me this - __ _ ___ ..__ day of authenticated Ihls .day of the a —.-- na o f I - -_ —_— -. ---------- TITLE: MEMBER STATE BAR OF WISCONSIN (If not. me known to be the person who executed the foregoing authoriLed by §706.06. Wis. Slats.) instrument and acknowledge the same. THIS INSTHUMENT WAS DRAFTED BY HEYWOOD & CAR I._S. - C - ._ 204 LOCUST STREET, BOX 12b HUDSON 14 1 54016 Notary Public. State of Wisconsin My commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged, Both are not necessary) ' Names ut yenons agnlug a any capaauy now oe Iyye<1 or ynntea below Umu signuure STATE BAR OF WISCONSIN w.scaum LogaI Hunk Co., Inc TRUSTEE'S DEED FORM No. 7 - 1998 6t�IWdUkJJ, Wes / OV.UV 01 115 0Y NbY 01 1,5 W by.l / C2 80.00 52"16'06" N6322'20 "W 70.48 72.98 7 80.00 13'08'21" N43'48'27.5 "W 18.31 18.35 y 6 80.00 39'07'45" N69'56'30.5 "W 53.58 54.63 M_HPUC 4C_ D _dQM_ 1S d 3 WILL HAVE A JOINT @WERD ° l y @ I VEWAY EASEMENT OVER ----------------------- OWN 88' WIDE ROADWAY 'ItMENT (N89 839.239 L4 — N88°30'23'9N 638.12'— — • — • — • — • — • — — — — . — ..... ? �. �. .................. ..... ............................... ....................... MENT GRANTED T JOSEPH FOR F 0 THE JO 1 FUTURE LOT 3 a __� LOT 5 LOT 3.403' ACRES ( 4 6,397 SO. FT.) rA 3.001 ACRES 3.000 ACRES 3.009 ACRE! INC. EASEMENT (130,708 SQ. Fr.)' (13002 SO. FT.) m (131,087 SO. F 9.002 ACRES $ MIN FFE - 925.0 MIN FFE = 925.0 ( SO. FT.) KC, ROAD EASEMENT \ MIN FFE - 927.5 \ H. W.L. - 923.0 I �\ 1 .. ..20'DRAINAG. \ .` .............................. .................. ...................... EASEMENT / H.W.L. = 925.5 --� -1 rr i Z — — — — — _ — — — — — — — — ,ve _.. _ .— .— .._—. —. ------ — . — —. — — — — — — — NUE (Private roads (S89°16'08' 1379 — .93 . 9 Cam[ .., - - - -- -- LEGEND FOUND ALUMINUM COUNTY SECTION LU CORNER MONUMENT V 0 FOUND P IRON PIPE O 2' X 30" IRON PIPE SET WEIGHING 3.65 LBS. PER UNEAR FOOT ALL OTHER LOT OORNSRO An MONUMNITtO WITH A I X 44' IRON PIft