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HomeMy WebLinkAbout030-2122-50-000 I / k r , n § "Ilk � J % � n ■ 2 E - �® �E c 7 § � z E z t a, o § 0 � R ® - m # • 2 § § ƒ $ ` CO 0 C R © ° 2 i § c 2 . � \ E E 7 § k / / § £ % R \ \ o \ 0 . 0 E A n r- CO 0 A R % - V V @ • . 000 0 \ \ % % to / ° 7 C cr m o § o ® c E 2 ) C 03 z § k : a o ° ' a m § F § § @ g 3 E \ k C \ k \ . \ 7 ) U CL 7 \ 2 k !? c j 7 z « 2 / . � + § . 0 % $ ' � # \ ! � § � ƒ � I � � % � � 0 < \ kCD �2 ' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM county' St. Croix Safety and Building Division Sanitary Permit � INSPECTION REPORT 430209 � 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 St. Joseph Township 030 - 2122 -50 -000 CST BM Elev: Insp. BM Elev: 7 Description: Section/Town /Range/Map No: 1/ 0 0 23.30.19.995 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic P - Benchmark '3 " � fp3 � /ate, C. Dosing �-.z �! Alt. BM Aeration Bldg. Sewer Holding . St/Ht Inlet 7.y5 TGNS TANK SETBACK INFORMATION SVHt Outlet -7 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic % i Dt Bottom Dosing Header /Man. g q q� ; gam Aeration Dist. Pipe Holding Act. System 4 9•I• t ri 9 . 5f Final Grade PUMP /SIPHON INFORMATION 64 Q S r r Manufacturer Demand St Cover y 3 Model Number 71 ift Friction Loss System Head TDH Ft Forcemain Length Dia. / ist. to Well / n SOIL ABSORPTION SYSTEM -3 C � 7 G �h BED/TRENCH Width Length G $ , No. Of Trenches PR DIMENSIONS No. Of Pits Inside Dia. Liquid Dep th DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR 6 : v Type Of System: UNIT Model Number. G C_/LNJQ..,�� 0/J 7 �� 3� r' �� DISTRIBUTION SYSTEM Header anifold I D istribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) _ Length Z<;1 Dia Length Dia Spacing p•. S SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over jxx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 3 / Bed/Trench Edges _- ___. —__ [] Yes 0 No D@ Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / Z / 3 Inspection #2: / / Location: 705 West Shore Drive Somerset, WI 54025 (NW 1/4 S 1/4 23 T30N R19W) Bass Lake Meadows Ot 5 Parcel No: 23.30.19.995 1. Alt BM Description = Tc P � S. T _ C v u i P 2.) Bldg sewer length = f � sr - amount of cover = y Plan revision Required? [] Yes [] No 4 V Use other side for additional information. SBD -6710 (R.3197) Date Insepctor's Signature Cert. No. �I AV I� ft � n^'h � Y' ,�,�1 ta. -�,� �� "L-t ✓L � ' �°� � r� .,,� Pic — YA __ _ _--� �� SoiA Test and stem PLOT PLAN ;T P.C. Collova Bl drs. Inc. DDRES .0. Box 489 Somerset Wi 54025 J4 4 SW 1/4s 23 /T 30 1 W TOWN Somerset COUNTY ST. CROIX Shaun Bird 226900 / DATE 9 /9/03 BEDROOM 3 NTIONAL XXX IN- GROUND ESSURE CONVENTIONAL LIFT HOLDING TANK I SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TA K SIZ JG TANK SIZE LOAD RAT A SQRPTI9N AREA 684 # of chambe CHMARK V.R.P. Top of Foundation A�UME ELEVATION i00' Filter ZabelA -100 REHOLE (D WELL *H, R. P. Same as Benchmark SYSTEM ELEVATION 94.0/93.9/93.8 4' below Arade West Shore Drive Vent � Standard Biodiffuser Leaching Chamber of Cover with 31.1 ft2 of Area }� 10` T '�� Pro 3 ` v J '6' Long 11 " Bedroom 30'/- House 4" Grade at System Elevation 3 ! ©� S Plans Designed Using o Conventional Powts Manual Version 2.0 45' �I 7Q' B -1 , 'e r— - 3' lls ith spac ng ed are has 0% Slope thus no contours Area of poor soils 50 , 25' B -3 20 25' B -2 V'' I c-- c Z 143rd Ave Safety and Buildings Division �UQ1l6Y s 201 W. Washington Ave., P.O. Box 7162 i cansrn Madison, W1 53707 - 7162 Sanitary Permit Number (t filled in by Co.) (608) 266 -3151 Department of Commerce State Plan I.D- Number )! Sa Permit Application �/ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, sI5.040)(m) Project Address (if di ferent than mailing addres I. Application .Information - Please Print All Information RECEIVED - PP 2 Property Owner's Na a arcel # Lot # Bloc SEP 10 2003 Property Owner's M ailing Address operry Location u I ST. CROIX COUNTY ` � y ZONING OFFICE S c2 L/ lh, 'ta,Section City, State Zip Code Phone Number cp Sj� j - So o2.� T N; { E rNv) l I II. Type of $tulding (check all that apply) Su ivision Name CS M 'urabe X , or 2 Family Dwelling - Number of Bedrooms a C Public/Commercial — Describe Use f ZW J btt�► kin . El State Owned - Describe Use ❑eity_OVillag Township of T •— _ III. Type of Permit: (Chec only one box online A. Complete line B if applicable) A' ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System I B. ❑ Permit Renewal rmit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner /t! Z I /11 IV. Type o POWTS System: (Check a ll that apply) Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ` ❑ Constructed Wetland ❑ Pressurized In round ❑ Holding Tank El Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter aching Chat ber ❑ Drip Line ❑ aveLless Pi ❑ ther (explain) �� gz!/ r V. Dis ersallTreatment Area Information: rev l Desig Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (s f) Disper 1 Ard4a Proposed {s System VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel I er Pla: 4 Gallons Gallons of Units Concrete Constructed Glass i New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigne , ui a responsibility for in stallation of the POWTS sho o n the attached plans. PI ber's Na me (Print) Plumber's ture MP /MPRS Number Business Phone Number tCC,t,c,,, Plumber's Addre ss (Street, City, State, Zip e) VI . County /Department Use Onl I Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Dat Issued I Signature (No Surcharge Fee) j ❑ Owner Given Reason for Denial Y j u � IX. Conditions of ApprovaUReasons for Disapproval I SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained Q/Z. tom. 3 as per management plan provided by plumber. r 2. All setback requirements must be maintained f as per applicable code /ordinances. /G/ ;J 7 Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size j SBD -6398 (R. 01/03) Wisconsin Department of Commerce SOIL EVALUATION REPORT p Division of Safety and B'pildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 81(2 x 11 inches in size. Plan must l include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel 1. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 3Q Please print all information. ewed by Personal information you provide may be used for secondary purposes (Privacy low, s. 15.04 (1) (m)). Pam' Owner Property location /� z D G of GL/ 114 � I4 S c z3T N Property Owner's Mailing Address ,./ ST, CROIX COUNTY Lot # Block # Subd. Name or CSC# yfi)/J 0 1 4 / / P nnira Zone•;? %nd t�lrks Comm +tte z - �s � /% - 4 City State Zip Code Phone umber. ?"i^� < (S P ) 200 City ❑ Village Nearest R r� S , New construction Use Residentil�l pBbWk� i�bi� days ride derived design flow rate ❑ Replacement ,❑ Public nLlil r � -I sha e Pi .- -_— _— --- --____ Parent material 4.ff.4 - Flood Plain elevation if applicable General comments �/ / 9 and recommendations: x3 -5 /v l r Boring �] Quest 7'�2Pi Boring # O!{iyrxs Pit Ground surface elev. ft. Depth to limiting factor" in. 5' Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. YZ Boring # Boring h Pit Ground surface elev. r ft. Depth to limiting fadr� /`/ in. Sc Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. r �- ` 5 z2s ' Ef fluent #1 = BOD > 30 < 220 nmglL and TSS >30 < 15 9W Effluent #2 = BOD < 30 mg& and TSS < 3C CST Name (Please Print) re CST Nun Bird Plumbing, Inc. Shaun Bird 2269( Address Date Evaluation Conducted Telepho 1008 192nd Ave, New Richmond, WI 54017 — --- / 715 -2 Parcel ID # Page of Boring Pit Ground surface elev. Depth to limiting factor in. Soil lication Rate Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 z C2, s - r z. ❑ Boring ❑ P ft. Depth to limiting factor in it Ground surface elev. Soil Application Rate i Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff# *Eff#2 Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ❑ Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Pit Texture Structure Consistence Boundary Roots GPDlfF th Dominant Color Redox Descrip tion- 'Eff#1 'Eff#2 Munsell Qu. Sz. Cont. Color Gr. Sz Sh. (fluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mg1L ' Effluent #2 = BOD, < 30 mg1L and TSS 130 mgll. tment 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. So' Test and stem PLOT PLAN PROJECT P.C. Collova Mrs. Inc. ADDRES Box 489 Somerset Wi 54025 NW 1/4 SW 1/4s 23 /T 30 1 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/9/03 BEDROOM 3 CONVENTIONAL XXX IN- GROUND 1 ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TA K SIZ 684 HOLDING TANK SIZE LOAD RAT A S RPTIO AREA # of chambe BENCHMARK V.R.P. Top of Foundation ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL sH.R.P. Same as Benchmark SYSTEM ELEVATION 94.0/93.9/93.8 4' below grade West Shore Drive Vent >6 „ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 10' Pro 3 6' Long 11 Bedroom 0 1 Grade at System Elevation House 34" Plans Designed Using S o Conventional Powts Manual Version 2.0 45' 7Q , 3 -3' 63' Cells with 3' spacing Tested are has 0% Slope and thus no contours Area of poor soils 50' 25' B -3 20' 25' 30' B -2 Vents 200' 143rd Ave - - - ou ty Wisconsin Department of Commerce j PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430209 0 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 St. Joseph Township 030 - 2122 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 23.30.19.995 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK IN FORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKEISTREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil FXJ Yes [] No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: ! / Location: 705 West Shore Drive Somerset, WI 54025 (NW 114 SW 1/4 23 T30N R19W) Bass Lake Meadows Lot 5 Parcel No: 23.30.19.995 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = revision Plan No Use others t de for additional information. SB"710 (8.3197) Date Insepctor's Signature Cart. No. Safety and Buildings Utvtslon wunty 201 W. Washington Ave., P.O. Box 7162 v - t - iscons�n Madison, WI 53707 - 7162 Sanitary Permit Number ( o be filled in by Co.) Department of Commerce (608) 266 -3151 43t� 2- 7) Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Project Address (if dif ent than mailing address) may be used for secondary purposes Privacy Law, sl5.04(1)(m) J k I. Application Information - Please Print All Information f 1 Property Owner's Na me Parcel # : Lot Block # # ILO 'A Property Owner's M ailing Address i Pr perty Location yy tA,Secdon Ci Ty ' (circl State 1 Zip Code Phone Number i e T� N; E W H. Type of Building (check t apply) o� S '�` 7 s bdivision Name CSM Number 2 Family Dwelling - Number edrooms ❑ Public /Commercial - Describe Use 1 State Owned - Describe Use e7� ❑City_ ❑Villa hip s h III. Type of Permit: (Check only one box o line A. Complete line B if ' pplicable) A. System ❑ Replacement System ❑ Treatment/Holding ank Replacement Only ❑ Other Mo ification to Exi tem List evi s rmit um r Da Iss B. ❑ Permit Renewal ❑ Permit Revision ❑ nge of ❑ Permit Transfer to New Before Expiration Plum Owner IV. Type of POWTS System: (Check all that apply) on - Pressurized In- Ground ❑ Mound > 24 in. of suitably 'oil Mound < 24 in. of suitable soil e ❑ Single Pass Sand Filter ❑ I tng Tank Peat Filter ❑ Aerobic Treatment Unit ❑ Recir Sand Filter Constructed Wetland El In- Ground El Ho I ❑ Recirculating Synthetic Media Filter r eaching Cha er ip Line Gravel -less Pipe Othe (explain) tr�it� V. Dispersal/Treatment Area Information: - Design Flow (gpd) Design Soil Application Rate( Dispers Area Re ired Dispersal e �pos (sf) S steJn jevation � VI. Tank Info Capacity in To Number Manufacturer P efab Sit Steel Fiber plastic Gallons Gal of 'Units Concrete Constructed Glass ` New Existing Tanks Tanks Sep[ic or Holding Tank Aerobic Treaunent Unit Dosing Chamber VII. Responsibility Statement- , the undersigned, a esponsibility for installation of the POWTS shown the attached plans. Plumb s Name (Print) Plumber's Si r MP /M Number- Business Phone Numb �L -te / / ✓� �� �(J ' � �� r Plumber's Addre ss (Street, City, State, Zi a� / J VIII. County /Department Use Only Sanitary Permit Fee (includes Groundwater Date Issued Is uing gent Signature Ao Stamps) Approved ❑ Disapproved Surcharge Fee) ❑ Owner Given Reason for Denial 1 5 2___� C) , 1 ZIT 3 IX. Con `'tip of A pro all easons for Dis proval Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54 NW 1/4 SW 1/4S 23 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/26/03 BEDROOM 3 CONVENTIONAL XX}C IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE A .7 AREA 684 22 IL LO D RATE ABSORPTION # of chambers BENCHMARK V.R.P. Top of Nail in Oak Tree ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 89.0189! 6' below grade West Shore Drive Vent >6 » Standard Biodiffuser of Cover Leaching Chamber Plans Designed Using with 31.1 ft2 of Area Conventional Powts 6' Long 11 " Manual Version 2.0 37 ' Grade at System Elevation B.M. #2 B -2 40 , 0 40 , B -1 Pro 3 25' 30' Vents 30 Vents Bedroom T House NP B -3 15' 60' 2 -3' X 69' Cells with >3' Spacing B.M. #1 100 Further testing will be done because of who did the soil test and the system' location 0 Assumed H.R.P. for no reference was given to how far north and south the 143rd Ave bench mark is! i PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 NW 1/4 SW 1/4s 23 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/26/03 BEDROOM 3 CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R.P. Top of Nail in Oak Tree ASSUME ELEVATION loo' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 8 9.0 /88t 6' below grade West Shore Drive Vent ALo Standard Biodiffuser Leaching Chamber Plans Designed Using with 31.1 ft2 of Area Conventional Powts 1 " Manual Ver sion 2.0 34" Grade at System Elevation B.M. #2 B -2 0' B -1 40' 40' Pro 3 25' 30' Vents 30' Vents Bedroom T House B -3 15' 60' 2 -3' X 69' Cells with >3' Spacing B.M. #1 100 Further testing will be done because of who did the soil test and the system location 0 Assumed H.R.P. for no reference was given to how far north and south the 143rd Ave bench mark is! I + ,Wisconsin Department ofCommerce SOIL EVALUATION REPORT Pap --Lof 3 Divislon of Safety and Buildings in accordance with Comm 85,1Aft Adm. Code County S+. Cray Attach complete site plan on paper not less than 81/2 x 11 inches in sine. Plan must include, but not limned to: vertical and honzomtal reference point (BM), direction and Parcel D. percent slope, scale or dimensions, north arrow, and locafi: r tto nearest road. Please print all �i . - - � j / by Date Personal information You Provide may be used for (m))• ` I �/ /� // ; <�. L , P Location P a ',W �1Q " �. J L �/GtJ 1/4 14S T Q N R E (or) Property Owner's Mailing Address 1 1 Fee T CROiX L Block # 1 Subd. ror CSM# S cit stwb zip code ING OFFIG ❑ village 5B Town Nearest Road New Construction Use: Residential / Number of Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material _- .' Flood Plain elevation if applicable zdiAV ft General comments SyS.{ e ¢ I t-v . c/ 0 • y0 and recommendations: �Gf eJ•e v• �• 2 O Boring # 1 ❑ �s M Ues Pit Ground surface elev. �• 20 ft Depth to limiting facto in. Sod Application Rate Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GPOW in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. - 8M * 0102 Z 2 X ' S Z GS . 2� 3 C2 -5 /1 vc I c �' •s" ' g q M 1 !� Z of 8�•z �z 1 # 09 pit Ground surface elev. `' ft. Depth to limiting factor / 2 in. Soil Application Rata Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. -EfW1 6 —Ig 10 yr 31Z 'I m 3 y8-0 to q CZ 4l '/ 3 v 44 c _ • S • 8 .L M5 6s-T MI * Effluent #1 = POP > 30 < 220 mg/L and TSS >30 150 mg/L • EfNuemt #2 = SOD < 30 mgfL and TSS < 30 mg& CST Name (Please Print) ature CST Number awl � -01— Z 30 9' Address Data Evaluation Conducied Telephone Number 211 0 ` 5-1 0 a 7i -zy -vac Property Owner Parcel ID # Page of a Boring # [] Boring C1 6- 4 1P it. Doti, to limiting sacra 121 in. IR Pit Ground surface obv. g-Ef Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary RoDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -01102 2 — dr c 2•8 6k n 14 1 0 Boring # El Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applimlikin Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Boring # ❑ Boring F ❑ Pit Ground surface elev. ft Depth to limiting factor in. Soil Application Rate Hors Depth Dominant Cob Redox Description Texture Structure Consistence Boundary Roots GPDNF in. Munsell Qu. Sz. Cont. Color Gr. Sz. She `Eff#1 "Eff#2 ` Effluent #1 = BOD > 30 5 220 mg& and TSS >30 < 150 mglt. ' Effluent #2 = BOD < 30 mglL and TSS _< 30 rnglL 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. SBD4330 (8.07)00) f t PAGE 3 OF 3 NAME LOT# � LEGAL DESCRIPTION vw ' /4sw' /4,S23 Tao ,N,R i q E (or)60 SCALE: F'= q O BM 1 ELEVATION /00. O BM 1 DESCRIPTION vt a; - FS " a k U/f 'ta oN BM 2 ELEVATION 100' o Z BM DESCRIPTION I ' S i3 r SYSTEM ELEVATION '?c), y 0 x f — t ALTERNATE ELEVATION S Z 0 I CONTOUR ELEVATION 3 gS' 2, AS Z a 0 q� 20 — 1 — — — 83 SIGNATURE DATE I� �I I i y M.�. 1»I.Or,1.Mf »a..W t ... A�,o� MeveM„r i I ' I Im M I I I I �✓ I � 16 - I .. I / fill '�� aaesv oos tai J y$, i I O r- mm0 7 1 \ 11 r r• .r �` 0 azz W l O�m �Z� x j I m �m — 0� —►�� 0 i; 0 1 I � C m N m ` e g� - -� c M N 1 1 x 0 r � wn -000 0 O 11 soils 1 1 !Q P PC1111 if .0 1 0 91 z n 12 is I fi m I I �Q ��I I I I lot Norso�sa�s ss.... •�••. � � I Maintenance and Contingency Plan fo r 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 o f t he filter. 3. Once every 3 y ears , 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 71 5- 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 OWNERSHIP CERTIFICATION FORM Owner/Buyer P. C. Collova Builders, Inc. Mailing Address P O Box 489 Somerset, W154025 Property Address o (Verification required from Planning Department for new construction) City /Stat ffi �-- k- Parcel Identification Number -Z (Z2 - S-a - cco r. ) LEGAL DESCRIPTION Property Location %,, `jj� r /4, Sec.( 2 T2_0 N -R1 W, Town of-- Subdivision ,� S Lot # Certified Survey Map # Volume , Page # Warranty Deed # _CP 6� n (f, Volume Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature.failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restricted plumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 Zoning Office within 30 da e e xpiration date. P. C. COLLOVA BUILDERS, INC. (715) 247 -2742 SIGN OF APPLICANT P.O. Box 489 DATE SOMERSET, WISCONSIN 54025 OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of th p rty de above, by virtue of a warranty deed recorded in Register of Deeds Office. P. C. COLLOVA BUILDERS, INC. - 7 SIGNA OF APPLICANT (715) 247 -2742 P.O. Box 489 DATE SOMERSET, WISCONSIN 54025 * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 1 , FROM P C COLLOVA HLDRS, INC PHONE NO. : 715 247 2747 Aug. 26 2002 09-12-AM P1 YOi 15 / `t pw 528 S1AIL BAR OF MSCO,1i 51N Fr)NM 7 19A8 1 t� TR USfitiU'S OFED F.: Es+�6�r ftR1Nl.F.EN M, WaLSH REGISTER OF DEEDS ST. (AM ca., WI 11kt S.LYEL. RECEIVED FOR RECM M"A - 2001 1$00 AN Y.V ; tlCA� I ; xFor !RUSIE DfEn tt l, UAN T..YA Rf:UpC ^1 8LII TR C1tLA ?17 CERi (bpY Fli, TRUST ACRGEMFNI' pATi<D rg FRU RY 2 1 CAM FEE: ... : Tkf+SSFER F 1275.pp E for vxhr kEU0 f. I 10. nhlc ealuuleras =on conveys wsnoµt warraruy is .. Di�S: f A P.0 COLLOVA $ , I N C IL �' d lDed tgtf csta[e In s•••__- _,,,w•,• .•_ «•— :f l:v:.M:lx ql :brd thefollowin 44cr IX Grrnree. i =.:..::.. T�CRQ vzCUST �D b CARI, s . C . State M wisM FART OF COVERNMENT LOT 7 0? SECTION 23, TOWNSHIP 30 VORTH,' 2 ST1ttBT. $oX 125 RANGE; 19 WEST AND 14'r J. STRYENS AND SHIRLEY'S PI.A'P IN THE;; Hf, WI 5416 TOWN Op 8T. �705SYH. $T. CROIX `AUNTY WISCONSIN I)ESCRIBi:F1 X,�.` AS FOLLOWS: 11 LOT 9 Or CERTIFIED SURVEY MAF FILED JULY 24. 1978 IN VOL. 3, PAGE 644. DOC. N0, 350360. 1 `' 1 330— i0 &9�T0�00« '`' "0'30 = TOGO' -TU PART OF NE>x OF 59I OF SECTION 22 ANTS PART Or GOVIANK15NT LOT I OF SEC'T'ION 23. ALL IN TOW\ISIIIP 30 NORTH, !LANCE 19 PsLm 1CLM;PSaI.x N nfl0 +W WEST, ST, CROIX COUNTY. WISCONSIN DLSCRIBF,D A5 FOLLO143: LOT 4 OF CERTIFIED SURVLq MAT FILED JULY 24, 1978 IN VOL. 3, ?AGE 644, DOC. NO, 356'160, PART Of NZ: OF See 01+ SI4(:T10N 22, '. 30 NORTH, RANCE 19 wh,'SF, D,t.'SCRISFD AS FOLLOWS: CUNNFNCING Al' TiM 80VT1IL'dQeT CORN61t OF SAID SECTION 22; THENCE M0 ° 32'0'v ALONG TIM EAST LING Oi'' SECTION 22, 1313.35 FEET TO A POINT THAT IS 16.5 FSE•t NORTH OF' THE :SOUTHEAST CORNEIj OF THE NEIL{ OF TI1I M OF $Air) SECTION 22; THENCE N89 "47 "W, 16.5 FEET NORTH Am) 9C.RALLEL T$r THE SOUT11 LI41! OF TH>r Nrh OF TliF. %rkz OF SkC 71014 22. 309,00 P814V TO THE POINT OF BECINNTNG 01: T11T3 DE TE&NCE.. CONTINU'_Nt; N89 "W, 202.78 FEET TO ME SOUTUXA5T; CORNER OF CERTIFIED $URVEY MAP AS RECORDED IN VOL. 2, PACE 595; 'xnENCE NO0 ALONO TILE LAST LINE OF SAID LURTIFIER SURVEY MAP 539.09 FF.FT TO 'TtIE SQt,`THLRLY R1011T Of WAY I,1NE OF A TOWN ROAD KNOWN AS SUNSET RIDCB; '1`tltNL'C S85 A',.GNG SAID SOU TOWN ROAD RIGHT OF WAY, 2O2.81 Fh %T: 11U'.'NCE S0001214311r, 537,44 FEET TO THE IOIN;` OF L'EGTNNLNG. j. (} aaoi This l.Q day of _ NVAU Y._ ........ . (SEAL) ...L E d��rt- ` __ . (SEAU 1 ; hE:l.,r:N E VAN SLYKII Tnut.. 'F•„wm AUTHENTICATION ACKNOWMCMENT '.iiyltitltx'e(�f __.}Ip &, t::- Ctnty vt,Y gE, Ssatc of WiaoGnSln, 1 55. x JANUARY 2001 Pnrnmlly clttk ufar'e ,f,e tri ;5 .„ _ ..-- ._..._....,.,..........iny Of iuJi0a mad tht. uay TIT1.F: MEMBER STATE BAR OF WISCONSIN �� ----^ •« •• __. Ilftwt.._ — ......_....._..__. _.,..r__ sov known ,e tw tN, jw%sm __. _.. wlu, e4voiwd ML u,ihart.rad L, 570G.06, W:a SWla) ;n:uwmunt anti aGknowsetiGn rw. name. 1' UM04T WAG DRAFTED Ev — __....._.. ..._.__..___ UY9081f L-Cg,(3I,,..S— C._.2 • LU! 'UST STREET, BOX 126 HUDSON W I $4016 Notar Ilwwc, Stoic of Wiuvir xi, .. _..__.---_—��....— ,_.._...,.... .,,..,...._.... My cortnix5kui lc pernllow (ir not Etah: rgiAl •ion d<,w (SlwMil,ros n ha aWhenttratcrl or ulimwladged. both arc tw "vto dry.) ' Na,w. ul WwN4.IMNiW NI dtty �.I,.,IIy nn,x x.lyµu et,Nlnl,a (,r!r u, r,l i,a JWf.. ' STATE BAR OF WISCONSIN w..:p,e� regal W.•,k 1:0.. iec, Tavarc s DEED FORM N,. 7 - 1046 LOTS 2. 3 ANA 4 OF CERTIFIED SURVEY MAP IN VOLUME 3, PAGE 6". - CURVE DATA TABLE (ALL LENGTHS ARE IN FEET) r _ _ _ _ _ _ _ _ _ _ / Curve Raft@ Centro! Chord Chord Are Twwat Bear" , onq.nl M Tonw N3714'1 Out ' 1 Nom or Lot �h 18 9 h 6'S3" 5891 W 15699 233 52421'1O"E 1T' W � 8 80.00 115'53'01" S33 W20.5"W 135.60 161.80 524"21'10 "E N882VO9 "W 7 60.00 51'13'32" N62'51'13 "W 69.17 71.53 NS828'09 "W N3714'17"W EA C2 80.00 5216'06" N63 22'20 "W 70.48 72.96 N371417"W N89'30'23 "W 7 60.00 13 N43'4827.5'W 18.31 18.35 N371el7"W NSO'22'38"W 6 80.00 39'07'43" N69'S6'30.5 "W 53.58 54.63 N50 72'38"W N89'30'23 "W LL7182 A 3 WILL HAVE A JOIN► / _ 9 C DRIVEWAY EASEMENT OVER BENCH 14MK: TOP OF 1• 40 r SHOWN 66 WIDE ROADWAY PIPE. l3tYAl10N 93039 Ekl6 -" EASEMENT Vo ,TEST SHOR! DRIVE - N8S'30'43'W 538,1lt' ---� ............. . - TV MDE T ASST LENT ORAN7ED TO THE ... ' S8S VN OF ST. JOSEPH FOR FUTURE LOT r LOT 4 - -T 5 LOT 6 LOT 8 3.407 ACRES (1!6,397 SO. FT.) 'A ! 3401 ACRES 3.08DACPE3 3.009 ACRES b TO AtFJIrgF1R CrE 2961 � (129.963: 9.10 AC NC. FJSEMEM �," 1 7 S0. FT.) TO 86. fT, #! .v (130492 SO. FT4 ym� 113146IORDNURY HIGH WATER MARK 3.009 ACRES Ci^S MIN F>=E 625.0 MN FFE 9M.0 X i � EJfC F40AAO EASEMENT `� � K � H.WA. 9120 I 1 MN FFE _8273 I C i _ NWW40'E 4V ` LOT 7 \ l� 10 MEANDER tsE I=Q ACRES ( SO. FT4 .................\.. % TO OR061AW! MOH WATER!MAC 5.44 ACRES f MN ME - 812.0 r FIWJ. - 9104 Z . roc (SWI OM io »s3'! _ - . _ . _ i M(11G?6G144fC� [i �'1G!1® ___O_____ 1 (5009406'E 16301 LEGEND 8000 wiwit 1s-20' (1469'3057 - E 3339 w FOUND ALUMO AI COt rm seanoN N88'30`49'E 03.01' b �. MO NowlWS . F OUND Ma4ENT Oo__llC_u_ ®Cl_OD_�u_C�- ___ paw O r K V WON PIPE SET WOOHNO2.66 LOS, PER IJNEAR FOOT RIVER S.r�� L )N 23 ALL OTNB11 LOT eotuues All[ Ma14U1mmm mm A 1 X M 69DON P" 1NSNN919a 1.18 LM. "a "Run row 4 P 6 7q©? �- NOM,FINA DRN17RNE LAYL WWO"WEAFFRE YWOPERAT�IONOF ! NOTE: SCRE EWAY ICOr ARE AT THE APPROVED AYE WATER ORWIAOE AND T1E ORSCRETION OF 11E TOYR491P. SOIL EROSION PLAN FOR THIS PRAT. THIS #*XUDES BUT 19 S OFFICE - - - - - - - - 1 2' WIDE UMM EASEMENT FLLM OR E�VAIM OR N iwNP n om' ' (ow 4 q ERIMB�R SS S OR G�9J1G�4 RUrCWAYS. 2 - d 6 - - � 7s ssiriAC+c FROM OroNAar V" wATEr+Lw+Ic wA V + m • � a d i. . • • • -. • ..... • .. • .... • . • . ROADWAY SEr9ACK (76 SACX FROM MGM-OF -WAY) d ors 1 ThW0U0N 6 WILL Not HAVE ACCESS TO BASS CAKE PFiEVpL13LrRECOROED DATA FROM 1798 OQIELOPL194t. .. `` -- 143RDAVO4LE4APANATE ROAD OWIEDBYOTHEA &NO 1 .1a H.W4. 9963 R10H WATER lR4E EIEVATiDN OF t.OT D AUM HAS WHYS OF DIRECT ACCESS TO 143RO it if dDesd4 STOW WATER RETENTION AREA AVBAX MIN FFE - 996.5 MMMUM FUM FLOOR gMA"ON 6J)781 A I THESE LOTS MAY BE BIURECT TO FUTURE ASSESSMENT$ NAVE 2 FFIES OEPE MW ON WAL0946 LOCATK" (: 9MF;i TO HAVE AN EPOW NCONROL `` - - - -? STORM WATER RETENTION AREA ZOrMKi OFFICE 6EFORE ISSUED. EWAYCOONS iUCTIONONLOT71S EIFVATltk4$ REFERENCED TO U$O$ DATUM (rNVp 910 SUBIECC TO fEVLW AND APPROVAL t(r40EA THE ST. CROIX COUNTY SNORELANO ZONP4 OPA)K&WE. ALL SAMAT10N6 AM 1000 HOW TO WN 9.L" DATUM OF 190 iM8 N6nRtIMEr1r DR4F MD 6r: WIUJIAM KANE JOB N0.06136 OATS: 05M=01 REY16ED• MO MI