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HomeMy WebLinkAbout030-1075-20-050 Alex Blackburn Froi Steve Olson Sent: Wednesday, December 09, 2009 10:19 AM To: 'rmcolbeth @dishup.us' Cc: Alex Blackburn Subject: RE: Permits for dairy operation Marie, Here is a link to the Livestock Facility Siting worksheets you will need to complete as part of the permits for the operations. http: / /www.Iegis. state. wi. us /rsb /code /atcp /atcpO5l_app_a.pdf Let me know if you have any questions. Steve Olson St. Croix County LWCD 1960 8th Ave. Ste. 141 Baldwin, WI 54002 (715)684 -2874 Ext. 135 Cell (715) 760 -1992 From: Alex Blackburn Sent: Monday, December 07, 2009 4:42 PM To: rmcolbeth @dishup.us Cc: Steve Olson Subject: Permits for dairy operation Marie, I reviewed your request and your property in the Town of St. Joseph will require a special exception permit. The property in the Town of Erin Prairie will require a land use permit. I have attached both permits and sub - chapter 2 of our zoning ordinance. Please refer to section 17.14 (1) (h) it lists the standards and required submittals for a land use permit. Erin Prairie property) Please refer to Section 17.15 (6) (u) it lists the standards for a special exception permit. (St. Joseph property) FYI, both of these sections contain the same requirements. Steve Olson from our Land and Water Conservation Department can assist you with most of these items. I included Steve on this e -mail so you can contact him. Steve's phone number is 715 - 684 -2874 extension 135. The special exception applications are due on the first Monday of the month, the next deadline is Monday January 4th, 2010. The land use permit for the Erin Prairie property can be turned in anytime if you wanted to get the process started. Let me know if you have any additional questions. File: Special Exception Application.pdf >> << File: Land Use Permit Application.pdf >> << File: Ch 17 SUBCHAPTER II General Zoning.pdf>> i Permits for dairy operation Page 1 of 2 AIex•Blackburn From: rmcolbeth [rmcolbeth @dishup.us] Sent: Tuesday, December 08, 2009 12:47 PM To: Alex Blackburn Subject: RE: Permits for dairy operation Thank you Alex, I'll be in touch. Marie From: Alex Blackburn [ mailto :alexb @CO.Saint- Croix.WI.US] Sent: Monday, December 07, 2009 4:42 PM To: rmcolbeth @dishup.us Cc: Steve Olson Subject: Permits for dairy operation Marie, I reviewed your request and your property in the Town of St. Joseph will require a special exception permit. The property in the Town of Erin Prairie will require a land use permit. I have attached both permits and sub - chapter 2 of our zoning ordinance. Please refer to section 17.14 (1) (h) it lists the standards and required submittals for a land use permit. (Erin Prairie property) Please refer to Section 17.15 (6) (u) it lists the standards for a special exception permit. (St. Joseph property) FYI, both of these sections contain the same requirements. Steve Olson from our Land and Water Conservation Department can assist you with most of these items. I included Steve on this e -mail so you can contact him. Steve's phone number is 715 - 684 -2874 extension 135. The special exception applications are due on the first Monday of the month, the next deadline is Monday January 4th, 2010. The land use permit for the Erin Prairie property can be turned in anytime if you wanted to get the process started. Let me know if you have any additional questions. <<Special Exception Application.pdf>> <<Land Use Permit Application.pdf>> «Ch 17 SUBCHAPTER II General Zoning.pdf>> 12/8/2009 Alex Blackburn From: Alex Blackburn Sent: Monday, December 07, 2009 4:42 PM To: 'rmcolbeth @dishup.us' Cc: Steve Olson Subject: Permits for dairy operation Attachments: Special Exception Application.pdf; Land Use Permit Application.pdf; Ch 17 SUBCHAPTER II General Zoning.pdf Marie, I reviewed your request and your property in the Town of St. Joseph will require a special exception permit. The property in the Town of Erin Prairie will require a land use permit. I have attached both permits and sub - chapter 2 of our zoning ordinance. Please refer to section 17.14 (1) (h) it lists the standards and required submittals for a land use permit. (Erin Prairie property) Please refer to Section 17.15 (6) (u) it lists the standards for a special exception permit. (St. Joseph property) FYI, both of these sections contain the same requirements. Steve Olson from our Land and Water Conservation Department can assist you with most of these items. I included Steve on this e -mail so you can contact him. Steve's phone number is 715 - 684 -2874 extension 135. The special exception applications are due on the first Monday of the month, the next deadline is Monday January 4 2010. The land use permit for the Erin Prairie property can be turned in anytime if you wanted to get the process started. Let me know if you have any additional questions. L� L�J LJ Special Exception Land Use Permit - 17 SUBCHAPTER Application.... Application.pd... II General Zo... Alx x B ackburn. Si, Croix County Zoning Specialist 1 �f ._ 1 r (No ee) (cw a crQ. S L f o D 7�47, t i 6 0nleA Cj) t Cz� --l- s � s� if i , I t } s •- � � f TES � � ,,� _e S , t a • , e - , - "w:.� w.g,ItlF 7 w r 4 T to It— Ci T it s • �� ,. � . � �, ' � t �.� � � .. .. ,. ,_ t` ..� � � t` • - � �► �. 0 aN 0 ; CO) 0 O v N K� F m_ O � N I� C N d N (D 10 3 7 0 cu c o m c w- 0 08 N O C N W l r� z rn ^i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix - Safety and Building Division Sanitary Permit No: INSPECTION REPORT 515264 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Schottler, John T. & Geor ine I St. Joseph, Town of 030 - 1075 -20 -050 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: AT\ 27.30.19.261 A10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER , `� CAPACITY STATION BS HI I FS ELEV. ' Septic •��.. 4 / Benchmark Dosing I �..ap / �^T Alt. BM n W N PJf�T /1J� C.C.S Bldg. Sewer 7.11 fi , 7 Holding `J St/Ht Inlet 0 TANK SETBACK INFORMATION St/Ht outlet , 45 TANK TO P/L WELL R1 QG. Vent to Air Intake ROAD Dt Inlet Q '/ ` , I g,` a �r•� 4 7 Septic 7 lb6 / l �l c ' 166 4f Dt Bottom Dosing 7 /DO 7 �� I 7 ��d Header /Man. Z-5 Aeration Dist. Pipe �j - 7,1 7 p Holding Bot. System .3 L6 �L Q? , 1 Final Grade ' ! 7 PUMP /SIPHON INFORMATION 5 '�� �� /• z Manufacturer Demand St Cover ab- GPM / _T lkCA_ c1b 7 ' Model Number � ] TDH Lift Friction Loss System He TDH,, , [ 4t 7 Z•3 Forcemain Len cth C I Dia. 2 ,11 Dist. to Well SOIL ABSORPTION §YS TEM BED/TRENCH Width Length r I— No. Of Trenches PIT DIMENSIONS No. Of Pit _ Inside Dim_ uid Depth DIMENSIONS 3 / Z \ f ep- SETBACK SYSTEM TO I P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer��, INFORMATION CHAMBER OR Typ � f System: t _ / I UNIT Model Number: C,&AL)e ­71 N+�-- DISTRIBUTION SYSTEM CJ j--9 glnt*e Header /Manifold Distribution x Hole Size � x Hole Spacing Vent to A 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 /S dded xx Mulched Bed/Trench Center 3 . Bed/Trench Edges Topsoil ` es 0 No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1382 Cty. Rd. I Somerset, WI 54025 (NW 114 NE 114 27 T30N R19W) 40 acres Lot Pa No: 27.30.19.261A10 Ca 1C.., � 1.) Alt BM Description = ", �SV � 1 d G44L 2. Bldg sewer length = t - amount of cover = / l� 3 o . 5 d Js Plan revision Required? E Yes No f b Use other side for additional information. Date Insepctor' Signature Cert. No. SBD -6710 (R.3/97) t= orrlrrterce_wi.gOV Safety and ut vision County 201 W. W �t A ..-�A Box 7162 score c i n 9bla 537j97 -7162 Sanitary Pen Number (to be tilled in by Co.) t Aepartment of Commerce 5/!5 Sanitary Permit APPIi n State Transaction Number In accordance with s. Comm. 83.21(2)_ Wis. Adm. Code. submission of s form fate governmental unit is required prior to obtaining a sanitary permit. Note: Applicat n for S are Project ddress (if di a ent the m 'lire address) submitted to the Department of Commerce. Personal information v u provide may econ �$' u oses in accordance with the Privacy Law. s. 15.04(1 )(m). Slats. I. Application Information - Please All Information Propem O net's Name / Parcel # Y�/ PLAN I �ROIX U ® e36 Property w Mailing Address p/yI �� Property Location OFp Govt. Lot C City_ State Zip Code Phone Number r /. A6 - Y., Section �� 7 (circle one 3�; �_ 11. Type of Building (check all that apply) Lot # T N: R E ❑ 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name Block # 9 Public /Commercial -Describe Use Ej ❑ City of El State Owned - Describe Use CSM Number ❑ Village of 4- �j� �. •'- Town of A/ /, II1. Type o Pe : (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B• ❑ Change of Plumber List Previous Permit Number and Date Issued ❑ Permit Renewal El Permit Revision ❑Permit Transfer to New Before Expiration Owner •� IV_ Tv e of POWTS S -stem /Com onent/Device: Check all that app X Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soi G n El Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) / V. Dis ersal/Treatm e Area Information: Design Flow (gpd) esign Soil Application Rate( f) Dispersal Area Required (st) Dispersal Area Proposed System Elevation -� �� VI. Tank Info Capacity- in Total # of Manufacturer m Gallons Gallons Units New Tanks Existing Tanks c y t Septic or Holding Tank _ S Dosing Chamber —_- 1 Respo sibility Statement- 1, the undersigned, assume respo4ibility for i.st.IIatkM of the POWTS shown on the attached plans. lit^ ^° amc ( Pr' t) - Plumber' , i lure MP/MPR5 Number Business Phone Number �j v - - 8 -29/7 P)u+r~6er s :� dress (Street_ City, State_ ip Code) r � s VI lt. Cnunty /De artment Ise Onl Permit Tee Date A Issuing Age ignature ed rrro• ❑ Disapp $ G ❑ er Given a on for Denial / �� • l & 1\. Conto for Disapproval t : Septic tank, effluent filter and dispersal cell must all be services / maintained eve. I ' X w/4-uu5 (A" 1� as per management plan provided by pkw0r. 2: AN sack requirements must be maintained Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x t t inches in size Valid thru 01/09 f14 Jp� ----------------------- C i — I"F ;4p,�C�jv "5b at Wisconsin Department of Comma SOIL EVALUATION REPORT Page Of .� Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not le tha x 11 inches in size. Plan must include, but not limited to: vertical and ho ' ontal nt (BM), direction and Parcel I.D. percent slope, scale or dimensions, no crow, an nce to nearest road. �' " 656 Please pri all information Revie y Date Personal information you provide may be u d for sel#fy rposaw, . 15.04 (1) (m)). 5 Z1// Property Owner p z�NN r CRO /kCOUN Q Property Location 1/4 � 1/4 S T N R E(or Property Owner's Mailing Address OF /C Lot # I 910c" Subd. Name or CSM# F City Ste a Zip Code Phone Number El City vi llage ® Town Ne Ro d re to New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate �, ����. S' GPD ❑ Replacement 14 Public or commercial - Describe: c Parent material C.ri��t Flood Plain elevation if applicable ft. General comments and recommendations: F-/1 Boring # Boring ® Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDffF in. Munsell Qu. Sz. 9ont. Color Gr. Sz.. Sh. *Efr#1 *Eff#2 G + to Id ,. l r ..s 6l Boring # Boring w ® Pit Ground surface ele� ft. Depth to limiting factor /Or in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDffI? in. Munsell Qu. Sz. qont. Color Gr. Sz. Sh. *Eff#1 *011#2 s e a. • q s O -75 1� Jr 1 * Effl t #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L * fltuent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Na M Signature CST Number Lj Addiesd Date Evaluation Conducted Telephone Number nr.r. n „n mnn u.m Property Owner ,I �Z�1 Parcel ID # Page of Boring # , ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor /.lam in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz . Color Gr. Sz. Sh. *Eff#1 *Eff#2 e � 4 1 F Boring # El E] ❑ 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 ❑ 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 *Ef##2 * Effluent #1 = BOD, > 30 _< 220 mg/L and TSS >30 5150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS 5 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 /OD) Property Owner. Parcel ID # Page - f _ of F Boring # }❑ Boring A Pit Ground surface elev. Z4f/"?' ft. Depth to limiting factor in. Soil Application Rate ,Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz nt. Color Gr. Sz. `fSh. *Eff#1 *Eff#2 ct �a R 4 ❑ 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 *Etf#2 ❑ 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 *Etf#2 * Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 150 mgA- * Effluent #2 = BOD 5 30 mg/L and TSS c 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) G' i i i G7 / i i iJ lee, 6 7 /�uz rd' ?� aaS loo 7 47 z4s�wz 164 P4., e5 — 41 3 :74 A9 Safe and Buildings . Safety s 9 commerce .Wl.gov 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188 -3789 ■ Contact Through Relay i s c o n s n www.commerce.wi.gov /sb/ e of Commerce www.wisconsin.gov Jim Doyle, Governor Aaron Olver, Secretary May 14, 2010 CUST ID No. 224263 ATTN. POWTS Inspector KIM A OCONNELL ZONING OFFICE KO CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/14/2012 Identifigtiat► Nuurbers Transaction ID No. 1793387 SITE: Site ID No. 756565 John Schottler Please refer to both identification numbers, 1374 Cty Hwy I above, in all correspondence with the Town of Saint Joseph a St Croix County NW1 /4, NEI /4, S27, T30N, R19W FOR: Description: Non - Pressurized In- Ground Object Type: POWTS Component Manual Regulated Object ID No.: 1265799 Maintenance required; 233 GPD Flow rate; 92 in Soil minimum depth to limiting factor from original grade; System(s): In- ground POWTS Component Manual, SBD- 10705 -P (N.01 101); Commercial System, Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "In- ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10705 -P (N.01101). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approvedXlalF1noftL the owner must insure that the operation, maintenance and monitoring duties as desc 'f the conventional component manual are complied with. A copy of this informatio» owner upon completion of the project. r • A state approved effluent filter is required. Maintenance information must be the otter of the tank explaining that periodic cleaning of the filter is required. Access to the filter for c Inust be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • KIM A OCONNELL Page 2 5/14/2010 • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sinc rely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis- Osborne POWTS Reviewer 2, Integrated Services WMART ode: (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis @wsconsin. gov Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, eh. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: "-w. commerce. wi. gov/ SB/ SB- BuildingContractorProgram.htnd Note: Effective March 29, 2010, we are consolidating our Shawano full- service office with our Green Bay office. Please address all plans, correspondence, mail, etc. related to previous Shawano services, for delivery after that date, to: Division of Safety & Buildings, 2331 San Luis Place, Green Bay, WI 54304. If calling moved Shawano staff after that date, call (920)492 -5601. i CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: Owner's Address: Legal Description: %��/— ��/ _��- F ' Township: County: _��• " ^, r' Subdivision Name: Lot Number: Parcel ID Number: Page 1 Index and title Page 2 Plot Plan, Page 3 System Sizing Page 4 System Cross - Section Page 5 Filter Specs Page 6 Maintenance & Management Plan Page 7 , �- 7 6,61,1_'Y Page 8 ��z!; 7 �4 � (' ep5 Page 9 'v.,,fn Designer/Plumber: i 9 ° . 1 �' = � License Number" Date: _l j_ Phone Number j/, _ ,? /_ Z , 7 Signature �� co Designed pursuant to the In- Ground Soil Absorption Component Manual for POWTS Version 2.0 SBDA0705 -P (N: 9y0 G�F'QC�� Page 1 " ',0 + O� ticF Af cg's -- 41, -5 /,p t Soil Absorption System Cross Section 4° Schedule 40 Final Grade PVC Vent Pipe With Vent Cap � ft Leaching Chamber `4—_ System Elevation ft ft Soil Absorption System Plan View IT ft _ft � Leaching Trench 1 ft Vent Or Observation Pipe . Chambers 4' Dia. Trench 2 Header Leaching Chamber Specifications Manufacturer And Model E1SA Rating �j sq ft per chamber Soil Application Rate gpd /sq ft gpd Design Flow + 7 Soil Application Rate 1 EISA = fly. 7 Chambers 2 rows of chambers each. C Page _,' of Z O � IF y CL ~ lL I.y W. r Q uj �zoo�c�i p W o 0 0 = cn Z F- w z o _, co cn LL- � a Luo¢ m _a' m a_ 6WLL ' no LL F ti LL N O C N W gLL a� �w� � � O O N U O C N J_ 1 r' r' IL y w f h Y C) J O o= N ® ISL W 4 W p � J • LL LL W m � ® N O �O POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _ _C/ of y FILE INFORMATION SYSTEM SPECiFICATiONS Owner Septic Tank Capacity ga l ❑ NA hem r` L Septic Tank Manufacturer 1' $ ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms NA Effluent Filter Model : ❑ NA Number of Public Facility Units s ❑ NA Pump Tank Capacity ga l ❑ NA Estimated flow (average) gallday Pump Tank Manufacturer Z i — ❑ NA Design flow (peak), (Estimated x 1.5) -� aI /day Pump Manufacturer ❑ NA J Soil Application Rate gal /day /ftz Pump Model ❑ NA C Standard Influent /Effluent Quality Monthly average* Pretreatment Unit )K NA Fats, Oil & Grease (FOG) <30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑. NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) <7 50 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Celi(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L In- Ground (gravity) ❑ in- Ground (pressurized) Total Suspended Solids (TSS) <30 mg /L bd NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA i .her. ❑ NA Other: ❑ NA "values typical for domestic wastewater and septic tank effluent. Other: ❑ NA iVIATiVTENANCE SCHEDULE Service Event Service Frequency spect condition of tank(s) At least once eve ❑ month(s) - ear(s) (Maximum 3 years) ❑ NA rump out contents of tank(s) When combined sludge and scum equals one -third (Y.) of tank volume ❑ NA '-spect dispersal cell(s) At feast once eve _ ❑ month(s) (Maximum 3 ears) ❑ NA ry `� year(s) Y Ciean effluent Ater At least once every: ❑ month(s) ❑ NA I 0� year(s) g rise c: punp, pump controls & alarm At least once every: ❑ month(s) ❑ NA .9 year(s) - .wsi; la'e-ais and pressure test 1 At least once every: 13 month(s) l9 NA ❑ year(s) At feast once every: ❑ months) ❑ year(s) � N ' 4 GM�r ® NA VIAiNTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. Alf other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the focal regulatory authority within 10 days of completion of any service event. ., a S P e 7 OT TART UP AND OPERATION g `or new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals That may impede the treatment process and /or damage the dispersal celi(s). if high concentrations are detected have the contents 'of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of e ffluent_ To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the System is Properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: 0 All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. Y The contents of all tanks and pits shalt be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. Q A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. Q The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Q Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS OWTS INSTALLER POWTS MAINTAINER Name Name Phone - Phone j - - - SEPTAGE SERVIC OPERATOR (P UMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone r` "his docurrrs,t was c - ::_ "ance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Lose Tank Cross Section And Pump Performance Specifications Minimum Pump Performance Tank Manufacturer P Required Tank Model Number �; GPMI@l Ft TDH Total Tank Capacity Max. Bury Depth Total Dynamic Head (TDH) -Feet Pump Manufacturer S Elevation Head Pump Model Number =' Distal Pressure Alarm Manufacturer ":5 - Network Pressure Loss - Alarm Model Number Force Main Pressure Loss " Switch Type 4, - Total anl��e Min. 4" Above Grade L With Locking Device Vent Min. 12" 4 Above Grade Weather -plof With Cap Junction Box �. �- •� — — — - Finished Grade — — — •. _ 1' ? Depth of Cover �, !!� Ft Disconnect Means 1 t > >< Outlet S Inlet >` Switch Settings and Reserve Capacity _ - _ -- ___ >; Tank Volume = GPI ;< '< t > Dimension Inches Volume Gal. '< ss> A >{ , / <' (reserve) A ; >< < Weep (alarm) B 2 B Hole < (dose) C 7 Off Elev. (dead) D V J Ft C 7 r i > r Total s D s < t y Bottom of Tank Elev. Ft ;{ y t e c< t t t > > > i S S S S S GENERAL INSTALLATION: The dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the excavation and is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28 Wis. Adm. Code. 03/05 lgi Page 8' of 7 • M GOULDS PUMPS Submersible Effluent Pump PE 1 " : u 1 ENT PUMP SPECIFICATIONS MOTOR FEATURES Pump — General: General: ■ Corrosion resistant • Discharge: 1'/2 NPT • Single phase construction. • Temperature: 104 °F (40 °C) • 60 Hertz ■ Cast iron body. maximum, continuous when • 115 volts ■ Thermoplastic impeller and fully submerged. • Built -in thermal overload pro- cover. • Solids handling: 1 /2" tection with automatic reset. ■ Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing • Automatic models include a • Oil - filled design. construction. APPLICATIONS float switch. • High strength carbon steel ■ Motor is permanently Specially designed for the • Manual models available. shaft. lubricated for extended • Pu m p ing range: e PE31 Motor: service life. following uses: p g g ' se • Mound Systems performance chart or curve. • .33 HP, 3000 RPM ■Powered for continuous • Effluent/Dosing Systems PE31 Pump: • 12.0 Maximum amps operation. • Low Pressure Pipe Systems • Maximum capacity: 50 GPM • Shaded pole design ■ All ratings are within the • • Maximum head: 25' TDH PE41 Motor: working limits of the motor. Basement Draining ■Quick disconnect power • Heavy Duty Sump/ PE41 Pump: • .40 HP, 3400 RPM cord, 20' standard length, Dewatering Maximum capacity: 60 GPM • 7.5 Maximum amps • Maximum head: 29' TDH • PSC design heavy duty 16/3 SJTW with NEMA 5 -15P, three prong, PE51 Pump: PE51 Motor: 115 volt grounding plug. • Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■ Complete unit is heavy duty, • Maximum head: 37' TDH • 9.5 Maximum amps portable and compact. METERS FEET • PSC design ■ Mechanical seal is carbon, 40 ceramic, BUNA and stainless PE51 MODELS: PE31, PE41, PE51� steel. i HP:.33, .40, .50 ■Stainless steel fasteners. 35 i 10- 2 GPM AGENCY LISTINGS 30 1 FT r - Q { _, - t C US a 20 + _, _ _ . _..M _ w. .. _ Tested to UL 778 and Z ` CSA 22.2108 Standards - By Canadian Standards Association Q 15 File #U38549 o Goulds Pumps is ISO 9001 Registered. OL r , r 0 0 10 20 30 40 50 60 70 GPM 80 0 5 10 15 m /h Goulds Pu mps CAPACITY 2002 Goulds Pumps ITT Industries Effective November, 2002 BPE31/41 <& ST. CROIX COUNTY -SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner7.8 L1 yer Mailing Address Property Address � (Verification req, rreLl from I 'nnit,p & Zoning Department for new cons(1 City /State Parcel Identification Number LEGAL DESCRIPTION Property Location �� , > ;.,4 , , Sec ,�2 '1` 6 N R _W, Town Subdivision Lot # Certified Survey Map # — , Volume , Page # _ Warranty Deed # V _ — , Volume Page{ Spec house yes no Lot lines identifiable yes- no SYSTEM MAINTENANCE AND OWNER CERTIFICATION linproper 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 tluoe 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. Uwe, 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 Planting & Zoning Department within 30 days of the three year expiration date. 1 /we certify that all statements on this 101. arc trt,c to tthc best of' myluttrknowledge. I /we atu/are the owner(s) of the Property described above, by virrue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 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 ma p if reference is made in the warranty deed. (REV. 08/05) 8 it �WT s * } * 'f 'ki?a.t r, -c9 r i' 7ba� y e x r.+ ..yn. ea3.w. f .e a's"i" fi3c;4'�"'= CrF'd4.i .✓1�'f:n .#.t ;^,'c n. '* .,.�:E. *�Ft $ v 7+ 5+%`�'i"'k a r"< -- iL +^ ^a$ ���' ,:'. .,9t' . ' cam'°" °""""' r W1�,� s G� !,"' "�,� ,r r S.' lax -[1L' QSte ti a r' CM ' rNw T.a,•,"a4, "�.k"ii`' PW '$f tf 5 ..n r :<.Y� �� '�s.,+' �''�'.'.E.r��. +97:Y1[le"'.. t�. :'�Mtk°^' S. '5� �7� tesri�FSS °mod �� 1,5, aem �a++w �� �sa� Il'�9"� "�� � •' �• r !fiat "�9�, t � SC:'.$ottller bns�ia.c>wd d�� e�,as- oaf E.E►� �'s'i p ��� � �u«ry ,wa a`� •• o `,� E'"'? � a y� �` '�'i�'"� ��45i: r p r5k � ,,, -✓ r u • .. _ . =Aw �, :. .. , €.a .a .�,.% 3 "+t �+t5 � a. � f - v � a T , � ��W �1F ak � ,v. O �} S�CR1f1 'rS tE't' s fr S t �1COyL7C �..,>< n �,a a �d t r+ P+� K o���Bl ,all i� Sets.o 27d 19, r Stitt of SwAr. TE of t ax [r44 yy 6e o L 6A lI..r'iii �r.wYi'.00 S011t�h �� rod.$ of the e'La� t s a � `3t � � the ``'i'v � k� e x � e � " ,-� � 5 ,x•- '�;`� k 'v4 cv � ,�', 7 c f m t .' r r a?, �� z k UPT t� + State- a. arnx k i ro t t• � F i j[ a Y T;asisl (Thl.s deed " givers ii> j , isaiaPakaon � , oE$ a r31; pa es EFb.ruaie/ 2S' 19;C7. ac�ecoic��de�r`uaxyZ8 ;1 o o �e+�dapoaca St oix" �acuerit z$7� 6 ;'i i.n thy` o #fcr�� orthe �t,egis t Cout►t , [,eiscons3>� and asset Erom��ceal�esatie Crans�Eerm�e puacaua.*it x w o Sect: -ion 77 oE. the+lieconas�ri� 3atus =es ^)t <q T r t k t i a t �yl >t r 6icetW Wei to .o5wiml)esr. s t o k I t 5 1 i @W *�1c biLCwDlld" AW Hcon ILI:L� xC p1 Ka z ?: r =A-L) 9iLi:NED A"104 D 56AF.ED"'.Ili PRF.SSRRGE �F . }+IaIC-�h�i 8 OrF ate S n r ) — A � - �� 3IG @ItiCe C►Xf' (SEAL? gars t. , r. sl.lso( Mar B tha . 0 � 4'laren.g�O and "`� *- aret Orf /1 '$ � _..� ! •. " HendrYk' W- Vah Dvk - 'Tale: 1[rnes slate By at Wisooas _:..: AQibtsrized ender _See" 706_+16 X'�i/S t , cXy' XXX.XXXX STATE OF i24CO'"ll( Personsllf come before oe,'thls - - - lbe abo'e named .. J raoo who executed the foregcini Instrument and rcicn awlestfect the arise. I* me known lo� be the pe' Tbis instrszsenl was dreffe by � William J. Gilbert, Rttlr. malswT PallAc.. F3udSon r sconsin . My '+:o®sis +Ion (v-cvb =a) (11s: Ttie use of witnesses - is oplia"j. tleate■ of persons ai.�.InW,in sn� c* W" be I.YPWd Ot prWad:be.low Yas- lr..sitoate4rss_ - � Re_ W"It^Jr" DliD --sT w'{ it" or- Wmico..wam.- TV(lslWo. b.� w "il liuwO yl SUIL ANU 51l t LVALUA1IUN Mt:IJUH 1 rage 1 of 3 Labor and Human Relations Division o; Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less th x has in size. Plan must include, but St. Croix not limited to vertical and horizontal refere e e b and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location nce to near r 030—J,075-20 APPLICANT INFORMATION —PL P L F0 ION R WE DATE PROPERTY OWNER: PROPERTY LOCATION John Schottler ': "k `. -� GOVT. LOT NW V4 NE 1/4,S27 T30 N,R 19 iE (or) W PROPERTY OWNERS MAILING ADDR LOT # BLOCK # SUED. NAME OR CSM If na na na 134 Co. Rd. #I `�� r CITY, STATE ZIP PHON + " B [ []VILLAGE (x]fOWN NEAREST ROAD Somerset, WI. 5402 °p,.i5..549 =Fi St. Joseph Co. Rd. #I [ J New Construction Use P J Residential / Number of bedrooms 3 [ ] Addition to existing building j i4 Replacement [ j Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .7 bed, gpdm .8 trench, gpd/ft Absorption area required 643 bed, ft 563 trench, 1`1 Maximum design loading rate _ bed, gpdm gpd/h Recommended infiltration surface elevation(s) _ 95.20 It (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable tors stem i® S ❑ U ®S ❑ U K7 S❑ U 10 S O U ❑ S L] U O S fl U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Glu. Sz. Cont Color Gr. Sz. Sh. Bed rertdl A:; 1 I4:< 1 0 -5 10 r3 3 none sl 2m r mfr aw 2 5 -20 7.5yr4/4 none sil lfsbk mfr gw if .2 .3 Ground 3 20 -88 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 9 Depth to limiting factor + 88" Remarks: Boring # . 1 0 -16 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 2 2 16 -27 10yr5 /4 none sil lfsbk mfr gw if .2 .3 3 27 -88 7.5yr4,14 none co s Osg ml na na .7 .8 Ground elev. *4 27 -47 7.5yr4/4 none sl 2msbk mfr na na .5 .6 9 8.7 ft. Depth to H -4 3mall areas of soil described intermixed to 47" limiting factor +88" Remarks: CST Name:— Please Print Phone: Gary L. Steel 715 - 246 -6200 Address: 1554 00th. Ave., rJew Richmond, WI. 54017 Signature: Date: CST Number: � 11 -4 -94 cstm 02298 PROPERTY OWNER John Schocttler SOIL DESCRIPTION REPORT Paqe2 o f 3 PARCEL I.D. # 030-1075-20 Boring # Horizon Depth Dominant Color Mottles Texture Structure. Consistence Boundary Roots G P D/ft in. Munsell Qu. SZ. Cont. Color Gr. Sz. Sh Bed ITrench 1 0-10 10yr3/3 none S1 2mgr mfr 9w if .5 .6 3 �!< AMA 2 0-16 7.5yr4/6 none S1 2mgr mfr 9w if .5 j .6 Ground 3 �6-29 7.5yr4/6 none Co S Osg M1 9w na .7 8 elev. 98.4 ft. 4 29-38 10yr5/4 none sil lfsbk mfr 9w na .2 .3 Depth to 5 38-84 7.5yr4/6 none Co S Osg M1 na na .7 .8 limiting factor +8411 Remarks: Boring # 1 0-7 10yr3/3 none S1 2msbk mfr 9w 2f .5 : 1 4 2 7—i6 10yr4/4 none S1 2msbk mfr 9w 1f .5 ! .6 3 16-82 7.5yr4/6 none co S Osg M1 na na .7 .8 Ground elev. qQ ft. Depth to limiting factor I f +8211 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel John Schottler 1554 200th Ave. CSTM2298 NW q S27- T30N -R19w New Richmond, WI 54017 MP RSW 3254 Town of St. Joseph (715) 246 -6200 1 =40' BM= nail at base of corner post at el. 100' Alt. BM.= top of edge of Co. Rd. #I at el. 100' ep � S � \ ^ v \ SC Gary L. Stee 11 -4 -94 1� O y C "u O r. 0 * cn m v, j I co J o C ° o m o Cl Cn CD n 3° CD M N e 0 0 CD CD CL z a _ y o CD m co U ° 10 CD CO Cr 1 CL p N 0 3 N NO -u _y 7 6 O 0 O N O 0 (� � y cn o ° o D o T 3 y m o o p a N o �+ op fD tt? N w d W c 6D CD � � � cn O CD v v CD y O C OD Co N m . CD , a T °.: AI. O O O Z A O c r- N N N A A n' o N w 47 'V C G O1 0 CD 0 O ! . CD CI 'O N O N <. > > 3 0_ z N ° z co z 0 O D a !r 9 hi o' m CD N N D) y C CD CD W D a Z CD 0 p Z M c - �j n Z O 0 Z V W 2 W 0 CD z 3 a 0 z m m I _ m m -° A A pj CD 0 'O C N fD 0) S CD N N �• N 0. 7 N A ' D) to 01 � � N p y O ... (D n n 7 co T O CD 7 CD p N f D S p 7 Z O. p0 p �n 0 O CD V a O y M cr N O CD N C ° ^. N fD - N X p CD o cc - C O O O cu 7 _ = O' N � 1 ? ?"N 0.7 m 7 N 0 o D . A � •- oD v - 3 N 0 F p CD G7 ( ; - I C I I A , 3� QN a- Mn N OHO c � 0 -0(_�0 �. - O D O ' O O m O a S j N A � b v, CD cfl O o CD o a C O ? 7 0 � � ; ■ � � § .. � � ± ƒ 0 f o w. § ) S § 7 E k \ § / C / / Co - 4 = , C Z Co / ] Cj) 0 ° CA ` E E ! o E o g g § 00 © (D /� %� e $ m m \ §2f (D k 2 E / §_ q_ 2 o r ca §_ ic � z ;% J / 0 0 o k, 0 r- 3 )) k 0 7 @ a v m R Q a-gd § § _< # z r � z .. / § 2 0 � g CD Co / - ° E \ ) __ -q CO) ° ® �_ = c ■ _ 0 � � � § R � ■ � § / -4 ] ¢ m } � �$ k m , = ¥ @ 5ƒ @ƒ /key 2 /( /[( }k§ \ §�k {)k Z G 0 =r CD � f E � /EE 2 G&�W o CD £ coq = am JG)\J /ƒ ) — ID g ` ( 7k \�f E- oco = PO S co = *= k Cn CD o © C )c [M GEC i — \ © S ; % / i= ƒ§. Err ® o�__, o < § \ 6 \� �\ � Parcel #: 030 - 1075 -20 -050 03/24/2005 04:23 PM PAGE 1 OF 1 Alt. Parcel #: 27.30.19.261A -10 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * JOHN T & GEORGINE M SCHOTTLER SCHOTTLER, JOHN T & GEORGINE M 1374 CTY RD I SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1382 CTY RD I SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 27 T30N R19W U_ EXC CSM 7/1814 & `l Block/Condo Bldg: e'" EXC PT TO HWY (0.250AC) I\ r / VI Tract(s): (Sec- Twn -Rng 401/4 1601/4) 27- 30N -19W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 03/27/2003 714766 2184/614 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 5371 Use Value Assessment Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 37.360 3,600 0 3,600 NO UNDEVELOPED G5 0.840 100 0 100 NO OTHER G7 8.000 43,500 449,100 492,600 NO Totals for 2004: General Property 46.200 47,200 449,100 496,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 030 - 1075 -20 -100 03/24/2005 04:47 PM PAGE IOF1 Alt. Parcel #: 27.30.19.261 B 030 - TOWN OF SAINT JOSEPH Current X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ' = Current Owner RICHARD A & MARIE C COLBETH COLBETH, RICHARD A & MARIE C 661 VALLEY VIEW TR SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 661 VALLEY VIEW TR SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.460 Plat: N/A -NOT AVAILABLE SEC 27 T30N R1 9W NW NE 3.457 ACRES LOT 1 Block/Condo Bldg: CSM 7/1814 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 27- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 789/398 07/23/1997 778/225 2004 SUMMARY BIII #: Fair Market Value: Assessed with: 5372 209,500 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.460 54,500 151,600 206,100 NO Totals for 2004: General Property 3.460 54,500 151,600 206,100 Woodland 0.000 0 0 Totals for 2003: General Property 3.460 30,200 113,800 144,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 211 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ----- �•....• v vain• •wa va�L - N ADDR SS , TO < <JNSHIP _SEC. T N, R W T. CROIX COUNTY, WISCONSIN. '3DIVISION LOT LOT SIZE PLAN VIEW -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 'r ejFST S /d o1 ,// V3 � rr 'T ' r :r I - C f! iC�c'�N CODP h I -TIC TANKS) 100 MFGR. _�� L C/F S CONCRETE_ STEEL NO. of rings on cover Depth Ig "' DRY WELL INCHES NO. of width length area 3 no. of Lines width are depth to top of pipe ,REGATE :.� RATE AREA REQUIRED AREA AS BUILT 2,6b . ;claimer: The inspection of this system by St. Croix County does not imply complete j pliance.with State Administrative Codes. There are other areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for / .tem operation. However, if failure is noted the County will make every effort to - cause of failure. :ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM.,,.. //J "INSPECTOR �Z. DATED _ /0 /O / 7 PLUMBER UE1 B - LICENSE �� /� REPORT OF ITISPECTION-- INDIVIDUAL SEWAGE DISPOSAL SYSTEM Sanitary Permit //,-I— r State Septic �/ '.'.A:IE u� a �' T&INSHIP • t. C oi^ ounty SEP TIC TA' ?K Size 0 �7Z gallons. `umber of Compartments v Distance From: Well ft. 12% or greater slope ,f I. Building' -,,�c' ft. Wetlands f: I1ighwater ft. DISPOSAT, SYSTE:1 Tile Field or Seepage Pit(s) Distance From: hell ft. 12 %.or greater slope ft Buildin i" ft. Wetlands f z FIELD righwater ft. Total length of lines t f . Humber o lines =� Des Length of each lineft, Distance between lines Width of the trench r ��S ft. Total absorption areaIC sq, ft. Depth of rock below tile in. Dp-pth of rock over tile �-- in.. Cover _ '�. Depth of tide below grade n. Slope of f 4 trench m in Der IDS) ft. Depth to Bedrock ft. Depth to ground water ft. PITS . Number of pits Outsi'e�dia ter ft. Depth below inlet ft. Gravel around 'it. ds no Total absorption area sq. ft. Square feet of seePape,. "bottom area 'required i Square feet of see n' q .e , . p , �t area/re Inspected by � -- �'�► -� `�,,r7 � / 1 .� - Y • itle : ,. f . • Q Approved .. Rejected Date 197 i t om,..,;;.::. _u.... .... ........ ... Y State and County State Permit P LB.6 7 Permit Application County Permit for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY n Mailing Address: W2, Rox ii OA .t,/ ,S�iC 'UrO r� ey- 3's-T. �' • S , .S�y B. LOCATION: _&W / %, Section .2,7 T30 N, R 8 (or) 4&2 ot# City _ Subdivision Name, nearest road, lake or landmark Blk# Village Township czS C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) * Variance Single family -K Duplex No. of Bedrooms 7 No. of Person D. TYPE OF APPLIANCES: Dishwasher _>(, YES NO Food Waste Grinder YES KNO # of Bathrooms- - Automatic Washer L YES NO Other (specify) E. SEPTIC TANK CAPACITY /,206 Total gallons No. of tanks / *Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement t Prefab Concrete X *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) 7 2 _7 3) 0 Total Absorb Area 60 sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches _ Seepage Bed: Length 7d ` Width Depth " Tile Depth 6 " No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size S/ I? r Percent slope of land � Q �✓S /� Distance from critical slope `tic .�_ I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Ce Tied Soil T ster NAME 041 J C.S.T. # S'S =/ and other information obtained from 2 caner ). Plumber's Signature MP /MPRSW# Phone # 71f' — .3 3623 Plumber's Address e7 C— PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). / t N Z�Zl /1111111 lVhVIel k) J54 76' 'bP of -Fo r ,A U� Rex",` 'jQ -Ai IC t— t 2 30 ,o9cr e s Do Not Write in Space B low FOR DEPARTMENT USE ONLY Date of Application - { Fees Paid: State County D e 7 �J Permit Issued / (d "te) sK jssuing Agent Name Inspection Yes No Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 r 2. state (pink copy) 4. plumber (canary copy) j Revised Date 6/11/76 EN 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 r MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION:' /a,' /a, SectionN, R& (or)&Township or Municipality Lot No. , Block.No. County S Subdivision Name Owner's Name: 4 Mailing Address: Z S- 06 teer�'e-L, 40,k � - 5 �c C 3C� b 9 TYPE OF OCCUPANCY: Residence No. of Bedrooms Other EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT X DATES OBSERVATIONS MADE: SOIL BORINGS 5 &_ ? t PERCOLATION TESTS SOIL MAP SHEET —�1 r 1 SO L TYPE 5 4' - PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN /IN P- N A, 3 //r P 2 rP C? r e 0 O Q / r / 7 P- � �, d SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- z 4 L� ♦� B 3 f6 — PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable ar s. Indicate number f gruare feet of absorption area needed for building type and occupancy. P� •� / J._��O •Od Ica e l-- Indicate scale or distances. Give horizontal and vertical reference poi s Indi a s�6 e. SAS Y6 P 8• LYjQU,4 afte-CL Q Z7 dt p1 1 i t N IWO 44 k I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and beli Name (print) Certification No. A ddress - Name of installer if known -� CST Signa re Y A —LOCAL AUTHORITY