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Wisconsin Department of Commerce
Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y
INSPECTION REPORT St. Croix
GENERAL INFORMATION (JTTA�'H TO PERMIT) Sanitary Permit No.:
Personal information you provice maybe used for secon ry purposes [Privacy Law, s.15.04 (1)(m)j. 363966
Permit Holder's Name: ❑ City ❑ Village ❑ T&vn of: State Plan ID No.:
Zeimet, Iris St. Joseph Township
CST BM Elev.:- Insp. BM Elev.` BM Description: Parcel Tax No.:
o �.� = g �,,,� 030 - 2027 -60 -000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV.
Septic 2 Benchmark 5 o5-1p op -D'
Dosing Alt. BM 1.10 0 •(00
Aeration Bldg. Sewer ?-(o 4 ,6 p t Ij, 0 f
Holdi St/Ht Inlet 6 1 op -s
TANK SETBACK INFORMATION St/ Ht Outlet 54 1 M • 3o'
TANKTO P/L WELL BLDG. Airl to ntake ROAD Dt Inlet
Air I
Septic 75�� 750 — NA Dt Bottom
Dosing A Heade / 6
Aeration NA Dist. Pipe
Hold' Bot. System '�
y 96.
- f 0
PUMP /SIPHON INFORMATION Final Grade
Manufac r Demand St cover
Model Number GPM
TDH Lift Fri m TDH Ft
ss ea
Forc in Length Dia. Dist. To we
SOIL BSORPTION SYSTEM
E Width r Length , No O Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ✓ 69-*5 DIMENSIQN
SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING n jf� ur r:
INFORMATION Type Of > / 0' OR UNIT CHAMBE NI° a Number:
601�V
System: y
DISTRIBUTION SYSTEMS
Header /
Mwil0ld �{ 4 Distribution Pipe(s) x Hol x Hole S acing Vent To Air Intake
Length Dia. - 1 Length ia. acing C t S
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only 1 ,
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
b�'k CO (Include code discrepancies, persons present, etc.)
Inspection #1: P141 /Ob Inspection #2:
Location: 1432 Triangle Drive, Houlton, WI 54082 ( 22 T30N R20W) - 223020439I -Lot 3
1.) Alt BM Description = � b{�Q
2.) Bldg sewer length = Z
- amount of cover=
} 3� ''
3) Zw4k A- -I CD -00 (3
Plan revision required? ❑ Yes P No
Us eeIgqtheff side fo ditional infocmation 1 02- 1 04 - 1 I S Z
4- t) 0 het, r"� � _�-•
�— t' &" { Q410 �JR,Q� Signature Cert. No.
SBD -6710 (R.3/97) I Z
D
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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Sanitary Permit Applicatign�. , Safety & Buildings Division
S In accord with Comm 83,21, WiS. Adm. , \ �� -A. 201 W. Washington Ave.
SCO See reverse side for instructions for ¢ompletin Is plic FiyF9 ``� W Bo x 7302
Personal information you provide may be used fo c3dary pur ose� Madison,
Department of Commerce (Submi po pleted form to county if cu:
[Privacy Law, s. 15.04( 1)(m)j ` ST
State OWrtCcI.
Attach com fete plans to the county copy only) for the system, on /2 x I iniWIn size.
Cou t� , State a it rPen-nit Number 0 Check if revision top v' tt applic W ' State Pla umber
I. Application Information - Please Print all Information i
Property Owner Name
y Location
S 40 1/4 1/4 S JV.N CE
Lot Property Owner's Mailing Address / Lot Number 1 Block Number
all
City State Zip We Phone Number Subd' ision Name or CSM Number
a. fy" J I �S GS �- l 2 ��
I Type of Building: (check one) �/ 0 City
1 or 2 Family Dwelling - No. of Bedr : 3 ❑ Vill age
Y ooms,
8 i
0 Public/Commercial (describe use): wn OS
O State -owned
III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest oad
A) 1. wew System 2. ❑Replacement 3. 0 Replacement of 4. 0 Addition to Parcel Tax Num ) Zz . 3o . zo. rq
system Tank Only Existing System 1 2,2
B) 0 Permit Number Date Issued
A Sanity Permit was previously issued
I - Type of POWT System: Check all that apply)
on- pressurized In- ground 13 Mound ❑ Sand Filter 0 Constructed Wetland
O Pressurized In- ground ❑ Holding Tank ❑ Single Pass 0 Drip Line
O At -grade ,� / — f �� ❑ A c T eaten nt Unit 0 Recirculating 0 Other:
><'�
V Dis ersaUTreatment Area Information: , 2
1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. SoQ Application 7 TTercolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals./ /sq, .) (Min. /inch) Elevation
VI Tank Capacity in I Total # of Manufacturer Prefab Site I 9teel Fiber. Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crate structed
Tanks Tanks
l 0 (9 ° ❑ o
7 ❑ a ❑ 0 0
VII Responsibility Statement
[ the undersigned, assume responsibility for installation ofthe POWTS shown on the attached plans.
Plumber's Name (print) plumber's i store (n stamps)' MP/MPRS No. Business Phone Number
Plumber's Address (Street, City, State, Zip Code
�d
VIII County/Department Use Only
❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No stamps)
Approved ❑ Owner Given Initial Adverse S harge Fee)
Determination o2a ob :� - 2* 2
IX. Conditions of Approval /Reas ns or D a LL
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SBD -6398 (R. 07/00) V
PLOT PLAN
PROJECT Iris Zeimet DDRESS 996 E. MinnvHaha Ave St. Paul Mn 55106
Govt Lot# 3 1/4S 22 /T 30 / 20 W TOWN St. Joseph COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 7/13/00 BEDROOM 3
CONVENTIONAL XXX IN-GRO&W CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 699 # of chambers 22
BENCHMARK V.R.P. Top of Rail Road Spike in Tree ASSUME ELEVATION 100° Filter Zabel A -100
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 97.3/96.3
Vent
ALong Sidewinder High
Capacity Leaching
Chamber
"
34" Grade at System Elevation
v Triangle Drive
Pro 3
Bedroom
House
150' 25'
T
IT X 69' Trenches with >3' Spacing 15'
1~ >1
&4&
15 Vents CO
22' B.M. -3 42'
20' = 44' 5 °
—Alt ---
Slol
B -2
u ens SOIL AND SITE EV ATION Page I of 3
:1]wwon of SA* and Buklings in accord with Comm 83.05, Wis. Adm. Code
r ; g at rLV rk-:Sn-
Anach complete site plan an paper not less flan MA x t t inches in skae. Ran must
awkde, but not mated to. vertical and horizontal reference Point (BMA, dieclan and St. Croix
percent slope, sate or dirmnssans, nodh wrow, and locaban and give to nearest road. Parcel i.D.#
APPLICANT INFORMATION - Phase print � !
� y ou rmq be used ax y I> - 2
Per Owner
Utsltx, C e, Y IS ��.�+�' Gav 3 U4 1/4 S 22 T 30 NR 20 W
Piopertl► ownees Maimg Addae # SulA Name or CSM#
1432 Triangle Dr -
Ci f State Zip Code eNumber SS �ity. '_. , Village ®Town Nearest Road
Saint 3 i T 54®82 STH 35
Usir X ReWenW DIM110n ID @d- M bWft
Code €terii,ied daily low 450 gpd Rewninw.1m d desionbaftrdo .7 bed, III -= 8- - ir+et At gpdgF
Absorplion area rewired 643 bad 1F 562 tack fF Mwdn m deli p loa*lg rate .7 bed, Wdffe .8 b ench, sxvr
Rernnin -- dad i Dn wtaoe elev4wgs) 97.30 g (as rid ID sde plan benclow
AdMonal de .sign / silo consideration
t vi rial I=% Over Gl l a 1 c V i � a i I O O � uiWash (/ . /�.�. Fl elevafim if NA � ft
for £ ! CAMI -e ntierrsl M� 1rd Prw qp � 6 AT /
1 n FM 1 T2 . (
bailable for stem � n s® u � M s O u �® S E11 u �® S 0 u � UI s® u Di s® u
SOIL DESCRIPTION REPORT "
B Horizon Deplh ' Dor "WColor Mottles Texture � Strucdre Mawary Rook GPDV1
in. Munsetl Ow SZ Cont Color Gr. SL Sh. Bed !; Trench
elev
1 1 0-9 10yr3/3 - sil „ 2msbk mfr cw 2f .5 .6
NI
2 9-2..5 l � 3/4 i - sil 2nrs fr bk m i car '! if r .5 .6
p 11 II II N !I N II A
Ground 3 25-410 2.Syr3l4 - 2msbk mfr cw - 5 6
i013'x5it 4 4Q-95 15yr314 - gIs 2msbk { mrv$ 1 - - 7
Depth b h V s Po u N
u u u u x II n n u
off'
q-7-30
>95 h M
.(, 0 1•(0 �
Remarks:
2 t 0-9 loyr3/3 - .1 2msbk mfr cw 2f . 5 i .6
2 9-24 10yr 3/4 - sil 2msbk mfr cw if .5 .6
Ground 3 24-41 2.5yr3/4 - 2msbk mfr cw - 5 6
elaw
p 11 II 11 II A b II II
97.30It 4 41 -96 1 2.5yr3/4 - 11 2msbk mvfr - - .7 .7 .
Depth ID i d I II
CanBirrg I p I
1 ii X 11 N I M II II
CST Name Rase P" Signaiw. T
Tt umw C. Nefim 715-246-2454
Address EavinNUomtai ByDcsjgp Rif#
14321201b Street„ NewRiAmood, W1 54017 ,2/12/2 227387 291
17
IOtOP E Utstes, Cb-k SOIL DESC € R� ORT '� Page 2 of 3
PARCEL Fjn* m =W By Desi
, Coior "
WIN ' e ' 1 '
UL Munsel Om Sz. Coat. Color , Taws Gr. & Sh. BotRtdarr Rook EPW
Bed : Tmnch v
3 TI 0-10 10yr3/3 - sil 2msbk mfr cw 2f 5 _6
2 10-25 10yr 314 - sil 2msbk mfr cw If .5 _6
Cj
elev 3 25111 2.5yr3/4 - gsl 2msbk mfr cw - 5 6
-- 100. ft 4 41 -96 ' 2.5yr3/4 R - gls ; ' 2msbk nn* - - _ y
Depth l
3lmstdg e 1 1 e
factor /
Remarks:
4 r 1 0-9 1Oyr_ 3/3 � � -- s7 _2msbk mfr cw 2f 5 .6
2 9-25 10yr 314 - - -- -- sil 2msbk mfr cw if _5 a .6
Ground
elev 3 1 254 t 2.5yr3/4 1 - 1 fist 2msbk mfr Cw - .5 .6 �
98.47 ft 4 41 -95 2.5yr3/4 - gls 2msbk mvfr - - 7 -
Depth tD
limiting
1 R e
I
Remarks:
5 1 0-10 IOyr3/3 - a 2msbk tuff cw 2f .5 .6
2 10-26 10yr 3/4 - $a 2msbk mfr cw if 5 .6
Ground
ciev 3 " 2640 ' 2-5yr314 - 2msbk tuff tw - 5 6 S
102.63 ft 4 140-1 1 2.5 }73:4 - 1 gls 1 2msbk mvfr 1 - 1 - 1 .7 -:-
Depth to
fix t
>110
G3.9 fo
�t � 0 � I I 1 R
Remarks:
Gmund
tip
�3 1 lg e
tadOf 1 s ` • 1 1 R e
Remarks:
v ia T ON v2a
fi , 1
b1-4 r 7
s o
ir, v i �Zu n IM+Q ���� ►1� 1
X 17
- roe 0 � Po le i � e�� ►� � i i tn
n 375
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT`
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address ° l `� ►'Yt' n n . /. t -J-'�'
Property Address f?- -�–
(Verification required fro Planning Department for new construction)
City /State 45z � Parcel Identification Number �� ' d � �U —60F6
LEGAL DESCRIPTION
:. G o v-/-1, '9 3
Property Location ' /., ' /., Sec. a �. , T 3 O N -R W, Town of 6 s
Subdivision . Lot #
Certified Survey Map # , Volume . Page #
Warranty Deed !# �� /"
" 7T , Volume Page #�
Spec house ❑ y5PED- no Lot lines identifiab s ❑ no _ ✓ e ���
SYSTEM MAINTENANCE ---
Improper use and maintenanceof your septic system could result in its premature failure to han a 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
master plumber, journeyman plumber, restrictedplumber 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.
Itwe, 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
days of the three year expiration date.
Ot
SIGNAT76RE OF ArIOLICANT DATE
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
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
SIGNAT UFLEF OF APPLICANT DATE U
* * * * ** Any information that is mis- represented may result in the sanitary pemiit 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
12
" w 1414FA 01-1
KATHLEEN H. WALZH
arud
REGISTER OF DEEDS
ST. CROIX CO. WI
KMIVEI FOR RfC0d
03-29-1999 9s00 m
NRMM 1EE1
EJoP, I
CE Y FU FEE:
z
T099 FEE= 217.50
7(99 -1P009 I�FEE= a.00
pffiml PIN 030 - 2027 -60
Return to:
Attorne' Title of Stillwater
1835 N tAy�e�stern Avenue
Stiff ater, MN 55082
WARRANTY DEED - INDIVIDUAL TO INDIVIDUAL
STATE DEED TAX DUE HEREON: $ ,
DATE: February 26, 1999
FOR VALUJABLB CONSIDERATION, Bradley S. Smith. .single person
Grantor(s), hereby convey(s) and warrant(s) to Iris Zeimet, a single
person Grantee(s), real property in St. Croix County, Wisconsin described
as follows:
Attached "EXHIBIT A." hereto made a part thereof.
The Seller certifies that the Seller does not know of any wells on the
described real property.
(if more space in needed, continue on back)
together with all hereditaments and appurtenances belonging thereto,
subject to the following exceptions:
easements, restrictions, reservations and covenants of record, if any.
Bradley S. ith
STATE OF MINNESOTA_ }
} as.
COUNTY OF Washington)
The foregoing instrument was acknowledged before me February 26. 1999
by Bradley S. Smith. a single person grantor(s).
` Notarial. Stamp or Seal�
or other title or rank) signature of Person
» Taking Acknowledgment
MlW00DRUFF Tax Statements for the real
w property described in this
instrument should be sent to
NNW I
(name and address of Grantee):
Iris G. Zeimet
THIS INSTRUMENT WAS DRAFTED BY
(name and address):
Attorney's Title of Stillwater
1835 Northwestern Avenue
Stillwater, MN 55082
1
141.403
THE SOUTH 150 FEET OF THE NORTH 880 FEET EXCEPT THE EAST 340 FEET THEREOF, IN
GOVERNMENT LOT 3, SECTION 22, TOWNSHIP 30 NORTH, RANGE 20 WEST, ST. CROIX COUNTY
WIS ^.ONSIN `
TOGETHER WITH AN EASEMENT FOR ROADWAY PURPOSES ACROSS THE SOUTHERLY 25 FEET
OF THE EASTERLY 340 FEET OF SAID GOVERNMENT LOT 3 IN SECTION 22, TOWNSHIP 30
NORTH, RANGE 20 WEST.
qol
Saute_ o�k.l�. C,r�.l
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V
425- \-f�
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FINDINGS, CONCLUSIONS, AND DECISION
OF THE ZONING BOARD OF ADJUSTMENT
ST. CROIX COUNTY, WISCONSIN
Case: 10 -00
Complete Application Received: February 22, 2000
Hearing Notice Publication: Weeks of March 6 and 13, 2000
Hearing Date: March 23, 2000
FI NDINGS OF FACT AND CONCLUSIONS OF L AW
Having heard all the testimony, considered the entire record herein, and conducted an on -site
inspection, the Board finds the following facts:
1. The owner of the property is Iris Zeimet, whose address is 996 E. Minnehaha Avenue, St.
Paul, MN 55106.
2. The applicant on February 22, 2000 filed with the Zoning Office an application for a
variance to the minimum required setbacks from a Class E road. The variance is to allow
a new home /garage 35 -feet from the road right of way of the Class E road. The ordinance
requires a 50 -foot setback to a Class E road.
3. The Town of St. Joseph verbally stated they have no objection to the application.
4. The variance to allow the home/ garage to be constructed would require a 15 -foot
variance.
5. The Board finds that granting of the variance will not be contrary to the public interest as
expressed by the objectives of the ordinance.
DECISION
On the basis of the above Findings of Fact, Conclusions of Law, and the record herein, the Board
approves the applicants request for a variance on the following findings:
1. The applicant has proven hardship. The unique shape and size of the lot requires that
the applicant obtain a variance to develop a structure on the lot.
2. The 100 -foot setback requirement from the bluffline of the St. Croix River is being met.
3. The applicant is asking for the minimum variance to alleviate the hardship.
4. The Town of St. Joseph recommended approval of the request.
5. This 15 -foot variance is not contrary to the public interest.
6. The spirit and intent of the ordinance is being met.
With the following conditions:
1. All structures including principle buildings, accessory buildings, decks, roof overhangs
etc. shall not be located closer than 15 -feet from the legally described road right -of -way.
All other setbacks must be met.
2. Applicant shall obtain building permits from the Town Board, and a septic permit from
the County Zoning Office.
3. This variance is valid for a period of one year from the date of issuance; failure to obtain
a building and septic permit and commence construction within this timeframe shall
result in revocation of the variance.
4. Any change to the above conditions shall require a new application and a new public
hearing.
5. Failure to comply with the above conditions shall result in revocation of the variance.
r'
The variance is approved on the following'vote:
B. Wert Yes
D. King Yes
R. Peterson Yes
N. Golz Yes
Chairperson Speer Yes
APPEAL RIGHTS
Any person aggrieved by this decision may file an appeal in St. Croix County circuit court within 30
days after the filing date shown below, pursuant to sec. 59-694(l 0), Wisconsin Statutes. St. Croix
County assumes no responsibility for action taken in reliance on this decision prior to the
expiration of the appeal period. St. Croix County does not certify that the identity of all persons
legally entitled to notice of the Board of Adjustment proceedings, which resulted in this decision,
was provided to the County.
If an appeal is taken of this decision, it is the responsibility of the appellant to submit at his /her
expense a transcript of the Board of Adjustment proceedings to the circuit court, which is available
from Northwestern Court Reporters, Hudson, Wisconsin. It is the responsibility of the Board of
Adjustment to submit its record (file) of this matter to the circuit court.
ZONING BOARD OF ADJUSTMENT
Signe
hai rson
Attest
Zoning Administrator
Dated: 05/01/00
Filed: 05/01/00
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POWER POLE I' IRON PIPE
APPARENT OPERTY INE 98
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