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HomeMy WebLinkAbout030-2128-20-000 Wisconsin Department � Commerce PRIVATE SEWAGE SYSTEM County: St. C roix Safety and Btfilding [*,lion , 4 INSPECTION REPORT Sanitary Permit No: 430522 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: Youssef, Radi & Tammi I St. Joseph Townshi 030 - 2128 -20 -000 CST BM Elev: Insp. BM Elev: BM P 1 Descri y Section/Town /Range /Map No: �_ (� 7 . 2 � 5 r 25.30.20.1044 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic OD h Benchmark �/ H l/ f Co Dosing Alt. BM Aeration Bldg. Sewer G 3 �/ I r o3. J• � /% 3 Holding _ St/Ht Inlet (O 3 I " 9. TANK SETBACK INFORMATION J' SUHt Outlet D' 41,9 TANK TO WE BLDG. Vent to Air Intake ROAD Dt Inlet Al Septic / f ' S Dt Bottom Dosing Header /Man. y 9`•0 Aeration Dist. Pipe 2 I Holding - Bot. System Final Grade /y O.t7 PUMP /SIPHON INFORMATION 2, q Manufacturer emand t Cover / rl S O 103.1 Model Numb TDH Lift / tn' n Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well — SOIL ABSORPTION SYSTEM BEDITRENCH Width / Length / 1 No. Of Tres PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS -� 12 1 SETBACK SYSTEM TO P/LtU BLDG WE LAKE /STREAM LEACHING Ma ufacturerm INFORMATION T e Of System: / CHAMBER OR UNIT del Number: DISTRIBUTION SYSTEM Header /Manifold J D' stribution (� �- x Hole Size x Hole Spacing Vent to Air Intake d o) l pes) //� ✓;� �/ _ — i Length Dia h Pi Length I 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 Ed es Topsoil g p Yes [ No U Yes (_ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: spection #2: / / Location: 1342 Birch Park Ridge Hudson, WI 54016 (NE 1/4 SW 1/4 25 T30N R20W) Ridge at Birch Park Lot 2 —� Parcel No: 25.30.20.1044 1.) Alt BM Description (3 �r �{��� 2.) Bldg sewer length amount of cover => Lj ( - 14-= 2 Gad he� Plan revision revision Required? ]Yes No Z� Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signat Cent. No. RECEIVED M See ty and Buildings Division Coun r y JA N 0 208V W. gshingt Ave., P.O. Box 7082 dison, WI 53707 - 7082 Sani�ta /ry2permit Number (to fiU d in by Co.) . C C (608) 261 -6546 Department of Co men UN State Plan LD. Numbs Sanitary lication /t/ /� nest information you provide in accord with Comm 83.21, Wis. Adm. Code, perso Project Address (� different than mailing address) may be used for secondary purposes Privacy Lsw, x15.04 ( ►)(m) I. Application Information - Please Print Ail Information Parcel # Lot # Block # property Owner's Name 11111111 ^^, { � ` Property Location D V property Owner's Mailing Address / ' /., Section 9 �(� Zip!Code /J 7 Phone Number 2 _ ��rcle e) or Clty,$tame 4 �/ �. T (J Tg (check all that apply) 6.� 6hC Su sion N umber ly Dwelli ng - Number of Bedrooms / ❑ publiciCommercial - Describe Use QCity ovillage ip of �c7 ❑ State Owned - Da='be Use lIL Type of Permit: (Cheek only oae box on line A. Complete line B if applicable) A ❑ Other Modification to Existing System w System E] Replacement System ❑ Treatment/Holdiag Tank Replacement Only List vi us Permit Number and Date Issued ❑ Change of ❑ Peani[ Transfer to New H. ❑ Permit Renewal ermit Revision Owner Before Expiration Plumber IV. Ty e of POWTS S tem: Check all that Is I Q single Pass Sand Fate 0 on Pressurized In -Ground Q Mound? ` 24 in. of suitable soil Q Mound 24 in. of suitable soil Q At Grade g O Constructed Wetland C1 Pressurized Lo-G ound Q Holding Tank Q Peat Filter Q Aerobic Treatment Unit Q Recirculating Sand Filter Reeireulata Synthetic Media Filter hies Chamber ❑ Drip Line ❑ Gravel -less Pipe Q Other (explain) V. Dis ersalfPreatment Area I ormation: U 1' squired 00 Dis proposed ( System El gva 'on / / Design Flow (gpd) Design Soil Application Rate(gpdsf) Dtsp 1 Area C O� / (o F D ' tee) Fi Plastic Prefab Site lass VL Tank Info Capacity in Total Number Manufacturer Y� r Crete Constructed G Gallons Gallons of Units / r 100 4-/ f� New Existing I Tanks Tanks septic or Holding Tank - AzmW Trea"Mut Unit / tbsint Chamber 0 v VII. Responsibility State Business eat- I, the undersigns me responsi l[ry for installation of the pOWTS shown on the atta Phone Number phone MPIMPRS Number ness PI 's Name (Print) Plumber's re Q.i�/ 0 {y Plumber's Address (Street, City, State, Zip t VIII. 16unty/Department Use Onl Sanitary Permit Fee (includes Groundwater Date Issued ssuing Ag t Si re ps) ` pproved ❑ Disapproved Surcharge Fee) 4 � (dd ) ( 0 � - ❑ Owner Given Reason for Denial fY IX. Conditions of Approval/Ressons for Disapproval /20/Yhll'ht 1/t^ S STEM OWNER/ad3'S� yD GOn1 OL L /NHS 7��m�i ✓'7Jr �c 1 Septic tank, effluL�rTt ii e T dispersal cell must all be serviced / maintained � jyn as per management plan provided by plumber. se ark requlremen s must be maTffraineU (� as per applicable code /ordi ances. Attach eoa[pkte (to toe Caanty aml for the system oa paper�RO less than Slr2 z It inches la site G�Z / "r SBD 6398 (R. 0810) PLOT PLAN ROJECT Riad Youssef ADDRESS 808 White Oak Ct. New Briohton Mn 55 112 NE 1/4 SW 1/4S 25 AND N/R 0 W TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE10 /31/03 BEDROOM 5 CONVENTIONAL )00( IN- SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000/600 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 7 ABSORPTION AREA 1 119 # of chambers 36 BENCHMARK V.R. Top of Spike in Tree , ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Be mark SYSTEM ELEVATION 94.8/93.0/91.0 4 ' below grade 480' Property Line 70' B.M. #2 is Top of Spike in tree 97. ' 70 , 3 -3' X 75' M # 2 cells with 3' 9% Spacing Slope le Sao, o .6rn A4-1 Vents B.M. #1 ° 10' 91' 95' q 40' 25' 1 22% lope 97 Bg 60' y �r �I� ✓� 30 B - 7 3.a� p3•a -3 r -4 5 f0 �I Combo Se J iA Septic Tank ' P AID p as Vent 3 o5 >6 „ Standard Biodiffuser B edroom of Cover Leaching Chamber H ouse with 31.1 ft2 of Area 6' Long 11" Plans 3" Crrade at System Elevati ii Designed Using 4 Conventional Powts Manual Version 2.0 l //V Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must county include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. y percent slope, scale or dimensions, north arrow, and location and distance to nearest road 36 c —2J — P /ease print all information. Re ' wed y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I Property Ownel, ^ Property Location Govt. Lot .rat/115:� 114 _5UJ14 S,� T N R a (c W Property Owner's Mailing A�ss / � Lot # Block # Subd. Name or M# V O D / City ` State p Code Phone Number ❑ ,� City [:]Village own sparest d fit -c/ ( ) J. New Construction Usv Residential /Number of bedroom Code derived design flow rate GPD ❑ Replacement I ,�,❑ Public commercial - Describe: Parent material rJ /� (�. `�U1�✓ Flood Plain elevation if applicable General comments and recommendations: 'S"c_ Boring 0 # ❑ Boring �C pit Ground surface elev. 1 ft. Depth to limiting factor in. Soil Appl icabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munseli / Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-10 41f al 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. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS 1 30 mg/L CST Alamo (Please Print) Si CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluati n Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �. -� —� C 715 - 246 -4516 Property Owner Parcel ID # Page of ? W Boring # Boring it Ground surface elev9� ft. Depth to limiting factor 2 — in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # Boring C] C] pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicat Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # ❑ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD_ > 30 220 mg/L and TSS >30 1150 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. SBD8330 (8.6/00) tz zzz ND 8 lit PLOT PLAN PROJECT Riad Youssef ADDRESS 808 White Oak Ct. New Briahton Mn 55112 NE 1/4 SW 1 /4S 25 /T N/R 0 W TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/31 /03 BEDROOM 5 CONVENTIONAL XXX IN- (KYND PRESSURE CONVENTIONAL LIFT HOLDING TANK i MOUND SEPTIC TANK SIZE 1 000/600 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1119 # of chambers 36 BENCHMARK V.R Top of Spike in Tre ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 94.8/93.0/91.0 4' below grade 480' Property Line 70' Ac B.M. #2 is Top of Spike in tree @ 97.0 yy 'Above- ►' n 1 Z ` Cedar- 70 5P1� 3 -3' X 75' 9% J B.M. # 2 ce with • ce s th 3 Sloe ��ur ��� 'j-0 Spacing p ` o . o .8m �/ j Vents B.M. #1 �b'� 10 91' 95' 10' g' 40' 25' 15' � 22% Slope 58 0' 99 B -2 60 , 30 Cal � B -7 B -3 B -4 a� oq 20' q8 -5 O' a Combo Septic Tank I Vent 30' o 5 ALo Standard Biodiffuser B edroom Leaching hamber H ouse g with 31.1 ft2 of Area " P Grade at System Elevati lans Designed Using 3 4" Conventional Powts Manual Version 2.0 Safety and Buildings Divisionb� (I m 201 W. Washington Ave., P.O. Box 7082 5 }_ ` l ro i ) N visconarn Madison, C ,` I C Sani Permit Number (to be filled in by Co.) Department of Commerce (608) l c V G 05--22 Sanitary Permit Applieat1 State Ian LD. Number nt In accord with Comm 83.2 1, Wis. Adm. Code, formatio you PAY maybe used for secondary purposes Privacy Law, sl5.04(1 m) Projec Address (if different than mailing address) . I. Application Information - Please Print All Information Z NI ST CROIX COON Y 1 342— pwK Property Owner's Name Parcel # t # Block # W Property Owner's Mailing Address / Property Locaabon� "To �� O e �' v y. c v� %. Section City, State Zip Code Phone Number n ,&VAl A 6_ &c one H. Type of Buildin (check all that apply) N, raj r W or 2 Family Dwelling - Number of Bedrooms. bdivision amo CSM Number ❑ Public/Commercial - Describe Use T m ❑ State Owned - Describe Use ❑City ❑❑Villag.,f�*ewnship of S7S III. Type of Permit: (Check only one box on line Complete line B f app Ica e) # ; A. ew System ❑Replacement System teatment/Ho ng Tpfok Replacement Only ❑Oth er ficanon to i g Systedf - ) r' B. ❑ Permit Renewal ❑ Permit Revision ❑ Chan o ❑ Permit Transfer to New List vious P it d Issued Before Expiration Plumber Owner IV. , Type of POWTS System: Check all that appl on - Pressurized In -Ground ❑ Mound 2:24 in. of suitabl ii ❑ M' d < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In round ❑ Hold' g Tank ' ❑ Peat Fi ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter , Cl Recirculating Synthetic Media Filter ping Chain ❑ Drip Line ❑ GPa 1 - less Pipe ❑ Other (explain) � W ' IA) 1 lJ v" ul V. Dispersal/Treatment Area I formation: Design Flow (gpd) Design Soil Application Rat f) ,Dispersal Area Required (s Dis Area Proposed (sf) Syst 1 a on f VL Tank Info Capacity in Tolk Number Manu Eau Site reel i P antic , Gallons ens of Units 1' lYw � `°' 1 ,FG ncrete Constructed Glass Z) New Existing ' l Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- , e undersigned ume responsibility for installation of the POWTS shown on the attached plans. P Name (Print) / � Plumber's _ re MP/MPRS Num Business Phone Num I�� Plumber's Address (Street, Cit,% State, p ) J eo /V `/ VIII. Coun /De artment Use Onl Approved Disapproved Sanitary Permit Fee (includes Groundwater Date Issued I sui Agent Signa (No Stamps) Surcharge Fee) .� j-¢� ❑ Owner Given Reason for Denial V J IX. Conditions of Approval/Reasons for Disapproval L,+ � SYSTEM OWNER: 3, I ` 1 Septic tank, effluent filter and `j I dispersal cell must all be e 'cedimaintalned l as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County 8111 (Or the system on paper rot less than 8l/2 : it Inches la size SBD -6398 (R. 08/02) PLOT PLAN PROJECT Riad Youssef DDRESs 808 White Oak Ct. New Briahton Mn 55112 NE 1/4 SW 1 /4S 25 /T 30 /R 20 W TOWN St. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/31/03 BED ROOM 5 CONVENTIONAL XX)C IN- GROUND ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000/600 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1 119 # of chambers 36 BENCHMARK V.R.P. Top of Spike ' ree :—$r = ASSUME ELEVATION 905. ' Filter Zabel A -100 ❑ BOREHOLE O WELL 'H.R. SYSTEM ELEVATION = 904.9/904.0/903.1 6.5' below g rade 480' Property Line 70' i 2 70' : ;�d1 sM Z "Caw- - /- ree . 9% B.M. #1 B.M. #2 10' 3 -3' X 75' -1 cells with 3' Spacing B -2 Vents 60' B -3 -4 ov*4 40' � 0' a Combo Septic Tank 20' Vent 0' Pro 5 >6" Standard Biodiffuser B edroom Leaching Chamber Rouse of Cover with 31.1 ft2 of Area 6' Long ed Grade at System Elevati Pla De n ng 4 , Conv owts Manual Version 2.0 i PLOT PLAN PROJECT Riad Youssef DDRESS 808 White Oak Ct. New Briahton Mn 55112 NE 1/4 SW 1/4s 25 /T 30 /R 20 W TOWN St Joseph COUNTY ST. CROIX 10/31/03 5 MPRS Shaun Bird 226900 DATE BEDROOM CONVENTIONAL XXX IN- GROUND ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND N SEPTIC TANK SIZE 1000/600 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 1119 # of chambers 36 ,BENCHMARK V.R.P. Top of Spike ' ree ; $ ASSUME ELEVATION 905. ' Filter Zabel A -100 ❑ BOREHOLE O WELL "H.R. . SYSTEM ELEVATION = 904.9/904.0/903.1 6.5' below grade 480' Property Line 70' 9% B.M. #1 B.M. #2 10' 3 -3' X 75' 40 ' -1 cells with 3' , Spacing B -2 , Vents 60' B -3 -4 40' 0' a Combo Septic Tank 20' Vent 0' Pro 5 >6 „ Standard Biodiffuser B edroom of Cover Leaching Chamber �? House with 3 1. 1 ft2 of Area 11J 11" 6' Long ng Grade at System Elevati ii Pla De ned 3411 Conv ' owts Manual Version 2.0 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 Wisconsin Department of Commerce SOIL EVALUATION REPORT 3 Division of Safety and Buildings Page of in accordance with Comm 85, Wis. Adm. Code le County Attach com p u 8 112 x 11 inches in size. Plan must include, but n limit ' JI reference point (BM), direction and Parcel I.D. percent scope, scale or dimensions, north and location and distance to nearest road. 0 — Z Z�1 - OO l� r eleasy R6U3 formation. Revie ed by Date Personal info tion you provide may be used fors ndary purposes (Privacy Law, s. 15.04 (1) (m)). ./ Bf1. d't Property Owner � ! G OFFI Property Location r� 1Fls� _ - Gook -LeE ?'J 1 /4!3-v 1/4 S ZS T N R - Lo E Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# City ` State Zip Code Phone Number City (] Village ® Town Nearest Road Ft;R1.D6 � ® New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate 6 GPD Replacement [] Public or commercial - Describe: Parent material L.O eS5 uu inz Flood Plain elevation if applicable General comments and recommendations: l`L'C r') Y'l �Yti u }� L.� C _� , � � 413 ? S r C LAJ 6 W U �u 1 r ri )_' p ffR- Q- �'�L.L , G1 42S-L LLf�V ATUk'13 Q Boring # t❑ Boring Lnl Pit Ground surface elev. C � ( 3 S ft. Depth to limiting factor 1 Z in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 z cs •s _b Z -q7 l0` -tti 31 b ( 7E 3 Qn -6 - ) lo-t rz _ r caw y16 y E Boring # ❑ Boring © Pit Ground surface elev. a b ' a ft Depth to limiting factor 7 L f 8 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 o $ t 0 `12 3 t - L — s i 1 - Z �s k. h-1 - . S - 8 Z 8=zs lay 2 316 ._. S i I Z`� S�k � elv � .S • S Z ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) / _p Signature CST Number Arthur L. Wege�rer- 0 off _ ©3 ` 1 9 220254 Address • W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Main St. River Falls, [•1I 54022 0 3 715 -425 -0165 Property Owner �6 USS L [= Parcel ID # U 3 ` ��' l Z U — 6 0 O Page Z of Boring # r❑ Boring Ll• pit Ground surface elev. �l 1 ft. Depth to limiting factor `7 1 18 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 C-S , VA F -�fl Boring # ❑ Boring ® Pit Ground surface elev. C11 -� ft. Depth to limiting factor } 1 Zo in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 o�tZ 1��1Vz 31z - S[ 1 Z sb� m v - 4- c - Z fz -qo I o' - IR Z` Sh c� bo -LZn Io�IR- VA F goring # ❑ 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 /ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 Effluent #1 = BOD, > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 - 264 -8777. SBQ8330 (R.6(00) ` PLOT PLAN Pa 3 of 3 � L t!.. On5 , y' a+ 3 P l {z.L ZZ "frbuu Q G" u xj - �, 1 ti 3 "b 1 p 712�� . gwt'tf pite Z t" k , t►� \Z" c�D 1�(�i Bwj W �1t4 Z Q 90 _- � �A, L o ,� �0 lv o 9os 3 ° 9-5 N J y 01�1p 'pfi-TwN T w ��TS L�2 Cc;1vGRtl t; � wt�o 1 60o cam, u_ v Gf'fr�- D J r!► lu D FL, . °[ 12.0 i LOT Lt NJ S�6•`13' L� 3 M .03_1EY C ti �Q -2 ! �1s) yzs- wi s z, z0 I CST Signature °—� Date Telephone No. CST # ST CROIX COUN'T'Y • SEPTIC 'TANK MA INTENANCE AGREEMENT AND r OWNERSIllp CERTIFICATION CORM Owner �-4" /I3ttyer A U SS _Ta "„ _( S. Y6U SS e k_' Mailing Address �8 W kiAve- C-( I �JQ �Yt .� 1 YIA(\j S Sll a- Property Address (� �Z / P C (y- �42tC l e (Verification required ftvm Planning Department for new construction) Parcel Identification Number 0306 -- LEGAL UESCIuP "jj()N 030 - 2.(z4 - 2.o - UZ30 61 Ptolwfy Location %., SA-2— y,, Sec. , T 3_0 N_R PQ W, Town of Subdivision L T Q f-(O G E A-r 019–C(4 Lot # Z Cerfifled Survey 5 , jap # - -- , Volume — Page # VVnrvnniy Deed # _ G,9Sl� � , Volume ,Page # Spec house 0 yes Kilo Lot lines identifiable yes O no . SYSI 1�.I "I'ANANC improper use and maintenance of your sept;b system could result in its premature failure to handle wastes. Proper maintenam consists of pumping out the septic lank every three years or sooner, if needed by a licensed pumper. What you put into the systa can affeef the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to nibmit to St. Croix Zoning Department a cettitication fo ►raster pitrnrbet, journeyman plumber, resfricted plumber or a licensedpumper verifying that (!)the - ai e w s ewa posal sy lel is in proper nl condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 Putt of sludge itwe, the turdersigned have read the above requirements and agree to 4 Intain the private sewage disposal system with the standar( set faith, herein, as set by the f)epartrnent of Commerce and the Department of Natural Resources, State of Wisconsin. Cettificatic staling that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 3 days qTe three yea expiration date. f' iON B v - A rrLICAN- ° 3 - DATE b , NER CERTIFICATION wc) certify that all statements our This form are true to lire best of my (onr) knowledge. I (we) Ant (are) the ownet(s) c file pia Im7 describe bove, by virtue of a warranty deed recorded in Register of Deeds Office. IONAT OC' PPLICANT �� /,;Z// 0.!F ` DATE ` * *� • Any. information that is mis re resent p ednuay result in the sanitarypennit being revokedby the Zoning Department. * * * ** • • Include rnllh this Appilcallon: a stamped warranty deed frbrn the Register of Deeds office 8 cagy of the certified survey map if reference is made in lire warranty deed • ill■■■■ iii/■■■ L!_''J ■ ■ ■ ■ ■7 ■ ■ ■ ■'■�f►7 ■ ■�I ■ ■ ■ ■■ - • • �I ■ril! ■ ■!� ■ ■ ■!� \ ■ ■�■i ■ ■ ■!� ■r�r!' ■fit ■ ■ ■ ■■ - . �1■ ■! era■ rior,■ ■r�o�� ■■e�■■■�+1► ■■�� ■►��i■■■■■ ' IIFa�II �i�i7■■ � `i ■ ■!1 ■► ■ ■ ■[o ►l�t'!Si] ■ ■11 ■ ■ ■ ■■ fig ■■ ■■ ■ ■ ■ ■� ■���� ■� ■ ■ ►�1� ■ ■��iiii ■ ■ ■ ■■ • - . ■ 11 ■ ■EEE ■ ■ ■■ ■Mir ■�� \ ■1Ce1'li ■ ■ ■ ■11 ■ ■ ■ ■ ■ ■i � . - • • ' ■ it■■ tiii2L'!■■■ ii '!�DI ■I ■111►N�1 ■ ■ ■ ■1i ■ ■ ■ ■ ■ ■■ " '' ally ■ ■ ■ ■ ■ ■ ■ ■ ■ ■��� %�I ■ ■IlI!�I ■ ■ ■ ■11 ■ ■ ■ ■ ■ ■■ s= �7 ■�� ■ ■ ■ ■ ■ ■� ■ ■'�i�lhs�.1 ■ ■ ■■ ■iii■■■■■■ ONE MOMME [ �i�1■: �i ::�. ■ ■ ■ ■ ■■ir�w�il;Il�l�w[�iI�l■ OMEN 1I■■■■■■■, No ONE ,is�,'�1!:!�'� ►�> ■ ■ ■ ■■ Iii■ I '�� /fii�Ll!1�:�lf�l����l ■ ■ ■ ■ ■ ■■ ■■■■ ■■r ■ ■ ■ ■ ■MMMUMMOL\O■■■■ ■O ■ ■ ■ ■ ■ ■■ UJ m EROSION CONTROL PLAN CHECKLIST a Check (✓) appropriate boxes below, and complete the site diagram with necessary information. i.z. Site Characteristics North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. ❑; Location of existing drainageways, streams, rivers, lakes, wetlands or wells. Location of storm sewer inlets. Location of existing and proposed buildings and paved areas. The disturbed area on the lot. Approximate gradient and direction of slopes before grading operations. Approximate gradient and direction of slopes after grading operations. *1 Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices Q. Location of temporary soil storage piles. Note: Soil storage piles should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be covered with a tarp or more than 25 feet from any downslope road or drainageway. Location of access drive(s). Note: Access drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick. Drives should extend from the roadway 50 feet or to the - house foundation (whichever is less). �yg"yr Q Location of sediment controls (filter fabric fence, straw bale fence or 10- foot -wide vegetative strip) that will prevent eroded soil from leaving the site. Location of sediment barriers around on -site storm sewer inlets. (� Location of diversions. Note: Although not specifically required by code, it is recommended that concen- .. trated flow (drainageways) be diverted (re- directed) around disturbed areas. Overland runoff (sheet flow)from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas. 14+. Q Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). -' Note: Such practices include maintaining existing vegetation, placement of additional r , sediment fences, diversions, and re- vegetation by sodding or seeding with use of erosion control mats. Location of practices that will control erosion on areas of concentrated runoff flow. Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip -rap. When used, a given in- channel barrier should not receive drainage from more than two acres f of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams (streams with year round flow). Location of other planned practices not already noted. Lai ` • ems U Indicate management strategy by checking (✓) the appropriate box. Q�k o Management Strategies z Temporary stabilization of disturbed areas. Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1 and September 15), or by other cover, such as tarping or mulching. Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment). Indicate re- vegetation method: ❑ Seed Sod ❑ Other • Expected date of permanent re- vegetation: — l • Re- vegetation responsibility of: ❑ Builder P Owner /Buyer • Is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? ❑ Yes ❑ No ❑m' Use of downspout and /or sump pump outlet extensions. Note: It is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement. Trapping sediment during de- watering operations. Note: Sediment -laden discharge water from pumping operations should be ponded behind a sediment barrier until most of the sediment settles out. Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water. . yAi Maintenance of erosion control practices. • Sediment will be removed from behind sediment fences and barriers ..f before it reaches a depth that is equal to half the height o f the barrier. • Breaks and gaps in sediment fences and barriers will be repaired imme- �A diately. Decomposing straw bales will be replaced (typical bale life is three months). • All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday. • Access drives will be maintained throughout construction. • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. I • Wisconsin Department of Commerce SOIL EVALUATION REPORT p age 1 of 3 I Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. �� 0 G. 11P , percent slope, scale or dimensions, north arrow, and location and distance to nearest road. / Please print all information. Reviewe y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I/ ZZ. O 7 Property Owner �� Kd�^^ ' f C Property Location Quest Development, Inc i //0 Govt. Lot E 1/2 1/4 SW 114 S 5 T 30 N R 20 ar W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Suite 150 10700 Old County Road 15 2 Ridge At Birch Park City State Zip Code Phone Number [ F Village ■ Town Nearest Road Plymouth AIN 1 55441 ( 7¢3 -595 -9512 County Road E Q New Construction Use Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD n Replacement F] Public or commercial - Describe: Parent material loess over outwash sands Flood Plain elevation if appli o General comments I and recommendations: C OA�C'�C � J ft 2 ❑ 1 Boring # ❑Boring > 0 pit Ground surface ele . 91.84 ft. Depth to limiting fa r r ' it Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Con B unda GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. / ., *Eff#1 " Eff#2 1 0 -11 10yr3 /2 sil 2msbk mfr cs 2f .5 •8 2 11 -17 10 r4/6 sil 2msbk mfr cs if .5 .8 3 17 -36 10yr4 /6 sil lmsbk MR cs - .2 .3 4 36 -98 7.5yr5/4 s Osg ml _ - .7 1.2 2] Boring # 11 Boring 98.25 >98 El 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 I "Eff#2 1 0 -9 10yr3/2 1 2msbk mfr cs 2f .4 .6 2 9-28 1 r4/4 - s Osg ml cs - .7 1.2 3 28 -98 7.5yr5/4 s Osg ml - - .7 1.2 *Effluent #1 = BOD > 30 220 mg /Land TSS >30 < 150 mg /L *Effluent #2 = B 5 < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 10/16/01 715- 246 -2454 ^ � A L nest Devel Inc 2 3 Property Owner Q p Parcel ID # Page of Boring 7 3 Boring # a Pit Ground surface elev. 84.43 ft. Depth to limiting factor >98 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10yr3 /2 - 1 2msbk mfr es 2f .4 .6 2 10 -29 10 r4/4 - s Osg ml cs - .7 1.2 3 2 9 - 9 8 7.5yr5/4 - s Osg MI - - •7 1.2 t7t7 ❑ Boring # 1__I Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD, < 30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. MD- 8330Test (R.07 /00) ► cQ I r �^ r Cv2Af (L/ o i I ' 0 � IOb l Wyl Jop eo ( kv -1 1 - (� ri X7381 A5"Z91 GOT` TO 13 r�-SS!'(lv + Nl Ety 0 3D • 2,1)3 • Z o • arm cd.v T�-c 7'� wiS . 3 z 0 • oav G- i'GC�v,��� MAVE 03 • 20 /o • ODD O 3 z 0 ! 0 �� + p Sewage Consultants 0 3 C9 Z 0 yd 655 O'Neil Rd. Hudson, Wis. 54016 - 715 , 3S 0 0/ SS' 7i S 7 72. • 3 VZI J STATE VAR ORWI9Caa FORM � � J � 2 i Document Number WARRANTY DEED KATHLEEN N. wALSH REGISTER OF DEEDS , This Deed, made between Dakota Development, LLC, a ST. CR UIX CO., WI Minnesota Limited Liability Com any RECEIVED FOR RECORD _ p 10 -24 -2002 11:00 AM Grantor, and Riad Youssef and Tammi Youssef, husband aad wife [AL REC FEE: 11.00 TRANS FEE: 458.70 COPY FEE: Grantee. CERT COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the PAGES: 1 following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 2, Plat of Ridge at Birch Park in the Town of St. Joseph. St. Croix Name and Return Address County, Wisconsin. 0 30- 2039-40,030. 2039 -g0 Parcel Identification Number (PIN) This i not homestead property. 0j) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ' -- - day of October 2002 Dakota velopment,�L� -- _. f= Dr/.0 a + ' • s AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. County ) authenticated this__day of Personally came before me th day of Octo 2002 the above named Dakota Development. LLC, a Minnesota Limited Liability Company TITLE: MEMBER STATE BAR OF WISCONSIN (if not, tom own to be the rson(s) who executed the foregoing in r c e �d the same. authorized by § 706.06, Wis. Stats.) \ THIS INSTRUMENT WAS DRAFTED BY +• Dt-� �� �\ Attorney Kristine Ogland Notary Pu I c, State of Wisconsin Hudson, WI 16 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) l Z- —'? f-2 _ , 1) • Names of persons signing in any capacity must be typed or printed below their signature. Udmnaaon Prdaaaianats company. Feed du Lao, W WARRANTY DEED STATE BAR OF WISCONSIN 800458'20¢1 FORM No. 2 - 1999 Tracy L. Turner Notary Public State of Wiscons' 0 v i ° �• �� co U / \� D I- 1 I� cam, �\ LN 1 \ c 1 GD -1°'- 1 / n z m $ r � Ln rv° 3�Z4 55o��N c \ I 411 CC)D 0 \ \ \ vl \TVA �C \ cA CZ CQn y ` \ 9� pZ9 N\ 00 Ln v 0(i \