Loading...
HomeMy WebLinkAbout032-2022-40-300 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safely acid Binding Division INSPECTION REPORT sanitary Permit No: 429927 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: Ibister, William I Somerset Township 032 - 2022 -40 -300 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: ( OD. r C3iM ( 06.30.19.553A20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � � Benchmark � �• ' Dosing Alt. BM l Aeration Bldg. Sewer 5( jed'i i o . Holding St/Ht Inlet �.1 TA K St/Ht Outlet SETBACK INFORMATION �o •—!� p .CO TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' 51) 1 C h t Dt Bottom Dosing u Header /Man. 40 ip..� . Q • N Aeration Dist. Pipe N Holding Bot. System 9.100 tG Final Grade P P /SIPHON INFORMATION 5 Manu turer Demand St Cover D 0.1-,�1 GPM 2,. '! Model Num (� T �c�r se ip� TDH Lift ction Loss System Head TDH Ft 9'90 Force in Length Dist. to Well OIL ABSORPTION SYSTE 3 cj BEDITRENCH Width Lengt No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /� z � 3 SETBACK SYSTEM TO ( P/L BLDG WELL LAKE /STREAM LEACHING M fact �Fu INFORMATION Type Of System: ' S � CHA UN ET OR Model Num ( 1 . 01 DISTRIBUTION SYSTEM , Header /Manifold Distribution x Hole Size Ix Hole SpacingVent to Air Intake A 1 K Pi s) > 1 Length Dia Leng Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil q L611 Yes jd No [, Yes _I, No O�TS: (Include dp dj crepe ies, persons present, etc.) Inspection # fir I Z A: P 3 Inspection #2: �'—t_.�._� ti Location 175 38th treet , om t, (i t 54025 (SE 1/4 NE 114 6 T30N R19W) NA L .19.553A20 1.) Alt BM Description = 4 "+ 2.) Bldg sewer length = y .... A , "to q � �� 3 1- � j - amount of cover = ID 411 � . Plan revision Re uired? Yes o q t�/dy 1 • Use other side for additional information. + ; "'_., '. • L_2' _ - _, . n InsepctorsSigrpture "R S13 6710 (�): CSk.�XO� S) V&, , _ o Q Safety and Buildings Division County p r 201 W. Washington Ave., P.O. Box 7162 ! f t l N VIsconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151 9 Department of Commerce S I .D. Number Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Project Address (if different than mailing address) may be used for secondary purposes Privacy Law, s15.04(Ixm) I. Application Information - Please Print All Information r _ f p a� a 1��, 7 ; Parcel # Lot Block # property Owner's Na me ;1I? 2j jv � er 1 � property Owner's M ailing Address Property Location �0 S 84 �. �;. ✓f� S4, _Z City, State Zip Code Phone Number n l7 � J/ T N, � E cl r H. Type of Building (check that apply) ! pp �er C �„H 6 e Subdivision Name CSM Number 1 or 2 Family Dwelling - Number of Bedrooms b 3Z, ❑ public /Commercial - Describe Use ❑ State Owned - Describe Use x 2 ❑ ity_❑Village ownship of v//[f/�a1 III. Type of permit: (Check only one box on line A. Complete line B if applicable) A. ew System ❑ Replacement System ❑ TreatmendHolding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal El Permit Revision ❑ Change of ❑ Permit Transfer to New Before Expiration Plumber Owner N, Type of POWTS System: (Check all that apply) Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Weiland 11 Pressurized In- Ground ❑ Holding Tank El Peat Filter ❑ Aerobic Treatment Unit ❑ Recircula ng Sand Filter ❑ Recirculating Synthetic Media Filter aching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Othe (explain) 3 ' J V. D' reatment Area Info mation: - ' W . Design Flow (gpd) Design Soil Appjicaton Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Ele on G 5 i I Z q7' o ?9 VI. Tank info Capacity in Total Number Manufacturer Prefab Site teel Fi r Plas he Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Z 10 / Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the under ' nine "responsibility for installation of the POWTS shown on the attached plans. s Plumber' Na me (Print) Plumber' ture MP/MPRS Number Business Phone Number � Plumber's Addre ss (Street, City, Stat Code) VIII. Count /De artment Use Only A ent Si o Stamps) =Su:,c=harge ee includes Groundwater Date Issued g Approved 11 Disapproved ^ � ❑ O wner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval _ 1 /� � ��� �✓� � Q' P-er b� Pte, �h.. nn Der not legs than 81/2 x 11 inches in size PLOT AN PROJECT Bill Ibister AD Ess 14806 58th ST. N Unit 4A Oak Park Heiahts Mn 55082 SE 1/4 NE 1 /4s 6 /T 30 /R w TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 i' DATE4 /24/03 BEDROOM 4 CONVENTIONAL XXX IN- GROUND ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39 IL BENCHMARK V.R.P. Top of 1" Steel Pipe = 1 3 K , - - 11 : = ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL •H.R.P. Same as Benchmark SYSTEM ELEVATION 99.0/98.7/98.4 3.5' Below Grade 45' 480' Property Line Vent >6 „ Standard Biodiffuser Plans Designed Using Leaching Chamber of Cover with 31.1 ft2 of Area Conventional Powts Manual Version 2.0 6' Long 11 " 34" Grade at System Elevation 04 Bedroom 126 House 00 M M. # .M4 I B -3 30' 138' 5 ST Vents 100' 3 -3' X 82' Cells with >3' Spacing 60' 5 ' B -1 40 0 ' Vents -2 PLOT AN PROJECT Bill Ibister AD ESS 14806 58th ST. N Unit 4A Oak Park Heiahts Mn 55082 SE 1/4 NE 1/4s 6 /T 30 /R W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE4 /24/03 BEDROOM 4 CONVENTIONAL X)OC IN- GROUND 4ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39 BENCHMARK V.R.P. Top of 1" Steel Pipe = 13� = ASSUME ELEVATION loo' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 99.0/98.7/98.4 3.5' Below Grade 45' 480' Property Line >6 Standard Biodiffuser Plans Designed Using of C Leaching Chamber Conventional Powts with 31.1 ft2 of Area Manual Version 2.0 6 ' Grade at System Elevation 2 4V 04 S44J -�"ccP° = 1 04 B edroom 126 House Cn 00 M M. #2 M.#1 B -3 30' 138' 5' ST Vents 100' 3-3'X 82' Cells with >3' Spacing 60' 5' B -1 40 0' Vents -2 Wisconsin, Department of Commerce 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 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. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. evi ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot S , 1/4 1/4 S T 3(1 N R (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CQAA# -- City State Zip Code Phone Number FICity ❑ Village TZ Town Nearest Road < < S I New Construction Use: f Residential /Number of bedrooms Code derived design flow rate F GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain el vationli cabfe ft. General comments and recommendations: ��s�iJ, /_ 98.17 Z(}Q2 Boring # Boring ❑ Pit Ground surface elev. , /�tL 2 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 e& . / - F i<- a 3o.2Y ,z Boring # Boring ❑ Pit Ground surface elev. �/ �_7 7 ft. Depth to limiting factor > 9S 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 sd - Al qq -* .tq ' Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 0 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CZNa (PI e se Print) i t r CST Number Add ess Date Evaluation Conducted Telephone Number SBD -8330 (R07 /00) / 5 Property Owner Q �bx °s�Jf Parcel ID # Page , r of 3 Boring # 0 Boring ❑ Pit Ground surface elev. ,& S�2 ft. Depth to limiting factor J _ 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 0- 7 zq ❑ 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 /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # ❑ Boring 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 /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. SBD -8330 (R.07 /00) Jp /akCS /�T Jf-��/�f A / = -fed sco -/k ✓ .��' ' ��� � 3, G Ael•�s Gas T L Y i,S.3 i NORTHEAST CORNER OF SECTION 6, T30N, R 19W, ST, CROIX I I COUNTY, WI. FOUND _ 80' I—• - ALUMINUM MONUMENT, , I i I � I I , EXISTING Z DRIVEWAY O U UN_P w I �'; ° N88 °42'53 "W U - `� -- 479.46 i v v / 435.94 c C ' , ^ _ , a V- Z) cn I I -� 40 �; �- z V) I n G QI ' Z O p c 01 I _ I _EXISTING F W <1 Z V o w F— IQ `` uW DRIVEWAY v LOT 1 JI �� Qw ► `�O V1� p E- w c� J �O �"ol p`nct'n w3 o d• O O U 0 3.00 ACRES r o o N I to ° ? c, v z (130,680 SQ. FT.) 00 N%. Q I w or ww�� CO v, a- I O aw Imo wUo� 9 � Q t`n- UcnUQ I woo I _ w �� — �i — — 40' N88 ° 42'53 "E I I - 435.26 / i � -- - • . -' -- 853.84 y EXISTING � DENOTES ? _1 -_ 476.85 FOUND --/ DRIVEWAY " / S88 L' 1 , 314" I.P. I i 0 UNP LAN _ _ _ _ I I \� i EAST I/4 CORNER OF - --' SOUTHWEST CORNER OF-' SOUTH LINE OF THE NORTHEAST QUARTER OF -' SECTION 6, T30N, l THE SOUTHEAST QUARTER SECTION 6, T30N, RIgW, ST, CROIX COUNTY, WI. RIgW, ST, CROIX OF THE NORTHEAST COUNTY, WI. FOUND QUARTER OF SECTION 6, ALUMINUM MONUMENT. T30N, R 19W, ST, CROIX COUNTY, WI, I I THE PARCEL SHOWN ON THIS MAP IS SUBJECT TO STATE, COUNTY AND 0 1 Z TOWNSHIP LAWS, RULES AND I REGULATIONS (I.E. WETLAND, MINIMUM LOT SIZE, ACCESS TO PARCEL, ETC.). BEFORE PURCHASING OR DEVELOPING ANY LOT, CONTACT THE ST. CROIX COUNTY ZONING OFFICE AND THE SCALE: lINCH = 100 FEET TOWN OF SOMERSET. NORTH II ,I SYMBOLS 0 DENOTES FOUND IP 1902 South Greeley Str( • o DENOTES SET 1" X 24" IRON PIPE Suite H3 GWO ©uildn Stillwater, MN 5501 WEIGHING 1.13 LBS /FT. ����� Phone 651.275.896 \ `1 Fax 6511.275.897t li BEARINGS ARE REFERENCED 1 1 I I � • • • i dlt- csls( TO THE SOUTH LINE OF THE 1 mcleodus- NORTHEAST QUARTER OF i ' L 0 ne SECTION 6, TOWNSHIP 30 j : THURMES NORTH, RANGE 19 WEST, / 2456_008 j ST. CROIX COUNTY, gTIL(_WATER WISCONSIN IS ASSUMED TO MN BEAR S88 °42'53 "E. CORNERSTONE t SHEET 2 OF 2 SHEETS I_ A N o St R v r Y I N r; , 1 rr I - - ' r 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 S13MC TANK MADftMdA14M r AND OWNERSHIP (Z&MCAIION FORM popaty Add 63 +'-, S �' P {v��oe� eat t�o�e P ��eacfor naer..e�N � �,� t� pared um6f � 5om NM*W LNG" DimcgRmm IUD L oca fi m ,;5 y � y Tk Xw14—W, Toavn of .. `� Lot # CalMed serves► MV # �l2 1 . Voiww � � . page, # W - ----- Deed # ( o %,3% . Volmne Z . p* # Sow bma ❑ y#�" Lot fM idcert *&,q O no �p�Opertmammdm fool I I eaf]ro�cs a a■�cos� 'ia�tsp atuLm�awa�lcRPmperma�ot�aoo cooi�e a�fp®eati� cattba sq�eteetveaTthueeyews acseona�;fseededby aPioe�edpa�peG Wlatyos�t mb the O� ceaa�ectths �Ctiaa of �a tack m a taea�e®t tba waste digwaal e� The peopec�jl career opm to admit to St. CWk ?:m ft Dud s 11 Ila agioa . by dw weer aed by a maOcP ,ariom�eapee�e�mtbsaae go% ft®d=Uoodbmnod&*above aed#gm * the seti��wie, a�setb!► �adc�oeame�aoemiB�eDe�medafx .�atBeaomoe�,b�eaf W3w�oetta- �at�rsopticsyatemba ibm I shmiseds otbecoaiploeaandaeee W i 30 d 7 Z/ dd& oW APPLrAW I ( � ce l�d� as tbia fooa aye am to So best of MW (WO iroeArWSM I (we) am (wo as oirreeKO of b % by tae oaf a w�ij►deed.�000aedodhl ref Deeds Offioee. Zj TO F � APP:UCA:NT DA 00*s«o A lion 8mt is eris3 ed.. .Ua is dire m *uypegnut r xdmdby d* 70nbx D ` .* y wtth s of �a ae i6ed �avrry msP if is mom° ht ift wouenq deed U 2028P 485 STATE BAR OF WISCONSIN FORM I • 1999 6 96 3 4 8 KATHLEEN H. NALSH Document Number WARRANTY DEED RE F DEEDS This Deed, made between Irene G. Hilde a/Wa I re ne RECEIVED FOR RECORD Hildebrant _._. 10 -30 -2002 10:30 AN _ WARRANTY DEED Grantor, and William P. Mister and Susan J. Bowden a /k/a Susan EXE?PT i Bowde Ibister, husband and wife as survivo ip mart a proper y REC FEE: 11.00 -- -- - - TRANS FEE: 180.00 - - COPY FEE: _ _ . - - -.. - - -- ------ - - - - -- - CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ County, State of Wisconsin (if more space is needed, please attach addendum): Part of the SEI /4 of NEI /4 of Section 6, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin, described as follows: Lot Recording Area ne ) of Certified Survey Map filed September 27, 2002 in Volume 1 6, Name and Return Address page 43 81, as Document No. 692089 S& C Bank P.O. Box 10 Balsam Lake, WI 54810 032- 202240 -100 _ Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not - 4W (is not) homestead property - Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and ordinances of record and will warrant and defend the same Dated this yu '— day of Octo 2002 l Irene G. Hildeb AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. - PO County ) authenticated this day of Personally came before me this � day of _. October 2 002 the above named Irene G. Hildebra TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, - -- instrument and acknowledged the same. authorized by § 706.06, Wis, Stats.) THIS INSTRUMENT WAS DRAFTED BY LAUX CUTLER, S.C., Att at Law _ Notary Public, State of is t D k State of Wlaeondn s�ceols, Wisconsin 54020 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) _ _: -- • -- -) • Names of persons signing in any capacity must be typed or printed below their signature. information profs: iwais company. Fond �M WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1- 1999 +' , 692089 VOL L PAGE 4381 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX Co., MI CERT.IF'ED SURVEY MAP RECEIVED FOR RECORD LOCATED IN THE SOUTHEAST QUARTER OF THE NORTHEAST QUARTER OPSFNW 6, 1 �MA,A R19W, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCMIMMIED SURVEY MAP REC FEE: 13.00 COPY FEE: NORTHEA!FfAWROER OF 2 SECTION 6, FOUND ALUMINUM UNPLATTED LANDS MONUMENT. NORTH LINE OF THE 51 /2 OF- THE SE 1/4 OF THE NE 114 — I -� 80' J EXISTING DRIVEWAY o UNPLA — LANDS o i m � N I I o 40' - __ -- N88 °42'53 "W - 435.94' -- I oc 40 1 f'- ' BUILDING SETBACK LINE ; _ N i z Z 1 -- 100" -- J -_I - 25 a ° I 1 p I� = I 1 I 1 pz JI °II�OI I - I �l ~�v lz V) o '00) a 1 wl (w�v Wol z ° Q <1 oo +"I, �- pNt1 LOT 1 iQ o o � co N Ji o �Q �I �Z l c . ° I o LL Q w zl ^M 1 �� �I ?a�� 3.00 TOTAL ACRES �wI . a ° I O I �, r u (130,680 SQ. FT.) i�' p N F - z o z I I I � x� zl LuW Iz QI Z ( °I 1 - �' w o I Z OL � " • CONTIGUOUS BUILDABLE AREA co M Q) i I �� - 5 U U) �U a LOT I= 2.39 AC. I- a- I N -z �I � ZI tu 40 " - I; lm °I 3 - 40' 25' (j -- - -� �� - -- 100' --�� _ — _13UILDINC SETBACK -LINE N88 °42 i • � / - - - 853.84 --.,� I i o E c - ° c ■ , 2 § # T $ 7 & _ /( 7 a 0 2 E woo - OD , E 7 m [ § � C) w _ / i C. C; @ E o S i ■ Q E -4 f § § ƒ c a ■ � . 7 $ § £ t § \ 0 CL q $ k BUk O i3 @ 0 r ■ � ° W § C.) § � % �- / 000 \ 2 'o / 7 § (a co ca T, 2. § E :r 7 � 0 ° E § 2 / � • ■ £ w A — e CL 7 .. E ¥ z \ \ ® am c :3 CD # C. } G , z CO) � a } § ■ 0 2 § CL 9 0 k . ■ T CO � } \ � , ) \ ■ _ Z � ^ 0) CL 2 A § � { � 0 % C _ . � CD � � S � � § � � k4 � 2 � � ■ i o m % §