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032-2035-10-300
. n■ ■�� o A. ' 7 � � Cl) & s � ° % _ E $ S n , ® a o § 3 �a 2 c\\ o R$ \ g j 7 P§ k 5 i § ; 7 a & $ § § a CD $; w @ G 9 ° 0 C) ` t 10 C R / / § 2 co a \ $ � § CD 9 § § > � Q m / § S a i g E c �� 7 \ § ■ �, k k k A ` / § § ■ ■ ■ \ 7 ° § o = o q { (D e ■ # § PO £ 7 °� § z » w � ƒ \ E § 7 0 g o 7 I \ \ ° 2 A y g E \ 7 $ k CL $ ■ f / co C e � a z § e § 2 � N z \ � § / � =k § i > / c \ - §0 a e o , � � § � k � � { 0 G / #o �k §i �\ � � Parcel #: 032 - 2035 -10 -300 02/15/2005 09:40 AM PAGE 1 OF 1 Alt. Parcel #: 9.30.19.607D 032 - TOWN OF SOMERSET 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 " O'LEARY, JEREMIAH Z JEREMIAH Z O'LEARY GILBERTSON KIMBERLY S GILBERTSON KIMBERLY S 506 164TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 506 164TH AVE SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.013 Plat: 1067 -CSM 14/3877 SEC 9 T30N R19W NW SW BEING LOT 3 CSM Block/Condo Bldg: LOT 3 14/3877 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 09- 30N -19W NW SW Notes: Parcel History: Date Doc # Vol /Page Type 10/11/2001 658820 1736/35 WD 10/30/2000 632665 1554/532 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 10870 278,600 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.013 48,100 188,100 236,200 NO Totals for 2004: General Property 3.013 48,100 188,100 236,200 Woodland 0.000 0 0 Totals for 2003: General Property 3.013 48,100 188,100 236,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #. 542 Specials: User Special Code Category Amount Special Charges Delinquent Char Special Assessments es p g q 9 p Total 0.00 0.00 0.00 1458 SOIL EVALUATION REPORT P age _ j _ d - 3 Wisconsin Department of Commerce A.C.E. Sod ft S'de Evaluators Division of Safety and Buildings in a �ordancewith Cantu 85, Wis. Adm. Code county St. Croix Attach complete site plan on paper not less than 8'h x 11 indnes in size. Plan must road. Parcel I.D. include, twt not limited to; vertical and hornontal reference pant (BM), dnrection and d distance to nearest 032- 2035 - - 3 00 percent slope, scale or dnmemsions, north err - Date Please print j ; , Reviewed By secondary (Pry 15.04 (1) (m)). Personal kdom�ation lrou provide may ^ � • r ropeRy Location Property Owrw :.- Lot _ NW 1/4 NW 1/4 S__ 9 T 30 N R 19 W Subd. Na Manchester Homes_�_�___._. 1 i -- - -- # glodc# - me or CSMr� Property Ov'Ws MaiTir►g Address _.._� c.. r�1 3 T CSM Vol. 14, Pg. 3877 6750 Stillwater Bldv. - Village ✓ Tar�vrn Neaest Road S Code tZKPU Mtlrnt city village Ave. City ` Somerset Stillwater MN Code derived design flaw rate 600 GPD &I New Constriction Use: of Res y ! 4 —_ -- tacerrnent Public or - Describe: Flood plain elevation, if applicable ___ - -- na - -- Parent material Glacial drift ___---- - - - - -- - - -- ts recommendations: Install 3 trenchs at 3'x 81.25' using 39 High capacity BioDiffuser infiltrator chambers at 96.QQ . Boring # Bo" Ground Surface Slay. 98.99 _ ft. Depth to limiting factor _ >93" in. Sot Applicatnon Rate ✓ Pit Roots GPDlft' Horizon Depth Dominant Color Redox Desrxiption Texture Structure Consistence Boundary *Eff #1 'E ds as 2f,1 m 0.5 0.8 10 r3/2 none I 2fsbk -__ - -- _ - - - -- -- - - -- -_ 1 0 -19 y _ - -- -- - -- -- - - -- cs f 0.5 0.8 none sil 2msbk mvft 1 f &v -- 2 19 -27 10yr4 /6 -- — - - - - - -- - - - -- - - 0.9 $l 2msbk mfi gw 1f &vf 0.5 — 3 27-56 7.5yr4/6 none - -- - --- - -- 1 msb m fr - - 0.7 1.2 none � - - - -- 4 56 -93 10yr4/6 - - -- El goring # Boring >96" in. Soil Apprratnon Rate ✓ Pit Ground Surface elev. 9_ 8_95 _._ ft. Depth to limiting factor __ ?1-- - -- GPOW Dominant Color Redox Description Texture Stnrciure Consistence Boundary Roots "EfF#1 "E Horizon Dept ds as 2 f,1m 0.5 0.8 10 /2 none sil 2fsbk -- -- _ - - -- 1 0 -10 Y _ ---- - - - - -- - 2fsbk mvfr cs 1 f &vf 0.5 2 10 -16 10yr4/6 none sil - — - - - - -_ _ -- - - -__ -- __� mfi - gw 1f &vf 0.5 0.9 7.5 4/6 _ 3 16 -32 Yr none si 2msbk 0.5 0.9 none ISNI mix 2msbk mfr 4 32 -96 10yr4/6 — __ - - - -- - - -- - . -- - - -. -th 20 2msbk si. Loading rate reflects rrios1 restwiive- erntered w nthn Fi34 consists of a unsorted mndure of apProximste<Y 80 won. * #2 = BOO' < 30 mg/L and TSS <-30 mg/L nt * Efflue #1 = BOD 5 > 30 < 220 m9n- and TSS > < 150 mglL CST Number CST Na (Please Print) Sig re: 3 602 Nam - - -- - James K. Thom _ -- �e Evaluatnon Conducted Telephone Number Aridness A.C.E. Soil & Site Evaluations 8128/01 715 248 - 7767 340 Paulson Lake Lane, Osceda, Wl 0 Wisco Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: • 370386 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: Manchester Homes I Somerset Township 032 - 2035 -10 -000 CST BM Elev: / Insp. BM Elev: BM Z:ption: / TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Z<;Q Benchmark Dosing Alt. BM - Aeration Bldg. Sewer H olding Ht Inlet y TANK SETBACK INFORMATION Ht Outlet /07. TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Septic 7too Dt Bottom Dosha V Header /Man. O N T 7• s Aeration _ Dist. Pipe M 1(( y H�Idirfg Bot. System R PUMP /SIPHON INFORMATION Final Grade /o•� facturer Demand St Cover - p� Z' IP a dpo Model Number :::� TDH Lift riction Loss Head TDH Ft For ain Length Dia. Dist. to SOIL BSORPTION SYSTEM (3 BED ENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME Z ` 3 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM Manufacturer. INFORMATION CHAMBE R -S Type Of System: I J / � ap Mo el Nu b r. DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size/ x Hole Spacing Vent to Air Intake Pipe(s) Length ` Dia Length ZS Dia Spacing _ - SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of odded xx Mulched x Bed/Trench Center Bed/Trench Edges Topsoil [ Yes [W No [M Yes i No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / 2 - 1 1 Inspection #2: ! / Location: 506164th Avenue Somerset, WI 54025 (NW 1f4 SW 114 9 T30N R19W) NA Lot 3 Parcel No: 09.30.19.607D 1.) Alt BM Description = ST 2.) Bldg sewer length = i W - amount of cover = 7 y or 3� dbS�r� ;,"I <' Plan revislon ifle'd? T Yes No ® 2 Use other side for additional information. Z � T Date Insepctor's Sigofiure Cert. No. SBD -6710 (R.3197) w 6 y7' 70h'e_ t2 �v� s o-*� r / gS3 o Sanitary Permit Application Safety & Buildings Division in accord with Comm 83.21, Wis. Atim. Code 201 W. Washington Ave. N* See reverse side for instructions for completing this application PO Box 7302 i sconsfn Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [PrivgewS 1�04(l)(m)) state owned. Attach com lete lans to the coon o � only) forth ste , on a er not less than 8-1/2 x I 1 inches in size. h State Sanitary Pe um i to previous application State Plan L D. Number .0 atx I.Application Information - Please Print aU 1n6rma Location: Property Owner Name Property Location L MeS fi n1Jll4 2JI /4, S T ,N, W Property Owners Mailing Address Lot Number Block Number ; c.Ja � \ `3 , - 7 Code P o Subdivision Name or CSM Number City, State Zip n z L' s �/a� 3877 ❑ City II. Type of Building: (check one) ❑ Village ❑ 1 or 2 Family Dwelling -No. of Bedrooms :� fi Kown of yL ❑ Public/Commercial (describe use):_ S ❑ State -Own ed Nearest Road Gq- 3 ' X 2 I Parcel Tax Number(s)032 u / 0.3 III. T e of Pe mit: Check only one box on line A. Check box on line B if a licable q• , • q • �� A) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System system Tank Only Existing System Permit Number Date Issued A Sanitary Permit was previously issued 310 ? ° IV. Type of POWT System: (Check all that apply) YW— t ❑ Sand Filter ❑ Constructed Wetland 2 on- pressurized In- ground ❑ Mound ❑ Single Pass ❑ Drip Line ❑ Pressurized In- ground ❑ Holding Tank g ❑ At- grade e ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: &- tr1C,45 ak3'j( &ZS u 5 - ! " u5u' 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application . Percolati n Rate 6. ystem Elevation 7. Final Grade Required Proposed Rate (GalsJday /sq fft.) (MinJinch) E levation ion (0 D� G(P�. - 7 to 0.90" D 50 ��o . —101 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Gallons Gallons Tanks Con- Con- glass Information crete structed New Existing Tanks Tanks ❑ ❑ O ❑ 2Gb l Wie C Wie one. Li C3 LJ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Business P, one I1umbe.r Plumber's Name (print) — ,,`' Plumbees .Si a (no; �ZN� _ G �--� 5/ Plumber's Address (Street, City, State, Zip Code) 670 AJiJ rA5X - /Q d 41'_=!_ U S Q d / IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issui g Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Su rc ge FS ` Determination X. Conditions of Approv�al for D�rs�approval: � (J p , a C,e .j i 1QA _ Py W �:s Sell S Kb� alb[ a�. E�Gt�CLCjon • /occi�c d / o�oP SZ`a� vo A I `d t C-5 doP/ �- 387 S. 9 7 of .5�.►�rs� -�, SE • �iX Co., c,J /. 9 .o /' A f e I-ev a - 0 o � Pao posed /,.2cv Lc.� /e5 eonC • W 8 5 e� fi C�^7�X^ � � y 6, m o rc5id os�d 3��en t/oA/ Prop ba g Seo✓e/' arc o4_ 3 x 8�• 25'u5inq as Pe cee-• �c i 13 h; X 0 ,1 SO 6io O: f-�uscr /eaek C•ka, bee-5 per Q3 b e� 5 � c �r "c - 39 fJ 3 \c1 X 8.A = To Cc �pQ p/� �occnC�cL�7n. /P1C //9S Xl S c g �o P O- I 7 E /e�Q �jor, • / d p �o \\ N vo �6�3 Cs.►� do� �. 38 7 7 Oc Y2 o 'h o 0 cv /esc� Conc. �3 �qao Qt6a / y b drrn ° rc$rdence Proposed 34--rencicS s/o o/c - - - -- Ejuild fn 5e.�.✓el';i'73K/av�� at 3 X 8 /.25u6i01 as �Qra�c 13 h, X ('. t?C, - 0 5 -0 cka,,, 6e,-s pew � i<rtAc -k (39 � A �E . 8, ��. TO o f 3 / eo /QCe g �o a a BioDif fuser Specifications i 76" �� ao 00 00 �o 00 00 00 � o 00 00 00 00 00 00 0 00 0o r 1 00 O DO OD OD O �� OO OD Chamber OD DD OD DO DD OD DO OO OD Height OO OD DO OD 00 DD X 70 OD OD OO Df OO OO OD OO 00 00 00 00 0 00 0 00 0 � � p Chamber Height J�� End View 34" i. 4' Knockout Universal End Cap Available Sizes s Ag "`'"x 91 D y r i Nw- 1458 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 - of 3 _ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sal & Site Evaluations Attach complete site plan on paper not less than 8' %x 11 inches in size. Plan must County St. Croix indude, but not limited to: vertical and horizontal reference point (BM), direction and - - -- - -- - - - - - - -- - percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. 0 - 2_0 - 10- _3_0_0_ Please print all information. By Dar evveq Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Manch Ho Govt. Lot N W 1/4 NW 114 S _9 _ T - _ - 30 NR 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 6750 Stillwater Bld v. 3 CSM Vol. 14, Pg. 387 City State Zip Code Phone Number ; City __J Village VY Town Nearest Road Stillwater MN 1 55082 1 651 -439 -2414 Somerset 164Th Ave. ✓ New Construction Use: e, Residential / Number of bedrooms 4 — Code derived design flow rate - -_ — 60 0 GPD Replacement j Public or commercial - Describe: Parent material Glaci drift —__ _ _ Flood plain elevation, if applicable _ - na _ General comments and recommendations: Install 3 trenchs at 3'x 81.25' using 39 High capacity BioDiffuser infiltrator chambers at 96.00'. FTI # j Bing — #ej Pit Ground Surface elev. 98.9 9__ ft. Depth to limiting factor — X93" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft? _ _ _ - - 'Efi#1 'Eff#2 1 0 -19 10yt3 12 n one I 2fsbk ds as • 2f,1 m j 0.5 0.8 2 19 -27 1 10yr4 /6 none sil 2msbk mvfr j cs 1 f &vf j 0.5 0.8 3 27 -56 ; 7.5yr4/6 none sl 2msbk mfi gw 1 f &vf 0.5 j 0.9 4 56 -93 10yr4 /6 none Is 1 msbk mfr - - 0.7 1.2 - -- -- - - - - -' iAd IN# •a� - - -- -- -- -- - -- Ong # J Boring - ✓J Pit Ground Surface elev. — 98.95 -__ ft. Depth to limiting factor -- in• Sal Application Rate Horizon Depth j Dominant Color Redox Description Texture Structure Consistence Boundary Roots _. _ _ GPD/ft=__ 'Eff#1 'Eff#2 1 0 - 1 0 10yr3 /2 none sil 2fsbk ds as 2f,1 m 0.5 0.8 2 j 10 -16 — 10y — M/6 � none sil il 2fsbk mvfr cs 1 f &vf 0.5 0.8 3 16 -32 7.5yr4/6 none sl 2msbk mfi 7 gw 1 f &vf 0.5 0.9 4 32 -96 10yr4/6 none Is/sl mix 2msbk mfr j _ - 0.5 0.9 con ' app Il 2 srsts of a unsorted mirdure of I roximately 80 l Is & 20� msbk sL Loading rate reflects most restrictive condition encountered within H34 horizon. ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS > < 150 mg/L lu #2 = BOD S30 mg/L and TSS <30 mg/L CST Name (Please Print) Sign ure: CST Number James K. Thompson 3602 Address A.C.E. Sal & Site Evaluations ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54 0 8/28/01 715- 248 -7767 property cwne r Manchester Homes Parcel ID # _032 - 2035 - 10_300 Page -_ 2 _ of _3 -_ a Boring # . - -j Boring — -- I✓ Pit Ground Surface elev. — 101.0 ft. Depth to limiting factor >98" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ GPDIfL.. —__ 'Eff#1 •Eff#2 i 1 0 - 16 10yr3 /2 none sil 2fsbk ds a s 2f,1m 0.5 0.8 2 j 16 - 38 10yr4/6 none sit 2fsbk mvfr cs 1 f &vf 0.5 0.8 3 38 -50 7.5yr4/6 none $l 2msbk mfi gw 1f &vf 0.5 0.9 4 50 -98 10y r4/6 none Is /sl mix 2msbk mfr - - 0.5 0.9 1434 consists of a unsorted mixture of approArnabely 80% 1 msbk Is & 20% 2msbk sl. Loading rate reflects most restrictive condition encountered within horizon. F-1 Boring # ; Boring - - -- - -- J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ SPD/fI! _ "Eff#1 'Eff#2 i Boring # - Boring - - - -- - - -- J Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ 0P13/fE____ `Eff#1 'Eff#2 I ' I i I � I 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 formed. please contact the department at 608-266 -3 151 or TTY 608 - 264 -8777. poi/ e�Q /l.CQ�QrJ �i� /oca �c d Poi° yo " i'�a n c�es� � incS /6e, 3 C,5 do� /�; �. 387 n w n w, S. 9 T. 8. Ofss /ie �✓ • .n c of a kw z /00. I o � a 3 q bdrm rzS d ernce rYl s - - -= C�a reA r= O SO l c 3 h CE . 8, Top o f (Zo, . 5/0,0 � a �n da�'o». E�ev.�•� ir9, si. -4.-eQ Sys�c'yi c , g 9 4 Division of Safaty and Buildings in a=rdance w1tv CWIrn :86, Wis. Adm. Corte A.C.E. Solt & Site EvAsations Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not Wed to: vertical and haizontal reference point (BM), direction and - -- - - - - -- - - -- - - - -_ - percent slope, scale or dimemsions, north arrow, and locabo n and distance to nearest road: Parcel I.D. 032 Pease print all inform 6w. - -- — Date - -- Pwmmd iMormation you provide may be used for secondary purposes (Privacy Lave, s 15.04 (1) (m)). Property Owner Property Location Manchester Hom Govt. Lot NW 114 NW 1/4 S 9 T 30 N R 19 W Property Owner's Mailing Address Lot # _ Brocte # Subd. Name or CSf # 6750 StiByitater Blcly. CSM Vol. 14 pg 3877 - - -- ----- - - - - -- ------------------------------------------------------- City State Zip Code Phone Number City Village le Tam Nearest Road Stiff eater � I MN 1 550821 651 Somerset 164Th Ave. le New Construction Use: se Residential / Number of bedrooms 4 Cade derived design flaw We 600 GPD Replacement Public or commercial - Describer — - — - Parent miaterw Glacial drift -- - -- - - - -- ..... Flood plan elevation, if applicable nix Genw al cwwrffits and : Install 3 trenchs at Tx 81.25' using 39 High capacity BioDiffuser infiltrator chambers at 96.00'_ Boring # Borin de Pit Ground Surface ear. 98.99 . -- ft. Depth to I(miting factor _ >93 - - -m• Scll App 1 Rate Horizon I Depth 1 Dominant Color Redox Description Texture Structure Consistence i Boundary Roots GPD/ 1 1 , 0 -19 10yr3/2 none ! I 2fsbk d as 2f,lm 0.5 0.8 2 19'27 j 1 none sii { 2m mvfr cs 1f &vf 0.5 0.8 -- 3 27 -56 7.5yr4/6 none I sl 2msbk mfi 9W 1 f &vf 0.5 0.9 4 56 -93 r 10yr4/6 i none is lmsbk mfr 1 - - 0.7 1.2 � � I _...._.. _ .....__.. �. - - - . l . - ...... _ - --- - ...._. . - - -- ..._ _.. ----------- -- - -- I, 1 I f ton Boring # fie Pit � Grourut. Surface elect. 98.9 ft. Depth to lirnfting factor — ��" M. Sod AppPicatlon Rate Horizon Depth Dominant. Color Redox Description Texture j Structure Consistence Boundary Roots GPDIft2 1 ( 0 - 10 10yr3/2 none sit C 2fsbk ds as 2f Inn 0.5 0.8 - -- - - - -- r - -- t { - ----- - -- -- -- - - - 2 � 10-16 � 10yr4/6 none sd 2fsbk mvfr cs � 4f8ovf 05 08 3 j 16 -32 7.5yr4/6 none st 2msbk mfr 1 9W 1 f &vf 1 0.5 0.9 -- - F - - ----------- 4 32-96 10 r4/6 none Is/sl mix 2msbk ; mfr - - 0.5 0.9 f a + ately - - - -� - - 20 2msbk sl Loadi _ ( ride reflects most r estrictive condition ernco inured within H34 consists of aunsortedmocture of approximately is & 20% ng hoftm Effluent #1 = BOD ? 30 < 22D nvYL and TSS 30 < mg/f #2 BOD 30 mWI- and TSS - X mWI. CST Name (Please Print) 5 ure: CST Number ,fames K. Tho mpson � �-- 3602 Address A C. E. Soil & Site Evduationa - Dad Evaluafion Conducted TdWwmNwtw 340 Paulson Lake Lam Osceola, WWI 8/28/01 715 ric aiy ci�i � a' i — ',u,. oBi iW e� subs a ..s s -Page 2 d 3 F Bing #� M Pit. Ground Surfgce elev. .....101.03 ft. Depth to limiting facto >98" in: Sol Applicatiort Rate Horizon NO DomweA Color Redox Dna#m Texture Struettim Canwence Mmdary .E -E I , I - -0 -16 { 10y+f3f2 . _. t. none - sit .. -} ds as. ; 2f,1m 0.5 2fsbk ; 0.8 2 16 10yrWra none sr! 2€sbk= ; mvfr I cs Sfi &vt 0.5 ( 0.8 3 38-50 7.5yr416 none sk 2msbk mf gw I%vf 0.5 0.9 I 4 1 - I 10 y r4/6 Wane 15Fs! mix! 2msbk � mfr � - � - 0.5 � 0.9 M4 consists of a unsorted ire of 80% tmsbk Is a 20% 2mst* s1. L oading rate reflects most r struaw condition awcounhwW Within h F-I Bo" # Boring Pit Ground Surface eisv. ___ _ -_ __ f• Depth to limitft factor _. in, Sod Rion Rate Horizon NO I twminant Color Redox Description Textue ` Stnxtrne Consistence Boundary Roots `E OPD1 2 1 C Boring # P�� Ground Surface elgv: --- - -__ _ -- ft. Depth to limiting factor - ....... in. Sod AppGca6ron Rate Horizon [Tepttr DornurantColor Reft Description Texture Structure Consistence 8ounday I Roods I 'i9�� nfirnc-ryi �i"C:�.�n�xtm i� � �� �rr�ity �rvi� svi�Jr;.r' s3 p�Yc+', if yuu need aasi��rn� � �, a or new materisi in an ahemnte format please contact the department at 608 - 266-3131 or T Y 608-264-9777. • O 50;/ E /e r/a coo • /o ca6e d p oo o. tzz 1063 CSrn r/u�/ �. 367 n w n w, ,45Scc•ncFl ¢ le�!'� /CV-cV' ell o l � y bdr JJ�� � aro � c SD 4c 0. � b � \ �L c S /o�Q Cl� ALkn ' � '° Qc g 'o P O� 5Du. 16 q :1 - 11- A Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington A\e. See reverse side for instructions for completing this application PO Box 7302 i Personal information you provide may be used for secondary purposes Madison, WI 53707 -,.,0_ Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1 )(m)] state owned. ) Attach com lete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x I I inches in size. County State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. D. Number 5{.ero►x I. Application Information - Please Print all Information Location: Property Owner Name Property Location �ck,� r dmas 11 w1 /4 IA, S9 TW,N,R )W Property Owner's Mailing Address Lot Number Block Number 0 lcc�a - L3 /da! 3 Cip, State Zip Code Phpac'I ii;rtbe Subdivision Name or CSM Number II r II Type of Building: (check one) - w 4s�. ❑City �ns�uS• ; l ;'� , ❑ Village l or 2 Family Dwelling - No. of Bedrooms: ZI { } Public /Commercial (describe use): , &Kown of O State -owned III Type of Permit: (Che only one box on line A. Checll%i on lineki� cable) t Nearest d �A St NTY A) I . ew System ❑ Replacement 3. ❑ Re' ilacertent g, 4IN bFclg:AdAit onto Parcel Tax Number(s) System Tank Oqly Exigtim 'stem .32 /0 B) Permit Nixpber Dzte- {ssae�- ❑ A Sanitary Permit was revi sly issued f } ' �j: / . (Pill IV.,'ype of POWT System: (Check %that ) Z ► � � on- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank 13 Single Pass C3 Drip Line . t -grade 13 Aerobic Treatmen nit ❑ Recirculating ❑ Other: 3 ' fra- Cxa.,, �3. 3 3 X I•ZS C.U4 V is ersal/Treatm nt Area Information: I. Design Flow (gpd) 2. DispersalArea 3. Dispersal a 4. it Application 5. Percolation Rate 6. System Elevation 7 Final Grade Required Proposed to (Gals. /day /sq. ft.) (Min. /inch) Elevation Cow loG(o.(o7 4,6. �G 0.5 /0 .80 109.5- 113.0' VI Tank Capaci in Total 0 # , & Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons nks Con- Con- glass New Existing crete structed Tanks Tanks S ❑ ❑ ❑ ❑ C, &kst ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement I, the undersigned, assume responsibility for ' stallation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber' Si nature (n tamps) MP /MPRS No. Business Phone Number Plumber's Address (Street, City, State, Zip ode) 1 6 70 D 6F Xo4ow v,05z ! W S O/G VIII County/Departrrtent Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) ',Approved ❑ Owner Given Initial Adverse S`�charge Fee) Determination '•!P - IX. Conditions of Approval /Reasons for Disapproval: l4(i ic, sy5 a ��s�u.�v�S d►...� noSi c�a.� c� I " 6a— eSl e Iu�.n� �e tee` FL00o R A W = "srvgC) SBD -6398 (R. 07/00) �� �� ■ S o; I Qb�S¢r'Ya �'on /0 s6axe .3677 sec.'?, T , 0�'So.►�u�Sc z P -o os� v 1 4 1 1 - 1 � s PrirA-ry 5YSf Arcq ■ ■ IN, r o.-- Ptopo'-sed welt -rm 30.3y v e � hl tl / ;ne p d bcdr"m � Pd� £ c v d as � ■ �P�opo�e.d ,, Sao �«.P, se.,o�'� �a.,�t'. iQ Otte I& I ed f /ef . O be in 4 f 6asc. Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites According to Chapters ILHR 20& 21 of the Wisconsin Uniform Dwelling Code, soil erosion control informa- tion needs to be included on the plot plan which is submitted and approved prior to the issuance of building permits for 1 & 2 family dwelling units in those jurisdictions where the soil erosion control provisions of the Uniform Dwelling Code are enforced. This Standard Erosion Control Plan is provided to assist in meeting I this requirement. Instructions: I 1. Complete this plan by filling in requested information, completing the site diagram and marking ( ✓) appropriate boxes I on the inside of this form. 2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading. Water runoff patterns can change significantly as a site is reshaped. 3. Submit this plan at the time of building permit application. Site Diagram Scale: 1 inch = feet EROSION CONTROL PLAN LEGEND PROPERTY LINE t _ _ EXISTING ' DRAINAGE TD TEMPORARY DIVERSION FINISHED -' DRAINAGE LIMITS OF 4 GRADING SILT FENCE STRAW BALES GRAVEL I VEGETATION SPECIFICATION i ' TREE PRESERVATION STOCKPILED SOIL Please indicate north by completing the arrow below. —N— PROJECT LOCATION BUILDER OWNER I WORKSHEET COMPLETED BY ' � Tyyl b DATE k i EROSION CONTROL PLAN CHECKLIST { g oo ` J Q Check (./) appropriate boxes below, and complete the site diagram with necessary information. Q QQ �oF / 2 0 Site Characteristics C� North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. ❑ C� Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ ?" of storm sewer inlets. Location of existing and proposed buildings and paved areas. i?` The disturbed area on the lot. P" Approximate gradient and direction of slopes before grading operations. k' Approximate gradient and direction of slopes after final grading operations. ❑ G�Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices V' 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). e' ❑ Location of sediment controls (filter fabric fence, straw bale fence or 10 -foot wide vegetative strips) that will pre- vent eroded soil from leaving the site. ❑ Location of sediment barriers around on -site storm sewer inlets. ❑ F? Location of diversions. Note: Although not specifically required by code, it is recommended that concentrated 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. Cam❑ 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 sediment fences, diversions, and re- vegetation by sodding or by seeding with use of erosion control mats. ❑ Q*� Location of practices that will control erosion in 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 of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams (streams with year -round flow.) ❑ lv Location of other planned practices not already noted. a c� Indicate management strategy by checking ( ✓) the appropriate box: � Q� mss Management Strategies l< ❑ 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 1st and September 15th), or by other cover, such as tarping or mulching. De Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment). Indicate re- vegetation method: Seed L�Sod ❑ Other ❑ Expected date of permanent re- vegetation: 4r, L , 2coJ Re- vegetation responsibility of: Builder ❑ Owner /Buyer CC7� Is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? Yes ❑�No ❑ ❑ VUse 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. ❑ VTrapping sediment during dewatering operations. Note: Sediment -laden discharge water from pumping operations should be ponded behind a sediment barrier until most of the sediment settles out C?� Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water. Maintenance of erosion control practices. • Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the barrier's height. i • Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be replaced (typical bale life is three months). j • 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. 'k For more assistance on plan preparation, refer to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW— Extension publication Erosion Control for Home Builders. The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through State of Wisconsin Document Sales, 608/266 -3558. i f Erosion Control for Home Builders (GWO001) can be ordered through Extension Publications, 608/262 -3346 or the Department of Commerce, 608/267 -4405. i t EROSION CONTROL REGULATIONS UNIFORM DWELLING CODE (DEPT. OF COMMERCE) PROJECTS AFFECTED • Straw bales, filter fabric fences or other barriers to • All new 1 and 2 family dwellings in Wisconsin started protect on -site sewer inlets on or after December 1, 1992. • Additional controls if needed for steep slopes or other • Additions to dwellings built after June 1, 1980. special conditions MAINTENANCE AND WASTE DISPOSAL APPLICATION PROCESS • Sediment controls must be maintained until the site is • Erosion control measures must be included on the plot stabilized by mulching and seeding, sodding or plan submitted with the building permit application to landscaping the local building inspector in communities where the e All building waste must be properly disposed to pre - dwelling code is enforced vent pollutants and debris from being carried off -site • Plot plan must show: ENFORCEMENT — Location of the dwelling, other buildings, wells, sur- face waters and disposal systems on the site with •Erosion control inspections will be made during other respect to property lines regular inspections (footing and foundation, rough con - struction, final, etc.) — Direction of all slopes on the site •Violations must be corrected within 72 hours — Location and type of erosion control measures • Stop work orders may be issued for noncompliance CONTROLS REQUIRED FOR MORE INFORMATION, CONTACT • Silt fences, straw bales, or other approved perimeter • Local building inspector measures along downslope sides and side slopes • Department of Commerce, Safety and Buildings Divi- sion, P.O. Box 7969, Madison, Wisconsin 53707, • Access drive (608) 266 -2128. STORMWATER PERMIT (DNR) PROJECTS AFFECTED — Proposed erosion and storm water pollution control • Any grading or construction project that disturbs 5 practices during and after construction acres or more and is not covered by a building permit — Documentation that an erosion control and storm • Smaller sites that are part of a planned development water management plan which meets DNR standards involving 5 acres or more of land disturbance has been prepared (plan does not need to be submit- • Effective October 1, 1992 for any new or continuing ted with the application) project —Other information related to site location and per- • Exceptions: Indian tribal lands and work done by local mit holder government staff CONTROLS REQUIRED APPLICATION PROCESS • Erosion control measures specified in the Wisconsin • File a "notice of intent" application (Form #3400 -161) Construction Site Best Management Practice Handbook with the Department of Natural Resources (DNR) 14 • Measures to control storm water after construction days before construction begins FOR MORE INFORMATION, CONTACT • Application must include: • Department of Natural Resources, Storm Water Per- - Timetable for land disturbing activities and installa- mits, P.O. 7921, Madison, WI 53707 -7921, (608) tion of erosion control measures including project 266 -7078 start and completion dates LOCAL ORDINANCES Check with your county, and city, village or town for any local erosion control ordinances including shoreland zoning requirements. Except for new 1 & 2 family dwellings, local ordinances may be more strict than state regulations. They may also require erosion control on construction projects not affected by state or federal regulations. A publication of the University of Wisconsin— Extension in cooperation with the Wisconsin Department of Natural Resources and Department of j Commerce, Ron Struss, Water Quality Educator, UWEX Western Area and Carolyn D. Johnson, Urban Water Quality Educator, UWEX Southeast Area. UW— Extension provides equal opportunities in employment and programming. This publication is available from county UWEX offices or from Extension Publications, 630 W. Mifflin St., Madison, WI 53706, (608) 262 -3346. Copyright 1997 by the Board of Regents of the University of Wisconsin System doing business as Cooperative Extension, University of Wisconsin— Extension. Send inquiries about copyright permission to Director, Cooperative Extension Publications, 201 Hiram Smith Hall, 1545 Observatory Drive, Madison, WI 53706. GWQ001A Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites DNR: WT -458-96 R -02- 97- 2M -1 0—S o � 21997' L 8 2 jo oF:lrn /o - 1I 6 - t4' X l�tv • /of 3 C Sm d o-P iy 3877 Sec.9, r , of ��ncrscz�, 5�. CroiX Co pr Top Soil r� Laced ups pl��, �^ pr �f Sce -o�ud '40 e�q 5A-e d �cY Pr;ma-r Sys-tem Areq 13 G r 5 /sue -- So7( -Eon 8 Seeded got Wi Kte - 3 .Stole 8 1 51 - E b �d Pcoposcd we rl N '�4s 3o2y �v e•�F�ue.+f. line �roPo�ed �/ � hedreom P. r. 6. d © be ih-I& a Cck - r - , / o of elee . ira.,,� 6,2 E /e%' - /o S 3 0(.' /11 / 1221 Wisconsin Department of Commerce SOIL EVALUATION REPORT pa 1 of 4 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sal & Site Evaluations Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 032 - 2035 -10 -300 Please print all information. R .ewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). `/� 11 — fl4 — z Ltd Property Owner Property Location Nottingham Devleopment / Greg Johnson Govt. Lot NW 1/4 SW 114 S 9 T 30 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSW 6750 Stillwater Blvd. 3 Proposed CSM City State Zip Code Phone Number _ j City A Village t6 Town Nearest Road Stillwater MN 1 55082 1 6561 -439 -2414 Somerset 1 50Th Street New Construction Use: Residential 1 Number of bedrooms 4 _ Code derived design flow rate 600 GIRD _J Replacement _j Public or commercial - Describe: Parent material Glacial till _ Flood plain elevation, if applicable NA General comments and recommendations: Install trenches using high capacity infiltrators. M i6 Boring # A Boring Pit Ground Surface elev. 112.98 ft. Depth to limiting factor >91 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= *Eff#1 *Eff#2 1 0 -7 10yr3 /3 None sl 2fsbk mvfr as 2f 0.5 0.9 2 7 -18 5yr3/4 None scl 2msbk mfr aw 1f 0.4 0.6 3 18 -30 5yr3/4 None gr. sl 2msbk mfr aw if 0.5 0.9 4 30-44 7.5yr4/6 None sl 2csbk mfi gw if 0.5 0.9 5 44 -91 7.5yr4/4 None sl 2csbk mfi - 0.5 0.9 Lil Boring #ng Pit Ground Surface elev. 112.95 ft. Depth to limiting factor _ y121" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fP t*Eff#1 *E 1 0 -12 10yr3/4 None Ifs 1 fsbk mvfr as 2f 0.4 0.6 2 12 -23 10yr3/4 None sl 2msbk mfr aw 1f 0.5 0.9 3 23 -38 7.5yr4/6 None gr. sl 2msbk mfr aw if 0.5 0.9 4 38-49 7.5yr4/6 None sl 2msbk mfi gw if 0.5 0.9 5 4 -121 7.5yr4/6 None sl 2csbk mfi - 0.5 0.9 i Info . * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30(< 150 mg/L * uent #2 = BOD mg/L and TSS <—, O mg/L CST Name (Please Print) Signat re: CST Number James K. Thompson ��� 7 � Dj -- 3602 Address A C.E. Sal &Site Evaluations Evaluat ion Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54 0 00 715- 248 -7767 property owner Nottingham Devleopment / Greg parcel ID # 032 - 2035 -10 -300 Page __ _ of 4 3 ] F Boring # Boring 1C� Pit Ground Surface elev. 113.61 ft. Depth to limiting factor >96" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP *Eff#1 *Eff#2 1 0 -8 7.5yr3/4 None sl 2fsbk mvfr as 2f 0.5 0.9 2 8 -15 7.5yr4/4 None gr. sl 2msbk mfr aw if 0.5 0.9 3 15 -24 5yr4/6 None scl 2msbk mfr aw if 0.4 0.6 4 24 -38 5yr4/4 None sl 2csbk mfr gw If 0.5 0.9 5 38 -96 7.5yr4/6 None gr. Is Osg ml - 0.7 1.2 Ong # Boring !!� Pit Ground Surface elev. 110.23 ft. Depth to limiting factor >92" in. go! Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKV *Eff#1 *Eff#2 1 0 -10 10yr3 /2 None sl 2fsbk mvfr as 2f 0.5 0.9 2 10 -21 10yr4/4 None sl 2msbk mfr aw 1f 0.5 0.9 3 21-42 7.5yr4/4 None gr. sl 2msbk mfr aw If 0.5 0.9 4 42 -74 5yr4/4 None sl 2csbk mfi gw if 0.5 0.9 5 74 -92 7.5yr4/6 None sl 2c sbk mfi - 0.5 0.9 1. /b fi� F5-1 Boring # A B Pit Ground Surface elev. 109.96 ft. Depth to limiting factor >87" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots : *Eff#1 "Eff#2 1 0-6 10yr3/3 None sl 2fsbk mvfr as 2f 0.5 0.9 2 6 -16 5yr3 /4 None scl 2msbk mfr aw 1 f 0.4 0.6 3 16 -32 5yr3/4 None gr. sl 2msbk mfr aw If 0.5 0.9 4 32-50 7.5yr4/6 None sl 2csbk m fi g w if 0.5 0.9 5 50-87 7.5yr4/4 None sl 2csbk mfi - 0.5 0.9 * Effluent #1 = BOD 5> 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. N you need assistance to access services or need material in an alternate format, vlease contact the department at 608 -266 -3151 or TTY 608- 264 -8777. property Owner Nottingham Devleopment / Greg Parcel ID # 032 - 2035 -10 -300 Page 3 of 4 6 ng # 3 Boring Pit Ground Surface elev. 113.10 ft. Depth to limiting factor > 123" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots : *Eff#1 *Eff#2 1 0-6 1Oyr3/3 None sl 2%bk mvfr as 2f 0.5 0.9 2 6 -24 7.5yr4/4 N one gr. sl 2msbk dsh aw if 0.5 0.9 3 24 -51 1Oyr5 /6 None s Osg ml cw - 0.7 1.2 4 51 -123 1Oyr4/4 None gr. sl 2msbk dh - - 0.5 0.9 D 7 goring # " Boring jA Pit Ground Surface elev. 109.18 ft. Depth to limiting factor >92" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -15 1Oyr3/2 None sl 2fsbk mvfr as 2f 0.5 0.9 2 15 -26 1Oyr414 None sil 2msbk mfr aw 1f 0.5 0.8 3 26-42 7.5yr4/4 None gr. sl 2msbk mfr aw if 0.5 0.9 4 42 -74 5yr4/4 None sl 2csbk mfi gw if 0.5 0.9 5 74 -92 7.5yr4/6 None sAs /sl 2csbk mfi - 0.5 0.9 Horizon #5 consists of an unsorted mixture of Osg s, 1 msbk Is, & 2csbk sl. No redox features observed at interface of tedural changes. F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < �O 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 - 2644777. SQ I° oF;ron /off Std. ■ S ;� pbse�Yau rn� /;� /l o� � �ta„� 1�.ev�• /of 3 ('Sr,4 do- iy . 3$ 77 Sec. 9, T , o rSo�crst�, Cl- it�i. / ■ ■ l7G r By ■ t �2 v ■ a � v v Ci � 8+ of elee.f✓,a„s,�,.nd.- Q e%` : lo5 ' NOV-03-2000 0 9: 2 6 Atli A. C. E. S o i l F- S i r e Eva I. 1t� X 4 0 - 1'T6 4 P-02 r • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O RSHIP CERTIFICATION FORM Owner/Buyer Mailing Address _ 6 7.50 ,�ll s; ter' / ✓� ., �rE �/� k �•- rr1.� . SSo87 Property Address (Verification required hrom Planning Department for new construction) City tate Parcel Identification Number Q3Z -z03S /0 -3c1� LEGAL DESCRXI.'TION Property Location t7 cJ %, n (-J '' /., Sec. 9 T N -R F9 W, To w L 01 Subdivision . Lot # 3 Certitled Survey Map # Volume Page # -3:5 2 7 Warranty Deed # (9 3 2 - 6 4'5 - --- -- , Volume (SS y , Page # Spec house Byes ❑ no Lot lines identifiable &-Y-es 11 no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every throe years or sooner, if needed by a liccused pump -r. What you put into the system can affect the ftunction of the septic tank as a treatment suige in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a ccrtlflcation form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a liceased 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. Vwr, the undersigned live read the above requirements and agree to nuintain the private sewage disposal system with the standards set forth, herela, 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 rew med to the St. Croix County Zoning Office within 30 days of the ear expiration date. SI APPLICANT DATE QWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) lmowledgc. I (we) am (are) the owners) of the property d e Bove, by virtue of a warranty decd recorded iu Register of Deeds Otl'icc. k j /03/cy ATURE O DATE 0 Any information that is mis- represeutcd may result in the sanitary pe rmit being fevoked by the Zoning Department. '• Include with [his application: a stamped wan dced frotn the Register of Decds offacc a copy of the certiflW cu. -vey map if reference is made in the warranty deed Conventional System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD- 10567 -P (8.6/99). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281 A8, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The utlet tilt shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enc osure. I�the filter is pP ui ed with an alarm, the filter shall be serviced if the alarm is activated. Septic tank eq manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface within the system and will promote frost penetration during cold weather months. Cold weather installations (October - February) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by removing biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to your county zoning or health inspector. Pg. 4 Of 5 t5 54 PAGE 53 + STATE BAR OF WISCONSIN FORM 2 - 1999 632665 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Nottingham Development, LLC, RECEIVED FOR RECORD byGreg Johnson, its sole member, _ 10-30 -2000 9:30 AM _ WARRANTY DEED Grantor, and Manchester Homes, Inc. EXEMPT N CERT COPY FEE: _ COPY FEE: TRANSFER FEE: 134.70 - - - -- RECORDING FEE: 10.00 — _ PAGES: 1 Grantee. 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): Recording Area That part of NW 114 SW 114, Sec. 9- T30N -R 19W described as follows: o Name and Return Address of Certified Survey Map recorded in Vol. 14 of Certified Survey Maps, Pap 3877 as Doc. No. 624984, St. Croix County,W�sconsin. DAVID J. ESTREEN 304 LOCUST ST. HUDSON W) 54016 1 032- 2035 -10 -300 Parcel Identification Number (PIN) This is not homestead property. Oil) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this a 3 r day of October 2000 Nottingham Develop LC + + Greg Johnson, i "s m ber AUTHENTICATION ACKNOWLEDGMENT Signature(s) Nottingham Development. LLC, by Greg Johnson, STATE OF WISCONSIN ) its sole member, ) ss. County ) authenticated th' of October 2000 - - -' Personally came before me this day of the above named ristina Ogtand _.. TITLE: MEMBER STATE BAR OF WISCONSIN - -- - - (If not, to me known to be the person(s) who executed the foregoing authorized by } 706.06, Wis. Slats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorn Kristina Ogland __- Notary Public, State of Wisconsin n, WT 540[6 __. My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) _- ._._.._.._._. __._— > •) • Names orpersons signing in any capacity must he typed or printed below their signature. InronabW Prureerbnea c ompan y. Faa au Lac, W1 STATE BAR OF WISCONSIN 90p - 7021 WARRANTY DEED FORM No. 2 -t999 \ 624984 CERTIFIED SURVEY MAP r rS 'ED IN PART OF THE NW1 /4 OF THE SW1 /4 OF SECTION 9, T30N, R1 9W, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. SCALE IN FEET 1" = 200' PREPARED FO R: NOTTINGHAM DEVELOPMENT L.L.C. 200 0 200 400 GREG JOHNSON MLMG° UUU[ED LQG�D� 324 S MAIN STREET --- _— __ —_ -- STILLWATER, MIN Q) GWHEED N3V 04G11L G°3� (1151) 439 -2414 ----------- W I /4 CORNER EAST - WEST 1/4 LINE OF SECTION 9 SECTION 9 165TH AVE. N 89 08 " Ol 62 W 27 6 */-j N 69'27'08" W 3.00 59c�01 4644.51' . \ ° �..OT: �' a, E I / 4 CO R NE R , z Q� o, o+ N H.111.L `.,�: ro SECTION 9 .5 "'o I ACRES c ul O �� v ��J �/ w rn A ",.:;.:: a LL ce n O� �_ 3 89 27'0$ ' E;'::K.i.:OJc; ,� z� pQOvy ►- In _°�/ LU w ¢ j W 3 013 ACRES cc t-Li LL �, �5� � o cc QOO A Q/ C/) LL) o LJ A ' Y ES pp, S 89 E s18,10` JJ ��, PR VATE ROAD EASEMENT �`0 17'8" fSZ / y0 1, l7oc r N 89 '01" W 53.00' — JD (o 2 y 9$ 3 e9a o a � / CONTIGUOUS BUILDING AREA � � UJI '" v �Q / LOT 2 1,3 AC U Lo LOT 3 1.3 AC ...LOT 2 LOT 4 2.5 AC ° i U) U I `� 3540 ACRES DI o ` I i5 SQ Fr OE'I $ $ I �Q/ CURVE DATA I� � t o I u- 1 ti Z I W <g/ NUMBER T RADIUS 233.00' dl �I 3 I N 89'44'18" W 353.02 v+ DELTA ANGLE 08'54'03" H.W.L. = n CHORD DIRECTION S 84 E LL 898,0 $ AR H ORD ENGN TH 36.20' O w 3 3 I.E- -- Y TANGENT IN S 89'12'01" E z to N TANGENT OUT S 80 E .. LEGEND OWNER I 131 $Q`. FT ALUMINUM COUNTY SECTION CORNER GAYLEN SCHILLING 33.00' MONUMENT FOUND 498 150TH AVE. 3S3;Oc�' 1' X 24' IRON PIPE SET WEIGHING SOMERSET, WI 64025 8 4'18' E 386,02' 1.13 LBS. PER LINEAR FOOT I SOUTH LINE OF THE NW1 /4 OF THE S \J1 1 4 100' ROADWAY SETBACK LINE I EXISTING DRIVE SENIE 1 I I •' LITIL IT/ �C.AC� 1CAIT _ AP P ROV PROPOSED DRIVE ST. CROIX COUNT, o X EXISTING FENCELINE Planninq Zoning and Parks C ge STORM WATER RETENTION AREA TO JUN 1 6 2000 HIGH WATER LINE ti H.W.L. — HIGH WATER LINE ELEVATION If not recorded Within 30 days of oo NOTE A GRADING THAT WOULD ALTER THE CAPACITY approval date approval shall be �� OF THE STORM WATER RETENTION AREA null and void �j' IS PROHIBITED SW CORNER NOTE B BUILDINGS ARE PROHIBITED WITHIN SECTION 9 c�7J O THE STORM WATER RETENTION AREA THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO. 99 -153 DATE 6/15/00 VOL. 14 PAGE 3877