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HomeMy WebLinkAbout032-2121-40-000 yw artmentofCommerce PRIVATE SEWAGE SYSTEM Countft. Croix Safe ings Division INSPECTION REPORT ` ENERAL INFORMATION (ATTACH TO PERMIT) sanitagvo.: Personal information you provice may be used for secondary purposes [Privacy Law, j(15.04 (1)(m)]. Ikff e ,'J &@ 711 ❑ cit ❑ v96"(W @VTWwnshi State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parce16302121- L (r r TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark GS Zj C2 Z/ ®32, Ion Bldg. Sewer ZS - Holding St Ht Inlet 5V '7� . Z TANK SETBACK INFORMATION t Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Air Intake Septic / 0 Q / NA IF NA Header / Man. Aer Dist. Pipe _ Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade nufacturer Demand St cover Model Nu PM Lift Friction m TDH )F Forcemain Length Dia. Dist. To well SOIL AB PTION SYSTEM _ BED / REN Width , Length , No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth IMEN 3 , DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LE ING I -r acturer: INFORMATION Type O U BE Moe Number: System: Ch , > IOU l 7 1 �_ OR DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) / x Hole Size x Hole Spacing Vent To Air Intake Length Dia. _ Length �7SDia. �/� Spacing 4 W SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only xx Seeded /Sodded xx Mulched Depth Over Depth Over xx Depth Of Bed/ Trench Center Bed /Trench Edges Topsoil ❑Yes ❑ No E] Yes E] No COMMENTS: (Include code discrepancies, persons present, etc. Inspection #1: �o IU /Q� Inspection #2:' / / - 5 4 Location: 1670 85te, Somerset, WI 54025 (SE 1/4 NW 1/4 12 T30N R19W) - 1230191096 North Bass Lake Estates -Lot 27 1 -) Alt BM Description = yep o� �a� ���w�• o s�A; 2.) Bldg sewer length= QI ' -amount of cover = yz Plan evis on eclu rl ed' Yes No > Use other side for additional inforrr(ation. L2 f� SBD -6710 (R.3/97) oat4 i nature Cert No r m� 3 .. C e o _ \yam "- a � \ � �� L /S � I Sanitary Permit Application Safety & B uildings Division In accord with Comm 93.2 1, Wis. Adm. Code 201 W. Waabingtm Ave. of See reverse side for instructions for completing this application PO Box 7302 Vi sc o D rpe of commerce Personal information you provide may be used,,jbr , Madison. W1$3707 - 7302 (Privacy Law, s. 15.04(#X0 (Submit completed form to county if not , 7 state owned, h co late lane to the Pour co only or on per not 8-1/2 x 1 es in size. County /J tare an P ..ft Number Won s Awl 1 1. um J ri L_Aff l1e:itVo — n ntornta on - ease nt ati information - 'fta II�oeatioa; Property Location /' r -w Sl �. lie 14, S/ OT - FWPwY � � l � � �' � t urn try, W E 1'hont i ome or Y l , I TY' o Hu! t (e edc one) c ity 1 or 2 Family Dwelling - No. of Bodroorms : � O 1 ge D bIiC/Comme (describe use):_ of D SUW-Owned '5Z T j / .'� l !Nearest lioa� ld r NOW 11 - L of rm t: (C onl Otte box on line A. Chec box on lint; B if ficabfe) A) lacetnent eplacement of 4. 5 . Addition to System system Tank Only Existing system D A S=Itwv Permit was p= iousk issued Pe rmit Num ssu° • TYPe Of rem: (Check all that apply) D "pressurized In'ground D Mound O Sand Filter Constructed Wetland D At grade In-ground D Holding Tank D Single Pass D Drip Line © Aerobic Treatment Unit O Recirculating D Other: V. DispersarT Mont Area ntormation: � - 1. cad Mat 3, p Area ppllettion 5. Parcolad = 6. ystem ev Fin Proposed Rate (GalsJday /sq. ft.) (Min lincdt) �` �', Elaystion l� Vil Tank Capacity in Total+ of Manufacturer Site i e Information Gallons dailono of Con. Con_ glass ew trite strutted TaNcs — Tanks D O VIII. Zipo bility Statement I'LIVOWS NOW 1, the !Ldonfl#=4 assume res IbIlIty for installation of the POWTS shown on the attached Dlons. m P1= s no stamps : o. _ ( j BUSI MrA Nu PIMWW% A ,p EL Cau»ty/Depnrtmant se Only E3 Dfs*Vroved S t LAPAo'oved D Owns' Given Initial Adverm suur arse Fee) ee Includes ater slee t u etm fennittallott p 6° t l X. COndltiong of Approval /Reasons f or D pproval: Pis C6.00 �oQB �.r � r,�.:� (� e-L si' s SBD -6398 (R. 07100) C� I ry OT PLAN PROJECT Joe Raustadt ADDRESS 3876 Lakewood Ave White Bear Lake Mn 55110 SE 114 IVW 1 14S 12 /T 3 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 ! DATE 5/6/01 BEDROOM 3 CONVENTIONAL )00( IN -GR U D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of 2 " Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL •H.R.P. Same as Benchmark SYSTEM ELEVATION 95.8/95.3 Alt. BM Top of Wood Lath @ 101.8' Vent j6'Long Sidewinder High Capacity Leaching Chamber 300' 588' Property Line " 3491 Grade at S ystem Elevation Plans Designed Using 160' Conventional Powts Manual Version 2.0 2 -3' X 69' cells with >3' Spacing To 85th St, Vents B -2 20' 9% 20 , ST 5' 0 3 Slope _1 * 30 , Bedroom 10' B M H ouse 10' Alt. Vents .M. 10' Drainage Easement C a� a I M XDPRESSURE T PLAN PROJECT Joe Raustadt ADDRESS 3876 Lakewood Ave White Bear Lake Mn 55110 SE 1/4 NW 1/4S 12 R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/6/01 BEDROOM 3 CONVENTIONAL X IN -G )00( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 IL BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE ( DWELL - H.R.P Same as Benchmark SYSTEM ELEVATION 95.8/95.3 Alt. BM Top of Wood Lath @ 101.8' Vent > 12" Sidewinder High of Cover Capacity Leaching 300' Chamber 588' Property Line 6' Long 16" 3 4" Grade at System Elevation Plans Designed Using 160' Conventional Powts Manual Version 2.0 2 - 3' X 69' cells with >3' Spacing To 85th St, Vents B -2 20' 9% Slope 20 - ST 5 ' o3 -1 * 30 , edroom B.M. `+^ 10' House 10' Alt. Vents .M. 10' a� a Drainage Easement 1~ a M ' -u 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. / / r4/ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I Property Owner Property Location ? J oe—, � � Govt. Lot 1/4 IV1 /4 V v N R � E (o CW Property Owner's Mailing AddressGt�lc Lot # Block # I Subd. Name or CSNJ# City State Zip Code Phone Number ❑ City ❑ Village wn Nearest Road (al) 6,- 3--0'j w Construction Usa>g�Residential / Number of bedrooms Code derived design flow rate J Q GPD ❑ Replacement ❑ Public orr m / mercial - Describe: Parent material Flood Plain elevation if applicable and recommendations: m comments end t and recommendati ons: � s • 3 M Boring # [] Boring c7l 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 L11 - p /! 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 /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 " Eff#2 J - d 4x- 4 s 3 ��/ ✓` .S c � �,� ,� r2 * Effluent #1 = SOD > 30 < 220 mg /L and TSS >30 _< 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Nam (Please Print) atpfe ST umber Q � t Address Date Evaluation Conducted Telephone Number lay j�F 2 A., 0 J VOi 2 1 - o/ /s-� SBD -8330 (R07 /00) i Property Owner Parcel ID # Page of [] Boring a Boring # Q O—Pit Ground surface elev. UU 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 l - . 41C - 1 i Qs . ❑ 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 /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ 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 m /L and TSS >30 < 150 m /L * Effluent #2 = BOD < 30 m /L and TSS < 30 m /L s < _ g _ g s_ g _ mg /L 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) � Soil Test Plot Plan Project Name Joe Raustadt Shaun Address 3876 Lakewood Ave White Bear Lake Mn 55110 C 2 6900 Lot -- --- Subdivision ---- - -- Date 5/6/01 SE 1/4 NW 1/4S T 30 N/R 1 9 W Township Somerset R Boring ()Well PL Property Line County S T. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" Pipe System Elevation 95.8/95.3 *HRp Same as Benchmark Alt. BM Top of Wood Lath @ 101.8' 300' 1 588' Property Line 102' 160' 101' 100' 99' To 85th St, -2 20' 9% B -3 Slope 2 7 Pro 3 -1 50' Bedroom 10' ouse 10' Al .M. o 10' 0 a Drainage Easement a 0 60 M # 7— '161 - 0 g Sanitary Permit Application Safety do Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. NO Deportment of Commerce scons See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 [Privacy Law, s. 15.04 (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) fort n pape s 8 -1/2 x I 1 inches in size. Crary Permit County i State S it Number ❑ C c vision vious IFAl State Plan 1. D. Number I. A lication Information - Please Print all Information Location: Property r a operty on Q CROIX f F 1/4 /4, S 2 T �v,N, {or Property Owners Mailing Address ) OUNTY Lot Number Block umber �� !^ IGCJavzJ' '' ZG r ` .,� _ Crn Z p ode Phb4p N)ain Sub rvtsron ame or S Number VE IPI pe of Building: (check one) 13 City or 2 Family Dwelling -No. of Bedrooms : ❑ Village ❑ Public/Commercial (describe use):_ AMTown of ❑ State -Owned Nearest Road 63i`T. C4 3 / K t0 0 • ` , ' ' - �T ern t.Qi` t; S arcel um s e r M. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. M ew 2. 0 Replacement 3. ❑Replacement of 4. 5. 6. U Addition to System System Tank Only 1 a , 30 , f Oq�, Exi S stem B) Permit N umber ate ssue D A Sanitary Permit was previous! issued IV. Type or POWT System: (Check all that apply) QWon- pressurized In- ground ❑ Mound Sand Filter O Constructed Wetland ❑ Pressurized In ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: .'/Z V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) T Dispersal Area 3, Dispersal Area 4. oil Application 5. Percolation Rate 6. ystem evatir_ . Fin e Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) �O �� Elevation U � � /Cf VII. Tank Capacity in # of Manufacturer Prefab Site Steel i ter- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks C3 CO E3 ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plum bees Name (print) P um er' re (nos MP/MPRS o. usiness Phone Numbeer Plumber's Address Street, City, State, zip re) _ 6� 7 L " IX. County/Department Use Only Disapproved Sanitary Permit Fee {Includes Groundwater Date Issued Issuing Agent Signature o stamps) proved ❑ Owner Given Initial Adverse Suroh a Fee) 6 p - Determination 2 ZS- _ U Zoa I X. Conditions of Approval /Reasons for isappr vai: • i s w ow lJ4 0. 7o 5e" (S 3j 1/VA ,. ��- (, ° D sys� vv101� `he _per" '� �,q S fe-C 6 Itil ► BkS ts SBD -6348 (R. 07/00) f}{� 5�5 ~f 10 PLO PLAN PR'OJECT' Raustadt DDRESs 3876 Lakewood Ave White Bear Lake Mn 55110 SE 1/4 NW 1/4S 12 /T 30 GR 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4/3/01 BEDROOM 3 CONVENTIONAL )00C IN -GRO D P SS RE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT' TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of SW Lot Pin ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL •H.R.P. Same as Benchmark SYSTEM ELEVATION 100.0/98.8 Alt BM Top of Mid Lot Survey Pin @ 106.40 Vent > 12" Sidewinder High of Cover Capacity Leaching Chamber 749' 6' Long 16" Property 3 4 „ Grade at System Elevation Line a� Please note: system is to be installed 2' Plans Designed Using a� a below grade along contour lines in Conventional Powts Manual Version 2.0 �° order to make the 5' seperation for coarse sand and gravels, plumber recommends doing another soil test at the time of initial excavation 4% Slope B--5 100' 101' 102' 30' B -4 B -3 50 ST Pro 3 -�- B Bedroom House Vents 2 -3' X 69' Cells with >3' Spacing 70' 4 ' B - 1 4' 33' 132' 114' P.L. 1 1 , Alt. , B.M. 39 2 26 30 3 780 Prop Line PLO PLAN PROJECT ` Joe Raustadt DDRESs 3876 Lakewood Ave White Bear Lake Mn 55110 r SE 1/4 NW 1/4S 12 /T_2 /, -]� 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4 /3/01 BEDROOM 3 CONVENTIONAL XXX IN -GRO I) P SS RE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of SW Lot Pin ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 100.0/98.8 Alt, BM Top of Mid Lot Survey Pin @ 106.40' Vent > 12" Sidewinder High of Cover Capacity Leaching Chamber 749' 6' Long 16" Property 3471 Grade at System Elevation Line a� c a Please note: system is to be installed 2' Plans Designed Using o below grade along contour lines in Conventional Powts Manual Version 2.0 order to make the 5 seperation for coarse sand and gravels, plumber recommends doing another soil test at the time of initial excavation 4% Slope - 2--5-100 , 101' 102' 30'' B -4 B -3 50 , ST Pro 3 B Bedroom House Vents 2 -3' X 69' Cells with >3' Spacing 70' 4 B -1 4 , 33' 132' 114' P.L. B M 39' 2' 26' 30' 131' � Pro ert Line 6 b or nsin Department ofIndustry SOIL AND SITE EVALUATION REPORT Pagel of 3 boy and'Human Relations Divisipri of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code / 2 7 COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 032 - 2045 -20 -200 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Gerald Smith GOVT. LOT SE 114 NW 1/4,S 12 T 30 N,R 19 for) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # I SUBD. NAME OR CSM # 11160 190th. Ave. NW 6 na IN. BAss Lake Estates First Addn CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [3rOWN NEAREST ROAD Elk River, M. 55330 (612 441 -8888 Somerset I 165th. Ave. [ij New Construction Use [x ] Residential / Number of bedrooms 4 [ ] Addition to existing building I ] Replacement [ I Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd /ft - 8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate • 7 bed, gpd /ft2 - 8 trench, gpd /ft Recommended infiltration surface elevation(s) 98.1 altr. Area= 96.8 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwaGh Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem 3 ❑ U 7 S ❑ U ®S ❑ U ®S ❑ U ® S ❑ U ❑ S ® U SOIL DESCRIPTION REPORT t. Zuvv 1 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 0 -9 10yr4 /3 none sicl 2msbk mfr gw if .4 (.5 ,:'`...1....` 2 9 -16 10yr4 /4 none sc l 2msbk mfr gw if .4 .5 Ground 3 16 -84 7.5yr4/4 none co s Osg ml na na .7 .8 elev. _-- 10 ft. Depth to limiting factor +84 11 � (q -- Remarks: Boring # 1 0 -8 10yr4 /3 none sicl 2msbk mfr gw if .4 .5 2 2 8 -18 10yr4 /4 none sici 2msbk mfr gw if .4 .5 3 18 -84 7.5yr4/4 none co s Osg ml na n .7 .8 Ground elev. 10 ft. Depth to . limiting '; factor ' +84 $ Cbi G Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Av . w RichrMn d WI 54017 Signature: Date: 12 -1 -98 CST Number: m02298 PROPERTY OWNER Gerald Smith SOIL DESCRIPTION REPORT Page 2. 6f 3R PARCEL I.D. # 032 - 2045 -20 -200 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -7 10yr4 /3 none 1 2msbk mfr gw if .5 .6 .� 2 7 -22 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 •� Ground 3 22 -84 7.5yr4/4 none co s Osg ml na na .7 .8 elev. 100 ft. Depth to limiting factor qg 9 +84 3 Z •� 2� S Remarks: Boring # 1 0 -8 10yr4 /3 none 1 2msbk mfr gw if .5 .6 ,S^ 4 2 8 -16 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 •'� 3 16 -84 7.5yr4/4 none co s Osg ml na na .7 .8 .�- Ground elev. 9 9.9 ft. — Depth to — limiting factor +84 Remarks: Boring # 1 0 -9 10yr3 /3 none sicl 2msbk mfr gw if .4 .5 2 9 -25 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 . J 3 25 -84 7.5yr4/4 none co s Osg ml na na .7 .8 Ground elev. 9 9.9 ft. Depth to limiting factor +84 Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) PRO,PERMOWNER Gerald Smith SOIL DESCRIPTION REPORT Page 2 •, of • 3 PARCEL I.D. # 032- 2045 -20 -200 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BorX�dary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -7 10yr4 /3 none 1 2msbk mfr gw if .5 .6 2 7 -22 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 Ground 3 22 -84 7.5yr4/4 none co IS Osg ml na na .7 .8 elev. 0 ft. Depth to limiting factor +84 32 •� Remarks: Boring # 1 0 -8 10yr4 /3 none 1 2msbk mfr gw if .5 .6 k 4 2 8 -16 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 3 16 -84 7.5yr4/4 none co s Osg ml na na .7 .8 Ground elev. 9 9,19 - ft. Depth to limiting factor +84 Remarks: Boring # 1 0 -9 10yr3 /3 none sicl 2msbk mfr gw if .4 .5 2 9 -25 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 3 25 -84 7.5yr4/4 none Co s Osg ml na na .7 .8 Ground elev. 9 9.9 ft. Depth to limiting factor +84 Remarks: Boring # Ground elev. 1 ft. Depth to limiting factor - -- F I Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L Steel Gerald Smith 1554 200th Ave. CSTM2298 SEhNW4 S12- TWN-MW New Richmond, WI 54017 MPRSW -3254 town of Somerset (715) 246 -6200 lot #6 -N. Bass Lake Estates First Addn. N 1'=40 BM.= top of SW lot pin @ el. 100 Alt. BM.= top of mid -lot survey pin @ el. 106.40' T � Gary L. Steel 12 -10 -98 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 this requirement. Instructions: 1. Complete this plan by filling in requested information, completing the site diagram and marking ( ✓) appropriate boxes 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. D 3. Submit this plan at the time of building permit application. Site Diag i Scale: 1 inch = feet EROSION CONTROL PLAN re- LEGEND PROPERTY LINE _ _ EXISTING Z DRAINAGE ON s � N _� T D TEMPORARY y DIVERSION FINISHED DRAINAGE _ LIMITS OF GRADING 'r SILT �—' FENCE PAD P �__ �_ ♦ STRAW p BALES m 1I Q GRAVEL S � O VEGETATION SPECIFICATION TREE PRESERVATION STOCKPILED SOIL n O f s P D Please indicate north by completing the gy arrow below. roe —N; to �►� I PROJECT LOCATION �UoR�� `per CS�w +�_5 L D "1 BUILDER U e ".5 CA ( aOA.54. OWNER 7 WORKSHEET COMPLETED BY P MD 404 DATE q' i j EROSION CONTROL PLAN CHECKLIST Check ( ✓) appropriate boxes below, and complete the site diagram with necessary information. Q QQ i V o F �o Site Characteristics North arro , scale, nd site boundary. Indicate and name adjacent streets or roadways. V ❑ Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ V Location of storm sewer inlets. lid Location of existing and proposed buildings and paved areas. The disturbed area on the lot. F6 Approximate gradient and direction of slopes before grading operations. L/ Approximate gradient and direction of slopes after final grading operations. I/ ❑ Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices X/ ❑ 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. i 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). i s I fence 1 -f El Location of sediment controls (filter fabric fence, st a bale e ce or 0 oot wide vegetative strips) that will pre - vent eroded soil from leaving the site. / F-1 X/ Location of sediment barriers around on -site storm sewer inlets. ❑ 1 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. ❑ 5/ 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. ❑ 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.) ❑ IV Location of other planned practices not already noted. a Indicate management strategy by checking ( ✓) the appropriate box: 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. 6/ Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment). Indicate re- vegetation method: Seed N/ Sod ❑ Other ❑ Expected date of permanent re- vegetation: !` /" o I Re- vegetation responsibility of: Builder ❑ Owner /Bu yer Is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? Yes ❑ No " ❑ 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 i pipe to stable areas such as established sod or pavement. ❑ Trapping 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 S/ Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water. S/ 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 I replaced (typical bale life is three months). I • 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. 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. Erosion Control for Home Builders (GWO001) can be ordered through Extension Publications, 608/262 -3346 or the Department of Commerce, 608/267 -4405. 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 . 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- ted with the application) J • Effective October 1, 1992 for any new or continuing � 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 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. GW0001A Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites DNR: WT -458-96 R -02- 97- 2M -1 0—S f 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. 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. Shaun Bird #226900 • r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer —'<�� Mailing Address ' 7 b 4 - cc�ir� C,r�� !� �,� ef� 1"A, S LD Property Address I G (Verification required from Planning Department for new construction) City /State Parcel Identification Number r LEGAL DESCRIPTION Location ' /a N � ' /,, Sec. 2 , TC�N -R W, Town Property , Subdivision T /�/� 1 �x��l � -S Lot # Certified Survey Map # , Volume , Page # Warranty Deed # E'/ v ��� , Volume 3l Page # Spec house ❑ ye Lot lines identifiable yes ❑ no INT SYSTEM MA _ ANCE 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 three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (arc) the owner(s) of the m oic, ty desert . above, b 3 / y virtue of a warranty deed recorded in Register of Deeds Office. � 3 u/ d I 1 SIGNATURE OF APPLICANT DATE ** * * ** A Formation that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with this application: a stamped warranty deed from the Register of Deeds office a covv of the certified survey map if reference is made in the warranty deed ,v Yogi 1531 90 627423 STATF. BAR OF WISCONSIN FORM 2 - 1999 K fHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI This Deed, made between Forest Oaks Condos, Inc. RECEIVED FOR RECORD 08 -02 -2000 9:30 AN — WARRANTY DEED EXEMPT # Grantor, and Joseph J. Raustadt and Barbara A. Raustadt, husband CERT COPY FEE: and wife, —_- COPY FEE: TRANSFER FEE: 119.70 �— - -- RECORDING FEE: 10.00 _« - -- - - - - - -- - -- PAGES: I 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 Lot 27, North Bass Lake Estates First Addition, Town of Somerset, St. Croix Name and Return Address County, Wisconsin. K106 - TINA OGLAND UZ Estreen $ Ogland Together with a joint driveway easemetn as shown on the recorded plat of P.O. BOX 359 North Bass Lake Estates First Addition, HudSon, WI 540 16 032 -2121 -40 -000 Parcel Identification Number (PIN) This is not homestead property. O{) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of July 2000 Forest , ,k, Cond —^ r raid esident AUTHENTICATION ACKNOWLEDGMENT Forest Oaks Condos, Inc., by Gerald Smith, its STATE OF WISCONSIN ) Signature(s) ) ss. President, County ) authenticated this3 f Jul y �day of 2000 — _ Personally came before me this day of the above named Kristina Ogland - --- -.,.._ — -- — —. -- —. 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 p 706.06, W is. Slats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 MY My Commission is permanent. (If not, state expiration date: - -_.— ) (Signatures may be authenticated or acknowledged, Both are not necessary.) —' - • Inbrm tl Prarescionals Company Names ofpersons signing in any capacity must be typed or printed below their signature. . Furd t�� STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2 - 1999 i co 0. N / N 28 256,560 SQ. FT. y / 5.89 ACRES LILJ LA s J i l� 3 r N N LAJ " x (V IM M S89'39'19 "W Z ^ Iy AGE 81 roi 3 : : ` �`. ���� -- 33.00' O N to ' S85'50'59 "E iv o _ ,_ _ 243.47 N N J N - / Q W N85' '59 "W -- -- .- ro 0 i - 33.00' O ' �, 50 243.47' 0 ° i _ --� 9'39`19 W v� 1� :,�9 - 3919 W ,.;. Zt `cWV 143.40 N N 2 7 3 0 112.43' N 0 ,N 257,522 SQ. FT. N CJ M M i 0 0 5.91 ACRES N O $ I V) 0 '` z 1 0 1! U) -- S89'39'19 W 779.51 259.46' 259.46' 260.59' 26 25 24 132,793 SQ. FT. 132,639 SQ. FT. - 133,216 SQ. FT. 3.05 ACRES c� 3.04 ACRES ry 3.06 ACRES N N N 3 3 U) to 0 0 N N OD 00 N : O N N n O / \ B A S- L A K E E S T A T E S \ / EAST LINE OF THE WESTERL Y 5 ACRES OF THE SE 114 OF THE NW 114 \ OF SECTION 12, ALSO BEING THE WESTERL Y LINE OF LOT 1 OF CSM \ VOLUME 11 PAGE 3025 \ N00 "E 1255.27' \ - - - -- 378.95' - - - -- ----- -- >' 226.67' - -- -------- 517.38'- - - - - -- v , c I SEDIMENTATION POND oiI j w C 25 - YEAR HIGH WATER o ELEV= 923.00' �? 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