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HomeMy WebLinkAbout032-2121-10-000 0 2 0 § ■ - � o / \ \ / \ D / } E m 2 7 e z \ w \/ CO 8 f O ° ` ® $ ( \ 2 a g ; § \ f \ \ ` ® R g « a 7 . c e « _ G / / \ \ t / \ \ § f ƒ S E R § / / § ^ ° ® ( E K \ � / f \/ E E , : zt co 3 $ / {� . \ z CL G m ( / o - a 2\ n r \ \ \ § Cn o cn % � K / \ 0 0 0 $ § rE 0 \ ° \ } o o § \ 0 o :3 m a J f \ } Ln \ c o< z \ z § \ � o > / { �- f \ \ r% \ \ 0 \ \ k CO) � / \ { 7 2 \ ƒ g \ \ { » � 22 t //} \ � 5 i }\ � � )% \ \/ . � �\ \ / \ � 2 � $ ) / \ . \ / \ o 0. \ 7 Parcel #: 032 - 2131 -10 -000 01/16/2009 03:14 PM PA 1 O F 1 Alt. Parcel #: 03.31.19.1163 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): O = Current Owner, C = Current Co -Owner O - RASMUSON, STEVEN D & RITA M STEVEN D & RITA M RASMUSON 504 239TH AVE SOMERSET WI 54025 Districts: SC = School SP = Special Prop Address es ' = Primary P P Y : ( ) Type Dist # Description ` 504 239TH AVE SC 4165 OSCEOLA SP 1700 WITC Legal Description: Acres: 3.010 Plat: 08- 017 - OAKWOOD ESTATES 2000 SEC 3 T31 N R1 9W NW NW FRL LOT 5 OAKWOOD Block/Condo Bldg: LOT 05 ESTATES EZ -UT- 1606/280 EZ -UT- 1628/638 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 03-31N-19W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 06/21/2001 649023 1665/426 WD 06/04/2001 647189 -O 16 51 /603 � � WD � 2008 SUMMARY Bill #: Fair Market Value: Assessed with: ZOU 280615 254,100 Valuations Last Changed: 11/03/2008 1�, �� Description Class Acres Land Improve Total State Reason (-P15 RESIDENTIAL G1 3.010 48,000 135,500 183,500 NO 10 Totals for 2008: General Property 3.010 48,000 135,500 183,500 Woodland 0.000 0 0 Totals for 2007: General Property 3.010 48,000 135,500 183,500 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: 09/14/2005 Batch #: 05 -11 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Qvlsion tt. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanity 84142 0 Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City []Village ❑ own of: State Plan ID No.: Germain, Mike Somerset Townshi Iz— CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.: 2_" JC_ 032 - 2131 -10 -000 TANK INFORMATION ELEVATION DATA 1 ' 9 ' TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic BEV < Benchmark J m ¢ 0-0 - C) Dosing Alt. BM t,;(o 1 3R Aeration Bldg. Sewer �• �q - Holding St /Ht Inlet T T SETBACK INFORMATION St / Ht Outlet. ( 2.31 TANK TO P/ L WELL BLDG. Ai Intake ROAD Dt Inlet .� Septic 3 �r °t r .. NA Dt Bottom Dosing NA Header / Man. S} 9 S 31 Aeration NA Dist. Pipe /0• p gs 3S� Holding Bot. System /•`t L 2 • 4g' PUMP / SIPHON INFORMATION Final Grade b� . Man acturer %GP S ZC> ' Model N TD Lift riction System TDH t ead d Forcemain Length Dia. Fi oist. lo Well SOIL ABSORPTION SYSTEM RENCH Width, Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM 3 L?. DIMENSION SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING Manu aj�urer: SETBACK CHAMBER - St�Lwr� INFORMATION Type r I Mo a Num er: System:Cr�nr►. D k 3 1 OR UNIT u DISTRIBUTION SYSTEM Header / Manifold II Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. L Dia. pacing SOIL COVER � k x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over a Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No 01 inspection / C OMMENTS: (Include code discrepancies, persons present, etc., Location: 504 239th Avenue, Somerset, WI 54025 (NW 1/4 NW 1/4 3 T31N R19W) - 0331191163 Oakwood Estates -Lot 5 d a! `l'�t S . 1.) Alt BM Description = WD 2.) Bldg sewer length = 2�$,0` - amount of cover = 18 "�- u* C-�j yx V F-o-W 0, — too 6C 9.14,- , Plan revision required? ❑ Yes ,j'"No Use other side for additional information. SBD -6710 (R.3197) Date Inspector's Signature Cert. No. 23 R r e- Sanitary Permit Application Safety &Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 ` �8'C011,Sjli Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [privacy Law, s. 15.04(l) m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system er n less than 8-112 x 11 inches in size. County— (/1 �/(���) / State San it� PermitNumber Check if rev tsi ri'(p previous application .,St °•ate Plan I. D. Num er V l 1 I. Application Information - Please Print all Information r " . , ` -: afion: Property Owner Name i PrapCrty Location E Q l/4 (, I4, S 3 T ,N, R (or Number Property Owner's Mailing Address ;7 RC7i. Lot um er ck K 13 59 wQj)A!-�) City, State Zip Code Phone Number Stlidivision Name or CSM Number ( ZY S"'1 oQ L S A E H. Type of Building: (check one) ❑ City X 1 or 2 Family Dwelling -No. of Bedrooms: 3 ❑ Village 13 Public /Commercial (describe use):_ 0Town of ❑ State -Owned 0 1 Nearest Road (� N `L 2 i x - P arcel Tax um er(s _ III. of Permit: (Check only one box on line A. Check box on line B if applicable) Q A) 1. New 2. ❑ Replacement 3. Replacement of 4. 5. b. Addition to System System Tank Only Existing System B) Perm ;,t Number Date Issue A Sanitary Permit was previously issued - Aj IV. Type of POWT System (Check all that apply) 'Non- pressurized hi- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground 0 Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade 0 Aerobic Treatment Unit ❑ Reci7lating ❑ Other: V. Dispersal/Treatment Area Information: • Z "` - 1. Design Flow (gpd) 2. Dispersal Are 3. Dispersal Amofre$�, 4. Soil Application 5. Pereolatio Ra 6. System Elevation 7. Final Grade i Required 3 z Proposed 3 Rate als. /d sq. ft. (Min. /inch) Elevation 5 D F"/, , s VII. Tank Capacity in Total # of Manufact rer Prefab Site Steel . iber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ C r IL106 1/000 / E ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume res onsibility for inst "' of the POWTS shown on ached plans. Plum bees Name print P um ig I tqusiness one Number &AAy r P lumber's Address (S treet, ity, State, Zip Code) (J IX. County/Departmeift Use Only ❑ Disapproved ❑ Approved ❑ Owner Given Initial Adverse Determination X. Conditions of Approval /Reasons for Di c 5 f S 0. I�i3tt� {U' t. IZtLt PA- x SBD -6398 (R. 07 /00) ME M M INE M moms 0 NEW MENEM WON IMP I. - Plam INN IN 1! son NOUN NO ■ ■ ■ ■ ■ ■ ■ MEN ■MEMO //� ■441 MEN/ EMMEM MEN OMM ■Mi■■ ■NMEN ■■M ■IWI ME Mrs. ' - !����M O� � .��,.�■�l , } 1 t jr i AV I t i t i . i l3 D 2nar/ i t ' i , 1 . S 1 1 ' I • a t s t } _ - t i i i t �- , r ' I , f i J t I r , t ! . I � � F , } r • , r ! i i , I i _ 3 � i S f i � 1 t 1 1 j 1 1 ! i � 3 t t 4 CC 4 � 1 , Page of MANAGE Ni' FL AN Ibis Private Onsite Wastewater Treatment Systen (POWTS) has been designed and is to be itrstaUad and maintained in according to Comm 83, Wis, Admin. Code, the in- Ground Soil Absorption Component Manual for Private Unite Wastewater TreatmerA Systems (SBB- 10567 -P; ?lure 11, 19991. 1. This POW has been designed to accommodate a maximum daily flow of g allons of domestic wastewater -per day. The quality of influent discharged into the POWTS treatment or disposal component shall be equal to or less than all of the following: a monthly average of 30 mg/L fats, oil and grease a monthly average of 220 mg/L BOD 5 a monthly average of 159 mg/L TSS. Wastewater shall not be discharged to the POWTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch. NR 140 Tables 1 & 2 at a point of standards application, except as provided in Comm 83.03 (4)m Wis. Adnim. Code. 2. The owner of this POINTS is responsible for system operation and maintenance. The following maintenance shall occur within three (3) years of the date of installation and at least once every three years thereafler� 1. The septic tank shall be pumped be a certified septage servicing operator, licensed under s2.81.48, Wis. Stats, unless inspection by a licensed master plumber or other person authorized to snake such inspection, finds less than (1/3) of the tank volume occupied be sludge and scum. More frequent pumping may be necessary to prevent solids from exceeding one -third (1/3) if the volume of the tank.. Wastes shall be disposed of by the pumper in accordance with ch. NR 113 Wis. Admin. Code. At each pumping the pumper must visually inspect the condition of the tank, baffles, rizers, and manhole cover and verify that any required locks are present. 2. The soil absorption component(s) shall be visually inspected by a licensed master plumber, certified septage servicing operator or POWTS inspector. inspection shall check for evidence of discharge of sewage to the ground surface and for ponding of effluent in the distribution cell. 3. The tank filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. The filter cartridge shall not be removed unless provisions are made to retain solids in the tank. Cleaning of the filter at more frequent intervals may be necessary. 4. Any pump, alarm or related electrical connections shall be visually checked for defects and tested to confirm that they are operating properly. 5. Reports for all system maintenance shall be submitted to St. Croix County Zoning in accordance with Comm 83.55 Wis. Admin. Code. 3. Defects or malfunctions identified during maintenance described in item 42 above shall be repaired in conformance with Comm 83, Wis. Admin. Code. 4. Anytime a failure or malfunction occurs, it shall be reported to the owner of this POWTS. Repair or connection of such failure or mafursctior_ shall comply with Comm 83, Wis, Admin. Code. 5. No one should enter a septic or other treatment tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases and rescue of a person from the interior of the tank may be difficult or impossible. 6. No product for chemical or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Department of Commerce in accordance with Comm 84, Wis. Admin. Code. 7. In the event that this POW°TS or a component of this POVM fails and cannot be repaired, the following contingency plan is proposed: The failing coin r lei aced. This may require a new soil evaluation to determine where a new soil absorption c component can be. 8. If this POWTS is replaced, or its use is discontinued, it shall be abandoned in accordance with Comm 83.33, Wis. Admin.. Code. 9. Name and number of local health agency mix Cannty —o> ig - 715 - 386 -468 . 10. Name of service contractor in case of failure or matfunetiorL Schmitt & Sons Excavating 715 -549 -6651 1036 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt County Attach complete site plan on paper not less than 8% • size. Plan must St. Croix include, but not limited to: vertical and horizon f 'nt B ection and percent slope, scale or dimensions, north istaA o nearest road. parcel I.D. 032 - 2131 -10 Please pri formal. `. R viewed By Date � Personal information you provide may ir�Edfor secon j u (�ivacy Law, s. 15� 4 (1) (m)). Property Owner i Prdperfy Location M & G Inc r' , 7 � 1 Goy Lot na NW 1/4 NW 1/4 S 3 T 31 N R 19 W Property Owner's Mailing Address `... - -' ST ( ;FOX tvt# Block # Subd. Name or CSM# 1359 Awatukee Trail Opt�NT'`l ' 1, 5 na Oakwood Estates City State 2T Jam` umber I City j Village e. Town Nearest Road Hudson WI 5 6 =371 Somerset 50Th St. New Construction Use: IJ Residential/ Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement I Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Areas I & It are both suitable for conventional drainfields with ratings of 0.7gpd /sqft. Possible system elevation for area I is 94.0' High trench 93.46' low based on 6% slope Boring # I Boring ✓l Pit Ground Surface elev. 99.74 ft. Depth to limiting factor >108 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ F in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 1 0 -5 1Oyr3/3 none sit 2mgr mfr cw 2m .5 .8 2 5 -15 1Oyr4/3 none sil 2msbk mfr gw 1f .5 .8 3 15 -36 1Oyr4/4 none sicl 2msbk mfr gvv - - - -- .4 .6 4 36 -73 1 Oyr5 /4 none Is 1 msbk mvfr gw - - - - -- .7 1.2 5 73 -108 10yr5/6 none ms Osg ml - - -- - - - - -- .7 1.2 D r Fil Boring # Boring lei Pit Ground Surface elev. 99.23 ft. Depth to limiting factor >103 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP5/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I " Eff#2 1 0 -5 1Oyr3/2 none sit 2mgr mfr cw 2m .5 .8 2 5 -16 1Oyr4/4 none sicl 2msbk mfr gw 1f .4 .6 3 16-40 1 Oyr4 /4 none Is 1 msbk mvfr gw - - - - -- .7 1.2 4 40 -50 1Oyr5/4 none sl 2msbk mfr gw - - - - -- .5 .9 5 50 -103 10yr5/6 none ms Osg ml - - -- - - - - -- .7 1.2 " 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 CST Name (Please Print) Signature: / CST Number Thomas J. Schmitt a 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 3/31/01 715 -549 -6651 c Property Owner' M & G Inc Parcel ID # 032 - 2131 -10 Page 2 of 3 3] Boring # Boring ✓J Pit Ground Surface elev. 96.50 ft. Depth to limiting factor > 107 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D : in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/2 none sil 2mgr mfr cw 2m .5 .8 2 9 -23 10yr3/3 none I 2msbk mfr gw 1f .5 .8 3 23 -42 10yr4/4 none Is 1 msbk mvfr gw - - - - -- .7 1.2 4 42 -54 10yr4/4 none sl 2msbk mfr gw - - - - -- .5 .9 5 54 -107 10yr5/4 none Is Osg ml - - -- - - - - -- .7 1.2 F-1 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 PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # I Boring y J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots D 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 —A 1 1;7 — T ry 9nQ_7AA_Q'7'7'7 I I rte- 6 a � P vc I L A. 1 i I : - ` -- ' w D � O'' br& Al 4c4 r z + I ' ;I i �Jq ; _ AI�J-� 7` t L i i i -- - _- -- � -_ � - -. i. _. -.. �. i _- -- i i _ ,_ � I ? � ' I __ ; _ � _ �_ � � _.__ �_ I , f i -F - -- � � i -_. ', � i, � _ �, I I i, � �, f � �� i I ' � __ ' �I ,1 I 1 i i t I ' _ I � � � t � � � �- � -_.... i i i � � � -- -v. r i � � i f - �... j .J i i i �.._ _ I � r i - _ _- I - - r - -- '. i � _ _- __ -. - i - i - -- ._ i I � I I - t ' ' I TM I � �� , - � � - -_ � ._ , 1 '. i � � � �_ i WhKion Denartmentof- COmnerce PRIVATE SEWAGE SYSTEM � Division PRIVATE Safer wW nt ' INSPECTION REPORT S Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes (Privacy Law s.15.04 (1)(m)). 384142 Permit Holder's Name: ❑ City ❑ Village ❑ own of: state Plan ID No.: ermain, Mike Somerset Township T BM E ev.� Insp. BM Elev.: BM Description: Parcel Tax No.: 032- 2131 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/L WELL BLDG. ventto ROAD bt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header /Man. Aeration NA Dist. Pipe Holding Bot. System PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number GPM TDH I Lift Friction System TDH Ft [ Forcemain Length Dia. Fi Dist.Towell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENS IM 1 N SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manu acturer: INFORMATION Type of CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 501 239th Avenue, Somerset, WI 54025 (NW 1/4 NW 1/4 3 T31 R1 9W) - 0331191163 Oakwood Estates -Lot 5 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = I Plan revision required? [:]Yes ❑ No Use other side for additional information. F_ EEI I I SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. 5D- 2 ? ' Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 14sconsin Personal information you provide may be used for second purposes p Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach complete plans (to the county copy only) for the system, 944pOF F qdOps 8 - 1/2 x 11 inches in size. Coun State Sani Permit Number ❑Check if revi ' n ous app ' i ry tate Plan I. D. Number C-"! 38 ) Z I. Application Information - Please Print all Information tion: Property Owner Name 3 �. Location C9' WK &6F -MA-1 M K « ' �'�_3 �F 17, .: 1- /4 /4, S 3 T 31,N, R (or Property Owner's Mailing Address - ST C t N mber Block Number 13 .E 9 ui r � �/1. �o>vlro " 1; City, State Zip Code Phone N division Name or CSM Number #a ,oso Yv GlJi' SYoI ( S C `' QAX' 0 -0 , 00 jff s II. Type of Building: (check one) — PQav 5" 2 — 'Cl City IK 1 or 2 Family Dwelling - No. of Bedroom p 3 , ►mss QQQ ❑ Village ❑ Public /Commercial (describe use):_ I$ Town of ❑ State -Owned S 0 1 T Nearest Road r GTf 5!' Pazcel Tax er(s) Z L O — III. Type of Permit: (Check only one box on li e A. Check box li B if applicable) A) 1. GrNew 2. ❑ Replacement 3. ❑ Replacement of 6. ❑ Addition to System System Tank Only Existing System $) Permit Numbe ed ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Non- pressurized In- ground ❑ Mound ❑Sand Filter ❑Constructed Wetland ❑ Pressurized In- ground ❑ Holding T ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Tr tment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4f oil Application 5. rcolation Rate 6. System Elevation 7. Final Grade Required Proposed to (Gals. /day /sq. ft.) (Mi 'nch) Elevation MArAA A "3L- //YF/L7yt.4T6k ys o o . D 9c2 • E/ X8.8 VII. Tank Capacity in Total # of Manufacturer PreN Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete tructed Tanks Tanks 57 E , 4 ofe ❑❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation WTS shown on the attached plans. Plumber's Name (print) P1u er's Signature (no stamps): RS No. Business Phone Number ?`S 'SY GG P mber's Address (Street, City, State, Zip ode) IX. County/Department se Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issui g Agent Signature (No stamps) 'Approved ❑ Owner Given Initial Adverse Surch a Fee) ` Determination 1 2aZ S, 0, X. Conditions of Approval /Reasons for Disapproval: 3 , o a.-g S u6vv_.. ((�� ((�� W , 7e � tn - - G e — I,sr Ss2FK� C.Cu �sw� . �.� 1 o.�, eSL 1M0�{ X19 A o j 4 s 4i ",. 4u 10..2 W�,o�.`�ti�eo�( cx 1 .m 1 k sys e✓� VIA Puq_ � �J o -T cA+�� rww�fi ►� �Q�1 SBD -6398 (R. 07/00) 4 i ..�. �� + � .r � i b ■■I11■Efi � S■■O■MII ENE mmummam ■■i l■■u■ ■■■ 1 MEMO 0 ■■■■. �� a ME wmzmmll�� ■■■ ■■■■■ ■E■ ■■ ■■■■ ■� ■■■ ■MM ■■■■ mi , ■■r ■R R■■■■■■■E■�■�MM ■ ■ ■ ■ ■■■ ■ SOME ■■ ■ ■ ■MN ME mmomm ME In i ME 0 ■ ■ i m"M 0 M ■SEEM■ ■■■ ■ ■�•� 0 �mmm�mm No No ME ■v S■ SOS■ IRS iir1ml if l I■r E■■■■E■i ■�____ .err• : �■■ I■ ■SEEM ©■ ■ ■■■ m W €� MOM ME l oom ■a ■M ■■■■ ■■■■M■■ 25,149 MEN r L ,W , . , .. ,1■!W■m■ ■■ �c. .■ t i all A /Y s ys - ---------- - A 4 � --4- - At � -7- A A Alf: i T Z C -5 ,4 t- L I - - AO- ----- -- - 7 Ti i kil � A 1- -�- i ll -�__ _-- rt I y02 S� --- ____ -- . -- i , DI ! K s F , ' i I _ i i ; I , I � 4 j I � f t i r , i 9 • s l � I I � • E , 1 I f�• t i � � i j � I i r , , i I , - -- I ' y , , j I ! j • i t • s I ! ' epartment of Commerce SOIL. AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of integrated services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County L include, but not limited to: vertical and horizontal reference point (BM), direction and /O ` percent slope, scale or dimensions, north arrow, and location and rest road. Parcel I.D. # APPLICANT INFORMATION - Please print mat" n �� Rn b Date Personal information you provide may be used for secondary p (Privacy l'� 1) (m)). Property Owner - _ 4 'P%perty'Ltion " Govt. Lot' ^/ 1/4y/4,S 3 T ,N,R E (or Property Owner's Mailing Ad ' # Subd. Name or CSM# City State Zip Code Phone' , oitw ❑ Village Town Nearest Road ew Construction Use: ><LResidential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow ��� gpd Recommended design loading rate _ bed, gpd/ft gpd/ft Absorption area required /d bed, ft ft 2 Maximum des' n loading rate _bed, gpd/fl gpd/ft Recommended infiltration surface elevation(s) )CI, .Q �� - (as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tapk U = Unsuitable for system I ,Sus ❑ u ❑ U 'Ks � ❑ U ,ms's ❑ u 1 ❑ S ;�r ❑ s u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/fl2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench or g Ground yd ` r y f vs• 9d ft . Depth to limiting factor Remarks: Boring # a -o z 7, .a- Ground II e , �ft. Depth to b limiting factor X12 Dz6 n. Remarks: CST Name (Please Print) � �ire Telephone No. Address Date CST Number 6u,� -9 2 V77 SOIL DESCRIPTION REPORT PROPERTY OWNER � . � �� � Page of PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench / e o l Ground �7-► S1� �/ - 5 /0 p elev. Depth to i limiting q CtZ . fa,c1to/r - /io- LL : j Remarks: Boring # r Ground elev �y� Depth to limiting • 6 (lZ•8 f ct `in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench Boring # 5 (3- 0 r �' S • Ground Depth to limiting / factor / Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -6330 (R. 07/96) Soil Test Plot Plan Project Name Hobby Farms Inc. Shaun Bi Address f P.O. Box 716 _ Hudson Wi 54016 CSTM #226900 Lot 4 Subdivision ------ Date 5/ 24/99 NW 1 /4 1/4S T 31 N /R W Township Somerset ❑ Boring 0 Well PL Property Line ✓ County ST. CROIX ,�r VRP Assume Elevation 100 ft. Top of Nail in Elm Tree System Elevation 92.8/9 * H R P Same as Benchmark it. BM Top of Nail in Elm Tree @ 10 1. 1 Alt. 10' B -4 -2 15' 15' Rep A Pri A 50' 2% B -3 Slope 5' N B.M 0 40' 50' r B -5 30' B -1 2% Slo a 130' 270' 50th Ave Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number L h 2- Number of Bedrooms Design Flow - Peak (gpd) Lj r Estimated Flow - Average (gpd) dD Septic Tank Capacity (gal) " Soil Absorption Component Size (W) Type of Wastewater Obmestic � Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) ts6D z ads'' Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se tic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter h all 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 enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole 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 one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 a Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION RM Owner/Buyer LL" Mailing Address U 7 L ze 11t /D sa lr lk Property Address es 4 a 39 44 J& V-4-1 (Verification required from Planning Department for new construction) City/State cSGME2 S � 7 Uh - Parcel Identification Number ' C 2131 (o -- CUD UEGAL DESCRIPTION 3 (. t 9 . t ((0 3 Property Location NeU - i /4, AIAV i /4, Sec. 3 T .3 / N -R�` _W, Town of Sol-14e s T . subdivision OAK74112001) f=5i d Le S . Lot # _ Certified Survey Map # , Volume . Page # Warranty Deed # _ C Y2.7 3 , Volume / ` , Page # /�:Z/ Spec house I1 yes ❑ no Lot lines identifiable (R yes ❑ 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 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 mastorplumber, journeyman plumber, restricted plumber or a li censedpumper verifying that (1) the on -site wastewaterdisposal 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. Uwe, 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. ) 'r _ 2L" IAOI 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 (are) the owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ° )►Y ltikS2 SIGNATURE OF APPLICANT DATE « « « * ** Any information 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 deed a copy of the certified survey map if reference is made in the warranty /�, \ k 3 ��, r �� ,��„� \I - - K � � �� ,� ' ynl. 1479PAGi 626 STATE BAR OF WISCONSIN FORM 2.1998 614273 Document Number WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Hobby Farms, Inc.. a Wisconsin RECEIVED FOR RECORD corporation. 11 -22 -1999 9:30 AN WARRANTY DEED Grantor, conveys and warrants to EXEMP N FEE: K *& LLC, a Wisconsin Limited Liability Company COPY FEE: TRANSFER FEE: 285.00 RECORDING FEE: 10.00 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (The " Property "): Recording Area Name and rn ' Al Pt of 032 - 1006 -60-OW Parcel Identification Number (PIN) This is not homestead property. That part of NW 1/4 NW 1A, Sec. 3- T31N -R19W described as follows: Lot 4 of Certified Survey Map recorded in Vol. 13 of Certified Survey Maps, page 3697, as Doc. No. 607536. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any Dated this S day of November, 1999. Hobby Farms, Inc. By •. * * Hank Fogel rg, President * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) Ss. authenticated this _ day of County ) Personally came before me this �` day * of November, 1999, the above named Hobby Farms, Inc., bv Aank Fogelberst. President TITLE: MEMBER STATE BAR OF WISCONSIN I 1i (If not, to now to be the person(s) who executed authorized by § 706.06, Wis. Scats.) ih oreg ing instr a and acknowledge the same. THIS INSTRUMENT WAS DRAFCED BY Attorney Kristin Ogland * A Q 2 Hudson, WI 54016 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Comm i 'on Is anent. (if not, state expiration date: necessary.) t ) � r l* . > �w y T- a : L � N CO lvn,.�. 'Names of persons signing in any capacity should be typed or primed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2.1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800855 -2021 r �► OAKWOOD ESTATES Lot 4 of a Certified Survey Map Recorded in Volume 13, Page 3697, Being port of the Fractional Northwest Quarter of the TH Northwest Quarter of Section 3, Township 31 North, Range 19 West, Town of Somerset, St Croix County, Wisconsin. NO sc NORTHWEST CORNER �J SECTION 3 -31 -19 MAP (FOUND ALUMINUM COUNTY MONUMENT) a., R.19 W. ST. CROIx CO.. W. N8952'42 "E 2641.84 - - - - - /Li - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — POLK /ST. CRO /X ROAD - -� - - T � % I 6 I \fit T - - - - - - - - - ---�- - - - - - - - - - - I I I I I i I 1 I I I I v 3 I I 3 I 33 ° CERTIFIED SUR VEY M AP VOLUME 13 P AGE 3697. - - - -- �- IZ I I NM -------- ---------------------- �------- - - - - -- 4444 -- I� I33' 1 LOT 3 I "` LOT 2 I LOT 1 I �° / N89'52'42 "E 1321.86' WeOend I I 361.20' ` •322.23' 300.59', yam\ 96 T306.07 31.77 : `7s' ti-I setback - - - 1290.09' � I I I 1 gy p\ � e I O v a c I w I M m U 1 I m N o LOT 5, . LOT 6 LOT 7•� I c = w ,,xx n1 I# LOT 8 N ti W 30 1 ,°- m ACRES Il fl 1,917 SO. FT. 131,207 SO. FT. fl a IJI,57J SO. FT. 3 131,140 SO, FT. 2 -102 a W I M 1 w _ J 01 ACRES rn M ACRES .T Ol Q:l 2 b N N MINIMUM F.F.E. -190.0 W .N .; D7 ACRES 1 1 I O I I I MINIMUM F.F.E.-190.0 I W 1 N I I p ...... f to o 1 I O 361 .36' --- - 12 Utility E oserrent I R�- I • • . h; 1 Z ' --TO M 4 444 I 3 WNf�jAO — N82'36'O8 W - -32 2.37' - - - _ o-� 75 9.65' 4 444- 1 - 75.92' - 140.11' -- -- 310. 2'-- r - 411. N8236'08`W 7 �� 450.33' �EROF P I \ 98'- - - - 55.09' " - e0 S86'S6'42'W �. ac-oc -s �12' Utility EOSe �� �0°a 4 3.24 ' 24 v h ment g H.WIL T' ' - © - Sg6.56�42'W 44 - - rn O 11' - �I WI ti n 3 ac 8 --- _ - =I W O F 3� I°' I �I yI �W 80' R. n OI I N w $= i '' .... 3 W Tempc h Y 0 1 o N .. ... a Easen. 3 _ : LOT 11 2 M � II ,2 LOT 10 ;� LOT 9 se9zso, E Upon JI O o 21 I 2 Z 130,668 SO. FT. 1 �' 130,766 SO. FT. ,^ 130,756 SO. FT. 168.82' ` M.W.L JI 1 I I iv J.00 ACRES 3.00 ACRES JOO ACRES 3� il. \� Z 3 I1 ,- MINIMUM F.F.E. -794.4 MINIMUM F.F.E..176.6 w 25 YEAR H.W.E.• - X28.82' P o� WetIond - -- - 1294.34'--- ` 356.45' 458.94' 478.95' \� I \ SOUTH L /NE OF THE FRACAONAL NW 114 OF THE NW 114 k J - - - - N89'25'01 "W 1323.16' - - -- - -�� MI I �I UNPLATTED LANDS ---- 4444 -- o^ ^I uQ v16 p� 1j 2 CURVE DATA Q CUWE RADW ARC CHORD DELTA CHORD BEARINGS TANGENT BEARINGS I A -B 1 467.00' 1 85.20' 1 85.08' 1 10'27'10' N87 9'43'W S81'5"41'. N82'36'08'W . 2424... .,, „-„n ,n r•,n' N87'49'43'W S86'56 N82'36'OB'W