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HomeMy WebLinkAbout032-1024-50-000 / � �� 2 � ; e CD n E 2 T ' 2 $ CD 2 0 ° t k $ S to 3 # 9 5 3 § > - o 0 ) § CD P% \° £�■ , .04 � ¥ a § 2 . 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Permit Holder's Name: City Village X Township Parcel Tax No: Laing, Karel I Somerset Township 032- 1024 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: n Section ( rown /Range /Map No: I I �) ` C: 09.31.19.124B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 0'e-" /ooh S,�S ley ?5 /66 Dosing Alt. B � A— Q �ti a 0.Je0� s. I� 3z A/. Aeration Bldg. Sewer k0 ' Holding SUHt Inlet TANK SETBACK INFORMATION St/Ht Outlet - 7. Z TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 X4 It / Dt Bottom O Dosing Header /Man. - 7.'75 _ 416 J 1 Aeration Dist. Pipe 7. q Holding Bot. System oC / 7 1 f 4 mil Grade PUMP /SIPHON INFORMATION Z hoo . 5 Manufacturer Demand St Cover GPM �-- Model mber TDH Lift Friction Loss m Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ; 'T BED/TRENCH Width Lang t No. Of Trenches PIT DK7S No Of� Inside ia. Liquid epth DIMENSIONS '3 CA— SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacture INFORMATION CHAMBER OR k�4 p Type Of System: r ! IU/ 1 - Z M UNIT Model Number. DISTRIBUTION SYSTEM Header /Manifold Distributio x Hole Size x Hole Spacing Vent to r Intaa e Length Dia Length Dia Spacin q SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over I Depth Over xx Depth of xx S ed/Sodded [ � -- No Bed/Trench Center W Bed/Trench E s 7 Top ' ++CC�� N� Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / 1 1 4/ O Inspection #2: Location: 2231 50th Street Somers t, WI 54025 (NE 1/4 SE 1/4 9 T31 R1 9W) NA Lot 1 Parcel No: 09.31.19.124B 1.) Alt BM Description 2.) Bldg sewer length = lb) r M A4 s � - eu� - amount of cover = t Z 1 So' �I'1bM ��LJM Plan revision Required? 0 Yes No 1 � Use other side for additional informati n. I SBD -6710 (R.3/97) Date Insepct s Signal re Cert. No. nP Safety and Buil 'on County 14 Al I vi'm m201 W. Washington ve., PQ.IB Madison, WI 3707 x jbg�•• E ani emit Sum (to be filled in by Co.) Department of Commerce ( 2 1-6546 Sanitary Permit Applicati n 9 200 State Ian LD. Number, In accord with Comm 83.21, Wis. Adm. Cade, personal informati you g�vvi may be used for secondary purposes Privacy Law, s15. 1 m) A COUNT t Address (if d ZONING OFF I. Application Information - Please Print All Information Property er's Name fit_ Parcel # Lot # Block # Pro er's ailin A Property Location City, State Fzliip de Phone Number ' "tim Q� le ) -� ��!/ I. Type of Building (check all that apply) N, R E I or 2 Family Dwelling -Number of Bedrooms —� ERSO S CSM Number >~loTi NcLUD�� JCT S ❑ Public/Commercial - Describe Use 7 ❑ State Owned -Describe Use VJ / r` /, f0.5C_ ❑City ❑Vill ownship a0 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System yst ep ys ❑ Treatment/Holding Tank Replacement Only ❑�ther Modification to E 'sti g $ystem B. ❑Permit Renewal ❑Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and C D J at Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl (O - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In round ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Ching Chamber ❑Drip Line ❑ Gravel -less Pipe ❑Other (ex lain) V. Dispersal/Treat ent Area Inf rmation: ) D 0 ) >'F(jSja� 5 1 I> / ) Design Flow (gPd) Design Soil Application Rate(gpd Dispersal Area Re wired (sf) Dispersal Area Proposed (sf) System Elevation Tank Info Capacity in Total Number Manufacturer /� Prefab Site Steel Fiber Plastic Gallons Gallons of Units V Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank _ Aerobic Treatment Unit Dosing Chamber VII. Res risibility Statement- I, the undersign a ume responsibi 'ty for in stallation of the POWTS shown on the attached plans. Plum Name (Print) Plumb 's S r MP/MPRS Number Business Phone Number 1 mber's A ress ( treet, City, tate, Zip s' VI . Coun /De artment Use On Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issu sluing A nt Sign tore tamps) Surcharge Fee) J� (To 1 ❑ Owner Given Reason for Denial I "? ' (J IX. Conditions of Approval/Reasons for Disapproval � /VV �; I , , ^` � „��� � 1, _ ' ��� �,yt. //� _'ern 3- 33 YST p OWNER: 3 �2 j �s{ C � £�, e p Inc aric�effluen � Se Ispersal cell must all be servi maintained,/ a agemen plan provided by plumber se ac r quiremenis must b maintained 0 wv&A as per applicable code /ordinances. Attach coinglete plans (to the County only) for the system an paper not less than 81# x t es in size SBD -6398 (R. 08 /02) - � , 0Hw1P a f f roc F0 ' S �i�/✓GA OI • S � A ' f ' r i 1 IV U5 4 0 00 k �'X %5�:✓ Q� JAt=- Ili lee. i 1� i r,C ST. CROIX COUNTY WISCONSIN ' ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 EROSION & SEDIMENT CONTROL PLAN (715) 386 - 4680 - Fax (715) 386 -4686 For 2231 50 St., Lot 1 (Somerset Twp.) — Owner(s) Karel Laing Parcel # 9.31.19.124B Under St. Croix County Zoning Code 17.70(3)(b) 5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Wisconsin Admin. Code Comm. 21.125 requires the building permit applicant and /or landowner to follow erosion control procedures and maintain them until the site has been stabilized. Erosion control is a requirement of the conservation easement recorded for this lot. The Owner is responsible for notifying all contractors performing construction on this site that an Erosion & Sediment Control Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Apply seed and mulch as recommended in #5 below. Maintain existing vegetation wherever possible to minimize sediment movement. Surface drainage is toward Pine Lake via >20% slopes, where grading and filling is prohibited. The west end of the proposed septic system is approximately 80 ft. away from the shoreline of Pine Lake (per CSM #419937). The OHWM must be staked prior to any construction on this project. 2. Route contaminated runoff into stabilized vegetated buffer areas by creating temporary diversions graded ALONG CONTOUR between excavation areas and any potential receiving waters (includes drainage ditches). Do not allow diverted runoff to be directed into the ravine that's immediately adjacent to the proposed house and septic construction sites. (See specification sheet for temporary diversions provided by Zoning Dept.) 3. If excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence may not be necessary. However, silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with diversions and vegetative buffers. The POWTS or Building inspector may evaluate ESC plan effectiveness and make recommendations to owner for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation - do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass /vegetation can get established. Erosion control matting can be applied any time of year and if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel free to contact me with questions regarding erosion & sediment control installation. Prepared by: Pam Quinn, Soil Erosion Inspector #66505 Owner acknowledizernent of ESC Plan re uiremen . 'd� / /2004 ST. CROIX COUNTY ='= WISCONSIN ' ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 EROSION & SEDIMENT CONTROL PLAN Ffi&ei 8ffi-9JW f9R40 386 -4686 For 2231 50 St., Lot 1 (Somerset Twp. ) — Owner(s) Karel Laing Under St. Croix County Zoning Code 17.70(3)(b) 5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Wisconsin Admin. Code Comm. 21.125 requires the building permit applicant and /or landowner to follow erosion control procedures and maintain them until the site has been stabilized. Erosion control is a requirement of the conservation easement recorded for this lot. The Owner is responsible for notifying all contractors performing construction on this site that an Erosion & Sediment Control Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Apply seed and mulch as recommended in #5 below. Maintain existing vegetation wherever possible to minimize sediment movement. Surface drainage is toward Pine Lake via >20% slopes, where grading and filling is prohibited. The west end of the proposed septic system is approximately 80 ft. away from the shoreline of Pine Lake (per CSM#419937). The OHWM must be staked prior to any construction on this project. 2. Route contaminated runoff into stabilized vegetated buffer areas by creating temporary diversions graded ALONG CONTOUR between excavation areas and any potential receiving waters (includes drainage ditches). Do not allow diverted runoff to be directed into the ravine that's immediately adjacent to the proposed house and septic construction sites. (See specification sheet for temporary diversions provided by Zoning Dept.) 3. If excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence may not be necessary. However, silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with diversions and vegetative buffers. The POWTS or Building inspector may evaluate ESC plan effectiveness and make recommendations to owner for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation - do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass /vegetation can get established. Erosion control matting can be applied any time of year and if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel free to contact me with questions regarding erosion & sediment control installation. Prepared by Pam Quinn, Soil Erosion Inspector #665054 Owner acknowledgement of ESC Plan requirements: 1_/2 04 --- ST. CROIX COUNTY WISCONSIN - ZONING OFFICE "��... f ��� Ir r 4 � w • - u.w ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Y - Hudson, WI 54016 -7710 (715) 386 -4680 • Fax (715) 386 -4686 January 30, 2004 Patrick McDonell 6914 Sherwood Road Woodbury, MN 55125 RE: Karel Laing property at 2231 50` Street, Somerset, W1 54025 Dear Mr. McDonell: This letter confirms zoning approval according to the architectural plans you have submitted for Karel Laing's construction project. The architectural plans reveal that you are moving the existing stone cottage across property and permanently attaching the cottage to the proposed dwelling. By ordinance Ms. Laing is allowed to maintain one single- family dwelling on her property, which this proposal meets. This approval has been authorized with the following conditions: \ - An erosion control plan must be submitte for the project area to the Zoning Department for review and approval. The plan must be approved prior to conunencinu site preparations. • All applicable se tbacks must be staked prior to con, menc the project. • The dwelling must be one hundred thirty - three (133) feet from the centerline of 50' Street or one hundred (100) feet from the right - of - way line. whichever is greater applies. • The dwelling must be setback 75 -feet from the Ordinary Highway Water Mark (OHWM)ofthe Pine Lake. • The aggregate width of the side yards for the dwelling shall not be less than 25 feet and no single side yard shall be less than 10 feet wide. • Sanitary Setbacks ■ The soil absorption field must be setback: 10 feet from the dwelling, 5 feet from a property line, 50 feet from the OHWM of Pine Lake and 50 feet from a well. ■ The septic tank must be setback: 5 feet from the dwelling, 2 feet from a property line, 10 feet from the OHWM of Pine Lake and 25 feet fi a well. • notify the Zoning Department 3 days prior to the commencement of the project. • Contact the Zoning Department upon completion of the project to schedule a final site visit to verity compliance with this approval. • Obtain a sanitary permit from the Zoning Department prior to commencement of the project. • Obtain a town - building permit prior to the commencement of the project. Please contact Jeri Koester, Town Clerk; at 715- 247 -3519 or Brian Wert, Town Building Inspector, at 715 -386- 5279 to obtain the necessary town building permits for the project. • Submit photos of the final construction to the Zoning Department. III I I' the scope oil' the project changes, please contact the Zoning Department immediately so we can assess the project to ascertain if additional zoning approvals or permits are necessary. A copy of your information will remain on file in the Zoning Department. If you have any questions, please do not hesitate to call. Sincerely, Rod Eslinger Zoning Specialist Cc: Property file Brian Wert, Town Building Inspector Jeri Koester, Town Clerk /✓ ice G✓ :J. 1f iGf D� ..1 O 0 0*64 -, c, r- n ® � or 0014 4% CD -, : o T 4' * rr o w x -* CD CD c a N-b d r r C► c r -+ � O m • _ C D It . i r" p A PPROVED -n / n o a D av T o m 261986 >< x m N ,a , Qti o -� / C O -" ST. C:tOIX COUNTY -IX X x m N rn COMPREHENSIVE PARKS PUQW � / Z •� p cn c n AND ZONING C01AgWTEE H 7 r ro G) 0 o A 7[ . CD ri o . CA i o 1 � w O e ast line of section N 'o� west line of sectio - -- '� C+ N \ o m, \ a n n p = u► - j ly \ - � O O �. i NAG, C V 's . N07d 04' 38" �--- o ; o \a 7C p �-� '/� ��9i�1►'XI& O i (mil s c� cn x C) iy o — .0 \ o c 1 No m A v i I m co V 6 IO n! a C 9S m - � v w ____ R -80' TEMPORARY CUL-DE -SAC z m 09 � �d oow+ S73 0 36'16 "W `\ a _. 7 i s � be 1735 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. 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 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. p2-1024-50-000 Please print all information. viewed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ` 0 Property Owner Property Location Karel A. Laing Govt. Lot NE 1/4 SE 1/4 S 9 T 31 N R 19 W Property Owners Mailing Address Lot # Block # S c. f 1,q q 3 --1, 5312 Halifax Ave. 1 CSM Vol. 6, Pg. 1751 City State Zip Code Phone Number City Village ✓ Town Nearest Road Minneapolis I MN 1 55424 952 - 920 - 7971 Somerset 1 2231 50Th Street ✓ New Construction Use: ✓ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Glacial outwash Flood plain elevation, if applicable /' na General comments 0,aec� /� / /�z� and recommendations: Install three trenches at elev. 97 QQ' using 39 leaching chambers. V / (� 7 ��" a Boring # Boring ✓ Pit Ground Surface elev. 102.95 ft. Depth to limiting factor >110" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 none Ifs 2fsbk ds as 2fm,1c 0.5 0.9 2 6 -22 10yr4/6 none Ifs 1 msbk ds cw 2fm,1 c 0.4 0.6 3 22 -31 10yr4/4 none st 2msbk ds ai 1fm 0.5 0.9 4. 31-45 10yr5/4 none sil 2fsbk dsh gw 1fm 0.5 0.8 45 -58 10yr5/4 c2f 7.5yr5/8 sicl 1 msbk dsh aw 1frn 0.2 0.3 6 58 - 80 10yr5/6 (Z none s 0 sg dl gs - 0.7 1.2 7 80 -110 10yr4/6 none s 0 sg dl - - 0.7 1.2 P] Boring # Ong ✓ Pit Ground Surface elev. 102.80 ft. Depth to limiting factor >1 06" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/flz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 none Ifs 2fsbk ds as 2fmc 0.5 0.9 2 6 -24 10yr4/6 none Ifs 1 msbk ds cw 2fm,1 c 0.4 0.6 3 24 -34 7.5yr4Y6 none Ifs 1 msbk ds cs lfm 0.4 0.6 4 34-44 10yr4/6 none s 0 sg dl gw - 0.7 1.2 5 44-60 10yr5/6 none s 0 sg dl aw - 0.5 0.9 6 60-106 s 0 s dl s - 0.9 H#5& contain 118" -1 /4 bands ci 1 4 Ifs spa at 4" - 12" intetrvals. L oading rate adjus t re reduced permiability associated with banding. Effluent #1 = BOD u > 30 < 220 mg/L knd TSS >30 < 150 i) g/L * uent #2 = B013 mg/L and TSS < mg/L CST Name (Please Print) Signature: -- CST Number James K. Thompson -- 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, WI 54020 10222003 715- 248 -7767 LandhaLzwtal ED Y+ 2�0 1735 Wisc n Deparhent of Com 3 S01 EVALUATION REPORT Page 1 of 3 Division of Safely and Building A.C.E. Soil & Site Evaluations i � m 85, Wis. Adm. Code Attach complete site plan FI ize. Plan mnut County St. CfOU( include , but not limited to: rence pant (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 032 -1024- 50-000 Please print all information. e Pemonal mformabon you Provide may be used for secondary pPom (Pnvwy Law, s. 15.04 (1) (m)). Property Owner Property Location Karel A Laing Govt. Lot NE 1/4 SE 19 S 9 T 31 N R 19 W Property Owner's Mailing Address Lot Block # I Subd. Name or CSM# G` I 1 " 3 1 5312 Halifax Ave. 1 CSM Vol. 6, Pg. 1751 City State Zip Code Phone Number City _J village a Town Nearest Road Minneapolis I MN 1 55424 952 - 920 - 7971 Somerset 1 2231 50Th Street !J New Construction Use: 1/ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement I Public or commercbal - Describe: 3 (3 2 Parent material Glacial outwash Flood plabn elevation, if applicable na General comments Z and recommendations: Install three trenches at elev. 97.00' usin 39 leaching chamb ers. - O° S � Boring # _J Boring 1/ Pit Ground Surface elev. 102.95 ft. Depth to limiting factor >110" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 I *Eff#2 1 0-6 10yr3/3 none ft 2fsbk ds as 2fm,1c 0.5 0.9 2 6-22 10yr4/6 none Ifs 1 msbk ds cW 2fm,1 c 0.4 0.6 3 22 -31 10yr4/4 none sl 2msbk ds ai 1fm 0.5 0.9 4 31-45 10yr5/4 none sil 2fsbk dsh gW 1fm 0.5 0.8 5 45-58 5 10yr /4 c2f 7.5yr5 /8 sicl 1 msbk dsh aw 1fm 0.2 0.3 6 58-8 ° 1 0 10yr /6 ' none s 0 sg dl gs - 0.7 1.2 .7[� r Re dox. observed in the lower V of H#5. Cornm.85.30(3)2 appplied to discount redox. features as indicator of seasonally saturated soil. � � 21 Boring # I Boring ny sift coats on ped faces in H#4 & 5. 2 Boring # J Boring ✓_f Pit Ground Surface elev. 102.80 ft. Depth to limiting factor >106" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0-6 10yr3/3 none ft 2fsbk ds as 2fmc 0.5 0.9 2 6-24 10yr4ro none IFs 1 msbk ds cW 2fm,1 c 0.4 0.6 3 24 -34 7.5yr4/6 none Ifs 1msbk ds cs 1fm 0.4 0.6 4 34-44 10yr4/6 none s 0 sg di gW - 0.7 1.2 5 44-60 10yr5/6 none s 0 sg dl aw - 0.5 0.9 6 0-10Ti 10yr6 /4 none s 0 sg di gs - 0.5 0.9 H#5 & 6 bn 118" -1/4 bands of 10yr4/4 Ifs 4" -12" intetrvals. Loading rate adjusted to reflect reduced permiability associated with ' Effluent #1 = BOD 5 > 30 < 220 mg/L and 4S >30 < 150 4L * = BOD <30 mg/L and TSS <,0 mg/L CST Name (Please Print) I nature: CST Number James K. Thompson 4 3602 Adder A.C.E. Sal & Site Evaluations a Evaluation Conducted Telephone Number 340 Paulson lake Lane, Osceola, 10222003 715- 248 -7767 Property owner Karel A. Laing Parcel ID # 032 - 1024 -50 -000 Page 2 of 3 F3 ] Boring # Borin Pit Ground Surface elev. 100•$ ft. Depth to limiting factor >90" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-6 10yr3/3 none Ifs 2fsbk ds as 2fm,1c 0.5 0.9 2 B -18 10yr4ro none Ifs 1 msbk ds cw 2fm,1 c 0.4 0.6 3 18 -35 10yr514 none sil 2msbk dsh cs 1fmc 0.5 0.8 4 35-42 7.5yr4/6 none Is 0 sg dl Cs 1f 0.7 1.2 5 42-60 10yr5/6 none s 0 sg dl aw - 0.5 0.9 10yr614 none s Oso dl CIS - 0.5 0.9 H#5 & 6 contain 118" -1" bands of 10yr4/4 ifs spaced at 4" -16" intetrvals. Loading rate adjusted to reflect reduced permiability with banding. ❑ Boring # i Boring Depth D ft. ep n9 Sal Appimt� Rate _f Pit Ground Surface elev. to timid factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots OME in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 *Eff#2 ❑ Boring # _j Boring Depth t limiting factor in Pit Ground Surface elev. ft. o g . Sal Applicaf 2 Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots *Eff #1 *Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mglL • Effluent #2 = BOD5-S mg1L and TSS <_30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. . � r►Gh n1an�� Top ��p rc,6�.: q a. /c . vi. •n. Pi P %ne[.a Re'- ♦ Eleda�E %ems 99GG �p� ° $3 rcto ♦ w ec� J /� ion, b / j�`# slope �-� ��, roz.8r' 4► � v' y �' m I a o 2 0 �, Exlst�n9 stone EX i s�'i r�q a ra�e . Soly S �rce� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer b?- s. !/ Mailing Address Z f/ _ 09r/4_ +'�` S ✓�� S� y Z T Property Address 2 3 /a S fi✓ (Verification required from Planning Department for new construction) �jAL5'fl cr City/State W Parcel Identification Number d 2 5 - 0 2 �3 LEGAL DESCRIPTION Property LocationNE '/,, 5E '/,,Sec. Q T�j_N -R Town of J` ®✓11 @-f 5 _ SM / Subdivision C . Lot # �. 51 Certified Survey Map # Volume (V 17 Page # �, Warranty Deed # 5 2 -5 1 03 , Volume I , Page # Spec house I yes no Lot lines identifiable [X yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof 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, restricted plumber 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 da o the three year exp ' n date. G ATURE OF AP LIC 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 perry described a ir tue of a warranty deed recorded in Register of Deeds Office. a — // /a� NATURE OF AP IC DATE tRfkk* 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 a copy of the certified survey map if reference is made in the warranty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Papa of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity a l O NA Permit 11 3 O Septic Tank Manufacturer L7 rU, DESIGN PARAMETERS Effluent Filter Manufacturer (7 NA Number of Bedrooms ❑ NA Effluent Filter Model © NA Number of Public Facility Units ONA Pump Tank Capacity al A NA Estimated flow (average) Pump Tank Manufacturer )' NA al /da _ Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer NA Soil Application Rate al /da /ft' Pump Model IKNA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA O Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L O Disinfection ❑ Other; Pretreated Effluent Quality Monthly average Dispersal Cell(s) O NA Biochemical Oxygen Demand (SOD,) 530 mg /L 2tin- Ground (gravity) O In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade 0 Mound Fecal Coliform (geometric mean) 510' fu /100m1 O Drip -Line Q Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: 0 NA Other: O NA Other: NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency month(s Inspect condition of tank(s) At least once every: � ear sl (Maximum 3 years) O NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume 0 N�, Inspect dispersal cell(s) At least once every: ­2 month(s) (Maximum 3 years) O NA O ear(s) Clean effluent filter At least once every: O month(s) O NA _$) year(s) Inspect pump, pump controls & alarm At least once every; O month(s) fNA O ear(a) _ Flush laterals and pressure test At least once every: O month(s) 3-NA O year(s) Other: At least once every: 0 months) O NA D e ar(s) Other. 0 NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank Inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal collie) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y3) or more of the tank volume, the entiro contents of the tank shall be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 1 13, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretr©atment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. ()MW 14i0 I) START UP AND OPERATION For new construction, prior to use of the POWTS chuck troatrnunt tank(s) for the presencu of painting woclucts of othur churl cui� that may impede the treatment process and /or damage the dispersal call(al• If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power Is restored the excess wastewater v; ill be discharged to the dispersal cell(s) In one large dose, overloading the cell(s) and may result in the backup or surface dischar )e of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to re: )rims power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump contn'is to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectant. fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medicatio; , oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code; • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems rrIust comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ­ h s' a has ��eed to to ide a suitable epl ement a. Upon f ' ure of the OWTS a it any. site v I do muto ca a sui le acemen era If no eplac ment re s a ila holden k a be in o to replace the failed POWTS. O Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules In effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO :10T ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT, RESCUE QF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTAL POWTS MAINTAINER Name Name Phone Phone SEPTAGE S ERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone �— This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.55(1), (2) & (3), Wisconsin Administrative Code, I� L) t,t -ik_tl 1 t.0 i� 51�:AIK IIAIt i• 1:;1 ��; ..1='+ t(11C.Nt .1 -1942 ••• ' , "..., �. ., 4U; T CLAIM + DEED 1 '3L KarelA. . ..... .9 ............................. - .. ..............................I ............ . � _I _.. __ .................. I FEB 1 3 lbb Karel A Lain .. trustee . of h° quit - claims to ..............• .`��. _. _ - Karel A. Lain Revocable Trijst d3 ed at January 5, 1 45, as amended It rollowin described reel estate in ... St, C_r� -- — - -- _ � R ... County. - - - --- _ - - -- �i ' State of Wisconsin: Kathleen i 4 10 3 Golf i „Try Edln.t, 'IN I I I I 'fax :'a reel No: ............ ............. Part of the Northeast Quarter of the Southeast Quarter (%Ei or Section Nine (9), and part of the Northwest Quarter of the So11; *.,1,X•,r Quarter (NW; of SW;), Section Ten (11)), ALL in Township Th,r ne (31 North, Range Nine tee -I ( 19 ) West., described as r•> i YN o Lo! On (1 of f led Survey "•1ap f i l ­I December 2, 1986, 1n oIume "F.” �)f Certified Survey maps, page 1151, as ��t_':mc�nt Flo. •� _TriE,� WITH and SUBJECT TO a 66 foot wide Private Road Ea,emer.t- as show's on say ert� }e urvey I j FEE Y' XF P E ii I This ..... S n o t . homestead property. (is) (ia not) fated this ....... � :............. . ..... _ day or ...... J a n u.a r y 5 tL..... (SEAL.) (SEAL) • Karel A. La i n !r ...... ............................... ..... M ...__..... .. (SEAL) _ .......(SEAL) AUTHENTICATION ACKNOWLEDGMENT 3lgnature(a) ............... ...... ..._. STATE OF W11 w . ----- ---------- •- -•-- ---.....-- 1 Z_ aaLl:ent.cater..a......- -- -�£y . .. � ........ ................... .-•---• >De•:,ar.a.i,l carne ^e;ori me l'n .......`.--.. '....a c'. ...... .... ". .... .. _;t ..........., 19Z:� . the above named • ................... ............................... ........................... TITLE: MEMBER STATE BAR OF WISCONSIN ---•--......• ........................ ............................... (it not..... ............................... authorized by 1 700.06, Wis. State.) to me known to be the r erson who es"uted the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTEE, BY K_,�.th 7rakr� attorney at -. Law I 470., Golf rr Edina, h!N 55� ?f i _ .._ _ Nntsry Pnhlic r '' t ' county. l LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1024 -50 -000 Parcel Number 9.31.19.12413 OWNER NAME: First KAREL A REVOCABLE TRUST Last LAING PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 9 TOWN 31N RANGE 19W 1 /4160 '/.40 Line — Description Line Description TOTAL ACREAGE 4.450 PLAT LOT BLK 01 SEC 9 T31 N R19W NE SE THAT 15 02 S 16 03 WITH P137B 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit I LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1028 -50 -000 Parcel Number 10.31.19.137B OWNER NAME: First KAREL A REVOCABLE TRUST Last LAING PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 10 TOWN 31 N RANGE 19W '/4160 '/440 Line Description Line Description TOTAL ACREAGE 0.000 PLAT LOT BLK 01 SEC 10 T31N R19W NW SW THAT 15 02 PART OF LOT 1 CSM 6/1751 16 03 ASSESS WITH PARCEL 124B 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, 177- Valuations, 178- History, F10 -Exit i •� �-t� � � -' � / /U�- .��� - S'a' � �/ � L 7A / :3 .0 /rzc� � a 41993 FILED ✓ P / i --q Nor O O O N A O = bob* of _ O r C'y ` 2 CD M r c cr / T T z O ~ e T. C:) x ° c •�*- Z -" cn x N "'. r C C7 a 7 N A .'D T A C] .n N O p' r '� �^ r 01 O -4 S ~ V) O O O M O — CD It E m O + + + APPROVED v+ w r '•' � � rr- m f O n O i• � o m w t> r T `a / 2 2 S ST. CaOIX COUNTY � � -. _ m o N H m COMPitEHENSIVE PARKS PL/QW �/ / Z O N C3 u' c n AHO ZONING CO M TEE O+ o+ O+ o �yQ O o, I + + v+ ", p , ,Q Q / N; ro io a h' rn1 A p y / C• : f �� y / a / m A 0 0 -1 Qp w 0. �` 1441,43' _ ' s� _ east line of section 9 N00 ° 24'00 "E m?, - --6�0' -� west line - of section 10 C7 N N -1 W N N O V`� C7 2 Z O :C m -r C7 0 N \ y W per I I v � W �.�.`\ W . O O < N AG, N 0 7 0 'G a= x m rzn , P N H V 04 38 or z z 32 0,61 \ o r-- o x m m ,�d t^ g 16 , �p @ � ` � A � A o p . M ` N 6 l8 ° 'V/ .8 ' 7 r �i9: t �?�d,\ p; r AC m m .. OB' /.. pz P B• O� „� O�ti H o I o 0 7 I N _ 0 N W W 74 0 u: E l co 4� 9ww W Cp \ 0/.� s • ai a � r �? ( v � f0 n!a T / @ 3 06." `. M + -� y 4 TEMPORARY CUB -DE -SAC M �^ I a ° ti` O R -80' ° S73 ° 36'16 " W 1p � x o z0 488.57 O m 9802 779.68' w 12 0 CD -V m N00 12 ' 24" W W 900.00, c. z m -o 2;,: o T o M 518.88' o c T q, ,C ° c y unp1atte'd iandt owned D others G. � ('r O m V ............................. .. .. CO N x w ti D ] (DLo(DrnDO r — . " m --1 O o rn Z m Bearings ar- referenced to the east line rt (DD n w — of Section 9 assumed to bear N00 P.,0 O o - r1 t rn m Oxan DD rn A rn 4 (D O M --� CL A (7 (D 0 o 0 O O o (D C N rj -+ (D C co CL C2 rr N N N 1 < i1 O o C Volume 6 Pane 1751