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HomeMy WebLinkAbout032-2159-30-000 � \\ j& o � \ 0 . 2 � 2 0 A e � \) I o k£ » ® »° # \ I[ . $ ®% ) c ® \% $° 7) 2 §) z § 16 k U. m e ) k§)\ d \J$ CO , � ! r 2 I / \ \ / 4.; 8 e � \ / ( 2 § ^ § $ a m ) { E 0 § k c k ) k k f \ \ / ) ( \ ) . ( \ / b / [ 7 N/ 5± _ \ U> t 4) 0 -C \ S ) ® . )§ 0 E/§ §�u� } m \ ) « } U') 4 2 ~ � § �\ 0. m 2 / n �\ k k k 0 E 2 § �a E a a / \ / / / 0 v < e > _ 1§ / » ® e cl ' 3 j f \ E '4 ' �S o @ s k <k/ i § \ } / § § / / k LO E 0M {) 2\ \� -� 2 & / § \ § 2 © g { 2 ® \ § 0 \ § \ o k / } \ j •k � 2 $ m { a : - . " CL » J ' k a § ƒ / a 2 �0 2 J — , C) � j2 \ \ m ! \ 2 0 � \ � � §« . E 2° 7\ � \ 0 s §)t a, /( \ — k2 {= \ _ 2 \ < n f C z _ \ \ \ § { e 7 \ ( 2 S 2 \ ƒ \ ) CL R §ƒ\ C 20, \ ( z 7 7 \ \ \ N 3 « E \ �/ n=U) \� )/) ca } k \ ) }E) k c 3±8) z co / j _ \ 0 ) \ . z <a { 2 / \ }« E ^ \ to k \ ) ( C/) § k 2 ) A b . \ & m _E y } \ U j } } z � •� t � § \ « � � � � 2 j q t @ @ ° ,# m m ) \ \ � \ R 7 g E \ e / cu I f k #z/ i \ C) § � k § \ \ \ m @ \ @ k § ° \ \ 0 CO & / 2 (D ® - ■ & % & \ / / 7 \ « f \ k \\\ E\ o k f) k\ ® (D ) m § § a< e w % E / \ § Q 3� k\ 0 3 3 Wisconsin Department of Commdree PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430653 0 (ATTACH TO PERMIT) GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: P.C. Collova Builders, Inc. I Somerset Township 032 - 2159 -30 -000 CST BM Elev: I Insp. BM Ele v� I BM Description: Section/Town /Range /Map No: �p p �� X3 1 T eh.W 12.31.19.1371 TANK INFORMATION U ELEVATIO DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic B chmark r lJ� T T ,.. . — 0 tow+ of �S •O r Dosing Al. M Aeration Bldg. e er O / Holding St/Ht Inlet .9S qG •� / St /Ht Outlet / TANK TBACK INFORMATION $ -� R6 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe A S . Lo Holding Bot. System Final Grade A 340 44 .10' PUMP /SIPHON INFORMATION Manufacturer GP l�and St Cov ��.�/ • � D . � p0, , o Model Number l S1 TDH Lift oss System Head T Ft Forcemain 7en th Dia. Dist. t SOIL ABSORPTION SYSTEM yr , BEDITRENCH Width Length N . Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 7 r 68, � r Z ) SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufact rer: INFORMATION CHAMBER OR t D l !_ Type Of System: y ♦ / � UNIT Model Number: O r/ DISTRIBUTIO SY TEM , Header /Manif ` Distribution x Hole Si z x Hole Spacing Vent to Air Intak I � Pipe(s) O Length Dia Length Dia Spacing J 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 6 ;catio ME T: ode discrepencies, persons r t etc.) sen Inspectio #1:� / 2: 1 20 Somerset WI 54025 SE 1/4 SW 1/4 12 T31N R19W Wild Turke (Retrea In spectio Lot/3 Parcel INVo: 12.3.15.1371 1 , ( ) 1.) Alt BM Description 2.) Bldg sewer length = - amount of cover = 3)- . l,- Imo �e � Plan revision Required? Yes ' No �7 �, _ _ -- Use other side for additional informs Ion. �i 1 gx I ' \ ate Insepctor's Signature Cert. No. /� - - C� SBD -6710 (R.3/97) 1 S C .s Safety and Buildings Division 201 w. Washington Ave- P.O. Box 7082 Madison, lt►rt 537p7 •- 7082 Sanitary Permit Num (to be fill in by Co.) �1 fsconsin (608) 261 X546 I.D. umber Department of commerce , tion Sanitary Perm Applica � inforn-at9on you pro e O pry{ pddres (if different than trailing address) to accord with Comm 83.21, mss. Adm. C may be used for sxorelalY Purpo privacy perso Law, s1 5.04(1)(m) MAR LUU 1111 i} I. Applicatlon Information - Please Print All Information ST. CR&X OUNTY Lot # M Property Owner's Name L - �a �� �� � � Property Location Property p ' M - Address / Z � Section ,•�, Zip Code Phone Number City, State 2 l circle e T N; State ' 15 II. ype of Bauding (check all that =PPIY) Subdivision N CSM Num - 2 Family Dwelling - Number of Bedrooms _ !y OL ❑PublirJCommercial- DescribeUse 3 / t � ue.P� [City [Village tP�� State Owned - Describe Use tD 'b - - U ('1371) Ter, Type of Permit: (Check only one box on Line A. Cotaplete line B if plicable) A ` w System ❑ Re�lacewent System ❑ Treatnleathioldiag Tank Replacement Only ❑ Other Modifies to Existing System ❑ and Date issued Change of C] p Transfer to New List Previous Ptstnit Number B. Ewal ermit Revision $efe Oration Plumber Owner �3�lo r3 -T Zlx� IV. T of PO VVI S System: check aLi that = l on Pressurized In- Ground [) _> Mound 24 in. of suitable soil [ Mound < 24 in. of suitable soil ❑ At Grade ❑Sin O ❑ (3 Aerobic Treatment Unit cul�ng Sand Filter Constructed Wetland C1 Pressurized la ound [ Flolding Tank Peat Filter Outer (eft ain !/ [ Drip Line [ Gravel -less Pi R,acirculatia Sypthedc Media Filter hie Chamber ia gaeVTreatmeat Area Information: Dis 1 Area Propoa System Elevation V. D Design Soil Ap li cat ion Rate(gpdsf) Dispersal j equired (st) Design Flow (gpd) � ? ..r- �`� l . fab Site 1 Fiber Plastic Capacity in Total Number Manufacture Concrete Constructed Glass VL Tank Info Gallons Gallons of Units New I Fxistiag Teaks Tanks S,Pa a Ftoldias Teak Aerobic Treatment Unit D-ins COsm6er VII. nopo=siblU Statement I, the under n sume respoasibilt for Installation of the pOVYTS shown on the a Phone Numba re MPlMPRS Number _ 7 y Pl s Name (Print) Plumber' ; Plumber's Address (Street, City, State, Zip C e) VIII. 2 ' 0 4 ungr /Department Use Onl Sanitary Permit Fee includes Groundwater Date Issued seer' g Agent Signztur ,(No tamps Approved [ Disapproved Surcharge GtJU ❑ Owner Given Reason for Denial I.Y. Conditions of APP rovaim asons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced t maintained b p GVOw as per management plan provided by plumber. q �,9 n S 2. All setback requirements must be maintained t�) t t � as per applicable code /ordinances. — c� c t Attach complete pi s (to the Comity only) for the system os paper not kss thsn l/2 s 11 lathes n sine SBD -6398 (R. 08/02) Soil Test and System PLOT PLAN PROJFCT P.C. Collova Bldrs. ADDRESS P.O. Box 489 Somerset Wi 54025 E 1/2 SW 1 /4S 12 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 2/26/04 BEDROOM 3 CONVENTIONAL )00( IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 BENCHMARK V.R.P. Top of ST Cover ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R,P. Same as Benchmark SYSTEM ELEVATION 95.0/94.0 6' below qrade od 251' Property Line 2 -3" X 69' cells with >3' spacing Vents - ope rty Line B -3 100' 15' 45' Vents B -1 15' N B .M. 20 20' 14% Slope i 120' p Drainage Easement T 15' B -2 15' Plans Designed Using 5 Conventional Powts AL Manual Version 2.0 Pro 3 Bedroom House Vent 88' >6 „ Standard Biodiffuser of Cover Leaching Chamber with 3 1. 1 ft2 of Area 6' Long 11" Grade at System Elevation 34" i Pro Town Road i �o� Soil Test and System PLOT PLAN PRO,f ,CT P.C. Collova Bldrs. ADDRESS P.O. Box 489 Somerset Wi 54025 E 1/2 SW 1/4S 12 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX 2/26/04 3 MPRS Shaun Bird 226900 DATE BEDROOM CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R. Top of ST Cover ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL * H.R.P. Same as Benchmark SYSTEM ELEVATION 95.0/94.0 6' below qrade 251' Property Line 2 -3" X 69' cells with >3' spacing Vents - ope rty Line B-3 100' 15' Vents 45' B -1 �B.M. 20' 15' 120' T 14% Slope Drainage Easement 15' B -2 15' Plans Designed Using 5' Conventional Powts Manual Version 2.0 Pro 3 Bedroom House Vent 288' >6 „ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long 1111 3499 Grade at System Elevation Pro Town Road Wisconsin Department of Commerce SOIL Page of Division of Safety and Buildings in accordance with Comm f 5, Wis. Adm. Code County ` X Attach complete site plan on paper not less than 8 1/2 x 11 inches ir size. ckl'bfi'�hso 1 2 include, but not limited to: vertical and horizontal reference point (B , dire d Parcel D. percent slope, scale or dimensions, north arrow, and location and di nce to nearest road. ST. CROIX COU d by Date Please print all information. ZONING OFFI E 7 Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04 (1) (m)). Property Owner _ Property Location • Ct/ � ��_ Govt. Lot 1/ 14 S /2—T 3 1 N R E (o Property Owners Mailing Address Lot # Block # Na a CSM# City State , Zip Code Phone Number ❑ City C1 Village Town N est Road New Construction Us esidential /Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material 42L.C Flood Plain elevation if applicable ! J ft. General comments and recommendations: e l' ��c�,cti -Y. �� 0 F-/1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor 4. ,9 - in. 19 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. 'Eff#1 'Eff#2 � _ t� Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting fado in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 AVIC 2- _ - I Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) _ Sig na CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address L Date Evaluation Conducted , Telephone Number 1008 192nd Ave, New Richmond, WI 54017 4 715- 246 -4516 r I r" Property Owner _ Parcel ID # Page of 1-31 Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor - E2_ 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. 'Eff#1 I •Eff#2 Is .> F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fl= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I Effluent #1 = BOD > 30 < 220 mg/L and TSS >30:E 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -9330 (RAM) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430653 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: P.C. Collova Builders, In I Somerset Township 032 - 2159 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: CST BM Elev: Insp. BM Elev: 7 12.31.19.1371 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM { !�L Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet �fZ� TANK SETBACK INFORMAT19N TANK TO P/L WELL N LDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cc er GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L IFXDG JWELL I LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mou nd 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 discrepencies, persons present, etc.) Inspection #1:F68. Z t 14 Inspection #2: Location: 2208 74th Street Somerset, WI 54025 (SE 1/4 SW 1/4 12 T31 R1 9W) Wild urkey R tr t — � t l T f Parcel No: 12.31.19.1371 1.) Alt BM Description = r 2.) Bldg sewer length = �� - amount of cover = /I Plan Use other foruadditionalinformation. No SBD -6710 (R.3/97) o n 1 ""A Date Insepctor's Signature Cart. No. "'D ck' 4 Safety and Buildings Division ry �t X 201 W. Washington Ave- P.0. Box 7082 ✓ l Madison, WI 53707 - 7082 Sanitary P ermit Number {to be Stied in by Co.) 8Y ,sconsin (608) 26i 6546 3 � 6 r De artment of Commerce re plsnlD.Number Sanitary Permit Applica ' r i E1V ED in accord with Comm $3.21, Wis. Adm. ?M i ain on y nk sl S. {t )(m) ject Address (if different than mailing address) m ayb e used for secondary pttrpo I. Applicatto o Information - Please Print At Information 2 -2 09 S T ST. 1 # l:or Property0)p='s Na ZONING OFFICE �L't f Q i/C• -/ Property ovation property Owner's Mailing Address ZipCode Phone Number City, State _ // / cle o a D 1 T _'> ( N: tf E ]a Type of Building (check all that apply) � o s (W S `^^ Subdivisio_n SM Numbe 1 or 2 Family g - Numbcr of Bodroorns ` y t ( 10 ❑Public/Commerciat- cribc Use ❑City vill gr own o 0 State Owned - Do-'be ?� lIL Type of Permit: (Cheek o one box on line A. Complete line B if applicable) p 3 — 21 3a TO L- /3 / A. System Cl Rep at System 0 TreatmewHolding Tank Replacement Only Other Modification to Existing System List Previous Permit Nttmber Date Issued ❑ Change of Permit Transfer to N B. ❑Permit Renewal ❑ Permit Revis Plumber Owner Before Expiration IV. Typ of PO WTS System Check all that a ❑ At ra ON " - Preaautized itt Gtnund ❑ Mound >_ 24 in. of le soil ❑Mound < 24 in. of su' le soil Gd Sin Filt d d Q ❑ Pest Fitter ❑ robic T e Unit ❑ R irc d Fir Constructed Wettand 0 Pressuri2ed la-0 and 0 Holdin s Pipe D Grav rave (e lain) er R Synthetic Media Filter hie Chamb � a V. Dis ersal/Preatmeat Area In ormation: Dis ea Propos yssem a Design flow (gpd) Design Soil Ircation Rate(gpdsf) ]?ispexsa Requ' (st) Si P t Capacity in Total Number a°` Cons ed VL Tank Info , Gallons Gallons of Units New Existing Tacks Tanks Septic err Holding Taak x Aerobic Tmonona Unit Doering C[famber pI VII. Responsibility Statement- 1, the undersign* m onsibiliry for installation of the WTS shown on Busness Phone Number Plumber s Name (Prier) Plumber's MPIMPRS Number tl Plumber's Address (Street ity, State, Zip t9l 9 j9 VIII. Court (D artment Use Only Date Lssued s ing gent Signature (N Stamps) Sanitary Permit Fee f � eludes Groundwater Approved 0 Disapproved Sum harge Fee) �� N 0 Owner Given Reason for ial IX. Conditions of Approv&VReasons f Disapproval 3) S S SYSTEM OWNER: 1 Septic tank, effluent fil and --� dispersal cell must a e serviced / maintained as per manageme Ian provided by plumber. �� tt S 2. All setback requi ents must be maintained as per applicable code /ordinances. 1 ov1. ua only) for the system oa paper not less than airs z it lathes Ln size Attach tosapkte plans (ter the Co ty SBD -6398 (R. 08/02) PLOT PLAN PROJECT P.C. Collova Bldrs. A DRESS P.O. Box 489 Somerset Wi 54025 E 1/2 SW 1/4S 12 /T 31 / 1 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE1 /8/04 BEDROOM 3 CONVENTIONAL XXX IN- GROUND R SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R.P. TO of 2 Pie r- ' P " P �^^- �) ASSUME ELEVATION 1!?Q Filter A -100 ❑ BOREHOLE O WELL *H. R. P Same as Benchmark SYSTEM ELEVATION 97.5/96.5 4' below grade 6 Alt. B Top of 2" Pipe @ 9 i �� 251' Property Line B -2 Vents a 20 P s Designed Using nventional Powts 2-3'X 69 ells with > ' Spacing 11% anual Version 2.0 N -� 50' lope Vk B -3 B -1 0' � 30 Vents 0 , 1 ote• e M. of sui for 45' 15' it ea. Alt cc syste ation ,M before exc g. Also, T survey was not completed at time of test. Set backs from lot lines may 30' change. Pro 3 t 88' �� Ho se >6" Standard Biodiffuser of Cover Ching Chamber 3 1. 1 ft2 of Area 6' Long 4 „ Grade at System Elevation C OP•t Pro Town Road r - PLOT PLAN PROJECT P.C. Collova Bldrs. A DRESS P.O. Box 489 Somerset Wi 54025 E 1/2 SW 1/4S 12 /T 31 / 1 W TOWN Somerset COUNTY ST. CROIX 7 MPRS Shaun Bird 226900 DATE 1/8/04 BEDROOM 3 CONVENTIONAL XXX IN- GROUND R SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD / RATE .7 ABSORPTION AREA 684 # of chambe 2 IL BENCHMARK V.R.P. Top of 2" Pipe J V (� ASSUME ELEVATION 1W Filt Zabel A -100 ❑ BOREHOLE Q WELL H. R. P. ( Same as Benchmark SYSTEM ELEVATION 97.5/96.5 4' below rade 6 Alt. B Top of 2" 99.0 ' � ' 251' Property Line f ` B -2 Vents 20' j Pi `Designed Using C ' ventional Powts 2 -3' X 69' Cells with > ' Spacing 11% nual Ver ion 2.0 50' lope B -3 B -1 0' 30' Vents 0 1 Please Note: Teste ea B.M. may not be suitable for 45' 15' sired building area. Alt, k system location .M. be excavating. Also, T surve as not completed at time est. Setbacks from lot li may . 30' change. Pro 3 I Vent 88, � House >6 Bedroom " Standard Biodiffuse H -fi r Leaching Chamber of 6 ,.� with 3 1. 1 ft2 of Area 6, 11 99 „ 3 455 Grade at System Elevation Pro Town Road Wi wnsin Departnent of Corrunerce SOI EV,AL YATIPN REPO T Rage of Division of safety and eufldings i acoordance vfh ARsch compieft site om paper not less time 112x 11 inches in size. Plan must include, but not Waited to vertical and horizontal reference point (BM), d'eaction and Parcel in. perowd slope. scale ordimerrsiom. north arrow. and location and distance to nearest road. Re#wed by Date Please pint sit informatron. t r� per@o" bdonnoWn You pmvWe maybe used for seoondarY Pe (PdVAICY LNW• s• 15.04 (1) (m)). f Ie WV, 71 V Properly n Preperty Location (-I Govt. Lot 1 Sfj IM S T 3 N R E( rW Pwpsfw oo_wmes MallkV ddrass lot!! # subd csnn(E x p' 3 -- e • Ow State zip Cafe Phone Number ❑City ❑ Village own Oaarlest Road �yOdr t rs) -�'9 7 �- ° New Constnxlyon Use: Residential / Number of bedrooms Code derived design flow rate GPD OReplacernent Q Public gr wmmqmW - DOmbe: Parent r. .� _ fi , .� �, Q i�. Plain elevation elevation if applicable A' /AOr tL General conments If v Borkv f60orrMrlerfdati0ine• �� %j�iPrta�Ci <�+!/Q'_���� y �9 # pK Grotsnd surface ela\r. e Depth to Is M g f clor z� — m Sol Application Rate Horiaon Depth Dm*mtCdm Redox Description Texture Struckm Consistence Boundary Roots GPOW in, munset flu. Sz Coat Color Gr. Sz Sh. 'Elf#1 •Ef(#2 Allw /7 C1 • ..,-� �3 �7� ® Ba ft p p( el i/� '� to factor � ln• X�i Pit Graxfdsurfaceev Ai" Soil Application Pee Horizon Depth Dornitu" Color Redox Description Text SVuct a Consistence Boundary Rods GPM h Munso flu. Sz Cont. Color tic Sr- W •E8#1 •Etf#2 -- j 2 -�Z l' � L C/` ..✓ Eflk,etit in Boo > 30 <_ 220 mglt and TSS >30 50M 94W mierd #2 = BDD _< 30 ffv& arnd TSS _< 30 mglL CST Number Conducted Telephorre Number Add Date Evaktebiori i Property Owner Parcel 10 # Pa d Barlrp # p er Ground suface elev. Z ft. Depth to limiting factor an- Sol Application Rabe Horimn Depth Donti kW Color Redox Description Texture Structure Consistence Boundary Roots GPDAF in. Munsell Qu. Sz. Cot Color Gr. Sz. Sh. TA" *1211112 I --j 3K 1 7 1 — Boring # ❑ Soring ❑ pit Ground su?aoe elev. R Depth to aniting factor Ir Soil Applicarjon Rate Horizon Depth Dominant Color Redox Description Texture structure Coruislence Boundary Roots GPM in. Munsell Qu, Sz. Cant Color Or. Sz. Sk 'Efl#1 'E1 2 Owing ❑ # ❑ Owing 11 pit Ground surf eiev. R Depth 10 9 factor in Sot Application Rate Horizon Depth Dominant Color Redox Desalptim. Texture Struetuure Consistence Boundary Roots GPDO in. Munsell Qu. Sz Corn. Color Gr. Sz. Sh. 'Eft#1 'EM • Effluent #1 = BOD > 30 < 220 mg& and TW >30:< 150 mg& ' EiBuent #2 = 8013 130 rruglt and M 130 ffo& 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 due department at 608 -266 -3131 or TTY 608 -264 -8777. 1 Soil Test Plot Plan Project Name P.C. Collova Bldrs. Inc Sha it Address P.Q. Box 489 Somerset Wi 54025 TM #226900 Lot 3 Subdivision Wild Turkey Retreat Date 9 /6/02 E 1/2 SW 1/4,S 12 T 31 N /1319 W Township Somerset [] Boring 0 W01 PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" Pipe System Elevation 97.5/95.7 *HRPSame as Benchmark Alt. BM Tool � 1 @ 99.0' 4 25 1' Property Line 102' 101'1001 20' B -2 a 11% 50' lope r, B -3 B -1 0' 1 '2 30 0 5 15° Please Note: Tested area B. may not be suitable for 15' desired building area. Alt. Check system location .M. before excavating. Also, survey was not completed at time of test. Set backs from lot lines may change. 88' Pro Town Road Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Co ncy Plan ption #1. system fails, determine cause of failure, use alternate area and install new sys m in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option #3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird #226900 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer P. C. Collova Builders, Inc. P O Box 489 Somerset Mailing Address , WI 54025 Property Address' 1 (Verification required from Planning Department for new construction) City/Stat ?tw_X9 Parcel Identification Number 032 - 2 1" - 30 137) LEGAL DESCRIPTION Property Location cS V., �iL V., Sec. a , Z N -R Town of �^ Subdivision Lot #. Certified Survey Map # Volume . Page # Warranty Deed # G q5 (0& / Volume Page # t? Spec house ❑ yes ❑ no Lot lines identifiable ❑ 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 masterplumber, joumeymanplumber, 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. Uwe, the undersigned have read the above require m0ccompleted agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commthe Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained and returned to the St. Croix County Zoning Office within 30 f th a ar expiration date. P. C. COLLOVA BUILDERS, INC. (715) 247 -2742 1 1 / d SIGN OF APPLICANT P.O. Box 489 DATE Y SOMERSET, WISCONSIN 54025 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 owner(s) of rty esc 'b above, by virtue of a warranty deed recorded in Register of Deeds Office. P- C. COLLOVA BUILDERS, INC. (715) 247 -2742 SIG OF APPLICANT P.O. Box 489 DATE SOMERSET, WISCONSIN 54025 * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department-'****** r ** 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 .0 i XA FROM P C COL.LOVA BURS, iNk; rNUNt NU. • t -0 car ( t" I ` I 1 r-1 1V /C'OjU6 AU. 11.Uf VAA. f1J J7U )AUDI AGVIJLCA w• JJrWJ V QUA, U zes & P 27. _ Mrs MR Or vAlica"kv vatw s . tww tiNtaLntlulw WAIUL4NTY MEZO 4A 8 -J BT. Uwu W. • �3 Tlis D" ."b&bwlwwn S►uaaa IJia.eQa C alb +t* MCCM FOR 91 1 K QwIaaD••i. .ier ma g a. -- ea - as - �aat 13 AN so aream fro J•CC aflar0 S u11d ar�a ire.a trEt,..eh� a t3un,,� am f fIlBlY. 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I is to 9e6 cm m4 ee:wm -i •Ht ' arDGfalMiey; YAp1T7 37A1ANttyetdaxv +rdeCtnatesrupetin �n�wnrnt'e�rrwrC�wr.+"" `-+'+ ' SZ1tL aAit Ol M'I.CJ!'61y �s+ww WAAAAJI;Y 1.9= POM(7Y.i.Potw � � �` • j t ( (jGQ u• � i� A a��'i'C 7l1 I _ ,...a in r-f) 00*06 (r li 558. � U Q \ I Q o N I ° o - - 55t 1r 49 .03' 13 Q l i - " o 60 _ I o 14 6.48' S 00 W 166.34' L g? 1 o 2 1 1.2 c 000 C\l I I o Z 01 Uj U 6 ° o I - ' z 4 - j u U u o co vi U Q o to to 0 °' w I F-I N o �° E-+ CV o 0 to ci II oI ca - O Comm p i� mm 0 :� I p0 O U J a O U J / o0 /W �. 4I — bg oi Lal O ou 1 32 a e« _ �? ��• 1 l 7 `1 00 S' 00 I p 00 I M m b d p c�0 �a1 O I 00 o °o to .,> _ � (O s 0 t �•�� Of 60' 0 LL'LS Ln I o W Lo `i O �- - 00 0 rn • 8 00 •p �i X5 .98'L5l 61,81.5 I N O z � ►--1 0 O S' *614 N ' 1�� 81 I ff-) 3 „ZC lZ.l0 N I ` m •- tv4�.I I � 218.89' 221.77' ma c: 1875.03' D - 1 Jessie Nye Subject: S. Bird, P.C. Lot 3 Wild Turkey, 430653 (tanks Only) Location: Somerset Start: Thu 2/26/2004 10:00 AM End: Thu 2/26/2004 11:00 AM Recurrence: (none) 032 - 2159 -30 -000 12.31.19.1371 2208 74th Street i Jessie Nye Subject: S. Bird, Lot 3 Wild Turkey, 430653 Location: Somerset Start: Wed 3/31/2004 1:00 PM End: Wed 3/31/2004 2:00 PM Recurrence: (none) 032 - 2159 -30 -000 12.31.19.1371 2208 74th Street 1 ST. CROIX COUNTY WISCONSIN -- ZONING DEPARTMENT ,`\ 1 N N Y N N■ N N - r�a�r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 May 26, 2004 P.C. Collova Builders, Inc. 672 205` Ave. Somerset, WI 54025 RE: POWTS Installation Inspection for P. C. Collova Builders, Permit # 430653 Location of Property: St. Croix County, Wisconsin Municipality: Somerset Township Subdivision or Plat: Wild Turkey Retreat Certified Survey Map: N/A Lot Number: 3 Address: 2208 74 Street, Somerset,WI Dear Applicant: A septic inspection of the above referenced property was conducted on March 19, 2004. This property is located in the SE 1/4 of SW 1/4, Section 12, T3 IN, RI 9W, Lot 3 of Wild Turkey Retreat Subdivision. At the time of the inspection, this Private On -site Wastewater Treatment System ( POWTS) was found to be code compliant for a three (3) bedroom (maximum 6 occupants) 1 -2 family residence. The inspection report and support documents for this POWTS are on file with the Zoning Department. If ou have an question regarding this system, lease contact our office at 715.386.4680. Y Y9 g g Y P Sincerely, Q Q� K vin Grabau Zoning Specialist Cc: file