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Home My WebLink About032-2160-70-000 Wisconsin.Department of Commerce Count Safety and Building fi,ivision PRIVATE SEWAGE SYSTEM St. Croix `s 1 1 INSPECTION REPORT Sanitary Permit No 463199 0 GENERAL,JNFORMATION (ATTACH TO PERMIT) State Plan ID N . Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit H vIder's Name: City Village X Township Parcel Tax No: P.C. dohova Builders, Inc. Somerset Township 032 - 2160 -70 -000 CST BM Elev: ( Insp. BM Elev: BM Description: {}. Section/Town /Range /Map No: 12.31.19.1385 TANK IN ORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing - Alt. BM Aeration Bldg. Sewer , / 0 10 1 `r D Holding i �` St/Ht Inlet • 1 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �/ Dt Bottom 7C Dosing Header /Man. Aeration Dist. Pipe 90 C1,ty S Holding ,_f _ —� Bot. System C) ( - io � .fcO Final Grade sbD t PUMP /SIPHON INFORMATION Manufacturer _ Demand St e over r .r• - r" ° � PM (2. � t y...�.� - I�.� - r � Z ' � D 1 Model N ber . ° I - L�j�L TDH Lift on Loss System Head TDH Ft Forcemain ength o well SOIL ABSORPTION SYSTEM BED /TRENCH Width t Leng f _ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ? 68'4 'S a 2 SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR aeCr,� Type Of System: S(l UNIT / r — ZS Model Number: �r t DISTRIBUTIPM SYSTEM Header /Manif IlDistribution x Hole Size x Hole Spacing Vent to Air Intake - If Pipes -� r Lengt Dia Length Dia Spacing (� SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Depth Mulched Over xx ept o xx Seeded /Sodded xx uce D O Bed/Trench Center BedlTrench Edges Topsoil L z] Yes f No E I Yes No C ?M ��(Iriclude cQdeU iscrepencies, persons present, etc.) Inspection #1:_�1 ' 2 / Inspection #2: L—cation/ 2237 74th Street Somerset, WI 54025 (SW 1/4 SW 1/4 12 T31N R19W) Wild Turkey Retreat Lot 17 Parcel No: 12.31.19.1385 1.) Alt BM Description = �• � S ) Lam' -'� Imo "�" -gu'e-r 2.) Bldg sewer length = ( - amount of cover = t�K > '4 C,ew an recision Required? Yes X N t Use other side for additional information. N e1C5 f. � I mo ' - � l N' - -- - - - -- -_ _ -- -- Date SBD -6710 (R.3/97) Insepctors Signature Cert. No. Soil Test and System PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 SW 1 /4 SW 1/4S 12 /T 31 /R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/10/04 BEDROOM 3 CONVENTIONAL XXX IN-GROKP6 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 Power Box ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 96.1/96.3 4.5' below qrade Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts Ad 335' Pro2erty Line Manual Version 2.0 Pro 3 bedroom house od Mo. 30' 100' B3 40' a 5 ST 0% Property B -1 Line 35' c 30 Vents q pa �V 20' B -2 70 ' B -3 Vent S lope 150' A Standard Biodiffuser Leaching Chamber with 3 1. 1 ft2 of Area 34" Grade at System Elevation Pro Town Road Safety and Buildings Division Countys� , 201 W. Washington Ave., P.O. Box 7162 c� N � Pisconsln Madison, 7 - 7162 Sanitary Permit Number (to be filled in by co.) De err ment of Commerce (6 51 W' Sanitary Permit A V . n Pl LD. Number In accord with Comm 83.21, Wis. Adm. Code tion yo providv� C1 V may be used for secondary purposes , s15.04(1)(m b , ject T 2Z3 ress (if different than trailing address) I. Application Information - Please Print All ONI Information ZNG OFF1 E� - 7 - Property owneesNeRe n Parcel # # n / n' ' / Bl # - Property Owner's Mailing Address Property City, State , Zip Code Phone Number y' Section / 0L 1 o), s o/� 2 II. of Building (check all that apply) T N: ``� -t-E I J or 2 Family Dwelling - Number of Bedrooms I / af a ubdivision Name 7,7 M Number Pub Cotrttnercial - Describe Use Ldi l State Owned - Describe Use City_ Vdlag fGTewnslup s Id Type of Permit: (Check only one box on line A. Complete line B if applicable) C D - ( 7 U A ew System Replacement System Treatment/Holding Tank Replacement Only Other Modification to Ewan System B. Permit Renewal &Wt Revision Change of Permit Transfer to New list Previous Permit Number and Date issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that apply) on - 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- Ground Holding Tank Peat Filter Aerobic Treatment Unit tug Sa nd Filtor Recirculating Synthetic Media Filter g Chamber Drip Litre Gravel-less Pi / (ex n).6 V. DispersaVf reatment Area ormah 10 ,1) s Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Proposed (sf) 6 `,- � � VI, Talc Info Capacity in Total Number Manufacturer Prefab Site teel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Tanks Tanks Septic or Holding Tank Acrobic Treatment Unit 0 Dosing Cumber VII. Responsibility Sta t- I, the untie asstune bility for installation of the POW'IS shown on the attached plans. Plu s Name (Print) Plumber' ignature MP/MPRS Number Business Phone Number -2 - - L Plumber's Address .((SStrreeet, City, State, Zip r✓ C_,/ L S VIII. Un /De artment Use Onl A roved roved Sanitary Permit Fee (includes Groundwater Date ued ui=gentgnat e M ) pP Disapproved Surcharge Fee) �-y� Ol7 I Owner Given Reason for Denial J V� _� / l 7 y k14- IX, Conditions of A val/Reasons for Disapproval SYSTEM OWI „ � �01 1 Septic tank, effluent filter and ` dispersal cell must all be s rviced 1 lumber as per management plan provided by y p 2. All setback licable codelordinanbes m aintained d�✓ �/ G 0 as per app U Attach complete plans (to the County only) for the system on paper not less than Un x 11 Inches in size • Wisconsin Department of Commerce N-f Page / of Division of Safety and Buildings D Q in acco ante with Comm 85, S. minty ; .t t YL Attach complete site plan on paper not less tha 8 1/2 O VCh s - ss Plan m t include, but not limited to: vertical and horizonta reference point BM),Cdiff�� ion an Parcel I.D. percent slope, scale or dimensions, north arro and 1 ti n and distance to near st road. �RO1X COUNT ; Revi ed b Date Please print all i rmaG OFFICE Personal information you provide may be used for secondary purposes (m)) Properly Ovine Property Location , e G -� Go �-� Got. LotJ 1/4 S� T N R l E P, eor) Property s Mailing Address Lot # Block # Subd. Na or CSM# V39 &&ZL city _ Zi1p�CTOde,,� Phone Number ❑ City ❑village Town Nearest Road New Construction sidential / Number of bedrooms Code derived design flow rate GPD ❑ Replaoement �El Public or commercial - Describe: -- - - - - -- -- - < -- -- -- - -- -- Parent material Flood Plain elevation if applicable / .� ft. General comments and recommendations: mendations: Boring # E] Boring a "�it Ground surface ele/ / Zft. 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 0` 0 � 31,. s /` � _T i'. o-3 S �- C� u , Boring # FL Boring j lam'" it Ground surface elev �'` '�' J � Depth to limiting fado --� / � — W'• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 / s' 3� i Effluent #1 = BOD > 30 < 220 mg/L SS >30 1 150 mglL flluent #2 = BOD < 30 mg/L and TSS < 30 mgll CST Nam (PI88S8 Prints Signature CST Number Bird Plumbing, Inc. Shaun Bird J 226900 Address D e Evaluation Conduc d Telephone Number 1008 192nd Ave, New Richmond, k, 54017 —0 715- 246 -4516 f► Property Owner _ Parcel ID # Page of Boring # ❑ Boring ❑ 'O Pit Ground surface ele /� ft. Depth to limiting factor ^ in. mil Application Rate . Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIT in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 I `Eff#2 -z - p r I y a- I -------------- J ®.� F-1 Boring # ❑ Boring [I pit Ground surface elev. ft. Depth to limiting factor in. Soit — Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. `Eff#1 •Eff#2 ❑ Boring # 0 Boring 11 Pit Ground surface elev, ft. Depth to limiting factor in. Soil dication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPQ1W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Efl#1 - Eff#2 1 Effluent #1 = BOD > 30 < 220 nVL and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mgA. and TSS < 30 rng/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. 5668330 (RVOO) Soil Test and System PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 SW . 1/4 SW 1/4S 12 /T 31 /R 19 W TOWN Somerset COUNTY ST. CROIX — a — � MPRS Shaun Bird 226900 DATE 11/10/04 BEDROOM 3 CONVENTIONAL XXX IN -GROU 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.P. Top of Power Box ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 96.1/96.3 4.5' below qrad Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts 335' Property Line Manual Version 2.0 Pro 3 bedroom house 30' 100' 40' ST Property 50 0� Line 35' B-1 30 Vents 20' B -2 70 ' 3% B -3 Vent Slope 150' t Standard Biodiffuser IF Leaching Chamber with 3 1. 1 ft2 of Area g 11" 3 " Grade at System Elevation I F Pro Town Road Safety and Buildings Division County�� 201 W. Washington Ave., P.O. Box 7162 v NI fiso'cons i n Madison, WI 53707 - 7162 Sanitary Perini plumber (to be filled in by Co.) Department of Commerce (� CEIVE 3 1 19 Sanitary Permit Applieat on s to Pl I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal info mna on yo4&\16e 6 may be used for secondary purposes Law, s15. lxm) PrOjfct Address (if different than mailing address) L Application Information — Please Print All Info ONIN6 OFFICE: 3 Property Owner's Name Parcel # ' ock Bl # .c Ilt? — Property Owners Mailing Address property Location City, State tip Code Phone Number Secti, ct to )) �, IN. 1'a T rW IL Type of Building (check Al that appl As s � - N^. wo Snbd� I a ai Describe ICS�jM� Nu or 2 Family Dwelling Number o - Numf Bedrooms - r�?J� Jt�.tCiC. Pu idCommerrial - ribe Use Q K� State Owned - Describe Use City_ Vil wnship of III. Type of 't: (Check only one box on line A. kmplete line B if appli le) 032 - 216 o - : ft - Cnm A. > < ' w System Replacement System T t/Holding Tank acement Only Other Modi o Existing System B • Permit Renewal Permit Revision List Previous P umber and Change o P t Transfer to New Before Expkation Plumber IV. 3bye of POW TS System: Check all that apply) K CWS on - Pressurized In- Ground Mound;_* 24 in. of suitable soil Mound iin of suitable soil At -Grade Single Pass Sand Filter Constructed Welland Pressurized In and Holding Tank peat Aerobic Treatment Unit Recirculating Sand Filter Recirculating Synthetic Media Filter g Chamber Drip Gravel Pi Other (explain) S' V. DispersaLlTreatment Area ormatio • Design Flow (gpd) Design Soi� Rate(gptlsf) Ais s s � persa�� equirod (t) . " petsa( P posed (sf) System ffievati J .Fj d , s L7 VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units( t u / / / Concrete Constructed Glass New Existing � l Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing 0amber VII, Responsibility Sta t- I, the a resl for installation of the POWIS shown the attached Pl s Name (Print) Plumber's MPIMPRS Number Business Phone Number Plumbers Address (Situ City, state z in 90& VIII. /De rtment Use Onl Approved Dina d San Permit Fee (i�udes Groundwater Date Issued t Signal (No Stamps) S e Fee) ven Reason fe IX. Conditions of Approval/Reasons for Disapprov SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach coml)lete plans (to the County only) for the system on paper not less than $W x 11 inches In aim y r� � �� . � '� s �� : ` �� , PWT PLAN PROJECT P.C. Collova Bldrs. Inc. -' /' ADDRESS P.O. Box 489 Somerset Wi 54025 SW 1/4 SW 1/4S 12 /T 31 /R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/5/04 3 BEDROOM CONVENTIONAL XXX IN-GRCf 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.P. Top of 1.5° pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 92.5/92.0 5.5 below qrade Alt. BM Top of 1.5" Pipe@ 100.8' 335' Property Line Well is to meet all Plans Designed Using .) Conventional Powts setbacks required b Z WDNR y Manual Version 2.0 600, 15' Vents >6 Leaching Standard Biodiffuser 9% Leaching Chamber Slope � �, 1 B - with 31.1 ft2 of Area Long J Grade at System Elevation 30 ' 34 0' 489' operty Lip B -3 ) 35' J 10' � ) 50' B -1 10' Pro 3 Bedroom House 200' Pro Town Road PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 SW 1/4 SW 1/4S 12 /T 31 /R 19 W TOWN Somerset COUNTY ST. CROIX T �T� 1', MPRS Shaun Bird 226900 DATE 11 /5/04 3 BEDROOM CONVENTIONAL XXX IN -GR ND 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 kk BENCHMARK V.R.P. Top of 1.5" pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 92.5/92.0 5.5' below qrade Alt. BM Top of 1.5" PipeC 100.8' 335' Prop Line Plans Designed Using Well is to meet all Conventional Powts setbacks required by Manual Version 2.0 $ 2 WDNR 15' j L — Standard Biodiffuser Vents 9% Leaching Chamber Slope �� 1 B -2 with 3 1. 1 ft2 of Area 1 2 Long 1 I Grade at System Elevation 30' 34 0 9 489' P operty Lip B -3 ) 35' B -1 10' Pro 3 Bedroom House 200' Pro Town Road i mrrsconein Department of Commerce SOIL EVALUATION REPORT Page at Divison a saw and enuildings in accordance with Comm 85, V1fiS. Adm. Code e Attach aomplaw stie Plan on Paper toot less than 812 x 11 inclm in size. Plan must include. but not limited to: vertical and hubo tai reference point (BSA). ciredlon and Parcel LD. Percent slope. sole ordwnernsions. north arrow. and location and costaroe to nearest road. Please paint att inrcwmason. fie taw yo u powift m be u-a for r+soortdary paposes tP*4-7 r.aw. 6-45. (IMM)i. f it .1 Properl Y 7`; Pr Loc ation / Govt. Lot 1 1/4 S `p -T N R E( W y Lot # # C&W $ 9 Ad �+ /t State Zip Code Phone Number ❑City ❑ Miage own Road � c Oas ( 1 S sy -S9 7 7 Ja rfo v New Constriction Use: Resider" / Number of bedrooms Code derived design flow rate GPO O pAplace"wt ❑ Public Qr conwnwcial - Describe: - - - -- Parert /� 3r Flood Plain elevation if applicable N /.sZ R and reoor ,CvwwWconvnwft 5 f r 5r�.w /,�i c/G� %.vY✓ J / El Pit Ground surface elev. , •� ft. Depth to NnMerQ tamer in. sal Appkedon Rate Hmbort Depth Dominant Color Redooc Description Texture Structure Consistence Boundary Roofs GPQff im Munsea CAL Sz ConL Color Gr. Sz. Sh. 'EW1 'ER#2 (9 -1 7 - G o - Fd - - Boring # 0 t ems/ / Jai Pit ! tt Depth to �n9 Sol Rate Horlwn Oep4h D"nkw t COW Redact Description Texture Structure Consistence Boundary Rods GPOHI< in. MunsW flu. Sz. Cori. Color Cx• Sz. 3h. 'ESf#1 *#Z e o � rjZ.o • Effluent #1= BM 5 :o 30 220 ff#L and TSS >30 < 150 ' Efrouent f2 =BOO 30 rrgll and TSS <_ 30 mgll . — d CST Number ( G d0 Evaluation Conducted Telephone Number Address _ 7 �� oz --' e4 ply Omer Parcel 10 # Page of ® Boring # ❑ Bor v Rpn Ground axtece elev. fL Depth !b knfty factor c rrr. Sot Application Ras Horizon Depth Dominard Color Redox Description Texture Strtxture Consistence Boundary Roes GpDNe in. Munseff Qu. Sz. Cont. Color Gr. Sz. Sh. •Eti#1 •Etf#2 9. o G6 �oz F-1 Bor # ❑ e«irr ❑ Pit Ground surface elev. fL Depth to liar" tador in. Sol Appikabon Rate Horhm Depth Dominant Color Redox Description Texture Suucdae Consistence Bourdary Roots GPM in. Munad Qu. Sz. Cant Color Gr. Sz. Sh. *M 'EffN2 F-1 Boring # ❑9 ❑Pit Ground surface slay ft Depth to tirrdUng factor in Sot! Application Rate Horizon Depth Dominant Color Redox Description. Texture SUucdne Consistence Boundary Roots GPDiff in. Mursell Qu. Sz. Cont Color Gr. Sz. Sh. 'E1f#1 'Eti#2 • Ef awt #1 = BOD > 30 < 220 mgft. and TSS >30 1150 nV& ' Eam t #2 = BOD _' 30 mg& and TSS _< 30 nglL 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- 2548777. ser,- auotR.aool .� Soil Test Plot Plan Project Name P.C. Collova Bldrs. Inc Shau Address P.O. Box 489 Somerset Wi 54025 ' - STM #226900 Lot 17 Subdivision Wild Turkey Retreat Date 9/ 6/02 E 1/2 S W 1/4S 12 T 31 N /R19 W Township Somerset R Boring Q Well PL Property Line County ST. CROIX �r VRP Assume Elevation 100 ft. Top of 1.5" Pipe System Elevation 9 2.5/92.0 *HRPSame as Benchmark t. BM �-=- Top of 1.5" Pipe@ 100 -8' 335' Property Line Please Note: Tested area may not be suitable for Alt desired building area. M. Check system location 15' before excavating. Also, B.M. survey was not completed at time of test. Set backs 9% 15' from lot lines may Slope 20' B -2_ change. 30' t~ a� 20' o B -3 35' 00 50' B -1 100' 99' 98' 200' Pro Town Road WILD TURI LOCATED IN THE NE 1/4 OF THE SW 1/4 LEGEND TOWNSHIP 31 NORTH, RANGE 19 WEST, TC PRC �2 �: LOCA O D DRIVEWAY DRAINAGE EASEMENT NOTE: BUI G SETBACKS COUNTY SECTION MONUMENT NO OWNER OR RESIDENT SHALL DO ANYTHING WHICH WOULD INTERFERE W (FOUND AS NOTED) OPERATION OF THE APPROVED COMPREHENSIVE WATER DRAINAGE AND S0; S �O�FOUN 3/4 IRON REROD _ _ PLAT. THIS INCLUDES BUT IS NOT LIMITED TO BUILDING UPON, OBSTRUCT 12' UTILITY EASEMENT EXCAVATING OR PLANTING IN ANY POND EASEMENTS, WATER DRAINAGE DI T SET 3 4" BY 18' IRON REROD WATER CULVERTS, BERMS OR GRASS SEEDINGS. WEIGHI G 1.50 POUNDS PER - - -- DRAINAGE EASEMENTS ST Ci�Oi? COUNTY ca 121742 4 FL ZONIM OrFIC;E LINEAR F AT ALL OTHER a& z79 A. CONTIGUOUS BUILDABLE GENERAL NOTICE STATEMENT NERS AREAS - - - -- CONTIGUOUS BUILDABLE EACH PARCEL SHOWN ON THIS MAP (PLAT) IS SUBJECT TO STATE, COUNT ■ SET 1 1/4' BY 18" IRON PIN BOUNDARY RULES AND REGULATIONS (I.E. WETLANDS, MINIMUM LOT SIZE, ACCESS TO WEIGHING 4.172 POUNDS PER PURCHASING OR DEVELOPING ANY PARCEL OF LAND, CONTACT THE ST. CF LINEAR FOOT HWE m HIGH WATER ELEVATIONS AND THE APPROPRIATE TOWN BOARD FOR ADVICE. S 00'06 NORTH -SOUTH LINE 1/4 SECTION LINE 2650' 2817. 298.12' 298.04 Lei tease' - - - - - -- r --- -- T 247.28' -- 33589' - -- 238_11_ E., 00 I T 4� Q I l ar,r N :1, ® r , , 1 I$ �m 0 ® I I W Q O prj d I ' Y3W N � ' , d W� [y N O I a w r co Q � 3E M �l►\ I' Q O NOj ®� i� / E - 0 o Y L— t J I — y .1P b H c0 3 il L / / W 00'41'13' W �Y ` t7� ,Q N - - - - -� 17356' tmae — � '13� -- -- -- --�� 1 •` n - P','Ab 'OA S / - „ _ •t'rd m QYOQI NYQL L£LZLt 3 .c L,9L00 N r — — — — — — i 0- \ 219.86' �acva = 0* n i Z j i g _ 252.88' R i 2' _ \ � ti i � / � y P4 � / / •'sir ` of + 0 Q � Li La b w, Vlk (A\ S W b S 00 E m n l Q rtc0 N cA 00 ^ 1 3 n I Q I r _ At'ort /p4 Im = xo 456.62' — t39.at' I I I M . S 1 ser rn a \ 01 too• I �1 � d'•�,yrP � � „'� 1 = � L $ a .rt,a r E sc sa r+� GO Zvi " �i T was r m^I I� I ®� Q t •tt ^M Ya e��,�^ H LL ® i CI I N CY N �- ; �I ¢ l ¢ r, N — Q rfl (n u N v too' 10 O rr� CNI r I 04 t L I 0 Q� 0 n d I E C7 .b „�. I 3 I I I '4� •• \ezR 1..� t7 M tf d 0 0 �' y' I w 3 s ' f� �ci __ I I __ L — _ ,L£.9Gd0 N — 3 �t0�r, 219.92' — — — 241.09' — — — — N 00 04'13' W 878.92' � 9 m ® � LL : 0111 @� < 0 lb I !2 b /iy I I I O CO + I I - - - - - -- 880.71' 481.90' ----- - - - --� 240.. 8 UNPLIITTED LANDS WEST UNE OF THE E 1/2 OF THE SW 1/4 N 0O,4,04* 1` 2654.74' Z ;�I Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Eff luent 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 ntin nc Plan Option #1. f s stem fails, determine cause of failure, use C `9rnate arb and install new system in ted 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 r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer t', C . Lo I IQ &L dec - s Snr Mailing Address Y(3 d0:X 4 g q, 1 t o 9 5 Property Address Q a - - 1 (Verification required from Planning Department for new construction) r City /State m�C A- Lit Parcel Identification Number p3Z -2r�o �- �C� / 3�S/ LEGAL DESCRIPTION Property Location 5L\) �/4, Sw '' /,, Sec. 1 d , T 3 k N -R 1 g W Town of ( So m ergc4- . Subdivision L �A Lot #. Certified Survey Map # -- Volume Page # Warranty Deed # Q$ 1,56 Ce- I Volume M. T Page Spec house ❑ yes U no Lot lines identifiable �Z yes ❑ no SYSTEM MAENTENANCE 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 die 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, 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 d of the three year expiration date. P. C. COLLOVA BUILDERS, INC. a (715) 247 -2742 16 /01 / O 2' a P MIL X P.O. Box 489 SIGNATURE OF APPLICANT SOMERSET, WISCONSIN 54025 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 owner(s) of property described above, by virtue of a warranty deed recorded in Register of Deeds Office. P. C. COLLOVA BUILDERS, INC. (715) 247 -2742 1 /al / 0 SIGNATURE 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. ** 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 FROM P C COLLOVR BURS INC rMU`1k NU. • r _J cwt ` t "+ t u : .o ccx � v` • i�rl t C. 1VIL4JVd aw LI -VI plu f1Ili) aou AM 1LL"J.'LDR Ur Jj r .� elyuua It 188SP 27 �ssc BTAYa %M (w wlaax ad MRM! - 'm IL a+ e"t vMlW WARRANTY ia2D b w • M., rS Tlia Dead, e & Imtwwa %aa■aa Datum Q M i C Quis' FO! nap D K111�QYIett.D.Yi. ■ie■es �� `r 54 -2M 1417o AN 4raawr, Intl � GM■re B u1w�n LR.a iMffi.. � tion,,� law f awa■a Ctai.otr, br a vwwbk eere0. oomr a s Qrw ......._, ACSB a sFlNQ � as. & l#WiafdMM"6 d nal000 da I -& - County 9Glle of Wlucexln (L►mav I;"$ a nodal• :lease WA A aftaftzap ' 4! Z eibw±�4 of 30w«+ ! 1. Tw-*i: 31 Ngit, ieatia t9 Waa4 3c Crd:r 1 Imrrd4a Ave County. WIMMI16. I Vase aaa Ietant Adbaa ?L'tti iftrtf.cAiw NL•a "=(.'LMI Y7 Is nn) a">t:aSC41M t0 'Xalnnraa: uaaRa�Ya, ta3LtlCilC:i9 «� sil�-Pfway of reaera. If nlq � f -say ar I` ■arltle n, ' 3�YL .QL41r! 4J._lio�alon, �« wc1f� - -. —.� f , AVUENTLCAT1W` AIC1LSCWLLDCMLV7 1%MU11% FOMM 611114 L■{ol" caw 0 aw Mdlv7diW1► STATd Cr WOW-- Lem lo► U L+rrl a Ptbsx m auo"11 ae w b J} / / /��tty Cfzar!� .yam .1700. tk.eertnl7Y4Uft S-&#* MO i%ff _ day OF -, mL ,mzx A $ A r: mK of 71.$CCt�:SN t no .a w b+ iM w•wrti> •+•nv � ";Wj jh ;Q -1WPa { I (Umt _ —.�. ;>srunxrratdseknewwtl�ducam ay�7 }�• y �QiSZ. Ws, THIN MRTAi)MGt1C GAS I; Wi' 7a &V - •�.�.. 1000ear Kriade and _ _ Xmiy carat, State of Wiaeaailn qtr My Cammbsj4n A Wmanau. of no. =f a =papa- UW I ¢lpa�°aa pl fi suntelaeet ar aebaotiadsed 3eJt cra +x nxer■7•; — . — _ .. _, _ _ - . _ __. _ ) •m1fa afpRlda simmla Littatnm '40 td W to lyp ar'lraued EOn bwawwmra. inwtier►agawJrGwe�+n nA'M MX Cf `YV=?1W,N oaerdeaa• WAAAA.Y7Y CKL9 FOea W%4-J"V �f f ��r��f Aa~'r'�C�� NO OWNER OR RESIDENT SHALL DO ANYTHING WHICH WOULD INTERFERE WITH OR CHANGE THE ,OPERATION OF THE APPROVED COMPREHENSIVE WATER DRAINAGE AND SOIL EROSION PLAN FOR THIS PLAT. THIS INCLUDES BUT IS NOT LIMITED TO BUILDING UPON, OBSTRUCTING, ALTERING, FILLING, OR EXCAVATING OR PLANTING IN ANY POND EASEMENTS, WATER DRAINAGE DITCHES, WATER RUNWAYS, WATER CULVERTS, BERMS OR GRASS SEEDINGS. E AS GENERAL NOTICE STATEMENT: Z SCAU JING EACH PARCEL SHOWN ON THIS MAP (PLAT) IS SUBJECT TO STATE. COUNTY, AND TOWNSHIP LAWS, % RULES AND REGULATIONS (I.E. WETLANDS, MINIMUM LOT SIZE, ACCESS TO PARCEL, ETC.) BEFORE 0 PURCHASING OR DEVELOPING ANY PARCEL OF LAND, CONTACT THE ST. CROIX COUNTY ZONING OFFICE AND THE APPROPRIATE TOWN BOARD FOR ADVICE. S 00'06'08" E SW 1/4 2650.03' UNPLATTED LANDS 2617.03' X60.71 3 335.69' 236.11' 2147.28' ��b2.D�`s IT. ry -- — — — — — — — — — — — l — — 209.72_ — I (d °° / I A. 2�� n _ 380 li I I I Q° I I (/? Q Q° 0 n I rn co v i U o co rl II W L Q cy II ^/ �I Q a cj I I TT L1_ U m I O O m m II / M ni 41 VJ J =n U J Vim- / .� I I V-1 Q Q 0) p U 3 00I I / /`� O O Um � I I C E" r--) O o W I I Q CV I / � O M _ /ham Z '� o m N O �N ^�. I / I I r7 ci N co I cn L b 9 \� cn •S •Od C BC. 1p \ ) s ,OZ•S�Z M ' S ` \ss� Edo 'ZI F.OZ N co I ^ / a ' S Lo r— o II oi fp1 vv C 6 0 clq eo is '� o . 16 r \ _ ~ 64'6L l 5p`L � II O _