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032-2117-10-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 158 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)]. 1< All Permit Holder's Name: City Village X Township Parcel Tax No: Steere, Nathan I Somerset Township 032 - 2117 -10 -000 CST BM Elev: Insp. SM Elev: BM Description: Section/Town /Range /Map No. 9(..•�'� (3.NA-. 15.31.19.1071 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM ` y Aeration - ' - w `` ". Bldg. Sewer S • s r ., Holding St/Ht Inlet ` JS 1, 7 S St/Ht Outlet TANK SETBACK INFORMATION L -3 S CI1 �5 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic I Dt Bottom i n Dosing Header /Man. q g.v« Aeration Dist. Pipe N P Holding Bot. System Sw 6 �' N1J p.V G1�. Final Grade PUMP /SIPHON INFORMATION �'� C 3 . 1-' Manufacturer _ m Demand St Cover 3 1GP •V C i 1 1 Model Nu r "To ✓� a �-r _ e. `?7.31 TDH Lift F ' i ss System Head TDH Ft Forcemai Length Dia. SOIL ABSORPTION SYSTEM LL BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS P,- --- SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufac _/� c�+ IN CHAMBER OR z e �l[ 1J1�.tJ� Type Of System: UNIT O n v �� + G 3 0 ` (�( ►A o a. Model Number C 4 DISTRIBUTION SYSTEM ,`r i'� cJ %., `%_A ' h -2 Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake st P ipe(s) [� Length C� Di Length SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over y�� Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center 5 Bed/Trench Edges Topsoil - N C C.0, Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: S / 2? / Q Inspection #2: hti t Location: 2160 59th St Unknown (SW 1/4 NE 1/4 15 T31N R19W) Shadow Pines Lot 14 Parcel o: 15.31.19.1071 T a 4 .� �. .S/a -�- _V &I 1.) Alt BM Description = ��� �� sla Ll �•,�, • v. 2.) Bldg sewer length = i"�� S ew IV"' } �•y } wl C- r.a: d9�sY. e - amount of cover = 3 Plan revision Required? Yes No S // Use other side for additions i'trrformation. SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. fe• >-) ��� /��' �& `w -rte Safety and Buildings Division oty � t 201 W Washington Ave., P.O. Box 7082 � as Madison, W1 53707 —7082 Sanitary P it Number (to be 5lled in by Co.) J Department of Commerce (608) 261.6546 � State Plan LD. Number i Sanitary Permit App liCSt1UII ________ -; project Address (if different than mailing address) in accord with Comm g3.21, * Adm- Code. Pao sl m oses Privacy ay be used for y:condary purpo Ifaw ►nation Informstion - Please Print All Information! N"Af 1 > f I. App ' arcel # I.ot # Black # ` Prope wner's Name �� CIitiIN�� Ot' F!CE p Location Pro er's Mailing Address Section �— i / dip e 111 Ph Number 'Q�irc ne) City, Stair ) y / N; R. LL-E t Q'tt�i u bdivieion Name CSM , N p um�ber II, T Building (checK all that apply) f. I1J�/ 1 Or 2 Family DwsliinS - Number of Bedrootas ❑ lidCommetcial- Describ ❑City ❑Villa o ipof ❑ s tau owned - Dericnlx use -� _ L Type f Permit: (Cheek only one box on line A. Complete lfae B Tt Rep b lacement only D otber Modification to Existing System II 1I (3 Replacemenr System 13 TreatmentlHoldiag List Previous Permit Number and Date Issued New Sysrarn ❑ Change of ❑ Permit Transfer to New !l �� d B. ❑ Permit Renewal it Rer. "sion Plumber Owner / 7 Before Expiration . Single Pass Sand Filter ❑ IV. a of FO�'�I'S i3 stem: Check all that a 1 2 Noes - Prasaurissd In Ground ❑ Mound 2 :2 in. of suitable soil ❑Mound <24 in. of suitable soil Unit ❑ Rmcirculzring Sand Filter In ound ❑Holding Tank [3 Peat Fiber [3 Aerobic Treatrrt Constructed wetland ❑ Pressurir�d ❑ Other (explain O D Line ❑ Gravel - less Pipe Reeirculatia Synthetic Media Filer g Area P roposed (sf) �Y p / ^ V. D1s ersaYrreatmeat Area I ormatioa: �p� l A Required (0) Dispersal (! ! q v Design Flow (gpd) Design Soil Appliearion Rate(gp f) ty 19 3 a d � (i` f pre Site Steel F' er Plastic Capacity in Total Number Manufacturer Concreu Constructed Glass VL Tank Info Gallons Gallons of Units New Existing Tanks Tanks 1 septic or Ho krwS Tank 7i (• Aerobic TraN-x- Unk Dee -- -- -- her V FTS shown on the attached plant assume responsibility for installation of the PO Business Phone Number VII, Responsibility Statement- I, the undersig lgp/MPRS Number i �✓ / plumber's T ame (Print) Plumber' tgnature «-Wn� ,fir Plumber's Addreu (Street, City, S� Z / Issuing A [ Sign ri S pa) srtment Use Onl Dar Issued c Y1II COUn /D S�ir permit Fee (includes Groundwater Approved C) Disapproved Surcharge Fee) Q owner Given Reason for Denial r" 4kO rov"easonr for Disapproval n „ „ IX. Conditions of App C,�(/�(/ ` SYSTEM OWNER p ank, effluent filter and disp ersal cell must all be serviced Ib p lumber. i mana gement plan provided y p I as per back re All setback requirements must b maintained 2 iicobte delor co as per app Attach eeetpkte pla as (te the Couary ealy) for tba system ea paper not less than ti112 : ti lactus to size e�n_�Z4Q (R. 08102) 4,9 est and System PLOT PLAN PROJECT Nathan Steere DRESS 13925 Fenwav Blvd N. Huao Mn 55038 SW 1/4 NE 1 /4S 15 /T 31 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE5/10/04 BEDROOM 4 CONVENTIONAL XXX IN- GROUND #ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 933 # of chambers 30 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE (DWELL *H.R.P. SameasBenchmark Alt. B.M. SYSTEM ELEVATION 90.7/91.0/91.3 3.5' below qrade 90' J Lj , 30' 459' Property Line is top of steel fence post @ 96.4' Well is to meet all B-3 to •° setbacks required by WDNR Pro 4 5' Bedroom B -1 House T Tv � 15' GPI -o 5' 75' 9% 3 -3' X 63' Cells with >3' Spacing Slo i 6 Town Road Leaching Chamber Standard Biodiffuser Plans Designed Using jL Conventional Powts with 31.1 ft2 of Area Manual Version 2.0 Grade at System Elevation 34 S est and System PLOT PLAN PROJECT Nathan Steere DDRESS 13925 Fenwav Blvd N. Huao Mn 55038 SW 1/4 NE 1/4S 15 /T 31 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/10/04 BEDROOM 4 CONVENTIONAL XXX IN- GROUND #ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 933 # of chambers 30 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Alt. B.M. SYSTEM ELEVATION 90.7/91.0/91.3 3.5' below qrade 90' 30' 459' Property Line is top of steel fence post @ 96.4' Vents 0 Well is to meet all 45' setbacks required by Pro 4 WDNR 0 5 Bedroom B -1 T 10 House 15' G�{•a 5' 75' 9170 .3.Z 3 -3' X 63' Cells with >3' Spacing Slo Town Road Vent Standard Biodiffuser Plans Designed Using > Conventional Powts of Cover Leaching Chamber Manual Version 2.0 with 3 1. 1 ft2 of Area 6' Long 11 " 34" Grade at System Elevation Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of ?/ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Coun �. 0 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 7 m� percent sloe scale or dimensions north arrow, and location and distance to nearest road. 0 3 2 - "�/ /� — l6-60Z� pe p , Please print all information. eview Date Personal iMorrnation you provide ma� be us y Law, s. 15.04 (1) (m)). ` S/� Property Owner - Property Location ? ��J+' `�c'4"`� Govt. Lot Si 1 /4 h/ 51/4 ST J ( N R 1 E (or) Property Owners Mailing Address Lot #� Block # Strb Name or M# i ' City State qp C tSn . F_ _ tier El City C] Village own Nearest Road �tPd , OF R( t w. _ S New Construction Us Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or oo - Describe: - -- Parent material Flood Plain elevation if applicable General comments and recommentiations-5y " �'4 ' Boring # Boring L Pit Ground surface elev� ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 0� e � Boring # XvIti ng Ground surface elev. � ft. Depth to limiting factor 1 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 •Eff#2 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) — — Signatur CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ��'-- .� 715 - 246 -4516 I Property Owner _ Parcel ID # Page of Boring © Boring # 71 it Ground surface elev. 1 1 ft. Depth to limiting factor in. T'Eff#1 Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots DM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 ) /16 !i Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 F-1 Boring # ❑ 1:1 Pit Boring Ground surface elev. ft. Depth to limiting factor 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 'Eff#2 Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 mgA. ' Effluent #2 = BOD < 30 mg/_ 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 -8330 (RAW) County t Safety sad Buildings Division J �L t 201 W. Wash n, ing A ve., . 708 2 ox 7082 Sanitary Permit Number (to be filled in by Co.) �S (erg) 261 6 53 r consi1t I State Plan LD. Number IL---� oe artment of commerce Application den- Code+ Privacy Sanitary Permit Ap P information youprovide es y law, you Project Address 01 different Ulan mailing address) In accord with Comm 83.21, Wis. A may be used for secondary purposes Iication Information - Please Print All Information - pi Q S 9 5 I. App 4" Par I # t # Block # property Owner's Name I oPeRY ation properly er's Mailing Address Q — r- _ �_ y. /� Section ---) (\ Code Y ���n City, State J NG OF CE: J N' /( circ one) I(E r W .r. Subdivision Name CSM Number Building II, ype (cheek all that a IY) 1 or 2 Family Dwelling - Number of Had S ❑Ptibli iCommereial- Describe Z - = tb t ❑City ❑VilLtge�lowrr ship of ❑ State Owned - D=nbe Use : . Complete line if applicable) 63Z - 2 l ( � /D MC HL Type o Permit: (Cheek only one box on II P A. w Systm ❑ Replacement System Trestment/Ho g Tank Replacement only [3 other Modification to Existing S ys< st evious P �r to Issued Cl of ❑Permit Transfer to New r B. O Permit Renewal C] Permit Revision plum Owner Before Expiration Iy, of POVVTS S tem: Check all that a 1 t e ❑ Single Pass Sand Filter 0 ressuriZed in- Ground ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ ❑ Holding T Peat Filter ❑ Aerobic Treatment Unit ❑ R Sand Fitter ❑ Pressurizod In-Ground [3 ❑ S / r ' Chamber ❑ rip Lt C) Gra Constructed Wetiand vel -less Pipe Other (explain) Reeimulatia Synthetic Media Fil V. Dis ersal�l'reatment Area Urination: Dis Arcs proposed (sf) S Eleva Doi ow ) Design Soil Application RMU" dsf) 1 As Required (SO �petsa�l anufaenrrar Prefab site Fiber Plastic VL capacity in Total N er Concrete Constructed ank Info Glass Gallons Gallons of nits L4z - f New Existing Tanks Tanks /v Septic «Holding Tank Affable Trwtment Unit Dosing Chamber n on the attached plans. VIL Responsibility Statement- 1, the underst ume responsibility for installation the POWTS shown s Phone Number MP/MPRS Number Busines�� Plum s N�atne (Print) Plumber' re Z O // Plumber's Address (Street, City, State, ip e) VIII. countyADepart ment Use Onl Sanitary Permit Fee (includes Grauadwate Agee[ Signature OS tamps Approved ❑ Disapproved Surcharge Fee) C] Owner Given Rea son for Denial IX. Conditions of ApprovaLtRessons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be Serviced I maintaine as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach Complete plows (to the County only) for the system ea paper not kss theca tll2 s l l lathes is size SBD -6398 (R. 08102 j31N/R T PLAN PROJECT Nathan Steere ADDRESS 13925 Fenwav Blvd N. Huao Mn 55038 SW 1/4 NE 1 /4S 15 / 19 W TOWN 'Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4/24/04 BEDROOM 4 CONVENTIONAL XXX IN -GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDIN TANK ANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 BENCHMARK V.R.P. Top of Nail in Double oak tree P:-'�.��SSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL s H. R. P. Same as Benchmark SYSTEM ELEVATION 91.5/91.0 3' below AC / N Well is to meet all Plans Designed Using setbacks required by Conventional Powts WDNR Manual Version 2.0 Vent >6 „ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long 11 11 34" Grade at System Elevation I 2L3' 8 ' Ce th 2.5% >� a . B-5 Slope B -3 45' 0' Town Road Pro 4 90' 0' Bedroom House B-4 50' B.M. #1 COOP* B -2 0 1 0 B -10 �- 20' M. #2 240' 414' P C PLAN PROJECT Nathan Steere ADDRESS 13925 Fenwav Blvd N. Huao Mn 55038 SW 1/4 NE 1 /4S 15 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4/24/04 BEDROOM 4 CONVENTIONAL )00( IN -GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 BENCHMARK V.R.P. Top of Nail in Double oak tree �9 ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE WELL H. R. P Same as Be Q r ak SYSTEM ELEVATION 91.5/91.0 3' below qrade r- Well is to meet all Plans Designed Using setbacks required by Conventional Powts WDNR Manual Version 2.0 Vent >6" Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long Grade at SysteK 34 : 2L3' 8 ' Ce th 2.5% >� a . B 5 Slope B -3 45' 20 Town Road Pro 4 90' 0' Bedroom House B -4 50' B.M. #1 0' 20 0 B�-2 10 B -1 20' M. #2 240' 414' r Wiseonsin'Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page 1 of 3 Bttreat_)of 'Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code 7 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size La mutt < ; -; Coun ty include, but not limited to: vertical and horizontal reference point (BM) ire cpbn and St. Croix percent slope, scale or dimensions, north arrow, and location and dis fib" newrq Parcel I.D. # APPLICANT INFORMATION - Please print all inform �� Revie by Date ;. / Personal information you provide may be used for secondary purposes (Pnva Lai s 15.04(1) �Oi �� /2q�� Property Owner op 41 Richard Stout , " >� P Ot P F � n �'`t4'NE 1 /4,S 1 5 T31 N,R 19 E (or) vK Property Owner's Mailing Address )Subd. Name or CSM# 1 353 Awatukee Trail e "' S ` s City State Zip Code Phone Number City Village To Ne wn a rest Road Husaon ri 154016 (715 )549 -6731 Somerset i 60th Street EjNew Construction Use: Residential / Number of bedrooms 4 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 6 0 0 gpd Recommended design loading rate 1 7 bed, gpd /fF --8 trench, gpd /ft Absorption area required R S A bed, ft 2 7 5 0 trench, ft 2 Maximum design loading rate � 7 bed, gpd /ft _ 8 trench, gpd /ft Recommended infiltration surface elevation(s) See plot plan ft (as referred to site plan benchmark) Additional design /site considerations Parent material CoC2 Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ®S El 0S ❑ U ER S ❑ U Os ❑ U El [:R U ❑ S q U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0 -6 1 Oyr2 /1 -- sil 2 rq aeK mfr cs 1 f .5 .6 2 6-99 10yr4 6 -- ms osg ml cs -- .7,.8 Ground elev. 9 5-0- ft. Depth to limiting factor in. Remarks: Boring # 1 0-10 1 0 r2/1 -- sil 2 mp r mfr cs if .5 ;.6 2 2 10 -36 10yr4/3 -- is 1 MA6 mfr cs -- .7 ;.8 3 36 -94 10yr4/6 MS osg ml cs -- .7�.8 Ground elev. 93 ft. Depth to limiting factor -9 Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number PROPERTY OWNER Page Richard Stout SOIL DESCRIPTION REPORT 2 ' of 3' — PARCEL I.D.# - Boren # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench 3 1 0 -6 1 Oyr2 /1 -- sil 2- , mfr C 1 f .5 -.6 2 6 -3 6 10yr4 /3 -- is 2vn4,(3K mfr cs -- .7 '.8 Ground 3 38 -99 1Oyr4 /6 ins osg ml cs -- .7 ;.8 elev. 92 ft. Depth to limiting factor –9-9– Remarks: Boring # F� c3 4 2 -99 10yr4/6 -- s osg ml C -- .7 ;8 Ground elev. 9 4 -44-ft- Depth to limiting factor 9 9 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring# 1 -6 10yr2/1 sil 2rn(v -0 mfr cs 1f .5 '.6 5 2 -99 10yr4/6 us osg ml cs -- .7 8 Ground elev. 9 2 Depth to limiting �9or in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) 5 Tou7" 4 e'7' /5/ P y , 3 oF3 �iJ �Za( R i ✓0 ,6 1 ° L T A la L5 Lo7"/'`f f ti C I � r v� r •Bma 0 r /3 1 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent fitter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the fitter. 3. Once evOry 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 ownor agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershod is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 ntingeney Plan trption )Jnn If system fails, determine cause of failure, use aftemate area and install new tested replacement area. option Y ' n #2. Install system m at a lower elevation, by removing chambers, removing biomat, and install new system. O tion #3. No adequate area is suitable for replacement area, and system elevation P 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 APR.ao.2oe4 9:55AW .aL SCHWIETERS BELISLE EXCAVA TNG NO. 470 P.c /3ppg^` -- ST MOU COVNTX SEPTIC TANK MAIN'T'3SN kNC2 AGREEMENT ArNJI _ CGWNERSHiP CERTIFICATION FORM, Ownerlf3�,:�•er l pr opert }+ r'1 .ilr'icnliar regw ^ed rran' PlAU44 DcParrment for new eoastruuttatt) Ll{yiSluw •_ parcel Identification Number 1 l CsdCa r Pr4perta LoCati�yu . fa, Set:, N -R,aW, Town of .'5nrryi�16 f Subdivision � ,Lot Cerri #ieii Sr i °vwy RX:Ip �� Volume Page # Warr:itJ#'g' ��w_5c:ti � q , V011srtrC a Page # Spec 1,0u 4 l yes no Lot lines ideztMabte yes L no 01 N1 jV t ' ° A' o1j "t' ctr�!';lulnlen;anscoryour scAtic system could result in irs prcrnalurc raiJure to handle wastes. propes'rg4iarettxiacc canstsrs or ",l�,,�rir{F OWL the std�tlu every chrae years or raeocr, if needed by a lieeris d pumper. What you "t inw ncc 9yarem r:aA *lll� l the 'ui +�t+uu ui" he 4013W: lank as a r j , e4=*nrsteg¢ Ln Lhe wart disp0501 exaa:rA, Qwr�ar a8rces to submit ro Sr, C:oiac 2oaiog Dopactmeata eptittostiofl form, sigised by the owner and by t raa;rlarPluull;tr,(uurilty1, 44 P lumber , restriemdplumbarat4llcemed tun erverif y . 8 � � at ! the oa.s iii 41 � {•Al,rl ; ;iiilll +, ���flCilily7l'! :111C1{Itr (2: ,{J In,SpCCliQ7 LRI llY� P p and (jf area , fta w4ttew9krtjl�osalsysters ssW), the septic tank is less than 1/3 full orsJudge, I/W fIYC ulldrtBiM +,nc{� litis+c trod the a r:�ttitern6lgts e gAtl IF= [ O main tain the private sgw'Age disposal system with the StttAdir see IorUl, htrelrt, a, eel by tht 1Jepurtmc,nl al' Cartta�aroe and the Department of Natural Resources, State of Wiscous'iu. Cer%jc&aoa $Lad tilt 1' " r'vP1'C aye "rn has bsen maintained must be complewd and rctumod to the St. CralX Couary Zoning Office witdlin X of cht (1L'Gt. t + C:1r Gtplt'1liQn d1Sto. t N*��"-' �Jr' �.r r'LtC',�rvr j � /d DATE 'r 'All stattrncr+ts an thia rornj arc we ro fhe bosr elm opurny tltlu ' eve, by vlr{ur of a warran Y (o u r ) knowledge. C (we) ern (are) the o s) of tY deed rcco:rdtd in [itgister or Deeds Office, DATE A fnl'art,i „,Lic,n I may result in the $ABArypartnit being revoked by tltc Zanins Department, ”" dnelude �, ill! this al9pticatlon: a stamped warranty deed Irani t he Register of Deeds omce u ro" or the ccrtiricd survcy map if r'eferenCe is made in the warranty deed 4;FR. 04 9 57Rh? - 'JL SCHWIETERS S&C BANN OSCEOiA �TIO.47� ""P.3.'?�00 Coy;nty srjni td CZtsn- t5teve Thompson 2/2 V .2547P 58S, - 7�ssM :LS, STA 11" OF WISG'gNFW FgIW I . C S99 7'itL>rRY R. wAl.Sk l:ocwnoat Nr,rnb�r WAFatANW DEEP IS= OF DEM . MIX Co., Mr TILil Did, iftAde iaewaen C . RRCCIVED !•aye RECOR>d ad _Nat�t _W 9�re Sind +rti. Z j Gaaatar, 04 / 1a/ Is.-MAN ,tire. auslemd snnd ,vd+e NARRAATY 06E0 Grantee. Crsatnt, fbr avatnrbte cau'desatim, conveys ad wa mt, w 3raatea F -XE�PT E the follaww dosat -hod " estate in - -St. rrAig County, &ate of WimmiA ME � : 11. M Mo (�f space is needed iatesiQe aixach eddea�dtun), 78� . 17% 78 F6S: E s L of � - - h es in ON Ta PAGiS s w>A of Satta7a, �. crdc ; N-0 rsT�. r+�L ATTORNEY AT LAW R.O,. F:L:4'x &SO . WIfD:�i:r.d, �JJ Sd3Y6 nisei uI *ffica et No*" RF'>r1) nip A nal bwa,smd ProprrtY Fa"pdaaa to wrarrttalia., 7"emM U, ggoriodaw ,Rqd ri&lrd. y of rreourd, ii (is , Doted this daY of V AUTEW,MCATla1V ACltSVOIIVI.EpGltdls�Tl' sue) R an „Ct M a:rJ 'DDchals C. cm%*a. STATE OP . } auttienslcat� ehiW - •_' _—��_ C4� Peesar pr =M balam ate ibis dty+ n4 —�.. -- -^ ate shove riutt M tend TMM�MUIX STAT Wa OIR WISCONMN gr not_ to ate lorr:Mta to etWtoriacd by 9 end 7011.06, Wts,'ststs,) bo d►t: paao % wha exea,ted da Cora�oins iascrtttneat eeltttaw)adged the sprint. 'i'FM DisuvmzNT w,s DRA.p = ]3Y Atiet7Rr+y itrbettt.�Q$I�ti g t� s - ,Vf'Y�] d � �—, rTars�7' Pltbl�e, St+te of ��` `_ _ _ , ..- - - •..__,._ �. Mlaawrltl may tr ilU hMis:aw or % M5 Cuttunissioa tp I►erta7aeAC. (If fsx vAl s �+cpimdan dste; SlmowJrdppd. 8atm sas rest t!0¢cssatry.} � .) * Nsrnks of pstatat9 sisnine M any ea,pgahy WOW bs* Q =lr 3 t Mra. d lhtarnpasn PrtlGssia+qF� t o., t+.sct u t,y t w Wp►ti�A?rtk &M wa of WISCONSION Wo Li , w MUM N06 2 •:999 i� ■ ■ i Located Northea, Quarter S St. Croi: Volume N J MATCH LINE (SEE SHEET 1) S89'25'09 "E 456.61 MATCH L I N E (SEE SHEET 1) 72' UTILITY £ASMENT r I I I I N& r 1 7 , 1 5 of I I 1 r N I 131,170 SQ. FT. EAST_ r 3.01 ACRES 28.04' PONd I I EASEMENT 11 25 YR H.W.L. t 925,47 ,I • O o i I N; POND �� v 25 YR H.W.L. �i, PONDY N \ NSOg 927.30 ' I YR H. ^�� 3 �� 459. 19 i 925.47. .,e '02 "�V o COD Z M I M N 3 (� ? ?3 v EAST 162.62' hf ,I I •5�`� l ; ®O �� I �_ - - - - -- 8E�r �� 5� � ��� 28.73' r �i� _ • I n 9 71.11 �:, ra � r r� o �5 ic- 25 :2b H. W.L � u� 30.19'�� r ® Z y P�O D 88 I �' i �X\ W rn tttt L�� — WEST 97.59 = 10 y � x Z r N 1 q, WEST 1162 . , / � Y / 40 o= r • 3 W'�� ?UPON O i 131, Q. FT. /l� ^ x� I EAs U I ` &S N m Q \ � -•fit{• _ � t0 �• 3.01 ACR JOINT • 414.7 21 "' 0 00 p O l/ S84-27 21 ; cN DRIVEWAY �' r o O N p �` `, Z o �� 1 3 o N Z�— 131,124 SQ. FT. ' , in Z ici II = 3.02 ACRES Z L0 a. LLJ N 1 ( x� �. ? 'ti � 4 336 "f i \ 1 �" 3 E lu I rn p Q p'`' 25 YR H.W.L. \ N� )T 8 xys46.00 ��� ,�� y� b �� f x 0 I n ,1 "' l / 6 X�4x" fix _.�i1 � '•o`'� h� . `. L 0 7 ? \ 0 / C) f T m ° lo t R i § � - \ \ \ / ° C 3 \' ! 9 [ ® < - \ E 9 . @ w m . o m ° z m« §_ ° k § § § § — _ ® to 0 0 @ z m > z> @ z e z> i% cn a > a / a> e > R §; \ k \ k \ \ CD 2 @! \ \ \ \ \ 3 cn ƒ f f f / \ rT cr ""A M T M �. J 0 0 0 ul Oro 2 2 2 _ % /. # $ A /§ & /§ ma ■(A , $ « _ C/) @ _ V a v . , C: J § / k k \ \ § / ) = > > 77 t §E t §E „ a 7 /m p 7 . O(/ CD m a,£ m �,� CD \\ 3 §\ 3 i [ 7 \ \ 2 w ■ « m s« (n E E � M g \A \\ � �) § E §E 2 %} /} 27 z CL CL 2� 2m OF 'z\ E§ 'CL 7 z _�» � # % I ® I $§± « §± 3 0 /\/ n D 0 C % E 0 \: \_ p \[ > ) > >o 0 Q6 2 ) CD CL \ f ;4 00 \ $ � 25 7 j / \ ? 2 2 K , , o o ; m q r0 ? f o C) k k k 0 i k'3\ it Test and System PLOT PLAN PROJECT Nathan Steere ADDRESS 13925 Fenwav Blvd N. Huao Mn 55038 SW 1/4 NE 1/4S 15 y/T1/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/28/04 BEDROOM 4 CONVENTIONAL XXX IN- OUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 2 8 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark Alt. B.M. SYSTEM ELEVATION 90.7/91.0 4' below qrade 90' 30' B•M- * 459' Property Line is top of steel Ven 45' fence post @ 96.4' B -4 Well is to meet all B -3 setbacks required by 20' Pro 4 WDNR 25' Bedroom B -1 5 T House 15' 5 ' 75' 9% 2-3'X 88' Cells with >3' Spacing Slope Town Road Vent >6„ Standard Biodiffuser Plans Designed Using Leaching Chamber Conventional Powts of Cover with 31.1 ft2 of Area Manual Version 2.0 6' Long 11 " 34" Grade at System Elevation Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code _ n County ?.l )`x Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 1 /4 j 3 N R E( ) w Property 0 rs fAailing Address Lot # Block* S me CSM# City State Zip Code Ofidne Number ❑ City El Village own Nearest Road ew Construction Use. esidential /Number of bedrooms Code derived design flow rate Q Q GPD ❑ Replacement C1 Public or com raaI - Describe: __— Parent material �l 7 1 Flood Plain elevation if applicable ni fT ft. General comments and recommendations: �� I Pmt >G�✓` ✓ l �' /�/ a v mendations: G © Bori # Boring Pit Ground surface elev. ft. Depth to limiting factor ` in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDflf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. �^ 'Eff#1 I - Eff#2 6.46 A-, ft,, � Z� 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 Effluent #1 = BOD > 30 1 220 mg/L and TSS >30 < 1 mgA- ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) JBe CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 s%2 `/y 715- 246 -4516 f Property Owner _ Parcel ID # Page of a Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDJff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ Pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 mgA. • Effluent #2 = BOD, 130 mgA- and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. 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