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HomeMy WebLinkAbout032-2146-50-000 II II II 111111 IIIII 8224767 Tx:4183956 Document Number Document Title 994934 St. Croix Count BETH PABST Y REGISTER OF DEEDS Occupancy Affidavit ST. CROIX CO., WI RECEIVED FOR RECORD 04/17/2014 12:44 PM ain ywn 0 U-) EXEMPT #: Name— (Owner)Typed or printed REC FEE: 30.00 being duly sworn,states,under oath,that: PAGES: 1 1. He/she is the owner/part owner of the following parcel of land located in St. Croix County,Wisconsin,recorded in Volume Page "- Document Number'453ZZ St.Croix County Register of Deeds Office: Records Area Name and Return Address A parcel of land located in the SE '/.of the 50 '/4 of Section / 5 �--I C-U-) T_LN-R /9 W,Townof 504V%e,05C� St Croix County,Wisconsin,being duly described as follows(include lot no.and SA' W 54Oa-S subdivision/CSM or detailed legal description): 6 3Z - 2-)4(o - 5d- OOC> ha,L I t�a [ d� I c.J Parcel Identification Number(PIN) , 0,k G As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a _bedroom home,or a design flow of 46o gpd. The design flow is calculated by assuming 150 gpd for individuals per bedroom. There are currently occupants living in this residence; (o occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However,I understand that if there are intentions to exceed the number of permitted occupants,the system will need to be modified to accomodate any increased wastewater flows and/or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this day of r * �' Vlz . AUTHENTICATION ,J%%11111/117 ACKNOWLEDGMENT Signatures) ;.♦�.. tiF v f'' STATE OF WISCONSIN )ss ♦ /authenticated this day of �St.Croix County. } i �the Pe before me this��day o ` � Z��, med] ,\ * `G :z_ TITLE: MEMBER STATE BAR OF WISCONSIN(lam P G��:to me.known to be the person(s)who executed the foregoing (if uthorized by§706.06,Wis.Stats.} .11 5♦♦♦� in frame nit acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY If/iriO F11',�♦ Notary Public, fate o isconsln Commis ion is permanent. If not,state expiration date: (Signatures may be authenticated or acknowledged. Both are not Date: Q/-/�' necessary.) THIS PAGE IS PART OF THIS LEGAL DOCUMENT-DO NOT REMOVE" led b sutxnwer. document tide.hams d return address.and�V(if negU ed). Other in/omm con such as the greinto taus n must be compte Y of the document or may be placed on add4bnel pages of the granting pauses,leagal despipLort,etc.maybe placed on this fast page h 00 to the reed fW(ee. Wisconsin Statutes.59.517. document.WL Use of this cover page adds one page to your document end s St.Croix County 994934 Page 1 of 1 mt of Commerce PRIVATE SEWAGE SYSTEM Coun St. Croix ng pivision INSPECTION REPORT / Sanitary Permit No: 399623 0 (ATTACH TO PERMIT) ! 11 gild i INFORMATION State Plan ID No: Ana' -mation ou provide may be used for seconds y p y secondary purposes [Privacy Law, s.15.04 (1)(m)]. ,es Name: City Village X Township Parcel Tax No: Kruschke, Richard T. & Danette I Somerset Township 032- 2146 -50 -000 CST BM Elev: Insp. BM Elev: •^� BM D cription: �} •1 TANK INFORMATION W ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W5 ! Benchmar Z\ t o� J S.gD ol.�o Dosing Alt. BM t 'f•�b o $: 8Y Aeration Bldg. Sewer • �0 b I Holding St/Ht Inlet 6 2d r )n3 � TANK SETBACK INFORMATION St/Ht Outlet (p. � O p•T • ( TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet I Septic t I Dt Bottom >Iao Dosing Header /Man. Aeration Dist, Pipe • b 40 a.1 � e2.90 Holding Bot. System 8•� of • 30 $ . SO o t • 'aD r PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM o�• SO O�.ZO Model Nuftqr. TDH Lift ri Loss System Head T H Ft Forcemain Length Dia. SOIL ABSORPTION SYSTEM LQ� 5 BEDITRENCH Width Length No. 9f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 r �$• " / SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufa rer: INFORMATION Type Of System: ,i CHAMBER OR � � pI "$t tCO ✓• 3 UNIT Model = ber DISTRIBUTION SYSTEM Header /Manifold ' C Distribution . Hole Size x Hole Spacing Vent to Air Intake 'T " Pipe(s) ! ) L Length Dia pacing 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 fog Bed/rrench Center 2i Bed/Trench Edges Topsoil Yes [A No F01 Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: T6b / l / 2-0O Inspection #2: Location: 2121 54th Street Somerset, W WII _ / 6 5 (S E R 1/4 SW 1/415 T31 NN R1 9W) NA Lo Parcel No: 115.311.19.11276 1.) Alt BM Description = �ofbk 4u' v C, 'l . �1 �1 '0 �"^'` P'�' '�' z�G�e s g4.,•- `�e'21.4 A 2,) Bldg sewer length - amount of cover = >t* "s� i/ C^ -� 31 �� IAr -log Plan revision Required? (] Ye N ,c, < Use other side for additional informa � SBD - 6710 (R.3197) Date Ins Sign ure / ,/ , r[J No. _1-s "A� 1 c1,/ Sa y and Buildings division County /� )( 201 W. Washington Ave., P.O. Box 7162 i Y isconsin Madison, WI 53707 - 7162 Site Address t l Department of Commerce 212,1 .S Sanitary Permit Applicat • \\ rr pp Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal ' a 'oq..yo rdvtliq/ Q a Z heck if Revision / ma be used for second purposes Privacy L 1)(m) I. Application Information - Please Print All Informatio �?��, ;� State Plan I.D. Number fV Property Owner's Name U S —t �� r� Parcel Number Property Owner's Mailing Address s .ti Property Location c , u " City, State Zip Code Phone Number --umber Block Number Subdivision Name CSM Number II Type of Building (Check all that apply.) ❑ City or 2 Family Dwelling - Number of Bedrooms O Village O Public /Commercial - Describe Use O State Owned Nearest Road Z/ III. Type of Permit: (Check only one box on line A. Numbering is for internal use.) (Complete line B, if applicable.) A. New 3 O Replacement of 6 ❑ Addition to Sy stem 2 ❑Replacement System Tank Only Existing System For County use B ' Check if Sanitary Permit Previously Issued Permit Number 3 �� 23 Date Isstt�tL / O IV. Type of POWT System: (Check all that apply. Numbering is for internal use.) G 44X Non - Pressurized In- Ground 210 Mound 47 O Sand Filter 50 O Constructed Wetland 22 O Pressurized In- Ground 41 Holding Tank 48 O Single Pass 51 O Drip Line n 45 O At -Grade 46 OAerobic Treatment Unit 49 O Recirculating 30 OOther / V. Dispersal/Tr ent Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals. /Days /Sq.Ft.) (Min. /Inch) 7&* f Elevation AV, _1� lo-- VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Dosing Chamber (/ ✓` VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' i lure MP /MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zi ode) VIII. Count epartment Use Onl Disapproved Date Issued su' g Agent Signs (No Stamps) Approved O Owner Given Initial Adverse Sanitary Permit Fee ud c� ater 11 Determination Surcharge Fee) IX. Conditions of pproval/Reasons for pp isapproval 1 ( tw,(�tJ� vu ►x t oQfu.(�a�Q t "s �--2 - &ew_ q, � st � 0 Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size PLOT PL Nj PR®JECT Rick Kreshkv ADD S 05 ctv Rd. E Hudson w 54016 SE 1/4 SW 1/48 15 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX e MPRS Sh a un Bird 226900 DATE /8/ 02 BEDROOM 3 CONVENTIONAL. )= IN- GROUND PRA RS CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1 . 2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of Steel Fence Post 100' -1 A38 EELEV Filt r A UM @ ZSbel 00 ❑ BOREHOLE O WELL ■11. it. P. Sarne as Benchmark SYSTEM ELEVATION 99 .0/96.6 I Alt. BM Top of 'Wood Post Qa 101.2' Vent Plans peed Using 1e � 12 ,. Sidewinder High Conve ntional Powts " Capacity Leaching Manual Version 2.0 of Cover Chamber 6' Long 16" Grade at System Elevation I y a I Pro 3 2 -3' X 69' Cells with >3' Spacing Bedroom 30' House 50' 35' 35 B__1 35 , T Vents Vents 100' B -. 12% r lope Property Line Zd Wd££ : t T T00Z SE ' I nr 'ON XUA = WMJA I PLOT PROJECT Rick Kreshkv ADD s 05 ctv Rd. E Hudson w 54016 SE 1/4 SW 1 /4S 15 /T 31 N/R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE /8'02 BEDROOM 3 CONVENTI )= IN- GROUND Pldg CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIIi r TANK SIZE DOSE TANK SIZE HOLDING TANK S=9 LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O W . 11 R . P. Same as Benchmark SYSTEM ELEVATION 99.0/96 I Alt. BM Top of Wood Post @a 101.2' I Vent Plans Designed Using > 12 „ Sidewinder High Conventional Powts of Cover Capacity aching Manual Version 2.0 Chamber 16" 6' Long Elevation t System Grade a y a3 Pro 3 2 -3' X 69' Cells with >3' Spacing / (i Bedroom House B -2 B -1 50' J- 3 35' w •' Vents 100' �.S R s: �-- 12% S lope Alt. g,M. 5' operty Line zd Wd2P_ : t ti T00z SE ' i of 'ON Xdd : W0;1j Wiscons*, Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County `�( Attach complete site plan on paper not less than 8 1/2 x 11 inch . Plan must ✓ ` O �x include, but not limited to: vertical and horizontal referen igt�B(tA r and Parcel l.D. percent slope, scale or dimensions, north arrow, and mn d d` }b� est road. 4 '�" o Please print all inf 'on. R �9 Re iewed by Date Personal information you provide may be used for purposes (Prly . 15. ) )). Zg� Property Owner Property' lion 1 �'(, ? vt. L ,_ 114 114 S f 3 N R E Property Owner's Mailing Address Ur `' x Lot # j lock # Subd. Nam or CS # City Sta )6 tip Code Phone tfmber ❑ Village own Nearest Road i S 6 )'0 ( ) - � r , S New Construction Use esidential / Number of bedrooms Code derived design flow rate 4 ? 1 J� 6 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable General comments � and recommendations: Boring # E] Boring 0 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/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z l o S XY s 222 ® Boring # ❑ Boring //)) Pit Ground surface elev. Depth to limiting factor / in. RE Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 �(S � Effluent #1 = BOD > 30 _< 220 mg/L and TSS >30 _< 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L C�I� ame (Please Print) ign re � � ST Number e �,� ✓ 9 Address Date Evaluation Conducted Telephone Number z SBD -8330 (R07 /00) Property Owner Parcel ID # Page of © Boring # ❑ Boring Pit Ground surface e ��� elev. �ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtftz in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 3 33 4 0 -0 4 Boring # ❑ Boring A Al Pit Ground surface elev. �() 1, d ft. Depth to limiting factor ( z in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 r n S c Z r' "3 Zo - .5 �� / A , 2. 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/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R.07/00) Soil Test Plot Plan Project Name Rick Kreshky Shau d Address 705 Cty Rd E Hudson Wi 54016 1 #226900 Lot 5 Subdivision Oak Haven bate 2/8/02 SE 1/4 SW 1/4S 1S T 31 N /R19 W Township Somerset Boring () Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 99.0/96.6 *HRpSame as Benchmark Alt. BM Top of Wood Post @ 101.2' V . Q _ I Pro 3 Bedroom House B -2 35 , B -1 D 50' 35' l ob' a- P� 25' 102' 100' 101' B -3 12% lope Alt. B.1VI. Property Line 1.' Td WdS:2:TT T00F SE 'Int 'ON Xdd WOdd (SSE a4EET 1I 1 MA T C H LINE N8915 "W 637.03' 2 24Z2Y J j I �I HIIL W, LOT 8 �'� : 135,192 SO. FT. f \ M Z - ACRES o N I MW FFE=922.2 , \d• N N89'15'2 2 "W ��.�• 636.33' LOT 7 � o .. 0,��` ,,.z— - • • — °•: _ � .. _ .. _ . . - — 134, 628 SO. FT it 0 00 ' 3.10 ACRES � /6 cv V-- t M /N. FFE -922.2 v CV U N89`15'22 "W 635.63' 04 345.82' 289.81' a to : W0 r z T M w p LOT 6 U) o LOT 5 131.720 SO. FT. 131, 081 SO. FT. ' 3.02 ACRES w 3.01 ACRES � MIN. FFE =929.7 M /N. FFE =916.7 I (n 7 N M I I HK ea.3o• N89'15'22 "W o �; �� �0 N89'15'22 "W 345.82' 66' JOINT DRIVEWA �/ Y EASEMENT 33.005'�\�� HNL �� -_" FOR LOTS 4 AND 5'15.22 "W -- 634.27' - - .7V .��I � 33.005 � N89 15'22 "W 345.82' N89'15'22 ' W 66.01' (n I o f Z I Soil Test Plot Plan Project Name Rick Kreshky Sha Lird Address 705 Cty Rd E Hudson Wi 54016 M #226900 Lot 5 Subdivision Oak Haven Date 2/8/02 SE 1/4 SW 1/4S 15 T 31 N1R19 W Township Somerset F1 Boring Q Well PL Property Line County S T. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 99.0/96.6 *HRpSame as Benchmark Alt. BM Top of Wood Post @ 101.2' U 0 v Pro 3 - Bedroom House B -2 � 35' 35' 35' B 1 70' OW 103' 25' I A L 0' 102' 101' B -3 12% Slope (, Alt. *B.M. �7 15' Property Line � T 'Safety and Buildings Division County l --� "TwRonsin 203 W. WaahingtMt Ave., P.O. Box 7362 w _ �T � ! L Madiaoa, wI x 3707 - 7362 Da rtmbnt of com merce a,oe $ ✓ Sanitary Permit Application Ma P Number p P In wood w* roman 0 .21. alas. Adm. coda, > a 9 Co Z �j b Pri Law sIS 1 >e U Chad if r L Apples Iniormeetion - plan plot All Informiation Pro" owme e NSIRS R ia741 owner" s MWft ACKM LILL, 1 Chy, am S ZIP Code I N R � E lumber CSM Number JL TYPa of SWNkS (look aN that np*)- -7 ! Z ?W* Dwa ft - Number of De E7 Po uxonwWow - Describe Use Sim owned lII. lypt of Fwa tt (Check only ana butt on Hoe A (numbering A 2❑ Rop menvo,>ssm 3 D R eple =AU of B [1 A -- Tank oai - a• Q aWk'f &MWY Permit Pmiously IeMd Permft Number Due Cawed IV. Toa at Fwmib (Cheek !R t Pt aP*) C Owing schism Is for laternal W) •�Proeauimd In-Grotmd �/ 210 Mound 47 © Said PlIter so Cl Constructed WuWd 22 d Pswudbtad Co -Ground 41 Q bolding Tjmk 48 Q Single P= 51 L1 Drip Liao 4s ❑ 46 a Am* Traltmert Unit 49 0 30 a Other o• t Aetiw Int : Deep. now V1+d1 d Area >5i � Area sou wPP�oA Percalulan Bare s Wm(Oals /Dsys/Sq.Ft.) ram 8ltvsttoa l (} Ci �� y! L VL Tanit Into CaPaolty in To41 Number Matrz$cturet Prefab site Steel Fiber Qalloos Galloon of Tanks Corm ate Conetnucted Glen PleadC New �t �' ` I sasaree ror i or the POWTS shown on the Attacked P Nassa 1 10VMPW Number Business Pboae Nm» bar L/XL Pla 6W# Ad*ee (Seaeu Cky, fta. code) l VIII. Camev Un ❑ ,W SWAIRy Femur Fee (hwludes Orou dwaser Dan Iesned Jswiut Agent sigmcum (No ❑ owwr ON= WW Advar e l DL - C 4 0dd Ya of AppMO2mmus Ow Djuppro a /N2 Uy✓y�2ic, .co /Lta'0°��'"+''�C�.. }�'�tQ [+�.a,c.h.�G4��Lct- oQ}�C�,e �0�aJ/�5- �j /�ev cvyc No4hvl�ic�� AI s�f t--Gcc 9`-c s 5e o'�sc�....�e� c•�e•c�r,�n � oze�.Z• ti��e �.�e�xtcP� K04 t� ai wa cr kt O r,ti C env) or aw gwmman Perm W 1W ma am _ U es nine SBD•6398 (R., 03l01) PLOT PLAN eROJECT Rick Kreshkev DDRESS SE 1/4 SW 1/4S 15 /T 31 / t 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/27/01 BEDROOM 3 CONVENTIONAL X0C IN-GRO N94ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of 1" pvc pipe ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL •H.R.P Same as Benchmark SITEM ELEVATION 96.0/95.0 f 84' B 1' Alt. B.M. 54' ft- Plans Designed Using Conventional Powts 8 dents Manual Version 2.0 \ B -1 � 8 ' 6 101. 2 -3' X 9 W Cells with >3' 9% Spacing Slope -3 qt8 So. 4 Vents a� 50 B -2 30' Pro 4 Bedroom House k Vent > 12" Sidewinder High of Cover Capacity Leaching Chamber 6' Long 16" Grade at System Elevation 34" 210th Ave PLOT PLAN `"PROJECT Rick Kreshkev DDRESS f SE 1/4 SW 1/4S 15 /T 31 '/ 19 W TOWN Somerset COUNTY ST. CROIX i MPRS Shaun Bird 226900 r E DATE 11/27/01 3 BEDROOM CONVENTIONAL XXX IN -GROUN ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 BENCHMARK V.R.P. Top of 1" pvc pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P Same as Benchmark \ SI TEM ELEVATION 96.0/95.0 (84' B 1' Alt. B.M. 54' Plans Designed Using Conventional Powts 8 )�ents Manual Version 2.0 \ B -1 toI• 6 8 ' 2 -3' X 94- Cells with >3' 9% Spacing Slope -3 4 Vents 50' B- T 30' Pro 4 �O � Bedroom � House k I I jL Sidewinder High Capacity Leaching Chamber 3 4 Grade at System Elevation 210th Ave i Wisconsin DepartmentofCommerce SOIL EVALUATION REPORT Page —L_ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. CRoix 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. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pendi Please print all information Reviewed y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 Property Owner Property Location Gerald J. Smith Govt. Lot SE 1/4 SW 1/4 S 15 T 31 N R 19 )Nor) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 11160 190th Ave. 5 na Oak Haven City State Zip Code Phone Number ❑ City ❑ Village kJ Town Nearest Road Elk River MN 55330 ( 612) 441 -8888 Somerset 1 Ave New Construction Use: [R Residential / Number of bedrooms 4 Code derived design flow rate r PD ❑ Replacement ❑ Public or commercial - Describe: ^ ' Parent material outwash Flood Plain elevation if applicable ' General comments A / and recommendations: �� Z�0' f oT Cqp� trenches @ el. 97.95, spaced to code 3.50' below surface GO z P j r\ . r] Boring Boring # Ground surface elev. 1 01 .60 ft Depth mg factor 90 in. ® Pit th t limiting 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 I 'Eff#2 1 0 -10 .5 r4/4 none is Os mvfr cfw 2f 7 1.2 a� u '6 F- Boring # [] Boring 101.20 90 2 1 x0 pit Ground surface elev. ft. Depth to limiting factor in. Soil A 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 1 0 -8 7.5 r4/4 none is Qsg mvfr qw 2f 7 2 8-90 7 5 4 non e--- ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 5 150 mg /L 'Effluent #2 = BOD 30 mg/L and TSS S 30 mg/L CST Name (Please Print) Signature . CST Number Gary L. Steel ✓ 02298 Address Date Evaluation C96ducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 5 -5 -2001 715- 246 -6200 Property Owner Gerald J--Smit Parcel ID# pending Page 2 of 3 Boring # ❑ Boring 98.50 90 3 ® pi Ground surface elev. ft. Depth to limiting factor in. — d — oilApplication 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 1 -8 7 5 4 none Is Osg 2f 7 1.2 3 14 -9 7.5yr4j none ms Osg ml na na 7 1 2 "' F] Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Ap 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 Boring ❑ Bonng # 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 /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30:5 150 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. SBO -8330 (R.6/00) .. STEEL'S SOIL SERVICE Gary L. Steel Gerald J. Smith 1554 200th Ave. CSTM SE4SW4 S15 -T31 N -R19W New Richmond, WI 54017 MPR W -3254 715 246 -6200 S town of Somerset � ) lot # 5- Oak Haven This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 0. 1 " =40' BM.= top of 1" pvc pipe @ el. 100.00' USA alt. BM.= top of 1' pvc pipe @ el. 95.30' I t o 4!` \ t q O ti< Gary L. Steel 6 -5 -2001 a ' 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 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 i i j Y � / Shaun Bird #226900 ST CROIX COUNTY �� SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner./Buyer �'. ( cV,e, I - .v�.. t`r /t ��0��� i 1 n .kdar ..s I ?rope+cy Address I a J q 5 +, _ VcrLCation : q aced ;'ram 'tanntnr, c ^ar ment (cr :e -,v co _c:ienj City/State ParCC! CZ : I,,MCC: LEGAL DLSC^J?7 - 1O^i � (( f ��f'�,Yfl�� il`iT.ef- �11.�1.1 •T `�'.: �t -��'.� --------- ^tv� SYSTEM, MATN=.JANC ..r- :'ogc:...... .�c:...3inua._:zo� ;ct:::��c.. ._�_c>�c._..�it::.. _ `.:.t•.- _._.ivy•.c._..�._c ?�.. ;cam.;' :cc :. W:.� O.t _ Septic cveve ,'+ice or izz . u ...__....... .;V l .- :_....�...'.`L'ir'_�'. '.tli.3: :C•: it.: ...... .:C ,SC`:.. •4 r1 '+,.. -, t�e:i= of ....: ;erde �:.Y, 3z a �'ea�ea! Wye it: - - -y=t.: ....,.._... - ,.^..� T�z nrcper y Ow er 3glycs :o ru:umi: to t CMa - Devi. —c= : t c.- ri5cation :ern. :;cd ..= ow= and '.y i zl=ixr or z .cen^ea au. . ?� rr ; +L-i (i See: siie *r_s;c vatcji -F ral :y °tey . in nrcper Cce=d=g cxditi= (i) aD-- : =d fi r: =g . ';F sac;.:. i„±c =tic 'zck . 1 -:= rLa. !,'? f-W! ::f -ad;!. Jt7C, lI1C lff l l . 3Ve i C i1.' lbave . Wit.:. =Wear Lad SZ_ to S :�t31,^. pn'r { pr�c Gi yoi:l Sj5'.LrS wits We S,dnC1r'S set :orb. arcin, u set b y and the De~ of sar.=i 7'e--ourc. State of Wisc =im Czm.F11C:d using, that your secdc z Isar �e3 alaia!aiacd must x ce�ric :cd � d e ^area' !o L__ St C of : Cou :t ?.ari ; Cf, ce wit',v ::7 'sy; of esr ticn =m f OWNER CERT'AFICA 0 I (we) = - y that III t=e=as this iasm Im Xx co 'Ic of -v 1 ,c r) tiowiccg {we) ;m (axt) '1tc owrc :;:31 c! he 'r , oed virtue of s arcs anry decd accorded i ^. Zrsi� cc of De- i; Cttica. MCNI ATUI A PtfcA�. DA7_= Koo* ** Azy inf or= tion that s =r- represented say resuit in am - maiLary permit being revoked by aic Zoning Dcnsruncrt. " tnetuda with this applleatlan: a stamped warranty decd from tha Register of Z49ds ofnce a e oC the certified =vey map 1 reference is made in the v amnty ficcd r — — r r - A �l Vol, 17��1FR,� 1 r • ' STATE BAR OF WISCONSIN FORM 2.1999 659915 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Forest Oaks Condo Inc — — RECEIVED FOR RECORD — - - -- - - -,— 10-24 -2001 8:00 PA - - -^ WARRANTY DEED EXEAPT II Grantor, and Richa T. Kruschke and Da nette A. Kruschke, CERT COPY FEE: husband and wife, — _ - -._ COPY FEE: - -- — - -" TRANSFER FEE: 122.70 —. — — — RECORDING FEE: 11.00 _ - -. PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 5, Oak Haven, Town of Somerset, St. Croix County, Wisconsin. Name and Return Address David J. Estreen I 304 Locust Street Hudson, WI 54016 Jlv Pt 032-104 & 032 - 104 -000 -- Parcel Identification Number (PIN) This is not - homestead property. CK) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this _2 day of September , 2001 �Mrestks Condos, In . +Gerald J. Smith _resident —.— AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) -- - - - -.— ) ss. ----- - - -. -- -- - -' St. Croix County ) authenticated this — _day of -- Personally came before me this _ - day of .9t ernber 2001 the above named - -- - — -- -- — —'— Forest Oaks Condos, Inc., by Gerald J . Smith Preside TITLE: MEMBER STATE BAR OF WISCONSIN '; me k wn to be the person s) who executed the foregoing (If not, —, _ — ._ - -,.— instru and acknowle gcd he same. authorized by § 706.06, Wis. Stats.) — —__— - - -. —. THIS INSTRUMENT WAS DRAFTED BY ••• _'_, U. _is.. — — — - Attorney Kristina Ogland _ 'Notary.Public, State of Wisconsin Hu WI 54016 , My Commis ion 0 permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) - -. -- • Names of persons signing in any capacity must be typed or printed below theit.si&ature. arc }o moron P ore. ooeu companr. r 8M STATE BAR DE*ISCONSIN WARRANTY DEED FORM No:: {J999 t •l, !fYli ,•Yl (SEE wET 1) 1 MA T C H L /NE o ll N8915'22 "W 637.03' Z 24222 J I I HK W F- I Q LOT 8' J 135,192 S0. FT. \ Z I • M Z 310 ACRES & N I M /N. FFE -922 2 N89'15'22 "W 636.33' LOT 7 - - -- 134, 628 SO FT. o 110 ACRES \ � , ��p C 4 M /N. FF£ -922.2 i Zo .0) r- • 3 � N89'15'22 "W 635.63' M 345.82' 2$9.81' 7- U-) W 0 = z � N i \ O W Q r 00 O M LOT 6 LOT 5 ` Q 131,720 SO. FT. 131, 081 SO. F7. i i 0 3.02 ACRES W 3.01 ACRES I I M /N. FFE -929.7 MIN. fFE =916.7 I 0 0 00 N i I I HNC ��. N89'15'22 "W N89'1 5'22 "W 345.82' _ 66 01' - o 66' JOINT DRIVEWAY EASEMENT t 33.005 1�` -- HIM -- N 89 ' 15 ' 22 "W -- 634.27' -- i FOR LOTS 4 AND 5 33.005 N89'15'22 "W 345.82' N89 ii 22 "W 66.01' al Z <( I J I LOT 3 ' I 711,153 50. FT. W 3.01 ACRES F 1 MIN FFE =906 0 w LOT 4 f-- U1,002 SO. FT. J r 6 3.00 ACRES of a MIN. FFE-916.7 Z i • % 0 • \ - -HNC Z v 400.63 .4.45' 297.12' taz Zn' o"L 1 Sa y and Buildings ivision County /� N VISConsin 201 W. Washington Ave., P.O. Box 7162 . G r Madison, WI 53707 - 7162 Site Address Department of Commerce Sanitary Permit Applicat p Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal' 'og.yol rJ, lily may be used for se heck if Revision 2 secondary Privacy 1)(m) ' •.. I. Application Information - Please Print All Informati Y �J / State Plan I.D. Number Property Owner's Name d'" S �� Parcel Number Property Owner's Mailing Address �`, ` '<< Property Location ��s r 3I �:i �.4 • S � T N, R V, City, State Zip Code • Phone Number Lot Number Block Number Subdivision Name CSM Number II , Type of Building (Check all that apply.) O City or 2 Family Dwelling - Number of Bedrooms O Village O Public /Commercial - Describe Use ❑ State Owned Nearest Road Z / J III. Type of Permit: (Check only one box on line A. Numbering is for internal use.) (Complete line B, if applicable.) A. New 2 O Replacement System 3 0 Replacement of 6 0 Addition to stem Tank Otil Existing System For County use B. Check if Sanitary Permit Previously Issued Permit Number 3 �� 6 2-3 Date Issues / O IV. Type of POWT System: (Check all that apply. Numbering is for internal use.) C 44X Non - Pressurized In- Ground 210 Mound 47 O Sand Filter 50 ❑ Constructed Wetland 22 O Pressurized In- Ground 41 Holding Tank 48 O Single Pass 51 Drip Line 45 O At -Grade 46 ❑Aerobic Treatment Unit 49 O Recirculating 30 13 Other l V. Dispersal/Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals. /Days /Sq.Ft.) (Min. /Inch) q9 Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank b oo v Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' i ture MP /MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zi ode) VIII. Coln /De artment Use Onl O Disapproved Sanitary Permit Feet ud roundwater Date Issued g Agent Signa (No Stamps) Approved Owner Given Initial Adverse Surcharge Fee) Determination .I ?6QZ IX. Conditions of pproval/Reasons for isapproval jk LL is �P.e 4� �,z �� Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 Inches in size I PLOT =L PRo,1ECT Rick Kreshkv AD d. E Hudson VA 54016 SE 1/4 SW 1/4S 15 /T 31 N/R 19 Somerset COUNTY ST. CROIX MFRS Shaun Bird 226900 DATE /02 BEDROOM 3 CONVENTIONAL )= IN- GROUND PRA RL CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons ^ L1Fr TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chambers 22 hk BE V.R.P Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A - 100 ❑ BOREHOLE O WELL • 11. R . p. Same as Benchmark SYSTEM ELEVATION 99 .0/96.6 Alt. BM Top of Wood Post @ 101.2' Vent plans Designed Using A21 Sidewinder High Conventional Powts Capwity Leaching Manual Version 2.0 Cbamber " Grade at System Elevation Pro 3 2 -3' X 69' Cells with >3' Spacing Bedroom 30' House B-1 35 . T 50' 35' 35' 7n a Vents Vents 100' B-. 12% lope Alt B.M. property Line 5 ' Zd WcEE : t Z S00Z SZ ' I of 'ON XUA W06-�