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HomeMy WebLinkAbout032-2146-60-000 0 @ 0 K -V 0 = § [ % § 6 § ° &(= E _ ��� f � to /® 2 2 E 0 t 0\ C/) 8 g f, -91 n\ g j 1 , e e / \ \ / 2 r < % IQ \ \ E / \ \ Cl \ c ` 0 \ ) a o w a / ^ ( \ / 0 E y (�a R e ¢ { � / \ § \ cn CD G J 8 / \ � J \ ° . . / C j \ § \ 0 E ƒ . / ~ \ \ § CL, 0 0 0 , 2 % % G = w ° r ® C7 2 J = F ƒ 0 ^ M 7 (C ƒ \§ : / / { e , )_ z / { z E CL Q e < m ) G CL k c o \ / / ƒ i � \ fE °» 0 � \\ 3 !LZ \ \k0 ERA CD E); @ CD !S / j � E\ \ // \ . G / 0 S : . 7 ST. CROIX CO UNTY ST. CROIX COUNTY LAND USE ORDINANCE FEE SCHEDULE PLANNING &. ZONING Effective January 1, 200 __ . _ _. -. Deleted: zoos ZONING PERMITS & APPLICATIONS Land Use Permit Fee Lower St. Croix Riverway Overlay District Floodplain Overlay District Shoreland Overlay District Grading and Filling $350 Riprap Sign Temporary Occupancy Nonmetallic Mining Tower (co- location and stealth facility) $550 Animal Waste Storage Facility Livestock Facility $1,000 Permits Processed in Conjunction with a Land Division, Special Exception, or Variance $50 i Other Permits and Applications Fee Rezoning $1,100 Special Exception $1,100 Variance $900 Appeals of Administrative Actions $450 Each Additional Item Considered Concurrently (Special Exceptions, Variances, Appeals) $175 Miscellaneous Fees Fee Readvertising for Public Hearings $225 Copies (Per Page) $0.50 Mailing Fee $4 Faxing Fee (Maximum of 15 pages) $ 5 Water Test ($50 + lab fees) $55 All fees are non - refundable. Fees will be doubled for applications submitted after construction has been initiated and written enforcement action has commenced. I I ,isconsin Department %I Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Byildinjj Division INSPECTION REPORT Sanitary Permit No: 404957 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: Jackson, Tom Somerset Township 032 - 2146- 60-000 CST BM Elev: Insp. BM Elev: BM Description: � // {{ G' '� - �'TDI� `h�GZ�L� L L I_v�"C�� h TANK INF R ATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / Benchmark Dosing - Alt. BM u r , �z�I 3 6 C. C' Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet - TANK SETBACK INFORMATION 7 a TANK TO P/L WELL BLDG. Vent to Air y ' , take ROAD Dt Inlet - A ­r L 1r Its Septic i� i. 1 I Dt Bottom Dosing Header /Man. � / -? - Aeration Dist. Pipe : /t / r %/ - t lVrrt .Z -r — Holding Bot. Syst /�, 9 �J`/ Final Grade PUMP /SIPHON INFORMATION 3 C 1 1 ( ", Manufacturer Demst St Cover / (� GPM 1 " d /�C • 5 Model Number TDH Lift Friction o System Head TDH Ft Forcemain Len Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width I Len ,9tth + No. Of Trenches EPITDIMIENSIONS No. 6f Pits Inside Dia. Liquid De i DIMENSIONS SETBACK SYSTEM TO P/L S LDG WELL LAKE/STREAM LEACHIN INFORMATION Manufactur / /L d v � CHAMBER R t Typ f System J C , U Model Numr�. / DISTRIBUTION SYSTEM cl3 -ehi Header /Maniyly Distribution � NL x Hole Size x Hole Spa Vent to nt ke / /i Pi L,� +,' LD ia Length Dia . Spacing � f 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 I ') Bed/Trench Edges Topsoil a, Yes =j No F Yes [ ] No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: ° -, V / Inspection #2: Location: 2125 54th St Somerset, WI 54025 (SE 1/4 SW 1/4 15 T31N R19W) Oak Haven Lot 6 Parcel No: 15.31.19.1277 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes ivo ` Use other side for additional information. 1� Date lnsepctor's Sign atu Cert. o. SBD -6710 (R.3/97) f tv, S i `I _i OF PL PLAN PROJECT Tom Jackson DDRESS 894 Arlinaton Ave W. St. Paul Mn 55117 SE 1/4 SW 1 /4S 15 /T 31 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/2/02 BEDROOM 4 CONVENTIONAL XXX IN -G D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE --x HOLDING TANK SIZE LOAD RATE •7 ABSORPTION AREA 933 # of cbamb rs 30 0 BENCHMARK V.R.P. Top of Lath ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL - H.R.P. Same as Benchmark SYSTEM ELEVATION 95.0/94.9 Alt. BM Base of Lath @ 96.3' 345' Property Line Plans Designed Usi4__ ?- r � r � c Conventional Powts , Manual Version 2. . 1601 Vents 2 -3' 94' Cells w >3' Spacing t -_ B-1 _ 40' B -3 70' 4 2% 100 Bedroom House ^Alt 0' l B.M. 54th St. B -2 ( i, Vents I Vent & ALong Sidewinder High\ ° Capacity Leaching ct Chamber I N N 6 „ 34" Grade at Syst em Elevation PL PLAN PROJECT Tom Jackson DDRESs 894 Arlinaton Ave W. St. Paul Mn 55117 SE 1/4 SW 1 /4S 15 /T 31 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/2/02 BEDROOM 4 CONVENTIONAL )00( IN -G D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE 1- HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 933 # of chamb¢rs 30 b BENCHMARK V.R.P. Top of Lath ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL sH.R.P. Same as Benchmark SYSTEM ELEVATION 95.0/94.9 Alt. BM Base of Lath @ 96.3' 345' Property Line y �- Plans Designed Usin�,_ Conventional Powts Manual Version 2 . 0 ' 160' Vents 2 -3' X 94' Cells w >3' Spacing l 50' B -1 v 40' S 30' B -3 100' 70' Pro 4 2% Bedroom Slope House ^Alt 0' 54th St. B. 20 2 Vents ;.a Vent ¢, > 12" Sidewinder High\ ° of Cover Capacity Leaching Chamber N N 16„ 6' Long 34" Grade at System Elevation /sZ 5 Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 r- 115consin Madison, W1 53707 - 7162 Site dress z De artment of Commerce S Permit Number Sanitary Permit Application 95 7 in accord with Comm 83.21, Wis. Adm. Code, personal information you provide Check if Revision mal be used for secon p ur p ose s Privacy Law, s15. 1 m State Plan I.D. Number I. Application Information - Please Print All Informati �- Parcel Number S I / 1" i l property Owner's Name Property Owner's M ' ' Address Property Location ST. CROIX COUNTY (,t/ Si / W ; S N City, State Zip Code I of be Block Number / SubdWision Name CSM Number WType of Building (check all that apply) ❑City or 2 Family Dwelling -Number of Bedrooms x L ;` �% `' ( L' ' ❑Village ❑ public/Commercial - Describe Use nship ❑ State Owned r.! M. Type of permit: (Check only one box on line A (numbering scheme for internal use). Completes fine B if applicable) A For County use 2 ❑ Replacement System 3 101 Replacement of 6 ❑ Addition to stem Tank Onl E sum B. ❑ Check if Sanitary Permit Previously Issued Permit Number Dauer IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) on - Pressurized In - Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland >. 4- 22� ❑ pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Lane 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D' tment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rau System Elevation Final Grade pro Itate(Gals./Days/Sq.Ft.)/ (Min./In-h) � ` 6 Elevation Pot' -+ "; V1. Tank Info Capacity in , total Number Manufacturer Prefab Site Stcel Fiber Plastic Gallons Gallons of Tanks - Concrete Constructed Glass New Existing i Tanks Tanks Septic or HoWing Tank kle— - z tT / Dosing Chamber VII. Responsibility Statement - I, the Li responsibility for installation of the POWTS shown on the attached plans. Pl is Name (Print) MP/IviPRS Number Business Phone Numbe Plumber's � �� / � Plumber's Address (Street, City, State, Zip VIII. oun /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing em Signature (No Stamps) Approved ❑ Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse Determination a LY Conditions of Approval/Reasons for Disapproval Attach compete plans tw the County only) roe the Mum 00 Papa not teas than $ x 11 ldehea hr she / !. __ ---7 -- QRn -A t'R 05/011 Wisconsir;•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 inches in size. Plan must r A 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 Owne Property Location "e� a— ('� Govt. Lot ✓ 1/4 ,j(,f/1 /4 S/,) T Y N E (o Property Owner's Mailing Address Lo Block # Subd. Name or CSM# a a City Sta Zip Code Phone Number ❑ City ❑ Village ;jRrfown Neares oa New Construction Use;, g Residential / Number of bedrooms &Z Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: YL Parent material © [ �C� Flood Plain elevation if applicable /✓ /7 ft. General comments f s' and recommendations: O �EC MAY p 2 2n 'q S T C Boring # ❑Boring (` ZONROIX COU Pit Ground surface elevi ft. Depth to i 6}F n. 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 f Boring # ❑ Boring 7 Pit Ground surface elev! ` ft. Depth to limiting factor 4401n. 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 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) Signature CST Number Address Date val tion Conducted Telephone Number SBD -8330 (R07 /00) Property Owner Parcel ID # Page of ® Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting fact .� 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 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 GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F 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 /ft 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.07 100) Soil Test Plot Plan Project Name Tom Jackson Sha Address 894 Arlington Ave W. St. Paul Mn 55117 M #226900 Lot Subdivision --- --- Date 5/2/02 SE 1/4 S W 1/4S 15 T 31 N/R 19 W Township Somerset Boring () Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Lath with Orange Ribbon 'System Elevation 95.0/94.9 *HRpSame as Benchmark Alt. BM B ase of Lath @ 96.3' 345' Property Line t 160' B -1 50' -3 100' 70' Pro 4 2% Bedroom S1010 e House t 0' M. 54th St. P 20' B -2 a rn 97' N 98' 1 * AV Safety and Buildings Division County 1 d , 6a o�sin 201 W. Washington Ave., P.O. Box 7162 I Madison, WI 53707 - 7162 Site Address r 2(7- S . Department of Commerce 3 7_ d Z � � / z� Sanitary Permit Application Sanitar Permit Numq I accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary purposes Privac Law, s15. 1 m ` I. Application Information - Please Print All Information State P umber l S. V. 0.112 Jl Property Owner's Name Parcel Number i - , RECEIVED Property Owner's Mailing Address Property lion d n , MAR 1 5 ?002 5 6�-A 1A; S -) T N, R (� E City, State Zip Code Phone Number Lot N�ber Block Number ST. CROIX COUNTY Z1 INING OFFICE Subdiv Name r� CSM Number H. Type of Building ' (check / all that apply) � o,c. ?v []city or 2 Family Dwelling - Number of Bedrooms hl+�e -_ • ❑Village ❑ Public /Commercial - Describe Use wownship ❑ State Owned n Nearest Road 2 3 9 3•� c.Cn c�X�S .S M. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A For County use New 2 ❑ Replacement System 3 ❑ Replacement of 6 11 Addition to stem Tank Only Exist stem B. ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) y-- k A f0D . 44Non- Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 El Constructed Wetland 22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Li 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ dating 30 ❑ ✓ Other 3. j �(r V. D' ersal/Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil x0pilation Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation jai• 3r/ , 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 POWTS shown on the attached plans. PIumN ' e (Print) Plumber's Signature MP/MP her Business Plane N Phmilxr's ss (Street, City, State, L w /" VIII. Co un /De artment Use Onl Approved El Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surchar a Fee) Pjp ❑ Owner Given Initial Adverse ��� I 1 n^ Determination Y ` IX. Conditions of Approval/Reasons for Disapproval kw- qs Attach complete pion (to the County only) for the system on pops not less than 81/2 x 11 Inches In sae ^ l SBD- 6398. 5/0 PLOT PlaAN PROJECT Tom Jackson A D S 894 Arlington Ave W. St. Paul Mn 55117 SE 1/4 SW 1 /4S 15 /T 31 N/ 1 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATES /13/02 BEDROOM 4 CONVENTIONAL )00C IN-GROUN16WESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 514 # of chambers 30 BENCHMARK V.R.P. Top of NE Lot Stake V nw )ASSUME ELE A TIO 100 Filter Zabel A -100 ❑ BOREHOLE O WELL •H.R.P. Same as Ben chmark SYSTEM ELEVATION 101.3/101.0 B.M. #1- 307'Property Line B -1 Plans Designed Using Vents Conventional Powts Vent Manual Version 2.0 > 12" Sidewinder High 8% of Cover Capacity Leaching Chamber 62' 6' Long 16" 34" Grade at System Elevation l 6 t. B.M 7' Pro 4 Bedroom 25' -S House 30' T Vents 2 -3' X 94' Cells with >3' spacing ZD 1 � C,ST� M N . PLOT P N PROJECT Tom Jackson AD ss 894 Arlington Ave W. St. Paul Mn 55117 SE 1/4 SW 1/4S 15 /T 31 N/ 1 W TOWN Somerset COUNTY ST. CROIX y � MPRS Shaun Bird 226900 DATE3/13/02 BEDROOM 4 CONVENTIONAL XXX IN -GROUNI� ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1 ABSORPTION AREA 514 # of chambers 30 BENCHMARK V.R.P. Top of NE Lot Stake / () ASSUME ELEVATIO 1 00' Filter Zabel A -100 ❑ BOREHOLE O WELL sH Same as Benchmark SYSTEM ELEVATION 101.3/101.0 B.M. #1 307 'Property Line B-1 Plans Designed Using Vents Conventional Powts Vent Manual Version 2.0 > 12" Sidewinder High 8% of Cover Capacity Leaching Chamber 62' 6' Long 16" 34" Grade at System Elevation B-3 6 t. .M 7' Pro 4 Bedroom 25' House 30' T Vents 1 2 -3' X 94' Cells with >3' spacing � � � � GST S B o M N Wisconsin De partment of Commerce SOIL EVALUATION REPORT Page 1 —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. iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z� Property Owner Property Location Gerald J. Smith Govt. Lot SE 114SW 1/4 S 15 T 31 N R 19 for) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 11160 190th. Ave. 6 Im Oak Haven City State Zip Code Phone Number ❑ City ❑ Village -] Town Near ad Elk River, I 1 55330 (612) 441 -8888 Somerset 1d (2 New Construction Use: ija Residential / Number of bedrooms 4 Code derived design flow rate 0 CAD [:1 Replacement ❑ Public or commercial - Describe: 140 '' r VLU Parent material outwash Flood Plain elevation if applicable --f na - ft•`I General comments ° l/ and recommendations: —1 CO X OO trenches @ el. 101.30', spaced to code 3.50' below grade \\, I G OFFICE ❑ Boring # F] Boring 1 g ® pit Ground surface elev. 100.30 ft. Depth to limiting factor 90 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 1 -12 10yr4/3 none sl 2mgr mvfr qw 1m .5 .9 2 12 -26 7.5 4/4 none is OSq ml Clw if 7 1.2 3 6 -0 75 4 nn F- Boring # Boring 21 ® Pit Ground surface elev. 100.30 ft Depth to limiting factor 90 in. Soil A lication 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 1 0 -10 10yr4/3 none sl 2mgr mvfr gw 1m .5 .9 2 10 -30 7.5 4 4 none is OSCF ml gLfq if 7 ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L AE9den t #2 = BO < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature . CST Number Gary L. Steel 02298 Address "6atjEvafuafion nductec Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6 -6 -2001 715- 246 -6200 Property Owner Gerald J . Smith Parcel ID # Mnc3i nth Page 2 _ of 3_ ❑3 Boring # ❑ Boring 1 04.80 ® Pit Ground surface elev. _ ft. Depth to limiting factor 90 in. - § - 6 7 1 -- A - pplication 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 -12 10 4/3 no ne sl 2mgr mvfr 9W 1m .5 .9 2 2 -30 7.5yr4/4 none is osg ml gw if .7 1.2 3 0 - 90 7.5vr4/61 none ms Osg ml na na .7 1.2 � �D(•3a z �g 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 GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 r] Boring ❑ Boring # E] pit surface elev. ft. Depth to limiting factor in. Pit =Soil plication 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 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. SRD -8330 (R.6 100) STEEL'S SOIL SERVICE Gary L. Steel Gerald J. Smith 1554 200th Ave. CSTM2298 SE'SW S15- T31N -R19w New Richmond, WI 54017 MPRSW -3254 town of Somerset (715) 246 -6200 lot #6 -0ak 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 rl " =40' /BM.= top of NE lot stake @ el. 1 00.00 ' s alt. BM.= top of 1" pvc pipe @ el. 100.20' 3 CO 00 IV Gary L. Steel 6 -6 -2001 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 r Shaun Bird #226900 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGRBEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer _7 D &i JaLk Mailing Address v/- Property Address o /,=2 (Verification required from Planning Department for new construction) City/State Parcel Identification Number 0 3 2 1 =;/dq LEGAL DESCRIPTION Property Location 4L I /a, �' /a, Sec. TN -RW, Town of S�ir�C-�'..L.c -T Subdivision 0 ,j5tK - Lot # _. Certified Survey Map # "` 9 Volume , Page # _ Warranty Deed # /-0 , Volume ® Page # Spec house ( yes ❑ no Lot lines identifiable V yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure w 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 mast -rplumber, journeyman plumber, restricted plumber or a h cense d 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 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 days of the three year expiration date. SI A OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the property dZribed above, by virtue of a warranty deed recorded in Register of Deeds Office. IGNA OF PLICANT 15 Alt « « « «« A information that is mis- represented may result in the sanitary permit being revoked by the Zoning Departm ent *« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survev mau if reference is made in the warranty deed w.: 1 8 r8 -x2.18 ` � 66731 O STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Forest Oa ks Condos, Inc. RECEIVED FOR RECORD — --- - — 01- 04-2002 9:35 AM WARRANTY DEED Grantor, and Thomas R . Jackson EXEMPT N CERT CORY FEE: COPY FEE: — - TRANSFER FEE: 143.70 — -- RECORDING FEE: 11.00 - PAGES: I Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Cro County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area O 6 nty AT Oak Haven, Town of Sonerset, St. Croix NameantlR��r�Add A OGLAND Wisconsin. 1 TT�II EY AT LAW P.O. BOX 359 HUDSON, WI 54016 P t 032 - 1043 -80 -000 5, 1043 -90 -00 Parcel Identification Number (PIN) This is not homestead property. O4) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this - day of _ December 2001. Forest Condos, c. + * Gerald J. Smith resident AUTHENTICATION ACKNOWLEDGMENT Signature(s) Forest Oa ks_ Cond Inc., by Gerald J. Smith, __ STATE OF WISCONSIN Preside ) ss' _— -- - County ) authenticated �th' y of December 2001 4V -- Per sonally came before me this day of the above named * Kristina Oglan TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (II not, _— _.. -._. - -- instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Og _ _ _ Notary Public, State of Wisconsin H udson, WI - My Commission is permanent. (If not, state expiration date: - - (Signatures may be authenticated or acknowledged. 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