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HomeMy WebLinkAbout038-1188-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and E,iaildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 363849 Permit Holder's Name: 1 ❑ City ❑ Village ❑ ToWn of: State Plan ID No.: Kopp, Steven Star Prairie Township CST BM Elev.:. Insp. BM Elev.: BM Description: Parcel Tax No.: c7 Po = CSC � ZL� 038- 1188 -30 -000 TANK INFORMATION 0 ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �0 Benchmark O Dosing Alt. BM ;� Op • p ' Aeration Bldg. Sewer • 80 9�. �5 Holding St /Ht Inlet 91,25-1 TANK SETBACK INFORMATION St/ Ht outlet TANK TO P / L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic > r S3' 0 �--^ NA Dt Bottom Dosing NA Header/ Man. e� Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufac rer Deman St cover 1 00 , 0 S Model N u m Nbc GPM TDH Lift L n S stem TDH Ft Forcemain Length Dia. Dist. To well SOIL SYSTEM TRENC width r Length No Of renches PIT No. Of Pits Inside Dia. Liquid Depth DIM N •Z DIMENSION SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Many tur r: _ S` SETBACK INFORMATION Type Of CHAMBER Moe Numb System: , p� r O t � I10 r �,-- -. OR UNIT — C! DISTRIBUTION SYSTEM Header /Manifold u Distribution Pipes + xH e Size x Hole Spacing Vent To Air Intake r Length �e- Dia. L ia. 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 Bed/Tr nch Center Bed /Trench Edges Topsoil I ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: 04J6Z1 Dalnspection #2: / I Location: 1308 214th Avenue, New Richmond, WI 54017 (NW 1/4 SW 1/4 13 T31N R18W) - 13.31.18.956 Northgate -Lot 1.) Alt BM Description = W 2.) Bldg sewer length= - amount of cover= t,r"u •� I$ ^ Plan revision required? ❑Yes r7No �CA.�.� -�-- � � 2 6 " Use other side for additional information. 06 1 03 T SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH t SANITARY PERMIT NUMBER: a _ 4- :T- a < g i E x s L }� E r I t m __vm_ ._v. _ . �_�. _ _ �� tt I Safety and Buildings Division Vi sc 6 nsin SANITARY P iT �PCATION 201 W. Washington Avenue -. P o Box 7162 Department of Commerce In accord Cbrdm 83.05, ks, qp le Madison, WI 53707 -7162 • Attach complete plans (to the county copy only) f r system, on paper less County � ST. than 8 v2 x 11 inches in size. e State Sanitar ' r Permit Number • See reverse side for instructions for completing thl l iplica Lgii 1)1'1 y � 363�j Personal information you provide may be used for secondary purposes • '' _' - ❑ Check it revision to previous application [Privacy Law s. 15.04 (1) (m)). t �; State Plan Review Transaction Number I. APPLICATION INFORMATION -PLEASE PRINT ALL I Rfifi�_il N �^ ProperW Owner Name Property Location S;G-2114A /V W1v4 Ltd 1/4, S f 3 T, N, R Property Owner's Mailing AddlFefs Lot Number Block Number i7 City, State Zip Code Phone Number Subdivision Na e r CSM umber j6pw 0/7 ( )� aw N 11. TYPE OF ILDING: (check one) ❑ State Owned It Nearest Road Cc] Village n 11 Public arl or 2 Family Dwelling - No_ of bedrooms Town of Ar 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 30 �� t 2 �� .� � 1❑ Apartment/ Condo 0 3 S — 1 7 U J 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) l A) 1 _ New 2. ❑ Replacement 3. E] Replacementof 4_ E3 Reconnection of 5. E] Repair of an ____System ________System _____________ Tank Only______________ Existing System ________ ExlstingSy/stem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed J 21 ❑ Mound 0 ❑ Specify Type 41 []Holding Tank 12,oSeepage Trench . 22 In- Ground Pressure / 42 ❑Pit Privy [] 13 [] Seepage Pit 'S . ®� 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION5�7 y 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (s q. ft.) (Gals/da /sq. ft.) (Min. /inch) Elevatio� tr, Oseet Feet Cap acit y VII. TANK in Ca g allo ns Total # of r Prefab. Site Fiber- Exper. INFORMATION New Existin Gallons Tanks Manufacturers Name Concrete strutted Steel glass Plastic App Tank Tanks Septic Tank or Holding Tank _ AD CC) ❑ El 1:1 1:1 1:1 Lift Pump Tank /Siphon Chamber I ❑ 1 ❑ 1 ❑ I ❑ I ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se yvage system shown on the attached plans. Plu a 's Na e: rint) Plum s Sig ature: o mps) MPRSW No.: Business Phone Number: U �0 o3 7f5J 165 -d Plumbef, o Addre�s�5treet,Cit ,St Zip Code): f � .. � DO ( /v -- (��.� IX. COU NTY/ DEPARTMENT USE ON c pp []Owner [] Disapproved Owner Given Initial S nitary Per Fee (Includes Groundwater ate Issuing Agent Signature (No Stamps) T . ° IX 1 A roved Surcharge Fee) !1 � _s � Adverse Determination , , 5 . � X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R.12/99) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS , t 1. A sanitary.permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained' The septic tank(s) must be pumped by a licensed pymper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division 4 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed: II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. i VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber into fill in name, license number with appropriate prefix (e.g. MP, etc_), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County / Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following': A) plot plan, drawn to state or with comple#e•difnensions, location of holding tank(s), sepfic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test dataioh A 115 form; a6t[TF all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated p�6cticeswhich can ' effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. NWkSWk S13- VIN -T18 torn of Star Prarie lot *7- NortbGste WS soil evaluation vas corju&Ad to satiety a Smdrig requ.ix+a wnt, it any or may not be suitable for your use. 0* 'location of the test away or may wt be as ahown . ftela N 1 "=40' St►t. tvp Of 1" Pvc Pip0 0 el. 100' Alt. HAS. s top or 1" pvc pipe 0 al. 98.20' r � , b v ?its I 1 P � r ss� I lie- Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Fh;Wan Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. Q - APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE J." '? Iq PROPERTY OWNER: PROPERTY LOCATION Greenwood Enterprises, Inc. GOVT. LOT NW 1/4 SW 1/4,S 13 T 31 AR 18 : k(or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM # 1416 Third St. 7 na NorthGate CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE []TOWN NEAREST ROAD Hudson. WT. 54016 ( ) Star Prairie I 214th Ave. [ New Construction Use [ :4 Residential / Number of bedrooms 4 [ ] Addition to existing building (] Replacement ( ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft . 8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate _ bed, gpd /0 8_ trench, gpd /ft Recommended infiltration surface elevation(s) 95.05 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem KI S ❑ U �7 S El FLI S El ® S [I U ®S ❑ U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITrer& <` 1 1 0 -13 10 r 2/2 none 1 lcsbk mfr qw if .41 .5 2 13 -30 10 r 4 4 none sicl lcsbk mfr gw if .2 .3 Ground 3 30 - 84 7.5 r 4/4 none ms osq ml na na .7i .8 elev. 9 8.6 ft. Depth to limiting factor + L]r Remarks: Boring # 1 0 -10 10 r 2/2 none 1 2msbk mfr gw if .5 .6 2 10 -20 10 r 4/4 none sci 2msbk mfr w if .4 .5 Ground 3 20 -84 7.5 r 4/4 none ms oSQ ml J o ria; .7 .8 elev. `` 9 8.9 ft. Depth to limiting r 3 149 factor X +841 qVP Remarks: 9' CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Av . 2ew RichmonA WI 54017 Signature: Date: 10 -27 -98 CST Number: m02298 1 PROPERTY OWNER iGreenwood Enterprise SOIL DESCRIPTION REPORT Page of 3 PARCEL I.D. # 038 - 1055 -20 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botx>dary Roots GPD /ft ................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed T h 3 1 0 -12 one 1 2 12 -33 1 sicl lcsbk mfr 9w if .2 .3 Ground 3 1 33-42 7.5 r 4/4 none sl 2mgr : :: I yea na .5 .6 elev. 98.8 ft. 4 42 -84 7.5 r 4/4 none ms osg na na .7i .8 Depth to limiting factor + 84 11 Remarks: Boring # 1 0 -10 10 r 2 2 none 1 lcsbk mfr gw if .4 .5 4 2 10 -25 10 yr 4/4 none sicl lcsbk mfr gw if .2` .3 Ground 3 25 -84 7.5 r 4/4 none cos osg ml na na .7; .8 elev. 99.0 ft. — Depth to - limiting factor Remarks: Boring # 1 0 -9 10 r 2/2 none 1 lcsbk mfr gw if .4 . 5 ?` 5 9 -12 10 r 4/4 none sicl lcsbk mfr gw if .2 .3 Ground 3 12 -80 7.5 r 4/4 none cos osg ml na na .7 .8 elev. 98 ft. Depth to limiting factor +80 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) r STEEL'S SOIL SERVICE Gary L. Steel Greenwood Enterprises, Inc. 1554 200th Ave. CSTM2298 NWgSW4 S13- T31N -T18W New Richmond, WI 54017 MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #7- NorthGate 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 mayor may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 BM.= top of 1" pvc pipe @ el. 100 Alt. BM.= top of 1" pvc pipe @ el. 98.20 5o s4 dw 44 f ©A 0 1 0 I , 305 �t Gary L. Steel 10 -27 -98 E AN r��il.� r �_ OP L F- _ 130.8 x cmifcd iron - , ) "tannni Depart--meet it,r i'.`f. ry sC�t.':Cf77�CiOt2: zc ., Fitt s . _63 0/ lr v Spex, `�1 F71VI � i � R I tI „yle. . ;e qltd IYFnuli Cnajace Ot !uur minty^ -' ' 'Lrnr / crilli d mr'.71: in its �p1'"TramrP tjfl rr, !o F1andif 'vanes. PIt1I1G+l ma _tom � t t COUSUI i OI p ul "4 ,?:. t out the 5C.;t1C lank vcry wee years o soon r. it nceded ov a Ucemvg -d pu rancr. What you Rau Int d f, r —trr�i Can al tct the .tii +l.' ii70 Of the %'ptku AxLK, as a trvat!Y itw StaS?C kn me masts dk4Ck558 S rte' ea3x- 'Ihe I,::C ; , owner a':xeas to Silbtklit to $L Croix 2oumz ijeT)artment a c:rtY; icatiary to l it , u.3r owo~ --- ! ui :t YDasYa,:: pSum.bG.,,, xne!�lsartpi� �cb�r, rest�ictedptttat�erflr�ti mcr,seMpuriZa-r'�.i'x LS in C,I DpeI opir if. . i condkt.im..' and)'oi i/' ab'e't M!t °t; i v''? Y)_9 F S4:''„ i.: I/we, , t.e i11i &: H1 h L SCL tC; I Viatwv ihat yox'r' ; .i ' oift +a9 ; �_._ y sll I (we') C`.I that y q : ,.;, , iY:r iii :: r. .,�. ^•`•' i }t'. the p . it,vy d(,, se o. Y! 'u i Any li �l iation tht L k31d5 1.2:r Ket r.:;, C ,,.1;' �t, N +� y:.' `t t7f rl a;'1 t. k • _ r •,, , +� «: n • e flit udG '.'r:? Itlttlk.. kIR' F: 1 E`nl, iP. .. i. r.. - YS_.. ,tCi2:Sfe,.1 4".': . .:t:fa. itir " +: I iU Vill.15n6PAGE 124 ' G22005 STATE BAR OF WISCONSIN FORM 1 - 1998 KATHLEEN H. WALSH Docameot Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Greenwood Enterprises. Inc. a Wisconsin RECEIVED FOR RECORD corporation Grantor, and Steven F. Kopp,.and_ Megan A. Kopp, husband and wife as surviyorshi marital 44 -28 -2000 8:00 RM property, Grantee. A.K.A. Meg ,an Kopp WARRANTY DEED Grantor, for a valuable consideration, conveys to EXEMPT# Grantee the following described real estate in St. Croix CERT COPY FEE: COPY FEE: County, State of Wisconsin (The "Property"): TRANSFER FEE: 63.00 RECORDING FEE: 10.00 PAGES: 1 Recording Area / [ a c me an Retu Add C d t a /l Ke,c. yoo s and sw-- t-l� 038- 1188 -30 Parcel Identification Number (PIN) This is not homestead property. (is not) Lot 7 of the Plat of NorthGate, recorded in the Office of the Register of Deeds for St. Croix County, Wisconsin on May 20, 1999 in Volume 7 of Plats, at Page 46 as Document No. 603503. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record. Dated this,2Z, of 2000. GRE D ENTERP B J * *Jam . es Rusch, its presi n By: s *Mary s s ry AUTHENTICATION ACKNOWLEDGMENT Signature(s) James E. Rusch, its president STATE OF WISCONSIN ) ) as. St. Croix County ) authenticated this 20 of I L , 2000. Personally came before me this al.;)4` day of 2000 the above named Mary R. Rusch, its seeFetary to me known to be the person(s) who executed the foregoing instrument and acknowledge the same. * Lois A. Mc� TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) * '® •••• '�' Notary Public, Sta f Wisc0 sin �1 T • ".� M Commission is rmanent. not • a ion ate: IS INSTRUMENT WAS DRAFTED BY • ,Ap pp THIS � pmt Y Pe � = , Lois A. Murray, Zilz, Estreen & Ogland, LLP F- 304 Locust Street, Hudson, WI 54016 (signatures may be authenticated or acknowledged. Both are not N� : P U B U v : essary.) �*F .• jbi 0••1 LWN ng in any capacity should be typed or printed below their signatures EttD STATE BAR OF WISCONSIN FORM No. 1 -1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, f - . e � o x� w -- ro t i I i OD 4 LA of Iv o Ri 2 \ �L a S, 000 E co o Li Li l� WI � N �O^ — gym � C- J , 6 6. 01' u I( in A 470.09' z x 1 m �I R X a Q ;� rn x ID 1 1 m o m -, Q n -� S, c _ � 3 X o \ s, Soo ° 1 i 03 NJ 0 i W o 0 X I jv t G w a A 292 '- o ❑ i° I ` t I G ° —