HomeMy WebLinkAbout038-1188-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Sa`�ty and nuOding Division
r INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) CO a 399444
GENERAL INFORMATION , Z � State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. -Z
Permit Holder's Name: City Village x Township r7r,71Tax No:
Wilson, Burton I Star Prairie Township 038 - 1188 -80 -000
CST BM EI v: Insp. BM Elev: BM Description:�� , .L
CM . ID I P CST $ rte
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 3 83 $ ' 6 .•
r o
Dosing V Alt. BM v cfl.13l
Aeration Bldg. Sewer
Holding St/Ht Inlet SUHt Outlet b / o � t
�
TANK SETBACK INFORMATION • } Q3• SLR
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic r } l I l Dt Bottom
Dosing Header /Man.
Aeration Dist. Pipe
Holding Bot. System S I
�
PUMP /SIPHON INFORMATION Final Grade S• to qB • 2 3
Manufacturer Demand St Cover
GPM
Model Numb
TDH Lift Fr 'on Loss System Head DH Ft
Force m Length Dia.
OIL ABSORPTION SYSTEM Z Z
BED/TRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 t /.
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manu er: L/
INFORMATION CHAMBER OR
Type Of System: u - r S i UNIT M I Number. ,
z &
DISTRIBUTION SYSTEM
Header /Manifold U Distribution x Hole Size Ix Hole Spacing Vent to Air Intake
Pipe(s)
Lengt Dia L f Length Dia Spacing
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 Bedlrrench Edges Topsoil ❑ Yes [&] No On Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection Inspection #2: / -
Location: 1326 214th Avenue New Richmond, WI 54017 (NE 1/4 SW 1/413 T31N R18W) Northgate Parcel No: 13.31.18.961
1.) Alt BM Description (� `
2.) Bldg sewer length = "
- amount of cover = )
Plan revision Required? [] Yes X No
Use other side for additional information.
SBD -6710 (R.3197) Date Insepctor's Signature Cart. No.
Aft
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application PO Box 7302
® ISCOn Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of Commerce
[Privacy Law, s. 15.04(1)(m)]_ (Submit completed form to county if not
state owned.)
Attach complete plans (to the county copy onl r e system, on paper not less than 8 -1/2 x 11 inches in size.
County State Sanitary Permit Number ek if reviV to previous application State Plan I. D. Number
C'Ir v I!'
I. Application Information - Please Print all Information Location:
Property Owner Name - i Property Location
` L.S 0 r ...1 z'G' Y ! 1/4 Sal 1/4, S Z3 T 3 j ,N, R (or)
Property ner's Mailing Address Lot Number Block Number
_ t?-J"' l
City, State Zip Code n ber Subdivision Name or CSM Number
0 C 0 ( O R M e- TL-
II. Type of Building: (check one) ❑ City
1 or 2 Family Dwelling - No. of Bedrooms : ❑ Village
Public /Commercial (describe use):_
Town of
❑ State - Owned
Nearest Road
ziyT�
Parcel Tax Numbers)
D
III. Type of Permit: (Chec only one box on line A. Check box on line B if applicable) _ b— S4�e
A) 1. 50 New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to
System System Tank Only Existing System
B) Permit Number Date Issued
15 A Sanitary Permit was previously issued 3
IV. Type of POWT System: (Check all that apply)
)B Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dispersal/Treatment Area Information: L Z s
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation
37 77 ' J,,2 9,2.3 .i Fe s '
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on t d plans.
Plumber's Name (print) PI is Signature (no stamps PRS No. Business Phone Number
c t _ -
P lumb e r's Address (SUeet City, State, Zip ode)
Gr i v 01&Lz1 ZA `C
IX. County/Departmelit Use Only
❑ Disapproved Sanitary Pennit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps)
Approved ❑ Owner Given Initial Adverse Surcharge Fee)
Determination v S 0- Q 0 �Z Z 10
X. Conditions of Approval /Reasons for Disapproval:
1. Effluent filter to be installed and maintained per manufacturer's recommendations.
2. This revision was submitted to reflect a change in system location.
3. Adequate number of observation pipes shall be provided to allow for the proper determination of system health during future inspections.
SBD -6398 (R. 07/00)
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" 1087
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt
Attach complete site plan on paper riot less than 8'% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D.
038 - 1188 -80 -000
Please print all infonnation. 1� 7wed y Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
z z
Property Owner Property Location
Wilson, Burt Govt. Lot NE 1/4 SW 19 S 3 T 31 N R 18 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
543 Homestead Trail 12 1 Northgate
City State Zip Code Phone Number City Village ✓ Town Nearest Road
Somerset I Wt 1 54025 715 - 549 - 6127 Star Prairie 4Th Ave.
of Construction Use: ✓ Residential / Number of bedrooms 3 Code de �� sign floate '� 4 0 GPD
Replacement Public or commercial - Describe:
.,. :.
Parent material Outwash Plain FI elevation, if appli '. n
General comments 1 0LL 2 UU I
and recommendations: Area is suitable for a conventional system with a 0.7 gpd /sgft - pissible svation l 9230'.
Fil Boring # Boring
6e Pit Ground Surface elev. 98.25 ft. Depth to limiting factor n� Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMI
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -10 10yr3/2 none I 2csbk mfr cw 1f .5 ✓ .8 ✓
2 10 -21 10yr4/4 none sicl 2msbk mfr gw 1f .4 ✓ .6 ✓
3 21 -87 7.5yr4/4 none cos Osg ml cs - - -- .7
4 87 -130 10yr5/6 none ms Osg ml - - -- - - - - -- .7 1.2 ✓
F-cl Boring # Boring
� 32
6e Pit Ground Surface elev. 97.65 ft. Depth to limiting factor ' i 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
1 0 -15 10yr3/1 none I 3msbk mfr cs 1f .5 .8
2 15-43 7.5yr4/4 none grcos Osg ml gvv -- - - -- .7 ✓ 1.6 ✓
3 43 -72 7.5yr4/6 none cos Osg ml gw - - - -- .7 1.6 ✓
4 72 -132 10yr5/6 none ms Osg ml - -- - - - - -- .7 ✓ 1.2 ✓
* 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) Signature: CST Number
Thomas J. Schmitt - - - 227429
Address Tom Schmitt Date Evaluation Conducted Telephone Number
586 Valley View Trail, Somerset, WI 54025 12/12/01 715 -549 -6651
Property Owner Wilson, Burt Parcel ID # 038- 1188 -80 -000 Page 2 of 3
7] Boring # Boring
✓ Pit Ground Surface elev. 98.15 ft. Depth to limiting factor ->130 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -12 10yr3/2 none I 3msbk mfr cs 1f .5 - .8 ✓
2 12 -28 7.5yr4/4 none grcos Osg ml gw - - - -- .7 ✓ 1.6 ✓
3 28 -51 7.5yr4/6 none cos Osg ml gw - - - - -- .7 - 1.6
4 51 -130 10yr5/4 none ms Osg ml - - -- - - - - -- .7- 1.2
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
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 PD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD 5 > 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
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ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer UU d j l-Z)r `L S o y , l
Mailing Address ��y3 or« s a � 7 /
Property Address Q41 77"Y
A l/L� •�
(Verification required from Planning Department for new construction)
City/State TRW fi� L/fi�ro,v 2 /// ' _ Parcel Identification Number O.� B
LEGAL DESCRIPTION
Property Location - %., 5 1 /•, Sec. L3 , T -R Town of ST.¢A .&d1/1e-
Subdivision - 4/0 2 rig l',+ - . Lot # .
Certified Survey Map # , Volume . Page #
Warranty Deed # i,1L5 9,6 , Volume /7/6 , Page # ,36A
Spec house ❑ yes ® no Lot lines identifiable R yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
property green form, signed by the owner and by a
The owner a to submit to St. Croix Zoning Department a certification fo
mastorplumber. journeymanplumber, restricted plumber or a li cense d pum verifying that (1) the on-site wastewaterdisposal 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
dayn d ate.
OF APPLICANT
OWNER CERTIFICATION ) the owne r(s) of
I (we) certify th� all statements on this form are true to the best of m y (our) knowled I (we am (are)
the r &S abo by virtue of a warranty deed recorded in Register of Deeds Office.
` r
-14n 41W14 IVU OF 4PUCANT
« « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.
«« Include with this application: a stamped warranty deed from the Register of Deeds office
the warranty deed
a copy of the certified survey map if reference is made in
POWTS OWNER MANUAL 8E lrlw[rHUCt
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner � W 1 t,Se1J Septic Tank Capacity br�0 al ❑ NA 6;7m # Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA. Effluent Fitter Model A- —1 ap ❑ NA
Number of Commercial Units E5 NA Pump Tank Capacity gal )&.NA
Estimated flow (average) gal /day Pump Tank Manufacturer `q NA
Design flow (peak), (Estimated X 1.5) gal /day Pump Manufacturer NA
Soil Application Rate 0, gal /day /ft' Pump Model NA
Influent/Effluent Quality Monthly average* Pretreatment Unit A
❑ Sand /Gravel Filter ❑ Peat Filter
Fats, Oil 8t Grease (FOG) :530 mg/L ❑ Mechanical Aeration ❑ Wetland
Biochemical Oxygen Demand (BODs) :5220 mg /L ❑ Disinfection ❑ Other:
Total Suspended Solids ( TSS) I <_ 150 mg /L Manufacturer
Pretreated Effluent Quality ' ❑ NA Monthly average* * Dispersal Cell(s)
Biochemical Oxygen Demand (BODs) :_30 mg/L %in- around (gravity) ❑ In- ground (pressuri zed)
Total Suspended Solids (TSS) _ :30 mg/L ❑ At -grade ❑ Mound
Fecal Coliform (geometric mean) :510 cfu /100m1 ❑ Drip -line ❑ Other:
Maximum Effluent Particle Size inch diameter
* Values typical for domestic (non - commercial) wastewater and sepU
tank effluent.
* * Values typical for pretreated wastewater.
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every 3 ❑ months QF year(s) (Maximum 3 yrs. )
Pump out contents of tank(s) When combined sludge and scum equals one -third (36) of tank volume
Inspect dispersal cell(s) At least once every 3 ❑ months 5Cyear(s) (Maximum 3 yrs.)
Clean effluent filter At least once every 3 ❑ months Xyear(s)
Inspect pump, pump controls 8t.alarm At least once every ❑ months �❑ year(s) 1NA
Flush laterals and pressure test At least once every
❑ months ❑ year(s) A
Other: At least once every ❑ months ❑ year(s) NA
Other: At least once every ❑ months ❑ year(s) kNA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an in
carrying one of the following licenses or certifications: Ma:
Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspectic
must include a visual inspection of the tank(s) to identify any missing or broken hardware, Identify any cracks or leaks, measure
volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dlspersa!
cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent or
the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate
notification of the local regulatory authority.
the entire
When the combined
accu be removed edby s eptage Servicing Opera
or l and disposed o in accordance e with h vo
NR 113, Wiscoi
contents of the tank sha
Administrative Code.
The servicing of effluent filters, mechanical or pressurized POWTS components, pretreat
ement components, and any other
maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
START Up AND OPERATION
S check treatment tank(s) for the presence of painting products or other c em
For new construction, prior to use of the POWT
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the cont(
Ar tko ranirftl ramovPd by i senUfre servicing operator prior to use.
i
Pa<< _vf..—
System start up shall not occur when soil conditions are frozen at the Infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) In one large dose, overloading the cell($) and may result In the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Sepup Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWT5 Malnulner to assist in manually operating the pump controls to
restore ncrmal levels within the pump tank.
Do not drive or park vehicles over unks and dispersal cells. Do not drive or park over, or otherwise dlswrb or compact, the area
within 15 feet down slope of any mound or at-trade sot( absorpdon area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the lift of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbiddes; meat scraps; medications; oil;
palntknx products: pesticides; sanitary naokins: tamponsi end water softener brine.
ASANDONEMENT
When the POWTS fails and /or Is permanently taken out of sery ice the following steps shall be liken to Insure that the system is
proptrly and safely abandoned In compliance with ch. Comm 83.33, Wisconsin Adminlstradve Code:
• All piping to unks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contenu of all tanks and pits shall be removed and property. disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, g: or another Inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the following measures have been, or must be taken, w provide a code compliant
replacement system:
0 A suitable replacement area has been evaluated and may be utilized foe' the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be Infringed upon by
required setbacks from existing and proposed strucwri, lot Ones and wells. failure to protect the replacement area will
result in the need for a new soli and site evaluation to establish a sultable replacement area. Replacement systems must
comply with the rules In effect at that time.
C3 A suitable replacement area h not available due to setback and /or soli Umltations. barring advances In POWTS technology
a holding tank may be Installed as a last resort to replace the failed POWTS-
0 The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacerrrent area. If no replacement area h available a holding tank may
be Installed as a last resort w replace the failed POWTS.
D Mound and at-grade soil absorption systems may be reconstructed In place following removal of the biomat at the
InfllvaQve surface. Reconstrvctlom of such systems must.comply with the rules In effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT
OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TRIEATMENT TANK UNDER ANY CIRCUMSTANCES.
DEATH MAY RESULT, RESCUE OF A PERSON FROM TK9 INTERIOR Of A TANK MAY BE DIFFICULT OR
ImPn lRl F.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name N per S H1M.i1' — Na me
Phone f S7 – Vtq IS Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name I Apncy s'T (—W 1X Cm"ff Y SIN
Phnn♦ I fbonj – It
656288
r :A i HL EEN H. WALSH
WARRANTY DEED R'-- 6ISTER OF DEEDS
c;tu X ::0.. W!
DOCUMENT NO.
RECEIVED FOR RECORD
',q -11 -200 10:30 AN
This Deed made between KATHLEEN E. WARRANTY DEED
HOFFMAN, a single person, Grantor and B URT WILSON EXEMPT h
and T.J. WILSON, husband and wife as survivorship CERT COPY FEE:
�JPY FE ::
marital prop_e�rantees TRANSFER FEET 66.00
RECORDING FEE: 11.00
PAGES: 1
Witnesseth, That the said Grantor conveys to
Grantees the following described real estate in St. Croix
County, State of Wisconsin:
Lot 12 l of Northgate in the Town of Star Prairie,
St. Croix ounty, Wisconsin.
Tax Parcel No. 038 -1188- o
This is not homestead property. RETURN TO:
Together with all and singular the hereditaments and
appurtenances thereunto belonging;��
And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of
encumbrances, and will warrant and defend same.
Dated this _(lam- day of September, 2001.
* 11t ILL- (SEAL)
Ka hleen E. Hoffman
STATE OF WISCONSIN
)SS
ST. CROIX COUNTY
Persor�onto e this 2A day of September, 2001 , the above named Kathleen E.
Hoffman, to person who executed the foregoing instrument and acknowledged the
same. p otary Public State of Wisconsin
lyCo��raFx�ctw,a My Commission (expires)•
THIS INSTRUMENT DRAFTED BY:
Attorney Barry C. Lundeen
MUDGE, PORTER, LUNDEEN & SEGUIN, S.C.
110 Second Street, P.O. Box 469
Hudson, Wisconsin 54016
)RTHGATE
m par, of the NE 1 %4 of the SW; 4 and in pan of the N W 1 4 p e4 t all
of that Certified Sufvcy ?131` retarded in Volume I3. Pagr
oe. St. Croix County. Wisconsin
UNPLATTED LANDS
6600' 1 195 7G'
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1001.5 NO 9:1lL " "! 590 sq :t a
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_ 1 1155 ac ' 1 41 I
68. sq. fl.
60 9 6 4 sq.fl n o
_ 1.4U0 ac 6N a70 sJ it � 1 1 S6'_ oc. o I z i z, 1
1.$ " i z i, = 1 133'3 � 9 31 I - , r te
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173. 0
55 "30.1 1 Q, 65 58' -ICi- �r>•OA'° v \ 56 " ° -_, - - -
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p I .11 at. _ NI I I 1.41 S aC. I
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LOCATION SKETCH ED LAND$ SII RVB'Oh'SCFI UlF ICA1L
SFCTION 13 i
T 3r
i 3..-,, Rlfi-n
h n on lot 6 is removed, or 3 g t r d \1'isconsin Land
Suneyor, baths a•ndy n+ the hest of my
hop 5 hw to the east side. then 211 _•, -_ J Lam,_ 1.1.aurcncc W. Murphy. ReBu c r
ct IS Changed right to channel L_. -- -- - pro fesvorml knuw1144;" wdcnumdiog and hail:
or lot 6 shall hove the 9 est end of -
r o5t the swntt.
1
.r race wife P Ural in full compliance l%ilb the provisions of Chapwr'_36, Wisconsin S1aWms. Charter IS of
Intl across land to the n orth of e oie- nns� Tulare of Star Prairie Subdivsion Regulations, and
of 6. The drainage course con - �'", the $t. Croix Couny lanJ Ux Rcgulauons,
of owntr's discretion within the limits of
d tnSenent, and soil easement width con ` Tide 14 Subdivision Regulauons under the City of hew Richmond E l 1 : , Rus Plat a r R
thin 15' in width, provided Jurisdiction, and by direction of <ireenwad fntcrprlses. I and James G Rusch and Maq' R.
,, to not Iess d NunhGatc:
al flow is allowed
to remain on Lot 6- Z ' fIIORT. •ye 5 Rusch, oarncrs. 1 have sum,*ed. divided and mapfrc
n.acTS - Thal such plat is a cancer rcprrxmafiun, nr scale. of the exterior MunJ:nres anJ IIk ubdivision
s
fhcrcOf; and
SCALE of the S of Lot
1N FEET �_xron - - That said plat is located in pan oflheNWI /4 oflhe SN'I /4, and in p•
- - SW 114, and in Pan of the" I "l E I /4 Page bei ng al 9. all in Section 11' 13 V ! H 18 \ \' To
t hat
a Certified Survey Map rccnrJrd in Valurnr I b nieulady described as f slows
0 :
100 200 300 s' of Star Prairie. SI. Croix Courtly Wisconsin, and is nwrc N
CURVE DATA TABLE C_r.,oeiog at the monumemcd A11/4 corner of said Section 13; thence S8 - E (assumed
and lu ,hc Point of
Cent'A Tangent Out he moms ented East-West 1/4 line of said Section he to ol" ion piped a) line t a I ' a ung assume, N
Curve Lot Radius Tangent
In Chord Chord Arc Dearing
Dearing Dearing Length Length angle beginning: thence continuing 589°07'26 'I: 3,615.68' along said East -Well 111 line to a 1 trim long the East
No. No. Length N66•)T34 "E pipe at the NE comer of said NW 114 of the SEIN: thence S �aMC "�c "
�. i0' along t
589°0726 "E lint of said N
W 114 of the SE 1 %4; thence 889 = how chard bears N89POT2 U' 115.75': tltencr
6 217.00' SSTP0T26 "E N78°7T34"E 92 .04 921.0 1' 2-1°30'
f-? °17• 1: 878°77')4 "E I ?0.09' 121.0 ' - 10'00" are of an 80.00' radius curve concave Northerly.
787 00' N66 -- 34" 10.18.42" 877 °11'16 "E thence S 0°52'74` \V 38.00: theme N69bT26"N' 116 (Kr: thence
589°07'26 "E 167
N89°O7' ?6 "W 491.54:
14 N66`2TWE N71°46'55 "E 53.72' 67.61' I7 °4I' I B" Soulhwesrerty 128.61' along the arc of a .00 radius tune co NMh 1 *2 - ly w 1nu
•• N77 1'16 "L• 864°01'55 "L' 67.15' S73'y5'30'L •, "N. 76.00'; Ilreoce
8 75.UT IS "11'5 chord hears 522°56'17`00' 1'_5 �S': drence 5159111 3 3).00 thencec 846 .1 __`\\' 1`/'115',
283.W' S8'R17"_6 "L 58171' ?8 ' 74.85' SNrr07'26`I:
e N85r0T2
5_6 10 875911'04 "E thence ?.179. thence S6?w09''- OS� \iA nee 10'13'37 1c••W�?It 6 along the West
11 21700• S7J°55'30"li SNI•)I '2N`I? 57A0' 59AT 15 JN 1U" $ "W 619.7 ?': thence 888 ° 10'52"
Sx')91T2G "li N8p58'19 "li 59 GS' 15.4x`10" 589917'26 "L lure fie last line of Lnts
9 -10 12 217.00' N75-04-04 1: NN2°58' 19 "I? 77.X1' 780x' S 0.57.31.00 line of said S W I /J; thence 580b726'E 480.01' along the South line of Lu14 of l onl
u aid
11.12 I7 8).011' 166110• 'R1W1'INI" Map carded in Volume 11. Page 354fl; thence N U 1')7" \ \' 360 . a a F
231011' SN99)7'26 "li S44.07'26 "li 129.51' ?8..57.40' 560 'L'
11'1.1 - S8' /'UT24 "li 574 "40')6 "li 116 _'4' 11151' S13°50.20•L 7 end 4 arded CenifeJ S slap: drvnec N8'1917 =4-W420 -W' alo ^8 11'e N °nh lint of se.'
19 •' INr 4y' 1 b '' = Lot ); thcnee 80°13'77 -\l' 66.01' along Ore East right. was' line of County Trunk Highway'
INr 4 S (r 5o \' , , 56. +G along Saulh line al Lot 2 of Ccnif cJ Sun cy Star rc<ndeJ
]0 .. 560°13'44 "i: SS2°0' -'03 "L 77 .. Isl x4 :4°42$4 ••C'•: thence SR9'07'"6'fi _. - b
.. 541 S0's_U'P: 5 ° 28'55 "li 1 _ 128 N4 44V7 ^_6' S45woo ,t V•Junre 1 3 . 1'aµ• 154x, rh. rr:. 1: dl 1 4u1 uT ILuru J4y1 r P...re " 1d Ocrl'ruu6rg r•� hrrc
21 NN'M7 "W ' \'ulrnnr 11, Vag, 1.
25 16700' S U•S'_'34 "N' S ?2°56'12 \V 126 1 / 1 2. 'xtu0'It0' of Lut 1 ^f said C'ndieJ Sur... hlap in
15-16 N IP5214 1. N44`t1T2r: W 276.1 T - 861.44'12 'U' Ica lur 57 1)U62 a <n•sl mare ur iess, mld Ix uag sutyevt to all
1671111. 62 '17' contiming 2.522.39, syuarc
17 -I8 N 0.5 +'t4 "I[ N30 5'5'7 " \ \' 171.5] 182.51' , 54 N8'PU7 ^ ^ -6 "N' aauGON w i
25 .. 79.81' S7 S•p4'04 - \V casements of record. �-
861 °44'3'_ "W 875.25'5')'W 71 IS °4x'30"
26 N8`nT26 "W S92'58'19 'a%' 59.68' 5' 889917'26' 5 ... - -.. , Si l' e •
575914'04 "\V S82°58'19 "\V 77.83' 78.08' 15 °48'30'
5
19.20 32 217.00' 7507 15 °11'56" 87)'5'3 "W 1 RLS 1711 3>s r'
21.22 33 _83.00' 8gg9)T ?6 " \L' L urI rcc \V. Murp ll = m -
27.24 N 566
283.00' N89�7-26 "W N81 °31'28 " \V 74.85' S 15 °11'56" _ ao \v MURPHY
N73°S 5'30 "1V 881 °11'28 " \V 57 e.0' 57..6' ,1 °lU'00• .2'_'14 "00 ICcb flc"' 00'iscunsin I .nr.l �w a: y••r ' EAOREr4CE o
25.26 JS 217. W' NN'rU7's_/�' \l' Ilatc Ibis Z� - Jav of xl:u.h. 199" = S 1710 W
?17110' N89917.26 "W S787T)4'• \V 021 V ?.7' , 1 "unxf' v. •.wrvEw Er.us..: 4, "
27.28 J7 566'^_2'14 "\v 578°3]34`00 12o u•r 121 ur i' w'sc. ,;� J 9; j
29.30 18 TN30(1' F 9 ......• S
` LAO b-t f3 Jis f o h
l uric Daal Par feugwrarl l'ul- I1rSr� r.ul.
: SNnIT26 "I. 14571' 1811^ 111 "1111" '+ r-2)o •l; .
7 71 NO UII' 8 2 14'17 - t I8311Y 111 °I rf iJ'
821 °': o w. - 1 1 This ur+lrunrem dmfcd by 1.•ums Ii Rusch
71.7- 525 °14'17 "W Nx'7U721i'\\' 145 7.'
73 -74 OI. 1 x0.011'
_
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application PO Box 7302
14sconsin Personal information you ma rovide be used for second u Madison, WI 53707 -7302
Department of commerce p y purposes [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not
state owned.)
Attach complete plans (to the county copy only) e *,VeM,,on paper not less than 8 -1/2 x I I inches in size.
County State Sanitary Permit Number '91 eCkjf_revi ion revious application State Plan I. D. Number
5T- c o t)C 319 = `�`
I. Application Information - Please Print all Inform Location:
Property Owner Name C o Property Location
/' f C NI 1/4 fW 1/4, S / T N, R (or
Property Owner's Mailing Address Sr Lot Number Block Number
City, State Zip Code ber : , Subdivision Name or CSM Number
7— J NO r .47
II. 'Type of Building: (check one) as, g` y ❑ City
X I or 2 Family Dwelling - No. of Bedrooms : .3 f 1 Village
❑ Public /Commercial (describe use):_ 19 Village
of
❑ State -Owned ,+ 4? x L
Nearest Road 12 j I/ 7N Avg
174
L T /1 3 X Cut Parcel Tax Number _ , ow
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) I &
A) 1. ®' New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to
System System Tank Only Existing System
B)
11 Permit Number Date Issued
A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply) -tiE q-- too
IR Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation
3 / ,.2- /N� i 4.
9s .15' 9o, 8
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete strutted
Tanks Tanks
B1 ❑ ❑ ❑ ❑
IA0 moo
❑ ❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on ed plans.
Plumber's Name (print) Pl 's Signature (no stamps 1,PRS N Business Phone Number
A/ C51 / 7 7 1//
Plumber's Address (Street, City, State, Zip ode)
lE — . . 7- J
IX. County/Departm nt Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin Agent Signature (No stamps)
K Approved ❑ Owner Given Initial Adverse Surch ge Fee) CD
Determination /o W / Q ,
X. Conditions of Approval /Reasons for Disapproval V `S &M& t , 0"e n CM
SBD -6398 (R. 07/00)
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WirnsinDepartmentofIndustry SOIL AND SITE EVALUATION REPORT Page 1 of 3
l a ' anti Human 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 St. 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. 038- 1055 -10
APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION R VIEWED BY DATE
�"
PROPERTY OWNER: PROPERTY LOCATION
Greenwood Enterprises, Inc. GOVT. LOT NC 1/4 5 t,-)1/4,S13 T 3 ) N, 8 E (or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # C°
1416 Third St. 12 na NorthGate � "H
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE RFOWN NEAREST ROAD
Hudson, WI. 54016 (715) 386 -3674 1 Star Prairie 214th Ave.
[ New Construction Use [X] 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 gi bed, gpd /ft .8 trench, gpd /ft
Recommended infiltration surface elevation(s) 95.15 It (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 2 S ❑ U 31 S❑ U ER S❑ U KI S U :97 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 Trench
.................
..................
.................
..................
.................
..................
1 1 -8 1
2 8 -20 10 r 4 4 none sicl lcsbk mfr CTW if .2 .3
Ground 3 L O-84 7.5 r 4/4 n
elev.
9 8.8 ft.
Depth to
limiting
factor
+84
0
Remarks:
Boring #
1 -9 10 r 2/2 none 1 lcsbk mfr QW if .4 .5
2 -26 10 r 4/4 none sicl lcsbk mfr C1W f
Ground 3 � 6-84 7.5vr 414 none r0s nq cl m n
I
t
98
elev.
ft.
Depth to
limiting S
factor -
+84 $• Qg8
u� C
COUNTY
Remarks ZONINGOFFICE ,��•,
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. Ave. Richmond, WI 40 7
Signature: Date: 10_28_98 CST Number: m02298
PROPERTYOWNER Greenwand Pnt r rise SOIL DESCRIPTION REPORT Page of
PARCEL I.D. # 038 - 1055 -10 46
Depth Dominant Color Mottles Structure GPb %f
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Barry Roots Bed jTw&
: LU 1 0-8 10yr 3/3 none 1 1 msbk mfr aw I f .4 .5
2 8 -22 10yr 4Z4 none sici lcsbk mfr qw if .2 .3
Ground 3 22 -84 7.5 r 4/4 none cos 0Sq ml na na
elev.
98 ft.
Depth to
limiting
factor
+84"
Le
Remarks:
Boring #
1 -1 lcsbk mfr w if .4 .5
4 2 10 -23 10yr 4/4 none sici lcsbk mfr gw if .2 .3
Ground 3 23 -84 7.5 r 4/4 none cos 0SQ ml na na .7 .8
elev.
98.7 ft. —
Depth to
limiting
factor
Remarks:
Boring #
1 0 -12 10 r 3/3 none 1 lmsbk mfr if A .5
5
2 2 -24 10yr 4/4 none sicl lcsbk mfr qw if .2
Ground 3 - 4 cos 0sa mi na na .7 .8
elev.
9 8.9 ft.
Depth to
limiting
factor
+
Remarks:
Boring #
E3
Ground
elev.
i ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel Greenw000d Enterprises, Inc. 1554 200th Ave.
CSTM2298 NE4SW4 S13- t31N -xl8w New Richmond, WI 54017
MPRSW -3254 town of Star Prarie (715) 246 -6200
lot #12- 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 may or may not be as shown
as permanent lot lines were not established at the time the test was conducted.
N
1 =40
BM.= top of 1 pvc pipe @ el. 100
Alt. BM.= top � of / 1 " pvc pipe C el. 99.7Q
l� 5 )
J N IN
2 IZ` v
0
�
w - 1
Gary L. Steel
10 -28 -98
FROM SCHMTT 8, SONS E}C PHONE NO. 715 549 6651 Oct. 08 2001 01:41PM P2
1087
Wisconsin Department of commerce SOIL EVALUATION REPORT pop t of t
and Buil om Schmitt
Division of Safety � in acsordanoe with Comm Cemm 85, Wis. Adm. Code
County
Apach cernpW site plat on paper not less 0M 8% x 11 kwhrs in sae. roan must St. Croix
k,hxle, fiat not limited to: renkal and hoftotal reference pant (BK, diractton and parcel I.D.
pamm slope, sde or anwd ions. north Arrow, and location and d1812noe 10 neat mad.
please print all information. Reviewed By
pwtsond wftmom you provide may be used for s¢cond2YY puYpreas (l tar►, s, 15.04 (1) (m)).
Properly Owner Property Location
Wilson, Burt GML Lal. NE 1/4 SW 1 /4 113 T 31 N — RI 8 W
Properly Owner's Mailing Address Lot a Bbdc Subd. Name or CSM#
54 Homestead Trail 12 _ )Worlhgate
City State Zip Coda Phone Number City 22 Village jj Town Nearest Road
gomerset I WI 1 54025 715- 549 -6127 Star Prairie 214Th Ave.
IN New Construction use. "17�' Residential / Number of bedrooms 3 Code derived design flow rate 4 5 0 GPD
IM Replacement Public or commercial - Describe:
Parent material Outwash Pla ... .. _ Flood plain elevation, 9 applicable no _.
General OMMOnts
and recomrrrendations: This boring was done to make sure that the sand goes deep enough below the system elevation to
provide proper filtration of effluent.
t e I O # Boring
Pit Ground Surface slev. — 98 - 7 R. D epth to limiting factor >133 ...,in softAppNrsdort Rate
Hod= Depth Donrrent Color Red= Ter(tUre St ructure CorwWwa I Boundary ROM Hft lt2
in. Muosel Ou. SL Copt C4*1 Gr. SL Sb
1 0-10 10yr= none I 2fsbk 4mfr t eW if .5 .8
2 10-21 1Oyr4/4 � none Bid 2msbk mfr gw if al- V .6
3 21 -97 7.5yr4/4 none ws 059 ml cs .7 1.2
4 97 -133 10yr55 none ms Dag _ml ' ---- .7 1.2
" Effluent #1 = SOD? 30 ! 220 moll- and TSS a30 150 mg/L ' CfiueM 02 = BOD 5,30 np/L and TSS 90 mg&
Nam CST Na (Piesse Print) T Signature: CS Number
Thomas. J. Schmitt 227429
Address Tom Schmitt Cate Evaluation Conducted Tele�rhone Number
SW Val4y Xr w Trail. Sonwmet, WI 54025 1018/01 715- 649-WSI
.mac sa=�,1 `s A b ° u i- �y
1��0 i