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HomeMy WebLinkAbout038-1190-70-000 0 10 ° 0 7 to o ° -4 C 7 w S mE £ E2 w 0-4 E « g e s ' BE ; @ ° $ i § Co / §( c ƒ 0 �2 ca ■ § § E Q E =r © g $ § # t k m � 3 0 C k § § $ § § ; n r ■ (D 8 8 § CO) & k- CD .. V WWI / 0 0 0 - UO � \ CA co \ 0 ) / a 0 - § f — g V 9 0 \ E N) 3 E m E 1 ( .. 7 X { k 9 2 0 0 zr w g k / kk■ } k / Q R ƒ ■ 7 2 W CL k 2 § @ co 2 # $ k � ® EjCL \§0 § RL 3 (D a- } H o � a% f E 0 � B � Sr � / \ � CL � 3 k � E ■ 0 0 . � : "„u� - �a - - -- z' ✓J' "c'E /u�6' _ //= 9 -a - - Wisconsin Department of Commerce y Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanity "tTlY Personal information you provice may be used for secondary purposes [Privacy Law, s 5.04 (1)(m)]. Permit Holder's Name: El City ❑ Vi a Tow f: State Plan ID No.: Turgeson, Michael r 1�iainelbwnship CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel TM- °1190 -70 -000 1 ,0 . O C� + O C VAI 25 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark o -ekZ CSO.O I Dosing Alt 3 fv$ �• Aeration Bldg. Sewer S. 32 _ qq . ID Holding St/ Ht Inlet �. I I 19-31 TA16K SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet _- ---- -- Air Intake Septic 35' a3` NA Dt Bottom Dosing NA Header/ I eff Aeration NA Dist. Pipe 'S •8�" l(o •SS Holding Bot. System 8 / gS,col' —R UMP/ SIPHON INFORMATION Final Grade �/ 90 `�. SZ Manufact Demand t cover 30 ` z �OD Model Number GPM TDH Lift L rlction TDH Ft ea Forcemain Length Dia. Dist. To well _T SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. f T enches PIT No. Of Pits Inside Dia. Liqui DIMENSIONS �' ��D DIMENSION SETBACK SYSTEM TO � BLDG WELL LAKE/STREAM LEACHING nufact INFORMATION Type O CHAMBER odel Nu r: , System: �v.�} i OR UNIT DISTRIBUTION SYSTEM Header / M nifoId u Distribution Pipe(s) « L x Hole Size I x Hole Spacing Vent To Air Intake Length / Dia. l Length 5' Dia. Spacing I 7 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 Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, $tc.) Inspection #1. 11 / oD Inspection #2: —4 -1 Location: 1341 214th Avenue, Sta Prairie WI 54026 (NE 1/4 SW 1/4 13 T31N R18W) - 133118978 Northgate -Lot 29 RA 1.) A4t BM Descriptive = RAP 11 F b*? ) -L 2.) Bldg sewer length= Z , 0 - amount of cover = ° Plan revision required? ❑ Yes No Use other side for additional information. J SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ;. T' _ _ _ 44 -4- iSCALE a F F i F 4 s S E ' E 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 V iseonsin personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(I)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the s stem -aQt less than 8 -1/2 x I 1 inches in size. County State Sanitary Permit Number ❑ Check ifr ion re, idus'aplitiFation Stale Plan I. D. Number 1. Application Information - Please Print all Information \ Location: Property Owner Name t ,r dr,. ; i Property Location t Z,/ - �S 1/4:5 1/4 S 3T N, K/XE or Property Owner's Mailing Address - ! Lot Number Block Number ST CRCt City, State Zip Code o �lud�ptN(; OF -tC� ;� Subdivision Name or CSM Number II Type of Building: (check one) _` cq ❑ City 1 or 2 Family Dwelling — No. of Bedrooms: _3 as pet (ar s 5u(,w, "I ❑ Village ❑ Public /Commercial (describe use): P E9 Town of C3 State-owned 7 III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road 1 AL A) 1. New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) /S. V /,P �7, System Tank Only Existing System 1 — Ov $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) '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 Dis ersaUTreatment Area Information: S` c 1. Design Flow (gpd) 2. DispersalArea 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 ✓ ✓ ,5 q VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ,C_ ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement 1, the undersigned, assume res on ibility for inst n of the POWTS shown on the attached plans. Plumber's a (print) , Plumber's Sign r �t MP /MPRS No. Business Phone Number I / - lumber'f Address (Street, City, State, Zip Code) 7 " ti VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) ❑ Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination S d Z Z IX. Conditions of Approval /Reasons for Disapproval: 4 ,4er l 4� rw4:��Rined /5cru c�� gee,. Iv ochc���cFt,► c ✓s ✓�Cow� L SBD -6398 (R. 07/00) 3,B+e A ll �p i 1 r Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and 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 7 BY DATE �u�l •� lag PROPERTY OWNER: PROPERTY LOCATION Q reenwood Enterprises, Tne. GOVT. LOT NE 1/4 SW 1 /4,S 13 T 31 N,R 18 :R(or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # I SUBD. NAME OR CSM # 1416 Third St. CITY, STATE ZIP CODE PHONE NUMBER ❑CITY [ MOWN NEAREST ROAD ( 214th Ave. [x] New Construction Use Residential / Number of bedrooms 4 [ ] Addition to existing building [I 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 .7 bed, gpd /ft .8 trench, gpd /ft Recommended infiltration surface elevation(s) 95.85 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft L Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK Unsuitable for stem a$ ❑U �7 S ❑U 7 S ❑U ®S ❑U ®S ❑U ❑S ®U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxiary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. — Twili MEMO 2 8 -22 10 r 4 4 none sicl lcsbk mfr qW if .2 Q Ground 3 22 -84 7.5 r 4/6 none ms OSQ ml na na .7 elev. 9 Depth to limiting factor + 8 4 Remarks: Boring # 1 0 - 10 r 3 3 none 1 2msbk mfr w if . 5•r' 1 2 -27 10yr 4 is lcsbk mfr QW if .2 Ground 3 27 -84 7.5 r 4/6 none ms osg ml na na . Z 49 ft. Depth to limiting .� pCr factor -' +84 ,`] Rr, M IR Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Ave. New Richmond, WI 54017 Signature: Date: 11 -2 -98 CST Number: mQ2298 c i 1 PROPERTY OWNER Greenwood Ent SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # 038 - 1055 -10 t Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence BoundEry Roots GPD /ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. T . _ . . :: 3 : 1 0 -10 10 r 3 2 10 -24 10 Ground 3 24 -84 7. elev. 9 9.6 ft. Depth to limiting factor yg +84 Remarks: Boring # 1 0 -10 10 r 3/3 none 1 2msbk mfr crw if .5 4 2 10 -26 10 r 4/4 none sicl lc bk mfr if .2 Ground 3 26 -84 7.5 r 4/6 none ms I 0sq ml na na .7 elev. 99 - 8 - ft. — Depth to - limiting factor + 8 4 11 Remarks: Boring # 1 0 -12 10 r 3 3 none 1 2msb mf r w if .5 >` 5 2 12 -29 10 r 4 4 none sicl lcsbk mfr w if .2 /.3 Ground 3 29 -84 7.5 r 4/6 none ms OSQ ml na na .7 A ft. Depth to limiting factor +84 Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD -8330 R.05/92 STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. Greenwood Enterprises, Inc. New Richmond, WI 54017 CSTM2298 NE4SW4 S13- T31N -R18W MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #29- 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 11 =40 1 BM.= top of 1" pvc pipe C el. 100 - Alt. BM.= top of 1 11 pvc pipe @ el. 100.20 /Tl A) '-t Gary L. Steel 11 -2 -98 I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM S V Owner/Buyer Mailing Address Property Address 1 � 21� -11 ,4U - Q w- (Verification required from Planning Department for new construction) Ci / State s -'W� �J -1L��o 1- Parcel Identification Number LE GAL DESCRIPTION Property Location 4L '' /,, 3 'A, Sec. VIi_, T 31 N -RJt6 W, Town of Subdivision ,,b" 64� _ , Lot Certified Survey Map # t __�_ , Volume , Page # Warranty Deed # , Volume , Page # Spec house ❑ yes X no Lot lines identifiable X yes ❑ no SYSTEM MAIN 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. The property owner agrees to submit to St, Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after w and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, 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 ays of the three year expiration date. #SOARE OF APPLICANT DATE OWNFA CERTIFICATION I (we) certify that all statements on this form are tnic to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue ol' a in Register of Deeds Office. / 00 IGNATURE OF APPLICANT D TE * * * * ** 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 a cope of the certified survey map if reference is made in the warranty deed t,l...1544PACE 196 /000 630225 STATE BAR OF WISCONSIN FORM 1 - 1998 KATHLEEN H. WALSH Documeotxumbelr WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Greenwood Enterprises. Inc. a Wisconsin RECEIVED FOR RECORD corporation Grantor, and Michael J. T=eson, a single person and Janette L. Slinker. a single uerson. 09 -20 -2000 3:30 PM Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys to Grantee the following EXEMPT N described real estate in St. Croix County, State of Wisconsin (The "Property "): CERT COPY FEE: COPY FEE: 2.00 TRANSFER FEE: 68.70 RECORDING FEE: 10.00 PAGES: 1 Recording Area N ame and.Return Address ooS, n4�v5 TI c c�40 Z"r) 038- 1190-70 Parcel Identification Number OW This is not homestead property. (s not) Lot 29 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 46e day of 2000 GREE OOD ENT ERP ES By: * * s E. Rusch, its president By: * *Mary R (_, 'ts sect ry AUTHENTICATION ACKNOWLEDGMENT Signature(s) James E. Rusch, its president STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this day of , 2000. Personally came before me this i;kj_ day of 2000 the above named Mary R. Rusch, its sect try to me known to be the persoq(s)- who .executed the foregoA instrument and acknowledge a N� Lois A. y TITLE: M STATE B F WISCONSIN R :• �' �f authorized by § 706.06, Wis. Stats.) Nota Public, State of Wisconsir ; ZI THIS INSTRUMENT WAS DRAFTED BY My o SID 's rman nt. 4 Loss A. Murray, Zilz, Estreen & Ogland, LLP •• 304 Locust Street, Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANrY DEED STATE BAR OF WISCONSIN FORM No. 1 -1998 INFORMATION PROFESSIONALS CO + t f k u U p e r�� t o cu ; Q ' y LL 1-- o d I Q` a cc) F- — � I � o M Z cr, 0 d Z W►— 00 -p- O IO 0£C .66'60£ M.8I,19.0 S 'D (n a Z I, C) cu Z cy aw o � 0292 M.8I,I5.0 S ,66'L82 I t` R► 6 u w` N C) co w d' .44 '001 N C, t 9 o �, � g � 5 CY C) m -,,, cu • -" - ,j OD O OD o/ ~ N � N M. bB,ZS.0 S ,££ b co ,00 61 /%.b ,ZS. 8 0 S � Z 9� ,� ap• ,00'88 8�. f •% .t7C,29.0 N ,00 - - -- ODO Ln 82 3.b8,89.0 NM, 92 3.b818S.0 N c`) OOi- �o,o t m o z V O W I ^ + ed U') w r N N a �i M uj l CO I f \ ••• W � ul) /� V1 c e O Q `--i N oG N I z o 10000£ 3.b£,25.0 N � q ' 001 o ti i o I o a� 0 [ ? 3. b £ , Z S . 0 N I 00 S p' 00 ►v `' F co p I z C g N I o 0 o I 100'000 3.b£,2S.O N v N CD M co I W o O � O �j o Q U CT\ a, W 3.v£,29.0 N �j N (li QI 00 0" I v S N o i 100'000 I 3.b£,29.O N 3 A o Q W 0 M N 3 �D W > i � S o co � Z I Q1 I f M 3.b£,29.0 N I I z I Z -- 1 -- I - -- -- - Ln r—+ °o I .00'00£ 3. £,8S.0 N 8 Jo 1 m 133HS 33S - 3NI H31dW o O