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HomeMy WebLinkAbout038-1190-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and�Building Division INSPECTION REPORT Sanitary Permit No: 384226 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: Wilson, Burton I Star Prairie Township 038 - 1190 - 80-000 CST BM Elev: / Insp. BM Elev: BM Description: c� .n 00.0 T PQ C t CT& ,, 5�-K `s I3►� I TANK INFORMATION U ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark w 3 a a3• l Dosing Alt. BM r cA•36 Aeration Bldg. Sewer f . S 3 as�� Holding St/Ht Inlet / 8:� If TANK SETBACK INFORMATION St/HtOutlet �. /Z IS-. 18' TANK TO P/L WELL BLDG. EVentbotake ROAD Dt Inlet Septic t 3q f S I Dt Bottom Dosing t Header /Man. $� p 9 't. QOr Aeration Dist. Pipe a `{s' v `Ey Holding Bot. System 43• S9 i r � q,q� 43 • �fo Final Grade ';. r • PUMP /SIPHON INFORMATION Z Manufacturer Demand St Cover w GPM - Model Nu r TDH Lift riction Loss System Head H Ft Fo main Length ell SOIL ABSORPTION SYSTEM (� Ct 4 J ~ 3 ENC Width Length lNo. Of Trench is PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 tf 0 SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING Manu _ �• n n INFORMATION Type Of System: t f CHAMBE OR , �� 3 5-V Mode `mber: DISTRIBUTION SYSTEM r�L Heade if Id Distribution x Hole x Hole Spacing Vent to Air Intake ,4 k Pipe( ,. (z l l_ength�wDia ( Length Dia Spacing I 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 BedfTrench Center Bedrrrench Edges Topsoil Yes [W No ns Yes [1j] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / C) - /_ b If Inspection #2: Location: 1337 214th Avenue Star Prairie, WI 54026 (NE 1/4 SW 1/4 13 T31N R18W) Northgate Lot Parcel No: 13.31.18.979 1.) Alt BM Description = �°��al i 2.) Bldg sewer length = 15' '1 1 - amo of cover = 3(o 44 + Plan revision Required? no Yes No O I , Use other side for additional information. ! _ _ / r SBD 6710 (R.3/97) Date Insepctor's Signature Cart. No. � 1 r 0 �' b ( ' Y fe0f1 /o,M 33 Zly I ' �[ Safety & Buildings Division Sanitary Permit Application ��IS j3 / 201 W. Washington Ave. In accord with Comm 83.21, Wis. Adm. Code See reverse side for instructions for completing this application PO Box 7302 oSCOnSOn Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce it l (Subm competed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x I 1 inches in size. County State Sanitary Permit Nu mber /` TCheck if revision to previous application State Plan I. D. Number 6t. f-0 ` � c f ---,-z (� I. Application Information - Please Print all Information Location: Property Owner Name Property Location D 1/4 U,) 1/4, S 13 T 31 N, R / (or Property Owner's Mailing Address of Number Block Number S 0 7 130 City, State Zip Code P one umber Subdivision Name or CSM Number D ( ) .5 - 61,;Z9 0 H ri� - II. Type of Building: (check one) City I 1 or 2 Family Dwelling -No. of Bedrooms : "' z ` [I Village E4 Town of ❑ Public /Commercial (describe use):_ ❑ State -Owned Nearest Road_ 7/ i9UL�- P — NFi G 11 R S Parcel Tax Numbers III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) 40 P A) 1. S ystem 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued P9 A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) 0 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 3 77 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 L1 6 - 0 / 5 V 377, a , 6� ,'�� R �Q` s", s,� 93 LL 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 K ❑ ❑ ❑ ❑ E T1 C- Do© Do ✓ ! ear ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement 1 , the undersigned, assume responsibility for installation of the POWTS shown on ched plans. Plumber's Name (print) P1 is Signature (no stamps): RS No. Business Phone Number / SP 63 Plumber's Address (Street, City, State, Zip ode) 8 — E IX. County/Departme t Use Only i ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) 1 Approved ❑ Owner Given Initial Adverse Surcharge F ee / Determination � �� 0 d R Z 4, z Uo 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. SBD -6398 (R. 07/00) : , r v�Nr rii�t's - : r i r j /MFic,�/1R7 ; i , gg ,o i T�I i t r : ' 1 _ _ - - -- fi r +- - - - -- - - -- S a e , 0D : i : , Lof --1 p SC — , i f , I � : n r : i r ; i I i - - -, - 3 � f- f it� � � F � � � I � i � � I � � j � 4 � j� f I _ II II 3 � � � '_ ff r C/ ` 1082 ' • Wisconsin Department of Commerce SOIL EVALUATION REPORT P age t of 3 Division of Safety and Buildings -- +.' , iniaccordaridswith Comm 85, Wis. Adm. Code Tom Schmitt . ...` County Attach complete site plan on perlwt less than 8% x 11 inches in Plan must St. Croix include, but not limited to: yd and hor)pntobf�erenoe point (8irection and percent slope, scale or dnllipns, northrrlr location and nae to nearest road. Parcel I.D. P �aC.. c, 038 -1190 -80-00 P qa a r 4► info. R Dat Personal information you r pr may be used for s" ,furposes (Privxy , s. 15.04 (1) (m)). L Property Owner rJc `- Properly Location Wilson, Burt Govt. Lot NE 1/4 SW 1/4 S 13 T 31 NR 18 W Property Owner's Mailing Add : ",. Lot # Block # Subd. Name or CSM# 543 Homestead Trail / `� - - - -- \ 30 na Northgate City State de umber j City f Village 16 Town Nearest Road Somerset WI 1 54025 715 - 549 -6127 Star Prairie I 214Th Ave. New Construction Use: 16 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement J Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd /sgft rating. Possible system elevation ranges from 96.28' to 91.73'. l� Boring # J Boring (�J 0 Pit Ground Surface elev. 99,15 ft. Depth to limiting factor >132 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ft' in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - E 1 I *Eff#2 1 0-10 1Oyr3/1 none I 2fsbk mfr cw 1f .5 r .8✓ 2 10 -22 1Oyr4/4 none scl 2msbk mfr gw 1f .4 r .6✓ 3 22 -82 10yr5/4 none Cos Osg mt cs ---- -- .7 v 1.6 ✓ 4 82 -132 10yr5 /6 none ms Osg ml -- ---- .7 ✓ 1.2 q 9S, S r 3• �s 2 Boring # J Boring Y't) Pit Ground Surface elev. 99.78 ft. Depth to limiting factor >133 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rood GPDlft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 * ff#2 1 0 -9 1Oyr3/1 none I 2fsbk mfr cs 1f .5-/ .8 r / 2 9 -17 1Oyr4 /4 none sl 2fsbk mfr gw 1f .5 .9 ✓ 3 17 -63 1 Oyr5 /4 none cos Osg ml cs - - - - -- .7 ✓ 1.6 ✓ 4 63 -134 1 Oyr5/6 none ms Osg ml --- - --- .7 1.2 ✓ * Effluent #1= BOO s > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < mg/L and TSS s mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt �o ...�.c� 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 9/2/01 715 - 549 -6651 Property Owner Wilson, Burt Parcel ID # 038 - 1190 -80 -00 Page 2 of 3 ' ] Boring # Boring Pit Ground Surface elev. 99.61 ft. Depth to limiting factor >131 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPDfiV in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 1Oyr3/1 none I 2fsbk mfr Cs 1f .5 .8 2 8 -22 1 Oyr4 13 none scl 2fsbk mfr gw 1f .4 ✓ .6 ✓ 3 22 -76 10yr5/4 none Cos Osg ml cs - - -- .7 ✓ 1.6 ✓ 4 76-131 1Oyr5/6 none ms Osg ml - --- - - --- 7 i 1.2✓ t 4S'..� lr C rr 1 ❑ Boring # Boring j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff# l *Eff#2 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP 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 s.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 noa.l motPrial in an altomotP c—t nlr+aco. — tlk . Al "—i—i of AaR- 744-11 it — 7 4AR- 74A_2777 t l l'o , i / 3 r �9 a� S'8, .73 -' n n J � rc�•� i Fir ! �3U�r � " /5�-► D►�Gt�a�b 6 y % X MO.? ' W ,F-J ,, Sr J G?397 ` ( 3 3 :� Z 14 Av 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 lVisconsin Personal information ma ou provide be used for second purposes p Madison, WI 53707 -7302 Department of Commerce y p y (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned.) Attach complete plans (to the county copy only) for thesystgn�, orl papq� of less than 8 -1/2 x 11 inches in size. County State S Number ❑ Ct o k ifrevisionto previous lication State Plan I. D. Number I. Application Information - Please Print all Information Location: Property Owner Name j Property Location JU r t _ r L S "' U a"! L 1/4 Y& 1/4, S Z3 T I N, R/ (or) Property Owner's Mailing Address r ± ? S r Lot Number Block Number 6 L13 1a S 7A-0 z r o IA City, State Zip Vo ' P one Num 10E - -- --- ubdivision Name SM Number Q Ew e II. Type of Building: (check one) Su y„ ❑ Ci R 1 or 2 Family Dwelling - No. of Bedroom a t�+we� (�l s . j ' ❑ Vil ❑ Public /Commercial (describe use):_ e X To of V ❑ State- Owned / T,c} Jz j Nearest Road / 7- IPA r n IPA TL !N F i T /L /+ T S arcel Tax Number III. Type of Permit: (Check only one box on line A. Xhe k box on line B i cable) 13 . 1. 8. 9 �9 O 1 qfl — SO — A) 1. W New 2. ❑ Replacement 3. ❑ Re cement of 4. 6. ❑ Addition to System System Tank O �[. Existing System B) a it Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) � N Non - pressurized In- ground ❑ Mound D Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding V ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. S ' App \at n 5. Pe rcolation Rate 6. System Elevation 7. Final Grade Required Proposed R Gals.. ft�l (Min. /inch) Elevation 37 - 2 , 06 . ) /00 VII. Tank Capacity in Total # Manufa rer Prefab Site Steel Fiber- Plastic Information Gallons Gallons T ks Con- Con- glass New Existing crete structed Tanks Tanks rKr 0 1 11 1 11 1 0 T ❑ ❑ ❑ ❑ ❑ VIIL Responsibility Statement I, the undersigned, assume responsibility r installation of the POWTS shown on th d ans. Plumber's Name (print) Plunfer'A Signature (no stamps): MP No Business Phone Number wAyliv Plumber's Address (Street, City, State, Zi ode O 596 LG E 79 S© f s' IX. County/Departm t U Only ❑ Disappr ed Sanitary Permit Fee (Includes Groundwater Date Issued ss ng AgenMSi'gn (N o stamps) Approved ❑ Own K ven Initial Adverse Surc azge Fee) QO Dete nation X. Conditions of Approval /Reasons for Disapproval SBD -6398 (R. 07/00) f i i Il ll1 ��n I { i o 00 0 ( — i I - r /k _� _ _ d' t— l--�— �- -— -- f - - - --T - — -- -) i ! I i I L 1 44 -4-4 � I i 1 11 a a I I { A l IZ --, i 1 -� i RfI ; -- I Aal ft i 4 I W V,4 c c I ca TA - -�_ —T — 7 4--A f/V /A(k ly . t . ORE A6 E S At GAAA ae I WOO 4 4 � j w VAC t 4F s • Y t • � i fi t —T € I -- v t - till j v! € t s { s I r { l , I 1 I I p � { I t Z E 1 , - i • I i t E : F - - -- . { t € i I , t f • 1 s 1 I � . 1 1 i . f s ° z ; f , 1 1 q f ?- i I r Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 LabotanHuntan Relations DiyiFion cT Safety s• Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but S 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 A EWEDJI Y DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT NE 114 SW 1 14,S 13 T 31 N,R 18 :9 (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # j SUBD. NAME OR CSM # 1416 Third St. 30 1 na I NorthGate CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD Hudson, WI. 54016 (715) 386 -3674 Star Prairie [ New Construction Use ] Residential / Number of bedrooms 4 ( ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate ._ bed, gpd /ft 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) 96.70 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 "1' U = Unsuitable for system �C7 S ❑ U CAS ❑ U 1 S ❑ U ®S ❑ U ®cS El U ❑ S ®U t SOIL DESCRIPTION REPORT ew J" 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 0 -12 10 r 3/3 none 2 . . • S' Uj 2 12 -24 10 r 4/4 none •`� Ground •� elev. 10 O ft. Depth to limiting factor +84 Remarks: Boring # 1 0-19 10yr 313 none I 2mghk rnfr if ' 2 2 12 -31 10 r 4/4 none sicl 2msbk mfr Qw if .4 .5 • `� Ground — cos o 1 elev. \�' 1 00.0 ft. Depth to limiting facttor +84 10Y A Remarks: ZONING OFFICE CST Name: -- Please Print Gary L. Steel Phone: 715 - 246 -6200 - Address: 1554 200th ve. New Rich nd WI 54017 Signature: Date: 11 -2 -98 CST Number: m02298 1 PROPERTYOWNER Greenwood Enterprise SOIL DESCRIPTION REPORT Page �of_ 3 PARCEL I.D. # 038 - 1055 -10 - Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed jTwich 2 11 -27 none sicl 2msbk mfr Qw if .4 .5 Ground 3 1 27-84 7.5 r 4/6 none cos osci ml na na .2 .3 . �. elev. 1 Depth to limiting factor f84" Remarks: Boring # 0 -11 10 r 3/3 none 1 2msbk mfr w if .5 .6 .� 4 2 11 -27 10 r 4Z4 none sicl 2msbk mfr w if .4 .5 Ground 3 27 -84 7 r 4/6 none cos osq ml na na .2 .3 • �- elev. 100.5 ft. — Depth to - limiting factor +84" Remarks: Boring # 1 0 -12 10 r 3/3 none 1 2msbk mfr gw if .5 .6 . 5 2 12 -26 10 r 4/4 none sicl 2msbk mfr gw if .4 .5 •`� Ground 3 26 -84 7.5 r 4/6 none cos osg mi na na .2 .3 elev. 1 00.4 t. Depth to limiting factor + Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: S13D- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Greenwood Enterprises, Inc. 1554 200th Ave. CSTM2298 NE4SW4 S13- T31N -R18w New Richmond, WI 54017 MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #30- 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. 101.10' ph �d 3 Gary L. STeel 11 -2 -98 3 -06 -1995 8:01PM FROM P.3 ' .raow,rn►wermlaft"Kprnwvmay, 544JIL AMY *11 C' CY'ALVA 11VN MC rvr[ I �+W Ww and Hamm RMadons Division ersakily & dlainps in acx�otd W ith ILHR.83.05. Wis. Adm. Code cau Attach complete site plan on.paper not less than 812 x 71 inches in si ze. Plan must Include, but mat limited to vertical an ttal d Waor reference ' and % of slope, scale or ARCEL I.D. t dimenaivned. north aniow, and lunation and �, 038- OS . 10 APPLICANT INFORMATION PLEASE � ` AL 1MFO VON pa D DATE �' PROPE1RTY0VW*R: i �� w PROPERTY LOCATION . LOT NE im. SN v4,s 13 T 31 ,mA 18 s(er w PROPERTY OWNEWS MAILWO AODRESS : ` X OT a BLOCK# $UBD. NAME OA CSM of 1416 rd St. 30 _Xa Nor CITY, STATE ZIP r .• Ph10N>r :t CITY OVIL (MOWN NFARESTPOAD HU&MP wI . 54416 ' F4 61 New Caretr zft Use k I ResidenNal�/ Ali "'y" Pt r rrt . �' (j Addition to existing IxAling L] (' ] Puble or - Code derived d* Ibw GQ0 _ gPd Rowmended design badng Me —,7 -- bed, 9Pd*—,B— , Wd* AbMlon grey required _858 _ bed, ft2 750 trench, 42 MWmuM design bad rate _ - 7: - bed, gpdM . trench, gpd* Reconeaerided inWatlan sur4c i elevation(s) 96.70 R (as relelr®d b silo plw. bendunw4 Additlo W design i slle oansiclwalions Parent maRerial _: aetwash Flood plain elevation, d apPrto W era _.. ft S a Suitable for system 9+► OUL WMI) "4MLlNO ffl �FIF A T -GRADE S!'S1l�1 pJ FILL 4%DM TANK U Unsuitable bt slum W S CIU CAS o U Sc7 s C7 U EIS O U � ❑ S W U SOIL DESCRIPTION REPORT Boring #r Horizon Depth Dominant Color L402015 Texture Structure Co s� t�� rme aoy Rool ' GPO/ft in. Munsell Qu, Sz, Cant Color Or. Sz. Sh. EW Toth 0 E l. -Z Or 2 2 -24 7. DWlh to oleo. . i .a ft. NmMing tacmr —+84" i Rernarks: Boring a' 2 12 -31 1.Q 4 e r' 2=kk mfr Ground _ ._,... elev. IQ i>evttt m limiting Li 'Remarks: TCST glint G L. Steel Phone: 715 - 246 -6200 200 e, w n WI 54017. ' Ekft' 11 -2 -98 C3T NambW. ax02229ti Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 3g Z2 Number of Bedrooms 3 Design Flow - Peak (gpd) S� Estimated Flow - Average (gpd) 6fl Septic Tank Capacity (gal) Soil Absorption Component Size (W) z— Type of Wastewater Dome tic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absor t'on Component Design Flow - Peak (gpd) Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic nd outlet filter shall be assessed at least once every 3 years by inspection. The tlet filter ha be cleaned as necessary to e nsure proper o erat' The filter cartridge sh be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the l Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 ` Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. •� C;2W�� �9� S� �tih S I 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 5ER7- 44 Sow Mailing Addi axe � Property Address (Verification required from Planning DepaMacat for new construction) S-hrl CityMtata R, , cH�oNo _ &Jz''_ Parcel Identification Numbar o -7 81/ — BO .GAL DESCRIPTXON Pwpedy Location - Ate. - Vo. 5 tv V4, Sec. 13 . T _1LN - RJ 8 W, Town of S TA . 4e9&, 6;7_' S"vWca Arm rw 6,4 . Lot # 3. o CettMed Smvey Map # �- - . Volume . Page # Warm ney Deed # L Y97G / - Volume 1634" . Page # < Spec house 17 yes 10 no Lot lines identifiable 13 yes 0. no ..Lnpnopaasaandmaim0aaanoeofY 'oars sys tanc�aaldremltinitspre�a Q+�futiun�eto hiadlewxstes.Pmpacma°°� ooadsts of oat dw - t ok . those or ff aeokd 'fioma ' . at yort put into ft s� P�8 � y'� by a . p�Pa Wh . ea:i affieettlta •5oadioa a[ tie aepfbc tamlcas : taatment:tsgo in lire �edi:poeel..sysoeso. . Tfa. p o w= agtoat to abmft to St. Cm& Zoaimg Deiiatuwa a o dfimtion fiocm. signed by. tiro -owm ttodby a 1 Jo=gm:apb=d ew,nxtacoodpWmbrrocatioeased vedfyiag st(Ljtheoa items is is peaper opeat�g oon�ioa nailer (2) after and P�B.(� }. � �� � .tlua tl3 of irt� Uwe. do rundemigoad have read die above icquircmeaft acrd agree to maintain the pdvaft sawage &qmg syd= wich *tom iat � badq'as set by die Deft of Qornmaoe and the Depantaoart of Nattnxl R,��oru�oetfi, State of Wes• � Mia8#M ym bas been maWdwd must bo ouVicwd and reword to due SL <lmix owj* Zoafng oWm vAk 30 dap date. jinkidw r Og AMICANT DATE QW1�iER• GRRT'IIrYC�ON _ fire that alt on this to the best of our kaa I we ant (are) the owVF(s) of Y form. are taste ( } oe�tfy my (our) t } t due of a wactanty dead recorded in Stec of Deeds Office. DATE +« Any information that is mis may result in the sanitary permit being revoked by the Zoning Dgmutm o t. s« Cndade trlth this application: a amampad wamaaty dad, fraee duo Register of Deeds otfioe a copy of the cartified survey map if refatem is made in the warranty deed , t STATE BAR OF WISCONSIN FORM 1 — 1982 645363 _ WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS DOCUMENT NO. VOL 1 6 36 P0.Gf J / O ST. CROIX CO., WI 7! RECEIVED FOR RECORD This Deed, made between Greenwood Enterprises, Inc., 05 -10 -2001 12:04 DM g Wi c -onc;i n ('nrrrirati on WARRANTY DEED EXEMPT Y Grantor, '! CERT COPY FEE: and Burton K. Wilson and T J Jane R Wilson, husband COPY FEE: 2.04 and wife s r i vn,-ch;�"' TRANSFER FEE: 68.70 8 ter p ��' RECORDING FEE: 14.00 PAGES: 1 Grantee, Witnesseth That the said Grantor, for a valuable considerat conveys to Grantee the following described real estate in St Croix THIS SPACE RESERVED FOR RECORDING DATA County State of Wisconsin: :i NAME AND RETURN AD O DRESS L f the Plat of NorthGate, recorded in the Office ii "" '� 7 ot 30 e Register of Deeds for St. Croix County, Wisconsin,'j', on May 20, 1999, in Volume 7 of Plats, at Page 46, as Document NuiTher 603503. �f/X�"•r 3).,D -7 it 038 PARCEL IDENTIFICATION NUMBER t: L This is not homestead property. (is) (is not) 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 except easements, .restrictions and reservations, if any, of record. and will warrant and defend the same. Dated this 9 day of April U 200 OD ENT]^ , INC. (SEAL) (SEAL) * ames E. RuSch. its Preside, r L (SEAL) (SEAL) use , i reta i s AUTHENTICATION ACKNOWLEDGMENT 5 i Signature(s) State of Wisconsin, ss. J St _ (Yni x County. J authenticated this day of 19_ Personally came before me this day of April XR2,QQ-1, the above named James F'_ Riigch, its Pr cid n and M ani * R. Rtsch, its secretary TITLE: MEMBER STATE BAR OF WISCONSIN (If not, S authorized by §706.06, Wis. Stars.) to me known to be the person exWted &&v ing instr#n and acknowledge the sa t ' THIS INSTRUMENT WAS DRAFTED BY Mary R. Rusch C .. * Sandra Gehrke i'•• 2 Q New Richmond WI 54017 St. Croix Notary Public, tgrky Wis. (Signatures may be authenticated or acknowledged. Both are not My Q mm' ion is ,, van anent. (If no , ...... • e�plrarion date: necessary.) �v Names of persons signing in any capacity should by typed or printed below their signatures. WARRAN "TY DEED STATE. BAR Of WISCONSIN Wisconsin Legal Blank Co., Inc. Form No. l - 1982 Mitwaukaa. W'S. � .:^-� �.. `� � �, l � �� � � � - � r _ , : ... .. .. _ Said lot t wr(s, ' Ri hmor;d and 31 104'•0 , 2- 3 8 " E 3G45.63� 100'' I x Ot — 7 +) A P ge n _ IaOl x n ( C 2,7 1, Z 9 A C- x I 139' X 4 5 , 7 C45) 4-9 X 1 4.'1 1^4 P -50 (5 200.00' 20i 66 0` i 1 I 6 10' DRAINAGE EASEMENT 0 0 CD o OD � � m i-�- -- 100' CO CO - 100 ' I tri I CO C W I 0i � 13 14 �' I 15 .� i I 59,022 sq. ft. m 57,600 s ft. 56, 160 sq. ft. W w v iu q' M►=- 1.289 ac. m 1.355 ac. r 1.322 ac. o / Z I o I M i o o o ° I Z Z I o ° ' O 33' 33' ! I cu —63.00'-1 - — 200.00' - - -� 616' L - - 195,00' i 4 E' 66 pp1 11 12 S89 °07' 2 63,00' — M M N 4 "34 ' C 166 p p , 20 19 N89 °07'26'W 1199.00' �,, w 72.00' - 192.00'- - - - - - 188.00' - - - - L 61.2 I 1p4.8 0 o 0 o o o I w (u 0 0 0 0 o i o Z in r` -1 `U 30 w 31 r 56,400 sq. ft. M f 55,865 sq. ft. ru 57,600 sq. ft. in 1.295 ac. u CU 1.282 ac. 0 1.322 ac. o 0 LP Z Z i C) z I Z 190.00' 192.00' 188.00' N89 °07'26 "W 2139.00' _W ZE of U NPLATTED LANDS a W — SURVEYOR'S CERTIFICATE J - L �' I, Laurence W. Murphy, Registered Wisconsin Land Surveyor, hereby certify to the best of my professional knowledge, understanding and belief: tn That in full compliance with the provisions of Chapter 236, Wisconsin Statutes, Chapter 18 of the St. Croix County Land Use Regulations, Town of Star Prairie Subdivision Regulations, and i Title 14 Subdivision Regulations under the City of New Richmond Extraterritorial Plat Review Jurisdiction, and by direction of Greenwood Enterprises, Inc., and James E. Rusch and Mary R. Rusch, owners, I have surveyed, divided and mapped NorthGate; That such plat is a correct representation, to scale, of the exterior boundaries and the subdivision ■ i y t j 1160.00' 200.00' 33.82' uo 11 m 12 w 68,036 sq. ft. 070 sq. ft. � 1.562 ac. 572 ac. N CD e PL — ( —D ) 65.58' 41.07' — — 5 °C S89 0 0 7'26'E 106.65' S� N 89 07 26 W 106.65 � � J 0 34-58' - 72.07' 22 ^I m o 0 ru 1O Li 33 ";r M 61,759 sq. ft. � I 1.418 ac. e CD 10 250.00' 250.00' LOCATION SKETCH SECTION i3 T31r1, R(8 '0l 2 20th Ave SMALL RCTS x = NORTH ATE Y C a ul p SMALL TRACTS z