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Home My WebLink About038-1194-50-000 ST. CROIX COUNTY WISCONSIN s . ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER - 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 Friday, April 05, 2002 P.C. Collova Builders, Inc. 1337 220th Avenue New Richmond, WI 54017 Regarding septic inspection for P.C. Collova Builders, Inc.. Location of Property in St. Croix County: � Municipality: Star Prairie Township I Subdivision or Plat: Pine Acres Certified Survey Map: Lot: 15 Address: 1337 220th Avenue Dear Applicant: A septic inspection of the above reference property was conducted on June 15,2001. This property is located in the NE 1/4 NW 1/4 of Section 13, T31N R18W, Pine Acres (Lot 15), Star Prairie Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a 3 bedroom home. If you have any questions regarding this, please contact our office at 715.386.4680. Sincerely, Kevin Grabau Zoning Staff cc: file Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y: Safety arbl Buildings Division Count INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Persona information you provice may be used for secondary purposes (Priv Law, s.15.04 (1)( m)1. 383830 Permit Holder's Name: ❑ City ❑ Village ❑ gown of: State Plan ID No.: P. C. Collova Builder Inc., I Star Prairie Township CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: CID I j ob 0 0je — Q`(u — M 1 6NA* ( 038 - 1194 -50 -000 TANK INFORMATION ELEVATION DATA ( fear ) TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic Uo ee �z'�s Benchmark I C0.0 Dosing Alt. BM 3 by M.S r E Bldg. Sewer St /Ht Inlet S , 2 02.93 TANK SETBACK INFORMATION St/ Ht Outlet r, o Z • TANK TO P/ L W ELL BLDG. Air i to ntake ROAD Dt Inlet 'A Air Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA I Dist. Pipe Holding Bot. System I 'Z�r (o , D' PUM / SIPHON INFORMATION Final Grade anufacturer and St cover M del Num r GPM TDH ift Lriction System Ft ead oss orcemain Fi Dist. To Well SOIL ABSORPTION SYSTEM [ c�na,5 �fl ENCH Width Length No. f Trenches PIT N0.Of Pits Inside Dia. Liquid Depth DIME NSI 3 " •1 2 DIMENSION SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING manuf acturer: SETBACK INFORMATION Type Of � V' •LLZ' vq � � l�r OR UNIT CHAMBER Mod Numb System: , DISTRIBUTION SYSTEM Header / Maai u Distribution Pipe(s) le Size x Hole Spacing Vent To Air J Intake l7O Len th Dia. Len �h Dia. S acin SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Overt' /� Q I► Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center (" _ v Bed /Trench Edges Topsoil ❑Yes ❑ No []Yes [] No COMME esent, etc. TS: (Include code discr pancies, per ) �� ( ' � ns pr Inspection # 1: ti's /I Inspection #2: �/- -f - -- • Location: 1337 220th Avenue, New Richmond, WI 54017 (NE 1/4 NW 1/4 13 T31N R18W) - 1331181010 Pine Acres -Lot 15 4, 1.) Alt BM Description =�r,S 2.) Bldg sewer length = 22.0 - amount of cover =24 Pfan revision required? Yes R No Use other side for additional information. O� SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. 1 � r r� 1 v �---- /� �b� y � '�, _ I �. I i I 33 T 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 10scons Personal information you provide may be used for second purposes p Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach com plete plans (to the county c opy only) for t4o p not less than 8 -1/2 x 11 inches in size. Coun State Sanitary Permit Number ❑ e� v' y , Tplication State Plan I. D. Number `. I. Application Information - Please Print all Information Location: Property Owner Name Property Location cn kJ41 14 Q/(/( T—?/,N, R/6r) Q Property Owner's Mailing Address ST G�IA Lot Number Block Number --`� , COUNTY �S City, State Zip Code one Subdi i¢ion Name or C ber II. Type of Building: (check one) - -_ - -.- ❑ City 1 or 2 Family Dwelling - No. of Bedrooms: 3 ❑ Village C Town of 5 - 9Public/Commercial (describe use):_ 01 ❑State -Owned Nearest Road P N mholis ` III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. Crew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) 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 U it 11 Recirculatin ❑ Other: V. Dispersal/Treatment Area Information: — 0 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 32,5 :37 x, �� -70 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 sho the attached plans. Plumber's Name (print) Plumber' ignatu (no -s MP PRS No. Business Phone Number MAP � r�� as d 3 � cme - eogq � Plumber's Address (Street, City, State, ZIq Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) V,Approved ❑ Owner Given Initial Adverse Surc4lge Fee) �\ Determination 2z'g.. X. Conditions of Approval /Reasons for Disapproval: SBD -6398 (R. 07/00) , N q o 5 96,470 r6 � !' 5 13 i3 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 8 iK 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, an I ' ance to nearest road. parcel LD.# a I `" t / , ~ Pendin APPLICANT INFORMATION - Plea pj hfa7i ►nforinaikw. Reviewed B Date Personal information you provide may be used for purpose rivacy Law,'s,. 44.04 (1) (m)). Y Property Owner - Property Location Lakes & Hills D_e veloment Govt. Lot 114 NW 1/4,S 13 T 31 ,N,R 18 ❑W�❑ Property Owner's Mailing Address J00 Lot s Block # Subd. Name or CSM# - - - -- k / L -- Pine Acres ity State Zip Code PhoneNumber_ Cii y Village ❑ATown Nearest Road f1 fdc ��i ly�v S,� //d tl�'- O S� 7�ti.�!d. t I 220 Th Ave. ❑ New Construction Use: Residential / Number of s 3 ❑Addition to existing building • ------ - - -- ❑ Replacement ❑Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpolfi? 8 trench, gpd/ft Absorption area required 643 bed, ft 562 trench, ftz Maximum design loading rate .7 bed, gpd/ft .8 tr ench, gpd/ft Recommended infiltration surface elevation(s) 96.9 ft (as referred to site plan benchmark) Additional design / site considerations Alternate Area Elev. 96.3 Parent material----------- - - - - -- Flood plain elevation, If applicable - - - --- ft S= Suitable for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system � S❑ u ❑ S❑ u X S❑ u ❑ S❑ U ❑ S N U ❑ S N U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GP D/ft 2 Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots - Bed Trench 1 1 0 -10 10YR3 /3 - - - - -- 1 lmsbk mvfr as if .4 .5 2 10 -18 10YR4 /4 -- 1 lmsbk mvfr gw lvf .4 .5 Ground 3 18 -36 10YR4/6 ------------ - - - - -- cl lms mf r as - - -- .2 3 elev - - - - - -- 101 6 ft. 4 36 -59 7.5YR -- --------- - - - - -- cs osg ml gw - - -- .7 .8 Depth to 5 59 -96 10YR5 /6 ----- ----- -- -- --- s osg ml - - -- - - -- .7 .8 limiting CVP-9,0 factor >96 1 1 1 xt , Remarks: _ 2 1 0 -11 10 /3 ------- - - - - -- 1 lmsbk mvfr as if 4 . 2 11 -20 10YR4 /4 ;------------ - - - - -- 1 lmsbk mvfr gw 1vf .4 .5 Ground 3 20 -35 10Y R4 /6 - -- ----- - - - - -- - - -- cl lmsbk mfr as - - -- 2 3 elev - — 100.8 ft. 4 35 -60 7.5YR4/4 +----------- - - - - -- cs osg ml gw - - -- .7 .8 Depth to 5 60 -95 10YR5 /6 ________ __ ________ s osg ml - - -- - - -- .7 .8 limiting q to factor >95 1 1 1 Flo .8 Si Remarks: CST Name (Please Print) Signature: Telephone No. Jacque Ha wkins Y n — 'F y Y(' Address Date CST Number Ref# &15' 5' '�' VC e l v; - 4/8/00 7_ z 7- &7 Z-- 388 r PROPERTY OWNER: Lakes & Hills Dew1oment SOIL DESCRIPTION REPORT Page 2 of PARCEL MA Pending Depth Dominant Color Mottles Structure GPD/fts Horizon in Munsell Qu. Sz. Corp Color Texture Gr. Sz. Sh. onsistence Boundary Roots — Bed ! Trench 3 1 0 -11 10YR3 /3 ------------ - - - - -- 1 lmsbk mvfr as if .4 5 2 11 -19 10YR4/4 ------------ - - - - -- 1 1 msbk mvfr gw 1 of .4 .5 Ground - elev 3 19 -35 10Y /6 ------------ - - - - -- c1 Imsbk mfr as - - -- .2 .3 - -- -- - — 101.f 4 35 -67 7.5YR4/4 ----------- - - - - -- cs osg ml gw - - -- .7 .8 Depth to 5 67 -98 10YR5 /6 -- ---------- - - - - -- s osg ml - - -- - - -- 7 8 limiting -- - - -- - - - - -.. factor q >98 ## -- - - -- - -- -- I Remarks: 4 1 0 -9 I0YR3 /3 -- --- - ---- -- - - - - -- I lmsb mvfr as if .4 .5 2 9 -16 10YR4 /4 ------------ - - - - -- 1 lmsbk mvfr as lvf .4 .5 Ground -- - 3 16 -33 10 YR4 /6 ------------ - - - - -- Cl l mfr a s - - -- 2 3 elev - -- - - - - - -- - 99.3 ft. 4 33 -76 7.5YR4/ -- ---------- - - - - -- cs osg ml - - -- - - -- 7 8 Depth to limiting - -- - - - - -- - - - - -- - - -..- - - -- — — factor i Remarks: 5 1 0 -9 10 YR3 /3 -- ------- --- - - - - -- 1 lmsbk mvfr as if .4 .5 2 9 -18 10YR4/4 ----- ------- - - - - -- 1 lmsbk mvfr as lvf .4 .5 Ground - - - - - -- -- - - — - -- - - - - -- eleV 3 18 -30 10Y ------------ - - - - -- cl lmsbk mfr as - - -- 2 3 99.3 ft. 4 30 -76 7.5YR4/4 ----------- - - - - -- cs osg ml - - -- - - -- .7 .8 i Depth to - -- - - -- - - -- - - - -- -- - - - - -- -- limiting - - -- - - - -- - factor > 76 1 -- -- -- - - -- - - -- - -- - - - - -- — Remarks: Ground - - -- - - -- - - ----- - - - - -- --- -- - - -- -- elev ft. Depth to limiting -- -- factor Remarks: II / lip � 7 Z- 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 8 0 Number of Bedrooms Design Flow - Peak (gpd) Sn Estimated Flow - Average (gpd) a� Septic Tank Capacity (gal) Soil Absorption Component Size (W) Type of Wastewater Dom tic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) lc.;Uo j 3 TW z —c-J 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 I 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 septi nd outlet filter shall be assessed at least once every 3 years by inspection. The utlet filte hall be cleaned as necessary to ensu • proper operati on . The filter cartridge should not 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 I ` Mant3gement 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. nt should be avoided particularly it absorption com one Traffic around or over the so p P 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. 3 S'1' UMIX COUNTY SEPTIC TANK MAINTENANCI? AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer IJ. t La (I oVA A I A ti S - :V- n j <. Mailing Address - 70 Ors . l d . �' /- - �vdsu -v L 1- 5 1L, Property Address (Verification required from Planning Deparmment for new construc(ion) City /State en� arcel Idcnlilication Number L1?,GAj DESCRIPTION Property Location We � y,, NYA[_ y,, Sec, T I N - - Town of Subdivisio t r4 e AcZe 5 Lot if �S Certified Survey Map It f Volume I'a g c it �. Warranty Deed U c � —�- -- Volume � S Page It v Spec house V yes II no Lot lines identifiable yes ❑ llo SYS'T'EM MAINT E kANCE Improper use and maintcuanceofyour 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 tie systcrrr 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 file owner and by a master plumber, journeyman plumber, restricted plumber or a licensedpumper verifying that (1) the on -site wastewalerdisposai system is in proper operating condition and/or (2) aRer 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 ag ree to maintain the r' g private sewage disposal system with [Ire standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification staling that your septic system has been maintained must be completed and returned to flic St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE Or APPLICANT DATE OWNER CERTIFICATION I (we) certify that ( ) all statements ants on this us form are true to the best of my (our) lrnowlcdg6: [ (wc) arrr (arc) tl►c owiici(s) of We property described above, by virtue of a warranty decd recorded in Register of Deeds Office. 1261 C) SIGNATURE F APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. *• Include with this application; a stnmpcd warranty decd from the Register of Deeds office R copy of the certified survey mnp if reference is made in the warmitty decd Corporation or Partnership to Corporation or Partnership VOL 1517PAGE 292 624 3 9 No delinquent tares and transfer entered' Certificate of KA ILEFN IT. WRLSH REGISIER OF DEEDS Real Estate Value ( ) filed( ) not required ST. CROIX CO., W1 Certificate of Real Estate Value No. ,19_ RECEIVED FOR RECORD 06 -07 -2000 4:00 PM VARRAMIY DEED County Auditor EXEMPT I CERI COPY FEE: COPY FEE: IRAOSFER FEE: 304.80 b _ RECORDING FEE.: Ica .00 PAGF5: 2 Deputy STATE DEED TAX DUE HEREON: $ Recording Area Date: May 31, 20 00 FOR VALUABLE CONSIDERATION, Lakes and Hills, Inc. , a Corporation under the laws of Minnesota , Grantor, hereby conveys and warrants to P.C. Collova Builders, Inc. , Grantee, a _Corporation under the laws of Minnesota real property in St Croix County, Wisconsin, described as Follows: Lots 9,11,®5 and 17 Pine Acres, St. Croix County, Wisconsin "The seller certifies that the seller does not know of any wells on the described real property: together with all hcrcditaments and appurtenances belonging thereto, subject to the following exceptions: Easements, covenants and restrictions of record. Lakes and Hills, Jnc.. By: Ricl rai d S Nels n Affix Deed Tax Stamp 11cre Its: President STATE OF MINNESOTA SS. COUNTY OF Ramsey The foregoing instrument was acknowledged before me this 31st day of May 1 19 99 by Richard S Nelson, President and the and of Lakes and Hills, Inc. a Corporation under the laws of Minnesota on behalf of the Corporation NOTARIAL STAMP OR SEAL (OR OTHER TITLE OR RANK) �� ✓ / ��` DEBORAH L. TEICH SI(TNA'1'URE OI' PERSON'I'AKIN(S ACKNUWLIiDGA11iiJ'1' NOTARYPUBUC.MINNESOTA MY COMMISSION Tax statements for the real Property desttlbed in this in ti uni-t $• F,xPIRES JAN. 31, 2006 should be sent to (Include name and addresi of Grantee): THIS INSTRUMENT WAS DRAFTED BY (NAME AND ADDRESS): P.C. Collova Bui lders, Inc. 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