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HomeMy WebLinkAbout038-1194-90-000 n y O! 3 - 0 n d L 1 I c (D 3 m : v' :m c " CD a , s 3 3 y m ° w o c�a O cno O y cn y 0 M < O ? O7 CO N 0) 7• v N 7 - �• W C) a= O =3 o a 0 ° ! I CD O R O 4 O fD N O O rt V 3 o V 3 O O C 1 y Vl U S'i c ? 0) m ua z cn z D a !° I w (� Z fn Z D !. m rn D D y (D c8 D co D y a _0 W c) l c a a c a a o o 3 O O 3 O O N LTI (D CD N 0 L � z z z z n r N �+ O O O O -0 I!� 3 o r i Z Z 000�! "y o O O-o ° O O ** - p - i - 1 m m' 3 m m 3 w to to �O I = �� 0 0 �m a( v°N'''i n CD CD y y y y' w .. y N N � Of CL a 3 o 0 C (n z �i O w O a o Er 5 CD 0 RL Vi 0 N y ' y.0 .O C (O 3L W to 5r fD N 7 c C v a W C (D a mm 3 a mm 3 ' _ -1 N a CD rn 0 < o o < o a _ o ° o Q o Q _ \�, \N .D tz N C cn W j w ° Co (D ' a o Z N O. f a y Z C G (D 0 0 A I o•in < occ W 2 °D o. ,,� :3 o- a CD �o m -' a m �o-0 m o O 00 0 O w - O O O O O O - O O. O C y - 'O °. O C y , °v r aa° w ° o r aa° m c o°:o °O�ov, o ho o : o m o o �° a o o �° o a o a col N 0< 7 ay m COm v (0 < 7 ay 9 i pp N p 1 0 O N y 6i N O I fD ° y 4 0 3, °v a o Z 2 0, s p S y p 3 S 0) o o -,�; a ° a cN a C o = 3 7 0 -3 cl y 0 V D) 0 C� fl1 D y 0 C d - = =1 o 0' 2 7 a - O• = 0 cr O fn y . ? GD '--h p y y 2. S N - 'O O O _ _ 4 m �3 aQ0a CD 3 CD m m N m co m m q CD in v m �n 0 3� CL 0 E 3 o m ° D' -'Qm m o m ro ° m ° ra C) w m o° 0 'v a �� a �� 0 � v I o 0 m aro ` En 4A tss ss O �v o O �., 0 0 0 � F f c a O O CL O O D N 3 d 0 7 n I M 0 N 0 N ° • W co CD CL ° C :z E N Q 0 7 ID K' ° 7 7 ID OD ^1 G, A: O o' b 3 0 C U) Z Cn Z D m m D c8 D co CD CD IW 3 O O N CL O CND 0 ( O C o O O p _ 0 = D ° m m m o O CD CD > > N N N N i 7 Q 0 _ f I O O• 3 ja c Z CD -I CO) 0 p 2 CD N a X M N t' z 7 0 j C j W Ii i A .Z � c n0 —_acD 0 0 Cl) nN N 0 0 2� 0 D CD CD N >_ fD S C� < G 7 7 .�•. N 1 8 N c N N CD 'C c �. J m 0 m a a do °, �I n n�i m a3 y CD 3 0 3 °�sv � m �> 0 q o ( 0 c� n 2 N CO 7 Q fD Oj T (O Q N C CD n ( 0 fD 0 m 0'0 0 y m Z o �o y m a 3 m CD 62 CL S N y 0 O N D) CD S (D 3 CS S @ C C O D a• L a a CL o d= O O< CCD D n 0 0 CD CD 0 0 7 v +� m m 0 y o -•N N m aS2CD Qf, 77 R D� 0 n N N . fD S a - . 7 �' CD ti Sm ad o�'� 0 3 CD CD ° C = D 3 N N O. a' C m �0 >> "a N 0 co CD N Q m o m a aN m °� N C o ( D o N 9' i CL c jao< >>'co 0 C L =cD y CD m o _ v CD c n ' - 0, ° ��CD N m o < 5 0-3 II o N O CO n CD CD CD CD 0 > A n m o r a m N Y 0 I m o°o ti I � 09 69 O 0 o g i �, a Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430354 0 t 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: Jacobs, Jeff I Star Prairie Township 038 - 1194 -90 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 13.31.18.1014 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic' t � c� f Z � Benchmark �. . �.. S I c) Z X /05 . GU Dosing Alt. BM Aeration Bldg. Sewer St/Ht Inlet g, 5 3 � TANK SETBACK INFORMATION St/Ht Outlet $• �3 9 3 .1.7 TANK TO P/L WELL B ROAD Dt Inlet Septic N l Dt Bottom . ► �� Dosing Header /Man. E /o_bs S E - r, Io.Q t ct f Aeration Dist. Pipe N F_ O . q ( 7 Holding Bot. System N V_ - ' - 4 c- c �= Final Grade PUMP /SIPHON INFORMATION wct / 7.3 Manufacturer Demand St Cover GPM Model N ber p TDH Lift ion Loss ISystem Head TDH Ft J e fe L-4- Forcema' Length Dia. Dist. to Well SO ORPTION SYSTEM — SL BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYST TO P/L BLDG WELL LAKE /STREAM LEACHING Manufac rqr: INFORMATION Type CHAMBER OR S - • (� rO^" E vi s J t/� S d +� ^� 8 / N ` a UNIT C'k . Model Numb '7" T7 DISTRIBUTION SYSTEM 1 � V e-w^ `- Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake J ' ` f Pipe(s) " t Length &I Dia `T Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of T eeded /Sodded xx Mulched Bed/Trench Center / f s Bed/Trench Edges Topsoil Yes I No Yes No oe COMMENTS: (Inclu�co e�i discrepe ies persons pr se ed etc.) Inspection #1: '5 / ,2? / 0 - 7 / Inspection #2: Locatign: 2184 134th Street Star Prairie, WI 54026 (NE 1/4 NW 1/4 13 T31 R18W) Pine Acres 19 / Parcel N 13.31.18.AI4 1.) Alt BM Description = ' r < w ^^ 'S � "__'C_Q + *--S } COr�..�o -c ,.c. <D!�►� -j� � 3�..b rv�-�` � i ✓ Gar � Fy..� �ti[✓ 2.) Bldg sewer length = 35 Kcj-t Lo C— C ✓ - amount of cover = �o ' ✓ r'� - d! /Q -- -- Plan revision Required? r 4 11, es No -- Use other side for additionamation. Date Insepctoes Signature Cert. No. SBD -6710 (R.3/97) N 0 to M d0 N N C O O C - C O CC C N i� NOaJ O O a) . O O ,�N d a O �O E v'O O E v 'O o -p I CU CU m v �oEf°o.5 cD oE@oa2 Or Y a U C y Vr -00 Y a U C y w 0 c a Z �p co a a ��0 �' a i " C . ' C E . N L- C'0 O N L r C h o I ? o a� ,�TU CCU j o c U.w U O O I = U - O fC ; U O fC N N10 C >p) N q1� N y 'O C >O f6 y� O C 7 0 O_ C C O C 7 0-- CL C C C Z rn U C p _O f0 O Z N U C D m 0 LL c 3$ U •O J ° o o c 3 `o U J Q o O pp U 0 0 0 N U N O c U N O o N U N 3 a�a a�� w a�� - 0 O 7 o O O 7 0 O Q J.Stga c �'.S (n Q J.Stga c ES I z °o � I � cn cn w j a m Z 0 o I o Z !I c U r ! o o c Z N Z I N M N Cl) N C C N N 3 L o L o I c r- Y O O o m c - I z cn :5 z z 01 N N N y N Mn I y C C C C CL ,F. c C C c c C CD Q N G a O O c rn d N N m E 6 ai c� E ai ai a `� - 33 aC7 z �� z o 0 0 a :� I • o N 'I I T Cl) o tq J U N N Z z z z Q cn N 0 � � � I N U') .. O O . O O E I d O O = 'CS 'n O O N O in m c a m c CL w V U)Q Q a; w 2 I QzFn zin o Qz0 zU) o c I w N a w C C o 0 3 a c E E N c d o c v (L °o i .LD V o G N �� E c6 N O rn •@ o O O N> N C U > N � M D. O M r ` c s m N d ao U o o �, N m w o N m I • O o in ! - v o z a t� z a to L: a 0 CD r I Z ..7' l9 z 4loo got 7 U to a� u� Jam' J � I �o zz rY7/ wS LOT �9 146 I, lo ox & 07 - � J✓OT�� SCA'C.� a 3o (o 92 °0 Q , I r O \ 1 1 \ \ \ J J \ o,1 -- Safety tutct Buildings Divieloii C6Uy Yry01 I�' �'1�•ustun� toll Arr�:., 1�:0. Y3ox 7(?b''2 • S i C`: c� r i t �Vhsconsin Madbwn, 'M 5 7'07 !08'2 S Ytu Address fiepu of Crs ^� _ � _ ` — d$ - AG. P e rn ift it ,a io s auitury 1?erurlC IV'uuiler hr aulox'd with CU IMu 812 Wis. Ad= Cody. pavouW1 la i riuddoli yo provide �� Check it ltevisieixt / 30 3 _ way b uscd fax g sCgt p urL� Y'rivut;�" w, 1. A ;aplic:xtioii Iu,t'grrrtu Xx I'le ►SS T'rrlxt An laornnutioxt Stute Elan I.D. 7Vuut rrolx:rly Owue 'a 1VHuu _ .111 =1e�! �F� 1:1rut� l+Juuillcr - 9 2nn hh Prop 'e tg A1i1] et�ss 1 Location I v / { Z / ? . ST. CRUIX CUUNTY V -A Nt�' ;4; s f3 'r 3i rr Tt T8 Y% City, 5ti►tc IP CFUL rr Lot •r 131oLk Nuxubcr x il CSlvi .Nonibcx� 11. Type of Biuldiug (Check all thud apply.) ; r 0011 r4 CCiy _ i t:6 1 or 2 F w:dy Uwellial; - Number of Be&nonts M Pubtio/C':c a=oreial - D= ribc: CJstr 0 stale t'Swnetl Lr12,,J >�J�C Ivc�u�st'ttnutl y 1iJ. 7.. "ylxt� ctf i >eitntits (Chock unV oue }anlz on lute Ni. N' uxdltei1xg for iuticuuuf rlsa.) (Car TeCc� l9ue }3, ii>r ttpr�llcabin. ) A New 3 U Ttc it►caen►aUt a k �i LJ ArJditfun to °L U ltepiac�ruent Syt;taYU Yi'ur Gouuty ago . -_ -- ' ClClreck if Sanitary Partak 1 .Issued Permit Number � Date Issued l �YPO (Y 3?U'�IJ'Y 9'ybtenn Whec:lc all thUt U11J Yy. Numbering Is for internid use.) 44 Nou •- Prauuml od In Cxround 21 0 mound 4113 5tuld .'f'i'lter 50 L'J Curlstruuted wetiund 22 JJ Preau.1=1 lu- Crxound 41 1;CdW.,'rauk 48 0 Ki►Ygae, puss 51 rj D.ip ul 45 0 At Grade 46 13 Aerobio Tmatnlent Unit 4.5 U 1'tr4 culadag 30 0 0ther 1r. Disp �k ITrtiutlz Area Itiforma' _ � � v Deals n Plow &pd) M- Persai Axw i71sI .. -a1 Area Soil AI511ticatlun Parcoiuliuu'rWe Systuux 131evuClo �� Fluid (trade 3 I7equieed p topuut"d /Da sl&J.Vt elvliu -Adch} 3 BievuliUu V1.'I'au11c Into 4 Caiaat:ity in Tefitl Tdurttller ac arcr - Prefab Site Steel MW Plasdo t3allons Gallons _ of Tai& � �/ � � DO C01101'ule CULWL'aeted Giads Now L- x1et41g l '1 m"- '1' �11t1c t �Ialillu�'1'uak � _... _ . /2ecc C 1 _ 17-41-19 01u11fx:r V11, ltesFaonsib iJy Stateuu�nt I, the underdig rtud ussuw x'aapulzs for lust of tlae 1's)'Vi't.S aliorvu vct We s pluxla. Plumber's Plauu; (Print} Iytutti► 'a Siputuc MI'1 _ umlxr uusiu= Phony M=bar Plumber's Address (Street. City. Slate, Ctp Corte) a L'i VW, Ct}•uu %1)e t�tuxtu j T)'ea Only u. - -- 1�laapprovart �....dta - Dat� Is6 Issawg A cat S1 u "whiJts) /Lppruvled £7wwr taiveo lu dal Adverse Slu c ary Purnxlt Pee (3t1e1udas Ground�vuler I1nur taivatic _ Sur t1 lrge� I�t) - -� �2 b lam. C rt t l�rovul/lkeasont; fur lilsuli ;xcuYal Si71 [. Oj�JL �/ 7rr �' D 7a ( - 2��1t 4h r 1 Septic tank, effluent filter and 51 6a- 4V dispersal cell must all be serviced / maintained /1 l , /�, Ir , ri C geV as per management plan provided by plumber. j e ` 2. All setback requirements must be maintained 0 as code S plifrlu {tu ttu+Guuuly nal . e D L \. L \ I h r s w� l ( b� a-l�nc�>�d as �h �m�in�l��� 4-a ! - l fi 13T - 63� (]t g5�t?'l Sbi �eeoY4'� �'Y�v>1 +h0- S- m i`�l &rn rgy CGS __ s. � c( al d � g f 16 f I I , I ISM I I I �31 /YA 7 I � to I I A I Sl 1 f I I , , i 1 i I l I I I a_ c I I I I I - -- = 3 I -- - -- - I I - I I ! I I I j I I I i j I , I _ I I I I II - 06s X ` CD x ( O till x ,z5 °° © SKI X cD / CD P I I cD ED OD I N I / co OD LTV O 00 j)a © d> 31 4 :' X t 390.9 �� - -- - - - - - -- 1 0 x 1 �, ! j O O / £'L� 6 WH 211001 i f r' X N / XP r ZjG96 lMH 2U14Z �i . , cn oo ( w 01 } ll 6ulPul i o1 Oo X I to po ca to 01 V U1 �N co CD �� -`4 0210 0 / ( x ° q V (D / DOS l oo �'� v "D / oo 01) . Ln cil f / / ' X 0 0 O , x xj a O ctOo N (A CID to LW cb (a Mix co "V /t W e J X OD O ��q N OD - >OD U X v _ W / cD 1 co 00 00 p _` Cb ' � S 8 A # "W Q' ~7� s ly N mac; �a X - _ - O, I o X v OD JZ X ,C. /• 5 Ir jr III Gs 1 6 CD. jr r X 0 � w N W ,9 f16 7 1 NIL-��s T3 //vf w r 2C 41 ca�� j i ' I I I r I i I i I y j , ' : I _a �I� ', I , I � d L j _ I I� i i ', _, ', l �i _ ' I �� � � I _ � - ,� - � ', ! � �. � I I i I '�, I I I _ I__' I I� _ f � _ _ { I �� �I ';�I �' - I _ f j'� .._ �I I � �� _, � � � II t . � �, _,_ ___ �� � '� I � i_ i ' ', ! I, j I ' I ICI i _ 1 i i � ' � �� ' ' I � i l ' � , I i � I i i I� � i I I_ I i i � -- -li I I _ i __ i r � i I � I I 'I ' _ i �; �, i I -_ 21 \ n 68, 652 sq. ft. 18 NI 8 p' �� 1.58 acres R 1 70,766 sq. ft. v ; 1.62 acres \ ?? �SO• ���, ��O in 22 g ,y� 70,332 sq.ft. N O � 1.61 acres 3 � 20 � a 93,346 sq.ft. 0 2.14 acres 20 • ,h 19 93,110 sq. ft. 2 0 , ° 2.14 acres I Drainage do �- � p I Ponding Easement / p o i100YR HWL 987.3 "� o — 1277.43'— � 11 ` 307.61 250.83 4 1 13 1310.43' (meaS.) 12 11 10 i 4 of NW 1 / 4 4, R18W 1310.45 (rec.) PRAIRIE GRAPHIC SCALE 100 0 50 100 200 +00 ( IN FEET ) 1 inch = 100 ft. ASSUMED BEARINGS REFERENCED TO THE WEST LINE OF THE NW 1/4 OF SECTION 13, T 31 N., R 18 W., ASSUMED TO BEAR NOO'00'46 "E. 1 Department of Commerce SOIL EVALUATION REPO pAt Pag Wisconsin ,/ �_ of Division of Safety and Buildings in accordance with Comm 85, 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 not limited to: vertical and horizontal reference point (BM), direction and Panel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R ew Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Rropertypmer Property Location b Govt. Lot 1/4 NN 114 S T 3, N R 1 E (or Property Owner's Mailing Address Lot # Block # Subd. Name or CS City State Zip Code Phone Number ❑ qfty Mllage [gown Nearest Road ❑ New Construction Use: ❑ Residential / Number of bedrooms 4 4 Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: s y S4d-v- � ° lo Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor --Iqb-- in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 3 I r to- 4 r k mvpk 6 vo .4 on a L •� Boring Boring # ❑ Q 2 ❑ Pit Ground surface elev. l�'� ft. Depth to limiting factor I in. Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff= In. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 , 5 ozo ar M I -- -wl1 Ida Nye Effluent #1 = BOD > 30 < 220 mg/L and TSS > mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST ", pa�� CST Number Address Date Evaluation Conducted Telephone Number 3S'Z /1/0 b Piny Own S Parcel ID # P AO a Q q Page z— of � Ong # ❑ Boring ❑ Pit Ground surface elev ' ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 b' I iu k Y'S, -r v �s' ❑ Ong # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Appli cation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 i F B°nng # C] Borin ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ADDlication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I 'Eff#2 Effluent #1 = BOD > 30 < 220 rrg1L and TSS >30 < 150 mgA. • Effluent #2 = BOD, < 30 mgA- and TSS < 30 mg/t. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBP9330 QtAM) r fE EVALUATION Page 1 of 3 / } D M n,• -3,�� �d � 0 �7Ci��,T7 n 83.05, Wis. Adm. Code /C C n must ion and County 37'- e,C D , :o nearest road. Parcel I.D.# Pendin CZ f 7�/ -ice S e 15.04 (1) (m)). eviewe Date / 9 Z Property Owner Property Location Lakes & Hills Develoment b Gpvt. Lot 1/4 NW 1t4,S 13 T 31 N,R 18 Property Q#ners Mailing AddressLod B e Z lock # Subd. Name or CSM# i 1 _,� ;,� h b L ^ Y ��' 19 � _ Pine Acres i ty l L State Code jE :.` s V�lage [Town Nearest Road fj �� ��aw k �7 �v /U 1f �D YS� 7 � ,e� l G I 134 TH. ST. �d c New Construction Use: Residua l9rt� edrooms 3 []Addition to existing building - -- --- [_] Replacement [-1 Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpolfts 8 trench, gpd/W Absorption area required 643 bed, T 562 trench, fl? Maximum design loading rate .7 bed, gpd/ftz .8 tr ench, gpd/W Recommended infiltration surface elevation(s) 95.5 ft (as referred to site plan benchmark) Additional design / site considerations �-� &0 �'�k 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 E S ❑ U ® S ❑ U I ❑ S ❑ U ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT Depth ! Dominant Color I Mottles Structure I GPD/fP 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 -19 10YR4/3 -- 6--------- - - - --- 1 Imsbk mvfr gw lvf .4 .5 Ground 3 119 -51 7.5YR4 -- - - - - -- - - - -- - cs osg m1 gw - - -- 7 .8 elev — —� -- -- - - - - -- 98 — 7 ft. 4 51 -83 10YR5 /6 -------- - - - - -- cs osg ml - -- .7 ! .8 Depth to limiting g S ,.s- factor > Remarks: �- G(GtR%tGdyt (p0 1 0 -11 10YR3 /3 ---- - - - - - - 1 lms mvfr as if .4 5 2 11 -23 10YR4/4 ------------ - - - - -- I l msbk mvfr gw l of .5 Ground - - -- 8 3 23 -59 7.5YR4/4 ------------ - --- -- cs osg ml gw elev 98.7 ft 4 59 -85 10YR5/6 cs osg ml - - -- - - -- .8 Depth to limiting factor >85 Remarks: CST Name (Please Print) Signature: Telephone No. Jacque Hawkins 0 4 �_ C. y 2 Z ` y � Address 141 — � - v Date CST Number Ref# (! v f !�(l r r r 4/8/00 391 PROPERTY OWNER: Lakes & Hilts Develom mt — S OIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D.# Pendinu Depth Dominant Color Mottles Structure GPD/Fts Horizon in Munseli , Qu. Sz. Cant Color Texture Sz. Sh. onsistence Boundary Root Bed Trench 1 0 -11 10YR3 /3 ----------- - - - - -- 1 lmsbk mvfr as if 4 5 2 11 -25 10YR4 /4 ------------ - - - - -- 1 lmsbk mvfr 9w lvf .4 .5 Ground eiev 3 25 -56 7.5YR4/4 ------------ - - - - -- cs Ogg m1 gw - - -- 7 .8 99.2 ft. 4 56 -87 10YR5 /6 - - - - -- -- cs osg ml - - -- 7 8 Depth to limiting _ - - -- - -� factor >8711 - -- -} I I I Remarks: - 4 1 0 -11 10YR3 /3 ----- ------- - - - - -- 1 lms bk mvfr as if 4 .5 2 11 -23 10YR4 /4 ------------ - - - - -- I 1 i msbk I mvfr gw l of 4! .5 Ground 3 23 -59 7.SYR4/4 ------------------ es Ogg ml gw - - -- .7 .8 elev - - -- - - - - 98.7 ft. 4 59 -79 l OYRS /6 ------------ - - - - -- cs Ogg rril - - -- - - -- 7 8 Depth to _ -- -- - y - � limiting - -- - - - - - -- — - - - -- -- - - - - - -- factor >79" - -- - - -- - Remarks: - - - - -- -- _ 5 1 0 -12 I OYR3 /3 ------------ - - - - -- 1 1 msbk mvfr as if 4 .5 �- -- - - -- 2 112 -26 1 OYR4 / 3 �- ---- - - - - -- I 1 m sbk mvfr gw I if .4 .5 Ground eiev 3 26 -56 7.5YR4;4 ----- ------- - - - - -- es Ogg m1 9-w - - -- .7 .8 56 -96 10YR5 /6 ------- cs Og g ml - - -- - - -- 7 8 6 - - - - -- - - - - - - to limiting �u -* - - -- - -- - -- - -- — factor 2. >96 — Remarks: Ground- -- -- -- - - - - -- - - -- -- - - - ---�-- eiev Depth to � - - - -- limiting fa �- - - -- Remarks: _ -- - -- �L �1 N ty a o� 0 r N � � 4T ST CROIX COUNTY SHPTIC '-, - ANK MA.INTT?rdANCE AGREEMENT Ax "d1) OWP ERSHIP CER11FICATION FOR-NI Mailing Address — aa Property Address —, I— - ,%�c� —t fir?! f '�?� - - -• . (V eritic,ation rcgotred fzou i Planning, Department for new construcaora)_ _ �_._— City /State �� _ _ Parcel Iderttil'ic.atiat� I�1umlYOr L E GAL TlESCRIPTIQ Property Location _ r•,—_ ,l4, li� — �4, St C Town of — zl�U4 Subdivision Lot # Certified Survey Map # -, Volume _ -- ..., Page # W Deed # �• jZ� _ . � , Volume L��_�_ Page # _� Spec house W ye$ F-1 Do Lot lines identifiable �Yes 0 mo SYSTE MAINTENAN Improper use and mainten2nceof your sa.t pc syste,ttt could result in its premature failure to handle wastes. Proper pruiiutensn�e consists of pimping out the septic tank every tbri 6 years or sooaex, if ae @dadby a licensed pumper. What you rut into the system can afftct tho function of the Gratin tame as a tree pneut stage id tlrt w aste disposal s The property owner agrees to tubzndt to Ste Croix zouing Department a c artikit',stxcjn foml, signed by tbr, owner and by a master plu. zttber, ourneymanplt miber,iestrictedpl<imc r oraliceimedtyumperverifying that (1) the on -site wgstrwaterclisposalsystem is in prqer operating COndit.WB and/or (2) after in: �ection a.gtl pumpbt g (if neetssaty), the se:tstic tktk is Iscs than 113 full of slaAge . Uu w, the midersigued have read the above requite, I nesnts and age* to maintain the private sewage disposal system with the standards set fortb. herein, as set by the Deparhveitt O f Core neMe And the Degas ioat ofNatuxal ResolateR, Stflto Of WiScOusla �ex6fidAtibn stating tlist your septic systeEl has beenraaintalnel I must h cotnpiete(j and rttumed to the St. Croix County Zoning OM4i 1!'within 30 clays of• three yeat expiralioti date. � 22� a GNAT ___4F APPLIC.AT -fl- DATE OWN C'E,It� I (Ae) ce that all nts on this a im, are true to Clio best of m (our) lcno� ledgo. t (we) am (are) the awner(sj of the properat)! ascri a ove, by virtue of a wamt �ity deed recorded iat Rtgktrr of Deeds Office, / 1 SIGNATURE Of APPLICANT A,f.RY.a.�M Auy information that is rnis- represented a ay result in the s anitary permit boing ravol'o,�ed by the 7oniog Department. Include with Ods application a stamped ware- itty deed from Cie Register of .Dee& of -five a copy of the a rtified smay snap if roferenc.e is remade in the warraaty deed • POWTS OWN 'S MANUAL & N'#+i4N,f ORMENT PLAN Pegs _ � of y F'lLlr Ii5iFOR 7I N SYS'ti flfiSBfi.Dig1CATIONS Owner Semis; Tenk Capeolty /- a 0 NA foarm , # 3 ptia ' talnufattsrrar 13 NA l7 S. FtA IRS Effluen Fil Ma nufactu ra r 0 NA Number of Sed0amm, a y C3 N A f ffruept, FlIftr M odel p Cl N A NeterrLier of Public Fa cll i ty Units _ 9(NA Pump Tank Capacity si .187'NA �Fstimated !Plow (average) �yOU - s3siltl Pump Tarok Monti- fac N A. Design flow (imak), (Est mated x 1.8) 6 0 () alidra Pump M•snufact NA Boll APPI1 Rates �~ � � 7 0j1d . Pump Model r � eNA Standard nl fluent /E fluent Quality Monthly everage" Pretreatrnemt 0 NAB Fats, Oil & Grasse (FOCI 1 - 430 mss /L 0 Sand /Graysi filter © Peat Filter Biochemical Oxygen Demand (SO D S220 mg/l. 0 NA 0 Meohaniasl Aeration Cl wetland Tota Suspended Solids {TSB) S1 SO MR /l» 0 010infeat1pn 12 Other: Pretreated Effluent Quality Monthly average Di4pecael calf(s) 0 N/•1. S la chomicaT Oxygen Demand (BOl) <O mg /L. Ct in- Ground (gravity) Q In- Ground (pressurized) Total Suspended Solids `{Tgg) $30 rag /L. 1:1 NA Q At 12 Mound Fr ioal Cta ffarrn (Baaametdc pagan) 514" 0411 00m Q *grip -Une Q other Max'rMum Effluent Far Siz iii dW 0 NA 0 NA 0 NA �''Vaicrew Other, [3 NA •typiaai for timmostic wastea+ m ar and amptir. Tank affluent. M,411N; s RrN�.i~.S f�; LE Serino Extent service Fregvortay rrtor is lnspeot condition of tank(ai At ttta, t once every: ears (Maximum 3 years} NA Pump out con-ten" of rarrk(al Whan oombined sludge and sou rn equals O r d (Y of tan vc =s C1 NA {M inspect dlepersaAl cell(W ,aft lesst once every- eRhrrwr'rr 3 ynacss} NA` ,>� e r e) Clean effluent fllterA 5 At least ogee orrery: � ear s) E3 NA ----- ---- ---•r- - - nxcrnfittel inspect pu mp, purnp oomtrcls & alarm At i"est once every- �1� ears 1=3 NA F113sh laterals and prensurs test At least range every; f=7 aer R) 13 NA mantilla) 0 NA At Iseat onne every. Cl resrls) 13 NA MAINTENANCE INSTRUCTIONS inspeotlons of tanks and dispersal cells shall be .made by an Individual oarrying one of Tire foilowing licenses or a asrtifioations. Nfaatsr Plurrmher,, Mamar Plumber Restricted Stwar; POWTS lntspsrtor; FOWTS Maintainer; Saptage Servic109 Operator. Tank inspections mugt inglude a vls ;uel lnstpegtian of the tanks) to idergify any missing or broken hardware, Identify eny amaa� or leaks, measure the volume of combineid sludge and 9ourn and too c hsbk for tiny back titp i7r pending of effluent on the ground aurfaaer. The disperastsl Wi (shill( be viiiiraQ.y lrispented to obsck flis'r effluent levels) in the obsaarvat'ran Pi1Pa'S and tp check fear any ponding of :effluent an the ground surface. The ponding asf effluent, on the gmund surface may R.'tdloate a falling crandiflan and' requires than irnmerdlaatse notifdoapition of the facial regulatory aust'hvrlty- When this combined eamurnulatuan of sludge and scum in any tank equalss one -third iq) or more of the tank volume, the entire cvntontas of the tarok shrill Ike rarnmve d try a .mptagn Servicing Operator and disposed of in accordance with chrspter NR 11 1NiNoonsb i ArIm.I nlstraVv© Cads. All other :seruirus. including but net limited to they aeruir-lncg of offlatont filters. me r.hanical or pressurized components, pretreatment uvfts, and any servining 9;t intervals of- 2 months, sheil be perforr gad L,ty a nordfind POWTS Maintaider. A service raapurt ghsll be prr►vided to the local rsw.gssiatury authrardty Vsi'lthin 10 cd'syss of completion of Garay servioaa ©vtspf. GMW (+1101) ?/ START UP AND OPERATION Page 2,- of For new construction, prior to use .of the,POWTS check treatment tankls) for the presence of palming produos or other. p4smiccals that may impale the treatment: lirocess acrd /cr damage the dispersal cellts) If high concentrations are detected have ihe obntants of the tank(s) removed by a septage servicing operator prior to use. System start up shalt not cccur•when soli conditions are frozen at the infiltrative surface. During power outages pump tanks. may fill above normal •highwater levels. When power is restored the excess wastatrvpter will be discharged to the dispersal aegis). in one large dose, overloading{ the call(s) and may result In the backup -or surd"- dlsnbarge of effluent. To avoid this situation have the contents of the pump trunk removed by a Septagle Servicing Operator prior to restoring power to the effluent pump or contact a slumber or POWTS Maintainer to assist in manually operating they pump dontrols to restore normal levels within the pump tank. Coo riot drive or parts vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 1153 feet down slope of any mound or at grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performame and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condorne; cotton swabs; degreasers; dental floss; .diapars; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable praeiirigs; gasoline, grease; herbicides; meat scraps; medio stjons; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANC)ONMENT When the POWTS falls and/or is permanently taken cut of service the following slaps shall be taken to Insure that the system is properly and safely abandoned in compliance with chapter Czmm 133.33, Wisconsin Administrative Coda: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed slid properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shalt be excavated and removed or their clovers removed and the void space filled with sail, gravel or another inart solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replace Grit system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement sail absorption system. The replacement area should be protected from.disturbance and compaction and should, lldt ise 1hfrIn0ed �apdn by required sgtbao)cs from existing and proposed structure, lot lines and wells. Failure to protest the replacement area will result In the need for a now soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. A suitable replacement area Is not available due to setback and/or soil Iiittitations. Barring advances in POWTS technology a holding flank may be installed as a last resort to replace the failed POWTS. e pla The site of been oval d t identify a suitablcer e area. o th i'Otl1tT5 a soil and site evat n n muss a parf ed to to a auitablo =rant area. na rea is available a h oldlnS tank may n- us' as a fast resort to repiaoe r!3 Fed POWTS, ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the bibmst at the Infiltrative surface. Ksconstrucstions 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 INSUFRCIENT OXYGEN, DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY 13E DIFFICULT OR IMPOSSi LE: 8001TIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name ����. �" /,p Name Phone �j J �2 (C8', Phone SEP'TAGE SERVIC' NQ OPERATE (PUMPER) LOCAL REGU LATORY A UTHQRiTY Name dame S�C�DI� tT Ze)"7 -"7 ri Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)f7)(d)&(f) and 83J54 3 4 3),'Wiecorlaln Adltlinlbtratitie Codb. 72 1 282 l� J 2 2 0 I' 1 1 0 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between Lakes and Hills, Inc., a Minnesota 05/13/2003 12:00PM Corporation, WARRANTY DEED EXEMPT # 17 Grantor, and J effrey A. Jacobs REC FEE: 11.00 - TRANS FEE: COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 19, Pine Acres, Town of Star Prairie, St. Croix County, Wisconsin. Name and Return Address 3 e-� )aoohs This deed is given in fulfillment of that certain Land Contract between the p Q , fix a/a parties hereto recorded August 9, 2002, in Vol. 1944, Page 523, as Document No. 686523. 6 6 c pra 1►r' 038 - 1194 -90 Parcel Identification Number (PIN) This is not homestead property. QK) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 1eq 71;w day of tom. ily 2003 Lakes and '' s * * By: Richard Nelson, (esident * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF W4&C4)N ilN OA ) ) ss. County ) authenticated this day of Personally came before me this day of M& 2003 t e above named Lakes and Hills, Inc., by Richard Nelson, its President, TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoit; instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission i e ex iration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) MAFWzENE j. � J * Names of persons signing in any capacity must be typed or printed below their signature. r orid L■c, W1 t 5 -2021 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 ■