Loading...
HomeMy WebLinkAbout038-1196-30-000 a PRIVATE SEWAGE SYSTEM County: St. Croix INSPECTION REPORT Sanitary Permit No: 430480 0 P d MATION (ATTACH TO PERMIT) State Plan ID No: provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ,e: City Village X Township Parcel Tax No: in Homes Inc. I Star Prairie Township 038- 1196 -30 -000 CST b., Insp. BM Elev: BM Description: Section/Town /Range /Map No: �r AL 6A S THO D 13.31.18.1027 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Be J Dosing Alt. BM r 19c) - �� // 2 S Aeration Bldg. Sewer B, f J mZ 3 -57; 'Z Holding St/Ht Inlet rap TANK SETBACK INFORMATION St/Ht outlet vd TANK TO /L / WELL BLDG. Vent to Air Intake ROAD Dt Inlet Vv r ' Se ptic �, ( Dt Bottom Dosing HezdeELUa Z IL Aeration _ _ Dist. Pipe / Holding 7- Bot. System 7i PUMP /SIPHON INFORMATION Final Grade Z. 3 Manufacturer GP M St Cover Model Nurlller kJ TDH Lift s System Head TDH Ft ForcemaiR— ength Dia. SOIL ABSORPTION SYSTEM BEDITRENCH Width i � ' L Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS l t� q / SETBACK SYSTEM TO P/L & JBLDG W ELkT JLAKE/STREAM LEACHING anuf er: r INFORMATION HAMBER OR Ty p Of System: / ,..� / �Znl �� 1 /' - M odel Number: IBUTION SYSTEM V p�-', Header/ fold Distribution t �^ /- x Hole Size x Hole Spacing Vent to Air In take h C Dia Length 1 0 Dia_ Spacing `— SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched too xx S Bed/Trench Center Bed/Trench Edges Topsoil E Yes D No r] Yes ;;J No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 1 1 /7-1 / AO Inspection #2: Location: 1340 216th Avenue Star Prairie, WI 54026 (SE 1/4 NW 1/4 13 T31N R18W) Pine Acres Lot 32 Parcel No: 13.31.18.1027 1.) Alt BM Description = �� ,' p�� / 2.) Bldg sewer length = 3 5 � f— 6 S 6_' 7 - amount of cover / revision Plan Use others de for additional information Yes r ° ^ No �/ O G 6� SQ Required? !�� 3 2 i /' - -- i— — —' I � - -- - __ - - - - -- — - - _----------- - - - -_' 1 SBD -6710 (R.3/97) I l Date Insepctor's ignature Cert. No. kd'�' P T PLAN PROJECT New Horizon Homes ADDRESS 1475 Hwv 65 New Richmond Wi 54017 1/4 NW 1/4S 13 /T 3 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 1 0/14/03 BEDROOM 3 CONVENTIONAL XXX IN -GR PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 BENCHMARK V.R.P. Top of 2 " pvc pipe ASSUME ELEVATION 100° Filter Zabel A -100 ❑ BOREHOLE O WELL .H Same as Benchmark SYSTEM ELEVATION 89.8/89.7 5 below grade Vent >6 „ Standard Biodiffuser Plans Designed Using of Cover Leaching Chamber Conventional Powts with 31.1 ft2 of Area Manual Version 2.0 6' Long 11 " 34" Grade at System Elevation r _i U/ 20' B -3 Vents 10' B -4 30 , ° 0 N 2 -3' X 69' Cells with >3 Spacing B- i ll� , Pro 3 Bedroom 50' House ST - 10' ALA C M. 216th Ave it Test and System PLOT PLAN PROJECT New Horizon Homes ADDRESS 1475 Hwv 65 New Richmond Wi 54017 1/4 NW 1 /4 S 13 / 131 /R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/21/03 BEDROOM 3 CONVENTIONAL XXX IN -GROUN RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 BENCHMARK V.R.P. Top of Lookout foundation �, �pl- NATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Vent SYSTEM ELEVATION 93.1/93.2 6' below grade >6 » Standard Biodiffuser Plans Designed Using Leaching Chamber of Cover Conventional Powts with 31.1 ft2 of Area Manual Version 2.0 6' Long V 1 Vent - Grade at System Elevation 34 B 50' 20' 2 -3' X 69' Cells with >3' Spacing 10, B-3 B -4 30 0 � 10' B -2 0 N T B -6 35 25 Please note: original benchmark B.M was destroyed, two additional 20' 50' borings were done to establish Pro 3 15 B -1 a new system elevation and Bedroom benchmark, House B -2 150' 216th Ave Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must Countx �, include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. �j Please print all information. viewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). (/yti 7i y j3 Property Owner Property Location (^ \ Govt. Lot 1/4 A S ✓ T 3 N R E( ) W Property Owne s Mailing Addre Lot # Block # S Name or CSM# c5r_ — Cihr gtate Zip a Phone Number ❑ City Village wn Nearest Road ( ) •- , 16-New Construction Residential I Number of bedrooms Code derived design flow rate !? GPD ❑ Replacement ❑-- Public or commercial - Describe: Parent material (JL( Y1. Q��i4A elevation Flood lai n if applicable General comments mm - 9 3j , .� Boring and recoendations: / � e ��i # ❑ 'ring it Ground surface elev. ft. Depth to limiting fade in. Soil Application 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 RMEW Z- Ong # ❑. Boring Pit Ground surface elev�� ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Cons' tence Boundary Roots GPD/ff in. Munse Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •E Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Pte) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address to E al tion Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �� 715 - 246 -4516 I Property Owner _ Parcel ID # Page of a Boring # E) E] ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft° in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 T- F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, 'Eff #1 •Eff#2 F-1 Boring # C] Boring 11 Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication 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 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD 130 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 need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SOD -8330 (8.6/00) 004.8 ✓ I I 994.2 9 I 99 -,7.2 PT L '�qp7. OOb.94 X I X 98.6 _ B16 w 634, 03, 500 sq. ft. �. 24 - 9�2 ass / 1 -- i 05.6 6: sq. ft. h x '� ��, x / es 1005.9 993.4 r 9S PT 6 76;5,5 - '978. 991.2 `B33 (\ i La zo— p� $c['es __ 67 sq:'ft. 67 3Q sq. ft/ . :rJi \ x.m e.Mt' hc acr`es \ 989.2 S4 x 3 69�3g sq,ft, �', = ►•� ��ff, �,. OD CV - - c 8 1 1 5.7 002. X 1005.5 1 . OQ5.1 x 1002.8 J _ .�. — PT' 1 ` 33 33 X2'002 -09' R =2000.00 90 82 0 =20 0 4 05 R- 2000.0(8 L= /;24.914 -_ .8 993.9 ��,12 ` 4.99 16 3 z33 Tnzb) 3.1 cr °- 4�1 ' 67 963 �q.ft. ► v� �� ° . / /5, 437 lq_ft. 1:56 aches / 1,0 acres �u - X J x 5 6 ; 995.5 / / 66,297 sq . t. 5.5 , ; 998.5 8 �� x tig — �� 682V6'22'E 10 .3 j x 997.1 275.29 99.7 / - 1005.° - N,. � r.e OD - - - -- w w/ 'moo iv \ C33 a �w 0. - + 00 bD C� .4% -1 CO) �w oo y° V�iS Aj C#) 36.51'c; SE Ul 282.10' 8 5 241.25' >31 6 3p\ O� i r � 6 p '� /•. 79 , Ns \� 77' S89 ° 55'30 "E 19 of - O�oJ 7 6'Q 'ly ?� ,� �� /� 371\ 07M Pad' ^ ^oEOS - - -- ,75.33 S09055130 99.55' r // 399 64' �. 2 17 \ `� es \ S87°04'03 "E 245.54'_ ,14 �\ r I\ x121.76 Z CD _ r 1 Fp, � o \N4 4 W t v w F `b� \ o 00 N co L N59 Flo �� \ \ w N 79°53'42OE 331.63 Cn ` ��F ; 10 0) 2 v $ N _ h + � 0 p CV co '1 o I 3.0 1--& o N co I NI rt cl OD 0 y I -- C4 7 j C _ J F _ 10 L C45 ££ r££ — — — -C42- C43 C _ _44 q73 C77 IT IV L 3' 33� l MATCH IN \ E— C ' SHEET 1 OF V b < j _ rt CD CD O `1 C1 o m Oo X� o �.. n� • O -- ° W O O O O CD CO -- CD CD a .� fD CD O O > > ^� CCD Z D :3 1 C] O ^~ C 0 > > " 0 0 C_ 0 . 0 C 0 r C f7 CD rt rt 3 N D S T. �; Co co a 0 �' ` �' ai c - a 0 n a n w to N c o b C� 0 � 3 CD C c 0 61 00 � Q s w- 3 °c N a C a c g W V) o o �_, < rn c> CD Safety and Buildings Division county �(� 201 W. Washington Ave., P.O. Box 7082 r V Madison, WI 53707 — 7082 Sanitary Pdmi[ Number (to be filled in by Co.) (608) 261 -6546 ��j© YEV Department of Commerce State Plan LD. Number Sanitary Permit App catRFECEIV In accord with Comm 83.2 1, Wis. Adm Code, personal formation you provide _ (y d may be used for secondary Purposes Privacy La , sl S 04(1)(m) r ess (if different than trailing address) 0 � 2-o 2 4 ,1,10ject.i,: 3 �� b� >v 6 . I. Application Information — Please Print All Information v �'� C Ulr. CC'' IO'!Parcel# Lot# Block# Property Owner's Name Property Location Property er's Mailing Address y. Section City, State J` Zip Code Phone Number �� N; J; I o W e) ype of Building (check all that apply) S s`"` 1 � � Subdivision Name CSM Number 2 Family Dwelling — Number of Bedrooms kCA-1 b Wb ❑ Public/Commercial — Describe Use 04— tM. i 2 15— �-- S ❑Ciry� ❑Village �'o ip of ❑ State Owned — Describe Use lD0 IIL Type ertttit: (Check only one box on line A. Complete ne B if applicable) V3 - 30- G C) 2 - A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of E] p Transfer to New Before Expiration Plumber Owner IV. of POWIS stem: Check all that a I on Pressurized In -Ground ❑ Mound >— 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Gtadc C] Single Pass Sand Filter o Constructed Wetland ❑ Pressurized ln-Gr and ❑ Holding Tank ❑ Peat Filter El Aerobic Treatment Unit ❑ R ✓ lading Pipe ❑ Other Chamber ❑ Drip Line ❑ Gravel -less Pi (explain Recirculating Synthetic Media Filter P V. Dispersal/Treatment Area I formation: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal ea R�e u (sf) Dispersal Area Pro ed f) System El ation r VI. Tank Info CaPtY Total Number Manufacturer Prefab Site Fiber Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tads Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement the undersigned, a responsibility for installation of the POWTS shown on the attached plans. MP/MPRS Number ^ Business Phone Number P1 er Name (Print) Plumber's S' G ( / (J / kl i Plumber's Address (Street, City, State, Zip . Coun /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued u g Agent Signature (No Scamps) Approved ❑ Disapproved Surcharge Fce) ` C1 Owner Given Reason for Denial 2SD l �I Z 0 3 IX. Conditions of ApprovaUReasons for Disapproval 3) _ /do C ` UUA SYSTEM OWNER:1 �dI(' I q �,� ` �g [ 1 Septic tank, effluent filter and / dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not 1es than 81/2111 inches In size SBD -6398 (R. 08/02) P T PLAN PROJECT New Horizon Homes ADDRESS 1475 Hwv 65 New Richmond Wi 54017 1/4 NW 1/4S 13 /T 3 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/14/03 BEDROOM 3 CONVENTIONAL )= IN -GR PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R.P. Top of 2" pvc pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P Same as Benchmark SYSTEM ELEVATION 89.8/89.7 5' below grade Vent >6„ Standard Biodiffuser Plans Designed Using of Cover Leaching Chamber Conventional Powts with 31.1 ft2 of Area Manual Version 2.0 6' Long 11 " 34" Grade at System Elevation a� 20' B -3 Vents 10' as B -4 30' 0 tn N 2 -3' X 69' Cells with >3' Spacing B- 2 Pro 3 Bedroom 20' 50' House ST 20' B -1 ents 10' 150' B.M. 216th Ave I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 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 Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re ewed by Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). \ I o�Z� /o 3 Property Owner Property Location ! Govt. Lot ST 1 14 / ET 4 S N R E (or) Property Owner's Mailing ` Ad ess — Lot f� Block # Name or CSM# r city State f Zip Code ftAe Number ❑ city ❑Village wn Ne�{e�t 13oa� New Construction Us 'dential / Number of bedrooms Code derived design flow rate , GPD ❑ Replacement ❑ Publi or commercial - Describe: Parent material Flood Plain elevation if applicable General comments and recommendations: ^) L) .1 , e � C . &k4yvj X AZ L�.t...� Boring ILI # �nns ❑ Pit Ground surface elev. � + Oft. Depth to limiting factor � � in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 r . ��_ ' ✓� Boring # ❑ Boring ❑ pit Ground surface eiev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2 ' Effluent #1 = BOD > 30 220 mglL and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address D to Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 r� _�� 715- 246 -4516 1 Property Owner _ Parcel ID # Page of F1 Boring # E:] Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 '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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 '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 GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mglL ' Effluent #2 = BOD < 30 mglL and TSS < 30 mglL 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. SBD -8330 (RAM) 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% x 11 inches in size. Plan must County - -_ include, but not limited to: vertical and horizontal reference point (BM), direction and _T/ percent slope, scale or dimensions, north arrow, and Joe*ftfVaff&;lrtance to nearest road. parcel I. D.# APPLICANT INFORMATION - Plea tall information. Pendin Personal information y ou provide may be used for evie Date y day pu vacy Law, s. 1S, (1) {m)) Q 6 Property Owner Property Luca ' Lakes & Hills Development Govt Lot 1/4 NW 1 /4,S 13 T 31 N,R 18 W Property Owner's Mailing Yress Lo # Block # Subd. Name or CSM# 32 -- Pine Acres City I State Zip�Gode P. , ❑ r ❑ VA LM e ®Town Nearest Road ry c c- Ew,� ,ham S&6 �� 216 TH. Ave. ❑ New Construction Use: Residential / Nttrn _`i f rooms 3 ❑Addition to existing building - ❑ Replacement ❑ Public or commerclaTdescdbe Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpolfe -8 trench, gpdV Absorption area required 643 bed, ft 562 $each, Maximum design loading rate .7 bed, gpd/ff .8 tr ench, gpd/ftz Recommended infiltration surface elevation(s) 90.5 ft (as referred to site plan benchmark) Additional design / site considerations Parent material - - - - -- Flood plain elevation, if applicable - --- -- ft S= Suitable for system Conventional Mound in - Ground Pressure AT - Grade TSys�t m in Fill Holding Tank U= Unsuitable for system ❑ S❑ u M S❑ u Z S u ❑ S❑ u S® u ❑ S M u SOIL DESCRIPTION REPORT Borin Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPDlftz 9# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0 -13 10YR3 /3 ------------ - - - - -- 1 lmsbk mvfr gw 2f .4 .5 2 13 -26 10YR3 /2 ------- - - - - -- 1 lmsbk mvfr gw lvf .4 .5 Ground 3 26 - 49 10YR4 /6 --------- cl lmsbk mfr as - - -- 2 3 elev — _ — -- - - -- -- — _ 94.8 ft. 4 I "49-6Y 7.5Y --- --------- - - - - - - s osg ml gw - - -- .7 .8 5 67 -93 10 YR 4 / ------------ - -- s osg ml - - -- - - -- 7 8 Depth to limiting s'�, (o ' factor >93" Remarks: 2 1 0 -14 10YR3 /3 ------------ - - - - -- 1 lmsbk mvfr g w 2f 4 .5 2 1 -25 10YR3 /2 - ------- - --- --- - -- I lmsbk mvfr gw lvf .4 5 Ground 3 25 -48 10YR4 /4 ------------------ cl lmsbk mfr as - - -- 2 elev - - - - - -- .3 95.1 ft. 4 48 -56 7.5YR4/4 ------------ - - - - -- s osg ml cw - - -- .7 .8 Depth t0 5 56 -94 10YR4 /4 ------------ - - - - -- s osg ml - - -- - -- .7 .8 limiting factor >94 11 Remarks: _ CST Name (Please Print) Signature: Telephone No. Jacque Hawkins ; ,� y7 Z J Y/ Address �� Date CST Number Ref# 4/10/00 a e - 7 405 PROPERTY OWNER: Lakes & Hills Development SOIL DESCRIPTION REPORT Page 2 Of 3 PARCEL I.D.# 'Pending ' Depth Dominant Color Mottles Structure GPDNI Horizon Texture onsistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 3 1 0 -11 10YR3 /3 ------------ - - - - -- I Imsbk mvfr gw 2f 4 ! .5 2 11 -26 10YR3 /2 ------------ - - - - -- 1 Imsbk mvfr gw l of .4 .5 Ground elev 3 26 -40 10YR4 /4 ------------ - - - - -- cl Imsbk mfr as - - -- 2 3 -- 94.0 ft. 4 40 -64 7.5YR4/4 ------------ - - - - -- s osg ml gw - - -- .7 .8 Depth to 5 64 -84 10YR4/4 ------------ - - - - -- s osg ml - - -- - - -- 7 8 limiting factor Y2. >84 ++ - - -- -- — Remarks: 4 1 0 -12 10YR3 /3 ------------ - --- -- 1 Imsbk mvfr gw 2f .4 .5 2 12 -24 1 /4 ------------ - - - - -- 1 I msbk mvfr gw lvf .4 . Ground — elev 3 24 -45 10Y / 6 ----------- - - -- cl Imsbk mfr as - -- 2 3 -- ft. 4 45 -6 7.5YR4/4 ------------ - - - - -- cs osg ml gw -- -- 7 8 Depth to 5 60 -89 10YR4/6 ------------ - - - - -- s osg ml - - -- - - -- 7 8 limiting — — factor 404-4- 404- Remarks: 5 0 -12 10YR3 /3 ------------ - - - - -- 1 Imsbk mvfr as 2f 4; 5 2 12 -24 10YR3 /2 ------------ - - - - -- 1 Imsbk mvfr gw lvf .4 .5 1 5 Ground elev 3 24 -52 10 YR4/4 ----- - - - - -- c1 Imsbk mvfr as - - -- 4 5 -- - - -- - - -- 95.2 ft. 4 52 -63 7.5YR4/4 ------------ - - - - -- cs osg ml gw - - -- 7 8 Depth to 5 63 -97 10YR4 /6 ---- -------- - - - - -- s osg ml - - -- - - -- 7 8 limiting - - - - - -- - .Gk_. Remarks: Ground — - -- elev Depth to limiting - -- - -- - - - - -- - factor Remarks: L A . Ys) �o � 0 L 4J 5 A � of I 5 �W • �a 6 lei cw � d! — 7 - d d S 7 0 / ids' =, r+ - ICY,, I 'b• Maintenance and Contingency Plan for a Septic System Maintenance Plan um e d once every 3 years. I. Septic Tank is to be p P once a installed in year. Please note: a larger filter is being 2. Effluent filter is to be cleaned interval of the filter. order to extend the mai ntenance 3. be inspected via the inspections pipes at the ends of pnce every 3 years, cells are to the cells. agrees to limit greases, garbage, and water conditioner discharge into the system 4. Owner plan. 5. The owner agrees to a rk this d rive over system. 6 Do not plant trees nor P from system. 7. Watershed is to be diverted away those required as per COMM. 83 8. Discharge into system is not exceed Contingency Plan 1. If system faits, determine cause of failure, use alternate area and install new system or install system at a lower elevation• vents as needed. 2 Replace any other failing compo Plumber: Shaun Bird 715-246- St. Croix C y ount Zoning 715- 38 -4680 _ Torn or 715 -2 715 _246-5148 Pumper Shaun Bird #226900 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 1 — , l r r Mailing Address Property Address Q ' ' ` A y-e, (Verification required from Planning Department for new construction) City/State tY Parcel Identification Number LEGAL DESCRIPTION Property Location ' / <, Cj/., Sect 2 T2N -R21W, Town Subdivision Lot # Certified Survey Map # , Volume . Page # �---� Warranty Deed # Z`k 35 � , Volume 2Z� 3 , page # S Spec house yes ❑ no Lot lines identifiablpdyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. 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, restrictedplumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da a three ye expiration date. /, , l j,� id NATUKE OF PLICA DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the vraD erty descri ed above, by virtue of a warranty deed recorded in Register of Deeds Office. !> J GNA O PPLICANT DAT * * * * ** 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 copy of the certified survey map if reference is made in the warranty deed 1 h/ 14!;euuj Ll : zu b514db'Lbbl LLLK I &A55U(UlA I t5 F'A(at d4 Z —•- .0 d • AJl ms NOIS30 3WOH 1SNIA SMS8313d ANVH138 (INV nV38 CL O O W J W LL 1 I ' W w 1 ui Z Cl) I r im o EO / /` rl r _ r f I J 2 2 6 3 P 0 5 4 - 7 z4- 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 Lake and Hills, Inc., a Minnesota 06 /04/2003 08:30Al1 Corporation WARRANTY DEED EXERT # Grantor, and N Horizon Homes, Inc., REC FEE: 11.00 TRANS FEE: 258.60 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 Loto ��..�� Name and Return Address ,, 51 and 55, Plat of Pine Acres in the Town of Star Prairie, St. Croix County, Wisconsin. – 038 - 1196 -30- 000, 038 - 1198 -20- 040,038- 1198 -60 -000 Parcel Identification Number (PIN) This is not homestead property. CK) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this of May 2003 Lakes and Hills, Inc., a Minnesota Corporation * * Richard Nelson * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) r ) ss. LJ'rtf'`_Y L. T County ) authenticated this day of Notary Pu blic ate of Wisc onsin Personally came before me this �� \ day of May 2003 the above named Lakes and Hills, Inc., a Minnesota Corporation by Richard Nelson, President TITLE: MEMBER STATE BAR OF WISCONSIN (If not, a known to th person(s) who ted the foregoing a k oivl d d t ame. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Notary Pub W, Slate of Wisconsin Hudson, WI 54016 My Commission is ermanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) �� ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals company, Fond du Lac, wi STATE BAR OF WISCONSIN 80"55 -2021 WARRANTY DEED FORM No. 2 - 1999 NOTX'R M A IF, lWTY Y 'OYP� 7R6 PINE ACRES { x 4rzvlaU in tM SR 1 / +l iqz hY 1% fin':K a,/ tM V rr NY lr t n ^t fr r. ONP ATTE PYC z Ccwrt4: Mv: u.,xvr: tJ LA s. :«. r.x •srn. rare» ,., -.:rr. u. s n +, ue... L ........ 2150.85' r i a 10 4 9 6 5 4 3 z t> 4 7 •.. � �e !1 T I- c W STREET I .. s r S00'S9'1T L ._. .. } is r� 28 470.24' 1 L \ s 29 30 L>: - u. r A/ :r.ry S �. �.. •{� ty is a 13 ti / 27 m s .... r , 4 ... ' 28 a 15 z r m c I Y 21 \ 25 I !g c. 16 b / 1 t� o ! r t I , PRAIRIE RICH ee5 N t F 4 a a ri ^. a.1•u .. :v.r w r•KtfN+ttw'!N 0� ! ^� 61,930 sq.ft. �h 1.56 acres a W • Denotes 1" Iron F ,o ; 1 - coil I i (unless noted) C46 Denotes Curve NL 367.99 Denotes drainage -61.54 S03'S6'21`W 1� I -- ( 12ft. in width of ` ~w- 177.69' I in I — T i Denotes Buildinc o v I y 67,220 sq.ft. Denotes Total L 1.54 acres I Denotes recorder (rec.) 6 082 sq�t. v I I � 1.54 acres ( ) meas. Denotes measurE a,, A I Vertical Datum is U.S.G.S. N � i w °� .. # °j I i All Other Lot Corners Are 0I 362.83 N00°49'40'W I i ,. .. I , 1 X 24 Iron Pipe Weighi y" ` 134.06' — 228.77' i COI o � 1 Ib Distances are computed N o^ /;� I I I i 0.001' and measured to Angles are computed to and measured to the 100' 4b 3 3 I oW a 34 Z �a X 65,768 sq. ft. I a5 ) 77 , 778 sq. ft. 4 acres 1.51 acres I I N ; / 1.79 /� 19 9.4 'Qi w 0 a 1 d^ _� 12.00' 211.4 w Z � /`� / i N10 .06�18 W � j EET, ; w i -E 211.45 � �j E-4 �. i S10 i r ' M .r �. O 9� ✓ - -- N A 1t ` 1SaN 2 Will C0NS �ti �Q► TODD PREPARED BY HENDE ' dASHOTAH, "�'�_ Todd M. Hendershott, RLS 2362 WI Q' Res ;stered Wisco sin Land Surveyor Dot( ; this /- day of 2000 S(JF{v \`a �n1111ti1lilltll \l This instrument drafted by Todd M. HendPrShntf