HomeMy WebLinkAbout038-1197-10-000 Wisconsin DeoartmentofComme!ce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division -
INSPECTION REPORT Sanitary Permit o:
488090 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)]. 01
Permit Holder's Name: City Village X Township Parcel Tax No:
Halle Custom Homes Inc. I Star Prairie, Town of 038 - 1197 -10 -000
CST BM Elev: Insp. BM Elev: BM Description: n Section/Town /Range /Map No:
C Lp;T Y3 V,• \ T v(7 W c� �i �- 13.31.18.1035
TANK INFORMATION ELEVATION DATA C' >N-- -6.4
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark O • QQ L �• G
Dosing Alt. BM
Aeration Bldg. Se er
Ho mg St/Ht Inle
Q-�- 4,5 QN-
TANK SETBACK INFORMATION S t /Ht O utl I t 5 . q�.5
TANK TO P/L WELL BLDG. V ent o Air Intake ROAD Dt I nlet \
ep is �O ±r" _ ✓ B ottom
3G
osing ea er a .
era ion is . Pipe s $ .3 91.3
�( d - 4 q1.
o ing o . Syste vt 940.2 -
-4 9
s
ina ra
PUMP /SIPHON INFORMATION j ? 9L
m anufacturer Demand St Cover
GPM I $ Q 7 ' S--
o e um e
nor
F riction ys em ea
orcem m eng ia.
WEABSURPTION SYSTEM
DIMENSIONS � i. (' a Z.
INFORMATION �' CHAMBER OR (3 i p� y0�
r � t .. O T � UNIT
Pipers) { � lOCjl
Length t Z Dia y Length
SOIL (;UVhK w
-- x Pressure Systems Only xx Mound Or At - Grade Systems Only
l ucpUt epth Ur 1 AA Wu
Bed /Trench C nter / Bedrrrench Edges Topsoil Yes No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 4 / lG / 06 / f�spection #2:
r-GX
Location: 1307 216th Avenue New Richmond, WI 54017 (NW 114 13 T31N R18W) Pine Acres Lot 40 Parcel No: 13.31.18.1035
1.) Alt BM Description = _v P Le W q C-0- r -� l c1;ov ASVQ Wes'-✓
2.) Bldg sewer length = lrj'
amount of cover = t 3.(5 I{
on q !� �� -- -- - — -
=visis de for additional informa u ti n. No I Cert'' -No.
(R.3/97) Bate
Safety and Buildings Division County cc (1 t
201 W. Washington Ave., P.O. Box 7162 V'� ` ✓� D 1
isconsin Madison, Wl 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
s (608) 266 -3151 V U b�
Department of Commerce
State Plan I.D. Number
Sanitary Permit Application �.
In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Law, sI5.04(1)(m) Project Address (if different than mailing a ddress)
I. Application Information – Please Print All Information 10 136 7 Zl � j , a r -je
Property Owner's Name � � Parcel #
:z =
Property Owner's Mailing / A / dd � re �(/� ss Property Loc
// / � ! ( �J 1 �C..� ' �/4,�. Section _
city qq Zip Code Phone Number
�/'� (. e J l�j N; R / �f E l r W
II. ype of Building (check all that apply) 0 a•5 d C �� Subdivision Name CSM Number
2 Family Dwelling -Number of Bedrooms
❑ Public/Commercial - Describe Use
❑ State Owned - Describe Use
2 ❑City_❑villag ship ofyA41
1II. Type of Permit: (Check only one box on line A. Complete line B if applicable) 7 – /d ^ CD
A. a System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
List Previous Permit N�b er an ate
B. El Permit Renewal it Revision ❑ Change of ❑ Permit Transfer to New
Before Expiration Plumber Owner
IV. a of POWTS System: Check all that a 1 �'
- Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland Pressurized In- and ❑ Holding Tank El Peat Filter El Aerobic Treatment Unit ec I g S Filter
Recirculating Synthetic Media Filter hing Chamber ❑ Drip Line [I Gravel-less Pipe ❑ Other (explai
V. Dis ersal/I'reatment Area ormation.
Design Flow (gpd) Design Sot Application Rate(gpdsf) Dispersal Area Requir d (sf) Disp rsea Proposed (sf) System Elevation
Prefab Site Steel Fiber Plastic
VI. Tank Info C apacity in Total Number Manufacturer Constructed Glass
Gallons Gallons of Units Concrete
New Existing hl� �e•6 ESA ' l
Tanks Tanks
Septic or Holding Tank — J
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- 1, the unde i ed, assume responsibility for installation of the POWTS shown on the attached plans
Plumber / 's Name (Print) Pl Signature MP/MPRS Nu Business Phon / Numbe r
,
Plumber's Address (Street, City, State, Zt Code)
Vm-gounty /De artment Use Onl
Sanitary Permit Fee (includes Groundwater Date ssu Issuin ent Signature Stamp
Approved ❑ ==n Surcharge Fee) 4 60 �^
Reason for erual –v
IX. Conditions of Approval/Reasons for Disapproval
SYSTEM OWNER: 3) PI o o- �
1. Septic tank, effluent filter and
dispersal cell must all be services /maintained 6MAM-P, A l?,K
provided umber.
na ement Ian r by plumber. ma P P ,[�� � � �
as Per 9 %•, "'J /jW ++ l ,n/L
2. AN setback requirements must be maintained .
as per appicabk code / ordinances.
re �'� •
Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size
SBD -6398 (R. 01/03)
Soil Test and System PLOT PLAN
PROJECT Halle Custom Homes ADDRESS 1113 Hwv 64 New Richmond Wi 54017
1/4 NW 1/4S 13 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 5/24/06 BEDROOM 4
CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chamber
, BENCHMARK V.R.P Top of Steel Fence Post ASSUME ELEVATION 100 Filter Zab� 00 _
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Q C5
Property Line SYSTEM ELEV TION 91.6/91.3 5' below qrade
Plans Designed Using
Conventional Powts Well is to meet all
Manual Version 2.0 setbacks required by
WDNR
B.M. * Alt. B,M. Top of
survey iron @ 95.9'
40' 20'
Draina easement
B -1 B -2
3% Slope
Vents 30' 0'
Pro 4 Property Line
180' B edroom
40' B -3 40' 20' House
Property Line 2 -3' X 90' Cells with >3' Spacing
Vent
>6 „ Standard Biodiffuser
of Cover Leaching Chamber
with 31.1 ft2 of Area
6' Long 11 "
34" Grade at System Elevation
216th Ave
i ,yy
Soil Test and System PLOT PLAN
PROJECT Halle Custom Homes ADDRESS 1113 Hwv 64 New Richmond Wi 54017
1/4 NW 1/4S 13 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 5/24/06 BEDROOM 4
CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers
IL BENCHMARK V.R.P Top of Steel Fence Post ASSUME ELEVATION 100' Filter Za]53�4 00
❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Ge
Property Line SYSTEM ELEV TION 91.6/91.3 5' below qrade
Plans Designed Using AL
Conventional Powts Well is to meet all
Manual Version 2.0 setbacks required by
WDNR
B M * Alt. B,M. Top of
survey iron @ 95.9'
40' 20'
Draina easement
B -1 B -2
3% Slope
Vents 30' 0'
Pro 4 Property Line
180' Bedroom
40' B -3 40' 20' House
Property Line 2 -3' X 90' Cells with >3' Spacing
Vent
>6 " Standard Biodiffuser
of Cover Leaching Chamber
with 31.1 ft2 of Area
6' Long 11 "
Grade at System Elevation
34"
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 County V �,
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. Revie by Date N O Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 6
Property Owner Property location
C' e 57 / Govt. Lot 1144 J14 S l—?T N R E ( ) W
Property Owner s Mailing Address Lot # Block # Subd. Name or /7 ,�/C�SM " -riv #�
J/1 (/c
City tate CZp Code Phone Number ❑ C. ❑Village " own Nearest Road
i C-1 ) 1 5 yr>/ ( )
New Construction Use esidential / Number of bedrooms Code derived design flow rate drp GPD
❑ Replacement ❑ Public oo commercial - Describe: __—
Parent material s G.t` c.�J -�GUi4 / Flood Plain elevation if appli blle � Vl,/ l ft.
General comments
and recommendations:
System Type /— System Elevation` ! /�
F I �� # ❑ Boring
pit Ground surface elev. S - ft. Depth to limiting factor n.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 - Eff#2
Z"*
3 �s -ra o
Boring # ❑ Boring
P-1 Q _
0 Pit Ground surface elev. ! J • ft. Depth to limiting facto/ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 I •Eff#2
— 1 3 G Iv s C /0
44 2� /I,'— ,
i f
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 Print) re CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 .� 715 - 246 -4516
Property Owner _ Parcel ID # Page of
Boring #
Boring
pit Ground surface elev.1 (,,Q i (aft. 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
u) , lo
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
a Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil ication Rate
Horizon ')epth 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 5 220 mg1L and TSS >30 < 150 mgA- ' Effluent #2 = BOD < 30 mgll. and TSS < 30 mg1L
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)
I
Property Owner _ Parcel ID # Page of
Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor j� in. R*Eff Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#2
r
0
❑ 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
F-1 Ong # E] Boring
1:1 Pit Ground surface elev. ft. Depth to limiting factor in.
Soil ication Rate
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ft°
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 ffKA 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.
SOD- 8330 (R.W00)
and uild s Div on County l
� 201 W- Washm o Ave., ox 162
M Madison, WI 07 - Sanitary Permit Number (to be filled in by Co.)
,ICO AR 6 2006 (6 ) 266 -3 ���� CrCD
Department of � 7CMommfer e rrte�^^
Sanity t Kr i l lic •on State Plan I.D. Number
In accord with Comm 8 rsonal info ation you provide
may be used for secondary purposes Privacy Law, s .04(1)(m) Project Address (if different than mailing dress)
I. Application Information - Please Print All Information 1 ;_ Ile
0 3 $- 1 7 -!
Property Own ' Name / ,I Parcel # Lot Block # 1��,A `,_�
Property Owner's M ng Address Property Lora
1 � r
/x /4, Section r-
City, State Zip Code Phone Number
� i
y JW % C (eircrZ)
II. Type of Building (check all at apply)
J T N; >E /v
L i 5 -1 " 4 C� 1
4 4
or 2 Family Dwelling - Number of drooms A vision Name CSM Number
❑ Public /Commercial - Describe Use
❑ State Owned - Describe Use r + ' � ❑City ❑ Village'�own hip of —
G- ✓ r
III. Typ of Per (Check only one box on a A. Complete line B if applicable) r
A.
74 - N ew System ❑ Replacement System Treatment/Holding Tank Repl ment Only
11 Other Modification to Existing System
i
B. LBefo7reExpiration it Renewal 11 Permit Revision 11 Ch of 11 Pe ' it Transfer to New List Previous Permit Number and Date Issued
Plumber O ., r
IV a of POWTS System: Check all that appl ( '
- Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ eeat 24 in. of suitable soil ❑ At -Grade 11 Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- nd ❑ Holding Tank il ter [I Aerobic Treatment Unit 11 Recirculating Sand Filter El
Recirculating Synthetic Media Filter hin Chamber El ine ❑Gravel- ss Pipe ❑ Other (explain) + Y /�
V. Dispersal/Treatment Area formation: /
D -gn Flow (gpd) Design Soil Application Rate(gpdsf) I D' � ersal Area Required (sf) I Nspersal Area Proposed (sf) System Elevaf n
VI. Tank Info Capacity in Total I Niober Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons I Winits � Concrete Constructed Glass
New Existing t,)
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit T 1
Dosing Chamber
VII. Responsibility Statement- 1, the u ersigne a e responsibility for installation of the POW TS shown on a attached plans.
Plumber's Name (Print) P ber's a MP/MPRS Number usiness Phone Number
-, ? - Z 6 = 4b
Plumber's Address (Street, City, State, rp C ,Q ,,,�
i'e V �
II. Coun /De artment Us Onl
pp roved Disapprov �for Sanitary Permit Fee (includes Groundwater Date Issued Issuin gent Si Stam
Surcharge Fee) ��
Owne en Rea? -
IX . Conditions of Approval/Reasons for Disappro
SYSTEM OWNER:
1. Septic to*, a1Mw o MW amd
disposal cep must ap ��u,le- u.�C - ' �
as Per management PO provldsd 01 0~.
2. 1111 setbtck t!equin wft must be eaillttknd
elt per atpplicole obdt / a r -
Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size
SBD -6398 (R. 01/03)
A VWO M3T&Y8
try Mfll trteums Allst 7itge$ 1
bloo lff71 1 M3 IV�yt,¢¢ Os 121xrn 1 IEZ
.IodmLdo Yd h4ml O* i two Iym z6
�Mf1MiI11RR1 9d }fiJff: �}�yr1s #oUFr!` +76dtst r1 . ".
.�ntfNp1p \ Opp 1!q i�
OT PLAN
PROJECT Halle Custom Homes ADDRESS 1113 Hwv 64 New Richmond Wi 54017
1/4 NW 1/4S 13 /4 18 W TOWN Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE3 /4/06 BEDROOM 4
CONVENTIONAL )00( IN -GROU RESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND \IZE AN SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING LOAD RATE .7 ABSORPTION AR EA 872 of chambers 28
BENCH of 2" pipe ASSUME ELEVAT N 100 Filter Zabel A -100
❑BOREHELL *H.R.P. SameasBenchmark
AL Pro rty Line SYSTEM ELEVKITION 3.1/92.1 3.4' below qrade
Plans Designed ing Well is to meet all
Conventional Pow �� setbacks required by
Manual Version 2.0 WDNR
Vent
>6» Standard Biodiffuser
f Cover Leaching Chamber
with 3 1. 1 ft2 of Area
Property Line 6' ng 1 "
34" Grade at System Elevation
Property Line
10% Slope
Vents
B. M.
65' 1 10'
70 T
B -1 4
Bedroom
House
2 -3'X 88' Cells with >3' Spacing
Please note: a new s R test an
revision is going to be one to ind a
Property Line new location, lower syst depth all
prior to installation!
COP 216th Ave
` 43Y1'N/ T PLAN
PROJECT Halle Custom Homes ADDRESS 1113 Hwv 64 New Richmond Wi 54017
1/4 NW 1/4S 13 / 18 W TOWN Star Prairie COUNTY ST.CROIX
MPRS Shaun Bird 226900 DATE3/4/06 BEDROOM 4
CONVENTIONAL XXXX IN -GROU RESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TAN SIZE 1255 gallons LIFT TANK SIZE D SE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 of chambers 28
,BENCHMARK V.R. Top of 2" pipe ASSUME ELEVA � N 100' Filter Zabel A -100
❑ BOREHOLE WELL *H.R.P Same as Benchmark
Pr erty Line SYSTEM ELEVATION 3.1/92.1 3.4' below qrad
Plans Designed g c7 Well is to meet all
Conventional Powts�"s setbacks required by
Manual Version 2.0 WDNR
Vent
6 „ Standard Biodiffuser
of er Leaching Chamber
with 3 1. 1 ft2 of Area
Property Line 6' Long
Grade at System Elevation
34
Property Line
10% Slope
Vents
B. M.
0 10' 10'
65' ST
B- 70 B -1 4
Bed om
House
2 -3'X 88' Cells with >3' Spacing
Please note: a new soil test a 1
revision is going to be done to ind a
Property Line new location, lower system depth all
prior to installation!
216th Ave
Wisconsin Department of Commerce ' SOIL AND SITE EVALUATION Page 1 of
'Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code
Attach on complete site p lan pap not less than 8 11 inches in size.. must
p p p County 1
include, but not limited to: vertical and horizontal reference poi rection and /
percent slope, scale or dimensions, north arrow, and loc o ,dAiAtanve"to nearest road. parcel LD.#
APPLICANT INFORMATION - Please jzi ffih a!l mforAnaWn.' endan
Personal information you provide may be used for secondgry purposes (Rdvdcjr "3w S. 15:04 (1)'tm)). a By Date
L 91 0
Property Owner Property 4ocation
Lakes _& Hills Developm r 'Govt tot ; 1/4 NW 1/4,S 13 T 31 ,N,R 18
Property Owner's Mailin Address tot # ' Blodc # Subd. Name or CSM#
_t'
40 - -- Pine Acres
Ci _, / State Zip Code PhoneN4 t W ;
City Town
f� Town Nearest Road
flc 216 TH Ave.
❑ New Construction Use: Residential / I�UeibBr Of be' o6 3 ❑Addition to existing building -
❑ Replacement ❑ Public or commercial describe
Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ftz .8 trench, gpd/ft
Absorption area required 643 bed, ftz 562 trench, fF Maximum design loading rate .7 bed, gpd/fF .8 tr ench, gpd/W
Recommended infiltration surface elevation(s) 92.0 ft (?s referred to site plan benchmark)
Additional design / site considerations Alternate Area Elev. 90.9 oc,-, op sys43, 46 Sb✓ lo-1
t Parenl material - - - - -- Flood plain elevation, if applicable - -- -- ft
ble for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank
uitable for system M S❑ U ❑ S❑ U ❑ S❑ U ❑ S❑ U ❑ S❑ U [I S® U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD/rf
Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistent Boundary Roots Bed Trench
1 1 0 -9 10YR3 /3 ------------ - - - - -- 1 lmsbk mvfr as if .4 .5
2 9 -23 10YR4 /3 ------------ - - - - -- 1 lmsbk mvfr gw lvf .4 .5
Ground 3 23 -30 10YR4 /4 -- ---------- - - - - -- cl lmsbk mfr as - - -- 2 3
I
elev — — - — - - -- - -- - -- -- -- -
96.5 ft. 4 30 -54 7.5YR -- ---------- - - - - -- osg ml cw - - -- .7 .8
Depth to
5 54 - 95 10YR5 /6 ------------ - - - - -- s osg ml - - -- - - -- 7 8
— - - - -- ----- - -- - - - -- - - - --
limiting
factor
>95"
Remarks:
1 0 -8 10YR3 /3 ------------ - - - - -- 1 l msbk mvfr as 2f .4 .5
2 - -- - - - -- - - --
----- - - - - - -- - -- — — - --
2 8 -17 10YR4 /3 ------------ - - - - -- 1 lmsbk mvfr gw lvf .4 .5
Ground 3 17 -28 10YR4/4 - cl I msbk mfr as - - -- 2 3
elev - - ------- - - - - -- _ - -- - - -- - -
94.9 ft. 4 28 -50 7.5YR4/6 ------------ - - - - -- cs osg ml cw - - -- 8
Depth to 5 G 60 - p 10YR5 /6 ------------ - - - - -- s osg ml - - -- - - -- .7 .8
limiting
fa ctor
>77
Remarks: _
CST Name (Please Print) Signature: Telephone No.
Jacque Hawkins Y7
qt° s '' L^^"-- - - - - -- Z `,F y y �
Address - 111 Date CST Number Ref#
-. 4/10/00 67 L 413
PROPERTY OWNER: Lakes & F ills Development SOIL DESCRIPTION REPORT Page 2 of 3
PARCEL LD.# Pending
Depth Dominant Color Mottles Structure GPD/fl?
Horizon in Munsell Qu. Sz. Cont Color Texture Gr. Sz- Sh. onsistence Boundary Roots
Bed ! Trench
3 1 0 -10 10YR3 /3 ---- -------- - - - - -- 1 Imsbk mvfr as 2f .4 .5
2 10 -19 10YR4 /3 ----------- - - - - -- 1 Imsbk mvfr gw lvf .4 .5
Ground
elev 3 19 -30 10YR4 / 4 ------------ - - - - -- Cl Imsbk mfr ---- - - -- 2 3
-- -- - --
96.5 ft. 4 30 -51 7.5YR4 ------------ - - - - -- cs osg m l cw - - -- .7 .8
Depth to 5 51 - 93 10YR4/ ------------ - - - - -- s osg ml - -- - -- .7 .8
limiting - - - -- — - -- —
factor
>93 11 - — --
Remarks:
4 1 0 -9 1O YR3 /3 ------------ - - - - -- 1 Imsbk mvfr as 2f .4 5
2 9 -16 l 0YR4 /3 ------------ - - - - - I I msbk mvfr gw lvf .4 .5
Ground — — - - -- - - --
elev 3 16 -28 10YR4 /4 ------------ - - - - -- Cl Imsbk mfr as - - -- 2 3
93.5 ft. 4 28 -50 7.5YR4/6 ------ - - - - -- cs osg ml cw - - -- .7 , .8
Depth to 5 50 -72 10YR4 /6 ----------- - - - - -- osg m l ---- - - -- 7 8
irrNting — - 2 << -- - - - - -- - - - --
factor
Remarks:
5 1 0 -9 IOYR3 /3 -- ---------- - - - - -- 1 Imsbk mvfr as 2f .4 .5
2 9 -16 10YR4 /3 ------------ - - - - -- I Imsbk mvfr gw lvf .4 .5
Ground - --
3 16 -27 10YR4/4 ------------ - - - - -- el Imsbk mfr as - - -- 2 3
elev _
93.5 ft. 4 27 -4 7.5YR4/6 ------------ - - - - -- cs osg ml cw - - -- — (. 7). .8
Depth to — —
P 5 46 -74 1 0YR4 / 6 -- ---------- - - - - -- s osg ml - - -- - - -- .7 .
limiting - - -- - - -- -- -- - - - -- - - --
factor C/ p, , ` _ 31, 2
>74
Remarks:
Ground —
elev
Depth to
limiting -- -- -- —
factor
i
Remarks:
r k
rx 12%
` r
a
`i
CIP
� e
0
I in I o
0
i
-o
3-
( , A) c
z
c
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Z
7 1:
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M
OWNERS:
Lakes and Hills Inc. kX
P.O. Box 10622 to the k•iA
White Bear Lake, MN 55110x' O',
George M. Birkholz and
TG?UTL O f
Marlon V. Birkholz
2175 32nd Street =
New Richmond, M. 54017 0
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<LAND CEMETERY WE AIRI W�
-------------------------- - - - - -- - - - - -E
ASSOCIATION North line of SW 1/4 of NW 1/4 - - - - --
p of Sec. 13, T31N, R18W
North line of Oakland i r
Cemetery Association O• o� @ 0. L. 1 z�
- - - - - -- 691.92 (rec.) n21
S89 °07'04 "E s '�, �� 589 "E cI
631.9 o -- 691.98 (mess.) se
363.32' 61.92' 239.00' 3
218.61' -300.92- ' `6� 66 i
` ----------- - 581.93'- - - - - - - - - - - - - - - -- --' c
X - '. V)
230_00 41 �
77,213 sq.ft. N Drainoge & =� N
1.77 acres v •r -'' Ponding O3 961.2 `� g \
M �' 100YR H`In N
S89V6'56
t � _ _
�
360 07' 36
4 F 170,462 sq. ft.
N 386 01, `�\ 3.91 acres
65,952 sq. ft. o g
1.51 acres 4 0
r 145,804 sq.ft.
` N89va'29 W— "3.35 acres
97.08' 2 ,181 ''
ir
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s 39
. / y /� AA 8 {`mil
.
oc
I iyY�Y . 1
' " l VAR
Maintenance and Contingency Plan for a Septic System
Maintenance Plan
1. Septic Tank is to be pumped once every 3 years.
2. Effluent filter is to be cleaned once a e r
y a .Please note: a larger filter is being installed in
order to extend the maintenance interval of the filter.
3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of
the cells.
4. Owner agrees g ees to limit reases garbage, a and w
9 9 water conditioner discharge scharge into the system.
5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over system.
7. Watershed is to be diverted away from system.
8. Discharge into system is not exceed those required as per Comm. 83
Con Plan
C ptinstem o#1. If fails, determine cause of failure, use alternate area and install new
s em in If
replacement area.
Option #2. Install system at a lower elevation, by removing chambers, removing biomat,
and install new system.
Option#3. No adequate area is suitable for replacement area, and system elevation
cannont be lowered. Install holding tank as last resort.
3. Replace any other failing components as needed.
Plumber: Shaun Bird 715 - 246 -4516
St. Croix County Zoning 715 - 386 -4680
Pumper Tom Mondor 715 - 246 -5148
Shaun Bird #226900
03/03/2006 15:53 7152467227 HALLE CUSTOM HOMES PAGE 02
ST CROIX COUNTY
S13F''1`!C TANK MARTMANCE AGR88IvOWr
AND
OWNBMFO =TmCATION FORM
owncr Buyer !� {' G_ � nne
Mailing Address 1 l l3 �.
�tDi[ - 7
Property Address l_
.4-C...
(verifies tion rrqub from Planning Department for new construction)
City/State hi t gW jj=Wp _ r W I parcel Identification Number 03`+�
LEGAL AF.St^KIP'IION
Property Location %,&d'14, Sec. t . N -R�W, Town of .S1 - .
Subdivision .,r i Lot # —�—.
Certified Survey Map # _ _ Volume — . .Page #
Warmuty Deed # Volume Page #
Spca house ❑ yes 0 no Lot lines identi5,able JK yes ❑ no
SXS�EM N
UVroper use and mainf enaneea f your septic system could result in its premature failure ro hAndlowas
YOU pu Ulto the U ��
consists of pampivg out the srptie tank every three years or wwtr, if needed by a licensed pum erp• Yrut
can affect the f mcdon of the septic ant: as a tmatmeat stage in the waste disposal system.
The property owner ngroes to submit to St. Cmix Toning Department a certification fot�m, signed by the owner and by a
masterp��•J plumber, tr tr ictedp1wnbcroraticenwdpWVervaifyi09(Ut( 1 )theO"towastemmadisposalsystem
is in p Wa opemfft condition and/or 0.) alter ingmcdon and pumping (if necessary), the septic task is less than 1/3 fill of sludge.
Vwe, the andeaigaod ba ve read the above requirements and agree to maintain the private sewage disposal system with die standards
set forth. berviN as set by the Departmcut of Commesve and the Department of Natural Resourom. State of Wisconsin. Certification
stating that your septic systear has been maintained must be completed and roomed to the St. Croix County ZORW g Office within 30
days of the three ye,4 expiratiAn date.
ONA F APPLICANT DATE
OWNER CT�iZ�`TC� M a l Q -
I (we) certify that al.( :statements on this form era true to the best of my (our) knowledge. t (we) am (arc) the owaer(s) of
the property described above, by virtue of a warranty deed recorded in Register of Docds Office -
ATt31tB hF APPLICAN r DAZE
•••••e Any information that is mis-rc mesented Wray result in the sanitsry permit belt revoked by to Zoning Leparbment. �`• "•
.s Include with this applicittion: a stamped warranty deed from the rf gist" O f D rs d", da rr►' the .va::saty deed
a copy of the certifred smrvcy map
!I
J 20691 3 29 7101046
WALSH
STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. DEEDS
Document Number
WARRANTY DEED ST. CROIX GO., VI
RECEIVED FOR RECORD
This Deed, made between Lakes and Hills, Inc., a Minnesota 12/05/2002 11:00AH
Corporation
EXEMPT #
REC
Grantor, and Halle Builders, Inc., a Wisconsin Cor ration FEE: 11.00
p° TRA TRANS FEE: 138.30
COPY FEE:
CERT COPY 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
Name and Return Address
Lots 20 and 40, Plat of Pine Acres in the Town of Star Prairie, St. Croix
County, Wisconsin.
038- 1195 -00 -000,038- 1197 - 10-000
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 day of December 2002
Lake and Hills, Inc. �J
* * v
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
(�� ) ss.
� j County )
authenticated this day of ,
Personally came before me this day of
December , 2002 the above named
Lakes and Hills, Inc., a Minn Corporation by
k '
D. x' F i2
TITLE: MEMBER STATE BAR S its
(If not, to me k to a person(s) who executed the foregoing
authorized by § 706.06, Wis. inst o ledged the same.
�r •
THIS INSTRUMENT WAS DRAFTED BY •
Attorney Kristine Ogland Notary Public, State of Wisconsin
Hudson, WI 54016 M ission is per nt. If not, state ex ion .
My P (
(Signatures e r acknowledged. B th a n ma be authenticated o o are o necessary.)
Y
* Names of persons signing in any capacity must be typed or printed below their sign re. Im(omoauon Prolessiomals company, Fond du Lac, wi
STATE BAR OF WISCONSIN 900455-2021
WARRANTY DEED FORM No. 2 -1999
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-Parcel #: 038 - 1197 -10 -000 03/06/2006 02:38 PM
PAGE 1 OF 1
Alt. Parcel #: 13.31.18.1035 038 - TOWN OF STAR PRAIRIE
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - HALLE BUILDERS INC
HALLE BUILDERS INC
1113 HWY 64
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description " 1307 216TH AVE
SC 3962 NEW RICHMOND
SP 1700 WITC
I
Legal Description: Acres: 3.350 Plat: 2304 -PINE ACRES 2000
SEC 13 T31 N R18W SW NW LOT 40 PINE ACRES Block/Condo Bldg: LOT 40
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
13- 31N -18W SW NW
Notes: Parcel History:
Date Doc # Vol /Page Type
12/05/2002 701046 2069/329 WD
06/07/2000 6244360 1517/272 WD
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
120274 26,800
Valuations: Last Changed: 10/12/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.350 26,300 0 26,300 NO
Totals for 2005:
General Property 3.350 26,300 0 26,300
Woodland 0.000 0 0
Totals for 2004:
General Property 3.350 26,300 0 26,300
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Monica Lucht 111,1Z
Subject: S.Bird / Halle Custom, Lot 40, Pine Acres, 488090
Location: Star Prairie
i
Start: Fri 6/16/2006 10:00 AM
End: Fri 6/16/2006 11:00 AM
Recurrence: (none)
May not be ready till 10:30
038- 1197 -10 -000
13.31.18.1035
1307 216th Avenue
i