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HomeMy WebLinkAbout038-1197-50-000 n■ o ■ o" 0 c § g § § ; ■ ° 7 TM 0) k @ / k 0 ° \ \ . a CD g , f � .� \� @ k ( R C. 22 2) c § 2 2 . i g C � © 7 />£ N) C E _ o 3 0 - Z Er 4 PO # C > z § § k n r CO) ° 2 S \ CO �' z @� 0 0 0 \ fT Oro / 7§ -0 k ƒ E of 7� °� > ) ■ m § � ■ � q . 3 .. 0) E } ° / \ o K E § / / } o / . I @ k } \ } i & I ,_ CD a a % ° d =r $ 0) § m 0) a w CO) ■ . ° �0.6 %§ _ © z o 7 2\ §E R ® =g CD\ E 06 / 2 kE 0 z00 ( _ \ CD /z / w } \ 0c r CL ¥ }{52 \ § f Dm' � CD , �Ck/ CL om W to ( D ; ®§ ( � ( �k ' rl k CL \ » w kC /\ Qb 0 } � o � � < \ D , C) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ` INSPECTION REPORT Sanitary Permit No: 430624 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information ou ovide may be used for seconds y F. Y secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Halle Builders Inc. I Star Prairie Township 038 - 1197 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: Sectionrrown /Range /Map No: I M -D l� a C5T sa ( 13.31.18.1039 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Cpl Fc� - Z-15- °2,45 cv'o Dosing Alt. BM - A 'r '(4-1& Aeration Bldg. Sewer (4 + Holding St/Ht Inlet w ell St/Ht Outlet A� Q TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic i�\ 2 l + _ Dt Bottom Dosing J l Header /Man. Aeration Dist Pipe nn q N 9 Holding Bot. System . 93.7s �� 4• �0 93. s' Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Numb r 9 9 wa ( 4 -, � , s TDH Lift Iction Loss System Head TDH Ft ��� / Forcemai Length ell r 7 SOIL ABSORPTION SYSTEM c1� /TRENCH Width Length No f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DI S 3 z � SETBACK SYSTEM TO I P/L JBLDG IWELL LAKE /STREAM LEACHING Manufact e : J INFORMATION CHAMBER OR • Type Of System: A t>� Q. ^ / 1 / UNIT del Number: z se Ct T a C '7 l DISTRIBUTION SYSTEM Header /Manifold f I Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) / Length '� Dia Leng is Spacing 7 3 O SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes E] No [] Yes No COMMEN S' Includ co discr ncies, ersons resent, etc. Inspection #1: , Inspection #2: I / Location: 1315 216th Avenue Star Prairie, WI 54026 (SW 1/4 NW 1/4 13 T31 N R18W) Pine Acre t 44 Parcel No: 13.31.18. 03 1.) Alt BM Description = 5T � , ` 51 F ` � � ' � 2.) Bldg sewer length= 29 ' # �3 Sc 4,44 w , - amount of cover (-) 3 w � rwk- tW4 -u `t t - S '4 _ J,.j A- too C -AT. 914-,-. - -- - - -- - -- - - -- Y _ l Plan revision Required? [] Yes XNo 1 Use other side for additional information. SBD -6710 (R.3/97) �� to — _ n' S \ InsGpcs $�naturQ / / S� ` No. a fety n Department of Commerce PRIVATE SEWAGE SYSTE County: S Safety and Building Division St. Croix INSPECTION REPO itary Permit No: GENERAL INFORMATION (ATTACH TO PER T) ( 0 rY Purposes [Privacy Personal information you provide may be used for seconds u I cy Law, s.15.04 1 )i to Plan ID No: OI m . Permit Builders Inc. rmit Holder's Name: City Village X Township Parcel Tax No: H CST BM Elev: Insp. BM Elev: BM Description: Star Prairie Township Sectionlrown/ 038 - 1197 -50 -000 Range/Map No: TANK INFORMATION 13.31.18.1039 ELEVATION DATA TYPE MANUFACTURER .. CAPACITY STATION BS HI FS ELEV. Se ptic �— t� Benchmark Dosing �.. Alt. BM �• O� • O Aeration a 3- q Bldg. Sewer . � 9 Holding St/Ht Inlet �• ��/ 64f . 3 TANK SETBACK INFORMATION St/Ht outlet TANK TO P/L WELL EG. Vent to Air Intake • 3 •OS I ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bqt. System - 0 .Zo PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover � &c A 4 t ou I Model Numb GPM TDH Lift Fiction Loss System Head TD Ft Force n Length la. Dist. to Well SOIL RPTION SYSTEM y �� ENCH idth I Length No. Trenche \ DIME Q � 21 PIT DIMENSIONS No. Of Pits Inside Dia. Liqui E�pth SETBACK SYSTEM TO v • P/L BLDG WELL LAKE /STREAM LEACHING M ct r INFORMATION a � • -5� Type Of S tem: f CHAMBER OR �, yl ` 4, l UNIT Model Number: ��• DISTRIBUTION SYSTEM -leader/Manifold F stribution x Hol h Dia P I x x Hole Spacing Vent to Air Intake Dia Sp acing TOIL COVER x Pressure Systems Onl )epth Over Y xx Mound Or At -Grade Systems Only j led/Trench Center Depth Over xx Depth of xx Seeded /Sodded BedlTrench Edges Topsoil \ xx Mulched F Yes n No J41 Yes u No 'OMMJENTS: (Include code discrepencies, persons present, etc.) Iris ection #1�t�.1 p L Inspection #2: / oca ion: 1315 216th Avenue Star Prairie, WI 54026 (SW 1/4 NW 1/413 T31N R18W) Pin � ��/ o: 13.31.18.1039 Alt BM Description = �f 4' Bldg sewer length = 2 9 r - amount of cover = Z 'an revision Required? W Yes le No - - - -- ❑ se other side for additional information. 3D -6710 (R.M7) Date -- -- I = - -� nse pctofs Signature Cert. No. . 91d r?4 N;�Zl I 9 . . . . . . . . . . . . ....... ....... AA I N 1 i i I I _ ... ... .... ... r I.... J­ J j. T .- 1 .... , .... } ._..... ... .... .. .. ........... ..... ..... .... ....... . . . ... .. ....... .. ....... . .... ... ... ........ .. 1 ... ...... 1. pa ZO 3!DVd !DNimonNi 3 080L89ZSTL 0Z :8 r 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 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 referen direction and percent slope, scale or dimensions, north arrow, �a q acrd to nearest road. ,, Parcel I.D.# APPLICANT INFORMATION - Pt �, rfint all nformation� Pendm ja Personal information you provide may be used for ry purdoses (P{�ya a law, s: -15,b4 (1) (m)). V By Date S .` � Property Owner ;P rty Location Lakes & Hills Development Govt Lot 1/4 NW 1I4,S 13 T 31 N,R 18 W Property Owners ailing Address S i ,Lot Block # Subd. Name or CSM# o k ��(,. �- ' u . _ ,+43 __ Pine Acres IN / State Zip G PIQ?d lifrri iiFrCr City Village Town Nearest Road �t 1`i !�i Nl S� D S/ yf, dry d " 216 TH. Ave. ❑ New Construction Use: Z Residenbal4-Nulllb ' �oms 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/fl? Absorption area required 643 bed, ft' 562 trench, T Maximum design loading rate .7 bed, gpd/fi? .8 tr ench, gpdi'ftz Recommended infiltration surface elevation(s) 94.2 ft (as referred to site plan benchmark) Additional design / site considerations t Parent material------ - - - -- Flood plain elevation, if applicable - -- - - -- ft ble for system Conventional Mound In - Ground Pressure AT - Grade System in Fill Holding Tank itable for system NS ❑ u NS u M S❑ U ® S❑ U ❑ S N u ❑ S N u SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure Consistent Boundary Bounda Roots GPD/ftz Boring# in. Munsell Qu. Sz. Cod Color Gr. Sz- Sh. Bed T r e nch 1 0 -10 10YR3 /3 1 Imsbk mvfr as if .4 .5 2 10 -19 10YR4 /4 ------------ - - - - -- I Imsbk mvfr gw lvf .4 .5 Ground 3 19 -38 10YR4 /6 ------------ - - - - -- cl Imsbk mfr as - - -- 2 3 elev 98.5 ft 4 38 -59 7.5YR4/4 ------------ - - - - -- cs osg ml cw - - -- D7: .8 5 59 -93 10YR5 /7 -- w- - - - - -- - - - - -- - - -- cs osg ml - - -- 7 8 Depth to limiting 'i . factor >93" Remarks: Or S 2 1 0 -12 1 OYR3 /3 ------------ - - - - -- 1 Ims bk mvfr as if .4 .5 2 12 -23 l 0YR4 /4 1 Imsbk mvfr gw 1 of .4 .5 Ground 3 23 -39 10YR4 /6 --------- - - - - -- cl Imsbk mfr as - - -- 2 3 elev _ 98.5 ft. 4 39-5jj 7.5YR4/4 ------------ - - - - -- cs osg ml cw - - -- 7 .8 Depth to 5 54 -92 10YR5 /6 s osg ml - -- - - -- 7 .8 limiting j �• `� factor >92" Remarks: CST Name (Please Print) Signature: Telephone No. Jacque Hawkins Y) L' y Y y4 Address .� yr W ive CST Number Ref # A0 15 , ��D uC /t ive �v; y8 4/10/00 ']L 416 Z � e s� �r 1 � � G co N e Q `J 4 Q 4 � M 12/05/2003 11:30 R'Y9724'Y HALLE BUILDERS INC PAGE 02 r DEC 18 2003 ST. CROIX COUNTY OFFIC E Pfoy and Buildings Division ZVI IM Washington Ave., p.o. box 7082 � ��� � Madison, WI 53707 — 7082 Sanitary permit Number (to b MW in by co.) (608) 261 -6546 0 � De srtment of commerce state PIWI.D.Namber Sanitary Permit Application AJ A In a .cord with Canon 83.21. Nis- Adm, Codo, Pusonal 1nfortnation yw pr* (lc proms Address (i[ di erect then mailing addrtes) may be used for seoondsry purposes Privacy Law, s15.04(l)(m) I. Application Information - please Prink Ali Information Parcel # # Block 8 Petry ces Name Ptopecy Looa lilon • 1 35 "party Owuer's Mailing Address Nw_%, Section City, State . Zip Colo Phone Number -'y� TLL N: Kil— cI II. Type of Building (cheek nil that app ly) _ Stsbdiviaion Name CSA1 N'nnixt ❑ 1 or 2 Family Dwelling - Number of 8edrooma (/N a CLCAAQ ❑ publiclCommercial - Dmcnbe Use / Wty ❑Vilkge fi of ©Sure owned - Descnbe Use S ! 4 r POl t lil. of Permit: (Check only out box on line A. Carnplete line B if applicabim) A New System ❑ Rcplaeentont System ❑ Treatment/Holding Tank Replece mat Only ❑ odu r Modifloatiun to Existing System mber and Dote -*ctmit Renewal ❑ Permit Revision ❑ pltange of ©pemioyanakr to New List Previous Permit Nu ,sued `scfate Expiration Plumbs CMI IV. a of FOWTS Sys Check all that 20DI Non - PM"mrised in -Ground ❑ Mound> 24 in. ol'suitable Soil ❑ Md C?b in. oun of suitable Soil As -Glade El Si pull Sand Filter ❑ I L n Tank ❑ Peat Filter ❑ Aerobic Trotmcnt Unit C1 Rocirculatitt SaPd iher 11 r Constfnctod Wetland ❑ Pressurised R Recirculating Synthetic Media iltxr 1f5lLcachin cha D Inc. ❑Gravel- s P ❑tether ex lain) V. Die alfrreattnent Area D Soil A lkation Rat dsf) Dispersal Ar- Required (st) Disp� Area Praposcd (stv stevation Design Plow (gpd) gr► PP d8p l/ !7/ ✓ z � 47 y.7 0 i �` Pro&tb s +ro Stccl Fiber Vl. Tank Info cap aci t y Gallo Plastic Ce aci in Total Number Mgmufacturcr u Coasiected GGallons! Gallons of Units [� _ New Existing Tnaka Trnkt HoldineTank opt) Aerebic Ttmtateat Unit DmngCmmber for inane o[ the POWTS shown on the attached plans. VII. Res onsibility Statement f, the %o aralRncd. aaxumc resrponslblilty umber susineas Pbonc Number Plumber's Name (Print) 'r, Signature M pEnn � s :11-e ZZ /Y7 Plumber's Addr / cas [street• City, State. Zip Code) VIII, oun !De srtment Use On Sanitary s) Pcttnit F cc i ntludcs t3rou>tdWAtcr i ate ssuc 1 inR Agcat Hna Pprov9d ❑ Disapproved Surcharge Fee) (U/ ✓ � U �� ❑ puma Given Reason for Denial 4 1}C. Condition of Approve sons for Disa prova� l Y M OWNER: p e tic tank, effluent filter and dispersal cell must all be serviced ined as per management plan provided by plumber. All setback requirements must be maintained as per applicable code /ordina , sot l tki aw tl tackier la / Atracki cempbte kit■ ■. (ea the C■+raty a■tyl for ekie fytteta P� g3Jg3 v SBD -6398 (R. 08102) • _.._..' I I , I t r .. � � r . r ... I _ f .._.... T I 1 i t . �.._.. - -• . .. .� ...t II . •�.. �. 7 � ' j.. t- �. i i 1 I I , J , I j ..j...._j,._. _ . r.,. - ,...._ j....,. .�•.. ..�_..Y.�.._ .t. , .�.... ,.�M...,.,j..,,..,.j.. _ .,,.,_._;.....- .�....,..{.. �..�....�j._... }...__ -, _ _ 3-•-•- .r._..j.._ _..,j.._,...i....... . I • 1 7 1 I 1 t i ' I .... j. r ..... 1 .... 1 .. ,.. ;........ i_... j... ;.._. _ -.4... : : ' t � .. ... .. 1 ._ .. r .. � . _. f ..__ i•.. _. 1.._- j. .. j- ...P -- • j.... .1._ ....�.......�.._ . .. , .. .. T ... _ _ . .. _.. . • � i • � i.. j._. j.... _ f- } -... �._ j......� ,. .�__ -i._....j. _._j -. _. -1• - -•t -•- . I _. �_ . � ...) - - •i -_......_ _. y ... _j... _ _, .j.... �, Z0 3EVd 9NIAXI811 311ID 080L89ZSIL 0Z :8 E00Z /EZ /ZZ �r ; :�.. •v ♦ . mac .. �. W Q' "W . '• 8'2 9 l 1 7,16 acres SOS A we 949 T f 995. jX , L_�� - - �'► f .. `, �",.." : `'� cb b_em v d 8 8�8 ft. 'io/ 7• Q�pto. 996. L 1 0 78 q• �- X I 994.3. X x 7 311.66 •I 993.7 s,i ao v+ 92. 5 , 74 • 6qft. 995.4 1.2 acres•.._- - 061 41 p __ - -- x'43 "LL' �'-_~ -. -- bA - .__ Q__ 0685 • -,.,, x 996.6 m N o I x x- 994.9 '" 8' 0 0• $ Ot I X 998.5 Pr x x Ar 03 • O Q N, Zg 2 66 4 .. -.p�� \\ / . 3 ' 6 ac 1002'1 j 0 4 I m c 996.8 1000.5 x1 0 999.3 - 1j \�j(�00� 8 '89.13 ' , . 1000.9 s ue• � 1001 I 189 13' 150.47 Ix - _ S89 I 68„ 7_E14 R� 3 00 x ]151 acre8 Yy ` 1000.9 4 C I 63,536 sq.ft. 47 _ s J I ,� 1.46 acres ^� t a 1B 61,717 . I r / I ` �y`l�` 998 b �S -� 1.42 acres sa.ft .8 ` I X a=21 ° s 66,504 sq. f , �� ,' I X 7.4 1000.9 - •? ° Q 998.12 861543 I ft. S8 * 07'26"E •h23 _ I X 1005.0 x e ` I I 999.1 1.99 a es ".� X 336.62_ - -._ I 81,401 , o� R '• :3 998 6 x I I 1.87 a 998.2 cres e �� L J '\ � 3 %' , 4 ^ � 9 b I 999.70 P �� `, 4 r ` . I 998 8 1001.4 1003. � 742 -�q: _ ...- ....9 `... � 65, 9x4.8 996.3 t. ,� I x 65,451 soft. ,�:Sfacree 6 �a�es�- 1 `, 6 85 sq.ft. t� X .• 1.� g %' ", _, to 996.3 61,086/ s �, 1.51 acr 61,220 x 1.40 b cr 1.41 acres 1001.1 ; 1092.7 - - -_ 33 3 ° o ° i �_ -- - X i X 1002.9 inn in Wood Enteclsr`JSe. �,�,'�� -s- X 998.2 X --Rbod "C ' 997.5 _7_ J 1 . -....J G. r 'S4017,• ,. �"p ��F�� OOGreenwodd Enterprises X 1002.3 '`�•_ 004.3 X00 -'S' ' °,; \ 2141 :County Road "C" Greenwood`nterprises New Ri0mond, M.. 54017 ZO LOT 1 1005.2 14 2141 County Rood "C' 1 q.2 �i e New Richmond, M.. 54017 x sR ONED 'AG. - RE.S. _. 1003.1 INIMMUMMUMMIMMM '� .ZONED AC. x- RES. _ We EX CA VAS INC. 352140' STREET AMERY, WI 54001 PRONE (76) 268 -6637 Fax: (715) 268 -7080 F ax Tot �,,,., From: Fax: pate: Phone: Pages (Includes cover): Re: CC: 0 urgent Cl For Review ❑ Please Continent ❑ Please Reply ❑ Please Recycle •Cowrnrents: 10 39Vd JNI7ondl 3 080L89ZSTL OZ -80 EOO Z /EZ/ZT w ` Wisconsin DepartmentofCommerce SOIL AND SITE EVALUATION Page 1 of 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 horizonta erence point (BM), direction and percent slope, scale or dimemsions, north a"W d location and distance to nearest road. �� P 7r 7, erid�n APPLICANT INFORMATION b� se pri all ipformati6p. Personal information you provide may be u ° gbcondaty�6rpo `(Privacy Law, a.�1 1 5.04 (1) (m)). evle Date, P - Property Owner roperty Location Lakes & Hills D men . ' _ ovt of im NW im,S 13 T 31 N,R 18 W Property Owne s Mailing Address o Block # Subd. Name or CSM# 44 -- Pine Acre$ City / State Code �oneNumber: dy, illage ®Town f 4 Nearest Road lft �L 0" 7`ar� 216TH.AVE. ❑ New Construction Use: ❑❑ Reside of bedrooms 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/R Absorption area required 643 bed, fF 562 tr Maximum design loading rate .7 bed, gpd/ftz .8 tr ench, gpd/fF Recommended infiltration surface elevation(s) 95.2 It referred to site plan benchmark) "❑� �. �� Additional design / site considerations ! J Ste• ` - Ole t Parent material- - - - - -- Fiood lain elevation, if applicable -- - --- ft ble for syst em Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank itable for system ® S El ❑ S F-1 U ❑ S El ❑ S El [ S ❑ U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/fts Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture Sz. Sh. Consistence Boundary Roots Bed I Trench 1 1 0 -11 10YR3 /3 -- ---------- - - - - -- 1 Imsbk mvfr as if .4 .5 2 11 -23 10YR4/4 ----- ------- - - - - -- 1 I msbk mvfr gw lvf .4 .5 Ground 3 23 -36 10YR4 /4 - cl Imsbk mfr as - - -- 2 elev -- - -- --------- - - - - -- 3 99.6 R. 4 36 -57 7.5YR4/6 -------- - - - - -- s osg ml gw - - -- .7 .8 Depth to 5 57 -94 10YR5 /6 ------------ - - - - -- s os g ml - - -- - - -- .7 .8 limiting factor - -- >94" Remarks: 2 1 0 -11 l 0YR3 /3 - ------- ---- - - - - -- 1 Imsbk mvfr as if .4 .5 2 11 -27 10YR4 /3 ------------ - - - - -- I Imsbk mvfr gw lvf .4 ! .5 Ground 3 27 -33 10YR4 /6 -- ------- - - - - -- - -- Cl Im mfr as - - -- 2 3 elev - — -22-2-ft. 4 33 -59 7.5YR4/4 ------------ - - - - -- s osg ml cw - - -- 7 8 Depth to 5 59 -89 10YR4/6 ------------ - - - - -- s osg ml - - -- 7 8 limiting factor >89" Remarks: - — CST Name (Please Print) Si nature: Telephone N o Jacque Haw Y7L - � Address f� Date CST Number Ref # l J� d uc' �cJ� y�'J� 4/10/00 a 417 PROPERTY OWNED: Lakes & Hills Development SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.DJ Pen Deptli Dominant Color Mottles Structure GPDIf� Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. nsistence Boundary Roots Bed Trench 3 1 0 -9 10YR3 /3 - - - - - -- 1 lmsbk mvfr as If 4 .5 2 9 -22 10YR4/3 - ----- -- -------- I lmsbk mvfr gw lvf .4 ! 5 Ground - -�- - 3 22 -30 10YR4 /6 cl lmsbk mfr as - - -- 2 3 elev - - - - -- --- ' " - - -- 98.4 ft. 4 30 -56 7.5YR4/4 ------------ - - - - -- s osg mi cw - - -- .7 8 Depth to 5 56 -80 10 /6 - ----------- - - - - -- s osg ml - - -- - - -- 7 8 limiting -- - - - - factor >80° - - - - - - Remarks: 4 1 0 -10 10YR3 /3 ------------ - - - - -- 1 Imsbk mvfr as if .4 5 2 10 -21 10YR4/3 ------------ - - - - -- 1 lmsbk mvfr gw lvf .4 .5 Ground 3 21 -34 10YR4/4 Cl lms mfr as - - -- . 2 .3 elev -- - - - - -- "' - " " -' _ _ 99.1 ft. 4 34 -53 7.5YR4/ cs osg ml gw - - -- 7 .8 Depth to 5 5 -89 10 5/6 ---------- - - - - -- s osg ml - - -- - - -- 7 8 limiting - -- — - - - -- - — - _ -- - factor >89" Remarks: 1 0 -11 10YR3 /3 1 l mvfr as if .4 5 5 — ----------- - - - - -- - ms - 2 11 -20 l 0YR4 /3 ------------ - - - - -- l I ms mvfr gw 1 of .4 .5 Ground - — - - _ - elev 3 20 -33 10YR4 /4 ------------ - - - - -- cl lmsbk mfr as - - -- 2 3 -- — - - - -- 99.6 ft. 4 33 -56 - �L ------ cs os ml cw 7 .8 Depth to 5 56 -94 10 ------------ - - - - - s osg ml - - -- - - -- .7 .8 limiting - -- - - -- factor �' r >94" SZ - Remarks: i Ground - — —� -- — elev ft. Depth to limiting - -- - -- -- — - - factor Remarks: U G W O Z c 46 N � e k Z M h � � � o ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT ST. CROIX COUNTY GOVERNMENT CENTER •'� �NNN�N.NNN M��Ni 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715)386-4680 Fax (715)386 -4686 Fhx To: �� ; From: u1 V1 Fa:c V / (�� � �, �v � — �� � Pages: Phone: j 6 Date:) , () Re: CC: ❑ Urgent For Review ❑ Please Comment Please Reply ❑ Please Recycle n r ^ n r 1 ;, v J" V %Gv� y r l . u 1 '4' f r,�� o r �f G Ilo7- Drti Zz I4 7 i Ne</ Sis T3 /NR I8' �.� 4 A� .61-144r � - 3� � = Department of Commerce ; SOIL AND SITE EVALUATION Page 1 of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 814 x 11 inches in size. Plan must County u include, but not limited to: vertical and horizontal reference point (BM), direction and ' 7 ` �,�� , x i f 3 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel APPLICANT INFORMATION - Please print all information. Pending Reviewed B y Date Personal information you provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m)). m Property Owner Property Location Lakes & Hills Development Govt. Lot 114 N 1/4,S 1 3 _T 31 N,R 18 ��✓ Property Own s Mailing Address Block # Subd. Name or CSM# E -- Pine Acres City / Siate Zip Code PhoneNumber illage ®Town Nearest Road fdL �( //0 6F I/ rc ,r." 4 ; L I 216 TH. AVE. New Construction Use: Residential / Number of bedrooms 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, gpolft Absorption area required 643 bed, ft' 562 trench, ft Maximum design loading rate .7 bed, gpd/ftz .8 tr ench, gpd/ft? Recommended infiltration surface elevation(s) 95.2 ft (as referred to site plan benchmark) Additional design / site considerations Parent material- - - - - -- Flood plain elevation, if applicable -- ---- It S= Suitable for system Conventional Mound In Ground Pressure AT Grade System in FUI Holding Tank U= Unsuitable for system ®s L7 U Z S❑ U E S❑ u E s ❑ u O S 0 u O S® u SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/frs Boring# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0 - 11 10YR3 /3 ------------ - - - - -- 1 Imsbk mvfr as if .4 5 2 11 -23 10YR /4 ------------ - - - --- 1 l msbk m vfr gw lvf .4 .5 Ground ---- 23 -36 10YR4 /4 ------------ - - - - -- cl Imsbk mfr as .2 .3 elev 99.6 ft 4 36 -57 7.5YR4/6 -- s osg ml gw 7 Depth to 5 57 -94 10YR5/6 ------------ - - - - -- s osg ml - - -- - - -- 7 8 limiting factor -- - - -- >94" Remarks: Z 1 0 -11 10YR3 /3 ------------ - - - - -- 1 Imsbk mvfr as if .4 .5 2 11 -27 10YR4 /3 - - -- I 1 msbk mvfr gw 1 of .4 .5 Ground 3 27 -33 10YR4 /6 - cl I msbk mfr as - 2 3 ---------- - - - - -- -- elev 992 f . 4 33 -59 7.5YR4/4 s osg ml cw .7 .8 ------------ - - - - -- - - -- 5 59 -89 10YR4 /6 s osg ml - - -- 7 8 Depth to ------------ - - - - -- - - -- limiting factor >89" Remarks: CST Name (Please Print) Si nature: Telephone No. Jacque Hawkins — _ �N-- -- - - -- Y7z ' i S/YI(e Add ess Sy Date CST Number Ref# f 4/10/00 '7 Z, 417 r PROPERTY OWNER: EAes & Hil'is Development SOIL DESCRIPTION REPORT Page 2 of 3 RARCEL I.D.# 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 -9 10YR3/3 - 1 1 msbk mvfr as if .4 .5 2 9 -22 I OYR4 /3 - I I msbk mvfr gw 1 of .4 Ground- - - - - -- - -_ _. _...- - - - - - -. ___ . - - -- - -- -- -- - -- - -- - - - -- --�- elev 3 22 -3 0 10YR /6 - ----------- - - - - -- cl 1 msbk m as - - -- .2 .3 98.4 ft. 4 30 -56 7.5YR4/4 ------------ - - - - -- s osg ml cw -- -- 7 8 Depth to 5 56 -80 10YR5 /6 s os ml - - -- .7 .8 ----------- - - - - -- g - - -- limiting factor >80 0 1 Remarks: 1 0 -10 10YR3/3 1 Imsbk mvfr as if 4 ------------ - - - - -- a 5 2 10 -21 10YR4 /3 1 1 msbk mvfr gw 1 of .4 .5 Ground elev 3 21 -34 10YR4 /4 ------------ - - - - -- Cl i m sb k mfr as - - -- .2 .3 — — - -- - -- 99.1 ft. 4 34 -53 7.5YR4/4 - cs osg ml gw .7 8 Depth to 5 53 -89 10YR5 /6 - --------------- -- s osg ml - - -- - - -- .7 .8 limiting — — - — - -- factor X89° - Remarks: 5 1 0 -11 10YR3 /3 - - 1 1 msbk mvfr as if 2 11 -20 10YR4 /3 - 1 imsbk mvfr gw lvf .4 .5 Ground elev 3 20 -33 10YR /4 ------------ - - - - -- cl imsbk mfr as - - -- .2 .3 99.6 ft- 4 33 -56 7.5YR4/4 ------------ - - - - -- cs osg ml cw - - -- .7 .8 Depth to 5 56 -94 10YR5 /6 s os ml - - -- - - -- 7 8 limiting ------------ - - - - -- — -- - --; factor >94" Remarks: i Ground ' elev i ft. ... , Depth to limiting --- -- -- -- - factor Remarks: s _ r d� s � � pU Clu PJ 0 CLI o ` \ ra Pv ST CROW COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM n Owner/Buyer Mailing Address //3 /`� �7` �Z' L.JI Property Address �J (Verification required from Planning Department for new construction) City /State I 4-1 /akrYLbj4Zj_ Parcel Identification Number _��� =1 I !3 5 LEGAL DESCRIPTION L ,1a31 - Property Location 5W '/4, ' /., Sec. T / N -R r W, Town of ��� <t Subdivision PZ- �' -� °-� . Lot # Certified Survey Map # . Volume . Page # Warranty Deed # 10q- 55z . Volume � Page # Spec house ❑ yes X no Lot lines identifiable [,7 yes ❑ 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, restricted plumber 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 days the three year xpiration date. ATURE F APPLICANT 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 owne of the property described bove, by virtue of a warranty deed recorded in Register of Deeds Office. / / GNA 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 stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed i POWT CCF MAR'S MANUAL & M,AN,+4f RMENT PLAN � e FI LE- # .f VY /�oYh LtJ a �L . of_�! t?wner `" M SPICELATI I�San t # - """"-�— ___ .�.� Saa�+c P Tenk Ceptka[ty do0 s C! NA ��-3 0 �0 oZ- sexttlo 'ysnk Manufacturer � BRS Ell: 13 NA luraarxr I =liter 11 f8 nufaaamrre Jut:rrRkaa9r of Becrnraa►a»rsr - r 2 II NA --- -- ---- .� !~T iJA E'f ftuteCrt Fiiitar ll/icrda Nu i4 0 00 Cl NA m. bar of Pub)Io Pasllrty Lln is _ '_-__ -- -� 1. - .,, �l >NA Purrib Tank C patatty ! s=1 NA I141m sted - flow (evereg " "'- — ' . TM eiltdrr PUMP TBtak Manugaicturer Q NA Deaalprt =vu (.Doak), {Estrrttstad x .,� _yam 1Awmp ltA'srut'aatw D NA 1! Istfrplisaltrasra Rare , Pump Mttdel aneiard Infivsn Efflitrent Quality lUlo gild y 0 NA Monthl overa&Q F Pretcee +a l,Jrrix _'___"'_ "" """ Nfi Fats, all & Givese ii;om �3o mg/L. 13 8andflftvet'i°Ifter f3iascfz ®rzr iatxl Qac Q Feat Filter !«?8mar►t� {tiQla S2?t? rrzg,�L © 1V Q Meohsnldni Aeration Q Wartisnd _ T Su spended afids (T991 .4 m plglnfa ©tsar 0 Others I'rstraarate a>:t 4u i t average kfn-Ground a9rsal Collis) BlucherMirai Oxygen Derrrand MOP?) aA rrr YL. 3 NA. >S la igraVitly) Q in -around ipressutrized) To Sararparrlded Srstia;<s 4T0 raaglL �l NA q at ra a 1 Mound CaaTrPaarrni {9eamaxdc eax�9 si p" cflif_1t7Elmi �_ Q Drip -L ne U other. Maxlrnuan Elfluem Farrtraie fte V in dle. q 1-0the t�hgr: V NA — _ q NA rd NA w89%warer ea7d sapo temk efi?b wro; r. Q NA serving it vens 1�Qrrriaa 1~reyalartay Inspect: aondItIon of tank(s) At loam once every; art fa3 plilaxarltxaaam 3 years} II NA PlImp out cent" aaf Tarlkfs) Wien carnbNed sludgar and savArn equate ong •third �} � tank vaiirmm a Q NA insp, ®at dPspersai Collis) At least wma, every: ri`ratTtAt +) {Ma�tfiwm � Yaaraf Ci NA r er $ _ 'Clean effluent •fl[rsr EIL � J � At least la avery�e 3 month 4a Ci NA Imspeat Pump, AuR•ap oaamtrals & alopm At la aatet once ev nxc rlthfo) II NA ..._ _ ..._.,_ er Flush laterals and prannure lost At least wnae every.- Q NA At leas once mpy morith 8) 0 NA 0 NA 11iI INSTRUCTIONG Insp®tttlrans of tankas and dlepereal calls shall be made hj an lnafivldaa>i! alerryrng ono of tilaa following gConses or aaertMuae Ions; Mantar Plumber, A4,24tor Plumber Ralat;rlewd 80w3r, POW Iruafarlt tar, POWTS Melmalner! Saptiagae Servicing Operatm, 'Tank inspeations rou al. 1nolude. a vIsusl IpippvOl ©n of the tank(s) to identify any naftslrag or bmkerr her dweM, Identify sny areaks or Leeks. maasurao the V014 me of combinerd ejudgo and aourn and too ohsbk for ony back up a2r pandliag of effluent on the ground swince- Thse disperse[ ©allfs>' shell be vlaualfy irtap' rated to aback tiaifl oftluent levels In the abservatfon pipes and to al000k for any panding Of aeffiuent: cats the ground surfeco. The pandit•!$ of effl an the gmund surfaua may Indloate a failing canditlian arlat tegtairees the imr Adlaate natifrtarailan of ties local rergurarary aaxrhorhy. W -ban Viet combined eaaurrtcttgtitan of aelud>ile and saute In MV tank equals ona -third IY or more aierat e or Thee frank shall 4a remained by a SePTega SaMuing Operator and dtspoewl in aaaccrdionas with cha�, the aentfre m Wmocrlsira dministrat[vm Code, NE h s, ,P All other sorullo as, Including but not t[m tmd tv The servicing of afflumn Mora. raa nhanUml or preaaudzed Components, prelaostment units, =d any servInIng at Inlarvale of S1 g manths, shall be p©lformed by ra caroled p01n/TS .NuMtelaier. A sewlcea rRP0rt a ball ba pMvjdsd T.tt the i©cml ra 9.08tq authn i n �' r ty vstiti:l 10 d$ of esatra ]article n Ya A f any service aevatyt. GMW (4,M) START UP AND OPERATION Wage -Z , �t Fbr now construction. pthar to pete.mf thgkI'E]WTS srhaaaic traatmerst •tankls) far the presence of IsarintInta produ or othrer clslerrrja Chat Corey rerapede the trfttrrraartt iicr gagass ;srrdYdr' tlerrnagas 01% dlsperaaaaol a ellls). if high aoncantm#rans are ctstyoted. taraeraa fi re as l'►tan t It of �tho tank(s) r©m ved by as aep¢age eearvitang fterstor polar to use. Sysrern start up shall not cnau r* whaatn sail nondltlans are fsxLe n at the lrrfiltraativrae surface. During pavnr outages pump tanks. may fill sho'Ve norm alfitghwaattr lsvWs. When p+awer is restored the wwass wasteWpter will h, discharged to the disperas) ca ft) In Mys lie doss, arrarlosdingl the asell -W and rraly result; in the backup -or a effluent. To avold this aaltua t-10n have the 00htmts Of the IY'UMP lAnk ramvvsd by a 2 80008 aSerarlatrrg Opatetmr prior ter aestorinr power to the eff uerit pump or contaart a Plumber or POWTS Malntariner it 6581st: Pro mmnuaUy Operating the primp OfJMrtrle 1:, f asta re null'Aal Isvels WfthItl the PUMP tank, DO not drive Or park vehiolse; 0mr ta'ulm and djaaPareal calls. Do not drive or park over, or otherwise dlsturb or aarnptaut, the aret withki 18 fast down elope at any mound ar at-grade soil absorption area. Reduction or ellrcrmatitan of the fnlb6lnrltag from tits wastewater aa'tr'eam may Improve the pearfarmanne and prolong the life oaf vu l°13WTS antIblotlns; babY wipes; alltasrettaa but%' condoms; caium ,swabs; degrassars; dental flosa; .diapars; tllattrfealants; far fourrdafmn dralna .(sump ptlrl p) water; fr0t and VegefiatWs lsaaslirrgs; gasolkiel grease.; harbtaidea; forest saraaps; madfasttons; all; laming praaduats; past doidres; sanitary napkins; taarrtpons; scrod water aaofesner brine. ABANIDONMEN' SNtz the Pthitfl"IS facts a3 ndfar is pa3rmanaamly - taken rout of sarWao the following steps strati be taken to Insure that that sykitarn Ir-. ProperIyr and safety abandoned in aompfia aS With callaptar Comm 83.33, Wlgoortsln Administrative Comm • All plpir►g to taroks and pits shall bar disacrrneated and the ttbaandemead pike oper►Ings eae#ed. • The nantahts of all tanks rand afte shelf Be ramovad arad properly dimposed rrf by a Septage asM- 01ng Opurawn • Aftibr pura•►ptng, all tactics and pitta mhaatl ha eXcAvaatmd and removed or their Wavers reatovad and the veld space filled With aarati, gravel or another Inert solid inarterlal. CONTINGENCY PLAN If the tG11 TS falls and cannot be repalred he follow)ho measures have berm, or must be taltprg, to prOv#de ra code compliant rtlp7 •►ant system: A vulta ale replacement area has been asa�rlustod land tmy be utfl#ze d for Then location of a replacement soil absorption 7710 rreplanement area shcualrl be protsaftd 'irtamAsturbance and oompsatfean and shatIldl, rot..ba . 5y ra3Quirad setbacks frain 9acta3ting and proposed strut"uNa, lot li and welts. axadlurs to protest - die repleasmant: arias wig! ratailtt In they need for a rlaw sail anti site evalustl= *0 astabillih a suitable replacement area Rispiseemant systems mtr:rt: 00mPlY varlt h the roles In affierat at that trios. Cl A suitable replautarrterrt a re a is root: avtrllabls care to setback tarr4f'or soil lirriltatlonas. Setring aduenews in PO'WTS tech rraaloBY a haIdIng Tank imy'bta installed as as last raaasaart to reptaco the fatlled POW TS. ca fleas an err aavalue ldarrtlfy sa a repleaoe►rs t nrrG►e. Upnra falltxr aai' the i'fl'tllf'!'8 a soil and sites i etl n m t bas rfatrrr to 1rs s s b10 tap baattaer are l' as aa�i ac�Ftartt asreff is available holding rani; rn a t ltd aai• 8 i ,sort to re a fsfled IBC 0 Mound and at-grade sail aba orotion sysxema may be recsonstrimted in place following rernuval df thra biarnat at tfle Inflftrative suilarxra R000natMoflaans of such asYstarris must crisply with The melee In affect at that time. < <l+'y'ARN1Ned> > SEPTIC, POMP AND OTHER TREA°TMEtI T TANKS MAY CrE NTAiN LETHAl. x#881118 AND /OR IN8UIeh70i NT OIC'yG BNE DD NQ r ENTER A SEPTIC, PUMP OR txTIOR TIWA.TMENT TANit UNDER ANY C #BCUMSTANC96 DVATH MAY REBULT. RESSUE OF A PERSON FROM Till INTERIOR OF A TANK mALY BE DIFFICULT On IMpQ8SIBLZ, AVCl1TJONAL, CoMMENTm P IaNT I S LLl;ai N Name Phone Phone S8E'TItGB 6EKV1Ct • ® opola lr7A tl< L CAL 'C0 TQIY AU'I'H Name . ` Nam � tsl�tcsrrea r' �6° yG p'a `I'hTtx cldrla tn7aant �nraa� clrtsttea3 to a ornPlIenco m Ftly ohspzor Car" rrt iii. 1 1I1a)I1 lid =11c } and 93.04(l). 03 igc 13). Wisscrinln ACltyi n*trattve Code. I J 19961' 315 4S STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO, , MI This Deed, made between Lakes and Hills, Inc., a Minnesota RECEIVED FOR RECORD Corporation 10 - 02 -2002 8:30 AN IaARRANTY DEED Grantor, and Halle Builders, Inc., a Minnesota Corporation EXW 4 REC FEE: 11.00 TRANS FEE: 78.30 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 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 44, Plat of Pine Acres in the Town of Star Prairie, St. Croix County, Name and Return Address Wisconsin. // ��� LAI V-L qLi 038 - 1197.50 -000 Parcel Identification Number (PIN) This is not homestead property. QE) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of October 2002 Lakes and Hills, Inc. M y ' AUTHENTICATION ACKNOWLEDGMENT Signature(s) 7 F WISCONSIN ) ) ss. County) authenticated this day of Personally came before me this day of October _ 2001 the above named Lakes and Hills, Inc., a Minnesota Corporation by Richard " - Nelson, President TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me t to bet per () who executed the foregoing instde t . acl le d s M authorized by § 706.06, Wis. Stats.) 1/ THIS INSTRUMENT WAS DRAFTED BY « G Attorney Kristian Ogland Notary Public, Siate of Wisconsin Hudson, WI 54016 My Commissio is Krm ancnt . (If not state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) �) Names or persons signing in any capacity must be typed or printed below their signature, inrOMMIM Proresdonn. Company, Fans du Lac, vw ss2021 WARRANTY DEED STATE BAR OF WISCONSIN aoo a FORM No. 2- 19 Ti'a'�y ,77. !9 6` lr0 � 0 ",51 31 E, < W V) � ''7.67 , 0 U O P A �, Q O �* S87 0 28 *43"N 124.4 ` - - -� � o o __ Southerly line of - - - Lot 1, C.S.M. 9/2460. o co A, w e `�' Z 0 O .13 °06'56 "E 68, q S . ft y C cR a' 18: 1 3' 150.4 7 ' 1.58 acres Southerly line o f C.$-M. 9/2460. o � .ED 45 - � 4Y ` 66,504 s q. ° ft. W �0 1.53 acres N 'q- C) z � S89 °07 4 7 26 "E 336.62 86,543 sq.ft. o M }' 1.99 acres 4 48 6 ;ED v 65,451 sc AY 65,685 sq. ft. 1.503 ac 1.51 acres 333.6 4' 177, 28' 24 . 96' LOT 1 1� 2TFED SURVEY MAP 6 7 _U -L 13 PAGE 3549 -- - -- GENERAL NOTICE STATEMENT: The parcels shown on this plat are subject to State, pro 50 150' 72,878 sq. ft. /2460. m 1.67 acres E , 43 .1 ., �? • Q. c a7I < W vi \\ �� . 334.75 0' c 7 w U 78,848 sq. »W i 3 3 7. . z 1.81 acres \ S 76'02 V43 0 w• 24.4 - 66 :� Southerly line of 38 Lot 1, C.S.M. 9/2460. cn �� N 68,310 sq.ft. \ g o �, N�6 � 1.57 acres \ a Z. ,\ \ O ff► g o:��y`b 2g N � IV 44 s89406'560E `� � 68,765 sq. ft. 150.47' 1.58 acres 216 T H- V C68 9 k sq. ft. :res 2 — .r S� N ' g 47 .� 3 86,543 sq. ft. 1.99 acres'`' �h 4, 9 H 48 65,742 sq. ft. m 65,451 sq-ft. 1.51 acres t• 0 1.503 acres 177.28' 247.96' 260.22' A� 6 7 1, 9 )TICS STATEMENT The parcels shown on this plot are subject to State, County laws, rules and regulations (i.e. wetlands, minimum lot size access to parcel, etc.) NO,RTH sing or developing any parcel, contact the St. Croix County Zoning office and the — — — — — wn Board for advice. This statement put on this plat at the direction of the St. :lonning, Zoning and Parks Committee. This instrumen 2� 5 l � O 0 Z-a �81 x v 1