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Permit Holder's Name: City Village X Township Parcel Tax No: Lockhart, Jodi --- Star Prairie Township 038 - 1210 -60 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: c � S , dam C4 -O L —Q Sc 13.31.18.1144 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing � ,.,.( X Alt, BM Aeration Bldg. Sewer Z U Holding St/Ht Inlet St/Ht Outlet TAN SETBACK INFORMATION TANK TO P/L WELL BLD Vent to Air Intake ROAD Dt Inlet Septic �G r � _ Dt Bottom Dosing _...._.- _._,..,. Header /Man. Aeration �':..,, Dist. Pipe w S Holding Bot. System S 7_ PUMP /SIPHON INFORMATION Final Grade ;7> Manufact rer Demand St Cover C GPM Model Nunr TDH Lift Friction Loss System Head TDH t Forcemak Length Dia. Dist. to Well SOIL ABSORPTION BED/TRENCH Width Length g No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS - Y • ----- ------ ---- SETBACK SYSTEM TO P/L BLDG WELL._ LAKE /STREAM LEACHING Manufa INFORMATION CHAMBER OR 1� a C� ivy Type Of System: , O r UNIT Model Number: DISTRIBUTION SYSTEM w c t., t! Header /Manifold Distribution C' C v n ole Size x Hole Spacing VgrIt to Airthtahe CPipes) -, _ .�_.__.._ .... �_............ I Length 1 / Dia Length Dia Spacing - - - � SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only - Depth Over Depth Over xx Depth of xx Mulched Bed/Trench Center cv --j Bed/Trench Edges Topsoil c , > �..✓ 7rS 1,- Yes [ -_� No _i, Yes I J No i COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Location: 1369 213th Avenue New Richmond, WI 54017 (NW 1/4 SE 1/4 13 T31N R18W) Northgate Lot 54 Parcel No: 13.31.18.1144 1.) Alt BM Description = , z,/ 3� <o p Z. Y k - °j 2.) Bldg sewer length = rr - amount of cover = ' c t -y-r e� -�u ✓ n o+ ; n S L•-I Q k' —A— ; h o P /a c v_ Inc *V l ( 1 Plan Use Ye No side for addition in e other ation. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Buildings Division County C / N v isconsin 201 W. Washington Ave., P.O. Box 7082 J C b Madison, WI 53707 — 7082 Sanitary etmit / Num , ef (to be filled in by Co.) Department of Commerce e✓j&- d Sanitary Permit Applic d o State Plan I.D. Number f / A In accord with Comm 83.21, Wis. Adm. Code, personal info ion you provide may be used for secondary purposes Privacy Law, s 5.04(1 V 3 2003 Project Address (if different than mailing address) I. Application Information - Please Print All Information i ?� 1 Z } 3 4-t, Av ST. CROIX COUNTY Pro Owner's Name Parcel # Z` i Block # 1 j d �Ud da , /- T 033, 0 5(¢ o // Property Owner's Mailing Address /P�roop�,e�rty�Location �, -� 7 0 J Cit Zip Code Phone Number - • Section / 3 tY irc one) Type T I N; E o w of Bullding (check all that apply) or 2 Family Dwelling - Number of Bedrooms D/ 6 Subdivision Name CSM Numbs ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use 1 T , C- _ / ❑City+❑Vitlage ownship of IIL Type of Permit: (Check only one box on line A. Complete line B if applicable) �U1 '+' ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. Permit Renewal it Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and j Date V Issued [I Before Expiration Plumber Owner 7I 2Z a 3 IV. lype of POWTS S ystem: Check all that apply) 'I Non - 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- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ping Chamber ❑ Drip Line [] Gravel -less Pi er (explain) / V. Dis rsal/Treatment Area Information: ' [310 D Deli Flow (gpd) Design Soil Application Rate(gpdsf) Dispel re Required (sf) is Area Proposed (sf) S tent O E ti n VL Tank Info Capacity in Total I Number Manufacturer Coo Constructed S St 1 ' Fiber Plastic ew Gallons Gallons of Units V11 2 Jl � 7� N Existing ` CJ Tanks Tanks Septic or Holding Tank Z 0 Aerobic Treatment Unit Dosing Chamber 14 1 VII. Responsibility Statement- 1, the undersig assume responsibility for installation of the POWTS showu on the attached plans. Plum 's Name (Print) Plumber' t MP/MPRS Number Business Phone Number / Plumber's Address (Street, City, State, Zip e) JJ VIII oun epartment Use Onl Approved ❑Disapproved Sanitary Permit Fee (t ludes Group r1cr D ate Issued Issuing Agen Signatur tamps) Surcharge Fee) /2 ❑ Owner Given Reason for Denial � ' J , v IX. Conditions of Approval/Reasons for Disapproval YSTEM OWNER: J A /��� l Septic tank, effluent filter and 6 (/ lA dispersal cell must all be serviced / maintained as per management plan provided by plumber S>✓ 0(1 All et ack requirements must be maintained P s b q as per applicable code /ordinances. �. Attach complete plans (to the County only) for the syste an paper not Was than 5 U2 x 11 Inches In sin SBD -6398 (R. 08/02) PLOT PLAN PROJECT Judi Lockhart A RESS 1890 200th Ave New Richmond Wi 54017 NW 1/4 SE 1 /4S 13 /T 31 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/31/03 BEDROOM 4 CONVENTIONAL X04( IN -GROU D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 870 # of chambers 28 IL BENCHMARK V.R.P. Bottom of Siding ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL •H.R.P. Same as Benchmark SYSTEM ELEVATION 90.8/90.7 4' below g rade 59' 213th Ave 184' 15' 15' B.M. #1 B -4 B -1 69' -3 7' 66' Alt. B.M. u 37' 0 110 N B -2 2 23' 2 -3' X 88' Cells 25 B-5 with >3 Spacing B -2 70' B -6 Pro 4 2% Bedroom 25 ' B -3 Slope Q House r � 45' 90 30' T 10' 20' Vent Drainage B-1 -1 � Easement > 6 „ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long 11 Plans Designed Using 34" Grade at System Elevation Conventional Powts Manual Version 2.0 PLOT PLAN 3 -0� -� PROJECT Judi Lockhart RESS 1890 200th Ave New Richmond Wi 54017 NW 1 1 / 4 SE 1/4S 13 /T i W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/31/03 BEDROOM 4 CONVENTIONAL M IN -GROU D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 870 # of chambers 28 BENCHMARK V.R.P. Bottom of Siding ASSUME ELEVATION loo' Filter Zabel A -100 ❑ BOREHOLE O WELL +H.R.P Same as Benchmark SYSTEM ELEVATION 90.8/90.7 4' below grade 59' 213th Ave 184' 15' 15' B.M. #1 B -4 B -1 69' 66' -3 7' >, Alt. B.M. 37' ZIF 110 �o B - 2 2 - 3 X 88 Cells N 2 2 25' B -5 with >3' Spacing B -2 70' B -6 � Pro 4 2% Bedroom 25' B -3 Slope o House 0 45' 90 30' T 20' 10' Vent Draina B -1 Easement >6" Standard Biodiffuser of Cover Leaching Chamber with 3 1. 1 ft2 of Area L Longl l 1 Plans Designed Using 3 4 9' Grade at System Elevation Conventional Powts Manual Version 2.0 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page r of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Count" 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 p percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 3Y- 1 I — U Please print all information. Reviewe � DatQ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). G� %' Property Owner Property Locatio 1 Govt. Lot 1/4 1 A S T �/ N R J E (or W Subd. Name or CSM# Property Owner's Mailing Address n Lot # Block # ` pvJ b T& Cc� CityState Zip ode Phone Number C C1 Village Town N est Ro New Construction Use. Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public owom�mercial - Describe: Parent material O_u -ICL .�'�/ Flood Plain elevation if applicable ZIZI )4 ft. General comments and recommendations: Boring # ❑ Boring �. Pit Ground surface elev. ft. Depth to limiting factor 30 dp in. Soil Kplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary IR wtsGP D/ff i in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. •Eff#2 1 — I L O �� L rr► r S v /r1 W ® Boring # ❑ Boring / lW A Pit Ground surface elev ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Z � / Al Zi _ _ _ > < > < Effluent #2 = BOD 130 and TSS < 30 mgtL Effluent #1 BOD 30 220 and TSS 30 150 E CST Name (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 � 715 - 246 -4516 li Property Owner _ Parcel ID # Page of f2;1 Ong # E] 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. Munse Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef 'Eff#2 Z � s F-1 Boring # ❑.'°&ring ❑ 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/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 F-1 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD < 30 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 altemate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8.6100) FSa r�tary Safety and Buildings uiviston � � 201 W, Washington Ave., P.O. Box 7162 eonir� Madison, WI 53707 - 7162 Permit Number (t a filled in by Co.) Department of Commerce (608)266 -3151 p I Sanitary Permit Application Sta Vect I In accord with Comm 83.21, Wis. Adm. Code, personal information you provide �- may be used for secondary purposes Privacy Law, sl .04(1 }- Pront than mailing address) I I. Application Information - Please Print All Information A , b Property Owner's Na me Parcel # Lot # Block # j S1 �,�; i li ,,� 1 j Property Owner's M ailin Add --- --- --- - Pr rty Location t� tk,Section City', State Zip Code Phone Number i (cir eon 7 T31N; R E rW I Type of Building (check that app I / S Subdivision Name n CSM Number � 1 or 2 Family Dwelling - Number of Bedroom N Li Public /Commercial - Describe Use r J p r I 1 I ' I 1 State Owned - Describe Use ,z, h O ` �Villagewnship of III. Type of Permit: (Check only one box on line Complete line B if applic e) 639 - wo — X00 -►CCb • u44) 1 A' [jew System ❑ Replacement System ❑ tment/Holding Tank Re ement Only ❑Other Modification to Existing Sysre i ' List to Pe u � B. ❑ Permit Renewal ( �_� Permit Revision ❑ Chan f ❑ Pe it Transfer to New at � Before Expiration Plumber Ow IV. Type of POWTS System: (Check all that apply) Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil and < 24 in. of suitable soil At- Grade ❑Single Pass Sand Filter j ❑ Constructed Wetland ❑ Pressurized In- round ❑ Holding Tank eat Filter ❑ Aerobic Treatment Unit U Recirculating Sand Filter L U _ R ecirculating Synthetic Media Filter Leaching Chamber ❑ Line ❑ Gray -le s 'pe ❑ Other (explain) 9 � i V Dispersal /Treatment Area Infor ation: Design Flow (gpd) Design Soil Application Rate(gpdsf) D e Argequi (sf) Disp ayQre roposed (s System Ele;atio , 66 5 !/ V V1. Tank Info Capacity in Total I umbe Manufac r Prefab Site S el Fiber Plastic I Gallons Gallons I of U Concrete Constructed Glass New Existing Tanks I Tanks Septic or Holding Tank 1 0 i Aerobic Treatment Unit ' I Dosing Chamber VII. Responsibility Statement- I, the unders' d, assume responsibility for installation of the P TS shown on the attached plans. Plumber's Na me (Print) Plumbe i gnature MP /MPRS Number Business Phone Nu b j 2 z �J�� z 6- -r Plumber's Addre ss (Street, City State, Z P ( AJ , �s 4 f VIII. County /Department Use Only Approved El Disapproved Sanitary Permit Fee (includes Groundwater Date Issued suin Agznt Signature o Stamps) i _ Surchazge Fee) 29V U Owner Given Reason for Denial VIZ O IX. Conditions of Approval /Reasons for Disapproval , J �F �k�L++4 VA . Attach complete plans (to the County only) for the system on paper not less than gl/2 x 11 inches in sue SBD -6398 (R. 01/03) .r M 4c PLOT PLAN PROJECT Judi Lockhart ADDRESS 1890 200th Ave New Richmond Wi 54017 NW , 1/4 SE 1/4S 13 /T 31 R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE8/6/03 BEDROOM 4 CONVENTIONAL XXX IN- GROUND RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 870 # of chambers 28 BENCHMARK V.R.P. Top of 2" PVC Pipe — %VV - * I ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE `O WELL *H.R.P Same as Benchmark SYSTEM ELEVATION 97.0/96.8 3.5' below grade 59' 213th Ave 184' AL 15' Vents B -4 B.M. #1 15' B -1 2-3' X 88' Cells 69' with >3' Spacing 66' 3 ^ �� >1 Alt. B.M. 137' N 23' 25, B -5 u Vents A k . g M " P L 20' B -6 C n T 20' a Pro 4 \ Bedroom o House Vent Plans Designed Using >6" Standard Biodiffuser Conventional Powts of Cover Leaching Chamber Manual Version 2.0 with 3 1. 1 ft2 of Area 6' Long 11" 34" Grade at System Elevation Wisconsin Department of Commence 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. x r/ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location �0 y � 1 4 2E Govt. Lot 1/4� "1/4 S 5T N E or) W Property Owner's Maili Address Lot # Block # Subd. Name or CS oZ D D _ City State Zip Code Phone Number ❑ city Village Town Nearest Road As P CE] ew Construction U . Residential / Number of bedrooms Code derived design flow rate GPD Replacement e�1 Public or co mercial - Describe: Parent material f Gt A Flood Plain elevation if applicable '^�� ft. General comments and recommendations: 161 BOring nng o ❑ Pit Ground surface elev. � J ft. Depth to limiting factor 01 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 •E 3 /z- ,s Z� - �: - �2- 'IT /0�) . (7 F-1 Boring # ❑ 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 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 ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 546 7 715- 246 -4516 Property Owner _ Parcel ID # Page of 1-1 Ong # E3 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 GPD* in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ 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 GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. '01#1 'Eff#2 F Boring # E] Boring 1:1 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. S h. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA. ' Effluent #2 = BOD < 30 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, lease contact the department at 608- 266 -3151 or TTY 608 -264 -8777. P P SBD -8310 (8.6/00) ,wpw.wrwwwni�w+ a VIL ^nu at1C av^LUAttVtr nr-rvn # rqp _3_w .3_ -Labor aril Flu�ttan Rl�tiorw mlimm of Sahty a swangs In aCOOrd with "R 83.05, Wit, Adm. Code Attach complete a#te pan on paper not lots than 8112 x 11 inches in si ze. Plan must include, but ;PARCEL not limited to vertical and horizontal reference point (6141), direction and % of o". scale or . D. dimensioned, north wrow, and location and dfsta= to nearest road. APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION 8Y d PROPERTY OWNER: PROPERTY LOCATION Cr aon LOT NN 1t4 SE 1 /4,S 13 T 31 .NA 18 t(w) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK i SM. NAME OR CSM N 1416 TTi rd 54 CITY, STATE ZIP CODE PHONE NUMBER MTY (]VILLAGE 19OWN NEAREST ROAD 1 New Conslrudion Use 1 ) _ ResWer" / Nun9w of bedrooms 4 ( 1 Addition to existing twilling i l Replacement f 1 Public Or commerdd describe Cade Owed d* Row W gpd . Recommended design toa"rare _bed. + _.,$_ trench, OW a6earptlon area ret)uired 858 � bed, ft 750 ICh, 11 Maximum design bading rye _bed, gpdM _ trenchht, gpd* Reoortlntertded IrAllration swbw eletWkwXs) 96.85 ft (as releaed to site plan benchmark) Addidoltal design / Sib oanSiderailms na Parent material Flood plain elevation, it applicable na R S ■ Suitabl6 BySbrtt CONVENTIONAL NO11ND IN GROUND i'REES SURE /►T GRADE SYSTEM N FLL HOLDW E J U.ulsuit iela ®s o L as _a u ®s nu t�s ou 6as ❑u os SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color MONO Texture . Structure Constetenoe Roots /f tZ ire. Munsell Qu. Sz: Cant Cow Gr. Sz. Sh. Bed i aancfi 1 2 12 -24 10 r 4/4 none Grouted 3 24 Depth elev. I OQ,,�It. to a kw 91•a� +84 ... Remarks: Boring 8 2 E 3 -25 1 2 GaocNtd 3 254W 7.5irr 6 mane elev. . )ZQ ' Al l --r Dept lOQ.S�tt. to �mfRng 18CNr +84 Remarks: CST Name:. -Please Print Gary L, Steel - 715 715- 245 -6200 Address; 1554 200th. AV& New Richmo WI 54017 Signature: Date: 11 -7 -98 CST Number: mO2298 i Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor,- Muman Relations Di *lion of Safety & Buildings in accord with ILHR 83.05, 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 St. Croix x not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 038 - 1055 -95 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R IEWEDBY DATE I f �r ,e 1 PROPERTY OWNER: PROPERTY LOCATION Greenwood Enterprises, Inc. GOVT. LOT NW 1/4 SE 1 /4,S 13 T 31 N,R 18 R(or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM # 1416 Thi St. 54 na NorthGate CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE JgOWN NEAREST ROAD Hudson WI. 54016 ) [ :4 New Construction Use [ I Residential / Number of bedrooms 4 [ ] Addition to existing building j ] Replacement [ I Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft , 8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate _ bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 96.85 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ®S ❑ U ® S ❑ U 21 S ❑ U ®S ❑ U ®S ❑ U ❑ S CRU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botx>daly Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmr& ................. .................. ................. .................. 1 10yr 212 none - 2 12 -24 10 r 4/4 none sicl 2 sbk mfr QW if .41 9 Ground 3 24 -84 7.5 r 4/6 elev. 10 85 1t. Depth to limiting factor +84 q o 0 Remarks: Boring # 1 0 -9 10yr 2 2 9 -25 10 r 4/4 none 3 25 -84 7.5yr 4/6 none cos 0SCI ml na Ground elev. 10 Depth to limiting factor +84 vO Remarks: sT c Ro,X CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 ZONING OFFr Address: 1554 200th. A New Richmo d WI 54017 Signature: Date: C3 11 - - e 98 AA V J4 PROPERTYOWNER Enterprise SOIL DESCRIPTION REPORT Page _ Qf. 3 PARCEL I.D4 038- 1055 -95 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bornclary Roots GPD /ft ................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed jTrench 2 12 -25 10 r 4 none sicl 2msbk mfr gw if .4 .5 Ground 3 25-84 cos osa rrLi na na .7 .8 elev. 1 Depth to limiting factor +84 Remarks: Boring # 1 0 -12 10 r 2/2 none 1 2msbk mfr gw if .5 .6 " ..4 '` 2 12 -22 10 r 4/4 none sicl 2msbk mfr w if .4 .5 Ground 3 22 -32 10 r 5/4 none sil I lcsbk mfr qw na .2 .3 elev. 4 32 -84 7.5 r 4/6 none cos OS9 ml na na .7! .8 100.45t. — Depth to - limiting factor +84 Remarks: Boring # 1 0-12 10 r 2/2 none 1 2msbk mfr w if .5 .6 " 2 12 -28 10 r 4/4 none sicl 2msbk mfr 9w if .4' .5 Ground 28 -84 7.5 r 4/6 none cos osq ml na na .7 .8 elev. 10 5t. Depth to limiting factor +84" Remarks: Boring # ................. Ground elev. i ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Greenwood Enterprises, Inc. 1554 200th Ave. CSTM2298 NW4SE4 S13- T31N -R18W New Richmond, WI 54017 MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #54- NorthGate This soil evaluation was conducted to satisfy a zoning requirement, it my or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 " =40' BM.= top of 2" pvc pipe C el. 100 Alt. BM.= top of 1 pvc pipe @ el. 97.85' JA 0 Gary L. { Steel 11 -7 -98 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 year. 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 to limit greases, garbage, and water conditioner discharge into the system. o save this Ian. owner a P 5. The ow agrees t g 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 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. 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 i ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer _J� /9? �/V Mailing Address Property Address ' (Verification required from Planning Department for new construction) City /State Parcel Identification Number 0 - 121 0- (00 6a 6 11� � LEGAL DESCRIPTION l Property Location /., 1 /4, Sec. T, N- W, Town of Mfr ru.!/�N Subdivision /t �� �' yGG , Lot # 5 Certified Survey Map # , Volume , Page # Warran ty Deed # 3 Volume ��9D . Page # 39) no Lot lines identifiable) — es ❑ 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 licensed pumper verifying that (1) the on -site wastewater disposal 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 d three y exp lion date. SIG 1 OF APPLICANT DA E OWNER CERTIFICATION I (we) certify t all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the pro erty described ve, y virtue of a warranty deed recorded in Register of Deeds Office. SI TURE OF 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 BS JERRY CiBILL E' - - -- - - -• - -- -1 _ JyO.232 P. 2i3 h � © 3 0 i JJJJ ��IaNny� J IF -JJJJJ JJJ JJJJ JJJJ JJ� JJJ_ BATH2 y LZ JJ JJJJJJJ ° - -J -JJ.J JJJ 1JJ - OPT. GLAS 0 - 0 ' J z ORS 4 ' - J.c °oJ ag Q J_J J_j I '� Z I Q o w i ^� JJ J � JJJJ .J s ° I Iv I V w V Cl o z 4 Cc v! p W W W Qn M�� m JJ J�ad JJJJJ„Jj w � Web ui N �ILI, N � v Q C -� am � 17C$ IM r TY /T7P NM '7(zgnI C ' 0� G'\ s ( ""'`` t -C-_ It rs s :' 2 19 0 P 3 9 0 71 5443 STSIT TSAR OF WISCONSIN FORM I - 1998 WARRANTY DEED KATHLEEN H. VALSH REGISTER OF DEEDS Document Number ST. CROIX CO., VI RECEIVED FOR RECORD This Deed, Made between _G3zeetlwood__Enterprises, Inc, -, -a- 04/01/2003 09:30AH Wisconsin Co -_, VARRANTY DEED -- - - - EXEMPT t and _._- 7•ndi_M- L ____.. -_ -___ REC FEE: 11.00 TRANS FEE: 80.70 COPY FEE: CC FEE: _----- _.___. Clalueo. PAGES: 1 I CI Grantor, for a valuable consideration, conveys to Grantee Lite following described real estate In t�..CroiX. _. - ___....... County, State of Wisconsin (toe 'Properly "): I o• „, hn I A.. Name a cl 11olmn Addross Lot of the Plat of NorthGate I I, recorded in the C. of the Register of De - r St. Croix county, Bremer Bunk, NA Wisconsin on June 20, 2001, in Volume 8 of Mats, at 532 South Knowles Ave i Page 55, as Document No. 648882. New Richmond,..,wl 54017 �I i 938_s _ a �i Parcel Identification Number (PIN( - - - - -- �I ! This __j5_Mt— homestead property. (is) (is not) �'• �i ii I. ii I I, I I II Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except L easements, restrictions, and reservations, if any, of record. Dated this - -, day of -__ - Mart:,I1_..- ------ - - - - -• -2003 ; D S , INC. (SEAL) (SEAL) * Jame E. R u:I_, President (SEAL) (SEAT ) - - - -- ' _.— r Ru sch, SeC1'IYeas AUTHENTICATION ACKNOWLEDGMENT Signaturc(s) State of Wisconsin, County. �i authenoramd this day of . Personally came before me this .__-_. _ /—r . day of March _ __...-20.03 —, the above named —Mary R..- Rusch. �eas TITLE: MEMBER STATE BAR OF WISCONSIN (If not, me known to be the person .`i__ yvtAAg,tecuyld the � authorized by §706.06, Wis. Stats.) _ instru ent and acknowledge the sa Q” 1 5 THIS INSTRUMENT WAS DRAFT ED BY S' z.. -- Mary.1Z._ Rusch.- .. _- - --- - - - - -- Sandra-'Gehrke L.Sr�- .. Nolar y Public. State of Wisr onwt _._New. Rlchti�I ,_- Vim_- S�1Z_--- --- .- _.____ ..._ My commission is permanent. (if ste N t"liNf� 1 Tlate: (Stgnuur,s may be authenticated or acknowledged. Both are not — S�pm4zer.._t, necessary.) ' Nams of persm,. si8ninµ in any canariry nu6I I. typed nr pdmrd bdl their stgnalnre. STATE BAR OF WISCONSIN ,vscwsm L Jl Blank Ca., I W WARRANTY DEED FORM Nn. 1- 1998 Milwaukee,'wis - 4 r- ^S z c o I—WQ= CY�-0 ... a M A 3 �-- • im T v� W I Q O J � AZUQ1- _ � �aa z Q >W co m OD J F- W 0% 4 Q O I cn 0 U p� Md f o N, Lo w, - II EE Z W M ZF-N z z M N W G/1 F- w O O p cnE-4 N �— N ° a z W 1— v, tn C3 N o ° SQN'd� Q311d -- N CD oaNJ¢ O I O cn a a ►_- 3 C o b/1 3S 3H1 30 b/1 AN 3H1 N .20'909 .88'jOL 3.LS�b CU M .LS.bZ.O S c0 9 88'091 100'011 100'091 7 cq a o� .PW , / o --4 CV? I o o ,ib'LST CD I � ifj�� ^ LT-- — — c 0o Z ( -, J W ,� -i ,00'06 1I M o ! % D �_ F- Ip C N N OD Dig z z 00 `'u M fU 3 N N 2 N N I ^' N o W I /'� - r, Li ' OC (IN wO �D (IN �. — _ I OD a) In (U a u J ____ _ _ Z - - - M °° t� aJ ,bT.O N z Z m �S Hl 8� j —'- 1 ,26'092 M o v co ON I c� v — ,16'0 b2 v> N a 0 Z I �0 LA- LJ lool I r. p • ° �, N� f r U c f W �I .� I Q0 O 2 ID_i Li 1 '– 0Z �I Wi i ( Q W � i-- I Ul , ION ` 'os W O Qi+' I = 00 O \ N 0 I - 8' — — ° CU I e I I z i a ' 1 n11 E� �E I_...; �N