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HomeMy WebLinkAbout038-1211-90-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430218 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)]. Permit Holder's Name: City Village X Township Parcel Tax No: LeQue Builders LLC I Star Prairie Township 038 - 1211 -90 -000 CST BM Elev: Insp. BM Elev: BM Description: Sectionrrown /Range/Map No: v c.;.. CC 11 k*- C S 13.31.18.1157 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark E.•t,ic � � c� 1 G. c CG 6.71 /C�, .7 I , c c. oG Dosing �� !CC% Alt. BM Aeration Bldg. Sewer 5, Og /� I G, Holding SVHt Inlet TANK SETBACK INFORMATION SVHt Outlet ot 5 4- 7 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet p /!'�� 7 �, ! e _ Dt Bottom Septic Dosing Header /Man. Aeration Dist. Pipe s E s L .'S'� ' i Holding Bot. System 4 1. y 1 c l - 7• 3 Final Grade PUMP /SIPHON INFORMATION 6 - ( -(. /a / . Manufacturer Demand St Cover GPM 4.23 for • `� Model Num r NE q , qo ' SYiS NW `i.'fl `) 7. j TDH Lift riction Loss System Head TDH Ft Forc ain Len( th a. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG FELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR c Z �I u u - S Type Of System: C c� n l., Q L` UNIT Model Number. A � " h 4s C3� a'_� „- 9 C � t H DISTRIBUTION SYSTEM a `�," Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake t Pipe(s) b .s- T Length O Dia � • Length Dia —" - 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 es ..� Bed/rrench Ed iTopsoil 9 _ - @ Yes A No Fn_ Yes COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: I / 24 / G 3 Inspection #2: / / Location: 1335 212th Avenue New Richmond, WI 54017 (NE 1/4 SW 1/4 13 T31 N R1 8W) Northga�t / e� II Lot 67 Parcel No: 13.31.18.1157 1.) Alt BM Description= :Sr. Cam. 2.) Bldg sewer length = 11 (c - amountofcover= i" Plan Use other i side for u additional n Yes No b �,/ - -- /, -- SBD -6710 (R.3/97) Date I ctor's Signature Cert. No. Safety and BMMngs Division County ` JIM 201 W. Wasbiagtos Ave., P.U. Box 7082 V n C IlVi sconsin M"son, WI 53707 — 7082 Sanitary Perv oNumber �(to be filled in by Co.) Department of Commerce (608) 261 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Win. Ada,. Code, personal iaf ease o you provide maybe weed tot sacotday purpose Ptivtw'y Law, a15.0e( })(an) Project Address (ifdiffetent than tailing address) I. Application Information - Please Print All Information 13� Property Owner's Name Psral Lot # Block # QQ � Property Owner's Mauling Address ''d 11M t �,k Sectionn 1 3 City. s Zip Cale Phone Number �et�s 4�T W� S o 7 S II. Type of BuUding (check all that apply) T N; R j - E i 4 S S Subdivision Name CSM Number Vi or 2 Family Dwelling - Number of Bedrooms ` ❑ PublidCammarcial - Describe Use p, t ❑ State Owned - Desmbe Use 3 V, OCRY VTownahrp of c, m, i I a III. Type of Permit: (Check only one box on line A. Complete Use B if applicable) A. New System ❑ Repis ,-M System ❑ Treamxnt/HoWing Tank Replacement Only ❑ Other Modification to Existing System B• ❑ Permit Renewal ❑ Permit Revision ❑ Chaumge of ❑Permit Transfer to New List Previous Permit Number and Dade issued Before Expiration Plumber Owner ( IV, TM of POWTS Systena, Cbeck an that a 4 v� K Nan - Ptessud-ad (m -Ground ❑ mound > 24 in. of suitable soii ❑ < 24 nn, of suitable soft ❑ At -Grade ❑ Single Pass Sand F' a Constructed Wetland ❑ Pressutiud In- Gtouud ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Rec=ulsting Sand Filter ❑ Rec—lating Synthetic Media Filter ❑ leaching Chamber ❑ Drip L ne Gravel -less ❑ Other (explain) V reataleat Area Information: @ L . , ` an.S Design Flow (gpd) Design Soil AWlicabon RaWds1) Dispersal Area Required (sd) Dispersal Area Proposed (d) yo m Elevation �70D 7, VI. Tank Info Capacity in TOW N Malluflicturer Prefab Site Steel Fiber Plastic Galkms Gallons of Units Concrete Constructed Glass New Exictima Tacks Tado ✓ sepmic Notmbag Tank per 0 . Traanoaet Unit Doci%Chrmbx VII. R adbUlty Statement- i, the atndea:ig an biHty for of the POWTS shown on the attached plans. P s Name ot) 's Si PR T Businm Phone Number S G S ! 3S Plumber's Address (Street, City, State, Zip Cods: �,�`` �v N. t c mo c�, ..r s v 1 VIII. c oup rtatest Use Onl Approved ❑ Disapproved Sanipuy Permit Fee (ieltndes Groundwater Date issued �Issui Signalme o S ) Surcharge Fee) qe ❑ Owner Given Reason fa Denial 2SC� 1 2 IX. Conditions of ApprovaUReasoss for Disapproval c _'} � ,L�• - �lMr� [/ ate ,j Attach css Vieft plans (a r Csaaty only) for the tysaaa nb paper eat tea aua stn s ri 1■ ter le eta ( (x �' S$'W -63 8 08/02) ��`�. / �• sue � . C� I , I ! I \ CIS. � ( � N � - �� OQLS , �ST rip , 63X ! , , ! J _ c� I I r ! .. c �QO l I V / 7 , I I I - I - - I I I I i I I , i I ! ! i J _ I ' I I I _ Q! -- -- -- : ; J � : • 3 , , , , d _ - - -- - - I + fi i -- - - Af(A , I • : : , - - - I , i I f , i rJr�� ��F trr - C�lie��+PrS �1. . �l i f S(r;,��� St :IT 39� ia A li 7 -/O �, �f`C�`c (` 5 T C ro zo,,Z6 CZA (Oc A, 13 T� 7ef � s w a.� ��- -= a la's^ -�-• ---/ ✓ y Q _ as , o c �o __ __ _ _ � SWL AND 511TE EVALUATION REPORT Page? d 3 t>Mrigien of safety a Buildngs in accord with ILHR 83.05, Wis. Adm. Code r COUNTY Attach complete site plan on paper not Gass than S V2 x 11 inches in size. Plan must im gwds, but St. Croix not limited to vertical and horizontal rOwence pant (SM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dietwvs to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION 8� o PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT NE 1/4 SW 14,5 "I T 31 ,N,R 18 lkorl W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # SU80. NAME OR_ CSM # 91 67 na NorthGate CITY,-STATE ZIP CODE PHONE NUMBER DCITY []VILLAGE =2 EST ROAD New Richmond, WI. 54017 (115)246 - 7071 Star Prarie th. Ave. * j New Ca►sirtction Use lx) Residential / umber d bedrooms 4 ( j Addibon tD existing !wilding C 1 Replaoerro t C 1 PLOAC Or omwwdw destxibe Code derived daily flow gpd fieRwMded design ding rate sZ_ _ bed, gpd* s 8 Vench, WO Absorpbctn area [squired Q58 bed, fl 750 _ 2 um design Ioading rate —L 2 bed. gpW ` � $_trench, gpd* Recanmended kAlradw surfae eletrathn(s) ft (as relemed to sibs plan bencftr wk) Additional design 1 silo consideraborw Parent material outwash Flood plain elevation, it applicable na d S •.8U tMlla lot SySbM CONVENTIONAL MOUND *WUND PRESSURE AT- GsRAOE sy sTEM N FLL MMOMIG TANK u - unsbbe uim sir bem ® s o u ®S o u ®S o u as o U t3 s o tf ❑ S $I U SOIL DESCRIPTION REPORT Boring * Horizon Depth Dominant Color Mottles Texture Sere CW SMoe Bwtoy Roots GPD/ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tonch E 1 0 -9 10yr2 /2 none 1 2csbk mfr Cs If .5 06 1 2 9 -20 10yr4 /4 none sicl icsbk mfr 9w If .2 .3 Grotxid 3 7.5yr4/6 none ins Ogg tal na na .7 .8 imp JZl1 to % i Remarks: Boring # 1f 1 0 -11 10yr2 /2 none 1 2c mfr 9w .5 sshk .6 2 2 11 -23 10yr4/4 none sicl lcsbk mfr 9w if .2 .3 3 23 - 84 7.5ry4/6 now sirs 069 ml na na .7 .8 Ground slew, 1 lo binAflng fader +84" Remarhs: csT Name: — Please Prim L. Steel Phone: 715- 246 -6200 Addrm: 1554 200th. Avae RiLfMoA 30 54017 Staaawre: / �— f"1 flat o.- e_W nn err *r...- d&!-A. - Jk%'1M Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Divisior,?ff,Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code .- COUNTY Attach complete site plan on paper not less than 8 1/2 x 1 L ize. Plan must include, but St. Croix not limited to vertical and horizontal reference point , direcb n d o f slope, scale or PARCEL I.D. dimensioned, north arrow, and location and dista a n earest roa 038 -1 - APPLICANT INFORMATION - PLEASE P T ALL I ��,g TION RE IEWE BY 4 1AT PROPERTY OWNER: PRO RTY LOCATION In � 1 GOy LOT NE 1/4 SW 1 /4,S 13 T 31 N,R 18 5c or) W Greenwood PROPERTY OWNERS MAILING ADDRESS j !CRO L074 BLOCK # SUBD. NAME OR CSM # 2Nr na NorthGate CITY, STATE ZIP CODE `. H'O Fil�'6 ITY ❑VILLAGE EROWN NEAREST ROAD New Richmo WI. 54017 a.5) -7071 Star Prarie 212 th. Ave. ] New Construction Use [x] Residential/ Number " o - 4 [ ] Addition to existing building (] Replacement [ ] 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 .7 bed, gpd /ft .8 trench, gpd /ft Recommended infiltration surface elevation(s) 97.30 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 ®S ❑U CAS ❑U CAS o ❑S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerch 1 0 -9 10yr2 /2 none 1 2csbk mfr cs if .5 1.6 2 9 - 10yr4 /4 none sicl lcsbk mfr gw if .2 .3 Ground 3 20 -84 7.5yr4/6 none ms Osg ml na na .7 .8 elev. - IM ,ft7 Depth to limiting factor +84 Remarks: Boring # 1 0 -11 10yr2 /2 none 1 2csbk mfr gw if .5 .6 2 2 11 -23 10yr4 /4 none sicl lcsbk mfr gw if .2 .3 3 23 -84 7.5ry4/6 none ms Osg ml na na .7 .8 Ground elev. 1 Depth to limiting factor +84" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Av New Richmond 54017 Signature: Date: 4 -24 -99 CST Number: m02298 I l PROPERTYOWNER Greenwood Enterprise SOIL DESCRIPTION REPORT Page __2_of` PARCEL 1.134 # 038 1055 - Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounclary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -11 10yr2 /2 none 1 lcsbk mfr cs if .4 .5 3:'" 2 11 10yr4 /4 none sicl lcsbk mfr gw if .2 .3 Ground 3 25-84 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 100. 91. Depth to limiting factor Remarks: Boring # 1 1 0 -9 10yr2 /2 none 1 lcsbk mfr cs if ................. ................. 4 2 9 -22 10yr4 /4 none sicl lcsbk mfr 9w if .2 .3 3 22 84 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 100 --7 ft. — Depth to - limiting factor +84" Remarks: Boring # 1 0 -12 10yr2 /2 none 1 lcsbk mfr cs if .4 .5 2 12-22 10yr4 /4 none sicl lcsbk mfr gw if .2 .3 3 22-84 7.5yr4/6 none ms Osg ml na na .7 !.8 Ground efev. 1 Depth to limiting factor Remarks: Boring # Ground �lev. 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 NE4SW4 S13- T31N - R18W New Richmond, WI 54017 MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #67- NorthGate This soil evaluation was conducted to satisfy a zoning requirement, it may 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 1 pvc pipe el. 100.00 Alt. BM.= top of 1" pvc pipe C el. 100.70 f 4-5 C Q.� 0 l F lo Gary L. Steel 4 -24 -99 ` CO Aggregate SAS f�Li w� • G7 SYSTEM ELEVATION AND SIZING CALCULATIONS Below Grade Aggregate Soil Absorption Systems Permit Number 7/18/99 Date X "x" Gravity Distribution only 1 Pressure Distribution 3 ft Suitable Soil 1 6 in Aggregate Depth 2 4 in Nominal Pipe Diameter 600 gpd Estimated Daily Peak Flow 0.80 gpd /ft Wastewater Infiltration Rate 750.0 ft Minimum SAS Size 97.30 Ift Proposed SAS Elevation Soil Surface Acceptable Finished Grade EL 3 (ft) Boring Grade Limitation SAS Elevation (ft) System Minimum Maximum Number Elevation (ft) Depth (in) Lowest THighest Elevation? 99.80 101.63 1 100.70 84 96.70 99.20 Yes 2 101.30 84 97.30 99.80 Yes 3 100.90 84 96.90 99.40 Yes 4 100.70 84 96.70 99.20 Yes 5 101.30 84 97.30 99.80 Yes 1. Depth of suitable soil required below the infiltrative surface for treatment. p q 2. Depth of aggregate below distribution pipe. 3. Based on chosen system elevation, and aggregate depth. The addition of fill for cover or the reduction of finished grade may be required to meet minimum or maximum code standards. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. SBD- 10553 -E (R.05/98) � C i E Z 12 03H rR } }r 4" rrr - err } } } rr w rRr !' f rrrR _? ` Iry Ia,t WI, a. t f rr }}► * Rs rr ►♦ Rr► ♦IF his I h w w *v . 112 1 , V • } r}Rr• i rr jg .. •Rrr } ♦si r► ►r} r }r }r ?* +e IF ,'� l ►} rr r}r • }r Rr } r rr — ` - 36" ` 1c�-I f7et D� t .FY , !J p 1 ye7af CaeHfic� � � ' 1 j 8 '+'�u u s7.�x Q,U � ,� a Qft� P'P" V vo1 5rdc� It f2 g $ EL a - - rff f r 4 (2 3-- i = +de*+afls) ' l ll: ' 1 t 12i1R � �Q.if {. l��' = J,i.e 1 Qf ¢slat c?'t+Qdi" ,e R.3 "t" ( �ottOm f 8 of emu, ca.g Totat { ( ssif /star of auC J 7e- „ 5.14 ${,.p.F°p' t 6 e�citr3 . 12 boon' s & VOW '.JV' nC M oQQdt e I t 1 F rOJcctcd Tr l I2rq r fi J -5 to 901 ft' c'se0 A... I E Vold , ro l es u � bA itkr ad( rysjg { 1 -- i i )`Ornrfr;� � ��_ 2.00 $y•I't. t j t lma V Qlr�ec at flwrry 12wrR +�'f 7.ry� t3 h� t►:t3 fi• 3b ire = 3 QQSQ.Ft. i fQ4a OM °mac 411- Qf uord v� - Proleclted Treae6 ruts "a 0,1 17 r �Crwesta c >It! Sa,pt Q.<22 t (1,yQ .- Y�+sl 0,211 - U log ft' L+at1r pa 76J X a 4,3 ,- T '0.213. Q'$03 @ t 7W c+tac ft t fl I i i JP i EPs Aggregate Trench System E ' 1 2a3H 6 i 9 IndUatriCd P ar* Indust riQi Grou p O w OaklOnd � �O6Qi�t� !!! j �EIET: r o f r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / ar :;LE NWC ~TtaN sirs llt WEt:'MAT ��.. ON Owner ` �. Tat~ic I�fanufactwer '�' S Prarrr�it # 3 p a 8 g( septic O Dose O Holding vol. 000 gat Tank NAlru#rtufacturer O NA h]I 11 PARAIIi T ms t4umber of Bedrooms 3 0 NA 0 septic El Dow 0 Holes vol. gat F Units © NA Effluent titer Mwwfecturor O NA Number of Public Fa cility »led ©� � Model A i o- Design ipeahc) flow = (Estimated x 1.5) pump ManufaeEzser O NA Sent A Refte Pump Model Manthtl► �# t�rertreaterreM unit 0 NA Standard k fktenVEf t nY 0 Peal filter Fats, Oil &+Grease (FOG) 530 :n9r- O So " Aeration O Wetland Siodmnical Oxygen Demand (BODJ 5220 mg/l. O NA O Mechanical Total Susp reeled Sow tTSS) S360 mg/! O Disinfection O Pretreated Effluent QuatitY Monthly average manufacturer Dispersal Celltsl O NA Biochemical Oxygen Demand iBOD,) S30 mg/l. IO M-t�iro d l�swiz'd1 Total Suspended Solids fTSS) 530 "V/L O NA Kln- Ground th y) Fecal Coi'rform (geometric meson) %IW didlOW9 O At: Grade 0 Mound �n ells. C] NA [ Drip - ire l3 Other: Maximum Effluent Particle Size Ya ❑ NA O NA •Values typlrsel for domestic wastewater and septic tank effluent. other: O NA MAg1tTF.It1ANl�£ Sil.E s Eve F m7orrthi6) j 3 yam) O HA �pect condition of tankts) At least once every: s) When � sludge and scum equals one -third tY of tank Volume 0 NA imp out contents of tarlc(s) 0 When the . high water alarm is activated O month0d tMaxknum 3 Years) O NA inspect dispersal tadlts) At least once every. Marts) ❑ month(s) Q NA Clean effluent fitter At least once every: � s) O month(s) O NA Inspect pump, pump controls &alarm At least once every: p s) El monthis) O NA Hush tatends and pressure test At bast once every: p arts) O rnaesthts) C3 NA At least once every: O s) O NA MANTENANGE INSTRUCTIONS ons: Inspections of tanks and dispersal cells shall be made by an individual carrying one of the followin licertis O for tpumes or certificatio0s: Master Plumber, Master, (ember Restricted Sewer; POWTS Mapector: POWTS Maaintakrer; Septage Sen'icing P of the tank(s) to identify any rn�^g or broken hardware. y anY cracks or a visual gr ound Panic. inspections mus include m�pecttor► of effluent on the gr leaks, measure the volume of combined sludge and scram and a deck for any back ► or pondtng tion pipes a rW to check for any surface. The dkspwsal Collis) -shall be visually w inspected to check the effluent lavels in the observe ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a fa&V °condition and requires the immediate notificadon of the local regulatory authority. When the co mbirted accumulation of sludge and scum in any treatment tank equals one -thkd iY,i or more of the tank volume, the Mire contents of the tank shag be removed by a Septage Servicing Operator aced dispose of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanic or �xessurized components, pretreatmerr units, and any servicing at intervals of S12 months, shah be performed by a certified POWTS Maintainer. A service report shad be provided to the local regulstory authoritY within 10 days Of completion of any service event. GMW 121p21 START UP AND OPERATION page of For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products, solvents or other cdeernicals *M may Irnpede the tfaegrwnt process and/or damage this son dispersal cell(s). It high canceretratrorss roe detected have the contents of the tank(s) removed by a sep tadige servicing operator Prior to use. System start Up shall not occur when sod corm are frozen at the Infr7Eretive surface. During extended Power outages pump tanks may fill above normal laghwater levels. When power is restored the excess wastewater will be discharged to the dapersal eeli(s) in one large dome and may Overload theme resulting in the backup or surface discharge of effluent. To avoid this situation ham the contents of the pump tank removed by a Septage SwWcmg Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the purnp ooetrals to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area Within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms: cotton swabs; degreasers: dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable P0611+'98: gases: grease; herbicides; meat Painting products, per• sanitary ice; tampons; and water softener brine. scraps: medications; oil; ABANDONMENT When the POWTS fads and/or is permanently taken out of service the following steps shall be taken to insure that the system is Properly asecf safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrath4e Code; • AN piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be rerreoved and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shag be excavated and removed or their covers removed and the void space filled with soil, gravel ar another inert solid material. CONTINGENCY PLAN If the POWTS fads and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system. A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area slwcdd be protected from disturbance and compaction MW should not be infringed upon by required setbacks from existing and proposed starch", lot lines and wells. Failure to protect the replacement area will result in the need for a new sod and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback andfor sot! limitations. Barring advances in POWTS technology a holding tank may be Installed as a last resort to replace the faded POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and atVrade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface_ Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEp"TIC„ PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL. GASSES AND/OR INSUFRCIENT OXYGEN. DO NOT ENTER A SEPTIC. PUMP OR OTHER TREAT&gM TANK UNDER ANY C"WA RYISTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS TALLER POINTS MAINTAIiJER Name ` -p- rS Nam Phone t S Phone SEPTAGE SERWOM OPERATOR (PUMPERI LOCAL REGULATORY AUTHORITY Name Name �T J`c3 `i h Phone Phor>e f This document was drafted by t he staffs of the Green take. Mannar m and Wa idwe County Zoning and Sanitation agencies in compliance with chaow Comm 83 . 2 2(2)(b)(lltdl &(f) and 83.54{11, ill b (3). Wisconsin Adrniniatrative Code. f - ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICA FORM t Owner/Buyer e 0 `t Ct; � Ve C C ,1� � rS L LC,,, Mailing Address 1 4 -7 6A a S Property Address a_` (Verification required from Planning Department for new construction) (� City /State Parcel Identification Number - �t LEGAL DESCRIPTION Property Location � V., -S W %, Sec. _l _ �_, T :3 LN -R-)-LW, Town of tet r �. Subdivision �or`��. r�o ,JJ-� , Lot #�� . Certified Survey Map # , Volume . Page # c Warranty Deed # - 7 ,1 7 Volume -. Page # � . Spec house qq yes ❑ no Lot lines identifiable a yes ❑ no SYSTEM MAiNMANCE Improper use and maintenanccof your septic system could result in its premature failure to handle wastes.. Propermaintenance consists of pumping out the septic tank every three years or sootier, 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-sim wastemniterdisposat system is in proper operating condition and/or (3) after inspection and pumping (if necessary}, the septic tank is I= than 1/3 full of shkAge. *r'c e read the above requirements and agree to maimtam the private sewage disposal system with the standards the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Ccd fimtibn tem has been maintained must be completed and returned to the St. Croix County Zoning Office within 38 iration date r c✓ IGNA OF APPLICANT DATE OWNER CERTIk'll TION certify that an statements on this form are true to the best of my (our) knowledge. 1 (we) am (are) the owner(s) of the described above, by virtue of a warranty deed recorded in Register of Deeds Office. r F� &GO ATURE OF APPLICANT DATE • * *• *' Any information that is mis- represcntedmay 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 trap if reference is made in the warranty deed �I j 2 2 8 8 F 0 8 9 - 7 a STATIi BAR OF WISCONSIN FORM I - 1998 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS Dxument Number ST. CROIX CO.. WI RECEIVED FOR RECORD This Deed, made between Greenwood ELntgrprjpes Inc, 06/25/2003 11:55AN Wisconsin o ation h WARRANTY DEED EXEMPT # Granter, i ii and FSria ­IA- TT REC FEE: 11.00 J TRANS FEE: 68.70 COPY FEE: 2.00 ----- -- CC FEE: Grantee. I PAGES: 1 I i Grantor, for a valuable consideration. conveys to Grantee the following described real estate in t-- rroix County. State of Wisconsin (the "Property"): Ne., Name and ROILJ[n Address ';,-" Lot ,f),Vof the Plat of NorthGate II, recorded in the cl 7 C ,,0 1 , 1 krj /2 p9 L, T,7 t6 �ice of the Register of Deeds for St. Croix County, 41 C/L)" Wisconsin, on June 20, 2001, in Volume 8 of Plats, ati Page 55, as Document Number 648882. (,Us' J 93 -a _038-1911-90- Parcei identification Number (PIN) Thi is not homestead property. (is) (is not) I I Together with all appurtenant rights, title and Interests. Granter warrants that the title to the Property is good. indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, and reservations, if any, of record. Dat ed this, 6— day of .Tune ES, I l (SEAL) (SEAL) ii jarrips F. Rn (SEAL) (SEAL _.SecLTreas_. AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, St. Croix Co authenticated this day of ---. Personally came before me this day of 2003 the above named j Jnmes 'F_ Rusch, its Pre-si a RuStcb,­UR 0 4-r�f­_ Ac fZ TITLE: MEMBER STATE BAR OF WISCONSIN ((f riot, me known to be the person S_ A�EA�dliecl tlZe fo re i riy f authorized by §706.06. Wis. Stats.) instrum d k I ac now c d ge the sat •'C 0 THIS INSTRUMENT WAS DRAFTED BY Mary R. Rusch Sandra Gehrke Notary Public, State of Wisconsin -- --- -- "e Richmond, _WI, My commission is permanent. (if riot, state e (laic: (Signatures may be aullicillicaled or acknowledged. Both arc not —September STATE BAR OF WISCONSIN W,scws,n Legal Blank C 1- WARRANTY DEED FORM No, I - 1998 M.'_u'aa. W.s Q „r' \ r o Loi t i w X a, I i I ~ I _ I I r - vi Z MI 0 og 2 _ I W o N I o I N ►,. I I - 3 14 i G _ I Z c - .w: 3• NORTHGATE II t of We SWIN and in part of Yrc MEIN of the SW IN &W in pwt of the NW U4 of the c 1 of the Pisao( NQdhGdc, as moordal in Volume 7 of PWs. Page 46 of the St Croix t0007CN S M'CH y din Section 13. T31K RIIIW. Town of Star Pmiria G SL oix County W"co 1013 1 sW Mtl Ave V 7Rlrl8 E I/4 CORNER SECTION 13 1 T31N. RIBV RoeHttstu LEGEND 1�T 8 — 210 th — SECTION CORNER MONUMENT FOUND 1 V ALUMINUM CAP _ � F Y X 36' RouND IRON PIPE WEIGHING 2t )AS LBSIFT. SET 125• IRON PIPE FOUND SCALE IN FEET i• IRON PIPE FOUND al IT unuTY EASEMENT PARALLEL WITH i P 0 100 200 300 n LOT OR RIGHT-OF-WAY LINE " ` gG011►s E Rttdt RLS 01376 BUILDING SETBACK LIN&WIDTH SHOWN V u < ertical Dattrrt b U.S.G.S.1929 Adjmf6nent. e8i stercd Wiseanin Lind Surveyor �yn L PONDING OR DRAINAGE EASEMENT LINE � � Dated this 26th day of Febnnry 2001 �� RWCO � ALL OTHER LOT CORNERS ARE MONUMEN TFD ° ; aa^ C WITH 1• X N• ROUND IRON PIPE WgGHlNG 1.68 L8SJFr. 30 m 29 36 _ _ „ W n 3S N W 32 n N 34 W I 33 o r n • O „ � IU 2 C G j z z _ I b NO ATE z z Is o z V_ol Pl tS; Pa�e_46 w ttauc s tt E casCW 9 7 00 • zsao N89 � 213 .00' 191.00• 58.00• 133.00' 7'�' 183.00' 209.00' :� 190.00' • ,29.00• 160.00 7 9.00• 111.00• 4 b 200.00' ?� i 209AW 225.00• 209.00' a 238.00• N F22W miWCila TMMGC _ 8.8 23080' Is ^ N ii N N n A 7 2— 4.8 r : ^ v - 45 46 Y I q 42 N :N 43 a:as 44 W _ $ i — — — — — — N rr — — — — — ly — — z z 8A4• N Z Z Z $' I 41 — •114A7 — 200.00— — 200.00— 209.00•— — 207.47 ° ' . ' ' � ST�atY '00' 270.00' ' ry u - N 89 V 930.96 �_ �' tlo _ — — 212 26 '� AVE. —� HjO. aC � i 63.95' --180 — — — — 26105 . � / 4 S 89 E 930.96' © g u — 178.960- - -- - -- 207.00• - - -- r - -- 203.98• - -- - - - 2 -- . 127 .01 --- 15• f i / N � h n• � � � t � -� iff h 64 0 171 70 69 N 68 n " 67 „) 66 65 z z cu c S 88'30'32• E S 6650'52• E N S 88 E E _ _ 97 78gY 205. 207.80 z Y = S 88'50'52' E 1927.33' POhptG AND BRAPOK ".. VAL Qtr as dTt°r non M [ASE . � 207.37 0.00' 195.00' 137.01 1 205.99' BMW 157.39' 21&65• 180.00' t - 88'50'52' E 1 14 \ is 16 I c_S FL far COUNTRY_MEADOWS FIRST ADDITION OW.Lt ---' - / VOL. 3, P. 739 VOL. 6 O F_PtATS_ - P ^ �2 1 Oreettmaad Entapises, toe. J9•s , 1 2141 C.T.H. •'C GENERAL NOTICE STATEMENT: The polmis shown on this plat we sutica to Stall. County New Rk -and. WL 54017 rd TowmNp 1nw4, tula and te`ulatlons (I .e, —lands. minimum kK sia. aooea b peal «e.) J i Before purc og ordry k VM arty peal, comact the St. Cotx County Zotdrtd OIEce and the SURVEYOR: apptoprime Town Board for advice. This sutcmen paw this plat at the direction of the SL. Ste Iq b / Cm& Cemty Planing. —ind and Parks Comminee. latnoo E Rursdu �• j % 2141 County Road C New RioheM& WL $4017 This Inmumern dmllcd by Junes E- Rush Sheet 1 o(3 shoots Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division 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 BM direction an to scale or PARCEL I.D. # not limited to vertical and horizontal reference point d /° of s Po � ) � P e dimensioned, north arrow, and location and distance to nearest road. 038- 1055 -10 APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION R VIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Greenwood Enterprises, Inc. GOVT. LOT NE 1/4 Syj 1/4 13 T 31 ,N,R 8 EAo W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK# SUED. NAME OR CS JS� 1416 Third St. 67 na NortbCatt u CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE gROWN NEAREST ROAD Hudson, WI. 54016 U15) 386 -3674 Star Prairie 212th Ave. [:4 New Construction Use [ J Residential / Number of bedrooms 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate - 7 bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 95.90' 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 ® S El ® S 1:1 U ®S ❑ U ❑ S lau SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed 7Tw& .................. ................. .................. ................. .................. 1.. 1 0 -18 10 r 2/2 none 1 lcs k mfr aw - 2 1 18 -36 10 r 4/4 none sicl lcsbk mfr C1W if .2 .3 Ground 3 36 -84 7. elev. 99 ft. Depth to limiting factor +84" Remarks: Boring # 1 0 -12 10 r 2/2 none 1 2 12 -30 10 r 4/4 none C-1 lrqbk mfr jZjW if -2 3 Ground 3 30 -84 7.5 r 4 elev. 1 9 9.7 ft. Depth to limiting f factor + 84 1. Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Met, New Richmond, WI 54017 Signature: Date: 11 - 9 - 98 CST Number: m02298 PROPERTYOWNER Greenwood Enterpris SOIL DESCRIPTION REPORT Page ..2 PARCEL I.D. # 038 - 1055 -10 ' Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft ................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed JTrench _....3. 1 -12 10yr 212 n ie 1 lcsbk mfr qw if .4 .5 2 12 -25 10 r 4 4 none sici lcsbk mfr qw if .2 .3 Ground 3 25 -84 7.5 r 4/6 none cos 0SCI ml na na .7 .8 elev. 9 9.4 ft. Depth to limiting facto Remarks: Boring # 1 0 -12 1O Zr 2 2 none 1 lcsbk mfr w if .4 .5 ' 4 >« 2 12 -29 10 r 4 4 none sici lcsbk mfr 9w if .2 .3 Ground 3 1 29 -84 7.5 r 4/6 none cos 0SQ ml na na .7 .8 elev. 99.4 ft. — Depth to limiting factor +84 Remarks: Boring # 1 0 -12 10 r 2/2 none 1 lcsbk mfr w if .4 .5 5 2 12 -30 10 r 4/4 none sici lcsbk mfr QW if .2 .3 Ground 3 30 -84 7.5 r 4/6 none cos osg ml na na .7 j .8 elev. 99.9 ft. Depth to limiting factor +84 Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) f STEEL'S SOIL SERVICE Gary L. Steel Greenwood Enterprises, Inc. 1554 200th Ave. CSTM2298 NE4SW4 S13- T31N - R18W New Richmond, WI 54017 MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #67- NorthGate This soil evaluation was conducted to satisfy a zoning requirement, it may 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. J N 1 " =40 1 BM.= top of 1" pvc pipe C el. 100 Alt. BM.= top of 1" pvc p ipe C el. 100.60 �A� .� N 4 44" i Gary L. Steel 11 -9 -98