Loading...
HomeMy WebLinkAbout038-1212-20-000 Wisconsin Department ar Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420744 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: Schmidt, David I I Star Prairie Township 038- 1212 -20 -000 CST BM Elev: Insp. BM Elev: BM Descrip it Section/rown /Range /Map No: I> ,5 13.31.18.1160 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark S 3 co - � Dosing Alt. BM -` C \ - �— AA Aeration Bldg. Sewer 7. Holding 77 S t Inlet Ta . TANK SETBACK INFORMATION St/Ht outl t p� 0 1 q-7. 14 TANK TO P/L /— WELL EBLD]G. Ven t to Air Intake ROAD Dt Inlet T Septic �/ / - 0 tS ` Dt B m Dosing He kr /Man. Aeration Holding - Final Grade PUMP /SIPHON INFORMATION sanc�`h ' -aa U ��/ / Manufacturer Demand St Cw r 3. O LOS. rp Model Numbe TDH Lift Fric i System Head TDH Fy For cemain Le Dia. 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 LDG WELL�J�T LAKE /STREA LEACHING Man ursr. INFORMATION T y O � f � Syst � em ,�,�� /► CHAMBER r ��6 fir^-" � ► � Y � © / _ h L� Model Number: DRKRIBUTION SYSTEM 22 G Heade anifold Distribuf(on ( x Hole Size x Hole Spacing Vent Air Intake i p Pipe(s) / w 1 , %T f y �G� (+ Length Dia �/ Length l Dia ''fT' '� Spacing hj2_1_ 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 q Bed/Trench Center ,S Bed/Trench Edges Topsoil `` C Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / 2 / 0 Inspection #2: / / Location: 1321 212th Ave New Richmond, WI 54017 (NW 1/4 SA 1/4 0 Unknown) Northgate II Lot 770 Parcel No: 13.31.18.1160 1.) Alt BM Description = 671 ' ( �JY— 2.) Bldg sewer length U3 - amount of cover = p / �! „ D �� �(, Plan revision Required? ,_Yes 0 �� I Use other side for additional information. — SBD -6710 (R.3/97) Date Insepctor' S' ature Cent. No. i Jane Hansen Subject: Sh Bird Northgate - 420744, Schmitt Location: Star Prairie Start: Fri 05/02/2003 9:00 AM End: Fri 05/02/2003 10:00 AM Recurrence: (none) Bring Laser 1 Safety and Buildings Division County !� l Vi scon s in 201 W. Washington Ave., P.O. Box 7082 82 Sanitary Permit Nt Madison, WI 53707 - Number be filled hod is by Co.) Department of Commerce (608) 261-6546 261 6546 1 4 20 1 1 Sanitary Permit App ' cado State Plan I.D. Number In accord with Comm $311, Wis. Adm. Code, personal i f nnatft may be used for secondary purposes Privacy IA ,.15.pp�d1 ft ' ` E D Project Address (il7differprit than mailing address) �.�. I a 1 a 1. Application Information - Please Print All Information I Ave /%T (L M AR 18 2003 - 1212- ow Prope�WQWner's Name Parcel # Lot # Block # ST. CROIX COUNTY S ILL '('1�C�C ZONING OFFI Property 's' Mailing Address j� Property Location t✓ i - Section City, State J Zip Code Phone Number ! of Building N; II. � or ng (check all that apply) us �w S S Subdivision Name CSM Number or 2 Family Dwelling - Number of Bedrooms ❑ Public/Conmercial - Describe Use ❑ State owned - Describe Use ❑Ci ty ❑Vi,lageV!'owmship o r P M. Type of Permit: (Check only one box on Hue A. Complete line B if applicable) A' Aew System ❑ R lacxment ep System ❑ TreatmeutMokh g Tank Replacement Only ❑Other MotiiScadon to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. of POWTS S stem: Check all that a pply) - Pressurized in- Ground ❑ Mound 2: 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In d ❑ Holding Tank ❑ Pent Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter - g Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersalffreatment Area Information: Design FI� Design Soi Ap lication Rate(g� Dispersal Area R (s Dis 1 Arya Proposed 1 ) ystan Elev /CL VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Talcs Talcs Septic or HoWing Tank �! Aerobic Treatment Unit X/ Dosing Clamber VII. Responsibility Statement - i, the un me responsibMty for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zi ) `' /t/tL"/ ('tJ 0 VIII. Court artment Use Onl Approved Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial JJ to 3 IX. nditions of Approval/Reasons for Disapproval - n /� -�- /� � �c 6 /W U. t M/T a�t•.tug/ CL4 tMt)NU'�- ,q-ll � t.Q,L .lot •.ww-� oa � c C&,%/&, 1"ce Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size SBD -6398 (R. 08/02) PLOT PLAN PROJECT David Schmidt ADDR4ess 602 Homes Ct. Osceola Wi 54020 NW 1/4 SW 1 /4S 13 /T 3 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 3 3 BEDROOM CONVENTIONAL XXX IN -GRO PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R.P. Top of 1 " PVC Pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL - H. R. P. Same as Benchmark 212th Ave SYSTEM ELEVATION 95.8 3.5' Below Grade Vent >6 » Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area Plans Designed Using Conventional Powts 6' Long 11 �� Manual Version 2.0 34 Grade at System Elevation � a a Pro 3 Bedroom House c� �U U 30' T 30' 2-3' X 69' Ce ith >3' Spacing > B -5 Vents 0% Slope 45' Vents 45' B -3 B -2 45 B -1 84 15 B.M. Alt 43' 53' 15' B.M. Property Line 5 PLOT PLAN PROJECT David Schmidt ADD_RZSs 602 Homes Ct. Osceola Wi 54020 NW 1/4 SW 1/4S 13 /T 3 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE3/17/03 BEDROOM 3 CONVENTIONAL X00C IN -GRO PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION loo' Filter Zabel A -100 ❑ BOREHOLE WELL O H.R.P. Same as Benchmark 212th Ave SYSTEM ELEVATION 95.8 3.5' Below Grade Vent AL ALo Standard Biodiffuser Leaching Chamber with 3 1. 1 ft2 of Area Plans Designed Using Conventional Powts 1 Manual Versi on 2.0 3 49) Grade at System Elevation I Pro 3 r Bedroom House N 30' T 30, 2 -3' X 69' Cells with >3' Spacing B -4 B -5 Vents 0% Slope 45 Vents 45' B -3 IF B -2 45 B -1 84 , 1 B.M. Alt 43' S3' 15' B. M. Property Line 5 r PR&ERTYOWNER Enterprises SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL LD. t 038- 1455 -20 70 N O, ' Boring # Horizon Depth Dominant Color Mottles Texture Structure Roots - G7P ' in. MunseQ Eau. Sz. Coat. Color Gr. Sz. Sh. Bed Teich 3 ]. 2msbk mfr gy if .5 .6 mfr Qw if .2 .3 Ground 3 28-84 7.5 r 4/6 none ms 069 mi na na .7 .8 elev. 49 ft. Depth to limiting - facW gS,8o +84 '. YY• � • Remarks: Boring # r ,41 0-12 I r 3/3 none 1 2msbk mfr gw if 2 12 -26 10yr 4/4 none sic]. icsbk mfr gw if .2 .3 Ground 3 26 . Syr 4 none ms osy mi na na .7; .8 9t. 5 �© Dept to -- s v i, a " + 84 11 Remarks: Boring # g'' 0 -11 10 r 3/3 none 2msbk w if .5 .6 $k } 5 11-28 lQyr 4 4 Ame sici lcsbk mfr if .2 .3 Ground 3 28 -84 7.5 r 4/6 none me 0ag — mi na na .7 ' .8 W smiting b +84v - Remarks: Boring # x - Ground Depth to ding Wisconsin Department of IndUstry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Dilision 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 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 -20 APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION R VIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Greenwood Enterprises, Inc. GOVT. LOT NW 1/4 SW 1/4,S 13T 31 N,R 18 IE (or) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1416 Third St. 70 na NorthGate CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [MOWN NEAREST ROAD Hudson, WI. 54016 115) 386 -3674 Star Prairie I 212th Ave. [Iq New Construction Use [ ] 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 .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) 95.75 ft (as referred to site plan benchmark) Additional design 1 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 I HOLDING TANK U = Unsuitable fors stem I R1 S ❑ U 11S ❑ U OCS ❑ U ( S ❑ U ® S ❑ U ❑ S [Nu SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botxxfary Roots GPD /ft .................. in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer>cFt ................. .................. ................. 1 0 -15 10 r 3/3 none 1 2 15 -30 !Dyr 4Z4 Ground 3 30 -84 elev. 9 9.3 ft. Depth to limiting factor 84 L ,V Remarks: Boring # ... 1 2 2 12 -26 10 r 4/4 none Ground 3 26 -84 7.5 r 4/6 none MS osa M1 -� elev. 99. ft. Depth to limiting t factor + 84 Remarks: r�.' CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Av ew Richmond, WI 54017 Signature: Date: 11 -9 -98 CST Number: m02298 PROPERTY OWNER Greenwood Enterprise SOIL DESCRIPTION REPORT Page of_3 PARCEL I.D. # 038 - 1055 -20 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITrench ....3.. 0 -14 10 r 1 2msbk mfr w if .5 .6 2 _lQyr 4/4 non sici lcsbk mfr Qw if .2 .3 Ground 3 1 28-84 7.5 r 4/6 none ms os . ml na na .7 .8 elev. 99 ft. Depth to limiting factor +84 �S Remarks: Boring # 1 0 -12 10 r 3/3 none 1 2msbk mfr 9w if .5 .6 4 ` "' 2 12 -26 10 r 4/4 none sici lcsbk mfr gw if .2 ! .3 3 26 -84 7.5yr 4/6 none ms osg ml na na .7 .8 ee G �� round 99 Depth to -- limiting factor +84 Remarks: Boring # 1 0 -11 10 r 3/3 none 1 2msbk mfr - w if .5 .6 5 2 11 -28 10 r 4/4 none sici lcsbk mfr qw if .2 .3 Ground 3 28 -84 7.5 r 4/6 no ms osg ml na na .7 .8 9 v2 ft. Depth to limiting factor 84 Remarks: Boring # Ground elev. ft. Depth to limiting factor t Remarks: SBD- 8330(8.05/92) I STEEL'S SOIL SERVICE Gar Steel 1554 200th Ave. �' Greenwood Enterprises, Inc. CSTM2298 NW4Sw4 S13- T31N - R 18w New Richmond, WI 54017 MPRSW -3254 town of Star Prarie (715) 246 -6200 lot #70- 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 C el. 100 Alt. BM.= top of 1 pvc pipe C el. 100.60 IL l o LT itq a ry � kv P Gary L. Steel 11 -9 -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. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 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 • i - Owner/Buyer Mailing Address 0- f Property Address a (Verification required from Planning Department for new constructio City/State Parcel Identification Number 07,8 -17 -12. — Zo �, Iltflo) LEGAL DESCRIPTION Property Location � 1�4, J d V4, Sec. , T N -RaW, Town of 5 cG f Subdivision ,/°./- ',;//, . Lot # / C� Certified Survey Map # . Volume Page # Warranty Deed # �s`f3`� , Volume Page # Spec house ❑ yesXno Lot lines identifiably6yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber or a 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da of the thr a year exVpiration date. 4� SIGNATURE OF 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 owner(s) of the property described above by virtue of a warranty deed recorded in Register of Deeds Office. r 3 /0lD3 SIGNATURE OF APPLICANT DATE * * * * * * Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with 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 21n Sl'A'I'E BAR OF WISCONSIN FORM I - 1998 705434 WARRANTY DEED XATHLEEN H. YALSH REGISTER OF DEEDS Document Number ST. CROIX CO., MI RECEIVED FOR RECORD This Deed, made between Greenwood Enterprises, Inc. 01/10/2003 03:45PH -a _Wi- 4:onsin _Corporaticn.__ -- - -- - - -- - - - - -- - -- - - - -- Grantor. REC FEE: 11.00 i' and � aK1f�L+ •arl[7 Norma S�hmic3t _ hncYvrnA arr7 _Wife___._._._ TRANS FEE: 74.40 II aS anrvisr ship_mar ital______prope y ----- _-- ----- - - - - -- i COPY FEE: 2.00 CERT COPY FEE: — - - -- -- --- -- PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in _ _____.St. Croix....... ___ —__ County, Slaw of Wisconsin (the "Properly "): H,vearlin,i MM Name and Return Ad ess ; f n s of the Plat of NorthGate I I recorded in the spy C3-no t� Its Office of the Register R_ Deeds for St. Croix County, !!; 4 � j Wisconsin, on June 20, 2001, in Volume 8 of Plats, ��5& LAS 7 O � at Page 55, as Document Number 648882. 'I - -- j Parcel Identification Number (PIN) l This i not _ homestead property. �I (is) (Is not) I� �I i� I I I , i I � Together with all appurtenant rights, title and interests. i Grantor warrants I at the lit le to IIit Properly is good. nwel vasible in fee simple and free and r]car of encumbrances om vI)I easements, restrictions, and reservations, if any, of record. Datcd Ihi, -� -- day of January. - - -- 2003 D F?VPF3t'1�F�6, INC.,' j (SEAL) lyM ' a (SEAL) — - - -- -. `• James E� Rus dens ii _ (SEAL) v __ (SEAL) » R Sec Treas I AUTHENTICATION ACKNOWLEDGMENT Signature(s) .- -_... — -- �--_ --- —� State of Wisconsin, SS. St. Croix _ __. County. JJJ /J authenocateci this day of Personally came before me this I c c _ day of January 2003 _. the above named !I Tames F R11--ch its President, and ! TITLE: MEMBER STATE BAR OF WISCONSIN (If not, Inc known to be the person !L_ _ who yCt�� YF rojf�M v� authorized by §706.06. Wis. Stars.) insVU nt and acknowledge the same. I ] C.1 '• THIS INSTRUMENT WAS DRAFTED BY c Mary R, R usch ------- --- - -fii- - Ski_ O a a Notary Public, State of Wisconsin New Richm ond, WI 5401 My mma ion is errn neat. l alj+eX )rr f�la �d R 4 � (Signatures may be authenticated or acknowledged Both are not necessary.) ' Names of persons signing in any capacity muss be typed or printed below their signature. '! WARRANTY DEED STATE BAR OF WISCONSIN w,sconsin Legal Blank Co., Inc. FORM No I - 1998 Milwaukee. Wis. 1! \ \ A I s I w I W N N w A C v D �I z n o W k^ 0 N O W r rl o of o � j A .� Q` 0% o i �' o 0 , yo o in N\� h o Z \ v �,0 o 4,� b 4,y� ;� I N 3 E 294.20' c c �j, �� ; I I ARC 200 q'PC I' r I ! •`�' I � � \,\ c CD O� I � I I 279 I H °., I m 33 33 N 0'52 M I I ' " I 229.61' n 1 I I I � � I I _ — l N 0 E 295.02' I ro I I o iv � I �-- I I o I ° c i; I I� ,-C w o w v ry I I to, .� 13 00 0 0 I (�'} co v yr : o 0S ; D o 1° N W Q I v Z I I I Id (Il m o I 229.40' ID ;p ' No•2,S7'E cn .� I I N ( ao ;:r, I Ul v I ° I CO I N 0 '34'E R; o o r 10 o f 279.40' D �►TI, 1 1 c ° 211-23 I C) I "' J ; 170 ;o 1 °�,° 0'24'57' E 296.23' 1 £ ru iJ °O rri 1 ± O A ;]> e I- +. i ;d ty r%) 0 fUICO — I ro � CD Im I� D Nei N o A�'' Q1 N .10 w0 I I – N %0 c W �0 I `o � %0 W ! 1. l z Vi c , M %D N .� I GO 0 I I z I m I D I I N 0 2 b` I z I I I i o O ; I Drn I I I n I o m N 0 E 1 297.44' 1 I ro — M M 212.4 4' I o o0 Z I I o I W 00 cn o 6� 00 OD rU L; ""� _w I N I I A � 1 �� N 3 O A 00 � -• I p 0 0 I I Z V 0 O M Ln 0 0 -� C: W ° .� < ° o ti `� \� I `o I N 0 2 _ m I c I 100' —i- z a --100 1 ( s � o i o N 0' 24' 5 7' E 298.6 ! N ?Q'__DR EA MENT I 1 _. N I