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HomeMy WebLinkAbout038-1205-70-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453177 0 (ATTACH TO PERMIT) GENERAL INFORMATION 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: Hodnett, Randell I Star Prairie Township 038 - 1205 -70 -000 CST BM Elev: Insp. BM Elev: IBM Description: Section/Town /Range /Map No: &14 V " &/j 14.31.18.1102 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � B nch rk Dosing Alf. BM WaU Q M ac, e Aeration Bldg. Sewer 30 Holding St/Ht Inlet &-Yu 97, 3 TANK SETBACK INFORMATION :itk -.tl? A ) DO r l4e-e St/Ht Outlet (o,73 . /7 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / no k Z � / a � / Dt Bottom Dosing Header /Man. Env -7. 9 7 Z.9 Aeration Dist. Pipe s 4. 9S 17 3 Holding Bot. System $ F-0 !76, PUMP /SIPHON INFORMATION Final Grade ✓LU 3.8 0 166, Manufacturer , Demand St Cover PM 1 G �g 41 3.5 6 Model Number TDH Lift Friction System Hea TDH t Forcem ' Lengt Dia. Dist. to Well SOIL ABSORPTION SYSTEM DIMEN BED/TRENCH IONS Width ! Length No. O Trenches � AM PIT 1317" No. Of Pits Inside D / ia� Liquid Dept 3 DIMENSIONS 1JQ TTff�r�C / ` / SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR LF/ od" Type Of tem: � , J b " DT n UNIT Model Number: DISTRIBUTION SYSTEM o Header /Manifold Distribution x Hole Size x Hole Spacing lVent to Air Intake Pipes) Length / Dia Len Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over ``` ��f xx Depth of xx Seeded/SoddeA j xx Mulched Bed/Trench Center f ' 2 Bed/Trench Edges y �/� Topsoil No Yes [K] No —(. 1 W COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:Qlo /aI / o q-!5�1 la� #2 / Location: 2157 128th Str et Star Prairi WI 5y44002�6 (SE 1/4 NE 1/4 14 T31 R1 8W) Prairie View Estates Lot 7 J Parcel No: 14.31-18.1102 1.) Alt BM Description =Ire �tu" 2.) Bldg sewer length = •2S / (�� t/`c.11 �� [�,�,{dl G s - amount of cover Plan revision Re uired? k Yes" Use other side for additional information. I(� /p /C (_,_ ______ ___ 0 j} 15V WT _ SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. 'j P � D Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. `� SCO See reverse side for instructions for completing this ap i I n � A Box 7302 Personal information you provide maybe used f5r secondMo e 1 Y Madison, WI 1 5 53707 -7302 Department of Commerce (Submit completed form to county if not 045 [Privacy Law, s. 15.04(l)(m)] state owned.) Attach complete plans (to the county copy only) for fife system, on paper not less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number PoCheck if revision to previous application State Plan I. D. Number r , 5 3 I w...,,. _.,., I. Application Information - Please Print all Information x _ s Location: / S Prope er Name ! Property Location 7T �q"X n'c Le- O g 0 4 L01)[t. .,S`F /4A4 4 1 T N,��( P pe er's ailing ddress Lot NuivbZA Block Number -�� City, State Zip Code 7Phonr+#vtYvbev - ° Sub ' ' ' n Name or CSM Number II. Type of Building: (check one) " " _ Q El City I or 2 Family Dwelling - No. of Bedrooms :_ P't ( ❑ Village • / /v2 ❑Public /Commercial (describe use):_ / O Town of ❑ State -Owned V r d Nearest Road C- ✓ QC/ i ©,(/ y� Parcel Tax Number(s) 5-9 "— �d III. Type of Permit: (Che only one box on line A. Check box on line B if applicable) A) I K New 2. ❑ Replacement 3. ❑ Replacement of f� 6. ❑ Addition to S tem System Tank Only /,e o�bu� ���� ,existing System B) Permit Number Date Issu d A Sanitary Permit was previously issued y�j Q� 3 p IV. Type of POWT System: (Check all that apply) 0 N on- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ A obic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Inf mation: Z - 31 _ ( �I 1. Design Flow (gpd) 2. Dispersal Area 3. DispersaLAAfa 4. Soil Application 5. Percolation Rate . s em evafion 7 inal Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) 7r, _ I � 9�, 5 vation 7 �t 6 VII. Tank Capacity in Total # of Manufacturer Prefab Steel Fite - astic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks �j � 1 , ❑ 11 ❑ l 44c- P� VIII. Responsibility Statement I, the undersigned, assume respons for installation of the PO WTS shown on the attached plans. Plumber's Name (print) Plumber's Signature (no stamps): MP/MPRS No. Business Phone Number / PlumKees Address (Street, City, State, Zip Code IX. Co ty/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date sued suing Agent gnatur tamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Zj Determination S� l b Q X. r! e �proval /Reasons for Disapp tan spsarcevmust all be serviced / maintained as per manageme ber. 2. All setback requirements must be maintained / _ O as per applicable code /ordinances. S yt s yS. S C SBD -6398 (R. 07/00) PLOT PLAN PROJECT Randell Hodnett ADDRESS 1817 11Othst NewRichmond Wi. 54017 SE 1 /4 NE 1/4S 14 /T 31 N/R 18 W TOWN StarPrairie COUNTY ST. CROIX � MPRS Byron Bird Jr. 220529` --'` DATE 5 -02 -04 BEDROOM 4 CONVENTIONAL XXX A rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000x600 COm LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 0 LOAD RATE .7 ABSORPTION AREA 857 # of chambers 28 IL BENCHMARK V.R.P Top of foundation wall ASSUME ELEVATION 100' ❑ BOREHOLE O WELL -H-R.P Same as BM Vent SYSTEM ELEVATION T -96.5 T -2 =96.0 > 12" Of Bio Diffuser with Cove 31.1 ft ^2 per 6 chamber at System Long 34" Elevation v" -� - D - P 4 bed house BM 3 L 30' 90' 10' 15' gage 7 45,; 3 8 B2 Driveway iS 35� O ob pipe --- 45' lob �B1 (15 100' . ( to PL rn� rs 75 , I-P.C� - PLOT PLAN PROJECT Randell Hodnett ADDRESS 1817 11Othst NewRichmond Wi. 54017 SE 1/4 NE 1 /4S 14 /T 31 N/R 18 W TOWN COUNTY ST. CROIX - T 5 -02 -04 BEDROOM 4 MPRS Byron Bird Jr. 2205 DATE CONVENTIONAL XXX A rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000X600 COm LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ❑ LOAD RATE .7 ABSORPTION AREA 857 # of chambers 28 BENCHMARK V.R.P Top of foundation wall ASSUME ELEVATION 100' ❑ BOREHOLE (D WELL IH,R.P. Same as BM Vent SYSTEM ELEVATION T -9 T -2 =96.0 >12 Of Bio Diffuser with Cove 3 1. 1 ft A2 per chamber 6" Grade at System Long 34" Elevation P 4 bed house BM B3 L 30' 90' 10' 15' gage M 45' 3 Y B2 Driveway IS 351 O ob pipe _---- 45' � s�. d. B1 15' '7 100' 0 75 to PL CJ rn�� F P-C.6 0 0 ? 0 0 / _ , J %; J% E 2 k' T CD E z E z o 4- m z= z o# I e a, o E k a o § n $ $ i 0 E ] q E m E w; 2§ E o °- o E 2 E00 0 7 ƒ » 8 \ 2 CD \ m CL o k t § . s; § E E (n k \ k @ z > ) % \ @ z > ) E 4 / « 5 >� E > g ® a ! G m ¥ c §' CL = c - CL _ ° ®� \ CD� � § a f § - n r @ ^ \ ^ \ � J 0 0 0@ 0 0 0 E� " 2 % CD 2 R] CA CA A§ CA ch ■ƒ e E v v 7 7 m 2 \ 3 k • g k \ m ` C ~ ( i i $ = co 0 § 7 ƒ 7 e 2 0 ° ƒ ] o ° -0 \ 5 7 § ƒ m § 7 § ƒ m @ G I m @ ( / k 2 C. / k 6 2 / / d / � @ , a s m- a o? c 2 [ ■ Z . \ # § 9 . . / ; m T ; CD w _ §) # k ( 2 § CD § ■ § r 7 z 7 ¥ ( CD # § I � � f {2}\ } /a 0 § )[ § « CD E c J ( ( o z 3 £ % � 3 ` E � ] ƒ i E(D m m � \} � ƒ 7 CL D CD » �a \ a /3 @ ƒ �% a $ 2m � \n § / 0 0 ƒ ~ CD No _o CD § \ C) � \ F v O } {snag 0 4 2004 Wisconsin Department of Commerce EV ALUATION R�EPQPT, Page / Of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. - Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and P I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 03f 102 s 70 — 0ea Please print all information. Re ewes Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / d Property Owner / Property Location Govt. Lot ��� 1/4 1/4 S T N R E Property Owner's Mailing Address Lot # Block # Subd. Name or CS /o ` city ` to Zip Code Phone Number ❑ tity ❑ Village J2�'T'own Nearest Road r W Z 0/ % New Construction Use,6 Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ PPu or commerci9l - Describe: Parent material /2l GL- C Flood Plain ele ati if applicable General comments and recommendations: Tr — � _ �� • , (. � Z F-11 Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor :2 ;� 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 I 'EfT#2 a 3io � 2 `' n Boring # Boring �i1 I ❑ Pit Ground surface elev. Z vt" ft. Depth to limiting facto in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 � / Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mgll. CST Name ( Print) � ignature CST Number Address �1 a Evaluation, Conducted Telephone Number /� I - I JAV, I 1_� H 0 Property Owner L ' 0 V O /G Parcel ID # Page of Boring # 12k ng ❑ Pit Ground surface elev. P ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Ef1#2 a ! 7 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 'Eff#2 Boring # Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - 042 Effluent #1 = BOD > 30 5 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD 130 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, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBo-8330 (P- 07/00) Soil Test Plot Plan Project Name Randell Hodnett Byron Bird Jr. Address 1817 110thst NewRichmond Wi. 54017 C #220527 Lot Subdivision PrairieViewE Date /2/2004 County CROIX S E 1 /4 N E 1 /4S 14 T 31 N /R W Townshi Star P r a irie Boring Q Well PL Property Line# Alt. BM top of corner of Basement ,BM or VRP Assume Elevation 100 ft. 1444 �- �� Ala y System Elv T -1 =96.5 T -2 =96.0 H.R.P Same as BM �Z P 4 bed house BM B3 L 30' T/' garage M 45' S S Driveway B2 d. S � - 45' __ v o B1 X 15' — Y- 6 100' 75' to PL � 2550P S9y , 7598'93 STATE BAR OF WISCONSIN FORM 2 - 1999 WARRANTY DEED - REG O H . WALSH F DEEDS Document Number REGTR O DEEDS ST. CROIX GO., WI This Deed, made between EWLEN Properties, LTD., a Texas RECEIVED FOR RECORD Limited Partnership Grantor, 04/16/2004 10:00AN and Country Livinct Builders, Tnc„ and Randell H- Hodnett and Sandia L. Hod n ett. Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXERT # the following described real estate in St. Croix County, State of Wisconsin REC FEE: 11.00 (if more space is needed, please attach addendum): TRANS FEE: 116.70 COPY FEE: Lot 7, Prairie View Estates, Township of Star Prairie, St. Croix County, CC FEE: Wisconsin. PAGES: 1 Recording Area Name and Return Address David J. Estreen 304 Locust Street Hudson, N 54016 W l- I ?A ClYK-- 038- 1205 -70 -000 Parcel Identification Number (PINT This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and right - of - way of record, if any. Dated this day of April 2004 /$WL Properties, LTD. BY: Paul Anderson /r'tG 5 , , Fiu ,y 41,E s * AUTHENTICATION ACKNOWLEDGMENT Signature(s) — STATE OF F . 1, ) ) ss. County ) authenticated this day of _ Personally came before me this day of April 2004 the above named EWL EN P LTD., a Texas Limited Pa - BY: Paul Anderson TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ _ to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Att orney Kristina Ogland * i i m e�� Hudson, WI 54016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) * Names of persons signing in any capacity must be typed or printed below their signature. _ u Lac, wt STATE BAR OF WISCONSIN ..•�!. ATHENA M. KOENEN 655 -2021 WARRANTY DEED FORM No. 2 -1999 t� X , Notary Public, State of Texas My commission Expires �, Auguit 23, 2006 rn -1 r O g< = O �o n C � vo 19 � z ba O z� rn CA. m I X 70 -q a5 m �Orn M m 0 M i O � " Z 55 CO) z � m m J � ;u C/) Z � M o c O " t7C1 z p c cn X o O Z M % z m Z � c v tnC�rn�r r � z Z � T n G) m Cn �r c _ (1) m Z 0 -� m G) C r rn o O IT1 - --� Z F o p m y m z N C M C X < m I s _ v �,� 'Z S� 3 �" na � S° s z o n �� - ������.�.�. z O 0 a _ ga " ���..Z �. Y9�•� � „per ln� U r-g Z s g s y v n o a t d `! n� S W NM I y o y z > Safety and Buildings Division count*-')- 201 W. Washington Avc., P.O. Box 7082 Madison, Q'L- 7082 Sanitary Permit Number (to be Wiled in by Co.) scons n (608 3 0 pepertment of Commerce ,,1 Plan LD. Number Sanitary Permit Applicati n in accord witb Comm $3.21, mss. Adm. Code, personal info on yovt$Q a eject Address (if different than �y�a 12 �' g address) may be used for secondary Purposes Privacy Law, s 15. (1)(m) () 'L C� I, AppllCation information - Please Print All Information arcel # Lot # Bloch # Property Owner's Name 1 f- l Property Location Property er's Mailing Address V / vl Section City, Zip Cod Phone N r S J f ircle e) C� N; �E or H. Type of Building (check all that appl Subdivision Name CSM Number or 2 Family Dwelling - Number of Bedrooms j ❑ public(commercial - Describe Use p C ❑ State Owned Describe - Des'be Use 2 3 0 J� ❑city ❑villa ownshlp of, D lIL Type of Permit: (Check only one box on line Complete e B if applicable) 3 205— — ) 2 A. Treatmen olding Tank Replacement OnlY ❑ O Modification to Existing System Ile Systan ❑ Replacement System Lis a us Permit nnbe and a Leased v B. ❑ Permit Renewal ❑ Permit Revision ❑ g of ❑ Permit Transfer to New Before Expiration Plum Owner IV a of POWTS S stem: Check all that a 1 on ❑Moun - Pressurised in -Ground [I Mound ? 24 in. of suitabl soil d < 24 in. of suitable soil [3 At Grade ❑ Single Pass Sand Fiber ❑❑ Peat Filter ❑ Aerobic Treatment Unit C3 and S� d Filter e Jo constructed Wetland ❑ Pressurvod !n ound ❑ Ho ' g Tank Recirculating Synthetic Media Filter hill charnb [3 Drip L e ❑ Gravel -less Pipe [3 other (explain V. Dis ersal/TrestmentArca ormatian: Dispersal Area Propos (50 Elevan �- Design flow (gpd) ign Soil Application Rate(gp f) Dispersal Required (sf) e 7 p ro f au Site ! Steel Fiber Plastic VL Tank Info Capacity in Total Number an er crete Constructed Glass Gallons Gallo of Units / �- '- ( � �l New Existing Tanks Tanks Septic or Holding Talc ^ Aerobic Treatment Unit Dealing Chamber PI VII. Responsibility Statement- 1, the ndersign ume responsibility for 1 M la 'on of the pOWTS shown oa the a ttached Plans. MP/MP N m Trusinessilnel�lt+j s m ' nbrrr /��� Plumb' Na (Print) lumber' re �� Plumber's Address (Street, City, State, od / .1 Of VIII. ounty /Dejppartment Use nl is in gent Signature Stamps) Sanitary Permit Fve (includes Groundwater Date Issued Approved ❑ Disapproved Surcharge Fee) — ❑ Owner Given Reason for Denial IX. Conditions of ApprovaVReasons for Disapproval SYSTEM OWNER 1 Septic tank, effluent filter and nred maintain dispersal cell must all .. lumber. as per management plan provided by p 2 as per applicable code/ordinances maintained ounty only) for the system oil paper not less than siR s 11 inches in size Attach eosaplete plans to the C SBD -6398 (R. 08102) PLOT PLAN PROJECT Ewlen Properties Lt.d ADDRESS 1430 220th Ave New Richmond Wi 54017 SE '1/4 NE 1/4S 14 /T 31 N/R 18 ' W'`OWN 'Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 3/29/04 BEDROOM 4 CONVENTIONAL X00C IN- GROUND 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 872 # of chambers 28 IL BENCHMARK V.R.P. Top of 1" Pipe g,N(= ASSUME ELEVATION 100' Filter ZabelA -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 96.1/95.5' 3.5' below q Well is to meet all setbacks required by Vent WDNR >6 Standard Biodiffuser Pro 4 Bedroom Leaching Chamber of Cover with 31.1 ft2 of Area House 6 Long 1 " 3 4" Grade at System Elevation 30' 224' T Property Line Plans Designed Using 8% Conventional Powts slope Manual Version 2.0 50' B -3 141' 2 -3' X 88' cells with 3' Spacing B-1 20 66' B.M. 39' Alt. 141' B.M. is 1 PVC Pie B -2 100. P 2 ' 51' GOV 237' Property Line PLOT PLAN PROJECT Ewlen Properties Lt.d ADDRESS 1430 220th Ave New Richmond Wi 54017 SE 1/4 NE 1 /4S 14 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 3/29/04 BEDROOM 4 CONVENTIONAL XXX IN- GROUND 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 872 # of chambers 28 ,BENCHMARK V.R.P. Top of 1" Pipe — g✓u ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 96.1/95.5' 3.5' below qrade Well is to meet all setbacks required by W Vent DNR Standard Biodiffuser Pro 4 > Bedroom of Cover Leaching Chamber House with 3 1. 1 ft2 of Area 6' Long 1119 30' 34" Grade at System Elevation 224' T Property Line Plans Designed Using 8% Conventional Powts slope Manual Version 2.0 50' B -3 141' 2 -3' B -1 20' X 88' cells with 3' Spacing 66' B.M. 39' 141' Alt. B.M. is 1 PVC Pipe B -2 100.2' 1 51' 237' Property Line • Wiscorfsin Department of Commerce SOIL EVALUATION REPORT Page _ 1 of 3 Division of Safety and Buildings ' in accordance with Comm 85, Wis. Adm. Code County St. Cr oix 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 . pending percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print, all info_�nha'tiaq. ev' ed by ate Personal information you provide maybe wSed forsecondary ur pose ryvaoy Law, s. 15.04 (1) (m)). Property Owner Property Locat' `i EL, �V U Ewlen Properties, Lt d-,' Govt. Lot SE /4 NE 1/4 S14 T 31 N R 18 3E (or) W Pr O e 's �t allin Address ".:.{ ) � G 4a� Lot # Block # Subd. Name or CSM# TV6 A ve. A + 7 na Prairie View Estates City State Zip,�,gde Ph U r �. _ El city ❑ Village [Town Nearest Road New Richmond 1W1 154 ( z i j Star Prairie CM "C" ] New Construction Use: ® ResidenoW t4u0te OT Code derived design flow rate ti(1(1 GPD ❑ Replacement ❑ Public or comm BAecr1 e: Parent material out - wash Flood Plain elevation if applicable na ft. General comments and recommendations: trenches @ el. 96.00', spaced to code 4.00' below grade Boring o e Fk . 2 - W a Boring # r-1 Ground surface elev. 100 O ft. Depth to limiting factor +96 in. 6U Pit Soil Application Rate1 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff #2 1 -12 10yr3/3 none sl 2mgr mvfr qw 2f .5 9 2 2 -96 7.5yr4/6 none ms — Osq ml a'�" X16 • ffl ❑ Borin g # F] Boring 2 ® pit Ground surface elev. 99.65 ft. Depth to limiting factor +96 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ffl in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 -9 10 Yr l 3 3 none sl fr qw 2f .5 9 ( O 2 -27 7.5yr4/4 none sl 2mbk mvfr qw if 3 27 -96 7.5yr4/6 none ms Osg MIL na na 7 1.2 � 41 ,? •� Effluent #1 = BOD > 30 220 mg /L an TSS >30 < 150 mg/L nt #2 = BO < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel ' 02298 Address Date Eva on donducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 12 -5 -2000 715 - 246 -6200 I Property Owner Men PrOAeYtieE . Ltd Parcel ID # pending Page 2 of 3 Boring # ❑ Boring F ❑X Pit Ground surface elev. 95.95 ft. Depth to limiting factor +96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -14 1Oyr3/ none 2f 2 14 -96 7.5 4 Os •� F-1 Boring # ❑Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 Boring E] Boring # Ground surface elev. ft. Depth to limiting factor in El pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30:S 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 5 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, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.6/00) STEEL'S SOIL SERVICE Gary L. Steel Ewlen Properties, Ltd. 1554 200th Ave. CSTM2298 SE'NE'' S14- T31N -R18w New Richmond, WI 54017 MPRSW -3254 town of Star Prairie (715) 246 -6200 lot V- Prairie View Estates 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. iN ,1 " =40 1 BM-= top of 1" pvc pipe @ el..1 Atl . BM. = top of J" pvc pipe @ el . 10 0.20' INA 'I Y � � _ u 7 Gary L. Steel 12 -5 -2000 ST CROIX COUNTY SEPTIC 'TANK MAINTENANCE AGREEMENT` AND OWNERSHIP CERTIFICATION FORM owner/Buyer �� Mailing Address Property Address Dep artment for new constru(tion) (Verification required from Planning De p Parcel Identification Number City /State LEGAL DESCRIPY ION 1 _ '� � � � w, Town of L T N - ation�' /., /., Sec Property Loc — Lot it -7. Subdivision Page # -� Certified Survey Map # ` Vol ume —j ��� � Page # Volum Warranty Deed # _ � Spec hour' es CJ no Lot lines identifiable )yes D no SYSTEM I' ) E INANC E Improper use as d maintenance of your septic system sooner, if needed by licensed pumper. What you put p into he system consists of pumping out the septic tank every three years o disposal s tem can affect the function c f the septic tank as a treatment stage in the waste Ys De D a certification fo The property am, signed by the owner and by a o �vner agrees to submit to St. Croix Zoning P that 1 the on -site wastewater disposal system masterplumber, journeynanPlumber, restrictedplumber or alicensed ng (if n cessarng the se ) tic tank is less than 1/3 full of sludge. is in proper operating cc adition and/or (2) after inspection and pumping (if necessary), P I/we, the undersigned hive read the above requirements and agree to maintain the Private sewage disposal system with the standards s, State of Wisconsin. of Commerce and the Department of Natural Resourceonsin. Certification set forth, herein, as set t y the Department Zoning Office within 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County ;STLGNA: Tys of the three year c cpiration date. WA D URE F APPLICANT OWNER CERTIFI ' knowledge. I (we) am (are) the owners) of I (we) certify that all statement of a waman deedrecorded in Register of Deeds Office. the property described i,bove, by virtue h' �y ac � DATE SIGNA OF APPICANT * * * * ** A 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 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent fitter 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 eve=ry 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 Con " ay Plan ption : #1. system fails, determine cause of failure, use alternate area and install new sy tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option #3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: ;Shaun Bird 715 -246 -4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 1468PAGE 556 513378 WALSH . c0 STATE BAR OF WISCONSIN FORM 2.1998 REGIST O DEEDS ✓D REGISTER O F - DEEDS WARRANTY T)IFFE) ST. CROIX CO., WI This Deed, made between Ernest J Dosedel and Marjorie B. RECEIVED FOR RECORD _Dosedel husband and wife 11- 05-1999 10:40 AN Grantor, conveys and 11ARRwn DEED EMPT I warrants to EWLEN Protaerties Ltd a Teams Limited Partnership CERT COPT FEE: COPT FEE: TRANSFER FEE: 1060.00 RECORDING FEE: 10.00 Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix _ County, State of Wisconsin (The "Property "): Recording Area — EST 31: - ..,CUS - " WI �dE� 038 -1037- 30.000 & 038- 1037 -6acon Pawl Identification Number (PIN) Tbis i no t homestead property. SY2NE' /., Sec. 14- T3 IN-RI 8W except commencing at the Northeast comer of said SE' /.NE' /, Sec. 14- T31N -R18W; thence Westerly along the North line of said SE' /.NE' /. to the Westerly edge of the right of way of County Trunk "C"; thence Southerly along the Westerly edge of said County Trunk "C" right of way a distance of 608 feet to the point of beginning; thence continuing South on the Westerly edge of County Trunk "C" right of way a distance of 208.71 feet; thence Westerly and parallel with the North line of said SEIANE' /. of Sec. 14- T31N -Rl8W a distance of 417.42 feet; thence Northerly and parallel with the East line a distance of 208.71 feet; thence Easterly and parallel with the South line a distance of 417.42 feet more or less to the point of beginning. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 25 day of October, 1999. * Ern— J. D el, i • Mirioric 11. Dosedel AUTHENTICATION ACKNOWLEDGMENT Sig de and M ' eR DnsedeL STATE OF WISCONSIN ) Q, ) ss. ' .° !.~ authenticated this County )` f dal'; : `i 999 � Personally came before me this _ day Of 1999, the above named y u�f� 10" g laffd to me known to be the persons) who executed the TIER STATE BAR OF WISCONSIN foregoing instrument and acknowledge the same. OV . rat, authorized by 1 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin Attorney Kristin Ogland My Commission is permanent. (If not, state expiration date: Hudson, WI 54016 —' ) (Signatures may be authenticated or acknowledged. Both are not necessary.) "Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DZED SPATE BAR OR WISCONSIN FORM N0. 2 - IM v n • . 208,914 SO. FT. \ K � 5 H.W.E. =385.4 4.80 ACRES �` \ eA\ o I, Wetland o �\ x`50- o C s M LOT 1 DRA / VOLUME 14 PAGE 3870 _ • � 1 � ; � 'r NACE EASEMENT : 162 7 4 ', D0&hA4fN_' NCf 624✓��I ---------------- y 67, 615 SO. FT. �- 1..55 A CRES ° I MIN, F. F. E =,38,9. 4 ° `O 1 � � I N89'01'50"W 277.77' S89'42'40 "W 1 3 0) I N r S00'17'20 "E 14.9E ' o )"W ^ © O ° 386.73' ' o i o N89'01'50 "W 450. � o io N 76 SO. FT. N N ° o a p UNPLA TTED LANDS 00 c � 1.76 ACRES p ----------- N p PARCEL IN WARRANTY 3 O 3 VOLUME _1158 PA GE_25. I ° I ss6.55'26 "w S89'01'50 "E 45( 77.78' -616'- 275.63' -- 38783' S I.O I • 6 N 82, 016 SO. FT. I` J I 1. 88 ACRES co 0 . sHED \ / S79•47.05 „E BARN \ / 3 59 96 w SHED . �•........ o -- o 8 ° Z 81, 001 SO. FT - 5,552 SG. 1.86 A CRES 153, 704 SO. FT 76 ACRES `y N 3.53 ACRES 550 58' 236.55' 312.64' A TTED LANDS 100 0 100 1 C. - LOT - 1 - VOL. - P G RAPHIC SCALE � --- - - - - i