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HomeMy WebLinkAbout038-1206-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420759 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: Ewlen Properties I Star Prairie Township 038 - 1206 -10 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: iA� I IVZ. IO ([RWee,& ab V UA 14.31.18.1106 TANK INF RMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic NG S l Z D Benc ark G • cam (O • I z • ! D IS ate¢ O Dosing Alt. 2• S N Aeration Bldg. Sewer Holding St/Ht Inlet Q . aZ O l • 4Ig I TANK SETBACK INFORMATION St/Ht Outlet I TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' 1 3 L r Dt Bottom Dosing Header /Man. Aeration Dist. Pipe 9,8p �C7C .o m•�Esr Holding Bot. System ; i o y $- 3 r Final Grade [ PUMP /SIPHON INFORMATION 4C A-- gt (v •a 0 . 10 Manufactu r Demand St Cover ma.yy,, PM 5•'t" Model Number TDH Lift F ' n Loss System Head TDH Ft Forcemai Length Di Dist. to well SOIL APSORPTION SYSTEM NCH idth Length No. 9f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME r 93• r e \ C Z� SETBACK SYSTEM TO � /L BLDG WELL LAKE /STREAM LEACHING M�nuf er. INFORMATION CHAMBER OR .� Type O System: � L �� UNIT • �� Model Number , -2— DISTRIBUTI N SYSTEM eIL Header /Manifol Distribution He S x Hole Spacing Vent to Air Intake $A P. e(s) I Length Dia Leng Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx S � � �� �,�,�Yes [F No � Yes �L]No COMIV 5 S n (Inc lu a discrepencies, persons present, etc.) Inspection #7; _ 1,�1(� A / ,, � ' 3 Inspection #2: � GIX� Location: 116 128th S New Richmond, VI 54017 (SE 1/4 NE 1/4 14 T3)N; 1) Prairjq�View Estates Lot 1, 1 � P�r'cel No: 14. ,31.18.110 • - •T vw.w. 1•.y(Q, t.6t,ei � . N, CiD�.g'� RJR" dpJCQ_ 1.) Alt BM Description = ( w 2.) Bldg sewer length = - amount of cover = � q2 H — 9 'Ian revision Required? j Yes ANo Z � - �((_ i 2 77 other side for additional information. 1 _ ^ �F X710 (R.3/97) � `_1) n - • r Insepctor's Signature Cert. No. w- Softy tmd BmUW Diva M onsty� / 201 w was Oa Am, P.O. BoK 7082 co x Madboo.Wl53707 - 7082 saeihtyPetmtNsmber (eo be6lkdiobyio) Department of commerce t 26I - 65a� -+z D c Sanitary Permit Application Sao PLa LD Nowbw b accwdvft C�0M. WiLAduL (:o&,pmmmd&dWnmdmym p wvidiD maybeo- dilwamoeduyu IaesPrivacyLss,sISAlpxm) PmjatAddtastGfdidWMdMaaHiogadda* L AppRodbu Iafa�® -Plum Print AN Warandoa 1 Z 8 �' S"T ✓ �� 6 39— 12 —o Ptopo"owmesNooe P, Lot inoet8 MAR 2 7 20 3 Ltcadee 3 o a�� Sr N co�N ,� 01%state Tap code F6aw i Ss• -L- 4 sacdal — IL Type of DoNdieg (cheat dl the apply) a s far s u �»� eus tor2PaastlyDwding- NamberofBedm q sYtbdivisimName tS ❑ !ate Dwcdb*Uw ❑softowaed- DeradeUse ( 3 X 93•�S S OtRjr Ovid�e ]c roww6ipa �' III. Typo of Yaraatt; (Check oWtr onto Lox od Nw A. Compieie ow B iytfpl ame) A- sytaem O Rq*mn eotsyss= O Tnwm=MoWwgTwk O* ❑ GdwM Mksdsea>dpitssystem B. ❑ PecokRico wd O P -- Rmidm O ( eof ❑Perm&TasoftwNw UaftvioasIP 11 Nw*o sod Dawhw ad BefoonqiMfillml P6raba Owes iv of POVM Cbeac an a" — f w fi - preantrmod To euosad O ldound> 24 ie afsab ble sot O xamd 2a is arwies6b.ot7 ❑ ❑ ale Pao &W MW ❑ Cm waa wabed ❑ Pseoemed b4mued O Ifel n Took ❑ Pat Fiser O Aerobic Trattaaet Ue8 ❑ er ❑ A[adi. Fits pwmba ❑ ' uw O Q" -bw O oma e F6nw Deftm Me A RWWW" D &M 7 V s IT Ta k left Qpw ffi Taaw Namba Peace site OAW FRa P canoes onWas ofuaits cmcrete cboso New �s Ta Tads &#&arffM"Tw& /1aaLicT�eatvei[ VII. pmt x, iie twdaaigaed, ssratsw esapaasd6ilky ter pdtlaw stag POW18 aiawa sa tia anaetsd P6tmbdsName side &u%w S� sufammIN Namba Pik sAAddU tom. UW. - TV ) vM U" App ❑ saoimry Pemtrt Fie rmebda eaasedwata me Lased Agaot cNa ❑ osw TwSa Ramm tar [Ma- Z ]X Cato atloaa of Appravd/Rea um S n rd,� ` u t `ax /r wme6 t�st�a� ���� --`••p ••e6s:m. stn :tt t■�e - PA r � _ M�� � ��e � c a1� SBD -6398 (R. 08102) P T PLA PROJECT Ewlen Prooerties ADDRE 1430 220th Ave New Richmond Wi 54017 SE 1/4 NE 1/4S 14 /T 31 3/R 1 W TOWN Star Prairie COUNTY ST. CROIX .MPRS Shaun Bird 226900 DATE 3/25/03 BEDROOM 4 CONVENTIONAL XXX IN-GROIrNYIRESSURE CONVENTIONAL LIFT HOLDING TANK 1260 9 allons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 933 # of chambers 30 BENCHMARK V.R.P. Top of Culvert ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL •H.R.P. Same as Alternate Benchmark Vent SYSTEM ELEVATION 96.0'/95.5' 4' Below Grade >6 „ Standard Biodiffuser of Cover Leaching Chamber Plans Designed Using with 31.1 ft2 of Area Conventional Powts B.M 11 " Manual Version 2.0 6 Long 4 Grade at System Elevation 3 Property Line Top of 1" Pipe is Alternate Benchmark @ 100.15' 2 ' B -4 47' 2 -3' X 94' Cells with >3' spacing 0 ' 120' B -2 1 2 Vents 4% 0 Slope M. Alt. N 5' B -3 0' Vents 30' 4—\1 25' 53' T TV Ac B- Pro 4 147' House 32 operty 'e 318' Property Line 431 T PLA PROJECT Ewlen Properties ADDRE 1430 220th Ave New Richmond Wi 54017 SE 1/4 NE 1/4S 14 / 1 W TOWN Star Prairie COUNTY ST. CROIX MFRS Shaun Bird 226900 DATE3/25/03 BEDROOM 4 CONVENTIONAL X00C 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 933 # of chambers 30 BENCHMARK V.R.P. Top of Culvert ASSUME ELEVATION loo Filter Zabel A -100 ❑ BOREHOLE O WELL - H.R.P. Same as Alternate Benchmark Vent SYSTEM ELEVATION 96.0 '/95.5' 4' Below Grade >6 „ Standard Biodiffuser of Cover Leaching Chamber Plans Designed Using with 3 1. 1 ft2 of Area Conventional Powts B.M 1 1 " Manual Version 2.0 6' Long 3 4" Property Line G o rade at System Elevation p rtY Top of 1" Pipe is Alternate Benchmark @ 100.15' 32' B -4 47' 2 -3' X 94' Cells with >3' spacing 10' 120' B-2 Vents >47 W .M. Alt. 00 N 5' B -3 0' 30' 25' 53 T B -1 Pro 4 �- Bedroom 147' House Property Line 318' Property Line Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 _ of 3 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, and16cation attd distance to nearest road. pendin Please print all lafdrmation. v' wed by Date Personal information you provide may be ugdddrsecondary poses Privacy Law; S• 15.04 (1) (m)). &-U 3 rp Property Owner ;1 L +.• s operty Location Ewlen Pro rties Ltd. G�vt. Lot SE 1/4 NE1/4 S 14 T 31 N R 1$ E {or) W Property Owner's Mailing Address -_ ~L # Block if Subd. Name or CSM# 1430 220t Ave- r- S' ,:HOIx 11 na Prairie View Estates City State Zip C e"` Phone FFtG! City E] Village [RTown Nearest Road New Richmond WI . 1 5401, ' 5) 248 -7 Star Prairie cm 11 New Construction Use: ❑ Residential / NumbaiQ h4a4 4 Code derived design flow rate 600 GPD ❑ Replacement • ❑ Public or commercial - Describe: Parent material nutwa sh Flood Plain elevation if applicable na ft• General comments and recommendations: trenches @ el. 98.10', spaced to code 4.00' below grade ❑ Boring # ❑ Boring 1 [� pit Ground surface elev. 1 02.1 0 ft. Depth to limiting factor +100 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 o-12 10 3 3 none L M na 9w na .3 .5 7 5 4 4 none sicl 2msbk mfr 9w n a .4 .6 3 3 - 101 none ms osg ml na na ' 7 1'2 •0 10 Boring # Boring 02 52] .10 102. . ® pit Ground surface elev. ft. Depth to limiting factor In. Soil P lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I `Eff#1 'Eff#2 1 0 -11 10 3 3 none L M na gw na .3 .5 2 11-34 7.5yr4/4 none sicl 2ms bk mfr gw na .4 .6 3 3 0 7'5yrOl none ms osg ml na na '7 1'2 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L t #2 = BOD 0 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature • CST Number 'e V-0221A Gar L. Steel Address -- Date Eval ation Cc cted Telephone Ntxrrber 1554 200th. Ave., New Richmond, WI. 54017 12 -2 -2000 715- 246 -6200 Property Owner Lvlen Prmerties Ltd Parcel ID # mn(l i ng Page 9_ of _ Boring # ❑ Boring 3 pit Ground surface elev. 100. 00 ft . Depth to limiting factor +1 00 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 'Eff#2 1 0 -12 1Oyr3/3 none L M na cs na .3 .5 2 12-361 7 5 4 4 none sicl M na 9W na .0 .0 3 36 -10 7.5yr4/6 none ms osg ml na na .7 1.2 4 Boring # ❑ Boring Q Pit Ground surface elev. 1 00.20 ft Depth to limiting factor +100 in. � 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 `Eff#2 1 0 -12 1Oyr3/3 none L 2msbk mfr gw 2f .5 .8 2 12 -23 1Oyr4/4 none sil 2msbk mfr carw if 3 23 -36 10v none sil 4 36-100 7.5 4 6 none ms O MI nel Da -7 Boring # F] Boring F-1 11 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 mg/L ` 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, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (RAM) STEEL'S SOIL SERVICE Gary L. Steel Ewlen Properties, Inc. 1554 200th Ave. CSTM2298 SE4NE4 S14- T31N -R18W New Richmond, WI 54017 MPRSW -3254 town of Star Prairie (715) 246 -6200 lot #11- 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. N 1 =40' "BM..= top of culvert @ el. 1 , /Alt. BM.= top of 1" pvc pi 0.15 �C V 610, h. to o , t °� �j Gary L. Steel 12 -2 -2000 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 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 0../Buyer �� �,✓ Mailin g Address Property Address d _6 6 (Verification required from Planning Department for new construction) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location i /4, AIE� i /4, Sec. T ,, 7 / LW, Town of CL Subdivision S�%r tLC/L.c -�' �r P_c,�u Lot # < Certified Survey Map # Volume . .Page # Warranty Deed # & 13 3 - +R' , Volume 0 . Page # Spec house - ❑ no Lot lines identifiabl > yes ❑ no SYSTEM CE 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 mastorphimber, joumeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of three year expiration date. 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. 015�� , - 1 k Sfd OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** *s 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 q 146 AA ��??p SPAG 556 613378 STATE BAR OF WISCONSIN FORM 2 • t998 KATHLEEN H. i kEGISTER OF DEED DEEDS ST. CROIX CO., WI This Deed, trade between Ernest J Dosedel and Marione B. RECEIVED FOR RECORD Dosedel husband and wife 11 -05 -1999 10:40 AM Grantor, conveys and DEED warrants to EwL1J Properties Ltd a Texas Limited Partnership CERT COPY FEE: COPY FEE: TRANSFER FEE: 1000.00 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 i ++ �_ i. EST cus ��� W 038 - 1057 -50-M & 038 - 1057.60 -WO Parcel Identification Number (PIN) This Is not homestead Property. S%NE'h, Sec. 14- T3 IN-RI 8W except commencing at the Northeast comer of said SE %.NE' /,, Sec. 14- T3 IN-RI 8W; 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 SE' /,NE' /. of Sec. 14- T3 IN-RI 8W 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 2S � day of October, 1999. w • Ernest J. D el " Mirjoric . Dosedel AUTHENTICATION ACKNOWLEDGMENT h,gna� ' '+ st J. Dosedel and Mariorie B. Dosedel, STATE OF WISCONSIN ss. •�'� !+ authenticated thi County ) d"I ; Oci ' .1 Personally came before me this _ day of 1999, the above named �Og to me known to be the person(s) who executed the TPF $ER STATE BAR OF WISCONSIN foregoing instrument and acknowledge the same. •.. not authorized by § 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 ryped or primed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM No. r - IM tln • 3 \ crix .... • - � i � / 9 / � 3 > �a� 81, 775 SQ. f `\ 1.88 ACRES F \ e 6 • � ,L�,6 � �- s � \ 9.50 7 9.01' - O � \ K _ F -5 �o h DRA /N . ° 92,468 SO. FT. \i -6 6'�' ` 4 L S88 *0. i N 2.12 ACRES Q 1 1 67,615 SO. FT. ... t ........ .. .- •. .� 1 ; 55 ACRES MIN, F. F. E. =389.4 12 y N89 "W 89,294 SO. FT. N I i 2.05 ACRES � � • © 0 • N89'01'50 "W � 09 00 318.04' I I 381.00 I O I S89'01'50 "E M — 350.05' w -50' I O I o I ° N 76, 767 5 ° 1.76 ACh a o , o d rn O 10 N i 13 !!�� i � coo 88, 918 S0. FT. N 3 3 2 04 ACRES 77, 508 SQ. FT. N `' I o 0 o I 1.78 A CRES I \ I O 0 I S86'55' 2E V), y cn i 275.63 N89'01'50 "W 350.05' I • O I I 00.04' 50.01' S83 35'28 "E I 3 07.14' N I ~: • / • 82, Wz I � 14 i 85,495 S0. FT 1.96 ACRES s: 86,917 SO. FT. 1 1 W y i w 2.00 ACRES \ v S� z AS • 1...... � ��° ��o• � moo, 1.8. i 76,552 SO. FT. so. 1.76 ACRES I