HomeMy WebLinkAbout038-1206-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
6 453035 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 -30 -000
CST BM Elev: Insp. BM Elev: BM Description: ,y Section/Town/Range/Map No:
ty.:� �y tic c . a r� S S , <� , c ✓, li c 14.31.18.1108
TANK INFORMATION ELEVATION DATA i �'� u S c<f Cr�C,
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 1 ))) — Benchmark
Dosing \ ,- — _ ` J Alt. BM
Aeration Bldg. Sewer
r olding St/Ht Inlet c; c
St/Ht Outlet
TANK SETBACK INFORMATION 9 �'
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic _ Dt Bottom
Dosing Header /Man.
it. C I 1 S3
Aeration Dist. Pipe v►.; i Z v 5
C
Holding _ Bot. System
Final Grade v
PUMP /SIPHON INFORMATION
Manufacturer Demand St Cover
GPM
Model 111,ber
TDH Lift > 5>c Ion Loss System Head TDH Ft
Force mai Length ia. 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 IWELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: I I It I I I C1 + tZ UNIT Model Number:
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
a Pipe(s) -- �—
Length I l%' Dia ( Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of 1 xx Seeded /Sodded xx Mulched
Bed/Trench Center t4 c4 `�, °-�� Bed /Trench Edges Topsoil r 1 Yes No Yes No
COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: // c' Inspection #2:
r r 1't.- . L%--
Location: 2157 127th Street Star Prairie, WI 54026 (SW 1/4 NE 1/4 14 T31 R1 8W) Prairie View lstates C P Parcel No: 14.31.18.1108
1.) Alt BM Description = -�- :.�:- °�" 3) \,. >. ' �' "` )
2.) Bldg sewer length
t'" � •� `<_ ( n� S -(c
- amount of cover= 1414 e w r_„�
Use other side for additional Yes No /
Re quired? g !c
informati n. -
Date Insepctoes Signature Cert. No.
SBD -6710 (R.3/97) p ^p.J C
f 5�7s�
Safety and Buildings Division County
W 201 W. Washington Ave., P.O. Box 7162 58 , Cro;X
seonsin Madison, W1 53707 - 7162 Sanitary Permit Number (to be fi lled i n by Co.)
tment of Commerce (608) 266 -3151 X2
Sanitary Permit Application State Plan I.D. Numl>gr
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide /`
may be used for secondary purposes Project Address (if fferent than mailing address)
1. Application Information - Please Pr' All Infor tion /.Z /
Property Owner's Name M 2 D 2004 Parcel # Lot #
Ew br7 ro -G Leal. od- a-&P -30-wo, Z/3
Property Owner's Mailing dress . r �' X C (� `: Property Location ��
q3 �e l �, ��,� I �
�� �., �., Section It
City, State Zip Code
J� Phone Number p ?
t t� ,/ STd 7 ��S �Sl �� T. �.3 T N, R trcle one)
11. Type of Building (check all that apply) Ll
i i or 2 Family Dwelling - Number of Bedrooms T Subdivision Name
❑ Public/Commercial - Describe Use 1 1 w I rl a , e4o
❑ State Owned - Describe Use oC D! ST._(� (�t/ / / ❑City_❑ Village �'1�wnship
111. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. I/ Cv System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification 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. Type of POWTS Syste Check all that apply)
N - Pressurized In-Ground ❑ Mound 124 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. DispersaLFrreatment Area Information: j% / V e. .r.Z , .4 0ZrCA~ A& — .r 27 5 S A8 �S
Design Flow (gpd) Design Soil Application Rate(gp sf) Di al Area Required (sf) Dispersal Area Proposed (sf) System Elevation pru700
0 r76 SS 7. ir! A .P. 8')o.8osr CX 9S. 60
Vt. Tank Wo Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units �/ `OQ Concrete Constructed Glass
New Existing y ()" FlFl�
Tanks Tanks r t,
Septic or Holding Tank / J / ZsU ' - ^' Q Sir ^ -
Aerobic Treatment Unit W �i/�,
Dosing Chamber
VII. Responsibility Statement - 1, the undersigned, assume resp6lipibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Pluml Signature MPRr4P4t:9-Number Business Phone Number
Plumber's Address (W, City, State, Zip CO)
d0. 16ax ;7_6 ujo9lYv171e cJ /. OZ.f
VIl Coun /De artment Use Only
Approved ❑ Disapproved Mary Permit Fee (includes Groundwater Date Issued suing Agent Si ature ( s)
�
e 4
Surcharge Fee)
3 z3
70 Owner Given Reason for Denial _
1?{. Conditions of Approval/Reasons-for Disapproval
SYSTEM OWNER. !
eptic tank, effluen ilter an
dispersal cell must all be serviced maintame
as per management plan provided by plumber. )
2 All setback requirements must be maintained
as per applicable code%ordinances
Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size
SBD -6398 (R. 01/03)
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _j_ of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code County St. CRoix
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 arrp�n(, # 46ft distance to nearest road. din
Please prir�rf , � la' tion.
,Reviewed
Date
jj
Personal information you provide may bf6�ed r seco ary}lpposes (PrivagyL w, s. 15.04 (1) (m)).
Property Owner I ' i_ t Property Location
Men Properties, Ltd' � - )Govt. Lot SW 114 NE 1/4 S 14 T 31 N R 18 W W
Property Owners Mailing Address —; of # Block # Subd. Name or CSM#
430 220th Ave. S1 cROlx ' 13
city State Zip ode`, t P eC < El City ❑ Village ® Town Nearest Road
F ew Richmond WI. r
54� T 715) 248 3 Star Prairie
Cm 11^rl
[a New Construction Use: Residential / hl" " o b d? 4 Code derived design flow rate 600 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Outwash Flood Plain elevation if applicable na ft.
General comments
and recommendations:
trenches @ el. 95.60'✓
F Boring
i Boring # f - 1 99.80 _
Cu Pit Ground surface elev. ft. Depth to limiting factor +100 in.
Soif A plication 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 *Eff#2
1 0 -14 10yr3/3 none L mfr cs if .5 .8
2 14 -26 7.5yr4/4 none scl 2msbk mfr aw if
3 26 -10 7. 4 6 none
ql S 69 4 1
Boring # EJ Boring -
2 �7 99.60
L^� Pit Ground surface elev. ft. Depth to limiting factor +100 in. Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. [ 1 5 *Eff#2
1 0 -14 10yr3/3 none L 2msbk mfr cs if .8
2 14 -28 7.5 4/4 none sicl 2msbk mfr ClW if
3 28 10 5 4 c2d7.5 5 6 sil
0. rid 0�
* Effluent #1 = BOD > 30 < 2k mg/L and YSS >30 < 150 mg/L * Efflught #2 = BOD < 0 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature CST Number
Gar L. Steel -. -' X2298
Address Evaluation Cond cted Telephori8 Number
1554 200th. Ave., New Richmond, WI. 54017 12 -2 -2000 715- 246 -6200
�I
Property Owner _17A l an Pr T,,AYt,' n s Ltd. Parcel ID #ceding Page 2 _ of 3
53] Boring # ❑ Boring
X Ground surface elev. 0 0 . 3 ft. Depth to limiting factor +100 in.
Pit =oil 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 -15 10yr3/3 none L 2msbk mfr Cs 1f 5
2 15 -36 7 5 4
3 36 -10 .5yr4/ none ms osg ml na na .7 1.2
F-1 Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil A plication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2
Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
F
❑ Pit Soil A lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff
•Eff#1 *Eff #2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
I
I
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L ' Effluent #2 = BOD 5 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 (R.6 /00)
STEEL'S SOIL SERVICE
Gary L. Steel Ewlen Properties, Ltd. 1554 200th Ave.
CSTM2298 SW4NE' S14- T31N - r18w New Richmond, WI 54017
MPRSW -3254 town of Star Pratfte (715) 246 -6200.
lot #13- 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' L
BM.= top of 1" pvc pipe @ el. 100.00'
Alt. BM.= top of 1" pvc pipe 99.45'
t
3 �o
``Gary L. Steel
12 -2 -2000
L
Conventional Septic System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD- 10567 -P (8.6/99). All local and/or state rules pertaining to system maintenance
and maintenance reporting shall be complied with.
Septic Tank
The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The
septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The
contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to
service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment,
maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge
accumulation in the tank. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge
should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed
from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank
manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for
service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective,
or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an
effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank
as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with
Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or
chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be
approved for septic tank use by the Department of Commerce, Safety and Buildings Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface
within the system and will promote frost penetration during cold weather months. Cold weather installations (October -
February) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by removing
biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a
new soil absorption cell to bring the system into proper operating condition.
Questions on the operation or maintenance of the system should be directed to installing plumber, Joe Stang at
(715) 684 -5166, or the St. Croix County Zoning Department.
FROM :EDINA STILLWATER v 430 7575 2004.03 -22 12:44 #966 P.02/02
�" LL e l— V...l� iV • J..J . iL L1y
rrt lei
R 1893% AM A.C.E. So i I d , S i to Eva 1 . 715 240 7764 P. 02
sr capix couNrY
SEPTIC TANK MAMMANCE AGREEMENT
AND
OWNPUEEP CERTIFICATION FOAM
ownimsuyw 6w' ca"
+.
M /s/3&,2.zD',¢�e 5o 17
1'r0perty Addrwis .2./4'7 /,; 19 1P
(VeriBe turqutired from Plozmine de em brpew ooltsertrotleet)
140d qOM N=bw Q 3,= /2% —,RD-660
j Y >:,00eticts Lj t/,,11' �rA. 9oc. >�, T &N-R-&W, Tows of :5 ' e
Subdivision ''a %/' C' d; ew 6t,-&j Lot # /
Certtfled Survey map # Vohrme ftp
'warranty Deed #--( , Volume y < ��
Spec h olne 0 yes "
SXAMM
Imp p i use and tasinta+ra+eee of your aspye system oauld re sult
tolt:raste of p In its PF=8ttrro f IUm to handle wastes. proper maintenance
p out the septic tznk every thres years or sooner, if deeded by a liurased ptrrapet. Whitt your pot into the systcm
earl atract the function of the septic tank as a treatment atage in the waste disposal system.
The property owner a rarees to submit ro $t. Croix Zoning DcPAnnMt a cQtitication lbtrtt, sited by the Owner and by a m%td"
plumber, jaurneyMM plumber, Ivstricted plumber or a licensed pumper verifying dean (1) fl7e an.sia waetew#tW cbsposal system is
prOP" operating ooaditioa anci/er (2) after inspection artd PMpitig (iftwoeasary), the septic IN* is less than 1/3 full of sludge. in
Uwe, the 111nder6igned have read the above Taquircm=ts and agree to maintain e the private sewage diepnse( System with the 6tAndards
t forth. herein, ae at by Hie pePartsrient of COMMeme and the ,
grin that partment of Natural Reaottrees, sate of wieeatai>s. CesUPrutt;on
S your septic system has been mainWm1A must be completed and rehueed to the St. Gralx couetty t ?trice within 30
I of the tar year explratiep to.
. JONATIURE OF APPLICANT I2.rCa
PA'3"lr
1(we) Certify that dl statements oq This fornr IttC ttve to the beat ofruy (a*) knowledge. i (we) stn (are) ilia owner(a) of the
P L scri above, by virtue of a watprtty heed rseaMed in
7� fli
i6trr of Ot:e.
SI NATURE OF AP'pI.ICANT E -,� --�-- L
BATE
Any inforrmtian that is mis.repreAe„ted mayresult in the aenitary Permit taunt; revoired by lbe Zoning Dcpaeonent. +• +r••
•' Tensile witb this AW a stamped waraaaty deed from the Rcrtister of Doe& otlfce
a mPY Of ft certified emnvey map if refWwu a is made in the warranty dreg
I
Vol.1468P o4? 0 -4�7
• 613375
STATE BAR OF WISCONSIN FORM 2 -1998 KATHLEEN H. WALSH REGISTER OF DEEDS
WARRANTY DRRD ST. CROIX CO.V WI
This Deed, made between Ernest J Dosedel and Marjorie B.
RECEIVED FOR RECORD
TMsedel, husband and wife 11- 05-1999 10:40 AN
Grantor, conveys and VARRN DEED
warrants to EIILEN Properties Ltd., a Texas Limited Partnership, CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 1080.00
RECORDING FEE: 10.00
A 417- Grantee. PAGES: i
Grantor, for a valuable consideration, conveys and warrants to Grantee
the following described real estate in St. Croix County, State of
Wisconsin (The - Property
Recordinx Area
DAViD J. �STRE I �
304 LOCUST ST.
iU069IN, WI 6401
038 - 1057 - 50.000 & 038 - 1057 - 60.000
Parcel Identification Number (PIN)
This is not homestead property.
S %:NEt /., Sec. 14- T31N -R18W except commencing at the Northeast corner of said SEt /sNEV4,
Sec. 14- T31N -R18W; thence Westerly along the North line of said SEKNEI/, 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- T31N -R18W
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 thi day of October, 1999.
&
* * Ernest J. D el
* * M jorie Jj. Dosedel
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Ernest J. Dosedel and Mariorie B. Dosedel, STATE OF WISCONSIN )
ss.
husbargi.and wife. County )
authenticated thi
day of October, 1999.
t Personally came before me this day of
- ' 1999, the above named
Kristir:: Oglaild
to me known to be the person(s) who executed the
TITLE: MEMBER STATE BAR OF WISCONSIN foregoing instrument and acknowledge the same.
(If not,
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin
Attorney Krisdina 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 DRED STAT& 3" OF WISCONM
... .._.. -. -.
PRAI VIEW ESTATES 3,77
wrA no Av PARE or AIF SYJI/ zar 114 a< ve AtaR)Iw<AST 1/4 Aw xw sxwmESr /14 a we Aawa4ST 1/4 S rmw /4 M AC W 51 NwIft "Aw 19 NEST • r.c
it7Ml ar STAR MW Sr 6ttpA CVL*7 L NgO MAi1L /Yri/A6 M Wr 1 or A C>OFWW &WWy AW AIEOAM N kYC11AE 14 PAW JQM
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SOM'SO'E 253.IW - - - ---A
r mg� II10. 011.]0' + ++ 1tlTr INNNIF
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29 30 31 32 201 AQPES +.•• /��� /� I
74838 S1a FT. 74388 $a Fr. 74838 S* FT. 7x4.44 S0. FT
Mrg
AA f C S 171 ACRES r 1.71 ACES r. j 188 ACRES
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246 SCt FT. �
X4 219 ACAS is — >` ?.08 ACRES
'?l ACRES 1 j Adw FFE.JMO
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10 _ = 1.70 ACRES �
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1 n , t = Isk 71,5M Sit FT. 204 ACRES = 1
j
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j 7t!SS2 SQ fT 188 ACRES
! 1715 ACPFS
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PLATTED L ANDS 1408 —w ! y/4I � UNPLATTE'D LANDS 'I
ueraer�w
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