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HomeMy WebLinkAbout038-1089-70-000 3 0 tr O m C y C O C O � O p N 1'. N t6 N a a� y I @ O H O C_ m N � p C _ C 7 @ U LL C co a 0 v 3 � I z N W Z . C 0 z a I r,w am N H U) c O O Z a c U .r 30 CD Z d C O '' � `N O z I c a - o m m ih ` N o N M • �, N i (a CO c N O w O Z Q Z - N o z ►.� N 1 C d t0 C m N C L ' V d C) L O o i, D D a n uJ - h Q o to V� y _E �? z> a 0 0 0 d m z • 4i @ a a (L a cn !�1 7 O U) > � N yr F1� fn _1. C�' N N } O O O N O T Z m d N � N a � cs) �i Q y d Q A ) U) . C N W o O O w p y> C y0 O O @ = Q) CL CD O (D 2 ` � O L � M ' N � � O co a0 m m c@@ C N C) d d v° '4 c c Z5 c co • ' O N (5 (n V O In 0 CL O� v � E a, �U a r � E 7 I l i C ly6 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 499140 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: Star Prairie Township Star Prairie, Town of 038 - 1089 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /bd Bko t CST 21.31.18.364E TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. p J Se tic Benchmark 3 ZDO SZ c ti , 10 v Dosing Alt. BM J • 11 q7 5';� Aeration Bldg. Sewer , 7 fy Holding St/Ht Inlet 6 . 4 5 y TANK SETBACK INFORMATION St/Ht Outlet �e TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 5d � 2- ' �7 Dt Bottom Dosing Header /Man. 7 , y'2 . y� Aeration Dist. Pipe 7. b ?,7. 7 Holding Bot. System cd,z 4 /•ZZ f�. PUMP /SIPHON INFORMATION Final Grade 1 3. I Manufacturer Demand St Cover 11, 3 PM S 27 ; �J Go �' Model Number TDH Lift Friction Loss System H TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 5 2- \!ems L 1 - SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: /►` INFORMATION CHAMBER OR /d Type Of I g4 (, �� UNIT Model a'W.J e, i,� 3 6 J DISTRIBUTION SYSTEM 17 1-7 Header /Manifold IDistribution Spacing Vent to Air lyftake� I I t Pipes) � 1� Z Lengt Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over G 71 Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center �b r 1( Bed /Trench Edges \ Topsoil Yes No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 2118 Cook Drive Unknown (SE 1/4 NW 1/4 21 T31N R18W) NA Lot 1 Parcel No: 21.31.18.364E �-J el Gl�a: d-- �o r15 1.) Alt BM Description = 2.) Bldg sewer length = �f I 3a - 7 1 - amount of cover = e Use o ther evisio de equir a dditional in Yes No 53 r 7 formation. Date Insoct&'sSi Cert. No. SBD -6710 (R.3/97) Safety and Buildin ivision 201 W. Washington Ave., P. 7162 V Madison, 53707 -7162 Sanitary Permit Number (to be filled in by Co.) (608) ) 266 -3156-315 1 4 7 A/0 Department of Commerce State Plan I.D. Number Sanitary Permit Application / 301 -3 d In accord with Comm 83.21, Wis. Adm. Code, perso information you provide may be used for secondary purposes Privac Law, s Pro Address (if different than mailin ddress) ZI l d Gov, �fi A_ I. Application Information — Please Print All Inf, ati n D t ( , p 60 Property Owner's Name 2006 Parcel # X11 Block # 0� Property Owner's Mailing Address N7 Property Location t� J� ��' ` ' 7., City, State ircle Section Zip Code Phone Number C ne) o t � T N; RJ_E or� II. Type of Building (check all that apply) Subdivision Name CSM Number I ,{ ❑ 1 or 2 Family Dwelling - Number of Bedrooms / ? p 6 ` JO` ¢ �q�✓ blic /Commercial- DescribeUse P /n-f' P Ct (o J O J O V . 1 I y ,, a ❑Village�jTownship o El State Owned — Describe Use Z Q� 51" (P L5 t.J 17 / 7 CL. ` S ❑o �— /"`� III. Type 9f Permit: (Check only one box on line A. Complete line B if applicable) A. ystem ❑ 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 Arc- IV of POWTS System: Check all that a 1 n - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil El At-Grade El 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. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capa VTanks Total Number Manufacturer Prefab Site el Fiber Plastic GalGallons of Units Concrete Constructed Glass New A/ 8e� Tanks Septic or Holding Tank Z S Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statemen - , the undersigne me responsibility for installation of the POWTS shown on the attached plans. Plumber's Natne (Print) Plumber's ture S� CA4_A,7W- /) umbe ( City, MP/MPRS Number Business Phone Number is Address Street Ci , State, Zi o �� VI oun /Department Use Onl Sanitary Permit Fee (includes Groundwater Dat Issue Issuin ent Signat re S Approved ❑ Surcharge Fee) ,yam g L-5/6 ❑ iven Rea so fhr Denial I ' w 15Z. Conditions of Ap*p roval/Reasons for Disapproval ygTENIOWNfR: 3 l��d S I � 1. Septic tank, effluent finer and , L,,,/ d u el ('(` 1 dispersal cell must all be services /maintained ( as per management plan provided by plumber. 2. AA 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) PLOT PLAN PROJECT Star Prairie Town Hall ADDRESS 2034 Ctv Rd 0 Somerset Wi 54025 SE 1'/ 4 NW 1/4s 21 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 93.1192.8 4' below grade 594 GPD CONVENTIONAL XXX AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 850 # of chambers 34 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Za ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark rZ ASS 384' Property Line 332' Property Line Calcs: Scale = 1/4" = 10 ' 330' Property Line 2 employees @ 13 GPd /employee = 26 gpd 3 floor drains @ 25 gpd /drain = 75 gpd 14'X 19' meeting room = 266 ftA2 266ftA2 / 10ftA2 /person X 1.3 gpd /person = 36 gpd 64' X 31' assembly area = 1984 ftA2 1984 ftA2 /10ftA2 /person X 1.3gpd /person = 259 gpd Total GPD = 396 X 1.5 (peak flow) = 594 gpd Tank size = 594 gpd X 2.088 = 1241 gallons (use 1255 gallon tank) Chambers: 594 gpd /.7ftA2 /gpd= 849 ftA2 /25ftA2 /chamber = 34 total chambers Pro Town Hall 14'X 19' Meeting room 3 Floor Drains 64' X 31' Assembly Hall 2 Employees Tank is to b properly bedded and pr vided Total GPD ® with lockdown over 594 with approved rning labels SI 85' Cells with >3' Spacing Well is to meet all - setbacks found in 97' Comm. 83 Vents 96' B -1 3% Slope B.M. Ct yRDC PLOT PLAN PROJECT Star Prairie Town Hall ADDRESS 2034 Ctv Rd O Somerset Wi 54025 SE 1/4 NW 1 /4S 21 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 93.1/92.8 4 below qrade GPD 594 CONVENTIONAL XXX AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 850 # of chambers 34 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Za - ❑ BOREHOLE O WELL w H. R. P . Same as Benchmark t°S 384 Property Line 332' Property Line Calcs: Scale = 1/4 = 10 330 , Property Line 2 employees @ 13 GPd /employee = 26 gpd 3 floor drains @ 25 gpd /drain = 75 gpd AL 14'X 19' meeting room = 266 ftA2 266ftA2 / 10ftA2 /person X 1.3 gpd /person = 36 gpd 64' X 31' assembly area = 1984 ftA2 1984 ftA2 /10ftA2 /person X 1.3gpd /person = 259 gpd Total GPD = 396 X 1.5 (peak flow) = 594 gpd Tank size = 594 gpd X 2.088 = 1241 gallons (use 1255 gallon tank) Chambers: 594 gpd /.7ftA2 /gpd= 849 ftA2 /25ftA2 /chamber = 34 total chambers I Pro Town Hall 14'X 19' Meeting room 3 Floor Drains 64' X 31' Assembly Hall 2 Employees Tank is to be properly bedded and provided Total GPD with lockdown cover 594 with approved warning labels ST 2 -3' X 85' Cells with >3' Spacing B -3 Well is to meet all setbacks found in 97' Comm. 83 Vents 96' B -1 B -2 3% Slope B.M. Cty RD C Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code t County • e r , Attach complete site plan on paper not less than 8 112 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, and location and distance to nearest road. 6 3Z ' — / g - 6 Please print all information. Review y Date Personal information you provide may be used for secondary purposes (Privacy Law, S. 15.04 (1) (m)). S Z 5 d Property Owner _ Property Location ell Govt. Lot 1/4 "/4 S I T3) N R E(, W Property Owners Mailing Address Lot # Block # Subd. me or CSM# o vo � Z / /Z) City StatV Zip Code Phone Number ❑ C. ❑ Village own earest Road New Construction Use: ❑ esidentiai I Number of be drooms yC+ 6a#e d 'ved design flow rate b y 6 0"0 GPD lo C3 Replacement ublic oclal Descr�[�Y13G� ✓ — ---- - - - - -- - — -- - -- Parent material �loo_d Plain ° el vation if applicable ft. General comments JUL 1 7 2006 un and reconenclations: D / /� l ST. CROIX COl NTY �cr t/� � • / System Type if o � ystem Ele atio & 1 Boring #. Boring Ground C 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 •E11#2 r/v 10v1317- C j , D -3 W,--5 .5 /G l� S /✓/ > > Z J 11 ® Boring # [] Boring L� (� t 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, f Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 o i L 2 .nsd /' (� 3 - .5 s ti / Ic Effluent #1 = BOD > 30 220 mg/L and TSS >30 1 ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L CST Alamo (Please Print) Ig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Con ucted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ��-- 715- 246 -4516 Property Owner _ Parcel ID # Page of Boring # ❑ Boring ® � Pit Ground surface elev. � ft. Depth to limiting factor Z 'n• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff in Munsell Qu. Sz. Cont. Color Gr . Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. - § ' o — ilApplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tt in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 Boring # Cj Boring El ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i� i Effluent #1 = BOD, > 30 < 220 mg1L and TSS >30 < 150 mgA_ ' Effluent #2 = BOD < 30 mg& 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. i seo-s330 tR.W00i Property Owner _ Parcel ID # Page of ® Boring # ❑ Boring MJ Pit Ground surface elelutl ft. Depth to limiting factor n T il ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary RooGPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#2 � C/ / S se Boring # ❑ Boring �I pit Ground surface elev. j Ci ` ,'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. 'Etf#1 •Eff* J F-1 Boring # a Boring Cl Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon 7epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Etf#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg& ' Effluent #2 = BOD < 30 mg& and TSS < 30 nxyL 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 -6330 MUM) Soil Test Plot Plan Project Name Star Prairie Township Shaun Address 2034 Cty RD C Somerset Wi 54025 CST 26900 Lot 1 Subdivision --- - ---- Date 7/12/06 SE 1/4 NW 1/4S 21 T 31 N /R W Township StarPrairie Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 93.1/92.8 *HRPSameasBenchmark Alternate Benchmark _Top of Survey Iron @ 95.5' 384' Property Line 330' Property Line Scale is 1" = 40' unless otherwise noted 332' Property Line Pro Town Hall 75' B -3 50' 97' 1 309 25' 96' 100' B -2 B -1 3% Slope AtI.B. 30' M. B.M. Safety and Buildings • 4003 N KINNEY COULEE RD commerceml.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 www.w i sconsin www.commer isco sin.go / t epartment of Commerce isconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 09, 2006 CUST ID No. 226900 ATTN. POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/09/2008 Identification Numbers Transaction ID No. 1308322 SITE: Site ID No. 716539 Star Prarie Township Please refer to':both identification numbers, County Hwy C above, in all corres ondence with the agency. . Town of Star Prairie, St Croix County SETA, NWl /4, S21, T3 IN, R18W -- FOR: Description: Commercial ( Town Hall) Non - pressurized In- ground System Object Type: POWTS Component Manual Regulated Object ID No.: 1090601 Maintenance required; 594 GPD Flow rate; 110 in Soil minimum depth to limiting factor from original grade; System: In- ground POWTS Component Manual, SBD- 10705 -P (N.01 /01); Commercial System, Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis..Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take A T' R precedence. IDEpARTWNT C tN 01 �fE The plumbing for this project discharges to a private sewage system. The approval covers only domestic /sanitary wastes directed into this system. The Department of Natural Resources must be contacted SEE CORF�EI regarding the treatment and disposal of all industrial wastes. • State and federal regulations prohibit the discharge of hazardous wastes to a private sewage system. Accidental discharge of any hazardous substance to a private sewage system must be reported to the Department of Natural Resources or the Wisconsin Division of Emergency Government. SHAUN R BIRD Page 2 8/9/2006 • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811A 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner-is--responsible for submitting a maintenance verification report acceptable to the county _ for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the components) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 GG4 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz J POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789-7893, 7:45 am - 4:30 pm Monday - Friday charlie.bratz @wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Cover Page s gF� 1 2006 Shaun Bird ��� /��' u d 049 Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 7/26/06 Owner: Star Prairie Township Location: SE1 /4 NW1 /4 S21 T31 N,R18W Lot 1 Cty RD C Star Prairie System type: In- ground absorbtion system(conventional) Manuals Used: In- ground absorbtion system (version 2.0) Page# 1. Cover Page 2. System Plot Plan 3.Chamber Cross S on 5 -6. maintance and tigency an 7 -9. Soil Test Signature License num r 226900 J J 7 VE D F COMb7ERCF IL[1lNG3 �PpNDEN . I Cross Section of Standard Biodiffuser Leaching Chamber Typical cross section for 2 of 2 cells ARC 36 Biodiffuser Leaching Chamber with 25.0 ft2 of Area To be >1' above grade -/ Finish grade elevation Ty Installation 96.0' Vent Grade Vent 3 ' 4 " 3 ' X30/34 Septic Tank 5' Long III 5' S' Long 1 » 3 6" Grade at System Elevation 36" Grade at System Elevation Spacing 5' 2 - 3' X 85' Cells Same on other end Observation tubeNent 9.5' -y � A B 17 chambers per cell System elevations: A B 92.8 ' Pagt of — z., T PLAN Q ER'S MANUAL & MAt+�AGE c � tQgTfpi�[s poVVTS SYSTF -M SPE Septic Tank Capes 5 g al © NA F " ictt = oTtoK ,_ <— x.11 n tZa D Septic Tank Manor went It=1teC � �2c� � -C'..1 a kA DESttt� P1M CIA �iclenf Fes' Model Lu t 0-0 . 0 NA t&nberof Bed f �y,Nq Pump -Tank CaPacRY Number Gomme� Units n , ¢ pump Tank Man mr W (at 9e) q atld - pump ManUMdwer Pump Model _ nt Unit Sol P+PP °n Rate MonthiY gage Pre I f=irtet - p Peat Ft Inftur� G) m y/L ❑ M anicat Aeration Q O�d Fats Oil & Grosse (FO S?Zfl ��' ❑ Dlsinfecdlon Bioche Q� scrods try} '050 m n- Mann ifactu & Total Mon" average" t3 a In- ground (pressuttzed) Priefir ByIuent Q - ground (gravliy) ❑Mound c;30 M911- At - g rade other siiochem� o Deraarsd (tiOD� � mg2 Q Dd ne ❑ r_ Total Suspended Solids (T-SS) :5 1W cfufl oomi mna el COW=' (9ebi" e!' i=!e�') `Fakirs ty pical f doh Fe trioit* wast»� Y inchdiameter ��kelRforp wasbE+� Maximum E'fAuent Particle S - ¢e «. values typical r Q e NTEPIMCE SCHEDULE service Frecluency •;� ❑months �l- YeaKS) (M�mu:n 3 yrs•) Servltx tac t p� least once every ird of tank volume �pndrGon o tank(s) itVtien combined sludge and scorn ego one -tJi CIS) inspect Ks) IMaximura 3 yrs - ? Pump Out contents Of tank(s) At least once every s) inspect dispersal cep At least once every p m � ,rs) 0 NA clean e ffl ue nt litter At least once every `� NA mp. Pu►Tip oontrats atarrn L3 csionths i3 year(s) Inspect P° test At least once every m onths 0 year(s) 0 NA Flush 6' ais and pressure At least once every s) p NA Q months II year{ Odw- At least once every bo che menses or Bl alt be made by an Cat tyin9 one of p following rrI di pe n ind S DS inspector: PC3W rs mta or WO I nspee6or►s hissw Plumber Restrscted PO on of the W k( s ) to idenfifY 1 sm wcKfor any back up �p mr - Master Plumber: include a visual inspecti scum and zn' t Sert� Operator. Tank insQe�or'S to inspected ck the e ffl u ent leve crate or teatcs. measure the volume of combined stodge and nd e ffl u ent on the hambrA +e, identftY any d surface- The dispersal cell(s) shaft ug cc. Ttte or p0n1* g of ellktent on the groun any ponding of ef�uent on tits ground fica � the local neguls -duly at�orw In the obse rvation ptp� and to check wires the immediate nob t2fik volume• the ground surface �y indicatie a faf ng d nand r� in any tan k eQ�s °ne' d (v or more d am ,_ NR ui Won of sludge and wrn in Se n9 pperat°r and disposed When the combined accUm i pYed by enta d fhe tank shalt be raetrt t components: and MW 113, Wisc�isin Administrative or pMSsurized POWTS romponents� POWTS maiat�er- The 9 °f �tlstent filters a is of 12 months or less shaft be P?rfO lion of any service event- 0Mermalntt Mnce Or n1Oni M9 at intQr atrtttorit�! within 1Q � Of con'►P A re pcwt shall - be provided to ttie Iocaf regulaturY produ or O ther START UP AND OPERAnQN treatment tanks} for the p = of pale r P - pO S chid cell(s). if ,�cen"fions are For new ooc n. per to use of the t s andlor damage the crisp c h e micals t m e $) p remo by a septage serviccng operator pciar to use r d etected Page of l'conciitions are frozen 3t the infiltrative surfaee- art up shat( not ctrvvht(rt is re�rtrd the t S �,fages pump Tanks trsay above normal tsighwater }er�eis. when I purging it oell(s) in one Large dose,rerloadng the ces (s) and may result in the wastewater be crs d=Ved to the id this sitssatiors have the contents of the pdmp Tank removed by a bac W or s arfar a des He of eft 'Power to the effluent pump or contac , a Ptttcnbet or POYVT`' Mat er !o asSiSt N Me �P conb1 fs to restore normal levers within the pump tank - y acs and drsWsal togs- Do not drive Or Palk Over- or otter d or(*Mpact, do not diYa or Pali( mound or at -grade soil ahs4rptlon area - the arm vAft 15 feet down scope of XW im are the pert VrW= and Pig the Gfe Redrrceion or-errrninadon of $'ie �g from the wastewater stream may Pr° d y detlfa( floss: d3Pec5: of the PQ 1AlTS_ an�tr 6rlfis; ,condoms; caftan swabs, �� meat drab rsrater fruit and vegetable peermgs 8 fey gmas med s; e* p"M Products; peshades sanftary pins: tampons: der brine. ft (SUMP PUMP a pp faits and/or is permane�Y taken out Of svrsoe er the forfouAng steps shad he W� tD insure that the liattce with ch_ C,4rssm 83.33, y •ssin Admisslstrative Code: When systeris is properly =d safety abandoned in cxrmp of a ned pipe ope m tanks and pits shall •be disconnected and the abandoned ort Se� ndang OP�� • A{[ piping to be re moved and properly disposed � and the void spate aonLenLG an tanks and Pits • After pumplag. at[ tanks and pits shall be excavated and removed or their opvem removed- and wffli so% gmVel or 2f*&er inert solid material_ repaired coMMGENCY PLATT the following measures have been, or must be taken. to provide a code if the p0VIITS fads and cannot be mmpGant replacement system evaluated and may be utilized far the tocatson of a replacement S.0 A suitable reptacement-ar has been and should not abso pin stern_ The replacement area should be protected from disturban and and �� to be infringed upon by required setbacks from e�ng and proposed st - es tablish t protect the replacement area wffl result in the need for anew soil and sits: at tha fin:e a suitabl replacement area- Replacerrrent syste must comply tivitis the rules in effect advances in POWTS' p A suitable replacement an33 is not avaffabie due to setback and/or soil Fun:ta s_ Barr►ng technology a folding tank. may be install as a tact resort is rsprace The fared gpltttTS_ CI The site has not been, e,aluated to identify a suitable replacement area Upon re re of the PO is Z a sotl 'an a. pert site evaluation must be to locate a suita>le replacement area_ tf no repiaces:ient alz 5 available a holding tank may be irastatlled as a Last resort to mplace the fazed PO place of the biomat at El Mound and at -grade 3011 absorption systems as ems ay be reconstructed in ptaoe to rul in effect at that lime sn5 the Ofirl>ra6ve surface, R uctsans of such systems ,must comply with the rul <cYfrA£2NtNL�� TANKS MAY CONTAIN LETHAL ,, GASES AND OR INSUFFICIENT OXY09C SEPTIC, PUMP AND OTHER 'TREATMENT TAN TREATMENT TANK UNDER ANY CIRCUMSTANCES_ DEATH MAY DO NOT ENTER A SEPTIC, Pil1VIP OR OTHER RESULT_. RESCUE OF A PERSON FROM THE INTERIOR O� A TANK MAY BE DIFFICULT OR IMPOSSI ADDITIONAL COMN(Oa - S POYYTS MAINTAINER POYYfSS INSTALLER / j r Name Y" Name CJ� t�Y+✓ Phone Phone SEFTA� sEMCIt4 s O PERATOR PUMP Lo :AL REGULA AUTHOR Name E y c ', Cr !Phone A 3' arid Sandation - daunrrent meets This doa b3' fTie stziFs of the Q aBA t srre, I�ILargtrette and Wauslura County Zoiting t does not hls doh me mi�aa mq of h- COMM a3-=4& (1X0&1 wid Z3- 5q1)• (2) 8 (j). W A* rirr&U7ffM Coda- Use of t t,�nr{?JOt) guarantee the perfor =01-1 of tlse POSVrs. ST. CROIX COUNTY SEPTIC TANK. MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address a2 bs Pro ert Address A l ` U � � P y (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number LEGAL DESCRIPTION Q Property Location t,c� r T 31 N �W, Town of T �'u �C /a �' /a ,Sec. / Subdivision Lot # Certified Survey Map # — 5 1 , Volume ,Page # Warranty Deed # , Volume . Page Spec house yes no Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 -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. 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe 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 w anty deed recorded in Register of Deeds Office. 4)�_�7 G A NAT ' LJRE OF APPLICANT(S) DATE * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * * Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) 1 FORM NO. %5 -A ' �c...aw.c...w.r® �7 ♦-. r- n CERTIFIED SURVEY MAP N 1/4 CORNER SECTION 21, T31 N. R18 W SCALE IN FEET O 100 200 300 �o �r — LEGEND — N 0 0 3/4" X 24", ROUND STEEL REINFORCING BAR N WEIGHING 1.502 LBS/ LINEAL FOOT SET 208. 6 3/4"X 24" ROUND STEEL BAR FOUND WEST P. K. NAIL FOUND m z a ° W �m Uj z M Z w J W _ J zoo U p I.qNQ AWNED @Y QQQJS N BY��ANGNESSN� QWQ o H N ~ h O U v Z ho S 88 34' 51 "E 384.00' C; N v � m om= op POINT OF BEGINNING 9 N °' a�a le SE -NW N JI ° O N LOT I I SO C31 m 3.186 AC. NORTHERLY RIGHT -OF -WAY z M 3 LINE o 1 NOTF: Lot 1 is to be used for al recreational purposes. I£ a home is O r =1 m erected the $100.00 park fee must be N / �1 paid. � o o -- N W / �I N QI O z z o �G = 25 04' 36" 0� / al ti R = 909.93 oAg 0 S CGUN�r � o f S 1/4 CORNER VA SECTION 21 THIS INSTRUMENT DRAFTED BY J.D. NICKLEBY T 31 N , R IS W a lit IL An 28 *J f see& C; APPROVED a , w Wkwsds �'" ASR 2 3 1980 e � ST. CRO1X COUNTY COMPak"IFNIMVE PARKS PLANWNG AND ZO NLLi G COMMITTEE Volume 11 Page 934 DESCRIPTION A parcel; of land located in the SE1 of the NWr of Section 21, T31N, R18W, Town of Star Prairie, St. Croix County, Wisconsin, described as follows: Commencing at the Nw corner of said Sect ion 21; thence S1 0 25'09 "W 2002.26' along the North -South _ Section line; thence WEST 208.6'; thence S1 "lti 211.30' to the point of beginning; thence continuing S "W 300.00' to the Northerly right -of -way line of present County Trunk Highway "C "; thence Westerl-y 398.25' along said Northerly line on a 909.93' radius curve concave Northerly whose chord bears S7'( "W 395.08'; thence N1 ° 25'09 'E 392 .89'; thence S88 "E 384.00' to the point of beginning. Subject to easements and restrictions of record. Containing 3.186 acres, more or less. 1, James E. Rusch, registered Wisconsin Land Surveyor, do hereby certify that I have surveyed and _napped the above described property; that such plat is a true and correct representation of t;he exterior boundaries of the land surveyed; and that. I have fully complied with the provisions of Chapter 236.3+ of the Wisconsin Statutes and the St. Croix County Subdivision Ordinance to the best of my professional knowledge, understanding, and belief. James E. Rusch Wisconsin Land urveyor S- ,ee {ldttltl Stevens rs, Inc. ♦ ♦ ♦�yGONs��� WO 1 Coulee lec Road - Box 321 ♦ ♦' Hudson, 1 4i.sconsin 54416 w March 6, 1980 z JAMES E. RUSCH s S -1 376 Surveyed. for: Vernon Nelson � S erFalls. Township Chairman WIS. � 'y'ya �t•�i�iiN Volume 4 Page 931 c 1 J V .. ........ 1 DOCUMENT N0. STATE BAR OF WISCONSIN - FORM Z rr, r / W ARRANTY DEAD V �'t. U 11 . ti I D I'MIS %1`A%;[ K3901010 FGA NIC0401" DATA I -- - - - - - -- -- •,._ _... - - —__ _ _ - -- - - - - -- REGif TZP.S OFFICE Robert J. Cook and Marjorie Mar E. Cook husband _1_ — . t. _ .t. cpo"X CO., Wa and wife "a Iciinti tenants�as to a._1[_3_ interest fia 4�aor� his 9th Theodore a Cook and Susan D. Cook husba Vinci wiEN s, j, tenants - as to a j/ i- ntgt 'ay ofsY _/.0, 1Q 84 and _Gary - ,as_ t a 1%3 as ...to. _ _ ' - - - -- cunvevs and rra (1�� g :.Town of St r Prai • St_ _Qroix wiscgnsin,,,..a, cigal 1 the tol lowinj described real estate In t. —Cr-QLX -- — County, State of Wisconsin, Tax Key No. _ 1 1 � Part of the Southeast Quarter of the Northwest Quarter (SEk of NA), Section Twcnty -onc (21), Township Thirty -one (31) North, Range Eighteen (18) West, described as follows: Lot One (1) of Certi°ied Survey Map, No. 934, Filed April 28, 1980, in volritrlc "4" of Certifies Survey Maps, page 934, as Document no. 363858. Grantors hcrcof, retain right -of -first refusal for a period of ten (10) years from the dare of this Warranty Deed, in the event the Grantees hereof decide to sell the above described property. I • 1 • 4 This 1 S n� thomestead property. —•_.- VS) Us not) rZ��, E.ceprton to *arranhes. ; 7 • r 4 Oateo tms _. 6 Day of - -� - - - ,...._ . e Theod a - J . Coo , _ _ l (SEAL) ��� -� (SEAL) . 11abe=rt J. Cook Sti{ran' D. Coo (SEAL) �' '► '" '~ ' ' ••:r -r•� (SEAL) j - Mar P orie E. Conk Gar L. Cook i N ' • AUTHENTICATION a ACKNOWLEDGEMENT S- gnatvres authenticated this , day of STATE OF WISCONSIN Croix _County. se. - Personally carne before mo. thla _ 6 day Ot TITt_E mEMBEA STATE BAR OF WISRONSIII It) �•:. �..,•. , the above•hamod autnorized by § T0636. Wi s. S11113.1 ~ R obert J. Cock, Ma_rjor�i:s Cqnk - Theodo J. Co ok, cop ' - -..._ .... rME rrtglrurnwr *as wafted by ' and Gary L. Cook T ,� _,�_ '• ' Rein.stra, Van Dyl>;-6-N S.C. Z00 /loom Sasso d0 eax 00 xiouo zS L897 98E 614 xrrd CT;TT�RON 900z/91/80 FORM N0, 985 -A H.C,Millar Conpuly� J .. CERTIFIED SURVEY MAP N 1/4 CORNER SECTION 21, T31 N, R18 W SCALE IN FEET 0 100 200 300 co — LEGEND — N O Q 3/4 X 24' i ROUND STEEL REINFORCING BAR N WEIGHING 1.502 LBS/ LINEAL FOOT SET 208. 6 3/4 24 ROUND STEEL BAR FOUND WEST P. K. NAIL FOUND 0 O? it a o W W m U W W Z O Z W J W — J LL o o U NPLATTED LAND OWNED BY DQO N UNPLATTED LAND OWNED p BY LANGNESS 0 F- fn V 0 W Z (no S 88 34' 51 "E 384.00' C; w a 9 p rn d m �z 0� POINT OF BEGINNING \ N w z o S��T► G SysT N W � 0 Z N =N YI s. SE -NW r.. < F- O � J � N ui � CO L O T I s 0 M 0 I m 3.186 AC. NORTHERLY RIGH� -OF -WAY 3 LINE — o1 O m NOTE: Lot 1 is to be used for m 1 ` recreationa:L purposes. If a home is 0 ° z� ��•./ W erected the $ 100.00 park fee must be N / 4I o) paid. / 0 0 3 W / HI N S� O zI Z A = 25 04 3611 w I o cv R = 909. 93 S ? - T O 49 k? ,, G 398.25 RuNK H�GN�P�i C ' OF —W VAR�A81GMT S I/4 CORNER SECTION 21, THIS INSTRUMENT DRAFTED BY J.D. NICKLEBY T 31 N , R 18 W 1. .2 � �Ot APR agl0 ,P APPROVED &will APR 23 1990 a L k ST. CROIX COUNTY I(R. COMP.ZEHENSIVE PARIGS PLANNING AND ZONING COMMITTEE Volume 4 Pag 934 PArcel #: 038 - 1089 -70 -000 07/02/2007 01:43 PM PAGE 1 O F 1 Alt. Parcel #: 21.31.18.364E 038 - TOWN OF STAR PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - TOWN OF STAR PRAIRIE, %TOWN CLERK %TOWN CLERK TOWN OF STAR PRAIRIE 2125 CTY RD CC NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): , = Primary Type Dist # Description SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.190 Plat: N/A -NOT AVAILABLE SEC 21 T31 R1 8W 3.19A IN SE NW LOT 1 OF Block/Condo Bldg: CSM IN VOL IV PAGE 934 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 21-31N-18W Notes: Parcel History: Date Doc # Vol /Page Type 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/26/1992 Description Class Acres Land Improve Total State Reason OTHER X4 3.190 0 0 0 NO Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00