HomeMy WebLinkAbout038-1107-10-000 JVisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. CTOIX
Safety and Building Division �, y Sanitary Permit No:
INSPECTION REPORT 395153 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:
Schalla, William I Star Prairie Township 038 - 1107 -10 -000
CST BM Elev: Insp. BM llev: I BM gescriptign: _ S
t e t� l li
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic , f ' n n / _ I D Benchmar � - / lob/
� f J — F
Dosing Alt. BM
Aeration Bldg. Sewer Z
�S
Holding `J S Ht Inlet
S Ht Outlet - 7 d
TANK SETBACK INFORMATION
TANK TO /L WELL BLDG. Vent to Air In ake ROAD Dt Inlet �--
Septic ` � � l � .�/ � f � Dt Bottom
�5 o0
Dosing Header /Man.��
Aeration Dist. Pipe 0� p Cj
Bot. Sys em 1 p
Holding ,'t.c j job
PUMP /SIPHON INFORMATION Final Grade 3�
Manufacturer Demand S Cover I A l ' OD, -7
Model Nu ber
TDH Lift Friction L System Head TDH Ft
For ain gth Dia. Dist. to well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width 1 Length I No. Of T riches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS U
SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /ST AM LEACHING c ✓ /, /,
INFORMATION HAMBER OR -� C!
Ty Of System: f ` ol� ( UNIT Model Number:
DISTRIBUTION SYSTEM Al
Header /Manifolcy Distribution GN �f �� x Hole Size x Hole Spacing Vent to Intake 61
Length Dia ^ r Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
D Depth Over xx Depth of xx Seeded /Sodded xx Mulched
B d/Trench e�; / Bed/Trench Edges Topsoil A Y es [] No [� Yes F] No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:__U_J 1 D /_P Inspection #2:
Location: 1918 County A I�p ad CC New Richmond, WI 54017 (SE 1/4 SE 1/4 26 T31 N R18W) NA Lot Parcel No: 26.31.18.450C
'
1.) Alt BM Description = 7 A f e r p 6u mJ a fs t- .t --` S S 4eVK `v7 dS I 'S diwc S t,& ,,., ar 5 vv~.0
1 - e lQ VA 41 �P°"�' SQ Cs we r -t- c�S sd taw he
2.) Bldg sewer length
='�� h � � d , ,
- amount of cover = l S't� -,� � l 4
y,2 �` ,S �ut�
KGs DS
Plan revision Required? � � Yes No I �, �{iyl„ r
Use other side for additional information. ' 1
Date Insepctor's Signature Cart. No.
SBD -6710 (R.3/97)
a 4 7 Y
C
� S
` Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162
S� s�� Madison, Wl 53707 - 7162 Site Address
LTP
tm8nt of Commerce
Sanitary Permit Applica ' -� Sanitary Pe Number
In accord with Comm 83.21. Was, Adm. Code, personal I !f J , �i{ Q� l � J — 3
ma be used for second ses Pri ❑ Check if Revision J ( !
I. Application iblformation - Please Print All Irrformatio -- ; State Plan I.D. Number
r LrElvf Q
Property owner's Name C•3
J . Parcel Number
Property Owner's Mailing Address - a D
U r t , Y Property
City, State Zip Code Location
01 GiXRCk 'A S,�'A; S T J iY R /
�...
Phone Number Lot ! N r Block Number
Subdivision Name CSM Number
--
II. Type of Building (check all that apply) ✓
Doty
2 Fatuity Dwetling - Number of Bcd=ooms ✓ �-
❑Village
13 Public/Commercial- Describe Use wnshi � ar. ✓ Pr
❑ State Owned rest Road
0 a_ /
M. Type of Permit: (Check only one box on -line A (numbering scheme for internal use). Complete line applicable)
A. 1 ❑ New ement System 3 ❑ Replacement of 6 11 Addition to For County use
stem I Tank Only Existing system
B • ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued
IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use)
Prossurir -d In- Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland
❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass" 51 ❑ Drip Line
45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other 6 75
V. DISPIRES&Meatment Area Information' t 4 bier A - to _
Design Flow (gpd) Dispersal Area Dispersal Area Soil A I' don Percolation Rate S stem Elevatio Final Grade
tNd Proposed Rate(Gals./Dayp/�SFt� j (Min.lInch) � Elevation
- 2 Z, 1 ?Z4
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
Dosisg Chamber
VII. flit Statement- I, flee undersigned, assume rw or installation of the POWTS shown o attached
Plumber's Name (Print) Number' Si MPAQRS Num Business Phone Numbe
� , �- 6
Plumber's Address (Street, City, State, Z e)
VIII me t Use Only
Approved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Surcharge Fee,
D❑ es Initial Adverse e on .
IX. Condit(ons of Approvalateasons
'U
a4 t: c ga,F1��ew.
.•(4 '�t,r -_. a2trrt�� no .. �., ; :. w,,,c.�,,, f� •'h etc `U CJ - f°"�:' .�a.� �
¢xiA t� ou, e 3 6�uytl.a►, c+,v tic uQ u wo„- r t) i�C.
� eemplete alms do the county gab) for an yW pot lees then $141 s 11 in size
�� �� Z • o - Coti►�calP 5 �m� J�n!'sbvl'L. � 1
SBD -6398 (R.. 05101) _
i
PLOT PLAN
PROJECT Wiliam Schalla ADDRESS 1918 Countv Road CC New Richmond Wi 54017
SE 1/4 SE 1 /4S 26 /T 31 /R 18 W TOWN Star Prairie COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE7/16/01 BEDROOM 3
CONVENTIONAL X04C IN -GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 377 # of chamb rs 22
BENCHMARK V.R.P. Base of House Siding ASSUME ELEVATION 100' Filter Zabel A -100
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 94.5
Alt. BM Top of Hydrant @ 99.6'
Property Line
Vent
Sidewinder High Plans Designed Using
> 12" g Conventional Powts
of Cover Capacity Leaching Manual Version 2.0
"
Chamber
6 Lon
16
Long 34" Grade at System Elevation B- Vents
Site has 0% Slope 70, o
and thus no
contour lines Alt
B -3
55'
2 -3' X 69' Cells with >3' Spacing
35'
75' 20' * B .M. DW 50' '
20' 25' 30' Wr 20' ISM 30 - T B -1 Vents
Pro 3
Bedroom
House
Well Please note: septic tank was unable to be 125
located, one does exist, and will have to be
pumped and buried at the time of installation
Note to County: boring were dug very deep
and the proposed system elevation may
have to be deeper due to the depth of the
existing building sewer.
County Road CC
WisccAsin Department of Commerce SOIL EVALUATION REPORT Page of
Divisibn of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
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 Parcel I.D. TT
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 7 ' �� / _CZ)n
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
Govt. Lot 1 /&Carl /4 T N R E r) W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1 e � °_' 3V
City ate Zip Code Phone Number ❑ City ❑ Village n earest Road
❑ New Construction use Residential / Number of bedrooms Code derived design flow rate cs� GPD
Replacement ❑ Public or c mmercial - Describe:
Parent material �� �.,t�r -e Flood Plain elevation if applicable <� ft.
General comments ,�—
and recommendations; — f /
F- /1 Boring # ❑ Boring
Ground surface elev. aj a ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
S X L 7 /Z
Boring # ❑Boring — /
Opit Ground surface elev •' ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
✓ 7
n
G
*Effluent #1 = BOD > 30 < 220 mg /L nd TSS >30 < 150 mg /L *Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L
CST N me (Please Print) Signature iber
Address DateFtvalu on Conducted Telephone Number
SBD -8330 (R07 /00)
�0
Property Owner Parcel ID # Page of
F3-1 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 /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
�9f a
,3 ice, fZ
❑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 /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F] Boring # ❑ El Pit Boring F
Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
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.
I
SBD -8330 (R.07 /00)
Soil Test Plot Plan
Project Name William Schalla Shan# d
Address 1918 County Road CC
New Richmond Wi 54017 V #226900
Lot 1 Subdivision ------- Date 7/15/01
SE 1/4 SE 1/4S 26 T 31 N/R 1 8 W Township Star Prairie
❑ Boring 0 Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Base of House Siding
System Elevation 94.5 *HRP Same as Benchmark
Alt. BM Top of Hydrant @ 99.6'
Property Line
Note to County: boring were dug very deep
and the proposed system elevation may
have to be deeper due to the depth of the
existing building sewer.
Site has 0% Slope B -2 5
and thus no
contour lines
a�
70' °
Alt. B-3 91-7
1-110 -hL
55'
5'
75' 20' * B M. 50' 9 q ' AJ
20' B -1 30 '
20' D W
Pro 3 - F, , be,
Bedroom
House
Well Please note: septic tank was unable to be 125
located, one does exist, and will have to be
pumped and buried at the time of installation
County Road CC
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
LiL�/U�t m
Shaun Bird #226900
ST CROIX COUNT y
SEPTIC WANK MA1'MNANCE AGRBVMBNT
AND
OWNERSHIP CERTIFICATI N FORM
Owner/Buyer � ��� - oy L
Mailing Address
Property Address
(Verification required from Planning Department for now construction)
r
CitylState (I� Parcel Identification Number
LE.. G„ pESCRIPTIO?y C�<S �j -- 4�Q
Property Location y., � %,, Sec. a . T N -R,� W, Town o f- - 5/ - f ��
Subdivision , ut #
Certified Survey Map # � i Volume j Page # 31 7
Warranty Deed Volume Page d _ z 1 K _.
Spec house E3 yes;Pfw Lot lines identifiaQ no
SL= MADMNA=
Improper rise and maint=aceof your septic system could result in fts premature fail= to handle wastes. Proper maintenance
consists of pumping butt the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the Amation of the septic talc as a bmtment stage in the waste disposal system.
The PmPerty owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
masterplumber, joutneysmnplumber, restrictedplumber or a licensed pumper verifying that (1) the ou -sito wastawaterdisposal system
is is Pmle' olMft8 condition and/or (1) after inspection and pump Lug (if necessary), the septic tank is less than I/3 fiill of sludge.
Uwe, the undersigned have read the above wT&ements and to maintain the Private Sewage sal tandards
set forth, here � set the P � � system with the s
iq by Department of C amerce and the Department of Natural Resources, State of Wisconsin.: Certification
starting that your septic systesa has been maintained uuu5t be completed sad retumod to the St.. Croix County Zooming otnoe within 34
days of the dine year expiration date
7 �, 6 1 moo(
SIQNA OF APPLYCATI'I` DATE
O R C 2MMAI 41Y
I (we) certify that all statements oa this f arc true to the best of my (our) knowledge. l (we }. am (are) 'the owner(s) of
e p rty do lb abo a. b of a ty deed recorded in Register of Deeds Office,
IONATURE OP APPLICANT
DATE
Any kformation that is iriis- representedmay result in the sanitary permit being revoked by the Zoning Department. "'••"� •
' • Include Wth appiieation: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey nap if reference is made in the warranty deed
c
1
5,18997 STATE BAR OF WISCONSIN UORNII 2 1982
WA RRA N FY DEED
DOCILIMENr NO.
REGSTI
Karea-- bi---- Basel- -and-Jaapat --L, Bur k-e St CK
as tenants in common pec !'c T P.
SEP 3 1996
k:(,r%v)s and %carrants to _William J. Schal la , Jr and
Rebecca A. S ta — husband -- an - d ---- wife , ------- at 9:15 A M
-�KALj.— -ik 0.4t, I I
P44stisrot Deeds
THiS SPACE RFSER',ED POR RECCROING DATA A
1'.4ME AND -IETt -HN ADDRESS
he following descnhtd real estate in St. Croix
Count%
State of Wisconsin
7
PARCEL IOENTIF,CATIGN NUMBER
Part of the SEI/4 of the SE1/4 of Section 26, T31N, R18W,
Town of Star Prairie, St. Croix County, Wisconsin, further
described as: Lot 1 of Certified Survey Map filed August 19
1996, in Vol 11 , Page 3143 , of Certified Survey Maps in
the office of the Register of Deeds for St. Croix County, Wisconsin.
T N'�FER
0-�
A
FEE
This is not homestead property
0.0 (is not)
Exception to warranties: Easements, restrictions and rights -of -way of record,
if any.
Dated this 28th February 96
d of A.D, 19-,
(SEAL) (SEAL)
Ka en M. Basel J L. Burke
(SEAL) (SEAL) &
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) State of Wisconsin,
A
ss.
St. Croix Count
authenticated this - day of 19_ Personally came before me this 28th day of
February
19 96 , the above w!med
Karen M. Basel and Janet L. Burke, 1 44
as tenants in common
TITLE: MEMBER STATE BAR OF WISCONSIN it A_
(if [lot,
authorized by §706.06, Wis. Staits.) Connie M. Gullixson - Tk to be the perst-m S 0 executed the foregoing
-0 me
Notary Public ins. 41d ackpo the sa
THIS INSTRUMENT WAS DRAFTED BY
Kristina Ogland Sta!e of Wisconsin 7 c 'i
l nnie M. Gullixson
Attorney at Law Notary Public, St. Croix Uiunty, Wis.
k;:3tureS ma -
y be authenticated or acknowledged. lk)th are not Nly commission ts l rmancrit. (if not, state expiration date:
necessary.) 14 19 97
'Narriesof persons si6nin in anycapikity should b%. typed or printed Mow their signatures. �. In �F
STATE BAR Of WISCONSIN Lega Biar* Co i nc WARRANTY DEED
Form No. 2 - 1982 Aws
FjLED �o
CID
s AUc
1 9 1996 ► 11
KATH�IH w
�C olx of
548338 � CI '" W
E1 /4 Corner of
CERTIFIED SURVEY MAP Section 26
Located in part of the SE1 /4 of the SE1 /4 of
Section 26 T31N R18W Town of Star Prairie
St. Croix County, Wisconsin. ^ Ln
N 0
UNPLATTED LANDS o OWNERS
�T 0 �, 11 ' Karen Basel &
0 S89 3 5 W 416.27 65 ,00' Janet Burke
w 1462 95th Street
M
N00 °04 05nW ; 65' 50' New Richmond, WI
c o 54017
Trailer •.•S89 0
5 • 'W t C' Ptr
m House �Jl�•
House
Shed
I L D
M to
w
C w
AUG I
V C
° NOIX COUNTY Shed U�
�? ;x• ;.• shensive Plannii •
.o N C/A
%oning and I AI
Im o 1 a.t3CS COfitrrllttel•
•�� _� O JI
m n iot recorded UI c
: u-an 30 days of : Barn =i ch � W
;lowovat data °• h Hi
<,iovat shag be %0 zi 3 m Q1
o -'' k "" LOT 1 lic Z
Ln Shed -r 'd' C
en
MI O o }-I •"-
cT p 0
z Ji o0 7.50 Acres Inc. R/W (326,879 Sq.; Ft.) zz Zj o +,
O N
6.69 Acres Exc. R/W_(291,629 SqZ Ft.) =O, 2 w
Al W 6.6 Ac. t Exc. R/W & water UI
n I �1 ' ' LEGEND
Ln 'vj
Y JI 19 Aluminum County Section Corner
aI c Monument
m �1 C O 1 "x24" Iron Pipe Set, weighing 1,68
lbs. per linear foot. \�)
. • • • • • . • • • • • • • • 100' Roadway Setback Line 50,'x'
u. �
=ac Existing Fencel i ne ALLEN
I I PREVIOUSLY RECORDED BEARING N
-
w-
Hdtp a ti
.— N
E 168.00' L-50 .00! �.!y .q� »....'' iG -lc? ,•,
SU ��`•� 1n � y �""
29' 218.00gce4b'�
N89 0 35'02 "E 1 '
N �
F SCALE IN FEET
UI
0 50 i 100 150 O Ln = i 001
1-1 001 c -r
s �S. O JI MI N C ,�-II
�re4C /cv N O JI MI z CIO
I M o O QI _
! /N/ 0 2
OI
2247.35' S9 ' 1\ W ER 218.001 i
L N89035102"E 198.27' tse9 ° 35 . 25 ; i N89 °35'02 "E 1/4 Corner of N89 °35' 02 "E South 1'
Section 26 Q o �
LOT 1 C.S. MM. .V, 7 ��