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HomeMy WebLinkAbout038-1221-15-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division. INSPECTION REPORT Sanitary Permit No: 514818 lk GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes tPrivacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: P.C. C011ova Builders, Inc. Star Prairie, Town of 038 - 1221 -15 -000 CST BM Elev Insp. Elev: M Description: Section/Town /Range /Map No: Y 0 � B , 0 Z2— 31.31.18.1215 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. a Septic �QUU Benchmark �n Dosing � Alt. BM Gt/ Aeration - - - - -- Bldg. Sewer tr �. 9z. 3 Holding _ _. St /Ht Inlet TANK SETS C St/Ht Outlet IN , TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / Dt Bottom > ,j 2R ---- -_ Dosing Header /Man. llv� Aeration Dist. Pipe Holding Bot. System Final Grade PUMPISIPHON INFORMATION L4i /w ,d Manufacturer Demand St Cover GPM Z o? •� 3. Model Number TDH Lift Friction Loss y m Head J TDH Ft Forcemain Length Dia. Dist to I F SOIL ABSORPTION SYSTEM e -J— BED /TRENCH Width I Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO (!� P/L G LAKE /STREAM ACHING anu to r: INFORMATION HAMBER OR Type Of System I Mode umber: DISTRIBUTION SYSTEM /) / llJ 'fin /`�Q Header /Manifoid Distribution x Hole Size x Hole Spacing Vent t Air Intake pip 14— / 41 _ /� Length Dia Lengt Dia Spacing 7 5 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only aov Dept Depth Over xx Depth of xx Seeded /Sodded r ulched B /Trench nter Bed/Trench Edges Topsoil [7j Yes [ No ❑Yes [j No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1 _ /(d / , Inspection #2: / / Location: 1847 90th Street New Richmond, WI 54017 (SE 1;4 NE 1/4 31 T31 R1 8W) Prairie Pond Breaks' LoN5 Parcel No: 31.31.18.1215 1.) Alt BM Description = / U1 2.) Bldg sewer length = 7— I/ / (jt� � mac._ - amount of cover = f 2 , Plan revision Required? ❑ Yes No y j Use other side for additional information. SBD -6710 (R.3/97) Date s Signature Cent. No. commerce.wi.90V Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 C ,�r� i y Madison, W 1 53707 -7162 Sanitary Petro itNumber be filled in by Co.) Sanitary Permit Applica ' n State Transaction Number AA- in accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this fo the ropri go ental unit is required prior to obtaining a sanitary permit. Note. Application f 5 are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary ��� 90 p urposes in accordance with the Privacy Law, s. 15. 1 m , Slats. , 1. AnDlication Information - Please Print All Information Property Owner' me C Parcel # 038 1zZl - �5�acx� , Property Owner's Mailing Address Property Location • z R O / ST. CROIX COUNTY Govt. Lot City, State Zip Code N w ' /., (1 ll ,'/ Section �'V T N, R / Kircl -E* Q. Type of Building (check all that apply) Lot # �- � / \ Subdivision Name or 2 Family Dwelling - Number of Bedroo ✓ v'�? / J _ QCi t� �,C�M.t �-•. Block# T ❑ Public /Commercial - Describe Use Cl City of CSM Number ❑ Village of ❑State Owned - Describe Use .-- Town of Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. )( New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number nd DIp Issued B. ❑ Permit Renewal ermit Revision _ ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration ` Owner IV. Type of POWTS S stem/Com onent/Device: Check all that appi No n- Presc�riz� L_ - G_�un ❑ Pressurized ln- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil [I Mound < 24 in of suitable r , t 6P1 te` _ ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑Pretreatment Device (explain) V. Dis ersaLTreatment Area Information: t Des" Flow (gpd) Design Soil Applicat Rate(gpdsf) Dispersal Area Required Disp Area Proposed ( System Elevation v i 641-i, 6 -�/ - to 9• VI. Tank Info Capacity m CmUons Units Manufacturer Gallons �+ New Tanks Existing Tanks Bcs�- Septic or Holding Tank f,r W I x u �' 7� Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assume nsibility for installation of the POWIrS shown on the attached plans. Plumber' Name (Print) Plumber's lure MP /MPRS Number Business Phone Number ��c1,L, F; Z Z�j'p�j z/ ✓ - -0 0 2 Plumber's Address (Street, City, State, Zip Code) VII oun /De artment Use Onl Approved ❑ pp�e i v enReasonfU permit Fee IX. Conditions Da �7 d lssu" era Sign An enasons for Disappr oval enial i ns o A � o : 1. Septic tank, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. All setback requirements must be maintaihed e system and submit to the County only on paper not lea than 8 1/2 x 11 inches in size SBD -6398 (R. 01/07) Valid thnrO1 /09 Soil Test and System PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. DDRESS P.O. Box 489 S omerset Wi 54025 SE 1 NE /4 1 /4S 31 /T 31 18 / W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 1 18/08 BEDROOM 3 CONVENTIONAL XXX IN -GROUN RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE WELL *H. R. P. Same as Benchmark Well is to meet alt' setbacks required by SYSTEM ELEVATION 88.5/88.6 5.5' below qrade @ B -2 WDNR i 90th St. Plans Designed Using 540' Conventional Powts Manual Version 2.0 ro 3 Z 9 edroom g M f House ST ° 0 1 60' Lot corner of 2 -3' X 6' Ce s kith different lot >3' spa ' g t 20' lye ' B -3 0' ' l ( 30 B -2 V 75' Vent B -1 6 „ Quick4 Standard -W of Cover Leaching Chamber tVV with 20.0 ft2 of Area OIL*' 422' 12„ 5.8ft ^2 /pair of end caps 4' Long 34" Grade at System Elevation 198' Soil Test and System PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. DDRESS P.O. Box 489 S omerset Wi 54025 SE 114 NE 1/4s 31 /T 31 / 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 1 18J08 BEDROOM 3 CONVENTIONAL XXX IN -GROUN RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE • WELL * H. R. P . Same as Benchmark Well is to meet a11' setbacks required by SYSTEM ELEVATION 88.5/88.6 5.5' below qrade @ B -2 WDNR 90th St. Plans Designed Using 540' Conventional Powts Manual Version 2.0 Pro 3 Bedroom B.M. * 30' House 60' Lot corner of ST 2 -3' X 66' Cells with different lot >3' spacing 20' B -3 30 ' 20' B -2 30' 75' Vent B -1 >6 „ Quick4 Standard -W of Cover Leaching Chamber with 20.0 ft2 of Area 422, 12 „ 5.8ft ^2 /pair of end caps 4' Long Grade at System Elevation 34" 198' Wisconsin Department SOIL EVALUATION REPORT Page of Division of Safety and in accordan wit 85, wiis. Adm. Code County Attach complete site pla paper not less than 8 1/ x 11 inc c '' �� include, but not limited to: vertical and horizontal ref ence point (BM),rc nd parcel I.D. percent slope, scale or dimensions, north arrow, a IocatiorpQ distance to nearest r ad. d3$-. I Z Z� 15- 00-6 Please print all inf �mation. 2QO Review by Date Personal information you provide may be used for sec dary p4tt"Pgrivacy Law, s. 15.04 (1 (m)). ' Q 8 Property Owner lNU OF" C' - Prope Location t ovt. t & 1/4 ,�I /4 S ,3 T� N R Property Owners Mailing Address Lot # Blod< # S Na Y I n S r— /-� /► CJ / ` / City State Zip Code Phone Number ❑ city ❑Village Town Nearest Road ew Construction Us . esidential / Number of bedrooms Code derived design flow rate .TV GPD ❑ Replacement ❑ Public o commercial - Describe: J _ Parent material _ O1.C�l� /r. if Flood Plain elevation if applicable Jam/ ft. General comments �I C '/j and recommendations: ry r cam'-- X L J 'J e/ 0���/�[,- 4�� �-�� System Type 'U I9/Il PiI'(;t") ft.Jl System Elevation I Boring Boring Pit Ground surface elev.A? 7 ft. Depth to limiting factor G' 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 r o Boring # � Boring l^_L Pit Ground surface elevl / ft. Depth to limiting factor y 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 f © -3 O , �/' ,� o m e Az - . D z 3 -s s - Glkl s Os lei / K' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S' re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 /-9:09 715 - 246 -4516 { . Yf � F Property Owner _ Parcel ID # Page of ❑ Bori # ❑ Boring 3 EA pit Ground surface elev. �J" � ft. Depth to limiting factor �iD in. 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 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. — 50 — ilApplication Rate Horizon Depth Dominant Color Redox Description Texture Structure 'Consistence Boundary Roots GPDM 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. Soil icafion Rate Horizon ' )epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Effluent #1 = BOD, > 30 < 220 mg1L and TSS >30 150 mgll. ' Effluent #2 = B013 : 5 30 nVI and TSS < 30 nVL 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 (RA/00) Property Owner _ Parcel ID # Page of Boring # E] Boring 4� M EA Pit Ground surface elev. / J" � ft. Depth to limiting factor �O 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 10 f 3�z �--- S j m -- C), b ,1• F-1 Boring # ❑ Boring ❑ 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 F-1 Boring # ❑Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. SoiF 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 •Eff#2 Effluent #1 = BOD, > 30 1220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS 130 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. SOD4330 (RAW) corrtrrterCe.Wi,$ov Safety and BuDdings Division County 201 W. Washington Ave., Box 162 C ,rO�' ISC A i� Madison, WI 5370 62 Permit Number (to be filled in by Co.) �Vn 51A1 S18 Sanitary Permit Application Transaction in accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental r unit is required prior to obtaining a sanitary permit. Note: Application forns for state -owned POWTS are Project Address (if different than mailing address) submined to the Department of Commerce. Personal information you provide may be used for secondary �� p in accordance with the Privacy Law, s. 15. ! m , Stats. / J 1. Application Information - Please Print All Information Propen Owner's Name L ,� - ko, Parcel ,# Property Owner's Mailing Address " operty Location / v Zip Code VoneN Y `/., Section City, State TY T / N; R FFICE 11. Type of Building (check all that ap C k o Subdivision Name r 2 Family Dwelling- Number of Bedroo BI ❑ Public/Commercial - Describe Use f CLL ❑ City of CSM Number ❑ Village of ' ❑State 0 - Describe Use n of III. Type of Permit: (Check only o e box on line A. Comple lige'B if applicable) A w New System ❑ Replacement System ❑ Treatmen ing Tank Replacement Only ❑ Other Modification to Existing System (explain) ---------- ' List Previous P Number and Dave Isstud B. ❑Permit Renewal ❑Permit Revision ❑Chan of Plumber ❑ Permit Transfer to New Before Expiration wner •-�L_ T e of POWTS Sy stem/Component/Device: Ch all that a pply) ❑ Non- Pre ssurized 1n-Ground fl Pressurized In- Ground At -Grade [] Mound > in. of suitable soil ❑ Mound < 24 in. of suitable soil ing Tank Other Dispersal Component (explain Pretreatment Device (explain) V. Dis ersaVrrestment Area Information: r c it A lic " n Rat Dispersal Area Required (s) al Area Proposed (30 stem Ele at' Desi n Flow Design So pp e(g f f) _ y VI. Tank Info Capacity in Total # of Manu er ,3 e Gallons Gallons Units New Tanks E: Tanks S (J Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assn risibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum ature MP/MPRS Number Business Phone Number Plumber's Ad ress (Street, City, State, Zip Cod VIII. Coun /Department Use Onl pproved �sappZt Permit Fee Date sued lssu' Agent Si ason Denial $ / 5 - 12-114 b7 IX. Condi 8% 2easons for Disapproval 3) D ` �rb n`e t. Septic tank, effluent filter and l dispersal cell must all be servlces /be / maintained as per management plan provided by plumber. 111(11 2. All setback requirements must be maintained allpff ac to o ple Me system and submit to the founty only on paper not less than 81/2 x 11 inches in size' SBD -6398 (R. 01/07) Valid thru 01/09 3;k T LAN PROJECT P.C. Collova Bldrs. Inc. D ESS P.Q. Box 489 S omerset Wi 54025 SE 1/4 NE 1 /4S 31 /T 31 1 W OWN Star COUNTY ST. CROIX 12/12/07 BEDROOM 3 MPRS Shaun Bird 226900 r / DATE CONVENTIONAL XXX IN- GROUND RI?SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 00 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 ,BENCHMARK V.R.P. Top of 1" pipe ASSUME ELEVATION 100' Filter BEST Filter ❑BOREHOLE WELL *H.R.P. SameasBenchmark Well is to meet a setbacks required by SYSTEM ELEVATION 93.6/92.6 6' below qrade WDNR Alt. BM Top of 1" Pipe @ 99.0' 90th St. Plans Designed g 540' Conventional Powts Manual Version 2.0 10% - B -3 Slope 2 -3' X lls with >3' spacing 65 Alt. B -2 B.M. ' w` Vents 0 10 B. 10 B -1 30' 30' 30' Pro 3 30 Bedroom House Vent >6" Quick4 Standard -W of Cover Leaching Chamber with 20.0 ft2 of Area 422' 1 „ 5.8ft ^2 /pair of end caps 4' Long 34 „ Grade at System Elevation 198' PL J D LAN PROJECT P.C. Collova Bldrs. Inc. ESS P• . Box 489 S omerset Wi 54025 s SE 1/4 NE 1/4S 31 /T 31 I4 W OWN Star Prairie PL ST. CROIX t / 12/12/07 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL XXX IN- GROUND > 700 SURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 ,BENCHMARK V.R.P. Top of 1" pipe ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE • WELL *H.R.P. SameasBenchmark 1 is to meet a'1'Y Well setbacks required by SYSTEM ELEVATION 93.6/92.6 6' below qrade WDNR Alt. BM Top of 1" Pipe C 99.0' 90th St. Plans Designed Using 540' Conventional Powts Manual Version 2.0 10% B -3 . Slope 2- X 66' Cells w >3' spacing 65' Alt. B -2 B.M. Vents 30' 10, �k 60' B. 10 B -1 30' 30' 30' Pro 3 30' Bedroom House I Vent >6„ Quick4 Standard -W Leaching hamber of Cover with 20.0 ft2 of Area 422' 1291 5.8ft ^2 /pair of end caps 4' Long 34" Grade at System Elevation 198' S e i t bwnsln Department of Correrww SOIL! EVALUATION REPOT Page of Division of Safety and a L--- in acooro dh ance v Comm M Wis. Adm. `code coxty Atlsch wnpiele aft pion on parer not less than 8112 x,1 indies in ske. Plan moat w � include. but not wed bx vedW and hodaorMet reference point (tidy. dGecdon and Parcel l.D. potent slope. scale ordtrnensions. nadh snow. and location and di storm to madras road. Plww print an Ardbmiancin. by Date pe - 1idomYdim you pMvWeaMbeundfors ocondWyPurPom IYN-YLRW•s.,5.04(1)(n)). f . l Z PMpeft A& w , 3 GU!/L'�/ !i Govt Lot L IM &4 2!: & �2 g T N R PropertyOwnees A Lot# Skick # Si kd Nome or CSW - v S CRY code Phone Number O tI► �❑ Vfage ' Town Nearest Road New Construdon Us Raskfenfid I Number of bedrooms _ Code derived design low rate '�J r� GPD ❑ ftplomnenl D Pubic or oornmerclal - Desut w Parent mdww e!5�zy z�e i.�. ( 4 f lloodd Ph in devellori ti General cormrenlr and • �'e.� o.� � � �lauJ 0 Ba�� a Pit Gnxxw surface deer. . R Depth >o tenor —lam- M Sol A Rate Horbron Depth Don*wltcoior Radoru Desaip m Texture, Structure Corusblerrce Boundary in, tduraieti Qu. Sz. Cast. Color Gr. Sz. Stu. - EW1 'E182 -I / S >�' �i • "? 1. t, � o ® a Boring pqt Guard aurieice elev. ff Ift. Dsptlr b ttrrriirg Taclor _1a SolA Role }mtwn Depth Dominant Padox Desa+p6on Text re Structure Coruistence Sourdery Rook GPOW k, tMursei Qu. Si Cart CdW Gr. Sz Sh. 'E * E (j �z g L 1 ,2, Y m CS m � , �S �7 i Z , 3 Dr /�{ y s s m / oa 4 7ct .7 ,2 r Q3.fo® • Eaerrt #1= BM > 30 <_ 720 nVIL and TSS >30 _< 1 % EMMuont 42 _ 80(k < 30 argil slid TSS c 30 mgiL as Dde eak �ikm Conducted Telephone Number b ndaiess �/ �`O/ -a 3 ! l Properly Owner Parcel ID # Page of # ❑ B04V F3 pit Gmundsufaoealev 2ZI Depth to Under gfaclor - -�b in Sol Horlm Depth Dorm mg Coto Redox Desm"on Texture Structure consistence Boundary Roots aPOpF hn. Munsel flu. Sz. Cons. Color Gr. Sz. Sh. •ma Z 1,5 4 t✓S p s/y C L lr rYN F r — n-► i n i. Z ere # ❑Boring ❑ pit &otad suface Nev. ft. Depth m factor h sol N Rare Horiaon Depth Dominant Color Rsdox Descr"on Texture Structure Consiatance Boundary Roots ( Mff In. Muruel Cm Sz Co>t Color Gr. Sz Sh. •� '� F-I erg # ❑ �g ❑ pit gourd sufeoe elenr. R. Depth to brftrng factor IrL id AmkMon Role Horizon Depth Domirnarrt Cohn Rsdm(DescrIrtion Twftm Structure Come Boundary Roots ku Morsel flu. Sz CW L Cot" Gr. Sz. Sh 'E1T#i *Elm • Efiluent #1= BOP, > 30_< 220 nVL and TSS >30 a 150 nV& ' Eflluent #2 = t BOD a— 30 mglL and TSS S 30 n#L The Deparbaeat 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 deparmumt at 608 -266 -3151 or TTY 608 -264 -8777. Soil Test Plot Plan Project Name P.C.Collova Bldrs. Inc. Shaun Address P.O. Box 489 Somerset Wi 54025 CS #226900 Lot 1 5 Subdivision Prairie Pond Breaks Date 4/9/03 E 1/2 NE 1/4S 31 T 31 N/1318 W Township Star Prairie N W 1/4 W 32 Boring ell PL Property F 1 g Q P Y Line County ST. CROIX i: B� ) or VRP Assume Elevation 1 f t. —Top of 1" Pipe System Elevation 93.6/91.1 *HRpSame as Benchmark Alt. B Top of 1" Pipe @ 99.0' Pro Town Road 540' 10% B -3 98' Slope 65' Alt M. 60 ' 30' 1 B 10 1 30' 30' 422' 198' i pp�ppp�,�r�p PRAIRIE POND BREAKS .. 'rW�'. (4 t011MY Nd>) Ir A.w 1✓t M 4 M LwmrlrxrnBnlBmpwnanowarnrrpuumafBCmxgnnanrwaraur9lwlcol ®woBlaAergwmAAOrABlanr o rwrA.,r. aaunrurtNAUlaalteNOaaArtgwnaewmla ,lnrNanNOpTI wne uTUn,TTlrwasraflNllNNrNBratalm I aA� a a K NRVLSIWtrC�NVn10r1wAm1WN1B BBBrleta0 ®IBrR61a R.l1W RIMI r10)i - �NrllwW WBBUru m mu r MMrl/ m ou MR d N BWIN KNNNNN NIaINYlu00 ®rKM7M U(°K , ydlwM w.t a NaNr MMME MIS, aNBQ MN N MM RMI r1 N Mt N KM 1S 1/I r lCN x rWr M l41AAx a l . III NMw lYrBA RNm A@NI NK OGNIN aTtMBa MMM aWNAaIa NNi lnrNt .. .. BASIS AI kvOI and rN EAarll N1a aY1N Br6 Y as Yar ■YIN rN cave ABIP u° ww ry 4* ow N - s NON7NWPSt00WlPJt QWe um aTA at Err wm 1ANa11am rl rrral YYar Y► ak Yi Bac ual•u — -4v W B. 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PC GYn Yrm.awe,.wgllwbn.Y C_ C_ LOIO ,ar'r'�LOfN a O j 9 9,257 19 It (AUp f pa” i 0 L8,11 e7e.s 79,424 q ft. 2.29 axle 4 Mr c Mx�. � � s�719'oet 1.92 aaa i WCttIRC 'll' S 4 r(� )La' /' I 89C.7971•II 0 r4.e7' MY \ r 704.42' ) (10tf✓D I'LLQ1100) 91nNirhllENar D NW46`11 11tH _.. -..` WUTINOORNNI N S7r'II' W 31aA2' el m . SX11d1d1 UNP(ARED LANDS I SHi SHEEI 2 OF 2 Euwwd:rrwlar,ra V a V w V CO t o - / �ti , • _ OD bo Ln oo �• a 7 i I � 0) 6 / Q� �2 N W V O % •—� N E oo� c 6 N �J O IJ y 10 coo �s v CD y ��0 1� �, y ��`�$ N CO 0 Oy N N 'r cwD ,c y a c,; �« o S Z p9 �q N .p r �� •`o� �OZ• Q Q ' 0 cf) X g N 8 -- 927.03' -- im 260.83' 198.22' t SECS S 00° 10'39" E wJW SO Ejff �* S 00' 10'39" E E UED L ANZ NPLA TI � �� � x 1 b � a• s., i . m , , 3 . o p O y o l J 5 a C c d N, m ►� o o N p IQ Er N °, x b o . 9 c G o t:r W rr b - 44 S tow T CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer P. C. Collova Builders, Inc Mailing Addresses ���fC S� J� ' �, &Mtre}- L.0 5VOc95 Property Address ! O � 5-&— (Verification required from Planning Department for new construction) City/State New Richmond WI Parcel Identification Number U 3 -- 1 aa I — . LEGAL DESCRIPTION Property Location SE '' /,, N E '' /,, Sec. 31 . T 31 N -R 1 W, Town of '� +Z,,r Subdivision Prairie Pond Breaks Lot #_. Certified Survey Map # Volume . Page # 695417 2021 27 Warranty Deed # 695419 . Volume 2421 , Page # _ 29 Spec house ❑ yes � no Lot lines identifiable 4 yes ❑ no SYSTEM MAINTENANCE 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 masterplumber, journeymanplumbcr, 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 113 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 da UOFAPPOxp � LICANT lion date. SIGNA 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 escribed ve, by a of a warranty deed recorded in Register of Deeds Office. M/10/ SIGNATURE OF APPLICAJft DATE * * * * ** Any 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 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 ��pttion �#1_ system falls, determine cause of failure, use alternate area and install new system in 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 U 2021P 027 STATE BAR OF WISCONSIN FORM 2 - 1999 6 `3 5 4 1 7 XATHLEEN H . YAL . WARRANTY DEED SH Document Number REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Douglas A. Strohbeen and Eileen RECEIVED FOR RECORD Strohbeen, husband and wife, 10 - 23 -2002 11:00 AN WARRANTY DEED Grantor, and P. C. Collova Builders, Inc. EXEMPT # REC FEE: 11.00 TRANS FEE: 1260.00 COPY FEE: Grantee. CERT COPY FEE: 1. Grantor, for a valuable consideration, conveys to Grantee the PAGES: following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Part of the NE 1/4 ofNE1 /4 and part of SE 1/4 ofNE1 /4 of Section 31, Name and Return Address Township 31 North, Range 18 West, St. Croix County, Wisconsin, described as follows: Lot 1 of Certified Survey Map filed September 17, 1993, in Vol. 9, Page 2686, Doc. No. 505678, St. Croix County, Wisconsin. 038 - 1125 -10 -100 & 038 - 1127 -70 -000 Parcel Identification Number (PIN) This is homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. (is) X)fo4 Dated this 21 of September 2002 + Douglas A. Strohbeen ' * Eileen Strohbeen AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this day of •..... Personally came before me this &W j oy of September 2002 the above named Douglas A. Strohbeen and Eileen Strohbeen, husband and wife, TITLE: MEMBER STATE BAR 0 (#SERB s (If not, to me known to be the rson(s) who executed the foregoing 4auth orized by § 706.06, W is. Stats. OF C 1� ; I instru nd a ged the same. � WIS _ THIS INSTRUMENT WAS DRAFT 1`b�BY "'�� • r�j�' Attorney Kristine Ogland Notary Public, State of Wisconsin Hudson, WI 54016 ommission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) , /TOD •) * Names of persons signing in any capacity must be typed or printed below their sioli Information Profasalonals Company, Fond du Lac. IM STATE BAR OF WISCONSIN 000.655-2021 WARRANTY DEED FORM No. 2 - 1999