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Home My WebLink About038-1221-20-000 Wisconsin Department ofContrner a PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 463309 0 GENERAL INFORMATION 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: P.C. Collova Builders, Inc. I Star Prairie, Town of 038 - 1221 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No /� � .31.18.1220 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Jam\ Benchmark ' � ,A Q&U �'vCJ Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet 9 ,� 7•I TANK SETBACK INFORMATION St/Ht Outlet 74S c W 3°l TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic (.0 " i 7 58 qb / x ' a Dt Bottom Dosing v V Header /Man. p z � yq Aeration Dist. Pipe 1 9 Holding Bot. System s, /'� t PUMP /SIPHON INFORMATION Final Grade 5 ��Q� Manufacturer Demand St Cover GPM T Model Numb TDH Lift Friction Loss System Head TDH Ft ' Z is . 8 - 7 Forcemain Length Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Z !_� CZ z , �R J� \ SETBACK SYSTEM TO l0 P(L BLDG WELL LAKE /STREAM LEACHING Manufacture . INFORMATION CHAMBER OR v Type Of System: ,' j - � . O UNIT '7 n J Model Number S 1 DISTRIBUTION SYSTEM Z Z. 1�_ Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Int ke Q j it Pi \ \ v'� �f b8 Length 1 Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only '^ Depth Over i Depth Over xx Depth of xx Seeded /Sodded j xx Mulched Bed /Trench Center J 5 Bed/Trench Edges ` Topsoil \ \es No es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / Location: 1891 90th Street Star Prairie, WI 54026 (SE 1/4 NE 1/4 31 T31N R18W) Prairie Pond Breaks Lot 20 Parcel No: 31.31.18.1220 1.) Alt BM Description = � �`�� CFA t' �,.> L.1,..�: �s + 2.) Bldg sewer length = 1 � - amount of cover = � '! p lu z e li: Plan revision Required? i Yes No Use other side for additional information. _ 65 Date I g re Cert. No. SBD -6710 (R.3/97) t y Safety and Buildings Division Co 201 W. Washington Ave., P.O. Box 7162' ` r b s Madison, WI 53707 - 7162 Sanitary Permit Namber (to be fdled in by Co.) 8 VIScons i n (608) 266 -3151 '03 3 O 9 De artment of Commerce State P1aaLD.Numb" Sanitary Permit Application d In ace and with Comm 83.21. Wis. Adm. Code. personal information y p p Address (f differ than tnailiog address) may be used for s000ndacy purposes pnvaq Law, sl �. L Application Information - Please Print All Information G't�� Parcel # Lot # Block # property owner's Name ? a v /lbvc.�j " , . , J, . - Property pzppetcypwrter'sMarlinSAddcess L�p ZUNI OFF i D 1 Code Phone Numb" city. State p (/� 0 T / t) � T N: R E r e of Building (cheek all that apply) ✓ 5 ` ` 5ubdivision Name t SM Numbs 1 or 21=artnly Dweninb — Numb= of Seoaoorns �! PublidCommercial - Describe Use ��, V of - State owned - Describe Use / III. Type of Permit: ((:heck only one box on line A. Complete line B if applicable) 03 A g�)>r:enoent System TraunenMolding Tank Replacement Only Other Modification to Exi0mg Systrnn List Previous ram Number and Dots Issued B. pert Renewal permit Revision Change of Permit Tranissfer to New Before Expiration Plumber O'er IV. o f POyi : (Check all that a 1 At - Grade Single pass Sand Filter � -P uriaed Inoynd Mound 2: in. of suitable soil Mound < 24 is of suitable soil Constructed Wetland Pressuri7td In and Holding junk Peat Filter Aerobic Treatment Unit R lating Sand Filter Chamber Line Gsvel -less Pi Ofher ( lain) �� l S 0MedsFilter wKS V > esrtment Area o - vandoa: Dispe+sei Area Requirod ( st1 Dispersal Area posed (st) at ` L Fl ow (ice) Design Soil Appliation Rate(gpdsf) 3- fv� - ? Site Fiber Plaint ftelab TO Number Manufacturer VL Tank Info Capacity in Concrete Constructed Class Gallons Ga1loas of Units New t3istins Tub Tams Septica Hol" Tank Aeaobic Trdtoteor Uaic bill for installation of the POWTS shown on the attached V I( ndbility Statement - L the �+ MP/MM Number Business Pbaute Nutitber p, / s Name (Print) plumbea s Si // — Z - 1� ✓ `� plmaWs Address (stmt, City, State, ?1p Code - // �[,O VM co t Use Onl Date Issued Anent Sigr,aaue Stamps) sanitary permit F=3c dwate (�- �sapp Surcharge Foe) - Owoer.avcnRason UL conditions o p SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. otplek plans (la the County only) for the rystan an paper not teas than U* It It incbea to slme PLOT PLAN PROJECT P.C.Collova Bldrs. Inc. DDRESS P.O.Box 489 Somerset Wi 54025 SE 114 NE 1 14S 31 /T 31 T R 18 W TOWN Star Prarie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 2/4/05 BEDROOM 3 CONVENTIONAL XXX IN -GR D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 1 00 , Filter Zabel A -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark �.BM— Top of 2" Pipe C 100 .2' SYSTEM ELEVATION 93.36/93.2 4' below grade Well is to meet all Vent >6 setbacks required by WDNR Plans Designed Using Standard Biodiffuser Conventional Powts of Cover Leaching Chamber Manual Version 2.0 with 3 1. 1 ft2 of Area 6' Long 11 537' 3491 Grade at System Elevation 190' 7% Slope V is 2 B -3 60 , B -2 2 -3' X 69' Cells with � >3' Spacing Pro 3 ?ro wn Road Bedroom 0' House B -1 ST 5 5 6� * 201' 323' Alt. N B.M. COP PLOT PLAN PROJECT P.C.Collova Bldrs. DDRESS P.O.Box 489 Somerset Wi 54025 SE 1/4 NE 1/4S 1 31 R 18 W TOWN Star Prarie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 214/05 BEDROOM 3 CONVENTIONAL XXX IN-GR9#RD PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 IL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Alt. BM - Top of 2" Pipe @ 100.2' SYSTEM ELEVATION 93.36/93.2 4' below qrade Well is to meet all Vent setbacks required by WDNR Plans Designed Using >6 ), Standard Biodiffuser Conventional Powts of Cover Leaching Chamber Manual Version 2.0 with 31.1 ft2 of Area 6' Long 11" 537' Grade at System Elevation 34" I w 190' 7% Slope Vents 20' B —= 3 60' B -2 2 -3' X 69' Cells with >3' Spacing Pro 3 ?ro wn Road Bedroom 0' House B -1 5' ST 5' *` 201' 323' Alt. B.M. WbconsIn Depabnent of Camierce SOIL E1(ALUATtON kEPORT Page o f Division of Safely and Bulkl ngs In accordance vM Comm Vft AdnL Code ; Courtly � Cc. I Aiboh complete site plan on paper not less tlian 8112 x i 1 Wise in aii. Plan W-0 include, but net limited to: vertical and hortzorita l reference point (W. direction and Parts! I.D. percent slope. scale ordimansions, north arrow. and location and dance to nearest road. Please print ap infornMIMM Dade pw=W x arne5oe you Wovids mW be undtor sa>ocidwy p wpo— (MV41CY t aw. 8.15.04 (1) (m)). F& • 12 Pmpwtyoww Property Location Govt+ tot�� 1/41/4 3 N R E( W p rop � y pi A�dd� Block # Name or City State Phone Cxy ❑ 1/Bage - Town Road Sa ei s eth Sl�Oa?. -5 e New Consbuttio n tlse Rasideri5al / Number of bedrooms _ Code derived design lbw rate '�Y'. �`rJ1 GPD O Replacement ❑ Public or commercial - Describe: Parent malarial Ql.- Flood Plain elevalkin N applicable Confirm conmieris and reoonxnendelioris # a 0 Boring Ground surface eiev. � R Depth ID &N�g factor � b I Sol Role �i Hovbwsi Depth Dominant Color Redact Description Texptre Shv*lre Consistence Boundary Roots GPOW IM Wad flu. SL Cord. Color Gr. SL Sh. 'EM 'EM12 1 s E -) # O t Groused surface elev. �8 Depth to limiting fdGlOr lo • Sol Application Rate Hodwin Depth Dominard Redorc Desaipdon Texture Slruclure Consistence Boundary Roots GPM In, Mlfsell Qtl. SL Cont Ci0W GG S7- Sh. • E • i O - D10 r Z L 2 Yn Cr L I I C (57 2 p lov 3 D= o 4 Cd �o • Etlkrerd #1= Bt)D > _< 220 ngfL and TSS > 30 = 1g: #2 = BDO <_ 3o mgil and TSS 3o mgll ( as b Address Dale ewWmNon Conducted Telephone Number a� Property Ow Parcel ID # page of ❑ Bain a 1--,' #- (� Pit Ground surMCe elev. / J � J 1L Depth to lines IaCbX kL irate Hor mn Depth Dominant Color Redox Desaipban Texture Structrue Consistence Boundary Roots GPOW in. Munsell flu. Sz. Cont. Color far. Sz. Sh. •Etf#1 'E1110 Bake # ❑ BorkV ❑ Pit c ►d surface nev I Depth m &rAV +actor to. son P40 Hainan Dept Donnas Cdor Radom Desa+ptiar Tmdue StrrX*" Car ron Boundary Roots GPM in. Mum CAL Sz. Cant. Color Gr. Sz. Sh. 'E01 •EMW D Bo[kV,# Q P Grourd surface elan►. R Depth b Mi ft to cior in. Sol Awkslion Rde Nouns Depth Domnan CWW Radar Desa"m- TgWW9 Sbucb" Consistence Boundary Roots GPOW im Mousey flu. Sz. Con. Color Gr. Sz Sh. 'ER#1 •E11#2 • Etfauen #1. am 30 :s m ffjgL arw TES >W 150 WO L ' Osiers #2 = mm, <_ M nQL aw TSS _< 30 mgli. The lkpattneW of Commerce is sn equal opporhmity service provider and =Ployex. If yon aced assistance: to =m services ear need material in an ahwmte format, Please contact tiro departtrrent at 608- 266 -3151 "TTY 608- 2648777. Soil Test Plot Plan Project Name P.C.Collova Bldrs. Inc. Sha B' Address P.O. Box 489 Somerset Wi 54025 � 9TM #226900 Lot 20 Subdivision Prairie Pond Breaks Date 4/9/03 E 1/2 NE 1/4S 31 T 31 N /13 W Township Star Prairie N W 1/4 W 32 ❑ B ring 0 Well PL Property Line County ST. CROIX B r VRP Assume Elevation 100 ft. = Top of Survey Iron System Elevation 91.5/92.6 *HRPSame as Benchmark It. B �'op of 2" Pipe @ 100.2' 537' 95' 190' 96' 7% Slope 97' 2 -3 60' B -2 0 A4 3 0' H B -1 201' 323' � .M. 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 Option # . If system fails, determine cause of failure, use � ornate aria and install new sys em 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 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer P. C. Collova Builders, Inc Mailing Address P O Box 489 Somerset, WI 54025 Property Address (Verification required from Planning Department for new construction) City /State New Richmond WI Parcel Identification Number LEGAL DESCRIPTION NE Property Location SE %,, '' /,, Sec. 31 , T 31 N -R 18 W, Town of Subdivision Prairie Pond Breaks Lot # y . Certified Survey Map # Volume , Page # 695417 2021 27 Warranty Deed # 695419 Volume 2021 , Page # _ 29 Spec house C' yes ❑ no Lot lines identifiable 9 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, journeyman plumber, restricted plumber or a licemedpumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. I/we, 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 of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of property described above, by virtue of a warranty deed recorded in Register of Deeds Office. a/y /O SIGNATURE OF APPLICANT 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 U 2021P 029 STATE BAR OF WISCONSIN FORM 2 - 1999 6 `9 5 4 1 9 KATHLEEN H. VALSH WARRANTY DEED Document Number ..REGISTER OF DEEDS ST. CROIX Co., VI This Deed, made between Cecil Brighton and Cleo Brighton, RECEIVED FOR RECORD husband and wife, 10 -23 -2002 1 1:00 "All WARRANTY DEED Grantor, and P. C. Collova Builders, Inc. EXEMPT # REC FEE: 11.00 TRANS FEE: 720.00 COPY FEE: Grantee. CERT COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the PAGES: 1 following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area NW 1/4 of NW I/4 of Section 32, Township 31 North, Range 18 West, St. Name and Return Address Croix County, Wisconsin. 038- 1131 -60 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. pK) (is not) Dated this Z# of September 2002 + Cecil Brighton V + AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss. St. Croix County ) authenticated this day of r y, R OM O' "> Personally came before me this ..,Am day of September 2002 the above named Cecil Brighton and Cleo Brighton, husband and wife, I h �F V11SC�,` TITLE: MEMBER STATE BAR OF WISCONS - (If not, to me kn to be a on(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instru d le ed the same. THIS INSTRUMENT WAS DRAFTED BY • , Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 M Commiss n is permanent (If not, state expir ion da (Signatures may be authenticated or acknowledged. Both are not necessary.) * Names of persons signing in any capacity must be typed or printed below their siviture Wormation Pmfoulonab c omp". Fond du Ln, w WARRANTY DEED STATE BAR OF WISCONSIN 800-655 IP21 FORM No. 2 - 1999 U 2021P 027 STATE BAR OF WISCONSIN FORM 2- 1999 6 9 5 4 1 7. Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX Co., YI Thi Deed, made between Douglas A. Strohbeen and Eileen g RECEIVED FOR RECORD Strohbeen, husband and wife, 10 - 23 -2002 11:00 AM 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 of NE 1/4 and part of SE 1/4 of NE 1/4 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) NXdQ Dated this y of September 2002 " + Douglas A. Strohbeen `i ' + Eileen Strohbeen AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this day of Personally came before me this Oy of September 2002 the above named * f E J Douglas A. Strohbeen and Eileen Strohbeen, husband and wife, TITLE: MEMBER STATE BAR OF' NI (If not, to me known to be the rson(s) who executed the foregoing authorized by § 706.06, Wis. Stats instru nd a ged the same. - -- THIS INSTRUMENT WAS DRAFT91) . ��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.) , �D [� -) • Names of persons signing in any capacity must be typed or printed below their sigM ture. Information Profel3lonals Company, Fond du Lac WI STATE BAR OF WISCONSIN 80"55 WARRANTY DEED FORM No. 2 - 1999 off ° o 110,168 sq. ft. 7.11 \ 1 -4a .............. 2.53 acres L.B.O. 886.3 514 36 _ o SOJA WATER 531 rn W F A ARE gi`rd's ASS RAW E n g32- / 'ILO ir ul 98,4 sq. ft. 322.74 2.26 acres 7.54 g,1 ' 6 2 ,0 L.B.O. 886.3 52 20� • g rn rn 6 0 \ 33 \ N 14 3 a• _ • _ N 322 66 � I 9 / ►vi v 91.18 t1 sq. ft. J acres f N N 50' 1«54'40 " E & LOT 22 t36.s1' LOT 2! �� v 86,749 sq. ft. W 1� 76,093 sq. ft. z 1.99 acres 4 4, M IN 1.75 acres ° °o f `�JOlNT DRIVE O 0 I EASEMENT .OT4 ° St N & ..................... 5..� 59 sq. ft. °' L 15.41 — ' LOT23 1 acres ; ( .� - 222.53' — 83,919 sq. f1 1 40 " E cD S 88'4241" E 237.94' —50 1.93 acres 136.61' _ co Co i N 8842 W 23625' �"� C 0 is F �� \ :. �� .............. ......... s / .OT M w O ( ; \ Ire. .- gR.EA ti E st• 9• 8q. ft, p Q RETENTION �1� R�sr A OS acres, W A TER I �- A� s 0 882 0 Lord 74.518 sq. ft.� SAS ,