The URL can be used to link to this page

Home My WebLink About038-1221-37-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 487938 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: P.C. Collova Builders, Inc. I Star Prairie, Town of 038- 1221 -37 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 3131.18.1237 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic to 6U Benchmark /OZ' Dosing A ^ Q � � � BM let- �� / - / „ ah .Bl Z. S O Aeration Bldg. Sewer 30 3 S -o , St/ / Holding t Inlet 1 h.�.y St/Ht Outlet / t TANK SETBACK INFORMATION Ip. 2 75 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing V Header /Man. -7-D Aeration Dist. Pipe Z ,-2 9 Ll Holding Bot. System g 1!5 9 �• D d Z• 1 PUMP /SIPHON INFORMATION Final Grade Z Manufacturer Demand St Cover P / (D s� lrh 1 `� 3 Model Number TDH Lift Friction L System Head TDH Ft 1 (' t) 8 • Forcemain Length Dia. Dist. to Well T SOIL ABSORPTION SYSTEM CV" B MENSIONS Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ED/TRENCH DIMENSIONS � � /' SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREA LEACHIN Manu r er. ' f INFORMATION CHAMBER 9R C O I `V S Type System: nt) ! ' �/ \ �' Model Number: �l{U 1 DISTRIBUTION SYSTEM ea er an / ld Distribution l/ I x Hole Size x Hole Spacing Vent to Air ke Len th j5 Dia Len th J(� Dia T Spacin - " / Au SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of 77�ded i � xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No Yes No i . COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:j lj_�!__/ Inspection #2: Location: 1875 90th Street Star Prairie, WI 54026 (SE 1/4 NE 1/4 31 T31 N R1 8W) Prairie Pond Breaks Lot Parcel No: 31.31.18.1237 da 1.) Alt BM Description = Z� � p j9/r' n l ' Y )- 2.) Bldg sewer length = � � - amount of cover Plan revision Required? !! Yes _ 10 t� ], ✓ Use other side for additional information. Date Insepctor's ture SBD -6710 (R.3/97) 9 afe an m anty 201 W h' n ®' iso WI 53707-7162 1-j� ary Permit Number to be filled in by Co.) ■ Co / /S� 266 -3151 Department of Commerce lan I.D. Number Sanitary Permit Ap 'ca In accord with Corms 8321, Wis. Adm. Code, personal inform on you may be used for secondary purposes Privacy Law, s15. ct Addre ss (ifdifferent than mailing address) I. Application Information - Please Print All Information - */ 5 2 J ?U�a Parcel # Lot # lock # Property Owner's Name ' eo e I L Property Location Property O is Mailing Address %, b /a ect. C - ty, State Zip Code Phone Number ' R I N; it e one) T �A E; W II. ype of Building (check all that apply) �r S Subdivision Name � C � Number amily Dwelling - Number of Bedrooms s ' j� - 0 ❑ Public /Commercial - Describe Use ❑City ❑Villa ip of ❑ State Owned - Describe Use III. Type of Permit: (Check only one box on line A. Complete line B 77ff A' tern El Replacement System [I Tr eatment/Holdin ❑ Other Modification to Existing System List Previous Permit Number and Date Issued Prmit Renewal [I Permit Revision ❑ Change of erm Before Expiration Plumber Owner e of POWTS S stem: Check aA that a l ) • on - essurized 1n Ground ❑Mound >_ 24 in. of suitable soil ❑Mound < 24 in. of suitable soil ❑ At - Grade ❑Single Pass Sand Filter ❑ C onstmcted Wetland ❑Pressurized In- ound ❑Holding Tank ❑Peat Filter ❑Aerobic Treatment Unit ❑ Rec.rculating Sand Filter Recirculating Synthetic Media Filter - ng Chamber ❑Drip Line ❑Gravel - le Pipe ❑Other (explain) �Jc �L � V. Dis ersalfr!matmsut Area formation: 3 - } S Design Flow (gpd) Design Soil A lication Rate(gpdsf) Dispersal ea Required (sf) Dis Ar� Roposed (st) System Elevation VI. Tank Info Capacity Total Number Manufacturer Prefab Site S Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Sta ent- 1, the undersi , assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print Pi r' ignat,. MP/MPRS Number Business Phone Ntunber� J - 7 - Z b Plumber's Address (Street, City, State, Zip e VIII. Coun /De artment Use Onl Sanitary Permit F X 30b — a . 13 cludes Groundwater Date Issued Issui Agent Signature (N�Stamps) �l %Approved Cl D ppm Surcharge Fee) s � ❑ en Rees for Denial . IX. Conditions o ppro 1 3\ / 14 SYSTEM OW NER: 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. Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in sire SBD -6398 (R. 01/03) OT PLAN PROJECT P.C. Collova Bldrs. Inc. A DRESS P.O. Box 489 Somerset Wi 54025 SE 1/4 NE 1/4S 31 /T 3 N/ 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/10/05 BEDROOM 3 CONVENTIONAL XXX IN -GRO 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 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter ZabelA -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 95.7/95.5 3' below qrade Alt. BM Top of Steel Fence Post @ 104' Well is to meet all 191' Property Line setbacks required by WDNR Plans Designed Using g Conventional Powts Manual Version 2.0 175' Vent >6 6 Lon Standard d Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area Vent Long 11 -2 Grade at System Elevation 3% Slope 30 � Bt4 1,)43` 34 10 35' 2 -3' X 69'Cells 1i th >3' Spacing 0' B -3 I Pro 3 Bedroom House 376' 90th St. OT PLAN PROJECT, P.C. Collova Bldrs. Inc. V3N/ DRESS P.O. Box 489 Somerset Wi 54025 SE 1/4 NE 1/4s 31 /8 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/10/05 BEDROOM 3 CONVENTIONAL XXX IN -GRO 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 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 95.7/95.5 3' below qrade Alt. BM Top of Steel Fence Post @ 104' Well is to meet all setbacks required by 191' Property Line WDNR Plans Designed Using Conventional Powts Manual Version 2.0 175' Vent >6 » Standard Biodiffuser of Cover Leaching Chamber with 3 1. 1 ft2 of Area Long 11 „ Vent -2 6 Lon 3 4 „ Grade at System Elevation 3% Slope 30 ' 10' 35' 2 -3' X 69'Cells with >3' Spacing 0' B -3 ST 30' 20' 5 , B -1 Pro 3 Bedroom House 376 90th St. IF r � Vi1soorw Dttpobtrent of cotrrrrrterae OIL ,EVALUATION REPORT p Dhr�onofSafely�d in accordance"' p8, wis. Win. code ry� cc Attach compbw sibs Plan on paper not loss then 8112 x 11 i es nch in size. Plan must 6xdude. but not limited 10: vertical and horizoritel reference point (13". direction and Parcel l.D. Percent stom scale ordimerrsiorrs. north arrow and location and distarm to nearest road Please prn►t all ifNorrtt ftm by Owe Pereorrel frdarrrretim you W&AW awy be teed for sowndwy Pupow tdvM Low. e. 15.04 (1) (m))• 1 Z /� property Govt tot p 114/)p4/114 W R E ( w propertyOwneratr n9Address Las Block# �ukci. Name Ivs stabs Code Phone Number ❑ qty ❑ Vage JaTown Nearest Road Sa efs� GrJf SYOas ( � S� °� New Construction UsA Ratrlderrtial I Number of bedroom _ _3 Code derived design flow rye GPD O Replacement ❑ Public or cotrarrarchd - Describe: -- Parent malaria) Rood Plaln dwaqon 9 applicable Generalconvnenls Borin # soft F I � artd t�ewrrrtrtendatitxt� / J 0�3 � / eel pit hound surfeos efev. � � d � R Depth to limilling fecw �� c! in' Sari Rate horizon Deter Dominant Redox Description Team Skcb" Cor oe Boundary Rods GPM In. 1Arxrsei tlu- sz. Cant. Color Gr. W- Sh. O M *OW 95.E a i3o�g # it P &Ound surbw dev #. DepM to limiling f ecr SoI A �liaulion Rate Hatton DWV% DpnyrHnt Cdw Redox Description Tease e Strode= Consistence Boundary Rails GPM In. mu men tau. Sz Cord. Color Gr. Sz w •Etr#1 3/-L s 2, rn �� GS Z m S •`I 36 � 2 - • tBiva t #1= BW > 30=220 rrg& and M >30 _< 1,5': • Mom #2 = BOD <_ 30 mgL and M S 30 mglL. EW _ - as _ Dube Evafrrdio 1 Concluded Telephone Number Address 5 ,y { Soil Test Plot Plan Project Name P.C.Collova Bldrs. Inc. Shaun Bird,- Address° P.O. Box 489 Somerset Wi 54025 -� CSTM #226900 Lot 3 Subdivision Prairie Pond Breaks Date 4/9/03 E 1/2 NE 1/4S 31 T 31 N /R W Township Star Prairie N W 1/4 W 32 ing ()Well PL Property Line County ST. CROIX B or VRP Assume Elevation 100 ft. =Top of Steel Fence Post stem Elevation 95.7/95.2 *HRpSame as Benchmark Top of Steel Fence Post @ 1� 191' Property Line 175' t 98 99' 30' B-2 B.M. 3% Slope 10' 35' 0' B -3 Alt. .M. 20' 13- 376' Pro Town Road f - 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. Rrscharge into system is not exceed those required as per Comm. 83 �40ntlng cy Plan ption #1. If system fails, determine cause of failure, use alternate area and install new system i ested 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 an other faili co m p onents as needed. p Y 9 p 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 Property Location SE '/,, NE y,, Sec. 31 . T 31 N -R 18 W, Town of Subdivision Prairie Pond Breaks Lot # 3� Certified Survey Map # Volume , Page # 695417 2021 27 Warranty Deed # 695419 Volume 2021 Page # _ 29 Spec house ❑ yes ❑ no Lot lines identifiable L9 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 is the eP g waste sal d.upo system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman lumber, restricted lumber � J YAP p or a licensed ve ' that the on -site wastewater sal Per �g 1 () �o 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. Itwe, 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 dais of the three year e34im on date. SIGNATURE OF P ICANT DATE l,✓' 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 described at ove,,bx virtue of a warranty deed recorded in Register of Deeds Office. �._ .�.— ATURE OF , PLICANT � 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 027 STATE BAR OF WISCONSIN FORM 2 - 1999 6 9J 4 1 T Document Number WARRANTY DEED KATHLEEN H. WALSH 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 AM WARRAVTY 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 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. Dated this y of September 2002 • Douglas A. Strohbeen ffi ,y ' Eileen Strohbeen AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. St. Croix County ) authenticated this day of Personally came before me this y of September 2002 the above named f � Douglas A. Strohbeen and Eileen Strohbeen, husband and wife, TITLE: MEMBER STATE BAR OF I (�$� (If not, to me known to be the rson(s) who executed the foregoing authorized by § 706.06, W is. Scats. � instru nd a ged the same. t,z OF WIS� - THIS INSTRUMENT W � AS DRAFT . _ �D�BY' 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.) V , "�D Z .) Names of persons signing in any capacity must be typed or printed below their si cure. Information PM(83310n&13 c Fond du Lac, W1 WARRANTY DEED STATE BAR OF WISCONSIN eoo 655 FORM No. 2 - 1999 U 2021P 029 STATE BAR OF WISCONSIN FORM 2-1999 6 9 Z4 1 9 Document Number WARRANTY DEED KATHLEEN H. W ALSH ST. CR� O W , . This Deed, made between Cecil Brighton and Cleo Brighton, RECEIVED FOR RECORD husband and wife, 1 0 - 23 -2002 11:00 A?I WARRANTY Da Grantor, and P. C. Collova Builders, Inc. EXE)PT # 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): ah(f�;�� Recording Area NW 1/4 of NW 1/4 of Section 32, Township 31 North, Range 18 West, St. Name and Return Address Croix County, Wisconsin. rj�- /�� _0 33- 1131 -60 Parcel Identification Number (PIN) This is not homestead property. (X) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of September 2002 • Cecil Brighton v ' + Cleo Brighton AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss. `•G . St. Croix County) authenticated this day of Personally came before me this day of ,: September 2002 the above named Cecil Brighton and Cleo Brighton, husband and wife, TITLE: MEMBER STATE BAR OF WISCONSIN F V,1SG (If not, to me kn to b a on(s) who executed the foregoing authorized by § 706.06, W is. Stats.) instru � de l e ed the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland Notary Public, State of Wisconsin Hudson, WI 54016 M Commiss• n is permanent (If not, state exWiion (Signatures may be authenticated or acknowledged. Both are not necessary.) • Names of persons signing in any capacity must be typed or printed below their si ture. Wonnation Professionaa Company. Fond du Lae, wt STATE BAR OF WISCONSIN 800•t355 V021 WARRANTY DEED FORM No. 2 - 1999 v O N •�7 P f0�� 0 '� m N OEM ��* �I -4 v� �• c� 0 0 - oK to 0 '� o0 v � o� � S .Z6'p N o n Q) C4%4 Im / 0 0 00 C5 C14 O J!f) m V7 O ` � N 0 , z O . � 4i I N ' ° �t+S'6L£ O Z/ A ' M.9*" gvos �. � in N 4-0 � io } ^ M CN I 3� <D O \ = 0 N cl� Q V) N I N I 0= CV M N V � M Go CY) LO O� w ~d' v p N� �00� s C'4 lqt 06 tD N d N J (o J I J Kj 00 ........S ... ,90 ZC5' •� 0 8 ��6£ N Z L — — — �i- — , *Z'L8l dk— ,b8't+8£- 3 01.00 S _ — % , COL6 3 .,6£,01.00 S '49 AU06 ,81'09 l l 3 „ 6C,0 1.00 S — — 00'561 — — 00'561- — — - ,00'561 — 600'961— o — . U l) .... ................ ..... .. .......... ................ k ... I I N W W J M c Pn 0 ul t w r W t Y x