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HomeMy WebLinkAbout040-1263-00-000 ST. CROIX COUNTY f WISCONSIN ZONING OFFICE t_ M B No N NEW nni ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 Fax(715)386 -4686 January 23, 2001 First Federal Attn: Tammie 201 S. Second St. Hudson, WI 54016 RE: Septic Inspection for Sam Miller located at 436 New Century Drive, Frontier (Lot 10), Troy Township, St. Croix County, Wisconsin Dear Tammie: A septic inspection of the above referenced property was conducted on 11/29/2000. This property is located in the NE 1/4 SW 1/4 of Section 5, T28N R1 9W, Frontier (Lot 10), Troy Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a four (4) bedroom home. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, Kevin Grabau Zoning staff /gm cc: file 1101 C armichael Road Hudson, Wi. 54016 Phone: (715) 386 -4680 St. Croix • Fax: (715) 386 -4686 Zoning Department Fc o ix To: Tammie From: Glad Meyer Fax: 386 -92 Pages: 2 Phone: 381 -5000 Date: 0 1 / 23 / 01 Re: Verification Letter — Fontier Lot 10 CC: ❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle • Comments:. I F Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 363951 Permit Holder's Name: ❑ City []Village ❑ T&vn of: State Plan ID No.: Miller, Sam Troy Township CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: 6D • o' ao . o' S'�>�ce = CST '9 VV 040 -1263 -00 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic f Z Benchmark Dosing Alt. BM 2. Aeration Bldg. Sewer Hci g St/ Ht Inlet 7, Z5-- oli• TANK SETBACK INFORMATION St/ Ht Outlet �.lc Z g9.33 TANK TO P/ L WELL BLDG. Air I ntake ROAD Dt Inlet c— ir Septic ,T' 20' --- NA Dt Bottom Dosing NA Header / Man. (r>. zZ E on NA Dist. Pipe g' Bot. System PUMP/ SIPHON INFORMATION Final Grade Ma turer Demand St cover Model Number GPM TDH Lift L oss n_ System TDH Ft m ead For en Length Dia. mai Dist. To well SOIL ABSORPTION SYSTEM 13 MkM ENCH Width 3f Lej)h No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM �j Z D IMENSION S SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING gnu actur r: CHAMBER ,b &Z INFORMATION Type O , i Moe Number System: Cvw� IS 3 OR UNIT - DISTRIBUTION SYSTEM Header / Ma ifold H I Di tribution Pipes) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. L Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/Tr nch Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #l: H /21/ 0 Inspection #2: -- t - t Location: 436 New Century Drive, Hy0son, WI 54016 1/4 SW 4 5 T28N R19 -0528 418 Fronti�L t 11 �. 1.) Alt BM Description= Tv� ������ a r` �R^ 2.) Bldg sewer length = 2 a s s �t - �---s` z c�vc�: s) H.a� 53.9 - amount of cover = > 34 13.D t C 3) - t .�� �. t�) OD t I z. Bs qv �' g j D s 3 z' t E> bS(N) I l • �3 9 Plan revision required? ❑Yes � No (Z 7- � I� S Z Us the side for ad itio al jnform tlon. &�� SBD -6710 (R.3/97) �1dL tom^^^ �iev� � `f- r 3 „eQ fit nspector's Signature n I Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ,..� F € 6 b � I S E f t e a r F 4-4-, .._ m -_ £ € + 1 g 5 tt ] q q € ! d v 3 g F �w �� Sanitary Permit Application Safety &Buildings Division NN O .S con si n In accord with Comm 83.21, Wis. Adm. Code 201 W Washington Ave. See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Oepertment of Cammecce Per (Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned. Attach com lete plans to the county co only) for the s e a -1/2 x 11 inches in size. C S Sanitary Permit Number ❑ Check i i o previou�appli '6ry," tate Plan I. D. Number I. Application Information - Please Print all Information ation: A P ;hon on Property Owner Name S' C11_ ! �� ) /43W114,S Property Owners Maiting Address $ r ����� t umber Block Number COUNTY City, State Zip Code r bdivision Name or CSM Number II. Type of Building: (check one) ❑ City ❑ Village 1 or 2 Family Dwelling - No. of Bedrooms : .Town of Public/Commercial (describe use):_ OF 'O n ❑ State -Owned Nearest Road Parcel Tax Number(s) O • /2 - '0 d O b III. T e of Permit: Check only one box on line A. Check box on line B if a licable _ 1 52- 19.1 rB ment 3. ❑ Replacement of 4. 5. 6. ❑ Addition to Tank Onl Date Issued Existin S stem Permit Number ❑ A Sanity Permit was previously issued . Type of POWT System: (Check all that apply) on pressurized In- ground LrA e_0 ❑Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In -grou , ❑ Holding Tank ❑Single Pass ❑Drip Line ❑ At-grade 001 FFkSE ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dis ersal/Treat nt Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Applicatio 9 Required Elevation 5. P (Mi ercolation Rate 6. System Elevation 7. Final Grade Proposed Rate (Gal /sq. ft nJinch) D Ca�'d c Cpl 0.s VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con - Con- glass New Existing crete structed Tanks I Tanks SEPT I C_ X I — L- 0 0 0 0 0 VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Business Phone Number Plumber's Name (print) Plumber's Si afore (nos ): MP/MPRS No. Plumber's Address (Street, City, State, Zr 3 Code) 10 70 PVA(7o� r'06t�_ A A,4 Se IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ❑Owner Given Initial Adverse c 5 )� rt � - ZND 4_)�� Determination 7 X. Conditions of Approval /Reasons for Disapproval: I"� r sum m �LL�/L- �-oT.� /d �,�oNTr ��. �/,�'� ��� �rN t7 2►�E 9 L OW T/zrm / ✓ N �ts,00 �Lv G� ► � ��Sz tZ5 G•� c S A �ittE� G�� 3 ti � V ,�� ZA W► A *�,u '71 �3 r Tb0 e ��> ►'T $TAI K E IQ� p SRec if ications 3 �r rN4-� & 3 B�ol�if fu �. # s k 11, � 76.. �N�, i 00 �o 00 00 00 00 00 00 00 �� OO OD OD OD OO OD OO � Chamber Dl OO OD OO Ol DO OD OD Height OO OD O� OO OD OO OO o 00 OD Do DD o DD OD oo DO OO OD OD OC OO O 0 0o r�o 00 00 00 � 0 00 0 r �; % Chamber Height '* End View a gOty Bi©C?iff sit `rS , r� h ad V a�� d �='s' 4' KnOCkOUt i Universal End Cap Available Sizes Length 76 °' 76" 76" Width 34" 34 34" Height 11 14" 16" Invert 6.5 9 11.3 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code A.C.E. Soil Bt Site Evaluations Attach complete site plan on paper not less than 8'A x 11 irxhes in size. Plan must County inctude, btA not limited to: vertical and horizontal reference point (BR, direction and St. Croix percent slope, scale or dimensions, north arrow, and_ tocaRion.and distance to nearest road. Parcel I.D.# Prt of 040 - 1021 -90 APPLICANT INFORMATION - P/ e,nt all information. R , B Date Personal information you Provide maybe used 3gC0fidary Purses (Privacy Law, s. 15.04 (1) (m)). Z,d'O Property Owner <� ; ` Property Location Miller Sam GovL Lot NE 1/4 SW 1/4 S 5 T 28 N,R 19 W Property Owner s Mailing Address -, r Lot # Block # Subd. Name or CSM# X35 it S P.O. Box 151 r " " 10 Plat Of Frontier Cit Stat Code PJtope9dlueiber E] City E] Village ®Town Nearest Road Hudson W I Troy Tower Road ® New Construction Use: ❑ Iii 061 f Number of be&oms 4 ❑Addition to existing building ❑ Replacement ❑ Public dr describe Code Derived daily flow 600 gpd Recommended design loading rate •5 bed, gpdff .6 trench, gpd/ft Absorption area uired 1200 bed 1tz imum design loading rate •5 bed, •6 trench, gpd/fF req 1000 tr fts Max g g 9P� Recommended infiltration surface elevation(s) 95.3' u trench, 92.9' lower ft (as referred bD site plan benchmark) Additional design / site considerations h'stall trenches usmg igh c �nS ft Parent material Glac ial outwash Flood Mal n elevation, 'ff applicable NA ft S= Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in �til Holding Tank U= Unsuitable for M S❑ U ® S❑ U ® S❑ u ®S ❑ U ❑ S M U ❑ S® U Y SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft2 Boring# Horizon in. Munsell Qu. S7- Cont. Color Texture Gr. Sz Sh Consisten Boundary Roots Trench 1 1 0 -10 10yr3/2 None A 2fsbk mvfr as 2f &m 0.5 0.6 2 10 -17 10yr4/2 None sl 2msbk mfr gw 2f 0.5 0.6 Ground 3 17 -34 10yr5/4 None sl 2msbk dsh aw if 0.5 0.6 elev 100.14 ft 4 34 -42 7.5yr4/6 None is Osg dl gs - 0.7 0.8 Depth 5 42 -108 10yr5/4 None s Osg dl - - 0.7 0.8 limiting factor 9S`• >108' Remarks: Z 1 0 -12 10yr3/2 None sl 2fsbk mvfr cs 2f &m 0.5 0.6 2 12 -26 1Oyr4/2 None sl 2msbk mfr gs 2f lm 0.5 0.6 Ground 3 26 -47 10yr5 /4 None A 2msbk dsh cw 1 f 0.5 0.6 elev 100.83 ft 4 47 -53 1 4 f2d7.5yr5/8 sil Om mfr aw - NP .2m Depth to 5 53 -107 10yr5/4 None s Osg dl - - A 6—✓ limiting O 0 . factor _ >107' (06.36 oZ. 3b R One foot rule awfied to d1sregW redox, features found in H #4..1#5 contains 1/4" -1/2" discontinuous bands of 1 3/3 Ifs at 8 " -15" intervals. LaKling rate adjusted to reflect permiabift re assocaited with banding. CST Name (Please Print) Signature:' _ Telephone No. James K. Thompson ��� �" 715- 248 -7767 Address A.C.E. Soil & Site Evaluations - -� Date CST Number R e f # 340 Paulson Lake Lane, Osceola, WI 54020 12/31/1999 3602 1159 PROPEWOWNBL Miller,sam SOIL DESCRIPTION REPORT „ss Page 2 of 3 PARCEL I.D! Prt of040- 1021 -90 A.C.E. Soil & Site Evaluations Dominant Color Mottles Structure G �� Texture sistence Boundary Roots Horiz in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed I Trench 3 1 0 - 10yr3 /2 None A 2fsbk mvfr cs 2f&m 0.5 0.6 2 14 -30 10yr4 /2 None sl 2msbk mfr gs 2f,lm 0.5 0.6 Ground elev 3 30 -66 lOyr5 /4 None sil 2msbk mfr cw if 0.5 0.6 99.7T It 4 66 -70 5/ f2d7.5yr5 /8 sil lmsbk mfr aw - 0.2 0.3 Depth t0 5 70 -128 10yr5 /4 None s Ogg dl - - 0.7 0.8 limiting factor >128' R7. 90 53.t: y gq. �Y YY Remarks: One foot rule applied to disregard redox. features found in H #4. 4 1 0 -12 10yr3/2 None A 2fsbk mvfr cs 2f &m 0.5 0.6 2 12 -22 10yr4/2 None sl 2msbk mfr gs 2t;lm 0.5 0.6 Ground elev 3 22 -44 10yr5 /4 None A 2msbk dsh cw if 0.5 0.6 99.w It 4 44 -50 1 /4 f1d7.5yr5 / 8 sil Om mfr aw - NP 0.2 Depth to 5 50 -120 10yr5/4 None s Ogg dl - - 0.5 0.6 limiting factor >120' Remarks: One foot rule applied to disregard redox. features found in H #4. H #5 contains 1/4" -1/2" bands of 10yr3/31fs. Loading rate adjusted to reflect vermiabilitv restriction assocaited with bandine. 5 1 0 -11 1Oyr3/2 None sl 2msbk mvfr as 2f 0.5 0.6 2 11 -42 10yr4 /4 None A 2msbk mvfr aw if 0.5 0.6 Ground elev 3 42 -50 10yr4 /6 None Is Ogg ml cw - 0.7 0.8 99.87 ft F4 50 -95 10yr5 /4 None s & gr. Ogg dl gs - 0.7 0.8 Depth to 0.7 95 -119 1 Oyr6 /4 None s Ogg dl - - 0.7 0.8 limiting factor >119" Remarks: Ground elev Depth to limiting factor Remarks: 0.3* w �r= .5a.» /'Yj,- / /�c•� .189.87 s5�b /G �oc��EQd /off s�d�'e nE.AY,5t4*,, .5e0- 7 �P. If6c� T . o- l'Ti'o/r, zFSC»' a� 83 ■ ■ az ■ ds 6q of lob sf.a.. e. .Assu.ncd Q lev' °�� U. AY-'i/V le^0 e4 �� ' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 5 P' % it Mailing Address Property Address < N ow r o re ) (Verification required from Planning Department for new construction) City /State A L) 0s 0 Ljj t Parcel Identification Number LEGAL DESCRIPTION Pro Location /V J5 '/s, S ' /4, Sec. S , T V N -R & Town of p�Y Subdivision r/2 N- / F . Lot # CertWiied Survey Map # fa of 1 4 —C . Volume Page # Warranty Deed # GD 6 fe . Volume Z_. . Page # 7� Spec house yes ❑ no Lot lines identifiableXJ 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, joumeymanplumber, restricted plumber or a licensedpumper verifying that (1) the on -site wastewaterdispoaal 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. I 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 S - A the three ear a iratioq date. I 0G W F P ANT 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 ,rty described above, ' e of a warranty deed recorded in Register of Deeds Office. SIGNATURE O PLIC '� « « « « «« being revoked b the Zoning s « « « «« Any information that is mis- represented may result in the sanitary permit Y �g Departm ent. «« 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 V01.1442PAGE 42 SPATE BAR OF WISCONSIN FORM 2 - 1995 660rS841 - WARRANTYDRED KATHLEEN H. WALSH REGISTER OF DEEDS This Deed, made between Kathryn B. Tuleren, and Ferris — ST. CROIX CO., WI R_ n0grWn wife and husband. RECEIbED FOR RECORD Grantor, conveys and warrants to 07 -14 - 1999 11:00 AM Sam E. Miller, a single person. NARRANTY DEE) EJ07pT 1 Grantee. CERT COOT FEE: Grantor, for a valuable considi ration, conveys and warrants to Grantee Copy FEE: TRANSFER FEE: eee1,10 the following described real estate in St. Croix County, State of RECWDIN6 FEE: Ie.00 Wisconsin (The "Property'): PAGES: 2 Rmnlina Area Name and Ream Address 040-1022-1 040- 1021 -90: 010- IM9 -20: 0(0- [028.70 Parcel Identification Number (P" This is not hornettead property. (See Attached Exhibit 'A ") Exceptions to warranties: Easeulents, restrictiorts and rights -of -way of record, if any Dated this 13th day of July, 1949. • • Kathryn B. ulgrcn " R. Tt2lgren AUTHENTICATION ACKNOWLEDGMENT Signatures) STATE OF WISCONSIN ) ) Its. authenticated this _ day of St. Croix Courtly ) Personally came before me this 13 day • of July, 1999, the above named Kathryn B. Tularen. TITLE: MEMBER STATE BAR OF WISCONSIN and Ferris R. Seen,, - xtfe - mom — o to (If rot, me rown to the per s) who executed the foregoing au[Itori:cd by J 706.06, Wis. Stars.) instVI and ac kno l g e the sane. THIS INSTRUMENT WAS DRAFTED BY `lam_ , Attorney Krlstina Ogland ' N blic, State of Wisconsin Hudson, WI SOO1tF (Sitimatfer may be authenticated of acknowledged. Both are not My Conunini0j � a�pc d OC f rot, sure expiration date: necessary) Breads Poulin —" Notary Public State of Wisconsin .Names of person signing In any capacity amid be typed or printed below their signatures wAaaAxrr OM FFA aM or wisco"M roam N. r - tssa MFOaaaA TION PROF eu+aw 9 COWANY FOND QV LAC, aM aOMIS& G71 r �.1442 43 EXHIBIT "A That certain parcel of land to Gated in the NE IA of SE �� Township 28 N I Rang W /' of SW % and the NE % of SW '/. of Section 5, ALL in' o Croix County, Wisconsin more f thence N87 ° 51 08' Eows. yJest, Town of Troy, St qu arter comer of said Section Inning at the West q t_West quarter line of said Seco'S1 08 "Ea Beg 288 meet to a on the O 1 T thence N87 (recorded beann9 854.00 feet; said East line, + � thence along 2342.24 feet; then cn o said NEE /• °f SW /4• + thence along the po int on the East he SE corner of said NE /• afa N / ;/ 4 o f SW '/•, o t s ° ^W P 4 "E, 466 (38 feet to + and the South line of thence S 54 S 3 2 /. a eet, o 1 f SW ,48 f said South line of said N 41 thence NOW', E, 17 \N 87 °54'54 "W, 2372 • rated West line of said N , of SW' /', thence along S 941.26 feet', thence 27-391 feet tq the monume ,E (recorded as ° recorded as N01 °3 " E), ine, Noo 3 (3 28 E (rec 458.40 feet to th13 0 ( line of said NE West 1 63 N88 20 N64°57' (recorded as N Said Nortlh 00 rded as 25'h rods) to the Point of alo Of SE I A of Sectido N89 24;� " 4 1 6 - B9 feet S88-401 a Beginning. I NORDIC HEIGHTS— ApQLUQN. �. 1 owl ,�[$ - �I: ,� ;Q IV• �N lO J N� V IC) r— - 40w,fla well 11" of Ip s.dlew (sr. %- m's wk) ta I rt e'. •1 f .._._._,_._._.�._._._., t /O.1A' •ba � ct 1 ! ' i .1 r \ 1 I I I I w 100• • „i `fib ® . � t \ 19 '.� •` �� 10 R I j f I 1 l4 o .) ;v I is I � . s..;` — •— •�•— • —• —•i , N �. '►� srolaa t a . 1 1 1 �k Q tAn ' p i Ik i t� s �x s. 1 1 u� ! l4usr 1 �r?SSCt ®. / i77F .A .......................... BR N E ET r NOW S 0'41'4r if l ti y 1 r u1sm Lrd lit WWI /4 ?I!I[ KNIT tr '�� L'�Mti __.:® - - Ildr 6rc Ml /1171 Salinn5� 'il r — C g a _ I ( NO 4450' t l) JJ' ® � � �1 i• � � I ' IO _ ♦ i' 1 1 ' pp I Ir lc= at I � �� �i• c I �� g� S U'l.f'71” I 1. icic� l sr1370 , W00 ra(. $ 0• ISy.I- 1