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Home My WebLink About042-1090-90-000 g 10 2i I 2 2 , } tc & - � � _ z o 2 ■ x F w w n, m(D o G) 9¥ : #- m § ± :5. E § 2 ) % @ 2 c m Q Q= g ° , i i � k § / 2 ; @ @ § § S § E E a k o k k� , e z > E a E g o o CL .. a E = o f § § - 00 . ��. � k k k m CD § \ 2 / M 2 V T [ 2 7 \ § ■ ■ ■ i 2 7 § G E { M& CL " 7 CL z - o .. ƒ e §%{ O � \ / $ % \ \ n CL z § 3 _ ■ I ° E a a I■ § F � [ i ■ T q d § C . 2 z 3 % § 2 . w f� ]cn 2 CD CL 20, ƒ c � Z kEto z ! � G\ ° 0 i m _ 1 11 4 , � \ $ � . ƒ 7 @ ? k k CD . 2 � � � /* WiscQqsin Department of Commerce PRIVATE SEWAGE SYSTEM y' Safety and Buildings Division Count St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryB�Gg2it�lo.: Personal information you provice may be used for secondary purposes [Privacy Law, 15.04 (1)(m)). Jbb �yJJ Permit Holder's Name: ❑ City ❑ V e wn of State Plan ID No.: Turner, Thomas rrar YO CST BIVI Elev. Insp. �� BM EI � .: BM Description 5 r Parcel _W- 1.690 -90 -000 46" TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic U J e- Benchmark lo YO !" - Dosing t. M O . eve- I I `f , 30 Aeration Bldg. Sewer /�� %fe �,z0 1197.90 Holding St /Ht Inlet � 1 .0 109, o(,' TANK SETBACK INFORMATION St/ Ht Outl e0l 10 g. F0 ` Ventto TANKTO P/L WELL BLDG. Aiir intake ROAD Dt Inlet r Septic f Aso y (fir NA Dt Bottom ---- Dosing A Header/ Man. Aeration -% NA Dist_ Pipe $ o r Holding Bot. System rf 9•s s L_ 10 .30 ' c f • a PUMP/ SIPHON INFORMATION Final Grade Manufactu Demand t cover L .,Q 1 r Model Number i GPM TDH Lift L Ion System TDH Ft Forc n Length I Dia. Dis . ell SOIL ABSORPTION SYSTEM TR NCH Width Length / No. Of renches PIT No. Of Pits Inside Dia. Liquid Depth DIME 3 S DIMEN I N SETBACK SYSTEM TO P/ L t BLDG WELL LAKE /STREAM LEACHING Man ctur r: _ n INFORMATION TypeOf CHAMBER M el Number: r System: _ (j -F' << f$D — ' OR UNIT a N DISTRIBUTION SYSTEM y Header/Manifold u Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length':QZ Dia- — C Dia. aci tan 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 I ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1• t*W/ OflInspection #2• �t Location: 1043 65th Avenue Roberts, W1 54023 4S�NW 1/4 32 T29N R18W�3222 1.) Alt BM Description = �'., �j1 I / 1 2.) Bldg sewer length / - amount of cover= > 3io Ste 3 0 — $ Plan r r�clulred�? ❑ Yes No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH , SANITARY PERMIT NUMBER: T - S ( c } 3 ° r ! g 3 f g ° i I l I g 6 i J p f I tt a } s 3 f x - Yd .�...� g ..�..,m, . ....,a .-:,., - .,.w.�..,..,... 5..,....,....,.. ......mod.. .... ��.... I_...we....wL a .......................: �,,..P.Pe � ........... ........... �..--.»....... �am�.....w.ze.,...»«..,.�..�.._ � ��me..,.......d......- s. .. � ,,,,.....,A...._.....s',....,.. ..»a.�.,,., .5..�.._��.w.....n »..d,:« - - �._ ..w..�.......a.....,........ f m�.�.,. J Sanitary Permit Applica ion Safety & Buildings Division r In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Wash ington O Box 7302 S C nS See reverse side for instructions for completing this application Personal information you provide may be used �f secondary purposes Madison, WI 53707 -7302 Department of Commerce [privacy Law, s. 15.0 �l ] (Submit completed form to county if not ` state owned. Attach complete plans to the county copy only) for the , on paper nofl 8 - 1/2 x 11 inches in size. County ��JJ State Sanitary Permit Number ❑ Clfeck if'revisi us appli Wtr State Plan I. D. Number ✓ r l r kV_ 3 C I. A phcation Information - Please Print all Information &M Location: Property Owner Name ri roperty Location � a i �. ��/ � t a L� \ ' P�'t 1/4& 1,A/4, S_V T, ,N, fI E o ff Property Owner's Mailing Address 1f c, t Number Block Number City, State Zip Code Ph a um 4 �` Subd'vision Name or CSM Number s Sys Z ` � t II. Type of Building: (check one) ❑ Cfty 1 or 2 Family Dwelling -No. of Bedrooms : ❑ Village ❑ Public /Commercial (describe use):_ own of ❑ State -Owned '4 - �rti . / Nearest Road , 3 68J t Pazcel T � mb� _ 0 Cl G III. T ype of Permit: Check only one box on line A. Check box on line B if a licable 32. 29. 1$. `H C_ A) 1. ❑ New 2 Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System S stem Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was p reviously issued IV. Type of POWT System: (Check all that apply) n= pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (GalsJday /sq. ft.) (Min. /inch) Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks Ste • 'K ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's lure (no stamps): MP/MPRS No. Business Phone Number Plumber's Address (Street, City, State, Zip e) / IX. County /Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) J KApproved ❑ Owner Given Initial Adverse kha ge F e) Determination o�047 X. Conditions of Approval /Reasons for Disapproval: * 6:x t s ` cYgam.. ►,►� �, or 1 .�� ems- r �f+txaoK cs eCa . A-d 4291.,"' PLAN PROJECT Thomas Turne DRESS 1043 65th Ave Roberts Wi 54023 SE 1/4 NW 1 /4S 32 /8 Z W TOWN Warren COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE7/3/00 BEDROOM 3 CONVENTIONAL XXX IN -G P ES CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 699 # of chambers 2 I)SENCHMARK V.R.P. Base of Shed Siding ASSUME ELEVATION 100' Fil r Zabel A -100 ❑ BOREHOLE O WELL - H.R.P. Same as Benchmark Alt. BM Top of White Stake @ 102.4' SYSTEM ELEVATION 95.5/94.4 Well Vent > 12" Sidewinder High of Cover Cap Leaching o 120' Chamber 6' Long 16" 34 Grade at System Elevation Existing 3 Bedroom 60 House 10' 45' 45' 2 -3' X 69' Trenches 15 30' with >3' Spacing T 35' B -3 ' 00' ❑ D W 20 (Collapsed) -a--V ents Septic Tank is 70' 10' 5' located under 36' N# 70' 10' Alt attached porch 6% Alt Slope Shed 125' 65th Ave I - Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size. Plan must �r o i x indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. QQ U Please print all Information. Reviewed by Date Personal Information you provide may be used for secondary purposes (Privacy Law. s. 13.04 (1) (m)). ` �— I T — Property Owner / Property Location T/l /h Govt- Lot ,S,—c 1/4N0 S 3 T Q N R /KE(ole Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# / o Y 3 6 s �4 -- Clty tate Zip Code Phone Number ❑ City E) ow Village n Nearest Road LQ L 5 O 31 A '7' f— 3 6 63 C- ❑ New Construddon Use' Residential / Number of bedrooms 3 Code derived design flow rate PD Replaioement ❑ Public or commercial - Describe: X s Parent material O si.^f4 1 Flood Plain elevation if applicable General comments and recommendations: Sy s4e , -C_. le—L) SA G�aO I Boring # ❑ Boring 7 Pit Ground surface elev ft. Depth to limiting factor //Oz in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W In Munseii 1 Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#i 'Eff 5� 3,� ® Boring # ❑ Boring Pit Ground surface elevl fl. Depth to limiting factor Z In. Soli tion Rats Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots WWII in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 3 3 9 Y-YO z o8 * Effluent #1 = BOD > 30 < 220 mg A. and TSS >30 < 150 ' Effluent 02 = BOO, 30 mg/L and TSS < 30 mg/L C (Please Print) to CST Number r7 Address Date Evaluation Conducted Telephone Number l�o� l 97 w-�0 Y c - 3 G a / Property Owner Parcel ID # Page of Boring # [� Boring . ,® Pit Ground surface elev. Z4V*f Depth to limiting factor in. Soil AppNc n,*Eff#2 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 —� Z 311 ,�- o v .� 88 .8 rz�f 8 F so" Boring [� pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicadon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f 2 In. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Q Baring # Wng Pit Ground surface elev. ft. Depth to limiting factor in. SoN k:Ww Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/M In. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. •EfM►1 1 •Ef #2 " Ef fluent #1 m SOD, > 30 < 220 rrQ& and TSS >30 < 150 mg1L ' Effluent #2 = BOD, < 3o mg/L and TSS < 30 mWL The Department of Commcrcc 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 ta.6rool Soil Test Plot PI Project Name Thomas Turner S 'rd Address 1043 65th Ave Roberts Wi 54023 CSTM 4226900 Lot ----- Subdivision - - - - - -- Date 7/3/00 S E 1/4 N W 1/4S 32 T 29 N/R 1 8 W Township Warren ❑ Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. B ase of Shed Siding = � System Elevation 95.5/94.4 *HRP Same as Benchmark Alt. B M -- Top of White Stake @ 102.4' ell ' t~ 120' Existing 3 Bedroom 60' House 0 45' 45' 15' 35' B= 70' Poo D W 20' (Collapsed) Septic Tank is 0' 15' located under 5 _ 70' V attached porch 36 B. 6% 1 Slope Shed 125' 65th Ave ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM � L Owner/Buyer ,M*,,,, %u i Mailing Address �Df'3 s 4"f /Z" Property Address (Verification required from Planning Department for new construction) q City/State g Parcel Identification Number LEGAL DESCRIPTION Property Location %4, � /4, Sec. �, Ts�,N -R�W, Town of Subdivision - Lot # ZV Cer_dfiu�d�urvey M" # � 9 -� . Volume . Page # ` � 1 Warranty Deed # -��% �� Volume Page # Spec house O Lot lines identifi able es O 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 treatmen t stage g in the waste disp system. The property owner agrees to submit to St. Croix Zoning Department a certification fotas, signed by the owner and by a master p l u mber, journeymanp weri lumber, restricted or a licensed fytng that ( 1 ) the on -site wastewater disposal system is in proper operating condition and/or (Z) after inspection and pumping (if necessary), the septic tank is less than 1/3 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 days of the three year expiration date. DATE SIGNATURE OF APPLICANT OWNER CERTIFICATION the owner(s) of I (we) certify that all statements on this form are true to the best of my ( our) lolowle e dg • I ( am ( are) the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. 1 / DATE SIGNATURE F APPLICANT ss « «ss A information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. «s Include with this application: a stamped warranty died from the e ef�ren D s made rn the warranty deed a copy of the certified survey map r r STATE BAR OF WISCONSIN FORM 2 - 1982 WARRANTY DEED DOCUMENT NO. VOL 1. 74PACE419 Joel L - chultz and Joanne T. Schul husband a wi fe , :un\•eys and \ \arrants to Thomas C. Turner and Sand S. _ Turner, husb a nd wife, as survirorG marital NLJv u -L 13D7 Prope — -- — - - - - -_ 10:45 A THIS SPACE R_SERV'ED PECCPD,NG DATA NAME AND RE T -AN ADDRESS i .. the following descnbed real estate in St Croix _ County, 0"! St, to of Wisconsin. `, �/� / �' , 042- 1090 -90 _ PARCEL iCENTIF,CAT10N NWBER A parcel of land located in the E 112 of SE _,4 of NW 1/4 of Section 32, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin beii further described as follows: Commencing at the W 1/4 corner of Section 32; thence Nly at an assumed bearing of due North along the Section line 473.00 feet; thence N8l along the centerline of an existing ( /�C� town road 1525,00 feet; thence N84 ° 27'E along said centerline 477,50 y 80 /,%s' feet to point of beginning- thence continuing N84 662.50 feet to the North -South quarter line; thence S0 along said quarter ` line 8006.73 feet to the center of Section 32; thence N89 along the quarter line 660.56 feet; thence N0 740.74 feet to the point of beginriing.•*� Except the Nly 33 feet which is being reserved for roadway and access purposes. This is TR ER { homestead progeny. (is) (cs not) 04 , / i r; Exception to warranties: F , Subject to easements, reservations and restrictions of record. ' Dated this day of October A.D., 19 97 '. (SEAL) 1 (.;EAL) �: s -,JOEL L. SC UL 4 • / 1 i �e e (SEAL) -- (SEAL) t _ JOANNE T. SCHULTZ AUTHENTICATION ACKNOWLEDGMENT Signature(s) - State of Wisconsin, - St. CJCix Lou y. authrnucated this _ —day of — , 19 Personally came before me this _day of � - October 19 the above named . 16 1 - a Joel L. Schu an Joa T__, _ Schulte TITLE MEMBER ST.-VfE BAR OF %WISCONSIN (If not. -- — -- -- 'ir authorized by j 706,0o, Wis. Stats.) to me known • -t per >on s_ who ow uicd the foregoing • S m5(rli nirnt ad 1 1)le INTHIS STRUMENT WAS DRAFTED BY STEPHEN J. DUNLAP H udso n, Ico is nsi n w — . — . _ - -- — Notary Pub S`t.. (Si may oe authenticated or ackno\\ledged. Both ale riot %IV ccnlm4 •.1s �rrnlanc�lj ,!f not state exhirau n :_`,ue ` necessary) • Namcs of prr.ons s.gmng to m ;.;pai) hon:d b) , %ped or p .., :.ed Se1v% their >lgr4:ure< WARRANTY Dt:FD STATE RAR OF WISC0* SIN W. SCJ' �• oar. C.,.'c • Form No. ._ - 1982 . Are 4s ...; 4 All s i