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HomeMy WebLinkAbout020-1320-20-000 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT �� ~ Owner Property Address r City /State l �0 Legal Description- Lot �� Block � Subdivision/CSM # '/ ' /4, Sec. , ' 2 N -R,W, Town of SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer /j Size ST/P / Setback from: House .. �D �Vve P/I, � 7 Pump manufacturer Model �� ,� ?i1� Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: ^ m2 a do Width _ Length ./-2-5 Number of Trenches Setback from: House z /--S Well P/L _/_,-_ Vent to fresh air intake ELEVATIONS Description of benchmark Elevation / /-P _ Description of alternate benchmark d, 4 1 . az - m,6e6,,1 Elevation 2ZQZ Building Sewer ST/HT Inlet �9��_ ST Outlet 90� PC Inlet 97 PC Bottom 9 %1,�2 Header/Manifold Top of ST/PC Manhole Cover Distribution Lines () - 9,9A Z () ( ) Bottom of System O 99, Final Grade () () ( ) Date of installation n2l � ermit number Z2&2 Z�� State plan number z � ; �2.�f� Plumber's signatur License number ,z ��� z Date Inspector Complete plot plan � i 1 NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW ,444 4A 4� .S H r �r eJ /Blu` T A Bw sic rr r We(/ INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count§T . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitay ftr170 Personal information you provice may be used for secondary purposes (Privacy w, s.15.04 (1)(m)]. t Hool jh der's Jyra ;_ 6/illage ❑ Town of: State Plan ID No.: O Lit CST BM Elev.: Insp. BM Elev.: BM Description: Parcelft6la13 & -00,Q TANK INFORMATION ELEVATION DATA A9900011 TYPE MANUFACTURER CAPACITY STATION In a BS HI I FS ELEV. epti (� �� «jc) BencJ� Q osing (,LJ �UU I4.8YA Q�51 ,yam Obi Aeration Bldg. Sewer Holding Fy Ht Inlet 7. -Z7 b z2 TANK SETBACK INFORMATION D Ht Outlet ?5� 7 .5b b.0 TANKTO P/L WELL BLDG. Air to I ntake ROAD Dt Inlet � g.� ir Septic / Z r NA Dt Bottom Dosing 61 > 76 , > S o l NA Header / Man. Aeration NA Dist. Pipe T 1 ff'r L ff1F Holding Bot. System YYLT1 •30 , z PUMP/ SIPHON INFORMATION Final Grade Manufacturer 1 2 Demand 5 d . v41111 ,L491' 2 Model Number F p a//Ad 7 � GPM Isq, TDH Li Lriction Sstem2, TDH Ft Fi A Forcemain Length Z Dia. q Dist. To Well SOIL ABS PTION SYSTEM BED / Width / Length No. O renches PIT No. Of Pits Inside Dia. Liquid Depth DIME 3 i DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O r � � ,� � � CHAMBER Mod Number: System: 7 Q 15 0 OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake N �� o f r Length Zc) Dia. Length D Dia. L Spacing D 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 /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) j HUD ,28.29.19 *,SW 734 CROSBY DR — S?. CR�O,cI�X EST LOT 26 Ttr �Cetcr �:3 = 07':15 / `� � 6 / c. %g h.S u�:e►cC� w/le� /� / n�e,�/�./ /' f Gf ✓ 4(JF(,3C�A/� �, 4c -K Plan revision required? ❑ Yes ❑ No Use other side for additional information. K '� L SBD -6710 (R.3/97) D e Inspector's SKp4ture Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division Vi sconsin SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue P 0 Box 7302 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less county than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number / r'� Personal information you provide may be used for s e co ndary y p y eC0 ry purposes E] Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)). State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATI N Prope Owner N e Property Location 114 1/4,S T N, R E (or Property Oj;!ngr 's Mailing Address L Number Block Number 12,1j — City, to Zip Code Phone Number Subdivisi n ' ' or CSM,Nu b ( > 11. YP F B I ING: (check one) ❑ State Owned ❑ !t� Nearest Road Fl Public 1 or 2 Family Dwelling E] VII age - No. of bedrooms Town OF J 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 2- Z41 , 16 a g o 1 ❑ Apartment/ Condo OZO— 1310-20-0cS 2 ❑ Assembly Hall 6 ❑ Medical Facility / Nursing Home 10 ❑ Outdoor Recreational Faci[ity 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1, , g New 2 ❑ Replacement 3 ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an ______System ________ System_____________ Tank Only__________ ^ ___ Existing System _________Exlstln System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 5d Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 12. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq_ ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min / h) E levation Feet Feet VII. TANK in g s Total # of N Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin structed Tanks Tanks — ❑ ❑ ❑ 1 ❑ ❑ Lift Pump T /Sipbew•E1m"er — ® ❑ ❑ ❑ ❑ ❑ ��] .RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for i9stallation9f the onsite sewage system shown on the attached plans. Plumber' Name (Print) Plumb is g r 1( S p MP /MPRSW No.: Business Phone Number: r F Pfuln tier's Add ress (Street, Ci ,State, ' Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate I ssued Issuing Agent Signature (No Stamps) [o Approved ❑ Owner Given Initial surcharge Fee) Adverse Determination 2� � �t'd0 I t lon ! )2o� / X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety a Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained: The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: I. Property ova ner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI_ Absorption system information. Provide all information requested for numbers 1 through 7. V11. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. • Safety and Buildings 15837 USH 63 HAYWARD Wl 54843 -8107 isconsin Philip G. Thompson, Governor lip Edw. Albert, Acting Secretary Department of Commerce January 06, 1999 CUST ID No.224263 ATTN.• POWTS INSPECTOR ZONING OFFICE KIM A O'CONNELL ST CROIX COUNTY 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 01/06/2001 IdentificatorrNumbers Transaction ID No. 204035 Site ID No. 165555 SITE• Please refer to both identification numbers, Site ID: 165555 above, in all correspondence with the agenc ST CROIX County, Town of HUDSON; CROSBY RD, HUDSON 54016 NW1 /4, SW1 /4, S28, T29N, R19W Facility: JOHN RICHTOR RESIDENCE SEPTIC SYSTEM CROSBY RD, HUDSON 54016 FOR: Description: MOUND SYSTEM, 600 GPD Object Type: POWT System Regulated Object ID No.: 443849 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: F' 0. 1. This plan action is subject to designer comments on the plan. Cc / " 2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular to the direction of maximum slope. AP 3. The area 25' below the downslope edge of the mound must remain undisturbed. T aEraizr °, NT 4. Corrections on page 3 of 7 as follows: W = 50'. Dl� Q F A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits SEE CO; , �B required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 01/04/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 7 PATRICIA SHANDORF ,POW S PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WLUS WiSMART code: 7633 >r � u ti RESIDENTIAL MOUND DESIGN INDEX AND TITLE SHEET Project JOHN RICHTOR Owner JOHN RICHTOR � Address 1231 100TH ST NEW RICHMOND WI 54017 a . Legal Description NW-SW-SEC 28- T29 -N -19W L Township HUDSON County ST. CROIX S R Subdivision Name Lot No. 26 � nally Parcel ID Number Plan ID Number 'Y WNGS ppt y x INDEX SHEET PAGE ONE SP0NbEn! ' MOUND CALCULATIONS PAGE TWO CE MOUND DRAWINGS PAGE THREE PRES. DIST. CALCS. & LATERALS PAGE FOUR C Dc) PUMP TANK DRAWINGS PAGE FIVE PUMP CURVE PAGE SIX PLOT PLAN PAGE SEVEN !` yf Designer KIM A OCONNELL License Number ;° Suture Phone No. 715 - 755 -3145 Date 12 -8-98 <r Natice: Tampering with this file by unauthorized persons Is prohibited Deliberate modification will result in disciplinary action under s.14ti,10, VA& Stats. 880-104=-f- (R.0407) Page 1 of 7 �k 3 E 3' L JPTIONAL WORKSHEET I. MOUND SYSTEM 11. IN AROUND PRESSURE SYSTEM-Continued- i. Wastewater Load, Total Dally Flow = 0,^ / gal. 10. Force Main: Minimum Dosing Rate = •.= v gprn- Use section H b3.15 (3) (c), Wis. y in. Adm. Code and PROVIDE A DETAILED Diameter LIST OF SIZING ON PLANS. 11. Total Dynami c Head: �r „ � System Head = 3,�7t25 ft. 2. Depth to Limiting Factor = Vertical Lift = ft. 3. Landslope = ---- ` ft. 4. Distance from Dose Chamber to Friction Loss = Distribution System = �,25 ft. ('130 = ..��.. ft. 5. Elevation Difference Between 12. Pump Selection: Pump and Distribution System = sir ft. Pump will discharge at least gpm 6. Absorption Area Sizing: at. -ft. total dynamic head. Pump mo�el and manufacturer: °• �� Area Required =_- sq. ft. - Bed or Trench Length (B) = l - S ft. Bed or Trench Width (A) _ __�- ft. 13. Dose Volume: Trench Spacing (C) _ ft. 10 Times Void Volume of 7. Mound Height: Distribution Lines = 1L: .'z_ gal. Fill Depth (D) _ �_ ft. Daily Wastewater Volume + Fill Depth Downslope (E) _ �� ft. 4 Doses in 24 hrs. = a �s�/- gal. Bed or Trench Depth (F) = S1 J ft. Backflow .. �.c' /87 7 - gal Cap and Topsoil Depth (G) _ _ ft. Minimum Dose = gal. Cap and Topsoil Depth (H) _ ft. 14. Dose Chamber: 8. Mound Length: Volume = ,_300 gal. End Slope (K) ft. Total Mound Length (L) _ _.. ft. I11. CONVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: _ 1. Wastewater Load, Total Dally Flows .__ gal. Upslope Correction Factor = Use section H 63.15 (3) (c), Wis. Upslope Width (J) = si, / ft. Adm. Code and PROVIDE DETAILED Oownslope Correction Factor LIST OF SIZING ON PLANS. Downslope Width (I) _ - .L�_ ft. 2. Required Septic Tank Capacity = gal. Total Mound Width (W) _-- ft. 3. Percolation Rate = min. /in. 10. Basal Area: 4. Absorption Area Sizing: Infiltrative Capacity of Refer to Table 2 in chapter H 63 Natural Soil = , . �2 gal./sq.ft. /day and PROVIDE A DETAILED LIST OF Basal Area Required = _36.L.'C sq. ft. SIZING ON PLANS. Basal Area Available = sq. ft. Required Area = sq. It. 11, If St. ,, lard Table. from Chapter Length = ft. H ':3 are Used, Indicate Table No. Width = ft. 12. For tF +e Distributioni Network, Use Numbers 5 - 14 in S ection I1. Number of Trenches= Trench Spacing = ft. 11. IN- GROUND PRESSURE SYSTEM „ 5. Distribution System: 1. Depth to Limiting Factor = ff.r^� Lateral Length = ., ft. 2. Landslope = % Number of Laterals= 3. Percolation Rate = •04M../in. Lateral Spy cing = In. 4 Proposed System Elevation = ql i>' ft. Distance frim Sidewall to Pipe = in. D Y ft. I Flow: gal. System Elevation = Wastewater Load Total Dal ...( 5. Y Use section H 63.15 (3) (c), Wis. Adm. Code and PROVIDE A DETAILED IV. SYSTEM- IN-FILL LIST OF SIZING ON PLANS, Fill in All Items from Section III Required Septic Tank Capacity = L 26�_ gal. 6. Absorption Area Sizing: V. SEPTIC TANK Percolation Rate = min. /in. 1. Capacity = ,gal. Area Required = sq. ft. 2. Manufacturer: System Length = ft. 3. Show Site Constructed Tank Details on Plan System Width = ft. 7. Distribution Pipe Sizing: VI. DOSING TANK Hole Sire = 1 ` in. 1. Capacity = gal. Hole Spacing = _ ft. 2. Manufacturer: Lateral Length L'/)It :1. Pump Manuldclurer: - Lateral She �/ In. 4. Pump Model: I.du +rdl tipdcing W - It, S. Operating Head= ft. Uislance IYom Sidewdll•lo five - In. b, Flow Rate= gp 8. Ulslrlbulion I'llrc Discharge Rate: 7. Show Site Constructed Tank Details on Plans Number of I lolcs Per I'Ipe I low Per 1'Ipe 1�. r/. Rlion•. V11. HOLDING TANK gal. 4. Manifold 5liinp: , 1. Capacity = I ype (cenlci or und)' 2. M mulaclurer: Length =_ ft. 3. Show Situ Constructed Tank Details on Plans Diameter -SHOW ALL INFORMATION ON PLANS - DILHR SBD -6761 (R.03/821 h PAG S OF PUMP CHAMBER CROSS SECTIO AN :;PE VENT CAP r VENT PIPE WEATHEKPKooF _ 1 _,APPROVED LOCKING JUWCTIOM BOA 1 ,- -,APPROVED COVER W ITN Z5 FROM DOOR, I WAµ LI+1'1a =1 WINDOW OA FRESH 12-MIL). AIR INTAKE GRADE 7 y" MIQ , I � le CC)QDUIT — IWAUJ. VR0V;DC I — IKILE T AIRT IGH T SLAB I I \✓ APPROVED JOIIJT A I I APPROVED JOIU' I III w/ PIPE W/ PIPE I II EXTEUDIUG 3' EXTENDIMC9 3' I II ALARM ONTO SOLID S01 OWTO SOLID SOIL. b I II Ow � ' I f CLEV FT. PUMP __J b OFF 0 COWCKETE &LOCK RISER EXIT PERMITTED OIJLy IF T AWK MAWLIFACTURCK HAS SUCH APPROVAL 3" RppAoVEb, 6EOt IiNG "vid TANK SPCCIFICATIOIJS SEPTIC E OOSE 1, (, LL-^ 8CR OF 005CS: _____ PER DAy TAW KS MALIUFACTURER: TAAIK SIZE : <<M GALLOWS DOSE VOLUMC y INC.LUUIMC DACKFLOW: ! GALL OW. ALAR►% MA►JUFACTURGR: MOOEL WUMDEK: .1 4L l) CAPAC ;ICS: A = IUCHES OR : GALLOUS OWITGH TyPC: // INCHES OK �' `''=� /'�` —�—/ -- B — _,Z.I,L_ GALLO►J: 9. 9 _ IIJCHE5 OR GALL0LS PUMP MAWLIFACTURCR: MODEL ►UMBER'. i l/ n / U _,�_ INCHES OR GALLO►J:. IIO � I I'unN AUU ALARM ARE 70 DE SWITCH TYPE: INSrMLL[c, G►J SEPARATE CIKCUITS MIWIMUM DISCHARGE RATE �4 GPM VORTICAL OtiFEREAICE OETWCEU PUMP OFF AUO DISTRIBUTIOW PIPE.. FEET + MIUIMLIM WCTWORK SUPPLY PRESSURE . 3 Z FEET IF X,�l n rr. `RlCT10►J FACzG0..- / FLCT } — FEET OF FORCC MAIW /o TOTAL 0tjQAM.IC. HEAL) = L-'= FC.I - T ID N _ - -_�' LIQUID DEPT H --: -- I►JTERWAL C)IME1.1510WG OF 1 - AUK: t,E►JGTH , 1 �^/ T I LICEIJSE IJUM4ER: DATE' 0 WEOSM �, 40 10 90 WEOJM -- r , - ' - 0 0 0 10 20 90 40 SO w 70 w SO 1vJ 110 1 GPM L. 0 10 20 30 M CAPACITY ,.w: :t�: ,P .. , , '\ , � - OULDL PUh1P5, INC. METER$ FEET 120 — NI O D E L. 3885 u - — — I I - SIZE ' /4" Solids 110 WEtSHH — 1 _ - 1041 -; - —�- -- -- r - -I -7 -- - 70 20 — �-- - _ tt ~ WEOSMH —� - -• - -I -- — — 15 50 _ }— - — F - - -,_ to �' - - — — - t0 OL 0 p 10 ZO 90 50 f0 70 u0 of 110 I:•0 GPM 0 10 CAPACITY • 1 046 G out" Puwnpa. Inc. Lao"" Ady. IYw4 C 7111 Wisconsin Department of Industry SOIL AND SITE EVALUATION -R-E- -0,13T Page 1 of 3 Labor and Human Relations � , {, ; t Division of Safety Buildings in accord with ILHR 83.05 VWI A(.�d li©de'.,,.� UNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches irY size n °yfiuso���de'ait *� St. Croix not limited to vertical and horizontal reference point (BM), direction and % f ape, se ols or .L I.D. # dimensioned, north arrow, and location and distance to nearest road. Cr riding I'• "'', `. R ED BY DATE APPLICANT INFORMATION PLEASE PRINT ALL INFORMATI µ " PROPERTY OWNER: Pffi ERTY LOCAJp'!G� Brid eland Dev. Company r , TZ 1/4 ��,S T N,R I R(or) W PROPERTY OWNERS MAILING ADDRESS LO � B��C�C AQ, Q8, fut+rt# 11736 117th ST. 26 t i X - Estates k rst CITY, STATE ZIP CODE PHONE NUMBER [ ❑VILLAGE MOWN NEAREST ROAD Lakeville, MN. 55044 1612) 985 -5000 P= I Crosb y Dr. [x] New Construction Use [x ] Residential / Number of bedrooms [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 450 g pd Recommended design loading rate nP ed, gpd /ft . 2 trench, gpd/ft Absorption area required nP bed, ft 375 trench, ft Maximum design loading rate nP bed, gpd /ft .2 trench, gpd/ft Recommended infiltration surface elevation(s) 99.15 ft (as referred to site plan benchmark) Additional design / site considerations system el. based on contour line of El. 98.15 Parent material glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL I HOLDING TANK U = Unsuitable fors stem ❑ S ®U ® S ❑ U 1 ❑ S IN U ❑ S (2 ❑ S IR U ❑ S [2 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Y Roots GPD /ft Boring # Horizon in. Munsell Clu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1< 1 0 -12 10 r2 /2 none .5 .6 2 12 -25 10 r4/4 none scl 2msbk mfr 9w if .4 .5 Ground 3 25 -58 7.5 r4/6 none s osg mvfr gw na .7 .8 elev. 97 ft. 4 58 -75 7.5 r4 6 none sl m na na na .4 .5 Depth to limiting factor +75 tl Remarks: Boring # 1 0 -18 10 r2 2 none 1 2c 1 mfr qW if n .2 2 18 -29 10 r4 4 none sicl 2msbk mfr qW if .4 .5 3 29 -33 10 r5/4 c2d7.5 r5 6 sicl m na QW na n .2 Ground elev. 4 33 -5 lcsbk mvfr 97. ft. Depth to 5 53 -75 5 r4 4 none sl m na na na .4 .5 limiting fac Remarks: CST Name:— Please Print Gary L. Steel Phone: 715- 246 -6200 A ddress: 1 200th Ave , New Richmond, WI. 54017 m02298 Signature: Date: CST Number: , - 6 -26 -96 PROPERTYOWNER Bridgeland Dev. CO. SOIL DESCRIPTION REPORT Page 2 of PARCEL I.D. # pending loot #26 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bour3y Roots T GP q in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1 0 -13 10 r2 2 none mfr 1f 2 13 -26 10yr4 /4 none sici ifsbk mfr gw if .2 Ground 3 26 -34 10 r5 4 2d7.5 r5 6 sicl lfsbk mfr gw na .2 .3 elev. 9 ne s os mvfr na .7 .8 Depth to 5 149-55 5 r4 4 none sl m na na na .4 .5 limiting factor 26" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # [3 Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Bridgeland Dev. Co. 1554 200th Ave. CSTM2298 NW4SW4 S28- T29N -R19W New Richmond, WI 54017 MPRSW 3254 town of Hudson (715) 246 -6200 lot #26 -St. Croix Estates First Addn. N 1 =40' BM.= top of NW lot stake C el. 100: /] 3(y' Pj. v `S d a Y✓ `S � f Z� Gary L. Steel 6 -26 -96 STEEL'S SOIL SERVICE Gary L. Steel CSTM2298 1554 200th Ave. MPRSW -3254 Now Richmond, WI 54017 (715) 248-8200 To whom it may concern; This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be satisfactory for your use. The location of the system may or may not be as shown, as permanent lot lines had not been established at the time of the test. Gary L. Steel OCT -09 -99 10:02 PM BELISLE EXCAVATING 7132473039+ P.01 ST CROIX Courm SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address p f � ,J ,' Property Address / ,� (V riticatIan r aired from fanning Department for new construction) — K �!J CitylState Parcel Identification Number LECAL DESCRIPTION Property Location /Y&—) X., " 421 Scc. T,?2 - R,[9-W, Town of _'Z�/J Subdivision _ m, ;r 4_ , Lot f# . Certirled Survey Map # , Volume . Page # Warranty Deed # s�"'� s , Volume J �,�, . Page # Spec house [I yes 3 no Lot lines identifable (0 yes O no MML4 MAINTENANCE Improper use and maintenan:e of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three yeah or sooner, if needed by a licensed pumper. What you put into the system can affec the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croce Zoning Department a certification form signed by the owner and by a master plumber, joumaymanplumber, restrictedplwnber or a licensed pumper verifying that (1) the on -site wastewater disposal system is us proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/wc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set torch, herein, as set by the Department of Commerce and the Department of Natural Resources, Sate of Wisconsin. Certification stating that your septic system has been maintained trust be compicted and returned to the St. Croix County Zoning Office within 30 days f the three year expfratic '" r, '� J / / SIGNATIME 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 ownet(a) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. .. I SIGNATURE OF APPLICANT DATE •'•.•' Any information that is mis- represented may result in the sanitary permit being revolted by the Zoning Departatant. ••••'• '• Intlude 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 teed DEC-21 98 10:58 FROM:R.F.STATE BANK 715- 425-1779 TO:171524730SO + PAGE: 02 saiszs VO 1,114 PvF004 DOCUMENT NO. STA-re 1 AA OF I CON IN FORM 2.1911 UO . REGI'S'T'ER'S O FICE_ 5T. CO., wl JUN 2 8 1998 cotrvoye end Warrants to 9 A the follawinl described real estetc in St. Croix County, State of Wiscuusin d L �- St. Croix Estates FirlIAd 000 in the Town of Hudson, St. Croix County �lsin, TEE s a �FER This homestead property. (i.l M) lj%C0ptioa6 to W arr2116CS: 4, Doted this 17th _ day of M, 19 98 ... t (SEAL1 • (SEAL.) AUTHENTICATION ACKNOWL90GURNT Signaturo. >wthenticau:d this day of STATE OF MINNESOTA ty nom— County Personalty carne before me, this _h _. day of may 1998 the above named Tl'i`LE- MSMSER STATE BAR OF WISCONSIN Ngai KLijmiak (If not. aulhoriaJ by 706.06. Wis. SWts.) This imilrumill Will dfaftcd by to me Mown to be the patxoa who exwroted the Blidalffia QrZ1is:lCRm COM PACY 16regoi0 instrument and aclntowle ed Ne snn�t. 2014 Imie Tr, S Lakeville 144 — (SignaMrec may be authentieatcd of acknowledged. • mda ] Aancr Bath aro not naoecsaryJ County, MN Notary Public .._��•ii - My commis ion expires lanuary 1, law• llk%A J. PUB OW Itluc-Mt MMIA 1 pARpT�COUNTr pp IMCesasrnaa IrproNUn. Tr. roue I •Names of perxms ►ilning in any capacity should be typed or printed below their signatures. see NW 0031 WARRANTY DEED STATE BAR OF WISCONSIN, FOR M NO. 1.1912 i 001 1 r / (\J CO 4 w Q / CIO L66 / cn It LAJ w LL O O ON Q a N w� c / N O l ,� O O tr v w O / J £ 1 1 O N 1 N a w — n' / �❑ i F I E F I r.: M l=1' •�fi 0) 01 M h w j 1- O - . ° h O O a M„ 600 � IL IZI �- / - - - w 1 — M,.86Oo90N o ;00 A M N _ t3AI8 Q - 0119f - N J M rn ,IL'9L \ 3..�£ _ ,90.912 OIo01 - - �- •IZI \ \ ibi - ,90'90b l 3 „85,60o90S �� r 1'� o \ \ \ w '0 ? r N LL. W J s� w w U W O W x LL \ _ [rI ?J C:i a N cr Cf) U) f. (O O U U ti W O N h a N a �,�R' \O� N W J N 01 00 O t0 In °�� �, ti o Z J N N N- N �\ OS U 0 � �� W O LL Z o ��` N to to U. a ti \ N w a OD a U) �� 6 3�, J N ro U. ` v w O x w % A� w cn w o i U U � 6' •� 2 a a �• � M N O O 06 n ti o _ J N = N - �C t1 8Z NOIIJ3S 8Z N01133S 30 b /IMS 3H1 d0 3NI 1S3M 6Z NOIIJJS i k ,90'Obb a 90 „t?219