HomeMy WebLinkAbout032-2109-70-000 ST. CROIX COUNTY ZONING DEPARTMENT.__.._._,.....__
k
AS BUILT SANITARY REPORT
Owner
Property Address
City /State -
r�
Legal Description: 0Ffi�CE
Lot —Z Block Subdivision/CSM #
i /4 , d j 1 / 4, Sec. �-, T_ N -R,�9 W, Town of
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer Size ST/PC
Setback from: House Well � P/L
j / �
Pump manufacturer Model
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: _ �u J o Width _� Length ZS _ Number of Trenches
Setback from: House - Well ` P/L 1 ` 7 Z Vent to fresh air intake /�
ELEVATIONS
Description of benchmark Elevation '
Description of alternate benchmark le Elevations
Building Sewer .9,2& ST/HT Inlet ST Outlet PC Inlet
PC Bottom Header/Manifold Top of ST/PC Manhole Cover
Distribution Lines () A5
Bottom of System
Final Grade
Date of installation I s Per it number 3 State plan number /
Plumber's signature �. -/ License number Date
Inspector
Complete plot plan
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
lie
h`s.use
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INDICATE NORTH ARROW
• Wisconsin Department of Commerce
Safety and Suildings bivision PRIVATE SEWAGE SYSTEM County:
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)]. 344700
Permit Holder's Name: ❑ City ❑ Village [jd Town of: tate Plan ID No.:
Town of Somerset b D. �-
CST B M Elev.:. Insp. BM Elev.: BM Description: Parcel Tax No.:
C 032 - 2109 -10 -000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 0(7
Dosi ng Alt. BM �0 . 2Q
Aera Bldg. Sewer 141 12, VP
Holdin (D Ht Inlet 1 /4-0 0 y4
ANK SETBACK INFORMATION (9/ Ht Outlet 14,3
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic 35' NA Dt Bottom
Dosing L, 7 t 0 NA Header/ Man.
A i NA Dist. Pipe
Holding
Bot. System
PUMP / SIPHON INFORMATION Final Grade
Manufacturer Demand St cover,, e2• �,3 . 7�
�(, f1 Model Number l;ww L 9 GPM
L oss
� eaema, TDH ��Ft
TDH Lift \q. 3•` D Sd,�_
Forcemain Length C1 1 Dia. HH Dist. To Well 'l
SOIL ABSORPTION SYSTEM
BE / TRENCH Width Length1 W1Qf Length Tr nche PIT No. Of Pits Inside Dia. Li uid Depth
EN I N 3 I DIMENSION
SETBACK
SYSTEM TO P/ L G WELL LAKE/STREAM LEACHING ufacturer:
INFORMATION Type Of r r 1 CHAMBE Mode umber:
System:� OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipes) r µ p x HOIe Size x Hole Spacing Vent To Air Intake
kk %A Length � Dia - Length � Dia. I I L Spacing � I�� a O ��
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 I Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #l: f4 / /r/ 9�Inspection #2: P? 1
Location: 1761 46th Street, Somerset, WI (NW1 /4, NE1 /4, Section 5 T30N -R19W) - 5.30.19.1025
v'Q�¢ 63 (`I :� r�BGr g00r ed
0 " ice 11 p�,�;� eUer ,_ pitr� fi e, per
Plan revision rVquired? ❑ Yes §I No
Y ® s o er s' ear additional information. cis 07 01
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No
SANITARY PERMIT APPLICATION Safety and Buildings t n Avenue
n
101 sc o n ' sin 201 W. Washin I n accord with ILHR 83.05, Wis. Adm.. P O Box 7302
Department of Commerce Madison, WI 53707 -7302
• Attach complete plans (to the county copy only) for the system' ' bn'paper not less County
than 8 112 x 11 inches in size. '
• See reverse side for instructions for completing this applic lion "" 4 • , State, anitar Permit umber
�O
Personal information you provide may be used for secondary purposes ! I] Check if revision to previous application
(Privacy Law, s. 15.04 (1) (m)].
State Plan I.D. Number
I. APPLICATION INFORMATION - PLEASE PRINT ALL F,O -,. t
Props Owner Name gy,,ocation
va U4, 5 �-' T , N, R jor
Property Owner's Mailing Address 4tNum6er Block Number
City, State Zip Code Phone Number Subdivision Na or CSM Num r
I dilz 64
( ) 0
. TYPE OF B ILDIN (check one) E] State Owned ❑ city Nearest Road
❑ Village
Public 1 or 2 Family Dwelling - No. of bedrooms Town O
Ill. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) S 36
1 ❑ Apartment / Condo 3 `� ` —7e-
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
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. New 2 ❑ Replacement 3. ❑ Replacement of 4 ❑ Reconnection of 5_ ❑ Repair of an
- _____System ________System _____________Tank Onl�r______________ Existing System ________ Existing 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 JaMound 30 ❑ Specify Type 41 []Holding Tank
12 ❑ Seepage Trench 22 ❑ In- Ground Pressure f 1 42 [] Pit Privy
13 E] Seepage Pit j (o K b 3 91 . 43 ❑ Vault Privy
14 ❑ System -In -Fill)
VI. ABSOR PTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. ate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /i ch) Elevation
Feet Feet
VII Capacit
TANK in allo Total # of Prefab. Site Fiber- Exper.
INFORMATION New Existing Gallons an Manufacturers Name Concrete stru n- Steel glass Plastic App
Tanks Tanks
Septic Tank or Holding Tank cAj2 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber n ws 21 1 ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for i tallation of the onsite sewage system shown on the attached plans.
Plumb r' ame: Pr )/ Plumb is gn u ) MP /MPRSW No.: Business Phone Number:
Plum eds dress (Stree��ity, S ^ te, Zip Code
,C �
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved S Surcharge Fee) Ko
nitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Sign ture (No Stamps)
Approved ❑ Owner Given Initial
Adverse Determination 3 Q`�'4°�
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD- 6398 (R.11197) DISTRIBUTION: Original to County, One copy To: Safety & 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 thi sanitary permit application must include:
1. Property owner'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.
VII. 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.
----------------------------------------------------------------------------------------------------
i
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
-., 10541 N RANCH ROAD
HAYWARD WI 54843
TDD #: (608) 264 -8777
*isconsin www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
September 14, 1999
CUST ID No.224263 ATTIC• POWTS INSPECTOR
ZONING OFFICE
KIM A O'CONNELL ST CROIX COUNTY SPIA
504 3RD AVE 1101 CARMICHAEL RD
OSCEOLA WI 54020 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 09/14/2001 Identficaf" ers
Transaction ID N . 241247
Site ID No. 17913
SITE: Please refer to both identification numbers,
Site ID: 179139 L above, in all correspondence with theagency.
ST CROIX County, Town of SOMERSET; 1761 46TH ST, SOMERSET 54025
NW1 /4, NEIA, S5, T30N, R19W
Facility: BRUCE YOUNGMARK 1761 46TH ST, SOMERSET 54025
FOR: MOUND, 450 GPD
Object Type: POWT System Regulated Object ID No.: 486511
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. P.0
Con
The following conditions shall be met during construction or installation and prior to occupancy or use:
1. This plan action is subject to designer comments on the plan. AP
2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular 0 TME1
to the direction of maximum slope. p f SA
3. The area 25' below the downslope edge of the mound must remain undisturbed.
4. Insulate building sewer per COMM 82.30(11)(c). f
SE=E COIF
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
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 08/11/1999
FEE REQUIRED $ 180.00
FEE RECEIVED$ 180.00
PATRICIA L SHANDORF , POWTS PLA VIEWER BALANCE DUE $ 0.00
Integrated Services
(715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM
PSHANDORF @COMMERCE.STATE.WI.US WiSMART code: 7633
r
MOUND SYSTEM DESIGN
Apphcaboo
INDEX AND TITLE SHEET
Project BRUCE YOUNGMARK
Owner BRUCE YOUNGMARK
Address 1761 46TH ST
SOMERSET WI 54025
Legal Description NW- NE- SEC5- T30N -R19W W
- - - - -- S'�. T S.
Township SOMERSET County ST CROIX Tona
Subdivision Name CEDAR VALLEY ESTATES Lot No.
IETY MME
Parcel ID Number 032 - 2017 -60 � S
Plan Transaction Number NDENCE
Inde x and title sheet Pagel cl q
Mound calculations Page 2
Mound drawings Page 3
Pres. dist. calcs. and laterals Page 4
TDH and pump tank drawing Page 5
PUMP CURVES Page 6
PLOT PLAN Page 7
Designer KIM OCO NELL License Number 224263
Signature C� Phone No. 715 - 755 -3145
Date 8 -2 -99
V011ce, Tarnpedng with this file by unaitthorized persons is prollibr(ed.
Deliberate modification v,411 result in disciplinary action under s. 145.10, Wis. Stats.
Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)).
SBD- 10462 -E (R.05M) Page 1 of
r
MOUND SYSTEM DESIGN
'lesidenfial Application
INDEX AND TITLE SHEET
Project BRUCE YOUNGMARK
Owner BRUCE YOUNGMARK
Address 1761 46TH ST
SOMERSET WI 54025
Legal Description NW- NE- SEC5- T30N -R19W
Township SOMERSET County ST CROIX
Subdivision Name CEDAR VALLEY ESTATES Lot No.
Parcel ID Number 032 - 2017 -60
Pian Transaction Number
Index and title sheet Page 1
Mound calculations Page 2
Mound drawings Page 3
Pres. dist. cales. and laterals Page 4
TDH and pump tank drawing Page 5
PUMP CURVES Page 6
PLOT PLAN Page 7
Designer KIM OCONNELL License Number 224263
Signature Phone No. 715- 755 -3145
Date 8 -2 -99
Notice: Tampering with this file by unauthorized persons is prohibited.
Deliberate modification will result in disciplinary action under s. 14510, Wis. Stats.
Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)).
SBD- 10462 -E (R.05M) Page 1 of
MOUND SYSTEM DESIGN
Complete red boxes as necessary. 1000 gpd maximum design flow.
Inch- ounds Metric
Residential or commercial? R (r or c) (y or n) h..:.J Replacement system?
Creviced bedrock site? n (y or n)
Slope 1 %
Wastewater flow rate 450 gpd 1703 Lpd
Depth to limiting factor 26 in 66.0 cm
In situ soil infiltration rate 0.5 gpd/ft2 20.4 Lpd /m
Contour line elevation 400.3 ft 30.57 m
Use standard fill depths? x OR Design depth? in cm
Fatace X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth.
Center or end manifold a Rio or s) Hole diameter 0. 25 fi n 0.725, 0.158, 0,188, 0.218, 0,25, 0 261 or 0.313 inch arty.
Lateral spacing 3.00 ; ft Use 0 lateral spacing for trenches.
-,ate Estimated hole space , 4.0 ft Not a final calculation.
Number of laterals 2 Pump tank elevation 93 5 ft Outside bottom of tank.
Forcemain length 60.0 : ft Forcemain diameter 2.0 =in 1. 5, 2, 3 or 4 inch only.
2.067 in Actual I. D.
1/8 =0125 114 = 0.250
SYSTEM SOLUTIONS Inch-pounds Metric 5M=0.156 W32=0.281
Estimated daily flow 450 gpd 1703 1 Lpd 3/18=0,188 5416 = 0.313
7/32 = 0.219
Absorption cell
Design load rate & area 1.2 gpd/e 375.0 1 ft 34.84 m
Linear loading rate (LLR) 7.14 gpd/ft 88.5 Lpd/m
Design width (A) 6.00 ft 1.83 m
Cell length (B) 1 63.0 Ift 19.20 m
Depth of cell (F) 9,5 in 24.1 cm
Sand filter
Upslope fill depth (D) 12.0 in 30.5 cm
Downslope fill depth (E) 12.7 in 32.3 cm
Basal area required (gpd/infiltration rate) 900.0 ft 83.61 m
Supporting components
Topsoil depth 6.0 in 15.2 cm
Subsoil depth at center 12.0 in 30.5 cm
Subsoil depth at cell wall 6.0 in 15.2 cm
End slope toe length (K) 9.96 ft 3.04 m
Up slope toe length (J) 8.10 ft 2.47 m
Down slope toe length (1) 8.80 ft 2.68 m
Total mound length (L) 82.92 ft 25.27 m
Total mound width (W) 22.90 ft 6.98 m
Project: BRUCE YOLI"K
Transaction Nur9w: 5 Page 2 of
MOUND PLAN VIEW
observation pipes (typical)
J
22.9 ft
A A= 6.00 ft 1.83 m
6.981 m B - 63.0 ft 19.20 m
1 B J= 8.10ft 2.47m
I K I= 8.80 ft 2.68 m
K=, 9.96 ft 1 3.041 m
L L _ EUM ft
typ. obs. pipe
(anchored securely)
I = down slope dimension = absorption cell (AxB)
J = up slope dimension plowed area (LxW)
K = end slope dimension LU 6'(152 mm)
T
MOUND CROSS SECTION
subsoil cap D = 12.0 in 30.5 cm
lateral topsoil G H E = 12.7 in 32.3 cm
invert 101.80 ft _ F= 9.5 in 24.1 cm
elev. 31.03 m F G = 12.0 in 30.5 cm
AsTM c33 H = 18.0 in I 45.7 cm
' E
y
sys. 101.30 ft U sand Fill
elev. 30.88 m 100.30 ft contour
30.57 m elev.
slope
D = upslope fill depth plowed layer
E = downslope fill depth tote: Absorption cell media will consist
F = absorption cell depth of aggregate and pipe with laterals
G = subsoil + topsoil depth at cell wall centered across Ax8 media. The cell
H = subsoil + topsoil depth at cell center media is covered with geotextile fabric.
Designer notes:
Project: BRUCE YOUNGMARK
Transaction Number: Page 3 of
PRESSURE DISTRIBUTION CALCULATIONS
Absorption cell Inch -pounds Metric
Width (A) 1 6 Ift 1 1.83 im
Length (B) 1 63.0 Jft 1 19.2 im
Lateral specifications
Number laterals 2
Holestlateral 16 holes
Lateral length (P) 60.00 ft 18.29 m
Hole diameter 0.250 in 6.35 mm
Lat. dis. rate 18.64 gpm 1.18 Us
Sys. dis. rate 37.28 gpm 2.35 Us
Hole spacing (X) 48 in 121.9 cm
Lateral diameter Pipe diameter Design options Design choice
Designer must 1 in (25 mm) Place X in red
"X" one choice 1 114 in (32 mm) box of chosen
from the options 1 12 in (40 mm) x X diameter.
provided. 2 in (50 mm) x
3 in (75 mm) x
Manifold diameter Pipe diameter Design options Design choice
Designer must 1 in (25 mm)
'X" one choice 1 1/4 in (32 mm) —�~ Place X in red
from the options 1 12 in (4o mm) x r box of chosen
provided. 2 in (50 mm) x .diameter
3 in (75 mm) x
4 in (100 mm) x
Distribution system contains: 2 Lateral(s)
LATERAL DIAGRAM - END CONNECTION
Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area.
L ateral s een ere over a dimension
Last ho drilled next to end cap i s
e P
All laterals we identical Holes drilled on the bottom of the lateral S
equaliy spaced
ForoB mail conn20tion via tee or cross to manifold at any point. Laterals & force main of PVC Sch 40
. - permanent end marker [per COMM Table 84.30.53
Inch-pounds Metric
Lateral length (P) 60-22 ft 18.29 m
Lateral spacing (S) 3.00 ft 0.91 m
Hole spacing (X) 48 in 121.9 cm
Manifold length 3.00 ft 0.91 m
Hole diameter 0.250 in 6.4 mm
Lateral diameter 1.50 lin 40 mm
Forcemain diameter 2.00 lin 50 mm
Project: BRUCE YOUNGMARK
Transaction Number: Page 4 of
TDH and Pump Tank Drawing
Total Dynamic Head
Operational head 2.50 ft M m
Vertical lift 7.40 ft Z�,o m Are laterals the highest point in the
Fraction loss 1.39 ft 2• m system? Yes "x' here. x
Total dynamic head 11.29 t m If no, what is the highest elevation
Dose Volume downstream of pump?
Dose is > 10 :times lateral volume Forc emain drain
Lateral void volume 12.7 gal 48.1 L back to tank? (X' one)
Minimum dose 127.0 gal 480.7 L ;';Yes
Drain back 10.5 gal 39.7 L : No
Dose volume 137.5 1 gal 520.5 L
Typical Pump Chamber Layout
In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC,
approved manhole cover with
7�' weather proof warning label and locking device
grade levels junction box
disconnect grade levels
alternate
4" vent pipe electric as per NEC 300 and outlet
Comm 182$ WAC location 18" (45 cm) min,
wall of pump
0 k- approved
chamber or outlet joint
combination tank
A Provide 1/4" weep hole or anti-
alarm on IL siphon device as necessary
pump on B
Grade levels
PUMP 94.4 ft C - pump tank manhole = 4'(10 cm)
Off elev. 28.8 m minimum above finished grade
D - vent =12" (30.5 cm) minimum
above finished grade
93.5 ft Pump tank elevation
3 " (75 mm) of bedding under tank 28.5 m bottom of tank
Tank manufacturer WEEKS
Pump tank capacity 19.04 gal /in
Pump tank volume 800 gal
Pump manufacturer GOULDS Inches Gallons
Pump model number WE0311 L A 24.8 472.1
'05 B 2 38.1
Alarm manufacturer S.J.ELECTRO INC E C 7,2 137.5
Alarm model number H.W. 101 i5 D 8 152.3
Project: BRUCE YOUNGMARK
Transaction Number: Page 5 of
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'Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Laborand Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix
°
not limited to vertical and horizontal reference po ( } point BM /o of ,direction and slope,
scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R V EWECIBY DATE
PROPERTY OWNER: PROPERTY LOCATION
Mike Lundberg GOVT. LOT NW 1/4 NE 1/4,S 5 T 30 ,N,R 19 (or) W
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
2040 Oriole Ave. N. 7 Ce
CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE (MOWN NEAREST ROAD
Stillwater, M. 55082 (612) 436 -6172 Somerset 180th. ave.
[xJ New Construction Use [ Residential / Number of bedrooms 3 [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate y 5_ bed, gpd /ft h trench, gpd /ft
Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate _ bed, gpd /ft .6 rench, gpd/ft
Recommended infiltration surface elevation(s) 101.30 It (as referred to site plan benchmark)
Additional design / site considerations system el based oncontour line of el. 100.30'
Parent material - _ pitted gi ari a i drift Flood plain elevation, if applicable ft
rMUUnisuitable able for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
for s stem O S ® U LAS ❑ U ❑ S RI U ❑ S ®U El S F% U ❑ S [ U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed jTrench
1 1 0 -12 10 r3 3 n one
2 12 -26 10 r4/4 none sil 2msbk mfr QW if .5 .6
Ground 3 26 -50 5 r4/4 cld7.5 r5 8 scl m n
elev.
lea.
Depth to
limiting
factor
26"
Remarks:
Boring #
r2 10-26 - 2 10 r4/4 none sil 2msbk mfr
Ground 3 26 -60 5 r4 4 c
elev.
1
Depth to
limiting
factor
26"
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 2004 Ala., New 4iftond, WI 54017
Signature: Date: 5 -26 -97 CST Number: m02298
PROPERTY OWNER Mike Lundberg SOIL DESCRIPTION REPORT Page 9 of .
PARCEL I.D. #
Depth Dominant Color Mottles Structure GPD /ft
Boring # Horizon P Texture Consistence Baxtdary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
3 1 0-10 4 s 2m r mfr 2f .5 .6
2 10 -28 10 r4/4 none sl 2mgr mvfr gw if .5 .6
Ground 3 28 -45 5 r4/4 none scl m na na na np .2
elev.
10 ft.
Depth to
limiting
factor
28 1,
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
...........
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L . Steel 1554 200th Ave.
Mike Lundberg New Richmond WI 54017
CSTM2298 NW4NE4 S5 T30N - R19W '
MPRSW 3254 town of Somerset (715) 246 - 6200
lot #7 -Cedar Valley Estates
N
1 =40'
BM.= nail in Cedar tree C el. 100'
Alt. BM.= top of steel post C el. 101.60'
1 4,b 00
h
Clow
6 70
l• /r d � � �
D
l*0
36
Gary L. steel
5 -26 -97
i
I
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /Buyer Y' 'ffr' ® `7 �����g
Mailing Address A� G� K �U
.Property Address � SE Soyre
(Verification required from Planning Department for new constnietion) V
City /State �D�'I e� UXT Parcel Identification Number "' c7u 7 '100
LE GAL DESCRIPTION - ---
Property Location NW 1 /4, See. , T_N - R Iq W, Town of ine���I .
Subdivision Ca fry Vftaesl MS , Lot # _.
Certified Survey Map # , Volume , Page #
Warranty Deed # 6 (a tZ , Volume 033 O , Page # l
Spec house ❑ yes IXno Lot lines identifiable 9 yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenanceof 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
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposaI 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.
- 1/we, the undersigned have read the above requirements and af;rce 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 3 0
da of the three yea expiration date.
flail
SIGNATURF, APPLIC T 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
ASIGNA perty describ d bove, by virtue of �arranty deed recorded in Register of Deeds Office. !�� C
p`/ / ' /
OF PLICA 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
.` . 58061;! VOL 1:3`30DecE1 ��
STATE BAR O WISCONSIN FORM 2 -- 1982
WARRANTY ^FED
DOCUMENT NO '
Cc - p - REGISTER'S OFFICE
- - - -- - - - -- - ST. CRO X CO.. WI
- - - -- - _ — _
conveys and warrants to Bruc C._ Younamark a JUN U 9 1998
Baa hus and wife,
-- - - 3:00 A M
Register of geed
THIS SPACE RESERVED FOR RECCRDING DATA
NAME AND RETURN ADDRESS
f the foliowing described real estate in St. Croix County,
State of Wisconsin.
a
r
i PARCEL IDENTIFICATION NUMBER
t ,
s
t
1
Lot 7, Cedar Valley Estates in the Town of Somerset, St. Croix
County, Wisconsin.
4 T A tSFER
This i nut homestead property.
XX3jX (u not)
Exception to warranties: Easements, restrictions and rights -of -way of record, '
if any.
Dated this c :� ' day of May , A.D., 19 9 8 -
Co
j
(SEAL) BY � ' (tiE mil.)
_ (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) State of Wisconsin,
St. Croix ss
— County
authenticated this day of _ -- , 19_ Personally came before me this -,? day of
— - t tta NE t May 19 98 , the above named
•? ��
� ���•Q`\,•., F�� ��.,� — Lunc�� Coro by `�r1 c'/toc / Lunc�h�.t
TITLE $1
MEMBER STATE BAR OF WISCONSL2`'
(If not,
authorized by §706.06, Wis. ';tats.) = to me known to be the pet >on —_ -who exe ;utcd the foregoing
?UB��C' instrurpcnt and _cknowled &l same:
THIS INSTRUMENT WAS DRAFTED BY hq
•,,, -
A ttor ne y Kristina _
H udson, Wi S43 Notar FUblo', _ ___ -- C° .t , WIS.
(Signatures may be authenticated or ackno%%terleed Both are not My commission permanent. (If t._t, ,tate expiration date
neces;ary.)
• Nures of p w>ns sign ••� m Inc .ape.ur .hnuu, I n . ,.t ..r „ •;r,:.ed b,. , them sign :m,res.
STAII. JAR OFWliCONSIN
'`'ARRA:, -N UFFD Form No. 2 - 198'
wrisconsin Deparcme t.of Industry, SOIL AND SITE EVALUATION REPORT Page 1 or 3
Labor and human Ri lations
Division of safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but St. Croix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 032-2017-60
APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Mike Lundberct GOVT, LOT NW 1/4 NE 1 /4,S 5 7 30 N,R 19 : J (or) W
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
2040 Oriole Ave. N. 1 7
CITY, STATE ZIP CODE PHONE NUMBER ❑CiTY (]VILLAGE iffOWN NEAREST ROAD
Stillwater, M. 55082 (612) 436 -6172 1 Somerset 180th. ave.
[xj New Construction Use j id Residential / Number of bedrooms 3 [ j Addition to existing building
I j Replacement [ j Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate _ bed, gp W __6_ trench, gpd/ft
Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate 5_ bed, gpd1ft gpd/R
Recommended infiltration surface elevation(s) 101.30 ft (as referred to site plan benchmark)
Additional design / site considerations system ei based oncontour line of el 100-
Parent material ,-tt ed �c1l ar•; a t drift Flood plain elevation, if applicable na. ft
S = Suitable for System CONVENTIONAL MOUND IN- GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK
U - Unsuitable fors stem ❑ S ®U IRS ❑ U ❑ S ®U ❑ S 6O U ❑ S 6c1 U ❑ S O U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Barx�ry Roots GPD /ft
Boring # Horizon in Munsell Qu. Sz. Cont Colo Gr. Sz. Sh- Bed Trench
1 1 0 -12 1 r3
mfr 2f - 5
2 12 -26 10 r4/4 none
,^ ,. � mfr
Ground 3 26 -50 5 r4 4 cid7.5 r5 L, L� ` ' r D
elev.
1Q A*.
b
Depth to
limiting>�� '
factor
26
Remarks:
Boring #
2 2 1 10-26 10 r4 4 none sil 2msbk m fr aw
Ground 3 1 26-60 5 4
elev.
101.0
Depth to
limiting
factor
. 26 1,
Remarks: � •. `��uNr` ;��_
FFICE �,
CST Name: -- Please. Print Gary L. Steel Phone: 715 - 246 -6200
Address: 1554 200 e. New is and W154017
Signature: Date: 5 - - CST Number: mO2298
PROPERTY OWNER Mike Lundberg SOIL DESCRIPTION REPORT Pap- 2 -of�3_
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Sourdafy Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. B� Tre►xh
3 -
IA 2 10 -28 1 r4/4 none sl 2mgr mvfr gw if .5 .6
Ground 3 28 -45 5 r4/4 none scl m na na na n .2
elev.
10 ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
Iimidng
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
Nmiting
faces
Remarks:
Boring #
4
Ground
elev.
Depth tt.
to
limiting
factor
r
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Nike Lundberg NWkNEa S5- T30N-R19W New Richmond, W1 54017
MPRSW -3254 town of Somerset (715) 246 -6200
lot #7 -Cedar Valley Estates
N
1 "=40
EM.= nail in Cedar tree @ el. 100
Alt. SM.= top of steel post @ el. 101.60'
5 /
x1 4,4 /4V " l
Y J
A *
Gary L. steel
5 -26 -97
I
I
r.M.
THIS INSTRUMENT DRAFTED BY ED FLANUM
CEDA
LOCATED IN PART OF THE
OF THE NEI /4 OF THE NE
CROI X COUNTY, WISCONSIN
Each Parcel shorn on this sap (plat) is subject to State, County and Township laws, rules and regulations (i.e. , wetl
siuisus lot size, access to parcel, etc.) . Before purchasing or developing any parcel contact the St. Croix County zonn
Office and appropriate Town Board for advice. g
4.
I EE
o
M ATC H S
cu 3 co
-- 35 C D
6 82 �• � �. 3 _ _ — — -- -- - -- — — — - -- ��
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(882.5)
G
C
7
(899.0) 4 3
/ C V iv _ — � 3.00 ACRES
�
CV 3.07 ACRES ► � —
Z ~ 133,751 S0. FT. 2 4 N 130,725 S0. FT.
Z `
8 oti
W 3 (906.0) orL� �` 613.44'
L
0
W
Z X
J
LLJ
0 N 4� (906.0) }// N
i — ao \
= � X6— �
o (924.3)
Z N 3 ��
� M �
OUTLOT I I 0 L0
N88028'54 "E 6.74 ACRES
.t\ • 170.82