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HomeMy WebLinkAbout038-1061-40-000 e1' ST. CROIX COUNTY ZONING DEPARTMENT r AS BUILT SANITARY REPORT 1I Owner reic %So �c! _ � RECEIVED Property Address n I-A KE � City /State /'Ew P116/1M6 r" 10 5y0/7 1999 _ ST G+OIX Legal Description: V, Lot -Block Subdivision/CSM # p6C 5k✓ '/4 NW ' /a, Sec. 15 , T2LN -R_L(�W, Town of nnn& WeAkt _ PIN # ti4 ..e..i...sne I SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION 1 Tank manufacturer Ww �s Size ST/PC /ZM / Setback from: House jq Welix P/L/ Lo c i Pum p 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: 6X II Width � � Length Number of Trenches Setback from: House JB7" Well 0A P/L M' Vent to fresh air intake ELEVATIONS Description of benchmark TOP Elevation ` Description of alternate benchmark Elevation 10Z, Z Building Sewer 21 - 41 10 5 . z ; ST/HT Inlet 2. t -73 ST Outlet A-,11b PC Inlet tt�n PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines O 1 1b2.3y ( ) . lob ( ) Bottom of System O Zr ,.2b ( ) , -yY //00 ( ) Final Grade ( 7 �10_514 ( ) ( ) Date of installation � / � ll 1 Permit number 39D?6 State plan number. Plumber's siguatur u License number a9Z Date Inspector Complete. plot plan Or i 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 ggoA 'OorrN N' 30P Rook is oi vSZc, 2 57 x 5 - rvCt��S �{wSC g A 0 INDICATE NORTH ARROW 1y � •r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 6T. URt, IX Personal information you provice may be used for secondary purposes w [Privacy La s.15.04 (1)(m)). 338996 Per rnl g1der�fj�arr ERIC El City ST ❑ Wa9P e 17r Town of IRIE CST BM EEllevv. . VN State Plan ID No.: . � Insp. BM Elev.: BM Descriptio : Parcel Tax No.: A A -- Q49 A9900256 038 - 1061 -40 -000 TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ff! �p�. �� /rra. D r Dosing Wl A 5.O�`f Aeration Bldg. Sewer ,Z. 2( /05"- z3 Holding St/ Ht Inlet a.�( 0 TANK SETBACK INFORMATION St/ Ht Outlet ,2. oY G6 TANKTO P/L WELL BLDG. Ventto ROAD Dt irliet Air Intake Septic NA Dt B Dosing NA Header / Man. Aeration NA Dist. Pipe vt (0 - � ` S Holding Bot. System C. 2 D • 20 •r6 q .8 PUMP/ SIPHON INFORMATION Final Grade 10c4,(o1 Manufact i <er Dgnzafycl A't•tw !• 33 Ob. �� Model Number GPM TDH Lift on TDH Ft Forcemain Length I Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width T I Length r Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type Of (r� �/ ( �� model Number: 7 System: C "'). T� OR UNIT DISTRIBUTION SYSTEM Header/Manifold u Distribution Pipe(s) % x Hole Size x Hole Spacing Vent To Air Intake Length L Dia. Length 5 Dia. Spacing 1Z I I 1 7 0 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 E] No ❑ Yes F] No COMMENTS (Include code discrepancies, persons present, etc.) ` 2 • � " '411-, SI''� LOCATION: STAR PRAIRIE 15.31.18.266A,SW,NW 216 1 GOOS L ret. Iy 1oz.o4 V X00.19 Lso. ,aG Plan revision required? ❑ Yes No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No Safety and Buildings Division Visconsin SANITARY PERMIT APPLICATION 201 Box Washington Avenue Department of Commerce In accord with ILHR x3.05, 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. awx • See reverse side for instructions for completing this application State Sanitary Perrmit Numbr Personal information you provide may be used for secondary purposes [1] Check it revi �t. V,.u2 [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION Property Owner Name `SO „ � 7 /4 t I V ation /� T N R /� �' � � /a �OTyl/ va S E(or Pr y Owqej 's Mailing Address Lot Number Block Number 0 1W no L CiVi State Zi de Phone Number Subdi lion Name r CSM Nu ber 4TO W ��°aez (7�6 15Y? 75 - II. TYPE OF BUILDING: (check one) ❑ State Owned o C ity N arest Road // Public 1 or 2 Family Dwelling - No. of bedrooms _ Town OF S Aft /�QI - C `A III BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 15. >I. I �• Z�� 1 E] Apartment/ Condo31 t �® 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 UF- PERMIT: (Check only one box on line A. Check box online B, if applicable) A) 111 0 New ' 2. ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an __S'ystem System Tank Only 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 ❑ Mound 1 30 ❑ Specify Ty 41 ❑ Holding Tank 12 %Seepage Trench 22 ❑ In- Ground Pressure V 42 ❑ Pit Privy 13 ❑ Seepage Pit C. 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorpp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (6q. ft.) Proposed (sq. ft.) (Gals/da sq. ft.) (Min. /inch) KtV Z TaP Elevation Y- 1q J�7� toAfftt /M-5 Feet VII TANK Capacity in gallons Total # Of Prefab. Site Fiber- Exper INFORMATION Gallons Tanks Manufacturer's Name Concrete con- steel glass Plastic App New Existin structed Tanksl Tanks 1 tic Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1:1 ❑ El El 1:1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print ber's S at e: ( o Sta s) MP /MPRSW No.: Business Phone Number: =aFF x I ?z3 LIZ 1 71.5-29 4 /-3 1VJ tier's Address (Street, City, State, Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Si nature (No Stamps) / �urcharge Pee) I q ' Approved [I Owner Given Initial �a Adverse Determination U X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber fan�� L1 KP- RAID ER i C IkRR)Se. / B8 rlwv 6l/ 9N LTo ►J , u,I / 5I-1D$ "Z .<'Ec /S T 3 t AR /B W T6w'xf OF STA t'RAn►L- 331' __K B E-L 2- 5 x S 7 TRENCHES I\ ©m a &jUSE 2� O Jew AAL WcE KS S, 7A MK Q d t „ &NCB{ j" ARC TbP bF v Z S TGEL PIV'9 bll' d SCYL Bar WAS �c,�� f''= Ll Gd r� � RbK0 E fZ I e. >L�`r E1.5d cl A, I/Wy 6H kovLzti� tv/ �loBZ svi l /l /o sce ,0WIJ 6F :!�TAZ � ARJ E 2232y2 8 Q ��'bSED 3 1,A \ELKS S'S PT IC TANI,L 2 S 5 7 7WAtMES v a b Egkvt) AllARV, 7bP t-,F �r SNP &0 ,' 10 657 "1 W s0 g Department of Industry SOIL AND SITE EVALUATION REPORT Page _ y of — Labor and 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 point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 038- 1061 -40 APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT Sys 1/4 NW 1 /4,S 15 T 31 ,N,R 18 X (or) W NER':S MAILING ADDRESS L T # BLOCK # SUBD. NAME OR CSM # PROPERTY OW MA � i 2153 C.T.H. "CC" ( na csm CITY, STATE ZIP CODE PHONE NUMBER []CITY E]VILLAGExRffOWN NEAREST ROAD New Richmond, WI. 54017 (715)248-7223 Star Prarie Go [ New Construction Use [xJ Residential / Number of bedrooms 3 [ J Addition to existing building (] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate _ bed, gpd /ft gpd /ft Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate _ bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 101.2— 99.9- 99.4 -97.2 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicablst ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ®S O U U S O U u s O U I [a s O U ER S O U O S al I SOIL DESCRIPTION REPORT V Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trenctl .................. ................. .................. ................. .................. 1 0 -25 7. 2msbk my 2 25 -82 7.5 r4/4 none MS nA Ground elev. 104 ft. Depth to limiting ati factor g +82 Remarks: Boring # 1 –28 7. r4 4 if .5 2 8 -82 7.5 r4/4 none is 0SCI mvfr n Ground elev. 104 ft. Depth to limiting ., .r IQ-7 factor 82 " l Vry Remarks: ;� L �2 CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 �9 Address: 1554 200th. New Rich and 144017 Signature: Date: 5 -6 -97 CST Number: m02298 i PROPERTYOWNER Lois Satterland SOIL DESCRIPTION REPORT Page 2 'cf 3 PARCEL I.D. # 038 - 1061 -40 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Borxby Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch 3 .. - 2 2 14 -30 7.5 r4/4 none scl 2m r mvfr Ground 3 30 -82 7.5 r4 6 none ms 0sa rrrvf elev. 10 ft. Depth to limiting factor +fib Remarks: Boring # 1 0 -30 7.5 r4 4 none s v ".4...... >M 2 30 -45 7.5 r4 4 none is 0sa mv aw 1f Ground 3 5 -80 7.5 r4/6 none ms 0SQ ml na na .7 � .8 elev. 10 ft. Depth to limiting factor +,q Remarks: Boring # 1 2 11 -29 7.5 r4 4 none scl 2csbk mfr qw if .4 .5 Ground 3 9 -80 7.5 r4/4 none is osq mvfr na na .7 1.8 elev. 10 ft. Depth to limiting factor +8 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. CSTM2298 Lois Satterlund New Richmond, WI 54017 MPRSW 3254 WIWI S15- T31NR18W (715) 246 -6200 town of Star Prarie lot #3 -csm 1 =40' BM.= top of 2" steel pipe C el. 100 Alt. BM.= nail in Ash tree C el. 99.70 005 c at< , ( i 7r7 f {� Z / e Gary L. Steel 5 -6 -97 I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer F-(L 0it,K. 81 S D nj / C 1r Fly -,'L I N e 01w r e l p Mailing Address , � ",A y \ l a Property Address 4� «0 --1 ��5� (G.��R (Verification required from Planning Department for new construction) kt City /State Akw K& (MW 0, 1KQ • Parcel Identification Number (�3 " �b� I —q LEGAL DESCRIPTION Property Location �� ' /,, �� '/4 Sec. �� T 31 N - RW, Town of S T Subdivision . Lot # Certified Survey Map # 5 10 3 y , Volume Page # 333 Warranty Deed # s to q 6 N , Volume a . Page # (.0 a '1 Spec house ❑ yes ❑ no Lot lines identifiable Ayes ❑ 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 septic can affect the function of the s tic 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 disposal 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. 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 exp lion date. SIGNA OF WLICANT 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 property described ab , by vi a of a warran deed recorded in Register of Deeds Office. s / SIGNATURE 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 L 564604 WARRANTY DEED Document Number FAUG R'g OFFICE IX CO., Wl 'Return Address for WON 9 1997 12:05 Pt,,,) `( —ik a 0. Parcel I.D. Number: Lois A. Sa'terlund, a single person, conveys and warrants to Eric D. He; — .___________.,the following described real estate in St. Croix County, State o Wisconsin: Part of the S W I /4 N W U4, Sec. 15 and part of the SE I /4 NE 1 /4, Sec. 16, all in T31 N -R 18 W, described as i follows: Lot 1 of Certified Survey Map recorded in Vol. 12 of Certified Survey Maps, page 3330, as hoc. No. 564356, St. Croix County, Wisconsin. This is not horr,estead property. Excertio.i to warranties: Easements, restrictions and rights -of -way a; -.cord y , if an Dated this � day of August, 1997. TR � Q FtF s - SEAL) Lis A. Satterlund AUTHENTICATION Sigilatu;e(s) Lois A. Satterlund, a single person, authenticated this t day of August, 1997. Kristina Ogla d TITLE: MEMBER STATE BAR OF WISCONSIN T141S INSTRUMENT WAS DRAFTED BY: , Aitorney Kristin Ogland Hudson.. WI 54016 W FILED 564356 AUG 2 61997 P- C KATHLEEN H. WALSH 1t7 Register of Deeds SL Croix Co, M CERTIFIED SURVEY MAP ti Located in the Southwest Quarter of the Northwest Quarter of Section 15, and part of the Southe yc�oe of the Northeast Quarter of Section 16, all in Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin. Prepared for and at the request of: Donna Preece NOTE: The parcels shown on this map are subject to State, County and Township Century 21 Premier Group laws, rules and regulations ( i.e. wetlands, minimum lot size, access to parcel, N . Knowles New R i chmond, WI 54017 etc.). Before purchasing or developing any parcel, contact the St. Croix County New OWNER' Zoning Office and the appropriate Town Board for advice. Lois A. Satteriund BEARINGS ARE REFERENCED TO THE WEST LINE OF THE 2153 C.T.H. "CC" NW 1/4 OF SECTION 15, TOWNSHIP 31 N., RANGE 18 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR N 00'57'46" W. Drafted by. Kristi A. Eylandt NOTE: SEE SHEET 2 OF 3 FOR County Section Corner Monument of Record I LINE AND CUR E DATA TABLES • Set 1" x 24" Iron Pipe weighing e � GQ �Ln Z i �� a minimum of 1.13 pounds per p� I linear foot. ,fir f /e/g1 Y v % I O Found Iron Pipe .T RONALD F. cn r I M= Measured As JOHNSON = R= Recorded As s-1 1 86 i y I �„n I 7 w AWISY Z rn < y 0 WEST LINE OF THE NW 1/4 U ---- LANDS ��NO S S OSE LK RD 1 As � ' I NORTH LINE OF THE SW 114 OF THE NW 114 K O. - - R. LAKE ROAD W. GOOSE GOOSE LAKE ROAD -- --- - - - - -N 89'24'27" E 1321.10' - _ — — 1 ��==-------- - - - - -- I _- - r — _= i - - - 440.00 — — — 440.00 _ - R _441.10 - 'c n f`'h189'29'23 "E 375.71 \ N89'29'23 4 E 440.00'Y/i 1 N89 440.00'/` II ZZ Z 7 - - I -L - - -- 1255.71'- - - -� I r- - -- - --' � f r O 10....... , . 1 I'U I I` Z 5 ... J. 1 ..�. �. � ao w -I Im '� �! co OD I N� I 100' BUILDING ; ► 1 x 1° i' 1 N� i l SETBACK LINE 1 j in I N FROM R. 0. W. IZ �' I � I I o o Ln 1 y Iz I ? 1 ;e,- N89.2427 "E � LOT 2 LOT 1 I z 41 co = 1. w I �No 48.64' � c N n I l I I tn�� Iz M o iQ I �Q= . LOT 3 m TOTAL AREA: W P TOTAL AREA: OD w o Z I -+m I� ♦ is I 432,892 SQ. FT. rn 431,974 SQ. FT. Q y+ o ff`+ I oo : TOTAL REA A: . 1 m 344,926 SQ. FT. I 9.94 ACRES 9.92 ACRES ° 7.92 ACRES I AREA EXCLUDING o AREA EXCLUDING I ZE 11 AREA EXCLUDING 0 D RIGHT -OF -WAY: y � RIGHT- OF -INAY: i • iD i 1 SIGHT -OF -WAY: 1 1 i 412,677 SQ. FT. 0 411,482 SQ. FT. l l I rn Iz x299,773 SQ. FT. I 9.47 ACRES 9.45 ACRES I ;cn / ACRES 1 1� I I I F F I I S 89'08'11" W 434.44' I FENCE L /NE --t►� o y I I IX - ` J :' LOT 4 j 0 , ► \ ,I, x 1 C Cjj / i /I TOTAL AREA: ° o j I I ► i tn 545,573 SQ. FT. '� �_ -- 440.01' _,I r - , ' -- - 440.01' 52 ACRES 12. i (.0 -- - - - - -5 89'08'11 W 880.02' - - - -- - � � c o I SHED ♦ DRIVE. AREA EXCLUDING p v+ 71, I �: SHED RIGHT -OF -WAY: SEE SURVEYORS REPORT (A � SHED 539,029 SO. FT. ON PLAT LINE o 12.37 ACRES \ o I i "� /9.7 , ° SHED I CD ORTH LINE OF THE PLAT BARN WEST 1 4 CORNER I ' / OF APPLE RIVER BEND HOUSE SECTION 15 -31 -18 FIRST ADD177ON 45.03o �1I / _ — c ` N89'5'5 "E ,.,262.00' -M =2 0. 3'- = 3. M= 300.02 -' i' r 0 R= 241.00' I �R= 234.00' I R= 228.00' R= 300.00' 5330.4 �'( ------ M -S 89'08'11" W 1310.00'--- - - - -- LOT 44 i LOT 43 1R LOT842 8 41 E LOT 41 i LOT 40 // a \ APPLE RIVER BEND FIRST ADDTION JOB #97031 1 I - - - -- 1 - - -- - - - - - - - - -- - � / Prepared by: TH£ SOUTH LINE OF THE SE 114 OF A & E THE NE 1/4 OF SECTION 16 250 0 250 NO TH LAND SURVEYING de CIVIL ENGINEERING Phone No. (715) 246 -4319 GRAPHIC SCALE 109 East Third Street, P.O. Box 325 SCALE IN FEET: 1 inch = 250 feet New Richmond, WI 54017 Sheet 1 of 3 Vol.12 Page 3330