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HomeMy WebLinkAbout042-1075-60-000 State of Wisconsin ~C d ~2 Scott Walker, Governor DEPARTMENT OF NATURAL RESOURCES Z7. G7 •!v~ 7 v Cathy Stepp, Secretary 101 S. Webster Street Box 7921 Telephone 608-266-2621 Madison WI 53707-7921 FAX 608-267-3579 WISCONSIN TTY Access via relay - 711 DEPT. OFNATUHALHESOUHCES August 22, 2013 Project No. S-2013-0426 4~16) Mr. Tim Mittlestadt Bowman Plumbing, Inc. 2819 Knapp Street Menomonie, WI 54751 Sub: Holding Tank Installation For ECI, LLC Roberts, WI Dear Mr. Mittlestadt: i I have received and reviewed your recent transmittal of completed WDNR form 3400-185 in reference to your proposal for installation of a new wastewater holding tank to serve the vehicle building / shop for ECI, LLC located at 742 130t" Street, Roberts, WI. According to your transmittal, the proposed holding tank will be used to store non-domestic wastewater, and the stored wastewater will be hauled by ABC Septic Service to the Menomonie municipal wastewater treatment facility for ultimate treatment / disposal. Based on this review, the proposed holding tank installation is acceptable to the Department of Natural Resources. As part of this acceptance, please also review and discuss the conditions of approval as outlined on page 3 of WDNR form 3400-185 with the owner prior to installation / startup of the proposed holding tank. If any questions concerning this acceptance notice, please contact Steve Smith, WDNR Madison office, 608/266-7580. Sincerely, Stephen J. Smith, P.E. Wastewater Section Bureau of Water Quality Cc: ECI, LLC 7012 6th Street N., St. Paul, MN 55107 Mr. Kevin Grabau - Admin., St. Croix County Zoning Dept., 1101 Carmichael Rd., Hudson, WI 54016 Pete Skorseth Baldwin Service Center d nr.wi.gov wisconsin.gov Naturally WISCONSIN Pri rated on Ra ycwd P. P., o t~1 County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN po DEPARTMENT Gto ~ q In accord with Chapert 12 St. Croix County Sanita7f?oin a PLANNING & ZONING yd~~ P onal information you provide may be used for secohd9 o ST. CROIX COUNTY GOVERNMENT CENTER $ ~pO [Privacy Law. S. 15.04(1)(m)]~ 1101 Carmichael Road Hudson, WI 54016-7710 G (715)386-4680 Fax(715)386-4686 ttach complete plans for the system on paper not less than 8-1/2 9-41 inches in size. N WY Sanitary Wrmit # ❑ Check if revision to previous application ON O 1. Application informa '6A se Print all Information Location: Property Owner Na ,X ~ 6WCv.. /t L. ~ 1/4 114, Sec r) I/ (o pi it C N, R E (or) Property Owner's Mailing Address Lot Number Block Number ,00 City, State Zip Code Phone Numer Subdivision Name or C N M Number Al S~ - S of 7,411 w II Type of Building: (chec o e) rOVRO amity ❑ Village of ❑ 1 or 2 Family Dwelling - No. of Bedrooms: % Public/Commercial (describe use): I" IJAIM 11 State-owned eares ad r4 S ~ II. Type of Permit: (Check only one box on line A. Check box on line B if applicable) 7tZ Q Parcel Ta Number(s) /1 ~ OQa A) 1Repair 12. Reconnection ❑Non-plumbing 4. ❑ Rejuvenation ot[tDat,'Issued A~~ V Sanitation u~7 B) Permit Number State Sanitary Permit was previously issued IV. Typ POWT System: (Check all that apply) Non-pressurized In-ground ❑ Mound is 24 in. suitable soil ❑ Mound 24 in. suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Req ' d Pr ed (Gals./day/sq.ft.) (Min./inch) Elevation 4!~ Q I _Y0 0 1 Za VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks Ovv ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement I, the undersigned, assume responsibility for rep at venation/installation of non-plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair a insof bing sani t ion syst Plumber's Name (print) lumber ignatu eta W P/MPR No. Business Phone Number Tim t2 OAJL~ I 75 ZKY 61112 0 Plumber's Address (Street, City, Sta ip Code) i VIII. Count Use Only Dis Sanitary Permit Fee Date Issued Issui gent Signatu o sta s) Approved Owner Given I I Adverse ~•Z5 Dd '9 /3 fZ FDe v IX. Conditions of Approval/Reasons for Disapproval: 9i, $eptio tank, effluent filter and dispersal cell must all be services / MainIned ooT V **.per management plan provided by plumber. Cy, d...~ a- i~ rte" z~I~~c~tM tegemef►t~atlud.laefnair►tained asirpp>lpblp "clods l ordkterio*s r» >3 rt «C~ t~ M f x ZV r a'wyr ~i ~ E P 77r w ~ ~'i of ~ j W [ru I 4 ~ ~ l! x ~ i~• YYY X Ike s a f~:~..} a ~ s S ` r 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. PL W 0.~0 iz. ~ II 2f S eXt U 5 1 INDICATE NORTH ARROW C o I a~i My, ~ p e» C\ aG N O v C rv, ~ O C t Q N o - ~I U 1 N O ° i O cC O co T O) O a ~ L N C C, ID O N N N L v z O V i i N c Z d 0 U. 4 0 O C ~ ~ U C C O N 70 C 'D m ~ N E Q N ?i w N U Co co Q a O ~ N co W O O L Z m y N Z a co 0 z v ° c U 7° N m 2 c (n F- O N c ~ N co O N N N 1~ N O~ O O •N U L N N N U O O O O 2 Q p w~ N N Zi-Z ZIOO N c N N m C: d C _ i M N L a o D 0 a U) 0 LO H co H = a Z> - 3: 3: a m • (n a a a a ~ a :3 oai N v, U OOi 0) N 't ~ N t0 O CY) O O O O O O] N L ~ ~ C C) co N ~ N N ~ w O w a o w ►y`i ~ O N 'O d N C O O O O Co c > E m U 7 7 C N t0 co CQ Op N i O Co N O O O y L6 co ~ m C O O O 00 I\ ♦~i p C E N - U O p • [ 7 Qj M N C C O r • ry~]Il t 1- O (O t0 M N N U y O N 2 M 0 - Y Y U} r O R A ~k w L • CL a, u Lm a w tt`1~•y E c c 3 ~1 A va~I 0 U0 Parcel 042-1075-60-000 11/07/2007 03:08 PAGE 1 OF 1 F 1 Alt. Parcel 27.29.18.427B 042 - TOWN OF WARREN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SCHLON-TICK HOLDINGS LLC SCHLON-TICK HOLDINGS LLC 780 BARGE CHANNEL RD ST PAUL MN 55107 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 742 130TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 6.500 Plat: N/A-NOT AVAILABLE SEC 27 T29N R18W 6.5 A E429 FT OF N 660 Block/Condo Bldg: FT OF NE SE Tract(s): (Sec-Twn-Rng 401/4 1601/4) 27-29N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/12/2007 855456 WD 10/26/1999 612747 1466/126 WD 11/16/1987 432167 796/571 WD 07/23/1974 456/358 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/20/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.500 53,000 137,000 190,000 NO Totals for 2007: General Property 6.500 53,000 137,000 190,000 Woodland 0.000 0 0 Totals for 2006: General Property 6.500 53,000 137,000 190,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 138 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 R ST. CROIX COUNTY ZONING DEPAR KENT,,,, AS BUILT SANITARY REPORT` Owner Property Address ?q2. City/State ~L~bai~6► 5~{ 0 7 _h~, Legal Description: Lot Block Subdivision/CSM # `1 1 tom- %4 c&,_ t/4, Sec.J), Ti° N-R18 W, Town of 'l07 r - SEPTIC SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: 1aa0/r 00o' ' Tank manufacturer TowwAi" Size ST/PC / Setback from: House S Well P/L Pump manufacturer Model Alarm location - (HOLDING TANKS ONLY) Setbacks: Service road fresh air intake Meter location Alarm location SOIL ABSORPTION SYSTEM: i Type of system: Widths Length Number of Trenches I, T- ~ Setback from: House 15o Well 3 SD P-/L S d Vent to fresh air intake 50 ELEVATIONS: Description of benchmark Elevation./00- o c Description of alternate benchmark Elevation loo. a a 9.7•: $ Building Sewer ST/HT Inlet ST Outlet PC Inlet PC Bottom Header/Manifold 7Y. Y Top of ST/PC Manhole Covf,, Distribution Lines O ~ F ( ) ~ ` °Z ( ) Bottom of System -6~'7 X ( ) ( ) Final Grade 3 Date of installatiogl I t yPe m' um S State plan number Plumber's signature License number 07~~44 Dat,/ 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. PL EW 1,4 3 zd s 2f Sfi C~'~~ l 5 yb ~ s ~a6 u C INDICATE NORTH ARROW Wiscdnsin Department of Commerce PRIVATE SEWAGE SYSTEM County: • Safety and Buildings Division 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)]. 3$3132 Permit Holder's Name: ❑ City ❑ Village (a Town of: State Plan ID No.: Town of Warren CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: !e. IJ 042-1075-60-000 et.0~ loo- 0, 6uws 4s"o TANK INFORMATION E V TION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark a DT- 9-j-1/0V 0 r Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St / Ht Outlet 6 •r `f 3.8,t ' TANK TO P / L WELL BLDG. Ventto ROAD §t Inlet A15_2 Air Intake T 83 Septic ' ltd' 5 NA :9t 04_ _•3Z 2. y(~ 3 t t~0' sjt r 0 / NA Header /Man. o If. Aeration NA Dist. Pipe 9.4 Holding Bot. System lt- 6 z 3 3 3.36 -5-PUMP / SIPHON INFORMATION Final Grade J.'o ufacturer j " Demand St cover .g S.ls- Model Nu GPM TDH Lift Fric S stem TDH Ft Forcem ength Dia_ Dist. To well SOIL ABSORPTION SYSTEM 960 /tTRt_NCW Width r Leng No Of renches PIT No. Of Pits Inside Dia. Liquid Depth DIME I N 3 , 5 DIMENSIONS, SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufactu er:~ S• n_ INFORMATION Type O r 1Z°~ CHAMBER OR UNIT Model Number: io~W~9 System: fob DISTRIBUTION SYSTEM Header/ anifold q Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. L ia. Spacing IQ~~ 32 ~Q. SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only [Dept, Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched d /Trench Center Bed !Trench Edges Topsoil F1 Yes E] No ❑ Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 10/ tg/99Inspeetion #2: / Location: 742 130th Street, Roberts, WI (NE1/4, SE1/4, Section 27 T29N-R18W) - 27.29.18.4273 o I ~ z5 tAk ® Da S 5 hNs o k e~ S' c Plan revision required? ❑ Yes 19 No Use other side for additional information. I~ b SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. • t I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: t s , s i i t l s c ° 5 6 s E S E s j 1 € ~ ~ t E t s ~ E Y t } a Safety and Buildings Division lfisc~nsin SANITARY PERMIT APPLICATION 201 W. Washington Avenue P O Box 7302 Department of Commerce In accord with ILHR 83.05, Wis. A PQ~ Madison, WI 53707-7302 • Attach complete plans (to the county copy only) for the system,,,0, pe no„Mess C60 `7 than 8 1/2 x 11 inches in size. '4(+L-S , State Sa itar Permit Nu b • See reverse side for instructions for completing this application y Personal information you provide may be used for secondary purposes ^ ~r Che'j revision previous application [Privacy Law, s. 15.04 (1) (m)]. '_'.'"X State PI n I.D. Number 1. APPLI ATI FORMATION -PLEASE PRINT ALL I OR ' Property Owner Nam , Propert Lota on 1/4 T , N, R ,&E (or Property O er's Mailing Addre s Lot b4r Block Number City, a /r Zi Code Phone Number Subdivision Name or CSM Numbe cv, p2 3 cis > M a $~}L a91(o I. PE F BUILDING: (check one) ❑ State Owned E] City Nearest Road 11 Vill Public1 or 2 Family Dwelling - No. of bedrooms Town OF / 111. BUILDING USE: (If building type is public, check all that apply) a el Tax Number(s) M 1 ❑ Apartment/ Condo $ ^ 16 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 _y stem Tank Only______________ 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 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 1PETseepage Trench 22 ❑ In-Ground essure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy "12 AL 14E] System-In-F' 1 - x „S f .3Q VI. ABSORPTIO SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7_ Final Grade Required sq. ft.) Proposed q. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation Feet • 5-Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Existing strutted Tanks Tanks Septic Tank or Holding Tank Q Zl- ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for install n of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Si r . No Sta MP/MPRSW No.: Business Phone Number: Plumber's Address Street, City, Stat zip Cod I 'Aa_, , ~2 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S~itary Permit Fee (includes Surcharge Fee) Groundwater ate Issued ISSUIn Agent Signature (No Stamps) 54Approved E] Owner Given Initial ~~-S lo."`f_~ Adverse Determination X. C NDI IONS OF APPROVAL REASONS FOR DISAPPROVAL: VOW*N 44 _4rja~__ SBD- 6398 (R.11/97) 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 this 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. 111. 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. 1 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. PLOT PLAN PROJECT David Haselman ADDRESS 742 130th St. Roberts Wi 54023 NE 1/4 SE 1/4S 27 /T 29 /R 18 TOWN Warren COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/30/99 BEDROOM 3 CONVENTIONAL XXX IN-GRO D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 954 # of chambers 30 BENCHMARK V.R.P. Base of Siding ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION , Alt. BM Top of Air Conditioner @ 100.0' ent Sidewinder High Bedroom Capacity Leaching ell Existing 3 fi 200' House Chamber with 31.8 ft^2 per chamber " e at System Elevation Alt. 34„ Grad .M. B.M. 0' S, Old Tank to be pumped and buried v~ T Baffles were not found in existing tank ° 30' Vent M T Ponding Water found at ground surface, system has failed 100' B-1 40' 75 :1309 Vents Vents 50' 90' B-3 B-2 6% Slope 2- 3' X 98' Trenches with 6' Spacing 125' Property Line I Wisconsin Department of Commerce SOIL AND SITE EVALUATION Divisionof Safety and Buildings Page of Bureau of Integrated Services in accordance with-~ R, _R 83_K Wis. Adm. Code s County Attach complete site plan on paper not less than 8 1 /2 x 11 inchesifr► size. Plan rta4st include, but not limited to: vertical and horizontal reference point (BM), direction acrd percent slope, scale or dimensions, north arrow, and location and distance-to,nearest foW, Parcel I.D. # APPLICANT INFORMATION -Please print all information fie iewed by Date Personal information you provide may be used for secondary purposes (PrNacy Law;~ktf> [id (rr1)). - l~- t ilt 7 Property Owner Pr 6* Lo 'bxi G tc - 1/4 114,S To~ 9,N,R E (or ->L- ZZ Property Owner's Ma ling Address ock# Subd. Name or CSM# Y'Z City State Zip Code Phone Number El City El Village oQ Town Nearest Road 3 1 (215 2~y/ W S New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial Describe: Code derived daily flow ~o gpd Recommended design loading rate ! bed, gpd/ft2 - Strench, gpd/tt2 Absorption area required 1/a.S_'bed, ft2 / (70 trench,, ft22 Maximum design loading rate! bed, gpd/w _ S~ trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation, if applicable N_ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ~ S ❑ U S ❑ U 4s ❑ U ..IesJS El U El O KU ❑ S XU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench /!lS C~ oC 'r 01 Ground 1l4 151, 9e v.~ ~Jft. Depth to limiting ~r l 4,ctor Remarks: Boring # of _4 U-4ir- Ground ~lev... ; Cam' - S 7ep'th to limiting factor in. Remarks: CST Name~~Il ase Print) i ature Telephone No. CL,,~ fr j oo ~ ~ ~ ~ Address Date CST Number 1 ' n OIL DESCRIPTION REPORT PROPERTY OWNER M Page ' o~ _ . PARCEL I.D.# ` Boris # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench a-ldL i' C uv ` hu, Ground a ft . Depth to limiting fac r I n Remarks: Boring # Ground elev. ' ft, Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench Boring # Ground elev. ft. Depth to limiting factor 'n. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) Soil Test Plot Plan Project Name David Haselman Shaun i Address 742 130th St. Roberts Wi 54023 CST #226900 Lot Subdivision Date 8/30/99 NE 1/4 SE 1/4S 27 T 29 N/R18 W Township Warren Boring ()Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Base of Siding System Elevation 86.5 *HRP Alt. BM Top of Air Conditioner @ 100.0' Existing 3 Bedroom 200' House Alt. B.M. B.M. 0' 5' rig T Baffles were not found in existing tank Vent M Ponding Water found at 100' ground surface, system has failed OMB-1 40' 0' 50' 90' JL- B-3 B-2 Slope 125' Property Line r SYSTEM ELEVATION SIZING AND CALCULATIONS Below Grade Chamber Soil Absorption Systems Permit Number 10/4!99 Date x "x" Gravity Distribution only 1 Pressure Distribution 3 ft Suitable Soil I Note 1: Bury depth as per manufacturer 18 in Chamber Height 2 8 ft Maximum Bury Depth 3 450 gpd Estimated Daily Peak Flow 0.50 gpd/ft2 Wastewater Infiltration Rate 900.0 ft2 Code SAS Size 40 % Down Sizing Credit 360.0 ft2 Reduction 540.0 ftMin. SAS Size 86.50 ft Proposed SAS Elevation Soil Surface Acceptable Finished Grade EL 4 (ft) Boring Grade Limitation SAS Elevation (ft) System Minimum Maximum Number Elevation (ft) Depth (in) Lowest Highest Elevation? 89.50 96.00 1 92.50 130 84.67 90.33 Yes 2 90.00 110 83.83 87.83 Yes 3 91.00 110 84.83 88.83 Yes 1. Depth of suitable soil required below the infiltrative surface for treatment. 2. Total height of chamber in inches. 3. Maximum bury depth as per manufacturer's recommendations. 4. Based on chosen system elevation, and chamber height. Top of chamber is equivalent to top of aggregate. The addition of fill for cover or the reduction of finished grade may be required to meet minimum or maximum code standards. SBD-10553-E (R.05198) - ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND RSHIP CERTIFICATION FORM ~y~'f~E s ~ 7?-6 -)CIc Owner/Buyer / Mailing Address,-zyL Property Address 1.C~ `(JaZ 3 (Verification required from Planning Department for new construction) City/State Parcel Identification Number' LEGAL DESCRIPTION Property Location ~L%4, L '/4, Sea2Z N-R~W, Town of Subdivision . Lot # Page # Certified Survey Map Volume b Warranty Deed # L 1 . Volume Page # Spec house ❑ ye4no Lot lines identifiable 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, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal 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 y septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of th a year p tion dat GNATURE OF-APPLIK!AMT DATE OWNER CERTIFICATION I (w 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 prope escribed a ve, by a of a warranty deed recorded in Register of Deeds Office. ATURE O APPLICANT 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 DOCUMENT NQ. wARRAM DD THIS e1ACS egssRvgn roll "CoaOiMe BATA I' STATi BAR OF WISCONSIN FORM !-JIM, R__ 11 T0M OR" w+~ _ ►A.E 5 . =T. Cw0a =0 ylA -_43"IG 7 i Iva. 96 _ 1- _ Wd for Dowd Nov. 16. 1987 Beverly .J. Denucci, formFrl IIe: erly J. 8.30 A Wagner.t and ..Ernig .J•.. Denucci her husban$, II + Gib* 4 conwyo and warrants to..Da.f11..R.A...Hast'.1mAn...dI)G~..ICdX I1...~e.... ~i>sa~ n ~...hu.akans~..and... wife ...am......... 4.r.i.A1...a..w.,go s. z :I TvR RIVER FALL. 53022 u i - - - tM following described real estate in S-tA.........................Connty. state of Wisconsin: Tax Parcel No: i! li The East 429 feet of the North 660 feet of the Northeast Quarter of Southeast Quarter (NEk of SEh) of Section Twenty-seven (27), Township Twenty- nine (29) North, Range Eighteen (18) West. St. Croix County, Wisconsin. `I i1 I 4 wet i FES !I N~; (1 r' This _.ls._.......... homestead property. f'r (is) (is tat) Exception to warranties: Subject to easements, reservations and restrictions of record. Dated this 1 . day of INTOivgmber.............................. 19..$7.. c ~S~K s.tChJ ........(SEAL) (SEAL) BEVERL ~ UCCI formerly II s VERL GNEA............ i (SEAL) .........(SEAL) ERN-IE_----.,-..DENIJCCI AVTHNNTICATION ACHNOWLSDGMZNT Signature(s) STATE OF WISCONSIN as. Pierce p ourAy. authenticated this day of....... 19 personally came before me t '3 .__..3._......day of e November 19•_ 8 7. the above named 41 Jii BeYer~Y...J~_..Wa~ner..a~ia..H e... TITLE! MEMBER STATE BAR OF WISCONSIN Denucci,,__,her-•husband•,_-........................... (If not. • authorized by 1 706.06, Wis. Stats.) to me known to be the person who executed the foregoing instrume^t and ackno►le~~e,/1ert:~ru~~ a THIS INSTRUMENT WAS DR.nFTED BY - ~ , STE?HFN J . Dt.' V1 A.P . iA C. Mc..lter i Iiudson~ Wiscons..n Notary Public Wis. My Commission is permanent. If n4t sae expiration (Signatures may be authenticated e acknowledged. Both ( . are not n.xemary ) date: April ._-5 19..99.-•) Names of Derwas signing in .nr capacity ahoald be tyyed or printed below their signawrea. Stock No. I3M RCIW1ACa NOVI STATFORAI OT! 151982 ~iN ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certif that I have inspected the septic tank presently serving the _ ,,2p residence located at: A/~ h , ; , Section T'10~ N, RW, Town of Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. d~r Last time serviced: Did flow back occur from absorption system? Yes No (If no, skip next line) Approximate volume or length of time: gallons minutes capacity: Construction: Prefab Concrete Steel Other _ Manufacturer: (If known):cr< Age of Tank (If known).: Th 0 M h ~5 01U6 0 tz (Signature) (Name) P ease print (Title) (License Number) Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis.f,,-Adm. Code (except for inspectio/n~ opening over outlet baffle). Name ~j%; 4% S ignatur MP/MPR© R 81. Croix Co„ UUI ` Z)rw I , AND IN THE NWI/4 OF THE NW 1/4.OFSEC~ SURVEY M AP CERTIFIED F SECTION 27 ROIX CO. WI. F THE SW 1/4 O ST. C LOCATED IN THE SW I/4RISW, TOWN OF KINNICKINNIC, T ION 34, ALL IN T 28 N ADELINE PESKAR PREPARED FOR' w1/4 CORNER Of SEC. 27. ( COUNTY MONUMENT iy 44 FOUND). 1 F S72,0 C g T T ! a O & ,Z 7~f'f~ 1/0 3'9 /4 • •~4NOS ASJ BEARINGS ARE REF- ERENCED TO THE WEST LINE S64 OF TH OF THE SW 1/4.( RECORDED HE 2 /2 S•3, F BEARING). / 7 c ; "L, Q in Co. tODO _ O N co _ C N )y( CJ . a L 0 T N Q N 9.91 ACRES E L, m 1 431.729 SQ.FT.I G"' w 9. 56 AC. EXCLUDING ROAD R.0-W• S N. S = ( 4 16 • 557 SO.FT.) .J• F ~ li 1"• 0: A O M 0 3 u, 0 A v PPR ul. 0• z z O N Q: J W• H , v~i O ~ • SAY 3,951 cr - W o VJ• 3 DRAINAGE WAY O) Q• ST. CR04X COUNTY ` HIGHWAY SETBACK LINE comprehensive P1849, Zoning am Parks Committal If not recorded • Rq ° within 30 dsys(d approval dtts N 80-55,30,,W M ' ~_•O 2 approval s h 9 t 1 ' b e N O R T H 13. 49 ~ (D 7=N60055 min ~ void .30 W SW CORNER OF SEC- 27; ( COUNTY MONUMENT SOUTH LINE OF THE SW 1/4 FOUND). LAN OS UN PLATTED ~ r JAMES M. IRON PIPE WEIGHING WEBER = 4is O SET I' X 24" S 18~ f w I. 13 LBS. PER LINEAR FOOT. W SPRING VALLEY .o~ WIS. SCALE I as u V0 0go9'®~ ' 300 DAMES M. WEBER S_ I 1s8oa 04 75 150 DATED r^ C~ SHEET I OF 2 95-24 THIS INSTRUMENT DRAFTED BY JIM WEBER Vol 10 Page 2916