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HomeMy WebLinkAbout030-2034-50-200 o (A O g a n (D T n A c r. • m d (D A cn z v z O w x ' � a c) .c • � o o to �l (D `Z Q C ( ( L W O N a CD N N c (a 'nOj t!.) N UJ = N Q -0 O A •S ! N N N a E O O O C (n n (D _•I CDJt O .7� O co U7 3 Q CD o O _ 3 FJ O 7 fA CD 3 O O N' c N O •� �1 C1 ( n. -4 N y °• Z 1 p N Z O N N ((0 W (n U7 N ( O (0 CD CD co 00 oZ N C c �I o_ z OO C C O C CC °.: h A A O W - G< G C Z N T O O O W (D (D N N I N o) 6) O & lV (D = I O 3 W �M L-T 2L N m (Ao Q N z 2. z z o D ' o v O 3 (V O N O N I M • y (D * l /i <O O ? N W m C> CL n 3 w 7 CD O C 6 .a O o 0 p Z M c 0 a A 7 R Z W A W m m p a 3 t z A C :: -. Na C Z O N Z W CD A ' D C a � n v c z a o •• Z u O I I � t I a I`- r ti ti ° o v a p a CD o, to O a CD CD o a Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 �ahoFanc: Human Relations Division of Safety & Buildings iryamord with" ILPR,83.05. Wis. Adm. Code COUNTY Attach complete site plan on paper not les att 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal refergnco point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location andtance to nearest road. 030- 2034 -50 APPLICANT INFORMATION— PLEASEf"INT ALL INFORMATION` , REVIEWED BY DATE PROPERTY OWNER: °'' PROPERTY LOCATION GOVT. LOT NE 1/4 NW 1/4,S3 0 N,R 20 xff (or) W PROPERTY OWNERS MAIi_ING ADDRESS LOT # BLOCK # I SUBD. NA O R CSM # /a �.�?? kq 149 Hi h St. 2 na csm CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE (MOWN NEAREST ROAD S New Richmond WI. 54017 (715) 246 -4767 1 St. Joseph 150 th. Ave. [ *New Construction Use (x)c Residential / Number of bedrooms 3 ( j Addition to existing building 3 j j Replacement [ j Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 5 bed, gpd /ft • trench, gpd/ft Absorption area required 900 bed, ft 750 trench, ft Maximum design loading rate .5 bed, gpd /ft .6 trench, gpd/ft Recommended infiltration surface elevation(s) 96.76 ft (as referred to site plan benchmark) Additional design / site considerations alt site if used system el. to be no lower than 96.23 Parent material outwash Flood plain elevation, if applicable na It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for system ig S ❑ U ta S ❑ U I & ❑ U a ❑ U ❑ S (Z ❑ S 09 SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure ( GPD /ft Boring # Horizon Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -12 10 r3 3 none sl 2m r mvfr aw if .5 .6 1' 2 12-84 7.5yr4/6 none 1 fs Osg mvfr na na .5 .6 Ground elev. 99.2 41. Depth to limiting factor +84" Remarks: Boring # 1 0 -16 10yr3 /3 none sl 2mgr mfr 9w if .5 .6 2 2 16 -3 10yr4/4 none sl 2mgr mfr gw if .5 .6 Ground 3 37 -84 7.5yr4/4 none 1 fs Osg mvfr na na .5 .6 elev. 10 _?ti ft. Depth to limiting factor +84 Remarks: CST Name: Print Phone: 715 - 246 -6200 Address: 1554 200th. Ave., New Richmond, WI. 54017 Signature: Date: CST Number: L -9, 5 -4 -94 cs m A . L STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Vernell A. & Stephen L. Skoglund New Richmond, WI 54017 MPRSW 3254 NE4Nw S24- T30N -R20w (715) 246 -6200 town of St. Joseph lot #2 N 1 40' BM= top of 1" steel pipe at el. 100' w /marker pipe, alt. bm. =top of NE lot stake at el. 102.75 n � � vo cv / r5� Gary L. Steel 5 -4 -94 G SA -Z6 .j �40 ,2p�l , �� ova z � eX� la /���9 FILED g 1994 ►- 0 03� coo Z/�U y�rs w `j JAMES O'CONNELL Q c3� lD� ? 7'?4 C� Register of Deeds J G19921 St. Croix Co„ WI / CERTIFIED SURVEY MAP Located in part of the NEa of the NWa of Section 24, T30N, R20W, Town of St. Joseph, St. Croix County, Wisconsin. I CERTIFI � Y i RAC i , i I L0 . hG. � i 15 v i � N1 EI I -__ - NW Corner w Section 24 — — North line of the NW} of Section 24. --r— — w _ S8905310111W S89 01"W 1100.85' U' 314.11' 228.29' 1500.85' o 0 0 C? 1> C _ � T N LOT 2 � I> 3.00 Acres nn � �� o L O T 3 I — I 130,723 Sq. Ftt^1��PR�.,; VEC) o °' 3.67 Acres Inc. R/W �7 1 2 159,991 Sq. Ft. Inc. R/W a wi 1�'g$JI 3.44 Acres Exc. R/W N 149,657 Sq. Ft. Exc. R/W a S7' �(Z . CROIX COUN7'"l `° s N � � \\ (� Compret�en�;•r�� Ply nrSr w � ' r o M Zcn;rla and o r Ln N c / o C: A o � s� Ir not recd dod " 1 within 30 day c4 approval dale 0 approval shah to mOl >Z void co m Ln m- o -n \ 1 o m c,- s o / . ; ... ....xr. . LEGEND \ r / Aluminum County Section y Monument Found s 01 • 1" Iron Pipe Found \ �, n Ill - 01.11 T...... D: nn 1 Zn4- S .�"/ •1 i ST. CROIX COUNTY ZONING DEPARTMENT AS GUILT SANI'T'ARY REPORT Owner I r �4"i, Address lu , e City /State Legal Description: Lot - Block �-- Subdivision/CSM # '/+ ' /, — �Sec.o2 , T�N_ � Town of a e PIN # SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: ao� Tank manufacturer ,�Ie.e Size ST/PCs Setback from: House Well a/ L Pump manufacturer Model Alarm location (HOLDING TANKS O Setbacks: Service road a -air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: I -- � Width Length Number of Trenches oZ Setback from: House Well 0 Vent to fresh air intake ELEVATIONS Description of benchmark Elevation � d Description of alternate benc k Elevation Building Sewer ST/HT Inlet r b ST Outlet, S � PC Inlet PC Bottom 'Header/Manifold YZ O Top of ST/PC Manhole Cover Distribution Lines () a () ��! c --- ( ) Bottom of System Final Grade C> ( ) ( ) Date of installation / ermit number State plan number Plumber's signature g License number ���Svz 7 Dat� Inspector Complctc plot plan K Wisansin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Divi sion 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)). 315971 Permit Holder's Name: ❑City ❑ Village Town of: State Plan ID No.: SKOGLUND, VERN 5T. JOSEPH CST BM Elev., Insp. BM Elev.: BM Description: Parcel Tax No.: 030 -2034- 50 — 200 TANK INFORMATION ELEVATION DATA A9800359 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ,�r° ;1 J - � �. Benchmark I_ Dosing Aeration Bldg. Sewer Z 4, Holding St/ Ht Inlet - 7 . _32 /b 3 6 t TANK SETBACK INFORMATION St/ Ht Outlet _ S� TANK TO P/ L WELL BLDG. Air i to ntake ROAD Dt Inlet ir Septic I ` �Qr NA Dt Bottom Dosing NA Header /Man. Aeration NA Dist. Pipe Iq ` (4 9G'3� Holding Bot. System ) �' �y 9ti' PUMP/ SIPHON INFORMATION Final Grade Manufacturer F3emand 7 S, ' wl Model Number GPM TDH Lift Lrictionz' System TDH Ft H Forcemain Length Dia. Dist. To well SOIL ABSORPTI N SYSTEM BED/TRENCH width Length 1 No. Of Tr PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3` � S DIMENSION SETBACK SYSTEM TO P/ L BLDG I WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type of CHAMBER Model Number: System: �� �,.� , OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) Vent To Air Intake Length Dia Length Dia. Spacing 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.) LOCATION: ST. JOSEPH 24.30.20,NE,NW 237 150TH AVENUE — LOT 2 Plan revision required? ❑ Yes J�No r Use other side for additional information. SBD -6710 (R.3/97) Date Ins 'cyor's Signature Cert. No. Safety and Buildings Division SANITARY PERMIT APPLICATION 201 E. Washington Ave. Visconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. P O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. 5 1 -" - 6e0 • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide maybe used by other government agency pro rams ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. / © 0 7' State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Property Owner Name Propert Location J'I G t /a il/ t /a, S 15 �� y T a , N, 11 (o Property Owner's Mailing Ad / dr ss Lot Number — Block Number r itate� ,� / Zip Code /, Phone Number Subdivision.Name or CSM Numb II. TYPE OF BUILDING: (check one) ❑ State Owned C it Nearest Road village Public J4 1 or 2 Family Dwelling - No_ of bedrooms Town OF /ro f`!•� III. BUILDING USE (If building type is p check all that apply) C q Parcel Tax Number(s) 1 ❑ Apartment/ Condo O1 f ' �• �� A ` 030 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 Syfstem ______System _____________ Tank Only______________ Existing System _________Existing System B) ❑ A Sanitary Permit was previously issued. Permit 7 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 12 Seepage Trench 22 ❑ In- Ground Pressure 1 42 ❑ Pit Privy 13 Seepage Pit ( f/ - 33-/75 43 C] Vault Privy 14 ❑ System -In -Fill id 2 f.JirtC�ari �n r r /' - cG� VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate VSyste Elev. 1 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) 94. Elevation ® r ,S 9v� - Feet Feet VII. TANK Capacity gallons g Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Exist i n structed epticTa Tanks Tank �dO / lveC R El ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 1 ❑ I ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's e: (Print) Plum s Signature: (N tamps) MP /MPRSW No.: Business Phone Number: Plumber's ddress (Street, City, State, Zip Code): _ IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate ssued Issuing Agen ature (No Stamps) Surcharge Fee) CRApproved []Owner Given Initial Adverse Determination I X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: NJ SBD -63M (FL I t196) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber PLOT PLAN PROJECT Vern Skoalund ADDRESS 250 Williams Ave New Richmond Wi 54017 NE 1/4 NW 1/4S 24 /T 30 N/R 20 W TOWN St. Joseph COUNTY ST. CROIX � MPRS Byron Bird Jr. 220527 DATE 8 4/98 BEDROOM 3 CONVENTIONAL XXX IN -GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 763 # of chambers 24 IL BENCHMARK V.R.P. Top of White Stake ASSUME ELEVATION 100' ❑ BOREHOLE (DWELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 9 4.4 Alternate Benchmar Top of Survey Stake @ 96.4 Alt. B.M. 600' Property Line 't`B.M. 260' W0 B - -5 2 -34" X 75' Infiltrator Leaching Chambers 5' 75' 6' Spacing Between Trenches -3 11% Sl Rep D Pro _ C Driveway Bedroom 30' 190' House T 225' B -2 30' B -4 Vent >12" Sidewinder High of Cover Capacity Leaching Property Chamber with 31.8 Line 6' Long 16" ft ^2 per chamber 34" Grade at System Elevation Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR_83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches inpl. Plan must County C t include, but not limited to: vertical and horizontal reference point (�dection and '� , l- r D 1 percent slope, scale or dimensions, north arrow, and location and his3en to r6 slm�ITcM4 pa el I.D. APPLICANT INFORMATION - Please print all Reviewed by Date Personal information you provide may be used for secondary purposes (PH w, s. 15.0_4T1):(hVJR ✓ Property Owner tiorr e �/f O ! c-t h j'... Govt. Lot �J, ,i1 /4 N 4,S j T 3 !� ,N,R c� o E (or) �J Property Owner's Mailing Address t �oj #, �pv Subd. Name or CSM# "o" 7 Ci State �^, Z Code Phone Number ❑ City ❑ Village Town Nearest Road r / ,x, c`� 6/` _ y vl7 1 (1 - T O �i New Construction use: Z Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate � S bed, gpd/ft ,_�trench, gpd/ft Absorption area required _2a(: bed, ft trench, ft Maximum design loading rate 5 - bed, gpd/ft _ , _�_ trench, gpd/ft Recommended infiltration surface elevation(s)2 ,�c, It (as referred to site plan benchmark) Additional design /site considerations Parent material t�zz - r [ w Ct4 Flood plain elevation, if applicable V l;* ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = unsuitable for system ,aS ❑ u R S ❑ u M S ❑ U I N i:�S ❑ u ❑ S J�l u ❑ S '2U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 0 V r 3 J-, C� Cy � Ground elev ; �ft. Depth to limiting fact r i' / Remarks: Boring # r- 2- s s S a- L l 5 6 / I rIIL Ground 9 I � ft• Depth to limiting Afa fa r r Remarks: FAd dress Please Print) Signature Telephone No. l )s Date CSTINu ber � Soil Test Plot Plan Project Name Vern Skoglund Byro Bird Jr. Address 250 Williams Ave , � New R Wi 54017 TM #3479 Lot 2 Subdivision Date 8/4/98 NE 1 /4NW 1/4S24 T 30 N/R 20 W Township St. Joseph Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft.Top of White Stake Orange Ribbon System Elevation 9 4.4/92.9 * H R P Sa as Benchmark Alternate Benchmark Top of Survey Stake @ 96 600' Property Line B.M 260' B.M. i 10' B -1 5' S' -5 35' 7 575' ' -3 11% Slo e Pri A Rep A Pro 3 fD y Bedroom Driveway House 225' Id 301 B -2 B -4 Property Line ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer er 4z a2 -c 4,'� �J(� C�irrr K� ^yam/ Mailing Address Property Address ..2 6:4A t -+ (Verification 7 4/,!' d from Planning Department for new construction) City /State /1✓ �'�.c,�, �, Parcel Identification Number C, 035 LEGAL DESCRIPTION Property Location /r 1 /4,, W 1 / 4, Sec. , T 0 N -R o? co W, Town of Subdivision _ , Lot it _ Certified Survey Map # �� /�i ,Volume j/ , Page # . Warranty Deed # % / 2 2:Z;- � 0 ,Page # Spec house �A yes ❑ no Lot lines identifiableX 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 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. I /we, 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 ommerce and the Department of Natural Resources, State of Wisconsin. Certification stati that your septic sysV ined st be completed and returned to the St. Croix County Zoning Office within 30 W days f the three 4e* q / ?— / SIGNA OF DATE OWNER CERTIFICATION I (we) certify tht all st ents on t form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the p operty describ4-is of anty recorded in Register of Deeds Office. Q� U / E OF A / IGNATUR DATE * * * * ** Any informpresented 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 � A 58'7 a F fLE� a ► '� 584 AUG 0 Kp1}{t_EENN.WpLSH 2 St,Cto Z lxCo ' N w z 3 CERTIFIED SURVEY MAP r?NO U o a L 0 CA TED IN PART OF THE NE >/4 OF THE NW >/4 OF SECTION 24, T30N, R20W, TOWN OF ST. JOSEPH, 0-0 ST. CROIX COUNTY, WISCONSIN; BEING PART OF LOTS Uj Z a 2 AND 3 OF CERTIFIED SURVEY MAP RECORDED IN U = m VOLUME 10, PAGE 2799. m ~ ° OWNER Of 0 NOTE This Certified Survey Map was prepared VERNELL A. SKOGLUND Q z to show the remainder of Lots 2 & 3 of 149 HIGH STREET Lo Certified Survey Map recorded in Volume NEW RICHMOND, WI 54017 Fe' a 10, Page 2799, after highway aquisition as described in deed Volume 1313, Page 076. w0-.0 m Z N NW CORNER (N01'28'32 "E EXISTING CENTERLINE N1 /4 CORNER SECTI 2 ( 5. 4 82') — �- OF 150 TH AVENUE _SE CTION 24 S89 °53'01 "W S00'08'47'W 5 "W (S88 ° 31'28 "E ) 5.5 3' 1500.85' �— NORTH LINE OF THE NW1 /41 1100 85' (1100.869 I w I I d 857 C 4 ),, W RI SMALL � � 38 8. 8 � S3' 1 1 � TRACT o S6�'gBNWY RiWIDrN I 0 CD 239.01- ---- LOT 5 LOT 6 0i a' 2.610 ACRES (113,694 SO. FT.) In ao W M a In 2.519 ACRES (109,742 SO. FT.) 00 0 o M LOT- 2 o LOT -3 W LOT _4 Z - I° m In C.S.M. IN V, 0, PC. 2799 w ------ - - - - -- ------ - - - - -- 0 _ �Oj, sr o m `; f Q Z- fo �P� L � \ ` w 0�