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Home My WebLink About030-2096-10-000 n to O 3 m n d rt " O n O O w O p � N y N 0 . A W CD °-' a a C '. <T L W° ICI w a '- m m(D N N O O N p c 3 to = 7 W fo 1 CO O O 1 '' fT (D N N a= n(D a C , OD O O -D ry fD fD ID CD A p o CT N 3 90 O C) cn j O v_ 0. N (D a C 0 m (n N N a -4 C cri =3 CD CD 3 a = w C) N A. j N p _ =r CL c co CD c cD CD ca co co ° 3 T o o 0 fT O O O j o o 3 v v v c n CD CO N r. fu N C. co y CD m C N z o A A o O Z Z m N N - -w D .. 7 O O n 0 Q N N w (D O O N H 0) a) m 7 M N CC N c S (D n a 07 j CD N <p 2 N in 0' A 2 o CL G) m W A CD (D m p C Z c g A Z N Z A m A a a O 0) C z C. O Z N 0 I I � I I I � o I ti 0 ti I o_ m oa w o O ti ° O- ti ST. CROIX COUNTY ZONING DEPARTMENT ; ' 'q � AS BUILT SANITARY REPORT R ECEIVED L A R tO Owner 5 �Q J l eg R IBC) _ Property Add ss / �'� a q City/State � c� Io vt � �JL . Legal Description: Lot Block NP Subdivision/CSM # C o u,w�� S t S NL. '/4 1�1 '/4, Sec.��, T 3O N -R O W, Town of S PIN # D' ?A96 —/o SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer Size ST/Pd / " Setback from: House s We11 - 41 3 0 Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: :r.>� �l��t °`' Width Length a Number of Trenches 3 Setback from: House aq l Well >s U PAL ;k Y Vent to fresh air intake >5 0 ELEVATIONS Description of benchmark �v%h �� J 1 0 -1 r' 6� Elevation Description of alternate benchmark Elevation Building Sewer ST/HT Inlet ST Outlet ' PC Inlet PC Bottom � Header/Manifold Top of ST/PC Manhole Cover 1 5^ Distribution Lines Bottom of System (� T U (Mj T V S (0 q a s Final Grade ( U U S ( 1 U U. S (U b, 05 Date of installation a/ 1 / $ermit number 3 I a State plan number Plumber's signature Y � � ►t License number L Date Ak ! 9 Inspector c 9 Complete plot plan Wisconsin Department o f Coun Division Commerce PRIVATE SEWAGE SYSTEM S T. CROIX Safety and Buildings Divi INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanit 0jljF5@2$o.: Personal information you provice may be used for secondary purposes (Privacy Ww, s.15.04 (1)(m)). Perini ' old apse: DiCity JbY318�❑ Town of: State Plan ID No.: CST BM Elev.: v � Insp. BM Elev.: BM Description: Parce — TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 12-0c> Bench, y.0� Dosi ng ^ D'I' Y+/\ 7 ;' .7N, / oa.a- Aeration Bldg. Sewer q.14 / too. re Holding St /X Inlet TANK SETBACK INFORM ATION >ns St /'Outlet TANK TO P/ L WELL BLDG. A�irrIntake ROAD Dt Inlet Septic 1 0,5 1 100 1 ( � NA Dt Bottom Dosing — 1 NA Header /Man. Aeration NA Dist. Pipe s7gZ v5z s` Holding Bot. System 7.9 Gf$1 PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number ._ ---- -- —GPM TDH I Lift Friction System - H Ft ead oss Forcemain Lengt Dia. Fi ist. To Well SOIL A�TION SYSTEM BB RE N Width Leng' „ No. Of Trenches PIT No. Of Pits Inside pia.— Liqui D DIMENSIONS ` SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Typ O �� CHAMBER Moe Number: Sys a yt a-7� � O 1 2o r OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) / x Hole Size I x Hole Spacing Vent To Air Intake Length _(2 Dia. � Len th 6 $ 7 < 3U S acin V' 9 p 9 ( C411a .'6 eN 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 E] Yes E] No ❑ Yes ❑ 7No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 24.30.20 , NE, NW 1479 24TH STREET de,P 4 RIM dev Wad A) 0 P-1 5 l �1 °°� ;4 C h�dt? Gv�l l'l /vt-Ct. 447T -7. Plan revision required? ❑ Yes �o Use other side for additional information. SBD -6710 (R.3/97) Date Inspector' ignature No. V isconsin Safety and Buildings Division SANITARY PERMIT APPLICATION 2 E. Washington Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7%9 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. Sfi. Cie 6 ` 1 • See reverse side for instructions for completing this application State Sanitary Permit Number 31sSa3 The information you provide may be used by other government ag y�grograms ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. , k/ 7 t Y *U C s l7 i J State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION --�'� Property Owner N e Property Location r. r.0 N£ 1/4 N W 1 /4, S T 0 , N, R - 20 (or) W Propert ^ Owner' MailingAddr�� Lot Number Block Number ^I � City tate (��►► Zip C�e Phone ber Subdivisio or SM Number �� VV II. TYPE OF BUILDING: (check one) ❑ State Owned it Nearest Roa r L Public 1 or 2 Family Dwelling - No. of bedrooms o Tow OF s Job �, o� "� S }' 111. BUILDING USE (If building type is public, check all thatap Parcel TaxNumber / 1 E] Apartment/ Condo O • � ` �_ ` �� _ — `6 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 E] Replacement 3. [3 Replacement of 4. E] Reconnection of S. � Repair of an ___ystem ________ System_____________ 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 12 aSeepage Trenchy 3`1 ti y Z In- Ground Pressure r r 42 ❑ Pit Privy 13 E] Seepage Pit SyS��eh�t0 i" C3 X $ S 43 ❑ Vault Privy 14 E] System-In-Fill --f - VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade u i1 Required (q. ft.) Pro osgd (sq. ft.) (Gals/dayfsq. ft.) (Min. /inch) �� Elev tior ion �1 Feet /0. •r, 1 Feet t VII. TANK in Ca g allons a allons Total # of Prefab. Site Fiber- Exper- INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin structed Tanksl Tanks eptic T oink Q tc ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber I I I 1 ❑ 1 ❑ 1 ❑ ❑ 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) Plumber' i � i : (No Stamps) MP /MPRSW No.: Business Phone Number: Plumb is A dress (St eet, City, State Zip ode): IX. COUNTY / DEP RTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued Issui g ent Signature (No Stamps) �g Approved []Owner Surcharge Fee) Owner Given Initial I �D !� / y Adverse Determination 6 ' X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: IBS 3 IRTT� DKTRMUTbM: OrighW to County. One copy To: Safety 6 Buildings Division, Owner, Plumber I t . L. r� r I L l) I r•, I �I I ' V I 1, I •. I .�IU I v.'II N A ME S - -4-e _ NA �S R s� . A 10 ._! _. - c a � s� _sfi �L I C F N 5_.. •� ��. Note pa�d�P�� fiS .•; �U11` �nyr.. Sj p•1'I <r syJ)��h. 1 I�pU S� �12bh. w tfr Ag V 54 G' J D •'• 3 IKe N ��.. S . • / e �� 3 )( (,2 7 s y •� �1�Y'k -Mn GV1,[�.` � I USINt LNTI' 1 �� Alt FRESH AI12 IREF.f3�AND OBSERVATION PI.QI3 C110SS .SE ION _._.._1 Approved Vent Cap :.Y Minimum 12" Above Einal ID ' A" Cast Iron Above Pipe Vent Pipe To Final Grader Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 tabot"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 -(, it d % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance'`t ` j 030- 2096 -10 APPLICANT INFORMATION — PLEASE PRINT Alf. INFQRM REVIEWED BY DATE PROPERTY OWNER: ,� ROPERTY LOCATION Vernell A. &Stephen L. Skoglutd �� ,; - r OVT. LOT ti4 tia,S 24 T 30 N,R 20 fir) W PROPERTY OWNERS MAILING ADDRESS 1 z1 . 1 ` OT # BLOCK # I SUBD. NAME OR CSM # 149 High St. 11 na Country Side Estates CITY, STATE ZIP CODE - PHONE NUMAE _ ` ❑CITY []VILLAGE ®[OWN NEAREST ROAD New Richmond, WI. 54017 X7,15 246- ' ,A St. Joseph St. Hy. #64 -35 New Construction Use [x$ Residential / Number of bAliioer t 3 [ ] Addition to existing building j ] Replacement [ J Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 5 bed, gpolft2 . 6 trench, gpolft Absorption area required 900 bed, ft2 750 trench. ft Maximum design loading rate • 5 bed. apd/ft - 6 trench, apd/ft Recommended infiltration surface elevation(s) 97.90 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND I IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem 1:1 U S❑ U S❑ U fRS ❑ U ❑ S U ❑ S [25tl SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure I GPD /ft Consistence Botnday Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 1 0 -12 10yr4 /3 none 1 2mgr mvfr cs 2f .5 1.6 2 12 -33 10yr4 /4 none s it 2msbk mfr gw if .5 .6 Ground 3 33 -80 7.5yr4/6 none 1 fs Osg mvfr na na .5 .6 elev. 1 Depth to limiting factor +80" Remarks: Boring # 1 0 -12 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 2 2 12 -32 10yr4 /4 none SICL lmsbk mfr gw if .2 .3 3 32 -82 7.5yr4/6 none 1 fs Osg mvfr na na .5 :'.6 Ground elev. 101. ft Depth to limiting factor T__ I +80 Remarks: CST Name:— Please Print Gary L. Steel Phon 715- 246 -6200 Address: 155 00th. V . hmond, WI. 54017 c Stm Signature:, Date: —1 -95 CST Number: 02298 STEEL'S SOIL SERVICE Gary L. Steel Vernell & Stephen Skoglund 1554 200th Ave. CSTM2298 NEQNW4 S24- T30N -R20W New Richmond, WI 54017 MPRSW 3254 town of St. Joseph (715) 246 -6200 1 lot 11- Country Side Estates N 1 =40 BM.= nail in wooden stake @ el. 100' Alt. BM.= top of SW lot stake C 82.70' i I 6A 36' 15 I Gary L. Steel 9 -1 -95 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and -Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 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 -- 2096 -10 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R D TE PROPERTY OWNER: PROPERTY LOCATION Steve Perro GOVT. LOT NE 1/4 NW 1/4,S 24 T 30 N,R 20 5(or) W PROPERTY OWNERS MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 5379 190th. St. 11 na Country Sice Estates CITY, STATE ZIP CODE PHONE NUMBER [ ❑VILLAGE DOWN NEAREST ROAD Farmington, MN. 55024 (612)460 -6401 St. Jose h I St. HY. #64 -35 { New Construction Use [x] Residential / Number of bedrooms 4 [ ) Addition to existing building (] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 4 bed, gpd /ft .5 trench, gpd /ft Absorption area required 500 bed, ft 500 trench, ft Maximum design loading rate .4 bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) 107.55 ft (as referred to site plan benchmark) Additional design / site considerations system el based on contour line of ei 106.55 Parent material pitted glacial 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 CRU ®S ❑ U ❑ S fl U Gi S ❑ U ❑ S CCU [Is CiU 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 Trench .................. 1 -10 10 r4/3 none sl lcsbk mfr cs 2f .4 .5 ._....1....._ 2 0 -20 10yr4 /4 none sl lcsbk mfr gw if .4 .5 Ground 3 0 -49 7.5yr4/4 none sl lcsbk mvfr gw na .4 .5 elev. 10 4 9 -70 5yr4/4 none scl 3fp1 mvfi na na np .2 Depth to limiting factor +70" Remarks: Boring # 1 0 -10 10yr4 /3 none sl lcsbk mfr cs 2f .4 .5 2 2 10 -32 10yr4/4 none sl lcsbk mfr gw if .4 .5 3 32 -58 7.5yr4/4 none of is M na na na .4 .5 Ground elev. 10 7.05 ft. Depth to limiting factor +58" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200!% Ave. New Ric mond WI 54017 Signature: Date: 5 -22 -98 CST Number: m02298 STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Steve Perro New Richmond, WI 54017 MPRSW -3254 NE4NW4 S24- T30N -R20W (715) 246 -6200 town of St. Joseph 4 lot #11 -St. Croix Estates i N 1 =40' BM.= top of Iron stake C NW lot corner @ el. 100' Alt. BM.= base of elec. transforner C el. 103.45' o� X17 I ( .3 5U d 0 aft e ,+ �� ► �" g fi Or r k � �- itit ,Z► I S ►2 Ga - L. Steel 5 -22 -98 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer !�-+ve Petro Mailing Address S 3 q ) od ty S� , Fa rms, � �✓ �o� RIV 5o Z Property Address 14 1 q R 4 (Verification required from Planning Department for new construction) City/State +, SDsev 'W I Parcel Identification Number 036 - 7896 16 LEGAL DESCRIPTION Property Location A IE' %., NW ;, Sec, Z14 T 3C Nt R z6 W, Town of S - Sc.5epA Subdivision _ C& gnTr °y 1� r GS�� ?P Lot # Certified Survey a # 16 27 33 ey P Volume 7 :_ , Page # z 7 Z Warranty Deed # 79 Volume 104,.1 , Page # o.Z? Spec house O yes 8 no Lot lines identifiable 1a yes ❑. no SYSTEM MNANCE hw pameandmaintenaneeofyoursepticsystemeouldresultisitspnmatrmefarlvretohandlewastes .Pronermaintenanee eon Of Pte$ oar &C septic tank evexy three years or if needed by a licensed pumper. What you pat into the system can affect.tlre fiction of the septic tank a treatment stage in the waste &Vosal,system. Tie PrOPedy owner agr= to submit to St Croix Zoniog Department it catification form, signed by die owner and by a m.sterP loumeymmpbm*Kx, restdctedphmberor a licensedpumpervaifying 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. Tom. the mod have read the above requirements and agree to maintain the private sewage disposal system with the standards set fordi, herein,'as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.. Certifcation 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 lion date. / / D ZO� - SIGNATURE OF APPLICANT DATE OWNER ATION 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 abo virtue of a warranty deed recorded in Register of Deeds Office. SIGNAlbF& OF APPLICANT ICANT DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department « « « « «« «« Inelude 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 Country Side Estates LOCATED IN PART OF THE NE' /. OF THE NW '/, AND IN PART O THE SE' /. OF THE NW' /, OF SECTION 24, T30N, R20W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN. i / h. •tot. 0••ot• •MtM H • 9 AM$ 11.. *Mom X rNtw. r t b • "a \ \ \;I , � � ��A.♦ wr 011! N. i /jlr • I .SQIR!E: S'�!'f[T Mar � ... .t � 3 \` • `J ` `•rl'�.� POND 7 AC Cf t. n �� •1 ' / w ., S.o nc.. � �I.ALL QGALc t 1•.t .t.l \ t SCCTION 24 1-4 Q M • t`SSK . I . . . / li.t.y .. ACNE r'3. A ••�-- « t... a... -.. fie' �' •� �'/� ' � t.m w s ��. .�•.. «.:........ r .• / .. • . •.•. - F� .r.t ..+t �---► ... 1 S.6 CnEs is .9 Aw - OU(VTRY :SIDE ESTATES lOCA7E0 IN Hrut GCF Tl E M"GF 71 ME PCMA /MI) N PART OF 711E - , T �Nw1A/SIN. �. T3011. R20MC TOM OF S= •FPM t Na.a w Nn C' -.. :.. � .fit �.�a�•�a/� m! _ _ _ - . �w..r"..a Nf S..N - - -_ �. -- „r. .Nr....�•M' � � 1 . /. a y. w.�:au wt - w. ii .N. M. M...M �.Nta w }}...�yr�. w .w. a.s • -/ _ �T` �•N••NaN.».�.�...t rY. - •�...aY. ' aN t.V-sft a N • •y .. ' � t • a.ta.. b . NNNI �. t1 INN 3 ` Aly+ �►• / / r •� ' LOT 10 1 _ LOT If _ • � /� /� ._ � ` - .:ISM :_ - _ :�: - ---� f LOT 7 ` ..w „•,rw essoar - -- -. ` LOT 6 _ - 14. !z tip! ., -- :LOT 5 del URE Jml- .`A .Y Mluia::W (” .......�. �✓ Tan Nidsm/Blund Realty _.. - - _ •:.� 715n86 -9060 - O[Tcx _ - 7I5/386 -5108 - OfL"ce Mb