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Home My WebLink About032-2114-90-000 c e, 0. 0 w � o 0 N � b ti ti II I tl h Z N G Z - R} lL c � O a 3 Cl) v � Z N O 0 Z d M�z!' am � o I 0 Z c 00 N - d Zz' O N z '0 CL 4 N N 7 y w •� C O N Q O 0 I O Z m Z N R O N 0 is Y v CL +) Z C r' O m. d i� 0 C O G G d o N O LO Z •N m �aaa o N '' 0) m N }w�j fn J V O O) 0) >- F II (0 0 0 N N O E M Q N m 75 d n U) N .: N III- M 7 LO O O C Iii M N C O O M y o � N (O O "+ O� F- N E N 0 0 0 J' \ O - U E O) c '0 N N N 42 c .. i t O N �j 47 .� N h In • Z." N N N '0 N N E 06 � • O L O O U) M O N Z Cn c C� C� 3 • Q y V' N C £ i O O A 0 a O m 0 -Wisconsin Department of Commerce SOIL AND SITE EVALUATION 1 3 DiNsion of Safety and Buildings Page of Bureau of 4itegrated Services in accordance with s. , ILl;lR- 3.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches"in size' Plan wst . County include, but not limited to: vertical and horizontal reference poin}'(BM); diregtionand,; - „"� St. Croix percent slope, scale or dimensions, north arrow, and location ajio distance tb.eeacbi;i. d. Parcel I.D. # APPLICANT INFORMATION - Please print all infori atloh Rea ed b Date Personal information you provide maybe used for secondary purposes (�rivacy Law, s. Property Owner �� bcation Richard Stout ' , `�,,_ .Govt,_Lot NF,, - '' 1 /4SW 1/4,S 3 T 3 3 ,N,R 19 E (or) W Property Owner's Mailing Address Lot # Mock# Subd. Name or CSM# 1353 Awatukee Trail 9 Meadowoods City State Zip Code Phone Number ❑ City ❑ Village f] Town Nearest Road Hudson Wi 54016 (715)549 -6731 Somerset 232nd Ave ® New Construction Use: Residential / Number of bedrooms _ 4 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 600 gpd Recommended design loading rate ._ bed, gpd/ft gpd /ft Absorption area required 858 bed, ft 7 0 trench, ft 2 Maximum design loading rate . 7 bed, gpd /ft gpd /ft Recommended infiltration surface elevation(s) See 1p Qt plan ft (as referred to site plan benchmark) Additional design /site considerations Parent material CNC 2 Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ U [2s ❑ U R] S❑ U 1 [0 S ❑ U ❑ S [0 U ❑ S Q U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench 1 1 0 -4 1 0yr4 /3 -- sil 1 j%t/ mfr cs if 2 4-24 1 0yr4 /6 -- sicl 2^Ah k mf i cs Ground 3 24-E 5 10yr4/4 -- ms osq mfi cs elev. 8 8 —5-0-ft- Depth to limiting factor -5- in. Remarks: Boring # 0— 7n u ' 2 6-35 1 w:Ej GS 3 35 -90 10 r4/4 In os Ground elev. 91 .5(7 ft. Depth to limiting factor 9 0 in. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number 7oa �oT9 df '` G G h d G Al o � 0 B I x ,, F_, cdyo$✓ ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT 4• L, is Owner Property Address ` City /State xvr Legal Description Lot Block : Subdivision/CSM # %4 L '/4, Sec. , Tfj N- R,/�W, Town of _ ,�,�,�k PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer S Size ST/PC / / Setback from: House Well Z P/L 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: , Width _�_ Length fZ Number of Trenches Setback from: House Well /,/ r' P/L Vent to fresh air intake f0 ELEVATIONS Description of benchmark _ Elevation I e1Ll Description of alternate benchmark Elevation 9/. 7 Building Sewer ST/HT Inlet 9< &Y ST Outlet 9V PC Inlet PC Bottom Header/Manifold -1Z, 9 7 Top of ST/PC Manhole Cover 9,r'cI Distribution Lines () $Z 9, - () ( ) Bottom of System Final Grade Date of installation,2Z2 122 P it nu ber -3�o l/y State plan number Plumber's signature License number Dat � Inspector Complete plot plan Wisconsin Department of Commerce - Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: ff �� INSPECTION REPORT 5• Cr o /-'C 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)]. 3a; I R Permit Holder Name: El City [I Village W] Town of: State Plan ID No.: M i C rNC,. s oK.%cir s C - CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: rr 0o l oo �a elP.c fir a S•�C TANK INFORMATION ELEVATION DATA 9Q 00 S7 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic p oa B nch r 9 a •�! j0�•7 SOU Dosi ng (f, B ►mil (o • o 10-C L Aeration Bldg. Sewer 0a - 7 Holding St/ Ht Inlet 1 09- D- q 2 TANK SETBACK INFORMATIONI St/ Ht Outlet , ? g10 o TANKTO P/L WELL BLDG. - we tto ROA Dt Inlet Air Intake pLI ` NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe S �e •�12 Holding Bot. System , y 3 9(o. Cj-> PUMP/ SIPHON INFORMATION Final Grade 9Sa Manufacturer Demand i Model Number GPM �Ove'� TDH Lift F System TDH Ft H ead Forcemain Length J Dia. Dist. To Well SOIL ABSORPTION SYSTEM G-W TRENCH Width , Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Ia 5ql DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of I CHAMBER model Number: Syste 'fA+',04,J ,5 S (OO OR UNIT DISTRIBUTION SYSTEM Header/Manifold it Distribution Pipe(s)) u , x Hole Size x Hole Spacing Vent To Air Intake IV- Length _ Dia- Length 5: Dia. Spacing t0 AST M 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.) S'rmergmf 3.34. /I W €"5w X333 S eg d o D r`� ,� �Q ��&1 - T °P ✓ S � " It,, d Ntaara�tvoc�5 Go f f � hG 112f� AIR 5 Gtf y yP/ / 4e s kj a7 e (e f f *-i e_ a ( /.�ao/ lx4rc �e pa wry ' 0;t� Ott 0 -fe-r- - Fr%4 n-pa • - t k ,�-�t" .e (Zt) c4i�ro w kS D.F.F N� �Y G (dow 5 (a pm, /'.G c! e / 5 0 3 A► ,I'raw•- � j Q �o �a 4 � -ttiwL _ Plan rev sion recIoned / �] Yes [YNo Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature A <2 ert Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count b . CROIX 4)' c t : � ; ) INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitarlPYMV: Personal information you provice may be used for secondary purposes [Privacy , s.15.04 (1)(m)]. P er& it Holder INC Name: [jbffi�jg e Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel bS � - 2114-90 /OCR s TANK INFORMATION ELEVATION DATA A9800518 TYPE MANUfACTURER CAPACITY STATION BS HI FS ELEV. Septic �A $ "Vo loo Dosing Y P Aeration ,�..- Bldg. Sewer (01 T ? Holding - -., _ , _..�_�... t' 5p* Inlet GD ,cog l Lg TANK SETBACK INFORMATION c St Outlet �, 1 p TANKTO P/L WELL BLDG. a tto Air Intake ROAD Dt Inlet Se ,?- 0�� NA Dt Bottom Dosing ----T' NA I Header / Man. 61S V 5 gz fb Aerat' NA Dist. Pipe R Or Holding �~- Bot. SystemZ PUMP/ SIPHON INFORMATION Final Grade GKZ Manufacturer ,aemand C 4 J C P yv - 7 • Model Number GPM TDH Lift Friction System TDH Ft Force ma in Length Dia. I f Dist. To well SOI ABSORPTION SYSTEM / JAENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth btMI NSION Z DIMENSION SYSTEM TO P / L BLDG I WELL LAKE/STREAM LEACHING Manufacturer: j SETBACK , CHAMBER INFORMATION TypeO 11 i er. Syste (OPA OR UNIT — 0 DISTRIBUTION SYSTEM Header /Manifold V Distribution Pipe(s) - x Hole Size x Hole Spacing 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: SOMERSET 3.31.19,NE,SW 2333 53RD STREET - MEADOWOODS LOT 9 l , Q9, e, ,�;C2 woo c f�L r.��f i �rr..s. - � car - ? �-e,. �... �g PA �� — o°>: � �7�.,.� 5", Plan revision required? ❑ Yes ❑ No Use other side for additional information. I F SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue Vi sionsin I n accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this application State sanitary Permit Number 3a 4/ ( p 7 Personal information you provide may be used for secondary pur poses El Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. AvX State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Property Qwner Name Property Location , /JS) 1/4 1/4, 5 T O N, R Or Property Owner's Mailing Address Lot Number Block Numbe Cit , State t j Zip Code Phone Number Subdivision Name or CSM Number II. TYPE F B ILDING: (check one) ❑ State Owned !t� Nearest Road p VII age ,gyp Public 1 or 2 Family Dwelling - No_ of bedrooms Town OF III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 3r 3/. 032-- 2-11 -ab 1 ❑ Apartment/ Condo - 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. 13 New 2_ ❑ Replacement 3. Q 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 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill 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 Required (sq_ ft_) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. r'nch) Elevation j� / Feet Feet capacity VII. TANK in g allons Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App Tanks Tanks New Existin structed Septic Tank or Holding Tank — ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 1 ❑ ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for in tallation of the onsite sewage system shown on the attached plans. Plumber' Na t)� Plumber's Si ur : <N ml MP /MPRSW No.: Business Phone Number: Plumber Address (Stree , City, Sta , Zip Co ): ite S bI IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuing Agent Signature (No Stamps) Approved El Owner Fee) Owner Given Initial f j Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber � W h / Zl� " w 'h 4 o pi rN A F i _NZI) % h s S Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page __/_ of Z Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. paw I.D. # APPLICANT INFORMATION - Please print all information Reviewed by Data Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property er Property Location 7 _ Govt. Lot - 1/4 1/4,S T ,N,R E (or) W Property Owneed Mailing Address Lot # Block Subd. Name or CSM# S Gty state Zip Code Phone Number El city El Village [Z Town Nearest Road 0 New Construction Use: p Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow( gpd Recommended design loading rate -- bed, gpolft _,. trench, gpd/ft Absorption area required bed, ft . trench, ft Maximum design loading rate _ bed, gpd/R gpd/ft Recommended infiltration surface elevation(s) 7 3 ft (as referred to site plan benchmark) Additional design/site considerations Parent material adw st / Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure 7AT-G System in Fill Holding Tank u= unsuitable for system s❑ U 10 S❑ u ❑ s❑ u ❑ u ❑ s ®u ❑ s® u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench r Ground elev. J - / ,V—L ft• Z2 - 05U Depth to limiting factor Remarks: Boring # a glGrr/o��und — _ _ ft. Depth to limiting factor Re arks: CST Name PI se Pri Signature ` Telephone No. Address Date CST Number n SC S Cl . .......... ............ .... . ...... zt �U l zi � Li R, � ry su y o � k w w • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM ' Owner /Buyer Cn�_ 'I� Mailing Address 135gt ; At_ , ,; A - rtt.ke,_ TR Property Address Da33 _7 3 v -o S tR -t n (Verification required from Planniiw Department for new construction) f City /State L"i 1 Parcel Identification Number 03Q -loot, - 90 7o_o 0 - LEGAL DESCRIPTION Property Location ! /,, _51 _ ' /�, Sec. _ T _ N -R �.W, Town of Certified Survey Map # Volume , Page # Warranty Deed # <j& / volume y /�G� , Pagu i; Spec house 14 yes ❑ no Lot lines identifiable ;R 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 syste - 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 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 o the three year expiration date. SIG)qATURE APPLICANT DATI? 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 pro rt described ove, by virtue ol' a wa rranty deed recorded in Register of Deeds Office. )v //v / 9K SI NATURE O 1 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 ti' s iMri MC n7 s 2 h1.2 9 2- �15T 6293.2 • Y �Me --- - - NCO :`1326 Err' . '.6'13�C 1326 17 - - �+•+•# - y "pIt ANY ' , ,7 � �,"; hry{ l y�w •Y .d^ r '� AC A. Os 1 /y% 7' 96+11 WL-OC ;AC • X M M P . R A f Y 133.6Y S0. Yl. C NI E -OIE -5 C 3.07 ACRES y a rw.t� cre' r ' O E : x I r 969.8 o YR..N1 9.96 5{,• +• :r+ 7 vy..> ,• 133.962 SO. rt. i f107 r. 8.08 ACRES - 1 i 61 4 )RPORA71ON .0 2 � 4 3 X I � lan.l •.. .- ._•_,,. ' '' ';,2.6 �. '.3 ,.- •'-•� -�� -• o l , Cf 645' 100:6 �nJ -b >f ?71.8 ...0/ .- ,, =- G 83 ,132270 fL 0 1 % •3.16 ,.CRES / 1� l D a 3 i 4 163.686 32- O `30. bo / 1.60' 'PO �`•P. ^ `9831 i' f / ' s7 /' f 7J7" '. - - - - - - - — - - -:- 9a7:�Y 1� t Q a l o - 0 . EE 99X5 1'•1 �, Q �;: _ t ' "• a 9810 . i X. 96d:} N31. 02 [ p Q `.� f�•' , ` - � O 985.3 w 736hc. n• X 97n 7 302 ORES 5 i f 130.732 SO. fT. i h 13 .00 1 A 3F,. 3.00 ACRES / CR i //� • 3 X - _ 986.7 BIO• 984.7 ' / -'- I fii 99 x r 980.6 _LJ a. b j' ' 1 992.6 y x' T _ C-.SY \ ` `�. s1 I 982.6• { L . `��..i�. _d_.w"" (1991. < - '. - o I , �•Y, ? _ 1 ,L : -� 3...... .�X �992.1 vOWME_12 - T �3 11 Y KO TS ' FARMS, - ,. 970 _ B 996.0 . - 981 3 -06 ' 6A 260TH Nom. _ _9 89 c I a x i 'I - _ -� x -• P . r75 Z`ar . ' - / 1 2- 974.1 ` 1 7 SR�s T•*' r 1 ,1 "` i �: yR d 9XOJ ; +�{I O977J X •-. - 130.729 SO Ff 3 � RE95891 ' • /r / 2 .L�e'. �� •....... M A C ': 1� � �d� YY7 � :. \4 �..•.. y .. ? � L� .r, �,... .�' �, t3c � �.. .+o _ - ar�'Ra"1�Im'� 1 1 �u' uRU�asE`fic7_n a+►� ;� S'� . .... - ca.-1 -<'� -- •.•. , - 29 _�. -329.74 - _ _ _ -__ N E J _; • I - - - - - -•- � +`_ -'il. - - 685 5 -�•�- � - - - r _ - _ . 9 9 c' - -� � � - CIA •.S I 1, I - '' •11 I. .'I BENCH MARK: . 4 T RON O F k ST. CROIX COUNTY WISCONSIN ZONING OFFICE r r d R M ST. CROIX COUNTY GOVERNMENT CENTER vial 1101 Carmichael Road Hudson, WI 54016 -7710 _ (715) 386 -4680 February 15, 1999 REMAX Team 1 Realty Attn: Stacy 103 Main Street Somerset, WI 54025 RE: Septic Inspection for M & G Inc. located at 2333 53rd Street, Lot 9 of Meadowoods, Town of Somerset, St. Croix County, Wisconsin Dear Stacy: A septic inspection of the above referenced property was conducted on February 2, 1999. This property is located in the NE %4 of the SW' /a of Section 3, T31 N -R19W, Lot 9 of Meadowoods, Town of Somerset, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom. home. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, • " VoE i nge r Assistant Zoning Administrator /sm ST. CROIX COUNTY WISCONSIN .� ZONING OFFICE p tl N g q 19 on ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road f,. Hudson, WI 54016 -7710 (715) 386 -4680 April 15, 1999 REMAX Team 1 Realty Attn: Mike Germain 103 Main Street Somerset, WI 54025 RE: Septic Inspection for M & G Inc. located at 2333 53' Street, Lot 9 of Meadowoods, Town of Somerset, St. Croix County, Wisconsin Dear Mike: A septic inspection of the above referenced property was conducted on February 2, 1999. This property is located in the NE'/ of the SW' /4 of Section 3, T31 N -R1 9W, Lot 9 of Meadowoods, Town of Somerset, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, Rod E linger? Assistant Zoning Administrator /sm