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Home My WebLink About038-1073-30-000 / 0 2 $ 2 � ts \ k ts . � $ A � � � } � � a � k � ƒ I ) � k o z 2 % z U. 2 � k � \ � Cl) � z B � 2 \ p- \ \ IL m e z I § B z « : 2 cc t m ® § n ? 2 7 / \ { a , § ° I Q zmz . ) C) Its ? 2 f / % i § % § o = 9 im a 0 a = E #§ k o k $\ k k k FL b �§§ z C a a a m o B ) § § 0 Q E c 0 0 § § § a 2 \ § ® _ E / S 2 o D C) 7\ '& -- \ q k ) E c \ § e .G ¥ b a EL E 8 8� n R oA a f '2 / 3 5 2 2¥]® LO - k 2\ 3 2 k a 3 cb o j \ !� § 0 z /) ) Cl) IL � ■ � ■ ¢ � EL ;IL ° CL § ' r a § k 0 0 2 U a-: P 8 10 Si' CRUIX Cob 3 1 SURVEY >tQ eF IE FD SW CORNER CERTIFIED SURVEY MAPS SECTION 17, M emu cw T31N R18W wbw4b COUNTY SECTION CORNER MONUMENT v P La.UE2 l�Q_ �) G— — — AN. � - TOWN _S 0 0 2 9' 03 " E 6 74. 4 7' co _ WEST LINE SW I /4� W I/4. CORNER NO °07'12 "W OF _ __ o " * 9 �O 270.99 ° 22 S 88 5� 3 E SECTION 17, 66' �63�% ro POINT OF BEGINNIN T31N R18W EAST 1 RIGHT- OF -WAY N LINE COUNTY SECTION * rn CORNER MONUMENT o ~ 1 Co 1 0 2.58 AC. '0 Md pp v LEGEND * T0 Q 2 "x30" IRON PIPE, WEIGHING 3.65 # /LINEAL FOOT, $? .1 SET. I� 2 % 0 N� °36 X8 6? O 1 "x24" IRON PIPE, WEIGHING 1.68 /LINEAL FOOT, UNPLATTEd I 9g.�Z SET LAND I a N - )F --&A FENCE ~ UNPLATTED I .— a 1 co a LAND 2 O N w- S w APPROVED 3.15 AC. to w I v to to = I M �t M ��giN1f1 //I JUN 2 1977 a �� ,, GDN % c0 ° , Co ° D ST. CROX COU:tY r W z 2 70.97' �, C OMPREHENSIVE PANU FL4kV r�r� . f WALTER J. s }— N 0 35 '38 "V4 AND ZONW6 WOW= GREGORY r III 122.12' 148.85' � 5 -1224 1 ; APPROVAL OF THIS MINOR SUBDIVISIOS RIVE 122.12' � r !FOES NOT MEAN APPROVAL FOR SEPTi <g N JE ® 3 Qi� �� 16 N 2.24 AC. ° o . = S'�`S7 l�tE� TO H+e 2.� ��eeioRsslk to ®153 °02'15" �" ,.� M(Y ASSUMED BEARING S 37 ° `� I 3' 6 ' W CCD 41 `9 6 I o� WEST LINE OF NEI /4 -SW 1/47 *20 ° 0 N0 °35'38 "W 'C °� 317'12 �y6 M SCALE IN FEET N 19 ° 17'2 8 W z 1b p UNPLATTED `� 128.97 O �\ �`\ 4 00 ao 0' 200' 400 600 SAND_ 2.04 AC . 8 io ° — Co . �\ 353 157 Q OWNER & SUBDIVIDER x,66' ST. CROIX COUNTY ZONING DEPARTM - 9NT AS BUILT SANITARY REPORT Owner Property Address - ty Ci /State s , Legal Description: Lot ,_ Block Subdivision/�W# ,dkJ- ' /4„�:"L ' /4, Sec. 2Z, T �fLN -RAW, Town of SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION :: 302 c 2 Tank manufacturer Size ST/PC Setback from: House /-/ Well l d� P/L 7�<_ 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: x ,a Wid A l , , Langer Number of Trenches Setback from: House --?/-_ Well 4466 P/L _9 Vent to fresh air intake ELEVATIONS Description of benchmark Elevation Description of alternate benchmark Elevation 99 „9 Building Sewer ST/HT Inlet ST Outlet 97. /l PC Inlet PC Bottom Header/Manifold gi Al Top of ST/PC Manhole Cover 90 7,? Distribution Lines Bottom of System O ! 2 s �- Final Grade O N lA ( ) ( ) Date of installation Pe mit number _,U State plan number Plumber's signature License number ,, Date Inspector Complete plot plan 'Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count . _ INSPECTION REPORT CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanita Personal information you provice may be used for secondary purposes [Privacy fCPte 't M , s.15.04 (1)(m)] Holder's Name: GE, RICK �� pwn of: State Plan ID No.: Elev.: Insp. BM Elev.: BM Description: ] v0 �� - Parcel6119fl - 073 -30 -000 TANK INFORMATION ELEVATION DATA A9800565 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. I 2C 'ZDQ Benchmark ay �v O 3 � Bldg. Sewer d4 TANK SETBACK INFORMATION 4 Inlet d- 9 3 Outlet , 0 Z f �5 TANK TO VATInIU Dt Inlet Septic Dt Bottom Dosing Header / Man. Aeration Dist. Pipe Holding Bot. System y S� PUMP / SIP Final Grade Manufacturer mand ber GPM t/y Model Number TDH Lift F * Ion tem TDH Ft Forcemain a Dia. Dist. To well SOIL ABSORPTION SYSTEM B TRENCH Widt NJ Length No. Of Trenches PIT No. Of Pits Inside Dia. N DIMEN I N uid De SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACH anufacturer- INFORMATION Type 0061 UPh- System: A IA C OR UNIT Mo el Number: DISTRIBUTION SYSTEM Header /Mani I i stribution Pipe(s) / Length pia. r / / x Hole Size x Hole Spacing Vent To Air Intake Length Dia. L Spacing 4 :{ �Q SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx De th Of xx Seeded / [ Bed /Trench Center p !fodded �Eo]�Yes Bed/ Edges Topsoil ❑ Yes ❑ No COMMENTS: (Include code discrepancies,'persons present, etc.) LOCATION: STAR PRARIE 1�,/7 . 912 214TH J AVENUE I v f/t''t f e 601 1U0 v � door � Src°br• Cls Ei//fTt;vi ra�7cry ( y S NV Wel / u�"`�1 Plan revision required? ❑ Yes No Use other side for additional information. ./ SBD -6710 (R.3/97) Date Inspector's Signature V i s�onsft SANITARY PERMIT APPLICATION z afety and W.Wahingt nAvenue 1 Department of Commerce In accord with ILHR 83 -05, Wis. Adm. Code P O Box 7302 Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 vi x 11 inches in size. • See reverse side for instructions for completing this application state sanitary Permit Number Personal information you provide may be used for secondary purposes fo [Privacy Law, s. 15.04 (1) (m)]. E] Check if revision to previous application State Plan I.D. Number I. APPLI ATI N INFORMATION -PLEASE PRINT ALL INF RMATION - Prop Owner me Property Location 114 114, 5 T , N, R E (or)dP Rcoperty Owners Mailin A dress of Number Block Numb r L City, State Zip Code Phone Number Subdivision Name or CS r PE OF BU ILDING ' (check one) ❑ State Owned ❑ It� Barest Road Public 1 or 2 Family Dwelling - No. of bedrooms Town O r III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 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. 5M New 2. [] Replacement 3. ❑ Replacement of 4 Reconnection of - - - - -- System -- - - - - -- 5yrs em - - - - -- Tank Only ❑ . 5. [] Repair of an ---- - - - - -- Existing System _ Existin9 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 CM Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit Iw X $ * 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 1 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. nch) Elevation RTRI }" Feet Feet VII. TANK Capacity INFORMATION in gallons Total # of Manufacturer's Name Prefab_ Site Fiber- Ex p p - New Existing Gallons Tanks Concret e Con Steel glass Plastic A p p Tank Tanks strutted E eplicuTanTjpoll _ 1 p ank /Siphon Chamber ❑ ❑ I ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the ndersigned, assume responsibility for inst lation of the onsite sewage system shown on the attached plans. Plum r' am . (Pr' \ Plumbe 's Si a r No ps MMP/MPRSW No.: Business Phone Number: t _ _ P u tier's A dress (Street, Ity, State Code): .7 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin ent Signature (No Stamps) Approved []Owner Given Initial I V Surcharge Fee) Adverse Determination Sp f X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11197) DISTRIBUTION: Original to County, One copy To: Safety a Buildings Division, Owner, Plumber • 7j � �/��i�.n1�,r /U�J � / -s�J �/ � s'K.c�7 �' /�i/- � /�lrJ ly 1 AE Aid lofi�,� i yY _A( ( ,,� lie) i� Wdlz W6econsin Zepartment 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 in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and C� percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 3_ APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). e. Property ( ner Property Location J4 AY_ I�F Govt. Lot 1 /4S� 1 /4,S� 7 T. N,11 E (or Property Owner's Mailing Addr ss Lot # Block�k Subd. Name or CSM# - City Stat Zip Code Phone Number ❑ City ❑ Village ® Town Neare New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate , bed, gpd/ft gpd /ft Absorption area required 4 3 bed, ft � trench, ft Maximum design loading rate , bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) / ft ( s referred to site plan benchmark) Additional design /site considerations G Parent material —a� Flood plain elevation, if applicable ft S = Suitable for system I Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system 1 0 S ❑ U NS ❑ U Es ❑ U 0 S ❑ U ❑ S ® U EIS 91 u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 J in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground elev o - ft• r Depth to limiting y� factor Z-9 in. Remarks: Boring # 1 9 Ground elev. Depth to limiting factor Z�in. Remarks: CST Name #ease Print Signatur Telephone No. Address Date CST Number -? -47 �Z,,I, t - f y o : 1 do a I J��PgL'�fRP t6L Jizf�it,�x �h2 ;.� /o 211 98 ,04-1 Wisconsin Department Industry, Labor and Human Rela SOIL AND SITE EVALUATION REPORT • Division of Safety &Buildings Page — 1 — Of 3_ y 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. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Jeffrey A. Rhein GOVT. LOT NW 1/4 STj 1/4 17T31 N,R PROPERTY OWNER':S MAILING ADDRESS 18 f fir) W 967 Sterling Ave. N. n/a Bn�a# SUn /aAMEORCSM# CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE Maplewood, PIN. 55119 (61P 739 -0253 SOWN NEAREST ROAD Star Prarie 214th. AVe. (xkNew Construction Use Residential / Number of bedrooms 3 ( I Replacement . ( J Public or commercial describe (1 Addition to existing building Code derived daily flow 450 gpd Recommended design loading rate • 7 2 8 9 9 bed, gpd /ft trench, gpd/ft 2 Absorption area required 643 bed, ft 5 6 3 trench, ft Maximum design loading rate . 7 bed, Recommended infiltration surface elevation(s) 1 n 3 - 2 5 — n n or 1 s enc ft • 8 trench, gpd /ft - ft (as referred to site plan benchmark) Additional design /site considerations r .I1 hes ,Zta=i ng at 1 Q3 25' and fell n Parent material outwash g 3 5 ' hP1nw c„rfano el Flood plain elevation, if applicable n/a ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem kiS ❑ U US El �S E3 )US ❑ U ❑ S �U ❑ S iaU SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Texture Mottles Structure PD/ft in. Munsell Qu. Sz. Cont. Color Consistence Bouxry Roots Gr. Bed Trends 1 1 0 -9 10 r3 4 2., none sl. m/ r mvfr a/w 2/m .5 .6 2 Q -86 10yr5/4 none .ls. 0 /sg ml na/ 1/m .7 .8 Ground elev. 109 Depth to limiting factor Remarks: Boring # P6&10yr4/4 0yr3/4 none sl. 2 /m /gr mvfr g/w 2/m .5 .6 none Is. 0 /s¢ m1 g/w 1/m .7 '. 10yr4/4 none Ground sil. 2. /m /sbk mfr g/w 1/f .5 L6 elev. 109 10 yr 5 / none S. 0 /sg ml n/a n/a .7 .8 Depth to limiting factor >86" Remarks: CST Name:—Please Print ax Phone: — Address: v — 0 T Signature: Date: CST Number: r 7 -20 -93 estm 2298 . STEEL'S SOIL SERVICE Gary L. Steel v e . C.S.T. 2298 Jeffrey A. Rhein 2s&1Nxshx1KftM MPRSW -3254 NTA SW] T- New Richmond, WI 54017 S 17 - T 31 T. !218 W (715) 246 -6200 town of Star Prarie `9 -2,0 1� 10 �b V o @ a� Gary L. Steel 7 -20 -93 . --------- ST CROIX COUNTY �r SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer R c k c " Ci G , LA Mailing Address R I'Z N '�` /A w 1 5 Proms Address X11 Z - 114 � � - Sevr�ers e i" W, Stf (Veri fication to u "-- q reed from Pl AW% Department for new commUction) CiRy/State S o , ,-- 's e zS'' peel Identification Number 0 -7 3 30 -d oo � G�DESCRIPTION Property Location to Y" S w %, Sec. 12 - T 3 N. _.�.. R_LL_W. Town of ri Subdivision 2 Lot # —,�,,,,�. Certified Survey Map # 3 / 3 Volume ,Page # 4 t? 3 Warrsnty Deed # FS � Fro � C� � Volume 13 6 8 � . page # 7 d Spec house ❑yea fk no Lot lines identifiable ; Z yea ❑ no SYSTEM NL,►iN't�Ne tv�r consists o lmproper use sad maintenanceof your septic system could result in its premature failure to handle wastes. Y Pumping out the septic tank every three years or sooner, if needed a becused � maiatenan can affect the function of the septic tank as a treatment mper. what you put into the sys tnurrt stage in the wale disposal system, mastetpl 'J ou propert own a to nst ro St Cmix Zoning Department a ecrtiftcation form, signed by the owner and by a is is plumberor a licensedpumperveritying that (1) the on -site wastewater PmPer operating Condition and/or (2) after inspection and pumping (if necessary). the septic tank is less than 1/3 fag ofsludgc. Uwe. the undersigned have read the above requirements and set forth, hert:iq as set by the Department of agree to maint the private sewage disposal system with the saadards s that your Conm� and the Department of Natural Resources, Stator Wisconsin. Cettirmation s � e septic ayatem has been maintained must be completed and returned to the St. Croix County Zoning OESce within 30 f �� expiration date. SIGNATURE OF AppUC / - - -� DATE OWNER CERTIFICATION 1(we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owneKs) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE `••`•• Any information that is mis represented ntay result in the sanitary permit being revoked by the Zoning Department. •'•••• Include with thus appllcatioa: a stamped warranty deed from the Register of Deeds ounce a copy of the certified survey map if reference is made in the warranty deed 341313 3i3�3 FILED J SW CORNER CERTIFIED SURVEY MAP �. � A., SECTION 17, Corte T 31 N R 18w COUNTY SECTION E CORNER MONUMENT .vL.P - L AUE2 LANl2 L TaWN _ �� V- - —_ -� = _S 0 0 2 9' 03 " E 674.47' WEST LINE OF SW 1/� 9 N0 "W , " S 88 °50'34 "E W I/4. CORNER >K /0 0 270.9 1 b ` 8.14 SECTION 17, $ 1 66' 8•• M POINTOF BEGINNIN T31N R18W EAST I RIGHT- OF -WAY N - LINE COUNTY SECTION * rn CORNER MONUMENT 0 ~ 1 0 1 0 2.58 AC. en LEGEND co 2 "x30" IRON PIPE, WEIMING 3.65 # /LINEAL FOOT, IQ 1 9' „ SET. IQ 28;36 \O M N \ \ 89 ' 6? O 1 "x24" IRON PIPE, WEIGHING 1.68 /LINEAL FOOT, U N PLATT EDI 1 � 96.\,z SET. N LAND 1 = a — - FENCE * ~ U N PLATTE D 1 N LAND CD °° 2 6 NW— SW 3.15 AC. so I a� U) In 0 JUN 2 9 1977 �� 5G pNSa00 tc) CD ° .a �•�, °0 ST. CROIX COV 1Y '% WWI W z 2 70.97' �, COMPU+e M rMUS PL406~ : WALTER J. 41 0 N 0 35 '3 8 "ux AND zorM40 C40N M GREGORY d 122.12' 148.85' .� S -1224 1 `° APPROVAL OF THIS MINOR SUBDIVISIO RIVEWiFALLS, ri HOES NOT MEAN APPROVAL FOR SEP?1 �r , I '•f� °�`�� .......••• 4 o 16 N 2.24 Ac. o ~ SYS . ! R TO H62.20 ,�� ®153 ° 02'15" � M O N O I ASSUMED BEARING 'k S 37 0 13'56 " W a `9 a °\ WEST LINE OF NEI /4 -SW 1/4 *20 ° N 0°35'38 "W w- °� 317 .1\4 M SCALE IN FEET 10,1 N 19 -17'2 8 W 80 0 UNPLATTED 128.97 O � , , 1 I 4 m m O' 200 40 600 SAND , 2.04 AC.108o - m I 157° CD �8� '3 v) p Z 6\• OWNER & SUBDIVIDER "' ep 1 S A�°I'; �F',�� A� O� \ Bikini ATTC11 Ed Germain