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12 St. Groix County Sanitary Ordinance
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COTITUNITY DEVELOPTUENT DEPARTT$ENT
ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, Wl 5401&7710
(71 5)38&4680 F ax (7 15)2454250
x 1'l.inches in size.
Countygg@BgDtfitrli*'E Check if revision to previous application
lnformation - Please Print all lnformationt.Location
1t4 1/4, Sec 3
T R EN,
Property Owne/s Mailing
<2q{
Address f
,,1*, *)r t/
Lot Number
./--
Block Number
City, State1//,*/,.)1il
Zip Cade
.{.{n,H
Phone Number SuMivision Name or CSM Number*&tu^<."Ls+*
Type of Building: (check one)
( t or 2 Family Dwelling - No. of Bedrooms:
E Public/Commercial (describeuse):
E State-owned
ll ,/4
1E Repair
one
RejuvenationA)Reconnection 3E Non-plumbing
Sanitation
U Village fll-Town of
B)E State Sanitary Permit was previously issued
Permit Number Date lssued
lV. Type of POWT System: (Check al! that apply)
El Non{ressrrized lnground
El Sand Filter
E Pressurized lnground
E At-grade
g1 Mound < 24 in. suitable soil g y6un6 a+g
E Peat Filter E Ddp Line
Q Single Pass E Offier
E RecirculatingEAerobic Treatment Unit
Mound > 24 in. suitable soil
Constructed Wetland
V. Dispersal/Treatment Area lnformation:
1. Design Flow (gpd)
.1r,n
2. Dispersal Area
Required
6. System Elevation 7. Final Grade
Elevation
3. Dispersal Area
Proposed
4. Soil Application Rate
(Gals. /day/sq.ft.)
5. Percolation Rate
(Min./inch)
Capacity an Gallons Fiber-
glass
PlasticVl. Tank Information
New
Tanks
Existing
Tanks
Total
Gallons
#of
Tanks
Manufacturer Prefab
Concrete
Site Con-
structed
Steel
2r,r,>rl 31vy I tr tr -g tr D
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Vll. Responsibility Statement
l, the undersigned, assume responsibility for repair/reconnection/rejuvenationfinstallation of non-plumbing for the POWTS shown on the attached plans. A
license is not required for tenalift repair or the installatioy'of non-plumbing sanitation system.
Y:Y.0P1.,,,,MP/MPRS No.
J2,'/J/-5
Business Phone Number
7t 1= <,Pl- 'z?t 7
Plumbe/s Address (Stfeet, Qity, State, Zip Code) / I )
-a;V/ -<@ r4/2. z')*<n;-,o/^ t, lr ,<-h-sr,
Vlll. County Use Only
tr Approved
I Disapproved
I Owner Given lnitial Adverse
Determination
lssuing Agent Signature (No stamps)Sanitary Permit Fee Date lssued
rX. conditions
tfri;ffifiir"trns
for Disapprovar: g;
l. Septic tank, effluent filter and dispersalcell
must be serviced / maintained as per
management plan provided by plumber.
2. All setback requirements must be maintained
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Innovation, QualiA
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Since 1965
wieserconcrete.com
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RECEIVED
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ST.CROXCOUNTY
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Maiden Rock, WI (800) 325-8456 Fond du Lac, WI(800) 641-5937
Portage, Wl(800) 362-7220 Spooner, Wl(800) 336'3416
Roxana, lL (618) 251-9210
STEEL HOLDING TANK DESIGN
Single Tank Option
INDEX AND TITLE SHEET
Hanson Family Real Estate TrustProject
Owner
Address
Hanson Family Real Estate Trust
5295 Neal Ave N
Stillwater MN 55082
Legal Description sec3-T31N-R1BW
Township Star Praairie
Subdivision Name
Parcel lD Number 038-1017-50-000
Plan Transaction lD Number
County St Croix
Lot No.
lndex and title sheet
Holding tank specifications
Site plan
Maintenance and contingency plan
Page 1
Page2
Page 3
Page 4
Designer
Signature
Kim A
,tr-'<i-,t* 1-.trit *lZ €*zrr-.
Phone No. 715-381-7917
Date 08121122
Designed pursuant to:
Holding Tank Component Manual For POWTS (Version 2.0)
sBD-10855-P (N. 03/07, R. 01/12)
License Number 224263
Version 7.0 (11112)Page 1 of 4
HOLDING TANK SPECIFICATIONS
P holdi tank ca
TMC
steel
SJE Rhombus
HW 101 lAlarm mo<
ank m number
manufacturer
I number
Number of bedrooms
Non-residential estimated flow (gpd)
Minimum holding tank volume required (gal)
Tank Dimensions and Data
38.0
8.0
120.0
58.0
Tank manufacturer
Tank Anchor Calculations
lbs Weight of tank
Safety factor
lbs Weight of anchor required
in Soil cover req. for anchor, or
yd3 Concrete counter weight
4
2000.0
vent
cap
finished
grade
J
junction
box
5500
1.50
11676
29.0
2.9
€23 " min
tether
weight
/
T
Liquid depth below inlet invert (in)
Maximum depth of soil cover (ft)
Lenoth (in) 'r
Diarieter i,nl J outside Dimensions
HOLDING TANK CROSS SECTION
manhole cover with
lockino device and
1- warniig label
12" min.4" min.
18" min
building
sewer inlet
Electrical is as
per NEC 300
and SPS 316.
blind
plug
to seal
outlet
Note: All tank joints,
and joints between
tank openings and
piping are sealed
water tight. Pipe and
vent materials comply
with SPS 384.
12 in service
26.0 in
Manhole and vent locations
may be reversed.
3 in. bedding under tank. Tank is anchored as necessary to negate buoyancy.
Because of this tank's rounded surface, soil cover alone may not be adequate to prevent flotation'
Project: Hanson Family Real Estate Trust
Transaction Number:
conduit
->vent pipe
Page2 of 4
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HOLDING TANK MANAGEMENT PLAN
This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and
maintained according to SPS 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P
N. 03/07, R. 01/12), and the St Croix County Sanitary Ordinance.
1. This POWTS is designed to accommodate a wastewater flow of 80.0 to 400.0 gpd.
2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in
the attached Holding Tank Servicing Contract and Maintenance Agreements.
3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet
(at which time the alarm activates), the pumper listed in the current Servicing Contract must be called to
empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code.
4. At each service event, the service provider should visually inspect the condition of the tank, risers and
manhole cover(s) and verify that the alarm system functions and manhole locking devices are present.
Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions
shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code.
5. All service events or inspections of this POWTS shall be reported to the county within 30 days.
6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed
by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes from this hold-
ing tank to the ground surface, including intentional discharges and discharges caused by neglect, consti-
tutes a failing POWTS and may result in issuance of correction orders or a citation by the coun$ or state.
7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
8. ln the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may
be installed in the same location (a new sanitary permit is required for such a replacement). Connection to
municipal services would also be considered at this time if they are deemed available to the property.
9. lf this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in
accordance with SPS 383.33 Wis. Adm. Code.
10. lf there is a problem with, or question about this installation, the following persons should be contacted:
a. Installer Kim A Oconnell Phone: 715-381-7917
b. Service Provider Phone
c. County Zoning or Health Dept.St Croix County Zoning Phone. 71 5-386-4680
11
Project: Hanson Family Real Estate Trust
Transaction Number:Page 4 of 4
ST. CROIX COT'NTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR IJTILTZATION OF EIilSTING SEPTTC TANK(S)
This is to certiff that I have inspected the existing septic and/or dose tank
presently serving the following residence:
(Street address located
at: _t/a,Section Town_;fl!_N, Range 121--W,
Town of St. Croix Counfy Wisconsin.
Upon inspection, I certiff that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (the,
appear(s) to be functioning properly.
Most recent date of inspection or service
Did flow back occur from absorption system? Yes- Nol
(if no, skip next line.)
Approximate volume or length
Tank Capacity:
Construction: Prefab Concrete
Manufacturer (if known) :72/c
Age of Tank (if known):
Permit (if known)
Plumber (Print ame)
/r/*s .-?.24JL3
)
(Title)(License Number) MP/}VIPRS
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Fiev.2l20l2
of,time: sallons minutes
/"H,^,imilK-
-31eel
Y other
Partel #: O38-1O17-5O-OOO Valid as ot OBlL9l2O22 09:24 PM
Alt. Parcel #: 03.31.18.59
Owner and Mailing Address:
HANSON FAMILY REAL ESTATE TRUST
5295 NEALAVE N
STILLWATER MN 55082
Distrlcts:
TOWN OF STAR PRAIRIE
ST. CROIX COUNTY, WISCONSIN
Co-Owner(s):
Physlcal Property Address(es) :
I. 1156 CTY RD H
Dlst#
3962
1700
8050
Plat* N/A.NOT AVAIIABLE
Descrlptaon
SCH DIST NEW RICHMOND
NORTHWOOD TECH
CEDAR I.AKE/N R
Parcel History:
Date Doc #
o2l2sl20r9
o8t24t20Ls
09ll5l20l4
10/09/1990
Vol/Page
I
I
I
883ns4
BlocUCondo Bldg
rYpe
QC
EZ-l
WD
WDAbbrevlated Acres:0.000
Description:
SEC 3 T31N R18W PT GL5 COM C HWY 799FT
E OF W LN WLY ON C HWY 161FT N TO SHORE
CEDAR LAKE SELY ON LKTO PT N OF POB STo..' more"'
more..
Tract (S-T-R 40% 160% GL)
03-31N-r.8W
2O22 Valuatlons:
Class and Descrlptlon
GI.RESIDENTIAL
Totals tor 2022
General Property
Woodland
Totals lbr 2O2l
General Property
Woodland
Acrrs
0.000
0.000
0.000
0.000
0.000
t.and
s7,300.00
Values Last Changed on 10/21l20L9
lmprovement Total
80,600.00 137,900.00
57,300.00
0.00
57,300.00
0.o0
80,600.00
0.00
80,600.00
o.00
r37,900.00
0.00
137,900.00
0.00
2022 Taxes
Taxes have not yet been calculated.
Key * - Primary
Quit Claim Deed
Document Number
This Deed, made between Richard Gilbert Hanson and Teri
Ann Hanson. husband and wife ("Grantor", whether one or
more), and Richard G. Hanson and TeriA. Hanson, Trustees,
or their ors in Trust, under the Han Familv Real
da
thereto. ("Grantee", wh one or more)
Grantor quit claims to Grantee the following described real
estate, together with the rents, profits, fixtures and other
appurtenant interests, in St. Croix County, State of
Wisconsin ("Property"):
See attached Exhibit A for legal description
Dated t n
*Richard Gilbert Hanson
Authentication
Signature(s)authenticated on
:t
Title: Member State Bar of Wisconsin
(lf not, authorized
by Wis. Stat. 5706.06)
il llllililltilillililililill8567085
Tx:4481345
to7aL70
BETH PABST
REGISTER OF DEEDS
sr. cRorx co., wr
o2l2slZOL9 12:01 PM
EXEMPT#: 16
REC FEE 3O.OO
PAGES:2
Recording Area
Return to:
Attorney Dallas E. Klemmer
PO Box 26
Keaau, Hl 95749
038-1017-50000
Parcel ldentification Number(s)
This is not homestead property.
*Teri Ann Hanson
State of Minnesota
r&.
Acknowledgment
)
County )SS.
Personally came before me on )dlfleabove-
named Richard Gilbert Hanson and Teri Ann Hanson
to me known to be the person(s) who executed the
foregoing instrument and acknowledged the same.
\d/k+/
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fr
This lnstrument Drafted By:
Attorney Dallas E. Klemmer *
Notary Public, State of
3
aj
St. Croix County 1O78170 Page 1 ol 2
My Commission expires
"it':. EIi"''AflD,' i4ATTHEIVS
-i. ., ilOilpJ IrUij_jC. i4NtvESOTAr. .r ,;'1 i,Wtrni:;ai3n !rr,.r:i.l4n 3., ZCr
Exhibit A
Part of Government Lot Five (5), Section Three (3), Township Thirty-one (31) North, Range Eighteen (18) West, Town of
Star Prairie, St. Croix County, Wisconsin, described as follows:
Commencing at a point in the center of highway, as now located, running East and West through the West Half of Lot 6
in Section 3, Township 31 North, Range 18 West, said point being the Southwestern corner of that certain piece of land
deeded to James Thompson in Volume 777,Page 599; running thence Westerly along the center of said highway for a
distance of 102 feet; thence Northerly to the shore of Cedar Lake; thence Easterly along the shore of Cedar Lake to a
point directly North of the place of beginning; thence Southerly to the place of beginning. EXCEPT the East 55 feet as
measured along the highway. Subject to County Highway "H" right of way.
Tax Parcel Number: 038-1017-50-000
St. Croix County 1078170 Page 2 of 2
SANITARY SYSTEM
OWN ERSH IP/ADDRESS FORM
File #:
Office Use Only
Creoted 2/2021
Community Development Department will utilize this information to provide the property owner with
information regarding operation and maintenance of your new or replacement sanitary system! This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
sudace water, property values, and county resources. Once approved, this completed form and educational
information will be sent to you by email.
. :-... , : :: _ r. _' . .irii_--:'.::r. -,i. :._::j.:i,:r r-.: O. WNER/EUYER INFO,R.IYIAT!.Q[.'..','' '
Owner/Buyer
Mailins Address tr2fl= \qrr-\ $*fe \\orHn
City/State/Zip
Phone Number lreq
Email Address (required) NJA
Parcel ldentification Number
(found on the property tax bill)
NEW TSYSTEM: LEGAL DESGRiPTION
property Location F=--rr,U 1/a , sec.D3, JLrrr nlLw, Town "t Shf PQ,tfie-
Subdivision Plat:t\W Lot #
Certified Survey Map #Volume_---____-_______ Pag e#
Warrangr Deed #before 2006)Volume Page #
Number of bedrooms Spec house tr yesF.no Lot lines identifiable dyes O no
1.,.,,., -
New Property Address
(Staff lnitials)
(Verification of new address required from Community Development Department for new construction.)
//
(Date)
This form must be submitted with oll Privote Onsite Water Treatment System (POWTS) opplications.
New Systemz lnclude with this form a recorded worronty deed from the Register of Deeds Office ond o copy of the certified
survey mop if reference is made in the worronty deed.
71 s-386-4680
cdd@sccwi.gov
Community Development Department - Land Use Division
St. Croix County Government Center
1101 Carmichael Road, Hudson, Wl 54016
715-245-4250 Fax
www.scani.gov
@lan'a Drawtnq Room 2O2l
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Community Development Department will utilize this information to provide the property owner with
information regarding operation and maintenance of your new or replacement sanitary system! This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, property values, and county resources. Once approved, this completed form and educational
information will be sent to you by email.
Owner/Buyer
OWN ER/BUYER I N FORMAT!ON
Richard & Teri Hanson
SANITARY SYSTEM
OWNERSHIP/ADDRESS FORM
File #:
Office Use Only
Creoted 2/2021
Mailing Address 5295 Neal Ave N
City/State/Zip Stillwater, IVN 55082
651-308-8913Phone Number
teri hanson 1 3@g mai l.comEmail AddreSS (requi
parcet tdentification Number 038-1 01 7-50-000
(found on the property tax bill)
NEW SYSTEM: LEGAL DESCRIPTION
P rty Location N 1/t
Plat:
wyq , Sec 03 -lB w, r o1 Star Prairier31 NR
Su DcveA o g rL _, Lot #I
#Volum Pag e#
(before 2006)Volume Page
Number of bedrooms Spec house tr yes f, no Lot lines identifiable,( yes tr no
This form must be submitted with oll Privote Onsite Water Treotment System (POWTS) opplicotions.
New System: lnclude with this form o recorded worronty deed from the Register of Deeds Office ond o copy of the certified
survey mop if reference is mode in the worronty deed.
o
71 5-386-4680
cdd@sccwi.gov
Community Development Department - Land Use Division
St. Croix County Government Center
1101 Carmichael Road, Hudson, Wl 54016
715-245-4250 Fax
www.sccwi.gov
OFFICE USE ONLY
New P Address ttf6 w RD r+
(Verificatjon of ngvy addressz/ t?/,a23
required from Community Development Department for new construction.)
itia ls)(Date)
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Tax Key
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Deocription
Tax Year
Legel Description
HANSON FAMILY REAL
ESTATE TRUST
038-1017-5G000
03.3 I .1 8.59
TOWN OF STAR
PRAIRIE
2022
SEC 3 T31 N R! 8W Pi
GLs COM C
HWY 799F? E OF W LN
WLYON
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Frrsr Name
Middle Name
Last Name
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,s4, cRoIX CO(-UYTY Nro.#iY::
SAI{ITARY PERMIT
.REPAIR fl
nrcbuugcrror.r (
NON-PLUMBtNG E
SANITATION
REJUVENATIoN tr
purpose of the sanitary permlt Is to allow repalr, reconnecflon,
or installatlon of non-plumblng sanltaflon as descrlbed in the
for permit.
The approval of the santlary permlt ls based on regulaflons ln forcs on
date of lssue.
(o) The sanltary permlt ls valld for 2 years from origlnal date of issuance and
be renewed for slmllar perlods thereafter. Appllcailon for renewal shall
through the county and shall comply wlth regulaflons ln effect at the
Changed regulatlons wlll not lmpalr the valldlty of a sanitary permit until
tlme of renewal.
(e) Renewal of the sanitary permit wiil be based on regulations in force at
tlme renewal ls sought. Changed regulaflons may lmpede renewal,
(f) The sanltary permlt ls transferabre. A sanitary permrt transfer shail be
obtalned from the St. Crolx County Zonlng Department.
OWNER
PLUMBER
TOWN OF
LIC. #
LOCATED
24toiII
WPTq sEC 03_ r 3l N;R \8w
AND/OR LOT --BLOCK
-
THIS PERIVIIT EXPIRES
SUBDIVISION lf you wlsh to rensw the permit, or transfer ownershlp of the permit,
contact the St. Crolx
AUTHORIZED ISSUING OFFICER - DATE f?7
UNLESS RENEWED BEFORE THAT DATE
TWO YEARS FROM ORIGINAL DATE OF ISSUANCE
POST IN PLAIN V IEW
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REZONING QUESTIONAIRE
All rezonings are to be consistent with County land use plans, County ordinances and other applicable local plans.
Your application will be reviewed by staff and presented to the County Community Development Committee for
consistency with the following ordinances and plans: St. Croix County ZoningOrdinance (Ch. l5), St. Croix County
Land Division Ordinance (Ch. 13), St. Croix County Sanitary Ordinance (Ch.12), St. Croix County Comprehensive
Plan, St. Croix County Outdoor Recreation Plan and the St. Croix County Land and Water Natural Resources
Management Plan. It is the applicant's responsibility to show that their proposed use is substantially consistent with
these ordinances and plans. Each ordinance and plan is available for review by contacting the Community
Development Department or on the County website at: www.sccwi.sov.
To assist in determining how your proposed use relates to the aforementioned ordinances and plans, please answer the
following questions on a separate sheet of paper and include them with your application materials.
l) Explain why you wish to rezone this property. Identify the proposed use if rezoned.
2) Explain the compatibility of your proposed use with uses on existing properties in the vicinity of this site.
3) Explain any interaction that you have had with the Town in which this property resides and elaborate on any
concerns they may have with your request.
4) Explain how the proposed use will affect stormwater runoff, wetlands or will impact any shoreland areas.
5) Discuss if the site has any wildlife, scenic or recreational value that should be protected or enhanced. Indicate if
you are willing to pursue such efforts as part ofyour proposed use ofthe property.
6) If the proposed use is residential development please submit a concept plan of an anticipated lot layout and
describe any significant features on the site (wetlands, floodplain, poor soils, steep slopes, etc.) that either support
development or are challenging.
7) Discuss any additional issues your feel that supports the consistency of your proposed use with County ordinances
and plans as well as any Town ordinances or plans.
8) lf proposing to rezone out of the Agriculture Zoning District, explain how your request does or does not comply
with the following (Wisconsin State Statute $ 91.a8):
(a) That adequate public facilities to accommodate development either exist or will be provided within a
reasonable time.
(b) That the provision of public facilities to accommodate development will not place an unreasonable burden
on the ability of affected local units of government to provide them.
(c) That the land proposed for rezoning is suitable for development and development will not result in undue
water or air pollution, cause unreasonable soil erosion or have an unreasonably adverse effect on rare or
irreplaceable natural areas.
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