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HomeMy WebLinkAbout038-1048-40-000TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic 2�S Z(o 0 Dosing Aeration Holding -- TANK SETBACK INFORMATION TANK TO P / L WELL BLDG. Air ,, intake ROAD Septic > 1 SI I 1 NA Dosing .-,---NA Aeration A Holding =_= --_-- - _ _._ _.� PUMP / SIPHON INFORMATION Mant4,acturer Dem Model Number, - GP TDH Lift ction System TDH t e may, Forcernain Length Di a. ° oweu Wisconsid Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City ❑ Village ❑ ToWn of: Campeau, Kevin Star Prairie Townshi] CST BM Elev.: Insp. BM Elev.: BM Description: b, FI FVATInm nATA County: St. Croix Sanitary Permit No.: 370374 State Plan ID No.: Parcel Tax No.: 038-1048-40-000 //. ,3,(_ l8. 205 H STATION BS HI FS ELEV. Benchmark 3. (..p o3.Go I om , o Alt. BM ,� )oy.LfS r Bldg. Sewer "Z(o0 Iell • 0 / St/Ht Inlet Ito•-so1 St / Ht Outlet oo . t)5 f Dt Inlet Dt Bottom Header/Man. -aist-i�ipeT 5 a 9 • q o 0 93 • o' Bot. System II• ° •Z° 1Z , 01) Final Grade ac e1 St cover PIT DIMEN 1 N LAKE / STREAM No. Of Pits LEACHING CHAMBER OR UNIT Inside Dia. Liquid Depth Man fturer: -'(�t , — S.w►►,d►� RIINC DIME SETBACK INFORMATION Width 1 Length No. Qf Trenches q3' SYSTEM TO P / L BLDG WELL Type O System: V. r 2.0 (os y Model Number: DISTRIBUTION SYSTEM Header/M nifold ` /'y Di Length Dia. 'T Cf%11 x Hole Size I x v Praccllra iurtPm-cOnly xx Mound Or At -Grade Systems Only ent To Air Inta '>,3C)/ Depth Over Depth Over xx Depth Of xx Seeded / Sodded I xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 3 Inspection #1: 0` 17,0/0 / Inspection #2: '� T— Location: AW 122nd Street, New Richmond, WI 54017 (SE 1/4 SW 1/4 11 T31N R18W) - 113118205A 1.) Alt BM Description = Y` ILI 2.) Bldg sewer length = O „ -amount of cover = 1 i 8 �I Levu ' ��� r � ux � Z " l 3) �c..�., ,A�--'too �•��..wi''�+''"w �e�✓ (. J Plan revision required? ❑ Yes $�7No C Use other side for additional information. ro� 1 o © � spa 1 Inspector's Signature Cert. No. SBD-6710 (R.3/97) �j �^^�_ n„ S ADDITIONAL COMMENTS AND SKETCH -,-"' S °� -} " -)t 1 Sanitary Permit Application Suety & ntutatngs ulvts'z. 201 W. Washington Ave• In accord �� sIh C�mno $3,�1. t'r iS• Adm Codr PO>30x?302 See rcversc sirle to tag this application Madison. WI 33707.730- .; for cr Dopa•:rr*m of Cemmrrao Fcrsonai information you provi,.c may br. used for secondary• purposes u prove uscd (Pdvacy Ljw. g 15 J4(1-)krn)j, (Submit oornpleted form to county Ifr� state owne( Attach Complete _ Plans (to the count) cjo❑I� r he Nstem. ,m a er yle than B-l/2 ti I inches in size. COut1 State Se>litery Permit N rttbCr CJ�C iTrevislo tevf s >ippliWti017 State Pl,n I. D. Number 1. Aa l�InfO tion - Please Pratt all information �—- Laaa1(on: Prop�Ryof erne 2r, L�iiU _ . proper: L.aeation � C j, J 114SL- 14.5�/ 7' N R apartyOwraes Ma A res: a v LoiNumber IJlock Nu r COUNTY V ZON Ciry, tam Z p Code 1404 Numtwr , ' Subdivision Nante or CSM Number 11;1 __�__�--- li Type of Building: (check one) ` AIC 1 or 2 Family Dwelling - No. of bedrooms: In Cli O wire Q Pub1k/CcrnmaroW (describe use), Tollage of / Q State-owned f III 'Typaof Permit: (Check only one box on line A Check box on lint B '.f 2L7plicablr) Nearest ad /T7 A) 1. !°New System Z. ❑ Rcpiaecment 1 1 M Repk ecmenl of t. ❑ Addition to part'; l ax Numbn(s) system faa Onl•• Existin& S stem ' TU 0 - �d Fennit Number (�. 3/- I . ZO��1 ate Iss wid O A Saal P it was rt:v(au ilstsed IV. Type of 3POOWT Systenn: (Check all that apply) 'ONenrpressurind In -ground D Mound ❑ Sand Filter G Constructed Wetland D Presn naW In -ground ❑ Holding Tank O Single Pass 0 Drip !.dire 0 At grade ❑ Aerobic Trs rnent Unit ❑ Recirculating O Olher: V Die ►/I'rUtra nt Area Information: (. Dos (W4) 7- aparaelluaa pt real Area 4. Sot Apo/ cuion S, Pereolauon Rat , 1y4l6m Elevation . F Grade /� Required Proposed Rate (Gals. deylsq. at) (Min.lincfo ,i� E Lion VI Tank Capacity in Tetai of Manuthmircr rcfeb site SNsI Fiber- PtartCicc ItetWorm1lou oat ons Gallons Tanks Con- Con- glass New Existing crete entered Trades Tusks z ❑ D � I - ❑ ❑ 0 0 VIi Responsibility Statement —0h5j,b11hy for inttdation of the POWT5 shown ei the attached plans, tuatees s Name (prim) Plurnba ' stun r,e statnps ; M iv PR5 N o. Bt,slrteas Numb" c � � f � l/ o PWmb&ii Address (Stier, Ck. State, Zip CWr VM ConatylDgmrtment Use Only D Disapproved San twy ertnit Fee (lneluces Grrt ndweter Ditto Issued law' sent rpnature No agtaps) 17i Approvbd ❑ Owner Given Initial Adverse Surcharge Fee) i nZZSU 1 ZoUcJ n� DL of Approval /Reas/on/s for Diertpproval: -)-�f /Conditions ` w \ ZOd�yt1 f0 .6 Poo' �Oe Ar•-� �\ 44 / CSC ly -10e bdaf 5ctevetie 1v allw ,�tr's v o6c SIRD-6399 (R 07M) PLOT PLAN PROJECT Kevin Camoeau ADDRESS 1245 Old Mill Rd. New Richmond Wi 54017 SE 1/4 SW 1/4S 11 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/27/00 BEDROOM 4 CONVENTIONAL )00( IN OUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 Gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 514 # of chambers 30 ENCHM V.R.P. Top of Nail in Oak Tree ASSUME ELEVATION 100' Filter Zabel A-100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Alt. BM a� Q SYSTEM ELEVATION 91.8 Top of Nail in Large Oak Tree @ 99.5 Vent > 12" of Cover 6' 16" Long N N B-2- 90, Vents 15Rep A 20' 45' B-4 5' Sidewinder High Capacity Leaching Chamber L-Grade at System Elevation Pro 4 Bedroom House B.M 20' 10, ST B-1 01 Vents -3 5 B 6 1 45' 7,77-7 Slope Property Line B-5 2-3'X 94' Cells with >3' Spacing Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of bureau of Integrated Services in accordance with $3,09, Wis. Adm. Code � Attach complete site plan on paper not less than 8 1/2 x 11 inches i �� F�fan mu include, but not limited to: vertical and horizontal reference point )�dfrectiT, County O 1, I A slope, scale or dimensions, north arrow, and location an +t nce to noar ''rrcc r}...dis_ percent 5 Parcel I.D. # APPLICANT INFORMATION -Please print all informatioii: Reviowed by Date Personal information you provide may be used for secondary purposes (Pri }acy I-aw, s. 15. D _Z_7ww.1 Property Owner tin Govt. Lot 1/4 1/4,S T I E (o W �� ,N,R Property Owner's Mailing Address tit #i j3j Subd. Name or CSM# City State Zip Code Phone Number ❑ city ElVillage ;Town Nearest Road Al- Construction Use:esidential / Number of bedrooms Addition to existing building ElReplacement // ❑ Public or commercial - Describe: Code derived daily flow 00 gpd Recommended design loading rate r � bed, gpd/ft2 T trench, gpd/ft2 Absorption area required T 5 3 bed, ft2 % ✓5 6 trench, ft2 Maximum design loading rater 7 bed, gpd/ft2�trench, gpd/ft2 Recommended infiltration surface elevation(s) fir•; /�� IL.P� f'z r��� ft (as referred to site plan benchmark) Additional design/site considerations �J Parent material Vi,r4,Flood plain elevation, if applicable r ft S = Suitable for system Conventional Mound In -Ground Pressure I AT -Grade System in Fill Holding Tank U = Unsuitable for system �S ❑ U ❑ U S❑ U ❑ U ❑ S RCu ❑ S U Boring # Ground elegy Depth to limiting factor Boring # f� Ground Depth to limiting S0II nFSCRIPTl0M RFP0RT Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 Bed Trench 31 S� ,� r s- a>� S . -.2 ., i C _ D Remarks: M MAW ©= -- _, ' � , fa to 7/-t in. Remarks: CST Name (Please P rint Address Signature Telephone No. s = 2V-6 - 4s c-�o Date CST Number i Stjoy Q 7- oo ,P- 6'� j 0 SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boring # S Ground / elev ft. Depth to limiting Horizon Depth in. Dominant Color Munsell Mottles Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots 2 Bed Trench Remarks: MM — >_ M I0�I . ME Remarks: Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 Bed Trench /'0 = 6i S CGs / )V)14 a Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R.9/98) Project Name Soil Test Plot Plan Kevin Campeau Shaun Address 1245 Old Mill Rd. New Richmond Wi 54017 Lot ----- Subdivision SE 1 /4 S W 1 /4S 1 1 T 31 N/Ri 8 W Township Star Prairie ❑ Boring 0 Well PL Property LineY, County ST. CROIX BM or VRP Assume Elevation 100t:�4op of Nail in Oak Tree System Elevation 91.8/89.7 *HRPSame as Benchmark CSTM #226900 Date 4/28/00 Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings Page of,_ in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County _� 6� /' -,N/ >C Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D. percent slope, scale or dlmenslons, north arrow, and location and distance to nearest road. -75 Please Print all information, eviewed by Date Personal information you provide may tie used for secondar y Purposes (Privacy Law, S. 15.04 (1) (m)}. Io _� Property Owner Property location Govt. Lot t 1145(_114 S" T N R E (or N Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# /z -- Clty State Zip Phone Number ❑ City ❑ Village Town Nearest Road B"New Construction Use,' I Residential / Number of bedrooms ` Code derived design flow rate _ �_ GPD Cl Replacement , i I ,� Public or commercial- Describe: Parent material—=51��r Flood Plain elevation if applicable General comments and recommendations: � C 171 Ong # ❑ Boring // j9- Pit Ground surface elev. � �ft. Depth to limiting factof/� in. ®® e• •.Redox CoDescription ® . ® • • ® 'a Boring # U Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. __ 'u. S Cont.z. Color ®®®® �•• a-e� av Z "V rIWL arm i m91L tmuent oz = 130u < 30 mg/L and TSS < 30 rng1L CS Name (Please Paint) �J Signature CT Number Address Date Evaluation Conducted Telephone Number ZAP ? f 2 ST CROIX COUNTY SEPTIC TANK MA.TNT8NA.NCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address /tea .Sf (Verification required from Planning Department for new City/State N/z/•t/ )e� &tail Parcel Identification Number � k ` 1D �I o U U LEGAL DESCRIPTION Property Locatianf�i '/,, 'A, Sect . T--N-R W, Town of Subdivision Certified Survey Map # Volume . Page # Warranty Deed # '-:: � 6 j Y4 Volume 4 Page # Spec house C1 yes ; 0 no Lot # Lot lines identiliables CJ no S_ YSTEM 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 agron 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 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 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain tl;e 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 day:sO the three 'ear a L'mtion date. GNA F APPL CANT DATE OWNER CERfiF_j A'nON (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 th p pe� �beti a e, by virtue of a warranty deed recorded in Register of Deeds Office. / GNATtJE OF —APPLICANT DATE I Any information that is mis-represented may result in the sanitary pen -nit 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 `� qq f� VOL 1226 PACE l 556340 I) STAI E BAR OF WISCONSIN FORM S — .982 PERSONAL REPRESENTATIVE'S DEED DOCUMENT NO. II Bonnie K. Campeau as Personal Representative of the estate of Merrill J. Campeau _ ('Decedent"), for a valuable consideration conveys, without warranty, to — Kevin Patrick Campeau, Jeffrey Allen Campeau, and John Michael Campeau, es Tenants in Common Grantee, the following described real estate in St. Croix County, State of Wisconsin (hereinafter called the -Property"): The Northeast Quarter of the Southwest Quarter (NL�SW_._) ?vi 0� f the Aa11 River, X the West three rods thereof; ghat part of the Southeast Quarter o Fie-�outhost Quarter 'SEj SW*) lying West of the Apple Rive__and r s f lath Street; thie Norfheast Quar er of ►1 3.3Tu-- ST. CROIX C ry, Y;1 rMV to Home MAR 5 1997 at 9 : 30 A. M -r.J G t.... 4k r t .., h�;;aer THIS SPACE RESERVED FOR RECORDING DATA - NAME AND RETURN ADDRESS Drafted by -1.,) 1 5h+ ('u.rn.+� r 3` 3 S+h Ajo PJ o 6 "�-t-t he Sdufheas er of th r w (NE SE NW ; and__that part of the Northwest PARCEL IDENTIFICATION NU ER Quarter of the Southeast Quarter (NW} SEJ)�\� o West of -the pl R ver; and Par o the Sou ua er of the No Northwest I� Quarte�(WNW}), own o Star Prairie, St. ZO�-- Croix County, Wisconsin described as follows: of Certified Survey Map fi ed October 23, 1995 in Volume 11 page 3003., as Document Number 535230, all in Section Eleven 11), Township Thirty-one (31) North, nge ighteen (18) West. Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the Personal Representative has since acquired. Dated this 14 day of C L � r—xA_ 19_97. 21 L1 (SEAL) (SEAL) -Bonnie K. Campeau Personal Representative Personal Representative AUTHENTICATION Signature(s) authenticated this day of .19 IITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) ACKNOWLEDGMENT State o: VA*Gan&W, i"t • nn PSot1 ss. %o.1-4 k ". e_ County. Personally came before me this ; *" day of Ft1D. , 195-1 , the above named Bonnie K. Campeau F f•�I to me known to be the person _-_ who executed the foregoing instrument and acknowledge the same. rt-I THIS INSTRUMENT WAS DRAFTED BY FILED MAY U 8 2'001 PREPARED FOR: CERT • ,� 15 � � U C� is �; �11 MAY 1 7 2001 SURVEY MAP PREPARED BY: DEVELOPMENT E LOCATED IN PART OF THE SE 114 OF & N LA S J. ZAHLERSURVEYING G INC.S. DEVELOPMENT INC. S & N LAND SURVEYING I 573 CTY. ROAD A THE SW 1/4 OF SECTION 11, T31 N, 2920 ENLOE STREET HUDSON, WI 54016 SUITE 101 R 18W TOWN OF STAR PRAIRIE, ST. HUDSON, WI 54016 CROIX COUNTY, WISCONSIN 49.5' ------------------------------------ PROPOSED TOWN ROAD T CENTERLINE S89037'09'W 317.38' 1� AS TRAVELED 59.62 C1 m Cn _ 300.89'_ _ — — 00 cOi� 0 C)'D ��� OC m V 0 rvl . . . . . . . . . . . . . C m� Dlzm N I \ wOm cKM am 2� OZ �!R p m m I DEDICATED TO wo' m � O I PUBLIC FOR 122ND °J a O STREET m _n m //AS E ( RIGHT-OF-WAY v0, ,- �i ao i 40* CID S89037135'W w30' DRAINAGE /rO .- 1 O 33. EASEMENT /co r�/t/ Z %��/ Note: Q Construction N I x within the drain- N117 age easement is 6 j< II 0 � �L prohibited. iC�) rn/0 N . I �tJig NEXISTING ��do js V 1� I a A% z GARAGE wAPPROVED co/ m0 j WELL--'"® \�\ \ ST. CROIX COMITY / n m w it ` P inninq Zoning and Parks Committe N CO N MAY 8 8 Z001 two M. EXISTING LOT y / O(0 HOUSE \ 1 not recorded within 30 days of m 5.284 ACRES cN proval date approval shall be -I (230,157 SQ. FT.) \a° �\ null and void 2 TO m_ w SW CORNER Cn � \m\w \ S1/4 CORNER SECTION 11 "S89*23'15"W / 102.73'N89°23'15"E1280.12' N89°23'15"E 400.00' SOUTH LINE OF THE SW1/4 LEGEND —2560.24'— 49.5, M[t�Jp��Ct CSD [�LQ[�DD - FOUND ALUMINUM COUNTY SECTION ----------------------- rnDKICD kAnkll ILACAIT