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HomeMy WebLinkAbout026-1165-15-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 648459 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Parcel Tax No: Todd Marek TOWN OF RICHMOND 026-1165-15-000 CST BM Elev: Insp. BM Elev: BM Description: Sectionfrown/Range/Map No: 22.30.18.1281 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO I P/L JBLDG 1WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR UNIT Type Of System: Model Number: DISTRIBUTION SYSTEM Header/Manifold I Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bedfrrench Edges Topsoil 0 Yes 0 No 0 Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 1436 129TH ST 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? [* Yes [* No Use other side for additional information. I� JI�I JI Date SBD-6710 (R.3/97) Inspection #1: Insepctor's Signature Inspection #2: Cert. No. SAN-2023-063 AarMe P Industry Services Division County 4822 Madison Yards Way Q Sanitary Mermit Number (to be filled in by Co.) $ V,�7 MAY 0 3 2023 Madison, WI 53705 P.O. Box 7162 Madison, WI 53707-7162/:;;�7 7 Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. I., Application. Information - Please: Print All Information Property O er's Name Parcel # /% Property Owner's Mailing Address Property Location /\ /1 Govt. Lot A] '/ �(�'/., Section City, State bew�IV 1 l�r� �lw/ Zip Code ' �` v/;77 Phone umber 1/ T 36 N R E II. Type of Building (check all that apply) of 7 Subdivision Name 1 or 2 Family Dwelling — Number ofBedrooms Opublic/Commercial — Describe Use 4 1/ /L /R?, Block # � ❑City of ❑State Owned — Describe Use illage of MTown of Vf!> CSM Number -E-DAC - X 1 III. Type of POWTS Permit: (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C i app icable. A. Wew System Y System []Replace'ment Y they Modification to Existing System (explain) ❑O g Y ( P ) Additional Pretreatment Unit (explain) ❑ ( P ) B. ❑IIolding Tank 4In-Ground ❑At -Grade ❑Mound Individual Site Design Other Type (explain) (conventional C. ❑ Renewal Before ❑Revision hange of Plumber ❑Transfer to New Owner ist Previous Permit Number and Date Issued Expiration , 3r )c 181. c IV. DispersaUTreatment Area and Tank Information: X d �� 43 S j,D Design Flow (gpd) Design Soil Application Rate(gpd/sf) Dispersal Area Required (sf) ispersal Area Propos d (sf) m El ion Q L Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units g�� Ui" �� I%�'� C o � 2 co M New Tanks Existing Tanks 0 a` U � Septic or Holding Tank 47J;_ [ Dosing Chamber GONC�� ❑ ❑ ❑ V. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's N e (Print) Plumber's Signature M' P% Number Business Phone Number sue/ Plumber's d ss (Street, City, State, Zip Code) 6L- G J�?� o VI. County/Department Use Only Approved ❑ Permit Fee $ Date Issued Issuing Agent Signature ❑ • en Reason Denial 3 �/ ry! • r 91ZD23 _ Conditions pprov n 1 ill Gt��.� I t 3� " Lam P vrh e'- LuP' lo23 r D 13 a,,—,1. ;IU SYSTEM OWNER: _ Septic tank, filter dispersal "'t+zSr''"'`�r effluent and cell must be serviced / maintained as per �� ,�,,, —C•Ng .. MLLAA--6e__ management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code / ordinances. w ­.P VtC ptaua tur Me system arm suormt to me t-ounty only on paper not less than S 1/2 x r t inches in size SBD-6398 (R. 03/21) 'k L� -� rl Altl 1,� >FK ,pp w,+ (L 1� Lot 15 Subdivision Lundy Meadows Date 8/11 /03 N 1 /2 SE 1 /4S 22 T 30 N/R18 W Township Richmond Boring Well PL Pr County ST. CROIX COPY .00 Q Property y Line BM r VRP assume Elevation 100 ft. Top of Survey Iron System Elevation 98.3/97.7 *HRpSame as Benchmark Alt. BM Top of 2" Pipe @ 100.2' B.M. 463' Property Line !15!1 B-1, 30' s% Slope S B-3 t 90' �C B-2LW�- 101' 103 -� q .-a 44 psi O a c� 0 M COPY Scale is 1 " = 40' unless otherwise noted .0 0 Pgof Private On -Site Wastewater Treatment System (POWTS) Index and Title Sheet Owner's Namc: Site address: Location: Lot Block , Subdivision/CSM being part of the 14of the l�� 1/a, Section TownJZ2 N, Range—&W, Town of Pierce County, WI. Parcel Identification # - - �- ®© Design: In accordance with Department of Safety & Professional Services (SPS) Wisconsin Administrative Code ch. SPS 381 through 387 and 391. Design manual (choose one): ❑ Holding Tank Component Manual [VER 2.0, SBD-10855-P (N. 03/07, R. 1/12)] In -ground Soil Absorption Component Manual [SBD-10705-P (N.01/01)] Contents: Page 1: Page 2: Page 3: 7 �� Page 4: G ��,<.�� o ,4/ Page 5: 0�C.. fck r Page 6: Page 7 : /�%i��'✓���� ��/� Page 8: Page 9: Attachments: Si Plumber/Designer: e t__L� 1_3/Wgned: _ Credential Number: 2 Date: 'k L� -� rl Altl 1,� >FK ,pp w,+ (L 1� Lot 15 Subdivision Lundy Meadows Date 8/11 /03 N 1 /2 SE 1 /4S 22 T 30 N/R18 W Township Richmond Boring Q Well PL Property Line BM or VRP assume Elevation 100 ft. County ST. CROIX Top of Survey Iron System Elevation 98.3/97.7 *HRpSame as Benchmark Alt. BM Top of 2" Pipe @ 100.2' Alt. B. t. U `t CD V INU N L 1207" TOP VIEW SIDE VIEW WLP1250-MR TANK SPECIFICATIONS t 0 DIMENSIONS; WALL- 2 1 /2" BOTTOM: SEPTIC 3" COVER: 5" z MANHOLE: 24" I.D. PRECAST CONCRETE RISER ial HEIGHT: 52 1 /2" O.D. LENGTH: 120 1 /4" O.D. WIDTH: 84" O.D. BELOW INLET: 41" O.D. LIQUID LEVEL: 36" o WEIGHT: 8.810 LBS. INLET AND , OUTLET: 0 4 CAST -A -SEAL BOOT OR EQUAL m a GASKET. CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: cc WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) W LIQUID CAPACITY, 34.81 GAL/IN W 3 HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: C u) 1.253 GALLONS ap LOADING DESIGN: 8' Or UNSATURATED SOIL v" I u� MN TANKS: N WILL HAVE ONE VENT OVER OUTLET 1 AND WILL HAVE TWO VENTS IN , COVER OVER INLET00 Wy TANK CAN BE USED AS: SEPTIC/ HOLDING/ PUMP OR SIPHON 4" OUTLET n 7 CUSTOMIZED TANKS: TANKS CAN BE CUSTOMIZED CONTACT WIESER CONCRETE TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS _J co D O I Z N o Q M 2 U W W N W 0 OF 0 a - or 2— Family Dwelling In - round Soil Absorption= m (2-cell Convention � # of bedrooms x 150 gal/day/bedroom = (_ 61ga.1/da Daily. Wastewater Flow (DWF) Soil Application Rate = � � � �gpd/ft2 (per SPS Table 383.44r-1, 2, or �) Design Loading Rate (DLR ) or pP -2 z 11 -DWFtlltv)Rai/day ; DLR gpd/ft2 - 5 ft Required -Distribution ce area - # Chambers = Required Distribution cell area ft2 ft2/ unit EISA = Chambers Chamber Manufa cturer and Model: . A) A ��f G Actual Distribution cell area = Required cell area__2� ft2 + /e,L ft2/ unit EISA End Cap Pair = 9.� ft Cross Section In ground Soil Absorption System �2-cell): 4" Schedule 40 PVC ♦� vent pipe with vent cap 12 Inches minimum Trench 1 Sys- tem Elevation 7 X n �__Pft 12 inches minimum \1/I I I\ T_ _Z(Linches Soil Cover / -z Inch Chamber Height Elevation ft Trench Separation Leaching Chamber Width 2, It to limiting factor Plan View In -ground Soil Absorption System (2-cell): Trench 1 ft header/ V�NI�VVIVIIIIN�ItlIVIn IIIV�I�NII�NIVN ft Leachlpg Chambers needed. r 4 inch Header ft with end camps Draw O for a Vent and 10 for Observation Pipe above. They will be located ft from the end of the cell. Vent pipes shall be Schedule 40 PVC and extend at least 12 inches above finished grade. Observation pipes that extend above finished grade must also be 4 inch Schedule 40 PVC. I Page of I N IHICK40 PLUS STA,NDARD Quick4 Plus Standard Chamber Side and End Views 48" r r (EFFECTIVE LENGTH) 12" ilk �---- 34" Quick4 Plus All-iri-One 12 Encap Front, Side and End Views 8- INVERT Quick4 Plus All -in -One Periscope 5 QUICK4 PLUS ALL•ERISCOP (34D'S � (3�WIVEI ) • ' • ALL -IN -ONE CN ' RQ 12.7" INVERT o -ONE1z Plus V ENDCAP Quick4 Plus Standard :Chamber Specifications Size (W x L x H) ... . ... . . . .. . 34" x 53 x 12" (86 cm x 135 cm x 31 cm) Invert Hei ht' 0, 6", 5.3", 8.0", 12.7" g (1.5 cm, 8.4 cm, 18.5 cm, 22,6 cm) Effective Length ... . .. . ...... . . . . . ..... . . 48" (122 cm) _.� INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY (a) The structural integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltrator ( 'Units"), when installed and operated in a leachfield of an onsite septic system in accordance with Infiltrator's Instrucllons, •is warranted to the original purchaser ("Holder") against detective materials and workmanship for one year from the date that the septic permit Is issued for the septic system containing the Units; provided, however, that if a septic permit Is not required by applicable law, the warranty period will begin upon the date that installation of the septic system commences. To exercise its warranty rights, Holder must notify Infiltrator In writing at Its Corporate Headquarters In Old Saybrook, Connecticut within fifteen (15) days of the alleged defect. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or Installation of the Units. (b)THE LIMITED W,1 RANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH RESPECT TO THE UNITS; INCOLIDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE (c) This Limited Warranty shall be void if any part of the chamber system Is manufactured by anyone other than Infiltrator. The Limited Warranty does not extend to incidental, consequential, special or indirect damages. Infiltrator shall not be liable for penalties or liquidated damages, including loss of production and profits, labor and materials, overhead costs, or other losses or expenses incurred by the Holder or any third party. Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of the Units; the Units being subjected to vehicle traffic or other conditions which are not permitted by the Installation instructions; failure to maintain the minimum ground covers set forth in the Installation Instructions; the placement of improper materials into the system containing the Units; failure of the Units or the septic system due to Improper siting or improper sizing, excessive water usage, improper grease disposal, or improper operation; or any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder fails to comply with all of the terms set forth in this Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder, the Units, or any third party resulting from i64tallalion or shipment, or from any product liability claims of Holder or any third party. For this Limited Warranty to apply, the Units must be installed in accordance with all site conditions required by state and local codes; all other applicable laws; and Infiltrator's installation instructions. (d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any party other than the original Holder. The above represents the Standard Limited Warranty offered by Infiltrator. A limited number of states and counties have different warranty requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters In Old Saybrook. Connecticut, prior to such purchase. to obtain a copy of the applicable warranty and should carefully read that warranty prior to the purchase of Units. i� INFILTRATOR' systems inc. 6 Business Park Road • P.O. Box 768 Old Saybrook, CT 06475 860.577.7000 • FAX 860.577.7001 800.221.4436 www.infiltratorsystems.com U.S. Patents: 4.759,661; 5,017.041; 5.156.488:5.336.017; 5.401,116; 5,401.459; 5,511.903: 5,716,163; 5,588.778:5,839,844 Canadian Patents: 1,329.959: 2.004,564 Other patents pending. Infiltrator, Equalizer, Quick4 and Quick4 Plus are registered trademarks of Infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc. is a registered trademark In Mexico. Contour Swivel Connection is a trademark of Infiltrator Systems Inc. 0 2009 Infiltrator Systems Inc. Printed in U.S.A. PLUS0510101SI-2 lccapts 1' 'VC Handle Fxtonsion 4larm swhh rho D-Shaped Inlet nukes •eplacirtp the cvtridge easy. The cartridge locks krto the case, so d, Rar will n"w that up and cause tt» systtam to beck up. The outlet has eight gussets which insures rnsxkwu a strengds and stabi lty under arty k*ad. The open bottom inlet decrease wrbulencs end allows material to fall back down hrta the tank boftma for addrtio" support and one n*olded-in hub on the We for stability. `:.::.. Single -Piece Filter Case - M Ne OuNis klab Il s irablernc ;:`� �. tral>reeterctrhl9l, =4 Heavy -Duty outlet ,reudet added lift case with eight Wnen 1K>f net oab or bask urda rstr"m wel qht .. �� r' ' Open Bottom Inlet �, •. '. �,-, �[4116tl tal�IrO[e arid ie'�Y'QS dW1e'e of fiher floating up in cue D-- of urjwmted teaU" berms trapped in the 9M z Molded -In Hubs 2 hubs on *fie bottwa p wide oow al uVW Ada"prnidn nddbanal rtgAltj 2 bottnre hubs haw tAs that "refy bdc tt*e !nc 6morai+Dm in Prtniat Drainage Zabel* 31Ysstr*vata Product A UMaim of Poly" k+c 3 Fairflold Blvd, Wallingford, Connecticut 06492 1-a77-765-9565 Farc 203-2848514 email: salesgpohlok.com Web she- www.poiylok com A Great Design The Best GF10 filter doesn't just trap solids, its The GF10 is known for. its strength. unique conical shape design allows unwanted The housing, as well as the outlet were material to now over the plates and fall back designed with durability in mind. To Into the tank. The filter has a one-piece hous- show just how strong the fitter is, we ing made of impact resistant PVC, placed a 420 pound concrete riser on The GF10 filter plates are locked together with top of the GF10 fitter case and con - five ribs and two sections of 3A' Schedule netted it to a 4' Sch 4d pipe. 40 PVC pipe. This unique configuration pro- To further improve the strength of this vides even weight distribution and maximum filter, our engineers redesigned the strength. handle, making it even sturdier than The GF10 is rated at 2500 GPD and is available the original design. in 1/8", 1116" and 1/32' filtration levels- The smaller filtration levels are ideal for residential settings and the 1/32" filtration can be used in most commercial applications including -y= ;. wastewater treatment systems, grease traps, dog kennels or salons. d' BEST 10" FILTER Me 0R In -ground GravityManagement Plan IWOOR shall be responsible for b perpetual operation and maintenande pursuant to The owner of this in -ground gravity system Wisc. Admin. Code, this system shall requirements of SPS 382-384, i1Yiac. Admin. Code. Pursuant ta:SPS 383.52'(2), roved management plan. be considered a human health hazard if not maintained h accordance be performed by a registered PODS Maintainer in Furthermore, all inspection and maintenance achvrtre5 shall pet accordance with -SPS, 383.52 (3), Wisc. Admin, Code. Nlaximu i$ =r! � Design Flow = gpd; BODa 5 220 mgL"'; TSS 5 ISO mgL"'; FOGS 30 mgL"' Inspection Checklist INSPECT EVERY 3 YEARS o type of use t o age of sys ern o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i:e., pumps, valves, Switches, floats, atO P .efc) Q material fatigue (i.e., leaks, breaks, corrosion, appurtenance(s) (i.e., distribution /drop boxes) o solids volume in anaerobic treatment tank(s) and any distribution ape o neglect or improper use (i.s., exceeding design capacities, prohibited activities, ete.) o extent of ponding in distribution cell prior to dosing clip float switch settings, etc.) o dosing irregularities- if applicable (i.e., pump re -cycling, connections, switches, controls, timers, alarms, etc.) o electrical components - if applicable (i.e., wiring, re to design specification) o distribution lateral or laterp! orifice plugging {measure lateral distal pressure — cornea o surface discharge of effluent or sewage back-up into structure served Maintenance Che klist MAINTAIN EVERY 3 YEARS (or when necessary) -- o sogtic and dose-taak(s)shall be pumped by a certified septagIe servicing operator licensed under s. 281.48 Wis. Starts. when the volurne�of soilds In the tank(s) exceeds or+e-third (1/3) the Nuld volume of the tank(s) or as required by,local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter s shall be inspected every 3 years and shall be cleaned when necessawillry o be g sale than 12 any accumulated solids according to manufactur+ees Specifications. A servicing period months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.551Nisc. Admin. Code- Report anv component failure or�matfunetion L ,%� �, LC ' t% Name of individual or company:Phone: � i.5- Z.73 — 4�. � ,� Phone: Local government unit: - `' t unit address: l�f zip: Local gevemnlen An defective part of this systerTi Shall be repair+ed,seplaced, or removed pursuant; of SSPS 383, Wisc.S 383.51 Admin. min. Y componenti Code. Repair or replacement of failed o malfunctioningreiOWTS may e shall approved by the department in No product for chemical or physical accordance with SPS 384, Wisc. Admin. Code. Con�tl'n,geen„cy.nn event that an failed treatment component of this"POWTS cannot be repaired, it shall be replaced pursuant to In the eve Y approval. A failed i round dispersal comp y a plan submitted to the appropriate agency for review and, apP n-9 be abandoned and replaced by a code -complying dispersal component in -a pr"etermined.area of suitable soils. Wjg At�nd. nQ merit if use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, W s.C. Admin. Code. ST: C R O UNTY SANITARY SYSTEM File #: Use Only ..1 Office y OWNERSHIP/ADDRESS FORM Created212027 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 INFORMATION Owner/Buyer �4,C--K Mailing Address City/State/Zip Phone Number (required)_ 3 Z7 Email Address (required) �`'dcl� —�_� Le� , p /---m1L Gd hr1 Parcel Identification Numbeir. (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location �/ , 1/4 , Sec. Z Z T 3PN R _fW,Town of Subdivision Plat: JJ6 V �150 , Lot # Certified Survey Map # car Volume .Page # Warranty Deed # 1 () U '( 0 (before 2006)Volume Number of bedrooms 41 Spec house ❑ yes AJ-4no New Property Address (Staff Initials) OFWE USE ONLY 3( 129 _ S-F. Page # Lot lines identifiable)M yes ❑ no (Veri� 'on o new address required from Community Development Department for new construction.) �8 �3 (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center cddCa�s� ccwigov 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax www. sccvv_i. ro_v r 5 M Thw er ring..m tir PnOPW4 or ProOiM4d. Thy W4 not be nprodur h4 mdmwn or uMd ra C-Wbbctron purpww wkk+Out ritlon pomkoton from ProeuIld per Fods Copyl9ht Law, IkuuliwrizAd use " r«uk IM copyj9ht wrkgemoft dw-leeL 4 O SCALE IS 112 AS SHOWN IF PRINTED ON 11X17 PAPER FRONT ELEVATION SCAM W-V-W NOT& t WBM oT4F11116E rroTm Ii ' 4fi 4. SM 4 6M - 24` OH AT EAVM 1/14 SM PITCH . S' OH AT EAVW WIZ IO1Q IV17. OM. VP' OH AT EAVW IZ` OH TYMCAL AT GAOLM ]` ,+ M166 MAM F. TO ADA*T NEEL HEK M ACC-OF4>W-vLY TO ALNSN FA6CIA6 r says - T►40M- SCALE IS 112 AS SHOWN IF PRINTED ON 11X17 PAPER mom lhb• a!'•r.p .. w propwny r ye. Was" onairlMa 140M , op or P R -O& 44 wq • •ia .30 ow Ar aAvft Mr.a.Yve lm r.owa.Wrw --, r---- w yR �R • =r�rnu+. r' a+ Ar MR QA . 1�' ON ATT dW0 s ft r FV.S d pw hti drCsprlWl Lw # •9 urrwd.a ir. ,auM .. if 04 TYPICAL Ar &#A s � � �r ��� 1RJN MANt. TO A0.N�T Itai ►�Irt�! kt i ACCOIbR16LT TO ALI•M pMCW rra s'o' ••o• `i ..... ! `, " wr r.o all,:�� , --------------- .. .. ... f4i�fl11M................ .. raw r.se ldav' 'd IfiM' rerr.y r"r��rO16 rrwrr►.rwaw W.LG. s.rw.ras�. ..wr. r.a•ra�G..r .bf r.0 Pww�ria�w rW.. � •.rrw ere \ r rrw rra. wa r.r rrwir. w FAMILY ROOM W,ry rrw�r.�s ra Rre►� ? rae ra: ara ir.wr r.• w rwwrs.0 } r�4 II'd IddY' i'�' am rawer rrrau.ow ............... --- --- ---- -----------•------ 0 .---_ -- -•----------------------- ry ru.wr.rarrro rn N e ------------------------ ' STORAGE +I•I •,a..� ra.. .-._ - } 9 `•r`� ' 1- STORY WALL SECTION ' wu'wrr.wwr ... .. a ��•I i. WW .......... ---- r..�..�a.4....� g w o..eirr..rew — ' ' UNEX"VATM .we.ora�� Q rs rrr. 1101!! rrNUNMV nrMtL r r.aranarnr '.q--- _-_ : ._ _.__._.. - Ie00� C?Bil mrDOYi a a. w..�r..s MOM- � �nauoewWsosieaoi®Tomereiof sea ......ertw. • . .rar...rrrr ........— —:: g --------------------------•-yw�r----------•-••--_-_LL M-4' Ids• •�M' r',!' s'J' aN' p r�l r � FOUNDATION PLAN, 3/ SCAM' U4 r 1'-0• FWM S.F. = ISM C7 N a Q r ' SCALE 13 112 AS SHOWN IF PRINTED ON I IXI 7 PAPER "am TO AUM PAWL" Dm *AG K BEDROOM uvws ROOM. ULLr - ------------- ; IMTH to ow 3 CAR GARAGE Me op MAIN FLOOR PLAN 'v-r A2: t Wisconsin Departnent of conmeroe SOIL EVALUATION REPORT Division of Safety and Buildrgs in accordance with Comm 85 Wis Aft Code Attach complete site plan on paper not kiss than a 112 x 11 inches in size. Plan must include, but not invited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions. north arrow. and location and distance to nearest road. County Parcel I.D. Reviewed by Please print all information. Persoesl kftrn Wm you provide may be used for secondary purposes (Pinscr Low. s. 15.04 (1) (m)1. Owner Property Location property .5 C//�� .1�� Q✓ /Y Govt- Lot 1/ S IM S 00, property OWrtrees Aaft Address�� Lot # _ 81odc !1 Subd. NanN City lf pte . Code Phone Number 0 Cky r ❑ vmage . 'WTQP Page Of. Date I T N R E �Q Nearest Road New Construction UsA Residential / Nrrnber of bedrvo code derived design flow rate GPD ❑ Rq*=rnent Pubic or Describe: —_-- _ _ - _ Par�erlt matortal Flood Plain elevation if applicable ,r.}C,1 e:� R cleneral Cor111118r1ts and weamunwx1ellotm c ��-� l (U/ �� �-P�a, � � 9'�r'�� .t/ ��/_��✓ i�J./�11i �'�v. � nay . &Xig U - A # Pft Ground surface elev. ft. Depth to limiting factor in. Sail Aodiration R>ea Oef'� 'A 111107T9- 9:7= Ml��oO oil 11,"IMoJGrJ5.JM 67 I�'1J�777Jf�s'JOF9/F!N��1/!�MWWMISM� Pit Ground atrfaoe Xt Depth to Inv" factor -,&P_ in. G,ii ArmlTrAlinn R--*o Eltlilerlt *1 s BOD > 30 < ZZ0 ft181L and TSS >30 ' Effluent #2 = BOD < 30 ffV& and TSS < 30 mgiL CST Name (Plow Print, Sigfleture CST Ntrriber Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ..- //— o n 715-246-4516 Property Owner - 8orirg 0 ❑ Boring 3K Pit Parcel ID # V Ground surface elev.3 R Depth to limiting factor—1.4kin. Pays of Sod A wketion Rate MI R_ MUM ve�rx�s�a�m�r�ee�� Rol !mM7 M MMM � oO m Eftent #1 : BOD, > 30 < 2M mg& and TSS >30 < 150 mgll - EAluent #2 = BODE j 30 rtgll_ and TSS < 30 nV& nw Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an alternate format. please contact the department at 608-266-3151 or TTY 608-264-8777. Soil Test Plot Plaal' William Stock/Steve Dalton S B 1748 112th St. New Richmond Wi 54017 Project Namur Address ;TM #226900 Lot 15 Subdivision Lundy Meadows Date V 8/11 /03 N 1 /2 SE 1 MS 22 T 30 N/R18 W Township Richmond [] Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 10o ft. Top of Survey Iron System Elevation 98.3/97.7 *HRPSa►me as Benchmark Alt. BM Top of 2" Pipe @ 100.2' Alt. B.* A. * Please note: Installer must B.M. verify all lot lines and setbacks 463' Property Line before installation. desired building area. Check system location before excavating. Scale is 1 " = 40' unless otherwise noted State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number 11 Document Name THIS DEED, made between William B. Stock ("Grantor," whether one or more), and Todd Marek ("Grantee," whether one�or more). Grantor, for a valuable consideration, conveys 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") (if more space is needed, please attach addendum): Lots 9, 14, 15 16, 19, 21, 23 and 31, Lundy Meadows, Lot 13, Whi etail Meadows This is not homestead property. hIIIIIIIIIIIIVIIIIIIIIIIIIIII ea rsi ss tx:aas3a3s 960901 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 08/01/2012 12:48 PM EXEMPT#: NA REC FEE: 30.00 TRANS FEE: 351.00 PAGES: 1 Recording Area Name and Return Address KRISTINA OGLAND ESTREEN & OGLAND 304 Locust Hudson, WI 54016 026-1165-09-000. 026-116 5-14-000: 026-1165-15- 000; 026-1 165-16-000; 026-1 165-19-000; 026-165-21- 000; 026-1 165-23-000, 026-1165-31-000; 026-1160- 13-000 Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: easements, restrictions and reservations, if any, of record. Dated &7 -14-A> D ?,- AUTHENTICATION Signature(s) William B. Stock , Parcel Identification Number (PIN) Z- (SEAL)By: (SEAL) *William B. Stock (SEAL authenticated on A7 230 1 ZAn Z-- *Kristina O land TITLE: MEMBE STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Kristina Oeland. Estreen & Ogland 304 Locust Street, Hudson, WI 54016 (SEAL) ACKNOWLEDGMENT STATE OF } ) ss. COUNTY ) Personally came before me on , the above -named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. Notary Public, State of My Commission (is permanent) (expires:_ (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED © 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. 1 of 1 INFO-PROTm Legal Forms 800-655-2021 www.infoproforms.com I . / All tot ccw~s morted with t T 0 Pipe (we4oh" 1.13 %a. Det 1 N e unless ottwwise shorn. LL .•Tg� 3 � a e it 37A9+ECT rp ilOS7Gavmv, nxisr QOIC~ "VS tvv& ti #AW44" W nW) % s s P 0 ND r Z! 0 'mow <^ ' f J -jI !-�E a ►y � Watw p LAW(a LWLt at LOT 13 Of , 6-�j 0,f* r WW ar a e arw4•• &U AW H w tb- 1,67t ACRES a 1� BAR / ,rw 1ER rQT& AREA: l55, ~ Sa FT• .150 AA4FS zi LOT ,14 �tREA �BQVf ad, ,L 4 1.53.t ACXf'S TOTAL ARfA-. h • 207.215 Su Fr. 1 f �414;7q�fi- h 1 C.B.Q=9f61.3' 7 0 0 LOTIS 91,697 ft. t� sq. 2 11 ocres Z L.B.0.=96t.J' f 1 447. 7? 8o,02'� t LOT 16 AREA .Bokf 12H wL \ .2• sof ACRES MA r�A-. , 106, 779 SO. FT. ' - ' 2.50 ACRCS g1� 0 L. B. 0. = 961.3' LOT17 till -IN ti AR��W O.h ��, 2 J64t ACRES 1 tea. TOLU ARE 1li t50 SO. FT. 2 60 A CWS A" - � t L.B.0.-961.3" Z w = � - ass. r4 • -_ -10&5. 76 ' i 236 - r� ___.� _____-.160 00' -3-Wisconsin Department of Commerce SOIL EVALUATION REPORT Page-4 of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must c—) l include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. /11 S `�✓d Pleasef-print all information. _� Re vi ed b Date Personal information you provide may be used for secondary purposls (Privacy law. s. 15.04 (1) (m)). ZJ Property Owner Property Location ` •��e., 5 fj C `� S � �� �,� Govt. Lot 1/ j 1 /4 S Z T N R E (o W Property Owner's Mai . Address Lot # Block # Subd. Name or M# —17 City late Zip. Code. Phone Number Cl City ❑ Village �T49K Nearest Road r %s!G it �' % s` � � ( ) / �~ /�' lC/• New Construction Us Residential / Number of bedroom _ Code derived design flow rate` GPD ❑ Replacement PPublic or qqTnmercial - Describe: _ _— _--_-------------- --- --- Parent material z Flood Plain elevation if applicable -41!! General corrunents and recommendations: > ��o �,� /J IT]Bonng # Boring— Ground surface elev. Q ft. Pit �/f /ems% Depth to limiting factor /tom ` in. Soil Annliratinn Rate Iffiamm Redox Description Structure Consistence =WAWA WE I Ong #, Boring Pit Ground surface elev/DC/' ft. Depth to limiting factor in. Cnil Annliratinn RatA Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont_ Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 -Eff#2 r, .",o Z2�2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >3)ZnV(l.---- - tmuent iTz = uuv _ .w mg/u dnu I oo - . j 11 uL- CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 2--- //_._. 0 ::� 715-246-4516 C7 Property Owner Parcel ID # Page of [� Bonng Boring # JoiPit Ground surface elevft. Depth to limiting Horizon Depth Dominant Color Redox Description Texture Structure in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. factor-4�j in Consistence, Boundary i Roots Soil Application Rate GPD/ft� 'Eff#1 'Eff#2 b r i ai ,r-- Boring # Boring ❑ Pit Ground surface elev. _ ft. Depth to limiting factor — in. Soil lication Rate Horizon Depth I Dominant Color Redox Description LTexture Structure Consistence BoundaryRoots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft#1 'Eff#2 (� I Boring I Boring # Ground surface elev. — ft. Depth to limiting f, ❑ Pit Horizon Depth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. ' Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SOD-8330 (RA/00) ` Soil Test Plot PI Project Name William Stock/Steve Dalton c Address 1748 112th St. New Richmond Wi 54017 (PTM #226900 Lot 15 Subdivision Lundy Meadows Date 8/11 /03 N 1 /2 S E 1 /4S 22 T 30 N/R18 W Township Richmond ❑ Boring Q Well PL Property Line County ST. CROIX kBMorVRp Assume Elevation 100 ft. Top of Survey Iron System Elevation 98.3/97.7 * H R pSame as Benchmark Alt. BM Top of 2" Pipe @ 100.2' Alt. B. PB� Please note: Installer must .M. verify all lot lines and setbacks 463' Property Line before installation. 5' � B-1 a5;,j_ 30' MIN 101' Scale is 1 " = 40' 8% unless otherwise Slope noted 5' B-3 Please Note: Tested area may not be suitable for desired building area. Check system location before excavating. 103' 6-r.-CAIX STATE SAN11TARY PERMIT enk PREVIOUS NO. OWNER JDb-b AkfO, PLUMBERFOG6P, LIC.# 72(oVv N SEC Z,+ ' AND/OR LOT BLOCK Ptevobmn SUBDIVISION AUTHORIZED14 - THIS PERMIT EXPIRES SBD-06499 (R11/20) 1�-anIc X CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority.