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HomeMy WebLinkAbout032-2007-30-100 OM 0 : ■ -0 0 e o m ■ . c 7.3 o cp n\ • / \ k�iI � : ® . A / E T. f z / ° j / E o o ,1 p. \ - » . 2 Q > _ { \ \ \ _ \ \ § ) ) 2 \ A K Cr' § k i ) , - CD . eil 0 E 2 ; @ / § \ / ° . \ CO ° g CL ( 7 ( a { B 8 E Z 1 o a m © ƒ / \ ± ¢ 22 CD77 ; : K / % $ 2 ) _ � . cn ® o ° ° _ I / _ \ \ ? E I 2 0 0 / .. \ _ < .1 mid I / k 0 0 " 2 E . if 0 0 o z § 7 I j j j \ / ° / o / 2 \ 7 2 E D Z § o .. k 7 c . m ® # \ - \ I f � 2 1 ® § 7 { / O \ ° e I o 7 \ / ; �. I ƒ % @ . N [ - E 1 } 3 5 _1 = o [ o : ii: �a - m \ \ _• /0 g Co -o I $ ) e I �o \ \ ao § » 2 V. 2 - F I g « ® E . CD o § a I \ i E. I w } ` 1I;1 to v. I to Oo / ' 4 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:. Safety and Buildings Division St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar �Qr{rtjt,No.: Personal information you provice may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. lIIILLLL44 Permit Holder's Name: X ❑ City ❑ Vi lage ❑ To, n of: State Plan ID No.: Stoner, Gaylord&Frances Somerset I ownship CST BM Elev.; Insp.BM Elev.: BM D%scription: ` Parcel b `�-C 007- � 1 U 0 TANK INFORMATION I ELEVATN DATA L0T C TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. rSe tic ( J e .S 12 Benchmark 2-(.( (02.610 1 CZ .0 Dosing Alt. BM Aeration Bldg.Sewer c.C.p c 06 ' Holdi St/Ht Inlet (o. Z® 4WP•`f6' TANK SETBACK INFORMATION St/Ht Outlet ‘'G Z— 96 0(f' TANK TO P/L WELL BLDG. Air VenttoIntake ROAD Dt Inlet Septic 66' 41D '4-- ' t f - NA Dt Bottom 11 Dosing NA eader Ma ,U�O ca� cic.ZS • A. c { Aeration NA Bist, 1.0, J Holding Bot. System 9%'0 4. c. t'' 8 �•33 -2 6 PUMP/ SIPHON INFORMATION inal Grade wee,.,-►,,a.�.�\ ' & e?Fc.o ' Manufa urer Demand St cover Model Number GPM TDH Lift _iiiitAll• stem TDH Ft Force • .. Length Dia. Dist.To v,- SOIL AB RPTION SYSTEM/Ia) P�� & BEB 1 RENC Width t Le`r7-Th r No Of T enches PIT No.Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 "Ts _ DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING ^1�1an faf rero'.�,�o� CHAMBER a✓" � "" INFORMATION Type Of r Iylp�el Number:,cl....v, System: ((f. , 6" 4- 3.9 (oa -}- - OR UNIT t}--tt DISTRIBUTION SYSTEM Header/Manifold �, Distribution Pipe(s) a Size x Hole Spacing Vent To Air Intake Length 'fee- L Dia. "[ ...Lgngth Dia. Spacing -----._ '? (est • 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 ❑ COMMENTS' (include cod d' re n les Demons r t Inspe -lion-tl:C 7(,2CD 1 sp❑r:uhon .,2.No I--" Location: /99 Highway 64, New'xiohmbnied, �4 1 (1 11/4 NE 1/4 2 T3ON R19W) -02.30.19.49013 1.) Alt BM Description= CST A(4' •B AA= [11W f paaa— �> l 5:, 2.) Bldg sewer length= Q-3-D f« -amount of cover= ''f s / ,e1 n A a / 3) ;s4--�`,�5 --L \no.— �,�/c5 /4J 1€,J} �, ea, k•�,,„ r J. . Planthe revision required?or di 0 Yes No Vsusi;,,,_ J -i..A6l1'8�- Ti ( C2_6 Use other side for additional information. I 2- Z$' 2eep ti SBD-6710(R.3/97) Date Inspector's Signature Cert.No. I I Safety and Buildings Division ,- SANITARY PERMIT APPLICATION n 201 W.Washington AvenueP 0 Box 7302 Department of Commerce In accord with Comm 83.05,Wis. .f Madison,WI 53707-7302 • Attach complete plans(to the county copy only)for the sys n paper rtibtless`• County than 81/2 x 11 inches in size. ~ri 9, 1 r' . e.>"Z)/!c • See reverse side for instructions for completing this app[cation ; St to Sanitary Permit Number 3TO Z 2`F Personal information you provide may be used for secondary purposes i r-`i �' . vac 0 heck it revision to previous application `1 g. [Privacy Law,s. 15.04(1)(m)). -Stale Plan I.D.Number .� . . ST (�1AOIX �._ I. APPLICATION INFORMATION - PLEASE PRINT AL 1NFORI1 MtON Property Owner N / c, tin ',T..c o7t am1C� lGa j ��s2 er / 1i4 .4 �T ,N, R7fE(or� Property Owner's Mailinc,+ Address N ';/pt t ri- r Block Number Cit to , / Zip Code I Phone Number lumber ,1/0 ch,-frze,7,4,/a“.0.-iw 7 _El-ecKLT -Atr pwl Lek I YPE OF BUILDING: check one Nearest oa 0 Public1 or 2 Family Dwelling // � V)4 III. BUILDING USE: (If building type is public I $ r l��y�� �j ,t ❑ Apartment/Condo \ oc" Y 2 ❑ Assembly Hall 6 ❑ Met1.3 , Jtdoor Recreational Facility 3 0 Campground 7 0 Mer 4 ❑ Church/School 8 ❑ Mot sta 1r vice Stationurant/Bar//CarDining Wash 5 ❑ Hotel/Motel 9 ❑ Offic ier: specify IV. TYPE OF PERMIT: (Check only one be ,!} A) 1. ❑ New 2. g..l eplacement tion of 5. ❑ Repair of an System ystem 'stem Existing System B) ❑ A Sanitary Permit was previously I Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressu cxperimental Other 11 ❑Seepage Bed 21 ❑Mound 30❑Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22❑In-Ground Pressure 42 0 Pit Privy 13❑Seepage Pit 3 ;ult 'riv / 14❑System-In-Fill / z. 9 C��e-i ,,�?�/ jf /` -' r id VI. ABSORPTION SYSTEM INFORMATION: - i 1.Gallons Per Day 2. Absorp.Area I g -50. 19 `-19U ev. 7. Final Grade RE - . Elevation �� _ �2 ?, -7 — gv-COO �� eet 76-5-Feet VII. TANK /‘a 1 o' ''y �')' - �``7 INFORMATION - V O-�' '�4 d iber- Plastic Exper cariAQAS--', i llass App. Septic Tank or Holding Tank • �\ ;I� 0 ❑ Lift Pump Tank/Siphon Chamber �N a(CO'C,1 .- ----- TI ❑ ❑ VIII. RESPONSIBILITY SD ' / 'S �'� --'�� .�---_ I,the undersigned,assume ' ��`'"� 'rr ,.� i plans. Plum 's Name:(Print) (� umber: /�sr / r �i PI er's Address(Street,City,State,: oatiA0 1) - "-' IX. COUNTY/DEPARTMEF _ 0 Disapproved issued Issuing Agent Signature(No Stamps) _-....rge Fee) Approved 0 Owner Given , Adverse Deter„„i,aiioh " O c2-5 - CV S-Zbaf) -'r -A jklApik-- ---- X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: -Irtoota L = AfttA 94 .6 ,ems-1--\;,t___,A.ko, OS p-er Cees DISTRIBUTION: Original to County,One copy To: Safety&Buildings Division,Owner,Plumber 1 SBD-6398(R.4/99) r Plot Plan ��7,,�y _ PROJECT � /E',"J�Xn4d"` ADDRESS �!/�e' l,�i hTe, 7-/` , e./a'/7 ) 1/4r c 1/4S. /T 1� N/R/7 W TOWNN5�, �� COUNTY , ‘,,-,--co,?- Byron Bird Jr. 220527 e) -� BEDROOM ,'C � �`�'�DATE �� �. CONVENTIONAL IN-GROUN RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE` 7 e LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE _ABSORPTION AREA # of chambersT ® BENCHMARK V.R.P. e:- d7- J1 e°eAtiSLUM E EL VA 100' ❑ BOREHOLE WELL *H.R.P. `f !' / 74 �9/YltT 6,1) - �j �P . ` SYSTEM ELEVATION 7 f" .,,2,_ / " -. . , Vent >12" ' Sidewinder High of Cover Capacity Leaching Chamber with 31.8 ft^2 6„ per chamber 6' Long Grade at System Elevation ,O `� �` 34" /' t / l w 1/\ y''11yyV kn $ q 14/ allill fo di a +� I �i�� / / 7 ?j> 73d )' Y6r1 0 / Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Sa;ety and Buildings Page of Bureau of Integrated Services in accordance with Comm 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 5 4 �e'E;rX percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Pare*LW.4.1 t 3o-2—`2?cr-'0? 0-an _7a'o20074.:? ,D 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)). Property Owner / Property Location 7 /,i Gv-i r Govt. Lot , 1/4� 1/4,S a Tom-9 ,N,R `.q E l Property Owner's M iling Address Lot# Block# Su d. Name or CSM# / 77, Y' City atf e °'Zip Code Phone Number ❑ CityNearest Road ❑ Village [,� Town � 770 C!� I S;k/JI (7/ $(7. 55- a)vL.e." .^ ,--- I 4- 9 6(( ❑ New Construction Use: ❑Residential/Number of bedrooms Addition to existing building ❑ Replacement ❑Public or commercial-Describe: Code derived daily flow 419° gpd Recommended design loading rate • 7 bed,gpd/ft2 - 3°, trench,gpd/ft2 Absorption area required 051 bed,ft2 7 ) trench,ft27 Maximum design loading rate 7 bed,gpd/ft2 - ` trench,gpd/ft2 Recommended infiltration surface elevation(s) �l / Cc' _ ft(as referred to site plan benchmark) Additional design/site considerations 7-, i" 1. GJ Parent material �1� ‘. .--_r,.- 7' CSc .- -) < 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 S ❑ U S ❑ U I5S ❑ U ,ems ❑ U ❑ S V5-U ❑ S Rt.U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 / re in. Munsell Qu.Sz.Cont.Color Gr. /Szz. h. Sz.Sh. - /-- Bed , Trench'. Ground q , f�'SG i° f`"�'" �: /' rA JI r�/ - 0ev‘ft. Li Depth to i limiting et-43.o factor _i_in. L(1.G/I/-L ' S-' Remarks: Boring# , ''r-- 02 '''';P /7,e-- ...,_,,, A;,_._.,_ j ,_ -2.,,,,, ,,,----„, ,,,,,,-- '0 . C: ,-72 -, ,11,..--e-- fry, . ::::," _./:,7 "1-';‘:4-4/1 - -- 7 6" Ground ,Nly_ft_. , Depth to - limiting - 5-1-(•/3?'(9 facts.. Remarks: CST Name Please Print) r-c7a .( 7-. � Signature� t ,Telephone No. j g �--- rr'163"'7� ,/ Addres �� Date CST Number (lG� frcAX SOIL DESCRIPTION REPORT Page of PROPERTY OWNER y PARCEL I.D.# BoringHorizon Depth Dominant Color Mottles Structure G D/ft2 # in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary RootsBed Trench / 02Pf- /427X0 Ground i'/ / i'i` ' •7-sr Depth to limiting 1$78 Y facto GJin. Remarks: Boring # / 0 ! y' `/7,-- -/ 7 1� $7 6,72.- 1' Ground Depth to 6,9/ 4h limiting factor 9.- in. , :p4 Remarks: �"��" Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench Boring# Ground elev. ft. Depth to limiting factor in. Remarks: Boring# Ground elev. ft. - Depth to limiting factor in. Remarks: SBD-8330(R.9/98) Soil Test Plot Plan Project Name Gaylord Stoner Byron Bird Jr. Address 799 Hyw 64 w, r �� New Richmond Wi. 54017 4-7-4'7CS #220527 Lot Subdivision Date 5/30/0.9 NE 1/4 NE 1/4S 2 T 30 N/R19 W TownshipSOMERSET Boring Q Well PL Property Line County ST. CROIX ,BM or VRP Assume Elevation 100 ft.BASE OF SE CORNER OF HOUSE System Elevation t-1=93.2 t-2=93 H.R.P. same as BM Alternate B.M. NW corner of house by 64 i It° 6 vl pri F.. ED DRAI 'i EL') tj Alt. B.M. Dri eway 2 4 bed house la • 75 15' 20 CO 1 40' 40' 25' ,*_ . 3 ' o 30' 1 �B well✓ >110' toP1 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer }f-e...--`�/�'c- ,5 � ." Mailing Address ZY7 V Property Address (Verification required from Planning Department for new construction) ��-� 7/ 7 . .� `Vie'_ ,•c & --o�a®2__'�-- �p City/Stateiii41) .(ef2"16/itz,, Parcel Identification Number LEGAL DESCRIPTION Property Location AZ-1/4, 1/4, Sec. O'Z , T ,1N-R , Town of _17 e7 Subdivision , Lot # . //GL ''-r- go---2---41 Aae' r` Certified Survey Map # , Volume , Page # - . Warranty Deed # 0.7 9 ' .5- , Volume 4 -5 , Page # ® ' Spec house 0 yes [ 'no Lot lines identifiable,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 system 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. Uwe,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 f the three year exp. tion date. / / c -,4: SIGN F APPLICANT DATE 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 property described above,by virtue of a warranty deed recorded in Register of Deeds Office. -..&-). / / SIGN : gRE F PLICANT 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 i,:.,.,",:,iTTAT,T , ! ,!: -:. DOCUM EN T NO 0 .1 c QUIT es...Am DCO VIft V 4 *TATE Of -CONS1M•rogks 13 " ,t! . ' ' •' ' !: TIO• •PACA AlteA141040 TOO ACCORD;NO DATA ,.*4 ;.. ) 'N'IS. TEIS 1.1".:DfINTURE, Msde by....Pc_WAT:1Y.Ilutisi:-.:2._...-. --------------------- r7,..:'4. r ,. , , . . •T A..,..1. 1."31-i 287,_ \\ ';' '• :1):-.___=-_- __ ),A. grantor , ..., ,e,. of. St.. .C.I'Ci.S._. County, Wisconsin, hat:by qclairns to Gay.3..ord......._.. - ' - - - -- ik ALTURA, TO -i 1.,. Stoner t, gr:-.n .-t.,-- s , of. St....Craix. County, Wisconsin, for the sum of iQne Dollar ( 1.0G) and other gDod and valulble consideration, ....Dollars, '..,.. the following trac, of land in_ St- Croix County, State of Wisconsin: :- i k Correncing on the E line of Section 2-30-19, where said line intersects the S line of State Trunk Highway "64", thence S 495 feet, thence W about 4. 0 feet to the E line of private hig ,ay to the Josephine Viellieux farm, thence N along E line of said private highway to S line of State Trunk Highway "64" thence 7 to point of beginning. Containing 4 acres 7ore or less. EXCEPT allE PARCEL DESCRIBED AS: Co-lrencing on the E line of Section 2-30-19 where said line intersects the S line of State Trunk Highway "64", , , thence W 165 feet, thence S 264 feet, thence E 165 feet, thence N to place of beginning. Said plot to contain one acre; subject to life estate reserved by Mildred E. Stoner, to occupy the house located on said property during her lifetire. FURTHER E.XCE1-'TRIG f the parcel described as: Part of the NE 1/4 of NE 1/4 of Section 2-3.0-19, described as follows: Correncing at the NE corner of said NE 1/4 of NE 1/4; thence S 195'; thence W 275 feet to point ef beginning; thence N parallel with the E line of said NE 1/4 of I- 1'F. 1/4 200 feet; thence W to E _ire of private highway; thence S on said E line 200 f. feet; thence E to point of 1-1?ginning. THIS IS NM.' Hal:STEAD PRDPERTY. '-' t , . . . . i.' . :k. 7.—f': •:'T:.'..*". i.:7. (I" NE, .4AP.Y. C.7‘!;11.NUE 1_,E,CIIIITION ON liEVEJ:SE .i, In V'itr,ess Whc!reof. th: said i:: nor ha S hercunto ,--.t her hand and st..0_ this 0,4 ye? day of . At;f °-11 IP'IA\ , A D. -t-1 ......., iZei.,-4- 0,---e---$ .,/ ._ 17.1, AND ST:1:_ET) IN i'REKEN,,:),, OF BeVerl V :T.-...----.e.:,4.-egy [ le, .S:f. [.1 k., Immmmgimiimsima , ,;, WARRANTY DEED DOCUMENT NO. ,. _.- A E'OQ STATE OF WISCONSIN—FORM 9 BOOK STATE . e"~ J THIS SPACE REUTLD FOR RECORDING DATA 29'7465 Mildred E. Stoner, single rttGISTERS OFFICE • THIS INDENTURE,Made by -- ST. C ROI X CO.. W I S. • Rec'd for Record this_12.th_ • day of__A,uEust___A.D.19.69 ro grantor--of St_ CiY County,Wisconsin,hereby conveys and warrants atZ115. P► to i ___—and--cif e -`/ Reg ster o De s grantee S RETURN TO of St. Croix County,Wisconsin,for the sum of enc dollar and other vallw bJ e r.on5:i deret3 ons the following tract of land in .a �'t_ Crni-r —County,State of Wisconsin; Commencing on the East line of Section 2, Township 30 North, Range 19 West where said line intersects the South line of State Trunk Highway 64, thence West 165 feet, thence South 264 feet, thence East 165 feet, thence North to place of beginning. Said plot to contain one acre. The purpose of this deed is to release all right, title and interest in a certain life estate reserved to grantor by a prior deed between partiesYdated6March 12, 1969 and recorded. May 20, 1969 in Volume 451 , page a D3, and substitute therefore the following reservation: SUBJECT TO a life estate reserved by Mildred E. Stoner to occupy the small house located on the East fifty feet of said property during her lifetime. . . .'!„..10•••,••••••••-,•_ , ":••,,r..,•,,..",!Ii„.1N,:,.•,,''•„.,,,,•Ili0,,e:•1,11:,:..,.•-•...•.1.:,..,....„.,....,•:.„..„ •• . ' ''•'•,,,• II•li,; .„"„,„„••:,,,i,,11'1' ,11:.:,,,,,•,••:'' ••' •:p••,, •• .... „. •• .•• , ••'''' . -4 ,„.••14.,•11,„,„.11.,•,,,,••:'•,,,f.1„1.••,•:,•••,;•••: ••,••.1!„.„:„.•:•:•••••„ ...... .. .. , „ .!, ...„,•••i•,,,,,..,A:, . ........... „. .„. ...,„P!••"•! •,....',„''':. 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