HomeMy WebLinkAbout026-1309-04-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)],
Permit Holder's Name:
JEFFERY & KATHY HOTEVEC
City Village Township
TOWN OF RICHMOND
CST BM Elev:
Insp. BM Elev:
BM Description: MM
I
TANK INFORMATION J P4 a;Cho,;npj I- jc rt" ELEVATION DATA
TYPE
MANUFACTURER
CAPACITY
Septic
w
Ccsing
Pump
e ktLQn
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
-2
`j
Dosing
Arn
Holding
PUMP/SIPHON INFORMATION
Manufacturer
Demand
&UIJ,5-
GPM
2�- Z� �
qe
Model Number
E POV
TDH
Lift
Friction Loss
ad
TDH Ft
' Pr C•nlcnlkw,
r
L7
Forcemain
Length Q`
Dia./'
Dist. to Well
DO pIM
SQ
SOIL ABSORPTION SYSTEM �t4}e� ooeo�o Cli,Aoo4s Ion Inww�
County: St. Croix
Sanitary Permit No:
651287
State Plan ID No:
Parcel Tax No:
026-1309-04-000
Section/Town/Range/Map No:
12.30.18.1682
STATION
BS
HI
FS
ELEV.
Benchmark
5,25
1073
r003
Alt. BM
Bldg. Sewer
I
SUHt Inlet
123
SUHt Outlet
Dt Inlet
Dt Bottom
� S
Header/Man.
it (
Y � r�
� �G
J
Dist. Pipe
Bot. System
I
�7
Final Grade
1 /
6.7�
Q • q
a(
St Cover ci I� cQ��
�
� `�q
7/
�P I Fl&c000
BED/TRENCH
DIMENSIONS
Width
'�
Length
" �
No. Of Trenches
1 2 11
PIT DIIMEc S
z
No. OfPits.. Inside Dia.
Liquid D
SETBACK
INFORMATION
SYSTEM TO
P/L
BLDG
WELL LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer: ^�—�
d.. r( 6l _
Type Of System
ConV14,onp1 w�eurn
I 2 �
�
100
I
Model Number6:2
DISTRIBUTION SYSTEM
Header/Manifold
Distribution
He Size
x Hole Spacing
Vent to Air Intake
Ll�
ipe(s) �..
..
Length Dia
Length Dia Spacing
SOIL COVER x Pressure Svstems Onlv, xx Mound Or At -Grade Svstems Only
Depth Ov
Bed/Tre ch en
epth Ov r
B d/ nc ges
- epth
T
eeded/Sodded
Y Mulched
❑ s ❑ No
❑Yes ❑ No
COMMENTS: (Include code discrepencies, persons present, etc.)
Location: 1464 166TH AVE
1.) Alt BM Description =
2.) Bldg sewer length =271
- amount of cover = j C
Ov r-
Plan revision Required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R.3/97)
Inspection #1: V27(27 Inspection #2:
595y 6G
Date I sepctor's Signature Cert. No.
S S E 13 20,23
'el )s
1himi-Wicnt of Safety
& Professional Services,
Industry Services Divikion
Sanitary Permit Application
1L lfdd]10� W1 Ll� 3&3 2 1(2 7. \X',s Al lm . Codc, subm issik iri r il- forn, to L.*!Ic jpjropriate gl)% CIF 1-11'Wrad] ul"11
I CLjUll Cd piic�r to �)L-,Jj Ding a 5znilzi1�, pc unit Note Appi ication I'l for state-o%iicd POWI-S are submitted to
Dcpairtment ot'Safety and L�,�rvices. PCTSOMI -ii you pEg7r&%.jMaY be used for secondary
ill Ictordmice pith the I acy Lax, q 15.04 (1 )( m ), S cats
- "40;00009
) fi P r n � atio ii PIc.-i �e Print All Informm at on
CA INVESTMENTLL(4L��
Prope rq' (.wnc r's Ma I I i n g A dd re ss
1505 HWY 65 PO BOX 44b
city. State
Zip Codc
NEW RICHMOND Wi 54017
It. Type of Building (check all that apply)
A I 111 2 Fam i I y 1. ) �%-v i I i rig - N uni 6cr o I'B tdrooms
G Public/(:,�inimcri`tjl - Dcscribc T ise
couliry
St Groin 5A g,
Sanatory Permit NLinibcr (Lo be filleJ in hy Co.)
65) 2 8 1
State Transaction Number
Proj' cc L A dd i css k j I'd i 1'.,'c rent than mall i n g address)
1464 166TH AVE
parcel. #
b 2-(o -- 130 0 60-D
Govt Lot
Phcme Nkimbff
S W NE '/4. section
Lot 1-30 N R 18 EorWX
45 Sub wtsion Name ec�_
Block 4 r
xt r7o&j
El City of
0 Stwe Ch-kred - Dzscrlbc Use CM Number I-] Vlllagc kit'
V TMNT1 111' MCHMOND
Typc of PONVIS Ve r-rn it: ((h eck c it Ike r '"N cm: "' o r " Repi ace"Ic n t ""and othcr applicable, on line A. Check one. box on. fine R. (7ow pi e line U i
PP I lica b I C.)
ace I'll El ��r Mod I fiLaU011 LL I I CM (e x p I a 1 n) _T] Additional Prctreatmew Unto (i!X [)I.LLri
A El Rept ment Syste
A New System
14oll d Ing Tank
� [n-Ground
—,
L] round
El Individual Site Design
CJ 06er TYpe (explain)
(conventional)
Renewal Before
11 Revtsiori
0 C hange of P I u ni bt r
L-1 'Fransfer to New 0,;xTitr
L isi Pre,%- i nus Pe mi it Num ber and Date Issued
Expiration
I
Ws, P era VT re , t r, 1 v ii I A rea a n d T-A n k I n formation:
I . I C
Dciigil I low 4�_"l lij)
S H
'
I 1�*' p r --�;i I A rea Rcqlj i red (st)
.%rt:a Proposed 1.st)
Systcrn Elevat' n
450
1 -7
650
700
1
T.zink Information
C -LI P a C I IN, 11-1
GaIllolls
Nr-w Tanks Lxi-ming
Taakq
G.1][0111i
(0
N1 aii tj I'act u r cr
r25 �- [A-P--,r
lu
U
i
L -d
U
U
T*
M.
V)
Cn
0
CL.
X 1000 WIESER
Dumng hani'kr X
X 1600 X
R V.N pp 11 -,1111111 S tat k: I'llent- 1, the undersigned,. as.qu.nie re s po n si bi I ity fQr iastanatiu n -or the POWTS s h o v% n on the il I -A C b ed ply
1 1 H I I I Ni I I I R'S N (j. i i her BWincl',� PlhL)nc Number
PALJI.,. R KOEHI,-ER 225410
-Flu—mbc. (StreeL, City, Swe, Zip Code)
321 WISCONSIN DR NEW RICHMOND 54017
('q o Lj n (y/1Dcp,% rimen t Use 0 n ly
App%cd [3 Pcinal Fce Date- Issued bisuing Ageni Signatilre
n 'r1lit c'�2_ -b. Z3
rt for r
�3�--
Colic 1`10 ons Q /k-eeas p
SYSTEM O�ATIEER: 3 o S
rz� 4e4+
1. S - j k r) �'c ter.., r. 1,., -F-1, en t riii ;Le,i a.9 d diSperSal r . i , P,
must be sc-P,,iced / mainta!-ned,-is per CaAAA.Q_r* S t c
C%
AN setback-. riequiremenis ii-iustb e m a-: n tq rk e d
as pef appiiGee co -le I r!rdln-�nnr��
I
�611A'Lli CIP ( I°M[11L'11 116r rhr S'1%'51`1Mk And 1,1JI)n1if T()J�ie Ca-unry Artly un paper noriess 'Kan 9 _V2 xAl Odle -;,I -i.:,
SBD-6.,98 (R- 03/22)
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�1
�, copy,
W(At-fll-s
Lot
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Derrick Const / Hotovec
Owners Name: Jeffery &Kathy Hotovec
Owner's Address: 1464 166th ave
New Richmond WI 54017
Legal Description:
SWIM, NE I A, Sec 12, T30n, R.18 W
Township:
Richmond
County:
St Croix
Subdivision Name:
Water's Edge
Lot Number:
45
Parcel ID Number:
026-1309-04-000
Page 1 Index and title
Page 2 Plot Plan
Page 3 System.Sizing & Cross -Section
Page 4 Filter S ecs
Page 5 Maintenance Information
Page 5 Mana ement Plan
Page 7 St. Croix Cty Septic Tank Maintenance Form
Page 8 Warran Deed
Page 9 C S M or Plat
Attachments: Soil Test & House Plans
Designer/Plumber:
o ram' -.
� � License Number:
,/� e umbe .
Gate:
� } Phone Number An „12 f� -
Signature
[designed pursuant to the In -Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01101).
Page 1
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wqt.c-ts
Lot
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k " � l, 0
SOI L ABSORPTION SYSTEM DETAIL ! GRAVELLESS LEACHING UNIT Page of
Project Name:
i� No. of Cells � Per Cell
tt Cell Width �Total No of
�6 tt Cell Length �� sq tt EISA Per Cell
tt Cell Spacing sq tt Total EISA
Manufacturer Model t.a to Len th EISA Rating
Mfttor EZ1243H-5ft 5.0' 25,4
EZ12031-1-1 --]10.Q' 50.0
Gravelless Leaching Unit Manufacturer:
G ravel leas Leaching Unit Model
Typical Crass Section
Finished Grade fi
Observation Pipe with
approved cap or vent
A2■:.
.
' :=■ Soil Back ll
......
.:
Geotextiie Fabric
-
*02S�ft infiltrative Surface
12 in
w OR
rmwom
left ft Limiting Factor
in
Slotted and Anchored Vent!
Observation Pipe with Cap
Plumber/Designer Signature: ��� -` /woo-0- - �
License #: ..� ��L:L '" Date:
PAGE 4 OF 5
GRAVITY -DOSED
SEPTIC / PUMP TANK SPECIFICATIONS
(No Scale)
IMPORTANT ` " : "" "'"
Anchor tank(s) as necessary
pursuant to SPS 383.43(8)(g)
Finished Grade
CAPACITIES @ 16-76� gal/in
Electrical
Depth (in)
Volume (gal)
A
23
385.48
B
2.0
33.52
[C]
4
83.8
D
10
167.E
must comply wi#h
SPS 316 and NEC 300
Weatherproof
—TI.—�Junction Box
Conduit
Airtight
Seal
41k P
Extend manhole riser as necessary.
Approved Locking Manhole
with blaming Label Attached
4" Min. or 2.0 f# above
Established Flood Elevation
:9 T J (typical)
Quick Disconnect
�- I Min.
• • (typical)
s
livsep
Hole
Pump
� Pump Tank Liquid Level = 16.76 in -Off
D
Force Main Diameter = 2 in Concrete#ocJk
Force Main Length = 100 ft 3' Approved Bedding Material Beneath Tank
Force Main Void Volume = 2.18 dal
[C]
Total Dose Volume TDV = 81.62 gal/dose
(:S 0.2C design flow + force main avid volume)
Vertical Lift = 5
ft
1"1 r Ilk ! r'ti T A a t Le -
Volume
= ADD gal
Manufacturer; WIESER
Pump Manufacturer: GOULDS
Pump Model: EP04
(See attached pump curve.)
Controls/Alarm Manufacturer: SJ RO1t11BUS
Controls/Alarm Model: PS PATROL
Float switches containin mercu are prohibited.
- Approved Joints with
Approved Pipe 3 f# onto
Solid Ground
(typical)
PUMP -OFF
i ELEVATION = 1 ft
INSIDE
BOTTOM
ELEVATION = 1 ft
l
ov -o) )C(0 • ► 2) � D . '� 2-
—1oo
SEPTIC TANK(S):
Total Volume = 1000 gal
Manufacturer(s): WIESER
Install approved effluent filter at the se tic tank outlet
imm di t I u ire m of the um tank inlet.
Filter Manufacturer: POLY LOCK
Filter Model: 525
fijgn�dt W'db'l
METERS
FEET
10
-
9
30
8
25
7
U 6
20
z 5
4
3
10
2
0 L
01.
0
14 W/h
CAPACITY
MODEL INFORMATION
Order
HP� Vohs
Amps
Minimum
Cercult
Phase
Float
raw
Cord
Discharge
Minimum M1 MUM
Minimum Maximum I Shipping
Breaker
Style
Length
Connection
On Level
Off LevI
S
Basin olids Weightel
DiameterSire lbs.k!g
EP0411
Hog
No Swrich
rvlarlual
Manual
2019-1
FP041 1 A 1
Piggyback /'
115 72
20
VVIde-Angle
10,
j
1211
6
27 /9.5
EF'041i I F
Hug /
.4
No Switch
20'
M' tf7U81
tAanual
20/9,1
LP041 I AC
Piggyback
VVI d e-A r) g I e
201
1211
6
21/9.5
EPO-412
Plug
230 6
10
Na Svv itch
10i Y11
Manual
Mar)OZ11
15" 20 / 9.1
EP04 12F
Plug I
No swilch
2op
Mar)ial
u
Manual
20/9 1
EP051 I F
Plug 12o,
115 13
20
No Switc:h
mantial
M-airlual
22 / 70
EP0511AC
.5
Piggyback
20'
Wide, Arigle
12
6
23/10.4
EF0512P
230 6.5
10
Plug f
No Switch
20'
Manal
Mar)ual
221
Inc.
Innavadarls in Zabel'
& Wastewater Products A Division of Pdylok Ina
PL-525 Filter
PL-525 Effluent Filter
The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has
525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off bail
installed with every filter. when the filter is removed for cleaning, the ball will float up and temporarily shut off
the system so the effluent won't leave the tank. i „
Features:
Rated for 10,000 GPD (gallons per day).
• 525 linear feet of 1/ 16" filtration.
Accepts 4" and 6" SCHD 40 pipe.
• Built in gas deflector.
• Automatic shut-off ball when filter is removed.
• Alarm accessibility.
• Accepts PVC extension handle.
PL-525 Installation:
Ideal for residential and commercial waste flows up to
10,000 gallons per day (GPD).
1. Locate the outlet of the septic tank.
2. Remove the tank cover and pump tank if necessary.
3. Clue the filter housing to the 4" or 6" outlet pipe. If
the filter is not centered under the access opening use a
Polylok Extend & Lok or piece of pipe to center filter.
4. Insert the PL-525 filter into its housing.
5. Replace and secure the septic tank cover.
PL-525 Maintenance:
The PL-525 Effluent Filters will operate efficiently for
several years under normal conditions before requiring
cleaning. It is recommended that the filter be cleaned
every time the tank is pumped, or at least every three
years. If the installed filter contains an optional alarm,
the owner will be notified by an alarm when the filter
needs servicing. Servicing should be done by a certified
septic tank pumper or installer.
1. Locate the outlet of the septic tank.
2. Remove tank cover and pump tank if necessary.
3. Do not use plumbing when filter is removed.
4. Pull PL-525 cartridge out of the housing.
5. Hose off filter over the septic tank. Make sure all
solids fail back into septic tank.
6. Insert the filter cartridge back into the housing making
sure the filter is properly aligned and completely inserted.
7. Replace and secure septic tank cover.
1A6" Filtration Slots
10,000 GPD1
�
Accepts 4" & 6"'
SCHD 40 pipe
Alarm Switch
(optional)
Accepts 1" PVC
Extension Handle
Rated for
10o000 GPD
525 Linear Ft.
of 1/ 16"
Filtration Slots
ISOCertmed to
NSFIANS1 Standard 46
Gas Deflector
Automatic
Shut -Off Sail
Outdoor SmartFilter@ Alarm Extend & LokTM
Polylok, Zabel & Best filters accept Easily installs
the SmartFilter@ switch and alarm. into existing tanks.
Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com
POWTS OWNERS MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM! SPECIFICATIONS
Owner DCCI INVESTMENTS LLC
Perm€t #
DESIGN PARAMiETERS
Number of Bedrooms
3
0 NA
Number of Public Facility Emits
0 NA
Estimated flow (average)
300
al/day
Design flow (peak), (Estimated x 1.5)
450 gal/day
Soil Application Rate
.7 allda Ift
Standard Influent/Effluent Quality
Monthly average*
Fats, oil & Grease (FOG)
530 mg/L
Biochemical Oxygen Demand (BODr,)
s220 mg/L
❑ NA
Total Suspended Solids (TSS)
5150 mg/L
Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Demand (BODr)
530 mg/L
Total Suspended Solids (TSS)
530 mg/L
0 NA
Fecal Coliform (geometric mean)
510' cfu1100ml
Maximum Effluent Particle Size
Y. in dia.
0 NA
Other:
0 NA
*values typical for domestic wastewater and septic tank effluent
MAINTENANCE SCHEDULE
Septic Tank Capacity
1.000 al
0 NA
Septic Tank Manufacturer WIESER
D NA
Effluent Fitter Manufacturer POL LOCO
p NA
Effluent Fitter Model
525
❑ NA
Pump Tank Capacity
600 gal
❑ NA
Pump Tank Manufacturer WI ES ER
0 NA
Pump Manufacturer
GOB j LDS
0 NA
Pump Model
' EP04
0 NA
Pretreatment Unit
0 Sand/Gravel Filter ❑ Peat Filter
❑ Mechanical Aeration ❑ Wetland
❑ Disinfection 0 Other:
NA
Dispersal Cell(s)
❑ In -Ground (gravity)
❑ At -Grade
❑ Drier -Line
0 NA
IX In -Ground (pressurized)
❑ Mound
0 Other:
Other:
0 NA
Other'
0 NA
Other:
0 NA
Service Event Service Frequency
Inspect condition of tank(s) At least once every: mon, year(s)
(Maximum 3 years; 0 NA
(s)
Pump out contents of tankis) When combined sludge and scum equals one-third (Y) of tank volume ❑ NA
Inspect dispersal cell(s) At least once eve ❑ month(s)ry: � � Year(s) (Maximum 3 years) 0 NA
Clean effluent filter At least once every: 0 month(s) 0 NA
CK year(s)
Inspect pump, pump controls & alarm At least once every: 3 0 month(s) 0 NA
I year(s)
Flush laterals and pressure test At least once every. ` 0 month(s) PQ NA
0 year(s)
Other: At least once every: 17 month(s) JQ NA
0 year(s)
Other:
GXNA
Mom
MIAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POwTS Inspector, POwTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or * ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected -to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified PO TS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
Page 71- of
START UP AND OPERATION
For new construction, prior to use o-A the POWTS check treatment tankis) for the presence of painting products or other chemicals
that may impede the treatmeni process and .ior damage the dis;persaj cell(s), 11' high concentrations are detected have the contents
of the tank(s) removed by a septage., servicing operator prior to use.
System start up shall not occur when soil coed itic-,int, are frozen at the infiltrative surface.
During power outages purrip tanks may fill above normal high water levels. When power is restored the excess wastewater will be
discharged io the dispersal ceWsl ire one jarge duse, over lDad-ir-ig the cefl�s) and may, result in the backup or surface discharqC of
effluent. To avoid this sirruation have the CDntonts of the purnp tank removed by a Septo L J�
?. _je Serv-�--ing Operator pcior to restoring
power to the effluent pump or contact a Plumber or POD TS Maintainer lo assist in manually operating the pump contrals to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal C-oils. Do not cirive or park over, or otherwise disturb or comp. nc-T, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following frorn the Wa.stems' ater stream may improve the perfc)rmance and prolong the fife of the
PC) W7S, antibictics; baby wip(as; cigarette butts; conclorns; cotton swabs; degreasars; dental floss, diapurl; disinfectantr,; fat -
foundation drain (ssu.rnp pumpl water', fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; metjications; all,
painting products; pesticides: azinitary rapkins; tampons; and vvat&r softener brine.
ABANDONMENT
.ervice the folio -wing str-ps shall be taken to _-5ure, that the system is
When the POWTS faills and/or is permanently taken cut of 5-
properly and saf0y abandoned in compliance with chapter Comm 83.33, Wis-.onsin Administrative Code-
0 All piping to tanks and pits shall be disc onne.-C-ted and the abandonad pipe openings scaled.
The conten-'Ls of all tanks and pits shall be, removed and proper[y disposed oi by a Sep Lage Ser-vr.lng Operator.
After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
Sol[, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS falls and cannot be repaired the tDHOWing measures have been, or must be takaLn, to ptovide a code compliant
repiacement system:
El A suitable. replacement area has been evaluated and may be utilized for the lo at on of a replacement sol I r-bsrptiorl
system. The replacement area s1hould be protected from disturbance and compaction and she llj[d not be infringed upon by
required setbacks from existing and proposed structure, lot fines and wells. Failure to promci the repo acernem area will
resin'[ in the need for a new soil and site evaluation to estabfish a sortable replacement arcn- Replasemeril S�rstams wuSal
comply with The ri.-Jes in effect at that time.
A suitable replacement area is not available due to setback and/or so-11 11mitMions. Barring advances in PDWT�S;
technology a holding tank may be instal ud as a last resDrt to replace the failed POWTS,
4- en e 1 -14
o* the RnIVIS—a
aigat" rle P7,77um, �':T_—ff -MT-77d. H TT U T. L_ F A La b L TurTt' �1 r C a lis av-aftatM6-15 h a d I n ri k
b 4- as ea f�_'b P__ fkj t�> eQ 57W CJC-JI 0
Mound and at-gradie soil absorption syster-ris may be reconstruc.ted in piace lollowing removal of the Merit at at the
infiltrative 7,urface. flee onstruCtions of such systems must c;ompiy with the rules In effe-�t a#&- that, time.
< <WARNING > >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDJIOR INSUFFICiENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY FiESULT. RESCUE OF A
PF-RS,ON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE.
ADDITIGNAL COMMENTS
POW-rS INSTALLER
Name COUNTRYSIDE PL-UMBING
715 246 2660
PO WTS MAINTAINER
Name PAUL R KOEHLER
Phone 152462660
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REG.21LATORY AUTHDRITY
Name N a -Fn e
POWERS SEPTICt 4-.DQ Aj
Phone 7152465600
I --zed 'r� �-,ompi-an-e vvitn -Ihapiler k... U r T I Yri E112, -.2! 21 ,.1. L-11) i j 1 1-1 & f, d Lc�"S 5 4! 1 i. '2t L 3� 1, wnt, -m -D d,!�.
IF nocumf2rit was dra, I L Aar s t, I V e C'
ST. CR V-v- i ,NTY. SANITARY SYSTEM File #:
Office Use Only
OWNERSHIP/ADDRESS FORM
c�o�e�/toz�
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.
..,
i„..�... ,, R _ '�'•�;i :2 .��i `�"+iS'•ww.. . Jam' �A. � s .;� '•
W4' �i . �'aAq�.,.. "$.:b. :��'.. ��. �fx •'� si�." � � Yam.
Owner/Buyer Jeffery & Kathy Hotovec
Mailing Address 1464 106th Ave
City/State/Zip New Richmond Wl 54017
Phone Number (required) 715-246-2320
Email Address (required) katn eff a@gmall.com
Parcel Identification Number 026-1309--04-000
(found on the property tax bill)
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Property Location S� �/a , � �2 N R/00W. Town of Richmond
p rty /a ,Sec. . T 30
Subdivision Plat: Waters Edges 1 st Addition , Lot # 45 .
Certified Survey Map # Volume . Page #
Warranty Deed # 113812
Number of bedrooms 3
(before 2005)Volume , Page #
Spec house 0 yes ® no Lot lines identifiable ® yes E3 no
+�F .d - ���.: t� ti;;�t-. •� p.�: _� ...� . , �, t.. ...�,�. .: Y:. ���ti..,�h .� :did• r �'fti "i�P ' e' . �. «.r.�.�ys .
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New Property Address
(Staff Initials)
(Verification of new address required from Community Development Department for new construction.)
( Date)
This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications.
New Systems: Include with this form a recorded warranty deed from the Register of Heeds 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 715-245-4250 Fax
cdd2sccwi.,!gov 1101 Carmichael Road, Hudson, Wl 54016 www.sccwi.govv
State L3ar of'Wisconsin Form 1-2003
WARRANTY DEED
Documern NUITIbPeF J1 O C-41 MC M N`aFn -.
BY T1 i IS DEED, DCC I I wivestm en is, LLC, a Wisconsin 11 m i ted I is b i I i ty
com pa ny, ( here in after "Grantor," whether one or rnme), c on veys and �Yarrants to
,Jeffery M. Holovec and Kathy K. Hotoycc, husband and wife as Survivorship
marital property,( hereinafter "Grantee"" wheffier one car more), tlie follo '
I wing
d cscribicd real estate in St. Cro i x County, State of W] sca its if,:
Lot 45, County Plat of Walers Edge First Addition W the Toivp of Rkhmond, St, Croix covilly,
Wisconsin,
Exception tc) walTantics. easements, rewictions iind covenants ()f record; higjjwjyand
street rights of way; and Municipal and zoning cy-diriances and agrcements entered
ul-Ider them; and further except real estate tj.xes accruing in the year of this Conveyance.
Dated
DCCI I rmen L to Wi con in i ited liability company
(S EA L)
_Rona-N L. Derrick, Mern bt r
AUTHENTICATION
Signature(s)
authenticated on
TITLE-. MEMBER S"I'ATE BAR OF WISCONSIN
if not,
authorized by is. Stat, § 706.06)
T1 US INSTRUMEN-11- DRAFTED BY:
St. Croi-x County Abstract & 'Title Co., Inc. by Anianda
W
Waytie m tbe dircci ion of the Grantor. 21 -S28413
1139447
BEET PA13 T
REGXSTER OF DEEDS
ST. CROIX CO.,, W1
RECEIVED FOR RECORD
09/ 20/ 2021 11: 10 AM
EXEMPT:
RE C FEE 30.00
TRANS FEE 177.00
PAGES-. I
X*The above recording -information
verifies that this document has
been electron I cafly recorded
& returned to the submittier
Rccord'mg Area
Nai-nc and Rcturrt A(ldress
SL CDOiX COUnty Abstract & '17111 c Cc Iric.
575 N.. Knowles Ave., Suite #13
New Riclnnond, W1 54017
026-1309-04-000
Parccl 1dc!1UFiCx1i0n NL1.Mbcr,1PR4)
T h i s I S "., OT homestead p-o pe -rt �,.
ACKNOWLEDGMENT
STATE OF WISCONSIN
St. Croix COUNTY
Personally carry before nic on q I I
IP
th e above-nam ed DCC1 I n vestm c n tsLLC', a Wilco ns i n
li rn i (ed liability c a m pa ny — 11on a Id [,,,. Derri c k, Mem be r
to nic known to be the rci-son(s) who execttted (lie t-oregolng
ins=ment and acknowled2td the acme.
__Ld
Nou-try Public, State of Wisconsin
My Co rn rn Iss ion (-?S perfiltill �n 1) (exp i res:
(Signs turcs 111,0y 4e autfierg tlelmW (fir acknovyleilgvd. 134)0 jarr not nrcrs!smry.)
NOTI-',., THIS IS A STikNDAR[) FORM, AiN)',%101)I FICATION'S'F-0 Tif 1.5 FO'Ri%l StiOULD 6F. CLE-MI'l DIEN-11F] ED.
WARRANTY DEED rU 2) 0 03 STATE B A R 0 F NV IS C 0 NS IN FORN1,N(Y 1-2003
Type nilmc below sigmMilres
St. Croix County 1139447 Page, I of 1
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DERRICK HOMES 715-246-2320 9
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ISSUE DAtE: 06-01-23
Rf1ASOM. 07-17-23
05-12-23
JM NtrAKR: 107s23
MAWN BY., w MMYN
SHEET#
4or4
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alk
Depa 0 men It of 2"SOIL EVALVII T #2014
IP SP Safety and in accordance with Comm 85, Is Acam Code Page of -- 3
Professjo�ial Services
N1, 6. Schmitt Steil Testing* Inc -
County
Atlach complete site plan on paper not less than 81/2 x 11 Inches in size. Plan m U s I
St. Croix
include, but not limited to: vertical and horizontal reference point fBM). &ection and
percent slope. scale or dimensions. north arrow, and location and diSta nice to nearest road Parcel I.D 02,(c>
Please print all information.
Reviewed By Date.
Personal inf-omiation you provide may be used for seoondary purposes (Privacy Law,& 15-04 (1) (m)) I 1�
.11'e/ tj Ar
Property Owner Property Location
DCC1 Investments, LLC Govt. Lot SWI/4, NEI/4, S12, T30N, R18W
Property Ownees Mailing Address Lot # &C ubd Name of-C-&M#
1505 Hwy 65 45 Waters Edge First Addition
i._
t State Zip Code Phone Number City Village Town Nearest Road
New Richmond W1 54017 I -599-4244 Richmond 1 66Th Ave.
New Construction Use Residential I Nvmber of bedrooms 4 Code derived design floW Fate 600 GPD
Replacement Public or commercial -[describe:
Outwash (Chetek-Onamia Ser Parent material i es) Flood plain evatlon, if applicable
General comments Area is SUable fix a con vent ionai -system with a 0.7 gpd/sqft rate, Install system 5.25' below grade along the contour. Slope of'
and recommendations. of is 2%.
Boring # Boring
Pit Ground surfaw, elev. 99.47 ft. Depth to limiting factor 103+ in. ISoil Application Rate
Horizon
Depth
iin�
Dominant Color
Munsell
Redox Description
Chu. Sz. Cont. Coior
'Texture
Structure
Gr Sz Sh
Consistence Boundary
M Roots
GPD/W
00W 'PEff#,2
0-11
2 11-24
3 24-39
4 39-57
5 57-75
6 75-103
10yr3/3
1 Oy r4/4
7.5yr4/6
none
none
nOT'le
none
none
none
sit
sd
grsl
gris
gds
g rc-os
2f sbk
2msbIk
mvfr
mfr
mfr
as
gw
gw
2vf 0.6
ivr 0.4
1Vf 0.4
1W, 0.7
------ 0.7
------ 0.7
O's
0.6
0.7
1.6
1.6
16
Imsbk
7.5yr4/6
7.5yr4/4
10yr6/4
lcsbk
mvfr gw
M1 CS
M I
Osg
Osq
2 Boring # Boring
P11 Ground surface elev 98.57 fl. Depth to 1pmiting factor 105+ in. [S-oilAppli-cation Patel
Horizon Depth
in.
Dominant otor
Munsell
Redox Descfrpfion Texture Structure Consistence Boundary
Qu, Sz, font L C010F Gr SZ Sh
Roots
- GPD/kl
PFff# I "Eff#2
1. 0-11
2 it-19-
3 19-27
4 27-41
5 41-59
6 59-105
1 Oyr3/ T none
10yr4/4 non+
S11
icl
2rngr mfr
2fsbk nifr
lmsbk mf r
GS9 M1
Osg M1
as
Im,,lvf
0.6
M
0.6
0.7
1.6
gw
qw
CS
1VF
0.4
7.5yr4/6 none
7.5yr4/6 none
7.5yr5/6
10yr6/4 none
grsl
rIs
gr-5
grCos
1Vf
------
0.4
0.7
CS
------
------
0.7
1.6
1.6
0S9
MI
0.7
Effluent # 1 = 60D 30 < 220 rngAL and TSS > 30 < 150 mg/L Effluent #2 = BODE s 30 mgA. and TSS < 30 mg/L
CST Name �Please Print) Signature, CST Number
Thomas J. Schmitt 227429
Address Schmitt Soil Testing, Inc. Gate Evaluation Conducted Telephone Number
1595 72nd St New Richmond, W1 54017 11/2/2016 715-760-1978
b si , D-&»'-N I., (k
r
P Pope rty owner DCa Parce, I I D Page 2 of _.1
# Boning
Pit Ground surface eley, 98.87 ft. Depth to linwing factor 105+ in- lSoil Avolicatlon Ratel
Horizon Depth Dorn in ant: Color
in Munsell
Redox Description Texture Structure
Qu. Sz. Cont. Color Gr- Sz. Sh.
Consistence Boundary
Roots
GPOM"
I E. ffl# I Eff #-21
1
3
0-14,
14-21
21-27
10yr3/4
7,Svr4/6
7.5yr4/6
7.5yr4/6
7.5yr4/4
no
none
none
none
none
none
none
sil 2fsbk
scl e fsbk
2msbk
g-r1s Osg
grsl OM
grs
g rcos Osg
mfr as
Mfr gw
mfr gw
M I CS
2m,2f
1Vf
0.6
0.4
0. E3
0.6
1.0
1,6
0.6
1.6
1.6
1Vf
------
0.6
0.7
27-43
6
7
L
43-51
51-68
68-105
mfr
M1
M I
gw
CS
---®
------ "I"
0.2
W
0.7
0.7
7.5yr5/6
10yr5/6
# Bof,ing
Boring --.1
Pit Ground surface e- lev- 991.37 ft. Depth to limiting factor 106+ in.
Isoil AuDlication Ratel
Horizon
Depth
Dominant Cow Redox Desuiption Texture i 51ructure 'Consistence
M U n5e.] I Ou. Sz. Coni. Color Gr- Sz Sh
Boundary
Roots
CPC 41-1
wEff#1 -Eff#2
1
0-10 10yr3/3 none sil
1{ 1. 7.5yr4/6 none sid
18-24 7.5yr4/6 none grst
24-32 7.5yr4/4 now ---rgrsl
32-42 10yr-5/6 none grs
42-51 '7 . 5yr4/ 4 notie g rs]
51-106 10yi-5/4 4 none g rtc
2fsbk
2msbk
mfr
as 1Vf
gw I I Vf
0.6 0.8
0.4 0,6
0.6 1.0
0.2 0,6
0.7 1,6
0.2 0.6
0.7 1.6
2
Mft
3
2msbk Mfr
OM mfr
CS
CS
4
5
Osg M1
OM mfr
CS - ------
CS
------
6
7
0
rrrI
F-1 n Boring
Ri t G r o u nd surface e lev. (I Depth to limiting factor i n. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GpDlfl2
in. Munsell Ors. Sz. Cont. Color or. Sz-, Sh. 4,Eff#1 -EM
.... . . . . . . . . .............. - - -- --- ---
. . . .......
* Effluent #1 = BODA-.> 30 < 220 mglL and TSS >30 �160 mq/'L ' Effluent #2 = 60C� <1 30 mg)L and TSS <,-30 mg/L
The Dcpartment of Commerce isaii) copportunity'
qual oprtunity servicL: provider w,id employcr- Ifyou riCCLI WSS'1�4-NIM:e to ,tk:Lxs,; kerviccs or
need material in an altt:T-natc formal, pleaw, conta;:i the depailment at 608-260-31-51 or 'I -IN 008-?64-8777.
S ('13
, D- 83 , V) I k 07-01) Sdvnitt SoN Tesbrog, Inc,
/4� ze cnq7-jo/�/
Page 3 of 3
Conducted bi
Schmitt & Sons Excavating, Inc.
Thomas J. Schmitt, CST 227429
586 Valley View Trail
SomersetAl 54025
Phone- 715-760-1978
Date .2
11 Backhoe Pit
A Bench Mark I Ell. 100.00'Top of 2" PVC pipe
Bench Mark 2 El. 100.50'Top of 2" PVC Pipe
Conducted For:
Name- W ( I Investments. 1.1.("
Address" 1505 11 �%
City, State, Zip-, Ne►% Richmond. NNll 54017
Subdivision-. Water Etige Ist Add'n
Lot Igo.: 44
Legal Description, S W1 A N VI /4 S 12 'r30 N R IS N\
Township, County: Richmond T4 m ship, St. ( rq 6 � ( i m fil
zilope= 1570
Scale 1 11= 400 P
C:fl
I%
0 4 y�
�L�OV
A ly' 2,
3
.00
........... ...........
106, /wA
X
WATERS EDGE FIRST ADDITION �,
04 PART OF THE NW IM C r�--:r �,i • 4, SW VIC CY THE Nk 1 4 5f i A Of t HE Nk V4 NW t�A
Lei OF THE NE 1;4 /11 THE NE ',A. SECT1044 12 t3LII R I 15VW. T OWN OY
—.I. "AD SST GROU COUNTY, VdSCONSIN
Oe"W I �,i7liI CUM 11-1 W'ga
6rl v c%rww cmhormt sr IJ-
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oll
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SWEV 2 OF 4
WATERS EDGE FIRST AMMON
Dccl
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NMI
FINAL PL�
VOf W - 4-11 1
vou T J.V w.r
Dep aft of
#2014
T
P6 SP Safety and r. i n accord a nr wrth C om m a 5, Wis. ACIM C Ocle Page 3-
Profsevioes �sa-orw Schmoil Testing, Inc,
Attach com plete site plan on paper not jes4 th on- 81/2 x 11 inches in size. Plan must C*Unty St- Croix
incluc�e, but not firrifted to, veslk�Efl gifild horizontal refeft�,nce p6nt (BM). direction and I - -, -.,- --- ----
percerd sk)pe, sca�e or dimensions. nortih afT,Ow, and locab o n arm d ista n ce to r�e a re st. f oad. P:@Mel 1_1). o z&> 1309 - Oq ()00
PleaSO Ping all inforrnation. I -
Relid Date
O)ofe,d By
Persona I Infccmabori you pro-vkje may t>e used for secof4ary purposes (p
nvacy L, 15.0 f 1) (m
Pry rty Owner P roPerty L 0 t i i
DCCI Investments, LLC
_God. Lot SW1 /41 N El /4, S 12, T30N , R1 8W
Property Owners Mading AWtess
_ _ .._ _Lot Slo(* # Subd- Name ov%W
Z4
1505 Hwy 65
45 Waters Edge First Addicon
State -Z--ipCo-de Phone Nun*er its Village To*.n Nearest Road
,-,New Richmond I W1 54017 612-59"244 Richmond
166Th Ave.
E>e:' New Con sttucbon U se: Reside ntia I I Number of bedrooms 4 Code derived design flow rate 6M GPO
Replacement
�-J Pub lic or oorrirnefW I - De scribe -
Parent Material Outwash (Chetek-Onamla Series)
Flood plain elevation, i applicable ft
General comments Ama is suitable for a conventional system wfth a 0.7 gpclJsqft rate. Install system 5.25 below grade ab-q U)e Contour. S" of
and reoommendatiorks, area is 2%.
WV1
180riqg 44�
JL Bohng
_
Pk Ofound surface elev. 99.47 ft,. Depth to 1knifing fackw 103+ In.,
Isoil Ax"icafion RwAi
Hor='n
Dep1h
in.
Dominant Ccgor
lures
M
Redox Description
Qu. Sr- Cont- Color
-Textvre
Structure
Gr- Sz. Sh-
ConsWwce
Soundairy
Roots
GPD1 W
--E 1W 4E ff' $2
0-11
11-24
3 24-39
1()yr3/3
none
S11
Sd
grsl
2fSbk
2msbk
lmsbk
mvfr
mfr
as 2Yf 0.6
gw ®1 0.4 0..6
gw 1Vf 0.4 0.7
gw 1Vf 0.7
I 1 1.6 1
10yT414
7.5yr4/6
none
none
none
none
Mft
MVfr
MI
4,
. --1
5
r3957
, . -
57-75
7.5yr4/6
7.5yr4/4
i grs
gris
Icsbk
OS9
CS
0.7
1.6
6
75-103
1 Oyr6/4
none
9rcos
OS9
Ml
0.7
1.6
Boring # Boring
Pit Grmnd SuffaCe elev. 198.57 ft- Depth to fimiting fa or 105+ in-
rsail ApgAicatkmn Matel
Horizon
Depth
in.
Dominant Cojor I
Munsell
Redox 1)escription
Qu. Sz. Cont. col -Of
Texture
Structure
Gr- Sz. Sh-
�nsistence
BwWa
Roots
GPON?
T"I -E"2
0-11
10yr3/3
none!
2rngr
mkt'
mf'r
as
gw
ImP
1Vf
F
0.4
--0.8
0.6
0.7
2
3 19-27
1 27-41
5 41-59
6 1 59-105
1 OW414
7.5yr4/6
7-SYT4/6
one
none
none
Ikl
grsl
j 2fSt*
lmsbk
Mft
gw
1VF
0.4
gris
gays
grODS
OS9
OS9
OS9
Ml
MI
MI
CS
CS
0.7
0.7
0.7
1. 6
It
1.6
7.5yr5/6
wne
10yr6/4
none
" Effluent # 1 = BOL) 5 > 30 < 220 mg[L and TSS >30 < 150 mgq- P Effivent #2 = BODC < 30 mgfL and TSS < 30 mgA-
CST Name (Plimse Print) Signature: CST Numt>er
Thomas J. Schmitt 227429
Address, Schm4t Soil Testing, Inc. Date Evaluation Cor"Jucted Telephone Number
1595 72nd St. New Richmond. Wl 54017 11/2/2016 715-760-1978
� BDr ' l 130 fIk V "'MY);
r
pWolty owrw DOCI-In L panne! ID
- . --�
OBWng
E• 3 mxtq _ Pit Ground surface ear. 9&87 ft.
paw 2 of .S
Depth to Gmipng factor 105+ in. Sooty AwpN=tiw Ratei
Horizon
DePM
In.
Dominanf Dolor
Munsell
Redx DescrOtion
Ou. St Gent. Doke
Texture
Gr. Sz. Sh.
i rxee
Elounda y
foots
1
G-14
10yr3/4
now
sU
2fsbk
Mf r
as
2M..2f 0.6 0.8
2
14-21
7.5yr4/6
n9
sad
2fsbk
Mfr
gw
1vf 0.4 0.6
3
21-27
7.5yr4/6
none
grsl
2rrisbk
mfr
ow
1vf 0.6 1.0
4
27-43
7.5yr4/6
now
gas
Dsg
ml
Cs
-.--.---.. 0.7 1.6
5
43-51
7.5yr4/4
none
grsi
Orn
mfr
gw
- --- 0.2 0.6
6
SI-68
7.5yr5/6
norms
grs
Dsg
cs
-.------ 0.7 1.6
7
68-105
1flyr516
none
grt�DS
Dsg
rrd
0.7 1.6
$oft # Pit Gad surfaoe elev. 99.3 f. Deph to Wn ft factor 106+ .Appgw*m Rate'
tbrlmn
C"M
in.
Color
MunwA
Rsdax on
Qu. Sz- Gont. Dvkw
Textum
Structure
Cr. Sz. Sh.
CorabWm
Bondtrry
Roots
GPDW
*Owl
"E=2
1
0-10
10yr3/3
n0r*
so
2fsbk
Mfr
as
1vf
0.6
O.8
2
10-18
7.Syr4/6
none
sid
2msbk
---
mfr
------------
9w
1vf
DA
D.6
3
18.24
7.Syr4/6
none
901
2Msbk
rnfr
CS
-------
0.6
1.0
4
24-32
7.5yr4/4
room
grsl
0M
mfr
CS
D.2
0.6
5
32-42
10yr5/6
nowgrs
�rM
CS
�
D.7
1 r6
6
42 -51
7.SYr4/4
none
WS1 -
Dm
rnfir
cs
- -
0.2
0..6
7
51-106
10yr5/4
nay
g lkw
Osg
m1
0.7
1.6
[j tit Gfouoa wrtaca ow_ ft DepM to um&q taCW ISoa &ppt+cabw carol
Q
' Ef ord #7 = SOD 5> 30 -S M anal[, and TSS >30� l 50 nV& ' Ment #2 a SDDs s 30 mg& and TSS - 3D mg&
The Dqxwbmnt of Commave Is an equal opportwity service provider and employer. If you noel assistsnce to access services or
need material in an alternate format, please contact the department at 608-266-3 t 51 or TYTY 608-264-8777.
SBU-030 (1t..O7M) .
Schmitt 5ai TesW q,1M.
' Ef ord #7 = SOD 5> 30 -S M anal[, and TSS >30� l 50 nV& ' Ment #2 a SDDs s 30 mg& and TSS - 3D mg&
The Dqxwbmnt of Commave Is an equal opportwity service provider and employer. If you noel assistsnce to access services or
need material in an alternate format, please contact the department at 608-266-3 t 51 or TYTY 608-264-8777.
SBU-030 (1t..O7M) .
Schmitt 5ai TesW q,1M.
Tin
Page 3 of 3
Conducted by; Conducted For*
Schmitt & Sons Excavating, Inc, Nameq D-CC1 liavestmcnts, LLC
Thomas J. Schmift, CST 227429 Address. 1505 llvv-y 65
586 VaIley View Trail City, State, Zip- New Richmond, W1 54017
SomersetAl 54025
Phone-, 715-760-1978 11 Subdivision: Water Edge Ist Add'a
sjnw�'M Lot No. + 45
Legal Description", SWIM MUM S12 T30N'RISir
11 Barkhoe Pit • Township, County, Richmond Tow nship,,St. Croix County
AL Bench Mark I El. 100.00" Top of 2"' PVC pipe
A Bench Mark 2 r=]. 100.50'lrop Of 2" PVC Pipe
Slope— 3%
Scale V, 40t
1� MOM% _-MF_ a ec
-4
f3� 9�.s �'
Ste+ � a3 96.87
Y 1 4� 4,37
■
��. ��-i�7 61 / `-`tom
.5 P,
IV
use
PROPERTY ADDRESS.
1464 -166TH AVENUE
NEW RICHMOND, WI SQ17
SCALE: 1 INCH a *50 FEET
v so 100
VERTICAL CONTROL DATUM: NAVO 1988 NORTH
Vegetation Management Plan:
1. Disturbed areas to be seeded as soon as passible after construction.
Temporary seed should be applied, if construction extends past
September 1st, of annual ryegrass and oats at the rate of S pounds per
1000 s.f. of area and left over winner. Permanent seeding shall be
completed the following spring. Consult table below for recommended
seeding mixtures.
2. A 35` wide vegetative buffer zone is required along the shore of
Paperjack Creek. Vegetative Buffer Zane shall comply ► ith requirements
of St. Croix County Zoning ordinance provisions in Chaper 16.34. Any
vegetation removal or maintenance must comply with 16.34(2) and
16.34(3).
RECOMMENDED SEED MIXTURES
I. Ty R. Dodge, VAsconsin Professional Land
seed
e
SurVerr, hereby certify that this Stake -out Plan
NM&urnlW
Areas d Use spades
Psop'n` h ions S"&V Rate
MINIMUM BUILDING SETBACKS:
was Prepared by me or under my direct
FRONT SO FEET
superAOo+'r and is correct to the bast of my
Li^ dry. wa4reinsd, Kwtjcky ekow ""
6 3 w 10W sq.t
24 OR
SIDE ID FOOT, tS FOOT COMBINED
knowledge arcs belief, and f M work was
2D
ear+ay, or gvvelly =6 rare t s m
la 13p acre
REAR 25 FEET
completed as of the lode shown hereon.
sr+d #+o ua a 10 slopes perrr+nid Ryeerase
3p
D.H.W.M. 7s FEET
BUB.L?ING LOCATION NOTE:
Building location is as staked.
DIMENSIONS ARE SHOWN FROM
Final constructed location has not been verified.
ee
LOT LINE TO FOUNDATION WALL
Aron d use
Spades
Propvrtlons Seadnp Rate
saao.& ctrrna
25
a,.rwhate *A
tah"U t rod nix
Cwads VA&ye
SW4w WwaWm
23 me w lops owl
20
*WW6*` *
So
contai M19 rmaw grass
is desired
Anal Ryeprsas
OR
10 35 bvi4ffe
10
$alt Cures
2
DOW
Little >skamem
10
94M
!late. Sae Yftcorwin OepwVnent of Trmm porlation standard
a"L&%
epedicaam "Man CW4"&V for additional irdwmabw
.�
IMPERVIOU1 AREA MCuuTIONs
p
p9fU�12023
AREA TO O.H,W.M.: "A89 SQ, FT.
r p
}
AREA WITHIN 300 FT. OF THE O.H.W.M.: "566 SQ, FT.
f
PROPOSED IMPERVIC)US AREA: S,47E SQ, FT.
8.7% PROPOSED IMPERVIOUS COVERAGE
i
S
,o.
u u
OA
LEGEND
0 FOUND IRON PIPE PER PLAT OR
L ► _ ... _. ... ORDINARY HIGH WATER MARK
AS NOTED
D WOOD HUB SET AT 10' OFFSET
OR ON BUILDING LINE
T.O.H. TOP OF HUB ELEVATION
• ••: ry •• ..._ ... —
.....- ... i��12�
• iti
.. _
�
...
; ; _ SLOPES �
FLOODPL11lN tJNC�` . _ � -
_ _
` -: r< T.O.P. TOP OF IRON PIPE El"ATION
_
_.... - O.H.W.ril. 75 SETBAgC
O.H.W.M. ORDINARY HIGH WATER MARK
x 55.5 . EXISTING SPOT ELEVATIONS
it
` LOT
UTILITY EASEMENT
�,1
TOTAL AREA
ANDER LINE
'' .-�" -1
-•-
PROPOSED SILT FENCE
W% 1112,275 SQ, FT.
_
L389 ACRES l
$
-
ALL EXTERIOR BUILDING CORNERS
AREA TO OHWM
� .... ���:. _�- ..
t � � MARKED WITH PIN FLAGS
ze
� i6,I389 SQ. FT. / #
r
I-S3S ACRESt :
u
L B.O.= 9a4+
#ANO INDEPENDENT PROPERTY
RESEARCH HAS SEEN CONTOURS SHOV+I ARE
O. H: 993. Z7
CONDUCTED BY THE PER GRADING PLAN.
"
• ' '
_ _ F«
, _
$ SURVEYOR. SPOT ELEVATIONS ARE
OVYNER/SUILDER IS FROM FIELD SURVEY AT
RESPONSIBLE FOR CONSULTING TIME OF HOUSE STAKING.
HOUSE
TIRE DOCUMENTS TO VERIFY ELEVATIONS SFIOVIR+I ARE
ANY OTHER EASEMENTS, NAVD 1983 DATUM.
COVENANTS, AND RESTICITONS
�"
_ _
u THAT MAY AFFECT THE
r PROPERTY.
{
GAR.
•
T.O.H. »997.1Z
FOUNDATION DIMENSIONS
-
-- - ......-.. fi
I INCH = 20 FEET
-----
PROPOSED
DRI SWAY
f
51-0
� TEST AREA
SO
r
f `t
T,O,P,-995.4 .,... + _ T.O.P.=996.
lilt
� 1
A=12 43'1W Ra783.0W L=173.924
166TH AVENUE
.�
PROAM
DERRICK CUSTOM HOMES
LOT 45, WATERS EDGE FIRST ADDITION - HOTOVEC RESIDENCE
SEC I �. r3f7tt', Q tEW. TD.'/' 1 d� RIC> .` If:, 57 R�]FY C�IJNT►, L" tSLOr sS 1
aruwn ea AS
IMUNUM r N&M
; ban kA M � � o� ex We
''-". a "a fth """ "M a)Wr23
,�� U eW�aA�
1utl-�Itin1 f motes SM � Srre9 An „� am-3X
�M
slob tr t a tY tw
HOUSE STAKEOUT PLAN
Mt11 O td N WC uE
im
„�,,
COUNTY PIAT s
WATERS � +r1DNgrlb � —
EDGE FIRST
PART OF
THE NW 1/4 OF THE SE 114. SW 114 OF THE NE 1/4, SE 114 OF THE NE 114, NW 114 [
OF THE NE 114 AND ALL OF THE NE 114 OF THE NE 114. SECTION 12, T30N. RIOW. TOWN ► r,,,+��",�
OF RfCHAl1 ST. CROIX COUNTY, WISCONSIN. � 0
soon 1tEtr,137E/t OF IFi'ERS %llam
fvclt +
sfl a PREPARED FOIL PREPARED BY: Sirr�echm �~ �
OM *rMlwl
LEGEND MW 1820E AY SS "►'�xt �'+� 1 [Ex MAT a"' r" r ''
7 MUM MAI 4MW= MWNCMwC0ftM �ilWi� NEW MOW.1AR A� COMUtTINVASSOCIAVe oocwmm ■ 110,100 � � � •, s'
Gee 2471E EM" Si. M. 101 VOL: 111 j
AAOf1E]M OltJti MGT[0 ! {� 1 ]J20 muomk wl S4016
i ootrfa l •yam. Owwt "11► N 11EWA w+t u �d� PIS1362•S277
r11rESt WWI
stT:-ct�o+l�rwt><vsr� tw 0 � 1iN LOCATION SKETCH
m004mxa U E�O
! !•'.BwL SECTION 12, T30N, R 1 S WSTj,ve"Almamool" "•.�xJQ L-J— 113 WE0VW knS tlL F{E1t L*VA11 Four
.� 6XISR1108 FDCF>wur t +sa+e»rtwr w 1htf AeLlr » t t7ltaas is Err ant f�
oftweN Ar LaCA?m
R Q'w1hmammmoopewoG fM to Comm
AM� - 1
vUTLON ,
.1llPpkTt17M oM TGr ■ I
'a • r� + Sa i I L
o� aF�weY +mom1AfA'�t twWsc I� 1
A+e6S �t' r�arn
T11Mr+s+snlKiAsT+tAs 1tAG1thMEQ 3fIfJWU1 arr fftts 1HAr is104wsa frt 1
�ssar►Flsuatlf�AFtfs ua% 1uCiTOit'A7frCClttrfft'AMp117M11►gyr
ter xt11wF1� q�slntr; � n aim 111tCuwwin 1' � +MMz ovri,tir t � Cf1
oa m % "S" grows mme. "%a ok "MAN ►oar =L oC>E'1� " � Acr *t+rultf C! wwAQ "* amm&"" ►AIIM #TC] It m ifwo1,Fsms alf I
verinlafwsrrr
FURTstIR� fAA�a� ��t�+Wr �rA11Ch 0*1AAG7' l:lE'1T. � 1
TOYYfE t� MLtiW1t71pl�Wt ►IQWCI.
caks"wwa MOW
UTS"1f n4ammew
Ai11A1tNs1iC11rpiANfiMoltl►��#IQNAIMI �M.rir ~ m
_ AMrMttifAmmxw i1L A 1SWr��er
flsosr+s oCslNuc wenowlft ►M
M7 /
MO pa"Vfwrrommovxhme lsftm *RDTa•" Qmwwcilq
arrlRN
VH&T lrfrM lAliAftl7M #1rtGlgM � Cr erff�irY ■•r+stsss*
srstels. rtnFtsctrrasrasa wit srorrt s+oua 1�11�k[rotsAMM ltiw�tl! in
fm dMfNYCf►pfi, „"�",��y'�
4•r se.er , ti
p�A 09 EST Lam" Ii�fEp
'w wweesrlelflo Wfl■fRt>RWAffl� fp "mloft or WOOD" row TM[
�Y�MMCt 11►ArMM �i4�1eA� UO CO�NGtNOMIUM � n pA r a ~
*Alr1111Mr1►.7111RMM�/1MLLfIypFR�p
O�MR sf1M M Olst�! OM><A4�1*folk► r
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. _ '•i,�
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Mht71:>tAA�iAo4ln tools
ftMff0/IIAEiYt'ifftIRLYM7IpI< � �. * ' • [
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LOT 62 , w 166TH AVENUEaten
L=
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y 20At
IAM
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SHEET 1 OF 4
1
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4c
SEE ;SHEET y
M COUNTY i w
COMMM SYSTDA ON oil
XMI1 THR EAST LIK of g
Tm his us cF secno" r i � � � � � � ►
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COUNTY
LEGEND
WATERS EDGE FIRST ADDITION
0 1 13W�0 3 1f4- LNL16WTyp PAR T OF T HF NW i g CW -T KE ,�E 114. U%,W 1 f 4 ']IF TH E Nt 1 M NW 4
V r I - ou"WDI bvAwFnp Or- r HL- NE IM AND ALL OF T)qE NE ?m 0� . SE IM OF 'nqE 1 .
0 MA WW N AS-"" n. Ae-Nm puK tHE 04E 114. SECMP4 lk. T30N. RIOW, TOWN
WOMP14fti, V,M r is, w e .LA. OF: RICHMONE). G-F iC"X CC�jN-ry. V0Sccx4S4m
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L 0,0. L4v* XT bit odmi;6 cptmpvb
cr4#vATb3**
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5-mm
CLIAIII WO&
Eky*C*dMW AL JU�Y Mq 31
PLAM L rKA T k3%ILEVA T krp, ou. I kg
x. r wmaE Lrrh 'rrT fAtEMELIE15 POAALLEL
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M I A14E4 A '.It 4r
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t* bAQ*ftAdVIdT ft*-_7ebN 1. � IN A tsir 51d
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titm m"r" yiAi#rIL
cimi C�� A
Tom" II Is --10
3,
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'RE I 5EC SHittF'T I
hrq P3r
IgpdC rW3
to 76 Q
166TH AVENUE
° Ap 0.
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OWNER JE�-Y
rv'%L-U-vM-1E%5-r=-'.qdR;A� �oE!-I(�� LIC.# 225�f,
TOWN "0""' F Qtc�w.oa�
SEC ty 9' 3o N
AND/1AND/OR-DLJCK '-
W P'*ro. CMrj&j SUBDIVISION
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TJf1S -rr-.,RMI Exri 2-qj 202--S7'
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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: 1f you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
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