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HomeMy WebLinkAbout648437 038-1242-11-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM 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: City Village Township OEVERING HOMES TOWN OF STAR PRAIRIE CST BM Elev: Insp. BM Elev: I IBM Description: at, WH4 10 -� - C) . �MAe yv-oc TANK INFORMATION TYPE MANUFACTURER y�`vW CAPACITY Septic UrIG W& 10 Dosing Aer ' n Holdi TANK SETBACK INFORMATION =�Mm - - __ MMFMM = PUMP/SIPHON INFORMATION Manufac rer Demand GPM Model Numbe TDH Lift n Loss System Head TDH Ft Forcemain Length Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix SAN-2023-045 Sanitary Permit No: f _ 777 SAN-2023-045 State Plan Parcel Tax No: 038-1242-11-000 Section/Town/Range/Map No: 31.31.18.1326 STATION BS HI FS ELEV. Benchmark 61mh .11- ta3 Q 0 I I l! o / 0 3,1 o Alt. BM l Bldg. Sewer , SUHt Inlet Q tOfl i O •SO SUHt Outlet a.o r ,C9 10 Dt Inlet Dt Bottom Header/Man. Dist. Pipe (o . (5,0 (� •ro l0`i.50 r 05•00 Bot. System ? ID �a3•�o 0q.00, Final Grade o +& 1b St Cove& q Z'I L 2.9O BED/TRENCH DIMENSIONS22) Width ( Length r 1O No. Of renches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO Type Of System: /� P/L I O BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer: � / • [k-r aR9 r Model Number: Q k, r DISTRIBUTION SYSTEM L7 rn LQ,— e,,,Q A- jack P%L visor-I-re,-AowC Header/Manifold I 11 Length Dia Distribution Pipe(s Length Dia pacin x Hole Size x Hole Spacing Vent to Air Intake , 20 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Overxx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center rench Edges TBe Topsoil Yes No Yes No COI M�ENT�(incl�adcode iscrepencies, persons present, etc.) Location)): 1824 90TH ST 1.) Alt BM Description = 2.) Bldg sewer length = - `{S' - amount of cover = yz"+ 14) Plan revision quite r d Ye _ f Use other side for additional i formatiorf. - -� SBD- — (R.3 ) Inspection #1: 04 6 83 &, spection #2: . o"1''"^ 3.1r3.7�.r12. �lt- c,4 .foers D .4 GPO/� sa- s >�per �vv� 0-4- BQ eeclke- Insep or Signature c 11 Cert. No. hK l vo Department of a ety APR, 2 0 2023 �r 4" & Professional Services, Industry Services Division - 2p23-OY5 Sanitary Permit Num cr (la e i led;AAIin by Co) ��9 yi�� - Sanitary Permit Application State Transaction Number In accordance with SPS 383.2)(2), Wis. Adin. Code, submission of this fonn to the appropriate governmental unit is rc(luired prior to obtaining a sanitary permit. Note: Application forms for slate -owned POWTS are submitted to tlrk; S )ell :I went of Safety and Professional Services. Personal information you provide may be used for secondary Pro cct Address {if different than mailing address) purpv5cs n accordance with the Privacy Law, s. 15.04(I )(m), Slats, 1. Application Information - Please Print All Information Property Owner's Name C)t veer- c - t` Parcel p — ! Z y — f ��' G Property Owner's Mailing Address t R celrrio hoLo Avc, ft, A LAA Property Location Govt. Lot /V il�.5iate ZiilCode Phone Number tj�ro�, 15jL)J-7 -(i�'4�,, Section 4 T S N R 1 Ear 11, Type of Building (checlk all that apply) I or 2 Family Dwelling- Number `Bedroom +" A4 �c'�1� 2 S 0 PubliclComnlercial - Describe Us Lad 111t L �SUbdlviil'on Name 1 I Block It *—� Cl City af _ ❑ State Owned - Describe Use DI X ❑ Vitlage of Town of- CSM Number 111. Type of POWTS Permit- (Check either "New" or "Replacement" and other applicable on line A. Check one box on line B. Complete line C ii a tics 1e. A Ncw System p y ❑ Replacement System ❑ Other Modification to Existing System (explain) ❑ Additional Pretreatment Unit (explain) Q' ❑ llotdingTank In -Ground ❑ AI -Grade ❑ Mound C1 Individual Site Design ❑ Other (explain) (conventional . ❑ Renewal Before Expirniou ❑ Revision ❑ Change of PI timber ❑ Transfer to New Owner List Previous Permit Number and Date Issued i y I p + t IV. Dispersal/Treatment Area and Tank Information: 3 )< 32-_ Des}ignnFFlow (gpd) Design Soil rlicaiion Rate(gpd/sf) 01spersat Area Required (st) ` IJ L6 Dis-persal Area P oposed (st) ��'� System Elevation f� i 01,0 - 1 ank Information Capacity in Gallons Total Gallons H of ulllt5 Manufacturer w o a U U u ? u n fi New Tanks Existing Tanks Scpue or[lu!kkng Tank l ! 1 } l s "ing C!cmlber V. Responsibility Statement- 1, the undersigned, assume reV69115ilitv for installation of the POWTS shown on (tic attached plans. Plumb is Name (Print) �lumbcMl'IN1l'l;S Number Business E'hone Number -6z& Plumber's Address (Street, City, State, Zip Cods 71 — c `r Vl. CovntylDepartment Use Only Approved d appro Permit I c : r,.tr I•sucd lti,uu: Agent Signature ❑ Reason or a ConditionsofA v a 3% s �� o-1 S W� b C��l� SYSTI=A (?INNER: 1 I. Septic tank, effluent filter and dispersal cell must be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code / ordinances. Attach to coatprete plans for the system and 5uhtnif to the County only on paper not less roan a ui x it tncnes ;it sue SBD-6398 (R. 03/22) * AS -BUILT DRAWING RECEIVED FROM PLUMBER VIA EMAIL ON 6/16/2023. System PLOT PLAN SAN-2023-045 PROJECT Oeverino Homes ADDIZESS 1433 Cemchous Ave Suite A N I/2 SE I/4S 31 /T 31 N/R 18 W TOWN Star Prairie SYSTEM ELEVATION 101.6/101.0 4' Below Grade CONVENTIONAL XXX MOUND SEPTIC TANK SIZE 1000 HOLDING TANK SIZE LOAD RATE .7 4/17/23 DATE CONVENTIONAL LIFT LIFT TANK SIZE ABSORPTION AREA 656 NIL BENCIiMARK V.R.P. Top of Survey Iron DBOREHOLE a WELL * I;, R.P. same as benchmark COUNTY ST. CROIX BEDROOM 3 HOLDING TANK DOSE TANK SIZE # of chambers 32 ASSUME ELEVATION Ian' Filter Lifetime Filter Vent Scale = 1 /4" = 1 Q` _.. 11 rinirkd Rtnnrlarrl SAN-2023-045 System PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A N 1 / 2 SE 1 /4S 31 /T 31 N/R 18 W TOWN Star Prairie cotrN-yy ST. CROIX SYSTEM ELEVATION 101.6/101.0 4' Below Grade 4/17/23 3 DATE BEDROOM CONVENTIONAL Xxx CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SI'l.b: 1000 LIFT TANK SIZE DOSE TANK SIZE (ILDING "TANK SIZE LOAD RATE .7 ABSORPTION :1Rv;k 656 # of chambers 32 CC) ENCHMARK V.R.P. Top of Survey Iron ASSUNIE FI .NATION 100' Filter Lifetime Filter LJ BOREIIOLE (D `V1•:1.1, * II.it. P, same as benchmark VentCOPY Scale = 114 _ 1 Q' 4 - 11� 0tr1clt4 Standard SA N-2023 045 1 S 1 SAN-2023-045 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 04/14/2023 Owner: Oevering Homes Location N1/2 SE1/4 S 31 T31 N,R 18W 1824 90th St. Star Prarie Used: In -ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Sect' 4-6. Maintance and Co tj ncy Plan 7. Filter Cross Sectio Signature License number System PLOT PLAN SAN-2023-045 PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A N 1 / 2 SE 1 /4s 31 /T 31 N/R 18 W TOWN Star Prairie cotrN-yy ST. CROIX SYSTEM ELEVATION 101.6/101.0 4' Below Grade 4/17/23 3 DATEBEDk(:)OM CONVENTIONAL Xxx CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SI'l.b: 1000 LIFT TANK SIZE DOSE TANK SIZE HOLDING "TANK SIZE LOAD RATE .7 ABSORPTION :1Rv;k 656 # of chambers 32 L BENCHMARK V.R.P. Top of Survey Iron ASSUNI ? FI .NATION 100' Filter Lifetime Filter LJ BOREIIOLE 0 WFI,L * 11. R. P. same as benchmark Scale = 1/4 11 = 1 Q' Vent� �� 0tl1c[t4 Standard SAN-2023-045 Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leachin�� Chamber with 20.0 f'12 ol' Area per Chaniber 6.6ft^2 pair of end plates Typical Installation 1'c111 A/ Grade 3' A�'-30134 Septic Tank Ll .. 5' Grade tit Systcm Fle% itiE)n Spacing_._5' System elevations: A 101.6' B 101.0' 3' To be >1' above grade Finish grade elevation 105.6' Velit 7' 1.011L, Grade at System Ele\ all m 2-3' X 66' Cells Same on Other end observation tube/Vent At end of cell' A B 16 chambers per cell POWTS OWNER'S NilaNiJAL. & MANAGEMENT PLAN SAN-2022,�045 of BILE INFORMATIONOwner I��lmlt# 7FS1014 PARAMETERS Number of Bedrooms •'] G NA Number of Public Facility Units i] IAA I Estimated flow (average) i �rallcia� Cjesign flow (peak), (Estimated x 1.5) -- dal/da Soil Application Rate affcia /ft, 1 Standard Influent/Effluent Quality Monthly average' Fats, Oil & Grease (FOG) 630 mg1L Biochemical Oxygen Demand (80D5) -<220 mg/L 0 NA _ � Total Suspended Solids (TSS) �150 mg/L !Pretreat_ Effluent Quality Monthly average Biochiemical Oxygen Demand (BQD5) = mgiL Total Suspended Solids (TSS) G30 mg/L NA Fecal Coliform (geometric mean) s104 ofu/100m1 ifvlaximum Effluent. Particle Size ' in dia, FN_A I-iQther: - �i CI NA, 'Values typleal for domestic wastewater and septic tank effluent. IAIN'PENANCE SCHEDULE SYS7PM SPFC:1Plr.ATlnhtS Septic Tank. Capacity al ❑ NA Septic Tank Mianufacturer ,-- © NA. Effluent Filter ManufacturerLD [] NA Effluent. Filter Model I� '! NA Pump Tank Capacity �p al X NA Pump Tank Manufacturer tA NA Pump Manufacturer K NA Pump Model �4 NA Pretreatment Unit ';WNA ❑ Sarid/Gravel Filter ❑ Peat Filter Cl Mechanical Aeration d Wetland ❑ Disinfection ® Other: Dispersal Cell(s) L3 NA 4 In -Ground (gravity) ❑ In -Ground (pressurized) 0 At -Grade ❑ Mound F1 Drip -Line ❑ Other; Other: — -- 0 NA Other: 0 Lira Other: ❑ NA Service Event i 4 Service Frequency Itnspect condition of tank(s) At least once ever Y_ ^7 Elnionth(s) (Maximum 3 years) ..,..� 11 NA } — .] i&year(s) !.Pump out contents of tank(s) When combined sludge and scum equals one-third (X) of tank volume ❑ NA lInspect dispersal cell(s) — - --- — At least once eve" _-_-- CCjj month(s) L� year(s) (Maximum 3 years) O Nla Mean effluent filter At least ante every: ` } © month(s) �— 0 NA I"d nspect pump, pump controls & alarm -- At least once every: _-. month(s) Ci years) ❑ NA 1_Iu0 laterals and pressure test I]ther, r: ❑ NA E ❑ NA i D NA MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be made by an individuiil carrying one of the following licenses or cortifications: Ma.3t��f (Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections include a visual inspection of the tank(s) to identify any missing or broRen hardw',me, Identify any cracks or leaks, measure the of !combined sludge and scum and to check for any bash up or pending of afflueni on the ground surface. The dispersal cell(s) shall h ,visually inspected to check the effluent levels in the observation pipes and to check for any bonding of effluent on the ground suitGxc:f::, The pending of effluent on the ground surface may indicate) a failing cundttio,i and requires the immediate notification of tht luL61 I'egulatory authority. When the combined accumulation of sludge and scum ill any tank equals lane -third ('a) or more of the tank volume, the entire contents of !:he tank shall be removed by a Septage Servicing 0P0'2t:ir and disposer; of in accordance with chapter NR 113, Wisconsm (Administrative Code. 1NI other services, including but riot limited to the servicing Of 0141r.00t !ittr,xs, rnachanjaal or pressurized components, pretreatment units, land any servicing at Intervals of S12 months, shell be pertol-wieid 0,/ a tu;4nified POV11'S Maintainer. A servica report shall be provided to the local regultitr:ry 313ti mils' vvil!lin 41V days of coiopletion of any service event. At least once every: At least once every: u momri(s) D year(s) Ci rtnonth(s) C7 vear(s) Page of START UP AND OPERATION SAN-2023-045 For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the .dispersal cell(s). If 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 conditions are frozen at the infiltrative surface" During poorer outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will ble discharged to the dispersal cell(s) in one large dose, overloading the call(s) and may result in the becxup or surface discharge of efnuenn. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank, Do not drive or part[ Vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Redudon or elimination of the following from the wastewater stream may Improve the performance and prolong the life of the POWT3: antibiotics; baby wipes; cigarette butts; condoms; cotton shvabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drdin (sump pump) water; fruit and vegetable pseiings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or Is permanently taken out of service the following steps shall be taken to Insure that the system is prope(fy and safely abandoned in compliance with chapter Comm 83,33, Wlsconsin Administrative Coda:. • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator, • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space Fitted with sy ll, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compll.W reply meet system. A suitable replacement area has been evaluated and may be ufilized for the location of a replacement soil absorption system. The replacement area should be protected from d)sturbence and compaction and should not be infringed upon by requliied setbacks from existing and proposed structure, lot lines and wells" Failure to protect the replacement area will result In the nEled for a new soil and site evaluation to establish a suitable replacement area, Roplaaement systems must comply with the ruled in effect at that time. © A suitable replacement area Is not available due to setback and/or soll limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. 17 The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site evalual)on must be performed to locate a suitable replacement area. If no replacement area Is available a holding tank may be installedas a last resort to replace the failed POWTS. 0 Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltra#ive surface. Reconstructions of such systems must comply with the rules In effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE Oi� A PERSON FROM THE INTERIOR OF A TANK MAY BE OIFPICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name Phone POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY NameTO �± Name Phone - /I ` kv This document was dratted In compliance with chapter SPS 383,22(2)(b)(t)(d)3(f and 383,54(1), (2) a (3), Wisconsin Administrative Code. SAN-2023-045 IZ61*1 01 6 fz� V-V N0II03S --!'v4b�93 Puo QSOO UaG-IGQ doo 10- ;ro VgVOOVLO� I. 2�1� SOIL EVALUATCN RE4,RT D^'sla~ a' SbtDh ah: aul 1 Vl Y[ Pam of �tlsC Oommpials ails pan a' Pa06r not Iasi then & " 1 t lndrtts in Slit PIBr I'11SE CD FIR-SJ I r� � �G � � ` 1i. b`f ro, rLnhoa tC i* a aria ` o`Z7'sta- r6fere'k;,e Pohl; {5!r', dire ta-1 enc j Pa •."ani Slop e, Da. saaia Or dn'te^.s��n6. "Jrir+. - SC aernw 8n� IJ::atybn al d+FtBn;a riBa^ASI road i_ - Pleas* prim all Information. Ra .y malr�,i. atlorrnauor. rrx; oo.w� ma. Ga �wc Io' s�wnSllrt Date J ��.,'F�+Ft (Pnva: Lcw r, r e Cr , r gmy; Z f "z_ L.r �` t1, GOI,! '� � $ .rI! G'� '•r.;✓ ; LiZ:?4��P r4 5 .S T .� / N R i JAM ua-rasa E Lot: a 91 0I S tact a GSA C to `C Ga7e - o-e i CAI) jf 11lte9j®Town Nearest Road l L .ems p , ++B+ti Ganstn y� JS�, F.ewenGa Nui l oN ba5•oO•n: ,aoe aan,rod deaf-, AmratE 21 GaD RaP.a e^ryrrt Puoh - co ni • -Describe Parerx; F"lena ++� 1,j rPUin erevabor if aP�caoie ''✓ Gal Coll 1. ft •l4 re,Ds'me:Illoil zs _S Ell L. Pil G-ojnd stx�a:,e elev, 6 - � R ;/,M)f:: iS677k DosCl LZt1.Sz. Cant. Color System Elevation^ Dam tJ Ivi factor in Sod Apiolli Rate 7extu, e. SLI.Il a Conaisteni &x-d&ry Roots Gppy Gr. St. Sh. s 1 ,-� ,.- ,} Pit Ground surfa;,e elevl-2 5. ft. Fibft;fX DeP1fl I Dom}nanl Calms', Reedak -Daac►+G611n Tarnwe kl. munseN QU. SL COnt. Color Ellklend N 1 ■ 8100, 1, 30 s 220 ffvk and > 30a 3G v 150 CST Name (Please Print) Bird Plumbing, Ina. Shaun Bird Mdreas 1432 1201h St. New Richmond. WI 54017 Dooth to Ill factor I �- i in $l►1fGtUre Consistwic'e BOLn'IC C." Sz. Sh. f- I 'Effirl I 'ERW2 Roots I GPOM "Effla, I 'Eft2 nI Ix C f, <4 U 'EMU" 92 ■ BaD. c 30 trlglL, and TSS a 30 Ill ure CST Number 226900 pale Evaivalian Conducted Telephone NLu7ybar 715-246-4516 SAN-2023-045 Property Owner _ JParcel ID DBoring N O BW^p Ground surface elev.` Pit � l Q. Depth to tkNdnp factor —4LOin. Pape of I Sol � -Ra-W7 M MI O I --A Effluent *1 - SOD, > 30 1220 nvt and TSS >30 1150 mg& ' Effluent #2 - 500,130 MQ& and TSS 130 mp1L 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. ssa+u.(RAMI SAN-2023-045 Soil Test Plot Plan Project Name Oevering Homes Investments Sha Bird Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 feSTM #226900 Lot 11 Subdivision Bella Vista Date 12/22/21 N 1/2 SE 1/4S 31 T 31 N/R18 W Township Star Prairie Boring Q Well PL Property Line BM or VRP Assume Elevation 100 ft, System Elevation TBD County ST. CROIX Top of 3/4" pipe `H R PSame as Benchmark Scale = 1 /4" = 10' SAN-2023-045 " File #: ST. CRO' `� UNTY, SANITARY SYSTEM office use Only r<r�ldtst», OWNERSHIP/ADDRESS FORM Owted212021 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. If you would like to view your issued sanitary permit online, you can do so by using the Property Files Scanned weblink. OWNER/BUYER "INFORMATION Owner/Buyer Mailing Addre City/State/Zip Phone Numb( Email Address Parcel Identification Number _ 0,5n- I L!l L' I I QU0 (found on the property tax bill) NEW SYSTEM. LEGAL DESCRIPTION; - Property Location �/a , Sec. TaN RJW, Town of J�U� �j"�l rle-- Subdivision Plat: i , Lot # �. Certified Survey Map # , Volume Page # Warranty Deed # 3 1 (before 2006)Volume . Page #r" Number of bedrooms _ Spec house � yes ❑ no Lot lines identifiable yes ❑ no jj„ ft I!'t OFFICE USE ONLY , New Proper y Ad ess t It4 C.IV(ool (verifi a on of7neaddress required from Community Development Department for new construction.) e (Staff Initials) It (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 715-245-4250 Fax cddPsccwi.aov 1101 Carmichael Road, Hudson, WI 54016 www,sccwigov SAN-2023-045 I 1 I I I I I sOpx�it4 O _—_—____-___ 0 MASTER eEO '' t - I sl --- >. s Q o x • x - ---------------------- � - — - — - — - — - i ------------ S 72a iu 1."0r I I I GAPMA I I fi I I k a e I I I I I I 1 I >oo,. t5MAUtU WALL LIM: .eR.nnw i PANEL DETAILS I f•f .. t? V.f bt1W.Cf1M1Y �MiRf4�wry macmwiue�im.n WS SO. FT. MAIN LEVELS MNN LEVEL i .ra• wll v you o lq, YouR w (715)248-3010 e.�.w NOTICEI WU*RTOVEFWY�ORExBl015. SMS.N LOC,TtOWS MD REPORT wry ERRORS PR10R TOPROCEICW . .uown�ar� w.� t0�"'n °a� uYe`n.mo�r.s �PPoo .T��a.aaraurarnma Felicity Homes S"nbach Prood MAIN LEVEL PNdwnf 8aRL]R.xt "Is P..nM 9i P�.PrM A3 w. Ta• ! � ---'------'------- FOUNDATION PLAN 5HFET INFORMATION! I FOUNDATION Document Number State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Name THIS DEED, made between Phillip B. Vaillancourt, a single person ( hereinafter "Grantor," whether one or more), conveys and Warrants to Oevering Homes Investments, LLC, a Wisconsin limited liability company ( hereinafter "Grantee," whether one or more), the following described real estate in St. Croix County, State of Wisconsin: Part of the NW 1/4 of the SETA and part of the NE 1/4 of the SE 1/4 of Section 31, T31N, R18W, Town of Star Prairie, St Croix County, Wisconsin; including Part of Lot 1 of Certified Survey Map Volume 3 Page 780, Document No. 356113 and described as follows: Beginning at the East 1/4 comer of Section 3 1 ; thence, along the east line of the SE 1/4 of Section 31, S 00° 33' 55" E for a distance of 1303.16 feet; thence, along the south line of said NE 1/4 of the SE 1/4, N 89' 3744" W for a distance of 138.55 feet; thence, along the northerly right of way of Rivers Edge Drive, on the arc of a curve, concave southerly, a distance of 274.00 feet, said curve having a radius of 883.00 feet and a chord which bears N 78° 16' 23" W for a distance of 272.90 feet; thence, along said right of way, N 87' 09' 45" W for a distance of 909.18 feet; thence, along the west line of said NE 1/4 of the SE 1 /4, N 000 37' 40" W for a distance of 546.85 feet; thence, N 48° 22' 14" W for a distance of 564.98 feet; thence, N 12° 45' 13" E for a distance of 308.04 feet; thencc along the East-West 1/4 line of said Section, S 89'16'509' E for a distance of 1661.38 feet to the Point of Beginning. Dated 5 P �►'18FJe wo U)p AUTHENTICATION Signature(s) authenticated on * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: St. Croix County Abstract & Title Co., Inc. by Marissa Berends at the direction of the Grantor. 20-S19176 i�iillili11�45 8713387 Tx:4610646 1113167 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 10/02/2020 10:51 AM EXEMPT#: REC FEE 30.00 TRANS FEE 657.00 PAGES: 1 Recording Area Name and Return Address St. Croix County Abstract & Title Co., Inc. 575 N. Knowles Ave., Suite #B New Richmond, WI 54017 038-1129-50-200, 038-1129-60-200 (part of) Parcel Identification Number(P1N) This IS NOT homestead property. S TAI'-- (SEAL) * Phillip .ya-Mancourt ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix COUNTY Personally came before me on 61 ' 30 • U;D the above -named Phillip B. Vaillancourt, a single person to me known to be the person(s) who executed the foregoing instrument pdpqknowledged the same. * Ar4DjWA S . 649,6E be - Notary Public, State of Wisconsin 5 2� 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. St. Croix County 1113167 Page 1 of 1 3 I �2? 5 16 18 ,,756 SQ. FT. U49' 65,451 SQ. FT. -533 ACRES 67,277 SO. FT- W. 871.0 ~ 261- 2 1.503 ACRES a w 1-544 ACRES LB.0. = 871.0 587'06'07"E 369.5,5' 399M, 17 67,762 SQ. FT. 68,647 SQ. FT. 1556 ACRES 1576 ACRES 4 L.B.O. = 871.0 1 rJ L.B.O. = 866-0 C5, S6 417.71- 0 ga, 16 74,403 SQ- FT 7A 1,708 ACRES 866.0 N26'23'45"E 21.19, 5$9*16'50"E 416.17' 80,549 SQ FT 1.849 ACRES LRO, 844.0 �' / = ti -Q. FT. n m4 15 CRES 1 94 re� w 47 ;7 844.01� 10 69 930 SQ_ PT t)6,013 SQ. FT. 1,515 ACRES 1605 ACRES d' 1 L.B.0- = 878.0 LB-0. = 854.0 a '4' on— '4 E GE 773: S89*16'50"E 327.59' A E 7 DRAlr4AG f'N I -4— f 14 66,092 SQ. FT. ro (-LT .517 ACRES 1LB.0, 99 878.0 EN T 5TA TUTE, 2.294 ACRES F6ETA PON L.B.O. m 854,0 T THE ACENT 6 Ij 352,14' 75.00. C) 321.63' N89"45'51"W 396.63' Zk� 13 '7 12 1-0 2 170,303 SQ. FT- 322,447 SQ, FT, 3.910ACRES 7,402 ACRES LB.0. = 867.0 A�l , CJ­ 1 N-qnc0,00 N, EASE WETL A N D C, I S02'50'17"W -NO2*50'17"E 747-39, - 16.64' 64 16.64' /T3 SAN-2023-045 COUNTY PLAT OF: SOIL TEST MAP/CBA EXHIBIT W/ CONTOURS BELLA VISTA Wcol) a wv+[ Or Ts •oucae7A•T Ou•R'•• Awn.erc OrTQ Nowr t QAor" or T • T Mln Otwrse ar tEK'Ipl )i. r0•wr� )i •oleo °•na• to • ro•• Or srA• M&AM.IT c°a°I CIA", �. eKWO•r0 KAU Or U" i Or TR f» °uwm W►locom O M VOtU1Y 7. NYOL Ye• N a0[1J.OXf Iltll�t )Y141. VIC114ITY MAP Lpl Lb aar+we row •uww.•w r' ♦ w %O T • I for p�t CtETrti[O ivivtt MA r C[Ar1/rf0 WSr voiuMe ►Abt ISii I voiuMi �Sj` t 4 I LJd LL �!}jly i ty�aSi J `\ I �""' . 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C36e G'ttsah Mmplete site plan on paps ,ot lesE than 6 ',': R ':' inc,�.es in sae- Pian must .�/ a�nt+Sl7 r �i� ! A L� % /y+ z t z „ f ! - o uftdude, loaf wt Eirrtitec fa: yerti;;ai and horizontal rsference poir% (EM); direction ant P C percent slope, scale or dimensions, north arrow, ant location distance and tc nsaresi road. a Please ,print all inFOrma:iar,. i Re W DY [late Psrzansi infonTmijon you provicw may b4 usad is se:ahaarn purposes (Pnva:y Lck, IIII N I r - Z. Prop". Ovmer Properh• Location hir����%-`i�4 � I�^Govi.Lot cz r3/ r,' R Property Owrtis 1,4811 Atfdrsss E; za /� Lot # Block to ' S Na, o- CSMf 'J2-1 } to Zip Cade One h'um G,jty ❑ Village N Town earest Ra d r� •�1 //� 1 ❑ I��a tJeN v:.A1St!UGt1J ..:5£. esidential Number of beiroo"ns Cade derived design fig- rate UPD ❑ Rep!arrrant J public r ranmer ad - Describe: Parent mateFl�,od Plain elevation i= applicable Ga-r€�l corirna: its �.1.!-�. CC ka ►'�. tI , � . fr J -- ald n5,�cxrxnandaba-1s # � Boririy - tr Pit Ground surface elev. �' C- Depth tc, ItrniGng `actor it . Sol! licafia Rota hiorizorl DepthDonliriant Color Rsao,c 6sscrtption Texture Stnuure Caruistence 6a jndaryRood GPD.rr in. MunseH Ou. Sz. Cont Coke Gr. Sz. Sit. f 'Eft#1 I 'Eff#2 19 n9 Baring Bon #Z Pit Ground surface elev/ - ft. Depth to limiting factor %_ in. Sail Application Re tiarizon DeptgDom1nant or Redox Descxiption Texture Structure Consistence Boundary Roots GPDM In. Ou. Sz. Cant_ Color Gr. Sz. Sh, -Eft#1 'Eff#2 A- r �. o 1f D1, Effluent #1 900. > 30 r 220 mg1L and TSS >30! 150 ' Effluent 02 = BOD. c 30 rng1L and TSS a 30 mg/L CST blame (Please Print) are CST Number Bird Plumbing, Inc, Shaun Bird 225900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, M 54017 � � �,7 � —� I 715-246-4516 SAN-2023-045 Property pOwner p Parcel !D # ring Cy Bog # Bof7ng 4 0,. Pit Ground surface elev. ft- �� Page --of Depth to limiting factor --4' in, Soil Application Rata Horzon Depth in. Dominant Color Munsell Redox Description Qu. Sz- Cant. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 'Eff#2 I Boring # Boring pit Ground surface elev- ft. Depth to limiting factor in. it Application Rate Horizon Depth in. Dominant Color Munsell Redox Descripton Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDtff 'Eff#t 'Eff#2 t3oring Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Aaoliication Rate Horizon '7epth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont. Color Texture Structure Gr, Sz. Sh, Consistence Boundary Roots GPDtff 'Eff#1 I 'Eff#2 . Effluent #1 = BADS > 30 � 220 mglL and TSS >30 < 150 mg/L ` Effluent #2 = BCIDS i 30 mpt and TSS 130 mglL 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, SBD-R330 (R-61CO) SAN-2023-045 Soil Test Plot Plan Project Name Oevering Homes Investments Shaok gird Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 ST°M #226900 Lot 1 1 Subdivision Bella Vista Dai#e 12/22/21 N 112 SE 1f4S 31 T 31 NIR13 1N Township Star Prairie ❑ Boring 0 Well PL Property Line County ST. CRUX k BM or VRP Assume Elevation 100 ft. Top of 3/4" pipe System Elevation TB❑ *HRPSame as Benchmark Scale = 114U = 10' COUNTY PLAT OF: SOIL TEST MARjCBA EXHIBIT W/ CONTOURS FELLA VISTA i.[xAn:Y" rn P W OF nrr" xna'1iwF jl•AYFFEx OF q-1— A FTNi. YONT1 tt r YJuu[[F'x (11 RYK 5fy':FitlA41 0!tiv -P OF 9T.(.; ;:!1 .: ":I•:. VAHCF 1. we_ci.. 1.1 nP vrM` tx .1- 1. CP[AR CIX'M�'. u.Y5CUN91P. INIw[IING VNti U( I (,F �liv [4€ IP1tff DSO— NAY Fft:O 1-D 1. Y[]G 9 1.11-1 crnP.w FyrvF.oR V 1 C? N[ T Y M A P ,�•� LOT f LCT 2 �_ E .V EF'i�!€o SUaV€v M_AP y Cf.I,r E[ 5V'1RV nR_o VOLUME 9 ACE 1531 ` VOI UMf Yd, LA 6U9' PRAT• `} Z P r, wa+ 1 r r SQL 1K13F— 1 , wrrw w f' 1 :/) - ae.:� �� ,• sr € j �o r�-'a`` !�—�ti�.,�A��+� F��� _�_ ,} l - r i 7 ? "�'w awwr�on+.wyn �w «r�wn as IN m� �No•�^T t_E� L rru.. r�ennr TRACT 4,_ t i dm.sn.wprrQ"-- +��: Tl a V�r% •�lY3Y,,.1 yam( S TI 1€O SUAVCF MA? j�ME 9. PAG! 56}n SHEET 1 OF 2 r �a6l)CCOUNTY NOG SAN-2023-045 r STATE SANITARY PERMIT AT '' T -, •r,'- T" 1 1 vT L Ie x T-u�€��rs , C.C. PLUMBE LIC-#22670 — TOWN OF �%vfAMU7:r7 AND/OR , BLOCK SUBDIVISION 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. iAll i ___AUTHORIZED OFFICER , THIS PERMIT EXPIRES- qj,2j(L7%Z6---- UNLESS RENEWED BEFORE THAT DATE SBD-06499 (R11/20)