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HomeMy WebLinkAbout002-1022-80-100 a O ~ 0 3 0o I M O fin y O 4 Q a M U C O p cc O O O L .N N F O O L O N h E co .O C O L N O C 01w ~ C tUp N 7 N O E O O N C N I Z > O L O C ~ ~ 0f y O N Z N •ZS N ~ a C_ N W IL Y `O N w c N N off U C a O C >i N C C>L O O> 0 0 C z , y U 7 f0 y -0 CL CL'o LL CN a) N O c•~ dca Z•C 3 v Lr).0 c > o~ m Q r Ow O ccn I M d, m z y E O z O z a m U E (9 (D r Z r N 0 Z N H y E O N ~ O O N O N :w :r O • 1~~ t t4 N_ a s6 2 Z Z 0 N z O N Z y (cj a 04 d c• r Y aDCL 0 Q ° o z~> 0 ooo aJ I •N ~aaa a c 3 p U) (D L ~ N fn J V p N N Z LO T r t0 O a O O N M p z 0 O O O O 0 N N N O O w O a E N 1-- N 7 0 N a N m C a) w 0 f0 •6_ Q A (n N J ~ ~ O I y o o O_ ~n c o CD E 00 O CC Q C E U ;d 7 O O o O N °w~ o 14 ca cao000 r _ N a N N \ N l \ N C C _ 0 to N_ N v C_ 6 75 O C W 3 Y N d N C c a) O o) 1.•I N N a OLO .r+ 7 C > L O CI O CD O to O y to U • o m U m° Z Y g cn Ca # II E ~t a L: a f ~-AMrq~N ~ County: t. Croix Wisconsin Departmegt of Commerce PRIo_ I'E SEWAGE SYSTEM Safety and Building Diyis'rrr. . INSPECTION REPORT Sanitary Permit No: ~ 395255 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village A Township Parcel Tax No: 002-1022-80-100 Cook, Bill Baldwin Township CST BM Elev: Insp. BM Elev: BM Des ption: (p 1.31 r lJa vr- TANK INFORMATION ELEVATION DATA $1a TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic tsOO Ben rgrk I~ . imD 1 ID -I` Alt. BM!( 011 Dosing ~r1 t* 2, ~~q •~,a Aeration Bldg. Sewer q-7-%1 Holding St/Ht Inlet 1 • • 3t St/Ht Outlet I SETBACK INFORMATION TAN-KT O P/L WELLr BLDG. Vent to Air Intake ROAD Dt Inlet Septic ~ t ~ - S 5 r Dt Bottom et;,3~ x•30 Dosing to t~ ~5 Header/ an. . ~ 73, 90 Aeration Dist. Pipe , f • 7' Bot. System Holding 25 Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover -3 -'7'5 /45S1, GPM P„ ~C Model Number 103.21 TDH Lift Friction Loss System Head TDH Ft 19a ^ plo- 'e r~ c 2. C i 3/ Forcemain I Length 7ia. Dist. to Well VOIL ABSORPTION SYSTEM + DT Width Length No. O Trenc PIT DIMENSIONS No. Of Inside Dia. Liquid Depth DIM SIONS it I 11Z -Ir I M, e ev L SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: i` INFORMATION ' CHAMBER OR Type Of System: NA- DISTRIBUTION UNIT Model Number: SYSTEM ! 1~ D B5 x Hole Size x Ho acing Vent to Air Intake Header/Manifold Distribution Pipe(s) Length Dia Length Dia Spacing x Mound ©r y SOIL COVER x Pressure Systems Only x stems Onl De th Over Depth Over xx Dept xx Se ed/Sodded xx Mulched P Bed/Trench Center i•- Bed/Trench Edges Top 1 '3% s ❑ No Yes [IV] No i `p~/, Inspection #2: COMMENTS: (Includ ode iscrep ncies, persons present, etc.) Inspection #1:~0 2 '14 ~Q j - ~eLocati6n: 2Cr35•~th Avenue Baldwin, WI 54002 (SE 1/4 NW 11411 T29N R16W)N.~A/Lot Parcel No: 11.29.16.158A10 1.) Alt BM Description 2W2, 2.) Bldg sewer length = as = > S~%' 0 - (}r , ~a•11 'f rk/ b'14 ®Xu.L- - amount of cover 4 0 3.) Contour = Jp3.3 ~l - T- Plan revision Required? Ye ❑ No I IZaI'1~-G~ Use other side for additions l 4k q, - l ormation. e'a~C~'LS Cert. No. Ps ate ^ ` n InsepcorsSign`ature (J , SBD-6710 (R.3(97) n N6'~ wr- yyVpu+n~L ,.nc+~.i,n~Q.. mrt? ~e¢.~ Nex.l~ v~ ~ a.Qsa . • ~ , . ~a. r w 1 O Q , ~It ~w1 .;14.,. i, ~ 1 N 9aJ~l` r fLL✓, ~j- G J r rv\A ok yq a/ 00, ~t v N HIS 12LJO Sanitary Permit Application Safety & Buildings Division 201 W. Washington Ave. In accord with Comm 83.21, Wis. Aram. Code PG Box 7302 ~ ~ See reverse side for instructions for completing this application Madison. WI 53707-7XI OwpBrtrnA>~4 or34amaaMStcm Personal information you provide may be used for secondary purposes (Submit completed farm to ounty if not [Privacy Law, s. 15.04(1 xrn)] start owned. not Attach corn lete tans to the caun co aril for the sv on er riot less than 8- i /2 x l l inches in size. - _r _-F Plar`I. KIT Cowl State Sank•••• n.....» u,.. r..v ox1 sus application S G) S i. Application into - please Print all Informatio / Location: _ n Property Location Property r C C a i'' a - r/ ^r, , L.otN_ _ Block Number Ftopaty Owner's ling A - 66) A. M Number t City, State Zip e«Ie - Phonul A. l . S1 I~ _ _ `C ` ❑ City ii, TT-pa of Building: (check one) ❑ Village IS. l or 2 Family Dwelling - No. of Bedrooms --~t.a ❑ 1'ublir./Commcrcial (describe use):_ ❑ State-(?weed Nearest Road p;;;71 Tax Numb-(-N - III. ° a of Permit: Check only one box on line A Check box on line B if applicably) Go to z Z - - (filt7 l / t - / 6 .L7_ r p A) 1. New 2. Replacement 3. ❑ Replacement of 4. 5. 6. Q Addlt'on to S' stem system Tank Qnl Existing S stem Pextrnt Numbex Date Issued B) O A Sang Permit was previously issued Ir. Type of i"OWT System: (Check, all that apply) i C3 Non-pressurized In-ground 411Mound l Y ~c 2 ❑ Sand Filter ❑ Constructed Wetland O Pressurized In-ground O Holding lank ❑ Single Pass O Drip Line O At de O Aerobic Treatment Unit O Recirculating ❑ Other. V. Dfs ersalareatment Area information: I (gpd) 2. Dtspetaa Men 3. Dispels 4. Soil Application 5. Percolation Bate 6. System Elevation 7. Fin Required Proposed Rate (Gals)day/s4. B.) NinJinch) Elevation lp y 4/,10 Vet. Tank tcity in Total # of Manufacture Prefab Site Steel Fiber- Plastic Information t3alioas Gallons Tanks Con- Con- glass New Existing crete strutted Tanks Tanks VIII. Responsibility Statement l the undersi assume res nsibili or installation of the POWTS sho n the attached Tans. 71 t3usiness Phone Numbar r rum s N rirn (print) Pl ° a's Signature (no ps) ham' ~ /S~~s W,n P;umber's Address (Snftt City, State ~ZipCode) ~ t~-ytt-Yl r~.T S N~tS l IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No stamp;1 Approved D Owner Given Initial Adverse Surcharge Fee) Determination 3 X. Conditions of Approval /Reasons for Disapproval: r Kf v; e_ Ltt'"r, ai. M✓rVa - 6y vev,'ewer Gt/a 5 zz^oroveal ii vO CO+v frrul eCt ~V ((~~kri'w' A /ol+.r..e /~CMve~'+ct~i~ ~voPosa:~ it Gs.s~s~e~ w~~ s ~c Jp/Qj~-s. 1"I ww~Pr ~U Csn F/v S QvP DC r l /'i,PS ''1`' C.~(/~ Safety and Buildings • 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD (608) 264-8777 nsin.gov *Isconsin www•commerc www.vAsconsin.gov Department of Commerce Scott McCallum, Governor Brenda J. Blanchard, Secretary June 19, 2001 CUST ID No.224229 ATTN: POWTS Inspector ZONING OFFICE KEVIN M LANNON ST CROIX COUNTY SPIA 4792 STATE RD 25 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/19/2003 Identification Numbers Transaction ID No. 651347 SITE: Site ID No. 631250 BILL COOK Please refer to both identification numbers, 250TH ST above, in all correspondence with the agency. TOWN OF BALDWIN ST CROIX COUNTY SE 1/4, NW 1/4, S11, T29N, R16W LOT: 9, SUBDIVISION: PROPOSED CSM FOR: DESCRIPTION: THREE BEDROOM MOUND SYSTEM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 797098 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.01101) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.01/01). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this information must be given to the owner upon completion of the project. The influent quality discharged into a POWTS component shall meet the parameters stated in COnlnl 83.44 (2)(a) If this tank is no longer used as a POWTS component it shall be abandoned by complying with Comm 83.33 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. KEVIN M LANNON Page 2 6/19/01 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, the owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 Charles L Bratz POWTS Plan reviewer 11- Integrated Services WiSMART'code: 7633 (608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM cbratz@commerce.state.wi.us cc: BILL COOK i Bill Cook - Mound Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (01 /01) Pressure Distribution, SBD-10706-P (01/01) Location: SE 1/4, NW 1/4, Sec. 11, T 29 N, R 16 W Town: Baldwin County: St. Croix Date: May 31, 2001 Gti / Owner: Bill Cook 4S Gtr` Address: 6030 Goldenrod Lane Q Plymouth, MN 55442 r~ Plumber: Kevi Lannon ~ Signature: License # MP 224229 Attachments: 6748-Plan Approval Application SBD-8330 page 1: cover 2: design criteria & calculations COI1t WFY 3: plot plan MPROVED 4: system cross section 5: plan view, lateral detail ~EfMR11MI OFC01 6: pump tank exit detail 7: pump curve 4EE E 8: system management page 1 of 8 { e r. Design Criteria Ye's Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Treated Residential Wastewater Contaminant Load: 30 mg/L < BODS Septic tank + "highly treated" effluent 30 mg/L < TSS Fecal Coliform < 10,000 cfu/100 mL Bedrooms x 100 gal/bedroom/day x 1.5 ¢ro gallons/day hydraulic load Design Calculations In situ designed loading rate c9 • Z i gallons/sq. ft. per day Depth to estimated high ground water 7"2-6 in. Depth to bedrock -)4-6 in. Cross slope at systems % Force main length ft. of in. Manifold/header length N (A ft. of in. Drain-back ~.4' gallons Lateral length @ s5-.-T ft. of W L in. Lateral elevation k'04•6%' ft. @ bottom of lateral Lateral hole size ;'16 in. @ 36.0 in. ( 3 • ° ft.) Spacing l 9 holes/lateral 3 holes total Lateral volume gallons Total lateral discharge rate 2 0 8 gallons/minute @ ft. head Network pressure compensation losses ° • ft. Elevation difference • t ft. Friction loss •z1 ft. @ z~ gallons/minute Total dynamic head ft. Pump/siphon 2 5 gpm @ t z ft. of head Manufacturer Model # S 3 0 Dose volume 4 gallons Lift/siPhon tank' : V ~•o Cor•~ 6 v-d gallons Septic tank k~ gallons Effluent filter - Measurement pump on and off 4--L. in. Height alarm from tank bottom 12.6 in. Reserve capacity 4~93 • j gallons specs.caks Page Z of g ' Sc~e•• s~o ■ So;1 Oi&rtw ,f P; t An u~n4~brd P:ts ind;ua o P"Ya W dory /ots r sA ~ a° /1sSa,h<a/ C ttc!` r /GYM cD; W* O 4r-1d. •a C= i.~: (wtml•L.~S WI..A % e %.zr C.dY%irO.H (IT h C C ~ to W T 013.x, t Norv .104 7 All k 46 *Qe 0 t7t ~dYl~ 3 t 1_ C eXn 40 ~d~e.Q fin.«'~ sE. Croix G tel. U. 4 ~t 32.0 t J 4 ts.+M C. v~v 4 S 4. Yx.- Wit 0. Vt ~~~lOw Zu . / VI ` ~n.tz &O.O~\ ~y ~trY \ ~9Y i, KYV' J 1 11 tQ4.Aj. ~o4,ts 1 b 0- M w..& to i-.OCO 1 - 1 p w. Q„, t~.11 0 i ~I Imo- ~ --~I b . l+' y ZZA' 101` SIo.L~'` ~ ~(~•LS` . lo,l' E- 1 O; PVC cr.~ aOti o\q =Q.~►v ~a a7~► ~..t.\`1 L0 1 I Di V ll l1- N u`+Q.', \ a + OJir .r Q.r w.'. -4. C7 . 5 / 1. o . N 0~. o P o `c ZS . 164 .t,t QM wl.Z V r ~ ~ ~ Vl 01 aJ~ o.~ ~ `t QJr ~00~ 0~... `:..Q.. vl 3 V • ~ ( 3 • `v / J 4. ~.r.~ (CD.6u c-L~ aQ ~V e~a• veteJ 1N%..% vo lvt hvh M~ ~ J • _ Forte M.a~w IS > WEA7NERPaooF LOCKIWG+COVER . tat tV,,f 'N" A/f3E4. G1v►tJt olac,oy~ttT--~ .L 4° P1P` 3' P no WD►STURBED " o SOIL 24 I.U. d v o X1 ^WLLP A yt A N~c 4" p,, oWROVLQ %•.IN 4f. 0 SKET auwr6 WFLES 3 owro V P^ AL W+EGTIONS ~ iDN q b • t~ oca~ Pw1P D (O SEPTIC E _ SPEGIFI•CATIOMS DOSE ev g . $ T&W-S MA►JUFACTUkrK' WUMDER OF DOSCS: PEK Dkz TAWK SIZE: 6uo GALLOWS OOSC VOLUME S 4 ALARM MAUUFACTUiLCR: "Vv, IMCLUDIMC, ISACKFLOW: C ALLOWS MODEL 1JU;4EIR: ► \4CAPACITIES: A=3$'4 IAICHE5OK GALLOUS SWITCH TyPt: B ~ Iuc►+cs oa GALL ous PUMP MAWUFAC. TURCR: C. IUCMCS OR sg" 0A L k. 0u5 MODEL WUMDER: C. bkuv -1o 0- ~ INCHES OR ~Oi42' GAILOUS SWITCH TyPE:, \MV " MOTE: PUMP AWD ALARM ARE TO OL MIWIAUM DISCHARGC RATE GM INSTALLED OW SEPARATE CIKCLIT6 VERTICAL DIFFEREMCC DETWECIJ PUMP OFF AUD OISTRIDUTIOIJ PIPE.. FECT + MIWIMUM NETWORK SUPPLY PRCCtuilE FLET ~ T,/ + FEET OF FORCE MAIM X 13~ f/poFEFKICTIOLJ FACTOR.. Z► FEET TOTAL DyUAMIC. HEAD a $ L' FEET IMTERWAL. DIMEWSIOMC Of TAWK: LEAJOTH \p~-;W;DTH ;LIQUID DEPTH t Engineering Details 1 $lit Pump Characteristics Performance Doto /4010r uwl Shelter OIN , I. „ Atrtets ik IK" SNIF70111 hA Load Amp i.0 n w _ _ ~ Meta TYIN Shoiled rob 14 1 RIAL 1350 I Phme 0 1 i } to y 115 Hart: 60 54 letgperahre 120'i Aatlltirat e d >t :o to rnus sat -t-- NLtRA Dedr A ttMn~See.l a ( r fnsrlatloa Casts A d R 40 24 tticcfar She 1-I/2• Nn (stattaf iot~l Kstai hN i 12 S" Het &,q 3/4" L19!aaal GPM f11.s.f 44 3i ~S i 0 daft We%ht 32 6s. rows Cord 15/3, SRW, 20' std. Dimensional Data Materials of Construction 0" I. MIN oesbwd~ "n ( la leweetitnel (+w) Z t Aneeslow: ~Y 1/tintb Noa110 Swdeu Star) , ,K raY: hr 911164" pro L*kfft OH Diebrlrk 01 Wow" ctsow~ett Motor Nwhol Cost koa . cow Tar! ka d. tk nww tV +o'ark~ m+dos~,s dr prldun s+d their tgd(alipn dibeet Mtke 1(AeAWW Seel ions: ca IcM* Shaft Seal Sal ktd : A"1111" POW Spriaa Slrtabss Stw wss hm-N tt' tiK E ok ftf Swim Gst kott Sbew Lower Raw MN's (250~, IV 7 {that Ithm NOW" tk • to UP 60"rod litonagtrsKe Fe:trMn Stttslttdasr Stoll A 1999 H romotic' Pumps, Ashlond, Ohio. AI! R' RON". ~rl° HYDRDMATIC' -Your Authorized Local Distributor - 1840loner Rod As"d, Oho 441051& 419.289.3042 Ft. 419.2114017 Web Site: www.pentdrptitnp.Cttn t SALES OFFKIS IN All AWOR CITIES AND COMES + O ~ 2S item e: W-0243 1208 GM tU[ }U~' System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Red Cedar Plumbing, 715-235-7341, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1 . If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. Maintenance SEE CORRESPONDENCE I . The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 A wisoonsin P t of commerce SOIL AND SITE EVALUATION Page 1 of 3 • Division of and Buildings in accord with Comm 83.05, Wis. Adm. Code A.C.E. Soil dt Site Evaluations Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must County include, but not limited to. vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, a ' and distance to nearest road. St. Croix Parcel I.D.# If. Z P• /6. 1.5--7 APPLICANT INFORMATION - - 1 p Win, 002-1022-90 Personal information you provide may be u ary ZPrivacy w, s. 15.04 (1) (m)). R evwed y Doi L/ Property Owner EIV \ Property Location Marv Utecht Govt. Lot SE 1/4 NW 1/4 S 11 T 29 N,R 16 W Property Owner's Mailing Address - f f a 899 Lot # BW# Subd. Name or CSM# 1067 250th Street Proposed CSM City S Zip CodeCdjt ovOlumber ❑ City ❑ Village ®Town Nearest Road Woodville 0NNlrgg9 2 '4$, Baldwin 250Th street ❑ New Construction Use: i uq i rr rooms 3 ❑Addition to existing building ❑ Replacement ❑ Pub dal describe Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpd/fF .6 trench, gpd/ft2 Absorption area required 900 bed, ft2 750 trench, ft- Maximum design loading rate -5 bed, gpdff •6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 104.25 at 12" above 103.25' contour ft (as referred to site plan benchmark) Additional design / site considerations Parent material Glacial till. Fkxxl lain elevation, if applicable NA ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ❑ S MU ® S❑ U ❑ S ®U ❑ S M U ❑ S M U ❑ S® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure Consistence GPD/ft2 l~cv Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz Boundary Roots Bed Trench 1 1 0-9 10yr3/3 None sl 2fcr mvfr as 2f&m 0.5 0.6 2 9-20 1Oyr4/4 None sl 2msbk mfr cw H&m 0.5 0.6 elevnd 3 20-27 7.5yr4/6 None sl 2msbk mfr gw if 0.5 0.6 102.26 ft 4 27-30 7.5yr4/6 f2d7.5yr5/8 A lcsbk mfi gw - 0.4 0.5 ' Y Depth to 5 30-40 5yr4/6 m2d7.5yr5/8 sl Om mfi - - N.P. 0.2 limiting factor 27" Remarks: B4 2 1 0-9 1Oyr3/3 None sl 2fcr mvfr as 2f&m 0.5 0.6 •s 2 9-17 1Oyr4/4 None sl 2msbk mfr cw if&m 0.5 0.6 Ground 3 17-26 7.5yr4/6 None A 2msbk mfr gw if 0.5 0.6 A,51- elev 102.34 ft 4 26-31 7.5yr4/6 f2d7.5yr5/8 sl 1 csbk mfi gw - 0.4 0.5 - Depth to 5 31-45 7.5yr4/6 m2d7.5yr5/8 A Om mfi - - N.P. 0.2 , limiting factor 26' Remarks: B5 CST Name (Please Print) Signature: Telephone No. James K. Thompson 5--- 715-248-7767 Address A.C.E. Sold & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, Wl 54020 7/6/99 3602 1060 A PROMKIYo ' Marv thecM SOIL DESCRIPTION REPORT ,aso page 2 of 3 PARCM LD # 002-i o22-90 AXE. Soil & Site Evaluations Depth Dominant Color Mottles Structure GPD/W kQW Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz sistenceBoundary Roots Sh. Bed Trench 3 1 0-11 10yr3/3 None Sl 2fcr mvfr as 2Mm 0.5 0.6 2 11-19 j 10yr4/4 None sil 2msbk mfr cw IMM 0.5 0.6 Ground elev 3 19-30 7.5yr4/6 None gr.sl 2msbk mfr gw if 0.5 j 0.6 103.79 ft 4 30-35 7.5yr4/6 f2d7.5yr5/8 sl Icsbk mfi gw - 0.4 0.5 Depth to 5 35-46 5yr4/4 m2p7.5yr5/8 scl Om mfi - - N.P. 0.2 limiting factor 30' Remarks: B6 Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: • Sc~11e~ / - ~a ' ~ Ste; I ©f~sert/o~ruv~ P; 21f) - u n nur„ bald Sa;l P; is ind, ea~~ /pCO~On o•~'~{~ Va. ~.-d ~ c-~w' ~roposed 1vts, J~ h &nc k l l< 7o14 or/-l' "A✓.C. W- ~~0 P' a d-ri✓cr7 i niD roared. ~Qa.30'Can~ok/ /l sSumQo! a teP., _ MO.60 ~r a~ ch \ .626 33 ■ ~ caner': \ Mart) \ ■ 32. ion 7 ,ZsaSf. 5~l~Z Set ale L ~C• /~Wy %H. c~~cJin~ ~/D6 sE. Croix G; tyre. E/e /09 31.' 3,20 ' r S ro . 1,3.20 IT 1 A am: if W 4. .,i sx F' i. F.San L '3 n~ } v • - .iii iY: t%: a ,ilt. 4 I' R { - L"r "R- ~WmmAk-, SE NW, Yt1i~y l..»G < flQ~~ G ~ r1~'3.'~14i x "sx'rSsc L,ys f. w v i y; •;Z ai; i5.. y i. y, 1, e 14 } I j ~ hr ~i 3 r•, a~ ~ is i y~,G{ jjyf ; t f ) j M' ~ f F~ H N 500 0 500 1000 1500 2000 2500 3000 Fei* E s Marv Utecht Section 11 T29N R1 6W 49665 S KATHLEEN H. WALSH REGISTER OF DEEDS FOLE ST. CROIX CO., WI $ JUN 2 7 2001 / RECEIVED FOR RECORD % 06-27-2001 2:00 PM CERTIFIED SURVEY MAP EXEMPT # T~ CERT COPY FEE: _UNPLA_TT_ED LANDS _ TRANSFER~FEE: 250-TH _ _sMU w RECORDING FEE: 14.00 N0016'41 "W 2624.16' w PAGES: 3 6611 1' - - - - - - - w _ • N Z o r It y~ 30 c Z~ V Q n lr 0 20 zv I rn m Z Qom Z ►G m m~ C~~ m ~ a~ N -0 00 C ~t:10 mA ~G;. m ao o do o yzm ~y m~ m p Z z ~o d a co v m D> n n o 00 ;Z wm x n cn m ►C r _ OD Z 0 0 -n 0) 0 -3 Q) 0 z L" y 0 G1 ° co h'1 C Z v ~ ~8E i o m ~ z ~N°Ot) y N z 00 i') 00 1~ lO ~0,+SNl~OO~oo ~ W~~og 4t vi yZ~\ c,f) 00 .i 33" 33' b m I O 0 CO A Z 0 10 m~ N rw -4 A 0 \ m-0M -q m p O -0 q ~ a z \ = Z 0 rA ~ L01 141 _r m z m P~ n n ~ m N m~ o r* o \ N 05° 58' 11" E 270.00 ago o CAC z n ' C, z . ~ o w ZO p Fri, . . 58' 11" W 270 0' o m to O 225.31' ' 69' r" °m 00D n C o z 12' UTILI / a v p O -i UTILITY EASEMENT O r CA o m w Lrj o CA ~ ~0 w X z m m z o G) v) 8 S z 00 ai m _Z OD N (n O G Re En A Z v m o m IC N P~ M 0 0 0 00 C ;u 46 w fn O ~ CA < m co n c ~ I~ z { -ccn SW1/4 OF THE NW1/4 mm y ~ m c r. m SE1/4 OF THE NW1/4 w ~m w m N tyij h7 n x o " I p mM Z CO) • O f D Z m 40 I0 r to o ~C/) ~ v 11 0 M .u.8S °ZO O SaNV 031'1 V7dNn Vol. 15 Page 4119 ' ` Aga& AUG-30-2601 11:31 AM R.C.E. Soil & Site Eval. 715 248 7764 P.01 .l~I.C.E. b~'ol si~e.~'baluati'o .Tsn~ K Tlk~ow labnsb&Wjar &Mw # 4WD d 6'alff Teter Mane #SQ09 Fax Transmission To: Fax 3B(- 1148(a _ From Jim Thom ` " n S":1 a site Evaduafia Fax 171 S 1248 T 764 _ eggs includina cover sbeet: 2.-. if this report is incomplete or illegible, please contact Jim Thompson at telephone #(715) 249 -777/67. ael-O~- a,, - - Pa )0/060 -669 LIU e a•" .a. t ~/S a>E 63 - ' mow- .tea AUG-30-2001 11:32 AM A.C.E. Soil & Size EL-,aI. 715 248 7764 P.02 P: b ~nots- ~ nan+~llr~dsi;/ Iola~+bn ~'Srb . S o rVaed Corn ~ a 4d 'root WA " i ado o~ Ii~ A✓, [ acri fiJ~ r~d• \ sus ~ too` 63 -Owner: Nord AAw.4f !04 7 S6 . . ! +ate , E~sr = pop 31.E . AL -&Amt. le / 3.Zd I • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM r Owner/Buyer W I L L I Arn L'19AIR M, ('00,k'_ Mailing Address 030 GOL D LA) OO L, HN,E /0L Pn oU rtfj 1?9N• J~54 4, Property Address c~ S 3 5_ 05 V-e- (Verification required from Planning Department for new construction) City/State WOODOLLEJ WE Parcel Identification Number LEGAL DESCRIPTION Property Location SE %a, 1VU1 '/a, Sec. , Tj? N-R!(/ Town of WOOD VIZ L, Subdivision Lot (;~~0 S~ ,Volume Page # ertified Survey Map qY l~ Warranty Deed # S3 7-Z'3 , Volume Page # 7-:7 Spec house ❑ yes M/no Lot lines identifiable B "'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. Owe, the undersigned have read the above requirements and hgree 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 of the three year expiration date. --Offlj" 0/(al7~-, A", /M - cc"k (0 SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION ,f(we) certify that all statements on this form are true to the best of M' (our) knowledge. *(we) as (are) the owner(s) of the property describedabboove, by virtue of a warranty deed recorded in Register of Deeds Office. Ll"M SIGNATURE OF APPLICANT 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 l~• ~k. (•l , IS'8'~ -~U ..169 5) PAGE3 1 1 STATE BAR OF WISCONSIN FORM I -2000 653223 WARRANTY DEED KATHLEEN H. WALSH Document Number -REGISTER OF DEEDS This Deed, made between Marvin L. Utecht ST. CROIX CO., WI and Sharon R. Utecht, husband and wife RECEIVED FOR RECORD Grantor, 08-07-2001 11:00 AM and William H. Cook and Lana M. Cook, VAWA11TY DEED husband and wife, survivorship marital property EXEMPT N CERT COPY FEE: COPY FEE: Grantee. TRANSFER FEE: 64.50 Grantor, for a valuable consideration, conveys to Grantee the following RECORDING FEE: 10.00 described real estate in St. Croix County, State of PAGES: 1 Wisconsin (the "Property") (if more space is needed, please attach addendum): That part of SW1/4NW1/4 and SE1/4NW1/4 Sec. 11-T29N-R16W described as follows: Lot 1 of Certified Survey Map recorded in Vol, 15 of Recording Area Certified Survey Maps, page 4119 as Doc. No. Name and Return Address 649665.Together with the rights of ingress and egress over a 66-foot wide access easement described as follows: Outlot 1 of Certified Survey Map recorded in the Office of the Register of Deeds for DAVID J. ESTREEN St. Croix County as Document No. 649665, located 304 LOCUST ST. upon part of the SW 1/4 of the NW 1/4 of Section 11, HUDSON, WI 54016 Township 29 North, Range 16 West, Town of Baldwin. 002-1022-30-000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements and Restrictions of Record. Dated this day of LE,7/ . a * *Marvin L. Utecht * *Sharon R. Utecht AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ~ ) ss. °J! = -1o n d7 R1_ County. ) authenticated this day of Personally came before me this day of _1601 the above named Marvin Utecht and * Sharon R. Utecht TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person s who executed authorized by §706.06, Wis. Stats.) Kay V. Palm the f r oing ' acknowledged the same. THIS INSTRUMENT WAS DRAFTED BAotary Public State of Wisconsin v. Palm Michael H. Forecki, Attorney o ry blic, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: Si natures may be authenticated or acknowledged. Both are not necescarj.)_ _ 12/12/04 'Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 ttorney Michael H Forecki 1830 Brackett Ave, Eau Claire WI 547014627 -Phone: (715) 835-3029 Fax: (715) 8354112 Michael H. Forecki T7230305.ZFX Produced whh LpFonnTM by RE FonnsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383-8805 wis(v, sinDepartment of Commerce SOIL AND SITE EVALUATION Page 1 of 3 ` Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code A.C.E. Soi16t Site Evaluations Attach complete site plan on paper not less than 8% x 1 inches in size. Plan must County include, but not limited to: vertical and horizontal direction and St. Croix percent slope, scale or dinnemsions, north arrouv, pmt a(d(~ t tis~. to nearest road. Parcel I.D.# If. L 9• _ . APPLICANT INFORMATION - pl nt all P rmathon 002-1022-90 Revi y Date Personal information you provide may be used ary pu n Laws 104 (1) (m)). L Z Property Owner., Pro rty Location Marv Utecht " fry 1 G&IJ,Lot SE 1/4 NW 1/4 S 11 T 29 N,R 16 W Property Owner's Mailing Address S7 0;jn1xf.; Lot Block # (S 4111 1067 250th Street Proposed CSM pry City State Zip, 008 City Village Town Nearest Road Woodville WI 54 7 -698-2 Baldwin 250Th Street New Construction Use: Residen rooms 3 ❑Addition to existing building Replacement Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpd/ftz •6 trench, gpdIff Basal area required 900 bed, ft2 750 trench, ftz Maximum design loading rate .5 bed, gpd/RZ .6 trench, gpdff Recommended infiltration surface elevation(s) 101.30' at 12" above 100.30' contour ft (as referred to site plan benchmark) Additional design / site considerations Mound to be installed in a "cresent" shape following contour. tParent material Glacial till. Flood lain elevation, if applicable NA ft ble for system C onventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank ❑ S® U table for system El S N U ® S0 U ❑ S M U ❑ S® U ❑ S MU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure Consistence GPDff i Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz Boundary Roots Bed Trench 1 1 0-9 10yr3/3 None sl 2fcr mvfr as 2f&m 0.5 0.6 2 9-19 10yr4/4 None sl 2msbk mfr cw If&m 0.5 0.6 Ground 3 19-27 7.5yr4/4 None sl 2msbk mfr gw if 0.5 0.6 elev 99.69' ft 4 27-42 5yr4/6 f2d7.5yr5/8 cost lmsbk mfi - - 0.4 0.5 Depth to limiting factor 27" Rernzwks: Z 1 0-9 10yr3/3 None sl 2fcr mvfr as 2f&m 0.5 ! 0.6 2 9-17 10yr4/4 None A 2msbk mfr cur if&m 0.5 0.6 Ground 3 17-26 7.5yr4/4 None sl 2msbk mfr gw if 0.5 0.6 elev 99.24' ft 4 26-45 5yr4/6 t2d7.5yr5/8 cosl lmsbk mfi - - 0.4 0.5 Depth to limiting factor 26" Remarks: CST Name (Please Print) Signature: Telephone No. James K Thompson 715-248-7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, WI 4020 7/6/99 3602 1059 PROPEK1Y0 WEE- Mwvuuxer SOIL DESCRIPTION REPORT joss Page 2 of 3 f, PARCEL l..alk 62-1022-90 A.C.B. soil & site Evaluations Depth Dominant Color Mottles Structure GPD/ft2 Horizon in. Munsell. Qu. Sz. Cont. Color Texture Gr Sz ~onsistence~ Boundary Roots Bed ~ Trench 3 1 0-9 10yr3/3 None sl 2fcr mvfr as 2%m 0.5 0.6 2 9-19 10yr4/4 None sl 2msbk mfr cw if&m 0.5 0.6 Ground elev 3 19-27 7.5yr4/4 None s1 2msbk mfr Sw if 0.5 0.6 101.41 ft 4 27-32 5yr4/6 U7.5yr5/8 cosl lmsbk mfi 9w - 0.4 0.5 Depth to 5 32-48 5yr4/6 m2d7.5yr5/8 scl Om mfi - - N.P. 0.2 limiting factor 27" Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: .Scone: / - ~o ' -'Io; l ©bservoAof P. ~ Anote_- is ind~ ca~~ N P1k kaAd 4!;,o-ttw proposed /o ts, COrr7 L 0 C. &n-c k) a,-K: op off'/-i "A boo - round. /0o.30'Can~ok/ /rS,Sum~o! eLed` _ leo.eD ~ -3 1 z r c \ Owner: \ Mara IC~~ ~ \ ■ 7 .Zso'y 56 . /o3.~SCorTEo~cr- ~Q~Z h~ rVr.ProUec../,►~TS s Eyy 11wA1.1 fee. -710 G /SOW; %n..O~.[xl~cJin, C. Croix G; (Ax. ' r S ro . 320 des ~ 5 ` I NW 114-NW 114 NE 114-NW 114 I ~ I ~ - i 157A 156 N I 477/157 t~ .6 Soe5e~ N~aT4e~ ; II w l 1083.71 1 I i CSM 16-4362 1 1 - 2 I 158A-30 1 ~ ~ 1y 1 1"J 1 1 1 1 I { SW 1/4-NW 1/4 SE 1/4-NW 1/4 I 1 I 1 SW 1/ Q 159A SW A/r 66 1 Io I 1 1 1 525.10 w I 158A-05 LOTI j PT0.v FI A-10 PG 4119 1 j 537.81 ~ - 1 O& \ 11 ~ \ OUTLOTI 158A-20