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Home My WebLink About020-1478-11-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT rmit NGENERAL INFORMATION (ATTACH TO PERMIT) D No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. No: P OermiteverinHolders HomName:es LLC, City Village X Township aka Oeverin Pro ertie Hudson, Town of rSection[Ton/Range/Map, nN wCST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA MANUFACTURER CAPACITY STATION BS HI FS ELEV. TYPE Benchmark Septic Alt. BM Dosing Bldg. Sewer Aeration St/Ht Inlet Holding St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Dt Bottom Septic Header/Man. Dosing Dist. Pipe Aeration Bot. System Holding Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM Len th No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth BED/TRENCH Width 9 DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: CHAMBER OR INFORMATION Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM x Hole Spacing vent to Air Intake Distribution x Hole Size Header/Manifold Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grad Systems Only xx Mulched Depth Over xx Depth of Depth Over Bed/Trench Edges Topsoil Yes 0 No 0 Yes E No Bed(Trench Center Ins ection #2: / / COMMENTS: (Include code discrepencies, persons present, etc.) Inspection p Location: 860 Hillside Trail Hudson, WI 54016 (NE 1/4 SE 1/4 13 T29N R1 9W) Alexander Meadows 1st Addition Lot 24 Parcel No: 13.29.19.3010 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes No E:~ Use other side for additional information. Insepctors signature Cert. No. Date SBD-6710 (R.3/97) ARM. COn'Itl'Ierce.Wi-tov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 l i onsin Madison, WI 53707-7162 Deparhmit Sanitary Permit Number (to ce filled in by Co.) rneme 2L' W/ <07 - Sanitary Permit Application State Transaction Number In accordance with s- Comm. 83.21(2), Wis. Adm. Code, submission of this form to the app riate mm tat unit is required prior to obtaining a sanitary permit. Note: Application forms for state-o d P are Project Address (if different ' ban mailing address) submitted to the Department of Commerce. Personal information you provide may be used sec purposes in accordance with the Privae Law, s. 15.0401(m), Stats. ! j ' [ ( n I, A ficatiou Information - Please Print All Informat' 'rl S (p b ~f t•~ IS i d~C tProperty Owner's Name Parcel # Property Owner's Mailing Address N/NG GI(• , Property Location ~ ~ZON~ 6 3aia~ / Rio 3 Ce- / Govt City, State . Lot ip Code Phone Number 1/4 , Se.lion _ 'rc le o ror of Building (check all that apply Lot T Z~_-- N; It . E r W Family Dwelling - Number of Bedroo Subdivision Name Bk pew ~.ou52. B ' ,tk tt~ ❑ Public/Commercial -Describe Use I ❑ City of_ r'7 _P44&_ ^ ❑ State Owned - Describe Use /(0 CSM Number p❑/~Village of _ of 2 l.~Ll e~ J } lQ 1.. ( 14. III. Type of Permit: (Check only one box on line A. Complete line B if applicable) - A. ew System ❑ Replacement System 11 TreatmemtHolding Trail- Replacement Only ❑ Other Modification to Exis, ing System (explain) ❑ Permit Renewal 11 Permit Revision El Change of Plumber ❑ Permit Transfer to New List Previous Permit Number s nd Dale Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply 1 10 on-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Moutid < 24 in. of suitable soil p ~-5 r ❑ Holding Tara: ❑ Other Dispersal Component (totplaitt) _ _ _ ❑ Pretreatment Device (explain)___ _ V. Dis ersaUTreat of Area Informatio Design Flow (gpd) Design Soil Applicati Rate(gpdst) DispeMat Area Require (sf) Dispersal Area Proposed (st) System Etc%ati n J VI. Tank Info Capacity in Total B of Manufacturer Gallons Gallons Units 2 b New Tanks Existing Tanks 6e64- Septic II a" U v, h w C7 p, or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume r usibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's re MP/MPRS Number Business Phone Number t Plumber's Address (Street, City, State, Zip Code VII Coun /De artment Use Only Issuin gent sign e A X pproved Permit Fee Date I eted I iven Reason for Denial $Y 5• 16 l IX. Contli ' Reasons for Disapproval d ,B,,rl ~e1o h Pr fkf Mot 1I 3 1. Septic tank eNl ustt filer and / spersgl cell must all be services / maintained A-Z w o[,.>,ti.Q.~ as per management plan provided by plumbor. 2. All seftiack regtth'erMft roust be mauttairted ,C an Code / Ofdl d a'F tJ 1 z,t/l , n ru c t Attach to complete plans for the system submit to the -C. oa;3~7 per no t 1 tLan 8 to x 11 iachrs in size eV`SBD-6398 (R. 02/09) PLOT PLAN PROJECT Oeverina Homes LLC ADDRESS 1433 Cernohous Circle Suite A New Richmond Wi 54017 NE 1/4 SE 1/4S 13 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/16/11 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK 1000 gallons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 660 # of chambers 32 BENCHMARK V.R.P. Top of 3/4" conduit ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Alexander Road SYSTEM ELEVATION 94.5/85.0 5.5'below qrade Well is to meet all setbacks required by WDNR Vent Plans Designed Using >6„ Quick4 Standard Conventional Powts of Cover Leaching Chamber Manual Version 2.0 with 20.0 ft2 of Area 10.2ft^2/pair of end caps Long 12" Grade at System Elevation 34" 8% Slope Vents 2-3' X 66' cells with >3' spacing 156' B-3 3' 81' Replacement area 10' 10' B-1 Pro 3 19' Bedroom House A1t.B.M.* B.M.* 18' 188' B-2 36' Hillside Trail Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 10/16/11 Owner:Oevering Homes Location: NE1/4 SE1/4 S13 T29 N,R19W Lot 24 Alexander Meadows Hudson System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-5. Maintanance and Contingency Plan 6. Filter Sp)ca#ti heet Signature License n6900 PLOT PLAN PROJECT Oeverina Homes LLC ADDRESS 1433 Cernohous Circle Suite A New Richmond Wi 54017 NE 1/4 SE 1/4S 13 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/16/11 BEDROOM 3 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 660 # of chambers 32 BENCHMARK V.R.P. Top of 3/4" conduit ASSUME ELEVATION 100° Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Alexander Road SYSTEM ELEVATION 94.5/85.0 5.5'below qrade Well is to meet all setbacks required by WDNR Vent Plans Designed Using >6" Quick4 Standard Conventional Powts Leaching Chamber Manual Version 2.0 of Cover with 20.0 ft2 of Area 10.2ft^2/pair of end caps 4' Long 12" Grade at System Elevation 3499 8% Slope Vents 2-3' X 66' cells with >3' spacing 156' B-3 3' 81' Replacement area 10' 10' B-1 Pro 3 19 Bedroom A1t.B.M.* House 5' B.M.* 18' 188' B-2 36' Hillside Trail Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 10.2ft^2 pair of end plates To be >1' above grade Finish grade elevation Vent Typical Installation 90.0' Grade Lent 3' 4„ `30/34 Septic Tank 3' 1" 5' Long 5' S' Long 3619 Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X 66' Cells Same on other end Observation tubeNent At end of cell A 16 chambers per cell B System elevations: A__84.5 B 85.0 Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Eff luent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. D' harge into system is not exceed those required as per Comm. 83 jontingen Plan tion #1. If s stem fails, determine cause of failure, use alternate area and install new tem in to ed replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715-246-4516 St. Croix County Zoning 715-386-4680 Pumper Tom Mondor 715-246-5148 Shaun Bird #226900 ST. CROIX COUNTY SEPTIC TANS. MAINTENANCE AGREEMENT AND OWNELtSMP CERMCATION FORM Owner-Buyer Mailing Afcn ass f' ('11 tG 166 !T C lJ;~ Property Adcl roes (vim iim pun=$ & zomnng D ~ now Om.) cityisiae Lj-WLL T zZ~ NR , Tows Of. prapea: y Loco stion V4, Sec. Lot #.f SubdrMm _ Page # Volume CearddMed Su rvey MAP # _ par # 'ws"uniy D sod # 2~ 3 9 V Voh me ` bmuue yea nao Lot lb" friaa aftb y no ooatd mug M 3s pmamsm he= to bwas wstlm Psi o Vamm ~ ~ put vmda~aamurce cece m~iHab pu cV** get the sop& 1mk ~ Yom or moom r, 3ff=wl* . by a noemaed the sq~~baom icaa sS6ct dra of dye ssprtlc ismk ss s # stsga is dre agate d3aposal syste®. ~ z ► ne qmofftd in. §C*mM 83.52(1) smd in Chq*w 12 - St. O me COM Y easbary Ozdi ww& The p roprrty aaW ap,W m A *n* to St: Cma County Pig d+ ?00,06 DVOOORt it tam by the oVVwm ~ and by a, =atre p 3 . nsuiowd p OF a 10e00d vesliift dw (1) the om-sate ~ teak is wastawatsm die posat system is in psapaor opwaft comdWan sn&oar (2) &V r hwpecdm and P ngftg (if umessaty). the . leas Aten 113 Ail ofT shrdge: . barro the above sequrime®s~s sad sipme tin mainmafn tare psivste Skl~ "Mm wim ttx ,un&.tds .ec t W&. hft-wo, as not by do D%m of Commmemoe and the ]watt ofNstud Resoatveh Sore of W ooas a Cerwkat m< s hating that yow sv* sysbmod hsa bean mftmiuod must be couplabd end t+ kwod to fire SL C om Comntq Pbmmg Zoning Dep w memo rvltLit► 30 days ofdo fi mee year coat doff I/we wdfy *mt aft -on *b Am= am trine to bast of =Wow b owbft& bvpe sm/are flue ow=dKs) of tha ptgxtty dorm 0" above, by vkftre of a asst =V deed ra mded in Ra*tar of Deeds Of &L Number of bedtmme _ 5 / ATE ONA OF CANT(S) ***A.ny imfbm matiam~ *a :b miemepoesantn A may not& in the sw*wy paw* b ft wyabd by dte Plsmft & Zmft Depsrmtao& hd aft wfflt t his %V a mca led wmxtanty dead ft m the Rogister of Deans Of lm end a copy of *e oeetffied wV" map if rcrmwe is jr ads in do waumm" deed. co W~l ~W~aa E, w Z1d,U' ~try~ ~!J cn u- CL C I.. II II~~I~I ,o~ 1 - r of-at ~I al L` QrQ _ ' a ~amtio sor sus as M 1 I- *FIT- . 1 A-ART ~ V . IN-Aw owl" 10 ;e ~ M yyy w f ~ r M A i 0 i ~ I _ . 1 • r 1 { ' STATE BAR OF WISCONSIN FORM I - 2000 8 T0 9 2 4 X34028463 1 Document Number WARRANTY DEED 943284 l THIS DEED, made between The RiverBank, a Minnesota banking BETH PABST t corporation, Grantor, and Oevering homes, LLC, a Wisconsin limited REGISTER OF DEEDS t ti liability company, Grantee. ST. CROIX CO., WI Grantor, for a valuable consideration, convevs to Grantee the following 1 described real estate in St. Croix County, State of Wisconsin (the 10/17/20112:47 PM 'Property"): EXEMPT#: NA REC FEE: 30.00 I Lot 24, Plat of Alexander Meadows First Addition in the Town of TRANS FEE: 90.00 Hudson, St. Croix County, Wisconsin. PAGES: 1 i t Recording Area Name and Return Address: St. Croix County Abstract & Title 1 219 S, Knowles Ave I New Richmond, WI 54017 SST7593 Together with all appurtenant rights, title and interests. 020.1478.11-000 Parcel Identification Number (PIN) r This is not homestead property. r Grantor warrants that the title to the Property is good, indefeasible in fee simple and &ee and clear of encumbrances except easements, covenants, and conditions of record, Dated this day of October, 2011. 1 The iverBank, a Minnesota banking corporation! 4 i i ~ i 4 eanine Sandberg, CF t E AUTHENTICATION ACKNOWLEDGMENT j Signature(s) STATE OF WISCONSIN ) COUNTY POLIO ) ss. authenticated this Personally came before me this JA'day of October, 2011 ' the above named The RiverBank, a Minnesota banking ii * corporation to me known to be the person(s) who executed the I'. TITLE: MEMBER STATE BAR OF WISCONSIN foregoing instrument and acknowledged the same. (If not, authorized by § 706.06, Wis. Slats.) k THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin My commission is permanent. (if not, state expiration date: Robert L. Lober f Lober Law Office alr i l t~" 2 ) 1 (Signatures may be authenticated or admowledged. Bo a necessary.) D"~~tNt l tnA 'Names of persons signing in any capacity must be typed or printed below then signature ~~~C~r' 0T,q'~ F WARRANTY DEED STATE BAR OF WISCONSIN FORM No. I-V6 9 + DRAINAGE : EASEMENT U" i BENCH MARK: TOP BENCH MARK: TOP OF 1" IRON PIPE, OF 1" IRON PIPE, y, V'. E ELEVATION 95610 ELEVATION 952.2 S89'S8'41 "E 443.48 f U2o 1 la p I ~ ~ YYETLAN ~ I BUFFER AREA MAY N ` 1•",.•'' APPLY - REFER TO N.R. 151 ADMIN. CODE / T ' SLOT 24 rQ lool 50.84 C IJ, X334 N8738'38"E 230.45` ° j-S < 82.413` _ _ A s / : HILLSIDE TRAIL ~ 'DRAINAGE ' °aw pw . 0 fl EASEMENT X" S81157-Ws S87'39'38"W 2353.08' c % o t / ~ "t \1 .02 2.07'- ~y0r,•f' t VI/W i~ Wisconsin SOIL EVALUATION REPORT #2024 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service Attach complete site plan on paper not less than 8/z x 11 inch Ue.Plan must County St. Croix include, but not limited to: vertical and horizontal referen oint ion and percent slope, scale or dimensions, north arrow, and locatio d diton rest road. Parcel I.D. , t1> Please prini all inform ice.-,,---~ Revie ed By Dat Personal information you provide may be us d for s~~yy ~ EQF.1L``-CE 1Qlvacy L 15.04 (1) (m)). Property Owner roperty Location LaCasse Development, Inc. DEC 0 4 2006 ovt. Lot na NE /4, SE1/4, S13, T291N, R19W Property Owner's Mailing Address of # 7e Block # Subd. Name or CSM# 573 Cty Rd " A" ST. CROIX COUNTY na Alexander Meadows First Addition City State Code- Phone Number Pt one Village Town Nearest Road Hudson WI 54016 715-381-5405 Hudson Alexander Rd. ❑ New Construction Use: Z Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Z Replacement ❑ Public or commercial - Describe: na Parent material Stream terraces and pitted outwash plains Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 88.70ft. Trenches spaced and depth to code 5.50ft below grade or and recommendations: to be adjusted to sand depth at time of insta aTion. F 1-1 Boring # Ground surface elev. 94.20 ft. Depth to limiting factor 110 in. ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-19 10yr3/2 none sl 2msbk mfr cs if .6 1.0 2 19-36 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 3 36-57 10yr4/4 none sicl 2msbk mfr gw na .4 .6 4 57-110 7.5yr4/6 none ms osg ml na na .7 1.6 gg!S -7 UU F2 ]Boring # ❑ Ground surface elev. 94.20 ft. Depth to limiting factor 110 in. ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/2 none sl 2msbk mfr cs if .6 1.0 2 8-24 7.5yr4/4 none sicl 2msbk mfr cs na .4 .6 3 24-110 7.5yr4/4 none ms osg ml na na .7 1.6 g~6 ~ n * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <.30 mg/L and TSS s.30 mg/L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994200th St. Baldwin, WI 54002 11/28/2006 715-760-0347 SBD-8330 (R.07/00) Property Owner LaCasse Development, Inc. Parcel ID # Pending Page 2 of 3 FilBoring # ❑ ❑ Ground surface elev. 89.80 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2 1 0-12 10yr3/3 none sl 2msbk mfr cs if .6 1.0 2 12-38 5yr4/4 none Sid 2msbk mfr cs na .4 .6 3 38-110 7.5yr4/4 none ms osg ml na na .7 1.6 / f ~ f GJ A ❑ Boring # ❑ ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2 ❑ Boring # ❑ ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel LaCasse Development, Inc. 994 200th St. CST-POWTSM NE1/4,SE1/4,S13,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St Croix Co. -Lk Direct 715-760-0347 Alexander Meadows First Addition, Lot 2 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1" = 40' I ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 99.40 ft Top of 3/4" pvc pipe ❑ =Borings Boring Elevations B1= 94.00ft B2 = 94.20 ft B3 = 89.80 ft B4 = 0.00 ft ~ U 7 s U~ t} t; \ 4 1 ' t i s i E! f i T•NIES~I'~1 LINE \ .~7~. .W 133 ~:t t ~ ~ } ~ ~ F ` i # # ~ } f ~ ~ X78'1 HVM= ♦ ■ 4PP FLF`~ i 838.0 ? w , 1 ; % r U VkkD 3.3 (w iiOT3 X914.$ f'o • (1 Fs . ` t Ego (Ac s c : r ,i • j / I X938 9 • d ~ • ~ f ~ ~ ~ 443• ' ~ \ ~ ~ 1 ■ i L ~ ~ ~ ~ ~ r im 161 ~ ' 4 ~ . ! i 3 1 j I / ~ ~ r 1ta 930.% 1:: i t 's lr 29 . / 951 100'---~; I ~•~F s f / cif Ole e r 4 \ \ ` e { "6937.0 t t . / ~ S ` • 11.34 At.) L 1 ; • / / j / 100, 9P.4 1 / a 1.11 4PRO &0 -4 L ■ LAC # ! ~O '~7' \ ) 44. i : Ar .r.......o...... j... t . ♦ ' ` i f ' r I#M=938.0 LBO= r 1~ X9dA £ 1l®Ts l / \ ~s~ o t ~1It■ 4 1 r AC. OT 12, \004 4c6k 029 A6. l 1 ; x985.0 AC.) % 9114 980 DRnM CAL pp JQ# J X951.0 49