HomeMy WebLinkAbout002-1028-90-000RECEIVED
SAFETY AND BUILDINGS DIVISION
Field Operations Bureau
13 East Spruce Street
REPORT Chippewa Falls, WI 54729
www. commerce.state.wi. us/sb
Jim Doyle, Governor
Cory L. Nettles Secretary
iscons
Department of Commerce
Date of Inspection: 10/14/2002
Project Name: Helgeson
Use: ~ Replacement -Residential
Legal Description: NE, NW, 14, 29, 16W
Site Number:
Subdivision:
Municipality: Town of Baldwin
County: St. Croix
Plan Transaction Number:
Sanitary Permit Number:
qpp 0 4 2003
ST. CROIX CO~~~
ZONING OFFICE
Plumber Name and Address:
NA
Wastewater Flow: 450 gpd
Persons Present: H. Grote
Certified Soil Tester Name and Address:
Henry F. Grote, CST 222774
E 4366 353`d Ave
Menomonie, WI 54751
Owner Name and Address:
An onsite soils verification was conducted at the above referenced site as per district policy for all sites with less
than four inches of unsaturated soil below the bottom of the A horizon. The intent of this investigation is to
confirm initial observations by the certified soil tester (CST) relating to the presence or absence of redoximorphic
features in the A horizon and subsoil. In-situ soil texture, structure, and consistence factors were also reviewed
as they relate to wastewater application rates. Other site conditions such as percent and direction of slope,
landscape position, land surface contour length, and surface water hydrology may also be noted and their effects
are factors considered in the recommendations and conclusions portion of this report.
It is my opinion that soil conditions at this site are unsuitable for a mound system using an interpretive
determination. The area evaluated appears to be very wet and has < 6 inches of suitable soil above a saturated
soil condition. Redoximorphic features were observed in the A-horizon and map iron concentrations and
depletions were apparent in the subsoil. Free water was observed at 16 depth. Other soil areas of the parcel are
similar.
One option may be to conduct a soil saturation determination using monitoring pipes during a normal spring
season.
A holding tank appears to be the only option for a replacement onsite system. The use of water conserving
fixtures is high recommended when a holding tank option is used.
If there are any questions regarding this report, please contact me.
eroy G. ansky, tewater ecialist
Ljansky commer .state.wi E-mail
715/726-2549 Fax
715/726-2544 Voice
~~~
cc: County ^ Plumber ^ CST
~~ ~~~ ~~,. ~ ~ I~ ~~~~
'~ ~ \ ~.
^ Owner ^ Other
y ~' ~ORIG91~~4L~,
Wisconsin Department of Commerce SOIL EVALUATION REPORT
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code
~+ o -,o z ~4~Od ~ y
Attach complete site plan on paper not les~han 8%z x 11 inch y Count
include, but not limited to: vertical and horizontal reference po t (BM),~I~tlr1 ~e parcel I.D.
percent slope, scale or dimemsions, north arrow, and location nd dist++~enl~;~-~o tMbbb~d
Please print all informatio Reviewed By
Personal information you provide may be used for secondary purpo es (Privae~6aN, s. ~.o®(1)~2
Property Owner ST. CR P o ert Location
NTY
1639
Page 1 of 3
Certified Soil Testing
St. Croix
002-1028-90-000
Date
Helgeson, Terry ZONI NE 1/4 NW 1/4 S 14 T 29 N R 16 W
Property Owner's Mailing Addre~ o # Subd. Name or CSM#
2533 CTHW E
City State Zip Code Phone Number 1 City m~ Village Vi Town Nearest Road
Woodville ~ WI 54028 715-698-2983 Baldwin CTHW E
_. New Construction Use: /! Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD
/ Replacement ~~ Public or commercial -Describe:
Parent material l oess over till Flood plain elevation, if applicable NA
General comments
and recommendati ons: install 4' x 120' rock cell mound on 97.7 co ntour as upslope edge of rock w/ 2.5' sand fill - approved soil
saturation determination required
Boring # ~i Boring
P
1 ~
it Ground Surface elev. 97.7 ft. Depth to limiting factor
ln• Soil Application Rate
Horizon , Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP OIft'
in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 ~i 0-5 I 10YR 2/2 - sil 3 m gr mvfr gs 1f/m .5 .8
2 5-10 I 10YR 2/2 - sil 2 f sbk mvfr as ~ 1f .5 ~ .8
3 ~ 10-15 10YR 6/2 cap 10YR 5/6,5/8 sicl 1 m sbk mvfr 1f .2 .3
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horizon 3 sbk parts to 1 m pl; perched ground water observed @ 14"
Boring # .-.1 Boring
~, Pit Ground Surface elev. 97.5 ft. Depth to limiting factor 9 in• Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-9 ~ 10YR 2/2 - sil 3 m gr mvfr i gs 1f/m .5 .8
_2 I, 9-12 10YR 2/2 f2f 10YR 6/2 sil 2 f sbk mvfr cs 1f .5 .8
3 12-16 ~ 10YR 6/2 m1d 7.5YR 5/6 sicl 1 m pl mvfr - 1f .2 j .3
I
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sicl is slightly gritty w! s & occasional f gr; horizon 2 low chroma redoximorphic features could be horizon 3 mixing
Effluent #1 = BODS> 30 < 220 mg/L and TS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS _< 30 mgr
CST Name (Please Print) S g ture: CST Number
Henry F. Grote 222774
Address Certified Soil Testing Date Evaluation Conducted Telephone Number
E. 4366 353rd Ave., Menomonie, WI 54751 9/27/2002 715-233-0398
y
Property Owner Helgeson, Terry Parcel ID # 002-1028-90-000 Page 2 of 3
Boring # Boring
/''I Pit Ground Surface elev. 97.7 ft. Depth to limiting factor $ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-8 10YR 2/2 - sil 3 m gr mvfr gs 1f/m .5 .8
2 ~ 8-10 10YR 2/2 f2f 10YR 6/2 sil 2 f sbk mvfr cs 1f .5 .8
3 10-15 10YR 6/2 m1d 7.5YR 5/6 sic! 1 m pl mvfr - 1f .2 .3
__
sic! is slightly gritty w/ s & occasional f gr; horizon 2 low chroma redoximorphic features could be horizon 3 mixing
^ Boring # -Boring
Pit Ground Surface elev. _ ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color i Redox Description Texture Structure Consistence Boundary Roots :
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
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^ Boring # -=i Boring -
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
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`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) Certified Soil Testing
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March 19, 2008
Terry Helgeson
2533 Co Rd E
Baldwin, WI 54028
Re: Failing sanitary system at 2533 Co Rd E, Further described as (NE1/4, NW1/4
Section 14, T29N R16W), (002-1028-90-000), Town of (Baldwin),
Code Administration
715-386-4680 Dear Mr. Helgeson:
Land Information ~ The St. Croix Count Plannin and Zonin De artment is the ` overnmental unit for
Planning y g g P 9
715-386-4674 the regulation of private sewage systems" in St. Croix County pursuant to Section
145.20(1) {a) Wis. Status. Section 145.20(2) (f), Wis. Stats. States that the
Real Property governmental unit shall investigate violations of the private sewage system
715-386-4677 ordinance and shall issue orders to abate the violations.
Recycling Based on our records our Sanita Permit #420614 for a re lacement holdin tank
715-386-4675 y ~' P 9
was never installed and expired on 12/16/04. This permit indicates that the existing
septic system has been identified as a Category 1 failing system pursuant to
Wisconsin Administrative Code Comm. 81.01 (92) and Section 145,24(4) Wis.
Stats. Category 1 system are those which fail by discharging sewage to surface
water, ground water, drain tiles, bedrock or a zone of seasonally saturate soils.
These are considered the most serious types of failure, and are given the highest
priority for grant assistance. The existing system is also considered a human health
hazard as defined in Wisconsin Administrative Code COMM 81.01(128) and
Section 254.01(2) Wisconsin Statutes. A failing system can harm the environment
by discharging sewage to the surface, to a lake or stream, or to groundwater. The
Soil Evaluation Report indicates that you have (0) inches of separation between the
bottom of the private sewage system and groundwater.
Pursuant to the St. Croix County Code of Ordinance, Chapter 12, St. Croix County
Private Onsite Waste Water Treatment Systems Ordinance, subchapter
12.1(F)(4)(d) when a failing POWTS is identified it shall be brought into compliance
with Wisconsin Statutes and Wisconsin Administrative Code.
Any plumbing work required for compliance/replacing or repairing the failing system
shall be performed by a plumber who is licensed in the State of Wisconsin. A list of
plumbers is enclosed for your information.
New technology is available that may be acceptable for your site. This technology
utilizes a mound system during dry times of the year. While sensors monitor the
groundwater elevations and if these levels become too high the system will switch
into a holding tank mode. Rich Halverson from Black River Falls (715-284-2556) is
the only plumber currently approved to install this type of experimental System.
ST. CRO/X COUNTY GOVERNMENT CENTER
1 1 O 1 CARM/CHAFE ROAO, HUDSON, Wi 54016 715-386-4686 FAX
A holding tank is still an acceptable option if that would better fit your needs.
St. Croix County participates in the Wisconsin Fund Grant Program, which is a financial
assistance program that assists property owners in replacing or rehabilitating failing
private sewage systems. All work, however, must be completed prior to our submitting
the application to the Department of Commerce to qualify for this grant. If you are
successful in receiving a grant through this program, a $125.00 Administrative fee is
due and payable to this office at the time you receive your grant award check. A
brochure outlining the general program is enclosed. 1f you feel you may qualify,
specifics of the program can be discussed further with you.
This letter constitutes an order to abate the above-referenced violation. Contact me at
715-386-4680 within 10 working days receipt of this letter to discuss corrective action.
Failure to comply with this order and with the provisions of the St. Croix County Code of
Ordinances, Chapter 12, St. Croix County Private Onsite Wastewater Treatment
Systems Ordinance, or any order issued in accordance with this ordinance shall be
Subject to a penalty as provided in Section 12.8 (B) (2) (a). Penalties include forfeitures
of not less than $10 per violation nor more than $1000 per violation as/or be subject to
injunctive relief. Each day a violation exists is a separate violation.
Respectfully,
,,
Ryan Yarrington
Zoning Technician
Cc: Town of Baldwin
File
Enclosures: Plumbers List
Wisconsin Fund Grant Program Brochure
ST. CROIX COUNTY GOVERNMENT CENTER
1 1O 1 CARMICHAEL ROAD. HUDSON, W/ 54O 16 7>5-386-4686 FAX
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERA, INFORiOAAs~'ION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)l.
Permit Holder's Name:
Hel eson, Ter City Village X Township
Baldwin Townshi
CST Eiv1 Elev: Insp. BM Elev: BM Description:
TANK INFORMATION
TYPE MANUFACTURER CAPACITY
Septic
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic
Dosing
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer Demand
GPM
Model Number
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length Dia. Dist. to Well
County: $t. CrOIX
Sanitary Permit No: 420614 0
State Plan ID No:
Parcel Tax No:
002-1028-90-000
ELEVATION DATA
STATION
Benchmark
Alt. BM
Bldg. Sewer
St/Ht Inlet
St/Ht Outlet
Dt Inlet
Dt Bottom
Header/Man.
Dist. Pipe
Bot. System
Final Grade
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: UNIT Model Number:
DISTRIBUTION SYSTEM
Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s)
Length Dia Length Dia Spacing
SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Onlv
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center BedlTrench Edges Topsoil
Yes ~ No
~ Yes ~ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / !_
Location: 2533 County Road E Baldwin, WI 54002 (NE 1/4 NW 1/414 T29N R16W) NA Lot 1 Parcel No: 14.29.16.2046
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? [] Yes [J No
I
Use other side for additional information. ' ~
SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No.
j Safety and Buildings Division County
X1)1 w. Washington Ave., P.O. Box 7162 ~ G I/' C
SCOOSIO Madison, WI 53707- - 7162 Six Addtess
De artment. of Corrmerce a ~ 7 ~ -'v 3 l ~Z as3 3 . ~•
it
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it A
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In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ~D ~~~
^ Check if Revision
` ma be used for seco ses Privac Law, s15. 1
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I. Application Information -Please Print All Information Stax Plan I.D. ber
8/ 375 a
Property Owner's Nam Parcel Number
~e ~ e / ~ s ...tJ Ooh - 0~3' - ~Dr-b~
Property O is Mailing Addre s , / ~{
Property Location
a~ 33 ~ ~, ~ ~ ST. CROIX COUNTY ~ ~ ~a
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City, Stax Zip Code P Lot N ber Block Number
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°
~ Sub 'vision Name CSM Number
~idwF:~ w~` t~'yo~~ 6q8~' Z
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II. Type of Building (check all that apply) L
~ ^City ~-' ~3 ~~ Vd~ s
~,1 or 2 Family Dwelling -Number of Bedrooms ,3
~/.s/ ! ^Village
^ Public/Commercial -Describe Use -dlownship ~ ,
^ State Owned Nearest Road
C O ~~ ,E
III. Type of Permit: C x on line A (numbering scheme for internal use). Complete line B if applicable)
A' 1 ^ New 2 Replacement System 3 ^ Replacement of 6 ^ Addition to Foc County use..
• S stem Tank Onl Existin S stem
B • ^ Check if Sanitary Perrnit Previously Issued Permit Number Date Issued
l:V. Type of Permit: (Check all that apply)(numbering scheme is for internal use) - --~J~h-. S%.Z~ 1-e~~~^~~ ~
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.
44 ^ Non -Pressurized In-Ground 21^ 47 ^ Sand Filter 50 ^ Constructed Wetland
ZZ3~ ~v
22 ^ Pressurized In-Ground Holding Tank 48 ^ Single Pass 51 ^ Drip Line
45 ^ At-Grade 46 erobic Treatment Unit 49 ^ Recirculating 30 ^ Other
V. Dis ersaUTreatment Area Informat ion:
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade
Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation
L ~~^
VI. Tank Info Capacity in Total Number Manufacturer Prefab Six Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
optic or Holding Tank ~/
r~• _ a~(> ,2 , ~GSC /~
Dosing Chamber
. Responsibility Statement- I, the undersigned, assume responsibility for tion of the POWTS shown on the attached plans.
i ber's Name (Print) Plumber's Signature PRS Number Business Phone Number
G/.llaw•. $Clt[ts~ta~c'-.i- ~ - / ~'.2~91f'~ 71~-3~G-31~? l
Plumber's Address (Street, City, Stax, Zip Code)
a m C.1 ~ 4/
VIII. oun /De artment Use Onl
Approved ^ Disapproved
• Sanitary Permit Fee (includes Groundwaxr
Surcharge Fee) Dax Issued
,a is Age ignature (No tamps)
^ Owner Given Initial Adverse .
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Dexrmination ~
ontlitionsnf Appro easons for Disa proval ~ , /_ -• ,~ G~TZ.~., ~_ ~~/~c/!/OZ~
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Attach complete phws (to We County ody)1for We system on paper not lest than 8 s 11 inchea in tfze~y., s,~ ~
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isconsin
Department of Commerce
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601-1831
TDD #: (608) 264-8777
www.commerce.state.wi. us/sb
www.wisconsin.gov
Scott McCallum, Governor
Philip Edw. Albert, Secretary
December 02, 2002
OUST ID No.222774
HENRY F GROTE
CERTIFIED SOIL TESTING
E4366 353RD AVE
MENOMONIE WI 54751
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 12/02/2004
SITE:
Terry Helgeson
2533 County Hwy E
ATTN: POWTS Inspector
ZONING OFFICE
ST CROIX COUNTY SPIA
1101 CARMICHAEL RD '
HUDSON WI 54016 ~ ~+~
~~a(~i~
Identification Numbers
Transaction ID No. 813750
Site ID No. 653648
Please refer to both identification numbers,
above, in all corres ondence with the a enc .
Town of Baldwin, 54028
St Croix County
NEl/4, NWl/4, S14, T29N, R16W
FOR:
Description: Three Bedroom Holding Tank System
Object Type: P ystem egu ate sect ID No.: 82777
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use:
General Approval Requirements: ~n _ S/ ~ p~~~~h~~~ ~V~t~~O,~~
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Holding Tank Component Manual for Private Onsite Wastewater Systems" SBD-10571-P (R.6/99).
• A meter, with remote reading device, shall be installed by a properly licensed plumber, on the water system, that
adequately measures the amount of water used by the structure, excluding hose bibs and wall hydrants, which do
not discharge into the sanitary system.
~/• A notarized Holding Tank Agreement between the local governmental unit/Municipality and the property owner ICOfI~I~
'~ ~,Lro' o'er is er gwred prior to the issuance of a sanitary permit. A Holding Tank Servicing Contract may also be required if ~~~~'
no other service provider for the holding tank has been. identified.
d
• 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.
SEE CORRE8
• 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. Stat
• Comm 83.22(7) 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.
~C_ NOTE: The servicing contract that is included in this plan is not a legal document in that it references ILHR code,
~/~" which is no longer in effect. This document does satisfy the requirement of the Holding Tank design manual, that a
statement from owner as to metho o disposal of the holding tan conten s, is to a me u e w~ e n an.
HENRY F GROTE
Owner Responsibilities:
Page 2 12/2/02
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).
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 83.55 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.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction/instal lation/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.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible
for the installation, operation or maintenance of the POWTS.
Sincerely,
~~~~~~
Charles L Bratz
POWTS Reviewer II ,Integrated Services
(608)789-7893 , 7:45 am - 4:30 pm Monday -Friday
cbratz@commerce.state.wi.us
Fee Required $ 60.00
Fee Received $ 60.00
Balance Due $ 0.00
WiSMART code: 7633
cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544
Terry Helgeson -Holding Tank
Transaction #
RF~~
No ~~FO
sq~~ ~r 8200
lye ~ z
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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 Manual:
Holding Tank, SBD-10571-P (6/99)
Location: NE 1/4, NW 1/4, Sec. 14, T 29 N, R 16 W
Town: Baldwin
County: St. Croix
Date: November 20, 2002
Owner: Terry Helgeson
Address: 2533 CTHW E
Woodville, WI 54028 ~~~ ~ NS. ~i~
~
~
F'~
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Designer: av
H nr Grote ,. S~~ NENOSE ':~( ,
GR
Signature: 1699
-- = N M~N~E
ME W
License # \S~
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WI D-16 -007 ~~i ~'' "~ N~`~~
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Attachments: 6748-Plan Approval Application
SBD 8330
Holding Tank Servicing Contract (copy) -pending
page 1: cover
2: plot plan
3: tank detail
4: maintenance information
~nally
.~VE'a
~ C~MIMERCF
..
page 1 of 4
y ,
..
% HOLDtN~: TANK CRuaS-SECTION ANU sPtc;lh"rC~A1iu~K~ ~~
~~proved
Vent Cap
4 " 1~ V Cr c 1,. c}o
Vent Pips
Weser Tight
,~eal
~~a.v~.~~~oh
~~~~
SPECIFICATIONS
Approved Locking
Weather Pcoof Manhole Cover \ L
Junction Box '^/ ~~-•~»•,~ ~-
12ii
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Finsl Crade ~ 4~~
~1o.u, "`~q ~
I
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,Approved Joint `- - - wi,`
Hi(;h Water
Alacm Svi tch ~` _ - -- _ 1~
TANK Manufacturer : ~' ' ~'''" ~ ~~~ ~'`"'~' r"`~
Tank Size: '~~~ G1allona `
ALARM Manufacturer: S S ~~'a.~i`~ S'~1•~•"`s _
Modal Number : ~dt H`^'
Switch Typa : w.~~~..~-~ »_~___
NU MA ER OF BEDROOMS : 3
Approved
Joint v/ s~4-c
Pic Pipe
Extending
3' Onto
Solid Sol'
c..r1 `
OWNER'S NAME: ` Q'~`~. `~~`'1~'to`^
ADDRESS: ~szi `-T`'``" ~'
LECAL DISCRIPTION: 1.1 s• 1t~ ~1w k~Ssc. 14 ,T 29 N,R Ito N
TOWNSHIP/MUNIL%~''ALITY: 13~1~.•-tiN
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Holding Tank Maintenance Information
As a condition of plan approval, a copy of these plans must be given to the owner and this
information reviewed with the owner.
The capacity of this system's holding tank is 4000 gallons. Under Wisconsin average use
conditions of nominally 50 gallons per person per day, the tank will become full after about 40
days of use by two people. Water conservation measures including the use of low flow water
fixtures will extend this time frame and are recommended.
A water meter must be installed on the potable water service to this residence. The holding
tank is equipped with an alarm which is installed 12 inches below the maximum water level of
the second tank. The alarm will function when about 630 gallons of capacity remain; this is
about six days of average flow for two people. At this time a licensed septic pumper must be
called to pump the tank before maximum capacity is reached. Septage disposal will be by
approved methods according to the Holding Tank Servicing Agreement filed with the county
permit application for this system.
The licensed pumper is required to submit a report to the county within ten days of any
servicing -such as pumping - of this system.
Any questions regarding the performance of this system may be referred to the installing
plumbing contractor, or to the St. Croix County Zoning Office at 715-386-4680.
Page 4 of 4
MOLDING TANK SERVICING CONTRACT
Contract Oate ~ ~ ~D /_,
5f This contract Is made between the ~ t%
~' (/ ~~TJa~ ___________________________________
Holding Tank Owner(s) Name(s) and I Pumper's Name
Terry Helgeson ~
I' S a'
We acknowledge the installation of (a) holding tank(s) on the following property: (Provide legal description:)
part pf the NE 1/4 of the NW 1/4 of Section 14, T 29 N, R 16 W, Town of Baldwin, St. Croix County
further identified as parcel ~k 002-1028-90-000.
1. The owner agrees to file a copy of this contract with the local governmental unit hereinafter called the "municipality", which has
signed the pumping agreement required in Ch. ILHR 83.18 (4j (bj, Wis. Adm. Code and
with the County of St. Croix
2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to Dave access and to
enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the all-weather access
road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay
the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. ~ ,/n.
3. The pumper agrees to submit to the municipality which has signed the pumping agreement required by s. ILHR 83.18 (4) (b), Wis.
Adm. Code, and to the county, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees
to include the following in the semiannual report:
a. The name and address of the person responsible for servicing the holding tank;
b. The name of the owner of the holding tank;
c. The location of the property on which the holding tank is installed;
d. The sanitary permit number issued for the holding tank;
e. The dates on which the holding tank was serviced;
f. The volumes in gallons of the contents pumped from the holding tank for each servicing;
g. The disposal sites to which the contents from the holding tank were delivered.
4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract,
the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the municipality
and the County named above within ten (10) business days from the date of change to this service contract.
Owner(s) Name(s) (Print) ~ Owner's Signature(s)
Terry Helgeson ~ 3~' ~ ~
------- -- --- - - - -- - - - -~~-r j
~ u'
_I..
Pumper's Name (Print) (Pumper's Signature
'~~~rr~" ,~ f,cn di i , ..
~'
Subsc~iDed and sworn to beldrk me on this date:
~ f
~~~~ t~~1~(.yL/ ~1 ~lQ PS6h
-,~ Olary blic
My commission expires:
Pumper's Registration Number
l97~'
SBD•7574 (N. 11/85) This instrument was dratted by the State of Wisconsin Department
of Industry, Labor and Human Relations, Bureau of Plumbing.
ovcuneer~r rvo WARRANTY DEED
5T~TE B.iR OP WI5CON3IY FORM 2-iP81
~S'7~~8 va- 61:~ ~~„11~
Donovan. Johnson _ .
c•wtcres :Ind w:Irrante ca .Terryy. M.. HelgesaR ..and.-ROhd,a _ L_...
Helgeson,_ husband .and .wife as- joint ten,ants__.._..
the fnllowin>; descrlbeJ real estate in -_ _ ._.S.t...CrQJ.1S............Cvunty,
Mate of 1P:;consin:
1N1a 4-A.:L R(9(RV(D FCf 1I 11[CORD,NO DAtA
:~irG15TE~$ OFFfCE
sr. c~v~z co., was.
::::'.1. fc:' Record this 15th
dpy .;_--~~.t._.A.~. 19_83
ut,ll_25 A ~
G ~ Rp6f~r w ~
RETURN TO
Tax Parcel No:...--.•.-••--•--....--•-.-•.--
A part of the Northeast 1/4 of the Northwest 1/4 of Section 14, Town
24 North, Range 16 West, Town of Baldwin, County of St. Croix, more
particularly describer; as follows:
Commencing at the N 1/4 corner of said Section 14:
Thence N 86° 58' S8" W, 576.58 feet to the point of beginning;
Thence South 641.00 feet;
Thence N 86° 58' S8" N', 256.76 feet;
Thence North 641.00 feet;
Thence S 86° 58' 58" E, 26.76 feet to the point of beginning.
Said parcel contains 164,352 square feet (more or less) 3.77 acres
(more or less).
Thi; IS. no.t_ _. homestead properh•.
(is) (is not)
T~u~ 1 `1 J)) C
u h'b
~~~
Exception to warranties:
11 hi; day of
~j,CZ,zt't~., ~~i~' 1 (SEAL )
Donovan. Joh on __ _ _ ..'.__
___... ~. __.(SEAL)
September ,>s83
1 ~E.1I,1
(~EAL>
AUTHENTICATION
Signature(s) -.-----Ilon1]Ydr1..aZ012r1S.Qri_...,-. _.-.-----
cuthent' this .!-.~.-day oP..S2.pt.embe~, 19..8.3
-- -----~~l.,l.V~--- -- - - - ---- - ----- - - ---
'----.Ioh.n.. G_..Nestingen----------------------------•---
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not. -------• ------------ ----•-- --------- - - .............
authorized by § 706.06, Wis. Stats.)
T41S INSTRUMENT WAS DRAFTED BY
..-----Jrihn--G-•---Ne~tingen----------------------
..--..-Baldwin,,-- WI 54002
(Signatures may he authenticated or acknowledged. Both
are not necessary.)
ACKNOWLEDGMENT
STI+TE OF WISCONSIN
ss.
----- - --------- ----y--- -- - -----County. IV111V
Personall • came before me this ...._........ -day of
............. 19..-...-. the above named
to me known to be the person .-.-.......- wfio executed the
foregoing instrument and acknowledge the same.
Notar}• Public -- -...-.._ ---. Courtt7-, Cis.
~fy Commission is nermanent.(If not, state esp!ration
date: _.- . _ .-.-..- - - _ _ -... 19 .)
•Namea of Denona eignin¢ in any capacity shuold he CyDed or printrd 6rt.:~.e tn• it -iR nata res.
STATE AAR or wtsco~sl~ Stock No. 13002
KGM«IINCOt+pOtry M F'r,HN \O. 2- t'~Q
F
ORM N0.985-A
Stock No. 26273
• 3g~~-~• CERTIFIED SURVEY MAP N0. 13111
Being part of the Northeast 1/4 of the Northwest 1/4 of Section 14, Town 29 North, Range 16
l~Jest, Town of Baldwin, County of St. Croix, State of Wisconsin as described in Volume r
of Certified Survey Maps, Page 13111 as Certified Survey Number 13111 .
NW COR. UNP_L,ATT~;',P 1(r,QNp$ NORTH LINE NW I/4 SCALE- "= '
SEC.14:T29N-R.16W ~~~, C.T. ~{ '- E _ --~ NI/4 COR.
c flaoGO~ ~„5~=-''27.77'- SEC.14,T.29N.-R.16~fa
~`
- ------
40.00
g.
J'
FW-~
~~
j=
S
~~ I256.76'
~ S86°58~58~~E
I ( 256.76
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LOT I
16 ,352 SQ. FT. f
3. 7 ACRESt
WI.H OUt R/W
154.081 SQ. FT.t
3.54 ACRES f
~ ORIVE
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EXISTING .
BUILDINGS
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1
1
.256.76'
N 86° 58' 58"W
,UNPLATTED_ ..LANDS.
SEP? .
'~Ir a~ 1983 ,
~, ~~: `~,
~~~
576.58'
1
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SHEET 1 OF 2
O 50 100 150 200
~~FGEI~
- O FOUND I" IRON PIPE
SET BERNTSEN ALUMINUM
CAP MONUMENT
BEARING REFERENCED TO THE
NORTH UNE OF THE NW 1/4 OF
SECTION 14 T.29N.- R.16W. ASSUMED
AS S 86°58158" E
APPROVE
S~~ 0 71983
ST. CROI~C GOUT .1 .
QONIPRENENSIVE PARKS PIA~•,...:G
AND ZONING C0~ITTEE
Volume 5 Page 13111