The URL can be used to link to this page

Home My WebLink About026-1004-30-130St. Croix County Planning and Zoning Wednesday, June 09, 2010 at 9:04.13 AM Detail Sanitary Information Page I oft Computer 0: 026-1004-30-130 Sub/Plat: NA Section: 1 Parcel 0: 01.30.18.16A30 Lot: 4 TWRNG: T30N R18W Municipality: Richmond, Town of CSM: Vol. 09 Pg. 2517 114 114: SE 1/4 SE 1/4 Owner. Rettig, Robert & Kathleen Curry 1706 1501h Street New Richmond, WI 54017 State Permit: 240723 Issued: 07/25/1995 POWTS Dispersal: Non -Pressurized In -ground Permit: New County Permit: 0 Installed: 08130/1995 POWTS Detail: Bed - Seepage Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/Inspector As Built Plumber Other Reauiremenls Additional Notes Money Owed Jim Thompson Yes Bird, Byron Jr. outcard to Kevin G. as of 212010 - still out revised 8/30/95 $0.00 Jim Thompson Signed ON Yes 6=10 for floodplain FEMA map query by Heather Zimmerman Maintenance Notification Scheduled Pump Date Pumped Notification 8/30/1998 04/202006 8/30/2010 Page 1 of 2 Pam Quinn From: Kevin Grabau Sent: Thursday, February 25, 2010 11:34 AM To: 'Zimmerman, Heather' Subject: RE: dfirm for 1706 150th Street Attachments: 1976 FEMA FIRM front panel.doc Heather, This is all the information that I have that I can provide you with. It is the front panel of the FEMA FIRMS dated March 26, 1976. I do not know what zone the structure was built in. Thanks. Kiiin Gra6au From: Zimmerman, Heather [mailto:heather.zimmerman@hp.com] Sent: Thursday, February 25, 2010 11:21 AM To: Kevin Grabau Subject: RE: dfirm for 1706 150th Street Hi Kevin, Would you be able to provide me with the community number, panel, suffix date of the map and the zone the structure was in at the time it was built in writing. The map that you provided we are unable to verity the zone the structure was in when it was built. Thankyou Heather From: Kevin Grabau [mailto:KevinG@CO.Saint-Croix.WI.US] Sent: Tuesday, February 23, 2010 1:48 PM To: Zimmerman, Heather Subject: dfirm for 1706 150th Street Heather, Here is the scanned copy of the old FEMA FIRM that I researched for this property. Thanks. ?Gvin Gra6au Code Administrator St. Croix County Planning & Zoning 1101 Carmichael Road 6/9/2010 Report for Parcel #026100430130 1 St Croix Co Page 1 of 1 005J a6� (I vwp�s 2009 Property Recor Coun Assessed values not finalized until after Board of Review Property information is valid as of 2117110 Years in red have delinquent taxes NOTICE: All payments received by County Treasurer will be posted the next day. Property Description Parcel ID: Map ID: Municipality: Public Land Survey: Quarter: QQ / Tract: Plat: Description: 026-1004-30-130 01.30.18.16A-30 TOWN OF RICHMOND SECTION 01 30N 18W NOT AVAILABLE SEC 1 T30N R18W PT SE SE BEING LOT 4 OF CSM 9/2517 12.06 ACRES Property Address: 1"s 150TH ST I Total Acres: lt.ub AC.KtS Assessed Value Valuation Date: 09/09/2008 Assessment Acres Land Improved Total Type Value Value Value Gl-Residential 5.00 65,000 192,000 257,000 G5-Undeveloped 7.06 21,200 0 21200 Totals --> 12.06 86,200 192,000 278:200 Installments Please pay your 1st installment or full payment to Municipal Treasurer, 2nd installment to the County Treasurer. Period Due Date Amount 1 01/31/2010 1,879.87 2 07/31/2010 1,963.07 Total Taxes --> 3,842.94 Tax Payment History Date Receipt Number Amount 01/29/2010 1551 1,879.87 Paid By: CK 5117 -- [ Specials Category Amount 4 u Billing Information Name / Attn.: ROBERT & KATHLEEN CURRY RETTIG Address: 1706 150TH ST City, state, Zip: NEW RICHMOND, WI 54017-6570 Ownership Primary Owner: ROBERT & KATHLEEN CURRY RETTIG Secondary Owner: NO SECONDARY OWNERS LISTED Deed Information Volume Page Document X 979 329 Fair Market Value Assessment Ratio., Net Assess. Val. Rate: School Districts: $273,900.00 1.0158 0.014374863 3962 - NEW RICHMOND Tax Detail Net Tax Before Lottery, First Dollar Credits 3,999.08 Lottery Credit (-) 83.21 First Dollar Credit (-) 72.93 Net Tax After 3,842.94 Amt. Due Amt. Paid Balance Net Property Tax 3,842.94 1,879.87 1,963.07 Special Assessments .00 .00 .00 Special Charges .00 .00 .00 Delinquent Charges .00 .00 .00 Private Forest Crop .00 .00 .00 Woodland Tax Law .00 .00 .00 Managed Forest Land .00 .00 .00 Penalties .00 .00 Interest .00 .00 Total 3,842.94 1,879.87 1,963.07 http: //stcroixwi.mapping-online.com/StCroixCo W i/ParcelReport. j sp?key word=026100430... 2/23/2010 St Croix County WI GIS Map t I iv 1�- SE - SE rt! .R i r r riot MEMPFF-A-V } ~, tir'lJ4P-• \, 7191296 r 836132 Q9 F LOT4 16A-30 ,M 3 37C 579/49 837/128 I vo 61 811.89 � •' • f'_ t J • V Fes+ I / current, or complete ana conclusions arawn are the responsiamry or me user. St. Croix County Planning and Zonin ThursdaJ•,December h,,aeesar,,:3s,a.ur Detail Sanitary Information Rge, of I Computer 0: 026-1004-30-130 Sub/Plat: NA Section: 1 Parcel 0: 01.30.18.16A30 Lot: 4 TN/RNG: T30N R18W Municipality. Rlahntond, Town of CSM: Vol. 09 Pg. 2517 1141/4: SE 1/4 BE 1/4 Owner: Rettig, Robert 1706 1501h Street New Richmond, W 154017 State Permit: 240723 Issued: 07125119% POWTS Dispersal: Non -Pressurized In -ground Permit: New County Permit: 0 Installed: 08/3011995 POWTS Detail: Bed - Seepage Bedrooms: 3 W1 Fund: POWTS Pretreatment: NA Notes Inspector As Built Plumber Other Requirements Additional Notes Money Owed Jim Thompson NA Bird. Byron Jr. $0.00 Signed Off: Yes Maintenance Scheduled Pump Date Pumped 1 st Notification 2nd Notification 3rd Notification 8/30/1998 Parcel #: 026-1004-30-130 12/01/2005 10:27 AM PAGE 1 OF 1 Alt. Parcel #: 01.30.18.16A-30 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner ROBERT 8 KATHLEEN CURRY RETTIG O - RETTIG, ROBERT & KATHLEEN CURRY 1706 150TH ST NEW RICHMOND WI 54017-6570 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description • 1706 150TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 12.060 Plat: N/A -NOT AVAILABLE SEC 1 T30N R18W PT SE SE BEING LOT 4 OF Block/Condo Bldg: CSM 912517 12.06 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 01-30N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 979/329 WD 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/30/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 54,000 170,700 224,700 NO UNDEVELOPED G5 7.060 9,500 0 9.500 NO Totals for 2005: General Property 12.060 63,500 170,700 234,200 Woodland 0.000 0 0 Totals for 2004: General Property 12.060 63,500 170.700 234,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certlflcation Date: Batch #: 109 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0 00 ,r DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS REPORT ON SOIL BORINGS AND PERCOLATION TESTS (115) (H63.09(1) & Chapter 145.045) SAFETY & BUILDINGS DIVISION P.O. BOX 7969 MADISON, WI 53707 LOCATION: SECTION: TOWNSHIP/Mtjb[QITY: OTNO.:BLK NO.: SUBDIVISION NAME: SE 1��E1� 1 /T30 N/R 18�ttor)W Richmond n/a n/a n/a COUNTY: W E M . St. Croix Lynn Forrest jr. 1 1677 150th. St., New Richmond Wi. 54017 :E NO : COMMERCIAL DESCRIPTION: RXesidence 3 n/a flew ❑Replace RATINri• Q. SHE mNJ.la fnr ...A�.n 1Is Ail.....dr.hl. fn. as .... DATES OBSERVATIONS MADE 7MURLE DESCRIPTIONS: PERCOLATION TES7 7-14- 1 7-14-92 Q_ _ ❑� • �L�_j�tw` MOUND: ❑u N �S OU O S ®U L O SG TANK: �C�JjI{/� RECOMMENDED SYSTEM: nvent (optional) trench conventional If Percolation Tests ere NOT required DESIGN RATE: II any portion of the tested area is in the under s.H63.0915)(b), indicate: n/a Floodplain, indicate Floodplain elevation: n/a dpriftwlPROFILE DESCRIPTIONS BORING NUMBER TOTAL DEPTH IN, ELEVATION DEPTHTOQROV D!UATER-INCHE CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH TO BEDROCK IF OBSERVED (SEE ASBRV.ON BACK.) OBSERVED 84 98.93 none >84 •; - sil.; - ,- U-11B-1 7.5yr414, Ell,;34-84, 7.5yr4/6, co.s. B-2 90 99.13 none >90 12, 10yr3/2, L.; 12-24, 10yr4/4, sil.; 24-36,- 7.5 4/4 ls. • 36-90 1 5/4 co.s. 8_3 84 100.83 none >84 -11, 10yr3/2, L.; 11-24, 10yr4/4, sil.; 24-36,- - 4 s. B-4 84 102.48 none >84 -13, 10yr3/2, L.; 13-22, 10yr4/4, sil.;' 22-28, 15 86 102.33 none >86 0-12, 10yr3/2, L.; 12-24, 10yr4/4, sil.; 24-33,- B- dprirlal' PERCOLATION TESTS TEST NUMBER DEPTH S WATER IN HOLE AFTERSWELLING TEST TIME INTERVAL -MIN. DROP IN WATER LEVEL -INCHES RATE MINUTES PER INCH PERIOD I PERIO PERIOD ZI P. 1 3.50 none 3 6 6 6 <3 p_ 2 3.70 none 3 6 6 6 <3 P- none P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate sale or distances. Describe what are the hori- zontal and vertical plevetion reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. lower trench= 95.43 SYSTEM ELEVATION upper trench= 97.33 alt. area=98.98 of- —- ----- - JIM V. - - - - tit 34 i 1, the undersigned, hereby certify that the soil to$ ed on this form we ! by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the deta recorded a t oation ""Cbe tes pre o the best of my knowledge and belief. N - J tO N f r� 1 INAME 1print): TESTS WERE COMPLETED ON: --- - -. H aIr G L � s 1. nn DISTRIBUTION: Original and one copy to Local Authority. Property Owner and Soil Tester. DILHR-SOD-6395 (R. 021RV - OVFR - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER O bev- ADDRESS 13301 A A/�e-w 12 c,� m,a _.l u -); Sy of SUBDIVISION / CSM# lia / "J2 na LOT #�_ SECTION_T- QN-R/_W, Town of1� ST. CROIX Count, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM P?r;, 3b !tx 15 ��. n� 1\ A INDICATE NORTH ARROW Provide setback and elevation 'lrp)OT-AormatTon on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ALTERNATE B' EPTIC TAN / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: 1A, 42 .6 Liquid Capacity: 066 lr`- Setback from: Well ors House1 Other Pump: Manufacturer Float seperation Alarm Location Model# �- Size ' Gallons/cycle: SOIL ABSORPTION SYSTEM Width: Length -,-3 6 ' Number of trenches ) 4c-y Distance & Direction to nearest prop. line: /D 1.! Setback from: well: 5a House 3 6 Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom'— Pump Off — Header/Manifold�A Bottom of system Existing Grade �% Final grade 9� -- DATE OF INSTALLATION: PLUMBER ON JOB: l LICENSE NUMBER: 3"l INSPECTOR: 3/93:jt •r Safety and Buildings Division CILJIR SANITARY PERMIT APPLICATION Bureau of Building Water System• In accord with ILHR 83.05, Wis. Aim. 201 E. Washington Ave. Code P.O. Box 7969 vw"'11111 Madison. WI 53707-7969 W Haacn complete plans (to the county copy only) for the system, on paper not lets than 8 in x 11 inches in size. County ` r C re i�4_ • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs (Privacy Law, s. 15.04 (1) (m)). ❑ Check if revision Io previous appiirat on State Plan I.D. Number I. APPLICATION INFORMATION m.—PLEASE PRINT ALL I F RMATI N Property Owner Name Property Location 1/4 Cr 114, S l T JV, N, R/ E (or Property Owner's Mailing Address -7 13 Lot Num Block Number City, State jZ1pCode1 Phone Number Subdivision Name or CYA Number e—roo 9 v0 (check one) ❑State Owned Public 0t OF V Ilage Neare R lad i El 1 or 2 Family Dwelling - No. of bedrooms own of III. BUILDING USE: (if building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/Condo e::5:� 4< 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 11�Oew 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System Tank Only- ____ __---SYstem ............. ______ Existyl System __---___ Existlnc�System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 1 ].�eepage Bed 21 ❑ Mound 30 ❑ Specify Type , 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In -Ground Pressure 42 ❑ Pit Privy 13 []Seepage Pit , 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: t. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade Re'471quired (so. ft.) Proposedsq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevati� Feet c..5 Feet VII. TANK Capacity INFORMATION in gallons Total Gallons # of Tanks Manufacturer's Name Prefab Concrete Site Steel Fiber- glass plastic Exper App. New Existin T nk rustCon strutted Septic Tank or Holding Tank �(% ❑ 11 ❑ lift Pump Tank /Siphon Chamber 11 1 Q❑ VII(. RESPONSIBILITY STATEMENT I, the undersigned, assu a responsibility for installation of the onsite sewage system shown on the attached plans. Plumber' Name: (Print) Plu r' ignature: (N mps MPlMPRSW No: Business Phone Number: Plum 's Address (Stree City, ate, Code L IX. COUNTY / DEPARTMENT USE ONLY 101, ❑ Disapproved Sanitary Permit Fee ('nd"dcSGra Mwetn Date IssuedIssuing Ag nt Signat (No S pproved ❑ Owner Given Initial Adverse Determination — p X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: INSTRUCTIONS 1 A sanitary permit is valid for tv6 ) (2) years. 2. Your sanitary permit may be re ewed before the expiration date, aril at a time of renewal any new criteria in the Wisconsin Administrat,,eCode vill be applicable 3. All revisions to this permit mus be approved by the permit issuing authority. 4. Changes in ownership(-,, pluml r requires a Sanitary Permit Transfer / Renewal Forrn (SBD-6399) to be uhmi:te•{ to he county prior to installai ion S. Onsite sewage systems rnust be r)roper!v maintained The septic tank(s) must be pumped by a licensed pumper vjhe .ev; r necessary, usually every 2 to 3 y_ars �.6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-381 S. To be complete and accurate this .anitary permit application must include: I. Property owner's name and tailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. It. Type of building being serve Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use If building typ, is public, check all appropriate boxes that apply IV. Type of permit. Check only r ie on line A. Complete line B if permit is for'ank replacement, reconnection, or rep tir V. Type of system. Check apprc triate box depending on system type. VI. Absorption system infor-nat in Provide all information requested for numbers 1 through 7 VII Tank information. f II in the 'apacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, mdict 'e prefab or site constructed and tank material Complete for ail septic, pump/vnhort ar.I holding tanks for th,,systerr Check experimental approval only If tanks r-eived expenmer. ,t! product i'pprrwa fro l DILHR. Vill Responsibility statement In allmg plumber is to fill in name, license number w!lh ippropr!ace oreflX le g. MP,( •cl, address and phone rnumner lumber must sign application form IX County/Departmen US., Or y X. County / Departmen' Us Or y Complete plans and specitic Dior. no! smalier than 8 1,12 y 11 incr_s most -! I pl.lr,s , 'us Include the !ollowln:: 0 p )t plan, drawn !O `-rule Or Wlth IOrj,r% - to ;',1 C t r1U � 'O ' Jn-".(5;. SP' rlc or f)lher 'reo inept, lKS; hc:i!7ing wVverS wells W.Iter mdlrisrov d'_'ti^ .iC..: ;t'��'^S .I,': iLi Olimpor Ipf n torkS, dlstr'hu',IOI, t, -)Xe,, So absorpllUn ,VStI'n1S, rePIJCctlle. Sj'-Left ]r(_ J Of ,nE' f,.,ld:ry se !ec B)'lori7ontal and v�.rtrcdl el VdtlO❑!e'. e'rnCe NOIfIIS, CI _Omr•CI(`SpC`(I�I.,itiOn:.'Or UUmpS Ln,i lontf Ui,; r!OSPV' rin elevation difrerencc ., a (tic I toss, pump perfurn-.ance (-urve, pu,np nludci gin,: p.� T) mdnuidr,ufer, tit cross se _tor of thesoil aLsorptior sy'tern flegr,ired by thecounty, Ft sa' e',' dafd o�, d 1' I'-1 r , dru t I -Ill �:Ilny ioiurnlati n. 1983 Wisconsin Act 410 included to crea!�un of �, rrr,., I;, effect grour'dwd?er The monic, collected thrc• jgi the e surcharges —2 �,,—! fo' and estauhShment of star ddrds. I, ;I :m,r�t nn utv?stca'onn Wisconsin Department of Industry, Labor and Human Relations Safety and Buildings Division GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) ST. C'ROIX Permit Holder's Name: City Village ❑ Town o RETTIG, ROBERT & KATHLEEN X CST SM Elev.: Insp. BM Elev.: BM Description: 6ej Z9 ,-,,v o - I IFA 01:41Lt 1.1e7:11 A IF -A ` dTaTT TYPE MANUFACTURER CAPACITY Septic Dos' — Aeration Holdirig IANK SETBACK INFORMATION TANK TO P/ L WELL I BLDG. pe intake ROAD Septic /66 I �S ` c NA Dosing q Aeration q Holdin PUMP / SIPHON INFORMATION Manufacturer_t nd Model Number M TDH I Lift I F Ion S s Ft Force Length Dla. Dist. To Well SOIL ABSORPTION SYSTEM ELEVATION DATA 7/? 1 ;a — STATION BS HI FS ELEV. Benchmark 4--( Bldg. Sewer 4y,S�' St / Of Inlet St/ t Outlet 3,�l1 9U,G3 Dt Inlet Dt Bottom7577-7 i Headetk Dist. Pipe Bot. System Final Grade ;� / BED/TRENCH DIMENSIONS Width Leng!� � No -Of renches PIT No. Of Pits Inside Dia Liquid Depth �,SETBACK LAKE/STREAM SYSTEM TO P/L BLDG WELL L nuadurer: - INFORMATION CHAM Type r- System:Cc.,1k-wd 1 G model Number: ,,j �/ OR IT ui�rrctoulwly �r�ItM LHeader / Length /� I Oistri ution Pipe s Le 33 r (,o x Hoe Size x H pacing Vent Tp Air Intake ngth Dia Spacing 9S — wIL LU V EK x Pressure Systems Only xx Mound Or At-Gr a Sv Iv Depth Over Bed /Trench Center 3/ C/� Depth Over N xx Depth Of xx Seeded /Sodded xx Mulched - Bed /Trench Edges 31 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No LVmnnrily r Y. tincluae cone aiscrepancies, persons present, etc.) LOCATION: Richmondd./1.30.18W, SE, SE, Lot 4, 150th Street Plan revision required? 2<es No Use other side for additional informa❑ tion. y_ SBD-6710(R 05191) Sek- 'i4s /3wJ( [a �C7 C"9,& }gate Inspector'sSignatur Cert No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: •3I�1� GILHR SANITARY PERMIT APPLICATION Safety and BuildingsrigWater System- Bureau of Buildin Water S 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less than 8 la x 11 inches in size. County . � � C� � � • See reverse side for instructions for completing this application State Sanitary P rmit Number The information you provide may be used by other government agency programs �, „0 pr 93 ❑ Cher it reel to previous lgpicarion (Privacy Law, s. 15.04 (1) (m)I. State Plan I.D. Number I APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Property N e h ► F°4�Location S T O, N, R (O PropertyOwner's Mailing AddresIV ? Lot Number Block Number LY ' Cl tote Zip Code Phone N r Subdivision Name or CSM Number O ( . pis : (check one) [IState Owned 20 J City Villae 0 earest Ro 1 f4 L Public 1 or 2 FamilyDwelling- No. of bedrooms Town OF PF r / O III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/Condo 67 .26 —/c+o — 3o 1 O 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office / Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. To New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ......System ________System_____________ Tank Only____-__-___ _ ExistinQSystem ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 []Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In -Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. AbsorP. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. Sys El !v. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation �,O eet lee 15eet VII. TANK Capacity INFORMATIONGallons in gallon sSteel TOtal Of Tanks Manufacturer's Name Prefab. concrete Site Con- Fiber- glass Plastic Exper App. New Existin Tan T nk strutted Septic Tank or Holding Tank ❑ ❑ lift Pump Tank 6i hon Chamber-2�411 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's me: (Print) 1 Plumbe ' ignature: (No St in MP/MPRSW No.: Business Phone Number: i o n 3 / /S' 7</ Plum r' ddress (Street, City, State, Zip Code): o/ IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee (lnc)udn GfOY1M.6"" ate ssue lssuing Ag t Sign re No St ps) Allp roved ❑ Owner Given Initial ¢ Suaharge F m) /¢ice Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: S111P63911(x OV94) 01STRIWTx1e. OF19M 110 Counl r, Oft, CUM To: Serer► i l.d.lu js Div,,ma. (Mir, Number INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin. Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. ll. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI Absorption system information Provide all information requested for numbers 1 through 7 VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. Vill Responsibility statement Installing plumber is to fill in name, license number with appropriate prefix (e.g MP, etc ), address and phone number. Plumber must sign application form IX. County / Department Use Only X County / Department Use Only Complete plans and specifications not smaller than 8 112 x 11 inches must be submitted to the county. The plans must include the follvom+g: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service, streams and lakes, pump or siphon tanks; distribution boxes, soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss, pump performance curve, pump model and pump manufa(turer; D) cross section of the soil absorption system if required by the county, E) soil test data on a 115 form, and F) all sizing information -------------------------------------------------------- ------------------------------------------ GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards PLOT PLAN PROJECT Rob Rettio/Kate Curry ADDREss1330 Herftape Drive #7 New Richmond Wi 54017 SE 114 SE 1/4S 1 /T 30 N/R 18 W TOWN Richmond COUNTYST. CROIX a::MPRS BYRON BIRD JR. 3318 DATE 7/15/95 BEDROOM 3 CONVENTIONAL %40( IN-C D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE •7 ABSORPTION AREA 648 BED SIZE 18' X 36' BENCHMARK V.R.P.Top of Survey Stake ASSUME ELEVATION 100' ❑ BOREHOLE (DWELL •H.R.P. Same aS Benchmark VENT SYSTEM ELEVATION 89.65 12" GgApE TYPAR COVERING 12" 3' 6' ® 3' 3' ® 3' i g SEWER R 18 35 45tee55' Rep A Gary Steel Soil Test � I � 45' I I I Vent I 1 % — lope -1 100 Pro 3 Bedroom House Labor ndHumennentoflndusvy, SOIL AND SITE EVALUATION REPORT Labor and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05. Wis. Adm. C`,nda Page _ of - COUNTY Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must include, but L T not limited to vertical and horizontal reference point (BRA), direction and % of slope, scale or PARCEL I.D. #f dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPEFffY OWNER: PROPERTY LOCATION O 'r GOVT. LOT 3 114 ^—im,S T 0 ,N,R /(jdP PROPERTY OWNE ':S LI ADDRESS LOT 8 BLOCK i SUBD. NAME OR CSM • p C 7_ - CI STATE ZIP CODE PHONE NUMBER ❑CITY LAG N NEAREST ROAD 6 .2 0" G (*New Construction Use 17+ Residential / Number of bedrooms [ j Addition to existing building [ j Replacement [ I Public or commercial describe Code derived daily flow YS6 gpd Recommended design loading rate iZbed, gpd/ft21-tench, gpolft2 Absorption area requireaL'Y ,3 bed, ft2 trench, fl2 mtxn design loading rate bed, gpc* trench, gp(W Recommended infiltration surface elevations) �� ft (as referred to site plan benchmark) Additional design / site considerations /1P.,o . S2 Gar/ �,�e / ,�d Parent material Qz t�C-#-� ./�- Flood plain elevation, if applicable'Az—) )q ft S = Suitable for system U= Unsuitable for stem �ENTIONAL XIS ❑ U MOUND S❑ U UND PRESSURE S❑ U AT•GRADE ❑ S U SYSTEM IN FILL ❑ S U HOLDING TAN ❑ S U Boring # 13 GG Ground /k ft. Depth to limiting n Boring fE [a Ground ft. Depth to limiting �J 3 SOIL DESCRIPTION REPORT .OEM s:. #. .. a .�. .. �� ...�: .• :. •: -..ti MAAM' Mom Remarks: nrm� ... WA eM ... � one Remarks: PROPERTY OWNER SOIL DESCRIPTION REPORT PARCEL I.D. ! Page _ of Boring # [3 Ground ev ft. Depth to limiting factor Qomarkc- Boring # 0 - Ground elev. ft. Depth to limiting factor Remarks: Boring # El - Ground elev. ft. Depth to limiting factor Remarks: Boring # «r sue; Ground elev. ft. Depth to limiting factor Remarks: M-8330(R.05M) DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY,- DIVISION LABOR AND PERCOLATION TESTS (115) MADISON7969 WI 53707 HUMAN RELATIONS (1-163.0911) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MLjtR2tttWY: OT NO.: BLK. NO.: SUBDIVISION NAME: SE '/f3E 1/4 1 /T30 N/R 181 (or)WI Richmond r n/a I n/a n/a COUNTY: WNE St. Croix Lynn Forrest jr. 1 1677 150th. St., New Richmond Wi. 54017 ISE NQ 8 C ION: I�� Ebasidence 3 n/a IN7Jew ❑Replace --------- - - ..!._L._ •-- -, s DATES 065ERVAI IUMb MAUL 1DRIP TS: 7-14-92 1 7-14-92 ONNV�--V�EpN NAL: l ❑U MOUND: ®S ❑U IN -GROUND -PRESSURE: �S ❑U -IN-FILL ❑ S ®U OLOING TANK: ❑ S WU RECOMMENDED SYSTEM:IOptional) trench conventional If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.091511b), indicate: n/a Floodplain, indicate Floodplain elevation: n/a A,, ,.. l , PROFILE DESCRIPTIONS BORING NUMBER TOTAL DEPTH IN, ELEVATION DEPTH TO GROUINATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) OBSERVED EST. B-1 84 98.93 none >84 - •' - ' sil.;- ,- 7.5yr414, sl.,; 34-84, 7.5yr4/6, co.s. B.2 90 99.13 none >90 -12, 10yr3/2, L.; 12-24, 10yr4/4, sil.; 24-36,- 7.5 4/4 ls. - 36-90 1 5/4 co.s. B 3 84 100.83 none >84 il.; 24-36,- -11, 10yr3/2, L.;-11-24, 10yr4/c,•ss o. B 4 84 102.48 none >84 13, 10yr3/2, L.; 13-22, 10yr4/4, sil.;' 22-28, - B- 5 86 102.33 none >86 0-12, 10yr3/2, L.; 12-24, 10yr4/4, sil.; 24-33,- - B- .a,,,,4.. l t PERCOLATION TESTS TEST NUMBER DEPTH JUGMS WATER IN HOLE AFTERSWELLING TEST TIME INTERVAL -MIN. DROP IN WATER L V L-IN H S RATE MINUTES PER INCH PERIOD I PrRIOD2 PE13100 3 P_ 1 P- 2 p. 3.50 3. 00 none none none 3 3 6 6 6 6 6 6 6 6 6< <3 <3 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. lower trench= 95.43 SYSTEM ELEVATION upper trench= 97.33 alt. area=98.98 — V;m s �t ; aka 4A.� T N I, the undersigned, hereby certify that the soil tests reported on Administrative Code, and that the data recorded and the location 'IISTRIBIITION: Original and one copy to Local Authority, Property Owner and Soil Tester. '4-SBD-6395 (R. 02182) — OVER — with the procedures and methods specified in the Wisconsin ty knowledge and belief. INSTRUCTIONS FOR COMPLETING FORM 115 - SBD 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the rotor mation (such as floor) plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL. TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob -- Cobble (3 - 10") SS Sandstone gi - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater Cs Coarse Sand Perc -- Percolation Rate med s - Medium Sand W - Weal is Fine Sand Bldg - Building Is - Loamy Sand > - Greater Than 'sl - Sandy Loam < - Les> Than *I - Loam Bn - Brown 'sil - Silt Loam BI - Black si -- Silt Gy - Gray cl Clay Loam Y Yvllm;, sel - Sandy Clay Loarn R -- Red sic[ - Silty Clay Loam mot - Mottles sc - Sandy Clay wr with sic -' Silty Clay fit - fely, fine, faint .c -- Clay CC — COINngn, coarse Pt -- Peat mm - Many, medium m - Muck d -- distinct p -- prnrmnerlt HWL - High vvariv level, Six general soil text) -Tres surface. water for liquid waste disposal BM - Bench Mark VRP Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. A ' . Soil Test Plot Plan Project Name Rob Rettig and Kate Curry Byro Bird Jr. Address 1330 Heritage Dr. #7 New Richmond Wi 54017 CI<TM #3479 Lot ---- Subdivision --- Date 7/15/95 SE 1/4SE 1/4S1 T 30 N/R18 w Township Richmond ❑ Boring ()Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 it.Top of Survey Stake NE Corner of Lot System Elevation89.65 "HRPSame as Benchmark 9 i STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER MAILING ADDRESS 1330PeriLL4e br. And- #' 7 AJw Q,chcz%ohet, Or 5yot-7 PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. &! $5 yo / 7 CITY/STATE PROPERTY LOCATION 1/4, 5:�r 1/4, Section �� T _: o N-R_2!5�r W TOWN OF G1 ! r `7/j,�A "� ST. CROIX COUNTY, WI SUBDIVISION — LOT NUMBER_ CERTIFIEDSURVEYMAPy66s VOLUMEPAGELOTNUMBER �t 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: 6Y_ r DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 I1/93 a W V M iuu -This application form is to be completed in full and signed by the owners) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------- Owner of property Z9 1'1?e. 11V 4e A Location of property/ l/4 f -1/4, Section __Z_,T.ZC N-R �� W Township Mailinga ress / .�33C z�r"X"g Address of site 76* /5 o f/f J��'�ez.'� ��aj'r" Subdivision name Lot no. other homes on property? Yes_^,,;r No Previous owner of property L vZY 42 tolo-l'o r• ►-c z Total size of property A eS Total size of parcel 2110 ec e„ICS Date parcel was created Are all corners and lot lines identifiable? 4_Yes No Is this property being developed for (spec house)? Yes 1 No Volume '7,7 and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. U 9/ a y and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. k1y/O/491 �; Siqftture of Applicant Co -Applicant 7-s-9s Date of Signature Date of Signature / — -- JOINS OB 1Y/ R ZONE C ZONE SAS 0 e m ZONE B y 0`l04 y°�ir o E B LL W N CC oQ y�o` Q in "Yd ZONE CCc - �Qqqq( Q�d r for ZONE A7 ZONE B 8'—' i Q peek 3/26/76 S o� ZONE B I ZONEA 76 �''' ZONE A4 ZONE. E.AO 3/26/76 I Gr�o $ •'x(�b 4 Brushy Z"'26ry/�� 7 A ZONE A v ZONE A 3126/76 �F %0 %0 Mound Lake 3/26/76 F V Uj J� X =— da gg R ME X JQ 4- 60'6 AN*- °a >-"� _1 v Long Pond Z?NE6A o�i mz o Q Z Z O O o z H O O ZONE C Cty. Rd. G 2 W 0 � J W W C G O w a Q cc mo w �1() Lundy CC i E Q Pond ONE A x V m 5Q Z a� V a: Z =VU v o �� z � W r� vI P cc Q 7 6 Creek r� JO1N$ 23