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Home My WebLink About026-1173-26-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety anti Building Division Sanitary Permit No: INSPECTION REPORT 552339 0 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 X Township Parcel Tax No: Oeverin Homes LLC, aka Oeverin Pro ertie Richmond, Town of 026-1173-26-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: ry\ I CS5-) 20.30.18.1380 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. i Septic I r I~ Benchmark ~7Jt-~ J1•T" ~1~• `{I 1600 7,a /eZ /ad Dosing Alt. BM~[~ z, a 9 Aeration Bldg. Sewer (,•ZZ 95,7$ Holding St/Ht Inlet 6.93 1 -5, 1_7 ~I g TANK SETBACK INFORMATION St/Ht Outlet 7 l C, TANK TO P/L WELL BLDG. Vent to Air Intake ROAD DtInlet 6'.J- Septic T2_ 36Dt Bottom S'Z AJ~} Dosing Header/Man. 75$ yZ Aeration Dist. Pipe e37.55 `fz- 7• &'9 71-32- Holding Bot. System 9.59 93. 9 Z Final Grade PUMP/SIPHON INFORMATION Z Xa add Manufacturer Demands St Cover Z 02 9 GPM GoJt.~- Model tuber TD Lift Friction Loss System H TDH Ft Forcemain Length [Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 Z __17e.,., SETBACK SYSTEM TO ~O P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR y r~ Type Of System- nn A) A_ UNIT Model Nu er: DISTRIBUTION SYSTEM 4--I to = 3 Z vLo Header/Manifold il Distribution x Hole Size x Hole Spacing Vent to Air I take Pipe(s) Length Dia 4 / \ \ So J 1 - Length N Dia Spacing d 5 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over ` jxx Depth of jxx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ® No Yes ® No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Location: 1081 145th Ave t Lew Richmond, WI 54017 (NE 1/4 SE 1/4 20 T30N R1 8W) Waldroff Meadows IV Lot 26 Parcel No: 20.30.18.1380 1.) Alt BM Description = 2.) Bldg sewer length = 36 L o c-k, a -amount of cover = I n n > q2 Plan revision Required? ❑ Yes No G 1 d I L Use other side for additional information. •J [ o t~ Date Insepct s Signat Cert. No. SBD-6710 (R.3/97) ~ PAID ree.wl.gov Safety and Buildings Division County I` 201 W. Washington Ave., P.O. Box 7162 T ' t(1M;PEC; n s i n Mattison, WI 53707--7162 Sanitary Permit Number (to be filled in by Co.) of Commero e 5 5233 State Transaction Number Sanitary Permit Application ` In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submisAsion of NON 110. al i{ing address) unit is required prior to obtaining a sanitary permit. NOT pplic ion fo I WTS re Project Address (if different than ma / submitted to the Department of Commerce. Personal information u prov a NO use or secon ry purposes in accordance with the Privacy Law, s. 15.04 l (m), Stats. /J ILI< 1. A lieation Information - Please Print All Infor ati + parcel # ' Property Owner's Name / ^r e ST, GRoix COUNTY d Z & / 7 3 - -~6= ~ ! 1 n Property Location Property Owner's Mailing Addre ~~`IM & a'`` Ql'~ /3 $O J Govt. Lot `t' 3 3 ~t° r r•Oo l ` ..JJ City, State Zip Code Phone Number -.5,e Section Z (CT, le ODOrN II. Type of Building (check all that apply) 6L Lot # M1- Subdivision Name 2 Family Dwelling - Number of Bedrooms Blue 4,61 P-14- ❑ Public/Commercial -Describe Use ❑ City CSM Number ^ ❑ Village of ❑ State Owned -Describe Use - own of ~ ~ - III. Type of Permit: (Check my one box online A. Complete line B if applicable) A. New System ❑ Replacement System ❑ TreatmentlHolding Tank Replacement Only ❑ Other Modification to Existing System (explain) - List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner 6P,,Y IV. Type of PO_WTS system/Component/Device: (Check all that apply) - on-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound? 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil IV S Q B. (explain) v ❑ Holding Tank 11 Other Dispersal Component (explain)____ El Pretreatment Device is erasUTreatment A rsalA P ro V. D is m Des' n Flow (gpd) esgn PP Dispersal Area Required (s Dispe Posed (s0 ste El A licatton Rat dsf) i Sotl q / VI. Tank Info Capacity in Total # of Manufacturer s o 0 n L' _ Gallons Gallons Units yy Existing Tanks p~ w C7 p New Tanks ~ ~L r£ U N ~ Sepuc or Holding Tank iy(jv - SRS Nhe attached Dosing Chamber _-on t VII. Responsibility Statement- I, the undersigned, assu ponsibility for installation of the POWTSMP/shown B plans sincss Phone Number umber Plumber's Name (Print) J Plumber' stare 2Z,6~~ J f Plumber's Add 32 2- ~ ress (Street, C%, State, , Zip Code} S 111. Coun /Department Use Ualy Permit Fee Date sued g 00 pproved tsappro ' 2 / Z iven Reason o nial 1X Condi easons for Disapproval . ° tank, nkt ` 1 p itnuant fBtei' inif 3JQ Ib ✓t Ae dispersal cell must all be services l i ed. 'r, l5 j~yLat~ +~t~2 t a e.l[ U' as per managernent plan provided by. plum /,Jt a1'G~ / 2 .0. ements must be rrlaintaindd cadt1l i0 . Attach to complete plans for the system and submit to the County only on paper not less than 8 112 x 11 inches in size SBD-6398 (R. 01/07) Valid thru 01/09 PLOT PLAN PROJECT Oeverina Homes LLC ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 SE 1/4S 20 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4/30/12 BEDROOM 3 CONVENTIONAL )00( 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 651 # of chambers 32 116 BENCHMARK V.R.P. top of iron ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 96.0/95.8 4' below qrade All piping shall be SDR 30/34, within 10' of tank piping shall be Schedule 40. Vent B-2 >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 12" 10.2ft^2/pair of end caps 4' Long 3 4" Grade at System Elevation Plans Designed Using Conventional Powts Well is to meet all Manual Version 2.0 setbacks required by 0, WDNR ST 25' 182' Pro 3 Bedroom B-3 House 2-3' X 66' cells with 32' >3' spacing B.M. * 102' Vents 120' Please note: additional borings will be done to verify soil conditions due to large tested area! B-4 Fld 45, B.M.#2 Property Line Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 4/30/12 Owner: Overing Homes Location: NE1/4 SE1/4 S20 T30 N,R18W Lot 26 Waldroff Meadows Richmond 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 Specifications She t Signature License number # 00 PLOT PLAN PROJECT Oeverina Homes LLC ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1%4 SE 1/4S 20 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4/30/12 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 651 # of chambers 32 BENCHMARK V.R.P. top of iron ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL 11 H.R.P. Same as Benchmark SYSTEM ELEVATION 96.0/95.8 4' below qrade All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Vent B-2 >6" Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 4' Long 10.2ft^2/pair of end caps 12" i 3 4" Grade at System Elevation Plans Designed Using Conventional Powts Well is to meet all Manual Version 2.0 setbacks required by 0' WDNR ST 25' 182' Pro 3 Bedroom B-3 House 2-3' X 66' cells with 32, >3' spacing B.M.* 102' ~ • 1 Vents 120' Please note: additional borings will be done to verify soil conditions due to large tested area! B-4 45, B.M.#2 Property Line 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 >i' above grade Finish grade elevation Typical Installation 100.0' Vent Grade Vent 3' 4" 3' x'30/34 Septic Tank 5' Long 1 " 5' S' Long 1 99 36" 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 B 16 chambers per cell System elevations: A_96.0 B_-95.8 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address (Verification required from Planning & Zoning Department for new construction.) T 1 City/State _ Parcel Identification Number-, 02 6 7 P? ! - 2 6 . CM? LEGAL DESCRIPTION Property Location SjE r/4 , Sec. T 3 ON R~~W, Town Of IZ- L- _ - Subdivision ,Lot # _z Certified Survey Map # Volume Page # Warranty Deed # Volume Page # Spec house yes no l,ot lines identifiable 'ye no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 purring (if necessary), the septic tank is less than 113 full of sludge. 11we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system Lm nsth the standards set forth, herein, as set by the :Department of Commerce and the Department of Natural Resources, State. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/wee certify that all statements on this fona are true to the best of my/our knowledge. I/we' am/are the owner(s) of the property described above, by virtue of a anty deed recorded in Register of Deeds Office. Dumber of bedrooms l2Yli IGNAT OF .APPLICANT(S) DATE ***,Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if is made in the warranty deed. reference (REV. 08/05) Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent 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. 8fested into system is not exceed those required as per Comm. 83 y Plan Osystem fails, determine cause of failure, use alternate area and install new 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 ILU 87 <K 6 C, f4 i a' 7-1 4 - F4 _ VA. - _ dell • I I f 1 ~ r 1 1 f ry 1 p o ~ r "r r i ~ _ I IAN i G w.: Y . - -,too 4 -1 I wr. w., I~ AGO-W 97,593 SQ. FT. fw 1.500 - + ACRES ' 1.500 ACRES 1 A~ N 65345 SQ. FT. V 65,345 SQ. FT. f C6 t it / `t`,~ tt f'` ry w / 4~ 'fib"arg - i I ! ` - - - - N89'59'36'E iQ18.95' / lam.` - 145th Avenue S89"S9'36'W 598. /'r W`2it LOT 26 LOT 27 4 ~ LOT 25 ~ ..r-..... 1.610 ACRES LOT 28 a kT 2.055 ACRES ; 70,111 $0. FT. ' • 2.819 ACRES 89,526 S0. FT. c 1.999 ACRES 122,797 SQ. FT. 87,073 SQ. ~T. I N Q 04 I ~ t 8 I 200,00' 2 .39% I N89'59'36'E 448.39' P • h I n LOT 29 t 2.120 ACRES /t 17j3 92,329 SQ. FT. f LOT 30 ?°oo. ff f ff ~ 1.926 ACRES ss ~ / 83,916 S0. FT. tpil $s~~~ ~ / \ LOT 31 £ aJ• E ! . 1.954 ACRES T 85,570 S0. FT. IAN 1'16 N III Illllllllllfllllilllli 8 0 5 5 3 1 1 Tx: 4041193 WARRANTY DEED 955218 BETH PASST REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI 04/26/2012 3:16 PM THIS DEED, made between Thomas NI Gallan, Gt- 51r1~1~ ✓y~~vC EXEMPT: NA ("Grantor," whether one or more), and Oevering Homes LLC a Wisconsin limited liability company ("Grantee," whether one or more). REC FEE: 30.00 TRANS FEE: 60.00 Grantor, for a valuable consideration, conveys to Grantee the following described PAGES: 1 real estate, together with the rents, profits, fixtures and other appurtenant interests, in St Croix County, State of Wisconsin ("Property"): Lot 26, Plat of Waldroff Meadows IV in the Town of Richmond, St. Croix County, Wisconsin. Name and Return Address St. Croix County Abstract & Title 219 S. Knowles Ave New Richmond, WI 54017 1210312 026-1173-26-000 Parcel Identification Number (PIN) This is not homestead property. Exception to warranties: Municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, general taxes levied in the year of closing and Dated this 20th day of April, 2012. T Lomas M Gallan AUTHENTICATION AC KN O W'LEDGMFNT Signature(s) STATE OF WISCONSIN ) ) authenticated on ss. ST. CROIX COUNTY ) Personally came before me on this 20th day of April, 2012, the TITLE: MEMBER STATE BAR OF WISCONSIN above-named Thomas M Gallan to me known to be the person(s) (If not, who executed the foregoing instrument and acknowledged the authorized by Wis. Stat. § 706.06) sam THIS INSTRUMENT DRAFTED BY: Robert L. Loberg t Notary Public, State of Wisconsin Loberg Law Office aI 1. My Commission (is permanent) (expires: (Signatures may a authenticated or acknowledged. Roth are not necessary.) - a r lU ~~0 *Type name below signatures x~, Qs~' `1. U t f: '.j-f NVARRANTY DEED FORNI NO. 1-2003 1 of 1 i Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85,.Wrs. Adm. Code County St. Croix Attach complete site plan on paper not less th jn size'. Plan must include, but not limited to: vertical and h onta i M), direction and Parcel I.D. percent slope, scale or dimensions, nort rrow, and location and distance to nearest road. 0,Z~p_- p~ Please pril'rit It kdf Tkvirp a /1 L` Revi ed Date Personal information you provide may be used f r secondary purposes (Prive ~acy,Law, s:,15.04 (1) (m)). ri Property Owner nN~NG UFFIC~- PfopertyLocation El David Waldrof Govt Lot NE 1/4 SE 1/4 S -4e T 30 N R 18 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# • / 3A 398 River Road 26 - WaldroffMeadows IV City State Zip Code Phone Number ityVillage ■ Town Nearest Road Hudson WI 54016 ( 7f5-549-6601 144th Avenue Q New Construction Use Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD Replacement Public or commercial - Describe: Parent material Loess over outwash sands Flood Plain elevation if applicable N-A ft General comments and recommendations: 1❑ Boring # Boring 0 pit Ground surface elev. 100.00 ft. Depth to limiting factor >90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/2 - sil 2msbk dsh as 2f .6 .8 2 6-14 1 3/2 - sil lmpl dsh cw if .4 .6 3 14-30 10yr4/4 - sil lmsbk dsh cw - .4 .6 4 30-90 7.5yr4/6 - s Os dl - - .7 1.6 F2 Boring # Boring 99.35 >90 0 pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/2 - sil 2msbk dsh as 2f .6 .8 2 9-16 1 Oyr4/4 - sil 2msbk dsh cw if .6 .8 3 16-26 10yr4/4 - sil lmsbk dsh cw 1 f .4 .6 4 26-39 7.5yr4/4 - s Osg dl cw - .7 1.6 5 39-90 7.5yr5/4 - s Osg dl - - .7 1.6 * Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature_ CST Number Thomas C Nelson 227387 Address 1 3L 1204 1~. Y1K lZrr`~n,cr~ s~ Date Evaluation Conducted Telephone Number s 1 - G plat y ~ s 2H6 Lys j Property Owner _ Waldroff Meadows IV Parcel ID # Pending Page 2 of 3 F7-1 Borin # Boring 9 ~ 98.85 24-30 ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil -Appricabon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/2 - sil 2msbk dsh as 2f .6 .8 2 12-24 1 4/4 - sil 2msbk dsh cw 1f .6 .8 3 24-32 10yr4/4 f2d5yr5/8 sil lmsbk dsh cw if .4 .6 4 32-90 7.5yr4/6 - / s Osg dl - - .7 1.6 fid ❑4 Boring # Boring 100.00 >90 • pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/2 - sil 2msbk dsh as 2f .6 .8 2 9-18 /4 sil 2msbk dsh cw 1 f .6 .8 3 18-24 1 4/4 - sil lmsbk dsh cw - .4 .6 4 24-32 7.5yr4/4 - is Osg dl cw - .7 1.6 5 32-90 7.5yr4/4 - s Os dl - - .7 1.6 ~I Boring # Boring F-1 H Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD5 > 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. Rnn valrrrmt (R 07=1 Waldroff Meadows IV lot 26 ~o a~ N01 )S° I CA 21 0 ~ fL 170 43 q ~b2 31 ' l - g' `bb lot 2.9 Soal e 1 " =40' B M 1 Top of iron pipe 100.00' B M2 Top of i ron pi pe 100.00 81 99.35' ' 8298.85 B3 100.00' 6Y4 100.96' 101, Thomas Nelson 227387 SE 10~ Zo ax%ew.