HomeMy WebLinkAbout036-1043-95-100
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
552360 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:
Kunze, Arnell Stanton, Town of 036-1043-95-100
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
18.31.17.2766
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER J~ CAPACITY STATION BS HI FS ELEV.
Septic z - ' Benchmark 41- Alt. BM
Aeration Bldg. Sewer
7.3 gz.r
Holding St/Ht Inlet . jb'• C
TANK SETBACK INFORMATION St/Ht Outlet y 11,9 V7.7
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic (05 / i Dt Bottom
Dosing Header/Man.
Aeration Dist. Pipe V ! • $S
Holding Bot. System PZ , • $
PUMP/SIPHON INFORMATION Final Grade
/7,
Manufacturer GP Rand St Cover
* ,fL 95
Model Number '
TDH Lift Friction Loss System Head H Ft
Forcemain Length ia. Dist. to Well
SOIL ABSORPTION YSTEM j
D T ength No. Of Tre s PIT DIMENSIONS No. Pits Inside Dia Liquid Depth
MEN EONS Width
` SETBACK SYSTEM TO (`Q P/L ZBLDG WELL LAKE/STREAM LEACHING Manufacture
INFORMATION Type Of System: - o 66 CHAMBER OR -LIB i
CdAuZ i a lts 72 f UNIT Model Numb r:
44 LJ
DISTRIBUTION SYSTEM S CLI) /64-/ = 3 r 4. OL,
- Q_
Header/Manifold > Distribution x Hole Size x Ho Spacing Vt1ched
u Pipe(s) ` \
Length Dia Length \ Dia\ Spacing
,
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 6 ~j a
Depth Over Depth Over xx Depth f xx Seeded/ xx `
Bed/Trench Center Bed/Trench Edges Topsoil Yes ❑ No ❑ No
t
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 1472 210th Ave. New Richmond, WI 54017 (S 1/2 SE 1/4 18 T31N R1 7W) NA Lot 1 arcel No: 18.31.17.276B
1.) Alt BM Description <.O q
2.) Bldg sewer length = L p~~ v T4- {-o
lD :
-amount of cover -
712--1 b 3t' N e-%j
7 42
C)^ A
Plan revision Required? ❑ Yes No 1
Use other side for additional informati n. ' ~ ~ ~ 4 ~ (p lJ
SBD-6710 (R.3/97) Date Insep or's ature Cert. No.
r V ED
commer eml.gov afety and Building v County
201 . Washington AvQ, 2
4 701? Madison, WI 53707-71 Sanitary Permit Number (to be filled in by Co.)
l~palitnent o cim>.„t3+ t)NTY 5 5 2 3
S a' ~ F lication State Transaction Number
In accordance with s. Comm. 8 Adm. Code, submission of this form to the appropriate governmental
unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal information you provide may be used for secondary 7Z ~6 AC
purposes in accordance with the Privacy Law, s. 15.04 1 m , Slats.
1. Application Information - Please Print All Informati
Property Owner's Name p~. Parcel #
Property Owner's Mailing Address Property Location / Z A, Govt. Lot C
City, State Zip Code ~j Phone Number '1A Section /
Lj c~ TN; RZ7leorW
e -1
II. Type of Building (check all that apply) Lot # /
Subdivision Name
r 2 Family Dwelling - Number of Bedroom
C_Z~
Block #
❑ Public/Commercial - Describe Use a t ~Q.v ~e
❑ City of
❑ State Owned - Describe Use CSM Number El Village of
/ / /
III. Type of Permit. (Cher only one box on line A. Complete line B if appy e)
A. ❑ New System acement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner ice'
IV. Type of POWTS System/Component/Device: Check all that a 1
on-Pressurized In-Ground ❑ Pressurized hi-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil P),)6
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
lo-- 01
V. Dispersal/Treatment Area Information:
De Flow (gpd) Design Soil Application e(gpdsf) Dispe 1 Area Required ( Disp sal a Pr s/e~d (s 1/,Sytern E evati
`v ° _7
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units U L
New Tanks Existing Tanks ° a
a C~ tin ti vi w c7 is
Septic or Holding Tank
Dosing Chamber
VIL Responsibility Statement- 1, the undersigned, assumes onsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's MP/MPRS Number Business Phone Number
Z, Z_
Plumber's A dress (Street, City, State, Zip Cod
Z S /21C.~ GC/ S f
VIII. County/Department Use Only
Permit Fee Date Issued Issuing ent Signat e
Napproved ❑ sappy $ i / ~ m J2_
❑ iven Reaso r Denial
IX. Condit E eWeasons for Disapproval as
1 Septic tank, effhlent finer and /
dispersal cell must all be_servtces / maintained ~Dt
as per management plan provided by plumber,
2. AD.set *ck requ(raments must,be maintained
as pekapoic file cak / or~s.
Attach to complete plans for the system and submit to the County only on paper not less than a 12 111 inches in size
SBD-6398 (R- 02/09)
PLOT PLAN
PROJECT Arnel Kunze ADDRESS 1472 210th Ave New Richmond Wi 54017
SW 1/4 SE 1/4S 18 /T 31 N/R 17 W TOWN Stanton COUNTY ST. CROIX
5/24/12 BEDROOM 3
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 1001 Filter BEST Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
All piping shall be SDR 30/34, within 10' SYSTEM ELEVATION 90.3/89.5' 3.5' below qrade
of tank, piping shall be Schedule 40.
Scale is 1" = 40' Vent
unless otherwise Property Line
noted >6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
10.2ft^2/pair of end caps
Long 12"
Grade at System Elevation
3411
Plans Designed Using
Conventional Powts
Manual Version 2.0
5'
Well 3' Old System is to
be pumped and
buried
50' ST 15' DW
3 40' 2-3' X 66' cells
Bedroom 15' with >3' spacing
House 20'
ST 15 0,
211 B.M.* 80' B-1 308% Slope
60'
B-3
15' B-2 ents
20'
210th Ave 300'
Cover Page
Shaun Bird
Bird Plumbing Inc.
1008 192nd Ave
New Richmond Wi 54017
715-246-4516
Date: 5/24/12
Owner: Arnel Kunze
Location: SW1/4 SE1/4 18 T31 N,R17W 1472 210th Ave Stanton
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
4-6. Maintanance and Contingency Plan
7. Filter Specifications Sheet
+ ja
}
Signature f£
License number #226 WO
PLOT PLAN
PROJECT Arnel Kunze ADDRESS 1472 210th Ave New Richmond Wi 54017
SW 1/4 SE 1/4S 18 /T 31 N/R 17 W TOWN Stanton COUNTY ST. CROIX
5/24/12 BEDROOM 3
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter BEST Filter
❑ BOREHOLE (DWELL *H.R.P. Same as Benchmark
All piping shall be SDR 30/34, within 10' SYSTEM ELEVATION 90.3/89.5' 3.5' below qrade
of tank, piping shall be Schedule 40.
Scale is 1" = 40' Vent
unless otherwise Property Line
noted ALo Quick4 Standard
Leaching Chamber
with 20.0 ft2 of Area
10.2ft^2/pair of end caps
2
Grade at Sys tem Elevation
34"
Plans Designed Using
Conventional Powts
Manual Version 2.0
5'
Well 10' Old System is to
be pumped and
buried
50' ST 15' DW
3 40' 2-3' X 66' cells
Bedroom 15' with >3' spacing
House 20'
ST 15 0,
B.M.* 80' B-1 308% Slope
60'
B-3
15' B-2 ents
20'
210th Ave 300'
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 c f 2 ce l Is
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber To be >1' above grade
10.2ft^2 pair of end plates Finish grade elevation
Typical Installation 93.5'
Vent PC/ Grade Vent
3' 4„ 3'
,A/=SeptficTank 191
Long 1 9? S' Long
Grade at System Elevation
3699 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__90.3
B__89.5
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner t Septic Tank Capacity ❑ NA
Permit # lJZJv gal
Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer AF - ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model _ ❑ NA
Number of Public Facility Units NA Pump Tank Capacity gal NA
Estimated flow (average) -7e5"O gal/day Pump Tank Manufacturer 11 NA
Design flow (peak), (Estimated x 1.5) y-~ 17 gal/day Pump Manufacturer NA
Soil Application Rate 7 gal/day/ft2 Pump Model T NA
Standard Influent/Effluent Quality Monthly average*I Pretreatment Unit NA
Fats, Oil & Grease (FOG) <_30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD5) 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD5) <_30 mg/L n-Ground (gravity) ❑ In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L 7K'NA ❑ At-Grade ❑ Mound
Fecal Coliform (geometric mean) <10' cfu/100m1 ❑ Drip-Line ❑ Other:
Maximum Effluent Particle Size in dia. ❑ NA Other: ❑ NA
Other: ,<NA Other: ❑ NA
*Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event I Service Frequency
Inspect condition of tank(s) At least once every' ❑ month(s)
ear(s) (Maximum 3 years) El NA
Pump out contents of tank(s) When combined sludge and scum equals one-third ('/3) of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ onth(s) (Maximum 3 ears) ❑ NA
ear(s) y
Clean effluent filter At least once every: ❑ month(s) ❑ NA
wear(s)
Inspect pump, pump controls & alarm At least once every: Ir Pith(s) NA
r s).
Flush laterals and pressure test At least once every: ❑ month(s) NA
❑ year(s)
Other: ❑ month(s)
At least once every: 111 NA
❑ year(s)
Other.
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
GMW (4/01)
Page of,
S1ART UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
repla a ent system:
suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
a holding tank may be installed as a last resort to replace the failed POWTS.
,eechnology
he site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
aluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
ma be installed as a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINE
Name ri/ Name
Phone _ Phone
J
SEPTAGE SERVICING OPERATOR (P MPER) LOCAL REGULATORY AUTHORITY
Name
~ ~l
Name z7rp /?2 7
Phone ~ _ 511 Phone
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at-grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and -water softener brine.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
e All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
istem. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS
echnology a holding tank may be installed as a last resort to replace the failed POWTS.
The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
aluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
ma be installed as a last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> > .
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NO
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINE • <
Name Name u rt_/
Phone °-l
Phone J
SEPTAGE SERVICING OPERATOR (P MPER) AL REGULATORY AUTHORITY
Name LOCAL
Phone 5XX Phone = 6
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
O,WNERSIIIP CERTIFICATION FORM
Owner/Buyer
Mailing Address IZ11 _
- nt for new cor►s ctru tion--.--_)
Address lanning & Zoning Departlne
Property . (Verification required from P
Parcel. Identification Number
City/State
DESCRIPTION - - -
LEGAL ^ l 7 w, Town of
~j/a , S l_-
Property Location": 1/4
Subdivision I Volume page
-
ap # page SO
Certified Survey M -
Volume
Warranty Deed # able es no
Lot lines identifi
Spec house Yes
AINTEN NCE AND OWNER CERTIFICATION
to handle wastes. Proper
M remature failure er. What you put into
our septic system could result in its p by a licensed pumP
SYSTEM ntenance of y
proper use and mai every three years or sooner, if needed, y yst owner rnaintenance
pumping out the septic tank a in the waste disposal sOetance.
Inaintenance consists of as a treatment stag
• 83.52(1) and in Chapter 12 - St. Croix Count Sanitary signed the
by
the system can affect sthe pecified in § Cofomrnthe septic tank t a certification form,
responsibilities are sp County Planning & Zoning DePartm n 2' a t
owner that (1) the on-site
verifying trig (if necessary), the septic tart" is
owner agrees to submit to St. Croix rioted lumber or a licensed pumpump
The property ourneyman plumber, restricted p (2) after inspection and a master plumber, j erattng condition and/or and by
wastewater disposal system is in proper og e disposal system with the
agree to ma the private sewag
less than 113 full of sludge. intain planning &
ned have read the above requirements and ag artrnent of Natural ResourcesCroix t County soonsui.
I/we, the undersig the DePartment of Commerce u d b completed and returned to the St.
standards set forth, herein, as set th
r septic system has been maintained m
Certification stating that yo, of the three year expiration date. owner(s) of the
Toning Department within 30 days 1/we am/ are the s form are true to the best stenlof Deedsooffc e.
,/we certify that all statements o deed recorded in Register
property described above, by virtue of a arranty
2 S ~~jZ
Numb of bedro DATE
OF APPLICANT(S) & `Zoning Department.
S GNATS revoked by the Planning
***Any information that is misrepresented may result in the sanitary permit being
Register of Deeds Office and a copy of the certified survey Map i
Y
lication a recorded warranty deed from the Reg
Include with this app deed.
reference is made in the warranty
(REV. 08/05)
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1,000 GAL. LBW PROFILE UF~CONCRETE, INC. 4154 CHIPPEWA FALLS, WI 54729
PUMP, SEPTIC, MEMBER OF:
OR HOLDING TANK (715) 723-7446 ■ FAX (715) 723-7111 ■ (800) 924-1516 w www.huffcutt.com NATIONAL & WISCONSIN PRECAST CONCRETE ASSOCIATIONS
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N TANK CONCRETE, INC. 4154 123rd STREET N.P.C. A. CERTIFIED PLANT
0 1,000 GAL. LOW PROFILE CHIPPEWA FALLS, WI 54729
PUMP, SEPTIC, MEMBER OF:
OR HOLDING TANK (715) 723-7446 x FAX (715) 723-7111 x (800) 924-1516 x www.huffcutt.com i a m NATIONAL k WISCONSIN PRECAST CONCRETE ASSOCIATIONS
Wisoonsin Depa nt of Commerce -7 SOIL EVALUATIOA~Z ~~Tt Page of
.3 4 DiAsion of Safety a Buildin"NN t,
h Comm 85, Wis. Adm. Code L
Attach complete s plan da 1W ,G 8 1/2 x 11 inches in size. Plan must
include, but not lim ed orizontal reference point (BM), direction and Parcel I.D.
percent slope, scat ons, north arrow, and location and distance to nearest road. D ~j WD
Please print all information. Revi d by Date
Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). /
Property Owner Property Location
Govt. Lot 1 /4 1 /4 N R E (or LW
A 'r7
PropertyOwmers Mailing Address Lot # Block # Subd. Nam CSKV '2o a
Z72-
z
City State Zip Code Phone Number ❑ City Village Town 1 ,7 Nearest Road
1017
yak,) je;(A" i~tj S4
If New Construction Use sidential / Number of bedrooms- Code derived design flow rate ~J Z7 GPD
Replacement ❑ P lic or commercial - Describe: - -
Parent material 6 Flood Plain elevation if applicable _ j 1 ft
General comments rj r✓~'{rt~tcJ~--+c G
and reconnnendatiorls: ~ -
i
System Type L'y System Elevation d'
FqBofing Boring
# ~l /7
Pit Ground surface eleve~ ft. Depth to limiting factor- in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 7 . 77 1 -/Z m";/2-
®Boring # Boring
'a pit Ground surface elevJ ' ~ft. Depth to limiting factor i ^ Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2
el'
Z- s ,6
J
.r
Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD 130 mg/L and TSS < 30 mg/L
CST Name (Please Print) Sig CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 _ Z' 715-246-4516
Property Owner _ Parcel ID # Page of
F,N) Boring # ❑ Boring
Pit Ground surface elev. ft. Depth to limiting factor /L 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
-l z 0 31 -1- Cr 0
Z_ S S ti m 571-) /10
' 161, 3 y S Os r, , -
Boring # ❑ Boring
F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication 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
Boring # ❑ Boring
F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon ')epth 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 = BOD5 < 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-6330 (R.6000)
Parcel ID # Page of
Property Owner
J ❑ Boring
E Boring # g Depth to limiting factor in. Soil ication Rate
Pit Ground surface elev. ~ ~ ft. g
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots tE GPD/ffEtf#2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
-1z 31 C, y 0
/10
3 S ~s ~
❑ Boring
El Boring # in.
❑ Pit Ground surface elev. ft. Depth to limiting factor Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots fEGPD/ffEff#2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
Boring # Boring Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate .
F-1 ❑
Horizon 'lepth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPD/ff
Gr. Sz. Sh. 'Eff#1 •Eff#2
in. Munsell Qu. Sz. Cont Color
• =
' Effluent #1 = BODS > 30 < 220 mglL and TSS >30:<-150 mg/_ Effluent #2 BODs < - 30 mgA_ 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.
SBD4330 (RAM)
Soil Test Plot Plan
Project Name Arnel Kunze Shaun B'
Address 1472 210th Ave
New Richmond Wi 54017 CSr4/122
#226900
Lot 1 Subdivision Date 5 SW 1/4 SE 1/4S 18 T 31 N/R17 W Township Stanton
F-I Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Bottom of siding
System Elevation 90.3/89.5' *HRpSame as Benchmark
Scale is 1" = 40'
unless otherwise
noted Property Line
5'
Well IL3'
50'
40' ST 15 , D W
3
Bedroom
House 20'
30'
zAal B.M.* 80' B-1 308% Slope
60'
B-3
15' B-2
20' 94' 92'
210th Ave 300'
44*!
CERTIFIED SURVEY MAP NO. 2028
Located in7 part of the Southeast Quarter of the Southeast Quarter and part o the
Southwest Quarter of the Southeast Quarter all in Section 18, Township 31 North,
Range 17 West, Town of Stanton, St. Croix County, Wisconsin. l
E. LINE OF $W V4 SE 1/4 SEC. is W. LINE OF SEV4 SEI/4 SE-18 {n^
UNPI.ATTED -LANDS Bearings are referenced 1
to the south line of the NORTH
491.16'- -
n~QQ°o0.0O•'11L o - N8a7'12"E Southeast Quarter of
So.
I'o
I Sec. 18-31-17, which is
N87°4 'S9" I assumed as WEST.
00
Owner: Viola Kunze
Rt. 3
f New Richmond, WI S4017
~ I
L O T m _ LEGEND
1
444,4e3 SO. FT. =(10.20AC.) a c1 • PUBLIC LAND CORNER
INCLUDING TOWN ROAD R/W CO z OF RECORD,VSTME. CRO1x
OI 1 9 1 COUNTY MONNT FOUND.
2 1
427,001 SO. Fr. 49.80 AC] Q-p 1 O s 1' BY24•' IRON PIPE WEIGHING
Q v EXCLUDING TOWN ROAD R/W W W~ 1.13 LBS. PER LINEAR FOOT, SET.
10 m ' t0 41 ""A c FENCE LINE.
POND SCALE. 1" = 200'
a l \lI ` 1 100' 200* 3 O'
CL ` 4f
Jr
°
0
o
Z o o,
SI/4 CORNER SE CORNER
I -~-7rEAST 329.78'-- M 1 I SEC.l8,T.31N.s R.ITVK
8EC.l9,T.3l N., R.ITW.7 NLY R/W LI ~
C.OVERNEAD POWER
/ TOWN ROAD (BOOTIE LAKE ROAD) wMi A . LINE
S. LINE OF SEC.
--WEST 529.71'- - 851.85'-~ 1
1244.99' - POINT OF J
WEST 2626.53--- BEGINNING
l1NPLATTEO LANDS_
SURVEYOR'S CERTIFICATE:
I Ronal F.-.Johnson, a Registered Wisconsin Land Surveyor, do hereby certify that I have
surveyed and mapped it parcel of land located in part of the Southeast Quarter of the
Southeast Quarter and part of the Southwest Quartet- of the Southeast Quarter all in
Section 18, Township 31 North, Range. 17 West, Town of Stanton, St. Croix County,
Wisconsin described as follows: Commencing at the southeast corner of said Section 18;
thence, on an assumed bearing along the south line of said Section, WEST a distance of
851.85 feet to the point of beginning of the parcel to be described; thence, continuing
along said section line, WE-ST a distance of 529.71 feet; thence North 00°13'01" West a
distance of 761.44 feet; thence North 87°40'59" Gast a distance of 40.00 feet; thence
North 00103100" West a distance of 80.00 feet; thence North 89°47112" East a distance of
491.16 feet; thence South 00°06116" East a distance of 844.88 feet to the point of
beginning. Containing 444,483 square feet (10.20 acres) more or less. Subject to a Town
Road across the south 33 feet of the above described parcel. Also being subject to all
easements, restrictions and covenants of record.
1 further certify that 1 have complied with the provisions of Chapter 236.34 of the
Wisconsin State Statutes and the subdivision regulations of the Town of Stanton and
St. Croix County in surveying and mapping this parcel. /
.J6hn4t~n I2. 6
Ron Johnson Land Surveying 3
P. O. Box 194 2719880-'
Amery, WI 54001 ~tNl4lIIr; JAhf~~ /
s 4
'role. (715) 268- 2601
CRONALLD tr S GTE
¢ SEP 2 7 1948
< 40 SL CUM cxwtin
9
,r~118lN SC i`
This instrument was drafte,4b R.P.J. VOLUME 7 PAGE 2028
flESER"[D FOR RECORD.NL DST,.
t.~OCUMENT NO. STATE 13aR 017 wI.5C'rn NSIN FORNT 16-196,2 -
TRUSTEE'S DEED
` _ } Q
t ntrr
S
3 !`.~;lh
Arnell J Kunze... OCT
a+s Trustee of at 10:30 A. r1A r
- -
ola W- Kunze Family -TKgS
r,r a- valuable consideration conveyr, without warranty to A> e
Kunze-and Linda L.--Kunz-Q- hust)and and wife
survivorship marital property. -
~N a
t - RL <
i - . - - - -
i . - - _ - -
Grantee. i
- St..:..CX'01X... . ..Co"IntY,_.
thn fniL svssrF. dr scrSbed seal- estate in -
q~ State of Wiseunsin: -
t, Tax Parcel No:
Part of -SW-SEsk of Sec. 18-T3iN-R17W described as -follows: --Beginning at the
Southwest corner of LoMe-South ~ 1 of a Certified Survey Map recorded in Vol. 7, Page
2028, this being on line of said Sec. 18; thence along the South line
of said Sec. 18 on a bearing referenced to and showt-ion said Tot 1 West a
distance of 600.87 feet; thence North a distance of 33 feet to.an iron pipe;
thence-'continuing North a distance. of_ 383.26 feet to an iron pipe; thence North
89°42'42"East a distance of 521.46 feet to an iron pipe; thence continuing North
89°42-'42" East a distance of 77.83 feet to the West line of said Lot 1; ti_ence
along,the West line of said Lot 1, South 00'13'01" East a distance of 419.28 feet
~i to the point of beginning. ~
~i
The parcel shown on this document is being added to the parcel shown on the
document recorded in Vol. 827, page 274, Doc. No. 443075, described as a parcel E,
of land located in part of SE4SE'k and part of SWkSE14, Sec. 18-T31N-R17W descrribed,.
`i as follows Lot 1 of Certified Survey Map recorded in Vol. 7 of Certified Survey:
Maps page 2028 as Doc. No. 4417631)"to create one parcel, and this transaction ;r
is thereby exempt from Chapter 18, of.the St. Croix County Land Use Regulations.
pursuant to Section 18.05(A)(3). x~
i
tPltshar - 39._96-..
Dated this day, of
- (SEAL) : G~ ` c.. (SLAI„
~f ,
li . Arrtell..~....K411 .
rrret~c
}
it AUTHENTICATION ACKNOWLEDGMENT
;i
tt! STATE OF WISCONSIN
tf Signature(s)
y as. , /It .51 ..County. ,
etc/ •.°-.day of
1j authenticated this -day of........... .19--••-- Personally came before me this
JeK~2ii~Ulb~1 . 1996.:-- the above named
Ari--eLL.J-.--ISunze------•------------
;~titistietv.i
TITLE: MEMBER-STATE BAR OF WISC t~
s
(If not -
S tats.) authorized by § 706.06, Wis. utats.) J E. .w, Tnknown to be the person . who executed the
O4SON re;kint: instrument /a>n){d/ Cacknowledge the same.
THIS rNSTRIJMENT WAS DRAFTED BY
.....Attorney D~~~id: J._• Estreen. 9~~F•Wt~G~.e~ ~
304•-Locust- St EIudson SJI,- tvotar P hltc C { i .x.. .-County, Wig.
. •
blv I ri__ion is permnnent.llf riot state expiration
,
(Sit natures may be au£h•±nticated or acknfnvled ed• Both 41
are not necessary.) elute; X
•Nnm, „f urrsnav i,eninc ~n nnv ---A, sh...04 be t--f or I.H.4l t.•1- their
STATE BAR OF RrISCONSnv Stock No. 13016
H.C.MdloiCanRxrY~, - FORM No. 38 - 598=
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