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010-1027-20-100
Parcel #: 010-1027-20-100 02/21/2006 10:25 AM PAGE 1 OF 1 Alt. Parcel #: 12.30.16.1686-10 010 -TOWN OF EMERALD Current X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -PETERSEN, WILLIAM G & ERICKA M WILLIAM G & ERICKA M PETERSEN 2687 170TH AVE EMERALD WI 54013 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description ' 2687 170TH AVE SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 3.000 Plat: 3975-CSM 14/3975 SEC 12 T30N R16W PT NE NE BEING CSM Block/Condo Bldg: LOT 2 14/3975 LOT 2 3.000AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-30N-16W NE NE Notes: Parcel History: Date Doc # VoliPage Type 11 /21 /2000 634125 1561 /464 W D 07/23/1997 723/547 04/01/1988 435766 806/422 LC ~nn~ ci ~nnnneQV Bill #: Fair Market Value: Assessed with: -- - - - - ------- -- - - 80103 206,700 Valuations: Last Changed: 10/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 22,500 167,500 190,000 NO Totals for 2005: Gen eral Property 3.000 22,500 167,500 190,000 Woodland 0.000 0 0 Totals for 2004: Gen eral Property 3.000 22,500 167,500 190,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 546 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSM ENT 30.00 Special Assessments Special Charges Delinquent Charges Total 30.00 0.00 0.00 Parcel #: 010-1027-20-000 0 Alt. Parcel #: 12.30.16.1686 010 -TOWN OF EMERALD Current '_Xj ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -PETERSEN, DENNIS K & JOYCE B DENNIS K & JOYCE B PETERSEN 2612 170TH AVE EMERALD W{ 54013 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 24.700 Plat: N/A-NOT AVAILABLE SEC 12 T30N R16W PART OF N 1/2 NE 1/4 Block/Condo Bldg: SEC 12 COM NW COR OF NE 1/4 SEC 12 N 89 DEG E 1758.84' TO POB S 2 DEG E TO S Tract(s): (Sec-Twn-Rng 401/4 160 1/4) LINE N1/2 NE 1/4 E TO E LINE N ALG E 12-30N-16W NE NE LINE TO NE COR W TO POB EXC S 20 RODS OF E 16 RODS NKA CSM 14(3975 Notes: Parcel History: Date Doc # VoIlPage Type 07/23/1997 723/547 04/01/1988 435766 806/422 LC ~nn~ c~ innnneQV Bill #: Fair Market Value: Assessed with: Valuations: Description Class Acres Land Improve 02/21!2006 10:25 AM PAGE 1 OF 1 Last Changed: 11/03/2000 Total State Reason Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 wsconsin Department of Commerce PRIVATE SEWAGE SYSTEM • ~Sgt`ety a~ Buildings Division INSPECTION REPORT G~N~RRAL INFORMATION (ATTACH TO PERMIT) Personal infom~ation you provice maybe used for secondary purposes [Privacy Law, s.15.04 (1 j(mj]. 0.~ `~0 ~' / .k, \~. 'Permit Holdei s Name: ^ City ^ Village ^ Towpp of: Peterson, William Emerald Township ST BM Elev. ~ " Insp. BM Elev.: BM Description: ,~ - ~-- "- a a. ~ ao . iJ t ~ gw~ ~ cs~ U TYPE MANUFACTURER CAPACITY Septic t~ } Z S'Of ~ '>7 Dosing ~1 t` Aeration Holding TANK INFORMATION TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Airlntake ROAD Septic ~~ ! ~>~ 35 ~ NA Dosing ! r tt ~ ~ s NA Aeration NA Holding PUMP /SIPHON INFORMATION Manufacturer ~,,p~-~ Demand Model Number ~~ ~ ~b ~ GPM TDH Lift ~~,.'k7 Lri n 2 ~ Systems ` F TDH ZoS3r Ft Forcemain Length~~ ~4t Dia. pist.ToWell ELEVATION DATA County: St. Croix Sanitary Permit No.: 384107 State Plan ID No.: (~~ ~c8 P~~sQd) Parcel Tax No.: 010-1027-20-100 STATION BS HI FS ~LE>V. Benchmark ,ZO p~,Z~ p~_~ Alt. BM s ~ 38 $".$Z r Bldg. Sewer °1.3 ,~ q(. $S" r St/ Ht Inlet ~ ~. jZ ~(,~ f St! Ht Outlet of tnlet Dt Bottom ~ $ ; ~ ~"'.~ r Header/Man. ~~ 9g_~ Dist. Pipe /'~~ l.~S ~, ~ Bot. System Z ' 2O X1'9-a o / Final Grade !`~. St cover dye vw~a,- ~~. 3 .~. ;. ao D Width ~ length No. Of Trenches PIT No.Of Pits Inside Dia. uid Depth EN I N ~ ~ DIMEN I N SYSTEM TO P / L BLDG WELL LAKE /STREAM LEAC nu acturer: SETBACK CH!>,AA m er: N INFORMATION Type O r t r o e u System: ~ ~' Itr'b OR UNIT SOIL ABSORPTION SYSTEM ---I DISTRIBUTION SYSTEM ~ ~~° So. P/L,} d w.~1c ~-- Header /Manifold z /! Distributi Pipe(sj~ 2 It o ~ ~ x Hole Size 4 ~~ x Hole Spacing Vent T~ take Length r O Dia. Length Dia. Spacing 2 Z,,, Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes No ^ Yes ^ No SOIL COVER x Press~e Systems Only xx Mound Or At-Grade Systems Only COMMENTS: (Include code discrepancies, persons present, etc.) L~~~I~'-D+LI ~ ~~ SBD-6710 (H.3/'97j ~~ ~ ~ W f Plan revision required? ^ Yes ~ No Use other side for additional information. ~ 0~' ~ Inspection #l: ~a / I,f)/m/ Inspection #2: ~--f--f-°°- Location: 2687 170th Avenue, Emerald, I 54012 (NE 1/41VE 1/4 12 T30N R16W) - 123016168B10 -Lot 2 1.) Alt BM Description = ~e~+1~" ~ti ~rQ. ~SE ~ ~ ~ ~ ,,~ Cu-.S~U-~ 2.) Bldg sewer length = ' 3s D ~ ~~.e,r~-to~•-~~e- • ~^- ~'r~-~b`"^~) -amount of cover = 3.) con~otu= ;,~., ~~-3.20 .~' {~ = to 1.20 / ,M.Q w,.w~- .l(~,Q. ~ [2-- l$`" Ss: t cow ~ oq P'`'' P"'""'"""' s(~.~._ k~.~d! . Date Inspector's Signature Cert. No. ~ z~~~ i ~~ ,~~,o Sanitary Permit Application Safety & Buildings Division ~'"., ~ In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. ~ ~ `~ See reverse side for instructions for completing this application PO Box 7302 sconsin Department of Commerce Personal information you provide may be used for second u oses ~ p ~ [Privacy Law, s. 15.04(1)(m)] Madison, WI 53707-7302 Submit Com feted form to Coup if not ( p ~' state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number ^ Check if revision to previous application State Plan I. D. Number 3 r ~ 7n I. Application Information -Please Print all Information Location: Property Ownefr~N~ame / y'V ~ ` ~ ~ ,Pr/operty Location /-~ /" ~1/4~~/4, S~ L T ,~T, R/E~or) Property Owner's Mailing Address Lot Number Block Number ~- ~ ~ ~~ Z City, State Zip Code Phone Number Subdivision Name or CSM Number II Type of Building: (check one) ^ City 1 or 2 Family Dwelling - No. of Bedrooms : ^ Village ^ Public/Commercial (describe use):_ Town of ^ State-Owned --"-- ~I ~ GG Neazest Road~,~ ti ~ 2 (rte (.t/~' er Pazcel Tax Numbe s) III. Type of Perm eck only o line A. Check bo if pplicable) Z . 3 0 • L - l~ - v A) 1. 2. etV__3. ^ Re lac 4. 5. 6. ^ Addition to System System Tank Only Existing System $) Permit Number Date ssued A Sanitary Permit was previously issued 'J y ) L dU N. Type of POWT System: (Check all that apply) ^ Non-pressurized In-ground --~Meund ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ~/^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V. DispersaUTreatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade /~ Required Proposed Rate (/Gals./day/sq. ft.) (Min./inch) Elevation VII. Tank Capacity in Total # of ~ Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks ~' - ' ^ ^ ^ ^ ~.s :s .cLZ~ ~~~ x- 7.~ ^ ^ ^ ^ ^ VIII. Responsibility Statement I, the undersigned, assume responsibility for install tion of the POWTS shown on the attached plans. Plumber's Name (print) Plumber' i (no stamps): MP/MP1tS No. Business Phone Number Plumber's Address (Street, City, State, Zip e) ~~~~ ~~~ ~ ~ ~l l IX. County/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Is g Agent Signature (No stamps) (,`Approved ^ Owner Given Initial Adverse Surcharge Fee) Determination --"- l(/ zpo I X. Conditions of Approval /Reasons for Disapproval: 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. This revision/transfer was submitted to reflect a change in plumber. 3. The original permit included the wrong soil test (located on lot 3 of the recorded CSM) and therefore the wrong state plans. New, correct, state plans have been approved. SBD-6398 (R 07/00) 03f,.24f1995 02:19 715-634-5150 HAY SAFETY AND BLDGS PAGE 01 99fery and buildings r - 10541 N RANCH ROAD HAYWARD Wl 54843 r w TDD #: (608) 264-8777 ,S~O~~~~ vaww.commero®-state.wi.uslsb www.wisconsin.gov Department of Commerce • Sean McCallum, Governor • ~ Phillp Edw. elbert, Acting Secretary October O8, ?001 OUST IA No.~26900 ~ A7-I11I: POWTS Inspecror ,; SHAUN R BIRD BONING OFFICE BIRD PLUMBING, INC :: ~ ST CROIX COUNTX SPIA 1008 192 ND AVE ° • 1101 CARI~CI~AEL,RD NEw RICHMOND WI 54017 HUDSON wI 54016 ~:; CONDITIONAL APPROVAL ~ ' PLAN APPROVAL EXPIRES: 10/08/2003 Identification Numbers Tratrsaction ID No. 676918 SITE. Site ID No. 625192 WILLIAM PI;T'ERSON Please refer to both identification numbers, 170T1~ AvE ~ f;" : above, in all cotres ndence with the a enc . TOWN OF EMERALD ~~~~ ST CTtOIX COUNTY ~~' NE1/4, NE1/4, S12, T30N, R16W , POR: NEW MOUND, 600 GPD ~ "~ OBJECT TYPE: POwT SYSTEM REGULA'S'ED::QBJECT ID NO.: 813272 The submittal described above has been reviewed for~coii~ot~naricCe with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITiOlY.°~LY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible foil?'cotnQliance with all code t~equire~an~ents. 'T'he following conditions shall be met during eoristtuctionr::or•'ins>;allation and prior to occupancy or use: General Approval Conditions: ~: • This system. is to be constructed and located iA;aCcordance filth the enclosed approved plans and with [be "Mound Component Manual for Septic Tank Lfflizeiit';foi P~yate Onsite Wastewater Systems" SBD-10691-P ( N-O1/O1) anti the "Pressure Distribution ComponeritiMamual:for Private Onsite Wastewater Treatment Systems" SBD-1p706-P (N.01/O1). ~.: :5:•: • In the event this soil absorption system'or an~'of its.toiripopent parts malfunctions so as to create a health hazard, the property owner must follow the`contingeACyplai:as described in the approved plans. In addition, the owner must insure that the operation, maintenanco'and'.monitot'ung duties as described in section VIII of the mound component manual are complied with. A°copy'o~this information must be given to the owner upon completion of the project. ' ' + A Sanitary, Pettnit must be obtained from the eosrntyro~iherC~:this project is located in accordance with the requirements of Sec. 145.135 and 145.19, 'GVis: Stats'~; • • Inspection of the private sewage system installatioriis'#ioquicd. Aira~ngcments for inspection shall be made with ,. ~., . the designated county ofFicial in accordance with•:th~:~nrovistoits of Sec. 145.20(2)(d), Wis. Stars. .,• • The maintenance plan for this system must be-gitien: ta-tlie awiner of the POWTS: Site Specific Coadiaioast , `~,;''•~ ~ , • The orientation of the ttiiound system must be such ehfic;tlte.'•1,'ongest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. `` `~° ' - . + Limit activities in the area 15' beyond the down`s1o~;;odgcDf the mound per Mound Component Manual. t: • ~~: ' :: ~~,; i,riH: .03/,2411995 02:19 715-634-5150 HAY SAFETY AND BLDGS SHA[JN R BIItD • Surface water drainage shall be diverted away from Materials shall conform to the requiremeiR's of COIF • The scale of the plot plan is 1" = 40' on the CST's • Maintain well and waterline set backs•per COMM E 'area. Nagt 2 e, p~utxtbing plot plan. 8)(~j', Holes must be drilled with sharp bit and all burrs and #oreignaaatter•removed before installation- .. , . tasio- a~4 ,a".. A copy of the approved puns, specifications and this:iettetiishall.:~e• on-site during construction and open to inspection by authorized representatives of the Departureni~;whicl,.iinay include local inspectors. All permits required by the scale or the local municipality shall be obtained prior to commencement of construction/installation/operation. in o tinting this approval the Division of Safety 6t •B,tiildiriigs~rese~es~thc right w require changes or additions should conditions arise making them necessary for code, cortiplia~e:~Asper state stars 101.12(2), nothing in this review shall relieve the designer of the responsibility for designir;a safe:building, structure, or component. IttquiriCS concerning this correspondence maybe made.ta'"ipde•at the telephone number listed below, or at the address on this letterhead. s `.' FEE REQUIRED $ 175.00 Sincerely, ~" • ~I/ RECEIVED $ 175.00 / BALANCE DUE $ 0.00 r% A ICIA L S ' ORF • ~" • POWTS PLAN REVIEWER , GRA'Z'ED SERVIC~~t;::• : A:° . WiSNJF.~RT'~ode; 7'633 (7 LS) 634-7810, FAX: (715) 634-5150 , M-F 7:45 AM =,;~:30~P1~ pSHANDORFCiPCOMMERC>;.STATE.WI.US • ~ • F.,:a ^:i v,~.'~ , ' ~:_$• cc: WII.LIAM PETERSON r .. ?: ~ . ~:k;:.~: . ,..: • . ~::1: . ~' ~~;: ;, ..~. .. _~::: . - ..i . '`;;;;~, ~. .' a,~, . .;h,; ~{, ', t~ %i, ~ y;' ~ . . °~~ r~. ~~Y~. 02 ,~ .~;: ~ 1 ~~ ~ l 1 / ••.,,i.' ,~,, .~ ~ Department of CommerF-e-~ ~~;'E' ~ ~? ~~~~ y ,' ~llG;~~ ~~" , October 08, 2001 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/08/2003 SITE: WILLIAM PETERSON 170TH AVE TOWN OF EMERALD ST CROIX COUNTY NE1/4, NE1/4, 512, T30N, R16W FOR: NEW MOUND, 600 GPD OBJECT TYPE: POWT SYSTEM Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Acting Secretary ATTN: POWTS Inspector ZONING OFFICE HUDSON WI 54016 Identific n ers Transaction ID No. 67691 Site ID No. 625192 Please refer to both identification numbers, above, in all cones ondence with the a enc . REGULATED OBJECT ID NO.: 813272 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 Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10706-P (N.O1/O1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • 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. • 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. Stats. • The maintenance plan for this system must be given to the owner of the POWTS: Site Specific Conditions: • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. ~ 'r` ~ SHAUN R BIRD Page 2 1018/01 • Surface water drainage shall be diverted away from the system area. • Materials shall conform to the requirements of COMM 84. • The scale of the plot plan is 1" = 40' on the CST's and the plumbing plot plan. • Maintain well and waterline set backs per COMM 83.43(8)(1). • Holes must be drilled with sharp bit and all burrs and foreign matter removed before installation. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/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. f Sincerely, ~..- ..--- .m ._.. ~-_--~ - A ICIA L SI~ANI~ORF POWTS PLAN REVIEWER , I GRATED SERVICES (715) 634-7810, FAX: (715) 634-5150 , M-F 7:45 AM - 4:30 PM PSHANDORF @ C OMMERCE. STATE. W I. US FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 cc: WILLIAM PETERSON I r -~ ~ _ ,~~0~~,~ ` Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.comm erce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Acting Secretary October 08, 2001 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/08/2003 SITE: WILLIAM PETERSON 170TH AVE TOWN OF EMERALD ST CROIX COUNTY NE1/4, NE1/4, S12, T30N, R16W FOR: NEW MOUND, 600 GPD OBJECT TYPE: POWT SYSTEM ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identific n ers Transaction ID N Site ID No. 625192 Please refer to both identification numbers, above, in all corres ondence with the a enc . REGULATED OBJECT ID NO.: 813272 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes e-,, and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in '~- ~ alp ~~ . chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. ,, r The following conditions shall be met during construction or installation and prior to occupancy or use: ~~ ~, r general Approval Conditions: t;, .:~=E::a ~~F :~' This system is to be constructed and located in accordance with the enclosed approved plans and with the . "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10691- ~ ~' """ ( N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment, ~ ~~`~ Systems" SBD-10706-P (N.O1/O1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of ~, the mound component manual are complied with. A copy of this information must be given to the owner upon comion of the project. • 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. • 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. Stats. • The maintenance plan for this system must be given to the owner of the POWTS. Site Specific Conditions: • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. ~ ~ ~ SHA[JN R BIItD Page 2 10/8/O1 • Surface water drainage shall be diverted away from the system area. • Materials shall conform to the requirements of COMM 84. • The scale of the plot plan is 1" = 40' on the CST's and the plumbing plot plan. • Maintain well and waterline set backs per COMM 83.43(8)(1). • Holes must be drilled with sharp bit and all buns and foreign matter removed before installation. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/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. ~ --~~j Sincerely, _ C` PATRICIA L SH ` O POWTS PLAN REVIEWER , T GRATED SERVICES (715) 634-7810, FAX: (715) 6 -5150 , M-F 7:45 AM - 4:30 PM PSHANDORF@COMMERCE.STATE. WLUS FEE REQUIl2ED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WSMART code: 7G33 cc: WILLIAM PETERSON ~ . r~ _` . ~. Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 9/11 /01 System type: Mound System Manuals Used: Mound Component Manual version 2.0 (01 /31) Pressure Distribution Manual version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-9. Maintance and Co gency plan 10-12 Soil test Signature 1 License number 900 9/13/01 .:, YM . _ .."~ ~~ + ;~ ~,,,~ . t ~~~ ., t ~ ;ti, ~~~ 9~ r PROJ~cT William Peterson NE i/4 NE 1/4S 12 /T 30 MPRS Shaun Bird 226900 _ DATES/13/01 BEDROOM 4 CONVENTIONAL IN-GRO PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND ~« SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 99.0 ss 2360 170th Ave Emerald Wi 54012 170th Ave Huffcutt Combo T W TOWN Emerald COUNTY ST. CROIX Pro 4 Bedroom House ,I 9 7' 99' 98 t B-1 Grading is to done to divert water away from system 9 6' 9% Slope B - 3 Area 15' Below System is to remain undisturbed B-G M Alt.l B.M. To is to be properly bedded and provided with lockdown covers with approved warning labels Well is to meet all setbacks found in Comm. 83 Property Line ' !. , • designer Na ~~~ ~ Ov Dati~ 9--~3 - ~~ 4" Observatian Pips PerForated Below Filter Fabric A81K C-33 Sond ~. _,,,,,~' To p s o i l _~.t t ~ ~ ~r. ~k ~ n wJo t 'X. Slope r Non-tiovea Filter Fabric •,Disfripufion Pipe i s.•sssr.~~srs. r G . ~•~ ,,,,_, ~~e s e d o r +f~'- z t Drain Rock Force M.o-n ~\`F iawt d From Rump tcYer ~D Cr_065 $lCtiOn O(A Ir4aund ~SYSlQrn Using ~ ~'-~- ~ A Bed For ~Tl1e Absorption Areo ~ ---- G / a ~ Ft. M ~ ~ 6 ,~„,,,,,~F t . ' 1 ~5~~ ZFt.• ' . J dam- '~ Ft. • K '3 ft. ., ,~ ~ . L p' , b Ft . ' N3~ Ft. L ---~-~----- 4~Observalion Ripe-~ ' e ~ -~ ww~ ..~~r w .rr~ ~. war .w. i ~~ w~ ~i ~. ~~ ~~ ~~~ A a ffo -I 3 0 Q 1 iO .r-w -~.. •..w~-~-~-~~ .~..~--.-w....... r-~w..~..~~t • ~. -r` ~~ Mr r... -. w...r~ w ~~ ~ .rr wr ~w MIU Disfribuliort Bed Qf %~~- 2 yg Pipt Drain Rock eN '~ C)Gi~tvOtiOt- Pipe Permanent Morker Pi pa or Rods -- K ~. Force Moin From Pump •~ i Pton Yisw Of Maund tliinp A Bed Far 'Ct~e ADsorplion Arlo v~oE._..,.o~..._._. C/cQ t Loeotod On iotton~, ~ squ•ny soeti•d rIK!!T 1/~pL.L piXK4 Ts CenM6~~ei ~tt r /R. ~ u/n ~ ' ~ Signed; t~istnburion Pipo l.oytwt LiCenSe Number; ~~' /11~1~ _~ oate• -l ~--la P ~ Ft. ~ _.._..... Ff. x 2 ~ Inches Y Inches / Ito 7 o Diameter ~l~ Inch Lateral ~" , ? » inch(es) Manifold " ?~ inches Force Main 2,~-- w Inches ~ of ?col@S/pipe Invert c"levdtion of Laterats q 5 Ft... P~rloro_tsd p~P~~~ +' , MahMiols o~ Cons~ruttion wf?, :'"' t ~~.. ;;, .~~a.w i.....fa M.F ~ e N11'DROMATiC ° ~~~~ ~ ~ EMI' ~ ddo 14803 Tii• ~ f ~.~.~b4? Fo~c: 419~tsi4087 S1~1.'1 WiYMp111,~ ~~ ~ wK n~+V11 ~S ~Q ~i-Vn,~~~ ~x ko "Pumps in the yeNow pages ai your Phase direchry ipr your hue! Dlstrfburor IteSnN W 02 6680 1 ? 9B SM ~1°e'"~--1 1, ~~~~~ incins, f NMMc Ior x5 tompoin~t ~ may ~r s 1/s tnd-. 4, ~tmaedo~ and mi~ia ~ 41n,grrr ____ i, MW. •11N. ~o Ay~u, ~~~~.aid.t ~~ + ~ f;, ~~,, ~y ~~-• a, 5r 8 My ~~C ~~i~ ~` ~ vdy~n'~{Ar ~ Syr O~IC~~" d ip 'r * ~ ~~lf7; ~ Up ~~~~~~) ~ A5.r •.if l~ ri ~ti S.A I a;V~N~rr,! ~ . sii~f ~ Cwlwit~ tiwlrSwl ~ ;. .. ~: 1 `.ter ~ ~ Maintenance and Contingency Plan for a Mound System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. 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. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below mound undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegetation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump with out float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If mound fails, determine cause of failure, test another area or remove pipe and sewer rock, retell soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715-246-4516 Pumper: Jerry Kolve 715-425-9188 St. Croix County Zoning 715-386-4680 Shaun Bird #226900 9/13/01 . r ~` ,~cww,~ PC)W7'S QWNER'S MANUAL & MANAC3EMENT PLAN a„~` ,~ FtL.E ~ T'ION OtMner ~ ^~ f 5 Pemat IIE D~l1 PARAIift~3 Ntrrtttter of 8edrnotrts O NA Nurntter d Conuitsrdat Units •~ ~ d tio~v javer>tEe) ~ . IIoM- tP~t?• (Estkrtsted x i .5) SM ApplltiMgOn Rate ~ .. tnil~ttNtE'flt~nt t MontMy everege• Fasts, t31t ~ Grease (FOC;) s3o rrtgll. ~ oxtrge<t oemand (f~ s2zo ttp/t. Total Suspended Solids (TSt3) SSSp Pretreated FJIlttArtt GuaEy o NA Mongliy average" sc~at„ia~t ox„~- Oarttand (f3ODa sso ~ Tots Suspended SoNds (TSS) S30 mglL Feat Cotform medic mean s10' ofu/100riti Macdmurm ENNrent Partkie Size K ktch diameter SYSTEM t3PEGIFiGATJON9 S•pfk Tank Capadty ~=S'"S" O NA 8epttc Tank Mancrfacpwr~r u O lYA Eti!~t Fier t+Aarttafacturer at .Z / ©fVA Model '' ~ (~ t~ump•Tank Cepee>ity ..f ~q f~ NA Pw»p Tanft Manufaoturor p NA . Pump Manctfsrxttter ~roa7 ' O NA' Purttp sC,~ef `f D v NA Pnetrsafrnent Urtk NA D SarldlCirRvel Fitter D Psat FNtar o Meoharticaf Aeratlart o wetland t~ often o on~e~: Manner Dfspetaat t,.e1i(s) !] In~rouuut (gravtly} a tn.ground (prssaurized) oat-~rd~ ~,Mou„d o a otl,ar: • vsh+a typrest tar domast~c tnon-ooe~rdM waatswata yea gptk t~+tk arlkNKtt ."~ VakN! ty~allor prrt~trad wastsWater. MAlNTEfdANCE SCHEDULE Service Event Setvfce Frequency inspect condition of tank(s) At feast once every O rttonths years) (Maximum 3 yra.) Pump out contents of tank{s) VVftert combined sludge and scum squats one-third (~) of tank volume trtsped ei~persat cell(s) At least once every 3 D mor>ths year(s) (Msximur» 3 yra,} cwt efnt,ertt f~ter At least once every D mortthsyd~oear{s) s' ,~ ~.~' lnspsd pump, pump controls ~ alarm At feast once every 3 [~ months s) O A Fhm1t and pressure test At feast once every O months year(sy O NA oti~; At least once every ^ months ^ year(s) NA o~ At feast once evert ^ months Q year(s) MAlNl"~UWCE tltiSTRUCTtC3NS Inspsofforts of tanks artd dispersal t~1is shalt be made by an irt~vfdttal carrying one of the following licenses or eertfAoafions: Maat~' Plumber. Masher Plumber Rssbrioted Sewer; POVVTS fnapedztr; POWTS Maintahter; Septage Setvfcarf8 Operator. Tank inspections must irtdude a visual Mtspeotlort of the tank(s) W ktentify any misshtg ar broker) ttatdwar+e, klentiy any aadts or leaks, measure life volume of combined sludge and scorn and to c~teeic for any back up or pondirtg of eMuertt ort the ground surface. The ditiper»at ttetl(s) sha11 be visuapy inspected fa check the eMuent levels in !tom oibservadon pipes and to duck for any ponding of efAtient on tote grarnd swfac~. The portdlrtg of efftueM on the grntrrtd aurlace Wray indicate a failing condidort and requires ttte immediate notiflc~riorr of the lots) regulatory atuthortly. when the contbtrxxi accxrmuiation of sttrdge and swrn in any tank equals one•third (X,) or more of the tank volume, the enika oontertts of ate ~ttk snail be removed by a Septsge Servldng Operator and disposed of in atxtxdsnce with ch. NR 1 i 3, Mflscartsitt Administrative Code. The servtdng cf effluent t'ifters, medwrtk~l or pressurtted PO1N'1'S t~tttlwr~tte, pretreat~rrtenE atmpottsnts~, end any other maintenance or monitoring at intervafa of 12 months or isle shag be perbrrned by a c~ifled POWTS Maintainer. A servkZe report shag be provided to the local regulatory aulftority w1thM 10 days of compleNan of arty service event. START UP /11Vp QPERATf4N Far new oonstrucxlon, prior to use of the P4vVTS check treatment ferrit(e) for the presence of paintlrtg pnxtuds or outer ci-emicsls that may impede rho treatment pr+aooss a~ndJor darnago the dispersal cell(s). ti high uonoarttrationa are detected have the contents of the tanks} removed by a septage servktng operator prior to use. s~ ... ' Page o! System start up shat) not occur when soil conditions ar+e frozen at the rnfiltrathre surface. "" Doting power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater wiN be discharged to the dispersal Deli(s) in one large dose. overloading the oeQ(s) and may result in 'the backup or surface discharge of eftlirenL To avo~ this situation have the contents of the pump tank removed by a Sepfage Servicing Operator prbr to restoring power to tl~e etfluerit pump or contact a Plumber or POWTS Maintainer to asst in manually operating tl1e pump controls to restore aortal levels witfsn the pump tank. Do not dtnre or park vettldes over tanks and dispersal ceps. Do riot drive or park over. or otherwise disturb or compact, the area wtthkt 15 feet down slope of any mound or at-grime soil absfirptbn tares. Redudiat or•etknirtaliat of the follo~wkiQ from the wastewater stream may improve the Perfot'mance and pr+oiorrg the Gfe of the POVVTt3: ~tttbiotics; baby vNP'as: dgar±ette butts; oondotrts; Dolton t;uirabs; degreasers; dents doss; tllapers: disinfec~au~s; f~ foundaftort diain (stamp pump) water; fruit and vegetable peelings; gatsoiine; grease; tterbic~s; meat ~: ~: Pa~~9 Pte: P~~ sautitary- rtapldns; mmports;'and wafter softener brine. At3ANDON~F.NT When the POVYi'S tails and/or ~ permanently taken out of service the foliowirtg steps shah 4e taken to Insure that the system is properly attd safely abandoned in compliance witl~t ch. Comm 83.33, Wiscoriain Administrative Code: • Ap p to tanks and pits shag be disconnected and the abandoned pipe openings sealed. • The conEents of ap tanks and pits shalt be removed and propery disposed of by a Septage Servidng Operator, • Alter pumping, sit tanks and pits shag be excavated and removed or their covers removed and the void space filled with soft, gravel or another inert solid material, CONTfNOENCY PLAN If the PC?WTS taps and cannot be repaired the following measures have been, or must be taken, to provid®a code compliant netptaoement system: ^ A suitable replacement ease 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 infrlrtged upon by required setbacks from existing ar?d proposed structure, bt lines and wraps. Failure to protect the replacement area wAl resuk in the need far a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the ruses in effect at that time. ^ A suitable replacement area is not avarable due to setback and/or soli limitations. Barring advances in POWTS technology a holding tank may be installed as a cast resort to replace the faileed POWTS. i~ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and alts evaluation must be performed to bcate a suitable replacement area. if no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. O and at-grade soil absorption systems may be reconstructed fn place folbwtng removal of the Womat at the infitdatlvve surface. Reconsbuctiorts of such systems must comply with the rules in effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TRFJITMENT TANKS MAY CONTAIN LEt'HAl. 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. ADDRIONAI. COMMENTS POWTS INSTALLER POWTS NIA1NTAlNER Name ~, Phone . „~= ~ ~- if s'l ,(, Name r~ j Phone ~// ,1'"`~ p~S- / SEPTAGE SERVICING OPERATOR PUMPER LOCAL. REGULATORY AUTHORITY Name , Phone 7 i ,r-. a, --- S'"/ Agency ~" •~ r Phone `~~ -- 3 6 r argue and 5andatlar pencbs. Rds document meets 't'his docaxttent was drafted bI'~he at:ffs d the Green Lake. M rte and Waushara Ccunry IAnirq the minimum requirements of ch. Comm 83.22(2)(bKt HdMd4 and 83.54(1). (2) 8 (3), Ylfuoonsin Admintsttatlvs Code. flee at this document does not guarantee the performance of the POWTS. GNSIN (2JDt) ~~ ~-i~-off c~tsiriUepartment of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT Page of In accordance with Comm 85. W1s. Adm. Cody Attach complete site plan on paper not lass than 8112 x 11 inches in size Plan must County s ~ ~ r~ ~.~ . i l b nc ude, ut not limited to; vertical and harfzattal reference point (BM), direction and percent slope scale or dimensions north arrow and l ti parcel I.D. , , , oca on and distance to nearest road. Please print a!! informaffon. Reviewed by Date Personal Information you provkle may be used for secondary purposes (Privacy Law, s. 15,04 {1) (m)). Property Owner / S ~ Property LogBon i ~ (` ~ ~ Govt. Lot ~~ 1/4 ~`t/4 S 12 T 3 N R ~j E ( ) W Property Owner's Maim dress/ ~ ~C~ Lot # block # Subd. Name or CSM# 3 -- ~ ~ Z 9 City fate Zip Code Phone Number i S~ ) Z ,~~ `~ - [j City [] Village own Nearest Road ' ( ~ 5) 26..E Y3l 1 ~ ~7 New ConstnaCtlon iJs .Residential / Number of bedrooms Code derived destgn flow rate GPD Replacement PubUc or commercial - ibe: °'Y /~ Parent material ._ y L~~~ ~~r~ ~,~ ~° _~ ~_ Flood Plain elevation if applicable ,~~~?~ ft. General comments ~ ~ , and recommandatlons: ~O~ir_ ~SG?k~'~p~ Gl,~v 9~ D / ~ - ~ R~rr~` ` 'C ~O .- aiEE $~f ~ ~' w Boring # ^ Boring ~%J ~ / d~ ,~~~lXyfyk ,` 1 ;~ Pit Ground surface elev. /~~ {? ft Depth to limitin factor ~ °~ . g ~, oil pU Uon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence 8oun oats ~ Qift= in. MunseU Qu. Sz. Cont. Color Gr. Sz. Sh. ~' - ~ *Eff#1 *Eff#2 ~ - ~~ ~3~Z s ~.~ ar~= s 9~ ~ ~ ,.- 6;.~ ~z.~-e._ s ~ L ~ , e,(~ , ~ ~ .s, Boring # ^ Boring ~ Pit Ground surface ele _~~~.~'Z ft. Depth to limiting factor _~ in. Soil Application Rate Horizon Depth Dominant Cvior Redox Description Texture Structure Consistence Boundary Roots GP DIftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#f *Eff#2 1 • ~r J , ~y C S //'1 1.. a ,s , - 6 -~ ~ ~6~ rn ~t/ ~, ~_ ~ C s . 6 S -- ~-n ~ ~ N~ ~ , 3 , s c~auvn~ fr t - gVIJ6 ~ JV = LGV Ii1~lL 8RU ~ ~~ ~sv ~ , au mg~~ - ernuent ii"a =GODS < 3o mglL and TSS < 30 mg/L CS~rne~l~e PtSt)r ^ /V'~~/. Si4gature ~~S~umbgY Add ~!!<< fi/~i L,1/// ~[JJJ Date Evaluation Conducted Tetepho[/nl`e[JlN)umber SDD-8330 (R07l00 ~ T ~ . Properly Owner Parcel ID # Page of © Burin # ^ Boring y>, g it Ground surface elev. "' ~ ~ft. Depth to limiting factor ~ ~ in. Soil Ap ligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz ln. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Elf#1 'Efffi'L I -- 3 s/ ~ in C .~ ,~..- .S-, .~ T s ~d ~ S ~ ' m ~ ~d V l nil i9 , S~.i ^ Boring # ^ Boring plt Ground surface elev. ft. Depth to limiting factor ln. Soil AppUcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # ^ Boring ^ Plt Gn~und surface elev. ft. Depth to limiting factor ln. Soil A Ilcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fN in. Munsell Qu. Sz. Cont. Color Gr. 5z. Sh. •Eff#1 `Eff#2 "Effluent #1 =BODY > 30 ~ 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 =BODY < 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.07100) ,: ____ .~ .Project NamE Address Soil Test Plot Plan William Peterson Shaun 2360 170th Ave Emerald Wi 54012 Lot 2 Subdivision ------- NE 1/4 NE 1/4S 12 T 30 N/R16 W Boring 0 Well PL Property Line BM or VRP Assume Elevation 100 ft. System Elevation 99.0 *HRPSame as Benchmark Alt. BM Top of 2" Pipe @ 98.8' rru~er~y ~ni~ ~M #226900 Date 9/13/01 Township Emerald County ST. CROIX Top of 2" Pipe ~ _ ti Wisconsin Department of Commerce • na,zer,,,, ~ Safaiv and Buikiinas JD ~ J l~'S~ 1 SOIL T Page 1 of 3 _._.__.. _. __ - in accordance with vvis. ' St. Croix Attach complete site plan on paper not leas than 8112 x 11 butnotlimitedb:werticalandhotizordalreferencepoi iricNide size. Plan must ),rectiog~~0 P _f• penidirig , and location north straw s i di i to , , on mens percent stops, state or ix R ~ ~~ Please. print all lnformaflon, ~ s~ N ~, Personal iMormetion you P-ovido may be used for secondary purposes (P ~ F~ . s. ~~fi • ` ./ ; . ` ~pe~YOwner 4"~~ i 'Property ~ ; ` %' ~~~' 1/4 NE 114 S 12 T 30 N R 16 ~ (or) W 'Lot;' Wm. & Erica Petersen . Block # Subd. Nerne or CSMf! Property Oumer's Mailing Address ~d~ Z 1 na csm pending 103 Teresa St. c;~y State Zip Code Phone Number ^ Village ~TOwn Nearest Road Roberts, WI;. 54023 (715) 749-1722 Emerald 170th. ave. New Constructbri Use:$] Residenttai ! Number of bedrooms 3 Code derived design flow rate 450 GPD ^ Replacement ^ Pudic or corrvrierniel - Oesaibe: ~ Paretdrnaterlal glacial drift . Flood Plain elevation ifappNcable na General cornrr~s and reoanrriendatloris: system el . = 95.70' system el. based on contour line of 94.70' Boring #F U ~~ 1 ~ Pit Ground surface elev. 95.40 ~ Depth to limiting factor 36 in. Shc RMe Horizon Depth Dominant Color Rector Description Texture Structure Consistence Boundary Roots GPO in. Mansell Qu. Sz Cord. Color Gr. Sz. Sh. *EtT#1 •Etf#2 1 0-10 10yr4/3 none ail 2msbk mfr cs 2f .5 .8 2 10-23 7.5yr4/4 none sil 2csbk mfr gw if .5 .8 3 23-36 7.5yr4/4 none sl 2msbk mfr ~w if .5 .9 4 36-55 7.5yr4/4 c2p 7.5yr5/8 sl 2msbk mfr na na .5 .9 ^ ~~ Q Boring tf Pit Found surface elev. y1~4U ft. Depth to limiting Ftarizon Depth Dominant Color Redox Description Texture Stivchire in. MunseN Qu. Sz Cont. Cdor Gr. Sz. Sh. factor 32 M, Consistence Bcwndary Roots Sod Rats OPD1tC •Etf#1 'Etf#2 1 0-11 10yr4/3 none ail 2msbk mfr cs 2f .5 .8 2 11-25 10yr4/4 none ail 2msbk mfr if .5 .8 3 25-32 7.5yr4/4 none sl 2msbk mfr gw if .5 .9 4 32-55 7.5yr4/4 c2p 7.5yr5/8 scl 2msbk mfr na na .4 .6 • EtliueM ft'1 = BOD > 30 < 220 mgll and TSS >30 _< 1 50 mgfL nerd #2 = BOD <_ 30 mglL and TSS _< 30 mgfL CST Name (Please Prfrd) Ga L. Steel Address 1554 200th. Ave., New Richmond, WI. Signature -54017 E clad 8-2-2000 _ CST Number 02298 Telephone Number 715-246-6200 ~ `, p~~yOwner Wm. Petersen ParcellD# pending _ Page 2 of 3 13odng # ^ Boring ® Pit Ground surface elev. _~ ft• Depth'to limiting factor 37 ~• Soil icatlrx~ Rate Horizon Depth Dominant Color Redox Description Texture SM~cture Consistence Bour)dary Roots. GPD/IF in. Munsell Qu. Sz. CoM: Color Gr. Sz Sh. 'Etf#1 +Eff#2 1 -12 10yr4/3 none sil 2msbk mfr cs if .5 .8 2 2-20 10yr4/4 none sil 2msbk mfr gw if .5 +8 3 0-37 7.5yr4/4 none sl 2msbk mfr yw if .5 .9 4 7-55 7.5yr44/ c2p 7.5yr5/8 scl 2msbk mfr na na .4 .6 ^ Pit Ground surface elev. ft. Depth bo IimiUng factor ~. Soil tcation Rate ~~9 # ~ ~~ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDRt: in. Munseq Qu. Sz. Coat Color Gr. Sz Sh. 'Eff#f +Eif#2 ~~ # ^ Boring ^ Pit Ground surface elev. ft. Depth to Nrniting factor ~. Soil icetion Rate I-torizon Depth Dominant Cotar Redox Description Texture Stnucture Consistence Boundary Roots +E~GP ~~ in. Murrseil Qu. Sz. Coat Color Gr. Sz Sh. Effluent #1 = BODa > 30 _< 220 mglL and TSS >30 < 150 mg1L + Effluent #2 = BOD3 <_ 30 mglL and TSS _< 30 rngtL 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 608-266-31ST or TTY 608-264-8777. sgD-1330 (REVD) w^ -- ` STEEL'S SOIL SERVICE Gary L. Steel yam, & Erica Petersen 1554 200th Ave. CSTM2298 NE4NE4 s12-T3oN-R16w New Richmond, WI 54017 MPRSW-3254 town of Emerald (715} 246-6200 lot -csm N 1"=40' BM.= top of 1" pvc pipe ~ el. 100.00' Alt. BM.= top of 1" pvc pipe C~ el. 101.15' / ~~ ~ ~~ s ~~ Gary L. Steel 8-2-2000 S'I' C'RC7iX t.'(~I::~'I ~ - ~ Siri'TiC; TAN'S; htAi~''I"~.~'r~NC~'~; AC1F~}:.Eht~I~I' __ ANll ~av~r;~>/l~xrP cE~~rY~tcATra~ rows. Owner/13uyer Maitin Address ~ 3 t ~ `` ,,~-y,-r~ ~4 Prapert~~ Addsass a Co g (VerificatiarZ rcq~:red from Flattnittg Aepattttuni far next r-- City/Statc ~~~ n lp f P~rcal id~tifio~tion Ntnaber _ i t -- f©.~`r.~ ~o Property Loctatian ~~ %<, ~~r ~s, Sec. , f,,,~,, T~,N.R.,L~W, Town of , ~ic~~. S11bdiVlSlOIi ~ ~ Let # '~ Certified Sarvey M~tp # ~~.~ 3~ ~,~~.~.., Vaitune ,.:,.~,, Fage # ~ ~ S~ w><~cy Y3ecd # ~' .~' % l z ~ . vai~s~.~, ~~~ # . Spot hoase O yes ~ na Lot lines identifiable ~ yes !~ no imptapac use atut mlulntenanceaf year septic syeum could result in its prasmaturrfailura to beadle wastes. proper maitttenaucc consists of pumping ant the ~t{c teak every three years of wonor, i# needed by a lica~ed pumper. what you pat into the sysrea~ cast aBeet the ttmctian~# the septic tonic ,rs s treatt:iant quo is tl~ sate di~osai s~rsta~g-. *~ c ~r74,cJiC t G -~=~ m ct.Y ~ B c~ i rv Act : ~ t~ G ~4nJF,-~ .4-~- L e=~PS r c~ ~ c € Y ~erty awrur' agrees to w'biuit bo 3t, Oroix Zoctiag Departt~at t certiticati+m gym, tigsted b3+ the aw~rr and try masterplumber, jousrtaymeaplttmber, reRtrictodplumber a a Yieenscdptnuper vorifyiag tbat(1) t!'se on-Rita wastewaterdtsposalaystem is in preps' operating t~oadition artdr'or (2) slier iaapoctioa sad pumping (if ~sauyy, the aoptia tank is less than 1 ~3 thII of siudgc. Ilwe, the undersigned Save reed the above retluiretriaats sad agree to msisttaln the private sewage $isposai system with the standards +eot forth, herein, u set by tbb Daputmaat of Cc»tantotce tool the Depetmtent of histttral iiesaurccs, State of Wiacanaia. 'metiuc: that }root septic system baR bct,a maintained ttws+t be eo:ttpktad sad tt:turaed m the fit. GYaiyc Cotutty Zoning Of&ce wititia 3~ - ~ throe data '~~ _~'~ MATURE OY~ pLICANT nATi OVVN~R CERTIF~,~ICATI,~ I (wq) aertilS+ that sit RtstemeuCS au this fozzrt axe ~e to the best of my (sett) Sntawledgc. 1(we.1 am (area the ovvncr(s} of above, a of a warranty deed recorded in Reguter of Leda t3fliee. A QF APP>:~ICANI` DATE w.wwww /may iaformtttion that is tsnia-cepresdntod may result in the sanitary permit bafaa revoked b7+ rlte Znrasn~ Department, "'°«"`• *. inelnde with thu appiicatian: a stamped watts:tty died fi'ozzt the Register of DeedR offive a copy of the certified tnttvey nap if tRferenco is made in the warranty dead ' ~ M • Document Number vei.15G11=AC~ 4G4 WARRANTY DEED This Deed, made between DENNIS K PETERSEN and JOYCE B PETERSEN husband and wife ,Grantor, AND WILLIAM G PETERSEN and ER[CKA M PETERSEN husband and wife, as survivorship marital property ,Grantee, Witnesseth, That the said Grantor, for a valuable consideration of one dollar and other valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin; 654125 KATHI. EEN H. WRLSH kEGISTEk OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 11-?1-2000 2:30 PM WAkRANTY PEED EY.EMDT tl B CERT COPY FEE: COPY FEE: TRANSFER FEE: RECAkOIHG FEE: 10.00 RAGES: 1 This homestead property. Name and Return Address Together with all and singular the hereditaments and a ROBERT F WALL ppurtenances 522 SECOND STREET thereunto belonging; And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of all encumbrances except HUDSON WI 54016 easements, covenants, and restrictions of record, and will warrant and defend the same. PART OF THE NE 1/4 OF NE 1/4 OF SECTION 12, TOWNSHIP 30 NORTH, RANGE l6 WEST, S X COUNTY, WISCONSIN (parcel Identification Number) DESCRIBED AS FOLLOW :LOT 2 F CERTIFIED SURVEY 010-1027-20 MAP FILED OCTOBER 25, 2000 IN VOLUME 14, PAGE 3975, ROC. NO. 632396. Dat d this/Z~Ot y f ~/iM~/ , 20Cb. NNIS K t N AUTHENTICATION Signature(s) authenticated this ,~ day of ` signature type or print name TITLE: MEMBER S7ATE BAR OF WISCONSIN {If not, authorized by §706.06, Wis. Stets.) ' YCE B PETERSEN ACKNOWLEDGMENT STATE OF WISCONSIN COUNTY OF ST. CROIX Personally came before me thisa~~f dayy of /t~v~ , 206`~'j the above named DENNIS K PETERSEN and JOYCE B PETERSEN to me known to be the person(s) who a cuted the foregoing instrum an alQtnowledg~ tl~e ti ~ e' ~ A ~ signature type or print name Notary Public S My commission U D L~~euaty, ~(~fe~0i,~sta>te expiration date: THIS INSTRUMENT WAS DRAFTED BY ~~fia~.~~ Robert F. Wall 'Names of persons si ~~gy,L!dQ`durty should be typed or printed below their signs ur s: ~ - ' ~J ~ \Y' V . ~~ 632396 F1`E~ . OCj 2 5 2000 tt. KAdoee~ CER T I F'I ED SURVEY M,4 P Located in the Northeast quarter of the Northeast quarter of Section 12, Town- ship 30 North, Range 16 West, Town of Emerald, St. Croix County, Wisconsin. Owners: Dennis & Joyce Petersen 2658 170th Avenue I 1 Emerald, Wi. 54012 ~ I NORTH L1NE OF THE NE//4 I I - UNPLATTEO LANDS see=oa'oo'E - - - - -- - -. -8.00,~-~ 893.94' ~- - -I L- - - /~ae.ea ' AVENUE ~ - .oz_ 5SS.1~ ~ 398.93' 0'K 622.50 N1/4 Corner ~~ Ne~•os'oo"w N 87'oe'o - 1 ~ -- Sec. 12-30-16. '~+: ' ae/ss' ..; (survey nail _ •.~~..-........ ................. I I NE Corner found) . ~ ti ,o` ~~J N~ ~~ ~ a ~j I Oi ~i ~ i ~ . ~' n v1 M I ~ O ~ ~ ~i d o. . 2 ~ ~+ ~ QI ~ N Ji Z i O, W ~t ~i Q, 2~ ~t ............_ ............._..... 1 Sec. 12-30-16. ~ (survey nail rs~,x~~r m ~~ I + k ' ~~~ I I (ti N ' f nl ~ 338.93' 41 @ 2~ i LOT AREAS 2: WIN I i ~ ¢~ ~ m Lot 2 - 130,680 Sq.ft. (3.00 acres) ~. NI m NI w including right-of--way. Y °;I 119499 Sq.R. (2.74 acres) Q: , of excluding right-of--way. m h ? °I Z o al Lot 3 - 969,909 Sq.ft. (22.266 acres) = I including right-of--way. ~ $~ ~ ~ 920,094 Sq.ft. (21.122 acres) ° W excluding right-of--way. I ? I i ~ - _ _ SO VTH L/N£ OF TH£ NE-N N 87'08'41'W 646. gpPR4'Nl~ArrEO_ ST. CROtX fXfIJMY talarsdrlp Zoning and Parks Commltee OCT 2 5 200 If not recorded vvitnin 30 days of approval date apprdvalanallbe nuM and void SCALE INFEST t"- 200' f00' O 200 I~ 400 This instrument drafted by^~[ I ~, ~ i i ~ W I I ~~ ~I ~~ Z I to I ~I 231.23' ro I 264.26' 1 i ' N87°08'41"W6 6 N ~ cu I I _ I I t~7 ~ ~ ~ ~ i 01 N I ~ ~ .s c ~i R~ Q ~ Ie I~ I ~ ; ~ ~ t I i N ~~ >' I LANDS - - E 1 /4 Corner Sec. 12-30-16. Legend (survey nail found. ) • 1"X24" Iron pipe weighing 1.68 pounds per lin. foot set. Bearings referenced to the North line of the Northeast quarter of Sec. 12, assumed to be 88?°08'00"E . Vo1.14 Page 3975 4002684 ~ 'W K. ~- Description A parcel of land located in the Northeast quarter of the Northeast quarter of Section 12, Township 30 North, Range 16 West, Town of Emerald, St. Croix County, Wisconsin, described as follows: BEGINNI1dG at the Northeast corner of Section 12; thence South 00 degrees 19 minutes 25 seconds West 987.27 feet; thence North 87 degrees 08 minutes 41 seconds West 264.26 feet; thence South 00 degrees 19 minutes 25 seconds West 330.32 feet; thence North 87 degrees 08 minutes 41 seconds West 646.42 feet; thence North 0 t degree 03 minutes OS seconds East 1317. l4 feet; thence South 87 degrees OS minutes 00 seconds East 893.94 feet to the Point of Beginning, containing 1,100,589 square feet (25.266 acres) more or less, and being subject to all easements, restrictions and covenants of record. I, Harvey G. Johnson, registered Wisconsin Land Surveyor, hereby certify that under direc- tion ofDennis Petersen, owner, and the St. Croix County Zoning Office, I have surveyed and mapped the above described property; that such map is a true and correct representation of the exterior boundaries of the land surveyed, and that I have fully complied with the provisions of Section 236.34 of the Wisconsin Statutes, the St. Croix County Subdivision Ordinances, and the Town of Emerald subdivision ordinances to the best of my professional knowledge, under- standing and belief. _~~~„~„__ ~,~,••c~~scotis''. ~ ' ~8~.-9/4 ~-~ ~ HgRy 2~ Harvey G. on S-1899 I h i J S JpHNS~ ~• ~ L S-7 k nc. nson urvey ng, o 8g8 N 216 Meadow Drive North Wisconsin 54016-1128 Hudson ~ W~3 N 'S ~ ~ ~ , ~ ~ .r,, ~ ` Kt:JISI't.l~s ~oIZO/oa N ••,,,;o suRVE~~,•• Each parcel shown on this map is subject to state, county and township laws, rules and regula- tions (i.e. wetland, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel contact the St. Croix County Zoning Office and appropriate town board for advice. N 7p 7C ~~~~ ~ ~ l~ ~~~W ~~~~.~e ti ~ ~o-im - °~~N ~~X o ~ ryry :~ ` ~ ~ • mam g $ ~ ~ ¢o~m M(n= ~1 Vo1.74 PAge 3975 ~~ ~~ ~~'0 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code See reverse side for instructions for completing this application 201 W. W ington Ave. PO Box 7302 ~SCOns~n Madis WI 53707-7302 Depa ent of Commerce Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1)(m)] , (Submit complete rm to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in ze. County State Sani Permit Number ^ Check if revision to previous application v - State Plan I. D. ber ( zS nC ~ $ . - o ~ I. Application Infor ation -Please riot all Information ocatio Property Owner Name Prope cation ` ~..>~ ~ ~7~./ f~'- ~~?.11 ~ /4 ` 1/4, SI~ EJ' ,N, R (or) W Property Owner's Mailing Address Number Block Number City, State Code Phone Number Subdivision Name S umber ~ / II. Type of Building: (check one) ~ s• ~ ~ ^ City, ^ Village ^ 1 or 2 Family Dwelling - No. of Bedroo ~~ ~'I'own of ^ Public/Commercial (describe use):_ ^ State-Owned ' ,~j ~~, s~4L. ~. - l~ Neazest Road ~~ t r ~ ~ p~ ,,,~q ~ ~. O ~ ~S~ Parcel Tax Number(s) ,~ ~ ~ _a I .Type of Permit: (Check only one box on line A. h k box on line if applicable) p (o ~ ~ 8 ~ j d °- A) 1. New 2. ^ Replacement 3. ^ Re cement of 5. 6. ^ Addition to System System Tank O Existing System $) Pe 't Num Date Issued ^ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ^ Non-pressurized In-ground ~ Mound ^ Sand Fitter ^ Constructed Wetland ^ Pressurized In-ground ^ Holdi Tank ^ Single Pass ^ Drip Line At-grade ~ ^ Aero c Tr t Unit ~ ^ Recirculating ^ Other: a7f'" 03 •`~S " ~ ^~ " 3 . Dispersal/Treatment Area Information: ~ 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal ASd 4. Soil Applicatio 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed R ate (Gals./day/sq. (Min./inch) Elevation ,,~,qy~ / VII. Tank Capacity in ~ otal # of anufacturer ~ Prefab Site Steel Fiber- Plastic Information Gallons ~riallons Tanks Con- Con- glass New Existin~; Crete structed Tanks Tan ~q~ _ ^ ^ ^ ^ ~ (/u ~v, r ~ /~:~ art ~''J ~ ... Ij~~ ~-~s ~~ ~'-- ^ ^ ^ ^ VIII. Responsibility State nt I, the undersigned, assume esponsibility for installation of the POWTS sho on the attached plans. Plumber's Name (print) Plumber's Signature (no stamps): M /MFRS No. Business Phone Number Y Plum er's Address (Stree ity State, Zip e) ~ . ~~.,.~ ~~~ 1 ~ /~ ~ IX. County/De artment Use Only :, ~ ' ; e,~ ,r ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Age (No stamps) a Approve ^ Owner Given Initial Adverse hazge Fee) . ~' ~~~\ - ~ Determination ~, ~ , '~j' ~p~ / X. Co rtions of Approva~`/R-eason's/for Disap rov ^.r y, '°- r.`-;i Pd R 1 `R. ~ ~ \G~ G .j~~S lS t~ a- `T~e ~~cN2.r-~$ GOFF '" Ou ~Q~ ~ rrS ~» "wv.-~ai~S 4~ ~ 1 . , 1~ ~ 4 X1,5 0+.0.~ E~t'~'~~l °rY ~ ~ ~(~1 c!o '~` dS ' . , . „ ---'---~ i ~,-.' ~I ~c A-t.l 5e~t"ba-c.1~S -~, S~S~,~ >~ cc S ~ alr:..~~a.~x .;~w~,c7lunq, ,,,~.,o~ ~-- a~,Q.t~ caa4K,c_ c~di~. SBD-6398 (R. 07/00) r