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HomeMy WebLinkAbout030-1021-10-001 � I I � � I o � N L ti M O V a. N I � c I L I 3 I N U U i 'C 7 C Z a> 2 LL O m.0 v oL I Q � U i I M N a Z y !' C c Z C N _ C 05 C4 w m (D (o H z 3 07 � Gvi 2 d y c d N V � c�CY 0) o •ti �: m per`. m t a3i O c, 0 Z Z N to _ m LO I'' y f1f//611 p is c (L 2 a w @ V7 d L (O N aQ ntn Z 0 ! p F' F— U) -o 333 FL di •N !' maaa CL N o a 0 � o M M (D w r N N wp N N N Z 0 0) 8, 8 O U CO c a (D 'O 4f Q N (A cc O O (O o Q r O1 v a V 'C L N C N Q (y O y W O `y 00 y } >- c) w _ t6 � 4i e Cc v� m a ` a • a m .� m c E r A Liam ', 0US L) Parcel #: 030-1021-10-001 03/31/2014 07:50 AM PAGE 1 OF 1 Alt. Parcel M 06.29.19.90A-01 030-TOWN OF SAINT JOSEPH Current ❑ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 04/11/2013 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner 0-BETKER, KEVIN E KEVIN E BETKER C-MCDANIEL, CARRIE L CARRIE L MCDANIEL 1212 TROUT BROOK RD N HUDSON WI 54016 Property Address(es): "=Primary Districts: SC=School SP=Special Type Dist# Description SC 2611 SCH DIST OF HUDSON SP 1700 WITC Notes: NEW FOR 2014; RETIRED 30-1021-10-000 (90A) FOR CSM 26-5916; LOT 1 BEING 030-1021-10-001 (90A-01)& LOT 2 BEING Legal Description: Acres: 5.003 030-1021-10-050(90A-50) SEC 6 T29N R19W PT NE NE CSM 26-5916 LOT 1 Parcel History: Date Doc# Vol/Page Type 10/24/2013 988025 EZ-U 05/20/2013 978897 WD 04/11/2013 976595 26/5916 CSM 11/07/2006 838291 CONSENT more... Plat: *=Primary Tract: (S-T-R 40%16o,/4) Block/Condo Bldg: *5916-CSM 26-5916 030-013 06-29N-19W NE NE LOT 01 2014 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 02/18/2014 Description Class Acres Land Improve Total State Reason Totals for 2014: General Property 0.000 0 0 0 Woodland 0.000 0 0 i I Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 W Safety isconsin and Building Department of Division Comirri PRIVATE SEWAGE SYSTEM County: St. Croix INSPECTION REPORT Sanitary Permit No: 561082 0 (ATTACH TO PERMIT) ~I GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. --i Permit Holder's Name: city Village X Township Parcel Tax No: Betker, Kevin St. Joseph, Town of 6 30 - /OZ~ /j _ /z)o CST BM Elev: Insp. BM Elev: BM Description: r+ Section/Town/Range/Map No /!j 9.52 6 ' 3 C~J 06.29.19. [6 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. .ti Septic b / Benchmark J 6051 y z #5 .7 2- /47 Dosing Alt. BM 1-15411 bli Z Aeration ~-r Bldg. Sewer 00, $7 L • Z Holding St/Ht Inlet 2.15 //1 Z Q //d ` -TANK SETBACK INFORMATION St/Ht Outlet Z •o TANK TO P/L WELL BLDG. Air Intake ROAD Dt Inlet S Nti Septic 16& / ~A- Z 7 IAI Dt Bottom Dosing Header/Man. 3 , /d r a Aeration lo, Dist. Pipe •7 X09 •a Z Holding Bot. System ~ • p c.~J PUMP/SIPHON INFORMATION Final Grade Z .(p Manufacturer GPMand St Cover ~4 Model Number 1 TDH 'ft Friction Loss System TDH Ft ~•G / z o a ai Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM '3 BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 SETBACK SYSTEM TO :I: BLDG WELL LAKE/STREAM LEACHING Manufj~e I INFORMATION Type Of System: CHAMBER OR / i 1 UNIT Mod umber q DISTRIBUTION SYSTEM E Header/Manifold /I Distribution x Hole Size x Hole Spacing Vent to Air intake j Pipe(s) ` Length Dia T Length ` Dia pacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges ` Topsoil No ` Yes f No] . COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Location: 1190 Trout Brook Rd Hudson, WI 54016 (NE 1/4 NE 1/4 6 T29N R19W) NA Lo/t-1 Parcel No: 06.29.19. 1.) Alt BM Description = r/ IL~- (:,bJ C•• 2.) Bldg sewer length = 27 - amount of cover = / Plan revision Required? ❑ Yes ko 7 7e? L/~ - ~ Use other side for additional information. ~ 1 J Date Insepctors Si ature Cerl No SBD-6710 (R.3/97) • PLOT PLAN PROJECT Kevin Betker ADDRESS 1212 Trout Brook Road Hudson Wi 54016 NE 1/4 NE 1/4S 6 /T 29 N/R 19 W TOWN ST. Joseph COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 5/18/13 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 .5 ABSORPTION AREA 931 # of chambers 46 BENCHMARK V.R.P. Top of 1" steel pipe ASSUME ELEVATION 1001 Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 112.7/111.5' 3' below qrade Pro 3 Bedroom House Well is to meet all setbacks required by WDNR 10 All piping shall be SDR 30/34, w Scale is 1" = 40' of tank, piping shall be Schedule 40. l 0° Unless otherwise -2 noted B-1 2-3' X 94' Cells 115' with >3' spacing Vent 113' >6" Quick4 Standar of Cover Leaching Chamber with 20.0 ft2 of Area , 12" 5.6ft^2/pair of end caps - • 159' 111 4' Long 3 4" Grade at System Elevation 109' 15% Slope 120' Trout Brook Road 174' B.M.* 479' Property Line 36' 42' 42' ll~ v~"aT'remr County Safety and Buildings Division Come /1 fo /L 201 W. Washington Ave. P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 53707-7162 a o„~wNAtdb 56 1 0<67 2- Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit _ Jo is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than ling address the Department of Safety and Professio Personal information you provide may be used for secondary ~f n purposes in ttccordantx with i -.040)(m), Slats. _ tt/ r~ (!dJ /eon 1. A lication Informati rint 1 Information v N Property Owner's Name ~A Parcel Cc-rc c, n H Property Owner's Mailing Address Property Location la Z ` la r t✓ ~qy Govt. Lot City, State Zip Code 1' C ~b Phon cbey ~~1~ /n, J✓_ j/a, Section J . Oil. ~ rcle o~~ T 2 N; R E of W/ II. Type of Building (check all that apply) Lot /i / trti or 2 Family Dwelling - Number of BedLrroorm Subdivision Name 6F- e~ t- Block tl ❑ Public/Commercial - Describe Use `L 'A.- ❑ City of _ © State Owned - Describe Use CSM Number/ / ❑ 'Village of z Ge.1l S 23 "2~6,~ ✓ / Town of M. Type of Permit: (Check WAY one box on line A. Complete line B if applicable)/ System ❑ R ep lacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) II• ❑ Permit Renewal El Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner n,e 1CV.T a of POWTS System/Component/Device: Check all that apply) t^^ 1d K-Non-Pressurized in-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soft ❑ Mound < 24 in, of suitable soil fr~► Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat nt Area Information: _ ea a ~ Resign Flow (gird) Design Soil Application Ra gpdsf) Dispersal Area Required (sf Dis tarsal Area Proposed in Elevation 57- MV, -7 111-5- VI. Tank Info Capacity J' in Total 4 of Manufacturer Gallons Gallons Units vW New Tanks Existing Tanks c2 t? Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, ass a espousibility for installation of' the POWTS shown on the attached plans. - Plumber's Name (Print) Plumber' S' afore MP/MFRS Number Business Phone umber Plumber's Address (Street, City, State, Zip Code) Z_ Z VIII. ount-V /De artment Use Only Approved - Permit Fee Date Issued Issuing A Signature teen Re n for Denial $ 475- OD 5 /43 ~3 IX. Condr Irw teasons for Disapproval ro; f e(Q. 44 - 1 Septic tank, efflUbrVilter d 3, rl~o dispersal cell must all be aervk:a I maintairtsd j /O Z as per management plan provided by plumber, 7io n 1 2. Ah ss($ aok requVements must bs malrttairltd %n ss Per applicable code / ordinsnoes. t5 f ► t ^ Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 111 inches iu size ti a I lee,-ak E~ka~ Gfin• t 5 SI D-6398 (R 11/11) r¢.~ v "~C, . / U Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 5/18/13 Owner:Kevin Betker Location: NE1/4 NE1/4 S6 T29N,R19W Lot 1 Trout Brook Road St. Joseph 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 V29 Signature License n PLOT PLAN PROJECT Kevin Betker ADDRESS 1212 Trout Brook Road Hudson Wi 54016 NE 1/4 NE 1/4s 6 /T 29 N/R 19 W TOWN ST. Joseph COUNTY ST. CROIX MFRS Shaun Bird 226900 DATE 5/18/13 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 .5 ABSORPTION AREA 931 # of chambers 46 BENCHMARK V.R.P. Top of 1" steel pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL IH.R.P. Same as Benchmark SYSTEM ELEVATION 112.7/111.5' T below qrade Pro 3 Bedroom House Well is to meet all setbacks required by WDNR 10' All piping shall be SDR 30/34, within 10' S Scale is 1" = 40' of tank, piping shall be Schedule 40. unless otherwise 10' B-2 noted B-1 2-3' X 94' Cells 115' with >3' spacing Vent 113' >6„ Quick4 Standar of Cover Leaching Chamber with 20.0 ft2 of Area 111' 5.6ft^2/pair of end caps -3 159' 4' Long 12 " Grade at System Elevation 3 4" 109' 15% Slope 120' Trout Brook Road 174' B.M.* 479' Property Line 36' 42' 42' -IL 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 To be >1' above grade 5.6ft 2 pair of end plates Finish grade elevation Typical Installation 115' Vent Grade Vent 3' 3' 4=SepticTank x5Long 1 ,f S' Long 1 3 6 " Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X 94' Cells Same on other end Observation tubeNent At end of cell A B 23 chambers per cell System elevations: A 112.7' B 111.5' POWTS OWNER'S MANUAL & MANAGEMENT' PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner y - Septic T ank Capacity al Permit # - , Septic I ank Manufacturer,_ D NA OF-SIGN PARAMETERS Effluent 1=filter ManufactiVer D NA Number of Bedrooms - - - - - 11 NA Effluent Filter Model 0 NA Number t of Public Facility Units Esf--__.-___~ mated flow (average) ~ NA Pump T-€Ink Capacity 11 NA ---(avera-_--._-__ U-~ al/da Pump "unk Manufactur=ar 11 NA Design flow (peak), (Estimated x 1.5) Jv_- ~ al/dy Pump Manufacturer NA - - Soil Application Rate al/da /ftj Pump Model NA Standard Influent/Effluent Quality Monthly average' Pretreatment Unit - NA Fats, Oil & Grease (FOG) 530 mg/L 11 Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 5220 mg/L FA NA ❑ Mechanical Aeration Cl Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection El Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) El NA Biochemical Oxygen Demand (BODs) <30 mg/L Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) <_30 mg/LA ❑ At-Grade © Mound - Fecal Coliform (geometric mean) 5104 cfu/100mi f.] Drip-Line ❑ Other: Maximum Effluent Particle Size - in dta. El NA Other: Other: _ 0 NA other: *Values typical for domestic wastewater and septic tank effluent. INA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 11 s) ( Maximum 3 Years) ❑ NA _ ear s~ Pump out contents of tank(s) - When combined sludge and scum aquals one-third (A) of tank volume C_1 NA Inspect dispersal cell(s) month 5 - At least once every: ) _ S ears (Maximum 3 years) ❑ NA Clean effluent filter At least once every' ( ❑ y onthi s) DNA Inspect pump, pump controls & alarm At least once every. D oaths s) - - F=lush laterals and pressure test - At least once every: O months s) ~ Other _ _v C year{s) NA At least once every: Ll monthly) - - - ❑ year(s) NA 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; E')eptage 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 :he 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 tha immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (J§) 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 an, service event. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of panting 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 Bump 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; diaprtrs; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicide:,; meat scrapf ; 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 Adminisirative Code: All piping to tanks and pits shall be disconnected and the abandoned pipe openings seale,a. a The contents of all tanks and pits shall be removed and properly disposed of by a Septagr: Servicing Operator. 0 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: 7LA 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 nplacement 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. Baring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. 0 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate 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. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following ntmoval of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in efft:!ct at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND/Oft INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMEJANCES. Dl+;'ATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER - Name Name Phone L/J j - - Phone ~~~J SEPTAGE SERVICING OPERATOR P MPER LOCAL REGULATORY AUK" HORITY -------r Name Name / S1?J1 _ -Phone J / b' _ ---Phone . - ---Lf _ " - This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), t~ (3), vViseni isin Administrative Code. IN UCTI ~r~~w x lyry rlr Hrr t1rl;~t' ~a,,ie, ,atltN Nstd tlrtrY ut` P.ilu autlLtt tank thru h pint, to vc+suru it fJt Cvlrtattttd uradtrr tiro a,acwW>+ t+pat,rlltg, t1' eep>~ rtilb(Y wdthwr htrstrt tttara pfpa rl+ltt~ tltt, pipit. tqF ihtiJ tttttiut air aoluwut uYl LgrlumJ irtldlttnhal plpte a1tYu t'ha twtity "Itto UCh .ar it tWYditt ttcn t ittttt ilt Jgtlil dry t4Url tah the rdtltttti l lpb, w,aasortr tlaa }rtnNtlJ Wttir»ttrpipe 'milrult:aleei l ~itryJu lrr~tcrw tftet i9lrwr ► Fite tatllk Jtad wall i( uttltelttly ilia i +sulrviism >3rsmwxrrt;, 1t' Lwidn itt'ad tat l'utiz sWtpart ttrutlead IM iutt utiilrtd, t i"k:1t . hut' instoommuetrs 4t111:rrr)fY Moo 170tiurwl s'upltlubtani'u, sidr ~uµpdre: ratlunttt weld d'o, F,rsJt w1t+a upoka the Nttyr'461a, It 'id. sU utNiied, presvesd to si:etp finuL; ppurt Makitclrf iF, ptot Saitrattt wilt! the Itltui i:aooy Uhtu the a "flat frrto t1Lq J titre t8t t~irre, rrbryrt rice t M4~'J tiffs Cw1m. }trttlasirt11 dottflt Uhtll tali Ylltirr 9or kr; Mgtn lfrn butt,rn, at 1 , If As rrwltr.9l iy rttlicmwl_ """tt into tht+ ' rkwkwlte tw, ialtttr :Jrtri 4gclr by tilrtlirrk " 'Wriiq ) ,l. 7trLt JAYritlent Out ts(tauld be t:iowtttid utlattr tftrte COM u41,060 hilik is s~mrtrlautl. Z. open that eUtiat mLtx:asd apnny,ly to rnxpaat the tunic'Jild intuit, 3, ialtirt(t I~tJy LGnptlc tattalc twit • '4 , itryttr rte tlto ltttttgrr, vtN u1~ ~wd~yrJd t ait~u t tlLetarJ ilrrrtutuf effluatrt~a 4, ths" ti,m nttrirrnt levcrr haw 11 wan (utwered bwNw thrt 111w4ft td till) eUtlet tape, rlrttlitr 1►uU vyp w, titt+ itittur 104"d(c+ ttiu dluliadlltt the 5. Slldti the t dr wad up attd uqt: or the l ava ow qsirtihty. 6, le VAS; swltt t twittane:twd tv art elar(ri its littissai, tit': swillr:lt shtwid ho ruartovesi by turteitrlp ~rturtturrJarkwrluw all, tlitd dttuittid with wetur (Ittiy. ° While huldkty the raetiat'idlity Col Ids tiltld (thrill, Mttt cutt. a j;w.j, *lowq) ever tittt duets eyta rl(tJ„ 411% myL fsFta tctitirldllr* MAW DAY, kvlw kht g aura am suptat"u: tDowterlm !e rimAd with Ilirt ll Itttll tk,t, t utl . ,f. le Vrtt: swJitch is utiliaatd, m W)Rr rpd pY blutltCfhll! iota Hltar art'i tur'►,il'10 clarkwtt;tr rarlw. ktrsun the, filth, cowidper back trait lye tathe filter ltovW hattr the hattoun tot tlfaw pr ltril duihrrr rrtttlY utJrus, JO.lieplace and sucure ttte ) L.. 'Ut•'4itii6 tiiltlhllt tit 0 tJp u tattk~ • . . npt YPr,:JatYtl 1 tort "J r1.i 4 tl'tt • i.1? :•V:,;lAl.t.v'• , . J . . i i i WWMAI umil i ihriClsft. 877-MWICTIfM i SJ"{ . ST. CROIX COUNT"e SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATICGN FORM Owner/Buyer 1/` ~T~~ - - Mailing Address _ 12- I Z Property Address 00_ ~l'(~• --~y - _ _ (Verification required froin Planning & Zoning Department for new construction..) City/State r' dYpQiParcel kientificatiorl Nut::-lber ~-d~----- LEGAL DESCRIPTION Property Location '/4 NF__ '/4 , Sec. le-) , T~ N 121 W, Town of Subdivision _ , Lot # Certified Survey MaP#_4 1076 J (`t/Z % / 5 ~ ~ cAuYne Page # Warranty Deed # 70 f I Volume - , Page Spec house yes no Lot lines identifiable yes 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, 0 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 wasi-e 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 pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. 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/we certify that all statements on this form are true to the best of 1ny/our knowledge. 1/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deei.ls Office. Nutn of bedro~ Sl/1~ l~3 STt'NATURE 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 reference is made in the warranty deed. (REV. 08/05) 0 0 976595 BETH PABST REGISTER OF DEEDS CERTIFIED SURVEY MAP ST° CROIX CO., wI LOCATED IN PART OF THE NE1/4 OF THE NE1/4 OF SECTION 6, T29N, R19W, RECEIVED FOR RECORD TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN. 04/11/2013 10:30 AM LEGEND o PREPARED FOR: EXEMPT REC FEE: 300.00 ® FOUND ALUMINUM COUNTY SECTION u a ERNIE & LYNN BETKER CORNER MONUMENT O m 1212 TROUT BROOK ROAD N. P SCOT FOUND 1" DIAMETER STEEL z HUDSON, WI 54016 ~PJ S ® SURVEY MARK NAIL w rv CO DOUGLAS J. % SET 1" OUTSIDE DIAMETER BY 18" °oo X w SURVEYOR: * . ZAHLER Q LONG IRON PIPE, WEIGHING 1.13 LBS. 6-6 r- DOUG ZAHLER 5-214 PER LINEAR FOOT w v N S & N LAND SURVEYING UDS ? w H w FOUND 1-1/4" OUTSIDE 2920 ENLOE ST. SUITE 101 O m v+ r- DIAMETER IRON PIPE w_ ¢ HUDSON, WI 54016 SU ¢ Z Z H PROPOSED DRIVEWAY w a O x SCALE: 1" = 200' 5 v NORTHEAST CORNER 200 100 0 200 SECTION 6 - -4 - - - - - - - NJ r. pdG144C CD 0.L%HDg ~3MR NG~MM(3C~W 0 - 35 - - - w - - 500°29'35"E 83.01' S89°48'11"E 1323.70' 1290.70' OPEN SPACE AREA =11.49 ACRES 33.00' Use of the open space area is limited to the uses prescribed in 168-18D of the Town of 5t. Joseph Subdivision Ordinance. ° Development within the Open Space is prohibited. The boundaries of ZE the Open Space may be changed with the approval of the town board. N N ------------------------------------------------pp_ 00 I 589°48'11 "E 1071.54' w_ w O o { LOT 2 T I ~ I I (mil m I TOTAL AREA EXISTING D j 1,044, 092 SQ. FT (23.959 ACRES) DRIVEWAY Vi i N89°41'44"E 479.00' ° a I EXCLUDING ROAD R/W m o U p I y 1 1,029,949 SQ. FT. (23.544 ACRES) 446'00 r4 33.00' w Q@ 0 w d S~ g ~ 1 n co I% - I o LOT 1 J o It _ u1 Z TOTAL AREA m IQo c~ Q. 217,944 SQ. FT. (5.003 AC.J p a n I y CD EXCLUDING ROAD R/W Z p o_ o N i 202,929 SQ. FT. (4.659 AC.) a I I v, ~I o I N m ~ 33.00' 625.59' 446.00' • N • 479.00' 589°41'44"W 1104.59' 66 r-33'r3, 0 can O~OO ~ ~ 9 `V' oUoIJVLIo V ~L~o ~ti.19 ~~.la ~[J 'i?~ O m C J 0o W J I{ v O 1 O SOUTH LINE OF THE NE114 OF THE NE114 • 89°53'34"W 222.39• . - . . Note: Lots may be subject to future assessments for any'upgrades or Z improvements to Trout Brook Road North. o Each Parcel shown on this map is subject to State, County and Township laws, f I rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.) Before purchasing or developing any parcel contact the St. Croix County Zoning Office and EAST QUARTER CORNER the Town of St. Joseph for advice. SECTION 6 D oAF2TED BY: DOUG ZAHLER PROJECT NO: 6435-003 DATE: 4/1/2013 SHEET 1 OF 2 f Vol 26 Page 5916 I IIII~IIIIIIIII II III IIIIIII{I III 8156054 State Bar of Wisconsin Form 1-2003 Tx:4127350 WARRANTY DEED 978897 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI 05/2012013 12:15 PM THIS DEED, made between Ernest H. Betker and Lynn J. Betker, husband and EXEMPT#: 8 wife REC FEE: 30.00 ("Grantor," whether one or more), TRANS FEE: 3.00 and Kevin E Betker and Carrie L McDaniel, as joint tenants PAGES: 1 ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address' needed, please attach addendum): Dwight P. Cummins That part of the Northeast Quarter of the Northeast Quarter (NE V. of NE 1/4) of Cummins Law Office, P.A. Section 6, Township Twenty-nine (29) North, Range Nineteen (19) West, St. 200 Professional Building 363 5" Avenue North I Croix County, Wisconsin described as follows: Lot 1 of Certified Survey Map B„sport, PIN 55003 recorded in the office of the Register of Deeds for St. Croix County, Wisconsin on April 11, 2013, in Volume 26 of Certified Survey Maps, on page 5916 as 030-1021-10-000 Instrument No. 976595. Parcel Identification Number (PIN) THIS DEED IS EXEMPT FROM FEE PURSUANT TO WISCONSIN STATU'T'E 77.25 (8) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: None Dated May 15, 2013 ` (SEAL) / - (SEAL) * * Ernest H. Betker (SEAL) _(SEAL) * * Lynn J. Betker AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA ) ss. authenticated on WASHINGTON COUNTY ) * Personally came before me on May 15 2013 the above-named Ernest H. Betker and Lynn J. Betker, w TITLE: MEMBER STATE BAR OF WISCONSIN husband and wife (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. y 706.06) 6 ° g instrument and ack ledge h same. Z ul J c 0 THIS INSTRUMENT DRAFTED BY: n * E Dwight P. Cummins, Cummins Law Office, P.A., 200 Notary Public State of Minnesota E 31- Professional Bldg 363 5" Ave. N. Bayport, MN 55003 My Commission (is permanent) (expires: 20 7) 2 (Signatures maybe authenticated or acknowledged. Both are not necessary.) NOTE: TIIIS IS A STANDARD FORNI. ANY NIODIFICATIONS TO THIS FORA SHOULD BE CLEANLY IDENTIFIED. WARRANTY DEED © 2003 STATE BAR OF WISCONSIN FORm1 NO. 1-2003 '1Tgbd name below signatures. DOCUMENT NO. STATE BAR OF-WISCONSIN FORM 1 198E -u. °"a~_ ""°'•Yea raft ile¢oaoUlG IIAT,I WARRANTY DEED it 51524 _ 297 yQl. 1t~Ge 1y-C. 3;aT~ Dav1 d J Waldzo f f and ST CROIX CO.. VW 'T'his Deed, made between RagedtXRCacatd Julie A. Waldroff, husband and wife - - APR 11 1994 • ~ A . and- •Ernest__H.Betker ._andLynn_J._ Betkert---hu sband and wi Y~e at -I Grantor 1O: 00OKOfboad~ as-_survivorshir, marital propArty . Grantee, Witnesseth, That the said Grantor, for a valuable considerationof ot}e dollar__and .other ._Rood__an........................... .valuable consideration i`.-- Lois Murray conveys to Grantee the following described real estate in St. Croix REruBN TO P.O. Box 359 County, State of Wisconsin: Hudson, _ WI 54016 T. Parcel NoP3071021'"10 The NE4 of the NE4 of Section 6-29-19 EXCEPT Lot. 1 of Certified Survey Map in Vol. "9", page 2638 as Doc. No. 501674 IMA-MEE8 _ ~5, 0 0 This i s not homestead property. (is not) ii Together with all and singular the hereditaments and appurtenances thereunto belonging; Ju 1 i e A . Wald ro £ f And.... David • S Wa 1 d_r o f'f and . warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record and will warrant and defend the same. C' day of Apr 1 1......-........................: F... Date Yhis r••/............. t .fll.._'... ...........(SEAL) (SEAL) lie- waft. Ei....FIa7dl"o.ff.. s (SEAL) ...........................(SEAL ) AUTHENTICATI0N ACHNOLVLRDGMRNT Signature (s) David J. Waldroff STATE OF WISCONSIN . and Julie A. Waldroff ss. County. n a this ~ --"--day of-.__--........... 2flPersonally came before me this day of 29-------- the above named . iA. Murr - - - ITLE: MEMBER BAIT. OF WISCONSIN (If not. authorized by § 706.06, Wis. State.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Lois_ e1... ~Iuu: ay -t Z i l z and Es t r een ~~tt Notary Public County, Wis.~P.a Any authenticated or acknowledged. Bo'h My Commission is permanent. (if not, state expiration :.rn Tint nPr•naCRrY_) s_._. •Names of rerenn% signing in any capacity should be typed or printed below their signatures. i STATE BAR OF WISCONSIN FORM No, i - 1982 Stock No. 3001 11. C.MdIer GHnpnr.y J21= E z s o O r W sR~n ¢ N gfi '111 Him hh'i J111p~ M~~ c I I sg$:yy~ 9~ i I*.1.... ,I b I I 9`ay~ i ~ I I I R .33M~ I QGtl {/H I I j I I I I 1 xv,we~., nvosn.mne •sr. on nnw I I I ` n-tvdtiv i~vro nilivua I 1 I _ - I I II I I• I I < a5 I~ . I I I I 1 I' I ~1 I - I I Qm II ~ ~ is ) rC~~ v I c~ $ j I I I i~ II 1 1YYY \ , %1 Yru I I a . n n ~ " I I rv I I ~y'v I I "s 1 ~ ~ ~ A o I ~x I.. y ~ a II II e~ $j~ , : 9 x j 1 ! a 1 a I I I _ n - - I I P I II ~ 1 q 1 I~ y of A I I I j i \ll ~`J~ F~' I 1 I I _ 1 1 I1; a 1 1 I I ~ 1 I mrt,sn ~d 9 g` sus d ~ o w fl~ Do 12 W co q °Z .l'kyg4g9~ Z Q W Q~ ~ JFJ $ W N~ LU Z B1oio°:. I I I ~n I macn C-A $fp5 ~ zff 5 A Y U - i I I ~I f I y- y~~ I@ t ~ s q -_--Ix 1 RyAy III k - 9 SCI H III ~i ;+ggI~ e 1 I I~ i 41 ~ v,m-n 1 oun-iooui rvn--- ~ _ i l 0 III ~ 1 111 e Ue `gi o - - °e 3'~ Y q1 k U>~>~~ 4P£6~C x T E h~ L~4❑ ~ ~ ~ N Q Q :W ° z a~ S~aE W If) fi ~ ~g g c > a m ¢ ~ J ri~ riW ~w _ ~J NQ N¢ 2 W Q Jfi J . ~ 1.LLl t1Jil1111J. it f 1 ufl Fs 1 , LLTI 2 r j~ pp 9 r LL1p1~`;e'"1' H~ ti ,t a _i ~ al ~ r t Department of SOIL EVALUATION REPORT #1705 x S P Safety and, f in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 = Professionvlces Schmitt Soil Testing, Inc. Attach complete site Ian on r t ~ thah 8%x 11 inches in size. Plan mu County p plan le St. Croix include, but not limited to: vei 1661 and horizontal reference point (BM), direction percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Aar I I.D. „ Part of: 030-1021-10-000 Nadi jiroit all information. Rev B _ Dat 0 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). y Property Owner Property Location Betker, Ernest, & Lynn Govt. Lot NE1/4, NE1/4, S6, T29N, R19W Property Owner's Mailing Address Lot # Block # . Na a or CSM# S/vl n~,„►, 1212 Trout Brook Rd. 1 Propose Acre Parcel City State Zip Code Phone Number ❑ City ❑ Village ] Town Nearest Road Hudson WI 54016 (715)-549-5999 St.Joseph Trout Brook Rd. N0✓. New Construction Use: [ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial - Describe: Parent material Outwash Sand (Burkhardt-Sattre Series) Flood plain elevation, if applicable NA ft. General comments Area is suitable for a conventional system wit /s rate. ossible system elevation for Area 1 is 113.70' (high Trench) and recommendations: 112.30'(Low trench) or 2' below grade. Slope of area is 15%. a Boring # ❑ Boring 0 Pit Ground surface elev. 115.70 ft. Depth to limiting factor 90+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-3 10yr3/4 none sl 2fsbk mfr as lvf 0.6 1.0 2 3-29 10yr5/6 none grs Osg ml Cs 1Vf 0.7 1.6 3 F69-82 5 10yr5/6 none grs Osg M1 Cs 1Vf 0.7 1.6 4 9 10yr6/4 none Cos Osg ml Cs 0.7 1.6 5 10yr4/4 none Ivfs lcsbk mvfr Cs 0.4 0.6 6 82-90 10yr6/4 none fs Osg ml 0.5 1.0 12•~ tt n L] Boring lp 2 Boring # Pit Ground surface elev~ 15.70 ft. Depth to limiting factor 90+ in. 9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/3 none sl 2fsbk mfr as 1vf 0.6 1.0 2 8-30 7.5yr5/6 none Is lcsbk mvfr gw 1Vf 0.7 1.6 3 30-55 10yr6/4 none grs Osg ml Cs lvf 0.7 1.6 4 55-69 10yr5/6 none Ifs Osg ml Cs 0.5 1.0 5 69-84 10yr6/4 none s Osg ml 0.7 1.6 ►V' Ilk * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 m L * Effluent #2 = BOD5 <_30 mg/L and TSS S30 mg/L CST Name (Please Print) Signature.- CST Number Thomas J. Schmitt 227429 Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 2/13/2013 715-760-1978 SBD-8330 (R.07/00) Property Owner Betker, Ernest, & Lynn Parcel ID # Part of: 030-1021-10-000 Page 2 of 3 a Boring # Boring r Pit Ground surface elev. 109.52 ft. Depth to limiting factor 91+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 *Eff#2 1 0-14 10yr3/3 none sl 2fsbk mfr as 2vf 0.6 1.0 2 14-22 10yr4/6 none Is icsbk mvfr gw lvf 0.7 1.6 3 22-52 7.5yr4/6 none vgrls Osg ml gw 0.7 1.6 4 52-91 10yr5/6 none s Osg ml 0.7 1.6 Boring Boring # Pit Ground surface elev. ft. Depth to limiting factor in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 *Eff#2 ❑ Boring F-1 Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Ett#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-8330 (R.07/00) Schmitt Soil Testing, Inc. Page 3 of 3 j Conducted by: Conducted For: Schmitt Soil Testing, Inc. Name: Ernest & Lynn Betker Thomas J. Schmitt, CST 227429 Address: 1212 Trout Brook Rd North 1595 72nd St. City, State, Zip: Hudson, WI 54016 New Richmond, WI 54017 Phone: 7"0-1978 PID: Part of. 030-1021-10-000 s.ynatare r~r~-tom Lot No. 1 (5 Acre Parcel) Date 1 Legal Description: NE1/4 NE1/4 S6 T29N R19W Backhoe Pit Township, County: St. Joseph, St. Croix County Bench Mark 1 El. 100.00' Top of 1" steel pipe. 0 Bench Mark 2 El. 103.04' Top of 6" wooden fence post, SE lot corner Slope= 15% 1"=40' 17 z v QLY~y 1133 ~C)'4 ~~N11 6M 3~O ,~ar jai 50u T H PAC &P T y Z-Iwt:- ti EL E NERGY E J J k V r IN,! J 1 j ' \ 11 \ 23.7 AC REMAINING 479' y, _P OP 5 D SAC LOT. K P PE SHEET 1 OF 2