HomeMy WebLinkAbout030-1057-60-150
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
(ATTACH TO PERMIT) 561097 0
GENERAL INFORMATION State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Oeverin Homes LLC, aka Oeverin Pro ertie St. Joseph, Town of 030-1057-60-150
CST BM Elev:
I of Insp. BM Elev: BM Description: Section/Town/Range/Map No:
4 • 8-3 is ( 23.30.19.201 E30
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPCITY STATION BS HI FS ELEV.
~11^441
Septic
14(1 Jcrc Benchmark
9z• 3
J 4- 1600q
Do>;iug. Z Alt. BM
6
Aeration (Lii.A. Bldg. ewer x
Holding St/Ht Inlet 9 • /
TANK SETBACK INFORMATION St/Ht Outlet Jr. Z SZ , I
TANK TO P/L WELL BLDG. ent t` it Intake ROAD Dt Inlet
9 6&
Septic ' 25 AJA- /a f 3 _ Dt Bottom ~r
Dosing Header/Man. Z.
Aeration Dist. Pipe
Holding Bot. System
9i•
L4 -
PUMP/SIPHON INFORMATION Final Grade 1,5 gG • (o
Manufacturer Demand St Cover
z
GPM z
Model tuber
TDH Li Friction Loss TDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DI NSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 z ~e
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR •C: C'
Type Of System: , UNIT Model Number:
o^,J ~o b Zd /l1
DISTRIBUTION SYSTEM J 5 /5f-!l✓ 3~5
Header/`MarlifoW / Distribution x Hole Size Ix Hole Spacing Ivent to Air Inta e
7 Pipe(s) "7 d ✓
Length Dia Length Dia Spacing 44
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth f xx Seeded dded xx ulched --g I
Bedlrrench Center 2 Bed/Trench Edges \ Topsoil Yes No No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 717 North Bay Rd. New Rich nd, WI 54017 (Gov't Lot 5 23 T30N R1 9W) NA Lot 3 Parcel No: 23.30.19.201E30
L
1.) Alt BM Description = Fl. I ~a b~
2.) Bldg sewer length =
- amount of cover
Plan revision Required? Yes No i _~f
Use other side for additional informati n. I__ l~ i (J T
SBD-6710 (R.3/97) Date Insepct s Sign a Cert. No.
PLOT PLAN C2-)
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
1/4 1/4S 23 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX
MPRS'Shaun Bird 226900 DATE 6/3/13 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 933 # of chambers 46
BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark
SYSTEM ELEVATION 95.9/94.9'4' below qrade
625' Property Line 11 piping shall be SDR 30/34, within 10'
of tank, piping shall be Schedule 40.
Vent V
Well is to meet all
>6" Quick4 Standard setbacks required by
of Cover Leaching Chamber WDNR
with 20.0 ft2 of Area
12" 5.6ft^2/pair of end caps
4' Long
Grade at System Elevation
34" Scale is 1" = 40'
unless otherwise
Pro 3 noted
Bedroom
House
0' ST 20' 72'
% B-1
0
0'
72'
B
11% Slope
2-3' 4' Cells with >3' spa ' g 4591 V A
to 1'r
B-3 16' di~
Vents
52'
N A 100' 98' 96' 20
2
450' 712' Property Lin
-22,6 4-v 5t G~iJ
ro County
Safety and Buildings Division
" F k, "i 201 W. Washington Ave., P.O. Box 7162 - tnit it
'c:yy r ;t Sanitary Per Number (to be filled in by C o j -
r Mattison, Wl 53707--7162
Sanitary Permit Appheation State Transaction Jtunbe,~ `
In accordance with SPS 3$121(2), Wis. Adm. Code, submission of this fc.)rm to the appropriate goverrnnental unit ~y
is required prior to obtaining a sanitary permit. Note; Application fbrnts for state-owned 1'OWT'S are submitted to recta Prvjert Address (if different than mailirtg address)
the Department of Safety and Professional Servies. Personal inforrrtation you provide may be used for se.oudary
_purposes in accordance i Privacy Law, s. 15.04(1)(m), Stats. - r
I. A licat' b tl Please Print All Information
Property O s Parcel
_ J P r ; 1r7~'h4z9-_.. _ { -V_ fLs
Trope Mtns Mailing Address - Property Location --~a - f----
( Z,01 -F 36
(:;1ty, state Zi en--- _-fit 6? Crovi. Lot)
P Phone
Nut+Spe
~j t? _ /J, ,/4, Section 3
C~~¢.~ 0~- ICXf uj 017J -U(aL* 'hole 1
I.I. Type of Building (check all that apply) T' _ t~__ N; R - L, r W
7 Lot
I or 2 Family Dwelling - NumbeY f'DVdrocrms _ Subdivision Name
C) Pablic&owrnercial Describe Use
- ~J City of - -
C) State Owned - Describe Use C5M Number U Village of
y E73 own of"5_ r sue,
III. Type of Permit:(Check only one box on line A. Complete line ll if applicatlrl - T
New System
❑ Replacement System Li Treatment/Holding Tank Replacetnant Only El Other Modification to Existing System (explain)
g- D Permit Renewal 1:1 Permit Revision ❑ Change of Plumber ❑ Pertnit Trausfer to Flew Ltst Previous Pc it Number and Date Issued
Before Expiration Owner
If_V. Type ofPOWTS S stern/Cum ontxtt/Device: Check all
Von-Pressurized In-Ground U Pressurized In-Ground At-Grade ❑ Mound > 24 at. f'suitablu soil ❑ Mound < 24 in. of suitable soil - -
U Holding Tank ❑ Other Dispersal Component (explau Pretreatment Device (explain).----
Dfs ersaJ/T,•eatment Area Information: ~ ,(%C - i (I//~y-(Q - -
Desi Flow (gpd} Design Soil Application Rate(gpdsf) Dis rsaI Area Reclui, ed (sf) Dispca,:ai Area Proposed (st) System Elevat11
VI. Tank Info Capacity in Total fl of, Manufacturer ~ "
Gallons A3
Gallons Units
qq
New Tanks I` Lxis-ting Tanks ~ M / ~ ~ U ~
A, U rn rrl w C7 w
Sceptic or Holding 1'auk -
- - T_ - - -
Dosing -Chamber
VIT_ Responsibility Statement- I, the underAsigned
esponsibility for installation of The POW TS shown on the attached plans.
Plumber's Name (Print) - atlue - _i MP/MARS Number ]3usiness Phone Number -
Pl umber's Address (Street, City, State, Zip Code) - -
-
1; CA~
VII onlit- /De rartment Use Only - Y-.-- _ _
Approved IJ Disapproved Permit Fee Date Issued Is tug Agen Signature
Cl Owner Given Reason for Denial 3
Ir; Conditions of Al~proval/Reasons for Disapproval _ \
SYSTEM OWNER; ( 5) ~~P Zvi S l ~lf~Q
1. Septic tank, effluent filter and
dispersal cell must be -h C 17j eryicedmaintained y as per management plan provided by plumber. _ 3 06)
2. All setback requirements must be maintained
- ap-ptica -q~9'_i
p e
uus for the system and subwit to the County you paper not less titan 8 1/2 111 inches in
Aye I
SBD-6398 (R- 11/11)
PLOT PLAN (Di
PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017
1/4 1/4S 23 /T 30 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 6/3/13 BEDROOM 3
CONVENTIONAL )00C 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 933 # of chambers 46
BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 95.9/94.9'4' below qrade
625' Property Line 11 i in shall be SDR 30/34, within 10'
P~P~ g
of tank, piping shall be Schedule 40.
1-Yy #
Well is to meet all
2L. Quick4 Standard setbacks required by
eaching Chamber WDNR
ith 20.0 ft2 of Area
.6ft^2/pair of end caps
34Grade at System Elevation ,
Scale is 1„ = 40'
unless otherwise
noted
Pro 3
Bedroom
House
20' ST 20' 72'
B-1
0'
72'
B.M.*
11 % Slope
4'
2-3' X 94' Cells with >3' spacing 5'
B-3 16'
Vents 52'
11 B-2
100' 98' 96, 20'
y Lin
450' 712' Propert
Nwv'l u
' l
•7788864873
VOL PAGE
KA79L8EIf M. yam,
REGISTER OF DUDS
RECEIVED SxFO~ kZCORD
11/93/2804 91s30PM
zp c APPROVED CERTIPIED suRVEY MAP
ST. CROIX PlannlnQ zomm and Parka Committee REP FEE s 15.00
COPY FEES 4,00
Z Nov 0 3 2004 PAGES1 3
s
if not r w ded Within 30 days of
v 1 date approval strap be
apprara nuil end vord BEARINGS ARE REFERENCED TO THE
TED LANDS WEST UNE OF THE NWI/4 OF SECTION
UNPLAT
II - - - - - - - - - - - - - - S 23, ASSUMED TO BEAR S00W'11'E
SOO'53'11'E 2653.76'
WEST UNE OF THE NWI/4
m
SOO.53'11 "E 459.99'
T3'21f.6$'
' sQ-i
~ mz
\\To lt,,~4
SOO-52 51 E 553.78
=I c)
Mier,
0
po.
I " S S01 44 40 'E6 25.15 ; IC C
I > \ap v m
I ~ 81.11: r23.19t-
w oo~oo 06 W
call
id w ago
gig
w 1
Eiji 'w W
CIO
SHEET 1 OF 3 SHEETS
Vol 19 Page 4873
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 6/3/13
Owner:Oevering Homes
Location: Govt Lot 5 S23 T30N,R19W 717 N. Bay Road Somerset
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
Signature t
License nu er #226900
Cross Section of Infiltrator Quick 4 Leaching Chamber 3
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 99'
Vent A91 Grade Vent
3' 4" 3'
X30/34 Septic Tank
5' Long 195 5' S' Long 1
-)0 " Grade at System Elevation Grade at System Elevation
Spacing 5'
2-3' X 94' Cells
Same on other end Observation tubeNent
7 At end of cell
A
B
23 chambers per cell
System elevations:
A-95.9'
B 94.9'
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _Z/- of
FILE INFORMATION____ SYSTEM: SPECIFICATIONS
[Owner, . Septic Tank Capacity ❑ NA
Septic Tank Manufacturer ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model L ❑ NA
Number of Public Facility Units - ANA Pump Tan K Capacity _ qaI
11 NA
Estimated flaw (average; -
gal/day Pump Tangy Manufacturer 11 NA
Design flow (peak), (f stimated > '1.5) ~J` J ~aUda Pump Manufacturer ^ - NA
Soil Application Rate - , J-qaIlda /ft2 Pump Model NA
Standard Influent/Effluent Quality Monthly average" Pretreatment Unit i NA
Fats, Oil & Grease (FOG) 530 mg/L 0 Sand/gravel Filter ❑ Peat Filter
Biochemical Oxygen Cemand (BOD5) 5220 mg/L ❑ NA ❑ Mechan cal Aeration ❑ Wetland
- Total Suspendeid Solids (TSS) 5150 mg/L Disinfec:ion ❑ Other:
Pretreated Effluent Qualiry Monthly average Dispersal (;ell(s) - ❑ NA
Biochemical Oxygen Demand (80135) 530 mg/L rdt n-Ground (gravity) 1J In-Ground (pressurized)
Total SuspenJecl Soflids (TSS) 530 mg/L Alm t-Grado ❑ Mound
^ Fecal Colifoim ;geome_4ric mean) <104 efu/100m rip-Line El Other:
Maximum Effluent Pailicla .:"iize in dia. ❑ NA er: ` uJ NA
Other: - - -
NA Other:
`Values typical for domestic wastewater and septic tank effluent. Other: - - - NA
MAINTENANCE SCHEDULE
Servirm Event Service Frequency
Inspect condition of tank(a) At least once every- ❑ month°s}
- -4 tear s (Maximum 3 years) ❑ NA
Pump out contents of iank(: ) - When combined sludge and scum equals one-third (Ya) of tank volume ❑ NA
Inspect dispersal cell(s) At least once every' - ~Q monthis) T
_-Q*ear(s; - (Maximum 3 years) ❑ NA
7~
Clean effluent filter At least once every: j ❑ monthi s) - ❑ NA
- - - - / years`
Inspect pump, pump controls & alarm
At least once every: ❑ month( NA
❑ year(s
Flush laterals and pressure test At least once every: ❑ month, s)- NA
❑ year(s)
other: ❑ monthfs)
At least once every: ❑ year(s) _ NA
NA
MAINTENANCE INSTR!JCTIlDNS _
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: 4aster
Plumber; Master Plum )er Restricted Sewer; POWTS Inspector; POWTS Maintainer; Ssptage Servicng Operator. Tank inspections must
include a visual inspection oil the tank(s) to identify any missing or broken hardware, identify any cricks or, leaks, measure the volume of
combined sludge and scurrand 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.
I he ponding of effluent )r the ground surface may indicate a failing condition and requires th,e immediate notification of the local
regulatory authority.
When the combined accu nialation at' sludge and scum in any tank equals one-third or more of It ie 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 !s 12 months, shall be performed by a certified POWTIS !Waintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any, service event.
START UP AND OPEFIATICiN Page of
For new construction, prior to use of the POWTS' check treatment tank(s) for the presence of painting
products may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents loft h;
tank(s) removed by a !septa.ge servicing operator prior to use.
System start up :.h,..ll riot occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. VVhen power is restored the excess wastewater will bi
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 Sepiage Servicing Operator prior to restoring
power effluent pump or ccnfact a Plumber or POWTS Maintainer to assist in manually operating the f'lirnp controls to restore normal level
within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or other%ise disturb or compact, the area withir
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 aanci vegetable peelings;
gasoline; grease; herbicides; meat scrap; ; medications; oil; painting products;
pesticides; sanitary nalakins: tampons; and water softener brine.
ABANDONMENT
When the POWTS ft ils 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 seale t.
• The contents of all tanks and pits shall be removed and properly disposer of by a SeptagF! Servicing Operator.
• After puniping. 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 PLAW
If the POWTS fails and cannot be repaired the following measures have boon, or must be taken, to provide a code compliant
replacement system:
A suitable reol acernent area has been evaluated and may be utilized for the location of a replacement soil absorption system.
The repla;erlent area should be protected from disturbance and compaction and should not be infringed upon by required
setbacks from oixisting and proposed structure, lot lines and wells. Failure to protect the r,-placement 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 rime.
❑ A suitable replacement area is not available due to setback and/or soil liriitations. Barring advances in POWTS technology a
holding tank rnEy be installed as a last resort to replace the failed POWTS.
❑ The site has no[ 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 tc replace: the failed POWTS.
❑ Mound and al-grade soil absorption systems may be reconstructed in place following namoval of the biomat at the infiltrative
surface. R,~cc,nntructions of such systems must comply with the rules in effact at that time.
<<WARNING>>
SEPTIC, PUMP AND OTHER 'TREATMENT TANKS MAY CONTAIN LETHAL GA:-SES AND/OFt 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 COMME:N1'S
POWTS INSTALLER
Narne ~ - ~ POWTS MAiN°faNER
Namv
Phone Lle 5EPTAGE SERVICING OPE RAT'()R PUMPER
Name LOCAL REGULATORY AUTHORITY
-L.~ !M Name Bz Phone~J __Phone ~ ~1m~
This document was drafted in cornplianae with chapter SIPS 353.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wiscoi isin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK: MAMTENANCE AGREEMENT
AND
OWNERSHIP CER.TIFICAMN FOPM
Owner/Bilyer La l_! - l_~ - - _
Mailing Address a__ ' f.-
Property Address
(e~eration. required from Plantiitlg & ling Department li» new construction)
_Meno(
City/State/ w_ .'Parcel. ,ldetiti.Cication Number,L_ _ f C7 S 7 .
LEGAL, D;ESCRIP'CION
G v,+J f In 4'
-
property :Location , `/a , Sec. .J T ~3a N tt / V~'; 'Town of
_
Volumt T _
:Lot #
- Page # ..-zj01
-
Certified Surveil Map
7-7
'Volume page
Warranty Deed
per :House yes no Lot lilies idewifiable yeS o
SYSTEM MAINT:LrLANCE..AND O WNERCERTIFICATION
jI., its pre
k you put into
Improper use smd rclt'i to 1: the septic septic system could
every three yeas or1soon r, if ne needed, arlicensed ump r. What
maintenance consists o_.'piuY 1.
8septic tank 3.52(1) and in reatmentlZage ill 1 ix Count y Sanitarys(3rdinax1Weer. maintenance
the systein can affect tl .e far: tioi( of the
responsibilities are sperr$,-,d t §
The property ow!rei agrees to submit to St. Croix County Planning & Zoning. Department a certification form, signed by the ing
-qite owner and'by a master pharber, journeyman plumber, restricted plumber or a licensed pumper verify if nelcessary), file septic tank is
wastewater disposal sy steam :is in l;~roper operating condition acid/or (2) after inspecliot.t and pumping
less than l /3 full of Stuagt:.
file
State of Wiscons ioeq
irernerits T/we, the undt:rsigned heave read file arl~ment of C omrnerce and t'hetDepa tmr it a tu Natural Reso uY"s, 'State system ns in.
sumdard set forth, Ile,eir, ws sex by the Taepa
C:ertifkation stating that ,jour septic system has been maintained must be conipleted ar d rerned to the St_ Croix County Planning &
Zoning Department wither, 30 days of the three year expiration date.
1/we certify ttat alk stmt:meuts oil this i:orrn are true to file best ofnY/Opee~cof~ f lee 11~''e amlare file ownr(s) of the
property described above, by virtue of a warranty deed recorded ill Register
Number of bedra ora! '
6,31l3
D-ALTE
1CiN '1:1J]~ C'II' Ai?-KICANT(S)
erinit being revoked by the planning & Zoning Department.
result h' rile sanitary' p
***Any infonnation that misrepresented may P. of t11e certified survey map if
IncltYde with this appliclit7on a 7'ectsrdrd warranty deed iiom the Register of Deeds d)~ficr: and a c;o y
reference is made in the+arran ty deed.
(REV. 08/05)
1
~,Ir► 'ILTER CARTRIDGE INSTRUCTIONS
S11561 Y Dry fit the water cast- vaq the eild at the otltl,kt Wipe ktm etesvre it is
Centered under the aaceets opefming. If n thin tank dwough the outlet or trolvoe.t weld ben t either tnotu pipit it fives
ape ( ) additional l pipe Ithte C
P he outlet let
S FP 2 Whole time rase is stilt dry "ttad fin the outlet piper, rrrearsure the imrtgtf,
of rib-incft pipe needed to hrae:c the filter to fare tank end wall if Utilittinll the
eptiohal supplemental ride suiwpurt. If side support rnathod. Ili nut utilized,
proceed to s#ep four:,
5•rI•t' x Fut• instagatianat Utlllalr+g the optienari stlppleirrental sides support.
solvebt weld time %-inch piptl unto the rv"r lava- If tAde SUpport trtatlibd IS not
utilized, proceed •tu step Sour:
' .4N~4i~•1
Solv@nt weld the gltel case Uhto the outlet pipe. losert the inter
cartridgv into the cese, pressirt!d doWn until the filter hicks; into the battotr+ of lc
the rasa.
If a VRS swltr le is ut'lli:✓. rd- insett trite time filter by g clockwise 91r.
g0", rand lock h turnip r `1Fs $ ,r,
wra~rrtenan~
1. 'The efHUent filter ,thuUld be tiaaned every time the ouptlc tratrii is
Serviced-
2. Upeh the outlet access opening to inspect the tank otld llitel; 6
9. Punvp the septic teak uunplrrtely, Milking SON to remove the sludge
layer en the bottom Of the tlilnk and not Just the scum and oftlumnt, u
a_ ooze the efrltreht level has t+ven towered baloW tht: invert of the
outlet pipe, firrrrl
y pull up on the Hrter hendte to dislodge the •
cartridge fronr the case. ` u
5. Slide the rartrid
rja up and et u: of time r:aee: firr deanhvg.
t;. 1( a VAN switch t:unnereted to all alarhr is 11rt1,tient, the SWiteh
sh'auid be rernoveed by turuinry courttardackwisa 9111, aittd deaued
with water only,
r. •„y
r. While haltliny the ceirtfidgp cm its side (large fiat surf.*ce facbey '~er,• ,
down) over the acscess upeniitg, rinse 00 the cartridge With WA(le '
only, niakiuy sure all septallu rovatterfal is rinsed back Into the tank. , i
a. jr vxs switch is utilized, replw„* by knsertlhg into Miter arvd ~ . t
turning clockwise SO". r< u,
9. ltmsert fifes ifitar cartridge back ifrttu the ta", prarsuvg dawn' Ulttil a.• ,
the filter locks intu tho bnttoun tat the case. `
YU.ftepiste and secure the 4cwhb flushing Can the tmnk. „
s:r t:• •o-a~.v ~lc "a x; r 9Mr:•lr:+?fyt{ • f; "f I... ~ i,wt' iA~ :.Va3?64.t~r'•'
WSW`wbeamlpwte.tCont 877-VAL CTIMS (653-4583)
12? :
1466
Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service, Inc.
Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. S- 1~
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. V 3(,-`~~jf~' , v
Please print ap-informationw iewed By
AJ4~ ~'W Dat
It 1`1 il -
.pues (Piiiracy Law, s. 15.04 (1) (m)). Q S
Personal infomration you provide m for secord
Property Owner Property Location
Eiring, John Govl. Lot 5 SE 1/4 NW 1/4 S 23 30 N R 19 W
0
Property Owner's Mailing Addres Lot # Block # FSubd. Name or CSM# , It(
1477North Bay Rd 3 na CSM# Vo . 3 Pg 861 d /
City State Zip todePh6ne' . J City I Village a Town Nearest Road
Somerset WI 54025 715-247-3136 St.Joseph 1011-1 North Bay Rd
V1 New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
I Replacement Public or commercial - Describe:na
Parent material Pitted outwas plains and Stream Terraces Floo ~plain elevation, if applicable na
General comments AAII^ w qua `
and recommendations: Conventional stem, stem elevation 96.90ft. Trenches spaced and depth to code 3.00ft below r .
ot.l lAilnr !
Boring # J Boring
✓l Pit Ground Surfaceelev. 99.90 ft. Depth to limiting factor 96 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/112
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-10 10yr3/2 none sl 2msbk mfr cs 1f .6 1.0
2 10-2 10yr4/4 none scl 2msbk mfr cs na .4 .6
3 26-96 7.5yr4/4 none Is osg ml na na .7 1.6
cr
Boring # I Boring
rm Pit Ground Surface elev. 96.40 ft. Depth to limiting factor 96 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 *Eff#2
1 0-10 10yr3/2 none scl 2msbk dfr cs 2vf .4 .6
2 10-36 10yr4/4 none sl 2msbk dfr cs 1f .6 1.0
3 36-96 7.5yr4/4 none Is/sl 2msbk mfr na na .6 1.0
*
Effluent #1 = BODa > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BOD < 30 mg /L /L and TSS <30 m9/L
CST Name (Please Print) S' nature: CST Number
David J. Steel ~ 2S~,~ 248956
Address Steel's Soil Service, In . Date Evaluation Conducted Telephone Number
7/24/2004 715-684-5680
994 200th St., Baldwin, WI 54002
Property Owner Eiring, John Parcel ID # Pending Page 2 of 3
F3 ] Boring # ~j Boring
N Pit Ground Surface elev. 92.30 ff. Depth to limiting factor 96 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-11 10yr3/2 none Sd 2msbk dfr 9w 1 C .4 .6
2 11-25 10yr4/4 none sl 2msbk dfr gw 1C .6 1.0
3 25-47 7.5yr4/4 none cos osg mvfr CS na .7 1.6
4 47-96 7.5414 none sl sl mfr na na .6 1.0
Boring # Boring
_j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # - I j 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 D
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
I
* Effluent #1 = BOD 5> 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.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 994 200'' St.
CST-POWTSM John Eiring Baldwin, WI 54002
Lie. #248956 SE1/4,NW1/4,S23,T30N,R19W Bus.(715) 684-5680
Town of St. Joseph, St. Croix Co. Fax.(715) 684-3449
CSM, Lot 3
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your
use. The location of this test may or may not be as shown, as permanent lot lines were not established at
the time the soil test was conducted. Legend
1"=40'
lAl Benchmark Ele. 100.00_
mop of 3/4" pvc pipe
( • Alt Benchmark Ele. 100~t
Top of 3/4" pvc pipe
❑ = Borings
Boring Elevations
tr0-1" B 1 = 99.70Ft
B2 = 96.40Ft
B3 = 92.30Ft
B = 00.OOFt
PO O'l
~y. ~ 52 r
1 .7;,
73'
;2 y-0~' Sz'
'Z
. z
~ J 1'?t')1
C) m - fi
v
~ BEARINGS ARE REFERENCED TO THE
U NPLATTE_D_L_ANDS WEST UNE OF THE NWI /4 5 OF SECTION
it 23. ASSUMED TO BEAR SOO.53'1i"E
_ _ SOO' _ 53 _ '11 _ "E _ _ 2653.76'- _ - -
m ~ to
c" 0
N E C) WEST UNE OF THE NW1/4 nO n
c
$ X S00'53'11 "E 459.99' O Z D
326.88' - 866.89 z z
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S00'52 51 "E 553.76 \rip
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77T1988C=3'
873
VOL PAGE
RfiG O
IS F DfiEDS
ST. CROIR CO. MI
RfiCEIVfiD FOR RECORD
11/03/2004 01:30PM
Z g c APPROVED CERTIFIED SURVEY MAP
C > ST. CROIX COUNT`( REC FEE: 15.00
nd Parks COMM" COPY FEE : 4.00
+~j Planning 7-111`11
z NOV 4 3 2004 PAGES: 3
22 ;:q
O m if not recorded within 30 days of
approval dots ^ptpro~vtl l shall be
null BEARINGS ARE REFERENCED TO THE
LANDS WEST UNE OF THE NW1/4 OF SECTION
ZJNPLATTED
c 11 - - - - - - - - - - - - - - S 23, ASSUMED TO BEAR SOO'53'11'E
SOO'5X11'E 2653.76'
m 4: cyl r
n~~+ p WEST UNE OF THE NWt/4 m
SOO-53'11 "E 459.99' _
1326.x$' n 866.8$
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I r CA r ~O 10
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tp N ~
~rr . SHEET 1 OF 3 SHEETS
Vol 19 Page 4873
i loll i
0
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-2003
WARRANTY DEED Tx:4130540
979859
BETH PABST
THIS DEED, made between John Eiring a/k/a John E. Eiring and Donna J. REGISTER OF DEEDS
Eiring husband and wife("Grantor" whether one or more) conveys and warrants ST. CROIX CO., WI
to Oevering Homes, LLC, a Wisconsin limited liability company ("Grantee", 06/04j2013 4:33 PM
whether one or more), the following described real estate in St. Croix County, EXEMPT#: NA
State of Wisconsin:
REC FEE: 30.00
Lot 3 of Certified Survey Map filed November 3, 2004, in Vol. 19 of C.S.M., TRANS FEE: 120.00
pg. 4873, as Doc. No. 778886 located in part of Government Lot 5 of Section PAGES: 1
23, Township 30 North, Range 19 West, Town of St. Joseph, St. Croix
County, Wisconsin; including Lot 4 of Certified Survey Map recorded in Vol.
3, pg. 861.
RETURN TO
TOGETHER WITH a non-exclusive 66 foot road easement as shown on said St. Croix County Abstract & Title Co. Inc.
C.S.M. Doc. No. 778886 and further described in Vol. 1501 of Rec., pg. 578, as 219 S. Knowles Avenue
Doc. No. 621037. New Richmond, WI 54017
Tax Pa el 030-1057-60-150
This is is not omestead property
Exception to warranties: Municipal and zoning ordinances and agreements entered under them, recorded easements for the
distribution of utility and municipal services, recorded building and use restrictions and covenants, and further except 2013
real estate taxes.
Dated this 29th day of May, 2013.
/ h firing a/k/a hn E (E ring
onna J. Eiring~F_
AUTHENTICATION ACKNOWLEDGMENT
Signatures authenticated this day of STATE OF WISCONSIN
20
COUNTY OF ST CROIX ss.
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, Personally came before me this 29th day of May, 2013, the above
named John Eiring a/k/a John E. Eiring and Donna J. Eiring,
authorized by § 706.06, Wis. Stats.) husband and wife to me known to be the person(s) who executed
the f egoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY S'~b
-12t. tt/C D 1rLS ,
Robert L. Loberg /Loberg Law Office * v! _ ~ >r -,~ti~ y
Notary Public*. C~Vb_k _ County, Wis
1314665 / alm
a ~
My Commission is permanent. (If not, state expatton crate,'
(Signatures may be authenticated or acknowledged. Both are
not necessary.)
r~FormNoll 2003
WARRANTY DEED
1 of 1
Parcel 030-1057-60-150 06/07/2013 01:52 PM
PAGE 1 OF 1
Alt. Parcel 23.30.19.201 E-30 030 - TOWN OF SAINT JOSEPH
Current OX ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
11/03/2004 00 0
Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner
0 - EIRING, JOHN & DONNA J
JOHN & DONNA J EIRING
1477 N BAY RD
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 717 N BAY RD
SC 5432 SCH DIST OF SOMERSET
SP 8040 BASS LAKE REHAB DIST
SP 1700 WITC
Legal Description: Acres: 3.117 Plat: 4873-CSM 19-4873 030-2004
SEC 23 T30N R1 9W GL 5 LOT 4 OF CSM 3/861 Block/Condo Bldg: LOT 03
ALSO PT GL 5 NKA LOT 3 CSM 19-4873
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
23-30N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
11/03/2004 778886 19/4873 CSM
04/11/2000 621036 1501/576 WD
07/23/1997 712/524
2013 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/11/2011
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.120 44,500 0 44,500 NO
Totals for 2013:
General Property 3.120 44,500 0 44,500
Woodland 0.000 0 0
Totals for 2012:
General Property 3.120 44,500 0 44,500
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