HomeMy WebLinkAbout030-2141-00-027 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
563894 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Bird, Shaun R. I St. Joseph, Town of 030-2141-00-027
CST BM EL V, Insp.BM Elev: BM ascription: _ Section/Town/Range/Map No:
I /V I$Ojy V 36.30.19.2077
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic / �0 Benchmark f 3.V t)2, �r S
Dosing Alt. BM
Aeration Bldg.Sewer � &.p �6• /ls�
Holding St/hft fS4w
0 10
St/Ht Outlet
TANK SETBACK INFORMATION 7. I . 7-5- 35
TANK TO WE L BLDG. Vent to Air$ntakeROAD Dt Inlet
�—
Septic 2S r ' + f Dt Bottom
Dosing Y E eader/ an. y • ,1 9/l C
Aeration Dist. Pipe 7 Holding Bot.System 7S
Final G e .L � �S f)
PUMP/SIPHON INFORMATION A d
Manufacturer Demand St Cover 3 O�
GPM •2 • �
Model Number on, r' 'J,/
TDH Lift Friction Loss s TDH Ft 14,-� Q
Forcemain Lenrgth Dia. Dist.to 4 3�ro
SOIL ABSORPTION SYSTEM 1(p =3Z
BED/TRENCH Width L Length No.Of Trenches Z PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM CHING Manu tur [ �
INFORMATION Ty e Of System: w r C(AMBER Mode N I 4&jL (
2.9'1 s
DISTRIBUTION SYSTEM
Distribution W f x Hole Size x Hole Spacing en o Air Intake
Pipe(s)rt�r Dia"' Length Dia Spacing > Q
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 5- Bed/Trench Edges Topsoil 0 Yes � No ❑ Yes ® No
4 V
COMMENTS:- (Include code discrepencies,persons present,etc.) Inspection#1: / Inspection#2:
Location: 807 124th Ave. New Richmon_d,WWI ,5/4017(NE 1-/4�S-W 1/4 36 T30N R19W)GNNataalliie's Ridges Lot t227'" Parcel No: 36.30.19.2077Q,�
1.)Alt BM Description= f o- ` ' I' ftWVGO�- * &� 'd o_ " - —' A\A I je cawAe�
I
2.)Bldg sewer length= YQ -Ju4- yo 4 uys a� S44-U XWQhil.,--r•�tS `
amount of cover AzLe 4d
Plan revision Required? ❑ Yes 9� ryo �
Use other side for additional information. u /��]
SBD-6710(R.3/97) Date Insepctors S Cert.No.
PLOT PLAN
PROJECT Shaun Bird ADDRESS 1432 120th ST. New Richmond Wi 54017
NE 1/4 SW 1/4S 36 /T 30 N/R 19 W TOWN st. joseph COUNTY ST.CROIX
8/27/13 BEDROOM 3
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND SEPTIC TANK SIZE i
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION loo' Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 93.6/93.5 5' below qrade
All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40.
S M K Pro 3 Bedroom
A t3
E � � House
30'
� 203'
4 q0
(� -1 24, B.M.*
2% Slo e
99' B-2 14'
109'
33' 40
2-3' X 66' Cells with>�'tspacing 62,
B-3
98'
Vent f k( 4,0,
Quick4 Standard 5�(S
of Cover Leaching Chamber
with 20.0 ft2 of Area 105'
Scale is 1" = 40' 12„ 5.6ft^2/pair of end caps
unless otherwise 34"
4' Long Grade at System Elevation
noted
2
;~"',r County ` ~J / - - - -
a w`., t c 7` _
k"'s Industry Services Division
1400 E Washington Ave Sanitary Permit Number (to be filled in by Co.)
P.O. Box 7162 /
Madison, Wl 53707-7962
f - -
5tate'T'ransactic'rl_N Ef~~t itary Permit Appl ication In accord it S 38 (2), Wis. Adm. Code, submission of this form to the appioprialt rimental unit
is requ' p o ob • ing a sanitary permit. Note: Application forms for state-owned POW"I' ratted to Project Address if dan] mailing address)
the D nt o - fety and Professional Servies. Personal information you provide 1118 be used dary rJj l
ur se. cc rdance with the Privacy Law, s. 15.040 )(m), Stats. - ~6~,,~ ~`vf n 11'~
1. Application Information Please Print All Information 0 1--__-_.----
Property Owner's NDTnii, - - ST- Parcel 4
1
--li. 111 Pperty Lo ca ti o r`
-
Property Owner's Mailing Address tiry ro (,2-977)
~L Govt. Lot.------
-
City, State Zip Code Plione Number ii ,S 1,111, Section
11. Type of Building (check all that apply) Lot B
Subdivision Name
FamilyDweling - NumberNumbei,;~f Bedrooms
Block #
oK
❑ Public/Commercial - Descri Use ❑ City of-__
CSM Ntnnber ❑ illage of
❑ State Owned -Describe Use
111. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. ew Sys[ern ❑ Replacement System C) Treatment/Eloiding Tank Replacement Only ❑ Other Modification to Existing System (explain)
- - {..ist Previous Permit Number and Date Issued _
B. ❑ Permit Renewal E-I Permit Revision ❑ Change oI Plumber 0 Permil'Fransfer to New
Before Expiration Owner - -
- -
IV. T ve of POWT'S System/Component/Device: (Check all that uLply) _
n-Pressurized In-Ground ❑ Pressurized In-Ground ,At-~G'ra-d\e ❑ ound > 4 to afaf'suitablusoil nd 24 in. o sua61e syil
❑ Holding'I'ank U Other Dispersal Component (explair GV~~/YV L r lr°a meat etr ain)
V. Dis rersal/`treatment Area Information;
D t i Flow (gpd) Design Soil Application Rate(gpdsf) Dispers I Area Required (sl) Dispersal Area Proposed (sl) System Elevation
V1. Tank Info Capacity m Total got, Manufacturer
Gallons Gallons Units H u
New Ttmks Existing TEUtks o ° b
,E, U n n C7 c
SepticorHnldingTank
Dosing Chamber
V11. Responsibility Statement- 1, the undersigned, assume r sibility for installation of the PO\VTS shown oil the attached plans.
Plum is ame (Print) Plumber's S' ire LN4RS Nuntber Business Phone Number
PState, Gip Code
'1x111. aunt /Dc artment Ilse Only
Penrtit Fee Date 'sued I rag go t Sigm are
Approved ❑ Disapproved
ef-
7 5 . - 3 u---
Owner Given Reason for Dental
IX. ft0 Mlb%A~ oval/Reasons for Disapproval
1. Septic tank, effluent filter and
dispersal cell must be serviced / maintained MA
as per management plan provided by plumber.
2. All setback requirements must be maintained
ions for the system and submit to rite County illy on paper not less than s 12 x I I inches in size
lie 11 11, 1,
SBD-6398 (8031: )
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 8/28/13
Owner:Shaun Bird
Location: NE1/4 SW1/4 S36 T30 N,R19W Lot 27 Natalies Ridge 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 eet
8.-10. Soil Test
Signature
License number #2 900
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 96.0'
Vent Grade Vent
3' 4" 3'
,A~30/34 :SSep:tficTank 5'
Long 1 S' Long 1 36" Grade at System Elevation Grade at System Elevation
Spacing 5'
2-3' X 66' Cells
Same on other end Observation tubeNent
At end of cell
A
B
16 chambers per cell
System elevations:
A-93.6'
B 93.5'
~3
PLOT PLAN
PROJECT Shaun Bird ADDRESS 1432 120th ST. New Richmond Wi 54017
NE 1/4 SW 1/4S 36 /T 30 N/R 19 W TOWN st. joseph COUNTY ST. CROIX
8/27/13 BEDROOM 3
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND SEPTIC TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 93.6/93.5 5' below qrade
All piping shall be SDR 30/34, within 10'
of tank, piping shall be Schedule 40.
/~l Pro 3 Bedroom
S House
l
30'
203'
40'
B-1, B.M.*
24'
2% Slo e
99' B-2 Vents 109' 14'
33'
2-3' X 66' Cells with >3' spacing
62'
98' Vent B-3
>6„ Quick4 Standard
Leaching Chamber
of Cover with 20.0 ft2 of Area 105'
Scale is 1" = 40' 5.6ft^2/pair of end caps
4' Long 12"
unless otherwise 3 4„ Grade at System Elevation
noted
2
PG'WTS OWNER'S MANUAL & MANAGEMENT PLAIN Page, _'1 - of
r=IL.E INFORMATION SYSTEM SPECIFICATIONS
Owner t Septic Tank Capacity cal t I NA
Permit # Septic 'T'ar k MancrfaCtul er NA
DESIGN PARAiMETIERS Effluent Filter Manufacturer ~ 7 C.I WA
- _
'Number of Bedrooms 0 NA Effluent Filter Model L J NA
- _
Nurnber of Public Facility Units NA f'nrnp Tan c Capacity I NA
Estimated flow (average) Purnp `I"an ( Nlanufac,tuvo- 7 NA
_.__..._~Z- real/day
- - -
Design flow (peak)(Estimated x 1.5) ~j~ al/da Purnp Mar lltactLIUM J NA
Soil Application mate / 7 al/da /ftr Pump Mo( el J NA
- - -
Standard - -
Iniluent/Effltlent (Alality Monthly average* Pretreatmtrnt Unit 1 NA
Fairs, Oil & Grease (FOG) 530 mg/L. LJ Sand/G) -avel Filter f.J feat Filter
Biochemical Oxygen Demand (Bolls) !~220 nrg/L 0 NA lJ Mechar, ical Aeration V.1 Wetland
"t"otal Siasper►ded Solids (TSS) .<_15q rrlg/L EI Disinfec tion I_] Other:
Pretreated I-Ifluent Quality Monthly average Di - sal ;efts) 111 NA
Biochemical Oxygen Dernand (BON) !'30 mg/t_ round (gravity) it In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg/L I I At-Graua IJ Mound
Fecal Conform (geornetr'ic mean) 5'10° cfu1100n1CJ Drip-Lima H Other:
Maximum Effluent Particle Size in dia, ❑ NA Othe`. Ll NA
Other: H NA Other' V J NA
'Values typir;a1 for doinestic wastewater and septic tank effluent. Other. f`1 NA
MAINTENANCE SCHEDULE
Service Event &rvice FrequetiGy
Inspect condition oi` tank(s) At least once every 1. morith s) ~ (Maxlmunr 3 yeas) F] NA
Pump out contents of tank(s) When combined sludge arid scum equals one-third ('f,) of tank volume C_I NA
Inspect dispersal cell(s) At least once every Cl 11011th s) (Maximum 3 years) I_t NA
_ ear(s
nronthis)
(Mean effluent filter At least once every /~Ly l NA
__--'eat Inspect purnp, pump controls & alarm At least once every: D months s) -1 NA
CI years;
Flush laterals and pressure test At least once every: CI monthi s) I NA
C._l year(s)
Other. At least once every: El rrtanthl s} 1.1 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; POWI-S Inspector; POWTS Maintainer; aeptage Servicing Operator. -rank inspections roust
include a visual inspection of the tank(s) to identify any missing or broken hardware, dentify any cracks or leaks, measure the V011111-le Of
combined sludge and scum and to check for any back up or ponding of effluent or the ground surface. The dispersal call(s) sliall be
visually inspected to cheek the effluent levels in the observation pipes and to checl: for any ponding of effluent on the ground surface.
]'he ponding of effluent on the ground surface may indicate a failing condition and requires th immediate notification of the local
regulatory authority.
When the combined accrrrnulatiOri of sludge and scum in any tank equals one-third ( fi) 0r more at tl ie tank volume, the entire contents of
the tank shall be removed by a Septage Servicing Operator arid disposed of in accordanc, with chapter NU 113, Wisconsin
Administrative Code.
All other services, including but not limited to the servicing of effluent biters, rnechar- ical or pressUPted components, pretreatment units,
and any servicing at intervals of 5'12 months, shall be perfortned by a certified 1'0WT"1; Maintainer.
A service report shall be provided to the local regulatory authority within 10 clays of completion of arp, service event
.
Page,__
START UP AND OPERATION
1=far new construction, prior to use of the POW1 S' check treatment tank(s) for the presence of panting products or other chemicals that
may impede the treatment process and/or darr age 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 oecc.tr when soil conditions are frozen at the infiltrative surface.
f)ilring power outages pump tanks may fill al:rnve normal highwater levels- When power is restored the excess wastewater will he
discharged to the dispersal cell(,;) in one large hose, overloading the cell(s) and may result in the backup or surface discharge of effluent.
"l-u avoid this situation have the contents of thO plump tank removed by a Septage Servicing Orwrator prior to restoring power to the
affluent pump or contact a Plumber or PONNT'", Maintainer to assist in manually operating the f"ump controls to restore normal levels
within the pump tank.
I]o not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb of compact, the area within
15 feet down slope of any mound or at-grade sail absorption area.
Reductinn or elimination of the following from the wastewater stream may improve the performance and prolong the life of the MOTS:
antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain
(sump ful mp) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scrape ; medications; oil; painting products;
pesticides; sanitary napkins; tampons; and wat(-r softener brine.
ABANDONMENT
inRaen the POWTS fails and/nr is permanently taken out of service the following steps shall be takran to insure that the system is properly
and safely abandoned in camplianre with chapter Cnairn 83,33, Wisconsin Administrative Code:
a All piping to tanks and pits shall he 0!1connectod and the abandoned pipe openings seale-.t.
A The contents of all tanks and pits shall be removed and properly disposed of by a Septagre Servicing Operator.
0 After pumpUlg, all tanks and pits shall be. excavated and removed or lheir covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN
It the i'OWTS faits and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replar..ement system:
!-writable 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 shot old not be infringed upon by required
setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in tlae need
for a new soil and site evaluation to castablish a suitable replacement area. Replacement systems must comply with the naves ill
effect al that time,
l.t A sellable replacninent area is not available due, to setback and/or soil limitations. Barrirxl advances in POWTS technology a
holding tank may he installed as a iast resnrt to replace the failed F-'OWFS.
The site has not laeen evaluated to identify a suitabie replacement area. Upon failure of the POINTS a soil and site evaluation
"rust be performed to locate a suitabie replacement area. If no replacement area is available a holding tank may be installed as
a last resort to replace: the failed poC ,V,FS.
l Vi Mound and at-grade ',Oil absorption syster1S ITlay be reconstn.lcted in place following removal of the hiomat at the infiltrative
surface. Reronstructions of such sy sterns must comply with the rules in effect at that time..
^-<:UVARNING7
5F,PTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN L.ETItot GASSES ANrrfOlt INSUFFICIENT OXYGEN. AU NOT
INTER A Si~PTI(' , PUMP OR OTHER TREA'TIVIEN'T TANK UNDER ANY CIRCUMSTANCES. lal`:'ATFI MAY RESULT. RESCUE OF A
I-I RSON 17ROM'I-jjF INTERIOR OF A TAW 14AY (3F II)IEPICUL,-1" OR IMPOSSiRL,I~,
AI DITIONAI_ COMMENTS - - POW TS' IN$TAL.lt^ER POVNTS MAINTAINER
Name
Nacrn0
Phanc J 6-f~ Phone
SUPT'AOE SERVI "INC; 0PERAT0RPUMPFIf LOCAL REGULATORY AUTHORrry
NameUr^- flame
>~hr~ne 2-1
f' hone
This document was drafted in r:rnnpli:araoa with chapter SP 8 38' 3.22(2)(b)(1)(d)&(f) and 383. 64(l), (2) lt, (3), Illfiscortsin Administrative Code.
ST. CROIX COUNTY v
SEPTIC TANK MAIMrENANCE AGREEMV NT
AND
j OWNERST11P CERTIFICATION FORM
Ownerftyer
Mauling Address Z-
Property Address XOT
(V`erifioat on required fro,ii
g n>; Department f r wnr wn c_onstruction. -
)
City/State "
-k-~~~y " W- Parcel Identification Nwrriber _,,~j?
property Locaaozl . y4,
Sec. , rr t~N' R W, ToWii of SI-1• V (~.S
Subdivision
- ~ Lot # C2
Certified Survey Map #
Volume
/ Page #
Warranty Deed # _
_ -___y Volume
Page #
Spec hour Yes no
Lot lines identiftabl y na
SYSTEM MAINTENA ICE AN OWN R CERTIFICATION
I. Improper use and man t"nauce of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists ofpumping out the septic tank every duce years or sooner, if needed, by a li,ensed pumper. What you put into
the system can affect the fauactiun of the septic rank as a treatment stage in the waste disposal s tF~rn. Owner maintenance
responsibilities am specified in §Corm. 93.52(]) and in Chapter 12 .-St. Croix Co
ur y Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification to
owner and by a mastar plumber, journeyman, plumber, restricted plumber or a licensed rm, signed by the
pumper verifying that (1) the on.-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessar
i less than 1/3 full of sludge. y), the septic tank is
t/we, the undersigned have read the above requirements and agree to maintain the private aewa e
standards set forth, herein, as set by the Department of Co g disposal system with the
' Certification stab that mrr~rce and the Department of Natural R~nsntu~ces, Starts of Wisconsin.
ng 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.
Itwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
i property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedroom
A , OF APPLXCANT(S) ATF
.I~ATF,
"**Any ndormation that is misrepresented may result in the sanitary permit being revoked by the Planning & Earring De
Partment.
kl.nclude with this application a recorded warranty deed from the Register of Deeds Office and a copy Df the certified survey map if
ireference is made in the warranty deed.
.1':xV. 08/05)
I
9
01 A /
2.17 913.3
( C.)
L.B.0 916.5/
91~rk'
g b LOT 2(
3.000 AC
~ 914.6 x
/ (2.74 AC.'
/ x L.B.O.= 915.:
loll,
/ X 914.5 g\ /
LO 27
3.00
(1.45 AC.) i'
913,5
L.B.O.= 915.5
• 91 .4 /
913.4 /
L T28 0\01 -
.006 AC. 3 .08 AC.) x 910.8 '
L. .0.a 915.5 H.W.L.= 913.5
/01•
7 908.8
~ ,OO
x i
909 /
X
/ 907.2
D /
_ 14 RR9.~ X
f'~ prey. ~i~
LTER CARTRIDGE INSTRUCTION''s
w'r ew x Cloy pt the Filtllr cawvr ar►ttt the Willi of 1:1u uUthkt
taitteratd under give 4w%: W& q wlefVq, if Vert, than rdtlnir ihtiellt hlulu ~►!►Yrl dkrtu tires
tank firrouyli the uuttiet or eolveat LYeld (t~lee) a+ddfiltdrat I+Iplo Off uutto
Cher
pipe_
a Wfhik floc came Is $011 dry fittlid Of ON nttdet fde,er, tuuasurv tiv+r fteivydt
of 414•-inet► pipe vowded to brar:c, it1to filtlur to tint petit mod well if UCllfeirlo the
mptiulval eiuppllUnrelntat edtle suPoort. If side support+rlathud Ire rlut utilf4w,
protVfld t* Soil fear
s r V P For irvstallatkrrur Uti ixir+li the uptiuMt fullplill frresib i) side enppert tz-
soluerrt imalif Now A-4helt efipa ard:a the filar rage. If We support MethetJ 4i ivot
ud 1he(w, i,rofted to stele hwi: 3
solvent weid the fllte:f' aria at tv the otltlel: oilm.. ftvu rt the lilts+' :a';i
cartrldyv into tile: Chase, orewslriel dumini untif the tikee lacks Into the bettt.iti of ~5 r
tttu crrtu_ ,
if a VAS Switch is Utilrnwd: insert later the filtecr mod lock try tUroirlfi
dockwifte WP, ft "r' t.
it • I'A J "
mantanance
t. *I'll e efffuesit filter rih.iuld be cfowmid every Usno tiro a ai/tIc terik I;;
serviaeel.
2. 013,etr the uUU%t• rrexosta erirs•natu to Inspect the tbhk. +lrld NItUr, `
lsuntp thiY +waptlc tairk corrrq -Awly, rnakirlli 5f Am to relfnUUe tho sludyya
ieyur' 04 the hetitsrvt Of thw t lr+k :trod rnlt jUdr the Srtnn atilt ~efllumnt', ;.q
4. once glrt arrlumnt h.ver fins Ewan Ip"ared below tht: invert ref the ~
outlet pipe, firmly pull up or, the filter hundttr to diafodya the i
ctvrCtWyu horn thb c060.
5. Slide the rartridW up and etu of thin Carer f=elt daU0111g.
lF. iY a VHS swftch write m.ted to are alsrt" 15 lrrRsefit, the sWi&Ii
sfreuld be removed by twrrrlratp t=oureterdo kwiss 90, and demand
with water only.
.j. While 110141riy the Corte'idge ors tt,s tddu (ladle Nat slirfmce (art;hiu 'u a` Cw'..•
down) over the 4:tfser apeanelpr 01e611 Off pie rlii:rldNa tgitlt wirkof dy.
only, ov,akirey aura all sefvtaga iraa erfal ie rllrsed back, Intrl the tank-
8, if VKb switch is utilfxed, repute by Iimerthits into titter arld
turr++ittg dtlekwiiee errf°. t.
9. llrselt thve Niter cartridifer brick itato the car*, prel mAig down' Inall + °
tine filter lucks Intty tkru brrROM of the 11440. ik
i0.itepiatei and secure the ac:t,eh i tliftihillij oil the Wilt.
E tr• •=g:.r. li `YS ; A q%.'.040 - t, t 14r 1 1t~iC' i.l`. '••V:+J!dla ~l"
w1N►"NKYtt"ttll5~~fC>CirNllt~~Mil~,i
r~
1344
Wisconsin Department of C rce 2005
]wl L EVALUATION REPORT
0~ Page I of 3
Division of Safety and Buildin ip "Comm 85, Wis. Adm. Code Tom Schmitt
Attach complete site pla on paper (iel3siGhSa~E~I~ ~r*1 r_. County
S' P tr4 \ St. Croix
include, but not limited to. re erence point (BM), na~nnd 1 r?
percent slope, scale or dimensions, north arrow, and location and distance o rldaresad. Parcel I. D.
Please print all information. 7
Revi By Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 5 717145
Property Owner Property Location Grand Properties, LP Govt. Lot NE 1/4 S 1/4 S 36 T 30 NR 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
712 Rivard Streeet, Suite 300 27 Natalie's Ridge
City State Zip Code Phone Number City Village ✓ Town Nearest Road /
~ 2J
Somerset WI 54025 715-247-5900 St.Joseph C.tH l I
✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement Public or commercial - Describe:
Parent material Outwash (stream terrace) Flood plain elevation, if applicable na
General comments
and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft rate. Possible system elevation for Area 1 is
95.20'. Slope is 2%.
Boring # Boring
✓ Pit Ground Surface elev. 98.65 ft. Depth to limiting factor 115+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
'Eff#1 'Eff#2
1 0-13 1Oyr3/2 none I 2fsbk mvfr as 1vf .6 .8
2 13-17 1Oyr4/4 none scl 3msbk mfr 9`N 1vf .4 .6
3 17-31 1Oyr5/4 none vgrlcos Osg ml 9w .7 1.6
4 31-87 1Oyr5/6 none vgrcos Osg ml cs 7 1.6
5 87-115 1Oyr6/4 none grcos Osg ml .7 1.6
Boring # Boring
✓ Pit Ground Surface elev. 98.65 ft. Depth to limiting factor 110+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
'Eff#1 'Eff#2
1 0-12 1Oyr3/2 none I 2fsbk mfr as 2vf .6 .8
2 12-24 1Oyr4/3 none scl 2msbk mfr cs 1Vf .4 .6
3 24-35 1 Oyr4/4 none vgrlcos 1 csbk mvfr cs .7 1.6
4 35-78 1Oyr5/6 none grcos Osg ml cs .7 1.6
5 78-110 1Oyr6/4 none grs Osg ml .7 1.6
r
n
1
* Effluent #1 = BOD s> 30 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD S.30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmitt 227429
Address Tom Schmitt Date Evaluation Conducted Telephone Number
1595 72nd St., New Richmond, WI 54017 4/21/05 715-247-2941
V,
Property Owner Grand Properties, LP Parcel ID # Page 2 of 3
3 ] Boring # Boring
V Pit Ground Surface elev. 97.99 ft. Depth to limiting factor 105+ in. Soil Application Rate
F
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots '
*Eff#1 *Eff#2
1 0-10 1Oyr3/3 none I 2msbk mfr as 1vf .6 .8
2 10-24 1Oyr4/4 none sl 2msbk mfr 9W 1vf .6 1.0
3 24-34 10yr416 none Is 1 csbk mfr 9W .7 1.6
4 34-51 1Oyr5/4 none vgrcos Osg ml cs .7 1.6
5 51-105 1Oyr5/6 none grcos Osg ml .7 1.6
rl
Boring # Boring
Pit G Surface elev. Depth to limiting factor
ft. in.
and
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
*Eff#1 *Eff#2
❑ 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
*Eff#1 *Eff#2
* 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
Conducted by: Conducted For:
' Schmitt Soil Testing, Inc. Name: Grand Properties, LP
Thomas J. Schmitt, CST 227429 Address: 712 Rivard Street
1595 72nd St. City, State, Zip: Somerset, WI. 54025
New Richmond, Wl. 54017
Phone: 715-247-2941 Subd.Name: Natalies Ridge
_ Lot No.. 1?7_
f' =fir Legal Description: /YA: l/45al/4 S36 T30N RI 9W
Township of St. Joseph, St Coix County
® Soil Boring
A Bench Mark El. 100.00' Tap of 2" pvc pipe
Q Alternate Bench Mark El. F. (~U Top of/ °'r.S"ler/ A i< corder pl
Slope=_,a?Z_ Contour Line EL #04
* P 0)
Scale 1" = 40'
n 4\
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CA
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C
This soil report was done to fulfill a zoning requirement. It may or may not be in a location suitable for your use.
8 11 2 2.9 3' ,
Tx : 4089263
STATE BAR OF WISCONSIN FORM 3 - 2000 969022
Document Number QUIT CLAIM DEED BETH PABST
REGISTER OF DEEDS
THIS DEED, made between Citizens State Bank, a Wisconsin banking ST. CROIX CO., WI
corporation, Grantor, and Shawn Bird, a single person, Grantee. 12/07/2012 1:23 PM
Grantor quit claims to Grantee the following described real estate in St. EXEMPT#: NA
Croix County, State of Wisconsin (the "Property"): REC FEE: 30.00
Lots 4, 5, 6, 11, 13, 20, 21, 26, and 27 Natalie's, Ridge, St. Croix County, TRANS FEE: 764.10
PAGES: 2
Wisconsin.
Lots are sold `as is' with all faults.
Recording Area
Name and Return Address:
'title One Premier Group
706 19th St S
Hudson. WI 54016 # 18811
Together with all appurtenant rights, title and interests. see attached
Parcel Identification Number (PIN)
This is not homestead property.
Dated this 7th day of December, 2012.
Citi n tate Bank
* Gene Haberman, Vice Chairman
* *
AUTHENTICATION ACKNOWLEDGMENT
STATE OF WISCONSIN )
Signature(s) ST CROIX COUNTY. ) ss.
authenticated this 7th day of December, 2012 Personally came before me this 7th day of December,
2012 the above named Citizens State Bank by Gene Habetma,
* Vice Chairman to me known to be the person(s) who executed
TITLE: MEMBER STATE BAR OF WISCONSIN the foregoing instrument and acknowledged the same.
(If not,
authorized by § 706.06, Wis. Stats.)
*Jay field
THIS INSTRUMENT WAS DRAFTED BY N lic, State of Wisconsin
My, cis permanent. (If not, state expiration date:
8/7/2016 )
Michael H Forecki, Attorney
(Signatures may be authenticated or acknowledged. Both are not necessary.)
*Names of persons signing in any capacity must be typed or printed below their s- re. PFNPIE:_I)
..Jotary Pub is
E i;tath of W isc n
1 of 2 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No. 3-2000
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Parcel 030-2141-00-027 08/28/2013 04:32 PM
PAGE 1 OF 1
Alt. Parcel M 36.30.19.2077 030 - TOWN OF SAINT JOSEPH
Current ❑X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
07/08/2005 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
0 - BIRD, SHAWN
SHAWN BIRD
1432 120TH ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 807 124TH AVE
SC 2611 SCH DIST OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.002 Plat: 10-065-NATALIES RIDGE LOTS 1/32 030-05
SEC 36 T30N R1 9W PT NW SW NATALIE'S Block/Condo Bldg: LOT 027
RIDGE LOT 27
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
36-30N-19W NW SW
Notes: Parcel History:
Date Doc # Vol/Page Type
12/07/2012 969022 QC
08/24/2011 940558 WD
02/12/2010 911845 QC
02/12/2010 911844 QC
more...
2013 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 05/11/2011
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.002 34,000 0 34,000 NO
Totals for 2013:
General Property 3.002 34,000 0 34,000
Woodland 0.000 0 0
Totals for 2012:
General Property 3.002 34,000 0 34,000
Woodland 0.000 0 0
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