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HomeMy WebLinkAbout020-1378-06-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: ® 420313 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)]. Pennit Holder's Name: City Village X Township Parcel Tax No: Ranallo, Frank Hudson Township 020- 1378 -06 -000 CST BM Elev: Insp. BM Elev: BM Description: -&_J TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic J ® Benchm rk Dosing Alt. BM -1Pcet gw r• 3 oa. Aeration BTdg. Sewer 3.25 Holding St/Ht Inlet TANK SETBACK INFORMATION SUHt Outlet qq 0 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet b? Septic > /J— /� Dt Bottom J_ Dosing �OD/ Header /Man. p Aeration // Dist. Pipe Holding ?' d Bot. System �,��� PUMP /SIPHON INFORMATION Final Grade /� Manufacturer emand St Cover G 4oZ o3.G Model Numb TDH Lift Frictio ss System Head TDH Ft Force main th Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Len th No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 (/ SETBACK SYSTEM TO 7 P/L BLDG WELL / T EAM LEACHING anufacturec INFORMATION CHAMBER OR Ty Of System: j ��, �� UNII Model Number: DISTRIBUTI SYSTEM On Header /Manifold Distribution x Hole Size ix Hole Spac! IVent to Air Intake L ength Dia L ngth / Dia ' Sp ( >27 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only '7 Depth Over Depth Over xx Depth of j xx Seeded/Sodded j xx Mulched Bed/Trench Center / Bed/Trench Edges Topsoil ❑Yes ❑ No ❑=[KN, COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: �/ Inspection #2: Location: 1034 Moonbeam sad Hudson, WI 5401��' 6 (SW 1/4 SE 114 12 T29N R19 ) Moonb age Lot 6 Parcel No: 12.29.19.2345 1.) Alt BM Description / P 0 �Nw = 'r'��--�� i,&j 2.) Bldg sewer length= `7 i - amount of cover aZ 03 Plan revision Required? Yes ❑ No Use other side for additional information. D 1Q SBD -6710 (R.3/97) ate Insepctor's 'gnature Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division I . INSPECTION REPORT Sanitary Permit No: 420313 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: Ranallo, Frank I Hudson Township 020 - 1378 -06 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I j Benchm rk ,6m*',/ / Dosing /j ✓ cr+ Alt. BM 1'1( l �I -4 d I . Aeration V B 9. Sewer 3. ZS job � Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet S qq TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 0? Septic , / � � i - 7 Dt Bottom � � / Dosing Header /Man. x(00 /P Aeration Dist. Pipe Z D q d Holding Bot. ystem / q( Final Grade PUMP /SIPHON INFORMATION v Manufacturer errand St Cover G / 1 o3,0 y Model Numb TDH Lift Frictio ss System Head TDH Ft Forcemain th Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width I Len th / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 'f U SETBACK SYSTEM TO ! P/L&ABLDG IWELL L / T EAM LEACHING anufactur INFORMATION Typ Of System: CHAMBER OR n , UNIT Model Number: DISTRIBUTIO SYSTEM -75-/ ,(4 Y VYihf O'r% Header /Manifold Distribution x Hole Size x Hole Spacin Vent to Air Intake 3 Pipe(s) 1 �� f � r Lengt Dia _ Length Di- L1, r ng ! SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only P© rZX '7S Depth Over T Over xx Depth of xx Seeded /Sodded xx Mulched �7- Bed/Trench Center q rench Edges Topsoil 4�/ Yes [N No ❑ Yes ® N o COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: qe 0 Inspection #2: / / Location: 1034 Moonbeam ad Hudson, WI 54016 1/4 SE 1/4 12 T29N R19/YV) Moonb a ge Lot 6 Parcel No: 12.29.19.2345 1.) Alt BM Description - Top OT i�t. 1 � �J� `"c llw jo 9f p� 7v?tJ 2.) Bldg sewer length = t - 7 107 �, - amount of cover = AXE Li Z 133 Plan revision Required? les [J No Use other side for additional information. SBD -6710 (R.3/97) ate Insepctor's Signature Cart. No. PLOT PLAN PROJECT Frank Ranallo A D ESS P.O. Box 131883 St. Paul Mn 55113 SW 1/4 SE 1 /4S 12 /T 29 N 1 W TOWN Hudson COUNTY ST. CROIX 8/14/02 BEDROOM 4 MPRS Shaun Bird 226900 - DATE CONVENTIONAL XXX IN -GR N RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 12 50 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE •7 ABSORPTION AREA 902 # of chambers 30 , BENCHMARK V.R.P. Top of 1.5" Pipe ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE 0 WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 95.3 Property Line Vent >6 » Standard Infiltrator Plans Designed Using of Cover Leaching Chamber Conventional Powts with 31.1 ft2 of Area Manual Version 2.0 6' Long 12" 34" Grade at System Elevation 125' 0 2 -3' X 88' Cells with >3' spacing 0 0 0 0 B.M. #2 35' B -5 70' B -2 25' Vents Vents .. 20' a B -3 10' �. 20 M.#1 B -4 B-1 8 Pro 4 Bedroom /2 " 41, 4e io �. r� Z2"� _ _ 3a i R 1 r y ela I I A V 1 / O lt { c X E �v ys 3 z e w -d L— DIrOJ S Safety and Buildings Division County 201 W. Washington Ave., Boa 7162 1 �Sconsin Site Address 2 Department of Commerce " T¢.f ! S� (Y6v 1 Or 1 Sanitary Pe �ca�i" < -�0 3 in accord with Comm 83.21, Wis. Adm. Code, tors• you Proms ❑ Check if Revision may be used for secondary purposes Privacy Law. si5. 1 m L Application Information - Please Print All Information State Plan I.D. Number Property Owner's Name Parcel Number ,j Ft-12 Property owner's Address Property Location 1,3 1 6 � 3 , �� 14. S �7 N. City. State Zip Cod -- N I at 19rtmber Black umber � Subdivision Name CSM Number SIL 0 dl �� 4 24 II. Type of D di�(c6eck� that ap ,qt �piy� l p1X G � 1G � ❑village ❑ Public/Commercial - Describe Use 7 Nearest Road ❑ State owned C 3 % k 93 - I - S .- 1 41( CALS III. Typegf Permit: (Check only one boa on line A (numbering scheme for internal use). Complete line B if applicable) A For County use 2 ❑ Replacement System 3 ❑ Replax� of 6 ❑ Addition m Tank stem Dam Isst Check if Sanitary Permit Previously Issued Permit Nnru ` r y 5 FOPZ= rized of Permit: (Check all that apply)(numbering scheme is for internal me) G / - (�00 . urized In -Ground 210 Mound 49 ❑ Sand Filter 50 ❑ Constructed Wetland In -Ground 41 ❑ H olding Tank 48 ❑ Single Pass 51 ❑ Drip Lane 45 ❑ At -Grade 46 ❑ Aerobic Treatmen I Unit 49 ❑ Recirculating 30 Q Other V. t Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soul Application Percolation Rate System vation Final Grade Required Proposed Rate(GaisJDays/Sq.PQ (Min./luch) Elevation 7-2 1K, ':� VI. Tanis Info Capaci4Y in total Number Mamnfacwrer Prefab Site Steel Fibres Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanka Tanta Septic or Holding TW* _ Dosing Owntxr VII. Responsibility Stat em - I, the responsibility far installation of the POWTS shown en the attached places. �ame (Perot) Flambe s M� �Ncttr�bec 13 P hone -2 Z( ✓ 'S Address (Sweet, C*, state , z 2 VIII. 1De ent u se Only � Approved ❑Disapproved ouy Permit Fee (includes Groundwater Date Issued Agent Signature (No Stamps) Fee) ❑ Owner Given Initial Adverse ( �� Determination I%. Conditions of Approval/Reasons for Disapproval ` "AOV� O il - Oct., 4o JA oemptAe plans 0o the Caunq saW for the systems as paper ant has than SW x 11 torches in size PLOT P PROJECT Frank Ranallo ADD s P.O. Box 131883 St. Paul Mn 55113 SW 1/4 SE 1 /4S 12 /T 29 N/R 1 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8 BEDROOM 4 CONVENTIONAL )00( IN- GROUND SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 933 # of chambers 30 IL BENCHMARK V.R.P. Top of 1.5" Pipe , ::7- ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL +H. R. P. Same as Benchmark SYSTEM ELEVATION 95.3 Uh ` Property Line Vent >6" Standard Infiltrator Plans Designed Using of Cover Leaching Chamber Conventional Powts with 31.1 ft2 of Area Manual Version 2.0 6' Long 12" 34" Grade at System Elevation 125' 322 Pro 4 vZ Bedroom `� °o B.M. #2 House IF 35' B- 1 70' .$;2 20' � B -3 � 30' , 35 20 .c21s� •� Vents T Vents M.# B -4 B -1 2 -3' X 94' Cells with >3' spacing PLOT P PROJECT Frank Ranallo ADD s P.O. Box 131883 St. Paul Mn 55113 SW 1/4 SE 1 /4S 12 /T 29 N/R 1 W TOWN Hudson COUNTY ST. CROIX MPR haun Bird 226900 DATE 8 BEDROOM 4 CONVENTIONAL XXX IN- GROUND SSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 933 # of chambers 30 BENCHMARK V.R.P. Top of 1.5 P ipe _ ( CFO ASSUME ELEVATION 100° Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 95.3 lM ` Property Line Vent >6 „ Standard Infiltrator Plans Designed Using of Cover Leaching Chamber Conventional Powts with 31.1 ft2 of Area Manual Version 2.0 6' Long 12" Grade at System Elevation 34" 125' 0 Pro 4 Bedroom o B.M. #2 House ° 35' B- 70' 25' 20' B -3 30' a 35 Vents 20 T Vents ° Ut M. #1 � f25 2 -3' X 94' Cells with >3' spacing ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FOP.1M Owner/Buyer c :Mailing Address �• .�.� • ���LC �� D� (�� - N� � !I ,�, Prepe: ty Address 'Jerificstion acquired from Planning Ue-art: ,grit for new con:truc -ion) City /State Parr-c! ?dealt;: c:.;:eu :Iutnbcr LEGAL DE -2,C1 IP Prcper7/ Lxa tict - , /O ;.,- _ ) : , f Lot t r Z /amim -tr Dee: r , SFY LL m':AL�, L A NC u JS�"•TDPC::.y =3IId ^33L1 teII.'1I:C_�L ,cu.: :C�t:C ..,._..�tilQ:L :J :..'. �rG"::C'..`: :1:1: - ='C ..,......� ��•�.. :C.:.1 :uC�: ."L31II(L :.:y .� tarsi=- of pupping out the septic to ik ever- ,hz= years sccner, f '� '�v a i =era -t z� -:. '4 aat you pu: zta J.1 e :-:i` :.. =a lffc'' fimcdca of the septic =1k SS a 7ez ent W ge in '..o- w=w di x=1 � The property owner aErecs :a su=m to St. cmiz =cring c.-t',i:ica ion fotn, :ignc owtsc and by i xs.L'rpitut��, Jt oy"..snPhmtber.: t± ctcc Pltt�.bc- or a .Kaase3 pure: -e= fyiaa, tL (1) the cn -site rnstcwate: is[:esal.ysteW in ?=per cpem :g cxdition sncloc (2) aCe: iaoMctinn and pt= ing (if accz—r a-; ), :ac it s C Stie tack les-. tb= 4 1,127 fall cf sludge. v/wc, the =d=ir..cd :save =d, the above 'vad zg ve to =iatain Ic private ac -p di sy step with the sta.ndar's set torts. herein, u set by the Legs. - rt of Cam=err: u d the D, =cat of Natw�i ecour cs, State of `Nast .rsizL Cer r on =9eflat your septic E43 bccn maintaincd -:.ust be cer=lctcd and to ^sre3 to rti• St. cmi.: Cou sty ?.anatg Cface within 30 J; o L'ae = y x vit SIc NR� CF APPLIC.M;+1 ONVN ,. g1- 1CA110 IN ( all s to —eats ea thus fern are =-c to tic elect of my (� 1) kaowicdge. : twc) ar.: l°s" j the ownet ;s) of the de- ab ve, rrtue of a warranty dc recorded in Rc3iz e: of Deeds OfT -ice. ) /� GNA 0 AP? 1QUN7 DA Any infor=Lien that s mis represented ==y recruit in die sanitary xt::rit being revoked by tic Zoning Dcparusent. " Include with this appliesdent a stanipc3 war decd from the Register of Deeds otnce a -n of the cattiiied wry" reap if reference is made in the w arranty decd Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 t 33 11 11 J t. U 6L34yc'iL STATE BAR OF WISCONS(fI FRM 2 • 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED R OF DEEDS This Deed, made between P. C. Collova Builders, Inc., a RECEI VEii FOR RECORD Minnesota Corporation, 07 - 29 - 2002 9 :30 AM — rht -rr.'r U_tu Grantor, and Colo Group, LLC _ REG FEE: 11.00 TRANS FEE: 197,70 COPY FEE: CERT COPY FEE: Grantee � PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix _ County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot Moonbeam Ridge in the Town of Hudson, St. Croix County, Name and Return Address Wisconsin'- Estreein & Ogland 304 Locust Street Hudson, W1 W16 020 - 1378 -06 -000 Parcel Identification Number (PIN) This is not _ -� homestead property. X) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this Z day of July 2002 T P. C. ollova Build Inc • - -- — _ • P. ollova, President AUTHENTICATION ACKNOWLEDGMENT ) Signature(s) P. C. Collova Builders, Inc a Minnesota STATE OF WISCONSIN ) Ss. Corporation, by P. C. C Presiden Court[ ) authenticated this of duly _ 2002 Personally came before me this day of the above named • Kristian Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Scats.) THIS INSTRUMENT WAS DRAFTED BY Att K orney ristine Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) .) Inrolmation Pns"vomis Company, Fo nd eo nd W t, wl • Names of persons signing in any capacity must be typed or printed below their signature. am,665-2ost STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2 -1999 Wisconsin DPpartfnento Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 395120 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: P.C. Collova Builders, Inc. Hudson Township 020 - 1378 -06 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. Sys PUMP /SIPHON INFORMATION Final Grad Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold IDistribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes [g] xx No F1111 Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1034 Moonbeam Road Hudson, WI 54016 (SW 1/4 SE 1/412 T29N R19W) Moonbeam Ri Parcel No: 12.29.19.2345 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? [f Yes ® No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety 4nd Hi:iIdiqs TJi�:sittt Cow:y 201 W . Wathfaatoa Ave. , P.O, Boa 7 t � * so , `, MadIM, WI $3707 - 1162 " iu Add s e !� r et+t f C Mfrs ro• { ` d� d Q tofu" PU Wt Application if' Ch�a Lt teeoel wieb Cam�t il.31. Nb- Alm. Coda, ravide 3 s � Q lt � ao aye_ ft PIMAD �n Ar RRVY r �! : OW G - ! 1 i cad �� w�l �- 8 . a Y N umber ub v v4 C8M Nurobei M Type of ndftg (cineit tbs>e a� X or Z Fea a Dash >ladrooms -3 OViilafe E Bubiw*wmerobi - Detattbe Use 10 0 sate OW=d Nprest 2 3' 6e c s 37 — ! k —00 o _I tlt. Type of y+tens€tt CCbeelt oedy ane beet A �autaberEt� ft�Ntyw! ure). Congdste it applicable) A' t,q' New s Q )itplaoaauot iiyeam NNZ 6 C = w ar' Cauafy we . a 9 . ! 9 , a -3 5 - >l • Cbeak it iGaaimry ! PsariaaaJy Iss Due Issued i I . Type of Ptlnaft (CQ; 21 do apply) am for interaal sue) - [ap I �i4 'Diaa - 8tetmbw Ttt•OMWW 3:© wow t7 !� Sind Fflter 30 Q Cosutrustwi wedaad I 3'z G Prettrndw k-Gr w 4t C3 l�idttg vi 4e ❑ Siglra lent SI Q Drip Lone 43 O A 46 Tt veil D Aeciraul 30 13 Other t V. AM M ea 11 sea Aw Asti system Eaysthm I FUAi tirade ll"dtW Pyopoiad RUKCWt,i Sq. 0 I wj%/Eaoltl Elevation a VE Tads TDOW Number Mientiacaure pow Site 'itaol 'Fit+et Plastic; ' of Teams ! L''oetlata Ccaatrtitcnd 01M i New i Vt1~. - , esntma far of flti! FOWTS as the ettadt+d • AleaMt a ft laws NusMa ROW A&MM heat, Code) A veil Q ttty wt � GtOUNIAr Ian a ll �natuts (N el 1 sod" POO) � D 2 l�. C Alpyrarttilf�eesatu for �1#t� I E f ' :s0l)k►3$8 aL. 03101) 1 r • o � �V oo �� I ti Ne y • v a a X v 3 � a N N A a a � � s nsh Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please prin � { n�1�oi►ngibn. R wed by Date Personal information you provide may be used for second ,`R` sus °11''rivacy Law . a5.bQ Property Owner �. t PrdQerty Location B Goyt1 Lot r 1/45 C 1/4,S T2 9 ,N,R q E (or Property Ow er's Mailing Address 1 Lot # Block# Subd. Name or CSM# City 1\ tale Zip Code Phone Nuriaab #�r City ❑Village T own Nearest Road " 7 aW., New Construction Use: Residential / N uln4>_ofedfl�errfs ? Addition to existing building Replacement ❑Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate _ bed, gpd/ft 'T trench, gpd/ft Absorption area required ? bed, ft rench, ft Maximum design loading rate bed, gpd/ft r trench, gpd/11 Recommended infiltration surface elevations) ft (as referred to site plan benchmark) Additional design /site considerations A= L + - Parent material Flood plain elevation, if applicable — ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system S ❑ U fps ❑ U 6as ❑ U F ts ❑ U I ❑ S r� , U — El S P9-,U SOIL DESCRIPTION REPORT ljwa Gam_ : E S � 2 -fto 1 Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench _ 0 -10 V 1 33 �5 w`F L F 2 Ground 9 —� ( elev. qUq ft. Depth to limiting 4S . Tel factor If 3° L Remarks: Boring # 0aa Ib Z - Ground elev. Depth to limiting factor 9 q in. Remarks: CST Name (Please Print) Telephone No. J J� k Si - - 71 2- 7- �foad` Address Date CST Number zll 3 -1- h S SU ��� �� �fU Z S J- 7 -66 Z5 3 305 PROPERTY OWNER SOIL DESCRIPTION REPORT I v Page Z- of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench -6 Iv 1Z l — IS A vv.'l=rk' Ground elev. S CS .�- q �.�Y Depth to limiting g factor Remarks: Boring # I W IMM M M rL Z to Ground elev loft. Depth to limiting � 'l in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # 04 , p S r ':.. >.::. i LS -2 Z H LS CS 3 2f, iom 1 6 Ground , elev. Depth to limiting ; factor to I in ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) PAGE_OF 3 NAME L'o 1 (o Va– LOT# LEGAL DESCRIPTIONS= /4,S iZT;t9,N,RiCIE(or)CV r SCALE: 1 y BM 1 ELEVATION ' V BM 1 DESCRIPTION fo 1 Z �10 /c—. -4z (aq J BM 2 ELEVATION ` y BM 2 DESCRIPTION SYSTEM ELEVATION Y J 7 C 1 ALTERNATE ELEVATION qS` CONTOUR ELEVATION ?1 Z •Q'S 00' � 13... L • s • 90M d -�D C 0 SIGNATURE DA TE 5 7 – 00 N 7 Y Y y �' � fit., . _.. _ %r• /^ it r ! 1 ;r ff FIT I' 1 .4 CD CL CD ,i ( I� cr � �S2 a � � 1 / / ,, ii• �'ii i qp 1 { V o f { Ifp'F , ga tn j _' fi } i i ii - � r i Ix ��� 44 i r? G cr C ° ?. N ti o cr ` N i 7 CL CD =) a g, 3 w CD U: �* O I 1 Ln X V W � � G tl n �.. ••r',,,,.. w 0 < su Invert 11 "-4 m CD a � g n g d t Private Onalte Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm Code each Private onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 64, and the conditions of approval by the department, agent, or governmental unit. The approved plants and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis, Adm. Code, and the in- Ground Soil Absorption Component Manual for Private Onslte Wastewater Treatment Systems SBD- 1 Q567 -P (R.6199). Table 1: System Des i n S ificati®ns Sa nitay . P ermit Number Number of Bedrooms Design Flow - Peak d S� Estimated Flow - erage Se fic Tank Ca act al m ci r Soli Abso tlon Corn onent Size T e of Wastewater Domestic 'fable 2: Soil 6bsorptlo n Component - Limits of Reliable O ration Se ptic Ta nk Component Soil Absorption Com nent� Degl n Flow - Peak d ) ATD Maximum influent Particle Site in tie Maximum so D m 22 maximum TSS L 150 Table 3: Maintenance Schedule Se tic Tank ins t artd /or service once eve 3 ears Outlet Filter Ins ct once a joar and clean at least once every 3 ears Soil Abso tiara Com onent inspect once evey 3 tears 812111c-TWA The septic tank shall be maintained by an individual Certified to service septic tanks under s. 281.48, State. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Greas Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic old outlet filter shall be assessed at least once every 3 years by inspection. Th"utlet flit shall be cleaned as necessary to ensure proms The filter cartridge not be rem ted unless provisions are ma e retain solids in th e tank that may slough off the filter when removed from its enclosure. If the r Management Plan for a Septic Tank and Soil Absorption Component filter Is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have Its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation In the tank. Manhole risers, access risers and covers should be Inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced.. Exposed access openings greater than 8- Inches In diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry Into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal uses, and rescue of a person from the Interior of the tank may be difficult or Impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank Is no longer used as a POWTS component. Soil Absot MUca Colvigment The soil absorption component serving this structure Is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors In extending the useful life of this component, The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, If any, In the observation pipes, and a visual Inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system Is prohibited and considered a human health hazard, Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or Impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen Into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 r - y a � _ Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over of within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow, Contingency Plan in the event of system failure, a new system could be Installed in an alternate area. With the installation of a diverter valve, the existing system could also be reused after a period of three to four years. It is the property owners responsibility to maintain the alternate area free from any planting of trees, shrubs, etc. In case of failure of the original system, the alternate area will be needed. If any trees, shrubs, etc. have been planted on the alternate area, they wiil have to be removed at property owners expense. R alternate area is destroyed, there are other alternative systems that can be used, in which, could result in added expense to the property owner. Any tank abandonment shall be done In accordance with Wise. Code 83.33. Any questions regarding this rode, please contact your local Zoning Office or contact the installing plumber. .Z % 1 4 to$0 `� rkm wrA %Xown. ` (�1S) 3 %b a s cizoix COUNTY SVPTIC TANK MAINTENANCE AGREEMENT AND n OWNERSHIP CERTIFICATION FO Owner /Buyer a VA 6 I L S -Av c._. f OFAJ4. ff� �A Mailing Address 7 0� 00. C /w4su �U Property Address (Vcrification'required from Planning Department for new construction) City /State L_ Parcel Identification Number LEGAL DESCRIPTION Property Location –NLW- V4, 5E__ %,, Sec. Tc"�aN -R_Iq _W, Town of I kA/3U Subdivision cxfn Lot It 6 Certified Survey Map 11 Volume Page # Warranty Deed _ (O / x'995 Volume -1 1A' . Page # 66 Spec houseyes ❑ no Lot lines idcntiftable)R�Yes ❑ no SYSTEM MAINTENANCE 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, if 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 waste disposal system. The property owner agrees to submit to St. Croix 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 wastewaterdisposal 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. Uwc, 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 Zoning Office within 30 da o — the -- thve vear exp on date. IGNA OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledg6. I (we) am (arc) the owncr(s) of th roperty es ribed abo by virtue o a warranty decd recorded in Register of Deeds Office. 7 /6 /OJ (if GNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with (ills applicatlon: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty decd V0L 11 J (, PAGE U STATE BAR OF WISCONSIN FORM 2. 1999 6 �. 89913 Document Number WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS This Deed, made between James A. Fisher and Rosemary F. ST. CROIX CO. , WI Campbell, 171/8 Rosemary F. Fis oth sin le persons, WEIVED FOR RECORD 02 29-m0 2:20 PM Grantor, and P. C. Collova Builders, Inc., a Minnesota Co oration, TTY DEED FEES my I TiIANSFER FEES 651.70 Grantee, REC FEES 10.00 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix State of Wisconsin (if more space is needed, please attach addendum): Part of West 1/2 of SE 1,4 of Section 1 2- 729N -Rl9W described as foliows: Recording Area Commencing at the NW corner of said SEI /4; thence E 763.1 feet; thence S 1980 feet; thence W 103.1 feet; thence SWIy to a point 165 feet E of the SW Name and Return Address corner of said SEI;4; thence W 165 feet; thence N2640.0 feet to Place of DAVID J. ESTREEN Beginning EXCEPT Lot 5 of Certified Survey Map recorded in Vol. 14 of Certified Survey Maps, page 3788 as Doc. No. 616755, St. Croix County 304 LOCUST ST. Wisconsin. g�a HUDSON, W154016 020- 1015.70-000 & 02 0 - 1015 -90 -000 Parcel Identification Number (PIN) This b no t ----. _ homestead ro c P P rty. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. 00 (is not) Dated this day of Fe 2000 am;er « aeCam bell, f/W& Rosemar F. Fisher AUTHENTICATION ACKNOWLEDGMENT Signature(s) .lames A. Fisber and Rose F. Campbell, f/Wa STATE OF WISCONSIN R e Fisher, botb single persons, } ,�1.. ) ss. . County ) , a ay of Febru 2000 _ tp Personally came before me this day of C « Is O . n �lC _____ _ the above named BER STATE BAR OF WISCONSIN i10t, to me known to be the persons) who executed the - forego not g authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristin& Ogland « u son, Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not necessary.) My Commission is permanent. (If not, state expiration date: « Names of persons signing in any capacity must be typed or printed below their signature. ) lnrermatbn Prohesix,ela c ' FO WARRANTY DEED STATE BAR OF WISCONSIN du °` wi FORM No. 2.1999 soo�sssoz, \ i:S- / , ' / r- : 9\``‘ \ o // 2,51 ACRES \ \ • '' ,�o"' // 109,166 SO FT \\_cs ?ci \. ^ / �+3' \ / e ^ y N73 s7s� E� / / .r� o ' 34„ � � •� I F- / O . 2.59 ACRES / // • U) N 1 112,924 SQ FT •• i oh �� I. ' cc co 0 MIN BUILDING MIN Z FFE A FFE ELEV. =930.5 O� ti • /• /• • i •/ . ' I c/ 1t,�0 u �j N 89°5729"W I C9 lO li • `t 316.86' i I • • cji H.W.L. =926.0 _ _._._ N T- • I I . • • T • \• 1117 N • N 89°5 MIN BUILDING 372 _ S SE E• V. =930.5 \ 21 • M \W • o Z 22.51'ACR • 109,476 SO FT co - w • 2 1 d' g wiz 94 . \ rn Np MIN I _•_•_ N \ FFEI e� '`� • \\ `� \ \ • • ECTtON CORNER N 89°57'29"W 373.12' 32.51' 0\ . •WEIGHING ) • FOOT PqA �. o • IN • O T )T CORNERS • 24' © MIN BUILDING 933 0 I '),i I 30 DRAT OOTNG 1.13 LBS. Oo > T FFE ELEV. =936.5 ,7 w .7- O'DRAI o I = I = Iv ASEME oa 7 t v en g 2.50 ACRES a0 co 40- • 109,099 SQ FT • o o • ^4) El o o ' �K LINE co Z ssy 1-ALONG ROADWAY @ > • 6i• 0 S32F \ ® C2 \\. 0 N 89°5T29"W • \ �89.21' \ '. O Z l • .NSION AREA TO a \ ��° 6? .01 EVATION \ 5. • UNE ELEVATION II a BUILDING s �L \\ 1LD ALTER THE CAPACITY \ \ ER RETENTION AREA 11 S A > N 2.52 ACRES 109,650SQFT _•_—•_•—� \ \. )HIBITED WITHIN • \, \ C1 RETENTION AREA • \ E 487.37' '\ M9°5714 „r_ f 1 V OQ 0 w 0 d Si !� 0 �� Z Z ° n w N ° N y C N N • a m CD n l m M 3 m@ m v, CO ^ CL 0 m ° o A O m 7' T -1 CD 0 N fl- 3 7 O N O W Ot pr ' e� CL 3 O. H y w w A lei cn v D 0 a cn z D a • ca ? V' a 5 m co CD DN d ICS Q o W a W o C V 0 0 ° W 3 0 Q2 m v o A A � z o 0 0 0 0 0 $ 1 r CO) CD M _ fD O O f/J . CD w N N O. 3 .. S 5 ml c CL 000 z OOOIn o gg = co 0 ca 0 CA 3 Im M° c o < Im O D c o 7 �_' 0° omi cr d rn 3 M a _ N of z m D z O D z O O > > v O s � o ? h co 'm � m m • ( y X N CD CD m CD S (O CL W O. 3 m 5 n 3 5 Z � 1 a sZOD a v a A CL a z 0 0 0 0 : f0 H z H 0 m I m m A w m D o n �vO D o CL 0 ov c ( 2 q' Q O LA. c m w �A f o' m m �• m v°, b o' v c f �v C m o a �w,'= > > o a v . CD = oom o o . m I CA O N 0 N CD = C'f 7 m O U1 ,I' m N C h m �w w O. A wmu - ,•°3 m 3 ° m v CD o C D 9. 3 ?. o tv �° ° o 3 K m ti 0 0 b °p CD m 1 00 00 ti c ° o °o CD Parcel #: 020 - 1378 -06 -000 08/05/2005 08:23 AM PAGE 1 OF 1 Alt. Parcel #: 12.29.19.2345 020 - TOWN OF HUDSON Current X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner FRANK A RANALLO O - RANALLO, FRANK A 1034 MOONBEAM RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1034 MOONBEAM RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.510 Plat: 2186 - MOONBEAM RIDGE LOTS 1/13 '00 SEC 12 T29N R19W PT SW SE MOONBEAM RIDGE Block/Condo Bldg: LOT 06 LOT 6 2.510AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 12- 29N -19W SW SE I Notes: Parcel History: Date Doc # Vol /Page Type 10/07/2004 776479 2671/594 QC 07/24/2002 684920 1932/633 WD 10/02/2000 630970 8/14 PLAT 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.510 55,300 218,800 274,100 NO Totals for 2005: General Property 2.510 55,300 218,800 274,100 Woodland 0.000 0 0 Totals for 2004: General Property 2.510 55,300 218,800 274,100 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