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HomeMy WebLinkAbout020-1378-10-000 Safety and Buildings Division ~tY~ , / // l ~ , 201 W. Washington Ave., P.O. Box 7162 ~ J ' T C /` ,S'COn~'~n Madison, VVI 53707 - 1 $roe Address De artment of Commerce ~D 3S' -~ J / ~ ~ ~ ~~ ~ ~: e R 0+~ I~o~6J Sanitary Permit Application S'°'>ai''' Perwt N 20 ~f Ig In accord with Comm 83.21, Wis. Adm. code, personal information yon provide ~,~ W'~'~kd' Revision ma be used for ses Priva I.aw, si5. 1 m I. Application Information -Please Print All Information State Plan I.D. Number OZO't3 Property Owner's Name Parcel Number / D CU1 02.0 -l3~&- -coo .23&'~ _ Property Addrec O~~ ~ ~ /`'"' LL ~ '~ Si:S N, City, State Zip Code Phone Number t ~ e Block umber _^ N ~~ ~ ,~ s~l,Z n ame CSM Num r ~-~-~~~ ` II. Type of But7ding (check all that apply) ~ ^City T 2 Family Dwelling -Number of Bedrooms ~~~ ^ Public/Commercial -Describe Use P ^ stage owned 3 tX 100 - ~ t "t'~.G~ ~ Nearest III. Type of ermft: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A' 1 w 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use seem Tank stem B. ,Check if Samtacy Permit Previously Issued Permit ~20 ~ ~ Da ~~~ L IV. of Permit: (Check all that apply)(numberhig scheme is for internal pse) 44 an Pressurized In-Ground 21^ Mound 47 ^ Sacd Filter 50 ^ Constructed wetland ^ Pressurized In-Ground 41 ^ Holding Tank 48 ~ Single Pass 51 ^ Drip L~n e / / ~ / ?~ 45 ^ At-Grade 46 ^ Aerobic Treatnxnt Unit 49 ^ Recirculating 30 ^ OtheroC~~ ~ ~rX-! V. tmeat Area Informat ion: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation F' al Grade ~ ~N~ 6~y Proposed ~~ ~ Rax(Gats /Days/Sq Ft.) ~ (Mm /brch) ~ ~~~ Elevation ~- ~G ^ ~G ~~o. VI. Tank Info Capacity in Totai Number Manufacturer Prefab Siu Steel -Fibs p)a~C Gallons Gallons of Tanks Concrete Constnrctcd Glass New Exisdn= Taoka Septic or Holding Tank _ /~ Dosing Chamber VII. Responsibility Stet t- I, the anti responstbBity for insta ation of the POWTS shown on the attached plans. ~ Name ) Plum P ll ~ ~ ~r Business Phone NN C ~ =- Phunber's Address (Street, City9. Stan, e) / l VIII. Coon /De artment vse Ont Approved ~~~"' ^ Disapproved Sanitary Permit Fee (includes GrouMwater Surc r; F Date Issued Issu' Agent Signa (No Stamps) lll ^ Owner Given Initial Adverse ae) L~ r- ~Z~ p~~L ` Determination J 1QC. Conditions of Appro easons for Disapproval ,~--Yn /~ - n ~~/~ - t.~ ~ ~S .~o„,,,.,nQ ~.. ~Si ~ ~o c:rz.ttttr~a a+~2~,twed/ C~`~. Slps~~.. ~ ~ t>'1 "" _ `. _ _ ~ ~' I ' / l r I -~s~ au2a~ _-e..s~e~..~ iilC.i'C-~hpuu.y. ~.~.;Q - "i w`~, a,r~,.,~>-~i l l 16~~ wuaea oomptete yam too me ~7 aaq) far the syrtem os pryer not tw nm stn x rl tocLes m dse 3-/b SBD-6398 (R. OS/Ol) PLOT PLAN PROJECT Matt Kari DDRESS 7052 49th St. N. Oakdale Mn 55128 SW i/4 SE i/4S' 12 /T 29 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11 /2/02 BEDROOM S CONVENTIONAL XXX IN-GR U PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 ,BENCHMARK V.R.P. Base of Walkout Door ASSUME ELEVATIO 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION Charlie Rvan Road ternate benchmark is of Basemen now .9 2-3' x 69' Cells with >3' spacing 92.5/92.4 30' 101' B-2100' 99' Vents 35 35 0' B-3~ ~ ST 30' , Garage ~~' B-1 .~6'' 0' I Fro 3 5 Alt. B.M. ~ Bedroom 5 ~ House B.M. c 0 0 ~ Vent >6„ Standard Infiltrator of Cover Leaching Chamber with 31.1 ft2 of Area 12" Plans Designed Using 6' Long Conventional Powts Grade at System Elevation Manual Version 2.0 a~ 0 M N wsconsin Department of t,.ommerce SOIL EVALUATION REPORT Page ~ of ~ Division of Safety and Buildings rn accoraance vinin wrnm aa, vvis. rwm. wue ~ Cou ~ ~ Plan must t l than 8 1/2 x 11 inches in size l Att h l t it r07 . an on paper no ess ac comp e s e p e include, but not limited to: vertical and horizontal reference point (BM}, direction and py~ I,p, ~ (~~ ~ 3~ ? am ( '~ ~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. , j ~ G~- Please print all information. 04 (1) (m)) l aw 15 r econda s P l i f ti id b s d f ~~ (Privac w a 'wed by ~ Date I t) r0 ~ 2 . . , . y . ersona n orma on you prov e msy e u o o s ry P P ( Property Owner ! ~' Q.. '~0./-, Property Location Govt. Lot c~ l,J 1 4 5 ~ 1l4 S~ Z T 2 N R E (or Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# s z ~l s~. 16 ~- rn ~ ~• Lily State Zip Code Phone Number ^ City ^ lage Town Nearest oad n ~ K rn r1 ss 12 ~ ( } b.~.., rt,.~, Y New Construction Use• Residential !Number of bedrooms Code derived design flow rate .SO GPD ^ Replacement ^ Public/~ commercial - Descxibe: ____ __~ -^___ Part3rrt material ~~ ce..Q.~-~ _ Flood Plain elevatwn 'rf applicable 1~ 1 z9 ft. General corrrrrreMs ~~ ~ ~~~~~~ -/,n,. J, ~ ~G~. and recommendations: ! `~ c~ ~ lS~.. l t>ZC~ /~ ling # gy~p{{ Bor;ng IOl pit Ground stafaceelev. /~, ? ft. Depth to limiting factor ~ un. Sorb licatlon Rate Horizon Depth Dominant Redox Desrxiption Texture Structure Consistence Boundary Roots GP D/ft= in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eif#2 ~ .----- ~ ~ r , ~ , ~ 9`~ ~~ ~°l4 Boring # ~ Boring , n~ /' /'sl ItJ ~ 1 Pit Ground surface elev. n. Depth to rmmng taaor ~T v ~. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GP D/fF in. Mansell Qu. Sz. Cont. Cdor Gr. Sz. Sh. `Eff#1 'Eft#2 2 s--~ js, ~---- ~ . a . ~ --- ov ~~~ ~ ? / - Z G.o 9G • Efflrnnt #1 = BOD > 30 < 220 mall and TSB < 1 50 mall ` Effluent #2 = BOD. < 30 mOIL and TSS < 30 n1gIL I.ST Name (Please Print) ~9nature ~J~ N~~ r/u_~. ~./ ) G A ,, Date Evaluation t.orrduded Telephone Ntxrrber /~®~3 Cpl ,1~~ it/e~ /~.c~~,r~~-~l~J's~~~ 7 //-a-~ z 'ice -l~~ ~,r/~ Property Owner Parcel ID # Page of Boring # ^ Boring pit Ground surface elev.~~_ ft. Depth to limiting factor /~ ~ in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DJft° in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ~Ar i~ ~ /J / G~(/ y`"' ~ ~ '~ ~ ~'~0 0 .~ `-' ~ e ~ - ~ ~ p- Ot ~, ----' ~- iv ~J - 7 a ~~ # ^ Bonng ^ pit Ground surface elev. ft. Depth to limiting factor in. Soif ~~ Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff'- in. Mansell Qu. Sz. Cont. Cdar Gr. Sz. Sh. •Eff#1 'Eff#2 a a ~~ # a Bonng ^ Ground surface elev. ft. Depth to tirniting factor in Prt Soil ication Rate Horizon Depth Dominant Redox Description. Texture Stnx~ure Consistence Boundary Roots GP D/ft` in. MunseN Qu. Corrt. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 • E(fluent #1 =BODE > 30 < 220 mglL and TSS >30 < 750 mglL • Effluent #2 =BODE < 30 mglL and TSS < 30 mglL ~0 department of Commerce is an equal opportunity service provider and employer. If you need assistance to access s ices or ~'~~ ~~~ ° need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. j ~ ~v ~ ~ ~3~aR.~~ `/u/ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ' INSPECTION REPORT GENERAL INFORMATION, (ATTACH TO PERMIT) Personal information you proJide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Kari, Matt Hudson Townshi CST BM Elev: ~ ( Insp. BM Elev: ~ BM Description: CST gtti ~'~ C~1i r ~ ..o Op.O -. S , e+~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic OtSO Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ ~ , „6 S Dosing Aeration Holding PUMP/SIPHON INFORMATION Demand GPM Head Ft ELEVATION DATA c°unty: St. Croix Sanitary Permit No: 420418 0 State Plan ID No: Parcel Tax No: 020-1378- -000 ~~ ~j(7 '8 STATION BS 3, a 5 HI I~ i75 FS ELEV. i »ifi ~ ~ Benchmark -T .fir' ~ -"a`a Alt. BM ~_ Bldg. Sewer ~ ,~.~ C ~ OS,- t! St/Ht Inlet ~- Sa qS.?S-~ St/Ht putlet ~ ~~ ~i c i QS•~ Dt Inlet Dt Bottom Header/Man. Q..~ ~~ / Dist. Pipe ,.,1•. 9, 30 S,. Bot. System 9 • (e. - 3 • i'S" i Final Grade 3.9D /~. ~S/ St Cover f • So ~ !. ~ / 0 SOIL RPTION SYSTEM ~ ~~ RENCH idth Length No. Of Tre ches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DI 3 f b$,.~.f ~Z SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufac r w INFORMATION Type Of System: CHAMBER OR .; ~. ~~i ,~„ ~~ ~.. UNIT Model Numb r (Z K DISTRIBUj~,OJV SYSTEM •.~Q ~ Q~.,.Q Q„p. t-,~ , Header 'f ti Distribution x Hole Size x Hole Spacing Vent to Air Intake Lengt Dia Leng Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx SeededfSodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~ Yes ~ No ~ Yes ~] No CO M N S: (Include cod dl'j~ -crep ncies, persons present, etc.) Inspection #1: d~~/~Z- Inspection #2: -->~'T~ ~~~~ p"Ir~o ~~hf~' . Lo l nn: 8 9 Charlie Ryan Road Hudson, WI 54016 (S1~1~{4~SE.1/~41.2B.T.29N R17W) /JloonbeaAmnRidge}L..ot 16 Parcel N :12.29.17.2389 1 Alt BM Descripti~~ ~ $- 3 9v+ ~`a....,. Ps ~ `9f S~-~ ~ ~ sl ~~ ~ tangy, _C. ~nA~ ~A'rlS~ ~~NSIQ~ 2.) Bldg sewer length = J oco.~c. , r - amount of cover = 3~o~nww~- ~" ~~ "'` z"~ tyoylo~ ~Q~, .. Plan revision Re wired . o U othe 'de for d 'tional inform tion. i .{~ ~ j © 211' i~ _ _ __~ ~ _ 1 p `, -~ ~ - -J G SB~-6710 ~7 vv 4JOrr~ ~ "'~'o~-'r"` ~ld3t s Insepctor's Signature Cert. No. >~5~~ S~~ t,n ~ tmear,t• of commerce 201 W. Washington Ave.. P.O. Boa 7162 Madison, WI 53707 - 7162 ~'-~a --~ Z. 3f~0~ sanitary permit Application in accord with Comm 83.21, Wis. Adm. Code, personal iofocmatian yon provide ma ~ used ~r Law, s15. 1 m L Application Information -Please Print Ali Information site. ~CCL Saiuimry Permit Number U a tit if Reviaiot- ~~ D ~{ ~ State Plan LD. Number _ //~ Owners Name ...-,r'..~a ~~... - ~ ~ Panxi Number ~aG-- l 37~ -D (,YID 2 ¢ ~ arty Location *~~ l Owners Mailing Address n L/ /!' ` ~ / Bi0C1< umber v ~• Strue ~ Cade Number ,* ys0 LoT ~- ~ ..-•-'° - . N er am Name rn ;.,.~ ,..~ k aR that apply) h G+~~--J City ec c Type of Bmldmg ( ~ ,~ ~l.oc 2 Faintly Dwelliag -Number of Bedrooms ~V~ ^ p~c/Commercial -Describe Use Nearest Rand 3' ~ ~ ~' _ one boa on lioe A (numbering st3teme for internal nse)• Complete >ine B if app ' ~~~ III. Type of Permit: (( ~' F~ ~7 use ~ ~ ew 2 ~ Replacetmem Systt~ 3 ~ R of 6 ~ Addition ifl Tait Bain Date lasted Std 0~....:r NnmMr B. ~ ^ Check if Sanitary Pemut Previously Issled IV. of Permit: (Check all that aPPly)<n~~°I ~' Preastrized ~,~~ 210 Moutai ~~~'_" lsi Csasnd 41 0 Holding Tank 45 ~ At-Cuade - 46 ~ A,erobic Treat - - - Flow (Bpd) Dispersal Area ~~ ~, ~~ VZ Tank Info ~g?` nt ~I scheme is for internal use) ~sl-~ ~~"`ca .~-r ~ n i~~n-~- ~p C/~~a~y~~ ~ 47 ~ Saud Fiber 50 ^ Consavcted Wetlaad 3/ ./ fez ~i~' 48 ~ single Pass 51 ~ Drip Line / . vent Unit 49 ~ Recir+calatin8 30 ^ ~~L'~" ~ C7 , ~/ Sod Application Percohuion System F.tevation Fnral Grade Raoe(Ga1s./DaYs/Sci.Ft,) (Min./Inch) i Faevatgn ,, oral Number Manufacdn'ei Prefab Site Gallons of Tanks Concreoe Constructed Sepoeornowmg aa.w - C.~~e/ iv ti > tuba r ~ for ~ the ~~ ~o~ on the rdtsicbed Pier VII. ility Staternent- t, tlee Business Phone ;~~,ry Mp/ivfPRS,N~u~ber s Name `~ ~- /l / ~ jTv ~s/J'~~ pbrmber's Address (Bleat, City, State. Cade) f ~ /" Glass Y.'_ G~c ,. ent USC ~ iStalE(1 Cffi $i$nlltgiC (No Stamps) Saniary Permit Fee Cmeludes Groundwater D~ Approved ^ D;sa~mved yyt~arge Fa) /p2 ~O~ ~ `-C ~~'' ^ Owner Given hndal Adverse ~ ] a ,>(". Determination P ~G~G~- C~ ~"4' Qin-c~ ,Q~ inc. Conditions of Appr~ ~aUR~ easo~ f Disarm ~`L~dn ~ r~~~ '~~1~ ~~~ ~-0/'-elAl/se~t ~S . p~ns~a%~-~ Gctie-r ~oor ~a>-soy'/s cuere n6t ~~` ~ /~,/~,. ,r~~rn~aa at 72 ,• a/- ,,J ~ d ~, ~ r~oucr~ ~~ a-~ftrm 7 / A~ t~ cto ~ ~~ rar ~ ~~ ~ 2~ cep ~ °'< <"" j~s.t~c-~--~.al S~~- un~ aue saw r~ -~d ate' ~ ~~ SBD-6398 (R. OS/01) ~~~/~~ ' - PL PLAN PROJECT Matt Kari DRESS 7052 49th N. Oakdale Mn 55128 SW 1/4 SE 1/a s~ 12 /T 29 !R N Hudson CouNTY ST. CROIX 9/16/02 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL ~4C IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 ,BENCHMARK V.R.P. Top of 1.5" Pipe ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark 401' Vent SYSTEM ELEVATION 92.5/92.4 Line >6„ Standard Inf>Itrator of Cover Leaching Chamber Plans Designed Using with 31.1 ft2 of Area Conventional Powts Manual Versit~n 2.0 6' Long 12" 34" Grade at System Elevation Please note: B-3 is located in a depression, as upon s ace a evatlon an so piT rofile. soil test Is oru surta~re ror a saris s ould not be used to installs stem. ~~ Al , a = sc a should never be us ~ ~ ~,Q~ ~~ for dimesions are assumption, and cannot be V`r`" /~ exact. C,~tii~° - B-4 -~ rl~i$~N 30' Pro 3 Bedroom 20' House T _ b 0 a .~ a 0 20 2-3' X 69' Cells with >3' Spacing ~~ ~ ~0' B-2 r i~~ 1 Site will be retested and a new soil test and revision will be filed B.M. #1 ~ 15' 1 10' 30' ~B 1 Vents 5' ,~ 12' u^. B.M. #2 25 /o~~G?'~ B-5 ~~.~ 2% // ,~ o. 0 M N PLAN PROJECT Matt Kari DRESS 7052 49th S~! N. Oakdale Mn 55128 SW i/4 SE .1/4S ~ 12 !T 29 /R N Hudson COUNTY ST.CROIX i MPRS Shaun Bird 226900 DATES/16/02 BEDROOM 3 CONVENTIONAL ~4C IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22 ,BENCHMARK V.R.P. Top of 1.5" Pipe ASSUME ELEVATION 104' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark 401' Vent SYSTEM ELEVATION 92.5/92.4 Line > 6„ Standard Infiltrator of Cover Leaching Chamber Plans Designed Using with 31.1 ft2 of Area Conventional Powts Manual Version 2.0 12" 6' Long _Grade at System Elevation Please note: B-3 is located in a depression, Gasedu on su ace a evation an soi ofile. of testis onl suita a or a s n s ould not be used to installs stem. Al , a = scale should never be use , ,~ /~,~ for dimesions are assumption, and cannot be ~~ 7"°'". exact. C,~77<~ ~ ~~'` B-4 ~~ n~$~`~ 30' Pro 3 Bedroom 20' House T ~ I I 20 0 2-3' X 69' Cells with >3' Spacing ~~O .~ -`~ ~ B-2 ~ °o ~ B.M. #1 '6~ i 5' 30' 1 ~ ~ ` 10 Vents Site will be retested and a new soil test and revision will be filed !1 -1 12' ~~ B.M. ##2 2s ~o~P+JIG~~~ B-5 ~~.~ 2% I/ ,~ a cn N 09!13i~002 09:04 FAX 6514500113 Hoffman ~J001 FRC~1 PC COLLblh4 ~_DR &~i]TOiEFlS EkC FAk ICJ. 7252943E,.3~ Mar. 19 ~ 9'3:0fF~M P1 ST Cn4tk COtlNI'Y , SCP7SC rA~rx MAt1v"t'E~,NntvcE nGd31rL-MENT AND p owtv~csxtt~ c~ttrtrtc~.TIQhP ~oRtvt Owncfl9uyer ,~~~'~Ril~ r~Y ~ q ~tat.~c,e.. ~. I ,VesiQcalion requistt! fmsn Planniee Je7arutlatt fox naw CitYlSsaio ,,,~~. -- parcci Iasent;t:ratiost Numbs ~ ~ ~~/`" ~ ~~ ..~, t.~AL-~~S CIZIPTtON '~'~' LStcziiots ~_ y., 1~" '!., Scc,l ~- i ALL- ~ ~ tY '- cw8 of ~(.~~'°_ ~ _. 5ubdiyi~iaa ~ lL f ~ ' t~~o Lot >r~ ~~ SOtaC ~7RittSL' Q ~!s ,~;J :;O Lat 'eu~ identifisi;Ic ~ y~ ~ uo .~o~ ~~ ~~ y-~~.c. Bic` ~` ~~~ ®~~ ~~ ~a~- SY'S'i'IpM MAtNPL;'r„d,Y~ rue aai ®aiataactic: a[ your oey.Ce. tys:aam eouldssmit b iia pxttirattitra~taiiuac+o t.;aca(c ,.-a;tp. Tropce mlietema: amedw of piaatrisa~ eat qls >4peia task every sk~ae yaaas or rctmex, if aoedr~ by a iiC~itrd pua~er. wiut yots pot ipso 16e ay~oera na aped ties tiaueolea o! th>G ar,++ic tassic ss a 5ua~est ~t isr ibo arms tfisposst syssem. t!x gropeery ~-..aes apses to atshssie to St Cst~:x. 7oeioQ D6pW'h>ocnR a eettGieasian ttxaa,, :igstd by the otroc atstf by s °~'°4~7~dP~pia'o6erw~at'ireax+dptur.~rea;ae:iiysoge~pstjl) "Won-sibsra~vaeesdiap~aal:7asam is in ptep.i trpanpie~ 4aa3idaa aadVat' (Z! afire it-~cetian ved pnnpias if sac~ssrJf. line stzxfc tsrsit is !ate tiCU 1/3 fist! s>E siudee. YRn. the ltorbasii;yad 6otre stud. tlaa aEot+e :e~-titaaunts ttad apse to stsu~rasin tike getrear, at:s+tit~e d>rpt:sal syciam with the Aaodatest sse fectlt, ~ as set iri+ the I7apaslosssss rf C~a-'ee aai f3u 3~epaetamest s+F N.eusad Reeema~. Stsse ol'Wzses~ Cerlifscstjorl ~R t~ 7~ JeP~ •7aaaa bee bass atsisLLaiaed mua ie eompie;ed sad t~estttaed to C.re St. uoi: totteey ZoatiKra t3t~ce aiQ~o 10 days eLt~ e~tsaar 7e~ aus~iu'do=~~.~ .'~ / - StG ~UlVRL' GF AX'P~,tCA34'[ 13w78 D'4Yl4LZt G'EI~T~I .!'LYE)w I t'M'gl ~Y ~ ~ a <o this toms m esue to tihe 4~s of ray !vut) kus~lesfyi, 1 (ws) stn (at) f6e owoat{t~ of ~. pw~j.aey Cesen~ed akrsee, by vines efe ~ar.raary decd neeorded in Ae7ise: of Dee~1s O[tfe~a. ~. ) j '. ~..... •51GGl~IA~LAiB OAF APPCZ~`ANT , DA7~ wae.e ~, c+rCeesaatfow tisu ie ati._ap..aa+aae rosy atrstiitt u 8rs xaait.ey srav~is 6einE Wreaked iy sire ~oaiua Deno~vrtaM. •••••• e. [aettade rrlta ebia ryrp{ie>rtt.n; . stamped w~eacawty decd dan ~e ltlyiseea of eetxfs ct'flu a aeery es' the tasdiMd awvey mep ~f ltlfinan~ce as amide in !!ee +wreesM y eltetl Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. ~~,Q . 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 l .,, Wisconsin 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 print all information. R sewed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ 9 ~' QY Property Owner Property Location ~~ ~'~ OU ~ Govt. Lot ~ ~ 1/4S I` 1/4,S ~ Z T~,~ ,N,R ~ ~ E (or) Property Owner's Mailing Address Block# Subd. Name or CSM# ~' S ~-- 1, vl%~ ISM ~~ ~~ ~ F~r~2 - City S e Zip Code Phone Number City ^ Village ~] Town Nearest Road New Construction Use: ~ Residential /Number of bedroomsl\ Addition to existing building Replacement ~ ~ ~ y~~ Public or commercial -Describe: ll Code derived daily flow _~`~" gpd Recommended design loading rate bed, gpd/ft2~_trench, gpd/ft2 Absorption area required _~~~bed, ft2 ~~~ tgrench, ft 2 Maximum design loading rate _~bed, gpd/tt2 ~ ~ trench, gpd/ft2 Recommended infiltration surface elevation(s) [ ~ ~ ` ~ ft (as referred to site plan benchmark) Additional design/site considerations 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 ~ S ^ U ~S ^ U LAS ^ U ^ S [~, U ^ S ,® U Boring # 1 Ground elev. gg. ~y ft. Depth to limiting factor ~-[min. Boring # Z Ground elev. ~J9. `1d ft. Depth to limiting factor ~_in. Remarks: CST Name (Please Print) G~/W z'~'1Gv~ y wt~-`~-- Address Date Zf 13 fit`' Sf. ~mer~-~, LJI 5~o2~S ~-?-y~ SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Structure C i B d R t GPD/ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ons stence oun ary oo s Bed ,Trench ~ 0- i© 3 - I =c~ ~ wi- ~ ~ 6 Z ~ ~ G Its ~ - ~ n1 ~.. F; ~ _ 5 ~ -~5 y - v ~ Z C _ ~ ~ S -i ~ ~ )'" ~S l~ ~$ ~S -/ Remarks: --z l 0 3 - s l Z K ~ ~; c -- 5 -6o y - Ls rn t=~ ~-5 r' ~ ~ ~_I 6 _ ~„~ V~^ 1 ~ - ~ ' ~ Telephone No. CST Number 2~~330 9 SOIL DESCRIPTION REPORT PROPERTY OWNER ~ Page Z of PARCEL I.D.# Boring # S Ground elev. ys.~ ft. Depth to limiting factor 1(¢_in. Boring # L~ Ground elev. 4~tt. Depth to limiting factor (~_in. Boring # 5 Ground elev. !~~ ?oft. Depth to limiting factor 1_~in. Boring # Ground elev. ft. Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench 3 t1-`fo C Il i ~r - ~-S ~,M5` ~~ FR Ls - ~' Remarks: 1 O-f3 O ~~I Zvr. ~ ~~ C J~ ~ ~' Z n -4 t o 3 - ~ ~ ZN. IBC ~ ~ C _ ~ 3 4Sr-1o co 4 ~.S ~ w~v ~(L - Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/fl2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed , Tr e nch I v~ IB (b 3' ~ - 1 S.1 M~bk r' LS 1 J \ / ~ ~ b Remarks: Depth to limiting ' factor in. Remarks: SBD-8330 (R.9/98) a ,. PAGE~OF~ NAME ('0 1d a.1 c~ LOT# ~V LEGAL DESCRIPTION SE '/o5~/aS lZTZ9,N,R (qE (or)(~V~ SCALE: 1 "_ ~~ ~ ' BM 1 ELEVATION ((~~j • O s" BM I DESCRIPTIONS ~ .~.~ Ouc, Q. D t w`F'!w v, BM 2 ELEVATION ~T 7. 7 Z BM 2 DESCRIPTION~,o al.) a ~~v~ p; (1e„ ,,,~/F7a~ SYSTEM ELEVATION ~ ~j • ~ U ALTERNATE ELEVATION ~ ~j• CONTOUR ELEVATION /~/~ EA ~~ B~ r a ~ ~~, ~r S- BZ ~ ~,,,~Y ~~ s~ ~ e~z 1 ~-- - ~ I ~ =-~--~~ ,~ vui~~~nsin Department of CommercQ SOIL AND SITE EVALUATION Division of Safety and Buildings Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than S 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and `t+ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # Page ~ of ~. r~ O APPLICANT INFORMATION -Please print all information. viewed y Date Personal information you provide may be used for secondary purposes (Privacy Law, 5. 15. 04 (t) (m)). g/ol-~/~ Z Property Owner ~. C~ ~'~ bu ~ ~ Property Location Govt. Lot 5 ~ 1/4S ~ 1/4,S' Z T~Y ,N,R ~ ~ E (or) Property Owner's Mailing Address D L ~ lock# Subd, Name or CSM# ~ ~ 5 ~~- 1, ~ 1 i~~ev +~ ~ E~ A-tom 2 ;~ ~- ~ City St a Zip Code Phone Number City ^ Village ~ Town Nearest Road ~~~~~~'-sv It ;~3X I ~~in 16 i ~ its ) ~~kr -:SCI ~`i- I~~ l~sr~n, - vnoo n he.aw.. QcQ ___ New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ~ Public or commercial -Describe: Code derived daily flow ~ gpd Recommended design loading rate bed, gpd/ft2~trench, gpd/ft2 Absorption area required _~~Lbed, ft2 ?~ ~ tgrench, ft2/ Maximum design loading rate bed, gpd/fit ~ ~ trench, gpolft2 Recommended infiltration surface elevation(s) Cl~~ ~ ` y ft (as referred to site plan benchmark) Additional design/site considerations i~f,-~- 1 7• ~ (~__ Parent material Flood plain elevation, if applicable ~ ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fitl Holding Tank U = Unsuitable for system S ^ U ~ S ^ U ~S ^ U ~'S ^ U ^ S [~, U ^ S ~ U SOIL DESCRIPTION REPORT Boring # Ground elev. Q$.7y ft. Depth to limiting factor t t~ in. Boring # z Ground elev. y9. y0n. Depth to limiting factor l~ in. Remarks: CST Name (Please Print) ~h.t-: ~.~ ~r~ Address Horizon Depth Dominant Color Mottles T t Structure n i tence C nda Bo Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. s s o u ry Bed ,Trench Z ~ - 6 ~~ ~ - Z -~ vv.. F; ~ _ 5 ~ ~;.~5 to y - u~Q l - ~ ~ ~..(( i (u ~ f~5 l~ LS ~~ Remarks: r ~' -Z -a ~ 5 1 2 ~ rn~~ ` ~' - r._ .. I '._ ST CR X _, , za~lN~o F,cE _~:_ _ ~- _ ate > III `:~~-!(`~2~`> ~-~ ~_~~ Telephone No. 7~5)Z`~7- CST Number ?.~33~9 ~ ~. PROPERTY OWNER SOIL DESCRIPTION REPORT page Z~ of ~ PARCEL I.D.# ~4f- ~ C I Boring # .:7 Ground elev. ./Oft. Depth to limiting factor ~in. Boring # L' Ground elev. 4~~ft. Depth to limiting factor t'~~in. Boring # 5 Ground elev. Q~ ?~. Depth to limiting factor [~.in. Boring # Ground elev. ft. Depth to limiting Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench Z -6o iu~RV l.3 ~ .~ Zr'~A91~ ~=~ CS S ' 3 u- o o a 1 y - LS ~ r~5 • I~~J ~fz, C 5 _ ~ a.i qo-ud i tit 4 1 ' _ ~^^S s ~.~ L ~. , Remarks: 1 0-13 d -- S~ I Z-~.r38~ - 'W~rQ C ~~ S, E Z ~ -4 - 0 3 - S. ~ ZM ~ IBC ~ ~ C ' _ ~ -=, N Sr•'io t o '1 _ LS wl5 4.tiv ~ (Z -- ; ~_ Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench 1 v.lo tb 3 3 _ ~,~ Mob ~ r-tZ LS ' J 1' ~ ~ ti Z -0-3~ icy ~ `r ~ 3 - b 1% ~; ~ ~' ~ 6 3 -60 io R 4 ~ y ~-- S ~ t~lv tom- LS .-- rs ~.-~ -IKC 10 ~ R - v~5 Cs .,~.. ~ C' ~ - ~- Remarks: factor in. Remarks: SBD-8330 (R.9/98) ~~ SCALE: 1"= ~('~ BM 1 ELEVATION ((S~) • O BM 1 DESCRTPTION~ a.~.I~ ~Quc, ~: t w~F'lau, BM 2 ELEVATION ~ 7. 7 Z BM 2 DESCRIPTION~,oTopl.) ~ ~Pv~ ~;(~~e. ,,,~/F~u~ SYSTEM ELEVATION l ~ • ~ U ALTERNATE ELEVATION q 3• ( y CON"fOl1R ELEVATION /VI ~ <:,>. y ~~ „,~. :. PAGE~OF~ 2 1 ~- - t~ I N ,~., _ G? U "_ . 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C. Collova Builders, Inc., a Minnesota Corporation; Daniel R. Beer and Kimberly A. Beer, husband and wife, Grantor, and "Matthew G. Kari and Suzanne M. Kari, husband and wife, Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, St f Wisconsin (if more space is needed, please attach addendum): Lot 16, oonbeam Ridge First Addition in the Town of Hudson, St. Croix Cou ,Wisconsin. Recording Area 689347 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 09-05-2002 9:30 A?I IiNRRANTY DEED EXE1~T # REC FEE: 11.00 TRANS FEE: 185.70 COPY FEE: CERT COPY FEE: PAGES: 1 Name and Retum Address Estreen & Ogland 304 Locust Street ~ ~ Hudson W154016 Part of 020-1378-09-000 Parcel Identification Number (PIN) This is not homestead property. ~) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this 3~ ' '` day of August 2002 P. C. va Builders, Inc. C ~ _ * Dae~el R. Beer .a * . C. Collova, resident + I~Imberly A. Beer AUTHENTICATION Signature(s) P. C. Collova Builders, Inc., a Minnesota Corporation, by P.iC~. C~oll~ova, President, Daniel R. Beer and authenticated this/' ~ day of August 2002 * /y}:~ ~;'C~ fist la-.. c ~ ~,, TITLH:$~R ~'1'A~'l~BAR OF WISCONSIN ~ ~~ (~~ r _ aurt~ea~by § 6.6ti (,Wis. Stats.) ~''~a'A~~II~'S~[JdvfENT WAS DRAFTED BY (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 * ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. County ) Personally came before me this day of the above named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. r Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: •) Information Professionals Company, Fond du Lae, WI 80055-2027 •. 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