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HomeMy WebLinkAbout020-1365-10-000,~~~ -~~. r,~--~ ,w,~ , s~,,,.aw ~~_ :+: r -"°"y"~ ~1 ;,, pNB11M119B^ - 7 IIpM ~N ( 1~~~~ -- March 5, 2001 Brady Utgard 110 N. Keller Avenue Amery, WI 54001 RE: Revision for Sanitary Permit #384111 P.C. Coflova Builders Riverpark Meadows Lot 10 Dear Brady: ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Fax (715) 381-4686 On March 3, 2001 you submitted a revision for the above referenced sanitary permit. Since this revision was submitted after the system was installed, we must charge you a $50.00 revision fee. Please forward this amount to the St. Croix County Zoning Office. If you have any questions, please call our office at (715) 386-4680. Sincerely, Shawna Moe Secretary Enclosure cc: file ` Vyisoonsin Oepartmentof Conunerce PRIVATE SEWAGE SYSTEM Safety and_Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Persoltal kltormafion you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit H i s Name: ^ City Vi lage ^ Todtrt o PC Collova Builders, Hudson Township CST 8M E ev.~ Insp. BM E ev.: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ e ~ S U ~ Aeratio tding - TANK SETBACK INFORMATION ~' TANKTO P/L WELL BLDG. vent to Airlntake ROAD Septic >S81 3 ~ NA NA Aeratio - N Holding PUMP /SIPHON INFORMATION - Ma fadurer Demand Model Num a -- GPM TOH Lift - ' ~ ~ Lriction S tem TDH Ft For~emain Length Dia. oist.TOwe11 cA11 eRCARDTI(1N ~V~TFM . 1 // . ~ St. Croix 384111 -/O -ov0 ELEVATION DATA STATION BS HI FS ELEV. Benchmark ~.3Z ~, & ~.. 3 Alt. BM ~ ~ . Z Bldg. Sewer ~ Z ~/ Ht Inlet Z ~ ~ / Ht Outlet ~_ ~ ja ~ Header/ Man. Dist. Pipe ~ R o ~ ?. .?~ ~ Bot. System ~ ~~ ~G 9 ~ . yo Final Grade St cover i - - BEO RE Width , Length a_c No.Of Trenches r~ PIT No.Of Pits Inside Dia. Liquid Depth ~ DIMEN f N SYSTEM TO P/ L BLDG WELL LAKE 1 STREAM L G Manua ur r: ~ r SETBACK INFORMATION TypeO G/ j S/ Z „_____ HAM R IT o e Num er. ~ System: l nICTQIQ11Tlf'1N1 cVCTGM Header /Manifold ~~ Distribution Pipe(s) ~, x Hole Size ~ ~ x Hole Spacing Vent To Air Intake Length Dia. ~ /Q ,Dia. ~ Spacing Length ~ S(]IL COVER x Pressure Svstems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched ` Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ~ Yes ^ No COMMENTS: (I~clude code discrepancies, persons present, etc.) Inspection #1: Z / f~/~/ Inspection #2: / / Location: 984 Kainer Court, Hudson, WI 54016 (NW 1/4 NE 1/4 15 T29N R19W) - 15/29192170 Riverpark Meadows -Lo1 1o y.~ U(anJ~d sYs{~~- l ca,~~~r. ~ ae'eG/ rCUr`S~aI'c~SC 1.) Alt BM Description = ~~ ~~ ~- ~~ 2.) Bldg sewer length=(~/ or<9eh, >!~sf Kew r~of /o~ah, -amount of cover =~~~ Plan revision required? ~ Yes ^ No Use other side for additional information. .l a ,„~, 6 ~ Oat Ins s Signature Cert. No. SBD-6710 (R.3/97) - I.,~ ', ~' Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. `~sconsin See reverse side for instructions for completing this application PO Box 7302 WI 53707-7302 Madison Department of commerce Personal information you provide may be used for second purposes [Privacy Law, s. 15.04(1 ~ " , (Submit completed form to county if not ~. ~ " °~ state owned.) Attach complete plans (to the county copy only) fort to rr4tgf s than 8 -112 x 11 inches in size. County ~ State Sanitary Permit Number ~ eC vision~previotYs,a~~ lion ' State Plan I. D. Number 3 ~- I. Application Information -Please Print all nformation. ', ~ , Location: Property ner Name `"; _, Property Location t' 1 rr r ~'+ r'a ~ ~t±~^~ - i , k-,-.... ' ~lJ Lt.t 114 /U~ !4, S f ST a />N, qr (or Property Owner's Mailing Address COI}NTY Lot Number Block Number ~D ~Q ~ L ~ /~~ ,~ 20NIIgGt~IGE ,, /'') City, State Zip Code F dngNurUber -~ ber n Name or CS Subdivisio ~j d l ( ~ ~ ~ i-1^.. _ ~ II. Type of Building: (check one) City 1 or 2 Family Dwelling - No. of Bedrooms :~ ^ Village Public/Commercial (describe use):_ Town of ^ State-Owned Nearest Dad / Tax Num (s Par - OaC] III. Type o Permit: (Check only one box on line A. Check box on line B if applicable) ~ .Z o A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to System System Tank Only Existing System $) Permit Number Date Issued ^ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V. Dispersal/Treatment Area Information: - /O O - 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) ~ ~ ~ ~ Elevation so ~ 3~s 3 ~ ~ ~ , a t.~~ ~~~ VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks / ^ ^ ^ ^ ^ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS show on the attached plans. Plumber's Name (print) Plumbe ' ignatu a (nos MP PRS No. Business Phone Number ~} Y G1~~~ ar~.3s7 i3 8~~9~s" Plumber's Address (Street, City, State, Zip C d // ,, ~~ . County/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ^ Owner Given Initial Adverse Surcharge Fee _~ Determination s~ . ©~ 3 ~ b X . Conditions of Approval /Reaso ns fo r Disapprov a l : / `C / + / // / / /~ f '1C /~7r5 4'PVrSior. G/aS SkbM.iTl"cG~ ~o ~'°L~IPL'~ C~ ~ih~n~P %~, J~/S/~c~n-~ 1C2~iah. C~t~1' ~~ t~l) SBD-6398 (R. 07/00) F- ' W+sconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT --r_-~ Page ~ of rn aceoraance wiui ~.vmm oa, ~( County ~, •~ C1 lan on er not less than 8 1/2 x 11 inches ~ "s~ an m st Attach com lete site a t Y p p p p / ~ inGude, but not Limited to: vertical and horizontal reference point erection percent slope, scale or dimensions, north arrow, and location a ddi~ance t~+~d. c a I I.D, .~ Rlease print all information. ~ " ~ wed by Date Personal information you provide may be used for secondary purpose (P~u~acy L~q,4~k~15.O4 (~) ('YJOO~ 2 Q PropertyOwner ...•~`, PISs tion .,tom ~~ ` ,r sLE 4 ftf 1/4 S ,S T Z ~ N R (q E (or) 11 Property Owner's Mailing Address of # BI ubd. Name or CSM# Q S~ C - C r~-~ r a ~,~ do ~ S City State Zip Code Phone Number ^ ~lllage [Town Nearest Road [~ New Construction Use: [Y] Residential / Number of bedrooms 3 '~ Code derived design flow rate hid GPD ^ Replacement ^ Public or commercial -Describe: Parent material OC?Fc+.J R S ~ Flood Plain elevation if applicable i!/~ ft. General comments SY~N,~, ~~, v . 9 ? (p Z and recommendations: ~. e%~~• `17•ly Z ' Boring Boring # z [~- P t Ground surface elev. ,~ ft. Depth to limiting factor ~_ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 2 - ~ ls" o -- m5 Q S / C - ,~ • lS--/ r l c3~s l - - ~ /• Z Boring # ~ Boring pit Ground surface elev. ~y.9 Z ft. Depth to limiting factor ~ in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1d~r31Z - Ls / s Cs lU~ ~ 7 l.. Z IZ /o.,~h'/ -- m s s c • /Z / !d ~ `~~ ~- 7 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * EfFluent i'FZ = BODS < 30 mg/L and T55 < 30 mg/L CST Name (Please Print) ~ I nature CST Number _a.IN~ -~ ~ty vVlrx.(~ ,~~~-. ~ Z.S.33~9 Andress Date Evaluation Conducted Telephone Number (~ Property Owner CEO ~ r!C» C l Parcel ID # Page ~ of _~ 3 Boring #^yBonng ['J' pit Ground surface elev. •Z Z ft. Depth to limiting factor ~= in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 ~ o_~ i3~z _'' ~ arts r- C l u-~' . ~ Z ~-~ Z - S C -- ~ 3 . r~~G~ ~ ~ - • ~ . ~. ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) PAGE 3 OF NAME (~o~ ~c LOT# ~~ LEGAL DESCRIPTION ~ '/4,,,w'/< S ~S~TZ~ N R ~~ E (or) ZOP~ SCALE: I"= /~O.O BM 1 ELEVATION /~O•C~ i„ BM 1 DESCRIPTION%~o~' a, Cn~sr.~ ~. ~.1 !~/fh BM 2 ELEVATION /OU • 3 $ BM 2 DESCRIPTION f o P o ~ ~~~'~'f ~ c-- ~3 Q~ ~ S SYSTEM ELEVATION ~7.~Z ALTERNATE ELEVATION ~7,(y Z CONTOUR ELEVATION ~~ 1 ~ „ f..,. -- `~ ~ ~~ / / DATE ~ ~ 0~ ~~_ a ~ ioo.3S ~ T~ ~. ~-. / ~~ ~~ N~ u~ / ~.~~~; s ~7 ~a' ~G, C,o~P,~a,F.o- /.o~" JO ~~ ~~.,, ~~ ~-~n s ~~ ~~~ ~-~0 5~,9~,~a aaO35 7 --~ -.,~a 14't~Nf~- T' Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21. V1'is. Adm. Code 201 W. Washington Ave. PO Box 7302 eonsin `~ See reverse side for instructions for completing this application WI 53707-730'' Madison s Department of Commerce Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)~ , (Submit completed form to County if r state owner Attach com lete tans (to the county co ~ only) f'or the system. on a er not less than 8-1/2 x 11 inches in size. Cot~s~y~,., State Sanit Petmit Number ^ Check if revis evious application State Plan 1. D. Number l C J~-~'~~ ~ t -, I. A lication Information -Please Print all Information - - ~ ~ Location: :' Propert Owner Name ~ ~~,, _ tJ J. 1 ? 4ul 1' Pro ert ~ Locat' ~ ~ ._t._ _ , l.~- /4 l/4,S , TOt /,N,>~/ or Property Owner's Mailing Address Lot Number Block Number 2~ ~ ~ 0 ~ ~ ~r ^ ~ ~~~' . ~~ . ~~ City, State Zip Code ` _ ` _ Phone Numb O~^+r`, r ~"' ' Subdivision Name or C 1\1 Nu er , I Type of Building: (check one) s bP~,Ilrp~~;i" .: , .t.-, -~-- ~~~ ,`~ drooms: _ ~ y il D lli - N f B 1 2 F ^ v Ilage ~ ~ , y we o. o e or am ng \"~--'--' Town of as Public/Commercial (describe use): ^ State-owned III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Neare t Road p) 1. ~lew System 2. ^ Replacement 3. ^ Replacement of 4. ^ Addition to Parcel Tax Number(s~ ' " ' ~ ~+= ©~ D Existin S stem ~~~ "1;3~ l T k O u v n " an S stem B) Permit Number Date Issued S t ^ A Sanit Permit was reviousl issued I,V. Type of POWT System: (Check all that apply) Non-pressurized In-ground ^ Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line c~ ^ At-grade ~ ^ Aerobic Treatment Unit ^ Recirculating ^ Other: fiZ ~ ~ Jt x~5 .S C,?) 3 V Dis ersaVTreatment Area Infor ation: - O ~ z _ 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation ate 6. System Elevation 7. Final Grade El ti /' „/ ySo Required ~~ Proposed ~ 7 Rate (Gals./day/sq. ft.) (Min./inch) ~---- gs~ y~ eva on 8 S ~ VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks r aao ~- ~o ~ ~ ^ ^ ^ ^ ^ ^ ^ ^ ^ VII Responsibility Statement assume res ensibili fer irsta!!ation of the POWTS sho on the attached laps. I, the undersi .ed, Plumber's ame (print ~ Plumber's 'nature (n tam s): MP PRS No. ' Business Phone Number 6 ^ G/L / ~ ~ 03.x 7/,~ o? - 9~s Plumber's/Address (Street, City, State, Zip C e) ~ ~~ ~ `"~~© ! O ~ t f VIII County/Department Use Only ^ Disapproved Sanitary Permit Fee (lnclu Groundwater Date Issued Signatur (No stamps) lssui Approved ^ Owner Given Initial Adverse Sur~arge Fee) ~ Determination ~ ~ IX. Conditions of Approval/Reasons for Disa proval: ~ Q.U. ~ r-~~' 1,,,~ ~ ~ &~.. tom. l+ • w • tr . ~ ~ 13.2. ~ ~, ~ ~~ ~,,.. ~ ~ .~ -~ ~-~'~~' ~~ ~- „,~- ~ ~° Par "~°"~ SBD-6398 (R. 07/00) ~ ~ t~S~ iw,-. ,~ 3-~ rec;~Ce, e.r - SYa~-.' "gay ~.e~°'"''`-- "°''' e.e~.,,pC:o..~- :~ ~~a.c,4-t c.itte.afR. • lJ ~ ~ ~~ ya ~ ,~ ice` o p~ ~~ O~ ~ ~ ~~ a~-~ ~~-a ~ _a ° ~ ,~ ~ .~_ o 3 ~~ ~ X X _- 'f t __~--~ ~ fl / ,~ ~ ~ /a ~--- ,~-l~ 5y 8~ yo` ~ r Wiecbnsin Department of Commerce 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 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. # Page I of ~ rc~ APPLICANT INFORMATION -Please print all information. Reviewed by ate Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ g r Property Owner D Property Location 1 ~ ~.-v~~Ov Govt. Lot ~~j 1/4,~~ 1/4,S TZ Gt ,N,R ~ E (or~ Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# "IU5 •,~ L 1C3 ~.tve~ ~Grk ~L~1 ~S City State Zip Code Phone Number Nearest Road ^ City ^ Village [~] Town ~~ad~~ I i~t1 151-lOtln I~`l15 ~5~iq-J9-1~7 I-IiAt~_~C1vi I ~~.~h~r C'nJ~r-~- (-New Construction Use: ®-Residential / Number of bedrooms 3' Addition to existiny building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow ~ (` _ gpd Recommended design loading rate ~ ~ bed, gpd/fiz~ trench, gpd/ft2 Absorption area required ~~_1 bed, ft2 ~7~ trench, ft2 Maximum desi n loadin rate . ~ g g Q bed, d/fib 0 gp trench, gpd/ft2 Recommended infiltration surface elevation(s) v~~P r n ~,yL1 Gvwe r X~P, yU ft (as referred to si te plan benchmark) Additional design/site considerations _ upper ~y. ~(6 ~ ~w~r SSt~~ yU Parent material C~t)'~C1.X).`~~ Flood plain elevation, i f applicable lUf9 ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ~ ^ U m S ^ U ~ S ^ U ^ S ^ U ^ S []~ U ^ S © U SOIL DESCRIPTION REPORT Boring # Ground elev. ~ . UU ft. Depth to limiting factor ~in. Boring # Ground elev. 9~1~.ft. Depth to limiting factor 1 ~ in. Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench ~ -~8 /d ~ ~ ~ rl ~ _._. 5~ 1 m5 bk mfr LS ~ ~ - y ~ . S Z ~ ~~ / y( -- m5 m J ~s -1, - 8 ~- .,-- 31.2 ~- Z ~ f, ~ ; Remarks: -~ - ~~ / /U r` J' ~l ~ ~ I I~r,Ct.bk im-~r C € ~~` 'v~ . 2 ` '~:-~ Z 9 I$ l0 y r yl `l -- 5 t~ 2 m k r ~r_ .. I. r r ',-• ~ ,~- ~,. 3 P~-/ l ~ y r ~J ~(~ ___.- t~r~5 L~~ m ti ~ 5 ~ ~ ~et~i~. , . -? F '^~' ` '' : ZOP1 NGOfFI ~` , /~ _ ~ ' Remarks: CST Name. (Please Print) 'gnature Telephone No. al Sc.-h u er ~ 1 ~ - Z~ ~ -goo ~ Address Date CST Number p Cedar S-t. ~ `f Somer-sel- - 5~-ioz..s ll- Fs -4 2 5 ~~ PROPERTY OWNER ~c~ (~UJc~ SOIL DESCRIPTION REPORT PARCEL I.D.# Boring # Ground elev. ~y.9o ft. Depth to limiting factor ~in. Boring # Ground elev. ~$, ~DQft. Depth to limiting factor ~in. Boring # 5 Ground elev. q ~ ft. Page Z of Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda R ts z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry oo Bed ,Trench l o-~ .lU r3 ~Z I m~bk- rr~ LS 1 d~ . `i ~ -s Z -t i$ iO r4 ~ mS d Im J ~ S - ~ 7 ; . g >r~ ~ p Remarks: ~~ •~ Remarks: Horizon Depth Dominant Color Mottles T t Structure i n C t da B R t GPDJft2 in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ons s e ce oun ry oo s Bed ,Trench Depth to limiting factor 1/ (oin. Boring # Ground elev. tt. Remarks: Depth to 1...~ limiting factor in. Remarks: SBD-8330 (R.9/98) _- _ _ _ _ _ NAME ~ ~ ~.U (~~ ELEV . y , U DESCRIPTION- o '~ ~~ z (afh I, ~ ELEV. gp,gd DESCRIPZ'TON~--Fa '~ e Iuth rr uPAe~" Lawc r SYSTEM ELEV. SS~• yC~ ~'(v ~`/O ~ ALT. ELEV. ~~' yo ~~' yU CONTOUR ELEV . Vl v r~- PAGE ~ OF cl=S~cl-~U-z9 /r1~c Ft2~7 P C COLL04tA BLDRS, INC PHONE N0. 715 549 5911 Feb. 14 2001 10:46f~1 Pl s ~• YJt~or+s~R ;^,gpartrn6tit 8f l;omrrsrcae SOIL ~VALUATIC}N REPORT P~s6 ~. ~` Division of 58fety s++o 9uuaings "'~ j to acec;cance with Ctxnm 85.4Yis. Adm. Code Ceuny ~ ~ r ~ ~ r attach ~;iale ~ pyQn'or; papsrnot less than 8 tl? x 4 t inches in size. Ptsn muse include, twt not timiteo ta: vgrtirsl and harizonta! tefe~nce paint (BMy, dtreGtion end Paget t.o. pdreant mope. scale oc dirsteslstvnt:. north ar. nw. and lac3tio:, end d,stanCe to n¢erest road. Reviev~d by +~ Cats pieas$ prMt nit Ntfcrnfa~ti0n. ~ - . Ponons~ inrDrtRaC~Ott you proViOs m4y b9 Wsd ier sa~n~'Y 4vR+oss1 tPrivsey i.aw. s. ! ti.Qd (1) (m})• Proae-4+'Ov+ner Provertytocat+ort ` t3ovt• tot - 1/4 ufSt4 3 t ,Z Q N R Jq !; tom) Prapeny dwnei a Malting Ac~roes tot ~ ~ 81ock ii Sudd. tVama or C9ir>Nk 5,~. ~p ri~ dog S il>me ~ ip one Nutnbor t,~ City Village 70wn nsearest Road t ~ - --- Gp'a ' (~ New ConstruGion Use: ~ Recidentitil / Nur»ber of bedrooms 3 • -'F~ Code derived dsatgr- flaMr Fate _._~P,~~ Q ReptaoaR+eret Q true cr coeYUtte'ctat - Uetic~he: S _ FfoodPta~eleva6on~eppYcabM ~i' _ft. PBrant,,,eyattat a~j~,3,..~.,~.._ c- a yykw• c~-~ v ~ ~ ? G ~- and tacoiiunendsttorss: S Ong ~ ~~,,.- Graured surtare elev. ~.t'0 Z n. QePth to Urnlang factor ~ tn• ~ tiara i :T Ptt ~{ Depth Dominant f: tsar Redax t~astxipt~n Texture Strube GonsisUanee Boundary #~oots `fit P ~ tn. AdunEeil Qu, Sz. Cont. Color Car. ~. Sh. r --~- { /~ '.T~ ~ 1 .- ~. . ~7 l Z , Z d a~nc Bo~9 ~ Ptt Tarour-d surface elev. ~,~ ft- 1?epth to IiRi$inQ tailor ~(~,~,,. in. Horizon t~pth t~otsanant Gobr Redox De9eliption texturE Strudt:te Con~ettunte i3oundery Rtsots t in. Mun~R t2tt. 32- Cant. Color_ _ Gr. Sz Sh. ~' /~~ r.~ ~ ` ` L S a tw ~,. y///e .i- ~ ~ .. C Effluent e'i = 8C)Os > 30 ^220 rt+grl. and YSS ~3fl < t Sf, Name ft~ieaoe Panty . /Sip e .~ ~ C -- ..- EtflseM ft2 ' t~0, _ 39 nigFt. end YSS ~ 30 +n8 ./' C57' Aturnbsr '~f~2 Address r - _ - s/ Dots ;"av8tu8dae~ CpnduCtad Telephrna Nu-nt~ { L71/ `~...3~C ~' .~7~f ..~G'i LYt.•S/ .'s'L.' f_.-.+~.ti~/ 5..1 Q c. ~ f~~`~• _ "~ ` C~ ~'~ _ ~/fJ ~y ~ ~ ~J~__ t FROM P C COl_LO4~R BLDRS, INC PHONE NO. 715 549 5911 Feb. 14 2~1 1O:47AM P2 ~r PerGeilDif ~~ (Q [~roPeRY Owner * ~y~r~9 ~ ~ ~~ 1`l~ Pft Ground suApw efav • Z Z t~. Dep~h tv ~~m~k+g taC[o .1,~' L_..~ in. Hartzon Oaath D4rninant Cobr' RedOx Deacriation Texture ~ ~ Sh. ~'~ ~~ fn. Mansell Qv. Sz_ Cont. Color _ H A 1 i~"'1 ~ t~orins Page . ~ , ~ ~~~`~~ a t3rou Pit i?d 6Uff8C!! 81@V. ri v 2pin ip Irrneuna reeaw ~^.._ u~, - Rats ttori7g n Depth DomtteaM Cob ft~ox OssCripUOn Texture Stn~cture Cora;abnq 90und8ry Roots in. ~ Munseli C2u. Sa. Cont Coksr Cn. Sz- Sh. •E~ ~ `E~le2 1 ' i f t>~M iK2 = BC+Ds > 3Q _220 mgA. ar~d TSS yg0 ~ 154 mg/~ ' FIlh:ent tea = BODE ~ 3J rngq, and T5S ~ ~ mgll Tree napartmrnt of Camm4ree is xa ectun! opportunity sxrYict pTcv ider and e+npfoyer. if yea nded assi9csnos to aecl~s 9ervicess or need msaai-eI in an a}teniat+~ feimat, ptcas~. co:-tgee the depaRment at 608-?6G-3J3i or 7`TY 60B-264-877'. Sr~nx ~ !o s:t.r:gn~ t3~!K1Q ~ ^ BO!'11yg t'3routuf sarfeae B18v. R. Depth m Iknifa-g lotto: '^• gop L.~. Pii GPWfF { Hotrion DeAM Doen~+ent q~>?x t~stxiption Texture gcNCatre Consistence t3attnSatY ~oota •r:~t ,n. ~ blunrs0 Ou. St. GatL Gotof Gr. St. Sh• FROM P C COLLOVA BLDRS, INC PHONE N0. 715 549 5911 Feb. 14 2001 10:48F~7 P3 `, PAG E~.Uf ~ __ NAME L.nT# ~I BGAL D£SCRSI'TIO~i " '/_ 't. S N R nM I ELE.VATION,^IJ,~U ~" ;: BM i DESCRIPTION ~{o~ o,~'~j~.~-~~'^~/ f3M 2)LEVA I'ION_/DU ~ ?/' S .- BM 2 D£SCIt1PTlON}Q~e~_t.I~'~" -c- Q~.af'S SYSTEM 1=I:EVATION, __~~.~~__ .._~ ALTERNATE E1,EVATIOIV_~~ _., .,_Y CONTOUEt. ELEVATION_,~t./~_ .y 1 X `_ ~ r ~ is --OCR SEPTIC TANK MAINTL~NANCI? AGILI?I?M~NT ~''~~' j ~~ '~ ~ ANll n OWNBItSIIIP CLR1'IrICATION FORM Owner/buyer ~. ~ . l L~ ~ ~ ot~A Q ~ ~ n s ~n~ ~ Mailill~ Address -70 `~ ~v . ~C d : ~ /~v~sav ~vL- .5 ~-v > (~, Property Address ~ ~ ~~L '' ~ (Vcri[ication required frotn Planning Department for new construction) City/Slatc~~-vu~~ ~-~ Parcel Idcutification Number LEGAL DESCRIPTION Property Localiou ~ y,, /(~~ %, Sec. ~ T N-R ~ W o 0 , 'I' wtt of !7S Subdivision I V~- /~ 1~,~',~} ~~~ ,Lot if l ~7_. Certl[ied Survey Map fE Volume _ Pa~c # Warrstnty Dccd t*E - 6 ~ ~ 2 (~7 Volunlc .~ ~ . I'a~e # ~ ~.~--_ Spec house ^ yes ~tlo Lot Hues idcntiGable yes ^ llo SYSTEM MAINTENANCE . Improper use and maintenance of your acptic syslcm could result in its prcnrature failure to handle wastes. Proper nrainlcuancc consists of pumping out We septic tank every three years or sooner, if needed by a licensed pumper. W Irat you put into the system can affect We function of the septic tank as a treatment stage in We waste disposal systccn. The property owner agrees to submit to St. Croix Zoning Department a cettiGcation form, sigucd by the owner nnJ by a mastcrplumber; journcymanplumber, restrictcdplumbcror a licensedpumperverifying that (1) the on-site wastcwatcrdisposal syslcm is in prol>cr operating condition and/or (2) otter iltspection and pumping (if necessary), We septic tank is Icss than 1/3 full of sludge. Uwe, the undersigned have read We above requirements and agree to maintain the private sewage disposal systctrr with the standards act forth, herein, as set by the Department of Commerce and We Department of Natural Resources, Slate of Wisconsin. Cerlilication staling that your septic syslcm has been nrairrtained must be completed and returned to We St. Croix County Toning Office within 30 days of We three year expiraliou date, SIGNATURE Or APPLICANT / / DATC certify that all statements on this form arc true to We best of my (our) krtowledg6. I (wc) nnr (arc) the ownct(s) of //~b~ ~'~i'9~~b~ivi~ue of a warranty decd recorded in Rcgislcr of llecds OfTice. y~wV~ APPLICANT Q /, b7, c~/ DA'1'C •~`''~4• ulf nnation Wat is mis-represented may result in the sanitary pcrnrit being revoked by the Toning Ucpartment. .,..~-~ •• Grclude with this application: a stmnpcd warranty deed front tltc Rcgislcr oC Dccds office a copy of the certified survey mnp iC reference is made in the wnrrnnly decd r 51'ATE QAR OF \VISCON>IN FO[Itl 2 - 1982,(^r~Q,G~.~-~. t4'~RyyRnnAKrriiTY UEFD K11'F)ILEEN ~N~FF IffllSll DOCUMENT No. ':t:. ~'JJiJP1Gi ~ ~~2 &TGICROIX COD~EU[ 1 RECEIVED FOR AC[ORD `-~3 Ffnrjorie )lalernee, Frencea August and Faul Kstner ! nu tcnenta n cununun --- 01-06-1939 9:10 AA - a kla Francis ._ August Eft f A GEED cvnvcra v.d Nunnn IC CERI tDP7 FEE] • ~, t.o_ ova lu cera, Ins.; a CODP FEET . 4([si:onsin Cnrporat•cn TRAKSfEA FFE1 1110.4D y, - - kE[plD11U FEE: 12.00 - FAGE9: 2 t ._,.. _ ., nw a•ace rrcsemeo ronCncconon:o vue dm lellnuind desuil»d :eel eN~lt .n ~t ~ Croix Cv„mr [1AV~t ' J, L.,S7~CL:'~ Slate ol4Vlsccfuin: 304 L'1CUST .'f• 3E 1/4 ^u(f !/4 See. 10-T29N-R19;1 excepting therefrom Lot I ~iUUSUN, w~ 5~O~c'1 • of Certified Survey tlap recorded lrl Vo1,7 of Cutcifled ' Survey FIaGd, Pe$e 2089 se Uoc. No. 447303, also excepting 02U-1010-20 • the rotlrtsd rigltt of t.a>. O2D~J024-90• o2n-1015-90 , ilE 1/h t1W l/4 Sec. IS-'f29N-R19W excepting tharnfrrm Lot Iv~l'ct-iu\uTficli~i'vfuelnin o[ (:ertified Survey Flop recorded in Vol. IU of Certified ~ Survey Mapc, page 2701 as Doc. Vo. SC7728. ' tIS! t/4 NE 1/G Sac. 15-T29N-Rl9W ' . ~: it ' lhb is not Iwtnawd Pte eny. -.1k1- l9 noU Fx:rplonto•Hlnlmict:f. ' 1 ~ ~~ I Dated Ihlf __ ~;'• dry of June / .' 9 99 . ._"'~~~SL:f"• ~ /4CLC~AI~nf '~,~~~~;D(r~~ i.l.=~ ~ (SrAI.) ,. • F~rn~nyce~s, ~Au uat a/~.AInu'8u'9_ ;r-~~_ u~~y,tn~~• , Pnul Warner i I ---~r~-F-•~-a ~• ~ ,.-. ,~(:SAII~-~~y'{ (BEAU t!arlorie~alernee f'!•-t •~-~~i~:t,,-':r!~ ~ ---~- i :.1. ~ 4~71`~~~~ AUTlIENTICATICIN ndqut~ ACKNO4VlEUGF1ENT '1 Si vrA,e'e),~-~~ n ) on SAC ATTICIIGt1~' 6 Starr. of 4~Is~:b~~Rw~ ;I I lF.'H(S15LT "A' I 1 u. '"-° Ring Canny wdtnnicncd Ihl+ dry of , ;9_ Tersa:nl:y r>Ime before the U,te 26 C_h_ _~ day of i June tq 99 _ I!,e abot•c n,mnl .I , - ~ F17LGt \1EMDf:R SIAT@ 0.4R OF Vt'ISCJNS(N trances uguct j (I(nol, audtorlrcd by 1706.06, vUi1. Stfu.) to rce FnuHn to ht ptlten "' Nfid tsetvtrd Ilse foreg:Arl; I inst + r {{ a r n wlydse 1 at e. . T.119 I',3rRUlAF.f11 Y145 tx1A:TfD PV I Nevl/ood b Cori 9.C. b Walter !lodyoeky 104 LacueC St., P.O, Bt:x 115 Hi son, RI 54O1S Ncttry Pu61ic, Klug _ Conntl;.Ulb,- (:~, (516r.a:ere! uuy be nu;lx~dared m ulu{ow'tdGtd. N,itfi are not T.ty eo~nnieciott It peomnent. ;If net,. utu e>,Piruiun d•te: ' nccctsory) Septeaber 1, 2001 ~ tb---•) •:hen el pn+ent egnufn.,,n.,pua,f.dM,,llbl gpedapn.ud 6dnr tna„Ipaoret. ~... ~ ~ .. ~ t\',1RM~lY f1GEU fiAi!fl.\t OF I~ISCOKSIN wiXmm\~rc nav.Cu. ve, Fore, No. 1 . 1981 \Y.wla:. ~'rt. e 1~ L 0 T 8 tia`' . ~, ~G~ ~~ \oh .~P ~,°` O: ti~ N~ O .: O: O o >: - 0 ~' °o • 2 V~ r, I~ .: I~ 1 I~ I~ I: ~: ~~ N N 'j'F ~ ~.~. ~ `` ~o `~ 2 ~ \ \ " Oy ~ 0 \ . ` ~, ~ ~` go ~~~ ~O~ \ ff o~ AR 7tu-; D ~ o~ ~ ~S ~ ~, s l ~ • ~ . \ •~ , ,~ LOT 9 ~~ ~ `'~/ `~~. ~ \ 2. 88 ACRES l25, 352 S0. FT. _ G ' ~ ~ ~ ~/ •., ~ ~~ """"""' N89° 58' 22" E I•'•.• N37° 30' 15" E ' 84. 4,9' ~~' x• 18 ~a O/ i ~ I ! 3iJ~~ ~ I / / / ~3, ~ ~ Il / ~~ ~ 13 362. 63'" " " " " " ~ r 0 1 O i 3 ~ ~-l~h.~ ~ 50' O i gr,,,,~ ~ ,(~ ~~~ ~o ; I Q 1 f I O . ~ ~ 'la I - , : ~' 6 s~ N 0 O Z • 2. RES ~ p~'~.122, 0 1 SO. FT. '~ '~ -~. ~ ~ N `~ of : -ri .~ EL ,is / / .. ! s -' / ,+ 1 i ~-r-~ - - 1 ~- ~- ;. 1 GH WAT ~' 1 ON= ' 13. 2' ~ ,' " .~ ~\ . •':• • ', ,~~ ~ O ! . .~, ~ _ _ ~~ _,~, 3. .• ! ~ a ~ '.r / I 1 / Q - 1 I _~ 1 / I / / I ~ Q ~ ~ S. ~ '` ~`' f ~ ~% LOT 1 I,'! ' _ ` °° `. . ' ' ~ ' 3. 17 ACRES I . ~ 1! -;' . _ ~ I E '•~ ~ 138. 02T S0. FT. ; I DRA NtAG - _ ~ i 4 ; i '~ w t ~ 1 ~ / 1 t i ~ O 2 ~ :... ............ ~ .......... 1 ............................. .... . i.. ..1.. •~• .............. ... W coo ` i i ~- H 1 GH WATER ' ,' g ~ ELEVATION= 913. 2' 1 "^-. ____~ _ ~ ~ AREA _ \~I I ---- -------- ~-----_- - cp --- --------- 1''~ - - - ' - 485. 46 ~_ ~ _ 2~ ~} ~_ .Mc CU_.~ Private Onsite 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 (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans 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 Onsite Wastewater Treatment Systems SBD- Table 1: Svstem Design Specifications Sanitary Permit Number g~{ t 1\ Number of Bedrooms Design Flow -Peak (gpd) -b Estimated Flow -Average (gpd) Septic Tank Capacity (gal) " Soil Absorption Component Size (ft2) ~- - '~~ Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) ~ 3~ Z- as Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 .Maximum TSS (mg/L) 150 Tab le 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. 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, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se k and outlet filter shall be assessed at least once every 3 years by inspection. T outlet filter hall be cleaned as necessary to ensure proper operation. The filter cartridges a removed unless prov sions are made to re am so ids in the tank that may slough off the filter when removed from its enclosure. If the 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 afmosphere within the septic or other Treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe 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 Absorption Component 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 ~ y ,-~ ~` r~ ti, March 13, 2001 P.C. Collova Builders Attn: Laurie 705 County Trunk E Hudson, WI 54016 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Fax (715) 381-4686 RE: Septic Inspection for P.C. Collova Builders located at 984 Katner Court, Riverpark Meadows (Lot 10), Hudson Township, St. Croix County, Wisconsin Dear Laurie: A septic inspection of the above referenced property was conducted on 02!15/2001. This property is located in the NW 1/4 NE 1/4 of Section 15, T29N R19W, Riverpark Meadows (Lot 10), Hudson Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions regarding this, please contact our office at (715) 386-4680. Sincere M,~ J n Sonnentag Zoning Technician Ism cc: file