HomeMy WebLinkAbout006-1036-40-075
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Parcel 006-1036-40-075 06/06/2007 11 57 AM
PAGE 1 OF 1
Alt. Parcel 17.31.16.249A-06 006 - TOWN OF CYLON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
03/22/2005 00 0
Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner
0 - KATZNER, ALAN L & LINDA C
ALAN L & LINDA C KATZNER
2150 220TH ST
DEER PARK WI 54007
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description ` 2172 220TH ST
SC 0119 AMERY
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 22.210 Plat: 4950-CSM 19-4950 006/05
SEC 17 T31 N RI 6W PT SE NE CSM 19-4950 Block/Condo Bldg: LOT 002
LOT 2
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
17-31N-16W SE NE
Notes: Parcel History:
Date Doc # Vol/Page Type
04/06/2005 791452 2778/425 WD
03/22/2005 790223 19/4950 CSM
07/23/1997 1174/56 W ID
07/23/1997 1174/55 WD
more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/06/2006
Description Class Acres Land Improve Total State Reason
PRODUCTIVE FORST LANDS G6 22.210 64,000 0 64,000 NO
Totals for 2007:
General Property 22.210 64,000 0 64,000
Woodland 0.000 0 0
Totals for 2006:
General Property 22.210 64,000 0 64,000
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
Parcel 006-1036-40-060 06/06/2007 11:53 AM
PAGE 1 OF 1
Alt. Parcel 17.31.16.249A-05 006 - TOWN OF CYLON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
03/22/2005 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O GEHRMAN, DEAN A
HRMAN I LQ/~
2150 220TH
DEER ( r
DEER PARK WI 54007
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description
SC 0119 AMERY
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 14.410 Plat: N/A-NOT AVAILABLE
SEC 17 T31 N R16W PT SE NE EZ-U-1187/527 Block/Condo Bldg:
EXC CSM 18-4718 & EXC CSM 19/4950
Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
17-31N-16W SE NE
Notes: Parcel History:
Date Doc # Vol/Page Type
03/22/2005 790223 19/4950 CSM
07/23/1997 1174/56 WD
07/23/1997 1174/55 WD
07/23/1997 1109/182 LC
more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 07/06/2006
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 9.410 1,500 0 1,500 NO
AGRICULTURAL FOREST G5M 5.000 5,000 0 5,000 NO
Totals for 2007:
General Property 14.410 6,500 0 6,500
Woodland 0.000 0 0
Totals for 2006:
General Property 14.410 6,500 0 6,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
453109 0
GENERAL INFORMATION (ATTACH TC; PERMIT)
State Plan ID No:
Personal information you provide may be used for sec ndary purposes [Privacy Law, s.15.04 ;!)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
jGehmrmT,-5uan-41-2tWz,) I C Ion Township 006-1036-40-200
CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
17.31.16.249
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 Di ipe
Holding Sys m
Xinl Grade
PUMP/SIPHON INFORMATION
Manufacturer em nd St Cover
/ p
Model Number
TDH Lift Friction Loss Syste He TDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: UNIT Model Number:
DISTRIBUTION SYSTEM
Header/Manifold Distribution 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 T Seeded/Sodded xx Mulched
Bed/Trench Center Bed Trench Edges Topsoil Yes No Yes 7N,
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: I /
Location: 2172 220th Street Deer Park, WI 54007 (SE 1/4 NE 1/4 17 T31N R1 8W) NA Lot 2 Parcel No: 17.31.16.249A20
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan 1
Use other side qforuadditional in Yes No
formation.
Date Insepctor's Signature Cert. No.
SBD-6710 (R.3/97)
,...2
) i
Safety and Buildin county,
. 201 w. Wash -7082 Sanitary Permit Number (to be filled in by Co.)
Nvisconsin Madiso 8) 261 6546 j 3 0
Department of commerce s4ate Plan 1_0 Numb-
Sanitary Permit A.ppliea on
G
in accord with Comm 83.21, Wis. Adm- Code, personal tnfo on you pro i 8 )
may be used for secondary purposes Privacy law, s] 5. (1)(rn.6 iON1NG "Pro ect Address if different than mailin address
~w 2 ('+z
1. Application Information - Please Print All Information
Parcel # dot r{ Bieck#-
Property Owner's Name SR ¢'n.• f O ~~Z ~G •
Property Location
Property Owner's Mailing Address y /
Section
City, State l Zip Code Phone Number
-(eircleprte)'~ 3 t0
T { N: It 1E o W
1,2
/i ✓
11. Type of Building (check all that apply) 7 14 S i ! CSM Number
f or 2 Family Dwelling - Number of Bedrooms _ C P,
❑ public/commercial - Describe Use .
❑City GVi1Lt$Pi ownsbip ofd
❑ State Owned - Describe Use
IIL Type of Permit: (Check only one box on line A. mplete line B if applicable) UO~p - G-(p
A. ew. System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modificanonto
List Previous Permit Number and Date Issued
❑ Cage of ❑ Permit Transfer to New
B. ❑ Permit Renewal ❑ Permit Revision (DH.ner
Before Expiration Plumber ~ f
S
IV. a of POWYS S stem: Check all that a 1 ❑
Non -pressurized In-Ground ❑ Mound > 24 in, of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At Grade ❑ Single Pass :Sand Filter ❑
El Aerobic Treatment Unit Recirculating Sand Filter
Constructed Wetland 11 Pressurized In~round 0 Holding Tank ❑ Peat Filter
❑ Drip Line ❑ Gravel-less Pipe ❑ Other (explain)
Recirculating Synthetic Media Filter^ ~ching Chamber
V. Dis ersalrTreatment Area Information: Di Area Proposed (sfj System Elevation 7r-
Required (st) t~ „7 i
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dis`crrsal Area spersa
<
Manufacturer Prefab Site S 1 Fiber Plastic umber
~ >
VI. Tank Info Capacity in Total N Concrete Constructed Glass
Gallons Gallons ofU Unnits its
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit /
Dosing Chamber
VII. Responsibility Statement- 1, the undersigned, as . tm[e responsibility for installation of the POWTS shown on the aEtta nhesdPhone Numbe
MP/MPRS Number
Plumber's Name (Print) Plumber's St 40
Plumber's Address (Street, City, State, Zip /
VIII. Coun A) artment Use Onl
Sanitary Permit Fee (i ludes Gr;_,er ~Dats sued Iss ing gent Signature o Stamps)
Approved ❑ Disapproved Surcharge Fee)
C1 Owner Given Reason for Denial SA i
IX. Conditions pprova al 3),W
SYSTEM OWNER: 1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained { as per management plan provided by plumber. l _ ty~ c f p Q ~p~~_ ~Q
2. All setback requirements must be maintained J
as per applicable code/ordinances
Attach comp it plans (to the County only) for the system on paper not less than 81/2 111 inches in siu
5-)
SBD-6398 (R. 08/02) 5_
O'~Lk 0, 6-xlkk si_w o-,,4 4o
Ebb,
P T PLAN
PROJECT Dean Gehrman ADDRE 2150 220th St. Deer Park Wi 54007
SE 1/4 NE 1/4S 17 /r 31 , W TOWN Cylon COUNTY ST. CROIX
1 /30/04 BEDROOM 3
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUND SURE CONVENTIONAL LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND SEPTIC TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA # of chambers 22
BENCHMARK V.R.P. Top of 1/2" pipe ASSUME ELEVATION 100' Filter Zabel A- I OC
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 98.1/97.6 4' below arade
Alt. BM Top of 1/2" Pipe @ 99.0'
Vent
1320' Property Line
>6„ Standard Biodiffuser
of Cover Leaching Chamber
with 31.1 ft2 of Area
Well is to meet all 6' Long 11 Grade at System Elevatioi
setbacks required b 34'
WDNR
Pro 3
Bedroom
House
Plans Designed Using
Conventional Powts
N
Manual Version 2.0 30'
50'
7% ST Scale is 1" = 40' 700'
Slope 20' 10' unless otherwise
B- so' noted
Vents
'40'
Alt. ~ 75'
B
s 5' B-3
500' O
> o Q
~e cr
Ven B-2
2-3' X 69' Cells with >3' Spacing
PLOT PLAN
PROJECT Dean Lehrman ADDRE 2150 220th St. Deer Park Wi 54007
SE 1/4 NE 1/4S 17 /T 31 W TOWN Cylon COUNTY ST. CROIX
1/30/04 3
MPRS Shaun Bird 226900 DATE BEDROOM
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
I
SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA # of chambers 22
BENCHMARK V.R.P. Top of 1/2" pipe ASSUME ELEVATION 100' Filter Zabel A- I Oo
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 98.1/97.6 4' below qrade
Alt. BM Top of 1/2" Pipe @ 99.0'
1320' Property Line ent
ji Standard Biodiffuser
Leaching Chamber
with 31.1 ft2 of Area
Well is to meet all setbacks required b Grade at System Elevatioi
WDNR
Pro 3
Bedroom
House
Plans Designed Using
Conventional Powts 4~
Manual Version 2.0 30'
50'
7% ST Scale is 1" = 40' 700'
Slope 20' 10' B-1 50' unless otherwise
noted
Vents
40'
Alt. B
5 51 B-3 S~5icQ9~nL~
500' O C
Vents B-2 1
2-3' X 69' Cells with >3' Spacing
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. e ' wed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property owner \ R F G , j7plif ratio
/(_-C V L'' , Govt. Lot 1/4 ,/~1/4 S ~T31 N R/L) E ( )
Property Owner's Mailing Address Lpt # Block Subd. Name or CSM#
":?r~ Z24 14
l;tty~ 1 State Zip Code Phone Nu r hG C3
lllage own Nearest Road
eii.CRV ~vUUM-
r
New Construction Use: Residential / Number of bedrooms J Code derived design flow rate v~ GPD
❑ Replacement ~~^77 ❑ Public r commercial - Describe:
Parent material f /L.lli~/C~ 4 S14v PSG A,~- Flood Plain elevation if applicable
General comments / T-
and recommendations:c ✓C~:-~-~T~...J
l
Ced2st I -t ~8•zoe,`+
Boring W y
( Bori#
Pit Ground surface elev. 0 ~ ft. Depth to limiting factor in. ~ .
III'_l,)11JI ~
~
Soil Application Rate ~.1
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
I
r~ Boring # ❑ Boring
Pit Ground surface elev. 03 r ft. Depth to limiting factor 1.- UD in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
-j
g- 2-
Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) nature CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 5401.7 - 715-246-4516
Property Owner _ Parcel ID # Page --Z-of
Boring # Boring , V
Pit Ground surface elev. ft. Depth to limiting factor / in. Soil -Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
.2-
/W Z P-/)~ ,
❑ Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil ~Eplication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
F-1 ❑ Pit Soil Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 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.6Po0)
Soil Test Plot Plan ;l
Project Name Dean Gehrman Shaun
Address 2150 220th St.
Deer Park Wi 54007
CM #226900
Lot Subdivision Date 1/30/04
SE 1/4 NE 1/4S 17 T 31 N/R 16 W Township Cylon
Boring O Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft.- Top of 1/2" Pipe
System Elevation 98.1/97.6 *HRPSame as Benchmark
AYt. BM ' Top of 1/2" Pipe C 99.0'
1320' Property Line
Scale is 1" = 40'
unless otherwise
noted
Pro 3
Bedroom
House
101' o
N
0' 102' N
7% 103'
700'
Slope 20' 10'
B-1
40'
- Flood Plain
Alt. 75 elevation was
B. established by
surveyor
-3 see attached map.
500' JIF
-2
- I~`Fg .sue
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
Corte' cqe cy Plan
O:ce on #1 If system fails, determine cause of failure, use alternate area and install new
m intested replacement area.
Option #2. Install system at a lower elevation, by removing chambers, removing biomat,
and install new system.
Option#3. No adequate area is suitable for replacement area, and system elevation
cannont be lowered. Install holding tank as last resort.
3. 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
ST CROIX COUN'T'Y
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
i
OwnerBuyer
Mailing Address"/- r
Property Address
(verification required from Planning Department for new construction)
parcel Identification Number f~ 2 cFq~
city/State /
LEGAL DESCRIPTION _W, r ~ . ~ , f , Town of
r/., sec. T.LI -
1/-
N-Property Location -
Lot # -
subdivision ,
,
Volume page #
Certified Survey Map #
a S S Volume Page
Warranty Deed #
Lot lines identifiable'es ❑ no
Spec house ❑ yep`t~,no
Proper maintenance
SYSTEM MAINTENANCE premature failure to handle wastes
Improper use and . sep ticsystem could result in its p What you put into the system
maintenance of your
septic tank every tree years or sooner, if needed by a licensed pumper.
consists of pumping out the disposal system.
can affect the function of the septic tank as a treatment stage in the waste signed by the owner and by a
owner agrees to submit to St. Croix Zoning Department a certification form,
The p p tewater disposal system
roe rt y pumper verifying that (1) the on-site was
lumber, restrictedplumber or a licensed pump the se tic tank is less than 1/3 full of sludge.
master plumber, jourmymanp inspection and pumping (if necessary), P
ndition and/or (2) after is in proper operating co sal system with the standards
requirements and agree to maintain the private sewage dispo
Uwe Certification
, the undersigned have read the above office within 30 , State of et by the Department of Commerce and the Department eotu ned~ the St Croix County Zoning wisconsin.
set forth, herein, ass c Y system has been maintained must be completed and
stating that your septi
days of the three year expiration date.
DATE
SIGNA -LjRE OF APPLICANT
OWNER CERTIFICATION our) laiowledge. I (we) am (are) the owner(s) of
to the best of MY I (we) certify that all statements on this form are true
deed rerecorded in Register of Deeds Office.
the property described above, by virtue of a warranty
i
DATE
SIGNATURE OF APPLICANT
information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department.
Any
stamped warranty deed from the Register of Deeds office
Include with this application: a deed
copy of the certified survey map if reference is made in the warranty
a copy
Proposed new home floor plan for:
Dean and Peggy Gehrman
2150 220th Street
Deer Park, WI 54007
(715) 269-5606
dpt@amerytel.net
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