HomeMy WebLinkAbout038-1007-90-000 (2)
a;lsr:c~sln :r-.h,;ro.~e-t of Comme•~e PRIVATE SEWAGE SYSTEM C-J"n`y' St. Croix
Sa'ci': B d 3m jlr'] Divisii:n
INSPECTION REPORT Satn:ery Perrl7 No
GENERAL INFORMATION (ATTAC.-I TO PERMIT) '~Ijje 1 11) No SAN-2018-395
I irformst rn• voa pv':WC m.r; be suc'ot settre::ni rufrosua IVnvacy -a., s 15.9<+' ✓
Pew, I Holdef s Name Cf-v VI age -oansrlp Patrxl Tax Nc
James Reckinger TOWN OF STAR PRAIRIE 038-1007-90-000
CS' LIM L cv. Insp R`.1 Elec BRA Descri aliore 1 S¢ctiontTav,r!RangeBdaa No
02.3-1.18.22F
TANK INFORMATION ELEVATION DATA
IYPF MANUFACTURER CAPACITY STATION BS HI F5 Ft FV
SephC - I Benchmark
Dosing Alt. SM
AerWen Bldg. Sevier 5 5 I r_
Holding St'W Irlet
TANK SETBACK INFORMATION SVH:OU:i
TANK TO P L V:'ELL BLDG. ':'ert :c Air Make ROAD oHnI t i'
Sc^tic r DI Botlom
Dosing Headc"Man. 4 ~
Aeration Dlsl. Pipe
Holding Bel System
r _
Final Grade -
PUMPISIPHON INFORMATION -
Manufacturer Demand St Cover
GPot
Model Number
T DH lit', Fncuon Loss System Head TDH rt
Fcrcemam I ength D a. U SI 40 Svc I
SOIL ABSORPTION SYSTEM
BED:TRENCH Vol t-ii :.13th Nn t)' Ilen-li PIT DIMENSIONS No Ot I'C5 Insice Did L qu 7 Ccpt'•
DIMENSIONS I
I
SETBACK SYSTEM to- P1 ~ D % LAKEiSTREAM LEACHING ma-wacu-er
INFORMATION CHAMBER OR
ao.e Cl Syrem. .._J UNIT A'oc¢I Nb°h¢•.
DISTRIBUTION SYSTEM (L~ u L r=) ! 7J~_ h ' , +
Hl'adeN rdatnlold Distih..tn' Ix .loleSte xFr. arl'3 'b'ent DCAi" ntase
Lenglr C a _ 1 e-~pte -Dla Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
OeptC er C'L'oP' O'C' xY Depti •J' Xx Seejed Sej G_d :'II1 Ucdl rs"Tc Cer'ICr Bel Tre9nh Edgar Iops01l
Yes Nc Yi.S N-
COMMENTS: ilnc I code discrepencies persons present. i Inspection kt. Inspect on q2.
Location: 1242 S CEDAR DR !I I:
i) AI: BM Descnptlon = '-1J-
2 ) Bldg sever length =
- amcun, cf cover =
Plan revision Requiredn Yes No
Use other Side for additional mfo•mahon.
SBDS 0:R 3',7' D e fhseoclors Sign ur ~L// Ce•I Nc
Industry Services DrAsion
1400 E
P.O n7016622 Ave Smitcy Pemt A IMmoher(ro be rdlad in by Ca)
Box
Madison, WI 53707 -7162
Sanitary Permit Application " S~T--vvcq~Imu~~
in aoawdlOae s~vh SPS 38321(2} ll'¢ Adm. Cade. snl~ssom oFilois fwm to the:ppoputa a®oW ®t
rquucd prim to olRait a Mary panut ?\04~. appFiaiaa forms Ca statcon'ord PO oresatho6cd ro _
the Ik(urtonrnt o>;Safety soul Prnfissioml Satiw-s Yasuol mfmmtian wt ptotidc mi)• Itc oral for Pralm Adbesa (d&ffmaat tb.o mai6og address)
_ puposes in aotadeat` ari6 the Pmatt~ l±n, s I iD1(I)(m), StYZ 1 `
L A UC:1t(on Infotartion -Plea a Print A0 W m - - r S ~PJa U
Rupah• G9moc-s Nmrc I Paod 3
Ropmty (laoa`s Moiling !ldrhess Pasperh l.ootimt oa - 3 1 . 1yJ • a s ~
cart lit
City state zip code Pbmte Kumbt N~,,_yy section
IL Type orBm'ItFmq (buck ad that apply) \ I.a
0 1 or 2 Fmmily Duelling - Xnmbc+ of Wdroooms - _ 1_ ~ • sub ii i+im Mm-
❑ Pnblidt:on m=W - D.-be in-- va tn6 Y,e_ Vo I S_ ~G 12 ✓t, 1,5 10 3~
tor..` ❑ rte, of r
u - ❑vna~ear
/ - Pr -
Iar..1L 12~~ce. rh 0-r,. of
DI. Type of Permit- (Cheo$ oily one box on line _ IM"ee$ifappSee6le)_ u -zarw-
❑ Nta-Sy9em CI R~-•t-•-••+SaRemlaeW:gTadc Repody ❑ ottax,GdfiotimbFavtigSem(
8. ❑ Pan it R.mseal ❑ Permd R Mum U L~ of U Pe>m"t Tromftr in Mess List Previous Pnmit?Mumlrr d . l,aned
eelore Hxpitaum PI®Ar owner / ZS C.s3 /~J /9~'
IV T of POWS Slstem/CompowWDev~-icc ((?sack all
dent amity j - - - - -
Pcrsramcd L14Ammd - - I4esssiecrl ImC'arwud ❑ .fit-i'aade ❑ idotm,d> 2d m of sRitsbk and ❑ MGUW a 24 im o(mitmble s 1 _
Tats OILor D-epasal co-poacat(4ybin) ❑t,,atrv„amt-D-m-(-v_:••)
V. . maUTresummt Ar m InformafSm:
Design FloJar\(!ffd) Design Sea Applicalim Discs -1 A- Rynucel (31) D'apasal .•1ra Mr~ud (sQ Symms- Elevation
YL 'rank info
s
(inilosm units ) 'Namfe~~ - u ?
ica' 1'adt F_vaugg Taal j.~// ~~s~ ~ U :n a w i. ~
stplicor liob~g Tank - - , ❑ ❑ ❑ ❑
Dosing chamber ❑ ❑ - ❑ ❑ ❑
VIL Respossibeq S/zlement- L (be tmdmilued, aswnte respscsmWV foritalallatioa of the POVIFTS sLeaa on the au,&,d pi,
Plumbrr yrltame(Few Pltmtbv's sigta HPraiYRS Mamba tlsPbmeV®ina
mm;bri z Addnas (.Stoaet. cay..%,k. Zip Co&) %
AML CoaoR artmemt Use Ott(y
Approved ❑ Do_aMT -d Panoii Foe DoaillssimccIp
~ ~E}(~.,trrc l'aD®al s L • ~ 7,~~IX con Lluappo\
c. 3 ~ XA1. LOP- Z,U
uis4.WL t•, cell rust dll t '_IC
~p 0.f¢- Q--)-i-C-~ 1-J to
es per m orayemen! plan p :.:iue•- by ylumov . co
2. AM aNtstrk rtrbh ^rn.s muul tc o,rt, n t : a _ d'o 4A
as pw ttpFeerAH cod.,.; :rd
;.nm;ta dj
.1t~ to rsmpidetttea tr1lsptm and sbrttt.--ateconn®iSor~ spapeoool toss rksS ra s If orisi ~
C~L~
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cyi
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e
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cor
CONVENTIONAL COMPONENT DESIGN
Residerial APptk akn
p.~~.~'1...ua RM)EX AND TITLE PAGE
Protect Name : fi qY / 1 I
1
owner's Nallrle~
Owner's Address=
Logoi Y
Townsto.
-Rubdhftion Name:
Lat Nom; - a-
Parc2fiD Number ,
page, WON am hie
page 2 Plot pim .
Page 3 &Jzv" S0g & Cross-Secicn ; , -Y -
Page 4 Fdk Specs .
Page 5 Niirdenalcc b9off nation
page 6 Ma mmimuent Plan f- ~ 3
Page 7 St Croc Cty Septic Tank Mmftnmm Form
page 8 Warranty Deed
pAge 9 CSM or Plat
Atladvme nts: Sol Tesi & Hou se plans
De9gnepVkwnber. % tkenae wanber_
Dates Ptm3m Wmn per
Signalu a
Pub re R6rsudSL7A6rrgi~ raa~p~rrioertul corns vtdowzo am-~wasP Paaw+~
Pave 1
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f (7~
~n~
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Firrers
PL.-525 EffLUENT RUER ( Ll
Polylok, Inc is pleased to add its r
new commercial filter to its existing
line of quality effluent filters. The
PL-525 is rated for over 10,000 GPD Alarm
(gallons per day) making it one of accessAAT" Amepts pVC 4
the largest commercial fitters in its ~ e> bocce s
class. It has 525 linear feet of 1,..16 t
filtration slots. Like the Polylok a
PL-122, the new Pbtylok PL525 hasr '
r' 3
an automatic shut off hall installed Say linear feet y S
x4itth every filter. When the filter is of t/t6' s
1 Razed for over E
removed for cleaning, the ball will tau Cadou'\f~ a-- to~oeor,
float up and temporarily shut off .a<
the system so the effluent wont.
?y
leave the tank. Alo ofhwOter on
dw nmriot em make that ofaimd ; __40Pipe~ F
PL-525 Ma€Wtaparwe:
The P"25 Effluent Filter should
operate efficiantly for several years i
under normal conditions before
requiring cleaning- it is recom- F
mended that the filter be cleaned t
every time the tank is pumped or ` i
at least every three years. If the s=
installed filter contains an optional
alarm, the owner will be ratified C
by an alarm when the filter needs E S
servirang. Servicing should be Gas
c
done by a certified septic tank s _ AtOomatie slmt~ff
pumper or installer. ~
I _ Locale the outlet of the t15. Pam[ Nee uersass
septic tank ssrtoto
2.`Remove tank cover and pump -
tank it necessary. PL-525 Installation: 1. Locate the outlet of the
3. Do not use plumbing when septic tank
fitter is removed. Ideal for residential and com- 2. Remove the tank rover and
4_ Pull PL-525 out of the housing. merctal waste tows up to pump tank if necessary.
5. Hose off altar over the septic 10.000 Gallons Per Day (GPD). 3_ Glue the fitter horsing to the
tank- Make sure all solids fall 4' or 6' outlet pipe. If the
Sher is not centered under the
bade into septic tank access opening use a Polylok
6. Insert the filter cartridge back Extend & Lok or piece of pipe
into the housing making sure to center filtm
the filter is property aligned and 4. Insert the PL-525 filter into
completely insefted. As housing-
I_ Replace septic tank cover. , 5_ Replace the septic tank cover.
r
DILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COUNTY
- - Gyro.
STA SANITARY PERMIT N
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ S 2
8'6 x 11 inches in size. Chdc urea9lon topr ous .ppuuon
-See reverse side for instructions for completing this application. STATE PLAN I.O. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY 0 PROPERTY LOCATION
/ t is, rI7 /a ,4-j%. S T N, R E or ev~ PROPERTY OWNER'S MAILING ADDRESS O Ill BLOCK k ewx
00
CITY,S T ZIPCODE PHONE NUMBER SUBDIVISION NAMED CSM NUMBER
if '0~7 ~.f
11. TYPE OF BUILDING: (Check one)/ CITY NEAREST ROAD
❑ State Owned VILLAGE ~ ~ D r
❑ Public 1 or 2 Fam. Dwelling-# of bedroom RCEL TAX
III. BUILDING USE: (ft building type is public, check all that apply) 0,:N'-/007.- GS^J- )
1 ❑ Apt/Condo lV
20 Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 U Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/BarlDining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one In line A. Check line B if applicable)
A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System Tank Only Existing System Existing System
8) ❑ A Sanitary Permit was previously issued. Permit # Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ~ Seepage Bed 21 ❑ Mound 30 ❑ Specity Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
140 System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 12. ABSORP. AREA 3. ARSORP. AREA 4. LOADING RATE 5. PERC RATE 6. SYSTEM ELEV. 7. FINAL GRADE
p,~ REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gels/day/sq. 11 (Min./i nch) ELEVATION
61e A ` feet Feet
VII. TANK CAPACITY Site
in allons Total #01 LPr b.Fiber- ExperINFORMATION New xistin Gaons Tanks Manufacturer's Name et ~a Steel glass Plastic App.
Tanks Tanks structed
I
Se tic Tank or Hot in Tank
Lin Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW Np.:
1(7511711 -7 Business Phone Number:
r
7l
Plu M (Street, City, Stet to Cose):
G f^
IX. COUNTY/DEPARTMENT USE ONLY
Disapproved Sanitary Permit Fee (Includaa Grourbwater Tr are saue 'sauing Agent Signature INo Stamps)
n(A roves Surcharge Furl
DO ❑ Owner Given Initial Q~
.4,5-IA t
Adverse Determination
X. CONDITIONS OF APPROVAUREASONS FOR DISAPPROVAL:
SSD-ON8 (lormerly Plb-87) (R.11/80) DISTRIBUTION: Original to County, One Copy To: Safety It Buildings Division, Owner. Plumber
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
i
OWNER/BUYER ~Qmr-.~ .~-k ~l T ey-
ROUTE/BOX NUMBER FIRE NO.~
CITY/STATE /v V1 R (,kML')K 2IP S~p")e
PROPERTY LOCATION: 11/4 ~y~6J 1/4, Section T_3jLN, R__L_W,
Town of ✓ (Cif- Pr- r' rte- Vin Sn St. Croix County,
Subdivision Y1 Lot No.
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
talk every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPEE.
What you put into the system can affect the function of the septic tank as a
treatment stage in the waste disposal system.
St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of
$3000 of the cost of replacement of a failing system, which was in operation
prior to July 1, 1978. St. Croix County accepted this program in August of
1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their
systems properly maintained.
The property owner agrees to submit to St. Croix County Zoning 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
wastewater disposal system is in proper operating condition and (2) after
inspection and pumping (if necessary), the septic tank is less than 1/3 full of
sludge and scum. Certification form will be sent approximately 30 days prior to
three year expiration.
I/WE, the undersigned, have read the above requirements and agree to maintain
the private sewage disposal system in accordance with the standards set forth,
herein, as set by the Wisconsin Department of Natural Resources. Certification
form must be completed and returned to the St.Croix County Zoning Office within
30 days of the three year expiration date.
SIGNED ilk a
DATE
St. Croix County Zoning Office
St. Croix County Courthouse
911 4th Street
Hudson, WI 54016
(715) 386-4680
Sign, Date, and Return to above address
DEPARTMLNT OF INDUST HY• INSPECTION REPORT FOR SAFETY& BUILDINGS
LABOR & -369 N RELnnONS PRIVATE SEWAGE SYSTEMS DIVISION
P O. ISO , NI BUREAU OF PLUMBING
MADISON, W'I 5J 707
NS~S?d' , Sec 2,T31-Rl8:d I-(CONVENTIONAL _JALTERNATIVE ".lurv .r
v .
Town of Star Prairie E. Holding Tank LI In-Ground Pressure Ll Mound
Co. Rd. x
VA\II 1'l RMll nULUL" ~ ADGRE$$1)f Pf ltMll II!1_Cl.q INSVEC Y U41
3 \
Jim Piekinger 6942 Wyndham ltioodbary, MN 55125 J`
.I NL MAP Per•n.n•.t sen... ,r ;f':I ".IIIV[Ir cffREY~.IIUM I'LA N R~LF' )'CS. nC ~'Et
m-'„-.~r,~.,.c.. xn~%rcnrir n::-- s.a wr..,. Y,,,..,.~
B on_Bi.rd Jr. 3318 SL. Croix 128653
SEPTIC TANKJHOLDING TANK ? 4p i.' 7r ! <r- <i
I NF IJfA 'll I. _I":r r I1V iA "N_ETEl IAV 1-T E tTf1 WARnIVG LAJ I 'Q^NInC ;'1VER
r , :PUVI:)fD J )IU
) n liu
J / DD J'
"`~e~'N ~ !/L~<3(.t.f', ?p.f~S J~ YES i~NO i_IVES NO
, xl~` ra. 1:;IA snsx ~-P R BER OF n`~Ar. d=eely w,LL xUIIanG N T., n.a_r
c,0• r C..D ..L.we nr / AnlmiIr
-YES X{ o Cas~ FEET FROM p ate / r
rL' Sc YES No NEAREST---- ASS. j
DOSING CHAMBER:
w r nsl: xl GJ~nb a I. ncin vPrr n n.r, I'.,. ."r, w.`. ..I. i' nw I~vE. Irca RCroAEn"
Ic 11f0 PNGVlGEO
r YES LINO _ VES ENO VC$ I NU
GAILONS PPIi CY„_E. o.lvrT'- IIJ 1:Y*Ppl> JPt RA r r,r.a. NUrdBER OF -':rtul" nt_r x r.- Y1 .11Sal
IDIFFERENCE 3ETPJE~N FEET FROM r.l oul
P„MP ON ANC OFF) I _-]YES L lio _ NEAREST _
SOILABSORPT ION SYSTEM.CFCCk the sod homiuo,at tie deotn of plrh, nn FORCE td .ul ~n AL Ar,u MAnxlYr,
I : nr , , I' soil can he rollad ow, 11 wire, coastrumu,) shall cPas9 GnU
MAIN
the so m'; e`cu9h Io cuntlnue.l
CONVENTIONAL SYS~Tr~
BEDlTR ENCH / , I.T11 nc T' S`u l I u'.: rrv_ t I:. af. e u o
T. E .S PIT t rr
DIMENSIONS i X t~ _ r /11,;;, -
„~A I T"'r'1 1 raI 1 ~USPPVI 'J9fl I A 1 \ V( L"I PPOPf''V IVfIL 3UIL1hG V VTTIIPCSP
eEL \ Psr rt „E c. I [ " NUMBER OF
" f u ,N [ J-'/~, I FEET FROM +L u t All nul
J 7 ~_Jr aZ I I NEAREST-i•i . 7 n 8 '\'^17 l~5 r
MOUNOSYSTEM L v, y. ,v,.v _ _ _
Mound site plowed perpendicular to slope Chect the texture of the fill material 'or PROVIDE A DIAGRAM OFSVSTEM
and fu•rown thrown upslope. mound systems to make ceLla.n that it ON REVERSE SIDE. SHOW ELEVA.
meets the criteria for meelum sand. TIONS MEASURED.
OYES -ENO
OIL COVER IE-11o - PEn%: i`m ~,i-irFn.:=r. -reSEdvS-icv m I'. _
r _ _ _ _ -IVES I_VO_ _ CYE$ LINO
E:f - P'I,I V' SPIV I:f II t-l n:. n. of is If T ,.,il SEtJL MILD,-tu
d~,Ei EC: ES _ 1
` .AYES I..NO CJ VES ~_NO CJYES I.~NO
PRESSORIZFD DISTRIBUTION SYSTEM:
-TIf Y.. n. Yo Gf---. Tar[nn. SVFanp rrx awEL UCPlN a-6ii v7dl_ - IILL~ •rn..lt colt.
8EDlTR ENCH I,., wfnprtx.
DIMENSIONS
rT AA (l,.E CSTf, P,pF l1,,L.1Md I.I.L VL U.1o, 1:\TP PIGF t SI.' 811. U41.I AA~1 F 5A lilri
f E'+ UTA ilt ef5 IGiA
ELEVATION AND P
DISTRIBUTION
INFORMATION. 't s~_e ^ir JF..I I, r... l:....lenr coLEn MCTePwL .f~ncA. .,II LLU UP.: IL~IOr PPr.rEc
PLAYS
JV S ?NO___1.___ LIVES LNO
COMMENTS" PE.wzM ru enn< j6iSt PYAr1DNV. t LLS. NUMBER OF. 1•P`GVtmv nf., xu.uomE.
FEET FROM Lw.
L]YES C.NO i' L1YES CI NO NEAREST
f,r.(.L: .,4./rL "i tFJ<t r fieF ti.( r l-i.L. J: !Aid.: ~i =Y
yr, i C
p,.,GJNi C~Lt• /.cc✓ t.Lrlx'C_ ~~.,c'Y-'~.C~~"3.'nF.:r....~~i?~.15 ~.%'1,'.~. %:,~r. ! c~~-C-~.
S<etch System on Retain in county ''.le for audit.
Reve•se S,de. _
S C4AiLn ~ it L~F
DILHR SBD 6710:R. 01i82i / / '°~'7 ~~"-I ~~,<d'~J`'`~'~'C'
Form - SIC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER J/1 W / Q CLL pl iii C' TOWNSHIP J/ar0 /'4i~y 4 SEC- ,7- T3LN-RZ2~ U
ADDRESS CROIX COUNTY, WISCONSIN
SUBDIVISION LOT (p ' TTT~ LOT SIZE 65 J~
PLAN VIEW
Distances and dimensions to meet requirements of 1111H 03
SHOT; EVERYTHING. WITHIN 100 FEET OF SYSTEM
I ~1r eo N
I
Ij
~4 (I
l Y I I /
;L
I ~ ~ 1 i i ,nf~d
17
7 /
INDICATE NORTH ARROW
i
I
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point: /oa Proposed slope at site: 2f 5'j "
SEPTIC TANK: Manufacturer:
:.I.;:,id Capacity:
Number of rings used: ,/_-.C,V/O Tank munha,Iv cover elevation:
Tank Inlet Elevation:~~Tank Outlet Elevation:
''777777"`` r
Number of feet from neare<L Road: Front,0 Side Rear, 0feet
From nearest property line Front,0Slde,(DRear,0 ~.5 feet
Number of feet from: Well / building:
(Include this information of the above plot plan)( 2 reference dimensiona to septic tank)
.,~s.mmnrv ~
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Nodal: Pump/Siphon Manufacturer: Poop Size
Elevation of inlet: Bottom of tank elevation;
Pump off nwitch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear,0 Ft._
Number of feet from well:
Number of feet from building:
(Include distanceu on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench:
Width: Length:Number of Lines: Area Built;
N
Fill depth to top of pipe: L~„z -i- ?6
Number of feet from nearest property line: Front, O Side, Rear,O 1t.
Number of feet from well: "2`/ Tt~
Number of feet from building: -U 6
(Include distances on
plot plan).
SEEPAGE PIT C /LN
'0.5 E~`~-1 (°S ((j0/ice" l/OwJ / 7J
Size: Number of pica: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Nan either a drop box O or distribution box O been uuod on any of the above soil
absorbtlon sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of botcum of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, 0PC._
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
Dated:Y a Plumber on dab:
License Number:/7J
1/84:mj
=r - y.
~I
G% .
Parcel 038-1007.90-000 09!20f2005 07:41 I
PAGE 1 OF 1
F
Alt. Parcel 2.31.18.22F 038 - TOWN OF STAR PRAIRIE
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
JAMES E & MARY E RECKINGER 0 - RECKINGER, JAMES E & MARY E
6942 WYNDHAM WAY
WOODBURY MN 55125
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 3962 NEW RICHMOND i
SP 1700 WITC
SP 8055 CEDAR LAKEIN R
Legal Description: Acres: 0.550 Plat: NIA-NOT AVAILABLE
SEC 2 T31 N R18W PT OF NE SW LOT 4 OF CSM Block/Condo Bldg:
V 5/1222 AND LOT 6 OF CSM 51'236 I
Tract(s): (Sec-Twn-Rng 40114 1601!4)
02-31N-18W
I
Notes: . Parcel History:
Date Doc # Vol/Page Typo
07!2311997 9191284
0712311997 653!329
07/2311997 6231454
2005 SUMMARY Bill Fair Market Value: Assessed with:
a
Valuations: Last Changed: 10/1212004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.550 134,000 104.900 238,900 NO
Totals for 2005:
General Property 0.550 134.000 104,900 238,900
Woodland 0.000 0 0
Totals for 2004:
General Property 0.550 134.000 104,900 238.900
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
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ST. C ROIX Community Development
^I''~'` 1101 Carmichael Road I Hudson WI 54016
Cam/ iJ l Y Telephone: 715 386 4680 1 Fax: 71 S-386-4686
www.sccwi.gov
11/29/2018
lames Reckinger
6942 Wyndharn Way
Woodbury, MN 55125
RE: Conditional Approval: File# LUP-2018-066
Project I ocalion: 2.31.18.72F, Town of Star Praine
Project Address: 1242 S Cedar Dr.
James,
Community Development staff have reviewed the Land Use Permit application for the
reconstruction of a single-family dwelling, attached garage, and driveway in the Shoreland Overlay
Toning DI'Alld pursuant to Ghapter'17.30 1.2 a. [Ile request has been conditionally approved based
on the application submission and the following findings:
• The proposed structures meet the 75-foot setback to the ordinary high water mark.
• The proposed structures meet the setbacks to the property lines.
• Total land disturbance is approximately 10,000 square feet.
• Erosion and Sediment Control plans have been submitted that meet Wisconsin Department of
Nalural Resources Technical Standards. Best Management Practices and stormwater management
will be incorporated.
• The Impervious Surface (IS) calculation resulted in 18% Impervious; therefore, mitigation standards
As per Chapter 17.30 M apply. For mitigation, *1 point is required to be mitigated, the method
chosen for mitigation was to apply Stormwater Management Standards in § 17.30 K.1. These
standards have been met as designed by Land Surveyor, Doug Zahler.
• 1 he County sanitary permit for reconneclion to the existing private onsite wastewater treatment
system is currently under review.
• No land disturbance to slopes greater than 19.99%> is to occur.
Based on these findings, approval of the I and Use Permit is subject to the following conditions:
L Prior to Construction, the 75-foot shoreland setback must be flagged and erosion control
measures, such as silt fencing, sediment logs, or beams most be installed downslope and prior to
all land disturbance activity.
7. I o reduce the surface runoff of impervious surfaces from '18% to 15%, the mitigation chosen was to
apply Stormwater Managerent Standards. An infiltration basin was designed to infiltrate and
reduce the surface runoff. As per § 17.30 M.2.d. the mitigation measures shall be maintained in
Nicole Hays
Nicole.HaysCtisccwi.gov
(715) 386-4742
perpetuity and an enforceable obligation such as a shoreline mitigation agreement, affidavit or
deed restriction must be recorded with the register of deeds.
3. 1 he best management practices for installation of the infiltration basin shall be rnet. Native
plantings for the infiltration basin shall be chosen by the applicant and agent at the time of
installation.
4. A pre-construction inspection is required to validate setbacks and verify erosion and sediment
control has been installed dog^ nslope of construction acUvilies. Please call me at (/1S) 386 4142 to
schedule this inspection.
S. St. Croix County reserves the right to require additional sediment and erosion control measures to
be installed if found necessary due to site specific eoncerns and will be documented in an as-built
site plan.
6. All temporary erosion control measures shall be left in place and maintained until the site has
reached a point of at least 10% permanent vegetation. Permanent vegetation shall be established
once final grade is reached or as soon as applicable per plan.
7. A post-construction inspection is required prior to removing the temporary sediment and erosion
control measures, please call me at (/15) 386-4742 to schedule this inspection.
8. It is the applicant's responsibility to secure any other required local, state or federal permit(s) and
approval(s) prior to land disturbance activity.
2. Failure to comply with the terms or conditions above may result in the revocation of this Permit by
the Zoning Administrator pursuant to Chapter 17.71 and chapter 17.30 P. (13).
This approval is subject to the conditions listed above; it does not allow for any additional
construction, structures, or buildings beyond the limits of this request. Your information will remain
on le at the St. Croy County Community Development Department suite. It is your responsibility to
ensure compliance with any other local, state, or federal permitting or regulations, including
co•itacting the I own of Star Prairie and the Department of Natural Resources to inquire if additional
permissions are required. This permit is valid for one year; with the possibility of up to two (2) six-
month extensions if the applicant submits the appropriate permit extension tee and documentation
to the 7oning Administrator. A copy of the Land Use Permit placard should be submitted to the
town's local Building Inspector upon applying for town building permit(s), The orange placard most
be posted on thejob-site and visible from public view.
Please feel free to contact me with any questions or concerns; I am typically available Monday-Friday
from 8:00 a.m. - 5:00 p.m.
Respectfully.
Nicole Hays
Land Use Techrician II
cc: Fiiv
ec: t ,,,1! 1 1 , i 1, 1 i t r- nr' r~1.Town of Star Praise
,nttr.t kcw ldets.corn Contractor/Agent
Nicole Hays
Nicole.Hays«sccwi.gov
(715) 386-4742
i
IIIIIII IIIIII Ilill~Ii' I
Document Number Document Tine
1074914
St. Croix County BETH PABST
REGISTER OF DEEDS
Occupancy Affidavit ST. CROIX CO., WI
RECEIVED FOR RECORD i
11/30/2018 09:28 AM
<lam~s E R2G~C,nA~t^ EXEMPT III:
Name - (Owner) Typed or printed REC FEE 30.00
being duty swom, states, under oath, that: COPY FEE 3.00
PAGES:2 i
1. Horshe is the owneripan owner of the following, parcel of :and located in St. t
Croix County, Wisconsin., recorded in Volume _53_ Page Document
Number q Z2lo3 St Croix County Register of Deeds Office: Rocordi Araa
Name and Return Address
A parcel of land located in the u 6 V. of the 51J V. o Section Z Tc.+ne_5 R ec.K r nq e-r
T~N-R S W, Townof_54-r-r;(-'& --,StCrox (p95f7 WynQtitr+1 WAy
County, Wisconsin, being duly described as follows (Include lot no. and WcoQb u r y, /'1N 55
subdivision/CSM or detailed Aga) description):
5 e~ ~ti(}G~r 038 -100`7 - 96 - rj00
Parcel Identification Numtxx (PIN) f
As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a
3 bedroom home, or a design flow of 4,156 The design flow is calculated by assuming 150 gpd for 2
individuals per bedroom. There are currently occupants living in this residence; _(o occupants are permitted
based on the design flow. Therefore the septic system serving this residence is code compliant. However, i
understand that if there are intentions to exceed the number of permitted occupants, the system will need to be
modified to aocomodate any increased wastewater flows and/or contaminant loads. I also acknowledge that I will make
this information available to any future parties interested in purchasing this property.
Dated this 30 day of _&Llernkiey,
J[i.nas ~ ReLk r4~e:r
AUTHENTICATION xlt'.I! t i U!/!7j ACKNOWLEDGMENT
Signatac(s)_.- Am~lg raj STATE OF WISCONSIN )
1.,02 }5.
county.
aWwrdlwted this day of R Y SL PGr Croix county.
~l/"r
,allyty.
came before me Uds Cay of ));J
_ ~O Z . i v / Y the above named
TITLE: MEMBER STATE BAR OF WISCONSIIS . . (5_
(If tWC `i to me known Lo be the persorn(s) who exo~lilod the foregoing
autfionzed by § 706.06. Wis. Scats.) ~i'_ •O F \V\ S' hrstrumeny5nd acknovned9e the same.r; i
TqS NSTRVM~NT WAS DRAFTED BY r' If I I I 10
Notan• P1LIic. S e of Wisconsin
(Signatures may be auUlenticated a acknowledged. BoU+ uic mqt My Commie If not. state expiration date:
neck »ary) pate: w 9
'
'THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE" _
This InMrnation must be conpkfed bl'srrbmRtor. i rrinr# {elg name 6 mrten eddios§, and pIN (I repuModJ. OfAermlolmeriorr suU+ as U)e i
granhg clauses, faegal desci*Am. etc. may be placed on this fasf page or tta document or may be placed on add0onal pages of Oie
document- Note: Use of this rarer page adds one page to your document and $200 to 8e rwcaraGra lee. Wrsconstn SlatWas. 59.517.
SL Croix County 10/4914 Faye 1 of 2 `