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HomeMy WebLinkAbout020-1374-20-000 r a ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner ifxl0 STUD /-i�e�A4J � T�,P w d nO .4 o ao Property Address ' - 13 , -5Z G 0 ti io $T . City /State 6-h 5le/0 iG Legal Description: Lot g_ Block A A Subdivision/CSM # T ejew Q 6,e 1 /a sw ' /a, Sec. i.� , Tom^ N -R.20 W, Town of 45av PIN # o,?o - /395/ --?o - aao SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer W rg FR Size ST/PC 1 150 / — Setback from: House /a ' Well -LOL P/L 1L 15 Pump manufacturer f Model Alarm location — (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: N Width V Length 93. 7S Number of Trenches -2 Setback from: douse Well G° , P2 Vent to fresh air intake ELEVATIONS Description of benchmark 1lAiL M OAK Elevation Description of alternate benchmark o &aL f vc Elevation // _ c> Building Sewer 1&' 0 .2 ST/HT Inlet IP' J " ST Outlet fu"- '70 PC Inlet PC Bottom — Header/Manifold f • Top of ST/PC Manhole Cover Distribution Lines (4) � `/ 1 � (''S) 'TA � I Bottom of System (4—) 5/ FO Final Grade (A 13 Date of installation / /lg/ Permit number State plan number Plumber's si ature C G - License number = 2 q 7 5 '� Date / of�o Inspector Complete plot plan �+ w NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. nba•rN- l�o t „"� AQi iwAY f rtfl.E” Q 7Po /os�a DD — -- — 0 WL <L 6 Ull r„4-v. = IN. y/' / 71 %ktr grAc OfrnAe K- %5 u ►sN ooze .40werl60a1- -�` ELE ✓. = Ito, � .� ..y /q'ot /:150 Getz �i�SE/l $EO /c 'tItvK `-'—' jRof'E/l�fl'+in�� 'COQ 3S P EFL «frur Live 4 V �ic� /C�bS�/ J-fi�N C��Ac9�• L�fi1 i- .�/S�PS 'sOU?�( PQop�t fq L.niE INDICATE NORTH ARROW ,xlo t5c A LE Wisconsin Department of Commerce y Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary�P..�ro.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 3 � � J J Permit Holder's Name: ❑ City ❑ Viu4ge I] ToW pOWnShl State Plan ID No.: Landsted Homes Inc., f�udsen 1 p CST BM Elev.: Insp. BM Elev.: BM Desc iption: Parcel T08? -20 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic - Benchmark Q. 0 0 31 � q9 cff Dosing Al . Aeration Bldg. Sewer 7. Holding St/ Ht Inlet � V 1 o3• b 3' TANK SETBACK INFORMATION St/ Ht Outlet 7 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic p 0 / NA Dt Bottom �--- Dosing NA q jjd / Man. /5,1 L7 S ZI r Aeration NA Dist. Pipe fS , / q 2, Holding Bot. System 341, cu-% PUMP / SIPHON INFORMATION Final Grade ( 7 - 7 - I'' Manufacturer ; Demand St cover Model Number % GPM p.o l it Cr TDH Lift ti n em TDH Ft /44-V 5M I ForcerFfi Length Dia. Dist. o Wen.. SOIL ABSORPTION SYSTEM I S RENO Width Len No f renches PIT No. Of Pits Iia. Liqu id Depth DI EN I N SETBACK SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING ure : CHAMBER INFORMATION Type O i OR UNIT el Number- System: DISTRIBUTION SYSTEM ka Header/Manifold `f Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. SOIL COVER x Pressure Systems 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: (Include code discrepancies, persons present, etc.) Inspection #1• V /7 0 /0V Inspection #2• / / Location: 223 Starr Wood Hu�dso�n WI 54916 (SE 1/4 SW 1/4 12 T29N R20W) - 1229202253 Starr Wood -Lot 20 1.) Alt BM Description = T-ihz'sf.�c'c bade a. . 2.) Bldg sewer length = 1 13, 0 - amount of cover = ) 8" + 5e << Gwer . Plan revision required? ❑ Yes ;4 No Use other side for additional information. 12— 20 0- 6 SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. S ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: � p i g I E z 3 ' Safety & Buildings Division 7� Washington Ave. \ Sanitary Permit Application 201 W. PO Box 7302 " W iscons i n In accord with Comm 83.21, Wis. Adm. Code Madison, WI 53707 -7302 Department of commerce Personal information you provide may be used for secondary purposes (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] state owned. Attach complete plans to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County State Sanitary Pe ' •Number ❑ Check if revision to previous application State Plan I. D. Number Croy 3 ' I. Application Information - Please PP&t nformation Location: Property Owner Name f ^, Property Location �tioS�- tab t ' 1/4 fL✓ 1/4, S T 9,N, or Property Owner's Mailing Address 0, ; 4 "�, ,!? Lot Number Block Number City, State Zip od 2q O� } Phone Number Subdivision Name or CSM Number Lea II Type of Building: (check one) <1 i ❑ City ,, 1 c� 1 or 2 Family Dwelling —No. of Bedrooms: �a'• n5 s w 6m; 2�c d ❑Village L1 Public /Commercial (describe use): CO Town of ❑ State -owned /S�4GLfoit/ III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road A) I. N New System 2. ❑ Replacement 3. ❑ Replacement of 4.. ❑ Addition to Parcel Tax Number(s) / Z . Z `f . ZCJ. 2Z 3 System Tank Only Existing System Ap — 7 y- $) Permit Number Date Issued ❑ A Sanitary Permit was p reviously 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: < 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Eleva on 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) q 1, q0. Q Elevation 6U U ✓ S oo s9, Fr Syy. av r (/ `_ 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 VII Responsibility Statement 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's S" ature (no stamps): MP/MPRS No. Business Phone Number 45 �7/z �, 2.,� � e!��1 ) Plumber' Address (Street, City, State, Zip Code) rv, VIII 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 Z Z -( p Z P J IX. Conditions of Approval /Reasons for Disapproval: f / 1 1 /0 -,ie�f w �/ 4e P)c {��d�q/ pvibt' 7a ;.,5�a��CL�iov� iv. Dr�Cr 'r0 1 cf Q�CVc�fior. S rig 9. �D.b 1 �� L oWCr 5 / S� ewe 75 Z, 1duUer (kdl( 6e i`KS /l�� :n �0�4rv.9 4iTC Q+.l 5 or`A �e QFSCrr'�el 3(�r� bc�ow r O-x deP4. a� S ys�cH - t(e�. (6Q�ory o�ty,N��9��d Shia# Gorreef So,`� �ts _/a et(ed ov wlon Se! r � No2��f �R��P�� �I^ ,..PLO 47- PLOT ii CROOi 08CTION PLANII ZAPPA OROS. EXCAVAYM MC _boo /. = �c� �� t� ! �. ��/ PWMOINO UMT .. FO � �r�frlf�cs�s oP ?tP�.uc < /trs . PROJECT /� /f7�1��iT�@ �iCi�I�S Lc9 0�0 EAeA ,e__- IQo�o >Gt3 &I, 5,;J IQoo .q S T e�eo/ x tiJtFt✓� I:h pK -� p, KG bQ AU " d.AK tQ�`5 t fJEud r 6,pt -�/ ry ? 2 rx M Srs a. -- �1 /.2• �� cj�• 0 P) sz 93 NO ! Q S8 ri A44 ' fj�1cl - �P1 ICE.��1 �g' — 0 5dr I-F, ?"Ales TPA �Lal/ lc�o.00' W E CALK f ta VZ�I olio D T .p dt=o c�BS i Vs1T,v�u � LIC ENGO: �a e-1 r/ �7 DATE: ©cam Ark ; GO I LT , E B "I sy. M� ► u � f� r ��`�'1� ��4'' � S To FINISH �4he^E �a�� 5 Side View ����g7�an1 T Enl H �o eta ,. �f4 So, c Ttsr End View C 15 o F gC) Tr: k , 34' - SIaEc..at.�a�R Htar+ ��PAc�r� ��AEL .� d CIO Cr- � s N ! 1 N o-� � I I d 0 ✓ 1 Q o 1 1 I 1 rj 0 U Wisconsin Department of Commerce SOIL AND SITE EVALUATION DIVIslon of Safety and Buildings Page L 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 5 T Cre / percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - P/ W2 "t n informatilon. Reviewed b Date Personal information you provide may be use fo' and guf�195e rivacy Law,'s. 15.04 (1) (m)). 2 Z ODD Property Owner �'-vr' ) LF Property Location p Govt. Lot Sf_ 114 1/4,S /Z T2? N,R ZO E (or) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 'ST'noL..J fVT'Y City State Zip OrJe z 01 M 16 ❑city yillage Town Nearest Road Aj 5d l New Construction Use: ® Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow A6n gpd . Recommended design loading rate al bed, gpd1ft Q. 6 trench, gpd/ft Absorption area required /at'Uc? bed, ft Po Ca trench, ft Maximum design loading rate 0, bed, gpd/ft A. g g gp trench, gpd/ft Recommended infiltration surface elevation(s) ,XD 9,i; z c ) /� /� ft (as referred to site plan benchmark) Additional design /site considerations JE L ui 11611 /JQ "hJ& � 1C /'' 'Al APPROVAL Parent material Q L A e— J A L r14- 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 El U %S ❑ U D] S ❑ U S ❑ U ❑ S U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench /: NF _ /AylQ > �-- 5 L U A er- c 5 q , N 3,� -3 iA 3 -- 54 ms s I (Y - 7 A V Gro 6 9 10 3 - - /a�/ 'S M5 M 5 ,7 Depth to limiting �Q 6 Z S Ye 3 S lac r in. , Remarks: Boring # Y ' - /b'-/ � S h 7e, 7 5YA -- 5 rn CS ®� Ground /Q •4 lev. Depth to limiting f 97 in. Remarks: CST N � (Please Print Signature Telephone No. NAB �Y 01JN goxJ -q �d Add -jo e 4 1`t U'& Sd J (3 / to 6 ~ / * d6 Z CST ZZ Num / i SOIL DESCRIPTION REPORT PROPERTY OWNER Page � of PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench �mcr �Gro - • I& 9' Jul /�'s /d'1 C5 6,� ,0.0 g _` I • ,� 3 �— Ski 1h5 �, �- Oo? .0 ►$ Depth to limiting fact- RG r Z p f n Remarks: Boring # 6- 4 In oe <r -3 rt ie 3 SG t175 A 6.7 d,$ Ground _9 3 SC S ! o Z lev. 9 ft. Depth to limiting Z f r 7'11 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # A - <r 6 -z4 i 3 _ 5 M 16 0 g 4 -41c 41 3 — S MS — 10 J 6,1 Ground S �j S ✓ •0 lev left. ' Depth to ? 2.2 'Y 'Z limiting 13 2. y � gtpr - in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) od On - w �1 � 4 S M i ' t r `s r <l' 6d Q— �n 1 � Y 1 � a K i 1 '►�9 1 J 4 '� I i I r r ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer LA SZ gq�s mac, Mailing Address ,592210 _'2t Property Address - Z;-3 5 k r LJ b (Verification required from Planning Department for new construction) City /State /�I� f ` � Parcel Identification Number ,0 C) ` LEGAL DESCRIPTION Property Location S, '/4, . SiM' 1 /4, Sec. , T ,!t N -R O, W, Town of Subdivision LQ 20, 5�1i �2� u Q Q/11 , Lot # c Certified Survey Map # Volume , Page # Warranty Deed # 4� �' . Volume 1- �- , Page # Spec house Oyes ❑ no Lot lines identifiable Ea"y es ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days the three year expiration date. � 7 L944 SIG ATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pr9perty described above, by virtue of a warranty deed recorded in Register of Deeds Office. rp� SIG TURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed VrA54 ?PArf 355 629839 WARRANTY DEED REGISTER OF DEEDS DOCUMENT NO. ST. CROIX CO., WI RECEIVED FOR RECORD 09 -13 -2000 10:15 AM This Deed made between STARRWOOD PARTNERSHIP, LLP, a Wisconsin limited liability EXEMPT I DEED partnership, and LANDSTED HOMES, INC., a Wisconsin CERT COPY FEE: corporation, Grantee, TRANSFER FEE: 1725.00 RECORDIH6 FEE: 10.00 Witnesseth, That the said Grantor conveys to Grantee PAGES: 1 the following described real estate in St. Croix County, State of Wisconsin: Lots 17, 18, 19, 20 and 23 of the Plat of Starr Wood in the Town of Hudson, St. Croix County, Wisconsin; Tax Parcel No. 020 - 1111 -60 & 80; 020 - 1112 -30 RETURN T0: A #7 This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances, and will warrant and defend same. Dated this 14 0 day of September, 2000. STARRWOOD PARTNERSHIP, LLP (SEAL) B udith A. Green — n / (SEAL) AND: G . Zappa� STATE OF WISCONSIN ) SS ST. CROIX COUNTY ) Personally came before me this.? day of September, 2000, the above named Stanwood Partnership, LLP, by Judith A. Green and Gary T. Zappa„ to me known to be the persons who executed the foregoing instrument and acknowledged the same, being authorized so to do. i4'l iGa'i!/�J�II'+Tt ' Not ry Pub ic. tate of Wisconsin My Commission (expires): THIS INSTRUMENT DRAFTED BY: Robert W. Mudge MUDGE, PORTER, LUNDEEN & SEGUIN, S.C. 110 Second Street, P.O. Box 469, Hudson WI 54016 IN PART OF THE ,NT LOT 3, ALL IN K COUNTY, WISCONSIN. L� 9 - S88.52'50 328.36' ' E - o A S 00'54'2 E • - Z N 46.54' - N ' W� 10 = 68052 SO FT _ 9 21 1.562 ACRES = - . S '20.00-• 25586 e 304 '" . A / 20 Ik 78453 SO FT - W 1.801 ACRES <SEE NOTE Bl) 1. 65910 SO FT O 1,513 ACRES . 12' Ao .,E 5 I I � 19 581 47'16 "E 298.08' 74095 SO FT 1.701 ACRES (SEE NOTE B0 ; 12 / 50, n 66181 SO FT 1.519 ACRES - � N88'44'38 "E •� 368.14' I CD . 0 51908 SO FT ' Z / 75.39 U 1.192 ACRES -- w a+ (SEE NOTE B:) S84'18'41 "E 296.97' .4p Q N88 44'38 11 E Z N 30 46'20" E Q z�n 1;4' ' i 104.05' •e►6��• / N 1 I PLAT OF: STARRWO 0 D PART OF THE SE 1 /4 OF THE SHIT I/4 LOCATED IN SW 1 /4 AND IN PART OF GOVERNMI NE 1 /4 OF THE SECTION 121 T29N, R20W, TOWN OF HUDSON, ST. CROI PARTNERSHIP ';'ATION SKETCH SECTION 12 � V m nh DON DR Od N = La ti d LOT 7 G� A ?D GE S VILLA — PARK e S CROIX STATIO__ N :p, ON NE WS LANDING N R A T T L E Y LANE \ N LOT 5 T29 N, R W / A 0 N