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Parcel #: 022-1024-40-100 10/17/2014 10:20 AM
PAGE 1 OF 1
Alt. Parcel#: 09.28.18.133A10 022-TOWN OF KINNICKINNIC
Current ❑X ST. CROIX COUNTY,WISCONSIN
Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units
08/15/2012 00 0
Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner
0-VAN BEEK,ALVIN DALE
ALVIN DALE VAN BEEK
479 VALLEY VIEW DR
ROBERTS WI 54023
Property Address(es): *=Primary
498 VALLEY VIEW DR
Districts: SC=School SP=Special
Type Dist# Description
SC 4893 SCH DIST RIVER FALLS
SP 0100 CHIP VALLEY VOTECH Notes:
RETIRED 022-1023-60-000,
022-1023-20-000, 022-1024-40-000; NEW
022-1023-60-100 REMAINDER,
Legal Description: Acres: 0.000 022-1023-60-200 LOT 1,022-1023-20-100
9 p OL 1, 022-1023-20-100 REMAINDER,
SEC 9 T28N R1 8W NE NW EXC COM SE COR,W more...
580.670 POB W 340', N 295', E 250.6', S Parcel History:
17DEG E 308.9'TO POB& EXC CSM VOL Date Doc# Vol/Page Type
3/737&EXC CSM 25-5869 08/15/2012 961779 CSM
07/24/2012 960403 QC
07/23/1997 935/266
07/23/1997 929/590
more
Plat: *=Primary Tract: (s-T-R 401/4160Y4 GL) Block/Condo Bldg:
*N/A-NOT AVAILABLE 09-28N-18W
2014 SUMMARY Bill M Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 05/08/2014
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 40,000 292,000 332,000 NO
AGRICULTURAL G4 30.366 4,900 0 4,900 NO
UNDEVELOPED G5 2.000 200 0 200 NO
OTHER G7 2.000 18,000 15,000 33,000 NO 08
Totals for 2014:
General Property 36.366 63,100 307,000 370,100
Woodland 0.000 0 0
Totals for 2013:
General Property 36.366 63,100 322,000 385,100
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
o CO)0 c to f ! 3.00
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®/yTz K ckford M °P Pub /s.,In
PIERCE COUNTY
RIVER FALLS 19 � )—
JOURNAL STATE RE ESENTATIV
Printing - Publishing
Advertising Office Supplies CAN HELP BUILD LEO MOH N
BETTER TOMORROWS
Phone: 4Z5 - 2484 FOR ALL ST. CROIX COUNTY
River Falls, Wis COIN NOW
54022
Parcel #: 022- 1024 -40 -000 12/07/2005 01:02 PM P AGE 1 OF 1
Alt. Parcel #: 9.28.18.133A 022 - TOWN OF KINNICKINNIC
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
ALVIN DALE VAN BEEK O - VAN BEEK, ALVIN DALE
498 VALLEY VIEW DR
ROBERTS WI 54023
Districts: SC = School SP = Special Property Address(es): = Primary
Type Dist # Description " 498 VALLEY VIEW DR
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 36.460 Plat i N!A -NOT AVAILABLE
SEC 9 T28N R18W NE NW E ck/Condo Bldg:
580.670 POB W 34 5', E 250.6', S
17DEG E 308.9' TO POB & EXC CSM VOL Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
3/737 09- 28N -18W
Notes: Parcel History:
Date Doc # Vol /Page Type
07/23/1997 935/266
07/23/1997 929/590
07/23/1997 906/38
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
88064 Use Value Assessment
Valuations: Last Changed: 08/10/2005
Description C lass Acres Land 1 Total State Reason
RESIDENTI L G1 2.000 60,000 314,000 374,000 NO
AGRICULTU G4 31.460 2,700 2,700 NO
UNDEVELOPED G5 1.000 100 100 NO
OTHER G7 2.000 20,000 85,100 105,100 NO
Totals for 2005:
General Property 36.460 82,800 399,100 481,900
Woodland 0.000 0 0
Totals for 2004:
General Property 36.460 47,800 297,700 345,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 143
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
T
Wisconsiii Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Bui?diiig Division
* INSPECTIQN REPORT Sanitary Permit No:
420324 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holders Name: City Village X Township Parcel Tax No:
VanBeek, Dale Kinnickinnic Townshi 022 - 1024 -40 -000
CST BM Elev: Insp. BM Elev: BM Description:
Y, z - 1 9,( y9g
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark �-
F�Gu.ZT
Dosing Ll Alt. BM
Aeration Bldg. Sewer l.f
Holding
St/Ht Inlet Of r
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic
> t C* �g6 Dt Bottom CIS /'2 lu�•Z o� /
Dosing LA IL < < � N �s � Header /Man. 9 -+0 �
Aeration Dist. Pipe }
Holding Bot. System
IC 9
Final Grade
PUMP /SIPHON INFORMATION {o 11 n
Manufacturer Demand St Cover p
L GPM (A� IdI LS� 't• 3 l6 •�b
��� Model Number A
� �- * 3
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length t JDia. 11 Dist. to Well
Z
SOIL A ORPTION SYSTEM Q 3 ) -,&
inq 6 t RENg Width , Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIM S
�j i3/• z e.vc 3
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Ean ufa ct I r n p INFORMATION Type Of System: CHAMBER OR 1'
i > el Number:
DISTRIBUTION SYSTEM L440 6..'i 04
Header /Manifold Distribution x Hole Size Ix Hole Spacing Vent to Air Intake
/1 t � Pipe s) ' - 7 0 L Dia 1 1-eng Dia Spacing
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
BedlTrench Center Bed/Trench Edges Topsoil
CI Yes No Yes :E:N.]
COMMENTS: (Inclu a co a discrepe ties, p Ssons pres nt, etc.) I spection #1:�/ 1 / 2� l I spec' n#2:
T � cw�� e4 *1� l u to . C'� �,,,,,,k� 5 -it: (s la•�c ems.
a [one 4j9 i able Vi r iv f Falls, WI 54022 (NE 1/4 NW 1/4 9 T28N R1 8W) NA Lot Parcel o: 09.28.18.498
1. Alt BM Description
2.) Bldg sewer length = (57t) Cow%
- amount of cover =
3 D0
Plan revision Required? Ye No r
Use other side for additiona o L L —
SBD -6710 (R.3/97) e Date n e�ctor s Signature Cert. No.
f ,
OP��
;�v
I
WEATNERPROJF
LOCKING COVER JUNCTICN
� GVICK D��C,oyVtGT --1
/ O p y IL PIP 6 3
nu HDIgTugbED
P v�
Sol l_ 24" I.D. II 4" 40
MA 1400E
I
QPa'kOVa<r1 A 2$.L HU:G �•, P�
CET �
PIS a FLE �AL 3' o«Ko
4ECTIOK4
t, V V 4L se Ow
� ��. Eo�f•rc
bcoCK
��..0
SEPTIC f SPEC- lFl*CATIOI�IS
rA►..I..S MALIUFACTUP tp �- -`;, S . '1^
TA►JK SIZE; �t}d - VCtj I\IUMBER OF DOSES: PER DAB
1 GALLOWS • .DOSE VOLUME
LARhl MA.WLI FACT URCR; S `� �^'� °t-tr` IMCLUDIM6 6ACKFLOW:
0DEL u UN4!!CR' 1 e �-F •� GALLONS
CAPACITIES; A =
SWITCH TyPG; y " Q '�"" wpb IAlCHCS OK 4 20'2' GALLOk.s
JMP II 6= Z " INCHES pq �ZQ•`a
MAIJUFACTUitCR: o••+•�i:C GALLOi.,s
MODEL IJ C ° �•g uCMES OH $lo•O
UMDtK: c' I�i[� 3 c7 i (,A LO�:
5WITCH TbPE; 1) . (.0 INCHESGR a C, A L LG,�'
Z'T ` NOTE; PUMP AWO ALARM ARC TO BC
MI►FFEKE'1 DISCHARGE RATC INSTALLED OQ 5EPARATC CiKC r�
G ►M
:RTICAL DiFFEREKICE OETWCCA! PUMP OFF AIUO 0 13TRIDUT �'�S
MINIIMUM ►JETWORK SUPPLY PRCS6LIKE . . ' • ION PIPE.. FEET
lJ Z � Fr-[T +a
FEET OF FORCC MAIiJ X 1'�4 F.T✓,� '
�oo,,FRICTlo1,l FACTOR. — FEET ZS
TOTAL Otlk�AMIC. HEAD = u
• 1Lt1 FEET
"ERAIAC DIME1J5101Ji • OF 1 �9" �2 ��
TAWK; LEKIC�TH
;W DTH �� LIQU10 DEPTH
Pump runs but delivers only Motor runs for short time then 3. Pump impeller may be
small amount of water. stops. Then after short partially clogged causing
>• period starts again. Indicates motor to run slow,
1. Pump may oe air locked. Start
and Stop several times by tripping overload caused by resulting in motor overload.
plugging and unplugging cord, symptom shown. Clear impeller.
Check vent hole in pump case 1. Inlet in pump base may be 4. Defective motor stator: return
for plugging. clogged. Remove pump and to Authorized HYDROMATIC
2. Pump head may be too clean out openings. Service Center.
high. Pump cannot deliver 2. Impeller or volute openings
water over 24' vertical lift. may be plugged or partially
Horizontal distance does not plugged. Remove pump and
affect pumping, except loss clean out. 1
due to friction through
discharge pipe.
3. Inlet in pump base may be
clogged. Remove pump and
clean out openings.
20 1
4. Impeller or volute openings
may be plugged or partially
plugged. Remove pump and 19 2
_ —�
clean out.
5. Pump impeller may be 18
1
partially clogged causing —
motor to run slow, resulting 15
i n motor overload. 4
Clear impeller. 15 5
8
Fuse blows or circuit breaker 14
trips when pump starts.
1. Inlet in pump base may be
clogged. Remove pump and 1211 n s
clean out openings. 23 22 21 10
s
2. Impeller or volute openings �7
may be plugged or partially
plugged. Remove pump and SHEF30 Performance Curve
clean out.
3. Pump impeller may be 9 30 )
partially clogged causing
motor to run slow, resulting
in motor overload.
Clear impeller. 6 20
4. Fuse size or circuit breaker is
too small.
s
5. Defective motor stator: return 3 10
to Authorized HYDROMATIC
Service Center for verification.
o� o
(apadt -U.S. G.P.M. 0 10 20 30 10 SO
titers/Wnd 0 1 2 3
4
r .
U - =
tary Permit Application Safety & Buildings Division
1, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application 15 Box 7302
` 1 SCo n Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of commerce [privacy Law, s. 15.04(lxm)] (Submit completed form to county if not
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.
Count 1 State S itary Fcr it umber Check if revision to previous application State Plan
I. App ication Information - Please Print all Information, Location:
Prope Owner Name roperry /)A) cation
1Z 0HJ b �'`t` G 1 /41 /4, S T 0,N, R/ r)
Property Ownces Mailing Add ss Lot Number Block Number
41
Stagy zip Code Phone Number Subdivision Name or CSM Number
ears LJL 54-02
II. Type of Building: (check one) 0 cit
1 or 2 Family Dwelling - No. of Bedrooms: ❑Village /Ck!4 y/ /c
fB"I'own of
❑ Public/Commercial (describe use):_
❑ State -Owned
,t_,... . n A n D Nearest Ro ad
�l • ZS " >< 3 T•''�� -�- ms`s � - GtaatM.�s °'C Paxae ax Number(s)
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable)
A) I. New 2. Replacement 3. Replacement of 4. 5. 6. Addition to
ystem System Tank Only Existing System
T
B) Permit Numb I Datq I slue
VLA Sanitary Permit was previously issued - S Z-4 9 A Z
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. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. ystcm Elevation 7. Final '
Required Proposed Rate (GalsJday /sq. ft.) (MinJinch) Elevatin
Grade
1z 4 12 13 1 3� -- �.Z
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks I Tanks
ppy
❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume res onsibili or installatiqf of the POWTS shown on the attached plans.
Plum e s Name (print) : P er s Si t no stamps MP o. Business Phone Number
o�� S z �i`'l� /3 7/f = Z3- 04 �f5�
Plumber's Address (Street, City, State, Zip o e
F��D X08
IX. County/Department Use Only
Disapproved Sanitary Permit Fee ancludes Groundwater . Date Issued ssui g Agent SignatA (No stamps)
Approved 11 Owner Given Initial Adverse Surcharge R s • ( Z--
Determination
X. Conditions of Approva /Reasons for Disapproval 4 n 4
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f POWTS OWNER'S MANUAL &MANAGEMENT PLAN Z.
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Septic Tank Capacity ODC7 a l ❑ NA
Permit # Z03Z� Septic Tank Manufacturer tT ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer it) To ❑ NA
Number of Bedrooms ?j ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units A f NA Pump Tank Capacity a l ❑ NA
Estimated flow (average) 3C)o gal/day Pump Tank Manufacturer w (� ❑ NA
Design flow (peak), (Estimated x 1.5) 420 g al/day Pump Manufacturer pro yK, 017L. ❑ NA
Soil Application Rate f 3 gal/day/ft' Pump Model 5rk-_r, & ❑ NA
Standard Influent /Effluent Quality Monthly average" Pretreatment Unit ❑ NA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BODd 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD,) 530 mg /L Ahn- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu / ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. ❑ JNAA Other: ❑ NA
Other: ❑ Other: ❑ NA
"Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: 3 ❑ year(s) month(s) (Maximum 3 years) ❑ NA
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
month(s) (Maximum 3 years) ❑ NA
Inspect dispersal cells) At least once every: year(g)
Clean effluent filter At least once every: , month(s) ❑ NA
years)
Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA
l0 year(s)
❑ month(s) ZN A
Flush laterals and pressure test At least once every: ❑ year(s)
Other: At least once ever ❑ month(s) �l�A
y� ❑ year(s)
Other: C r NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tanks) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals on
Q -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and' disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
r Page of
!START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
r System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant
replacement system:
❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
EK The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER p POWTS MAINTAINER
Name L. �1Z r6� i(/L- Name
Phone �- 7i3� Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name C/� LtN
Phone Phone f�(S ZY6 c7
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
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T.L. Sinz Plumbing Inc. -rDIO0 Or—
E5609 708th Ave. :�,r odd \4 d.o • Phone: (715) 235 -2644
Menomonie, V1ZI 54751 �� Fax: (715) 235 -2592
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ATION REPORT * Y of . Wiscdnsin Department of Commerce U
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 Lr
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. R viewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). C)
Property Owner Property Location
Q L Govt. Lot Al r 1 /4A/t,J 1/4 S T N R E (or)t9
Property Owners Mailing Addrgs; Lot # Block # Subd. Name or CSM#
City State Zip Code Phone Number ❑ City ❑Village Town Nearest Road
K W Sydz S I ( 1 Y) 1- Y Z $' 8 Va t U�' ecJ p r
New Construction Use: ( Residential I Number of bedrooms Code derived design flow rate Y -5 /1 O GPD
❑ Repladement / ❑ Public or commercial - Describe:
Parent material Flood Plain el ation w ft.
General comments s ���� e V . (U , Z (J
and recommendations: (; 2002
S r. ��ROiX COUNTY
70NI
Boring # E] Boring
`f- Pit Ground surface elev. ft Depth to limiting factor Soil Application Rate
i Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
low 3 / 1- _ ,S rn ab ic �� C ✓ , S �'
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77, Boring # ❑ Boring
Pit Ground surface elev. ft Depth to miting factor �i�_ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture shycture Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. z. Sh. 'Eff#1 "Eff#2
1 o - it la. ( 7
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-I C&Ar sY
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< - OD 30 mg /L and TSS < 30. mg/L "
CST Name (Please Print) gnature CST Number
Rdat+v� S��ww�cc P-
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Address Date Evaluation Condud Telephone
I� doh �� w1. 5'�'UZS -✓ /� -_ Z pis -�Y7 -�
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Property Owner Parcel ID # Page of
a Boring # ❑Boring � �
Pit Ground surface elev. 4 ft. Depth to limiting factor n.
- 7
Soil Application
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fl=
In. Munsell Clu. Sz. Cont. Color ", Gr. Sz. Sh. 'Eff #1 i •Eff #2
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F-1 Boring # ❑ Boring
Ground surface elev. ft
❑Pit nw surfs Depth to limiting factor in.
i moil Application Rale
Horizon Depth . Dominant Color Redox Description _ Texture _Structure Consistence Boundary Roots GPD /Ilz
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff #2
Boring # ❑ Boring
❑ PIC .Ground surface elev. ft Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD /fl=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff #2
' Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg/- • Effluent #2 = BOD < 30 mgA and TSS < 30 mglt.
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 TFY 608 -264 -8777.
SI)MIDO lrto-rM)
PAGE 3 OF
NAME PaA6.e e LOT# LEGAL DESCRIPTION A /I? Y41jvi Y S R TZ'� N R 1 `� E(orX�
SCALE: I"= y�
BM I ELEVATION /oC? • o
BM I DESCRIPTION
BM 2 ELEVATION
BM 2 DESCRIPTION
SYSTEM ELEVATION T� '� o
SYSTEM TYPE o ✓l t)-,C njbrc,>A cc
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T.L. Sine Plumbing Inc.
E5609 708th Avenue Phone: (715) 235 -2644
Menomonie, WI 54751 Fax: (715) 235 - 2592
FAX TRANSMITTAL
Date: I 0 DZ No. of Pages:
(including cover)
7b ST Chill (g ?ox3tpJIP,
Attu: aul , )
From: 1 yPz> -:S�'t wz-
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' Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application Box 7302
SConS ®n
Personal information you provide may used or secondary purposes Madison, WI 1 5 53707 -7302
Department of Commerce [Privacy Law , S 1 b be e u us d f (Submit completed form to county if not
d' -/S , . state owned.)
Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x I 1 inches in size.
County y � A f State Sanitary Permit Number D Check 'f revision to previous application State Plan I. D. Number
(��
I. Application Information - Please Print all Information. Location: '1
Owner Name ��Pr Location
3 9 2��2 NJ6 1/4bW1/ 4 TCAf,N, R/fE (oa
erty Owner's M fling Address Lot Number Block Number
l)�
IC� ST ( X kji
City State Zip Code Phone Subdi ' n Name or CSM Number
9 �w5 ( S) 089
II. Type of Building: (check one) C'ty jr�n �G��yh j C
IX-1 or 2 Family D ling - No. of Bedrooms : 3 ' � ❑Village
❑ Public /Commercial cribe use
/ F`l'own of '
�2
trJl
❑ State -Owned -e �
3 V J �
Nearest Road
P Num
III. Type of Permit: (Check only oT#&box on line A. Check box on line B if licable) �..
A) 1. IN New 2. 0 Replace t 3. Replacement of 4. 5. 6. ditio
System System Tank Only Exi
B) Permit NumberL Date Is d
❑ A Sanitary Permit was previously issu
IV. Type of POWT System: (Check all that ap qW
• Non - pressurized In- ground \kH ound S rting Construe We an
• Pressurized In- ground ❑ Sin I�p Line
• At - grade robi eatment Unit ❑ Rec Other:
6 .
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal / Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate m Elevation 7. Final Grade
,�/ Required t D Proposed to (Gals. /day /sq. ft.) (Min. /inch) Elevation
7Sb ,14 n s so/Ts � '' .0 `?7, 0 -r
VII. Tank Capacity in Tot # of facturer P Site Steel Fiber- Plastic
Information Gallons G ns Tanks Con - Mass
New Existing crete structed
Tanks Tanks
�{ r c 11m) ❑ ❑ ❑
1 ao Acv
r v laoo 00 X60
VIII. Responsibility Statement JF
1, the undersigned, assume respo ili r installatio of the POWTS shown on the attac plans.
Plumber's Name (print) Plu b is Sign re o stamps): MP/MPRS No. Business Phone Number
Plumber's Address (Street, City, te, Zip Co e)
IX. County/Departniffint Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date ssued Issum en t Sign re stamps)
Approved ❑ Owner Given Initial Adverse Surcharge Fee)
i
Determination 4
X. Conditions of Approval /Reasons for Disapproval:
N� As Pik (0 QVO4A� u� /bw�>✓�- �'lcru;.r� � notiJ w�c� �s� �7cur wS
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must
Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 5
percent slope, scale or dimensions, north arrow, and location and distance to nearest road Z'�j� ' �J
Please print all information. by a Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)j
Property Owner Property Loc
c , .e fi Govt. Lot ': 1/4Z44 J 1/4 S q T Zg N R /� E (or)0
PMR.r is Mailing Address Lot # Block # Subd. Name or CSM#
U •e
State Zip Code Phone Number ❑ City [1 Village ® Town Nearest Road
0 A s w i S 0 (7/ - 1 - I K, % A A r G I ` 11 wc
R New Construction Use: Residential/ Number of bedrooms 3 ` Code es' n flow rate 00 GPD
❑ Replacement _❑ Public or commercial - Describe:
Parent material f ! / Flood Plain levation if applicable '� � ft.
General comments and recommendaations: elle 1• ` Y d A U G
CG � e4 . �' ;3,L5 -6 1 6 2002
ST. CROIX COUNTY
ZONING OFFIC
F Boring # � Boring pQ /
[(� pit Ground surface elev. /��(� ft. Depth to limiting fad 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
Boring # Boring
® pit Ground surface elev. •��Q 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
a 1/ /o r Z _ S,' / mob m G S v-� , 1 ,
Z LS .6
v .6
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
ature CST Number
s a
Address Date Evaluation Conducted Telephone Number
i
s
Property Owner �n,�� Parcel ID # Page _� of
E Boring # El Boring
IR Pit Ground surface elev. 1 2�-V ft. Depth to limiting factor in. — Soil Appl icatlon 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
Z 1 2 - 3 0
❑ Ong # ❑ Boring
❑ 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
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sal Akpoication 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 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mgA- ' 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.
ssasawtrt.aroor
08/5/2002 21:17, FA% 17152352592 TLSINZPLUMBING Q04
PAGE Or
NIA M F I !�_A n ba � c.IC I 2 L L• �i.AL. DFS
SCALE: I "= --
13M l LJ.EVATI0N f/I 0 . Q
L9M I UL'SCRIMON
13M 2 ELEVATION ��ra S C� I
IN 2 D SCRII'i'JONj n 0 � � T y�- ;O.'12 f- - -' -' --
SY I IEVn TION '0 0
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I
EROSION CONTROL PLAN COMMENTS:
For 479 Valley View Rd., Kinnickinnic Twp. Plan — owner(s) Alvin Dale Van Beek
1. The main source for construction site runoff will be the house foundation excavation and
any soil stockpiled until final grading and stabilization is complete. Apply seed and mulch as
soon as grading is done to minimize erosion.
2. Divert runoff away from road drainage ditches by creating temporary earthen berms
ALONG CONTOUR between construction activity and Valley View right -of -way. Silt fence
may be required to prevent sediment from moving into drainage swale — vegetation alone
cannot be expected to provide sediment control. Maintain existing vegetation between
excavation for house & mound septic system and road drainage ditch.
3. Construction equipment and vehicles must use only one stabilized driveway access that is
designed for heavy equipment; this will avoid muddy, rutted conditions that allow
contaminated runoff into the road ditch.
4. Stabilize new mound septic system with seed and mulch immediately after installation — do
not wait for final stabilization/landscaping of entire site to cover exposed soils on the system.
5. If builder /excavator grades the site to create temporary berms as recommended to contain
sediment and leaves adequate vegetative cover between work area and road ditch,
installation of silt fence MAY not be necessary. Use mulch or other cover materials to
prevent erosion. Silt fence will be required if sediment cannot be contained on the property
with diversions/berms. Septic system inspector will evaluate ESC plan effectiveness and
make recommendations accordingly.
Please feel free to contact me with questions or ask for assistance with erosion & sediment
control ' stallatio
Pam Quinn, Soil Er sion Inspector #665054
i
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Standard Erosion Control Plan
for 1 & 2 Family Dwelling Construction Sites
According to Chapters ILHR 20& 21 of the Wisconsin Uniform Dwelling Code, soil erosion control informa-
tion needs to be included on the plot plan which is submitted and approved prior to the issuance of building
permits for 1 & 2 family dwelling units in those jurisdictions where the soil erosion control provisions of the
Uniform Dwelling Code are enforced. This Standard Erosion Control Plan is provided to assist in meeting
this requirement.
RECEIVED
Instructions:
1. Complete this plan by filling in requested information, completing the site dji jTry al taking (*/) appropriate boxes
on the inside of this form. AUIa 1 4
2. In completing the site diagram, give consideration to potential erosio thatm�®qp4bWfpre, d ring, and after grading.
Water runoff patterns can change significantly as a site is reshaped. zolvlN� oFFiCE
3. Submit this plan at the time of building permit application.
Site Diagram Scale: 1 inch = feet
EROSION
CONTROL PLAN
LEGEND
PROPERTY
LINE
EXISTING
' DRAINAGE
- TD TEMPORARY
DIVERSION
K
FINISHED
-� DRAINAGE
LIMITS OF
GRADING
SILT
FENCE
STRAW
BALES
GRAVEL
VEGETATION
SPECIFICATION
TREE
PRESERVATION
STOCKPILED
SOIL
Please indicate north
by completing the
arrow below.
I
—N—
PROJECT LOCATION
BUILDER " q OWNER
WORKSHEET COMPLETED BY l DATE �� a
EROSION CONTROL PLAN CHECKLIST
` z b 41 Check (*/) appropriate boxes below, and complete the site diagram with necessary information.
Q QQ
�oF ? o Site Characteristics
COY / North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways.
• Ci' Location of existing drainageways, streams, rivers, lakes, wetlands or wells.
• �ocation of storm sewer inlets.
GY' " / Location of existing and proposed buildings and paved areas.
Q' The disturbed area on the lot.
E�� Approximate gradient and direction of slopes before grading operations.
[41"' Approximate gradient and direction of slopes after final grading operations.
?r O Overland runoff (sheet flow) coming onto the site from adjacent areas.
Erosion Control Practices
C�J' ❑ Location of temporary soil storage piles.
Note: Soil storage piles should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be
covered with a tarp or more than 25 feet from any downslope road or drainageway.
O" Location of access drive(s).
Note: Access drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick.
Drives should extend from the roadway 50 feet or to the house foundation (whichever is less).
Cam❑ Location of sediment controls (filter fabric fence, straw bale fence or 10 -foot wide vegetative strips) that will pre -
vent eroded soil from leaving the site.
[a-"0 Location of sediment barriers around on -site storm sewer inlets.
E]ii ❑ Location of diversions.
Note: Although not specifically required by code, it is recommended that concentrated flow (drainageways) be
diverted (re- directed) around disturbed areas. Overland runoff (sheet flow) from adjacent areas greater than
10, 000 sq. ft. should also be diverted around disturbed areas.
❑ C Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade).
Note: Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions,
and re- vegetation by sodding or by seeding with use of erosion control mats.
�❑ Location of practices that will control erosion in areas of concentrated runoff flow.
Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of
such . ractices as in- channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip-rap.
P p P
When used, a given in- channel barrier should not receive drainage from more than two acres of unpaved
area, or one acre of paved area. In- channel practices should not be installed in perennial streams (streams
with year -round flow.)
❑ ❑ Location of other planned practices not already noted.
EROSION CONTROL REGULATIONS
UNIFORM DWELLING CODE (DEPT. OF COMMERCE)
PROJECTS AFFECTED • Straw bales, filter fabric fences or other barriers to
• All new 1 and 2 family dwellings in Wisconsin started protect on -site sewer inlets
on or after December 1, 1992. • Additional controls if needed for steep slopes or other
• Additions to dwellings built after June 1, 1980. special conditions
MAINTENANCE AND WASTE DISPOSAL
APPLICATION PROCESS • Sediment controls must be maintained until the site is
• Erosion control measures must be included on the plot stabilized by mulching and seeding, sodding or
plan submitted with the building permit application to landscaping
the local building inspector in communities where the • All building waste must be properly disposed to pre -
dwelling code is enforced vent pollutants and debris from being carried off -site
• Plot plan must show:
— Location of the dwelling, other buildings, wells, sur- ENFORCEMENT
face waters and disposal systems on the site with •Erosion control inspections will be made during other
respect to property lines regular inspections (footing and foundation, rough con-
struction, final, etc.)
— Direction of all slopes on the site
•Violations must be corrected within 72 hours
— Location and type of erosion control measures
• Stop work orders may be issued for noncompliance
CONTROLS REQUIRED FOR MORE INFORMATION, CONTACT
• Silt fences, straw bales, or other approved perimeter
• Local building inspector
measures along downslope sides and side slopes • Department of Commerce, Safety and Buildings Divi-
• Access drive sion, P.O. Box 7969, Madison, Wisconsin 53707,
(608) 266 -2128.
STORMWATER PERMIT (DNR)
PROJECTS AFFECTED — Proposed erosion and storm water pollution control
• Any grading or construction project that disturbs 5 practices during and after construction
acres or more and is not covered by a building permit — Documentation that an erosion control and storm
• Smaller sites that are part of a planned development water management plan which meets DNR standards
involving 5 acres or more of land disturbance has been prepared (plan does not need to be submit-
• Effective October 1, 1992 for any new or continuing ted with the application)
project —Other information related to site location and per-
• Exceptions: Indian tribal lands and work done by local mit holder
government staff CONTROLS REQUIRED
APPLICATION PROCESS • Erosion control measures specified in the Wisconsin
• File a "notice of intent" application (Form #3400 -161) Construction Site Best Management Practice Handbook
with the Department of Natural Resources (DNR) 14 • Measures to control storm water after construction
days before construction begins FOR MORE INFORMATION, CONTACT
• Application must include: • Department of Natural Resources, Storm Water Per-
- Timetable for land disturbing activities and installa- mits, P.O. 7921, Madison, WI 53707 -7921, (608)
tion of erosion control measures including project 266 -7078
start and completion dates
LOCAL ORDINANCES
Check with your county, and city, village or town for any local erosion control ordinances including shoreland zoning
requirements. Except for new 1 & 2 family dwellings, local ordinances may be more strict than state regulations. They
may also require erosion control on construction projects not affected by state or federal regulations.
A publication of the University of Wisconsin— Extension in cooperation with the Wisconsin Department of Natural Resources and Department of
Commerce, Ron Struss, Water Quality Educator, UWEX Western Area and Carolyn D. Johnson, Urban Water Quality Educator, UWEX Southeast Area.
UW— Extension provides equal opportunities in employment and programming. This publication is available from county UWEX offices or from Extension
Publications, 630 W. Mifflin St., Madison, WI 53706, (608) 262 -3346. Copyright 1997 by the Board of Regents of the University of Wisconsin System
doing business as Cooperative Extension, University of Wisconsin — Extension. Send inquiries about copyright permission to Director, Cooperative
Extension Publications, 201 Hiram Smith Hall, 1545 Observatory Drive, Madison, WI 53706.
GW0001A Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites DNR: WT- 458-96 R -02- 97- 2M -10—S
i
Z Indicate management strategy by checking ( ✓) the appropriate box:
�a �`�
Q0 o Management Strategies
Temporary stabilization of disturbed areas.
Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized
/ by seeding (between April 1st and September 15th), or by other cover, such as tarping or mulching.
C' Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment).
Indicate re- vegetation method: Seed (mod ❑ Other ❑
Expected date of permanent re- vegetation: �� G
Re- vegetation responsibility of: Builder ❑ Owner /Buyer
Is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? Yes ❑ No ❑
C�❑ Use of downspout and /or sump pump outlet extensions.
Note: It is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage
p ipe to stable areas such as established sod or p avement.
PP P
❑ Et Trapping sediment during dewatering operations.
Note: Sediment -laden discharge water from pumping operations should be ponded behind a sediment barrier until
most of the sediment settles out.
2 000" Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water.
Maintenance of erosion control practices.
• Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to
half the barrier's height.
• Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be
replaced (typical bale life is three months).
• All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday.
• All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday.
• Access drives will be maintained throughout construction.
• All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized.
For more assistance on plan preparation, refer to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code,
the DNR Wisconsin Construction Site Best Management Handbook, and UW— Extension publication Erosion Control for
Home Builders.
The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available
through State of Wisconsin Document Sales, 608/266 -3558.
Erosion Control for Home Builders (GWQ001) can be ordered through Cooperative Extension Publications, 608/262 -3346
or the Department of Commerce, 608/267-4405.
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TO
#: (608) 264 -8777 erc
Visconsin www
w ww.commerce.state.wi.us/sb
ons
.wisonsin.gov
Department of Commerce
Scott McCallum, Governor
Philip Edw. Albert, Secretary
August 01, 2002
CUST ID No. 139462 ATTN: POWTS Inspector
TODD L SINZ ZONING OFFICE
T L SINZ PLUMBING INC ST CROIX COUNTY SPIA
E5609 708TH AVE 1101 CARMICHAEL RD
MENOMONIE WI 54751 -5520 HUDSON WI 54016
6
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 08/01/2004 Identification Numbers
Transaction ID o. 772516
SITE: Site ID No. 60298
Dale Vanbeek Pleas both identification , Valley View Rd above, rres o ce wit enc
Town of Kinnick' c
St Croix County
NEIA, NW1 /4, S9, T , R18W
FOR:
Description: Proposed Thre edroom Mound System
Object Type: POWT System ulated Object ID No.: 86301
The submittal described above has been r 'ewed for conform with a pl' sconsin A ip inis ve Codes
and Wisconsin Statutes. The submittal has CONDITIO LY The owner, It define in
chapter 101.01(10), Wisconsin Statutes, is resp ible for c liance e requirements.
The following conditions shall be met during const do installatio rior to occupancyt use:
General Approval Conditions:
• This system is to be constructed and located in or ce with the enclosed a pr ;plans.
• A Sanitary Permit must be obtained from the unty where is pr 'ec d in acc ance with e
requirements of Sec. 145.135 and 145.19, is. Stats. r
• Inspection of the private sewage system stallation is required. A gemen o ection shall b i
the designated county official in accor nce with the provisions of .145. d), Wis. Stats.
• Comm 83.22(7) - A copy of the ap oved plans, specifications and this er shall be on -site durin
construction and open to inspecti by authorized representatives of the D ent, which may' c oc� •
inspectors.
r
Owner Responsibilities: `
• Comm 83.52(1)(a) - The o er of a POWTS shall be responsible for ensuring that the eration an
maintenance of the POW T occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
• Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to
the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
RO.W.T.S.
Conditionally
1
r >
r
TODD L SINZ Page 2 8/1/02
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely,
vw , Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Gerard M. Swim
POWTS Plan Reviewer - Integrated Services
(608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633'
jswirn@commerce.state.wi.us
cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544
Henry F Grote , Certified Soil Testing
Dale VanBeek - Mound
Transaction #
Construction Materials and Techniques
All materials must comply with Comm 84 and be installed in accordance with manufacturer's
specifications. Construction methods must comply with the following Component Manuals:
Mound, SBD - 10691 -P (01 /01)
Pressure Distribution, SBD - 10706 -P (01/01)
Location: NE 1/4, NW 1/4, Sec. 9, T 28 N, R 18 W
Town: Kinnickinnic
County: St. Croix
Date: July 30, 2002
Owner: Dale VanBeek
Address: 498 Valley View Road
Roberts, WI 54023
Plumber: Todd S` z
Signature:
License 4 MP 1 462
Attachments: 6748 -Plan Approval Application
SBD -8330
i
page 1: cover
2: design criteria & calculations DECEIVED
3: plot plan
4: system cross section JUL 1 i ZOOZ
5: plan view, lateral detail
6: pump tank exit detail SAFETY & BLOGS DIV. .
7: pump curve
8: system management
page 1 of 8
PDVED
DEPARTMENT OF COMMERCE
DIVISION OF 6
-AFETY AND BUILDINGS
SEE CORRES ONDENCE
I
s
e /
i
Design Criteria
Residential Wastewater Contaminant Load: 30 mg /L < BOD < 220 mg/L
Anticipated septic tank effluent 30 mg/L < TSS < 150mg /L
Fecal Coliform > 10,000 cfu/100 mL
Fats, oils, grease < 30 mg /L
3 Bedrooms x 100 gal/bedroom/day x 1.5 Ar�;_O gallons /day hydraulic load
f
r
Design Calculations
In situ designed loading rate gallons /sq. ft. per day
Depth to estimated high round water �� 3 ° in.
P g g
Depth to bedrock b in.
Cross slope at system l %
Force main length ft. of Z in.
Manifold /header length ft. of -2- in.
Drain -back
'Z. 9 gallons
r Lateral length Z @ ft. of ��l z- in.
Lateral elevation 5 � ft. @ bottom of lateral
Lateral hole size 3 /1 b in. @ 6c.0 in. ( S` ° ft.) Spacing
holes /lateral holes total
Lateral volume b•Sb gallons
Total lateral discharge rate 2s•n g gallons /minute @ Z ft. head
Network pressure compensation losses ft.
Elevation difference }'� ft.
Friction loss ft. @ z� gallons /minute
Total dynamic head ' 2 i ft.
Pump /si*on 2 . `� gpm @ ft. of head
Manufacturer C_ Model # S k LTF 1 0
Dose volume I b gallons
Lift/siphn tank `� w w` `*� - v� o �.�o 6 v gallons
Septic tank gallons
Effluent filter
Measurement pump on and off �' 8 in.
Height alarm from tank bottom 3 g in.
Reserve capacity z ° gallons
specs.cales.res
Page Z of
E'
I
N A M F Il -e LOT# LEGAL DESC'RIPTION/V/ X # ,S T ,N,R. )S' E(or)�W
SCALE: 1 "= 410 - - - - --
13M 1 ELEVATION 40 . O
13M l l)ESCRIPTION , . , - e -- — ��-
13M 2 ELEVATION o
13M 2 DESCRHYFION 4,() 0 QVC ----- .. - - - --
SYSTEM ELEVATION / %, 0 0 �5 �
SYSTEM TYPE moo f\a : L��ew.
CONTOUR FIENATION s
-V 1 0
Bi ► ac+Fa.
' Savvr.
C
(
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SIGNATURE " DATE
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11
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WEATHERPROOF
LACKING COVER .JUNCTION
QvicK Dlac,o64yacr --\
'rl777?77 7,
4'
+0 3 � 174'177
PIPE T
no N oISTuR6ED
S016, 2 4`' I.D. II 4" 4o
M4HU / i VENT
K
AW itovtD
sJ(ET 3bJIJT'J _� gAF'FLE 4 0
L. Pin a AL 3' o•�o
VA
1 1
CLev, ..
� s"'$ 42-
5 9 6,74 ow4-
p Pt�W
h ••
bcoCK
SEPTIC f - SP EGIFI 14 q� ( �'
DOSE w ��` "
TAW,.S MAWUFACTURER; S • (�
IJUMBER OF DOSES,
TAWK 5IZ PEK DAa
E .. ` � - VC 1 yALLOKJS DOSE VOLUME
ALARP'1 MAWUFACTLJRCR: S `� 1' �°< -i�� IKJCLUOIAJG 6ACKFLOW: �
GALLONS
MO DEL KJUP%'B'ER: Z�.Z
`b CAPACITIES. A_ IUCNES OR 4 2O ' 2 ' GA�LOi.5
4 n �
SWITCH TyP[; 1 �'��'�'` `^'
PUMP MAWUFACTUKER T g ` Z IuCHE5 OR 2q GACCOUS
o.. c b0
MODEL. ►JUMCE IQC
R: HES OR GA��0L.
S 1ak� 3 c7 �'C,
JWITCH T LJPE: �Q•V
D' InICHES OR GALLG
WOTE: PUMP AWD ALARM ARE TO BE
M'WIMUM DISCMAItGsE RATE -Z ' INSTALLED O 5EPARATE CIKCL r�
GrM ow
VERTICAL DIFFEKENCE DETWErm PUMP OFF A►JO 013TRIbUTIOW PIPE., FEET
+ MIAJIMUM KJETWORK SUPPLY PRESSURE . . . . • . .
1.3q FT --�_ F CCT + n
+ �� FEET OF PORC[ MAIN X -- Y 0 FEFRICTIOU FACTOR. 0 1 7 - 1 ZS
FEET _
TOTAL DykJAMIC. HEAD k1'2
Q FEET
WT ERAJAC DIME►JSIOKJG TAKJK: LEWC,TH `� -`„ �Z+1 4
;WIDTH 2
--- ---- -� ; DEPTH
PA u 6 - R 8
Engineering Deta;ls
Pump Characteristics Performance Data
r tA*lw UWi SelinierrbM
Awosiatk M444h SNFF30AI
4""4" .3o
FW load Asp
Mle►er TYP4 tale 0 } ;
RAAL
P hM e
Vek lIS
Nerfs 60 I f
Ionnperetae 140'F AtItlleiit wM4+1 six i
NFJAA Des4a A uw,Kea•i e s s
W>ae� an A A
4K41 9141 }'1 /2'N►713tiewi} Total NOW =eti 4 12 i6 `0 94
5#14 H"A ng 3/4' ( l alts.) ar lM (U .S.)
only welgit 30 611.
Power Cord 18 /3, SJTW, 21Y OIL Dimensional Data
ION
NA"
of Construction i '�" Al N�
..,,e 1e,eaW kr eobmd e,e.
Ner"dle StaiRkss Steil my 21/1 W4
hr cM it iM pupew
Ubuill, 00 Dktlatrk Of y WOW" vqw
Motor Nees Cut ken e ,1 r � oil
owl 04VO6h
pno erg
c,eawROs
COW Celt troll Nr1 S. On/Dll
4, we nwvo de riFh, el mete
t R *00 to Ow prl w eed,Mi
ioedfasan rte nuke
#ed d" Sed Faris Cnyiest /Caaatc
Sboft Seal Sew bir Atto&ed Steel 1
Springy Swehis Stw
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wss htte�N
r F Ik „� tiu
(JO�I
test Gs1 koa Sktew
lows It1F+rP
tenon fide IDOIWW s1k s a�� e•ve I
L1113 F.pineotW 1lteret oalk
Fastenten Stsidess Steel --
a 1999 H dromatic' Pump, Ashiond, C>io, AP R' is Reeved.
Fjjw HYD RQ MATIC M - Your Authonzed Loccl Diu6butor -
840 Ovey Repel AAW, Uho 44105 Tel: 41 MOMS? Fix; 419.581-4017
Web Site: www.peritcirpuop.com
SALES OFFICES IN All MAJOR (ME$ AND COOMIE1 (� �:
item u. W- 02.8360 1208 6M
System Management
Management of this system is critical. As a condition of approval of these plans this system management section must be
reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems
develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715- 235 -2644, or the
St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance.
General
Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows
into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the
better and longer the system will function. Typical system components include aseptic tank or compartment to settle out solids and contain
greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment
to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to
protect ground water quality and public health.
I . If the septic tank is installed prior to sheet -rock and /or painting, pump the septic tank before normal use begins to ensure adherence
to contaminant load design criteria.
2 Install water - saving appliances whenever and wherever possible.
3. Repair even small water leaks as soon as possible.
4. Never pour grease or oil down any drain or stool.
5. Garbage disposals are not recommended; if you must have one, use it sparingly.
6. No paper products other than tissue should go into the system.
7. No chemicals should go into the system.
8. Avoid surge flows of water; try to spread laundry throughout the week.
9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans.
10. If septic or pump tanks are no longer used, they must be properly abandoned.
11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching
may be required to maintain a functional system at start-up.
Maintenance
1. The septic tank must be inspected every three years by a properly licensed person.
2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume
equals one third of the tank volume.
3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into
the septic tank to remove accumulated material.
4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell.
Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption
cell.
5. If this systern contains specific treatment components other than those mentioned here, maintenance requirements will accompany
their specifications.
6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump.
If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve
capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or
two days should pass before any necessary repairs can be made.
7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system.
8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system.
9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth.
10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area.
11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient
oxygen.
Contingency Plan
Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring
may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54
(2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing,
and /or installation of additional treatment components or conversion to a holding tank may be necessary.
p g Y . Y
Page 8 of 8
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer ze 1 V
Mailing Address 1 �9 s C N V 0 ��
t -lw
Property Address - 7 J C) O`
(Verification required from Planning Department for new construction)
City /State Rob C�Ls 1 0 WT— Parcel Identification Number 22 ''/ U 2
LEGAL DESCRIPTION
`� 1 o F W Town of n Y\ property Location 1 /., Sec. T N -R ,
Subdivision Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # ` r7 � I - , Volume __ EZ 6 � , Page # _ c
Spec house ❑ yes no Lot lines identifiable ❑ yes ❑ 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 wastewater disposal 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 been maintained must be completed and returned to the St. Croix County Zoning Office within 30
Oj ofthree year expire
SIGNATURE 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 owners) of
G ove virtue of a warranty deed recorded in Register of Deeds Office.
SIGNATURE OF APPLIC 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
929 FC,! 590
VOL
00CL.'MENT NO. WARRANTY r1EE0 T—s SPACC lft;acft�co 0 Acco".-C 0.1.
477731L STATE BAR OF WISCONSI I FORM 2-1982
&GWERS Ott
..... ALMX.VAN..8EaK ..................... ST. CROIX 00.. WIS.
............. .................. . .. ....................
......... I .... ....... I . .................................................... ......... ..................
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ronvevs and warrants to ..ALVI - N-0 * A ' LEAAN-51UK . ......... 8:30 A.
......................
of ................. ................... sea#
.................................................................... . . ................
............................................................... I ... ..... . . ................
. ..................... ...... .............. ACTURN TO
... ....... .......... .................................. ............... .
tile follo-;nk des-ribed real estate in ... 5t. Croix
1� 0. BC 4�j
.... County,
sta te of Wisconsin: Paver Fails, WI :>4022
Tax Parcel No: ..............................
the NE 1/4 of the NW 1/4 and the West 361.25' of the SE 1/4 of
the NW 1/4, the SW 1/4 of the NW 1/4, and the NW 1/4 of the NW 1/4
of '% NW 1/4, all in Section 9, T28N, R18W, Town of Kinnickinnic,
St. Croix County, Wisconsin.
EXCEPT:
Commencing at the Southeast corner of NE 1/4 of the NW 1/4,
Sec. 9, T28N, R18W, thence N89o56'W 580.5 feet, the POINT OF
BEGINNING; thence , N89o56'W 340 feet; thence NOo4'E 295 feet;
thence S89o56'E 250.6 feet; thence S17o8'E 308.9 feet to the Point
of Beg the excepted part being 2 acres, more or less.
And EXCEPT Lot 1 of Certified Survey Map, recorded in Vol. 3,
Page 737.
Contains 125.85 acres, more or less.
This ....... i5 ...... homestead property.
fl& (is
Exception to warranties:
21st Nove
Dated this ................................................ day of ..... 91
... ..................... 19 ...... ..
:. /. :.....: ........ (SEAL)
..................................................... — (SEAL)
... AlmaJan-Be.ek ................................
....................... ................... ....................... (SEAL) ..... .. .. ..... ................. I ........ ...... (SEAI.j
...................... ........................................... ................................................... - .... ..
AUTHENTICATION ACKNOWLEDGMENT
Signature (a) ................. ....... ........................ ......... 'I'-*TE OF WISCONSIN
............ I ...................................................................
---P�ercq ................... County.
authenticated this ...._... of .......................... Ij ......
Personally came before me this ...... (lay Of
je ...... ................ 19.2.1 .. the above named
---.AJioa.-Van..Be- k ...............................................
..............................................................................
.............................................................................
TITLE: MEMBER STATE BAR OF WISCONSIN
w. .....................................................................
(If not ............................................................ Z I '.
................................................................................
authorized 1)y i 706.o6. Wis. stats.) known to be the person wl� t•4jte:
instrument and acknawledge t
...........
............... ......... P,0..Box.467 ..............................
River Falls, Wl 54022 ...................... ..... . ......
.... .................. ------------- * ............. * ------------- Public ... Pierce ......
' .... ..... .'..
(Signatures may be authenticated or acknowledged. Both �v commission is permanWi. ( ii no t .'- kto
are not necessary.) . ....................................
Z ! •Nam" of persons sizutne to say CaPecity should b* ty- o r 1 "' "c b* t"
QOCUMENT N o, WARRANTY NEED r "a Space, ncacwvco row wccouo.wo CA.a
STATE. BAR OF WISCONSI 1 FARM 2--ine
4"3ois 0 "m wL 935 E 266
ALMA VAN SEEK REG�Sr OFFICE
................................... ............................... .... ............................... ST. Mix CO., WI
...................................................... ............................... ..................... Reed for Record
......................... ............................. ............................ ... ...................... FEB 17 1992
ronvevs and warrants to .....
- ................... ............................... .................. � 10:45 A. M
ALVIN DALE VAN BEEK
...................................................................... .....
................... of 0
.............................. ............................... ................... weivoin To
'a ........ ...... ............................... ................. HAMMARC'A K
; lie followioK des••rilwd real e-date In ....St . Croix County C LAW OFFICES, S Ci
' P.O. Box 467
;: Mate of Wisconsin; P.O.
Falls, WI 54021'
Tax Parcel No: ..............................
i
The NE 1/4 of the NW 1/4 and the West 361.25' of the SE 1/4 of
the NW 1/4, the SW 1/4 of the NW 1/4, and the Nit 1/4 of, the NW 1/4,
all in Section 9, T28N, R18W, Town of Kinnickinnic, St. Croix
County, Wisconsin.
EXCEPT:
Commencing at the Southeast corner of SE 1/4 of NW 1/4, Sec.
,r. 9, T28N, R18W, thence N89 W 580.5 feet, the POINT OF BEGINNING;
thence, N89 56'W 340 feet; thence NOo4' E 295 feet; thence S89 56'E
250.6 feet; thence S17 ° 8'E 308.9 feet to the Point of Beginning,
the excepted part being 2 acres, more or less.
And EXCEPT Lot 1 of Certified Survey Map, recorded in Vol. 3,
li Page 737.
Contains 125.85 acres, more or less. F
This
.....lS .................. homestead property.
( K x AA)
F` Exception to warranties: None
Dated this ...... ". I ........ t.�:.... ........ day of ...... .. ..... ........... .........
;'!...... ........ al....... -. �G..�, ..._/1 ��.,t.'... (SEAL) _ ................. _.. ............... .............. ........ (SEAL)
...
Alrna. Ven- Beek ................ ....(SEAL)
.(SEAL)
i
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) ....... .......................................... "PATE OF WISCONSIN 1
k• ...................••••--•-•-.....•••--- •- ••••........--- ••- ...... - - -• ........ Pierce r --
` .. ......................- - - - - -- count y
authenticated this .. ....day of ........................... 19...... Personally came before me this .2 ,la of
....__,Januas
?_. )(...... ........... 19.92.. the above named
.... •--•.............._. ................ ...........••..................
;. ---------------------•-•---......---- ............................ a
• .. ......... . -.lm Van Beek
iITLE: MEMBER STATE BAR OF WISCONSIN ............................ .............
............... ..................•............. { •aJ..... s..::..
(If not . ............................................................
1
• ...,,
- authorized by § 706.06, Wis. Stats.) �••- .✓ ��-•• • R s
rose known to be the pt•rson ... W1FI0 cut.
--iegoing instrume d w Teo
ack no . e tJie . h
HA�v1 r fi�P a i S S.C. �.
.P.O. Box X ••-- • ......................... z
Sharon-- J_..Strnm .......... .. . __ f;
River Falls. WI 54022
•tart/ Public Pierce
n
�' �`'
(Signatures may he authenticated or acknowledged. Both Commission is pemanent.(lt rat, St�{F cx `raN n
are not necessary.) ti p, 09 -25 . . 19.9.4...)
•Hams of persona sisrping in any capacity ehuuld be typed or ,.rmud :.eln.. u. !.noaturee.
ST,' :A ilAlt tiY ' I :CI >NSIN �e,.�L wl.. 1 OAA•L
At
01999 Cload Cnrtog,,gqucs, Inc. Sr. Cloud. MN 56301
SEE PAaE 30 Y
Mr Put Dean &Glenda 69.5 Simonson �
a, ' Dan & JaGQue 38.9 sA&o e. n.x N Hansen Farm Inc v ,ol
_ 196.6 b 7zs b
8 v •
CAF N 4. • F' LenertZ
Hunter • • 5 65 Nelson zo• o - ao
F &F 5 `ri of
Harold ,..� � Abdul 71.8 Ma "
N F4rM V 11 r y` B `"r+ 1 Gloria °`� e ap 40 Lueck �'
L v A 716.7 152.4 &sham:
t.ertertz 197.5 SS • Vorwald �> . ' 3 M »atar Heinbuch 94
KI 388.$ Trust oNR Q Gerald &
' - •Galen p&H 5 379 Robert & 1 � Y iy�, ,5: 109.9 6: Robert �• Y. Kathleen
• C� 71,ompxm Feser lavwa.e a spa �i 3 170.2 I 1 a & DOrls '
lox ` Phine Daniel pp 120 Flden& 40 z° &gale Barbara Mark & Gacbe A Benson etal
B.adeu J & Iw.er�km .y 34 N's N¢U. Robert o 160
73.2
42 & can -V : • • tawrentt Ickler Laurie 1].4 • ca
.Shaw 'O z $ tanert: Alvin &Holly Lisa Delander t &A • Garbe v
Harry • James e6 Van Beek Bom srhmnr " �'ilT` 53 N
Johnson 40 0 6 Lubich 6 0 118 19.9
• 40 78 lames �•" •
Trust etal aon & Arnold & 115
° Aid Su M sheds Mudler Joanna & Mary Fisk 44 A '°
• s 35 Marcella Lueck
&M a: =k • Pin • B • Qz 160 vL
20 • a 30 Van ek • 4 19 _ 3 56.3 S umner Ro
James Jr & $ 110 c &Ll • mss• a z Ma 160 •
Elaine Ray E B 9 Paul• Ka N
Thomas & Lisa ,. C&S C &I WeMter: 0 a K &D� vv £ 127.3 Y tab Me R 160 180 • q5 Viola
• 157 Jo„es R10 C, &M "6 Hi6 r aij RK:Vors.a1J i] • Madsen& Liddle
• 73 "4 N _ JudBe 22. xA ' - N t. Fm Tr 84 F.p ie
or made=& ce= • "s > "' Marvin
• R &1 B • 15.9 T - 5 Anne Kao s z c ' 2 56. 305.7 •
•Johnson 158
John & [.enertz F,adedrk • 27 _ m " • °' z • R Oppenheimer w &r •M Robert &
Carol Fa & R tz ~ a z s c& Phoebe •Mar.;^ ) Trustee 1p Thekla Madsen
F er of Davi & Phil; & 3B z Y ` P l0 333 G,egn y & H 6 n ae.kk • s6 80
ey Paulson &Ka mnn
Lay P P Gordon Kath & 9 tr1 a4R
113.4 Dorothy Bethany r &R ; �'� Truesdill Brent • Lh 5 &B Kan: Tr can
'" U &natty Smith KN 6 • •38 4o A m 100 Dorothy
142.6 Ne40 : Line- niv <`z .a Jr 42.5 awtho 40 tz T a z o ss 4.1 �4 4� • Phi Oipps
Michael P &IG ]
• Ryan& m M
Susan 13.5 John Agronomics Gerald M ONR } Harold
117.3 40 Linehan sd,midto D&1 z0.a Inc Emholtz + Morrow 113.2 II
Cd ng Mickelson 40 sm Trs Cr
3 37 P 173.5 122.2 138
e �; IV 3 N 673 Goud 221 a • 154. r F - 1 1 r - • 4 J
Sa + &KGner 2 • i� Tn 17 • •S
i y 208.1 • 406 • + sa Tdd& t46 °1G 0 $
• �, d tans • s e 39 Robert '� 139
4/F j • David 4 Wolf
< 3 �. [\ $1e" Y David Munkittrick & 3 154 • Jeffrey & Nancy B = Sz.S t F 186 B&ars�s
p " • • S W & vKk 88 F William & .� " ' "€ „ &.1d • T Broom 0 s Orlande
p c David .2 Schroeder & Ross CR Qui le Christensen Gerard -" w& & rnatt • 20 55.2 a4
t7 rR Screaton :e Screat tuart Jr on y = HmrarJ a.=ea o&c e` Philli ps
��AA S & Esther Fuller • 163.9 oNR • 39 & Robin - rr zo •3 i a • Pem„o^ Far. Trust 93 i
v1 •� 7 Norman 5 • ^ - at 9.7 Ri
d; • K &K x0 R &L a1 �e<� r.
..1 Donald &Gloria • Ge"r8ia "a N ck tce a • ' s
& l d h 40
a 89 ]cmrhr,er Mueller $ a 57.3 Rider Tr2 • 0 Gerald & Anthony & : i '$ a ` 140
40 _ Rlr a,• JJ Robin Rick t.ora lames • • Glenn& B 20 �
8 Rom dr • &Mary ' T ley E1 .2 • 102.4 jp E i • John 58.2 x Donna Badje s0 x
Judith John 158.7 80 Purl -t 3o.s Tho & ' 2 - e 1 G Temmce y
s�•aton Fuller Da e & Ra mond &
7r ~ 71� •Rita �"': allentine 250 Gdffey �ii Tn •K 4- 40• •Olive laCOb
Bettendorf Led & Beverly Low z 40
odw • David & ., 78 • EE odRh 140 • Robert Jr 60
• F 140 Juliann Luse 479 • Dela ena Z • •
• • 80.4 53.3 2 c 1.015 28 • SS 31 Howard 1'e - -- • g W �rt'� Ona � �
pw 2 na,a„i ^& m PSw Ro aid Hans v Vir rv"othy ions ._ Madsen 4B Gordon ]--
Daniel &Ann cr " ` n E B Trouan Ddz;s t o 7B 80 Keatley m�
Ba ° _ . ToumleF ou
'g �� to6 °redam• 3 3s ' Ja t x xis Ir � sm TR 91.3 LM � Grif ey c a JH it &N
Krumwiede B • • _ : J )r & N 2 3 3e 160 ° a TmPst�
Jol,n ce y ^ Alan & 31 R a john & L F 24.7 lhom Son -)
• Candd Chads •Gar)' )amen & 63.3 U nlclzuBlain Kimberly GM +rpe Trust Marlin `, 30 V
168.8 Bettendorf R & shar t>a & M Solwn u. ° ^ge 52.9 ]Gear `4 Domin;< Daniel &
9.1 c
Hartle '- A ^dersmr ,., 44.5 r • w 7 er Haas V &Sally Jeanne
••39 9 unis rr Hill - _
g ` Sm DLWit on l &I " Keith& 20 Alley &
• x • •g Linda ��)orr
ree Fbrer• 40 r` �a 7 k• C k • .�
N 1 . 5 p Tm H 10 6_ Delwra Leota 13 ha en R &1 K &K
W 11 FO 26.0 ,a.2 • 10.1 i Alden 29.5
28.7 O $ 1 1Y S.1 1&CK 49 RBIWm& Smal Tract Andrea 7n AndIea x River Falls �'B m G 1N r r0 s • ^ R • _ • > t ".
29.5 Trs "15 BH 5 v 40 C y _
O c St ro1X c Trl ] 6 - & z m = own
Gerald
s&GC ^ad =- Land Trust $ t. County
Err= Daniel& m i „ iu
'g .D 743 l wane &Betty Ta s s c 4
Linda U Tr qp l.ee rNAaabma 3 ,^i, T &K t &I 3155 z GS Christopher sn
6 'd He4 B1U 59.2 x RL 2703 d 9 rya &sherry ' 2 a -,
32 Eugene
3 Tr 42'7 9 rbe 2 • K
p ramer
40 314.5 0, Soderbck = 37 o, n & K ^e ¢ ' sa+ ti
z oe ea Vernon 41
& 3 Krt � • S s[ M eaih�+ine r i°
•� =,
Fuller 112.8 138.8 Peskaz Vernon & 5 E l; a �t n ° & Betty
Debo , 3 91.16 aM. o
Fulle` I \ vem n & Stanley „dish Peer n r� ° Swenson Tr 200 W
94 Ruben &Karen 9 1 Daniel& l:� ) Arnold Adeline Peskar Hansen Fm Tr
Rr 114.3 1 1 3 20.6 Y • 40 • Ms ° ,.�
r�iu, c•• R & !•Davie Janet Bauer 101.3 r1 Peskar &Rose _ 99
• w coaa [arson
o tar , ,9.9 39 FL6 Yunker lA 3 , &Lr Judith ❑ • &Te= Bauer Gary &
o m m Hansen v Wachtler t 1•
Paul Sr & " 219 `E• �^ cK, rra. s - • 6 vo°, , • gq,q Judith Grimm 140
Janet Cudd Tr Cudd's Mobile Gerald 37.3 40. c iL , s = 101.6 59 {
61.8 Horne Court 65 &Caro] aB �t�- s vemon& Jd _ y ,8
65 KB Paul & Rr wT a s[anle Peskar r, _ _ _ U 213.8 177.8 ••
Leslie John & 110 Williams 6 Met Walker _ " „" r _ ; „ ' x • • • M
• Alice
35 Kuhn Margaret _ 0l • - c "e '� ° • C]
_ 79
.9 Hanson Tr ' F _ Vernon & �.
T. n, _ • )s 5 55 ' Stewart Iadhh David &Debra
125.6 5 t ^^ ^e 130 Ralph 100 ao Lerm c Ovsak f • Lucille Kelly U ^ j
39•
RIVER " _ 251.3 142.4 39 <
Sn. Trs RM 10 k U • Todd&
T Cri vj
Robert & rheod,rre 1 • • Dean Bergseng Patricia Robcy 159.9 W
�• w )Kenneth &Dame, _ GraC2
F ALLS Karen Miller Nicwlson 1 120 80
• 57.3 & R�ih Lee Nelson
3 q0 • 1400 1500
Rr cnucwn z'= 1200 1300
° o M 1000 1100. PIERCE COUJM
900
REAL ESTATE Midwest Appraisal Service; Inca
214 N. Main DENNIS R. SCHULTZ
River Falls, WI 54002
R U D E R WISCONSIN CERTIFIED RESIDENTIAL. APPRAISER #98
t • FARMS • HOMES • LAND
S I N C E 1 x 7 0 • COMMERCIAL TERRY D. BLA
• Buyer Representation WISCONSIN CERTIFIED RESIDENTIAL AP PRAIRA #56
• Seller Representation
p WM. RICHARDSON :
Gary W. Kruger, Bill Schramm, David Regre, WISCONSIN CERTIFIED RE SIDENTIAL APPRAISER 060
GRI REALTOR" Broker /Owner REALTOR ® 113 S. MAIN STREET
OFFICE (715) 4�
Office (715) 425 -8400 a -mail: W� 54022 FAX (715)
m
..,•a• FAX (715) 429:9459 krugerre@pressenterco
zLl$ir. w �Jr .
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
*iSconss TDD #: (608) 264 -8777
n www.commerc .wis ons
Department of Commerce www.wisconsin.gov
Scott McCallum, Governor
Philip Edw. Albert, Secretary
August 01, 2002
CUST ID No.139462 ! 2002 ATTN: POWTS Inspector
TODD L SINZ ZONING OFFICE
T L SINZ PLUMBING INC ST CROIX COUNTY SPIA
E5609 708TH AVE 1101 CARMICHAEL RD
MENOMONIE WI 54751 -5520 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 08/01/2004 Identification Numbers
Transaction ID No. 772516
SITE: Site ID No. 648298
Dale Vanbeek Please refer to both identification
Valley View Rd numbers, above, in all
Town of Kinnickinnic correspondence with the agency.
St Croix County
NE1 /4, NW1 /4, S9, T28N, R18W
FOR:
Description: Proposed Three Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 863015
The submittal described above has been reviewed for conformance with applicable
Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been
CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10),
Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to
occupancy or use:
General Approval Conditions:
• This system is to be constructed and located in accordance with the enclosed
approved plans.
• A Sanitary Permit must be obtained from the county where this project is located in
accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for
inspection shall be made with the designated county official in accordance with the
provisions of Sec. 145.20(2)(d), Wis. Stats.
• Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall
be on -site during construction and open to inspection by authorized representatives
of the Department, which may include local inspectors.
TODD L SINZ Page 2 8/1/02
Owner Responsibilities:
• Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that
the operation and maintenance of the POWTS occurs in accordance with this
chapter and the approved management plan under s. Comm 83.54(1).
• Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved
management plan or as required under s. Comm 83.54(4) shall be considered a
human health hazard.
• The owner is responsible for submitting a maintenance verification report per Comm
p 9 p p
83.55, that is acceptable to the county for maintenance tracking purposes. Reports
shall be submitted at intervals appropriate for the component(s) utilized in the
POWTS.
In granting this approval the Division of Safety & Buildings reserves the right to require
changes or additions should conditions arise making them necessary for code
compliance. As per state stats 101. 12(2), nothing in this review shall relieve the
designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number
listed below, or at the address on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others
who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely,
Fee Required q $ 175.00
Fee Received $
175.00
Gerard M. Swim Balance Due $ 0.00
POWTS Plan Reviewer - Integrated Services
(608) - 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm
jswim @commerce.state.wi.us
WiSMART code: 7633
cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544
Henry F Grote , Certified Soil Testing
I