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HomeMy WebLinkAbout026-1296-02-000 4 County: cJisconsin E;ipartment of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety.snd BuAding Division t 1V INSPECTION REPORT Sanitary Permit No: 514956 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 Holder's Name: City Village X Township Parcel Tax No: Country View Ridge LLC, c/o Oevering Homes I Richmond, Town of 026- 1296 -02 -000 CST SM Elev: Insp. BM Elev: BM Description: r Section/Town /Range /Map No: 07.30.18.1533 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic _ . Benchmark Dosing / Alt. BM Aeralier� k � , r Bldg. Sewer � <1 Q � �/ Holding ._ _ SUHt Inlet TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet I -:::` « ( . I 9 7, 35 Septic ., / .y • Dt Bottom Dosing ,` z� 7-4 / Header /Man. ? . Aeration Dist. Pipe J ICE 3 .'96 - 7 c / . (.o Holding • - -- Bot. System PUMP /SIPHON INFORMATION Final Grade 2 ,V / , Manufacturer , Demand St Cover I t 7 / GPM Model Number _ Z'� - L p q E � ��' � C o�ou {- L.�. r7 TDH Lif , Friction , s System , ea TD H //• Z 13 Y Forcemain N / Dia. // Dist. to Well .J Z SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length No. Of/T�enc PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /,F 1 76 /•C �_ SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Typ O SysterTy �Z CHAMBER OR lt1 UNIT Model Number: �v DISTRIBUTION SYSTEM /Vp( Header /Manifold Distribution / x Hole Size �� I x Hole Spa)ng J V;� to Air Intak \ Pipe(s) � Length Dia Length U Dia Spacing Z SOIL COVER x Pressure Systems Only xx th Mound Or At - Grade Systems Only Depth Over Dep Over xx Depth of xx Seeded /Sodded Mulched c Bed/Trench Center . �L Bed/Trench Edges Topsoil ' Yes 0 No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: I / / `` Inspection #2: /V / O hs Location: 992 165th A N w Richmond, WI 54017 (SE 1/ NE 1/4 7 T30N R18W) Country View Ridge Lot 2 Parcel No: 07.30.18.1533 1.) Alt BM Description = / 2.) Bldg sewer length - amount of cover = 7 )$ Plan revision Required? , ured Yes ;K V �J Use other side for additional Information. SBD -6710 (R.3/97) Date Insepcto Signa a Cart. No. Kcv, <-1 co ;nZ p� ,gpoy Safety and Buildings Division Coumy C 201 W. Washington Ave., P.O. Box 7162 � . 612 - /y, ■ ■ Madison, WI 537 162 Sanitary Permit Number (to be filled in by Co.) ■� S1 J IV Sanitary Permit Application Transaction Number 7 In accordance with s. Comm 83.21(2), Wis. Adm. Code, submission of this form to the appropriate sal unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned PO oject Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary �� /� 7 / ses in accordance with the Privacy Law, s. 15. 1 m , Stats. I. Ucation Information - Please Print All Information Property Owner's Name arcel # ` 0 7-4 12- 96 • OZ - properry O s Wa ing Address S EP �/5 33 , t _ 7 City, State Zi Code p honeNiTnmW01XC OUNTY y., /w� y,, on ZONING OFFICE / �r E TN; RI rW II. pe of Building (check all that apply Y Nam Subdivision Na or 2 Family Dwelling - Number of Bedro Bl ❑ Public/Cornmercial - Describe Use ❑ City of CSM Number ❑ Village of ❑ State Owned - Describe Use If Town of a a" D r III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal emit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expirati Owner IV. Type of POWTS S stem/Com onent/Device: Check that a I ❑ Non - Pressurized In - Ground ❑ Pressurized ln - G ro und -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (exptam) ❑ Pretreatment Device (explain) V. Dis r"yTreatment Area Informatio Des' Flow (gpd) Design Soil Applicatio te(gpdsf) Dig rsal Area Required f) IhspeBgl & Propos" en VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units U a New Tanks Existing Tanks H y fi i5 a Septic or Holding Tank Dosing Chamber ` D VII. Responsibility Statement 1, the undersigned, —Wde responsibility for installation OWTS shown on the attached plans. PI s Name (Print) _ PI ignaturc MP/MPRS Number Business Phone Number t5t,.- 2 -� Plumber's Address trees,, c i i y State, Zi ode) j l 7 VIII. Coun /De artment Use Onl pproved Disapproved Per Feee� Da I ued Issuring A t Signature ven Reason for De ' 1 $ ! ZA / b � DL Conditkolo(OpPrOM900mas for Disapproval Q , A C�Cf ra 1. Septic tank, effluent filter and 3) 11 'I" - P � J I 1 dispersal cell must all be services / maintained i rvb w w q A. C A - i�i as per management plan provided by plumber. 1 2. AN sefack requirements must be maintained A)d �' 4 I A Attach to complete plans for the system and submit the County on paper not less than 8 12 11 tack" In sir SBD -6398 (R. 01/07) Valid thru 01/09 PLOT PLAN PROJECT Country View Ridoe LLC ADDRESS P.O. Box 176 New Richmond Wi 54017 SE 1/4 NE 1 /4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 98.6 BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none kk BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100 Filter BEST GF10 -8 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark B.M.* Property Line Scale = 1/4" = 10' 1 Acre Lot 3 3% Slope Area 15' below system is remain undisturbed 98' a DT B -2 �y Pro 3 Bedroom C House o` Well is to meet all Grading is to be ST setbacks found in Comm. �� done to divert 1,' o run -off away �h 8 3 Tan are to be properly bedded / from system and rovided with lockdown covers with approved warning labels 301' Property Line Rcopy 165th Ave PLOT PLAN PROJECT Country View Ridae LLC ADDRESS P.O. Box 176 New Richmond Wi 54017 SE 1/4 NE 1 /4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 98.6' 3 BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. Top of 2" pipe ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑BOREHOLE O WELL *H.R.P. Same as Benchmark B.M.* Property Line Scale = 1/4" = 10' 1 Acre Lot B -3 3% Slope Area 15' below system is to remain undisturbed 98' DT B -2 Pro 3 99 Bedroom House Well is to meet all Grading is to be ST setbacks found in Comm. done to divert 83 run -off away Tanks are to be properly bedded from system and provided with lockdown covers with approved warning labels 301' Property Line 165th Ave Safety and Buildings 3824 N CREEKSIDE LA commerce.wi.gov HOLMEN Wl 54636 ■ TDD #: (608) 264 -8777 scons n www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary September 19, 2008 CUST ID No. 226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/19/2010 Identification Numbers Transaction ID No. 1588217 SITE: Site ID No. 742479 Country View Ridge LLC Please refer to both identification numbers, 165 Ave I above, in all corres ondence with the agenc Town of Richmond St Croix County SE1 /4, NE1 /4, S7, T30N, R18W Lot: 2, Subdivision: Country View Ridge FOR: Description: At -Grade / Three Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1200684 Maintenance required; 450 GPD Flow rate; 42 in Soil minimum depth to limiting factor from original grade; System: At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), Pressure Distribution Component Manual- Version 2.0, SBD- 10706 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administratve 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • The changes made in red to this plan on 9/18/2008 by this reviewer were acknowledged and approvedby the system designer. C011f,1 i • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component are. APPA Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and ENT dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption SEE CORRE area. chs. NR 811 & 812c • 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 POWTS installation is required. Arrangements for inspection shall bemade with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stat • 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 Owner Responsibilities: • Comm 83.52 Responsibilities. 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. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or addtions 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 $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633! (608)789 -7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 9/11/08 Owner: Countryview Ridge LLC Location:SE1 /4 NE1 /4 S 7 T30 N,R18W Lot 2 165th Ave Richmond System type: At -Grade Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706 -P(N. 01 /01) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Contige plan 9 -11. Soil test Shaun Bird OVED Signature ) F COMMERCE License number 2290 D}NGS �PONDENC RECEIVED S E P 15 2008 SAFETY �I BUILDINGS Y A B > ' S._. -- - LA• a-^AL -f p ST!►SEL���D,tflcTfsrt WELL 5 11/6B i!C B :1/Z B At = F• /�} G£L i of - Z h Afs"ErmN rE . L - v� = Z h�4 ,rya S�r�•t� Fabric pis ribution Lateral Soil Cover sma; mr.b Observation -Observation Observation we ll - 2 7.5t A - : 5 0 5WE w P3.ats+ V �= with Law =wd Crems Saction of wisconsC At- a 3 -Logle Absarption Area on s Slopfng C,,,,1tas�tf�7t,= IC E i K Page_ C f Distribution Pipe Detail for Lateral *tw*rk w • • u TultM -UP - . - PAC Force !lain Distribution Pipe P *'Last hole Shwld Be Next To tuRsi- uP /J Hole Diameter � Iech P �- Ft R x Inches Lateral Viamtsr L^ Inch( Force Main Diamtter r inches Y dam_.. Inches #� Of Holes /Pipe Invert Elevation Of Lateralsf /— Pt• Sued; License wimber: Date: _ • — �.•. ilt Moss :tt—e� f-•_ ���,r.�i� - . - "plot yC1riT CIA C:. rtic! ' nl�RO�►Ra 4pLitt/iTR W&AIrlttAS�,00f a► .! ICVtR 1 ��ytrs�ai lox Lt. Imam OrRt. t�•M•ei. ! t AA wplllf�JlM� ! I�R4�L ; j �MIY. rr�il�! 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AN • - ao0 ss moo 70 6t Sr. h 39 __ Im 23 a Ln:n.63XW u+rr,�c oM twrs�s�cw, �w�rrvwess. ea. ecori wmssa�s��r=• �o�►wN.�.w+a FLOW- LITERS/Hom � !! � f'tiCti0ltr Co�cod Case Iron 0 loon am 300 Motor Hous Impeller Material C'arbosls►e io _ _ 1Vve Clo Vu w . _ . _ ao - Volute ADS Power Coad SXrW A 7.5 Mechanical Shaft Sea[ Nitrale with carbon and ceramic faces Ck Fasteners -- Smi"Idu Seed _. a SbAft -- - - -- �Sliinlelnt Sled 2z Bearings Upper Skm and Lower i FW1 eearin 0 Q rL a 2Q sQ i0 80 puw PERFORMANCE CURVE LitttC aunt 1,PkMp C06 usv bow lANse»l#- oiW @m CIMOKWIN pbm 4gS.t17jS1! .PWm 4*LZ e.1S6e ism www.LktteoftutPump.com 0 Fan 99M6 -07105 r PLAN �� a �'S MANUAL & MA14AO .M ENT TQNS POWTS OVA SYSTE -M o rte SePdc T a NA F- L' C, Sam Tank Manus Q titA 13 NA fl Na pmt PN� D Na Of e° tvA Pumg•�� 0 wa maw UrAS pump Tod Numbef Of piimP E tbw } �c 'i.� -Pump Model r7 Nat &I wPl�p°dOr' Races svet� j3 p INet{•and a :00 rn9 t7 m Q 0816r. Fets.� & Gen" � � mglL Q t °n omw tom) �'� -- �isPsrsd tast<Cs) II tcr.gmund (per) Toad SawpowmSed ON e p 16-9round Pr+t#t MODS) � m� .grade . � o Comr B ed Somas c[u1400mt OW w• TOW Food C y, Inch dlaMe j', Eta � Ysfues t Service Frequency MpiNT CE s) (Ma)irnunn 3 yr:•) Service Event At feast once every mon �erthk+d (Y) of tank volume of tanfQs3 vvf,en combined sludge and scum► m4 s) �M�denurn 3 yrs -? condnon pump mt co Of WK9) At )eas once every 0 y sacs) trrsp 1 celf(s) At most once every . 0 mods s) Q NA C [e enifitter At 108st once every s) Q NA fropect p +p. PL" press a afarrrR p t feast once 3 0 Monde 0 Y ews) O NA i�csot+ end pe to At j s st once Q EI yea(s) Q cow At feast OnCO CwOry ja oa,.c Uft goons" SePtVe or pt,® of t he carrybw �gTRi1t:TYONS � e� be made by ��� W S fnsPI P bWTS a rr Ck for any bw* up Cr MAWVEWWW E MAPS P4on e s insDec ton °f tfse O �i scum arrd io cbe °�' Tank insPsr�Ons tnu � �roluma of opmbined jo cdw* 00 on the WARY Sent � cracks ar 1ea'ic% T d'rsp f e caa(s) # MW of elti r- hwdwwv6 on the ground ef8uer># err the l �, of the local nwAo °ry the or porAft a t ggkIst in the � PIP" and ► and requ the immedrabs owe �tljC�h NR �d sANO mW i a ta�n9 stodge and sasr» in any tank t''qus ° posed of to ' ' Whw me apm � by a SePW@ Servtdng nponerrts: s � pdmt� ode_ ar pressuft -Od POWTS =np0nSr0- ' �a°'a d powlsifthAww - of eft" t aws, � cf.12 =f I Or kM- shalt be P o f any seivW eye �� or mor 9 tt o >ocd reps au "* within 10 days A 904* U or t>ti am START UP AND OPERA710M _ pOWTS d%w*. ?� tank(S) 2r cW For OBW �6rn the 'L p y a s� sery cing P� to tae Qe�ec�ed gte conbe" Me ".4,1 _ ' Pve af o 'fin at the in�bve sesit- VAwn Sa ' �d%60r= asp is te�'� the excess std w' Sho not � {� abonre nom �a� � �((s) and MW nMA ui aye Ov�+9 ! ° t to eV cW*) in one � 8 the conb�.ofthe pump � removed bye wa< be - Y'o avCid tNrts s On a Pktanbec or PAS �bo d d e _ _ to tits etlluent pisrr�P or oaf tsar 0,8=wV for 6 t+��8 t>orrrNw ietveis within !ha pump tank' Y fi P AW °, tb trot drnre or pack ors ao n Otd(Worparc MW d or at a MR a�rp� amp. � � aid pvbg 910 � , ,�, is feet tr wa yam may on ori of btNt�s; Coridorz� so ttan s wabs d69 ' dst" � meat °� � dca'�e (%VW Pte' ry rsm whet so�eaer be scrays; a� .taiCen Cut of service shall to � tlmt Lhe they fuuowhV StMM 1A fails arid/o� is �� yy � ch. Comm 83.33. W is PnpP.dy , d silty grid the abandorsed PIP^ op ~ sealed �m AN POW tO tic w mid N> sN� bed and property d' of • . itto "milt afa utar$m and and K�ved or V,,Ir ^°� Me vold *polo Atte: Vxr4 0- silt baw i ert said materIaL fin ed w 64 9� CflNTflitCMO"t' PE measures gave Nom. O r numt be tal=L to prrmde a code it 0,, i t faft and Gates be MPOW n of a reptaeoement sol t b6M eyatua g rid ma be u ts�¢ed for the atsd corm acid shoved Mt i1 ASUMWO w should be fmm e:dsdng ar#d ProP�� chj u2 Wt Wk" M t m es weds- be bh*Ved , in the need for a new soil and situ j plg fine ��t s must oomph'vsrith the rules in nMK Sam POWTS bie'due W setback and/or soil � M �� SW VS is not D nog lied as a last resort to replace the fad � . meat area UPS area of r the aea is a a soil.and - rho aft has not bean to klenft a su able re puw ent are$. if no � area is �t>fe a be Owftnved to Nocats sr amb replaoen► ho �� nV be Nast � "Olt bo replace lire tailed POINTS. cted in place fioilowtrSS �no�raF of the bwr�t � . and ate sy comp with the wlea in atbacCattTi2rCSrt jrnust GASSES �R p�q�CIMT OXYls�hl. �C�ptlAdP AND OTHER ZRF�►3 NldENT T �N�T NT TK UNDER �" t7EATH1Y DO HOT ENTER A SEPTtC„ �wOR OF A TANK MAY -- D L'T OR � -E- RESULT.. RESCUE ADDM0XAL COMMA POWTS NiA1NTA ' P0wfS NiriSTAi3.ER Name ,s Nam — L op y,-- b P � — — — P=hwe SEPTAGE SF�tyK�11tG OPERATOR LOCAL REGULATE 1ttT�HOKtt� Phone agency L 0Pu .a r�tarr:e t),, phone . 7/✓ — ��� nra w=mwptww araioed WON suit e(Sw gpan Lsee. mid Waasl+�ra Counh uid me, d ay. C nm a ZMS)(I~ and 83-Wll (4 & (3). A*dM%V-*° chide tb's oEtlds doe � sd ems oral POW rs. r. x, Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division or safety and Buy kkVs in ac cordance with Comm 85, Wis. Adm. Code Counb C 1 A t Attach complete site plan on paper not less than a W x 11 inches in size. Plan must J 7 t 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. Reviewed by Date please print all information. Pwsarst irdonmstion you proves may be used for seaondwY Purposes (PrW*y Lew, s. 15.04 (1) (m))• FCI %Y Ow Property location ner G Gov(. Lot E 1/4 1/4 S . T N R • E ( W Owner •ng A ddress Lot # Block # Subd. Name or CSM# Number ❑ City ❑ village 1B Nearost Road OF pis Zi 0 jT 0 & m h, et—, Construction Use esidential / Number of bedrooms ,�_ Code derived design flow rate GPD Replacement ❑ Public or commercial - Parent material d Flood Plain elevation If applicable itl` Y Gerwal comments and recommendations: System Type System Elevation — �❑ sorkv 117 a # Pit Ground surface ow. � ft. Depth to g factor � lo• SoM Applicati Ram Horimn Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots In. MunseM Qu. Sz. cont. color Gr. Sz. Sh. 'EW1 *002 77- o / © -4- s ms z ft p Boring A Boring # A ® �. Pit Ground surface elev. � ft. Depth to limiting factor in. � Sol Ram Hortzon Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Muns" Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Ef(Q G /-3 r- -- -- ' OF —7 S k x Eflkmtt #1 = 800 >•30 S 220 nVL and TSS >30 < ' Mov #2 = WD s 30 wG& and TSS 1 30 mg& CST N" (Pteasa Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address 9 Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �/�- 715- 246 -4516 Property Owner Parcel ID # per of BO 3 BOMB # ❑ 0 Bo ring Grouna surface elev. 9 ft. Depth to litobN im Soy Rate Horizon Depth Dominant Redox Description Texture Gr. consistenos Boundary GPDA1° in. Munsd Ou. Sz Coro Color Gr. Sz. Sh. 'Elf#1 *802 2 -30 IOU ❑ Bow # ❑ft in. ❑ Pit Ground surface elev. it. Depth C factor Sol r*002 Horizon Depth Dominant Redox Description Texture Structure Conststerx�e BmWar Y Roots GPD in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. a soft # ❑ pit Ground surisoe elev. R Depth to &Wft tg�' in. Redox Desciption• Texture Swcue � BAY Rooffi Horizon 'leplh Dorrrinant Gr. Sz. Sh. 'Etf#i TOM in. Munsell Ou. Sz. Cont. color • Eftwt #2 = 8OD < 30 nglL end TSS <_ 30 mQ L ' EtMrent #1 = BOD > 30 1220 mgll. and TSS >30 1150 mOA. •— . 1 o rtunity service provider and etnPloyer. If you need assistance to access services or Th Depattrnent of Commerce is an egos PPo lease contact department at 60 &266 - 3151 or TTY 608 - 264 - 8777. need material in an alternate format, p SzosawtR.�i Soil Test Plot Plan P roject N ame Country View Ridge LLC Shaun d Address P.O. Box 176 New Richmond Wi 54017 CS;�M #226900 Lot 2 Subdivision country view ridge Date 4 /11/08 SE 1/4 NE 1/4S 7 T 30 N /R W Township Richmond ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" pipe System Elevation 98.6' *HRPSameasBenchmark ❑ B. M. Property Line Scal e / = 1 4 = 1 0 1 Acre lot 0 B-3 Scale is 1" = 40' 3% Slope unless otherwise noted B -2 98' 99 301' Property Line 165th Ave I -- Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County I ' include, but not limited to: vertical and horizontal reference point (BM), direct' n a Parcel I.D. percent slope, scale or dimensions, north arrow, and locatio dis ce t ear ad. 0Z( — / 9 ! — aZ Please print all informatio Revi ed by Date personal inforrnabon you provide may be used for secondary purposes (Priva m)). Proropp / ���rAlyy Owner Ae RE CE IV E: Prope ocation ( �� n vr t. Ile_ Govt. Lo sC— 1/4 114 T J N R E (o W Property Owner'UMailing Address of # Block # Subd. Name or CSM# SEP 15 20 0 so >- /7 ( nn � — ( ) City tate Zip Code Ph a Nug be ROIX COU TY� Crty Village To Nearest Road /JQ� (uci W� ) SYDJ (' ZONING OFFI E ew Construction Use esidential /Number of bedrooms �— Code derived design flow rate �� GPD ❑ Replacement ❑ Public or commercial -- D J cribe: Parent material DL.0 ..-0 c,vl Y� dt�/LTi /�� Flood Plain elevation if applicable General mimendati �d/l � /` / �• `�' and recorrwnendations: �// � . Gns•k.. �'o C rte. System Type System Elevation y M Boring # Boring 5L Pit Ground surface elev. ft. Depth to limiting factor 7 Q in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 4 Via- %v 3 0 -y1 1 6 " S ., Aw l z �. , -7 ® Boring # ❑ Boring Q pit Ground surface elev. " ft. Depth to limiting factor L 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 -/ Df Z- �,i'o f r > C / Gtr s 70 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 194& ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) g CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �� 715- 246 -4516 i Property Owner _ Parcel ID # Page of F Boring # ❑ Boring 131 it Ground surface elev. w ' / 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..$z. Sh. 'Eff#1 I •Eff#2 3t,,.-, --- 0. 30 Boring # ❑ 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 E) Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F 1:1 Pit Soil ication Rate Horizon 'lepth 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 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. seo-8330 (RAM) I f , Property Owner — Parcel ID # Page of Boring # 11 Boring D ,� ��pp Ground surface elev. / (/ ft. De to limiting F IZ71Pit P 9 factor. ^�° -L� in. � -- Soil Application Rate Horizon Depth Dominant Color Redox Description, Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr-,4Z. Sh. 'Eff#1 •Eff #2 Z -30 y F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. - To — ilApplication 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 '042 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth 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 1150 mg/L ' Effluent #2 = BOD <_ 30 mg& and TSS < 30 mg/L Ttie 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. SOD -8330 (R.6N0) • Soil Test Plot Plan Project Name Country View Ridge LLC Sha i Address P.O. Box 176 New Richmond Wi 54017 #226900 Lot 2 Subdivision country view ridge Date �11/08 SE 1/4 N E 1/4S 7 T 3 0 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" pipe System Elevation 98.6' *HRpSame as Benchmark ❑ B. M. Property Line Scale = 1/4" = 10' 1 Acre lot B -3 Scale is 1" = 40' 3% Slope unless otherwise noted B -2 98' 99 301' Property Line 165th Ave <. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Z Division of Safety and Buildings in accordance with Comm 85, 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 Parcel I.D. /� percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Q Z 1 -" 1Z �! O Z- Zo Please print all information. Reviewed by /S33 Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 9 �� Property Owner Property Location Q vl l c is. 2 /41. 1,L Govt. Lot '6E 1/4 A/C.,. 1 14 S 7 T N R / p E (o W Prope Own 's Mailing Address Lot # Block # Subd. Name or CSM# . fl . t ir 1'7(, City P State Zip Code Phone Number ❑ City E) Villag n Nearest Road ,,, New Construction Use: Residential / Number of bedrooms _ 3 Code derived design flow rate � GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments / +�� / L I and recommendations: Cb" �'� `'�"� 7 ✓ 5 ICS 131 Boring # MB' ❑ pit Ground surface elev. �n ft. Depth to limiting factor / in• coil Application Rate 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 /a Yx 3 z, S L Z,,,, r 4 z /5- Fr -- D . 0 F-1 Boring # ❑ Boring El Pit Ground surface elev. ft. Depth to limiting factor in. - iio ­ ilApplication 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 = B > 30 < 220 mg& and TSS >30 < 150 mgll 'Effluent #2 = D < mglL and TSS < 30 rrglL CST Name (Please Print) – _ Signature CST Number I (We 3 A lf 7 Address Pate Evalua' n Co ;ad Telephone Number / O 8 7/S -38(0 - y(o Property Owner _ Parcel ID # _ Page of ❑ # :❑ Boring Boring ❑ Pit. Ground surface elev. ft. Depth to limiting factor in. " Soil Application date 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 F-1 Boring # ❑ 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 'Eft#2 Q Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 1 '01#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mgll. 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. SOV- 8330(8.6100) Soil Test Plot $/11/08 Project Name Country View Ridge LLC Address P.O. Box 176 New Richmond Wi 54017 6900 Lot 2 Subdivision country view ridge Dat SE 1/4 NE 1/4S 7 T 3 0 N /R W Township Richmond [] Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 2" pipe System Elevation 9 8.6' *HRPSameasBenchmark B. M. Property Line No Scale = 1/4" = 10' 1 Acre lot B-3 Scale is 1" = 40' _y 3% Slope unless otherwise noted B -2 98' 99 301' Property Line 165th Ave 04,22/08 TM 09:30 F Z1S 386 4888 ZI Oe f uMO�.wl,00w � :as«� AM � n s- s� f Tim �"� �,aooaiw d�iis s +dlw • =w be wit p,UG r�o•�w A °o "` U xlt► i�aioa �. /5 �' yMSbST CROP OFF' � � • � moo.. � .�.aR p �►d man e f ❑amp -� �,� �NaMscN� ti Tw* � QaL.rt�/N�asmeiRios�'N� A. dmwmbw IDr«.at MNM d �9t i► d � Indw�id Q ►N�re}ard Q Q © f *Uft"o* IICrMrD4��a""tt Am s lti0! f Ta�icid► GYlru Udw i 1N+r7Mis ai�s��"+rr � �ws � wsMO � railheMi mkMIL lYe�sturw� VIL L z5v wow ko - w fr L/J cob A� IOLL YSTEM OWNER:S�`�- !!►�!�U�w"" 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per mana emen • , ��� ,.c..a.+rrw"""��"` se ack requireiM�t'�' as per applicable code /ordinances. XX� LOT PLAN P ROJECT Country View Ridae LLC A DRESS P.O.Box 176 New Richmond Wi 54017 ' SE 1/4 NE 1/4S 7 /T /R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/11/08 BEDROOM 3 CONVENTIONAL XXX IN- ND PRESSURE CONVENTIONAL LIFT HOLDING TANK - � MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1 157 # of chambe 57 ,BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100 Filter ST Filter ❑ BOREHOLE 0 WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 98.4/98.1/97.8 4 below qrade B.M. 186' property line Well is to meet al Scale is 1" 40' setbacks required b q unless o erwise i WDNR Vent noted Plans Designed Using Conventional Powts >6" each* Chamber Manual Version 2.0 of Cover Leach' g Chamber 100' wit 0 ft2 of Area 5. ^2 /pair of end caps 4' Long 12 34" Grade at System Elevation 10' B -1 Vents 4% Slope 45' ° N 3 -3' X 78' ce with >3' spacing h 4 4 A ' System is t e installed 5 13 -3 upslope a uch as po ib)e �.� 45' � 10 B -2 50' - 103 101 30' Pro 3 Bedroom flyuse fi —pLei� L fit ST 301' �U�' �G►A��� Property n6 Line ECOPY Town road I LOT PLAN PROJECT Country View Ridae )/T A DRESS P.O.Box 176 New Richmond Wi 54017 SE 1/4 NE 1 /4S 7 /R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/11/08 BEDROOM 3 CONVENTIONAL XXX IN- ND PRESSURE CONVENTIONAL LIFT HOLDING TANK - � MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1157 # of chambe 57 BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100° Filter ST Filter ❑BOREHOLE O WELL *H. R. P. Same as Benchmark SYSTEM ELEVATION 98.4/98.1/97.8 4. elow qrade B.M. 186' property line Well is to meet all Scale is 1" 40' setbacks required by Unless O erwise WDNR Vent noted Plans Designed Using Conventional Powts 91 Quick tandard -W Manual Version 2.0 of Co Leac g Chamber 100' wi 0.0 ft2 of Area ft ^2 /pair of end caps 4' Long 1 B -1 Vents 34" Grade at System Elevation 10 4% Slope 45' 3 -3' X 78' c s with >3' spacing System is be installed 5 B -3 upslope much as possible 45' 10 103 B-2 50' 101' 30' Pro 3 Bedroom House ST 301' Property Line Town road TYPE -1 SEASONAL lfittAND DEUNEATED BY Greg callow of 1 II GRAM ENVIRONMENTAL SERVICES ON 9 -16 -2004 `91 l /� r i 1� g74.00' j l 3a, eirav -I' � � � \ \ • ,tea..✓ � / � .�, .o. ? x \ I I sq.ft. 00 acres I I 87,120 sq. ft. l - II 2.00 acres 1 24 87.-17,589'2256 °w — 874120. t,3 . J \ / I N I s 1.79 n x 981.5 / 1- �,�, I ' r VIEW RID beast Quarter, part of the Southeast Quarter of the Northeast Quarter, p id part of the Northwest Quarter of the Southeast Quarter, all in Section Town of Richmond, County of St. Croix, State of Wisconsin - - -Found Northeast Corner ,, \ � Section 7 -30 -18 Bench Mark p �� Aluminum Monument Top of 2" 0. D. Iron Pipe Elevation 974.12 ft - NAVD 88 t14 I 00 1 1 East Line o I N 1 1 Northeast G - - - -- N88 "E 507.00' --- -_ I I of Section ' 110.91' 186.24 -- 139.10' 176.85' l i 24.28 ' Q Drainage i t` 33.00 °O I w Easement0' k2' ��\\ 00 M Z N5.YV1'30 "E ri It I 00 �__ N' 123.98' 1* N 1 1* M O S29 12 E - -- 04 O c0 2 W 81.17' N , I O 04 a O 1 w 33 33 I (n W 43,587 sq.ft. 'P O 46,280 sq.ft. W 1 tJ 46.278 sq.ft. s 4 a 1.001 acres Y q' 1.062 acres M + L0 I ��s LBO 1.062 acres 975.00 LBO = 970.5 LBO = 970.50 M i i68 sq.ft. N O a0 O I i )0 acres O rn d- J , = 975.00 O l N O 0 1 i - 169.03' - - - _ N ° o_ N6 5j4: 5_ "W y-4.76' I , Un A 1 64.27' -- / r + Found East quarter �'• Drainage t0- y i,> > — — ` — - N89'22'50 "E; �/ Section 7 - 30 - 18 RoAroad asement tJ ` , - - -- _ Spike N O ,n 167.35 o �,.\ S . PAB NO2 � 56'16 "W �1�� % 2 M I ? ,, 108.48 2 N89'22'S0 "E 42.1s, , �,' © — — —167.35— — 5 ,1� N I k9 9''G A : 2 4 � I _d 43.580 sq.ft 43,629 sq.ft. . C14 � i A• 1.002 acres n 1.001 acres o I I I (N8933" ss � z I I QI 115.62' 195.00 «� 1 OI I rn — N87"11'00 "E 310.62' 5 I WI 87,548 sq.ft. 00 V- I 1 0 0 0 �I 2.010 acres i 04 2 r i i 00 J 'J Ui st .., 43,561 sq.ft. _ I ?I fL. Wiscomin Department of Commerce SOIL EVALUATION REPORT Page l of Division of Safety and Buildings in accordance with Wis. Adm. Code County II I Attach complete site plan on paper not less than 8 1/2 x 11 i es it include, but not limited to: vertical and horizontal reference int (BM), ire'CE t arcel I.D. i 6-7 percent slope, scale or dimensions, north arrow, and locatio and distance to nearest road. Z Please print all informatio MAY 2 �� Reviewed by Date ,/ G Personal information you provide may be used for secondary pu es (P ' cY Law, S. 15.04 (1) (m)). Property Owner Z cation /7 ,'e F��E `^ 114 l4 T 3O N R f E (o w Property es Mailing Addr jot# Block # Subd. Name or CSM# 7% Sox / 7 �o �L — L��u "/ ie Cily State Zip Code Phone umber ❑ illage To Nearest Road M New Construction Use: esidential /Number of bedrooms J Code derived design flow rate GPD ❑ Replacement ❑ Public or meraal - D scribe Parent material FI Plain le ation if a licable /7 /� ft• General comments � / 7• and recommendations: y "` «�� o f✓)e C Se- vr, ng / n , ` Bon # Gro und surface elev. � Depth to limiting factor ' Z D in. ✓ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 3 ✓V1 i �t ® Boring # Boring /c'1� I Z- Pit Ground surface elev./ (J ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a -! 014 r 3 s r 2," n- C, - C S a o On 1721/c Il �r Effluent #1 = BOD > 30 220 rrtg/L and TSS >30 < mg/L ` Effluent #2 = BOD < 30 mg/- and TSS < 30 mpt CST Name (Please Print) Si CST Nurnber Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, V) 540 715- 246 -4516 Property Owner Parcel ID # 5 ge of _ / Boring Boring # Pit Ground surface elev. 7/� ft. Depth to limiting factor in. Soil plication Rate Horizon Depth Dominant Color Redox Description Texture Stnrcture Consistence Boundary Roots GPD1fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z (D� r � ---- -- . G Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 Boring Boring F # O Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil !i7 on Rate Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots ? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EEff#2 Effluent #1 = BOD- > 30:S 220 mg/L and TSS >30 < 150 mg1L ' Effluent #2 = BOD, < 30 mgA- and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R6(00) Soil Test Plot PISBird Projedt Name Country View Ridge LLC Address P.O. Box 176 New Richmond Wi 54017 TM #226900 Lot 1 B Subdivision Country View Ridge Dat 5/20/05 SE 1/4 NE 1/4S 7 T 30 N /R W Township Richmond E] Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron /Nail System Elevation 98.4/98.1/97.8 *HRPSame as Benchmark B.M. 186' property line Scale is P = 40' 100' unless otherwise noted 10 1B-1 4% Slope 45' 45' B -3 45' 10 103' B-2 101' 301' Property Line c Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter Is being installed In order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 C n ncy Plan Option #1 if system faits, determine cause of failure, use alternate area aril Install new cyst tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 71 5- 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 71 5- 246 -5148 Shaun Bird #226900 N= Voi ici Vo lur, u8: LL NAA ' 115 386 4686 Q001 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer C Mailing Address , D , y- f -) Property Address (Verification required from Planning p&Zoning De for new construction.) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location '/4 , 4�E_ /4 , Sec. , TN R�W, Town of Subdivision Plat: ,Lot # Certified Survey Map # `" , Volume �/ Page # Warranty Deed # I z - (before 2007)Volume Z&S Pa e # 0/0 Spec hou> <yes f no Lot lines identifiabl • yes C, no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 I!3 full of sludge. 1 /we, 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 Planning & Zoning Department within 30 days of the three year expiration date. 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of rooms NA OF APPLI id-a CANT(S) DATE * *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) FROM :OEUERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:14PM P12 } .n�u I s low V wt, y r O 1 � t N J s J r FROM :,OEVERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:14PM P11 i� ME «A -. a N tag WW Jim p o w . ....— .— .— .— .— .— .— .— �.�...�.. �I l . Parcel #: 026- 1296-02 -000 08/13/2008 04:50 PM PAGE 1 OF 1 Alt. Parcel #: 07.30.18.1533 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 11/29/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner % OEVERING HOMES O - COUNTRY VIEW RIDGE LLC COUNTRY VIEW RIDGE LLC PO BOX 179 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 992 165TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.062 Plat: 10- 090 - COUNTRY VIEW RIDGE LOTS 1/27 026 -05 SEC 7 T30N R18W PTS SE NE & NE SE Block/Condo Bldg: LOT 002 COUNTRY VIEW RIDGE LOT 2 (1.062AC) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 07- 30N -18W SE NE 07- 30N -18W NE SE Notes: Parcel History: Date Doc # Vol /Page Type 11/29/2005 813158 10/090 PLAT 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/22/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.062 19,900 0 19,900 NO Totals for 2008: General Property 1.062 19,900 0 19,900 Woodland 0.000 0 0 Totals for 2007: General Property 1.062 19,900 0 19,900 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 , U 2656P 061 7743 IL Y STATE BAR OF WISCONSIN FORM I - 1999 KATHLEEN N. WALSH 4 Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., VI This Deed, made between Gerald A. Kieckhoefer, Jr. and David RECEIVED FOR RECORD J. Kieckhoefer Grantor, and Country View 09/14/2004 10 :26AN Ridee. LLC Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXW # the following described real estate in St. Croix County, State of Wisconsin (the "Property ") (if more space is needed, please attach addendum): REC FEE: 13.80 See attached Exhibit A TRANS FEE: 1410.60 COPY FEE: CC FEE: PAGES: 2 Recording Area Name Return Address n 4 cs ^ A V� 26- 1025 - 40-000 Together with all appurtenant rights, title and interests. 026 - 1024 -30 -000: 026 - 102440- 000, 026- 1025 -30-0 Parcel Identification Number (PIN) This is not homestead property (is) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record. Dated this 2r11,1141 day of - 2004 * Gerald A. Kieckhoefer, Jr. * David J. Ki khoef * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Gerald A. Kieckhoefer, Jr. and David J. STATE OF ) Kieckhoefer ) ss. County ) authenticated this da of 2004 Personally came before me this day of the above named * Kris tina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stars.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Kristina Ogland, Estreen & Ogland 304 Locust Street, Hudson, WI 54016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co.. Fond du Lac, WI STATE BAR OF WISCONSIN 800-655 -2021 WARRANTY DEED FORM No. 1 - 1999 U 2656 P 062 Exhibit A Located in part of the SE '/< of the NE Y.,, the NE '/. of the SE '/<, , SW '/. of the NE '/. of Section 7, Township 30 North) Ran a 18 V1%the NW °f the 5E and the Of St. Cro1x, State of Wisconsin described as follbws:I 9 mot• Town of Richmond, County Commencing at the East quarter comer of said Sect! n 7, this also being the Point of Beginning; Thence S00 "37'10 sne of the SE'/ Pof sa °E along the Eat ti id Section 7 a distance of 880.99 feet; Thence S89 0 18'55"W on the northerly line of a Certff' 3752 a distance of 690 0" n the westerrly line of said Certified SUrvey age .00 feet; Thence 300 °37'1 ?ed SurvOY Map recorded In Map 428.42 feet (Record 428,50 feet); Thence S89 °1I8'52"W along the south line of the N % of the SE '/ of said Section 7 a distance of 1146,36 feet Thence N00 ° 33'53"W 1384,45 feet; Thence N88 1048.00 feet; Thence N51 ° 00'00 "E 25 feet; a point on the East line of the NE'/ of said Section ;' Thence S00° 0'35 E Wong " (d East li ne of to terminating. the NE % of said Section 7 a distance of 248. 0 feet to the Point of Beginning acrd there J f r 1 r Ws oonsi n Department of Commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings in accordance with mm Code ,. Founty 57 Attach complete site plan on paper not less than 8 1/2 x 11 ' che inducts, but not Limited to: vertical and ho rizontal reference int (d parcel LD. percent slope, scale or dimensions, north arrow, and locati and est road. Please print all informati n. JOB Revie ed by Date Personal information you provide may be used for secondary pu es (F9'7ad}CI 1 Property Owner 6gntEl.ocatio Govt. Lot 1/4 �/4 1 T 3D N R/ j E (o W Property , i s Mailing AddrKs OK i0t V Block # Subd. Name or CSM# 0 j So x /? 6 ( At-f– Ar. 2- X I — ---] 'Y /"./ 1, city State Zip Code Ph Number ❑ C' ❑ 'llage li(Tota Nearest Road//' New construction Use: esidential /Number of bedrooms J Code derived design flow rate GPD ❑ Replacement ❑ Public or mmercial - D / $scribe:-- Parent material ✓/ Flood Plain elevation if applicable �!/ � ft• General comments o v � l i &�� O. and recommendations: S ,+�-� J' Sh e V C. A' � S S Z iT 4 Boring � W � # Ground surface elev..�� ft. Depth to limiting factor Z , Pit Soil Application Rate Horizon Depth Dominant color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. 'Eff#1 j 'Eff#2 -1 L Z /z— 7. a 2 Bori # P 7 3 P it Ground surface elev. , ` / ft. Depth to limiting factor �_ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munselt Qu. Sz, Cont_ Color Gr. Sz. Sh. 'Eff #1 'Eff42 0 -1L o 3 / Z s f r 5 a �- 3 ya- 7,s � -- ( le � MF, 11 F � 1C)"rm. lvrs Y — rylorr It 1� Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 nVL CST Name (Please Print) Si CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401 715- 246 -4516 Property Owner _ Parcel ID # Page of 3 Bodng # Boring "��; ��' pit Ground surface elev. Depth to limiting factor in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDJff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Efi#1 `Eff#2 C i I '�� �,S ✓�� SI ►�� tolL l v �s - ,-�,' A G n r 2 F - 1 Bari ❑ ° Boring 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Boring F Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Appl ication Rate Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 _F --- El Ef fluent #1 = BOD. > 30 _< 220 mg1L and TSS >30 < 150 mgfL ` Effluent #2 = BOD, c 30 mglL and TSS 1 mglL 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. seD4330 Soil Test Plot Plan Project Name Country View Ridge LLC Shau d Address P.O. Box 176 New Richmond Wi 54017 CS #226900 Lot 1A Subdivision Country View Ridge Date 5/20/05 SE 1/4 NE 1/4S 7 T 30 N /R W Township Richmond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron /Nail System Elevation 91.1/90.9/90.7 *HRpSame as Benchmark 176' Property Line * B.M. AL 0' 97' B -1 96' 45' Scale is 1" = 40' B -3 30' unless otherwise noted 4% Slope 5 ' 15' B -2 100th St. i J