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Home My WebLink About026-1131-06-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety acid Building Division INSPECTION REPORT Sanitary Permit No: - 399670 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID N 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 No: Stock, Bill Richmond Township Parcel Tax 026- 1131 -06 -000 CST BM Elev: Insp. BM Elev: BM Description: O t. (o O 1 t 4 0 CST tub Z u _ P l)t TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark , C. 1 "Ib 2. 6 I0� I • b O Dosing Alt. BM 112.81 2.49 110 ,07 -' Aeration Bldg. Sewer Holding St/Ht Inlet 6• (� 1�6•b�j� St/Ht Outlet TANK SETBACK INFORMATION � 6 •`f 0 0(. TANK TO P/L WELL BLDG. 7VentEIntak ROAD Dt Inlet Septic �� / 2 t Dt Bottom Dosing Header /Man. IDS qs q� • (I r Aeration Dist. Pipe }.29 • }T b• IT- t Holding Bot. System 9 . Final Grade %&,-L {p PUMP /SIPHON INFORMATION Manufacturer Demand St Cover CA) Model Numb TDH Lift tion Loss System Head TDH Ft Forcem Length Dist. to Well ' SOIL A ORPTION SYSTEM RENO Width ' Length f o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME NS - SETBACK SYSTEM TO /L BLDG WELL LAKE /STREAM LEACHING Manufacgr — �\, INFORMATION CHAMBER OR "=vl `` Type Of System: 6 r 9a t _ , UNIT - 1��►r Model N ber: DISTRIBUTION SYSTEM Header /Manifold u Distribution x Hole Size x Hole Spacing I Ventt > o Air Intake O� l� Pipe(s) t Length 1'� Dia \ Length 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 Bed/Trench Center Bed/Trench Edges Topsoil Yes � No [] Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #14 0 / 22- 2ZV Z_ Inspection #2: Location: 1014 159th Ave New Richmond, WI 54017 (NW 1/4 NW 1/4 17 T30N R1 8W) B & R's Rolling Acres Lot 6 Parcel No: 17.30.18.908 1.) Alt BM Description CA,-e '�� 2.) Bldg sewer length kaw.it" Sl - amount of cover= —�„ \11�et " �Oi (l " " — X 3.0 X Plan revision Required? ❑ Yes No •L3 Use other side for additional information. ttN l SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix , Safety and Building Division INSPECTION REPORT Sanitary Permit No: , � 399670 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 Holder's Name: City Village X Township Parcel Tax No: Stock, Bill I Richmond Township 026- 1131 - 06-000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 2 • `h; Septic BenchmTA c I ' (V2.g6 l.� 2f20 Eta 2_ 5 z Dosing Alt. BM ' Z0, ' /z.2. Aeration Bldg. Sewer / Holding St/Ht Inlet St/Ht Outlet TA SETBACK INFORMATION / Jo TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Wet Septic , / t ttom Dosing Header /Man. Aeration Qist. Pipe Holdi o.' System Final Grade PUMP /SIPHON INFORMATION Manufacturer Dbmari'6f' St Cover GPM Model Numb TDH Lift riction Loss System Head TDH Ft Forcemdin Length Dia. Di ell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEACHING Manuf t INFORMATION Ty Of System: , CHAMBER OR Zh YP / r � "- Y a l UNIT Model Number: C-b V% . DISTRIBUTION Sl( TEM Header /ManifgI Distribution x Hole Size x Hole Spacing Vent to Air Intake ,�G�v (� It Pipe( Length 4 Dia 1 Length 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 Bed/Trench Center Bed/Trench Edges Topsoil E41 Yes III No Yes �jj :No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:,TMW1 2Z/2002— Inspection #2: Location: 1014 159th Ave New Richmond, WI 54017 (NW 1/4 NW 1/4 17 T30N R18W) B & R's Rolling Acres L7 Par l No: 17.3 318.908 1.) Alt BM Description = � '"`O'"`� C�,�el, I 2.) Bldg sewer length - amount of cover = Plan Use other revis Re side for additional information.f No Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) i Safety and Buildings Division - TCounry - ---- ---__ 201 W, Waddngton Ave.. P.O. Box 7162 i / Madison. W1 33707 - 7162 Seft j -� D! artt»�rit of Commet t:� ono p Sanitary Permit AppliicailQn_ Sardtary Permit Number In word vft Comm, 19.21. Wls. Adat. Code. VRSWW la�wh_ I 4igtr yorr ° �� G - P'lwawea Prlert All al3 1 to t ech if�Rev o Sate Plan I.D. Number Pro" Oww's Name ,�� ! . ? B Parcel Number Q z 6 - ! 3 9 'a Maft Addrase — �^ s"Tca party Location rMJt �MM 'i '' ? li S T 30 N 1 e;" `. Lot Hwnber Block Number �� Subdivision Na me UYN Number M+ Type of Duaft (CAKk all tW apply) or 2 hmily Dwelling - Number of Bedreoais ✓ s k e s o ❑ Fnb[ie/cAmatercid - Doecrlbe use ® San Owned C -. yvi,U Nearest Road >II. of Permltt +Clmc9t ;* ��lM ( box nun Iine A (numbering atdseme for internal use). CowpWe am B if applicable) A. 3 Cl ptsyrlwoemtm Sys#nt 1 3 0 Replacsma u of 6 0 Addition to For Couot7 use Tank 0211V I WA S pl • 0 cheek if Sub uy permit previously lamed Perak Number Daea lasted R T}pw oi' PWME (C9tack ail drat apply)(ttombering echrme III for internal use) 4�gKiA - Prinudmd hi-Ground 210 Mound 47 0 Saari Pileer 30 0 Co nstruuw Vvays�d 22 0 Fonuind W4ruuad 410 Bolding Tank 48 0 SAM& Pass 510 Drip Line 43 0 &Lwa 46 0 Aerobic Treatment unit 44 13 Rmcircuiatizur 30 0 Outer i V. t Area W t Dadpl NOW WO DiVend Area Diapereal Area 9oi1 Appltcadon f 1et+c0181:1011 Run SyUm movatiott t'irml Grade ltaW0&1s./Days/Sq.Ft.) (Mia./lach) Elevation .S /LCV YI. Tank We Gpwaily its Teal Nutrtbsr Msnt>dtcturer I'titab Site Steel Piber 041100 Pj jc GOODS of Tanks Concrete Constructed Glass Now t3atatlpa 7 Tanks u VM pSamwnE I rl,. aarterea for Installation of the PO WTS ahowa on the attwched pinmWt Now PLtmbeC 1rtPlltiiPR3 Number Business Peons Number _ -9 1 j Pptmber's Address (&rest. Chy, Soo, Zip ) ✓ Va U" = 20MMOVa 1 Fee (includes Oroaadwaber Bats Usued MUDS Agsnt Signature (No &SMS) ives Initial Advert , Z 2 - j - , OC) 1 W IX. C ,✓ A nse at Apperdmawang tar 6reapproertl �/0.rcr5 r Ap�ds evopista Cta ea. e:ear qr orb') for tar aritrs er piper not 100 than 63/3 a lll lochs w use SBDO98 X..051'01) PLOT LAN PROJECT Bill Stock D RESS 1478 112th St. New Richmond Wi 54017 NW 1/4 NW 1/4S 17 /T 30 R 8 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 1/17/02 BEDROOM 4 CONVENTIONAL )00( IN -GROU RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 514 # of chambers 30 BENCHMARK V.R.P. Top of Wood P.L. Stake ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL - H. R. P Same as Benchmark Vent SYSTEM ELEVATION 95.7 > 12" Sidewinder High of Cover Capacity Leaching Plans Designed Using Chamber Conventional Powts Manual Version 2.0 6' Long 16" Grade at System Elevation , B.M. 34 ,!mot ► G� 5- = I (see so1 �6+) 30' 407' Property Line 5' -1 Vents 5 2 -3' x 94' Cells with >3' Spacing B -4 35' B -2 v, Vents 75' 40' 791 20' T 5' 3' B-3 Pro 4 Bedroom House PLOT LAN PROJECT Bill Stock ,AD RESS 1478 112th St. New Richmond Wi 54017 NW 1/4 NW 1/4S 17 /T 30 1 1R 8 W TOWN Richmond COUNTY ST. CROIX ,/ MPRS Shaun Bird 226900 DATE 1/17/02 BEDROOM 4 CONVENTIONAL XXX IN-GROUN6XRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 514 # of chambers 30 BENCHMARK V.R.P. Top of Wood P.L. Stake ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL - H. R. P. Same as Benchmark Vent SYSTEM ELEVATION 95.7 ALong Sidewinder High Capacity Leaching Plans Designed Using Chamber Conventional Powts " Manual Version 2.0 Grade at System Elevation B.M. 34 Alt. 30' 20' 407' Property Line 5 ' -1 Vents 5 2 -3' x 94' Cells with >3' Spacing B -4 35' B -2 Vents `s 75' 40' 20' T 5' - 3' Pro 4 B -3 Bedroom House Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Div; Ion of Safety and Buildings In accordance with Comm 8 Wft AOIL, .Cods Coun Attach complete site plan on paper not less than 81/2 x 11 b�lr size. must include, but not limited to: vertical and horizontal referen M Parcel I.D. , percent slope, scale or dimensions, north arrow, and 6t! rtd dia . , t road. .g Please paint all lnforma 1 7 - `01 Date Personal information you provide may W used tot soomAhuy \ tP�Y law; s Property Owner . , ,r ,. f .�, , 114 l4 S T N N R Property Owners Malting Address ,( lot a # Subd. Name or M# $late Zip a Phone Number _ ❑ qty ❑ Village M Town Nearest Road .5 d/ � o ( New Construction Use:,® Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material L-t �` Flood Plain elevation if applicable ft. General comments and recommendations: �j�_ ysr �� !�S 4 0 B Boring # Boring ' a Pit Ground surface slay. '.� tt. Depth t0 Nmiting factor � in. Soil Application Rate Horizon Depth Dominant Color Redox Description Tod ure Structure Consistence Boundary Roots GPD1ft In. Munseil Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ®/ ray . -� a 4 Boring #ng r P Pit Ground surface elev /� Z ft. Depth to Smiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW In. Munsel Ou. Sz. Cont. Color Gr. 8z. Sh. •Eff#1 •Eff#2 d s � !/�,•.,� -� .. /• ! �,6"� + ..,+ i�. Vii., ✓ 9s 4 • Effluent #1 = BOD > 30 < 220 mg& and TSS 40 _< 150 mg/L ' Effluent #2 ■ BOD < Matld MIA CST Na (Please Print) t Signature CST44Umber Addres De Evaluation Conducted Telephone Number / '/ AMP • x' Property Owner //7/0c ' Parcel ID# Page of ❑ Boring �C !� Boring# -y / , Pit Ground surface elev. / ft. Depth to limiting factor" f in. Soil Application Rate Horizon Depth Dominant Color Redox Description , Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell ) Qu..,Sz. Cont.Color, : Gr.Sz.Sh. *Eff#1 *Eff#2 . t' '�'� ,/o Z 1`x v` u--- , G 5 �/ <. ' ,5-7, tfr1.1", 7,/z. Boring# ❑ Boring ` a.Pit Ground surface elev. V ft. Depth to limiting factor ,.%a in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consists'ce Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 'Eff#2 L9-- t/'y � ,,'�- ,►;- r ✓ Wi• j / -5 -4yZ l> /.-"// /'� 4St` ,7'`//��✓ Boring# El 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/ft2 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. SBD-8330(R.6/00) Soil Test Plot Plan Project Name Bill Stock ByrOn Bird Jr. Address 1478 112th St. New Richmond Wi. 54001 - C M #220527 Loth Subdivision Rolling Acres Date 11/4/0J2 NW 1/4 NW 1/4 S 17 T 30 N/R18 W Township Richmond El Boring Q Well PL Property Line County ST. CROIX ,BM or VRP Assume Elevation 100 ft.top of PL wood stake System*Elevation q;5 ✓ H.R.P. same as BM NB.M. lit Alt. BM 407' PI 30' 20' 5' �B 1 Alt. BM Ass. Ely. !01.6 top of white stake 75' PL 200' B 35' 75' 98 99 �3 100' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM �l Owncr /Buyer Mailing Address -z _Property Address (Verification requireA from Planning Department for new construction) City /State Ae l ( C`T G C`J�T� arcel identification Number 1,F GAi, DESCRIPTION Property Location /, \ p y ' , N ' / <, Sec. �, TN -R�W, Town of ` C Subdivision /� ll , Lot Certified Survey Map # , Volume , Page # Warranty Deed # � IV 9 /V , Volume j , Page # l Spec houses D no Lot lines identifiably yes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper mai consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into th 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 t master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposa is in proper operating condition and/or (2) after inspection and Pumping (if necessary), the septic tank is less than 1/3 full of Pwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the s set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Cert stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office w days of the three year cxpi bti ciatc. SIGNATURF. OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all s atemcnts on this form are tnte to the best of my (our) knowledge. i (we) am (are) the owr the property described ab VC, y rrtu of a ti + decd recorded in Register of Deeds Office. SIGNATURE. OF PPLICAN 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 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 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 `� Shaun Bird #226900 .I I STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WAIkRA1N I'Y DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between John C. Van Dyk and Eileen K. RECEIVED FOR RECORD Van Dyk, husband and wife, 08 -31 -2000 2:30 PM WARRANTY DEED Grantor, and William B. Stock and Ro Stock, husband and EXEMPT # CERT COPY FEE: wife, COPY FEE: TRANSFER FEE: 186.00 - RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 2 and 3 of Certified Survey Map filed July 28, 2000, in Vol. 14, Page Name and Retu i Addres 3914, as Document No. 627230, located in part of N W 1 /4 of N W 1/4 of Section 17, Township 30 North, Range 18 West, Town of Riclunond, St. Croix County, Wisconsin. ��Si7Yt LA.) (,o -F 3 00 26- 1049 -70 -100 Parcel Identification Number (PIN) 'Phis is not homestead property. (K) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of August 2000 * * J?* Van Dyk C * * Eileen K. Van Dyk AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) • • ) Ss. j. PHAN p County ) authenticated this d TARY PUBLIC Personally came before me this ) �/ — day of nvvvvvvvvvvvvvvvvvvvvVVVVVVVVVVW August 1 2000 the above named John C. Van Dyk and Eileen K. Van Dyk, husband and wife, * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to fne known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) /2/ oe THIS INSTRUMENT WAS DRAFTED BY or Attorney Kristina Ogland Notary Public, State of Wisc sin Hudson, WI 54016 My Commission is permangn . (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ld / os z ) * Names of persons signing in any capacity must be typed or printed below their signature. Information Pr ofessionals c ompany, Fond du Lac, via 800 -655 -2021 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 1 Ic I 1 33•-I , -0 I> 1 I � I C C) I I iD IZ cn 1 IZ I i(n 6.82' - - - - -- I im HEST L /NE OF THE NW 114 — \ \ -33 - -- N00'37'29 "W - - - -� - - - -- �,\ a —� d. — S00'37 29 E 329.31 _-7 V \\ /// � - -- \-�— 1w w z OD Z to m ° I ry LOT 2_ N ° _ 0 CERTIFIED SURVEY MAP m cn o 0t, VOLUME 14 PAGE 3914 w I I ------------ - - - - -- - o I 00 .o co Ico rr g I + w '� ' ► I k I 0 N00'37'29 "W 329.31' RI 100.00 o ' -4 \ I ra cn I a qD Z � w z t o ^ o y -4_ O m � i N00'52'46 "W I i 329.33' I r O O ! r �6 d l \ V N Z I z r cs y o r �(b c .l o�i *m I r-i ' z N00'52'46 "W 406.96 k 'r i ID Ct I to I I 10 N00'52'46" W 1 I � 429.34' I f