HomeMy WebLinkAbout026-1053-40-000 r -
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
$afety'end Building Division
INSPECTION REPORT Sanitary Permit No:
430263 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:
Jackson, Dave I Richmond Township 026- 1053 -40 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
Q ,D 1 O b► 0 0 5'1 18.30.18.274E
TANK INFORMATION ELAVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
(Oaf b. o loo. IbO.C)
Dosing Alt. BM 5r.
Aeration ) Bldg. Sewer �+ u 4q, O
Holding D St/Ht Inlet a
TANK SETBACK INFORMATION St/Ht Outlet
6•ba 93.80
TANK TO P/L WELL BLDG. Ee ROAD Dt Inlet /
Septic > u / Ko t Dt Bottom
Dosing
Aeration Dist, -Plf SoV
rnp of QfthO N 7.10 j
Holding Bot. System t40 2 •
- •70
Final Grade
PUMP /SIPHON INFORMATION
Manufacturer Demand St Cover
GPM �. 3� 9 9 , C
Model er 1
TDH Lift ion Loss System Head TD Ft
Force aim Length Dia. t. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width 7 T ngth G No. Of TTenehes C GEES PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ! � It ` -&
SETBACK SYSTEM TO ��JJ P/L JBLDG IWELL LAKE /STREAM EACHIN D� Manufacturer: (y
INFORMATION Type Of System: 7 no,t 04 CHAMBER R t
�;t3Y► U a . L/ 6 Y SS 1 '*C Model Number.
.
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
I I Pipe(
1 1 -ength —LOL Dia 1 ' Length Dia Spacing D
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded Ixx Mulched
BedlT Yes J No I ' J Yes ] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:(/ &/3 E1
Location: 1528 95th Street New Richmond, WI 5401 (SE 1/4 SW 1/4 18 T30N R18 W NA Lott Parcel No: 18.30.18.274G
1.) Alt BM Description
`
e4A
L
2.) Bldg sewer length = 3(,p 7 N _ _ C � � � � S � ��
- amount of cover = CO
1/ 0 o3 rUo�"
Plan revision Required? Yes j No
-- S"i
Use other side for additional information. ! �! _, _
SBD -6710 (R.3/97) Date qpctor's Signature Cart. No.
So �) Nt, 'k of . L- O\XW MP,d, 5 i s
► NOV 1 3 2003
Safety and Buildings Division County
ST. C CO
ROIX ON Y J21 W. Washington Ave., P.O. Box 7082
` � ZO O FFICE Madison, WI 53707 – 7082 Sanitary etmit Number (to be fill is by Co.)
(608) 261 -6546 a
Department of Commerce
,
Sanitary Permit Application � State Plan LD. Number /I -
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Law, s I5.04(1)(m) Project Address (if dill rent than mailing address)
I. Application Information - Please Print All Information 1j; ,l j
Property O Name Parcel # � Loot ## T y t Block #
Pro J /— er's Mailing Address Property Location
P_ c2 '/ %, Section
City, State /� Zip Code Phone Number
Al. i � ` T N: c
of Building (check all that apply) RJR
Subdivision Name CSM Number
1 or 2 Family Dwelling - Number of Bedrooms
❑ Public/Commercial – Describe Use
❑ State Owned – Describe Use l� Qnx ❑City ❑Village,Oownship of I
IIL Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System .
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal it Revision ❑ Change of ❑ Permit Transfer to New
Before Expiration Plumber Owner 4 3o 2 o 2 r'13
IV. Type of POWTS System: Check all that appl
- Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil 11 At-Grade ❑ Single Pass Sand Filter ❑
on
Constructed Wetland ❑ Pressurized in- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
❑ Gravel -less Pi ❑ (explain)
Recirculating Synthetic Media Filter hing Chamber ❑ Drip Line lx Other ( ex P -S
V. Dispersal/Treatment Area Information: qA i A S
Design Flow (gpd) Design Soil Application Rat ds persal A.Fea Required (s� Dispersal Area Proposed (sf) System G e
Y /
7
VL Tank Info Capacity in Total Number Manufacturer Prefab Site Stec Fiber Plastic
Gallons Gallons of Units Concrete Construct Glasa.-
New Existing
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- 1, the uaderro sume responsibility for installation of the POWTS shown out attached plans.
Phun 's Name (Print) Plumb gnatuze MP/MPRS Number Business Phone Num
Plumber's Address (Street, ity, State,
I. oun /D a m nt Use Onl
Approved Disapproved Sanitary Permit Fee (includes Groundwater Date sued I in Agen Si re (N ps)
Surcharge Fee) - ( ( t
❑ Owner Given Reason for Denial
IX. Conditions of Approval/Reasons for Disapproval��d
SYSTEM OWNER:
1 Septic tank, effluent filter and d maintained T f� / G `
dispersal cell must all be service lumber. 0/
as per management plan provided by p
2. All setback requirements
code /ordinances. maintained
p er er app
lica
Cr the system ON paper no t less than 81/2 : it /ache In size
Attach complete plans 0 the oaaty only) ta
- Y
SBD -6398 (R. 08/02)
Soil Test and System PLOT PLAN
PROJECT Dave Jackson A ADD ESs 2725 E. 8th Ave N. St. Paul Mn 55109
SE 1/4 SW 1/4S 18 /T N/ 8 w TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 11/10/03 BEDROOM 3
CONVENTIONAL XXX IN -G O ND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambers 22
BENCHMARK V.R.P. Bottom of Siding ASSUME ELEVATION 100' Filter Zabel A -100
BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 92.4/91.7 5' below qrade
L
> tandard Biodiffuser
of C eaching Chamber
ith 31.1 ft2 of Area
6' 34 Grade at System Elevation
Plans Designed Using
Conventional Powts
Manual Version 2.0
Pro 3
Bedroom
House
35' SB.M.
T AL
B -1 30'
10, 0'
Vents B -2
2 -3' X 69' Cells with >3' Spacing Vents
B -3
7% Slope
30'
Property Line 330'
- -- - -- - - - .. .... ...... ... -.. ._..� , .... ��.... �.., ran" i.u. _
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information, viewed y Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). �jYr G'► �� 0�
Property Property Location
Govt. Lot /4 S T �N R E ( ) W
Property Owner's Mailing Add re Lot # Block # Subd. Name or CSM#
to Zi ode Phone Number ❑ city Q Village own Nearest d
ew Construction Use' esidential / Number of bedrooms Code derived design flow rate � GPD
❑ Replacement ❑ Public or com raal - Describe: ___
Parent material OIiC !;? � Flood Plain elevation if applicable ti ,L / ft.
General comments
and recommendations:s5 "a ��✓ 1
ID Boring # Boring
i Pit Ground surface elev. ft. Depth to limiting facto 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.
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
Effluent #1 = BOD > 30 220 mg1L and TSS >30 1150 mg/L ' Effluent #2 = BOD 5 30 mg& and TSS 130 mg/L
CST Name (Please Print) Sig CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address D e Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 ---�� 715 - 246 -4516
Property Owner of
a pit Parcel ID # Page Boring # Boring Ground surface elev. ft. Depth to limiting factor in. Soil — Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Pndar, Roots GPD/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
,�. V t 7 '2- A
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 'Eff#2
Boring # ❑ Boring
13 Pit Ground surface elev. ft. Depth to limiting factor in.
Soil ication 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
Ef fluent #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 -9330 (R.6=)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
430263 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:
Jackson, Dave Richmond Townshi
026 - 1053 -40 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
18.30.18.274G
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing Alt. BM
Aeration Bldg. Sewer
Holding St/Ht Inlet
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic Dt Bottom
Dosing Header /Man.
Aeration Dist. Pipe
Holding Bot. System
Final Grade
PUMP /SIPHON INFORMATION
Manufacturer Demand St Cover
GPM
Model Number
TDH Lift Friction Loss System Head TDH Ft
Forcemain Length Dia. Dist. to well
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 Manufacturer:
INFORMATION Type Of System: CHAMBER O R
I
Model Number:
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s)
Length Dia Length Dia Spacin
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 0 No ` _ I Yes ', No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / ! Inspection #2:
Location: 1528 95th Street New Richmond, WI 54017 (SE 1/4 SW 1/4 18 T30N R18W) NA Lot Parcel No: 18.30.18.274G
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? [] Yes [j] No
Use other side for additional information. ELL.___
SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No.
i
FORM NO. 985•A ;
1
i
35G 548 o
(o f ° I °I 0 44 {
CERT(FIED , fS U R V E YA A P I-w N /4 CORNER
J R. . SPIKE FOUND! Q
r UNP_LA_TTED LANDS_ 30
I
LEGEND N �5 N 9 "E 616.00' I
6 33' 33'
o I" X 24" IRON PIPE WEIGHING o0 9 0 583.00' � o
1.68' LBS. /LINEALFOOT SET F a, G,� ti
O o �s 020 5�_ 1
r POND 00
z o 0 F,, '� 0 s
� o o 1 I i
�z 10 40� RES INCLUDING RIGHT -OF -WAY '0 1
�,1 N 3.787 ACRES EXCLUDLNG RIGHT -OF -WAY
Z
APPROVED
W 5 i
�o I
z w N 89 "E 616.00' I
cn =
I
APR 2G 1979 W,z / r � 'o 5g��
ST. CR01X CJU. • i W `l z N , -°o bVI o r��j 2 0 01 I N'
COMPREHENSIVE PARKS PLAk. aNG Z — 0 O
AND ZONING COMMITTEE N =w Qi o 4.002 A CRES INCLUDING RIGHT -OF -WAY M Ki 1 Q
a m J i 3.787 ACRES EXCLUDING RIGHT OF-WAY N a -�
$
M F N
A: r.i< ,VAL Ur liiw MIIVL.h JU..UIVISION
DOc.S NJC N1'CAN APP &OVAL FOR O N 89 "E 616.00' O 1M1
I
BUILDING SITE OR SEPTIC SYSTEM: 308.00' 275.00' 33' I ° w
w� _
REFER TO H62.20. ~ ,'� I ~'
SCALE IN FEET ai z may} /� � a
JI so
./ W lNI J �
0 200 400 �� O �� . �0 o �� X30 I zi i
o 0_
_ 3 �
- 0 4 0�
SE—SW 4.016 AC. INC. R-O -W 'O `r 4.016 AC. INC.R•O•W QI
°D. 3.808 AC. EX. R-O-W r 3386 AC. EX. R•0•W N 1 01
' i o I
in CO I
THIS INSTRUMENT WAS DRAFTED BY SCOTT B. LOHMAN z I
Owner &Subdivider: I
Richard Jones 11;10
Richard 13
Rt. 4 0i
New Richmond, WI 54017
s
NORTHERLY 0 0�� S 89 I' 13 "W 83.06'
RIG_H_T OF-WAY LIN 10 308.03' 2 1 POINT OF #
S LINE- SW 1 4 X28.19 3 30.60 3 08.00' _ BEGINNIN*
SW CORNER S 89 or 616.00 IS1 /4CORNE
SECTION 18 _ _ _T_0_W_N RO
_ _ _ AD_ _ _ _ _ _ _ _ _ _ ,1(q _ I P. K. NAIL :
T30N, R 18W d FOUND
P.K. NAIL FOUND UNPLATTED LANDS 3333
DESCRIPTION I
A parcel of land located in the SE-1 of the SY�, of Section 18, T30N, R18W, Town of Richmond,
St. Croix County, Wisconsin described as follows:
Beginning at the S1 corner of said Section 18; thence S 89"28'06" W (assumed bearing referenced
to the North - South 1 Section line, bearing recorded North) 616.00' along the South line of said
SW1; thence North 1134.00' ; thence N 89 E 616.00' to said North -South 1 line; thence South
along said North line 1134.00' to the point of beginning.
Subject to existing Town Road right -of -way along the East and Southerly sides of the above .
described parcel, as shown on the attached map.
Containing 16.0356 acres, more or less.
I, James E. Rusch, registered Wisconsin Land Surveyor, do hereby certify that I have surveyed '
and mapped the above described property; that such plat is a true and correct representation of c
the exterior boundaries of the land surveyed; and that I have fully complied with the provisions
of Chapter 236.34 of the Wisconsin Statutes and the St. Croix County Subdivision Ordinance to
the best of my professional knowledge, understanding and belief.
James E. Rusch ., c.I> 9
Wisconsin Land Surveyor S -1376
Stevens Engineers, Inc.
1409 Coulee Road - Box 321 L E D 4`' JAM,
co
,� �, r ..
Hudson, WI 54016 MAY 1 1979 � R LSCH
JAMES a CONNELL
S-1376 f
o River Falls
2621slae of Deeds m t o
'rch 30, 1979 S;, CroIx County, X00 Wis.
789 ®� R ! sup
Z c 3 Pa, - C:
O J e
. v
11
100 1600 See Page 58 1 700 1800
R'
2 z Russell c n
QVI Peterson z o s a
h rD m�� = a �7 ao tnd Cfn 7 r? uu lot
W 2 ma V �'�• 78.E N�R, (ym 01
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.,__,_
itrcel #: 026- 1053 -40 -00 06/21/2006 01:49 PM
O PAGE 1 OF 1
Alt. Parcel #: 18.30.18.274G 026 - TOWN OF RICHMOND
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
DAVID A & MARILEE J JACKSON O - JACKSON, DAVID A & MARILEE J
1528 95TH ST
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description ' 1528 95TH ST
SC 3962 NEW RICHMOND
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 2.340 Plat: N/A -NOT AVAILABLE
SEC 18 T30N R18W 2.34A IN SE SW COM S Block/Condo Bldg:
1/4 COR TH N 11 34' TO POB N 173.86' TO
NE COR S 89DEG W 615.99'S 175.5'N89 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
DEG E 616' TO POB 18- 30N -18W
Notes: Parcel History:
Date Doc # Vol /Page Type
12/05/2003 748439 2469/466 EZ -U
08/05/2003 733914 2348/502 WD
05/02/2001 644303 1630/141 QC
07/23/1997 769/74
more
2006 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/30/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.340 32,600 154,500 187,100 NO
Totals for 2006:
General Property 2.340 32,600 154,500 187,100
Woodland 0.000 0 0
Totals for 2005:
General Property 2.340 32,600 154,500 187,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 09/07/2005 Batch #: 05 -7
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Safety and Buildings Division wuttLy
201 W. Washington Ave., P.O. Box 7162
/scon Madison, WI 53707 - 7162 Sanitary Permit N mbe�/ to be filled in by Co.)
s/n, (608) 266 -3151 3 D 3
Department of Commerce
State Plan I.D. Nturlber
Sanitary Permit Application
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Law, s15.04(l)(m) Pr oject Address (if d ifferent than mailing address)
I. Application Information - Please Print All Information / J �� ��
�r
Property Owner's Na ^� Parcel # 0 0 /0 53 - B #
l/ 1
Ls, Property Owner's Mailing Address JSiv y Location �
�2 -2 tk,l t &,Section
City, State Zip Code P ne N
n C y - a trcl C V 2 � �� N' E W
II. Type of Building (check all th apply) n ✓� ion Name CCLM .�luraber
�1 or 2 Family Dwelling - Number of B rootnst �_ �3s6 Public /Commercial — Describe Use 1 1 State Owned - Describe Use 2 G �fv _ ❑village owriship of
III. Type of Permit: (Check only one box on a A. Complete line B if applicable)
A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replaceme Only ❑ Other Modification to Exist g System
r
List e i us t d Date Issued
B. ❑ Permit Renewal ❑ Permit Revision ❑ ange of ❑ Permit Tr sfer to New
Before Expiration Plum Owner
Type of POWTS System: (Check all that apply)
n - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Moun < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter
Constructed Wetland ❑ Pressurized In - Ground ❑ Holding Tank ❑ P at Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter
El Recirculating Synthetic Media Filter chin Chamber ❑ Drip L ❑ a -less Pipe Other (explain)
V. Dispersal/Treatment Area Information: O L 41 31- g
Design Flow (gpd) Design Soil Application Rate,(gpdsfl Dispers r a Req ' ed (sf) Dispersal ea Proposed 10 System Elevation
./ �/
s ' S"
VI. Tank Info Capacity in Total Number Manufac rer Prefab Site cee] Fiber Plastic
Gallons Gallons of Units _ /1 „ /J � - T Concrete Constructed Glass
New Existing V
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility State nt- I, the undersi ass a responsibility for installation of the PO shown on the attached plans.
Plumber's Na me (Print) Plumber' gna e MP /MPRS Number Business Phone Number
7 oo l� -
Plumber's Addre ss (Street, City, State, Zip e)
VIII ounty /Department Use Only
Sanitary Permit Fee (includes Groundwater Dot Issued ssuing A nt Signatur o Stamps)
Approved ❑Disapproved
Surcharge Fee) ^� ��Q
j
11 Owner Given Reason for D ial of
IX. Cotglitions of Approval /Reasons for isapproval - t
q.
G� >zS
Attach co lete plans (to the County only) for the systenj#n paper not less than 81/2 x 11 inches in size
SBD -6398 (R. 01/03)
T PLAN
N
PROJECT Dave Jackson AD RESS 2725 E. 8th Ave N. St. Paul Mn 55109
SE 1/4 SW 1 /4S 18 /T 30 N/ W TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE 8 BEDROOM 3
CONVENTIONAL X04C IN- GROUND PRFS
X
CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANKS E
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambe 22
IL BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION 100 Filter Zabel A -100
❑ BOREHOLE O WELL IH.R.P. Same as Benchmark
B..M Alt SYSTEM ELEVATION 95.7/95.5 4.5' below grade
>100 50' 50' .M. * 330'
100 0'
B -3 100'
Vents Vents �,5 0
B -2
50' T 0' t�
03
B - 1 Bedroom
Ouse
11%
Slope
2 -3' X i
rn
k E Standard Biodiffuser
Leaching Chamber
with 3 1. 1 ft2 of Area
Plans Designed Using
Conventional Powts
Manual Version 2.0 Grade at System Elevation
r
PLOT PLAN
PROJECT Dave Jackson AD RESs 2725 E. 8th Ave N. St. Paul Mn 55109
SE 1/4 SW 1/4S 18 /T 30 N/R W TOWN Richmond COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE8 / 6/03 BEDROOM 3
CONVENTIONAL XXX IN- GROUND PRE XURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANKS E
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 # of chambe s 22
BENCHMARK V.R.P. Top of 1" PVC Pipe ASSUME ELEVATION 100' Filter Zabel A -
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
B..M Alt. SYSTEM ELEVATION 95.7/95.5 4.5' below qrade
>100' 50' 50' M. * 330'
100 50'
B -3 100'
Vents Vents S t
50' 0'
T
B -2
o3
B -1 edroo
House
11%
Slope
2 -3' X 69' Cell with >3' Spacing
rn
Vent
>6„ Standard Biodiffuser
of Cover Leaching Chamber
with 31.1 ft2 of Area
Plans Designed Using 6' Long 11 "
Conventional Powts Grade at System Elevation
Manual Version 2.0 3 4"
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of 3
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
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 0 , �d 3
percent slope, scale or dimensions, north arrow, and location.arjd distAnc@ to nearest road. lri
Please print all i rmation. j6- 6cz
R iewed by Dat
Personal information you provide may be used for co purpostjqPr' y Law c, 15.6.4 (m)). `Z
Property Owner Prt1 Location
C`d7
Govt:-L-ot SE 1/4 SW 1/4 S 18 T 30 N R 18 lk(or) W
Property Owner's Mailing Address ,,` °� X Lot Block # Subd. Na M#
1522 95 r` SS �� n <: , , , I na csm penbdin
City State Zip Code P�ehe Numbe Q Or r F E] Village Town Nearest Road
St
06 `.. r
New Richmond WI 54017 ( ,i 1 - Richmond I 95th-
( New Construction User Residential / Number o ^ I Code derived design flow rate 600 GPD
❑ Replacement . El Public or commercial - Describe:
Parent material twash Flood Plain elevation if applicable r ft•
General comments f RS+ -7 V/ ! �. �
and recommendations: �
—(� ��CA /^' V
trenches @ el. 96.20'
Boring n Boring
1 g Ej pit Ground surface elev. 1 00.00 ft. Depth to limiting factor 1 OO in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i `Eff#1 'Eff#2
1 0 -10 10yr3/3 none L 2msbk mfr qW 2f
2 1 10 gw if .3
3 23 -10 7.5yr4/6 none ms Osq ml na na 7
Boring # F] Boring
pit Ground surface elev. 1 OO.20 ft Depth to limiting factor 100 in. F-21 Soil ADPlication 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 'EtT#2
1 0 -10 10yr3/3 none L 2msbk mfr 2
2 10 -23 10 4 4 if .5 8
3 23 -40 10 5/4 none sil 1csbk
440-10 7
` Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 150 mg /L fluent #2 = B < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature . CST Number
Gary L. Steel 4 02298
Address Date Evaluation nducted Telephone Number
1554 200th. Ave., New Richmond, WI. 54017 10 -26 -2001 715 - 246 -6200
I
Property Owner Brenda Lauck Parcel ID # pending Page 2 of 3
❑ Boring
3 ] Bones #] pit Ground surface elev. 100.20 ft Depth to limiting factor 100 in
Soil 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 I - EfP#2
1 0 -8 10 3 3 none L
2 8 -30 10 4 4 none Sil 2msbk
3 -1
Boring # ❑ Boring ❑
Ground surface elev. ft. Depth to limiting factor in.
❑ P 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 # Ground surface elev. ft. Depth to limiting factor in.
El pit Soil lication 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 5 220 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 (R6I00)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
Brenda Lauck New Richmond, WI 54017
MP SW 3254 SE4`�4 S18- T3mN -R18W (715) 246 -6200
town of Richmond
csm
N
1 " =40'
BM.= top of 1" pvc tipe @ el. 100.00'
alt. BM.= top of 1" pvc pipe @ el. 100.80'
OD �' 15 ". 60 '
NI
Ij1 `oo
1°
290
S 5
to r(1
D
�C2
Gary L. Steel
10 -26 -2001
T �
,/ C o f
617
I -d d =L0 Co za 2nd
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
owner/Buyer J
Address
Malting A
5 S4,
Property Address 1
(Verification required from Planning Department for new constriction)_
Cit Parcel Identification Number a�(0 -/05 3 '' d
LEGAL DESCRIPTION 1 ` CT
Property Locatio ' / ' /4, S </ , T N -W, Town
Subdivision Lot # of 3 �4i'z
Certified Survey Map # , Volume _ , Page #
Warranty Deed # 33
91 — LL Volume 23 �� . Page #
Spec house ❑ yes no Lot lines identifiabl 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, joumeymanplumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system
is m proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning office within 30
of a three year expiration date.
Y
A "PURE F PLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (ourj knowledge. I (we) am (are) the owner(s) of
Qperty des above, by virtue of a warranty deed recorded in Register of Deeds Office.
/ J
SIGNA OF APPLICANT DATE
Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * *"
* Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
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, e, 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- 246-45
St. Croix County Zoning 715- 386 -4680
Pumper Tom Mondor 715- 246 -5148
Shaun Bird #226900
I
2393 D 502 733914 13
STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH
WARRANTY DEED REGISTER OF DEEDS
Document Number ST. CROIX Co., WI
This Deed, made between Brenda K. Lauck
RECEIVED FOR RECORD
Grantor, 08/05/2003 10:45AN
and David A. Jackson and Marilee J. Jackson husband and wife WARRANTY DEED
Grantee. EXEMPT #
Grantor, for a valuable consideration, conveys and warrants to Grantee
the following described real estate in St. Croix County, State of Wisconsin REC FEE: 13.00
TRANS FEE: 124.50
(if more space is needed, please attach addendum): COPY FEE: 3.00
(See Attached Exhibit "A") CC FEE:
PAGES: 2
Recording Area
Name and Return Address
;DAL) t 7- "- k S 10
A-) AS k'. 8'7'� fivt
IVo -SS- P,t„l M4 5s /o7
026 - 1053 - 40-000 r'Al 2 00
Parcel Identification Number (PIN)
This is not homestead property
(is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this day of August 2003
* * Brenda K. Lauck
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Brenda K. Lauck STATE OF )
ss.
�,� _ County )
authenticated th' r - day of August 2003
Personally came before me this day of
the above named
A' E BAR OF WISCONSIN
J`, _ to me known to be the person(s) who executed the foregoing
n ; *Morizei `§�Q� Wis. Stats.) — - instrument and acknowledged the same.
THIS IN,F MENT WAS DRAFTED BY
orney Kristi tea Oand
AQ er+.Wl 54126' , ' 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 Professionats Co., Fond du Lac, WI
STATE BAR OF WISCONSIN 800 -655 -2021
WARRANTY DEED FORM No. 2 - 1999
• 23y8P 503
EXHIBIT "A
A parcel of land located in the Southeast Quarter of the Southwest Quarter (SE' /. of SW' /.), Section Eighteen
(18), Township Thirty (30) North, Range Eighteen (18) West, being further described as follows: Commencing at
the South quarter comer of said section; thence North (assumed bearing) along the North -South quarter section
line, 1134.00 feet to the oint of beginni g; thence continuing North along said line, 173., 8� t to the Northeast
corner o tom' he Southeast uarter of the outhwest Quarter (SE% of SW %); thence South 89 degrees 37 minutes
13 seconds West along the North line of the Southeast Quarter of the Southwest Quarter (SE% of SW'/), 615.99
feet; thence S uo h parallel with the North -South Quarter section line, 175.50 feet Ig thil NoM line gf Lot One
of that Certified Survey Map recorded in Volume "3" page 789• thence Nortty 89 degrees 06
seconds East along said line, 616.00 feet to the point of beginning.
St. Croix County, Wisconsin.
VoL 1630PAGE141
STATE BAR OF WISCONSIN FORM I. 1999 &- G4*3a*3
QUIT CLAIM DEED KATHLEEN H. WALSH
Document Number REGISTER OF DEEDS
ST. CROIX CO., WI
This Deed, made between j&FFn9 C. LAUCK
EI1lEp FOR RECB
05- 02-2001 9:30 AM
Grantor,
QUIT CLAIM DEED
and BRE NDA K - LA UCK EXEMPT N SM
CERT COPY FEE:
COPY FEE:
Grantee. TRANSFER FEE: M -1
RECOtDINQ FEE: 12.00 I /
Grantor quit claims to Grantee the following described real estate in PAGES: 2
County, State of Wisconsin: (if more space
is needed, please attach addendum): ( o
Recording Area
SEE ATTACHED ADDENDUM J
Name and Area Address
Attorney Patricia M. Heim
PARKS_ 0 LTD. 22
201 Main Street, 10th Floor
P.O. Box 1147 � rL
La Crosse WZ 54602 -1147 f
026_1052_95_
Together with all appurtenant rights, title and interests. r (PIN) 1
This homestead property. 1
�,p�� 001
Dated thi daY of — Ld- IL --- -> (is) (is not) '\
AUTHENTICATION ACKNOWLEDGMENT Il
STATE OF WWG9WtAN M I tlne5CTtX) � l G
ss.
Signatures) • r Tauek County ) s. `
}i1
, 2001 �Persopally came before me this day of
authenticated this day of 1 the above named ee k, to me known to be the person who executed TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, the foregoing instrument and acknowledged the same. f
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY�
•
N Yy�
ot4ry � ,, e n (K11X1f1Fty✓t 1_ p
At torney Patricia M Heim Iy
P O B T 147 La Crosse WI 54602 -1147 My Commission is permanent. (If not, state expiration date: N'
(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. SARAH F. STEPHEN3
STATE BAR OF W ISCONSIN G ARY PlWIC.IMNNESOT�
QUIT CLAIM DEED FORM No. 3.1999
Parke OTIaherty LTD PO Box 1147, La Crosse W 1 54602.1147 sue yr0ett■iron E4 g1,"of ■ 97592FX
Phone: (609)784.1605 Fax:
proeed wdh Zx Fwm by RE Fo-sh t. LLC 10025 Fineen Nie Rose. chra n TT", W
• ~ VOL 1630PAGE 142
Legal Description Addendum
Primary Grantor: LAUCK 392 -58 -4306
JEFFREY C.
P i Gra • LAUCK
BRENDA K. 394 -68 -7417
rcpl 10: 026- 1052 -95 -00 & 026 - 1053 -40 -00
Legal Description
A PARCEL OF LAND LOCATED IN THE SOUTHEAST
QUARTER OF THE SOUTHWEST QUARTER (SE 1/4 OF SW
1/4), SECTION EIGHTEEN (18), TOWNSHIP THIRTY
(30) NORTH, RANGE EIGHTEEN (18) WEST, BEING
FURTHER DESCRIBED AS FOLLOWS: COMMENCING AT
THE SOUTH QUARTER CORNER OF SAID SECTION;
THENCE NORTH (ASSUMED BEARING) ALONG THE
NORTH -SOUTH QUARTER SECTION LINE, 1134.00 FEET
TO THE POINT OF N N ; THENCE CONTI
NORTH ALO D LINE, 173.86 FEET TO THE OF
NORTHEAST CORNER
THE SOUTHWEST QUARTER (SE 1/4 OF SW 1/4);
THENCE SOUTH 89 DEGREES 37 MINUTES 13 SECONDS
ST A THE NORTH LINE OF THE SOUTH SW
QUARTER OF THE SOUT
1/4 615.99 FEET; THENCE SOUTH PARALLEL WITH
THE NORTH -SOUTH Q '
FEET TO THE NORTH LINE OF LOT ONE (1) OF THAT 11
CERTIFIED SURV Y MAP, RECO DOME "3 ",
PAGE 789; THENCE NORTH 89 DEGREES 28 MINUTES
06 SECONDS EAST ALONG SAID LINE, 616.00 FEET
TO THE POINT OF BEGINNI
Co
. IS SUBJECT TO AN
NT
EXISTING TOWN ROAD RIGHT -OF -WA
EASTERLY 33 FEET THEREOF- SAID PARCEL
IQNTATNTNG 2.34 ACRES EXCLUDING SAI 33 FOOT
RIGHT -OF -WAY-
LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02
REAL ESTATE TOWN OF RICHMOND
COMPUTER NUMBER 026- 1052 -95 -000 Parcel Number 18.30.18.274C
OWNER NAME: First JEFFREY C & BRENDA Last LAUCK
PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment
1522 95TH ST
SECTION 18 TOWN 30N RANGE 18W 1 /4160 1 /440
Line Description Line Description
TOTAL ACREAGE 4.002 PLAT LOT BLK
01 SEC 18 T30N R18W 4.00SA IN 15
02 SE SW LOT 1 OF CSM VOL 3/789 16
03 17
04 18
05 19
06 20
07 21
08 22
09 23
10 24
11 25
12 26
13 27
14 28
F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit