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HomeMy WebLinkAbout026-1137-26-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Divisior. ` INSPECTION REPORT Sanitary Permit No: 405055 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: Halle Builders Inc. I Richmond Township 026- 1137 -26 -000 CST BM Elev: Insp. BM Elev: BM Description: Q` 100 7 VC. - t3Nt ( C S T gtp 6,* TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchm I Dosing J Alt. BM Aeration Bldg. Sewer ' Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet t' c ly- TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet D T Septic \ 100 a'� Dt Bottom Dosing / Hea r /Man c is —, Aeration Dist. Pipe / Holding _ Bo . Syst / 1 , q PUMP /SIPHON INFORMATION Final Grade �V ` Manufacturer Demand St Cover GPM /0 3.0 Model Num r TD H Lift ion Loss System Head TD Ft For in Length Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width r Length / No. Of Trenches,- PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM EACHING M r INFORMATION (HAMBER OR 57 Ty Of System: t / Y ,/ UNIT Model Number: � 0 �' � DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size 7,-- ole Spacing Ven it Pipe(s) f tOt� r 1 Length _ L 2L Dia _4_L1 Lenqth Dia �/ Ra n SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of 1 7Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil � l Yes ] No Yes [] No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 1 10 / (32-*' Inspection #2: Location: 1480 111t St tNewLt t �" " ichmond, WI 540 (NW( 114 SW 1/4 21 T30N R1 8W) Golf View Acres Lot 26 Parcel No: 21.30.18.982 1.) Alt BM Description = 10 r tr �P -- 2.) Bldg sewer length = (� �t.(fa �;►' ` Se> S/ 6Z1- u - amount of cover - -� -- -- - - -- - - - - -- Plan revision Required? �J Yes No j � _ -- Use other side for additional information. � SBD -6710 (R.3/97) Date Insepctor's ignature Cart. No. Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 14sconsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not j — _0 - © / Z I state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x I 1 inches in size. County State Sanitary Permit Number 0 Ch k if revision to previous application State Plan I. D. Number I. Application Information - Please Print all Information RECEIVED Location: Propeqy Owner Name - Location �j ��3� NW 1/45V l 1/4, S7ij T (0,N, RJh - (or& Property Owner's Mailing Address Lot Number Block Number c , L 1 7 ST. CROIX COUNTY 9 City, State Zip Code Subdivision Namq, or CSM Number Ij. Type of Building: (check one) ,Q ❑ Ci l� 1 or 2 Family Dwelling -No. of Bedrooms: (, ❑ Vi age ❑ Public /Commercial (describe use):_ Town of ❑ State -Owned a a lea e�t,�: �p , ZZ X 12 11 Nearest Road p / S 3 _ _ 1 3 / Z / Parcel Tax Numbe s) III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. ACNew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) av 675 " Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland 31 / v Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatme Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Gr / Required / Proposed Rate (Gals. /day /s ft.) (Min. /inch) ✓ Elevation 17 1� 6 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ /OOQ /Coo VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on ed plans. Plumber's Name (print) Plumber's Signature (no s ps): R Business Phone Number � / z zi Plumber's Address (Street, City, State, Zip Code) yl /- 3 5V6 T72, % "� S - ,;" /Jz e • Lv r uv IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued uing Age t Signature ( s ) Approved ❑ Owner Given Initial Adverse Surcharge Fete)¢. Determination X. Conditions of Approval /Reasons for Dis pproval: 1 ) Wd I oca ft�,.. m.0 l+ &-p- 641 = I� �?� ,.� 91 . > ZS �i rn, (zr, 8, > s7J ate, sfks SBD -6398 (R 07/00) 22 � fl 1 41'/ Sw /1!w S Z i 73a NK 18' w Za a(o V a ,4V � Q �► l �Z ,, / % � foo X02. � � L !, s � �z nn �� Y �mG I 14 Rf F T4 r � � O Hof-. ��•:. �..� � I t i Wlsconsin Department ofcommerce SOIL EVALUATION REPORT Page of l j�vision of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County S4. C rol Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. v' by Date Please print all i►obn. . Personal information you provide may be used for ary purposes vacy Law, s. 15 -04 (1) (m)). (,L! /Yr�Y•- �� Z" Property Owner Property Location U Govt Lot S (,V 114 �j (,�11 14 S Z! T N R E (o or CSM# Rtcl',ard e Property Owner ev.� Acres s Mailing Address lot # Block # Subd. Name i � i�. . Co x IOto S ' � ��x Glot��x (� city State Code ' T , City ❑ Village (Town Nearest Road OFF /-- G� ` - `� Code derived design flow rate 4 5 O Cn00 GPD ® New Construction Use: ® Residential/ Number of �d,r 9 s ❑ Replacement ❑ Public or commercial - Describe: Parent material ©L c Flood Plain elevation if applicable fl General comments s y S -F-c. G (c V. f G• �o and recommendations: 4- f - f' I e M • 9li S� ❑ Boring # Boring D ft Depth to limiting factor 115 in. ® pit Ground surface elev. /dU • P �g Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Structure in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 6 - 11 lu S;I Z CS Ivy $ Z it - 3o ILirq 1 14 — S. 2 r 8 3 3p -115 l C� to m S m L e, l Boring # El Boring ® Pit Ground surface etev 7 fL Depth to limiting factor l l in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color I Gr. Sz. Sh. 'Eff#1 L •Eff#2 I o -iZ 1 Sf I Z .51 •3 Z ) _ S') Z 5 8 i _ m 3 ' Effluent #1 = BOD > 30 _< 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Pratt) S' nature CST Number Acdam Sc hu ke,r -- Z533c�i Address Date Evaluation Conducted Telephone Number 2 0S 80�' �4 • Somerse-4 w 1 5' - 102 — - -o/ Properly Owner N t'_ I5o n Parcel ID # Page 2 of 3 3 Boring # ❑ Boring © Pit Ground surface elev. 16016 ft Depth to limiting factor i n. Soil Appiication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roofs GPDlfF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Ef1#1 *Eff#2 I o - l( 3Z — s;l 2 �r c �v� ,5 •8 2 . a4 _ z h a 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 # Ground surface elev. ft Depth to limiting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff? in. Munsd 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.07/00) Property Owner N e 150 Parcel ID # Page 2 of 3 F-31 # Boring °ng © Pit Ground surface eiev. /6 a • d R Depth to limiting factor i — in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Stnidure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Efr#2 I It, 3Z — s .l �r c 1v -5 •8 Z S;1 a J f- .Sb Z h i, F-1 Boring # E] Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Suucture Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Efr#2 ❑ Boring # ❑ Boring El Pit Ground surface elev. ft Depth o limiting factor in. Sod 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 Effluent #1 = BOD > 30 < 220 ng/L and TSS >30 < 150 mg& ' Effluent #2 = BM, : 5 30 mg/L and TSS < 30 mglL T he De of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Department 9 PP ty need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. sao-a330 (R07/W) I PAGE�OF 3. NAME (.5o n LOT# zCo LEGAL DESCRIPTION Vic,/ '/a Cec1 /a,S 2 (T 3Q,N,R1 E (or)(c SCALE: 1"= / 6 BM 1 ELEVATION /Od - d BM 1 DESCRIPTION �-p p o / i c P•' f� - - f' BM 2 ELEVATION g 9 S7 l $QC.Z/ BM 2 DESCRIPTION fo p a - / "t Con P10 e SYSTEM ELEVATION 96 • Sy ALTERNATE ELEVATION 9(. • S C NTOUR ELEVATION ili a S /o O� No .S (o0e S X40 I l° e Aa 5 q_ �1. -Z- I SIGNATURE DATE =/O O / r ST CROIX COUN'T'Y SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address 2 1 G L m IJ Cl Propariy Address /y 0 / � (Verification required from Planning Department for new construction) City/State A� oe;C`i� m oyj !,y / Parcel Identification Number 1 - — 'ab r 0 0 0 LEGAL DESCRIPTION Property Location M \W '/4, '/4, Sec. 21 , T 3 2 N -R_Zy 6 Town of Subdivision Orr V � LJ A (, f �-S . Lot # a Certified Survey Map # N1 �t , Volume , Page # Warranty Deed # 6 - 7 9 1 S I , Volume 1564 , Page # Spec house yes no Lot lines identifiable K yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system, The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposalsyctem is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/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 Zoning Office within 30 days of the three year a iration date. 2 2 NATURE F APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described bov , y virtue of a warranty deed recorded in Register of Deeds Office. GNA F 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 U 1864P 125 ~ STATE BAR OF WISCONSIN FORM 2.1999 HA 7 4 9 8 1 THLEEN H. MALSH Document Number ARRANTY DEED RE OF DEEDS This Deed, made between illvale Develo Lim ited, a RECEIVED FOR RECORD Minnesota Limited Liability Partnership,_ -- _ _ 04 -01 -2002 WARRANTY DEED — —'— EXEMPT At Grantor, and H alle Builder Inc. - - REC FEE: 11.00 -- — — — - - —' TRANS FEE: 163.80 -- - -- - - -- — . —_.— — COPY FEE: — _..-- _ —_ - -.. - - -. CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in S t . Croix _ County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lots 23 and 26, Ifview Acres, Town of Richmond, St. Croix County, Name and Return Address Wiscon 'n. KRISTINA OGLAND ATTORNEY AT LAW P.O. BOX 359 HUDSON, WI 54016 P art 02 - 1060 -80; 026 - 1 & 026 - 1 064 -10 — Parcel Identification Number (PIN) This is not homestead property. 0E) (is not) Exceptions to warranties: Easements, restrictions and rights - of - way of record, if any. Dated this Z ,b_' day of _ _Marc h -- — 2002 Hillvale Development Limited • • By_R S. Nelson AUTHENTICATION ACKNOWLEDGMENT Signature(s) H illval e Development Limited, a Minnesota — STATE OF WISCONSIN } Lim ited Liabili Partnership, by Richard S. Ne lson — _ ) ss. -- County } 'authFntk*tf tkis` "U day of March 2002 - -- • „ 1.. ' � — — Personally came before me this _ _ . — day of the above named .14ristTna B:.MEMBER STATE BAR OF WISCONSIN P '•., r to me known to be the person(s) who executed the foregoing (INip —__— —. —_ -- -- instrument and acknowledged the same. (I�lri,pd by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY « -- Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 -- 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. n ama+on a,me a +s canpany, rand au tee w+ soosss-zoz+ WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2- 1999 STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY DEED This Deed, made between [Iillva Development Limited, a M inneso ta Limited Liability Part Grantor, and Halle Builders, Inc. - - - -- — 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 Lots 23 an 26, G Ifview Acres, Town of Richmond, St. Croix County, Namc and Return Address Wisconsin. Part 026 - 80;026 - 1063 -95 & 026 - 1064 -10 Parcel Identification Number (PIN) This is not homestead property. -- X) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this Z U day of March _ _ _ _ 2002 Ifillvale Development Limited - - --- - -- - -- — AUTHENTICATION ACKNOWLEDGMENT Signature(s) 1lillvale De velopment Limited, a Minnesota STATE OF WISCONSIN ) L imited Liab ility Partner by Richard S. Nelson ) ss. - - -- — - -- -- - - -- — - -- C o l l n l y authenticated this 2- 6 day of Mar ch 2002 Personally came before me this day of -- -- the above named + Kristina O gland TITLE: M1;Mf3L'R STATL' LIAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If no(, _ _ instrument and acknowledged the samc . authorized by § 706.06, Wis. Stats.) TIIIS INSTRUMENT WAS 1)RAPTEI) 13Y - Attorney Kristina Ogland Notary ['uhlic, State of Wisconsin Hu dson, A1'I 540 16 My Commission is permancxtt. (If not, state expiration date: (Signatures may be authcntic fled or acknovNlcdgcd Moth are not necessary) -_ - - - ' Names of persons signing in am' capacity must be INpcd or printed below their v;natu1e Inlo -1,011 Professionals Company, Fond du La. WI goo as °, � oil STATE, BAR OF \\ ISCONSIN 11':11t12:1NTY 1)FV1) FORM Nu. 2 - 1999 E1/4 corner Sec. 20,-T30N, AC -U-S R18W. Per Boundary-Survey Q' r, GRAPHIC SCALE by S & N Land Surveying r 0. 7 114, part of the SW 114 of the NW 0 IN FM ov1 ; I NE 114, part o the SE 114 o the Richmond, St. Croix County, �� I " �• ASSUMED BEARINGS REFERENCED TO THE NORTH LINE OF THE NW 1/4 ^ {gyp UNPLATTED LANDS OF SECTION 21, T 30 N., R 18 W., ASSUMED TO BEAR N89 "E. ° i m 8 n S00 ° 41'43 "E 626.78' he Public" 1966.38' P - ____ --- - - - - -- I ✓ ---- - - - - -- - -- - - - - -- ---- 403.40' -- - - - - -- 1 209.00' 211.64' ,0 I 209.00' - 1033.04'- gy p. I °_ - - - - - - - - - -- ---------- - - - - -- VICINITY MAP 134 sq.ft. 2.00 2.00 acres °1 °o _ _ J �� CTH F G I ! 3d L.d I N00 °41'43 "w 37 ° 38 39 o G���G x .3,.. V) I j a 87,153 sq.ft. c, a 87.153 sq.ft. o, a 87,325 403.40' W 2.00 acres i 2.00 acres z 2.00 acres `' '• I ' ° I i 35 86,981 sq.ft. o z I I I I I i 2.00 acres NOO °41'43 "W 0..1t - 625.22'- N00 ° 41'43 "W � � 209.00' 209.00' 207.22' L _ ... - 1 ' - - ----- 1 383.00' 130.78' 302.95' 191.49' SECTION 20 & 21, T.30 N., R 18 W. SCALE: 1" = 2000' 1 Sj00' 210.00' I I I $ OWNERS: �1 ! rn p Hillvole Development Inc. r� 1 q i 68,536 sq.ft. & w o O P.O. Box 10622 n N White Bear Lake, MN 55110 I O 30 1.57 acres ' ,j 87,254 sq.ft. N u� 1 3 32 �o �' ' r 2.00 acres u I 33 t` 0 87,091 sq.ft. a rr`7 o� SURVEYOR: a,n ' 0 87,150 sq.ft. ro 2.00 acres Todd M. Hendershott no N 2.00 acres a N J �. Z Metro Land Surveying & Eng. c° I ,,fI a, a w r' -! 332 County Rood D" - v CA 135F 0 /- \� I i� 0: Little Canada, MN 55117 c� I LLJ 4 sq.ft. /- '� F-1 in acres `7b J C29 - '•� 5 g "E �� 0 rJ - - ` \ 3 210.00_ i 116.92' C32 5�i t\ u, �- 100 --1 p - -- - 5 °39 201 / IN I 2 N i f - -- 585.92 „" y N E 1 / 65,713 sq.ft. 7 j i- 11 1 TH ST. 5j5 .39'21" _ ` f' 1.51 acres soyi 41 43 "E 585.92' _ 1 ---- - - - - -- - -- 212.01' C23 C26 � 1 a psi I 27 - i ' W Z 87,154 sq.ft. ,GU '"I sq.ft. a n f 73,355 sq.ft. > J 2.00 acres acres 75,674 sq.ft. 1.68 acres ' 3 w \�� * I 1.74 acres - n o. N �, \ d o Todd M. Hendershott, RLS 2362 6 W Registered Wisconsin Land Surveyor I co 220.47 Doted this _ day of 2001. i '41'43 "W r S0054'03"E 239.43' i - S005835E - - 3.91' r - - - - -- - - - - - -- 0 4 ^ z W 1/4 corner N c 958.� 25`(R $ ���> DRAINAGE EASEMENT--' West line of the Section 21 I sq.ft. 958.3 too NW 1/4 of Sec. 21 T30N, R18W 1 acres - - - - 34.35 210.39' ! 250.40 /( 1 270.90' -. -,� ._._ - -.) . - -- - _ N00°54'45 "W 244.74' NOO*54'45 "W 521.30' - East line of the ---� , south line of the - -MATCH LINE i.° - -= NE 1/4 of Sec. 20. - NE 1/4 of Sec. 20 `� ' SEE SHEET 2 OF 3 SW corner of NE 1/4 Sec. s - h N i � LEGEND: UNPLATTED LANDS - 20 T30N, R18W. Per C.S.M. -- �, --- - - - - -- - LANDS - VOL.13, PAGE LEGEND: q N , sq.ft. 3665.(1 "iron pipe) � y Q, 87 154 Denotes Total Lot Area Denotes County Surveyor's Mon. 47 2.00. acres South line of the NW 1/4 of Sec. 20: j a co Alum. Cap Found (unless noted) (rec.) Denotes recorded measurements W 1/4 comer Sec. 20 T30N, R18W. Per O Denotes X (meas.) Denotes measured distances and angles C.S.M. Dm./605017 VOL.13, PAGE 3665. 1 3. lbs Iron Pipe Set - Weighing 3.65 bs /ft. � Vertical Datum is U. S. G. S. 1929 Adjustment (Alum. Co. Mon.) ` '��' • Denotes 1" Iron Pipe Found All Other Lot Corners Are Monumented With PREPARED BY. (unless noted) 1" X 24" Iron Pipe Weighing 1.68 Ibs /ft. C46 Denotes Curve Number Distances are computed to the Nearest METRO - -- Denotes drainage & utility easement 0.001' and measured to the nearest 0.01' uTm t ( 12ft. in width UNLESS NOTED) Angles are computed to the Nearest 00'00'00 ".5 - - -- Denotes Building Setback Line and measured to the nearest 00 M. Hendershott Sheet 1 of 3 sheets v i 3 68,536 sq.ft. N 30 1.57 acres ,h � 3 M 0, ^'� 87,254 sq.ft. 33 32 0 A ° � co` 2.00 acres 0 87,091 sq.ft. M o 87,150 sq.ft. 2.00 acres N � 2.00 acres rn 1 — n 00 — C29 _ "E CD � o � N 2151 — — — 210.00 — ► — 116.92' C32 5 9 N 100 - 585.92 — — N15o39, 21 W �N i 29 - 111 TH S T. 5,3g 65,713 sq. 585.92 _S1 __ �' 1.51 acre 212.01' C23 — o � C26 — \ ti� 0 ° N �S 27 - -- 28 N 2 6 73.355 sq.ft. w 87,154 sq.ft. 75,674 sq.ft. to 1.68 acres 2.00 acres 1.74 acres � J es r� p W ^ 0 W s I� W) Z m 00 M — S00 "E 220. S00 ° 54'03 "E 239.43' b 00 1 �\ Ui ° 0 H.W.E. 04 ° 958.1 25YR o > DRAINAGE EASEMENT 210.39 958.3 100YR o. — — — 34.35 � 250.40 270.90 N00°54'45 "W 521.30 244.74'/ �.,� .. o n N00 54 45 A' -- - -- " E ` MATCH LINE " C*' b v Noo°2s o2 w rec.) v NE SEE SHEET ,2 OF 3 � M L �UNPLATTED ECEN ---- --------- 1 � O Denotes County Surveyor's v0 " L , Aluminum Monument (unless 00 N 87,154 sq.ft. Denotes Total Lot Area noted) CO v ' O Denotes 2" X 36" Iron Pipe Set (rec.) Denotes recorded bearings Weighing 3.65 Ibs /ft. Vertical Datum is U.S.G.S. 1929 Adj r' tment • Denotes 1 M J" Iron Pipe Found All Other Lot Corners Are Monumented With (unless noted) 1" X 24" Iron Pipe Weighing 1.68 Ibs /ft. C46 Denotes Curve Number — Denotes drainage & utility easement 0.001' and measured the 0.01' 12ft. in width Angles are computed to the Nearest 00 -- -- Denotes Building cAfh.,..� # .-- __ J . . POWTS OWNER'S MANUAL & MANAGEMENT PLAN wage ct� FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity 1 0.e a l ❑ N. Permit D� Septic Tank Manufacturer © N, DESIGN PARAMETERS Effluent Fi lter M anufacturer ❑ N, Number of Bedrooms © NA Effluent Filter Model /DO ❑ N, Number of Public Facility Units ❑ NA Pump Tank Capsotty al 13 N, Estimated flow (average) g al/day , Pump Tank Manufacturer q Ni Design flow (peak). (Estimated x 1.5) y 6 al /da Pump Manufacturer ❑ N, I Soil Application Rate 7 ai /da /fta Pump Model 11 Ni Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ N) Pats, Oil & Grasse (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (00D.) 5220 mg /L Q NA 13 Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) %150 mg /L q Disinfection is Other. Pretreated Effluent Quality Monthly average Dispersal Collis) ❑ Ni Biochemical Oxygen Demand (BOG.) 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA 13 At -Grade ❑ Mound Fecal Coliform (geometric mean) 510* efu /100ml ❑ Drip -Line ❑ Other Maximum Effluent Particle Size % in dia. ❑ NA Other: ❑ N/ Other: ❑ NA other: ❑ N1 * Values typical for domestic wnwwwater and septic tank effluent, Other. ❑ N` MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tanks) At least once every: �this) (Maximum 3 years) ❑ NA EYear s) Pump out contents of tank(s) When combined sludge and scum equals ono -third (N of tank volume ❑ NA Ins ect die ersal cells m� nth(s) (Maximum 3 years) ❑ NA P p () At least once every: Ellyear(s) Clean effluent filter At (east once every: �&onth(s) 13 NA Inspect pump, pump controls & alarm At least once every: m ) O yeaa r(s) r(s) ❑ NA Flush laterals and pressure test At least once every: ❑ months) ❑ NA ❑ year(s) Other; C� month(s) At (east once every: ❑ Ye ar(sl ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carving one of the following licensee or certification: Master Plumber: Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tan Inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surfed The dispersal cell(s) shall be visually inspected to check the effluent levels In the observation pipes and to check for any pondin of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires th irnmadiate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (XI or more of the tank volume, the entir contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 11: Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatmen units, and any servicing at Intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. aMW (410 E0 3BGd JNI7cindl 3 LE9989ZSTL 96:0Z Z00Z/51/50 � of� START UP AND OPERATION Pegs For now construction, prior to use of the POWTS check treatment tankis) for the presence of painting products or other chemic that may Impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the conter of the tank(s) removed by a septage serAcing operator prior to use. System tram up shall not occur when soil conditions are frozen at the Infiltrative surface. During power outages pump tanks may fill above normal highwater [ovals. When power is restored the excess wastewater will discharged to the dispersal collie) in one large dose, overloading the eellis) and may result in the backup or surface discharge effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restori power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls restore normal levels within the pump tank. 1 Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the or within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and prolong the life of t POWTS: antibiotics; baby wipes; cigarette butts. condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fi foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; most scraps; medications: c painting products; pesticides; sanitary napkins; tarnpons; and water softener brine. ABANDONMENT When the POWTS falls end /or is permanently taken out of service the following steps shall be taken to insure that the system properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: a All piping to tanks and phs shall be disconnected and the abandoned pipe openings sealed. a The contents of all tanks and plta shall be removed and properly disposed of by a Septage Servicing Operator. a After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled wf soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code complies replacement system: [,7 A suitable replacement area has been evaluated and may be utilized for the location of a replacement moil absorptic system. The replacement area should be protected from disturbance and compaction and should not be infringed upon t required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area w result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems mu: comply with the rules in effect at that time, 17 A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWT technology a holding tank may be installed as a last resort to replace the failed POWTS. Q The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and sit evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tan may be installed as a last resort to replace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the b(omat at th infiltrative surface. Reconstructions of such systems must comply with the rules In effect at that time. < <WARNINQ> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NO' ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF 0 PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INS ER POWTS MAINTAINER Name Nam® Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name •aA /h Phone Phone 215 3 �ro This document was drafted in compliance with chapter Comm 83,22(2)(bl(1)(d)a<M and 83.64(1), ( 1k (3), Wisconsin Administrative Code. Z0 39bd 9NImondi 3 LE9989ZSTL 9E :0Z Z00Z /51/90