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HomeMy WebLinkAbout026-1160-18-000 o to o z 3 0 @ § R § ^ mq i7 k . � \i f = E _ & 0; ( 2 �. a co # k 0 § _ % pi k C i }'/ m � E § ■ �c -4 (a > M $ Q = c > o - /% / § ƒ: O o 0 [ . rr 0 3 E o o o § CL & £ CO) CA CO) � � & E T 0 g I # 2. ( 7 E - a ; " \ \ . = E 0 \ ) 0 \ 7 } \ . ( \ / B { \ 2 M. / 7 0 E 22 2 °- E _ \ i z $ k \ ® _ § & E/ )Z �z9 I2 e ¥ ri « $ ■ M § w \ \ 0 k ! / 2 o ; z Z } w k I /}?CL �\\# § § \/2 CD % CD Ef ƒ � /7� \ \($ d@ # $0\ i c- 0 ) ¥ ¥ 2(\ 3 C« \ &( � 0 » < § \ E OL \ 2 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453427 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Dicicco, John Richmond Township '02& - //col) -/ g- CST BM Elev: Insp. BM Elev: BM Descriptio Section/Town /Range /Map No: Gs - � 23.30.18. / v TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 4.10 lad •'76 /d � Dosing { - 1 1( Alt. BM (��, t 2t / Aeration Bldg. Sewer 4 /d Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet ($ z TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / /JA- Z r / Dt Bottom Zic Dosing Header /Man. Aeration Dist. Pipe C l 7.55 Holding Bot. System 3 . 7 17,J�b J PUMP /SIPHON INFORMATION Final Grade Manufact P St Cover 3. Model NO ber (` TDH Lift Friction Loss S ead TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BEDITRENCH Width / Lengthf No. Of Trenches PIT DIMENSIONS No. Pits Inside Dom_ Liq ' epth DIMENSIONS 3 jib �- 1 Z_ e� � '� � rn�� SETBACK SYSTEM TO P/L BLDG 1 WELL LAKE /STREAM LEACHING Manufactureri,�P INFORMATION CHAMBER OR Type Of System: A / 13 1 A- A / UNIT Co &O C� ✓ t � Model Number6 1 / 6 r�. DISTRIBUTION SYSTEM Z�'l ,' )(Je)(- , i Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake k ' Pipe(s) ` �, , /�- /� ' Length V1 Dia t f Length Dia \ Spacing V f� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded/ odded j xx Mulched Bed/Trench Center / _ , -7 Bed/Trench Edges \ Topsoil ` Y No �s No COMMENTS: (incl c ode discrepencies persons present, etc.) Inspection #1: Z_ / d � / T � Inspection #2: Location: 1307 146th Av - New Ric WI 54017 (SW 1/4 NW 1/4 23 T30N 18W) W Parcel No: 23.300. .118. L 1.) Alt BM Description 2.) Bldg sewer length = 24 - amount of cover 4=7 _ Plan revision Required? Yes No I Use other side for additional information. i Z _ Date In ctors nature Cart. No. SBD -6710 (R.3/97) Al an Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 S L visconsi Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151 a Department of Commerce Number D. Sanitary Permit Application State Plan I. (,v/ In accord with Comm 83.2 1, Wis. Adm. Code, personSlit►fotWmAY ati4u provide may be used for secondary purposes Privacy Law, sl } , ' Project Address ( different than mailing address) 1. Application Information - P se Print All Information# � ) (,// 1 ` Block N Property O er's Nam i Property wner's Mailing Address Property Loca io s ,��// 3b ' ... - ...._. a �wl., Section Ciry, State Zip Code Phone Number / �( j D ?S T d N: R II. Type of Building (check all that apply) Subdivision N me ` CSM Number 1 or 2 Family Dwelling - Number of Bedrooms ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use u 1 ST ' f - ❑Village o hip of 111. Type of Permit: (Check only one box on line A. Complete line B if applicable) - 0 A ' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiratfon Plumber Owner IV. Type of POWTS System: Check all that appl At Grade ❑Single Pass Sand Filter Non -Pressurized ❑ Mound > 24 in. of suitable soil ❑ K Mound < 24 in. of suitable soil ❑ ❑ Constructed Wetland ❑ Pressurized In -Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter chin Cham Dri i ❑ - ess pe ❑ Other (explain) V. Dis ersaVrmatment Area Info a ion: Design Flow (gpd) Design Soi n Dispersa Area R ired s Dispersal Area Proposal (sf) l Ele�io / lid L , g , VI. ;mHol;dingTank Ca city in 'tal Number Manufacturer Prefab Site teel Fiber Plastic Ga Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Sept Aertment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for laSta I[ation of the POWTS shown on the attached plans. Pitt �� Ium Signer re PRS Number Business Phone Number a �� 7 /S' - odd o m s a e tint -1 7FSF Plumber's Address (St eet City, State, 'p Code) ( V III-County/ e artment Use Onl Sanitary Permit Fee (includes Groundwater Date ssued I uing Agen ignatur No Approval ❑Disapproved Surcharge Fee) 1 S'v, 6 7 ❑ Owner Given Reason for Denial o � IX. Conditions of Approval /Reasons for Disapproval 3 `l 0'YI 3 s � �,t - ���,,,� saw S YSTEM OWNER: �Q� Vl��!/�1 �/3 / n eptic tank, effluent filter and 5 // ��"" � dispersal cell must all be serviced / maintained QYL 4*�w y as per mana m n far✓1 2. set ack requirements must be maintained as put applicamle lam (to the County o ( system ona�r not ku n 81/2 s 1 inches In size / SBD -6398 (R. 01/03) 4r� /D o o N� YD /oo, C/ a IIJ C— Gr T= c7y t s <7 3 , s , 0 x B- v' � f - /on o R 1 00 = yo Leo ( r,�P, s s y 7` a 0 0 r, x 8-3 ab7 �3jk -1 i Bird Plumbing Inc. 1008 192nd Ave New Richmond WI 54017 715- 246 -4516 Subject: Whitetail Meadows Soil Tests To Whom it may concern: I Shaun Bird did the soil tests on this subdivision known as Whitetail Meadows in Richmond township. Aftbr a couple of installations, some of the soils were found to have a more weak structure than what was found in some of the borings. In order to protect home owne actors, it is my recomme uinn from St. Croix County Zoning office that the systems be oversized u sing a .3 loading rate instead of the on i . 4 rate On the lots that were originally sized fora .5, I recommend using a.4, not the new .6 that the state has suggested. The soils are what the tests indicate but the large areas tested did not reveal some of the weaker structures that were found upon installations. If a installer can prove otherwise, that the weaker structures do not exist, then the installer should proceed with the soils that he /she believes are present. Shaun Bird CST #226900 z•d d64:T1 40 sa add ST. CROIX COUNTY bow WISCONSIN woof u. ZONING DEPARTMENT ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 r --�" `" Phone: (715) 386 -4680 Fax (715) 386 -4686 Memo to File Fronv Pam Quinn Date: 4/27/2004 Re: Sandy loam structure misinterpretation on subdivision soil reports Recent soil on -site determinations have brought a problem to our attention. During these on- sites, borings were excavated to confirm soil conditions where two conflicting soil reports had been submitted for zonir department review. The soil profiles, evaluated by myself, Dave Fogerty, and Dave Steel (all certified soil testers) differed from the original soil reports in that massive (structureless) sandy loams were encountered in horizons that were described as having either moderate, medium subangular blocky (2msbk) structure by Adam Schumaker or weak, medium granular structure (I mgr) by Shaun Bird. There apparently has been a misunderstanding between "structure" caused by handling samples of the soil during texturing versus the soil characteristics in situ. The soil, when chunks were taken out of the profile to hand texture, with pressure parted into "crumbs" that appeared at first to be subangular or granular in shape. However, these were not true peds that broke apart along planes of weakness, but fragments created by handling. The soil when observed in the horizon did not have distinct units of structure and should have been reported as "massive ". Added notation: on 4/23104 Mark Iverson (Cedar Corp. certified professional soil scientist), Shaun Bird, and myself did an evaluation of soils on Lots 6 & 9, Richmond Meadows where the original soil report described the third horizon as sandy loam, "I mgr". On Lot 6 we checked soil profiles within a POWTS distribution cell and then excavated a test pit on Lot 9. The sandy loams in question were a weak, coarse to very coarse subangular blocky structure, where planes of weakness were just discernible when peds were parted from the profile. The peds separated with very light pressure by soil tester. Sand coatings were observed on the ped faces in the Lot 9 soils, which supported the determination that some structure existed to allow water to move through the upper portion of the sandy loam horizon. However, below the weak - structured soil we found massive (structureless) sandy loams and the boundary between these horizons was irregular, which would mean a distribution cell could encounter alternating weak and massive sandy loam. Shaun said he would amend his soil reports with a memo recommending that any sandy loams he identified as "l mgr" or "2 mgr" be assigned a lower loading rate of 0.3 gpd/ft2 (see attached memo for Whitetail Meadows) to provide a larger dispersal area. Page Two — Soil Memo 4/27/04 Massive sandy loams have been assigned a soil application rate of 0.2 gpd/ft with the code changes in Comm 83.44 -2, effective as of 2/1/04. The application rates listed on the soil reports were higher due to the structure having been described as either weak or moderate, which affects the calculations for sizing of POWTS distribution cells. Obviously, one of the concerns is to make sure loading rates for the soils are not in error and allow undersized POWTS to be installed. For example, in December 2003 Lot 35 of Richmond Meadows subdivision h p � had to have its loading rate reduced to 0.3 gpd/sq. ft. when the installer encountered massive sandy loam at the system elevation. The sandy loam horizon had been described on the soil report as "I mgr" with firm consistence. Leroy Jansky, Dept. of Commerce Regional Wastewater Specialist, has been consulted on this situation and advised the zoning department to require on -site verifications for any lots with this potential misinterpretation on the soil reports. All soil reports with sandy loam "I or 2 mgr" as its structure will be required to use a design based on the current code's soil application rate for massive sandy loam @ 0.2 gpd/sq. ft. unless additional soil testing proves otherwise. Z Wisconsin Depart! nent of commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code i r County Attach complete site plan on paper not less than 8 112 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. 'ew b Please print all informi3tion. Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). M `�r'L/'v ter! Property Owner Property Location h qc �/� J Govt. Lot 1 /4 S��T N R E( W Property Owner's Mailing �7Address Lot # Block # Subd. PJa or CSM# sta Zip Code Phone Number City ❑ Illage own Nearest Road Y , r s ( ) j l New Construction Use Residential / Number of bedrooms -�> Code derived design flow rate �� GPD ❑ Replacement ❑ Publi or commercial - Describe: ____ -- - -- - -- - - -- - -- Parent material a>14-4 Flood Plain elevation if applicable R General comments and recommendations: G ��� �� Q "/ rn Boring Boring # U l O e ' p ,) i t Ground surface elev. r v ft. Depth to limiting factor y` in. mil lica6o ate 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 lJ � � a • a 2.S � /F—n-1 Boring # Boring oil - Y Pit Ground surface elev v ft. Depth to limiting factor �in. SoiI Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDrfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2 iO 3/z --- Effluent #1 = BOD > 30 1 220 axyL and TSS >30 < 150 ' Effluent #2 = BOD 1 30 mg/L and TSS < 30 mg/L CST Name (Please Print) re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ' .— 715 - 246 -4516 Pro Owner Pa ?' of 3 Property .— Parcel ID # e 9 5 Boring # ❑ oring –�, \ it Ground surface elev. CJ' 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 'E J i'Lr 5L n 1, �`� 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/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring # (D Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. F1 Soil ication 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 • Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = BOD <_ 30 mg& 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. SOD -8330 (8.6/00) Soil Test Plot Plan Project Name William Stock/Steve Dalton Sha Address 1748 112th St. New Richmond Wi 54017 M #226900 Lot 18 Subdivision Whitetail Meadows Date 8/15/03 S 1 /2 N W 1 /4S 23 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 Survey lron System Elevation 94 .0/93.5 *HRpSame as Benchmark Alt. BM Top of 2" Pipe @ 100.2' Scale is 1" = 40' Please note: Installer must unless otherwise verify all lot lines and setbacks before installation noted Please Note: Tested area may not be suitable for desired building area. Check system location before excavating. B -2 97' a� 40 a 6% Slope o B -3 � 20' -1 40' 98 M.g .CIA 120' .M.S 267' Property Line 10' Jul 21 04 10:37a P.1 Jul 21 04 11:02a LISA AMM KROLL 715 - 246 -5700 P• ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP C'- RTIFICATION FORM r Owner/Buyer ©F'1 11 0 Mailing Address L J �` %� M c, A I rJ S �. Property Address L o'f i Z-�, �i� !� 'r f%C� tm (V h�mw e g P ag X 0 at for toew coasuuction) LJT / P arcel Iden@-alien Number V fi LEGAL DESCRIPTION -` �� Froperty Location Si '`/ ' /,, ' /,, Sec. ' 1 3 . T N -R�- -- Town of Subdivision c o L Lot # j Certified Survey Map # , Volume _ . Page # Warranty Deed # 7/, ? 6 . Volume Page # 3 Spec house P9 yes © no Lot lines identifiable yes Q no SYSTEM I'VLA2 j'W411TL"! Improper use and maisteaanceof your septic system could result in its paea==fatRtaneto baadte wastes. Proper maintenance consists of pemoping out the septic task every three years or sooner, if needed by a licensed pamper. What you put im the system, can affect the Function of the septic tank as a o ereaom v. stage in the warn disposal system lbe pteportp owuor agrees to submit to St. Croix Zoning Depaxnacut a cat6wim form, sighed by the owner and by a masterphuaber. jotaneymanplurabm resuictedphunbercra licamApampetverifying dmt(1) the on-so wastewaserdisp ual system is in FW" oP=tixkg cmditim and/or (2) after inspection and pining (if aecem yj the septic tank is ims tin I13 tdl of sludge. Uwe, the tmdcrsigaed Lave toad the above requirements and agree: to mai ftk the private sewage disposal system with the standards set fortk herein. as set by the Department of Comoaercc and the Deparmrent of Natural Resources, State of Wiseonain. Certification stn that . system has been Mintaincd must be completed and renamed m Me St Cmix Cmaty Zomag Office within 30 "ATEU OF APPLICANT DATE OMM CER CATION I (we) eeaiify drat all statements on this fora: see true to the best of my (our) knowledge. I (we) am (are) the owner(&) of 1&e d above. by virtue of a warranty deed recorded in Regina: of Deeds Ofriice. S A F APPLICANT DATE 600400 Any iafc=tiou that is mis- represented may crS& in the sanitary permit being rewired by We Zoning Depamnent. 000 •• Include with this :ppikstion: a stamped warranty deed from the itegister of Deeds otl"ace a copy of the amfied survey rasp if referuace is made in the wamnty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page f of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner �" — Septic Tank Capacity Z 6 00 a l ❑ NA Permit # Septic Tank Manufacturer, ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model — �® ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA Estimated flow (average) :3 00 gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) 7 --,gal/day Pump Manufacturer ❑ NA Soil Application Rate al ay /ftz Pump Model ❑ NA Standard Influent /Effluent Quality erage* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L _1K In-Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: a ❑ mo nth y ear(s) ) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell( At least once every: p� ❑ year(g (s) (Maximum 3 years) ❑ NA / Clean effluent filter At least once every: ❑ month(s) 13 NA -M year(s) Ins Inspect pump, pump controls & alarm At least once eve ❑ mo nth(s ) ❑ NA P P P every: ❑ year(s) Flush laterals and pressure test At least once every: ❑ year(s)month(s) ❑ NA Other: At least once every: ❑ month(s) 13 NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the 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 surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page Z 'of ?/ START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant replacement stem: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. rj T alua ' a ro ing tank be ' e ai e . F9 I J7l�,. fbR_ A16�AJ (bNS7R(X710 ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name u G Name Phone 7� r Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY / Name Name ST. t d UN 20AII � Phone Phone 3g( This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.5401, (2) & (3), Wisconsin Administrative Code. U. 2 6 18 P 2 3 6 -7 4S c3 (D,4!5 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED RE OF D This Deed, made between Dalstock. LLC RECEIVED FOR RECORD Grantor, 07/19/2004 09:30AN and John Dicicco WARRANTY DEED Grantee. EXEMPT # Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 11.00 the following described real estate in St. Croix County, State of Wisconsin TRANS FEE • 142.50 (if more space is needed, please attach addendum): COPY FEE: Lot 18, White Tail Meadows. St. Croix County, Wisconsin. CC FEE: PAGES: i Recording Area Name and Retur L p AiwJ Tm.E, INC C� SU E 200 =0 61i:WOA LAKE ROAD MW , MN 55112 FILE NO. 10 1 Part of: 026 - 1068 -80 -000 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights - of - way of record, if any. Dated this 15� day of July , 2004 Dalst ,LLC * AUTHENTICATION 11ll ACKNOWLEDGMENT Signature(s) Dalstock, LLC, By: STATE OF W t SCAN S h ) ss. _ -- County ) authenticated this — day of July ^ , 2004 _ Personally came before me this day of ---------- - - - - -- –V --- - - - - - _the above named b03 yfa(�4-[��_---- . - - - -- - - -.- * Kristina Ogland D ' 'f h TITLE: MEMBER STATE BAR OF WISCONSIN ��� (If not, _ _ %'' � ... « «; r t nown to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) mont and acknowledged the same. THIS INSTRUMENT WAS DRAFTED 1 Attorney Kristina Ogland d 4 • * " $ _ H_ udson, WI 540 – W S -- - - - - -_ ___ ty �Sbli . State of c rS •• — - - - - -- ,' –� •. °•a.•.••' k0iC, remission is permanent. (If not, state expiration date: – v . ,e (Signatures may be authenticated or acknowledged. Both are nota :'. :> J +.stesat�'� * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, wl STATE BAR OF WISCONSIN 900.655 -2021 WARRANTY DEED FORM No. 2 - 1999 w V • • r` ..0 ti o co to OD S4 N 33' � v c� O `' „� � •o ��• OD tS ♦ y � •�O\' �O O Q 6 29.46 128.18' _� •)�� \ `• 57.64' N00'29'28 "W \ ` \ ' • 502 49 03 ,5j 08'. ,A � N I ` � y I p I � aa C s I y � • • �. � ` L V m . • .8S'66l - M "8Z.6Z.00� N M i W ,8 l'L0C L4 XW�87AEE-7— ,6�' lL5 I 3„SZ,6Z.00S ; w r ,t V66 L — 3 "8Z.6Z.00`. I v A J / W I v r ' v O N O OC v i , �n ; 1 •D O N I y 47. 2' 40.1 'g2 87.40 w \ s ?Oy NOQ29�28 "W �� , • F / / • 87.40' �,' / 00 S00'29'28 "E —L10- ti �� �,'' o 0 0 . ,�•� II � •A O