HomeMy WebLinkAbout026-1072-80-200 Wisconsin Department of ComIne+te Count
PRIVATE SEWAGE SYSTEM St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
463228 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:
Oldenburg, Wayne I Richmond Township 026- 1072 -80 -200
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
/6 U, �ti) � 5 Z 25.30.18.380820
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark b
Dosing V_)/ Alt. BM -7
�Jv S � G
ltJ
Aeration Bldg. Sewer R q� ' Z
--
Holding — — - -- St/Ht Inlet �. 1 , 6 1 5.
TANK SE CK INFORMATION St/Ht outlet 9 �7
TANK TO P/L Vent t� Intake ROAD Dt Inlet
Septic >� O p y � l t t L � Dt Bottom
Dosing > I _f Header/M q� L
yvtQjy�,
Aeration Dist. Piped
Holding Bot. st /� ^ ^ n �—s c q 3.5_
Final Grade _ U Cf O 6 t s
PUMP /SIPHON INFORMATION G I--- 2 S'
Manufactur errand St Tir kl 3.7- o
GPM
Number
j�� J
TDH Lift Friction Loss S Head TDH Ft
Forcemain Length ia. Dist. to Well
SOIL AB RPTION SYSTEM ,7-/ (� 3
BED /TRENCH Width Len Y No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO 1 P/L BLDG WELL LAKE/STREANy LEACHING Many"ry-r:l ✓ /
INFORMATION T f S stem: s i CHAMBER OR Model Num
YP Y 1
I
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size I x Hole Spacing Vent to Air Intake
Length I Dia w Length Dia Spacing I
I
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 i No ]Yes No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 1443 140th Avenue New Richmond, WI 54017 (NE 1/4 NW 1/4 25 T30N RI 8W) NA Lot 3 Parcel No: 25.30.18.380Q20 f
1.) Alt BM Description =
2.) Bldg sewer length= )�
amount of cover =� Z � G 6dV101V
Plan revision Required? Yes No '� Il i - Q
Use other side for additional information -
Date Insepctor's Signature Cert. No.
SBD -6710 (R.3/97)
• �Q ftty d Buildings D ' ' n County
lv ME ngf�rt P . Bo 62., seonsirn tso ) - 716 0 Mar Permit Number (to be filled
by Co.)
Department of Commerce
l 22
Sanitary Permit Application C' 0 7 State Plan I. . Number
In accord with Comm 83.21, Wis. Adm. Code, personal information y provg9- 1
may be used for secondary purposes Privacy Law, s15.04(1 Z . RQ / XCO lecjAress (if different than mailing address)
N � ry
I. Application Information - Please Print All Information /C
Property Owner's Name Parse # Lot # Block #
J 0240 - /o 7-Z - fib - 2M 39b F. - p)
Property er's Mailing Address Property LAX. uv..
City, fate � Zip Code Phone Number %4, AY., Section
c le o
IL Type of uilding (check all that apply) T Q N; R or
1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name CS�Iy d umber
❑ Public /Commercial -Describe Use -
❑State Owned - Describe Use ❑City_ ❑V' ageATownship of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A ' ❑ New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B• ❑ Permit Renewal ❑ Permit Revision Change of $ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner t 3a 3 �� q �/� 3
IV. T of POWTS Sys tem: Check all that a
R Non - Pressurized In- Ground ❑ Mound> 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter % Leaching Chambe ❑ Drip Line ❑ Gravel -less P'pe ❑ Other (expla n)
V.DispersaVfreat mcut Area Information: ¢e ?,
Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Ele do
r
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units I` Concrete Constructed Glass
New Existing
Tanks Tanks I `
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plum 's ame Print) Plumber's Si MP/MPRS Number Business Phone Number
Plumber' Address Street, City State, Zip Code)
VIII. Coun /De artment Use Onl Sa
Approved ❑ Disapproved Denial d
Sanitary Permit Fee ' cludes oundwater Date Issued Issuin gent Si ature o Stamps)
PP PP
Surcharge Fee)
/
en 40--9 �I
IX. Conditions prove p ���
SYSTEM NER: 3 J f-�1 t Sc e >1 tk�
1 Septic tank, effluent filter and _
dispersal cell must all be serviced / maintained
as
t plan provided b plumber.
er mane emen a rod
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P 9 P P
2. All setback requirements must be maintained
as per applicable code /ordinances CL aAPD_
Attach complete plans (to the County only) for the system on paper not has than lll/2 x 11 io�h `size `
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SBD -6398 (R. 01/03)
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN,.,, Page. of ,-Q
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner , Septic Tank Capacity gal O N ;,,
Permit # Septic Tank Manufacturer ) ❑ N' j
1'v Effluent Filter Manufacturer " O Nr,
DESIGN PARAMETERS
Number of Bedrooms O NA Effluent Filter Model ❑ NA
Number of Public Facility Units E1 NA Pump Tank Capacity oal NA
Estimated flow (average) a l/day Pump Tank Manufacturer �N<,
_ Design flow (peak), (Estimated x 1.5) al /da Pump Manufacturer ANA
Soil Application Rate gal/day/ft' Pump Model '
Standard Influent /Effluent Quality Monthly average* Pretreatment Unit <' `.
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter O 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) O Ni,
Biochemical Oxygen Demand (BOD 530 mg /L 126n-Ground (gravity) E3 In-Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L 12' NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu /1001111 ❑ Drip -Lino ❑ Other;
Maximum Effluent Particle Size Y in dia. C1 NA Other, ❑ NA
Other: ❑ NA Other: ❑ NA
I
*values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
❑ onth(s} {Maximum 3 years! ❑ NA
Inspect condition of tank(s) At least once every: ear(s) ,,
Pump out contents of tank(s) When combined sludge and scum equals one -third (Ys) of tank volume ❑ NA
❑ month(s) (Maximum 3 years) ❑ NA
Inspect dispersal cell(s) At least once every: � month(s)'
� .
Clean effluent fitter At least once every: O month(s) ❑ Ni, Oyear(s) _+
❑ month(s) EJ N<
Inspect pump, pump controls & alarm At least once every; ❑ ear(s)
❑ month(s)
Flush laterals and pressure test At least once every: ❑ ear(s)
13 monthls) A
Other; At least once every: O ear(s) N
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. Tanis
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.
t3MW lalu r
. Page 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 ad by a septage servicin g operator orator p riot 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 bo
discharged to the dispersal cell(&) In one large dose, overloading the cells) and may result ln backup or surfer 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 an mound or at -grade soil absorption area.
Y 9 P
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;, Moot-, 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 fealod,
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage .Servicing Operator.
0 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 system: : .'! I
>d 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 rnusi
comply with the rules in effect at that time.
0 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.-,-- -
O The site has not been evaluated to Identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
0 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.
so
< < 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 Name
i
Phone _ S Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY A THORITY
Name Name
Phone Phone yf .
'his document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.64(1), (2) & (3), Wisconsin Administrative Code.
ST CROIX COUNTY
_ SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /Buyer A Met n (�
Mailinb address qS NO
Property :Address
(Verification required from Planning Department for new construction)
City/State /elf R c 0 d W x parcel Identification Number
LE GAL DESCRIPTION
Property Location 4L— t /a, Sec c ' , T 3 N -R W W, Town of t
Subdivision Lot #
Certified Survey jvlap # 79()96 , Volume �1 , Page # � .
Warratiry Deed # :,� - X Z Volume ��— , Page #
Spec house ❑ yes ? no Lot lines identifiable yes O no
rr
SYST MAI
Improper use and maintenanceof 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 wastewater disposal system
is in proper operatin ; 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 aet by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. C
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 tluee year expiration date.
W . ,J
SIGNATURE OF APPLIC T 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 owners) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. '
W a�� I dly/? "- _5 ! Z1S L_
SIGNA URk: OF APPLIC T 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 2 4 15 P 18 `f 7 40 4& E,7
STA# BAR OF WISCONSIN FORM 3 - 1998 KATHLEEN H. WALSH
QUIT CLAIM DEED REGISTER OF DEEDS
ST. CROIX Co., WI
Document Number RECEIVED FOR RECORD
\i This Deed, made between Sohn _�[�f]S_ O 09!19!2 ®83 01:I5P1?
— - - - - -— - - - -- - - - - - - -- -- — QUIT CLAIM DEED
__- _ -- - - - -_� - EXEMPT # 8
Grantor, REC FEE: 11.00
and - 1� . . i "4 E� H ---- ._.. — COPY FEE:
CC FEE:
PAGES: 1
Grantee.
Grantor quit claims to Grantel the following described real estate in
Coun�y. State of Wisconsin:
Name and Return A
�o�n oldPn5uf9
4NS NO A 4v
i
Nekr R. cR mav Of, syob
-L0 -oso
Vol. o L . ') ye U.I I Y Parcel Identification Number (PINT - - -- — T
l
This homestead property.
(is) (is not)
Together with all appurtenant rights, gtle and interests.
Dated this —! ! day of
(SEAL) (SEAL)
P� SEAL) - - - -- — - - - - - -- ____ - -- (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signatures) 14� W
State of Wisconsin,
v : n7 ?li
t r — L2t
authenticalB, - L 1 tfay vf - , Personally came before me this _.1_ day of
? (1�,,_, -_,__, UU theabovenamed
...
_
TITLE: MEMBER STATE BAR OF WISCONSI n —$ f ~ to
- - - --
(If not, _— 1 me known to be the person _ who executed the foregoing
authorized by §706.06, Wis. S[ats.) instrument and ackn owledge the r same.
THIS INSTRUMENT WAS DflAFTED BY Li�k ec�- =-
Notar Publ St ate of Wisconsi
y c, Stn ,
My commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged, Both are not
Y
necess a r . 1 -" - fr - - - -- -- .- - - - - -' - - - - --
) /
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1651
Wisconsin Department of Commerce SOIL EVALUATIO REPORT P age 1 of
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evalua QA1
County
Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I. D.
. of - 1072 -80 -050
Please print all information. ;R B Date
Personal information you provide may be used for secondary proposes (Privacy Law, s. 15.04 (1) (m)). `
Property Owner roperty Location
John Oldenberg (Wayne Oldenbefg) govt. Lot NE 1/4 1/4 S 25 T 30 N R 18 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
1445 140th Ave. 2 CSM Pending
City Stato Zip Code Phone Number _j City _j Village ✓o Town Nearest Road
New Richmond I WI 1 5417 7.1 -246 -5563 Richmond 1 140Th Ave.
t/ New Construction Use: 10 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement _j Public or commercial - Describe:
Parent material Glacial drift Flood plain elevation, if applicable na
General comments
and recommendations: Addendum to report completed 10/31/02 to accomodate relocated building site. Install three trenches at
elev. 95.5' using 39 leaching chambers. Dosing recommended -see memo pg
Fil Boring # Boring
Pit Ground Surface elev. 96.89 ft. >105" in. Soil Application Rate
0 Depth to limiting factor APP
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
1 0 -10 10yr3/3 none sl 2fsbk mvfr as 2fm,1 c 0. 0.9
2 10 -21 10yr4/4 none r.ls &cob 2msbk mfr aw 2fm 0.5 0.9
3 21 -34 7.5yr4/6 none jr.1s&cobb 2msbk mfr cw 2f,1m 0.5 0.9
34 -47 10yr5 /6 none s 0 sg ml gw if 0.7 1.2
I b 5 47-62 5yr4/4 none sl 2fsbk mfr aw if 0.5 0.9
6 62 -105 10yr5/4 none Ifs / sl 1 msbk / 2msbk mfr - - 0.4 0.6
H#5 & 6 contain weathered limestone fragements that somewhat mimic redox. concentration color patterns. These patterns do not indicate saturated soil
conditions.
F6113oring # I Boring
6el Pit Ground Surface elev. 98.28 ft. Depth to limiting factor >106" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-4 10yr3/3 none sl 2fsbk mvfr as 2fm,1 c 0.5 0.9
1
Ag 2 4 -15 7.5yr4/6 none r.ls &cob 2msbk mvfr aw 2fm 0.5 0.9
3 15-40 10yr4/6 none s & gr 0 sg ml cw 2f,1m 0.5 0.9
�2I"XU 4 40 -58 5yr4/4 none sl 2fsbk mfr gw if 0.7 1.2
5 58 -96 10yr4/4 none Ifs / sl 1 msbk / 2msbk mfr aw if 0.5 0.9
6 96 -106 10yr5/4 none sil lfsbk mfr - - 0.2 1 0.3
H#4 & 5 contain weathered limestone fragements t somewhat imic redox. concentration color patterns. These patterns do not indicate saturated soil
conditions.
* Effluent #1 = BOD ? 30 < 220 mg/L and TSS >k < 150 mg * E = BOD < 30 mg/L and TSS < mg /L
CST Name (Please Print) Signat . CST Number
James K. Thompson 3602
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 20 6/172003 715 - 248 -7767
SOIL AND SITE EVALUATION 1651 Page __Z__ 3
PROPERTY OWNER: John Oldenberg (Wayne Olden
PARCEL I.D.# PA. of 026 - 1072 -80 -050 A.C.E. Soil & Site Evaluations
REPORT MEMO
Recommended dosing of effluent to facilitate system operation and longevity. Dosing will allow shallow system
installation to utilize coarser soils in the upper portion of the soil profile and provide for greater distribution of effluent
throughout system.
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1598
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sal & Sit Ev
'
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference pant (BM), direction and Parcel I.D.
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Pr{ o 26
Please print all information. R B Date
Personal information you provide may be used for secondary purposes s. 15.04 (1) (m)). G
Pr Owner - 1 Pr Location G
�dY �rtY
John &Arlene Okfenber 9 Govt. Lot NE 19 NE 19 S 2 5 T 30 N R 18 W
P
--
roperty Owner's Mailing Address 0 5 2 oQ� Lot # Block # Subd. Name or CSM#
1445 140th Ave. h'l"3 J Proposed CS 7 �p/
City State ip Code one City �j Village a Town Nearest Road ''
New Richmond WI 401� '; i �4 Richmond 140Th Ave. I
New Construction Use: Residential / Number of bedrooms 2 Code derived design flow rate 300 GPD
j Replacement Public or commercial - Describe:
Parent material Glacial drift Flood plain elevation, if applicable na
General comments
and recommendations: Install two trenches at elev. = 95.50' using 20 leaching chambers.
Boring # ,;:J Boring
im Pit Ground Surface elev. 98.88 ft. Depth to limiting factor >94" in. Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /R
*Eff#1 *Eff#2
1 0 -8 10yr3/2 none sl 2fsbk mvfr as 2fm,1c 0.5 0.9
2 8 -29 10yr4/4 none grsl 2msbk mfr aw 2fm,lc 0.5 0.9
3 29 -35 10yr4/6 none s & gr 0 sg ml cw 2f,lm 0.7 1.2
4 35-48 10yr5 /6 none s & g 0 sg ml aw 1fm 0.7 1.2
5 48-63 10yr4 /4 none grsl 2fsbk mfr cw 1f 0.5 0.9
6 63 - 78 10yr4/6 none Ifs 2msbk mvfr aw 1f 0.5 0.9
7 78 -94 10yr5/4 none cos 0 sg dl - - 0.7 1 1.6
Boring # ,A Boring
Pit Ground Surface elev. 98.8 ft. Depth to limiting factor >96" in. Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft
*Eff#1 *01#2
1 0 -13 10yr3/2 none sl 2fsbk mvfr as 2fm,lc 0.5 0.9
2 13 -24 10yr5/4 none sic[ 2msbk mfr aw 2fm 0.4 0.6
3 24 -36 10yr4/6 none sl 2msbk mfr cw 2f,lm 0.5 0.9
4 36-48 10yr5 /6 none s 0 sg ml gw If 0.7 1.2
5 48-67 10yr4/4 none s 0 sg ml aw - 0.7 1.2
6 67 -74 10yr4/6 none sl 2msbk mvfr aw - 0.5 0.9
7 74 -96 10yr5/4 non cos 0 sg dl - - 0.7 1.6
* Effluent #1 = BOD ? 30 < 220 mg/L and TSS > 4_150 mg/L t #2 = BOD -s mg/L and TSS <-0 mg/L
CST Name (Please Print) Signat : CST Number
James K. Thompson � 3602
Address A.C.E. Sal & Site Evaluations ate Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 54020 10/31 /02 715 248 - 7767
+ Property Owner Joh &Arlene Oldenberg Parcel ID # P of 026 - 1072 -80 -050 Page 2 of _ 3
D Boring # � Boring
Pit Ground Surface elev. 97.22 ft. Depth to limiting factor >93" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2
*Eff#1 *Eff#2
1 0-8 10yr3 /2 none sl 2fsbk mvfr as 2fm,1c 0.5 0.9
2 8 -19 10yr5/4 none sl 2msbk mfr aw 2fm 0.5 0.9
3 19-44 10yr4/6 none sl 2msbk mfr cw 2f,1m 0.5 0.9
4 44-68 10yr5/6 none s 0 sg ml gw if 0.7 1.2
5 68 -83 10yr4/4 none sl 2fsbk mfr aw 1 f 0.5 0.9
6 83 -93 10yr5/4 none cos 0 sg dl - - 0.7 1.6
4] Boring # Boring jo Pit Ground Surface elev. 98.98 ft. Depth to limiting factor >96" in. Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
*Eff#1 *Eff#2
1 0 -9 10yr3/2 none sl 2fsbk mvfr as 2fm,1c 0.5 0.9
2 9 -20 10yr5/4 none sl 2msbk mfr aw 2fm 0.5 0.9
3 20 -33 10yr4 /6 none sl 2msbk mfr cw 2f,1m 0.5 0.9
4 33 -51 10yr5/6 none s 0 sg ml gw if 0.7 1.2
5 51 -62 10yr4/4 none sl 2fsbk mfr aw If 0.5 0.9
6 62 -96 10yr5/4 none cos 0 sg dl - - 0.7 1.6
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 :
*Eff#1 *Eff#2
* Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 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.
LEGAL ST. CROIX COUNTY, WISCONSIN NEW TXSCR02
REAL ESTATE TOWN OF RICHMOND
COMPUTER NUMBER 026- 1072 -80 -200 Parcel Number 25.30.18.3808 -20
OWNER NAME: First WAYNE H Last OLDENBURG
PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment
SECTION 25 TOWN 30N RANGE 18W %160 NW 1 /440 NE
Line Description Line Description
TOTAL ACREAGE 2.070 PLAT CSM 17 -4614 026/03 LOT02 BLK
01 SEC 25 T30N R18W PT NE SW 15
02 CSM 17 -4614 LOT 2 16
03 (2.070AC) 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
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division ,
INSPECTION REPORT Sanitary Permit No:
430349 0
GENERAL INFORMATION (ATTACH oro 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 N//o:
Oldenburg, John Richmond Township 0 .2o A) d kj
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
25.30.18.3
TANK INF MATION ELEVATION DATA )
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing Alt. BM
Aeration Bldg. Sewer
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG71 Vent to Air Intake ROAD Dt Inlet
Septic Dt Bottom
Dosing Header/
Aeration Dis ipe
Holding Ft. Sy m
PUMP /SIPHON INFORMATION Final Gr
Manufacturer Deman St Cover
GPM
Model Number
TDH Lift Friction Loss System Head Ft oe
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. renches PIT DIMENSIONS Of Pits IV Dia d Depth
DIMENSIONS
SETBACK SYSTEM TO JIPIZ JBLDG JTVELL LAKE /STREAM LeXHING Manufacturer-
INFORMATION CHA R OR
Type Of System: U
Model Number:
AK N
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spa Vent to Air Intake
Pipe(s)
Length 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 BedlTrench Edges Topsoil
Yes No Yes No
COMMENTS: ude code discrepencies, persons present, etc.) Inspection #1: / / Inspection
Location: 1443 140th Avenue New Richmond, WI 54017 (NE 1/4 NW 1/4 25 T30N RI 8W) NA Lot 3 Parcel No: 25.30.18.igQ8
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? U Yes Z No - - j L - -- — -- — – j
Use other side for additional information.
SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No
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PUMP CHAMBER CROSS SECT ION AND SPECIFICA
VEUT CAP
4`C. I. VENT PIPE
WEATHERPROOF APPROVED LOCKIAIG
� 25' FROM DOOR,
JUNCTION BOX MANHOLE COVER
WIIJDOW OR FRESH I2 "MIIJ.
AIR INTAKE
I
GRADE
18" h11 AI.
CONDUIT -
----------
18 "MIN. � ---- - - - - --
\
INLET PROVIDE I — - --
AIRTIGHT SEAL
*� A I i
I
I I I
I ''I ALARM
6
I I)
I
0 *APPROVE I Ow
JOINTS WI I I
ELEV. FT. APPROVED PI
3' ONTO PUMP OFF
D SOLID SOIL
CO CRE BLOCK
RISER EXIT PERMITTED OkJLy IF /FiCATIOUS
K MANUFACT R HAS SUCH APPROVAL
SEPTIC f SPEC,
DOSE r
TAMKS MA MUFACTURE IJU
MBER OF D S: PER DAB
TAWK SIZE: y (2 ALLOUS DOSE VOLUME 160, 106
ALARM MAMUFACTURER: / / INCLUDING BACKFL la G/ GALLONS
L) MODEL UUMBEK: CAPACITIES: A= o? I ES OR �! GALLOAIS
+ SWITCH TYPE: r B= I mc OR v GALLOWS
I
PUMP MAMUFACTURER: _ C= IAICHES v GALLOWS
I MODEL DUMBER: D INCHES OR GALLONS
j 5WITCH TYPE: NOTE: PUMP AWD ALARM ARE TO BE
MIUIMUM DISCHARGE / E _,3e GPM INSTALLED OU SEPARATE CIR TS
VERTICAL DIFFEREUCE BETWEEAMP OFF AMD OISTRIBUTIOM PIPE.. LS2� FEET
+ MI UM NETWORK SUPP PRESSURE . , , , , . , , , . , FEET
♦/ FEET OF FORCE MAIM X � FzFRICTIOU FACTOR. s/' ` _ FEET
TOTAL DyIWAMIC. HEAD = , FEET
IIJTERIJAL DIMEUSIOUS; OF TANK: LENGTH ;WIDTH — _;LIQUID DEPT
51GUED: LICEOSE HUMBER: o�n 025 DATE:
Goulds E 7 7
Submersible
} Effluent Pump
~j EPO4
EP05
APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron
Specifically designed for the stainless steel, grade turbine oil for for efficient heat transfer,
following uses: • Capable of running lubrication and efficient• strength, and durability.
• Effluent systems dry without damage to heat transfer.
• Homes components. ■ Motor Cover. Thermoplas-
• Farms Motor: Available for automatic and tic cover with integral handle
• Heavy duty sump • EPO4 Single phase: 0.4 HP, manual operation. Automatic and float switch attachment
0
• Water transfer 115 or 230 V, 60 Hz 1550' include Mechanical points.
• Dewatering RPM, built in overload with Float Switch assembled and ■ Power Cable: Severe duty
automatic reset. preset at the factory. rated oil and water resistant.
SPECIFICATIONS • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower
115 V. 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing
Pump: EPO4 built in overload with construction.
• Solids handling capability: automatic reset. EPO4 Impeller: Thermo -
3 /a" maximum. • Power cord: 10 foot plastic Semi -open design
• Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for AGENCY LISTING
• Total heads: up to 24 feet. with three prong grounding mechanical seal protection. SP Canadian Standards Association
• Discharge size: 1 NPT, plug. Optional 20 foot ■ EP05 Impeller: Thermo-
• Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for (CSA listed model numbers
rotary/ceramic- stationary, three prong grounding plug improved performance. end in "F" or "AC ".)
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F (40 °C) continuous superior strength and
140 °F (60 °C) intermittent. corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel.
10
Ca r unning ! ,
pable of I
d withou
dry ut damage to s 30 ! I
components. i i T - �: , ir_ ,sGPM ----
Pump: EP05 e
• Solids handling capability: 0 25 �zsFT
3 /a' maximum. Q 7 i
W
• Capacities: up to 60 GPM. _ --
• Total heads: up to 31 feet. 2 6 20
• Discharge size: 1'/i' NPT. Q i
• Mechanical seal: carbon- } s _ I_
rotary/ceramic - stationary, ° 15
BUNA -N elastomers. �<_ 4 ! I
• Temperature: ° ; EP05- -
104 °F (40 °C) continuous 3 10
i
140 °F (60 °C) intermittent. 2 EPO4 _ —
i i 1`
Safety and Buildings Division County
I V A m Wa Ave., P.O. Box 7082 e
seons�n 201 W. Was Madison, WI 53707 - 7082 Sanitary Permit tube (to be filled is by Co.)
Department of Commerce (608) 261 -6546
Sanitary Permit Appli atlo .. y , . _.� state PI Nu Iw
In accord with Comm 8321, Wis. Adm. code, personalitf, ..t ion gotr omvldb /�'
may be used for secondary Purposes Privacy Let , s 15.04(I)(m) Pr Addres ►f different than mailing address)
t
I. A lication Information - Please Print All Information i i -'
00
1
2Property 'a Name T" Parcel # Lot # Block #
�I s
D
a6 - - s�
a a �
ailing Address roperty [ovation
,,`` Z' i� A Vt C AA,t t Zip Code Phone Number IvL ' �`' Section
f (circle one) ✓ /i
IL of
Building
r Cpl 7i� T _ N; R E or W Yv ` ` 0
/ v
Type g (check all t apply) 3 Q�� ,
a ,k1 or 2 Family Dwelling - Number of ms Subdivision NM Number
❑ Public/Commercial - Describe " Use
0 State Owned - Des y i
Use D ST / 3 ❑citt of
III. Type of Permit: (Chick only one box on li . Comp le t✓ T W O
A New System 0 Replacement System reatment/Holdi Tank R laeem 1 ❑
eP Y adon to Exis System
!s• ❑Permit Renewal ❑Perm=Revision ❑Chan of jPit T e vious P Number and Date Issued
Before Expiration Plumber
IV. T ype of POWTS System: Check all that appl
on - Pressurized In-Ground 0 Mound > 24 in. of suitable so' ❑ Mo < 24 in. of suitabl it At -Grade ❑ i e Filter
/ / Co ' nstructed Wetland ❑ Pressurized In- Ground ❑ Holding k ❑ Peat Fi ❑ Aerobic n it ❑ 1
Recirculating Synthetic Media Filter ching Chamber Drip Line ❑ Gra -less Pi er la
V. Dis ers&VI'reatment Area Infor
Design Flow (gpd) Design Soil Applition Rate(gpds Dispersal Area Required (sf) Dis Pro ed System '
( I 1
�s
VI. Tank Info Capacity in Total Number Manufacturer S r Seel FOW p
Gallons Gallons of Units Con2K Constr Ass
New Existing
Tanks Tanks
septic or Hording Tank O6 �•' /o? / '
Aerobic Treatment Unit Nor
Dosing Clamber Fjo :,— /
VII. Responsibility Statement 1 , the u ersigned, assume responsibility for installation of the POW IS shown on attached plans.
Plumber's Name (Print) tO tuber' Si tare r �P�PRS Number usiness Phone Number
3%5 _ 6
Plumber's Address (Street, City, State, Code)
U- �6a
VIII oun /De artment Use Onl
Sanitary Permit F includes Groundwater Date sue uin A en ature m
Approved 13 Disapproved �' P 8 s )
❑ caner Given Reason
g ( P L
Swrcharge Fee) � I O
on or Denial t
rov easons for isappro L S �
1 Septic tan , e uen i ter and,�s
dispersal cell must alt be service m ainfa d
as per management plan provided by plumber.
2. All setback requirements must be maintained S� lgyu °�2P�
as per applicable code /ordinancesakuM....� v
A
1.
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Per u l-Ily
s 9s, s
1 3 Tn�
-Pt -I = lad ,
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S-21 — 7__ -7 - 7
CLEAR LAKE,
%, ''•., w �`' VOL 17 PAGE 4614
SURVti I b Z REGIS�TR OF DEEDS
' ST. CROIX CO. MI
C E R T I F I E D S U R V E Y M A P RECEIVED FOR 1ECORD
09/18/2003 01:30P
Located in part of the Northeast Quarter of the Northwest Quarter, part of the CERTIFIED SURVEY HAP
Southeast Quarter of the Northwest Quarter, part of the Northwest Quater of the REC FEE: 13.00
Northeast Quarter and part of the Southwest Quarter of the Northeast Quarter, all COPY FEE: 3.00
in Section 25, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, RAMlin. 2
Prepared for and at the request of: IFrEM
OWNER. Section Corner Monument
John Oldenburg $ of Record UNPLATTED_LANDS
New Rich mond, WI 54017
1445 1 Ave. 0 Set 1" x 24" Iron Pi weighing
g
Richmond, foot
Drafted by. Howard H. Herrild III 1,13 pounds per line NORTHEAST CORNER
O Found 1 Iron Pipe SEC. `25 -30 -18
NORTHWEST CORNER NORTH 1/4 CORNER lioo.ov Top of Pipe Elevation (FOUND ALUMINUM
SEC. 25 -30 -18 SEC. 25 -30 -18 R- N89'06'W COUNTY MONUMENT)
(FOUND ALUMINUM (FOUND ALUMINUM S 89'50'59" E 2651.87'
OUNTY MONUMENT) COUNTY MONUMENT) -_-
" �� NOR TH LINE OF THE NE 1/4
230.56'
S 89_55 O1 E 2597.92 S 805
9'59" E —
� — ..— .. —.. —. D 2 6. — - � —..
LOT 2 V 40RTH LINE OF : _ S 8950'59" E -'
�'� S 89'50 59 E
THE NW 1/4 C ✓ 2164.8 '
�e �'��' H 256.79' I<
TOTAL AREA- N 1 .�. v Ip
90,305 SQ. FT. �o /' G 10.
2.07 ACRES IF I �
I " 1 . ' 1oa7•''
AREA EX. R.O.W.: �/ Ap
84,860 SO. FT. a ^ h
1.95 ACRES Q �pt1"' ? B /.� APPROVED w b p
sr, clzoix COUNTY , U1 r+
Plannim 7n -li � i P ;rks COm , �* H
140 N- A.AN-UE y, '/ S E P 18 2003
�.
- c,�'" I N 85 35'28'�E 398.94 A
t cold it d witnin 30 days of
w 90.68 •... 3
145.28 162.98 I r al d pproval shall 1, V
Ic 156.98 16TO27 � a �; E �, ' null and void — —
�� 77. 0' TOTAL AREA: —
I i`C �•
I� X8535'2 � �,. \ •' 1,266,043 SQ. FT. PLIBZA�
L n
p n�.......... .�..� i���RIVEWAY I 29.06 ACRES �1Z2L.,� IC
lr G - �p O \ v' \ EASEMENT I AREA EX. R.o�IV.. j'� LIB!^ar- SB IV
t i p N •� r� (� TAIL 1 28.14 ACRE,S " . • .. • S 88'59 10
,200.01' • I
c ti' 996.33•,'
;0 Z w SHED cn i Icn
°' w C 1y
C -4
oD � N � POND
"'�0 986.10' a � ; J rcl
Ga Q -��00 M ; I ORDINARY HIGH WATER t m
ran \ 0 S 89'47'27" E* 989.66 MARK 982.4' I /
t" O 162.43' \ CONFIRMED 11 -12 -02
Z Co 0 9 � \ z : I BY ST. CROIX COUNTY i /
m ZONING DEPARTMENT 14
I A A 'o I — /
C6 P
Mv, 00
997.33 N E 1 4 OF THE NW 1/4 NW�4.OF TH NE
— .SE 1 4 OF THE NW 1 /4 SW 1/4 OF 711 NE . — .. — • . — • . — ' `b ' _No 1N
/j-•• T — •/4 .1W . —.
200 0 N 8752'52" W 1290.01'
R =N89'06'W 1 1.46
GRAPHIC SCALE UNPLATTED - LANDS 1 '
SCALE IN FEET: 1 inch - 200 feet I CURVE TABLE
CURVE1 RADIUS A CHORD I CHORD BEARING I CENTRAL ANGLE1 TANGENT BEARINGS
A -B 275.00' 291.17' 277.76' N55'1531 "E 60'39'54" N85'35'28 E N2455'34'E
C -D 150.00' 173.02' 163.58' N57 "E 66'05'16" N2455'34E S88'59'1 0 "E
JOB #0057SU98 E -F 308.00' 326.11' 311.09' N55'15'31 "E 60 N85'35'28E N2455'34 "E
Prepared by. G -H 117.00' 134.95' 127.60' N57'58'12 'E 66 N24 "E S88'59'10 "E
E O Consult Grou Inc. BEARINGS ARE REFERENCED TO THE NORTH UNE OF THE
i
NE 1/4 OF SECTION 25, TOWNSHIP 30 N., RANGE 18 W.
Phone No. (715) 246 -4319 WHICH IS ASSUMED TO BEAR S89'50'59 "E.
lax No. (715) 246 -3830 NOTE: The parcels shown on this map are subject to State. County and
7. Box 3
Township laws, rules and regulations (i.e. wetlands, minimum lot size, access
Richmond. WI 54017 to , etc.
arcel
1 of 2 p ) . Before purchasing or developing any parcel, contact the St.
Croix County Zoning Office and the appropriate Town Board for advice.
Vol. 17 Page 4614
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner - Septic Tank Capacity J :4& a l ❑ NA
Permit # Septic Tank Manufacturer (�,� ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms q ❑ NA Effluent Filter Model _ C ❑ NA
Number of Public Facility Units NA Pump Tank Capacity C) 0 a l ❑ NA
a
Estimated flow (average) nalidav Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) ej C-) g al/day Pump Manufacturer ❑ NA
Soil Application Rate al /day /ft2 Pump Model ��) ❑ NA
Standard Influent /Effluent Quality Monthly average` Pretreatment Unit
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 in- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510` u /100ml ❑ 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
❑ month(s) (Maximum 3 years) 13 NA
Inspect condition of tanks) At least once every: ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ year(s) (Maximum 3 years) E3 NA
Clean effluent filter �('� ��� At least once every: ❑ month(s) ❑ NA
• ❑ month(s) ❑ NA
Inspect pump, pump controls & alarm At least once every: 13 year(s)
❑ month(s) ❑ NA
Flush laterals and pressure test At least once every: ❑ year(s)
Other: ❑ month(s) ❑ NA
At least once every: ❑ 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.
.. . .._ I -. I I - -- __ -'- __.._,_ ___ :.a wi ....,,.,.e M tho "nlr unlume_ the entire
Page Z of 2
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 system:
• 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.
T
alua ' o ing lank
b e ai 0 ?R0418 TI'E'D, fb2.- A1&%/ 40 STR(JC-71 p
❑ 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
E e Name
e /� ^ Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
E me Name s^r ( d 20d /ne Phone - 7/f_ — 3W
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address 9 1 U 61
Property Address 3
(Verification required from Planning Department for new construction)
City /State tj Ro' C�� j �J _ parcel Identification Number Wtic&4
Cd r az &- ]
LEGAL DESCRIPTION / a7a -0-
Property Location n
P rtY %.,' /., Sec. °� 5 , T 3t �1 -R, Town of tiV�.cY
Subdivision Lot #
Certified Survey Map # -7 VO V(O Volume / , Page # (o l
Warranty Deed # 7� / Volume S U Page #_.
Spec house ❑ yes f � no Lot lines identifiable 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 licensed pumper that the on -site wastewater disposal
. P�Pe �g 1 () sal system
dtspo ys
is in proper operating condition and/or (2) fter inspection ) ursp on and in if necessary), septic tank is less than 1/3 full o
PAP g ( az'Y)� P f 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 expiration date.
t jv�4 f, W v —x= l /J
SIGN TURF OF APP ANT DATE
I
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 above, by virtue of a warranty deed recorded in Register of Deeds Office.
/ 1 6 /0_?
S NATURE OF A ICANT DATE
* * * * ** Any information that is mis -re resented may result in the sanitary P Y 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
DODGE
CLEAR LAKE, • • 43�� 7 IQ14 6 1
•'•.,• vJl .; VOL 17 PAGE 4614
SURVti� f o --'zr _ REGIS�T OF DEE
nnrnnmpmu�a ST. CROIX CO WI
MI
CERTIFIED SURVEY MAP RECEIVED FOR K ECORD
09/18/2003 01:30P
Located in part of the Northeast Quarter of the Northwes uarter, part of the CERTIFIED SURVEY !!AP
Southeast Quarter of the Nort o e Northwes Quater of the REC FEE: 13.00
Northeast Quarter and part of the Southwest Quarter of the Northeast Quarter, all COPY FEE: 3.00
in Section 25, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, }lAMPin. 2
Prepared for and at the request of: LEQENQ
OWNER:
John Oldenbur Section Comer Monument
g
1445 140th Ave. of Record UNPLATTED_LANDS
Set 1 x 24 „ Iron Pipe foot e weighing
New Richmond. WI 54017 � 1,13 pounds per line g
Drafted by. Howard H. Herrfld 111 NORTHEAST CORNER
O Found 1” Iron Pipe SEC. "25 -30 -18
NORTHWEST CORNER SORB //4 CORN 100.00 Top of Pipe Elevation (FOUND ALUMINUM
(FOUND ALUMINUM (FOUND ALUMINUM R= N89'06'W COUNTY MONUMENT)
COUNTY MONUMENT) COUNTY MONUMENT) S 89'50'59" E 2651.87'
NOR TH LINE OF THE NE 1/4
S 89_55'01" E—�r 2597.92' S 8 9'5 0'5 9" E
`I — — 0.56' p 256.45
LOT 2 - — = S E -'
ORTH LINE — OF 23 89'50'59"
i. S 89'50 59 E ✓ 2164.8
TOTAL AREA THE NW 1/4 I P C ��'/ •' H 256.79' 1< ,n
90,305 SQ. FT. x r + N 1'00' �r im
2.07 ACRES a o /e► G 10. I�
� Aar war I
AREA EX. R.O.W.• �' cw .
84,860 SQ. Fr. �p, �°" .^ �^�'�,y :'• APPROVED (u ,
B 1-0 � Ir
1.95 ACRES P� 01 � %"' /.�
ty ST. CROiX COUNTY uwi Po IO
F 2 P(annim 7n�i— —I Pnrks Com + m I
I
i _AN�F y ,� S E F 1 g 2003 0,
QTR-!
14 i
_ _ �-
La I_ N 85'35'28'�E 398.94 A app y V
t t corn itnin 30 days s of
4
w 16 2 9 8' I 90.68 r a id d royal shall be
w ` 15. _ _
_ o
�167.02C �`( E o. �. TOTAL AREA nuu "nd Vold d
In 156.98' s N 77. 0' — — —
� 1 �'c,. �\ .IOINT •� 1,266,043 SQ. F7. PrIBI Df__
I< •� RI wA 29.06 ACRES — k!2 ,644 Ic
I c�r
........ \��' T I AREA EX. R.O1N_. �dlaE�� �-0
(SEE SHEET 2 1,225,570 SQ. FF.'
tAI� t'. FOR DETAIL)I 28.14 ACRES' S 88'59 10 E i-
`fl L 'rn Z / X200.01' • I
I
i0 tom*\ 996.33 ,{ v
I � CT'J i 1 I r
t ¢\ �• y r ,
I�i t3t 7 " HOU �Z
A Z SHED o 0
w c
°4 ta v 11 / POND
r
w4 1 N tf p // 1 Ww
m t rn 988.10 I D
M 00 ��O j ORDINARY HIGH WATER / m
' m < 0 S 89'47'27" E 989.66 r� MARK 982.4' '
1� \ O 162.43 CONFIRMED 11 -12 -02
b� ,p 9,Q = j BY ST. CROIX COUNTY
Im v \ < �. I rrn ; / I ZONING DEPARTMENT v
TO
K� $° 92 /
ITO
pir C+ 0
KfA
0 0 0
to . 100
0
997.33 — — -� NE - 1 4 OF THE NW_ 1/4 NW�4 THE NE 1 4
NE 1 �4 — — — — — — N O
a" 1/4 OF TH TH
200 I 00 N 89'52'52" W 1290.01'
R— N89`06'W 1 001.46
GRAPHIC SCALE UNPLATTED_LANDS 1'
SCALE IN FEET: 1 inch = 200 feet I CURVE TABLE
CURVE I RADIUS ARC I CHORD I CHORD BEARING I CENTRAL ANGLE TANGENT BEARINGS
A —B 275.00" 291.17' 277.76' N55'15'31 "E 60 N8535'28E N24'55'34 "E
C —D 150.00' 173.02' 163.58' N57'58'12 "E 66 N24'55'34 "E 588'59'10 'E
JOB #WI057SU98 E —F 308.00' 326.11' 311.09' N55'15'31 "E 60'39'54" N85'35'28 "E N2455'34'E
Prepared by G —H 117.00' 134.95' 127.60' N57'58'12 "E 66 N24 88
34 E S "E
J EO Consuffing Grou inc. BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE
NE 1/4 OF SECTION 25, TOWNSHIP 30 N., RANGE 18 W.
Phone No. (715) 246 -4319 WHICH IS ASSUMED TO BEAR S89'50'59 "E.
Fax No. (715) 246 -3830 NOTE: The parcels shown on this map are subject to State, County and
P.O. Box 325 Township laws, rules and regulations (i.e. wetlands, minimum lot size, access
New Richmond, WI 54017 to , etc.
arcel
Sheet 1 of 2 p ) . Before purchasing or developing any parcel, contact the St.
Croix County Zoning Office and the appropriate Town Board for advice.
Vol. 17 Page 4614
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This Made this.. �+ _3« » ... ». day of ..._ .........August A. D., 19n...62
Indenture .............. __ ,
between, » Charl.� Ha- �ta?> s. en__s 3ns� ...�Iun_�x_anaes...Hc►r�sen. h.1.s...i.£+K......._.. -.....» ... ................. ............ ..
` • John._ A.••» O1dgr�Uur, �• t�n�,« �irl�! �... G. �.. O�.clgltj�u�Sa..�'1;.�.b...Wif. -- -•• -•, part..�.IRS...__.__.. of the first part, and
g . - ..... .._Y ............................ --------- . _._.._- ._..... _
_» ........-. ....... _ .......... » ..» ..--- ............................ » ...........................
. ............................ _ ........ __ part i e s
_. - ...___...... o f the second part.
Witneeeeth, That the said part--_1- E..S_• of the first part, for and in consideration of the sum of. ... '- ... ' r' 1 n e y F i v C
_--_--.-.-.----_-.-.:-r.-.-----.-.---_-.- ...... ........
----.---.-----1-.----.--_--_-.-_-.--.---
t _ . »» in hand paid by the said part. .... i U._..__ of the second part, the receipt whereof is hereby confessed and acknowledged,
given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by time presents do.- ......... _..... give, grant,
bargain, sell, remise, release, alien, convey and confirm unto the said part ... I.C ... ^ . th
. -- of the second part, .._._eir heirs and assigns
forever the following described real estate situated in the County of ... ..........:.: ...... 1 .?: ..._..- ....._..._...- ........_. and State of Wisconsin, to -wit:
Part O! `•Ic -t `'One -hal of n ^rt Of
Zast one- 'i, --, If of
�- •_c`io:: ant ,.1 -
(25), TO'::r:! Thirty " 1 1,
as follow,: , ihPa
Cemaenc1n;; nt north gj;irter ' =ner if 7 ,-, 1 ,4 Soc_tion Tcnty -fi
(25 ); thcnce ''ort}? 9 n .r ;t n 1 ;r; n ?it'1 I n;_ of ti 1 `'ectinr.,
60? fce-t; r�,'. I1C�' f;out'1 west, l.,rl r `i . ri ♦ �, .0 -• -1 �;n.::,nG� �i
C",st, l ?C' .cCt1 t11 ::1cc mil t' L; 1 j � t
- -. i1�rt�1 1;
of s,aic'. r:e ti;n; ,":._ nort'1 L on ,. <id north line G i
feat to 01,1;,e Of inuin Subject to cl�cnEnt fcr cattle
p1s �;e One thQ nort,n 1i:kt of vliic;
south of t21r northeast cornor of n'.Ove dcscri''e:' tv Ict rn a 2>:ten<15
hest 100 'Cet r:Ore .Dr lc: to :;hors of si,,,111 laic
with all ibd singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all estate
j tr,iu ; interest, claim of demand whatsoever, of the said part. .... ies....... of the first part, either in law or equity, either in possession or
etpettincy of in and to th #above bargained premises, and their hereditaments and appurtenances.
To have and to hold the said premises as above described with the hereditaments and appurtenances, unto the said part_wA &._-__
of the second part, and .._.._ heirs and assigns FOREVER.
And
the Bald C n <a r 1 e:: ' 1. 1_ n e r 1 1 1
r .
r r 1 1,1. •ifc
I,
._..... ............................. ._ ...................... ........................... - ....................... _ .... _ .... _ .............................................................
... _........... .....................................
for .... ��: p�, 1th.S -a�?, r•- -,__... heirs, executors and administrators, do ....... _........... covenant, grant, bargain, and agree to and
i
' with the said art___ - -_ 19e5...... of the second part ..................... _ `i 9_4 __- -heirs and assigns, that at the time of the ensealing and delivery of ;
these presents._. ? e - _ a Y well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of
Inheritance in the law, in fee simple, and that the same are free and clear from all incumbrances whatever ... d - -no exceptions
....................._ .... _ ...................... - .......... ............... _ ................. _-- ................... --... -- -............. - ..... ............. -
................. --...--.-
.._.. . ............................ -.-..... .................... .... ---_-- ... ............................. -..................... ............................. _ ..........
.-- ......
_ ................_.__._....-.._...._...-...._....-_........-....__........_..----.. .- ......- .........- .-- ... -.. -.. .................... _ .... _...... ------.. - ...•-----
- ° - --- .......
................... .................... .......... - ............. ........ __._ ..... _ ...... « .. ...... . .._ ..... _.._ .. . .. .... ... ....... ... ... ......... •. .......
......................... - .... _............... -- -•-- ----° - ..
and that the above bargained premises in the quiet and peaceable possession of the said part --- ....... of the second part, - - -___ 1C .':?;._ heirs • _
and assigns, against all and every person of persons lawfully claiming the whole or any part thereof ,- .._- _-- ._...... t ........... ... .....- will forever
WARRANT AND DEFEND.
In Witness Whereof, the said part .... Les ..._.._._. of the first part ha . .... - G... - .. - -_... hereunto set ..... , ak_ir ....... hand_..: ................ and
thirt first 1u . u t � 2
seal S..- ._....._. this. __....._ «. Y._......... . day of. ... ..... __.._.: ._.. a_..... - -.. ... ........ I A. D., 19 -------
s .... . ..- -- _.... /...!..... .. ............ ..- .(SEAL)
SIGNED TD IN SENCE OF ch n r , :
— V _.._ .__._.-...__... «_.._........•__
_.. A
i
Pa 0. Swenb j
une 17T.L ......._...._.....» __._ (SEAL)
Nanc C Olson
........ __.. ........ _ ....................................... ................. ..... (SEAL) I
STATE OF WISCONSIN
�I
-
St
-• -.GrA l x _.. s. i I
- ». - -.—••
Personally came before me, tbis.L..�11 �' 3' . •19 .�.:. .A•T - ....:......... A. D:, 19.._ 62
daF o�
the above named 11SP11 ,
}3._. R't+nc Ij 1ris.6ti _h 7 s:...w .
«.
• .....». .__.. »... _ .....
...«......»..» ..._ «. •. ............ .....................................
to be the penon:_ who executed !the foregoing fnstrumetitt ind knoei the a
t0 m! IrrlOwn .S
Received for Record this»- » »_. -�.},. „ day of �S�
Member
too
Register of Deeds Nogr�r. RnblIc...!,t_ .. ».. »... Connty, Wis. I
4 ». »» ...........» _ . ».._ Deputy Register o(0erds, M 1 �. , i,s{asIon estpi "--Q -9 Wb=- ..3.1 ---- — - , A D, 19_6L
�t
F
This matttmenc was drafted by Paul 0. Swd . ReelQ`1
on$ n
�'�'N Wiaeoada Lasat 1sLa1t Osasa>•r�► _
WAARAlIT! 1fA � nt4aa, �Ita00aatf 14000
CERTIFIED SURVEY MAP
Located in part of the Northeast Quarter of the Northwest Quarter, part of the
Southeast Quarter of the Northwest Quarter, part of the Northwest Quater of the
Northeast Quarter and part of the Southwest Quarter of the Northeast Quarter, all
in Section 25, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin.
DETAIL I
JOINT DRIVEWAY EASEMENT � l l ay
loo 0 100 BETWEEN LOT 2 AND LOT 3 / I .0. � I
GRAPHIC SCALE Z9g/ . I�
SCALE IN FEET: 1 inch = 100 feet k 3 A i /
L4
SCALE I I
N
o / ion
.�.'ld 't• eh / z
�� '• ,•{Q S 03'35'51' E 124.30' A.
CCODGE
9
rri
SURVEYOR'S CERTIFICATE:
I, Ty R. Dodge, a Registered Wisconsin Land Surveyor, do hereby certify that by the direction of John Oldenburg,
I have surveyed, divided and mapped Y � pp a parcel of land located in part of the Northeast Quarter of the Northwest
Quarter, part of the Southeast Quarter of the Northwest Quarter, part of the Northwest Quarter of the Northeast
Quarter and
Q part of the Southwest Quarter of the Northeast uarter all in Section 25 Township ownshi 30 North, orth, Range
18 West, Town of Richmond, St. Croix County, Wisconsin, described as follows:
Commencing at the North Quarter corner of said Section 25; thence, on an assumed bearing along the north line
of the Northeast Quarter of said Section 25, South 89 degrees 50 minutes 59 seconds East a distance of 230.56
feet to the point of beginning; thence South 89 degrees 50 minutes 59 seconds East a distance of 256.45 feet to the
west line of Lot I of a Certified Survey Map recorded In Volume 15 Page 4031 in the St. Croix County Register
of Deeds Office; thence, along last said west line, South 00 degrees 33 minutes 59 seconds West a distance of
589.27 feet to the south line of Parcel 2 recorded in Volume 1644 Page 562 in the St. Croix County Re gister ister of
Deeds Office; thence, along last said south line, South 88 degrees 59 minutes 10 seconds East a distance of
200.01 feet; thence South 00 degrees 33 minutes 59 seconds West a distance of 760.71 feet; thence North 89
degrees 52 minutes 52 seconds West a distance of 1290.01 feet; thence North 00 degrees 33 minutes 59 seconds
East a distance of 907.80 feet to the centerline of 140` Avenue; thence, along last said centerline, North 85
degrees 35 minutes 28 seconds East a distance of 398.94 feet; thence, along the arc of a curve concave to the
northwest 291.17 feet, said curve has a central angle of 60 degrees 39 minutes 54 seconds and a chord that bears
North 55 degrees 15 minutes 31 seconds,Eastil,a distance of 277.76 feet; thence North 24 degrees 55 minutes 34
seconds East a distance of 173.42 feet; t hence, '$long the arc of a curve concave to the southeast 173.02 feet, said
curve has a central angle of 66 degrees 05 minutes 16 seconds and a chord that bears North 57 degrees 58 minutes
12 seconds East a distance of 163.58 feet; thence North 01 degree 00 minutes 50 seconds East a distance of 10.72
feet to the point of beginning. Containing 1,356,348 square feet (31.14 acres). Subject to 140 Avenue (A Town
Road) along the northerly line of the above described property. Also subject to all easements, restrictions, and
covenants of record.
i
I also certify that this map is a correct tepress"maticxf to scale of the exterior boundaries surveyed and described,
that I have complied with the provisions of Chapter 236.34 of the Wisconsin State Statutes and the Subdivision
Ordinance of the County of St. Croix and the Town of Richmond in surveying and mapping the same.
Ip Z-\ - aZ
T R Dodge — Registered Wisconsin Land Surveyor No. 2484 Date
JEO Consulting Group, Inc.
P.O. Box 325
New Richmond, WI 54017
Sheet 2 of 2
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