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026-1073-40-200
Wisconsin D4partment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 399609 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: RJC Development I Richmond Township 026- 1073 -40 -200 CST BM Elev: Insp. BM Elev: B Description: tOD I l t l Vc4c ' o — a TANK INFORMATION tLEVATIbN DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark � L-'V 5 (5L d • o 10 • t) c� Dosing Alt. BM ( ✓ots�c. Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet - 7- s TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet (3, ( a' , p Septic / Dt Bottom U O ®/ >� 1(.61++ 5"7 GYZ -to Dosing J Header /M n. 5 (,Z C1 s Qo � l Aeration DitPipe — I � 5 0 N 4 Holding Bot. System ( '� Z It,. ^L3 PUMP /SIPHON INFORMATION Final Grade *3. W 17-3 Manufacturer Demand St Cov G-T i L pj GPM rI Model Number l �1 W�'O3llL V TDH Lift I Friction Loss System H ad TDH� Ft Forcemain t Len th Dia. Z �, Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 f� SETBACK SYSTEM TO _ 1 P/L BLDG WELL LAKE/STREAM LEACHING anufa INFORMATION e I CHAMBER OR 14 ru T 1 YP Of Y stem: ' O J �/ l / UNIT Model Number. DISTRIBUTION SYSTE V M o p � 3 Header /Manifold Distribution x Hole Size x Hole Spacing ent o A Intake (1 Pipe(s) f Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only De er /� Depth Over xx Depth of xx Seeded/Sodded xx Mulched d/Tren h Center / 1, / Bed/Trench Edges Topsoil [in] Yes � No n Yes ® No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: // Inspection #2: Location: 1324144th St New `Riich,�m,�on 1 J 54017 (NW 1/4 SW 1/4 25 T30N R18W) Richmond Hills Parcel No: 25.30.18.38520 1.) Alt BM Description =bar �-""" d( - "i KI w < < i1J� L'-5 R U c3 c�i � — 2.) Bldg sewer length vw Sala- OCAJ74- - Imo- 0 nYl� J°ua1 z'CL dAI --}o 10' - �ocdt ZcJ� = I � =/ - amount of cover = J /� Q Plan revision Required? [� Yes o �T'lilL�1.� 1 Use other side for additional information. (% SBD -6710 (R.3197) Date Insepctoes Signature Cart. No. I i Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all i Reviewed by Date�r�/�� Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Prope Owner Property Location t 1/4 J 114 T N R (orN Property Owners Mailing Address 0t # Block Subd. dame or CSM# 7 ' - c Cit State Zip Code Pho a Num 1 2 Ci Village ^ Town Neare oaf - ( ) AO New Construction Use: 12 Residential / Numb o of hsi2 Co a derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: 12 Pit # ❑ Boring Pit Ground surface elev. 97S-S ft. Depth to limiting factor } _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 Q 9 S L, , c� �? - / - S 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 Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 * Effl nt #1 = BOD > 30 < 220 mg /L and TSS >30 _< 150 mg /L * ffluent # - BOD < 30 mg /L and TSS < 30 mg /L CST Nam (P ase P ' t) Signatur CST Number Addre s e valuation onducted Telephone Number SBD -8330 (R07 /00) Property Owner Parcel ID # Page of F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # ❑ Boring El 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 /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ' Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) l __ 7e� A -T-6w ' u�w 0 n� �,r Q N 5 /- '- �s -yd6 r J i L y _ f i 7�� �, �,�J.� /� >,,, =,�/ ��c'_ �J% - _54ti� /� - see .��- 7:3or✓ - �f� /8� I _ 7�ie�/r�a>✓o yuz X e u�w` 0 n� I 18 io 3'.31a S �5 -ylJb 51 � G� �,�,' S l - 7 �- /`/•cam? � � � �• � �� G i I \ I X07/ /4400 K _ r- - -- - --- N00'25'35 "E 140TH SrR / RICNT - OF- WAY -- -. -- _ — — — -- — — _ \ - - - -- - - - -- N00 *25'3` N00'25'35 "E V 1465.56' w °i i CENTER /NE 140N ST, l Y _ _ j N00'23'52 "1 Rich T- oF- wA Y — I I , \ I - -- - - - - - - - - - - - 359 Oi' ----- » - Z - - - 652 I, 00 (A z -N -� C —� Q� _.... v ...... . . . . D 0 = !� iC p N) o O a 168 Z v O Ul o \n a t il l I -p I r I � I .a�ti� oz I 1 • tl V Z N00 25 35 E ( - -- - - - - -- 291 -- — - -- .o� 4� \ - 162.27' 129,31 9 2 1 1 o p y I I , y I ) / 0 Q0 t t C . - _ - - — - - - 126.08' S00'05'55 "W 290,71' I • 126.06" 00 (O 2 Oo ' LA CT1 ONO O ^� a 01 o > CC n tiul r ," / I r jz Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 *i5consin Madison, WI 53707 - 7162 Site Address 5'f De artment of Commerce qf� 132`f Sanitary Permit Application S Pernik Number 3c06 In accord with Comm 83.21, Wis, Adm. Code, personal information you provide ❑ Check if Revision may be used for soconcluy purposes Privacy Law, sl5. l m I, Application Information - Please Print All Information State Plan I.D. Number r ' x Property Owner's Name Parcel Number 2Ej1_ ?;� a I-Ed-1 - /2) Property Owner's Mailing Addresf Property Location bf 'A, ; T N. R E_ City, Swtc Gip Code Pho Lot Number Block Number Subdivision Name CSM Number �fJia�e� _ Ll. Type of Building (check all that apply) ^~ Dory I or 2 Family Dwelling - Number of Bedrooms ` _ NQ Y —�—� {-- ❑village O Public /Conunercial - Describe Use Gus �' S - r ST QRnt, OIownshi El State Owned f rS Zt)tV1pFp� Nearest Ron 3 x 93-;K c III. Type of Permit: (Check only one box on line A (numbering ,.) Complete line B if applicable) A. 1 .0 New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addison or County use 7T S stem Taak Ord Exis S stem B. ❑ Check if Sanitary Permit Previously issued Permit Number Date Issued IV, Type of Permit; (Check all that apply) (numbering scheme is for internal use})E - 1 - 44 23 Non - Pressurized In - Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 C3 At -Grade 46 O Aerobic Treatment nit 49 ❑ Recircula g 30 ❑ Other V. DispersaUTreatment Area Information: Design now (gpd) Dispersal Area Dispersal Area Soil Applrcauon Percolation Rate System Elevation Final Gradc Required Proposed Ra te(Gals. /Days /Sq.F(.) (Min./Inch) �/ Elevation /�X 9 A/Z1 — / Vi - Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing , Tanks Tanks Septic or Holding Tank Dosing Chamber VII. Responsibility Statement I, the undersigned, asjrume respoasibl4ty for installation of the POWTS shown on the attached plans. Plumber ame (Print) Plumber's Si r MP/MPRS Number Business Phone Number s — Pl is Address (Street, City, S m, Zip Code) VIII, Count /De artment Use Onl X - Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) CID El Owner Given Initial Adverse ¢t- ZZS f Y0D O _ _ U �cU . Conditioru of Approval /Re worts for D 04 r4c,l seA s die. a�aa;� 'ctttc c / Attach comp c ouaty only) or the oo paper not tan than 81r1 x 11 tacha to sue SBD -6398 (R. 05/01) Safcty and buildings Division County 201 W. Washington Ave., P.O. Box 7162 I visconsin Madison, W1 53707 - 7162 Site Addreu �— Sf' De artment of Commerce # 1 321f — i Sanitary Permit Application S,N 3°j°1'6t� r In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary purposes Privacy Law, s15, 1 m I. Application Information - Please Print All Information State Plan I.D. Number i Property Owner's Name Parcel Number Property Owner's Mailing Addresf Property Locadon T N. R City, State Zip CWC Pho t Number Block Number ;'- Subdivision Name CSM Number s.� U. 'Type of Building (check all that apply) ❑City 00 1 or 2 Family Dwelling - Number of Bedrooms ❑ Public /Conuncrcial - Dc Use Al — w — S w•� ST (;fnx f i �T �e'ts ,owtuhip _ ❑ State Owned Otx�TY Neamst Road z / X 93-aS r O OFF�CE M. Type of Permit: (Check only one box on line A (numbering ;rose) /Complete line B !f applicable) A. I JZ New 2 ❑ Replacemment System 3 ❑ Replacement of 6 ❑ Addison or County use System Tank Orily Existing System B. ❑ Cbeck if Sanitary Permit Previously Lssued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(ntlmbering scheme is for internal use} —fdO 44 23 Non - Pressurized In Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Consuucad Weiland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment nit 49 ❑ Recircula g 30 ❑ Other V. DispersaVTreat ment Area Information: ` Design now (gpd) Dispersal Area Dispersal Arca Soil Application Percolation Rate System Elevation Final Gndc Required Proposed Ratc(Gals. /Days /Sq.F(.) (Min./loch) �/ Elevation / i Vf. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing i Tanks Tanks Septic or Holding Tank Dosing Ctumber VII. Responsib(li Statement- I, the undersigned, &V=e responsibl4ly for installation of the POWTS shown on the attached plans. Plumber's ame (Print) Plumber's Si MP/MPRS Number Business Pbone Number PlUmbe r s Address (Street, City, S te, Zip Code) VIII, County /De artmen Use Onl K Approvcd ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Sumps) Surcharge Fee) CID E) Owner Given Initial Adverse __ _ _ D ct cr minat wn 22S ' �Z OI IX. Conditions of Approval /Reasoms for Disapproval 7 Attach tromp c ount7 odr) or the oa papa oat tun than Un x 11 caches In AMC SBD -6398 (R. 05/01) 1 01- T r gew A, Ek-� //B oa��faPck �U� y 3 q � I ti 11 �- 3X y3y i Il G ref ti G I r - -- �?s' s Wisconsin Department of Industry SOIL AND SITE E V A L U O 111 � R` APORT Page 1 of 3 ha�-or and-Hu man Relations Division of Safety & Buildings in accord with ILHR 8 5;1iis. Adm. Pode • ��� COUNTY St. Croix 'I Attach complete site plan on paper not less than S 1/2 x 11 inches in Oize.;'Pla must me u de" taut PARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction aqd oQ of s6o; scale or dimensioned, north arrow, and location and distance to nearest road pending �T Off; [RVIEWED BY DAT APPLICANT INFORMATION— PLEASE PRINT ALL INFORMAVON zO&Nry ( o`I PROPERTY OWNER: �; ` .R ,PERTY L R J C Development, Inc. :Q_dv�?T `F. W 1 /4,S 25 T 30 N,R 18 k(or) W PROPERTY OWNERS MAILING ADDRESS LO r SUBD. NAME OR CSM # 1868 CTH. "C" 2 na csm CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE []TOWN NEAREST ROAD Somerset, WI. 54025 (715 247 -5721 Richmond 140th. sT. [ New Construction Use Residential / Number of bedrooms 4 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd /ft trench, gpd /ft Absorption area required 1200 bed, ft 1000 trench, ft Maximum design loading rate .5 bed, gpd /ft •6 trench, gpd /ft Recommended infiltration surface elevation(s) 95.20 ft (as referred to site plan benchmark) Additional design / site considerations alt. Area= 94.90' Parent material pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL I HOLDING TANK U = Unsuitable fors stem ®S ❑ U ® S El U ® S El U ®S ❑ U El S G a U ❑ S ICU � SOIL DESCRIPTION REPORT , Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Y 1 Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench .................. 1 0 -15 10yr3 /3 none 1 2msbk mfr cs if .5 .6 S' 2 15-37 10yr4 /4 none sil 2msbk mfr gw if .5 .6 S� Ground 3 37 -88 7.5yr4/6 none sl 2csbk mvfr na na .5 .6 •� elev. 99 . 2 ft. Depth to limiting factor RS Zo +88" Remarks: Boring # 1 0 -10 10yr3 /3 none sl 2msbk mfr gw if .5 .6 •S 2 2 10 -24 7.5yr4/4 none scl 2msbk mfr gw if .4 .5 `t 3 24 -84 7.5yr4/4 none sl 2msbk mvfr na na .5 .6 Ground elev. 9 8.6 ft. Depth to ' limiting factor +84" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 246 - 6200 Address: 1554 200th. Ave ew Richmond .WI 54017 Signature: �`/ , Date: 5 -4 -2000 CST Number: m02298 PROPERTYOWNER RJC Development, In c -SOIL DESCRIPTION REPORT Page 2 .:� _ PARCEL I.D. # pending Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerrh 0 -12 10yr3 /3 none sl mgr my r if .5 .6 .� X40 vi:.. 3 2 12 -42 7.5yr4/4 none s1 2msbk mvfr gw na .5 .6 Ground 3 42 -11 7.5yr4/6 none ms Osg mvfr na na .7 .8 elev. 10 ft. Depth to limiting factor 3 , 4 +11 0" i Remarks: Boring # 1 0 -9 10yr3 /3 none sl 2mgr mvfr gw if .5 .6 2 9 -40 7.5yr4/4 none is Osg mvfr gw na .7 .8 3 40 -60 7.5yr4/4 none sl 2msbk mvfr gw na .5 .6 Ground elev. 4 60 -90 7.5yr4/6 none ms Osg mvfr na na .7 .8 9 9.3 ft. Depth to limiting factor +90 Remarks: Boring # 1 0 -8 10yr3 /3 none s1 2msbk mfr gw if .5 .6 2 8 -20 7.5yr4/4 none sl 2msbk mfr gw na .5 �.6 3 20 -46 7.5yr4/4 none scl 2msbk mfr gw na .4 .5 Ground elev. 4 46 -60 7.5yr4/4 none sl 2msbk mvfr gw na .5 .6 98.9 ft. 5 60 -88 7.5yr4/6 none ms Osg ml na na .7 1.8 Depth to limiting factor + Remarks: Boring # Ground elev. ft. Depth to limiting factor I Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel RJC Development, Inc. 1554 200th Ave. CSTM2298 NW4SW4 S25- t30N -Rl8w New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #2 -csm N 1" =40' V BM.= top of 1" pvc pipe C el. 100.00' Alt. BM.= top of 1" pvc pipe @ el. 99.50' n�'' N 6 qO a o` o' t Gary L. Steel 5 -4 -2000 ' 1 -22 -1995 10 : OGPM FROM f P. 1 , h � I • ' ��'"� �t•In3��� .���5� STEELS SOIL SER VICE Gary L Steel RJC DevelopmWt, Inc. 1554 200th Ave. CSTM2298 NKSK S25- 00N -MW New Richmond; WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot *2 -can N 1" =40' BM.= top of 1" pvc pipe 9 el. 100.00' Alt. BM.= top of 1" pvc pipe @ el. 99.50' H N 6 qo • /7i vl� A 4 O( 0 1 016 � as a5 5' Gary L. Steel 5-4 -2000 PAGE of PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS V E NT CAP y VENT PIPE WE ATHERPR OO F APPROVED LOCKING _ JU NCTIOM OOX MANHOLE COVGR W ITM ? 2S' FROM DOOK, WA RNING LABEL WINDOW OR FRESH 12�MIU. AIR INTAKE GRADE I y " MIN. I CO►JDUIT -- ' la•nw. b� - -- - - - - -_ PROVIDE I - - - -- INLET _T AIRTIGHT SEAL I II) V I I APPROVED JOIN A I I APPROVED JOIQT W/ PIPE I III W/ ' PIPE EXTENDING 3' I 11 1 ALARM E7.TE1JDIIJG 3' OWTO SOLID SOIL. I II ONTO SOLID S01! D I I i I ON LLEV. FT. b PUMP -� - -� OFF 0 COAICKETE DLOCK RISER EXIT PERMITTED OWLy IF TANK MAUUFACTURCK HAS SUCH APPROVAL B" pPPAoVEa BEDCIn+G "ndcr Trti�K SEPTIC E SPECIFICATIOUS DOSE TAWKS MANUFACTURER: IJUMBER OF DOSES: - PER DAy TAW SIZE: GALLOUS DOSE VOLUME ALARM MANUFACTUR><R: N �e INCLUDING BACKFLOW: GALLONS MODEL QLIMISEK: �� ��� CAPACITIES: A IUCHESOlt SZ GALLOws SWITCH TYPE: ` B = - I ' CHES OR S GALLONS PUMP MAUUFACTURCK: S C = d 1s INCHES OR 1��- GALLOUS MODEL NUTABER: _ICJL - D- INCHES OR GALLONS SWITCH T`JPE: MOTE: PUMP AND ALARM ARE TO BE MIIJIMUM DISCHARGE RATE GpM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFEKENCE OETWEEIJ PUMP OFF AIJO DISTRIBUTION PIPE.. ,� FEET lt.'l + MIAJIMUM METWORK SUPPLY PRRE . . . . . . . FELT + FE ET OF FORCE MAIN X �c = /on r,.FKICTIO&l FACTOR. _ FEET TOTAL 091JAMIC. HEAD = 1 � FEET � - ,C.f e� - A IUTERUAL DIMEIJSIOUG, OF TAWK: LELIGrH - ,WIDT14 - -jLIQUID DEPTH SIGIJED :_ ' LICENSE NUM BER - 9;2 � 3 DATE: r _ (– l: l 1 V1 1 1 1x41 O.l: - .....� Curves Pump MMR$ FEET GO ;MODEL 38&5 25 80 — SIZE 1 /4 Solids WE15H 70 20 WE 10H O WE07H WE- H - 40 — 10 WEOJM - --'`� — —�-- - 1-- —r— :Z:t -�E I — 1� �' - — "-�' I WEOJI — _tom -r -� 0 0 0 10 20 90 40 50 60 70 60 50 100 110 120 GPM 0 1'0 4 CAPACITY �.,,�•��.�•T:- ►� „ 1 ,,Ify, .� .{ «- r,� , °`GOUIDti PUh1P5. INC. METER$ FEET 120 } _ — -- MODEL 3885 SIZE 1 �, Solid„ 9v c 110 WE15HH I— i - -� — 30 100 0 � WEOSHH 10 77 20 r.. 10 0 ,�H 0 10 20 00 40 50 lA 70 , w 1 W 1 10 1 ;'p GPM L L —..— 0 10 N 30 m'T CAPACITY •I WO Opoos Pvmps, Inc, E Jwry. I C)w POWTS OWNER'S MANUAL 8Z MANAGEMENT PLAN Page _ of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity a l ❑ N A Permit # Septic Tank Manufacturer ,�� s ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA, Effluent Filter Model ❑ NA Number of Commercial Units lid NA Pump Tank Capacity gal ❑ NA Estimated flow (average) gal /day Pump Tank Manufacturer x ❑ NA Design flow (peak), (Estimated x 1.5) gaf /day Pump Manufacturer s DNA. Soil Application Rate gal /day /ft' Pump Model ❑ NA, Influent/Effluent Quality Monthly average* Pretreatment Unit 9 NA. Fats, Oil 8t Grease (FOG) s30 g/L m ❑Sand /Grave{ Filter C3 Peat Filter :530 /L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) ❑ Disinfection ❑ Other: Total Susp Solids (TSS) :5150 mg /L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average ** Dispersal Cell(s) Biochemical Oxygen Demand (BODs) :530 mg /L XIn- ground (gravity) ❑ In- ground (pressurized) Total Suspended Solids (TSS) s30 mg/L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) _ <10' cfu /100ml ❑ Drip -line ❑ Other: Maximum Effluent Particle Size % inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency con dition of tank At least once eve El months U years) (Maximum 3 yrs. ) Inspect con on ( ) ev e r y Pump out contents of tank(s) When combined sludge and scum equals one -third ()i) of tank volume Inspect dispersal cell(s) At least once every ❑months 18`year(s) (Maximum 3 yrs. ) Clean effluent filter At least once every ❑ months ® year(s) Inspect pump, pump controls 8i.alarm At least once every El months ®year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) 1Z NA Other: At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Mast, Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank Inspectior. must include a visual inspection of the tank(s) to identify any missing or broken hardware, Identify any cracks or leaks, measure tt- al volume of combined sludge and scum and to check for any back up or ponding of effluent on the groun surface. The dispers 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 (Ys) 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 ch. NR 113, Wiscons Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other maintenance or monitoring at Intervals of 12 months or less 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. 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 chemic that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the content of the tank(s) removed by a sentage servicing opera prior to use 2 of System sure up shalt not occur when soil conditions art frown at the inflltndve surface. During power outages pump tanks may fill above normal hlghwater levels, When power Is ratored the excess wastewater will br 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 Sepup Servking Optrator. prior to restorint power to the effluent pump or contact a Plumber or POW75 MalnWner to assist In manually operating the pump controt, to restore ncrmal levels within the pump tank. Do not drive or park vehicles over unks and dispersal cells, Do not drive or park over, or otherwise diswrb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reductlon or elimination of the following from the wastewater steam may Improve the performance and prolong the life of the POWTS; antibiotics; baby wipes; clgarette butts; condoms; cotes swabs; degreasers; dental Ross; diapers; dlsln(ectanu; fat; foundation drain isump pump) water; ft and vegetable peelings; gasoAne; grease; herbicides; meat scraps; medication%; oil, paindnst products oesocides; sanitary napkins: tampons; and water softener brine, AUANDONEMENT When the POWTS Iails and /or Is permanently taken out of service the following steps shall be liken to Insure that the system is properly and safely abandoned In compliance with ch, Comm 83.33, Wisconsln Adminiatradve Coder • All piping to unks and pits shall be disconnvctvd and the abandoned pipe openinga sealed. • The contents of al( tanks and plu sh4(1 be removed and property disposed of by a Septage Servicing Operator, • Aner purnpinlg, all tanks and pltl shall be excavated and removed or thtlr covers removed and the void space (hied wltn soil, gravel or another Inert solid material. CONTINGENCY PLAN If the POWTS falls anti cannot be repaired the following measures have been, or must be liken, w provide a code compliant replacement system; A suitable replacement area has been evaluated and may be utilized for the location of a replacement soll absorption system. The replacement area should be proeected from disturbance and compaction and should not be infringed upon t requlred setbacks from existing and proposed strucwre, lot Imes and wells. Failure to protect the replacement area will result In the need for a new soil and site evalwgon to esubilsh a sultable replacement ana, Replacement systems rnust comply with the rules In effect at that time. O A suitable replacement are b not available due to setback and /or soil Ilmlutloru, barring advances In POWTS technology/ a holding link may be Installed as a law resort to replace the failed POWTS, 0 The sltt has not been evaluated to Identify a sultabie replacement area. Upon failure of the POWTS a soil and site evaluation must be performed w locate a suitable replacement area. If no replacement area Is available a holding Bank ma be Insulled as a last resort to replete the failed POWTS, C Mound and at-grade soil absorption systems may be reconstructed In place following removal of the biomat at the inflivaclve surface. Rrconstrvaioru 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 OK OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT, RESCUE OF A PERSON FROM TKE INTERJQR OF A TANK MAY St DIFFICULT OR IMPAWRI F. ADDITIONAL COMMENTS POWTS INSTALL ,911t POWTS MAINTAINER Name N am e e Phone _ �— S — r phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATO RY AUTHOR Name :: ./ Phnnr fhont i - — - SEMC TANK MAINMANCE AGRHEMENT AND OWNERSHIP CBRTWICAMON FORM OBaYer 1 A ddress / - ,Q�zz — ph P Mt»liug r' •��P °'��f�e,� Lv y Addm / 13 A q lye s �s� (ve�iticatiao twnt;rcd � �� City/Swe Pared Ides t iett Nutntxx L.R,GA�. DESCRIP QN PY+ogrrty Lacation „& 'f,, 'Y4, Sec.. - -. T2 N"R W, Town of i &zp _- sabtiiviaian rraon � # �. CerfifW Survey Map #— - _ _ _ (o � oltune , Page # Wm"aty Deed # 3, O �otttme , I Sa . ?age # Spec house P. yes 0 no Lot hoes idaaififiable yes 0 no S� A�_IA�I1'�N�1Y1� Improper use and maintcaea cof you septic syncm eovld m=K in as premaw a failare to handle wastes. Pwper+ e ooasisb cf peace Od dw aspic tuk every &w ymv w . if aeeded by s He asod Wbat y on pnu ia/o the system can affect me fi MdOn of the septic teak as a treatmaat stage in the route disposal system. The properly server agrees to anbmit to fit. Cmix 7Aa* Deparannnt a eanfcadon -fon4 sued by the owner and by s MSIq°p .joun&y►maa rdMttcd . msI* xamodpumpa.. vsrifymg jat (t)ffieas4ne madnmterdLVesaisystem is is proper gOmdW caadidm and/or (2) afteriaspeaim and pmq& g (i*f mommy). tine sgntic tads is lest Om 113 foil of dodge. Vwe. &c =Kkn*w d bane read dw abm seqwninsw and *Mme in maintak theprtvaw sewage diapasal system with the sundlIC s at hgd% bavin. as set by the Depaument of ComamtxCC tad the Dgm%a ni of Natud Ranmaeet. State of Wisconsin Cutifimtkoa daftag dw yore septic system bas bean maiataiaed mow be computed aid- retwnwd to the St. Cma Canig l Z+oa+ng Office within 30 days of the three 7can exp MUM date. "TMOFCANT DATE 4WM C'CRT�ICATXON I (we) cutify that alt staftniews an this form are tine W the bca of my (WO b'a. I (we) am (we) the o•act(s) of tone property descrAwdabove. by vi - of avvurmty deed in Register of Dee& OtScs_ WM OF lIPPUCANT DA�'h`gE ••••�• !►ay iedawnatiCa that ismis�mayasukiz3bc- saainr] pap t beWS aevoked -by4bc ?.owing Dopmusent. �t.r.• '• - Inncladc with tbts appttcadw a steeped watnaty deed 8+an the Rehr of Deeds office a Copy of flee o rtifted survey map if reference is made in the wimmm r dcod .1507PAU 155 �O 622236 STATE BAR OF WISCONSIN FORM 2 - 19W KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Jerome A. Mortel and Dianne J. RECEIVED FOR RECORD Martel, husband and wife 05-02-2000 10:00 RN WARRANTY DEED EXEMPT I Grantor, and RJC Development, Inc., a Wisconsin Corporation CERT COPY FEE: COPY FEE: TRANSFER FEE: 1185.00 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return A Tess e The NW' /4ofSW' /4; the North 4.5 acres of the SW 1 /4 ofNW''h;thNE' /. and y f_ , of SW '/4 and the SE 1 /. of SW '/.; all in Section 25, Township 30 North, Range 18 West, St. Croix County, Wisconsin. 026- 1073 -30- 000;026- 1073 -40- 000;026- 1073 -60 000 Parcel Identification Number (PIN) This is not homestead property. 01) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this _�� day of May 2000 + * ome A. Mortel + + Dianne J. Mortel AUTHENTICATION ACKNOWLEDGMENT Signature(s) Jerome A. Mortel and Dianne J. Mortel, husband STATE OF WISCONSIN ) ) ss. and wife County ) authenticated this 15A, day of May 2000 Personally came before me this day of the above named . Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized 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.) • s of rsons signing in an capacity must bet d or printed below their signature. 1(0 A"'" 0 " P ° � f 0 °" c0 " ' Fon 1° Name g g y P tY typed P STATE BAR OF WISCONSIN 80D.655-2021 WARRANTY DEED FORM No. 2 - 1999 CERTIFIED SURVEY MAP Located in part of the Southwest Quarter of the Southwest Quarter and port of the Northwest Quarter of the Southwest Quarter all In Section 25, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin. SURVEYOR'S CERTIFICATE I, Rona l d F. .I(II1nF:4)r1, a Reg.i sl erod Wi.scous i n (.and Surveyor, hereby certify t:haL by Lhe direction of RJC Development, Inc., a Wisconsin Corporation, I have surveyed, divided and mapped part of the Southwest: Quarter of the Southwest Quarter and part of the Northwest Quarter of. the Southwest Quarter all in Section 25, Township 30 North, Range III West, Town of Richmond, St. Croix County, Wisconsin described as follows: Beginning al; Lhe West Quarter corner of said Section 25; thence, on an assumed bearing along the east /west Quarter line of said Section 25, South 89 degrees 52 minutes 26 seconds East a distance of 248.00 feet; thence South 00 degrees 25 minutes 35 seconds West a distance of 460.01. feet; thence North 89 degrees 52 minutes 26 seconds West a distance of 248.00 feet to the west line of the Southwest Quarter of said Section 25, this being point "A" herein after referred to; thence, along last said west line, South 00 degrees 25 minutes 35 seconds West a distance of 718.01 .feet to a point herein after referred as point: "B "; thence Soul :h 89 degrees 52 minutes 26 seconds East a distance of 354.00 feet; thence South 00 degrees 25 minutes 35 seconds West a distance of 291.58 feet to the north line of that property described in a Warranty Deed recorded in Volume 1205, page 534 in the Register of Deeds Office in said County; thence, along last said north line, South 89 degrees 55 minutes 25 seconds West a distance of 354.07 feet to the west line of said Southwest Quarter; thence, along .last said west line, North 00 degrees 25 minutes 35 seconds East: a distance of 292.83 .feet to a above said point "13"; thence, continuing along last said west line, North 00 degrees 25 minutes 35 seconds East a distance of 718.01 feet to above said point "A "; thence, continuing along last said west line, North 00 degrees 25 minutes 35 seconds East a distance of 460.01 feet to the point of beginning. Containing 217,523 square feet (4.99 acres). Subject to 1.40th Street (a Town Road) along the most westerly line of the above_ described property, also subject to all easements, restrictions and covenants of record. 1 also certify that this Certified Survey Map is a correct representation to scale of the exterior boundaries surveyed and described; that I have complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Subdivision Ordinance of the County of St. Croix and the Town of Richmond in surveying and mapping the same. R nald F Tohnson Reg. No. 1186 Date' A & E Telephone # ( 715) 246 4319 v rr l�('(}�* band Surveying k Civil E n �( �7� c.•,� V_ .tiy� Y 9 9 g ,�e..,,� 7r s i O. Box 325 ' New Richmond, WI 54017 R O tS F �+ 3 71? A WIS Y. ' * a En M+ y • H � +�00 @lrfV :�o I!T��tpp7 -SIT pp W- im1V + , orrimo . AR1KiFB 6 T XXX C� 0 0 tzi co Sheet 2 of 2 — EO= /^ Vol.14 Page 3900 �. /r+ -� R �y •:� Vt/is r er '3 � Q- • C 1 4 'V6 ��'ie a *CERTIFIED SURVEY MAP Located in art of the Southwest P Quarter of the Southwest Quarter and port of the Northwest Quarter of the Southwest Quarter all in Section 25, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin. Prepared for and at the request of: OWNER: RJC Development, Inc. 1868 C.T.H. C" Somerset, N 54025 Drafted by. Ty R. Dodge i �I ��� 3 • I I j JUL IO£Sr >/4 GARNER UNPLATTED LANDS 1 9 2000 w1n1LE SECDAN 25 -30-18 11j' I EAST -N£sr 114 UN£ q NH. (FOUND ALUABNUM I Of COUNTY MANUME7✓TJ - -- S89'52'28'E 5263.58*- - _ " 89'52'26 "E 248.00' 21 X 5.00' S89'52'26 "E � 5015.58' r rr K 1.f 33,00': i I I EAST 114 cawER 5EC77ON 25 -JO-18 rl N l I I (FMWD At UWWM .-I Iwl I o .TJ' o I COUNTY MONUMEwr) L O T 1 o ZI LEGEND, �i ° wi w i I w 1. 13 �I� County Section Corner Monument m FIB{ of Record e «: .: I I h VA • Set 1" x 24' Iron Pipe weighing IN jja a minimum of 1.13 pounds per Y I o 0 linear foot. R - Recorded As • • • • • • • • • • • Denotes Building Setback Line (100' from R -O -W) c "s '_ N, I ai E u LOT AAE4& �E�o dl I } 33.00': nm mj �� 215.00' LOT 1: 2 E > c wl TOTAL AREA: M 248.00' 114,081 SQ. FT. /2.62 ACRES A a RI � I /'ANr a" AREA EXC. R -O-W: _ cppp 98,901 SQ. FT. 2.27 ACRES . 02 0. bU1 n o �I I �w� UNPLATTED L AND S LOT 2: in DF QVJM ND TOTAL AREA: ° o�' a o �I NN n I 103,442 SQ. FT./2.37 ACRES E o rnt �� +� w i t I in I AREA EX R -O-W: c_ ©I 'g WI I W I p �. 93,780 SQ. FT. 2.15 ACRES c LP-6 Ift -0 a FI •"� Q i I z S69'S2'28 "E 354.00' ° C 1 0 1 I ��. 321.00' 3. a ' � � p Z I ` � ` 33.00 • c d 0 NI I ° , I I fV t o vl N � rn tit I � pp N y m c 1 1 I [V I 1ff o Z L O T 2 m o I I I N N SOUM LONE OF 7N£ NW 114 N I 1 t I I OF THE SW 114 C,0d - -0 _..`..— .._.._..�. —..—..,..—..,.._..—..—....._..— CL 3C ° w. a1o1 �l I I w I� NORM LlN£ OF TIE SW 114 lE a e p <I �I I in JJ� OF THE SW 114 t U �Ir,l �1 c °n xI�I (�(�1 I p ut UNPL LANDS O o a a �I �1 <I _ z�, 6 f I�la1 ; I C Ivl �{j � 4M!!3 o io�l I z �� x.33.00'; 321 _______________ JI isi I S89'55'25 "W 354.01' NORTH LINE OF THAT PROPERTY DESCRIBED t �i I JJ I IN ORDER IN VOLUME n I UNPLATTED LAN _ 205 PAGE 534 IN REG1 OF DEEDS I I --- - - - - -- {�tOIX COU WISCONSIN. ST. CROIX COUNTY Plannina ZMirn s-1 Perks roe rnittne �! JUL 1 9 2000 1 sOU7Nt1EST cARNER SECTON 25 -JO -18 JOB A00049 (MUNO J /4' /ROW ROD) It not rewraau wivon 30 days of Prepared by. `. approval date approval shall be A & E 15D nulband void 150 NO TH LAND SURVEYING do CIVIL ENGINEERING Phone No. (715) 246 -4319 GRAPHIC SCALE 109 East Third Street, P.O. Box 325 SCALE IN FEET: 1 inch s 150 feet New Richmond, WI 54017 BEARINGS ARE REFERENCED TO THE WEST LINE OF THE Sheet 1 of 2 SW 1/4 OF SECTION 25, TOWNSHIP 30 N., RANGE 18 W. WHICH IS ASSUMED TO BEAR N00'25'35 "E. 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