Loading...
HomeMy WebLinkAbout026-1130-18-000 'O O ti ( O r y I C o 0 n N m M 0 E 6 o oo a° o °W oa�0i tit 3 N O y+ c R N p O o 1� U o CO N MO a.� O f0 N M N y o, 3 O 'j c Z a)E 3 c C m c LL C M ° O O ` O 3 a � :3 Vl Q LO OQ X'O , (D � � ! Z £ I CO z w z cn N a m H Z i O Z a c d Z c -o E E I ° I L� N (0 Yj O N • a 2 0 O Owa Z Z N CD I � I U) m O Q Co- IL �w c o O tt G rr m a a � E G 2 _rn m I 00 o •N ; aaa EL Z tl1 J U Q O O 6 N t N N p } 1- O) r M O Z O O O O O _ N N N 0 0 0 '= p 7 N co Co a U 'a Ld�pp Q A (!1 f0 O C 7 ai O O c i W 2 C O O E O j (D O N sf co gO O O .i O � U a r pp m N N N N V C C C 0 M p 2 O ` 7 7 C OO N O e ~ N O U N N o N d C� u i° rn n • O N U v Cl Z N a a fn • a d 9 d a c _1 A tia2 l, oU)) 0 Safety and Buildings Division County Nv 201 W. Washington Ave., P.O. Box 7082 ,S 7(„Q.—t:.t„ , L s n Madison, WI 53707 — 7082 Sanitary Permit bfilled in by Co. De artment of Commerce (608) 261 6546 Sanitary Permit Ap FF State Plan I.D. / Numb In accord with Comm 83.2 1, Wis. Adm. Code, ptxao info itle D may be used for secondary purposes Privacy Law, a15.04(I xm) Project Address Of different than mailing address) 1. Application Information — Please Print All Informatioi i Property Owner's Name ST. CROIX COUNTY Parce) #, I 1 Block# FFICE o ( b Property er's Mailing Address Property Location A P - , v ut �,� Iye L e ,,M a section -5 City, State Zip Code Phone Number G �`� - a/ g, circle one) II. Type of Building (check all that apply) I U! 6 T 3o N; RL_QE or W PP Y) u 0 1 or 2 Family Dwelling - Number of Bedrooms � Gym Su 'vial n Name C / SM�Nu w mber L ❑ Public/Commercial - Describe Use �' [3 State (Tuned - Describe Use ❑City ❑Vill �` ip of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. fi( New System ❑ Replacement System yst ep ys ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal 91ermit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner L —7 (3 b3 IV. T of POWTS System: Check all that apply) 7 ❑ Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland K Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersalfrreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation OD - 7 9 6'7 g 7i� VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank / r� Aerobic Treatment Unit J Dosing Clamber 5^6 r VII. Responsibility Statement -1, the undersign assume responsibili for installation of the POWTS shown on the attached plans. Plu #Nm (Print) Plumber' i re PRS Number Business Phone Number � 1.1 �� D35 7 Plumber's Address (Street, City, State, Zip C O T;V � VIII.jjCoun /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date sued lss ' g Agen Signature (N tam s) Surcharge Fee) qtr �-,` (To S7 ` � �— ❑Owner Given Reason for Denial � J CJ 7 IX. Conditions of Approval/Reasons for Disapproval Attack complete plans (to the County only) for the system on paper not teas than 51/2 x 11 inches is size SBD -6398 (R. 08/02) auomersime Effluent Pump 3871 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, • Capable of running lubrication and efficient strength, and durability. following uses: dry without damage to heat transfer. ■ Motor Cover. Thermoplas- •Homes Available for automatic and • Effluent systems components. tic cover with integral handle • Farms Motor. manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EPO4 built in overload with ■ EPO4 Impeller. Thermo- * Solids handling capability: automatic reset plastic Semi -open design 3 /i maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING ; --� • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. 0- Canadian Standards Association i . • Total heads: up to 24 feet. with three prong grounding m EP05 Impeller. Thermo- * Discharge size: l' /i NPT. plug. Optional 20 foot plastic enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with end in F" or "AC".) rotary/ceramic- stationary, three prong grounding plug improved performance. 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- •Capable of running dry without damage to 9 30 * • S components. Pump: EP05 e • Solids handling capability: 0 25 Zvi. z 3 /,' maximum. a ----- - — -- i W • Capacities: up to 60 GPM. = i • Total heads: up to 31 feet. 6 20 i 3 _ • Discharge size: 1 NPT. z 5 - L • Mechanical seal: carbon- } rotary/ceramic stationary, —1 4 15 1 BUNA -N elastomers. - -- EPO5'— i 0 • Temperature: �" 3 10 104 °F (40 °C) continuous . 140 °F (60°C) intermittent 2 1 5 I �i 0 00 10 20 30 40 50 GPM L _L 70 , 0 2 4 6 8 10 12 m °/h CAPACITY O 1995 Goulds Pumps, Inc. Effective May, 1995 83871 PAf F GF PUMP CHAMBER CROS5 SECTIOIJ AMD SPECIFICATIOnJS VEIJT CAP 4"C.I. VENT PIPE —7 fr WEATHERPROOF APPROVED LOCKING � 25' FROM DOOR, JUMCTIOU BOX MAMHOLE COVER WIUDOW OR FRESH IZ "MIU. AIR INTAKE GRADE I 4 "MIN. CONDUIT - IB "MIN. IAILET PROVIDE r I - - - -- AIRTIGHT SEAL * A I I II I I I 1 ALARM d I 'I. I 0 *APPROVED I ON JOINTS WITH ELEV. FT. APPROVED PIPE I 3' ONTO PUMP OFF D SOLID SOIL CONCRETE BLOCK C1 X6 RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E ' SPEC,IFICATIOUS DOSE TA WKS MAN UFACTURER: .I11. _ IJUMBER OF DOSES: PER DAS TANK SIZE: GALLONS DOSE VOLUME ALARM MAASUFACTURER: IMCLUDING BACKFLOW: D GALLONS MODEL ►DUMBER: �� jg� CAPACITIES: A= °� 1 � IUCHES OR GALLOUS SWITCH TYPE: 8 IMCHES OR GALLO►JS PUMP MAIJUFACTURER: - C - Z S INCHES OR /✓� • GALLOLIS 1 `' I MODEL NUMBER: J51' D- _L INCHES OR GALLOME j SWITCH TYPE: ' MOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE 3 _GPM INSTALLED O /- SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET �100`7 b + MIIMII�MUM NETWORK SUPPLY PRESSURE . , , , , .. . , . . � FEET + � FEET OF FORCE MA X T�,�� q /pp FZF RICT10Al FAGTOR..y FEET TOTAL DYNAMIC. HEAD FEET IUTERNAL DI SIO S OF K. LENGTH ;WIDTH - ;LIQUID DEPTH SIGNED: LICEIJSE NUMBER: DATE: Wisconsin Dep4tment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safebyand Building Division ' INSPECTION REPORT Sanitary Permit No: 420730 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: Cameron Homes, Inc. I Richmond Township 026- 1130 -18 -000 CST BM Elev: Insp. BM Elev: BM Des ption: Section/Town /Range/Map No: . d - 2, 7 1 / d z Z 25.30.18.878 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benc r Dosing _ � Alt. B �p o , 0i. 7 i` 0 9 . b Aeration /� AD Bldg. Sewer s D �• 3 d �� Holding V St/Ht Inlet TANK SETBACK INFORMATION St/Ht O})tlet TANK TO P/L WE BLDG. Vent to Air Intake ROAD Dt Inlet savrr/ o � 4, y7 � y Septic �, �� / 1 h S D Botto Z U ' • 3 1Y4 Dosing HeaderiJvlp- lv ' t ro•r7 ,Do l.� r�W w' `Y , Aeration Dist. Pipe �p utQS� cJ �� 24 p 9- Holding BZ S��ystem D Vk .Z Q • 2 p� v Final Grad- -/ PUMP /SIPHON INFORMATION L 04-5 1 51 O S I 46 V D Il e Manufacturer GPM Dema St over / / �-e YS t)�7� 3 Model Number �—, P. yr ` e ,u 97. l TDH Lift Frictio 7 gss System] � d TDH Ft Forcen Length - Di 2 h Dfst. to �el� t 1� SOIL ABSORPTION SYSTEM 9 BED/TRENCH Width / Length No. Of Trenches PIT D SIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WE / LAKE /STREAM LEACHING anufacturer: INFORMATION CHAMBER OR Typ Of System: / � , / , � //G /1 ✓ UNIT Model Number: DI IBUTION SYSTEM T d Bader/ nifold Z ion A/ x Hole Size x Hole Spacing Vent to Air Intak Pi e s ti f �I 1 -57 Z Length Dia Le gth Dia p8 2cing_� _�qr SOIL CO ER 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 ;»• No 0 Yes [] No COMMENTS: (include ` ode discrepencies, persons present, etc.) Inspection #1:��// © Inspection #2: / J Location: 141 1 J Ave New Richmond, - 1/4 NW 1 R1 W R Pine Corner Lot 18 _ Parcel No: 25.30.18. 78 05�T" c mond, WI �40,1e�.7A�(NW /4 25 T30N 8 ) Red /1�, / �� 1.) Alt BM Description t = �W t � � P K IL�� ov 2.) Bldg sewer length = .[/ 'I"� ��_ _ J•, /, � amount of cover Plan revision Required? Yes PAo Use other side for additional information. 1 ____ (� SBD -6710 (R.3/97) � Date Insepctor's ig ature Cert. No. Safety and Buildings Division County m m 201 W. Washington Ave., P.O. Box 7082 S ` on, WI 53707 - 7082 Sanitary to be filled in C /SCOnS /� Madi `� Permit Num (608) 261.6546 a � 3 C o. ) Department of Commerce Sanitary Permit Application State Plan I.D. Num err In accord with Comm 83.21. Wis. Adm. Code, personal information you provide 4 maybe used for secondary purposes Privacy Law, s 15.04(1 xm) Project Address (if different than mailing address) 1. Application Information — Please Print All Information I L/ /o _ Owner's Name � �� If V RECE �eMMAR 1 3 2003 �o =/� t# e>acka Property Owner's Mai 'ng Address ST. CROIX COUNTY' Location O, eOX 0? L ZONING OFFICE 1 /4. /� "- 11 Section O City, State Zip Code / Phone Number / q !� I ti'l I/" S / 7 ^- of 9 (�/ / �i or one) T N; R or W ]t7. Type of Building (check all that aPP ✓�� �� 9K1 or 2 Family Dwelling - Number of Bedrooms SufAivision Name CSM Number ❑ PublicJCommerciat - Describe Use ❑ State Owned - Describe Use ❑City ❑V' lager 2=ip of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) - A. New System ❑ Replacement System ❑ Treatmertt/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 IV. Type of POWTS System: Check all that apply &7 A Non - Pneasudzrd In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Coosttueted Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Cbamber Drip L' e ❑ Gravel -less Pipe 11 er (explain) V. DisPersalffreatment Area Information: -- / Design Flow (gpd) it Application Rau " Dispersr' " Required (s J Dispereal Area Proposed (t] T ! Elevao / A -'t. D / Z- VI. Tank Info Capacity in Total umber Manufacturer Prefab Siter abeig Ai Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Talcs Tanks Septic or Holding Tank V Aaobic Tmetmeat Unn Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assume responsibility for I stallation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum s Si MP PRS Number Business Phone Number aaa 3s 7 ,5-- Plumber's Address (Street, City, State, Zip Code) / jJ VIII. J00o un /De artment Use Onl proved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued uing ett Signature tamps) Surcharge Fee) # fJV ❑ Owner Given Reason for Denial K Z , '� � (3 Q IX. Condition s of Approval/Reasons for Disapproval ` � G Op 3 � /' ItiYt e- / � .E � 14&v / O cu -n�v n- c r��wn s s� �. 93 ? Sys�ern � A ftsCh �eompkte,ptau (to the way only) for the system on p aotienth 81/21111"h SBD- 6398 U� /� ,ago w� aa AA - f = ,do 7oJ° e-1r �� � � ,Q a � loa as �°� ��-�- Y Q D q OtI4 -1 3e \ V. 9 8 ° l'� 6ij A 3 ?- 'Toll/ g � j r 8a -I �3 !3 3 G- -6 H -1i W isconsin Department of Commerce SOIL EVALUATION REPORT Page -1—of_ 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Q��O -113Z>-1 percent slope, scale or dimensions, north arrow, an and distance to nearest road. diri Please print 10 �ajibn.. Re ' we y Date qy Personal information you provide may be us d f } )Ieondary p rposes (PrivaLaw, s. 15.04 (1) (m)). Property Owner � r C , ; �C t roperty Location Via..:.; : t.J Oakwood Land Develo ovt. Lot NW 1/4 NW 1/4 S 25 T 30 N R 18 %(or) W Property Owner's Mailing Address e ? U L t # Block # Subd. Name or CSM# 1611 H 10 City State Zip t Phone Agcy 4 7E ❑ City ❑ Village IN Town Nearest Road Spring Lake Park, T. 55 (61z�jt�ltv�96�c ; Richmond 140th. ST. R1 New Construction User.] Residential / - Code derived des ow rat design flow 600 GPD � �— 1 . 2 p p S El Replacement ❑ Public or commer& b;s�e: _ Parent material glacial drift over oUtwash Flood Plain elevation if applicable na ft. General comments and recommendations: trenches starting @ el. 98.20', spaced to code followed by trenches 4.00' below ade U �. S` d z'' S s� ❑ {❑ . Boring # F] Boring 1005 +86 1 pi Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Cotor Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 2 8-2fi 7-5 4/4 non 1.2 Boring # ❑ Boring 100.5 +90 2 JL1 pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr 3/3 none L 2msbk mfr 2f .5 .8 2 8 -17 7.5 4/4 none sicl 2msbk mfr qw 1 4 41 -90 10 6/3 non Effluent #1 = BOD > 30< 220 mg/L and TSS >30 < 150 mg/L uent #2 = BO < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature . CST Number Gary L. Steel 02298 Address Date Ev luation tonducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 11 -16 -2000 715- 246 -6200 i f Property Owner 08kWOOd Land Dev _ Parcel ID # pmdinq Page 2 of 3 F- Boring # ❑ Boring 102.2 +110 3 ® pit Ground surface elev. ft. Depth to limiting factor in. [ Soil : Applicatlon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 L k 7 _ E] Boring 6 ?• F - 4] Boring # 102.2 +110 ® pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0 -12 10 3/3 none L 2msbk mfr qw 1m 2 8 -24 7.5yr 4/4 none sil 2msbk mfr 9W 1m .5 .8 3 24 -43 7.5 4/4 none sl m na ClW if 5 72 -11 10yr 6/8 none ms Osg mvfr na na .7 1.2 Boring # Boring F ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKf 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& and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SOD -8330 (R6=) I STEEL'S SOIL SERVICE Gary L. Steel Oakwood Land Development 1554 200th Ave. CSTM2298 NW' N NW'' S25- T30N -R18w New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #18 -Red Pine Corner This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1 " =40' BM.= top of 1" pvc pipe @ el. 100.00' Alt. BM.= top of 1" pvc pipe @ el. 102.25' A h fie° �qo f i Gary L. Steel 11 -16 -2000 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _L_ of FILI SYSTEM SPECIFICATIONS Owner ,0 A Septic Tank Capacity a�Q g al ❑ NA Permit # O Septic Tank Manufacturer f ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 1 1-A60 ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l �136NA Estimated flow (average) Q a g al/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) 1 !!!�d al /day Pump Manufacturer DkrN''A Soi Application Rate al /da /W Pump Model RYA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit A Fats, Oil & Grease (FOG) 1530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODJ 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 0 Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /L NA ❑ t -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m ❑ 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 a fluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank ❑ month(s) (Maximum 3 years) 13 NA 12 s) At least once every: ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third %) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: > ❑ month(s) (Maximum 3 years) 13 NA year(s) ❑ month(s) ❑ NA Clean effluent filter At least once every: ,� year(s) Inspect um ❑ month(s) ❑ NA Ins p pump, pump controls & alarm At least once every: ❑ 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. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page Z of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products 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. Al � • T he site has not DPPn wv i�� *�•� *^ _ - _ ` `�' ' -- `- "� -� of the P�Vl a c oil and s ite e I t � 1- -� �. I no ant area If nn rant 1 hla hnldlnQ ta • Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name LA ,5 Name Phone �� r . � - Zj 5 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY �S Name Name Name / Phone Phone /5- ��(fl 7� gQ This docwnent was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1). (2) & (3), Wisconsin Administrative Code. VL W \VaL1 vVVdL#4♦A SEPTIC TANK MAn4MNANCE AGREEM ".NT AND OWNMED CERTIFICATION FORM �. v 4� &a OwnerBuyer ��!t:4 . i ' but Matluig Address ��l Property Address ) Y/ 0 (Verification required from Planning Depar fo r new construction) City /State / fel' 'e' C *A11L o'un ' • Parcel Identification Number J °� /0 071 la - / /3a - IS LEGAL DESCRIPTION Property Location ��'� ' /s, /�� %4, Sec. . T - N -R W, Town of Subdivision �� ^� . Lot # � . Certified Survey Map # , Volume . . Page # Warranty Deed # � �3 -5 , Volume "- I — . Page # a� Spec house ❑ yes g no Lot lines identafiableXyes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature fa ciure to handle wastes. Proper maintenance of out the septic tank every three or sooner, if needed b consists pumping epti cry years , y 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 properly owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, jomueymanplumber, resWetedplumber or a hcemodpun4w verifying tha 1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the Septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private ewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural "ounces, State of Wisconsin. Certification statina that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da f xpira e. 3 (a (}NATURE OF APPLICANTO 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 theV des e, by a of a warranty deed recorded in Register of Deeds Office. 3/ 6 S ATURE OF APPLICANT DATE ** ** ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. « « * « «« •• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed J 1933' 22� STATE BAR OF WISCONSIN FORM 1 -1 98 KA THLE E N 6 5 7 1 3 WARRANTY DEED REGISTGISTER H. OF DEEDS ST. CROIX CO., tfI Document Number RECEIVED FOR RECORD This Deed, made between Oakwood Land Develgp nt. Inc.. a 08 -01 -2002 9:00 AN Corporation Grantor, an _ Cameron Homes Inc. a Corporation , Grantee. WARRANTY i EXDPT Grantor, for a valuable consideration conveys to Grantee the following XEI4IT # described real estate in St. Croix County State of REC FEE: 11.00 Wisconsin (the "Property"): n M q\vv�, Ur?6r4A COPYSFEE: 104.70 CERT COPY FEE: PAGES: 1 Recording Area Name and Return Address Inc. lJttlYyT � x Pin r Court New mo 540177 Fr LY1�e Mt 554 026 107290000 Parcel Identificatlon Number (PIN) This Is not homestead property (Is) (is not) Lot 18, Red Pine Corner, St. Croix County, Wisconsin. QZ(Q — / _ not) Together with all appurtenant rights, title and Interests. None Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this 30th day of July, 2002. (SEAL) (SEAL) S Oakwo�L.n Dev elopment, Inc. (SEAL) (SEAL) ACKNOWLEDGMENT STATE OF Na +WN Signature(s) State of Wisconsin, ) ss. St. Croix County authenticated this da�i 16f SWAMNA1 , _ i'ASY PUBLIC Personally came before me this = day of may, = the above named Oakwood Land Development. Inc. by: Greaory J. Peterson. Vice President to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person who execut the foregoing instrument and a to W ge the same. (If not, authorized by §706.06, Wis. Slats) THIS INSTRUMENT WAS DRAFTED BY Coldwell Banker Burnet Notary Public, State of Wisconsin 1301 Coulee Road H WI 54016 My commission is permanent. (If not, state expiration date: 3595 ( I ures may be authenticated or acknowledged. Both are not necessary.) ' Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED FORM No.1 -1998 MllwauKee, Wis. I�. 0' 87Y LOT 23 / ' ` `� DRAINAGE >� tqj `W 145 81 ' /' `mo ` \ `�ASEMENT • � , - -- — �� 70,362 S4 FT. ` 0 w ti 1.62 ACRES 23.89•... „� • • � ` � M /N. F.F.E. 985.5 ,� • 20° 9 0 6 , 0 ` o�� ENT ^ N \ \ y 0 0 ••� \ 5 RAC �•V� 3�a• /` .\ �8, ��' O 21 \ IV 21 p9 27 "K, _ � ' 40 " _ _ �k LOT 22 �� \ 66, 000 SO FT ° ° °• ----�. 199 .91 " s •° s9' N8479 36 £ 9 �- 1.52 ACRES O ` MIN. F.F.E. 985.5 LOT 21 7 66, 000 sq. F r. +� rn 'i'A 1.52 ACRES �.o • M LOT 19 3 °ss 90,9J2 S0. FT. ° Tt 2 2.09 ACRES o ,°,� Z MIN. F.F.E. 985.5 N °°' N LOT 20 -I 0 66,386 S0. FT. �0• G ' / � 1.52 ACRES .5 I FT. N 3 � • 55 �/ \ 985.5 ' �sg ?5 , N�o i A17 2. o i • /' 293214 "W N7 �3 FAR �ls 9/9Y N l • © ® / . . LOT 18 3.6 -..� r� SAO°° f 66,454 SO. FT. co ^ (o / �o i 9b ' 1.53 ACRES t s lb I /72 3 0, 2g ,., w 40 ,� LOT 11 26i 23, �% ry ^ �/ 66,953 S0. . '. FT. o N 1.54 ACRES WES � o LOT T7 0 t° o 65,656 S0. FT. "' 04 N 1.51 ACRES 1 l • / 3 04 N " 00 3 6t afNW1 /4_ _ c� _ G _ _ OF J _ S _ 3 /IRTH LINE H£ W 1/4 0F.7H£ NW 1/4 �i' • 10.00' il �. / 12 i NE N / 10 LOT 12 T 27 0 S88'27'09 "W 306.1 MA TCH LINE SEE SHEET 2 LOT 16