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HomeMy WebLinkAbout026-1130-21-000 0 7 x 13 0 / CD ' /■ \ 7/ z 0 mƒ / 8 £ ° e E . § m - @ / / « , c ƒ a ; § P ■ \ e \ S ] Q } $ �; \ § C7 a a , L y \ C.- / j \ 0 . e \ \ ' ` \ � E § # e / / § / ¢ \ \ 3 \ G § 7 @ � » § $ ¥ ^ / \ k c E , c ID T / T M T g �, 0 \ � k I (a (A § 3 0 %\ 0 6 'E ooS 0. \f ;/ £g&� ƒ N \ } / } \ ° e \ CL & w 0 o fi / . \ }( $ < } 2 E _ \ ` CD cu : m \ z f \ ; / C 0 . § ] m 0 f / 7 o ;z\ . 7 z » , �$ ;2 PJ « -0 > , . / § 0 7 CD % oA 0 ° . C D ; ' i\ k CL / @@ $ }\ /3 \ , / # ® � ~ � ° J \ / (D \ � � k 2-0 A0 16 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 Personal information you provide mavJ=msed for secondary purposes Madison, WI 53707 -7302 Department of Commerce [privacy �3a4( wn (Submit completed form to county if not state owned.) Attach complete plans (to the county copfon y.) or th ,system, 6 not less than 8 -1/2 x l 1 inches in size. County State Sanitary Permit Nu ❑ he ion to'prtwi s application State Plan I. D. Number I. Application Information - Please Print all Infor bn t Location: Property Owner Name C, j r 1 t t Property Location - 'S T C'RDX L � 114 l 114, ,N, (or PrWrtf Own6es Mailing A dress 7p0NG oFi= f� Lot Number Block Number City , Zip Code Phone;N.!k " Subdivision Name or CSM Number . Type of Building: (check one) ✓ a.s pv- ❑ c i ty e R 1 or 2 Family Dwelling - No. of Bedrooms : 0 Town of • Public /Commercial (describe use):_ • State -Owned s 26 �� Nearesf Road le 7� ~ ��- �;� rJ .� i X � $" r �� arcel Tax Number( III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) q) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply)–k A-1 co $Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dis persabTreatm ent Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 7 6. System Elevation 7. Final Grade Required Proposed Rate (GalsJday /sq. ft.) (Min. /inch) Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks � ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the un ersigned, assume responsibility for installatiojpbf the POWTS shown on the attached plans. Plumber Main ri!no Plumber' Signat ps • MP/MPRS No. Business Phone Number Pt r Add (Street City, State Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ss ' g Agent Signature (No stamps) l� Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination 22's . — X. Conditions of Approval /Reasons for Disapproval: Ip r -- Ac, ^ is SBD -6398 (R. 07/00) I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 395171 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information ou provide may be used for seconds purp [Privacy Law, x.15.04 (1)(m) Y P Y ry P P I Y Permit Holder's Name: City Village X Township Parcel Tax No: Peterson, Michael I Richmond Township 026- 1130 -21 -000 CST BM Elev: Insp. BM Elev: BM escription: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark I e 3 Dosing Alt. BM .Z Aerat' Bldg. Sewer qG -s Holding S t Inlet St! TANK SETBACK INFORMATION t Outlet 2. TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Header /Man. t 7 Aeration Dist. Pipe ZIP olding Bot. System Final Grade ' PUMP /SIPHON INFORMATION cturer Demand St Cover Model Number TDH Lift Triciion loss System TDH F Forcemain' Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM }D BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 / ` 5-e SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM I G Manufa Curer: INFORMATION CHAM OR Type Of System: IT Mffel Number. > JO I DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake _ , q Pipe(s) < I '> r Length Z.5 Dia_ 1 1-ength ` Dia Spacing COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of ded xx Mulched Bed/Trench Center Bed xx Seeded /Sod /Trench Edges Topsoil Fjj� Yes ❑ No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Al - 3 1 _l &-/ Inspection #2: — Location: 142�1381:1)Avenue New Richmond, WI 54017 (NW 114 NW 1/4 T30N R18M Red Pine C -S Parcel No: 25.30 1.) Alt BM Description = Pd/ 'O si� / SY'54,,_ 4141 Sws{alr'td Gr4*oPv Ytid• /0`2•� 2.) Bldg sewer length = I q / (,I el (je�; n� ��+• S"� A,,j r`. - t amount of cover = > � r e." 64-LL Plan re isiorl`R�g iificr? _aj Yes No Use other side for additional informs if'on. t SBD -6710 (R.3/97) SYSJIe Sri 04 4 ' o.3 /R`L r �-,o� eep o nature- 5 �� �� � �� q ,ra 0 �� ��s' ��/ C, J- v o i )�-Z VGA' PkA r6 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 Nvi seonsin Madison, WI 53707 -7302 Department of Commerce Personal information you provide ma ed (Submit completed form to county if not for secondary purposes (Privacy ) 9 a4( )()n , 1", state owned.) Attach complete plans (to the county co on y) or the, system, 6n." not less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Nu - . i ❑ 1heffli ion to i s application State Plan I. D. Number I. Application Information - Please Print all Infor n Location: Property Owner Name C� ( 11117 Property Location '�&A44' Y GRQtX It'l 1/4 1/4, N, (or Pr is Mailing Ad dress i,, _ ZONINU :, ' Lot Number Block Number ;. r City, ate Zip Code Subdivision Name or CSM Number ( ) . Type of Building: (check one) s ❑ city 1 or 2 Family Dwelling -No. of Bedrooms: city -0-Village Ef Town of ❑Public /Commercial (describe use):_ ' ❑ State -Owned ��8 S / �} ✓ V Nearesf Road 6'2 O ©O / arcel Tax N mber(s) -3 1 r III. Type of Permit: (Check only one box on line A. Check box on lin B if applicable) A) 1. KNew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) -1 co )Non pressurized In ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispers Are 3. Dispersal ea 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Lam' Proposed �2t�� Rat (Gals. /day /sq. ft.) (Min. /inch) Elevation zr i VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks fid ❑ ❑ ❑ ❑ f 's ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement 1, the un ersigned, assume responsibility for installatioigof the POWTS shown on the attached plans. Plumber' am pri Plumber Signa ps MP/MPRS No. Business Phone Number L- Pl er Addr (Street, City, State Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ss ' g Agent Signature (No stamps) �Q Approved ❑ Owner Given Initial Adverse Surcharge Fee) - 1. Determination 2'jfj ' � &LkA X. Conditions of Approval /Reasons for Disapproval: rS S, is SBD -6398 R 07/00 06/14/ 2 14: 17 7153514232 riltI-' --UA r�a� Wisoon'aln tMpartmant of Commemo SOIL. EVALUATION REPORT • Page 1 of 3 _ olvision of Satiety and Buildings in accordance with Comm 85. Wis. Ado. Code County Attach complete site plan on paper not less than S t12 x i i Inches In size. Plan must Include, but not limited to: verticAl and horizontal reference point (BM), direction and pocel 1.0. percent stops+, scale or dimensions. north arrow, and location and distance to nearest road. pending Please print aff information. Reviewed ay Date Personal Information you voviAe rtmoy he usedtof securnlOry purposes irdvany Law. S. 15.04 (1) (m)). — I PMpar lyowner Property Location Covt. Lot NW 1/4 NW 114 S T N R Q Wor)'' -N - I wow I and roperty ar s ling ras Lot # Bk .. # 5ubd. Name or # Red Pine (7orne-r city tale ;p Code Phone umber Clty Village ®Town Nearest Road R New Construction Uae:0 Residential ! Number of bedrooms 4 Code derived design flow sate --600 ❑ Repiacement ❑ Public or con " ercIA - Describe: Parent matyrfal _ __._____A.J .2� a 1 rj r i f t Flood Plain elevation if applicable na ft. Gvnerat comments and recommendations: f or system long &vity a. found is recommended trenches starting @ el. 96.20' spaced to code followed by trenches 1 h Plaw -- ara Holin �S tieing # n pit Ground surface eley. 9 9.90 g. Depth to limiting factor In. ioatian Rate Horizon Depth [dominant Color Redox Description Texfure Structure Consistence Boundary Roots GPD1fF In, Munson Qu. Sz. Cont. Color Gr. Sz. Sh. "Ef1#1 'Cff#2 .5yr4/4 4 RA� 5 F Boring # F Ong 99.70 2 Up Pit Ground surface elev. __ ft. De pth to iimltinp favor _ ..... ` In. WI R lication fete Horizon Repth Dominant Coto; Radox Description Texture Structure Consistence boundary Roots Gp in. Munsetl cu. Sz. Cont. Color Gr. Sz. Sh. .EfV1 •Eff#2 2-2.1�- S?Y 4 t�t�t' �..- 3 2 6-76 - ,53r 4 4 n one _sl M 1 r _ 'Effluent #1 = 801) > 30 220 mg1L and TSS , -30 t 150 m glt 30 mg1L and TSS <_ 30 mg/L CST Nama (Please f}rk t) Signature CST Number G ary . _ L St ee l ,: _ — W — — . , Q2298 Address pat© Evaluatia: iucted Telephone Numbar 1554 200L )i, Ave., New RiChmond, WI. 54 1 1 - -1 5 -2000 715- 246 -6200 06/14/2'001 14 :17 7153014232 NILLSLH P1'4 UE 03 I 1 ' Rowty ownar kwn x'3 rand nor Parcel ID N pendiM Page ? _ of 3 # Q Boling 98.30 + /l5 pit Ground surface efev. ft. Depth to limiting factor � � SON Application Rite t°iotizon Depth DanKWA Color Redox Oesotiptlon 70xture Stricture ConsisaM" Boundary Roots GPCw In. Muntzall du. Sz. Cont. Coax Gr. St Sh. 'EM 'Eff#2 1f 0 4 A44 0 5/4 mane Ifs osq mvfr na 8orirx� # © 98.10 +� q Pit Ground surface elev. _ ft. Depth to limiting fader , in. Soil A Rate Horizon Depth Dominant Cokx Redoz Description Texture I Structure Consistence Boundary Roots GPDVtt In, Munsell Qu. Sz Cont. Color Gr. Sz. Sh. •l ffift •E 21x>sbk mfr Ow 3 2 64a 7 4/4 Boling F 98 Pit Ground surtaoe elev. R. Depth to limiting facto in. W cation Rate Horizon Depth Dominant Color Redox Desw"on Texture SUUctura CorWatence Boundary Route Pt) M. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. 'Et}7f1 •EtF#2 1 0 -10 10yr2/ none L 2msbk m 2 10- 1 Oyr4 /A none sicl 2msbk 3 26 -7 7.5yr4 4 none S1 M na w 1g 5 4 TU - 7.5Yr4i 6 none S1 2msbk mvfr n na S • Eeluent #t • aoa, > _ mat ari Ts s >ao r t - Efiuer+t tf2 = BCX7 < 30 rng/L and TS3 30 mgA, The Department of Commerce is an equal opportunity service provider and employer- If yna ne.ed assistance to access services or need material in an niternate format. plesse contact the department at (4.R -266 -3151 or T'iY 608 -264 -8777. t9Dll10 (iLtgO) �Jbi 14f 1i1F11 14: 1 ,' r'1� _ti14 �t hJiLL�Ltd PAGE E04 V STEEL'S SOIL SERVICE Cary L. Steel Oakwood Land Development 1554 200th Ave. CSTM2298 NWJNW} S25- t30N - R1 BW __ New Richmond, WI 54017 MPRSW - 3254 town of Richmond (715) 246 - 620u i lot #21 -Red Pine Corner This sail evaluation was concocted to satisfy awing requi rement, it may or may not be suitable for your use. The location of the test may or may not be as shown an permanent l lines +ere not establibbed at the t ime the test xas conducted. N 1 =4b' HM.= top of 1" pvcr p ipe @ el. 100.00' Alt. BM.= top of 1" PV wipe @ el. 9$ - 30'. S r� i Gary L. Steel 1 1 -15 -2000 i r 914A)6Y 16^ // l 3 , J t ass _ � - -- i _. -. _- -- l i _- !� I : -__ -- _ _ _ _ i r _ i ,. - - -- - _- _ - i _ - - - -- ___ _ _ - -- I � _: ___ _ __ __ l i - - - - -'- - -- -- - -- _. __ i i i i i , - , - - -- _ _ _ _ -r _ _ i _ I� _ _ _ _- -- - _ -- - -- -- i __ -- _ _ _ _ - - _ _ - __�� __ - __ -__ __. - -. ', -- _ I i __ __ _ - -__ _ - j __ �._ _'_ -�, - - -- ___ � ', Wisconsin 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 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, pending r Date Please Please print ald�rthatibrt. , ; . iewed by Personal information you provide may be use , licohdary purposes (PriJacy Lgw, s. 15.04 (1) (m)). Property Owner / � � �; t'; � f roperty Location &A. Lot NW 1/4 NW 1/4 S T N R E)dor) W roperty caner s a d re iling s ~,' -� } sl a 11 L 4 t# Block # Subd. Name or CS 1611 14wy #10 N Red Pine Corner City State Zip PhonEffluhivotll City illage GaTown Nearest Road New Construction Use: R] Residential rNi]imber of jbedto�fi ls` ' Code derived design flow rate inn GPD ❑ Replacement ❑ Public or commereist -bia6ib�r" Parent material glacial drift Flood Plain elevation if applicable } ft. General comments and recommendations: for system longf 3rvity a mound is recommended trenches starting @ el. 96.20' spaced to code followed by trenches r Boring # F] Boring 99.90 + 8 8 L� - 0 pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate H rizon 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 .5yr4/4 none sl 4 2 -88 5 4 6 none sl �6.20 F-21 Boring # Boring 99.70 Depth to limiting factor +78 in ® Pit Ground surface elev. _ ft. Soil Application Rate Hw6on 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 1 -1 2 2 -26 4 3 6 -78 7.5vr 4/4 none sl M Z Q Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gar L. Steel 02298 Address Date Evaluation ducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 1 1 - -1 5 -2000 715- 246 -6200 Property Owner nalzmod Tana Dw7 Parcel ID# pending Page ? of 3 - F T I Boring # Boring 98.30 + 8 4 Q Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 •Eff#2 mfi Clw if 5 9 4 4 -84 1 Oyr 5/4 none lfs osq mvfr na na .5 9 FA� Boring # Boring 98.10 + 8 4 ® 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 2msbk mfr 9H 2m 5 3 26 -84 k5yr 4/4 none S1 Boring # Borin 98.90 ® 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 -10 10yr2/2 none L 12msbk mfr c 2 10-26 10yr4/4 none sicl 2msbk mfr 3 26-70 7.5yr4 4 none sl M na gw if 3 .5 4 70-81 7.5yr4 6 none sl 2msbk mvfr I n 32. 8 Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg1L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg1L 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 (RAM) STEEL'S SOIL SERVICE Gary L. Steel Oakwood Land Development 1554 200th Ave. CSTM NW4 S25 t30N - R18W New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #21 -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 shorn 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" pv pipe @ el. 98.30'. �i Gary L. Steel 11 -15 -2000 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) Septic Tank Capacity (gal) Soil Absorption Component Size (ft Zao - ^ Type of Wastewater Donibstic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 1Zao - u Maximum Influent Particle Size (in) U 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). Theo operating condition of the tic tank and outlet filter shall be assessed at least p 9 septic once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component or filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 i ST CROIX CO N 11 SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer _ � ! C In ,� 2 � s.. � e � F � �� •�--'� � � � � Mailing Address Property Address (Verification required from Planning Department for new construction) City/State ;��/ ��.+�a GU, f Z Parcel Identification Number - O _ / 7-2- 9- ' ®� LEGAL DESCRIPTION Property Location. %4, ' /., Sec. T -R_W, Town of Subdivision er-- ,�� ��P�i�.� . Lot # . Certified Survey Map # Volume . Page # Warranty Deed # ��9f13 , Volume - A/ / . Page # Spec house ❑ yes ) 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 f0m74 signed by the owner and by a .. p l u mb er , journeyman plumber, restricted plumber or a licensed Pumper verifying that (1) the on -site wastewater disposal 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 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 n three year expiration date. NV A �9 4b SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION the owner(s) of I (we) certify that all statements on this form are true to the best of my (our) knowled I ( we ) am (are) the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE s « « « «« A 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 I �6 W.1671MGE STATE BAR OF WISCONSIN FORM 1 - 1998 649534 • WARRANTY DEED KATHLEEN O DEEDS REGISTER OF DEEDS ST. CROIX CO., WI Document Number RECEIVED FOR RECORD This Deed made between Oakwood Land Development, Inc. 06 -29 -2001 10:45 An WARRANTY DEED EXEMPT N Grantor, CERT COPY FEE: and Michael ON Peterson and Kerri L. Peterson, husband COPY FEE: TRANSFER FEE: 104.70 and wi f e 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 Wisconsi (the "Property"): Recording Area Name and Re OF Michael D "Peterson l F � `' ' G Kerri L. Peterson 93c� SQmr-L NOW (,ca d, t 5 7 �1b�1 26 1072 95 000 Parcel Identification Number (PIN) This is not homestead property. �o Red Pine Corner (is) (is not) Records of St. Croix County, Wisconsin. Abstract Property. Together will all appurtenant rights, title and interests. none Grantor warrants that the title to the Property is good, indefeasable in simple fee and free and clear of encumbrances except Dated this 2 9 th day of June 2001 (SEAL) (SEAL) Oakwo Land Development (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGEMENT Signature(s) State Of Wisconsin, �ivENDY SWA'� } ss. W�S� St. Croix County. authenticated this 1 Personally came before me this 29th day of June ' 2001 , the above named Gregory J. Peterson as Vice President TITLE: MEMBER STATE BAR OF WISCONSIN to (If not, me known to be the person who executed the foregoing authorized by §706.06, Wis. Stats.) instrument and a owledge the same. THIS INSTRUMENT WAS DRAFTED BY Coldwell Banker Burnet 01 -15971 ) 1� 1301 Coulee Road * w � )o, L � Notary Public, Stategof Wisconsin Hudson, WI 54 016 My commission is D t. (If not, state expiration te: ( Signatures may be authenticated or acknowledged. Both are 741 1 ) not necessary.) 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