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HomeMy WebLinkAbout026-1130-27-000 Parcel #: 026 - 1130 -27 -000 04/02/2008 08:39 AM PAGE 1 OF 1 Alt. Parcel #: 25.30.18.887 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - GIANNINI, MICHAEL A & CARI E MICHAEL A & CARI E GIANNINI 1375 140TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ` 1375 140TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.520 Plat: 08- 043 -RED PINE CORNER 5/45 026 -01 SEC 25 T30N R18W PT SW NW RED PINE Block/Condo Bldg: LOT 27 CORNER LOT 27 1.520AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 25- 30N -18W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 10/22/2004 777739 2680/619 WD 09/22/2003 740799 2415/525 EZ -U 06/04/2003 724436 2263/406 WD 04/04/2001 642123 8/43 PLAT 2008 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/30/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.520 34,200 189,200 223,400 NO Totals for 2008: General Property 1.520 34,200 189,200 223,400 Woodland 0.000 0 0 Totals for 2007: General Property 1.520 34,200 189,200 223,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 09/07/2005 Batch #: 05 -7 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430065 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: Knopp,Jon I Richmond Township 026 - 1130 -27 -000 CST BM Elev: Insp. BM Elev: , Description: SectionlTown /Range/Map No: (7 0 • ( CO-O I CYC I& *— 25.30.18.887 TANK INFORMATION LEVATI N DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark r EC• -fiC• o• `� lay' Dosing Alt. BM Aeration Bldg. Sewer 5"•g2, C(146 Holding St/HtInlet •q2. •�pZ TANK SETBACK INFORMATION St/Ht Outlet '�•2( 3.331 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �r ' S ,1 Dt Bottom Dosing Header /Man. Aeration Holding Bot. Sy m I PUMP /SIPHON INFORMATION Final Grade �•(� • 3� Manufacturer Demand St Cover • • p If Model Number / TDH Lift F Loss System Head TDH Forcemain ength Dist. to Well SOIL BSORPTION SYSTEM 3 ago E f Length No. Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM v �• SETBACK SYSTEM TO P/L jBLDG IWELL LAKE /STREAM LEACHING Manufa W INFORMATION T Of System: r CHAMBER OR T ' Type 33 1 \ .�.�^ UNIT Model Number. ' Z 1t DISTRIBUTION SYSTEM J Header /Manifq S Distribution x Hole Size x Hole Spacing Vent to Air Intake u Pi Length Dia Length Dia Spacin SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of odded xx Mulched xx Seeded /S Bed/Trench Center Bed/Trench Edges Topsoil t' FE Yes � No Fe-] Yes � No \ CO IV� ENTS' (Include a di a ncie , Qersons present. a Inspection #'L ,Z�L� • �T �23' Inspection #2: "' Login: 1375140th St New Richmond, _�WI e� 54017 ISW 1/4 NW 1/4 25 T30N R Red P' -- 11 e �A,' ce o: 25.30.18.887 1.) Alt BM Description = �7 •T hA o+.1Ve�Q_ CAVO1" , �S • S S ST• ""�" 2.) Bldg sewer length = �(Q. O '�..sp a g 9 Z • pt� f - amount of cover C� ��Sb g •o� $ S`� = �� • W �� �� v c�• • `^ c'�o �N) _ �' Sa x .1 3.0 ► S•�$ z �j l • 9 (v Plan revision Required? Yes X No Use other side for additional information. / D4% ♦ n _ Insepctoes Signature Cart. No. SBD -6710 (R.3/97) 4,A^" C . S Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430065 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: Knopp,Jon I Richmond Township 026- 1130 -27 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: 4 ¢ C$'tir - 8 / -' 25.30.18. a [J TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C' © Benchmark Dosing � Alt. BM , Aeration Bldg. Sewer 1 r.gZ Holding St/Ht Inlet 1 �� 4 4 3 ' /z TAN SETBACK INFORMATION St/Ht Outlet -2C a (0 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , 1w i � Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System q PUMP /SIPHON INFORMATION Final Grade •��' Manufacturer GPM St Cover �OS s3 Model Num r TDH Lift Fn s System Head TDH Ft I Forcemain gth Dia. 71'��.� IL ABSORPTION SYSTEM '? BED/TRENCH Width � Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth An DIMENSIONS ��� SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING M fagty�r: INFORMATION CHAMBER OR Yk�Cr Type Of System: r ( UNIT V Model Number: `� w DISTRIBUTI N SYS EM Bader Distrib tion x Hole Size x Hole Spacing Vent to Air Intake /�' t� Pipe(s) Length /� Dia Length Dia pacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over TBedp/ Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center rench Edges Topsoil L Yes No,I Yes No C0M y ? T 5 j: cd iscre pencies, persons present, etc.) Inspection #1: 1 4 Inspection #2: Location: 140th St New Richmond, WI 54017 ( SW 1/4 NW 1/4 25 T30N R1 8W) Red Pine C orner Lot 27 Parcel No: 25.30.18. 1.) Alt BM Description = 54 -j" 2.) Bldg sewer length = �'p Cs� Q pt/ 6z" - amount of cover = `.' I Yi 't J �oZ N1 �� Plan revision Required? [ :?i Yes [ No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. 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 applic PO Box 7302 14sCons Personal information you provide may be used for secondary 5ues Madison, WI 53707 -7302 Department of commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number Chec) jeiq�h9rFYs app ation State Plan I. D. Number - 7 s L�'d � )C 3 tx'� l�� �� 99� I� I M A I. Application Information - Please Print all Informatio Location: 13 Property Owner Name JUN 1 0 2003 a Property Location V e 1 f 114��4, S f A,N, R T( r Property Owner's Mailing Address Lot Number Block Number C State Zip Code ` Phone Number Subdivision Name or CSM Number i C � 21 -�r) 4 Ceel4Rol < 10- '*-' 7, L 0 '- - II. Typ of Building: (check one) ❑ City 1 or 2 Family Dwelling - No. of Bedrooms : J � - k � d a Town of ❑Public /Commercial (describe use):_ f� ❑ State - Owned Nearest Road f — vyL * 3 �� / ' Parcel Tax Numbers) /�,3C III. Type of Permit: (Check only one box on line A. Check bo on line B if ap plicable) A) 1. XNew 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) on- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Tr9atment Unit ecirc lating ❑ Other: ke Sfd . 1 1-� 3/ • V. Dispersal/Treatment Are Info rma ' n: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. Syste Elevation 7. Final Grade Required Proposed 2 I Rate (Gals. /day /s (Min. /inch) '� /, s levation VII. Tank Capacity in Total # of Manufacturer Prefab Si e ^ teel fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's Si (no slam s): MP/MPRS No. Business Phone Number Plumb Address (Street, City, State, Zip Code) IX. Co ty/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing ent S stamps) " P / Proved ❑ Owner Given Initial Adverse Surcharge Fee)�� Determination C � X. Conditions of Approval /Reasons for Disapproval: L 31� " l�- aye �!�- s�- � -n-� al�,v �d&Ue— 1S � -� - / 3 SBD -6398 (R. 07/00) add � _ �y �� 4-0-d Z zl� k`- se PLOT PLAN PROJECT Jon Knonn ADDRESS 200 Elm at W. Amery Wi. 54001 SW. 1/4 NW 1 /4s 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Byron Bir Jr. 2205 r DATE 6- BEDROOM 4 CONVENTIONAL _ G ade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gal LIFT TANK SIZE DOSE TANKS ZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1200 # of chamb s 39 BENCHMARK V.R.P top of Driveway N. Post ASSUME ELEVATION 100' ❑ BOREHOLE O WELL I H.R.P. same as Bm Vent SYSTEM ELEVATION T- 1 = 91.5T- 2 =91.4T -3 =91.3 f Standard Leaching C Chamber with 31.1 Cove ft ^2 per chamber 6' at Systern Long 34 " Elevation PL 94' 140th st O ob pipe 7 3 1.25 �`-f• �' 95' 3 6' 'Y 6' � S 25' � � 2 B 1 95' 113 36' B2 15 st BM Alt Bm 4 bed Ho se Driveway Garage PLOT PLAN PROJECT Jon Knonn ADDRESS 200 Elm st W. Amery W. 54001 SW 1/4 NW 1/4s 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX 6 -8 -03 4 r MPRS Byron Bird Jr. 2205 DATE BEDROOM CONVENTIONAL XXXX Grade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE a LOAD RATE .5 ABSORPTION AREA 1200 # of chambers 39 BENCHMARK V.R.P top of Driveway N. Post ASSUME ELEVATION 100' ❑ BOREHOLE O WELL 1H.R.P. sameasl3m AV SYSTEM ELEVATION T- 1 = 91.5T- 2= 91.4T -3 =91.3 Standard Leaching Chamber with 31.1 ft ^2 per chamber Long 34 Elevation PL 94' 140th st O ob pipe B3 81.25 95' 3 6' 25' 6' BI 95' 36' B2 f15' 5 BM Alt Bm 4 bed House Driveway Garage 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 81 /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 information. iv $q 2411 eviewed y e Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). GL's Property Owner Property Location O h p Govt Lot 114 14 S N R! E Property Owner's Mailin dress / Lot ck # Subd. D !yr - .e I City" State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road e r o (/ i mo•z o f� New construction Use: esidential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement Public or ercial Describe: Parent material �a<< r a. / oath Flood Plain elevation if applicable — ft r General comments d and recommendations: /Aac( i + u Tic— ah 0] Boring # Boring pit Ground surface elev. 1/42f-r ft. Depth to limiting factor _2 7 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 2 14 1 i 1. 0 r . Boring # Boring 2 pit Ground surface elev. °Z ft. Depth to limiting factor 7 in. Sal plication 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 'Ef1#2 /� D I A C dAtki- VPC 0. - s �4 '- ZP ✓ ✓ r0. Effluent #1 = BOD > 30 < 220 mg/. and TSS >30 < 150 mg /L 4fRuent D < 30 mg/- and TSS < 30 mg/L ��— CST Name ( Print) Signature r CST Number Address Date Evaluation Conducted Telephone Number l01 Property Owner a1�n 12 0� Parcel ID # Page Z of F-31 Boring # Boring ❑ pit Ground surface elev. /y / ft. Depth to limiting factor >� in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/1F in. Munsell Qu. Sz. Cont. Color I Gr. Sz. Sh. •Eff#1 I •Eff#2 L OP- -f , 3' 3. Co'• Ag V 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/fF 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. Sal 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 Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS a 30 mg/L The Department of Commerce is an equal opportunity i p q pp y sery ce 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) Soil Test Plot Plan 3 Project Name Jon Knopp Byro Bird Jr. Address 200 Elm St. Amery Wi. 54001 G�f #220527 Lot Subdivision RedPine Date / -Count ST. CROIX SW 1/4 NW 1/48 T 30 N /p18 W Townshi Richmo M Boring Q Well PL Property Line# Alt. BM Base of Driveway post ,BM or VRP Assume Elevation 100 ft of N. Driveway Post System Elv. T -91.5T -291.4 H.R.P. T -3 =91.3 Same as Bm PL 94 140th st 40' B3 95' 30 25 B1 95' 36' B2 BM Alt Bm 4 bed House Driveway Garage r Soil Test Plot Plan Project ,Name Jon Knopp Byro Bird Jr. Address 200 Elm St. Amery Wi. 54001 C4f #220527 Lot 2 Subdivision RedPine Date / County CROIX SW 1/4 NW 1/4 S 25 T 30 N /R W Townshi Richmond n Boring Q Well PL Property Line# Alt. B Base of Driveway poat ,BM or VRP Assume Elevation 100 ft top of N. Driveway Post System Elv. T -91. -291.4 H.R.P. IF-3=91.3/Same as Bm PL 94' 140th st 40 B3�,�. 30 0 25' `� .2 �L B l 95 , 36' B2 80� y •� �'� M I Ili ���o✓ Al_ m 4 bed House Driveway Garage N 01T T scA-c E foo rrn bw Wisconsin Department of Commerce SOIL EVALUATION REPORT Page — !—of 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 C ro i x include, but not limited to: vertical and horizontal reference- peint,(BM), direction and Parcel I.D. pending percent slope, scale or dimensions, north arrowand location and distance to nearest road. p g Please print olfinformation. ,''. Review b ��n� Date Personal information you provide may be use br secondapr,pur bseH ivacy Cew p.�5.04 (1) (m)). M41 V ' " Property Owner / _, 'r -� Pralb Locatio Lot SW 1/4 NW 1/4 S25 T 30 N R 1 j (or) W Property Owners Mailing Address tot Block # Subd. Name or CSM# 1611 City State Zip Code •°' ,hone OFFl 1. " - V City ❑ Village K] own Nearest Road t. Spring Lake P#4 P#4, 55432 Richmond 9 New Construction Use: g Residential / Number - '4 Code derived design flow rate 600 GPD [I Replacement ❑ Public or commercial - Describe: Parent material glacial dr ift Flood Plain elevation if applicable na ft. General comments and recommendations: mound @ el. 100.50', based on contour 1 ine of el. 99.50' ❑ Boring # F] Boring 99.80 80 46 ® 1 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 /fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 1 0 -10 10yr 2/2 none L 3 22 -40 7.5 4/4 none scl 2msbk mfr 4 40 -46 Syr 4/4 none lfs OSG mvfr qw na .5 .9 5 46 -70 5yr 4/4 c2d7.5yr 5/6 scl M na na na .0 .0 F Boring # E] Boring 99.80 ® Pit Ground surface elev. ft. Depth to limiting factor 66 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -11 10 2 11 -23 10 4/4 none sicl 2msbk mfr 1 4 33 -66 7.5 4/6 none is gg mvfr 7 5 66 -50 Syr 4/4 none scl M na na na .0 .0 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L 4Dt.Ealiation nt #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Gar L. Steel 02298 Address Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 11 -15 -2000 715 - 246 -6200 �I Property Owne rOakwood Tand_ pee- Parcel ID# pending Page 2 of 3 E] Boring 5� Boring # n pit Ground surface elev. 99.3 ft Depth to limiting factor 57 in. lXJ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/M in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 2 16 -30 10 4/4 none sicl 2msbk mfr if 4 6 3 30 -57 7.5yr 4/4 none is Osq mvfr qw na .7 1.2 4 57 -70 5 4/4 none scl M na na na 0 0 a Ong # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # F] Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 5 220 mg1L and TSS >30 < 150 mg1L ' Effluent #2 = BOD, 5 30 mglL and TSS 5 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (PAM) STEEL'S SOIL SERVICE Gary L. Steel Oakwood Land Development 1554 200th Ave. CSTM2298 SW4NW4 S25- T30N -R18w New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #27 -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 SE lot stake @ el. 100.00' Alt. BM. =.top of mid lot survey stake @ el. 99.50' OL k- k" Id `0 � t00% ,. Steel 11 -15 -2000 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ' of y FILE INFORMATION SYSTEM SPECIFICATIONS Owner �� �� Septic Tank Capacity 6 al ❑ NA Permit # v yJ� Septic Tank Manufacturer �/�� J� ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units NA Pump Tank Capacity a l ❑ NA Estimated flow (average) al /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) _ _ al/dav Pump Manufacturer ❑ NA Soil Application Rate , al /da /ft2 Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit 1 XNA 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) A Biochemical Oxygen Demand (BOD 530 mg /L - Ground (gr avity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 a cfu /100m1 ❑Drip -Line ❑Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA P earls) 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: ❑ earls)(s) Maximum 3 years Y ) ]�E NA Clean effluent filter S east once every: 2 ❑ yea�ls1(s) ❑ NA ❑ month(s) ❑ NA Inspect 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) 13 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 tankls) 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. GMW (4/01) 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 cherInicals 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. 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. ❑ 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 i POWTS INSTALLER POWTS MAINTAINER Name y , pn ��. Name =on p Phone Z6 !� Phone /S �'� SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone 6 / Phone 6 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.540►, (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address /�� / y� f� _ �• (Verification required from Planning bepartment for new construction) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location �� r/. ��� V4, Sec. �S T 3 �N -R /`e W, Town of li( Subdivision <- �r� . Lot #. Certified Survey Map # . Volume . Page # _ Warranty Deed # 70 Volume d Page # Spec house f -yes ❑ no Lot lines identifiable -Wyes ❑ no MEW CE �NAN 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 c a treatment stage in the waste can affect the function of the septic tank as g disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastcrplumber, journeyman plumber, restricted plumber or a li cense d p verifying that (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 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 a iration date. SI OF APKICANT 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 owner(s) of the prope escn hove, by virtue of a warranty deed recorded in Register of Deeds Office. SI TURF OF AP LICANT DATE « « « « «« information that is mis -re resented may result in the sanitary * « « « «« �Y P Y �Y � rmit 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 2 2 6 3 P y p 6 724436 d L STATE BAR OF WISCONSIN FORM 1 —1998 KATHLEEN H. REGISTER OF DEEDS DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number 06/04/2003 09:30AH This Deed, made between Oakwood Land Development. Inc. a Limited Liability Corporation Grantor, and _ JON D. KNOPP AND WARRANTY DEED MARY J. KNOPP HUSBAND AND WIFE EXEMPT # Grantor, for a valuable consideration conveys to Grantee the following REC FEE: 11.00 described real estate in St. Croix County State of TRANS FEE: 99.00 Wisconsin (the "Property"): COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address Jon D. Knopp X 140th Red Pine Comer New Richmond, WI 54017 L Parcel Identificadon Number (PIN) 046- 1130 -47 -6kJJ This Is not homestead property. (is) (Is not) Lot 27, Red Pine Corner, St. Croix County, Wisconsin. 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 28th day of May, 2003. (SEAL) (SEAL) Q Oa wood Lan eveiopment, Inc. (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, WENDY SWAT ZINA ) ss authenticated thigh �a St. Croix County C �� Personally came before me this 28th day of May, 2M the above named Grecory J Peterson. as Vice President to me known to + be the person _ who execu d the foregoing TITLE: MEMBER STATE BAR OF WISCONSIN instru an a acknowledge the s e. (If not, authorized by §706.06, Wis. Stats) • W r d z C44 THIS INSTRUMENT WAS DRAFTED BY Notary Public, State/of Wisconsin Cotdwell Banker Burnet 1301 Coulee Road My commission s permanent. (If not, state expiration date: Hudson, WI 54016 3 -33724 ) (Signatures 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 Milwaukee, Wis. I � i J • N W i N E I LOCATED IN PART OF THE NOR AND PART OF THE SOUTHEAST �I SECTION 25, TOWNSHIP 30 NOF 11 I O I:I I I � S W S E I I'I NOTE: NO OWNER OR RESIDE WITH OR CHANGE THE OPERi __�� = =�=_ _=— �_- _�__ =�__= DRAINAGE AND SOIL EROSIOP I; 130th Avenue BUT IS NOT LIMITED TO BUIL VICINITY MAP FILLING, OR EXCAVATING OR SEC. 25, T..30 N., R.18 W. WATER DRAINAGE DITCHES, r TOWN OF RICHMOND, ST. CROIX COUNTY WI BERMS OR GRASS SEEDINGS. NOT TO SCALE -mss --- Y3 5' LOT 26 ve4l: LOT ------ �__ - - -- TH LINE _OF W ., NW 1L4 0 MA TCH LINE. tiNORTH LINE OF THE SW 114 0 33 I ; S89'S2'26 "E 330.00' N SEE Sf I MA TCj -- 6 ' - 1 $2 g ► LOT 27 S88.27'01 0 66, 000 SO. FT. co 1.52 ACRES � �--; I N LOT 0; 3 I ; 66,7525 1.53 AC S89.52'26 "E rl Oi ; 330.00' N r- mI 00 I I U I O 1 r- � w ; I LOT 28 66, 000 S4 FT. U I 0 3 0 Qf � a i Q I I Co N 00_.._.. -.._ N 1.52 ACRES i4 N N 1 N I I /2 I �_ I a 2J• p i 00 HS8• S —1 w l I Cp o f V' Li I CN F—i I I 589 "E w l --I i I w I 330.00' U i> N I j� i M LOT 29 ►— I o , 66, 983 SO. FT. LOT OI O o° 1.54 ACRES J I I p °0 0 70,062 SG Z `I' N 1.61 A0 I i I I I' L------- - - - - -- ---- - - - . - - -- I -� \ - -- C`on•r'n nr_ r nnc n-v �