Loading...
HomeMy WebLinkAbout026-1076-95-400 . ._._ . .. . _. ' o 0) o ■ c � 2 § i Q! § X g 2 = 0 ° & 9 \ % . CD co V 0 » & - . §0 00 CL ` D ] � EE 1 ƒ i 'A % \; /§± ¢ » CD / o t� 0 . z §?j0r■ ° 2 / � 9 & % "WA. T T T ■ 0 0 0 £ .. \ rr3- CO) §) J § J m co § g 9-0 d 2 . . L § . & i i i / 7 ƒ 2 \ o [ 0 \ , / CD / g 3 E " B CA k / z o R ' @ -1 rl) ::E § 0) CL Z ° ;o 0 co 0 z w $ Gk§J)CL 3ee3CD § T A § 0 }z % / \k0 ° ©#§ , { /�\ \ 'g\ ) 0 {M i =,E E/ —§ , ■ 9317 E 2gi- a 0. a 5- Er 2 2 E § 4 ' 2 � ■ o CD \ 169 ? § CD , � Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building DiJrsion !, INSPECTION REPORT sanitary Permit No: 453487 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: Erickson, Terry I Richmond Townshi CST BM Elev: Insp. BM Elev: BM Descripti Section/Town /Range /Map No: / a _U �, C) /l/ W 5J7__ ._ � er 26.30.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benc ark Dosing Alt. BM, Aeration vJ� Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , � � �• , Dt Bottom t Dosing / Header / MMn. s i Aeration l I I,� Dist. Pipe Holding Bot. System O) I o - 5t} o­-, Z O LL F inal Grade PUMP /SIPHON INFORMATION -­ M /� �7• �. D'L, �0( Ma acturer Demand St Cover r GPM �7 �(✓ 0 CS �. S 07,71 I Model Number f �- �' Ste✓ U� TDH Lift Friction L Sys e TDH Ft Forcemain ' 4 "01 - j Dia. Dist. to well SOIL ABSORPTION SYSTEM G % ✓� C�/� BED/TRENCH Width Length ^ 1 No. Of Trenc s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO / P/L BLDG WE L LAKE/ REAM LEACHING Manufa �r INFORMATION CHAMBER O F- UyG Ty Of System: � , r Model Number: S'T7 ` DISTRIBUTION SYSTEM _w t_k Header /M Id Distribution x Hole Size x Hole Spacing Vent to Air Intak I R Pipe(s) q Length_ Dia Length 1 Dia _ Spacing_ SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded j xx ulche Bed/Trench Cen ,, - Bed/Trench Edges Topsoil 7I Yes No `] Yes F, No COMMENTS: (Include We epencies, persons present, etc.) Inspection #1:10/ 7 / � Inspection #2: Location: 130130th Ave. (pending) New Richmond, WI 54017 (SW 1/4 WI1/4�26 9T330N R1 8W) NA Lot 4 Parcel No: 26.30.18. 1.) Alt BM Description = 4T• 2.) Bldg sewer length = qo, �YB In n �4- -amount of cover = �� Plan revision Required? Yes /No Use other side for additional information. to b Date Insepctors Sign ure „ Cert. No. SBD -6710 (R.3/97) />' � � � �� 7��� PLOT PLAN PROJECT Term Erickson ADDRESS 242 S. Montana NewRichmond Wi. 54017 SW 1/4 SW 1 /4s 26 /T 30 NIR 18 W TOWN Richmond COUNTY ST. CROIX MPRS Byron Bird Jr. 220527 r DATE 4 -23 -04 BEDROOM 4 CONVENTIONAL XXX A CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1 000 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE >5 ABSORPTION AREA 900 # of chambers 30 BENCHMARK V.R.P Base of PL stake ASSUME ELEVATION 100' ❑ BOREHOLE O WELL •H.R.P Same as BM Vent SYSTEM ELEVATION T -1 =100.5 T -2 =100.0 > 12" Of Bio Diffuser with Cov 3 1. 1 ft ^2 per chamber 6„ LOIIB Elevation �Y d ►^°� 1/litfivw alt BM ✓ V Ate BM ^^ PL 2M , I\ 43 LJ 3 103' 330' 100' 15' I D aD ` st O ob pipe PL 3 Bed House Garage Drive ay 2 I AdOO PLOT PLAN PROJECT Terry Erickson ADDRESS 242 S. Montana NewRichmond Wi. 54017 SW 1/4 SW 1 /4s 26 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Byron Bird Jr. 220527 DATE 4 -23 -04 BEDROOM 4 CONVENTIONAL XXX Z t -G rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 0 LOAD RATE >5 ABSORPTION AREA 900 # of chambers 30 BENCHMARK V.R.P Base of PL stake ASSUME ELEVATION 100' ❑ BOREHOLE O WELL +H.R.p. Same as BM Vent SYSTEM ELEVATION T -1 =100.5 T -2 =100.0 > 12" Of Bio Diffuser with Cove 31.1 ft ^2 per s� VyVI chamber 2 (1/6 bo WO'L r Long 34" Elevation T4 7 t !! alt BM q 6 • d suv'�ac� �sSm (/� Ghee �t r`�� u. 6� re-� BM CD 6& Pj/�- PL 208' -'7- I� WrWLjt B3 �� 50 N or 43' `03 101 121 3 b 103' -�C, 330' 100' l o y B 15 st O ob pipe PL 3 Bed House Garage / Drive ay 2 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 Box 7302 14scons Personal information you provide may be used for second purposes Madison, WI 1 5 53707 -7302 Department of Commerce � p u � (Submit Completed form to County if not [Privacy Law, s. 15.04(l)(m)] state owned.) Attach complete plans (to the county copy only) for the system, on pap n l ess than 8 -1/2 x 11 inches in size. County t State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. D. Number Gr® y� 5 ! f3 6 I. Application Information - Please Print all Information Location: Property Owner Name Pro L9cC t /fie Property Owner's Mailing Address/ LotNarmer Block Number City, State Zip Code Phone Number SubdWision Name or CSM Number Aazt C-Aj��z j - II. Type of Building: (cTieck one) ❑ Ci e '.... 1 or 2 Family Dwelling - No. of Bedrooms : ❑ Village ❑ Public /Commercial (describe use):_ L j O Vown of ❑ State -Owned 3/ Nearest Road Parcel Tax Number( j0 O III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. UMew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to S 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) > Zq � r, ion- pressurizi and ❑ Mound 2� ❑ Sand Filter ❑ Constructed Wetland ❑ ress�n- ground ❑Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatmen U it ❑ Recirculating ❑ Other: �toia /�U.jE'7Z 57D. L,�� � . V. Dispersal/Treatment Area Information: _ L 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grad Required Proposed �32"� Rate (Gals. /day /sq. ft.) (Min. /inch) �) _ ©S —Elevation te VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing • crete structed Tanks I Tanks ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned assume responsibility for installation o f the POWTS shown on the attached plans. Plumber's ame (print) Plum s i nature (no stamps): MP/MPRS No. Business Phone Number Plumbe ' Address (Street, City, StaOr Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Dat Issued suing A Si stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) * 0? r g�2 Determination X. Conditions of Approval /Reasons for Disapproval: 0 � J � ( a � W + SYSTEM OWNER: �3 Sz �itQ. �IO1�"PIC!/�( 'r (OZ•0 = 132- Kbf - 0I ep is tank, effluent fi er and dispersal cell must all be serviced / maintained ynt as per management plan provided by plumber. / 2. All setback requirements must be maintained ' & 3. V3 Ul �( � � f-e d 3 SBD -639 (R. 07/00) C� PLOT PLAN PROJECT Terry Erickson ADDRESS 242 S. Montana NewRichmond Wi. 54017 SW 1/4 SW 1 /4s 26 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX r MPRS Byron Bird Jr. 22052 �/ 4 -23 -04 BEDROOM 4 DATE CONVENTIONAL XXX rade CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE 0 LOAD RATE >5 ABSORPTION AREA 900 # of chambers 30 BENCHMARK V.R.P Base of PL stake ASSUME ELEVATION 100' ❑ BOREHOLE (DWELL sH.R.p. Same as BM Vent SYSTEM ELEVATION T -1 =100.5 T -2 =100.0 >12" Of Bio Diffuser with Cove 3 1. 1 ft A2 per chamber 6" Q—de at System Long 34" Elevation alt BM BM PL 208' N T 80' B3 �, B2 1049 43' 94' 3 103' 330' 100' B 15' 102' st O ob pipe 15' pl,,, 3 Bed House Garage Drive ay 2 I - 7 E66 ?41 VO4-JA—PAGE 4777 KATHLEEN H. REGISTER OF DEEDS ST. CROIX CO. MI RECEIVED FOR RECORD 06/23/200 11:50AM C ERTIFIED SURVEY MAP CERTIFIED SURVEY MAP REC FEE: 13.00 LOCATED IN PART OF THE SW1 /4 OF THE SW1 /4 AND PART COPY FEE: 3.00 OF THE SE1 /4 OF THE SW1 /4 OF SECTION 26, T30N, R1 8W, PAGES: 2 TOWN OF RICHMOND, ST. CROIX COUNTY, WISCONSIN. PREPARED FOR: NOTE: NO BUILDINGS ARE ALLOWED TOM KROHN WITHIN THE DRAINAGE EASEMENT. THE 2131 HIGHWAY 35 NATURAL FLOW OF STORM WATER SHALL SOMERSET, WI. 54025 NOT BE IMPEDED. SURVEYOR: LOT 4 DOUGLAS J. ZAHLER 2.16 ACRES (93,869 SO. FT.) TOTAL AREA S 3 N LAND SURVEYING, INC. 2.00 ACRES (87,`120 SO. FT.) EXCLUDING RNV 2920 ENLOE STREET LOT 5 HUDSON, WI 54016 28.43 ACRES (1.238.372 SO. FT.) TOTAL AREA 27.75 ACRES (1,206,776 SO. FT.) EXCLUDING RNV BEARINGS ARE REFERENCED TO THE WEST UNE OF THE SW1 /4 OF SECTION 26, ASSUMED TO BEAR NORTH LINE OF THE SW 1k NORTH LINE OF THE Be 114 N00'08'18'W OF THE 8W1H OF SEC. 26 y ' �p� 1� -- OF THE SWIM OF SEC. 26 SCALE 1'- 250' S89 °52'33 "E 87.26 250 500 in of Wi y w DOUGLAS J. H I W 1/4 CORNER _ OL_9 PG 248 c 1__ —_ - OF SECTION 26 O to U , Z '66. "Op m-4 3 9 0 52'38 "E 379.70' to �sQe'as� O "41, O °= Go all M m. F4 I , I LOT 5 ' I YSL -1Q33. r? `} a \\�I ^ FI I w Yj APPROXIMATE ELV"60.0s I I act J!%29_ i. y`5 \ \ib io Si of % �v A RV Q I \� o n Q ice \ o 4:_ , �FdlF I \ N 210.00' c b 0 1g14"W ^ ^nr I :3 — CD S` 91.15 1 p X7 1' 25 J �FE NCE LOT 4 �eO'%"t'tc " I _ k P �``6_1� 44 267 - - - -- Y " ... K ur . . E ... . 2Q ZL ....... ` ...................... ..� . ?� b S 114 CORNER SW CORNER OF CROACHES 8Y S89 1161.45' g • ��{ � OF SECTION 28 SECTION 6 210.00' 951!_45' .00' �- 32.34' �--• 198' 75.00' 0� 951.31' 1090.2i'��i - - -- j N89 11 49'55 "W 1161.31' - 1 S89 2806.55 L- LEGEND -SOUTH LINE OF THE SW 114 OF SEC. 26 I& SET SURVEY MARKER NAIL 0 FOUND 1* O DIAMETER IRON PIPE APPROVED Q SET PIPE. EI DIAMETER LB S. PER 18' LONG PwwAng Za*q WW IRO 1(1" LINEAR F PI PE, WEIGHING 1.13 LB ....... SETBACK JUN 2 12004 O SOIL BORINGS DRAINAGE DIRECTION ARROWS Ifs � �at ~ � DRAFTED BY: WESANDERSON 1r+fwndvOM REVISED: 6116/04 DATE: 4/12/04 SHEET 1 OF 2 SHEETS Vol 18 Page 4777 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County / r Attach complete site plan on paper not less than 81 /2 x 11 inches in size. Plan must l/ include, but not limited to: vertical and horizontal reference point (BM), direction and p I.D. a percent slope, scale or dimensions, north arrow, and location and distance to nearest road. / — �_--7 Please print all information. sewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). g 2 Property Owner Property Locatio err , Govt. Lot `r rJ 1 /4S({JI /4 S ' 4 T O N R/ E Property Owners Malfing Address Lot # Bbcic # Subbd. ame M# C• State _ p e e umber City Villag Town Nearest Road �cli�rc H ; .6 76 Tian JR New Construction Use: um r o bedrooms Code derived design flow rate 15Z S� GPD ❑ Replacement [] Public or co mera Describe: Parent material Flood Plain elevation if applicable General comments and mmendations: �'�, _ / _ /e C /, V l00• Boring # Boring ❑ Pit Ground surface elev U,�? S ft. Depth to limiting factor `7 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tF in. Munselll� Qu. Sz. Cont. Color Gr. Sz. Sh. ✓ 'Eff#1 'Eff#2 Boring # Boring _ v 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 � m Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 150 ng& ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL CST Name (PleW Print) Signature CST Number Address /� ate Evaluation Conducted Telephone Number Property Owner r rr C //" Parcel ID # Page of a Boring # �Borin ❑ pit Ground surface elev. I ft. Depth to liming factor i_ i7 `7 in. �— Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. �r •Eff#1 •Effff#r2 D /r r e. m , 5z F-1 l� ���� �� Boring #� ❑ Boring � � -- ❑ pit Ground surface elev. ft. Depth to limiting factor in. _ Sal 'cation 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 E] �n9 F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. 1:1 pit Sal Appl ication 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 5 30 mg& 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 fomnat, please contact the department at 608- 266 -3151 or TTY 608- 2648777. SBI) 8330 (R.07 /00) � Soil Test Plot Plan Project Name Terry Erickson B yron Bird Jr. B 1 Address ' 242 S. Montana NewRichmond Wi. C #220527 Lot Subdivision Date 4/2212004 County CROIX SW 1/4 SW 1/45 T 30 N /R W Townshi Ric Boring Well PL Property Line Alt. BM Base of PL Stake 3. L� ,BM or VRP Assume Elevation 100 ft of PL Stake System Elv. T- 1 =100.5T -2 =100 H.R.P. same as BM - Y �/x N -�C Vt S� U/n� , IM S"� a -� alt BM R & q ( 0,, S k4wk o'er. 4-e- �-e ve - r&,- Sv pv ` BM PL 208' IN W , B3 150' B2 104' 43 103' 30 330' 100 102' PL 130tj ave ye a "f. & EMEl ME FA ga V A p f k i wvw:w + �""' t ♦ w. SFr.,, �, s `�, `, ,'�� „a.�;.. 2. $�ES try r _: gn " t # . .�„ '� yak} 3 K . + - t • I N 7 �.¢/�L�, ✓ . • ' .� .•ter' f� 1 - iMA �. 111111111 Jill 111 1111 Jill !1111111 r � '. ��� r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner T er _ rI � Septic Tank Capacity a l ❑ NA Permit # 53 Septic Tank Manufacturer Id .Q f ❑ 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) 3CD I/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer ❑ NA Soil Application Rate r /da /ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Tota Suspende Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L 94n-Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /L NA ❑ At -Grade ❑ Mound Fecal Coliform (geome mean) <10 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 month(s) (Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 0 mon h(s) (Maximum 3 years) ❑ NA Clean effluent filter t least once every: ❑ month(s) ❑ NA � �G7] X year(s) ❑ 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: At least once every: ❑ month(s) ❑ year(s) ❑ NA 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 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant replacement system: C� G A suitable replacement area has bee evaluated and may a utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. T a o in tank tjll� aluat e ai e . FfZD44115 MZI 9 A16_' �✓ 40"5 72(JCQ 1. D b - ❑ 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 A l ,- Name Q Phone l� Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Q n ' �.� Name ST. C l G 20hI1 N Phone L Phone "7 /S 3�(p- 4 I & SO This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.5401, (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 25 r Mailing Address 3oef\ Property Address L /3 (Verification required from PVnnmg Department for new construction) City/State G� wy Parcel Identification Number_ LEGAL DESCRIPTION Properly Location �= %4, ' /., Sec. T N -R-X—J�W, Town of Subdivision , Lot #. Certified Survey Map # 7 7`F/ Volume I , Page # y Warranty Deed # _ �2 ? 7 / , Volume Page # Spec house ❑ yesjRLno Lot lines identifiable yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, joumeymanplumber, restrictedplumber or a licensed pumper 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the year expiration date. OF APPLICANT 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 e described above, by virtue of a warranty deed recorded in Register of Deeds Office. /t S 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 U. 2638 P 408 771771 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 - 1998 REGISTER OF DEEDS ST. CROIX CO.. WI RECEIVED FOR RECORD This Deed, made betweenThomas E. Krohn, a single person, Grantor, and Terrance J. Erickson and Cheryl M. Erickson, husband and wife, as 08/16/2004 10%00A1! survivorship marital property, Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEIPT • the following described real estate in St. Croix County, State of Wisconsin (The REC FEE: 11.00 "Property "): TRANS FEE% 60.00 COPY FEE% Part of the SW 1/4 of SW 1/4 and Part of the SE 1/4 of SW 1/4 of Section 26, CC FEE.- PAGES: 1 Township 30 North, Range 18 West, St. Croix County, Wisconsin described as follows: Lot 4 of Certified Survey Map filed June 23, 2004 in Vol. 18, Page 4777, Doc. No. 766-T4 - - Recording Area Name and Return Address Hendrik W. Van Dyk VAN DYK, O'BOYLE & SILER, S.C. Post Office Box 118 New Richmond, WI 54017 P rt or 026-1 -9-5-0-00 Par identification Number ( N) This is homestead pro Exceptions to warranties: Easements, restrictions and covenants of record. Dated this day of August, 2004. *Thomas E. Krohn * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Thomas E. Krohn STATE OF WISCONSIN ) ) ss. 7 S[. Croix County ) auth lated this 43 day of . 2004. Personally came before me this day of 2004 the above named * endrik W. Van Dyk to me known to be the person(s) TITLE: MEMBER STATE BAR OF WISCONSIN who executed the foregoing instrument and acknowledge the (If not, same. authorized by § 706.06, Wis. Stairs.) THIS INSTRUMENT WAS DRAFTED BY Hendrik W. Van Dyk VAN DYK, O'BOYLE & SILER, S.C. Notary Public, State of Wisconsin P.O. Box 118, New Richmond, WI 54017 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not ') necessary.) "Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM Nu. 2 - 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. WI 800 -855 -2021 LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF RICHMOND COMPUTER NUMBER 026- 1076 -95 -000 Parcel Number 26.30.18.402 OWNER NAME: First THOMAS E Last KROHN PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 26 TOWN 30N RANGE 18W 1 /4160 '/440 Line Description Line Description TOTAL ACREAGE 24.610 PLAT LOT BLK 01 SEC 26 T30N R18W PT SW SW 15 02 EXC THAT PT TO LOT 2 CSM 16 03 9/2486 & EXC PT TO CSM 17 04 9/2673 & EXC THAT PT TO A 18 05 PARCEL DESC IN 1033/20 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, 174 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF RICHMOND COMPUTER NUMBER 026 - 1076 -95 -100 Parcel Number 26.30.18.402A OWNER NAME: First SCOTT E Last HAWKINS PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 1321 HWY 65 SECTION 26 TOWN 30N RANGE 18W 1 /4160 1 /440 Line Description Line Description TOTAL ACREAGE 9.000 PLAT LOT BLK 01 SEC 26 T30N R1 8W PT SW SW 15 02 BEING LOT 2 OF CSM 9/2486 16 03 9 ACRES 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF RICHMOND COMPUTER NUMBER 026 - 1076 -95 -300 Parcel Number 26.30.18.402B -10 OWNER NAME: First CLYDE E & MARILYN Last VETTER PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 1302 130TH AVE SECTION 26 TOWN 30N RANGE 18W '/4160 1 /440 Line Description Line Description TOTAL ACREAGE 6.210 PLAT LOT BLK 01 SEC 26 T30N R18W PT SW SW 15 02 BEING LOT 1 OF CSM 9/2673 16 03 ALSO A PARCEL DESC AS COM SW 17 04 COR SEC 26; TH N 00 DEG ALG 18 05 W LN SW1 /4 308' -POB; TH CONT 19 06 N 00 DEG W 476.09'; TH S 89 20 07 DEG E 355'; TH S 00 DEG W 21 08 476.38' TO NE COR CSM; TH N 22 09 89 DEG W 355' TO POB 23 10 EXC PT TO HWY PROJ 1620/589 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit 7 6 6 7 4 1 VOL —PAGE 4777 XATALEEM H. ALSH REGISTER OF DEEDS ST. CROIX CO. MI RECEIVED FOR ECORD 06/23/2004 11:50AN CERTIFIED SURVEY MAP CERTIFIED SURVEY MAP REC FEE: 13.00 LOCATED IN PART OF THE SW1 /4 OF THE SW1 /4 AND PART COPY FEE: 3.00 OF THE SE1/4 OF THE SW1 /4 OF SECTION 26, T30N, R18W, PAGES: 2 TOWN OF RICHMOND, ST. CROIX COUNTY, WISCONSIN. PREPARED FOR: NOTE: NO BUILDINGS ARE ALLOWED TOM KROHN WITHIN THE DRAINAGE EASEMENT. THE 2131 HIGHWAY 35 NATURAL FLOW OF STORM WATER SHALL SOMERSET, WI. 54025 NOT BE IMPEDED. SURVEYOR: LOT 4 DOUGLAS J. ZAHLER 2.16 ACRES (93,869 SO. FT.) TOTAL AREA S & N LAND SURVEYING. INC. 2.00 ACRES (87,120 SO. FT.) EXCLUDING R/W 2920 ENLOE STREET LOTS HUDSON, WI 54016 28.43 ACRES (1,238,372 SO. FT.) TOTAL AREA 27.75 ACRES (1,208,776 SO. FT.) EXCLUDING RNV BEARINGS ARE REFERENCED TO THE WEST LINE OF THE SW1 /4 OF SECTION 26, ASSUMED TO BEAR NORTH LINE OF THE SW _NORTH LINE OF THE BE 114 NOO °08'18 "W OF THE SWIM OF SEC. 26 -� �T P�'A �� Q� SCALE: 1 "- 250' 1 t OF THE SWt /4 OF SEC. 28 S89 250 500 " � pF w1SC 0 C-2 DOUGLAS J, tr2 3 H L_O_T_ _2 _C_SM_ _ C W 1/4 CORNER _ OL_9 OF SECTION 26 O � Z APp 3 '7 ( S 9 °52'38 "E 379.70' N1±-3� `ess F4 114 00'. 89° 52`38 "E 355.0 �F\ S LOT 5 \ w YDI - APPROXIMATE ELV= 960.0t , �I c C q °Ra /Hq 6 I �4r g g r n c= G SAS \ tTi �MFNT I \ 1 V ap 210.00' o b w 13'14 yN 6 �/ � Ap 1 "pis 1 O _ _ Z L 4 '°ROx�ygTF�( ✓�'Ss�'�� VO�L �26 S � yy \ ice N-e3 =�4" 2 ^a.a#• `5 — _ Y - Cff - 7- SETSACKLINE iE� j ENCRO^1HES �" ` ... .. ~ _ ... ...... e't '� 'L1 5 114 CORNER S89'43'46 "E 1161.45' s � 210.00 951.45' _ -- 32.34' �- �- 7 .W OF SECTION 26 / �\` T 1�-21 0.00��' 951.31' 1090.24 - -- - --- i N89 °49'55 "W 1161.31' - -' - 1 S89'49'55 "E 2806.55' LEGEND L- -SOUTH LINE OF THE SW 1/4 OF SEC. 26 ® SET SURVEY MARKER NAIL 0 FOUND 1 "OUTSIDE DIAMETER IRON PIPE APPROVED Q SET 1° OUTSIDE DIAMETER BY 18" LONG ST" CROIX COUNTY IRON PIPE, WEIGHING 1.13 LBS. PER Pb11 rw zw*1} 8" P%*S L` W"VIMSe LINEAR . ...... SETBACK JUN 2 12004 ® SOIL BORINGS t DRAINAGE DIRECTION ARROWS If rxA recorded MIt/11m 20 days O4! approval dew am - be DRAFTED BY: WES ANDERSON nwwwv fd PROJECT# 6418 -01 DATE: 4/12/04 REVISED: 6116/04 SHEET 1 OF 2 SHEETS Vol 18 Page 4777 CERTIFIED SURVEY MAP Located in part of the SW4 of the SW4 and in part of the SE4 of the SWa, all in Section 26, T30N, R18W, Town of Richmond, St. Croix County, Wisconsin. N AP W} Corner of OWNER PROVED Section 26 Masonry Nail Found Marvin L. Utecht MAY 1321 Hwy, 11 New Richmond, WI 54017 W ST. CRO1X COLWTY' o :;pnwehensive Ptaffwong o , Zoning and o Perk CD z U I V f L H T T—� V l_ A I V V` 1f not recorded Note Existing Shed to be removed. whin 30 days of 85' 50' North line of the Sj of the SW} (S89 11 E, 2612.22') val'date - S89 15 "E 734.71' 1 „ �'shasbo N00 15 11E SHED 701.71' t S89 40 Cfll loo' O Cf) i 181.76' 2 HOUSE a BARN Z I Lam LLJJ C'-) I 4 1 N89055145 11W <I - I _ 12.00' �D n , _J I Q LOT 2 _ nl 11JI =� M I611 3 - 11Jl I m 9.00 Acres Inc. R/W U _ I Q� Ln �I u� © 392,045 S -0. Ft. u, -J I M ., 8.50 Acres Exc. R/W o <I 100 �-I � q• t. 370,213 S F o J I ji 85' 45'10 o O 11 N U) 2 z r — 45.00' 689.71' I` N89 "W 734.71' •n ri i t I� I P /A T T r1 I A I� I r� y O r'I �t w• a y i �u Si Y J . U. y 0 �. F t.� A l Z r- C l W � O L C) SCALE IN FEET 0 00 200 400 I J �N V) S89 "E 1946.32' a� a� v N — SW Corner of N89o37' 32 "W 2606.57' W Section 26 South line of the SW} 2 Masonry Nail Found ix E-+ Vol 9 Page 2486 SHEET 2 OF 2 SHEETS U � 0 ° f c g; g 2 A 4 7! �— — i — � § 0 ƒ 0 / [ k — . I E « ° § $ § - 2 A / ( \ k � § ° o , � § 2 X 7 ] § o c d J ° E = 4 > E E _ £ to a C CL 3 \ E B $ . / \jf � $ § q { A \ \ , § [ \ - / 0 0 0 L cn § Ch § \ 7 ~ > / 6 m \ / ;k2-4 / ! # : \ E , o ƒ m 2 ƒ k 0 / \ 2 § N \ \ \ _ f m CD C6 — j ■ a / CL § 9 0 " \ \ � @ \ £ I ' E = 005. 0) =�> / m�m,,,� n kikk\\#a § \ �§ \5ECL(D0 CT C D M cD \ 'CD % ) §98«0 CD $ .CL q:_, a § = = I§JR\�§n_ =E 3EEI%E &oN/ ) gCL a8 —3__ 3t �== -0 q � = §i K .0- 00)ƒi //E $ 117E ; , -, EE © \ » {\E5 !) % e ®qo §Emm \ \ o 9C Vi § ±CL 2£2 E 7 }I+ § 2 Eg =g � K . 0 � < % § r 4 840 / CERTIFIED SURVEY MAP 3 Located in part of the SW of the SW4 and in part of the SE4 M of the SW4,'all in Section 26, T30N, R18W, Town of Richmond, St. Croix County, Wisconsin. 'u co LEGEND N= 4) 4J-0 B Section Corner y 0 1" x 24" Iron Pipe Set, weighing 1.68 lbs. per linear foot. s � a —►� Existing Fenceline ° y v m Roadway Setback Line ; ,o C N W ® Existing Well � c a> o p Existing Septic Vent i T - T � , ,r�L L 'C-' U NP VL,A i i FEV L. AN... 01 N O (4-- O N North line of the Sj of the SWJ (S89 "E, 2612.22 in z S89 "E 660.25' — S89 1217.26 i , M y ���;��r �•r.a�, :.. �.��.i'� :a�_ � .• 11.E MAY 2 oNNELL °' 0 a1 Deeds = N....- 909 C WI cnb '1. 94 CJ 1 Y CJ I _ O APPROVED � � M z_ V N �. <1 a ,-1 LOT 1 � M M c MAY �2 1 b �JI 20.00 Acres Inc. R/W Cn H V J I ,- L -1 W a ; 871,194 Sq. Ft. ST . CROIX MUNTY " o 4J ;;omtxohensivo Planning �I o '" 19.56 Acres Exc. R/W o o Q I 2o9 and J - 851,868 Sq. Ft. - JI Packs Commitfe� �- I ,5 1 I _11 o o '� I 0 0 4J _31 If not recorded -31 0 0 ■ U)W within 30 days of approval data pproval shad tt� s r4A Si void '- N co .. O N S 19467 32? "E N89o "W 660 .261 1 4' M T 660.25 M _ N89 "W 2 60.6.57' M L— South line of the SW} � S} Corner of a 130TH AVENUE Section 26 x i ii i i -r--r n ir,c: 1" x 24" Iron Pipe Set C H SCALE IN FEET ���� -a! ! �v- ai�+v.� :.' 0 100 200 400 TS Vol. 9 Page 2486 SHEET 1 OF 2 SHEE 0 � c0)o / % k c � ° C 2 _ ■ = z ° & m 2 n =\- f \ \ \ - \ p \ § �C :) 3 w i o m . CD /§/ % § 3 $ ] \ »_ E_ /� ` CD ® 0) CD § U) k k A \ �- 0; { o o o 3 a q / \ { PL / ^ § J 2 3 v o§ § k i \ ■' ;e ® . 2 % w; § Q a w ƒ .. = E ou z :3 E o k ° / ° y \ ° 2 \ u g 3 E z 2 7c6 w m 0 > I � ■ a k O § 9 � & Do � 2 --I 0) . j C ] z k \ OD , 2 U ) � k . � �r- /\§%k /C§ B CD CD 6'- mn3, §70 CD / a- z % e , o E = o F §EgL0 gw-= 22 CD { CD /0 CL 0 &\ \i R =� kmtk cr $ CY -- k +g % ƒ \/[ w a D q �$7+ »aa= 8 '{te qb 0 2 \/� i k < % § I i '86'0£'9Z ueld Sold uo sa3ou 999 - 99 /MH PUe 430E 10 aauaoo Beau (auou) :eouennoaa Wd 00 :4 b00Z /L /06 n4l :Pu3 Ad 00:Z4 b00Z/L /06 n41 ::pe4s Puow40i�{ `99 AmH 1 9 'anb' 430£ 6 :uoi}e30 Pala '9NO IJ3 - L8b£9i :;oefgns a N aissar