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HomeMy WebLinkAbout026-1175-16-000 Wisconsin Departrpent of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety *d Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 514857 0 GENERAL INFORMATION 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: Miller Homes of Hudson, LLC I Richmond, Town of 026- 1175 -16 -000 CST BM Elev: Insp. BM Elev: Description: Section/Town /Range /Map No: BM /Do 31.30.18.1416 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER w CAPACITY STATION BS HI FS ELEV. Septic z:1 Benchmark som �J�e44.— S / Z50 / 9. ZS 25 /61*, F P �p gZ5 Alt. BM /649 Aeration Bldg. Sewer Holding SUHt Inlet /aZ. y TANK SETBACK INFORMATION St/Ht Outlet a Z - 65 7 ZD 1 TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet � Septic 3,9 / �� /1 ' 43 Dt Bottom 7 ` \ Dosing Header /Man. • 27 Aeration Dist. Pipe $•Z7 /6o.9Q Holding Bot. System �o� -�•.. 91S �a0 PUMP /SIPHON INFORMATION Final Grade 45 �7 Manufacturer Demand St Cover GPM lGt" 4A_ Model Number TDH Lift Friction Loss System H TDH Ft Forcemain Lengt Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length J# No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 qL 1 Z 1 W I --- — -- SETBACK SYSTEM TO P/L JBLDG 7FELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: I u CA ✓•O 7 A / UNIT Model Number: DISTRIBUTION SYSTEM �}� 7 1e ,V 34- Z I nv 3Z-. Header /Manifol� Distribution T ole Size I x Hole Spacing Vent to Air take — Pipe(s) ` Zr� 0 Length Dia Length � Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over 1 Depth Over xx Depth of xx SeededlSodded xx Mulched Bed/Trench Center C G Bed /Trench Edges ` Topsoil Yes A No Yes l No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 903 131st Avenue New Ri hmond, WI 54017 (NW 1/4 NW 1/4 31 T30N R18W) Willow River East Lot 16 Parcel No: 31.30.18.1416 1.) Alt BM Description = C�.q,: w5 �0 2.) Bldg sewer length = I� - amount of cover = 4/5 Plan revision Required? [ ° Yes o Q$ Use other side for additional information. Date Insepcto V Signatur Cert. No. SBD -6710 (R.3/97) I Safety and Buildings ' ' 'on Co 14 201 W. Washington Ave., P. ox �', G ( ; }< Aff N viscO��,n Madison, WI 53707 — Sanitary Permit Number (to be filled in by Co.) e artment of Commerce (608) 266 -3151 5 1 gs 7 Sanitary Permit Application state Plan I.D. f Number D In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide 4 V 4 may be used for secondary purposes Privacy La Project Address (if different than mailing address) EIVED yo=n i3� sT Avg I. Application Information - Please Print All Information Property Owner's Name f APR 2 4 200 Parcel # Lot # Block # Property Owner's Mailing Address ZONING OFFICE Property Location Cit �✓ IC rs�� l� , )' /,, Section i City, State Zip Code Phy Number ° L , 7-7 /7 /�c�rc� Ulf le lhct s'�O l (4 � /� � (� d � T N; R je E * o ' W I H. Type of Building (check all that apply) _19 S re t k �,� �"� Subdivision Name 1261►4.Aiumher El 1 or 2 Family Dwelling -Number of Bedroo ' /, El Public/Commercial - Descri V r) IO W ' R . to*-/ F4S I �}- 7 � 9 1 T ❑ State Owned - Describe U _ �� 4i5 �►' W - FJVfk iw S ) � ❑City ❑village Powriship of A:ei.VUOI III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System . ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. El Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type ofPOWTS System: Check all that apply) 2 rY 51 Q, ' y- Z 3 • v—' 3 - N -Pressuriz In-- Grrouunnd ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade LJ Single Filter ❑ Constructed Wetland LJ Pressurized In- Ground ❑ Holding Tank [I PeatFilter El Aerobic Treatment Unit El Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Applicatio te(gpdsf) Dispersal Area Required (s Dispersal Area Proposed (sf) System Elevation / VI. Tank Info Capacity in Total Number i Manufacturer Prefab Site - Steel Fiber Plc Gallons Gallons of Units c � p f� F (.� BLS Xoncrete Constructed Glass New Fadating r Tanks Tanks Septic or Holding Tank Z j © LV s ✓ Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement - f, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Plumber's-Address (Street, City, State, Zip Code) !' VIII. Coon /De artment Use Onl If Approved ( �er v Sanitary Permit Fee (includes Groundwater Date Issued Issuin t Sign o Surcharge Fee) , / ivenRea son rl2enial VL Conditions of Approval/Reasons for Disapproval - 3 , ; . SYSTEM OWNER; ra 4 / 1. Septic tank, effluent filter and wr�-�. V� p •�"� dispersal cell must all be services / maintained i! as per management plan provided by plumber. v 1 ti 2. All setback requirements must be maintained as per applicable code / ordinances. n _ / lr—a ._� , Attach complete plans (to the County only) for the system on paper not less than 91R x 11 inches in size SBD -6398 (R. 01/03) /'Yl ; ll�✓ /�D - D 3 !3l s-' AVE .�E 12 -,v�— L D/ loll 2 Z--s 3 y /o8 d . 0� 3u R�B6� X30 m N �tii � '3kg2•s�2s to ok� - V ._ �1•� �� 1 3. /Y1, Tor e� (a' ��, t�• ^ /03, ECO PY sw A V E. Pe/ 416 - d 2 - 2 - s d 3 6 Lac g3r, � Zsc �,►i, S-r . _ a D �• N .� 3 � a 3 • cha.,�b� �? •��' 13, /y, Ter e� �a tr ,o o n ' , 4' 3� . T 2117 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil 8 Site Evaluations Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must � County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimernsions, north arrow, and location and distance to rest Parcel I.D. 026 -1175 -16-00 Please print all information. viewed y Date PerBOn� information you provide may be used to 04 (t) (i ) . Property Owner Prope Lora Miller Homes Of Hudson, LLC . Lot NW 1/4 N 114 S /31 T 30 N R 18 W Property Owner's Mailing Address Lu t # Block # Subd. Name or CSM# P.O. Box 10 16 Willow River East City State Zip Code hordV OF E J C _J Village iM Town Nearest Road Hudson WI 54016 1 - Richmond 1 903131St Ave. 01 New Construction Use: !6 Residential / Number of bedrooms Code derived design flow rate (008 GPD _f Replacement —J Public or commercial - Describe: Parent material Glacial outwash Flood plain elevation, if applicable Na General comments and recommendations: Site suitable for conventional disper a 0.7 loading rate. Recommended installing 44 Q-4 chambers in 2 trenches at elevatio 100.00 /1 4-4) Boring # - I Boring sm Pit Ground Surface elev. 103.12 ft. Depth to limiting factor >111" in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture stnx:ture Consistence Boundary Roots in. Munn Qu. Sz. Cont. Cola Gr. Sz. Sh. •Eff#1 " ff#2 1 0 -9 1Oyr3/2 none sil 2fsbk mvfr cs 2fm,ic 0.6 0.8 2 9 -15 10yr4/4 none sicl 2fsbk mvfr gw 2fm,1c 0.4 0.6 3 15-24 7.5yr4/6 none gr is 2msbk mfr cw 2vflfm 0.7 1.6 4 24 -54 1Oyr4/6 none gs 0 sg ml cw - 0.7 1.6 5 54 -111 1Oyr514 none s Osg ml - - 0.7 1.6 !00 N � Horizons 4 contain approx. 10 gravel. A l Boring # 1 Boring LEI Pit Ground Surface elev. 104.55 ft. Depth to limiting factor >118 in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 'E 1 0-8 10yr3/2 none sit 2fsbk mvfr cs 2fm,1c 0.6 0.8 2 8 -25 1 Oyr4 /4 none sicl 2fsbk mvfr gw 2fm,1 c 0.4 0.6 3 25-35 7.5yr4/6 none gr Is 2msbk mfr cw 2vflfm 0.7 1.6 4 35-61 1Oyr4 /6 none gs 0 sg ml cw - 0.7 1.6 5 61 -118 1Oyr5/4 / none s Osg mi - - 0.7 1.6 — 7 ,r Horizons #3 8 4 contain approx. 25% gravel. Effluent #1 = BOD? 30 < 220 mg /L an TSS >30 < 1 0 mgtl Effluent #2 = BOD 130 mg/L and TSS S30 mg/- CST Name (Please Print) Signatur . CST Number James K. Thompson t 3602 Address A.C.E. Soil 8 Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 4/14/2008 715- 248 -7767 �L Property Owner Miller Homes Of Hudson, LLC Parcel ID # 026- 1175 -16-00 Page 2 of 3 a Boring # J Boring Pit Ground Surface elev. 102.50 ft. Depth to limiting factor >114" in. Sol Application Rate Horizon Depth Donftnt Color Redox Description Texture Stntcture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 1 0 10yr3/2 none sil 2fsbk mvfr Cs 2fm,1c 0.6 0.8 2 12 -25 1 Oyr4 /4 none sic] 2fsbk mvfr gw 2fm,1 c 0.4 0.6 3 25-32 10yr4/6 none gr is 2msbk ml cw 2vf1fm 0.7 1.6 4 32-47 10yr4/6 none gs 0 sg ml cw - 0.7 1.6 5 47 -98 10yr5/4 none s Osg dl aw - 0.7 1.6 6 98 -114 10yr6/3 none s Osg dl - - 0.7 1.6 1 it Horizon #4 contain approx. 5% gravel. !� L F-1 Boring # J Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Sol Application Rate Horizon NO Dominant Color Redox Description Texture St uch re Consistence Soundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # I Boring Pit Ground Surface elev. ft. Depth to limiting factor in, Soil Apples Rate Horizon Depth Dominant Color Redox Description Texture Stru Consistence Boundary Roots MIFF In. Munsell Qu. Sz. Cott. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD 30 t 220 mg/L and TSS >30 < 150 mgA " Effluent #2 = BOO <30 mg/L and TSS <_30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777. SBD -8330 (8.07100) A.C.E. Sol & Site EvakaKW S I \ I /J/• / /c/ f>lo�nns a f /j/K dS Gil � I s LY / - / 82 _ • B3' 6 ama TP of /oz` wcude�! Y of• T- -host 4-e 5 I p . 3W',3 Wi I 4 f ` 23 9 i '( wi N W 304.23' lj t SW CORNER ° W SECTION 30 uii 1 (' `f NW COINER SECTION 31 1 LO' Z! cal LOT 17 r?2 Z; 1 1.57 ACRES 2.14 of j 68,226 sq. ft. � r 83,08 1-130-=931.0 M � 2? i s A h � ° O m m ►n -c 1 o LOT 16 33' SEE r ' 2.34 ACRES - - s 101,$44 . ft. Nlg 15,04' q 5z' r LBO --93 IT86°350$''W 33' BENCHMARK y POIVDING 1 s` ELEV. -= 930.72 "AREA LOT 14 HWL ELEV. = L SEE ACCESS RESTRICTION NOTE 928.59 �J g 2.10ACRES �f 9 1,434 sq. ft. i r BENCHMARK LBO =922.0 ELEV, = 937.15 ' t 66 CID LOU 11 r O N - - - - V- I N o { lk i . z I , � LOT { t EE ACCESS RESTRICTION , NOTE , •' j 2.21 ACRES EA E 96,343 sq: ft. . BENCHMARK w ! ELEV - 930.24—, CAI b ,Dr '7 7S3 ?� OWNERS COUNTY PLAT ° slMDAVENUE °ACK WILLOW RIVER EAST NEW RICRMOND, W 54017 s'ECnox.m LOCATED IN PART OF THE SW1 /4 OF THE SW1 /4 OF SECTION 30 AND IN PART OF THE NW1 /4 OF THE NW1 /4 OF SURVEYOR SECTION 31, ALL IN T30N, R18W, TOWN OF RICHMOND, ST. CROIX COUNTY, WISCONSIN. EDWIN C. F—UM NORTHLAND SUMEYINO, INC. 056 ANVJ✓T15' \PO. RO %14 GL� RDRERTS. VJI 5402] 22 ggg iEMPORMV - _ IIRPI . y� \s`ONS z� A"j-1 tl131hMU D N /qJ a S 248)3 " /31N Extro AMER G ! 51orv N8740'S5 °E 1442.08' svn,. or sfnrox]° " I I,.X M .. xlfx s<]v,x LxE OE mE xc6rR lasoe f iaP,xE Swv. z61 rq °°s..s ]zea (9�Sl1fN��'Ok n � ��� `� 3 z " A EASEMENT 1]w.ra 2.90 ACRES LOT 1 \ in ACRES 2.LOOACRES LOT7 DIWNAfiE EASEMEMr DETAIL ✓6 %9p PP&]6 hC!Shc7� 1 - - 91 n 2.06ACf" e fLfv. a,4e5 80,961 . n � LOT 22 Enc,M LE , •AREA Y ,wa W I9 2.02 ACRES z r9 LOT 2 '^ y 105..73 w. rt. t F/SENE ' nut m°v Q n 54awze7 ]m3e - - "q 9i mZN. ieac. urvf _ _ x _ PAOUgrEUPO6wv m �, .xsc EnxrErvl to I92 E5 9 - It z , \ s as o' °; e "q _ 77 - - N �rfa.aow Ex :rox LOT 21'. 2-ACRES. Wass]e Q � o >e I •. ° �� '+' �'' ;, _- AREA.: ppNOIN °m ` ry ,,:v / LOT 3 N W. 1 w.n S 1.BO 81,]71 AI LOT - R .r ACRES :+ e Z LOT 20 L7� \ - ° eE]ucl6unx Luv.- Z 10 \ a ^ JaV V LOT 19 �! \ 1 t9a ACRE9 \ "� / 04295 -fl. -... ` W Nn a xe IcY L OT 10 Q� 2.53 ACRES m LOTS - r' & LOT 16 ja .w� LOT 11 6EEKKE69 nE 01]NxoT[ a _ _ __ a ( °ssW I m \ y P ei,TiCaEn G N 130T1I sw�4rvxEx — - — — -- --- — AVENUE LaD�r m 9ArvER �!I� -------- a _ 9x]I /. �- LOT 17 / Cif LOT 13 - 15 >ADRE9 / 9e,2z9 83,61 e0 R \ •; ` , `Tf+ / LOT LOT m - F'� /.p:, LEGEND �_ y° 2.36 ACRES $ _ W „sw S \ ate`, uuww ca,xnSEC��gx \ 101864 q .lpi " FNCIwiMx x 19 4S. K POND /NC O amk6sPU IaEiA roo* �, \U AREA" LOT 14 usv I E E .ory xore Y / J` Les �n u,rul raor vs 8 KK 21OAMES \ ` cl 9 Lro sR°" 4'P d° /`� rJ. AS PFe "FwR rtp, rtlmm4 -.� P• a (. A , ' / mlKxu PPE PrM Mo O �\' S > TEMPORARY CUL DE SAC DETAIL - - vsE"Ervl O i . � „v4 rE6urvE POrvtaw PnEw Z . LOT 15 0 /' / 1xo ` m A m awnrs uLVLrow 2.21 ACRES " I]2.2a 9ENMx✓WB P of 60x nPE ' Erb`Lx VrE LOCATION SKETCH eLEw.tux ro r9 ��� � _ �` 9vznbsrREer I — \ � s AE PLAT jj v"%EAn"owrEmv"rcisewma6 .wrnfx6 " aPER.11oum�"irvf / � \ � Pmmc9 cowmR,� w6lm owRrfAro wafAaaw / wruunECro - �°-�-1�orHavE:iiie..'._ LoTt �rw '. �' LOTS _ __ fxR WARe OAMNAGEO90xES .YM1E11AU91MVS , wA \ % cuefers, sox OAVSS aPe0ap5. � i Asfr4Ms i �' � / xO POLEd1B11 6 FOCKIE6NIE ttt BE P1/10EO SULIInul rxE - - _. �L 9XNEY Si �ORO6°16UCr mI OS 31 31 ST16TREET /" Axrtal sAMwAiWx OPS2mMaN E s K�•' A,A. \ mk wE0 >t.�un EwRDeEUrsullEAfwsET m R60eemES»n R1NAn=R - - EAO1 PenefLSkrowN 6w9unis su6lferrosrAre. LOTS LOTS °OUntt IHOiOANRBUw9 RDIE5N10eEb .LAnOKrl . f. �I � -- ��WrvniRU+exWMVAVE t MErIMOg Mrv 9s AC�ssro 6�Ei01 � vmrvew \ SEC. 30 831, T30N, R18Wpf0A0N iaxR29PRLe nnzmA6mArE uauuexrs or asrnPC SCALE IN FEET 1' = 10d 196 0 1os too SHEET 1 OF 2 SHEETS l ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM J OwnerBuyer ��. ���-✓ /ifs ryta_ S L / L Mailing Address elc_lu 1-1,,ds p o, Property Address b 3 1 .411 Alow f:ak A nn V tel SDI (Verification required from Planning Department for new construction) 0 1 U i City/State �� �.��wo�/ a) r �`� � Parcel Identification Number z(a 1 / ��" (o `0 0 0 LEGAL DESCRIPTION Property Location ly N U ' /,, Sec. 3 T '3' N - RAW, Town of 6L' �� ►�'� •� Subdivision W�M otv R: 0 �z+r 5cxs , Lot # Certified Survey Map P - 7 � �; 3-7 Volume D Page # � Warranty Deed # :: 3 8 , ?9 Volume r , Page # Spec house Dyes ❑ no Lot lines identifiable yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic could result in its premature failure to handle wastes. Proper ma e consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into inc s ; can defect 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 a master, plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on site wastewater disposal sys• ^T is in proper operating condition and/or (2).4fter 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 set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Ccrtifllca ^o:: stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office NO Lh--:: C' days of the three veal expiration date. Z'5 O GNA F 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 oNvn,,r. dhc property described above, by virtue of a warranty deed recorded in Register of Deeds Office. z 3 NA APPLICANT DATE ' • `• • • Any information that is mis- represented may result in the saaitary permit being revoked by the Zoning Department. Include with this application: a stamped warranty decd from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 838999 I � KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name 11/17/2006 10:40AM WARRANTY DEED EXEMPT I THIS DEED, made between David H. Railsback, a /k/a'David H. Railsback II and REC FEE: 13.00 Aria J. Railsback, husband and wife TRANS FEE: 1057. 50 ( "Grantor," whether one or more), COPY FEE: and Miller Homes of Hudson LLC a Wisconsin Limited Liability Co CC FEE: —Y ° y PA GES: 2 ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is RIVER VALLEY ARc & TITLE needed, please attach addendum): 1200 HOSFORD STREET. SUITE 201 Lots 5, 11, 14, 15 and 16, Plat of Willow River East in the Town of Richmond, St. HUDSON, WI 54016 Croix County, Wisconsin. 026-1175-05-000,026-1175-11-000,026-1175-14-000. 026-1175 -14-000,026-1175-15-000,026-1175-16-000 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. (is) (is not) Dated ( t (-a ( a (SEAL) x (SEAL) " vi *D/ " avid H�. Railssback, a a Davi 1 s ack II __ L (SEAL) t,1. (SEAL) "Aria J. Railsback AUTHENTICATION ACKNOWLEDGMENT Signature(s) David H. Railsback, a/k/a David' H. Railsback 11 and Aria J. Railsback husband and wife STATE OF ) authenticated on I l ) ss. I ��� COUNTY ) 'Kristina O land Personally came before me on TITLE: MEMBER STATE BAR OF WISCONSIN the above -named (if not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Attorney Kristina Oeland Notary Public, State of Hudson WI 54016 My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 0 2003 STATE BAR OF WISCONSIN FORM NO. 2 -2003 ' Type name below signatures. INFO -PROT" Legal Forms 800- 655 -2021 www.intoprotorms.00m 1 of 2 Grantor: David H. Railsback, aWa David H. Railsback II and Arla J. Railsback Grantee: Miller Homes of Hudson, LLC ?' Additional parcel Ws: 026 - 1175 -11 -000, 026 - 1175 -14 -000, 026 - 1175 -14 -000, 026 - 1175 -15 -000, 026 - 1175 -16 -000 2 of 2 t POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa ,L-E INFORMATION C.Z:�; �caAi [�-f #f (� SYSTEM SPECIFICATIONS Owner II _ o 4d Septic Tank Capacity -- I _ Septic Tank Manufacturer WO t s a-fl, DESIGN PARAMETERS Effluent Filter Manufacturer Number of Bedrooms ❑ NA Effluent Filter Model Number of Public Facility Units NA Pump Tank Capacity r al Est matee flow (average) L4 g . al/da y Pump Tank Manufacturer Design flow (peak), (Estimated x 1.5) 1 0 g al/day Pump Manufacturer r, Sol Application Rate 7 al /da /ft� Pump Model � •, ; Standard Influent /Effluent Quality Monthly average• Pretreatment Unit 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) Biochemical Oxygen Demand (BOD,) 530 mg /L In- Ground (gravity) ❑ In- Ground Ipressur,_ec Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At-Grade ❑ Mound i Fecal Coliform (geometric mean) 510' cfu /100m1 ❑ Drip - Line ❑ Other: Yax mum Effluent Particle Size Y in dia. ❑ NA Other: 1— ❑ NA Othe r. awes typical for domestic wastewater and septic tank effluent. Other: _ MAINTENANCE SCHEDULE Service Event Service Frequency inspect condition of tank(s) 0 least on.ee eve month(s) (Maximum 3 ears; �' earls) y Pump out contents of tank(s) When combined sludge and scum equals one -third (Y,) of tank volume a every: ❑ yea aspect dispersal cell(s) At least once eve ❑ m r(g) l (Maximum 3 ears) � y ` Clean effluent fitter At least once every; _ Z ❑ month(s) _ ear(s) aspect pump, pump controls & alarm At least once every: ❑ mo nth ❑ year (s) l (sl sn laterals and pressure test At least once every: ❑ mo nth O yeaars ) r(s l ) Other ❑ month(s) At least once every: ❑ year(s) - Otner - - . MAINTENANCE INSTRUCTIONS nsoections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or ce-t f a Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator nspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracKs cr measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the grounc s.,­ The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any pc' of effluent on the ground surface, The ponding of effluent on the ground surface may Indicate a failing condition and requ res mmediate 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, me contents of the tank shall be removed by a Septage Servicing Operator and dispo$ed of in accordance with chapter NP ' Wisconsin Administrative Code, All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretrea uhlts, 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. . T �T'4JP AND OPERATION Page -2- 0f _Z 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 ce11(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 hot 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; o i 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 .s 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 end 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. O 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. Iv� T alua _P1 if b e ai a �R -l I'� /T �o �- �/,�✓ (�' fV p tank O 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 L N �-7 1 N ame P IL . . 7 5 Phone SEPTAGE SERVICING OPERATOR (PUMPER) Name LOCAL REGULATORY AUTHORITY Name 157- C �^ Phone d l���� Phone '71 r� _ 3 S/ (v This document was drafted in compliance with Chapter Comm 83 . 2 2(2)(b)(1)(d) &(f) and 83,64(1), (2) & (3), Wisconsin Administrative "Code. l ��� �'�'t' �jl �;li' fi 1� r� i� / <����✓ �/'fta - AA of ,V 1: S7 4 0����� ® (D Filters X PL -525 EFFLUENT FILTER Polylok, Inc is pleased to add its new commercial filter to its existing line of quality effluent filters.The PL - 525 i s rated for over 10,000 GPD t -- tgalions per day) making it one of Alarm accessibility Accepts PVC The largest commercial filters in its extension nand r class- It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL -122, the new Polylok PL -525 has an automatic shut off ball installed 525 linear feet 4 with every filter. When the filter is of 1/16" removed for cleaning, the ball will filtration slots Rated for over float up and temporarily shut off 10 ,000 GPO the system so the effluent won't eave the tank. No other filter on the market can make that claim! Accepts 4" & 6" SCHD. 40 Pipe \ r PL -525 Maintenance: The PL -525 Effluent Filter should _ operate efficiently for several years under normal conditions before requiting cleaning. It is recom -, I mended that the filter be cleaned ��— every time the tank is pumped or ��-- at least every three years. If the I i nstalled filter contains an optional r: alarm, the owner will be notified ?, by an alarm when the filter needs servicing. Servicing should be Gas deflecto done by a certified septic tank �� �� Automatic shut ofl , pumper or installer. ball when filter 1. Locate the outlet of the U S Patent NoN 6,015,488 is removea septic tank. 5,871,640 2. Remove tank cover and pump tank if necessary. PL -525 Installation: 1. Locate the outlet of the 3. Do not use plumbing when septic tank. filter is removed. Ideal for residential and com- 2. Remove the tank cover 4 Pull PL -525 out of the housing. mercial waste flows up to pump tank if necessar 5 Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing t, tank. Make sure all solids fall 4" or 6" outlet pipe. If n,, filter is not centerea un,;er Hack into septic tank. access opening use a P -i 6 Insert the filter cartridge back Extend & Lok or piece ct nto the housing making sure to center filter . the filter is properly aligned and 4. Insert the PL -525 filter tit_ completely inserted. its housing. 7. Replace septic tank cover. 5. Replace the septic tank i Ck4 rti STANDARD CHAV9EW Quick4 Standard Chamber (EFFECTIVE LENGTH) Eff =I AR M ! I - - 34'' - - I SIDE VIEW SECTION VIEW MultiPort End Cap 1 16" ) s I v 3.1 SIDE VIEW TOP VIEW FRONT VIEW ` I _ yeti gYHV1�'� Quick4 Standard Chamber Nommal`Specifications .' MultiPort End Cap Nominal Specifications Size (W x L x H)+ 34 ". x'52 x Size W x L x H ( ) 34 116 "x12" Effective Length 48" Invert Height. 8" or 1.25" Invert Height 8" f INFILTRATOR SY_ST_EMS_INC, STANDARD LI MITED WARRA ;v 'i Ir CI 1I / LI 11 1 I11 l d 1 111 III 1 IRir.l S 'J� ! Cl Il t; Ih;t, IIC cCnlc Pen is SS,ej fo Ithe ,( I( S,t t, Id Il ii ,I: pv rV I 9wovo :IC 11 It - fer Oh wll ()eq n uPn, Ih �I 1 wil —1 1 1 :1: Cnronralc Hea1()II I, ! ., _. ..I �I iI 'J I: I I ,El1 llY li'll 7(, ).t,( rrr � N.lrr; iri;V � / • [ X I-USNF III[ H[ 11 r -4( f HL it We11 �N - f:� VJI I I �iF o I �. It��rls�n IANARIILY RFII „ 1_��I)IIIIII>>� SYSTEMS INC I 1 f JE V IP S A I l Y 3 11 I I I. I', W 1 1 Environmental Onsite Wastewater Solutions if 1P ll - .c 1(. y Il 6 BUSIn2SS Pal"( Road ). BOX rn in Ili = II pl). nenl of mo (p. 11 I. ❑r I IJ 1 o f " I. , ,. - id if the all 11 c :, Old Saybrook, CT 0647;; 161 d.)n,I Iv sr nl be void If the Holrle� f,1,1, I r. .)v a,l (I fs c I rnln n m 1 h�� 860- 577 -7000 • FAX 860 -77 7-?IBC' ' �.' i 51 III rU C � ll aC OhP H(I(lf..l.f.'ll I 800- 221 -4436 e lU re(, by I . �I I"", d :IIC Pt cable I:Iw_ :In0 I,I llr it) I I I .)r la ,) .I a.,e 11 I1 I 9f 5 3:3f- 01 7 5.401.1 16 40 .45 1 y0 r I ti3 Rti_ i °t f3 3y F -, fd -C )I )Pr pateni . Pendlnq . eii tmown,irks of Infiltralo "iY ien )r (l ,) ' -U' C lrl ,la(l0 I k nf`anf l!I!r.110 5y�10 1)S If' V i loil - SWvol connection M(:lol 11 I � >:I - PECI`CCEDP—PP ) )I,r _. )�I I , - uv a: .;na�nnr Spare *. Ou<kC,.l.(.)..e , il, �- - , S I ) •� ,Inc i� ?_OJ:. I fltralor Systems I II(: r 1!cr! :n 1, .`. A Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ( of Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must Y �t Include, but rat limited to: vertical and horizontal reference point (BM), direct= and Parcel 1.1) . �/ f� percent slope. scale or dimensions, f to nearest road. G 26 -- 1 J v Please p t al d. ® Reviewed by Date ' V/ Personal itdorrnation you prove may be for secondary purposes (RiveoY s. 15.04 ( (in)). U U Property Owner /Uuj Property Location 3u✓ 30 Q Lot Ntx) 114 114 S' T 3d N R E( W Property Owner's Mailing Address Z I t''' OFF-ICE # Block # Sub& Name CSMl1 i IIbLJ t� i1/o't city Code Phone Hhrrrttner p ❑ Y T Nearest Road /Zh ( ) i New Construction use: Residential / Number of bedrooms 3 Code derived design flow rate ! . )rt7 GPD ❑ Replacement ❑ Public or commercial - Describe: — Parent material Oa-t.4j � Flood Plain elevation if applicable ft. and Genera comments: s� y ,�. tOU AA&� oAa.. 3. S & --ltd 2 IF DI Boring # a Pit Ground suface elev. 7 , fL Depth to willing factor --"= in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G PDff In. Munsel tln. Sz. Cont. Color Gr. Sz. Sh. *1211#1 '101112 &I ',3, 32 IL-J11 9 / B Boring oft surface elev. ` ft. Depth to limiting factor /" inn. ® R Pit Soli Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff In. Mansell QU. Sz. Cont. Color Gr. Sz. Sh. '131#1 'Eff112 Z IL Effluent #1 = BOD > 30 220 mg& and TSS >30 < 15r' • Eftei t #2 = BOD <_ 30 mg& and TSS 1 30 mg& CS ) CST Number t Address Date Evaluation Condnxtted Telephone Number lo Property Owner Parcel ID # Page of Bonng # C9► Pit Ground surface elev. ft. Depth to iimifing factor 9,� — in. 5oU Application Rye Horizon Depth Dondnant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Ou. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 21 'Sy c s 2 . S , 2- -28 5/ — c L J Z , 3 t3— y/ S s c� 7 /. Z F-1 Borft # ❑ Bin 0 Pit Ground surface elev. ft. Depth tD WnMV factor in. Sod Application Rate Horbw Depth Dominant Color Redox Description Texture SWc lure Consistence Boundary Roots GPDNF In. Mussed Ou. Sz. Cont Color Gr. Sz. Sh. 'Eif#1 'Eff#2 Boring # ❑ Ong und sutace elev. ft. Depth to d nV ctor In. F ❑ pit GroW fa Sol Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPOW In. Munsed Ou. Sz. Cont Color Gr. Sz. Sh. 'Etf#1 'Eff#2 Effluent #1 = BOD > 30 220 mgll. and TSS >30 1150 mglt ' Effluent #2 = BOO, < 30 mg& and TSS 1 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 alternate format, please contact the department at 608- 266 -3151 or TTY 608- 2648777. saD.aswOtA=) Soil Test Plot Plan Project Name David Railsback Shaun d Address 845 133rd Ave New Richmond Wi 54017 #226900 Lot 1 6 Subdivision Date 12/12/02 SW /NW 1 /4SW /NW1 /4S 30/31 T 30 N/R 18 W Township Richmond FJ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 93.8/91.7 *HRPSame as Benchmark Alt. BM Top of Steel Fence Post @ 104.0' Please Note: Tested area may not be suitable for desired building area. Check system location before excavating. Soil test was done to satisfy Zoning Requirement. 408'Property Line 376' Property 96 Line 95' 97' 13 _2 6% Slope B -3 80' 0' B -1 \IU'P rope 1 d � 0 31A y Line 5' Z cc �\ A N y v Ln \ \\ \ ® \\ V uj 4 ....... ru ol e -2 CD JOINT 3 EAS \ - EME 3 fYT op 695 F \ FS LIIS F \ \ /�® � Ln o '�'• *' ;•.. /_ a ., `erg^ T- F tc 5r UJ U n �' � U b DD La C-4 - . CL 1 Q330 NI a391y�S30 Sd SS3H03 OMd SS3kIflNl 4lOd 11J3W3Sd3 301M .99 LZ -- 4L'90E 4/ ZOIZ9 ,6£'£99 3.0 L190.00N LE NUUO3S JO cc c a ®u� ® ®n -Od D .. .' .`�! _ �_ KVii.: i'rr it , •'. ••i i',Y V i ; ^ . 1•: __ _ _ '>.f J> fll�t4nRaf i:' 7% \J7J, A. LOr 2 1 OT Sjw,Q. IL LL CA 1 • ) I / lee T ,, u•:•.,,:r S 1i rcnE y i •.^:'MCI �, S II 1 I :T.141..1 .. 11v1 , , 1x,1„ Lar4 U. Al !.. '^ #, \. �. \, / �• �. /r, 111 :1c. A01.•. V, b1.:7S �.�. '� ! / � �� ///•� � f b11 .•Ill,. 1fy■1 rlonx:n. f Ar t A � iii LCTp• L3T 13 • .. •. _ LUI 11 i.�. ��� - •. ,a• - i�Jti,aa ice c ll dJf,�1.q r,' t XT 12 ij 1 (J% I QC • �• l r.• ' /�/ _ J •' ,,\ ,. '' • �'rt, Y : -:' /. ,E.'er•CP:11r -4Gr .- LOCATION SKETCH v UJI It FLAT \ • 1 f.LL r•j �,r!, Call Jim Henry & Associates for more details. � ( -FOLD �� Information deemed reliable but not guaranteed. Jim N ?nry R ACCMI�tGC 1 llew s 90 3 131 s+ AVE, E, ' �c %`�'` OZG. 1175= /G•oao e -7. 2D - 'f 0 ° Z t S: C r ' L 93r, M Z sc air, Sr . � 7 ' /O 3 • s'.� � k w /0e n �. / �, lt.• o v � 3 3 - C1w ✓� \ mr � � "3k�2•S�s � L i � r ✓ i \ q ;c v 1 •�' �, . pi . /Y1, Tor .\ ;t►• . ,'C, of s'Tt ► O o , o o' op "TOP. ��, t/• � /o3,9y,