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HomeMy WebLinkAbout026-1097-70-000 0 fA Q $ U n d r_ C d a O \/1 I � O O O y p O W CD O=r • 3 O ±: m a m W � 3 O —� CD 5 O O �.►, N 7', O p O O cn v 'S CD 0 CD 0A�t O CL 3 D o . C 7 O r� t11 y m C (V U.! z tE O Vi a N O _ 0 I� -w N S z p D n r co O O m y C a 3 z : O O O Z 0 s 3 vi cn a < a- v O o N o CD m y ] W c0 m a m n rn °1 N a d A o J N N z o O D 0 =r a O CD N "No • N 7 '= C (� N N C (= N S (p n a O d (6 Z <p O N C m a N CD Z co W V Wo A O m m Z CO 'o 3 z D N {y N z;�� D 3 sad Q a CD m m CD -0-am Z M 3•m o a 3N°o� e� a CD a o e -S ti •m a a I a0 0 ao a w O Q ,., CD A o� 3 CD 2 S O w co � !. 0 01 Oho a A �- o bRp O CD N �» O N N o a a nr Parcel #: 026 - 1097 -80 -050 05/13/2005 09:22 AM PAGE 1 OF 1 Alt. Parcel #: 34.30.18.526A 026 - TOWN OF RICHMOND Current ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 3 Tax Address: Owner(s): * = Current Owner * KELLER, RETIRED NUMBER RETIRED NUMBER KELLER Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 63.000 Plat: N/A -NOT AVAILABLE SEC 34 T30N R1 8W PT W1/2 NW FKA Block/Condo Bldg: 026 - 1097 -80 (526) AS DESC IN TI- 1595/101 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 34- 30N -18W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 12/30/2003 750360 18/4684 CSM 03/02/2001 639639 1595/101 TI 02/13/2001 638449 1586/246 TI 293110 444/263 WD 2004 SUMMARY This parcel will not get taxed. It exists soley Assessed with: for parcel history tracking purposes. Valuations: Last Changed: 04/19/2004 Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 63.000 10,200 0 10,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 026- 1298-18 -100 02/13/2008 10:33 AM PAGE 1 OF 1 Alt. Parcel M 34.30.18.1573A 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 11/06/2007 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - RIDING MEADOWS LLC RIDING MEADOWS LLC 2440 N CHARLES ST NORTH ST PAUL MN 55109 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1221 130TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 36.017 Plat: 5472 -CSM 23 -5472 026/07 SEC 34 T30N R18W PT NW NW; BEING RIDING Block/Condo Bldg: LOT 01 MEADOWS NORTH ('06) LOT 18 (7.390AC) NKA CSM 23 -5472 LOT 1 (36.017AC) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 34- 30N -18W NW NW Notes: Parcel History: Date Doc # Vol /Page Type 10/06/2007 863682 CSM 01/18/2006 816695 10/0097 PLAT 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/08/2007 Description Class Acres Land Improve Total State Reason Totals for 2008: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 026- 1097 -60 -100 05/13/2005 09:21 AM PAGE 1 OF 2 Alt. Parcel #: 34.30.18.524A -10 026 - 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): * = Current Owner * RENNER, LESLIE J TR LESLIE J TR RENNER 17905 BRIGHAM TRL WAZATA MN 55391 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 1221 130TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABL SEC 34 T30N R18W PT NW 1/4 EZ -U- 1419/468 Block/Condo Bldg: COM NW COR SEC 34; TH N 89'E 813.97FT TO POB; TH CONT N 89'E 1178.43 FT; TH S Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 00'W 30.94FT; TH S 00'W 1447.71 FT;TH S 34- 30N -18W NE NW 89'W 1178.43FT;TH N 00' E 1451.41 FT;TH N 00' E 27.21 FT TO POB Notes: Parcel History: Date Doc # Vol /Page Type 08/12/2004 77142 2636/546 ALC 04/16/2002 676468 1873/470 LC 04/16/2002 676467 1873/468 WD 04/16/2002 676466 1873/466 QC mor .. 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/30/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 35.500 6,200 0 6,200 NO UNDEVELOPED G5 0.500 100 0 100 NO OTHER G7 4.000 24,000 119,300 143,300 NO Totals for 2005: General Property 40.000 30,300 119,300 149,600 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 30,300 119,300 149,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 1 V CV NOV 1 2 2007 I llilll lilll 11111 illll iilll 11111 1111 111111 1111 1111 6 8 2 2 ST, CROIX COUNT`( 863682 SURVEYOR'S RECORD KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED CERTIFIED SURVEY MAP 11/06/2007 FOR R ECORD 04:20PM CERTIFIED SURVEY MAP Located in part of the Northwest Quarter of the Northwest Quarter VOL: 23 PAGE: 5472 and part of the Northeast Quarter of the Northwest Quarter of REC FEE: 13.00 Section 34, Township 30 North, Range 18 West, Town of Richmond COPY FEE: 3.00 St. Croix County, Wisconsin; being Lots 18. 19 and 20 of the Plat of PAGES • 2 Riding Meadows North as recorded in St. Croix County Register of n Z m Deeds Office. z w � 00 ° m a West Line of The NW 7/4 UNPLArrED LANDS o T D R. O. W I 00 0'03 5 737 57 I a m rn ....... ... eostefy :::e z v Z right -of: way } n n m of 120th = st. 0 z rn Co c,r U I N m Co N �rri O C ao o v nl m O v ° a °w a p N W to , p I�i� 1 � C) 2 0) -4 -4 r CL ° y Co y _ v M _ in 01 co r 3 m p m o �,i `� o (_ tb V C t � .P : `D ` ° I a °C a- ° c g k N 0 J �(D ` �/1 3 n �G a O 00 I I U ° ' N a o 0 o � m O cD D Ho ° O Z ° C: m o CD n p m `< �' m Op 0 n C °. Oo 3 --4 c--' w 3 �y n a) -E s Ib m m i; v O _. O UVD v ° 5 C �. Z f ° ;a �- Nom. y :A tb in CP v a m d zr S00'03'52 "W 625.72' mo rn z� o C. L/NPLAT7E0 LANDS 7j 1 �D v om X JOB # Wl057SL1264 Z� n��2 bo orb Prepared by. o v, 0j..EO ti o s Consulting Group, Inc. E, � o c � � � r1 / U � Phone No. (715) 246 -4319 SCHULTZ Fax No. (715) 246 -3830 2031 P.O. Box 325 o1 P New Richmond, WI 54017 6, Sheet 1 of 2 �O t'f. so ��Su 11111k so 1111111k Vol. 23 Page 5472- 0Ch0 c�tn O',13 0 tv `r1 .r 1 N 7 N „ N n A to �• K M n 71 CD 3 M 3 d 3 rr 3 = +� Z Z m Z o w X In Z Z m Z O T :i) C.) O O O rn O A 0 S O O N 0 (D ?� o c m CD 3' a a C m CD o ` CD m ° n m m= o s O ` 1 CD m m m m N a ou O 3 N a 3 3 0) (D -V 0 5. 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D D a �\ o 0 o 0 df(n> 3 z > 3 ���• d� a cD m m a cD ao 3 0 <m ' 0 t� O O N c m m X m c 0 off° o a 0 o a m0 CD v_CD yam N :3 N = CD 0] * CD m F ' a I 3 0 �) CD r O N CD C 0 3 m N 7 c O (Cv v !p 0 O fl C X CD O N p ~ �2 N a w 7 Od .z N �! O CL !A O O O A 0 O A N N < C V 0 0 o 0 a � � a O L O CL �' Parcel #: 026- 1097 -60 -100 05/13/2005 09:21 AM PAGE 2 OF 2 Parcel History: cont. 04/16/2002 676465 1873/464 WD 03/02/2001 639640 1595/107 LC 03/02/2001 639639 1595/101 TI 02/13/2001 638449 1586/246 TI 293110 444/263 WD wlsoonsinDepartmentvi Division Commerce PRIVATE SEWAGE SYSTEM Safely and Bt>angs Divi County: INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 384136 Permit H ees Name: (3 City Village (3 own of: State Plan 10 No.: eller Sr., Herman Richmond Townshi ST SM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 026- 1097 -70 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM I Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht outlet Vent to TANKTO P/L WELL BLDG. Airintake ROAD Dt Inlet Septic NA Dt Bottom Dosing NA Header/ Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number GPM TDH I Lift Friction S ystern TDH Ft Forcemain Length Dia. oist.Towell I I I - I I SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENS DIM E N S I ONS-- SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manuacturer: SETBACK INFORMATION Type Of CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size I x Hole Spacing Vent To Air intake Length Dia. Length 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 xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1221 130th Street, New Richmond, WI 54017 (NW 114 NW 1/4 34 T30N R18W) - 343018525 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3197) Date Inspectors Signature Cert. 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 application PO Box 7302 lVisconsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce p (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] 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 ❑ Check . if revision to previous,ap 'cation State Plan I. D. Number c - I. Application Information - Please Print all Information Location: Property Owne Name J L Property Location a / / /', 601/4 U 1/4, S-3 0,N, Ifd (or Property Owner's Mailing Address �� Lot Number Block Number : , u ti ✓ l'a^S ILA -1C- Y1 City, State Zip ode Ph s,N / Subdivision Name or CSM Number II.3ype of Building: (check one) ❑ city U I or 2 Family Dwelling - No. of Bedrooms: '.� - age ❑Public /Commercial (describe use):_ own of ❑ State -Owned Nearest Road e vo— Parcel Tax Number(lb ., III. Type of Permit: (Check o one box on line A. Check box on line B if applicable) 2 0 1 a S A) 1. ❑ New 2. Iff 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.Yype of POWT System: (Check all that apply) won- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At - grade r ❑ Aerobic Treatment Unit ❑ Recirc ❑ Other: -z . X 5 - rrt,t,t,- :. �.�t 1 V. Dispersal/Treatment Area Information: — ,( Ca 4 a 7 Y .TN ; N ,&7 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Ap cation 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) )4 �IA T Ele ' - 300 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks 11 0 ❑ ❑ ❑ ❑ ❑ oo- VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on t ched plans. Plumber's Name (print) Plumber's Signature (no stamps): MFqgLS No. Business Phone Number 4 / ec k li I �-19 2 2 2 Z 7 S -7�'�- 3 3 Z� g Plumber's Address (Street, City, State, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Si ature (No stamps) �l,Approved 11 Owner Given Initial Adverse Sur ge Fee) Determination a2s• 00 •2{ Zeo t X. Conditions of Approval /Reasons for Disapproval: w.c e c.�, c 0 e- �eve._��� t� c� Z- S�dU"re..... wilX N� 'C�2• � � St�^�- Irv. C,6tn -�,t 1 SBD- S S , n_ i N 1 goo � p COP, Im Rob r �„ _ _ 30 ! q� _4 b t Ld w p is CI j2 L&C o opt S A101 7 j l vr w SOO Ta tj 7 94 J _441 30 Ft 16 EL - 5? OLeG Iry r __ _.�� __ _ ..� .- � �--� ...�.. -� �� ter 15 .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 8 1 -* -11 inches size. Plan must Include, but not limited to: vertical and horizontal,rQtgrence pojnt- (B�M, rectlon and Parcel I.D. Q Z(.Q • /017 70 • 0M percent slope, scale or dimensions, north arr w, and, location and di`sti( o nearest road. Please print ail liiforma�l'' � 4 Reviewed by Date Personal information you provide may be used for second ses (Pri Law s: 15.04 (1) (m)). , Z Property Owner I Rfoperty Location �� / 2 /� c p0\ * - ov .Lot NM) 1/4/V 1/4 S J � T 30 N R /d E (or W % Property Owner's Mailing Address Gv G OF # Block # �ubd. Name or CSM# 13 , a - •�� cor'N AV O , City , p State Zip Code PqoFle ❑ City ❑ Village &Town Nearest Road AU) f�l(�{n ON71 ��• Sy0 /� C � c � �( / 13 a - -sT ❑ New Construction Use: Residential / Number of bedrooms Code derived design flow rate %t O*y" GPD Replacement ❑ Public or commercial - Describe: Parent material ✓! V G!/ �Floodlain elevation if applicable IV/It ft. General comments /y����E �A, ��itpiyS ,^ ,� L� and recommendations: DES s ysr s F Boring # 1i Boring 9f . �/ Z 7 jR Pit Ground surface elev, ft. Depth to limiting factor C/ in. Soil App lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /R= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff#1 'Eff#2 0 10Y 313 SL .2 shk lw w Z f - , s • y' Z /3 • /o ye 31 L S ,& I ,ter C IT '•r---j r- 3 z1.33 7.s ye .— sC z�-Jje 4 d s - . . y' J 3 - y 7 sye y G s 1 ,e cs -- • 7 i. Z S 0 ?•lyres/ G S 1.,,, ,� cS' – , - 7 /. Z •�o A k-qo.o a Boring Boring # ❑ �� n Pit Ground surface elev. ' Q ft. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2 L •/0 /o Y9 3 13 — 54. z f s 6,e j e w Z -F . s 7 z / 0-/9 7ss Zs• /,M vf'e C .7.�. /. z 3 •5D 50 (o L S /4A IM 117/ CS — • 7 /• Z 50 -11,o /o s s D .S CS' /. Z l- �► 7.s �a�� Z5 / C S . 7 /. Z + 97.0 p.0 S?. 8` Z3 ( 81. go tt�.�s`f Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature A., _ / _ CST Number 9066RT z1GB�2� �yT' T 2Z43"ZS Address Date Evaluation Conducted Telephone Number /UOV '715'•3A�•�i�S Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 Wig 2(,2-co / AL � p e_A—;��s � -- r� Property Owner ` Parcel ID # Page Z of a Boring # ❑ Boring Ground surface elev. �/• d ft. Depth to limiting factor In. [,�.. Pit D Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' In. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 d •l3 yl� 3/3 L 17 Ae f•P . ' y / - )-0 7.s' yR 3/ SL /Afi Mr i2 . Co LS / .Hr v�� cS : 7 A i 770 SAV /- 2-- Boring # Boring ❑ Lo ❑ 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 /fl' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # ❑Boring [� pit Ground surface elev. ff. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure . Consistence Boundary Roots GPD/ft' Qu. In. Munseli Q . Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 '002 2 I e I _ Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 150 mg/L ' Effluent #2 = BOD 130 mg/L and TSS < 30 mg/L I ' 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. S8D -8330 (R.6M0) I r v fob � 7s f , flIoYO of 2 6 56 A;�v J s , oP�� �- ��2 ,4 sS�M 3 .2� > /l "o, I /ice ~ G lQ S'7 „--2, : ► g /N fiLTit''rf sYsl - gl �s7" o T A/v --L. f pao42 FL N11Na FO � ON M G ON KS Y ALA- - �MNEp �e 6PN B �,o3kA ), OR 1VN 5ei 3 ,� - rt�'`s c� �.Q°"� .su• -e� � � re,�g -cwt- s Ys�s �s,., - s -� e V (a .zt , 2cac y - -{-tom. Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms r 3 B 2 # Design Flow - Peak (gpd) 60 Estimated Flow - Average (gpd) 2cry Septic Tank Capacity (gal)' _ Soil Absorption Component Size (ft 5D - car Type of Wastewater D mestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) z- as N Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank - The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filte shall be cleaned as necessary to ensure proper operation. The filter cartridge shou no be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. ' Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and - reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 I r; Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the com may obstruct wastewater flow. C ✓ �� !� / -,U - ;6UV_-O _A� 'e, k, v, 7/ 5---7 `f � , ��•..� � : --ter 3 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil:Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) Estimated Flow - Average (gpd) a� Septic Tank Capacity (gal) Soil Absorption Component Size (ftz) z Type of Wastewater Do estic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) tt - 0-5 P AZ `$ Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic nk and outlet filter shall be assessed at least once every 3 years by inspection. The utlet felt sh be cleaned as necessary to ensL p o eration The filter cartridge should not be removed unless provisions are made to rem in the tank that may slough off the filter when removed from its enclosure. If the i Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption components operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 i Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. _T� Akaw,5 ,P , 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer d F= � : Ad lV ��� /1 c �- Mailing Address 3 O Property Address (Verification required from Planning Department for new constriction) City /State N E u� 11 i� � mn e /vd V aa rcel Identification Number b 2 C- - t o F 7- 70 —00 LEGAL DESCRIPTION Property Location U) ` /., W V /., Sec. T.LO_N -RR, Town of o d Subdivision )OM4 + Of 440 ��-L' . Lot # Certified Survey Map # , Volume , Page # Warranty Deed # $� , Volume S` 2 D , Page # to 'ya Spec house ❑ yes [J'no Lot lines identifiable Dyes ❑ 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 master plumber, journeyman plumber, restricted plumber 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 three year expiration date. SIGNATURE 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 owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE 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 4 Ifc. Lt! is gsttd . t Ism Co s s 70 • ;' tWAT1 01 wesmai me 18. W pW4«► Y s .r 325983 � I � This Indenture, made this 21st d ay of JsRLUUry b:tween Matthew Keller , • single man, .. part 1 of the Sru part and Herman W. Keller, 3r« and Bennie )Keller, husband and wife as point tenants ;. part i es of the second part. U;itntserto, That the said part I of the first part, for and in consideration of the saw of . One Dollar and other valuable consideration 2MIMMA 1 to hi m in hand paid by the said parties of the second part, the receipt whereof is hereby confessed . and acknowledged, hag given, granted, bargained, sold, remised, released and galtclaimed. and by those presents do es &ive, grant, bargain, sell, remise, release and quitclaim unto the said part i es of the second part, and to their heirs and assigns forever, the following described real estate, situated in the County of St. Croix , State of Wisconsin, to -wit: Any and a31 interest I say have in the life estate specified in the warranty deed dated July 24 1968 and recorded July 23, 1968 in the office of the Register of Deeds, St. Croix County, Wisconsin, ft Volume 444 of Records on page 263, Document No. 293113, which said .,III deed conveyed the following described real estate: The Northwest Quarter (NW j) and the West Half of the Northeast Quarter (W of NEk) of Section Thirty -four (34) Township � Thirty (30) North, of Range Eighteen (18) West. ! fiN • E MP'T 4Co IE?abt an0 to 1?010, the same together with all and sir gular the appurtenances and privileges thereunto belonging cr in anywise thereunto appertalnfng, and all the estate, right, title,: interest and claim I whatsoever of the said part y of the Erse part, either in law or equity, either in possession or expectancy of, to the only proper use, benefit and behoof of the said part Jos of the second part, their heirs and assigns forever, 1 In TUMIC90 MOtttot, the said part y of the first part ha s hereunto set his hand and seal this 21st day of January` , A.D., 1974 . Signed and Sealed in Presence of Matthew feller _Edward R. raiser �....� _.( Seal) . ,I State of wAotonsin, �. St. Croix County. Personally came before me, this 2141- day of January , d D., 19 74 the above named Matthew Weller, a Tingle man to me known to be the person who executed the foregoing instrument and aeknewl ' j REGISTERS OFFICE 4 ST. CROIX CO.. WIS. Ree foe Reootd this_? % I Edward R.L. R lCa�aetr ON :`^ tlalr of 19_75 •0000...••• 8 Notary Public 3t _ Croix d oan�y►, via: jji as Permanent It s of t).ees Ar commissio d wis/ - D ted by Edward R _ I�aisE,t Attorner L bw s New Riabpond,, Wisconsin .., is Y y ��K Wmarisin Depadment of Comff'e`ce PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary PermitNo.: Personal In(wmWn you provice may be used for secondary purposes (Privacy Law. s.15.04 (1)(m)1. 384135 Permit Holder's Name: ❑ City Village ❑ Nown of: State Plan ID No.: eller St., Herman Richmond Townshi T BM E Insp. BM Elev.: BM Description: Parce Tax No.: 026- 1097 -70 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St /Ht Outlet TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Sot. System PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number GPM TDH Lift Friction S tem TDH Ft Loss mead Forcemain Length Did. Dist. To Well SOIL ABSORPTION SYSTEM BED / TRENCH Width Length No. Of Trenches PIT NO.Of Pits Inside Dia. Liquid Depth DIM I DIMNI SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Manu acturer: INFORMATION Type O CHAMBER Mo a Num er: System: OR UNIT DISTRIBUTION SYSTEM Hea er /Mani of Distribution Pipes) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 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 xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1221 130th Street, New Richmond, WI 54017 (NW 1/4 NW 1/4 34 T30N R18W) - 343018525 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (a.M7'') Date Inspector's Signature Cert. No. Sanitary Permit Application Safety & Buildings Division I In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 rsconsin Personal information you provide may be used for secondary purposes 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 ❑ Check if r4visiog to preWidus application State Plan I. D. Number - Cft [ 3 I. Application Information - Please Print all Information Location: Property Owner Name Property Location "? 1/4 M / 3 Tad N, R /` Q E (o Property Owner's Mailing Address Lot Number Block Number -3 /tea wt f C605 City, State Zip Code Phone Number Subdivision Name or CSM Number w lQ <o a� o ( 7t ) 2 G 5 y 13 II. Type of Building: (check one) ❑ City f5� o g 1 or 2 Family Dwelling - No. of Bedrooms : _ �I "P lage own of p.G l 1► rn o �o( ❑Public /Commercial (describe use):_ /1 ' ❑ State -Owned Ne arest 0 Ro a4 t Parcel Tax umber(s) 016 — /0g 7 7O. III. Type of Permit: (Check o y one box on line A. Check box on line B if applicable) 3 1 1 . 30. . S a A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System T7 B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IVfType of POWT System: (Check all that apply) IF Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade �' � 6 ❑ Aerobic Treatment Upit 10 0 Recirculating ❑ Other: V. DispersaVI reatment Area Information: Q ,.,,'tei- 1. Design Flow (gpd) 2. Dispersal Area 3. Dispe Area 4. Soil Application 5. Percolati n Rate 6. System Elevation 7. Final Grade DlJ Required Proposed Rate (Gals. /day /sq. 8.) (Min. /inch) f� ;�� q Elevation z �s��P Z7,5" 37 ��� ado o . .1 qS" VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks Z,a 6r �, P:�u ❑ ❑ ❑ ❑ ❑ DD VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's Signature (no stamps): PRS No. Business Phone Number Plumber's Address (Street, City, State, Zip Code) 9G 7 c� 4� S IX- County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) �1 Approved ❑ Owner Given Initial Adverse Surch a Fee) Determination �S , ZI , 2� f X. Conditions of Approval /Reasons for Disapprov l: SBD -6398 (R 07/00) © Y O 0.� / so 7�• 1'� r H�r �o b r r s W.'- 1 � � r4 l O"P / t €'O /a c. ed . T"O J D /" YS id r 000 �a loQ�DO a l ._ i �Q .t go G � y f � _ d F, � � Lv � � �... Y ._ _..�_.. to l�� u.� /t�� 'e 1� A44 N PL tA- w b -r t A7 y /VAAL) Id TnL AS: 4 5` 1 i ' t i d ca - •�.�, rte` �. ► rl d1 Ta � k O 0 0 1 /dDl ®o a ?� r od OF�'` ;I g3 c�Dl �P �- - 110 90/ r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Sr; C/� ��'� Attach complete site plan on paper not less than 8 1q..x -11 inches i 1v size. Plan must include, but not limited to: vertical and horizontal.refQrence point (BM);"d{rection and Parcel I.D. O Z�Q /0g17 , 7Q • (X� percent slope, scale or dimensions, north arrow, and location and dfstance•to nearest road. Please print aft informal' ti Reviewed by Date Personal information you provide may be used for second V ises (Pri Law 9: (1) (m)). 2. 1 ZM I Property Owner i Property Location �+ G�' Gave. Lot NA) 1 /4NW 1 /4 S J T 30 N R /d E (or W Property Owner's Mailing Address GO pF # Block # Subd. Name or CSM# z i /3-- ,., T�taG r ; City , State Zip Code Pkbptep r_- F ❑ City ❑ Village [ jJ Town Nearest Road Aw R l[rY1Mmil WI SY /7 1 r W c1 M 0,V D 13 0 S T: ❑ New Construction Use: W Residential / Number of bedrooms Code derived design flow rate S•GC %t Owe GPD INAReplacement, ❑ Public or commercial - Describe: Parent material , S 4VD V d !/ G!J Flood Plain elevation if applicable A1 0 ft. General comments � / � and recommendations: /��( �' = 2 lr-oR z �XIS•Ti'Ntr A yw /1fw m 3 13 c7,p y s h��ES s ysT� -r S Boring # ❑ Boring 9S• & Z > Pit Ground surface elev. ft. Depth to limiting factor C/ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0 ,/5 io 3�3 sZ z shk w Z , S • �' Z 13-1-1 /o ye 31 L 17 s e cs 'rte- `--�- 3 ?/• 33 7.5 /y 5e- 2- > -s6k 3' y 7 sye y Z- s 1 X cs -- .7 �. z S 2 ' f1l 7.sylf S/ L. S /mil R cS — , 7 • //D 10 R s --- s. D, -r - i• z a j-90.c) a Boring # ❑ Boring '7 Q nL —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 /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o • /D /oYR3 /3 Se- 2 �s6X - -ee w Z .s 3 19%5 17 sA 6 S //m t1n VfX -rS .7 /- Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number 13,512 % Z/LBIe r C �,�' u 2-443 Z S Address Date Evaluation Conducted Telephone Number yov• Z S 3 e� • �i��' Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 A L i Property Owner �• Parcel ID # Page of 1-31 Boring # ❑ Boring Ground surface elev. y/• b t pit / ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 l '!3 10Y�e 3/3 L /Irs w ' z /3 zo 7-S* ye a / SL 41)1152 f . Co 3 p 7 S ,Q LS /ter Mr vie CS �o s S. 6 d a b� ❑Boring # ❑ Boring 6 ° 36 ❑ Pit Ground surface elev. ft. Depth to limiting factor m. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i F] 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 /ftz 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 < 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 (R.6/00) • o WEGC.� 2 '/i r__ . I Q florro of � 5 oP 6 1gel)"O coo r o s •T • �" 5G�� v D i►2 s; Gar y3 .zz' S YST S .0 oe p ;•21D 3 S�y ; �40 sy g8 •o jvFST" Go T `/�tl, -� Sf -er,� /�oST � • NG FO L NON� N S pEPl�1.`� AL EN PR E �AgpN�00 ,p31��' , `f�i,S c O-•. f, ,�+ -ems C"` �� ` " > • .., � . . - - - � � • - - .� � ... Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number ;4A Number of Bedrooms 3 B 2 Design Flow - Peak (gpd) ao Estimated Flow - Average (gpd) Septic Tank Capacity (gal)' Soil Absorption Component Size (W) - c Type of Wastewater D mestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Desi n Flow - Peak (gpd) z- •T.s W Maximum Influent Particle Size (in) U 1/8 U Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank - The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filte shall be cleaned as necessary to en proper operation. The filter cartridge shou no a removed unless provisions are made to retain solids ­­ in tank that may slough off the filter when removed from its enclosure. If the i Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater _T� ec C- 3 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In -Ground Soil -Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number '✓�,�,r Number of Bedrooms 3 2 / Design Flow - Peak (gpd) SD Estimated Flow - Average (gpd) Septic Tank Capacity (gal) _ ne Soil Absorption Component Size K) Type of Wastewater Do estic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) Q, Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg/L) 220 Maximum TSS (mg/L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and dean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic nk and outlet filter shall be assessed at least once every 3 years by inspection. The utlet filt sh be cleaned as necPSSary to ens ure p o eration. The filter cartridge should not be removed unless provisions are made to re rselids in the tank that may slough off the filter when removed from its enclosure. If the i Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized 'entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when'the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. component Traffic around or over the sod should be avoided particularly p during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep - rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. Yi � /4 - Sao E ILv 4LE- 1'0 ,k cAl =71'Q -3 - 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM r. Owner/Buyer �` f Vl a A� I f E YF J f Mailing Address / / / 3 O / - k ff Property Address P (Verification required from Planning Department for new construction) City/State A W i c- � PT) /V d �a rcel Identification Number b - ° ? - 7 0 —e�o � 11 LEGAL DESCRIPTION Property Location � %, !V W '/4, Sec. T O N - RJ - 9 — (:ik Town of ir, M o d- Subdivision )04r.4 + e f Lot # Certified Survey Map # , Volume , Page # Warranty Deed # 7- 5 - 7 F , Volume 2 . Page # to 'ya Spec house ❑ yes (J'no Lot lines identifiable Oyes ❑ 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, journeymanplumber, 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 o three year expiration date. SIGNATURE 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 owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE 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 fr<. 11.11, QGhAnfs . omm we ft*w ' MATS OF Y a k ^ } ks* M AC wt.. slaweN a 325983 r�ct ; . This Indenture, made rus 21st da of b -tween Xatthew Kellen a giggle sari part y of the sax yore and _ Bennie Keller hu and wife as W K nni a us H r�l n Koller,, Sr. d e a , an , j oint tenenta ; 1 e s of the second � t� 1arL Ujitntoorto, That the said part f of the first part, for add in consideration of th@ stem of - . One Dollar and other valuable consideration a 4 to him is !rand paid by the said part 1 go of the second part, the recelpt wh@reaf is hereby confessed and acknowledged, has given, granted, bergalned, sold, remised, released and quitclaimed, and by thow presents does &ive, grant, bargain. sell. reatlse, release and quitclaim onto the acid part is$ 01 the second part, and to their heirs and assigns forever, the following described real @&tact, situated in the County of St Croix , State of Wisconsin, to -wit: i Any and all interest I may have in the life estate specified in the 4 warranty deed dated July 24 1968 and recorded July 25, 1968 in the 4 1� office of the Register of Deeds, St. Croix County, Wisconsin, In ; Volume 444 of Records on Paso 263, Document No. 293111, which said deed conveyed the following described real estate: The Northwest Quarter (NMI) and the West Half of the Northeast Quarter NJ of NIJ) of Section Thirty - four (30 0 Township j, Thirty (30 ) North, of leans@ Eighteen (18) West. ,.P. ! Co t}flbt an* to I?oib, the same together with all and singular the appurtenances and privilege& thereunto belonging cr in anywise thereunto appestafafag, and all the estate, right, dtit, interest and claim whatsoever of the said part y of the first part, either in law or equity, either in possession or expectancy of, to the only proper use, benefit and behoof of the said part ies of the second part, their heirs and assigns forever. 7n tAiitntost MOtttot, the said part y of the first part hs s hereunto set his hand and seal this 21st day of January , A.D., 1974 Sighed and Seated in Presence of V �iji(?� e i U' . �� ._(Seal) I►iatthew Keller Edward R. raiser _._ ( Seal) f ___.( Seal) if ; i i ! �Gth of �ifitonsEfin. 3 0 St Croix Co Personally came before me, this 21st day of January , A. D., 1.0 74 theabovenamed Matthew feller, a Atingle man !� to me known to be the person who executed the foregoing instrument and aelrnervl j) REGISTERS OFFICE ST. CROIX CO.. Wli. 1 Reed to Remd this_ lAt_L • Fdxard R. [Aser j0 N of 5 ..• f dA1t ��Z�__ ...... 8: Notary Public o A Co ' *lat } Pernanent t R .'fo'fDr+rOs My commissiodwMISOMisl D red by Edrard 8_ iCs+iao ittsrne �et�L New Riglmond,_ Wisconsin i Lwin