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HomeMy WebLinkAbout030-1074-80-055 / �.�� / , ; � ; ■ f T ; $ k & ( 7 ° § E : § § ' 2 2/( o E k \ : S k , c E • ® o / /Cl; 77� £$mot 2 \ 4 2; I m: 0 k/ . ®: & G @ E § : % 2 2 v> Z R CD -C M �� ©: 7 & 0 0 0 co co &: CL ® _ƒ § § CL \ k n / m £' r ca , CD ■ o c k k � - �- 0 0 0 ; 2 v $ ■ ■ ■ m Or o § Q [ g k U �CY) � > k 0 rD 7 c _ @ § Oro S ; # 7 E CL 2 �_2 __ ■ CL R � ! ® d m 0 2 CL � ) r? � 2 � C o A § CLDL® § 2f§ƒ ko z % 0 E k ' M '-C D % C, 2 ;J} 3 2 °. �«R it ch � � 2 - @ Ul � � � ■ � 2 $ \ CL a � % Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division • INSPECTION REPORT Sanitary Permit No: O (ATTACH TO PERMIT) GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. /t Permit Holder's Name: �C� l ,, - aA City Village X Township Parcel Tax No: % 0 / �— pslande� lamio., - bad . --Warren-Townshi CST BM Elew Insp. BM Elev: BM Description: Section/Town /Ran /Map No: D a . U / 6 Pt�C gyY►��l 7- 03 0- 2 $- TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 1 9 . V �� / OD -O Dosing Alt. BM T CoV Aeration Bldg. Sewe 2,0 l0 •� Holding St/Ht Inlet s-a � � y. 1112 • �/ TANK SETBACK INFORMATION St/Ht Outlet /o/ . 9 � TANK TO P/L WELL BLDG. 1 en Air Intake ROAD Dt Inlet Septic \ Ob C' ✓ 6 r C Dt Bottom �� f Dosing J Header /Man. Aeration Dist. Pipe -�— Holding Bot. System PUMP /SIPHON INFORMATION Final Grade -7 Manufacturer Demand S over D . �© I / ` b Model Number TDH Lift Fric ISystern Head Ft Forcemain L Dia. Dist. to Well . :7] F r RPTION SYSTEM Width Length No. Of Trenches 3 PIT DIMENSIO S No. Of Pits Inside Dia. Liquid Depth pr SYSTEM TO l P/L BLDG WELL LAKE /STREAM EACManu Typ Of System: T Model Number: ' / IBUTION SYSTEM Header anifol9' Distribution x of ize x Hole Spacing Vent Air Intake Pipes) � 4 / T ength_� Dia r Length Dia Spacing /v SOIL COVER x Pressure Systems Only x ound br At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center _ Bed/Trench Edges Topsoil 6 / Yes i,I No Yes No COMMENTS: Include code discrepencies, persons present, etc.) Inspection #1:9 /47 / 03 Inspection #2: Location: J41,- 4023 (SWV SW "e(8N RI 8W) ?4&I:ot i Parcel No: Q" 1A 1.) Alt BM Description = ST - WV ex 2 (a• 2.) Bldg sewer length - amount of cover Plan revision Required? Use other side for additional information. - . . Yes i�..� No r r SBD -6710 (R.3/97) Date Insepctor's Signat Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 5r %,y Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) consin (608) 266-3151 Department of Commerce Sanitary Permit Application State Plan LD.N ber In accord with Comm 83.21, Wis. Adm. Code, personal information you provide — ;07A may be used for secondary purposes Privacy Law, s15 04(1 Xm) Project Address ("crent than mailing address) 1. Application Information - Please Print All Inform a on t, Z o rty wrier's Name Parcel 0 1A)t # Block �"er s *Na Property L-atio- Vj Owner's Ma, Owner's Mailing Addr�s P 1/7 M % 1A, Section City tate ZAP Code L-- Phone Number -a(Circte,9ke T - N; E cCy., � ( • S 11. Type of Building (check all that apply) Subdivision Name CSM Number k , or 2 Family Dwelling - Number of Bedrooms ❑ Public/Commercial - Describe Use El State Owned Describe Use 2 X4e� E1City__0VJlage)tTownshJp Of Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) A, krNew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision Cl change Of ❑ Permit Transfer to New list Previous Permit Number and Date Ism" Before Expiration Plumber Owner IV. Type of POWTS System; (Check all that apply) je Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-Ground Holding Tank ❑ Peat Filter El Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ 1ra I-Less Pipe , Recirculating Synthetic Media Filter 0� D !;ff , J Gra V. Dispersal/Treatment Area Info_rVnnfian-- , � ) A h H ✓ , \ Design flow (gpd) I Design Soil Application Rate(gpdsf) I Mspersal Area Required (sf) Dispersa P l Area ropo"I sf) System Elevation 1 �' tern St _T — Total Number Manufac Prefab site eel Fiber Plastic Si te f V1. Tank Info Capacity in I�f turer Steel Gallons Gallons of Units Concrete Constricted Glass New Existing Tanks Tanks - TIT - 1-c or4jWj Aerobic Treauncra Unit mv— Dosing Chamber VIL Responsibility Statement- 1, the under igp6.<`ass u.V".slbHity for installation of the PoWrS shown on the attached plans. PI 's Name (Pr• t) P Si t MP RS Number Business Phone Number Plumber's Address (Street, city, state, 0 7V wi, J4/7 J7 VIII. ountv /De partment Use 011�< ta s) , ly Permit Fee (includes Groundwater Dat Issued �ssfiing Aot Signature "Proved ❑Disapproved Sani Surc Fee) u � D Owner Given Reason for Denial 1 Conditions of Approval/Reasons for Disapproval 1,A 0C P14 I ��2 - " �10 C V 4&15 01 04 _S4e4— P6 t� fd ama complete I (to ty 001 ) for t Sys c pipe I I inches to size ` ��� - ��, , V ��7 m_ �w fd 0 1/03) V-1 If(R. W-04 � M "� T.L.' Sinz Plumbing Inc. S� �aseoh Si C'/2 E5609 708th Ave. �3 /(-�� Phone: (715) 235 -2644 Menomonie, 54751 Fax: (715) 235 -2592 1 04— wwwAsinzplumbing.com - 71 - 7 2� ti 52 U ` PJ A S P u '' l r - �,e l ?� g'4V6"f . �� l� AxA-1 ' T.L. Sinz Plumbing Inc. E5609 708th Ave. � 3 N � r c Phone: (715) 235 -2644 Menomonie, 54751 Fax: (715) 235 -2592 �aj Jo4 www.tisinzplumbing.com - 7 11 CS✓YI sas ZCz 3 X52 �UD 3 q- a� 8 f nj S 0 �' PAGE_OF, I N AME 6� � -� � r OT# LEGAL DESCRIPTIONiQ Y - Z6 T &R. / 9 Midf SCALE: V= 1 -10 BM 1 ELEVATION 4 O 0 1 BM I DESCRIPTION 9b® BM 2 ELEVATION BM 2 DESCRIPTION SYSTEM ELEVATION ty 9 `I - 6 Lo- e r 73, ' SYSTEM TYPE L✓f Ll-fl Iyoil � / _ rt CONTOUR ELEVATION q • yv 4 ° ° u� a �• D I I od S � SIGNIATURE b i I D Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ( of _ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code aunty Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must n include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Infonnadon. viewed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location 2 Govt Lot 114 114 S T o N R E (or Property Owner's Mailing Address Lot # I Block # Suod. Name # City l , State Zip Code Phone Number ❑City ❑ lag [:Tow O Nearest Road 1 d IWl o ( )' I-UW /o oSe D K {] New Construction Use: 5� Residential I Number of bedrooms —" Code derived design flow rate y _1, p GPD ❑ Replacement ❑ Public or commercial - Describe: -- - -- Parent material _— dJ C /� �_ _ _ - - -- F od Plain elevation if applicable General comments RECEIVED AUG 1 1 2003 p Boring Y: �: Boring# �0 i� G OFFICc Pit Ground surface elev. ft. Depth to limiting factor _ o on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1ff° in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o I-2 Ia r li 3 • C, z z Z i o ly S; I Boring # E] Boring �''0 F ® Pit Ground surface elev. � ! -ft. Depth to limiting factor j p a — in. Sol A Rate Horizon Depth. Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I o— 3 13 — L m� .� r 2 !D Qf� 0 0'1' O eZ 7 1 9� -s- Effluent 01 = BODj > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg1L and TSS < 30 mg/l. CST Name (Please Print) nature CST Number — 57 -CU 4 Address Date Evakfalion Conducted Telephone Number Property Owner ____ Parcel ID # _ Page of Boring # ❑ Boring J ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soi lion Rate Horizon Depth Dominant Color' Redox Description Texture Structure Consistence Boundary Roots GPDIft? in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •EW1 'Eff#2 La aLa O ) o 11 Z ❑Boring # ❑Boring ❑ Pit iGroundsurface elev. ft. Depth to limfing factor in. Sol Avplicatlon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1W in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring Boring # Ground surface elev. ft Depth to limiting factor in. F ❑ Pit Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOIfP in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 'Eff#2 Effluent #1 = BOD > 30:s 220 mglL and TSS >30:s 150 mgiL ` Effluent #2 = BOD < 30 mglL and TSS _< 30 mg1L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. SBD- 8330(R.07/00) , PAGE,�_OF,3 NAME a 1 SCALE: 1 "- L-10 f BM 1 ELEVATION Dd BM 1 DESCRIPTION BM 2 ELEVATION BM 2 DESCRIPTIO 1_s � <e SYSTEM ELEVATION -j:2Q q j 6 La er e13, 9`° SYSTEM TYPE we'll i�fsll -w CONTOUR ELEVATION qkl Q 1 3z . hoc ) era __ ad Q cr o - r -� A SIGNATURE -/ DATE �9 V ol APPROVED ST. CROIX COUNTY Planning Zoninn arvi rr ~' ° " MAR 2 5 2003 CERTIFIED SURVEY MAP If not recorded wam-1 0.;. ;f LOCATED IN PART OF THE SW1 /4 OF THE SW1 /4 OF SECTION approval date approva; sr,a, off 26, T30N, R19W TOWN OF ST. JOSEPH, ST. CROIX COUNTY, null and void WISCONSIN, SURVEYOR: PREPARED FOR: N rn ° _ m DO J. ZAHLER BRETT AND MARY BADER 1r �rrI - ;0 S S N LAND SURVEYING, INC. 717 132ND AVENUE c 2920 ENLOE STREET HUDSON, WI 5 0 -y C4 HUDSON, WI 54016 )I PROVED ° ST. CROIX COUNTY Z Planning Zoning and Parks Committee 14 Z m W1 /4 CORNER Z IC SECTION 26 MAR 2 5 2003 y o M IZ x'�z I� If not recorded within 30 days of t1 m C-) NOTE: I shall be m I� LOTS MAY BE Sdi ?JffG & $9RE SPECIAL o < d i� ASSESSMENTS FOR ANY UPGRADES AND o (m IMPROVEMENTS TO THE ROAD. I A Ia I � I Z v I 1 7C D LOT 1 PLAT — OF BASS -- LAKE SOUTH �m I ZONED AC —RES 6 ' 33, 33' C-2 132ND AVENUE w - W9 0 46 w �? NORT LINE OF THE SW 4 01 TH S Wl /4 N89 °47'51 " E , 520.00' A 10 zZ IZ rr N o N .......... ............................... .�`.�............... : N D C5 Cn i 1 I� ` I v' � tsj o I n V ^� HOUSE iv a b I Iy c $ SHED LOT 1 a i ro O POOL C2 1 i 0 m c� I � I I IZ E 1 Jdu I V INE S89 °47'51' W 520.00' I V O E o pF W/S I ZONED AC— RES c�2 H V DOUGLAS J. o UNPLATTED LANDS ; z ZAHLER 1 i z S -2145 C3 LOT AREAS HUDSON 140,418 SO. FT. (3.224 ACRES) TOTAL W m 131,040 SO. FT. (3.008 ACRES) EX. R/W LEGEND ' A. FOUND ALUMINUM COUNTY SECTION CORNER MONUMENT SET V OUTSIDE DIAMETER BY 24' SW CORNER 0 LONG IRON PIPE, WEIGHING 1.13 LBS. SECTION 26 PER LINEAR FOOT 0 FOUND 2' IRON PIPE 0 FOUND 1' IRON PIPE SCALE IN FEET I" = 100' . . . . . . . • • 100' ROADWAY SETBACK LINE 100 0 100 (9) SEPTIC SYSTEM WELL EL L THIS INSTRUMENT DRAFTED BY DOUG ZAHLER JOB NO. 6189 -01 DATE 7/24/02 REVISED 8/8/02, 9/19/02 SHEET 1 OF 2 SHEETS /P ' r " GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE TOWN OF SAINT JOSEPH COMPUTER NUMBER 030 - 1074 -80 -000 Parcel Number 26.30 .19.259A Claimed 1 Date Re- certified / / Relate Number: OWNER NAME: First BRETT E & MARY M Last BADER CO -OWNER Mailing Address 717 132ND AVE City HUDSON State WI Zip 54016 - Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date � HISTORY PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name- Type SD Apartment Post Office 717 132ND AVE School District: 5432 - SCH D OF SOMERSET Special District: (1) 1700 - (2) - (3) - WITC �yZQ,(�T, _�l��Ll•�' Plat Code: Last Changed on: 07/02/1993 Book Number: 1 I � SECTION 26 TOWN 30N RANGE 19W %160 '/440 Map Number: 00 - Sales Area: / Parcel Control 0 TAXABLE Number of Units: 4 ZONING: Permit Number: Type: +` Bank Numbers: F4 -Prev, F5 -Next, F6- Legal, F7- Value, F8- History, F10 -Exit, F12 -More LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SAINT JOSEPH COMPUTER NUMBER 030 - 1074 -80 -000 Parcel Number 26.30.19.259A OWNER NAME: First BRETT E & MARY M Last BADER PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 717 132ND AVE SECTION 26 TOWN 30N RANGE 19W '/4160 '/440 Line Description Line Description TOTAL ACREAGE 34.270 PLAT LOT BLK 01 SEC 26 T30N R19W SW SW 15 02 EXC CSM 7/1900 (REPLACED BY) 16 03 CSM 8/2170 17 04 18 05 19 �f 06 20 07 21� 08 22 09 23 110 24 11 25 ,,,y✓` 12 26 13 27 14 28 � O F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O WNERSHIP CERTIFICATION FORM Owner/Buyer 7 � Mailing Address Property Address (Verification required from Planning Department for new construction) �y W Parcel Identification Number City /State i E� sr DESCRIPTION T 3 N -Rf ' �q W, Town of st �� \ Property Location :ll /4, /4, Sec. — �) Lot # Subdivision - -'� �j bS Page # Ce led Surve� Map # Volume a ` 1 Volume S �( Lot' _, Page # Warranty Deed # - I Lot lines identifiable ;6 yes ❑ no Spec house ❑yes 1 1� no SXSTEM lYttt► J M ANCE failure to handle wastes. Proper maintenance of pumping out the septic tank every three yea Improper use and maratenan+ ceof Your septic system could result in its b a licensed pumper- What you put into the system consists years Or sooner, if needed Y can affect the function of the septic tank as a treatment stage in the waste disposal system � ent a certification form, signed by the owner and by a The owner agrees to submit to St. Croix Zoning Depa� that 1 the on -site wastewaterdisposal system property verifying ( ) �W pl journeyman plumber, restricted plumber or a licensed �Y tic tank is less than 1/3 full of sludge. i s in proper operating condition andlor (2) after inspection and pumping (if necessary the the vote sewage disposal system with the standards I/we the und�xsignod have head the above requircmeuts and agroe to maintain Pn State of Wisconsin, Certification eat of Natural Resources, Office 30 eat of Commerce and the Departm set forth, heroin, as set by the Departm c ompleted and returned to the St. Croix County Zoning stating that your septic system has been maintained must be comp da of the three expiration date. DATE SItJI•tAT(JRE OF APPLICANT OWNER CERTIFICATIO rm are true to the best of my (our) kn owledge. I (we) am (arc) the owner(l) of s t atements on this form that all stn �, I (we ) cry deed recorded in Register of Deeds Offs the rope dc= abo e, by virtue of a warranty 7 DATE SIGNATURE OF APPLICANT ««a« «« A information that is mis represented may result in the sanitary perm being evoked by the Zoning Department- warranty deed from the Register of Deeds office «« Include with flits appllcatlon: a stamped a copy of the certified survey map if reference is made in the warranty decd l POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa / of FILE INFORMATION SYSTEM SPECIFICATIONS w` Owner Septic Tank Capacity 0Q al ❑ NA Permit # Septic Tank Manufacturer �/� ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model wQ ❑ NA Number of Public Facility Units ,A!J'NA Pump Tank Capacity al XNA Estimated flow (average) gal/day Pump Tank Manufacturer A Design flow (peak), (Estimated x 1.5) f� gal/day Pump Manufacturer NA Soil Application Rate t 7 gal/day/ft, Pump Model NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD :_30 mg /L AIn- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510' cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: v rM A Other: NA Other: NA "Values typical for domestic wastewater and septic tank effluent. Other: NA MAINTENANCE SCHEDULE Service Event Service Frequency ❑ on(,) (Maximum 3 years) ❑ NA Inspect condition of tank(s) At least once every: earls) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: „3 ❑ ear( ►(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: O _jn year(sl onth(s) 4e & 90 NA ❑ month(s) ON A Inspect pump, pump controls & alarm At least once every: ❑ year(s) ' ❑ month(s) I VN A Flush laterals and pressure test At least once every: ❑ year(s) Other: ❑ month(s)A At least once every: ❑ year(s) Other: �] NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of , $TART (1P AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals r that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents 0. of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant re ment system: plac 1W A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER ./ POWTS MAINTAINER Name G /I�� N(,•. Name Z. Phone ,. Phone �; SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name !� Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. DOCUMENT NO. j STATE BAR OF WISCONSIN -FORM i vo► 541 / WARRANTY DEED 33 ; �� i THIS SPACE RESERVED FOR RECORDING DATA T11i5 DEED, made between Laurence REGISTER . Forger and Anthony Fur�er, $ OFF ICE both single_ persons____,__ R•:c'd. for R;;c;,rd this -_4th_ — - -- _ -- - -- -_ Grantor du Of st and Brett E. Bader and Mary M. Bader husband and wife - --_A•D.19 75 -- - - -as -. joint tenants _ -- Q0 P. M. Grantee, r Witnesseth, That the said Grantor for a valuable consideration __. to them - -__ g.yhta of Daedt -- i n haled. p - - - - -_ -- - - -- conveys to grantee the following described real estate in _ Ste Croix ___County, RETURN TO State of Wisconsin: The Southwest Quarter (SW 1/4) of the Southwest Quarter (SW 1/4) except the East Twenty -six (26) Tax Key #___ rods of the North Forty (40) rods thereof, in This is ______ homestead property. Section Twenty -six (26' Township Thirty North (30 N), Range Nineteen West (19 W) St. Croix County, Wisconsin, containing 33.5 acres more or less. Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; And La urence Purge and A nthony Purger, both single_per-sons -- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except a and will warrant and defend the same. 'I �i Executed at — this- 4th--- day of-- AugUS 19_ 76 SIGNED AND SEALED IN PRESENCE OF A .eAA- ) 4 / (SEAL) rSEAL) (SEAL) - - -- - - - -- - -- — - (SEAL) i i i Signatures of authenticated this _ day of _ i 19 - - -- -- - - -- -- Title: Member State Bar of Wisconsin or Other Party Authorized under Sec. 706.06 viz. ( 4 STATE OF WISCONSIN S t C 12 c t X . —_— County. � L Personally came before me, this _ % _— day of ___. ,� - 19 7 (,1, the above, named —_La arena. Fhrge r- anti Antho _F'llrg -_ —___ to me known to be the person - -_ who executed the foregoing instrument and acknowledged the same. - "'�•'':.,, ' .•t .art ...,.. `rte : j�� 't This instrument was drafted by -- _— Notary �ublic - _ t k-�ount) Wts. : 'y " (f The use cf witnesses is optional. My Commission (Expires) (Is) �- 2 Names of persons signing in any capacity should be typed or printed below their signatures. R.CMxN.Ca.owMlrvtt WARRANTY DEED —STATE BAR OF WISCONSIN, FORM NO. I — 1971 ... a o �t 1� 9 � . OO M" CD rZ \eA 4 7.71 - �, JI, rn I 76 4 '" ~ C / RECEIVED b N �� .LOT 3 I ' �� I �Ci 8 2002 4 I I UA 520 QO/ /uIX C v T' ZON ING 0 F CE Y l �, 763 RC1w ° e a I LOT 2 a tu s • IX C TY I j Phnning .o.in d .rk. 52 Q� . l3r z 711 Q if not r rded 0) I rihin 3U , of ' M (� aPPro date Proval sh It be vni� I 1`� Li 4 u� 762 nl.11l nd 1 t N LOT 853.79.' Al 6i pL = 132ND AVE. �raposed / oT LOT •2 LOT 'I c � N Ac- � 259 6 257 E C. S. M. VO L. 19'Jt C. S. M. VOL. 8 , �AG _ 2170 SW //4 SW 114 259 A � C RTIFI E( 2 57A4 1 534.4.'' l can c�: G Ca fe-d I the Sw' /'y c-F the SW '/y o4 S 26 �o N� Town or St. J'oseph,. �Dcwcd For. Re cd t3 " g: M4r C rc�er N .a nd (4 "en he r 7. � S1 132.n4 Ave.. j son, w I SY o I �ds6n w a 1 256 B 1 49177 257A3 257 A2 �. w LOT 3 LOT 2 A 364.4 ^ Zoo r 268. I Zoo . 'o [ T R &44ENT LOT 8 BOW- � SE 0 -SW //4 ` SURVEY AP VOLUME 3, _E 7 - - -- - - - -- 257 Al ' LOT I � I Q J 779.22' 257A5 S 1/4 COR. t JOSEPH `E' PLAT T- 29 -30 -N • R -19 -W >wners) SOMERSET'S' PAGE 62 See Page 112 For Additional Names. 800 700 ' 800 150th AVE 900 $ 500 Ruth TS 1 0th A�/E' R&p, R , o c8 & Richard 24 . km �i Vuhs abeth 14 A33 , 7 ,9 tr 21 Simon tr man I 40 o Houle o 1 80 m ao ~ 75 148th AVE v 5 r �* r Helen , �' on ..b. aulc& = & Glenn Karen I to O Houle aaa I R ao Bell H � 36 V m Basel PQ 120 Ed- 1 40 8 sa 39 48 RIGHT Donavin John & 2 "a`" za 2� gl John & I Kr & th Jud Georgine WEST arvvK Joha & Sett Schottler 23T Pear IDDEN tr Georgine I SHORE o 1 c OAK Marty TR Schor Kathleen DR d c t oy N s w 5 W e tr 228 lobo 8 z A tr VALLEY 119 365 ;" � 39 �' j 120 00 & e D&as142 I VIEW T tr & tr 361TERRIE ¢ 20 br 140th AV SK 15 �i 1 N 2 Edward & 1 3 , LN t1 FRO 4 ' 8 e Mau- B&M S1lzette 5 POND Hendrik 0 N' it Bw Sontag " v 25' quad 3e oC 5 O c LN 28 c ~ & VanDYk I '17 I R&l 1r LV zo Y SftV= M tt gg wl Ktlslich d D 65 tr 6 S LAKE ; .- M T &C 20 16 �" • oC / HOWAR co Lange .P �� ,9 p 117 RS RD Q 36 cw 1u I r� / — p6'� W1 v i h s kh�d .A 0 7 � Gj Da W L `/ O'P C H 2 Co Dav stmns 1] m er « 1 ackII I 3,•d' -7A W =� KE to 1 64 113 &shan>q 40 3 nd v llQ�4J 0 RL V J I tr UK 32 s 2 -41 AVE 160 I � g E & L.A. 0 30 6 - 7// 9 � �� . 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(715) 672 -5941 bill @durandbuilders.con t N6344 State Road 25 Durand, Wisconsin 5473( ��..- r �. a111� r .aa► .Ilr, Aft a - d merce PRIVATE SEWAGE SYSTEM County: St. Croix efe INSPECTION REPORT Sanitary Permit No: 430267 0 r E NERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No ersonal 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: `� C Bader, Bret & Ma St. Joseph Township V 3 -1 T 1 U7 - Do Od D CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 26.30.19. 2- A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 n – [] Yes � No Yeses No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 719 132nd Ave. Hudson, WI 54016 (SW 1/4 SW 1/4 26 T30N R1 9W) NA Lot Parcel No: 26.30.19. 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? E— Yes ❑ No Use other side for additional information. I SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. ~ w O O M c a I � w h O O N n i C N � a C y E E ) 9 2 (D 0 w, . j U) S. � I aD Z o 1 o m o m LL c rn 3 m y m 7 Q t L Cl) Z y I, I m Cl) CL 0 N f- U) ii o z a z $ 2 Y U) H r l E m N a�i c I N � p 5 I N . Of N •N I I d p N O Z C Z N v h f , " rmrNrU) E N . (r1 ° 3OOG a: Fn I I � N -;j oaaa N CL � I J V O C U) } > N N �i Q LO t-- Cp N N O I N M O m c ) NI m 0) Q p d Q Z U) 3". O 3 c 3 u O � ° � N L 47 C i. L C U C w ~ M ' c o N m C l) N U) Ca � O z S (. Ll v) m a • a d .2 a ttw� 3 3 _1 A V IT O N v