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HomeMy WebLinkAbout030-1085-90-100 0 0 IM ' ° n � :g_\ a s ;a z— z \#@ m w n. a$ o w o :. oC . C § am w i ' gi C \ k / -cD 3— w: v � cr 8ƒ g 2�; \ o § 2 co \ ( c g / >£ §� / } 3 , o W \ % § � (A o c � ° ° 0 k z o o o - ® z / } § CA CA ■ $ > o o / 2 m 0 , m gE2 , � ■ � z 3 f § � ƒ � � / e > 7 { @ 5 C C / § i E _ f § w zm . � / � k � / $ \ � Z d § CL § 2 § E \ 2 7 2 46 2 / � k � $ § � \ � CD � � @ � m ƒ � ) qb \ 0 ¥ � § � ? ? Parcel #: 030- 1085 -90 -100 02/06/2007 03:34 PM PAGE 1 OF 1 Alt. Parcel #: 30.30.19.312A 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/17/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner BRIAN J & KELLY J PRUSHA O - PRUSHA, BRIAN J & KELLY J 322 138TH AVE HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description 322 138TH AVE SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.000 Plat: 4996 -CSM 19 -4996 SEC 30 T30N R19W NE NW CSM 19 -4996 LOT 1 Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 30- 30N -19W NE NW Notes: Parcel History: Date Doc # Vol /Page Type 11/21/2005 812507 2931/372 EZ -1 07/21/2005 801025 2848/258 TD 07/21/2005 801024 2848/257 WD 07/21/2005 801022 2848/236 TD more 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/02/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 60,400 198,500 258,900 NO Totals for 2007: General Property 3.000 60,400 198,500 258,900 Woodland 0.000 0 0 Totals for 2006: General Property 3.000 60,400 198,500 258,900 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 Wisconsin Department Yf Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 479269 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Schnobrich, Gerard I St. Joseph, Town of CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: %" /Z) 1 9 -3 Gs 30.30.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ,/Z 50 Benchmark 3 5 'n, ( a 9(c'. Deeft Alt. BM Q Aeration Bldg. Sewer 3. ya Holding St/Ht Inlet q. 5b TANK SETBACK INFORMATION St/Ht outlet , rBS 9v7l, TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ \ Septic / 7 4 �t Dt Bottom \ \ Dosing G Header /Man. 5.3 9y� 3 Aeration Dist. Pipe $'S • 9'S 5 •V 9Z. 71S Holding Bot. System D PUMP /SIPHON INFORMATION Final Grade 31 5 1 � 1 7 (o -I Manufacturer Demand St Cover / c�p GPM �'� �e,� �..0 Q .0(3 Model Number 97. 9 TDH Lift Friction Loss System Hea TDH Ft Forcemain L ength Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width gth No. Of Tre PIT DIMENSIONS No. O Pits Inside Dia. Liquid Depth T DIMENSIONS 64 Z \ /` SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR �7 0�►' Typ Of�Sy` /� A),/� UNIT Model Number: a J ; DISTRIBUTION SYSTEM 5Z d Header /Manifold /� Distribution x Hole Size x Hole Spacing Vent to Air Intake / Pipe(s) \ \ LdvJ Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx De th f xx Seeded /S dded xx Mulched Bed /Trench Center ' Bed/Trench Edges Topsoil � ' Yes � No ." Yes [. ] No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: Location: pending Hudson, WI 54016 (NW 1/4 SE 1/4 30 T30N R1 8W) NA Lot 1 (� l Parcel No: 30.30.18. 1.) Alt BM Description = 2.) Bldg sewer length = j42 - amount of cover = Plan revision Required? L Yes ° No Use other side for additional information. -- Date Insepctor's ignature Cert. No. SBD -6710 (R.3/97) ` Safety and Buildings Divis;on County '^ �- /sconsln 2 Q 1 w, Washington Ave., P.O. Box 7162 -� Madison, WI 53707 - 7162 • N ��Yce ` � Department of Commerce Sanitary Permit Number (to he filled in by Co.} I (608} 266 -? I I Sanitary Permit Application C I i•D. Number In accord with Conan 83.21, Wis. Adm. Cade, be use personal informs could Ma + Y d for seconds os p _ rY pm' es Privacy P any Law, W. `�Unl' ,r Project dress (if ditferetn than tnailtng address) y 1 Application Informati - - on -Phase Prittt All Itttormadon < L Property Owner's Na me !� Parce At Lo Block p r y gwner-s M ailing Address � l4 � Pro Locado C;ty, state -'`-" • _ ,,��� / Zip Code Phone Number �� T N: �== '"`' 'p •Section d s U I I of Buildin k :a B uilding (checll that a =� � C� 2 ? °ircl i PP I Y} 5� J R E o yUl or 2 Family Dwelling - Number of Bedroom$ Q e o Nu ( ❑ Public /Commercial - Describe lase M ��� ^ ^X_'c • L-. State Owned - r d Describe Use 5city L1Village .Jl'ownship ofjOO�5 ep Type Of Permit: (Che only one box on Dine A. Compl li ne B i appli cable) _ i� New System j �J Replacement System ❑Treatment/ Molding Tank Replacemenr Only ❑ Other Modification to Existing System L IV D Permit Renewal Permit Revision ❑ Change of 7�� Permit'iransfer to New List Previous Permit Number and Dace Issued Before Expiration Plumber Owner T ype of SS System: tch" al tbM � 1 _ w Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil 1 Mound < 24 in. of stuttable soil (J At•Grade 71 Single Pass Sand Filter -' Constructed Weiland 11 Pressurized In- Ground ❑ Molding Tank L7 Peat Fitter G' Aerobic Treatment unit L Recirculating Sand Filter 1 U Recirc ulating Synthetic Media Filter Leachi Chamber L Drip Line ❑ Gravel -less Pi V. Dispersa� l /T reatme Area Information: _ Other (e xplain) Design Flaw Design Soil Application Rate(gpdst) 7_pispetsal Area Required 4 Dispersal Area Proposed (sfj Sys Elev ion Y --� -� I l ad y a 9 � VI. Tank Info 1- - --i- -- - Capacity in Total Number Maautacturer �r-- -- �- Gallo ns Gallons I of CJttits (,r �_/� f- ( Prefab Site Steel Fi' Cr b plastic I Concrete New ETxfsttng /^� �' C�ttatTUCt+ki , Glass _ Tang � "T'anks ptic or }iutGing Tank o 2dG Gee BSc r Q( :aerobic Treatmeru Unit I rk�sing�' Chamber VII. _ --- _.1._ -_ _ \ ", Responsbbiht y Statement- 1, the u nd e r sig ned , _� -- wi stune responii1billty for It itUation of the POW show on the att ached plaits. _ Plumber's Na me (Prinq Plumber's S; gnature - - MPRS Number �T$ustness Phone Nu» tber �� ,`Ili` f Plumber's Addre ss (Stmt, City, State, Zip Code) ��� �� ��l ���"� 3 P 2 ,✓ \ VIII. Cotmt /De arttent Use O Approved 11 �� Sarutary Permit Fee (' eludes Groundwater Date Issued Issuing gent Signature (No Stamps} j 1 Surcharge Fee) i $ _ L O n e nial _� _ _� — ��- �( �IX. Condition of Approval/ — ` " - �� SYSTEM 1 Septic tank, effluent filter and dispersal cell must all be se iced if Maintained as per management plan provided by plumber._ 2. All setback requirements must be maintained 1 i as per applicable code /ordinances. 7 .dam 4, 36 Attar! — -- -- CUalglete plum (lo the county only) for the eystotg on er not inches in ixe � � �6►1 -� Ode � d 0 � B m a i c ov *4 4/ 1 0 61 0 LJ t s 2 2, Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. i County Attach complete site plan on not less tha/g8 x 11 l ust include, but not limited to: vertical a horizontal W irection and Parcel I.D. percent slope, scale or dimensions, no ow, tion and distance to nearest d. Please print all in for atior� 2 2 2005 Re 'wed by Date Personal information you provide may be used for seconds purposes (Pnva ,J1N5 (1) (m _ Z� s Property Owner /) r i t� r' � N I N G rty L lion &i s c .^ f'l V � A e ,I- Govt. Lot . / 114 j/ 1/4 S jCfi 3 N R fi E ( w Property Owners Mailing Address / Lot # Block # Subd. Name or CSM# City State Zio Code Phone Number ❑ City ❑ Village 53 Town Nearest Road l I w it Q New Construction Use: Residential / Number of bedroom Code derived design flow rate - 'Y 3_0 /6 d GPD 6 Replacement ❑ Public or commercial -Describe: �--- Parent material 1 Flood Plain elevation if applicable Gener com ments a recommendations: 7?/ 57� �li✓� '� (� 4' SZ✓ G� c •.t-r r ye J P/ I Boring # a Boring J9 Pit Ground surface elev. Z t. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Boring P it oring Ground surface elev. 0 O �� n. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Z qY -sue _ • Effluent #1 = BOp > 30 < 220 mWL and TSS >30 < 150 mg& ' Effluent #2 = BOD 1 30 mg/. and TSS < 30 mglL CST Name (Please Print) - - Si CST Number Vic. G _ 36 x Address jC, - p� Dato Evaluation Coxiu Telephone Number I Property Owner r y -�� Parcel ID # /fit Iai V2 Page 2- of 1 -31 Boring # ❑ Boring ® pit Ground surface elev. 96 ID ft. Depth to limiting factor P (0_ in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff #2 r 3% - S r F-1 Boring # ❑ Bon ❑ Pit Ground surface elev. ft. Depth to limiting factor in. !To Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef1#1 •Eff#2 F-1 Boring ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture S#ucture Consistence Boundary Roots GPD/H' in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. •Efr#1 'Eff#2 • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = BOD 130 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. SBD4330 ca.60)) PAGE > OI< -3— _ NAME �'j f ✓� A 5Vt LOTi LEGAL DESCRIPTION Ai A $!`' /4,S,j; 7 j ,R E(OR)60 r 'SCALIr. V SM I ELEVATION ® 1 DES CRIPTION SM 2 ELEVATION 2y. 6 �1 se c 30 SM 2 DESCRIPTION T dee- G�;�[/�� c SYSTEM ELEVATIO 4ve �y S'� LcM. — � T tj SYSTEM TYPE c?��1 �✓1 R-- i 4 S / Y p i 5 r r 131iiNATURE <IDATE- ' v I uyt v+ SEPTIC TANK E PUMP CHAMSFR CRO53 5 ECTION AND SPECIFICATION 4" CI VEND' PIPE -12'" "MIN. ABOVE GRADE E WEATHERPR y25 FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE N WITH CONDUIT MANHOLE COVER FINISHED GRADE W/ PADLOCK & 4" CI RISER 0/ _ - -WARNING LABEL --- --�.� 4" MIN. 19" IN. 6" MAX. l NLET rl �t WATER TIGHT SEALS GAS- ' TIGHT + A SEAL , FA PPROVED __i— OINTS WITH APPROVED ALM PPROVED PIPE 'IPE 3' $ ON ' ONTO )NTO SOLID f ' OLID 50IL ;flIL C PUMP OFF EDEN . FT. ---- OFF' RISER EXIT D RMITTED ONLY TANK MANUFACTURER 3" APPROVED BEDDING UNDER TANK HAS APPROVAL CONCRETE PAD SPECIFICATIONS S EPTIC / DOSE TANK MANUFACTURER: �t �.Y�.._._ NUMBER DOSES PER DAY: �'� TANK SIZES: SEPTIC '4 0 GAL, DOSE VOLUME INCLUDING DOSE Sjo G A GAL. FL WBA K: 159 u.,. 0 C ALARM MANUFACTURER: . D ��sm CAPACITIES: A = - INCHES = CI GAL. MODEL NUMBER: �' SWITCH TYPE: rr\% e. B z 2 INCHES = 4 a GAL. PUMP MANUFACTURER: Gm A oi C r INCHES = GAL. MODEL NUMBER: p q c SWITCH TYPE: MALC D = INCHES 2 k . GAL. REQUIRED DISCHARGE RATE y 0 GPM PUMP & ALARM WIRING AS PER ILLHR 16.23 WAC VERT1"CAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . . /o- FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . . 2.5 FEET + (� _ FEET r ORCEMAIN X Z,66FT /100 FT. FRICTION FACTOR . , !S7$7 FEET _.__..._ T.OTAL DYNAMIC HEAD = _3FEET .INTERNAL DIMENSIONS OF PUMP TANK: LENGTH _. - ; WIDTH . ' DIAMETER LIQUID D 3� � i CY�L p ee J y SIGNED: .,.►' LICENSE NUMBER: q0 DATE: _ 1/88 [b]GOULDS PUMPS Submersible Effluent Pump 3871 EP0 � ` EP05 APPLICATIONS • Fully submerged In high 0 EPOS Impeller. Thermoplas- ■ bearings: Upper and lower Specifically designed for the gra te turbine oil for tic enclosed design for heavy duty ball bearing following uses: lubrication and efficient Improved performance. construction. . ■ Cuing and • Effluent systems heat transfer . ng Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms superior strength and corrosion Heavy sum • Hea du ma operation. Auto- resistance. camda SUndards Assodmw P mat ic models Include ' Water transfer Mechanical Float Switch r Motor Housing* Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "F" or "C ".) factory. strength, and durability. SP ECIFICATIONS ■ MOW Cover. Thermoplastic Goulds rumps Is ISO 9001 "sw W. • Solids handling capa FEATURES cover with Integral handle and ' / ;' maximum. ■ EPO4 Impeller: Thermop float switch attachment points. las- • Capacities: up to 60 GPM. tic Semi -open design with 0 Power Cable: Severe duty • Total heads: up to 31 feet. pump out vanes for mechanical rated oil and water resistant. • Discharge size: 1'h" NPT, seal protection. • Mechanical seal: carbon. rotary/ceramic-stationary, BUNA -N elastomers. • Temperature: 104°F (40°C) continuous 1401 (60 1 Q intermittent METERS , FEET • Fasteners: 300 series stainless sleet. 9 30• -�SGPM • Capable of running dry without damage to e � zs FT components. 25 Motor: • EPO4 Single phase: 0.4 HP, s; 115 or 730 V, 60 Hz, 1550 i RPM, built in overload with s automatic reset, 4 • EP05 Sin phase: 0.5 HP, Epos 115 V, 60 Hz, 1550 RPM, built in overload with _ EPO4 automatic reset. 2 • Power cord: 10 foot s standard length, 16/3 t SJTOW with three prong grounding plug. Optional 20 ° ° o to 20 so 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug " -�- (standard on f PC5). ° z 4 6 8 10 12 MI/h CAPACITY Goulds Pumps � 2000 Goukfs FunWs I TT l ndustri e s Effective February, 2900 6367f ui�k4� STANDAW CHAMBER Quick4 Standard Chamber 48 (EFFECTIVE LENGTH) ..................... e fin 34"— SIDE VIEW SECTION VIEW MultiPort End Cap 1 6 . 1 2" 77 L A SIDE VIEW TOP VIEW FRONT VIEW am 0, 'Nominayshaw P i ibations Wv. JEUN catlong-Pl 11i III E n it; a irl �, ` Size W X X ,"s X si"Z6 34 x 161 Effective Length 48" I n vert Height 8" or 1.25' Invert Height 81 INFILTHA TOR SY jIEMS_ INC. STANDARD _LIMITED WARRANTY In 3 P.110111i or An 1-0'. IUK by 1001 I 'UF'45�1, i hi M III jp m ter al nritl u n A a I I',Nr Iw rvrn yCar Gorr. Iha dale Iha. the septic W t ,a i.,aued fnr PIr• sPp!r yslWr• CW :tat ning IhA Wur ;; provWed, however, soin* system - w-ldan- with li ­­i i wenanUrd to !ho Q ,,, Vj pUOi 0-10clei 6.11 at .1 " --to per `X reyr ed Or alPlAsc-bli (Me —31 P—IJ -11 begin Op.n i i tale J'at InIzallialk, of Ito sepw. systern hon"'Im-'s d ty 1 111E lerge i dt.(ecf. InGI razor will supply rcgolacsmer t Units for I dot arnni 1) Ii j(> do covei oy jr , 0!Jt(A!. 1,rai s exc,i the omt of removal ani insialfaijon of the Ji 'H ! h I ii WARRANTY AND REM IN SU81PARAGRAPd a AIIF. EXCAYWE. 't i A;'tf-- NO OTHER WARRANTIES WFIH RESPECT Iflus i-IIII'led Wav be . Ally *J If any Part 0 the rharlb —,.Wrn e r- rflarota(. i )vin 0Y nje ell-i than Infiltrator, The bi Viartarry(ID85 SYSTEMS INC ir�i 1,AeAe id to I ctin swo- Jr d ti �o bu iia"') Ii omli Of ilquicli di includli i i producl Arid proms i Gi materials. 0�0`10ad C"tr, lo�eb 01 expenses i m�-,d IN tl-� Hoi or arr 1�*d Party S00i Envilronnnntal Onsite Wastmater Solutlone Wla,'w m-Awage we damage to ?i Jnils 6- to o"-r �v an d ii aleralO accid6ml, hrits". qbUft cs ringli of linn Units i-9 sult to vehicle ti or Other condiii­ w t-ji ara nut �mlmltfflh by the Installation Insinjoiji f t Ina iii m urn ground n0i set f in the Installation instruct j pl 6 Business Park Road - P.V. BOX 768 1 (1 LOifs or the ;i sW— c k, o to Willi I Zr siting ,, I probe, siling. —1 —1. or , 'r , ii anty. any Qli went no: r.aui Oy Infit 'aw, is i warrant shall be v it, ii X� One at Old Saybrook, CT 06475 Z he i falls —Pi with 41 Of the t0r(hS Set toll, In this Urhitsi 860 • FAX 860-577-7001 sh Infili Qf i State and!i cod ar diner the f r-� ns i loss 01 darn r. i if). i 1� 0.1 i 'k" b th Pam rawilog i IhslaAi of ship- o. 's � kieoranyll"I'di Fl�t Units i Allin all site w ndtr o r zrKi ,,,i [-,,4 appicaW �% and i7`!tf1tv'1 Wailaltch i1strucillonstfebstalled in, ab�.,ordi 800-221-4436 A No vibresentatw Of Infili has the aul" ty 0 change extend 11-sis bi Mi. Ni aPPIm 10 any ParIv other Iiijifi Inecing, 01 Hold, Th above ra{irecant rile Sian tar I n ( Irator. n umber of si and cDtlllii IWO delatehl warranty reqlu ;1 3- ,T-ts AfoypijeClusooll lnit, h.. 'P.ali Headquarters In Oki Sayi Connecti i losuChpui " of I " a � and Gt Wd carei read that wari pour to the purchase ul Units Canadian Patents 1,329,959 004,564 Other Patients ponciii 0 t Equalizer and Sideffinder ahat registered Oadernarks of 111111i Systems Inc . mfifilmi is a negistorod trademark in France. Infiltrator Systems Inc. to a registered trademark In Mexico Contour, contour Swivel Connection. M'Clol-i PoWuff, Shpt -ock, Crairnberspacet, PoSi Quki Quici RECYCLED PAPER ,1f)ri C).Lirni :vat tiariomarue M Infill-,", C-1-- "" T, -- .,; , .1 . ' POWTS OWNER'$ MANUAL 81 MANAGEMENT PLAN Page of FIi,E INFORMATION Owner SY TSM SPECIFICATIONS �5-E.R �� �- •N�� _ Septic Tank Capacity ai C] NA Permit if i I� .2 C� Septic Tank Manufacturer O NA OiEs10N PARAMETERS Effluent Filter Manufacturer Q q NA Number of Bedro oms Q NA Effluert Filter Model d NA Number of Public Facility Unite, A Pump rank Capacity al 0 NA Estimated lbw (average) !1'D V t Ld& X , Pump Tank Manufacturer e 0 NA Design flow (peak), (Estimated x 1, 5) soda pump Manufacturer �,. / ❑ NA Sol! Application Rata Pump Model ' sl /d /ft° © NA Standard Influent/Effluent Quality Monthly avarsgsi)" Prevostrimt Unit 0 NA Fats, Oil & Grease (FOG) S30 mg /L 0 Bend/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (Boo 5220 mg /L 0 NA Q Mechanical Aeration C7 Wetland Total Suspended Solids (TSS) 5150 mg /L O Disinfection ❑ Other: Pretreated Effluent Quality Monthly ,average Dispersal Call(s) is NA Biochemloal Oxygen Demand (1300.) '30 mg /L Q in- Ground (gravity) D In- Ground ppe Total Suspended Solids (TSS) $30 mg/L Q NA Q At-Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /100ml Q Wp•Line 0 Other: Maximum Effluent Particle Size Ya in die. Q NA GtFler; 0 NA Other. 0 NA ' ❑ NA "Vskm typical for domestic wastewater and sceptic tank effluent. ate: 0 NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(sl At least once every: mon a (Maximum 3 y ears ) ❑ NA 3 ear a Pump out contents of tank(el When combined sludge and scum equals one-third (Y of tank volume O NA Inspect dispersal cell(#) At Ierls«t once every: e�snth(s) (MaxZ�m 3 years) O NA Clean effluent filter At beat once every: � inminthis) 0 NA 0 ears) A ff Inspect pump, pump controls & alarm At least Once $very: _--- month(s) D NA C3 earls) Flush laterals and pressure test At least once every: mon (s) C3 NA - C7 ear(sl Other At least once every month(&) ❑ NA O earls) ther: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shat! be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, PQW+VTS inspector; POWTS Maintainer Septage Servicing Operator Tank inspections must include a visual inspection of the tankla) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and Baum and to check for any back up or ponding of affluent on the ground surface. rho dispersal cells) 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 sours in any tank equals one-third IY3) 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 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 1, START UP AND OPERATION For now construction, prior to use of the POWTS chock treatment tank(e) for the presence of painting products or other chemicals concen are detected have the contents I fhi h igh e s and/or dams t d era i c8i (si. I _ , that may impede the treatment rccea / e he .lap... d . g Y P P 9 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 talu In one large done, overloading the collie) 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 PQWXS Maintalner 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 et -grade sol± 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; condom cotton swabs; dogreaeora; dental floss; diapers; disinfectants; fat: foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meet scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently takers 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. a Ali piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. s The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. e 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 falls and cannot be repaired thgr following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wails. 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 tine. ❑ 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 lest resort to replace the failed POWTS. $A © T sit d site e tank 0­11 W' ❑ 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 C ONT AI N LITHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIiRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR Oi; A TANK MAY SE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POVVTS INSTALLER POWTS MAINTAINER Name "ll �( ��► a �Q � Name Phone �. Phone SEPTAGE 8ERVICING OPERATOR (PUMPER) OCAI REGULATORY AUTHORITY Name Nan1e S CtOIx C&Lk tJ i Y Zs N / AJ�__ Phone Phone This document was drafted in compliance with chapter Comm 83.21201111)(d1601 and 83.54(1), (2) b 131, Wisconsin Administrative Code. Jun 07 D5 01,:44p All Metro Glass 6514391917 p.l ST CROIX COUNTY SEPTIC TANK NtAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OWner/Buyer Mailing Address S P Ofd Ptopatty Address (Verification r from Planning Dcpatfrnent for now coastructloa) (ty/State Pared Identification Number 0 YeL DES RrnpN Property Location E %, who v;, Sec. ,-Q, T � -Rja_W, Town of Subdivision Lot # e Certfiled Survey Map # _ �� 6,11 Volume 9 . Page # warranty Deed # 7e 2 ® Volume D7 . Page # Spec house ❑ yes t3' no Lot lines identifiable &dyes ❑no M MAWMNANCE Improw use and mainteaaaccOf your septic system could result in its premature failure to handle wastes. Proper maintenance of P out the septic tank every three years or sooner, if needed by a licensed r. can affect tiv funcdon of the Septic tank as a treatment stage in the waste disposal system, p�� What you put into the system The property owner agrees to submit to St. Croix Zoning Dq rtm=t.a certification form, signed by the owner and by a laslor plumbe4jOUrUOYMAnplumber, restricted pltmaber or a licensed ve its is proper operating condition and/or (2) after inspection and p�i� �� that (!) the on - site was�tcwat�erdisposa! System Pumping (if necessary), the septic tank is less than 1/3 full of sludge, the naderswaed have read the above requirements and agree to maintain the private sewn e Drib, herein, as set by the Department of Commerce and the 8 disposal system with the standards that your septic system has been main Department of Natural Resources, State of Wisconsin, Certification sWing days of the three Year a twined must be completed and returned to the SG Croix County Zoning Office within 30 Q�/ Y xpiration date. � 1..�°r � SIGNATCTRB�OF APPL l zDOS DATE OWNE E ATrnly I (we) certify that alt Statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the Party descnbed above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APP ~ � LICANT / 7 / 7.4 DATE a••••• Any information that is mic- d npresentedazay result in the sanitary permit being revoked by the Zoning Department. s. 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 decd A P N� IN ART OF THE NORTHERN HALF OF THE SOUTHEAST 1/4 OF THE NORTHWEST 1/4 SECTION 30, TOWNSHI 30 NORTH, RANGE 19 WEST, TOWN Of ST. JOSEPH, ST. CROIX COUNTY, NTY, WISCONSIN. vv 0 -- INDEX CONTOURS DEVELOPER — - INTERMEDIATE CONTOURS GLEN JOHNSON CONSTRUCTION ��- TREEUNE P.O. BOX 809 kC A 7 HUDSON, WI 54016 �� WETLAND (715) 386 -2974 SUBDIVISION PARAMETERS SLOPES 12 -207. TOTAL NUMBER OF RESIDENTIAL LOTS= 14 TOTAL BOUNDARY= 48.5 ACRES LENGTH OF ROADWAY = 2300'* SLOPES >20% MINIMUM LOT SIZE= 3.0 ACRES MINIMUM ROW WIDTH= 66' DRIVEWAY SURVEYOR/ENGINEER NT HUMPHREY ENGINEERING INC. JOINT DRIVEWAY 145 MAIN STREET, P.O. bOX 252 00 VILLE, WI $4028 715 698 -3440 V . 1 5771 1 S F •'" - Q; - -3:62 At. ' i 54463 S. Fr 3` 55. Ac. w O, I , 0 1 I - 6 135901 F "� I , Ac nOl I r `( PROPOSED - 1 77 I 1 9 S.F. SF 13 , 130746 S.,F.' x:00 Aq I I 1 1 . 01 , I , Ld — L I 1 w �I \ , a 1,30670 S.F. 796.4..'S.F. 79 ;S:f. 146747 1 , 1367 S F. 314 C. ' I I J 2 0 7 8 i' tl 7 6 702067 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD Document Number QUIT CLAIM DEED 12/12/2002 10:00AN MARK BROWN and GLENDA M. BROWN, husband and EXEMPT # 3 wife and each in their own right, Grantors, quit claim to REC FEE: 11.00 GERARD D. SCHNOBRICH and MARLO M. TRANS FEE: COPY FEE: SCHNOBRICH, husband and wife as survivorship marital CERT COPY FEE: property, a one -half (1/2) interest as tenants in common and PAGES: I JOYCE R. BROWN, a one -half (1/2) interest as tenants in common, Grantees, the following described real estate in St. Croix County, State of Wisconsin: The NE 1/4 of NW 1/4 of Section 30- 30 -19. The SE 1/4 of NW 1/4 of Section 30- 30 -19, EXCEPT the lands Return to: described in a Warranty Deed in Vol. 502, page 636, Doc. No. D. Peter Seguin 2:1 318424, AND EXCEPT the lands described in Certified Survey Mudge, Porter, Lundeen & Seguin, S.C. Map in Vol. 1 of CSM's, page 272, Doc. No. 334044, Vol. 3 of 110 Second Street, PO Box 469 CSM's, Page 632, Doc. No. 350084 and Vol. 7 of CSM's, Page Hudson, WI 54016 2052, Doc. No. 443725. - Tax ID # 030 - 1085 -90; Part of the SW 1/4 of NW 1/4 of Section 30 -30 -19 described as 030- 1086 -40 and follows: Beginning at the NW corner of Parcel 1 of Certified 030 - 1087 -50. Survey Map filed in Vol. 1 of CSM's, page 272, Doc. No. 334044; thence North to the North line of said SW 1/4 of NW 1/4; thence Easterly along said North line to the East line of the SW 1/4 of NW 1/4; thence Southerly along said East line to the North line of Parcel 1; thence Westerly along the North line of Parcel 1 to the point of beginning. Together with a non - exclusive easement 66 feet wide for roadway and utilities, running from the South line to the North line of said SW 1/4 of NW 1/4 of Section 30- 30 -19, which easement lies immediately West of and abutting Lots 1 and 2 of the Certified Survey Map in Vol. 3 of CSM's, page 632, Doc. No. 350084, and is centered on the West lines of Parcels I and 2 of the Certified Survey Map in Vol. 1 of CSM's, page 272, Doc. No. 334044, and the centerline of which easement is also generally recorded as being 821 feet Easterly of the West line of said SW 1/4 of NW 114. The purpose of this Deed is to correct and reform a previous conveyance recorded in the Register of Deeds Office for St. Croix County on April 4, 1996 in Volume 1 170 at Page 254 as Document Number 541725 and also a conveyance recorded August 29, 2002 in Volume 1963 at Page 130 as Document Number 688689. Subject to easements of record. This is not homestead property. Dated t 's �� day of �j u- �rti ' 2002. (SEAL) '0� a (SEAL) Mark Brown Glenda M. Brown AUTHENTICATION ACKNOWLEDGMENT Signature(s) of Mark Brown and Glenda M. Brown STATE OF WISCONSIN ) a t enticated pis day of )ss 2002. COUNTY OF ST. CROIX ) Personally came before me this day of TITLE: MEMBER STATE OF WISCONSIN , 2002, the above named Mark If not, authorized by §706.06, Wis. Slats. Brown and Glenda M. Brown, to me know to be the persons who executed the foregoing instrument and acknowledged the THIS INSTRUMENT DRAFTED BY: same. D. Peter Seguin, Attorney Mudge, Porter, Lundeen & Seguin, S.C. 1 10 Second Street, PO Box 469 Notary Public, State of Wisconsin ` Hudson, WI 54016 My Commission (expires): (Signatures may be authenticated or acknowledged. Both are not necessary.) QUIT CLAIM DEED