Loading...
HomeMy WebLinkAbout030-2131-02-000 ,partment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix !dting Division INSPECTION REOORT " Sanitary Permit No: U3 7,2 4 — 0 P_",ir_RAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 5 3 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 9j cJ Permit Holders Name: City Village X Township Parcel Tax No: Piera ostini, Paul & Sheridan I St. Joseph, Town of 030 - 2131 -02 -000 CST BM Elev: Insp. BM Elev: T Description: SectionrTown /Range /Map No: M .L - 23.30.20.1056 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER , y S CAPACITY STATION BS HI FS ELEV. Septic Benchmark W� sue.- F!►.�, /o O.bz J60.(0 "ZZ Dosing a Sz Alt. BM ( A__ (?4 2 Aeration Bldg. Sewer Holding St/Ht Inlet 7-4( /(o TANK SETBACK INFORMATION St/Ht Outlet 74r6 73 04 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Q., � if I Septic 7 S / � )L I 24 / Dt Bottom Dosing / Header /Man. Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade 47 Manufacturer Demand St Cover �� y GPM �-- Model Numb TDH Lift Friction Loss S TDH Ft Forcemain Length Dia. �Dist.11 SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 76 Z ~_ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: / � INFORMATION CHAMBER OR Type Of System: I \S>5Z) Z,I p� n /� UNIT Model Number: DISTR SYSTEM GJe,6 f— T ( ,v 7 4- Ile) Ala 4._g__ Header /Manifold 1/ Distribution x Hole Size x Hole Spacing Ven Air Intake Pipes) ` A-+- �+-t Length Dia__ I Length , \ Dia \ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only o Depth Over Depth Over xx Depth of /Sodded xx ! 8 Mulched Bed/Trench Center Bed/Trench Edges Topsoil Z g � p N___ xx Seeded Yes R No _yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 132 Heritage Trail Hudson, WI 54016 (NE 1/4 SW 1/4 2 T30N R20W) Settlers Glen Lot 2 Parcel No: 23.30.20.1056 1.) Alt BM Description 2.) Bldg sewer length = L - amount of cover Plan revision Required? Yes No Use other side for additional information. / SBD -6710 (R.3 /97) Date Insepcto Sign re Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix l vi isconsin W Madison, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (60L266-3151 , � Sanitary Permit App11Ca State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal mf lion you p NA may be used for secondary purposes Privacy Law, s 15. ) Project Address (if different than mailing address) I. Application Information — Plea ePrintAllInformation # 132 Heritage Trail RE Property Owner's Name Parcel # Lot Block # Paul Pieragostini Jail n # 030 - 2131 -02 -000 Property Owner's Mailing Address Property Location 1056) 351 —D Williamsbur Place sr Ck +7:COi (' g -ANNING ' . 1NI NE City, State Zip Code Phone th ICE %, SW /, Section 23 New Richmond, WI 54017 (circle one) II. Type of Building (check all that apply) T 30 N; R 20 E or W ( ` , n� Subdivision Name CSM Number Q 1 or 2 Family Dwelling — Number of Bedrooms ( .S J 6 k d-d �lC / neY ❑ Public/Commercial — Describe Use / J Settler's Glen ❑State Owned — Describe Use ❑City_❑VillageINTownshipof St. Jose e III. Type of Permit: (Check only one box on line A. Comple (a line B if applicable) A. ❑ New System p y g P Y ❑ Replacement S ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System B• ❑ Permit Renewal ❑ Permit Revision N Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plum r Owner 377Z '7Z 1 /6 IV. Type of POWTS System: Check all that appl IR Non — Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland El Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculati g an ,Fil r ❑ n ^�� 7 L t t✓I� f!/ V Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil Application Rate( sf) Dispersal Area Req (sf) Dispersal Area Proposed f) System Elevation l ;�:► 450 .7 642 700 90 J VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Tanks Tanks Septic or Holding Tank 1000 1000 1 Weiser /PolyLok 525 X Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP /MPRS Number Business Phone Number PaAR. Koehler 225410 715 - 246 -2660 Plumber's Address (Street, City, State, Zip Code) 321Wisconsin Drive, New Richmond, WI 54017 VILVCountyl De artment Use Onl Approved o Sanitary Permit F e (includes Groundwater Dat Issued Issuing ent Signat a (N Stamps Surcharge Fee) / 7. /d ven Reason for Dent IX. Conditions of Approval /Reasons for Disapproval SYSTEM OWNER: 1.. Septic tink, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code / ordhanew. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Paul Pieragostini Owner's Name: Paul Pieragostini Owner's Address: 351 -D Williamsburg Place New Richmond, WI 54017 Legal Description: NE 1/4, SW 1/4, Section 23, T 30N; R 20 W Township: St. J oseph County: St. Croix Subdivision Name: Settlers G le n Lot Number: 2 Parcel ID Number: 030 - 2131 -02 -000 Pagel Index and title Page 2 Plot Plan Page 3 System Sizing & Cross - Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenanc Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer /Plumber: P aul R. Koehler License Number: 225410 Date: J anuary 21, 2011 Phone Number 715- 246 -2660 Signature Designed pursuant to the In- Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD- 10705 -P (N.01/01). Page 1 I PLOT PLAN Paul Pieragostini NE 1/4 SW 1/4 Sec 32 T 30 N R 20 W 351 -D Williamsburg Place St. Joseph Township /St. Croix County New Richmond, WI 54017 P.N. 030 - 2131 -02 -000 132 Heritage Trail Settlers Glen Houlton, WI 54082 1000 gallon septic /Wieser /Filter PL525 Trenches EZ Flows NORTH Date: 10 -27 -10 Scale: 1" = 40' #220537 A in IN = 4" Elm Tree EL 100' 1 = Nail 'In 16" Em Tree EL 100' ' o PLOT PLAN Paul Pieragostini NE 1/4 SW 1/4 Sec 32 T 30 N R 20 W 351 -D Williamsburg Place St. Joseph Township /St. Croix County New Richmond, WI 54017 P.N. 030 - 2131 -02 -000 132 Heritage Trail Settlers Glen Houlton, WI 54082 1000 gallon septic /Wieser /Filter PL525 Trenches EZ Flows NORTH Date: 10 -27 -10 Scale: 1" = 40' #220537 Nat in AS = 4" Elm Tree EL 100' 0 = Nail in 16" Em Tree EL 100' '`_ IO TA- - . �T' LIJ - C8 rr �sz I I � I � d o i � O ( ! 6 1 - M 1 i 7 L - - - --� . Z,�,'L►7: CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: r CL, ' h ' Owner's Name: t �t •2 r , Owner's Address: Legal Description: �I l l� lye a3 T-3d N R a d w Township: %X T County: Subdivision Name: n Lot Number. D` Parcel ID Number f7 3D — at 3 ` � �` _ p O Page 1 Index and title Page 2 Plot Plan Page 3 System Sift ig & Cross - Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St Croix Cty Septic Tank Mai Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer /Plumber: (2,,t ; h �� �. l.Q rS License Number: -s 1 Date: 10— 7 _ I L Phone Number - Lklk 44 T -7g - SI S Signature Designed pursuant to the In- Ground Soil Absorption Component Manual for POWTS version 2.0 SBD -107 S P (N.01/01). P 7q s v4 ovSafety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 ■� Madison, WI 53707 -7162 Sanitary �N (to be fi ed is by Co.) 7Z I ommme Sanitary Permit Application Soft Trsesaeteon In accordance with s. Ccanm. 8321(21 VrvL Ades Cale, submiwim of this fom u the appropriate Sovemntanal Ahi und is required prior to obtaining a samtuy pent Notes Application forms for state -ownod POWTS are project Address (if different than mailing address) submitted to the Departmeer of Cot ww= Personal way be used for secondary ourposcs in accordance with the Privacy Law, 8. 15. i m Sorts L ■ iafarmatlos - Plem Print All I[ade propertI Mane pared # V0- ` - 3 -d -oo c� Pmpaty Owner's Mailing Address 11 ' Location ! � Y 'C' s ST, CROIX COUNTY A Govt. Lot P c �+ may, zip � _ yti Sw V, suctio N 017 T 30 N; �-°�w 11<.. Type of BwMM (cloak all thtd aPP 6k 4 Su Nun - 1 or2famffyDwd iW- NwmbcrofBedro _. _ ❑ Publicreomnweial - Describe Use f ❑ city of ❑ State Owned- DescdbeUse CSM Number ❑ Village of Town of r `� nen t r cr ' - dE type of Permit: (C4eek oulf okeb&lfa hire A. CqMplete lice B if applicable) A- New System 0 Reply ..W Systa. ❑ Tv w ea/Holding Tank Replaoemcnt Only ❑ Odw Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Charlgo of Pha_nber ❑ permit Transfer to Ncw 1. Previass Permit Number and Date Issued Befoe Expiration Owrur IV. of POW TS SysftmAC dDevlce: Check all that a No - Pr=+uird h Ground ❑ Pressurized bW3ro d n 0 At -Grade ❑ Mound?! 24 in. of suitable soil 0 Mond <24 in. of suitable soil 67 ter Diapasal Component (explain ❑ pretresUnr m Device (explain V. DilsveradnYeateavot Area Laf®rmatmn: Design Flow (0-0 AeDcsiga Soil Application Dispersal Area Required ( Dispersal Area SopW System Ek (rr D / o VL T lab Capacity in Total #of Maaufacturor Gallon Gallons Units a Nm Tmks &+a8 TaqlM HWkft Tank (VO opq VII. ity Statement -1, the nadersiRasd + =awwae res"Nsibillty for instapation of the POWTS s the attad" plans. , g 1 s 3i amber' Business Phone Numbs S 7 7f S "7 0 (" Ten 0-- umber's Address (Street, city. State. Tip Code) UP- N ls.W:L' S Vm. Use Only A Pent Pee Date S A xoved Rtftpp $ ��� Given Reason /13 Z9 /tS DL ns for Disapproval 1. Septic tank, etflutnt Ster and dispersal ce0 must all be services / maintained as per management plan provided by plumber. 2, AN aethack,requirements must.be maintained Att ach to eGmpkte pleas [o tae syslaw and wbok m the CGnnry Gary Gn paper a" kw eats. a >n : I 1 lacbm In Sim SBD -6398 (R. OU07) Valid thru 01IM9 c c�� _•e, r as''. - - _ -IV E ye S 30 ti a A - _ �. 'c rnend -cam s` of - p 'l - , .�J31 se - _ l on �� �e�,c, �ta.�� �s���_ f PZS� - _f� c'1�r�►a, _.- S?�. 3- 41._ -- - - : - - - -- - �! 5 - �7: Ve Ey s � ►_� r c� o s. r�' � _ - 4 - � y �3T 30 I1J R oZ© ic.) Pi ) V _ t o_c o �s : ;c. Al 'iez*fwa 1l�CSa - __ Qc 't .�, - sq -Ols - - -- - - - - - -P -gfifi - - - o CA r l jZ - - 0 r h` IV E y4Swyy S<&-� T 30 a o u 351 b �,.�;1� "•w.s��,. ,�L . S�t 1. / s�'Cro,X N to Sk/Of 7 D30 -- a131 -C A -oot 13A 44.Q f o Q O 6+xQ `r rlc" °L7 �_ ; 1 ,< _ YO r. �o EZ1203H v ♦erect ' :a: '• - .._ ♦srtvty 7rr ♦O♦7 ar: -- ,. ,.* vvvvvv 4re1e 70 1 ♦177!9 v♦7 '. ✓+ ...�:. ✓ice :�"' ♦r ♦ ♦reb ^If TTT f� rvv "'.4 :Ors'- ..` .. e �� vv - ri •'a - Jl \ w ; rev - vv1 r ♦v 4.625 Tr °v Iry - * /� /+�,� p p� v v ♦ d P ♦ -" 1/2 Circ. '= 1 8.84" evv vev ees rvv 7ve v Try ! 70e♦7T0 eb� 110T7rT 0077701 ♦r vv ♦71♦vOf 1 1OOPrr - vvtly ♦v ♦v'OO.P 7'1 Pt;ti /r 7 am 2411 8 B0it0m 36 V Yotume §—W [nterface,&M hula, �q Void Coefficient in Aggregate given at S7.4W Sidewall (2 Side walls) 2+ 18'84m = 3.14 O.D. of 4" pipe - 4.625 inches 12in 2 3t25iu Void volume per linear ft a 3.i4 •( tfc = Q.1I7 ft l30tt0M ltt t 12ia /$ 2.00 � • TOW Sad Interface Area 5.14 SQ. . O.D. of crsltercytindcr= T2.5 inches rm cin 0f center tinder= � 6.73w Void volume 33125ia a . J. a88n1, c 3.t4 ( �13a11rt —3.14 12intft .574 -..422 f O.D. of outside cylinders — Q inches l . Projected Trench Area Void volume in outside Cylinders = 2.3.14 bin }- • .574 = .901 W Sidewail Height - 12 in. *2 - 2.00 Sq.FL t2int RI ((/ Bottom = 36 in. - 3.00 Sq.FL Void volume at bottom between, cylinders — t[ 24°c • '6°c 1 — c a n �"A lLlt2inttc t26ctfi { tt t2iatR =0213 R' ProjeetedtieRChArts SAOSq.Ft. Void volume at aursidc 110110m cornets (1/2 of void volume between cylsndas) 4115 t 2 =0.I08 w Total void volume = 0. 117 + 0. 422 + 0.941 + 0.215 + 0.108 =1.763 cubic ft l ft Gaitons per ft = 1.763 X 7.48 = 13? e}1hlns Per finear M tt 3 L Xt�` = S EPA Aggregate Trench System ED 203H Z `ZOw Ring-odustrial Group 65 lndustdol Park Rd. Odkland, 71`f 3BO60 SCALE FU 1 aft EZ12034 -.l OW. t M 1 tt- -ZT-Ot �L- EFFLUENT FILTER Polylok, Inc is pleased to introduce its new commercial fil ter to its existing w. ng tine of quality effluent filters. The PL -525 is rated for over 10,000 GPD (gallons per day) making t one ne of the largest commercial filters in its e# class. It has 525 linear feet of Alarm 1/16" filtration slots. Like the accessibility Accepts PVC Polylok PL -122, the new Polylok extension handle PL -525 has an automatic mai tc s but off i ba!l installed with every fil- ter. When the filter is removed for cleaning, the ball will float 525 linear of 16" up and temp filtration slots Po y shut off the Rated for over system so the effluent won't 10,000 GPD leave the tank. No other filter on the market can make that h Accepts 4" & s° claim. Why have Ater at all if SCHD. 40 Pipe the effluent leaves the tank during regular cleaning? -� i 0 , See Polylok's complete line of products by Visiting Gas deflector our Web site: Automatic shut -off ball when filter ` is removed �w.polylok.cam , _ _ ___ _. r 9m! W 2 Inc ,mob 1- 877 - Polylok (765 -9565) Fax: 2 03 - 2848514 ;{ Made in U E -Mail Address: salesopolylok.com Web site: www Polylok.com w - Fo �zr Precastem vrsa oa�ss ST. CROIX COUNTY P 5 SEPTIC TANK MAINTENANCE AGREEMENT AND n OWNERSHIP CERTIFICATION FORM Owner/Buyer a5� r l" I Mailing Address �l C %-W onns &-4 VL U PL_ t2l u4,m a q0 >4°l � Property Address �77i � 1 L. (Verification required from Planning & ZonIng Department for new construction. City /State �- Parcel Identification Number 0'�"o ° Z 131- 01 - O o � LEGAL DESCRIPTION Property Location l'"� 1 /4 '/ , Sec. T �b N R - 70 W, Town of i Subdivision l - - C- L' `� , Lot # . Certified Survey Map # , Volume , Page # Warranty Deed (o 4-Z r 7 , Volume , Page # Spec house ye no Lot lines identifiabl ye) no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 7 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 wastewater disposal 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 Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Nu o edr oms SIGNATURE OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) i POWTS OWNER'S MANUAL. & MANAGEMENT PLAN Page of RtE INFORMATION SYSTBUI SPROFICAnOW OVmw 1 R Septic Tank Capacity DNA Permit Septic Tank Manufacturer �j ," 0 NA DEEM PARANUME S Effluent Filter Mmi ecttuer D NA Number of Bedrooms Cr NA Effluent Rkw Model 0 NA Number of Rubric Facility Units 0 NA'- Pump Tank Capacity ga l D NA Estimated flow (averagel 3 0� �/ .Pump Tank Manufacturer 0 NA n flow (peak), ( Estimated x 1.5) '' a sVdav Pump. Manufacturer 0 NA Soft Rate aU lft� i'P Modal Cl NA Standard InfluenttlEffluent Quality Monthly evorage` Pretreaunem Unit 0 NA Fats, Oil & Grease (FOG) 530 mg/L O Sand/Gravel FVW 0 Pest Filter - Blochernical Oxygen Demand (8013 5220 mglL 0 NA 0 Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) 5150 trQ/C 13- Disinfection 0 Other: 13 NA J�ertsd F�fkra(itti _ - - - - Biochernical Oxygen Demand (BOD 530 mg/L i (In Around (gravity) 0 In -Ground (P ) Total Suspended Solids (TSS) 53O mg& 0 NA - 0 At -Grade 0 Mound Fecal Coliform igeornetric mean) :0(r dull oorrif 0 Drip -Line 0 Other. Mwdnx n Effluent Particle Size Ys In dia 0 NA Other: 0 NA Odw.. 0 NA Other. DNA * Yatum typal for domestic wastewater aW septic tw* effluent. Other. 13 NA MAINTENAWE SCHEMI1.E Sae.�s. Evatnt Servios T-ency . Inspect condition of tank(s) At !seat once every: moM �(s) Mlmft rtm 3 years) 0 NA Pur np out Cont,afft of U When combined "go and man equals one -third tY1 of tank vnkune 0 NA Inspect dispersal cell(s) At least once every: O morttih(s) 3 "wt) 0 NA Cl earls).. Cleary effluent lifter A least onm every: r ❑ NA Inspect pump, pump controls & alarm At least once every: martthtsl 0 NA 0 earls) Rtwh laterals and pressure test At least once every:. irlonth O NA 13 yearts) • other: At- once everyr . C0l month(s) ❑ NA 0 NA L MAINTENANCE WIRUCtIONS - Inspections of tanks and dispel cells sib be made by an individusd carrying one of the fM wkV Ili nses -or vardficatimmm Master Pkm*w,, Maeter.Pkm*w Restricted Sewer POWTS Spector: POWTS.Martekner, Ssptage Servicag Operate► Tank inspections must include a visual Inspection of the tank(s) to identify any missing or broken hardware, Identify am► cracks Orkiaks, measure the volur ne of cornb(rted sludge and scum and to check for any back. up or ponding of efluent..on.the ground surface. The dispersal call(s) shall be visually inspected tar c the effkrent levels in the observation pipes and to check for any pondk8 of effruent on the ground scwfboi - The pondkV of effklent on the gmund swFace may kMcate s faNing =.eandition slid'mWilret the in unedlets notiffeation of the local reguisttay authority. When the combined accur nulatim of sknd8e and salon in any tank equals one-third (Y,) or more of the tank vokxm, the aft cxlntents of the tank shad be removed by a Sig Operator and dbPMW of in eecordance wiffs chapter NR -113, ultiscmwb Administrative Code.:. AN other services, including but ncnt Wnited to the, Servic * of effluent filters, medtanW or pressurized componarrta, pretreatinent usdts, and arty s _ tg at intervab of S12 morothe, shaA be perfonraad by a certified POVMTS Maintairm. A service report shaft be prWAded to 'the local 109WINtog authority witiart 10 days of compkition of any serviawevwt. � START UP AND OPERATION . pow 4Z4 For new construction. prior to use of the f'�11V fS dwick treatment lank(sl for the of P . - . products-or OUter;.dnernicats that may impede the treatment process mWor damagia the dispersal cell(•). if high am detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur whern`soll dons are fmzsn at the afltra*e saface. Dunng power outages Pump tanks may IN •bore normal hiyhwiateir levels. When power is restored the excess Waslavater will be d to the dispersal cell(s) in one urge dose, oveirlbodkV the ceq(s) and may result in the bacasp 'or. aiuface of effluent. To avoid this SfomMotn have the corrtartts'of the tank removed a Sep<ags Servicing Operator prior to restoring, power to the effluent pump or contaot,a Pkm*w or POWTS .-Maintainer to assist in nmmafly operating the pump csntmia.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 oral- grade soil absorptions area. Reduction or of the fotlwaing from the wastaw ter strawn may improve the performance and prolong the A% Of the POWTS: antftotics; baby wkxM ddgetatte butts- condonm cotton degreasers-, dental fkmW d disidecterM fat-, foundation dram (sump pump) water; frult and vegetable peslhW, gasofltte-, grease: herbicides; meat scraps. men ono; oU-, painting products; pasdiSde_ sanitary napkins; tampons; and - water softener brine. ABANDONMENT When the POWTS fails awYer is permanently taken out of sion icu the following steps shell be taken to ins m that the system is property and astel abandoned in cormplar>Ce wridf Owtor Gorrmnn 83.33; Wisco a l Code: • AN pk*W to tanks -and pits shall be connected and abandoned pipe openings sealmL- • The contents of an tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pump tM, ea tanks and pits AM be eowe ated `and_ removed or their drovers renwved and the void apace filled with soil, gravel or another inert sold material. PLAN If the POWTS left - and can imot be repaired the fNlowl; ineemas have been, or musvbe taken, too provide a code . system: replacement A suitable replacement anus has been evaluated and may be utNzed for the location of a rephumment sod. absorption system. The r rifirrt sho dd.be protemaki froi. ditwbwm and compaction and should not tr*Wmed upon by nwAred setbacks Aram edging and proposed_ alluctsrre lot -fines -and wells. FaArre to pwts0 the t -area wit rew* in the need for anew soft and site evaluation, to establish a.sultable reptacanent area. Replacement . systens must comply with the rules in effect at that tirrne. Ct A suitable, replacsrnent area is not available due to setback and/or soft limitations. Bwr1rig' advances in POWTS tedun b" ,a hokft teak nW be installed as a last resort t,o replage the failed POWTS. Q The site has not been evaluated to identify a suitable replacement' area. Upon failure of the POWTS a soil and ate evaluation must be perftinad to locate a suitable replacement •rear If no replacement area is available a- bolding tank may be Installed as a last resat to replace the failed POWTS.. ❑ Mound and at-grade soil n systamns may be recoirtstructed in piece following removal of the blomat at the fi ve :surface. Reooriii�ttwCinis nf. systiem ttruptyidterules .in.effictt - SEPTIC. -PUMP AND Q'THM TREATMIENT TANKS MAY CONTANt LETHAL GASSES ANDlOR OXYGM. DONUT %ENTEII A SEPTIC, PUMP OR OTHER TFMATME&IT TANK UNDEIR ANY Citil MSTANCES. DEATH MAY RtMAT. -OF A ERSON RIOM THE RITINGROF ^TANK MAX 13E DIFFICULT OR 11111P'OSSEWL. ADDITIONAL COLTS POWS WSTAt.1.CS 1rOWT8 MAINTAINER Name S Name Phone - i t s S Phone SEP rAGE SEtt K=Q OPERATOR ) LOCAL R68ULATORY AUTHORITY E 5 O t e Phone 7� S This dodaxrmu was drafted lo convilenm wkh d Comm 83.22(2) 1bN1)IM &(f) and MUM% (2) & (3). Wisconsin strathm Code. START UP Ails OPERAYiON rage d, of For new constnxdon, Prior to use of the POWTS dieck treamma tankfs) for the presence of painting prp* duets-or 4ydw -� that maAr impede this trestrrnerrt process atidlchr damage the dispersal caplet. ff high concentrations are detected have the oorrbents Of the tw*W removed by a she asryi*g .operator prior to use_ SYStem stat up shall not occur when -soil terns are tram at the knftltrative setrface, Dwing power outages pump tanks may 10 above nounsd tfthwitar kr4sis. When power IS restored the sxc w*bte vellhbe to the disperaal cad(s) in one .urge .dam, rnrerk adkig *e oafs) and may result in this tiadcup` or. surface effluent. To avoid this situation have the conten s` of Ilia a #wile of PutnR rerrnarved - by a Septage Servicing Operator prior to restorina . power to the effluent pangs or contacts F*Mmbw or POWTS=Maintaiirer to ascot In mShuapY operating the pump controls -to restore normal levels within the pump tank. 10 not drive or park vehicles over tanks and dispersal ceps. Do not drive or park over, or otherwise disturb or co npact: the area within 15 feet down slope of any mound- or A"rade sop absorption area. hfeductiaa or �ellrnkndorn of the following frrom Use a astaWater.stiream may improve the psrlbcma� and ppdoft Tde Of file 7 S= bebY woes: sugsretbe bartts� z teotdor� sw degreasers: dental fmw dkgers: ecUrr b% fat foundation drain Isump pump! water, fruit and vegetable peeffngs: 9880111 t gr*&W, herbicides: meat scraps: me ow, op; - painting products; per; sanitary : and -water softener brine. ABANDONlY1BItT When the POWTS fags and/or a pears WMV taken out of service the following steps shed be takaita to ntem*a the system is proPetiY and sa[!etY &n col Grace v cNapt -Comm OWNI. Wiscoa n. dminisdative Code: • Ali- piping to tanks;and pits shag be disoornnected and absndorhed pipe openings sealed.- • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Sexvkft Operator. • After pumping, all tanks and pits shag be w cavated; and removed or the& rovers removed and the void apaos filed with MR. gravel or another Inert solid mateiriai. OONTMIGE NCY PLAN If the POWTS falls cannot be repaired the fopowlnCf measures have' - been. °or must be taken, for provide a code . replacement qystsm: A suitable replacement area has been evaluated and may be utilized for the location of a r+eptac nWrit sod :; absomtlon system. Tile re0 yarft thouldto p vteoterd'* n disM ba nce and compaction and should not'be -upon by. rem setbacks -from a ig s04* proposed bt.pnes - and wens. ,.- Palace to prritect'tf& teptaoement .area win result In the need4or a sww sob and site evalration to.-est a.auitebie replacement area. Fispiacement . systems ,must comply with the rules in effect at that time. El A suitable replacement alias is not a due to setback and/or sop moons. BWrhV advahoes In POWIS tec hrockMy s balftig tank n y instated as a last resort to replMe the'fallec? POW fS. Q The dW has not been evaluated to khantlfy/ a suitable replecorrent' area. upon failure of the POWTS a sop and site evaluation must be.perknued to`.locate a suable replecoMerif etas: 'If no nwinc ement am Is evade afwk** tank may be installed as a last resort to replace the failed POWTS. D Mound ash at-graft saiE Jbstapthon sYeterrls ne'► ben rasauct�d in place fiouovving removal of the. Mamas at the give surface. �.oE.unu rules- in : effBCtE t <WANNIM> > - SEP'i1C. P~ AND OTHM TREATNOW! TANKS MAY CON7`AW 'Lgft TH' @ASS AND/OR tNSi!l IIT OXYGI. DO NOT QI TER A ST3+if1C. OR OTHR TMAT1 Wff TANK UND@i ANY CHMMMAIRM. EATH MAY IUMMT. fE-OF A MM FMK TIM .> TW".OF A TANK MAY IM QffIQXT OR NWOSSiBLL S PQWTS "K1ISTALLh POWTB lih1AWAUNl3l Name S Nam Phone S Phhwhe „ SW TAW SOWICM OP TMA MAUtNRih LOCAL REBUhAATORY AUTHOh t1'Y Phone Phone 3 This dooumem was drafted in convilsace with dpapter Comm 83.221231bKi IN &ill and 83.W1 1, l21 & 131. Wisconsin Adminbustive Code. i UNOFFICIAL COPY ! 411441111111141 144441111114111141411111411114111 * 9 0 6 4 2 5 1 State Bar of Wisconsin Form 6 -2003 906425 SPECIAL WARRANTY DEED BETH PABST REGISTER OF DEEDS Document Number Document Name ST, CROIX CO„ WI RECEIVED FOR RECORD 11/04/2009 10:40AM SPECIAL WARRANTY DEED THIS DEED, made between Lakeland Construction Finance, LLC, a Minnesota EXEMPT I limited liability company REC FEE 11.00 ( "Grantor," whether one or more), and TRANS FEE: 150.00 Paul R. Pieragostini and Sheridan G. Pieraeostini, husband and wife PAGES 1 ( "Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real estate, together with the Tents, profits, fixtures and other appurtenant interests, in St. Recording Area Croix County, State of W isconsin ( "Property ") (if more space is needed, please attach 1 addendum): Name and Return Address Lot 2, Settler's Glen, St. Croix County, Wisconsin KRISTINA OGLAND ESTREEN & OGLAND 304 Locust Hudson, Wl 54016 030- 2131 -02 -000 Parcel Identification Number (PM) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances arising by, through, or under Grantor, except: easements, restrictions and reservations, if any, of record. Dated _ l (en Conatru t n F ante, LLC (SEAL)B akela M (SEAL) * * Richar rew, a president (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE 'Of MINNESOTA ) * COUNTY ) TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me on 4&& 2 //6 amg, (If not, the above -named Lakeland Construction Finance, LLC, a authorized by W is. Stat. § 706.06) Minnesota limited liability company, by Richard Lerew, vice president THIS INSTRUMENT DRAFTED BY: to me known to be the persons) who executed the foregoing instrument and acknowledged the same. Kristina Op-land, Estreen & Ogland 304 Locust Street Hudson WI 54016 MARIJO THOMFORDE Notary t' rate of �b p7 ;! Notary Public My Commission (is perman t) (expiress My Commission Expires Jan 31, 2014 ated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY I NTIFIED. SPECIAL WARRANTY DEED Ci 2003 STATE BAR OF WISCONSIN FORM NO. 6-2003 * Type name below signatures. INFO -PRO^' Legal Forma 800- 655.2021 www.lnfoproforms.com 1of1 =cZU Q N '/o Z W Z ►— Q U) f-- � N O � � Z � U o w a M ¢, o QU)rn co o m ~ ~ C6 co @ @ I I IN / Pf v1 F" a 00.00. / W O - - - - -- N O W 0 J I Oa�v1 jCD r o Z z� r x 0 F,FNE'' o °I N a Est d I I WWz� G' E— Qo I ! I OOON d� (� o� I o�o I tx E,,c CY �c�, I :s I M I 11 WV c, m co co I� ~co z a�W cal m W I �� co W� I I , 001 I 1 00 , ►.a a I co N N I R �I E9'LlZ 3 5£ZSeooN Wi sco nsin ueJpartment of Commerce SOIL EVALUATION REPORT Page ' of 3 Divis�n of Sarety and Buildings in accordance with Comm 85, Wis. Adm. Code County Croi Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must " include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. P /, � 7 ? percent slope, 1/2 scale or dimensions, north arrow, and location and distance to nearest mad. �v` Please print al! informafion_,_� a by Date Personal information you Provide may be used for seconds Pu EF jI" 1 .04 (1)�(m)). �/J yr Property Owner ZGo Property L 3cation Z Q I-/ IK c� rr r 10. uyr S Fa u U 2 W. Lot e 114 Sw 114 S 2 3 T 3p N R 2 E (or Property Owner's Mailing Add s Lot # lock # Subd. Name or CSM# (.612 - b \\ C� ST ;i� � .Selflwv City State zip Code Phone ❑ Village IS Town Nearest Road GPD ( New Construction Use: Residential / Number of bedrooms Code derived design flow rate y s 0 �01� C5 ❑ Replacement ❑ Public or commercial - Describe: Parent material U Flood Plain elevation if applicable ft. General comments S -.per o (e V, 9O. O U and recommendations: Se e_ a f ,s - Eil Boring # ❑ Boring © Pit Ground surface elev. 9 7 ft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftr in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •01#2 I ® -Ica ICS Z 5 i I Zrnalok rYl�r c5 I 5 Z Ica -40 I ti 5"d Znnsbk mfr C X70. Boring # ❑Boring �- ®Pit Ground surface elev. ft Depth to limiting factor ()F 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#2 312- 5 j I abk, r c S kl � 5 y 2 1 D•o y << • Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mgfL and TSS < 30 mg/L CST Name (Please Print) Signature CST 3 Qr 2-5 Address Date Evaluation Conducted Telephone Number 7�Y i -Y O J' 25 z 2-Y U ome �� 5�1 l 5 5 1 �. , �1 S (7r�) Property Owner _ ((11 01t, N Parcel ID # Page - Boring a Boring #- . &pit Ground surface, elev. G 5'?o ft. Depth to limiting factor In. Homan Soil Application Ra Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' In. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. . 'Eft #1 Eff #2 y S car c y � I.2 F-1 Boring # ❑ Boring j ❑ pit ' Ground surface elev. ft. Depth to limiting factor In. Soil Application Rai Horizon Depth Dornlnant Color Redox DescripfJon.._ .. Texture _Structure Consistence Boundary Roots GPD /ft= In. Munsell Ou. Sz ConL Color Gr. Sz. Sh. 'Eff #1 'Eff#2 i D Boring # ❑ Boring ❑ Pit • Ground surface elev. fl. Depth to limiting factor in. Soil Application Rat, Horizon [fin. th Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPDIft' Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'EIt#1 'Eft #2 j I • Effluent #1 = BODs > 30 < 220 rml/l- and TSS >30 < 150 mg/t. ' Effluent #2 = BOD < 30 mg/4 and TSS < 30 mg /t. 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. samino (R07100) t I Property Dwner,b t4orr Parcel 1D # Page t csl i Boring 1t , lit 'I. `aPit Ground surface etev. 4 tt. Depth to *Wring factor _ In. • Sot Application Horizon Depth Dominant Color ftedox Description Texture , Struchn Consistence aoundary Roots GPDIIII In. tusunseU t1rr, Sr- Cor►t Color Gr. St- Sh. •EI1#1 •Et E tfr 3IZ. i i L►, -,ck r�rl— c 5 k14 . IS .2 r 4 1�.. , c t ti Cn r p - _ -� !. � - F-1 Boling fl ❑ Boring Ground surface elev. IL Depth to Rmiling factor in. ❑ Pit Intl Appligtiorl Horizon Depth . Dominant Color Redox Description _ Texture - Structure Consistence psutndary Roots GPD10 In. Munseil Ou- Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Et F Boring N ❑ pit Boring ❑ Ground surface elev. ft Depth to limiting factor in. Soil Apptir alior3 t Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAt In. Munsen Orr: Sz. Cont. Color Gr, Sr- Sh. `Eit#1 'Ett ' Effluent #1 = BOD, > 30 < 220 molt- and TSS >30 < 150 nv A- ` Effluent #2 = nQn, i 30 mg/1 and TSS = 30 molt. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services of need material in an alternate format, please contact the department at 608 -266 -3151 nr *M 608- 264 -8777. 51111 11311 rR.Q7A30) r - PAGE3_OF3 NAMEN LOT# LEGAL DESCRIPTIONt/ j4w X ,S z3 T 30 ,N R� 20 E(orY� SCALE: I"= BM I ELEVATION /(��. BM 1 DESCRIPTION ,',j BM 2 ELEVATION d ! BM 2 DESCRIPTION Oa SYSTEM ELEVATION `f(� 0 SYSTEM TYPE CONTOUR ELEVATION 1 n 0 �Z • c SIGNATURE _� DA TE z/ z L• r t. • r e r- ♦ V : `2 T fi' ; 4 �7�ii 7X^ �•S �i •.:< Vii'- ^ ��� 7 � 1 e . x 920.4 LOT IN N i. �.•'h Yh � : .yam '`�; � ,�,0. , • S i " tii .'.I' � '��y �''�C Ynr Parcel #: 030- 2131 -02 -000 05/14/2010 01:48 PM PAGE 1 OF 1 Alt. Parcel #: 23.30.20.1056 030 - TOWN OF SAINT JOSEPH Current OX ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner 0 - PIERAGOSTINI, PAUL R & SHERIDAN G PAUL R & SHERIDAN G PIERAGOSTINI N346 RIDGEWOOD CT APPLETON WI 54915 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 132 HERITAGE TRL SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.000 Plat: 09- 058 - SETTLERS GLEN 1/45 030-03 SEC 23 T30N R20W PT NE SW SETTLER'S GLEN Block/Condo Bldg: LOT 002 LOT 2 (3.000AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 23- 30N -20W NE SW Notes: Parcel History: Date Doc # Vol /Page Type 11/04/2009 906425 WD 07/02/2008 877752 QC 12/05/2005 813584 2939/064 WD 05/17/2004 762691 2572/468 WD more... 2010 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/04/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 72,500 0 72,500 NO Totals for 2010: General Property 3.000 72,500 0 72,500 Woodland 0.000 0 0 Totals for 2009: General Property 3.000 72,500 0 72,500 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