HomeMy WebLinkAbout030-2131-06-000 i
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division 0 Sanitary Permit No:
INSPECTION REPORT 488124 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:
Rudenick, Jason I St. Joseph, Town of 030 - 2131 -06 -000
CST BM Elev: r Insp. BM Elev: BM Description: c Section/Town /Range /Map No:
(0.O I M . a C, TF6IM # Z = Pt1C AW 23.30.20.1060
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic / I / Benchmark r l D
Dosing Alt. BM
Aeration Bldg. Sewer /
Ho In S t /Ht Inlet
TANK SETBACK INFORMATION t t utet
Vent o it Intake ROAD Dt I
ep is > I ' r o om a t zj
osing FF5 t
A eration D ist. P ipe
0 In o . y s em
PUMP /SIPHON INFORMATION In r�
f n I
anu ac urer emano St cover h � r
02 ---7
m ociel er , ^ ' f ns 0 i
I metion LOSS systern neaa — ----- Ff
,><
t - orcemairy L enc tn
21
DIME NS
INFORMATION J CHAMBER OR ` C
I ype 01 System.
,- fe 8J r > Q UNIT
H"011,:: �SPduhly
Pipe(s) Qr
Le th Dia Leng Dia Spacing c� J
x Pressure Systems Only xx Mound Or At - Grade Systems Only
Bed /Trench Center Bed/Trench Edges Topsoil j Yes No 1 'I Yes 7N,
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / Inspection #2:
Location: 1446 Pioneer Circle Hudson, WI 54016 (NW 1/4 SE 1/4 23 T30N R20W) S len Lot 23.30.20
1.) Alt BM Description =S t `N�' k m l' , � _ r
2.) Bldg sewer length `J.( S 0
u (1 ��
- amoun�f cover= �z -t- ctJ�Cc 1 � � � .L�•D � (¢ O r
3) 5e� o—t y " bq •f �j `^� /( J �1U J �_{ _ —
- T - --
Plan revision Required? Yes X No
Use other side for additional information.
4 BD 67100 (R.3/97)
NEC Safety an Build' 1 s Division V 201 W. Washi ton A,f�.�. zo62 �s����� Madiso , WI 53707 - 71 2 6 Number (to be filled its by Co.)
De artment of Commerce 08)21- 3 1.2
State Plan I.D. Number
Sanitary Permit App ' t1
In accord with Comm 83.21, Wis. Adm. Code; persona(`' dr you ide pro ec[ Address (if different than mailing address)
may be used for secondary purposes Privacy Law-, j
I. Application Information - Please Print All Information
Property Owner's Na inc J Parcel # V Lot# >*
r1
030 -Z( 3f —0( --0o
Property Ow eer 0 C Address
Property Location
? V D � C7 A-R P %,�5 W
City, State Zip Code Phase Number
5 +1 / 1�i �// �j g� circle one)
l.,L h7/ d'" a � `� T � N; R�E 049 • ( Q
II. Type of Building (check all that apply)
Subdivision Name CSM Number
�-1 or 2 Family Dwelling - Number of Bedrooms
� S LM5 s4.tA/
❑ Public /Commercial - Describe Use No vie. ,
❑ State Owned - Describe Use t a- 1 +Z - ❑City_ ❑Village VTownship of 'ti 3QSEPF3
III. Type of Permit: (Check only one box on line A. Completo line B if applicable)
A ' New System y C1 Replacement System ❑ TreamiendI- Iolding Tank Replacement Only C1 Other Modification to Existing System
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
TV. TZpe of POWTS System: (Check all that apply)
ta No -Pressurized In•Gr ound ❑ 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 ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter
❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel - ess Pipe ❑ Other (explain)
V. Dispersal/Treatment Area Information: (03 ' 1 6 3 c
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s Dispersal Area Proposed (sf) System Elevation
0 ✓ J`` ✓ / Z�6 I to qS�o
VI. Taiik Info Capacity in Total Number Manufacturer Prefab Site Steel iber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
— Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigiied, assunjfi respo[islbility for Installation of the POWTS shown on the attached plans.
Plumber's i rint) D plumbe 's Si gna re MPINM Number Business Phone Number
Plumber's Addre ss (Street, City, State, Zip C e)
VIII ount /Department Use Onl
A ❑ isapprov Sanitary Permit Fee (includes Groundwater Date ssu d Issui Agent Si atu s)
Surcharge Fee) �\
❑ 0 iven Reasot Denial
IX. Couditiolis of Approval /Reasons for Disapproval.
I . STEM OWNER: 3) — g �► �r oA a .
1. Septic tank, effluent tiger and
dispersal cell must all be.sen4m / maintained WC , y
as per management plan provided by Oumber.
2. AN setback requirements must be maintained
a: W appk" �a /°��
a,. 9 5
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)
I
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51314WO MITEYZ
dafnt6.''7SSt'1 5c: S�6+rt..r!ri9T9� r�yt RJL ".t'92 {jA
asJ1�Ht�sD�(i '• IYXS� 9��iE: +i4Qf. 1� 86
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131
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Wisconsin Department of Commence SOIL EVALUATION REPORT Page I of 3
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code minty
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must 1
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. (� . Z - 0(p - r-co
Please print all i Re by Date
2
Personal information you Provide may be used for ar�i • 000y:. ^'• s. 1 .04 (1) (m)). "444
3/131 03
Property Owner Prc Location
Gast. Lot lu ll,' 1 /45F- 1/4 S 2.3 T �J) N R � E (or) W
Property Owner's Mailing dress L # Block # Subd. ame or CSM#
s "
�t L Sh [[ V6
City State Zip Code Phone - -•• City ❑ Village ® Town Nearest Road
E] New Construction Use: Residential / Number of bedrooms Code derived design flow rate �� f�� O d GPD
y
❑ Replacement ❑ Public or commercial - Describe:
Parent material _ 10 y �" a k Flood Plain elevation if applicable �// 4= - ft•
General comments S s /, r✓1 P �2 V . ,/ P 9 �3 3 - C �v , , U ° D
and recommendations: gs', j 3 �f �/ -)60 '?°
Boring # Boring
pit Ground surface elev. � ft Depth to limiting factor in.
E*Eff#1 cation Rate
Horizon Depth Dominant Colon Redox Description Texture Structure Consistence Boundary Roots D /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efl#2
b - ICS lD 3 3 S, t CS I v
S
Cc 5 i ( 2 �k l i- SS
3 —
r
Si_ 2 m !Shk
` Boring # ❑Boring
® Pit Ground surface elev. -20 ft. Depth to limiting factor g5 Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1t
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
-(2 Ib 3 3 Ji 24)no, rYl c c S I \J
Z 12- - I Lfl4 5 i 2-f
L4 Ib r 311-P — L Zr,,s Irk – – 5
3.53' —
Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mgiL and TSS < 30 mill
CST Name (Please Print) Si a re CST Number
)dw > c h �. `-- 2-533C 9
Address Date Evaluation Conducted Telephone Number
5`�D25 �7t5�Z`f 7- �fo�8
Property Owner Parcel ID .V Page . of
Boring # ❑ Bonin n
' ® Pit Ground surface elev. tt. , Depth to limiting factor In.
Horizon Soil Application Ra
Depth Dominant Color Redox Description Texture Structure Consistence Boundary Is GPD/W
In. Mansell Qu. Sz Cont. Color Gr. Sz. Sh. 'Effiil •Effli2
2 m k rry�-
_ Lf/t, C65 d ► s — 7 1. Z
sL
� � y
Boring ❑ Boling
❑ pit Ground surface elev. ft. Depth to limiting factor _ in,
Soil Application Rai
Horizon Depth Donditant Color Redox Description...., Texture Structure Consistence B ,undary Roots GPD /11t
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Effili •Effii2
❑ Boring # ❑ Boring
El PIC t n�und surface elev. ft. Depth to limiting factor In,
Soil Application Ralt
Horizon l�pth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD /fit
in. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. •Eff#1 •EfN/2
i
- ' Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/14 and TSS < 30 mg /1-
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an altemate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777.
M-1330 (R0710o)
i
PAGE - 3 OF — 3
NAME La r rt a qp LOT# 6 LEGAL DESCRIPTION Vc&l Y5 E A .57 T 3 ,N R Za E(or
SCALE: I"= O
BM 1 ELEVATION O
BM I DESCRIPTION
BM 2 ELEVATION /,00.0
BM 2 DESCRIPTION Pdr- P j - - - -- — -- _ _
SYSTEM ELEVATIOd '� ° L
SYSTEM TYPE Con v evx+,bn a- t — + _
CONTOUR ELEVATION
• rg � z 0 e
•
q& 0C)
9q,0
I3
14 0,
' d
SIGNATURE 4° _� /��, DATE ` T/ Z
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address
Property Address -) y (o P o �- C_\ ry1 4__ ,()
(Verification required from Planning & Zoning Department for new construction.)
City /State S �S te_ w 1 Parcel Identification Number ()3 " 02 3 DO
LEGAL DESCRIPTION
Property Location ti) W '/4 , _'/4 , Sec. ,� 3 , T 3D N R ,20 W, Town of LN
Subdivision �:� �(` (j, A , Lot # �.
Certified Survey Map # - 11 c1 JO) , Volume , Page # 3
Warranty Deed # 0 J I , Volume , Page # I
Spec house 'yes no Lot lines identifiable ;' yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
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.
Uwe, 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.
Number of bedrgAms
SIGNATURE OF APPLICANT(S) 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)
8203 1 8
KATHLEEN H. WALSH
State Bar of Wisconsin Form 1 -2003 REGISTER OF DEEDS
WARRANTY DEED ST. CROIX Co. WI
RECEIVED FOR RECORD
Document Number Document Name 03/08/2006 01:45PIf
WARRANTY DEED
THIS DEED, made between Select Development Corporation, a Minnesota EXElPT 1
corporation REC FEE: 11.00
- -- TRANS FEE: 266.70
COPY FEE:
( "Grantor," whether one or more), and Jason Rudenick CC FEE:
PAGES: 1
( "Grantee," whether one or more).
Grantor for a valuable consideration, conveys to Grantee the following described real Recording Area
estate, together with the rents, profits, fixtures and other appurtenant interests, in Name and Return Address
St. Croix County, State of Wisconsin ( "Property") (if more space is Four Seasons Title, Inc.
needed, please attach addendum): 206 2nd Street
Lo t 6, Settler's Glen, in St. Joseph Township, St. Croix County, Wisconsin. Hudson, WI 54016
030 - 2131 -06 -000
Parcel Identification Number (PIN)
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 except:
easements, restrictions, and rights -of -way of record, if any.
Dated � � �� � � �'
> SELEC bEVELOP T CORPORATION
(SEAL) ,:�': (SEAL)
s
(SEAL) (SEAL)
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
authenticated on OHM L NNM ST. CROIX COUNTY)
rwrmy PumC Personally came before me on `"2 j1 &
* the above -named kella St- the r.
TITLE: MEMBER STATE BAR OF WISCONSIN of Select Development Corporation, a Minnesota corporation
(If not, to me known to bg the p(mson(s) who executed the foregoing
ntan �' e ackn6y..W
authorized by Wis. Stat. § 706.06) ins �urt� . -
THIS INSTRUMENT DRAFTED BY:
Brent R. Johnson - Lommen Abdo Law Firm Notary Public, State of WISCONSIN
Hudson, Wisconsin My commission (is permanent) (expires: )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED 02003 STATE BAR OF WISCONSIN FORM NO. 1 -2003
*Type name below signatures. INFO -PRO"' Legal Forms • (800)8552021 • trrfoprofo ms.cam
I Of I
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page L of Z
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner V�! a N 41 p E4 fe (Z Septic Tank Capacity g al ❑ NA
Permit # Septic Tank Manufacturer C.0 C�C��� ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer L ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model /p p ❑ NA
Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA
Estimated flow (average) gal/da Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) O 0 gal/day Pump Manufacturer ❑ NA
Soil Application Rate o,,15 al /da /ft2 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 530 mg /L ❑ In- Ground (gravity) ❑ In - Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA
Other: ❑ NA Other: ❑ NA
*Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
IS ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
[3 month(s)
Inspect dispersal cells At l east once eve (Maximum 3 years) ❑ NA
P P cell s) ea every: � Gf( year(s)
Clean effluent filter At least once every: ❑ month(s) ❑ NA
G1 year(s)
Inspect pump, pump controls & alarm At least once eve ry [3 month(s) El NA
❑ year(s)
Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA
❑ year(s)
Other: At least once every: p mont )(s) [3 NA
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.
GMW (4/01)
Page 2— of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the 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
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 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 D � J L7 D Name
Phone 7 �f T7 Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name S C FD 1 y (�:6u N-F
Phone Phone g? 96 6 06
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.
rAf
STANDARD CHAMBER
q 52"
Quick4 Standard Chamber 48 " Zkic*4
rb,3) (EFFECTIVE LENGTH)
e B B
12"
34" SIDE VIEW
SECTION VIEW
MultiPort End Cap
A
1 s•
12"
" SIDE VIEW TOP VIEW
FRONT VIEW
9'
4
INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY
(a) The structural vtegrtty of each chambec, end plate, wedge and other accessory manufactured by Infiltrator ( "llygts' , when Installed and operated
In a leachfiea of an onslte septic system in accordance with Infittrator's Instructions, is warranted to the odglnal purchaser rHokler'j against defective
materials and workmanship for one year from the dale that the septic permit a Issued for the septic system containing the Units; Provided, however.
that if a septic permit is not required by applicable law, the warranty period will begin upon the date that Installation of the septic system commences.
To exercise its warranty rights, Helder must notity Infiltrator In writing at Its Corporate Headquarters in Old Saybrook, Connecticut within fifteen (15) - / • -
clays of the alleged defect. Infiltrator will supply replacement Urns for Units determined by Infiltrator to be covered by this Limited Warranty.
Infiftrata`s liability specifically excludes the cost of removal and/or installation of the Units.
Q
THE UMrfED WARRANTY AND IN SUBPARAGRAPH (a) ARE I Y OR I ITN THERE ARE OTHER WARRANTIES WITH RESPECT
T SYSTEMS INC
TO THE UNITS, INCLUDING NO IMPLIED LIF� WAR WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR ICUTAR PURPOSE.
(c) This Limited Warranty shall be void t any part of the chamber system is manufactured by anyone other than Infiltrator. The United Warranty does
not extend to incklental, consequential, special a hdlect damages. Infiltrator shag not be liable for penalties or liquidated damages, Including loss of Environmental Onsite
Wastewater Solutions'
production and Profits, labor era materials, overhead costs, or other losses Or expenses incurred by the Holler or any third party, specifically
excluded horn Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse or neglect of
the Units; the Units being Subjected to vehicle traffic or other conditions which are rat permitted by the Installation iratmctbns; failure to maintain the 6 Business Park Road
• P.O. Box 768
minimum ground covers set forth in the installation Instructions; the placement of Improper materials Into the system containing the Units; failure of Old Saybrook, CT 06475
the Units a the septic system due to improper siting or Improper slA g. excessive water usage, Improper grease disposal, or Improper
proper operation;
any other event rot caused by Infiltrator. This Limited Warranty shag be void If the Holder fails to comply with all of the terns set forth in this United
Warranty 860- 577 - 7000 •FAX 860 - 577 -7001
.
Further, In ro event shag Infiltrator be responsible for any loss or damage to the Holier, the Units. or a n y third pant resulting from installation or ship 800 - 221 - 4436
meet, a from arty ims ar
product liability cla of Holder or ty third party. For this Limited Warranty to apply, the Units must be Installed In accordance
with all site conditions required by state and local codes; all other applicable laws; and nNtrator$ installation Instructions.
(d) No representative of Infiltrator has the auft* to change or extend this Limited Warranty. No warranty applies to any party other than the origi-
nal Holder.
The above represents the Standard United Warranty offered by Infiltrator. A limited number of states and counties have different warranty require-
ments. Any Purchaser of Units should contact nfiltrator's Corporate Headquarters in Old Saybrook, Connecticut, prior to such purchase, to obtain a
copy of the aPPkable warranty, and should carefuly read that warranty prior to the purchase of Units.
U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839,844
Canadian Patents: 1,329,959; 2,004,564 Other patents pending.
Infiltrator, Equalizer and SldeWinder are registered trademarks of Infiltrator Systems Inc. Infiltrator Is a registered trademark in France. Infiltrator Systems Inc.
is a registered trademark in Mexico. Contour, Contour Swivel Connection, Microl- eaching, PolyTuff, SnapLock, ChamberSpacer, Posil-ock, QuickCut, QuickPlay RECYCLED PAPER
and Quick4 are trademarks of Infiltrator Systems Inc. 0 2003 Infiltrator Systems Inc. Printed in U.S.A. Q011203HP -0
Parcel # : 03A-2131 -06-000 04/11/2006 02 :33 PM
PAGE 1 OF 1
Alt. Parcel #: 23.30.20.1060 030 - TOWN OF SAINT JOSEPH
Current X', ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
O - SELECT DEVELOPMENT CORPORATION
SELECT DEVELOPMENT CORPORATION
12415 55TH ST N
LAKE ELMO MN 55042
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description " 1446 PIONEER CIR
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 3.000 Plat: 2443 - SETTLER'S GLEN LTS 1/45 030/03
SEC 23 T30N R20W PT NW SE SETTLER'S GLEN Block/Condo Bldg: LOT 006
LOT 6 (3.000AC)
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
23- 30N -20W NW SE
Notes: Parcel History:
Date Doc # Vol /Page Type
12/07/2005 813801 29401481 WD
06/24/2003 727050 2286/018 EZ -1
04/29/2003 719301 9/58 PLAT
2006 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations Last Changed: 05/3112005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 3.000 79,600 0 79,600 NO
Totals for 2006:
General Property 3.000 79,600 0 79,600
Woodland 0.000 0 0
Totals for 2005:
General Property 3.000 79,600 0 79,600
Woodland 0.000 0 0
Lotter redit: Batch #:
� Claim Count: 0 Certification Date:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
COU NV PLAT OR S E TT LER'S GLEN
y „
LOCATED M PART OF THE WV4 OF THE SWV4, PART OF THE NEV4 OF THE SWV4,
PART OF THE SE114 OF THE SWV4, PART OF TIM ?MIA OF TM SEIf4 TIDE SWSA OF
THE SEIg OF SECTION Zk AND R4 PART OF THE NZIA OF THE NW 1/4 OF SECTION 26,
ALL IN T30M R20W, TOWN OF ST. JOSEPH, ST. CROM CoUmTWISCONSM
mom
rHE pecpFATI NALTRNLEASElAENT
ANDTHECONSSWATION EASEMENT -. - . -. ..- . -.._»-...-..-..-..-
SHOWN ONTHISPIATAREE 'ED .....
TO THE TOUMI OF ST. JOSEPH. .... ............
........................ ....... . ...............................
LOT 6 LOT 7
3AW
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4 aaoo AGR88 aoDO AL>�9
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ip ewM*
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..........
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f
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Lao. -666•o .! /
A LOT 10
LOT ORNMAGE C : •\ so®aAS%� \ ♦ I `\ saooAar�
\ �,� 180,T6281i FT. ♦ \ '!� \ 18or60i 80• Fr. I
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♦ ♦ 8 008 LKS1� s \
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w w I
LOT 13
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LOT 17 of w
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e� '' ��\ ''•• •'\ LOT 16 •� -
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\ '°•• : v lamm 4 2M 04-06 STREET
\ \w
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om law
M . WMANDOWN
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