Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
030-2131-20-000
n Cl) 0! 3 n d O y! C N O 3 CD CD 3 N :► Cl) T m r o - P� Cn (n w o • n tea O N cn G . O CD 7 O y O O O N ~ N\ a 0 j CA (D CD O N 0 N N D. Uz N 7 to CU CD 0 O ► `S O O - C CD C CD O A O 3 3 N O 3 O E5 0 RL n v D p CD cr:� w CL T N B p m 0 O C C2 O ti. O O O 3 w N t _ O O _. Z N 00 O J L ., O N N w '. CD (D 0 0 2 (q O C A A CD 3 .. D' a 000fD �• N c N CA N (D r( 3 v v g o CD a R 'O O N lV CL m R . (D 7 G7 CC CA CD I O D 7 z l O T 7 mr v h o �• N y III / CD p C C N CD A a CD Q A 2 cD y _ 0 A n CO 7 Z a C) .. CA M w W 0 CL ' Z C A TI C Y Cn O 3 * � N Z CD A CD A I 0l< 7 `< N CO 7 7 N 0 ° o D N N N ° a C d 3 0 3 A O N O C Cap (D 2. O G � m a c m K -m S-{ O 61 �' z aw N7 (D D�� ° 7 CD o o a CD °o°Z• dcr m WOyo A 3 7N3c ° �os�o� y 3 CD < -. <= CD°'°v CD ��- a a 0 CD CL N O N ? CL o'o 3 0 3 cD CD - m a� ? a -°° o m °� m a c 7 CD M Cr N N CD d 7 O CD 7 C c a CD k (D C. a c ° i m CD°' < m co < < rn ° x CL << 7 NCDa) fcn a V1 7 CD .0 O N 7 6 O= O 7 AW ?CD aiN Q 0 O CD O Cl) 0 CD r4 CL 0 cc O CD '690 ti CD •goludsiCl f,j!lou Il!M sao!naaS Sulpl!ng `uolloungluw uuulu ue si aragl3I '£ •uotlounjim uuele ue ao Xoua &owo lenloe ue si ajagl aaglogm auluualop of eaje aqI Joago pue uo!leool uurle aql of puodsai ll!m 1auuosi3d saoInaaS 5u!pl!ng •Z •uut,le oql jo uo!leaol aql so3 S I I I alnq!lsan Jo S I £J aop!.uoa ul paleool laued .tole!ounug aql ) ioago ll!m lauuosiz)d sootmos 2ulpl!ng `uuele alq!pnt, ut, But.reaq uodfl - 1 :s.inoq ssoulsnq asnoglanoo lt,uuou Butinp luana uuele 31g an!lot, ue JOJ lauuoslad sooiAnS 2u!pl!ng Xq pamolloj oq ll!m sdols asagZ sal;!I!q!suo sag saaln ias /aauBua;uieW ulpl!ng •j3!ngS aql ao alumile pa1eu21sap s!q `ioleulpiooD an!IWls!u!Wpd oql Xq palsanbai uagm leaagl gwoq t, Bulinp soo!nap .10 sa5enloed u2i;)jo3 .ioj snit ao sluau pubp anlloodsaa jo uolloadsu! ql!m Islssv • £ wpeaZ 1 0013 aql o (s)uos Ouissiva ,Cut, poda -I •lulod Xjgwsse paleuSisap s jumlledop aql lu snsuao lauuoslad e lonpuoD •Z •lu;)wlledap 1no,C jo uoilenoena ,Cllaplo pue ullt,o a loal!Q • I sa.4.1. !suo sag peaR Wlulae aQ .1soil punuituol a yl jn a;nuaalln palms tsap sirs jo jolnulpjooa anjln.rlsygwpd aqj o; suosjaa jklsqui 3uv lio a L •lol Suplied aql jo puo gS aql it Isod pueuuutoD oql of ssaull! to ,C1nfu! wo.g 2ull3j3ns suos I sisse `uo ilenoe na OuunQ •9 •sluedn000 Xue jo swooi paleuB!sap lealo `uo!lenoena Bui1nCl •S •2uipl!nq oql 2ullt,n3t,na ut uzagl lsisst 10 /put s2u!puel llannlmis of suoslad polges!p anouz `uoilt,noena Ou►1n(I •l, •salnol uo!lenoena p31t,u2 Oulsn .Cj![!q!suodsal 3o ease 1noXjo uollunoena �llaplo ut, as!n.radns `uotlenoena SuunCl - £ •sao!nap 10 softniot,d ugraloj 1o3 go=)s ewe ue gl!m Is!ssu `luaagl gwoq a Bul1nQ •Z •soo!n1aS Sulpl!ng of spaau aout,ualuirw 10 spaezeq Modal put Xl!l!q!suodsaa 3o t,ale anoX loadsui Xiouilnog • I sal)... !suo sag aapea7 1 0013 goo, aunt mvp uoistnag Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. C roix Safet and Building Division Sanitary Permit No: INSPECTION REPORT 453016 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal inrormation 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: St. Joseph Development Corp. St. Joseph Township 030- 2131 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: t?O - D 1 1 Vf_ L01.11W_S4j = 4- 1 23.30.20.1074 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic f Z" /4SD Benchmark (0� jCD, Dosing t ( Alt. BM Aeration J Bldg. Sewer ^ f. yo / Holding St/Ht Inlet 1 SUHt Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic � ZS � � \ � t Botto J � Dosing L t M << O -' IT Aeration Dist. Pipe (01-06, Im .9k .g' Holding Bot. System PUMP /SIPHON INFORMATION Final Grades �� O s- '0310 ► Manufacturer Demand St Cover � .,4 GPM t/,i 41, -3,5 O Model Number 5f F - 3D TDH Lift . FrictionLoss System Head T 3� Ft S� t Forcemain Length O t Dia. t� Dist. to Well SOIL ORPTION SYSTEM ITREN Width r Length- engt No. Of renc es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIPSM&CNS 3 C1 ► e�► - - SETBACK SYSTEM TO ( P/L JBLDG IWELL LAKE /STREAM LEACHING Maaaactuec INFORMATION CHAMBER OR ti Type Of System: ✓ ► r �._ UNIT ModeLhl f DISTRIBUTION SYSTEM (J.07 Header /Manifold I D istribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil Yes No Yes No OMMENTS: _ (I cl e code cr pen es, persons present, etc.) Inspection # Inspection #2: / m CO O 1 ocation: 139 Heritage Trail Hudsoi , WI . 14016 (NE 1/4 SW 1/4 23 T30N R20W) Settler's Glen Lot 20 Parcel No: 23.30.20.1074 1.) Alt BM Description = ST /D•' 2.) Bldg sewer length amount of cover 3� Slit., COA" All, ► C �lu��+b�r 5�+ U w'TMa+ti S �S O /'f7 Z .lb /S ot> .a L,_ 1 Plan revision Required? N � Use other side for additions atio (�wMaLe( q-r J - -- . l / Date Insepctcr's Signature Cert. No. SBD -6710 (R.3/97) 1 6C G� i �S V� �J ` ti I + /-�► D \ 0 1� i �au��l by UUUf Cola r►• v I o d o ft c �1 3 (D T (D ^' I c � o m vi o c p m CD a, a o � r- I � w Co � H • N� CD CD ID O �o N Na= p �o y off' o C N a CD 7 7 Q N a CD M 7 7 Q N CD •0 Q 01 - 0 Q -4 O C1 0 O 4 3 o c V 3 c 5 ;r m o o O C c v ? CS to z cn z D cn z cn z D W a CD e m ca D co D CD D D C a a W a. n W o00 I 3 O O 3 O O o o \r CL CL K) W W O z z z z o o c° 0 r� �+ O O O O p pp N N Q H• A :3. 3 _ o� � y,,, � z z 000 �� vim' z z I o In (n - ° cn to v , ( N N N N 0 CD cr C7 0 CD N N O O CD ° O O I(D A v v c Z 7 7 y a a a a Si a g � a a n a O m ° 3 — N N CD ! a o. \ M O_ O_ ON pD C 7 Z =R Bi 7 M O w (0 O a (0 O p T7 c fD O c fD (D O n N 7 C 7 C CD (4, W CD ° a ! a ( y o m a m w -1 CA yr w Q BE v o 3 a A z CD 0 m I a o I W T m w w I � a , z 0 o c 3 a� %► (n N =� 3 0 N. s N. =r y I CD a A I CD o o� N� °° o o a CD o �l< N �' v a oo a �. N N O a j W O U7 N - 'O 0 d W N N �- fD (D CD pp C < �1 n+ A O N A - O ° N (D 3 3 O N O, O O . G p a.- (D U) I m a °'c CD Q �,O ° �? m a m ac CD l< �,O CDO w am' a-< m DCD� O Cn Z a �� m DCD� O cn Z a Eg I a< ac o CD y� a< ac o 6 0.0 a CD o N 0 v-0 0 #° � o N 3� o.o �° � o m °ci m3 m (D I a o'� ° v a m as o'° an d a� i �° o < <oo o� �° o ° <oo' o� v 7 m fD °• O CD `G 7 m fD a 7 n CD `� A S a0. ° a (D a O a 1 ° c rn r UCD,* a- Ao c rn r m m o m m ti --0 O 7 p C) 0 N O 7 0 7 p N N fD Q? j E 7 O p 0 O Ol 7 ( 7 fD !// (D O O N N 0 0 v C) oO o CD ti y b � N y S T �o sE� �c v�nP K4- -- SiGS �l -L•� !-� r Z =too IL 46 Iq. o t7 l- �JFEc� i7" I ZSn�7Sv C�u�,.cao T,t,cK ✓N- ��ro�� -r�� SNP 3v p�,�p � ; r. (� KI�L�u :Rio To6E I � &4 - zK Gr l lnv- E2 S ' Flo S�t-s N�E� S s ftv-r ��✓ q9.c� � Lo c �3 \ 1 Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7162 Permit N / tars umber (to be filled in by Co.) Dep artment of Commerce N *6consln (608) 266 -3151 s' ,- ) Sanitary Permit Application o State Plan LD. N ` s30t! In accord with Comm 83.21, Wk. Aden. Code, personal information you provide may be used for secondary purposes Privacy Law, sl5.04(ixm) Project tf than mailing address) 1. App / n ilnf madon - Pi Print All Inf atbn Pwperty Owner's Name # # Block # . 2004 p 91"A ad 77 PmpertyOwner's MWft Address GO , i ," Location �;' d. - 0MNG " l City, State Tip Code Phone Number V4, -J Section N; RQ c ircl e W ) IL Type of Building (ckeck *11 that apply) I' Subdivision Name C3M Number 0 1 or 2 Family Dwelling - Number of Bedrooms 7 � ❑ Public/Commercial - Describe Use , / '3 �p ❑state owned - Describe use ,- p 1 ST• CAS !.J _tj C4gl± 1161 -(� ❑Cih! ❑Village Jglownship of Sr III. Type of Permit: (Check only one box on Hue A. Complete line B V applicable) A ` $tNew System ❑ Replacement System ❑ Tre /Hddmg Tank Replacement Only ❑ Oder MOMORtien to Existing System I B. ❑ Permit Renewal 't Revision ❑ Change of t Transfer to der_ t P�r Permit Number and Dee issued BefmExpiraunm a Plumber own«• 1V. Type of POW tS em: Check an that a / Non - Pressuriwd lo- Clmuad ❑ Mound > 24 in of suitable soil ❑ Mound < m suitabk soil ❑ At Grade ❑ single pan Sand Filter 11 Wetland ❑ Pressurized k4round ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment unit ❑ Recirculating sand Filter ❑ Recirculat SyndWk Media Filter Dri Line ❑ vel -less P ❑ aw (explain) V. DispenaVrmtment Area ormation• Design Flow (gpd) Design Soil Application Rato{gpdsl) Dispersal Area (st) Dispersal Area Proposed (at) I Sys Elevation VI. Tank Info Capacity in Total Number Manuboturer Prefab Steel Fiber Plastic Gallons Gallons of Units Concrete Constucted Glass New I Bxistiag Tacks TWO s � no I Aerobic Treatment Unk Doming Chamber 50 I 17 - S - - D , / / V11. Res nsib Cement- I, the ander4pited, apjA,/r,"asMty for installation of the POWTS shown on the attached a Name ) P �Ssi MP/MPRS Number I Business Phone Numbs �/39y& Z /k z3S- 7.4 IC Plumber's Address (Street, City, State, ' ) 5I X08' iltritn2t� liJd' Sy7s' VW. C 0 fimn me t Use On ly ved ❑ Disapproved sanitary Permit Fee (' ludes Gramdwateri Date uad Issuing S' Stamps) Sumbarge ❑ Owner Given Reason for Denial Fee) tj J ) . � 012 1X. Conditions of Approval/Reasons for Disappro (� t;e oft u 0 A eompMte plats (to the Cowry fa the system a ksr al/3 s i l lashes is she SBD -6398 (R. 01/03) II �•- Wisconsin Department of commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 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. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed D Personal information you provide may be used for secondary purposes (P ' acy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 1/4 1/4 S N ROO E (or W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 3 Fa�t�e 6 n o S e-f-E & I City State Zip Code Phone Number 0 City ❑ Village © Town Nearest Road WT (�)> ayg -5`?3 s C 1 e i^, E] New Construction Lion Use: 0 Residential / Number of bedrooms 3 L Code derived design flow rate O G GPD C - 1 Replacement I] Public or commercial - Describe: — Parent material 0 ✓ a S tom. Flood Plain elevation if applicable General comments and recommendations: S ys �t ✓Vii e l J . `�. U v 2!.c7 ► V " Boring # O Boring pit Ground surface elev. IU y ft. Depth to limiting factor 1 -6 — 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 0 jot ati -1 (OS 0s6 ml — — n 1. Z F) 7, Boring # ❑ Boring ❑i pit Ground surface elev. 103, :7 0 ft. Depth to limiting factor, / 1 in. 4RootsGP Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#2 Z // -38 / - S G/ m Q �� m — /" Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA. • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) - - CST Number Address Date Evaluation Conducted Telephone Number d'� 50 AS . .� �s t'o /U" v 7/5 0 oZ-� f Property Owner Parcel ID # �� 2 Page _ of _3 F—;] Boring # ❑ Boring ® pit Ground surface elev. 103 (Q(I ft. Depth to limiting factor / in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 /v ors t W\f , e,5 IJ1 is . El B oring # ❑ Boring ❑ Pit Ground surface eiev. ft. Depth to limiting factor in. ScF - A — ppl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Ong # ❑ Boring ❑ Pit Ground surface slay. ft. Depth to limiting factor in. Soil Applica Rat 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 Effluent #1 = BOD, > 30 <_ 220 mg1L and TSS >30 150 mgA- ' Effluent #2 = BOD, < 30 mg& and TSS <_ 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777. seuaMPtAM) PAGE 3 OF - NAME; LOT #)v LEGAL DESCRIPTION:-1/4 1 /4,S T E ( or ) W SCALE: l e,^IELEVATION: BM 1 DESCRIPTION: A BM 2 ELEVATION: =- BM 2 DESCRIPTION: a SYSTEM ELEVATION: R I C, ,} SYSTEM TYPE: Cc-) � J co� _ -- 3 I i i 1 1 V SIGNATURE: DATE: �-Z i z U, 2 5 2 6 P 0 0 5 - 7 'Zi61-9QD -7 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIK CO., WI STATE BAR OF WISCONSIN FORM I - 2000 RECEIVEQ FOR RECORD Document Number WARRANTY DEED (:: !03/12/2004 10:0 @AK THIS DEED, made between St. Joseph Development Corporation, a EXEMPT V DEC Minnesota Corporation, Grantor, and Blake Builders, Inc., a Minnesota Corporation, Grantee. REC FEE: 13.00 Grantor, for a valuable consideration, conveys to Grantee the following TRANS FEE: 275.70 described real estate in St. Croix County, State of Wisconsin (the COPY FEE: CC FEE: "Property"): PAGES. 2 SEE ATTACHED EXHIBIT A Recording Area ?y Name and Return Address: Land Title Inc. 1900 Sii�ll Lake Road Suite 200 New B 33a S 1-3 Together with alf appurtenant rights, title and interests. 030 - 2043 -10 -000 030 - 2032 -10 -000 030 -2032- 70 -000 030 - 2033 -40 -00 030 - 2033 -20 -000 030- 2032 -50 -000 p 3a -a13�- Parcel Identification Number (PIN) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Dated this 10th day of March 2004. St. Jose lh Development Cot oration * Kellei St. Martin, Vice President * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA ) WASHINGTON COUNTY. ) ss. authenticated this 10th day of March, 2004 Personally came before me this 10th day of March, 2004 the above named Kellei St, Martin, Vice President of St. Joseph * Development Corporation, a Minnesota Corporation to me TITLE: MEMBER STATE BAR OF WISCONSIN known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) 1 THIS INSTRUMENT WAS DRAFTED BY * �-- Notary Public, State of MINNESOTA My commission is permanent. (If not, state expiration date: Greg Booth A ttorney 1 900 S ilver L ake R oad S uite 2 00 New Brighton Mn 55112 (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature r NANCY J. LENTZ NOTARY PUB L'C- MINNESOTA WARRANTY DEED STATE BAR OF WISCONSIN My Comm, ExppgRgQ. ?a r • FROM CERTIFIED SOIL TESTING FAX NO. J 71 , 5 233 0398 Jun. 14 2002 05:5 AN P2 -._ { WEaYH�.APRr.�aR I �bax >uc c'�41CIt OtiGCyµttT-�^� \ r MGM a 0 ?JDt'vSl}5�8�t3 u Soli* 2a Y -S- MAA it OLE I i /A" r 4a CET =&.(r,% �Ft� �AL PtPG nv t 2" 0 I wcix:.rxc 4 ocr 1 Pub I a SEPTIC f __SPEG�!✓ }CA7'1� QQ v DOSE TAW / �� K 4+ � \ �.111��BER OF DOSES: �'Lh Cr., TAS.:K S12t; Z1'� _��' *ALL0&JS ..D VOLUMC AUA90 fd"U FALTU0, LR: s 1 �t ti�rY� 4►JCLU 41fICa �1tif Xf . + 00EL WL4A6EK: CAPACITIES: A = .� 111taats OK �1Z t,s SWITCH T3PC: r . bwl� 8 �e � �ucKes �R 3�,1dr Pump MAkJU FACTURE R. C i LKtS OR -AL MODCI_ IJUMbCu: - -. 7 { 102,¢2 SWITCH TtIPC: ryv�.car •` kI PUAP AUD ALARM ARC TO e)(. e)(. M IW AUM D;SCHAPt.E RATE &2 r 1iNSTTALL.ED 0►.1 SEPPAATC CiKC'�• "� VERTICAL DIFF[RC1,}CE br PU" OFF AL10 015TRl41.ITIO" PIPE.. FCCT — 7 53� O} rMl►lIriUM >v�TWaRK SlJPPl.J PRssLSr4E .b „ FCCT + _ %d �tET Oi ipRGIC J'�1►� X X f d��FRICTIQIt fACT6f4.._. FELT D TOTAL. WdWAKlt /h[ µEAU �1.�_ FLET C 1UTJ:RQA -. OIM!`Wfbi OF TAWK: LEWCvTH _......._;wiorK .Performance w holesale Products Page: 6350 -1 �' Section: Performance Data ba a Dated: January 2001 RPM: 1 550 Discharge: 1 -1 /Z" Solids: 3/4" 12 40 9 30 tz _ W W Z 6 20 o SHEF30 - 3 ' ! 0 0 Capacity -U.S. G.P.M. 10 20 30 40 50 Liters/Second 0 1 2 3 _ The curves reflect maximum performance characteristics without exceeding full load (Nameplate) horsepower. All pumps have a service factor of 1.2. Operation is recommended in the bounded area with operational point within the curve limit. Performance curves are based on actual tests with clear water at 70° F. and 1280 feet site elevation. Conditions of Service: GPM: TDH: 16 HYDROMATIC POWTS OWNER'S MANUAL a MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner E Septic Tank Capacity g al ❑ NA Permit # Septic Tank Manufacturer /T ❑ NA DESIGN PARAMETERS E ffluent Fi lter Manufacturer ❑ NA Number of Bedrooms ❑ NA. Effluent F ilter Model 1CTG8 ❑ NA Number of Commercial Units ,,0 A Pump Tank Capacity r gal ❑ NA 'Estimated flow (average) yl gal /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) O gal /day Pump Manufacturer j y 0 ,4#7Z ❑ NA Soil Application Rate gal /day /ft Pump Model ❑ NA Influent/Effluent Quality Monthly average* Pretreatment Unit R!'NA Fats, Oil 8t Grease (FOG) <_30 mg /L CI Sand /Gravel Filter ❑ Peat Filter <_220 mg /L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) ❑Disinfection ❑Other: Total Suspended Solids (TSS) <_150 mg /L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average* * Dispersal Cell(s) Biochemical Oxygen Demand (BODs) <_30 mg /L Dispersal (gravity) ❑ In- ground (pressurized) Total Suspended Solids (TSS) <_30 mg /L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) s10' ci`u /100m1 ❑Drip -line ❑Other: Maximum Effluent Particle Size i8 inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every oA!o s ❑ months years) (Maximum 3 yrs. ) Pump out contents of tank(s) When combined sludge and scum equals one -third (Ys) of tank volume Inspect dispersal cell(s) At least once every ❑ months Kyear(s) (Maximum 3 yrs. ) Clean effluent filter At least once every f ❑ months years) O Inspect pump, pump controls 8Z.alarm At least once every ,.2 /„ $ ❑ months f�year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ 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 (Ys) 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 ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other b maintenance or monitoring at intervals of 12 months or less sha ll be p erformed y ` a certifle d P OWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. 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 ..F #t . .n., i by � ca tnoa car virinv nnarntnr nrinr to nca. 1 Page of System start up shad 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 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; oaindne oroducts; pesticides: sanitary napkins: tampons: and water softener brine. ABANDONEMENT 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 ch. 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 IMPMCIIR1 F. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name �L /NL -�!3!� /.vc. Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Agency S & -i r wy 4j /'V Phnna Phone -?/,- '3 '160 08/13/2004 13 :45 FAX 7152352592, T L SINZ PLUMBING INC IM002 ..,..�, . _ ` r . _ -/ 2-3 T Z,, v�rJ i 6 7— �oSt =loo 4�; w--c sfml�g. Iq J7�5o�7sv ��►tic6o T.+-wK U IQf @v L3� o Togs J r- �S't'MLl �- Z��'7y( �Z� QJIC(C �- Svr.�r �S L 40 � i f ! c l t { f I I 08/13/2004 13:45 FAX 7152952592 T L SINZ PLUMBING INC 000.1 L) \0 T.L. Sinz Plumbing Inc. E5609 708th Avenue Phone: (715) 235 -2644 Menomonie, WI 54751 Fax: (715) 235 -2592 FAX TRANSMITTAL Date: No. of Pages: oZ (including cover) To: Cry A= From Subject. PL., T,64. Message: - - -- - Signature: Safety and Buildings'Drvisioa 201 W. We01,119 on Ave„ P,O. Box 7162 5 to a flUed by Co.) /� O�'r� Madison, Wt 33707 - 7162 ,, tuy Pa t Numbs scj . %6U)266-3151 ' j�S D , De artment of Commerce Sute Plan I.D. Number Sanitary Permit Application FvEO in accord with Comm 83,21, Wis. Adm Code, persotul ect Add= if diffeaeot than Btailiug address) sm + + may be used for ooduy t P°a "�' Law, 15.(}4( - (3. 11 6- 7 I �-� /ems � ), Application lBtormsdon - Please Print All Information 61- � Y n Lot N B '-d Property owner S401; , \� °a Property Owner's Mailing Address % / C , section C ' 3 ��LI16 �j J�f�7 J�/"G�p Code � Pboae um Number City, State zip �,E oV T Ni )),Type or Building (check all 11161 apply)5 Subdivision Hum CSM Number or 2 Family Dwelling -Number or Bedrooms / GAFI C) Public/Cootmerolal - Describe Use ( • 2 X OC(ty_ ❑Village. 15rowou 0 Sute Owned - Describe Use 11 1, Type of Permit (Check only one bo on IIBC A, Com It e t B if appl able) 3 D l �( laoaalent only 0 Other cation to Existing System A X Now System ❑ Replacement Sys 0 Tmannest olding Tank RV II foul Number aBd'Date lss +Led B. 0 Permit Renewd 0 Permit Revision Chang of C] PermtcTtaas&rto New PI Owner` Before expiration lY. T e of POWTS System. bock all that a l > si Pus Saari Filter 24 is of sulub soil otn>4 < 24 in. of suitable soil ❑ At de NOB - Pressurized ht•Oround [3 Mound - liter ; 0 Constructed WctLtnd 11 Pressurized 1p.Omund ❑ Hol g Tank 13 Pea ter ❑, Aerobia Treatnsattt Udt Recirculstitt Synthetic Mails Pow ISO 11 Did Lk , C] 1-less Pi ❑ Other V. D(s ersanrestmeat Area Informations so Dispersal Area Rcquir (sf) D sperssl Ara Proposed (sf) Syst Design Flow (gpd) UaIP Sol Ap� doo Rs , ,Z 9 S QQ � g $'y, I 40 MauuhcAUCr Prefab Site Plastic e S teel class VI, Tank Info odious T0� oruniu norcte Constricted New 8xistiay Tanks Tanks L )c Sepyic ur Hulling Tank Acrubie Troatmen Unit X During C)urmbcr 7 / / '""� r G� Vil. Res aslbW Statement- the and Bed, ass BsibW for latsusdon of the POWPs shown an the attached ns. Number Business. PhoBe Number s Name (Print) PI 's 3 -2/ — �OJA L �!N'�- 10 71 lJ . Plumber's Address (Street, City, tau, 27 C I'll Zb Ill, Count /De t►rtmea Use Oa) permit Fa (includes Orouadwatar Date Issued s Agee {Signature ( o Stamps) ',Approval ❑ Disapproved $utcbarge Fee) z 57' ❑ Owner Oivem Ranson for Denial U IX Condldons of Approv6URegsons forDlsapproval SYSTEM OWNER; 1 Septic tank, effluent Miter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances, Attub compkk plans (to rite County osly) for ibe system oa paper sot leas thu 61/1 s f Iseha Is site SBD -6398 (R. 01/03) � art /y sr� ly say �, • L T36� Sao w - ro wto . S,Etfl crts 3� 9S tl ,�k 6 6 Q s, c r w J G,�1� a� � 4S. ►� y yB s i y IA F 99.8 0 9 ChArr D 0' e G� Oo , � / N /css /tv « fd� ah ��f k L3r^ � 2 ' 144, 466 4f - 2 COPV �l3 I I I , ' • • ,qy — .�T HOC S �1 O/ l/�m�A/��� � u - `�'1'l�'9 " T39 G?o Xok 20 Sit fI G/l 6104 ST Geo Y C �•7 `k it y � J A ( Z � Q `°w �� c "P 6 ` "r1/ p� ��,LLP yyB s y , Go 8M1� Z 99. S Idoo GhAir S� A A i = yo �� 1, , �^ b r^ I l , ;6-43 Ao a r �(Cf � k fNc� r1►�Rk # / /DO /��( ��/1 rc �'/"� �, Q 4 � • Tap o r -,' Lam! t /N` , �4f-2 , e3 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code fn"Y Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must r01 X include, but not limited to: vertical and horizontal reference point (BM), direction and l I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road Please print all =Iry - - -- wed by Date Q Personal infomraaon you provide may be used for purposes rNacy s. f5. (1) (m ?)• u Property Owners Prope Location c , lr 6t 14(4 6 %) Govt. of f\ f bi 1/4 � 114 S Z3 T N R 20 E (or W Property Owners Mailing Ad "s Lot # Block # Subd. Name or CSM# Il�ro. City State Zip Code Phone Number Ijuity ❑ village U-Townlj Nearest Road 1�e 55c) '�"2 New Construction Use: [ Residential / Number of bedrooms - Code derived design flow rate y 5 an GPD 0 Replacement ❑ Public or commercial - Describe: j S � Flood Plain elevation if applicable material K)0 ��� /b ft• General comments and recommendations: © Boring # ❑ Boring pit Ground surface elev. 9 0 , 40_ ft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description ET exl ure Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 - Eff#2 2 rnV I -31 I C s. 5 .2' 8 . ( 7Z # ❑ Boring qq pit Ground surface elev. I "I I d ft Depth to limiting factor i^ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 I 0-l2 '0 31 -- S C I f cS 1v� ,Ps \� .o 2 Z -44 I ICI Sic f )_Jn CS — 4 3 -i C� r y I CoS O ,m 2- Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = 13013, : < 30 mg/L and TSS < 30 mg/L CST Number CST Name (Please print) i g Z5 3309 Sc�nun�ok�r Add s Date Evaluation Conducted Telephone Number s �` �� � 51 inZS Property Owner oars 10(e • Parcel ID # 3 ❑ Boring Page of Boring #' . " ' ® Pit Ground surface elev. oo ft. Depth to limiting factor I Z$ In. hiorizon Depth Dominant Color Redox Desai tlon Texture Soil AppUgtion R. P Structure Consistence Boundary Roots GPDltlt In. Munsell Ou. Sz. Cone Color Gr. Sz Sh. 'Eff #1 'Eff /12 -( IO 2,aibL tY - 4w - c- S ) , I f CD - 7 1. Z Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rai Horizon Depth Dominant Color Redox Description,._ .Texture _Structure Consistence Boundary Roots GPD /fit In. Munsell Ou. Sz. Conl. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. it. Depth to limiting factor in. Soil Application Ralc Horizon [fin. th Dominant Color Redox Description Texture . Structure Consistence Boundary Roofs GPD /ftt Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2 - ' Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/h and TSS < 30 mg /l. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SBDQ70 (R07/00) i I PAGE 3 OF 3 NAME Q 90 LEGAL DES IpTION AJW Y4 -CE t4 z 3 T 3 0 N 00 SCALE: I"= �U BM 1 ELEVATION BM I DESCRIPTION m �L L-�.T ��' BM 2 ELEVATION BM 2 DESCRIPTION - - - -- �� Z SYSTEM ELEVATION qS, 00 l SYSTEM TYPE CONTOUR ELEVA'T'ION `��•6U �SU 1 o° 6 '7 7 So e l SIGNATURE DATE -Z oZ 1 ROM :C'ERT IF I ED SO I L TEST I NG tF-!RX NO. 715 233 0398 - .Jun. 14 2002 05: S2RM P2 1DCkINCG CCOvCtR �' Sumac, .c >• I c�•.v.Pn� a sa4icK �r +t.ayvttT --� 4 � o, ij7i�7lT /7 0 T1r?►.;jS17A�EA J �. 1 * �} r sit 4� Sot 2 4" Y.S. f 1 t. V�!� _ MAH UOLE I I — cY,rc F - - -- - 1 L 40 MT =a-rr6 WFI..E ± Al + � � 3 ' srEC.�`la>•+S I �^ ""'/ � � � � t;� - � � ON � � � �►;,:,u..c 1� Pw�' j C4�vtaRtTC" t i I ,i \4 -"D 4 SEPT,C t __SPEGIf' ) ' C �Tl �6 "J05S K��Gti� �. Tn1ir 5 MA�IUFACTUti1�R: l;Uf- M bV - P- OF DO - ._ PLK Ta�K S13.C; t LS"O ' dALL0Q:S ..00SC VOLUME l lr ALAAY4 15�, uFACTUA,LR; S `� a �a,� 4A1CLi1fl47aG bACXPLt�r1: 9O �- �JC�rCi V�A.`vr7S CtsPACfTIES:.t = .......�IUtFtCS OK ,.,n.����: 5t -WJTCH TJPL: M- {zw+•�. �pw�(� g � Z JVCxE3 ^,R 14,14. PUMP ' AkIUFACT - -- ,= G...�� C a 5 iut►tES Pst - 40 + MDDSL IJumbr D t u�H ES OR \ °1. swiTCK 713PE; uQTE: PUAP AUO ALARM ARE TO 4L Mik`IMUf"'s Q }$C}�,1�}�(�,F i�A'F'E G�+� 1NSTALI.ED p1.1 SEP�RATC Ctr(C� "� VtRTtCAL DlFFCRCWf.[ OE7WEEW PUKP OFf AiM 015TVWTIO" IPWE.. « FEET + rti►ilPo tUA k rTLJORK SUPP4.!d PRELLUR . . . . . . . . / FLFkT + Za C[ET OF ipRGt JiIlF.1 X •1=�. F T %0, r:FKICTlQ" FACYCA. FEET TOTAL OtiWAAIQ HCAD sF'� -- �— FLET A A 1 It 11,fTl:R UAt. DIMCI�SVOidTr OF TAWK: LEA. ICiTN - ......�� �kli01'31 �; LIQLl10 CA?T s-i — - - Per#ormanc e Wholesale Products Page: 6350 -1 . - ' Section: Performance Data B ata Dated: January 2001 RPM: 1 550 Dischargq-I Z" Soli ds: 3/4" 12 40 9 30 tz W Z g 6 20 o SHEF30 - 3 ~ 10 0 0 Capacity -U.S. G.P.M. 10 20 30 40 5 0 Liters /Second 0 1 2 3 _. The curves reflect maximum performance characteristics without exceeding full load (Nameplate) horsepower. All pumps have a service factor of 1.2. Operation is recommended in the bounded area with operational point within the curve limit. Performance curves are based on actual tests with clear water at 70° F. and 1280 feet site elevation. Conditions of Service: GPM: TDH: IrU j ?D 14YDROMATIC STANDARD CHAMBER 52' Quick4 Standard Chamber W (EFFECTIVE LENGTH) 6 12' 8' U. SIDE VIEW SECTION VIEW MultiPort End Cap a I 16' 12' el I SIDE VIEW TOP VIEW FRONT VIEW Svc � � .� •, '��; � .`�5`r v 1 A` � �.� � F1.y�y: P '•.h..y & Got. 4 � ': a3 -�3� a. � u- 5` INFILTRATOR SYSTEMS. INC. STANDARD LIMITED WARRANTY (a) The stnw7ural In"* of each chamber and plate. wedge and other accessory marvisictised by Maratm ('Unksj, when installed and operated in a leadhneld of an onsits aspic system in accordance with trhasrator's instnfctions. a warranted to the original purchaser ("Hdder'T against defective materials and workmanship for one year trom the date that the septic parnA is issued for the septic system conning the Units: provided, however, that lt a septic permit is not reWred by applicable law. to wanenty period will begin upon the date Tat installation of to septic system commences— To siterose its wanaray rights. Folder mist notify Infltraor in writing at its Corporate Heaftiarters in Old Saybrook. Cdrnectiaa wahin Mean (15) • days a9� sW stage defect. > r fc the a bn determi lid by kriYaator to be mooed by th li is fted Warranty. (b) THE UUTED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE 8 U1SIVE THERE ARE NO OTHER WARRANTIES WITH RESPECT SYSTEMS IN TO THE UNITS. t EU JCLUDIN' NO NPU WARRANTIES OF hERCHANTABUTY OR RTNESS FOR A PARTICULAR PURPOSE. (pt This Um1ed Wwra ty des be void it any part of the camber system is mamdack red by anyone other then infiltrator The United Warranty does Envi ronmen ta l not andend to incidental, consearatiel. special or indirect damages. Mrator shall not be sable for penalties or llgxMW damages, honing lose a i=nvirDnmental Onshe Wastewater S011 IM11S production and pnofsa, Tabor and maler", emceed costs. or other loesee or wipe see nctared by the Poch or cry bird party. SpedflceN wic ided from Umited Warranty caerage are damage to the LAWS due to ordinary wear and tsar, alteration. soddent. rNaee, abues or neglect of the Un ts; to Units bang aubocftd to vehicle traffic or ot oon6tiare which we not permitted by to instal etim iratwbons: takse to menan to 6 Business Park Road • P.O. BO 768 ffw*wn grand coves sot forth n to nstaltaton resuaons: to placement of inrroper materials into the sysem containing the Units: rare of to Units or to septic system due to Improper siting or nq>roPa sang, aaesaive wale wage, improper grease disposal. or improper operation: or Old Saybrook, CT 06475 any other event not cawed by Infiltrator. This Limited Warranty sheill be void t to Holder tails to comply wet all of not tennis sot form in this Limited 860- 577 - 800-221-4436 7000 •FAX860577 -7001 Fuller. n no emit shall hWaor be responsible for any loss or damage to to Holder. the Uhl!& a ay third party raismig from inaa atbn or ship- mats, or tan ary prodnot hsWy dare a Holder or any third poly for the Ld Warranty to apply, the Unfits mat be installed n accordance with Y site conditions reghaad by sate ad local codas; sit other applicable laws; and Yfi tratog installation I (cq No mspmmaativa a kWkaa hear me a *wnty a chmp or adeW Otis L"od Warranty No warranty applies to cry Pay other men to orpi. rW Holder. The abore reptaeerts the Stallard Ltrllled Warranty oft by kilittraroc A smiled mrrklar of Miss ad oartlsa hate dKerent wamM ns h motors. Any padres a Lk is d contact kdlaaor's Corporate Headquarters in OW Saybrook Comecdaa, prior to act pirdase, to obtain e copy of to applicable warranty and shaAd cask* read tots warranty Prior to the p oc ass at 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. Mrator, Equalizer and SideWander are registered trademarks of IrlfAtrator Systems Inc. InMrator is a registered trademark in France. Infiltrator Systerro Inc. is a registered trademark MOU k in Metdco. Contour, Cor Swivel Connection, PolyTuff, SnepLock, Cha Ptay nberSpaoW, PosiLock. CU1CkCUt. Q �� m oral rl. "A oro frorl•morl- M InR t-f— Q—t— IM ON 9n M hahrofry Q—fomo 6v PrW-4 M I 1 R A Mf f >Mwp n POWTS OWNER'S MANUAL 8T MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner 5j J ,= pA Septic Tank Capacity 1 200 gal ❑ NA Permit # 3 ® Septic Tank Manufacturer q 4 k ❑ NA DESIGN PARAMETERS Efflu Filter Manufacturer rerj4D ❑ NA Number of Bedrooms y ❑ NA, Effluent Filter Model & • - yu& . ❑ NA Number of Commercial Units *NA Pump Tank Capacity —7S-C gal ❑ NA Estimated flow (average) gal /day Pump Tank Manufacturer G ❑ NA Design flow (peak), (Estimated x 1. gal /day Pump Manufacturer ❑ NA Soil Application Rate gal /day /ft' Pump Model FF 30 ❑ NA Influent/ Effluent Quality Monthly average* Pretreatment Unit IXNA Fats, Oil & Grease (FOG) :530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter <_220 mg /L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) 11 Disinfection ❑Other: Total Suspended Solids (TSS) _ <150 mg /L Manufacturer Pretreated Effluent Quality ❑ NA Monthly average ** Dispersal Cell(s) Biochemical Oxygen Demand (BODs) 530 mg/L Xin- ground (gravity) ❑ In- ground (pressurized) Total Suspended Solids (TSS) :530 mg /L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) _ <10 cfu /100m1 ❑ Drip -line ❑ Other: Maximum Effluent Particle Size % inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect co ndition of tank(s) At least once every a fe S ❑ months A y ears) (Maximum 3 yrs. ) Pump out contents of tank(s) When combined sludge and scum equals one -third (A) of tank volume Inspect dispersal cell(s) At least once every a /V ❑ months 2 (Maximum 3 yrs.) Clean effluent filter At least once every �, ❑ months & year(s) ,04 Inspect pump, pump controls ez.alarm At least once every ❑ months j'year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ 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 (%s) 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 ch. NR 113, Wisconsin Administrative Code. The servicingwlaf a fluent filters, medhanical or pressurized POWTS components, pretr l` , :ntc�omP9rwvts t -and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a 'rfitied,�P L'e fJWIT$ Maintainer. A service repots shall be provided t:o "the local regulatory authority within 10 days of cgleoptip, of any servile event. 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 ^f ti— tnnL Icl rn ^va`i kv a ca taoa carvirina nnpratnr nrinr to ncp System start up shall not occur when soil conditions are frozen at the infiltrative surface. Page of 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 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 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. ABANDONEMENT 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 ch. 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"'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 TINDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMp(1 RI .F. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name E5999 708th AVE E.45669 ?08th*m Phone Phone MENOM W1 54751 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Agency !W f/'D/e 7_ -WIAi Phnna Phone _11 3h` Dom a ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FCP�M 0' vner;Buyer St. Joseph Develpopement Corporati Mailing Address 1 . 2_4_1 _ 5 th Street Nor Lake Elmo MN 5504 1'ropeny Address (verification required from Planning Department for new construction) City /State Town of St Joseph ,W I Parcel Identification Number gAP AttarhPei Deed -_ -__ LEUAL DESCRI I N 030 — 2,(3( — 20 —oan610 ��� Property Location NE- '/,, SW ' /,, Sec 23 , T ',v _ Nr -R 20 W, Tcrvvn of Subdivision Sett 1 er' s Glen Lot Certified Survey 11'tap # , Volume _ page # Deed # 700569 ,. Volume Pal� ,_�, Spec house O yes G no Lot lines identifiable yeS n 110 SYSTEM_ hWHjENANCPE Improper use and maintenaneeof your septic system could result in its premature failure to handle wastes. I'r ,jpc- t;,aintcn111:'t consists of Pump ng out the septic tank every three years or sooner, if needed by a licensed ptunper. What you put into) the s� -scea; caa affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification forrrl, signed by tiu° �)wncr and by master pl umber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site « r disposal syst is in proper operating condition and/or (2) after inspection and Pumping (if necessary), the septic tank is Icss than I. " full of s1 Lc Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal s eitl. t rr. starc�a- set forth, herein, as set by a Department of Co , , erce and Ulu Department of Natural Resources, Statc of'� :'isccnsi❑ Ceniticz: stating 'u, Your septic s t has been maintained must be completed and returned to the St. Croix County Z ormig Office days of a ee ar a ration date. SIG ',,;URp pfi PLICANT 3 . 0� d D,A,TE OWNE t F AT N 1 {we) certify th if statements on this form arc true to the best of my (our) ov led�c. I j wc? am t::e pre ry ribcd e b virtue of a warranty deed recorded in 1?egiste; of Deeds �)fr.e 7) bq �I lA1 LRE APPLICANT Any info Y rmation that is Mis- represented may result in the sanitary permit bung rev,,, kcd by rho 7 r,,_ A PARCEL OF LAND LOCATED IN PART OF THE NWi /4 OF THE SW 1/4, PART OF THE NE 1/4 OF THE S W 1 /4, PART OF THE SE 1/4 OF THE SW 1/4, PART OF THE N W 1 A OF THE SE 1/4, AND THE SW 1/4 OF THE SE1 /4 ALL IN SECTION 23, AND IN PART OF THE NE 1/4 OF THE NW1 /4 OF SECTION 26, ALL IN T30N, R20W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN; DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTH QUARTER CORNER OF SAID SECTION 23, THENCE S89 °59'28 "E ALONG THE SOUTH LINE OF THE SE1 /4 OF SAID SECTION 23, 1329.95 FEET TO THE EAST LINE OF SAID SW 1/4 OF THE SEI /4; THENCE N00 °05'53 "W, ALONG LAST SAID EAST LINE AND THE EAST LINE OF THE NW 1/4 OF THE SE 1 14, 2662.66 FEET TO THE EAST -WEST QUARTER LINE OF SAID SECTION 23; THENCE S89 °57'49 "W, ALONG SAID EAST -WEST QUARTER LINE, 1103.88 FEET; THENCE S00° 15'03 "E, ALONG THE EAST LINE OF LOT 2 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 3, PAGE 711, AND THE SOUTHERLY EXTENSION THEREOF 541.62 FEET; THENCE S89 °44'57 "W 349.84 FEET; THENCE N00° 15'03 "W A DISTANCE OF 100.00 FEET TO THE SOUTHWEST CORNER OF SAID LOT 2; THENCE ALONG THE SOUTH LINE OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 4 PAGE 944 S89 °44'57 "W A DISTANCE OF 699.66 FEET TO THE WEST LINE OF LOT "A" OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 4, PAGE 944, AT ABOVE SAID OFFICE; THENCE N00 °1 5'03 "W, ALONG LAST SAID WEST LINE, 445.55 FEET TO SAID EAST -WEST QUARTER LINE OF SECTION 23; THENCE S89 °5749 "W, ALONG SAID EAST -WEST QUARTER LINE, 1107.54 FEET; THENCE S00 °1 7'14 "E A DISTANCE OF 304.14 FEET; THENCE N89'4 1'28"W A DISTANCE OF 404.95 FEET; THENCE S00 °1 7'14 "E A DISTANCE OF 1025.47 FEET TO THE NORTH LINE OF THAT PARCEL DESCRIBED ON DEED RECORDED IN VOLUME 562, PAGE 563; THENCE N89 0 05'35 "E ALONG LAST SAID NORTH LINE, 1222.12 FEET TO THE EAST LINE OF SAID PARCEL; THENCE S00° 15'40 "E ALONG LAST SAID EAST LINE, 1352.12 FEET; THENCE S02 °52'23 "E, ALONG LAST SAID EAST LINE 1324.16 FEET TO THE SOUTH LINE OF SAID NEIA OF THE NW I/4 OF SECTION 26; THENCE N89 °55'00 "E, ALONG LAST SAID SOUTH LINE, 66.08 FEET TO THE WEST LINE OF LOT I OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 5, PAGE 1352, AT ABOVE SAID OFFICE; THENCE NO2 °52'23 "W, ALONG LAST SAID WEST LINE AND THE WEST LINE OF A PARCEL RECORDED IN VOLUME 623, PAGE 331,1325-87 FEET; THENCE N00 15'40 "W, ALONG LAST SAID WEST LINE, AND THE WEST LINE OF LOT 1 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 2, PAGE 348, 521.61 FEET TO THE NORTH LINE OF LAST SAID LOT 1; THE1 iC,E S89 °53'49 "E, ALONG LAST SAID NORTH LINE, 894.17 FEET TO THE EAST LINE OF LAST SAID LOT 1; THENCE SO4 °28'32 "E, ALONG LAST SAID EAST LINE, 523.40 FEET TO THE SOUTH LINE OF THE SW I A OF SAID SECTION 23; THENCE S89 0 53 1 32 "E, ALONG LAST SAID SOUTH LINE, 107.05 FEET TO THE POINT OF BEGINNING. PARCEL CONTAINS 162.778 ACRES, SUBJECT TO RIGHT -OF -WAY FOR S.T.H 35/64 AND C.T.H. "E" AND SUBJECT TO ALL OTHER EASEMENTS, RESTRICTIONS, AND COVENANTS OF RECORD. bL/ bb/.Lbb4 btu: 44 bbl4JJJ: eb4 l3LAKt t3U1LdJLkb HAbL bl/ b3 . LOCATED IM PART OF TM NWV4 OF TM SWU4o PART OF THE NE114 011 '1116 aw u+, AND r* CMSEWATM EW HART OF THE SEU4 OF THE SWl/4y PART(* Tfi� N WU4 OF TH19 SBU4, THE SW U4 OF pqwN () THIS KAT ME CO THE SE1/4 OF SECTION ?.3. AND IN PART OF THE • CROIX/ICOUN'I'Y +4 O�V�SCONtr1N N THE TOWN OF ST. JOSEPH. ALL IN T30N, tCOW, TOWN OF Sr J d w coueuA # tMa>M I � i X '. r� � oeTA1t: DRA94A N MW t L cq to pan ....... ...... ,xr ,r ... �.�prr�� ........................... i � 8sY",M'47'tiU M0.f4' ♦ \ .r.ww r ..... LOT 2. .................... lam..... ............................. [\ o .. ,....� . ............ ,. %. 0. \ •.000/ S 710,000 d0 �. Lot �� \\ LOT SJOM ACM LOT 31 M.wL .w.o - _M6AITA0l� YRI►11r•• `!"•"_ � • L.s O.wY00.0 �\ 130.707 AO. M. 4 "ri0N r' •� N ,•'�, soot � �: f: ` .,tr•. tao.7:t •o. Fr. DRA04AG6 WIL IMLPJBW LOT sawn at AWACM '• s ' �'� Mo�r,a. *AN 82. FT. \ �4�f 1+ ` 1 `• l , D SAM �s,o •eaaa U. 2526P 006 EXHIBIT A Lot 20, Settlers Glen located in the Town of St. Joseph, St. Croix County, Wisconsin 0 CO) 0 3 - 0 0 C d o m � (D ° \1 3 I " O � Chi d N ID ai O C N C tp O O cn r -- w • = < � 3 < m O L C_ W FBI 3 7 CD N O. M, 7 CD y O O O j IJ Oo ° O O0 rn c W E G N C O . - 3 3 3 y < CD CD ° o =r A (n Z U) Z D cn Z cn Z D a c m co D ca D �' CD ca D co D CO a c a n co o fl W O o 0 1 3 0 O 3 O O �CO N I t L N 00 W O O O O O Q 0 0 2 ( O C N I z z 000CD rf Z Z � O fn fn - 0 (n f "0 N N fn N N C N N C (p (A (A O CD 1/) � O 3 G O O CD a g a I a a a a c(D :3 O d I 3 CA � CD N N CL a Ul O_ O_ O =h 3i 7 � O N N a CD ° O �i to ° O x -; a m < tD m' < fD D ° � v_i c � vi c x m W 7 �' W = j N n a o CD a o ° 3 o p z o .. O w "• O cn c r C I :3 m 0 �x � `m m� A z o fl; a a) a rn a 3 m m � o o Z - N ANT. W T Ill W O W CD CD a 3 Z 7 7 O 9. (n C N < < S S J ' S? y Z C m CD a I I 3°3 CD O O< Ch< O> O a CD O O N y< v o O Q fD 3 'O ;z CD W rn N a fD 3 'O �. W 4/ N a c cDF P ONO O O <O �3 3 0N� O O G a =0 0 m m 3 3 = amt m o ts� a' CD A v a ca m atT� a�' p m' � w 5 c am ° 01 < � CD D o o :3 M . a u < i �� m D ° mo o o ° I M ui O O m CD O C . v v CjD N N N' O O y < m d v N CD CD 0 7 - No a 3 °° < CD O O 7 p' O a CD 3 O N < y y o ° W" * ' CnCD o (n o .�3 v_ �' ° W� F. =3 m ? co < = O' co < = O' CL �, nc 0 c� m a � ac 0a c ° m o °� od- ° a ° 5 � oy ° Q� ° oN 3 °_' °' o � °O� 3 v ° mo o_ �o CA CD -°� m o CD 3 Qm -0-0 m cD 3 I ° a O�ov a•o o a o° as 5 co CD °. �, O a -1 CD a �, O a t0 CD CD cn N <_ <_, -� U1 1 . 0 ti O O (n 7 O O N o O Vl 7 _ N N CD O d 0 0 A 7 (D 0 7 0 .p 7 O �O O :3 O d I O U) CD CO t m ti O O I CD CD ao A O O O O O ~~ Q 0 O a O 0 L N