HomeMy WebLinkAbout002-1016-10-001^Oew^^wm mcox,.w PRIVATE SEWAGE SYSTEM M08291610i
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Sadie add NNIN Deldric INSPECTION REPORT 624873
GENERAL INFORMATION (ATTACH TO PERMIT) All
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3tEM OWNER �� iyQ1Wt
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9eper lank effluentme11aantl CPtAll
dispersal eep must be sera�raa y)O y� `ggesuaas par _
qll Nlbe6 management pinmual beaby melnpleineer �W iV l �pyvq y�/I I��-
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Omuur/Buyer I[ 1 1 I Run 51 n_ _-
Meiling Address YMIJ Vale Avt
Property Address 7 it `� I Ul" AV-(
(Venfiwionrrgmrtd fiew Plennmipushing Depammm an mew mvwmi
City/Start fJddeO In CAI I Pareelldennficanon Number 00f-I011i-/0-ODD
LEGAL DESCRIPTION O
Progeny LPcn000/va Y., '/.,Sec ,TPINRJU W,Townof VAULAIn
Subdivision Plat I , Lot # �.
Certified Survey MapL al1y Volume 30 ,Page#
Warraety Deed # I 39 3 I (before 2W7)Volume — Page #
Spin hoax Oyes*0 Im line idemifiaLle OYesOna
mpmpuru could msult in mmurnanw, mwelohmidlewanes Proper
n of pumping out the septic mark years every three yor sooner, if center, by a lmenud pumper Whmyouputlmo
the sysonn<an ariecl the Nmmn of the cli tank as a treatment sage in the wale disposal gi Oxnermainteni
responsibdnms we spui in 4SPS 38352(D and in Chapter 12 St Cmia County Summary Commerce
The pmpeny m,wagnes m.wbmit to SI Came County Planning @ IDning Oepamnent a remfimuon form. si8md by the
wnerard by re mavxplu s it an aCmeymmt Plumber, mbC and plumber after
a hrenxd Pumper veng; (if that (11 die o wo
wsstawaur dngml system u a ProMOPotafinB <endClCon anNor (2) Nor Ltspeclloo aM PumPIo80f naesuy],1M wow unk Is
lest thin I/3 full ofdWg
pone. me Automatic! have read the shore rgmremems and agree to mamaCn the prn'ate xxage disposal system such TO:
sbndmds W One, bureau, as sst by the Department Oeky AM Professional Sena and due Department or Naval Resources.
Swe ofWaxansom Constitution woung the your mom, svnem he been mmmmied must be completed aM moaned to ee St Cam,
Ctumy, planing A/ mg Department within 30 days of the 01 your expansion tlau
pw<ardry um allsw<mme inn m�a arm m<Irt<m me ben mrmrhma wmwlaaya pweam/aredeounnandoi
propal deanMd crows. br tame of wamnn deed recorded in balance of faxed, Dina
Number of bedroo'mLs
r UGNAT RE OF APPLICANT(S)
Eil AT Za20
I GNATURE OF APPLICANTS) DATE
... Any Cnformnion Oat is mauFeneNd may, molt in the analLLry permit May mvoked by the Panning H lining Department e
hC<M1Ne with Nit application a mmmi mmmaty tlN from the Resonant of Ueels OR¢ aad a ropy of de cerified survey map if
of is made in the wamnry d H
(REV. W12) 3
Dav TriemertPLUMBING
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Filters
PL-525 EFFLUENT FILTER (COMMERCIAL)
assessesse
Polylok, Inc is pleased to add Its
new commercial filter to Its existing
line of quality effluent filters The
PL525 is rated for over 10,000 GPD
Igallons per day) making it one of
the largest commercial filters in Its
class It has 525 linear feet of 1/16-
filtration slots Like the Polylok
PL-122, the new Polylok PL525 has
an automatic shutoff ball Installed
With every filter When the filter is
removed for cleaning, the ball will
float up and temporarily shut off
the system so the effluent won't
leave the tank Ato other Afar on
Me market can make that aMiml
PL-525 Maintenance
The PL525 Effluent Filter should
operate efficiently for several years
under normal conditions before
requiring cleaning. It is recom-
mended that the filter be cleaned
every time the tank is pumped or
at leas[ every three years If the
installed filler contains an optional
alarm, the owner will It novfietl
by an alarm when the filter needs
servicing Servicing should be
done by a certified septic tank
pumper or installer
1. Locate the outlet of the
septic tank.
2. Remove lank cover and pump
tank if necessary
3 0o not use plumbing when
filter is removed.
4 Pull PL525 out of the housing
5 Hose off filter over the septic
tank Make sure all solids fall
back into septic tank.
6. Insert the filter cartridge back
into the housing making sure
the filter is properly aligned and
completely inserted.
7. Replace septic tank cover
n9 Alarm Aganslwc
ast x ,n,lnr ,on Hartle
6251inaar Net
Dolls"
puratmn sl Rated for aver
10.MGM
Ansel & 6- P'
SCHo ......
Gas dMaeNr
AutamaHc all
call when HHw
is removed
w'ot"t nw 8,m5,488
PL-525 Installation:
Ideal for residential and com-
mercial waste flows up to
10,000 Gallons Per Day (GPD)
1 Locate the outlet of the
septic tank
2 Remove the tank cover and
pump tank if necessary
3 Glue the filter housing to the
4- or e" oulet pipe. If the
filter is not centered under the
access opening use a Polylok
Extend & Lok or piece of pipe
to center filter
4. Insert the PL525 filter into
its housing.
5. Replace the septic tank cover
SIBS %n 0ve-r-,N 61t1
Technical Specifications
PL-525 EFFLUENT FILTER (COMMERCIAL)
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Nam Pa�� ,�,..
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WLP750—MR
TANK SPECIFICATIONS
DMENsaxs
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i1�OP
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LOADN DESKM B-V UNSANRARD SOL
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TANK. WK VESAiI /ID (SI 7URAL PIER)
CUSUXAM TANKS:
FOR MS TANKS C TACT WEYA CONCM
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PRN•ATE SEY/AGE SYSTEM
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INSPECTION REORR
m N° 420080 0
OENEIIALIhINJ
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TANK INFORMATION
EVANOM DATA
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TANK SETBACK INFORMATION
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St. Croix County
Occupancy Affidavit
P qq� L +f<rsDn
wner
Name - (0) Typed or printed
being duly sworn, states, under oath, that
He/she is the ownerlpan owner AT the following parcel of land located in 51
Costs County, Wisconsin. recorded in Volume Page_
Document Number (034 l a Croix County Register of Deeds Office
A parcel of land toccaa��ad�'lp�mp N�6 %of rheyg v. of Seaton �, T 29 ry �neenapBew dare..
—R pe_W. Towna Mun_LLSt Cron county, Wisconsin being duly Hansa vt �Frirvvo, id 1, LLC
described as rolbws pn,m/aaj lot no and subawasubicsM or dejatied legal /J a'�/} Ib'1
deecnpmn)Gr ,� YI"1 30 74 �0 l..�i' tol S 40 0
Pesel annual NundertPlxl
As owner of the above deecribed property, T edmowledge that a Pmme On -site Wnstewstar Treatment System
(POWTO serving the primary, residence is sand for 3 bedroom(s) with a all wlusmwater flow Of4W gallons/day
OWF ( is based on 150 add /bedroom@ 2 Paribas per bedroom) Am um ofy occupants are permitted, if the
umber of occupants exceeds due maximum for POWTS demgm the system will be mrdersaed to awommddate
increased wastewater flows and/or wrtammant loads and maybe subject to prerreareas failure lalsomimowledge
toot I will make this information available to any future peones indurated In forecast this property
dDade into // day of yti M7D
N
TITLE MEMBER STATE BAR OF wleooeslu
aamcneed DY s-roE.ea, w, Sorel
Community Development Deoatlmem St Croix County
ISmi rely to wtherhaten or acknowledged Both are rot
lowest
GTPTEOew�SIN MNOWLEDGMEM
at
gatgLK WMintywx 1� Ma� day or.t.
onne aooenameom �Pm ( ��5,�
an
the Pi eRR wolonte the sent
until ... t Man andravAral he Parse ..Bantu,
St. Croix County
Occupancy Affidavit
P L �AY\56V}
Nanf )QJwner) Typed or printed
being duty sworn. states, under Oath, that
l eare is the several owner of the munwing parcel M land located in s
Cmix County, Wisconsin, awarded In Volume Page
Document Number W b SY Cmw County Register of Deeds Was Rerortw area
A moral Nland lWaiteed ln' E A of thioh of Seoul 8 T3 N mM end Four' mercm
-RA W. Town of st. Cron: county. Wisconsin, being duty J}N,.sen-�'wrrnf44 {�II-C
deearbed as follows (include lot no and subdrviMGn/CSM or tleWlled legal ?i Irl'Avt 5Yb descnphon) d
As owner of fie above descnbed property, I acknowledge that a Private Onsite Wastewamr Tramment System
(POWTS) of the primary residence is scudfor 3 bedrom(s)with a designwastewaterflow Of�iG lOs day
(DW isbasedoniSOOd/bedroom@2pp umperberoom) AmaewumofaoccupameampermiMdpfthe
umber of weripams exceeds the mammu n for Pi dai the system will be undersized to accommodate
uncreassed wastewater flows and/or wmammant loads and may be subject to premature failure I also acknowledge
that I will move this information available to any famre pares untamed m purchasing this property
oared Me �dWym SN..Inr,NA ede
AA AA 17
V
W (M
AMTHENTICATION
TITf MEMBER STATE BAR OF WISCONSIN
(If tut
arrested by 5 706 06 Wia Seta)
THIS INSTRUMENTWAS Dwi By
(sieneuiu may Fe aurenaamed o, 11xwmm9ed mmorenm
'WWWry)
ACKNOWLEDGMENT
STATE OF Wisnothria
pa
Si.emlx Gnellyyema M1ekre me NN�� do" f..e
�tM1ea ore M1amd P i ��
Sanitary Easement
Hanson Farms 1984, LLC, lane owner and grantor, grants
pennanerrt Septic Easement lights to
Want add future owners of the Northeast Quarter of the
Nartheast Quarter of Sei:am B. Township 29 North, Range 16
West. Town of Baldwin, SL Croix County, Wmeonsi n
over lands labeled in part of the Northeast Quarter of the Northeast
Quarter of Second 8, Township 29 North, Range 16 West. Town of
Balsam, St Chase County, Wsiorwm, Eengi duly desrnhed am;
follows
Hanson Fame 198a LLC
ni8l 107s Avenue
Baldwin, WI 51002
SEPTIC PA CEAffNT DESCRIPTION
The West 102 feet of Lot 1, Certified Survey Map. Volume 30. Page 6800,
Document Numoer 1102de2, recorded W the o w W Me Register M Deeds, St CroixCounty, Wleconsm
This easement runs moth the lam and hinds all have successors and or assigns
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107 Oo' �1 Hanson Farm 1964 LLC
`° o Northeast Corner �2294107th Avenue
R,o, zBaldwin, WI 54002
ena--0 Section 8-29-16
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0. Found Government Corner
North is referenced to the 3/4 Iron Pabst
St Croix County Grid System) Computed position
SANITARY EASEMENT DESCRIPTION
Part of the Northeast quarter of the Northeast quarter of
Section 8, Township 29 North, Range 16 West, Town of
Baldwin, St Croix County, Wsconsin, more particularly
described as follows
The west 107 feet of Lot 1 of Cernfied Survey Map, Volume
30, Page 6800, Document Number 1102482, recorded at the
Office of the Register of Deeds, St. Croix County, Wisconsin