HomeMy WebLinkAbout020-1230-40-000 (2)l smNwn°�d ,
OENERALINFOR"TION
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
(ATTACH TO PERMIT)
3Zo
<n..N 61. Croix
x �� 630347
r.. xo 020-1230-40-000
�nNramwwNN29 29.19 1232
TANK SETBACK INFORMATION
V°"'
L , B
57.7
TPNNTO
q
WELL
BLOC
Ilo4inm a
gpAO
EITRI
s.pue
7•
>25
-7'
o..}LaF
(P.6357.L
Ow
N.m.M,n
lo.l
Y1,3
a.r.nen
ao
Tt
F.w
Mnamv
an( svaem
T1
le.�
9
PUMPISIPHON INFORMATION
FinmcweI
a4nuhOure
Sl Lowr_
'4 An
b73102.7TOM
N
b.s7
17.L3rnxemew
fn In Ft
94�
( Dla
wW
BOIL ABSORPTION
SYSTEM ...5
DWANSIONa
sysrEM To
Pn
BLOL
urea
NvsrgEOM
.mw
L.r9�l�da ql, ,
SOIL COVER um symma only M,W,d Or At-G apama ony
COMMENTS: (Ineuae,WdWWd,&nma wrwne aaaen(and 1�maeawnn < mw¢Iw,92
x LWOn 489WUNTRY VIEW RO—VGYITA OM nil yy.df
6Vk (LING ,(e
,)NAT...ranth-
e n- Fiu..c added v.. E>i,sN'�R�3 wlnTl.
nan rover-fxV,5 ITD -44" t+t+-.143 {o
ewn�gequlrMa I yes NO I 5
eeeAwn.I �narmm7` _ _ ISoy35�
R047 10P N0 wro Iduadr6wnwee
. ,.,•
11
������%�
IndJe�s.mma BNlxpn
scicA.
,dB Q_3']9
•. OB
ta00 E w68HIpIcn An
OCT 12 2020
sonny Fmw Nunwft le blmn by Col
6Y.,:
umpmwn�a'7lM
6303¢}
co Application
sm.gmm.nm xdne.
.m,amw nuspsses.xun wa Amn coonmemnm nru:.wlmmb. m0rl
uwewinrroodsnineeemlYrypunul None Algliuum Pmu(u rluea l's ue
polo AeMvlllAR<mr Nn mepbS+leml
Ne 4penmenlofseQry WpmRueJServi¢r perwnJ UJomvmny:x pwWe nry4 ¢navy
nnomin Nr - Isw 1 ISNIMInhynots
409 Uunuy Vpw Rm1
I Apollowflan labmerlon- Plmm Print All lnPonnoll
Slmly L Brm e, noun)
'=
amlv(kaom°
Pbo499 Coube V, An Aetlrer
e99ComCome6 Rw
1'mPmt Xfl (.1x3Z)
(3OM1 Iu
NW'k SE'q mblon 29
TV, Sul,
try COR
Fme Nm[e
Huemo Wl
5016
(ytle m)
TAN RI9Ew�l
11 Type of 6ulleiog lebeek all Job Apply) p
X /
SIM.. Nam
®I m2bnlyl)"Iny-NwnWnrBnecum O
e�LL
ymm�u:y vimriyafnin
❑pudiJCommernJ-WnTe Vre
p
❑ boy of
❑ smetMee-Lmipe Vx
❑YII4N
(SMNumYer
® Tmmnr NWan
III.T
0dPvnrl: ffJhmkonIvQ06bGxQ1JlAoA. Coon Ie411na Blfe Iwble
❑New syagn ®peplrsimll Sy@m ❑i2WrcmMoleiy TnLPglrsoml LWy ❑pry>MMi(eeinm Euery9yepmluMunl
❑Pmmil RnewJ ❑ftrm°Rerum
❑lMg or
❑And Tmlvb New
Lot immu Finat Nude, ne Tom lssme
aeon eap�m
Plunn,
2H03 9/3al
IV of Plsysvenv n nmwevla Cneckulllhaln
Nmenopumlln4mm ❑%pu,wllrtGmuM QAwMe ❑Moma,xe In orwemRW ❑MxaJexoleorAulWlewl
Ll xmaus rmk An, oupm,l rsmpounl (n1m) Cl Nomwn: boom('0,A)
V.Bn nvl?rnlnenf
Am l.k,Uelmn:
plon
eon sml Applvm
wguW Am Smoke un
oupeyl Mon Proposal lm
s5'mm 6Ro,tlm
a5omRw
Rm In"ll
My
93V.91r
b5
n r.pk Into
Copan,Qwlm
k Nv
gp
Spg
°� r
g
_ T.
Tomn
non
d B
g d
'1 W
i
sepuevxIfidn Tma
320
IOW
13R0
I
WlmrCanuleWVEFS9
I nsuAcNnb
Vx. Rkopnolbilify Sol LUe moon nW, I'll, "Up"dwhy for in w0000f H, PUWIse6mem W.me.N
u
Plb0'a Mont(Pm% 5 ww C(
MPRAPR6 NurzM
N r
John Sdndnw�(�
}Ux60
91s.xMdb
Munnou I Admen (snce riy, Son. zm long)
596 volley New Tml, Somerset WI5e0x5
Coun
etlnenf Use Only
:;V111
pAmm ❑ti R,mn Fs gpl�mqss AFnIS n
f5o,
m, Bmw t y9s - ).m
zo1�-
�
gXSYSTEMo09 ppmr M00""4 by 0 ojl l Ilya gjnAl�+y. :iC R},
n
R
SYSTEM �. f, p ��yy VVM� n� Fa`m np e1i2
Sepletank, elMenlllllerand �, .VgM1Nte-eIX rFW
maaamal ®p mml be serwea l ma,o:enma
aspermanagemenlplanp,winber �[ 1pyyVpy-
hed asteuned I� IIJMS 4a pMY1«/Ia UN^ INRArLTgSwAfC
�aa Jer aJJ'ncaY.a�Sr.�dR11flB6IY�1r^errhpruitl4Mm�[yp £pp ��
SSM398 (1003114) INf M1T\6'A,�^ P� yl
SYSTEM PLOT PLAN
Brener 3 BW=m Septic Synem
T
m awzp aur,s. ,u.. � &Ile 1'•eP
Wo.w,aTrti.my
GOIP\
GOpV
CONVENTIONAL COMPONENT DESIGN
Reedental ApIcri
INDEX AND TITLE PAGE
Project Name:
Brander 3 Bedroom Replacement Septic System
owners Name
Shirley L. Blander Trust
Owner's Address
489 Country View Road
Hudson, Wl 54025
Legal DescrItfon:
NW1/4, Si S29, T29N, R19W
Township
Hudson
Counry.
St Croix
Subdivision Name
uppings Country View
Lot Number.
4 Block Number
Parcel ID Number 020133040000
Plan Transaction No
Page 1
Index and title
Paget
Plot Plan
Page
Existing Septic Tank Specifications
Page
Existing Tank Certification
Page
Sepic Tank Specifications
Page
Effluent Filter Information
Page]
Valve Diagram
Page
System Sizing &Cross Section
Page
EZ Flow Information
Page 10
Management and contingency plan
Page 11
Septic Tank Maintenance Agreement
Page 12
Warranty Deed
Page 13
CSM or Plat
Attachment]
Soil Evaluation Report
Designer
John Schmitt
Llcnese Number MPRS223760
Date.
10/5/2020
Phone Number 715J600485
Signature:
/941
In-
round Soil Absorption
Component Manual Version 205BD-10705-P IN 01/01)
Page 1
BPLOTomS
Bremmernder etlmom S3 Beptic Syelam
a
u„mm ♦w,
gale. I.-W i
.
DI
c
m w ,m
T�d' _
UM
'...wP
i .,p..e.
1e.
BPFEIV AND BI IMINGS DIVISION
Plumtiry "oduc1 Review
wmlllercs.wl.gov
to w sass
Mail woo nnii 53101 shall
isconsin
Dw.pThmaahww
Mlwmwd dLanMltl
aim Daya Bevanv
almere J. Lwmneval kwmwpy
February 16, 2010
WEEKS CONCRETE PRODUCTS
RAY WEEKS
183221UH STREET
NEW RICHMOND WI W17
Re Desalphon SEWAGE TANKS, CONCRETE
Manufacturer WEEKS CONCRETE PRODUCTS
Product Name SEPTIC, HOLDING, OR PUMP
Model Numbm(H. 1000
(491N L L., 21 76 GAUIN .84 IN MAX. DEPTH OF BURY 511 G.P.D. WHEN USED AS A
SEPTIC TANK BASED ON A 3 YR SERVICE INTERVAL FOR RESIDENTIAL
WASTEWATER, TANK DIMENSIONS• 841N LX IN. W X491N H)
Product File No 201001
The spackboasldns ands plain for this plumbing product have bean reviewed and determined to he in comphance with
chapters Comm 62 through ON, Wisconsin Administrative Cade, and Chapters 145 and ISO. Wboonatn Stables.
The Department hereby issues an approval based On the Wisconsin Statutes and Me Wisconsin Administrative Code This
approval Is valid uMll the and of JUNE 2015.
TINS approval Is contingent upon compllance W Ire the following stipulahon(S)
This lank must be designed to withstand the pressures to which It will be subjected.
The manufacturer must keep at the manufacturing plan] a set of plans and specifications bearing Me department
stamp of approval The plane and specifications must be Open 10 maperi0n by an authorized representative of the
department.
When this Product receives wastewater from dwulings and is used as a septic lank, it will prodilw an a ent quality
with a maamun maturity average value for ROD5 of greater than 30 mi and leas than Or pual to 220 mph TSS, or
greater than 30 mi or falls than or actual to 150 mph TBS. are F O G of fells Man 30 mi
Approval is issued for this product as being equivalent to a floor color water Gallas when the fixture Chun is Insisted
In 0e vertical position. The design meats the Intent Of a Comm 02 32 (5) (c) and 84 20 (5) In), Wis. Adm. Cape. which
requires water closets t0 discharge through a minimum diameter 3' drain pipe Or fitting and the bowl to nonfarm to ANSI
Standard At 1219 2M. The Intent Of the code is mat aince this product provides the same functional performance all water
closets that meet ANSI Standard At 1219 2M
BEDDING: BeCCing ma l shall be used to provide a uniform bewring surface. A must, of "Men been of
send or granular bad on top of a form and uniform be" Is recommended The tank should not Mar on rocks. Sibs
with high ground waste tables should he" eua lly d"19m bedding. Salle should W compaeW prefer the tank.
This approval supersedes the approval issued on 4/21/2005 under product file number 20050106, This approval Niter shall
be ircoryOrabtl with your premWfly approved Olana ardvor specifications approved raker p idud file number 200501 ON
As of May 15. 2008, a Copy of a successful water tlghtnesa test report for this product must be AVAILABLE FOR
INSPECTION AT THE MANUFACTURER'S PLANT pear to this product bring math all a POWTS holding or hsetmens
Unit In Wisconsin.
The department is in no way endoreing this product Or any advemsing, and is not responsible for any situal which may
result from Its Yee
Sinprely,
Jean M MacCubbm, CST
Ergineehng COOIuIbnt—Plumbing Product Reviewer
Conte Salery 8 Buildings Div.; PO Boy 2658, 201 W Washington Ave., Madison ON 537032658
Phone: 608-266-0955, FarBOB-2834456, E mail Jean MacCudbin®wisconsin.gov
OW fall iN 1n97I
FIB Rat ffel
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF EXISTING SEPTIC TANKS)
This is to certify that 1 have inspected the existing septic and/or dose tank
presently serving the following residence:
(Sheet address) e89 county Yew Roas located
of nun '/., ss y,, Section J Town 4 N, Range 19 W,
Town of Hudson St. Croix County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements ofSPS. 394.25, and it (they)
appoints) to be functioning properly.
Most recent date of inspection or service 10.20-1988 (l- 5— Z Il
Did flow back occur from absorption system? Yes_ No
(if no, skip next line.)
Approximate volume or length of none.
gallons minutes
Tank Capacity: tmo
Construction: Prefab Concrete x
Steel
Other
Manufacturer (if known): Weexe
Age of Tank (if known): 913011988
Permit number (if known) ttaeoa
- Z�
bon sa
i
(Li used PlumberSignature)(Print
•
t
�YAQ`4j
s
MPRB
zza]so
(Tide)
(License Number) MP/MPRS
Zy
(Date)
Form to be completed by licensed plumber (Dept of Safety and Professional
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer
(NR 113 Wisconsin Administrative Code)
Rev. 2/2012
s' r
A' CAST -A -SEAL A' CAST -A -SEAL
FILTER OR BATTLE
>8
W320—MR
TANK SPECIFICATIONS
Lb19 N&
/NL T
BOi,P1 J"
COWA: '
ID NECAS! Cg1O1E2 IE4R
HEKHT
LENM. 4-2
W TH,c: -2'
nvm: LET
uKMlp LEM1 u'
WDOIT >ew LlKL
INLET AND OUTILET.
.' CAST -A -SF OWL OTI EWK GASKET
WET AND WT£T fl AID FILTER
xLscv N. sz D Nl- nO
(OTHER STATES SEE KNART)
uaAD CAr W &W C A
LOMNC CE9gf LE-V LNUTLIRAM SDL
TANK CAN BE .S AS
S Tc / Iltl / A tll SRgI
CDwT m DEsNm P pro FIWn)
NP( WR mmm /ID (S,ROLT EBFIQ
WSTr an Tuws
FM C151CY TANKS CCNTACT 1117 R C E
a=
�
o er
DATE
s c
FOR APPROVAL
PL-525 Effluent Filter
PI.-5b Filter
The PL525 Filter is rased for 1G W GPO (gallom per day) making it one of the largest filter in an; ciaaa It has
525linear feet of 1/16- illusion slats lake the Polylok PL-132 tM Polylok i'L-525 Bas an autovunc ehWro((Ball
installed with every filter When the filter is removed for clearing, the ball will float up and temporarily shut off
the system ro the effluent won't leave the Imk
realm"
• Rased for 10,000 GPO (gallons per day)
• 525linear feet of 1/16" filtration
• Accepts 4" and 6' Si=40 pipe
• Built in gas deflmor.
• Autmnnc shutoff ball when filter is removed
• Alarm Y".xibthty
• Atteyts PVC dteswon IuMle
Pt-;x5 l mtal lninn
Ideal for midennJ and mmmmul waste Rnws up to
10,000 gallon per day (GM)
1. Locate the burger of me septic tank
l Remove the tank cover and pump tank if n"emary.
3 Clue the filter Musing to the4-ter V out et pipe If
the filter u not centered under the access opening use a
Polylok Extend Its In4 or piece of pipe to center filter.
4 Insert the PL•525 fill" into its housing
5 Replace and secure the septic tank cover
PI :Ei Malnlen"',
The PL525 Effluent Filters will operate efficiently for
several years under normal conditions before regwnng
cleaning It is recommended that me filter be cleaned
every time the tank is pumped, in Y least every three
yeah If me ill W mo filed by minas whenfi alarm,
the owed will be notified by an alarm done
the hirer
reeds servRuns pumper ormasa es, be dorw byacvtifred
septic tank pumper or uuull"
1 Locate theautlet of the serve tank
3. Remove tank cover and pump tank if n"weary
3 Do not use plumbing when filter is removed
4. Pull PL525 cartridge out of the housing
5 Hose off filter over the septic tank Make sure all
solids fall back into rupee took
6. Indi the fdtor otNdge back meo the Musing us"
awe the tour is property against sort complr2y anted
J Replace and secure septic tank cover
1/16" Filtration Slnfb I
{[ Ahem SwlrtF
1011] GPD (Optlentl)
Ahern r rve
P+Mlw, Handle
Pa wsor
m®crD
su mn,a, w
ama-
Fleaasn stuta
A,ep
YMDner pip,
luinswa to
Xle Yes sl rose 40I
Aulc-0 BJI
k
u.re..... r..,.nr,n.,. tin.,x eu..da inn..
a lvlasm.kuien•.�en wan�mc a ashaYla
m wry•w.
Polylok lnc. 3Forf Id Blvd. Wallingrd4C W91 TWI Free gT116.5956.5 For: M AS4 M14
bu0anml cw w FMUN peenye pyl/i BWC
ley AoIXxee KII88IW
,t Is ceF
RgRCV
Ary Vl9V
RffR
Tied
VµVE01RECIlON
RroE
The Bull sun verve'^ Is Eion to t to dva noes or ong"
lifeflela or sy4eme In addition K I m me advantages al longer f OUT POW
life and eater Installation rc le One most Public r disposal
safe f oVf POs!
ffiemannp {earl¢ available Per ely no co d with
eppnewater due
use has ehowhly n and ex with
wastewater eto me values change of r internal
operating characteristicsdo anotherc n he [bang{ over from one
drainageTimor
by to another can he accomplished without
In less Men f 1N PoR!
sancta by sashay Turning Ne valve without digging or
contact wl[M1 washwetec and gull sun a Valve Is available In p sum 40 ears
small Is me rnereva,{pale disphmik an systems
rae used . m cpnmeMal. IedusMFl� ana
iemnal apmlunona.
OPERATING THE VALVE
ys"kc
ySVhc
FIRM The direction control handle should be rotated
No pealrok Ily to direct effil to one or the Other
of two septic Gelds. After removing the screw cap
at Me top of the rtur Nbe, Me valve handle can
be tumM with Me Kaye key furnished.
m 1 BULL RUN VALVE
Complete Valve Kit
Ors Contains
1. Bull Run Valve body
3. EF' Valve Key
l fuser ap Adapter
ylvl gat�p6 f watertght Aattu ( P
wwULK BULL RUN E a.n ONLY
FIRVORLER PULL RUN VALVE m cot CAST mwR
MWEY28 SUAL RUN VALVE KEY Or BRVCIRISER -<'
ssi wR RUN Kure rcv aa. ADJUSTABLE TG Ip' HIGH
IN -GROUND
Stepped
Elevation
Trenches with EZ1203HP Bundles
3-ft
Trench ..
ttt t.
ILA
_
iil�iiu
:�.�acl
(No Scale)
Highest Trench Lowest Trench laa aDNimble)
OBSERVATION PIPE DETAIL
System Eleval - 93.5 fl, 92 5 R, R, fl. R s
r rrreacm
w w
TYPICAL TRENCH ^'•m^^•'-'a'^^
PLAN VIEW 4-0 I411®n:Maw
(NO $Cale) Pedomted Iateml �n�pxen. 1U fl
(typlcal) IHa�nB� 14Pm11 e.w
-- ___---------_— — _---
I 6= ss fl
Pal
INSTALL PER TRENCH: EZ1203H Randle
Pm)
6 10.fl WMlea®SUff EISIJwit=300 IF Ism Mlmtpewr sysmi.. ucl
Irulel Wrzuenlb mmuktl�YaYem¢Ibe.
+1 Sfl burMes@25fl E45P/unit=25 fl'
=PmPo EISA pert =325 fl' RNuireO Infil•afimM Mtibution McMod:
x 2 trenches = Proposed Total EISA= 550 fl' branched manifold
RFCFT
Installation Instructions for
EZfiow Systems in Wisconsin
..........................................
Ypscram Department of Commerce. Smay and BWHrgs
Cal tied renewed the spandko 1pe mayor pbm for this
fuel and determ ma it to be in comorance weed maptera
Comm 82 Mmugh 61, Wlsrneln Admin, Cede, and Chapers
145 and 160, tars osen Statutes, All sdes must meet Me $IM
IS get Captain 8Us =tints& sph diseases as Malin
IOW regulations
The ypored grNuch ae IMpM (31'Y Wg4s wam, Re In
center dumbm 5OF I0' bngUa) and PA9HP( 17 Males
whit pipe In each bundle In 5' or IC' angel
A single pipe bundle contains a 1mr IF perforated pipe our
rounded by EPS aggregate and Is held together v.M poy-
ehtyler netting, A single aggregate bundl<conWna aggregate
ony and is had together win potental nettng.
MMM u Equipment Needed
• Hop, Buwles
Ezmu Gnteax Fade
EZror, Imemal Plpe Coupons
• Rpe for Herder and her
• BarkhoerE,ori Or
ImaYlleYen Inabuoror
The instruction for msWlehnn of EZflw products are grvan
brow This pror must de InsWbd an acmmpase wd, sedan,
rube defined m chadmirs Comm 82 through B4, pyromania Ad-
m,n,aaLre CUJe. mM City m 145 and I wrski Star.
ubs, as well as Me and pri dgvmmnls camnt cresgn
manual
1 Ann the Meal heath eeputmem has mossmonee song,
wndguraton, and layout for Me EZAI rysteme stake
OF mark with Rot the lboatlm of mantes pit Imes Be
GreWl to of mrrect tank, ,led plan, Feeder ap ordrs-
Mutant tax and trench bottom elevations More InsW-
Ybpi M par suplez
9. BanO.e Wastic EZAOw st+FPn9 taps pm la F N
dMlas m IM bnah(esf. Rempe infidel b male
trntli Moue gster, a weird
3 This peri must M1em gerstdi tone Met mission re-
gwrements of s Comm 64 W (6) (g), Wrs Adm Gt
installed directly on too M 1M or mtl noiealng
down along the sides of Me product to a Rent at least six
inches from the bottom of product
4 wxn nzWIM in a Masan, Me bench srwuYJce ergs
of sToursrotnNsoresIeseevave-
tn. lakainsists MMappYdy afterbrkrs ampHe
MNIEVowe
Y�
..................................... 6...
5. The Abe w vet(SO nere_ssary for a given Me steel
be uratl based r maximum duly sewage flow (G PD) and
nit Trammell for the site It mortal cn m Is met, the
Elf smog ran Ix used In Weather, rewnmg In a 409,
smeller dninfield,
5 Rare Und, barrel m e QMv u figure W
pour by ry I design Rand sp 1 far this peticu-
m site The tap or rmismnsl wreles preparing pipe
For gonad ep to m] Mh an interval ppe wpbr. My
a resail aggregate ry dandles that may be required,
should be tatted agents the other ag iregmeany hun-
dlerred do rem More arty type of conrcp9r.
T, The top of aami GEO cylinder mnleins a Mer tape pre-
manubclurN In between Me nelMq and ggregal< The
fahnc is nseded to orm nt and m4u me matauer
sMY make sure Me fire GEO v; pWMiM upward and s
in ¢mocha wrlh Me tarp prbnN n the adjacent oral
de Moe bminfllang.
8 The EZflw OnMMW Systems should be Instaad In a
brtl bench in all arrectiona Moth alarms rid elrg the
hench Mttom) ndshoultlfolbw the pond.., of the Mount
summer elevation (uniform depth), with ml continuous
amfol lo-frt raindrop bundles pri amid to she
eM central bunch datrihueon piR Interconnected
wgwt any dams, stepdwms ar other writer ales.
9 The hancn top par ee graded surly mat ware wN M
lair Bill should be saran or sodded immealatey,
OF normal M reduce ermion
10 Uflow• EPS dandles are flexlde and ran M In curved
trenches as may be p ersary to avoid trees, bankers Or
Other obstacles.
11, End aphrome is Mahler Men w . Merelwe, d I
he agooki that naNN Mgaw.y lott5 Wuy IW b
causs EZMr, separam to fiwl be of papal wham
patlinq occurs Field eaperrence I shorn. Mr2ser.
Mar me is not a prodem Mien systems hand a minimum
of 6' of sop For "rewmmended by manufacturer
.............................
Page 9
In -ground Gravity Management Plan
IMPORTANT'
The Owner of Nis ingrourd gravity system shall be responsible for its Peet al operation and memenanp, puleusle to
requirements of BPS=484, Wsc Admin Cade Purl 10 SPS 38352(2), Wsc. Amin. Code. mis system shall
M considered a human health faced if not maintained in accordance wen Inis approved management plan.
Furthermore. all mepachon and maintenance cmils, shall be performed by a registered POI Melnbiner in
accordance with SPS 383 52 (3), Wsc Admin. Code
Maximum Dlepenal Area Operating Limits:
Design Flow, 450 gpd; SODS 5220 mgL'i; TSS 5150 mi FOG 530 mi
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
• age of effort
• nuisance felon (I a, aeon, user complaints, etc)
• mer3mnicel malfundtlm (i a.., pumps, vales, patches, finery, etc)
• centered fall (10. leeks, breaks, conown, etc.)
o Wilds volume in ensemble treatment lank(s) and any distribution appWenaneels) (I e., dlMbutlm I dmp coxes)
• neglect or improper use 1, e. exceeding pill desecrate, prohibited agNNes. etc)
oextent ofprice pending In diambuepn call to dosing
dosing imagutsdtes- dapplicable 0 e. pump reciding, noel switch Intense, etc.)
ebcldcel mmpments- Sappkcable p e., wrong, cannecaona, watww , cormbda.8mere. noms, etc.)
o tliablbuemlatemi IXim"a mylugginB Imwwre lalerel Metal wemre—tempera todWBn epenifiatlen)
o surface discharge d emuenl or sewage backup Into structure Served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necaaary)
p Septic and does tank(el shall be pumped by a cen?ed septage servlang opelder licensed under S. 281.48 Wla
Slats when the volume of wilds In me III exceeds onslhld (113) the liquid volume el the tell an
as required by local ordinance Disposer of contents Shall be purel to NOR 113, Wlec Minn. Code.
in Emuent filteds Shall be Impacted every 3 years and shall be dsaned when necessary to remove any
accumulated wets eccpdmg to manufacturers speclilcatlms AseNidng WM wllaNreysbegreaterManl2
months.
System maintenance reports shall be submitted to the proper local government um In wapdmce w1m
SPS 383.85 Mae Admin. Code. Report any component falturs Or matfunNon W:
Name of mdivaual or company Schmitt& Sons Excavating, Inc. probes. 715-760-0486
Loral government um St. Croix County Community Developement phorm 715-3864680
Lor.I Bovemment unit address 1101 Carmichael Road, Hudson 21p 54016
Any detective pad of this system shell be repaired, replaced, or removed pursuant to SPS 383.51(1), Mae. Aimin
Cade. Repair Or replacement of falktl or malfunctioning comporeds shell comply fifth SPS 383, Mae, Admin. Code.
No product for chemical or physical restoration of the POWrS may be used unless approved by tea department In
accordance with SPS 384, val Aimio Code
Contlnaencv Plan
In the event that any failed treatment component of this PON?S cannot be repaired, it Shall be replaced yu suent d
a plan submitted to the appropriate agency for review and approval. A failed li gerund dispersal nmpment may be
abandoned and replaced by a cpdeamplying dispersal crmpment In a pre-detemiined area Of suitable wife.
Svetem Abandonment
If use 0 thle POWiS is disdenfinued, 4 shall be abandoned In accordance wilt BPS 353.33, Wtsc. Aims. Cads.
ST. CROLC COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERMCATION FORM
Owna/Bnyer Shirley L. Brander (Trust)
Meilmg Address489 Country View Road, Hudson, WI 54016
Property Address489 Country View Road,
(Violations distend boom fission & amass Dennison for Was wmWdgon.)
coy/Sts.Hudson, WI Penfield Identification Numbe<020-1230-40-000
r FGAr. DESCI LUM
Property Locations NW '/e, SE % , Sm. 29 . T 29 N R 19 W. Town of Hudson
SubdivisionPlat:Rossing Country View Lot#4
CettlRed Survey Map B , Volume , Page 9 —
WerrenryGood M T102�j (before 2M7)VolumePW
sped namegvl�o Ia liner ldenufiebk DynOm
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
IMPICOM uaaod mamlwmne ofrourMIMIC ayoem word mull in its premature fauure to handles a, loser
mn,mmmn Comas ufpumumi om me Ill bunk every Wec Neon mission, If beaded. by a bcweed Compere Whetympminto
m<,rn<mcan omWifutaennof. 383
in vumwt cage ioneta Comte sanitary
coati Owns memlwm<
rnponeibilitiesere fpttlGed m 45P5.1g15i(p nntl In CMpnr 4-gt Cmu County Swwy Oaw<nce
The pmpeny owner ngm to submit to gl Cmix County Punning® bmng Depmtment acMlfcetion fmm, signed by N<
tossue and by a ouster plumber,lotnmywn plumber, tradition plumber me uema poster verifying that (1) the Inside
wastewater disposal sysmm is in brow epenong condition sabot (i) after m,p¢tlon and p ampong (ifneaswy), the Optic mik is
I ,, than 10 rW ofatudge.
uwe. Ue wanwg m to,<tm d,e.m'c rtvwtetmw am aga m mvvuu the wi.ea sawas despoil mum wiat the
standards as rm1 herein.a, ant by me orpanment of Sandy and Nnfnaioso S ua w the Da.tmmeorNsnaat sessions.
State of Wiuoam. Cemfication auling Net younepuuptem hn din maauewd bum be w�kvd mdmtmN m the Sin Cmlx
Ccunry Puwng & ]ow.g Depnnenl wMln ]u dnya alNe three lvargpuenon doe.
Ilse mtify 11v1 all Wknlmiu on Is, fmm art we an Me kN ofmylour kmwledge. base amtere ttr owm(n) of in:
property described abuse, by some of a warranty deed taotded In Pajamas of Deeds Ounce.
Numberoflodroo.ms; 3SIGR�TURF OF APPLICANT(S) DATE
"'ivy Information lost u mtvryaomtM may Odeon in the tottery Mmll bang rtrokW by the PI®g & lining Depmmae..
Imhtle son Nia ePobcwan a t,sordM ownnry dso horn to Rooster of Dads Onto end a aqy of the ceNfird survey MP If
ter is madem the wonsy dw.d.
0. FT.
a
—zA
00
e
b_
5
e7.120 SQ. FT.
2.00 ACRES
_
N8995.22,E
33:
a
uo. oz
4
2
D
n
_
el, ava 80. FT.
�&
I
^
2.01' ACRES
_
q
l
®
/Wu
.
M ASIA
141.019�$0. r
4E9.0e -
1 3.24 ACRES
'
s..
a
(Q�
SO. PT.
EA9 ACRES
2.49
•
\
60
a
ee
a.
q
7
Page 13
Depanrnenmt SOIL EVALUATION REPORT 02076
Ba WelYend 1..111111 n, >v,.ra of today I of 4
_.
a 4rOreavanal5ernm
smnn sou r.urr9 I,
�. e:r° eBP or a., an a,r r sl ceoIS
mcluae,ey.mne.,f,
aend.... a noto I'd l lW1n°,nl.,y r, or Try, .y1C
GZG-t23oaaaoa
noun m.
v.+ea fir pne
vo,m IT.... .: e..2. v. ,n :..,m n... .. I
J
Meuse v r.a 9EV1 529 i29N Rt9W
.w
EBrar.del�.ShrleyL
Road 4µngs LOuniry Vew
p
Sum Z Cne o,nrc r.nrti -v unay ew Nnmtayo
wl S101b didscory cCWt vr"RWO
a u.. . rnn , °r°ea. or 3 norm ne of easy. . e .w G°
er eema do
°orvfoni 1Order
m•rSand ,Bun . er Sees a a n "HiVyy MA I
1 IBa.y• By.y
LJ llprn I, dop ryCo96+ 1Syr gpsounn Se
m,. Dprn Non9a -1.1.1 .,onnw. startery Rfr GRIT'
p.
S gea:
Se ST Iran -co•
v . IN,3 3 n.-.e 'Or a5 M 0.6 10
on w
2 . _. INN'4 .nro _ eme -Ti,CO C 6 10
3 2134 1MM.5 _re a nW H. do, !N CE 10
le 91 I^m5:6 .ye :'5 1 n -- S) 15
( Sanyo do 3e11w mnau.w. 9:73 ]eprn..11,; ram, 95e n
1 09
IO,3i3
.ore
.I Yegr
mrry
a5
M
Cfi
IB
2 420
INdM
°me
51 dm50k
mM1
gw
IN
06
10
3 28 38
1WN/4
nme
I 2,r
It,
9w
IN
06
10
4 38 96
7 3yr5/e
none
ys ]59
ml
-
--
07
16
warm Cwn,&ale• Snlhy 1.(Too) e.,ryllc. 0:0.133090-000 ewe _z.m a
❑3
gar..ve
All
I'd:m.re w.a ee,
%0:
k Dem wlmn.w r.wi pe.
nflaW
saa,bpnulua Bar
rWl.on
Cern
oan„n.nlewor
`APftr IW
Imll
5vynurt
ean.mna eeune.ry
eapll•
Ill
CA So Cod Coal
0, So Sn
_
1
0^17
1bp3/3
Mne
oll
imgr
moor as
3N
0.6 1.0
3
1737
_ _ _ IOYr3/4
nine
9
3msbk
Wr par
1%"
0.6 10
3
11 _M
INAM
nl re
grsl
tmsbk
m/r qw
1w
06 10
3044
).Sp516
raw
ITS
0sq
ad a
—
aJ 16
5
M'96_
I0yr6pMHW
s
O•g
ml .._
.__
07 16
❑
Bonnva
Soong
Pit co,,aa wdaw m.
It Cell 10'1 near
mRoon,—
KOo Rom,
an
Cell
wl'anl Cow
RNo.Cxvpinr
rulvn
ynynow
Coal Baune.ry
cell
Will
a At Cont. cob,
cr Sir sn
Emll.en";
�
All
Bonny
po cro.oa wn.ar.M, _
n Coll m"Wing
Paolo,
yeneplr+mn ena
Marron
Dol
D0111111 Coll,M
R
eawn
slrvu
nn
C...Al Bo'l
BwM
GPi
In
Mun
Ou of Cab
or Sx6n
_ _
'Enluem At 9BOD,+ 30< Tpa ri TSS•30 a lEOmyL EMaw1Q•B ,, s X ri AM a30I
l no wpnwmnl or Corni i, an eyva l opeonomn w,w, pi der mild nnelm or I r,,, neN le.i9nw[ to omne or, un or
n lw nblar:w In dl nlemde:.,mla: ewae,nnlna m, aorandnv a nnx.+nr.u61 n, I I3 ena.yv.em
Conducted for Shirley L. Brander Trust
489 Country View Road
Hudson, WI 84016
PIB 020-1230-00-000
Lot 4 Rossings Country View
NW114 SE114 S29 T29N R19W
Town of Hudson
Conducted by Thomas Schmitt
CST 227429
9111RO20
BM 1 100 00' Bottom of siding on the walkout side of the house
BM 2 103.41Top of inspection pipe on existing septic tank
St Croix County, WI
Lgnd
NI
1
km
St Cron County, WI
�egeM
• Cp qo SOIL EVALUATION REP9RT R0]3
4 k rA OG cOLI m G - m cm, PanImoron
w!
e • Praees a smmm Sol T•wll9, Inc
rn monp ommIsma 6k.M� MImom moms F
y -
51 ok
prznl eeoe vaeadrnmsma.onnanw amvzlm am eswmzema Plesaa Po evtl n/oamtllm�Pellona ,m. m. .a .,,Inr,.wr..,a wollmu
vroxeM Gxaer �m PowtLV a.
&uNeemwr,m Sh�L RmY1 fret Cd NWI/4.SE1/4529. RBN, HIWY
geyrypwvra erapq Nbau sw • gN• NLE wCSW -
4R0 Country VlVimRON 4 _ Lr98 Country VW
CM SIq zriO Plgne N"oor I CO ,Wisop, 1 Twm Nsaresl Rmf
Now: GnY.Wm two GW
Wr um w toldnomm rCoal 4M 50 3 CunE Engn now 4
,RM.'zzm Pmea o-cmnwMCaub
olmom sbmol oVv,mh sent(RUM11erot-3sobe series). -. _ _ {py ganolwnbl.xglxmNe Nn n
Geeeml mnmmm 4maMB"em a mee AsyMemx aG79se+9nrne wmnnenmmnermmwrepHmememie�.s'Regn
remmene.rryn. IRHTI9Ys1MbBM6 skyaYM IB]%/_ d
���•
rM
9722
Pmn
GwM Ounw owl _e
Cµonlo w, M1aw _%!_
yx4{pYyrgn yy
wRocb
ran
Gommsd Cobr
d:Co0ulpten
wmtom
Cduu
BttNsry
Gmom'
Munwl
Gu Sx Conr Cobr
Gr 6x 86
1
p9 IOyr3/3
m-e 9
211g
mW _.
IN
06
10
$
3
421 ]OP4/9
21-34 108r1/6
IT9
I ncoe
2mm"
I -3m2k
mh
h 9w
1M
IN
06
06
10
10
4
34-% IoV5/6
roz 9rs
1 Oy
-N
_�1-10
]
] fi
-.
-
yt 9 S Sb
4.4 6 N
F2Bo-YV•
ny
IIN
9]R
GumzuMsrw _ e
GpmbxnitlpbW _9W _
SNI4gaoopr Ren
o-Rom
1bm.
Dom I NaWordOmr Re]or Googol
SLwbe
E ry
GFPIP
wool
in MunM Cu 8[ Cml CdarI
I Gr Sr Sn.1
1
U9 IOyr3/3
9
2m9r
mHr as
hN
0.6
LO
]
9-2R 1 tgm3/4
2&3B 1"/4
3&% ]. Syr5l6
_
rote 9
TnCmW I 9
FooIrp
inelx
2mrtk
0% _-�
mh qw 1W
mn 0x IN
ml�---
06
0.6
]
14
1.0
1.6
3
4
-
lIns
31 Po
-, , 9G.
•EmueM•1=SOD" Wa x20 mqIk mAss>ro<150 m9>t EIRaM•2. 9CG5<so m9M1 ant TSs sw mpM1
CST Nome IPMsw PrM1 sl9roWm e,
CST Num
TbnaJ U74N
�
Mdwe BrNnYSz izbp, lz Cw+]uYl Ttlµr»HnM
N S. Hex RiNmvq WISWI/ P111R03r1 m ]IS]M19M
wxerty rpwo WRR9e,, 3M1triP/1 (TMA) _ pe,MIIDN 02o-I2DMm ppe 2 of-4
�fiO1ne
Mm G,oune aunemety
9602
rt CWnlo ninB leaor
gOt
yy.�py�ymR
Cegn
Mrr nemc
eaRa o
T emn
Smtlun
Co ,Steno.
PoIldry
Memep
0, ft on
W L SI
1
017
10/A/3nCM
-1
9
2W
mM
8S
M
06 10
2
1222
10/,3/9
rcne
9
21
mF
gn
10
06 1.0
r
3
D-M
10 /9
,me
—
_ y9
2m;k
not
roll
M
06 10
5.
NM
7. Y /6
grs
Cy
ml
--
02 16
5
M%
I0p6/9
Moor
5Dry
ml
--
0.7 16
9z.ro
Ewa
Ponn9 e
Poem
PO Gmum suReseW
It Oepllr blMllMM1po,_
-.
e
R plgbWrr
w¢m [ww
tivdopbe
Tu4n
So wm
¢lenoi..PwMVY
R
Of41Y
Cu.h Ga%CaW
WSe S,
❑
WON 0
PuM
lot WouMau,kneN
6 GeMbIFMm M1Pw_
$glOpYaMeP4
Ibbne
GM
Gc,wwl M
RMV PewW
Tetlun
SUWun
PZMeM1
1nRttb
F CRM'
In
Muux
Ou Y tart fm
W 4 Pn.
r
-ElRwnel•(=,y MI•}M rgLa,q T56 aW. lw0 •EIR.mn�PGOy. xrty.em 156�P0vph
M Ihl�,nem oll'arvrcw rsm ggw,unrtt sm,u pmrM W rnplytt. 1()w ztd m,mnw,ormr m'rmw
mtl rtelmY Inan Jlmlwe f tle (amat pleen mn,s'I,M JelMmm, Y WFI66JI51 LAITY 6RFE6F8)T
St Croix County, M
Conducted! for Shirley L Brander Trust
4B9 Country Vier Road
Hudson. WA M016
Legend
PID: 020-1230401-000
Lot 4 Rossings Country View
w--
NW1/4 SE1/4 S29 T29N R19W
_
^'
Tern of Hudson
_—
Conducted by Thoras J Schi
CST 227429
9111/2020
n..w
Fwr
w
`
41
wuz{i, / bnmiv>au.RMwE6
m�
7"Ti"
" ®
1
N
®100 00' Bottom of siding on the walkout side of the house
4 Own
BBBMMM 222 103 41' Top of inspection pipe on existing septic tank
m
i mee-,1C_ 104
AS BUILT SAMELEu. , sCTIE REFORT
.m ss RR*/ A,ie1tr aou camfi, nsoxsis s
.s "An wL crag
sueuivulanga , wr�e/ size a Lf 4....
y my Oto-/13o-yo( X1
/3lt
Olrtmeo and CYmlwa t. .eee T".irmmn of 11M 83
eauCwwe: n...tum tn....tsea ee .an t nn m I" Tp s w f r
et..rtlen of "Ift"i f.r.t.o fe .m JNO= V.3%n...e aop..t .1 an -
swig i.Ytt, M... f.etu...T w1;wr iquid c.e•tl Y, mee y)nl
Newt of tine. �. I e... ml...... .I ... t a. J6
i.nt mirt e1w.. a Tank 7.w6
Elm mormt nt.v.rtline : nongOsm.Owe,® t
Nwb,' of feet Elm. wil � milaHg: fi4 al'[,Er..,,/ ka,
lan.lwoanES Infa:..uan of tM .b ?1.1 ni.n)( z t.b t tnU
2 gFYbe SEES
P,pT,. yy
Steel ....T". dzT Liquid Gpeel y
» wP„fph n f twee` .� alma _
lievatim of Intel ew exh elx.rt
Pw, off Settee elxett l... Set .,
Stax....faexr ee eb,yp.
mbernf hw.wext prupertyl<w. t,O,u..O...r.pR._
P.Mer If feet frw ,11.
r p x m twitg:
(let'",, i'ew... I, Flue plan).
wu uwVpwn grsrd
•J:�
Width ef, L.ngth 346� H.b. .f Li"'. S an 1ti LwfTn
Fill a.pth fe enp fFile. 4o"
N,,b" of het froenur..t prop ty IIDx v .nn 1, O aide. O Rxr,eh. le
Pumbx of feet from Fall, ,S
Nmbe..f feet flew h.ilnfrg s2
(hteme died"", en Pill pan).
TIS
ssv St � meet .f pit, e
Liquid depth � buttom of seepmad pit Situation'
mes .1tFhef.tew We .r rlb.ea0 a....ea.n SIT
.f IS, nea Sett
.hwrbtL.. 17wet (uxn.ee)1efx m
OG
m LI�Y�xr AA pate
RMrt of ring, v — flee.elm, of Wetw If tee
Radler of feet from nxreet pr.p y Fault. 0 Side. Omt, DPt
ewbrt of feet ftv Fa31
epee. If felt flon building
ember at feat III, n,,reat Mail
lwp"t". qq�. Lpp R (}�p�
Mt Plumbee .n Jib, .�/t;
L,ew.e x : M )M s
31".v
DEPARTMENT OF rxoUSTRY, INSPECTION REPORT FOR (� � SAFETY e BUILDINGS
I BOaHUMAN RELATIONS PRIVATE SEWAGE SYSTEMS) v IiDivisim
NAD ;pSURNOT OF PwueiNG
SW E.�9Pf�TP9N- R19W hQFGrvvervTlorvAv ❑ALTERrvA.nvEV
rtt 061Odd Oi ❑HOItlmq Tank ❑In 6rwntl Pressure ❑Mountl
i I104% COW 'ull
n..mrnxn.em.
.owe„o. Li—
ry xn.v.u,
heIIwn
/G-2o-kfl `3a
.:...�.
hildens
.,,..,
t. caul
112 80 3
EEFNFAi. xKIMOrDING TANK
,.4
MADL
rD(M.. gs';a9ARL,.
4v...r
over ONO
OrEs NO
FEETflDM'-LEE
KILL AMAM,A'
DYES ONO
DYES NO
❑ !Su G
GA�tONS PENcycEE w.... .o..,e.,w....�.,.'_ xGMGExOF-. ....r.,. ... .�. ,. .,�.....
ID�FEExErvcE RE
TEEN cyEG r,
GFA_
OF G FORCE
the Fee IS HER MOugh to continue MAIN
A WIDTH
% 18 44 S"�nek
��.�.np
••9'4.`.�19I
'It
eE
..o�`U�—�•.=�.
I foa
r
.l [
z7 r-s
7
OUNDSORSTEM
M... delta plowetl perpoechmar Redeem CLOCK the fill More PROVIDE A DIAGRAM OFSYSTEM
ReELEVA-
M iuweYEwn vO.IOP❑NO
e6ehevTgena br metlwm eantl RIDGE MEASORED.SN
wEM.vv„
mw.x.m........ .
.x ...Mums.
]rss No
cYEs ONO
_
MILESONO
Oyler ONO
PRESdURIUED DISTRIBUTION
SYSTEM
EM
VAN I'LL"
MEG P.,
ISM
FIFE
Di PIPE MATERIAL & MARKING
E:S�TR
— — ONLRY IOYES
oD N
oyes ONO
CWMENTS,..,
ow.
- ..�
rRe.,....,..
HOLDING
4,38
❑YES- ONO
_ ❑YF c1
gKAU 5-G'+
ME
S/
GIs
notsh III On M A fibe to, Gua r
PIPING Side
xx seosno�N allaxl ZoR419 AAlwx.leten
DI