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Home My WebLink About030-2125-80-000 W consin.Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safetyand &silding Division INSPECTION REPORT Sanitary Permit No: 430124 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Gerhard, Bob St. Joseph Township 030 - 2125 -80 -000 CST BM Elev: Insp. BM Elev: B D scription: � Section ( rown /Range /Map No: /0 • o // U D • Q L4 — /') `" 25.30.20.1022 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � Benchmark Y Dosing (/1/ Alt. M JZ � �0 {�-t Aeration Bldg. Sew r d ,O Holding St/Ht Inlet Z 12's TANK SETBACK INFORMATION St/Ht TANK TO P/L WELL BLDG. Vent to it Intake ROAD Dt Inlet Septic f \ / Dt Bottom I Dosing / Bader /Man. Aeration • 0 Holding Bot. System Jn C ' Q � /I 1 - -- Final Gr e ( I)F pe,,,-- FF PUMP /SIPHON INFORMATION S/ 3 1 5 , j S ��4 Manufacturer Demand St Cov r _ GPM �Q k '8&' Model Number 121 IPA VA) TDH Lift Friction s System Head J TpH Ft 1 Forcemain L Dia. Dist. to Well SOIL ABSORPTION SYSTEM /� (' ��cZy� - ✓ .,1< r,;� BED/TRENCH Width / Len h ll No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREA LEACHING Man re. J_ _ INFORMATION CHAMBER OR � Typ Of System: f UNIT �I06 W Model Number: DISTRIBUTION SYSTEM UJ J HeadedMa ' olft Distribution x Hole Size x Hole Spacing IVent to' it Intake r kej-. Pipe(s) / t � — Length Dia Length Dia Spacing �L��_ SOIL COVER Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over 1 pth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center rench Edges Topsoil I Yes 1 No (, Yes No A. COMMENTS: Inclu code discrepencies, persons present, etc.) Inspection #1: Jb/ 11 v Inspection #2: Location: 1357 Birch Park Rd Hudson, WI 54 16 (E 1/2 qW 1/4 25 T30N R20W) Birch Park Lot 18 Parcel No: 25.30.20.1022 1.) Alt BM Description- �(n(�� /4�f� 4W, YY�� 2.) Bldg sewer length - amount of cover =�� ✓t.�c_ G��c� y Plan revision Required? Yes WNo Use other side for additional Information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) mm IMMEMMI ffiffinampom MENOMMEM moss ■■■■N■NN■■■mmom_P- MommoN.m "I! Ir ,� ■ ■ ■■■ ■r■�� ■ ■!!� ■ ■��■ mom N■■NN■N %as nowmot■■■�■mo__m_i ME Ew NOON ■ ■ ■ ■ ■ / /�`�iiii' :��' ..r��Ir� ■ ■ ■■■N�,/iN�!' '� ■ ■ ■ ■ ■ ■ ■■ MMMEMNON ■ ■ ■ ■ ■■/� �� _ ice!_ .,� ■ ■ ■ ■ ■ ■ ■ ■■ MEMO ■ ■ ► ® ■N... �� i ■NMEMME ■ ■ ■■ NOON■■ / ■ ■ ■ ■ ■ ■■ 0 02 .. .../■► ■I N■■N■■N ■NNNN / /■�i■�■■■ - !�!'i■■■■■■■■■a No ME ■ IVM ■ NONE NNI N mom ■■ .■ ■■ ■■■� ■■N/ ■NN■■■■N■ W�..m N,��iN/ /ANN■■ �_ -�■�■ SriSOri■SS■■■S r� ■■■■■■ ./V / /M■N■ ■O■■� ■■■■■■ %m /■■ ■N, �N NO ■ ■■■ No N ANA 00 P /► \m ■ ■ N ONE ■one ■ ■ ■■■ ■■■■ ■NN■ us ONE �■ ■■ ■;rte■ ■ ■■■■■■ ■ ■ ■ ■■■ ■ ■ ■■ son ■■rll■■■mil■■■■■■■N ME mom NSN ■■■mmem sun SOON ON mom Em Noun MONSOON mo /�� mom NOWN NEE\M ■ ■ ■ ■ ■NU ■■rM ■ ■ ■ ■ ■ ■■■ ■ ■ ■N NONSENSE \ \MEN■■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ■NOO MEN ■Sam ■■►\ ■ ■ ■■N■ ■■■■N■■■■■ ■■N■■■■■■ ■\NEEMS MEN ■■■■ ■■■■■■■N El l "�� ;,• .;. � , fir � •. �tacunr .. .1.. • .M a. .., a, rr.r r. r • • •1 •: r f.Y 7 • i ■ 1 i MWI VA AV IF VA ,. :::: �f:. I •. ■ ■ ■.ra1)Cf M -`i , to � i. � .': :ri ■.• r a ,C. 'I1 1_ Iffi is �' � •�' /��y'�• ' o, f � try ` 1 g not ■ l / OF "' ■ III... r........ . VA 1 • • ll:I�1 •. ■�'1 A.r.yy�I�S ��r�' :: �:il ii Ilr. ��r •: �, . .I■. Marl.. ■nala {.11 ..ryka�rli ......� � I{ • /lf 1■1r IIU 11 Nr11 ■r 111.11 rI1 ..':�• q .� ir. f 1 uy.l r.ru a Ib II /ur i �[ t � : L `•��al br,M r ,ar �i WI "� L rrr An— � �i �E� �•• • Ir 11 •. HrlrfrlNl ■ .. -.a •... J ■ i; .�10 i4,, Z. {� li►lr i 9 ' /{ i cy. t`llr.l r,.•. • � 1■IY �gi,'iyl� V�i�i7 ��. � •{�a Zir��,'��°Ci_�. s =� r S �fg•..•;=e •• I Oa ! r i:r.K ■ RI M . Use i w RI .� .�:; "..,;. r ?a fa•• Safety and Buildings Division County m 201 W. Washington Ave., P.O. Box 7082 N Isconsin Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 261 -6546 Sanitary Permit Application State Plan I. umber In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s15.04(Ixm) Project Addr (if different than mailing address) I. Application Information - Please Print All Information roperty Owner's Name m _ _ 1 # Lot # �� Block # ✓ 1/? I Property Owner's Mailing Address J U 1,3 a 7 0 U Pro Location Ci mate / e ty,� ip Code Pone bbr �� ' Section R-- T N; o , II ( . Type of Bui 'ng (theck all that apply) Id 1 or 2 Family Dwelling- Number of Bedrooms `� S` e;.,., ligne CSM Number ❑ Publk Commercial - Descrbe Use /1 ❑State Owned - Describe Use �� l� ❑City ❑Villa {�7 wnship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) - A ' New System ❑ Re Sy Y� ep ys ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of 11 Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a 1 Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In ound ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Cham t - er (explain) V. Dis ersaUTreatment Area Inf rma 'on: t Ch Design Flow (gpd) Design Soil Applicati Rat t Dis�Area �uired ea Proposed (sf) Syst Elevation c 4�qNrz�_ (v 0 . Tank Info Capacity in Total Number Manufacturer Prefab Site toel Fi Plastic Gallons Gallons of Units / //� Concrete Constructed Glass New Existing YV Tanks Tanks I �" Septic or Holding Tank � — 7 Aerobic Treatment Una losing Chamber VII. Respo sibility Statement- I, the undersigned, assujne responsibility for installation of the POWTS shown on the attached plans. Plum s are Print) Plumber s Si MP/MPRS Number Business Phone Number PI tier's Ad (Street, City, State, Zip e) VIII. ounty /De artment Use Onl pproved ❑ Disapproved Sanitary Permit Fee (includes Groundwater D Issued Is ng Ag t Si to tamps) Surcharge Fee) 61) ❑Owner Given Reason for Denial I� Conditions of Approval/Reasons ens for Disapproval Ownl/L, vim Jl��i ham 3 Attach complete plans (to the County only) for the system an paper not less than ain sit inches in size SBD -6398 (R. 08/02) I ,� �i°'.s1!s{ / /!.�',P/l� -��g� ,>� C'elrow�• �.C�DG'.0 r - ,gr� Ai 9v �s - 1 sYSg _ k 6 y .a 3 FIE I, 3 //WS d� ?� �'lli�l�r�i�, ..f/"� ■�J.�, ■ ■ ■ ■ ■ ■ ■ ■■ ■tea_ _ MENOMONEE mm Wl mom ME momas *own mommum EEEEEEEEaaEE • s m 772 1 EVESIM■■■■M ■ ■ ■ ■ ■ ■ ■ ■ / /■■N A!�11.. iW - w. ■� ■.��i ■ ■ ■ ■ ■ ■■ ■■■■■■■ /E■ ■��m Eli'� _ �!� ■ ■■ MEMO MME■ME■ ■^__ -1� !AWN.- ►� EO►i ■E■ ■■■ SOMEONE ■ ■ ■■ IEEE. �!■ /� ■ ■� ■��f1O ■MM ■ ■OM■ ■ ■ ■E=N ■ ■E■E■ ■O■■ 0■ MUNEWIMEN NNE MMM ■�r■a■MEE ■EEO ■EEEEEE ��_... M■NNE■EEEE .�aE ■E sa■ ■►aE mom ■ ■ ■E`E ■ ■MEMMEMEM ■■■ ■� MEN■■■■ MEMEN■EMEE /i■E ■■ MEE �rso !7E■ M■■E■EEMEWrAM ■■MOM■■ / -� aye ■■ EMEMEMEM ■ ■■ ■ ■■ ■■mom ■■ ■■■■ '! �o■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■E■ ■ ■ ■ ■ ■EMME ■EM ■ ■ ■ ■ ■ ■ ■ ■ ■E■■■E ■ ■EE■■E ■, 6EEE■ ■ ■ ■■■■■■E■ ■■■■E■■■MEM■Eno M■ESE MENEM ■■MEMO ■■■ME ■ ■■E ■ ■EMEEMM Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. Croix 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 1. D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R iewed y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location rl Quest Development, Inc. Govt. Lot E 1/2 1/4 SW 1/4 S 25 T 30 N R 20 E (or))W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Suite 150 10700 Old County Road 15 18 1 1 Birch Park city tate Zip Code Phone Number I Town Nearest Road ty p Ity � Vll age Plymouth MN 1 55441 ( 7¢3 -595 -9512 County Road E New Construction Useo Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD Replacement - Public or commercial - Describe: Parent material Flood Plain elevation if applicable / ft. General comments This site is suitable as a below grade conventional system, and recommendations: 7? 1 2002 ST �ROIX g , COt)NTY F Boring # ❑ Pit D Boring Ground surface elev. 85.35 ft. Depth to limiting factor > in -� X W.71.2 to Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary 6ets� in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 2 1 0 -30 10yr2 /2 is Ifgr mvfr cs 2f 2 30 -98 7.5 r5/6 s Osg ml - - .7 1.2 r D I r atz a Boring # ❑ Boring 103.95 >98 Q pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -28 10yr2/2 1s Ifgr mvfr cs 2f .7 1.2 2 28 -98 7.5 r5/6 s Osg ml - - .7 1.2 I * Effluent #1 = BOD > 30 : < 220 mg /L and TSS >30 < 150 mg /L * Effl < 30 mg/L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 12/10/01 715- 246 -2454 Property Owner Quest Development.Inc Parcel ID # Page 2 of 3 3 Borin # Boring g Pit Ground surface elev. 85'92 ft. Depth to limiting factor >98 in. Soil 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 I *Eff#2 1 0 -98 10yr2/2 - is Ifgr mvfr - - .7 1.2 ❑ Boring # Boring n Pit Ground surface elev. ft. Depth to limiting factor in. Soil 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 a Boring # Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil 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 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L 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. SM- 8330Test (R.07 /00) �rc� 0 ' � 1 w c� c 0 6 e z� v N / 1� loo f� 1 8535 6(1 10SAS 2 Z 7 3 53 7 P 1-0 To 13 6 - �9 �O + N61V iti D / vi p 0,,f L ):) rod /SYv tk� Cam oic 6 Xi s T i ;U G- ? /NS -> *// pE,eMt' i s 69 3D . 2-,/)3 I • Z 6). oi5ry ceN T�-e- T' IiiS. 0 30. Z 03 SD • oav G �'GC�u S�� A1ASTEi D 3 - 2.0 ?k - 0 •&`Z 3d Z U leo . Ulbricht & Associates Private Sewage Consultants 0 - 3 D 6ss O'Neil Rd. l/ Hudson, Wis. 54016 �15. 3 ?(0 - ?/1? S 7/ S - 77:). • 3 ye{2- ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATE FORM Owner/Buyer _ DDb 6tXhGl,trA.,/�yy � I�cv-)c '1U�i Mailing Address 10 17 2 ��eS+ 1.r1 wood bu r �5 Property Address 1 3 5 - 1 _'E;f<rC�%&y " t-1 td5o Wt 54 I k ,�2 (Verification required from Planning Department for new construction) ~� City/State � Vdcpco 14 W I Parcel Identification Number 030- - L 125 -W- COO LEGAL DESCRIPTION (W Property Locati onj 'A 5j4 ''A Sec. 25 T -�!C&R 20 W, Town of S -:&JpG - Subdivision p1 rth, Lot# p _e jfled Survey Map# `%olurre _ Page Warranty Deed# 126 1 (2_ Volume Page 3 5 _ Spec house yes V no Lot lines identifiable d es no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on- site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by th Department of Commerce and use the Department of Natural Resources, State of Wisconsin Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within I Oda,. s of the three year expiration date. - ZN a4cv 9 03 SIGF4ATb4kE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. — & �� s 03 SIGNATIjRR OF APPLICANT DATE 0000040 Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department••••• •• Include with this application a stamped warranty deed from the Register of Deeds office a copy of the certiQed survey nap if reference is made in the warranty deed. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _�_of j FILE INFORMATION SYSTEM SPECIFICATION Owner / _ Septic Tank Capacity al ❑ NA Permit # Se ptic Tank Manufacturer o NA Effluent Filter Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Mo ❑ NA Number of bedrooms o NA Pump 'yank Capacity al -4 NA Number of Commercial Unit -d NA Pump Tank Manufacturer ANA Estimated flow averse gal/day Pump Manufacturer s NA Design flow (peak), Estimated x 1.5) : — al/ ay Pum Model ra-NA Soil Application Rate gal/day/ft' Pretreated Unit influent /Effluent Quality Monthly Average* ❑ Sand /Gravel Filter o Peat Filter Fats, Oils & Grease (FOG) 530 mg /L n Mechanical Aeration o Wetland Biochemical Oxygen Demand (BODs) <220 mg /L ❑ Disinfection ❑ Other: Total Suspended Solids (TSS) < 150 m /L Manufacturer Monthly Average ** Dispersal Cell(s) Pretreated Effluent Quality El NA Xln- ground (gravity) ❑ In- ground (pressurized) Biochemical Oxygen Demand (BODs) <30 mg/L ❑ At -grade o Mound Total Suspended Solids (TSS) <30mg /L ❑ Drip-line ❑ Other: Fecal Coliform (geometric mean <10 4 efu /100mL Maximum Effluent Particle Size ' /8 inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. ** Valucs typical for pretreated wastewater, MAINTENANCE SCHEDULE Service Event Service Frequenc ns ect condition of tanks At least once ever o mo nths ears (Maximum 3 rs) lump out contents of tanks When combined sludge and scum a uals one third '/� of tank volume ns ect dispersal cells At least once every ❑ months ears Maximum 3 rs) lean effluent filter At least once every ❑ months earls s ect p ump, pump controls & alarm At least once ever (i months ❑ year(s) NA lush laterals and pressure test At least once every o months ❑ year(s) ANA >ther: At least once ever ❑ months o year(s) �o NA )they: At least once ever _ ❑ months ❑ year(s) t;i,-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. Wank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any ,;racks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ,, round surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to _:heck for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a tiling condition and requires the immediate notification of the local regulatory authority. . "hen the combined accumulation of sludge and scum in any tank equals one -third ('/3) or more of the tank volume, the entire ontents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. Fhe servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. \ service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION i'or new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other Ihemicals that my impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have 'he contents of the tanks(s) removed by a Septage servicing operator prior to use. Owner: 2.(/ , L��Cn Pageof System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal high water levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact. The area within 15 feet down slope of any mound or at -grade soft absorption are. 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: -'e 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 es in effect at that time. sui bl eplacement area is not available u to setba and /or soil limitations. arri advan s in POWTS n to hold' tank may installe s a st re rt o repl c th iled P s t has of ee evaluat d to t enti a suits le eplac m tar • U o ailur of t e S oil nd site evalu ion m be pe o d to locate a suitable replacement area. f no replacement area is avai a ile a h ding tank may be installed as a last resort to replace the failed POWTS. o 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 the time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTAL POWTS MAINTAINER Name Name Phone Phone ' IEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REG LATOU AUTHORITY Name Name Phone Phone j J 2 2 8 1 P 3 5 9 726486 DOCUMENT NO. I STATO BAR OF WISCONSIN FORM 1 -1982 p•L WARRANTY DEED KATHLEEN H. WALSH I REGISTER OF DEEDS ST. CROIX CO., WI !I RECEIVED FOR RECORD i! Thi Deed made between .......... ........ --.................. ................... 06/19/2003 Og:�OAw Birch, Park,._L..L.C,.,._ a.. nnesota .. limited-liability ........... �I (;QIAP.a?4y - - - _.......... ... ............. ..... WARRANTY DEED ............ .. ................. .. . ... ... .. ............. Grantor. REC FE EIPT # 11.00 and...... RAb.er.t.- A..- Gexbazd. and. JennifEr -.5 ...Daaahue,- .- ...- --••- ----.. hus_ hand_ and teife - CFEEE 200 OP E: . ii --------------- ........................................................ - ----- •-- -• - - -•-- Grantee, PAGES: 1 One - D la Witn T the sa Grantor, for a valuable Calt&ideratinn I -...k uRii Fai;_ etn�e�T.'1le �nueJ conves to Grantee the following described real estate m �tr..- CFAIX......_..._ �, �2 rC 1 300 County State of Wisconsin: } Q " Tax Parcel Lot 18, rch Park, St. Croix County, Wisconsin Opp i i it ;I �I li i, i' This ....... ----- homestead property. (is) (is not) Together with all and singular the hereditaments and g g appurtenances thereunto belonging; And......... B1.rcb...FArk,....L. C..----• -- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations of record, if any. and will warrant and defend the same. Dated this ... 407,3.Jl. day of .May:.. ...... ............................... jl ii .............- - ------ °-(SEAL) B. .0 . &...._.............• ....... ..---.(SEAL) By ....................................................... .... ... ............ ...-- - - - - -- Jam M. Waters, Its Chief Manager .................... - ........I ......................... ........ (SEAL) _... °-... -.... ....(SEAL) - -- i AUTHENTICATION ACKNOWLEDGMENT MINNESOTA Signature(s) ......................_.... ._......._.....__-- ............ STATE OF W ISCAWSW ss. _ -_ -- ----.. -- ..Count Z` authenticated this ........ day of ...................._. , 19_...._ en Personally came before me this 3 day of the above named , May'- 2002..__.... ' x -------• ....................°...--•---.._....... _....- ..- ........._...... -..... James M. Waters Chief Mana er of Birch �! ............................................... ............................... Park L. L. C_ t..a..Minnesota limited r: TITLE: MEMBER STATE BAR OF WISCONSIN liability company on beha• lf •- of the - • • o ..... th .-- --.... (If not . .......... .. limited liabilit com an authorized by # isJ - YaL)NCi• ......... .......y. p_._.y ... ryPublic to me known to be the person _- ....... who executed the Mlnneaota f ego inst ent and acknowledge the same. MY CommaW n Ezpkee,Yn.91.1006 ,I THIS INSTRUMEN i h.. l � .. .... ... ... . .. —. ... .:.. ..... .... L r`' r l ^`- 3o No ary Public _. - -••- ot ..__County. Tp&.MN (Signatures may be authenticated or acknowled ed.ot My Commission is permanent. if n, state expiration are not necessary.) data: ..................................... ------ -- - ----- 19_... - -._.) • - - - -- I, 'Names of persons .!RninR in any enpamty should be type) or printed below their eixnRturm. •• +nn. wT. nmrn STATE nAR OF WIRCONRIN wl- -,:in Ixeai Nlank Co. In,. 4 dl SE 1/4. and tM N" IA Of Vw Sir t/4 of Mw SE . srr IVAJ ! ion 25. 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