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Parc : 032 - 2016 -10 -010 06/29/2006 04:02 PM
�A PAGE 1 OF 1
Alt. P rcel #: 4.30.19.528A -10 032 - TOWN OF SOMERSET
Curre L U� ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # S s Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
KEVIN C & ANN M ERLITZ O - ERLITZ, KEVIN C & ANN M
685 N BAY RD
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 13.680 Pla N/A -NOT AVAILABLE
SEC 4 T30N R19W SW SW EXC THAT PART O BI ck/Condo Bldg:
CSM 611742 EXC PT TO HWY PROJ 1488/266
EXC PT TO CSM 16/4327 Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
04- 30N -19W SW SW
Notes: Parcel History:
Date Doc # Vol /Page Type
12/20/2001 665789 1795/310 WD
02/04/2000 617931 1488/266 WD
2006 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations ('! t Changed: 07/14/2004
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 13.680 27,400 0 27,400 NO
Totals for 2006:
General Property 13.680 27,400 70 0 27,400
Woodland 0.000 0 0
Totals for 2005:
General Property 13.680 27,400 0 27,400
Woodland 0.000 0 0
Lottery Credit Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel #: 032 - 2016 -20 -100 06/29/2006 04:02 PM
PAGE 1 OF 1
Alt. Parcel #: 04.30.19.529A 032 - TOWN OF SOMERSET
Current �X! ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
KEVIN C & ANN M ERLITZ O - ERLITZ, KEVIN C & ANN M
685 N BAY RD
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 22.660 Plat: N/A -NOT AVAILABLE
9 p
SEC 4 T30N R19W SE SW EXC PT TO HWY PROJ Block/Condo Bldg:
1488/266 EXC PT TO CSM 16/4327
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
04- 30N -19W SW
Notes: Parcel History:
Date Doc # Vol /Page Type
12/20/2001 665789 1795/310 WD
02/04/2000 617931 1488/266 WD
2006 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations Last Changed: 07/14/2004
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 22.660 45,300 0 45,300 NO
Totals for 2006:
General Property 22.660 45,300 0 45,300
Woodland 0.000 0 0
Totals for 2005:
General Property 22.660 45,300 0 45,300
Woodland 0.000 0 0
Lottery Credit Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
I
i
Parcel #: 032-2015-95-000 06/29/2006 03:50 PM
PAGE 1 OF 1
Alt. Parcel #: 4.30.19.527A 032 - TOWN OF SOMERSET
Current Xl ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
KEVIN C & ANN M ERLITZ O - ERLITZ, KEVIN C & ANN M
685 N BAY RD
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE
SEC 4 T30N R1 9W NW SW EXC PARCEL 527B AS Block/Condo Bldg:
DESC IN VOL 743/493 & EXC CSM 6/1742 &
EXC CSM 7/1844 EZ -IE- 1378/187 EXC CSM Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
13/3592 04- 30N -19W
Notes: Parcel History:
Date Doc # Vol /Page Type
11/13/2002 698163 2044/228 WD
02/04/2002 670125 1829/169 EZ
02/04/2002 670125 1829/169 EZ
11/17/1998 591832 1378/186 CSC
mo...
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/14/2004
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 8.890 17,800 0 17,800 NO
Totals for 2006:
General Property 8.890 17,800 0 17,800
Woodland 0.000 0 0
Totals for 2005:
General Property 8.890 17,800 0 17,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: 12104/1998 Batch #: PRGRM
Specials:
User Special Code Category Amount
I
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel #: 032 - 2015 -90 -000 06/29/2006 03:51 PM PAGE 1 OF 1
Alt. Parcel M 4.30.19.526 032 - TOWN OF SOMERSET
Current XI ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner
KEVIN C & ANN M ERLITZ O - ERLITZ, KEVIN C & ANN M
685 N BAY RD
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description
SC 5432 SCH D OF SOMERSET
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE
SEC 4 T30N R1 9W 40A NE SW EZ- IE- 13781187 Block/Condo Bldg:
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
04- 30N -19W
Notes: Parcel History:
Date Doc # Vol /Page Type
11/13/2002 698163 2044/228 WD
02/04/2002 670125 1829/169 EZ
02/04/2002 670125 1829/169 EZ
11/17/1998 591832 1378/186 0C
morG .
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/14/2004
Description Class Acres Land Improve Total State Reason
UNDEVELOPED G5 32.000 64,000 0 64,000 NO
PRODUCTIVE FORST LANDS G6 8.000 32,000 0 32,000 NO
Totals for 2006:
General Property 40.000 96,000 0 96,000
Woodland 0.000 0 0
Totals for 2005:
General Property 40.000 96,000 0 96,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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Vol.13 Page 3592
i
.,consin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix
safety and Building Division
INSPECTION REPORT Sanitary Permit No:
488243 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:
Erlit7, Kevin I Somerset, Town of 032- 2015 -95 -000
CST BM Elev: Insp. BM Elev: BM D iption: �1 Sectionrrown /Range /Map No:
I Z. q2.3 J� 04.30.19.527a
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic / 2 S Benchmar • / loo
Dosi Alt. BM t - `7
Aeration Bldg. sewe
Holding t Inlet ! / g p
TANK SETBACK INFORMATION t Outlet
TANK TO P/L V BLDG. vent to Air intake ROAD Dt Inlet G
ep is ) �bl) � 33� ��l'i�'�"'� DVB -Ottom
osing
era ion is S'
1 6, 3 - a
o rd mg B
F inal Uracle
PUMP /SIPHON INFORMATION ---"` lr✓ 4 ��- /
anu ac urer Demanci st cover
GPM
o e um
l n Os ys em Flea
W
mn I ifengin uia.
SOTE SYSTEM
DIMENSIONS 3/ CIA /
0 r /
INFORMATION � 3 �j
w b 3 S l
J`
Q r p
es)r Dia I LE n th V Dia Spacin th Q Q 9 9 g _S� � �—
x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Of
t
1 1 , F "'U I
Bed/Trench Center Bed /Trench Edges Topsoil Yes No Yes No
COMMENTS:- (Include code re a cies, p ersons pre nt, etc Inspection #1 / Inspection #2:
0 ' )o 7:
Locatio Unkno (NW 1/4 SW 1/4 4 T30N R19W) NA Lot Parcel No: 04.30.19.527a
1.) Alt BM Description = 96 - jv.. 6, ja2g"z -bl 4kle
2.) Bldg sewer length *_f l 31Y
- amount of cover 7 ` ���
Plan revision Required? I Yes i L4, — /^ �— /�
t7 � to �,Ct{LJ
Use other side for additional information. (/7/(/V�_
� i
�.- pate Insepc 6e, S+gna na C2 No.
SBD -6710 (R.3/97)
L,
I
A A, Safety and Buildings Division County
1 201 W. Washington Ave., P.O. Box 7162 , se i onsn Madison, WI 53707 - 7162 Sanita vPeNumber (to be filled in by Co.)
608) 266 -3151 J XS v (
Department of Commerce
State Plan I.D. Number
Sanitary Permit Appli �'
In accord with Comm 83.21, Wis. Adm. Code, personal inf ation ou provide
may be used for secondary purposes Privacy taw, s P ff ent than mailing address)
I. Application Information— Please Print All Information EIVED
Property Owner's Name
/r 1 V_ ✓� = JUN 1 9 2006 _
Property Owner's Mailing Address Property rocafion
ST. CROIX COUNTY
J Q _ Sa)' /., Section
City, State Zip Code
n !/ (circle o )
r�lC ! Qd
T, N-, R E or
�
II. Type of Building (check all that apply)
0 1 or 2 Family Dwelling - Number of Bedrooms � S
❑ Public/Commercial - Describe Use
❑ State Owned - Describe Use ❑City_ ❑Village STownship of O/'pF _ rP5e
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. It New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
❑ Chan List Previous Permit Number and Date Issued
B. ❑Permit Renewal ❑ Permit Revision Change of Q Permit Transfer to New
Before Expirat'i'on Plumber Owner
I t A 0q
IV. Type of POWTS System: Check all that appl
V No - 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- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe El Met (explain)
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (sf) Dispersal Area Proposed (sf) ystem Elevation
G 00 90,
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units �� Q� � Concrete Constructed Glass
New Existing u ^
Tanks Tanks
Septic or Holding Tank
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) m 's Signature /MP umber Business Phone Number
Plumber's Address (Street, City, State, Zip Code)
G
VIII. t:ount /De artment se Onl
Approved 11 Disa oved Sanitary Permit Fee (ipcludes Groundwater Date Issued Issuing Age Signature No raps)
Surcharge Fee) lT / i �fi�
El OwncrGiven Rea nial _3
IX. Conditions of prove val �,(J
SYSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained J J
as per management plan provided by plumber. G� '��^�
2. All setback requirements must be maintained
°
as per applicable code /ordinances. ) t3 t �^
Attach complete plans (to the County only) for the system on paper not less than Elrt x 11 inches in sit
BD -6398 (R. 01/03) — � Jos C UAA
� 1
�te PUS i;f �iY j ai- �NS�DEC_r" /OM B FI /�ES _�_.
VA 7 .2"
A 6 e 5
70,
(;6/ O/1iUcu�Ar E=�IS�7Ety i �/0. P.L r
_ 1
At
, AP &� �` goo
t
T/i ENcd�S y BA50
2 �
IvZ�O G� S, i //l moo Ai :E2
/
yy
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- l9 v G ok, c)/rG 6
/ter El l 7z—
,��` ►__
U8�;' A 13hy Ra Ma y 1116te" 72
" pU'C _ y�dti _ rrspa� 1�� �S
- -- -
SCA - --
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r
- _ �6i iOkrvecvA eA s�tEN� y�. ,�,�.
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-
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, AREA
-
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oo
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- - -�.• Haste "�-, 96
t IPSO 6: S. 7. // ioo A/
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t �... � � �/ 1378
Wisconsin Department of Comrrrerce � �-� N PORT Page of 3
Division of Safety and Buildings ' ccordan with Gomm 85, Wise MR
. Coc Tom Schmitt
Attach complete site plan on paper not less than 8% x 1 inches in size. Plan must County
include, but not limited to: vertical and horizontal refere point St. Croix
percent slope, scale or dimensions, north arrow, and n ar� N Parcel I.D.
032 - 2015 -95 -000
Please print all infonnabon. f evjdwed By Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / 2�� 7
Property Owner Property Location � (4
Editz, Kevin & Ann Govt. Lot NW 1/4 SW 1/4 S 4 T 30 NR 19 W
Property Owner s Mailing Address Lot # Block # Su ame o S ' _ CL / CCMA
685 North Bay Rd. na ? CSM 743/49 8.890 Acres
City State Zip Code Phone Number j City Village 16 T Road
Somerset I WI 1 54025 715 - 247 - 3778 Somerset 50Th St.
New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
_I Replacement J Public or commercial - Describe:
Parent material Outwash Flood plain elevation, if applicable na
General comments ✓
and recommendations: Area is suitable for a conventional system with a 0.5 gpd /sgft rate. Possible system elevation is 90.50'.
Slope is 6 %. -
Boring # J Boring
0 Pit Ground Surface elev. 93.95 ft. Depth to limiting factor 125+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
eP P ry
*Eff#1 *Eff#2
1 0-6 1 Oyr4 /4 none Ifs 1 csbk mfr cs 2vf .5 1.0
2 6 -16 1Oyr4/6 none fs Osg ml gw 1vf .5 1.0
3 16 -51 1Oyr6/4 none is Osg ml cs -- .5 1.0
4 51 -55 7.5yr4/6 none grs Osg ml cs -- .7 1.6
5 55 -59 1 Oyr4 /4 none Ifs 1 msbk mfr a .5 1.0
6 59 -125 1Oyr6/4 none s Osg ml --- .7 1.6
F
q0, $t7
a Boring # .-.I Boring
sm Pit Ground Surface elev. 93.95 ft. Depth to limiting factor 124+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF
*Eff#1 *Eff#2
1 0 -7 1Oyr4/4 none Ifs lfsbk mvfr gw 2vf .5 1.0
2 7 -17 1Oyr4/6 none Ifs 1csbk mvfr gw 1vf .5 1.0
3. 17-43 1Oyr5/6 none fs Osg ml ce .5 1.0
4 43 -55 1 Oyr516 none Ifs 1 msbk mvfr cs .5 1.0
5 55 -124 10yr6/4 none s Osg ml — ---- .7 1.6
* Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <_30 mg/L and TSS <30 mg/L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmitt may, 227429
Address Tom Schmitt Date Evaluation Conducted Telephone Number
1595 72nd St., New Richmond, WI 54017 9/10/05 715- 247 -2941
Property Owner Erlitz, Kevin & Ann Parcel ID # 032 - 2015 -95 -000 Page 2 of 3
*
F31Boring # Boring
i/ Pit Ground Surface elev. 97.85 ft. Depth to limiting factor 136+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GE
*Eff#1 *Eff#2
1 0 -7 10yr4/3 none Ifs 1 msbk mvfr gw 2vf .5 1.0
2 7 -17 10yr4/4 none Ifs 1msbk mvfr gw 1vf .5 1.0
3 17 -37 10yr4/6 none Ifs 1 csbk mvfr cs .5 1.0
4 37 -136 10yr5/6 none fs Osg ml — .5 1.0
0 5d S
Horizon 4 (37- 136") has 2" bands of Ifs 7.5yr4/6 1 csbk mfr
F—I 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
*Eff#1 *Eff#2
F—I Boring # �j Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Gpn
*Eff#1 *Eff#2
* Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD s —
< 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.
Page 3 of 3
Conducted by: Conducted For:
Schmitt Soil Testing Inc. Name: Kevin and Ana Erlitz
Thomas I Schmitt, CST 227429 Address: 685 N. Bay Rd
1595 72nd St. City, State, Zip: Somerset, Wl. 54025 M i3 n5% CS
New Richmond, WI. 54017
Phone: 715-24 -2941 Subd.Name: NA C 743/4 8.890 Acres
Lot No.: NA
c7i Legal Description: NW1/4 SWIM S4 T30N R19W
® Backhoe pit Township, County: Somerset, St. Croix
Bench Mark EL 100.00' Top of 2" pvc pipe
Bench Mark EL 92.30' top of 2" pvc pipe
Slope= 6%
Scale I 40'
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner r Septic Tank Capacity a l ❑ NA
P it A Septic Tank Manufacturer � ❑ NA
DE RN PARAMETERS To Effluent Filter Manufacturer �� ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model A V00 ❑ NA
Number of Public Facility Units N NA Pump Tank Capacity a l ■ NA
Estimated flow (average) g al/day Pump Tank Manufacturer ■ NA
Design flow (peak), (Estimated x 1.5) 4 100 g al/day Pump Manufacturer 0 NA
Soil Application Rate , j al /da /ft2 Pump Model i NA
Standard Influent /Effluent Quality Monthly average Pretreatment Unit i NA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (SOD 5220 mg /L ❑ NA O Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD,) 530 mg /L @ In- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510' cfu /100ml ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. O NA Other: ❑ NA
I Other: O NA Other: O NA
`Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA i
MA ENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA
A y ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume O NA
Inspect dispersal cell(s) At least once every: ® month (Maximum 3 years) O NA
Clean effluent filter At least once every: month(s) ❑ NA
Ira ❑ year(s)
Inspect pump, pump controls & alarm At least once every: ❑ month(s) 0 NA
❑ year(s)
'
Flush laterals and pressure test At least once every: 13 ❑ month(s) ■ NA
Other: At least once every: p month(s) 13 NA f
Other: O NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks;
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. `.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may.indicate a failing condition and requires the '
immediate notification of the local regulatory authority. - -
When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume,. the entire-:!
contents of the tank shall be removed by a Septage Servicing Operator.and disposed of in accordance with chapter
*sin Administrative Code.
Af1'�lher services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.':
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
L -
` Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
m start up shall not occur when soil conditions are frozen at the infiltrative surface.
g power outages pump tanks may fill above normal highweter levels. When power is restored the excess wastewater will be
discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may'result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or-must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< < WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MA INTAINE R
Name C Name S C All C
Phone �5 _ Phone
SEMWE SERVICING OPERATOR (PUMPER) LOCAL REGUL AUTHORIT
e _ C O/ Name s!. ClJu
r
Phone Phone _
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. s'
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer X11 /.✓ ae- A& A / BSI L i i 7
Mailing Address a 2 s�
Property Address — 7/, 5 7.
(Verification required from Pl nning Department for new construction)
City/State ,�ONfjgFit St e aZ, Parcel Identification Number
LEGAL DESCRIPTION ( I
Property Location -4W- '/4, (dL 1 /4, Sec. T,_IQ.N- R.L�_W, Town of
Subdivision Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # Volume 0 1; , Page #
Spec house ❑ yes 8 no Lot lines identifiable ® yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists ofpumping 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.
i
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your seppic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days ��thqAr ear e
GN TURE PLICANT DATE
OWNER CERTIFICATION
I (we) ce that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of I
;IGNA prop virtue of a warranty deed recorded in Register of Deeds Office.
/Z2 Oti
OF APPLIC DATE
� e
* * * * ** Any infordiation that is mis- represented may result in the sanitary permit being revoked by thalZoning Department. * * * * **
** Include with this application: a stamped warranty deed from the Register of Deeds office !r
a copy of the certified survey map if reference is made in the warranty deed '
3
' E
i
t
i
I
,,,,. 18?9PAGE 169
Document No. Ea 7 01. Za 5
KATHLEEN H. WALSH
EASEMENT AGREEMENT RE61STER OF DEEDS
ST. CROIX CO., WI
Re: A 66 ft wide easement for access located in part of the NW 1/4 of RECEIVED FOR RECORD
the SW 1/4 and in part of the NE 1/4 of the SW 1/4 of Section 4- 30 -19, 02 -04 -2002 10:00 AM
Town of Somerset, St. Croix County, Wisconsin, further described as EASEMENT
follows: Commencing at the West quarter corner of said Section 4; EXEMPT A
thence S03 degrees 55'35 "E, along the West line of said SW 1/4, CERT COPY FEE:
COPY FEE:
683.10 ft; to the point of beginning, thence N89 degrees 1845 "E 1452.19
TRANSFER FEE:
ft; thence S03 degrees 55'35 "E 66.10 ft; thence S89 degrees 18'34 "W P AAO CE S: FEE: 23.
1452.19 ft; thence NO3 degrees 55'35 "W along said West line 66.10 ft.
to the point of . be innin
g g
This Easement Agreement is hereby entered into by and between Return to:
Beverly M. Lloyd, formerly known as Beverly M. Erlitz, and hereinafter D.Peter Seguin
referred to as "Lloyd" and Kevin C. Erlitz and Ann M. Erlitz, hereinafter Mudge. Porter, Lundeen & Seguin, S.C.
referred to as "Erlitz "; 110 Second Street
Hudson, WI 54016
WHEREAS, Erlitz are the owners of Lot 4 of a Certified Survey Tax Identitleation No.:
Map recorded in Volume 13 at page 3592 and Lloyd is the owner of
unplatted lands adjoining the said lot in the Certified Survey Map as 032 - 2015 -90 -000;
referenced herein and being owned by Erlitz; and 032 - 2015 -95 -000; and
WHEREAS, all of the parties hereto have an interest either by 032 - 2015 -95 -500.
way of specific easement or by inclusion within the legal description to
their lots in the above described access area located off of 50' Street,
Erlitz lot being to the north of said access and Lloyd's unplatted lands adjoining said access being located on
the south and east of said access; and
WHEREAS, the parties hereto wish to and confirm their respective individual and common interests in
said access point from 50 Street;
NOW, THEREFORE, for good and adequate consideration, including the recitals and provisions
contained herein, the parties hereto do hereby agree as follows:
All the parties hereto agree and consent to the others' unrestricted and non - exclusive right to the use of
said access area as more fully identified herein.
Erlitz and Lloyd shall have the right to the unrestricted but not exclusive right to the use of said access
easement for purposes of ingress and egress to their respective lots and/or unplatted lands.
The parties hereto agree to be individually responsible for the construction and maintenance of any
driveways which may have been or which may be constructed from said access easement area onto their
respective properties.
The parties agree that they will be individually responsible for the construction and maintenance of any
common roadway located within said access area as follows:
Erlitz shall be responsible for one -half (%) of the cost of construction and maintenance of any roadway
Page 1 of 2
V 2049 P 228 698163
REGISTER OF DEEDS H. WALSH
WARRANTY DEED ST. CROIR Co.,
MI
DOCUMENT NO. RECEIVED FOR RECORD
11/13/2002 09:30AA
EXERT #
REC FEE: 11.00
This Deed made between BEVERLEY M. TRANS FEE: 525.00
COPY FEE:
LLOYD a /k/a BEVERLY M. LLOYD, f /k/a CERT COPY FEE:
BEVERLEY M. ERLITZ, f /k/a/ BEVERLY M. PAGES: i
ERLITZ, a single woman, Grantor and KEVIN C.
ERLITZ and ANN M. ERLITZ, husband and wife as
survivorship marital property, Grantees,
Witnesseth, That the said Grantor conveys to RETURN TO: S
Grantees the following described real estate in St. Croix D. Peter Seguin t ,r
MUDGE, PORTER ET AL. '
County, State of Wisconsin: 110 Second St, PO Box 469�
Hudson, WI 54016
N1 /2 of the SW 1/4 of Section 4, Township 30 North,
Range 19 West Tax ID# 032-2015-90-000 d r 0
EXCEPTING THEREFROM that part of Certified Survey 5 -�5 -000
Map in Volume 6, Page 1742 located in said N %2 of the SW 1/4
AND EXCEPT Certified Survey Map in Volume 13, Page 3592
AND EXCEPT Certified Survey Map in Volume 7, Page 1844
AND EXCEPT a parcel conveyed to Alice J. Fleischauer in Volume 743 at Page 493 as Document
Number 413344.
Subject to easements of record.
This is not homestead property.
Together with all and singular the hereditaments and appurtenances thereunto belonging; and Beverley
M. Lloyd, aka Beverly M. Lloyd, fka Beverley M. Erlitz, fka Beverly M. Erlitz warrants that the title is
good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and
reservations, if any, of record.
Dated this Z &!t day of November, 2002.
(SEAL)
Beverley M. Loyd, aka Bev rly M. Lloyd,
fka Beverley M. Erlitz, fka Beverly M. Erlitz
AUTHENTICATION ACKNOWLEDGMENT
Signature of Beverley M. Lloyd, aka Beverly M. Lloysl, fka Beverley STATE OF WISCONSIN )
M. Erlitz, fka Beverly M. Erlitz authenticated this ay of ) SS
November, 2002. COUNTY OF ST. CROIX )
TIT MEMBER ST E'B F WISCONSIN Personally came before me this day of November, 2002, the
above named Beverley M. Lloyd, aka Beverly M. Lloyd, fka Beverley
(Signatures may be authenticated or acknowledged. Both are not M. Erlitz, fka Beverly M. Erlitz, to me known to be the person who
necessary) executed the foregoing instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY:
D. Peter Seguin
MUDGE, PORTER, LUNDEEN & SEGUIN S.C. Notary Public, State of Wisconsin.
110 Second Street, Post Office Box 469 My Commission (expires):
Hudson, Wisconsin 54016
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