HomeMy WebLinkAbout032-2035-10-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No: 405196 0
ERA � INFORMATION (ATTACH TO PERMIT)
GEN State Plan ID No:
L
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: Village X Township Parcel Tax No:
City
Thompson, Curt & Mar aret Somerset Township 032 - 2035 -10 -100
CST BM Elev: llnsp. BM Elev: BM Description:
/0 0 5, o
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic - Benchmark A
Dosing `f Alt. BM . on 'f"
Aeration B ld. � Sewe
a 5 1 3. 73
Holding St/Ht Inlet
3.3
TANK SETBACK INFORMATION SVHt Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
S T n
Septic � _ � � /J � � � � / Dt Bottom _ � �. `37
Dosing}ST/ �1 I i �h Header/Mana . r rf, �'� �.�� • oZ
�
Aeration Dist. pe
Holding - Bot. System I 7�pn 1 3.3;
Final Grade
PUMP /SIPHON INFORMATION • 9 �� • 7 S
Manufacturer De St er 0 4V - V- -
r
Model Number
TD H Lift Ictign Los System�He dd TDH Ft
Forcemain Len (y Dia. Dist. to Well �� / N I
SOIL ABSORPTION SYSTEM z-1
e�
BEDITRENCH Width Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS O
SE'T'BACK SYSTEM TO v P/L BLDG WELL LAKE /STREAM Marryi�cfurer
INFORMATION A Ty f Syst em: - I AJ C,.— Model Number:
D RIBUTION SYSTEM
Manifold
IDistributio r x Hole Size x Hole Spacing Vent to Air Intake L Pi✓
Le gDi^ , pacing � �r � n th a
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only oi,B S
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges / Topsoil
�� LJ Yes No =; Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: r / Inspection #2:
Location: 1627 50th Street Somerset, WI 54025 (NW 1/4 SW 1/4 9 T30N R19W�)� NA Lot 1 / Parcel No: 09.30.19.607B
1.) Alt BM Description = T �( Qas� � JU144X_ +V/
2.) Bldg sewer length = l�/ 4 �dYr;�Q /$ �+� e( uuu •n C,� C(ti
- amount of cover = U N o JA4-1A,=4,,,d
em
Plan revision Required? Yes V<O
Use other side for additional Information.
SBD -6710 (R.3/97) Date Insepctor' s ignature Cart. No.
',
2} 5
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
�. See reverse side for instructions for completing this application PO Box 7302
Personal information you provide may be used for secondary purposes Madison, WI 53707-7302
Department of Commerce [PrivacX) s. 15.04(l)(m)] (Submit completed form to county if not
—0 S ,y L2- state owned.
Attach complete plans to the county copy only) for the system, on paper not less than 8 -1/2 x I 1 inches in size.
County . ^ rO
State Sanitary Pe it Numba ❑ Check if revision to previous application State Plan 1. D. Nub
I. A plication Information - Please Print all Information Location:
Property Owner Name Property Location
e &r a re ;6 _ZZa sdo? t•V IANOIA, S F T 30,N, P/J6 W
Property Owner's Mailing A, j Lot Number Block Number
,3 ZZ Wes C� ;he T. CROIX COUN (Y /
City, State Zip Code Phone Nb&b H(3 u r F Subdivision Name or CSM Number
;ll M SSO �'�. � 39 -02X �/ 3$77
Q , ❑ City Il. Type of Building: (check one) dS �Strio•wr ! ❑ Village
❑ 1 or 2 Family Dwelling -No. of Bedrooms : I &-T6wn of
❑ Public/Commercial (describe use):_
❑ State -Owned
Nearest Road 570 -6� cL
Parcel Tax Numbers)
IIl. T e of P it: Check only one box on line A. Check box on line B if a licable 5 6, ❑ Addition to
A) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. ExistiEL System
System System Tank Only Date Issued
B) Permit Number
❑ A Sanitary Permit was previously issued
IV. T e of POWT System: (Check all that apply) ❑ Sand Filter ❑ Constructed Wetland
on- pressurized In- ground ❑ Mound ❑ single Pass ❑ Drip Line
• Pressurized In-ground ❑ Holding Tank g
• At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dis ersal/Treatment Area Information: p K/ fQgc.�. oa'. E sTA = S ri . ckgLPM ¢r
w (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. Syst Elevat on 7. Final G e
1. Design Flo
Required Proposed Rate (GalsJday /sq. ft.) (MinJinch) of Elevation
0. 7 114 9.3.
VII. Tank Capacity in Total of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- gloms
New Existing cretee structed
Tanks Tanks
17'' ❑ El ❑ ❑
71_0
VIII. Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Business Pl:ore 1lumber
Wes e (print) PI ber's Signature (no stamps): Mp/NLPRS No.
C.l�ane // Z50 36 �s 3�0 - Z
s (Street, City, State, Zi e)
o a /� 4e / rr ��✓, 1 �J
IX. County/Department Use Only
❑ Disapproved I Sanitary Permit Fe-e I ncludes Groundwater Date Issued Iss in Agent Signature (N tamps)
pproved ❑ Owner Given Initial Adverse Surc Fee) �
Determination
X. Conditions of Approval pp
/Reasons for Disapproval:
V,
:w .11. "Lil �a� d �M
Wk
f TIL
N01 - �NS�A?.L 5� /M Cer�lKoc.fs as'S�owr� � O /�itZraz >D l:fw�'7oN0
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■ .So%I Obw'�a�orn-
♦ ElC t/a�; ors
loco- fcal,o�o�
N�
let /� c5 1W /Y If 3377
h w5 to 6. f 7 - 30d e 19c0,
SO T , oa<.S7nersa� SE . Gs� iX Cs y cJl.
A lt. 6.M To ?oF
Proposed drA,eo•y cjara92 Mid -/ot 5i&ke.
iO4 0.5'
373.02 373c
Proposed a P ro posed Proposed d,sp,'Saj cc_LL.S
c t 3'X 88. �s' u s, 8
y bedr�fi
rasidence 6;o /ca
B3
Ccm bin a 4 s. e.
4e 4c A, E ■ w
rry a SY' ouE/if. 39
v
prude elev,- a�i
Q r-opos W-f b Id
SrJe _ 103.2
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■ � 1 OlxsU'r/a�orn-
♦ Ele I/at�rrn
. loco- fcal,o�o�
N'�
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SD � T . oo<Sa►�e,�G� SE. Cr1o;X Co mil.
Sfree�
• ,,Bp 8�
m
Alt.6.ot : To ?of
Proposed driue"�0'Y cjora9e Mid - /ot` sKe.
37 3. o2 3 X3
Propose d e Pro posed Proposed d ;spar sa F au -S
we. l I ----��
y bedcuorn
residence � b:o d+�µ�' /ca hers
d B3
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Co' Std ,ASCII
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d . Wisconsin Department of Commerce SOIL AND SITE EVALUATI N Page 1 of 3
Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code
AC.E. Soil &Site Evaluations
Attach complete site plan on paper not less than 8 x 11 inches m sm Plan must County
vxkjde, but riot fi rtibed to vertu and hor¢artal refbrerim par" riirediorr and St. Croi
percer t slope, scale or derrernmons, north arrow, and or1 arsd dtStan rummest road. Parcel l.D.# ---
- - -- -- - - - --
�• 032- 2035 -10
APPLICANT INFORMATION - �l�taA " bon
Personal information you provide may be used for pu s law, s. 15.OX ( (m))- R eviewed B Date
r te¢•.. ; . 7tlt)Z
I
P Location
G g len Soh llin BUYER. G J n , fi . • ry ` Govt. NW 1/4 SW 1/4 S 9 T 30 N,R 19 W
Property Owner s Maift Address Lot # r Block # S Name or CSM#
C
498 150th Avenue [ Proposed CSM
_ - - -- - ------- - - - - -- --------------- - --
City State Zip OFFic [ [] Village ZToMm Nearest Road
Somerset WI 5402 ,5- 549 -6173 -- - Somerset 50Th Street
New Consh fiction Use: 4 ElAddiGat to existing Wilding
R*-xx mernt [J Pubk or commwialdescribe
Code Delved daily flow 600 gpd Recommended design badirrg rate .7 bed, gpdr .8 hvich, gpd&
Absorption rea required 857 bed, fl? 750 hash, W Maximum design loading rate .7 bed, gpdV .8 tench, gpdV
Recommended inflation surboe elevation(s) 93.50'. It (as reforetl to site plan benchmark)
AddWorlal design 1 site consideration Install trenches using high capacity infiltrators.
Parent maw Glacial outwash Flood plain elevation, I NA ft
S- for system Conventional Mound in- Ground Pressure AT -Grade System in Fill Hol fxxj Tank
U= Unsuit�e for system NS E7 U E S❑ U ❑ S❑ u M S❑ U ❑ S® U ❑ S N U
SOIL DESCRIPTION REPORT , opp a 70Wo ry
Horizon Depth Dominant Color Mottles Texture Structure Boundary Roots -- - GPDr - in. Munsell Qu. Sz. Cont. Color Cr. Sz. Sh. Bed ; Trench
1 1 0 -10 1Oyr3/3 None I 2fcr m as 2f 0 .5 1 0.6
2 - 10-21 7.5yr4/4 None cl 2ms m fr cs if 0.4 0.5
Ground 3 21 -34 7.5yr4/6 None sl 2msbk mfr cs - 0.5 0.6
elev S
98.18* ft 4 34 - 60 7.5yr416 None is Osg mt as - 0.7 0.8 - }
Depth to 5 60 -94 10yr6/4 None s Osg _ ml - -- _ - - - -- - -- - - 0.7 0.8
limiting r
facer 9 3 -Sb
yW
Remarks:
2 1 0 -13 1 Oyr4 /2 None sl 2fcr mvfr as 2f 0.5 0.6 S
2 13 -19 10yr5/4 None sl 2msbk mfr cS If 0.5 0.6 S
Ground 3 19 -31 7.5yr4/4 None scl 2msbk mfr cs - 0.4 0.5
elev
97.64' ft 4 31 -52 7.5yr4/6 None Is Osg ml as - 0
Depth to 5 52 -90 10yr6/4 None s Osg ml - - 0.7 0.8
limiting _ -
factor - - - - -- - - - r.9� ,68 - --
Remarks:
CST Name (Please Print) Sig re: Telephone No.
8
James K. Thom 715- 24-77b7
- - -.. - - -- - -- -- - - - 5 - 48 - - - -- - - - -- - - --
Address A.C.E. Soil & Site Evaluations Date CST Number Ref #
340 Paulson Lake Lane, Osceola, WI 54020 5/2/00 3602 1223
l
PRMM OWNM Gaylen schdi ng, SUYEk G=g ]ohn son SOIL DESCRIPTION REPORT Page 2 of 3
'PARCEL LD.# 032 - 2035 -10 AC.E. Soil & Site Evaluations
r#epth Corr*tanl Cobr "odles S'truc�re to TeAn �ns�e�Wtmdaryj
i
0r° . Manse# Qtl. SL Cont Color Gr. Sz Sh. Bed Trench
3 1 0 -9 10yr3/3 None sit 2fcr mvfr as 2f 0.5 j 0.6 , S
2 9 -30 7.5yr4/4 None sicl 2msbk mfr cs if 0.4 0.5 .-4
Ground - --
elev 3 30-45 7. 5yr4/6 None is Osg mfr cs - 0.7 0.8 ,
98.53' ft 4 45_85 7.5yr4/6 None s Osg ml as - 0.7 0.8 • �-
Depth to 5 85 -97 10yr6 /4 None s Osg ml - - 0.7 0.8
factor
timi4ng
Remarks: _ - - --
1 0 -13 10yr312 None sit ithinpl mvfr as 2f NP 0.3 /
2 13 -22 10yr514 None sit 2ms mfr cs 1 f 0.5 0.6 5
Ground
ele 3 22 -51 7.5yr4/4 None sicl 2msbk mfr cs - 0.4 0.5 `'f
_99 31' f _ 4 51 -74 7.5yr4/6 None is Osg ml as - 0.7 0.8
Depth to 5 74 -93 10yr6/4 None s Osg ml - - 0.7 0.8
4
f actor
>93
Remarks: - - --
5 1 0 -8 10yr3 /3 None sl 2fcr mvfr as 2f 0.5 0.6
2 8 -21 7.5yr4/4 None scl 2msbk mfr gs if 0.4 0.5 , �{
Ground - - -- - - - - -- __ - 3 21 - 29 7.5
el y - - -_ .- -- -- - - - - -- -- -. - - -- - - - - - -_ - -- - - - -_. - - - -- - - - -- . -- - -- - - -- _
ev r4 /6 None sct 2m mfr as - 0.4 0.5 ,
99.71' ft 4 29 -74 7.5yr4/6 None is Osg ml cs - 0.7 0.8
Depth to 5 74 -94 10yr6 14 None s Osg ml - - 0.7 0.8
facer
>94
Remarks: _-
Ground -
elev
Depth to
limiting
#actor
Remarks:
P�. 3 x'13
cc 11 " n e
p. e
Ele(/a
/ , locaitdofo1
CayJin �� /�ing Pl4j� ✓ e.
SO'` T.o��Somersa SE.GbiXG
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1.2.2 3
BioDif fuser S
76"
° ra
. �o coo 00 00 00 00 00
�� oo DO coo OD ao DO oo
=� COO a� DO OCR OO �fl CQO Chamber
Heg
O 00 Qo cQO 00 00 OD QO rn
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��O) OO DD 00 �� OQ OD QO
' � 00 C7 0 QQ OC OQ 00 QO
00 00 0E 0o ao O oo
All rps`
withstari'
ins, all�dr�!JI y Chamoer
and . - 6 Jbs He gni
mum of 1�
for�)J 1.0 log` s End View
4*1.
Ca ci i
pa tyre op
designed ip
34"
A minimum PT 11 8,
required for; i �
r
1
4" Knockout
Universal End Cap
Available Sizes
r,t; ^ ^. P 7 t � 4
Lentz 6 _�.7k�» 76"
Width 34 34
�� »
�
Heigh'i r J,Ro = ,�" 16"
7
}., the _S
Inert .$ 9 11.3
4. sr
�,9,
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and — ►
Comm 16.28 WAC 4 in. min.
Disconnect
Tank component is properly vented iz -E Alternate outlet
location
I
Forcemain diameter
Wieser Concrete Manufacturer 2 in.
Capacityl 757.64 Gallons
Volume 16.12 gal /inch A
Weep hole or ariti-
Dimension Inches Gallons B siphon device
A 25.45 410.33
B 2.00 32.24 C Pump off elevation (ft)
C 7.55 121.63 87.00
1 .00 193.44 D
D 2 D
Total 47.001
D ose tank elevation (ft)
3" Bedding un er tank. 86.00
Alarm Manuafacturer LevelArm
Alarm Model Number DLV
Pump Manufacturer jZoeller
Pump Model Number 198 � —
HEAD CAPACITY CURVE
EFFLUENT M
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NONE No
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OMEN l NONE .. . . ..: .: . . .
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0 1 1MNM ►" v1■ on .. ... .
■ ■����I���ii�EMM ■E■
TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE
SEWAGE AND DEWATERING
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WERM
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JUN -19 -2002 09:41 PM R.C.E. Soil & Situ Eual. 715 248 7764 P.05
'.^s
Indicate management strategy by checking (✓) the appropriate box.
o.
Z
Management Strategies
0 Temporary stabilization of disturbed areas,
Note: It is recommended that disturbed areas and soil plies left inactive for extended
periods of time be stabilized by seeding (between April 1 and September 15), or
by other cover, such as tarping or mulching.
Permanent stabilization of site by re- vegetation or other means as soon as possible
" (lawn establishment).
`? • Indicate re- vegetation method: M -Seed ❑ Sod ❑ Other
• Expected date of permanent re- vegetation: 'Se i _ 1.0 �z
• Re- vegetation responsibility of: ❑ Builder 0"Owner /Buyer
„ • Is temporary seeding or mulching plaDned if site is not seeded by
" Sept. 15 or sodded by Nov. 15? Orles 0 No
. Use of downspout and /or sump pump outlet extensions.
Note: It is recommended that flow from downspouts and sump pump outlets be routed
through plastic drainage pipe to stable areas such as established sod or pavement.
Trapping sediment during de- watering operations.
'. Note: Sediment -laden discharge water from pumping operations should be ponded
w behind a sediment barrier until most of the sediment settles out.
Proper disposal of building material waste so that pollutants and debris are not carried
off -site by wind or water.
.y
a. w
Maintenance of erosion control practices.
s Sediment will be removed from behind sediment fences and barriers
before it reaches a depth that is equal to half the height o f the barrier.
• Breaks and gaps in sediment fences and barriers will be repaired imme-
diately. Decomposing straw bales will be replaced (typical bale life is
'gym° three months).
All sediment that moves off-site due to construction activity will be
w.l. cleaned up before the end of the same workday.
All sediment that moves off -site due to storm events will be cleaned up
before the end of the next workday.
k
Access drives will be maintained throughout construction.
All installed erosion control practices will be maintained until the
disturbed areas they protect are stabilized.
For more assistance on plan preparation, refer to the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site
Best Mondgement Handbook, and UW— Extension publication Erosion Control for Home Builders.
The Wisconsin Uniform Dwelling Code and the Wlscor►sin Construction Site Best Management Handbook are available through
the State of Wisconsin Document Sales, (608) 266 - 3558.
E.rosioh Control for Home Builders (GWQoo1) can be ordered through Extension Publications, (608) 262 -3346 of the
Department of Commerce, (608) 267 -4405.
JUN -19 -2002 09:40 PM A.C.E. Soil & Size Eual. 715 248 7764 P.04
EROSION CONTROL PLAN CHECKLIST
a Check (✓) appropriate boxes below, and complete the site diagram
96 with necessary information.
£' H
Y
z Site Characteristics
North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways,
. ❑ Location of existing drainageways, streams, rivers, lakes, wetlands or wells.
Location of storm sewer inlets.
Location of existing and proposed buildings and paved areas.
The disturbed area on the lot.
Approximate gradient and direction of slopes before grading operations.
Approximate gradient and direction of slopes after grading operations.
(7 Overland runoff (sheet flow) coming onto the site from adjacent areas,
Erosion Control Practices
❑ Location of temporary soil storage piles.
>« Note: Soil storage piles should be placed behind a sediment fence, a 10 foot wide
vegetative strip, or should be covered with a tarp or more than 25 feet from
any downslope road or drainageway.
Location of access drive(s).
Note: Access drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide
and 6 Inches thick. Drives should extend from the roadway 50 feet or to the
house foundation (whichever is less).
' rJ Location of sediment controls (filter fabric fence, straw bale fence or 10 -foot -wide
vegetative strip) that will prevent eroded soil from leaving the site.
Location of sediment barriers around on -site storm sewer inlets.
ql ' Location of diversions.
Note: Although not specifically required by code, It Is recommended that concen-
trated flow (drainageways) be diverted (re- directed) around disturbed areas.
Overland runoff (sheet flow)from adjacent areas greater than 10,000 sq. ft,
should also be diverted around disturbed areas.
Q� Location of practices that will be applied to control erosion on steep slopes (greater than
12% grade).
Note: Such practices Include maintaining existing vegetation, placement of additional
sediment fences, diversions, and re- vegetation by sodding or seeding with use
of erosion control mats.
!' ❑ Location of practices that will control erosion on areas of concentrated runoff flow.
Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected
from erosion through use of such practices as in- channel fabric or straw bale
barriers, erosion control mats, staked sod, and rock rip -rap. When used, a
given in- channel barrier should not receive drainage from more than two acres
' of unpaved area, or one acre of paved area. In- channel practices should not be
installed in perennial streams (streams with year round flow).
fJ Location of other planned practices not already noted.
,JUN -19 -2002 09:39 PM A.G.E. Soil & Size Eual. 715 248 7764 P.03
F`n ee /, me
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irk 01,
i _•� y`.opro �s��4��.��� � �.,'. rN'iL�f' /►1ja1 -�oL S'�.aX.
373.01 3g3,o:
Proposed Prapo�d � Propossd d;sp�r� c�L1s
ryc. � � -- � --��'' y � I�1� aE 3 �jr ee. ss �.cs, .z e
� boo dl�,•�" /u �.l c�t.,M
$I;pi !sd �; /�"dP �►C iA f 11601 n[ 5 ideryl 4
/essr„ 3a aims 83
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rsaf'6ac�t� 2 6ssurwwfeJ�'� Q pssac�b /d . 7 PLY fro
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w:ti m 30 d p,s f C'o••lpk � o�
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Conventional Septic System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained
in accordance with component manual SBD- 10567 -P (R.6/99). All local and/or state rules pertaining to system maintenance
and maintenance reporting shall be complied with.
Septic Tank
The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The
septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The
contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to
service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment,
maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge
accumulation in the tank. The utlet titer shall be cleaned as necessary to ensure roper operation. The filter cartridge
should not be removed unless provisions are ma a to retain so ids in the tank that may slough off the filter when removed
from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank
manholes risers, access risers, and covers should be inspected for water tightness and soundness. Access openings used for
service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective,
or subject to failure must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an
effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank
as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with
Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or
chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be
approved for septic tank use by the Department of Commerce, Safety and Buildings Division.
Soil Absorption Cell
Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should
h
be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for
vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface
within the system and will promote frost penetration during cold weather months. Cold weather installations (October -
February) dictate that the system be heavily mulched for frost protection.
Influent quality into the system may not exceed 220mg/L BOD5, 150 MG /L TSS, and 30 mg/L FOG. Influent flow may not
exceed maximum design flow specified in the permit for the installation.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the
owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring.
Contineency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by removing
biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a
new soil absorption cell to bring the system into proper operating condition. nn ��� ���
Questions on the operation or maintenance of the system should be directed to your plumber, 44w+iehten at (71 5) 4 M 6 i 9
or thePellrEetmt Zoning Department.
Ste" = c�iuc
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /Bu5w �arl- le fIT:ptic e ::2 �e0 4t
Mailing Address 1.3 2 ? 6<,84 Alm
Property Address 162 7-
(Verification required from Planning Department for new construction)
- SWa Identification Number
City /State ��.�� tc�l. ParcelIdentific
LEGAL DESCRIPTION
Property Location 1210 56o /,, Sec. �� T _N- R_Zy W, Town of �ir+erSe�
Subdivision CS / W7 Lot #
Certified Survey Ma 2 �' , Volume _ . Page # 3
P # � f�� T y
Warranty Deed # & V Zoe , Volume 1904 . Page # 32�
Spec house ❑ yes 2n Lot lines identifiable Ryes ❑, no
SYSTEM MAINTENANCE
handle wastes. Proper maintenance
of our septic p remature failure to stem could result in its p
Improper use and maintenance y p y p
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
master plumber, 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 the Department of Commerce and 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 30
days of the three year expiration date.
G
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
i that all statements on this form are true to the best o m ( our) knowledge. I (we) am (are) the owner(s) of
I (we) cert f Y (
the property abov virtue of a warranty deed recorded in Register of Deeds Office.
4 / / e// O;z-
SIGNATURE OF APPLICANT DATE
* * * * * * Any information that is mis- represented 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 certified survey map if reference is made in the warranty deed
• + � i9a6N 526 If
STATE BAR OF WISCONSIN FORM 1 - 1998 KATHLEEN HgMALSR
Document Number REGISTER OF DEEDS
032 - 2035-10 -100 RECEIVED FOR RECORD
Parcel Identification Number (PIN) 06-07 - 2002 11:30 AM
THIS DEED, made between Nottingham Development, LLC, WARNM DEED
Grantor, and Curt M. Thompson and Margaret Thompson, Grante EXEMPT t
Grantor, for a valuable consideration, conveys to Grantee the following REC FEE: 11.00
described real estate in St. Croix County, State of Wisconsin (the TRANSFFE : 137.70
OPY "Property"): CC COPY FEE:
k — Loyl , of Certified Survey Map in Vol. 14 , p age 3877 as Document Number
624984, Town of Somerset, St. Croix County, Wisconsin, located in part of
the Northwest % of the Southwest r/* of Section 9, Township 30 N, Range
19 W.
Rec ordin g Area
Name and Return Address: L,
Land Title Inc
This is not homestead property. 1900 Silver Lake Road
New Brighton, MN 55112 -1789
Together with all appurtenant rights, title and interests. C) 5 5L( D
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
Dated this 5th day of June, 2002.
Nottingham D v opment, L
(SEAL) (SEAL)
* Chief Manage
(SEAL) (SEAL)
*
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF MINNESOTA
}SS.
WASHINGTON COUNTY.
authenticated this 5th day of June, 2002 Greg Johnson, Chief Manager for Nottingham
Development, LLC, a limited liability company, under the laws
o1 Minnesota on behalf of the limited liability company,
* personally came before me this 5th day of June, 2002
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, Wis. Slats.)
THIS INSTRUMENT WAS DRAFTED BY
Gregory Booth Attorney * Nanc Len
1900 Silver Lake Road
New Brighton, MN 55112-1789 Notary Public, State of Minnesota
(Signatures may be authenticated or acknowledged. Both are My commission is permanent. (If not, state expiration date:
not necessary.)
*Names of persons signing in any capacity must be typed or printed below their
signature.
■ NANCY J. LENTZ
NOTARY PUBLIC- MINNESOTA
my Comm. E.pn*s Jan. 31.2005 .
IMAM
■
z�
624984
CERTIFIED SURVEY MAP
�LbdAtED IN PART OF THE NW1 /4 OF THE SW1 /4 OF SECTION 9
T30N, R1 9W, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN.
SCALE IN FEET 1" = 200' PREPARED FO R:
NOTTINGHAM DEVELOPMENT L.L.C.
200 0 200 400 G1RE(3 JOHNSON
UMPL17IFT RAHP% STI L L MAIN STREET
----- - - -� —_ STILWATER,MN
N -----------
() HCD o y @cTM[EN% 165 439 -2414
1/4 CORNER EAST - WEST 1/4 LINE OF SECTION 9
SECTION 9 ' , 6 - +/- F '27'08" W
165TH AVE. N 89 27 08 W 625.01 ---�
59C O1
3.00 4644.51'
2 0� .V. °o L �' E1 /4 CORNE\ z ��� o N SECTION 9
w o Q J o, I $ 5� 0 4qd AGRES = : Q 1- 0 N �pI
, f- Si: i89.':7'Of:. 9 .:01ai: 'i /
�u— �O
Ik
o ... S ,
in
w Q c' A 3 U13:ACRFS,i = �
L w g J W . 131,246: SQ F:T M:
co
2 ICU N N: Z oa
cc A �/
v)ww o ,
o/
ZZ� .S9u� --
v N 18,10'
pp S 89 E 5
w Q cri PR VATE READ EASEMENT �e 'd J� fSZ / 40 l7oc. '
m X80-174811
I —N8! '01' 53,00' T � / 2 9 9 $ 3
W.L. o /
898.0 0
� I I ^ m / CONTIGUOUS BUILDING AREA
4 1 W M Q / v / LOT 1 1.4 AC
(�� v �/ LOT 2 1.3 C
W
gi b"" 2
/ LOT 3 1.3 AC
r� e ll LOT 4 2.5 AC
�o m (/� o+ I " 3 540 a4CRES ci: v
o
p I ^ ^ I 154
o� E I c I �Q/ CURVE DATA
uj
0 $ z I W �/ NUMBER
RADIUS 233.00'
N 89' # -#'18' W 353.02, 0 DELTA ANGLE 08'54'03"
w n CHORD DIRECTION S 84'44'59.5" E
CHORD LENGTH 36.16'
LL
ARC LENGTH 36.20'
LU 3 37 `k ,." z TANGENT IN S 89'12'01" E
Io iu: TANGENT OUT S 80'17'58" E
LEGEND
OWNER I `;1 %6:;5:::$::F:i:;? ALUMINUM COUNTY SECTION CORNER
QAYLEN SCHILLING 33. MONUMENT FOUND
498 150TH AVE. 353, -::? O 1' X 24" IRON PIPE SET WEIGHING
SOMERSET, WI 54025 8 4'18 E 386 .02' 1.13 LBS. PER LINEAR FOOT
I SOUTH LINE OF THE NW1 /4
OF THE S \J1 /� 100' ROADWAY SETBACK LINE
r I EXIST ING DRIVE __ - - -_ 12' UTILITY EASEMENT
APPROVE O �� �� PROPOSED DRIVE
ST. CROIX COUNT, o �' X_ EXISTING FENCELINE
Plannlnq Zoning and Parks C ge U
5 , STORM WATER RETENTION AREA TO
JUN 6 ZQ�� 0 H.W.L. = XXX.X HIGH WATER LINE
N H.W.L. = HIGH WATER LINE ELEVATION
If not recorded within 30 days of oo NOTE A GRADING THAT WOULD ALTER THE CAPACITY
approval date approval shall be �� OF THE STORM WATER RETENTION AREA
null and void �j' � IS PROHIBITED
SW CORNER NOTE B BUILDINGS ARE PROHIBITED WITHIN
SECTION 9 O THE STORM WATER RETENTION AREA
THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO. 99 - 153 DATE 6/15/00
VOL. 14 PAGE 3877