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HomeMy WebLinkAbout032-2176-11-000 r 0 fN O 3 'o n d o c m o c 3 3 "0 3 r° I V (D "Z W "i ''.. O0 N W e� = < < C O OD CD j' S. N - N O N m C p p C v C :J N N N C O "S 0 0 C: n 7 O O (D 3 O .•r- 3 N = 0 O N_ N ° O � �1 c 3 N p N N � co v D a N fD Ui A In C L m w s w '�' V 3 C,. 00 N N CO CL z ° D rn rn 3 o rT C7 c c Z roa OOO f �. C C) r rye. cn cn to ro n cr p N h O !� ° CD m o L co I o d _ " m ff CD -3 N .N+ N � 01 2 p A N Z -4 N p v j O 0 D o 03 CD O v > m cm �• N 3 N CD C N ro N C � _. N � C Q ro v x a w ro N A _ O. � 3 C� � 1 z CD v � _ p O A z 7c v c A N .. O =3 C _ A A I C O N CL < z c Z CD a m a y N L o a CD z O j N ro CD `n y 3 a a. i e ti O O V O 4 ro pp O E O N a O L I �. Parcel #: 032 - 2176 -11 -000 05/2912007 08:58 AM PAGE 1 OF 1 Alt. Parcel #: 4.30.19.1496 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 01/2812004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - LIPPO, ELDEN L & MARILYN K ELDEN L & MARILYN K LIPPO 1632 83RD ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ` 1632 83RD ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.200 Plat: 09/99- LAKESIDE ESTATES 1/22 032/04 SEC 12 T30N R1 9W PT NW SW & SW SW Block/Condo Bldg: LOT 11 LAKESIDE ESTATES '04 LOT 11 (3.20AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 12- 30N -19W NW SW Notes: Parcel History: Date Doc # Vol /Page Type 04/03/2006 822041 WD 11/10/2005 811724 2925/680 WD 01/28/2004 752813 9/99 PLAT 08/22/2003 736985 2385/383 WD more 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.200 76,200 0 76,200 NO Totals for 2007: General Property 3.200 76,200 0 76,200 Woodland 0.000 0 0 Totals for 2006: General Property 3.200 76,200 0 76,200 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 Jisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 488070 0 ATTACH TO PERMIT) GENERAL INFORMATION ( 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: T.I. Magnuson Homes I Somerset, Town of 032- 2176 -11 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: MX O ' 6•p . CS 8 OA* / 12.30.19.1496 TANK INFORMATION ELEVATION DATA B UFACTURER CAPACITY STATION BS HI FS ELEV. 4 �t do E�. Benchmark Ait. BM Idg. ewer gab t t inlet , 3.12 .9s TANK SETBACK INFORMATION S t/Ht O ut l et 0�. I TANK TO P/L WELL BLDG V ent o it n a e I nle t S eptic f � , Ot Bottom _--- -- osing 'Header/Man. era ion D ist . P ipe 11 .31 00 . 1 �4 o mg o . System (2 • SI b .1� PUM ma ra e SIPHON INFORMATION ?4, anu ac urer Demand st yover GPM m odel um r I IO o S y S e me au o en g in MY PTION SYSTEM 3 S MUM .11YE11 I lt�llunub PMu11v1E-I1SI No 1 111bluti Uld. [qulu Uupul DIM S or INFORMATION CHAMBER OR UNIT 11— 1.1 luid Pipe(s) Length Dia Length Dia Spacin 510111- t;UVhK x Pressure Systems Only xx Mound Or At -Grade Systems Only Bed/Trench Center Bed/Trench Edges Topsoil 1 I Yes ] No ] Yes ` COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: ( } 7�0(p Inspection #2: Location: 1632 83rd Street Somerset, WI 54025 (SW 1/4 SW 1/4 12 T30N R19W) Lakeside Estates Lot 11 Parcel No: 12.30.19.1496 1.) Alt BM Description = S•T � 2.) Bldg sewer length = 2.0« - amount of cover = jib f Plan revision Required? Y� —� J Use other side for additiona informa No tion. SBD -6710 (R.3/97) r - 1 r N .�v� �__ � �� s r N ylisconsin et ttil ' Division County o 20 ingto ve., P.Q. B 7162 adrso ant y Permit Number (to be filled in by Co.) Department of Commerce 648} 66 -31 IVEE Sanitary Permit Applicati State Ian LD. Number personal informatio P you prdvide In accord with Comm 83.21, Wis. Adm. Code, u� ' may be used for secondary purposes Privacy Law, s15.04( )(m) Projecl Address (if different than mailing address) s I. crzow Y I. Application Information — Please Print All Information C/ d I (p 3 Z 83 Property Owner's Name Hltj _7�;U6_ - - " Parcel # Lot # Block # MOW Property Owners Mailing Address Property tion P ny I (o 3 g 83 9D s . City, tate S w ' %, S w ' /., Section 2 y Ziip Phone Number 2 p. N � I �i M O >J T> W ( S�Fo ' ��� T 3 0N, R 1 W e) II. Type of Building (check all that apply) 5 X1 or 2 Family Dwelling -Number of Bedrooms Subdivision Name 654 p(pl ❑ Public/Commercial - Describ se �z)- 1- t�►�.G� s 6;5 Tr¢T�S ❑ State Owned - Describe Us D J5 1 . C4 /)/��K5 (n/, a ,2 Z3 . Ocity ❑VillageZTownship of $O M; R- SE T III. Type of Permit: (Check only one box on line A. Complete line B if applicable) O 3 Z z 1 �6 - )<New System y El Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl XIon - 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 ❑ Oth xp r V. Dis ersaVrrestment Area Informati d,�- , p Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal ea ropos ystem Elevation Co 00 .7 57 cl o y 9 Z •o VI. Tank Info Capacity in Total Number Manufacturer refab Site Steel Fiber Plastic Gallons Gallons of Units -1 ncrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1 2—tO kj I. g se- C omare --,00 X 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 Na ( Print) lumbe 's Signature RS Number Business Phone Number 2 z� �s — 715; 772 2 Plumber's Address (Street, City, State, Zip Code) 2812 10 ­E Av E SP211' ✓A+L-L-E'l wl 19 - 7(, - 7 VIII. Coup /De artment Use Onl X Approved 11 Disapproved Sanitary Permit Fee includes Groundwater Date Issued Issu' Agent Sign (No Stamps) _ Surcharge Fee) PIG Reason or at — , IX. Conditions Approval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced ! maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size SBD -6398 (R. 01/03) I 032 -2) - 76• (!-coo �ACs6 3 c F 3 �ov�D FOUND SVit'leyORS SUR�F1foRS Lar cAO. M - r- POST NOR'rN PRoPERz� LINE -r -POST So�{•�f�i ` �, t l 1 60 1 9 - 1 48 " CQUIG 44 - FovRS 5 Y s'r'£ M Fau RS RM 2. 8• PRoPt�y Ex.Tb�cs Ir�EsT PWOPfRt� *rl? 83 'x' ST. A PPwox . � L.pG.. OF � { Zg, c � F3•� c�RcoM► 4toM E !O 10 00 8M ! 12-00 L L. W t E 5ER, K 'CJ� ---- X69. S' $M ! ^ ! 00. DO • Sti"'1 �-= 9�.7y' � {� �.P 'SCt t3Y C.S:f. 00 SYSTEM A • �I Z o C 4R,�}tSF `flo•c) °� �e ft 9 S YST'EM B � R d •o � �i z gr3�V�. GCE - 0 3 2) 1 1- 000 LOT II �A�3aF 3 in " A = (-O tno v k = 2�EN�- �1MARK. ®= Boki&J FovwD Fo SJRdE�oR.S v 0z\ E` *R:s LOT cAP.a tEa. - tJORT�I PR.oPERTy LINE T -POST 1 6 SS' C 22� 8� �- 18 "QU1�.K-�ovRS � SYST£ M -Fou RS BM 2 13' �. No Ex.T6K10S wEs PwsPF�T� 'Ca 83" ST. UWI~ lrREATEI. TkA u A loci' L.oc.. O F 4 P-A=: (:;lRCpM HoM E �% S 82.53 ` i 00 ® p Ro POSC SM { {200 Ctiq LLoAJ W l E S ER, SEa-r K 0. �4.EYATton1S = p - PI 9q.69' 132 a.53' Sou•r4 B3 = 9 1. 18' moa , crz. - ry utjc - ,q.oq' 00. 00' Bri 9 t.7y' S Y S TEM A : cl •o cl'JRADE-`&.0` � SET BY pf 9 S �CS B• 9 0 .o C &, 2 WC G Wisconsin Department of Commerce L RFCEIVE-D :Adm.Code R ORT p / Division of Safety and Buildings in accordance Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County 5 - T C RO 1 x Include, but not limited to: vertical and horizontal reference pant (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 6 2 - Z r76- - D D O Please print all information. a Date Personal iniortnation You Provide may be used for secondary purposes (Privacy Law, s. 15.04 (t) (m)). F&I (9 l w 6 Property Owner Property Location /,� 2 /� � T • T ' / ' ► A �, N N `5o,\1 HONE E,S Govt. Lot l" W 1/4 " 1/4 S t 2 T `� " N R I f E( W Property Owners Mailing Address Lot # I Block # Subd. Name or CSM# /(.0 3 2 D S4. 1 11 - L A K 19 5 1 DIF E'57,1 TIE City S'kft Zip Code Phone Number ❑ City ❑ Village JA Town Nearest Road Ily RIcftM 1 54.01 ( !2) 9A10.78� soME� -r $3'- New Construction Use: (XI Residential / Number of bedrooms 3 Code derived design flow rate ' 50 - '7 5 0 GPD ❑ Replacement ❑ Public or commercial - Describe: _ Parent material Flood Plain elevation if applicable A ft. General comments and Area Spot Tested suitable for a conventional inground system MONT.S.) ❑ Boring D # 9 g' 69 ® Pit Ground surface elev. fr. Depth to Iknit&ig factor ) 9's in. Sal Application Rabe Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPQW in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 1 0 -12 Iu Yi2 2 /1 - Q 2 bK a 5 C 5 - 5 Iti'1 G, Is 2- 12 -29 Io YA '414 - Siei 2f bK 05 3 .-v � 3 29 - IoYID % - SiCI 2- 1"bK lit,w a 21 V -`A' (o -(A 44 "9 10 M V-1 - 3 0 s C( -_7 (o FROST FO IJn/ D 2 Y2_ 2_ 1 NC. E:S WN. n 2 # ❑Boring /1 ® Pit Ground sixface elev. `7 2 S3 ft Depth to limiting facto 7 9 5 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rods GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I •Eff#2 0 -/! I li gp- Z /1 - 2 bK C 5 3 rn 2. 11 - 14 1oYtq-` 5ie/ 2frPI '-f-i 0-5 3'1 2• 3 1 - 35 10YR-'*I - 5C l 2 CbK M - F - a :�L V-f- �O - 4 5 -95 Ir7YeZ 5 1'F S O I - - •� I No T �� Effluent #1 = BOD > 30 1 220 mg& and TSS >30 < 150 mg& • Eft #2 = BOO A S 30 nng1L and 1W : S 30 myiL CST Name (Please Print) Signature CST Nurnber JE/V/V lAL82/G 'T F59'%3•<-L Address L., Date Evaluation Conducted Telephone MEnber 24 i v? "Ave EPP21Ny ✓4 L-f Ir w 1 / - 2 6 - O(, �7 )5,772 •3442 I I I Property Owner Parcel ID # p age 2. of 3 �� # ❑ Bones ® Pit Ground surface elev. -/ /• f g ft. Depth to rirr*hg factor ?� in. � . Horizon Depth Dominant Redox Sod Rate Descr�tion Texture structure Consistences Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. GPWIF o-7 f�Yi2z `Eff#1 `Eff#2 /1 _ Q m r • , fr 2 'Lb I Y R `F/ - g r CI ryl-F, a w CS vim, av4 , AF 3 20-% 0 s d f — - 7 E # ❑ ❑ Pit Ground surface elev. ft. Depth to running factor Horizon Depth Dominant Redox Desaiption Texture Std Sol lion Rate In. WOOD Qu. Sz. Corti. Color Car�is<ence Boundary Roots GPD/ff' Gr. Sz. Sh. 'Eti#1 `Eff#2 ❑BorhV# 0 Boring ❑ Pit Ground surface elev. ft. Depth to Nmitlog factor in. Ramon Depth Dominant Redox Description. Texture Struchxe Consistence Boundary Roots Sod GPD1ff Rate in. MurmeB Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 - Eff#2 Elfhrent #1 = BOD > 30 1220 not and TSS >30 < 150 mglL • Effluent #2 = BOD < 30 s _ mg1L and TSS < 30 mglL 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. srin.aaroMAM) L. • I I FA &G 3 o F 3 S c.�LE p t = q b' ®- B( FOUND �ovN� SU�dE�tOR,S SUR�E�oRS t.srt c�oR.N62 7 Fos'f NORT�I PR.aPEKTy LINE - r—PO 5 Soy•�f9 r l 160 BM �. 0 99.69' � PRoPER.'cy Exx6�fl•S 1AlEs F 11 83 ST. u N E CsREA ?ER. IRAN 3 gl r ! zS , �% SL,bPE g2,S3 ` s' +3! BMJ X9. �o LEyA'� n1S BI = 99.69' 132 = I a.s 3 ' 53- is' 00 . oo' z�. q�v� C,•ZAaE f ArcIMS Viewer Page 1 of 1 kF� NW 114 S 114 i cl ;I I O 2 "` ) 1496 '15072 11 TN 0MER,SE,T A OnD2 y ` OnC2 1495 1 !1 http: //72.21. 230.178/ website /LRPortal /ARCIMS /MapFrame.asp ?PIN= 2/2/2006 � ss 5 }� r� ' i � f e u F Y tY d l* #s, �w �s Jt 5 � Sz a'p't g ak,� rte. .•v Ml NI ULBRICHT & ASSOCIATES CO. 2812 10th Ave. • Spring Valley, WI 54767 Reg. Designers of Engineering Systems 715 -772 -3442 Private Sewage Consultants PROJECT INDEX PLAN ID # DATE FIF 8 OWNER �T Z . NiACTN USC N PHONE Co l2•�1��D'(IZ ADDRESS I la 3Ig �33 FD S 1 IN :ELJ R->K-H MOND,VI) I LEGAL DESCRIPTION TOWN OF S ONAE:RStrT COUNTY S'r•c RoIX C S TM _ J / n1 Y LA L3 P_ Ic - t - •ti T # Fs'S `193y LOCAL AUTHORITY/ SUPERVISION 5� C- ROIX C'OU>J i'i- ZOtJi PROJECT DESCRIPTION: I nl S T q t... L. N C W I N RO uN tJ (NOWT S Y s - r E M F O R. A 1r D R 0o M l v S E' O/ l. D - T l 1. lJ C —S�� ►^� W ASTE S LOW (, gallons /c. c . _T g15 POW YST-EM SHAI✓L- I t 3 C- o 2 PO 2 A - rc PER CO A PROPER Z �F3 L FI L l-E2 J MC�I�E t-. A -- IoC 1Z" X 20 ` MrRs Z 3-1 5 Ulbricht & Associates Private Sewage Consultants 26 12 , I Qth Ave. spfing Valley, Wl 54767 s Pg.l INFILTRATOR SIZING WORKSHEET P5.2 SYSTEM PLOT PLAN P9.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. P9.4 of It 11 is it P9.5 OWNER MANAGEMENT PLANS & ZABEL FILTER SPECS P9.6 (OPTIONAL) CROSS SECTION AND SPECS FOR DOSING TANK. PG (OPTIONAL) PUMP PERFORMANCE SPECS. The attached plans and specifications are based on "In- Ground Absorption Component Manual For Private Onsite Wastewater Troai -mangy fivci -Ramc . � (Varci nn ?_n) gPn_1 n7q_P(mni /(11 _ 0 0 -� o � o � LU 1� I Q Q w J a J ^ U ca LL y LL Lo � r r. Lf - w j L � a Iff 7P 7 K { -- «���. 7 -e&tC-X Q 2 . 00 Cho SS SEC ion ©/C T�'��v�s" 21514 6- 7e, 7 v � � P � I1iAl. / 2 • . Iff j lrji Mt K 9 0 - C)U OVER: See Reverse Side for Vent/ Observation Pipe Details. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa . r of 2 — fltE mtFORnIIATiON SYSTEM SPECIRCATIONS Owner I M ACS. N V 56 rJ t tit C Septic Tank Capacity DNA Permit # 1 200 gat Septic Tank Manufacturer s ❑ NA W ESER . DESIGN PARAMETERS Effluent Filter Manufacturer Z s4 B L_G ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model A — to o D NA Number of Public Facility Units )1 NA Pump Tank Capacity al ANA Estimated flow (average) Od al /day Pump Tank Manufacturer ((q Design flow (peak), (Estimated x 1.5) Co Cab g al/day Pump. Manufacturer WNA Soil Application Rate -_7 al/da /ft2 Pump Model ,WNA Standard InfluentlEffluent Quality Monthly average* Pretreatment Unit ANA Fats, Oil & Grease (FOG) 530 mg /L 0 Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑. NA ❑ 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 An -Ground (gravity) ❑ 1n- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L J�WA 13 At -Grade O Mound Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: D NA Other: Other. ❑ NA ❑ NA * Values typical for domestic wastewater and septic tank effibent. Other. ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume E3 NA Inspect dispersal cell(s) At least once every: 3 ❑ month(s) (Maximum 3 years) ❑ NA Year(s) Clean effluent fitter At least once every: _ 2 ❑ month(s) © NA year(s) Inspect pump, pump controls & alarm At least once every: O month(s) ❑ NA D year(s) Flush laterals and pressure test At least once every: 0 month(s) s) ❑ NA Other: E3 month(s) At feast once every: ❑ year(s) - 13 NA Other: ❑ 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 NR 113, Wisconsin Administrative Code. All other 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. i START UP AND OPERATION Page 2 of Z For new construction, prior to use of the POWTS deck treatment tank(s) for the presence of painting. products or othet.chemical that may impede the treatment process and /or damage the dispersal cell a) If high concentrations are detected have the content; of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cells) in one large dose, overloading the cells) 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 tt 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 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 PO`WTS 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. [7 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 MAINTAINER !Name '� g(Zl Name Phone S', 7 +2 3g4 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name . C jZb( ONQ k L"IJ 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. OWNER'S MAINTAINCE - 'OF' SEPTI -C SYSTEM POWTS (landowner) is reponsible for proper operation and maintenance of -this system. Regular periodic inspections and servicing is necessary for the safe healthy operation of,this system. The owner is required. by code to submit all necessary maintenance /inspection reports to the controlling,authorities:. SPECIFIC CONTACT AGENTS yI_ *. Governmental authority/ inspectors: lA2 &- /s• 3006 • y��c� * Licensed installer, responsible for maintenance "Users" manual: Providing an operation/ 2 -zt�31 S * Licensed service / inspection - - agent other than installer: * Electrician, for pump, electric Controls, wiring units: . v. LDS • S e c IMPORTANT OWNER MAINTENANCE REQUIREMENTS 1• Winter traffic'(sledding, shoveting, etc.) across the area shall not be permitted, or frost can /will penetrate into the cell, freezing up the system. Discontinuos use in the . winter,(a vacact.ion. trip, resulting`in`no Water use) can also Lead to freeze ups. 2. Water conservation needs be exercised! - Or system can be hydrolically overloaded and destroyed. This svis�em was designed for a maximum Wastewater flow of (O ' Co gals. daily. 3. POWTS are not desned to accomodate wastes from a garbage . disposal unit, or any other unnatural sources of waste Any introduction of such waste materials will overload --and destroy this system. 9 • If A power outage-occurs, or a pump fails, it may resu In a temporary overload of effluent being pumped into the. cell, which tray adversely impact the cell (leathge). It is recommended that a licensed pumper empty the dosing tank, allowing the pump to return to dosing the correct amounts. Consult your installer - immediately for advice. 5• Neglect of the vegetative (the cells insulation & erosion preventive) can lead to failure. Compaction or heavy traffic also can destroy t he system. It IS NECESSARY TO REGULARLY WATER THE VEGETATION OVER A SYSTEM!! Effluent in the kystem beneath IS NOT sufficient alone tO maintain a _ % over. 6. Periodic inspecti b the owner, Y w er, or his agents, is necessary. Inspection pipes and ports been incorporated into the system: on the mound basal area (effluent level inspection pipes), cleanout terminals on the pressurized laterals, at each tip - for flushing and cleaning the laterals out:. The filter system in the tanks ground c over /manhole). Only a licensed laro e Qiked above Person should be performing this work which invollvesihealth & severe safety risks. Evidence of effluent systems treatment cell shall also be regular lyinspected. 74WA37 Y2 fe� 1 tot5P 68® e� ?24 �3 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX Co., WI STATE BAR OF WISCONSIN FORM I - 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 11/10/2005 08 :00AN WARRANTY DEED THIS DEED, made between Copar Development, LLC, a Minnesota, EX9PT # limited liability company, Grantor, and T. 1. Magnuson Enterprises, Inc a REC FEE; 13.00 Minnesota corporation Grantee. TRANS FEE: 2367.30 Grantor, for a valuable consideration, conveys to Grantee the following C F FEE described real estate in St. Croix County, State of Wisconsin (the PAGES; 2 "Property"): See Attached Exhibit A Recording Area Name and Return Address: Land Title, Inc. 1900 Silver Lake Road, #200 New Brighton, MN 55112 #250130 Together with all appurtenant rights, title and interests. 032 - 2045 -40 -200, 032 - 2045 - 50-025 Parcel identification Number (PIN) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Dated this 3rd day of August, 2005. C�Develo ment , LLC * Thomas D. Hansen, chief manager * s AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA ) WASHINGTON COUNTY. ) ss. authenticated this 3rd day of August, 2005 Personally came before me this 3rd day of August, 2005 the a ve named Thomas D. Hansen, the * (r�j>�NiM l" of Copar Development, LLC ,a TITLE: MEMBER STATE BAR OF WISCONSIN Minnesota limited liability company, on behalf of the limited liability company (If not, *.L MOUNTAIN authorized by § 706.06, Wis. Stats.) �j Nota Public - Minnesota THIS INSTRUMENT WAS DRAFTED BY * S. Mountain Com;;WW Jan 31, 2010 Notary Public, State of Minnes My commission is permanent. (If not, state expiration date: Larry Mountain, Attorney, 1900 Silver Lake Rd #200, New 01 -31 -2010 ) Brighton, MN 55112 (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 r 2A? 5 P 68 1 File No.: 250130 EXHIBIT A Lot 8, Lakeside Estates, St. Croix County, Wisconsin, together with a 66 foot wide access easement as shown on the recorded plat. Lot 19, Lakeside Estates, St. Croix County, Wisconsin, together with a 66 foot wide access easement as shown on the recorded plat. Lots 1 15, 16, 20, 21 and 22, Lakeside Estates, St. Croix County, Wisconsin. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer . Z. M q (;g-j\l U SC) /1J Mailing Address 1 (0 3 g 3 r S 191 G>yMDnJ D V.// Prop Address `� �O a?.. p 3 y � Y (Verification required from Planning & Zoning Department for new construction.) City /State N C- W R 164/Mpn/A,Lv I Parcel Identification Number d 3 2' 2-1 6 0 00 LEGAL DESCRIPTION C ' I � 6 & ip/ Property Location 5 W 1 /4, 5 v1 1 /4 , Sec. 12- , T _ao N R 19 W, Town of S v M C Subdivision L A K S i o t✓ X57 g TES , Lot # � S Certified Survey Map # ------ — , Volume Warranty Deed # g < < , Volume 2925 , Page # Spec house yes C>-o Lot lines identifiable � no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in 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. Owner maintenance responsibilities are specified in §Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 113 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 Planning & Zoning Department within 30 days of the three year expiration date. 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. Number of bedrooms A / 7 /e4 SIG ATURE O APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) W - EPL a I \ ................. ..... X56 8 4 4 J�' o N \ ® \ \ A9409 3.95 BS.00N m \ - - GWOU NMOI O LL p c9i ` ,°� l 89' 409 N49S-eS.00S a�Z � p 00 y O : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 S 1 co O� N3 . sc 2 Z r . w z ir Q II O p CC Cd co I—� CO J�Q J L) ^ rg Q N p O ri Y1 F- vi w r. w cn GO '�ESbZ u I5 \ N'w O a acs c� 0 ci b3lbM \� o "' N r _ � SS 98•OZ9 99EL4 ,4e•cae AO •09 L 101 g