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HomeMy WebLinkAbout032-2044-30-300 1 o 0 v, o 3 C 'o 5 4 .0 5 Cl) g 0 Z y Z o w co cn 3 7c 'o �A z �p ao ! (1) o ►( 1� n Si O fA O o f n y fD m pi O ? -, 1 O N w `C t m m 3 m Fe 13 is N ►-� c a o y rn l o a O to Z I CD o N ;s �c _ n rn Dpi m y m y °' m m N 4 7 �CC N a 7 Q 7 W I C A N W O G o c G Q g O o ° G3 O v'3 u7 a o __ °°� O _ p o N IA f f(A A M O G (n 2 D a " c CD 00 00 3 oo ` a O ooh CL NN N fD Z N N �p CD W o O O p O fD n p CA C N� C,T� CT f 3 w Q (V $o p:9 1 � I o O IC U 3 o o 0U) 0 I � c 3 yyN o w D N c :3 Q V O G a :3 a v O O o w m " IN v ro co CD CD I Tj �+ � �i I 7_c °� � �+ �•° N 3 ° I Q n �f Z �, Z V J N 't D, o I =+ D, o Q 0 a m o y CD o c� h• X ! CD N N 0) N w �. I w O �' a s j O. 7 d 3Z j o m ° c b z m a(6 y o o O 3 !? C M N c CL A 7 Z lmm m _ a W Q Z N 8» 0 a ! A O r: Z 3' 3 m CO to z o ru I a M. a 3X.c a _ cc = cn ° m M CD CD z a o' z a m o ° w m m o CD N � N CD "y T. cc�p—pc�0 F o w A goo, CD - 9ooa CD =: v C7 y d CD b n a � 0 x•mm 3�.� ma y. 3 (D 3 7 co 0. 2 y fC O I x t v , 0 bil Cf c I d � (a I � 3 I x3 a 0 o j M a CD < o p c p r c o o o ma f - Wisconsin Department of Commerce County: Safety and Building Division PRIVATE SEWAGE SYSTEM St. Croix • INSPECTION REPORT Sanitary Permit No: 94 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: Brochman, William I Somerset, Town of 032 - 2044 -30 -300 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 12.30.19.648D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark V-Oet Dosing Alt. BM V Aeration Bldg. Sewe Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System (Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number U 0 4 TDH Lift Friction Loss System Head TDH Ftgr, Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBILD3 WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold 113istribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over Topsoil Depth of eeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges xx S 9 Ll Yes n No E Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1663 85th Street New Richmond, WI 54017 (SW 1/4 NE 1/4 12 T30N R1 9W) NA Lot 3 Parcel No: 12.30.19.648D 1.) Alt BM Description = 2.) Bldg sewer length = 30+ 4 5 i t ny..�1r - amount of cover = - 20 .o x[.Z Ses..•Vr Plan revision Required? 0 Yes 0 No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. v �t�l County Sanitary Permit ST. CROIX COUNTY WISCONSIN G p in accord with Chapert 12 St. Croix ( Ijag{ rdinan_ce PLANNING & ZONING DEPART61EW `p, *b Personal information you provide may be soceN a ST. CROIX COUNTY GOVERNMENT CENTER �i ,pq [Privacy Law. S. 15.' (1)(m 1101 Carmichael Road ,8t �; _ G ED Hudson, WI 64016. 7710 ( 715)386-4680 Fax (715)386-4686 Attach complete plans for the system Ln a errtotless t n 8 _q'V. x 11 i ches in size. County 5anitar Pe mit If O Check revision to previous application N(1� I, Application Information • Please Print II Information ZO " -" ` r` "` ovation: Property Ow er me % 1/4 1/4, Sec N, R or Property Owner's Mailing Address Lot Number Block Number City, St e Zip Corte phone iVumer Subdivision Name or CSM N umber 14 C 3 11 Typ of u I : (check one) G ity ❑Village To I ,y " or 2 Family amily Dwelling • No. of Bedrooms; � ❑ Public /Commercial (describe use)'. El State -owned Nearest Road 11. Type of Permit: (Check only one box on line A. Check box on line B if applicable) Parcel Tax Number(s) (� A) 1 1,ED Repair 2. Reconnection 3.❑Non• plumbing 4. ❑ Rejuvenation °' 6 Ta v Sa it 'on B) Permit Number _ Date Issued State Sanitary Permit was previously issued 3 , IV. Type of POWT System: (Check all that apply) 77 ' 7'77- 7 Non - pressurized In ground Mound a 24 in. suitable soil ❑ Mound 5 24 in. suitable soil ❑ Mound A +0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized in- ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At -grade A ❑ Aerobic T,leatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: _ 1. Design Flow (gpd) 2. Dispersal t 3. Dispersal Are 4. oil App cation Ra 5. Percolation Rate 6, System Elevation. 7. nai Gr Required Proposed 3?j (Gal day /sq.ft.) (Min. /Inch) Elevation / 91 VI. nk Information Capoicty in Oollons Total If of Ma ufacturer Pre ab Site Con- Steel Fiber- Plastic New Bxisting Gallons Tanks i Concrete structed glass tanks Tanks ❑ Q ❑ a VII. Responsibility Statement W 6 - _ I, the undersigned, assume responsibility for repair /roc /in nnenction /rejuvenationstallation of non-plumbing for the POWTS shown on the attached plarts A licens 1811 rewi for terr alift repair o th e install on of non pluinb"nq s u•.;tation system. Plumb (p Piumb�s r�resti MPlMPRS Na, Business Phone Number i Plumber's Address (Street, Cit )) , State, Zip s) VIII. CounW Use Onl Disapproven Sanitary Permit Fee Date Issued I ing Apent Signatu No stamps) J ,i�N��wcc Ownei Given Initial Adverse ,� ��` � d� Determination IX. Conditions of Approval /Reasons Isapproval: n — 1 of TEM OWNER: � V ti rw 1 )Septic tank, effluent filter and 7 /,fib �— dispersal cell must all be serviced / maintained > :; as per management p lan provided b lumber. f ! Uq 2. All setback requirements must be maintained as per applicable code /ordinances. �'� � ��� � mss � � �t%� /w, ��0 '�.�i��/ . skJ �� J(/ti1� - s.�� /� - T.�6f+/ -�9r✓ y ,A Oze ,A Aj Aar �xv- ol /l - �l 98, 45- ' lei � „4's S � /Do 84ye. JI -17117 �IDC /aT 3 s /zz, � z v o ; o x p 70 -1 �. C/) m CO D a, LO m 0 03 9V m a 0 -n r o 0 ;o ct-J D o Lv G)m Q m n lot z 14 1 0'0 m N W ° � ° � N o 4 o Fn av • � -n M cn c 0 CO c Cl) Z —I 0 lz m o Cf) Z , m n z w _ --i < X m D ow ' w m y sL 1 79 O v m ., a s> D' w ° ' Li It t'# v SE m d O o 3 Z 5 m On � Z Z Z 0 o 0 llz0 0 (A 0 0 y� 3 v 0 r� m M tD c 3 O� Z 0 c0 W O H O ? W O N W � �• D7 t/i O j p (� W N 00 4 p e�•r fA n N O (DD n N S f O N CD tD O "► ` 1 N 7 O O O C CL A ON v c'�D '��' co p W O O CA CL fo CL S 7 H d 7 W N v+ w 3 y H 3 0 o d W d 0 v cn vD A 4rn, cnzD m 4rn (D m? n a w <n' D (' a w p a = 3 rz 'COL O O .•. 0 >• O " O CD Z rn w c/) �r o aCD z o or - w y N m o m 3» Q 0 3 0 ? a�i O fA co y a 00 9 y N N G w D O 7 V� 1 .► CL ; V ; -4 V Z m M O D o D o v O o O o' ? "W � m o� m o m �• CD N N N w c a s c a s z CD CD CD 3 c N a a AZ; w �° c N CL c z A ;p C ri C :i Z m Z t r N � ? 7 <D C M.O_a O x,co p n CL a) <� a 3� n o' cG Gn m T C O O A �1 7 ry Z CL O :E O Z O. m o @ o m o a o m N �o (D N c n 5 n :r m m� m d g s ?.0 N �. C 0 cc 221- > > n m v CD 0 , �- oov X X c 3 c� O 5 c a 2 0 a y cc W C �.3•X Z D C co .r a M n CD N 0 N � �m� 3 ° c 3 � A O O A > CD DO CD m A 00 00 .. ooi °oi �'' b Wisconsin Deliartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 395169 0 GtNERi4L 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: Brochman, William I Somerset Township 032 - 2044 -30 -300 CST BM Elev: //11 Insp. BM Elev: BM Description: V TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Z O Benchmark Dosing Alt. BM L4 2 -D Aeration Bldg. Sevyer ,3 Q•3S Holding S t Inlet �� Q Z Outlet TANK SETBACK INFORMATION d TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic „� / � � � Dt Bottom Header /Man. l Z C Q ing / Aeration Dist. Pipe p Z O olding Bot. System . L Final Grade PUMP /SIPHON INFORMATION facturer Demand St Cover X GPM Model Number TDH Lift �ficfi:on Loss em Head T DH Ft For main Length Dia. Dist. to SOIL ABSORPTION SYSTEM BED/TRENCH Width Length en P No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 '? 3. 5 SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LE HI NG Ma fact gr: INFORMATION A OR Type Of System: IT mode N b r: DISTRIBUTION SYSTEM Header /Manifold IDistribution x Hole Size x Hole Spacing ent to ntake f V Pipe(s) f (/ ^ /] Length_ Dia_ Length Dia Spacing 'v SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Dep th Over xx Depth of T77�ded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil D Yes ] No [] Yes ❑ No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:_j Inspection #2: J 1 Location: 1663 85th Street Somerset, WI 54025 (SW 114 NE 1/412 T30N 11119W) N Lot 3 / S Parcel No: 12.30.19.618D 1. (� Alt BMDescri Description Ot e �( y�) S( � S � ;�Sl �JU�6C� )91 Q ✓cam 2.) Bldg sewer length= Ib' so �o�d �.� K 5P 4Y - amount of cover DbsC - � �6L ✓t Nt• Plan revision Required. [] Ye o Use other side for additional information. Date Insepctor's re Cert. N . SBD -6710 (R.3/97) .1 , h� c Q� C a e ° ° � ��+ �, �o��� ,. e L �l �j; l �.,� � �w � � C Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 `m seonsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)j (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) t e' y n er not less than 8 - 1/2 x 11 inches in size. County ) State Sanitary Permit Number revise s application State Plan I. D. Number 3 S �:` ��� I. Application Information - Please Print all Informat' it = =, / Location: Property e e Property Lo cat ion R ' �4� Ze, 4 1/4 1/4, S T N, R (o Property Owner s Mailing Address Lot Number Block Number City, State 7 Zip Code :.:. Phone Numb ,' Subdivision Name o CSM Nurnl, II. Type of Building: (check one) /✓ sk r �ah S ° SK, 6w.`c{�cd ❑ Vi lla g e 5d 1 or 2 Family Dwelling -No. of Bedrooms: ❑Public /Commercial (describe use):_ 2f Town of ❑ State - Owned A Nearest Road " Parcel Tax Number ( s ) III. Type of Permit: (Check only one box on line A. Check box o line B if applicable) A) 1. J9 New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: - 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate als. /day /sq. ft.) (Min. /inch) Elevation 15?9 we VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement 1, the undersig assume responsibility for installation the POWTS shown on the attached plans. PIumMer Nam (print) Plumber' ignatur ps): MP/MPRS No. Business one Number PI mbar s Address (S et, City, State, Z' C de) ex 10/ /��" /1' )7 - IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fe� Determination Z Z S. 0 0 X. Conditions of Approval /Reasons for Disapproval: �`F7�IltPN1 7 +��CV h1 �lC r>.S�a��t4 hlGtiY� /aihl:� 1 pGV Iv M�It �0.GTI�y�Y$ APCOW�hn'�4GtrlM SBD -6398 (R. 07/00) r _ _ r i I Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau-of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and C ` percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information Reviewed bj Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location L G Govt. Lot c– t 1/4 1/4,S Z T ,N,R I E (or Property Owner's Mail! Address Lot # Block# Subd. Name or CSM# City State 7 Zip Code Phone Number ❑ City ❑ Village Q Town Nearest �Road / ✓a"� �r � 1.6 ( ) - w Construction Use: 5irilesidential / Number of bedrooms 1_ Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: �( Code derived daily flow 14 DU gpd Recommended design loading rate 7 bed, gpd /ft V trench, gpd /f1 Absorption area required gf , ; bed, ft 5 0 trench, ft Maximum design loading rate _ _ bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevations) I''�'r T1 /�► ft (as referred to site plan benchmark) Additional design /site considerations Parent material e(i�Leaee .fin _ Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ U.S ❑ U El j9 [I U El S U ❑ S U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench f 1, Ground _ / �i ' > 1 I v �ft. Depth to limiting Q . factor 7 J 2 D in. ? j (p • (o Remarks: Boring # Jr' `' , Z Ground elev.f r , �y�Zft' a T S NT`i Depth to 7CNdil� , limiting `1 factor _2/_,_5 in. Remarks: CST Name (Please Print) S' n e Telephone No. 15 c ri 3; Address Date CST Number I PROPERTY OWNER �`' �' ��2IL DESCRIPTION REPORT Page of 1 - PARCEL l.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 Lj in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 60& Ground elev. I Depth to 8 limiting facto ct 7�L�in. �a yG Remarks: Boring # 3 - o s ©rn s Nip- e1 . Ground eleY Depth to limiting f aatQr �7 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # �-� s S r Ground , ft Depth to limiting c r in. Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) I Soil Test Plot Plan Project Name Cycella Flandrick Sha ird Address Raleigh Rd N Richmond Wi 54017 CSTM #226900 Lot 3 Subdivision -- ----- Date 12/6/98 SW 1 /4 1/4S 1 2 T 30 N /R W Township Somerset Boring ()Well PL Property Line County S T. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 89.5/8 * H R P Same as Ben Alt. BM Top of Survey Pipe @ 95.7 660' Property Line Pro 4 Bedroom House 25' w 5' ° B -5 30' -1 0 ' P{ . CD 6% Slope -3 0 ' -2 B -4 30' 51 Alt 120' ;1& ' 660' Property Line B.M. ,z 9,5, - - I s r Gl I � _ __ �_ __ __ _ . .- __ -_ __ I_ _, __ _ �_ Q __ _ - - - -' _ - -_ - _ - - - - -- _ - _s._ -- _ _ _._ -. j -- __ _._ �_ _: _ _, _. _ _ _ -' _. _ ._ ', ', ', ', _ _ _ _ _ , _. ', I j -- __ __ _. � ; i ', I � ' I � � _ . __ _ _- i - -- _.: ', � ' 'i _ �_ __. �r — — - _ — __ � � � I _ _. _ __ i ' � I �, �� _ .._ __ - - - - -- i I _, � ' I l Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) 4O6 Estimated Flow - Average (gpd) '(oo Septic Tank Capacity (gal) ! Zoo Soil Absorption Component Size (ft) Type of Wastewater Domestic Table 2: Soil Absorption C omponent - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the ♦ Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole 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 one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by type freezing. This of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 I -- 2 1� • S "I' CROIX COUNTY SIP"TIC 'TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer t ll'C� T : � r Cl u Mailing Address 10. " f `1g Property Address���/ (Verification required from Planning Department for new construction) City /Stat Parcel Identification Number 63Z ^��'3� LE GAI, DESCRIPTION Af IV Property Location 6 00 '/ 'A, Sec. �, T _3 N -RI ' I W, Town of 1 5 6 WLe-V ' 0 Subdivision , Lot # _. Certified Survey Map # Q I , Volume 3 Page # Warranty Deed # y�� / , Volume 0 , Page # Spec house ❑ yes IR Lot lines identifiable E ycs ❑ no SYSTEM MAINTENANCE 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. The Property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplurnber, journeyman plumber, restricted Plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition anwor (2) alter inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, 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 tl our septi stem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of three y', expiration date. 7 11216 1 . 1, ,� ii5TATOkfbf APPLICANT DATE OWN ER CERTIFICATION 1 e) cer ' y that all statements on this foam are tntc to the best of my (our) knowledge. I (we) am (are) the ossner(s) of M the r desc tb 1 above, by virtue of a %�arranty deed recorded in Register of Deeds Office. IGNATUR.E 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 cope of the certified survey map if reference is made in the warranty deed .....1620PAGE 604 STATE BAR OF WISCONSIN FORM 2 -1998 KATHLEEN H. WALSH Document Number WARRANTY DFFD REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Cyrella M. Flandrick a /k/a Cyrella RECEIVED FOR RECORD Flandrick, Grantor, and William P. Brochman, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee 04 -19 -2001 9:45 AN the following described real estate in St. Croix County, State of Wisconsin (The WARRANTY DEED "Property"): EXEMPT N CERT COPY FEE: Part of SW 1/4 of NE 1/4 of Section 12 -30 -19 described as follows: Lot 3 of CORY FEE: TRANSFER FEE: 135.00 Certified Survey Map filed December 23, 1998 in Vol. 13, page 3577, Doc. No. RECORDING FEE: 10.00 594356. PAGES.". 1 Recording Area Name and Return Address Ronald L. Siler VAN DYK, O'BOYLE & SILER, S.C. Post Office Box 118 New Richmond, W154017 032 - 2044 -30 -300 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Subject to all easements, restrictions and covenants of record. Dated this -Lr— day of April, 2001. FILED Z DEC 2 3 1998 ► 8 KATHLEEN H. WAM Register of Deeds CO., WI CERTIFIED SURVEY MAP ti Located in part of the Southwest Quarter of the Northeast Quarter of Section 12, Township 30 North, Range 19 West, Town of Somerset, St, Croix County, Wisconsin. Prepared for and at the request of: OWNER: Cyrella M. Flandrick 114 CORNER T :1 1914 Raleigh Road r SEC. 12 -30 -19 New Richmond, WI 54017 1 • r � 1 (ALUM. CO. MON.) Drafted by. Krlstl A. Eylandt I r; ' UNPLATTED LANDS r , sy��D LANDS : o NORTH LINE OF THE SW `G ��''�F 114 OF THE NE 114 to RONALD F. 3 I x • JOHNSON I ,Z I ° "' s ->>rss Ih :C14 AMFRY. °0 f COL 1 ,r Wis. 1 ° "ice s N CERTIFIED SURVEY MAP " N� SU R`j � :.YI VOLUME 12 PAGE 3388 I .�- 33.00' Zi C.S_M. of I t� N89'37'57 660.07' o f VOL_ 11 PAGE 3205 �1 627.07' 0 o 1 ` f TOTAL AREA of W� i I I i 3 N 202,623 SQ. FT. - Qi v y W� iv I o� o 1 4.65 ACRES ° J j o v► dCi 0 I ,° Q AREA LESS R.O.W. C ° N I i 192,492 SQ. FT. Q� c N �, v I�� 'n 1 33.00' 4.42 ACRES Q_ U a' o i N89'37'57 "E 660.07' o Cj = i `0 (o 627.07' N o v �1 pplN I TOTAL AREA rn cam ap; .04 01 U: 202,623 SO. FT. E >, c o� � I o� o L4 h" 4.65 ACRES o v o M' I w oI o W �: AREA LESS R.O.W. 0 t a - c° �, wl O 1 I N 'hI "� N C�: J 192.492 SQ. FT. n N o a o NI � QI cn 1 I Co 0 p. 4.42 ACRES co \ 3: o •` r� tnl a I N o j�: w > o I O BI i I I p I O Iz z N89'37 57 "E 660.07 cn E� L_ o i 627.07' r �, o - 33.00' TOTAL AREA c o 202,710 SO. FT. ° ` ° oI a I 4.65 ACRES N ;` a 0 1 M M ~ AREA LESS R.O.W. 0 y °` P o 1 I 1 192,578 30. FT. M 0 an -- - - -_ -- 4 100 J 4.42 ACRES m` E I I ; N _ J PLAT OF NORTH I i 627.07' a; 1 ' ' I ` S893919 " ' W 660.07 ° c BASS LAKE ESTATES — I UNPLATTED LANDS OF OWNER a 'o 300 3. - -- _ — L _ _ _ _ t — — .. —.. —. ~; ao JOB #97108 (R i 4) 11 N SOUTH LINE OF THE SW 1/4 OF THE NE 1,/4 z f ° tL z UNPLLUED LANDS LEGEND e - -SOUTH 114 CORNER County Section Corner Monument SEC. 12 -30 -19 of Record (ALUM. CO. MON.) • Set 1" x 24" Iron Pipe weighing a minimum of 1.13 pounds per linear foot. O Found 1" Iron Pipe 200 0 20o NO TH Prepared by. A & E GRAPHIC SCALE LAND SURVEYING do CIVIL ENGINEERING SCALE IN FEET: 1 Inch = 200 feet Phone No. (715) 246 -4319 BEARINGS ARE REFERENCED TO THE NORTH -SOUTH 1/4 109 East Third Street, P.O. Box 325 LINE OF SECTION 12, TOWNSHIP 30 N., RANGE 19 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR S00'28'20 "W. Sheet 1 of 2 Vol.13 Page 3577