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HomeMy WebLinkAbout032-2136-40-000 Parcel #: 032 - 2136 -40 -000 05/30/2007 05:03 PM PAGE 1 OF 1 Alt. Parcel #: 13.30.19.1206 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 NATHAN R MANOR O - MANOR, NATHAN R 1579 84TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description 1579 84TH ST SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 3.330 Plat: 2515 - STONEWOOD 2000 SEC 13 T30N R19W NE NW LOT 4 STONEWOOD Block/Condo Bldg: LOT 04 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13- 30N -19W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 11/25/2003 747504 2462/436 EZ -U 09/19/2003 740592 2414/320 WD 02/12/2001 6383490 1585/538 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/09/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.330 49,600 203,400 253,000 NO Totals for 2007: General Property 3.330 49,600 203,400 253,000 Woodland 0.000 0 0 Totals for 2006: General Property 3.330 49,600 203,400 253,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 09/26/2005 Batch M 05 -17 Specials: User Special Code Category Amount Special Delinquent Charges ecial Assessments Special Char a De ue t C p p 9 q g Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division r INSPECTION REPORT sanitary Permit No: 430387 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)I. Permit Holder's Name: City Village X Township Parcel Tax No: Manor, Nate I Somerset Township 032 - 2136 -40 -000 CST BM Elev: Insp. BM Elev: FBI Section/Town /Range /Map No: Q o' <_J0 j ) 13.30.19.1206 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , Benchmark Dosing Alt. BM� J Aeration Bldg. Sewer Holding SUHt Inlet c TANK SETBACK INFORMATION St/Ht Outlet 7. 1 O 9 Q • Sq TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , N e i' �p,/ Dt Bottom Dosing >� Header /Man. �b Z 9� �.. Aeration t. Pipe N E is . Z N 1,_4 .o . Rto .'7 Holding ; ot. System X 1 5. 6 S 11, 7 q lS.7 PUMP /SIPHON INFORMATION Final Grade 1 7. 1 99 P � Manufacture Demand S Cover v� GPM Model Number , ; g SC O •Z A 94.7'3 �'t w ro -z 94.G�' TDH Lift 'Friction Lo System Head TDH It Force in Length D Dist. to Well SOIL ABSORPTION SYSTEM -7 BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS C� SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufa turer: INFORMATION Type Of System: CHAMBER ORv�� \��'b• � ��'� ` _3 t OI UNIT Model Number: 6 cz� PST� IBUTION SYSTEM �- Header/ anifold Jbistribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia r Spac .ti SOIL COVER J x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Z p h Over xx Depth of xx Seeded /Sodded T Mulched Bed/Trench Center L C , ,_ b Td/Trench Edges �_. Topsoil Yes No r] Yes No COMMENTS " (I f nclude code discrepencies, persons present, etc.) Inspection #1: /o / U l 6 �3 Inspection #2: Location: 1579 84th Street Somerset, WI 54025 (NE 1/4 NW 1/4 13 T30N R19W) Stonewood Lot 4 /f Parcel No: 13.30.19.1206 i ® 1.) Alt BM Description = 7 s y� 3) S c'"/ V - a `l. a r 2.) Bldg sewer engt = -.. I00' �� Sb t ���tcE'ti`iO - amount of cover = ° I — � Plan revision Required? [j Yes D No 1 ,.o Use other side for additional information. �� a7s SBD -6710 (R.3/97) Date Insep Signature Cert. No. Safety and Buildings Division County N visconsin 201 W. Washington Ave., P.O. Box 7162 St. Croix Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151 3 De artment of Commerce J� 30 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s I5.04(1)(m) Project Address (if different than mailing address) '# IS--q 84th St. I. Application Information - Please Print All Information +C tv Property Owner's Name v G• Parcel # Block # Nate Manor P 2 Z0�3 C4 ' Property Owner's Mailing Address co oN \Y Property Location r i„ 549 Omaha Road ST. GRU X �FFIG (Z� City, State Zip Code er NE y,, NW '/., Section 13 Hudson, WI 54016 15- 426 -9806 T 30 N, R 1 9 ( W e) II. Type of Building (check all that apply) o� Z 1 or 2 Family Dwelling - Number of Bedrooms 3 Subdivision Name CS Number Stonewood El Public /Commercial - Describe Use � ryry �y C1 State Owned - Describe Use (mob l ❑City _ []Village 9•ownship o III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 5L No t (� p - -) A. gNew S y stem ❑Replacement System El Treatmenr/Holding Tank Replacement Only 11 Other Modification to Existing System B. 11 Permit Renewal ❑Permit Revision El Change of El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that apply) /LT5 tt Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ �� S Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter Recirculating Synthetic Media Filter X® Leaching Chamber ]?rip Lie t \ g yn g p ❑ Grav - s Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: a h Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (st) ystem Ele :T) 450 0.66 p . � 643 684 95.7 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Stee Fiber astir Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1000 1000 1 Wieser X Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume res onsibili f inst n of the POWTS shown on the attached plans. Plumber's Name (Print) Pl ber's Signature MP S Number Business Phone Number Jim Hurlburt 222997 715- 283 -4851 Plumber's Address (Street, City, State, Zi o J & R's Eau Galle Plumbing, N 260 CTHW D, Eau Galle, WI 54737 VIII. Court /De tment Use Only Approved Sanitary Permit Fee includes Groundwater Date Issued Issuin Agent Signature (No Stamps) Surcharge Fee) Z � wner Given Reason for Denial W IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: OWNER: / S" S �?�c t Terri Ova 1 Septic tank, effluent filter and heo-� S � dispersal cell must all be serviced l maintained as per management plan provided by plumber. c a ` at S 2. All setback requirements must be maintained I I as per applicable codelordinances. L) Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 In hea in s1 / SBD -6398 (R. 01/03) P 0 9 M cl G 1 7 co 0 � M J V .� n rl Z C 79 � w � o — s � 04 r \ a rl y s ffTT I � --I O —b c� s e� P f D M � 3 -� z: o J �� r?r , lb p A r � � d•. tit 0 - f a `; P r7 y f � N J J OOOO�J do i 9 s —� c0 If/ 1 � w at dt lzl .w % O- bto' O p z. IL I 1862 Wisconsin Department of Commerce SOIL EVALUATION REPOR Page 1 of 3 Division of Safety and Buildings in accordance with Co 85, REA;E d� D Certified Soil Testing Count Attach complete site plan on paper not less than 8% x 11 inches in size. Ian must 2� St. Croix include, but not limited to: vertical and horizontal reference point (BM), dir ction anQ percent slope, scale or dimensions, north arrow, and location and distan to nea arcel I.D. Please print all information. S T. CROIX COUN Stevie d y Date Personal information you provide may be used for secondary purposes (Privacy L , s.15.00M kM N G 0 F F C Property Owner Property Location LJP Manor, Nate Govt. Lot NE 1/4 NW 1/4 S 13 T 30 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 549 Omaha Road 4 Stonewood City State Zip Code Phone Number City Villa a Town st Road Hudson WI 54016 715 - 426 -9806 t 84Th St. 4 4F V.1 New Construction Use: 40 Residential / Number of bedrooms 3 Co derived design flow rate 450 GPD Replacement Public or commercial - Describe Parent material sandy /loamy outwash Flood plain elevation, if applicable NA General comments and recommendations: install 2 - 2.83'x 68.42' (St'd, Infiltrator, 22 shells) leaching chamber trenches @ system elevation of 95.7 following 100.0 - 99.0 surface design line f Boring Boring # Pit Ground Surface elev. —110 ft. Depth to limiting factor > 60 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -4 7.5YR 3/2 - sil 2 m gr ds gs 2fl m .5 .8 2 4 -8 7.5YR 3/2 - sil 2 f sbk ds cs 1 m .5 .8 3 j 8 -18 7.5YR 3/2 - sil 2 m sbk sh cs 1 m .5 .8 4 18 -42 7.5YR 3/3 - sil 2 m sbk mfr cs 1 m .5 .8 5 42 -48 7.5YR 4/6 - sl 0 m mvfr gs - .3 .5 6 48 -60 5YR 4/4 - sl 0 m mfr - - .3 .5 outside proposed system area 2 B n 9 # Boring Pit Ground Surface elev. 100.0 ft. Depth to limiting factor > 88 in. Soil Application Rate orizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -4 7.5YR 3/2 - sil 2 m gr ds cs 1f /m .5 .8 2 4 -11 7.5YR 3/2 - sil 2 f sbk ds cs 1 m .5 .8 3 j 11 -26 7.5YR 3/4 - sl 0 m dh cs 1m .3 .5 4 26 -44 7.5YR 4/6 - Is 1 m sbk dsh cs if .7 1.2 5 44 -88 7.5YR 4/4 - s 0 sg ml - - .7 1.2 S• �/ I 5• iP -- * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mgL CST Name (Please Print) Signat r CST Number Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 9/16/2003 715- 233 -0398 Property Owner Manor, Nate Parcel ID # Page 2 of 3 37 Boring # _j Boring ✓j Pit Ground Surface elev. 100.6 ft. Depth to limiting factor -60 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0 -7 7.5YR 3/2 - sil 2 m gr ds cs 1f /m .5 .8 2 7 -12 7.5YR 3/2 - sil 2 f sbk ds cs 1M .5 .8 3 12 -24 7.5YR 3/3 - sl 2 f -m sbk ds gs 1 m .5 .9 4 24 -43 7.5YR 3/4 - sl 2 m sbk dh cs - .5 .9 5 43 -80 7.5YR 4/6 - Is /s 0 sg ml - - .7 1.2 occasional gy si coats on peds inhorizon 4; horizon 5 has occasional inclusions 10YR 4/3 sil w/ c2p 7.5YR 4/6 - 10YR 6/2 redoximorphic feature estimated as below about 60" (pit not entered - read from surfce in backhoe bucket); outside system area 4 Boring # - Boring Pit Ground Surface elev. 100.0 ft. Depth to limiting factor > 88 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 1 0 -4 7.5YR 3/2 - sil 2 m gr ds cs 1f /m .5 .8 2 4 -10 7.5YR 3/2 - sil 2 f sbk ds cs 1 m .5 .8 3 10 -20 10YR 4/4 - sil 2 m sbk dh gs 1M .5 .8 4 20 -31 7.5YR 3/4 - sl 1 m sbk dh cs 1M .4 .6 5 31 -88 7.5YR 4/4 - s 0 sg dl - - .7 1,2 irregular inclusion 5YR 4/4 sl (0, m, mfr) @ 53 -62" one location on east pit wall 5 oring # I Boring 1„ f/ Pit Ground Surface elev. 98.2 ft. Depth to limiting factor > 88 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -4 7.5YR 3/2 - sil 2 m gr ds cs 1f /m .5 .8 2 4 -11 7.5YR 3/2 - sil 2 f sbk ds cs 1m .5 .8 3 11 -24 10YR 4/4 - sil 2 m sbk dh cs 1m 5 8 4 24 7.5YR 3/4 - Is 1 m sbk ds gs 1 m .7 1.2 5 34 -88 7.5YR 4/4 - s 0 sg ml - - .7 1.2 horizon 5 has occasional Is inclusions (7.5YR 4/4) ` Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R 07/00) Certified Soil Testing o 9 r Gil Z) o 3 � Z � � J � � ko s _s n s � - P °8 o J �b cf TT�t�x o p . Oc N l I J c.!► 0 s � s , POWTS OWNER'S MANUAL MANAGEMENT PLAN Page \ of 3 FILE INFORMATION SYSTEM SPECIFICATIONS Owner o, +t Septic Tank Capacity gal ❑ NA Permit # q3 0 3 Septic Tank Manufacturer W; wt., ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 100 d/bedroom 3 ❑ NA Effluent Filter Model ❑ NA Number of Commercial Units NA Pump Tank Capacity al (A NA Estimated flow (average) - al/day Pump Tank Manufacturer NA Design flow (peak), estimated x 1.5* al /da Pump Manufacturer NA Pump Model p NA Soil Application Rate ,n.'} al /da ft pretreatment Unit E) NA Influent/Effluent Quality (NA ❑) Monthly Average ** ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L '� ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) < 220 mg /L '' C] Disinfection Other: Total Suspended Solids (TSS) v Manufacturer: Model: <_ 250 m L Cell(s) Pretreated Effluent Qu ity ❑ Monthly Average * ** Dispersal Biochemical Oxygen D a (BODs) �'In- ground (gravity) ❑ In- ground (pressurized) Total Suspended (TSS <_ 30 mg /L C3 Drip-line C3 Other: 30 mg /L ❑ At -grade El Mound Fecal Coll form ometric mean) I0Vu1100m1 Leaching Cha ber Manufacturer .1.,, .. 4 Maxim Effluent Particle Size 1/8 inch diameter Model S V Approval Stipulation 1aa t *Wastewater Flow Verification on and calculations: Soil Application Rate o gpd/ft Area Req. G 1* Z ft' (Other than bedroom based) Absorption Area Credit per unit ft Minimum Number of Chambers 2 2 ❑ Aggregate Desi n Flow/ Rate = ft min ** Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. ,/ COMM84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual — Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 ❑ SBD — 10570 —P (R.6/99) "At -Grade Component Manual Using Pressure Distribution" NrSBD — 10567 —P (R.6/99) "In Ground Absorption Component Manual" ❑ SBD — 10705 —P (N.01 /01) "In Ground Soil Absorption Component Manual' Version 2.0 ❑ SBD — 10628 —P (N.6/99) "Recirculating Sand Filter System Component Manual' ❑ SBD — 10656 —P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual' ❑ SBD - 10572 —P (R.6/99) "Mound Component Manual' ❑ SBD - 10691 —P (N.01 /01) "Mound Component Manual' Version 2.0 ❑ SBD - 10595 —P (R.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657 —P (R.6/99) "Drip -line Effluent Disposal Component Manual' ❑ SBD - 10573 —P (R 6/99) "Pressure Distribution Component Manual' ❑ SBD - 10706 —P (N.01 101) "Pressure Distribution Component Manual' Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequenc Inspect condition of tanks At least once every 3 ❑ months (as ears Maximum 3 s.) Pump out contents of tanks When combined sludge and scum equals one -third 1/3 of tank volume Inspect dispersal cells At least once eve ❑ months Cr ears Maximum 3 s. Clean effluent filter At least once every 3 ❑ months 25 year (s Inspect pump, pump controls & alarm At least once every ❑ months ❑ ears 19 NA Flush laterals and pressure test At least once every ❑ months ❑ year (s) ® NA Valves At least once every ❑ months ❑ ears IN NA Other: At least once every ❑ months Cl ears E@ NA I - Page z of START UP 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. ___ System start up shall not occur when soil conditions are frozen at the infiltrative surface. 1� OPERATION The property owner is responsible for the operation' and maintenance of the'POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water- saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. 0 Valves Valves shall be operated in the followi g anner: 0 Alarms Alarms should be tested on a regular basis by home owne . an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day resery nder regular operating nditions, however water should be conserved until any problems with the system are corrected t prevent back -up of sewage into 'the dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). CCSeptic Tanks Component 1 Tank inspections must include a visual inspection of the tank 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 backup or surfacing of effluent . Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) 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 NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. 0 Pump Chamber/Treatment Tanks Compone The inspection must include a test of all el ical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing,'mi ng o okeri security devices and other hardware and the condition of the filter. Any service needs or repairs shall promptly take care of. page 3 of 3 in- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. ❑ Mound, At- Grade, In- Ground Pressure The inspection shall include recordi=occurring ls of ponding, if a n the observation tubes and a visual inspection for any evidence of surface seepage or disc discharge to ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% ht of th omponent may indicate overloading or impending hydraulic failure necessitating more frequent monito The pressure distribution system is ith an ope ' at the end of each lateral to be used for flushing. The laterals should be flushed at least once everears. Pressure ecks of systems with multiple laterals should be done to ensure that equal distribution of effl rring to promote the longevity of the system. REPORTS Reports for maintenance, ins p tion, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil. gravel or other 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 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. X 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. O Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name tw %A,%%.%6. 4- I Name Phone 4-%C) 1 Phone SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY [ Name Agenc Phone Phone Mks - 31Qb -4b% I f-i 1_1 u .4 1 u ' r.) '1 ;_t - iL LE P L - Ll r•. I. i 4 SET HC' TAYK MAITUTINANC H AGREWA'1-V A 4 OWNFRISHIP CERITI WTION FORM RJ (V1Cjjj1C,DtjQU ed C.-OM PIAW)ii. 1)c,pzi for new oonsf-luctiouL V, ;'i'vi'State NR fic a t i on N'tuab Or 136 0( 6 12— Md Parcel Id-atiN 11ILS L R_ ITQ N piw' uxeatiun /., See. 'r 30 N.R _LT_W, Town Of Lot Celiffied sun Map P Vulu 0 Sac)_ Spec. houix, D ves ;R zo Lot Uncs ideutiflable Dd 'i" U L'U lmprnper U&e and maitacnaao4 of your septic system could zcsWt in its prmawm failura to'handle W062. Ptopsr rrAinte.u=" ronsisis of pawing out the hqtic tank every threte, years or sooner, if needM by a licensed pamper. WbAt you put into tf:� f v<tew c an mdtcct the fimetilon of the acetic tank as a tre-ment sisge in the wv_sle diSpoml system. The, prup4r%yuwuci agtec* to subuiit CQ St. aoix Zoning Dcpattmcnc a m fom idpod by too owr•f ai-'l by a restricted plumber or a Uoemedp=p:rvefifyin Wt(l) the t5 rn poo up-n-#6.r,g condition and/or (2) after insimetion sa)d pumping (Lf u4 PALsafy), the septic, task iA less d= 113 full 6' 1,�Aic' too aadci tgnod have read the abvvc requircuients and agr" to inaintaia the piwite smajo disposal system wii• t' +c standards iri forib, herein, its set by th,-. Department of Commen r and the Dipartmout of Natural Renurm, State of Wiwn tnitioatioa Ua* That your SCPCiC sys tem has been Ma ifitained must by completed and retaned to the SL Qoix County ZoniDg , i ice wv;iv330 Ir __xP1!Ut1Q1t&te" 1:20/ DA` P rectify t hat aU &WOMCCiS 00 61-s 104ru are tcac to the test of my (our) knowicdgo. I (wa) anti (F-re) th- o-men-9 01 J'_e' by virtue ol 2 Awmaty deed tec*fded in Register of Deeds ffl kv. O. DATE 'Pic.4 CWCJ mq lc5ull to th,! c.d n toxy permit bomg revoked by die a Zo isa D ent: SU warranty de e4 tT�-.M fle Kqpstfm Of Deeds offi aL C'14Y Of the Gerdi 1;uIvL I-lap tf mfamact- U Iludo j.'l 1110 Y'arm'It decd ............. .. ....... . . .................... A I U �•a q � I 7 uu 40592 STATE BAM,OF &I�S7N� nn OR� �- U998 WARRANTY DEED ;j KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., NI Document Number C _ - RECEIVED FOR RECORD This Deed, made between it 09/19/2003 09:30AM IwI ScemsJAr L/�/TZ Z1^9 /TY o�Pi��t/y it WARRANTY DEED j EXEWT ik j' Grantor, REC FEE: 11.00 and V TRANS FEE: 159.00 COPY FEE: j CC FEE: _ Grantee. j PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following it described real estate in �T e/G��x County, State of Wisconsin Recording Area (the "Pr erty "): l' Lo T 57 — 1 — e &W OF YOW61%8 i i Estreen & Ogland 304 Locust Street i Sr &AeD I,Y 6e u 5co AISI i✓ Hudson, WI 54016 I I I� DMZ- �13�O- yo -oao 'I Parcel Identification Number (PIN) This homestead property. *9) (is not) (t l � II I` j j, L Together with all appurtenant rights, title and interests. �j Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Dated this (O T)q day of - 4C0 A?4'6e Q ;i (SEAL) Y! 4� (SEAL) * * 1 RR go V 4�� N ( (SEAL) (SEAL) I' AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, County authenticated this ` ay of 3 Personally came before me this day of ji the above named * 1 s—r lof 14 6&1- UA-Y-d ii TITLE: MEMBER STATE BAR OF WISCONSIN to (If not, me known to be the person who executed the foregoing authorized by §706.06, Wis. Stats.) instrument and acknowledge the same. li THIS INSTRUMENT WAS DRAFTED BY I. ,.1f lee- �1 Gf V1,v� Notary Public, State of Wisconsin ZZ7 " 7 mil d� •• 7`�1J,0�d/C /��! 1 71 My commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not ) necessary) Names of persons signing in any capacity must Le typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc. WARRANTY DEED FORM No. 1 - 1998 Milwaukee, Wis. m --------- ---------------- �a ■ 38th ST. T i ...............' ■ ' T O ■ o ...... ---- -r - - -- C z' m Z ■ N n s ©- 50th W CA ' ST, u -� ■ Z y i O o ■ f ".� W A m LA Z 0 ■ 0 S i CT Z CTH I V♦ ■ S fry 9'�0 .. 9 a • eh qa 85th ST. W 1 ^9 Trell;R 0 O _ d, z 85th ST. 100th ST. ; z v 0 o Z ' I s ' A z �1 110th ST L♦ '.... -• - -- 0 -- -- - - , t ------ K 'C�_ A ■ n� o° �) ■� S 0 ' o 47 i z ' ------ ---- - -- ■ J O �_ .■ ■.■ ■■■ ■s■■:�■ � to Z Z —r-- L 2!?'LATTED LANDS W w ---N$r43WW 107 .63'•' - 4 - — ------ ------- — ----- -41K --------- --- , ; M ;� i ".. C4 jr ; - W 500'&37 ...... ................ 32M Jai . . ...... ....... yy w og , 19&W 3IUr 4 o il T .. ......... ...... 48 4 -� k all X 2i -s V1 ' S8r4W5$'V 43LIW z w X m ". 0 ,z -5 I c C- u it CO �MMAWW coat p z At w N TH - o w a w X FRI 1 W,W 11419WHIIII? SI&W P- vz -4 A-� si;w. % . 'K A O 61 z -4 T1, MOON w .......... 7:7 z 4 sib ----------- ......... ... ...................... 1 rag! SEA Ix lim. um /". �,p WJV- 0 n 6w r a. r: eav, -4 0 sEcylay fj-v ffww 2 - Avov RPC) I; K 4W7 1-00 - �T - 7 ----------- -ir--n -- — --- t; A;;� A Wisconsin Department of Commerce SOIL AND SITE EVALUATION - `t)ivis on'of Safety and Buildings Page of Bureau of Integrated Services in accordance with Comm 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 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - P1 06 � n o tion. Reviewed by Date Personal information you provide maybe used rg ary pure ses ( ��/ s. 15.04 (1) (m)). Property Owner ` >:� h �f� Property Location Govt. Lot 1/4 �� 1 /4,S T�� ,N,R E (or& Property Owner's Mai i g Add s j a 1; + CQD r Lot # Block# Subd. Name or CSM# City Stat Zip Code Phone�'N(Gf`nber ❑ City El Village 12 Town Nearest Road �r New Construction Use: Residential / Number - d bedrooms _' Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow dQQ_ gpd Recommended design loading rate Z.-2 bed, gpd/fi gpd/ft Absorption area required �f D bed, ft2 rench, ft Maximum design loading rate Z, bed, gpd/ft gpd/ft Recommended infiltration surface elevation(s) y 7 ft (as referred to site plan benchmark) Additional design /site considerations Parent material 9 �� 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 1 ❑ S ® U ®S ❑ u ❑ s ®u ❑ s ®u I EIS O U ❑ S -® U SOIL DESCRIPTION REPORT # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground ' /° y s Al el ,ft. 5 `� 6 _ _ Depth to limiting factor Remarks: Boring # Ll s' 0 Ground S T — qlev. ; f�ft. Depth to limiting factor 124-in. Remarks: CST Name (Please rint) Signature + Telephone No. Address Date CST Number o SOIL DESCRIPTION REPORT ' PROPERTY OWNER AI �! Page of _ r PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3. Ground S elev. �ft• Depth to limiting factor Remarks: Boring # �. Ground elev. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # g, .. Ground elev. ft. ' Depth to limiting , factor ' Remarks: Boring # M Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R.9/98) yy�,as mss ,;j A Ro =-- Lo s. i