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HomeMy WebLinkAbout032-2172-09-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and E4dlding Division INSPECTION REPORT Sanitary Permit No: 8060 - 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Ott, Dave & Kelly Somerset, Town of 032 - 2172 -09 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: U25 AN 1 Q 6) "S" 18.30.19.1449 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic (� 5 2 n ' / Z Benchmark /�� / K <9, � 1Z ✓00 ' Alt. BM ZIL& k /dam I Jc, I k a,) 4- S; I Aeration Bldg. Sewer Holding St/Ht Inlet 9 (.Z Y S TANK SETBACK INFORMATION St/Ht Outlet x .17 97.95 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , _ '7 � zb Q _ Dt Bottom Dosing Header /Man. J3, $ cf . 3Z Aeration Dist. Pipe c741 . 1 6 Z 13.8 93.3 Holding Bot. System y. \ V Final Grade / D Z PUMP /SIPHON INFORMATION d �� Manufacturer Demand St Cover GPM Model Number S q 3 z TDH L' Friction Loss S TDFH Ft ` / / d cl z ' 17— v Forcemain la. Dist. to Well f ls� SOIL ABSORPTION SYSTEM BED /TRENCH Width . Length, No. Of Trenches PIT DIMENSIONS No. Of P its Inside Dip. _ Liquid 2teth, DIMENSIONS �— SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: , Model Number 30 i �� 7 75 1A-- UNIT b DISTRIBUTION SYSTEM Z3 t' LZ = S �7 Header /Manifold , Distribution x Hole Size x Hole Spacing Vent tp Air Intakk( cr Plpe(s) \ \ \ \ 3t,1�� ( ` l C Length Dia 't Length Dia Spacing ,,. L.o�J SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over i Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes i j No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: ! / Location: 359 153rd Avenue Somerset, WI 54025 (NE 1/4 SW 1/4 18 T30N R18W) St. Croix National Southern Estates Parcel No: 8.30.19.1449 1.) Alt BM Description = W0.tk z"t- 5;�� SewcAa�111 2.) Bldg sewer length = 2 g Z - o� ' - amount of cover = ZLf Plan revision Required? Yes /N0 / ( j Use other side for additional information. `t' 1 b n j Date Insepcto! Signat Cert. No. SBD -6710 (R.3/97) I Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 716 C 00 tisconsin ent of Commerce Madison, WI 53707 - 7162 Sanitary Permit Number to be filled in by Co.) Departm (6 66 - 51 up Sanitary Permit Applie tion State Plan I.D. umber ___- -- In accord with Comm 83.21, Wis. Adm. Code, personal inform rovide may be used for secondary purposes Privacy Law, s15.04(1 xm) Project Address (if different than mailing address) L Application Information -Please Print All Information Property Owt r' ame N 1 4 2006 P;rce l # / Lot # Block # Property Owner's Mailing Address ST. CROIX COUNTY r y Location ' City, P O l l �' \ ' •, � WS ection Q / State Zip Code Phone Number _S_L / / N` 1341?3/ T 3 0 N; R G E o e one) t , II. Type of Building (check all that apply) ❑ 1 or Family Dwelling - Number of Bedrooms (� Subdivision Name CSM Number El Public /Commercial -Describe Use V ZG s efy ❑ State Owned - Describe Use ❑City_ ❑Village township of SD'7yJ�1L -� III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A- New System y ❑ Replacements stem ❑ Treatment/Holding Tank Replacement Only ❑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 8 � v� -v /- ZD - 6 IV. Type of POWTS System: Check all that apply) 2 4 - 2 - IN Non - Pressurized In- Ground ❑ Mound > 24 1 of suitable soil El Mound < 24 in. of suitable soil El At-Grade El Single Pass Sand Filter El Constructed Wetland El Pressurized In -Gro d El Holding Tank El Peat Filter El Aerobic Treatment Unit El Recirculating Sand Filter El Recirculating Synthetic Media Filter thing Cha r Q Dip Lie ❑ G vel -less Pi ❑ O er (explain) r/ V. Dispersal/Treatment Area Information: I� 4 Design Flow (gpd) Design Soil Applicatio Rate(gp spersal Area Required (sf) �D[i�perrsal Area Prop (sf) System Elevation 6/ �/ �/ GL i` I r/ 7 ✓ Q te./G e T Vi. Tank Into Capacity in Total ut ber Manufacturer Prefab Site Steel ter Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Hokling Tank 23rV �J Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum be 's Signature MP /Nlffe"umber Business Phone Number Plu er's dress (Street, City, State, Zip Code C �UJT 1 (-�- L4_) D VIII. C unt , /De artment Use Onl pproved 0 Disapproved Sanitary Permit Fee (includes Groundwater Date Issued ssuing Ag t Si atur o Stamps) Surcharge Fee) �/D ❑ Owner Given Reason for Denial ��� i /&p 0 IX. Conditions of Approval /Reasons for Disapproval j t 92 -A dui =Qd too Attach complete pla (to the CoudYy only) for the system on paper not less than 81/2 x 11 irAhisin size SBD -6398 (R. 01/03) I LA N U C o *+ /ytP �Z�'`C`�✓ :I ) I e V r ( C- 6-t-1- 5� `` p6eP p AAA 6 �! 0,6-� AP LL � G- L At G��c. o .� g t� t3 G- L r aId" Wisconsin Department of Commerce SOIL EVALUATION REPORT (/ Page 1 of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 032 - 2172 - 09 - 000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ❑ )W DAVID E. & KELLY C. OTT -- -- NW 1/4 SE 1/4 S 18 T 30 N R 19 E(or)W Property Owner's Mailing Address of # jBlock # I Subd. Name or CSM# 359 153rd Avenue 9 -- St. Croix National Southern Estates City State Zip Code Phone Number Mity []Village Town Nearest Road Somerset, I WI 1 54025 ( i 153rd Avenue Q New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement Public or commercial - Describe: Parent material outwash Flood Plain elevation if applicable General comments Additional boring required to extend system area due to location of dwelling. Addendum to soil report dated and recommendations: ' 07 - 14 - 04 by David Steel. Conventional In- ground Syste -- 0.7 loading rate - to be designed by 'nsta11' plumber. f >6 K 4 Boring # ❑ Boring ❑ Pit Ground surface elev. 94.28 ft. Depth to liming factor 120 in. Soil Kplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 *Eff#2 1 0 -4 10YR3 /2 - 1 2fsbk mvfr cb 3vf -m 0.6 0.8 2 4 -12 IOYR3 /2 1 If- -msbk mvfr as 2vf -f 0.4 0.6 3 12 -20 10YR3/3 sit 2fabk mfr cis 2vf -f 0.6 0.8 4 20 -33 10YR4 /4 sicl 2fabk mfr cs 2vf -f 0.4 0.6 5 33 -36 7.5YR4/4 is Ifsbk mvfr cw lvf-f 0.7 1.6 6 36 -59 10YR3 /6 Osg ml cw -- 0.7 1.6 7 59 -72 10YR4/6 sl lmsbk mvfr cw - 0.4 0.7 ❑ 4 Boring # ❑ Boring 0 pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate 14T!zon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 P *Eff#2 8 �2 -120 10YR4 /6 Is lmsbk mvfr -- - 0.7 1.6 Horizon 6 has 10 -15 %g. Horizon 7 has some pockets of cs&gr and some cl. * Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Mary Jo Hollister o 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 04-19-06 (715) 426 - 1775 Plot Plan for Site and Soil Evaluation Page -L of Property Owner DAmD '6. 4 icmu Y G- OTC' 1 " =40ft. Legal Description Lr 9 . , sr, cn�x. NPt` . o (except where noted) r�YPh OF- 2AP- se% / ISM 0N.R`4w,% = Backhoe pit � r sonr,, � , �� - r , Wit �'o }JC c o uti�r�6� `l� c..dr� ► �l North � A J ;� ® ; A�nnr-D 1" Of �? � � l0Y• DO' k� eLWI Y t, J ay e{. 28, QYo106 Site Location: b , SAC• r`a r STEEL'S SUIT, S �'j p. INC. Page 3 of J. Steel CST- OWI SM 994 200 St Lie 48956 lr Mdal Development, Inc. NWt/4,561 /4,sI8,T3ot4,tttyVV Baldwin, WY 54002 Town ofSometsa St. Croft Co. &s•(715) 684 -5680 SL Croix Nail g oyim � Fax.(715) 6843449 Tt is �r Ut 9 Use. a►'at0ati0n was aaaWt,� t0 - a pkicao the t� t �'4 ttt r iot � rat be suitable foryour W rat escablishW at Legttad A BdchmWk GIG. 100.001 =t 70 P Of 3/4- pv0 pipe • - Alt Benchmark Ele. 100.00Bt Top of314 -pvc pip � ° goeiags Ba k% El"Utions B I b 97.90Ft DWIM Of SS*and °} SOIL E1/ALUAT"N REPORT 1456 in accwdanae wM COmnr E5. YVir Aft. Cone P89e I of 3 a eleaife aa and `�`a,.ar�xilbare,ma�, PlMnW count' sreerasais keina fercwp° °mn am""° no anorestabeaeyin b aro St. Cron Mhttal!/rtforatardioa, neereatraaa Paraetl0. Pending P. p+OPenYOwner PA+ ia na6aem (ecrta..xisa Pe Date — Resfdertftal Inc. prapeety Location 8M A OYwter a Mo01ne — God tot na NW 1A 8929 Aztec Or. �lodc ate SE 1 W S IR_ 7 30 N R 19 W QV 4 Subd Name er CSfyur Eden ptg stma ZI CO Oe Prwrte► Mtmbyi — 9 na SL C matiortat sarrlttam Estates I MN �7 952 -83�. g f� �N VOW M Town Nearest Road Somerset 1x7 tarttr• Mety corarn,csoa U SC � Residentlai t Nlrttbet of - 1' � ""M 4 Codedeinedtlesgnnvrrrate p1�C�I�.; 6 00 coo Pawd mataral Knots &jwsh General cOmntettts Fbod plain elevation, if SWMcsbte na _ Old MW--dWWW C WWBnb=W SySWN etevaliott 912ML TrendM Spaced and depM to code 6.67ft below grade. F gg Bo Pit around surtsee etev 97.90 ft paptn to 6niting factor 120 in. sw Appicdon Rate Nation DOW Do, hVICabt RetbttDeMWM TwOM Corsiclain BatMdy Roos h wm QL St. Cad. Cda &. SL SK 1 0-13 Oyr312 none sd 2msbk mfr cs If 6 .8 n 2 13-M Oyt4/4 now sid 2msbk mfr 9W na 7.4 .6 3 36-48 .5yr4/4 crone cos 0 " nwfr cS na 7 1.6 4 _ 2 r4/4 room orr► mfi a 0 0 0 5 72 -120 .5yr416 cane Is OSg MA na no P Orou d surface ew. _9790 R oepm to �^e f ew 120 m. Sal AppkAw Rate 1l0e06 O"t kMM CAN RedtaD=*Aion Te.tu9 Stiumre Cauetmm S*ud" Roots UL 0k St Cmr. CdW Cw S4. &L " EMI 'E 1 0.6 Oyt9f1 none Sil 2mebk mfr cs 1Yf .6 .8 2 .5yr414 none 2msbk mfr a na 4 6 3 35.120 Syr4(6 none cos Dag ml cs na .7 1.6 ' EBbrerd erl = oOD 30 220 mgn. arts TSS >30 < 160 mgt. /7 ' EtBuem S2 = SOD _30 rngl. and TSS <30 mgfL PST None a PA Number Z00 /Z00'd T690 XTIVA d119 MSW OBTZ SO Z19 00 :11 900Z.OT "NYC Page 3 of 3 ST'EEL'S SOIL SERVICE INC. David I Steel 994 200 Si; CST-PC WTSM Residential Development, Inc. Baldwin, WI 54002 Lic. #24 9 956 NWl /4,9El /4,S18,T3 Bus.(715) 684 -5680 Town of Somerset, St Croix Co. Fax.(715) 684 -3449 St_ Croix National Southern berates, Lot 9 This soil c valuation was condeuxe d t satisfy a zoning requirerawk it may or may not be suitable for your use. The 1 Nm6ft of this test may or may not be as shown, as pennanew lot lines were not established at the time th e soil test was conducted. Lageend 1 "2 40' ♦ = B�clurrark Ere. 100.00f't Top of 3/4^ pvc pipe e - Alt Benchmark Ele. 100.00k Top of 3/V pvc pipe ❑ Borings Boring .Elevations B I = 97.90Ft B2 = 97.90Ft B3 r 92.50Ft 84 = MOOR t g � 4eFr 600 /£00'd Z69L# xxxZ'dM IE9HOg2w 08TZ 596 ZT9 TO:TT 90OZ,OT'AIdL ti 1456 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service Inc. Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix 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. Pending _ Please ;mayt nr ai r ' fi(o � nied By Date Personal information YW P e V for rposes (Ffriv Law, S. 5.04 (1) (m)). R� 2-0 Property Owner Property Location Residential Development, 1 1 6 C. : 1 2004 ovt. Lot na NW 1/4 SE 1/4 S 18 T 30 N R 19 W Property Owners Mailing Address of # Block # Subd. Name or CSM# 8929 Aztec Dr. ti 9 na St. Croix National Southem Estates City State City J Village Id Town Nearest Road Eden Prairie I MN 1 55347 952 - 934 - 6238 Somerset I Cty Rd V New Construction Use: !1 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement I Public or commercial - Describe: Parent material Knolls of pitted outwash Flood plain elevation, if applicable na General comments and recommendations: Conventioanal system, system elevation 91.23% Trenches spaced and depth to code 6.67ft below grade. M im Boring # J Boring Pit Ground Surface elev. 97.90 ft. Depth to limiting factor 1 20 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -13 10yr3/2 none sil 2msbk mfr cs 1f .6 .8 2 13 -36 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 36-48 7.5yr4/4 none cos osg mvfr cs na .7 1.6 4 48 -72 5yr4/4 none scl om mfi cs na 0, .0 5 72 -120 7.5yr4/6 none Is osg ml na na .4 1.6 t.Q F Boring # I Boring Lt N&J �' a U/1 b / 0& — /ov. ? P bel Pit Ground Surface elev. 97.90 ft. Depth to limiting factor 1 20 in. Sod Application Rate Horizon Depth 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 -5 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 5 -35 7.5yr4/4 none 2msbk mfr cs na .4 .6 3 35-120 7.5yr4/6 none cos osg ml cs na .7 1.6 * Effluent #1 = BOD? 30 < 220 mg/L and TS >30 < 150 mg /L * Effluent #2 = BOD S30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number David J. St 248956 Address Steel's Soy Service I, Date Evaluation Conducted Telephone Number � � C�� ��fcU6� 7/14/2004 Property Owner Residential Development, Inc. Parcel ID # Pending " Page 2 of 3 31 Boring # Boring 1/ Pit Ground Surface elev. 92.50 ft. Depth to limiting factor 120 in. Sod 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 -8 10yr3/1 none sl 2msbk mfr cs 1vf .6 .8 2 8 -28 7.5yr4/4 none ms osg ml gw 2f .7 1.6 3 28 -120 7.5yr4/6 none cos osg ml na na .7 1.6 F-1 Boring # - I Boring �j Pit Ground Surface elev. ft. Depth to limiting factor in. sou Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 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. Page 3 of 3 STEEL'S SOIL SERVICE INC. David J. Steel 994 200 St. CST - POWTSM Residential Development, Inc. Baldwin, WI 54002 Lie. #248956 NW1 /4,SE1 /4,S18,T30N,R1gW Bus.(715) 684 -5680 Town of Somerset, St. Croix Co. Fax.(715) 684 -3449 St. Croix National Southern Estates, Lot 9 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend 1 " =40' Benchmark Ele. 100.00Ft Top of 3/4" pvc pipe Alt Benchmark Ele. 100.00Ft j � O l p of 3/4" pvc pipe ❑ = Borings Boring Elevations B 1 = 97.90Ft B2 = 97.90Ft B3 = 92.50Ft B4 = OO.00Ft 5lor �� J - N ��y�� ��• SFr �c �l� • �� `� "�- � X16 � '� �., ,,,,, .. _ r • � "'•ry '911' "�� _-.te • �� � � '�."- IS'.�16 /fM�� �._ ' T • s 1 • T V .o JI � t ` yl At— iiz N NW mo o" ra WAWA Nia i. , -►� FA F, NOR .r ty and Buildings Division County C P—Q / � Ave., .0. Box 7162 I in ton A . °r .20.1 W . as 1 g , w w "i,, S dison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) li► I. / • y , , •�, , ,. (608) 266 3151 � t0 Q p of Co erne State Plan I.D. Number lication a n r In accord with Comm , 1, Wis. Adm, Code; personal information you provide may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailin address) r� I. Application Information - Please Print All Information ,`� Property Owner's Na me Parcel N J Lot a Block If 6 LL z Z 17 © Property Owner's M a -- Addres Pr�oppe�rty Location J Q 6 6-ftlr rt? O �/J/ C �,4, 'k,Section 6 O City, State Zip Code Plione Number L c 31 7 (circle e) T N; RE ar� H. Type of Building (check all t 171 or. 2 Fanuly Dwelling - Number Su lsion Name CSM Number S ❑ Public /Commercial - Describe Use as IONAC. ❑ State Owned - Describe Use - ❑City_ ❑Village JgTownsliip of �f�f III. Type of Permit: (Check only one box on 1 A. Complete line B if applicable) A. New System ❑Replacement System Treamient/I•Iolding Tank Replace m Only ❑Other Modification to Existing System . B. O Permit Renewal ❑ Permit Revision ❑ Ch of ❑ Permit infer to New List Previous armit Number and Before Expiration Plumber Owner IV. T e of PATS S stem: (Check all that a 1) A N - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil d < 24 in Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank Filter circulating S ter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ D Line raver V. Dis ersal /Treatme t Area Information: Design Flow ) esign Soil Ap lication Rate(gpdsf) Disp I Area Required (s Dis ersal Area Pr (s Systet evatiol 9/, Z 3 I • 9 i z 3 23 VI, Tank Info Capacity in Total Numw Manufacturer Prefab Sit Steel Fiber plastic Gallons Gallons of is w ifiz Q A - Concrete Cons cted Glass New Existing Tan Tanks Septic or Holding Tank z J rd / � E // ( W / �7 Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- 1, the ersigiied, assume resp risibility for installation of the POWTS shown the attached plans. Plumber's Na me (Print) tuber's Si gnature MP /jam Number usiness Phone Number b 2 Fyn Zzi�� 73 Plumber's Addre ss (Set, City, e, Zip C#) Y VIII. Count /De artme Use Onl X Approved ❑ Di pprove Sanitary Permit Fee includes Groundwater Date Issued Issuin Agen ' natu (No Stamps) -- Surcharge Pee) ❑ Ow en Reason for Denial QPVJ .4V IX. Conditions pprova N�g SYSTEM OWNED; 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) y 4 P rR A-� l V✓ �3 0 Jt ve SAN �-•L- r � j CONVENTIONAL SYSTEM CROSS SECTION I NO SCALE I I GA �ou/Z i. 12" COVER 12" COVER 12" COVER "] 7 , Q i - t .'J N . z !�( .. ). ?ilv..i� ....1 .:e.t 1. ,. ..4•r .,'.. ... :. ,....� .... ::�..n. :,. s.. .l.. ': Y.' 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J +1•�. 11' � I:� �:�l::i ^ : :: : ;;i • „'. ..... :.:.:::: ct�PS ELEVATION TI �� Z 3 _ IN SITU SOIL T3 410,723 9c1 ft z 3 I QUICK 4 STANDARD INFILTRATOR DIMENSIONS: HEIGI-IT 12” LAYING LENGTH 40" WIDTH 34” I I I I �I i I I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner u is Tank Capacity �- � � � Q -� Sept Ta P Y gal ❑ NA Permit # 060 Septic Tank Manufacturer w s ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Z "e ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l ❑ NA Estimated flow (average) Q t� gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) al/day Pump Manufacturer ❑ NA Soil Application Rate j 3 al /da /ft2 Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg /L ❑ 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 AL,In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. 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 ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA G1 year(s) Clean effluent filter At least once every: M month(s) E3 NA ❑ year(s) Inspect pump, pump controls &alarm At least once every: ❑ month(s) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) El NA ❑ year(s) Other: At least once every: p yea (s) ❑ 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. �GMW (4/01) e Page 2 — of Z START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. 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 cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall lie 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: X A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name p Cyr A) Name Phone S Z 7 Phone El E SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name e eaoly Zp^J�" Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)jd) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 01/16/2006 11:36 AMEC 17155310688 NO. 683 D002 W TAW M A�� mff nqc t TIO w mTm g .. cy do ii fbc�iie* C ftyp a - LjT- _#'rat # . ° 1 v, *a how 70 so es* d� � �r�iee� ++�,'�,� t�i� SAS � �.s�+� � its as�R � � • i � per► �"'� � p��'P'� WIN IN COAMr -- OEMI asa# 'Woos � tiu►T6 mi me to so m a q w0ft bsft go I .I 1 I K I liq IF �� z�� "` `��� �v�►�'�i�,�s+r# !XA ` � �� L } �c,ZR { � r �l�G1G • � "" . O W Arm NMI Ar 2z qp� 4 � lL. '��r 'r ."`Qi p FRI hit Louss �d. 8 1 tS06 - 7 KATHLEEN H. WALSH • REGISTER OF DEEDS ST. CROIR CO.. WI S'L'ATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD lkicunwnt Nuurhtx WARRANTY DEED 01/09/2006 01:30PH WARRANTY DEED THIS DEED, made between Residential Development, Inc., a EXEMPT Mi Minnesota Corporation, Grantor, and David E. Ott- and Ke lly C. Ott, REC FEE: 11.00 husband and wife, as Survivorship Marital Property, Grantee. TRANS FEE: 390.00 Grantor, for a valuable consideration, conveys and warrants to Grantee COPY FEE: the following described real estate in St. Croix County, State of Wisconsin: CC FEE: PAGES: 1 Lot Nine (9 S aint Croix N ational Southern Estates, St. Croix County, Wisconsin. Recording Area Name and Return Address: FAina Realty Title, Inc. 400 S. 2i St. — Suite 115 Exceptions to warranties: Hudson, WI 54016 Easements, restrictions and rights -of -way of record, if any. 491899 032 - 2172-09 -000 Parcel Identification Number (PIN) This is n t homestead property. Da is /day December, 2005. R identi el nt, c. B • Ri 1). Marra , President AUTHENTICATION ACKNOWLEDGMENT Signature(s) _ _ STATE OF MINNESOTA ) U K - C'l C*— — COUNTY. ) as. authenticated this 30th day of December, 2005 Personally carte before me this Decemlx;ral 2005, the _— above named Rick D. Murray, President, of Residential Development, Inc., a Minnesota Corporation, to me (mown to TITLE.: MEMBER STATE. DAR OF WISCONSIN be rson(s) w ecuted the foregoing instrument and (Ifnot, ._._- .--------- _--- .---- _ —__ -- ackrtow edged the same. authorized by § 706.06, Wis. Slats.) THIS INSIUUMP.NI' WAS DRAfIlil) BY C Peterson, Fram & Bergman -- Steven H. Bnms Tho ry Public, State of Minnesota 50 East Fifth Street, St. Paul, MN 55101 My conunission is permanent. (If not, state expiration date: (Sipaturos may be authenticated or acknowledged. loth are not mccasary.) — ) *HaancS ol'peisons Signing in any capacity must be typed or pinto below their signature DAWN D. PtSTULKA NOTARY PUBLIC • MIMIESOTA WARRANTY DEED IrfA711 BAR OF WISCONSIN 0 1 � 1 2010 Drainage Eosement N 99$2 39 ' E 345.84 16 r ��• y *, N35'34'33TW _ 14 r ..S 50.77' 0 39`00- EE 4 71.18' { t f Cr) 33' t r` ..2 sq. / / •— Nf acres / ! / V 130,8 ( /p © , 00 sq.ft. 3.003 acres Qf LIJ U �f L t CO _ O ti •- g 1 lent �1. 131,132 sq.ft. i �I s ue• 3.010 acres Ci tp N 89'53'00` E 396'.50 v e 0 0° � v � N y .. yr. ft. s a 1 0 za lb 238,763 sq.ft. ° i cn CP 5.481 acres n o fi co iLl A 0 w / South Line of the Northwest Quarter of the Southeast Quarter of Section f8