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Page 1 of 1
Pam Quinn
From: Becky Eggen
Sent: Thursday, June 03, 2010 1:15 PM
To: Pam Quinn; Ryan Yarrington
Subject: FW: Septic tank
Well, aren't we just the bad people? I got a chuckle out of this response.
B ecky
From: Tou Yang [mailto:toucyang @yahoo.com]
Sent: Thursday, June 03, 2010 12:49 PM
To: Becky Eggen
Subject: Re: Septic tank
The septic tank for my property at 2306 76th street, Somerset, WI, 554025. ID: 032 - 2181 -23 -000 never
did get pumped and will not plan to get pump. Because we hardly live there and the septic tank never
much. d the roe was in the be inin phase of being foreclose b
did get use uc . An property rty g g p g y the bank because
your property tax is too high and I can't afford the real estate payment and the tax at the same time.
Thanks,
Tou Yang
6/3/2010
r
Wisconsin Department of Commerce Count
PRIVATE SEWAGE SYSTEM St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No: 479363 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal informe` ion 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:
Van g, Tout & La Xiong I Somerset, Town of
CST BM Elev: Insp. BM Elev: BM Description: Sectionlrown /Range/Map No:
6 1 (Zl 7 01.31.19.
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 3 Z 5� Benchmark �� J
fv5 ��.� ^ 1 � Alt. BM 3 , 16 5 .9
Aeration Bldg. Sewer
J6,7. coS
Holding St/Ht Inlet
7.33 Paz Z
TANK SETBACK INFORMATION SUHt Outlet 7- (Pi It ' $
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet _\
Septic I r 36 , — Dt Bottom
Dosing Header /Man. wt)-5 9 -
Aeration Dist. Pipe /6'13 `19.32
Holding Bot. System 11 15 9 •
PUMP /SIPHON INFORMATION Final Grade (o IKZ " 519
Manufacturer Demand St Cover
Model
T H Lift Friction Loss System I TDH Ft
Fo main Length I Dist. to well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width 1 Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 7 �3
SETBACK SYSTEM TO P/ BLDG G WE L LAKE /STREAM LEACHING Manufacturer.
INFORMATION CHAMBER OR
Type Of System: i J UNIT Model Number.
DISTRIBUTION SYSTEM 57 3z4- 314.3 31,115(°
Header/Manifol d [Distribution I x Hole Size x Hole Spacing Ve t Air Intalge
9 Pipgs)� � p \ v vh G1,� a
Length Dia Len th Dia S acing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
1 xx Mulc
Depth Over Depth Over xx Depth of xx Seeded /Sodded
Bed/Trench Center ` L<6 Bed/ Trench Edges � Topsoil ` Yes No ed Yes [: No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 2306 76th Street Somerset, WI 54025 (SW 1/4 SE 1/4 1 T31 R1 9W) Woodland ` Meadows Lot 23 Parcel No: 01.31.19.
1.) Alt BM Description = �I UL, C b`l �l� C Ilia wS 4-- 01—
2.) Bldg sewer length = 36 Act
- amount of cover = GtC2 1►�l C°A
4 r
r 1
Plan revision Required? ]Yes o
l ' ��
Use other side for additional informa ion.
Date Insepctor's Si nature Cart. No.
SBD -6710 (R.3/97)
Safety and Buildings Division County
` 201 W. Washington Ave., P.O. Box 7162
i� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.)
eonsin
.De artment of Commerce (608)266 -3151 Tof 3(o 3
Sanitary Permit Application State Plan LD. Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you prov
may be used for secondary purposes Privacy Law, s15.04(lxm) �O jest Address (if different than mailing address)
L Application Information — Please Print All Wormation r A Arm 71, rk r, . Il e. /q/
Property Owne - - Name -. - 1 # \ Lot # Blook # v,
Property Owner's Mailing Address AA AUC 0 1 Property Location \
-?e ,S/✓ 1'S .td✓ V, Section
City, State Zip C
I; 1 /� ZO ING OFFICE (circle one)
44 v�.1" /d S d 08 T N> R2 - L*,C
IL Type of Building check all that apply)
le i or 2 Family Dwelling - Number of Bedrooms S . Subdivision Name CSM Number
❑ Publio/Commereial - Describe Use l✓6dOLANO /y! o aw�S �'
❑ State Owned — Describe Use
' +ty Zmf}sguoownship of -o. lV scY
III, Type of Permit: (Check only one box on line A. Complete line B if applicable)
A ' ONew System ❑ Replacement System ❑ Tr atmeat/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑Permit Renewal [I P Revision ❑ Change of ❑Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWFS System- Check all that apply) 157,
c S
X Non—Pressurizedlin-Ground ❑ Mound?: 24 in. of suitable soil ❑ Mound , < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized hm- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Reoiroulating Synthetic Media Filter glAwhing Chamber ❑ Drip Line ❑ Gravel -leas Pipe ❑ Other ( lain) y
V. Dispersal/Treatment: Area Worration:
Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation t�
i
00 .? poao .?008, -e 9f: 3
VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
� J
Gallons Gallons of Units / ', { ,� D 1 Conorete Constructed Glass
New Existing W r Z" —' —/ Septic Tanks Tanks 1TG'
or ,boa /.Poo J �/f lft Za.✓6it rI'
Aerobic Treatment Unit
Dosing Chamber
VIL Responsibility Statement- I, the undersigned, swum responsibility for iostalladon of the POWTS shown on the attached plam.
Plumber's Name (Print) Plumber's Signature MP/1V M Number Business Phone Number
zees AJ C W-?.7 ole
Plumber's Address (Street, City, State, Zip Code) I
VIII, County/Department Use Ord
Approved ❑ Sanitary Permit Fee (includes Groundwater Dato Issued Thsuing ent Signature (No Stamps)
Surcharge Fee)
❑ al C 2mS
IX. Conditions A-pp-o
SYSTEM ER. 3 )�- 0��- -�� - '" �s o- ��
1 Septic tank, effluent filter and
dispersal cell must all be serviced / maintained it's 1
as per management plan provided by plumber.
2. All setback requirements must be maintained
as per applicable code /ordinan . q) No
Attach complete plans (to the County only) for the system on paper not has than K4 z It Inches in Was Y�/�^�
SBD- 6398 (R. 01/03) ( L-' � ,�S Q
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Wisconsin Department of Commerce X %A'M, 10� REPORT Page 1 of
Division of Safety and Buildings
in accordant;e with;Comm 85, ' Wis; ,p�tp. Code
a ( County St.Croix
Attach complet site on �M I than 81 x 11 inches in size. Plan must
include, but not limited to: vertical ontal re ence poird Wy- direW&i and Parcel I.D. Pending
percent slope, scale or dimensions, north arrow, a locatiorW1$di t0W6
Please print all information. w ._ Re awed qy Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(l) (m)). qLrm� (n . og
Property Owner Property Location
AHRH Properties LLC Govt. Lot SW 1/4 SE 1/4 S 1 T 3 N R 19 EE (
Property Owner's Mailing Address Lot # Block # Subd. ;Nan)ve or CSM#
404 Screen Avenue 23 - Woodland Meadows
City State Zip Code Phone Number ;ty 0 Village own Nearest Road
New Richmond I WI 1 54017 ( 7 � 5 222 - 0169 CTH I Somerset
El New Construction Use[] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
Replacement
r-1 Public or commercial - Describe:
Parent material Loess over glacial till Flood Plain elevation if applicable AA ft.
General comments * with continuous bands of f 1, 7.Syr4/ 1 inch thick �' L'
and recom ons:
Conventional system dyy .0
jcT�E�u C-� P So 1
0N _ _ U w�f
Boring �reSs�ifl fy
El Boring #
Pit Ground surface elev. 100.39 ft. Depth to limiting factor >86 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i *Eff#1 *Eff#2
1 0 -23 10yr3 /2 sil 2msbk mfr as 2f .6 .8
2 23 -32 10 4/4 sicl 2msbk mfr CW if .4 .6
3 32 -54 7.5yr4/6 s Osg ml cw - .7 _ 1.6
4 54 -86 7.5yr4/4 fsl Om dvh _ - ,2 .5
a Boring # ®Boring 101.68 >86
Pit Ground surface elev. ft. Depth to limiting factor in. F soiiAppl ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -6 10yr3 /2 sil 2msbk mfr as 2f .6 c
2 6 -14 1 3/2 sil lmpl mfr as 2f .4 .6
3 14-28 10yr4 /4 sicl 2msbk mfr cw if 6
4 283Z 10yr4 /4 sicl lmsbk mfr cw - 2 3
5 42 -86 10yr4 /6 s* Osg/Om /dvh - - .5
* Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = B0 9 r ,: 5 30 mg/L and TSS _< 30 mg/L
CST Name (Please Print) Signature CST Number
Thomas C. Nelson 227387
Address Date Evaluation Conducted Telephone Number
1432 120th Street, New Richmond, WI 11/17/04 715- 246 -2454
Scale 1 Woodland Meadows
BM1 Top of condut 100.00 Lot 23
BM2 Top of conduit 101 .40
B1 100.88'
82101.88'
83101.88'
N OO
is L AI
ati
S�•P` G$' � Z
o
�2-f
Thomas Nelson f U G
227387
i • y `
Maintenance
The interval for servicing septic tanks is set by state and local code. Throughout the United States there is a
wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years.
The Zabel'" filter, which does not increase the frequency of servicing for the tank, should be cleaned when the
septic tank is normally inspected and pumped. However, our filter is virtually self- cleaning. The continued action
p I
of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fa I to bottom of
the
the tank. If your filter contains a SmartFilter"' alarm, you will be notified by an alarm when the filter needs servicing.
To service the filter:
'Servicing any Zabel filter should only be done by a certified septic tank pumper or installer.
Locate the
outlet of the
septic tank.
Firmly pull the filter handle
and slide the cartridgA 0 V
Remove the tank of the
and pump the <; * Note: A tee handle may.A
necessary top , ; , to be used it the filter is trik;
any solld below ground level to
escaping to th Contact Zabel for info
when the f handles
rem
s 4
While holding the cP r1tidQ0 QGAi" > t: f C
the access operlln 1� k . !� Insert the fllter<`tfHdtt
cartridge with fr back in the
careful to rinse all sure the flit
b proper)
*Note: It is not neces completely i
spotless- The biome
aides in the efreatme
Pr
be left on the filter. If n
may be disass Replace t
�N.
A1AOE IN USA
The products) shown are covered by one or more of the following patents:
U.S. 5,762,793, 5,580,453, 5,591,331, 5,759,393, 5,683,577, 5,582,716, 5,779,896, 5,593,584,5,795,472,5,736,035, 4,710,295, 5,382,357, 5,482,621
U.S. Des. 386,241, 349067, 4605501,5098568, Des. 309007, Australia: 134440; Canada: 2,135,937; Israel: 111574; New Zealand: 264824,
Other Patents Pending
Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1- 800 - 221 - 5742 • Website http: / /www.zabel.com
A1001300.1- M.61499
s-
Private On -Site Wastewater Treatment System (POWTS)
Index and Title Sheet
Owner: yfld " is )(1014
Project Name and System Type: P;u 44,114 1. !,. ' 41.4 - $ , !'oors
Location: fie, loo. '` 76 �` �r
Street Address
.SE' 4 1,F41 Z9 ,r 1Z !✓000� � �o �J�,ioe<r s
Legal Description /
!/az✓„! of .�a,•ide sir J T �iloix �o. -
Township /County
Contents: Page 1: Jam# "r-
Page 2: eo�, r �,..v � .4,.rr - S« rte..✓
Page 3: �oa r OLJN �R � �rs.✓�... /7�i.✓.R «.Y �.�r tea...✓
Page 4:
Page 5:
Page 6:
Page 7:
Page 8:
.Page 9:
Attachments: ..laic w.ot 4.. rr.r Zoed s r
Plumber er: �yss _,oAr.✓ Signed:
Credential Number: Date: 7-WC -of
POWTS OWNER'S MANUAL AND MANAGEMENT PLAN
FILE INFORMATION Septic SPECIFICATIONS
Owner a �/ a f �A ,Xia.� Se tic Tank Capacity /,7ao O NA
Permit # 310 . Septic Tank Manufacturer i 4 lea O NA
Effluent Filter Manufacturer Z ,e j p NA
DESIGN PARAMETERS
Number of Bedrooms 100 room ❑ NA Effluent Filter Model �0 ioo ❑ NA
Number of Commercial Units —, NA Pump Tank Capacity NA
Estimated flow (average)* 00 g al/day Pump Tank Manufacturer p NA
* `00 gal /day Manufacturer [3 NA
Design flow (peak), estimated x 1.5 Pump Model ❑ NA
Soil Application Rate , ,? g al/day ft Pretreatment Unit O NA
Influent/Effluent (NA ❑) Monthly Average **
Quality ❑ Sand/Gravel Filter [3 Peat Filter
Fats. Oil & Grease (FOG) < 30 mg/L ❑ Mechanical Aeration ❑ Wetland
Biochemical Oxygen Demand (BODO 220 mg/L p Disinfection ❑ Other:
Total Suspended Solids (TSS) Manufacturer: Model:
5 250 m Dispersal Cell(s)
Pretreated Effluent Quality ❑ Monthly Average * ** In- ground (gravity) ❑ In- ground (pressurized)
Biochemical Oxygen Demand (BODO < 30 mg/L I ❑ At -grade ❑ Mound
Total Suspended Solids (TSS) -- 30 mg/L CJ Dri line C3 Other:
Fecal Coliform (geometric mean) < 10 cfu/100m1 Af Leaching Chamber Manufacturer A✓ /LPAw rot,
Maximum Effluent Particle Size 1/8 inch diameter Model & 10 Laying Length/Chamber
*Wastewater Flow Verification and Calculations: Soil Application Rate - .7 ,gpd/ft Area Req. 000 ft
(Other than bedroom based) Infiltrative Surface/Chamber -ESIA Ratin ft
Minimum Number of Chambers IX4 + i, ,✓O c4.*s
❑ Aggregate Desi Flow/Loading Rate= fe 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 prctreated 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 (8.6/99) "At -Grade Component Manual Using Pressure Distribution"
SBD — 10567 —P (8.6/99) "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"
p SBD - 10572 —P (8.6/99) "Mound Component Manual"
O SBD - 10691 — P (N.01101) "Mound Component Manual" Version 2.0
❑ SBD - 10595 —P (8.6/99) "Single Pass Sand Filter Component Manual"
❑ SBD - 10657 —P (8.6/99) "Drip -line Effluent Disposal Component Manual"
❑ SBD - 10573 —P (R 6/99) "Pressure Distribution Component Manual"
❑ SBD - 10706 —P (N.01101) "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 tank(s) At least once eve ❑ months , 3 ear(s) (Maximum 3 .)
Pump out contents of tank(s) When combined sludge and scum equals one -thins 1/3 of tank volume
Inspect dispersal cell (s) At least once eve ❑ months 3 00 year(s) (Maximum 3
Clean effluent filter At least once eve y X1 months ❑ ear(s)
Inspect pump, pump controls & alarm At least once every ❑ months ❑ ear(s) NA
Flush laterals and pressure test At least once eve ❑ months ❑ year(s) ❑ NA
Valves At least once every ❑ months ❑ year(s) ❑ NA
Other: At least once eve ❑ months ❑ year(s) ❑ NA
Page , 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. v
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.
❑ Valves
Valves shall be operated in the following manner:
❑ Alarms
Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service
POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any
problems with the system are corrected to 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).
Septic Tanks Component
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 ponding of effluent to the ground
surface. 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.
❑ Pump Chamber /Treatment Tanks Component
The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be
made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters.
Any service needs or repairs shall be promptly taken care of
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. Pa a �/ of -S�
g
❑ Mound, At- Grade, In- Ground Pressure
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 greater than 75% of the height of the component may indicate overloading or impending hydraulic failure
necessitating more frequent monitoring.
The pressure distribution s opening stem is p rovided with an o nin at the end of each lateral to be used for flushing. The laterals
should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to
ensure that equal distribution of effluent is occurring to promote the longevity of the system.
REPORTS
Reports for maintenance, inspection, 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.
T moved and roperl d i sp osed of by a Septage Servicing Operator.
- The contents of all tank.. and pits shat. be re P � Y "Po
- 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
repl a ent 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.
❑ 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
it
as a last resort to replace the fa 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 CONTIAN 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 FROINI THE VgTERIOR OF A MALNK MAY BE DIFFICULT OR
IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name /No- a�� 8/G Name �sr e, r � � rifi o X e.
a�
Ph n �y -sy
Phone Syo7
SEPT SERVICING OPERATOR (Pump - 6/ni ,,,b w LOCAL REGULATORY AUTHORITY
Name A en ,Sr. L o Zo.v.rr OFiic•r
Phone Phone 7is .fd'� - G8a
K: \WPDATA\EH\POWTS OWNER'S MANUAL.doe page _r e .f
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer "I (A `(AN lQ e LA &
Mailing Address Ce3Lo N��� j. R�rlE A06. 1d, 57r o c Z12/t/. J %oc}
Property Address 1, O Y z 3 I.JOa b c M E.1: Do c✓s NO � �p
e�
own/ 0," (Verification required from Planning Department for new construction.) �p
m C`-
City/State Parcel Identification Number
LEGAL DESCRIPTION 1�
Property Location .SW �/, , 5 t /. , Sec. � T 31_N R I `� � Town of
Subdivision /,Upp c q„C,� /�Ao�1s , Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # �9� ��S , Volume Z -7 , Page # 2 32-
Spec house = yes u no Lot lines identifiable yes - 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 systern.
The property owner agrees to submit to St. Croix County Zoning Department a certification form, signed by the owner and
by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal
system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of
sludge.
1 /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 R State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning
Department within 30 days of the three year expiration date.
7/
SIGNA RE APPLICANT DATE
OWNER CERTIFICATION
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.
SIGN URE F APPLICANT DATE
* * * * ** Any information that is misrepresented 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 and a copy of the certified survey map if
reference is made in the warranty deed.
U 2 8 3 7 p 2 3 2 799495
1
KATHLEEN
E GISTER OF DEEDS
State Bar of Wisconsin Form 1 -2003 ST. CROIX Co.. WI
WARRANTY DEED
RECEIVED FOR RECORD
Document Number Document Name 07/06/2005 10:15Ad
WARRANTY DEED
EXW t
THIS DEED, made between AHRH Properties, LLC, a Wisconsin limited liability REC FEE: 11.00
company TRANS F 142.50
( "Grantor," whether one or more), CC FEE:
and Tou Yane and La Xiong . H rsband and wife PAGES: 1
( "Grantee," whether one or more).
Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area
estate, together with the rents, profits, fixtures and other appurtenant interests, in St.
Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach Name and Retum Address
ndum): David J. Estreen
Lot 2 , Woodlan M eadows, St. Croix County, Wisconsin 304 Locust Street
Hudson, N 54016
w�- iS�a -1rt.
Part of 032 -1002- 20-000
Parcel Identification Number (PIN)
This is not homestead property.
(is) (is not)
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free
and clear of encumbrances except: easements, restrictions and reservations, if any, of record.
Dated Jun 20
AHRH es, LLC
BY: (SEAL)BY: (SEAL)
*Raym . Herrmann, Special Administrator *Ro i er, Member
for the Estate of Al Herrmann, Member
(SEAL) (SEAL)
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) AHRH Properties, LLC, a Wisconsin
limited company, by Robin J. Haffner, Member STATE OF IOWA )
authenticated on ) ss.
COUNTY )
* Kristina Oaland Personally came before me on June I G l ` 2005
TITLE: MEMBER STATE BAR OF WISCONSIN the above -named AHRH Properties, LLC a Wisconsin li
(If not, liability company, by Raymond P. Herrmann s�_'
authorized by Wis. Stat. § 706.06) administrator for the Estate of Al Herrmann Member
to me known to be the person(s) who executed the fore
THIS INSTRUMENT DRAFTED BY: instrument acknowledged the same.
Kristina Ogland, Estreen & Ogland a
304 Locust Street, Hudson, WI 54016
Notary Public, State of ZZkPeLvk )l
My Commission (is permanent) (expires:
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003
Type name below signatures. INFO -PROTM Legal Forms 800 - 855 -2021 www.infoprofmms.com
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