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032-2149-40-000
')epartroent of Commerce Count PRIVATE SEWAGE SYSTEM St. Croix (ding Division INSPECTION REPORT Sanitary Permit No: 499269 0 ...4ERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: rersonal 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: Grand Pro erties L.P. Somerset, Town of 032 - 2149 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No /in 6M 1 G. — % 02.31.19.1300 TANK INFORMATION 0 ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. (,;. Ic /c Septic %r. Benchmark Dosing. r Alt. BM Aeration Bldg. Sew r A s �"`- 12— (.4 `1 y Holding SUHt Inlet 12 .'S7 If 3 i TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 SG` J 5 /'5 / s� Dt Bottom ' 1 �� . T3 Dosing Header /Man. 4. 3 le, Z 45 Aeration `E✓ 3 Dist. Pipe �� Holding --' Bot. System `�„J �(, fi • C$ � � Final Grade / PUMP /SIPHON INFORMATION t/, 65 Manufacturer / Demand St Cover Z , •'} ��!(/ 3 l 'tj k GPM i C.v - / Model Number Ao , y /d f- 35 TDH Lift Friction Loss System ead TDH � Ft Iz 51 /. ly,r Forcemain Lengt��, Dia. of Dist. to Well 66 SOIL ABSORPTION SYSTEM BEDITRENCH Width i Lengthy No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. I Liquid Depth DIMENSIONS I 4 Z SETBACK SYSTEM TO 'S P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR I►�'< ► I�/�ti Type f System: i o / UNIT Model Number: DISTRIBUTION SYSTEM c ° L'Z I v.,,, Z'3 L �5'�4_ Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake , > Pipe(s) Length Dia Length Dia Spacing ` \ �� �' '�� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center '/` _ Bed /Trench Edges ` Topsoil N\ Yes ' No `Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: ! / Location: 2342 61st Stres Somerset, WI 54025 (NW 1/4 SW 1/4 2 T30N R19W) Grandview Estates Lot 4 Parcel No: 02.31.19.1300 1.) Alt BM Description 2.) Bldg sewer length = /� - amount of cover = 5 Plan revision Required? Yes No 7f L � i Use other side for additional information. ____ —___ - - Date Insepctor's Sign re Cart. No. SBD -6710 (R.3/97) �, �.. ;. .:w �., i J _ � L � }� � , L J } i y J�`' �I \Y E 'A ' '� i h f / /;: rte ? f ,' _-- '_....... r - - - -�- l.. < . � � .. � ', � \ 1. _.. �`l " �4 a �, 1 � \ r� � � C . ` y ���`�w '�...' � �,:� � � i r-_ Safety and Buildings Divon County ~� _ __ s 1 201 W. Washington Ave,, P.O. Box 7162 `j A On�°r i Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled m by Cc.) pepartmY nt of Commerce li (608) x-3151 - State Plan I.D. Number - -� Sanitary Permit Applicatio J,V4 In accord with Comm 83.21, Wis. Adm. Code, personal information you provid may be used for secondary purposes Privacy Law, s15.04(1)f1l!fr"""" Project Address (ifdifferrnt than (nailing address) i rf � 11. Application Information - Please Print All Inform - --� Property Owner' s Na me DE Parcel # Biock N 1 IKITV Property Owner's M ailing AlKtress Property Location lti -e- City, State Zip Code Pitme Number �-- d- 1 ad GJ /" S y � _�� ?Y - J�' 7 � ircle Iv T � N: R�E o� � II, Type of Building (check. all that apply) ok as is�4m*'4r — - -- - - i or 2 Family Dwelling - Number of Bedrooms Ain Jos ak s , - Subdivision Name CS vt WUCrL�er ' ,� E Public /Commercial -Describe Use � dl ;_ice �ay._ _ -,. ti_ -- 'v C' State Owned - Describe Use T 8 _ JCity_1-Village,LTownship of t - III. Type of Permit: (Check only one box on line A. Complete line B if applicable) J �j Z - 2)A j 9 D OQ�) i A ( V-New System ❑ Replacement System [ Tre a 'Holding Tank Replacement Only l ❑ Other Modification to Existing System - - - - - List Previous Permit Number and Date Issued B. ❑Permit Renewal L1 Permit Revision bongo of i� Permit Transfer to New Before Expiration Pbxmher Owner _._ ___ - -- Ic_ IV. T of P OWTS System: (Check all that a i _ - -� Mound < 24 in. of suitable soil IDI At -Grade "Li Single Pass Saul Filter I F Non - Pressurized In- Ground ❑ Mound > 24 i s. of suitable soil n ❑ Constructed iWetiand 11 Pressurized in- Ground a Bolding Tank `i Peat Filter ❑Aerobic Treatment Unit u R eirc:dating Sand Hirer ❑ Recirc Syn theti c: Med ia Filt oLeaching Chamber 0 Drip Line 1.3 Graver -le Pip i_1 Other (explain) - __•�__ � -� V. Dispersal /Tre atment Area Information: - - Design Flow (gpd' // Design Soil Application Rau gl;)iu Dispe l Area Required (s£y Uispersal Area Propo�cf��n ( SysteElevation VI. Tank Info Capacity in Total Number Mamfactun:r — 7 Prefab Site 15teel Firer `Plastic Gallons Gallons of Units Concrete I Constructed J Glass i New Fxisting Tanks Tanks Septic Or Holding Tank F ber znent Unii p tlsibility Stat ement - I, t undersigned, assume respon slbillty for atlation of the POWTS s hown on the attac plan f Plumber's Na me (Print) Plumber's Si gnature - M f PRS Number Business shone Number T. d plumber's Addre ss (Street, City. State. Zip Code) ! D 2D -- VIII. County /De ar tment Use Only Sanitary Permit Fee (includes Groundwater �TDate l Si ed rissuing ent Signature { S Approved l Surcharge Fee) �i wne ►ye Reason vial --- - - _ IX. Conditions of ApprovalfReasons for Disapproval SYSTEM OWNER: ✓✓ I ( J. Septic tank, effluent filter and dispersal cell must all be services / ma int ia: as Pte• management plan provided by plumber, 2. All setback requirements must be maintained as per applicable code 1 ordinances. Attach C p oar lets laws ( to the County nary) for de system on pape.r not Icss than 81 /2 x I1 inches in size SBD -6398 (R. 01103) e 1 O . `i i 1, 9 ^� \jl ; J a 1 b O u � eft � c` b 'Q 60 Q �a "" P 1050 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Coae Tom Schmitt 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. Please print all information. Review By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z Property Owner RECEI Property Location M & G Inc Govt. Lot na NW 1/4 1 S_ 2 T 31 N R 19 W Property Owner s Mailing Address DEC 1 Lot # Block # Subd. Name r CSM# 1359 Awatukee Trail 4 2006 4 ( na Grandview Estates City St to ZipT o Cg I EZ)UI r� J City _j Village yf Town Nearest Road Hudson I 5 715 - 549 - 597 Somerset Cty.Rd.I ✓J New Construction Use: yJ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD _ f Replacement Public or commercial - Describe:_ Parent material Outwash — Flood plain elevation, if applicable General comments and recommendations: Suitable for a conventional system with a 0.7 gpdLagift rating Possible system elevation for Area I,step trenches, (high trench) 1 02.09 (low trench) 1 01.13. Based on a 6% slope ❑Boring # l Boring ✓j Pit Ground Surface elev. 106.35 ft. Depth to limiting factor >101 in. Soil 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 1 0 -8 1 none sl 2fsbk mvfr gw 1f .5 .9 2 8 -14 1Oyr4/4 none sl 2msbk mfr gw 1f .5 .9 -- — — -- - - -- -- - - - - -- 3 14 -19 7.5yr4/4 none Is 1 msbk mvfr cw - - - - -- .7 1.2 4 19 -34 1Oyr4/6 none cos Osg ml cs - - - - -- .7 1.6 5 34 -101 1Oyr5/4 none ms Osg I ml - - -- - - - - -- .7 1.2 /02 ,09 / - -- - -- - 51' `67. Boring # . - Boring vol Pit Ground Surface elev. _ 105 _ -- ft. Depth to limiting factor -___ X96_— _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 1Oyr3/2 none I 2mgr mfr cs 1f .5 .8 2 8 -16 1Oyr4/4 none sicl 2msbk mfr cw if .4 .6 3 16 -25 1 Oyr4 /6 none Is 1 msbk mvfr gw - - - - -- .7 1.2 4 25 -35 1Oyr5/4 none cos Osg ml gw - - - - -- .7 1.6 5 35 -96 10yr5/6 none ms Osg ml - - -- - - - - -- .7 1.2 * 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 Thomas J Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 5/21/01 715 - 549 -6651 Property Owner M & G Inc Parcel ID # Page ___ 2 of 3 a Boring # Boring V1 Pit Ground Surface elev. 102.43 ft. Depth to limiting factor > 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Raots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10yr3/3 none I 2mgr mfr cs 1f .5 .8 2 10 -26 10yr4/4 n one sicl 2msbk mfr cw 1f .4 .6 3 26 -36 7.5yr4/4 none Is 1 msbk mvfr gw - - - - -- .7 1.2 4 36 -49 10yr5 14 n one cos 0Sg ml cs - - - -- .7 1.6 5 49 - 100 10yr5/6 none ms 0Sg ml - - -- - - - - -- .7 1.2 ❑ Boring # —� Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate GP Horizon Depth Dominant Color Redox Description Texture Structure Consisten ce Boundary Roots *Eff#1 *Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. F -1 Boring # 1 Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate GP Horizon Depth Dominant Color Redox Description Texture Structure Consiste nce Boundary Roots *Eff#1 Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Rh * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD S mg /L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. 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SHEET 1 OF 2 SHEETS u �• x 932- r AID * .� iii• r aR S E PTIC TANK E PUMP CH AMBt ; R CR 5£C 'ION AND SPECIFICATIONS 4" CI VENT PIPE 12" MTN. ABOVE GRADS WEA THERPROOF ?:25 FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER FINISHED GRADE -- W/ PADLOCK. & �� - -- WARNING LABEL ++ Cl RISER.. - 4" MIN . 1B "' SN. ' 6" MAX. NLET Fl WATER TIGHT SEALS GAS + t "_':.GHT APPROVED A SEAL 1 JOINTS WITH ;PPROVED ---- ; 'ALM APPROVED PIPE 'IPE 3' B + S ON 3` ONTO )NTO SOLID ' 1. SOLID SOIL C SOIL PUMP OFF ELEV. FT , - -- d OFF RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDAING UN'AEA TANK CONCRETE PAD SPECIFICATIONS SEPTIC ! DOSE , / TANK MANUFACTURER: �0..2V_ NUMBER DOSES PER DAY : `�` TANK SIZES SEPTIC ' n GAL. DOS£ VOLUME INCLUDING . _ DOSE �� � GAL. FLOWBACK: P� 9 GAL. ALARM MANUFACTURER: m- CAPACITIES: A = INCHES = CI�� GAL. MODEL NUMBER: DLV SWITCH TYPE: Tv\&v, _ r B = 2 INCHES % 4 �. GAL, PUMP MANUFACTURER: C C = D INCHES = GAL. . MODEL NUMBER: PCB SWITCH TYPE: YY rms: D = INCHES = _GAS. REQ�.IRED DISCHARGE RATE '40 GPM PUMP & ALARM WIRING AS PER II.HR 16.23 WAC VERT ;CAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . ��.. FEET * MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . . . — 2.5 FEET + Q FEET FORCEMAIN X zo bn /100 FT. FRICTION FACTOR . FEET .... T.OTAL DYNAMIC HEAD = FEET i "'TE;RNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH DIAMETER ID �--- ---- ! &,4L pout J a SIGNED: . j�J��- =�o�- r-- z�+' ---� LICENSE Nt.JMBER: �,a,�l Q� 'V DATE: 1i$$ GOULDS PUMPS Submersible Effluent Pump 3871 EPO4 E P05 APPLICATIONS • Fully submerged in high • EP05 Impeller. Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specdicaliy designed for the lubrication and efficient improved performance, construction. following uses: heat transfer, • Effluent systems ■Casing and Base: Rugged thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation. Auto- � Cawdlan Standards �ariatioo • Heavy duty sump matic models include resistance. • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "F" or "C ".) factory. strength, and durability. SP ECIFICATIONS ■ Motor Cover. Thermoplastic Goulds Pumps is ISO 9001 Mss FEATURES cover wlth integral handle and • Solids handling capability: float switch attachment points. 1 14 " ma)(mum. • EPO4 tmpeller. Thermoplas- ■ power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant, • Total heads: up to 31 feet pump out vanes for mechanical • Discharge size: I V NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic- stationary, BUNA - N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. METERS FEET • Fasteners: 300 series 1° stainless steel. �-- , 9 30, a► 4 5GPM _. ..... •Capable of running dry without damage to e is Fr components. Motor: r • EPO4 Single phase: 0.4 HP, Y 5 20 _ 115 or 230 V, 60 Hz, 1550 RPM, bunt in overload with s 15 automatic reset. q EPOS • EP05 Sin phase. 0.5 HP, 115 V, 60 Hz, 1550 RPM, ° 3 10: . built in overload with EPO4 automatic reset. 2 • Power cord: 10 foot s standard length, 16/3 1 SITOW with three prong grounding plug. Optional 20 ° oo 10 20 30 4b so GPM foot length, 1613 SJTW with three prong grounding plug (standard on EP05). 0 2 a 6 s 10 12 m , /h CAPACITY Gou lds Pumps V 2000 Goulds Pumps ITT Industries Effective February, 2000 83871 POWTS OWNER'S MANUAL, & MANAGEMENT PLAN Page of �. t=t! -E INFORMATION ' Owner SYSTEM SICWiCATiOMS Ssptio Tank Capacity 11:1 NA Permit # ----- _� I .�S'�i al `.septic Tank Manufacturer ❑ N A DESIGN PARAMETERS Effluent F itte r Man ufacture r �>� �� ❑ NA Number of 9edrooms ^t� G1 NA Effluent Filter Mod el ❑ NA Number of Public Facility U nits Q NA Pump Tank Capacity Q ❑ NA --�– – ai Estimated flow (average► (* 00 al/d Pump Tank Manufacture fie S � 9, O NA D flow (peak), ( x 1.5) d O al/ a pump M anufacture r 0 � 13 NA G to u-I _ Soil Application Rate al /ft z Pump Model ❑ NA Standard Influent /Effluent Quallty Mcnthly average" Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) j 530 mg;L Q Sand /Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA 10 Mechanical Aeration ❑ Watland _ Total Suspended Solids ITSS) 5150 mg /L a Disinfection ❑ Other: pretreated Effluent Quality I Monthly average Disperse! CallW O NA Biochemical Oxygen Demand (SOD,,) 530 mg /L ❑ In Ground (gravity) E3 in Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L J NA 13 At - Grade Q Mound Fecal Coli (geom mean) s10 cfu /10 Q Drip -Line Q Other: Maximum Effluent Particle Size Y in die. ❑ NA Other: ❑ NA Other: _ NA Oth+ar; ❑ NA t `Values typical for dornestic wastewater and septic tank effluent. Other: ~ Q NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tankisi At least once every; monthls) {Maximum 3 veers) Q NA � y Pump out contents of tank(s) ; When combined sludge and scum equals one -third Q;) of tank volume ❑ NA Inspect dispersal cell(s) At least once every; O month(s) (Maximum 3 years) NA _ 3a year(s) ❑ month(s) Clean effluent filter — I At least once every; r ' g earls) C-3 NA • Inspect pump, pump controls & alarm l At teast once every: rnonth(s) D ,, _., _+ f _ -N _ _ ❑ year(s) Flush laterals and pressure test At least once every; ..�„ ❑ month(s) ❑ NA ❑ year(s) Other. �� ❑ month(e) At least once every: ❑ yearle) ❑ NA Other: Q 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 tankls) 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 an the ground surface. The pending 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 lYl 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 fitters, 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. apoo er.glejlsluiwpb u$auooryly ovq'C$ pup ta {Ail ll' }ZL`'£13 wu,oC) jeideya 400 eaue+ldwoo ui pey®ap lom wawnoop ` sua4d euo4d �s aulle N aweN AMWOHIR Aa01VIAM 1d�C�"I Wdwnd) H d0 ONIOIAN39 30V1d39 9u0yd � f �-- $ �` -- / L T suo4d a1L1f1 � .�.... _ N S 1 w ei4 k13NIV1N W 04 U311VISNI S,iMOd S1N3WW00 WN0111cov 3121990dW! 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'luon s+q 1ltM J94eMalsem seeox9 043 pelols9l el lennod ue 1 f ( ; ; a 4M '019A91401OM48(y l euifou 9noge 313,1 Aew 8711161 d um d se6e no 1 POW8yosrp 3 Amod Bu �n aae }ins enllejlll ;ul 9441 1p ueibl; "? suoglpuoa (loS u64M in000 lou lle4s sin eels welsAS 8311921100 04 ene p 'Alen al joljd JOWj9do 8wolnles o691des a Aq ilJuel 0441 ;o 4 Aio Si suolleilu0ouos 4 ijgtoff I; I alp 9443 e8ewep Jo /pue sseoold luew penowel Js leell 941 epedw Aew 4g ill ul sl9alwaya 19430 la sionpo ld 8ulluled ;o eau9sold ay} lo; {e}7lural 1uoWiepli �loayo S1MOd 841 ;o 9sn 01 l oud 'uollonilsuoo enau lod N411Vk13d0 (INV in -LwV18 I START UP AND OPERATION of For new construction, prior to use of the POWTS check treatment tankfal for the presence of aintin that may impede the treatment process and /or damage the di Products or other contents en If high concentrations are detected have the ts spalrsall aell(sl. conten of the tank(s) removed by a Septage servicing operator prior to um. p g 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 wiii be 'joag too discharged to the dispersal cellisl in one l arge effluent. To avoid this Situation have the contents of the p din t# k c all($) an by a s in the Servicing u pp,r s r p rior t + o hargei of Power to the effluent pump or contact a Plumber or POW.T3 Malntajner t o assist restore normal levels within the pump tank. in manuall operating the pump controls t o Do not drive or park vehicles over tanks and dispersal cells, Do not dr within 15 feet down slope of any mound or at -grade soil absorption area s of park over, or otherwise disturb or comps, t, the area Reduction or elimination of the following from the wastewater iltream may Improve the performance and prolong the life of the F'4W7g; antibiotics; baby wipes; cigarette butts; con foundation drain (Sum dorms; cotton BWabs; degreasers; dental floes; diapers; disinfectants; fat: p pump! water; fruit and vegetable uoe9inge; gasoline; grease; herbicides; meat scraps; medications oil; Painting products; pesticides; sanitary napkins; tampons; and water softener brine, ABANDONMENT When the POVIaS fails and /or is permanently taken out of aeryicd the following steps shall be taken to insure that the system is Properly and safely abandoned in compliance with chapter COMM 83,33, Wisconsin Administrative Code; • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and ro p perly disposed of by a Septage Servicing Operator. • Attef pumping, all tanks and pits shall be excavated and removed or their rovers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soi! absorption system, The replacement area should be protect6d from disturbance and compaction and should not bey 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 rust camplY with the rules in effect at that time, ❑ A suitable replacement area is not available due to s®tback andlor soil limitations. Barring advances in POINTS technology a holding tank may be installed as a lest resort to replace the failed FOWTS. .1iRCI The site as not n evaluated to identify a suitable replacement area. upon failure of the POWTS a soil and site iV } evaluation be performed to locate a suitable replacement Oren. If no replacement area is available a holding tank may b tape s a last resort to replace the failed POWTS. G Mound and at -grade soil absorption systems may be reconotructed 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 CpNTAIN ikTHAI 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 0jFFICtjLT OR 1MPQsSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POVifTI; MAINTAINER =me � S 1 3 4 --31 a.J Phone SEPTAGE SERVICING OPERATOR (PUMPER) 1QtrAL IREI'3UU4TORY AUTHORITY Name Name Phone Phone 715 - � Th„ document was drafted ire compliance with chapter Comm 83.22(2jlb;t1 lid)&(fl and 83,64(1), (2) & 131, Wisconsin Aaministravve Code. ST. C1ROIX COUNTY SEMC TANK MA MENAN'C6 AGREEMM4T AND OWNERSZW CERTMCAUON PORM owwauyar M4 IC wn � �' �' �ri - or 1 f f o Mailing Address .. E Ag J'1] LgA2a V2 1 . 7 ....._ (vebfm ica vagv�e fiom'Plamiug & Zoning Dopvftmt for she w coaanotction.) Citylstm r3 ..� �1 j Parcel ldwtificat+cm Number ^ — c property Location '/{ Y4 , Sec. � T N Rj J W, Town, of Srab Vision , Y' C.•1r1 �• t�,Ca _ — ► Lot 4 Ctarti8ed SOrmy Map 0 , vo lume Virexrsnty wed # G 5` D y V �pltunc 9pw houm yaa n W tiYeet identifiable Yss 10 Km MA = AN" an g.w R con n hppf,Dpff Up and nuhOUM" of your sop* syseom could ret in its preellaAtt'o & � tl nw4t 1a y � enatace cmusm of * . W hd y o u a into ptltrgai� out $!E �pttG teak 44q'} tl>re�e years or Bd017A!'� if =064 °� the arystam c u eft the l; op ofthe mptic tank as a uvat=1 31690 in d* was% "POW sysr�ms �m maintemace rexputtseblllties are mm c&d in f comet. 83.5211) wd in C*ter 12 - Sk, Ckeix Coln" 8&0*y wwffilm The pop" WWW r so t to 5"r CMM Cain P1010i»g & Z0'W s Depnttr M a eertifiration fibre+. alprtcal by ft aWW sad by a masuff phtutt>e ,joti mysaILD phmAw, mfto wd rsln obW Of n HCOANd FIR" ""ryuNk %at (1) aw on-silo ►+walsteWAW diapoW syvb= is in proper opecating cend1601% uadlar (2) after tspeodw and pee WW8 (if•aaa 0- the aoptW oak es Less tho 1/3 f hu of slWp. Uwe, tlya ti83gtud kLYa ttad dye above teyuiretrON sed age to r ukdwitl the privata "Wage disposal sYMM with der sw&rds set ftQ4 hw+ ti as set by tie LmWbow of Comex ad the Dapeetan o of NdWW AeINEO , St" Of Wlwordh'- f;cawcation staling that your agot syst= has bm =bwdw4 =0 be corVlcW ad r Wxwd to the SL C10h +C•OOnty 'Plam*% & Z,u,i q Dopsrrtnx O WkWA 30 4qv of the three ym a ons date. Uwe teal* that alt tents an this fares ar to to the bat of myfottr knowledge. Il emlare the owmr(a) of the property described stlla% by viepeo of a warratetY deed toaorded i n RegWar of Deeds Ogee. N umber = _ 1'2- IL2- DATE ` � APP ) "�wAay fsfotthttpon tymt fie rem may tesulr itl ttuo sooatary permit bsdng rcv,1W by ft Pk=4 & ZODiV DGparMWM' ••• lk 16M s mmded wunwy dead f am, ft R,eglstex of Deeds U#aea and a copy of the certlded 5"y � � 1n,.lsedG vwith *As app mferEtce is mado In this WSTM tY dtiod r - - 12/12/2006 14:19 17152473622 PAGE 01 12 11212006 T UB 14:10 PAX 715 380 4687 6T C ROIX 04 RE OF DDED6 �qqi /qqi IIUE. 164 P1cE 627 $7A78 BAR OF WISCONSIN FORM 2 - 1999 W DEED KATHLEEN H. WALSH Document Number REC,ISTER OF DMS 5T_ CROIX CO., WI I tilt Deed, tt WQ bMwatett Ilalrold J. Maehtner and Mar !! t J. REMM FOR RECi>IID SeirseRtner, bttsbtand and Wfe, 06r16 -RQ4t 14:40 AA DEED Grantor, and Grad ProDeaN LP4 8 -- — CRT COPY FETE: COPT FEE; _ TMISFER FEE: 8[5.00 -� REMUS F: 10.00 Grantor, for a velttable comidMi0g, conveys to Grantee the followins described teed estate in St. Croix County, State of Wisconsin (if mars space is nc%led, please attach addendum): Raeatding .Area W 113 of SW 114 of Section 2 -19 EXCEPT Lets 1, 2, 3 and 4 of Cert;fied Name av! Retmn Ad Survey MOP Stud NgvcMber 6, 1985, in Volume 6, Pap 1607, and EXCEPT E10 of NEt114 of SW I/4 of SWIM, sAd EXCEPT 91/2 of SE 114 24A K� &w- of NW 114 of SW 1/4 thereof. u!kv - L� A 032-1005 -20-10 d: 032.1 3x Pared ldentiricmion Number (PIN) This is not _ . ho�arJtoed peeperly. 04) tb not) Exceptions to warranties: Easements, restrictions and rights - of- -way of tecotxl, if any, Dntod this day of Mq ZANY ' � �— — • l�al'�tlt J. Sdta AUTMENTICATION ACKNOWLEDGMENT 51gaature(s) Harold J. Settaehtaerand MargmaJ.9chacbt■er, STATE Or WISCO lneaband and Rift; ) ss, County ) atttheut(loate d this day of May Personally came before mo this _ day of the 4beva named e Krlstitia Ogland _ _ -• -- TULE. MEM13ER STATE BAR OF WISCONSIN to me known to be the pmon(s) who executed the rwsgoin not, g (if in authorized try § 746.06, Wis. Stets.} sezruemeent anal acknowledged the same. THIS WSnUMENT WAS DRAFT$D BY A ttorn y KrhM g etd Notary Public, state of WlmnsEn - H WI T My CommiWon is permanent. (if not. meta exple Lion date-, (3*mt tm flay be am*cdioud or ackmwi* d. Bulk arc not wcm mryj ...�._�. •) Named ofptssons *!A9 in 91Y UPWRY mW be typed Of primed below tltelr signature- 1*TWQ1k nP►orMb-Aft comw,a. Fans a ix eni STATg BAR OF WISCONSIN coo esia� l WARRANTY DEED FORM Ito. 2 -1999 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division r INSPECTION REPORT sanitary Permit No: 479215 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: Grand Properties L.P. I Somerset, Town of 032 - 2149 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 02.31.19.1300 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet SVHt Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1 Septic Dt Bottom ` Dosing Header /Man. Aeration Dist. Pipe Holding Bot. Syste►u Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only had Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulc Bed/Trench Center Bed/Trench Edges Topsoil 1 11 Yes [ f No r Yes [ No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: J J Inspection #2: Location: 2342 61st Street Somerset, WI 54025 (NW 1/4 SW 1/4 2 T30N R19W) Grandview Estates Lot 4 Parcel No: 02.31.19.1300 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ] Yes [] No Use other side for additional information. �. _ Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County _ D AN IN 201 W. Washington A Box 7162 ] / , �h �/ X �seonsin Madison, WI 5 707 - Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 26 3151 HtF #, / 5 lr Sanitary Permit Appl' tare PI 1. D. Nu In accord with Comm 83.21, Wis. Adm. Code, personal i ou provide tl t /VTJ may be used for secondary purposes Privacy Law, 5. ) �. ` O 1 116roje ct ddress (if different than mailing address) C R( )IX r - I. Application Information - Please Print All Information p N(3 Property Owner's Name Parce # Lot # Block # j e ttilY) ebPe eTi,e S L .19 / Property Owner's Mailing Address Property Location P rtY g P Y 7/ W 5to City, State '' 11 Zip Code Phone Number �`' `- -� -�'' Section _50 /1 t S f T O !- SL/(;?o� 5 p2 �17� e /c10Q (circle opF) 11. Type of Building (check all that apply) T N; R �E or ub division auk U 1 CSM Number E 1 or 2 Family Dwelling - Number of Bedrooms Qk a5 1 S GW ❑ Public /Commercial - Describe Use 6 5 74 71 5 ❑State Owned - Describe Use ❑City_❑ Village ZTownship of _To u1 e e III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 42 — A ' X New System P Y g P Y g Y ❑ Replacement System ❑ Treatment/Holdin 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 IV. Type of POWTS System: Check all that appl X Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating and Filter Recirculating Synthetic Media Filter Z 1,! ' ❑ Drip Line ❑ Grav -less e ❑ Other (explai ) V. Dispersal/Treatment Area Information: , (� Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation P, 6 w /0,?, o? ysC 0 ,7 1 6 6 s 3 I c.aw IN 13 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank /000 /OOC I W EerS - Aerobic Treatment Unit W/ z ,4&EL Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu er's ignature MP/MPRS Number Business Phone Number — b 14 Se HYrl.frr 1 2137& c 7/5 Plumber's Address (Street, City, State, Zi de) 616 /5 7- 0Mt �s�'r W� 5 VII oun /D artm ent O Approved El rsapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing t Signa a (N to Surcharge Fee) ❑ tven Reason for 1 ��� IX. Conditions of Approval/Reasons for Disapproval J; �� SYSTEM OWNER: Ot,Jr�l' M� t r�YC 1. Septic tank, effluent finer and -. 4dIM�Ot, )— dispersal cell must all be services / mak takwd / as per management plan provided by plumber, 2. All setback requirern —ts must be maintained as per applicable rode 'ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) i GkAND C57 Z- 0 - F Z 7 1 PRoPoSc.o W ELL � pRono� r- 3 g� 2c�orn 14,e A 6t5 �00064Ls,�. ARiveW4 ALT 14th i-/ T, c NC IY OZ • 09 S rA �L !GQc Ion 6Z� 63 Ioy 1 - 3 o-O �FFusF C 7 - ,e,: lucfI ® 8m EL. :1oo.00 ` T op o Z pV k; U P Y A 4L F PI rl_ - 10S.7a TAP ©� Z ` 7 V& ® $��►2 1���� PRAWW6 woe o �JQflGU /�� ✓ o 6 P-PrN) & k 7 S C /yI c K C" f /yliai� 7/Z R I U144o S% :Sv /nC Ae S i Ml T YO 14Jr 5-1-10-10- - W ELL FROP05 r, BR)eoo► �V l 7, ,48c'L - / f�D S' 5 i Fw1 r'L�V 14 T 8% SGDO AtT L ©k) %!2C - i = /© /. g 83 - 8rc to $- 3 �' i 0,0 /A�V cee i cq B�oO�= <usfe) -et 8 m, ta- .:10 0o ` to o'Dif Z PSG - -- - �} 05 70, '7, VG pmtj J ,Eu1� riF S'' C 14, K C C f=,ei4� n - - 7/z 1 Ll [ s% S Ave � S IVJr ;5 __ r _ _ _ _ - - -- - -__ __ _ - - -- - - - - -- - ____ _ __ _ _ _ _ _ _ _ - -- -- _- ___ __ r - - - - -_ r _ _ _ - __ _ _ _- .._ _ -- __ __ _ - -_ _ _ _ _ _ __. ___ _ _ _ _ - - - - -_ _ _ -- - - - - -- I_ __ _ _ __ _ _ __ _ _ __ _ __ _ __ . _ __ - - _ _ ___ BIODIFFUSER CROSS SECTION 4 11 PVC Inspection + Vent Pipe n r it Approximate Grade— r. 1 =1 I II � E1 •_ /�d�� A.1109e .n en A.eo w.'Oln E1 3' — A vW991 QOM Area !NOM ' 1050 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt 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 dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. 032 viewed By Date Personal information you provide may be used for secondary purposes (Privacy taw, s. 15.04 (1) (m)). /8 Property Owner Property Location M & G Inc Govt. Lot na NW 1M SW 1/4 S 2 T 31 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1359 Awatukee Trail 4 1 na I Grandview Estates City State Zip Code Phone Number `j City J Village 16 Town Nearest Road Hudson WI 1 54016 1 715 -549 -5971 Somerset Cty.Rd.I M New Construction Use: pj Residential / Number of bedrooms 3 Code derived design flow 4e PD Replacement J Public or commercial - Describe: Parent material Outwash \ ` Flood plain elev a ^, " appli����� �r '_ General comments 1° , and recommendations: Suitable for a conventional system with a 0.7gpd /sqft rating. Possible sys levatiQ�for�A4ea2(�op trenches, (high trench) 102.09 (low trench) 101.13. Based on a 6% slope 0 , MP t c X Boring # I Boring 0 0 - 0 N vi Pit Ground Surface elev. 106.35 ft. Depth to limiting factor >10 C i "" Soil cation ate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Ef #2 1 0 -8 1Oyr3/3 none sl 2fsbk mvfr gw 1f .5 .9 2 8 -14 1Oyr4/4 none sl 2msbk mfr gw 1f .5 .9 3 14 -19 7.5yr4/4 none Is 1 msbk mvfr cw - - - - -- .7 1.2 4 19 -34 1Oyr4/6 none cos Osg ml cs - - - - -- .7 1.6 5 34 -101 1Oyr5/4 none ms Osg ml - - -- - - - - -- .7 1.2 p2.o9 Fil Boring # Boring 6 Pit Ground Surface elev. 105.09 ft. Depth to limiting factor >96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GFD — / — W in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. *Eff#1 *Eff#2 1 0 -8 1Oyr3/2 none I 2mgr mfr CS 1f .5 .8 2 8 -16 1Oyr4/4 none sicl 2msbk mfr cw 1f .4 .6 3 16 -25 1 Oyr4 /6 none Is 1 msbk mvfr gw - - - - -- .7 1.2 4 25 -35 1Oyr5/4 none cos Osg ml gw - - -- .7 1.6 5 35 -96 1Oyr5/6 none ms Osg ml - - -- - - - - -- .7 1.2 r /oZ. o 3 (P 7 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: A Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 5/21/01 715 -549 -6651 Property Owner M & G Inc Parcel ID # Page 2 of 3 3] Boring # J Boring H' Pit Ground Surface elev. 102.43 ft. Depth to limiting factor > 100 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 -10 10yr3/3 none I 2mgr mfr cs 1f .5 .8 2 10 -26 10yr4/4 none sicl 2msbk mfr cw 1f .4 .6 3 26 -36 7.5yr4/4 none Is 1 msbk mvfr gw - - - - -- .7 1.2 4 36 -49 10yr5/4 none cos Osg ml cs - - - - -- .7 1.6 5 49 -100 10yr5/6 none ms Osg ml - - -- - - - - -- .7 1.2 f olct. ❑ Boring # 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2 Boring # Boring F Pit Ground Surface elev. ft. Depth to limiting factor 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 * 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 naaA motarial in on oIt—to f ,mat n].— —t—t tha A- -tr.,Ant at fl1Q- ')AA -21 1;1 — ' T - F V t. nQ -7(.A -2777 7 - loci. y�e 30 A3 20 4- d P o2 it 7z 1 << yo Al m Ae 6� Y 5� 6� TiW as y�y wz d radiliew Es0,Aos L/7 /0 5W -4(4-1 IVLJ -L :�� Sot T3 //V P-/ g&✓ �� ` .ti � .� �_ .. - _ , _.. i i f .a.. f �. t _ _ . _ _ _._. M . - - -.__.k ,.. c , 1050 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt 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 Parcel I.D. percent slope, scale or dimemsions, 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 M & G Inc Govt. Lot na NW 1/4 SW 1/4 S 2 T 31 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1359 Awatukee Trail 4 na Grandview Estates City State Zip Code Phone Number _f City _j Village &n Town Nearest Road Hudson WI 1 54016 715 - 549 -5971 Somerset Cty.Rd.I ✓J New Construction Use: y Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD _f Replacement -) Public or commercial - Describe:_ Parent material Outwas — Flood plain elevation, if applicable General comments and recommendations: Suitable for a conventional system with a 0.7gpd /sqft rating. Possible system elevation for Area I,step trenches, (high trench) 102.09 (low trench) 101. 13. Based on a 6% slope Boring # _j Boring ✓j Pit Ground Surface elev. _106.35 ft. Depth to limiting factor >10 1—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 -8 1 O yr313 none sl 2fsbk mvfr g w 1 f .5 .9 2 8 -14 1Oyr4/4 none sl 2msbk mfr gw 1f .5 .9 3 14 -19 7.5yr4/4 none Is 1 msbk mvfr cw - - - - -- .7 1.2 4 19 -34 1Oyr4/6 none cos Osg ml cs - - - -- . 7 1.6 5 34 -101 1Oyr5/4 none ms Osg ml - - -- - - ---- .7 1.2 F2 ] Boring # J Boring 0 Pit Ground Surface elev. 105 5 09 ft. Depth to limiting factor - > in. Soil 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 -8 1Oyr3/2 none I 2mgr mfr cs 1f .5 .8 2 8 -16 1Oyr4/4 none sicl 2msbk mfr cvv 1f .4 .6 3 16 -25 1Oyr4/6 none Is 1msbk mvfr gw - - - - -- .7 1.2 4 25 -35 1Oyr5/4 none cos Osg ml gw - - -- . 7 1.6 5 35 -96 1Oyr5/6 none ms Osg ml - -- - - - - -- .7 1.2 " Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg /L " Effluent #2 = BOD S30 mg/L and TSS s30 mg /L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt l 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 5/21/01 715 -549 -6651 Property Owner M & G Inc _ Y Parcel ID # Page _2 3 a Boring # — � Boring Pit Ground Surface elev. 10243 ft. Depth to limiting factor > 10 0 in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 DIR Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -10 10yr3/3 none I 2mgr mfr cs 1f .5 .8 2 10 -26 1 10yr4/4 none sicl 2msbk mfr cw If .4 .6 F 5 3 26 -36 7.5yr4/4 n one Is 1 msbk mvfr gw -- .7 1.2 4 36 -49 10yr5/4 none cos Osg ml cs - - - - -- .7 1.6 49 -100 10yr5/6 none ms Osg ml - - -- -- --- 7 1.2 El Boring # -� Boring imiting factor in. Pit Ground Surface elev. ft. Depth to l Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. L I 1 P f El Boring # Boring limiting factor i j Pit Ground Surface elev. ft. Depth to mng n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 PDL � ' Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i' C, D ' Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD S mg /L and TSS S mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or r"r — T FnQ_7AA_Q777 40 6qi 39' 4 -- :3�c' T z a� !-� � ✓' % m G- mac . p rr,�,�l iti.g � �/ ; cm as T• .Sa,", '' o s 7 a2 2y�y Zr / Yoa Lo y Gro—delie� C.s a ,c3 OA 5-ly - (4(1 - / YO ST CROIX COUN'T'Y SEPTIC TANK MAINTENANCE AGRBBMBNT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 7/ 2 & -+9,0 Sr Su < E /02 S © .� l car sv0 z r Property Address o33 61 - (Verification required from Planning Department for new co (truction) City/state YOnie,� i W I Parcel Identification Number o 63Z - 21 , 4 1 - 5/0 - 60 LEGAL DESCRIPTION Properly Location M O %4, W V4, Sec. . T_ N -R LLW, Town of s® "] eesE T Subdivision a e A Al o V 1 E Cd �s i ffTE S . Lot # Certified Survey Map # , Volume . .Page # Warranty Deed # � y5� 9 , Volume O Page # 62- 7 Spec house [S yes ❑ no Lot lines identifiable a yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance cons 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 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and retumed to the St. Croix County Zoning Office within 30 days of the three year exn iration date. x 3�� SI m" (01 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 prope-gy d bed a ve, by virtue of a warranty deed recorded in Register of Deeds Office. l2Slb� / SIC3 AT[JRE 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 copy of the certified survey map if reference is made in the warranty deed Page of 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 tanks) removed by a septage servicing operator prIaLp use. System start up shill not occur whbn soil conditions are4rozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater Isvels. When power Is restored the excess wastewater will be discharged to the dispersal calls) 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 be taken to insure that the system is properly and safely abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Ali 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. r r rr e After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or-must be taken, to provide a code compliant replacement system: ■ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing 'and proposed structure, lot lines and wells. Failure to protect the replacement. area will result In the need for a new soll and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. O 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. E3 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. Rdconstructions 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' John. SchAtt Name Owners choice Phone Phone (7 �49-65651 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name hoice Name St. Croix Ct . Zoniri Phone Phone 715 386 -4680 t This document was drafted In compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.64(1), (2) & (3), Wisconsin Administrative Code. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Grand Properties L.P. Septic Tank Capacity 1000 at ❑ NA Permit # Septic Tank Manufacturer ❑ NA Week s C.P. DESIGN PARAMETERS Effluent Filter Manufacturer Zabel ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model A -100 ❑ NA Number of Public Facility Units IR NA Pump Tank Capacity a l 0 NA Estimated flow (average) 300 g al/day Pump Tank Manufacturer ■ NA Design flow (peak), (Estimated x 1.5) 4 9 g al/day Pump Manufacturer 0 NA Soil Application Rate 0,7 gal/day/ft' Pump Model 0 NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit 0 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 Collis) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L 0 In- Ground (gravity) 'O In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L 0 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: 0 ear(s) (s) (Maximum 3 years) ❑ NA 3 Pump out contents of tank(s) When combined sludge and scum equals one -third %) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 3 ® month(s) (Maximum 3 years) [3 NA Clean effluent filter At least once every: ❑ m ) ❑. NA 0 yea r(s) r(s) 1. Inspect pump, pump controls & alarm At least once every: month d NA<: Y Hush laterals and pressure test At least once every: 13 ear( )(s) O NA< Other: At least once eve ❑ month(s) p NA.; every: ❑ year(s) Other ❑ NA B 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,...pondin of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires`tha immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third %) 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 1,1 Wisconsin Administrativs 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 wlthin 10 days of completion of any service event. VOL 64OPAU STATE BAR OF WISCONSIN FORM 2 - 1999 E�45709 KATHLEEN H. WALSH i Document Number WARRANTY DEED REGISTER OF DEEDS ST . CROIX CO., 0 , This Deed, made between Harold J. Schachtner and Margar J. RECEPJED FOR RECORD S chachtner, husband and wife, _ 05 -16 -2001 10:00 AM - - - WARRANTY DEED EXEMPT N Grantor, and Grand Propert LP, CEkT COPY FEE: COPY FEE: - - TRANSFER FEE: 825.00 —' - - - RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area W 1/2 of SW 1/4 of Section 2 -31 -19 EXCEPT Lots 1, 2, 3 and 4 of Certified Name and Return Add ss Survey Map filed November 6, 1985, in Volume 6, Page 1607, and -- EXCEPT E112 of NEI 14 of SW I/4 of SW I /4, and EXCEPT EI/2 of SE1 /4 ofNW1 /4ofSW1 /4 thereof. ? "A O'L— t W Jy vZ v Pt 032-1005-20-100 & 032 - 1 -30 -500 _ Parcel Identification Number (PIN) This i not homestead property. 04) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ' day of May 2001 ' Haro J. Scha to z, tne AUTHENTICATION ACKNOWLEDGMENT Signature(s) Harold J. Schachtner and Margaret J. Schachtner, STATE OF WISCONSIN ) ; husband and wife, ss. a r �,�. County ) authenticated this S�day of May 2001 Personally came before me this day of 1 the above named s Kristina'Oglaiid - -- TITLE "MEMBER STATE BAR OF WISCONSIN - - -- (Ifnot, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by 706 06 Wis Stats ) E ;a t THIS INSTRUMENT WAS DRAFTED I3Y s t Atto rney Kristina Ogland Notary Public State of Wisconsin; - Hudson, WIx54016 s is i s r� ?, : a K , c y a 4 c * t fyt M °Commission is permanent (If not state expiration` date (Signatures may be authenticated or acknowledged Both "arc not necessary.) ..k.,d- �.t.�r•":� .fi�?4�y ��, 2S,1 e: t Dae$ r .�t. —,. . :.{s`, a - ..2 �- 7 • -Names of persons signing to any capacity must be typed or printed below their signature Woansi(on P'a.N3u company Fond dul>fc un t - STATE BAR OF WISCONSIN eao ass coat WARRANT DEED r ;:t � X ��t��a FORM N0 2 1999 — Parcel #: 032 - 2149 -40 -000 06/01/2005 12:20 PM PAGE 1 OF 1 Alt. Parcel M 2.31.19.1300 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): ` = Current Owner GRAND PROPERTIES LP GRAND PROPERTIES LP 712 RIVARD ST STE 300 SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description " 2342 61 ST ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.460 Plat: 2012 - GRANDVIEW ESTATES SEC 2 T31 N R19W SW NW LOT 4 GRANDVIEW Block/Condo Bldg: LOT 04 ESTATES Tract(s): (Sec- Twn -Rng 401/4 1601/4) 02- 31N -19W NW SW Notes: Parcel History: Date Doc # Vol /Page Type 06/10/2002 681331 1907/467 EZ 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.460 56,300 0 56,300 NO Totals for 2005: General Property 3.460 56,300 0 56,300 Woodland 0.000 0 0 Totals for 2004: General Property 3.460 56,300 0 56,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00