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HomeMy WebLinkAbout032-1007-30-300 I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety W;,d Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 488167 0 rENER QL INFORMATION 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: Crotty, Brian I Somerset, Town of 032 - 1007 -30 -300 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: `7 1 2 3 93. C Sr gm+ 1 Cs,.e 03.31.19.45A30 TANK INFORMATION t EVATION DATA TYPE w o MANUFACTURER / tCA ACITY STATION BS HI FS ELEV. Septic f ��-- Benchmark � 4 r ''off 13 Z3 Dosing Alt M _ / / / apt l ! • �d I Aeration Bldg. Sewer f 8'7- 31 H olding t/Ht nlet 0 r TANK SETBACK INFORMATION S t /Ht O TANK TO P/L WELL BLDG. V ent o Air Intake ROAD Dt In p 1 \L B ottom f e is � 5 � .�d `—r osing Header/Man. era ri on -F— P, W ca 15.`tr $ e3 o Id ing I Sot . Sy Final Grade PUMP /SIPHON INFORMATION 12.30 anu ac u r eman over GPM o e um er i pnct ys em mea orcem i Lenz in uia. ( 1 2 0 Avr - U. D 3� t IMEN S 3 (off e a. L CHAMBER OR Sr INFORMATION y UNIT I lm d e l C_ Pipe(s) Length Di Len Spaci 1 x Pressure Systems Only xx Mound Or At - Grade Systems Only BedlTrench Center BedlTrench Edges Topsoi{ Yes ;s ii No Yes ;j No O ENTS: (Incl de co a %r pencies, pe sons p es nt, etc.) Inspection #1: Z4, CD Inspection #2: t -- - > L w.A to-AS4 r i « cf ib n . `ocn: 2352 County Road I Somerset, A 54025 (NE 1/4 SE 1/4 3 T31 RI 9W) NA Lot 3 Parcel No: 03.31.19.45A30 1.) Alt BM Description = T'� � o F J�Ow�.�� �$- use:2•Q•o� Ge.�a -r2 . 2.) Bldg sewer length= SZ - amount of cover = 42 �¢ 5, CW,¢s: Plan revision Required? I Yes ] No VA 2 Use other side for additional In rmati ---- �- 6ate -)-. -' 9li aXA-XAA _ lnsepct �ar 77 SBD -6710 (R.3/97) Safety and Buildings Division County 201 iiiultltis FNVIsconsin all Madison, WI 5370p � _ San' Permit umber be filled in b Co. Department of Commerce (608) 7 6 -3151 , /G 7 Sanitary Permit Applieatio N11 A `, (' 4 - ) O of State Ian I.D. Number In accord with Comm 8321, Wis. Adm. Code, personal informatio you provide A may be used for secondary purposes Privacy Law, s15.04(1 m) 5 . r i'; , i,K , G N YProj Address (if different than mailing address) I. Application Information - Please Print All Information 2,35Z C T l 2 k _ Property Owner's NM � Parcel # Lot # Block # Property Mailing A Pr 7 oper s Pr a Locatio - ^ City, tate Zip Code Phone Number <, V•, Section T c. � N; R o 1 II. Type of Building (check all that apply) O k 46 )e , �Ior2 Family Dwelling - Number ofBedrooms -. :5'J6 V14 , , Ii + r Subdivision Name CS ❑ Public /Commercial - Describe Use o t15Q ❑ State Owned - Describe Use 2- U , CC. :5 L , ) L/ t J G K, (`e ❑City ❑ Vill e (?�`I'ownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. , New System ❑ Replacement System ❑ 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 IV. Type of POWTS 5 stem Che ck all that appl Nf 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 Sand Filter ❑ Recirculating Synthetic Media Filter tLeaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Applicatiog Rate( gpdsf) Dispe - m Area equired (sf) Dispersal Area Propos (sf) System Elevation 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 _ Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assumli responsibility for installation of the POWTS shown on the attached plans. Plumber's am (Pri r Plumber' Si MP/MPRS Number Business Phone Number u 1 '�J Pluinber Address (Street, Ci , State, Zip e) C� ) s. o VIII. Coun !De artment Use On Al Approved rsappro Sanitary Permit Fee (includes Groundwater Date u Issuin gent Si at aS s) Surcharge Fee) ❑ er ' en Reason for Denial IX. Conditions of Approval/Reasons for Disapproval SVE M OWNER: 1. Eeptc tank, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. AM setback requirements must be maintained as per spplcable code / ordinances. Attach complete plans (to the County only),for the system on paper not less than 81/2 x 11 inches in sire SBD -6398 (R. 01/03) I Q� K _f i Na q � ' � o ' 0 e� 0 v rl m e ' rz V J \ o e� a a� ti Y �� TZ IIR .Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code minty Cro f Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and loc istance to nearest road. 3 - - 30 - 3� l • 3 °) Please print all f 121 Re awed by Date Personal information you provide may be used for purposes ( ` acf.s. 5.04 (1) (m)). , I P er , , P rty Location Q D - }� C ' - p f f - �✓ Govt. P� 1/4 5� 1/4 S / N R /9 i! (or) Ao. Props es Mailing Address L0 Block # Subd. Name CSM# ` IV S Rm $� 5 ' #A- 5 ZY1 city State Zip Code U.%, rty [] Village (Town Nears oad Sb m Z " e\ I[ New Construction Use: 0 Residential / Num �Ded s Code derived design flow rate © GPD ❑ Replacement ❑ Public or commercia — - - Parent material �i��� O rt'---r4 Flood Plain elevation if applicable �� ft. General comments f �,'�" 4 •r G ree s ys+ e F/. and recommendations: Boring # ❑ Boring p F ® Pit Ground surface elev. (? ft. Depth to limiting factor 7 121 in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z J2-,31 ' 0,Y'? v Ax- S i ° G 2A-0/c 3 jl -3Z 7..sye I &A As 0S 14 L c G- — . 7 1 2 y 5 2 -1 21 /o k4 of . / c6 1 Boring # C] Boring �i O ® ❑Pit Ground surface elev. � ft. � Depth to limiting factor 7� In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. •Eff#1 'E02 o -(� 10 ,l//,� SG �� sd� /F� cam- 9rZ , y . 6 Z -27 / ®j' ; 5 � ZA14t AA, 1 14 zs - Vr 7s m .7 /,Z /7- Af Ds A Z-- ' Effluent #1 = BOD > 30 220 mg& and TSS >30 1150 mg& ' Effluent #2 = SOD < 30 wG& and TSS _< 30 mg& CST Na r i nature CST Number Address Date Evaluation Conducted Telephone Number /T �Z O Z 3 I Property Owner Qbrrt' Cr o ce Parcel ID # Page of J M Boring # ° Boring ® Pit Ground surface elev. uX 6 ft. Depth to limiting factor 7 �Z in. r*EfMf#1 c ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#2 8 /or,� % Sy is ��. c w , y a 6 3 32 -sY 7S�,P AW Al f D f f t'� C — 0 7 y S,/ 1 2Y R �s- s 4S n► L - 0 7 1.02 Boring It ° Boring ® pit Ground surface elev. ft. Depth to ffmiting factor ? //z in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stnuxure Consistence Boundary Roots GPDM In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 •Efr#2 I o -ii /ojR k IVA S L 7 C &-- ,� o V 6 % Si G Z /tis c �i a s 1 o S . £l 3 3,r-so 7rj2 f {' /"i s D1y tt-7 c. C <.- _ .7 / 2- L/ m - biz /off 6 / A E � Boris G// Q a Boring # ®pit Ground surface elev. 0 6, `' 1L Depth to limiting factor 7 /// In. Soil Application Rate r Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPON In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Etf#2 6-1Z 1' / L %mf & �', aFi c w /r% , -/ ; Z 2 i7 ;2 /o IVA i 2 ^r3t r-► �� �1 l s" . X 111 A" A f DS N L z Effluent #1 = BOD, > 30 1220 mg& and TSS >30 1150 mglL • Effluent #2 = BOD 130 mg1L and TSS 1 30 rng& 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. sao433o t UM) III ' y Cof Property Owner Parcel ID # Page of J a Boring # [] Boring ® Pit Ground surface elev. YX 6 ft. Depth to Nmiting factor 7 � in. Sofl !cation Rate Horizon Depth Dominant Color Redox Description Texture Stru Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 I •Eff#2 3 32 -sY ,,sj�P , IV 1n 1 D .Sf 1, Y 1 /2v `y Ms 4.S rr, 4 1.02 • 1/ E ��# Boring ® Pit Ground surface elev. ft. Depth to flmiting factor ? f /Z in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 J 14 o S . fl 3 3-T so 7rr2 }�- /'2 c G- • - 7 /, Z 6/ A/A .7 ,Z Boring # ®Boring Ground surface elev. 0 6 8 ft Depth to *nWng factor 7 in. pit soft To lydtion Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 6- 1,7 /o /t L �F� �- /et y 2 i7 12 /ay IPA iris' ©s l"t 4, `r I - - /'� lo• �Y JUG i�,1 ©S 1� L o A ;2- • Effluent #1 = BOD, > 30 220 mgll. and TSS >30 < 150 nV& • Effluent #2 = BOD, < 30 mgll. and TSS 130 mglL 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. OWNER Page 3 of 3 Name- Ro4, Goof y Brian Parnell Address / 95 q *VO�JA CST 231314 Sl3rk.,c 4r (A. ry 0 1j Date S'- /,?- 0/ AL Benchmark 1 - 04 M.'d Lot - 93. -13 faGzle:� Benchmark 2 =TD f tee fas lvevi 1 AJ 1-0 Soil Boring Suitable Area Y'= 40' Scale 7 --- --- -66 (lot Ivi A Ar Li ot tQt -Y I L U *10 i i � i� �6 � j i I - T - _4 ......... AN I T FORM NO 995-A J W s gar 8 8 8 Stock No. 26273 rl Id rg 3A =s r4i •' �ro O =O tiWWO S M 0z�U o rtified Survey Map No. 4126 �xW� oiume 15 Page 41 . f BEING A PART OF THE NORTHEAST 114 OF THE SOUTHEAST 114 OF SECTION 3, TOWNSHIP 31 NORTH. RANGE 19 WEST, TOWN OF SOMERSET. ST. CROIX COUNTY, WISCONSIN. LEGEND _covernrnent Corner (as noted) ! J APPROVED o _... set 314" x 24" rebar weighing PREPARED FOR: ST. CROIX COUNTY 1.502 lbs./lineat ft. Pw wng zoning and lnks Co ee • .__.... Found I" iron pipe unless noted Robert A & Mary M Crotty (�U�c 3 � i 3CrD JUL 17 2001 Draina arrow 1953 s et . Street a8 Somer W! 54025 � 32- WOW If not N orded 30 days of Unptatbd Lands �0 1 . Meat line of the of AW 1 14 of the sa' 114 ! 0 a1 4 � 6551.93' ` � • — J� SCALE: 1 "=20j 1 62279 fi 1 S 0 tA .5 s P, n� 6.56 AC ! k O. FT. ! � Z SOV27 "W 660.63' 1 c ! �l� 330.31' 1 330.32' I // + I ! LOT 3 4 I> n— !lo 6.75 AC* LOT Found 314" rebar Y- LOT 2 6.77 A —' -- — —� 29 FT. 14 293671 SO. FT, m including R/W 1 c R r w �I + Q Including R/W I Nr ° fl 6.53 ACt ��" 6.53 ACt a* 284380 SO. FT.2 1 a. + 1 284371 SO. FT. Exelu ing R/W !Q St0 °' n1 Excluding R/W al l ., • as g p �'�• ��' 1 I s b' i 66.00-► n w�.'B o• • W L66.00' 100_ toadtuay setback r r tv Found 314' tY 33!.19' $$ 331.19' 1_56' _ NOlZ7'22 - N01 7'22' 987 — • 331 27 331.27' -- S01 a t SOl"SY39'W 6 Southeast corner -- — -- -- Section 3. T3fN, R191F Sit 2650.10 East 1/4 Corner Found Aluminum Monument u±+ewnq Larch Section 3. T31 N, R f 911' -- �to thm Aluminum Monument North b r. tine of the So utheast f //4, which CZMR CCJtPde MN is atrtumed to beer S03'ti7'39' I 6" MW AITNaz AMMONVAM n 6476f PACC-L PAC[-L Wr 3 VOI.15 Page 4126 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer _ &%r1q0_ � 1 Mailing; Address Property Address - SQ �l o� (Verification reyui ig Zoning Department for new consu•uction.) City /State _5omgzEAj ( — Parcel Identification Number OU R J001 ' SO - 300 _ LEGAL DESCRIPTION F '/, Sec. 3 i' 31 _ N R�_W, Town of 5on1-ecb�' Property Location Jam_ , �_ ; - 1 /4 , See. Subdivision "U JA Lot # Certified Survey Map Volume /S _ , Page Warrailty I)eed # Volttll]e -- � Page t� — Spec house yes no Lot lines identifiable es ino SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of ptunping 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, Owner maintenance responsibilities are specified in §Comm. 8152(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date, 1 /we certify that all statements on this lunn are true to the best of my /our knowledge, I /wc ani/arc the owners) of the property described above, by virtue of a warranty deed recuraed in Register of Deeds Office. Nu er of bedrooms 3 ha SIGNATU V F .APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office ttnd a copy of the certified survey milp if reference is made in the warranty deed. (REV. 08/05) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity ga l ❑ NA Permit # Septic Tank Manufacturer S ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms J � ❑ NA Effluent Filter Model _ ❑ NA Number of Public Facility Units ONA Pump Tank Capacity gal IVNA Estimated flow (average) gal /day Pump Tank Manufacturer -0 Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer NA Soil Application Rate 7 gal /day /ftz Pump Model EMA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit A Fats, Oil & Grease (FOG) :30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD :5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) 0 NA Biochemical Oxygen Demand (BOD :30 mg /L ' JiIn- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) <_30 mg /L N( NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) <_10 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size %8 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 y ear(s) 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: ❑ month(s) (Maximum 3 years) ❑ NA -&-year(s) Clean effluent filter At least once every: ❑ month(s) ❑ NA years) ❑ month(s) Inspect pump, pump controls & alarm At least once every: ❑ year(s) NA Flush laterals and pressure test At least once ever ❑ month(s) year(s) NA p y' ❑ yearls) �' Other: At least once ever ❑ month(s) A Y; ❑ year(s) 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 ( %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 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 :12 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. 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 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 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 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: 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 INSTALLJiR POWTS MAINTAINER 0 04 1 14 Name / Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTH I Name Name Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. I START UP AND OPERATION Page IV of 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 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 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: 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 INSTALL R ' POWTS MAINTAINER Name / Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTH9 TY Name Name ' Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. FORM NO. 985•A R tY�mr ��ws $ g Stock No. 26273 CL W w � p -y' .•r M SAO v f•1 r. N a SO X U. � M ,...�` oc�, = rtified Survey Map No. 412 4126 �YIx Cn olume 15 , Page BEING A PART OF THE NORTHEAST 114 OF THE SOUTHEAST 114 OF SECTION 3, TOWNSHIP 31 NORTH, RANGE 19 WEST, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. LEGEND .,...... Government Corner (as noted) I APPROVED o ........ Set 314" x 24" rebar weighing PREPARED FOR: ST. CROIX COUNTY 1.502 lbs. /lineal ft. Planning Zoning and Parks Committee Found I" iron pipe unless noted Robert A.' & Mary M. Crotty 1953 934d Street JUL 17 2001 •••.• Drainage arrow Somerset- WI 54025 \ _. _ �10 U'nplatted Lands a not recorded a p pr oval shall be 30 days of West line of the of NE 1/4 of the SE 1/4 I \ apprpya(�te a null qn 461d ' ' "" ' ' — • • — • • NO213'30 "E - I � 659.93' 1 • • � • I H o y SCALE: 1 200' 32M I A 66.04�. KNUIPP s w I " 8 0 200' 400' Iy v LOT 3 S I a N 6.56 ACt I n M \�� 285718 SO. FT. c' I Rt S01'27'22 "W 660.63' I N• � 11 330.31' 330.32' I 71 I p to _ I � I �n LOT 3 t to'' I s � ; p I I to V I �� N LOT 1 I w Igo w Act a a y LOT 2 6.77 a Found 3/4_ rebar 6.75 ACt 294828 SQ. FT. I io + `' ^ E A 00 CD Q o tn 66' LA .c`vo 293871 SO. FT. W Including R/W .. +' r � - " 2. I c, o Including R/W u, '° & m 00 0 to N to 6.53 ACt �o ti ti A d I 6.53 ACt N 284380 SQ. FT.�° C, S a p 0 , �.I .. 284371 SO. FT. r Exclu ing R/W N � � I Excluding R/W ° . i ° I pp �� a -q I i W LOT 4 e N ( �o _oH� 66.00' ->- � �b a a1� 0 � may w 166.00' too roadway setback o N _ —_ -- }— t13 Found 3/4" rebar 19 6 _4 331.19' o 331.19' 1 1987.56 _4 N01 " N01. 27'22 " a, 331.27' 331.27' -- — S01'57'39 "W o ' SOt'ST39 "W 662 C . T. H. "I" a' Southeast corner _ — -- — Section 3, T31N, R19W S01'57'39 "W 2650.10 East 114 corner Found Aluminum Monument Unplatted Lands Section 3, T31N, R19W Found Aluminum Monument North is referenced to the east line of the Southeast 114, which CEDAR CORPORATION is assumed to bear S01 39" W 604. WILSON AVENUE MENOMONIE, ML 64761 pACE_L OF 3 Vol. 15 Page 4126 FORM NO. 085-A Stock No. 26273 Certified Survey Map No. 4126 Volume 15 , Page 4126 . BEING A PART OF THE NORTHEAST 114 OF THE SOUTHEAST 114 OF SECTION 3, TOWNSHIP 31 NORTH, RANGE 19 WEST, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. SURVEYORS CERTIFICATE: I, Peter J. Gartmann, Registered Wisconsin Land Surveyor, hereby certify that I have surveyed, divided, and mapped a parcel of land being a part of the Northeast 1/4 of the Southeast 1/4 of Section 3, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin, and more particularly described as follows: Beginning at the East 1/4 corner of said Section 3 ; thence S01 °57'39 "W along the East line of the southeast 1/4 of said section 3 a distance of 662.54 feet; thence N89 °08'49 "W along the south line of the North 1/2 of the northeast 1/4 of the southeast 1/4 of said Section 3 a distance of 1324.23 feet to the West line of the southeast 1/4 of said Section'3; thence NO2 °13'30 "E along said West line of the southeast 1/4 of said Section 3 a distance of 659.93 feet to the North line of the southeast 1/4 a of said Section 3; thence S89 °15'47 "E along the North line of the southeast 1/4 of said Section 3 a distance of 1321.24 feet to the point of beginning. Said described parcel contains 874,411 square feet, more or less, or 20.07 acres, subject to any easements of record. Together with an access easement over the east 133.00 feet of the north 66.00 feet of Lot 3 recorded in Volume 14, Page 3930. Access easement is for Lot 2 only. N� Dated this day of L ,20 0 l PETER J. '>k Peter J. Gartm n, R.L.S. 2279 QART1UANN 3 2 IWAPP VA �s 9ZLh abed SL *IOA 14Lf9 '/Il '9JNpIfpNNX NpljYll&WLV Vya" ,jp Z SOVd :AS jo Aep — S!41 a)il jp 6wuoZ a4A AS :03AO8ddtl FORM NO. 985-A Stock No. 26273 Certified Survey Map No. 4126 Volume is ; Page 4126 . REINC A PART OF THE NORTHEAST 114 OF THE SOUTHEAST 114 'OF SECTION 3, TOWNSHIP 31 NORTH, RANCE 19 WEST, TOWN OF SOMERSET. ST. CRIOX COUNTY, WISCONSIN. y OWNERS CERTIFICATE: As owner, I hereby certify that I caused the land described herein to be surveyed, divided, and mapped as represented on this Certified Survey Map. I also certify that this Certified Survey Map is required to be submitted to the following for approval, Town of Somerset. 1) Town of Somerset In witness whereof, the said Town of Somerset has caused these presents to be signed by Robert A. and Mary M. Crotty and counter signed by Ed Schachtner, its Chairman on this a''" day of — , 2001. Robert A. Crotty tft Mary M. Crotty OaAj Countersigned: Ed Schachtner Town Chairman STATE OF WISCONSIN) SS COUNTY OF ST. CROIX) Personally appeared before me this oM day of , 2001 the above named Robert A. and Mary M. Crotty and Ed Schachtner respectively, of the Town of Somerset, to me know to be the persons who executed the foregoing instrument. — �� Notary Public T ��..,�� , My Commission expires JjERI KOESTE oix County, Wisconsin Notary Public State of Wisconsin OWNERS CERTIFICATE: As owner, I hereby certify that I caused the land described herein to be surveyed, divided, and mapped as represented on this Certified Survey Map. I also certify that this Certified Survey Map is required to be submitted to the following for approval, Town of Somerset. 1) Town of Somerset In witness whereof, the said Town of Somerset has caused these presents to be signed by Christo er A. Crott and counter signed by Ed Schachtner, its Chairman on this day of , 2001. Christopher A. Crotty J 59 K2 4 f gZttr +rEsd st'1'°'A s ; sYds.ndxs uwsuo)s,tA 'A4uno) x'oJ) IS ) iiq� - eAoN . •IuawnJ;sui 6ui063JO; a4i pa4n3axa oqm suosiod ay; ani 3adsaJ Jau;y)ey P3 Pue A44O asjal to uMOl ay; �° ��l { aJeadde AIleUosJ aq of r►ou�{ aw o; '} o �(ep --- --�iy aw aJO ;aq P 3 u�nL (XIO2!)� ' 1S 30 x 1N(10) • Jaydo;s'Jy) paweu anoge aya IOOZ w SS (NISNO3SIM 30 31d1S uewJi uMOl Jauly)ey)S_ per .pa ubis.ialu nO3 817249 • KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 3 - 1999 REGISTER OF DEEDS Document Number QUIT CLAIM DEED RECEIVED FOR RECORD This Deed, made between Robert A. Crotty and Mary M. Crotty, OIJ26/20% 18t5ea husband and wife, QUIT CLAIM DEED EDEWT # 8 Grantor, and Brian E. Crotty and Cynthia M. Crotty, husband and REC FEE: 11.80 wife as survivorship marital property TRAILS FEE: COPY FEE: --- - - - - -- ---- - - - - -- CC FEE: PAGES: 1 Grantee. Grantor quit claims to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area A parcel of land located in the Northeast Quarter of the Southeast Quarter (NE1 14 of Name and Return Address SE 1/4) of Section Three (3), Township Thirty -one (3 1) North, Range Nineteen (19) Judith A. Remington West described as follows: Lot 3 of Certified Survey Map No. 4126 recorded on July REMINGTON LAW OFFICES, LLC 17, 2001, in Volume 15 at Page 4126 as Document No. 651361. P.O. Box 177 TOGETHER WITH and subject to that access easement for ingress and egress across New Richmond, WI 54017 Lots 1 and 3 as shown on said Certified Survey Map. 032- 1007 - 30-300 Parcel Identification Number (PIN) This is not homestead property. (36) (is not) Together with all appurtenant rights, title and interests. Dated this ,?Y 46 day of January , 2006 A ,e) '. , �_ r * * ROBERT A. CROTTY //1 • * MARY M OTTY AUTHENTICATION ACKNOWLEDGMENT Si natures STATE OF WISCONSIN ) Signature(s ) ss. ST. CROIX County ) authenticated thi day of ' Personally came before me this o? y10�k day of January , 2006 the above named * Robert A. Crotty and Mary M. Crotty, husband and wife, TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY * i0dith A. Remington Judith A. Remington, Remington Law Offices, LLC, Notary Public, State of Wisconsin P.O. Box 177, New Richmond, WI 54017 ( 15) 246 -3422 My Commission is permanent. (if not, state expiration ate: (Signatures may be authenticated or acknowledged. Both are not necessary.) •) * Names ofpersons signing in any capacity must be typed or printed below their signature. information Pro f essionals company, Fond du roc. WI STATE BAR OF WISCONSIN 9 QUIT CLAIM DEED FORM No. 3 -1999 817249 1 of 1 Parcel #: 032 - 1007 -30 -300 05/09/2006 09:25 AM PAGE 1 OF 1 Alt. Parcel #:' 3.31.19.45A -30 032 - TOWN OF SOMERSET Current [ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co-Owner ROBERT A & MARY M GROTTY O - CROTTY, ROBERT A & MARY M 1953 93RD ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2352 CTY RD I SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 6.560 Plat: 4126 -CSM 15/4126 SEC 3 T31 N R1 9W NE SE BEING LOT 3 CSM Block/Condo Bldg: LOT 3 15/4126 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 03- 31N -19W NE SE Notes: Parcel History: Date Doc # Vol /Page Type 09/2912003 741653 2421 /488 EZ -U 07/23/1997 852/12 07/23/1997 570/407 2006 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/09/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 6.560 800 0 800 NO Totals for 2006: General Property 6.560 800 0 800 Woodland 0.000 0 0 Totals for 2005: General Property 6.560 800 0 800 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