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HomeMy WebLinkAbout032-2141-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453355 0 GENERAL INFORMATION (ATTACH�TO PERMIT) State Pla 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: Carr, Steve I Somerset Township 032 - 2141 -20 -000 CST BM Elev: Insp. BM Elev: I BM Description: Section/Town /Range/Map No: / Cu. W ;t 60k, 03.31.19.1232 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 12- Benchma ~,-e Dosing Alt. BM Aeration Bldg. Sewer A r Holding St/i et �( f TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to , Air Intake ROAD Dt Inlet Septic > /` I Dt Bottom Dosing C ) Header /Man. ( 30 c b l p Aeration Dist. Pipe t'v� . 60 f Holding Bot. System 3 D S -3 Final Grade 3,5D O � PUMP /SIPHON INFORMATION `� J •Sa � Manuf cturer GPM Demand St Cover ` t � n �. Model Nu er TDH Li tion Loss ea d TDH Ft F main Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM a RENC Width I Length ( No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMEN I S 7 Z� SETBACK SYSTEM TO T P/L BLDG IWELL LAKE /STREAM LEACHING Manuf surer. INFORMATION CHAMBER OR 1 1D� Tye Of System: .� I UNIT Model Number. D I I DISTRIBUTIO 4 SYSTEM Header /Manifol Distribution x Hole Size x Hole Spacing Vent to Air Intake L Pipe(s) , CZ / Length Dia Length D cmg 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 [] Yes No Ir � Yes _, No E �N/� S' Include o scre nci rso s resent, etc. Inspection #1: Z Inspection #2: L cation: 2355 50th Street Somerset, WI 54025 ( 1/4 SW 1/4 3 T31 19W) Deer Trail Estates Lot 7. Parcel No: 03.31.19.1232 1.) Alt BM Description =C� VV T 2.) Bldg sewer length GA t h - amount of cover = 34 i 3) F�,t Plan revision Required? E Yes No �' Use other side for additional information. SBD -6710 (R.3/97) Date No. ) — LIL�i dL�,Q� � n Safety and Buildings Division Coun / 201 W. Washington Ave., P.O. Box 7162 V v isconsin Madison, WI 53707 - 71 (2 Sanitary Permit Number (to a filled in by Co.) (608) 266 -3151 De artment of Commerce State Plan I.D. Numb" Sanitary Permit Application 4 ,5 3 3 a< in accord with Comm 83.21. Wu. Adm. Code, Pets4n finf° _..t. P ` Project Address (f different than taailiag sddtesa) may be used for seootdaty purposes Privacy Tw. sl : L Application IdOrmation - Please Print All Ltformadoni ` —ef Parcellk Lot# Brock Property s Name re Pro Ikon ProPedy Owner's Mailing Address / �� -r/ S / �fy__�!''�. Suction Zip Code Phone Number is w IL Type of Building (check all that apply) ' SO4vision Name M 2 Family Dwelling - Number of Bedrooms Public/commercial - Describe Use nn City_ Vi use htp o� State Owned- Describe Use ( Z) r k c5 - III, Type of Permit: {Check only one box on line A. Complete line B if applicable) A S y stem m Treat ment/Holdng Talc Replacement Only Oilier Modification to Existing System List Previous Purart Number and Date Issued B. Permit Renewal 't Revision age of Perrot Transfer to New Before Expiration Plumber Uwner IV. a of POWTS S eck all that a 1 ) - Pn�ariied ln-G nun l Mound? 24 in of suitable soil Mound < 24 in. of suitable soil At Grade Single Pass Said Filter Constructed Weiland Pressurized In4round Holding Tank Peat Filter Aerobic Treatment Unit Recirculating� F Recirculating Syatbetic Media Filter ' Qm bet Drip Line Gmvel-less Pi Other (explain) V. Di tment Area Information: Dis Area Pro S cup II Design How (gpd) Design Soil Application Itate(gpds f) � ( C, � / &�" n J ' (/ Prefab Site / ced Fiber Plastic VL Tank Info Capacity in Total Number Mann[acturer aim Gallons Gallons of Units Concrete Constructed New E" ng Too ks Taub scpdcor HotSM Aerobic Tmata�ear Quit Dodag Cbwaber e oaibility for Installation of the FOWTS shown on the attached as. VII. Res ondbillty Statement-14 the and Plumbers MP/MPRS Nu Business Phone No me -� Plu a t) Plumber's Address Crt�ciw- �Sftft- rcw�)� O F VIII, Con me at use Only Si re o Stamps) Sanitary Permit Fee (includes Groundwater Date Issued Agv Approved Surcharge Foe) Given 1 _ — J � en Reason o J roval IX. Conditio Apprnval/Reasonsfor Disapp 3 n,Q� J��� l`^ Y om-► SY STEM OWNER: R: 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach coatikk Plata (to the County only) for the systeat on popes not less than S1JL z It inches is sin I � L PLOT PLAN PROJECT Steve Carr ADDRESS 72153 CSAH 27 Dassel Mn 55325 SE 1/4 NE 1 /4s 3 /T 1 N/R 19 W T OWN 'Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/15/04 BEDROOM 4 CONVENTIONAL XXX IN -GRO PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 BENCHMARK V.R.P. Bottom of Stake . F ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H. R. P Same as Benchmark SYSTEM ELEVATION 96.0/95.9 3.5' below qrade 400' + property Line 50rd St. Property Line Plans Designed Using Conventional Powts Pr 4 Manual Version 2.0 Alt. B.M. B droom is top of H use 9) pipe @ 0.9' 20' 10' B.M. r 30 30' B - 1 90' B -2 45 Well is to mee 11 20' setbacks require b 140' WDNR 40' B -3 2 -3' X 88' Cells with >3' spacing 0% Slope i V operty Line ent >6 „ Standard Biodiffuser of Cover Leaching Chamber � 5 with 3 1. 1 ft2 of Area , l i lt 6' Long 'I A ll Grade at System Elevation PLOT PLAN PROJECT Steve Carr ADDRESS 72153 CSAH 27 Dassel Mn 55325 SE 1/4 NE 1 /4S 3 /T 1 N/R 19 W TOWN' Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/15/04 BEDROOM 4 1 if CONVENTIONAL XXXX IN -GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 BENCHMARK V.R.P. Bottom of Stake = ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL H. R. P. Same as Benchmark SYSTEM ELEVATION 96.0/95.9 3.5' below qrade 400' + property Line SOrd St. Property Line Plans Designed Using Conventional Powts Pro 4 Manual Version 2.0 Alt. B.M. Bedroom is top of House " pipe @ 0.9' 20' B.M._* y 30' 30' B -1 90' B -2 45 , Well is to meet all 20' setbacks required by 140' WDNR 40' B -3 I- 2-3' X 88' Cells with >3' spacing 0% Slope AL operty Line Vent >6" Standard Biodiffuser of Cover Leaching Chamber with 3 1. 1 ft2 of Area 6' Long 11" Grade at System Elevation Wisconsin Department of Commerce SOIL EVACUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. p 2 _ �( - Zer- C aD Please print all infoait Re 'wed by — Date Personal information you provide may be used for second ry purpes W. s,'tt.04 (t) #n)). Property P Owner Property L cation .. , , k Lot � 1/4 1 /4 S� T 3/ N R E( row Property Owner's Mailing Address Lot # lock # S Name or CSM# X07/ s� �.�rt' 02 a State Zip Code Phone -- ❑Village own Nearest Ro d ew Construction Us Residential / Number of bedrooms Code derived design flow rate CT lr GPD ❑ Replacement ❑ Puublic or commercial - Describe: _— Parent material �L %2� ��L/�lr� Flood Plain elevation if applicable ft. General comments and recommendations: ���� l e, 4 4 6 Boring /, Boring # Boring Ground surface elev. � ft. Depth to limiting factor �✓ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 /f n ng # Boring g �/ t it Ground surface elect. ft. Depth to limiting factor y L � / ( -/ in. v Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 D r g2. F Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 1JOA& Effluent #2 = BOD 1 30 mg/L and TSS < 30 mg/L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address I Date Evaluation C nducted Telephone Number 1008 192nd Ave, New Richmond, WI 4017 /- Y 715- 246 -4516 Property Owner _ Parcel ID # Page of Boring # L� ❑ Boring i t Ground surface elev. ft. Depth to limiting fad l_�_ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 1 D sZ .S /L - 0 �y Y F -1 Boring # E) E] ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Ef##2 F-1 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 GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1150 mgA. ' Effluent #2 = BOD 130 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (8000) ' Safety and Buildings Division County r 201 W. Washington Ave., P.O. Box 7162 Madison, WI 53707 - 7 162. Sanitary Permit Number (to be filled in by Co.) Isconsin Department of Commerce (608) 266 -3151 S 3 3 S S Sanitary Permit Application State Plan Number In accord with Comm 83.21, Wis. Aden Code, personal infortnation you provide N nay be used for secondary purposes Privacy Law, Project Address (f different than mailing addmss) I. Application Information - Please Print All Information O 2— — —aO Property Owner's Name /f j i Parcel # Lot # Block # Property owner's Mailing Address z( ! i , G 0 r r i (L Pmmpeq Location V Vj 23 City, S I ZSip Code Phone Number G S-� T 1 N; R 7, 1Q. Type of Building (ch all that apply) r h V4 Qtr L Subdivision Name CSM Number 2 Family Dwelling - N t of Bedrooms / lsr PubridComtnercial - Descri U ^/ state owned - DescnlUx Use S� C �G.s 'W I Gifl�� -�sF� City_ v Township of C o �V! IIL Type of Permit: (Check only one n line A. Complete line B if applicable) A. ew S RVIaceme nt SyN Treatment/Holding Tank Replacement Only Modificafl to Existing System orist B. Permit Renewal Permit Revision of Permit Transfer to New Pzevw kDate � Before Expiration Plu Owner IV, Type of POWTS System: (Check all that apply) Non - Pressurized In -Ground Mound 2t 24 in. of suitable soil < 24 in. of sui a �Jl atment At S' Filter Constru a and Pressurized <n Ground Holding Tank tier is Unit ilia Recirculating Synthetic Media Filter Chamber Dri P Line v Pi ) 1 V. Dispenwriesibuent Area Information: r F S Design Plow (gpd) Design Soil Application f) Dis Area R Dis posed (st) System ffiewati 7 CS 3 . 3 VL Tank Info Capa «ty in Total Number Manufacturer Prefab Site Steel Fiber e Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks I / - Septic or Holding Tank Aerobic Treatment Unit 1 Dosing Chamber Yd Responsibility Statement- a and a nsiblli for installation of the POWTS aheavrn o khe attached plans. Plu (Print) Plumb MpftAm Number Business Phone Number Plumbers Address (Strut, City, State, Tap Ct Nqm Coun /D epartment Use Onl Sanitary Permit Fee (includes Groundwater Dare Issued uing t Starr) Appmv Disapproved Surcharge Foe) � S-©' re 30 Owner Given on for Denial r EK. Conditions of Approv easons for Disapproval YSTE R. (� "0 3 S_�� `nGC�ttil�l 7 - S1� 1 4-e6l�k CST 1 Se tic to effluent filter and P r dispersal cell must all be serviced / maintained as per management plan provided by plu m b er. . / / 2. ail mark requirements must R mdilILL11rrUU as per applicable code /ordinanceseM,^ 3. _ Attach complete plans (to the County only) for the system ena Pa n less than 8 1 inches in size S /tie yo fe �r�e rsed ,� Z 83 � Y t� r � 40 .r� .r LOT PLAN PROJECT Steve Carr ADDRESS 72153 CSAH 27 Dasse) Mn 55325 n 1 /4 1/4S 3 /T 3 N/R 19 W 'TOWN 'SOmerset COUNTY ST. CROIX V 6/29/04 4 MPRS Shaun Bird 226900 DATE BEDROOM CONVENTIONAL XXX IN -GR D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambe 28 kk BENCHMARK V.R.P. Top of nail in 8" popple ASSUME ELEVATION 100' Filter Zab -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 90.3/90.2 6' below qr 180' 400' + property Ljo e Please note further testing 75 will be done t ' • find a more ` uitable ar 5 B -1 2 ,A 2s 0' 2 -3' XI Cells with >3' spacing AF nts 4 B -3 30' 1 B. #2 is top of it in 15 B. T 5" pop tree 25'; Pro 4 Well is to meet all Bedroom 0 setbacks required by House WDNR S�/S V SA Standard I ki�' . ,� of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long 11 Plans Designed Using Grade at System Elevation Conventional Powts 34" Manual Version 2.0 1 s A6 N Joe �wv Nor � 1 OF VIP TA so Qw W ' + Y -Y t w q�� Hfi h� t r AV = ■ .� . . Ob Pb C •/ ` �V �► • • •n �.� a .a 1� IS 1 Vs : . - Y - r Wisconsinpeparlment of commerce SOIL EVALUATION REPORT Page _, -of Dkision of Safety and Buildings ' in accordance with Comm 85, Wis. Adm. Code County 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 ABM), diection and Parcel I.D. ptsroent slope, scale or dimensions, north arrow, arfd # r�d dlsl�noe to nearest road. Date Please Print SK Wi ath Personal information You provide may be used seieon�n , 1 avr: s,15.04 (1) (m)). Property Owner ! " - / P rty L Lot IM 1/4 S T N R I E (or Property Owners Mailing Address S'T C ROI X i-_ # rlo&# . Nw MW _ S i�UNTf r r1 J . r City Stab Zip Code City ❑ Tillage [Town Nearest Road ['j3 New Cotetruc ion Use: fA Residential I Number of bedrooms 3 _ Cade derived design flaw rate /,00 GPD ❑ Replacement ❑ PUW or Commercial - Describe: Parent material Flood Plain elevation d applicable n ft General comments Syslc G C Y • 0 7 • 4 m and recommendations: 1"t. e I V, 9 • C' F Boring # Boring Pit Ground surface elev. 9S yQ ft Depth to lirnniting factor / Z in. Sal Appikation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G PDff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. ,L Vj 1 o, r -12$ 21 n Boring # ❑ Bong Pit Ground surface elev. T G' - 0 0 ft Depth to limiting factor /Z in. Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIIP in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'EfM 'Eff#2 1-� l m Etc r CS _r( 914 S 1 2 6k T r GS .3 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mglL and TSS < 30 mg/L CST Name (Pam Prltt) Signew CST Number S3 Address Date Evaluation Conducted Telephone Number Zl 3 h 6 '- 54, Lo rnecsc e 4 6 Z -- 2-0 e-) W dq 7 Property Owner vw �. ' Parcel ID # Page 2 of in F-31 Boring # El Boring I Pit Ground surface elev. 9G • ft Depth to �ndni9 factor Z- . Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Ou. Sz. Cont Color Gr. *EfW1 *092 r L \c ir4r . 3 1.2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting fador in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz W *Eff#1 *Eff2 F-1 # ❑ Boring El Pit Ground surface elev. ft. Depth tD limiting factor in. r-Effil Ncation Rate Horizon Depth Dominant Cob Redox Description Texture Structure Consistence Boundary Roots * Eff#2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Effluent #1 = BOD, > 3o : S 22o mg/L and TSS >30 150 mg/L * Effluent #2 = BOD 130 mg/L and TSS _< 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. SBD -8330 (R07M) wnsconsin Department of Commerce SOIL EVALUATION REPORT Page �_ of Didion i�f and Buildings in accordance with Comm 85, Ws. Adm. code c°un" Mach complete silo plan on paper not less than 81/2 x 11 inctnes in sine. Plan must incude, but not lirrtled to: vertical and '.1zontal dnraction add Parosi I.D. percent slope, scale or dimenslons, north arrow, * &n 1� to nearest road. Please print A� i Reviewed by Date Personal kftffn"- y- pmvWo nW be used EaieDond�fi s \15.04 (1) (m)). Property Owner _ Pr" Location R c6 kj kk, o s k t �i .° S Gait lot 1/4 1/4 S T N R E ( or Property Owners Mailing Address ST C ROix L°(* Block # Subd. Name or CSW - � - OO U N-Y f , , I r T — 5 City _ Stale Zip Code , ' ' ' /Q City ❑ Village WTown Nearest Road New Coon Use: (� Residential I Number of bedrooms 3 _ Code derived design flow role �� Q GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable /Q R General comments S k W. 3? 0 and recommendations: e I C V . 9 • y ❑� I 5 Boring Pit end surface elev. 9S O ft Depth to limiting factor / Z in. Sod Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G PQM in. Munsell Qu. Sz Cont. Color Gr. Sz- Sh. i - EfWl - ► a -►e — T i4 r 65 . 2 •3 Z to c LA I q AL t, — .2 . 0B oring E] Boring Pit Ground surface elev. yG .tom ft Depth to limiting factor /Z 21' in. Soil Aw Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOW in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. - EMM - E Q -1 •1 r'\ 6Q r CS -1 •3 914 sit Z r b(c I 3 y0 -tzar ( — s — 2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mgll. and TSS < 30 mg/L CST Name (Please Print) — — Sgnatu CST Number 190bi� 3C_kL't4aa' oe4 S3 Adder pate Evaluation Ckxhducled Telephone Number 2-11 Q 5 4, oai f- PAGE 3 OF 3 NAME �� r �. k LOT# LEGAL DESCRIPTION Sri' /4MJ /4,S ?j T 31,N,R IqE (or) r SCALE: F'= roo i BM I ELEVATION , C� BM 1 DESCRIPTION ►ut ; ; n BM 2 ELEVATION for • d K �? 1 BM 2 DESCRIPTION rtu� ( SYSTEM ELEVATION 0 ALTERNATE ELEVATION S q. Q0 / CONTOUR ELEVATION IL 1 % ( � s O l d l I SIGNATURE DATE _ �Q� ST CROIX COUNTY PENANCE AGREEMENT` SEPTIC TANK AND' OWNERS HIP CERTIFICATION FORM u er y�� � ,M t� 5 �, � owner/Buyer � y �' / ' .. Mailing A ddress Address annin artment �for w construction) P roperty (Verification required 5rom Pl Dep g S Parcel Identification Number il 12 — City /S.tate LE DESCRIP I O N s Z 3 Z � T N_ W, Town of Lion 1�4j� 1 /" Sec. / l r Property Lora lST ,gd���i Lo #• Subdivision r' Volume Page # Certified Survey Map # � , Page # - -�---. Volume � b 0 P g --- -- Warranty Deed # d Lot lines identifiabl yes no Spec house 0 yeb < Y,v r emature failure to handle wastes. Proper maintenance YS ltil� tic system could result is its p What you put into the system S improper use and ma of your Sep a licensed P out the septic tank every three years or sooner, if needed by system consists of Pumping task as a treatment stage in the waste disposal can affect the function of the septic went a certification form, signed by the owner and by a was tewater to St Croix Zoning Department er verifying that ( °n "site disposal system The property owner agrees to submi 1/3 full of sludge. restrictedplumber or a lieensedpump the septic tank is less than masterplumber, journeymanP lumber, inspection and pumPmg (if necessary), is is proper operating condition and/or (2) after sys tem with the standards agree to maintain the Private sewage dispo havc read the above requirement's and Resources, State of Wisconsin Certification Uwe, the un d ers igned erce and the Department of Natural Office within 30 De of Comm feted and returned to the St. Croix County Zoning O set fo herein, as set by the Dep ma i n tained must be comp X your septic system has been year expiration date. DATE i K �d �Zo OF APPLICANT OWNE R CERTIFICATION our) knowledge. I (we) am (arc) the ow ner(s) of 4e, e) certify that all statements on this form are in Resister of Deeds Office. des ed abov by virtue of a warranty U z — OF APPLICANT De artrneat. ' ua� may result is the sanitary pernut being revoked by the Zoning p A information that is mis- repre p warra nty deed from the Register of Deeds office deed «R Include with this a p • lrcation: a stamped warra e is made in the warranty a copy of the certified survey M if referenc Maintenance and Contingency Plan ;for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent fitter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the Ce11S. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershod is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 C, Plan t ion #1. " ystem fails, determine cause of failure, use alternate area and install new s tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. rJo adequate area, is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: '%5haun Bird 715 -246 -4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird *226900 STATE BAR OF WISCONSIN FORM 2. 1999 KATHLEEN H. WALSH WARRANTY DEFjD REGISTER OF DEEDS Document Number ST. CROIX CO.. WI RECEIVED FOR RECORD This Deed, made between P. C. Collova Builders, Inc., a Minnesota Corporation, 01/10/2003 09:30AN i_XE,Irp; T it Grantor, and Steven J. Carr and Julie Carr, husband and wife, REC FEE: 11.00 TRANS FEE: 128.70 COPY FEE: CERT COPY FEE: 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 Lot 7, Deer Trail Estates, First Addition, St. Croix County, Wisconsin. Name and Retun A dre KRl� IRA OGLAND ATTORNEY AT LAW P.O. BOX 359 HUDSON, WI 54016 032 - 2141 -20 -000 _ Parcel Identification Number (PIN) This is not homestead property. 0j) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of January 2003 P C. o ilders, Inc. i * Marti A Collova, Vic President AUTHENTICATION ACKNOWLEDGMENT Signature(s) P. C. Col lova Builders, Inc., a Minnesota STATE OF WISCONSIN ) Corporation, by Collova, Vice— President ) ss. County ) authenticat dt 's ay of January 2003 Personally came before me this _ day of _ the above named * Kristin O gland TITLE: MEMBER STATE BAR OF WISCONSIN -- — ---- (If not, to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kr Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) * Names of persons signing in any capacity must be typed or printed below their signature. Information professionals company. Fond du Lac, wr STATE BAR OF WISCONSIN e00-655-2021 WARRANTY DEED FORM No. 2 - 1999 UNPLATTED L DS oz� a („� Z w <O --- - - - - -- - - NO2'48'43 "E 2374.64' NO2'48'15" 341.42' ! --- - - - - -- - - - - - -- NO2'48 "43 "E 289.99' w w 50TH S719EET w WFSr c _ _ _- -- w ��\` NO2'48'43 "E S02'12'53 "W - 3 41.31' ` -- - e rr — , ----- - - -___ • .� - - - -- W NO2'37'19 "E �Q-- 289.96' N Z OD ..................... ............................... .............. ............................... Cli N ti � �yy�`� 505 30 N• J9, cn OD �� o 0' \ X 11 L co xb ?� tp ti .9•� i ,tee O ul) \ y 0 � v y 502'12'53 "W I 289.90' I !v f ° o I c I- T � O I �_ s -D