The URL can be used to link to this page

Home My WebLink About032-2141-90-000 Q G O Si 0 2 3 0 -1 T n w CD I eD - ~ ^ \ 1 .w °w ` O• n d o ° o j N CD 7 3 CD p C CD A n O N f.J 7' C 1 N 2 O CO C, 0 H N o ° C N O Z D - N CD CD D W 10 a -a =r c a _ o > 3 O oc`n~ 1*0 CD A o (n l~ o o 3 y N N CD N !0'f Q OZ ooo~ cn v 0 CA CA (a CD r3:: CD 0 f* !R O A !~i D) CL o U) 0 0 0 D o03 ' 7 3 j (D <D CD y CD C C N CD GJ CD . C1 z CD 3 5 cn c6 co o N D a a z v a ? z 0 Z w m 2 00 Z I y Z ~ CD I A F I CD M co 7 s3 < xtO- N V N 3 9 p' a ~ 0 y 3 oN fU CL CS CD O Q7 .Z7 Z a 7c O O d C fD Z g: CD C CD F 0 c a=r o49 o -CA a3 0 Q > > r. o a; CD A I 3 W to pp ~ • VC CCDD O O CL N < co 3 E9 N b C O O C 0 CD C~0 'm om.CD 003 OCD ~ =r _ o t 0-0 I o ~ CO CD 0 a N 3 a o CD do ti O ti N °o C Wisconsin Department d Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 405113 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) Permit Holder's Name: City Village X Township Parcel Tax No: McQuinn Greg 032-1006-50-000 , I-Savi-er---af-Upmhmo*k~Township CST BM Elev: Insp. BM Elev: BM Description: / UD - D ~0D• d so-/J~ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchm rk In~k6 657 r / D Dosing Alt. B w a Z" 5" D~ S D Aeration Bldg. Se er Holding St/Ht Inlet TANK SETBACK INFORMA St/Ht Outlet TANK TO P/L ELL BLDG. Vent to Air Intake ROAD Dt Inlet (iU4 Septic l { S Dt Bottom j Dosing a>q Header/Man. a a. 8- s Aeration Di . ipe i ~ o~ rliawt / a ~ 3 ~ , Holding - Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cov Model Number - TDH Lift Friction Loss System Head TFt --r,1,41~~ Forcemain Length Dia. SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM (CHA EACHING Map}afeptpre~r~ . SW- INFORMATION Ty Of System: BER O Model Number:' i ye,,+~, ~ _5'~ 9 05 DISTRIBUTION SYSTEM S Header/Manifold Distribution U/114 wtrti l Ix Hole Size x Hole Spacing Vent to Air Intake / /t Pipe(s) / t_j fITe 0 ) S Length_f_ Dia Length= Dia Spacmg~~ 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 _ I Bed/Trench Edges Topsoil E] Yes E] No Yes :E] ]No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 0 / v Inspection #2: Location: 522 239th Ave Somerset, WI 54025 (NE 1/4 NW 1/4 3 T31 N R1 9W) Deer Trail Estates Lot 14 Parcel No: 03.31.19.37 1.) Alt BM Description = ,If CST 2.) Bldg sewer length = S - amount of cover = Plan revision Required? L Yes Use other side for additional information. SBD-6710 (R.3/97) Date InsepctorSignature Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 57e c&4,L Nvisconsin Madison, WI 53707 - 7162 Site Address 7/-1 .2 a ;Z 3F9 Department of Commerce 3 ~DD 9-.j0 -vz Sanitary Permit Application Sanitary Permit Number 0 g"~l 3 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide - Check if Revision may be used for secondary Purposes Privacy Law, s15. 1 m u I. Application Information - Please Print All Information i-, State Plan I.D. Number / P Owner's Name Parcel Number Property Owner's Mading Address Property Location 7 UPS _ e L % Nul -A; S T 3 ~ N, R City, State Zip Code Phone Number Lot umber Block Number Subdivision Name CSM Number Q E S ✓ U. Type of Building (check all that apply) ❑City 5'I or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public/Commercial - Describe Use ownship - ❑ State Owned VAv,„ f_ „ _ ) ~I X Q l / l{ Nearest Road ? T ~l r 111. Type of Permit: (Check only one box on line A ((numbering scheme for internal use). Complete line B if applicable) 6 ❑ Addition to For Coubey use A 1 New 2 11 Replacement System 3 11 Replacementof stem Tank Onl stem I Existing B. J~ Check if Sanitary Permit Previously Issued Permit Number Date Issued - oo IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) lazed 44 X1 Non -Pressurized In-Ground 210 Mound 47 ❑ Sand Filter 50 Constructed Wetland 22 ❑ Pressurized In-Ground 4111 Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At-Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. tment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade ✓ / Required Proposed Rate(Gals./Days/Sq.FL) (Min./Iceh) i- Elevation 06 957 92,019 7 /1//1- 975- 73, 5~~ VI. Tank Info Capacity in Total Number ~~ture; Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New FacistinY Tanks Talcs Septic or Holding Tank Dosing Chamber VII. R*ponsibility Statement- I, the undersigned, assume responsibE ty for installation of the POWTS shown on the attached plans. P Name (Print) P is Signature MP RS Number Business Phone Number ✓S- _G~ Phtmbees Address (Street, city, State, Zip -Code) 594 12A L t- 0/67-W 7% r-501 1'nne 1,- 7--- f VIII un /De artment se Onl Approved ❑ Disapproved. Sanitary Permit Fee (includes Groundwater 14D Issued Issu Signature (No Stamps) Surcharg) a G Q ❑ Owner Given Initial Adverse IX. Determination p / C,,ytl~iti of Appr oval/Reasons for Disapproval At P-7, c,~d ~~-uh-~'(J„G~w- Uri, BIOG/z~i!/.l-Phi Ga ~ ~tG~~~lf~l•L,o &aA~ Atfisch campkte plans (to Caanty enly) for system an paper ad less than SW x 11 lad= In SBD-6398 (R. 05101) . cU/sio~ „PUG tl~i.-- P r Fl/D tlo-- arto - - - TQEkG.~ES Bt t1 _ e rte- - - 34 got A39 7,11' ,QA tN- _ . ~ 3.1r?A ~ - W -VAGGEY_.-U/~lr'J__Tl2 _ sSory1E~~ PU - SCgc.'°= yB, G i hc- r- 1 - 6i OH- - - x 3 l - - p c21'7c2.~' 1140 'r Wisconsin D6partment of Commerce SOIL EVALUATION REPORT Page 1 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 dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 032-1006-50-000 Please print` all information.., J Revie d By Date Personal information you provide may be ed for s@cQn~ary pp[Q,( sAe PrN4p¢ Law, s. .04 (1) (m)). O Property Owner roperty Location McQuinn, Greg L. W. Lot NE 1/4 NW 1/4 S 3 T 31 N R 19 W Property Owner's Mailing Address - of # Block # Subd. Name or CSM# 12020 18th St. N 14 Deer Trail Estates City State p Code Phone Number„ City Village r Town Nearest Road Lake Elmo MN 55042 Somerset 239Th Ave J/' New Construction Use: ✓ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft rating. Possible system elevation for Area I is 87.50'. Slope is 6. Boring # Boring Pit Ground Surface elev. 93.98 ft. Depth to limiting factor >156 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 2mpl mfr cs 2m .5 .8 2 8-26 1Oyr3/4 none I 2msbk mfr gw 1f .5 .8 3 26-44 10yr4/4 none si 2msbk mfr gw .5 .9 4 44-74 1Oyr5/4 none is 1msbk mvfr CS .7 1.2 5 74-156 10yr516 none ms Osg ml 7 1.2 Boring Boring # a 6e: Pit Ground Surface elev. 91.73 ft. Depth to limiting factor >155 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/V in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 1Oyr3/3 none I 2mgr mfr cs 2m .5 .8 2 6-20 1Oyr5/3 none scl 2msbk mfr gw 2m .4 .6 3 20-48 1Oyr4/4 none sl 2msbk mfr gw 1f .5 .9 4 48-66 10yr5/4 none Is 1 msbk mvfr Cw .7 1.2 5 66-155 10yr5/6 none ms Osg ml .7 1.2 2:6!L ~~g&~-n * Effluent #1 = BOD? 30 < 220 m and TSS >30 < 150 mg/L * Effluent #2 = BOD5 S30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. ooo' 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valle View Trail, Somerset, WI 54025 8/21/02 715-549-6651 Property Owner McQuinn, Greg L. Parcel ID # 032-1006-50-000 Page 2 of 3 3 ] F be Boring # Boring Pit Ground Surface elev. 93.92 ft. Depth to limiting factor >151 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 1Oyr3/2 none sil 2mgr mfr CS 2m .5 .8 2 8-19 1Oyr5/3 none I 2fsbk mfr gw 2m .5 .8 3 19-36 1Oyr4/4 none s1 2msbk mfr gw 1f .5 .9 4 36-56 1 Oyr5/4 none Is 1 msbk mvfr CS .7 1.2 5 56-151 10yr5/6 none ms Osg ml .7 1.2 -7 -7 0 L( V ❑ 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. 'Eff#1 *Eff#2 ❑ 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. *Eff#1 *Eff#2 *Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <_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 -A - oltP. 1. f -.t . .....,r~~t th. A.-*- 4 of ff1Y_7A4_'2I G I - TTV Af1R_7AA_9777 ' t( n IJ = Igo 77bn~ D + 5 dih y pap- on `I oose ~ 1~ • ~ s Aff Shy o-P 2,~Pvc /D~W e"L. ~S. 70 poi - Aµ 3 i z a3 Ilp r R J 67 I a39 ~e y G fe9 L . 1~t Q u, h Q rc~,...~ ~k b y : ?11Qa 3`,, .Sc k ~ra ry. 0 ~cyvH s y i p v~ S~ ws~" .i j ~ - I f ~ _ __i ' + I i i f I c i i i ~ i _I i I _i _ ~ ~ ~ ~ ~ I i l Wisconsin Departmentof.Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 405113 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: McQuinn, Greg Springfield Township 032-1006-50-000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System 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. T uid 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 Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ❑ No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 522 239th Ave Somerset, WI 54025 (NE 1/4 NW 1/4 3 T31N R19W) Deertrail Estates Lot 14 Parcel No: 03.31.19.37 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ~ _ T- - -JI T ~ - j Yes No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 RG ( NV!4consin Madison, WI 53707 - 7162 Site Address Department of Commerce S" f X021 ,3/ / 4 M 23 9 1kV& Sanitary Permit pplieation Sanitary Permit Number In accord with Comm 83.21. Wis. Adm. Code, personal information you provide 4O57I1 ❑ Check if Revision may be used for secondary purposes Privacy m 1. Application Information - Please Print All Information RECEIVED State Plan I.D. Number Property Owner's Name Parcel Number MAY 2 .7 200 Property owner's Mailing Address ST. CROlx COUNTY Property Location ZONING OFFICE 11020 f87* 3Ti -Al A( F 'A 'A;S T 31 N,R City, state Zip Code Phone Number Lot Number Block Number 3 Subdivision Name CSM Number Dee r ee C Sso ~,2 - .s Es II. Type of Building (check all that apply) "low ❑City I or 2 Family Dwelling - Number of Bedrooms A/ []Village ❑ Public/Commercial - Describe Use Vftownship ❑ State Owned Nearest Road Z K t Z43 III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. 1 New 2 ❑ Replacement System I T 3 ❑ Replacement of 6 11 Addition to For County use stem Tank Only System B • ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use . 14-imp , 44 Pf Non -Pressurized In-Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In-Ground 4111 Holding Tank 48 ❑ Single Pass 5113 Drip Line 45 ❑ At4rade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D' ersal/T reatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area it Application Percolation Rate stem E15- n Final Grade Required Proposed Rate(Gals.Mays/Sq.Ft.) (Min./Inch) Elevation s o. A 91, 9~' VI. Tank Info Capacity in Total Number Manufacturer Prefab Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Hokling Tank / Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plans. Plumber's Nano (Print) PI 's Signature KefnNumbe_r--:;1 Business Phone Number ~E Plumber's Address (Street, City, State, Zip Code) ~ D A4t-1-A;-: ~c /,//&~zo 12? S~ew'&:Fad CALE &/f - VIII. Coun epartmen(Use Only 1 Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ❑ Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse 05,01 Determination ag-, IX. Conditions of App oval/Reasons for Disapproval .~n sts(~e~w. ( _ 5 ~k ~t. t~w,0 t~., tSIA~,►~w,naQ ! .~lo~Cgd/ Attach complete plans (to the C-MY only) for the system on paper not less than SM x 11 Inches In size SBD-6398 (R. 05101) /v t-1tA-7S 31 M, Q3 - - - _ - 8 - -IN CAL C-7 ~-~J~~2--=- f04'24f IAIrG /=OR -D 2 1)2A ncG _ . - - _/^l~r~u,,M~✓' _ _ - Ostia-,~.. p~ - _ /,2o,Z p ~BTH s', %iZ L rC~_ EL~ro;17AI S TO YA W4 -,u eltT i~ A4aaa E--gs - 3 YIN 3 ` 7 - - ySTI ~c_ 9/.T 6 z-3X 86- s , t r fir/ = -,ff4,(i os ' O,CZ44eA Zeal 0 - - - I I f?1zALU' a~Q 4- -1~ ~iL l - - - .SAL , MCC L/Z C _ _ _ _ _ _ _ _ _ _ _ _ _ _ / AVV. sin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County C'(01 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. Please print all info ~Reviewed by Date ~~L I I Personal information you provide maybe used for seco s6"s'"(Pnaacy Law;''s',15.04 (1) (m)). Property Owner Property Location Govt." of AJ 1/4 4/k/ 1/4 S ?j T N R q E (or N _ 31 I r Property Owner's Mailing-Address Lot ' ck # Subd. Name or CSM# 54. 14 1) eer I r4' E5 C e City State Zip Code ne Num K ❑-Cify ❑ Village [$Town Nearest Road V..- , COUN rY d 4~l 54 0 2v ( a ! SO rn New Construction Use: [W Residential / Numbe f'?-046fmis Code derived design flow rate 6e lb GPD ❑ Replacement ❑ Public or commercial - Dees Parent material a c3+ WCL s 1\- Flood Plain elevation if applicable ✓t J ft. General comments C. Y,511-C kY\ -C -C V. CrV' 6-0 and recommendations: 0-4-4. -e C • Q/.s17 1-1 1 Boring # Boring Q ® pit Ground surface elev.. Od ft. Depth to limiting factor /DO 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 0-I7- to r3 z b :q C-I~~ • 8 2• I Z -yo In r q14 2mSbk C - . 9 3 LS 1M50 M r - - .-1 l.Z Boring # Boring Fz-] ® Pit Ground surface elev. QY 2 O ft. Depth to limiting factor 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 1 0-17 10 ~~Z Si ( 2 < < v-~ •5 .3 2 I Z _ 3L 0 3 r•/ 2- mab k GS - .5 .8 3 -Ila I L 5 I m -7 Z ' Effluent #1 = BODS > 30:< 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Plea Print) ignature CST Number 3 9 Address Date Evaluation Conducted Telephone Number t-b 4. 4 ~ SLA - 9-/3--od -i( 5) 2-(4 7 - v Ii J Property Owner & O LOLL a f, Parcel ID # Page--2, of 1-31 Boring # ❑ Boring ® Pit Ground surface elev.. yo ft. Depth to limiting factor 19 in. Soil Applicati on 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 o l0 SO c5 • 5 .8 z si J; 4 3 -11 ID LS lm _ •1 1.2- r~ Z Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. ❑ F1 Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit 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 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-2648777. SBD-8330 .07/00 PAGE J? OF__~ NAME k rrlc4&j Sit,' LOT# LEGAL DESCRIPTION Ee T-9 1,N,R )aE (or)o SCALE: I"= /()y BM I ELEVATION •0 BM I DESCRIPTION-Wd; ►S ` Bart(c ¢r BM 2 ELEVATION /GCS • Q BM 2 DESCRIPTION Ylc4, ( ,'n 1 SYSTEM ELEVATION j SO ALTERNATE ELEVATION fl-S-6 CONTOUR ELEVATION x/A a, (10 s ~o pt prv o e- 0, Ica SIGNATURE DATE -C) cj 4 Page of MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed and is to be installed and maintained in accordingto Comm 83, Wis. Admin. Code, the in-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems (SBD-10567-P; June 11,1999), 1. This,POWTS has been designed to accommodate a maximum daily flow of (A010 gallons of domestic wastewater-per day. The quality of influent discharged into the POWTS treatment or disposal component shall be equal to or less than all of the following: a monthly average of 30 mg/L fats, oil and grease a monthly average of 220 mg/L BOD 5 a monthly average of 159 mg/L TSS. Wastewater shall not be discharged to the POWTS in quantities or qualities that exceed these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch. NR 140 Tables 1 & 2 at a point of standards application, except as provided in Comm 83.03 (4)m Wis. Admin. Code. 2. The owner of this POWTS is responsible for system operation and maintenance. The following maintenance shall occur within three (3) years of the date of installation and at least once every three years thereafter: 1. The septic tank shall be pumped be a certified septage servicing operator, licensed under s2.81.48, Wis. Slats, unless inspection by a licensed master plumber or other person authorized to make such inspection, finds less than (1/3) of the tank volume occupied be sludge and scum. More frequent pumping may be necessary to prevent solids from exceeding one-third (1/3) if the volume of the tank.. Wastes shall be disposed of by the pumper in accordance with ch. NR 113 Wis. Admin. Code. At each pumping the pumper must visually inspect the condition of the tank, baffles, rizers, and manhole cover and verify that any required locks are present. 2. The soil absorption component(s) shall be visually inspected by a licensed master plumber, certified septage servicing operator or POWTS inspector. Inspection shall check for evidence of discharge of sewage to the ground surface and for ponding of effluent in the distribution cell. 3. The tank filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. The filter cartridge shall not be r removed unless provisions are made to retain solids in the tank. Cleaning of the filter at more frequent intervals may be necessary. 4. Any pump, alarm or related electrical connections shall be visually checked for defects and tested to confirm that they are operating properly. 5. Reports for all system maintenance shall be submitted to St. Croix County Zoning in accordance with Comm 83.55, Wis. Admin. Code. 3. Defects or malfunctions identified during maintenance described in item #2 above shall be repaired in conformance with Comm 83, Wis. Admin. Code. 4. Anytime a failure or malfunction occurs, it shall be reported to tl►e owner of this POWTS. Repair or connection of such failure or malfunction sliall comply with Comm 83, Wis. Admin. Code. 5. No one should enter a septic or other treatment tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases and rescue of a person from the interior of the tank may be difficult or impossible. 6. No product for chemical or physical restoration or chemical or physical procedures for POWTS may be used unless approved by the Department of Commerce in accordance with Comm 84, Wis. Admin. Code. 7. In the event that this POWTS or a component of this POWTS fails and cannot be repaired, the following contingency plan is proposed: 'll,e fai1jn"mnmmL-s-halI be r~phw&L This may require a new soil evaluation to determine where a new soil absorption c component call tv. 8. If this 1'OW'I'S is replaced, or ils use is discontinued, it shall lx abandoned in accordance wilh Comm 83.33, Wis. Admiu.. Code. 9. Name and number of local health agency:-SLC[QibLoulliy-Zollillg - 715-3BO-4f80. 10. Name of service contractor in case of failure or malfunction:_Schnutt &QnsExcvtyaling 715-541-6651 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer &'r~ L• 1no, ( u"rid Mailing Address 100ao /J 10t, ~ / r^~ SSUy~. Property Address (Verification required from Planning Department for new construction) City/State l""($ 6 / WisoNy lr-) Parcel Identification Number ~3~`/ao6 So_ 0,00 LEGAL DESCRIPTION Property Location L_ '/4, W '/4, Sec. I-) , T31 N-R/ 7 W, Town of Subdivision Lot Certified Survey Map # , Volume , Page # Warranty Deed # Volume Page # ~a Spec house O yes Ok no Lot lines identifiable 4~q yes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal 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. 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 Zoning Office within 30 days of the three year expiration date. SIGNATURE OF 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 pro erty described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNA URE OF APPLICANT DATE Any information that i Y is mis-re resented may result in the sanitary permit being by the Zoning revoked b Department. P Y 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 '401 79i PAGE 521 STATE BAR OF WISCONSIN FORM 2 .1999 E? 6 5 6 8 3 WARRANTY DEED RE i .E[iI1ST O DEEDS Document Number SEF; OF DEEDS ,.;iJiX CO,, GII This Deed, made between K,,, -k; Far, r Inc RECEIVED FOR RECORD Corporation i2-19-2001 3:30 AN ORRAN.TY DEED Grantor, and Gregory L. McQuinn and Angela L. Branham, i COPY FEE: TRANSFER FEE: 128.70 RECORDING FEE: 11.00 "AGES: 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 14, Deer Trail Estates. St. Croix County, Wisconsin. Name and Ret Ad ss KR1:'~'IPP~ OGLAND ATTC-INEY AT LAW P.C., 90X 359 HUDSC,J, WI 54016 032-1006-50.000 Parcel Identification Number (PIN) This is not homestead property. 0O (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. 4- Dated this day of December 2001 Kowski Farms, Inc. rev- ~ 'Roger kowski ~ r KK~~ ]AUTHENTICATION ACKNOWLEDGMENT Signature(s)"r' farms, Inc., a Wisconsin Corporation by STATE OF WISCONSIN ) Roger Kukowski, its President ) ss County ) authenticated thys - d day of December 2001 Personally came before me this day of the above named . Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (if not, to me known to be the person(s) who executed the foregoing authorized by S 706.06, Wis. Stars.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY « Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, WI54016 My Commission is pennanent. (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. 6 o malmn Prorasamrnra c~oany. Ford a tam wt WARRANTY DEED STATE BAR OF WISCONSIN atshyss-2o2t FORM No. 2 - 1999