HomeMy WebLinkAbout032-2142-60-000 Wisconsin Department of commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
395161
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information ou provide may be used for y p y secondary purposes [Privacy Law, s.15.04 (1)(m)).
Permit Holder's Name: City Village X Township Parcel Tax No:
P.C. Collova Builders, Inc. I Somerset Township 032 - 2142 -60 -000
CST BM Elev: Insp. BM Elev: BM Description:
1 00 1 � I CST" � ZR o Z_
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
!0270 0 -35 10,0,3y
00. /06
Dosing _ Alt. BM
3 6 4 o sr mss
Aeration Sewer Bid . r
7�� 5 7
Holding St/Ht Inlet
d
TANK SETBACK INFORMATION St/Ht Outlet S! ( �3
TANK TO IP /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
OT
Septic S.D , � � / � ^ f Dt Bottom �
i
Dosing Header /Man.
Aeration Dist. P'
Holding Bot. System a
�•-
PUMP /SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover Z _
Model Number
TDH Lift
!! ss System Head TDH Ft
Forcemain Length Dia.
SOIL ABSORPTION SYSTEM d
BEDITRENCH Width y Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS '1
SETBACK SYSTEM TO P/L JBLDG WELL LAKE/STREAM LEACHINq Man fa rer:
INFORMATION CHAMBER R mil
TypW System: + / UN
3 / / IT Model Number:
AEL
DISTRIBUTION SYSTEM Ler 4�
Header /Manifold Distribution -G} x Hole Size x Hole Spacing Ven Air Intake S
�r P1pe(s) ' /( Spacing
L Length Dia
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over / / Depth Over xx Depth of x T Mulched
Bed/Trench Center ,� S Bed/Trench Edges Topsoil Lill Yes 0 No [] Yes [] No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ` / 1 b / 0 YD/Vnspection #2: I /
Location 2359 13rd Street Somerset, WI 54025 SSE 1/4 NW 1/4 3 T31N R19W) Deer Trail Estates L<' Parcel No: 03.31.19.1246
.. . i
l S` Siolin
1.) Alt BM D Iption -�„�,� s ai••i cc`lds1�� SeuACni + - ar•.�+u -.,dr �•
2.) Bldg sewer length = Zy y — � if', p,�
amount of cover =
SIN
N � ` i 1
2 lan revision Required? ❑ Yes [ O5 j
Use other side for additional information. `
Date Insepctor's ignature Cart. No.
SBD -6710 (R.3/97)
r
Safety and Buildings Division CMIAYC"
N Visc rN 201 W. Washington Ave., P.O. Box 7162 resin Madison, WI 53707 - 7162 Site ,
Department of Commerce -5/9 a - 16c� �// Z 5 '�� 3r -
Sanitary Permit Application Sanitary Permit Number 3Is rt. 0
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide l (' a if Revision '•
nay be used for priva cy Law 1 m
I. Application Information - Please Print All Information RECE State Plan I.D. Numbem
Property 's Name APR 3 Parcel Number 3 z — Z.(c�Z • Q -v D D
C' cu)l ") 0 .I 1'q ?
Property Owner's Mailing Address Property Location
12 L j_3 � / �� SZONIN Ile COUN TY' .SUS /f/( S 3 T 3 � N, R E
City, State Zip Cade Pho>ue r Block Number
\Subdi vision Na& CSM Number
II. Type of Building (check all that apply)
--t"" ❑City
or 2 Family Dwel ft - Number of Bedrooms =- � ✓ ` ? i -� `� Y Dviliage
❑ Public/Commercial - Describe Use &wnsbip
❑ State Owned _ Nearest Road 1
M. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete Hue B if applicable)
A. 1 2 ❑ Replacement System 3 11 Replacement of 6 ❑Addition to For County use
Tank Onl
Previously Usued Permit Number Date 1
B. Check if Permit 1 ` lases 3 O
�ikL�
IV. Type of Permit: (Check all that apply)(numbering scheme is for internal useYi - i�, coy
49,L -Pressuri In- Gra rnd 210 Mound 47 11 Sand Filter 50 ❑ ConWucted Wetland � /.��
22 ❑ Preswnzed P In Grand 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line
45 ❑ At -Grade - 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other
V. D' t Area Information:
Design Flow (gpd) Dispersal Area Dispersal Area Sod Application Percolation Rate System Elevation Final Grade
Required j Proposed Rate(Gals./Days/SgYL) (Min./Inch) 1-7l Elevation
VL Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Eat r'—
Tadis Tanks
Septic or Holding Talc
losing Ober
VII. Rtxponsibility Statement - I, the undersigned, assume reapomrbitity for installation of the POWTS shown on the attached plans.
Plumber's Name (Print 7rr' Signature MP/MPRS Number Business Phone Number
Phnnbees Address (Street, City, State ) r�
/De artment Use Only
Approved ❑ Disapproved stay Permit Fee (includes Groundwater Date issued L Stanops) Surcharge Fee) ❑ Owner Given initial Adverse Determination � . /
I% Conditions of ApprovaURelsons for Disappr / N
r t• � I
,r`
f y',. �C t t ,.' C, ®'ji, ✓ GN /��;V/> �C'\ `1'7/ h U / ,k /f: ,;
f
Attach complete phms (to tie County only) for the system on paper mot leas than 81/2 x 1111ches In sine
SBD -6398 (R. 05101)
PLOT PLAN
PROJECT P.C. Collova Builders Inc. j ARVq1ESS P.O. Box 489 Someset Wi 54025
SW 1/ 4 NW 1/4s 3 /T 31 R 1 TOWN Somerset COUNTY ST. CROIX
MPRS Shaun Bird 226900 DATE3 BEDROOM 3
CONVENTIONAL )= IN -GRU PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE
1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 684 22
# of chambe s /
,BENCHMARK V.R.P. Top of Survey Lath ASSUME ELEVATION 100' Filter Zabel A -100 l/ / r
❑ BOREHOLE O WELL H. R. P Same as Benchmark
SYSTEM ELEVATION 0/90.5
Alt. BM Top of Survey Iron @ 97.0'
a�
a Pro 3 Vent
o Bedroom
House > 12" %Sidewinder High
X s^" of Cover Chamber�aching�-
t 25' ;
-M,
20, T B -3 �6' Long' Grade at System Elevation
20' 35' 34 „
2 Vents
70, B -2
4 6 /2-3' X 69' Cells with >3' Spacing
Slo
50' �
Plans Designed Using
Conventional Powts
Manual Version 2.0
�T al
53rd St.
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page f of
Divisson 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. 3.31 • ,
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0 7 „2 Y ,�,, _ v
Please print all information. 1e`" by 2002
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Al m to B
Property Owner Property Location OFFI E
��L;` Govt. Lot (�J 1 /4f',��14 S T N R G E
Property Owner's Mailing Address I ,- Block # Subd. Name or CSM#
.ter ��
City State Zip Code Phone Number ty Village Town Nearest Road
New Construction Use: esidential /Number of bedrooms Code derived design flow rate 4 xJ c GPD
❑ Replacement n Public or co mercial - Describe:
Parent materia r cr -L Flood Plain elevation if applicable /L-/% ft.
General comments
. �y'�L_ ,.1 ���cLc�^' �� Q ,�� -,�.. ;
and recommendations: , � � ��" �
`5 re_�-f' vias dow— 6h LET
m Boring # ❑ Boring 3q S1 t'O 1
,® pit Ground surface elev., ft. Depth to limiting factor _/�0 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
D - .�
Z- .a
l (;
® Boring # Boring
Pit Ground surface elev. J' ` 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
2 _ z ---- -� �' - a
'Effluent #1 = BOD > 30 < 220 mgJL and TSS >30 _< 1 0 g1L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L
CST Na a (Please Print) _ � Z � Cam' Nym�ber
Address to Evaluation Conducted Telephone Number
SBD -8330 (R07 /00)
Property Owner Parcel ID # ' 3 I 1 1/ 2 Z `' Page a of
Boring # �❑� Boring
H IPit Ground surface elev. v ft. Depth to limiting fa r 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
II
F] 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 /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2
F-1 Boring # ❑ El Pit 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/ft
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
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777.
SBD -8330 (R07 /00)
• Soil Test Plot Plan
Project Name P.C. Collova Mrs. Shaun d
Address P.O. Box 489
Somerset Wi 54025 M #226900
Lot -g' Subdivision Deer Trail Date 4/29/02
S W 1 /4 W 1 /4S 3 T 31 N /R W Township Somerset
[1 Boring Q Well PL Property Line County ST. CROIX
BM or VRP Assume Elevation 100 ft. Top of Survey Lath
System Elevation 91.0/90.5 *HRpSame as Benchmark
Alt. BM Top of Survey Iron @ 97.0
a
a Pro 3
° Bedroom
0
House
M
Alt. 2JY
M. B -3
B. 35' 97'
20'
20'
96'
B -1 70' -2
95'
6%
50' Slop
l
a3 sal
Sanitary Permit Application Safety & Buildings Divit
In accord with Comm 83.2 1, Wis. Adm. Code` 201 W. Washington F
See reverse side for instructions for completing this application PO Box 7
` isevnsin Personal information ou provide may secondar p be used for seconds p urpose s Madison, WI 53707 -7
Department of Commerce (Privacy Law, s. 15,04(I)(m)] (Submit completed form to county is
state own
Attach com ete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x I I inches in size.
Court .1, 0 State SaanarY Permit Number Check if revision to previous application State Plan I. D. Number
q..5 e l
I. Application Informatio - Ple ase Print all Information Location:
Property Owner Name Property Location
/4 S T ,N, R or (.�,( tiion
6_� - f C&t4lx-,� Pro cny Owners Mailing Address SC - 1/4 � X4
Lot Number Block NumG
70,5 G-
Clry, State Zip Code Phone Number Sub vision Name or CSM Number
o ( rfY
-S
11 Type of Building: (check one) ^hoc p p Cit
I or 2 Family Dwelling - No. of Bedroo s: !y�(J - '` 0 Village
0 Public /Commercial (describe use / - 1 Klown of
0 State -owned _ l_
III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Near e ow
A) I. j KNew System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Numbcr(s)
System Tank Only Existing System yA — Q O 0
B) Permit Number Date Issued
D A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply OD
Non pressurized In- ground O Mound O Sand Filter O Constructed Wetland
Pressurized In- ground ❑ Holding Tank D Single Pass ❑ Drip Line
O At -grade r r k43 O Aerobic Treatment Unit O Recirculating O Other:
• ?�
V Dis ersaMeatment Area Information:
I Design Flow (gpd) 2. DispersaWca 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Role (Gals. /day /sq, ft.) (Min. /inch) levation
�� X -S 89r�0 160
j VI Tank Capacity in ii`otal # of Manufacturer Prefab Site tber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structcd
Tanks Tanks
O ❑ ❑ D
❑ O ❑. D
X12
VII Responsibility Statement J
1, the undersigned, assume res on ibility for installation of the POWTS sho-wr the attached tans.
Plumber's�e (print) PlumberWgriaturc stamps MP MPRS No. usiness r
�s � '
%p 5 01/ Z/
Plumber's Address (Sweet, City, State, Zip ode)
I.
Sr C P00
VIII County/Department Use Only 1vqVG p PFrCE :
O Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ss A e W(N I t ps)
Approved O ar e Owner Given Initial Adverse Surch Fee) ap 5
Determination 2215 � ��
IX, _Cond itions f A roial eas or Disapproval :'` S�OQ S - !I Cr J t
� r
N � .
a1
IdOO N
-- /D S '
S .0�, 9? �o
_
#4 B _ 16 N
l
T 8t-
7
-/ ,� H -/a
Ncr
/doh LL-"N
d� !
AuT g1'^�
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of
„Dvi*P,of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code County ro
Attach complete site plan on paper not less than 812 x 11 inches in sue. Plan must
inctude, but not Ignited 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 811 i by Date
Personal hftrmaiw► you nee may id for 89 �eh�es (PrhF&W Law, s. 15.04 (1) (m)). .0" - Zcr I
Property Owner �� N u tv ; Property Location
Q,C - lJ f't.Ow Govt Lot S 1/4 VW1 14 S 3 T3 I N R) E (or
Property s Mailing Address Lot # Block # Subd. Name or CSLW
ZONNGOFFICE
City State Tip Cods, Raw Num qr � ' ❑ City ❑ Village UTown Nearest Road
4 New Construction Use: p Residual / Number of bedrooms Code derived design flow rate tQ d d GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material U f'LAJa - .1S -- — Flood Plain elevation If appliicc able R
General co mmen t s; nil sons: s Y S+e ei n a
and I g., ei�v'• �q.
Boring # El ring
14 Pit Ground surface elev. Q O ft Depth to limiting factor / Z- ( in.
Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD/W
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'EN#1 TRW
6- 1 0 c 11Z ( v / f G I V . Z-
L p -H l 1 5�
3 -(ti y b vhs 7 , 2
q•6 �
loo
❑ Z Big # Boring
❑
Pit Ground surface elev. •Ci O ft Depth to GM&Q factor / in. Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/IE
in. Munsetl Qu. Sz. Coot Color Gr. Sz. Sh. ( 'Eff#1 I 'Eff#2
b-)0 j CS v� •2
2 -� t 1C 1 C
3 -- V-A S mg
" Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 1 30 mglL
Name (Please Print) - - CST Number
X53309
Address Date Evaluation Conducted Telephone Number
ii &) S�. Sd l fUZS
9- /3 -vo 6'71S a 7- Y64)<3
1
c �
Property Owner K r � r t aw S k Parcel ID # -- paw of
F Boring ° Bor ing
Pit Ground surface elev. ?3-(06 ft. Depth to limiting factor Z / 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. `EfW1 *Eff#2
y5 -IZI 01 r L4/ to
Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicabon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistenoe Boundary Roots GPDHF
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. `Efffti `Ef 1V
❑ Borsrg # Boring
❑ Pit Ground surface elev. ft tD limitlog factor Sod 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 'EfW2
Effluent #1 = BOD > 30 220 mg/l. and TSS >30 < 150 mg/L ' Eftlu mt #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
need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 60 &2648777.
SBD4330 (807/00)
PAGE - ;,Z_ OF
NAME LOT# Z LEGAL DESCRIPTIONSe '/4+w'/4,S3 T3(,N,R 14 E (or) V
SCALE: 1
BM 1 ELEVATION 11)0, d
BM 1 DESCRIPTION ,�,,�, •„� Z O •` a o� K — -F --
BM 2 ELEVATION CO C)
BM 2 DESCRIPTION n GA (i
SYSTEM ELEVATION (9 d
ALTERNATE ELEVATION �• d
CONTOUR ELEVATION Vlyq
(P O
q3•
0
I / • Q,., 1.
DATE
SIGNATURE -- G" ��
S
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number 3q 5 1(v t
Number of Bedrooms
Design Flow - Peak (gpd)
Estimated Flow - Average (gpd)
Septic Tank Capacity (gal) Zaa
Soil Absorption Component Size (ft) t- -
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow - Peak (gpd) 1 2dDct 4 z - a� �
Maximum Influent Particle Size (in) 118
Maximum BOD (mg /L) 220
Maximum TSS (mg /L) 150
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the septic and outlet filter shall be assessed at least
once every 3 years by inspection. The T tlet filter hall be cleaned as necessary to ensure
proper operation. The filter cartridge sho be removed un ess provisions are made to
remain so ids in the tank that may slough off the filter when removed from its enclosure. If the
t Management Plan for a Septic Tank and Soil Absorption Component
• filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years: The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
Management Plan for a Septic Tank and Soil Absorption Component
Plantings of deep - rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
S-k� 6715)
A
N
FROM : P C COLLOVA BURS, INC PHONE NO. : 715 549 5911 Feb. 01 2001 07:33AM P1
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
,nn
OWNERSHIP CERTIFICATION FORM
Owner/Buyer (b E 1 a vA A I J n ,.
Mailing Address - 706 0v • A' d . �" X /v 30 GU v 1(�
Property Address -3
{Verification requirtd from i'lanning I)epartta7eltt for new construction) �� )
City/Slaty M�, _ Parccl Identiftcatiosl Numb
LEGAL D 1� ItIiE'TIO 3. 3 t. t g! Z< f
Property Location 5-a- '/,, !v w '/,, Sec. Z� T N -
�t�V� Town of
Subdivision
uaaaA,4�L Lot #
Certified Survey Map # Volume page ft
Warranty Deed # _
5 1 Volume Pa e 3
Spec house Q yes ❑ no Lot lines identifiable ❑ yes ❑ no
SYS'T'EM MAW .NANCtii
Improper use and mainten11unce of your septic system could result in its prrtuatum.faihue to handle wastes. Proper matntenit=
consists Of pumping out the aeptia tank every three years Of soener, if needed by a lieemwd pumper. What you put into the system
can aged the function of the septic tank as a treatment stage in the waste disposal system.
The propeM Owner agrees to submit to St. Crain Zoning Department a certificati fotm, signed by the owner. and by a
m 1 M P 1 Uftdx4jowzey=nphuubef, restricted plumber or It licensed pumper veritging that (1) the on -site wastcweiterdiaposal system
is is FVOM Weridng condition and/or (2) after inspection and putmpiag (if neussa 7), the septic tank is less than 1/3 fail of sludge.
1lwe, the undenipad have read the above requirements and agree to maintain the private sewage disposal system with the standards
set ford6. herein„ as set by dw Department of Commerce and the Department of Nattual Resoureas, State of Wiseninin. Corti()cation
slating dart Y= Sept tryatem lus been maintained must be completed and returned to the St. Croix Co unty Zoning Office within 30
da
ya,taf the 1krft ar expirati date.
t_2r 1"C33iE OF APPLICANT DATE
UWNLR zgn t^ATrnrl
lkwo) ardfy that all statements On this form are true to the best of my (our) kaowledgd. I (we) ant (are) the owrnt(s) of
tha,ptbpert�i`+�te"bed�bove virtue of a my deed recorded in Register of Deeds Ouse.
, X(3NAIVK33 OF APPLICANT
DATE
'` e •ee t= Any information that is this- represented may result in the sanitary permit being revoked by the Zoning Department. r'a "•
•; Include with they apptteattou: a stamped warranty decd from the Register of Deeds once
a easy of the certified survey map if reference is made in the warranty decd
l
, OV1441 THU 11:13 FAX 715 386 4687 REGISTER OF DEEPS
WARRANTY DEED
3TATZ gcS W 1, KATHLEEN H. UALS)f
REQ31STE DEEDS
OCCU1.1614T 140, 6T. CRG F Co., W1
AECEIVE) FOR RECORD
This Indenture, mi,f this d o f
A D.,AI_ZQQI 03.21-2001 9:30 An
b4i"on In;, Ij kARRANII DEED
—Z — a Corpuration. duly EMPT 11
. and �iiflts* uii4cr an b7 vloriu4 of th e lav'a or the State or VAscumin, locato: d at CER7 COPY FEEL
W onliton. wc party of IN M ari
E part. d COPY FEES
P.C. C0110va Bulleors, r . 1w iecoasilL torpor tion MANSFE11 FEE; HUAI)
RECMINO FEE. 10.00
PAMI I
put lea o f t h e steo
Pori.
h 1h.0 the said p arty of Ihe'nrsi part, for and loromaidmation of the sum of
86, 100. DO
k ir the second pUL Ito receipt whrLrojijhtfjb 1 N1a SPACE ! Etkhvl[0 ICR AMPUNG DATA
and wknowicdErd, hat aMn. SMnled, boir6atacd, oold. IVMs.'d. r.kased. aliened, cocnvq4l NAM2 ANO A.TUAW AWntiC
and cojillymcd, and by chase PrCIMIS olcti Ovd, yams, bargain. stil, reinisic, alien. cronveyAnd
- CrLllrM U 1110 the Md PM I PA of the StCohd poll, - thri i t OAKEY A QMY TXTLE
and 5IMPS 1) the fol)zvina dcralud fdal ef.Wtv. -Aoomed in dm County of e l Box 126, Osceola, WI $4020
St. Croix
SE214 61 wigcorwin. toi•yviv
Luty 6, 9, LD. 11, 12, 17, La, 19. 20, end @2 of the is
Plat of Daer Trail Estates, according to L116 recorded
Plat on file an4 of record In the offica of the 032-2141-40-00
Rugist of Deeds. St, Croix Councy. WiteonsLa,
557
032-2141-611-110
032-2141-
032-2142-2C-00
032=2142-30-00 li
032-2142-40-00
032-2142-5C-00
117 IdaMAY CONTWLlf DUCin?"ION ON UVIALS; $J09) 032-2142-60-00
Together with an and oilquias the hVitcluatunts and app-articircono:4 thereunto belonjing or Li any oviQ opperuintn and all Ll-.t estate.
orIgil, tide, irtarcal, claim or dsmprW whom.mr, of ght; said Party at III* brit gait. 9i'lid in law cor aquhy, ckhcr in poaLmion or expectant -/ if,
In and m chi above lairpincO picni'Dus, and their ha.edit.imaras and appurtenances.
T; hive and to hold at stud prar.oarb as above do:xrbcd with The helediLarr-ents and appurter.3r.ces, witto iW said 7)art 4 r, `. of tint
5CC-Aj Put, and to --jhj:' i r hdrl And assigns ?0kI!VFL
And tho said gQwnkl VArroin
piny 31 the firic. part, for iticirani its suermsoll, does covenint. Limit, bargain and agree to :rod With tint said pan . no of the strand
I:hei-. part,
Min and asst that at the Ilins of the conseshig and dtllvvry J lKW' Potsms to Ii -ell iti-d .1 tine, T—ims
above ducubed, 1i of 44x-d. sure, pcirgo, ahiciule and !ndiAcuible estate ofinkarition.-c in the law, in fu timiol uj& that the ;Prae are free and
LItAl' fTLI11 all I1=JMbr1L,.Cei %lotWaVEr . .. . .
aklc 11 wl of u lic vo: bi rpinard p rey ttor, on the quiet and ptokccA I)lc "vt ia to of the ca id pa rtAr�-'_ of the Am rd part, their
hei -a, an r,;i ps. aga inst 01 a nd every Nrion o fitriuetic lawfully 4 taint i rojit t he Whok Or any part tIMCMd. it Wil fare vior WA RRANT And DEFEND.
In Witness Whe-.eof, the j:oLd Neo-liciri Forma- ire.
Rcrair 9
Normqn KulgouAW 4- Sccrelpq
Wilcoriarri, and lu corpamig :eat to be hZMLn:' ' aPixtd this
I Art . day of
—,A.D,.Wg 2nnl,
is
SIGNED AND 5ZALID IN P•NCO Coo
Pkaidda
Roggr lCukawoki
srrcwry
Stall; of NVIF-ronsin,
rolk
otic. jhi Itth dz!ul
Royer xwk** M 1 President and - every
of use :bm-r named Corpormain. to we k 11OV-11 LU b: %c purbotn:& wr.Q executed the foregoing lnstruffienj.ju% tUleOlus 4n to ha sash Prcsidcnr
And -kcructary of said Ckti-c-moll. Jad aclintow]-cigotJ tha they Mocu" III, threfultie is ITI, IMCII it Mekki OIt 1et4
by nA suihonty.
TM111 V4F.TR" T WAS CcVjE0 SY
Ponal NO
V" YK SILER, S.C. ijAl.
Post Mi r ; I Notary Public. ognl it County, Wis.
dew Rittimo 1HOL I (tqili�)Cisj
. ...... or) IN
%ARPANtt DEED -ay CO(pi(Silui, MAT SIN %i"w&;n L49d filan CO re
141AIRN
A /L ES TA TES ---
he Northwest Quarter and port of the Southeast Quarter of the Northwest Ouarter
vest Ouarter and part of the Northwest Ouorter of the Southwest Ouorter 0// in Section J. I
lerset, St. Croix County, fsconsin. I
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Ilk yu
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l i SHEET 1 OF 3 SHEETS