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Home My WebLink About032-2159-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix � Safety and Building Division INSPECTION REPORT Sanitary Permit No: 453240 0 GENERAL INFORMATION , (ATTACH TO PERMIT) State Pla ID No: Personal information you provide may be used for secondary purposes [Privady Law, s.15.04 (1)(m)]. Permit Holder's Name: Village X Township Parcel Tax No: City P.C. Collova Builders, Inc. Somerset Township 032- 2159 -80 -000 CST BM Elev: Insp. BM Elev:� BM Description: Section/Town /Range /Map No: CZ'O D m 'U end 12.31.19.1376 TANK INFORMATION ELEVATION DATA """S TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ` 1 l A �C� -T .. '� Benchm�a Dosing ow. 24" Alt. BM Aeration L1^ ��, Bldg. Sewer ,I S r Holding St/Ht Inlet 9 1 30 , �_..._ TANK SETBACK INFORMATION St/Ht Outlet g TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic D r Dt Bottom Dosing Header /Man. Aeration Dist. Pipe • /o � ,6,5 Holding Bot. System 0 9 •moo - -- — } o S zo (db PUMP /SIPHON INFORMATION Final Grade 2 1 7 .9 0 r Manufacturer Demand St Iver _ r GPM 2 ' 2 � t3U Z(o Model Numbe TDH Lift Friction Loss System Head T Ft Forcemain Length Dist. to Well SOILABSORPTION SYST EM a ,, BEDITRENCH Width L No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 ( J 1 SETBACK SYSTEM TO \\ P/L BLTDG WELL LAKE /STREAM LEACHING Man ture INFORMATION Type Of System: CHAMBER OR 2 � / 11\ Model Number: /' i �1 � DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake � u Pipe(s _ - - -- i Length J� c 1 Dia Length Dia Spacing > SOIL COVER x Pressure Systems Only xx Mou Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil g p [ Yes No Yes No OMME 'Z- 3 j (Includ code disc en lies, persons present, etc.) Inspection #1: Ney '/ f 2 m Inspection #2: — 7 ,.5T Av e. Somerset, WI 4025 (SE 1/4 SW 1/4 12 T31N R19W) Wild Turkey Retreat Lot 8 Parcel No: 12. 1. 13 4 `t S V et ation: 3 2 4th �6 1.) Alt BM Description = /�� 2.) Bldg sewer length = j amount � a� o cov 2 1pp tGG try b Plan revision Required? _- Y � No Use other side for additional rm n Date Insepctor's Signature Cart. No. SBD -6710 (R.3/97) � , Safety d Buildings Division County �Numb fl > 201 W. Wash�ngton � ve0 iseonsi n Madison, WI S37d .�lf Sanitary Pernrit (to be filled in b Co.) 6608) 266 - 3151 S' 3 z Department of Commerce State Plan I.D.N�r Sanitar r H tion 4 In accord with Comm 83. in rntatiO4 you Project Address (f different than matting address) may be used for IAW J A S 04(})(im) ; L Application information — Please Print All Information Parcel p s Block g Property Owner' G ��9C�G✓ Property Location progeny pwr��a Mailing Address Section City. S ^ 2rp Code Phone Number / N. I( E r W IL Type of Building (check all mat apply) Subdivision ! N ba r 2 Family Dwelling - Number of B�roosag �� - �� / PublulCommercial - Describe Use State Owned - Describe Use UL Type of Permit (Chedc only one box on line A. Complete line B if applicable) A _ System Replacement System Treatment/Holding Tank Replacement Only Other Modification to Existing Syst on List Previous Permit Number and Dace Issued B. Permit Renewal Permit Revision Change of Permit Transfer to New ll Befom Expiration Plumber Owner '�� O� �� o� (✓ f) IV. a of POWTS S stem: Check all mat apply) - Pressurized In -Ground Mound _> 24 in. of suitable soil Mound < 24 in. of suitable soil At -Grade c Pass Sand Filter Constructed Wetland Pressurized In-Ground Holding Tank Peat Filter Aerobic Treatment Unit R Sand Filter R ec i rcu l a ti ng Synthetic Medra Futter taramber Drip Line Gravel -less Pipe other (explain) V. D' ersaVfreattmeat Area rtmation: Dis (so Di s persal Area Proposed (st) 7d Gl= Desi Flow (gpd) Design Soil Application Rate(gpdsf) 1 3 RctPrued s� capacity in Total Number Manufacturer Prefab r Plastic VL Tank Info concrete co Gallons Gallons of Units New Fsiuing 'ranks Tanks Sep6ror Hol fin Tank Aerobic Tieatnrsr Uri: Dosing - O b. VII, Responsibility State I, the and ed, assume responsibility for installation of the PORTS shown oa attwhed Phone Number Plu s Name (Print) . Pi s Signature MPlMPRS Number Business Plumber's Address (Street, City, state, Coon 1De artment se Only Date Issued t Sign tan>ps) Sanitary Permit Fee C udes Groundwater ` Approved Surcharge Foe) 2c> �p Owner caeca for / o IX. Conditions o ptoval/Reaspus for Disapproval �j M �, , Sl - O is A - SYSTEM OWNER: I Septic tank, effluent filter and dispersal cell must all be serviced / maintained C) as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances- Attach eompkte plaos (to the County only) [or the systtm on eaper x nut less 81CL s 1 inc in r cu( k� a Soil T and System PLOT PLAN PROJECT P.C. Collova Builders Inc. ESS P.O. Box 489 Somerset Wi 54025 E , 1/2 SW 1/4S 12 /T 31 N 19 TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11 /21/04 BEDROOM 3 CONVENTIONAL XXX IN -GROUN 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 # of chambers 22 BENCHMARK V.R.P. Top of foundation ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL H. R. P. Same as Benchmark Plans Designed Using SYSTEM ELEVATION 95.1/94.7 4' below qrade Conventional Powts Well is to meet all Manual Version 2.0 setbacks required by WDNR t L — Standard Biodiffuser Leaching Chamber with 3 1. 1 ft2 of Area � Grade at System Ele; 11 p ' o p 34 ro Towl Road % Pro 3 Slope Bedroom House 35' F— O Vents 1' B. M. * ST B -2 40' -P--L 70' Ij 2 -3' X 69' Cells with >3' Spacing 0' 504' Property Line 60' Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings ccordance om 85, Wis. Adm. Code County Attach complete site plan on paper n t D 1/ c 1 _ ISO f *- include, but not limited to: vertical and oriz tall re (BM), ireCt on and Parcel I.D. percent slope, scale or dimensions, north arrow, and I i d distance to nearest road. Please print all informaa�on. a wed by A Date Personal information you provide may be used for secondary p poses (Privacy Law, s. 15.04 (1) Property Owne r tbperty Locatipn n l)vt: tat -- . r 1 4 S ! 2.T, 3 N R E (o W Property Owner's Mailing Address Lot, I Block # qad. Na CSM# City State , Zip Code Phone Number ❑ r Village llage Lvn Ne st Road `C�� ) -� true ion Us Residential / Number of bedrooms Code derived design flow rate -Y`L7 GPD ❑ Replacement Public or com rclaI - Describe: _— Parent material / «gyp ti� Flood Plain elevation if applicable ��A ft. General comments / and recommendations: CQ� /c 7� 1 / F -11 Boring Boring # � Boring 4—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/lf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 r Boring # Boring �J Ground surface elev. L ft. Depth to limiting factor in. Soil Application Rate R ox Description Texture Structure Consistence Bo unda r y Horizon Depth Dominant Color ed ry Roots GPDA? P P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 Z l 3 /0 - � /// /f�' 3 / iv / J v ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Nam (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird �� 226900 Address , ate Ev ation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 — 715- 246 -4516 r T � Property Owner _ Parcel ID # Page of F31 Boring # Boring , nit 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. I 'Eff#1 'Eff#2 Z K j F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil licetion 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 Boring # E] Boring 1:1 Pit Ground surface elev. ft. Depth to limiting factor in. F Soil icetion 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 t 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 -8770 (8.6100) P PLAN PROJECT P.C. Collova Builders Inc. DDRESS P.O. Box 489 Somerset Wi 54025 E 1/2 SW 1/4S 12 /T 31 R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE BEDROOM 5/17/04 3 CONVENTIONAL )= IN- GROUND ESSURE 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 # of chambe s 22 ,BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION 100° Filter bel A -100 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 97.7/96.7'4' below qrade Alt. BM Top of 2" Pipe @ 100.3' Plans Designed Using Conventional Powts Manual Version 2.0 Well is to meet all setbacks required by WDNR Pro 3 Bedroom House 246' Property I ine 0 ' B -3 td ents 35' 20' B -1 ro Tow Road 35 10% B -2 2 -3' X 69' Cells lope with >3' spacing 15' i B.M. 15' Alt. M. 175' > Standard Biodiffuser Leaching Chamber with 3 1. 1 ft2 of Area Grade at System Eleva on 34 220' 504' Property Line Couoty �f�, and Buildings I}ivision w sued in by Co.)`. Wast�iIIgtoa Ave., P O Box 7082 SaaitaryPertnttN 2' O / 2Q1tX. `� Madison, W1 53101 — 7D82 �_ ' (608) 261-6:546 $r,tc Plan LD. Number Oepertment of Commerce perk Ap cation tf different than ttlailil►g sddtrosa] Sanitary LA stcotd _ projat Address c sun 13 1, Wis. Ls , s15. ., t ...��..' ayb b e u sed for secondary p"00 Y � ttay e u I fi0�4 / ✓ Loth BlocIc+M i tion — Please Print A ll 11P MAA p # I, Application Infarma �f , g a _a Prope s Name 4 �� C)r., ��' `a, properly Location / 3 �o / section �� ' Pro M , 's Mailing Address �� cod phone Number I (ci go Zip e ) i N. R or City, State v V U ) _) „� Subdivisiaa 1 T a of din bk g Ceee all that apply) Buil GtN W r of 13odroo � of or2F+mily»elling— pryasbe aaY ❑City— •Vi113 o P ❑ Publieco=wrial — Dcscrilx Usc e B line - be Use D 1 ❑ State 1Y° ed— Descri Complete n if appll�ble) Type of Permit: (Cheek only one box on line A. ent only ❑ other M co Existing System Q TYea=enVHOldiag Tulle Rep�m 11033 System Aeplaceateat Liss previous P�t;t Number cad 72srs 7aaued A. New syst= n P m t wafer to New' ❑ Change of Owner B. ❑ Permit 1tss� r] Permit Aev "sion Piu%nber Before E ❑ ,qt - Ccide 11 Single Pans Shad Filter Check all tlsat a l 24 in, of suitable soil t .T ry of PO'8 S stem: table soil ❑ M °std enc unit ❑ ReeiK e uritsd ia,Gmuad ❑ Mound> 24 in. of Stu ❑ past Filter ❑ Aerobic Trearat G —Pteat d ❑ Holding Teak ❑ (%plain} pressutited tali [] Gravel -less Pipe Otber & C:oasnveted Weiland er Chamb ❑ Dri Line S item El evati � 53 Filter Dispe¢�' opened C. e6c Media er EL.,�� Raciratyda Stare �ormscti0 ds „ � Aryl Required ( G V. DL ecsaUTreatment Ace rJ ✓/ cI L 3 Site Fiber Pl�tic ign Soil Application 72ate(gP D6i °W �) Maau£acr C,onctete i constructed l Glass Tots] N`la'ber 1 Capacity to of Units I ' VI. Tank Info Gallons Gallons ,y fihisting '', TZil T `/ septic at Holding Tank ' f I.erahle Tryimeat Unit I shed ptaas. P ties at the pwrB abawn oa the arts PhoneNti+m J I � aChhmbef foriasralla some rsapansibiIIty igp/MPR5 Number I, the tiadsrs ae onslbYUty Staters CJ Fyt+mhes' Plumber'& ama (Pcinr 0 j c; • Stare, zi Plumber's Address (Stree4 Issuing Date isauesi � Ptrmit Foe (includes Grouadws"r yjII, un /D arcmcat use Oal gaairary ❑ Disapproved Surcharge proved Fm) ✓ I ❑ owner Given ReaB°n `or Denial revs) Co i rowtUAes{sons for Oi w a . UL Conditions of App - n ,�' �ey,,t,eD2,v� -t.Q2 SYSTEM OWNER: _RuU /" ( �"• /� 1 ep lc an , effluent filter and ,� Can SY ills ersal cell must all be serviced I maintained 3 I as per management plan provided by ptumber. aintained 2, All setback requirements must be m a Ila s It )aches in �' as per applicable code /ordinances sot l tha 3 , { ow Cotttlly ally) for Owe SYsuta eo p aper AI OmPle" p onfl_A109 (R. 08)02) ' P PLAN PROJECT P.C. Collova Builders Inc. DDRESS P.O. Box 489 Somerset Wi 54025 E 1/ 2 SW 1/4S 1 2 /T 31 R 19 �W TOWN Somerset COUNTY ST. CROIX 5/17/04 3 MPRS Shaun Bird 226900 �� DATE BEDROOM CONVENTIONAL XXX IN- GROUND ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 B RPTION AREA 684 22 A SO # of chambe s BENCHMARK V.R.P. Top of 2" Pipe ASSUME ELEVATION 100' Filter abel A -100 ❑BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 97.7/96.7' 4' below qrade Alt. BM Top of 2" Pipe CC 100.3' Plans Designed Using Conventional Powts Manual Version 2.0 Well is to meet all setbacks required b 9 Y WDNR Pro 3 Bedroom House 246' Property I ine 0 ' B -3 ld ents 35' 20 B -1 ro Town Road 35 10% B -2 2 -3' X 69' Cells lope with >3' spacing 15' B.M. 15' Alt. B.M. 175' Vent >6„ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area 6' Long 11" Grade at System Elevat on .54 220' 504' Property Line r r vulaoonstn Department of conanerce SOIL EVALUATION REPORT Page of Oivisioo of Safety and Bdldings in a000vdarnoe will, Comm 85, wis. Adm. code , - complete site plan on paper not less than 8112 x 11 in Size. Pisa m ' C (, S /t C7 3 include. but not limited 6D: vertical and horizontal reference (BM), direction and parcel I.D. peroent slope. scale ordirnenslons. north arrow. and location anM distance to nearest road. Z - 2151 - • 3 Please paint all lnformatlon. by Date 4 Personal woron You provide am be used for seoondery pwpoM ( Y . s• 15.04 (t) (m)). �i , l Ps'aperty/1 / / ZZ , C L I.� c� Govt. l.""to � 1 114 S 1�. T 3 N R E( W Property s Mellin Address Lot # I Blocic # Subd. CSM# ` crate zq code Phone Number ❑ city O vase own OftareO Road 9 —S9 I-S' I'a �•c� New Construction t>se: Residential / Writer of bedrooms Code derived design Dow rate GPD O ROP O Public - Describe - - - -- Parent ` Flood Plain elevation if app A_-*'_/AA: fL t3errerailcorrarrarMs 5 5 �'�.�. el� �a��.v� -� A 6 1 , era reoonrrnenaations: c j❑ Barirrp a>t Borst o 1 pn Ground surface elev. i R Depth to timitirng factaor/ i^ - Sol Application Rafe Horizon Depth Domirwnt Cakw Redox Description TexWe Sbudune Consistence Boundary Roots GPDW in. Munsell CAL Sz. Cont. Color Gr. Sz. Sh. 'E1f!!1 •Eff#2 11 - 2 -3 o ---- / `f3.2 - Zv 0 ® � .lEJ pit Ground =few elev��_� f Depth do Nmidng factor / lo Soo Application R ate Horizon Depth Dominant Redox Description Texture Structure consistence Boundary Roots GPM i, Murnseli au. SZ ConL color Gr. SZ Sh. ' 1 s • E wnt #1 = BoD > 30 220 mg& and TSS >30 1 ' Effluent #2 = BM , :5 30 mg& and TSS _< 30 mgll. . CST Number C omem P_dM Address Law Evaluation Conducted Telephone Number ply OWner Parcel ID # Page of # ❑ Bor"rg F � �, Pit Ground surface elev. 14 I R. Depth to Ondin8 factor � in• �y Rate Hor(aorr Depth Dominant Color Radar Description Textue Structure Corsstenoe Boundary Rails GPDIff in. Munsell tau. Sz. Cont. Color tar. Sz. Sh. " Eff#1 - EM 1 7-7 a,$ �S•�� Q Bore # ❑ eoring ❑ Pit Ground surface elev. R. Depth to f"nft factor in. sod Application Rate Horimn Depth Dominant Color Radar Description TO&" Structure Consistence Boundary Roots GPDVff in. Munsell O L Sz. Cont. Color tar. Sz. Sh. 'EIS') 'EfM2 ❑ �►9 .. t9 factor in. F ❑Pit Ground surface elev. R. �� ^9 Sad Rabe i wimn Depth Dominara Color Radar Description. Tendae Structure Consistence Boundary Roots GPDn+ff IM Munsell Ou. Sz. Corw. Color Gr. Sz Sh. 'EM 'EfM2 • Eft wnt #1 = SOD > 30 220 rrglL and TSS >30 1150 mg& ' Effluent #2 = BOD < 30 nnWL and TSS <_ 30 rnglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or p W FPo tY P need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608- 264 -8777. SM43o(".i M) Soil Test Plot Plan Project Name P.C. Collova Mrs. Inc Shau d Address P.O. Box 489 Somerset Wi 54025 TM #226900 Lot 8 Subdivision Wild Turkey Retreat Date 9/ 6/02 E 1/2 S W 1/4S 12 T 31 N /R W Township Somerset R Boring 0 Well PL Property Line County ST. CROIX "B VRP Assume Elevation 100 ft. =Top of 2" Pipe System Elevation 96.0/95.6 *HRpSame as Benchmark lt. BM : Top of 2" Pipe @ 100.3' Please Note: Tested area may not be suitable for desired building area. Check system location before excavating. Also, survey was not completed at time of test. Set backs 101' from lot lines may N Y change. 35' ' x ° B- 99' 3 F� 10% B�2 , lope 1 ' B.M. Alt. .M. 175' 220' 504' Property Line y 4 • • a — ; 61 S WILD TURI LOCATED IN THE NE 1/4 OF THE SW 1/4 LEGEND TOWNSHIP 31 NORTH, RANGE 19 WEST, TC [ ,.. PR D DRIVEWAY DRAINAGE EASEMENT NOTE• V - LOCA OHS — — BU' G SETBACKS COUNTY SECTION MONUMENT NO OWNER OR RESIDENT SHALL DO ANYTHING WHICH WOULD INTERFERE W (FOUND AS NOTED) OPERATION OF THE APPROVED COMPREHENSIVE WATER DRAINAGE AND SO 2 � �O�FOUN 3/4' IRON REROD � I2• UTILITY EASEMENT E CAVA N OR PLANTINGTIN IS NOT LIMITED TO ANY POND EASEMENTS WATER DRAINAGE DI D �' SET 3 4" BY 18' IRON REROD WATER CULVERTS. BERMS OR GRASS SEEDINGS. WEIGHT G 1.50 POUNDS PER — "— DRAINAGE EASEMENTS I�OIK. COUNT LINEAR FO � OT AT ALL OTHER a �& 2sn� NI OFFICE AREAS CONTIGUOUS BUILDABLE GENERAL NOTICE STATEMENT: HERS -- CONTIGUOUS BUILDABLE EACH PARCEL SHOWN ON THIS MAP (PLAT) IS SUBJECT TO STATE, COUNT ■ SET 1 1/4' BY 18' IRON PIN — BOUNDARY RULES AND REGULATIONS (I.E. WETLANDS. MINIMUM LOT SIZE, ACCESS TO WEIGHING 4.172 POUNDS PER PURCHASING OR DEVELOPING ANY PARCEL OF LAND. CONTACT THE ST. CF LINEAR FOOT HWE HIGH WATER ELEVATIONS AND THE APPROPRIATE TOWN BOARD FOR ADVICE. s 00106 NORTH -SOUTH UNE 1/4 SECTION LINE 2650' 2817o 298.12' 298.04 i tease' 335.89' 238.11 -- - - - - - I R - - - -- W 247.28' -- - -- - -- LL; ®" Iy �b I — m 7 o to r, O N a�I " I �"r Q / u: y t m .- O 1 0N'y d W 1 E W CV O d a w l / N M QQ _ a-1 d g r I of I' I. O d n ; E co Q- 1t .09 -, i Q M M d - ®m ,�' eo O to S '\ o�� M i ai Q W d gm N N 00'11_13' 4� E W 101 .sa —� °+►.r;'oyr` ``_ g ,5� e y� ; \ ` ° - ZL► M .LZ.9L S -O -� \] Yr \�' s - �.a►• ` �i j ro (1VOR NYQL LTLZLi 3 .LZ.9L00 N 8 i�.� \ ro` ` \ 219.85' 6[ 9B = - oreci - - - >.� + Y \ i i / �` \ ' .t9b, z _ _ /�,/ o 252:88' ; / - - - - ` cQ LL: co m a, yr b a' b S 00'03.40' E O O _zf .zs a -tczco ud. !1R 00 I $ _; 458.82 �� 1a9.et' j I^ — m •oo .ZA> 0 S ,,+ �r ay et N Y 0Y w ? I 100' I I. �n & �t7' � 11g1 tj Id (Q f 00 a �r.er n' ►e ii -� n. I �/I A : y t - I Q w [, Iv r o I ad (� N ®1 ®' li �i t , r n �9; I^ E-4 t t ri Q I N 0 ai yt W I k 4` I 100' I t E N � I Q d s \ I M ` 3 114, f :3 e I r j On ^ E'� CD °r R ?;? d I a/ I '$ I I 4 T a 5 M I I L — — I I _ _ 219.92' — — 241.09' 459, 1x11' I 3 .L£,9GZ0 N i .ya — — — — N 00'04'13' W 878.92' f — 07 - 9 m ®m I I I vi '; I �I o N Q�I m� I � I E ®^ Q H 'o 'T N cq CO - - - - - -- 880.71 - - -- - — 481.90' — � 240.: D UNPLATTED LANDS WEST LINE OF THE E 1/2 OF THE SW 1/4 N 00104'04' '>7 2654.74' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer P. C. Collova Builders, Inc. Mailing Address P O Box 489 Somerset, Wl 54025 Property Address - 13 Q 24 1 - (Verification required from Planning Department for new constriction) City/State Parcel Identification Number -COD LEGAL DESCRIPTION \� ) o /37� Property Location %,, 5.1 Sec. T 3 / N -R� V, Town of �, Subdivision Lot # �. Certified Survey Map # Volume . Page # Warranty Deed # _ �¢�" 5 (0 1 Volume / Page # Spec house Yhes ❑ no Lot lines identifiable yes ❑ no MAINTENANCE AINT 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. ne property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner- and by a masterplumber, journeyman plumber, restdctedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stapug that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 ys a thr e ar iration date. P, C. COLLOVA BUILDERS, INC. (715) 247-2742 SIGNA OF APPLICANT P.O. Box 489 SOMERSET, WISCONSIN 54025 DATE OWNER CERTIFICATION (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the rtyrdascribf abo , irtue of a warm R er o f Deeds Office. '� VA NALDERS, INC. (715) 247 -2742 k2� / , P.O. Box 489 SIG14ATURE 6F PLICANT SOMERSET, WISCONSIN 54025 DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Maintenance and Contingency Plan for a Septic System Maintenance Plan pumped once every 3 years. 1. Septic Tank is to be pump 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 ev+ary 3 years, cells are to be inspected via the inspections pipes at the ends of the Cells. 4. Owner acrees 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 �onti ge cy Plan Option #1. system fails, determine cause of failure, use alternate area and install new ,system in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option #3. No 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: Shaun Bird 715- 246-4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 FROM P C COLLOVA HLDRS, INC rHL)Nt NU. _J cv r r w r u� G. co coot uc• i�rr r ri aljaiYA 3LUrl LL•U, rju iltr d7U Auel ALV1JLDA Ur Mnuua gyuus. 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