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HomeMy WebLinkAbout032-2163-03-000 a ° o N ~ p °` d a 0. o a I o I I d � I � I Z I � I a N N � z O LL C O O 3 Q Vl I v 3 `l) � I z E F Cl) a m o o zv' w m Z Q � o N 1- c d N z N N y C Q c Q f0 C O O C w z M :3 z ti � LL N r d N C U In 0 d O Q § CL w - C I y H d N O > o o a E E m r v1 (n _� r 0 U !� CD M 6 0"0 a. 65 z R a a C �, CL 3 �Pftb 7 0 lq Z M M N to J U p O p p O N N N a moo . N m 4? d Q z (n c6 N a n ` p ► y i ; o � 4) w c E M m U d p V iy c'' O N M NNI N W �+ a H N M E f O N N> C L N O r U) C9 It 04 O z c Y Cl) V � � � •• E I a , * , Q e C% CL d o ,w ++ E ` 'c c _1 A loao oinc°) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420796 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: Grand Properties L.P. I Somerset Townshi CST BM Elev: Insp. BM Elev: , BM Description: Section/Town /Range/Map No: 00.0 , W,a Z u PJ�- CebTv6" 1 14.31.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark r Dosing O V Alt. BM 2.Zo Aeration Bldg. Sewer L - t Holding St/Ht Inlet Esc. �.« TANK SETBACK INFORMATION St/Ht Outlet - 8 %. TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 2.S' 0 56 1 Z Z ! Dt Bottom Dosing Header /Man. 3 r 23 Aeration Dist. Pipe g.r71 (6 /; Holding Bot.System ,3S r Final Grade r PUMP /SIPHON INFORMATION 0a ,%4A 0 Manufacturer Demand St Cover I GPM 4- 30 Model Nurlkber TDH Lift Fri n Loss System Head TDH Ft Forcemain r gth i or -- r - SOIL ORPTION SYSTEM ENCH Width Len th No. Of Trench s PIT DIMENSIONS No. Of Pits Inside pia. Liquid Depth DIM 3 Z SETBACK SYSTEM TO 1PIL 113LDG WELL LAKE /STREAM LEACHING Man pturer: INFORMATION Type O =Syste ' 3S 1 1 i CHAMBER OR Model Number: DISTRIBUTION SYSTEM A ►Je. Q�L , Header /Manifold tl Distribution x Hole Size Ix Hole Spacing Vent to Air Intake pe(s tf Leng) So , 1 1-eng Dia Leng 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 OM,�AE�ITSj: Jlncl de o discrepencies, persons present, etc.) Inspection #l�_ �g1 3 Inspection #2: ocation: 2114 62nd St N @WIChmO nd, WI 017 (SW 1!4 SW 1/4 14 T31N R19W Gavin's Acres Lo 3 Parcel No: 14.31.19. 1.) Alt BM Description= t L_ 2.) Bldg sewer length = ZZ Y+ � - amount of cover Plan revision Required? Yes )<No Use other side for additional information. 1. . — ___1 I __� SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Parcel #: 032 - 2163 -03 -000 04/05/2005 10:43 AM PAGE 1 OF 1 Alt. Parcel #: 14.31.19.1395 032 - TOWN OF SOMERSET Current ' X I ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner PAUL W & MARY K GAUSMAN GAUSMAN, PAUL W & MARY K 2114 62ND ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ` = Primary Type Dist # Description " 2114 62ND ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.010 Plat: 1971- GAVIN'S ACRES LTS 1/16 032/03 SEC 14 T31 R1 9W PT SW SW GAVIN'S ACRES Block/Condo Bldg: LOT 03 LOT 3 (3.010AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 14-31N-19W SW SW Notes: Parcel History: Date Doc # Vol /Page Type 09/04/2003 738798 24001101 WD 05/19/2003 721975 2245/510 EZ -U 05/19/2003 721974 2245/509 EZ -U 03/09/2003 714143 9/54 PLAT 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 11787 237,200 Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.010 48,000 153,100 201,100 NO Totals for 2004: General Property 3.010 48,000 153,100 201,100 Woodland 0.000 0 0 Lottery Credit: Claim Count. 1 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Z, 1115 Wisconsin Department 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 legs 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 dimemsions, north arrow, and location and distance to nearest road. Parcel l..D. Please print all information. 32, 0 3 — 0 3 — 06 C Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner RE CE IV E D Property Location Grand Properties, LP Govt. Lot SW 1/4 SW 114 S 14 T 31 N R 19 W Property Owner's Mailing Address Lot# Block # Subd. Name or C RIVIS 712 Rivard Streeet, Suite 300 J 1 9 200 3 Gavin's Acres City Sth Zip Code Phone Number City Village ✓ Town oad Somerset f 1 O x Y -590 Somerset 60Th St. ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 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 96.35'. Slope is 6 %. a Boring # Boring ✓ Pit Ground Surface elev. 99.85 ft. Depth to limiting factor ? g6 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 -8 1Oyr3 /3 none sl 2msbk mvfr as 2f .5 .9 2 8 -17 10yr5/3 none sl 2msbk mfr gw - - --- .5 .9 3 17 -24 10yr4/4 ' 1 � 2 sf 21sbk mfr gw ---- -- .5 9 4 24-38 7.5yr4/6 none is 1 csbk mfr dw - -- .7 1.2 5 38 -96 10yr5/6 none ms Osg ml --- - -- .7 1.2 a Boring # Boring ✓ Pit Ground Surface elev. 99.85 ft. Depth to limiting factor >97 in. Soil Application Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots Q PDIfl= in. Munsell Qu. Sz. Cont. Color Gr. Sz, Sh. *Eff #1 *Eff#2 1 0 -9 1Oyr3 /3 none sl 2msbk mvfr as 2f .5 .9 2 9 -21 10yr5/3 none sl 2msbk mvfr gw --- - -- .5 .9 3 29 -33 7.5yr416 none Is lcsbk mvfr dw -- -- .7 1.2 4 33 -97 10yr5/6 none ms Osg ml -- - - -- .7 1.2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD <_30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature:, CST Number Thomas J. Schmitt , 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 6/12/02 715 - 549 -6651 r Grand Properties, LP Page of 3 Properly Owner Pe Parcel ID # 9 2 ] Boring # Boring or Pit Ground Surface elev. 97.65 ft. Depth to limiting factor >96 in. Sol 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 1 0-7 10yr3/2 none sl 2msbk mvfr as 1f .5 .9 2 7 -16 10yr4/4 none sl 2msbk mfr dw - - - -- .5 .9 3 16-21 7.5yr4/6 none Is Osg ml di -- .7 1.2 4 21 -96 10yr5/6 none ms Osg mf -- ---- .7 1:2 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 P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boris F-1 Boring # g Pit Ground Surface elev. 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 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >.30 < 150 mg/L * Effluent *2 = BOD S.30 mg/L and TSS is-30 mg& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or nP., i maFa. i , :., nn oltA...afa f—+ ..1—. n .,.to r rho A—.4-1p o* AAQ- 144-11 4 1 n. 7 - rV 4.A4_')fA-Q'777 P 343 LJ -3 6 cwtw, l c 1 4 13 x- / ° a )o , ' s © - 107 Sipe, t'aw oti► �a+ , na.� p ropsr�res Owe a,h Ly'. �iorsaS �, Sc l+rht y G57tM aa7 `�a n Safety and Buildings Division C 201 W. Washington Ave., P.O. Box C oeo 1 seonsin Madison, WI 53707 - 7162 ress Department of Commerce ( ^'- ST Sanitary Permit Applil, Sanitary Permit Number l In accord with Comm 83.21, Wis. Adm. Code, personal " orma WE D ❑ Check if Revision ma be used for secondary purposes Privacy La v, sl5. 1 m I. Application Information - Please Print All Information State Plan I.D. Number APR 1 4 2003 rty Owner's Name Parcel Number , ST. CROIX COUNTY Parcel Um ZONING OFFI ' Owner Mailing Address roperty on 7 Z l� lt/ ic' ! . SU / T r / o� S'-0 A 5 WA, S T N.R / 7 49 City, State Zip Code Phone Number Lot Nymber Block Number Subdivision Name CSM Number ,Son i 64s6 ) A v, N s 11 c e s H. Type of Building (check all that apply) ✓ / ii ate,, /y��' -� OC'ry ® I or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public /Commercial - Describe Use l / ®Township S o m e s e T 'I) ❑ State Owned / t: �. ) T U r— � l0 /// Nearest Road e 3 2 31,X61-S-1 &Y-6 III. Type, It (Check only one box on line A (numbering scheme for internal use). Complete line 11 if applicable) A For County use 1 P. N 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to S stem ew I I Tank Only Existing System B. Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(nulmbering scheme is for internal use) k) o�`� 44 ® Non - Pressurized In- Gr 2111 Mound 47 El Sand Filter 50 ❑ onstructed Wetland 22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 1 / 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D' ersat Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area J Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks W1 Z.4,eEL 4 -1 0 0- " ' -100 Concrete Constructed Glass - New I Tanks Tanks off yb��� i r/L %,4' Septic or Holding Tank / ysr , _ O ®0 gt ic S Dosing Chamber V VII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number J040 SCH1�l(TT 14 9 �; .nv I 9;t37 ��S` S�`� '�o� SI Plumber's Address (Street, City, State, Zi ode) 616 15 4 06 5 0 In ce5IC r �.� 5 `/0?_5 VIII. Count /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Is nt Signature N Stamps) Approved ❑ Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse a� �' 7 S/0 Determination IX. Conditions of Approval/Reasons for Dis approval Z z at� n, �? ini �/ P P (to the County y) for the system o no Less than 112 x 11 inches in size SBD -6398 (R. 05101) GAv►ws >�C2E5 Lo 3 _ y'' Q � ' VC TNSPEcriun! # V 7' Pf Ferri. (o eAo 2 7. I _ L- [ N E q{3 o -- 0 2. zABEL A -/00 t _ B (n ; PeEPw Z � � 3 BEBOP ® 6>se a 3 X 6t).31 _ $►eDi%-ic i . 3 X bZ, /0 �' etn�crr�s - DR ►�iwa� _ i' B Al TeP o•= V' PVC 6L.= /00 .0 d 4 19 01 Tod 0 c L'' P P Cc. X00.0' REPEeTy LIAie' 7 RWjtei) S' Su,rt /n0 !'01'6 1 -S0 -H Ave _ .5cm6e5 WI _! 5y0.Z5 �oi�1 sE% - U11 SYDZ� - ! / /P4.5 ala 3 7 6 0 6,gv r rus A Lc PVC TN5Pr<7W 1;t�t,U }��RB JK - Says; rr ►t ��.. ' 9�� 3 _ 0 i ALT i 1 4$ It / _ ✓ / ° /CDV 9.7 ZA8EL A -joo J _ 9,Y\ Do o v 3 BEO� roL °- - PRcPes� n Bm ree ®= p, 6t = /ae,o V A Lr Brn TOP 0 r— PVC P P6 C[ / ©p, p � Boe, )tams - G RA(J PQQPe2T +eS Z fed ST. S.w�rt /(2© 1 � 1J 6 16 /-507 AUt _ - -- ------- -- ------- - 1115 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must 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 LD� Please print all information. e Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). — 4 S Property Owner Property Location , 20 Grand Properties, LP Govt. Lot SW 1/4 SW 114 S 14 T 31 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# r 712 Rivard Streeet, Suite 300 3 1 1 Gavin's Acres ° K City State Zip Code Phone Number City Village ✓ Town Nearest Road Somerset WI 1 54025 1 715 - 247 -5900 Somerset 60Th St. d /0 ' ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 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 96.36. Slope is 6 %. ❑ Boring # Boring ✓ Pit Ground Surface elev. 99.85 ft. Depth to limiting factor >96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 - Eff#2 1 0 -8 10yr3/3 none sl 2msbk mvfr as 2f .5 .9 2 8 -17 10yr5/3 none st 2msbk mfr gw - - - -- .5 .9 3 17 -24 10yr4/4 ' 1 d 0} ��j2 /g sl 2fsbk mfr gw - - - - -- .5 .9 4 1 24 7 38 7.5yr4/6 none Is 1csbk mfr dw - - - -- .7 1.2 5 38 -96 10yr5/6 none ms Osg ml —_ 7 1.2 '- z12 7X F2 # Boring ✓ Pit Ground Surface elev. 99.85 ft. Depth to limiting factor >97 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 I "Eff#2 1 0-9 10yr3/3 none sl 2msbk mvfr as 2f .5 .9 2 9 -21 10yr5/3 none sl 2msbk mvfr gw -- .5 .9 3 21 -33 7.5yr4/6 none Is Icsbk mvfr dw - - - - -- .7 1.2 4 33 -9 10yr5/6 none ms Osg ml - - -- - - - - -- .7 1.2 Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg/L ` Effluent #2 = BOD 130 mg /L and TSS < 30 mg/L CST Name (Please Print) Signature:_ CST Number Thomas J. Schmitt 11 � 1 1 1t 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 6/12/02 715 -549 -6651 Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 F Boring # Boring 1111 ✓ Pit Ground Surface elev. 97.65 ft. Depth to limiting factor >96 in. Soil Application Rate Horizon Depth Dominant Color , Redox Description Texture Stricture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -7 10yr3/2 none sl 2msbk mvfr as 1f .5 .9 2 7 -16 10yr4 /4 none sl 2msbk mfr dw - - - -- .5 .9 3 16 -21 7.5yr4/6 none Is Osg ml di -- .7 1.2 4 21 -96 10yr5/6 none ms Osg ml -- - - -- 7 1.2 F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal 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 Stricture 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/1- ' Effluent #2 = SOD < 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 Pn.i ma*—W thA .7ay.aAmssnt at rnQ-144 -11 G 1 n, rTV 4/1R_')4A -9'77 7 P"z 34-3 - F- 3 L 3 G ow ou llc ►yes 07 t/c �,;ae EL- 14 Ate'= N �Lop.e = Co /41 5-r' yo b � e� ' k Q c e�csrx� ,- lJ� � brow iti► G na P o p orkes O� ��y L y .. y csy� as ?�ra� 161) S 8 G tfd l 1 e S z � �n`� � C�o.. ►mss 12c�� /-1; r` sy9- 6 f Ste,! sw y . / q - I r3 N 1 a �,,^ °o / A c �. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ll� of 'FILE INFORMATION SYSTEM SPECIFICATIONS {, Owner Septic Tank Capacity 1000 al Grand Properties L.P. I7 NA Permit �q /„ Septic Tank Manufacturer Week's C C.P. P . E3 N ` 1 � , Effluent Filter Manufacturer ❑ Pik DESIGN PARAMETERS Z a be 1 Number of Bedrooms 3 ❑ NA Effluent Filter Model A -100 a NA ■ NA y , Number of Public Facility Units IN NA Pump Tank Capacity ga l Estimated flow (average) 300 gal/day Pump Tank Manufacturer ■ ivA Design flow (peak), (Estimated x 1.5) al /d4 Pump Manufacturer ■ NA °° Soil Application Rate al /da /ft= Pump Model r NA' Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ■ NAB f, Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter. ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland p Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:. Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NAB fi Biochemical Oxygen Demand (BOD 530 mg /L ■ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ■ NA ❑ At -Grade ❑ Mound <`r Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other. E3 NA Other: ❑ NA Other: ❑ NA` 'Values typical for domestic wastewater and septic tank effluent. Other: C3 NA' MAINTENANCE SCHEDULE z= Service Event Service Frequency x ❑ month(s) (Maximum 3 years) • ❑ NN Inspect condition of tank(s) At least once every: 3 ■ year(s) Pump out contents of tanks) When combined sludge and scum equals one -third (Y of tank volume ❑ NA ,' ❑ month(s) (Maximum 3 years),:,:! Inspect dispersal cell(s) At least once every: 3 ■ year(s) Clean effluent filter No -de�a At least once every: 1 year(s) month(s) arl l(s) ❑ ■ Np Inspect pump, pump controls &alarm At least once every: ❑ month(s) ❑ year(s) ❑ month(s) ■`"j�p Flush laterals and pressure test At least once every: ❑ year(s) MAI ❑month(s( Other: p At least once every: ❑ year(s), Other: ❑,N MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifica Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Ope .1 . f .1 1 . inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks:of - n u �d�su a. effluent o the ro 'n u s - p or ondi efflu 9 p g of measure the volume of combined sludge and scum and to chec for an bac k The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check forany,,;pon of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requir immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with. chapterNR Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters; mechanical or pressurized components, pretra units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of-any service event.', pop of c: START UP AND OPERATION For now construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal Collis). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) in one large dose, overloading the cell(s) and may *result in the backup or surface discharge ''Of , effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls ° to , restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. , Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of1he POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; -fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil,' painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is } �l properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. r ua. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant replacement system: h ■ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorpti , system. The replacement area should be protected from disturbance and compaction and should not be infringed upon,by, required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement Mae will u' result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with thequies in effect at that time. V # ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installe s a last resort to replace the failed POWTS. i� Th site a not bee valuated to ' entify suitable epla ement are Upon fait a of the S a so' S IR eva uat' n m t be erfo ad to I ate a sui ble re acemen area. no replace ent ea ' availa olding,t� y ma instal a last r ort replace the f ' OWTS. 11 Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. #. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN DO.; NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OfFA PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Owners choice John Schmitt Phone Pho (7 15)-549-6651 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Owners choice St. Croix Ct Zonin Phone Phone (715)-386-4680 C ,,' This document was drafted in compliance with chapter Comm 83.22(2)Ibl(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administratn►a .,,. { y ST CROIX COUNTY SEPTIC TANK MADUENANCB AGRBEMBNT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer mlKt 6c, fli- 1A) (5,e ,410a L a Mailing Address 71Z / Property Address ( 14 � (Verification required from Planning Department for new construction) 0 31- /04 10- 80 - coo City/State Parcel Identification Number - - l) ty � LEGAL DESCRIPTION Location %., S W %4, Sec. T N R W, Town of S O mElse T Prop —�- � Subdivision b 4ol AJS 4 e- es Lot # Certified Survey Map # A - oolume Pag Warranty Deed # t a A.2 - 3 . Volume 9 1 Page # .5 6 Spec house W yes ❑ no Lot lines identifiable ® yes ❑ no SY- SW — M CE Improper use and maintenanceof 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 )`he 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 masterphrmber, journeyman plumber, restricted plumber or a licensedpumper 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. Ilwe, 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 da ys of the three year expiration date. I x tz< /0 ` SIGRATtM 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 p roi rty described bove, by virtue of a warranty deed recorded in Register of Deeds Office. Al SI TURF OA APPLICANT DATE *s « « *s 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 U 1952P 585 N 66"7n37 STATE BAR OF WISCONSIN FORM 2. 1999 KATHLEEN H. WALSH ' WARRANTY DEED REGISTER OF DEEDS Document Number I ST. CROIX CO., VI This Deed, made between Walter E. Germain and Debr C. — RECEIVED FOR RECORD G husband wife, —. -.__- ____. _— 08 -20 -2002 9:30 AN - - WARRANTY DEED EXEMPT 1 Grantor, and Grand PK2perties, LP • _ REC FEE: 11.00 ' — TRANS FEE: 916.50 - - _ - — -- — COPY FEE: CENT COPY FEE: Grantee... — — —. -- PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Cr ___ County, State of Wisconsin (if more space is needed, please attach addendum): The W 1/2 of SW 1/4 of Section 14, Township 31 North, Range 19 West, Recording Area R p n Wisconsin, EXCEPT and 2 of Certifie urvey Map in Vol. I, Page 236, Doc. No. Name enKR�et�tr�rA4rS GLAND T nd 4 of Certified Survey Map in Vol. 3, Page 746, Doc. No. AnpRNEY AT LAW C P.O. BOX 359 f Certified Survey Map in Vol. 9, Page 2454, Doc. No. 480266 HUDSON W 1 5 4016 4 and 5 of Certified Survey Map in Vol. 10, Page 2889, Doc. No. 032. 1040.80-0 03 1041.10 -0 00 _ —.,_ Parcel Identification um er This _ is n -- homestead property. 0{) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. I . q'4, Dated this L day of June _ 2002 W alter E. Germain _. - - -- - -�_- — -- ' -- - - -- - -- � Debra C. Germain - AUTHENTICATION ACKNOWLEDGMENT Walter E. Ge rmain in d Debra C. Germain, STATE OF WISCONSIN ) Signature(.) — -- — ) ss. husband wife, -- - — _ — — — County ) authenticated this day of _•tune - , 2002 - Personally came before me this _- day of the above named Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to ntc known to be the person(.) who executed the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, W is. Stals.) - - - -- TIIIS INSTRUMENT WAS DRAFTED BY • J Attorney Kristina Ogla ___ _ Notary Public, State of Wisconsin Hudson, WI 540 - - My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) -- — — — — —' — —'— — hdormatian Prdsuiw4 ComtNrW, FOM du t►'. WI 'Names of persons signing in any capacity must'm typed or printed below their signsturc. $004W STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2 . 1999 l o o l • \� \ ` / i 1 nti.•o .r.. :«:. i w f, R i -*eat - i ^ I I L.ur" t7!n'. -""" . t+r�.+'�s�..�, r..i.. � \ 21 , 5 � \ ` ` / � i�},•Yr -r- rwr...v;;� yY�,�q �.�..�i �.y„� � l�S;e:.r � \ \ \ -- 1281.70' - \ ` / - 317.55 �— —\ �— -.;;-303.36 \ \ 3 — --�- 7 -- � a 312.00' — — 301.17' -- — 363.00'. �3 f - 2 � 20 ' / / ./ ^ \ \ \ B3 •\ I 1 00' BUILDING SE W #�� ( ,', 1 � LOT 2 \ LOT 3.01 ACRES i 1 \ ° 0 1 J. ACRES \ �; r ^ 3.38 ACR. 81 ;;131, 040 SQ. FT. I 131076 SQ. FT. 1 147,238 S4 I ( / Existing fence 0.5 f west of property line 312.00' ✓ \ 323.00' N01'33'19 "W 1700.94 1 r I 1 \ 960 BOON (NO N * �/ . 6 p 1 ye \-' �j Jerk X 6 tye ,\,, } �e I � �e I Cs w `.a 4 r n N O n N O 3 0 C C m f C ,°: f C 10 C CD C + � 3 lD 7 fD 3 �• � •O I m A ID � lD Z ° = Z Z ° can c° �°� a 0• O N 0 C) CD ! O N .fie (D N =r 0 CD O N 0 m CO N r j v 7 0 m CL w ° Ch y c rn l r �° ? cn Z D M a m N Z D a o DN a co DN 0 . W m CL c °° m a c ° O -� w rn c O con o 'I so m a °� p -I N N N 4� = it N c C to 00 = c '! 3 a • c r ? p CO) S O O g O 0 0 0 0 `ft 3 3 vitivi - 1 j U) � a wD v v v c o v v° ° tG ID Q� �1 _ fir ID fG 0 3 m m 3 m v 3 :3 m 0 0 O ° O 0 0 v -0 m m m o m ;o m p N C c CD C N c N I a a 0 m m 0) -� y 0 a 3 A z A CD CL a z 0 .. m CD m co c 3 a 9 A z 0 0 ^' 0 m o m m 0 CD �ma c ca m f N p (D N d m3 0 c y im a S' my m o cm' F5F3amm c 3 to CD CD a v m w v o a y m 3 m CD CD n Cn 0 n =v W C O D , 9' a CL U)i °_' 0 4 A ! n ! CD m F j Al � I 3 m g. 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