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Home My WebLink About032-2163-11-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTt'� T!>a PERMIT) 453122 0 GENERAL INFORMATION 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. Somerset Township 032 - 2163 -11 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 1�) W1. C- 14.31.19.1403 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark CS_ �b ion •K, 166 Dosing Alt. B NA A e� 4 - 1&n, 6�4, 1 to .$� Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet lb Zb �✓�• Zf TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / 57 ' e- - Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Co (1, W6 7 3 ?7 Holding ot. System • I I F2 15 q PUMP /SIPHON INFORMATION Final Grade / 7 Manufacturer Demand St Cover Aerp M 2' Z y /6Z 15 Model N er TD Lift Friction Loss em Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length, No. Of Trenches PIT DIMENSIONS No. Of Pits Insi Dia. Liquid Depth DIMENSIONS '3 U, Z, 7— 1 \ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufac INFORMATION CHAMBER OR 1__ A Type / Of O S �� e a (, � I 1 1 - 7 1 J� A UNIT Model Number` a f DISTRIBUTION SYSTEM ID �1�� // �e��e. Z 1 7 d- I— Header/Ma iiffol i �� Distributi n \ x Hole Size x Hole Spacing Vo A ir Intake 7 Pipes) U' Length Dia / Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only � Depth Over Depth Over xx Depth o xx Seeded /Sodded xx Mulched Bed /Trench Center / _ 1 \ Bed/Trench Edges \ Topsoil ` p \ r! (� Yes No No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: o /233 / 7 Inspection #2: / / Location: 2137 62nd St nkn (NW 1 S 1/ 1 14 T31 R1 9W) Ga vin's Acres Lot 11 ' / Parcel No: 14.31.19.1403 1.) Alt BM Description = 2.) Bldg sewer length = 7 P , r - amount of cover = - q2-" S A r+, 4 ; Plan revision Required? Yes No r d Q Use other side for additional information. 6�� S Date Insep C rt. No, SBD -6710 (R.3/97) '5 j \ f S4ell Safety and Buildings Division County _ N viscons i n P.O. Box 7082 ' 201 W. Washington Ave., /, a 0/ Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce — (608) 261 Z 5 / �)— D-- Sanitary Permit Application State Plan I.D. Number A In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide /" t may be used for secondary purposes Privacy Law, s 15.04(1 xin) roject Address (if di ffer6nt than mailing address) JV I. Application Information — Please Pr 11 Information Property Owner's Name a 0 2 / 3 Parcel # Lot # Block # Property Owner's Mailing Address Location YJUD 71_ , City, State Zip Code Phone Number S %, Section r - �0 / -/ 1- 12 �'X;; a ciE or IN o ) T N; R . Type of Building (check all that apply) -d IN 1 or 2 Family Dwelling — Number of Bedrooms [/jn Q/)Z ttPif �Qr S ubdivision Name CSM Number ❑ Public/Commercial — Describe Use ❑ State Owned — Describe Use OZ D /s 6 87,6 J� 7 // ❑City ❑Village Township of . /'r III. Type of Permit: (Check only one box on line A. Complete line B If applicable) A ' New System ys 11 Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl ® Non — Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explai ) V. Dis ersaVrreatment Area Inf r ation: 7 d D 1 FUSE 7 / Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (so System Elevation L/ SD , ` 6 Y 3 1 96. F VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic New Gallons Gallons of Units // 1G /j J � cnetc Const�tcted Glass Existing Tanks Tanks Septic or Holding Tank U � Aerobic Treatment Unit Dosing Clamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installatio the POWTS shown on the attached plans. P hi PRS N mber's Name (Print rcr's Signature MP um Business Phone Number Plumber's Address (Sheet, City, State, Zip Code) \ �j VIII. ountv /De artment Use Onl Approved ❑ Disapproved Sanitary P ermit Fee (includes �Grou� ter Date sued Issuing ent igna re (N ps) 11 Owner Given Reason for Denial ) oC IX. Conditions of A provaUReasons for D' pprov 1 Septic tank, effluent filter andh�� dispersal cell must all be serviced / maintained ��J, 7E — gev..t � lYI� as per management plan provided by plumber. / �3 2. All setback requirements must be maintained as per plicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 Inches In size SBD -6398 (R. 08/02) TON / o / o G G 1Q4 0 - - - - - -- L ly - - - -- -_ - -- -- - - - - -- -- - PRopast Z/7 IV r = :YQ''_ ZiYS124F C -_ -_ -! _ 1 o Z — - --- - - - - -- -, b, f3- - C,7 — �11C CRS — -- �� — 98' til _ - - -- -- f -to pRoposr� _ _ , i ?I�Z- Af�)-,-A r I , DI! 1123 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 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. Please print ► Re ewes By cv pate Personal information you provide may be u for (NA�, s. 15. (1) (m)). l 2 Property Owner P perty Location Grand Properties, LP 1i vt. Lot NW 1/4 SW 1/4 S 14 T 31 N R 19 W Property Owner's Mailing Address t # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 sr' c'r,Ulx COUNT 11 Gavin's Acres City State Zip E City Villager Town Nearest Road Somerset WI 54025 715 247 - 5900 Somerset 1 60Th St. W, New Construction Use: i✓ 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: Ar table for a conventional system with a 0.7 gpd /sgft rating. Possible system elevation for Area I 96.80'. tope is 7 %. Boring # Boring WA o n � �,.0 • Vr Pit Ground Surface elev. 100.26 ft. Depth to limiting factor >94 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture structure Lure Consistence Boundary Roots GPD/f 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 *Eff#2 rr 1 0-9 1Oyr3/3 none sl 2mgr mfr as 2f .5 .9 p 2 9 -13 1Oyr4/4 none sl 2fsbk mfr gw - - - -- .5 .9 tP 3 13-94 1Oyr5 /6 none ms Osg ml - -- ---- -- .7 1.2 , C( / g6.3o �f�•s� 83- 2 ' Fil Boring # -_ Boring Pit Ground Surface elev. 100.26 ft. Depth to limiting factor >90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfi in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 *Eff#2 1 0-9 1Oyr3/3 none sl 2mgr mfr as 1f .5 .9 2 9-19 1Oyr4/4 none sl 2msbk mfr gw -- -- 5 .9 3 19 -24 1Oyr5/4 none Is Osg ml gw - - -- .7 1.2 4 24 -90 1Oyr5 /6 none ms Osg ml - - -- - -- .7 1.2 , 1. * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = B09 S30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Thomas J. Schmitt c'' 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 6/15/02 715 - 549 -6651 r Propetty Owner Grand Properties, LP Parcel ID # Page 2 of 3 31 Boring # Boring Pit Ground Surface elev. 97.86 ft. Depth to limiting factor >96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stnucture Consistences Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10yr3/2 none sl 2msbk mfr as 1f .5 .9 , ( 2 7 -22 10yr4 /4 none sl 2msbk mfr gw --- .5 .9 3 22 -31 10yr4/6 none Is Osg ml gw - - -- . 1.2 4 31 -96 10yr5/6 none ms Osg ml - -- - -• -- .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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efl#1 *Eff#2 ❑ 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 * 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 —A —f—;.1 ;n — oItae•nots f-+ .t -1.— at F.(15t_7(.!._11 G1 — T tnR- ')tA_Q777 • Pa.9z 3 a � A � $� ac ' qo 94 J r►1 p r p or ke-s b - v�0.�w 4 J avwt & S S m I li�rc�w IX � � � � 1 i � �" �I y cs �r� a a � q. Sw�e 16D S 8(s t/e,t1ey (Jre� `Gr� a,�.� $$gyres C? r t ST. CROIX COUNTY WISCONSIN ZONING OFFICE { N N N N N Igo ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road •.. _ .�. �-- -- Hudson, WI 54016 -7710 - (715) 386 -4680 FAX (715) 386 -4686 February 7, 2003 Allen Schlipp JEO Consulting 250 Paperjack Drive, Suite 3 PO Box 325 New Richmond, WI 54017 RE: Gavin's Acres Final Plat Dear Mr. Schlipp: On February 5, 2003, the St. Croix County Technical Review Committee reviewed the subdivision map for Gavin's Acres located in Section 14 of the Town of Somerset. The committee made the following comments: 1.The road not built between Lot 12 and Lot 13, and road extension of 210 Avenue will need the enclosed Roadway Easement Agreement completed and returned. 2. Use Low Building Opening "LBO" rather than MFFE of FFFE. 3. Lot 9 must have driveway built beyond the drainage easement prior to septic permit issuance. 4. Lots 10,11, 13 and 15 must have driveway constructed to 100' setback line prior to septic permit issuance. You may be receiving comments from the Surveyor's Office. All revisions should be submitted to our office 10 days prior to the Planning, Zoning and Parks Committee (PZPC) meeting. You may check with this office to determine when the Committee will hear this plat. If you have questions or concerns, please feel free to call this office. Sincerely, on Sonnentag Zoning Technician - Subdivisions JSrh Enc. Roadway Easement Agreement Cc: Mike Germain Town of Somerset File ST. CROIX COUNTY ` WISCONSIN ZONING OFFICE �\ M t ■ ■ NnRO ST, CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 yam (715) 386 -4680 FAX (715) 386 -4686 February 28, 2003 Allen Schlipp JEO Consulting 250 Papedack Drive, Suite 3 PO Box 325 New Richmond, WI 54017 RE: Gavin's Acres Final Plat Dear Mr. Schlipp: At the February 25, 2003, meeting of the County Planning, Zoning, and Parks Committee, conditional final approval was given to the 16 -lot major subdivision. The parcel is located in Section 14 of Somerset Township. The conditions are as follow: 1. The engineer to verify that a financial guarantee is sufficient to cover the required driveway construction for lots 9, 10, 11, 13, & 15 as outlined in the February 7, 2003 TRC letter. r Minor Map revisions as req sted. Once the above conditions are met you may submit the final plat to our office for signatures. If you have questions or concerns, please feel free to call this office. 7 sin ntag Zoning Technician - Subdivisions JS /jh Cc: Mike Germain Town of Somerset File t 1123 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 ordimemsions, north arrow, and location and distance to nearest road. 7eviewed l I.D. 2 ^� �� LD Please print all information. y . Date /! Personal information you provide may be used for secondary purposes (Privacy Lary, s. 15.04 (1) (m)). Property Owner Property Location , Grand Properties, LP Govt. Lot NW 1/4 SW 1/4 S 14 T 31 N R 19 W Property Cwvner's Mailing Address Lot # Block # I Subd. Name or CSM# 712 Rivard Streeet, Suite 300 11 Gavin's Acres City State Zip Code Phone Number City ; Village y Town Nearest Road Somerset I WI 1 54025 715 - 247 - 5900 Somerset 1 60Th St. New Construction Use: y Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD i 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 96.80'. Slope is 7 %. Boring # _: Boring V. F Pit Ground Surface elev. 100.26 ft. Depth to limiting factor >94 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G PD / ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2 1 0 -9 10yr3/3 none sl 2mgr mfr as 2f .5 . 9 2 9 -13 10yr4/4 none sl 2fsbk mfr gw - - - - -- .5 .9 3 13 -94 10yr5 /6 none ms Osg ml - -- - - - - -- .7 1.2 F2 Boring # _.: Boring Pit Ground Surface elev. 100.26 ft. Depth to limiting factor >90 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 -9 10yr3/3 none sl 2mgr mfr as 1f .5 .9 2 9 -19 10yr4/4 none si 2msbk mfr gw - - - - -- 5 9 3 19 -24 10yr5/4 none Is Osg ml gw - - - - -- 7 1.2 4 24 -90 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 k�' 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 6/15/02 715 -549 -6651 res p P B = 7& Alt-) 1 9 n -b r u w ��► G na..� Ql Oru�,a �� 6 J'. �tar1 a S �. P r oP orkos C, �. m 1 l,n4- a. v��' 14 �.r�s C ?� s) sq q� 6� s w� c �° isw n S 1, r �1 0 + Jancrs- f Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 Boring # ' Boring Pit Ground Surface elev. 97.86 ft. Depth to limiting factor >96 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD /R' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -7 10yr3/2 none sl 2msbk mfr as 1f .5 .9 2 7 -22 10yr4 /4 none si 2msbk mfr gw - - - -- .5 .9 3 22 -31 10yr4/6 none Is Osg ml gw - - - -- .7 1.2 4 31 -96 10yr5/6 none ms Osg ml - -- - - - -- .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 PDJ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#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 GPDIfV 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 —A —f.Aol in on altr.rootA lr—t -lama nnnt —t 0'. iianortmPnt wt lr1R_7/.h_'3I G I —'ITV Fnft_7��_4777 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT ' AND, OWNERSHIP CERTIFICATION FORM Owner/Buyer �' 4/4 Na Mailing Address 7/,2_ %J a a a S% Property Address 13 7 " "j S (Verification required from Planning Department for new construction) City/State T �i ` Parcel Identification Number Q -0 3 LEGAL DESCRIPTION 0� Property Location JUJL ' /,, ` Ul '/4, Sec. , TAN -R, _W, Town of i�� .r,L T Subdivision i-A U 1 y 1 �" Lot # _ . Certified Survey Map # , Volume , Page # Warranty Deed 3 2 Volume Page # 5B 5 _// Ll 3 Vey q p . s� Spec house ❑ no T,Ot lines identifiable 11 yes ❑ 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 septicisystem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 davg gthe three ,vea� i rtCq'n date. - / & /af SIGNAMME OF,"P IC DATE OWNER CERTIFICATION I (we) certify khat all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the,pmperty describe.o abovo; by virtue of a warranty deed recorded in Register of Deeds Office. GNAT? OF LICANT DATE lee p `information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. « « « « «« ss 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 I t , d POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page —2— of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity a l ❑ NA Permit # �-- Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units 1 NA Pump Tank Capacity a l ® NA Estimated flow (average) 0O gal/day Pump Tank Manufacturer M NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer ® NA Soil Application Rate gal/day/ft' Pump Model M NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ® NA Fats, Oil & Grease (FOG) S30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ® In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) ' 100m1 / ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia ❑ NA Other: ❑ NA Other: ❑ NA Other: [3 NA 'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA , MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ® ear( ►(s) (Maximum 3 years) 13 NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once `every: 0 month(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ month(s) ❑ NA ® year(s) ❑ month(s) ® NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ' ❑ month(s) ® NA Flush laterals and pressure test At least once every: ❑ year(s) ❑ month(s) Other: At least once every: ❑ year(s) ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may. indicate a failing condition and requires the 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 entire <� contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter N R 113 , Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment . 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. Page 2__ ', START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). 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 cell(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 of the 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 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. 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: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption 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 area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last r ort to replace t failed POWTS. Th s' ha n bee ev uated to id ntify a s tabl replaceme t are . Upon fai re f the PO S soil and it e al u n t b perform to I ate suita a repl cement ea. If o replac ant a ea is av able hold' tan ay a nst ed as a last res rt replac th ailed PO S. 101 ound 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 OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name — Name - Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name L Name �, 7 At CAQ 4K Phone Phone Cam' This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. U 1952P 585 A STATE BAR OF WISCONSIN FORM 2- 1999 A 8 7 S 3 KATHLEEN H. MALSH Document Number WARRANTY DEED ' REGISTER OF DEEDS ST. CROIX CO— MI This Deed, made between Walte E. Ger main and Debr C. _ RECEIVED FOR RECORD Germa husban wife, -- - -_ - 08-20 -2002 9:30 AH -- -- - — WARRANTY DEED -- - -- -- EXEMPT N Grantor, and Grand P rop ert ies, LP —. ... - REC FEE: 11.00 — -- -- — TRANS FEE: 916.50 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in S t . 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, St. Croix County, Wisconsin, EXCEPT: Recording Area 1) Lots l and 2 of Certified Survey Map in Vol. 1, Page 236, Doc. No. Name and R Ad r OGLAND 332995; 2) Lots 3 and 4 of Certified Survey Map in Vol. 3, Page 746, Doc. No. A P O BOX 359 W 353786; W 1 540 6 3) Lot 5 of Certified Survey Map in Vol. 9, Page 2454, Doc. No. 480266; HUDSON, 4) Lots 3, 4 and 5 of Certified Survey Map in Vol. 10, Page 2889, Doc. No. 526637. 032 - 1040 -80- 0 00;0 3 2 - 104 -10 - 000 — —_.— Parcel Identification Number (PIN) This _ is n homestead property. 0€) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of June 2002 + + Walter E. Germain - -- — + Debra C. Germ AUTHENTICATION ACKNOWLEDGMENT Signature(s) Walter E. Ge rmain an d Debra C. Germain, STATE OF WISCONSIN ) — -- ) ss. husb w ife - -. - -- County ) authenticated this day of .tune 2 – Personally came before me this — _. -. —. _— day of the above named + Kri stina Ogland — . -- - - -_ - -- TITLE: MEMBER STATE BAR OF WISCONSIN Lo znc known to be the person(s) who executed the foregoing (If not, - - -- instrument and acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Atto Kristina Ogla _— - - -- —_ —. Notary Public, State of Wisconsin { Hud WI 5401 —_ My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) — + Names of persons signing in any capacity must be typed or printed below their signature. I nto met Frotess ona Compoor. Fong coo - tass W s:, tnn - STATE BAR OF WISCONSIN WARRANTY DEED FORNI No. 2- 1999 1123 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I 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 t 1 inches in sae. Plan must St. Croix 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 information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Grand Properties, LP GovL Lot NW 1/4 SW 1/4 S 14 T 31 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 11 1 1 Gavin's Acres City State Zip Code Phone Number City .. , Village ✓ Town Nearest Road Somerset I WI 1 54025 715 - 247 -5900 Somerset 60Th St. ✓ New Construction Use: y 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 96.80'. Slope is 7 %. rec` , Boring # _.. Boring ej Pit Ground Surface elev. 100.26 ft. Depth to limiting factor >94 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD /It' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -9 1Oyr3/3 none sl 2mgr mfr as 2f .5 . 9 2 9 -13 1Oyr4/4 none sl 2fsbk mfr gw - - - - -- .5 .9 3 13 -94 1Oyr5/6 none ms Osg ml - -- - - - - -- .7 1.2 a Boring # i Boring Pit Ground Surface elev. 100.26 ft. Depth to limiting factor >90 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Stnrcture Consistence Boundary Roots GPDIfI' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft #1 'Eff#2 I r. r 1 0 -9 10yr313 none sl 2mgr mfr as 1f .5 9 '.`. 2 9 -19 10yr4/4 none sl 2msbk mfr gw - - -- .5 9 3 19-24 10yr5/4 none Is Osg ml gw - - - -- .7 1.2 4 .24 -90 10yr5/6 none ms Osg ml - - -- - -- .7 1.2 'Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = B02 S30 mg/L and TSS <30 mg/L CST Name (PleasePnnt) Signature CST Number, Thomas J.'Sitt 1 227429 chm n Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valle View Trail, Somerset, WI 54025 6/15/02 715 -549 -6651 t Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 3 Boring # :' Boring Pit Ground Surface elev. 97.86 ft. Depth to limiting factor >96 in. Sol 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- 10yr312 none sl 2msbk mfr as 1f .5 .9 2 7 -22 1Oyr4/4 none sl 2msbk mfr gw - - -- .5 .9 3 22 -31 10yr4/6 none Is Osg ml gw - - -- .7 1.2 4 31 -96 1Oyr5/6 none ms Osg ml - -- - - - -- .7 1.2 Boring # Boring / � 1 Pit Ground Surface elev. 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. nn 'Eff#1 'Eff#2 O - �% /4 �3✓-� �v ®Boring # _ Boring Pit Ground Surface elev. Depth to limiting factor in. Sod 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 o - e /c3 I e 3 a6 -({v 7 ,cv /t ol i 0 l 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. 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