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HomeMy WebLinkAbout032-1059-90-110 Parcel #: 032 - 1059 -90 -110 0312812008 03:29 PM PAGE 1 OF 1 Alt. Parcel #: 22.31.19.299A -10 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - MAMER, DAVID J DAVID J MAMER C - NELSON NAOMI L NELSON NAOMI L 2016 60TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 60TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.230 Plat: 4358 -CSM 16 -4358 SEC 22 T31 N R1 9W PT SE SE FORMERLY LOT 2 Block/Condo Bldg: LOT 7 CSM 10/2742 NKA LOT 7 CSM 16/4358 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 22-31N-19W SE SE Notes: Parcel History: Date Doc # Vol /Page Type 04/19/2004 759993 2551/443 QC 09/09/2002 689690 1971/207 WD 1078/66 PR 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.230 49,100 86,500 135,600 NO Totals for 2008: General Property 3.230 49,100 86,500 135,600 Woodland 0.000 0 0 Totals for 2007: General Property 3.230 49,100 86,500 135,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 575 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r — - Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety/ and 8uildi!ng Division INSPECTION REPORT Sanitary Permit No: 430204 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)J. Permit Holders Name: City Village X Township Parcel Tax No: Mamer, Dave I Somerset Township 032- 1059 -90 -110 CST BM Elev: Insp. BM Elev: BM De cri tion: Section/Town /Range /Map No: (o /' fl /OL DS OM 22.31.19.229A10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Be h ark /004 l7 0/. Q D/ •O S' Dosing / Alt. BM fj �p 6 d .Sr. Aeration Bldg. Sewer 4- r yo /a S 9�• 3 Holding St/Ht Inlet D 7 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L aWELL BLDG. VenttoAir ROAD Dt Inlet oL t" Septic ���/ 3 3 , Dt Bottom Dosing Header /Man. J (e Aeration Dist. Pipe y Holding Bot. SystWOO `Zr �� y 17, PUMP /SIPHON INFORMATION Final Grade / S -' Manufacturer Demand St Cover / GPM 4 5 ' a Model Number TDH Lift Friction Loss System Head TDH Ft Forc ain &166 Dia. v Dist. to Well w 16 6 2 SOIL A SORPTION SYSTEM BEDITRENCH Width Le No. Of Trenches PIT D No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM L A Manufacturer: INFORMATION A BER OR _ Typ�C�fjS sty em: / ,�// IT Modgl Number � V tQ�/k'C� 1/ S YD✓l�V DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size I x Hole Spacing Ven Air Intake 9 i l_engt� )� p g Len th Dia ' Dia S acin � SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over 4- Depth Over xx Depth of xx Seeded /Sodded 67 xx Mulch d 6 Bed/Trench Center 1 � Bed/Trench Edges Topsoil �` S� Ij Yes Yes [ ; o COMMENTS: (I 8 60th S Somerset, set, WI 54025 (SE 1/4 SE 114 22 T31N R19W) NA Lot lu code discrepencies, persons present, etc.) Inspection #1: / Inspection #2:/ Z Location: 2018 t er �b� arcel No: 22 1.) Alt BM Description = 2.) Bldg sewer length = 3 J� 6 �� " , Cl� a Q A - amount of cover = S ��'� Aj- jt4- � 3.) Contour = 9 - T Plan revision Required? 'Yes �{�� ... -; -3 'D Use other side for additional information. - - -_ �_ - -- -- - SBD -6710 (R.3/97) Date Insepctor's Signat a Cert. No. Safety and Buildings Division City 201 W. Washington Ave., P:O. Box % �► r JC vh4c Madison, Wl 53707 - 708 Site Address Departmento €Commerce PAID (:I+ Sani Permit Number Sanitary Permit application Sanit _ 3 oZ�be In accord with Cotmu 83.21, Wis. Adm. Code, personal information you provide ❑ Chec if Revision may be used for secondary purposes Privacy Law, s15.04(1)(m) I. Application Information -- Please Print All Infopnution State Plan I.D. Number Prope wner's Nwtme Parcel Number C 1 . Zz4Mo� Property Owner's Mailing Address Property Location sF�'AT4CS4,SZZ TV N, /9 1±- City, State Zip Cbde - _Pluute, bwxwsd Lot Nuqjr Block Number v� CSM Number ib 4 H W ?/ . Type of Building (Check all that apply.) y� (xr S H� t ❑ City 13 1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public /Commercial - scribe Use L]Towm ' A+W3 * - ' f - 0 State Owned • JU Nearest Road gn 4 a <�' �� �" s T- III, Type of Per (Check only one box on line Numbering is for internal use.) (Complete line B, if applicable.) A. 09L New 3 ❑ Replacement of 6 ❑ Addition to S ste J 2 ❑ Replacement System Tank Only Existin g System For County use B. ❑Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of POWT System: (Check all that apply. Numbering is for internal use.) 44 ❑ Non - Pressurized lit- Ground 21Iv1ound 47 11 Sand Filter 50 11 Constructed Wetland 22 ❑ Pressurized In- Ground 41 Holding' rank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 OAerobic Tr ent Unit 49 ❑ Recirculating 30 ❑Other V. Dis ersal/Treatntent Area Information: Design Flow (gpd) Dispersal ea Dispersal Ara Soil Application Percolation Rate ystem Elevation Final Grade Requirr i(r Proposed Rate(Gals./Days /Sq.Ft -) (Min./Inch) Elevation q's 700 Wa 40 CS. 97,0 9g, S g" VI. Tank Info Capacity in Total Number Manufactafer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing ranks Tanks r Holding Tank 000 /t0 X Dosing Chamber ce I VII. Responsibility Statement- I, the undersigned, assume responsibility for iustallation of the POWTS shown on the'att u:hed piatw. Plumber's Name (Print) �lyaa(1er's S, nber Business Phone Number �"` 2 Z 151- Plumber's Address (Street, City. State, Zip Code) o t VIII. County Department Use Onl Disapproved Sanitary Permit Fee ❑ Date Issued ss ' Agent Signature (No Stamps) f Grnuudwater � Approved Owner Given Initial Adverse Surcharge Fee) Q 3� Determination O} , 2003 IX. Conditions of Approval/Reasons for Disapproval Att & complete plans (to the County only) for the system on paper not Iess than 8112 x 11 inches to size SBD -5398 (R. 05101) I i p I I i [ I t I : : I Ir !� ... 11 I I i t ' I v oki t -- ---- I r (_. r -S G .SY -_ _ _ l - ... 1. -_ - - - -- - I _ Ad R E PO D NC 1 ...._t.._.... j. __.__ .. - .. _. - - -. - { l . .. ......... - ------ _ -- -_� __ ► ...... _ Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TD #: (608) 264 -8777 Visconsin www vnww.commerc . o ns ov .wiscnsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary July 16, 2003 CUST ID No.221471 ATTN. Rod Eslinger DENNIS J GILLE ZONING OFFICE GILLE TRUCKING & EXCAVATING, INC. ST CROIX COUNTY SPIA 352 140TH ST 1101 CARMICHAEL RD AMERY WI 54001 -2840 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/16/2005 Identification Numbers Transaction ID No. 885036 SITE • Site ID No. 661603 Dave Mamer Please refer to both identification numbers, 60TH St above, in all correspondence with the agency. Town of Somerset St Croix County SE 1/4, SE 1/4, S22, T31N, R 1 9W FOR: Description: New 3BR Mound Object Type: POWT System Regulated Object ID No.: 910840 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: P JXXV P` . • Note the adjustment on depth of sand needed at downslope side of the mound on Pg 3. o�d.� Also Address • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of Q let o the POWTS explaining that periodic cleaning of the septic tank out filter is required. The access opening g Ot used to service the filter shall terminate at or above finished grade with a watertight cover. p� VSfi�a • This system is to be constructed and located in accordance with the approved plans, the "Mound Component Manual for Private Onsite Wastewater Systems Version 2" SBD- 10691- P(N.01 /01).� S • The pressure network is to be constructed in accordance with publications SBD - 10706- P(NO1 /O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)" A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or componen DENNIS J GILLE Page 2 07/16/2003 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address i lett erhe a d. on th Lett ea d. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 "ennisSorenson Wastewater Specialist, Field Operations �tTiS11r1AR code: 7633 (608)785-9336, Mondays 7:OOAM- 3:45PM dsorenson @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Gille Trucking & Excavating Inc I i I 1 r MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Commercial Application CFA INDEX AND TITLE PAGE it// v ��D sgF 2 6 loo, Project Name. DAVE MAMER Owner's Name: DAVE MAMER 0 Owner's Address: 2024 DESOTO ST. # 8 MAPLEWOOD MN. 55117 Legal Description: SE SE S 22 T 31 NR 19 W Township: SOMERSET County: ST.CROIX Subdivision Name: Lot Number: -- Block Number: Parcel I.D. Number: Plan Transaction No.: E SYSTEM Page 1 Index and title Page 2 Data entry jttal � J Page 3 Mound drawings Page 4 Lateral and dose tank VED Page 5 System maintenance specifications A, () Page 6 Management and contingency plan ETY AWSUt Page 7 Pump curve and specifications (� iRESPOND Designer: DENNIS GILLE License Number: 221471 Date: 06/2 3 Phone Number: 715 - 268 -6637 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 7 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r. Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 8344 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 450.00 Design Flow (gpd) :� -OM Site Slope ( %) 96.50 Contour Line Elevation (ft) 29.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 75.001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd/ft 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) C Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 1.50 Estimated Orifice Spacing (ft) = 4.50 ft /orifice to Forcemain Diameter (in) orcemain Length (ft) Does the forcemain drain back? C_Y Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 14.68 Forcemain Drainback (gal) 8.08 Vertical Lift (ft) 67.44 5x Void Volume (gal) 3.14 Friction Loss (ft) 82.12 Minimum Dose Volume (gal) 17.72 Total Dynamic Head (ft) 41.19 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia, options choice 0.75 1.25 x 1.00 x 1.50 x 5 x 2.00 x X 1.50 x X 3.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 600.00 Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) 42.00 Total Working Liquid Depth (in) HUFFCUTT IManufacturer 14.29 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.001 Dose Tank Capacity (gal) IZabel IF ilter Manufacturer 14.291 Dose Tank Volume (gal /in) A100 Filter Model Number HUFFCUTT Manufacturer Project: DAVE MAMER Page 2 of 7 Mound Plan View T 1110 B . Observation Pipe 3 ' J K 4-�-- _ 1 • " :.•r;•;.•: j .. Y . eR �, ; �,��..° M A •r•. • •• « •ar .; :'; ld W °: I; I . L - Mound Component Dimensions Down slop toe extension made. A 6.00 ft . �E 9.2- -6@2 in H Efift ft K 7.13 ft B 75.00 ft F 9.50 in z ft L 89.26 ft D 7.00 in G 0.50 ft J ft W 17.62 450.00 (ft Dispersal Cell Area 1 900.00 (ft) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 1 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 98.88 (ft) —� H I F :: ' "'' " — 97.58 (ft) Lateral Dispersal Cell 97.08 (ft) -10- — Invert Dispersal Cell t Elevation E : D . ,.•. . . . .. 5 = � t ma '{ ti� { t { :'� ; 'tip { `{ ' " {`? � ' { •{ ~ ' ? �x '� ry 4 }- _' { ' '�� {{ {�{ J. 'k 'J r'��✓'��{ � {•�'� � '� L,'�' _ ' r'_� ,,. 96.50 (ft) Contour Elevation Q< % Site Slope Geotextile Fabric Cover Shading Key v 1 Dispersal Cell See lateral details on 1Q ® Topsoil Cap .a 1.5 ft . .. Page 4 for number, size, 77 - ' Subsoil Ca 0 c 5 .i ' '_;' and spacing of laterals. ASTM C33 Sand 1° "' '% F Laterals are equally 0.5 ft S : Typical Lateral • ; spaced from the T illed Layer c . �.,.- ,....•..,.•: °° ❑ -.� gg g °�, :;.•, 5 I distribution cells 5 r _':� A re ate d o _ . ::r:.::::.. r:•..�. centerline in the }- A distribution cell (AxB). Project: DAVE MAMER Page 3 of 7 i ICI Center Connection Lateral Lay D i ram Force main connection via tee or cross to manifold at any point. Laterals are ideraic al rJ =39 P S ,k •- Turn -up vdball valve or 1E X 4IEx ( x12 Laterals &force main of PVC Sch 40 aleanoutplug per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in 7 Lateral Diameter 1.50 in Orifice Spacing (X) 5 Lateral Length (P) 36.75 ft Orifices per Lateral 25 Lateral Spacing (S) 3.00 ft Orifice Density 4.50 ft /orifice Lateral Flow Rate 10.30 gpm Manifold Length 3.00 ft System Flow Rate 41.19 gpm Manifold Diameter 2.00 in Total Dynamic Head 17.72 ft Forcemain Velocity 4.21 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and —� Comm W 4 in. min. 16.28 AC Disconnect Tank component is properly vented y F— Attemate outlet location Forcemain diameter HUFFCUTT Manufacturer 2 in. C7" Capacityl 600.00 Gallons 0 /2 Volume 14.29 gal /inch A 0 Weep hole or anti- Dimension Inches Gallons B siphon device A 28.24 403.56 C B 2.00 28.58 P um off e levation (ft) C 5.75 82.12 � 89.50 D 6.001 85.74 D Total 1 41.991 600.00 Dose elevation (ft) 3 " I F 89.00 Alarm Manuafacturer LEVEL ALARM Alarm Model Number DVL Pump Manufacturer IZOELLER Pump Model Number 1140 Pump Must Deliver 41.19 gpm at 17.72 ft TDH Project: DAVE MAMER Page 4 of 7 Mound System Maintenance and Operation Specifications Service Provider's Name =DENNI GILLE Phone 268 -6637 POWTS Regulator's Name ST. CROIX CTY. ZONING Phone 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 r in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft' Maximum FOG 30 mg/L Type of Wastewaterl Domestic Maximum Fecal Coliforml >10E4 7 cfu /100 mL Service Freguencv Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ••............� ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral _ "y Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: DAVE MAMER Page 5 of 7 I� Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Ger2ral This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with Its' component manuals [SBD- 10691 -P (N.01 /01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components, Septic or pump 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 84nches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shalt 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. The operating condition of the septic tank and outlet filter shah be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum 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 a triennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shah be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shah be tested to verity proper operation. If an effluent finer is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: DAVE MAMER Page 6 of 7 I I - PAL 11 X 1111 bAhNfSl7'Y 4. �UfG? l r• ; 1rlUl�f•9 Mttau 3 lift GiVittWCN]' ANL9 fir;' ATflYllVfryNa ttflw- _. rt. Mel'tetct Cdu ,....... _... T.. -. -__ ,..., ss �.� a. rtt „ „sto w _. t to �_ .».._... ...�....__..»..•.. »_....__ to y •_ _ li rsrry 140, - 1.14.0 an a! rtMMU {m �sut ire -• ,t 10 WIT 10.. t CSI.. �a a.uf na trlu - ^" ." _. __ ._... _ ...,__�......,w._ IN a�lr auto 1rGiytlr 4a r �'�..• itl�t(wa r.... —'_ .,....._... _.,.,.._.M.,.....,,«...... ...._«....,..NL...".- ... ---- F .. 1C."'IF VI •r..[' � man . � ,,,..... �.. ...... ..... ._.. -. _ •.. _.. _._ ,•.» ... ..«._ _ ,„, -,- t .1n ... t „fie _� • + nri,..�•1 V "�'” ....yn GNU wu, • Nat . _ Y Ora . ..c rtlll a na ra tt i 1 . a An 1 6310 11.0w Pr?n MtNrrt'G i7Y n� +ril � �li� • aa ,�,, • •.�. n u;r rxu 1.. 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C . i Please print all information Rev' wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). C) �� 3 Property / Ow er Property Location Y 7 Govt. Lot 114.5 - 1/4 T� N R -E-(or Pr p Owner's Mailing Address Lot # 1 Bloc # Subd. Name or 4 'rY 4 t3s`f� �CO -�os i y Sta a Zip Code Phone Number ❑ City ❑ Village LQ Town Nearest Road C715 New Construction use: Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: ----- M s Parent material Flo Plai I ble I ft. General comments and recommendations: C��aJ�mu� � c' JINN 2 ] 2002 ST. Cr�OiY, Z f i^ - - E l Boring # E] Boring I W� I � Pit Ground surface elev. _1's2� � 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 I *Eff#2 s S 1 4 Boring # F1 Boring 1 ® Pit Ground surface elev. , /• 9 ft. Depth to limiting factor 3 '� Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. C nt. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 3 AZ T - IS 3 � s * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * ffluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Name (Pies rint) I Signature CST Number Address Date Evaluation Conducted Telephone Number SBD -8330 (R07 /00) Property Owner Parcel ID # Page of Boring # Boring pit Ground surface elev. — ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consist nee Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 S 3 _ - F—I 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 Boring # ❑Boring ❑ Ground surface elev. ft. Depth to limiting factor in. El Pit 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 (R.07100) Property Owner Parcel ID # Page of -ff F Boring # Boring ,Z Pit Ground surface elev. —21L� ft. Depth to limiting factor - 2 9 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 - v S — C ❑ 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 Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit 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 -830 (R.07/00 ) I I � � �4 `K 4 o e h � s� �n M 4- U � J'r p �1 "1 APPROVED .1 1.. S ., ` ,` ST. CROIX COUNTY �� y ,. , P7amim Zowng and Parks Commitle' ` � tt . TV A. 20O = C'OOGE 6 8 8 4 0 5 VOL 16 PAGE 4358 If rwl recorded within 30 days of g - o - 2 KATHLEEN H. WALSH approval date approval shall be REGISTER OF DEEDS null end void ` ` .` " ST, CROI X Co., M I RECEIVED FOR RECORD C E R T 08 - 28 -2692 9:]5 i A n FI E D S U R V E Y M A P Located in port of the Southeast Quarter of the Southeast Quarter of S i n I ect o 22, Tow IB&t &UR8 a MAP 19 West, Town of Somerset, St. Croix County, Wisconsin, being Lot 2 of Certified Surve pme }fie 2742, Document No. 515270 as recorded in the St. Croix County Register of Deeds Of 1 ces: � 2 m OWNER: O A 0 K e Vonasse i 210 60th Street g 0i = Somerset, WI 54025 yy In Drafted By. Howard H. Herrild III C� D WEST LINE OF THE o i SE 1/4 OF THE SE 1/4 O A m y m� UNPLA r7F17 LANDS 1 N 00'09' 12" E 659.47' z o3.8 - - - -- 8v� d m • O Q1 - q j a rA a 0 w fill g i s $a g o 3 -3- a as in rn lO I•W �� ?ac 7 a W Q. IW r Imo^ I�I�o ` v �u a �' o V a j a, r I Ic o c a w -0 3 la �lo, o w D "' o t b c IA I� � a z m' � N 1� I� g I< a � OD N n ° ? a 00 <D I N 0 0 2 N O 1 u 4 O V N mm � Vp m0 O v OD `o mz wrn ;a 'a n N m Mm p A �� ti r Nr N P? O I� m00 in � g N m00 _ — to Z I� � a g g p co 100'°-- pp, n^ In m �ONm I j ZC�1 N B O `� h Z 1 O o O C W -�+ Iw�n,L�� ~ ° "'II V cir I'`\ I- ; D i A in r 2ro0 I�� I� _ L m m� F � � � � y Zr. I o - rn I� (� ° o m vw I� �J�� m C ` m w 1 o + A o I� S 00'00'09" E ° �, 659.48' (� 365 .46' 294.02' 313' N00'OU'09 "W 6 X24 . - 29402 c+ . 6 .4 u - S00'0009 E JL5.72' at S 00 500'00'09 "E 2651.44' 0 80TH STREETI /�. � T LINE OF THE C- LOT 3 JOB # W057SUSG�T 1/4 OF SEC. 22 SERENI T>' Prepared by. J EO ConsullingGroup,lrx . NOTE: The parcel(s) shown on this mop is /are subject to State, County and Phone No. (715) 246 -4319 Township laws, rules and regulations ( i.e. wetlands, minimum lot size, access Fox No. (715) 246 -3830 to parcel, etc.). Before purchasing or developing any parcel, contact the St. P,0 Box 325 Croix County Zoning Office and the appropriate ]own Board for advice. New Richmond, w1 54017 Sheet t of 2 Vol. 16 Page 4358 ST CROIX COUN'T'Y SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ID r Mailing Address G i�T � �� '`� rn N �5 S Property Address Cd) 7 (Verification required from Planning.Department for new construction) City/State �X rnE U3 t'T w Parcel Identification Number I d S 2_'):�A -��> LEGAL DESCRIPTION Property Location ' / <, 5 C ' /., Sec. ?_Z_ . T a N -R C � W, Town of Subdivision . Lot # Certified Survey Map # 12.5 S'y�`J , Volume --- , .Page # J Q Warranty Deed # �no � � , Volume Page # Spec house ❑ yes IK no Lot lines identifiable JR 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 masterplumber, joumeyman plumber, restricted plumber 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. Vwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin, Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. _)_;� /7 7 izf103 SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT 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 U 1971 P 207 <<' STATE BAR OF WISCONSIN FORM 2. 1999 KATHLEEN 8 6 9 0 SH WARRANTY DEED EE OF DEEDS Document Number ST. CROIR Co., MI This Deed, made between Kyle J. Vana sse _ —. — ._— RECEIVED FOR RECORD — -- — — — 09 -09 -2002 3:35 PM — — — - - -- _ — — WARWM DEED Grantor, and EXEMPT # — — — — REC FEE: 11.00 - -- — TRANS FEE: 150.00 — — COPY FEE: — -- -- -- CERT COPY FEE: Grantee. PAGES: i Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. C _ County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 7Df Certified Survey Map recorded in Volume 16, page 4358 Name and Return Address Document No. 688405 being part of SE 1/4 of SEI /4 of Section 22, 171 rTg 0 LC( a L Township 31, Range 19, St. Croix County, Wisconsin. 3 3 I A� — 'j TN .fT rU lD Metro Legal Services EDIRET 361)(135 A 203490 WD 123691 P t032- 1059 - -100 Parcel Identification Number (PIN) This is not - -, — homestead property. 0{) (is not) Exceptions to warranties: Easements, restrictions and rights - of - way of record, if any. day of Au st 2002 u Dated this Y �— _— . —. - -• — • Kyl i - AUTHENTICATION— ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) Kyle J_Vanasse — - -_ - -_, —__— ) ss. County ) authenticated this 7 day of August _, .2002_ Personally came before me this day of the above named r Kristina Ogland — — — — TITLE: MEMBER STATE BAR OF WISCONSIN to me 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 i — ._-- - - - - -- - - -— Attorney Kristina O H _ Notary Public, State of Wisconsin son — —. —. — My Commission is permanent. (1f not, state expiration dale: (Signatures may be authenticated or acknowledged. Both are not necessary.) * pmtnsanels company. FoM du Lw WI Names or persons signing in any capacity must be typed or printed below their signature. Inlormalion , STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2 - 1999 ST. CROIX COUNTY l mnlnn Zoning and Pe *e C Q"Ute TV •. y � 6 a E3 -+ 0 3 • AUG 2 8 2002 DODGE � VO1.� 10 _pAGE 4358 S•2484 CLEAR LAKE, r 7 — 2 $ - a Ht►THLEeM H. MALSN not,omded wl'thin 30 days of �ry wI REGISTER OF DEEDS tpprovel date spproval jhall he a, C Q• �• nA and void �' °r tiOSUR`1SA0P 8T• CROIY CO• MJ �•NINHnMtd <•`�� RECEIVED FOR RECORD C E R T I F I E D S U R V E Y M A P 08 -28- 2 6 912 `'g AM Locat44 In part of the Southeast Quarter of the Southeast Quarter of Section 22. Tow I aFBt P9 MAP A M 19 West. Town of Somerset. St. Croix County, Wisconsin, being Lot 2 of Certified Surva me a 2742 Docurnent No. 515270 as recorded In the St. Crolr County Register of Dead@ Off St 2 z OWNER: Em . -� KO Vonaase 20t0 600h Street �+ Somerset, Wi 54025 Di $ Drafted BY Howard H. HerrIld IN WEST LINE OF THE ir Fn ir SE 1/4 OF THE SE 1/4 g I V�Va4 7 CANQS I 00'09' 12" E 659.47' ��n1 g • 0 �1 rb U y N o CO I to OD It� I , NN mp e = � � 3 w W g i l t b . w N LA !� ��c1e le I_ r, on -1 A. o N z► f1 i b, rn a C w v , i � c i o rn Lo zi p1lopo Ea (r I 00'00'09 E c 689.48' - 365 .46' 294.02 3' � , N! 00'00'09"w Jr, i24r. o, " 0 000 E J a' 00 58.4 E 6 S00'OU'09 "E 25$1,44' a B_ 8 7�L _ S I R E.5 T� EAST LINE OF THE C JOB / WI0675US; 1/4 OF SEC. 22 SERENITY Prepared by. �EO COM ft Geajm NOTE; The parco(s) shown on this mop Is /are subjdat to Stale, County and Phone No. (716) 245 -4319 Township lows, rules and regulations ( i.e. wetlands, minimum lot.site, access Fax No. (71 5) 246 -3630 to parcel, etc.). Befor@ purchasing or developing any parcel, contact the St. PtO. Box 325 Croix County Zoning Office and the appropriate Town Board for advice, New Richmond, WI 54017 Sheet 1 of 2 V01.16 Page 4.158