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HomeMy WebLinkAbout032-1060-60-120 Wisconsir'DeFyartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Saf@ty aryl Building Division '! INSPECTION REPORT Sanitary Permit No: 499277 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: Hallas, Ricky & Dianna I Somerset, Town of 032 - 1060 -60 -120 CST BM Eiev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /00 1 g f - v\ \ GS" 23.31.19.306A20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. w r Septic 5• 0 � Z � Benchmark Alt. BM 33 / , g Aeration Bldg. Sewer 3 /C, . Zoo Holding St/Ht Inlet 6 az '7$ . / 7— , TANK SETBACK INFORMATION St/Ht Outlet 1 4- 15 4 7 9 9 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1 Septic , / Dt Bottom Dosing Header /Man. 7- c 7L • 5 Aeration Dist. Pipe Holding Bot. System B • �S• .zAr Final G de , PUMP /SIPHON INFORMATION Pl lJ 3 • Z. 160 Manufacturer Dem nd St Cover �� GP �,� t.�,. 3. Model Number I TDH Lift Friction Loss System Head TDH Ft r�l I 7 1 Forcemain Length Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length / No. Of Trenches ' A PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 113 Z 1(eJ�L1 \` ` SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of Systee I (> Z � / 0 (0 � / 1n UNIT Model Number: a >n� ✓ ✓ �,'o,r_ writ' DISTRIBUTION SYSTEM (' ZZ + Z. = 4 - 1 Header /Manifold D x Hole Spacing Vent to Air ntak� Pipe(s) ` \ Length `f' Dia Length \ Dia \ Spacing c 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 L /_� Bed /Trench Edges \11, Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 680 205th Avenue nknown (SE 114 NE 1/4 23 T31N R19W) NA Lot 3 Parcel No: 23.31.19,306A20 1.) Alt BM Description = S�re�,I'S 2.) Bldg sewer length - amount of cover O Plan revision Required? Yes >(No Use other side for additional information. _ t ILJ Date Insepcto s Sign r Cert. No. SBD -6710 (R.3/97) commeree.wi. ov Safety and Buildings Division County 9 201 W. Washington Ave., P.O. Box 7162 It eon s i n Madison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) rtment of Commerce Y T9 Z 7 Sm Sanitary Permit Applicatio u late Transaction Nu In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form t ap tnmental unit is required prior to obtaining a sanitary permit. Note: Application forms a -owned POWTS Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be ondary / purposes in accordance with the Privacy Law, s. 15.04 I m , Stats. f �7 I. Application Information - Please Print All Information I Fagan Property wner's Name 1 Q E Parcel � 0 - e Property O er's Mailing Address J AN N 1 Zp Property Location N'V Govt. Lot 7 City, State Zip Code �}1 '/4 1 /4, Section + 4z one)— 3 I T le o N; R w 11. Type of Building (check all that apply) Lot # ((( I or 2 Family Dwelling - Number of Bedrooms Subdivision Name Ofr. a�.0 �' 4,400u Block # ❑Public /Commercial - Describe Use r l 6d !� ' a. e C CSM Number ❑ Village of ❑ State Owned - Describe Use l Town of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A" New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) ❑ Change of Plumber List Previous Permit Number and Issued B. El Permit Renewal El Permit Revision ❑Permit Transfer to New Date Before Expiration Owner c IV. Type of POWTS S stem /Com onent/Device: Check all that appl Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required Dispersal Are posed (sf) System Elevation / i VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tanks n 2 0 B 5, 9 ,°' o 1✓ P o �o �1. sz a U iz w a Septic or holding Tank Dosing Chamber VII. Respo sibility Statement- I, the undersigned, assume respon ' ility for installation of the POWTS shown on the attached plans. Plumbe 's am (Print) Plumber' ign c MP /MPRS Number Business Phone Number I Plumber's Address (Street, City, S te, Zip Code 1 1 VIII. County /De p artment Use Onl � Permit Fee �77,��0 Issuin ent Signa re Appro�cd D $ IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1. Septic tank, effluent finer and dispersal cell must all services / maintained as per management plan provided by plumber, 2. AN setback MMirements must be rn-intalmd as per 0- 11 1 *11,111MV f. system and submit to the County only on paper not less than 8 1/2 x I1 inches in size SBD -6398 (R. 01/07) Valid thru 01/09 r � �f� ����G9�Y- Jo e �\ j / � — �C /�,d l � Ake- j U \ Al ilk vivo _ 1� �� ,_ 8 S pT J i NP i SC O n Si n L EVALUATION REPORT #2041 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service 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 I.D. 0:3 Please print all information. r�Re #e d By Date Personal information you provide may rrva y Law, s. 15.04 (1) (m)). Property Owner Property Location J.G. Hause Construction Govt. Lot na SE1/ , NE1 /4, S23, T31N, R19W Property Owner's Mailing Address C Luuu Lot # Block # Subd. Name or CSM# 14791 60th St. N 3 na CSM Vol. 8 Pg 2148 City Stab Zip Bijd& er City E j Village Z Town Nearest Road Stillwater IVIN Somerset 205Th Ave Z New Construction Use: Z Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD El Replacement ❑ Public or commercial - Describe: na Parent material outwash Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 9 7.55ft. Trenches spaced and depth to code 4. 92ft below g rade or and recommendations: to be determined at the time of installation. F 1-1 Boring # Boring Pit Ground surface elev. 98.15 ft. Depth to limiting factor 100 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 -17 10yr3/3 none sl 2msbk mfr Cs if .6 1.0 2 17 -36 10yr4/4 none sl 2msbk mfr Cs na .6 1.0 3 36 -74 7.5yr4/4 none Is osg mvfr Cs na .7 1.6 4 74 -100 7.5yr4/6 none Cos osg ml na na .7 1.6 q' Boring # Boring pit Ground surface elev. 98.15 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 1 0 -18 10yr3 /3 none sl 2msbk mfr Cs 1vf .6 1.0 2 18 -36 10yr4/4 none sl 2msbk mfr Cs na .6 1.0 3 36 -66 7.5yr4/4 none Is osg mvfr gw na .7 1.6 4 66 -100 7.5yr4/6 none Cos osg ml na na .7 1.6 / * 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 David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 12/1512006 715 - 760 -0347 SBD -8330 (R.07 /00) Property Owner J.G. Hause Construction Parcel ID # 032 - 1060 -60 -120 Page 2 of 3 3] F Boring # E] Boring Pit Ground surface elev. 101.55 ft. Depth to limiting factor 100 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#t *Eff #2 1 0 -12 10yr3 /3 none SI 2msbk mfr cs iff .6 1.0 2 12 -40 10yr4 /4 none sI 2msbk mfr cs na .6 1.0 3 40 -65 7.5yr4/4 none Is osg mvfr gw na .7 1.6 4 65 -100 7.5yr4/6 none cos osg mI na na .7 1.6 F-1 Boring # L— 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#t *Eff#2 I 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 GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD 5 < 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. Steel's it Service SBD 5330 (R.07 /00) SO + STEEL'S SOIL SERVICE 3 of 3 David J. Steel J.G.Hause Construcion 994200 th St. CST - POWTSM SE1 /4,NE1/4,S23,T31N,R19W Baldwin, WI 54002 Lic. #248956 Town of Somerset, St.Croix Co. Direct 715- 760 -0347 CSM, Lot 3 Fax 715- 684 -3449 Legend N 1" = 40' = Benchmark Ele. 100.00 ft h � } Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.00 ft 37 / i3 ��' l �a b 4 Top of 3/4" pvc pipe ❑ = Borings Boring Elevations 3y BI = 98.15 ft B2 = 98.15 ft B3 = 101.55 ft B4 = 0.00 ft -t3 E 36-6� 9 FrLE.fl S S EP O 81989f' C f 411361 JAMES O'CONNELI ap 0i Deeds SL on" Co CERTIFIED SURVEY MAP LOCATED IN THE SE1 /4 OF THE NE1 14 OF SECTION 23, T31N, R19W, TOWN OF SOMER ST. CROIX COUNTY, WISCONSIN. W1 /4 CORNER OWNER SECTION 23 T6' z NORMAN J. DUFRESNE SCALE IN FEET a 1541 WINDEMERE DR. T31N, R19W MINNEAPOLIS, MN 55421 0' 100' 200' UNPLATTED LANDS 26.84` LOT 3 C SM VOL. 4 , PG. 113 440.00' DOC. # 374,789 1 I N2 °09`15 "E 466.84' w LOT 3 — — — - I 140,170 S.F. (3.218 AC.) _ I a INCLUDING TOWN RD. R /O /W o t4 1ci 132,000 S.F. (3.030 AC.) o �C 1 ° EXCLUDING TOWN RD. R /O /W o M 1 UNPLATTED ` LANDS °off °o ° o a� 27 _ 63 N2 ° 09'15 "E 467.63' X co 440.00' oo w RIGHT-OF- co I ' �WAY LINE 00 �! I HZ zl cn H I cn � wE I_ LOT 2 0 140,406 S.F. (3.223 AC.) o Nt` 1 a INCLUDING TOWN RD. R /Q /W ° L O T 2 CS I I ° 132,000 S.F. (3.030 AC.) V OL._3_ _PG 7 6 6 6 1 EXCLUDING TOWN RD. R /O /W DOC. # 355,157 I, I I S2 ° 09'15 "W 468.42' t 28'42' 351.00' 89.00' + POINT OF I � � UNPLATTED BEGINNING NPLATTED LANDS LANDS U -------- - - -F -- I -- -- - - -- - - - L O T 1 C S M rn VOL. 3 P G . 7 6 5 " N DOC. — # 355,156 �!� E1 /4 CORNER ASSUMED BEARINGS REFERENCED TO E -W1 /4 -SECTION 23 SECTION LINE WHICH BEARS N87 ° 36'3 5 "W. APPROVED T31N, R19W SEP 9 1989 Vol. 8 Page 2148 ST. CRov C(JUN Y THIS INSTRUMENT WAS DRAFTED BY BRIAN V. HALLING NS1vL PA42KS PLAM04+ AND ZCWK Y-- COARAMEE r 12/28/2006 15:20 FAX 1 715 247 5058 BELISLE EXCAVATING Z 007 ST. CROM COUNTY • .tom . SEP7 IC TANK MAINTENANCE AGREEMENT AND - OWNERSHIP CERTIFICATION FORM Ow11e17/130yer_ ( 'Z` C'L - - Nfailirni; Address t Property Address (Verilicu(ia„ rcquire�l tram l'lanniu �1: Zutilng Department for new co —' City /State rizrrj W t Parcel Identification Number C) 2 -- > 0 U -- b O �-- LE DE GRIP ON Property Luc -ation S ), , Al u - Z �. A e �N R v ,Town of � d r s Q. _. � Subdivision G Lot #,. I Certified Survey Map Volume page # Wstrrttut�� Used it Spec house Yes n , �` Lot linen idontitlable n� nv v i SYSTEM i.. MN N D OW NER C ERT . CA TYON , improper use and trtaintenance of your septic system could result in its premature failure to Dandle wastes, proper maintenance consists of pumping out the septic tank every duos years or sooner, the syste if needed, by a licensed pumper, what you put into system can affect the ftulction of the septic rank as a treatment stage in the waste disposals stun, licensed pumper, r responsibilities are specified in gCutnm. $3,52(1) and in Chapter 12 - St. Croix Coup Saui Y maintenance ry t8ry Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification fo owner and by a master plumber, journeyman plumber, restricted plumber of it licensed, signed by the wastewater disposal system is in proper opera dag condition and/or (2) after ' ection and pu pi n (i f g that (1) the on - site less than 1/3 full of sludge,' PPir►B (if necessary), the septic tanl: is Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal s stem with the standards set forth, herein, as set b the Dc artm y ' Y cut of Co P m�rnerc Certificat' c and the D arhnrrmt of Na ton stating that your septic system has been maintained must b returned Resources, State of y pia n i e Department completed and returned rime to th St. $ P nt w'tl ' Croix Ca within .iU days of she tlu'vc year expiration dato, upty Plarwu►g & Zonis live ;;edify that all stutcnleuts uu tlus lw•gi arc true it) tilt• best u!'my /our k,rowledbo, f /we alWare the owner(s) of ffie proporty described above. by virtue of a war►'ut,ty dtcd 1e4vrdcd iu AcAlster of Deeds Office. Number of bedroo s SIGNATURE OF APPLlCANT(S� DATE ** *Any information that is tuisrepresented may result in the sanitary permit being revoked by the Pla & nut � Zonung Ueparunent. Include with this application a recorded warranty decd from the Register ofDeods Of ide and a copy of the certified attrvey rr>ap if reference is made in the warranty dead. (REV, 08105) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner �, Septic Tank Capacity ga l ❑ NA Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units 12� NA Pump Tank Capacity a l O NA Estimated flow (average) gal /day Pump Tank Manufacturer - NA Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer EFNA Soil Application Rate gal/day/ft' Pump Model ANA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit _12KNA Fats, Oil & Grease (FOG) 530 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 Di ersal Cell(s) 0 NA Biochemical Oxygen Demand (BOD _ <30 mg /L In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) _ <30 mg /L I dNA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ 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 eve ❑ month(s) (Maximum 3 ears) ❑ NA ry' Z ear(s) y Pump out contents of tank(s) When combined sludge and scum equals one -third (%) of tank volume ❑ NA Inspect dispersal cell(s) At least once eve ❑ month(s) (Maximum 3 ears) ❑ NA n'' years) y Clean effluent filter At least once every: ❑ month(s) ❑ NA _Ei'year(s) aspect pump, pump controls & alarm At least once every: ❑ month(s) ANA ❑ year(s) 'aterals and pressure test At least once every: ❑ month(s) �'NA ❑ year(s) - At least once every: ❑ month(s) ❑ NA ❑ year(s) 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 NR 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. START UP AND OPERATION Page ,,,2 of For new construction, prior to use of the POWTS check treatment tank(s) 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 an mound or at-grade soil absorption ar ea. Y 9 P 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: XX A suitable replacement area has been evaluated and may b P y e utilized for the location of a replacement soil absorption P P 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 resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ 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 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 Name 1 Phone Phone —� This document was draftee cc- ;pliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) 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 1 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 resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ 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 OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name 'V Name i Phone _ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name l J Phone Phone -� This document was dra- e� c_- -p!iance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. `3 KATHLEEN H. WALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM I - 2000 ST. CROIX CO.. WI Document Number WARRANTY DEED RECEIVED FOR RECORD 01/09/2007 11:20AN THIS DEED, made between Scott J. Hause, a Single Peron Grantor, WARRANTY DEED and Ricky A. Hallas and Dianna M. Hailas, husband and wife as EYEMPT # survivorship marital property, Grantee. Grantor, for a valuable consideration, conveys to Grantee the following REC FEE: 13.00 described real estate in St. Croix County, State of Wisconsin (the COPYSFEE: 201.00 "Property"): CC FEE: PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Land Title Inc. 1900 Silver Lake Road New Brighton n 55112 1 Together with all appurtenant rights, title and interests. 032 - 1060 -60 -120 Parcel Identification Number (PIN) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except PAMELA A. SCHEEL Dated this 8th day f Jan 1 Pubk4A Y January, 2007 .IMt In S * Scott J. HausY AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA ) WASHINGTON COUNTY. )Ss. authenticated this 8th day of January, 2007 Personally came before me this 8th day of January, 2007 the above named Scott J. Hause , a Single Person to me known to * be the person(s) who executed foregoing instrument and TITLE: MEMBER STATE BAR OF WISCONSIN acknowledged (If not, authorized by § 706.06, Wis. Stats.) *Pamela Sch THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Minnesota My commission is permanent. (If not, state expiration date: Larry Mountain, Attorney, 1900 Silver Lake Rd #200, New Brighton, MN 55112 (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 of 2 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 EXHIBIT Part of the Southeast Quarter of the Northeast Quarter (SE % of NE Y4) of Section Twenty-three (23), Township Thirty-one (3 1) North, Range nineteen (19) West, Town of Somerset, St. Croix County, Wisconsin, described as follows: Lot Three (3) of Certified Survey Map filed September 8, 1989 in Vol. 8 of C.S.M., pg. 2148, as Doc. No. 451361. 2of2 Parcel #: 032 - 1060 -60 -120 01/11/2007 03:38 PM PAGE 1 OF 1 Alt. Parcel M 23.31.19.306A20 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 SCOTT J HAUSE O - HAUSE, SCOTT J 613 MEADOW LN SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.218 Plat: N/A -NOT AVAILABLE SEC 23 T31 N RI 9W PT SE NE LOT 3 CSM Block/Condo Bldg: 8/2148 3.218 AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 23 -31 N-1 9W Notes: Parcel History: Date Doc # Vol /Page Type 10/24/2005 810216 2914/510 WD 10/24/2005 01/15/2002 668380 1815/485 WD 07/23/1997 1090/236 LC more... 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 145451 64,600 Valuations Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.218 49,000 0 49,000 NO Totals for 2006: General Property 3.218 49,000 0 49,000 Woodland 0.000 0 0 Totals for 2005: General Property 3.218 49,000 0 49,000 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 �I APR -28 -2000 16:08 FROM:MN /DOT CONSTRUCTION 6512963811 TO:817153864686 P:1/4 Construction & Contract Administratlon 395 John Ireland Blvd. MS 650 o St. Paul, MN 55155 -1898 + o f Fax: 651.298 -3811 Tiransportatio Fax �! `J,� 1 4 �r� �,1. i b✓1 PIe —�in C� 1 ��° 1 — 7 i s — 3 P.- q 6 8 -G Papem =5 . Rea ❑ Vet �o� ReMlew ❑Please Cdn+ntelnt pleaie Roply CI Plooee RoWele - r+& i • APR -28 -2000 16:08 FROM:MN /DOT CONSTRUCTION 6512963811 TO:817153864686 P:2/4 ' Ylflsica +t�ui�p0wrtaiSsolliiaudtry, -: .- .._ � ., _._ ... ..... _... L .h ,sre'Hurnan ReMAona S �o L A N U 411 Ti 6, 9 A L U A i� A ja P O Wf _ of DWjan at Safety a OLAk arw in accord with ILHR 03.05, %M&, 0 4m. Code AtpE 0 complete site plan an paper not leas then 81x2 tc 11 inches In size. Plan fit a Include, Taut F PAARCEL Croix rKK In'Aod to vertical and horizontal ralerar+ce Point (BM), direction and % of 06 a or dimanoicned, north arrow, end location and distance to naerrat rood. 0 -60 -120 APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION DATE PROPERTY OWNER: PR LOCATION Merril G. DeStreich a .L DT SP. 114 NE 1x~,823 T31 ,N,R19 .8(0W PROPERTY OWNERS MAN_ING ADD RMS LOA I 9LOCK N 1 SUBD. NAME OR � 8861 Ideal Ave. N. 3 na 30GA- Cam 146 GI1Y 5 A i E zz��P PHOAIE NUMBE=R ❑ ILLAGF OWN f APSST ROAD 67 � c / Nb1IRZmedi. M. 5511 ?5105 §12 )426 -5320 zeal 205th. A New Consfr'ucOon Use R"denflal / Number of bedrooms 3 (S A041Mon b esisdnp hulldln9 L I ReplavOrnent [) Publla w aomrnerdai descAbe Code deriYed daily flow . go ReWmVer&d deeigrt h a ing rate • 5 bed, gpdMt ' 6 trench, MW Ahsotplion area required 900 bed, 0 750 bon* ft2 Mtndmum d I hrg rate . 7 beO, gpolll - Rsneh, Aammmended infl(tration surlece eleranon(s) 105.18 ( referred to sne plan benchmark) Addhional design tsO meslderadom ' na Parent material outwash plain elevellion, it aWlIcable na R S Sttitabio for system LDM 0 IoNN. �_o A IN•GROUNDPR Rte AT�GRAD 6YFMM W Ftll, M TANK U Unsuitable for s stem i s m s ' bcl s t] u W S u ©S IN u ` u s 11 u -SOIL DESCRIPTION ORT Boring 8 Horizon Oeptn Dominant Color monies Textu structure Comma 8aurtday ficom GPO /ft in. Munsell Ou. St. CoM Wor Or. 52. Sh. Bed 1 0 -10 10yr3/3 alone 91 2mstk mfr ce If .5 .6 2 10--21 10yr4 /4 none $1 1meltK, mwfr car 1£. .4 .5 Ground 3 21-45 7.5yr4/4 none Co 4 Oeg toll Tf na .7 .8 10 9 1 .18 h 4 45 -84 10yr5 /4 Inane £ s Oag m], na na .5 Dspih le IlmMing NOW +84 "� I Remark$: Boring #� 1 0 -10 10yx3 /3 none e1 2ragr mfr Cs 2 2 10 10yr4/4 '. none aft � 1it18bk tti!~ �c na . � � • t3 3 20 - 90 7.5,yr4/6 none f s 05q mv'fr na rid Ground OWN. Deo to Gn�ting tacbor +90 Remarks: T Noime- Pleat" Print � 715-246-6200 G L. Steel Add ress: 1554 200. . Ave. NeV R' d, WT. 54017 Signature: 6 9 Ca d F- 24R- LOO-TSS u2isea v 9 u 1 T 00 i siTT.a..laW 6E =S1 — E3 -� o _ze APR -28 -2000 16:09 FROM:MN /DOT CONSTRUCTION 6512963811 TO:817153864686 P:3/4 PRO jMOwWR. Verr.il G . oestr SOII. DESCRIPTION REPORT Paga01 3 Pr;110 u,m 032 - 1060 --60-120 Depth DominAnt Color Mottles structure GPDIft Boring 9 Horizon Toww C arr Ioard" Know In. Munsell Cu. S4 coat, Color Gr. U Sh. Bed 11ierd) >. 1 0 -10 10 r3 3 none , 1 Zag m a; z Cs 1Z • 5 7 .6 I 2 10-50 7.9yr4/6 none co El Ogg ml gw na -7 .8 I Ground 3 50 - 96 10yr5/4 none f s Osg ntvfr na na .5 .6 elev. 10 . f3 81, ' Depth to Ironing IatlDr . r96'! _ } Remarks Baring # I' 1 0 -7 10 .r3/3 none sl 2msbk mfr cs if .5 .6 . • ' 2 7-48 7.5yr4/6 none co 030 ml gvr na .7 . 3 48 -80 10yr5 /4 none > Ogg ►nuts nn na .5 I .6 t3rpund eler. I 109 it. Depth b Ilrriing factor Remarks: Bo ring r # 1 0 12 10yr3 /3 none 31 2mgr mfr cs if _5 1.6 S 2 12 - 80 7.5yr4/6 n 1 fs Oeq mvfr na na •5 ; - 6 around i IO Uepd+ to limiting � factor Remarks: Boring 0 � Ground r ele". ft Depth to limldng tfiCtG Remarks: sBD- e93otR.bgtr+2) fr'd S2L8 ^LO*-1Sq U21sea 7 9uF100 ,1 SITTJJeN 8c :%T $DOE ZZ 1� V) t5 /v U V O, n ,,l APR -28 -2000 16:09 FROM:MN /DOT CONSTRUCTION 6512963811 TO:817153864686 P:4/4 i STEEL'S SOIL SERVICE Gary L. Steel Merrill G. oest raieh 1554 200th A ve. CSTM2298 SBkNa S23- T31N -B19w New Richmond, W 54017 MPRSW -325 4 town of Somerset (715) 246$200 N 1" =40' BM top of SW ,lot stake at al. 100 � t I I 4�d 1� 1 Gary L. St 5 -9-94 *'d 5249- too -T99 ustsea v 2UtTo41 stttuuaw se :ST R00a 22 .add I I ST. CROIX COUNTY WISCONSIN PLANNING & ZONING DEPARTMENT . :� t � N � N ■ � � • Mn■ ST. CROIX 10 GOVIE RNNMWT Road Hudson, Wl 54016 -7710 Phone: (715)386 -4680 Fax (715)386 -4686 FAX To: From: Fax: Pages: 3 Phone: Z/5 AZ9 Z- Date: fi CC: O Urgent For Review O Please Comment O Please Reply O Please Recycle CS Y W F1 o S SEPOSIMO- JAMES o-coNNm ! 'o A . o „ a et o.. st 4)lc& + CERTIFIED SURVEY MAP 4. LOCATED IN THE SE1 /4 OF THE NE1 /4 OF SECTION 23, T31N, R19W, TOWN OF SOMERS , ST. CROIX COUNTY, WISCONSIN. W1 /4 CORNER OWNER SECTION 23 z NORMAN J. DUFRESNE SCALE IN FEET T31N, R19W a 1541 WINDEMERE DR. ' MINNEAPOLIS, MN 55421 71 w or 100' 200' { I UNPLATTED LANDS r LOT 3 CSM ( 6I 26.84' V O L . 4 , PG._113 + I 440.00' DOC. # 374,789 I N2 °09'15 "E 466.84' I E +I W I LOT 3 fH y I 140,170 S.F. (3.218 AC.) { o° INCLUDING TOWN RD. R /O /W o (z (a 132,000 S.F. (3.030 AC.) v EXCLUDING TOWN RD. R /O /W cn M UNPLATTED ` LANDS I r- o' ° I o til ( '^o o CD � 27.63' ° o al N2 ° 09'15 "E 467.63' `O "oo 440.00' - �I co Ln Hs o I N . RIGHT -OF-- ----- - - - - -- i z z I ,, LINE y cwI H I t-a r Hi I- LOT 2 - oIl 1 140,406 S.F. (3.223 AC.) ° o c'41 �° INCLUDING TOWN RD. R /O /W o L OT 2 CSM I I° OL 132,000 S.F. (3.030 AC.) e° V ._3, P G . 7 6 6 I 6 I EXCLUDING TOWN RD. R /O /W D OC. # 355,157 1 I II I I ' S2 0 09'15 "W 468.42' I 28.42 351.00' 89.00' } I_POINT OF UNPLATTED BEGINNING ----------- - --�-- � UNPLATTED LANDS LANDS LOT 1 CSM a, V OL. 3 P G . 7 65 DOC N . !J 355,156 � �% E1 /4 CORNER ASSUMED BEARINGS REFERENCED TO E -W1 /4 -SECTION 23 SECTION LINE WHICH BEARS N87 ° 36'35 "W. APPROVED T31N, R19W SEP 9 1989 Vol. 8 Page 2148 SL CRoi.A C THIS INSTRUMENT WAS DRAFTED BY BRIAN V. HALLING 00MFRB4ENSA NANK3 PWNOW AND 2C)MNI CC*AkM17EE St. Croix County Map Output Page Page 1 of 1 i St. Croix County Mappin LOW 7196 11$9 1188 7187 306F mow: t� y ✓3 t3 � 4 63.78 r #px h w SE 1 /1 -NE 114 � o 01 21 20 LOT4 I OT5 LOT6 1200 1199 306C 3060 A 6`r C9M VOL CSM VOL 10 PG 2 953 3WE W HITETAIL RAILS �x mj 6 3¢ana 330dG 3GV 3av 202 376D3 "n CSM VOL 8 PC; 2148 "° x 05 18 19 LOT3 T2 Somerset 23 1197 E3 1198 306A20 306 10 3068 2q 17 a n Ds 3Wn4 3WA5 375 300 yp5 .yam , y � Y � 3150 s 8 ` 315E 315E eft LOT2 LOTI R jQ j LOT3 GSM VOLJ PC 76 ?CSM VCL3 PC 711 vA...«..,.,__ MM 316G h " f CSMWL4PG 1135 � 050 316A NE 1 /4 -SE 1/4 # ., � �� fAirilclyal 6d.rtil atlrr St. Croix County Planning Department �r "11,Ir1 ti,` 1101 Carmichael Road �r' "1rvey M �+x �'�'�� Hudson, WI 54016 0 P mil Phone: (715) 386-4674 PCXV1 W as rcws J Orai rrage DISCLAIMER: The information contained on this map is advisory. Map Streams accuracy is limited by the quality of the public records from which it was D a1n prepared. It is not intended as a substitute for an accurate field survey. Pr11l191a1 h 14.9 .rhC ain AERIAL PHOTOS : Aerial photography is date - sensitive. Features that exist rl presently in the County may not be present in the photos. http: //69.5 8.147.26 /servlet/com. esri.esrimap.Esrimap? ServiceName= StCroixOV &ClientV... 4/28/2005