Loading...
HomeMy WebLinkAbout032-2187-00-001 / e \ \ \ \ 0 / �C\ � ■22 . \ Ifs 02� � §§� � kk) ID § ��E$/ U § 5 a) A - e k « ;2& <cE�� \ % o � ® Z L B _ $ \ / / z / . R § b a m \ ¢ � \ § « \ C 3 _ § § m ® $ 7 / ?) 7 � / \ LO ~ ° : CD f 4 In k �5 / \ @ § $ < / [ w z _ z L " '/# E LL CD 2 e 0 a C L _ Ld 4 \ ) & o a E & m m m _k = d \§ 2 2% a. U - a K 2 2 2 7 2 Q o 0 ZT 2 � qg § 8 4) 2 E B 2 0 \ 0 § § £ \ \ § § o C - c % \ 2 4 A \ a § 3 ° 1 6 0 § / / } % § E 0 C) LO a) §� §� 2 & 2 j c \ \ \ { \ 2 / & (f � $ § £ c - § g / \ G k o 2 p / 2 2 # k C ; L ,. � � (k a § / J a 2\ 0 2 L Parcel #: 032 - 2187 -00 -001 06/11/2007 10:38 AM PAGE 1 OF 1 Alt. Parcel #: 23.31.19.1584 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/11/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - CARNAHAN, LON LON CARNAHAN PO BOX 298 SHAKOPEE MN 55379 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 2010 68TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: 11 -006 -C M & E BUSINESS PARK 032/06 LOTS 1-4 SEC 23 T31 N R1 9W PT SE SE; BEING C M & E Block/Condo Bldg: LOT 01 BUSINESS PARK ('06) LOT 1 (3.000AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 23- 31N -19W SE SE Notes: Parcel History: Date Doc # Vol /Page Type 07/31/2006 830974 WD 07/11/2006 829363 11/006 PLAT 04/04/2003 716023 17/4491 CSM 02/01/2000 617725 1487/356 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/18/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wiscons7 Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Buibrig Division ` INSPECTION REPORT Sanitary Permit No: 499156 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 Holder's Name: City Village X Township Parcel Tax No: City Wide Insulation I Somerset, Town of CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: " e TANK INFORMATION ELEVATION DATA TYPE MANUFACTU ER CAPACITY STATION BS HI FS ELEV. Septic _ „ Benchmark' Dosing Alt. BM . Aeration Bid .Sewer Holding St/Ht Inlet t St/Ht Outlet r'r TANK SETBACK INFORMATION 2p TANK TO P/L WELL QLD0. Vent to Air Intake ROAD Dt Inlet if Septic Dt Bottom (/y, 13� Dosing eade Man. Aeration Dist. Pipe i Holding iBot. System I y > Final Grade PUMP /SIPHON INF ORMATION Manufacturer Demand St Cover �/ �� '�1,/• 4 ' , GPM Model Number TD H Lift friction Loss System Head TDH Ft Forcemain Length [sib. - - Dist. to Well t SOIL ABSORPTION SYSTEM FOIGIi Width Length+ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS .."1 1. '4 , SETBACK SYSTEM TO IP/LIQ JBLDG JWE4U J LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR l Type Of System: a UNIT Model NurAber. DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing ent to Air Intake Pi Length "` Dia " ` Length Dia Spacing SOIL COVER x Pres a Systems Only xx Nla r At Grade S ems Only Depth Over Depth Over xx De h of xx Seeded /Sodded xx Mulched Be tinter Bed /Trenc s Topsoil Yes No Yes No COMMENTS: ( (Include c . / ( r�dg disprepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 2010 68th Street Sometset, WI 54025 (SE 1/4 SE 1/4 23 T31N R19W) NA Lot 1 �°� Parcel No: 23.31.19 zg � 1.) Alt BM Description =1+a 2.) Bldg sewer length - amount of cover = 2 r Plan revision Required? Yes /r�o Use other side for additional Information. Date Inse's Signature /_ / / Carl. No. p or SBD -6710 (R.3197) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 l Visconsin Mattison, WI 53707 - 7162 Site Address De artment of Commerce 14 20 / O (e — 6 Sanitary Permit Application Sanitar Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal informati u p ❑ Check if Revision ma be used for secondary ses Privacy Law, s15. I. Application Information - Please Print All Inform 'on State Plan I.D. Number Property Owner's Name Parcel Number n Property Owner's Mailing Address A n (� q q Property Location s� 7,l , J go A P D_ BOX OC! !� 'A 5E Si ;S°f3 T�� N.R�9 City, State Zip Code P ne N Lo t be e /rr� N ber C � /V V e CSM Number 5Y377 3 FP ` � �s Z9 3 b3 II. Type of Building (check all that aPP Sr "06' El 1 or 2 Family Dwelling - Number of Bedrooms CR0/ A/ ® Public/Commercial - Describe Use VJAJef 14QL45; f OFF/ C(r ®Township S purt 2S T O State Owned Nearest Road t!'" ....1o eT� 6$ ST. III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A 1 9 New 2 ❑ Replacement System 3 Replacement of For County use 6 ❑Addition to System Tank Ottl Exis ' S stem B. O Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) I / 44 ® Non - Pressurized In- Ground 21❑ Mound 47 O Sand Filter 50 O Constructed Wetland � 22 O Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 510 Drip Line 2/ 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 O Recirculating 30 ❑ Other �rG VIOGI V. Dispersal/Tr ent Area Information: lei Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade rs Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks /� p ncrete Constructed Glass New Existing i� i 7Yt gcS j tpf- /Q -e) Tanks Tucks t lE�Q Septic or Holding Tank ;OOD /COO Dosing Chunber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum 's ignature MP/Iv1PRS Number Business Phone Number 7 ©tM(1 �'c/fr���i QV 76 0 7 57- -sY9 --6 647 Plumber's Address (Street, City. State, Code) VIII. County /De artment Use Onl Approved Disapprov Sanitary Permit Fee (includes Groundwater Date Issued Issu' gent Sig to No ps) e Surcharge Fee) o O Own ' enlnitia se Determination 0 EK. CondtiOTOADq�fl OW/Reasons for Disapproval 3 GD rc1-i .,,4A t 0- �� �' J. Septic tank, effluent fitter and / dispersal cell must all be services I maintained rL,( e„ t ` A. e � t t\n -C-f W ( tr'►� Qe- +�a`'�` �• as per management plan provided by plumber. / t 2. All setback requirements must be maintained �ad Po, J 5 ham , t �4.A cy- �l as per appikable tole !ordinances. ✓ Attach complete plans (to the County only) for the system on pap not less than 81/2 x 11 Inches in size SBD =6398 iR. 05101) 5 Q a t)s b etr.►� -- Pry r�.c.,t•�.. 5 ��l�e.�- /o ac,.�•'o /t_ i- �Go! � 5 ec. rc / � Q y O '» 'St . \ CN— [C 7 �j y1 v /'X t � 3 I.0 -1, C( U i n !— I— � ' -�;^, �i r •�, '^ ter. r `\ L � rf 0 � y IN 0 RECEIVED� Wisconsin Department ofCom FEB 1 7 2006 erce SOIL EVALUATION REPORT Page of .� Division of Safety and Buildings ST. QROIX CO N In aocorc7an�e Ai J s m 85, Wis. Adm. Code County Attach complete site plan on paper not less than 81/2 x in size. Plan must 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, a Date //ll Personal Information you provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m)). Property Owner Property Location Govt. Lot s. 1/45 1/4 S T N R 061 Property Owner's Mailing dre Lot # Blo u Name sr CSW CC a.fi�.BiJd City S 6 Zip Code Phone Number n City n Village f0 Town Nearest Roa 2 10 New Construction Use: CM Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable fl. General comments and recommendations: Ss�Ee 93. G F— Boring # E] Boring /] [2 pit Ground surface elev. 9"?- ft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 l _3 � 3 - 2 � Boring # 0 Boring > - 131 Pit Ground surface elev. ft. Depth to limiting factor //S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 dc I * 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 (Ple 7 �_ Signature � Evaluab CST Number f Address a cted Telephone Number s 1 Property Owner Parcel " , ' Pael ID # Page of 13 Boring # ❑ Boring Pit Ground surface elev. 9,7,-5 ft. Depth to limiting' factor /S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 I *Eff#2 d Ar F 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/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *011#2 ❑ Boring # Boring G ❑ ❑ Pit round surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 5 220 mg/L and TSS >30 5150 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.07 /00) I Property Owner Parcel ID # Page C;;� of 13 Boring # ❑ Boring Pit Ground surface elev. _�7 3 ft. Depth to limiting' factor ,r in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Ef1#2 _6 6 _ F Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor (n Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 - 01112 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 GPDAP 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/- 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. 38D -8330 (R07/00) t Safety and Buildings 4003 N KINNEY COULEE RD commerce.Wl.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.commer isco govsb, Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 30, 2006 CUST ID No. 223760 ATTN.• POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 586 VALLEY VIEW TRAIL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/30/2008 Identification Numbers Transaction ID No. 1314068 SITE: Site ID No. 713622 City Wide Insulation Please refer to both identification numbers, 68 Street above, in all correspondence with the agenc Village of Somerset St Croix County SE 1/4, SE 1/4, S23, T31N, R19W FOR: Description: New Non - pressurized In- ground POWTS Object Type: POWTS Component Manual Regulated Object ID No.: 1092758 Maintenance required; 405 GP D Flow rate; 115 in Soil minimum depth to limiting factor from original grade; ' System(s): In- ground POWTS Component Manual, SBD- 10705 -P (N.01 /01); Commercial System 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be located and constructed in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner..of the tank explaining that periodic cleaning of the filter is required. Access to the tank/filter for maintenance purposes must be provided per Comm 84.25(7), Wis. Adm. Code. • Comm 83.22(7) - 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. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. P.O.W.T.S. Conditional PpRnvFn JOHN F SCHMITT Page 2 8/30/2006 • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. 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 erard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 i SCHMITT & SONS EXCAVATING, INC. 586 Valley View Trail Somerset, WI 54025 715 -549 -6651 SEPTIC SYSTEM For: City Wide Insulation Job Location: 68` Street Address 1725 W. 3 Ave. Shakopee, MN 55379 Legal: SE ' /4 SE '/e S23 T31 N RI 9W Township: Somerset County: St. Croix Contents Page I Plot Plan Page 2 System Cross Section Page 3 Calculations Page 4 Floor Plan Page 5 &6 Management Plan Attachment 1 Soil Evaluation Report Attachment 2 Map Attachment 3 _ In- ground POWTS Component Manual, SBD- 10705- P(N.01 /01): Commercial System By: 7 MPRS 223760 Date: 8 -25 -06 RECEIVED AUG 282006 SAFETY & BUILDINGS 0�;'ARTMEN7 OF COMMERCE I \'15�ON 'ETY AND 11101NG1 ?F`O'P'_ E ^!CF BIODIFFUSER CROSS SECTION 4 "PVC Inspection t Vent Pipe Approximate Grade �6 E1 . _ /3 L _L �I- E1 • _ q3 -F 3 �. ac -- aeioge Ooe� Aeo wbtn - .'_qe iOr� ='ep NCI^ (2 ITY W,orz j7Z/A)G CALC � S 3 FLook JS �W i— D 76 - GPD t19�C = �l C � C,P � Pn x Z/ O's 6P D 1 N rY1 u� ►'l �T AN) 1 L c r r1 6 'g�- Oe, l� CD i n #) 1 (5 , eC1 4 c BLJILd/tiU to r 7S �,����tes��;1d o�u �► -'� + CS l /y �3 Y6 4 L/(o-77G A LLOAJ DW 10 v L t4 vo rL-J/Lc) X 3)1 �(q6 X 410 S) Pr L Aj ,TAB K VOL.ullrc ^ Ll - (� �c s mm c i u 7' -10 1/2' 8 O 8' -6 O 8'_6" O 8 -6' ©' -10 1/2" MANSARD GABLE - Z, o I I I o N I I m y I ^; n w r Co o rp O I r =' Z I 0 - T> 7j -� � w CD (� ` I =Q I 'gyp �x ng I I. Z L o 0 � z(� C I N z o Ny N Oz ' I I c < V I \ m m D I m O I i m r I Ov r m I O V o c °Z 0 AD I � I V O o 100 O I I C13 � 1 I I 4 z c- o C N I ®x 07^ C xJ C% n� O m pZ D NJ w ! v ^ D I I min LnM o y 0 oz am mr O ` I 2x I mm O (f m co x I o °O� ( Irni a s r- 1 r o I — v m m;o 1 cli I" � � I \ m * m ni 1. I � I o 1 2'x2' MANSA SAVE I o uu LA cli Z \x D o I mu z x =I o N I --1 10' 1 1/2' N v � �w �� vlv N Om Z m. O rn O� � A rn � � � � i x vO 1 F in r�i x uf� rm O ao o IN m A �N Ol ° I m \ \X C I� K 4'- cn� O rn >a+ z� C 1 I s o I IN �oD J D �CD Nome N rn MIN. / O I 00 ¢7 O In o Im W N Oz p n Om I r v � D�r -n R7O D Im > m �� K? I S -' A� -0 m 0 m _ � -i o0 ^' 15'_7 5' -4" I J no °m o =mom = z I m� m(nX ! O I o ' 2'x2' MANS ARD EA - - _ o m D w m m = (� T - 10 1/2' 8' -0" 8' -0" I 8' -0 °• ( —,, r � _ I o O NJ m N ^' ^' ? J ? I mm O N T m2O pA w I � O ONI m O u C! o _ 0 I I I 0 ZN m O I I v o Oz N I ; r �� J I I N ti I f - _ _ _ 2'x2' MANSA GA BLE - N 7' -10 T/2' 8' -6" 1 8' -6" 1 8' -6 8' -6' 7' -10 1/2 " N u + 0 Page of START UP AND OPERATION 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 highwa ter 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. %BANDONMENT 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. ONTINGENCY 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: IN 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 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 POVVTS. ❑ 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 ?ERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. )DITIONAL COMMENTS )WTS INSTALLER POWTS MAINTAINER Name t .{ Q 5 c 17 Name Lt_ IL Phone S t f c� _ �, j Phone =PTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name dl,L�1VCl� 5 C ffc'/ C !- Name 7. 6 /SC CE? ,t) i Y ZEN /'U Phone Phone 7/ J - 3 F - 6 0 s document was dratted in compliance with chapter Comm 83.22(2)(b)11)(d) &(f) and 83.54(1), (2) & (3). Wisconsin Administrative Code. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa of FILE INFORMATION SYSTEM SPECIFICATIONS Owner i Y � J t F 47 Septic Tank Capacity /000 al ❑ NA Permit 4 Septic Tank Manufacturer L -O tr c P ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer .�`. -�-y: Q�� � ❑ NA OL Number of Bedrooms W NA Effluent Filter Mode! ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity a l 0 NA Estimated flow (average) 970 gal/day Pu Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) e g al/day Pump Manufacturer ® NA Soil Application Rate , gal/day/ft' Pump Model ® NA Standard Influent /Effluent Quality Monthly average • Pretreatment Unit 19 NA 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 Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD,) 530 mg /L M In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /100ml ❑ 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 i MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tanks) At least once eve ❑ month(s) (Maximum 3 years) 11 NA ever 5d year(s) 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: 3 ® month(s) (Maximum 3 years) ❑ NA ❑ month(s) ❑ NA Clean effluent filter At least once every: r OR year(s) ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) Flush laterals and pressure test At least once every: ❑ mont h ) El year(s ❑ NA 11 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 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. A3 t2p '-:9? 4 KATHLEEN H. WALSH REGISTER OF DEEDS State Bar of Wisconsin Form 2 -2003 ST. CRO I K GO., W1 WARRANTYDEED RECEIVED FOR RECORD Document Number Document Name 07/31/2006 02 : 00P K WARRANTY DEED EXEMPT Y THIS DEED, made between Thomas F. Belisle,a. ttlarriedEerson REC FEE: 11.00 TRANS FEE: 329.70 COPY FEE: ( "Grantor," whether one or more), CC FEE: and Lon Carnahan. PAGES- 1 ( "Grantee," whether one or more). Recording Arta Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is ?U-k Estreen & Ogiand W 1 needed, please attach addendum): r0 304 Locust Street 1 Lot 1, CM & E Business Park. St. Croix County, Wisconsin. Hudson, Wl 54016 032 - 1063-0 -200 Parcel Identification Number (PIN) This is not homestead propany. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of- -way or record, if any. Dated 4 17— (SEAL) _ (SEAL) * *Thomas F. Belisle (SEAL). - Y( AU'THENTICATTON ACKNOWLEDCMNT y� AMY J. Signature(s) MCCUNE authenticated on STATE OF ) ? COUNTY * TITLE: MEMBER STATE BAR OF WISCONSIN Personalty came before me on (If not, the above -named Thomas F. Belisle }e� —Ber3 authorized by Wis. Stat. § 706.06) to me latown to be the person(s) who executed the foregoing THIS INSTRUMENT DRAFTED BY: instrument and acknowledged the same. Attorney Kristine Oeland Hudson. WI 54016 Notary Publosike of -0C.Z2 st r1 My Commission (is permanent) (expires: (Signatures may be autdeaticated nr aekaowledged. Bork are not necessary.) NOTE. THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 0 2003 STATE BAR OF WISCONSIN FORM NO. 2-260 • 'tyre name beinw signsL.re9. INFO-PRO— Levi Forms 800-085 -2021 www.infop uforms.00m �� o v 1 oft � n Ir ST CROIX COUNTY ` SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _(-' /T Y� 1OZE 1 all a rza l Z QAI r 4 RAIA M Mailing Address UJ 3R6 &e- 9� 9 .SAdKQPEE /`7N Z; Property Address 7-11 S (Verification required from Planning Department for new construction) City/State , S % / ZIL'- Parcel Identification Number D. LEGAL DESCRIPTION Property Location jE '/4, SE %,, Sec. 13 T -LL - R_[ W, Town of SO�`7E/eSE'T Subdivision , Lot # .�_ Certified Survey Map # Z 3 (-o 3 , Volume . . Page # Warranty Deed # -�Z� . Volume . Page # - Spec house ❑ yes N no Lot lines identifiable r1 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 mastorplumber, journeyman 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification 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. 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 t the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. } SIGNATURE OF APPLICANT DATE I * * * * ** Any information that is mis- represented max result in the sanitary permit being revoked by tha?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 E r i Vw w C. X & E, BUSINESS PARK 89363 SEC 0% OFSIS�FRgt W RECISIER'SOff7C8 ST M C OUNTtt� W (A COUNTY PiAT) sr.cRDacoms. Sw Located !h part of the Southeast Quarter of the Southeast Ouarter of Section 2J, Township Jt North, Range 19 West, Town of Somerset, a tl .':w T b.ia of 2 of a Certified Survey Yap recorded in Volume 17, Page 4491 of the R egiste r of Deeds Office of St. CraIX Count, �sconslh. y a - M. ° 9 ' Y • P eo�� �a 9 9 / y- d i.Th em M. Wash 3 Vyt•` Ine aY fre Saulh % oY the � „• � apevp� ° � tc5 euptrc - Smrloeas(4, o! L!E S^u(nwsl � ,1 'UWU IA�M�p�,_,y;, "� — I S69'C649” IC4344 u.O1 1Gpm BO apZSE 7aney.resnneef 5^e,•r� :: - iam' 5S)t2' nr.l7• S W S'c �5, <. - . t m z 1 �\ \ BEARINGS 9 REFEREVCEO r OR U769 _ I _ -- w SOUTH LINE OF ME SE-1/4 OF SECTION 4411 \° ^ 23, i.3i V. R.15 W., Wii�l IS ASSUMED tn:ex 8o PAT 7emmcrar7 .y�e m 10 BEAR N8908'05'W. 1 d rre:Mm r I ^, r -de =sec Easement 4 4X� n m l r tu be ertti"guehed vow, _ 7 mtmsb clfAerxd) LOTS a I J0,8J7 >q fi. n " n' I00 acres W - p .0 ° b740sq. ol, e 1 j ?, SOr,_Yea Nk =881 a' y o^ 1 O Its 4 N• l 9997 V32'19 6 E �p I e 58615 o 11 JJJ I ie11'' / a!Cinage CCSLmMf ��, ■ m r' i tt loo- Yev.HM. =8820' m I■ ■ ■ I. M JO'0ranoge uo IN '> 9 / Eosemml 'u� GR1P,-0C 6G1lE 4 j 44 al ,nrF�l c � T mk lam -i0' SB9 J'o'4B" N �.IP ^189ro806'W 268.01' ;i � 420.1'.' 1 mm . P 4� r4.6r i 9; 1 11' u1,Ffry LOT 4 p•� �c 1 Ez mec; iJ0, 915 sq. !� ro� 0 ,prco) JG1 ccres LEG6tli . Y�= aff r' Z sea o!—''1 g(1 County Secta care 4omme ,Igi b/ I l V m 0 °und I or P _ I J `t oposed 0r reway ri e I T u ` . I 11 ',I S lc:ahsn (fpicagl rdo G wb9tirg m n'rnum of 0 pod per Enedl fool Set 1 %cm. s 18' I(oh Pipe ° s LOT2 ! 0 d weg i•g 1,13 9cura per Snead loot c o o f30,751 sq. /.. ' 0 � I 1 — — Edserreet ,me ecres Plopcsea Drimaoy Locotidn iii I I I, 1 edTarg Bet6dCN , ... ,.... . .,.. _... . ,1W bon Right- el -V7oY) to p ..B.O. Lum AlowoNe BeBI Opening m N j4' awe t0C-R7 N.WL) p r 5416 Beck ^rra9 - Icp o' 'non Reba a Ppe p. ro e6ously Recorded Cinrela 1L4; a m /4p 1 �SECi:aa iJ-J1-rS 40 <0 � 1 $GCheeC51 Eanv 1a2Fi 6B9'C8'Ofi "E " -- � ffwnd f' Oel lJ,?2<7' fl 200TH A P63, 7439%06'11 561.98' R. 1 N99'015 96 -W 115.43' (P =S88J; 11'Wf LSo0h The of 'he sou(Eeos! 114 / JOB i''07SU122 `,f� - I PrgaeC b/ �- j,W - -AB 1 �- _ • JEO I I i;U�V� ka "�� J llh aR ^��"I�P,C oR oERRING Se000 GG O: 1 40,87' S0713'44 "E ', S00 S144344 "E Ph., NO!715)246 - ;2 1 4600015105 0 ',12188 121.52': Nc10819'Y S14 IN1 '44c I S0020 �qc Po, N o 32s 246 -3930 3 4 i5 4?0 2.65' N �Blo °i �00'2TC6 N443441'Ij AewRieemomM9Z'7 4 460.C'C 00 120 /.' 120.'76' S0!':34�'E dl4'43'4414� Nw o " °i; STet S or Z ' r