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HomeMy WebLinkAbout032-2099-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 499159 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Lied, John I Somerset, Town of 032 - 2099 -10 -000 CST BM Elev: Insp. BM Elev: BM Descrip 'on: Section/Town /Range /Map No: . a 26.31.19.946 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / Z 5 -_- 0 Benchmark • 1 Dosing M Alt. BM i 4 c ! A O Aeration p„, Bldg. Sewer Holding t/ t Inlet �d T ' -7 St/Ht Outlet TANK SETBACK INFORMATION TANK TO 5_ WELL BL Vent to Air Intake ROAp Dt Inlet Septic too r r i / V � b � _ _ _ ,,,,,1, ,� Dt Bottom Dos, ng �/ Header/ an.- l Aeration Di Op - 3 Holding BotAys St • 4' 2 Final Grade 3 PUMP /SIPHON INFORMATIO Manufacturer , t $ /_� GP St Cover I q ,3 D, I Model Number '1 -1 �- u C• Uh. TDH Lift �� Friction jets G System H a T D H Ft + 5 b „� jo J' f Forcemain Length Dit Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width �e 6th ( o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS A l SETBACK SYSTEM TO P/L B� WEL LAKE /STREAM HAMCHI OR Manufacturer: / INFORMATION 4 � Ty Of System: �� � ' � _ ! _ / NIT Model Number: /) DISTRIBUTION SYSTEM � Header /Man dd ( Distribution x Hole Size rle Spacing Vent to Air ntak Pipes) k �_ �• ----- Length is Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded Mu ched Bed/Trench Center /�- Bed /Trench Edges Topsoil I Yes No Yes 1 No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / 3 / Inspection #2: / Location: 1978 62nd Street Unknown SW 1 NW -g /4 2 R19W) Pinecliff Lot 1 AdA c( Parcel No: 2 to Air 1.) Alt BM Description cove = 1 "T �,, _ `' I +v �C v w 2.) Bldg sewer = >� O a T (,t1i - vr►{ Jl�'j 7 A� _ _ I J(JL n S `� / S � ,ll Its - - amount of cover = (;,(! !" f h.-^ Plan revision Required? Yes No Use other side for additional information._ /'_� u J - Date Insepctor's Signet re Cert. No. SBD -6710 (R.3/97) Safety and Buildings Di n County 201 W. Washington Ave., P. ox 7 2 t ) J,��O��i�� Madison, WI 53707 — 71 S itary Permit Number (to be filled in by Co.) (608) 266 -31 q Department of Commerce Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, sI5.04(1)(m) P 'ect Address (if different than atlin ad ess) I. Application Information — Please Print All Information 3a 1 D Property Owner's Name S E P 0 6 2006 arce k# Property Owner's Mailing Address ST. CROIX COUNTY Property LZin � ) Section 0 1J City, State Zip Code Phone Number �,c� Lk.,� 1 ��/ I . uc T N; orW II. Type of Building (check all that apply) _( �� 5 MC Subdivisi n Name CSM Number 2 Family Dwelling — Number of Bedrooms ��` El Public /Commercial — Describe Use � VLAD l ❑ State Owned — Describe Use trC'Ce( ❑City Villa of to III. Type of Permit: (Check only one box on a mplete lin i applicable) A. w System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ ther Modification to Existing System List Previous Permit Number and Date Issued B. El Permit Renewal ❑ Permit Revision ❑ Change of El Permit Transfer to New Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl on — Pressurized In- Ground ❑ Mound ? 24 in. of suitable soil C1 Mound < 24 in. of suitable soil El At-Grade El Single Pass Sand Filter El - -- ❑ Constructed Wetland C1 Pressurized In- ound ❑ Holding Tank ❑ Peat Filter El Aerobic Treatment Unit ❑ Recircul ` ng Sand Filter Recirculating Synthetic Media Filter ing Chamber g9rip Line avel- es pe ❑ r ( plain) J V. Dis ersaVrreatment AreaA41thr mation Desi Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) ystem Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site teel F' r Plastic Gallons Gallons of Units Concrete Constructed lass New Existing Tanks Tanks Septic or Holding Tank ; S Aerobic Treatment Unit Dosing Chamber VII. Responsibility Staterri I, the undersign, ume responsibility for installation of the POWTS shown on the attached plans. Plu is Name (Print) Plumber',a ature MP/MPRS Number Business Phone Number 2z� 7�� 01 & Plumber's Address Street, City, State, p l VT p LJ� _ / V . Coun /De artment Use Onl Sanitary Permit Fe includes Groundwater Date Issued Issuing gent Signa re o Stamps) Approved ❑ Disa roved Surcharge Fee) J(j� El ven Reas or Denial "`� IX. Conditions pprov SYSTE R: ) 2 4 T�9/1 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by Plumber.} - 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) T PLAN PROJECT John Liedl ADDRESS 750 Sharon Ave New Richmond Wi 54017 SW 1/4 NW 1/4S 26 /T 31 /R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE9 / 6/06 BEDROOM 4 CONVENTIONAL )00( IN -GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 LIFT TANK SIZE 765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1200 # of chamb s 48 IL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark ? Well is to meet all SYSTEM ELEVATION 92.8/92.4/92.0 5' below qrade setbacks required by WDNR Alternate Benchmark of Steel Fence Poy @ 104.7' Plans Designed Using Conventional Powts Scale is 1" = 4�� Manual Version 2.0 Property Line unless otherwise B.M. noted NAd.B. 200' B -1 3 -3' X 80' Cells with >3' Spacing Pro 4 40' Bedroom 5' 90' House -2 0 9 Vents 30 90' 97.5' 40 ' 3 �u,C Iv 10 Huffcutt B 4 ' Combo Tank / D 4 %Slope 95.5' 0 s �- Ven wn5v� > 6» ARC 36 Biodiffuser of Cover Leaching Chamber with 25.0 ft2 of Area vixy 5' Long 11" Grade at System Elevation 36" Town Road Y T PLAN PROJECT John Liedl ADDRESS 750 Sharon Ave New Richmond Wi 54017 SW 114 NW 1 /4S 26 /T 31 /R 19 W TOWN Somerset COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9 BEDROOM 4 CONVENTIONAL XXX IN -GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 LIFT TANK SIZE 765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1200 # of chambers 48 IL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100° Filter BEST Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 92.8/92.4/92.0 5' below qrade setbacks required by WDNR Alternate Benchmark T op of Steel Fence Post @ 104.1' Plans Designed Using Conventional Powts Scale is 1" = 40' Manual Version 2.0 Property Line unless otherwise B.M. noted N Ad B. 200' B -1 - 3 -3' X 80' Cells with >3' Spacing Pro 4 40' Bedroom 5' 90' House �40' Vents 30' 90' 40' 97.5' Huffcutt 40' Combo Tank -B 33 4% Slope 95.5' Vent >6 » ARC 36 Biodiffuser of Cover Leaching Chamber with 25.0 ft2 of Area 5' Long 11 " 3 6" Grade at System Elevation Town Road ED L J, Wisconsin Department o. Corn 0 OIL EVALUATION REPORT Page of Division of Safety and Bui ings J UN�Y GR t/ardance W omm 85, Wis. Adm. Code County T 1 , C ✓b i x— Attach complete site plan paper not le n 8 1/2 x 11 inches in size. Plan must include, but not limited to: rti orizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dim sions, north arrow, and location and distance to nearest road. Please print all information. e ' wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location (� r (� x ti / Govt. Lot_ o 11414,) /4 S p � T � N R E ( r) W Property Owner's Mailing Addre Lot # Block # Subd. Name CSM# City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road New Construction Use;�Z / Number of bedrooms _ Code derived design flow rate 6 GPD ❑ Replacement ❑ Public Str commercial - Describe: Parent material Flood Plain elevation if applicable General comments and recommendations: Adda � "Elvatio System Type C - o Sys em �.� --10" aJ4 a.jr. -- P Boting # Ing 01 U / / I Pit Ground surface elev. U ft. Depth to limiting factor &Z2-.., 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 'Eff#2 t� o -r lo(,- 3/t- 3 7 0 L3 Z -8a Boring ® # /wit Ground surface elev. P 7 a ft. Depth to limiting facto 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 'Eff#2 b I t -S .0 0 Effluent #1 = BOD > 30 1 220 mgiL and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/_ and TSS < 30 mg/L CST Name (Please Print) S' rei CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Coe Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 �— 715- 246 -4516 T Property Owner _ Parcel ID # Page of 3 Boring # Boring i t Ground surface elev. v ' 9 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 D I N /'o J,f , - a Q2.O ..6 FIT Boring # ❑ Boring ❑ Pit Ground surface elev. r ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure ' Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 s , I F-1 Boring # El Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 5 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS 130 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. SOD -8330 (8.600) Project Name John Liedl Soil Test Plot Plan Shaun B Address 750 Sharon Ave New Richmond Wi 54017 CST 226900 Lot 1 Subdivision - ---- --- Date 9/ 6M S W 1/4 NW 1l4S 26 T 31 NIR W Township Somerset Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 92.8/92.4/92.0 *HRpSame as Benchmark Alternate Benchmark Top of Steel Fence Post @ 104 Scale is 1" = 40' Property Line unless otherwise B.M. noted �At1.B. 200' B -1 40' 5 ' 90' B -2 40' jF 0 ' 97.5' 40' B -3 4% Slope 95.5' Town Road SECTION ANt7 SPECII CATION SEPTIC TANK E PUMP Ct "AMB£.R CROSS WF ATHERPRW �,r G VENT PIPE 12 MIN. ABOVE GRADE JUNCTION 8OX APPROVED > FROM DOOR, idINDOw OR WITS CONDUIT W1 MA COVER FADLDCY- F- FRESH !SIR INTA I �WARNING LABEL GRAD E � .�D� ++ MIN- F Itl :t� fp- IN. _. i s INLET � s GAS , WATER TIGHT SEALS �` TIGHT j '�,jAPpR�tED A SEAL JOINTS VITH F ILTER �� r ALM APPROVED PIPE APPROVED B ' ' fll3 SID SOIL PIPE 3: C t ' QNJTO SOLID OFF SOIL PUMP OFF ELEV .'93 IFT. 4 3" APPROVED BEDDING UNDER TANK / C ONCRETE PAD SPECIFICATI DOSE lajgB£R SEPTIC ! D DOSES ?£R DAY: / TANK MAYJrACTURER / ;L GAL. . L105E VOLUME IN CLUDING GAL G - TANK SIZES: SEPTIC FF,QLdSACK• � GAL - / GAL. DOSE CAPACITIES' A ' INCHES ALARM MANUrAclultER ;a �/ L � 5 2 INCITES = GAL. -- MODEL INIUMBER : swlTCR ' T'Y'PE: i �✓ C INCHES = '0 .� . PUMP MAWJFACITURER S II = INCITES = / S MODEL t+ uMbER ' C SWITCH TYPE 15.23 WAC a GPM pump S ALARM ;.7IRZ NG AS PER I LHR r REQUIRED DISCHARGE E �--- Z FE FERENC£ BETWEEN pU?+IP OFF AND DISTRIBt#TION PIP£ • FEET VERTICAL DIF J �_ FEET' + MINI l4UM NETWORK SUPPLY PRESSURE rT- FRICTION FACTOR . • g � FEE:T + f�_ FEET FORMA; TOTAL s1� F TO`FAL DYNAZMIC HEA 7 J j J : WIDTHS+ DIAMETER 7 KP T ANK: LENGTH INTERNAL DIMENSIONS i3F LIQUID � �-- -----" ' T 1 0 0 ' � LICENSE NUMBER = � v S;GpiET3: _ i(88 TOTAL DYNAMIC HEAD /CAPACITY HEAD CAPACITY CURVE PER MINUTE MODELS 53/55/57/59 EFFLUENT AND DEINATERING 25 _ Model 53/55/57/59 6 20 Ft. Meters Gal. Ltrs. 5 1 1.5 43 1 63 15 1C 3.1 34 129 a z 4 15 4.6 19 72 r c - � 10 Shut — off Head 19.25 ft. (5.9m) o 5 3 15f 16�— 6 5/32 4. 5/8 I 1 1/2 —11 /2 NFT I 0 U.S. GALLONS 10 jo 30 40 50 3 15/16 LITERS I 80 160 _ FLOW PER MINUTE 009697 P 4 1/16 O l Variable level float switches available. l I Variable level long cycle systems available. Available with special cord lengths of 15% 25', 35' and 50'. ~ Alarm systems available. 1 i 10 1 /i6 Duplex systems available. I h 3 3/32 SK656 Single Seal Control Selection Listings S� <�ECsss� uE.ys%i Model Volts Phase Mode ! Amps Simplex Duplex CSA UL 1. Integral float operated mechanical switch, no external control required. M53I55 & M57/59 1 15 1 Auto 9.7 1 — y y 2. Single piggyback variable level float switch or double piggyback variable level N53i55 & N57/59 11 �' 1 Non 9.7 2 3 or 4 & 5 y y float switch. Refer to FM0477. SN53 115 1 Auto 9.7 y y 3. Mechanical alternator "M - PaK' 10 - 0072 or 10 - 0075. BN57 115 1 1 Auto 9.7 N Y BE53157 230 1 Auto 4.8 * — y y 4. See FM0712 for correct model of Electrical Alternator. D53155 & 557/59 230 1 Auto 4.8 t — • -Y Y 5. variable level control switch 10 -0225 used as a control activator, with Electrical E53155 & E57/59 230 1 Non 1 4.8 2 1 3 or 4 & 5 Y Y Alternator (3) or (4) float system. Single piggyback switch included. O CAUT1011 For information on additional Zoeller products referto catalog on Piggyback Variable Level Float Switches, FM0477; F _ r r� r s 5 r` `" y r St C Electrical Alternator, FM0486; Mechanical Alternator, FM0495; Sump /Sewage Basins, FM0487; and Singie Phase h G C oda �XE C; sE `'.s.s Cc V ¢ ct.c. a• J se.Y Simplex Pump ControllAlarm Systems, FM0732. For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. Louisville, KY 40260 Manufacturers of. . L' SHIP TO: 3649 Cane Run Road d7 ® Louisville, KY 40211.1961 � ,. p//,�P 51=f /939 u ® PUMP !O. (502) FAX (502) 774-3624 8 -PUMP hitp: //wwwxoellercom © Copyright 2002 Zoeller Co. All rights reserved. Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor'�w.5 4Grian Relations Page of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County 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. Ewed # APPLICANT INFORMATION - Please print all information. b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property ner Property Location CRC�x V c Govt. Lot S(n1 1/4, cT N (or)(J Property Owner's Mailing A dries, Lot # Block# S e Ci Stat Zip Code Phone Number earest Road f ) ❑ City Town New Construction use: Residential / Number of bedrooms _ l Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow Z40— gpd Recommended design loading rate 0_ bed, gpd/ft .. k' trench, gpd/ft Absorption area required ,S bed, ft -� trench, ft Maximum design loading rate , /7 bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) 97 7 ft (as referred to site plan benchmark) Additional design /sit siderations I r ;•/tt:a Parent material O,. /.Q ,6 Flood plain elevation, if applicable 4 ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ u ;Ds ❑ u U s ❑ U I ❑ S ❑ U ❑ S n u ❑ s ® u SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench J L - Ground 3- , elev. Depth to 3 �� limiting factor 22�_ in. Remarks: Boring # j 6 s 3 66 Ground _ � lL� ft• , Depth to limiting factor "9' Remarks: CST Name (Please Print) Signature / Telephone No. Address Date CST Number `e! ) -I�- 1 SOIL DESCRIPTION REPORT • y PROPERTY OWNER Page of� PARCEL I.D.# Borin 9 # Horizon Texture Consistence Boundary Roots Depth Dominant Color Mottles Structure 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench RE AQV 7 Ground �! elev. Depth to limiting factor Remarks: Boring # SON j S Ground F elev. Depth to I I limiting factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; L Ground j - elev. Depth to limiting factor j V in, Remarks: Boring # .. ';:Y Ground elev. ft. Depth to limiting factor in ' Remarks: SBDW -8330 (R. 08/95) T ' . K ' Cl , 3 ys : . : • '"` Parcel #: 032- 2099 -1 -000 07/03/2006� 0 P 1 P Alt. Parcel #: 26.31.19.946 032 - TOWN OF SOMERSET Current XJ 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 JODY L RADZIWILL O - RADZIWILL, JODY L 4447 HELENA WAY N OAKDALE MN 55128 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1978 62ND ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.450 Plat: 2311 -PINE CLIFF SEC 26 T31N R19W W1/2 NW1 /4 LOT 1 PINE Block/Condo Bldg: LOT 01 CLIFF 3.45 AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 26-31N-19W NW Notes: Parcel History: Date Doc # Vol /Page Type 06/08/1998 580585 1330/53 WD 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.450 59,200 0 59,200 NO Totals for 2006: General Property 3.450 59,200 0 59,200 Woodland 0.000 0 0 Totals for 2005: General Property 3.450 59,200 0 59,200 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 L Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 �ntinge cy Plan Option #1 If system fails, determine cause of failure, use alternate area and install new to n tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 -246 -4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address -7 Property Address r artnnent for new cons ction.) (Verification required from Planning & Zoning Dep City /State Parcel Identification Number 2 ` l 1 LEGAL DESCRIPTION 1 r 1 �--4 T �( N R/— _W, Town of _� Property Location /4 & —A /a , Sec. , Lot # �- Subdivision P/1 Volume Page # Certified Survey MaP # --�' , ' ter Warranty Deed # Volume Page # Spec house yes no Lot lines identifiable GP no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its ptrfemata d by a licensed pumper Proper every three years or sooner, u put into maintenance consists of pumping out the septic tank the system can affect the function of the septic tank as a treatment stage in the waste disposal Sy s tem- n 0wn maintenan ce responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary form The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification on si by ihe owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying ecessary), the septic tank is wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (' less than 1/3 full of sludge. requirements and agree to maintain the private sewage disposal system with the I/we, the undersigned have read the above 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 Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this [o true o t e Register, of Deeds kno wledge. Uwe am/are the owner(s) of the property ed above, by virtue of a warranty deed � SIGNA OF APPLICANT(S) DATE ** sult in the sanitary permit being revoked by the Planning & Zoning Department. * * Any information that is misrepresented may re Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105 State Bar of Wisconsin Form 1 -2003 WARRANTY DEED 8 c 8 S 3 7 REGISTER H. MALSH EG ISTER OF DEEDS Document Number Document Name ST. CROIx Co., yI RECEIVED FOR RECORD THIS DEED, made between Jody L. Radziwill and Mike Radziwill, husband and 0 6/30/2006 10:05A?I wife ( "Grantor," whether one or more), and John K. Liedl a nd Deborah L. Liedl, husband and wife as survivorship marital property ( "Grantee,' w et er one or WARRANTY DEED more). EXEMPT # REC FEE: 11.00 Grantor, for a valuable consideration, conveys to Grantee the following described real TRANS FEE: 255.00 estate, together with the rents, profits, fixtures and other appurtenant interests, in St. COPY FE Recording CC FEE: Croix County, State of Wisconsin ("Property") (if more space is needed, please attach g Are AGES: — - - - -- --------------------------- - - - - - -- ri Um ): Name and Return Address of 1 Pine Cliff in the Township of Somerset, St. Croix County Wisconsin. Key Title, Inc. 1477 So. Knowles Ave., Suite 101 New Richmond, WI 54017 File No.: 6 -1076W 032 - 2099 -10 -000 Parcel Identification Number This IS NOT homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, Restrictions, and Covenants of Record. Dated June 28, 2006. J dy will Mike Radziwill AUTHENTICATION ACKNOWLEDGEMENT Signature(s) STATE OF WISCONSIN ) ) SS. authenticated on St. Croix COUNTY ) Personally came before on June 28 , 2006 Jody L. Radziwill and * Mike Radziwill to me know to be the person(s) who executed the TITLE: MEMBER STATE BAR OF WISCONSIN forego' g instrument and cknowledged the same. (If not, authorized by Wis. Stat. 706.06) *Ju 'ta A. Myers U8/D7j THIS INSTRUMENT DRAFTED BY: No Public, State of Wisconsin My commission (is permanent) (exp Attorney John Schneider Balsam Lake WI 54810 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. IT ,ARANTY DEED Copyright 2003 STATE BAR OF WISCONSIN FORM NO. 1 -2003 rm software by: Automated Real Estate Services, Inc. - 800.330.1295 File: 6 -1076W SAFETY WARNING — Risk of electric shock. This pump is SAFETY GUIDELINES supplied with a grounding conductor and/or grounding 1. Read all instructions and safety guidelines type attachment plug. To reduce the risk of electric thoroughly. Failure to follow the guidelines and the shock, be certain that it is connected to a properly instructions could result in serious bodily injury grounded grounding type receptacle. and /or property damage. 2. DO NOT USE TO PUMP FLAMMABLE OR Your 115V effluent pump is equipped with a 3 -prong EXPLOSIVE FLUIDS SUCH AS GASOLINE, electrical plug. The third prong is to ground the pump to FUEL OIL, KEROSENE, ETC. DO NOT USE IN EXPLOSIVE ATMOSPHERES OR HAZARDOUS prevent possible electrical shock hazard. Do not remove LOCATIONS A S CLASSIFIED B Y NEC, the third prong from the plug. A separate branch circuit is ANSI /NFPA70. FAILURE TO FOLLOW THIS recommended. Do not use an extension cord. WARNING CAN RESULT IN PERSONAL INJURY When a pump is in a basin, etc. do not touch motor, pipes AND /OR PROPERTY DAMAGE. or water until unit is unplugged or shut off. If your 3 During normal operation the pump is immersed in installation has water or moisture present, donottouchwet water. Also, during rain storms, water may be area until all power has been turned off. If shut -off box is present in the surrounding area of the pump. not accessible, call the electric company to shut off service Caution must be used to prevent bodily injury to the house, or call your local fire department for when working near the pump: instructions. Failureto follow this warning can resultin fatal electrical shock. a. The plug must be removed from the receptacle The flexible PVC jacketed cord assembly mounted to the prior to touching, servicing or repairing the pump. pump must not be modified in any way, with the exception b. To minimize possible fatal electrical shock hazard, of shortening the cord to fit into a control panel. Any splice extreme care should be used when changing between the pump and the contra{ pane{ must be made fuses. Do not stand in water while changing fuses within a junction boxand mounted outside of the basin, and comply with the National Electrical Code. Do not use the or insert your finger into the fuse socket. power cord for lifting the pump. 4. Do not run the pump in a dry basin. If the pump is The pump motor is equipped with an automatic resetting run in a dry basin, the surface temperature of the thermal projector and may restart unexpectedly. Projector pump will rise to a high level. This high level could tipping is an indication of motor overloading as a result of cause skin burns if the pump is touched and will operating the pump at low heads (low discharge restriction), cause serious damage to your pump. excessively high orlowvoltage, inadequate wiring, incorrect 5. Do not oil the motor. The pump housing is sealed. motor connections, or a defective motor or pump. A high grade dielectric oil devoid of water has FLOW- LITERS /MINUTE been put into the motor housing at the factory. Use of other oil could cause serious electric shock o so 160 2 +0 320 and /or permanent damage to the pump. 60 Is.o 6. This pump's motor housing is filled with a dielectric lubricant at the factory for optimum ,0 12.5 N motor heat transfer and lifetime lubrication of the bearings. Use of any other lubricant could cause w damage and void the warranty. This lubricant is LJ 30 lo. o non- toxic; however, if it escapes the motor 5 housing, it should be removed from the surface �, quickly by placing newspapers or other absorbent w 20 ¢ material on the water surface to soak it up, so _- 5. 0 = aquatic life is undisturbed. 10 2.5 7. In any installation where property damage and /or. personal injury might result from an inoperative or o I ° leaking pump due to power outages, discharge o ,0 6o so too line blockage, or any other reason, a backup system(s) and /or alarm should be used. FLOW- GALL ❑NS /MINUTE PUMP PERFORMANCE CURVE V 67AIJ I 115V 60HZ / q 3 LITTLE GIANT L SUBMERSIBLE Pump Company EFFLUENT PUMP OWNERS MANUAL FOR 9EH - CAUTION - READ SAFETY GUIDELINES AND INSTRUCTIONS CAREFULLY or e • SAFETY • INSTALLATION • OPERATION • REPAIR World's Largest Manufacturer of Centrifugal Pumps W. - o OD / 0 - t 1 � \ 7 Aft s a C' No IN i y M � i 45 A ES I 4 SO. FT. 9' N81 ., W � l / / � .• 12' 13 Q 277, 81' Z W 3.00 • AC v 13(85• s 7- CH F�. 6 6• ;R Jk, S ?,OC L J, HARTMAN DBA 36 LIFF PARTNERSHIP RTMANHOMES ' 9 INC. 3 1 S7 go�9 2„w %I N STREET 3ET, WI 54025 AR MATS ,LOT 21 130, 768 sq. ft, N.B.A. /C. B. A. o m / 126,888 SOXFT. N O 3. DD acres n 2.91 ACRES z l L07'20 o �iQ \ 131, 053 sq. ft. N O 3.01 acres r' 20 3p . 4' X3 38 , , Co p r . z N.B.A. /C.B.A: \ �Q ®/ ✓ f �, 124,646 SQ. 'FT. 2.86 ACRES LOT 15 136, 298 sq. ft. 3.13 acres o , N. B. A. /C. B. A. `- - r 116,823 SQ. FT. �g� F 2.68 -,ACR ES .:, 10r16 D _.. -- 132, 096 sq, ft. O 3.03 acres oyl ` N.B.A. /C.B.A. SrK 102,217 SQ. FT.^',� �J v 2.35 ACRES�Y 3 O Z7 L07'17 (1) K: (D \�eo: � 131, 077 sq. ft, j r ► W j. \ 3.01 acres a� z ` (n 0 �� � I p o CD ?S O LOT 18 I ' 137, 345 sq. ft. 3.15 acres N. B. A. /C. B. A. 47,654 SQ. FT, N. 1.09 ACRES I0 r— N 1 Z A (n O m N m :jm O -1 z = m �L f Imo? 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