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HomeMy WebLinkAbout032-1099-10-200 O N Q C m O m m m z 7 Z fl a c (D 3 3 m O O C O O CO CD O O N O O W CD p Cn W `C • O w 3 c O 3 3 j N �- m m o �_ �_ w m m o (D N V C O O N c,_ CD �_ � 3 3 O 3 3 O A S S lA ' n CD CD n 7 O O y O CD CD �. d O C1 C1 I N C) e ' ; 7 N Cp 3 N � 7 O O C N C O C O !1 d O CO O) CD 00 tVV D z i a a- Z D a a, C/) rl) m m m `, m o N° o 0 o W o y c c •�,,+,� 3 a N m m °: O O O r 0 0 0 co PL cn to w a s N N y C-11 ° D CO Q v O G m a' 'U D O A `G IN A M N O M N ~O C'�D A Cn (O (� 7 _ 91 N O !►icy CD O Ln z j z z z 0 D 0 D 0) d -0 E; !r N y N • N N CD Z C CD C S d C 6 Q 3 n O N N C) 0 O A Z n y - O N c 0. CL p Z O � � O Z 0) W A W A m CL a Z 3 , 3 A � g g ; 3 3 m m m CD A 7 A A CD d 0 C: m a O T d T m C CD * G C z c. N � z o O O a CD m N = N N N a ( G O 'a o m a 3 4 I - O � w � tV C 0 � O w A m m b a oa o Q o 0 o F o °o C o° CD Parcel #: 032- 1099 - 10-200 03/13/2007 10:48 AM PAGE 1 OF 1 ` Alt. Parcel #: 36.31.19.460A -20 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - LEMIRE, JOHN D & KIMBERLY D JOHN D & KIMBERLY D LEMIRE 650 A CIRCLE PINE NEW RICHMOND WI 54017 Districts: SC = School SP = Special 4roperty Addre ' = Primary Type Dist # Description * 1894 80TH ST SC 5432 SOMERSET ` SP 1700 WITC t Legal Description: Acres: 13.334 Plat: 4005 -CSM 14/4005 SEC 36 T31 N R1 9W NE NE BEING LOT 3 CSM Block/Condo Bldg: LOT 3 14/4005 THIS DESC INC IN 032 - 1099 -10 -200 (460A -20) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 36-31N-19W NE NE Notes: Parcel History: Date Doc # Vol /Page Type 01/12/2001 636677 1574/557 QC 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 13.334 26,700 0 26,700 NO Totals for 2007: General Property 13.334 26,700 0 26,700 Woodland 0.000 0 0 Totals for 2006: General Property 13.334 26,700 0 26,700 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 Wisconsin De County: partment of Commerce PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division T INSPECTION REPORT sanitary Permit No: 430438 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: Lemire, John I Somerset Township 032 - 1099 -10 -200 CST BM Elev: Insp. BM Elev: T Description: Sectionlrown /Range /Map No: 36.31.19.460A20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding SVHt Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header an. Aeration Dist ipe / - I, r Holding vot. Syste t__/F A I r Final Grade PUMP /SIPHON INFORMATION / / \ L Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDI`ji Ft Forcemain Length Dia. Dist. to Well f SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of T r " ches PIT DIMENSION6N No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO I P/L . / BLDG WELL LAKE /STREAM ACHING Manufacturer: INFORMATION CH BER OR Type Of System: r IT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of 7��ded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil - - Yes L ] No Yes ' No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1890 80TH STREET Somerset, WI 54025 (NE 1/4 NE 1/4 36 T31 R1 9W) NA Lot 3 Parcel No: 36.31.19.460A20 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = r Plan revision Required? ( Yes R No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Parcel #. 032-1099-10-200 11/02/2004 09:46 AM PAGE 1 OF 1 Alt. Parcel M 36.31.19.460A -20 032 - TOWN OF SOMERSET Current XX ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): = Current Owner LEMIRE, JOHN D & KIMBERLY D JOHN D & KIMBERLY D LEMIRE 650 A CIRCLE PINE NEW RICHMOND WI 54017 Districts: SC = School SP = Special operty A s(es): " = Primary Type Dist # Description " 1894 80TH ST SC 5432 SCH D OF SOMERSET SP 1700 W ITC Legal Description: Acres: 11334 Plat: 1189 -CSM 14/4005 SEC 36 T31 RI 9W NE NE BEING LOT 3 CSM Block/Condo Bldg: LOT 3 14/4005 THIS DESC INC IN 032 - 1099 -10 -200 (460A -20) // Tract(s): (Sec- Twn -Rng 401/4 1601/4) 36-31N-19W NE NE Notes: Parcel History: Date Doc # Vol /Page Type 01/12/2001 636677 1574/557 QC 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 58,400 Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 13.334 26,700 0 26,700 NO Totals for 2004; General Property 13.334 26,700 0 26,700 Woodland 0.000 0 0 Totals for 2003: General Property 13.334 53,300 0 53,300 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 Safety and Buildings Division County ` N 201 W. Washington Ave., P.O. Box 7082 ons�n Madison, WI 53707 — 7082 Sqi itary Permit Number (to be filled in by Co Department of Commerce 08)261 -6546 je �30 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide I ,�* _ T may be used for secondary purposes Privacy 5.04 (lxm) Pro Addres (if di erent than mailing address) I. Application Information — Please Print All Informatio Pr e rgs Na me g Parcel # # Block # I v i !_�1i� ©� �' i �.-► �. p - D er's Mailing Address y Property Location 0 �6of1- City, State J Zip Code / Phone Number ���L� 'i., /yL�'i., sectio n/ x ` C'( �K' 7 ucleo ) II. Type T _&; R E o of Building (check all that apply) / #'u" O T - or 2 Family Dwelling — Number of Bedrooms Lylt� Subdivisio n Name C Number �M ❑ Public/Commercial — Describe Use V, 7 ❑ State Owned — Describe Use 01_ 16 ❑City_ ❑Village Township o III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' ❑ Replacement System ❑::New System ep ys ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ermit Renewal ❑Permit Revision ❑Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner q �1 IV. Type System: Check all that apply) 1 / P 1on — Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized o m k ❑ Peat Filter ❑ Aerobic Treatment Unit 11 Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leach Chamber rip Line ❑Gravel -less Pi Other (explain) V. Dispersal./Treat ent Area In or Design Flow (gpd) Design Soil Application te(gpdsf) Dispersal Area Required (so D spe 1 Area Proposed (s� Sy,�(�m Elgvation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fi er Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing JA)/ klo6 Tanks Tanks ptic or kling Tank Aerobic Treatment Unit Dosing chamber VII. Responsibility Statement- I, the unders , assume responsibility for installation of the POWTS shown on the attached plans. Plum 's Name (Punt f Plum s 'gnature MP/MPRS Number Business Phone Number I 's Address (Street, City, State, Zip ��e.� -- � � /7 !sue° r r •---., VII Coun /De artment Use Onl Approved ❑Disapproved Sanitary Permit Fee i cludes Grouqdwater Date sued ssuing Age Signa re o ps) Surcharge Fee) < ) UV_ ❑ Owner Given Reason for Denial , V IX• Conditions of Approval/Reasons for Disapproval � � //--` / - YSTEM OWNER: �QA%�i t �/J 1 Septic tank, effluent filter and � f7�1 dispersal cell must all be serviced / maintained �rLPh� as per management plan provided by plumber. / / ./ I ' v ^ , /Z d� 3(. ��� Let 2 All setback requirements must be maintained �' �/f' ?_JP D I � as per applicable code /ordinances. �-• —/V D A ` - - °'^•- ^'��• Ito the CbwffWaply) for the system on paper not less Man 1/2 :11 Inches In si SBD -6398 30 PLOT PLAN PROJECT John Lemire ADDRESS 700 E 5th St New Richmond Wi. 54017 NE 1/4 NE 1 /4S 36 /T 31 N/R 19 W TOWN Somreset COUNTY ST. CROIX MPRS Byron Bird Jr. 220527 *.- DATE 9 - 18 - 00 BEDROOM 4 CONVENTIONAL XXX IN -GROU D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 500 # of chambers 30 BENCHMARK V.R.P nail in 8" red oak Koee 4�' I ASSUME ELEVATION 100' ❑ BOREHOLE O WELL sH.R.p. same as BM SYSTEM ELEVATION T -1 =91.9 T -2 =91.7 # Alt BM Elv. 100' nail in white Pine tree #alt BM El 100 23 PL > 20% sloe PL d house 20' of B.M. 80th st , garar e 1 �L 4 15 250' 35 B2 100' ob pipe s h ' di ivt way > 20 %slope 250' 489' LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1099 -10 -200 Parcel Number 36.31.19.460A -20 OWNER NAME: First JOHN D & KIMBERLY D Last LEMIRE PROPERTY A PD -- Street Name -- Type SD Apartment 1894 80TH ST SECTION 36 TOWN 31N RANGE 19W NE 1 /440 NE Line Description Line Description TOTAL ACREAGE 13.334 PLAT CSM 14/4005 LOT3 BLK 01 SEC 36 T31 N R19W NE NE 15 02 BEING LOT 3, CSM 14/4005 16 03 17 04 032 - 1099 -10 -200 (460A -20) 18 05 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF SOMERSET COMPUTER NUMBER 032 - 1099 -25 -000 Parcel Number 36.31.19.460C OWNER NAME: First DUANE & MARLYN Last LEMIRE PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment SECTION 36 TOWN 31N RANGE 19W %160 '/ +40 Line Description Line Description TOTAL ACREAGE 0.000 PLAT LOT BLK 01 SEC 36 T31 N R19W THAT PART 15 02 OF LOT 1 CSM 5/1348 DESC 16 03 AS FOLLOWS: COM E1/4 COR 17 04 SEC 36 N 1577.89' -POB N 80' 18 05 N 89 DEG W 660'S 330'S 89 19 06 DEG E 137.22'N 250'S 89 20 07 DEG E 522.78' -POB 21 08 5 -21 -01 PER BOB E THIS 22 09 PARCEL IS INC IN THE DESC 23 10 OF 032 - 1099 -10 -200 24 11 LOT 3 CSM 1411005 /RETIRED 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit k IS90 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. 5�5�1 See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary Madison, WI 53707 -7302 Department of Commerce ry p (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m) state owned. Attach complete plans to the county copy only) fort tem, orr 6r no ss than 8 -1/2 x I 1 inches in size. County State Sanitary Permit Number ❑ r( revision to previous appIkiftion State Plan I. D. Number G ra i 3 SO I. Application Information - Please Print all Information Location: Property Owner Name t ' (� Property Location / 1/4 /4, S 6T N, i6 E Property Owner's Mailing Address . Lot Number Block Number City, State Zip Code Phone Number Subdivision Name or CS Number ✓.1'f �( _ s (034? C P s I1. Type of Building: (check one) 0-L rr ❑ City � 1 or 2 Family Dwelling -No. of Bedrooms : ❑ Village ❑ Public /Commercial (describe e): r r Town of ❑ State- Owne 2 3 K ' Nearest Road CcJt ��� n �� ✓ Q � /' Parcel TaxNumber(s) (,, / III. T ype of Permit: ec on one box c n line A. Check box on line B if a tiAble ) -7 > ; ; — 1 ^ < _ -- -L A) 1. JKNew 2. ❑ k-eplacement 3. ❑ Replacement of 4. ' 5. 6. ❑ Addition to System S s Tank Only ' >`' A Existing System B) Permit Number Date Issued ❑ A Sanitary P ermit was reviou issued ri',. IV. Type of POWT System: (Check all tZNon- pressurized In- ground ❑ Mound °' ❑ Sand Filter ❑ Constructed Wetland • Pressurized In- ground ❑ Holding Tatlk'' ❑ Single Pass ❑ Drip Line • At-grade ❑Aerobic TAatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: -` 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area r 4. Soil Application 5. Percolation Rate 6. System Eleva tio 7. Final Grade Required Proposed Rate (GalsJday /sq. ft.) (Minlinch) �r� / Elevation 16 VII. Tank Capacity in Total, :il # of anufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallggds Tanks Con - Con- glass New Existing r crete structed Tanks Tanks e AfG l ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume res o bility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plum s Signature (no stamps): MP/MPRS No. Business Phone Number Pluntfees Address (Street, City, fate, Zip C IX. County/Depart t Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued j su' Signa' (No stamps) Approved ❑ Owner Given Initial Adverse Sur arge F� 89 Determination X. Con itions of proval /Reaso s for Dis pproval: 5c— l Yuu CJ� C J(� OM Olb�/ f &As. �rCl s wt &+ bA `_V� �e Q s: - oz cQ.cll a-,�t yes 4 PLOT PLAN PROJECT John Lemire ADDRESS 700 E 5th st New Richmond Wi. 54017 NE 114 NE 1/4s 36 /T 31 N/R 19 W TOWN Somreset COUNTY ST. CROIX 9 -18 -00 4 MPRS Byron Bird Jr. 220527 DATE BEDROOM CONVENTIONAL XXX IN -GROU D PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 500 # of chambers 30 BENCHMARK V.R.P nail in 8" red oak ASSUME ELEVATION 100' ❑ BOREHOLE WELL *H.R.P. same as BM O SYSTEM ELEVATION T -1 =91.9 T - =91.7 # Alt BM Elv. 100' nail in white Pi #alt BM El 100 723' PL > 20% sloe PL ed house 20' B.M. 80th st , garar e B 1 B1_'50 250 �k 4 15' 35 B2 100' 'JA ob pipe di 'v way > 20 %slope 250' 489' bvis�l Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, 900 T11 111 and distance to nearest road. ,D 3 2- /D - JzJb r ! Please print a _ n: I r Re awed by Date Personal information you provide may be u \ urp&as (Privacy Law, s. 15.04 (1) (m)). i' Property Owner 1AL Property Location a �l Govt. Lot r 1/4 1/4 S U T V N R E (o Property Owner's Mailing Address c") ± r Lot # Block # Su d. Name or C M# ST cRaA l City State Zip Cod kh F!C« ❑ City ❑ Village Town Nearest Road ��� `' /yd of ..� • n df� ® New Construction User Residential / Number r Code derived design flow rate GPD 7 ❑Replacement ❑ Public or commercial - Descri e: Parent material { A a 4LZ Flood Plain elevation if applicable / ft. ot General comments y and recommendations: E ' F ' Boring # Boring ,3" S I ( I Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o ❑ Boring # Boring �- ❑ pit Ground surface elev. fL Depth to lln (ting factor > ,-01 In. Soil Application Pate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz In. Munsell Qu. Sz. Cont.: Color Gr. Sz. Sh. •Eff#1 'Eff#2 yea sf S r G ST to • Effluent #1 : BOD, > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = SOD, < 30 mg/L and TSS _< 30 mg/L CST Na a (Please Print) Signature CST Number Addr9d Date evaluation Conducted Telephone Number ` r Property Owner ��^i� �e r t- Parcel ID # Page of D 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 P ry GPD/ft a in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 e .'I$ (3. 2-/ -+l -Z ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 F-1 Boring # ❑ Pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Effluent #1 a SOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = 13013 : 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. SBD -8330 (R6/00) r Soil Test Plot Plan Project Name John Lemire 71C, Bird Jr. Address R 700 E. 5th st New Richmond wi. 54017 STM #220527 Lot Subdivision --- -- - - -- Date 9/18100 NE 1 /4 N E 1 /4 S 3 6 T 3 1 N /R W Township Somerset Boring Q Well PL Property Line County ST. CROIX ,BM or VRP Assume Elevation 100 ft.nail in 8" Oak tree System Elevation T -1 =91.9 T -2 =91.7 H.R.P. same as B M #alt BM El 100 723' PL > 20% sloe PL B.M. 80th st B 50' 15' 250' 33 B2 100' �^ > 20 %slope 250' 489' 662'P A POWTS OWNER'S MANUAL 8t MANAGEME141 PLAN rage of ,, .FILE INFORMATION SYSTEM SPECIFICATIONS Owner y7 e 1 r Septic Tank Capacity O al ❑ NA Permit # Septic Tank Manufacturer GU -et- fi' 5 ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 1 >�❑ NA Number of Bedrooms p NA Effluent Filter Model /d o ❑ NA Number ber of Commercial Units ❑ NA Pump Tank Capacity gal ❑ NA Estimated flow (average) gal/ ay Pump Tank Manufacturer ❑ NA 4 Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer ❑ NA Soil Application Rate gal /day /ft Pump Model I] NA Influent/Effluent Quality Monthly average* Pretreatment knit ❑ NA ❑Sand /Gravel Filter ❑Peat Filter Fats, Oil at Grease (FOG) s30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) :5220 mg /L ❑ Disinfection O Other: Total Suspended Solids ( TSS) 1 5150 mg /L Manufacturer Pretreated Effluent Quality ' ❑ NA Monthly average* * Dispersal Cell(s) Biochemical Oxygen Demand (BODs) :530 mg/L n- ground (gravity) ❑ In- ground (pressurized) Total Suspended Solids (TSS) s30 mg/L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) :510' cfu /100ml ❑ Drip -line ❑ Other: Maximum Effluent Particle Size inch diameter * Values typical for domestic (non-commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Frequency Service Event Inspect condition of tank(s) At least once every months years) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (Ys) of tank volume Inspect dispersal cell(s) At least once every ❑ months Xyear(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months pdear(s) Inspect pump, pump controls ez.alarm At least once every ❑ months ❑ year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA other: At least once every ❑ months ❑ year(s) ❑ NA i MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Mast Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing ' Operatork cra • lea n k insp sureof must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify y surface. The dispersal volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground f effluent on cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding o 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. of the tank volume, the entire mutation of sludge and scum in any tank equals one -third (A) or more n When the combined accumulation g , NR 113 Wisco contents of the e tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other maintenance or monitoring at intervals of 12 months or less 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 c t s or For new construction, prior to use of the POWTS check treatment tank(s) for the presence of p ainting chem that may impede are detected have ti the conte'r tr eatment p rocess and /or damage the dispersal cell(s). 1f high concen P ede the tr p ', in o erztor nor to use. nF r1,o ran{r(t'� ramovPd •.Y � SentaRe se rvtU g P P tl Page System start up shall not occur when soil conditions art frozen at the 111111tradve surface. During power outages pump tanks may fill above normal hlghwater leveb. When power Is restomd the excess wastewater will be discharged to the dispersal cell( In one large dose, overloading the ce(t(s) and may result In tht badtup or surface discharge of effluent. To avoid this situation have the contents of OR pump tank removed by a Septage Servidng Operator -prior to restorinti power to the effluent pump or contact a Plumber or POWT5 Malntalner to assist In manually operating the pump controls to restore ncrmaf levels within the pump Link. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise diswr'b or compact, the area within 15 feet down slope of any mound or at -grade sod absorption area. Reduction or ellminadon of the foilowir+.g from the wastewater str'earn may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; tat; foundation draln (sump pump) water; hit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting cmducts: pesticides: sanitary navkins: tampons; and water soMner brine. ARAN DON EM ENT 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 ch. Comm 83.33, Wisconsin Administrative Codet • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of a(( tanks and pits sha(I be removed and prc+perty 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 provl4e a code compliant replacement system: O 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 fora new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules In effect at that time. O A suitable replacement area Is not available dire to setback and /or soil (imitations. Barring advances In POWTS technology a holding tank may be Installed as a last resort to replace the failed POWTS. I The site has not been evaluated to Identify a sultab(e replxm eent area. Upon failure of the POWTS a soil and site evaluadon 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. O Mound and at-grade soil absorption systems may be reconstructed In place following removal of the biomat at the lnflitrative surface. R:eeonstrualons 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, RESGUtc Of A PER SON FROM TWE INTERIOR OF A TANK MAY BE DIFFICULT OR IMpfMIMRI F. ADDITIONAL COMMENTS r POWTS INSTALLER POWYS MAINTAINER Name / ,�, Ve < Na me n Phone Phone SEPTAGE SERVICING OPE TOR (PUMPER) LOCAL REGULATORY AUTHORITY Name d "-L ®!� Apncy ,mo Zo o n ` Phone 7/ h` � _____ h n —6-c:' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer .,} ate!/? �e o /^L 70 o Mailing Address �` /,� l C �j�n f Property Address (Verification required from Planning Department for new construction) City /State me ^ 5 AIJ ' Parcel Identification Number LE GAL DESCRIPTION '0 Property Locatio /4' �/4, Sec. J 7 )C, TN -R W, Town of a /n Subdivision 5n? , Lot #_. Certified Survey Map 3Y?Z(o , Volume Z'Z , Page # Warranty Deed # Volume 1 , Page # Spec house ❑ yes a no Lot lines identifiable Xyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. ]/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da of the t e y r expiration date. 1 01 6101 S NATURE 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 FNATURE s T'eXe, by virtue of a warranty deed recorded in Register of Deeds Office. I ANT DATE OF APPLIC 0 /�7/ Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Zen 0 THIS INSTRUMENT DRAFTED BY Doug Lahler JOB NO. 00 -93 Oo3 :m0 N F- 0 5 a W 0 BEARINGS ARE REFERENCED TO THE a Q < 3 3 Z EAST LINE OF THE NE1 /4 OF SECTION 36 ID o c ASSUMED TO BEAR S00 °1 4'42 "E � r- c, D 3 C, -i r m a - ... W O w` m (n z r O Z w j N w o m \! �� m y Z m awcn�r -I :0,o -f 'm o�oa3K QkIM(_D_0WpRMU M[M �Z : m w w m _ �E aS T O w N N 00 °30'45" W 662.84' a � II o n " C5 N woC Pt O w o: •. . 0 0 (D cn cn �1 I I o m 3 a -, o I(� I� Y �i o��� o �� ,� oZ h1 0D I o Z W O° co �� � m m ill Z 1 0 N I oa �� CAA W 0 2 A �� W W O I I� Y ' "1 O O • i co") m W m i� i °0 .n (p J 7 /b D -1 I� I N —4 IN I V o OD Ivu Ip o ` D I ,�° Z p 0 m Z I I A I� o X - Or �o r- O C I Nni 0 O > Cl) - m 111 i� C 0 '11 3 O O n _`z K 0 j oo z rec. as S00 °08'56 "E 250.0 rec. as N00 0 08'56 "W C M _ - - -- D z r- T �� n C� 0 I m S 00 °14'42" E 250 80' S 00 °14'42" E 220.80' m C '0 0 is mm �) yr co p C7 i �] m D m� m i O m W , -- Z T O m ( �� Z j O j f� o Z (n 0 l O N F- 0- =i I� m I�I o0 am ao a I�I� w O z= ,qn I , � Q cD (O Q i i OO O m 0 O ka I v w i w c � r m i o w N i�l`� , I I m m I�lo «off 73 Z I° I� uN N v Inln m I � I❑ ,V N A I I C2 �� Sly I a-, - oo w w Id o S00 14 2 "E O 191 . 7' o S00 °1 4'42 "E ci - ,t�z� ,v6 —r -� S00 °14'42 "E 1577.92' °? S 0 °14' 42" E w 886.05' m 80TH STREET 191.87' ° EAST LINE OF THE NE1 m O 0 recorded as S00 OB 56 E 0 O C t MM[- [�&cn1 [ECQ>_[►�A G�D% IMI�/GIl[ D� 0�1' 1C G30 0) � 0 ft1 - - - - - - 0) -1 X 0 zz Cn O " O 00 Z m �C D m z 0 0C ° �t rn < � m _C m0 D ocmnc000 . ( D CD ` r oD 53 m z� �� 0 rn 1 r - r SURVEYOR'S CERTIFICATE I, Douglas I Zahler, registered Wisconsin Land Surveyor, hereby certify that by the direction of Duane Lemire, I have surveyed, divided and mapped a part of the Northeast Quarter of the Northeast Quarter of Section 36, Township 31 North, Range 1.9 West, Town of Somerset, St. Croix County, Wisconsin; described as follows: Commencing at the no; theast corner of said Section 36; thence along the east line of said Northeast Quarter S00° 14'42 "E 886.05 feet to the southeast corner of Lot 2 of Certified Survey Map Volume 12, Page 3316 and the point of beginning; thence continuing along said line S00° 14'42 "E 191.87 feet; thence N89 °2333 "W 522.78 feet; thence S00° 14'42" E 250.80 feet to the south line of said Northeast Quarter of the Nor theast Quarter; thence along last said line N89 0 28'48 "W 723.19 feet; thence N00 °30'45 "W 662.84 feet; thence S89 0 32'01 "E 726.28 feet to the west line of said Lot 2; thence along said west line S00° 14'42 "E 220.80 feet to the southwest corner of said Lot 2; thence along the south line of said Lot 2 S89 °7.333 "E 522.78 feet to the point of beginning. Containing 580,846 square feet or 13.334 acres. Subject to right -of -way for 80th Street as shown on this Wrap , and subject to all other easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a correct representation to scale of tine exterior boundaries surveyed and described; that have fully complied with Chapter 236.34 of the Wisconsin Statutes and the Land Subdi ision Ordinance of the County of St. Croix and the Town of Somerset in surveying and mapping same. Of W ISC O I DOUGLAS I �y ' ZAHLER Douglas J. Zahler RLS 21'45:; Date * x_2145 S & N Land Surveying, Irrc;': HUDSON 212 Walnut St. IS. Hudson, WI 54016 $U %fi ,t f. 1 STATE BAR OF WISCONSIN FORM 3 - 1998 63 6? I 42UI M D I'ATHL..E:FN H. WALSH Vol. � Phu REGISTER OF DEEDS Document Number ,T. CF,,.: I„ x CO. WI I; RECEIVED, FOR RECORD This Deed, made between f<2 01 -12 -2001 8:00 AM I _ ! MIT CLAIM DEED Grantor, �.i EYE7�1'T 4 8 CENT COPY FEE: and 0 VA COPY �� 1� —� ��� L `( �l � -- COPY FEE: !I TRANSFER FEE: RECORD149 FEE: 10.00 Grantee. J FACES: 1 Grantor quit claims to Grantee the following described real estate in County, State of Wisconsin: i , Reccvding Area —1— �) - 5 G k L) t%i 3 C. 1 f% 1 `% i� f 'Name and Return Address L �.s o Y) c,t �cl� �� t- t G('t. N O! 7 ,1 c LUU 1 P4 0::5� Parcel Identification Number (PIN) This homestead ro rt . p pe y not) i I' li 4i I i i ii Together with all appurtenant rights, title and interests. I� I Dated this I day of - f1�10.a l➢ _. (SEAL) G'L' 1 `f� Lf � (SEAL) i - . \. f (SEAL) _ c�1..C�,�., 1 I _ (SEAL) \ (fin I � AUTHENTICATION ACKNOWLEDGMENT i Signature (s) i, State of Wisconsin, ss. I! County. JJ CL *I authenticated this day of P rsonally came before me this �I day of ?r 1 l( ! (Jm , the above named I I ►tuull 3 1 D. kle w1 t r e f TITLE: MEMBER STATE BAR OF WISCONSIN : •C1 9� . N f to ' - • J . /� - 7l rE to l �. - r� r ! (If not, S * • Itte known to be the person i — who executed the foregoing I! Z authorized by §706.06, Wis. Stats.) ,p *is�ument nd acknowledge the sa e. i THIS INSTRUMENT WAS DRAFTED BY 1 ��i F • •�� ��� �' L` -G.� OFrrwISGO��,``` - �I I Notary Public, State of Wisconsin My commission is permanent. (If not, state expiration date: I (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. STATE BAR OF WISCONSIN Il QUIT CLAIM DEED FORM No. 3 - 1998 Wisconsin Lega � B waui<ee, Wis. T � Y rx /off iooy�o 63482 1 :0 /o aw ��o� 20 •T.� W THIS INSTRUMENT DRAFTED BY Doug Zahler JOB NO. 00 -93 3, 0' m BEARINGS ARE REFERENCED TO THE N a ? a � C EAST LINE OF THE NE1 /4 OF SECTION 36 a 3 v ASSUMED TO BEAR S00 °1 4'42 "E jj 94 M gj9- z y i 0 h a m N 00 °30 W 662.84' V O a �2 " R 6,12 ZOO o ro e= OO mn gig OD `� O 1� L n m m m ICJ I� d ;� ' r 400 Ir[� M mv m� i o� o r - i0 i� M 1 I� CL Z j O W I oo I � y ,p OD a O w w .,I o `� f � m O ° m O 0 ; W m 1'9 y -t C I �� � n� I 1 —I Z ' I�r� O 0 ? 0 C) Z C r Ipuu I O I o NV =a o ,� , O m 1 3 / z � A P X i O C m 1 EST`'LINE q~F CSM 5/1348 to o an O o o" Z cK '� O g m K. z '� 1 8 m Z m C Z i ° rec. as N00 0856 O C __ y 7 1 0o r rec. as S00 0856E 250.00 I ° ' — 1' m �� m m� v i� D r - O O m S 00 °14 E 250.80' :; ::: �::::::::::: S 00 °14'42" E 220.80' m O ng V c I •� rn 2 m 0 Z iOp v v ,s7 O�Z n m Cl) i m i o 1 'o r g p m O 1 fn�i z 1 P t3 z ;:: ;) Cl) :Fi i P i y W — 9 1 o m I P I o a e p :::::::::: ..::::::: :.:: oo a n -� c� o) ... • .. cc 1 l o m Z = O 10/:1 A i I JI ►lli i;.iiii!i. O 1 I w O lJ0 �1 � m z Z O O w m 1 Z I C o ,: z In 1UG Cr) �: I I^ Z z 1 I °� ;:;;;;; : m m m I I° �G` ..•........ l o l 31 Z i I l o � 1 Ig ji:: � J 0 � oo w I ww i d l i w S00 °14'42 "E 10 �2 191.87' ` S "E �--- L 4 i "z - w - '1_ S00°14'42"E 1577.92' °� w 886.05' C/) B OTH STREET 191'87 ° " EAST LINE OF THE NE1 /4 m O D --------------- recorded as S00 08 56 E p 0 00 0 zC z > - - - �-f -0 8 m Q r .ti 0 �! '� z C 17 a� m C c a w m C-.) =. 0 .o DEC J 6 2000 cn -1 v m y D G sv KATHLEEN H. WALSIJ ! O 0 �p a v -' va x () Rcgister of Deeds f 0) o w �, SL Croix Co., WI j r Z a O m Vol-14 Page 4005