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HomeMy WebLinkAbout036-1043-70-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 514969 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: Bishop, Julie I Stanton, Town of 036- 1043 -70 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: ,� �� '�?� 18.31.17.273A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE CAPACITY STATION BS HI FS ELEV. Septic u 3 ®u 1000 Benchmark 3.7 1 *1 7S' /00,9 Dosing Alt. B Ae>&seg- Bldg. Sewer 4�, . i Y S Holding SUHt Inlet , n� TANK SETBACK INFORMATION St/Ht outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet r h► 1 Septic S .D ' (' t Dt Bottom Dosing Header /Man. ��,, Aeration Dist. Pipe yr '`J 6L Holding Bot. System Q fOe PUMP /SIPHON INFORMATION Final Grade <S• 7 Manufacturer Demand St Cover PM Model N ber I TDH Lift Friction Loss System Head H Ft 67 T 93 Forcemain Dia. o well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. �Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 � G SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System_: UNIT Model Number: t- I . 5 0 so , DISTRIBUTION SYSTEM 2 (7 ' 3Y Header /Manifold t Distribution x Hole Size x Hole Spacing Vent to Air Intake Pip Length_ Dia Length Dia Spacing SOIL COVER x Pre ssure Systems Only xx Mound Or At - Grade Systems Only Depth Over p Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center y,99 Bed/Tre lTopsoil E] No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: �r / L / Os Inspection #2: / / Location: 2126 150th Stre t New Richmond, WI 54017 (N 1/2 SE 1/4 18 T31N R17W) NA Lot Parcel No: 18.31.17.273A . 1 1.) Alt BM Description = TA (,a VE l �� (+ � If.* CF 4'S ,Il 2.) Bldg sewer length= �1 �i ' � 6 �(4 q� - amount of cover = Z y (.� ��� � � `k �� ' � K � I„` c/ ow Plan revision Required? ❑ Yes 0 ('I � 76 L b (A i Use other side for additional information. L lv ° a,, ( Date InsepcIrgnat �� r� e r 2 P Cert. No. SBD -6710 (R.3 /97)i{ t '1 L� 1 _ + i / Ll6tvy► �l►t.� �S �(V r - Safety and Buildings Division Count ` 201 W. Washington Ave., P.O. Box 7162 �' is Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) eonsin Department of Commerce (608) 266 -3151 5N 4 C, Sanitary Permit Appliea State Plan IDN mber In accord with Comm 83.21, Wis. Adm. Code, personal inforA u ide , may be used for secondary purposes Privacy Law, s15. 4 (l )(m) Project Address (ifdifferent than mailing address) I. Application Information - Please Print formation Property OHmer's Name Parcel # Lot # Block # T I e 3 6- /6q 3 7o - do Property Owner's Mailing Address, , .. Property Location ( , 2-7 /I City, State / v Zi Code T tuber Section ` ZONIi! �rp O 7/J - 7 7 j j/ (circle or - o ? p 1� T � N, R�E o� II. Type of Building (check all that apply) or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number ❑ Public /Commercial - Describe Use t ❑ State Owned - Describe Use 17 4 ❑City_❑VillageirT wnship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B List Previous Permit Number and Date Issued ❑ Permit Renewal El Permit Revision ❑Change of El Permit Transfer to New Before Expiration Plumber Owner IV. Type of POWTS System: Check all that a I a KNon - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil M�4 it�itable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland Pressurized In- Ground nk ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching hamber ❑ rip Line ❑ Grave -less Pi ❑ Other (explain) V. Dispersal/Treatment Area Information: t Design Flow (gpd) Design Soil Application Rat ispe sal Area Required (sf) Dispersal Area Prop st) ystem Elevation �y� /dam t �� - yam VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 00 000 A 1 Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Piut)�e Name (Print) Plumber igna re MPRS Number Business Phone Number t, Plut er's Address (Street, City, State, Zip Code) o e) X � l fl l � CIO CD V Il. .ount /De artment Use Onl Approved isapprove Sanitary Permit Fee (includes Groundwater Date Issued Issuing ent Sign re o Stamp Surcharge Fee) . O iven Reason Denial C'onditions of Approval /Reasons for Disapproval 1 I SYSTEM OWNElZ: 3 / �` ''�'� aria 1. Septic tank, effluent fffter and dispersal cell must all be services /be services / maintainer as per management plan provided by plumber. 2. All setback requirements must be maintained W p>ver applicable code / ordinarwaa. ae�4 IA� 4.,X' ��� Attach complete plans (to the County only) for fik system on paper not less than 81 x 11 inches size SBD -6398 (R. 01/03) M `e-I nri . ra a C)s �.� ECp pY o. i T � � M CZS w 0 M el CZ l� a x �Uepart meant o Co mmp -rce cell _ EVALUATION REPORT Page 1 of v Ion of Safety ndBuil ings TO in accordance with Comm 85, Wis. Adm. Code County P mplete sl' plan paper not less than 8 1/2 x 11 inches in size. Plan must. ��• � � � 4 de, bu tjl %d to: v rtical and horizontal reference point (BM), direction and Parcel I.D. perc mensions, north arrow, and location and distance to nearest road. — I Q — 7 loo S�ZON�NG P lease print all Information. Re ' e Date PefsonalInformalion you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). y Prope Owner y�/� Property Local Z'vh C -I K os (fie C � �0 Govt. Lot I 1/45E 1/4 S T3 N R' E (or Property Owner's Mailing Ac1dress 40,4 Block # ubd. Name or CS 1 ,LS ,5-. d� , Z73 City State lip C(- Phone Nu:nber ❑ Vill age '® Town Nearest Roa N� ;�h�►p w S ala 1,71(-7 -al S+atn ctv IS NTH " ❑ New Construction User Residential / Number of bedrooms Code derived design flow r ^te CL ^, GPD Replacement ,1. ❑ Public or co mterc-iiaal - Describe: T� _ Parent material ^!_W i.. } .yam �— �' D Plain e:evation if applicable _ ft• General oomments S V ` � . S -t � — q� S " —I) and recommendations: "V - b o*" % r., S te-{ aA q`f 9.S' Boring # Boring a 9 g l6 a t a t --- pit Ground surface elev. _ � ft. Depth to limiting (actor in. $oil Application Rate Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2 O- I 11 D y(Z a. L IFS m�r— w rr o L to a' 7,5%f tk r4 e- c� I%) y in t_ C w ^ 9 E] Io ng t �1 Borin e �/ dpf ';i Ground surfzce e!ev. 7 � I ". Dept;; to limiting tam cr in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture SWcture Consistence Boundary Roots GPD /fP In. _Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2 oi F5bkL imf r 9 o- L. - -" , 4- _ _ -- ' Effluent #1 = BOD > 30 < 220 mg/L and TSS 40 < 150 mg/L Effluent #2 = BrJD _ "• ,ngA- and TSS E 30 mg/L CST Name (Please Prin') Signature CST Number Address �0,.�,.�„�,' to Evaluation Conducted Telephone Number yo L � Property Owner G•s5e.e Parcel ID# _ Page _ of _ Boring # ❑ Boring QQ I ® ; W Pit Ground surface elev. _99.93 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. 1 1 1 1 'Eff #1 'Eff#2 IV 10 L. a E5btt aw I . I _ bk MIFr Cw I t F $ •3b ,7, S --' . L- n-sboc I I c I J oF I I . 3 Y 767 5 6-54 1 - 7 1 1d o -► 7,57 --- S /,6 Boring # ❑ Boring _— ❑ Pit Ground surface elev. h. Depth to limiting factor _ in. Soil Applica tion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roc:: GPO /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ Boring El Pit Ground surface elev. __ h. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /tf In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff #2 'Effluent #1 = 1301), > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = 801),< 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. S1)D4J30 (R -&W) Property Owner _ �-S'. �'"' Parcel ID # P _ age _ of _ ® Boring # El Boring W Pit Ground surface elev. _L; 3 M. Depth to limiting factor G� 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 o -i a 31 L a w a , Y a Boring# ❑ Boring ❑ pit Ground surface elev. _ h. Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPON in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 'Effi12 a Boring # ❑ Boring . ❑ Pit Ground surface elev. Depth to 1hnilin9 factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure . Consistence Boundary Roots GPD /if In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 'Eff #2 ' Effluent #1 = 60D, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg1L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to agcess services or . need material in an alternate format, please contact the department at 608- 266.3151 or TTY 608- 2644777. sao•u�o lR.doof 4 Q n 4L �. 'J CO s m o� ,1 . o� o O Q { /T 4 J V) 7-. Cif, a d 01 r) %J loo 1\ `! V 5 �� v ! + N• `2 72 q !� 1 7 WA11R `NTY 001E D .4AOe+ X011 L Crisdhcme Farm, Inc . , a duly organized ],J'�6 and existing Wisconsin corporati 1� 4 9 30 ­­%L s and w: wants u• Julie_ L Bishop .. _ I rlr. 'nr :l - : it `.FR Vr17 P(iR nG.CbligndG r)AiA - Idle' loll v. ing descrit real estate in - St.., Croi � : Counlv, Stall ill Wkconsin: 036- 1043 -70100 Ifla n�.. -i Idcnrificati(m Nun:.,cr) - See attached description. at !7 FE L— n 1 ^1 This deed is given in full satisfaction of that certain land contract between the parties hereto dated November 20, 1992 and .recorded in Volume 983 at page 87 as Document No. 492063. is not homestead property. (I (i, Furl) munici al and zoning ordinances, easements and l- ixceplionto warranties: p restrictions of record and any lien created by act or omission of Grantee. Dated this _� da) of _ Max CRISDIIOME FARM., NC. fstal.) /mac -. ,SE ) DAVID A. KRUSCHKE, president _ fSEAI.) RICHARD E. KRUSCHKE, secretary AtJ T1 1 ENT 1CAT10N ACKNOWLEDGMENT Sii:naturc( ) SI Chi= WiSC'ONMN ss. ST. CROIX County. ^� y� d .nu hc;tl i;:a1.'cl Ihi< clan ^I I Prr•..•n .11 ra cn a• hclnnr mr thic « ay of May .19 h above name David A. Kruschke, president and Richard E. Kruschke, secretary, r'Ii - Lf. �•i( �il;l :l{ >1 :117` Ii,V2 <)r S1`iSC c :,a:SIN as Officers of Crisdhome Farm. -. Jn c _ :Itn h.•rvr..t I,% k . Ur., M, Slat 1., nn: lrn.un In he tilt s uho executed the t;vcr.in in�'nlm�lTt •nJ aikn.•c.k•dee the same. REh7I V ETON LAW OFFICES .Juds.th A. Remington C ith A. Remt- ngtdPf Naw Richmond W1 54017 �i :,.t 1'.a s> _ U Loix rn.n u..: - mac t. ;nEh• - n: r. ne:a .. .1.. lr..ic.•�? li.!h :nc nq \i. • "Lm r ,.rrn,.lnrnt. X11 nrl. Talc c`/:itJ U„r, d;ltr. 1 • • t • 1: , ' 1 ; 1 1 , l - l l l e \ ! < t 11 �, 1'. . - t . - .. '. Part of the North Half of the Southeast. Quarter of Section 16, To 31 North, Range 17 West, described as .follows: Beg inning at the East Q cor n et" of Section 18; thence South along the East line of the Southeast Quarter of said Section 829.79 feet; thence North 89 'West 1859.94 .0 y pp �. mot, 0A 1 177.) F .,i- t1-5 — �l vnrt tb`o ���ln Z inc feet 1; thence Nor 4li v t.� . . i. f'C.- - � of the North Ha IA or the Southeast_ Quarter Sour- 89 East 1860.00 feet to the place of beginning, which parcel contains 35.056 acres excluding right of way. Also, a non - exclusive perpetual easement for ingress and egress to the above described property over the driveway located in said North Half of the Southeast quarter of Section 18 to the South of the above described property as said driveway is presently laid and traveled. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner J v Septic Tank Capacity /00c) ga l ❑ NA Permit # 5 Septic Tank Manufacturer ors c.� ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer P Dt D ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 5 Z ❑ NA Number of Public Facility Units ANA Pump Tank Capacity gal Estimated flow (average) Pump gal /day Pump Tank Manufacturer Age Design flow (peak), (Estimated x 1.5) $(� gal /day Pump Manufacturer 1.1 rA Soil Application Rate C) .7 gal /day /ft2 Pump Model Standard Influent /Effluent Quality Monthly average* Pretreatment Unit A Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD <_220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) <_150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Morerage Dispe al Cell(s) ❑ NA Biochemical Oxyge emand IB 5 <_30 mg /L -Ground (gravity) [3 In- Ground (pressurized) Total Suspended SS) S30 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform ( eometric mean) _ ° 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 MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once ever ❑ onth(s) (Maximum 3 ears) ❑ NA p Y: years) y 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: ❑ nth(s) (Maximum 3 years) ❑ NA year(s) month(s) Clean effluent filter At least once every: ❑ ❑ NA year(s) Inspect pump, pump controls & alarm At least once every: ❑ mo ❑ yeaarr((s) s) 1 ❑ NA Flush laterals and pressure test At least once every:' ❑ month(s) ❑ NA ❑ year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of :0 2 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. GMW (4/01) 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 highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTA ER POWTS MAINTAINER Name c, Name Phone 7 Gp '79 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name �— �A Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. SAFETY AND BUILDINGS DIVISION Plumbing Product Review commerce.Wl.gov P.O. Box 2658 Madison, Wisconsin 53701 -2658 isconsin Department of Commerce Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary August 19, 2008 AK INDUSTRIES, INC. WASTEWATER KURT A. SNEARLY PO BOX 640 PLYMOUTH IN 46563 Re: Description: SEWAGE TANKS, POLYETHYLENE Manufacturer: AK INDUSTRIES, INC. Product Name: 1000 GAL. ALL -IN -ONE SEPTIC, SEPTIC /SEPTIC, HOLDING Model Number(s): AKS 60452 -A10 1021 GAL. (50" L.L., 24" MAX. DEPTH OF BURY, 488 G.P.D. WHEN USED AS A SEPTIC OR SEPTIC /SEPTIC; TANK BASED ON A 3 YR. SERVICE INTERVAL FOR RESIDENTIAL WASTEWATER) Product File No: 20080289 The specifications and /or plans for this plumbing product have been reviewed and determined to be in compliance with chapters Comm 82 through 84, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of August 2013. This approval is contingent upon compliance with the following stipulation(s): • This tank must be designed to withstand the pressures to which it will be subjected. • The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the department. • Installation and servicing of this product must be in accordance with the manufacturer's instructions. A copy of the manufacturer's installation and servicing instructions must be given to the owner of the system. • When this product receives wastewater from dwellings and is used as a septic tank, it will produce an effluent quality with a maximum monthly average value for BOD5 of greater than 30 mg /L and less than or equal to 220 mg /L TSS, or greater than 30 mg /L or less than or equal to 150 mg /L TSS, and F.O.G. of less than 30 mg /L. • A minimum 2" diameter vent must be provided on the building sewer within 12" of the connection to the tank or on the tank installed in accordance with the manufacturer instructions. • When wastewater from this tank is discharge to a POWTS treatment or dispersal component that consist in part of unsaturated soil, provisions must be made to remove any solid or suspended solid exceeding 1/8 -inch in diameter before the wastewater is discharged the soil component. • Tank Bedding: As per manufacturer's instructions, provide 6 to 12 inches of 3/8 to 3 /4 inch gravel type aggregate or AK Industries Inc. approved aggregate. • In specific situations, the second chamber may be retrofitted as a lift station; in these cases, the distributor must work with the owner to determine the actual septic volume(s) available. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Jean M. MacCubbin, CST Engineering Consultant -- Plumbing Product Reviewer Commerce; Safety & Buildings Div.; PO Box 2658; 201 W Washington Ave.; Madison WI 53703 -2658 Phone: 608 - 266 -0955; Fax: 608 - 283 -7456 E -mail: Jean.MacCubbin @wisconsin.gov SBD- 10564 -E (N.10/97) File Ref: 08028902.DOC i SAFETY AND BUILDINGS DIVISION Plumbing Product Review commerce.Wl.gov P.O. Box 2658 Madison, Wisconsin 53701 -2658 isconsin Department of Commerce Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary December 11, 2007 NORWESCO, INC. ANASTASIA R. O'HARA PO BOX 439 ST BONIFACIUS MN 55375 -0439 Re: Description: SEWAGE TANKS, POLYETHYLENE Manufacturer: NORWESCO, INC. Product Nam • SEPTIC TANK Model Number 1000 (46.25" L.L., 36" MAX. DEPTH OF BURY; 479 P.D. WHEN USED AS A SEPTIC TANK ASED ON A 3 YR. SERVICE INTERVAL F R RESIDENTIAL WASTEWATER) Product File No: 2 70527 The specifications and /or plan for this plumbing product hav een reviewed and determined to be in compliance with chapters Comm 82 through 4, Wisconsin Administrati Code, and Chapters 145 and 160, Wisconsin Statutes. , The Department hereby issues an appr al based on a Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the a of Ja ary 2013. This approval is contingent upon compliance wi the following stipulation(s): • This tank must be designed to withstan the pre ures to which it will be subjected. • The manufacturer must keep at the anufacturing pla t a set of plans and specifications bearing the department's stamp of approval. T e plans and specific tions must be open to inspection by an authorized representative of the department • This product may only be use as a septic tank. • Installation and servicing o this product must be in accordance with a manufacturer's instructions. A copy of the manufacturer's install ion and servicing instructions must be given the owner of the system. • The manhole riser on is product must terminate below grade within six inch of finished grade. • When this product r ceives wastewater from dwellings and is used as a septic tan , it will produce an effluent quality with a max' um monthly average value for BOD5 of greater than 30 mg /L an ss than or equal to 220 mg /L TSS, or gr ter than 30 mg /L or less than or equal to 150 mg /L TSS, and F.O.G. o ess than 30 mg /L. • Before this pr duct is installed a warning label meeting the requirement of Comm s. 84.25(8)( Wis. Admin. Code must be securely attached to the manhole cover. This approval supersedes the approval issued on 5/9/2007 under product file number 20070190. SBD- 10564 -E (N.10/97) File Ref: 07052701.DOC NORWESCO, INC. Page 2 December 11, 2007 PRODUCT FILE NO. 20070190 This approval letter shall be incorporated with your previously approved plans and /or specifications approved under product file number 20070190 The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Jean M. MacCubbin, CST Engineering Consultant -- Plumbing Product Reviewer Commerce; Safety & Buildings Div. PO Box 2658 201 W Washington Ave. Madison WI 53703 -2658 Phone: 608 - 266 -0955; Fax: 608 - 283 -7456 E -mail: Jean.MacCubbin @wisconsin.gov j Parcel #: 036- 1043 -70 -100 08/18/2008 04:12 PM PAGE 1 O F 1 Alt. Parcel #: 18.31.17.273A 036 - TOWN OF STANTON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner O - BISHOP, JULIE L JULIE L BISHOP 2126 150TH ST NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2126 150TH ST SC 3962 NEW RICHMOND / J SP 1700 WITC __' Legal Description: Acres: 35.670 Plat: N/A -NOT AVAILABLE SEC 18 T31 R1 7W PT N 1/2 OF SE 1/4 BEG Block/Condo Bldg: E 1/4 COR SEC 18; TH S ALNG E LN SE 1/4 829.79 FT; TH N 89DEG W 1859.94'; TH N Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 841.73'; TH ALNG N LN N 1/2 SE 1/4 18 -31 N-1 7W S89DEG E 1860' TO POB Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 1186/193 WD 07/23/1997 983/87 LC 2008 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 04/16/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.670 15,000 68,200 83,200 NO AGRICULTURAL G4 20.000 2,700 0 2,700 NO UNDEVELOPED G5 14.000 9,800 0 9,800 NO Totals for 2008: General Property 35.670 27,500 68,200 95,700 Woodland 0.000 0 0 Totals for 2007: General Property 35.670 27,500 68,200 95,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 120 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND w' OWNERSHIP CERTIFICATION FORM Owner/Buyer ) Ca4t \ /L Mailing Address t 1 a JSQ S T' , ,. Property Address (Verification required from Planning & Zoning Department for new construction.) City /State �tJ- 1.y- - Parcel Identification Number b 3 6 LEGAL DESCRIPTION Property Location N 1 1a 1 /4 , 1 /4 , Sec. c) , T 3 t N R_W, Town of Subdivision , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # / / 0?0 3 , Volume g�3 , Page # Spec house yes no Lot lines identifiab yes SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. I /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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we amlare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 4 -'b / 77 d7 44-0GNAXU" O PLICANT(S) DATE ** y information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** 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. 08/05) �11 14 I n e ..S Q2 woo vp Eil Q Q p 1 z R 4 fi VI s ,� ►� lu AMP CA ti~ l 5 �� UA c w ° 3 o oC C O 00 p p N O i r Z I I F. w � N 7 co LL C- c) CL a) E LLI = O U O Cl) CL a m I o z v i c of d Z v o N E N U O N ' N N N U C� N � v �1 Q. (` O ^1 0 0 Q O z Z r _ N CL m d - L N o a L -2 _ o E cm • �a E IL a CL a FL S; o cn O fA J U a3i o N z z a N oO O ?5 a .�.. il Q '6 . Hs ) .� • '',, 'p i z v2 N r � c0 N v) ^i +� c c, ) � � N C © R r Q C N N 0 M 3 m c r t � N 7 N v C M �_ C M C @ Oa (O O i�l M N O C 'O 7 O � Cn ! CD to O z N of Z O � I w M L a #t a L: a w • cat CL w 2 m y �Mwwl �'c c ( A u a 2 j': 0 0) V FLETC ILLIAM J. ;20-1470-04- AN , CHRIS S: C ER STONE RIDGE C: L: 8 Sanitary LDWOOD RIDGE C: L: 4 Sanitary 0 - 13 -08 -000 08.29.17.1109 0 24.29.19.2987 G UR , KERRY (LYNN) LAR N, JOHN A. & LESLIE C: VOL. 22 PG. 5413 L: 5 Sanitary S: 35 ACRES L: Sanitary 40- 1064 -70 -110 16.28.19.241615 34- 1053 -40- 0 24.29.15.371A PARKI ON, DUDLEY SNYD ,GERALD (JERRY) S: C: VOL. 06 PG. 1740 L: 1 Sanitary S: TES & BOUNDS C: L: Sanitary 2- 1062 -50 -000 21.28.18. P336A 2- 1027 -90 -000 13.29.16.198B TALMAGE, ROBERT & ALICE WEBER, LLOYD A. S: NA C: L: Sanitary S: 40 ACRES C: L: Sanitary 038 - 1091 -10 -000 22.31.18.373A 028 - 1021 -90 -000 14.28.17.121 WEFE EFFREY & ROBYN S: C: VOL. 23 PG. 5546 L: 1 Sanitary 0- 1014 -30 -025 04.29.19.59A25 I I 4 HE DON D & MARY BONTE TRUST Sanitary S: ACRES C: L: Sanitary 00 18.31.17.273A 0 6- 1039 -10 -000 18.30.15.284 GE KINK, KERRY (LYNN) D RIDGE C: L: 4 Sanitary S: A C: VOL. 22 PG. 5413 L: 5 Sanitary 0 24.29.19.2987 40- 1064 -70 -110 16.28.19.2411315 PARKINSO , DUDLEY WEF , JEFFREY & ROBYN S: NA C: VOL. 06 PG. 1740 L: 1 Sanitary S: C: VOL. 23 PG. 5546 L: 1 Sanitary 022 -106 50 -000 21.28.18.P336A 03 - 1014 -30 -025 04.29.19.59A25