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Home My WebLink About038-1213-70-000 . o 0 § . ■'� � @ � , � \ ; ■ � � ® 2 / / ° § r- f } § 2 0 w 0-4 § \ / 2 § § j E F m � 0 § i �R w §ƒG g to 0 a 2 m v > E % § E e, 5 @ \ a / o 0 U i f e= m @ C # § " CL CD / § k / g o a i � . CL \ 0 0 0 � } / ) co CO) k 7 CD gW)} J cx \ § \ f ~ = g > >0 O / \ _ � ° E } E \ ] � ■ ° , a -_ CL 9 0 . w M q -q 2 CD 0 CL \ j 7 z % $ i # � kE§�\ -�a0. k' 3_ & 2ƒUGG c )2 >§ } a _ 0CL Se m6-ID 2 + -0 § i2§ ■ �o0 f . CD0;0, X ■ \/\ 7 CL CD Q �E[ \ ° * N 0 § � \ N VIsconsin Safety ui tgs -' ision County 201 W. Was to . Bc�162 cJ , M n WI 537 uJi/ Sanitary Permit Number (to be filled in by Co.) Department of Commerce "`' a Vo7 Sanitary Permit Appli ation State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal i ormatian yo► provide f may be used for secondary purposes Privacy La , sI5.04(1)(m) Project Address (if different than mailing address) L Application Information - Please Print All Information , COUNTS 1v� ZONING OFFICE J j a pZ S Property Owner's Name Parcel # Lot # Block # A/4 Property Owner's Marlin Address Property Locati`onn'� 5 7 3 15, V.., 5 µ' V., Section City State Zip Code Phone Number 3$ - SyG T 31 N; R E oo Oircle ne) II. Type of Building (check all that apply) L 0 - 1 or 2 Family Dwelling - Number of Bedrooms Subdry ' Alon I Name CSM Number ❑ Public/Commercial - Describe Use ❑ State Owned - Describe Use ❑City _❑vill ownshi f III. Type of Permit: (Check only one box on line A. Complete line B if applicable) _ ��jp A. E-'New System ❑ Replacement System p y ❑ TreatmendHolding Tank Replacement Only ❑Other Modification to Existing System B_ List Previous Permit Number and Date Issued ❑ Permit Renewal R Permit Revision ❑ Change of ❑Permit Transfer to New Before Expiratfon Plumber Owner yaa mss y -3 -� IV. Type of POWTS System: Check all that appl Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis ersaVTreatment A rea Inf ormation: Des�n Flow ( pd) I Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 7 U-/ 870 9�,s' 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 Aerobic Treatment Unit Dosing Chamber 00 O � VII. Responsibility Statement I, the undersigned, assume responsibility fo 'nstallation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum re M MPRS Number Business Phone Number GK 6 ass Plumber's Address (Street, City, State, t 0 VIII. unt /De artment Use Onl pproved El Disapproved Sanitary Permit Fee (includes Groundwater Date ssued Is s g Agent S' natu (N ps) Surcharge Fee)�� {,n ❑ Owner Given Reason for Denial 7 '� IX, Conditions of Approval /Reasons for Disapprovq -749 sys 1 Il f 6 2- Attach complete plans (to the County only) for the system on paper not less than 8I r2 x 11 inches in size SBD -6398 (R. 01/03) X3-1 13- 3 2 r"' �` COMBINATION SEPTIC/DOSE CHAMBER TANK & PUMP SPECIFICATIONS PER COMM 84.25 CODE CHANGES 2/1/2004 Access Opening, not top of cover, Access Opening, not top of cover, must extend to a point no greater must extend at least than 6" Below Finished Grade 4" Above Finished �G ade . Covervvith Wi A?N V ,JT Z7 / rv' Lockin Device �j�l/ Qnl 8 9 PPt2eveD CA (typical) Finished Grade " Z .M �N./ rr� vr►-� Min. 23" 30 pr 42 Access Opening 0C IM5ULA� Min. 23" Access Opening P l P6 11 2 "file, r , �R cC/ ,37 A //' Oulet Effluent Filter f r u /�! if "o✓C 'SL R Union ; ;q,eaYEA P1 R6 ,3 PT, Inlet Baffle 0/00 SOt- /D SO /C_ i Pu p 3 ",Sa.+-►d o rq ra In �y uo e r w� h oen�&t 2 lower fah Qd �l Two ComparFment Septic/Pump Tank ( 4v L _ _ _ ✓ G( /�f) SPECIFICATIONS TANK MFR: DOSES PER DAY: 3 TANK SIZE: SEPTIC /, dG GAL. DOSE VOLUME: 21 GAL. DOSE GAL. (INCLUDES FLOWBACK & <20% OF DWF) ALARM MFR: G. zk-k1j CAPACITIES: A = 6 NCHES = '/ 3 GAL. MODEL # Switch type: y Q — B = _2 _INCHES =GAL. PUMP MFR: - C = N NCHES = GAL. MODEL #: D SWITCH TYPE: D = S INCHES = /a GAL. REQUIRED DISCHARGE RATE GPM PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) _ FT. MINIMUM NETWORK SUPPLY PR�SSURE (DISTAL & NETWORK PRESSURE) _ + FT. 05 FT. OF FORCEMAIN x b FT. /100 FT. FRICTION FACTOR ...... _ + , y 3 FT. TOTAL DYNAMIC HEAD (TDH) = 9"35 FT. INTERNAL TANK DIMENSIONS: LENGTH ; WIDTH ; LIQUID DEPTH 3 MP/MPRS SIGNATURE: LICENSE NUMBER: d3 0 ,3.5 [(� GOULDS PUMPS Submersible Effluent Pump M EPO4 & EP05 Serie APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for following uses: lubrication and efficient g heavy duty ball bearing improved performance. • Effluent systems heat transfer. ■ Casing and Base: Rugged construction. • Homes Available for automatic and thermoplastic design provides • Farms manual operation. Auto- superior strength and corrosion AGENCY LISTING • Heavy duty sump matic models include resistance. SP, Canadian Standards Association • Water transfer Mechanical Float Switch File # LR38549 • Dewatering assembled and preset h the 9 Motor Housing: Cast iron for efficient heat transfer Goulds Pumps is ISO 9001 Registered. SPECIFICATIONS factory, strength, and durability. ■ Motor Cover: Thermoplastic • Solids handling capability: FEATURES cover with integral handle and ' /A maximum, ■ EPO4 Impeller; Thermo float switch attachment points. Las • Capacities: up to 60 GPM, tic semi open design with p 0 Power Cable: Severe duty •Total heads: up to 31 feet. Discharge size: 1' /r" NPT, pump out vanes for mechanical rated oil and water,resistant. • • Mechanical seal: carbon. seal protection. rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60 'C) Intermittent, METERS FEET • Fasteners: 300 series 10 stainless steel. -- - -- • Capable of running 9 30 dry without damage to — ' �f - - 5 GPM i components, s - 25 �25FT Motor: w z _...:...... • EPO4 Single phase: 0.4 HP, 6 20 1 1 15 or 230 V, 60 Hz, 1550 a - RPM, built in overload with i 5 automatic reset. 15 • EP05 Single phase: 0.5 HP, 4 115 V or 230V, 60 Hz, 1550 ° � _ EP05 RPM, built in overload with 3 10 automatic reset. 2 • Power cord: 10 foot EPO4 standard length, 16/3 1 5 _ S ITW with three prong 5� grounding plug. Optional 20 0 00 P foot length, 16/3 S1TW with 10 2 0 30 - three prong grounding plug 40 so GPM (standard on EP05). 0 2 4 6 8 10 12 m +/h CAPACITY 2003 Goulds Pumps Goulds Pumps ENeciwe July, 2003 83871 ITT Industries Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420425 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be usad for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: LaCasse Custom Homes I Star Prairie Township 038 - 1213 -70 -000 CST BM Elev: Insp. BM Elev: BM Description: /60 6104 mx h use d TANK INFORMATION EL A ION IYATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / 11 � Benchmar . IQ `� / Mr' 1 &v, o Dosing d Alt. BM 's 7 • (� VI Z & -1150 w Aeration Bldg. Sewer a.G 92- 9 Holding = ° St/Ht Inlet 92. p o v r --. TANK SETBACK INFORMATION St/Ht Outlet 0 / TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet S f QOT- q G Septic ET ► � J Dt Both Dosing � M Header/Man 3o yore, "/ it y Aeration Dist. Pipe u //�� vv� �� qi �I'; Holding Bot. System `•, { r b- / PUMP /SIPHON INFORMATION -^t4d Bald Final Grade Fl a ' N Zr ` 9 /00. Manufacturer Demand St " M ••`Z� �� i� .� �0' 7 GPM K.rb>', Model Number CPO/ Z TDH Lift` ,qZ Friction Lq,s System Hea T - Forcemain Length '01– Dia. 2 Dist. to Well /W *r- , / SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS U� SETBACK SYSTEM TO 0 P/L BLDG WE L LAKE /STREAM LEACHWG _ anuf er, INFORMATION CHAMBER ORjO Type f System: UNIT Model Number: DISTRIBUTION SYSTEM B.ttL� Header /Manifold Distribution n x Hole Size x Hole Spacing Vent to Air Intake I Pipe(s) (f � I--- / Length Dia Length Dia acing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil - —; Yes No U Yes �J No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 1 / Inspection #2: Location: 2225 122nd Street Star Prairie, WI 54026 (SE 1/4 SW 1/411 T31 N R18W) River Place Lot 7 Parcel No: 11.31.18.1168 1.) Alt BM Description = /bOt�2 C_4 A�Lt�w�o 1 atT Cdl ►✓� y / 2.) Bldg sewer length =� ►rl�l� - 5 / ' U � .-�p Vln ft `7 S�— Sb l �S - amount of cover = &O �G� Plan revision Required. /Yes lal N -- - �,�lil%Zr�- t7` / Use other side for additional information. i SBD -6710 (R.3/97) Date Insepctor's Sign ture Cert. No. A Q � 9 a 1 a� �t Safety and Buildings Division County , � MA , 201 W. Washington Ave.. P.O. Box 7162 Vl�CO�$`n Madison, WI 53707 - 7162 Site Address De artment of Commerce 19 •1 D Z - 3�OD/P Da S� Sanitary Permit Application Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision �Qo V way be used for secondary pEnses Privacy Law, s15. 1 m I. Application Information - Please Print All Information State Plan I.D. Number Parcel Property Owner's Name Parcel Number �1 4 Property Owner's Mailing Address Property Location / 73 (/ ii c5"-, T / N. R / E City, State Zip Code hd& Y ` FDAN, t ttber Block Number _ Subdivision Name CSM Number II. type of Building (check all that apply) qV 3 R-- Vk4w�l ❑City or 2 Family Dwelling - Number of Bedrooms ' []village ❑ public/commercial - Describe Use ❑ State Owned Nearest Road III. Type of permit: (Check only one box on line A (n e ' scheme for internal use). Complete lme B if appli cable) A For County use 1 New 2 ❑ Replacement System 3 El Replacement of 6 ❑ Addition to Sy m Tank OnlyExis ' stem B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal rue) D - SI�D. C 44 [rNon - Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wedand S� d 34 / 22 ❑ pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line /� �( qv►v, f, t�J 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other 2 izt-C. V. D' 1saUlYeatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation � 00 goo i�)� 7 yp VI. Tank Info Capacity in Total Number M� Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tams Septic or Holding Tank ��6 Chamber mber VII. Responsibility Statement- I, the undersigned, assume responsibility for jpqaUation of the POWTS shown on the attached plans. p A e (P rint) Plumber's ' lure �� RS_N m r Business Phone Number 7Xs ^ a Plumber's Address (Street, City. State, Zip ) C ount /De artment Use Onl Sanitary Permit Ff(include undw ater Date Issued su ent Signature Stamps) Approved ❑ Disapproved Surcharge Fee) �/ Owner Given Initial Adversel,f 3 Determination IX. Conditi of Approval/Reasons for Disapproval �PA,.-CA- /J Id Z pkte lane o a y) for t o ten on paper e Y 3 u t - SDI x 11 inches I w sin z �( �-,��t 2 . 3 - s � f SBD -6398 (R. 05101) / - p y 7 �l x � x v° I3 -3 e rr , 1,1A, "Pd, 990357 / Co z� ,ge/h 0- / _1 Q° 3 -3 vg `Tj -7 f � 1 3 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page `_ of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. CROlX Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Periling (J oZ / 3 D Please print all information. Re ' wed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). i 3 Property Owner Property Location LaCasse Developmen Inc. Govt. Lot SE 1/4 SW 1/4 S T 31 N R 1 R (or) W Property Owners Mailing Address Lot # I Block # I Subd. Name or CSM# 573 Cty. Rd. "A" 7 na River Plac City State Zip Code Phone Number ❑ City El Village JATown Ne Hudson, iWI. 1 54016 (715) 381 -5405 Star Erairic- - I [ New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate E3 Replacement ❑ Public or commercial - Describe: 1 'j twash Flood Plain elevation if applicable ff ou Parent material General comments and recommendations: n CAG�IF trenches @ el. 96.40' r] Boring Sip!2 N� $� g Boring 1 g pit Ground surface elev. 99. tt Depth to limiting factor 120 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 sil 2msbk mfr 2 9 -27 10yr4/4 none sil 2msbk 3 27 -12 7.5 4 4 none pscl ml na na .7 1.2 C Boring # ❑ Boring 2 ® Pit Ground surface elev. 100.40 tt Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I 'Eff#2 10yr4/2 none 1f 5 2 11 -40 10yr4/4 none sil 2msbk mfr cu 3 40 -12 7.5 4 4 non .7 1.2 lox i _ Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L uent #2 = OD < 30 mg/L and TSS 5 30 mg/L CST Name (Please Print) Signature CST Number Gary L. Steel 02298 Address bate Evaluatiorf Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6- 22-2001 715 - 246 -6200 Property Owner LaCasse Dg - IN C. Parcel ID # mnding Page -a— of -3 a Boring # ❑ Boring pU Pit Ground surface elev. 99.50 ft. Depth to limiting factor 120 in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont: Color Gr. Sz. Sh. 'Eff#1 •Eff#2 sil 2msbk mfr Cs if .5 .8 2 12 -32 10 4 4 none sil 2msbk mfr 19W 1f .8 3 32 -12 7.5 4 4 none rcos osq ml na na .7 1.2 ❑ 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # Boring El pit Ground surface elev. ft. Depth to limiting factor in. Soil liption 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 I 'Eff#2 Effluent #1 = BOD > 30:E 220 mg/L and TSS >30:E 150 mg/L ' Effluent #2 = BOD 5 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD4330 (P-6=) a STEEL'S SOIL SERVICE Gary L. Steel LaCasse Dv . 1554 200th Ave. e., Inc. CSTM2298 New Richmond, WI 54017. SE S1 1 - T31 N 8W MPRSW - 3254 town of Star Prairie ( 715 ) 246 - 6200 lot V -River Place This soil evaluation eras conducted to satisfy a stoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as ObOMn as permanent lot lines verrer not establia39d at the time the test was conducted. N 1 11 =40' BM.= top of NE lot stake @ el. 100.00' alt. BM.= top of SE lot stake @ el. 93.75' 1 5 C DT j Sd v� Gary L. Steel 6 -22 -2001 S`T' CRO1X COUNTY SEPTIC 'TANK MAINTUNANCL AGRUUMUNT AND OWlql?RS1111' Cl?It'1'II-'ICA'1'ION DORM Owner /Bayer Z Aa% S S.e.. ae t e M o" Mailing Address 6'7,7 C7M r t4 L f Property Address _j 1., e -� r , (Verification tcquitcel lions Planning Ucpallutcnt for new cousl filet ion) Ci(y /Slate Parcel Identification Number - 1 LEGAL DESCRIP'T'ION Property Location .5 %,, _St,� ' /,, ,5cc. 'I' �1J -It >b' W, 'Town of S�4r` ��rlrl Subdivision l.ol it 7 Certified Survey Mltp Ir~ _ -- Vuluntc , Page Warranty Deed 11 (0 , Volume 1�� Page 11 _ q L Spec house ❑ yes l Lot lines identifiable Iy ❑ no SYSTEM MAINTENANCE Improper use and ntainlcuanecof your septic system Coll ItI IcSUIf in its ptenta III c filiIIIIe to handle wastes. Propermainlenaucc consists of pumping out the septic tank emy thtcc ycats or sooner, if needed by a licensed ptuuper. What you put into Ilse system coil affect the function of ilia scplic lank as a Treatment stage in Itte waste disposal system. The property owner agrees to submit to St. Croix Zoning Dclm(nicnl a cetlificalion form, signed by the owner slid by a ntasterplurttber, journeyman plumber, resit icicd plumber or a licensed pumper vet ifying that (1) (lie ou -site wastewaterdisposal system is in proper operating condition and /or (2) filler inspection and pooping (if occessaty), file scplic tank is less than 1/3 full of sludge. Itwe, the undersigned have read file above tegttitentcnls and agree to maintain fife wivale sewage disposal system with the standards set forth, hercht, as set by the Dcparlutcot of (-ortunetcc and file Depatlnteut Of Natural Resources, Stale of Wisconsin. Certification slating that your septic syslcm has been maintained must be cotttplcled and resulted fo file Sl. Croix Courtly Zoning Office within 30 days of the thr year expiration date. / SI NA 'UR - APPLICAN' 4 ►z/ a L DA'm OW NER CER'I'11?1CA'I'i0N I (we) certify that, all slalentcnts on this litnu ate "lie lo the best of my (our) knowledge. I (we) ant (are) file owuer(s) of the troperty as ribed ova, by vitluc of a wauanly decd tecotdctl in Itegisler Of Uccds Office. GNATUR OF APPLICANT UATLr Any information that is ntis- tcprescnled stay tcsull in life sanitary pcunk being revoked by the Zoning Department. t * * * ** ** Lrclude with tills applicaliou: a stamped wattauly decd from file Register of Uccds Off cc a copy of Ilse certified survey ntap if reference is made in the warranty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of . FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity X) a l ❑ NA Permit # O Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 7 ^ ❑ NA Effluent Filter Model r ❑ NA Number of Public Facility Units A Pump Tank Capacity a l GI-14A Estimated flow (average) gal/day Pump Tank Manufacturer Q-WA Design flow (peak), (Estimated x 1.5) Q gal/day Pump Manufacturer ❑-IOTA Soil Application R l al /day /ft' Pump Model IJ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Gr ) _ <30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade - ❑ Mound Fecal Coliform (geometric mean) <_10` 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 W N Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month y ear(s) ar(s) ) (Maximum 3 years) ❑ NA jq Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell yels) s) At least once every: ❑ mo nth year(s) l (Maximum 3 years) ❑ NA Clean effluent filter S �.� At least once every: ❑ mo nth $ yea() rs ) ❑ NA ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ' ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) Other. ❑ month(s) ❑ NA At least once every: ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. r Page of • START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) 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 tankls) 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 cellls) 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 INSTALLER POWTS MAINTAINER Name Name Phone 'i Phone �:j f SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone PhoneJ.,. This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.5411). 12) & (3), Wisconsin Administrative Code. �0 • �ni 159?Paf 639 STATE BAR 00 WISCONSIN FORM 2 -1998 KATHLEEN H. WALSH REGISTER OF DEEDS ocument Number WARRANTY DRFD ST. CROIX CO., WI This Deed, made between Kevin Patrick Campeau, Jeffrey Allen RECEIVED FOR RECORD Campeau and John Michael Campeau, as tenants in common, Grantor, and 02_27 -2001 11:00 AN LaCasse Development, Inc., a Wisconsin Corporation, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee NARRANTY DEED the following described real estate in St. Croix County, State of Wisconsin (The EXEMPT M "Property "): CERT COPY FEE: COPY FEE: TRANSFER FEE: 1290.00 The Northeast Quarter of the Southwest Quarter (NE 1/4 SW 1/4) lying west of the RECORDING FEE: 10.00 Apple River, EXCEPT the west three (3) rods thereof, that part of the Southeast PAGES: 1 Quarter of the Southwest Quarter (SE 1/4 SW 1/4) lying west of the Apple River and cast 122' Street; and the Northwest Quarter of the Southeast Quarter (NW 1/4 SE 114) lying north and west of the Apple River, all in Section 11, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin; and Recordist • Area EX CEPT Lot 1 of Certified Survey Map filed No 3, 2000, in Volume 14, Q Name and Return Address Page 3988, as Document No. 6329 - 4� re tr e - r 2. r- 5 3 -2 Kf) G to (Ps A it .S, - Above described land is subject to an easement for ingress and egress to said Lot N . u ( :5 1'7 1 as described on deed recorded in Volume 1555, Page 37, and subject to all other easements, restrictions and covenants of record. Part of 0384048 -10 & 038 - 1048 -40 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Subject to all easements, restrictions and covenants of record. Dated this _ y of February, 2001. 1�� lt"ezev in Ick C tpea ll/ John Michael Campeau *J y Al en Campeau —' AUTHENTICATION ACKNOWLEDGMENT Signature(s) Kevin Patrick Campeau, Jeffrey Allen Campeau and John Michael STATE OF WISCONSIN ) Campeau ) sS. p s.. ....... County ) a ►at da y of February , 2001. { .....�i ; — old •. • �� Personally came before this day of � r f' — • 2001 the above named 1 a * •• ih A , - nd to me known to be the S �, FTM S P TE BAR OF WISCONSIN person(s) who executed the foregoing instrument and acknowledge n (If the same. •aslthorized'by § 706.06, Wis. Stats.) • I THIS INSTRUMENT WAS DRAFTED BY Hendrik W. Van Dyk " VAN DYK, O'BOYLE & SILER, S.C. Notary Public, State of Wisconsin My Commission is permanent. Post Office Box 118, New Richmond, WI 54017 (If not, state expiration date: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800- 855 -2021 I w r W IT X 40 c� � o O ,, 8 �+ a Opp . , o m �Z C : 9 r ,�a•�ez a m J� 3.63.66oOON n r N �t�o'9t�E 3.L &Q Z t o T 0QC z ��O $ �Q� ...... ............. ... .............. o . ......... f ...... . a _ o O 800°22'51 E v- 549.06' 6.21' — —yes va' — ,ee•e� .t�•1� — . .w — — — — — 4 - 3 4 6.0 2` 4 W � V1/EST LINE OF W � Z � Qo WHIM) Mv @VNIEM _ o� co to l 8CU Q) . 3 a C C t0 � _ p N r Ohm O c n 3 IA w A 00Q • � �F VV 3 O X y 2 8 Z ' z z �Tr 8w U _ Ro E �Qcz m w $ w3Z$ Q w Q 8� @ �, m m o LL Nr z w a mmi U N 3 ��u� 09 w �— v w a a cn— u� D z i O 2— p z n Q Q J Q W Q IL N �i 1 1 310 49.5 ' 952.3 x I . 949X L T 11 X II LOT F D 1.537 CR I 952.3 th (1.637 CR I X .672 ACRE I I ( .672 ACRES) X 950.3 SOUTH LINE O THE N j I I E1 /4 OF THE W114 I NORTH LINE F TH (I W 950.9 8E1/4 OF TH $W11 952X = + r 306' 948.7 2 7 �1 X 948.9 X X { I B-10 t � : i I X 946.8 1.64 OAC 2 ACRE 9 t r .644 AC R ! 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