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038-1213-80-000
o ca O 0 (A O g v 0 Cz r_ = CD N I p CD W • 7 K ;; G —. tA\ Of 1 z< cn z n 0 ° v c c 00 = m v c o 00 ,I Cl) OD °< • L1 (D # W N OD O. > > CD V CNO to '. CD m N y ro N CL O v 1 _. CD O n 7 O O 7 N n 3 H C) O O y 1p 0 CD fD I W Z N N z D (' a N) m ce" D a j W W co m O O- L d O O "' O 0 0 O C rn m N rn rn rr a CD O O O °' z O O O I CD N U1 fA I3 . . . m cr CD m F : * n� » Lm a w C , CD N 01 N < 3 H A M - �1 a N Z O O D 7 v O D< g o m to CD D CD y M n 10 c m C m m F CD W CD Q A 3 n 3 m 0 CD co Z N co -1 CA N 3 C O Cn T �_ ,'� 0 cr 87 Z O m a v n �' O N .. _. C W W m zt Z , CD CD m m CL o g a cn o ~` o 00 N CD pl A W A N O N CD a a C7 y _ N o N N C — N C O M — — (D I �° O CD CD S u N C D CD CD I h 3 Q Q` � I w A N O N A N C CD A ., CD I m 0 0 0 0 e ti o o CL ti r Wiscon, in,Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix 'Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488285 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: • t Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 0 Permit Holder's Name: City Village X Township Parcel Tax No: Christenson, Michael Star Prairie, Town of 038 - 1213 -80 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No / Ub " fe r d F �� .. �1a'�` • '-, (6 fA 11.31.18.1169 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE: 5 CAPACITY STATION BS HI FS ELEV. ti �, Septic Benchmark t , , es-� _ , � z' i z 5 b 3.'9 /0 • 19 l eSD Alt. , i-e� 9ey.93 Aeration Bldg. Sewer 5.53 9$'.�}�o Holding St/Ht Inlet G.97 97 TANK SETBACK INFORMATION St/Ht Outlet 1 7.5 `1�' &cf TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Z-7 Dt Bottom Dosing Header /Man. S,30 Aeration Dist. Pipe Holding Bot. System 9.17 C4,'- PUMP /SIPHON INFORMATION Final Grade 9 ,� . 4 A1 Manufacturer Demand St Cover �J GPM qf' � \ Co i t'— 7' 6 9 c / . 9 3 Model Number TDH Lift Friction Loss System Head TDH jFt Forcemain Length ia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Tren PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO / 1, P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: / INFORMATION CHAMBER OR : r Type Of System: r� /\ UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold / Distribution ` I x Hole Size I x Hole Spacing Vent to Air In ke Pipe(s) ` Z�- Length Dia Length Dia Spacin SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Dep of xx Seeded /Sodded xx Mulched Bed/Trench Center 3 " / Bed/Trench Edges \ Topsoil No es No COMMENTS: (I nclud e code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: Location: 1230 221 St. Star P rr airie, WI 54026 (SE 1/4 SW 1/4 T31 N R18W) River Place Lot 8 Parcel No: 11.31.18.1169 1.) Alt BM Description = � G lhc� "n...5 to J 2.) Bldg sewer length = Z'7 - amount of cover Plan revision Required? Yes No -� ! �� Du — � i "4 f Use other side for additional information. �_ —. J ----- qpre's — Date InSi Lure Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Sox 7162 VIsconsin Madison, W1 53707 - 7162 Sanitary Permit Number ( be filled i by Co Dep artment of Commerce '� ' -�� r ` 4 zzs Sanitary Permit Application State Plan LD. Num In accord with Comm 83.21, Wis. Adm. Code, personal infamation you provide A A may be used for secondary purposes Privacy i.aw, si5.04(1" ' p (it'dittereat t fling we L Application Information — Please Print AN Information Property O aces Name Parcel # Lot # Block # fV Property owner's Mailing Address RECEIVED Propert Location L � �iti,5 w�i. section I City, State Zip Code Phone Number S-�b 1 JUL 3 1 2006 cdre�, i 11. Type ofBuikling (check all that apply) T 3 � N: R�F _ - 1:.� �l or2FamilyDwelling— Number ofBedrooms bK ST. CROIX COUNTY SubdivisionNaune CSMNumber Oq ❑ PublicJCommerciai — Describe Use c R a, U State Owned — be t UCity LiYitlagelWownship of rcC f III. Type of Permit: (Check only one box on Use A. mplete e B if applicable) A. 1VN—,v Sy", n n R rem!•_ ^t Cvetwn n T.no T. A t ,A. n n nµ� *�II' � • :.�a:.. e, B. ❑ Permit Renewal 1 it Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Die L4stued Befnei � 50 l � `V Plumber Owner IV. Type of POW1S System Check all that a PC Non arized Lr- Ground ❑ Mound >24 in. of suitable soil ❑ Mound <24 in. ofsuitable soil ❑ At Grade ❑ Single Pass Sand Fitter ❑ (:lmmctn2M! I WMtaral i1 P..gc.�r�sw+i In1_.m.,.,p�t C1 FT�I.t — in„d Tey.b O Pea Flu n A=dbsc T - =-==t Uh : °.^.v.,w.•:tt$:.g ° .afi.:u °i.a�".. u Recirculating Media Filter ❑ Leaching Chamber ❑ Dr Line Gnavel-lexs Pipe ❑ Other (explain) V. Dispersalfrreatmerat Area Information• Design Flow (gpd) Design Soil Application RaWApds8 Dispersal Area Required (sf) Dispersal Area Proposal ( S 95 -/ oo -, VI. T& Info Capacity in Total Number Manuthcu r I Ptdkb I Site Steel Fiber Plastic Gallons Gallons Of Units /� Concrete Constructed Glass T=ks Tanks L✓ (a AL 62!5 "a* T-k i Aembk Tremnnaa Unit �fl �aaraver VU. Responsibility Statement 16 the a re VensibiNty for of tie POVM shown on the attaclied plans. umber's N 7 -- . t) bees i WftAPRS Business Phone Number tS' a (o s! Plumber's Address (Stye M City, State, Zip Code) I V, �° t VW. couaftalw§rtment Use Onl Approved ❑ D pptov Sanitary Permit Fee (includes Groundwater Da Issu' Si S ) ❑ easou Surcharge Fee) $ � ifi. wmciiiions of 4 75, 6o A rev ` ices "for Tiisapprovai nP SYSTEM �IVN�: i3' N 1. Septic tank, offluett MW and ( J dispersal call must all Tai per mwqpnmt plan provided by pktrl7bir. 2. AN aettbaek nquMrmtatta Must be tnakt @kW as par appicew coda / otdktNtt , Attaeh eawplete phm (era the Comfy oily) for the m m on pacer not ims time 812 x I i ioc6m is sow SBD -6398 (R. 01/03) ,i �t ,. (�.� �irrvc; a� � , 2 •.� fit f1T 2 'lJY9c' ��b s� .• :?y:7 (t .� <';ti "Omuiq yd �r9b!VOSr,} :TgH; 1'1ftn5;?�Kf'(�fli 1llt� d6 �J�fN/iklf�lil :9ti ?BiJR' G:� +ti(►ti9�i::p81 71.�itjllt Ka S -spon lie10 ' MflQO >li. t> 1K) Ei I i Floe '-,VN- x' N re 1Y UJ V sL1 +� Ilt t iN�O i1 J �A% s J q O I n 0 -- 3 D -- ©C) c� I SO s co /P I to 3c - I/( .p r I 8 Q '7 - aco -o tv S @c t ".=7 i as -37 a = 10p oS Q A-tV � iry\ �csp�� fouL, k' I / CSD i aas� el � 5 I le \ 4 0 i p i PO Lu e f Flo RXV11- • n1%c�Q l.hr:�S - V le 11So 1ti1— S 7� Sw�J� It 7'3 N IQ i L r a ao W Ad e,, Lv�-z ; %)4�2v^ ( � ��at-Q- Loft* g K) i C J �9 % q () l 7 c� A !mil 3 —�rd - 0C) v 1 <). s 0 i& S�k rlC. cu /P() l O. 3v a 7 - aL o . -o (o A 16P o4 4'd i , f co Q A- tV �iiY\ lapa� f ouv'J4k / as aag v s v � s W W N Z U a� Z -- -- 44 -- �Wmm WN Q�ch� 0 m ow cm .j 0 C6 O m� Aj Q � nC�O w N NzUc o z Q ^N ~�ao b z 2 H M 0 0) Q a O r Wi t SOL _ 0 w 0 0 Ig .sac` _ a1 0 C a N v O 1 2 883' Q v \ O ` 800°22'61 NE 41 8.8$' O M PRIVATE � � o RO AD N O r r j ^ o / \ .� \ NOC r n I 9 LN � C-9 1 I � W �b0'9bE 3ALE�SL� ' c'ii.J CD �. \ �O O O ci F. o0 ¢p `� :i m IC CM z s o� N r CD g .� . . . . . . . . . co t t m 0 al a �. O O I ! d��ld� +- S00 "E •- 849.06' -- - - 203.04' - - N00 1 "W 616.41' � 122ND STREET -- .� --~_ n WEST LINE OF THE SE1 /4 OF THE 8W1/4 � o tQ 7 I fftwnsin � SOIL EVALUATION REPORT pop In ==ft rim a Omm f, wra. aew toad. ca•+r .MRaoti�idlxNlfaEand mn�lt�w�ice�oMR ,�olidnand i �I1D_ oM deW8ft a te.+ ++wa ,and arda�no.a+�wer c)38 - �j 1 - Ss'd _ a o0 Phrse pr,tat ON boa, g► Do �ir+©uair �M c CA r /S5'e n s e , D r& Lo try S M s T -3 u R/ s w laas �� to : Sad N.a.arC� �Y OV p Raid tirN►cona�„ �o„ u ap Row.dwlawA.r Coftd sowrab Oftb=Wl aPD �+ubtsar- Daaaac tirrt+,t f�aodFmrroitonitappwE#i IL �wrroaaa,a� md win �.aMraltlion� rj 7"V 3 PUG p 1 20 � t�aiar To *m sD a.. Rails MAWr CA etc am Molar QL Sys. f Tm ' -3a S C n� 1 to E Ha imi, t� ridoa 'room a am owaldwoo omm d Naoir 6L Coki t ,w QL ft aat carat er.:� UL D D Eft" 42 • 900 < �D e�pll and T8B < �O +apli CST MtOA86W Daly Tdoo+a+e ■ m mm Wawa 10-7x�--Jffii A 1�� -- I --- I � 7U ■ : m M� ®Mm L + ►e sr. Ems. • ..�. ■ : Tm SEE L , ■ : - c•es a it � "� a :..� �t :C �t �- - r31 N LO Q L r ���:.: tiCi^►�O�'1�, l� Sy O 7 \a �r-et r Q. ra 3o as I " /9 u,_ `T- At,- Nc , S � � t = e Sze o � 4� A 100 .�f r 5 E 3 � ' �e- t 4p- � etlSot,` EZ1203H vvvvvv vvvevvv "; '� i•• °` vvvevvv ♦tt OOVO r ,,!!� vvvvvvv vOOVV VO ,•. •.�• • 'y am Ovv OeVe VVT TVV 0 : •i� :• I :v f ` •: 1'. •j• vv t 9 v - vv tt VVV v ev 24 v v vv evv II ovo v ve 6 4. 2 5 os vvv evv ° V ° ° ° ° 1 " 1/2 Circ. =18.84" vvv voe vvv evv sov v WV vvvvvvv v v vvvevvv a vvvovevvvvio iivvvio vvvvvvv vvvvvvvvvvvvvv ♦O VOVVv vOV VOVO oVOVeeOVVOVVOV vV VOV Vv tt 24 "— ® Bottom i 36 11 - 12 -1/2" DIA.. (typ.) Void Volume Soil Interface Area In- L EL Ft Void Coefficient in Aggregate given at 57 4%. Sidewall (2 Sidewalis) 2 . 18.84in — O.D. of 4° pipe = 4.625 inches 12in 3.14 z. Void volume per linear ft. = 3.14' If[ = Q.l 17 fN lfl 3125in Bottom 12in / ft, 2.00 O.D. of centercylinder = 12.5 inches Total Soil interface Area 5.14 SQ.FT Void volume in aggregate of center cylinder =(3.14.( 6.25in )' — 3.14 • 23125in -.574 = .422 ft- T 2 ' ;; / ft 12in / ft J J O.D. of outside cylinders = 12 inches Projected Trench Area Void volume in outside cylinders R 20 3,14( 6m 1 4 .574-.901 . ft3 Sidewall Height = 12 in. *2 = 2.00 Sq.Ft, 12in1ftJ Bottom = 36 in. = 3.00 Sq.Ft. Void volume at bottom between cylinders — 24in • 6m 3 1 bin - 1(l2intit 12in /ftt2W/ft)=Q•215 ft Projected Trench Area m 5.00 Sq.Ft l ), Void volume at outside bottom corners (112 of void volume between cylinders) 0.215 / 2 = 0.108 fN Total void volume = 0.1 17 + 0.422 + 0.901 + 0.215 + 0.108 = 1.763 cubic ft / ft Gallons per ft = 1.763 X 7.48 = 2 ealions per linear ft. t/ EPS Aggregate Trench System EZ1203H EZflow Ring -Industrial Group 65 Industrial Park Rd. Oakland, TN :8060 SCALE ME NAME- EZ120M,l SHEET: 1 of 1 11 -27 —Ot POWTS OWNER'S MANUAL St MANAGEMENT PLAN ' Polls _L of FILE UFORFAA7M Ovmer- S s Ttpt)fS Penult # Septic Tank Capacity S . Q NA Septic Tank Manufacture t S © NA 9>11 AARAMEi Effhuent f Manufacturer p C3 NA K .edrppms Q NA . Effluent filter Model Q NA Plic � Units Q NA Pump Tank Capacity D flow {average) v (gy p Tank manufacturer © NA w {peak), (Estimated x 1.5) Pump Manufacturer DNA Sad Application ation fiats � �p M -0 NA Standard arhfhrentlEffluent Quality M0 averages* Pr eatment Unit Fats, On & Grease IFOGS 530 Q NA �. ❑ Sand/Graves Filer ❑Feat Filt t3iochemtcal Oxygen Demand {BOD 5220 mg/L. 0 NA 0 Mechanical Aeration Q Wetland Total Suspended Solids r=) 5750 cam/L O Dissection 0 Other UM ; Pretreated Efent Quality y} y average D C © NA Biochemical Oxygen Demand (800.) 530 mg/! In- Around JWovity) D tr,- td (premed) TOW Suspmtded .mss TSSY M mg/L 1 NA Q At -Grads ❑ Mound Fecal Coftform lgecmetnjc mean) 510' cfulit omi 17 Drip -Lkm D Other. Maximum Effluent Particle Size Y. in die. D NA OtJher: Other. C1 =111A Q OVA Other' D NA "Values typical for domestic wastewater acid septic tank effkaw- Other 0 NA MAtNTfNANf~E SCl�tff.E Servift Event _ Fnonna► Inspect condition of to rik(s) 3 At least once every l W06num 3 years) Q NA Pcanp out contents of tankts) When combined sludge and scorn equals Deer- third (7Y of tank vflkmte al ❑ NA Inspect dispers cents) At least once every: 0 montl�{s) ttiNdawrth 8 ) 0 NA Clean effluent filter At least once every: mondh{s) s }- J13. NA Inspect pump, pump controls & alarm gt,loem Once may t3 (s) Q year(s) - Flush laterals and pressure test At feast once ever D month {s) our: 0 {s) - At fat once every Ot her t MA VnS%[ANCE 1NaTRUCMNS tnapeC&ms of tanks and dispersal cabs shag be made by an individual carrying one of the follo Master Number. _Mas Plumber Restricted Sewer; POWTS �nsea Or casrtificatlons: ter inspections must include a visual ins , POWTS Maantasiner, Septage Swv�hg Operator. Tank measure the volume of combined Pecton Of the tank {s) tQ,identify any missing or broken hardware, Identify any cracks or leaks, sal cell {s) shawl be visually and sracm and to chock for any back up or ponding of effluent on the gtound atp°face. The dispersal effluent sa l the isually � to' Check effluent levele in the observation pipes and to check for any pending ground surface. The ponding of effknent'on, the (Pound surface . may indicate a failing condition UW en Immediate notification of the local regulatory authority, quires the When the combined accumulation of sludgeatcnd scxnm in any tank equals one -#" t)2) or more "of - the tank volume, the entire Contents of the tank shell be removed by a Sept49e Servicing - Operator and disposed of in y .cam NR 113. Wiscorhskn Admlriama►tive code, All Other services. including but not limited to the swvicirV of effluent files, mechanical or presonUed components, pretreatment +nits end any servicing at intervals of 512 months, 9ha0 be performed by a certified POWTS Mai ntsiner. A servise report shat) be provided to the oaf regulatory author" within 10 days of completion Of any service event. START UP AND OPERATION Page of F, new cmmftuction, prior to use of the MU check that m8Y impede the treatment prod andlor VOIB Rlent tank(s) for the p of painting products gr _other chemicals of the tank(s) r ed.bY a � trio 'operatt�r prior to else. (s). tf NO cotes are detected have the contents System start up shad! not occur when meow we frozen at the dative surface. discharged to the disperse; pump tanks any IN a normal two' kvekL When power is restored the excess twits). one large -dose, � the �(sl and wastew wb1 O f WMMnt. To avoid this situation have the contents Of the purnp tank removed ya (t in the backup or. p cGo reat Power g power to the effkW nt pump or cx>nt= a Pkrrnber pr 0OWTS Mahal ner to asst <m�m Operat error to restoring teedwe no"" levels within the pump tank. - Y operating the P conuois tc Do not drive or park vehicles over tanks and dispersal coils. Do not drive or park over, or otherwise disturb or coca wdnin IS feet down slo pe of Pmt. the au any mound � apt -grade soil - absorpiion� arm. Reduction or elimination of the following fiom the wastewater stream may improve the perkwmance and prolong the We of the PoWTS: antiblotif eab wi pes c1garette butt; rxxedona; : dental foss. diapers, disknfectsnta, f faemdation drain (sump pump) water fruit and vegetable : pew; ire;. geese; herbicides;. meat scraps; medications; oil; products% per. s anitary naphs:= tsrnpw. . and water softener- brine. ABANDONLUW When the POWTS fails "andlor is paccnan ndY taken out of service the following, steps shell be taken to insure that the system is Properly and safety abandoned it cOMPISFIM With chipter Comm 83.33, Win Ade sative -Code: • Ad Piping to tanks and pits shad be disconnected and the abandoned pipe openfts sealed. e The contents of all tanks and pits shad be removed and property disposed of by a 9eptaga Sonvicir g Operator. e Ater Pumping, an tanks and pits shad be excavated and removed or their covers removed and the void space filled with sod, gravel or another inert solid mirterM. CONTINGENCY PLAN - R the POWTS 18113 and cannot be repaired the fodowang measures have been, or .must be taken, -to Provide a code compliant rep lacement system: P area A suilabte replacement arse has been evaluated and may be utilized for the location of a � o► The "fit should be pmftc ed fran dhMst mo and or1 rat and W* lW � upon by reed "se6adca ilea mdsgW and Pied "st cdae, lot altos and walk. to pratsn P tom rapupcernent arse win result in the need for a now svi! and site-evaluation, to establ<edt a stdtabte�t area. Repipcenjent systems "must c .with the rules In effect at that tine. - E3 A suftaW monoanent area" is not avaNable due. to setback arxllor sod fimitations. BWjftL advances in POWTS technology a holding tank may be installed as a last resort to replace the fated POWTS. Ll The site has not been evaluated- to identify a suitable replant area. Upon fadkue of the POWTS a soil and siro evaluation must be perfomned to'tocate a suitable replacement are& ff r replacement area is available a folding tank nay be instaged as a last rreaort replace the failed POWTS. E3 Mound and at -grade sod abs t systems may be reconstructed in piece following rarrroval of the bkmmt at the infiltrative surface. Recotns&ucd nns of such systems must conpPy with the rules in effect at that tine. < <WARNMIIO> > S@TtC. PUMP AND. OTHER TWATUM, TANKS MAY CONTAIN LET"AL 6ASWS AND/OR NEWT OX1f66�i. 00 NOT igIITER A SIB'71C. PUINP OR OTHER TIMATIV!lSIT TANK U ANY CIRdlMSTAriMS. DEATH MAY RESULT. iJiSCUE OF A PBBON FRONT THE INTERIOR OF A TANK MAY BE Onfl ULT OR yAOSSWjL ADDITIONAL COdI11111EIiTS t!llMT POW FS Name a Name tie ( S 135 Phone WTAGE O!°MIATM rumrm LocAtI.Ar AUTHOIM Name Name l� X n t2 Phoine _Phone S lie do=r*mt was drafted in cwwomm wide chmaw Comm 8&=21(M fl and ea.W), (2) m (31, WW==tn AdmkftVative Code. STARTUP AND CATION Fbr f page Of ' . Prig to use of the POWTS check (s} that MY Rflpede the treatment p 0x00 �t tank for the Presence of painting Products cat o emicais to use. Of the tank(s) ramoved.by a septage 9 tMr prior d �(s}• If high cuncenurattons a detected have the contents System start up shalt not occur when soil Conditions we. frozen at the eve surface. dbdwrgW Power may IN alcove itil�tvvaRer levers. When . to - - . may result i n the PCotP tanks Ott. To dial tank JD one large nal i hwa the - ceN(s} and wewatoer will be avoh� this sttuaOm have the conter}ts of rite pucinP tank removed P or su fro a dischage'of Power to the effluent pump or contact a by $ SePtage Servicing Operator Prior to restoring MUMS normal levels within the � � POWTS Maintainer to assist in ma�nuaily operating the -pump controls - to PwnP tank. Do not drive or park y over Wks and dispwaal calls.. Do not drive or park over, or otherwise disturb or compact, the area Within IS facet down slope of any t round or at - grade - mg. mat' area. Reduction or iblo a#on of the s.. cig irtg Rain the wastawatm- stream may improve the perforrnarnce and prolong the l ife of the POWTS: arty; baby wipes; cigarette bcitis; condoms; cofton swabs; degreasers: dental floss; d' foundation drain (sump i Pl vorai�- fruit : d4hkctant ,- fat;. g prodtaa in pesticides; s and vegetable 9 e: grease; herbicides; Rteet s nqW, rnedications; oil; sa nitary naP�:= twnpcww, and water softenw.brine. ABANDONMENri' When the POWTS fairs aerndlor is ply Uken out of service the follo steps shall Property and safely abandoned in compliance with Corium 83.33, W insure that the system is • AN Piping to tanks and pits shag be disconnected and the abandoned Pipe openings seated. • The contents of all tanks and pits shall be removed and properly disposed of by a 9eptage Servicing Opergtor. e After PtxnPmg, all tanks and pits shall -be excavated and removed a their covers removed and the void �aoe fgied with sod. gravel or another ktert solid materiel. CONTMIIGBWY PLAN if the POWTS fads and cannot be repaired the following measures have been, or must be t*en..to provide a code compliant rsf>ment system: _ A . er le,, t aea r has beef+ evaluated and may be utilized for the location of a r� absor replacement area M orm and should be protected fran disturbencs and c, sh=M �t.ba upon by r i d amb acks #rntn aid P structure. lot lines and wells. Falitue to PrOM91110861Aumnent area will result in the need fors new eoll and aits.evak� ion to bte n a sulta area. went systems must come :with the :w the .Mies in - effect at that tone. ❑ A suitable reptaoanent area - is not available due to setback andfor song li nitations. Barring advances in POWTS technology a holding tank may be instaged as a last resort to replace the failed POWTS. Q The site has It been evaluated- to identify a suitable replacment area. Upon faliure of the POWTS a soil and site even numt be petiomud to - locate a suit" f0plac entent eves. ff ram rePiacemetnt area is avall" a holding tank nmy be installed as a last resort -too replace the failed POWTS. ❑ Mound and at -grade soil al prt&on systems may be reconstructed in piece following removal of the biomat at the mfihratm surface. Reconsv ucdotns of such systems must comply with the rules in effect at that time. < <WARINNB> > SWMI Pty AND- OT M TREAT .T TANKS MAY CONTAbll M LFMAL 6ASSE8 AND/OR OXYGEN. 00 NOT CIQ11T M M A SEP7i0. PUINP OR OTHER T MENT TANK UUM ANY t fligNflSi'A DEATH MAY RESULT. AESCUE OF A """ION FM THE N TERIOR OF A TANK MAY gE DST OR AIIPOSSIME. ADOITIOIUAL . Nastene R S Name Phone P411Y175 , __ A ( J as EpItione sat; YICM QVINATOR BRMMNMI LOCAL. i 1tATORY avnFeoluTx mare Pfno►Nant IS his document was drafted in complience with dmPt8r Comm Bs sz0ltbxt urn &M and `93.541t 1, r2l m tar. wises, Adminisuatve code. r Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 VIsconsin Madison, WI 53707 – 7162 Sanitary Permit Number (to be filled in n by Co.) (608) 266 -3151 2 De artment of Commerce `7` S Sanitary Permit Application late Plan LD. In accord with Comm 83.21, Wis. Adm. Code, personal information ' V may be used for secondary purposes Privacy Law, st5.04(l X Project Address (if different than mailing address) I. Application Information – Please Print AU Information 23o 22 :5 1 �"• AJe— Property Owner's Name Parcel # Lot # S Block # / LAI Property Owners Mailing Address J U L Property Location i1 '/,, '/. Section , �1 City, State Zip Code S mo T N; R�E o W II. Type of Building (check all that a ) ��; �; a ,�,N.. Ot 1 ubdivision Name CSM Numflej I or 2 Family Dwelling — Number of Bedroo ❑ Public/Commercial — Describe Use t 4' ❑ State Owned r4V1 ❑City ❑Village Township of F ^ ^ i" i III. Type of Perml : (Check only one box on line A. omplete line B if applica A. CXNew System ❑ Replacement System ❑ T ent/EIolding Tank lacement Only [I Other Modification to Existing System B. 11 Permit Renewal ❑ Permit Revision Change of Permit Transfer to New List Previous Permit Number and ate Issued Before E iration Plumber Owner M IV. Type of POWTS System: Check all that appl L Non — Pressurized In- Ground ❑ Mound ? 24 in. of suitable soil Mound < 2\le soil 11 At-Grade ❑ Single Pass Sand Filter ❑ Constructed — Wetland Pressurized In- Ground ❑ Holding k [0 Peat Filter c Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber Drip Line Gr❑ Other (explain) V. Dispe rsalfIrreatment Area Information: Design Flow (gpd) Design Soil Application P te(gpd Dispersal Area Required (sf) Dis Nsal r ea Proposed (0) System Elevation , r I W ✓ ,"1 ✓ WS7 - QUO ✓ VI. Tank Info Capacity in ToW Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gal of Units Crete Constructed Glass New Existing Tanks Tanks A' Pa 1a k- P�- 525 Septic or Holding Tank ✓ Aerobic Treatment Unit Dosing Chamber �� U 16 e r° Y / VII. Responsibility Statement ifthe undersigned assume ponsibility for inter f the POVM shown on the afte1w plans. P umber's Nam nt) P bar Si afore PRS bacr� Busirte one Nu // mbar Plumber's Address (Street, City, State, Zip Code) V g - - "\ - ` rf1 LOA S- © f VIII. Couniv /De artment Use Onl Approved ❑ Di roved Sanitary Permit Fee (includes Groundwater Date sued Issui gent Si Surcharge Fee) 11 luau Reason for Derfial IX. Conditions Ap rop_ _ yal/Reasons for Disapproval dispersal cell must ON ss per management plan provided by pkimber. 2 AN sebsck requirements must be maintained as per applicable cork / ordinances. Attach complete plans (to the County only) for the systrm on paper not ins than St fl x 11 inches in size SBD -6398 (R. 01/03) 1 •'R3MWO M3T*Y2 tow { ®n!+ ;inlet 341"? .t jYJfll6tnlsC!'1 29 �w' ii' �:! '1i li! — Ifis"g8iv iiA I r fort p��� _ ��C: el �. C �r`�S���So✓� `% Ste` /� Sit T al N R W u IQ r o� �► p3�s —t a 13 — l o� - �y�tca e•�s /� py $DES? bra =� 1 re vac V� Lc) , B fr f 11� rt cam( � , � P �- ? Ak II I a ?� a p��h L cc u Q r �►— p3Fs -( !3 — S _o© -1 4 Act I '7 ti f a ?6 7 -ar Wisconsin Department of Commerce SOIL EVALUATION REPORT Page - ! —o f 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County St. Croix 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. I pendin Please print all information R iewed %, Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 3 Property Owner Property Location Govt. Lot SE 1/4 SW 1/4 S T N R (or) W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 573 Cty Rd. " 8 r. 8 rid City State Zip Code Phone Number ❑ City ❑ Village k] Town Nearest Road Hudson, IWI. 1 54016 (715) 381 -5405 New Construction Use: L� Residential / Number of bedrooms _ 4 _ Code derived design flo a 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material QUt Flood Plain elevatio if ap li e M ft 0 _ General comments � • Q and recommendations: Q _ C trenches @ el. 97.00' rre5y" `5 Z El Boring g . zoo T a Boring # ® Pit Ground surface elev. 1 OO. 4O ft Depth to limiting factor 12O ` Soil A li ' ate � Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 �— 5 8 •�P _ e sil non •� 2 11 -32 10yr4/4 none sil 1csb E mfr j qw if 2 3 3 32-12C 7.5vr4/41 none 7 [-2] f rt b� Boring # Boring ® pit Ground surface elev. 99.90 ft. Depth to limiting factor 120 _ in. _S 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 1 _ mfr • �° '® i 2 12 -36 10yr4/4 none sil 1 3 36 -13 7 4 Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg /L ent #2 = BOD 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature ST Number Gar L. Steel 02298 Address ate Ev uation Con cte Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6 -24 -2001 715 - 246 -6200 Property Owner LaCasse , Dey. , I nc . Parcel ID # pending Page 2 of 3 F- Boring # ❑ Boring 3 ® pit Ground surface elev. 100.40 ft. Depth to limiti ng factor 120 in. Soil lication 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 . (P 2 10 -12 7.5yr4/4 none gr Cos osg mi na na .7 1.2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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 # E] 1:1 Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil licetion 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 ` Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 (P-6=) Property Owner LaCasse -. Dey. , I nc. Parcel ID # PM ng Page 2 of 3 Boring # ❑ Boring 3 ® pit Ground surface elev. 100.40 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 2 10-120 7.5 4/4 none qr Cos I OS9 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 ❑ Boring # ❑ Boring ❑ Pit Groundsurface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 nxA and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If ou need assistance to access services or P 9 PP tY P Y need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD -8330 (RAW) t STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. r�aCasse Dev., Inc. New Richmond, WI 54017 CSTM2298 SE4SW' S11 T31N - MPRSW -3254 town of Star Prairie (715 ) 246 -6200 lot #8 -River Place This soil evaluation was conducted to satisfy a zoning requirewnt, it may or may not be suitable for your use. The location of the test may or may not be as shown as permnent iot lines were not entabliabod at the time the test was Conducted. , _1 =40' ,BM.= top of NE lot atake @ el. 100.x' ,alt. BM.= top of 1" pvc pipe @ e98.90 lap 5 � -4 Ik a� L. Steel 6 -24 -2001 C csA e �S o r� EZ1203H evvovov :f' ".i i �' • • !•`°` ": vosvvvv vvasevo '•' �••r t• Ovvosys vvv "':�^. , vov FF vve 'i: '.�� �' t�„e .:.e. ".vvv 24" vvV �" .`.:f vov vve VV oeo �.��� VVT it vvv vvv OP VTV vov VT ; o 0 1" 1/2 Circ. = 18.84" vVW VVv oov vvv vP♦ PV v vv sv vv v o v ovPO vv VvOVVOV v VVOVOVOV VOVO VOO9POP vvOV VO• avvvvvvevvvvvv PVVO VVV OeV OOVV vavOVVVVVVPVOV Ov Vvvvv 2 4 11 ® B ottom 36if - 12 -112" DIA. (typ.) Void Volnme � S oil Interface Area Void Coefficient in Aggregate given at 57.4 %. Sidewall (2 Sidewalls) 7 18.134in s O.D. of 4" pipe - 4.625 inches 12in 3.14 Ift Void volume per linear ft. = 3.14 • ( a ! ft ) 23125in i' 12i , tft -0.117 fN Bottom 2.00 l Total Soil Interface Area 5.14 SQ.FI' O.D. of centercylinder -• T2.5 inches Void volume in aggregate of center cylinder - 3.14 • ( 6.25in 1' _ 3.14 • ( 2'3125in )I • .574 .422 W 112in /ftJ I l 12in /ft J O.D. of outside cylinders - 12 inches Projected Trench Area Void volume in outside cylinders- 2.3.1 bin •.574- .901 ft' Sidewall Height - 12 in. *7 - 2.00 Sq.Ft. i12 / ft) Bottom = 36 in. - 3.00 Sq.Ft. Void volume at bottom between cylinders — (( 24m bin )_(3 1 "in 12in /ft • 12in /ft �t2in�ft)=)] -0.215 fN Projected Trench Area - 5.00 Sq.Ft. Void volume at outside bottom corners (1/2 of void volume between cylinders) 0.2 / 2 - 0.108 ft Total void volume - 0.117 + 0.422 + 0.901 + 0.215 + 0.108 = 1.763 cubic ft / ft Gallons per ft = 1.763 X 7.48 - 13.2 Eallons ner linear ft it 36 Y/ = � EPS Aggregate Trench System ED 203H ow Ring Group 65 Industrial Park Rd. Oakland, TM 3,8060 SCALE FLE NAM?_ EZ12OM -"l SHEET: 1 oft 11 -27 -01 } t 4" CI VENT PIPE 12" MIN. ABOVE GRADE 6 WEATHER PROOF >_ 25' FROM.DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W1 PADLOCK S WARNING LABEL 4 " MIN . 1Q" TN 14LET 1' E � WATER TIGHT SEALS GAS - TIGHT; 4 „ A SEAL APPROVED �_ ALM JOINTS 4l/ CI -I PIPE ` PIPE 3' ONTO II SO TO �' , ! ON SOLID SOLID SOIL SOIL C 1 �t RISER EXIT PUMP OFF ELEV . -f- - � 'q � FT. ►- — T' off D PERMITTED ONLY IF.TANK MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE DAY: -- TANK MANUFACTURER: � � ..� NUMBER PER TANK SIZES SEPTIC GAL. DOSE VOLUME INCLUDING DOSE GAL. FLOWBACK: Z- GAL. ALARM MANUFACTURER: CAPACITIES: A = INCHES =+ AL. MODEL NUMBER: 6 = u .. B = 2 INCITES = /. - Z-GAL. SWITCH TYPE: /c, / PUMP MANUFACTURER: u C = t, INCHES = /J '7 GAL. MODEL NUMBER: t -, L SWITCH TYPE: D = /(), �2. INCHES = 1( ' LGAL. REQUIRED DISCHARGE RATE S GPtT )/6 PUMP & ALARM WIRING AS PER ILHR 26. 23 WA( VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE . . lo FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . - . . . .%. . - �4W FEET + Za FEET FORCEMAIN X 3,3 FT /100 FT. FRICTION FACTOR - . FEET TATAL DYNAMIC HEAD 1 INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER LIQUID DEPTH [QGOULDS PUMPS Su mersible Va #*a Effluent Pump u e � M ODEL :: WE Seri PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS ■ Shaft: Corrosion - resistant, Single phase (60 Hz): can be operated continuously Specifically designed for the stainless steel. Threaded • Capacitor start motors for without damage when fully following uses: design. Lodrnut on all models maximum starting torque. submerged. • Homes to guard against component • Built -in overload with ■ Bearings: Upper and Farms damage on accidental reverse automatic reset. lower heavy duty ball bearing • Trailer courts rotation. • S1TOW or STOW severe duty construction. Motels ■ Fasteners: 300 series oil and cords. tr resistant N Power Cable: Severe duty Schools stainless steel. power • Hospitals - 'A —1 HP models have rated, oil and water resistant Hos • ■ Capable of running dry NEMA three prong Epoxy seal on motor end Industry without damage to provides secondary moisture • Effluent systems components. • grounding plugs. barrier in case of outer jacket 1 A HP and larger units have la damage and to prevent oil ■ Designed for continuous bare lead cord ends. SPECIFICATIONS operation when fully wicking. Standard cord is 20'. Three phase (60 Hz): optional lengths are available. PUMP submerged. •Class 10 overload protection � � • Solids handling capabilities: in MOTORS must be provided in O-ring: Assures positive 3 /4" maximum. separate ordered starter sealing against contaminants • Discha a size: 2" NPT. ■ Fully submerged in and oil leakage. • Capacities: up to 140 GPM. high -grade turbine oil for unit po wer . STOW cords all have • Total heads: up to 128 feet lubrication and efficient heat p AGENCY LISTINGS TDH transfer bare lead cord ends. TeMdmucns •Temperature: ■ Class B insulation on m for Continuous CSA 22.2108 standars Operation• p ngs are sv cnnackn standards 104°F (40 °C) continuous IA -1'/ HP models. � Associalm 140°F (60°C) intermittent ■ Class F insulation on 2 HP within the motor manufacturers �Cks Me d • See order numbers on models. remmmended.working limits, sis ISO 90M Regbtemt reverse side for specific HP, voltage, phase and RPM's MEMRS FEET available. 40 130 ; SERIES: WE 120 FEATURES 35 110 I RPPM 3500 °5 & —! t ■ Impeller: Cast iron, semi- 30 loo 5 GPM L open, non -dog with pump - 90 r ` out vanes for mechanical lu 25 go seal protection. Balanced for X smooth operation. Silicon 20 70 I bronze impeller available as o an option. 15 5o ■ Casing: Cast iron volute ° ao type for maximum efficiency. 2" NPT discharge. J 2 - ■ Mechanical Seal: SILICON 5 - CARBIDE VS. SILICON ' CARBIDE sealing faces. ° 00 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 GPM Stainless steel metal parts i 1 4 1 1 1 E t I BUNA N elastomers. 0 s 10 15 2 0 25 3 0 35 nWhr CAPACRY Goulds Pump 0 2004 rrr water Tedmolagl, Inc ITT Industries Effective December, 2004 www.goukls.com 83885 POWTS OWNER'S MANUAL & MANAGEMENT PLAN paw of FILE EIIFOMATION V J Owner. SYSTEM SI�CIFtCATK)NS Permit # Y Septic Tank Capacity —0 N ❑ NA ai Septic Tank Manufacturer - A OESttaiN PARAMETERS Effluent Filter Manufacturer Number of Bedrooms l.) NA ❑ NA Effluent Filtw Model c Q NA Number of Public Facility Units © NA Pump Tank Capacity O C Q NA Estimated flow (average) ai O al /da Pump Tank Manufacturer l r °`S Q NA ` Design flow (peak). (Estimated x 1.5) O al/d Pump. Manufacturer ` ` [�G�- � ❑ NA Soil Application Rate r� 6 / aUId Pump Modes Standard Influent/Effluent Quality Monthly averag Pretreatment limit Fats, Oil & Grease (FOG} < 0 NA mg /L ❑ Sand /Gravel Filter Q Peat Filter Biochemical Oxygen Demand IBODI 5220 mg/L ❑ Mechanical Aeration Q Wetland Total Suspended Solids iTSS) 5150 "VA. Q Disinfection Q Other: Pretreated Effluent Quality Monthly average Dispersal Gemal Biochemical Ox © NA Oxy gen Demand (BOD 53Q mg /L In- Ground (gravity) 17 in- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L 13 NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /100m1 Q Drip -Line Q Other: Maximum Effluent Particle Size Y in dia. p NA Other E3 NA Other NA Other: Q NA "Values typical for domestic wastewater and septic tank effluent. Other: Q NA MAEVffENANCE SC LIE Service Event Ft inspect condition of tank {s) At least once every: !$) y ear(s) (UoIkN Y e ws ) NA Pump out contents of tank(s) When combined sludge and scum equals one -third (y NA Inspect dispersal cents) At least once every: 0 month(s) / ears) NA Glean effluent Filter At least once every;. months) ears) NA y ear(s) NA inspect pump, pump controls & alarm At least once every: morith(s) Flush laterals and pressure test At )east once every: ❑ month(s) Other. 0 years) NA At least once every: Q mortt is} Other: 13 years) lk NA MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual c Master Plumber; Master Plumber Restricted Sewer; POWTS In �*Ymg one of the following licenses or certifications: Spector, POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tanks) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scrim and to check for any back up or ponding of effluent on the ground surface. The dispersal cells) shall be visually inspeoW 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 scurf in any tank equals one -third IY 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 fitters. 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. START UP AND OPERATION Page For new conUmction, prior to use of the POWTS check treatment tank(s) for the presence of Painting products that may impede the treatment process and /or damage the dispersal COWS). high or Other chemicals corncsndattons are detected have the contents of the tank(s) removed by a septage servicing operator poor to use System start up shall not occur when sail conditions are frozen at the infiltrative surface. During power outages pump tanks may fit) above normal h discharcged to the die ighwater !ovals. When power is restored the excess wastewater will be pwsai call(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; far foundation drain (sump pump) water; fruit and vegetable peelings; gasoline;. grease; herbicides; most scraps; medications; oil; painting Products; pesticides; sanitary napkins tampons; and water softener brine. ABMDONMlS1 T 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 safety abandoned in compliance with ~er Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • 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 a system. The replacement area should be protected from disturbance ringed u ce and compaction and WmM trot be km °ration nxiuired setbacks from exis** old Proposed structure, lot lines and wells. Fag" to upon- by result in the need for a new Wit and site evaluation to establish a suttabte � the. t area will comply with the rules in effect at that time. replacement area. - Repialcernenrmt systems must ❑ A suitable replacement area is not available due to setback and/or soil limitations. Bani ng 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 perforrrmed 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 blomat at the infihrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNINQ> > SEPTIC, PUMP AND OTHER TREATIUtT TANKS MAY CONTAIN LETHAL BASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. MATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR nffgSS WI L ADDITIONAL COMMENTS POWTS IIISTALLER POINTS VAi1MTAt� Nartn@ i Name ' Phone Phone 1� SEPTAGE SEWWCIla OPERATOR OVUM) LOCAL REGULATORY AUTHORITY. Name Name �� ci c ✓n i h. Phone Phone b This document was drafted in compliance with chapter Comm 83.22t2libt(9I(d) &(f) and 83.Wi ), (2) & Mi. Wisconsin Administrative Code. START UP AND OPERATION Page For new construction, Prior to use of the POWTS check treatment tank(s) for the presence of or 0 #0 that may impede the treatment process and/or r demo the dispersal cell(s). if high concentrations are detecte paintitn8 products d have of the tank(s) removed by a sePLage serv operator prior to use. System start up shall not occur when sock conditrons are frozen at the int,,&z )ve surface. During Power outages pump tanks may fill above normal highwater levels. When power is restored discharged to the dispersal lion in one large dose, the excess.waetewater will be effluent. To avoid this situation overloading the cell(s) and may result in the backup ou surface discharge of have the contents of the pump tank removed by a Septage Servicing o p erator g P 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 withirn 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 fife 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; medkations; 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 safety 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. 0 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 rnt 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 nmbb 9ed upon by required setbac from existing and Proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new evil 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 rep" 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 ANO/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 FOR OF A TANK MAY BE O1FFlCULT OR IMPOSSIBLE. ADDITIONAL COMMENTS Povvr II+ISTaR.LER IwvNTAIN�R Name Name Phone 1 Phone SEP AGES VlCNIG OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone This document was drafted in compliance with chapter Comm 83.22t2)(b)(1 l(d) &(f) and 83.54(1), (2) & Mi. Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC: "LANK MAINTENAN AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer 1� L�C�L4-e l S • _.; _G:Mk6a) fl ...,. _. �r ; s ensof) Vlaifinl; Address Ot uQ 1.-ane W2t,.� 'QiS�Mora tL )? 57' Property Address .� 23p 21 4 14 142�.� R "m= W 1 $ q (Verification required from Planning &. Zoning Department for new construction.) City /State UtW R � I Parcel Identificati Ntunber 036 -1213 -g -0 L EGAL DESCRIP'110N SE Property Location 24_ % , ,el_ % , Sec. _t , T _$J_ R 1$_ W, Town of S4c Qra;r; e, Subdivision H. 0. P_ Lori # . Certified Survey Map # „- w: , Volut 1 1 Page # Warranty Deed # _ B2 2 .....m., Volume , Page t# Spec house 0 yes bi no Lot lines identifiable 6i ym 0 no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and amintenance 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 aiiect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Conan. $3.52(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 pturmber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pwnpinm (if necessary), the septic lank 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 Commence and the Department of Natural Resources, State of W isconsin. Certification stating that your septic system has been maintained mums# be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I /wc certify that all statements on this form arc true to the best of my /our knowledge. I /wc am/are the ow of rite property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms — 3 �� ✓��� SIGNATURE OF APPLIGAN��_ CS) DATE ** *Any 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 Regist of Deeds Office and a copy o the certified s rvey map if reference is made is the warranty decd. (REV. 08105) TOO 0 9NINOZ 0a M IS 9891 99C STL XVd ZOcST aU 90 /CT /90 :� 0 ' 823261 KATHLEEN H. WALSH State Bar of Wisconsin Form 2 - 2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX GO., WI RECEIVED FOR RECORD Document Number Document Name 04/20/2006 101 15A WARRANTY DEED EXEMPT li Develop men Inc.. Wisco Main Cor oratio THIS DEED, made between LaCasse gEC Fes; 11.00 TRAILS FEE: 117.00 ("Grantor," whether one or more), COPY FEE: and Michael S. Christenson and Gretchen Christenson hosband and wife CC FE 1 ("Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following Name and Return Address described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Lot 8, Plat of River Place in the Town of Star Prairie, St. Croix County, Wisconsin. - wk-�C� 038 - 1213 -80-OW Parcel Identification Number (PIN) This is not homestead property. ( is is not Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated 00 (SEAL) * *LaCasse Development, Inc. (SEAL) (SEAL) * AUTHENTICATION ACKNOWLEDGMENT Signature(s) i authenticated on STA OF l ) ) ss. COUN ) TITLE MEMBER STATE BAR OF WISCONSIN Personally came before me on (If not, the above -named LaCasse Dave Rmen nc. a Wisconsin authorized by Wis. Stat. § 706.06) Corporation by k" 01C LJ - L - 0 - Ca-C-S Its THIS INSTRUMENT DRAFTED BY: to a known o be the person(s) who executed the foregoing s ment a ack d the same. Attorney Kristina O _ Hudson WI 54016 &,.r.f U - GpT� t � c�ta#.e o \ 1� ic, Star of _ My C mission (is permanent} (expires: 17 = 201 ) (Signatures may be antbeatin or ac Both are am necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED g 2903 STATE BAR OF WISCONSIN FORM NO. 2-2003 " Type name below signatures. INFO -PROTM Legal Forms 800 -855 -2021 www.infoproforms.com Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix ' Safety and Building Division INSPECTION REPORT Sanitary Permit No: 488239 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)]. Ar Permit Ho er's Name: City Village X Township Parcel Tax No: Christen on, Michael Star Prairie, Town of /8-1213-80-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /R a /Map No: 11.31.18.1169 TANK INFOR TION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS O rHl FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Balffirn Dosing der /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Derfind St Cover G Model Number TDH Lift Friction Loss System Head DH Ft F-F Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length N PIT DIMENSIONS N Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEA ING Manufacturer. INFORMATION CHAMB OR Type Of System: UNI Model Number. DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spa c Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing I \ SOIL COVER Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over epth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ® No Fe-1 Yes 0 No COMMENTS: (Include cobfdiscrepencies, persons present, etc.) Inspection #1: / / Inspection Location: 1230 221 St. Star Prairie, WI 54026 (SE 1/4 SW 1/4 11 T31N R18W) River Place Lot 8 Parcel No: 11.31.18.1169 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? 7 Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cart. No. Safety and Buildings Division County _ /+, 201 W. Washington Ave., P.O. Box 7162 S 7 i sconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 51 4 1 '8� - L� Z3 Plan I.D. Number Sanitary Permit Application State N - In accord with Comm 83.21, Wis. Adm. Code, personal information to Vid e may be used for secondary purposes Privacy Law, 04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Information 1 V�ED � 230 2 ZI 54 e - Pro erty'O tame ,- 1 Parcel # t # Block # �a✓ K =JN 6 2006 tj►` 3-I& Z "L , o Property Owner's Mailing ddress ST. (,R Property ation 726 Na xCO(/NTy Section City, State Zip Code Phone Num + (circle one) I/ 'akt —. P sd.. Type of Building (check all that apply) syCl� 7 'r-- T 3l N, R�E or® ` 1 3 ., El or 2 Family Dwelling - Number of Bedrooms Subdivision Name /� CSM Number El Public /Commercial -Describe Use d[ e W v� 61-a �/ ❑ State Owned - Describe Use b -SA- Ce kl 1 f ❑City ❑Village ❑Township o + Yeas* -e III. Type of Permit: (Check only one boa on line A. Nmplete line B if applic le) 0. A. VNew System ❑ Replacement System ❑ Tr enUHolding Tank eplacement Only ❑ Other Modification to Existing System `-^ B. El Permit Renewal ❑Permit Revision ❑Change Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber wner IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized ht- Ground ❑ Mound > 24 in. of suitable soil o < 24 in. of suitable soil El At-Grade El Single Pass Sand Filter El Constructed Wetland El Pressurized In- Ground El Holding Tank [I Peat Fi El Aerobic Treatment Unit El vculating / Sandy El Recirculating Synthetic Media Filter Leaching Chamber El tp Line ❑ el -less Pipe ❑ Other (explain) yy'�✓'� V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) I OR spersal Area Required ( Dispersal Area Proposed (sf) tens El on Cl Co VI. Tank I i N Steel Fiber In fo Ca p ac ity ty in Total her Manufacturer Prefab Si Plastic Gallons Gallons Units Concre a Constructed Glass Ne. Existin Tanks Tanks S tic Holding Tank jtal L /tv- .t Aerobic Treatment Unit NL Dosing Chamber L� 4^ VII. Responsibility Statement- I, the und igned, assume responsibility for installa ' f the POWTS s wn on the attached plans. Pluber's Name (Print) s Sigpqture umber Business Phone Number Plumber's Address (Street, City, State, Zip e) s Y i< /� / VIII. Countyffiepartment Use O Approved Disapproved Sanitary Permit Fee (includes Groundwater Dat Issu d Is in gent Signa ____ :�) Surcharge Fee) 00 7 ; " L.0 r � on IX. Conditions of Approvayonsons for Disapproval SYSTEM OWNE . 3> �To�. Sy�'e 1. Septic tank, uent filter and V� �p e dispersal c must all b�Vk.es / mairlt0kW f � e ` ' ,� 51 cQ C5 a as per m a gement plan provided by phlrnbe � 2 L 2. A code/ ofdktir>ces. al per if). c1 Attach complete plans (to the County only) for the system on paper not less than gl/2 z I l inches in size SBD -6398 (R. 01/03) Z Z / y 7/ - - r 3/ weg1"/ girl U I I i 2 09 4"2, i ( ' a. f O :Z2 - I tle � W/ L_I I T`I l L=J � j� LV 2 r , 5- f i Combination Tank Component Cross Section Approved Manhole Covers With Warning Labels and Locking Devine / 4" Min- Above Fh al Grade Weather Pmof Junction Box Electric per NEC 300 b2 COMM 4" rc- 16.28 WAC 4U Vent �/' > or =� to 12" �'" Above Final Grade Discon iect Alternate Outlet Location W /Approved 4" Sleeve Inlet Approved, Force Main Diann. Effluent Filter y3afll < or :- to 1/8" Weep hole or And Siphon Device Particle Size A - - Ti Pump Off Elev. a C 'rank Mfr. D i Dose Tank Elev. 7 r � Vertical Difference Between Ptunp Oil" arid. Distribution Pipe Mi iintum Required Supply Pressure : ....... ............................... = FT. of Force Main x/, Friction Factor/1001 -, = Total Dynamic Head -------------- - - - - -- q Wwriber of Doses ... = Per Day Cray.. Per Day / #of Doses lY. ), Gal. Volurue of Backflow .... ......- • .... ..... .......... . . .. ............... ...... � Gain. Total Dose Volume ..... ............................... -....... ......................... - 3j. 5 Gal. Pump Tank Capacity &11 Gallons I)MwnsioIls Inches 'C�allolw P ump Tank Volune / Y,13 Ga l ch A f j,�(,, j2? 7 Y I� Punzp Mfr. 2 ` C g, — 7 -f 1' 07 � Pump Model N J&/0 _ = D /Z. /'27 Minitnurn Discharge lute = 30 PM Alarm Mfr L ¢ 6L, w� rotatl= t l W z 7 Alarm Model nub Bed Tank per COMM. 83.45(5) Anchor Tank as necessary to negate buoyant Ibrcers per COMM. 83.43(8)(8). � s�� • 088 ®BO88©©aaaa .. DSOSSmm slogan 0 COMIC Callon 0 asss0naaaaaaan ®ann ago oa ® ©aaaana. 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Ali ' �M e 4:: �utsrl .,(tiry:rx++�Ia:�;'Na.fu:c��.ei, i�9- ...._.!�'_�/.� -��•� �0_7� .`. �£y:i�: 9�'�� i.rawF:- fffi;�I:L " .����t;I:s;: � ::'r•':r'tYa:�:`1u f.I.'L" Ser�,y't:�:;':1 �•t'3�:'1rt�,f'�rtyt.� /'G'oG ��' (.�.rr:kllj�f.r:!e,1 1.,nal:fiJ :e(r i�tr:$c•] 1 ' !'�kl•Fa�:e:'ild' s,It:axt: C,� y _ 1'u + � � �i.. F F.1 � � • .I.�I�aat,f:�r.c�xc_ - -_ - _..._..__- _..___ - ...._ .............w...,._._ 'N .._..___._. ___..,....,.._.__._, ....-. ...... .. C ;cs�r.'r.L�';11�.tc�:! ::E • c�r,'Cr',�i:;c';LVrl:�.d::;'x'� .J1Cl�Llt!`.( _ .._,____.. .........- _._.._._..__..._..._. _.._.,_....__„ _.,-- .,...- ' ...._,.. -�_._. :I:�:iH�� �:3.1:a•cct:it:C:t�. f�o:cra;�z�t.r,:ra :I; 1 �t.1.JtlsR:�r,�1: + +rrl:Fas ,Cx7 ' I4 >> Distil k�tr. : !r� , JJ Hy :N!':seanik .t : .t:t:t'c r ,_.-_...._._.__..__._.__.....___......._......__..__---..,...__----- :f Ctoss 5ectio:a ofdistrilxution ca.11(s) ]:.. aj. filxr�ta: 1. 1�r; a ( ��'r.�:a•...I�.ii���'t't;ti'�;c, �,,.t•,,, .�(L " J;l;;li��1 (.111'1 ^i.�� M-210.9 IDV7F DIAL T ........... ..., .................... I PGWTS OWNER MANUAL & MANAGEMIENT !PLAN Pads _— oil FILE INF >gRMAT,)O Owner SPECIFICATIONS _.__ _._- .;�....r;! ...._._ _ septic "Tank C�apa ci /nc��+ � ` .. - � NA _ Pc�rmrt _ _ Seaptics 'Tank Manu faoturrer ___.. . DESlIGN PIRIiAt ME"I ERS E'fflu Ftlter fiur ^er _.__._...u.. -__ L_J -11(A Nurnl3oraf Bedrooms _ �.__._........_....._.__ 0 NA l fftuent Filter (Model _...� __ _ ..,.. ^ luA Numbcar of 1lufalic Feolilty units -- ��W. —.—_ _.. l � U.....,..._......._ .__.._.__.� .. ._._.__...,__....... �._.,.� . i9 NA Pump Tank Capacity (ol>h 111 Estimated flow (averag __.........�.. ,. Pump Tank Manufacturer 3�'� u rv,a Design flow peak g ( peak) , fl s'fiimetttac3 x 1.b) !]errs tlllenufac;turar cltry P � ,�� C7 NA_ ucrl! Jlpplu a�U[on Pate — _.__— ..- _.....___......._ — -� l al /d /fizz Pdtxs M Strrndarc! ;nf AlHo ludnt /llfltint Quality _ _ Monthly averages" Pretreatment Unit CJ N Fats, Oil & Grerise (1 :0G) 530 nig /[.. 0 Sand /Grauel - ifter l"J'Peat plftal E3lochcrm)c al Oxyl.)ern Den-ictnd (BC.ID 5220 mg /L 0 NA 1:1 Mechanical Aeraation 17J Wetland Total Suspemded Solids ff$S) :0 a0 rrrg /L 1J Uisinfoetion 0 Other: Preti E fluepl atli3lily _ _..._.__., iVlonihl - averrige .... Di.spersitaf celitsi .fJ- -N 1310c Oxygen Demand (BBD ,,) X30 rng/L. 1 -1 In- Ground (gMV1•ty) D h7-C3rourid (: pi'[.9. 4 surize d) Total Suspendtad Solids (TSS) 530 rngJL D NA © At-Grade T:1 Mound Fecal Co)lfortn (geomotrio mean) 5 cfu /'100ml EJ Drip -Line 17 Other- ._ d.. _..._, _ ..__..... Maximum Effluent Particles Site i in dia. 0 NA Other: r l NA Other: _'- -._._. _. -- -- - -___. ._..._...... .._._..,_`.__...._._-----_........._...___..._.„_._......._..._ ,..._..___....._._.__- -- ....... . CJ NA other: 0 NA * 'Vetuws tyr.r,ar31 for domestic vva>;tdwa #tjr:arrd saptir: tsnlc effluelit. n'thur: NA MAINTENAN AN SCHEDULE ..... , .�.,......�� .r... `- -mow.. �Suriylce Event So rvlcQ Frgigenry lrrspeot condition of Tank(s) At least once eve k.l nlclnt ;t sl i__.. �..._�.....- ......_._. �� � year s) (Maxlrrrurrr 3 years( t,.) IV'A. Purnp out oontents of tank(s Whan combined sludge and squnl equals one -third ( of tank volume 0 NA Inspeot dis;zersal callis) At: IOWA oriro rave -- 77 �! mr;attth(sI ,_. ___._.._...,_...,. ........ �._ _. �.. _._ _ _....._ _ — � , r � `� �s)'Irea�rl9) ( 3 years) 0 NA Glenn ,e1''fi a ,...,,. _ u. nt filter At least once every: �• Z � r��[ ye ar(s ) (a) 0 NA Inspect pt.trnp, pur'np 0ontrols & alarm At least once, every: 0 rj iT orith(s) [;:1 NA 1 :lush IstamIs and pressure tryst At least ones ever © rncrnt:l)(s) y° CJ NA At least once every: G tnc'rnCh(r) 0 NA ..,_ ......... ._ 1:.J IAA MAIWENANCE INSTRUCTIO Insptact:io[1[•r of tunics and dispersal coils shall be made by an Individual carrying one Of 11 following, license,: or certifications: Master Plumber; Master Plumber Restrirrted Sewer; POWl"S Inspector; POWTS M i •tai , r •, p an dtnor, .,e to c Sc.rvirh�t Op erator. Tank Tank P £l Fl er inspections mufti: Include a visual insprrctiQn Of the tank(s) to identif p Identify a ny missing or broken hardware, Identify any cracks or leaks, Measure the volume of cornbined sludge and scum and to cheok for any back up or poncling of offluar•rt on thee ground surface. 'rhe di spemal cellis) -hail be visually Inspeotpd 'to aleck the effluent levels in the observation pipes and to oheck for ,;arty pranding. of owf3!1[sent on the ground surface 1 "I pond illg of effl on the [,h ound surface i78 fnrl Ste ei •fei!!r[y condition and requires tiles !MTR-id noti of the lacer( regulatory authority. When the nonrbinerl accumulation of sludge and Scum i[a any r:@rri< eaqursls one - •third Wi or more of the tank volume. the entire coritents Of *he tank shall boa removed by a 861Aa9e Servicing Operator and disposes - 1 of in accordance whil chapter NT•i 113, Wisconsin Administrative Code. All other rservioes, including but: not lirril:ted to the aerviginc0 of fiffluent filters, mechanical or pressurized components, pretreatment units, and :?r servicing a't intervals of x'12 months, shall the perforn ed by a certif)ad POW'T5 Maintainer. A service report Wsail big Provided to.th.eloca) regulatory authority within 1.0 days Of cnrrrpledon of any..aervice avant. . 623261 KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., VI RECEIVED FOR RECORD Document Number Document Name 04/20/2006 10:15AN WARRANTY DEED EXDPT # THIS DEED, made between LaCasse Development. Inc., a Wisconsin Corporation RfiC FEE: li. 00 TRANS FEE: 117.00 ("Grantor," whether one or more), COPY FEE: and Michael S. Christenson and Gretchen Christenson, husband and wife CC FEE: PAGES: 1 ("Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Lot S, Plat of River Place in the Town of Star Prairie, St. Croix County, Wisconsin. 038 - 1213- 80-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated I I J� (SEAL) " • •LaCasse Development, Inc.* (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATF, OF ) ) ss. COUN ) * TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me on (If not, the above -named LaCasse Deve ment nc. a Wisconsin authorized by Wis. Stat. § 706.06) Corporation by: Ridkatx & C>J . Lo- Cc ss e— Its THIS INSTRUMENT DRAFTED BY: to a known o be the person(s) who executed the foregoing Turner s ment a ac d d the same. Attorney Kristina OeMadr.14 Hudson, WI 54016 �� W 1SCOn * �/ Sta te ic, Stat of My Co ission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS 1S A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 ' Type name below signatures. INFO- PRO' Legal Forms 800 - 855 -2021 www.infoprotbrms.com 1of1 Parcel #: 038 - 1213 -80 -000 06/20/2006 03:23 PM PAGE 1 OF 1 Alt. Parcel #: 11.31.18.1169 038 - TOWN OF STAR PRAIRIE ' Current _XI 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 - LACASSE DEVELOPMENT INC LACASSE DEVELOPMENT INC 573 CTY RD A HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description * 1230 221ST AVE OR SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 1.923 Plat: 2397 -RIVER PLACE LOTS 1/30 038/01 SEC 11 T31 N R1 8W PT SE SW LOT 8 RIVER Block/Condo Bldg: LOT 08 PLACE Tract(s): (Sec- Twn -Rng 401/4 1601/4) 11-31N-18W Notes: Parcel History: Date Doc # Vol /Page Type 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.923 32,000 0 32,000 NO Totals for 2006: General Property 1.923 32,000 0 32,000 Woodland 0.000 0 0 Totals for 2005: General Property 1.923 32,000 0 32,000 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 Aug 03 06 03:46p LeQue Builders 1- 715 -246 - 4676 p -1 FAX TRAN SMITTAL 3�r 3 i LeQue Builders 1421 129th St. P.O. Box 15 New Richmond, Wl 54017 Phone (715)246 -257 Fax (715)246 -4676 www.leauebuilders.com Attention: From: 111' Phone: Date: ' *of Pa es. Comments: Z - 1 OIL a "wa I q A 2 c c-) 11 El ❑ x 13 11 0 13 Egg 103 ? ? A I j t ch CO R F13 I T13 ue En CA 0 0 (A W CA) t 0 0 02 0 C4 q , cn Ln Lrl vr lamp tn 1[7 43 c%i ru cj CM N Ci IR C) C) C) C) 4D Ck 0� go C) 0� -J 5, .r C> n n 0� 0% 00 Le i Go C)- cn C) t o 0 C% v) in V) cl qr !�! -;r `n 0 %n M W) %n cli (V to Ln 0 C%j 4p� qr 40� 41V 40+ 40P# 4F)� 44 401 *F� oil, 4w 40. 6i J "0 CO C -4 (NJ r4 cm en 4D en qw Lr) CM (V C'J in C%j LO Fog 0 4 4 • s.f,�, ii1 5! � j s� S� �� •i ,� O O AWL S - -N%UH 3WO313M OE:91 900L /SL /L0 sJaPTTng anbal - 90 E:o 2ny Aug 03 06 03:46p LeQue Builders 1- 715 -246 -4676 p.3 LaCasse Custom Homes custom home builder in Western Wisconsin ragC c url z- Raver Lo t priced at $99,900 - Lot 23 River Lot priced at $89,900 - Lot 27 River Lot priced at $94,900 - Lot 26 River Lot priced at $90,900 - Lot 24 Interior Lot priced at $54,900 - Lot 21 Interior Lot priced at $40,900 - Lot 14 Interior Lot priced at $38,900 - Lot 6 V River Place -d 16 -- -! L .r. 17�Id'4 _[t IB l al_ :1'S� f � .'•1 � ` .J _ Vii.. CA, 1. sAd •d 13 1:•r.:.. a �.: . ::,: 1.•:_ ; ___ - I 1 ILcd rt t: �y >hy l,•R.n•.•1 .. 11 .1•., .:;,. �,...._ i 24 At chif I - 1: �a•Id 1 Yr / S1 Ca.[� I. c.C1 e - .:� 7'�., U L--tM I Call LaCasse Custom Homes at (715) 381 -5405 or (651) 430 -0503 todayl Home About Us Sales Center Models & Specs Team Members About Wisconsin Communities Photo Ga!lery Suuina z Home cur Customers..... Our Friends Contact Us http:// www. lacassehomes .comBuilding %20Sites,htrn 08/03/06