HomeMy WebLinkAbout038-1185-80-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
572807 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information yoy provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Vo alun, a I&Ann I Star Prairie, Town of 038-1185-80-000
CST BM Elev: Insp.BM Elev: BM Description: 11 II Section/Town/Range/Map No:
13.31.18.939
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
p I S
Se tic .6 Benchmark Gxa rI w 106c> Benchmark -5 /O2.5
Dearng �CQ, /`d' l� Alt. BM . Z • 3 /aO�.
Aeration aD .,�. ,.� Bldg.Sewer
Holding St/Ht Inlet
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/l, WELL BLDG. ena lAir Intake ROAD Dt Inlet
Septic 33 55 fa 33 Dt Bottom
3
Dosing Header/Man. / i
Aeration Dist. Pipe L AcZar •(r
(o • LS 9 S
Holding Bot.System 7• c1 74, (o
e--5 2-
Final Grade �cj•
PUMP/SIPHON INFORMATION 'J
Manufacturer Demand St Cover 1
• t3 ��
GPM ,- a
Model Number �fl v�� /D• �Z
TDH Lift Friction Loss System Hea TDH Ft
v
Forcemain Lengt ia. Dist.to Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width / Leng�h No.Of Trend PIT DIMENSIONS No.Of P' Inside Dia. Liquid Dept_ h
DIMENSIONS 3 5a lL GZ 11wA JA.QA '\\
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of System: UNIT
Model Number:
CO�JBw�O ZO 51
DISTRIBUTION SYSTEM /� ✓5
Header/Manifold (l. (" istribution x Hole Size Ix Hole Spacing Vent to Air 1Intake
4m— G6 Pipe(s)
Length Dia, Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over r p( Depth Over xx Dep of xx Seeded/Sodded xx M ched •
Bed/Trench Center �• Z 56J�.Bed/Trench Edges "�` Topsoil Yes No es No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2:
Location: 2120 135th Street New Richmond,WI 54017(SW 1/4 SE 1/4 13 T31 R1 8W) Prairie Flats Addition Lot 8 Parcel No: 13.31.18.939
1.)Alt BM Description= t �4.: �. g r}— l0.1 a .�
2.)Bldg sewer length �
-amount of cover= �l Cv � �L
Plan revision Required? Yes No I '�
Use other side for additional information.
Date Insepctor's nature Cert.No.
SBD-6710(R.3/97)
PLOT PLAN
PROJECT Daniel Vorwald ADDRESS 2120 135th ST. New Richmond WI 54017
SW 1/4 SE 1/4S 13 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST.CROIX
SYSTEM ELEVATION 95.7'3.5'at B-1 DATE 10/5/14 BEDROOM 3
CONVENTIONAL M IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND
SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter Zabel A-100 Filter
❑ BOREHOLE O WELL -H.R.P. Sameas Benchmark
135th ST.
All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40. Scale _ 1 /4" _ 10'
80' A valve is to be installed
Existi g to use a 'isting system
ailed Bottom of siding
S ste g
0 Y
15' '
B- ' 5' 10,
T
00/000 Existing 3 Of
Bedroom
5
99' House
1
5� t PV
100 2-3' X 66' ce r t s acing
SZ
101
B- �I
Vents 102'
Lven
�6„ ick4 Standard
operty Line of Cover aching Chamber
h 20.0 ft2 of Area
ft^2/pair of end caps
4' LonGrade at System Elevation
34"
Property Owner_ Parcel ID# Page of
Boring 37 # ° Bones —S =
Pit Ground surface elev. ft. Depth to limiting factor � in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Shwture Consistence Boundary Roots GPDRf
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
0-A 3 � b C> h
Boring# Bering
°
F-1
E] Pit Ground surface elev. ft. Depth to limiting factor in. Sod Application Rate
Falzon 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
F-1
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Sod 8wication Rate
Horizon lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDIff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 *Eff#2
•Effluent#1 =BOD,>30:s 220 rng/L and TSS>30_<150 mg/_ 'Effluent#2=SOD,130 mg/l.and TSS 130 ng/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 altemate format,please contact the department at 608-266-3151 or TTY 608-264-8777.
SSD4330(R.6=)
RECEIVE Safety and Buildings Division Connty�'l 1
r K 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.)
Madis OCT o W 7-7162 --t ! �� ,_)- Yo
1OMMUf�' g� gp�rt Application
anon State Transac Transaction
In accordance with SPS 383.21(2),Wis.Aden Code,submission of this form to the appropriate governmental unit
is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address( ifferent than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law,s.15. 1 m,Slats.
I. Application Information—Please Print All Information --��
Property Owner's Name n Parcel#
IV i C_X_ V t w 03 t3- //S 15--
Property Owners Mailing Address Property Location (/ )
d 1 /3 544 S�' Govt.Lot cj/
City,State Zip Code Phone Number SLO y, S 1A, Section
_ / circle
M Type of Building(check all that apply) Lot# T t--N; R E W
l
2 Family Dwelling—Number of Bedroo ((8 Subdivision Name
r,
` Block#
Q Public/Commercial—Describe Use n J .---� Q City of
❑State Owned--Describe Use CSM Number ❑grillage of // p
of
III.Type of Permit: (Check on box online A. Complete line B if applicable)
A" Q New System Replacement System Q Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain)
B- Q Permit Renewal Q Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and C//Z,?/ate sued
Before Expiration Owner 3 / 0 30 —7 � Z
IV.T e of POWTS System/Component/Device: Check all that apply)
/
Non-Pressurized In-Ground ❑Pressurized In-Ground 0 At- e ❑Mohr >24 in.o surt�,bls soil Q Mound<24 in.of suitable soil
❑
Holding Tank Q Other Dispersal C r J 1 ' Y l L
g persal Component(explain)I� l tretreatment Device(explain)
V.Dispersal/Treat ent Area Information: !
ign Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(sf) Dispersal Area Proposed(st), System Elev
VL Tank Info Capacity in Total #of ManufacturerL
Gallons Gallons Units o b
New Tanks Existing T / 'a 2 a m
U;V4(, V)
Septic or Holding Tank 1
Dosing Chamber
VII.Responsibility Statement-1 the undersigned,a e responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name(Print) PI s ignature MP/MPRSS Number Business Phone Number
Plumber's Address(Street,City,State,Zip Code
VI .Countv/De artment Use Only
Permit Fee Date Iss ed issuing Ag t S"p atme ,7
Approved ❑Disapproved $ i s t e
❑Owner Given Reason for Denial
IX.Conditions of Approval/Reasons for Disapproval 7 f 4 o 7
SYSTEM OWNER:
1.Septic tank,effluent filter and Al
dispersal cell must be serviced/maintained , a r
as per management plan provided by plumbe / J
1�! _ GT
or a system and submit to the Co ty Daly oa 1)a per not less than g rrz z 11 inch
as per applica�l��°d&�'l8g�fi� S. p eg,n s1ize s
SBD-6398(R. 11111)
y/zrxr
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 10/5/14
Owner: Daniel Vorwald
Location: SW 1/4 SE 1/4 S13 T31 N,R18 2120 135th St. Star Prarie
In-ground absorbtion system(conventional)
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter SpjaShee t
8. St.Croix sting septic tank form
9. Soil Bor ication
Signature
License n900
PLOT PLAN
PROJECT Daniel Vorwald ADDRESS 2120 135th ST. New Richmond Wi 54017
SW 1/4 SE 1/4S 13 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST.CROIX
SYSTEM ELEVATION 95.7' 3.5' at B-1 DATE 10/5/14 BEDROOM 3
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32
BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter Zabel A-100 Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
135th ST.
All piping shall be SDR 30/34,within 10'
of tank,piping shall be Schedule 40. Scale _ 1 /4" _ 10'
180' A valve is to be installed
Existing to use existing system
10fiH
Bottom of siding
15 50,
Existing 3
Bedroom 30'
99' House
Well
100 2-3' X 66' cells with 3' spacing
101
B- '
Vents 102'
Vent
>6„ Quick4 Standard
Property Line of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ft^2/pair of end caps
4' Long 12"
34" Grade at System Elevation
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber
5.6ft^2 pair of end plates To be >1' above grade
Finish grade elevation
Typical Installation 99.5'
Vent Al Grade Vent
3' 4" X
X30/34 Septic Tank
5' Long 1 5'
3697 Grade at System Elevation Grade at System Elevation
Spacing 5'
2-3' X 66 ' Cells
Same on other end Observation tubeNent
At end of cell
A
16 chambers per cell B
System elevations:
A 95.7'
B 95.7'
Property Owner_ Parcel ID# Page of
F-1 Boring# El Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil icaaon{fate
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
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soi Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
F-1 Boring# ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
I
I
�I
�I
Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mgA- 'Effluent#2=BOD5 130 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(8.6/00)
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page Of ?
Division of Safety and Buildings
in accordance with Comm 85,Wis. Adm. Code
County no/ x
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. Q 0
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). tW
Property Owner Property Location
—a r- t r Ur �(� Govt.Lot S:.,J 1/4,$[ 1/4 S 3 T 3 N R Y E(o)w
Property Owner's Mailing Address Lot# Block# Subd. Name or CSM#
)- S P
City State Zip Code Phone Number ❑City ❑Vllage own Nearest Roa4
W ;6'al W) D
❑ New Construction UsOE�Residential/Number of bedrooms Code derived design flow rate Y,I GPD
eplacement �-� ❑• Publi or commercial-Describe:
Parent material c�CJt Flood Plain elevation if applicable
General comments 2/)r
and recommendations:
n
System Type �J�L System Elevation
# ❑ Boring Q Q //0 pit Ground surface elev. ` ` " +� ft. Depth to limiting factor�in.
Sal Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 I •Eff#2
ZZ 3-3v S ice, s <
Boring# ❑ Boring
J9 pit Ground surface elev. � ft. Depth to limiting factor in.
Sal 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
k
Ef fluent#1 =BOD.>30<220 mg1L and TSS>30<150 mg/L •Effluent#2=BOD,<30 mg/L and TSS<30 mg/L
CST Name(Please Print) Sign CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1432 120th St, New Richmond, WI 54017 Y 715-246-4516
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
is to certify that I have ins cted the septic tank present:].
:serving the U0 fw�� Y
Qw�
resid�ce located <3t :
Sectzon � , T�N, R � W
, 'Town ()f:
Upon inspection, I certify that I have font(]
the tank and baffles to be in good condition, and it appears to he
functioning properly.
mast time serviced: tL—Q.a"Z Q
flow back occur LXOM absorption system?
------ - Yes _ No (If no, skip next line)
Approximate volume or length of time:
gallons �,i m.inutcs
'apacity:
Construction: Prefab Concrete Steel
Other
------------
141-unufacturer: (If known)
Aature)
known) :2 0zrz-
( (Name) Please print
-.. 5 '7-
(License Number)
Date
form to be completed by licensed plumber (s. 145. 06, wiscons.in
Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative
Code)
Plumber (applying for sanitary permit) Certification:
Ir, accepting the above statement regardi existing septic tank
condition, I certify that the tank to the e t of my knowledge will
conform to the requirements of ILHR 83 , Adm. Code (except for
inspection openin ver outlet baffle)
Signatu MP/MPRS�U� '
Y L�
phi�\ i
r
f ♦
. �rrrrrsuarrrr�rrrrr '�`�y, � 1
' I)Flifitf..m to IN s
- R�atw�r.wrrw►� _. _.
'� l t t l t`�'t t'■ lit't�t't�t�
M'M l llttttt� � �1A ,
NO
Lt1
l � l
T , o►
.. ai
•
�wr�ara�rrsr.w.+urrr �
i w rrrr►s�wsrr .. ._ -- -- - -'
1' i.■1i1 i.ii'i i i.■ iA w.11�w r�l
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pageof
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner Tank Manufacturer: 4c.ABf<S ❑ NA
Permit# �� ;53::�eptic ❑ Dose ❑ Holding Volume: (gal)
DESIGN PARAMETERS Tank Manufacturer: �.NA
Number of Bedrooms: ❑ NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal)
Number of Public Facility Units: NA Vertical Distance Tank Bottom(s)to Service Pad, / /� (ft)
Estimated(average)Flow: �� (gal/day) Horizontal Distance Tank(s)to Service Pad: // )TT (ft)
Specific servicing mechanics must be provided if vertical is>15 feet or
Design(peak)Flow=(estimated x 1.5): J� (gaVday) If horizontal is>150 feet. Specific Instructions to be rovlded back.
In Situ Soil Application Rate: , "7 (gal/dayM2) Effluent Filter Manufacturer: e— LIL- i'
❑ NA
Standard(Domestic)Influent/Effluent Monthly average Effluent Filter Model: IT 6
Fats,Oil&Grease (FOG) s30 mg/L Pump Manufacturer:
Biochemical Oxygen Demand (BODs) s220 mg/L ❑ NA A
Total Suspended Solids SS x150 mg1L Pump Model:
High Strength Influent/Effluent Monthly average Pretreatment Unit
(FOG) >30 mg/L Manufacturer.
(BODs) >220 mg/L
• SS) >150 mg/L ❑Mechanical Aeration [3 Peat Filter
❑bisinfection ❑Wetland
Pretreated Effluent Monthly average ❑Sand/Gravel Filter ❑Other.
(BODs) s30 mg/L Soil Absorption System
(TSS) s30 mg/L NA
Fecal Coliform(geometric mean) s10' Ground(gravity) ❑In Ground(pressure) C3 NA
Maximum Effluent Particle Size 3(,in dia. ❑ NA ❑ Grade ❑Mound
El D Drip-Line ❑Other:
Other: Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Pump out contents of tank(s) when combined sludge and scum equals one-third(X)of tank volume
❑When the high water alarm is activated
Inspect condition of tank(s) At least once every: ❑month(s) (Maximum 3 years) ❑ NA
ear(s)
Inspect dispersal cell(s) At least once every: m°Ks�s) (Maximum 3 years) El NA
Clean effluent fitter At least once every: l months) NA
earls)
Inspect pump, pump controls&alarm At least once every: ❑month(s) NA
❑year(s)
Flush laterals and pressure test At least once every: ❑month(s) NA
❑yeags)
Other: At least once every: ❑month(s) NA
❑yeags)
Other:
❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper).
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 a check for any back up or ponding of effluent on the ground surface. The soil
absorption system 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 treatment tank equals one-third(%)or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator (pumper)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 30 days of completion of any service event.
GMW-005(02/05)
START UP AND OPERATION Page 7--of
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are
detected have the contents of the tank(s)removed by a Septage Servicing Operator(pumper)prior to use.
Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these
conditions is not recommended, as the excess wastewater will be,discharged to the soil absorption system in one large dose causing an
overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the
contents of the pump tank removed by a Septage Servicing Operator(pumper)prior to restoring power to-the pump or contact a Plumber
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
Do not drive or park vehicles over tanks or the soil absorption system. 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 treatment
tanks and soil absorption system: acids, antibiotics, baby wipes,-cigarette"butts, condoms, cotton swabs, degreasers, dental floss,
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat
scraps,medications,oils,painting products,pesticides,sani4ry napkins,solvents,tampons, and water softener brine discharge.
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 s. Comm 83.33,Wisconsin Administrative Code:
• All piping to tanks,pits and other soil absorption systems 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(pumper).
• 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 the time of their permit issuance.
-A—A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be
rehabilitated and barring advances in POWTS technology,a holding tank may be installed as a last resort.
❑ 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 TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE.
ADDITIONAL INSTRUCTIONS:
d t' S f LZ
POWTS INSTALLER POWTS MAINTAINER.OQ
Name Name a` `
Phone J Phone a�0 yJ
SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY
Name Name
Phone f J y� Phone
This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections
Comm 83.22(2)(b)(1)(d)&(f)and 63.54(1),(2)&(3),Wisconsin Administrative Code.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMTE'NT
AND
CWNE.RSfIIP CERTIFICATK-IN DORM
Owner/Buyer --
.N,o __-
Mailing Address c-I
Property Address
(Verification required from Planning&Zoning.Department for new construction.)
City/State __-- -- -—�` - Parcel Identilicatiotf.Nut Iber
LEGAL DESCRIPTION
Property Location ��-c J ;iy ,S '/4 Sce. 3 13 p j
---— W, Town o f J�f F c:(-.L-�A(
Subdivision
--- ----- ----- Lot# �l
Certified Survey Map # ------
---------_-__—_--------------__----- _....__-- ___, Vc'lutnf: Page
Warranty Deed#
� " _�.- ---, Page#
1 __---•
Spec house yes no Lot Iine identifiable(\!y=-e�s CIS-��'j�lj//`
r � �V
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failrtre to handle wastes. Proper
maintenance consists of pulttping out the septic tank every three years or sooner, i1 needed,by a licensed Pumper. What you put into
the systern can atfect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in§Comm. 83.52(1) and in Chapter 12-St. Croix County Sanitary Ordinance.
7'he property owner agrees to submit to St. Croix County Plaruting&Zon ing Department a certification form, signed by the
owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site
wastewater disposal system is in proper operating condition and/or(2)after inspection and purrtpittg(if necessary),the septic tattle is
less than 113 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 froth,herein,as set by the Department of Commerce,and the Dc pattn,ent of Natural Resources,State of Wisconsin.
Certification stating that your septic system has been tnrintained must be completer)and returned to the St. Croix County Platmitrg
Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of illy/our k nowledge. 1/we ant/are the owner(s)of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Number of bedrooms
SIGNATURE OF APPLICANT
DATE
***Any information that is misrepresented may result in the sanitar
y permit being rovoked by the Planning&.Zoning Department. ***
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey reap if
reference is made in the warranty deed.
(REV.08/o5)
URT CORNER
SE ON 13
(x' IRON PlPE FOUN:
W UNPLATT,ED LANDS
S 89'43827" W 2582.09"
50.18 354.69 357
y � � ev
1,92 ,ACRES
p 83,587 5Q. FT. /
f
caw �'� �•�: / �ti�f
1.92 ACRES ,
83.587 SQ.. FT,
to
It Ile
�. e r ,✓
CO z
Pei
W 1.92 ACRES r° ' / 78 212
i 83,587 SQ. FT.
00 loo. E
3ZF 92
269.65 1 - 1.71 ACRES
74,341 5O,
t7
VOL 1589►w 403 to
STATE BAR OF WISCONSIN FORM 2-1999 KATHLEEN H. WALSH
WARRANTY DEED REti.LSTER OF DEEDS
Document Number ST. CROIX CO_, WI
This Deed,made between P.C.Collova Builders, Inc.,a_ —_
RECEIVED FOR RECORD
Minnesota Corporation,_ _—_ 02-21-2001 9:30 AN
WARRANTY DEED
EXEMPT 0
Grantor, and _Daniel A.Vorwald and Ann M.Vorwald,husband and CERT FAY FEE
wife, TRANSFER FEE: 426.60
-- RECORDING FEE: 10.00
PAGES.,1
Grantee.
Grantor,for a valuable consideration,conveys to Grantee the
following described real estate in St.Croix County,
State of Wisconsin(if more space is needed,please attach addendum):
Recording Area
Lot 8,Prairie Fiat Addition,Town of Star Prairie,St.Croix County, Name and eturn Address
Wisconsin. NDCk f X\S& �v\Ac'
��Jb �YO C1C1L ��-
���,�, '('t�N 55y3S
038-1185-80-000 _
Parcel identification Number(PIN)
This is not homestead property.
0j) (is not)
Exceptions to warranties: Easements,restrictions and rights-of-way of record,if any.
Dated this --day of February __— 20.01
P. .Collova Bull er Inc
P.C.Collova,President
AUTHENTICATION ACKNOWLEDGMENT
)
Signature(s) P.C STATE OF WISCONSIN.Collova Builders,Inc.,a Minnesota )ss.
Corporation,by P.C.Collova,President County )
authenticated this day of February 2001 da of
Personally came before me this Y
the above named
s Kristina Ogland _._.. _ ----------
TITLE: MEMBER STATE BAR OF WISCONSIN t0_rr�ekno`wn to be the person(s)who executed the foregoing
(if not, __ —..--.— instrument and acknowledged the same.
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY
Attorney Kristina Oglan_d_ Notary Public,State of Wisconsin
Hudson,WI 54016 My Commission is permanent.(If not,state expiration date:
(Signatures may be authenticated or acknowledged.Both are not necessary.) —'
Information Professionals Company.Ford du Lac.WI
Names of persons signing in any capacity must be typed or printed below their signature. BM-655-2021
STATE BAR OF WISCONSIN
WARRANTY DEED FORM No.2-1999
_ I
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ti ST. CROIX COUNTY GOVERNMENT CENTER
--
__ "x 1101 Carmichael Road
Hudson, WI 54016 -7710
(715) 386 -4680 Fax (715) 381 -4686
March 8, 2001
P.C.CollovaBuilders
Attn: Laurie
705 County Trunk E
Hudson, WI 54016
RE: Septic Inspection for P.C. Collova Builders located at 2120 135` Street,
Prairie Flats (Lot 8), Star Prairie Township, St. Croix County, Wisconsin
Dear Laurie:
A septic inspection of the above referenced property was conducted on 01/04/01. This
property is located in the SW 1/4 SE 1/4 of Section 13, T31 N R1 8W, Prairie Flats (Lot 8),
Star Prairie Township, St. Croix County, Wisconsin. At the time of the inspection, this
septic system was found to be code compliant for a three (3) bedroom home.
If you have any questions regarding this, please contact our office at (715) 386 -4680.
Sincerely,
luv� n, r --
Kevin Grabau
Zoning Technican
/s
cc: file
r
ST. CROIX COUNTY ZONING DEP TMENT
' AS BUILT SANITARY REPORT
Owner /- C
Property Address XQ�
City /State
Legal Description:
Lot Block Subdivision/CSM #
1 /4 $E ' /a, Sec. 13, T__,N -R_/AW, Town of PIN #
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer L ' Size ST/P 16M — Setback from: House Je Well VO
Pump manufacturer Model
Alarm location
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
Type of system: 11-JO x Width 3 Length 7.S Number of Trenches
Setback from: House 30 Well +6 �P/L - /0 � Vent to fresh air intake ---
ELEVATIONS
Description of benchmark T Elevation ,.oy /
Description of alternate benchmark Elevation
Building Sewer 7 Sg ST/HT Inlet , a ST Outlet
0 PC Inlet
PC Bottom Header/Manifold c 3 7, 3 l Top of ST/PC Manhole Cover
Distribution Lines O 9 5 .3 ( ) 2 31
Bottom of System () 73 () 15� 3 ( )
Final Grade ( ) 9 8 , / () 9 9,dv �
Date of installation G /a y1 a Permit number 3 7 b L5 ? State plan number '"--
Plumber's si nature Z! �A_License number Jkj- o 1)3 7 Date
c
Inspector �t_"JAIA_ Complete plot plan �
E
NOTICE Please provide the following:
• A plan view sketch showing everything within 100 feet of the system.
• Two horizontal reference points to center of septic tank manhole cover.
• Show alternate benchmark, if applicable.
PLAN VIEW
q /
/-8
z�' acs +
any""" ' U
o' .4 4 ,Z
cy/1 q i,4
the - ,� E . JJJ Tfti i s •tea- toe' `�
�*' 1
ep t
INDICATE NORTH ARROW
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y'
Safety and Buildings Division Count St. Croix
INSPECTION REPORT
.GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary,E�{Teo.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. SS �/vV vU //
Permit Holder's Name: ❑ City ❑ Villa � i o township State Plan ID No.:
P.C. Collova Builders, JJ
CST BM Elev.: Insp. BM Elev.: BM Description: ' Parcel T�t{ Nol 1 -80 -000
Co. DI W. ID � 3 i 25
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark j .S✓r 00 • '
Dosing t' 'Of,( •�
Aeration Bldg. Sewer - S , 5'
Holding St /Ht Inlet
TAN SETBACK INFORMATION St/ Ht Outlet �• �(-�I ,o(�'
TANK TO P/ L WELL BLDG. Air I ntake ROAD Dt Inlet
Air
Septic 1 > 3o' D — NA Dt Bottom
Dosing NA Header / Man. I'D •
Aeration NA Dist. Pipe 1 CH. q4
Holding , Bot. System I Z - 13.
E 5
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand St cover
Model Nu r GPM
TDH I Lift L iction System H Ft
Fo emain Length Dia_ 7_ 7 Dist. To Well
SOIL ABSORPTION SYSTEM
M TRENCH Width r Len , f Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMEN I N . DIMEN I N
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK CHAMBER - Numb ^ SAW
INFORMATION TypeO , Moe
System: Qarw- 5 3 2 52 + OR UNIT -
DISTRIBUTION SYSTEM
Header old v Distribution Pipe(s) x Hole Size x Hose Spacing Vent To Air Intake
Length �� Dia. ng I'%- �
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
El ❑ No ❑ Yes ❑ No
COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: ��lD'�lol Inspection #2• --E--
Location: 2120 135th Street, Star Prairie, WI 54026 (SW 1/4 SE 1/4 13 T31N R18W) - 133118939 Prairie Flats -Lot 8
1.) Alt BM Description =�
2.) Bldg sewer length= 10. p
- amount of cover= (�
3) 6 ,ry -pex V�
LA
.,
b
Plan revision required? s No 03 0 � o r
Use other side for addition Information. [ Z
SBD -6710 (R.3/97) s is 5 natur ert. No. -
M �
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER: t
..
1 ..3 € 4
6
y
3
3
. ._1
i
{
a 1
r
i
_ry i
i
a
3
i
� {
ScAi E 1, �
.._
l
�— Sanitary Permit Application Safety &Buildings Division
In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application '
PO Box 7302
14sconsin
Personal information you provide may be used for secondary purposes Madison. WI 53707 -730.
Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if r
state owner
Attach complete plans (to the county cop) only) for stem. on paper not less than 8 -1/2 x 1 I inches in size.
County State Sanitary P nui;1�1P er ,, \ C a ki L7 ev to previous application State Plan I. D. Number
I. Application Information - Please Print all Infor n'" ' Location:
Property Owner Name � �.'
Property Location
:5 (L4 /45f -1/4, S � T �,N, ty or W
Property Owner's Mailing Address
/ Lot Number Block Number
1 17 - / �' ! U �� [5
City, State Zip Code Mike Number % Subdivision Name or CSM Number
5 G/ ,�-
II Type of Building: (check one) ` - ❑ City
At I or 2 Family Dwelling – No. of Bedrooms ❑ Village
❑ Public /Commercial (describe use): P(Town of
Cl State -owned j
III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road
A) 1. JkNew System 2. ❑ Replacement 1 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s)
System Tank Onlv Existing System p
B) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply) /31 3 `
O.Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland
❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V Disp ersal/Treatment Area InformatioRA, (Do
1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (gals./day/sq. ft.) (Min. /inch) Elevation
SGT 75' p f8�•�
VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
❑ ❑ ❑ ❑
coo l �
❑ ❑ ❑ ❑ ❑
VII Responsibility Statement
I, the undersigned, assume responsibility for installation of the POWTS showylpn the attached plans.
Plumber's Name rint) Plumb Sign re (no s): P PRS No. Business Phone Number �/� I Plumber's Addre s (Street, City,
VIII County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater DIs. ' Agent Signature (No stamps)
pproved ❑ Owner Given Initial Adverse Surcharge Fee) -4=16
Determination
IX. Conditions of Approval /Reasons for Disapproval: 4�–(k,_ Z /l am 57hall ~e -1� - urrp�ra. ale ,re�,�., p k
0
A ll; 14 5 / .
L� ivl
stflr_ .6—v- ibm -Z;k�G• l l ("a w• ru °vtce� c wt .Nrtitit ru `y� S
Q /LIt a a. _ - 54V wc k_ kaa by e Cr 4w,n r ee d
�i ;�% 3X e�
3 � 3 �`
SBD -6398 (R. 07/00)
46Jr
7, .-
s�
l7 S
�
3 S L/, 69
( - :z) ) 68:7s'
�Wfl(4 be in 4 lod k,
Z/1 '� S� IoSQ✓ ✓nfi � ✓!
Wiscwnsft Department of Commerce SOIL AND SITE EVALUATION Page 1 of
't3ivisioisof Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code
Gille Trucking & Excavating, Inc.
Attach complete site plan on paper not less than 814 x f t inches in size. Plan must County
include, but not limited to: vertical and horizontal refe BM), direction and St C roix
percent slope, scale or dimemsions, north arro d \ 1Q9ti ance to nearest road. Parcel I.D.#
APPLICANT INFORMATION - P asee'print a info n. Re iewe By— Dat
Personal information you provide may be used r sbondary (Pr' acy L'/ s (1) (m)). ' O
r
Property Owner AAddressl i roperty Location
Case , Dan vt. Lot SW 1/ SE im 13 T 31 N,R 18 W
Property Owner's Mailing 3; of # Block # Subd. Name or CSM#
323 Sawmill Lane � cA � kN1 Y P 8 Prairie Flats
City dde`��t� City ❑ Village ZTown dearest Road
New Richmond W1�/ -,.715 -246- Star Prairie ) Hwy 65
Z New Construction Use: Z Resi bedrooms 3 ❑Addition to existing building
D Replacement ❑ Public or commercial describe
Code Derived daily flow 450 gpd Recommended design loading rate .7 bed, gpd/ftz .8 trench, gpdV
Absorption area required 643 bed, fl? 562 trench, ftz Maximum design loading rate .7 bed, gpd1W .8 tr ench, gpd/f-2
Recommended infiltration surface elevation(s) a i'7. S ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material U - wc.6 , Flood plain elevation, if applicable ft
S= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank
U= Unsuitable for system ®S ❑ U ❑ S u M S LI U ❑ S M U ❑ S U ❑ S® u
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPDIft
Boring# Horizon in Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. C onsistence Boundary Roots Bed Trench
1 1 0 -11 7.5YR2.5/1 ---- - - - - -- SIL 1FABK MVFR AW 1VF .2 .3 1
__
2 11 -22 7.5YR4/6 ---- - - - - -- CL 1FABK MVFR AS 1VF .2 .3 ,
Ground - 3 22 -98 7.5Y R5/3 ---- - - - - -- S 0 -G ML - - -- - - -- .7 .8 -7
el � e +1�, - - -- — - - - - - -- - -
Depth to '� Z
limiting -- -
factor
98 IN. ' -- — -- —
Remarks: _
2 1 0 -12 7.5YR2.5/1 ---- - - - - -- SIL 1FABK MVFR AW 1VF .2 .3 �-
2 12 -30 7.5YR4/6 -- - - - - -- CL 1FABK MVFR AS 1VF .2 3
Ground
3 30 -96 T /3 ---- - - - - -- S 0 -GR - - -- - - -- .7 .8 • -- 7
ele -- - -
Depth to
limiting
factor 96 _
961N. -— — --,-
Remarks: — — - -- — - - -- - --- - - - - -- - — -- — --
CST Name (Please Print) Std lure: Telephone No.
Dennis Gille _ 715 268 - 6637
Address pp t CST Number Ref #
372 140th Street Amery, WI 54001 Vf6/97 3409 107
MOPERTY OWNER: Casey Dan SOIL DESCRIPTION REPORT Page 2 of _
FrARCELH.D.#_ Gille Trucking & Excavating, Inc.
Depth Dominant Color Mottles Structure GPD/ft
Horizon Texture onsistence Boundary Roots -- —
in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
3 1 0 -11 7.SYR2.5 /1 ---- - - - - -- SIL 1FABK MVFR AW ] j VF .2 .3
2 11 -25 7.5YR4/6 ---- - - - - -- CL 1FABK M VFR AS I VF .2 3 2
Ground
el ev 3 25 -96 7. -- -- - - - - -- S 0 -GR ML - - --
7 s
-- — — —
Depth to
limiting -
,
factor
96 IN. - -- — — - - -- —
Remarks: -- —_
4 1 0 -10 7.5YR2.5 - --- - - - - -- SIL 1FABK MVFR AW 1VF .2 .3 ,1
- - — --
2 10 -26 7.5YR4/6 ---- - - - - -- CL 1FABK MVFR AS 1 VF .2 .3 2
Ground
3 26 -96 7.5YR5/3 ---- - - - - -- S 0 -GR ML - - -- - - -- .7 .8 �'
elev _
1 60.3
Depth to �! '
limiting — -- -- -
factor
96 IN -- -- - -- - - -- - - -- -- - - -- — - - --
Remarks: -- - — _ - -_ --
5 1 0 -11 7.5 ---- - - - - -- SIL 1FABK M VFR AW IVF .2 3
2 11 -28 7.5YR4/6 ---- - - - - -- CL 1FABK MVFR AS 1VF .2 .3
Ground
elev 3 28 -96 7.5YR5/3 ---- - - - - -- S 0 -GR ML - - -- - - -- .7 .8 ,
- _ -- - - -
Depth to
limiting — --
factor
96 IN,
Remarks: — — - - -- -- - - --
Ground — - -- - - - --- - - - - -- -- - - - -- -- -
elev
Depth to
limiting -- — —
factor
Remarks:
aos
�o PAS
� q Lo TL r � �{
r '
/ ►' �k +� Pory a CaNC�I�
0
363, ?s
6
3
y ,
\ y
\ r
Private Onsite Wastewater Treatment System Management Plan
Septic Tank And Gravity In- Ground Soil Absorption Component
Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
System (POWTS) shall include information and procedures for maintaining the system within
the parameters of Comm 83 and 84, and the conditions of approval by the department, agent,
or governmental unit. The approved plans and permits for system are on file at the county
zoning or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
10567-P (R.6/99).
Table 1: System Design Specifications
Sanitary Permit Number 7b 3 0 7
Number of Bedrooms 3 _
Design Flow - Peak (gpd) ,_C? —
Estimated Flow - Average (gpd)
Septic Tank Capacity (gal)
Soil Absorption Component Size (W) � �3
Type of Wastewater Domestic
Table 2: Soil Absorption Component - Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow - Peak (gpd) D
Maximum Influent Particle Size (in) 1/8
Maximum BOD (mg /L) 220
Maximum TSS (mg /L) 150
Table 3: Maintenance Schedule
Septic Tank Inspect and /or service once every 3 years
Outlet Filter Inspect once a year and clean at least once every 3 years
Soil.Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
The operating condition of the septic tank and outlet filter shall be assessed at least
once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure
proper operation. The filter cartridge should not be removed unless provisions are made to
retain solids in the tank that may slough off the filter when removed from its enclosure. If the
Management Plan for a Septic Tank and Soil Absorption Component
filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of scum and sludge in the tank
exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the
time of an assessment, maintenance personnel shall advise the owner of when the next service
needs to be performed to maintain less than maximum scum and sludge accumulation in the
tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by
an effective locking device to prevent accidental or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank may be difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the
tank is no longer used as a POWTS component.
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least
once every three years. The inspection shall include recording the levels of ponding, if any, in
the observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage
from the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
2
Management Plan for a Septic Tank and Soil Absorption Component
Plantings of deep- rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
V► cu s e n -�- C, vK a v u< t {�U� �. � �, a K I P CO ff ex",.`f S cio 4 'i6 S� Sf
e ProPGr owns S kovf o( c<ni�,c. d - ✓- �fn{ S¢,Lroix
�o ►n ►vl q o yvt �-c� ®��i c � ®7�S � �f fo8"D .
3
S'T• CROIX COUN'T'Y
SEPTIC TANK MAINTENANCE AGREEMENT
AND
nn OWNERSHIP CERTIFICATION FORM
Owner/Buyer 1 1 oVA g n S _X-N t....
Mailing Address - 706 Ou . A0450.v I,v L s
Property Address
(Verification required from Planning Department for new construction)
City /State 57?W &41f lG , LjC: Parcel Identification Number
LEGAL DESCRIPTION
Property Location %, �_ /,, Sec. �3 , T_?LN R (S 9 Town of S RtC
Subdivision _a- 1 0 1 0E FL-4yi r. Lot 11
Certified Survey Map It Volume , Page #
Warranty Deed # � 6 +6 Volume / . Page # 0?0�
Spec house ❑ yes t(no Lot lines identifiable l yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewa(erdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic lank is less than 1/3 full of sludge.
Uwc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the three year expiration date.
SIGNATURE OF APPLICANT
DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledgE. I (we) am (are) die owner(s) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
y t2v /b0
S IGNATUPfJOF APPLICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by (lie Zoning Department. * * * * **
** include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the ceitified survey map if reference is made in the warranty deed
VOL 1.116 FAU 209
STATE I3AR OF WISCONSIN FORM 11 — 1982 6OOEa6r 1
LAND CONTRACT KATHLEEN H. WALSH
Individual and Ctv kEGIS7Ek OF DEEDS
(TO BE USLD FOR All- IRAMAC ifONS MILRE OVER
DOCUMENT NO. 525000 IS FINANCID Atli) IN ONH R NON CONSUMER ST. CROIX CO., WI
ACI IRANSACI IONS)
RECEIVED FOR RECORD
Contract, byand between Da J . Casey and — _ ! 04-05 -1999 9:30 AM
BettYr__ D—_ Ca_se_ y_ ,___husband__and_mi_fe -as ________ _. LAND CONTRACT
__survivorship marital property _ ( "Veodor" EXEMPT N
whether one or more) and R__ _ C Ql.L2vsi_Bsails?er.S.,._Sric —_ CERT COPY FEE:
COPY FEE:
- -- -- -- - - - - -- - -- -- -- -- TRANSFER FEE: 570.00
RECORDING FEE: 12.00
Vendor sells and agrees to convey to Purchaser, upon the prompt and lull performance PAGES: 2
of this contract by Purchaser, the following property, togelhcr with tine rents, profits,
fixtures and uthcr appurtenant interests (all called the "Property "), in __ - - - --
S t . Croix _ County, State of Wisconsin:
THIS SPACE RESERVED FOR RECORDING DATA
O t 8/ 9, 10, 13, 14, 15, 17, NME AND RETURN ADDRESS
18, arid 21 of Prdirie pl ats
Addition in the Town of Star ?�ff w � I - SN
PT St. Croix County 5 39 S. �r�w L>C S �v£'
Wisconsin. w� w R IC HMdw OD
t✓ 1
038 - 1185 -80 -000, 038 - 1185 -90 -000
038 = 1186_- 01 -00 038 = 1186 -30 -000
DE
PARCEL INMICArION NUMBER
038- 1186 -40 -000. 038 - 1186 -50 -000
038- 1186 -70 -000, 038 - 1186 -80 -000
038 - 1186 -90 -000, 038 - 1187 -10 -000
homestead propcity.
(is) (is nn4
Purchaser agrees to purchase the Property and to pay to vendor at 323 Sawmill La ------ New — Richmond , S_7I
the suns of $_19Q_,_QD0___00 _ in the following mannee (a) $ - J.0_, - 000_ -
at the execution of this Contract; and (b) the balance of $__1-80 .0 0 Il,_04_ together with interest front date
hereon un the balance omstauding (rum time to time at the rate of ._._)ii - t percent per anmmn until paid in (till as follows:
Purchase price determined as follows: Lots 8, 9 and 10 $19,900.00 each;
lots 13, 14, 15, 18 and 19 $18,900.00 each; lots 17 and 21 $17,900.00 each.
A Warranty Deed will be given for each of these lots upon paymEnt of the
original purchase price (stated above) of each lot, plus accured interest.
Provided, however, the entire outstanding balance shall be paid in full on or before the 29th day of March, 2001
19_ (the maturity date).
Following any default in payment, interest shall accrue at the rate of 8 % per annum on the entire amount in default (which shall
include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance).
Purchaser, unless excused by Vendor, agrees n, pay nonthly to Vendor anwunts sufficient to pay reasonably anticipated annual taxes, special
assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these
obligations when due. Such amounts received by the Vendor for payment of taxes, ;assessments and insurance will be deposited into an escrow
fund ur trustee account, but shall not bear interest unless otherwise rr•yutied by law,
Payments shell be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid
without premium or fee upon principal at any time after i �.i t Ja — 0 , _— 19 9 0X)AlX'f4'0N)`XIX M'Xp?(c P�5161i14C 15 IY7d +Tk
}ttHfXaXlx t�S Xi l�'VItIlOIOX' X
in the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of
principal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that
said indebtedness Would have been had the monthly payments been made as first specified above; provided Ilion nionlhdy payments shall be
continued in the event of credit of any proceeds of insurance or condeuutation, the condemned premises being thereafter excluded herefront.
Purchaser states that purchaser is satisfied With the title as shown by the title evidence submitted to Purchaser for examination except: -
None.
Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be Iciained by Vendor until
the full purchase price is paid.
Purchaser shall be entitled to take possession of the Property on ____)vMa LcTh 3 19_91_.
• em;, Oaa One
I.INn(O \'llt.lf l - In�lirida.il :inJ f.or �oanae S1AIF. DAN OF 1V"CONSIN Wi ;ca�:�n t eg�,l DmIl, Col, I—
I 1 ono Nu. I I — 19R2 Iddweun,: a, •.V. ;.
THIS INSTRUMENT DRAFTED BY ED FLANUM
ION OWNERS
DANIEL AND BETTY CASEY
323 SAWMILL LANE
D IN PART NI!♦ CORNER NEW RICHMOND. M 54017
SECTION 13
R 1 a n W (2 IRON PIPE FGJNO)
SIN. W
n�o
O N
Q N
h
N UNPLATTED LANDS
S 89'43'27" W 25 82.09'
50.10 354.69 352.64• ]T
4
N ! s
N'nON AREA) 8 s l�q8/ 1 .92 ACRES
03.584 S4 FT. -
1.92 ACRES
b x3.587 50. FT. �i� � f 4M/ z
„w
ir � �O �� r l y ,N• •�� .
.7 \\ o
2.92 ACRES ,� {
83.587 S0. FT. o S90 '00'E -
• 7
r /
N90 • 00'W
8
� t , 7 w � ` / / \�T / . . .. n
ny
10 /15
n I.BG AY
I W 1.92 ACRES `q , I 78.212 S0. FT. 4 '
83
1 .567 50. FT.
1 iA c!/ / I I o W
�I
co I I O 7 90b0'00' E
.t 348.92
r I N Od .� x1'41' � �/ /A. T _
11. 4
269.66 ` f / 1. ACRES _
1 SC. FT.
1 '• 1 1\ f/ S O W
1.92 ACRES 15 \� IL '
I \ 83.583 50. FT. �\ 2
� 2
b
I = I
56.885 S0. FT. o 0
o
N
N; S 90 E, a\ a ! I o
198.04' 12 sO 16 g 0 0
O N 1.81 ACRES ( Z
78.988 SO. FT
•` Fes_
W � o ?, �
W I N , i I
M
N I
- ,o RA
r
r 33'1 33'
N 1 S 89 4 I I s 89'46 c_
n 201.38 DEDICATED TO THC PUBLIC 201.3 /
S90 --
198 04 z_ S 90 E 467.9 _
n
S1'4 CORNER r�nA+►► Af /C+t/►/i,
T
FROM PC COLLOVA BLDR &BROTHERS EXC FAX NO. : 7152943245 Jan. 02 2001 08:01AM P2
w4woun Departn e AkAA, t S . EVALUATION RSPORT
omciarl t rn 85. Wo, Adm. Code
t
�.aactt oomgalae a
do in slag. Fun meat
ar,ww, : (BM). dredian ana Wbr ®I L0.
parcArttSbpo. e� t>rstanoe to nea►e5t road.
cTti � Reviawod try Vale
wesoer Normal ( "�6 ,2')°f tQ r �..... It. 04 ( r) t J) •
Property A A/ — pm" l ocation
j tf Q 1 3Mt tea S lg s j� Im 8 /3 T ` ( H R ( (a10 4.
ptvg4rtyC)wr+erslAe�pngAOdress Lot# BfOCit* a3rr�d.tlalltaeat
CA, C . Phone llutntJer 0 c"Y Vttiage Q Tow PFawvst Roa d
n iif
( Meet Ctbanc ion tJsC Reeiderlladdi i N~ of
do*-, nw now _f Sb 0 G GPC {
OEM Q Puta�tceteantne►aat aatxriao: I #
Paul MGM* C�% ` C S `V, Fl�S Plsirt a watirm r anca mbie
GW."oanmencl cysfew ee v- 031 1
and
rNC +,V4AA S t (i— 13a If wog UfAS crtT2CJC Cc • SO
y SRniht✓js 0 v
t, a.
-- s amity
L sM x � h S' a�. 3W ltmle
Ronson s3" 0"j" Radme 000"M ; Texitrrr' wrtmte Consisartm, eourxWr Roam
1
fr. MOW flu. U Coot Color or. S: SL
65 uc
y
j
cc 3 -0
(0
R
Qk PtS[t Dopth 0 firrfitln9 raetn* Rate
Mangan DepM Dwri t O DOW 86dm 005aOlD7! IWONe SwJcwm O'"aWaroe 8our+dsyY RooOs
in. t rwa 0). ,s''P- Cant. Cclor Gr. Sz. Sh `ow '
So-f Z T S y S tree -i � -f ar 5
r S /1 - �!
S is iasf f=1r ` i n .' c 5 4 Z, Z
I
ERUSQSSi tfit = eclr 38 x� Lana tss X30 s "le (12 - eon,:! 30; tad 1W <_ w not
csr "To (WAMM P0110 �� ttart>or
{ Address Date -vAnil n Cbrn>t,ded irr�pr+aar t
.2 —b ZOo
:d Wtti2:6�i 9 LZ '��i 'ON itFJd
`s 5
FROM PC COLLOVA BLDR &BROTHERS EXC FAX NO. : 7152943245 Jan. 02 2001 08:02AM P3
Prop 0w/>er I I C _V `may.. —.�_. PAW tai0 Prge vi ,
« D Boom q q
e t Gmu+t9wbot:e v.. it Dem to favix, - . so>a
Hcfkw Doaeh ova>, eolor tiaaetc of ott I Ttadlse aatralu►e ow~ 40 ®oundoey $bob
in nturtmae Qu. sr- Cam Cover. or. Sa. SR
Z 10 Cult
WL yvL L --
Bor3g 8 L7 8�owtD
[3 Pit Caraund surfsoGelar. M ae�tt tp 6rnibng 1lletor
Maroon 060 Domirmtcow Terre 9trvaeme 001*0enoe 801andwy f rAft �P
b+. elwlsalt ou. Sa. Cars. Qolbr _ � Gr. Ss. S+►. 'fi '�
�� � �] t3gring
0 Pt C>�aRtdst1t1t1�eleV.�.�lL bnDtht01L'sdlV>gtular n *A*
Haftan 000* greet~Galas t2a wo"Woot Te4m Sbvcrtrre rJOneGiSWAnae fturtdaty 4i0t1A RW
in. fAunsoR Qu. Sz 00K color
w%a tt *1 Mo.). 901220 ffgk bed I= >90 <-150 M.4k ' EdMeerd 900 K 30 tngrL and Tftj 9011811
The Depumom Of Commem is art equal oppoMmity service pnovidwmd omplayer. if need ssseseatrea t0 access aaviees or
need maaarlal to an akernaw fccraay pisses seated the department at 00-2W3151 or Try alt &:64•s m.
sroxxwta orb
£d Wd8Z:60 0092 !-3 ' 'ON XFid I.CkI�
I
a"
!O
FROM PC COLLOVA BLDR &BROTHERS EXC FAX NO. : 7152943245 Jan. 02 2001 08:00AM P1
Q� P AG Vt
NAME to I[ a Q q LOT# D I-E*" D yr$ t N 2 19' E tot
SCALE: t " �C� .•__
8M t tIHSCRfP ICON � . rah ?e p • '�'
13M 2 M y (n 4 1 3
DM Z .DESCRFP' O N *59 A� S 'a Alsliar l�
f
SYSTEM SLEV Kr. joN 472 - cc _
ALTERNATE ELEVATION
CONTOUR ELEVATION
C
e, -v
•$_%
J:
$1
i
2d WUBZ :69 0092 LZ 'ON XUd = WMd
Ma,, �
� �
,� � ✓
I t���_"_
F
II I
h
�
_,