HomeMy WebLinkAbout038-1209-40-000 Wisonsin D4partment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and &Aiding Division
INSPECTION REPORT Sanitary Permit No:
420509 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Mau han, Rex I Star Prairie Township 038 - 1191 -70 -000
CST BM Elev: Insp. BM Elev: BM Description:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark d U d
d
Dosing Alt. BM yiJC� O
Aeration - Bldg. Sewer , C � /
olding Ht Inlet
TANK SETBACK INFORMATION S t Outlet , P�
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic ±LS / Dt Bottom
Dosing Header /Man. �� 3 , 0/
5
Aeration - ~ Dist. Pipe D 9r
olding Bot. System
R.
PUMP /SIPHON INFORMATION Final Grade
M nufacturer Demand St Cover
GPM
Model Number
7 TDH Friction Loss stem Head TDH Ft
- ' Forcemain Length Dia. Dist. to
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 3 S ,/
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM L54C Ne Manufac er:
INFORMATION MB R
Type Of System: �
-5
I i Moe umb
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
pipes) f i
Length Dia / I Length V �� Dia Spacing — f Aq 111
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 0 Yes 0 No [] Yes 0 No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:1,/ Zy Inspection #2:
Location: 1322 212th Ave Star Prairie, WI 54026 (NW 1/4 SW 1/4 13 T31 R1 8W) Northgate Lot 42 �S Parcel No: 13.31.18.987
1� 3.) p�s� ✓vet {t`w. s ivy 2r`d G'�t�„fjrr
1.) Alt BM Description = t�inroP ���
r r
2.) Bldg sewer length= + / or n / �+ YY) �It,.L,S/ ( ' w e , - r e GIGS 1 J —� We- (,�,<ed 4 c� eWt,
-amount of cover= 44 de t Y Q " f 06WV ��"'�C 0.7 - t 1, i
Pe.r p 1 f ✓ 5� Sy S¢ W4 uoujej {ri 'Ke 16� (i'h c L y 44e
Plan revision Required? Yes No
Use other side for additional informati n. Lo Z d
Date Insepctor Sign re Cart No. L
SBD -6710 (R.3/97) S 5 �� , . tk5,�a��� /M, Ve ` \ \ -Sec rW s�oec `a,, "fvl
Ge IkK y 7,ori �If�, 5, b J fps (Net( J a,' J � `J S kee f -
c
Safety and Buildings Division County
s 201 W. Washington Ave., P.O. Box 7162 St Croix
N visconsin Madison, WI 53707 — 7162 Site Address
Department of Commerce 13 2., Z 2 l L7"` Av
Sanitary Permit Application j
Sanita�ryPermitNumber
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ) ` 2, 050_�
may be used for secondary purposes Privacy Law, s1 5.04(1)(m)
❑ Check if Revision
I. Application Information — Please Print All Information n o g State Plan I.D. Number
O �►� rvv m3 8. - /t0 S — fro
Property Owner's Name — ` Parcel Number
Rex Maughan
3� •( 3
Property Owner's Mailing Address Property Location
1416 3 St NW %; SW %; S13; T31 N, R 1 8W
City, State Zip Code Phone Number Lot Number Block Number
Hudson, WI 54016 42
Subdivision Name CSM Number
Northgate
II. Type of Building (check all that apply) ❑ City_
X 1 or 2 Family Dwelling —Number of Bedrooms 4 ❑ Village
❑ Public /Commercial — Describe Use X Town Star Prairie
❑ State Owned Nearest Road
/ Z 214 Ave
III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable)
A. 1 X New 2 ❑Replacement System 3 ❑ Replacement oqExisting 6 ❑ Addition to For County use
System Tank Only Sy stem
B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued
IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use)
44 X Non — Pressurized In- Ground 21 ❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland
22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line
45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other
V. Dispersal/Treat l ent Area Information:
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation System Elevation Final Grade
Required Proposed Rate(Gals. /Days /Sq.Ft.) Rate Elevation
(Min. /Inch) Qy S
600 ✓ 857.1 ✓ 870.8ft2 .7 `_ N/A 95-8" 99.0
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
Septic 12,50! 1250 1 1 Skaw Precast X
VII. Responsibility Statement- I, the under ' ed, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) er's Signa 'e MP /MPRS Number Business Phone Number
Thomas D. Gustum /, 1 / .'14) 227618 715 658 -1344
Plumber's Address (Street, City, State, Zip Code)
N13450 937 St New Auburn, WI 54757
VIII. County/ e artment Use Onl
Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Surcharge Fee)
❑ Owner Given Initial Adverse Z ao
Determination
IX. Conditions of Approval /Reasons for Disapproval n� /
al✓ keSr`de Kce l S ve f fe i c l ej �e r Oe e6t,4 it1, C y Qt "1 �GI.GVa`r
` Owm,,, �el� rv( -Cr #e✓ P✓ AARn k - e. ,uNev5 )/2CUtn+wtiey�or'c iv.S.
Attach complete plans (to the County only) for the system on paper not less than 8112 x It inches in size
SBD -6398 (R. 05101)
10/24/2002 10:07 17156581344 TOM GUSTUM PAGE 05
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plot Map
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Page 4 of 4
Chambers Page 1 of 4
Cover Page
Project Name: Maughan 600 GPD Conventional
Owner's Name Rex Maughan
Owners Address 1416 3rd St
Hudson, WI 54016
715- 505 -4991
Legal Description Nw '/4, Sw '/< Sec 13 T 31 N, R 18 W
Township Star Prairie
County Saint Croix
Subdivision NorthGate
Lot# 42
ParcelID# 038 - 1055 -20
Table of Contents
pg_
1 Cover page
2 Calculations and Drawings
3 Management and Contingency Plan
4 Plot Map
total # of pages: 4
Designer Name: Thomas Gustum
License #: 227618
Date: 10/24/2002
Ph. #: 715 - 658 -1
Li
Signature:
Design Methods Used
"IN- GROUND SOIL ABSORPTION COMPONENT MANUAL FOR PRIVATE ONSITE WASTEWATER TREATMENT SYSTEMS" (Version 1.0) SBD- 10705 -P (R.6t99)
Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715- 643 -6068 email: 3ba@3badvisement.com
Chambers Page 2 of 4
Calculations and Drawings
Site Conditions Infiltration Elevations
Site Type: Private V Trench #1 Trench #2 Trench #3
%Slope 3 % Contour Elev: El 0.00 0.00 Ft
# of Bedrooms '4 Infiltration Elev: 0.00 0.00 Ft
Depth to limiting factor 84 in Limiting Factor Elev: 92.00 N/A N/A
Soil Application Rate: 0.7 gal /ftA2 /day Treatment and Dispersal Zone: 3.00 N/A N/A
Effluent Quality Eff # VV Cover Material Required: 0 N/A N/A In
Design Flow: 600 gal /day Finished Grade Over Cell: 99.00 N/A N/A
Max BOD 220 mg /I
Max TSS 150 mg /l
Distribution Cell Septic Tank
Choose chamber type: Septic Tank Manufacturer: Skaw Precast
Infiltrator Standard Septic Volume Chosen: 1250
Laying Length: 6.22 Ft Effluent Filter Selected: Simtech 110
EISA Determined Area: 3 1. 1 Ft2 Note: Access opening of sufficient size to be provided to allow removal of filter.
Open Bottom Area: 15.50 Ft2 Opening to terminate at or above grade.
Chamber Height: 12 Inches
Required Infiltrative Area: 7.1
Total # of Chambers: 1 7b
Total Cell Length: 174.2 Ft Cross Section of Septic Tank
Cross Section of Cell 12" Min NGrde
Cover Material Observation Pipe Syst (if required) - Final Grade 18" Min
Ground All joints to
Contour be water tight D3034 or
Leaching Effluent Sch40
Chamber Filter Pipe
Elevation
3" Bedding Under Tank
Plan View of Typical Cell
Length
O a
Dbyervatial Width
A51"M 'SO5�f �b�ervatlon
or 5ch 1O .1„ pipe Pipe
PVC Pipe
,- r
Page 3 of 4
In- Ground System Management Plan pursuant to comm 83.54 W. A. C.
Owner's Responsibility:
The component owner is responsible for the operation and maintenance of the component. The
county, department or POWTS service contractor may make periodic inspections of the
components, checking for surface discharge, treated effluent levels, etc. The owner or owner's
agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or
the department.
Septic Tank:
Septic tank(s) are to be inspected routinely and maintained by department approved individuals
when necessary in accordance with their approvals. The use of chemical /biological "treatments"
is not required or recommended. If such additives are used, make sure they are approved by
Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned
as necessary, with provisions to keep solids from passing the septic during removal. No more
than 113 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank
has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in
accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the
inspector does not recommend pumping of the septic tank, then the owner must be notified of
when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be
routinely inspected to be watertight and of good repair.
Absorbtion Cell
The absorbtion component must remain free of ponded surface water prior to pump operation. If
4 inches or more water level is detected in the observation pipes, the owner must be notified of
possible problems /failure. The designed daily flow capabilities of the component should never be
exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to
grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive
walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion
capabilities and /or possibly cause it to freeze in winter conditions.
Performance Monitoring:
Performance monitoring must be done at least once every three years following the installation or
at the time of a problem, complaint, or failure.
Contingency Plan:
If the septic tank or other components therein (including floats, alarms, etc) become defective,
the defective tank or component must be replaced immediately to ensure that the system can
operate as designed. If the absorbtion component cannot accept wastewater or ponds
wastewater to the surface, the component must be repaired or replaced in it's current location by
removing the clogged bacterial mat, aggregate /leaching chamber cell, and distribution piping
within the cell and replacing failing components in order to return system to proper working order
as required. If repair is not feasible, a new system is to be constructed in a designated
replacement area
Plot Map
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Page 4 of 4
Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor Anc6Human Relations
0)0;Wtwsafety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
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 % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 038- 1055 -20
APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION R ',VIEW`f DBY DATE
T&-,8. ry
PROPERTY OWNER: PROPERTY LOCATION
Greenwood Enterprises, Inc. GOVT. LOT NW 1/4 SW 1 /4,S 13 T 31 N,R 18 fic(or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # I SUBD. NAME OR CSM #
1416 Third St. 42 na I NorthGate
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE :EJfOWN NEAREST ROAD
Hudson, WI. 54016 h15) 386 - 3674
[]] New Construction Use b J Residential / Number of bedrooms 4 [ ] Addition to existing building
I I Replacement [ ] Public or commercial describe
Code derived daily flow 600 g pd Recommended design loading rate • 7 bed, gpd /ft .8 trench, gpd /ft
Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate .7 bed, gpd /ft trench, gpd /ft
Recommended infiltration surface elevation(s) orig.= 95.9 alt . =94.7 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material outwash Flood plain elevation, if applicable na It
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U =Unsuitable fors stem ®S ❑ U ] S ❑ U ®S ❑ U ®S 11 U ®S El El C U
SOIL DESCRIPTION REPORT
��Y
Boring # Horizon
Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends (o-t��
1
1 0 -8 1 1 2msb s �
�`�"-�-�"' �� 2 8 -22 10 r 4/4 none sicl lcsbk
Ground 3 2_g I ,
elev.
9
Depth to
limiting
factor
+84
q 4
Remarks:
Boring #
1 — if .5 .6 �S
2 12 -26 10 r 4/4 none sicl lcsbk mfr qw if .2 .3
Ground
6 -84 7.5 r4 6 none cos os ml na na .7 .8
elev. , 1
9 9.9 ft.
Depth to
limiting
factor
+ 8� I -� Nov r
`� L-
Remarks: �,,. '.` COUNTY
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 - 6200`
Address: 1554 200th. Ave. New Richmond WI 54017
Signature: Date: CST Number: m02298
11 -4 -98
PROPERTY OWNER Greenwood Enterprise SOIL DESCRIPTION REPORT Page _,2. 3_
PARCEL I.D. # 038 - 1055 -20 14 '
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourclary Roots GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITw&
1 0 -10
2 10 -26 10 r 4/4 none sicl lcsbk mfr Qw if .2 .3
. Ground ..
3 26 - 7.5yr4/6 none Cos OSQ M1 na na .7 .8
elev.
g8- . -70ft. *24X - ront--iguning It- Ls 14-
Depth to i
limiting
factor
+84
Remarks:
Boring #
1 0 -8 10Y 4/3 none sl 2msbk mfr 9w if .5 .6 '
2 8 -20 10 r 4/4 none sl 2m r mvfr Qfw if .5 .6 5
Ground 3 1 20-30 10 r 5/4 c2d7.5 r 5/6 sil lcsbk mfr Qw na .2 .3
elev. 4 30 -84 7.5 r 4/4 none cos os a ml na na . 7 ! .8
98.0 ft. —
Depth to -
limiting a � qsv 3(f
factor �Z
+84
Remarks:
Boring #
1 0 -10 10 r 3 3 none 1 2msbk mfr qw if .5 .6
2 10 -31 10 r 4/4 none sicl lcsbk mfr 9w if .2 .3 'Z
Ground
31-38 1 r 5/4 2d7.5 r 5/6 sil lcsbk mfi na .2 .3 Z
elev.
gR_ ft. 4 38 -84 7.5 r 4/6 none cos OSQ ml na na .7 .8
Depth to
limiting Q -
factor
+84"
Remarks:
Boring #
13
Ground
elev.
ft.
i
Depth to
limiting
factor
Remarks:
SBD- 8330(8.05/92)
r
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 Greenwood Enterprises, Inc. New Richmond, WI 54017
MPRSW -3254 NW4SW4 s13- T31N -R18W (715) 246 -6200
town of Star Prarie
lot #42- NorthGate
This soil evaluation was conducted to satisfy a zoning requirement, it may or may
not be suitable for your use. The location of the test may or may not be as shown
as permanent lot lines were not established at the time the test was conducted.
N
1 =40'
BM.= top of 1 pvc p ipe C el. 100'
Alt. BM.= top of 1" pvc pipe @ el. 100.10
-7-
1�
t
Gary L. steel
11 -4 -98
s
=mom
r ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer �-
Mailing Address �J`F - �o w t�
� �t7� A 1 3Q nv�a ; S
Proper Address l �k�� t
P rtY
(verification required from Planning Department for new construction)
City /State ! kc, c 4-6, , C e-- Parcel Identification Number L- -o+ y
LEGAL DESCRIPTION
Property Location N tiS %4, W V4, Sec. l3 . T3A N- R-._W, Town of n k.-v
Subdivision N b{'AN :s; -� -- . Lot # �. .
Certified Survey Map # . Volume . Page #
Warranty Deed # Volume . Page #
Spec house l& yes ❑ no Lot lines identifiable 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
mastorplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the three year expiration dfte.
2 d - M 2�1-� 0 / /
SiGNATbRE OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
/ l / o2
SIGNATURE OF APPLICANV DATE
Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
«« Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
I
U 1962P 452
STATE BAR OF WISCONSIN FORM I- 1998 6 8 6 6 1 3
WARRANTY DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
Document Number ST. CROIX CO., MI
RECEIVED FOR RECORD
This Deed, made between Greenw Enterprises. Inc , a ._ 08 -29 -2002 8:55 AN
t li5r'QTLi IlIICorpara inn - _ ..—
WARRANTY DEED
— — - - -- -- EXEMPT #
Grantor,
and �� P9a�9Ia_n_�/12f1RQr - - - -- -- _ —.— TRANS FEE: 88.00
TRA FEE: 88.50
- -- — — — COPY FEE:
- - -�— -- CERT COPY FEE:
Grantee. PAGES: 1
Grantor, for a valuable consideration, conveys to Grantee the following
'. described real estate in _ St. Croi x County, State of Wisconsin
(the "Property'):
Name and Return Addre s L
Lot 42 of the Plat of NorthGate II, recorded in the Rex A. u han
Office of the Register of Deeds for St. Croix County, N117 130th Street�
Wisconsin, on June 20, 2001, in Volume 8 of Plats, ing WI 54734 yam w gy r i l
at Page 55, as Document Number 648882.
nzu Parcel Identification Identification Number (PIN)
This Is Not homestead property.
(is) (is not)
/ OJ
Together with all appurtenant rights, title and interests.
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
easements, restrictions, and reservations, if any, of record.
Dated this — �� day of 2002
-- . D I INC
(SEAL) (SEAL)
James
(SEAL) '' y�r�� (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) State of Wisconsin,
ss.
fit. Qrni x County.
authenticated this day of Personally came before me this r day of
200 . the above named
TITLE: MEMBER STATE BAR OF WISCONSIN tO
Qf not. me known to be the person Sed Ith�oregoing
authorized by §706.06, Wis. Slats.) g instrument and acknowledge' tthhhe s�am p
JAS Li , ,`�E.. Z r C
THIS INSTRUMENT WAS DRAFTED BY ..
Mai* - R-. Rusch __ Sandra Cehrkn - ...
Notary Public, State of Wisconsin
New R1C hmond. WI 54017 My cd on is �perr / paanent. / (If/not state expiration date:
(Signatures may be authenticated or acknowledged. Both are not
necessary.)
' Names of persons signing In any capacity must he typed or printed Wow their signawre.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
WARRANTY DEED FORM No. I - 1998 Milwaukee, Wls.
W
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N 34
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99.0 - N ST R UCT URES AL O WED IN EAS 67.00' 18
133.00'
243.00' 200.00 1 20C
� �1� , 999.0 - NO STRUCTURES ALLOW IN EASEMENT U
2.80' 230.20' W
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14 S 89 11 00
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12
DTH ` COUNTRY MEADOWS
\ VOL. 6 OF PLATS,
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U 2 0 2 1 P 1 8 9 695449
REGI TE OF DEEDS
ST. CROIx CO.. VI
Document Number Document Title RECEIVED FOR RECORD
St. Croix County 10 -24 -2002 9:45 AM
AFFIDAVIT
Occupancy Affidavit EXEMPT #
REC FEE:
TRANS FEE: 11.00
COPY FEE: 2.00
CERT COPY FEE:
ame — (Owner) Type or printed PAGES 1
being duly sworn , states, under oath, that:
1. He/she is the owner /part owner of the following parcel of land located in St.
Croix County, Wisconsin, recorded in Volume Page Document
Number St. Croix County Register of Deeds Office: Recording Area
r
A parcel of land located in the OV of the S V. of Section 13 e and R Address
T 3 1 N — R —� W, Town of .Sfa,i Ar ai f , St. Croix - 4/" 3 (5 h
County, Wisconsin, being duly described as follows (include lot no. and 1.c� 3
subdivision/CSM or detailed legal description):
AJa r+ii7 t c o? La f V-7 e j 2 - j - 76 - CZr6
Parcel Identification Number (PIN)
As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a
q bedroom home, or a design flow of 600 gpd. The design flow is calculated by assuming 150 gpd for 2
individuals per bedroom. _ occupants are permitted
based on the design flow. Therefore the septic system serving this residence is code compliant. However, I
understand that if there are intentions to exceed the number of permitted occupants, the system will need to be
modified to accomodate any increased wastewater flows and/or contaminant loads. I also acknowledge that I will make
this information available to any future parties interested in purchasing this property.
Dated this _0? q_ day of OC /0 f oZOaa .
AUTHENTICATION
Signature(s) STA
- )SS.
authenttcated this day of St. Croix County. )
P�rsooally came before me this day of
0900 / the above named
it -
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not to me known to be the persons) who
authorized by § 706.06, Wis. Slats.) instrument and acknowledge the sam .
THIS INSTRUMENT WAS DRAFTED BY in Z
PL77LI
* W Es c
Notary Public, State of Wisconsin
(Signatures may be authenticated or acknowledged. Both are not My Commiss on i pe. rtna�ent. If not, state expiration date:
necessary.) Date: 0
"THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE"
This Information must be completed by submilter dpwff nt title. name b rstum address. and EM (if required). ottler information such as the
granting dauses, leapal description, etc. may be placed on this first page of the document or may be placed on additional pages of the
document. h&W Use of this cover page adds one page to your document and 52.00 to the recordina lee. Wisconsin Statutes, 59.517.
09/27/2002 13:39 17156581344 TOM GUSTUM PAGE 01
GUSTUM SEPTIC SERVICE
September 27, 2002
Hi there:
Attached is the revised pages for our 4 bedroom conventional system application for Rex
Maughan. If you have any additional questions, please call.
Sincerely,
Brian Japutl><tich
Gustuln Septic Service
N13450 937 1-11 ST • NENV AUBURN. WI • 54757
PHONE: 715 - 458.1344 • FAX: 715.6+58,1344
09/27/2002 13:39 17156581344 TOM GUSTUM PAGE 02
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Calculations and Drawings
Site Conditions Infiltration Elevations
Site Type: Rfrate I V Trench #t1 Trench 92 Trench 93
%slope A% Contour Elev: 98.85 0.00 0.00 Ft
# of Bedrooms 4 Infiltration Elev: E 96.50 0.00 010 Ft
Depth to limiting f 80 In limiting Factor Elev: 92.18 N/A N/A
Soil Application Rate: 0.7 al/ft"2/day Treatment and Dispersal Zone: 4.32 N/A N/A
Effluent Quality ER #1 • Cover Material Required: 0 N/A N/A In
Design Flow. 600 gal /day Finished Grade Over Cell: 98.85 N/A N/A
Max BOD 220 mg/l
Max TSS 150 mg/I
Distribution Cell Septic Tank
Choose chamber
ape Septic Tank Manufacturer: Skaw Precast
Ir www standard w Septic volume Chosen: 1250
Laying Length: 6.22 Ft Effluent k=ilter Seed; Simtech 110
E I SA Determined Area: 31.1 Ft2 NOW: Access opening or a dent aft ti be wo~ tc allow nomad of filter.
Open Bottom Anna: 15.50 Ft2 opening to terminate at or avow grade.
Chamber Height: 12 Inches
Required Infiltrative Area: 857.1 F12
TOW # of Chambers: 28
Total Cell Length: 174 Ft Cross Section of Septic Tank
Cross Section of Cell 12° Min ode
Cover Merto Observation Pipe Min
(if required)
_ _ - - Final Grade
Ground All joints to
Contour be water fight D3034 or
L Eltluent Sch40
Leeching Stem Filter Pipe
Chamber Elfevadon
3" Bedding Under Tank
Plan View of Typical Cell
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a Set 10 ,111 pipe Pipe
PVC Pipe
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Plot Map
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