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Parcel #: 038 - 1182 -70 -000 10/16/2007 04:51 PM
PAGE 1 OF 1
Alt. Parcel #: 20.31.18.917 038 - TOWN OF STAR PRAIRIE
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
O = Current Owner
Tax Address: Owner(s): , C = Current Co -Owner
O - MINOR, RICHARD
RICHARD MINOR
PO BOX 106
SOMERSET WI 54025
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description ' 2025 CTY RD C
SC 5432 SOMERSET
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: 06- 074 - COUNTRY LIVING FIRST ADDN 038 -96
SEC 20 T31 RI 8W PT SW SE LOT 7 COUNTRY Block/Condo Bldg: LOT 07
LIVING FIRST ADDITION 5 AC
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
20-31N-18W
Notes: Parcel History:
Date Doc # Vol /Page Type
09/05/2003 738908 2401/147 WD
04/06/1998 576500 1312/162 WD
2007 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/13/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 5.000 47,000 115,300 162,300 NO
Totals for 2007:
General Property 5.000 47,000 115,300 162,300
Woodland 0.000 0 0
Totals for 2006:
General Property 5.000 47,000 115,300 162,300
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
Pop ,n7inepartment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
,ety and Building Division
INSPECTION REPORT sanitary Permit No:
430363 0
GENERAL INFORMATION (AVAC1 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:
Minor, Richard I Star Prairie Township 038 - 1182 -70 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No
Q X31.18.917
TANK INFORMATION ELEVATION bATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 8�
. (J
Dosing Alt. BM
Aeration Bldg. Sewer ,
Holding
St/Ht Inlet as,
St/Ht Outlet • I �,
TANK SETBA ATION !�
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic \ ` _ V016/ Dt Bottom
Dosing Header /Man.
Aeration Die Q
r a 6 - ' 1 " 7 -
/
Holding Bot. System �J
PUMP /SIPHON INFORMATION Final Grade •� / • 2
Manufacturer Demand St Cover ! Q ST
GPM ,�yN
Model Number
TDH Lif Friction Loss Sy d TDH Ft
Forcemain Length Dist. to Well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Insi a Dia. Liquid Depth
DIMENSIONS l
SETBACK SYSTEM TO l P/L BLDG WELL LAKE /STREAM LEACHI Manufacturer:
INFORMATION CHAMBER
Type Of System: , , / UNIT
(Af N um er.
DISTRIBUTION SYS M
Header /Manifold Distr1 trbn x Hole Size �ole Spacing Vent to Air Intake
4 1 Pipe(
Length t� Di Lengtfi Dia Sp
SOIL COVER x Pressure Systems Only nd 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 Yes No I ] Yes I No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:J_ /;� /4-3 Inspection #2: / /____
Location: 2025 County Road C New Richmond, WI 540 (SW 1/4 SE 1/4 30 T31 RI 8W) CounfryLiving I Lot 7 Parcel No: 30.31.18.917
1.) Alt BM Description =4• LOWY Qrp( CINAIW — , jr � d
2.) Bldg sewer length = 40 1,3, r 1 � /�` ' R 'Z (i(�C
N* 1
- amount of cover = n LAI%
Plan revision Required? j Yes No /
Use other side for additional informati
SBD -6710 (R.3/97)
Date Ins. c is Signature - -- Cert. No.
t
` Sa and uildings Division County
�. ,� 201 W, Washington Ave., P,O• Box 7082 S' T G'r
iseonsirn Ma d ison, WI ani Permit Number ( to be filled in by Co,)
Department Of Commerce (605 26 6546 RECEIVE 1 /3o3(.. - 3
Sanitary Permit Appli State 1•n. Number ]
In accord with Comm s3.2 1 Wis• Adm. Code, personal information ou pro 1 2 i 2 0
may be used for sarandary purposes Privacy Law, sl S,Oa(1) ) mjeet ddress (i ifferent than mailing address)
I. Application Information — Please Print All Informatlo Y 2-0 S
ZONING OFFIC C�. C
PropeRy Owner's Name Parent # Lot # n Block q
�(r, lra• -� �'I ' 2
Property Owner's Mailing Address p J O
J d� Property Location
City, State Zip Code Phone Number S �• F %, Seeli ? r f
-S o �rJ eT .S'y o Zj (cirel one)
II. Type of Building (check all that apply) T_r! Ni R�E o
1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number
❑ PubUclCommencial- Describe Use /
C1 State Owned- Describe Use QX�n ❑Villag- OTb"hlp of �+ I j ,,
III. Type of I'erIbit: (Check only one box on line A. Complete line B If applicable)
A' ew S ate
�Y a, ❑ Replacement System ❑ TreatmendHolding Tank Replacement Only ❑ Other Modification to Existing System
B • ❑ Permit Renewal ❑ Permit Revision ❑Chan Be of List Previous Permit Number and Date Issued
Before Expiration Plumber ❑ Permit Transfer to New
Plumber Owner
Iv. Type ofPOWTS S atom: Check all that a 1
)zNon — Pressurizrd In- Ground ❑ Moturd> 24 in. of suitable soil ❑ Mound <2a In. ofsuitable soil ❑ At -Grade
❑ Single Pass Sand Filter ❑
Constructed Wetland O Pressurized ht- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter hing Chamber ❑ Drip Line ❑ Gravcl -less Pipe Other (explain)
V. D a' ersaVrreatment Ares I orrnatlon: ,
Design Flow (gpd) Design Soil Application Rate(gpdsQ Dispersal Anew Required (sf)/ Dispersal Area Proposed (at) System Elevation
V. 2 !�`� Y
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber
Gallons Gallons of Unity
Now 1.txicting Plastic
Concrete Constructed Glass
Taoke Tanks Hollins Tank
Aerobic Trcatroent llnit
Dosing Chamber
VII. Resp onsibility St
Moment I, the undersigned, assume responsibility for installatlon of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature /MPRS Number Business Phone Number
A'1.'.,4 -- C i�e.. Gr/, "441 1 t; �✓. _ rG 7/ 1' = Z 6 �-,� �i L
Plumber's Address (Street, City, State, Zip Code)
f'• a . Q Z 3 �. ��..�:- [-ti.J S — �, � CL (,dT Grp
VIII oun /De artment Use Onl
Approved ❑ Disapproved Sanitary permit Fee (includes Groundwater Dat Issue sluing Agga Signature ps)
C1 Owner Fee) 60 Owner Given Reason for Denial 2 r
I}L Conditions of Approval/Reasons for Disapproval �` �
S STEM
1 Septic tank, effluent filter and '
dispersal cell must all be serviced / maintained
as per management plan provided by plumber. � _ 'U "
2. All setback requirements must a main a1
as per applicable code /ordinances. Y `
Attach eompiale pleas (to the Cmmly only) for the system op paper not leas Than 81/1 x ii Inches In size
SBD -6398 (R. 08/02)
Plot Plan
Project Name
' Address P 0 . D
Lot 7 _ B Subdivision Country Livin Date 9/,i / 6? -:3
SW 1 /4 SE y /4S 20 T 31 N /R W Township Star Prairie
Boring PL Property Line County S T. CROIX
BM or VRP Assume Elevation 100 ft. Top of Property Line Marker
System Elevation 96.4 � H R p Sa me as Benchmark
County Road C
l ot
15 -7 587'
Property
Q Line
t4 2-- 2g /v`�� w1
a 1% B -1
lope
B- 80' 15
40'
15'
1s ,
S 6 " 30' 75 ,
Rep A. B -4
c 4
6 S'' B -5 80
575'
Property
Lane
372' Property Line
Plot Plan
Project Name ��,��G� /' Gu•,
' Address �, o �,._
Dp !0
Scrk• -ems rc7"
V.0 Z S
Lot 7B Subdivision Country Livin Date
SW 1/4SE 1 /4520 T 31 N /R18 W Township Star Prairie
Boring PL Property Line County S T. CROIX
BM or VRP Assume Elevation 100 ft. Top of Property Line Marker
System Elevation 96.4 �HRpSame as Benchmark
County Road C
bl
a v, l..
o ` 587'
Property
Line
2 9
1% B -1
0 lope
B- 80' 15'
40
St- Y , 30' �'' 15'
Rep A . B -4 75'
�-Tv., e 4
6S" B -5 80'
575'
Property
Line
372' Property Line
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MADE KI USA
A1011m12
2-z s�1r�r
� r,,, FlOtradon 7�76�
- The original Zabel Filter for waste flows from 3,000gpd to 4,500gpd.
- Disc dam design is proven to reduce TSS and BOD in residential
and commercial waste flows.
- All A100 -12 filters come ready to accept the Zabel SmartFilter on an ' •
a
Alarm. ;n r� one'
- Easy to install either in the tank or outside the tank in a Zabel rj tat O v er �0p
Basin Assembly. _
- Extension handle included with every filter.
Commercial
Filter
Package
' i A100�- 12x16 -FP A100 -ADA
Reducers are included with all A100 -12x16 0. A100 1200's they are optional
on A100 12x16 Filters
A= 1/2" Tee (SLIPxSLIPxSLIP)
Handle Parts Included
B =12" Female Adapter (MIPTx SLIP) 'a"' C
Certified to C =1/2" Schedule 40 pipe too
ANSUNSF Al
Standard 46
WASTEWATER FILTERS & ACCESSORIES 1--
• LIST -
PART N DESCRIPTION
t/!2 00Cartridg
A100 -12x16 12" x 16" Case and Cartridge 169.95 133.00 108.00 102.00 98.00
A100 -12x30 12" x 30" Case and Cartrid a 208.95 174.00 1 158.001 148.00
A101 -12x16 Cartridges 12" 54.00
x 16" Replacement Cartridge 97.95 81.00
A101 -12x30 12" x 30" Replacement Cartridge 137.95 115.00 1 104.00
Commercial Filter Package A100- 12x16 -FP A100 -12x16 and 26" Basin Assembly 293.95 191.00
ACCESS FM
A100 /300 - RHEK -SF SmartFilter Retrofit Handle Extension Kit 7.45 4.75 4.50 4.40 4.30
A100 /300 -RHEK Retrofit Handle Extension Kit 7.45. 4.75 4.50 4.40 .4.30
A100 /300ADA Extension Apapter 29.95 19.00 18.00 17.00 16.00
FC100 Flow Control /Maintenance Plate 9.95 9.00 8.00 7.00 6.00
SmartFilter Alarm
All Zabel Filters are SmartFilter ready. Add $75.00 to the rice of any filter or filter packag to add the SmartFilter Alarm.
10
Wisconsin Department of Industry SOIL AND SITE EVALUATION
Labor and Human Relations Page of
Divisionof Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in'size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Parcel I.D. �„'
Q
3 0
APPLICANT INFORMATION - Please print all information, iewe ,kt
Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)).
Property Owner Property Locatio
Govt. Lot 1/4 f S o90 T 3/ ,N,R E ( r) W
Property Owner's Mailing Address Lot # Block# Suu Na
A?v4f __
City State Zip Code Phone Number _ ` 8r A( d - a
El city ❑Village � T wn "``q -� e-W..
New Construction Use: 1 54Re sidential / Number of bedrooms Z r Addition to existing building
❑ Replacement ublic or commercial Describe:
Code derived daily flow gpd Recommended design loading rate bed, gpd/ft �� trench, gpd /ft
Absorption area required bed, ft J trench, ft Maximu oading rate _ bed, gpd/ft trench, gpd /ft
Recommended infiltration surface elevation(s) � i tv 9.W. ft (as referred to site plan benchmark)
Additional design /site considerations
Parent material Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In Grou d Pressure AT -Grade System in Fill Holding Ta
U = Unsuitable for system ❑ U ❑ U ❑ U XS ❑ U ❑ S U F] S ZIP
SOIL DESCRIPTION REPORT
Boren # Horizon Depth Dominant Color Mottles Structure GPD /ft
Boring Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ed ,Trench
o -h
Ground
O�el v.
Yr i
Depth to I `�
limiting
f to
l � in.
o� Remarks:
Boring #
Ground
v 1
�epth�to
limiting
�� f r
n. Remarks:
CST Name Please Print) Signature Telephone No.
J
Address /, Date / CST Number
f
g' Ns y D E SCR IPTION REPORT Pag of
PROPERTY OWNER L � � � O � j
9
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Structure 2
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed ,Trench
��� � / .moo? S —•-{' ��
.:. :.. ,........... l�� ry � '�
Ground 3 Q. ,/
m ft.
Depth to
limiting
fa r ,
Remarks:
Boring #
0- /2 ✓ S �.S`
Ground
el v
Depth to
limiting
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # 6 7- 12 /'
Ground
Depth to
limiting
/ma
��- Remarks:
Boring #
...........................
..........................
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBDW -8330 (R. 08/95)
1
Soil Test Plot Plan
Project Name Charles Bor strom
9 Byron Bird Jr.
Address
2033 Co. Rd C
Somerset Wi 54025 CSTK4 #3479
Lot 7B Subdivision Country Livin Date 9/ 25/96
SW 1 /4SE 1/4S20 T 31 N /R W Township Star Prairie
[] Boring ()Well PL Property Line County ST. C ROIX
IL BM or VRP Assume Elevation 100 ft. Top of Property Line Marker
System Elevation 96.4 * H R P Same as Benchmark
County Road C
587'
Property
Line
1% B -1
lope
B -2 80' 15'
Pri A B- 40'
15'
15 '
30' Rep A . B -4 75'
80'
B -5
575'
Property
Line
372' Property Line
SB_CredentialDetail Page 1 of 1
WI COMSIM 0P140 t>0wx1n sl map tir s ltxkx wa T s
About Commerce Ousiness Comma reify International Petroleum Prog Corns So1ety& $t4kfirVs Ernplo M
Customer Details
Name MICHAEL E WILSON
= Contact o CLAYTON,WI 54004
Specific contact information is not available for this customer.
Credentials listed for WILSON, MICHAEL E
Black=Approved Yellow In Renewal Process Re =Ex fired or Not Val id
Credential CE Hours CE Needed
Type Exptration Needed By
Master Plumber 03/31/04 12/31/03
Refrigerant Handling Technician 05/12/04 u 02/11/04
7 —
http: // apps. commerce. state. wt. us/ SB_ CredenttaUSB _CredenttalLtst.cust td- 225150 9/23/2003
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S f CROIX COUNTY
SEPTIC T, %NK MAINTENANCE AGREEMENT
a AND
OWNERSHIP CE RTIFICATION FORM
Owner/Buyer.. )(/dni�
Mailing Address
--
Property Address VYX 0,7iJ, L _ .
(Verification rid4uircd from Planning Department iot new construction)
City /State LS 8 L. U)T_ Parccl Identific:i! Number O
LEGAL DESCRIPTION
Property Location JW ' /,, ' /,, Scc., T N -R_Vd, Town of
Subdivision � �, / !o /i"D P . , Lot #
Certified Survey Map it U _, Vol nnc , Pagc P _
Warranty Deed # "-) �3 5r G9 , Volume cQ ( 4 0 , Page # 19
Spec house ❑ yes OR no Lot lines identifiable 9 yes ❑ no
SYSTEM MAINTENANCE
Improperuse and mainienanceof yourscptic 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 imo 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 ( ner and by a
master plumber, journeyman plumber, restricted plumher or a licensed pumper verifying that(]) the on -site wastewaterdi.posal system
is in proper oper;iting condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, 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 Commetcc 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
d e ear expiration date.
ne / g9/ a3
OF APPLI CA 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) ti,e owner(s) of
the pr y rib d above, by virtue of a warranty deed recorded in Register of Deeds Office.
GNATURE OF APPLICANT DA "1 i3
•.'••• 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 G„m the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
PLEASE RETURN COMPLETED FORM TO:
i
SEPTIC TANK MAINTENANCE AGREEMENT
OWNER /BUYER / (.Lr L .L[�1 �l /� DATE /A:_-
A :_ �.
ADDRESS P o /0 G" s o i e' �T L✓� S —
SEE TAX RECEIPT to complete the legal description below:
Re: Property located in the � 1/4 1/4, Section AD , T_,31_N, R_W,
Towrr ,%r PrQ iri 2 , Lot, Subdivision/ Plat
Improper use and maintenance of your septic system could result in its
premature failure to handle wastes. Proper use and maintenance should
extend the life of the system considerably. Proper maintenance consists of
pumping out the septic tank every 2 -3 years or as needed by a licensed
septic tank pumper. What you put into the system can affect the function
of the septic tank as a treatment stage in the waste disposal system..
Avoid allowing the following substances to enter your sanitary system.
1. Clear water from sump pumps 7. Grease
2. Chemicals - lye, acids, etc... 8. Disposable diapers
3. Paper other than toilet tissue 9. Cigarette butts
4. Sanitary napkins /tampons 10. Fabrics
5. Garbage from grinders 11. Garbage
6. Septic tank cleaners 12. Drain oil
1 ('i?X County residents may be eligible to receive some cost share funding
for the replacement of failing systems whereby such systems were in
operation prior to July 1, 1978. In providing any cost sharing, the state
requires that owners of all new systems agree to keep their systems
properly maintained. Naturally, the proper maintenance is beneficial to
you and the general public.
The property owner agrees to submit to the county a certification form (to
be provided by the county) every 3 years -- signed by the owner and by a
master plumber, journeyman plumber, restricted plumber, or a licensed
septage hauler. The form shall require certification of the following.
a. That the on -site wastewater disposal system is in proper operating
condition.
b. That after inspection and after pumping (if necessary), the septic
tank is less than 1/3 full of sludge and scum.
I, the undersigned, have read the above requirements and I agree to
maintain the private sewage disposal system in accordance with the
standards set forth, herein, as set by the Department of Industry, Labor
and Human Relations.
SIGNED DATE
6
• POWTS OWNER'S ,MANUAL & MANAGEMENT PLAN Page of Z
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner -A" Septic Tank Capacity /0 g a l ❑ NA
Permit # v 3 3 Septic Tank Manufacturer �� �,,� C1 NA
DESIGN PARAMETERS
Effluent Filter Manufacturer Z 13 NA
Number of Bedrooms ❑ NA Effluent Filter Model 4 _ /p E3 NA
Number of Public Facility Units ;"A Pump Tank Capacity al NA
Estimated flow (average) _V'&V gal/day Pump Tank Manufacturer WA
Design flow (peak), (Estimated x 1.5) s al /d Pump Manufacturer $NA
Soil Application Rate al /da /W Pump Model fa. NA
Standard Influent /Effluent Quality Monthly average" Pretreatment Unit A
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration [7 Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other;
Pretreated Effluent Quality Monthly average Dispersal Cell(s) O NA
Biochemical Oxygen Demand (BOD 530 mg /L An- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y. in dia. ❑ NA
Other: ❑ NA
Other: ❑ NA Other: 17 NA
"values typical for domestic wastewater and septic tank effluent. Other. ❑ NA
MAINTENANCE S
Service Event Service Frequency
th(s) ( Maximum 3 years) ❑ NA
Inspect condition of tank 13 mon
s) At least once every: ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
O month(s) (Maximum 3 years) 13 NA
Inspect dispersal call(s) At least once every: }7:year(s)
❑ month(s) O NA
Clean effluent filter At least once every: - 3 J2:year(s)
0 month(s) CIA
Inspect pump, pump controls & alarm At least once every: ❑ year(s)
❑ month(s) '•W-f4 A
Flush laterals and pressure test At least once every. ❑ ye ar(s)
Othe ❑ month(s) CYNA
r:
At least once every: ❑ year(sl
Other! ,ONA'
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following gSery icing Operatorc Tan
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector, POWTS Maintainer; iage
inspections must include a visual inspection of the tanks) to identify any missing or broken hardware, identify any cracks ocks surface.
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the g ponding
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any serv)Ce event. GMW (41011 .
M
Page 7 of Z
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cellls) in one large dose, overloading the cellls) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to-
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
I7 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.
d The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
< < WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY SE DIFFICULT OR IMPOSSIBLE.
ADDMONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name L1
E
u E� 1�-�, iC� E ✓ "C
Phone _ _ Z , 'I
SEPTAGE SERVICING OPERATOR iPUMPER) LOCAL REGULATORY AUTHORITY
Name Name
Phone S = ,2 !t (v s`7 n k" Phone r- _ 3 P' - �/ d ,IUD
This document was drafted in compliance with chapter Comm 83.22(2)(bl(1)(d) &(f) and 63.540), (2) & (3), Wisconsin Administrative Code.
V V I j i I r V V V V V• V V L f LLi I T V r� 1 4 V V V 1 LLLL •\ i I LJL W f Lf ILL L V �• -
V 2 H 0 1 P 1 7 738908 �'�
STATE BAR OF WISCONSIN FORM 2 - 1999 HATHLEEH H. WALSH
t)oR,meat Number ST. REGI STER C�X F DEEDS
RECEIVED FOR RECORD
This Deed, made between Beniamin J. Warless and Alicia- A.
_WaNess hob d and wife. Grantor, 09 /05/2003 10:00AN
and Richard Minor WARRANTY DEED
_ Grantee. EXEWT 4
Grantor, for a valuable consideration, convoys and warrants to Grantee REC FEE: 11.00
the following described real estate in 3t. Crok County, State of 'Wisconsin TRARS FEE 143.70
(if more space is needed, please attach addendum): COPY FEE:
Lot 7, Country Living First Addition in the Town of Star Prairie, St. CC FEE:
PAGES: 1
Croix County, Wisconsin.
Recording Area
Name and Return Addrm
R THE RIVERBANK —
J ` ' P0 130X 188
OM-F—OLA, M 54020
038 - 11870
Pamet fdend6catiom Number (PtM
This is n ot homestead property
(is not)
Exceptioas to warranties: Easements, restrictions and rights -of -way of record, if any.
Dared this � _ day of Atn!t _ , 2 003 _
B atnin J. 16nless
• ' Alicia A. Wades
AUTHEN'T'ICATION ACSNOWLTMGMENT
Signatt *) �„�� ',� _ �n/Gfi►n/(t�i STATE OIL WISCONSIN _ )
Sr. CROT% County )
authenticated this A� of �V i./ .
personally came before me this _ day of
August . 2003 the above named
�( tC fj Y Ramdtt J. Wenless and Alicia A. WoOss, huff ad 2nd _
" & wife
TITLE: MEM ER STATE BAR OF WISCONSIN
(If not, _ _ _ to me known to be the persons) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same.
THIS INSTRUMENT WAS DRAFTED BY
Attorney
Hud WI S g07.6 _ Notary Public, State of
My Commission is permanent. (If not, state expiration date:
(SWIt uss may be authenticated or acknowledged. Both are not necessary.) _ �. _ •)
• Names of persons signing in any capacity must be typed or printed below their signaoue. kdormulan Profemlonals Co.. Pond du L:y wt
V ATS am OF WISCONSIN aoo 655�2o2F
WAnAANTY DEED FORM No. 2 -1999
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