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HomeMy WebLinkAbout038-1116-90-100 c E o v n C7 t o � CD I � 3 ID _ 0 a C b o cn z 3 O w w o 0 0 o=r L - W w• ro a a ro a 3 ro N m v w m 0 7 O ro ( ro a O fD fD C 7 OD �. 11 C. r- g N zt c— Q N N 7 N m p O m (D a CL o _ v a F ' W co N W ° O y o y o Q Z D Z D a v I 3 CL a 0 101 0) CD : o m CD 0 1 0 0 n o ca !�l 0 3 3 to c 0 ro m c 0 0 0 0 0 0 0 l�Vy O r G p ro Q T G G p p LA CD CD ID ID N lV cn L N CL I c =� D m o D v 0 v -o O o ? p N fD l�1 • ro N CA o r m JD ;;: O m - c a c m o w @ m a 3 3 m � Z J co CD N C6 O w N T c ' n CL v 0 1 Z -I N a � a `(° i — j o 1 1 r z 0 3 0 3 a;o o " o C z C a N N CD CD O A N m d a 3 o C 3 CD y< a 3 ro x a ?c oo ro D � (n 3 T N p<j O �. T E C (D 9• 3 CJ C j 7 7 Z O CD ZJ O_ � Z 3 d O 0. 3 p f0 !(D p> Ul CD w c � a Ul n � o - cn 3 cn w m ro ° m m D ° m 9: 0 CL < N 7 3y, < < O Q O ID Q 3 r,.. N x N N fi o —� C N L O O N CD N J 7 W'0 N O 7 = N p N C y v I ro o a o I b � m a w CD m do cn tf, O to O a 0 p Cl o •- Wis,ofisin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 506232 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: Johnson, Erica I Star Prairie, Town of 038 - 1116 -90 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: oc, mow` k ( 29.31.18.488K1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic '1 Benchmark �z so .9 Z_ A . 9 /dr> :5 ��^' AItF t k., •�� /d Z Aeration Bldg. Sewer 7, Z7 99.65 Holding St/Ht Inlet e�q . / - Q" J TANK SETBACK INFORMATION St/Ht Outlet 7 g• 0 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet jJoC1A.— t Septic r 21 Dt Bottom � � "'Oal►i n Dosing Header /Man. /z. rg 94l. -73 Aeration Dist. Pipe #.7 41 Z IZ• Zo 7 Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Coverer � GPM F I �.. �O -P0 hoZ. 9:S, Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Leng Dist. to Weii SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside ia. Liquid Depth DIMENSIONS 3 9 7— SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: C /— INFORMATION Type Of System: Z� &7- �� O� ! CHAMBER OR G L r /d O UNIT Model Number: ' o �► DISTRIB SYSTEM '1 •M Header/Manifold II Distribution ` x Hole Size x Vent to Al' Intake Length Dia t + Length Dia Spacing �.. ♦- SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over u 1 Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center 5 i Bed/Trench Edges Topsoil \ es 0 No Yes E] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1999 Cty. Rd. C S merset, WI 54025 (NW 1/4 NW 1/4 29 T31 R1 8W) NA Lot 1 Parcel No: 29.31.18.488K1 1.) Alt BM Description = f 2.) Bldg sewer length = 33 - amount of cover = 4 a. -4 Z 1 5th- 4& +_.-L (f O Plan revision Required? 0 Yes Nj"No Z `i Use other side for additional information. SBD -6710 (R.3/97) Date Insepctoiggnature Cert. No. Generated by PDFKit.NET Evaluation tomrner+ce.wi.gov Safety and Buildings Division c ounty 201 W. Washington Ave., P.O. Box 7162 SAINT CROIX i sco n s i n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled m y C o.) Department of Comm erce S-0 t f' 1111% a Sanitary Permit Application tate TransactionNigreb� In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate ; governmental unit is required prior to obtaining a sanitary permit. Note: Application wned P %lect A ess i different mailing address) re POWTS a submitted to the Department of Commerce. Personal information you provide may be us or secondary purposes in accordance with the Privacy Law, s. 15. 1 m 1999 CTY RD C L Application Information - Please Print AN Infor ation C E IV E D Parcel # Property Owner's Name 038 - 1116 -90 -100 ERICA JOHNSON 3 ( i S Property Location X JUN 1 9 2007 Govt. Lot P roperty Owner's Mailing A ress 1999 CTY RD C ST. CROIX COUNTY NW `Y., NW '/4, section 29 C ity, State Zip a (circle one) SOMERSET WI 54025 (651)772 -2222 T 31 N, R 18 Cr II. Type of Building (check all that apply) Lot # Subdivision Name . 7 (e 1 or 2 Family Dwelling - Number of Bedrooms 4 Block # ��� Vi/ ;2d 0 C Public/Commercial -Describe Use —~ (� City (' State Owned - Describe Use CSM Number (^ Village STAR PRAIRIE Y V� Qv (i Township of III. Type of Permit: (Check only one box on line A. Complete fine B if applicable) A. t New System (e Replacement System ( Treatment/Holding Tank Replacement Only Other Modification to Existing System B• F Permit Renewal F Permit Revision (� Change of Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner �� �.ryir>✓n /� 7D P on / IV. Type of POWTS System: (Check all that apply) �C Non - Pressurized In- Ground r Pressurized In -Ground I At -Grade r Mound > 24 in. of suitable soil r Mound < 24 in. of suitable soil r Holding Tank r Other Dispersal Component(explain) r Pretreatment Device (explain) -.�o / s V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 600.00 0.70 -r/ 857.14 900.00 4-" 94.00 VI. Tank Info Capacity in Total Number Manufacturer c� a Gallons Gallons of Units New E d a d+ W Tanks Tanks a U vi rn iz C7 y sepe' rHoklingTank 1250 1250 1 Wieser Concrete Products r r r J �in �>>er r r F_ F Vn. Responsibility Statement I, the undersigned, assn respoasibility for installation of the POWTS shown on the attached plans. Plumber's Name (Prim) PI is ign MP/MPRS Number Business Phone Number 3 —C ALVIN POWERS 220537 (715)246 -5135 Plumber's Address (Street City, Sta re, ip ode) 1969 185th ave, New Richmond, WI 54017 VIII. unty/Department Use Only pproved (` Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ssuing Ag Si tamps) Surcharge Fee) �J y v�v G /0 ❑ Owner Given Reason for Denial ���+++YYY 7 J IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: < /Z 5 ��.[. ! < 2cj o 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained » ,��/ as per management plan provided by plumber. u� /�G � 2. All setback requirements must be maintained ��/ � as per applicable code/ordinances/ 3 14Z � � 12 Attach complete plans (to the County only) for the system on paper my less thmi,8W x 11 inches ' in sin �Le � anc Click K&M- 6093gkxc(kAgf)NKItcNE- tT01 /09 aa, Cnal?, Generated by PDFKit.NET Evaluation Prat- /�l� r• AJ , v- iV VJ s q 7 f � Ce' i © / \10 0 0 � 4 � / Q S Zs W Owner. ; �9 NSON Bench Mark Description BENCHMARK Address D 11 Pvc BACKHOE PIT p ClhState,Z'p: SOMERSET, WI 54025 AUG BORING 11 Drawn BY: Calvin Powers ELEVATION s Address: 1969185th Street OBS PIPE o City,State,ZiP: New Richmond, WI 54017 VENT PIPE • Phone: (715)246 -5135 scaLE 1'= WELL O Click here to unlock PDFKit.NET Generated by PDFKit.NET Evaluation POWTS INDEX (Private On -Site Waste Treatment System Index) Project Owner Name & Address Parcel ID Number ERICA JOHNSON 038- 1116 -90 -100 1999 CTY RD C County SOMERSET, Wi 54025 SAINT CROIX roject Street Location Legal escripfion E CTY RD C & 90th ST NW 1/4 NW 1/4 Sec. 29 T 31 R 18 W u mitter 0 Return By Mail Lot Block Request: E] Call For Pickup 1 Return By E -Mail Subdivision CSM Type of System & Component Manual Utilized: CSM [] Mound (version 2) SBD- 10691 -P & SBD - 10706 -P (N. 01/01) (0— Town (] Holding Tanks SBD 10571 -P (R. 06/99) fly In -Ground (version 2) SBD 10705 -P (N. 01/01) C city STAR PRAIRIE At -Grade SBD 10570 -P (R. 6199) Other Petition for Variance & Individual Site Design village CONTENTS For official use only Page# Description 1 INDEX 2 Plan Design 3 Cross Sections 4 Site and Soil Evaluation 5 User's Manual n/a Vicinity Map Attachment: SBD -6398 Attachment. STMA (if required) Designer/Plumber I the undersigned, hereby certify that the plans and specifications submitted herewith were prepared under my CALVIN POWERS direction and control. 1969185th ave SIGNED (& SEAL: 1969185th ave, New Richmond, WI 54017 JL/ Calvin Powers Drawn By: 1969185th Street New Richmond, WI 54017 Click here to unlock PDFKit.NET Generated by PDFKit.NEY Evelualion A u , A) vJ 5 q 7 3/— /& 4 i � I L V I � I S 0 �� �. �o ki K L - 72 — Owner. ERICA JOHNSON Bench Mark Description BENCHMARK Address: 1999 CTY RD C 1' PVC BACKHOE PIT p Gty,State,ZiP: SOMERSET, WI 54025 AUG BORING a Drawn BY Calvin Powers ELEVATION e Address: 1969185th Street OBS PIPE o City,State,Zip: New Richmond, WI 54017 a VENT PIPE 0 Phone: (715)246 -5135 SCALE. 1 • = WELL O n 0 3 CD =r n w 0 �a* c(D C � - N Cr < - o v -1 Q ` • s 'T1 jtuZ�� {� mrnz to < i - r O �G R f .� r m ..► N 33 S LA O rri - r = th •� c� ° z w0N�; zx D o 7 , N �`�° �i m c o W < g M y O as Ln o -u o .-« g —i O S N O z o m N - o �-� n >> F in o a s 4 I r m Z ��, 0 w / z CO - D Z O az on $ (D N C zlo Z 7D tl) S� m 0 7 ) j O m -" In so �-p N 1.1 m < O O e C» 0 N < m 3 n 7 cn y CD o C m rn a #•� I z Po n{ 3 M z O �o o m m� v CA m O N W i �p 2 Tt p o v <° ° °E _ -� ° .« Z r - O Q o m v, Z R, m A Z� vs a n C O o p �•� _ v O _t ::3 "m 50 =5 to w O� ^ A M CD r iO oo A O 0 O r a o 0 0 y m ° O 2 ' Z Generated by PDFKit.NET Evaluation Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 2 . Division'of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County SAINT CROIX Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 038- 1116 -90 -100 percent slope, scale or dimensions, north arrow, and location and d ! SA ce t nea t road. please print all information, eW Date / Personal information you provide may be u .04 (1) (m) Property Owner Property Location C ERICA JOHNSON Govt. Lot NW 1/4 NW 1/4 S 2 T 31 N R 18 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1999 CTY RD C 1 CSM I INKY City State Zip Cod one um r (` City (' Village �iTown Nearest Road SOMERSET WI 54025 - STAR PRAIRIE CTY RD C & 90th ST C New Construction Use: (i Residential ! Number of bedrooms 4 Code derived design flow rate 600.00 GPD Replacement 15 Public or commercial - Describe: Parent material OUTWASH Flood Plain elevation if applicable 83 ift. General comments and recommendations: Boring # r Boring 99.00 98 (s Pit Ground surface elev. ft Depth to limiting factor tn. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1% in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 1 0-9 10YR3/1 Is 1 msbk mvfr gw 2f 0.7 1.6 2 9-31 10YR5 /6 Is 2msbk mvfr gw 1f 0.7 1.6 3 31 -98 10YR4/6 s Omsg ml 07 1.6 Comments: 2 1 Boring # C Boring (*- Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ftx in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 1 0-18 10YR3/1 sl lmsbk mvfr gw 2f 0.4 0.7 2 18-33 10YR4/6 Is 1 msbk mvfr gw 1 f 0.7 1.6 3 33-72 10YR5 16 s Omsg ml 0.7 1.6 I I Comments: ' Effluent #1 = BOD ,> 30 < 220 mg/L and TSS >30 < 150 mgfL Effluent #2 = BOD ,< 30 mg/L and TSS < 30 mg/L CST Name (Please Print) _ ' S' natu CST Number Calvin Powers o 220537 Address Date valuation Conducted Telephone Number 1969185th Street, New Richmond, WI 54017 6(5/2007 (715)246 -5135 C I iC ( nere to rJn1oCK ILlf-KILNE -8330 07 00 I Generated by PDFKit.NET Evaluation Property Owner ERICA JOHNSON Parcel ID # 038 - 1116 -90 -100 2 2 Page of Boring # Boring 98.90 pit Ground surface elev. ft. Depth to limiting factor 96 in. of Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 1 0-11 10YR3 12 Is lmsbk mvfr gw If 0.7 1.6 2 11-18 10YR4 13 s Omsg ml gw it 0.7 1.6 3 18 -28 10YR4/6 Is lmsbk mOr gw if 07 1.6 4 28-84 10YR5 /8 s Omsg ml gw if 0.7 1.6 5 84-90 7.5YR4/4 Is lmabk mvfr gw 0.7 1.6 6 90-96 10YR514 s Omsg 0.7 1.6 Comments: ❑ Boring # (` Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/k2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 Comments: ❑ Boring # Boring (� Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDM6 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Comments: * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD 5< 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SOD- 8330Test(R07 /00) Click here to unlock PDFKit.NET Generated by PDFKit.NET Evaluatign UL P)o LA ��� o fl RS � - A = p s a9 7T3�� r P6-CL L r tq 6 o ►,� \OV/ o v � Q �J 14 cNN �S K) o c\ oil S � Owner. ERICA JOHNSON Bench Mark Description BENCHMARK A Address: 1999 CTY RD C I PV BACKHOE PIT p C•ity,State2ip: SOMERSET, WI 54025 AUG BORING o Drawn By: Calvin Powers ELEVATION s Address: 1969185th Street 0 OBS PIPE o VENT PIPE • City,5tate,Zip: New Richmond, WI 54017 �� Phone: (715)246 -5135 SCALE: 1" 0 WELL 0 Click here to unlock PDFKit.NET ST. CROI K COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERS CATION FORM Owner/Buyer C Mailing Address Property Address (Verification required from Planning & Zoning Department for new construction.) City /State .sue nn - C r C, _ Parcel Identification Number LEGAL DESCRIPTION Pro Location N lJJ !4 , Q 1 Property ' PJ tj '/a , Sec. Q T 3/ N R 1 W, Town of -5 1,4 P P 1V� I A! ) r Subdivision ['SVYI , Lot # Certified Survey Map # 0� 7 , Volume , Page # Warranty Deed # 7 ` , Volume Q u , Page # Spec house yes} Lot lines identifiable (jjj) no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted 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 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGMA AP ANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) Generated by PDFKit.NET Evaluation ST. CROIX COUNTY PLANNING & ZONING Dear Homeowner: If you own property that is served by a private on -site wastewater treatment system you are required to provide proper maintenance on this system as per 145.245(3) Wisconsin State Statutes and Chapter 12.7 of the St. Croix County Ordinance. Proper maintenance will help to ensure the longevity of your private sewage system I` and avoid premature failure. Code Administration 715- 386 -4680 This maintenance program requires inspection of or pumping of the private sewage system at least once every three years at the owner's expense. Inspections may be conducted by a licensed master plumber, licensed journeyman plumber, licensed Land Information& restricted plumber, licensed POWTS maintainer or licensed septic tank pumper. Planning The inspection shall certify that the system is in proper operating condition and the 715- 386 -4674 septic tank is less than 1/3 full of sludge and scum. If the inspection reveals sludge and scum volume to be greater than 1/3 volume of the tank, a licensed septic tank Real Property pumper shall service the tank. The St. Croix County Planning and Zoning 715- 386 -4677 Department is required to track maintenance reporting so your cooperation is greatly appreciated. Recycling 715- 386 -4675 Please return the information below to: St. Croix County Planning & Zoning Department, 1101 Carmichael Road, Hudson, WI 54016. --------------------------------------------------------------------------------------------------------------- ST. CROIX COUNTY SANITARY MAINTENANCE CERTIFICATION FORM System was installed in The private sewage disposal system is in proper operating condition. The septic tank was recently pumped by a licensed septic tank pumper, or it was inspected and is less than 1/3 full of sludge and scum. The effluent filter has been inspected and /or cleaned. All septic systems approved after July 1, 2000 were required to have an effluent filter installed in the septic tank. If your system was approved before this date, you are not required to install a filter, but it is usually recommended. Describe any other maintenance that may have been performed. Signed by: Title: License Number: Date: Signed by Owner: Date: Parcel ID Number: 038- 1116 -90 -100 Property Address or any changes: 1999 CTY RD C Click here to unlock PDFKit.NET St. Croix County Government Center I Generated by PDFKit.NET Evaluation CONVENTIONAL SYSTEM USER'S MANUAL PROJECT: ,999 CTr RD C SYSTEM START -UP For new construction, prior to the use of the POWTS, check the treatment tank(s) for the presence of painting products, chemicals or other foreign objects not being apart of the POWTS that may impede the treatment process and/or damage the dispersal cell (s). If high concentrations are detected, have the contents removed by a septage servicing operator prior to use. Additionally, system start-up shall not occur when soil conditions are frozen at the infiltrative surface. SYSTEM OPERATION A conventional in- ground septic system consists of a septic tank and a subsurface soil absorption cell (see plot plan). In the septic tank, solids settle out of the waste stream and anaerobic bacteria facilitate the partial breakdown of organic matter (primary treatment). Clarified effluent from the septic tank discharges via gravity flow through an effluent filter to the soil absorption cell. The soil absorption cell removes pathogens, organic matter, and suspended solids from the septic tank effluent via physical filtration, biological reduction of contaminants by aerobic microorganisms, and ion bonding to negatively charged clay particles (secondary treatment). The soil serves as a fixed porous medium on which beneficial microorganisms grow. These organisms feed on organic matter present in the wastewater and help eliminate pathogens. Three feet of suitable soil between the distribution cell and bedrock or high groundwater is sufficient to protect public health and groundwater quality. This system type requires about five feet of suitable native soil. The conventional system is a passive system that relies on gravity flow. The flow volume entering the septic lank controls the volume discharged to the soil absorption cell. The effectiveness of a conventional system depends on the type and permeability of native soils and the slope and drainage pattern, of the site. The septic tank requires periodic pumping as determined by State and County Code, as well as inspection of the sal absorption cell. the effluent filter component also requires periodic maintenance. MANAGEMENT & CONTINGENCY PLAN This Private Onsite Wastewater Treatment System ( POWTS) has been designed, and is to be installed and maintained according to Comm 83, WI Admin. Code, the Conventional Soil Absorption Component Manual for ( POWTS SBD- 10706 -P; Jan 30 2001) (, and the POWTS owner's County Private Sewage System Ordinance. This POWTS has been designed to accommodate a maximum daily flow of 600.0 gallons of domestic waste per day. The quality of influent discharged into the POWTS treatment or dispersal component shall be equal to or less than all of the following: ** a monthly average of 30 mg/L fats, oil and grease ** a monthly average of 220 mg/L BOD(5) ** a monthly average of 150 mg/L TSS Wastewater shall not be discharged to the POWTS in quantities or qualifies that exceed these limits or that result in exceeding the enforcement standards and preventative action limits specified in ch.NR140 Tables 1 & 2 at a point standards application, except as provided in Comm 83.03(4), WI Admin. Code. The owner of this POWTS is responsible for system operation and maintenance. The following maintenance shall occur within three (3) years of the date of installation and at least once every three years thereafter: 1) The septic tank(s) (and pump chamber if applicable) shall be pumped by a certified septage servicing operator, licensed under s.281.48, WI Stats, unless inspection by a licensed master plumber or person authorized to make such inspection, finds less than one -third (1/3) of the tank volume occupied by sludge and scum. More frequent pumping may be necessary to prevent solids from exceeding 1/3 of the volume of the tank. Wastes shall be disposed of by the pumper in accordance with ch. NR113, WI Admin. Code. At each pumping, the pumper must visually inspect the condition of the tank, baffles, risers and manhole cover and verify that any required locks are present. Please note that owner must provide septage servicing operator with reasonable access to tank(s). This may include (but is not limited to) construction of a designated drive or servicing pad to within 150 horizontal feet and /or to within 15 vertical feet to bottom of the tank(s), foot traffic over and through property, or vehicle traffic over and through property. 2) The soil absorption component(s) shall be visually inspected by a licensed master plumber, certified septage servicing operator or POWTS inspector. Inspection shall check for evidence of discharge of sewage to the ground surface and for ponding of effluent in the distribution cell(s). 3) The tank filter(s) shall be inspected and cleaned to remove any accumulated solids according to the manufacturer's specifications. The filter cartridge shall not be removed unless provisions are made to retain solids in the tank. Cleaning of the filter at more frequent intervals may be necessary. 4) Any pump, alarm or related electrical connections shall be visually inspected for defects and tested to confirm that they Click here to unlock PDFKit.NET Generated by PDFKit.NET Evaluation are operating properly. (if applicable) 5) Reports for all system maintenance shall be submitted to the County Government in which the POWTS is located in accordance with Comm 83.55 WI Admin. Code and the County's Private Sewage Systems Ordinance. No one should enter a septic or other treatment tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. No product for chemical or physical restoration or chemical procedures for POWTS may not be used unless approved by the Department of Commerce in accordance with Comm 84, WI Admin. Code. In the event that this POWTS or a component of this POWTS fails and cannot be repaired, replacement of the POWTS or the component shall occur in accordance with WI Admin. Code and the County's Private Sewage Systems Ordinance that is in affect at the time of the failure. If this POWTS is replaced and its use discontinued, it shall be abandoned in accordance with Comm 83, WI Admin. Code. Any component failure, defects, or malfunctions identified during maintenance described on the previous pages shall be repaired in conformance with Comm 83, WI Admin. Code, and the County's Private Sewage Systems Ordinance. Below, in addition to the regulating agency, is a list of names and telephone numbers of the properly licensed individual(s) to contact for such repairs. County Office: SAINT CROIX REGULATORY AGENCY: Address: 1101 Cam*hael Rd. City St Zip Hudson, WI 54016 Phone: 715 - 386-4680 Name: CALVIN POWERS INSTALLER: Address: 1969185th ave City St Zip New Richmond, W154017 Phone: (715)246 -5135 Name Calvin Powers POWTS DESIGNER: Address: 1969185th Street City St Zip New Richmond, WI 54017 Phone: (715)246 -5135 Name: Wieser Concrete Products TANK MANUFACTURER: Address: 2815 Riley Road City St Zip Portage, W153901 Phone: 800 - 362 -7720 Name: FZ -Flow ABSORPTION CELL MFR.: Address: 65 Industrial Park City St Zip Oakland, TN 38060 Phone: 800 - 649 -0253 Name: Polylok, Inc. EFFLUENT FILTER MFR.: Address: 4003 Capital Drive City St Zip Wallingford, CT 06492 Phone: (203) 265 -6340 Click here to unlock PDFKit.NET - 7942E.'9 1Z i DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1962 WARRANTY DEED KATHLEEN H. WALSH 2 7 g 8 P 0 3 5 REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD This Deed made between __Rona1cl.. Ii __-- CaxQOn__ anal__•_ -•__ 05/06/2005 10:15AN WARRANTY DEED - -- --- -- - --- - ---•------ -- ------ •--- -- ----------------------- ---- --"----•----------•- ------------------------- ---------- _ _. EXEMPT # ----------- --- --- ------- ------- " -- •---- --- ---- ---- -•- ---- Grantor, and- __--_Er_i_ca__Johnso-n__,a. Singh.__ persorx ---------- --- ----------------- -- REC FEE: 13.00 - - - ----- - - --- TRANS FEE: 675.00 COPY FEE- ----------- ' CC FEE: --- -•- --•--- •- -- -- --- --- - - -- -- -- - -• - -- -- -- - -- Grantee, PAGES: 2 Witnesseth That the said Grantor, for a valuable consideration,._____ conveys to Grantee the following described real estate in ------- St.. -._ CrC17.X..__. RCTVRN ToStillwater Title County, State of Wisconsin: PO Box 206 Stillwater MN 55082 Legal description attached Tax Parcel No: ii f I . I This --___-___7.S ---- _---------- homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And warrants that the title is good, indefeasible in f e m e sip a a c le e u le nd free nd ar of ncmbrances except ----- and will warrant and defend the same. Dated this 4th – ---- ------ --- - - --- day of - -- Mays • 2005 - - ---•- - ----- --- -- - -- -- KJK ........ 7 ----------------- (SEAL) G�LQ� ?`1 (SEAL) *Ronald L. Caroon _(SEAL) � < <"" e -- _(SEAL) y ,Ma Ann Caroon AVTHNNTICATION ACSNOWLRDGMIMNT Signature(s) --------------------------------------------------- STATE OF WfK0[}fiISMMINNES TA as. ------------------------- ---- ---- --- -- ----- --- ---- - - -- -- - ---- -------- --- ---- -- WASHINGTON unty. ---- -- -- -- - --- ------ --- --- -- Co authenticated this -------- day of ------------------------- _ 19 ----- Personally came before me this - 4 th__ -- -__day of - May,_._ 2005 --------- ,. ......... =----- --- the above named - Rona��_ L Mary - __Ann_ .______ Caroon husband and wife TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. State.) to me known to be the person ------------ who executed the foregoing instrument and ack ledge the same. THIS INSTRUMENT WAS DRAFTED BY David M. Newberg PO Box 206 ... " "�f--------------------------- • Stillwater, MN 55082 `--•- -- --•-- ---- --- ---- ------- -- -- -- --- ---- --- ---- -- --- --- -- --- --- ---"------------- •-----•-----•--- ------ ----- -- -- --------------- - ---- Notary Pub ' nty, Wis. (Signatures may be authenticated or acknowledged. Both My Commi e e piration are not necessary.) date: h _ - -•___ h d_....___, 9_.__ - -__.) Names of persona sirnins in any capacity should be typed or printed below their eiQnaturee rh.l�1(f WARRANTY DEED STATE BAR OF WISCONSIN Wiseoneia Legal Blank Co. Ine- FORM No. 1-1992 Milw.ok wi. U. 2798P 036 That part of the NW 114 of the NW 114 of Section 29, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin, described as follows: Lot 1, Certified Survey Map recorded December 21, 1988 in Vol. 7, Page 2055 as Document No. 444007. 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