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HomeMy WebLinkAbout038-1125-50-000 Wiscong County: ±n Department of Commerce PRIVATE SEWAGE SYSTEM St. Croix gaiety and Buil 'ng Division INSPECTION REPORT sanitary Permit No: 399492 0 ATTACH TO PERMIT) GENERAL INFORMATION ( 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: Riebe, Kevin I Star Prairie Township 038 - 1125 - 50-000 CST BM Elev: Insp. BM Elev: BM Description: - 3y/ f lOO /0"' 10� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 5 � O Benchmark � 03 Wf P, Dosing Alt. BM S Ov oa, 3. P4 l fl, 7 1- Aeration _ Bldg. Sew Holding YHt Inlet A Ht Outlet TANK SETBACK INFORMATION 2, 7� Q, (P Z TANK TO P/L WELL BLDG. Eent r Intake ROAD Dt Inlet Septic + / / � "I f r S � / Dt Bottom Dosing Header /Man. ?D QG.t� Aeration Dist. Pipe �t • �� Holding Bot. System L ,L8 �P� zf p . -z.Cl q PUMP /SIPHON INFORMATION jSS s ( final Grade Manufacturer /� Demand St Cover (� 5 GPM Model Number ' ( s L f 0 TDH Lift ^ O Friction Loss / System Head jTDH r'5 Ft Forcemain "! Le th , Dia. Dist. to Well �i3S 1 > / S' SOIL ABSORPTION SYSTEM Y BED/TRENCH Width Length I No.0f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 6(P 1 Z SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM VdkVRING, Manuf u INFORMATION AMBER O Type Of System: � / j,5-- r s > jG UNI Model Number: / 5` DISTRIBUTION SYSTEM x wt -4 , Header/Manifold �f Distributi/,on� � x Hole Size x Hole Spacing Vent to Air Intake �— L� It Plpe(s) 'L / O S Length Dia Length J� Dia Spacing 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 [p� Yes ❑ No ® Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 1 ( / � / O Inspection #2: Location: 1900 Raleigh New Richmond, WI 54017 (NW 1/4 NE 1/4 31 T31N RI 8W) NA Lot 5 Parcel No: 31.31.18.516C 1.) Alt BM Description liv / � 2.) Bldg sewer length = 2xi ST /r� S,, L°)Lt(SF/�,.6 (NBt S Q�,,,, �,., e6' - amount of cover = ��' 4W6e/'u�l71ti s ;t�s�11,�/ Plan revision egwre . e � Yes rNo Use other side for additional information. 0 SBD -6710 (R.3197) Date Insepctoes Si ature Cert. No. K J �Ot 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 -7302 Department of Commerce [Privacy Law, s. 15.04(I)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 1 I inches in size. Coin ' W ✓ State Sanitary Permit Number ❑ Check if revision to previous application State Plan I. D. Number Ij I. Application Information - Please Print all Information Location: Property Owner Name Property Location / /� 1/4 IYC-1 /4, S 31 T 31 N, R (or) Prope Owner's Mailing Address Lot Number Block Number M0D 80, Nk IVA City, State Zip Code Phone �lurtibeF• ._., Subdivision Name or CSM Number C3 IK &E-a2 flieff1goaq � 1 7 II. Type of Building: (chuck one) ; ..r ' n ❑ City 11 Village Of I or 2 Family Dwelling -Wo. o'(Bedrooms : describe use : ( ) \fir �9 ❑ Public /Commercial F��� ` 53 Town of _ �,._ ❑ State -Owned S JA / V Nearest Road ck)o �� OF 1GE Parcel Tax Number(s) III. Type of Permit: (Check only one box on line A. Check b �ine:B.if applicable) A) 1. ❑ New 2. Replacement 3. ❑ Replacement o A4 , -" 5. 6. ^ Addition to System System Tank Only Existing System $) Permiti3umber Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) -Y, . Q 4. -1(5b C 29 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. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 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 ySD 3 377 8 J 1wt- 9s ".� s' M. 66 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks 7 OU c�0 E l C 0 800 / _ 'S ❑ ❑ O ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plu a 's Signature (no stamps) M PRS No Business Phone Number rJ Cf� ,s r /' 15 -� Plumber's Address (Street, City, State, Zip o e) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Iss 'ng ent Signature (No stamps) b(Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination 2 5 .G.7 Zm' X. Conditions of Approval /Reasons for Disapp uu►a., ,rie�e ti,�,ti J J AL SBD -6398 (R. 07/00) 1 1 ; i Pee w !P - 1 1 I F J__ 1 k f ; NE1 H 4v, 241 ou 1 1 �' I ; At' I j 8 ' I i j 1 1 I I ; I I AL g u- 70/71 64 1 � I I QS r ALI _6 j � I Ml 77 M O / Awl _ I �I I i I l 1 I 1 , f ► 1 1 _ _ I I i j I 1 I 1 i 1 ; 1 i -- -.a. - - �--- — t -- -- i 1 1 f -- - -L'�' 1 _ _' �f - t-l5 - SL �!_ . -! _ -_ - jam"- ""'�1T_Aff E I y i ` E , i At P - - { �— — — — + — -- — -- - - ti . - , r , 2 i i I� a , -- - - - - - -r - ! + WC-LL - - - - - - -- - - - -- -- , , , L , T._ ` T l ' - i I , i t fi F , , 4 , I ' 1 i C i i a. y i r ' � I E M I , i s ' i 9 f � { I ; + I t I I _f ' , I 1 1 � F x a 1 . + F ' + 1 F I j I ;r E i E i , I , 3 i 3 i i • a I , r y f - 1057 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accord �Cp Adm. Code Tom Schmitt 1 � : � .,...;.._.:..._.. County Attach complete site plan on paper not less than /= 1 " hes in size. must ` St. Croix include, but not limited to: vertical and horizon ce p(B direction and ' parcel I.D. 038 1125 - - 000 percent slope, scale or dimemsions, north ar w, 1 locatio ce to nearest road. Please print al iQ rma t�, '6'�"" ` � v R iewed By D a te Personal information you provide maybe usedstondary purposes (P�iv�ty Lbw, s. 15.04 (t}(m)) Property Owner operty �ocation �A o vt. Lof na NW 1/4 NE 1/4 S 31 T 31 N R 18 W Riebe, Kevin ��,� c v Property Owner's Mailing Address`';; , L Block # Subd. Name or GSM# 1900 Raleigh Road ! na City State Zip Code Pho utrvb City _j Village sol Town Nearest Road New Richmond WI 1 54017 1 715 - 247 -3420 Star Prairie I Raleigh Road New Construction Use: 0 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD �I { Replacement j Public or commercial -Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area suitable for a conventional system with a 0.7 gpd /sgft rating. Possible system elevation is95.25'. I i M Ad Boring # ,1 Boring Pit Ground Surface elev. 98.84 ft. Depth to limiting factor ' in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 1Oyr3/3 none sl 2mgr mvfr CS 1f .5 .9 2 9 -14 1Oyr4/4 none sl 2fsbk mvfr gw 1f .5 .9 3 14 -32 1 Oyr4 /3 none grvls 1 msbk mvfr gw - - - - -- .7 1.2 4 32 7.5yr4/4 none Icos Osg ml ci - - - - -- .7 1.4 5 54 -96 1Oyr5/4 none ms Osg ml - - -- - - - - -- .7 1.2 i A 1 W . 2 3.08 �q•o�3 Boring # Boring jd Pit Ground Surface elev. 98.75 ft. Depth to limiting factor --?! 00 in. Soil 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 10yr3/3 none sl 2mgr mfr cs 1 m 5 .9 2 11 -24 1Oyr4/4 none grsl 1msbk mvfr gw 2f .7 1.2 3 24 -41 7.5yr4/4 none Icos F — Osg ml cs - - - - -- .7 1.4 4 41-52 1Oyr5/4 none Is 1msbk mvfr cs - - - - -- .7 1.2 5 52 -100 1Oyr5/4 none ms Osg ml - - -- - - - - -- .7 1.2 2 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 5/30/01 715- 549 -6651 Property Owner Riebe, Kevin Parcel ID# 038-1125-50-000 Page 2 of 3 3 Boring# Boring ✓ Pit Ground Surface elev. 98.59 ft. Depth to limiting factor >98 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-9 10yr3/2 none sl 2mgr mfr cs 1 m .5 .9 2 9-22 7.5yr4/4 none grsl 2msbk mfr gw 1f .5 .9 3 22-37 7.5yr4/4 none !cos Osg ml cw .7 1.4 4 37-98 10yr5/4 none ms Osg ml cw .7 1.2 YO.08/W.08 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/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 Boring# Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1 =BOD 5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<_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 naaA matar;al;n an altarnata f rmat mane'.rnntant tha elor artn,ant at A(11227AAA 1 G 1 nr TTV fr1Q_')f,I_2117 f — o � Oie a o' 83 S iF � l j I rc�...►��, 9 �'� l2� "e r��k a> -raj �:.�ef.•�.'�i� ,rx, l 1 , s S � P ,r� r � U E l,,,T CAP �- I A��ROVED �OCK''ll: ± "C..Z. 4E ".T P! °r \,v EA7 HERPI:00� 1 i �MAiSHCLF COYEF. i JUIJCTiOM BOX W1W,4" 1146- LA WIIJVJW OR �"RES�! � � AIR. IMTAKE GRADE I y " Mtt` ] 1 Lr Lv— COQDUIT PROVIDE tUL.ET AIRTIGHT SEAL, ` I A PPROVED JOIWTS APPROVEQ jolm'i A 1 EXTE .PIPE wlr -. - I. PIPE 1 � 1 ALARM OKTO SOLID SOIL £X1'£A:AifJfs ONTO OLI O UTo SOLID S t5 i 1 oIJ . c ILLE,V. -- FT. PUMP — r. OFF x D COUCKEYC DLOCK 3! RISER EXIT plrttA11TEA 0►JL`3 IF TAWK MA)JUVACTUKV -lt RAS SUGF1 APPROVAI- •5PECIFI AT . . 1 01m SEPTIC f DOSE'. .�= �= Y ` S W MBER OF DOSES: PER >7A„3 TAAIKS /M AAILIFACTUftER: l.�l TAWK SIC GALLOIJS IMCLUDIFJG SACKFLAW GAtL0�15 gI ~ ARM 1w►AAIUFACTIJR¢R: p �Jl �� CAPACITIES: A= 1j-- iuCNE5 OR GALLO MODEL %WfAbEIt` �_, tIyGHES OR 3� GALLOAIS B '-- SW ITCH TyFi: J GAL'.OIJS r WCHES OR 1 2— p11MP MAUl1FACTLIRti<R: D . _ j_ tI1C1IES Oft GALLOIJS MODEL MUMDER: _�.L� 3') NOTE: PUMP AkJD ALARM ARE TO bE 5W17GFI TYPE: �� INSTALLED OU .zEPP.RATE CiRCUi TS t 11JIMUM DISCKARG E -- - - E RAT G PIA AL /At. VERTICAL DIFFEREAICE D6 TWE£IJ PUMP OFF AISD 0I5TR;bUTtOI Pt? E.. . 5 FE / } Mif,1IMUM t SUPPL' PRESSLIKE . . . • • . . . . F 7� ' FACT0&.._Je JL— FEET �! FEET OF foRCE MAIM Y, rT. FjKjCf tOAa � ' NEAb TOT AL t�'�tuA MiC f ffFllrHT ' H __22, ' t_IQUiD DEPT►-I !iJ'TERkJAL DIME1J5401UE c)F T AQK% - H �!� ;WCD i •� DATE: /3'�� ,/A HEAD CAPACITY CURVE MODE - I 4 30-1 i I ��� I I ~� 3 5 /g 20- + 15 4 io- 2— 1 1/2-11 12 NPT 4'0 0 r7' 7 80 U.S. GALLONS i "G 10 30 LiTERS 1 60 240 0 so FLow PER MINUTE M'00E:l- 98 60 CYCLE Feet Golland yate,, I '-:te's 7 45 4.5 2 20 A 25 05 Lk v0— 2 009971 4 3/16 SKI 102 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, tar duplex systems, are available and vadabie level float switches are available for controlling single supplied with an alarm. and three phase systems. re available • Mechanical alternators, for duplex systems, are available Double piggyback variable level float switches a with or without Warm Switches. for variable level long cycle controls. SELECTION GUIDE 1. integral float operaten 2 pole mochanical switch, no external control recluired. Standard all models - Wei ht 39 lbs. - H, 1 /7 P. 2, Single pig variable level coat switch or doUlate piggyback variable level. MLEiTtz float - witqr , r— Control selection �t-,.RefettoFMO477, 3, Mechan a ft eirri ,-,tor 10-0072 or 10-0075. mc Volta -Ph Mods Am . simptox - Duplex 4 S FtA0712, for crrrec m odel of Electrical Afternator. MW 115 1 Auto 9.4 1 or I F. 7 5. Control switch 10.0225 eased as a control ac li v ator, specify dip4ex (3) cr (4) 115 , s "r I N 9.4 or 1 2 265 3 ol & 5 float system 115 or connection or, wired 3n 1 1&7 6. Four (4) h J-Pak, junction box, for watertight D98 2' 30 1 Auto 4.7 2 or 2 & 6 3 or 4 & 5 slirlWax or d-,jolex operation, 10-WQ2. r E98 230 1�1 Non — 4.7 -Pak, lot qMtPri19t`it co"'inection of 6 P ! ' Ce ' 7. Two f�2) hole,! CAJT!GN All i(V-48'iOn Of c0ntlo!s, d ev i ces an d wiring s hould be done by a quaRfled For Information on addition; Zoeller products refer to calatog on Piggyback Variable Level Switches, ri lu to, ti e jectical ad safely cez should be followed c d gthe-,Iost FIM0477; El Alternator, FMO486; Alternator, F1010496; Saw3ge Usins FMO48 7] recent N ectrician, Electrir COde „ NECI n and th- O cc oc u p at i on al Safety and He alth Act (OSHA). Single Phase Si Pump Control, FM15%; Alarm Systzms, FW734. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. o BOX 6347 'V . ”' TO " KY 40256-11147 SHIP TO,- 3649 Ca rip Pun Road qp Lwis0lo, KY 40d11.19q! (5a • 1 (e0o; 928-PUM hffp.-#Www.zoe11er.coM P P/�4 mar. FAX (502) 774-3624 POWTS OWNER'S MANUAL 8Z MANAGEME14T PLAN Page of ILE INFORMATION SPECIFICATIONS Owner Inl � Ea Tank Capacity (S60 al ❑ NA Permit # -Z Septic Tank Manufacturer (,�_ ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Z1t6?+L ❑ NA Number of Bedrooms 3 D NA. Effluent Filter Model A­ I UU ❑ NA Number of Commercial Units NA Pump Tank Capacity U� gal ❑ NA Estimated flow (average) S gal /day Pump Tank Manufacturer W ❑ NA Design flow (peak), (Estimated x 1.5) — gal /day Pump Manufacturer ❑ NA Soil Application Rate d, �- gal/day/ft' Pump Model ❑ NA Influent/Effluent Quality Monthly average* Pretreatment Unit NA ❑ Sand/Gravel Fitter ❑Peat Filter ' Fats, Oil at Grease (FOG) s30 mg/L ❑Mechanical Aeration ❑Wetland Biochemical Oxygen Demand (BODs) :5220 mg /L ❑Disinfection ❑Other: Total Suspended Solids ( T55) 5150 mg /L Manufacturer Pretreated Effluent Quality ' ❑ NA Monthly average ** Dispersal Cell(s) Biochemical Oxygen Demand (BODs) <_30 mg/L Xin- ground (gravity) ❑ In- ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ At -grade ❑ Mound Fecal Coliform (geometric mean) X10 cfu /100m1 1 ❑ Drip -line ❑ Other: Maximum Effluent Particle Size -A inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every 3 ❑ months Xyear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (A) of tank volume inspect dispersal celi(s) At least once every ❑ months 0(year(s) (Maximum 3 yrs.) Clean effluent filter At least once every '2— ❑ months qif-year(s) inspect pump, pump controls ez.alarm At least once every 3 ❑ months Kyear(s) ❑ NA Flush laterals and pressure test At least once every ❑ months ❑ year(s) TNA Other: At least once every ❑ months ❑ year(s) CKNA Other: At least once every ❑ months ❑ year(s) A NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Maste Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspectfow 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 to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) 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 f the tank hall be ac removed a Septage Servicing Operat or l and disposed o in accordance e vo entire with ch.NR 113, Wisconsii contents of the tan Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatement components, and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START LIP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemica that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the content of rho tank(sl rernove-d by a sentage servicing operator prior to use. s Patc System start up shall not occur when soil conditions are frozen at the tnflitradve surface. During power outages pump tanks may fill above normal htghwater levels. When power Is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the ceif(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of cite pump tank removed by a Septage Servicing Operator •prior to restorinti power to the effluent pump or contact a Plumber or POWTS Malntalner to assist in manually operating the pump controls to restore ncrmai levels within the pump sunk. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwlse dlswrb 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; dlslafectants; fat; foundation draln isump pump) water; frult and vegetable peellno; gasolne; grease; herbiddes; meat scraps; medications; oil; wlndnv Products; pesticides: sanitary napkins; tamponsi and water softener brine. ARANDONEMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is property and safely abandoned In compliance with ch. Comm 83.33, Wisconsin Administrative Codet • 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 property disposed of by a septage Servicing Operator. Aher pumping, all tanks and pits shall be excavated and removed or thelr 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, W provide a code compliant replacement system. 0 A suitable replacement area has been evaluated and may be ud itted 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 strucwre, 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 rnust comply with the rules In effect at that time. Q A suitable replacement area is not available due W sttback and /or soil limitations. barring advances In POWTS technology a holding tank may be Installed as a tact resort to repim the failed POWTS. 0 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. D Mound and at-grade soil absorption systems may be reconstructed In place following removal of the biomat at the Infiltrative surface. Reconstrvctlons of such systems mwst.compty with the rules In effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASS9S AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY R1$ULT. RESCUE OF A i ER$ON FROM TKE INTERIOR OF A TANK MAY 6E DIFFICULT OK 11HIMSSIR1 i. ADDITIONAL COMMENTS POWTS INSTALLER 'POWTS MAINTAINER Name N iw r Na me Phone /s — — 6 Phone / SEPTAGE SERVICING OPERATOR (PUMPERI LOCAL REGULATORY AUTHORITY Name Agency, (, Ceb IX _ P1tnnv h n 5y- ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer U /n! R 2- L? �- Mailing Address W-1 • s & i 7 Property Address /100 AL,t --i4W 40 (Verification required from Planning Department for new construction) City/State c� Parcel Identification Number 3 �— LEGAL DESCRIPTION o Property Location ., �•, Sc.:. � T,_,U N - R l6 W. Town of -5 7AP Subdivision . Lot # Z . Volume i . Page # Certified Survey Map # � 2 �' Warranty Deed # 630 Y4 / . Volume � �y 5 � . Page # Spec house ❑ yes R no Lot lines identifiable Q 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 foram, signed by the owner and by a mastorplumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the o n-site wastewaterdisposal system is in proper o p e rating 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 Commerce and the Department of Natural Resources, State of Wisconsin. Certification ed --=t b^s e ^m ^feted and returned to the St., Croix County Zoning Office within 30 ,,...ting that your septic system l�;s b0--r- =a n* .a:L days of the throe year expiration date. 5 *kA - fl= CW &FUCANT 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 prope described above, by virtue of a warranty deed recorded in Register of Deeds Office. 10 0. ig IM 01? AIAL ANT « * * « *« 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 O � " I 1545PAG� 18 ' 60441 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS 5T. CROIX CO., WI This Deed, made between Clyde P. Hause and Barbara B . Hause, RECEIVED FOR RECORD n /k/a Barbara B. Harrison, divorced and -.remarried, 09- 22-2000 2:30 PR _ WARRANTY DEED Grantor, and Kevin W. Riche and Susan M. Riebe, husband and wife, CERT C N ERT COPY FEE: COPY FEE: TRANSFER FEE: 627.00 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): Lot Five (5) of Certified Survey Map recorded in Volume 11 of Certified Recording Area Survey Map recorded in Volume 1 I of Certified Survey Maps, page 3081, as — Document No. 542562 in the Office of the Register of Deeds for St. Croix County, Wisconsin, RE T IJPi'l f <_ "' 1'Ut ONE 706 19TH S"IREET SOUTH HUDSON, Wl 54016 3a- 1125 -50 -000 _ Parcel Identification Number (PIN) T This is homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this 2 ` m day of September �_ 2000 • Clyde P. H se • Ba rbara B. Hause, n /Wa Barbara B. Harrison AUTHENTICATION ACKNOWLEDGMENT Signature(s) Clyde P. Hause and Barbara B. Hause, n/ka STATE OF WISCONSIN ) Barbara B. Harrison, husband and wife, ) ss. County ) authenticated tis 24 day of September 2000 K 6/� J Personally came before me this day of the above named . Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person( s) foregoing who executed the fore (If not, instrument and acknowledged the same. B 8 authorized by § 706.Ob, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY + _ Attorney Kristina Ogland 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.) u J • Names of persons signing in any capacity must be typed or printed below their signature. wo nation Prorassionals company, Fond do 4ac, M STATE BAR OF WISCONSIN e0oass 2ort WARRANTY DEED FORM No. 2. 1999 a��y� gib 25 2 D3�° it s- o 074 e, CERTIFIED SURVEY MAP Located in Part of the Southwest Quarter of the Southeast Quarter of Section 30, and part of the Northwest Quarter of the Northeast Quarter of Section 31, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin. Existing Parcels Of Record: Volume 1054 Page 28 CURVE DATA LOT I CURVE I RADIUS LENGTH I CHORD BEARING I DELTA IN - TANGENT BEARING- OUT LOT 1 A -B 203.14 145.41 142.32 S 34'1713.5 W 41'00 43 S 54'47 35 W S 13'46 52 W ' 35 W LOT 2 C -A 203.14 32.86 32.83 S 59'25 39.5 W 09'16 0 9 S 64'03' W S 5447' - C -8 203.14 178.27 172.60 S 39'5 50'16 52 S 64'03 44 W S 13'46 52 W - D -E 170.14 150.59 145.72 S 39'0815.5 W 50 S 64'29 39 WW S 1346 52 W W(S Prepared for and at the request of p� John Witt �tp Century 21 1 UP. � • 304 North Keller Avenue I �I L�R Amery, WI 54 / S - 21A 5 Owner : Thomas and Marlene Haugen I CV 1900 Raleigh Road 0 X 15• Q New Richmond, WI 54017 n / Drafted by. James M. Brault I _I LOT _2 I 0 1 C.S.M._ VOL.8 _PG.2396 % R -N 89 R- 187.40' S 89'58'33" E 187.18' / N. -'LINE OF. -THE NE 1/4 SEC. 31 ` - 3 5'f .I s 7g,0z'S S 00 35" W LOT / Te �- 4 - E _ • 88� - 156.85' -- ��� �cS, g� '— - -- - .58' - © i1 -1- 1358.73' 119 -_/ 37.27' �� - - -� 2674.58' N 89'49'25" W - -- QA 96 o ; •�R= 2674.49' NE CORNER SEC. 31 SE CORNER SEC. 30 m D j I 100, (w N m / 7 - N S�r� � i W w I z I ��� / � / LOT 4 AREA MIX m I Z 0 LOT 5 �, / 7,745 sq.ft.-& 00 I m �' 0.18 acres-& V I w I OF DRIVEWAY i�/ i AREA TO MEANDER LINE 7,124 sq. ft. A ® i i 0.16 acres z o I 0 �� AREA EXCLUDING �7 418 sq. ft..* co II ; to 1 Q I� 63'f - - co ,\ - 33.95 -1 n ° I,/ 0.17 acres-& 94.40' 128.35' N 89'49'25" W N� / J�?i LOT 5 AREA 6, b 6 3 588 s . ft. _t I LE UNPLATT LANDS o q w 3• 3 � County Section Corner Monument / � 2 .84 acres-& 0 / of Record (Aluminum) AREA TO NO TH MEANDER LINE O Set 1" x 24" Iron Pipe weighing / 26,434 sq.ft. a minimum of 1.13 pounds per 0.61 acres linear foot GRAPHIC SCALE 4" Rerod 0 15 30 60 90 120 AREA EXCLUDING O Found 3 / R /GHT - OF- WA Y O Denotes Septic Vent u �■ 30,528 sq. ft. -& p Denotes Septic Tank ( IN FEET) 0.70 acres-t 1 inch = 60 ft. BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE CiC JOB #96025 NE 1/4 OF SECTION 31 TOWNSHIP 31 N., RANGE 18 W. A & E LAND SURVEYING WHICH IS ASSUMED TO BEAR N 89'49'25" W PHONE # (715) 246 -4319 NOTE: Lots 4 & 5 shown on this map are existing parcels FILED P.O. BOX 325 created prior to the County Subdivision Ordinance. Lot 4 109 EAST 3RD STREET will be added to the adjacent Lot 2 of C.S.M. Volume 8 NEW RICHMOND, WI 54017 Page 2396 b ffidavit. Register of D" Sheet 1 of 2� Z a�xG� g0 . 0 Vnl 11 pane 3(1R1 SURVEYOR'S CERTIFICATE 1, Douglas ✓. Zahler, Registered Wisconsin Land Surveyor, he Southwest t Quarter that l have surveyed, divided and mopped a par d west Quarter of the Southeast Quarter of Section 30, a n p art of the North of the Northeast Quarter of Section 31, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin; described as follows: Commencing at the Northeast Corner of said Section 31; thence on on assumed bearing along the north line of the Northeast Quorter, North 89 degrees 49 minutes 25 seconds West a distance of 1358.73 feet to the point of 3 �nnIn . thence South 28 degrees 09 minutes 46 seconds East a distance of the centerline of Raleigh Road; thence, along the arc of o curve, concave le to the southeast, a distance of 150.59 feet, said curve has c central g of 50 degrees 42 minutes 47 seconds and a chord that bears South 9 degrees 08 minutes 15.5 seconds West for a distance of 145.72 feet; thence, 13 degrees 46 minutes 52 seconds West a distance of 25.11 feet thence North 89 degrees 49 minutes 25 seconds West a distance of 128.35 feet to a meander line established for the purpose of this survey, thence, along lost said meander line, North 03 degrees 23 minutes 42 seconds West a distance of 171.12 feet; thence, continuing on last said meander line, North 52 degrees 54 seconds 02 seconds East a distance of 2785 feet to a found 314 inch rerod being on the south line of Lot 2 of Certified Survey Map recorded in volume 8, Page 2396 in Register of Deeds Office in and for said County, thence, along the south line of lost said Lot 2, South 89 degrees 58 minutes 33 seconds East for a distance of 187.18 feet (recorded as North 89 degrees 49 minutes 25 seconds West a distance of 18740 feet) to a found 314 inch rerod; thence, along the southwesterly line of lost said Lot 2, South 28 degrees 09 minutes 46 seconds East a distance of 43.35 feet to the point of beginning. Including all land between said meander line and the shore line above nes of of the Apple River between the northerly and southerl of the Apple Rivere Containing described parcel extended westerly to th 44,333 square feet (1.02 acres) more or less. Subject to the right —of —way of Raleigh Road on the southeasterly side and described o parcel and subject to all easements, restrictions l also certify that this Certified Survey Map is a correct representation to scale of the exterior boundaries surveyed and described, that l have complied with th e provisions of Chapter 236.34 of the Wisconsin Statutes and the Subdivision Ordinance of the County of St. Croix and the Town of Star Prairie in surveying and mapping same. OF WJ'Y0, ti N y ZAHLE � 0 2145 Date R x Dougla 4T DOUGLAS J. Douglas Z le eg. N � A. & E Land Surveying Tele. (715) 246 -4319 $ -2145 HUDSON, P.O. Box 325, New Richmond WI 54017 t WiS. NOTE: The parcels shown on this map are subject to State, County and Township yQ laws rules and regulations ( i.e. wetlands, minimum lot size, access to parcel, `S� etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. An affidavit will be filed stating that Lot 4 of this map is to be added to Lot 2 of Lot ifed Survey Map recorded in Volume 8 Page 2396, said Lot 4 by itself is not a buildable Sheet 2 of 2 Vol. 11 Page 3081 ELEVATION SURVEY FOR KEVIN RIEBE LOCATED IN THE SW %4 OF THE SE' /4 OF SECTION 30 AND THE NW' /4 OF THE NE1 /4 OF SECTION 31, T31N,R18W, TOWN OF STAR PRAIRIE, ST. CROIX COUNTY, WISCONSIN, BEING PART OF LOT 5 OF CERTIFIED SURVEY MAP IN VOLUME 11; PAGE 3081 IN THE ST. CROIX COUNTY, REGISTER OF DEEDS. 3 4 � RECEIV EO OCT ?.. ,1 2001 ST C PZIX m OOIINTY �j !! MN IN GUFFICE of Scale 1" = 50' / 8 6 s.ee 3S,+- 62.8' S7 2, S OO' 10' 35" E 86 3 / V' S E 15 6.85 N TOP OF INSPECTION 87 0' 872.4' 119.58 3 .27 W COVER / DWELLING O 2 � n' B -3= 872.4' / te 0 PROPOSED SEPTIC Kati Q` 1ti AREA C / Cv tt ^ ^p .... W y4i W /.� REGIONAL FLOOD ELEVATION 00 ACCORDING TO F.E.MA. MAP - MY Q NOTE: ALL IMPROVEMENTS EXISTING AND PROPOSED ARE ABOVE FLOOD ELEVATION 858.3' LOT 5 OF lu CERTIFIED SURVEY MAP h w VOLUME 11, PAGE 3081. a 233.95 S 2 e9• /2 NOTE. WATER ELEVATION SUPPLIED BY EXCEL ENERGY. THE WATER ELEVATION ABOVE THE DAM WAS 855.22' AT 9: 00 AM ON 10/15/01. THE 855.3' WATER ELEVATION SHOWN HEREON IS AN INTERPOLATION BASED ON THE APPROXIMATE "SLOPE" OF THE POOL ABOVE THE DAM. C « * G RO 2295 NEW RICHMOND WI f PREPARED BY: Q' GRANBERG SURVEYING q '='p ~ '' «• 1239 C.T.H. "E" S U NEW RICHMOND, WI. 54017 PHONE ( 715 ) 246 -7529 JOB NO. 0 1 -050 '14 '1 Su bmersib le I ���Fs GOULDS � r 4 �x s ; METERS FEET 10 MODEL: 3871 9 30 8 25 7 W 6 20 S C7 5 FE 15 Z 4 O 3 10 a 2 EPO4 5 1 0 00 1 20 30 40 50 US. GPM 0 2 4 6 8 10 12 10M, CAPACITY MODEL DVP03 Pump Specifications Features and Benefits "/10 and 1 /2 HP • EPO4 impeller- semi -open design Up to 60 GPM with pump out vanes to protect Maximum head to 32' mechanical seal. Discharge size Vb" NPT_ • EP05 impeller - enclosed design Solids: 1 /4" maximum for improved performance. Motor • Rugged glass - filled thermoplastic All motors feature ball casing and base design provides superior strength and corrosion Q 3 5 40 U.S.GPM bearing construction. resistance. s 1o�Mr Single phase: 115V .Cast iron motor housing for Materials of Construction efficient heat transfer, strength, Cast iron nnri riiirnhilit t BEARINGS REFERENCED TO THE SOUTH LINE OF Lr=6END LOT 5 OF THAT CERTIFIED SURVEY MAP RECORDED 1" IRON PIPE FOUND _ IN VOLUME 11, PAGE 3081, PREVIOUSLY RECORDED _N AS AND ASSUMED TO BEAR N89 0 49'25 "W. 0 1" X 24" IRON PIPE WEIGHING 1.68 LBS. / LIN. FT. SET. I, JOSEPH W. GRANBERG, REGISTERED WISCONSIN LAND SURVEYOR, HEREBY CERTIFY THAT I HAVE SURVEYED AND MARKED THE NORTH LINE OF LOT 5 AS SHOWN HEREON IN ACCORDANCE WITH OFFICIAL RECORDS AND A -E7 OF THE WISCONSIN STATUTES AND THAT THIS MAP IS A CORRECT REPRESENTATION TO SCALE THEREOF. S00 010'35 "E S28 09'46"E / S 79 � 02 ' S 6.66' � 4 E 74 38 13.96 , log, +- 119.56' 37. 27' I r I N89 49 ' 25 " W 156 NORTH RLY BOUNDARY OF LOT 5 OF CERTIFIED SURVEY MAP I� VOL. 11, PAGE 3081. LOT 5 OF 2 C r 1 f IIr SUF VF-'*I' MAP OL VOLUM 11, PA6r 3081. OL 4qo� < I cn � �� nJ /� C q � I MEANDER LINE o o H --- - -� - -- 94_40' -- �3395cv N89 49'25 W 128.35 / / I / � DESCRIPTION: THE NORTH LINE OF LOT 5 OF THAT CERTIFIED SURVEY MAP FILED IN VOLUME 11, PAGE 3081 AS DOCUMENT NO. 542562 IN THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE. SAID MAP BEING LOCATED IN THE SW 1/4 OF THE SE1 /4 OF SECTION 30, AND THE NW1 /4 OF THE NE 114 OF SECTION 31 OF T31N,R18W, TOWN OF STAR PRAIRIE, ST. CROIX COUNTY, WISCONSIN, FURTHER DESCRIBED AS FOLLOWS: COMMENCING AT THE SE CORNER OF SECTION 30 ( NE CORNER OF SECTION 31 ); THENCE N69 49'25 "W ALONG SAID LINE 1358.73' TO THE POINT OF BEGINNING; THENCE CONTINUING N89 49'25 "W 156.85'; THENCE N00 10'35 "E 6.88'; THENCE N79 02'54 "W 74.38' TO THE POINT OF TERMINATION ( NOTE: THIS LINE DOES CONTINUE TO THE SHORE OF THE APPLE RIVER AS SHOWN ON SAID CERTIFIED SURVEY MAP AND AS SHOWN HEREON. ) C N GRAPHIC SCALE 1 " =40' * w. 0 40 80 120 ICHMOND � e wi .� U1 9 °•• 0 � BOUNDARY SURVEY THE NORTH LINE OF LOT 5 OF CERTIFIED SURVEY MAP IN VOLUME 11, PAGE 3081 IN THE ST. CROIX COUNTY REGISTER OF DEEDS. PREPARED BY: GRANBERG SURVEYING Scale: 1" =40 SURVEYED FOR: KEVIN RIEBE 1239 C.T.H. " E " LOCATED IN THE SWi /4 OF THE SEi /4 AND THE OF SEC. 30 AND Date: 6/18/2001 THE NWi /4 OF THE NEi /4 OF SEC. 31. T31N. Ri8W. TOWN OF NEW RICHMOND, WI. 54017 STAR PRAIRIE, ST. CROIX COUNTY, WISCONSIN. PHONE ( 715 ) 246 -7529 Revised: Drawn By: JWG Job: 01 -027 Surveyor: JOSEPH W. GRANBERG