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HomeMy WebLinkAbout040-1037-30-100 0 ? r W ° 2 % k 0 1 - 0 T ® © \ ® 7/ z m 2 E / [ f e « § # } \ ^�� � �� 0 � ° / / q i - § ! Cl 2 S @ o a 0 � ` (D In \ , 2 2 \ # z 2 # & « © § § 4 CD o o m §[ c g ° ° \ M \ 0 0 o I �- J -0 K) 2 � £ : '% > D / 2 v v \ 2 EkD ca \ 2 � » � = g > \ 0 . / CD �- _ - CA ° - ( 2 E z )/ wcn ■ z m ` z \ / OD C" M § ] CL � z § F § 2 7 2 # % ® � E US' _$> kCD C } /§/ % 0 cn CD%\ � S2■ § C , a3E \ � CD § a D . � k \ § \ f 0 � \ � � tv 0 / c ( m J _% ; 6 7 T to 0 2 fƒ 0 ° m Z @ 2 7 E $ CL E g b# \\\ g t { = o ( { ' { o \ S o § CL A / � $ % § § CD 2 m c R n CD a e 3 CL 0 E E 7 § k � Q �§ /i � m v > 2 E - 4 °� § \ § 2 2 § : ® { § # a § § a ƒ o 0 /o CO) k ° ° k; T "NIA - I } � ` (a 2 § / \ p Cr v R �i c � n , £ ■ . � \ § 7 D (a E ; B f z / g \7 / / { / 7 - _ C c e5c: } J N/ o « -n a � E k - / ■ ¥ G $ { ■ T § § � � 2 o ■ 2 C4 2 � # 2 � C. Ee : § CD ®§ n �a, £ ƒ@@ F % ƒk% ƒ CD (D CD � @ kCDC It §/ � � \§ / . 0 f � � o w \ \ � ® K 0 * CD t \ 0 Cb V;,,*' 0 7, 3d , / t, 10A o - 7 Parcel #: 040 - 1037 -30 -100 10/03/2006 09:02 AM PAGE 1 OF 1 Alt. Parcel #: 08.28.19.124A -20 040 - TOWN OF TROY Current - XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/04/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co - Owner CHRIS J FEYEREISEN O - FEYEREISEN, CHRIS J 429 TOWNSVALLEY RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description ' 437 TOWNSVALLEY RD SC 2611 HUDSON SP 1700 WITC r L L1 escription: Acres: 3.502 Plat: 4942 -CSM 19 -4942 040/05 E28N R19W PT NW SE BEING CSM Block/Condo Bldg: LOT 02 19 - LOT 2 (3.502AC) � Tract(s): (Sec- Twn -Rng 401/4 1601/4) 08- 28N -19W NW SE Notes: Parcel History: Date Doc # Vol /Page Type 03/04/2005 788874 2759/492 QC 03/04/2005 788799 19/4942 CSM 02/23/2005 788076 2754/013 EZ -CN 08/02/2004 770349 2628/266 EZ -CN more 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 08/23/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.502 70,400 179,100 249,500 NO Totals for 2006: General Property 3.502 70,400 179,100 249,500 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 k Wisconsin Department of Commerce Count PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division I Sanitary Permit No: INSPECTION REPORT 463345 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: Fe ereisen, Chris I Troy, Town of CST BM I v ,, // r In BM lev: BM Description Y Section/Town /Range /Map No: T• 1 Z. Y74• I�Z CST Wl 1 08.28.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � f� l2so Benchmark �\ 3, Dosing vt Alt. BM y � 5 Aeration Bldg. Sewer '¢+u 3 I / Holding St/Ht Inlet � 3, &(, o. TANK SETBACK INFORMATION St/Ht Outlet .A TANK TO P/L WELL BLDG. VLto Intake ROAD Dt Inlet Septic or 40 ♦ Dt Bottom Dosing Header /Man. Aeration Dist. P' e D ' u+,VJa C - -. • 003 • St Holding Bot. System ' + Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cove GPM �• I Model Number TDH Lift Frictio oss System Head TDH Ft Forcemain Length Dia. SOIL BSORPTION SYSTEM RE CH idth r Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM N Z SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacture INFORMATION CHAMBER OR . Ty� System: �� • • UNIT Model mber� L VV . [► DISTRIBUTION SYSTEM r* /lp' Header /Manifold ��( Distribution x Hole Size x Hole Spacing Vent to Air Intake Pip (s) `> Q� L Dia Len Dia Spa COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over TBedp/ Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center rench Edges Topsoil I ! Yes No Yes No C ` MM.MENNT , S S : .LLu ode cod t<discreQ2ncie ersons pre nt*etc.) Inspection # Inspection #2: - Zb Jon: 437 Townsvalle Ro d Hudso , WI 54016 (NW 1 /4 /I SE 1/4 8 T28N R19W) NA Lot 2 Parcel No: 08.2 .1 D 1.) Alt BM Description = J �.•, Bldg sewer length = Q , O ��• Aujau 2 CL 9 9 �' ID 3 v m int of c = � 1 I took l ed 1 _ _` _ l w ` r " 10 I Z r 0" �X •"g Plan revision Required? Yes o Use other side for additional informati K v � U — Date Insepcto s Signature Cart. No. SBD -6710 (R.3/97) Safety and Buildings Division County , 201 W. Washington Ave., P.O. Box 7162 s r N vi s onsi % Madison, WI 53707 - 7162 °SMVXary Permit Number (to be filled in by Co.) Department of Commerce �i 3 - ° „' a 633 '4 s State! Plan I.D. Number Sanitary Permit p t _ In accord with Comm 83.21, Wis. Adm. Code, personal o 'o you aw, provide ( ",.it -- may be used for secondary purposes Privacy L .04(1 (m) Projec Address (if different than mailing address) I. A cation ation - Please Print 1111 Information �rr 5 re h . Property Owner's Na 4e Parcel # , 3 t # Block k Property Owner's M ailing Address operty Location j f a T ; U) 'A, tk,Secdon City, State Zip Code Phone Number (circle e) II. Type of Building (check all that apply) t V •7 { L, T N; R��E ot�w 9 1 or 2 Family Dwelling - Number of Bedrooms CSM Number n G ❑ Public /Commercial - Describe Use V of I ❑ State Owned - Describe Use - ❑City_ ❑Village XTownship of Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable) S A ' New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that a 1) 2 S k&r A Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter i ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain , V. Dispersal/Treatment Area Information: 3.5O Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (so Dispersal Area Proposed (sf) System Elev tion / VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Phx , Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 00 ( 1 ) Aerobic Treatment Unit Dosing Chamber / I VII. Responsibility Statement- I, the undersigned, assume responsibility for ustallation of the POWTS shown on the attached plats. Plumber's Na me (Print) Plumber's i gnature MP /MPRS Number Business Phone Number 4 A 6, , � � Plumber's Addre ss (Street, City, State, Zip Code) 4?9 VIII. County/Department Use Only _ Approved ovSen Sanitary Permit Fee includes Groundwater Date Issued =44ntnature o Stamps) Surcharge Fee) ❑ O for Denial IX. Conditions Approval 1 3� <� vw O�?� SYSTEM OWNER: 1 Septic tank, effluent filter and c � G dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained 11 I ^ as per applicable code /ordinances. 5- j _t> Attach complete plans (to the County only) for the syste on paper of less than 81/2 x 11 inches In size ffk-5 'W90 �_A SBD -6398 (R. 01/03) �� Cam. Le- l w� sy, 03/10/2005 14:26 FAX 715 425 8466 BETTENDORF TRANS /EXCAVAT 16002 -- •.•• vov J oao ST CIU CO ZONING P* 0T- P4 a N P 2 of 2 . — - .!roe,,.,.. 9 _ .. LoT'2 502 A C OWsE g 28►9N .�. R,t FEY[; RFrseN o�r,N'�R —T , oil. >IZ $� 1 36 h tsgos t.4& 1n r: T cp m h r. a . 79S'rA11 Q CELLS 3 A i t E .4rN..,Wl q-rd �et�r,oas -� � �,�GDv�R • Q Z ar a;Row i e Cb / SAFE Y fts 94. 9 o, 5 6 M 2 09/10/2005 14:26 FAX 715 425 8466 BETTENDORF TRANS /E%CAVAT 0 002 -- -- • �.. .iov J oao ST C1M CO ZONING - PCUT 11A N' It 002 P 9 z of 2 sCAiE I L 0r :Z SD AC NW SF- 8 8 B 19 y p 90 S zpt: � '1► q � '1 ecSE.N+�,,�?' c© cm CID s m r a L � K J 6+ USfAL1 a CELLS 3On' �QCN.,1d 9•fd �e [ i Boas i rk . covErt ar 3 .�-_. . a m v� %-,k r Co / S AI Y POST N Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wit. Adm. Code counlY ST. CROIX Attach complete site plan on paper not less than 9112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), Parcel I.D. (Pending) percent slope, scale or dimensions, north arrow, and location and distance to R by bate Please print all OkOrn ....r. - may ._ _ ) 5 � Personal information l+� p rn+N be used for !soon s. 1 }. Property Owner El El NORMAN FEYEREISEN Lot NW 1/4 SE 1/4 S 8 T 28 N R 19 Property Owner's Melling Address Lot Block # Subd. Name or CSMif 429 Townsvalley — (Pend {My Stage ZipCode NiV* �'F�r � - ®V�age own Nearest Road Hudson, Townsvall Road H n, WI 54016 ( New Construction Used Residential / Number of bedrooms 3 Code derived design lbw rage 50 t PD Replacement ® Public or conurreraal - Describe: Parent material outwash Flood Plain elmdion if appiir aW N-A $ General comments Conventional In- ground Trenches — 0.7 Loading Rate and recommendations: To be designed by installer. Fil Boring # ® Born Ground surface elev. S" 1. Z9 ft. Depth to �itil factor >100 iM Pit SW Appkabon Race Horizon Depth Dominant Color Redox Description Texdxe Strtclum Come Boundary Roots GPDW in. Munsel Qu Sz. Cart Color Gr. Sr- Sh 'EW1 •Eller 1 0-8 10YR2/2 — sl 2f -msbk mvfr as 3vf-m 0.6 1.0 2 8 7.SYR3/4 — s & gr Osg dl a 3vf-m 0.7 1.6 3 1442 I OYR3 /6 — s & gr On dl gs 2vf-m 0.7 1.6 4 42 -100 10MA — s — — 0.7 1.6 (Horizon 4 bw some sr and some cobbles) 2 Boring >104 ❑ Q Fit Ground srtfaee elere. _ ft h ts — Flonizat Depth Dominant x Ear =- in. l4�el (lit. Sz Garr£ '. r, to 4 1 2 a cg p it p sbk o 2 6 10 i t3YR2d"2 — , tt & f'Jr ?f- nrrgbk mvfr ! a 2vf, 10-1$ 3 7 SYR_3 /4 ,V.... is & Yr On dl gw 2vf-m `. 4 18 -If? 10YR54 E ' 6 d Eder t #1 = BOO > 3D:5 220 mgit_ and TSS >W c aye } - CST t ilk w � C5T Number Mary d Ilolliswr .(.(.f Address W9875 690th Avearue, River l:alis, Wt 544 �- .r Property Owner FEYEREISEN, Norman Parcel ID # (Pend' g) Page 2 of 3 F -7 1 Boring Boring # a Pit Ground surface elev. �Q3. 3g ft. Depth to ti factor 115 Soil lication Rate Horizon Depth Dominant Color Redox Description Texture re Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color G Sz. Sh. *Eff#1 *Eff#2 1 0 -3 10YR2 /1 -- 1 ' 3 bk mvfr cb 3vf-m 0.6 0.8 2 3 -15 10YR2 /1 -- I /7 > abk ds ci 2vf-m 0.6 0.8 3 15 -22 IOYR3 /3 -- 1 2f -msbk ds ci 2vf-m 0.6 .0.8 4 22 -28 10YR3 /4 -- 1 2f -msbk ds cw 2vf-m 0.6 0.8 5 28 -39 10YR3 /4 -- s & gr Osg dl gw 3vf -m 0.7 1.6 6 39 -115 10YR5/4 -- s Osg I dl -- -- 0.7 1.6 (Horizon 6 has some gr.) ❑ 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 - 0112 Boring Boring # Ground surface elev. ft. Depth to limiting factor F in. Pit Sal ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Murrell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 150 mg/L * Effluent #2 = BOD < 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. S13I3- 83307rat (R.07 /00) ,. ?A 3�3 PRoeosez Lort Z 3• �OZ . /2 884.3 nsva`t o+�T++� s�'l�, fir. r ry L BORM e A • Y. 87. 8 Q� a �s G Y a JP77, 1^a - e . Y r r a:_L. i - .di -+'. 1i 1 .i. J ✓ J 8J r a' ✓ a r' u__;` <' r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ' of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner cAfZA Septic Tank Capacity I ZOO a l ❑ NA Permit # i 1 r 3 4S_- Septic Tank Manufacturer 6- (SG-f_ ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer L_ ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model A-1 OD ❑ NA Number of Public Facility Units ANA Pump Tank Capacity al A Estimated flow (average) gal/day Pump Tank Manufacturer A Design flow (peak), (Estimated x 1.5) 6 g al/day Pump Manufacturer A Soil Application Rate d al /da /ft2 Pump Model E"A Standard Influent/Effluent Quality Monthly average` Pretreatment Unit EkNA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg/L n- 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: "A Other: ❑ NA Other: NA *Values typical for domestic wastewater and septic tank effluent. Other: EPA MA SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA y ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Ins Inspect dispersal cell(s) At least once every: [3 month(s) (Maximum 3 years) ❑ NA p pe year(s) Clean effluent filter At least once every: / E3 month(s) ❑ NA t ❑ year(s) ❑ month(s) NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) �C ❑ month(s) Flush laterals and pressure test At least once every: ❑ year(s) A Other: ❑ month(s) NA At least once every: ❑ year(s) Other: I LNA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and 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 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 service event. Page Z of 2 START UP AND OPERATION . For new construction, prior to use of the POWTS check treatment tank(s) 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 cell(s) in one large dose, overloading the cell(s) 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. ❑ 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. T s oil and o m9 ank alua ' �DIQ- !�/ CONS77Z( C-71 ON e tai lea �RO(- !!81'7m ❑ 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 BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 15t. C ( bU 2 A11�(1 Phone Phone — 71f;_ — 3 ?1(4- This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 03/10/2005 14:26 FAX 715 425 8466 BETTENDORF TRANS /EXCAVAT 1 003 Z ?/ START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the diaper :l ;%l ceills). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to usW. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks -may fill above normal highwate:r levels. When power is restored the excess wastewater will be discharged to the dispersal call(s) in one large dose, overloading [lie cells) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tEmk removed by a Sep Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS AflEdntainer 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 fait drive or park over, or otherwise disturb or compact, the area within IS feet down slope of any mound or at -grade soil absorptioiu area. Reduction or elimination of the toWowing from the wastewater scream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotion 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 poermanently 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 613.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the :Ibandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and Dr;: disposed of by a Septage Servicing Operator. .After pumping, all anks amd pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or anoth r inert solid material. CONTINGENCY PLAN If the POWTS fails a cannot be repaired the following measur -s have been. or.must be taken, to provide a code compliant replacement sys A suitable replacement area has been evaluated and mat 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, lat lines and wells, Failure to protect the replacement area will result in the need for a new soil and site evaluation to estllblish a suitable replacement area. Replacement systems must comply with the rules in ef"ect at that time. ❑ A suitable replacement area is not available due to sotbaek and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort Ito replace the failed POWTS. T I• clue :� a o :ng ank ?91DWBrM M, ¢oR -A/&✓ Lt,rvSTR11 0� ❑ ound and at -grade soil :absorption systems may be ret:onstructed in place following removal of the biomat at the i iltrative surface. Reconstructions of such systems rnuwl comply with the rules in effect at that time. <i<WARNIN > I SEPTIC, PUMP ND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. 00 NOT ENTER A SEPTI , PUMP OR OTHER TREATMENT TANK UNDER PIYY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A OERSON FROM TH INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADO M ONAL COMME CGkee I< - zlr � _.�. �� Cl�•. a 7� /e�s� on ce /yr Lae 1 o we red POWTS INSTALLER POWTS MAINTAINER Name 1 [� Name Phone 5' _ a p Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name $ T . 2Il�t1 Phone Phone 3,94 446 This documant was drafted in complianae Mth chapter Comm 83.22121(b)(11id)&(f) and 83.6411. (2) & 131, 11Miaoonain Administrative Code. I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer ._ C_� _ �E `i � 5 K/ Mailing Address Property Address (Verification required from Planning Department for new construction)_ 1 City /State WuLScri W ; Parcel Identification Number C - I 0,39 - 3 0 e.5 LEGAL DESCRIPTION Property Location NUl y SL y4, Sec. Tb_N -Rj_a__ W, Town of Subdivision , Lot #. Certified Survey Map # -,Volume / 9 , Page # 4 -", Warranty Deed # g , Volume Z 7" , Page # Z Spec house ❑ yesXno Lot lines identifiable l,�j 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 fiuiction of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site 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 Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owrrer(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** InOude with tills 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 03/10/2005 14:26 FAX 715 425 8466 BETTENDORF TRANS /EXCAVAT lit 001 II 285 COUNTY ROAD SS EXCAVATI RIVER FALLS, WI 54022 900 -828 -3723 715- 425 -6200 715 - 425 -8466 FAX F fi Y, e- C FC GY c' L,5 ems- TQi.�c'L� LA) 07 i I I I PLOT .,PL 4 N pq 2 0�2 _ SC I = 50 L OT 3.502 AC N 8 28liW CH RIS FEYERETSEN OWNER 0 E 51G 9 EP 0V ' $a ,4 72,0- „ �L. 894.sZ 7'Y par �S�p�: co JD QD rrf j I A p_ 4 f� c1 a3 AN e N STALL a CEL15 3'xga EA C 4 W 17 9 -f0' 6E cTIowe. T FLOW., MODE E Z 12.o:5 - Wt TH VI Covtlr bH D ow�t s� ai.�� o- 0 tb �r a .. _,. SPIKE I:�kc6 HOST El. 9 04, 6 8 M 2 I 788874 !� P�q STATE BAR OF WISCONSIN FORM 3 - 1998 QUIT CLAIM DEED KATHLEEN EEG OF DEEDS ST. CROIX GO., MI Document Number RECEIVED FOR RECORD �? Igsqq eedi ate between 03/04/2005 01: 30PM Va G f R 14 Se n Se r*% oUIT CLAIM DEED -- EXEMPT • 8 Grantor, and __ REC FEE: 11.00 C�-1s S = i - e y F f e t S r> TRANS FE CC FEE: _ —, Grantee- PAGES: 1 Grantor quit claims to Grantee the following described real estate in C t O ► X County, State of Wisconsin: Rc-cording Area 1/ Name and Return Address n -� h f�S Vl1 S h i r I e e 7 r� c i s en g, /ay y T - r g "J, R 1 1 W F0 w n - - - �-+. Cro; X <f&Lt n +\4 Pl'. p c�U - 1037 -3o = l Parcel Identification Number (PIN) bed i (� O f' o� This trt t � � S homestead property. f S C 7p n • (Is) (is not) 4 Cr C - 7 gg 7 qy 1 Together with all appurtenant rights, title and interests. Dated this 4 '-- day of l (SEAL) (SEAL) -- -- - Norl acs )"e- ye/`e / �, �•Z (SEAL) S ! e /� , 1 c�7 (SEAL) AUTHENTICATION ACKNOWL EDGME:NT Signature(s) — _ -- — State of Wisconsin, Ss. County. authenticated this day of Personally came before me this day of `Ttt Lt�.Cw 30el5 , the above named JrmAAI ? 4 r Sc 5h; r le ` re c.-- 77 TITLE: MEMBER STATE BAR OF WISCONSIN _ to (If not, me known to be the person -S who executed the foregoing authorized by §706.06, Wis. Slats.) InstruraTE and acknowledge the sa e. THIS INSTRUMENT WAS DRAFTED BY r - Notary Public, State of Wisconsin My coma / ssion is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not � 'L .was! —_ •) 1� necessary.) � tL — — -- — Names of persons signing in any capacity must be typed or printed below [helr signature. ( STATE BAR Of WISCONSIN Wisconsin Legal Blank Co.. Inc. QUITCLAIM DEED FORM No- 3 - 1998 Milwaukee. Wis. • 1� 78879'9 VOL 19 PAGE 4942 KATHLEEB H. NALSH REGISTER OF DEEDS ST. CROIX CO. YI RECEIVED FOR kECORD 03/04/2005 09:30AM CERTIFIED SURVEY MAP CERTIFIED SURVEY MAP LOCATED IN THE NW 1/4 OF THE SE 1/4 OF SECTION 8, COPY FEE: T28N, R 19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONS ES : 3 SECTION 8� 1 LEGEND T28N, R 19 W L O T �, C. S.II /I. I COUNTY SECTION CORNER I CA MONUMEp�ALUMINUM i I I VOLUME 17 PAGE 4526 I 1 1/4" x 18" IRON I – I 0 PIPE WEIGHING 1.680/ I LINEAR FOOT. SET. - --�E– EXISTING FENCE. I I BENCH MARKS: ® SOIL BORING PERFORMED BM#1 -TOP OF 1 1/4" B1 BY MARY JO HOLLISTER I RON P I PE N JULY 12. 2004. OI I I ao� I ELEVATION-894.12 CvI I I i c) (NGVD29) - BUILDING SETBACK LINE. I­_ 1 ( / I ' 9 1 I BM/2 -4 SPIKE IN THE .............. DRAINAGE EASEMENT I NORT FENCEPOST SIDE OF BOUNDARY. J I v ( i ( ELEVATION - 904.50 PREVIOUSLY RECORDED (NGVD29) (R- J INFORMATION. INTERMITTENT STREAM. UNPL A T TED LAND I Jx- FlI{Jx - - - - - - - - NOTES: 1. ALL IRON PIPE (FOUND BM# 1 OR SET) ARE DI MENS 1 ONED 8• • 1 40 . ,. . 45' 3.441 AS OUTSIDE DIAMETER. 46.74' 275.71' b 2. MINIMUM LOW BUILDING 100 -YEAR OPENING FOR HABITABLE I I I HIGH WATER .� STR - 892.0. / I N ELEVATION-890.0 _ 3. NET BUILDABLE AREA 50' -1.346 ACRES. I I I DRAINAGE ;g A I 10 3 I tEASEMENT 1N I D I NI 1 �, j _ r of LOT � �� I LOT 2 62 J I J 3.502 ACRES W I o �:' I I I ,� I �) 152.530 S.F. I v$ o I v �I 3 TOWN ROAD 83 , m o( I RIGHT -o F -WAY ' . Q I - -— J J I 3.000 ACRES 81 I g I o SU r I $ ! EXCLUDING F I ~ II ;Z I V_E - _ 1 Z I Z I RIGHT-OF-WAY DR WAY • • I 150' r �" , 1 k � I o 03 �� .,'�,,�" I so• SCALE. IN FEET 4 jI `II I I of �. L - - -J �I I I � I I •' � / / I 44.6 . • • 32.65' 2712 38 69' 0 50 100 200 g , W 315. 6' BM #2 POINT OF BEGINNING W I I/ I II o I UNPL A T TED L A ND JA D. FLKINS S -2246 JOB #04 -2724 O I ' RE STEREO LAND SURVEYOR Zt OGDEN ENGINEERIN C OMPANY I I I 2 AND WN E FEYEREISEN RIVER FALLS. WISCONSIN 54 MAN 022 429 TOWNSVALLEY � I �• I HUDSON. WISCONSIN 540116 DATE: JULY 1. 2004 S 1/4 CORNER I I i REVISED: DECEMBER 1, 2004 SECTION 8 REVISED: JANUARY 20, 2005 T28N. R19W THIS INSTRUMENT DRAFTED BY DANIEL P. KUGEL PAGE 1 OF 3 Vol 19 Page 4942 � 5 ��. a p °F d ti 0. 0 n j h N � pp O i ,�C I I �L I I I � I d Z C LL O 3 d a � � I Z w E ° o ro z a m I E z v o Z O lL N U) ~ W O c E N I I � a .� N a CY N N N N n o Z 0 Z d E N .. y d AI L a E` N �o Z 0 - > ow = 555 a � I •N =aaa a m o ai w o 0 M J U � N Z m 0 � 0 I O _ m c Z H C5 N Q M m Q in �o I � H H p A7 p N O N Lo t, H C"! X O` >, M O N Y O • 0 �' O F- U- � O 2 Z r \ CC #6 n 0) a E 2 c 3 _1 A c iOinci , ^ Pol -Ihe PL-122 Effluent Filter System Page lmf 2 DL OXV "! n c. ' � About Polykk VVhmVs New P*adocxm Product Resources Interesting Links Contact Us Site Map NEW � The PL-122 Effluent Filter System Adaptef PL'122Test rRuU8ecily polybk'a new Effluent Filter io constructed with (o|hme'hl(i) 1/1 6th inch fi� |�tionslots that will stop all solids urhnu»(ndip4` ` greater than 1/1 6th inch. This design, although not PL122 Effluent Filter new tn the filter industry, prov the best design for septic effluent filtration. With our new patented filter, wo provide more 1/16thfi|traUnn area than any other |tor.including �|traUonslots on the top Com��cnom�� of the filter element. housing, nwFNpr tM to buy, - A Has M own gas deflector. AV * Provides double the area oomr "NEW Swkd/ TOP MEW Vm units of similar size. Over 12 linear feet of1/10th inch filter n Ali Pohlok Fili,m which � Umf u, vx/a.mmmov � � significantly ---__~__ between cleanings. * Has o flow control ball that ohu the flow nf effluent when the fill md`Uh '' -- removed for cleaning. The oopi system will function withou replacing the filter. Therefore, r need to pump the tank to clean NSE * Has iCaown gas doOo�o,baU which allows the effluent boant the filter from the sides, deflect --- the solids awa * A built in passive warning oyob alerting t homeowner ofpote problems months in advance u filter matures. Kis modular; allowing you hu increase your filtration area by snapping two or more filters together. BOTTOM MEIN * Easy \n install on new tanks, or retrof in existing systems. * No gluing of tees or pipe, no extra parts bobuy. • Has the ability to adapt to either the septic tank wall, the cast in Baffle vem • Comes complete with it's own housing that will accept extension pipes for deeper liquid levels. * No support system needed with multi filter use. b1bp 4/8/2005