The URL can be used to link to this page

Home My WebLink About040-1304-18-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No: 463350 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: Village X Township Parcel Tax No: City Zehm, Mike Troy, Town of 040 - 1304 -18 -000 CST BM Elev: Insp. BM Elev: BM Descriptions Section/Town /Range /Map No: i 08.28.19.1824 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W 3a 'r Benchmark (z f bb 8 9r0 q W 98r Dosing � ^ Alt. BM (� - Vrvlek 7.3 96 3.a Aeration Bldg. Sewer 1.1� Holding St/Ht Inlet j6-6 q00 , n°1 TANK SETBACK INFORMATION St/Ht Outlet /6 -- F9 c , TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 15 1 7 33 , 33 i Dt Bottom �7 ro g .O Dosing Header /Man. t 1 . 3. 1 4 797 • P Aeration Dist. Pipe t t. apt q g 4 117 Z ( Holding Bot. System / Final Grade 1� (�. J PU /SIPHON INFORMA — T _ R• D `fin Co Manufacturer Demand St Cover M q63 . 3 Model Number 3.—� Sc� TDH Lift Friction Loss System Head T Ft /�• 0� � 0 1 Forcemain ength Di Dist. to well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length // No. Of Trench_e1 PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 qZ Z I levI cLak. � SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: _ .//�� CHAMBER OR .J.r�'r INFORMATION Type Of System r ' i UNIT Model Number: S �" I /U � v �a� DISTRIBUTION SYSTEM 7_3 cac, A RD • -, Header /Manifold i/ Distribution x Hole Size x Hole Spacing Veto Wa ke 1 p , Pipe(s) N____ Dd-I�. c5 Length 1 Dia r 1 1-ength Dia Spacing �D 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 5 . 5 Bedlrrench Edges ` Topsoil \ \ Yes [W No Yes [ $'l No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 446 Sunrise Ci rcle Hudson, WI 54016 (NE 1/4 SW 1/4 8 T28N R19W) Sunset Valley Lot 18 Parcel No: 08.28.19.1824 1.) Alt BM Description = ' v r°� <5Z G JeA'5 2.) Bldg sewer length = q;r - amount of cover Plan revision Required? 1 Yes Use other side for additional information. Date Insepctor's Sign re Cart. No. SBD -6710 (R.3/97) r ' Safety a6lBuildings Division County 201 W, Washington Ave ;T:{3: 162 �f 0 /� � cons Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 3 � �' St, e Plan I.D. Number Sanitary Permit APPlicati n - In accord with Comm 83.21, Wis. Adm. Coda, personal informal n you ovide ' may be used for secondary purposes Privacy Law, s15.0 1)(m):i� ' , '- .. Pr ect Address (if different than mailing address) I I. Application Information - Please Print All Information 5l 2 1 Parcel ��u �n C! -C ZOt;[_ Property Owner's Na me k Lot k 8 Block N Property Owner's M ailing Address Property Locati l 8 J LA A 1/ 5 ,Section City, State Zip Code Phone Number D V f a CV l �U l �(� J'70 T z t� N; R E or � II. Type of Building (check all that apply) �/L� �J, >s CSM Number 6r*" t 6"'L Subdivision Name 2 1 or 2 Family Dwelling - Number of Bedrooms ❑ Public /Connmercial - Describe Use u r0 S e* - V e ❑ State Owned - Describe Use - ❑Cit ❑Village IL1Townsin of 2 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A" New System p y' ❑ Replacement S ❑ Treamneht / Hold ing Tank Replacement Only ❑ Other Modification to Existing System B. El Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T e of POWTS S stem: (Check all that appl T; IN Non - Press In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized n - Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Leaching Chamber ❑ Drip Line - avel - lest ipe Other (explain) V. Dispersal/Treatment Area Infor cation: Desi n Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Disper al ¢3e�, Iro ° sed (so System Elevation q7 S �g �� aw � j re K 5� IA 0 b 7.0 VI. Tank Info Capacity in Total Number Manufacture Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank, Aerobic Treatment Unit 1 l Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gn MP /?d1b TNumber Business Phone Number R 0 6,� N�c yo,✓ atui � Z ,6 9 7 7/s a - 7 Plumber's Addre ss (Street, City, State, Zip C ) s�C, VII Count Department Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued ssuing A nt Signatur tamps) Surcharge Fee) f �� d ❑ Owner Given Reason for Denial Y7 , i ( (y 0 IX. Conditions of Approval/ ons r tsappoval YSTEM OWNER: L�� - Mud,? 1 Septic tank, effluent I ter and�f" dispersal cell must all be serviced ! maintatti�d as per management plan provided by plumber 2. ' setback requirements must be mainlined —�/ // -- as per applicable code /ordinances. 3 C�LuQG b�-S�c� Attach complete plans (to the County only) fat the system p er t less that x Ph t s'ze ?/ <i J4, SBD -6398 (R. 01/03) PL bf PLAN 5 N 3 ..t AC`, � a A(A-6� o 17/ 9� 0 v Y o�tc 11�.c vu LL. PL6f PLAAJ J0 2 ' �� a� oP vk P P 1 zz P(o A IT y ti L VA r LL I A Lk f4 CONVENTIONAL SYSTEM CROSS SECTION NO SCALE IV �6a t 12" COVER 12" COVER 12" COVER i - J' • ..:.: + .: ... .... 1 ....: .... .., .£a,. .x: : : . ...:.... .....:" :a: •.� l e>1.,1,`;': : :,'7 .z 11 .......k. „ I ...,. .c. :.1. , ..:.:.:{.. J�... ..k 1,.. ... .k {a„ 1 i ......l,l..l }t..:1.. ,•1'; .r. .4.,. ..t ... ,, ...... . t ..:. • , r .. <:...:!...' .... :.J..... ,. .. . :;• , •c�:: • .t, a.', �. k e.'i:� . :H, ... ,ks£ .. .... :.. I .....+, ...: 2. ... ...:. :,. .,... .: v. !. ,.. .s:: :.':v ., 1 :):i + :: ";4 ,,!.s' f,,.., ,. .., .E• <. , L .. . ..:.N . ..... .......let, ... .. zt: ! 1,. ,.. ... , ...,... ,,,,:' , 5.. ,J • . ,i 1. ,d, l F. • 41, ti• .+.• ; , : .;;:;,.i s .. #,:.;.; �.::: ...:. , :.. ,, 1, ., i, ....!. .....: ..... .: L..,:. .'••:r•':;: , . :;.� .{.!J %1 I•, !i�: 1. J: ' ?i�i . 41 , , ..., ..r4<,...., I. ....3 .q « }, ,. i...... .:,..� . I , ..a.. ... .. s .. . , ... .. d , '2. :.,4i� ::: ,,��'• ....1 + ,WI, .... r:,l i ... .. .. ... ....: , 1 ..+ , . .�♦. .. I. , .... 4 1 ....:+ i. ... �:. ;: . :1;' Ar.��i:i:� :r; l,�'..1.:':'::.:'}.: :�,�: ).�l ..�.,. .S .........: . .. :.. V. I, 1 . t 1. ,:. .x:'..: !:.�: J:J. ' .Ili: ' I . !.: 1•'.'.: 1 ...on. , ., ... , :L .,.... £ .: „J II .. + , }...,... ..: i .,.,., ..4:. ,,., ..... > : ,. .,:�;,,..:... { .. Si'!;: Jr:A• ,!.1 . c i:i'; � :W,i . ++.. . I 1 ...:.. ........:.w. l .. , . ,..�:..1 . ....:. , . .. . . ... ...:.. .. :.rc ..:: ,. , ! I: o ,. �il.e. ! � :5' <'; ,V :ls +:::. ,1 l CI�''•�`<c,. ,;,i •• l: ,.. .:: .:; <:nL,1..,. .... ...0 ,.1 .xv .!t1.J1I , ::.a .. ...: ,: ,A: .1 :.. •'. .. ,. ,k:1J.. 1•:::•.. .,:I�i �l'�`.::.'.. .. ii j:t "tl „ '. (i;': :o; ,. , , k,l..:nI t Ih : . N..., ..,, k u ;.. 1 ^ •yk : ..: , }. �li !.4.. ':}f ,.t ,, ..: .,..,e... ,. , 3•...: i l ,....,. . ,.. .... U .,,.,..:. ..1 ..,..I ,..... r: t .. ..:.:..:. . 'r:: ` .J ,. i;i: r•. uie'i1( :: , .J. ;` .',•itJ.�;iil I...... 1.. ,. ..II...... ,,.... ,,..,. : .. , ,;.:�; �;:�;, ;.4•,11 ;a..,.,. :: ...,•L:`,.,....' ;if1 ^ i!i” ,��:; ui� .a.• ' ^4 };:�., :. (L L ..k .. .. ,::) ... .. ........ :: , ,.......:.. ., ,. .....+ ..... . ,..., ..,.:.. :�.. 1 .,, .....:.. .. .,..4.:.. .z •t .1. ... .... v ,...... �J+.: .... .. > -: s . ..... ..:.....1., ;:1 .kl: zx!t: g '..fi.:: i:: �. .....1,: . � ..1...::. 1 , t. .t .. ... ..... r ,.... .. ..� ..... ' ..Yi':.. ::.1!'44'•.: .,t'ii��i��i`....;.;.' �.H .,.1•i:'..:': .IIL, b . 'l 11. l I ...t.t. .. ..+: k:.,.. ::�, .... ... .. ICI .,. .t :d .! : ,.1.�.. :Iv ,.,.,...... E. ;.•,.;, ,.....:. <...l:k.. 4} .... •• ..�M; ..1 ......... ... .r..l i.. ,......:. .. ,,, .1 1 • .,:� 1P• L.J. "I, . . .,. 1. : ...., ,.. 1I ...... F... .. .... J . r. .. k`: ,....: :.• : .H,: N'i.. '. ,;I, �.Fn . ..... ., >.:... ....::4. ., . l ..:. r , .. ... r.., .. ....: ......... ..}... .., . , i•r .:L I +:Ia.; �,., „rlr;:: ,! :� }::'::��! li ll ...,..... ,. �,n,.a ........ .. i , 1 ....... ..., � , ....... �...� .. .... � r,l I :.. S Y .....::.. ...: ,l ..:.: �:i��! ' <li� �'. i'j rl•, %:i' `:4:'��I� "� �.. n .. ....r r .... .. .1.1.. .: ,..t. � ...: ,.: ....... ..... ..1 „,.,........ .� liif� ,.G'. t`, ".c a > .a•,.. .�. . „ , .....,.,. ni •,. ...: .i..l s.r, .. ..... ��.L. ...... ,. I I ... x, . .!l .... :.t;,,,.. _ li'. � 'r : a.h .. :.. .. ...:.:L ,...., .. ..:, ,.. ..... .... ,:,, 1, ....:,...: :.,, .... .. ..... 1., .iii'. �'; �`;.•; y {h :'.�•�;iiss'�;I I,...:, ) :J�`ii. ......:: 1,,1..,... ..ea.J;J":11 ...........: .�r ...,.......:.,.,,• ....�. ,I,.1 :..., . {'t: "1'. I'I'f I ..... .. ..... ..:: ..... ..., . , , : ... ..,... . S .. I � 4, .... ..:: ..,•, .,.:!: .., , .. .J...i t .. r.� . t. ..... >, 1 to ,:.... ... ..:... ..,. • 'ii;' "li `I : I i ELEVATION T1 6 " 97, 5 IN SITU SOIL T2 3`7 _I ' T4 7 i QUICK 4 STANDARD INFILTRATOR DIMENSIONS: HEIGHT 12" LAYING LENGTH 40” WIDTH 34" i I I RECEIVED_ WisoonsinDepartmentof Comm rce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings i J r1lcc""Con* 85, Wit. Adm. Code Attach complete site plan on per��Q� �1 in size. Plan must County ST. CROIX include, but not limited to: %ti I a dd _ point ( M), diredi and Parcel I.D. (Pendin ) percent slope, scale or dimens' ns no i to _ �� j Please print all information. _ e Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ' S( 0 Property Owner Property Location u [D ARTHM & MARIYLN FEYEREISEN Govt. Lot -- W 1/4 SW 1/4 s 8 T 28 N R 19 E (or) W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 420 Townsvalley Road 18 -- Sunset Valley GAY State Zip Code Phone Number ocity Vllage Town Nearest Road Hudson, WI 1 540I6 1 ( 71) 386 - 2122 Townsvalley Road 0 New Construdion Usejq Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD ® Replacement ❑ Public or commercial - Describe: Parent material outwash/sandstone Flood Plain elevation if applicable NA ft and re General re co m mendations: Conventional In -g r ound trenches - to be designed b installer and recommendations: Sr Sn Y PB - ring # ❑ Boring Q Pit Ground surface elev. 901.53 ft. Depth to limiting factor >1 12 in. Sal Application Rate 'nMion Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0 -5 10YR2/2 - 1 3f -lsbk mvfr ab 3vf-m 0.6 0.8 2 5 -19 IOYR2/2 - I 2f -mabk mfr ci 2vf-m 0.6 0.8 3 19 -27 10YR3/4 - I 2f-mabk mfr cs 2vf-m 0.6 0.8 4 27 -33 10YR3/6 - sl 2f-msbk dsh aw 2vf-m 0.6 1.0 5 33 -50 1OYR3/6 - s Osg dl ab 2vf-m 0.7 1.6 6 5 I OYR3 /6 M 10YRN6 s sg Ml as - 0.5 1.0 7 60-112 10YR4/4 -� s Osg ml - - 0 1.6 0 Boring a Boring # 902.7 > 102 Pit Ground surface elev. ft. Depth to limiting factor in. Sort Application Rate Horizon Depth Dominant Colo Redox Description Texture Stnictm Consistence Boundary Roots GPD/FP in. Munsell Qu. Sz. Cont. Color Gr. Sh. " Eff#1 'Eff#2 d to 1 0-5 10YR2 /2 - sl 3fabk ds cb 3vf-m 0.6 1.0 2 5 -17 10YR2/2 - I 2f -msbk ds ci 2vf-m 0.6 0.8 3 17 -26 10YR3/3 - I 2fsbk dsh cs 2vf 0.6 0.8 26-40 IOYR3 /4 - sir 2fa&sbk dsh cs 2vf-m 0.6 0.8 5 40-49 10YR3/6 - Is Ifsbk ds cs Ivf -m 0.7 1.6 6 49 -54 I OYR3 /6 9 7 - (P p g Osg ml cs - 0.7 1.6 7 54-102 I OYR5 /4 - , 9 s i 0sg ml -- - 0.7 1.6 #1 = BOD, > 30 220 mg/L and TSS >30 < 1 * Effluent #2 = BOD < 30 mg/L and TSS < mglL CST Name (Please Print) i nature �/ C ST Number Ma Jo Hollister / V j &_ 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Fails, WI 54022 01 - 13 & 07 - 09 - 04 (715) 426 - 1775 MAR, 14. 2005 9:25AM MICHAEL, ZEHM. HOMES N0, 476 P. 2'� 1 :RELIPNT FIONES Ltd FAX N0. :715-381-9212 9 Mar. 13 2W5 07:54PM P2 MAR, 11 -160 . 5 9: 05AM MI 2ENM. 019 X0. P. 1 ST. CMUM (oTwff $BMerANK AND COOSRSW CERTMOWN FORM 09va,ed8ayec r w A- YC- C- l SE —j Z-110 IC Hll F L- Z �ErH M 1!tti:agwd�cs�s 3 G A /� /+? 6/t Duos o •✓ zv ciq�es�e �C dA.�n �� 4'a�+o�l L�poa I�ber h Tow•.s6r� z� � I.000tloo 6W _ /�h , SM t� _ L r �_ NA��II„ Town of �o (8 , uv low sg+oo Loare�yesl � Lt ye9 w�° a �]�lemadddrdtdai�Pew. pan 6�weta 1 �nd�st ai}er eoefememaea �M a�gMts�dolmltrre4rlboeeYOMe rsooe it' soda borasem ai.pmv v&mYmpd men - 1 cu saw tbs aotl 5t Ihn tgt� diq�ostl own jowjmmemoe � m spe Rd in d cb� R3.s U adis Cats 12 • sR Ceoc Comb► Swibea► Oend�.. �rapra�etgrowara�aes oa �tist, � C�*e�gpooig6Dep4�; � q'�ad b awn�imd bgra meemer. P p�see i�catied tbas (� opAEe w�stewat� dL studKdm �y � psi oP�aa eaodidoa � � edb: won wd ��eoe®Y�. sloe aepl4c �aae ie leap sben 1/3 �4, a1 wt � book=wor � me �bwa o�Ceotuoae��md� �o meiodnma p�l�e eev� �ooale�eEemte�, � - � aq�w� of Nsta:v is�ae� 6oee af �Tiocpt�. oEr� mots bd coam sad z ed eo Most. Cnk coimwznbg d� ��'i1'Y1lL GCa� SMA UR$ OF APPLMANT ! • l7AT '•'� Ohre as t�toII oo dtis em �aa tv the bat of'ffiyfour f iftD who the oruaw(s) attic pwpocW 'b� ba► vfetueoFew. oe�sq►aeedree�,��,�r + � G N.&TM pL�C,,- 3 1 J3 Iv -6' DATE ...«� �dncio�ep�ec,��D►eaodesMa �Oi� M.,� Room i go&' =' Wdepa2d*�a � at om" =d ..w arms carmaea.cmwmm if RECEIVED TIME MAR, 13. 10:16PM PRINT TIME MAR. 13. 10:19PM b . POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of Z FILE INFORMATION SYSTEM SPECIFICATIONS Owner �II�CY�ii�EL Z� Septic Tank Capacity f a l ❑ NA Permit # Septic Tank Manufacturer (,v� Ey ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units 9 NA Pump Tank Capacity a l ❑ NA Estimated flow (average) �Ur(� g al/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer ❑ NA Soil Application Rate p gal/day/ft' Pump Model ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit NA 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 to In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510` cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 2- 3 ❑ month(s) (Maximum 3 years) ❑ NA ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: Z, ❑ month(s) (Maximum 3 years) ❑ NA year(s) Clean effluent filter C &_b At least once every: 3 mo (ts (s ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: At least once every: 0 yea��s(s) ❑ NA Other: ❑ NA 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. GMW (4/01) Page Z of 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 replac 7Asuitable system: 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 ech ology a holding tank may be installed as a last resort to replace the failed POWTS. h ite as o bee aluated o entify a su' ble placement ar Upon failur a POWTS soil and site e atio ust be erfo med locat a suit a replace ant area If no r lace t area i le a h to ay be i talled a last as to repla failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Lit /Vttfo✓) Name Phone 15 - 2? 7 9(KK Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name 5 7 CAOIX -- e- Phone Phone 7, 3 gb_ G 5F This document was drafted in compliance with chapter Comm 83.22(2)(b)l1)(d) &(f► and 83.54(1), (2) & (3), Wisconsin Administrative Code. - `-MAR. 11. 2005" 3:36PM MICHAEL ZEHM. HOMES' ' N0, 471 P. 2 It. 5PAGE154 D EC 2 8 1995 F� 900 QliITCLArM DEED pgYEREISEN, his wife, hereby p ARTHUR N. FEVER -ISEN and MARILYN E. x gran and convey, to ARTHUR A LE T UST, MARILYN ll the real they EES OF TOE FEY)RESSEN REVOCABLE TRUST, ,i wn in St. Cr County leg all y described as: f the SW ,1 /4, the S 1/2 of the S 1/2 of th NSE /o o f The E 1/2 o r Section 8, the W 1/2 of the NW 1/4 of Section 16, the the NN 1/4 and the SE• 1/4 of the NE 1/4 of Section 17, all in Township 28 North, Rainge 19 West, fEE XCEPTING pants previously conveyed. EMPT p,�iTSUR N. FE SEN kT�LE �-j ER �ISEN STATE OF wISCONSIN) ACKNOWLEDGEMENT T. CROIX COUNTY ersonally came before me on December 28, 1995 the above - named .{ TOUR N. and MARILYN E. FRYBREISE11, to me known to be the per Ions who executed the foregoing instrument, and acknowledged the is same. Notary Public. Perma�lemt commission. �. Drafter: C. W. Malick, 413 Brookwood Dr., Hudson. Cr - a f h i ..a,f 1 .... "A I ' lid 17 r d. _ I L_ "� �I is � I•m_ � �i _ I a �• r.e 11 I I` g ": I (-- - - - --- — - - -- - - - - - -, - -- r�Tr - -- I I I I — I I I I 1 3 19 � * 7My I Ij � I I I I I I I� r'^awft ti -- -- ----- a- - ---. -.- I - - �. -.__.. -._. -- • _ w . -__.. - -� - r - -• 0 2005 Royal Oaks Dosign, lrlc 05 d �E � 'ON a dd S3WOH 'WH3Z '13dH0IWL zrWVb65 l l ='So0 dW: a 4 CAM , It !6 :.AA ='F--l- 1 3 A' 77, ........ ... ......................... . ........... ........... ........ .......................... ............... 'hi -n .?l 4 ................ -------- ... ...... el Q) L -14!-- D N. z :K le Al d.0 ..... ........ . . ......... -- I m a qq fill y` im LL -- — — — — — — — — I f7 al 'ON S3AOH'AH1Z'13VHDlA 06� I I 5002 '1 O VA ' ..A. -- w u �� ,o11 Tri. f n X41 1 n I mo " I� O 6 ' C ' •�� y.1.4 ON OI I Va V' tl I 'Y s � „ i p .... �i I a: � Lul _ k - n� Iu.• � - - Ir F m I I, 1 b � --• d , qua. M x I ; III R i }}{{ . _.. .... . ................ i ' 14 —__— I � :, I� � 1 1. A te- •� � --� - � . k . ...... ... �..I 3 r• ` R U G� � - � � • I I v 1 I I II 1 I II 1 I I I 1 I jl �I 1 � I I 1 I i I 11 R II 1 I I I I I I I 1 II I I I } I I II � I I 1 I I I it f I 1 I Ij 1 I I I �I I I I I I t V r I 1 I I 1 1 I I I 1 1 fi mow" I I I p eO �1 z� L d lD 'ON Wd00:Zl PHI VN r ,MAR. 11. 2005,, 3:36PM, MICHAEL, ZEHM. HOMES N0. 471 P. 3 9C'4 ;� z ' sca 10 �. " N 1/4 CORNER I I Pill SECT N 8 / I l — x y , T2 R 19 I SE= RESIDE DIAL , G ICU T 1 RED BRICK ADOI T /ON RE--R SI ENTIAL - -� - - - _ 900.4 x �. ' 14" E 13 Aj1 9 10.8 �T --WEST ON L l E L 257.66 .2 s 13. j 227 p 5 _0 Z N 1x G 910.8 LOT 19 o CD I ;� 0 0604 ACRES oo O1 2 6 • , f 6 ,875 S.F. rv_ ni 1 , 1 � AC S 50 I 1 65.4 S.F. I M .0- 1\ N 04 . 41 E 91 I I g t9 0. 0 S i a do 9 0 S �0 � �� x o C179) ` 7 6 A lp Gip orn ^ 91 . 1 r E =80' d' I \6,36S. S' / 0 B –P 1 `° R S ir_a�\ ` N 01 I • 00 87.04r w �Q 1 x N r- l op �9os.1 0 x \ �9s J� so o cn 7 p 00' x co I 1 C m 379 .F I � I • 1.570 ACRES S.F. J 5 I 1 13 71. 50 0' 2 .2 $ • 8:�a.� 256. 53' I