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Home My WebLink About040-1306-36-000 0 2 0 ■ -0 0 2 K \ 2 m ID f) �I7 k 0 ƒ ( o / 0 m £ \ / $ 2 q �. / E $ E ( « / / [ m ? - / � \ \ \ / - - > \ / \ § ° 8 ƒ @ m / $ } K & Co / 2 ® ( - / (D -4 ( / > / � / \ \ G E m ® \ k C a = \ § [ § E CD :3 § 0 o o k rr § 2 w « g § w (A � e / § \ cr o § _ > { � 9 CD ( k 2 § \ § SN . / > ? £ ( g c S I / (n 0 ƒ § @ 2 & Or o � [ 3 E / 7 / w ■ } /§R � i� ®d = co 'D m m _ � ? \ / \ f \ � En =gmm=E=+m> - r-4 0 M ( =§k§+gE %Ak E� =� (a = / /d) Sr "kk a ch /gym 0 % o0 m-j— 3 §kƒƒ /a \ <(D 6 * E I @ ƒgm30 CLk/ a R;, \ \ #c =,� - ®a(n !E�%E[)=�� \ \ � \ / §§ \ \k� k 0 CD(n 00) Cm = w c � E 0 o @�, E : E P � < \ �_ E \ K i k \ � � \ i % Wlsconsi:DepartmentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix Sa4ty and Bu''Jing Division INSPECTION REPORT Sanitary Permit No: 487921 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: Van g, Anthony Troy, Town of 040 - 1306 -36 -000 CST BM Elev: I Insp. BM Elev: I BM Description: Section/Town /Range /Map No: [M .O CS 0 ( 08.28.19.1863 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W ( 6; 12. �;t Benchmark CJ� , Dosing Alt. BM �•� o 2•� r Aeration Bldg. Sewer U 7 O'• �/ Holding St/Ht Inlet ;Z. c / /Z) q�•fo0 t l TANK SETBACK INFORMATION St/Ht Outlet �' / �f • 3b TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic —1 + Z l Dt Bottom Dosing Header /Man. Q f • 3Z/ Aeration Dist. Pipe (( Holding Bot. System �. � p PUMP /SIPHON INFORMATION Final Grade 1 01. 0m , Manufacturer Demand St Cover qs M 11 Model Numb q b•o TDH Lift riction Loss System Head TDH Ft loz.l Force mai Length Dia. Dist. to Well S ABSORPTION SYSTE ra�tt.� TRENC Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. 77� DIM S 7 O �, ( 3 ) L SETBACK SYST TO P/L JBILD G WELL LAKE /STREAM LEACHING Me INFORMATION r CHAMBER OR ` Type Of ?m: ' $ r 1 3 1 I -X — UNIT Model Num er: -tL DISTRIBUTION SYSTEM S 7 Header/ anifold �� Distribu ion x Hole Size x Hole Spacing Vent to Air Intake Length Dia Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of x xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 1 Yes No Yes _I No COMMENT t- cjygle cod d's epencies, persons present, etc.) Inspection #1: Na . B �-� � Inspection #2: �— 2 kp_'S w,(�.0 L Location: 407 4ordyn Lane Hudson, WI 54016 (S 1/4 NE 1/4 8 T28N R19W) 08.28.19.1863 1.) Alt BM Description = TAP , t W ' � 2.) Bldg sewer length = 2 1 f • 3% f t IZ I •`�� N� " 9g �� 1 amount of cover = /$ "{-. L $d C — ° Ia •� ex L #' (_ Pia revisi N n e u Use Side q I inal mma ti `"' -- - -- � f-� Date spcto - - - -1 - -- — -- - Iners Signature Cart. No. Safety and Buildings Division County -� ; �t.� 201 W. Washington Ave., P.O. Box 7162 6 7 — . s in Madison, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.) Department of mmerce (608) 266 -3151 Z 'ta>ermit Application Stat Plan I.D. Number In a Gard wi Com 83.2 , is. Adm. Code, personal information you provide 1 . YfU1T. t. %UUi� Y may used secondary purposes Privacy law, sI5.04(1)(m) Project Address (if different than mailing address) �'Ir1G OFFICE pp (cation Information — Please Print All Information Znjqe!t_ IA Property Owner's Name Parcel # < 36Lot # Block # OVb_ 13D la` 000 G3 Property Owner's Mail in ddre Property Location //a / � U • ��"� %., �l -- yG, Section City State Zip Code Phone Number cl II. Type of B ding (check all that apply) 6 T N; R E o W CS O .SbtKr lor2 Family Dwelling— Number ofBedrooms Subdivision 1 ber ❑ Public/Commercial — Describe Use ❑ State Owned — Describe Use , t,,J J5* Villa a �ownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable oZ A. 944ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement n y Cher 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 appl K Non — Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Moun < tn. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ 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: Des' gp Flow (gpd) Design Soil Application Radsf) Dispersal wired (sf) Dis Area Proposed (Sf) System Elevatio i VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank �O '--- / 7t O / l Aerobic Treatment Unit OC Dosing Chamber VII. Responsibility Statement- I, the unde igned, assume resp nsibility for iliktallation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu is S' natu M MPRS Number Business Phone Number s a Q3 5 7 7�s - a6 8 Plumbers Address (Street, City, State, Zip d VIII. n JDe artment Use Onl pproved Sanitary Permit Fee (includes Groundwater Date I sued Issuin gent Signat (No mps) Surcharge Fee) iven Reason for enial IX. Conditions of Approval /Reasons for Disapproval L *Work datstlt o tltd P1111" prOVIdN 2 M tts&salk te**wrwft must be tttsli t its r W applod'tls Clods atdttrtcss. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) I I Ns ti1MS Nq Ir/'1� Md1111t1q Yd bob" nmq Strif"4~ MR Nr bK is*ve fl sd saum sklrlmvLq tl 1 2 A - i NA I 06~4 no aboa Oft* AW go go A 0 T- 3 laso a t� 83 7= ` ja kr 1 A-- Wisconsin Department of C ommerce S OIL EVALUATION REPORT .Qjvision of Safety and Buik ings Page of MAR 0in2'CW wi h Comm 85, Wis. Adm. Code Attach complete site pi on p r I t� County include, but not limited t verti F U �J,112 x 1 inches in size. Plan must S 1 Cam ) rn erenc percent slope, scale or point (Bh1), direction arsd d J to nearest road. Parcel I.D. on and distance Please print all information. R e vi k ed by ''Date Personal information you provide may be used for secondary purposes (Privacy Law, s, 15.04,(1) (m)). Property Owner P ZZ� Pr e o Location 1/.4.N�1/4'S �• T Z� N R �� E (o{ W Property Owner s Mailing Address Lot # Bbd. Name or CSM# ews City State Zip Code Phone Number V l �� LC City ❑Village Town Nearest Road New Construction Use: ® Residential / Number of bedrooms - Code derived design flow rate U S Q - Ub. GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material G Lie) } L ��,� Flood Plain elevation if applicable General comments ft and recommendations: fi=t L`nZ s4`Tv (Z L� �o`7�fiU C)t=- LQ�-LS Tp QL� �-1�N ��H S r --- -- �_ Boring # ❑ Boring ® pit Ground surface elev. C Z • `J ft. Depth to limiting factor `� Z in'. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil A GPD /ftzn Rate in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 s ? b I { a Boring # ❑ Boring ® pit Ground surface eiev. C)6- ft. Depth to limiting factor ' 0 in. Soil Application Rate i Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. S4. Sh. 'Eff#1 I *E ft Z ►>? s 2 h� c 1.,� I z - F , s . 3 Z , z_ao Yl Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L . CST Name (Please Prin_ t) S ' -A L: tdegerer 04 'f 0 . 3 ,.1S —3� CS Number Address g 220254 W e e r e r Soil i l T e s t i n ff & Design S e r v i c e Date Evaluation Conducted Telephone Number 421 i1. Main St. River Falls, FII 54022 \`Z -Z�Z_O 715 -425 -0165 Property Owner `� U ( 7�-- Parcel ID # 1 flJ C 7 Page of a Boring # ❑ Boring ® pit Ground surface elev. - 1: 1 1- 4 - o ft. Depth to limiting factor 7 Ot Z I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil A GPD Eton Rate In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 •Eff #2 1 V4 R 3 11 - L Z►�s b I wt `F�- c i,v -Z � , s . g Z ly _Z1 I0'-t R 3J 6 L 2 S m ft- CS 1 � • S - $ • 10 ]z V/6 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Soil Application Rate Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftx in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in, Horizon Depth Dominant Color Soil Application Rate Redox Description Texture Structure Consistence Boundary Roots GPD /ft= In. Munsell 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 Tlie Department of Commerce is an equal opportunity service rovider and employer. nployer. If you need assistance need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 services or SB"330 (R.6/00) Property Owner M L`V N "L () 1 7 �� Parcel ID # t '��`]) fv (S P age # E] Boring Page ' of � ® pit Ground surface elev. ft. Depth to limiting factor '7 ck Z In. Soll Applloalion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ill In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. • Eff#1 •Eff #2 -1 V � OK IZ 3 13 L. Z hViS b k 10`-1 R 316 — �, Z w/ I-c 3 Zg o'l 1Z V/6 o S 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 /fl 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. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil A GPD /ft n Rate in. Munsell 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 Tlic 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. SBD•8330 (W6/00) Wisconsin Department of Commerce SOIL EVALUATION REPO Division of Safety and Buildings Pace of in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan 2 must County C, include, but not limited to: vertical and horizontal reference point (EM), direction and 5 l percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. Reviewed by Personal information you provide may be used fcr secondary ate / pur^oses (Privacy Law, s, 15.04 (1) (m)). Property Owner _ Property Lecaticn t J I Sb`} N R 1/.4.N�1/4S Z� Property Owner's Mailing Address T E (cr W 3 3 Lot # Blccic o # Subd. Name or CSM#t P . �� 3 � City State Zip Code Phcne Number �N L� ❑ City ❑ Village Tcwn Nearest Road Lr 22 New Construction Use: 3 Residential / Number of bedrooms Code derived design flow rate ❑ Replacement ❑ Public or commercial - Describe: GrG Parent material G l—\AC) % I CIN Flood Plain e!evation if applicable (� !`1 General comments ft and recommendations: Z l"J }-) LIZ ��U IZ ��;--;`� Lf• =qr,�t o ., LS '3 L` M ►� C Boring # ❑ Boring ® Pit Ground surface elev. -2 Z • `J ft. i Depth to limiting factor in. Horizon Depth Dominant Ce1cr Red Seil Application Rave ox Descripucn Texture Struc.ure Consistence Boundary I Rects GPD /ftz �n• Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. I •E,#2 VZ 38 1 1 ? �� 1 I � I El Boring # ❑ Boring ® Pit Ground surface elev. C) • O ft, Depth to limiting factor 7 o D in. Horizon Depth Dominant Color Redex Desc�ption Textu Boundary Roots Sod A pplicatio n Munsell Cu. Sz. Cont. Color Rate in• •Eff #1 •Eff>r2 a _� Z Z 1� _q 0 I J ' Effluent #1 = BOD > 30 _< 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 CST Name (Please Print) - s _ mg/L and TSS < 30 mg/L -A'rthur L: JWegerer S' nature CST Number Address d`• • � 3 Z.) S- 3 6 220254 W e g e r e r Soil Testing & Design Service Date Evaluation conduced Telephone Number 421 N. Hain St. River ra11s, UI 54022 �2 -ZZ_U� 715 -425 -0165 PLOT PLA.d Page 3 of 3 Scale 1' „ J Q i • 50/0 r U 0' I I - -- a� .1 �Z -ZZ.u 715- 425 -0165 220254- 03- Z 1S -36 CST Signature Date Telephone ado. CST No. Job NO. ,N a, - q7. 31io r �0 T-- 3 = �o 13 IJ50 -� IT a 0 B - 3 r 9os 9Y 3 : 1� �o2v ��s� ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer An+hmg Va Mailing Address 6 Aj 6 U Property Address d (Verification required fro fanning Department for new construction.) City /State Parcel Identification Number 0 Vb /3a 4 — n o n LEGAL DESCRIPTION Property Location y, y. ,Sec. , T ,2j�_ R_Z 9 W, Town of _TA Subdivision ,Lot# Certified Survey Map # , Volume , Page # Warranty Deed # , Volume _4'2_�• Page # Q Spec house = yes ko Lot lines identifiable .' 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 County 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 Department Mthin 30 ays of the three year a ion date. SI NATURE O APPLICANT DATE OWNER CERTIFICATION I / we cetti that all statements on this form true to the best of my/our knowledge. I /we am/are the owner(s) of the property descri above virtue of a warranty d e recorde n Register of Deeds Office. SIGNATURE OF PLICANT —� DATE Any information that is misrepresented may resu the sanitary permit being revoked by the Zoning Department. ;'•• *• Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. . U, 2883 P 109 8QA56E1n KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO.. MI RECEIVED FOR RECORD Document Number Document Name 09/8712085 09:50AN WARRANTY DEED EXEMPT # THIS DEED, made between B & L Land Development, Inc., a Wisconsin Corporation REC FEE: 11.00 TRANS FEE: 299.70 ( "Grantor," whether one or more), COPY FEE: and Anthony C. Vang, CC FEE: 1 ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Lot 36, Plat of Sunset View Development in the Town of Troy, St. Croix County, Wisconsin. RVAT 2683517 040 -1306- 36-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated August 25y: 2005 (SEA4'& (SEAL) * 4LLand Development, Inc. (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF Wisconsin ) ss. St. Croix COUNTY ) TITLE: MEMBER STATE BAR 0� � Personally came before me on August , 2005 (If not, 1► _ .. S the above -named B & L Land Development, Inc., a Wisconsin authorized by Wis. Stat C orporaflon to me wn to be the person(s) who exec ted the foregoing THIS INSTRUMENT DRAFTI Y'Z - - ,Z ins / �t and acknowledged the sam . co Z Attorney Kristina O land P U a .. A!7 ) "A.1 A Hudson, WI 54016 N Q�_ ' ' ' ��` " Connie M. Gullixson Or T� Notary Public, State of Wisconsin My Commission (is permanent) (expires. — ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 • Type name below signatures. INFO-PRO— Legal Forms 800- 655.2021 www.intoprolbrms.com �I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity � t� a l ❑ NA Permit # Septic Tank Manufacturer , ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 01 ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 1 4 — sas ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ NA Estimated flow (average) J V 6 al /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) ZOL -0 gal /day Pump Manufacturer ❑ NA Soil Application Rate ♦ 7 gal/day/ft 2 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 lZIn- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ 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: ❑ month(s) (Maximum 3 years) ❑ NA year(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ months) (Maximum 3 years) ❑ NA years) Clean effluent filter At least once every: ❑ month(s) ❑ NA 'V year(s) 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: ❑ month(s) ❑ NA ❑ year(s) 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 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 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. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone _ a 9 ys Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone _ 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. LLI ,6l'L , VC 3 „JO,9Z.00 N / r - - - -J °'° I Lo w o I Z O j� / 0 I ` I� g / S 00'00'04 "E 230.25' N Z o I 0 u I0 N p - - - -� -(0 33'133, O I O� � m I w I ----- - - - - -J � �. I of Q N d O ,OZ'/-t C 3 „SC,CZ.00 N Z � C-i --- - - - - -- v� / CD� Q ^ m in z ° `� I� Lri o C\2 CCDV in 00 r=, 0. TO M p d �� O ?�O 5 / I o \ O M o / Z 1 s N - 0 C\2 C14 ,gF' OS Q 1 �� w I s O N s �� ”, O B ;� � I I ti o N —� _ � iv ur) LO ► O / � 09'47 159.98' o REC. AS N00'05'30 "W 12 4 a? U in rn I U 0 00 � o � N u7: -� Cv r o r C•Q ci 1 N I O C C 2 CO p /! O O � _ M i• I N I �� O I� I � i' � M � M ma a o I w I O I I to � M r / � k wo 0) w J N " �[ W , co O 1[1 to o : c0 O 1 O Z W 6" D M Z ~j 1' PO z g N` 6 3 : j I N v) Go 0 U 185.15 205 . 17 /y....... n ... 1 � cU ui N W37 42 561.83' 4J' N = S _QUARTER LINE_ 2798 I I UNPLATTED LANDS` ` n LOt 5 U (.££ iS£ PLOT PLA Paae of ? t Scale 1' w O . I i i I i )Pi L 1S' i X1 0 V0 I — LG i - - - _ - 715-425-0165 220254. v3- ZlS -3� CST Signature Date Telephone No. CST No. Job NO. Parcel #: 040 - 1306 -36 -000 10/04/2005 11:39 AM PAGE 1 OF 1 Alt. Parcel #: 08.28.19.1863 040 - TOWN OF TROY Current ' 1 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/17/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner ANTHONY C VANG O - VANG, ANTHONY C 9853 WYNSTONE CT WOODBURY MN 55125 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 407 JORDYN LN SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.210 Plat: 10/09- SUNSET VIEW DEV 040/04 LOTS 1/37 SEC 8 T28N R19W PT SW NE BEING SUNSET Block/Condo Bldg: LOT 36 VIEW DEVELOPMENT ('04) LOT 36 (1.210AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 08- 28N -19W SW NE Notes: Parcel History: Date Doc # Vol /Page Type 09/07/2005 805665 2883/109 WD 06/17/2004 766198 10/09 PLAT 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/06/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.210 80,000 0 80,000 NO Totals for 2005: General Property 1.210 80,000 0 80,000 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 ��,�� _ i�� ' I