Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
040-1310-00-015
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety aid Building Division INSPECTION REPORT Sanitary Permit No: 506359 0 GEnRAL 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: Lid erdin , Gary I Troy, Town of 040 - 1310 -00 -015 CST BM Elev: Insp. BM Elev: BM Descrip Section/Town /Range /Map No: 1 '3� 1% 1 q 3 ( . Zg 17.28.19.2002 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. .Z Septic � Benchma k W �Z& 2 �h1 t ,o D. Dd Dosing � /•[ r Alt. BM �^ Aeration I Bldg. S S� �';���it,�� — ' 930 � Holding Ht Inlet .,(,,, 8• 93 st/ TANK SETB K IN RMATION - 73Y. TANK T L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ; ` i Dt Bottom �- 1 Dosing Header /Man. g 3.3 • � ? r�l�`•, r G / J ? J Aeration Dist. Pipe -�- 1 30• � Holding B ot. Sy stem / VS - 12 LF Final Grade l PUMP /SIPHON INFORMATION • 3 93 Y . 9 Manufacturer u Demand St i �K 2 • / G l �� ` t0 GPM Model Number I D ` 3 • S TDH Lift _ , jr i ' Loss System Head TDH Ft S Forcem r Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TR5NCH Width t Length No. Of Trenches PIT IMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 3 ' SETBACK SYSTEM TO P/ BLDG WELL LAKE /S EAM ACHING Manufactur r: 3 6 INFORMATION (EROR AMB Ty Of System: T ' _ ` . UNIT Model Number: >20 DISTRIBUTION SYSTEM ► V !�+ Header /Manifold Distribution 1 x Hole Size x Hole Spacin Vent to Air Intake liU Pipe(s) V; _ Length / i Length 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� ' ,S Bed /Trench Edges Topsoil Yes No Yes No j COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: W / 1 �/ a Inspection #2: / / Location: 489 Meadow Ridge Lane Hudson, WI 540 (NE - 1/4 SE //4 0 Unknown) Meadow Ridge of Troy 15 Parcel No: 17.28.19.2002 1.) Alt BM Description 2.) Bldg sewer length = 7b + '0 Q rr � , �7JD�T"' n amount of cover =� at' 6 � Plan revision Required? ` ! Yes r�+f No V / /a . n I V 7 �A- - - —— � - -. Use other side for additional information. -- Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) k y. 2 commerce.wi.gov a e Build ngs Division County 201 W. Washington A e., P.O. Box 7162 St. Croix i s co n s i n 0 C T U 41JOW, WI 5 5707- 7162 Sanitary Permit Number (to be filled in by Co ) Department of Commerce S anitary P rmit Ca 10 State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission. o t is form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned Project Addr ss if different than marlin ad�rcssi POWTS are submitted to the Department of Commerce. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04 1 m), Stats. I. Application Information - Please Print All Information Property Owner's Name Parcel b Gar Lid erdin Y 9 9 040- 1310 -00 -015 Proxm Owne 's ailing Addres Property oca Locatio D �' S k /lrti� , 2 4 Ridge Lane Govt. Lot Ci State Zip Code Phone Number NE k. SE ti, Section 17 Hudson, WI 54016 (circle e) II. Type of Building (check all that apply) Lot b T 28 N; R 19 jo W 1 or 2 Family Dwelling - Number of Bedrooms 4 Subdivision Name rl /� I �j/Q S J Ltdy -yt u Bloc Meadow Ridge of Troy ❑ Public /Commercial - escribe Use 00 _ f2 ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of _ ®C'l'own of Troy I III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. LAS New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System texpiair) B • ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner r pU IV. Type of POWTS System/Component/Device: (Check all that a l) $J Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At Grade ❑ ound > 24 in, of suitable �^ n ^ ^� 74 of cu table soi, , ❑ Holding Tank ther Dispersal Component (explain tAy �lFretreatmefi, ✓oricc to,�,a„� � /�T V. Dispersal/Treatment Area Information: Design Flow (gpd) Desigroo il' plication Rate(gpdsO Dispersal Area Required (sf) Dispersal Area Proposed (sf) System (ion 600 ,5 6 1200 - 1200 EISA 922.5 VI. Tank Info Capacity in Total b of Manufacturer r�, Gallons Gallons Units c New Tanks Existing Tanks _ C U Septic or Holding Tank v 1250 1250 1 Wieser X Dosing Chamber i VII. Responsibility Statement- I, the undersigned, assume responsibility for instal ion of the PQOWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP /MPRS Number Business Phone Number Jim Hurlburt MP 222997 715 - 283 -4851 J Plumber's Address (Street, City, State, Zip Code) N 260 CTHW D, Eau Galle, WI 547 VIII. ount /De artment Use Onl Approved ❑Disapproved Permit Fee �U Datte I ued -7 Iss tng Age t Signature C3 Owner Given Reason for Denial ! J D ` Q / Q � I3� t o8 ��roTa1 /R ons r ppr v� M ,���. AS 1 Septic tank, effluent filter and {{ yy�� F� 0 dispersal cell must all be serviced / maintalne — J d 912 j! /07 �D .41QJ as per management plan provided by plumber. �� . 2 All setba ee,�c ck requirements must be maint as per a � o, tae o comp a M for the system and submit to the County only on paper not less than 9 1/2 x inches in ' e SBD -6398 (R. 01/07) Valid thru 01/09 s _�_ �` A rt 1 (Z1, �. ~V V J 1 g 1 ,V dei O o l--*— U °C3z "t Q 7a 5' t t , CL Sz -olt C tzz -,S; 1 - 45—a.v a52 -0.-°1 9 Z -z.� -Z, \ � �' Z 7- 7 � V � � V o -4 a.1 a �� a.tr v.�, � e ., • y� c.tyv J -i.+�. �+�G •. , �e �J � ,. 1 ` � �• M S� � V R ZZ.S O p 2,a — F' S` O m 7.q IDJ � O. p' ❑ "n 1r:�..1:0.� �eo�. O • 3' , v�1Q.Mo• .4,ti �t�+2 [�'• (�1�C. Ca -r�;cp u s I \ t Cl VIL 4A., A, \ 9 - ?- . t �+ i �y 00 V Y s' .• s, y �1w ck �.a -�l S'' 2.4 —� 7 O p 2.4 l S � m 2.q. 1 g,`+r evL kb 0 S' I t Wisconsin Department of Commerce IL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings In with rfYim 85, Ws. Adm. Code Cody St. Croix Attach complete site plan on paper 81 OR 1 include, but not limited to: vertical and hWaontM Parcel F.D. - - percent slope, scale or dimensions, north arr , and loc Lion and distance to nearest road 0 V O 3 — — 0/ S Please print all inform a 'on. S E P 2 1 2005 Review y Date Personal information you provide may be used for secondary (Privacy Law IZ d 5 Property Owner ST. CROI n DCCI Land Planners Inc ZONING 1M SE 114 S 17 T 28 N R 19 E Pro perty Owner's Mailing Address lot # Block # SubdZName or CSM # 1505 HWY 65 15 Meadow Ridge Of Troy City State Zip Code Phone Number ny ©vinage wn Nearest Road New Richmond i WI 1 54017 1 ( ) East Cove Road New Construction Usee Residential t Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD Replacement ® Public or commercial - Describe: Parent material Loess over glacial till Flood Plain elevation if applicable MA_ it General comments * with i cr ntinuous lavers 1 ". sl__Om_ Svr4/ / and recommendations: c onventional system in deeper horizon Z/Ir Bid . Anr 36 5 zf. �- . s s �-� ,nom- - I �- Q - � I/9 1❑ Boring # �0 Boring El Pit Ground surface etev. 93197 ft. Depth to limiting factor X 150 In. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPQ f4 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'EN#,2 1 0 -9 10yr3/2 - sil 2msbk dsh as 2f .6 .8 2 9 - 28 1 4/4 sil 2msbk dsh cam If .6 .8 3 28 -150 7.5yr4/6 s Osg di _ _ ,7 1,6 ❑ 2 Boring# © Boring 929.21 >140 Q Pit Ground surface elev. ft. Depth to limiting factor in. Sol Application Rath Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eif#1 I *Eff#2 1 0 -7 10yr3/2 - sil 2msbk dsh as 2f .6 .8 2 7 -34 1 /4 - ifs Osg dl cw if 5 1.0 3 34 -70 5yr4/4 - Om dh cw _ .6 4 70 -140 7.5yr4/6 s* Osg dl Effluent #1 = BOD > 30 c 220 mgiL and TSS >30 c 150 mglL • Effluent #2 = BOD c 30 and T55 30 mgA_ CST Name (Please Print) Signature CST Number Thomas C Nelson 1 ` - " 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 9/18/05 715- 246 -2454 Property Owner DCCI Land Planners Inc Parcel ID # Pending Page 2 3 of 3 Boring # Boring 936.48 >140 E] 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. S2. Cont. Color Gr. Sz. Sh. `Eff #1 `Eff#2 1 0-10 10yr3/2 sil 2rmsbk dsh as 2f .6 .8 2 10-26 I /4 - lfs Gsg dl cw if 5 1.0 3 26-69- LOyr4 /4 - sl Qm dh cw - .2 .6 4 9 -14 Syr4 /6 - fs Osg dl - - .5 1.0 2 , 8 3 Z� F-1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soli Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe in. Munsell Qu. Sz. Cont. Color Or. Sz. Sh. •Eif#1 ' - W F-1 Boring # Hpit Bourg Ground surfac elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 • Effluent #1 = BOD > 30 220 mg& and TSS >30 150 mg/L ' Effluent #2 = BOD a 30 mg/L and TSS 1 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. SBD- 8330Teat (8.07/00) 'r DOCI LAND PLANNERS, INC. ,o �o ®SOIL BORING \ Lot # 15 - MEADOW RIDGE OF TROY • + \ 4, $ NE 1/4 OF THE SE 1/4 OF SECTION 17, BENCHMARK ,•,. T28N, RI 9W, TOWN OF TROY, ST. -TOP OF CONDUIT + ��owpp°"'"` CRODC COUNTY, WISCONSIN. a ALT BENCHMARK ��t • t • -TOP OF CONDUIT • . • . • • • TOM NELSON CST - Uc. # 227387 N NOTE THE CONTOURS IDENTIFIED • ENVIRONMENTAL BY DESIGN ARE PRIOR TO CONSTRUCTION. �! WT IV 1432 120TH ST. CONSTRUCTION GRADING WAS IN PROCESS DURING SOIL TESTING. WT •r wr.r NEW RICHMOND, WI 54017 CONTRACTOR MAY NEED TO ph. # 715 246 - 2454 CONFIRM FINAL CONTOURS • ,,.„ DURING INSTALLATION. • • SCALE IN FEET 1 40' • ouno �~ 1 100 0 100 41f _uT ' 2 "E 41 j • 89 5 0 19 � 2 � — �_ _-- - -- B2 B2 \ ®92 1 � t� •1• 2.00 - � 36.4 \ ._ S�� J & 932 uo �i o �lv 6.N C( z 4-0 - 911,9 p A 3 K `t 31o,L45 I commerce.wi.gov Safety and Buildings Division County 0 201 W. Washington Ave., P.O. Box 7162 St. Croix i s eo n s i n Madison, WI 53707 - 2 Sanitary Permit Number (to be filled in by Co.) Department of Commerce • Transaction Number Sanitary Permit Application I AJ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appro governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned oject Address (i different an ailin address) /, POWTS are submitted to the Department of Commerce. Personal information you provide may be used for ��7'7 eoa� secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. I. Application Information - Plea Print All Information h Property Owner's Name Parcel a Gary Lidgerding C ' 040 - 1310 -00 -015 Property Owner's Mailing Address Property Location Govt. Lot / \ 489 Meadow Ridge Lan 0d j S ST. CROIX COUNTY C Z�2 City, State Zip.Co�e / Phone Number NE 'k, SE 'k, Section 17 Hudson, WI 54016 (circle e) II. Type of Building (check all that apply) Lot # T 28 N; R 19 00 W 1 or 2 Family Dwelling - Number of Bedrooms C4 15 Subdivision Name R12 f - Block # Meadow Ridge of Troy ❑ Public /Commercial - Describe Use ❑ City of El State Owned - Describe Use CSM Number 11 Village of 5kTown of Troy I1I. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' 9 New System ❑ R System y p y ❑Treatment/Holding Tank Replacement Only El Other Modification to E 'sti (explai B. El Permit Renewal El Permit Revision El Change of ❑ Permit Transfer o revio tuber nd ssued Before Expiration Plumber Owner IV. Type of POWTS System/Component/Device- (Check all that appl ) Y.tI Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At-Grade � _ �❑ Mound > 24 in. of suits le soil, ❑ Mound < 24 in. of soil ui s 36 11 Holding Tank El Other Dispersal Component (explain) 7c.L' atment Devtce�eDrafn�r V. Dispersal/Treatment Area Information: 'mot' Design Flow (gpd) Desi it pplication Rate(gpdsf) Dispersal Area Required (so Dispersal Area Proposed (sf) 600 0.67 857.2 900 EISA 924.0/922.0 ^� VI. Tank Info Capacity in Total # of Manufacturer � tyy Gallons Gallons Units o 1 v ` New Tanks Existing Tanks o a U Septic or Holding Tank X 1250 1250 1 Wieser Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for ins lation of the POW IS shown on the attached plans. Plumber's Name (Print) umber's Signature MP /MPRS Number Business Phone Number Jim Hurlburt I MP 222997 715- 283 -4851 Plumber's Address (Street, City, State, Zip Code) N 260 CTHW D, Eau Galle, WI 5 37 VIII. County/Department Use Onl ❑ Approved ❑ Disapproved Permit Fee Date Issued Issuing Agent Signature ❑ Owner Given Reason for Denial � I IX. Conditions of Approval/Reasons for Disapproval f� SYSTEM OWNEi / 1 Septic tank, effluent fitter and jet•r _SySiI C /"yip;-,. // dispersal cell must all be serviced / maintained ,9 as per management plan provided by plumber. 2. All setback requirements must be maintained 9ns for the system syr{lubmit to the ountxnly on paper not hat /2�r ch yin size ry�� SBD -6398 (R. 01/07) Valid thru 01/09 I J " .a/J �h1� M Zia," 132.. n 11 • �--�q ���w. �-:� L.u.,,,,� ��.�� 1 1�1� 5�- \�- 28 -`��w �a 4.0 36 i wc mow, L+� S �,.r +a C.o� -Fow � � -F0.1M l "T�.��� S a� �0•. -c 2_ - ate. ° 125, b Z2. p �t1 i V � G� w ��•l�u. vx, r ci T �t a„ a z1. o O 2.a (�-?u' 11.8 •�5, g' z.a 0, p C v.c1l — Gah T4 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer `� ,/ <' v 1. Mailing Address Property Address f ' (Verification required from Planning Department for new construction.) City/State Parcel Identification Number 0� 13/40 — 0 — Q� LEGAL DESCRIPTION Property Location L '/4 , %a , Sec. ) I , T a� N Rk IV, Town of i �a Subdivision f'cl(U W P (d I Lot # . Certified Survey Map # , Volume , Page # Warranty Deed # P} (a © q (D , Volume X Page #--- >( --. Spec house yes no Lot lines identifiable yes) no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle waste . Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner ma' tenance responsibilities are specified in § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Zoning Department a certification form, signe by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site astewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is 1 ss than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage dispos d system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, Stat of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Departm t within 30 days of the three year expiration date. Ri o% 7 SI GNATURE Of APPLIC DATE OWNER CERTIFICATION Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the ov mer(s) of the property desc ' e abov , y i of arran deed recorded in Register of Deeds Office SIGN TURE OF APPLICANT DATE * * * * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning apartment. * * * * ** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certil survey map if reference is made in the warranty . ty deed. POWTS OWNER'S MANUAL MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner C> AR-y Septic Tank Capacity gal ❑ NA Permit # Septic Tank Manufacturer ❑ N A DESIGN PARAMETERS Effluent Filter Manufacturer ���� ❑ NA Number of Bedrooms 100 d/bedroom ❑ NA Effluent Filter Model r , N Number of CoTrsFiCrcial Units NA Pump Tank Capacity al t[a NA Estimated flow (average)* g al /day Pump Tank Manufacturer O N•A Design flow (peak), estimated x 1.5* al /day Pump Manufacturer R Soil Application Rate o, al /day ft Pump Model N.A Influent/Effluent Quality (NA❑) nt ly Average ** Pretreatment Unit g N 4 Fats. Oil &Grease C) Sand/Gravel Filter ❑ Peat Filter (FOG) ) 5 30 mg /L`-- ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) ❑ Disinfection Other Total Suspended Solids (TSS) 5 220 mg/L 5 250 m L V. Manufacturer: Model: Prerreated Effluent ua ' * ** Dispersal Cell(s) Q O Monthly Average Ef In- round (gravity) L Biochemical Oxygen De d ODs) 5 30 mg /L g (g y) ❑ In ground (pressunze�) Total Suspended �etric SS) ❑ At grade ❑Mound Fecal Coliform (ge ean) < 30 mg /L ❑ Drip-line ❑ Other: Vau/100m1 ® Leaching Chamber Marie (-\\Z) S Maximum Effluent Particle Size 1/8 inch diameter Model Fzk"kcati�n vA r approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate o.5 gpd/ft Area Req. k o o t' (Other than bedroom based) Absorption Area Credit per unit t Minimum Number of Chambers 4 ❑ Aggregate Desi n Flow/DxZlIng Rate= ft nL " Values typical for domestic (non - commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specification ** *Values t ical for prerreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ", R.J. Otis — ASAE Publications 5 -77 and "Design Manus I - Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 ❑ SBD — 10570 —P (R.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD — 10567 —P (R.6/99) "In Ground Absorption Component Manual" tS'SBD — 10705 —P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD — 10628 —P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD — 10656 —P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572 —P (R.6/99) "Mound Component Manual" ❑ SBD 10691 —P (N.01 /01) "Mound Component Manual" Version 2.0 ❑ SBD - 10595 —P (R.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657 —P (R.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD - 10573 —P (R 6/99) "Pressure Distribution Component Manual" ❑ SBD - 10706 —P (N.01 /01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units Cl MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Freq Inspect condition of tanks At least once every ❑ months CZ ears Maximum 3 vrs Pump out contents of tanks When combined sludge and scum equals one -third 1/3 of tank volume ✓ Inspect dispersal cells At least once eve ❑ months ears Maximum 3 vrs. _ Clean effluent filter At least once ever &months ❑ year (s Inspect PUMP, pump co ols & alarm, At least once every ❑ nths ❑ ears a NA Flush laterals and ressure t At least once every months ❑ ears N NA Valves At least once every months ❑ ears f g NA Other At least once ever ❑ onths ❑ earls NA START UP E ' �� ',�:' '' r :'� Page_z of 3 Foi 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 thedtspersal cell . 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,condrtrons are frozen at the infiltrative surface. OPERATION �. The property owner is responsible. for the operation' arYdrhAinteriance of the' - POWTS and submission of required reports. The quantity and quality of the wastewater stream will affeathe performance and lorigei�iry of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains shou a discharged to the ground surface whenever possible. Note: this does not include laundry waste; showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fait peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., sh not be flushed into the system as they can seriously damage your POWTS I and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. 0 Valves Valves shall be operated in the llowing manner: 0 Alarms Alarms should be tested on ,a regular b 's by the h e owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a.l day serve under regu erating conditions, however water should be conserved until any problems with the system are co cted to prevenfback -tip o ewage into dwelling or surfacing. INSPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). eptic Tanks Component Tank inspections must include a visual inspection of the tank 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 backup or surfacing of effluent . Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) 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 NRI 13, Wisconsin j Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's � specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. 0 Pump Chamber/Treatment Tanks mponent The inspection must include a to o e ectrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, bibkeH security devices and other hardware and the condition of the filter. Any service needs or rep taken care of. i Page 3 of ZIn- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. El Mound, At- Grade, In- Ground Pressure The inspection shall include recording the leve of ponding, if any in observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any di harge to the gr d surface must be promptly reported to the regulator authority. Ponding greater than 75% of the height o he com ent may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with opening the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3 ears. Pressure ch s of systems with multiple laterals should be done to ensure that equal distribution of effluent . ccurring to promote the ongevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. 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 other 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: 5j�'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 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. O A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technolouv a holding tank may be installed as a last resort to replace the failed POWTS. O 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. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES 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 -+ s- - a s - � S 1 Phone SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name A ene S., C2o%k � - x oNcd � G Phone [. Agency Phone ►S- 3 g 6- O g 1 11111E 1111! 1111! 1111111111 IIII1 IIII 111Eil 111E 1111 8 6 0 9 6��++L 2rr�� 1 ' 8U THIS DEED made between DCCI Land Planners Inc., a KATHLEEN H. WALSH Wisconsin Corporation ( "Grantor") and Gary A. Lidgerding and REGISTER OF DEEDS Judith M. Lidgerding, husband and wife, as survivorship marital ST. CROIX CO., VII property, (Grantee"). RECEIVED FOR RECORD WITNESSETH, that the said Grantor, for valuable consideration 09/21/2007 10:30AM conveys to Grantee the following described real estate in St. Croix WARRANTY DEED County, State of Wisconsin: EXEMPT x REC FEE: 11.00 Recording Area 1 00 Name and Retum Add Lot Fifteen (15), Plat of Meadow Ridge of Troy, in the Township of PAGES 1 Troy, St. Croix County, Wisconsin RIVER V /+LLE\ ABSTRq 1200 HOSFORD STREET. SUITE 201 24016 r 040- 1310 -00-015 (Parcel Identification Number) This Iti-M homestead property. Grantor agrees to sell this tit to Grantee on the condition that Derrick Homes, LLC, Divine LLC, or Dreamstructures, Inc. will be the builder of the home to be constructed on this lot. Dated this 2M day of Se tee m , 2022. OCCI Land Planners, In /� Corpo Name L Dea ant ; M ®RI R. evens ecretary STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this 20th day of September, 2007, Ronald L. Derrick, President, and Michael R. Stevens, Secretary of the above named Corporation, to me known to be the persons who executed the foregoing instrument and to me known to be such President and Secretary of said Corpo acknowledged that they executed the foregoing Instrument as such officers as the deerdof sore Corporatio hority. PAAAELA J. UTLEt�OE 1 ry c THIS INSTRUMENT WAS DRAFTED BY Pamela J. Rut - I ` Of sconift OCCI Land Planners, Inc. PO Box 445 Notary Public St. Croix County, WiJonsin. New Richmond, WI 54017 My Commission Expires: July 27, 2008. 1 of 1 Parcel #: 040 - 1310 -00 -015 09/25/2007 12:08 PM PAGE 1 OF 1 Alt. Parcel #: 17.28.19.2002 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/20/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - LIDGERDING, GARY A & JUDITH M GARY A & JUDITH M LIDGERDING 588 EBEN CT STILLWATER MN 55082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ` 489 MEADOW RIDGE LN SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 0.000 Plat: 10 /085 - MEADOW RIDGE OF TROY LOTS 1-31 040/0 SEC 17 T28N R19W PT NE SE MEADOW RIDGE Block/Condo Bldg: LOT 015 OF TROY ('05) LOT 15 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 17- 28N -19W NE SE Notes: Parcel History: Date Doc # Vol /Page Type 09/21/2007 860962 WD 10/20/2005 809848 10/085 PLAT 01/18/2005 785170 2732/370 EZ CON 01/14/2005 785053 2731/551 WD more... 2007 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/24/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 85,000 0 85,000 NO Totals for 2007: General Property 0.000 85,000 0 85,000 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 85,000 0 85,000 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 In W nilwvnaxim' HUDSON W1 54C PREPARED FO OF t�` l PM DCCI LAND PLAT . EMAIION aolue 1505 MY 65 ,�• 20. &V— C Mew • . NEW RICHMONIO <\ �• •� LOT 1 ��� �t •. LOT 12 a� • '� uo•szao � . ♦ too OL • —" •_� 412. w It1D , t It goS 4M o s � �' ° •�� ��� �' � `• �' � `parr `� ` Z ' • .... • • � ' � . ` � !��`• 9240 C'� ' ' '$- ; ` � '' ` •� � d o e s'' 1 ' LOT 15* LBO -927.7 � � 1 LOT 16* '�• `Z �• VIA * % •'•� • • ..� LOT 14* ,./�� : ` `, . � . � . • �' L80 -927.7 . w OUTLOT 4* ��'• I�1 ~ CONSERVANON AREA OWNED BY HOMEOWNERS ' ASSOCIATION ♦.. i % ,1 r l9 `w.