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02/17/2010 14:31 FAX 715 273 0444 NELSON— PLUMBING 1a 002/002 W P11 e m t it Q-t e �] C ; Ir i p a . rte •._.., `� -, Ll m � � Q -) - Z g d l y O a Z V ac cr Z '• C w is %v ° L4 o v, o r N�•� y 62/18/2610 07:42 7152350867 ROGERS PLUMBING PAGE 02/82 1iM _ n as m,a wa 6. w m m a s� m Ir ���s: am m -m taW m tea � R ,_ _ v m-, W m w m3 m � f3� m a� —� t? d 8 m p W s EF ad 0 ° 1� `Ma - :2 as' a'c 3• H 3 w g � c co � M m 'o Or 1 0 0 a �. o W - 76C n c X 0 3 r° �mC g e m m O C fd m m a_ao a `C 0 a� S W m � — � 0.-tS 0 � Q U aW_ m o�1 lD 'G c p Is ts m G � -�} !!� 4 .-, � � � � Q �• � a L � M me • b � y j WW 10 fro =I- mr CL a rt 3 s o F 16C 1 l a g al o m y gm'v maw m ar -. - o aro I M 06 r W m W o ci fn it CL m y o — p mSl. 3m�m g mheo� �� o� o►m+ Ap �. �. 11 ao �` �' „ a ° $?��� �' X acs �o � 3a �,� &;, m, &I y a 8� 9 o o 1 � p �� .C ��o g Q 9 m w g m 3 r c b @mci ' `K 5 6 r 1 CA G ° SLo �0 a al i o,ot g as a — m t W s m cy rt 7 9 R's 13 'K o 7 FLT' .► d� CD alp K tr I c� cn 0 3 - 0 O y ; 0 O 7 m A I n A CD 3 - A� I oD 0 m 0 ° O m_ o 0) C • CD 7 7 C tD O D N N CO C A C d d 3 O O CD O O CD w N CD : v N O @ O O n Sp o N° O 3 > > ° r D ° O °' m � o ' v D — a m In CL 0 o °� 0 0 a _ CL "` z O OD W ( CD -< N N a 0 o c7 r cn w CD 0) c°n N 0 a (D c m CL O O O < `r� _ (;t 0�CD vvoN CD p A _ m CD co 3 o 0� ` j j N N � � O C D o '0 D O 7 !rl O N N CD �• m Z oa 5 cp � cu o> s I _ M vq _m m C/) o M m 3 ,< N j. m o S. m a z m N N N N 3 C r +• CD ° 'B CD v A z O� a H < CD N CD N CD < to z --I W CD w T m co 0 3 o CD 3 o Z co i CD 3 A i a) �c�y 0 <cM�(DCO'o Q <�°c ° ' a mm a c m 30��o3�vm3mcD� °m0w3aWID a: O CD fD 7 3 3 N ' 0 3 C cn 0 14 0 `< a y CD CL 0 O a O N (� O '<_ Q O 3 N C O_ D n N O n O C O D - M N T 7 `z O N d CD 7 CL 4 O ° Z C 0 00 0 < 7< �, CD N Cn CJ � a • a�< CD CD O N N Q O G °D U) Cn CD CD O a y 0 00 m O m CD =r CO. 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CD =r O T , - O fD j n CD 1 r • CD CU O I CD i 05/27/2009 12:55 FAX 713 273 0444 NELSON- PLUMBING g 001/001 jr C Q A n' n C m E3 s F ��a IT �Ri G n � z i a� - O a°a a eh ri D w ; 9 . `c C z a a c e e m � � �► ri za CD 14 o r o , o� y = m e ' o" g d A _ po 3 N N �� � � H ^► S W(m a CROIX COUNTY PLANNING & ZONING January 2, 2008 Jeff Sather Or Current Property Owner 85 E Woodridge Dr. 00 River Falls, WI 54022 40 RE: Pretreatment System Service and Inspection Requirement Code Administradon Dear Property Owner: 715 - 386 -4680 This property's Private On -site Wastewater Treatment System ( POWTS) includes a Land Information &" pretreatment component that must be inspected at intervals specified in its service contract. Planning 715 - 386 -4674 St. Croix County Sanitary Ordinance 12.7 and WI DComm 83.52 (1) state owner q. responsibilities for maintenance and inspection of POWTS that require evaluation and Real Property monitoring at intervals of less than 12 months. The sanitary permit issued for installation of 715-386-4677 this POWTS required that an ATU Service Agreement be recorded on the deed for this property. If ownership has changed, this must be corrected. Recycling 715- 386 -4675 Based on our records the pretreatment unit on this property is due for an inspection and maintenance service. Inspection and maintenance reporting for a pretreatment unit is separate from the routine pumping /inspection required for the septic tank. The certified septic tank pumper and the POWTS maintainer that inspect your system are required to submit reports to St. Croix County so that routine maintenance completed on residents' septic systems can be documented. Please return this form to St. Croix County Planning & Zoning office along with a copy of the pretreatment inspection form completed by the licensed POWTS maintainer to avoid enforcement actions. Please be advised that fines and /or forfeitures of not less than $100.00 and more than $500.00 per day everyday can be issued if the required service is not completed in a timely manner. If you have any questions about what is required feel free to contact me at 715 - 386 -4680. Sincerely, Ryan Yarrington Zoning Technician Pretreatment Component inspection and maintenance service date. POWTS maintainer Name and license number: POWTS Inspection Service Contract provider name: Address: Phone: Service Contract date and duration: ST. CROIX COUNTY GOVERNMENT CENTER 1 101 CARMICHAEL ROAD, HUDSON, W1 54016 715- 386 - 4686 FAX PZPCO. SAINT-CROIX. W1. 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Q 06 0 to 2L m o o 0 �s ma a� o I L ro W �3�� 2 2L 90 2L cr Sa m g � C �� �,'� �W ��S m a� a a •� SR � s m g m a a • p r Q 'g pr OL 6 g, 5 N . _�; W 1 1 a��$ cr 9� I ce M. a g Q xrc FORM a vr o m zoo/zoo SNIownld- NOS13N bbb0 ELZ 9LL Xtld 60 :OL LOOZ /80/90 V ), w T28N., R.1 9W Unplatted land � N 89 W 216.00' 108.00 108.00 0 COUNTY TE S 7 E OF W ISCOI 3_ ST CROIX COUNT 1, Car 0 0 22 County of St. Croix 21 o o I tax sales and no o _� ,6 ° affecting the Ion ° 0 0 Z (21 6.00' ) e° 108.'0 108.00 ° N 8 9 534 W '- 0 0' 200:00' ° CERTIFICAT •• 0 9 ° , o I ° pe o treasurer of the T. e o° 20 � o° in my office, there i . ° 6 — > 1966 affecting tht 7 9 r < O uk. . ° J: ° 9 COMMON CC l � Reso 1w J.Froncis a Richar owners, i s hereby a 2 I hereb common council of 0 17 $ _ 72 N �, •= o ,. TOWN BOA F 1091/417 w,S,27t 200 0 6 C ?I�t. . M �9 0 08.0 108.0 ti £_ 0 L z W 223° 21 ti 9 9.30. , 11 /E //4 - NW l/ " 5656 W 75 774 564� ° � 9 15.00 v 108 00' 1 08.00 200.00' 2 3 200. o 20 7 7.3 N 76 0 7728 2.so 564 A 24 200.00 0 P00 5 777 0 �� .772A a. �- 71 0 18 SD 25 778 824 771 0 ?8 27 26 150.00' 17 200.00' ^°o lV �k &t! ; c o ti � y � 1 o q l , 72 a 77 o0 r: 7 780 79 h 5 ,s 0 769 o 00.00' 100.00' 00.00' ` o ° 826 M o il� 15 0 76 8 6 "• 6 �,�� 69 74 150.00' o 0 820 821 822 75 767 - N)o ' 99.00' 99.52' 76 00.00',- 766 12 200.00' I w o ° 829 � . a 765 < o 30 � ° „� 1 o N 56 .r ° 200.00 4 N W OOR SEC. 36 r bi da 565 A NW 114 - NW 114 I 0 0 O N O M 51 96 1 'moo a� 784 783s 565 � ��` �� y � ` 82 ,� 7 85 c. s. nn . V. �. IT r' P9 'w1 786 0 5 a � �: R'. 787 ` �� 78 8 rou ��6 4 65 , z 789 9 817-818 I S1 8 l 37 790 �� ��`°' Y� , ss o0 7/,s.��, 33 o�� / 3 814 �`� 4JU 13 10 5666 39 4 - 0 j FORMERL Y LOT 1 70 LOT 71 I DEDICA TED FOR I OAK RIDGE ACRES I WA R C O DEED VOL. 1005, PAGE 551 I I J DOC. #498232 - — — — — — — — — — — — — I� r r� o 'Oj o E. WOODRIDGE DRIVE r Irn A r J (R - 00 °07' W) N 00 °22' 23" W ----- - - - - -- 82.32' N-i- - - - - -- cl tiff y r b N N X r ~ �C 0 C N b 51 l rn I5 � y Oo X = �, m i O p n7 -Z % � I oo Z 0 0 to 0 b� ti 00 I J w C-0 D C ; F- � r rR1 Z 5' 5' mlk r. �y c) a� 0 — — — — - -, ry N Ln --------- - - - - -- 100.00' 5 00 0 07'00" W rn � i G) o I rn v z 0 - ODmC 0 - r I rn pm r m Z^ rn X < zN -a v _ o p _ >c n c� m� Z z� OoAn'N - ° m "TI R t0 m ��y co rn m z D O n o ;u v 3 rn O m p<2 m 0 Dm r r Wisconsin QEpartmer�6 PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Buil&ng INSPECTION REPORT Sanitary Permit No: • 488007 0 GENERAL INFORMATION (ATTACH TO PERMIT) St to Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 217 3bw ' "T "uS • 1 e•' Permit Holder's Name: City Village X Township Parcel Tax No: Sather, Jeff & Lori I Troy, Town of 040 - 1185 -90 -000 CST BM Elev: Insp. BM Elev: BM Description: P, K Section/Town /Range/Map No: 6D. C) tv.a' g �°1 S 36.28.19.772A TANK INFORMATION V ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic G'��- .5 d- 3 /Z50 Benchmark s /bs 65 � Jop Dosing Z 975 � yZs Alt. BM I Aeration a6 ✓L• Bldg. Sewer 5, SZ �`> • 53 Holding l �5 St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION �• 33 `�� 72 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 7. fT 2 , 3 Septic 7, 3 i a i _ of A Dosing 7 Z� Z`l� r _ Header /Man. .43 7 �r 50 L . Aeration Dist. Pipe \ Holding Bot. System A, r �I S Fi Grade PUMP /SIPHON INFORMATION `L� L .,Z ( ) M anufacturer Demand St Cover �, ` Z • 5 /�Z S9 GPM Model Number �� ,��,(D �i l L 4 2 r/ '^� 7 b DH Lift Friction Loss Syste Head TDH Ft Forcemain Length / Dia. 2 (I Dist. to Well �� r/�' �, h t '(• ( 9 9 r .0� SOIL ABSORPTION SYSTEM Eb IMMKOH Width Length No. OfiTeneNes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ENSiONS SETBACK SYSTEM TO P/L J B v^ - WELL LAKE /STREAM LEACHIN Manufact INFORMATION CHAMBER OR Type Of �. � r ��( r-i � UNIT o umber. DISTRIBUTION SYSTEM Header /Manifold Distribution i y x Hole Size u t x Hole Spacing Vent to Air Intake ' '' Pipe(s) r � r r (11 - Length 3 •� Dia Z Length 'C / ' `pia 1 4 Spacing /3 Z 0 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx SeededlSodded j xx Mulched Bed /Trench Center Bed/Trench Edges Topsoil Yes I > No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Ins ction 1: 1 V'1 # 2j Ins ction #2: Location: 85 E Woodridge Drive Hudson, WI 54016 (NE 1/4 NW 1/4 1� 36 T28N ) Oak Ridge Acre Lot r Parceo: 36.28.1 .�2A 1.) Alt BM Description = ST tMOM 1 p �p Q S PE^ 2.) Bldg sewer length = 13 ' / f amount of cover = P an revision IL Tired? 1 Yes No - zoo -- l - ( - -- e*L Use other side for additional information. � L� t" � - ' - -- Dat InsepcCert. No. SBD -6710 (R.3/97) G/ I Safety and Build E ounty n 201 W. Washington A �r (.. Madison, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.) 1*6consi (608) 26 Department of Commerce TJ I.D. Number /7 0 3 D Z O Sanitary Permit Applicati n RECEIVE In accord with Comm 83.21, Wis. Adm. Code, personal informati n you provide may be used for secondary purposes Privacy Law, s15. 1)(m) d if different than mailing ress� S (�` `t t 1. Application Information — Please Print All Information Property Owner's Name ZONING OFFICE Parc # Lot # r Block # � STN o - �B o--a B� Property Owner's Mailing Address Property Loca'tiion) ff g� �C e M�'h, � ' /., Section 3W City, Sta Zip Code Phone Number / � �� \ circle C J 71J�r7�Gl�a� T�N; R E W R. Type of Building (check all that apply) Subdivision Name CSM Number �Ior2 Family Dwelling — Number ofBedrooms ❑ Public/Commercial —Describe Use II k ❑ State Owned — Describe Use 7 X Sy �O J c• t l ❑City_ ❑Village �Townshipof 1Q III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' ..New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision El Change of C1 Permit Transfer to New Before Expiration Plumber Owner ti. J IV. jXpL2f POWTS System: Check all that appl ❑ Non — Pressurized In -Ground I Mound > 24 in. of suitable soil 9 Mound < 24 in. o f suita soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In -Ground ❑ Holding Tank ❑ Peat Filter % Aerobic Treatment Unit ❑ Recirculating 1 Sand Filter ❑ // Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line C1 Gravel-less Pipe ❑ Other (explain) 5 q i , V. Dis ersaVrreatment Area Information: ' Design Flow (gpd) esign Soil Application te(gpdst) Dispersal A rea qui� Disperse Area Proposed (s System Elevation I n O-D J/ F1lJ 11' r 7 S VI. ' rank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing t to k 5z 5 Tanks Tanks Septic or Holding Tank J z C V�j CLIt, Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement 1 , the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plu 22� ber's Name (Print) Plum is Signature MP/kf@KYNumber Business Phone Number CSo�✓ �S 2 73 Plumber's Address (Street, City, State, Zip C VIII. Count /De artment Use Onl Sanitary Permit F Groundwater Date ssued Issuin ent Signatu (No amp pproved ❑ Disa Surcharge Fee) n Reason rnial IX. Conditions of Ap roval /Reasons for DisVprpval 3 God t `d-� r Ufa Ott e. SlST ?;J QRER: i. 1e04ictallk- ~f 9wo ace- N' � tec G.J /� Gf�l'�'• K t'Ils' penal cep must aN 0AISI i�i� � � c.,i2. t' � a� .� �1� I 1 I D , vim as per manapam rit plan provided by plumber. 5 dD 2. AN setback reWirements must be maintained as per q*ficable Code / txdlnaftcea. Attach complete plats (to the County only) for the system on paper not less than gl/2 x 11 inches in size SBD -6398 (R. 01/03) r n 3 d f h °t O � f � I � APPr�ceN!d�� ! g � p repaSe r,� 46dY+, �Lonc� � q d rah' 2sp v ry BX_ 3_4 r6 ra a t j r � ' ynowb 4 tI17 o/2�hep�o%sf �.i_�aT 7 z A ry be y, er o E� �• R�Wpe 'g v e Sc / a les f'�_ 2 041 - j j Cd7` lVe we t7 r`mr' aS c. Qr r�6�'M a ' y N y V \° as (3�d ►e?�t Ae it ek d ° ,� // // �... L"A r 7 7.,?- A D k o h. C p e. 116 J, %c T/ 6�Xer 20 ,�'f. Safety and Buildings d commerce .wi.gov MADISON WI 53 BOX 7162 07 -7162 TDD #: (608) 264 -8777 i s c o n s i n w w ww.co e.w i. gov/s sin.go / Department of Commerce vuw.wiscosin.gov Jim Doyle, Governor Mary P. Burke, Secretary October 20, 2005 CUST ID No. 220673 ATTN.• POWTS Inspector CHARLES L WEBSTER ZONING OFFICE WEBSTER EXCAVATING, INC. ST CROIX COUNTY SPIA N5815 770TH ST 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/20/2007 Identification Numbers Transaction ID No. 1203020 SITE• Site ID No. 705965 Jeffrey & Lori Sather Please refer to both identification numbers, 85 E Woodridge Drive above, in all correspondence with the agency. Town of Troy, 54022 St Croix County NE1 /4, NWI /4, S36, T28N, R19W Lot: 19/772A, Subdivision: Oak Ridge Acres FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1044910 Maintenance required; 600 GPD Flow rate; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per . s.145.06, state. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be located and installed in accordance with chs. Comm 82 83 and 84, Wisconsin G Administrative Code, except where the approved plans grant exception to these rules. Div!`'. / • A manufacturer's technician or other authorized factory trained individual shall be present during all phases of the installation process. All system components requiring calibration shall be completed by _F ,�F.;; manufacturer's technician or under the direct supervision of the technician assigned to the project. • Prior to transfer of this property, the new owner shall be given notice that a POWTS exists that requires maintenance on a more frequent schedule than a standard system, and that said maintenance events must be reported to the department's maintenance reporting system pursuant to this approval. • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operations and maintenance manual and /or manufacturer's owner's manual for the POWTS described in this approval. • A valid maintenance /servicing contract is required for the life of the system. A copy of the initial warranty or contract must be submitted to the county prior to issuance of the sanitary permit by the permit issuing agent. CHARLES L WEBSTER Page 2 10/20/2005 • The owner shall report to the county authority any changes in maintenance /service contract providers or conditions of service within 30 days of such changes. • The owner is responsible for submitting the Maintenance Verification Report to the County for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A filing fee will be assessed for each transaction processed. • Appropriate county officials and division employees, as well as employees of the University of Wisconsin Small Scale Waste Management Project, shall be permitted access to the property at any reasonable time of the day for purposes of inspecting and monitoring the system. Monitoring and inspection includes, but is not limited to, constructing soil borings, or other physical examinations of the system or site, and collection of soil, groundwater, or wastewater samples for testing off site. • In event that this system malfunctions so as to create a human health hazard by discharging wastewater of unsuitable quality to another POWTS component, the ground surface or the waters of the state - including zones of seasonal soil saturation, the owner agrees to employ properly licensed personnel to repair, modify or replace the system (including the possibility of utilizing a holding tank with off site disposal) with such action approved by the department and appropriate local officials. If compliance with the conditions of this approval or chs. Comm 83 or 84 is not maintained, the owner may be subject to an enforcement action by the department or county to ensure compliance. Pursuant to s. 101.02 (13) (a), Wisconsin Statutes, penalties for noncompliance with an order of the department include forfeitures of $10.00 to $100.00 per day of the continued violation. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance o e POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Robert Kanter POWTS Plan Reviewer, Integrated Services WiSMART'code: 7633 (608)261-7735, Monday -friday 8:OOAM - 4:45PM rkanter@conunerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 4 Webster Soit Testing ft Sewer System Design Charlie 8t Kris Webster, Owners N5815 770'' Street, Ellsworth, W1 54011 Tetephone: (715) 273 -3430 Fax: (715) 273 -4181 W1 licenses: MP220673, ST220673, ST 261669, PEI 8803 POWTS Index Sheet Pag 1 of 8 Mound System for a 4 Bedroom Residence Property Owner/Project Name: Jeff & Lori Sather Lot 19 -772A CSM Vol 500, Pg 136 Subdivision Name -Oak Ridge Acres NE % NW % 836'F28 N R 19W Town of Troy, St Croix Count WI REC EjvE® Contents OC T 0 ? Page 1 of 8 Index Sheet 2405 Pa Page 3 of 8 Plan View Cross SAFE. & B�pGS. p'V - - -g Section Page 4 of 8 Distribution Pipe Layout Page 5 of 8 Pumaim Chamber Layout Page 6 of 8 Puma Performance Curve Page 7 &8 of 8 ffement Plan �SCQIys S A . '` OR b WEUT*R p w► . WA WOMW mo ` r Ai.t�` t s Component manual used Name: Mound Component Manual for POWTS Version: 2.0 SBD- 10691 -P Date: January 30, 2001 Name: Pressure Distribution Manual for POWTS Version: 2.0 SBD 10706 - P Date: January 30, 2001 f { Page . Of tic -" l Approved Synthetic Covering Distribution Pipe Frs C 3 3 Medium Sand " g 9.75 Topsoil - �__= F Elegy _ —' E D _ 3 % Slope Bed Of i -2 z 'Force Moin Plowed Aggregate From Pump Layer / } c o., - fo(' � e c 9 d / / ho _�— E / 6 /f� /I ` of tJ Cross Section Of A Mound System Using q e o- .r; A Bed For The Absorption Area r r th, J G 4_ Ft. A 7 Ft H ! Ft. . Linear Loading Rate= /Z-OGPD /LN FT g - 9 - 0 Ft. / /�P Design Loading Rate= 0.S /SQ FT j L5 Ft. —4 74cce5y bax' Ft. rhIea p/e �� /cry 1 K _ _ Ft. /tfe..t ! f L K L5 Ft. r yr'�'��/ t.tfco� /cn W X Ft. L - , *Observation Pipe K A - --------- - - - - -- ------------- - - = - -- - -. Distribution \"Bed Of Pipe Aggregate Observation Pipe,` f'ra -" P" P i (anchbr securely d,be - i- oLsr �vdt'oH �•�PS �° 4 re 'dA,cfC'$- o t s c C kF � E 4�, "4 L� � c�dfiC. t�•q_Lif' od�� /1�/E', f/re%S�t'tdvri �itic�cs's�atfcobe r�' Plan View Of Mound Using A B - ed For The Absorption Area j q Page _ Of ✓ l -! ! f . � � ^� f r til} � � _l "dam Perforated Pip Detail 0 End View Perforated y PVC Pipe c° l ° Holes Located On 8ottom, Ate Equally Spaced .,sue t i Oislm�ution Pipe defid� P 47.S Ft. Distribution P ipe . Layout S 3,5 Ft. �S�-� 0 �'�<1 V X .�� Inches Y 3 Inches Hole Diameter Inch Lateral Inch(es) Manifold Inches Force Main " �- Inches — — — — # of holes /pipe 2 �«ess box Invert E 1pvation of Laterals - ti����✓�d �k Place lst hole /S , n _from center of manifold with succeeding holes at 3 'A .intervals . /w G. 6 C 'I,'O L �s �F� ��n Y' O h' /' O �O •Z ✓CL4�/..tiLS �/l, l'L' / �fq,,,.,� I at C�L Ufr' _J i .key Wei fA 9,1, Aj j ch. 6 Ics A 76, 0 mot. '�7- T;- d)Cl�s�C�o,f' weep ho1 i c F D .r P...k Pr +(�lde .tccesf *a few... � p d S - - er oh. to Tr {rd v4. , d C - � /.lets 4 'Q`•� d oses l46.S` {s 't'•�k MaywFa�.�- c�;�c,. ca�.����P,rod��� � v °�w�„ of B��tfto�.. •{c31�,� �_,�- Gaffs ls- P 'c1,..P Male/ IV'- _ M o /� - �t _;..��� a- X23 t/s C ..,w4es oL Gals tol tdof D = - r».A t G L / iOC4,,r 7 9 �' Ga+ i s / ✓r l�ereAC'� �' .t {��i f ,"ree. pe'rker" Pu -*,o of'F' �D, )�. O4rf'iDK �/� �� �� rr Ps-ex -Fwk .. _ ; c�3fl 4 s� - f t 6-f P. ce— tw 6 lee fe e�id,- .efsy7�oYC�wr,�.%, r.fa D�,r.aw.Jt� �CdC� f�- T ft. £X7c TaxK 1 LcH :� / 4s Cl 5LJ1 Pw - cA,Ift h er ea ac: *y - Myers ME40 Series of 4/10 HP Effluent and Drain Water Pumps Page � of SSPMA Min. Sump Dia. Duplex I 36 in. I 81.4 mm I PDF Reader Download Product Performance Chart CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 30 b 25 6 z � g � _ _ 20 6 _ s �. 15.. 4 � 10 3 -7 5 2 0 0 0 0 20 30 40 50 60 7o so vo 100 CAPACITY GALLONS PER MINUTE �1 Penta r z e y�vY 7s �1 a 5= ,- 'w. . p11t>afDt3tottp FE Myers is a certified ISO 9001 registered quality system. Copyright © The Pentair Pump Group All Rights Reserved Primacy Policy - Terms and Conditions of Use By using this site, or by accessing any information on this site, you are agreeing to the Terms and Conditions, http://www.femyers.com/products/sse/sse 5/20/2004 I • POWTS OWNER'S MANUAL & MANAGEMENT PLAN pase of FILE INFORMATION SYSTEM SPECIFICATIONS Owner �-�'�`� Cow,` Sa Septic Tank Capacity i - ILS - 0 g al ❑ NA Permit # Septic Tank Manufacturer W; I!;-, C 1 chi A DESIGN PARAMETERS Effluent Filter Manufacturer ,Po / /p r ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model Z ❑ NA Number of Commercial Units . NA Pump Tank Capacity 7 7-5 5— al ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer (.cs�r Cohc�c ❑ NA Design flow (peak), (Estimated x 1.5) 6 al/day Pump Manufacturer ' Q . - ❑ NA Soil Application Rate _ aVda /ft Pump Model ��{ Q ❑ NA Influent/Effluent Quality Monthly average' Pretreatment Unit ❑ NA ❑ Sand/Gravel Filter ❑ Peat Filter Fats, Oil &Grease (FOG) 530 mg /L ,Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD 5220 mg/L ❑ Disinfection L ❑ Other. Total Suspended Solids (TSS) 5150 m /L Manufacturer ����i` �` Pre ted Effluent Quality ❑ NA Monthly average Dispersal Cell(s) ❑ In- ground (gravity) ❑ In- ground (pressurized) Biochemical Oxygen Demand (BOD 530 mg /L Mound Total Suspended Solids (TSS) <_30 mg /L ❑ At -grade Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Dri -line 0 Other Maximum Effluent Particle Size Y inch diameter values typical for domestic (non - commercial) wastewater and septic tank effluent. •� values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every 3 ❑ months year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one -third (4) of tank volume Inspect dispersal cell(s) At least once every ❑ months years) (Maximum 3 yrs.) Clean effluent filter At least once every )<months . ❑ years) Inspect pump, pump controls & alarm At least once every X months ❑ year(s) ❑ NA Flush laterals and pressure test At least once every s ,� e q�o! ❑ months ❑ year(s) ❑ NA Other. 71 =pQc7� �Pds At least once every 1!� months ❑ year(s) ❑ NA Other. E At least once every )Kmonths ❑ year(s) ❑ NA Wlr,-Z sr �yv 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 ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreattFment components, and any othe r maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event START UP AND OPERATION. For new construction, prior to use of the POWTS check treatment tank for the of products or other s) p P i � chemicals that may Impede the treatment process and /or damage the dispersal cell(s). If high concentrati ons are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Page of `,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. ABANDONM ENT 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 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 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 s ite 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 t ' Ze t� t ke p , I O w, i�^ . `' / / / P ✓/, d f7'd c ror�h�� POWTS INSTALLER POWTS MAINTAINER n Name R , e,r ?J e (N elso 1 oMtD+ n Name Phone 7l 5 LL 9� g 4 Phone SEPTAGE SERVICING OPERATOR PUMPER C4 4�L,,., LOCAL REGULATORY AUTHORITY Name Agency f Phone Phone / - 3 g 6 4 , L9 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and sanitation agencies. This document meets the minimum requirements of ch. Comm 83.22(2)(b)(1)(d) &(0 and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use of this document does not guarantee the performance of the POWTS. GMW (2/01) 10/20/2005 14:21 715 -273 -4181 WEBSTER EXCAVATING PAGE 02 76a" cri m z . 5N r----- - - - - -z 1 1 I 1 O f C I 3" 1 3 F > 9 Po I I -j v, 1 rn II a II =i r t � I � 3$ 791" rrt ' a y — Q ZN �c�f � �I�TI�Ga4�� rrl G 7 T m z y�CC� ��`,47zrir �. 1 m c z i�� � r` i,i.. caW -0 > -41 m m . y� �o 0 • � C), �p a t O *d Z7 °- 0 +�1 ��y [� r T3 afw. V aTV.� Z n i SZ"'C MAN UAL DRAWN BY: Sw ,�sne tr3 HWYlO. a AEM ROM IR sa7Ga bATE: MAY 2003 REV, uAN. 2055 800325 -8456 .WI425 975 BIO 750 GILD r ^ M -q b zr 21 :dg rq zN VW Pry i qw a t v 3 A .�^ at S� b NA AA oil 11 T E rg Q ld ��. T b � � m•y '�'I rn 7q `�, iit -.� y � C - y 2 «< 5 3- lee S 6 c m-- I,xZxm !fa -fr mZ ' F A Ga r ozSJ r 1lra t��l ��'1 .�C3y t�AO # � e*�rtiv ���a� 'o M ' Z FA to a r z z rn 8 I ' � pri�c� m rd � c °c 0 r ° tea c � ?z r � �� r : Tr r ! n�z�rn -+ 1'1 ib m +�. _1" L1 r n� nx -9 -n C4 CO z N r� { � a z� o�fn �►+ � �.{ C! .r9 �p T yt"� �T7 �� `txy 3 a� �" y� ! 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W q "� D Ll y r'1 " a C 3 - q r ty z n -4 n z �--1 O < v Z - ti < r td .. my N rnM 7 COT -4r1 MM m-t v Ln C0 39VA 9NIiVAVOX3 �GiS93M T8Tb- 8LZ -STL TZ:t7T 5002 /0Z /0T Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of Division of Safety and Buildings in a th m Is Attach complete site plan on paper not less t 12 x 11 inc e. Plan mus IVE Coun S� • ��O ( k include, but not limited to: vertical and horizontal refer int (B ), direction and Par l.D. percent slope, scale or dimensions, north arrow, and tocation a nce t4@4brE0t (p y *t e — X10 -0Q Q Please print all information. L Revi wed b Datel Personal information you provide maybe used for secondary purposes (Priv cy La*. 17 t5.v KWUNT '' Z� Property Owner rr � x rev '-0 �, J ^ems Go r,. Lot fJl= 1/a �1V�1/4 S3(Q T a.� N R �� W Property Owner's Mailing Address Lot r Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road 7!Q �� 3foS� T � = E. (t Doc —� e J • C. 'Dr� * e. New Construction Use:) Residential /Number of bedrooms �_ Code derived design flow rate C GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material �5\ Flood Plain elevation if applicable N ft. General comments and recommendations: Sl �e- SJL Of\ � S� t S ° {Y J' � �n Q ` So h� }, ` C• t_ a n F ❑ Boring Boring # Pit Ground surface elev. 9S ft. Depth to limiting factor /:S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz: Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 S� `'m r rc��t c��J 3co 0 (p 0"3 -P.S lDyf?. 'Y3 I St �m�l S a� 0•.('0 0 0 ,� O =Z' �I 5� �%tr.7,z✓ m�r- -- p, L) Boring # ❑ Boring a 0 Pit Ground surface elev. 1W. �O ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Rxtu Structure Consistence Boundary Roots GPD /fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0-9 `' m 10\ M � c �-S c o 0, fo O's "k, o� 0 :1 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CS,T Name (Please Print) Si nature CST. Number Address Dat valuation Conducted Telephone Number ` -U Property Owner �eCee� nR� ° � Parcel ID # C7 y' t _ �y OC R Page ; of Boring # F - 1 q // ICI Pit Ground surface elev. C N' I ft. Depth to limiting factor _�� Soil A lication Rate I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bouncary Roots i GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o�rrl C, r rn D Cp 0.3 — i 0 Y1?. 3 I ? - 3J uR � � , L j i i I Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bourn :ary Roots GP91ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 7 I f i . i I Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boun :ary '. Roots GPDtfg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i 'Eff#1 'Eff#2 i. i t Effluent #1 = BOD > 30 < 220 mg/- and TSS >30 150 mg1L * #2 = BOD < 30-7K 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 altemate format, please contact the department at 608 -266 -3151 or TTY 608 =264 -8777. SBD -8330 (R.07 /00) - • �-- `� �sa��c� ;taPJ - �o: y�f� r- � oR t ��-her P� 3 � �� R � I i s ,c} Jae. GdvdfC' I ,ocotk ,A s « ca -' Ne;y,orstwell I � � p..p�s�oC g6dY•�, ' e 4o 7SA, -1-- s - ---- -- 2 IN ` � o ^� u�C ` 11 ` � y. Piz gad r ig J 3. y ,- c d . tA' 1 b d L/ v^OwbGi ?7aA Cd 6�c Tv b�xet {extra; 4, l e i s ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer :7£rcQifi� F 4 '�G>zz :a SA rL +)Z_ Mailing Address :?S' r �Joofl oc u"C LA L i G✓.= YzlUa-a Property Address �� �� �= fl� �i� 1` 9 — 'J je r - 4 4 LS �A � K rL11z"R (Verification required from Planning & Zoning Department for new construction.) City /State ri4LLS Parcel Identification Number 04/0 /1 F '7U 0 0 LEGAL DESCRIPTION Property Location '4/c 1 /4 , 1 /4 , Sec. 3, T N R_LtW, Town of Subdivision 1t - 0,4g ferb6 )q es , Lot # j Certified Survey Map # 1-OT 1 - 77-2 A C_Srrl -,Volume S'0 , Page # � 3 Warranty Deed # -� 3 ,2Q ) 5"aO , Volume , Page # Spec house yes no Lot lines identifiable ye no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance 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 Planning & 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 Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 3 - SIGNATURE OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) e i 2.437 �l M. y &13 1 P ® 0 14 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX Co., MI Document Number Document Title RECEIVED FOR RECORD St . Croix County 11/18/2005 03:20PN AEROBIC TREATMENT UNIT (ATU) AGREEMENT SERVICING AGREEMENT EXEMPT # REC FEE: 11.00 TRANS FEE: COPY FEE: 2.00 tate Plan Transaction Number- /a.o o CC FEE= PAGES: 1 Name - (Owner) Typed or printed Being duly sworn, states, under oath, that: 1. He /she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume ;0-2 6 Page S--o' O Document Number 73/ rf - LSt. Croix County Register of Deeds Office: - Ar Lot / 9 Recordin area A parcel of land located in the '/4 of the /9/'/4 of Section Name and Retum Address ` 3 F , T N - R 7 W, Town of '_Tit =FFim if P SrrN ill i2 d� r' R o , St. Croix County, Wisconsin, being SS E woo 0erv4,C Oil duly described as follows (include lot no. and subdivision/CSM or , u- aa detailed legal description): 77.".) A - 47d r 04c7 -116' TO Ob d Parcel Identification Number (PIN) Agreement Date: As an inducement to the county to issue a sanitary permit for a POWTS equipped with an Aerobic Treatment Unit on the above - described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Comm 83, Wis. Adm. Code relating to Aerobic Treatment Units (ATU) and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) technology. If the owner falls to have the POWTS and ATU properly serviced In response to orders Issued by the governmental unit or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., the governmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703. State. 2. The owner agrees to maintain a contract with a licensed POWTS maintainer for the life of the system. The POWTS maintainer will perform periodic inspections and maintenance as required by the manufacturer and the Department, including, but not limited to: the blower, electrical controls, and treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254.59, Slats. 4. The owner recognizes that the county. Department of Commerce, or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. S. The owner or the owner's agent agrees to report to the department or designated agent at the completion of each inspection, maintenance or servicing event in a manner specified by the department or designated agent within 10 business days from the date of inspection, maintenance or servicing. 6. This agreement will remain in effect only until the county office responsible for the regulation of POWTS certifies that the aerobic treatment unit no longer serves the property. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the Register of Deeds, and the agreement shall be recorded in a manner that will permit the existence of the agreement to be determined by reference to the property where the Aerobic Treatment Unit Is installed. Owner(s) Nama(s) - Please Print Subscribed and swom to before me on this date: SCFF��'Y P- +- Lo2r �- 5.4-rt•+isL� .,<;�� :,T� � :. Notarized Owners Signature(s) Notary Pubii Governmental Unit Official Name, Title - Please Print My Commission Ex s ^ • * "k* t Governmental Unit Official Signature Drafted Personal Information you provide may be used for secondary purposes (Privacy Law s. 15.04(1 xm)] "THIS PAGE 13 PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE" This Information must be completed by submitter document title. name & return address and E,(L (if required). Other information such as the granting clauses, legal description etc. may be placed on this first page of the document or may be p laced on additional pages of the abcument: Note Use of this cover page adds one page to your doewnent and &.00 to the recordina fee. Wsconstn Statutes, 58.517. . !i A '73 1 742 'J Z 3 2 $ P S Z O REGISTER OF DEEDS Document Number WARRANTY DEED S T. CROIX CO.. W RECEIVED FOR RECORD This Deed, made between Rolling Hills Development 07/23/2003 10:15AK Inc., a Wisconsin corporation, Grantor, and Jeffrey P. Sather WARRANTY DEED and Lori J. Sather, husband and wife as survivorship marital EXEMP-' property, Grantees. REC FEE: 11.00 TRANS FEE: 108.00 Grantor, for a valuable consideration, conveys to COPY FEE Grantees, the following described real estate in St. Croix CC FEE: County, State of Wisconsin (the "Property"): PAGES: 1 Lot 19, Oak Ridge Acres, Town of Troy, EXCEPT as described in Volume 500, Page 136. Reco rding e and Return Address j y 1 0. S'Amf"e !►I s ytc0r s )( Fifa f w= 40- 1185 -90 -000 (Parcel Identification Number) This is not homestead property. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: easements, covenants, and rights -of -way of record, if any. Dated this day of July, 2003. (SEAL) (SEAL) " and N. FOX, Pr esident (SEAL) ;c//tc i° 10 -. jg� (SEAL) *Frances J. Fox, 46 cretaty AUTHENTICATION ACKNOWLEDGMENT Signatures of Rich rd Fox and Frances J. Fox authenticated is July, 2003. STATE OF WISCONSIN COUNTY C. . Gaylord Personally came before me this day of June, 2003, TITLE: MEMBER ST BAR OF WISCONSIN the above named to (If not,. _ me known to be the person(s) who executed the foregoing authorized by § 06.06, Wis. State.) instrument and acknowledge Ihn same. Notary Public THIS INSTRUMENT WAS DRAFTED BY County, WI. C. L. Gaylord My commission expires Attorney at Law P. O. Box 46 River Falls, WI 54022 (Signatures may be authenticated or acknowledged. Both are not -Names of persons signing In any capacity should be typed or necessary) printed below their signatures. MFORMATION PROFESSIONALS COMPANY FOND OU LAC. WISCONSIN e0D -063.2031 Dy I a C. S. M. v_I� ,� = „ T P 293_ Zi ioe 22 � -- /�/ �/ ��` 0 5 N 7 5 7 74 � 4 B N w l�-T N 56 - 56 V) - 6 ioe ' ' ios' _. 20- •--•- ----_- C zoo 1 772 B rQ, 7 "fi 19- / 1560 24 772�A E 777 N\ \- \1 - „ 25 . I`l 100 A t �� \ , ,---� •_— _- ---- -- pop ^ O -65 - � 64 '$2 � ro W ei A. • � � �. 'i!� 1 MIN - �� MlrllMUnn�. I CD 1 A .E3 I R I ,� "" rJ ; ., E LOT U r \ 1 00 M It.� �CRt i � -- 39 ;: % 5 � 160' 7 I 4 -- 31 _- �- 4r� - ,��a; - `•� 5e �. o \\ _. .� -- �i MIrJIMUM �a 3 m � - ` ff . f31 I a w 7 \A�IINIMU►J► r r,!!J1M CBE L OT - \ �. ,9 I I : h _ r X'RE LOT 1 I'�CRE LQ 80 \ 2--- -- - 7 z_u N 1 A L -922-5633 13 4 ('����� I ,� 9�E.5 \ —`..- pint C 1 — — W W cr- N I uj uj I Z I l i v LA- 5 , y ITT GOULDS PUMPS Residential Water Systems APPLICATIONS MOTOR Specially designed for the following uses: General: • Mound Systems • Single phase • Effluent/Dosing Systems • 60 Hertz • Low Pressure Pipe Systems • 115 and 230 volts • Basement Draining • Built -in thermal overload protection with automatic reset. • Heavy Duty Du Sum p • Class B insulation. Dewatering • Oil - filled design. • High strength carbon steel shaft. SPECIFICATIONS PE31 Motor: Pump — General: • .33 HP, 3000 RPM • Discharge: 1 1 /2 " NPT • 115 volts • Temperature: 104 (40 maximum, continuous when • Shaded pole design fully submerged. PE41 Motor: • Solids handling: 1 /2" maximum sphere. • .40 HP 3400 RPM • Automatic models include a float switch. • 115 and 230 volts • Manual models available. • PSC design • Pumping range: see performance chart or curve. PE51 Motor: PE31 Pump: • . 50 HP 3400 RPM • Maximum capacity: 53 GPM • 115 and 230 volts • Maximum head: 25' TDH • PSC design PE41 Pump: • Maximum capacity: 61 GPM AGENCY LISTINGS • Maximum head: 29' TDH PE51 Pump: • Maximum capacity: 70 GPM • Maximum head: 37' TDH CO us Tested to LIL 778 and CSA 22.2108 Standards By Canadian Standards Association METERS FEET File AR38549 40 i PE51 .MODELS: PE31, PE41, PE51'.. HP:.33, . .W 35 - _. 10 2 G p r 1 Goulds Pumps is 150 9001 Registered. 3 -PE41 1 w 25 PE31... ,. x _ Q z 20 ; o J Q 75 i 10 o . 5 0 0 0 10 20 30 40 _ 50 60 40 GPM 80 0 10 15 m 3 /h CAPACITY 11122/2005 11:34 2626922418 PETERSEN PAGE 04/11 36. 2 ,?, -z Y) �o 1009-- Yo _ ccr8 Wastewater Services POWTS INSPECTION AGREEMENT The correct operation of the below equipment significantly influences the life of the wastewater system. Periodic inspections will help extend the life of the system and prevent the need for costly repairs. This agreement authorizes access to your POWTS equipment by a trained and authorized Petersen technician during daylight hours to provide regular inspections and routine maintenance to help assure the equipment is working properly. It is hereby agreed by and between Purchaser and Ivee -f >D ✓ A (Service Provider) that in consideration of the payments provided for herein, Service Provider will provide the services of a factory - trained representative to perform periodic inspections of the equipment described below. Service Provider will prepare a written report after each inspection and provide a copy of the report to the Purchaser. This report will contain recommendations for any operation and maintenance deemed appropriate by the inspector. This agreement does not assume any responsibilities or obligations that are normally the responsibilities of Purchaser and does not extend to cover any costs that may be associated with any recommendations made under this agreement. In no event shall Service Provider be responsible for any special or consequential damages, including but not limited to, loss of time, injury to person or property or incidental economic loss due to equipment failure or for any other reason whatsoever. Service Provider may supply additional services, parts or labor only after authorization by Purchaser. 7 This agreement shall remain in force for a period of _� years, beginning _ — Z •�-� e li 20 and will automatically renew each year thereafter for one year unless canceled by either party with at least 30 days written notice. This agreement may be canceled by the Purchaser only if replaced by a service agreement with an authorized service provider for the equipment listed below. Service Provider may delay or cancel future Inspections if payment becomes at least 15 days past due. Periodic Inspections: The Purchaser agrees to pay Service Provider $ .d �a per inspection for four (4) inspections for the first two years at six month intervals and one (1) inspection each year thereafter. Payment for the first two years of inspections is due at the time of installation; additional payments are due upon inspection. Any additional testing or services required by Purchaser will be billed based on time and material amounts. / Date Service Provider er N � �S�ature �q % Phone l � 2 ? �y Address ' Z 3 a ✓a' City ct State wl Zip ✓'moo /i Equipment Covered Under This A reement Description Model No. Serial No. Install Date Location if different from System Owner t c - YY�i< t�s-k, ficS M vp -23 S stem Owner: Date: Signature: Print Name: � F/''�' " , � Phone: Street: City, Stateft, Zip: CC S P E -Nail: Payment Type: Check Cash American Express Visa MasterCard Other Credit Card No. Exp. Date Payment Amount: Name on Credit Card (print) Signature: This aO,ffmts ea by Tel: 888 -455- 6864, 262 -692 -2416 Petersen Resources LLC Fax: 800-669-1232,262-692-2418 PO Box 340,421 Wheeler Ave., Fredonia, WI 53021 -0340 USA E -Mail service a@petersen -cc WE LOVE TO SERVE Our Customers QUAUTYPRODUCTS SINCE 1916 11/22/2005 11:34 2626922418 PETERSEN PAGE 03/11 A Complete this section ONLY if the FASTO was installed in tank at the jobsite. Tank Manufacturer: ( � . Tank Model No. Working Liquid Volume in Trash Collector Chamber: Working Liquid Volume In FAST Treatment Chamber: FAST system installed using which method: ')< Lid Suspension (Check one - X) — Leg Support FAST system installed into tank by whom: w1 sre A- c� G B Tankage Yes No Service & Access Ports Yes No Concrete Tank Trash Tank Clean Out Present X Fiberglass Tank FAST Chamber Clean Out Present Anti - Flotation Installed Trash Tank Vent H Loading Capabilities Inspection Port Access to Grade Fill Over FAST Lid Tank Level Watertight Joints & Piping C Alarm PaneMping Yes No Visual Element Operating Length of Air Supply Line: Audio Alarm Operating Sensor Switch Installed Diameter of Air Supply Line: yC D Air Blower Y No I Yes No Filter Element Inside x Inlet and Outlet Pipe Installed Correctly Blower Hood Installed �_ Blower Operates Correctly Blower Hood Secure y— Blower Area Subject to Flooding Blower Area Ventilated Blower Area Subject to Snow Load Wired for High eiAlaty Voltage (Circle one) Blower Hood Vents Clear _ Voltage: Z, Z p Single Phase oreFhree.e; Brand: 50 Hz or 60 Hz: E Treatment Unit Yes No Yes No Air Lift Operates Correctly Remote or Inspection Port Vent Module Insert Stable � Module Sealed & Bolted to Tank 4" Outlet Pipe Placed J� Length of Vent Line: Air Line Connection Glued to Airlift D� Air of Vent Line Pipe: Z �' E Treatment Unit Yes No Yes No Manuals Onsite for Owner NSF Inspection Service Given to Owner Warranty to Owner SC After NSF Service Contract to Owner . G Remarks & Describe/Sketch Treatment System Components and Configurations Attach Additional Sheets if Necessa * Product Re istration .Re art must be com leted and returned to Bio- Microbics, Inc to effect warrant .* Ps test product registrat(on.doc 11e22/2005 11:34 2626922418 PETERSEN PAGE 02111 8450 Cole Parkway • Shawnee, KS 66227 - Phone: 913422 -0707 - Fax: 913- 422 -0808 e -mail: onsitedbiomiaobkx.com ■ www.biomicrobics.com • 8W-753-FAST(3278) i I N C 0 a P 0 R R 7 E D Warranty Registration & Start -Up Report Please Circle or Highlight Model: MicroFAST® HighStrengthFAST® RetroFASTe NitriFASTe LagoonFASTe Model Size: 0.25 0.375 0.5 � 1.0 1.5 3.0 4.5 9.0 Serial Number: 3U�16( Date of Installation: INSTALLATION SITE NAME S� �JL Company: ADDRESS .� CITY /STATEIZIP U e-fi PHONE/FAX OWNER if different than INSTALLATION SITE) NAME Company: ADDRESS CITY /STATE/ZI P PHONEIFAX BIO MICROBICS' DISTRIBUTOR NAME Petersen Supply ADDRESS PO Box 340, 421 Wheeler Avenue CITY /STATE/ZIP Fredonia, W153021 -0340 PHONE/FAX 262- 692 -2416 262- 692 -2418 INSTALLER NAME ADDRESS CITYlSTATE /ZIP PHONE/FAX �? NAME CONSULTING ENGINEER if applicable. ADDRESS CITY /STATEIZIP PHONEIFAX Please mail or fax Completed form to Petersen Supply, PO Box 340, over4 Fredonia, WI 53021 Tel: 888-455 -6864 Fax: 804 -669 -1232. Thank you.