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Parcel #: 040- 1170- 50-000 12/13/2005 08:30 AM
PAGE 1 OF 1
Alt. Parcel M 36.28.20.647D 040 - TOWN OF TROY
Current X,, ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
STUART J KRUEGER O - KRUEGER,STUARTJ
216 N ILWACO RD
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): ' = Primary
Type Dist # Description " 216 N ILWACO RD
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 2.000 Plat: N/A -NOT AVAILABLE
SEC 36 T28N R20W PT G L 2 COM AT INTSCTN Block/Condo Bldg:
OF RIVER & S LINE OF G L 2, TH E 402 FT,
TH NLY 132 FT, TH W 66 FT, TH NLY 66 FT, Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
TH W 138 FT, TH NLY 70.125 FT, TH W TO 36- 28N -20W
RIVER TO POB,EXC P647C
Notes: Parcel History:
Date Doc # Vol /Page Type
08/12/2003 735169 2360/019 0C
10/16/1997 567013 1270/495 WD
07/23/1997 1087/104 LC
1246/475 WD
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
103354 384,400
Valuations: Last Changed: 07/21/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 220,000 150,000 370,000 NO
Totals for 2005:
General Property 2.000 220,000 150,000 370,000
Woodland 0.000 0 0
Totals for 2004:
General Property 2.000 220,000 150,000 370,000
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
� ST. CROIX COUNTY ZONING DEPAR T _ ` �
AS BUILT SANITARY REPORT
_P 0 4
Owner 5
Addres 2/5'
�- City /State
Legal Description: ' 0 4 5¢ //s ,sy,
Lot N� Block Subdivision/CSM # / - ASR T or- G0 V'7 Lo T Z
'/4 44I '/ NJ4) Sec.3&, T-�LN -R� - W, Town of _ T'R 0y PIN # 6y0 • 1170 • 30 • dd10
Oyp • //? o . SSp . M7)
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
iv e W,-- W / E5�2i � 41 o -
Tank manufacturer C0wC -a f- Size ST/PC l v / to Setback Setback from: House ? Well � P/L
Pump manufacturer _M%[j5R2 5 Model Af YQ //O.Up4
Alarm location
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fr intake W me
Meter location
Alarm location
SO ABSORPTION + • L g x 2- /
IUN SYSTEM CMG
Type of system. /
YP Y DUN17 Width L QJ Length 3 0 Number of Trenches J
Setback from: House —y-bU— Well 25' P/L Z Vent to fresh air intake >
ELE
s v /?oE yoX � �/' �- 40 T
Description of benchmark 60RiVElt T Elevation
Description of alternate benchmark 4v e7l Elevation q1. 05
Building Sewer ST/HT Inlet ST Outlet /V I PC Inlet
PC Bottom q3 ' 7 7 Header /Manifold Top of ST/PC Manhole Cover 671?1
Distribution Lines ( ) lo g . y ( ) �d 14J 15P
Bottom of System ( ) Q� O �' / 070
/y'
Final Grade ( ) � 0 • &0 ( ) ( � � 7 '
A 2.0
Date of installation / / Permit number � D5 State plan
Plumber's signature t �NV License number Z�. Ce 3 5 Date `�' r
P JCS U /�� t /Lf}�
fns ector 20D
ORIG . Complete plot plan �
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4QN am A to V>
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it t s=s1n Department of Commerce PRIVATE SEWAGE SYSTEM County,
ety and Buildings Division
ti I INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) SanitarxUr —tNo.:
Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. 3
Permit Holder's Namty [] Village TwRO State Plan ID No.:
Krueger. _ e: Stuart ❑Ci Tro Township WS
CST BM Elev.: Insp. BM Etev Parcel Tax N-
.: BM Description:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV.
Septic SE2_ 0 Benchmark 5, ( cm. O `
Dosing I=) c � Alt. BM os, 0 3.qL 1 01. 1 1.57 '
Aeration Bldg. Sewer 8.. . oS
Holding St /Ht Inlet S - q r
TANK SETBACK INFORMATION St/ Ht Outlet
TANKTO P/L WELL BLDG. Vent to ROAD Dt Inlet
Air Intake
Septic rj 2 s ( NA Dt Bottom
Dosing tc u t NA Header / Man.
Aeration NA Dist. Pipe 112' tS O$.6G f
Holding Bot. System 10 -4 .g r
PUMP/ SIPHON INFORMATION Final Grade
l Manufacturer Demand
%t onvor
pForcemain Numbers – p GPM /e 10.1(0 &.11, () IM- 0
Lift Lriction •`t� Sy TDH %9. 2.
��Z
/ stem Fi
Length" .+S Dia. r ' Dist.Towell
SOIL ABSORPTION SYSTEM 3' �—--�
B E W/ T Width Length r No o f T s PIT No. Of Pits Inside Dia. Liquid Depth
MEN I N 9 1`��S DIMEN I N
SETBACK SYSTEM TO P/L BLDG WELL LAKE STREAM
M- 2.
LEA HING anu acturer.
INFORMATION Type O / �.6 CHA Mo a Num er:
System: � 1 n -� OR
DISTRIBUTION SYSTEM
Header / Mani old ++�•� Distribution Pipe(s) r ri x Ho3�ize r r x Hole Spacing Vent To Air Intake
Length '�•� Dia. 2 Length 14.0 Dia. �V Spacing z•Sd '� Z
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑Yes ❑ No ❑Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, a .) Wo9 o r r
Inspectio # os/ q/ f) #2 AL 11
Location: 215 Ilwaco Road, River Falls, WI 54022 (SW 1/4 1/4 36 T28NA2 W ) .
pha„� ew
1.) Alt BM Description �r L pe-4C
2.) Bldg sewer length= 9 0'
- amount of cover
3.) contour = 1 (SU ^4' 3. * w.F 140
Plan revision required? ❑ Yes FNo
Use other side for additional inform tion. 19 Z.cn
Inspector
SBD -6710 (R.3197) Date s Signature
' Cert. No.
-n . /G>f} C GO /P� • /Pi U-Gt, �f /lf
F Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application PO Box 7302
�WISCVnsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of Commerce (Submit completed form to county if not
(Privacy Law, s. 1$ "0¢(I)(rn)�_ state owned.
Attach com let e lans (to the county copy onl t yh" stem, on paper not less than 8 -1/2 x 1 I inches in size.
County • C�o, State Sanitary Permit Number ,. •( eck if eCvision to previous: State Plan I. D. Number
'S 1? �o I y
I. Application Information - Please Print all In format io `'' Location:
Property Owner Name Property Location �n
J /""`1/4,S ,N,)�E or W
Property Owner's Mailing Address •, Lot Number Block Number
�l /L1 r41A) S r. PST aF �ovrLo7` /
C, State Zip Code )shone Number- Subdivision Name or CSM Number
II Type of Building: (check one) ❑ City
❑ I or 2 Family Dwelling - No. of Bedrooms: ❑ Village _leo y
❑ Public /Commercial (describe use): ji"QTown of CGO n
El State-owned %,4
III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road d QVAq�31a�
A) 1. ❑ New System 2. Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s)
System Tank Only Existing System " ZJ? La.
D •J't7
$) Permit Number Date Issued
❑ A Sanitary Permit was previously issued
1V. Type of POWT System: (Check all that apply)
• Non - pressurized In- ground Mound ( ,x l q') ❑ Sand Filter ❑ Constructed Wetland
• Pressurized In- ground Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V Dis ersaUTreatment Area Information: C4 r - Q 7, Q
1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation '
VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing �-� crete structed
//►►�� T Tanks n �W�.ji �.Vv
r 00/G ❑ ❑ ❑ ❑
VII Responsibility Statement
I, the undersigned, assume res on ibility for installation of the POWTS shown on the attached plans.
Plumber's Name (print) Plumber's Signa ure (no stamps): 171P /MPRS No. Business Phone Number
[;o off ulel�r zz�3�S �iS' 3X6 ' ,f
Plumber's Address (Street, City, State, Zip Code)
VIII County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin gent Signature (No stamps)
Approved ❑ Owner Given Initial Adverse Surcharge Fee
Determination 3 2 S�o U Z O rti
IX. Conditions of Approval /Reasons for Disapproval:
ff�
�0" M�dl <� [� Fl f t (A(wQ UW� Y(J auoiGtf yrAr� ; ;�.g ON S / �D�as '�Z ° � / ($�. `ry x/ �i ✓l✓�11G�� /�
V V v� >a ry UPM fw/ f SK[�` �r Rt stt�( Yom! f� / 1r ri4/ Y7 lr� °faUQ i° `/ f � Cror Cd(t✓J �iY! �n� G 1
7h. s se >< �.�
SBD -6348 (R. 07/00)
i
Safety and Buildings
PO BOX 7162
MADISON WI 53707 -7162
s TDD #: (608) 264 -8777
iseonsin www.commerce.state.wi.us /SB
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
November 03, 2000
CUST ID No.226375 ATTN: POWTS INSPECTOR
ZONING OFFICE
ROBERT W ULBRICHT ST CROIX COUNTY SPIA
655 O'NEIL RD l YOI. CARMICHAEL RD
HUDSON WI 54016 '�` ' p HUD - SON WI 54016
RE: CONDITIONAL APPROVAL
Identific ers
PLAN APPROVAL EXPIRES: 11/03/2002 nsaction ID . 445448
ST '�i - "" t Aife ID No. 201159 `� 'J SITE: ,t i lease refer to both identification numbers,
, '� ?�ir�C. �a =��OE , Site ID: 201159, STUART KRUEGER CABIN �� bove, in all correspondence with the agency.
ST CROIX County, Town of TROY; 215 N'LI:,W,� (
SWl /4, NW1 /4, S36, T28N, R20W — c�
FOR:
Description: MOUND DWELLING GPD 150
Obiect ne: PGW Sv;t:m Rewate. :-bled 1D Rio.: 768553
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.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• 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.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sinc ely, . DATE RECEIVED 10/18/2000
FEE REQUIRED $ 175.00
FEE RECEIVED $ 175.00
JAMES B QUINLAN , POWTS PLAN REVIEWER BALANCE DUE $ 0.00
Integrated Services
(608)266-3937, 7:00 AM 3:30 PM MON / FRI
JQUINLAN @COMMERCE.STATE.WI.US WiSMART code: 7633
cc: STUART KRUEGER
Safety and Buildings
PO BOX 7162
MADISON WI 53707 -7162
TDD #: (608) 264 -8777
ww
Viscons w.commerce.state.wi.us /S8
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
November 03, 2000
CUST ID No.226375 ATTN: POWTS INSPECTOR
ZONING OFFICE
ROBERT W ULBRICHT ST CROIX COUNTY SPIA
655 O'NEIL RD 1101 CARMICHAEL RD
HUDSON WI 54016 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
Identification Numbers
PLAN APPROVAL EXPIRES: 11/03/2002
Transaction ID No. 445448
Site ID No. 201159
SITE• Please refer to both identification numbers,
Site ID: 201159, STUART KRUEGER CABIN above, in all correspondence with the agency.
ST CROIX County, Town of TROY; 215 N ILWACO RD
SW1 /4, NW1 /4, S36, T28N, R20W
FOR:
Description: MOUND DWELLING GPD'f3`0
Object Type: POWT System Regulated Object ID No.: 768553
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.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• 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.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sin c ely, . /f DATE RECEIVED 10/18/2000
---C�- FEE REQUIRED $ 175.00
FEE RECEIVED $ 175.00
JAMES B QUINLAN , POWTS PLAN REVIEWER BALANCE DUE $ 0.00
Integrated Services
(608)266-3937, 7:00 AM 3:30 PM MON / FRI
JQUINLAN@COMMERCE.STATE.WI.US WiSMART coder 7633
cc: STUART KRUEGER
ULBRICHT & ASSOCIATES CO.
655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems
715-386-8185
Private Sewage Consultants
T 7 PROJECT INDEX
P lan I.Q. # Date G�' �Z "- Z&Cr
Owner 5TVAe % e - , Phone 71 • yZ • 7.2 PJ
Address 2,1f �. �Ii¢!,(> S 7 7 -
/l✓� f�`l ��• S Y OZ. Z
Legal Descri ption �ov7- 4�' 6 r ear >-- Z 1: 0y0- 1170 -30 oe
5 %/,, 40 %y 5.�. 3G , T o w oy0 •1/70•So• ova
Town of -T,p p y County C P_ 0 r
C.S.T. R. Al SIP /`Gd?- Installer �. �i1L(3R l cLt T—
Local Authority/ Supervision M S 2 Z. 7
5 T• CQ c X 2o 1 . 0 6-.
PROJECT DESCRIPTION
• e01t4 G4i5 - 1q 8;0 T S yS T. 7Q � /f - !s 5254SO V* Z
, s
so l �
PDX40 /W *7�E Ila PAP S ylr. wp/ /a " .sr��1� f(// �S
p.O.W.T.S.
Coll "l itionCikv UlbnGtit & ASSOCIates
�+ private Sewag Consultants
AP P RO
,
ED
y 655 O 'Neil Rd . 4018
DEPARI V ENi I OF COMMERCE Hudson
Wis. 5
/ OIVIIOtvt�F SAFETY BUILDING J
' SEE CORRESPONDENCE /� Jr
Pg. 1 PLOT PLAN VIEWS
Pg. 2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS v
Pg. 3 PIPE LATERAL LAYOUT
Pg. 4 DOSING CHAMBER CROSS SECTION & SPECS.
Pg. 5 PUMP PERFORMANCE SPECS
Pg. 6 OPERATION, MAINTENANCE, AND PERFORMANCE REQUIREMENTS
This design for installation is based entirely on measurements, elevations,
landscape conditions (slopes etc.) and soil suitability provided by CSTM
L The accuracy of his specs, as reported, shall remain the sole responsibility
of the CSTM.
Any use of this POWTS design ty any licensed plumber, or any
related unlicensed parties or persons (excavaters, laborers)
shall not be construed as an assumption of responsibility by
the designer for the workmanship, construction, placement,
substitution or selection of any components not specified, or
any assumptions by the plumt that any unspecified components
are state approved or proper, or the effects of poor judgement 1
' if working under adverse damaging weather conditions (wet /frozen
soils) by any such parties or persons.
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F / 8$ Fr. iN VER r OF �y ] ATERA(S � 50
78
F FT• i
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G . 5 F- 1 r
H I.o FT. • T ° P OF � IATERA IS
PLA VI of MoU-�jD wI rli 13ED
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FoRct: MAW A $ FT•
Fr
K 9 S Fr
---- - - - - -- - - - -- o -� 38 Fr
T
w ---- - - - - -- -- - - -j ` 1 F
K -�� — o — Fr
� W � L$
o w Fr
B of
To 1 1n
PVC_ Wpep A 93PF5ATE
d f3SE R VhT� o,� ,
Pip E S 10CA7'1 c)5
PERMAu t"T M ARKERS
REG?UiRED BA SAL h►ReA - 'D Ai�y � h Sr E' F / ow - I.7 - 36
SOIL I,J trIQATit3E . 5
C AiPAci ry Sa. Fr,
PROMSED BASA4 MeA� B (A + :1
x( + 1
FT,
p ips - L,4\ --
To
P Fr
R
Fr
F n X �NcNEs
R E MAt ,�
�p FT of ?� PUG y
VARt A(3LE .
TOTAL VOID U0IC)-jE F, 2- GALS. WSToNacL-
H oil; D,' w
To 7 llo /U�y�—
AMETE'R
/7�kIa/C�K
I- "
3.3 5.
Fopc MAw 2
1►�GI{ES
.#' of Ho1E5 /p; p15 /8
I -OV ERT ELEVATIOKJ
of LATEIgA S
SEE PtLx:PS(5 SIDE `F'aF�'. 109
TIR" i"AL C/O T) &TA(L
` PER f hTE P' P E
Z
� \
Re"ovt^ All DRill BORR5 \ Y
61E 1 c ) cATED 0.0 BoTroM E`qvAllY AC
$ E L7
p
IIi sT Ri [3uTlom 'Dtsc hA9 &E RATE
POR E�Ach LAT" L,
PER 0-rf s //l 88
GAL�M��v.
TOTAL - OISTRiQUTloO 'Di5CHIlR6E FATE r-OR
NET woR K 3
G'AL/Ml � a•5 Mt'Nt
I
ID
AT
�a vb-,e
s 4-o _
/RUC 134//
dd 1'
SEPTI TAN t PUMP CHAMBER CROSS _SECTION AND SPECIFICATIONS
sN�
4" CI VENT PIPE 12" MIN. ABOVE GRADE >; WEATHER PROOF
a ? l0' FROM DOOR, WINDOW OR
FRESH - AIR INTAKE Aee�0 0 JUNCTION BOX APPROVED (� WITH CONDUIT MANHOLE COVER
5"& 4,0 W1 PADLOCK &
WARNING LABEL
MIN.
o INLET '
I �. 0 I l i
GAS- '
11 ivy 7 . TIGHT i ,
��� 2!ABe �� - A I SEAL
f PROVED
ScD. 40 F, t ,,-r __I__
QUC pi fad AA B ALINTS W/
,I (`�► 0� t L `�'! ' 30� ON PE 3' ONTO
3� to S O I LD 3 � 3 i SOLID S O I L
PUMP OFF ELEV . FZ'. -A— _ RISER EXIT
93,'7p D I Z•2 RMITTED ONL TANK
NUFACTURER
3" APPROVED BEllDING UNDER 'TANK HAS APPROVAL
CONCRETE PAD
SPECIFICATIONS
SEPTIC / DOSE MID10'15510N Z
TANK MANUFACTURER: 7 NUMBER DOSES PER DAY:
7S
TANK SIZES SEPTIC /0'40 GAL. DOSE VOLUME INCLUDING
DOSE GAL. FLOWB 85 GAL.
ALARM MANUFACTURER:
11•11-e' 1 CAPACITIES: A = Co• INCHES = GAL.
MODEL NUMBER: —
3WITCH TYPE: B = 2 INCHES = 33 GAL.
PUM MANUFACTURER: / yEYO S A C = S 2 - INCHES = G5 GAL.
MODEL NUMBER: /yam' p
SWITCH TYPE: j
� /O -}J - " - D = 2(o * (42 INCITES = 7 3 Z' GAL.
REQUIRED DISCHARGE RATE / GPM PUMP & ALARM WIRING AS PER ILHR 16.23 WAC
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE g FEET
+ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . g.Z5 FEET
+ SD FEET FORCEMAIN X 3.3(2 FT /100 FT. FRICTION FACTOR 1-7 FEET
TOTAL DYNAMIC HEAD �.- FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ���Z WIDTH It ; DIAMETER
LIQUID DEPTH jIt 3.3 ' )
SIGNED: LICENSE NUMBER: DATE:
P/C 'SPECS
C. I Of= DE P14-
- SEPTIC TANK, per Comm.93.44 (2) (c) shall be equipped with an
outlet attached approved filter device (Zabel
fliter). Tank shall have an approved above
ground locking manhole cover for regular (every
12 months or less) inspection & servicing by a
licensdd service pumper.
_ I
fit
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A ,`p
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ME40 Series S s '
a 1 .
4/10 HP Effluent ``
n n
and Drain Water Pumps
Performance Curve
„
MODEL ME40 EFFLUENT PUMP f;
CAPACITY LITERS PER MINUTE
0 50 100 150 200 250 300 350
40 12
i
35 ; 4 r�
10 N �'
W 30
ti
8 p
a ;
Z 25 Z `
D r 0
a
W 20 6
1 1
G p
0
2 }
5 �.
f � i
1,
2,
0 0 10 20 30 40 50 60 70 80 90 100
CAPACITY GALLONS PER MINUTE , p
t
1`
1
F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 -1923 1 {
419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 ": 4
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Pg. 6 of 6
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the
septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and
outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to
ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that
may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if
the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of
the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise
the owner.of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in
the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required.
However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and
Buildings Division.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to
verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
Mound and Pressure Distribution System and the mound
No trees or shrubs should be planted on the mound. Plantings may be made around the mounds perimeter,
shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic
(other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the
infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather
installations (October- February) dictate that the mound be heavily mulched for frost protection.
m not exceed 220 m
Influent quality into the mound system ay /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may mg
/L
exceed maximum design flow specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each
lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be
compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is
required to maintain equal,distribution within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,
and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its'
component manual (SBD- 10572 -P (R. 6/99)) and local or state rules pertaining to system maintenance and maintenance
reporting.
No one should ever enter a septic or pump tank,since dangerous gases may be present that could cause death. Septic and
pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access
openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed
unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall
be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be
immediately repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired
or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions on the operation or maintenance of this system should be directed to your county zoning or health inspector.
SEE REVERSE SIDE Pg.6 FOR MAINTENANCE REQUIREMENTS SPECIFIC
TO THIS SITE, DESIGN, AND COMPONENTS
Pg. 6 Continued. "
POWTS (landowner) is reponsible for proper operation and
maintenance of this system. Regular periodic inspections and
servicing is necessary for the safe healthy operation of this
system. The owner is required by code to submit all necessary
maintenance /inspection reports to the controlling authorities.
SPECIFIC CONTACT AGENTS
• Governmental authority/ inspectors:
3g& 7 CO
• Licensed installer, responsible for providing an operation/
mai "User l ��al :
- 7 1Y
3 96 ! ` Z Il 3J? S
• Licensed service / inspection agent other than installer:
. ,v SI
r
�,�, Gov r� 3
• Electrician, for pump, electric controls, wiring units:
IMPORTANT OWNER MAINTENANCE REQUIREMENTS
1. Winter traffic (sledding, shoveiring, etc.) across the mound
area shall not be permitted, or frost can /will penetrate into
the cell, freezing up the system. Discontinuos use in the
winter (a vacaction trip, resulting in no water use) can also
lead to freeze ups.
2. Water conservation needs to be exercised! Or system can be
hydrolically overloaded and destroyed. This system was
designed for a maximum wastewater flow of 160 gals. daily.
3. POWTS are not designed to accomodate wastes from a garbage
disposal unit, or any other unnatural sources of waste.
Any introduction of such waste materials will overload and
destroy this system.
4. If a power outage occurs, or a pump fails, it may result
in a temporary overload of effluent being pumped into the iry
cell, which may adversely impact the cell (lealtkge). It is
recommended that a licensed pumper empty the dosing tank,
allowing the pump to return to dosing the correct amounts.
Consult your installer immediately for advice.
5. Neglect of the vegetative cover (the cells insulation &
erosion preventive) can lead to failure. Compaction or heavy
traffic also can destroy t he system. It IS NECESSARY TO
REGULARLY WATER THE VEGETATION OVER A SYSTEM!! Effluent in
the system beneath IS NOT sufficient alone tO maintain a
grass cover.
6. Periodic inspections by the owner, or his agents, is
necessary. Inspection pipes and ports have been incorporated
into the system: on the mound basal area (effluent level
inspection pipes), cleanout terminals on the pressurized
laterals, at each tip - for flushing and cleaning the laterals
out. The filter system in the tanks (via a locked above
ground cover /manhole). Only a licensed properly qualiOied
person should be performing this work which involves health
& severe safety risks. Evidence of effluent ponding in the
system's treatment cell shall also be regularly inspected.
Wisconsin Department of Industry SOIL AND SITE EVALUATION
Labor and Human Relations Page of 3
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis.
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and ST
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. #
APPLICANT INFORMATION - Please print all Information. Revie ed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Zp Z 6O
Property Owner Property Location
SU L t E 4A N Govt. Lo� SW 1 /4 AW 1 /4,S 3 tP T 2 ,N,R Z O E (or W�
Property Owner's Mailing Address Lot # I Bock# S or CSM#
7y cry, - RI? . F - / /
City State Zip Code Phone Number Nearest Road
Rfmi GfF /S GlJ/ 5q0 z.Z (7I5 )qz$- Zy3B ❑ Clty ❑ vaa e E Town
❑ New Construction Use: B<esldential / Number of bedrooms - 3 Addition to existing building
2 Replacement ❑ Public or commercial - Describe:
Sod -
Code derived daily flow gpd Recommended design loading rate • S bed, gpd/ft trench, gpd/ft
Absorption area required 315 bed, ft 375 trench, it $
Maximum design loading rate bed, gpd/ft trench, gpdift
Recommended infiltration surface elevation(s) S Pe1 3 r • G J� �� it (as referred to site plan benchmark)
Additional design /site considerations �E�t� /��S d U-vfJ SVS. ev q
Parent material _ g Korexr,� ' cr0 Flood plain elevation, if applicable ft
S = Suitable for system Conventional �M�ouunnd In- Ground Pressure AT- Gradee System in Fill Holding Tank
U = Unsuitable for system ❑ S a U LJ s ❑ U El ['� El I� U El [9 0 S
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft2
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
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Boring # .
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CST Name (Please Print) Signature Telephone No.
•Rota �.T u l b k i 6-k — '1 c 5- 3 P6- 8 RS
Address Date CST Number
Ptivate Sewage Consultants
855 O'Neil s. _rmPole Aj T S i.v", ow ( 6 t/A�
Hudson, Wis. 54016
/1 0"
G1NA� _
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Moo,vO 5/5TFCj 4�;1'4 &C ,p� 4vi,�ED
S• H A-tf ► SOIL DESCRIPTION REPORT
PROPERTY OWNER Page z- of .3
PARCEL I.D.#
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Boring #
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ST CROIX i OUNTY
SEPTIC 'TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Mailing Address � • WJ/V ST; �1 U
Property Address ' 2/5 71 • _T W .' f eca Aq • �i U-Gti ' f f�s s y�'2'
(Verification required from Planning Department for new construction)
City /State Parcel Identification Number �yo • 72/) • 3
ayD j� 70 • SD
LEGAL DESCRIPTION f
Property Location s � ' /,, � :�, Sec. 3 � , T 2,� N -R 20 W, Town of
Subdivision , Lot #
Certified Survey Map # , Volume , Page #
5&'7 013 - /270 --
Warranty Deed # Lo/ Cr (o /y Volume Page # 3 5:2
Spec house CJ yes kno Lot lines identifiableAes O 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 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 the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
mg that y r sep , V se
ystem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
da f the tee r expiration date.
if //J/ 0 ° .
NATURE APPLICAN' DATE
b NER CE IF TION
I (we certi y fat all statements on this form are true to the best of my (our) knowledge. I (we) 9 (are) the owner(s) of
r=rty cri ab ve, by virtue of a warranty deed recorded in Register of Deeds Office.
MATURE F LICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
+ ..W
L r
DOCUMENT NO. WARRANTY DEED �I
t t �
c���. r49�
} Michael J. Hahn and Julie S. Hahn, Grantor, conveys and warrants to
Stuart J. Krueger and Charlene L. Krueger, husband and wife as marital .EGIS T E R'S 0'
property, Grantee, the following described real estate in St. Croix S T. L R OIX L'�>„ v
v.� county, State of Wisconsin: ,
Rsc'd far
Commencing at the point where the highwater merk of Lake St. Croix OCT 1 6 1997
intersects the South line of Lct Two (2), Section Thirty -six (36),
Township Twenty -eight (28), Range Twenty (20); running thence East_ 9:40 Alf
v the South line of said Lot Two (2), 402 feet; running thence '�V`'
4 North 21 °50' East, 132 feet; running thence West 66 feet; running = cyt
thence North 21 °50' East 66 feet: running thence West 138 feet; running ti
Re later of Ned'
thence l,orth 21 °50' East, 70.125 feet; running thence West to the "
highwater mark of Lake St. Croi- running thence Southerly along the
highwater mark of Lake St. Croix to the point of beginning; also the
rights of ingress and egress g by deed recorded in the office of
the Register of Deeds for St. Croix County, in "217^ page 207 and the
• easement granted by deed recorded in the office of the Register of b'
$;. Deeds for said County in 11 184 1 , page 30. �.
Except a parcel thereof heretofore conveyed to Halene W. Moore, more
particularly described as follows:
Commencing at the point where! the highwater mark of Lake St. Croix . .
intersects the South line of Lot Two (2), Section Thirty -six (36), NAME AND RETURN ADDRESS
Township Twenty -eight (28), Range Twenty (20); running thence East
along the South line of said Lot - wo (2), 50 feet; running thence North Rodli, Beskar, Boles & Krueger, S.C.
40 feet; running thence West 50 feet, more or less, to Lake St. Croix; 219 North Main
running thence Southerly along Lake St. Croix to the South line of said IPO BOX 138
Lot Two (2); Also the right of ingreP3 and egress granted by a deed River Falls, WI 54022
recorded in the office of the Register of Deeds of said County in
"217 ", page 207.
- •r
Together with an easement for roadway purposes for ingress and egress
over, along and across the following described real estate, being part 4
'i. of Government Lot Two (2), Section Thirty -six (36), Township Twenty-
G <. eight (28) North, Range Twenty (20) West, in St. Croix County, �� ^ t� 70 S Q U O C) _
Wi se:insin.
Parcel Identification Number fPINf k
The following parcel of land in said Government Lot Two (2), presently used for purposes of ingress and egress, and F
being subject toeasements for travel, described as follows: beginning at the southeast corner of said Government !cot;
thence North 0 °20' West 369.00 feet along the east line of Government Lot Two (2); thence South 89 1 52' West 798.55
feet; thence North 23 1 17' East 315.83 feet; thence North 67 °11' West 33.0) feet; thence South 22 °49' West 131.90 feet;
thence South 23 °17' West 136.81 feet; thence South 22 °11' West 66.30 feet; thence South 23 °40' West 194.4 feet; thence _
South 23 1 09' West 66.20 feet; thence East 37.02 feet; thence North 22 °37' East 32.24 feet; thence North 22 °37' East {
198.50 feet; thence South 88 °55' East 131.93 feet; thence North 22 °22' East 1.50 feet; thence North 89 °52' East 647.43
feet; thence South 0 0 20' West 335.90 feet to the South line of Government Lot Two (2); thence East 33.00 feet to the
point of beginning.
'a
This is not homestead property.
Exception to warranties:
. All easements, restrictions and rights -of -way of record, if any.
Dated thi _16 _ day of October, 1997.
(SEAL) - -- Gam- )
PA
-��-� _(SEAL)
Jr hn
,a Mic a H X Jul e S Ha
I
ACKNOWLEDGMENT ACKNOWLEDGMENT •' •,!.. .�
STATE OF MINNESOTA ) STATE OF WISt!ONSIN ) �!
) ss. y ) ss. ,�.•��. �, �
_ COUNTY COUNTY )
Personally came before me this day of erso 1 c�{ More me this �: flay Af l t
19 the above named 1 ? 9 "7 ��med
,e ti 1
to me known to be the person(s) who executed the to me known be thdp zonls) exec ed the
foregoing instrument and acknowledge the same. fdr grin ins men. $nd acknowle the s*iw p
Notary Public County, Wis. Notary Public f �.� County, Wis.
My commission is permanent. (If not, expiration. date: My commission ,ie-p apes►E- (If ot, expiration date-
THIS INSTRUMENT WAS DRAFTED BY-
Stuart J. Krueger
P.odli, Beskar, Boles & Krueger, S.C.
River Falls, WI 54022
... -
. Mt >.Af c: [�LI'� • .:
r -
1.482 PAGE 357
631..661
KATHLEEN H. WALSH
DOCUMENT No. REGISTER OF DEEDS
TRUSTEE'S DEED ST. CROIX CO., WI
RECEIVED FOR RECORD
01 -07 -2000 5:00 AN
TRUSTEES DEED
Gene R. Kind, as Trustee of Gladys R_ Kind Family Trust, for a valuable EXEMPT N
consideration conveys without warranty to Stuart J. Krueger and CERT COPY FEE:
Charlene L. Krueger, husband and wife, as marital property, Grantee, COPT FEES
the following described real estate in St. Croix County, State of TRANSFER FEE: 9,00
Wisconsin: RECORDING FEE: 10.00
PAGES:
PART OF GOVERNMENT LOT TWO (2), SECTION THIRTY SIX (36), TOWNSHIP
TWENTY EIGHT (28) NORTH, RANGE TWENTY (20) WEST, TOWN OF TROY,
DESCRIBED AS FOLLOWS: Commencing at a point on the South line of the
Northwest Quarter of Section 36, Township 28 North, Range 20 West,
22 rods and 6 feet East of the high water mark on Lake St. Croix;
running thence N21 ^50'@ 18 rods; thence N21-50'E 4 rods; thence East
8 rods; thence Southerly parallel with said first course 4 rods; thence
West 0 rods to place of beginning. . , , , . . .
NAM@ AND RETURN ADDRESS
P-09 , A46mg -, i Kn # kf''t*'&
7.0- SOX 1 ; f
R�uiFtx F el,'S. Wt5 Slloyz�
040117030000
Parcel Identlfication Number (PIN)
Dated this day of September, 1999.
QL)1DYS R. KIND VAAKILY TRUST
c KP /� S var, ) (SEAL)
G enKn ,
AUTHENTICATION ACKNOWLBDGMPrT
STATE OF WISCONSIN )
Siy ature(3) ) es.
COUNTY )
ated this day of 19 Perso 11y came before me this a.— day of
authentic ��� ' 19 "_ the above named
Gene R. KM d, Trustee of the Gladys R. Kind Family Trust
to me known to be the person(s) who executed the
foregoing instrument and acknowledge the same.
OP
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by 5706.06, Wis. Stets.) _
P ti County, Wis.
THIS INSTRUMENT WAS DRAFTED BY: Notary
My commis ens t : %If not, expiration date:
Stuart J. Krueger�� ` )
Rodli, Beaker, Boles & Krueger, S.C.
1•
P.O. Box 138
River Falls, WI 54022 �..Wis E' f,t.
• �� GO VERM VENT
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