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HomeMy WebLinkAbout032-2114-30-000 P_ Wisconsin Department of Commerce Safety'and Buildings Division PRIVATE SEWAGE SYSTEM count INSPECTION REPORT ST. CROIX G'NERAL, I (ATTACH TO PERMIT) Sanitar 2 e .[rt� i T Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)). S u L g Permit Holder's Name: Cit Vill a Town of : State Plan ID No.: LINVILLE, LORI �O"RERSE CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Fax No.: o b [o� k .� v.c l a:fbn TANK INFORMATION KOcs ELEVATION DATA A9800473 TYPE MANUFACTURER CAPACITY ST TION BS FS ELEV. Septic l Benchmark / �� Dosing I�/K Aeration Bldg. Sewer j ag �.ls Holding &I et TANK SETBACK INFORMATION �` a tlet �./ TANK TO P/ L WELL BLDG. " tO ROAD Dt Inlet Air Intake Septic 7 NA Dt Bottom _ rorle 6 . Dosing Header /Man. �(or S Aerati NA Dist. Pipe $L �y� Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Model Number cl� vct� Manufacturer Dem nd -�- (0 -/a . GPM I 1 / TDH Li Friction System TDH F Fi 10327 Forcem in Length Dist. To well SOIL ABS ION SYSTEM BE / EN �'2'S Width 22 Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM N J DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type CHAMBER Sys. ° Model Number: �? ►� .� ! OR UNIT DISTRIBUTION SYSTEM Header / Maoi�old Distribution Pipes x ole Size x Hole Spacing Vent o it In ake ►c1 rl Length Dia. Length Dia. Spacing k e SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only N Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil E] Yes C] No ❑Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) �ATION: SOMERSET 3.31.19,NE,SW 2334 53RD STREET — MEADOWOODS LOT 3 f 3 3 42(�v-�� 33 k BM Welk "} ' 1t Sal �fTp `� bla��- �,v�l�,-h� (;o (°t�I Ilan revision required? ❑ Yes Jse other side for additional information. .4 J14 3BD -6710 (R.3/97) Date Inspecto ' Signature Cert. No. /'l Z 7 6 5 P 1 1 7 789643 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. , WI Document Number Document Titre RECEIVED FOR RECORD St. Croix County 03/16/2005 08:25AN Occupancy Affidavit AFFIDAV EM PTT# nr� REC FEE: 11.00 PCk C C.AA e S TRANS FEE: oo� _ COPY FEE: Name - (Owner) Typed or printed CC FEE: being duly swam , states, under oath, that: PAGES: i 1. He/she is the owner /part owner of the folio w parcel of land located in St. Croix County. Wisconsin, recorded in Volume - Page & Document Number St. Croix County Register of Deeds Office: Recadt Area A parcel of land located in theF K of the Sb( Y4 of Section 3 Name and Retum Address T N — R IGV_ Town of _So�nev.s a et St. Croix Pwl _j Moo01 f— County, Wisconsin, being duly described as follows (include lot no. and 2354 63-A S t , le e'L subdivision/CSM or detailed legal description): 5 owe r s e 7Lw, W r 5 4 o ZS Lot 3 Meadowoods Town of Somerset Parcelldentification NUMber (PIN) As owner of the above described property. I acknowledge that the septic system serving this residence is sized for a — L bedroom home, or a design flow of !QQ2 L gpd. The design flow Is calculated by assuming 150 gpd for 2 individuals per bedroom. There are currently A occupants living in this residence: A occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However, I understand that if there are intentions to exceed the number of permitted occupants, the system will need to be modified to accomodate any increased wastewater flows and /or contaminant bads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this I S / day of /-1 .4., C_ ti 2 y g %`,, ...... • • �O • r 4 % C A T , t r tf L AUTHENTICATION ACKNOWLED6 ENT..• 4 b SignahKe(s) STATE OF WISCONSIN r.nu 0 t authenticated this da of St. cwix County. • y ,�� Personally came before me this / day of M A" �t)p g p above * a�i tMoc��e.. TITLE: MEMBER STATE BAR OF WISCONSIN (if not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. State.) instnrnent and acknowledge the same. THIS mdMUMEW WAS DRAFTED BY / No o re_ 0 r (Signatures may authenticated or Notary Public. State of Wisconsin may) acknowledged. Both are not My Commission is pegrlarmt. If not, state expiration date: Date: t �.. 3 t 16 /o "THIS PAGE IS PART OF THIS LEGAL. DOCUMENT– DO NOT REMOVE" _ TAts Worntadon mwf be oarpleled by aubmNer: and By (!f requir". OthaNrttOmvfion such as the WOnft louses. lsspar desa(p m- eft may be pAwd on runts )fist~ of 6W down k ormay be ptaosd on addMonaf pWos of the doarrnent- &gL Use d ffNs ooverpape adds one papa n you document and 12.00 to me reomd ino tae. Wisoonsin Statures. 5g.517. Safety and Buildings Division 201 E. Washington Ave. , SANITARY PERMIT APPLICATION P Box 7969 nsin, In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -796 Department of commerce not less County Attach complete plans (to the county copy only) for the system, on p y States nitary Permit Number than 8 12 x 11 inches in size. lication See reverse side for instructions for completing this app app cation Check if revision to r rams e information you provide may be used by o der government ag�n� p�og S State Plan I.D. Num r rivacy Law, s. 15.04 (1) (m)]. 33 5 Gl / `��- — op C, APPLI ATION INFORMATION property Location N, R E ( N -PLEA E PRINT ALL INF RMA TIO 1/4, S T operty Owner Name Block Number Lot Number ro rty Owner's Mailing Address Phone Number Subdivision Name or CSM Number ' ©• Zip Code ( ) Nearest Road 1 ity, State [] ity /W �LtJ State Owned village .� �V,>� I. YPE F B ILDING: (check one) ❑ Town OF o p - ODD Public 1 or 2 Famil Dwellin - No. of bedrooms Parcel Tax Number(s) �/ L/ 3 III. BUILDING USE (If building type is public, check all that apply) �J 3.31. Iq. ro5l 10 C] outdoor Recreational Facility 1 ❑ Apartment/ Condo 6 ❑ Medical Facility/ Nursing Home 11 ❑ Restaurant/ Bar/ Dining 2 ❑ Assembly Hall Campg round 7 ❑ Merchandise: Sales/ Repairs 1 2 ❑ Service Station / Car Wash 3 ❑ Campg 8 ❑ Mobile Home Park 13 ❑ Other: specify 4 ❑ Church/ School 9 ❑ Office / Factory 5 [] Hotel / Motel licable) Check box on Reconnection of 5. ❑ Repair of ys IV. TYPE OF PERMIT: (Check only one box on line AReplacement of line B, i 4. ❑ Existing System ________ Existin(- Syst -- New 2. C] Replacement 3. [3 Replacement Only_______________ _ _ __ g ---- - A) 1. P6 System ________System __ _____ ______ Date Issued B) [] A Sanitary Permit was previously issued. Permit Number V. TYPE OF SYSTEM: (Check only one) Experimental Other Non - Pressurized Distribution 30 ❑Specify Type erimental Tank Pressurized Distribution 41 ❑ Holding 42 ❑pit Privy 21 []Mound 11 ❑Seepage Bed 22 E] In- Ground Pressure #. _ 3 X' p� 43 ❑ Vault Privy 12 Seepage Trench 4 „ = ill 13 Seepage Pit 5-43 = /7. x T 14 ❑ System -In -Fill 3/•B VI. ABSORPTION SYSTEM INFORMATION: 7. Final Grade Elevation s/da / 2. Absorp. Area 3. Absorp. Area 4 Ga ga Pert. Rate 6. System Elev. Loading Rte S. ft) (Min. /Inch) Feet Feet 1. Gallons Per Day Re uired (s ) Prop sed (s . ft-) ( r D • .•�� OF Site Fiber Exper. Prefab. Plastic Capacity # of Conc Con- Steel glass App Total VII. TANK in gallons Gallons Tanks Manufacturer's Name Conc strutted INFORMATION New Existin ❑ C] C] ❑ ❑ Tanks Tanks ❑ ❑ ❑ ❑ Septic Tank Lift Pump Tank /Siphon Chamber VIII. RESPONSIBILITY STATEMENT Business Phone Number: I, the undersigned, assume responsibility for installation of th site sewage system shown on the attache p plpyMPRSW No.: Plumber's Signatur� tamp v ,•� Plumber's Name: (Print) Z er's Address (Street, City, Stat ip Code): E ONLY ate ssue UNTY / issuing Agent ignature (No Stamps) O EAR MENT (indudesGroundwate ❑ Disapproved Sanitarymi a Surcharge Pee) K Approved ❑ Owner Given Initial Adverse Determinaton APPROVAL: X. CONDITIONS OF APPROVAL /REASONS FOR DIS DISTpIguT10N: original to County. One �� TO' Sated 8 guldings Division. Owner• Plumber 4 014; j ; Ile >Z0 — 77b /SG --IV di i ' v ' v'ct6 9M 4 2- 7-0,p VA ' Zip t ,, /V D /-07 -'?vl// �I #z a IF Ott - (Arr w Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page �_ of 3 Division of Safety and Buildings Burea"f Integrated Services ,. ,Err - nce with s. ILHR 83.09, Wis. Adm. Code �s� , P , County Attach complete site plan on paper not le Rbala °$ 1/2 x 1iches in size , Plan must y include, but not limited to: vertical and iz*tal ref f3R (BM); direction and . percent slops, scale or dimensions, nooh..a�fow, and "I t atfdrr &rid distance td,nearest road. parcel I.D. # APPLICANT INFORMATION 1 se pri f L in;;Aation I Reviewed by Date Personal information you provide may be use4f6t condary rWpp{Privacy Layi 11.04 (1) (m)). 2 Property Owner ,, r Property Location 1© .� v� L a ��.. Govt. Lot °9 1/4S , 1 /4,S 3 T jl ,N,R C E ( W Property Owner's Mailing Address _ -f` Lot # lock# Subd. Name or CSM# . D. 4 0'r City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road &OA&WAl2 SYP17 126 )3SI-742-1— .5ib' , WC-xF,-r zg AI-5� ,,e r.4X 2 y 7 — yY d' JZ New Construction Use: � Residential / Number of bedrooms — Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow V gpd Recommended design loading rate bed, gpd /fi • I F trench, gpd /ft Absorption area required _ bed, ft2 5,6Z trench, ft 2 Maximum design loading rate 7 bed, gpd /ft . ,p trench, gpd /ft Recommended infiltration surface elevation(s) _. 9�•y ft (as referred to site plan benchmark) Additional design /site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ©S ❑ U E/ S ❑ U I] S❑ U [Z S ❑ U ❑ S ID U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench c G C_ Ground 3 Z�_ S fT Scrr G elev. /03 Z ft. Depth to limiting factor DS" in. Remarks: Boring # / Z Z 9-' 1 cs Ground elev. 1 0 0, 3 ft. Depth to limiting fact( Remarks: Signature / Telephone No. CST Name (Please Print) Date CST Number Address pAYE FOOMY OLUMONG Licgns Pork Tesw & pkar"r #W33 4-3- 209 0 0 %nd WWo t4Slt4 S4023 74c).3656 40 -3 to 7 eqlrA (( zorx/e K- AD -cc ` Z h `R v a a 3! IkA Qq I � �M z M M J 1 0 v v V 1 '^i r' n 40 «,, WiscorrSin Department of Commerce SOIL AND SITE EVALUATION Divi$iom of Safety and Buildings Page 1 of 3 Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size ". Plan must 'County include, but not limited to: vertical and horizontal reference point (BM ) `dirp ion and ,�r,, St. C r o i X percent slope, scale or dimensions, north arrow, and location and di lance to ne nest road: n Parcel I.D. # APPLICANT INFORMATION - Please print all inforrOation. % r A Reviewed by Date Personal information you provide may be used for secondary purposes (PrivaC -levy, s. 15.04 (A}(m)):C; Property Owner pp �p ation ZU�Nf ftXACE ; Richard Stout :' Govt. Lot NE Y4 SW 1 /4,S 3 T31 N,R 1 9 E rbw Property Owner's Mailing Address Lot t(` 151 oclt# 8ubd. Name or CSM# 1353 Awatukee Trail '3__ Meadowoods City State Zip Code Phone Number ❑ Nearest Road Hudson Wi P4016 (71 5 P49 -6731 Somer Somerset 232nd Ave 4 New Construction Use: Residential / Number of bedrooms 4 Addition to existing building Replacement RPublic or commercial - Describe: Code derived daily flow _ 5 0 0 gpd Recommended design loading rate.,, gpd „6_ gpd/ft g g � _ bed, /fi trench, Absorption area required 81�n n bed, ft trench, ft h 9$— Maximum design loading rate- bed, gpd/fF ••dG trench, gpd/ft Recommended infiltration surface elevation(s) SPA 1= c) plan ft (as referred to site plan benchmark) Additional design /site considerations Parent material 0 Flood plain elevation, if applicable It S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = unsuitable for system S❑ U ® S ❑ U [Is El U I ID S EJ U ❑ S E] u EIS U U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 1 0 -5 10yr4/3 -- sil 1 J# C ?b G mfr cs if .5 .6 BPS 2 5-1E 10yr5/4 -- sil 2/H mfr cs -- .5' .6 Ground 3 18-El 10yr4/6 -- sicl 2 *I:Th mf i cs -- . 4 , .5 elev. I • ?Q ft 4 51-S6 1 0yr4 /4 -- sl 2msb` mfr cs -- . 5 , . 6 Depth to limiting ; fa for 6 in. Remarks: Boring # 1 0 -6 10 r4 3 sil «bk ; 2 6 -31 1 0yr4 /6 -- sicl 2 t4 6/ mf i cs -- .4 '.5 'y 3 31-65 1 0yr4 /4 -- sl /Net yf( mfr cs -- .5 - . 6 1 � Ground It ft Depth to limiting factor 85— in. Remarks: CST Name (Please Print) J �inature , Telephone No. Address Date CST Number _s e. (0 na %1 / i n rn�re{ I ti I f M II3 • Y5 U I Visconsin Department of Commerce SOIL AND SITE EVALUATION lNision of Safety and Buildings Page 1 of _ lureau oYlntggrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Mach complete site plan on paper not less than 8 1/2 x 11 inches in size` Plan must County icludb, but not limited to: vertical and horizontal reference point (BM)j- , dirpcfion and , ,, St. Croix percent slope, scale or dimensions, north arrow, and location and disfanc4io ne4bW roads! Parcel I.D. # kPPLICANT INFORMATION - Please print all information.%° ' °? "o I Reviewed by Date p 'ersonal information you provide may be used for secondary purposes (Privacy �aW s. 15.04 Of {m)b (� 'roperty Owner P1 G Uon , Richard Stout Govt. Lot NE 1 !� SW 1/4,S 3 T�) N,R 1 g E orMX 'roperty Owner's Mailing Address" 11oc1 #,.,- ' 'Subd. Name or CSM# 1353 Awatukee Trail `-3 " Meadowoods ;ity State Zip Code Phone Number ❑City o ❑ Village ® Town Nearest Road Hudson Wi 4016 (715 P49 -6731 Smerset 232nd Ave R New Construction Use: Residential / Number of bedrooms 4 Addition to existing building Replacement RPublic or commercial - Describe: Code derived daily flow 6 0 0 gpd Recommended design loading rate -To bed, gpd/ft _ trench, gpd/ft Absorption area required 81 ,11 Q bed, ft _trench, ft 2 Maximum design loading rate- b bed, gpd/ft ••� trench, gpd /ft Recommended infiltration surface elevation(s) Sep plot plan ft (as referred to site plan benchmark) Additional design /site considerations Parent material 3 Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system 1 91 S❑ U ® S ❑ U Qs ❑ U IL S❑ U El s E] U El S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 1 0 -5 10 -- sil 1 jlt� �i mfr cs 1 f .5 .6 2 5-1q 10yr5/4 -- sil 2/}t a mfr cs -- .5 . Ground 3 18-El 10yr4/6 -- sicl 2IN:b�f mfi cs -- .4 .5 elev. . 2 ft 4 51-S6 1 0yr4 /4 -- sl ,�.wpk mfr cs -- . 5 .6 Depth to limiting fa 06 y m. Remarks: Boring # 1 0 -6 10 r4 3 -- it '_fn���"t 2 6 -31 10yr4/6 -- sicl 2m� mfi cs -- .4 .5 3 31 - E 5 1 0yr4 /4 -- sl plInat ( mfr cs -- .5 - . 6 Ground el�v(1 ft ; Depth to limiting factor 8-5— in. Remarks: CST Name (Please Print) ignature , Telephone No. 660 c, i'� k-2r Address Date CST Number not- �3 •m E /eu / O' i n C Cam Fret 3, Sd A) I �L3f gy p, 0 M �3 s6a 6 b Ll MI i f to ST. CROIX COUNTY ZONING DEPARTNY AS BUILT SANITARY REPORT Owner 1 4 S r CR` X17 f Property Address .� �� 3 1 co City/State r }�ir��oFFlc� ` Legal Description: Lot _ -3 Block — Subdivision/CSM # / /%F t /4 ' /a, Sec. 3 , T 3 7 N -R 19 w, Town of PIN # o ez SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer - z e'5 e Size ST/PC� Setback from: House Welln/- P/L — Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: ' r e rrc Width 3 Length 6b Number of Trenches Z Setback from: House Well P/L Vent to fresh air intake ELEVATIONS Description of benchmark co v 1 0a1t T r• ec Elevation oo. Description of alternate benchmark o Elevation �7 9 Building Sewer ST/4T-Inlet o ST Outlet /a- / PC Inlet PC Bottom Header/Manifold 10 ,0-a y Top of ST/PC Manhole Cover /o1. ZZ Distribution Lines ( ) ( ) ( ) TNr /Y 4,11-r Bottom of System O p O ( ) Final Grade Date of installation /o /?/ /�� Permit n ber State plan number Plumber's signature License number >- z I f Xc' Date /o1e >1 / // Inspector /Z,'/ Complete plot plan 58 7 587 705 STATE BAR OF WISCONSIN FORM 2 — 1982 WARRANTY DEED DOCUMENT NO. i t RICHARD 0. STOUT and JANET P. STOUT, husband "1Z j and wir ST. CROIX CO.. WI Rood fat Record i SEP 2 5 1998 i conveys and warrants to LoRi J . 1 : 3a Rla .sue � Doads i THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS !! the following described real estate in St r o1x County L z h -Mr Gr � i State of Wisconsin: Q �, X Z31 Lot 3, Plat of Meadowoods , Town of Somerset, St. Croix County, Wisconsin. Ii i! I 0.3?- 1006- QO -OAO— PARCEL IDENTIFICATION NUMBER I I I TRAIJ§FER j j I �I j This is not homestead property. j; (is) (is not) j I, Exception to warranties: easements restrictions, rights -of -way and covenants ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address •d o �P ?;V7 Property Address (Verification required from Planning Department for new construction) City/State _ .�, ,- �,f `, Parcel Identification Number )PAI LEGAL DESCRIPTION Property Location XII.F %., Scu %,, Sec. - . T 3I N -R LLW, Town of Subdivision / Lot # 3 Certified Survey Map # Volume . Page # - Warranty Deed # _ S 7 ' - Volume 7Wr --Ie . Page # al) 7 Spec house ❑ yes )" no Lot lines identifiable j d yes ❑ no SYSTEM 1VLAT�NANCE consists ImPr' use and maintenance of your septic system could result in its premature faffure to handle wastes. Proper maintenance Q Pumping the septic tank every three years or sooner, if weeded 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 masterPlumber, j ,restrictedplumberoralicensed v Is is Proper oPemtmg condition and/or (2) after inspection and Pump that (1) the on -site Rrastewaterdisposal system Pumping ( the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements set forth, herein, as set b the and agree to maintain the private sewage disposal system with the standards Y Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that Your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days f lion da TURF OF APPLICANT DATE .OWNER. CERTIFICATION I (we) certify tha all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the ' by warranty deed recorded in Register of Deeds Office. SIGNATURE O APPLICANT 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 V) Q d l0 W C O 00 00 V) 00 M (30 PO cp n 00 Z 98 - - - -- 9g cp oo 00 Z � .................. n r- rn M O e- 0 N a rt ` �• O • � tD A£Z8£ 3,.99.0 WON -- - - - - -- � r ' _ • oo 000 00 , Z -_ ,Ol'08£ ' 3„SS,0LOON --- � 0 � \ �`68fZ Z N -, o � II ` bJ sf'9[ f` ro N M NI N I I a O \ M ( " °I ZI V) I N U �rn zO N 3 O c 0 \ 0) w O� N U L. 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W Q CD ao a co � �'��,- c �� F r CD `G N 7 (�j N a CT S fl;diu v como- c �o 0 CL a o = < Cy •O 0 CD ' C O CD S O 0 — .-�—,. N N z ID a) a aCD v r.� 0 wm o m o CD T 00 N tU < a W c O Cn S 7 CD to a f = ;0 C C) ) S: CD N cc O : n O 3 0 y cn N n 0. IL (o Co O N D a N 3 0 0 , CD m, `Cy Cr 7 N 7 'O 7 C 7 @ 0 Q C c 0 CD 7 O a S n na 5'i ao avQ� S 3 x '0 CL 3� o o < ti N� 0 CSC O N CD N F CD 0 V 'a. i c o n o m a N cL 3 m N C C O- 0 cn M fD to O qb N 0 X O 0 O CD DC N O +A Ef) O �o O O * O y � O O L CD A 5 ST. CROIX COUNTY WISCONSIN PLANNING & ZONING OFFICE ^ :�\ 1 1 M/ 1 u INN M son r. S T. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 March 17, 2005 Paul Moore 2334 53 Street Somerset, WI 54025 RE: Remodeling/bedroom addition, Town of Somerset, St. Croix County Parcel # 032 - 2114 -30 -000 - Computer #3.31.19.1051 Dear Mr. Moore: You have requested the Zoning Office review your remodeling/addition project for compliance with the state sanitary code (COMM 83). When remodeling or adding onto a dwelling, you are required to examine whether or not the planned modifications involve an increase in design wastewater flows to the Private On- site Wastewater Treatment System ( POWTS). I have reviewed your remodeling plans for the above residence. The project involves finishing one additional bedroom in the lower level of the structure. The septic system was designed and installed based on wastewater flow for three (3) bedrooms with a maximum occupancy of six (6) persons. This project will increase the total number of bedrooms to four (4). Technically the POWTS will be undersized for the number of finished bedrooms within the residence; however, current occupancy does not exceed the design wastewater flow for the POWTS. An Occupancy Affidavit is required to disclose the disparity between number of bedrooms and septic system sizing to any future owner(s) of the residence. This affidavit has been submitted to the St. Croix County Register of Deeds office and recorded against the deed as document #789643, Vol. 2765, Page 117. The original system was installed in October 1998 by Dave Fogerty and was inspected by zoning staff at the time of installation. The system was found to be code compliant at that time. Inspection report, as- built, and sanitary permit documents are on file with the zoning department. A licensed septic pumper, Darrell Dunn, has inspected the system and found that it has frozen during the winter and the tank needs to be pumped to remove accumulated solids. We do not have a record of previous maintenance on this system. Please provide pumping records so we can update the sanitary database. Mr. Dunn has agreed to pump the tank as soon as weather permits, on or before April 15, 2005. To prolong the life of the POWTS, the septic tank should be pumped at least once every three years or when the tank becomes 1/3 full of sludge and scum. To extend the lifespan of the system, take water conservation measures such as repair or replacement of leaking plumbing fixtures, reducing shower time, running the ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to 7,Zil fy that I have inspected the septic tank presently serving the L 41 0 0`2 E residence located at: /V t 1 /4, S !4. , 1 /4, Section .3 , Town 3 L_ N, Range -2 — W, Town of S o W cyz s &=7 , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service y-! j - FOB Did flow back occur from absorption system? 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