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HomeMy WebLinkAbout040-1231-10-000 ` ST. CIZOIX COUNTY ZONING DEPART NT C> �1ELL AS BUILT SANITARY REPORT Owner �— $ Address City /State fTl1 d.+✓ A // / _ f »_ t � Legal Description: . y' Lot / Block Subdivi ' sion/CSM # CdU.��j2 4,DO J� `' l�. l�,, Sec. 3 , T4N -R Town of T� D £ PIN # O /Z /. SEPTIC TANK -- SE CHAMBER -- HOLDING MA I LDING TANK INFORONS 1 3 7 DO Tank manufacturer Gv /ES Size ST/PC ! /1y �/ /U�� 7 SO Pump manufacturer GpvLp Setback from House 7 Well p/L Alarm location ,t PS, p� Model _ / C Q ©s (HOLDING TANKS ONLY) Setbacks: Service road ___-___ Vent to fresh air intake Meter location Water Line Alarm location SOIL ABSORPTION SYSTEM: Type of system: / 00ty Width ,, 9p Setback from: Souse �� Well --- Length Number of Trenches P�- 20 Vent to fresh air intake _? 2� ELEVATIONS: Description of benchmark S�1�PUEYO� �S �/ 4-7 5 CD'P'�1� /OD •O Description of alternate benchmark top of Cp Elevation Elevation Building Sewer p ST/HT Inlet ST Outlet PC Inlet a 0 0 ' 0 0� PC Bottom ° S 2,3 H 3 70 ( Header/Manif l Top of ST/PC Manhole Cover Distribution Lines ( loe . 70 Bottom of System () AD , 2 ( ) Final Grade ( ) /0Z.30 ( ) 507-- '2'2 ' fl? ( ) ,l Date of installation / / Permit number 32 � State plan number Plumber's signature 46 " 4 2Z � O License number 2 2 e37s Date / / � • Inspector koe9 � zz Complete plot plan a \v � c o \ 1 � � w GV IL w \ fl V C � M MODEL 1 3 MODEL 3871 Vertical • Pump EPO4 .0 Submersible • ov i Pump Specifications 73 HP METERS FEET Up to 40 GPM 10 Discharge size 11/4" NPT 9 30 MODEL: 3871 Solids: W maximum Motor 6 25 Single phase: 115V o ' Materials of Construction 6 Brass /thermoplastic a 5 ,5 Features and Benefits >_ EPA *Top suction eliminates a 3 10 impeller clogging. 2 •Corrosion resistant 1 5 C 4 construction. • Float actuated switch. ° 1 °° 10 20 30 40 50 U.S. 0 2 4 6 8 10 12 m.+mr METERS FEET CAPACITY T 25 Pump Specifications Features and Benefits MODEL DVP03 6 20 - - ° /16 and 1 /2 HP • EPO4 impeller- semi -open design = 5 Up to 60 GPM with pump out vanes to protect ° ,5 - - - -- -------- - - -_ -_ ____. _ _ - - - - - -. _ - - -- Maximum head to 32' mechanical seal. 0 3 10 - Discharge size 1 NPT • EP05 impeller - enclosed design - - forim 2 Solids: 3 /4 ' maximum proved performance. 5 - - - -- - - - — Motor • Rugged glass - filled thermoplastic All motors feature ball casing and base design provides ° °° ` -5 -1 ° 15 20 - 25 30 35 °o U.S.CPM bearing construction. superior strength and corrosion 0 2 ; 6 Single phase: 115V resistance. CAPACITY 8 10m3mr Materials of Construction • Cast iron motor housing for Cast iron efficient heat transfer, strength, Thermoplastic and durability. Stainless steel • Corrosion resistant threaded stainless steel shaft. • Available for automatic and manual operation. • CSA listed models available. All Models are designed for continuous operation and feature stainless steel hardware. Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: ` INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes (Privacy Law s.15.04 (1)(m)J. 320210 Permit Holder's Name: ❑ Cit ❑❑ Village Town of: State Plan ID No.: LOEBLEIN, JACK & JANET TR CST BM Elev.: Insp. BM Elev.: BM Description: tr Parcel Tax No.: v6 113M t 040- 1231 -10 -000 TANK INFORMATION ELEVATION DATA A9800398 g MANUFACTURER CAPACITY STATION BS HI FS ELEV. a.z, o `p Bench rr s� �• 3� � JA SC7 am 2 4 . 1 1) 3. 103. Aeration Bldg. Sewer (� Holding I Inlet 17� q TANK SETBACK INFORMATION St 10 Outlet TANK TO P/ L WELL BLDG. Ven t Dt Inlet Airintake Se t' Sow ti 4 ry 1 '�� NA Dt Bottom `813 66�uOSI'L Osin �� `. ZS� NA Header /Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand S( Gaa • 75� Model Number ? _'jOGPM �y. TDH Lift 15. Friction' Systeml TDH S t He Forcemain Length 9Lt Dia. 2" Dist. To Well SO BSORPTION SYSTEM DIMENRENNH Width �( Length O l No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMEN I N SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufactur : INFORMATION Type O , CHA Syste S� $' r" ((4 �' OR U Mod umber: DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s)� Hole Size Hole Spacing Vent To Air Intake Length _V_ Dia. �_ Length Dia. ,ZN Spacing x 1/*" x & A 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 pj Bed /Trench Edges 12, Topsoil G` Yes ❑ No WYes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) r 1'9 , Z'5 9-3 . �� LOCATION: TROY 3.28.19,NE,SE 549 TR LLIUM LANE — COUNTRYWOOD LOT h0 I ot.T �'S'� lit � cn mv5 wive- ✓ce'l dej - ?v �p GtitiM -�n g �� (� all 1 �s Plan revision required? �] �es No E�;R Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature C Sys Vi sconsin SANITARY PERMIT APPLICATION S afety and Buildings Division 201 E. Washington Ave. Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, W1 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. S7. 4ol• x • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs �� 10 Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. ❑ State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION / /3 It Prop Owne�7ame C GO �� L � + ,p open L ation �! �t/ i/a 1 /a, S 3 T , N, R/ f E (0 r( Property Owner's Mai 'ng Addres Lot Number ck Number 22/` 7 y 5 . co�,v Cvoov City, Stat� n %� Zip Code / (hone ;umber � Si ision Na a or CSM Number O II. PE rlt F ( �� ILDING: (check one) ❑ State Owned F] ity Nearest Road ' Public 1 or 2 Famil Dwellin - No. of bedrooms 0 vlllan OF ?� ©� 7///Z/1/-- 44— 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo &y0 - /. 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. lew 2. ❑ Replacement 3_ ❑ Replacement of 4 Reconnection of an _____System ________System _ Tank Onl ❑ 5. [] Repair of ___y______________ Existing System __Existing Systst em B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 EY&und 30 ❑ Specify Type 41 [:] Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System- In -FiII VI. ABSORPTION SYSTEM INFORMATION: 1 _ Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade S Requi ed (sq. ft) Pro / osed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) / � D � Z U Elevation 3 3 Feet Feet VII. TANK iCa to s Total # of site INFORMATION Gallons Tanks Manufacturer's Name Prefab. Con- Fiber- plastic Exper. New Existin Concrete strutted Steel glass App. Tanks Tanks Septic Tank or Holding Tank Mdv 140-0 ❑ ❑ ❑ ❑ Lift Pump Tank -1so 7 ❑ ❑ 1 ❑ ❑ ❑ Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signat re: (No Stam MP /MPRSW No.: Business Phone Number: 201 7 2-6!3 7 , 5' 7 1S•3Pr •A3 Plumber's Address (Street, City, State, Zip Code): ASS' �'�.`� .`� !� IX. COUNTY / DEPARTMENT USE ONLY E] Disapproved Sanitary ermit Fee (Includes Groundwater ate i ssue d Approved ❑ Owner Given Initial y Surcharge Fee) 9 Agent Signature (No Stamps) Adverse Determination �� . CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, owner, plumber Safety and buildings r ' 15837 USH 63 HAYWARD WI 54843 -8107 N*isconsin Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary July 22, 1998 CUST ID No.259518 ULBRICHT & ASSOCIATES 655 O'NEIL RD HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 07/22/2000 Identification Numbers Transaction ID No. 113464 Site ID No. 14056 SITE: Please refer to both ide, ficatioat,nnndbers Site ID: 14056 above, in all correspondence =with the.ageney: ST CROIX County, Town of TROY NEIA, SETA, S3, T28N, R19W JACK LOEBLIEN FOR: Description: MOUND Objeclt Type: POWT System Regulated Object ID No.: 29859 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. This plan approval is for a 450gpd mound. The following conditions shall be met during construction or installation and prior to occupancy or use: • This plan action is subject to designer comments on the plan • Correspondence Note: • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the Zabel filter will be required. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to P. 1 A inspection by authorized representatives of the Department, which may include local inspectors. All permits Conti! tj required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. 1% P R, DEPARTMEI}T 0 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the addresy[VIS'ON OF SM ET on this letterhead. • Sincerely, DATE RECEIVED 07/14/1998 FEE REQUIRED $ 180.00 TOM BRAUN, PLAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 (715)634-3026, M - F 7:45 AM TO 4:30 PM TBRAUN @COMMERCE. STATE. WI.US - .ULBRICHT & ASSOCIATES CO. 655 O'Neil Road •Hudson, WI 54016 Reg. Designers of Engineering Systems 715- 386 -8185 ' Private Sewage Consultants - PROJECT INDEX DIL.HR Plan I.D. # 113464 Date July 22, 1998 Owner Jack & Janet Loeblein Phone 715- 425 -2464 Address c/o Mann Vagley Contracting, Paul Paulson, 14 Dry Run Rd. - - - -- - - L/,V rt V & <2 1? Legal Description Lot #1, CS PIN # d �/L3 /0 NE, SE, Sec.3, T28N, R19W. Town of Tr oy County S Croix C.S.T. Gary Steel, CSTM2298 Installer Robert Ulbricht Local Authority/ Supervision St. Croix County Zoning Dept. PROJECT DESCRIPTION s: New construction. For a proposed 3 bedroom home. S Estimated daily wasteflow: 450 gals. Soils are permiable (.5/.6 GPD /ft2) but seasonally saturated at 40" as evidenced by mottling. A long narrow T.S. mound system using 12 sand fill is proposed. wa lly For ultimate clarification and pretreatment of the )VE effluent, a Zabel filter system shall be fitted to the COMMERCE AND BUILDINGS septic tank. Requirements for filter and tank maintaince shall be provided to the owners. DENCEE t & Ass oclao�S a �taata d1b��a Sewaae G � ,Net% ors � � Wi n. W►$. 5a X22 z� 3 ?S Pg,l PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS G� Pg.3 PIPE LATERAL LAYOUT Pg.4 DOSING CHAMBER CROSS SECTION P9.5 PUMP PERFORMANCE SPECS V� o o " � 0 I Co CA � 4 a, CA o °° * c x^'9 N CO 3.� Z �� CYI CA O ^O O G a < m C go rn tv O 9OT-C, a = � r cs c� om o o �\ cub N P5 Z of Cj CR OSS SECT 100 o f MOUAJ D r ti Bee OED e % " ro DiSTRif3uT�a,� 1 :x A59Qc5aTE & r Ise c k,s G s P l P N 6- OF T°PS0iL sysrEM IEVA r io&] Uu; FoR M T•o E Ur �i H E r- __..' � — Rh - � - MEIN..• �� SAu .I , To p Soy /— 1 ' ( 7c, 510PE FORCE" uN � FORM REP �9. z 0 , If 0 Fr. — ELEvArio S - - r / Fr. 1mvERr of 2- H )AT £RAI S 100-70 FZ FT. Top of Rock /0/. /r H 1•S F T. To /Od� p of 2 IATERAIS �O PLAN VIEW OF Mou.�jD - wi rtt t3E FORM MAiA A 5� F . I t_ —• I (3 0 � F K' /0 F T I• a - - IT F r W 20 N 1 Fr- f3Et7 of To PVC. cAppEp rO�V 5U R 1 uTooN Plpt✓ uETwo R k T O TAL v tit uH o F L ATE-RAC- Tw o 12 /2 • VC p D%STRIF3uT LATERAI. eoo cAP Y x _ // X /Y� i (BUG V=oRCE MAW LAST VAo I E S N A 11 (3 NEVT To END CAP VOID VvIuME F'o 9 -tuvERr l; IEVArlv&3 dF 2 ir FoRcE MAW 100. 70' PERFoFATED (PIPE DETai L � No1E5 locATt;v Ox-) G OTr SH All BE7 I - y `) VARiA(3LIF Y SN/N UtST�NCE p �� Fr HOIE t)"AKE Te R r- AT ERA L- 2, MANI FOLD FoRcE MAik) Y 4( 9 i►�cl,� s # or lioleV p i p E 20 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS -VENT CAP WEATHER PROOF 4 "C.I. VENT PIPE APPROVED LOCKING JUUCTION BOX MANHOLE COVER 25' FROM DOOR, .. W /w,1 ,(A)/A) A/3 WINDOW OR FRESH AIR INTAKE fppr ��E� ^��ON GRADE I 4" MIIJ. Z 1 / 18 "MIU. 0 CONDUIT L -- ___ INLET PROVIDE I AIRTIGHT SEAL I APPROVED JOINT A y I K I I APPROVED JOINTS 1J /C.I. PIPE �N 1 �VtA I I W /C.I. PIlE ZXTENDIUG 3' �0� 15 1 ( II ALARM EXTEI.1 MG 3' OAlTO SOLID SOIL B �, ✓ I II ONTO SOLID SOIL 3 I I ON E L E V. FT e" 1 I PUMP -� - -� OFF wsis 3 Oe D .I v /voiP eF OP b � �� BLOCK 5/f VP c c /t VA j, GY�i�v lr RIStR EXIT PERMITTED OIJL4 IF TANK MAUUFACTUR6.R HAS SUCH APPROVAL SEPTIC E 5 P C, I F I CAT I OU S D OSE F- 4p v 3 TAIJKS MAI UFACTURER: W' c IJUMBER OF DOSES: y PER DA TANK 51ZE : 750 GALLONS DOSE VOLUME. �S ALARM MANUFACTURER: INCLUDING BACKFLOW: GALLO"S MODEL NUMBER: �U L ' CAPACITIES: A= INCHES OR GALLONS SWITCH TYPE JL'ER C.V P- Y F 10 AT— s= Z. INCHES OR 3 GALLONS PUMP MANUFACTURER: � q 0 E /lei C= INCHES OR GALLOUS MODEL NUMBER:n ,, ` D = INCHES OR GALLOUS SWITCH TYPE: p ��ya��� /"` ll ac . F lo T - - MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE PM Q INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEU PUMP OFF AMD DISTRIBUTION PIPE.. FEET fiAok SE C S MINIMUM NETWORK SUPPLY PRESS RE . . . . . . . . 2.5 FEET EAC I o / � ,D{ P lit + FEET OF FORCE MAIN X r - 5 V F Yo it. FRICTION FACTOR.. �' 2- FEET t 7+ ZS TOTAL DYNAMIC HEAD = / )�-(po FEET ii p /s '' 3 9 INTERNAL DIMEIJSIONS OF TANK: LENGTH ;WIDTH --( ;LIQUID DEPTH �D HEAD CAPACITY CURVE ./ MODEL "9w, 7/e o ' e 4 5/a 2 8 J 5/e 15 - i 4 e 1 J /Ie F 10 2 ` 1 5 1/2 -11 1/2 NPT O U.S. GALLONS 10 2 LITERS 10 50 80 70 e0 e0 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC NEAMLow ►E kwouTE ErrIuENT AND DEWATEINNO HEAD CAPACITY 12 UNITS/MIN L2O& S GALS ITRS 72 273 SI 170 s I7o 25 95 J 5/16 2T' CONSULT FACTORY FOR SPECIAL APPLICATIONS 0 Electrical atterrlaiors, for duplex systems, are available and supplied with an alarm. e Mercury float switches are available for controlling single and *; Mechanical alternators, fo without alarm s%vltch9a. r duplex systems, are available with or • Double piggyback a back mercury float switches are avai le for variable level long cycle controls. Standard all mode - Weight 39 Ib• • �/ H. P. SELECTION OUIDE 1. Intepret float operated 2 Pole rnechenicat switch, no external control required. SD 8e_riso Control select 2 • Single piggyback merc ury Iloal switch , Model Vplte - 61m le Ph Mode Am s Du le switch. Refer to FM047 or double P�gyback mercury, float M98 115 x x 9. Mechanical alternator 10-0072 or 10-0075, 1 uto S.0 l ot & ? — 4. Sec FM0712, la correct 6. Mercu senses made! of Electrkal Alternator, "E Pak ". Oge 230 t + Auto 1.� rY ltoal switch 100228 .usid q a control &cgvator .E� 290 1 or 1 i 7 duplex (3) or N) Wat syslerr 1 Non 4.S 2 ol.R # 4 0 a 1 ! 6 8' F�r�(�) " luncdod box, Iw plix iDr duplex operallor% 16-0002. or caked in elm• Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT 1+? 1 of 3 Labor and Human Relations 0� ge.�_ .,Divisinr _pf Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St . RME not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or (�� dimensioned, north arrow, and location and distance to nearest road. L tZx i �g95 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION WE0B )jT CPQx D `� COtyfVTY PROPERTY OWNER: PROPERTY LOCATION Richard Stout _ .. GOl(T, LOT NE 1/4 SE U4, 1£ (or) W '.. ;; PROPERTY OWNER':S MAILING ADDRESS OT # LOCK # na SUBD. NAME OR 1353 Awatukee Trl. '�t � (�Q'mt L- wvdQd; CITY, STATE ZIP CODE PHONE NUMBER []VILLAGE EITOWN NEAREST ROAD Hudson, Wi . 54016 ( 715 549 -6731 Troy Tower Rd. New Construction Use [ :1 Residential / Number of bedrooms 3 [ J Addition to existing building j J Replacement [ J Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 5 bed, gpd/0 - 6 trench, gpd/ft Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate • 5 bed, gpd/ft •6 trench, gpd/ft Recommended infiltration surface elevation(s) 100.19 ft (as referred to site plan benchmark) Additional design /site considerations sustem el. based on contour line of 99.19' Parent material limestone uplands Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ❑ S ®U 91 S 1:1 U ❑ S ®U 0 S E7 U ❑ S CC ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure I GPD /ft in. Munsell Du. Sz. Cont Boring # Horizon Texture Consistence Boundary Roots Bed Tnrich Color Gr. Sz. Sh. . l . 1 0 -10 10 r3/3 none 1 2msbk mfr qw 2f .5 .6 2 10 -29 10 r4 6 none sil 2msbk mfr CIW if ..5 .6 Ground 3 29 -40 7.5 r4/4 none sl lmsbk mfr qW na .4 .5 elev. 9 4 40 -80 7.5 r4/4 2 5 r5/8 sl lmsbk mfr na na .4 .5 Depth to limiting factor 40 " Remarks: Boring # »>��:::E 1 0 -12 10 r3/3 none 1 2msbk mfr cs 2f .5' .6 A OM ME 2 12 -23 10 r4/4 none sicl 2msbk mfr gy if .5: .6 Ground 3 23 -33 7.5 r4/6 none sl lmsbk mvfr Cfw if 1 .4 .5 elev. 4 33 -60 7.5 r4/6 none sl m na na na .41 .5 9 Depth to 5 60 -72 10 r5 6 none is osq mfr na na .7 .8 limiting fa +72 Remarks: CST Name._ Please Print Phone: Gary L. STeel 715- 246 -6200 Address: 1554 200th. AVe. New ichmond Wi . 54017 1 - Signature: Date: CST Number: > ., STEEL'S SOIL SERVICE Gary L. Steel Richard Stout 1554 200th Ave. CSTM2298 NEaSE4 S3- T28N -R19W New Richmond, WI 54017 MPRSW 3254 town of Troy (715) 246 -6200 l lot #72- Country Wood N 1 =40' BM-= top of 1" steel pipe by SE lot stake Alt. BM.= top of SE lot stake marker wooden post C el. 105.25 o � m N R 2 0 � r c p�k Gary L. Steel 10 -19 -95 ----------------------------- ,- - - - - -- - - - -- ------------------------------------------------•--- 03/22/1994 15:05 7154258695 r MANN VALLEY EXC INC PAGE 01 ST�[XOIX COUNTY SEPTIC TANK MUNTENANCE AGREEMENT -- AND OWNERSHERTIFICATION FORM Own er /Buyer Janet and Jack Loeblein Mailing Address 2211 East 4th Street, Saint Paul, Minnesota 55119 Property Address 549 Trillim Lane Hudson, Wisconsin 54016 (Verification required froth Pl=JA N!epartment for new construction) City/State Hudson, Wisconsin ParedAdentification Number © 31— / © LEGAt DESC�ip'I'ION ' Property Location t /,, s F, , /,, Sec 28 N. 19 W Town of �O Subdivision Country Wood — 1 Lot # Certified Survey Map # Volume . Page # /✓� O Warranty Deed # Volume . Page # Spec house O yes no mkw ffot lines identifiable yes D no MTE MAINTENANCE Improper use and maintenance of yow Septic syshmlaould refult in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three yearowel oaer, if needed by a licensed pumper, What you put into the s can affect the fuoction of the septic tank as a treatment � in the waste disposal system. ystem The property owner agrees to submit to St. 00601110ning Department a certification fottn, signed by the owner and by a master plumber, journeyman plumber, restricted phanberttoWeensed pumper verifying that the on -site wastewaterditgrosal system is in proper operating condition and/or (2) after inspecticoW pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements tlttgwree to maintain the pri vate sewage disposal system with the standards stating that your se set font, herein, septic sy stem set sy the Department of Commerce Rttttl�e Department of Natural Resources, State of Wisconsin. Cettificatiop has been maintain stem ed mustGNMrnpleted and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. JIJ C lfl���J�� ' n�l - DATE OWN R CERTIFICATION I (we) certify that all statements on this form aatttttafe to the best of my (our) knowledge. I (we) am (are) the owne of the property described above, by virtue of a warranty ddmiaanorded in Register of Deeds Office. i L ON�AO 8 / 2� 1 / 98 DATE •.M••• Any information that is min - tepresented may rem" the sanitary permit beicS revoked by the Zoning Department. •••••• Include with this applleation: a stamped warranty dt o tfrom the Register of Deeds office a copy of the ccrdrlialmwey trip if rcfcmnce is -mate in the wtmnty deed -