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HomeMy WebLinkAbout038-1027-40-010 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Secty and Building Division Sanitary Permit No: INSPECTION REPORT 538753 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may Wised for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Parchert, Arnold & Janet Star Prairie, Town of 038 - 1027 -40 -010 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No: o 1 6 f 6.5-F 06.31.18.121A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Z. i /07-.1 / o0 Septic I �r y Z Benchmark / /O /•' �Od 000 Dosing �yQ 3 Alt. BM Ga � O t 1 Aeration / Bldg. Sewer F 7' '7 Q Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Ven/ to Air take ROAD Dt Inlet -- Septic 7 166 /�/ 3 Dt Bottom 5S q 1 IJ / Dosing 1 / Header /Man. q 95.2— 7 7 /bO 36 Aeration Dist. Pipe Holding Bot. System 7 , �o 5 �� a b PUMP /SIPHON INFORMATION Final Grade $ 9 / /.L Manufacturer � It - � � Demand St Cover I 19 � q 3 G rr a / I Model Number / £ //0 TDH Lift 9. 2 Frictio Loss System Head 9 TDI �, Ft (J� O J 4/, r /, �0 / '�+ a J I , e 7 7 Forcemain h Len t / Dia. i / Dist. to Well / D 3 g so Z 7 i cy SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of� PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS . 57 /•(� I ____1 \ SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: \ INFORMATION CHAMBER OR Type O ystem: ' /� 7 `oO � UNIT Model Number: /71oo DISTRIBUTION SYSTEM l j Header /Manifod 11 Distribution //L i/ x Hole Size i x Ve Air Intake Pipe(s) L�tL (( 3 / z Length_ Dia Length ! 7 Dia Z Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only •�— Depth Over Depth Over xx Depth of ' o xx Seeded /Sodded xx Mulched Bed/Trench Center / -7 Bed /Trench Edges Topsoil ` �V� Yes E] No N [] No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / �q / D Jinspection #2: / / Location: 2309 80th Street New Richmond, WI 54017 (SW 1/4 SW 1/4 6 T31 N R1 8W) 40 acres Lot �i U /�1'arcel No: 06 31.18 121 A 1.) Alt BM Description 2.) Bldg sewer length = `/ / / / r Q 16 1.j 0 /� - amount of cover = r Plan revision Required? E Yes jvirw 4 �1 7 Use other side for additional information. ,_ Date Insepctor' Signal a Cert. No SBD -6710 (R.3/97) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538753 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Parchert, Arnold & Janet I Star Prairie, Town of 038 - 1027 -40 -010 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No: 06.31.18.121A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia I Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of T77eded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil g p � Yes [ifl No a Yes F] No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / ! Inspection #2 Location: 2309 80th Street New Richmond, WI 54017 (SW 1/4 SW 1/4 6 T31 N R1 8W) 40 acres Lot Parcel No: 06.31.18.121 A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? 0 Yes 2 No i Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) ---- -_ _ t carnmerce.W1.gov Safety and Buildings Division coun , [ /'`, 201 W. Washington Ave., 7 7162 T 1 ' ��0� � � � Madisory�VI 53707 -7 Sanitary Permit Number (to be filled in by Co.) I�♦„ Qepamnent of commerce 5 3 $ 75 _ State Trans on Number r Sanitary Permit Apphc 9 jj In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropri ate governmental d POWTS are Project Address (if different than mailing address) unit i!; required prior to obtaining a sanitary permit. Note: Application forms for state -owne submitted to the Department of Commerce. Personal information you provide may be used for secondary p urpoies in accordance with the Privac Law, s. 15.04(l)(!11), Stats. A I. Application In - Please Print All Information a f parcel # Props -rty Owner's Name Property Location Property Owner's Madtng Address -- ` �� f City., State > Zip Code one Number y� -c „/' - - 7 ction T on T N R E W 11. 'Iype� ding (check all that apply) y ` Subdivision Name -i-or 2 Family Dwelling - Number of Bedrooms -- Sf.GF�01X�W� ok ❑ Public /Commercial - Describe Use �a ❑ City of CSM Number ❑ Village of ❑ Si ate Owned - Describe Use �. __ ..— n of — g X 57 oa, COQ_ III 'Type o Permit: (Check only one box on line A. Complete line B if applicable) ... ❑Other Modification to Existing System (explain) A stem ❑ Replacement System El Treatment/Holding Tank Replacement Only List Previous Permit Number and Date Issued B. ❑ Permit Renewal El Permit Revision ❑ Change of Plumber ED Permit Transfer to New / Owner Before Expiration IV.. Type of PO TS System/ComponentlDevice: ( Check all that appl ❑ Men-Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ound> 24 in, of suitable soil Lcilnd < 24 in. of suitable soil ❑ I folding Tank ❑ Other Dispersal Component (explain)_. - ❑ Pretreatment Device (explain) a ' V. I s rsallTreat nt Area Information: Dis creel sea Pro sed (sf) System levat' Dcs n�F l Design Soil Application Rat gpdsf) DispeJreequired P J Capacity in Total # of Manufacturer VII. Tank Info ° d �' Gallons Gallons Units w � U p � New Tanks Existing Tanks x ,I tj rn v Seinic or Holding Tank Dosing Chamber f V It 1. Responsibility Statement I, undersigned, assu onslbiltty for installation o the POWT �`MPRS Number Business Phone Number hlm ame (Print) r' t Plumbe ' store P � �l �r!Cti• d � Pl umber's Address treet, City, State; Zip Code y'lII Coon IDe artment Use Onl Permit Fee Date Ysued Issuing nt Signature Approved ❑ Disapprove I l0z wner Given Reason Denial 11K. Conditi V f I_asons for Disapproval 3 A - c,, Cd 1 o ti I 'I; epNc tank, efflutnt filter and dispersal cell must all be services / maintained as per management plan provided by plumber. /p 1W A- ol 2 AN st fback requirements must be maintained >� —,r � a - n Attach to complete p sins r e system and submit to the County onlynn a lp a on proper not le�s� then 8 t1`re l I ca.a tG (MD-639 (R. 01/07) Valid thru 01/09 y J t&%, �70 ” ' �a� �o co mmerceml.gov Scott Walker, Governor sconsin Paul F. Jadin, Secretary i Department of Commerce April 06, 2011 CUST lD No. 226900 ATTN: Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/06/2013 Identification Numbers Transaction ID No. 1925018 SITE: Site ID No. 765839 Arnie Porchett Please: refer to both identification numbers, 2309 80TH St above, in all correspondence ^with the Town of Star Prairie agen St Croix County SWl /4, SWl /4, S6, T3 IN, RI 8W FOR: Description: Mound, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1308672 Maintenance required; 450 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; 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); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.01 /O1) and the Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the proj&i' All holding/treatment tanks are to comply with Comm. 84.25(7)(a). o o /L zS; O, oQRT Maintenance information must be given to the owner of the tank explaining that periodic eaning�D�Eh ter is required. Access to the filter for cleaning must be provided per Comm 84 product approval's tions A Sanitary Permit must be obtained from the county where this project is located in accordance wifi the requirements of Sec. 145.135 and 145.19, Wis. Stats. I SHAUN R BIRD Page 2 4/6/2011 Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 > Balance Due $ 0.00 Julia Lewis- Osborne POWTS Reviewer 2, Integrated Services WiS1v1AR.T ci�de< (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis@wisconsin.gov Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.ivi.goN,/SB/SB-BuildingContractorProgram.html Cover Page Shaun Bird Bird Plumbing Inc. RECEIVED 1008 192nd Ave APR -1 2011 New Richmond Wi 54017 SAFETY &. BUILDINGS 715- 246 -4516 Date: 03/ 28/11 Owner:Arnie Parchet Location:SW1 /4 SW1 /4 S 6 T31 N,R18 W 2309 80th St. Star Prairie System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and �o igency plan 9 -12. Soil test k Shaun Bird Signature License numbe 2 6900 OF ar a ,� F TY C �FSA oBG� �N Ftic� PLOT PLAN PROJECT Arnie Parchert ADDRESS P.O. Box 102 New Richmond Wi 54017 SW 1/4 SW 1/4s 6 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 94.2' 1.2' sand lift 3 BEDROOM CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND )= SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of garage slab ASSUME ELEVATION 100' Filter BEST GF10 -8 BOREHOLE O WELL «H, R. P Same as Benchmark 40 Acre Parcel 94' 92' B -3 90 Scale = 1/4" = 10' ❑ 93' B -2 B -1 12% Slope 80th St. Well is to meet all DNR Setbacks Area 15' below system is to remain undisturbed 185' B.M.* Huffcutt Shed Combo Tank is to be properly Tank bedded and provided with lockdown covers with approved warning labels 350' Pro Bedroom House Cty Road H PLOT PLAN PROJECT Arnie Parchert ADDRESS P.O. Box 102 New Richmond Wi 54017 SW 1/4 SW 1 /4S 6 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 94.2' 1.2' sand lift BEDROOM 3 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND )= SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of garage slab ASSUME ELEVATION 100' Filter BEST GF10 -8 BOREHOLE O WELL *H. R. P. Same as Benchmark 40 Acre Parcel 94' 92' Scale = 1/4" = 10' 0 B-3 90' 93' B -2 B-1 12% Slope 80th St. Well is to meet all DNR Setbacks Area 15' below system is to remain undisturbed 185' B.M.* Huffcutt Shed Combo Tank is to be properly Tank bedded and provided with lockdown covers with approved warning labels 350' Pro Bedroom House Cty Road H Mound System Cross Section and Plan View ,�, E Dimensian Feet J ....:..... ..: A r -- r. B T r D Z A r r � E . a. r r _._ r r F . Z . i G I r r H r I r r J i K i L YY K 13 j Z L Sloe % Topsoil =ASTM C -33 = Clean aggregate r i Cap Material sand fill O= 4 in. sch. 4n "I p c -'�' '/z to 2 '/z in. dia. observation 1` i. Pe Geotextile Fabric "" H F -�-- Ft { D E ! 3. D Ft Contour Plowed Surface Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Ea is ing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a K inch soil wire when a sample is rolled between the palms of the hands. ASTM C -33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire it: c►und is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10/071g1 Page of Pressure Lateral Layout Two Laterals — End Manifold 4 -- Threaded ClL:anout Lateral Turn-up ----► Aug Manifold r X Force Main L Long Sweep ±)0 > ]fiend Distribution Network S ecifications Pressure System Construction Lateral Diameter In. Manifold Diameter In. Laterals are constructed of Schedule 40 P'v Orifice Diameter In. pipe. Orifices are drilled perpendicular to A Orifice Spacing) In. the pipe with a sharp drill bit and face down. L Lateral Length) Ft. Lateral turn-ups terminate with a threaded 1vI Manifold Length) Ft. cleanout plug and are enclosed in a 6-8 irich Force Main Diameter In. diameter lawn sprinkler valve box accessi�.ile Force Main Length Ft. from finished grade. ••••• Grade •••••• :�j ••••••• 6-8 Inch Lawn Sprinkler Valve Box �._ db Page of X3105 lgj Septic-Dose Wank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer ixle- Manufacturer T e C Tar*Nlodel Number /V—Z V Pump Model Number To ct r �jE Capacity j '/,/_3 a Alarm Manufacturer N umber Bury Depth Alarm Model Number Switch Type � Total Dynamic Head (TDH) - F r, ,- /�/, Fil er Ma n ufactu rer I eet qFiler �-.\doel Number Elev ation Head Distal Pressure -3.0 Network Loss Kim jmwn Pump Performance Required— Force Main Loss ------- 4- 12 GPM' l Ft TDH Total Outlet Manhole Min. 4" Above Grade With Locking Device. Inlet Manhole Manhole Min. 4" Above, Grade < 6" Below Grade Sealed Watertight Securely Mounted With Looking Device Weather-proof Junction Box Finished Grade MWA , Vent Min. 12" Disconnect Above Grade With Vent Cap Means 1!7 Outlet Filter I • nl0t *---.Inlet Baffle A Switch Settings and Reserve �Capacity Tank Volume GPI �4451 0— Uieep on Inches Volume Gal. B Hole Dimensi (rese X (alarm) B 2 O e "on C X (dose) C Ft Swi' h Set T D n OI im sio ese ve) A X 7- J Bottom (dead) D Total D 1"levation X Ft GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance witti the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be oxceeded without prior approval. Manhole covets exposed to grade have an effective locking device (pacillock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and Raid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch, 40 PVC to bridge the tank jexf�avation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02'1'05 U Page of �t BY: HPIL6t 3100; 1 110 ow nnei ; 7W - -uo a.i7vtw, , t+y.w wv 1 p nM 9 .H SERIES SUMP /EFFLUENT PUMP a9s p -+ - 0 at alw.i +!�!� r a � a � na! w s� u! :tlttsls allr9 wo t!6 7N t39 1099 74 [i 71 tL! N sn ,!lel >l91117 VAP 4nB 719 77l 9b 1091 71 14 56 7D iif ilLbist#t anll9 WOM ! 8M 110 w 79 9/ !$ 41 ill � .m In MAIM oil JON Ilow Ft.OY- 6lTE9000 �� � — C! t740 a0b7 -.�� r,, UDNd VYIlO ._.. _• - SAW N it Q srA slqd � � gamic Blca to -. �, �.rr�il+arrrMw Ilr TM ITM o im. f0 80 viOV- GALAams/ftl om �" Puw F ctmv� Lr tit 11ia9R +�iM�Ml.7W +>!11at A1Rii�a1� MPM POWTS OVwwER MANUAL & MANAGEMENT PLAN pfLE u�tFnwt�tw'tnoe�c :3YS`fEM �P TOW Ow w O a r Q 2 Septic Tw* `4sp r OT '(.✓ L} NA I'etttzitf sepftTonk Ma DMA �+! PE"1 Effitlert� Fd6el' p ilia f d !�A i18!lt ;" lidO f3 NA t+� m wof CO Unb PUMP-Tw* ' �3v . a NA aemad flow ON~ ) Putrtp Tw* MtiutttfaefYtW ,�� f] NA Oe� ttlo�w � x Y� .PumpMaa?t i ` G �c n NA' ftIIAppNIWd Refs 0 Pump Modod n e'' Q 1tItIuN Nlyeet �p ®" P ixestswint Unit FW9L-OI & Gntlse (FOM 230 WO& L'7 tSandOr4wel Ffbw D Pent raw PAO A! sreeWd t�gipertt Dernsnd (BOQJ J= mg& 0 t7�rtfecgon ©ther_ Melt Aeealllort 3 ther - .T O ai OM �"" son" ) SO D Pm hotted t�B209 � avenge" s) Bbc wnk* OxyW Dwrtd ('WQJ SSG m WlL D In -gmund (Q�RYM t3 (p�rse Told ScRperWW &W8 (ram 530 mg& II e ca! rnaan AlIr dt iDOMI Q e D Ofh Ba eu- . maim m Eflttuent Partide Stce K incttdiameasr !-' lhtfeee eyploaf ibr etaenlalyd raplar. I��e� tSCHiraDtllE . se!'vtbe Event 8errrtw l=reet *nW . Inspect of tanks) At feast once every D rnw*w s) (Metdmum 9 .) Purnp out aontwtts of t MKS) When combined sludge and scum egusts one -O" Cr.) of tank volut ne Inspect Cooper" asri(a) At Isast once unary © Ks) (Majdaturn 9 :,r .) C®an afflusnt f#br At least once every I.7 trtontde . t(s) Insi+ed purrtP, !►p oontruts alarm At lewd atu�e ervery D !rio s) O NA Fluedr i l arAb and p es w e test At IwW once evW Q months s) Q NA At resist once wimy 13 trronthe tip yesr(s) D NA At least Woe eveitty Q months a yee r(s) a NA NAIIwnu ANCE NwAlwcTJOw nVedbu of tenets aW etlepolel cells sititf to milde by an bdv ual torrrying one of the ftftwlttg go rues or On � Ma/ler Plumber. *snow Pkanber• Rso&kftd samr. powrs Mspeeaoe; PtyY1tT8 8apdge � Opi�rator. TW* Insp�ona must tndude a mead inspecdon of the tanlgs) to IdwMW =W adep ft or bnolcen trard" — R, kkn t)r MY OUG4 or IWO. a ee MOU fire valUMO of Combined akxfta and a== and to d wk for any beck t cr pon fft of olUmt oft gw gmtrnd rim. The dlspenflal Cgga) shalt be vtsuay &A a td b dtselc the etllusrs tewe In the cbesrrsitl V pipes and to Check for any paodrig of effluent an the lg wnd suftm lIm pandit elf eOwt on they gMwW atsbw may hNicI e 8 ftft CUrdOW end rngUkW tire Immedits nodlicafnbon of tits Jweii nQut Wmy auil+ fry. Wheer the Omvi r bW accunwWon of sludge and slum in my lrtnk OrAo- fnd (* or mote Of the tank valtune, fti Wfltte M ftlb Of the hark shd be i+M OVed by s >:eplVe S wvldng OpetwW ad Cbpaeed of In tiacetd wm with ah. �I 1 13, VVbW wh Ilu III t ft Code, The UM" ofefflclod fters. m edtltnk* or PM=rlMd POWTS oompoftenf L pnobwi ,Mt aumponeivts; and arnl +'� ormortharirfg stets of�2 ntvn!ltts or aria!! he � Z'fY= 4ettipsd PaW"C8 may' A soviV tsport shd'be pnc> f*d tb the 1ccat regcriabty etiWW* INMin 10 days of CW"pWM of wW so vin wMt. START UP AND OPERIt77ON For new =W&j%ftL pdar to Use of rite POWTS o1id& treatfiwt Unk(s) for the pis OM of p1MAQ Ptodtf5 Or Oh' chant =k tirat,rtair impede the troabrearet process andfor tlarrfige the dbpdfr W ttetd!('s). if hIgh odi ave xtsniritttt>t>& fib h On wrltents of &e iankts) removed by a sept8ge servicing operslor' prior m utter SyStom start up shall not a=r when sorb conditions are frozen at the infiltrative surface. During power outepes pump bu tcB fi0 albove noffnW highwater levels. When power is tes%XW the exom wa j*wmarwo be dWdu gW to the MOO) in one large dose, overloading the aeR S) aW may rte nt the beiajup or surfiaos divicharge of e fork To avoid this shation have the contents of the pcinttp femov�ad by a i `SeP'l� �D'CP�� i�� 9 POWW to the effluent pump or contact a Plumber: or PC?WTS Maintrdner zn at3SRlkt 1ft fABtlU* OpargUng the pump Conttpls to restore normal teveLs within the pump tank Do n1lt dri m or pmk vo idw om l3 d dtspwW gaits. Do not dmre or park over, tar c9le be ftM of compalx, the am wftin 1 feet dawn 81*8 of any motmd or at -grade soil absorption area. Reduntion or erani nation of the Isar ombg "m the wastewater stream may improve the perbriiwm and prolong- Eft± of the Pow& buns; Condoms; cotton swabs; degrerams; dgltlai aces; dta w;; dillk 1Wx1an(s; Ella; f ndoMm d>'l do (SUMP Pump) water, fruit and vegetable peermgA; gas e; glTlt w, hefts;; meat �l*i. me ; at peiet ng f�� Rimes: sanitary napkins. tampons. -; and wafer w tie w Mine. AelAM)ONMMEW When the POViiT'S faits and/or is pwmanentiy- taken out of service the fonowing steps shall fte taken to Insure that: me sysftTr is praperVAnd Safietyabandoned in Compliance with ch_ Comm 83.33, Wac onsin Admtnisbaffm Cade` • Aft plping to tanks and pits shaft be disconnected and the abandoned pipe openings sealed. • The contents of air tanks and pfts shag be removed and prop" disposed of by a Septage Servicing Oper,3tor. After pump. all tanks and pits shah be excavated and raemovea or their covers removed -and the .raid sFcrroe fitted ware son, grwd or another inert solid material CONn?lGENCY PLAN If the P:)Wi'S fails and cannot be repaired the following measures have been, or must be taken, to provide a code: con0ent replacement system O A suiiabte replacement aran has been evaluated and maybe utilized for the location of a t eplaoement sop 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 yells_ Failure to protect the replacement area v ll result in the need for a new soil and site - evaluation to establish a suitable replacement area_ Replacement systems must comply with the rules in effect at that time. D A suitable replacement area is not available'due to setback and/or soil limitations. Baring advances in PoY!rTS technology a holding fankmay be installed as a last resort to replace the fazed POWTS_ the sine has not been evaluated to identify a suitable reprac - Meet area_ Upon failure of the POYVTS a soil .artd evaluation must be performed tro locate a suitable replacement any- ff no replacement area is availaW a holding lank may be ins;Wed as a last resort to replace the failed POWrS. Mound and aft -amft 9* ab*xpdon systems may be reconstructed in place fb0owing removal of'the b"mmat sit • 11139VU Surf W Reconstructions of such systems must comply with the rules in effect at that time. <<WARN 114G>> SEPTIC, PUNfP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES A NDIOR INSUFFICIENT U7CYGE -N. 00 , 1110T ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTAMCES. Dt_ATFi UjjkY RESUL 11 RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDrfI01M COMM XM POWTS INS TALLER POWTS hWNTAINER tYame Name _ Ph; Phone J SEPTAGE yEWiCiNG oPt Ftaro T WP LOCAL REGULATORY AUTHOti Y N2rrile CY . ------------ _j Phone �. Phone t .-r78� d Thee Q°w^°°m *as drrrlbd> the siatPlr of the Lame. h(arqueite and Waushara County Zoning and Sanh&n Vmft& Thk dttet2nlW r m*$ ue - inin — nwu.menes of c!e Coma 1 *&M ad 93.5s(t). (1) � (3 ?. VV sconsin � Gacfe flee of tlrk dactnnent does eat guara+dee the perlomnanae or the Powrs. Gatrv(Zrot1 X11 g� Wisconsin Department of Com P A SOIL EVALUATION REPORT Page —/— of Division of Safety and Buildings cordance with Comm 85, Wis. Adm. Code County / Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D, percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 30 ' 0 Z Q — Q j U r Please Re ' wed Date Personal information you provide may used f rivacy aw. s. 15.04 (1) (m)). 2 Party Owner Property Location Govt. lot �j 1/4-5 1/4 S T N R 8 E (or Prope Owner's Mailing Address Lot # BI # Subd. Name or CSM# ST. CROIX COUNTY City State Zip El City ❑ Villa STown Nearest Road , / New Construction Use: W Residential /Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material `'�� Flood Plain elevation if applicable r General comments /, e and recommendations: Boring # ❑ Boring pit Ground surface elev. ft, Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 , -1� hf 6� 21 Boring # ❑ Boring ® pit Ground surface elev. � ft. Depth to limiting factor ��8 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 •Eff#2 S' , 3 Zo ..3 Effluent = B09 > 30 < 220 mg/L and TSS >30 < 150 mg/L uent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name t) Signature CST Number Address ✓ a e Evaluation Conducted Telephone Number Property Owner Parcel ID # Page of .� Boring # ❑Boring pit Ground surface elev. ���• ft. Depth to limiting factor in. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. gont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 y . F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor 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 'Eff#2 F Boring Boring # Ground surface elev. ft. Depth to limiting factor in. El pit Sol 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 'Eff#2 I • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBD -8330 0L6W) j GJes �— ;��i,� ✓�h'��`T �SiJ /i`' rid %�f -si�G � - T.� //� �lBilJ ILI .a7 i l 1 go I fM i f 7�r ctS.E.a lJr�/ • Parcel #: 038 - 1027 -40 -010 04/13/2011 02:09 PM PAGE 1 OF 1 Alt. Parcel M 06.31.18.121A 038 - TOWN OF STAR PRAIRIE Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 08/27/2010 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner ARNOLD C & JANET L PARCHERT O - PARCHERT, ARNOLD C & JANET L 14770 SUYDAM RD SOMONAUK IL 60552 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 3962 SCH DIST NEW RICHMOND SP 1700 WITC Legal Description: Acres: 35.012 Plat: N/A -NOT AVAILABLE SEC 6 T31 N R1 8W PT NW SW & PT SW SW COMM Block/Condo Bldg: AT W1 COR SEC 6; TH S 1437.07 FT TO POB; TH E 424.05 FT; TH N 446.05 FT; TH Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) E 953.19 FT; TH S 1255.24 FT; TH W 06-31N-18W SW SW 1377.70 FT; TH N 788.40 FT TO POB 06-31N-18W NW SW Notes: Parcel History: Date Doc # Vol /Page Type 08/27/2010 921598 WD 0671772010 QC 08/12/2004 771467 2636/532 EZ -U 08/05/1994 519904 1090/206 QC more... 2011 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 01/13/2011 Description Class Acres Land Improve Total State Reason Totals for 2011: General Property 0.000 0 0 0 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. CR.OIX COUNTY SHMC TANK MADUENANCE At REE144INT AND OWNStSHM CEELTInCATION FORM OwnearBuyer � e {.• �n ' . propaty A �yP Parcol. onNumber �j r Cifiy /Sta�o l � IL �j g L8 W, Town of�Al �� �' � � 4 ,� '(,c�, �/� , Sec. � ____� T N p Lo Snbdiviam Page # Vob=O - s wed Swrvey Map # -- past # -. — (� spwbou' y°c` ays � �,m n � wbatYM put into md °f y" sW ee yeas or.00aa;. n+eeaesd. �� s� ta�aa �,�, " Stem G&U a g e d the fncdm astspeciftdin _, 83.52(1) =d is �� 12 - st t�a3x a m foam. sigaod �' ft r� oo saber to Sc c�oac cry p� 2s MA prop may own= 95 . = gWod p or s Ucenred (if nooetisay), the awd° took is owner and by cem"oa M&or (2) d'ber wastcwa�' sy stena'vrilh t he d>ffi 1/3 W Of stodge• and agree td 1be p&SM sew+�e a,:ds s e foat]s, beaada6 sat by dO DO � � � =L* oomph 3q�of *m7m s Of 60 I/� ache tha a'a'►r►°Z{ ) tit & m this Soam are tcoe tom of Doeds bad Vv*Pat above, by vim° of s �vmogiY dodnomded Ofilm Number of b ��1- 1 W DATE CANTS) Eby $re Plm & Z b* ..� .s..poy d is s� may rest the aa�o ar3► p bo�o8 Y off tine wr"Y i mP s with this appHesdom a mmaded deod frma the RO&W of Deeds O and t coPY vann reface is merle sn dxs wa arty des& f�'- 08� Illlllllllllllllllllllilillfll 8005766 State Bar of Wisconsin Form 2 -2003 Tx :4004517 WARRANTY DEED 921598 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between Gregory L. Nelson, RECEIVED FOR RECORD 08/27/2010 4:15 PM ( "Grantor," whether one or more), EXEMPT #• N/A and Arnold C. Parchert and Janet L. Parchert, husband and wife as REC FEE: 30.00 survivorship marital property, TRANS FEE: 382.50 ( "Grantee," whether one or more). PAGES• ' 2 Td Grantor, for a valuable consideration, conveys d warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other interests, in St. Croix County, State of Wisconsin ( "Property") (if more Recording Area space is needed, please attach addendum): Name and Return Address K See the attached Addendum. Ronald L. Siler Van Dyk, Williamson & Siler, S.C. 201 S. Knowles Avenue New Richmond, WI 54017 Part of 038- 1027 -20 -000 & part of 038- 1027 - 40-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Subject to all easements, restrictions and covenants of record. Dated August a' l9, 2010 SEAL SEAL * Gregory elson * (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) Gregory L. Nelson STATE OF WISCONSIN ) authentic ed on Au ust�(o , 2010 _ ) ss. -�� COUNTY ) * . Ronald L. Siler Personally came before me on , TITLE: MEMBER STATE BAR OF WISCONSIN the above -named (If not, authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed the foregoing THIS INSTRUMENT DRAFTED BY: instrument and acknowledged the same. Ronald L. Siler of Van Dyk, Williamson & Siler, S.C. 201 S. Knowles Ave., New Richmond, WI 54017 Notary Public, State of Wisconsin My Commission (is permanent) (expires ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED C 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Ty name below signatures. 1 of 2 Addendum All that part of the Northwest Quarter of the Southwest Quarter and all that part of the Southwest Quarter of the Southwest Quarter of Section 6, Township 31 North, Range 18 West, St. Croix County, Wisconsin, described as follows: Commencing at the West Quarter Section corner of said Section 6; thence South 00 degrees 07 minutes 36 seconds West, bearings are based on the St. Croix County Coordinate System, NAD 83 (1986 adjustment), along the west line of said Northwest Quarter of the Southwest Quarter and along the west line of said Southwest Quarter of the Southwest Quarter, a distance of 1437.07 feet to its intersection with the south line of the north 116.00 feet of said Southwest Quarter of the Southwest Quarter and to the point of beginning of the parcel of land to be described; thence South 89 degrees 01 minutes 36 seconds East, along said south line of the north 116.00 feet, a distance of 424.05 feet to its intersection with the east line of the west 424.00 feet of said Southwest Quarter of the Southwest Quarter; thence North 00 degrees 07 minutes 36 seconds East, along said east line of the west 424.00 feet of said Southwest Quarter of the Southwest Quarter and along the east line of the west 424.00 feet of said Northwest Quarter of the Southwest Quarter, a distance of 446.05 feet to its intersection with the north line of the south 330.00 feet of said Northwest Quarter of the Southwest Quarter; thence South 89 degrees 01 minutes 36 seconds East, along said north line of the south 330.00 feet of the Northwest Quarter of the Southwest Quarter, a distance of 953.19 feet; thence South 00 degrees 07 minutes 36 seconds West, a distance of 1255.24 feet; thence North 88 degrees 09 minutes 44 seconds West, a distance of 1377.70 feet to its intersection with said west line of the Southwest Quarter of the Southwest Quarter; thence North 00 degrees 07 minutes 36 seconds East, along said west line of the Southwest Quarter of the Southwest Quarter, a distance of 788.40 feet to the point of beginning. This parcel contains 35.012 acres, more or less, and is subject to the right of way of 80 Street. This parcel is also subject to a IGHT OF WAY EASEMENT FOR RURAL ELECTRIC LINE, Document Number 771467. This parcel is also subject to all easements, covenants and restrictions of record. 2of2