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HomeMy WebLinkAbout030-1020-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538754 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)I. Permit Holder's Name: City Village X Township Parcel Tax No: Bird Plumbing, C/o Shaun I St. Joseph, Town of 030- 1020 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No 0� 6VK I 05\0. 19.8613 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. ^' 3, It 165. 11 / Oz . 2. Septic P J -P�G J F i , Z /� Benchmark Q /Os1 /90 Dosing i Alt. BM l � Aeration Bldg. Sewer d 11 3 Holding St /Ht Inlet )' 7 '73.7 TANK SETBACK INFORMATION St/Ht Outlet 1_� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet A ll Septic 5 p / k0 i 7 166 / Dt Bottom Dosing 7 5d 7I�� /�� y 1406 / Header /Man. 2 55 8s Aeration Dist. Pipe o Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer , � r �A - Dem and St Cover r a Model Number CT�� Ca 3 . to /dZ - TDH Life 7S Friction osss System Head T Ft Forcemain L I Dia. 11 Dist. to Well i L aP ae, 15� z SOIL ABSORPTION SYSTEM OJ BEDITRENCH Width i Length / No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia Liquid Depth DIMENSIONS /Z S a _ SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer INFORMATION CHAMBER OR Type Of System: / /�� /� / ^ UNIT Model Number: �L wJ a DISTRIBUTION SYSTEM 6C-L:5 �-- Header/Manifold Distribution x Hole Size J1 x Hole Spacing if 7nlo Air Intake Pipe(s) Length Dia Length 4618 Dia Spacing 3Z 7N CL, SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of r��odded j xx Mulched Bed/Trench Center /� ¢� Bed/Trench Edges Topsoil I � Yes J No s No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ✓ /�/ 1 / N nspection #2: / / Location: 481 River Rd. Hudson, WI 54016 (NE 1/4 SE 1/4 5 T29N R19W) metes & bounds Lot 0,�,�:� Parcel No: 05.30.19.868 1.) Alt BM Description = Ft GoJ e.�. G��,�, �.p� Ja 2.) Bldg sewer length = ` 0 - amount of cover = /J Plan revision Required? Yes >(No Use other side for additional information. 7jJ T SBD -6710 (R.3/97) Date Insepctor's ignatur Cert No P A; Gomme".WI.90V Safety and Buildings Division County /) Jti 201 as ington Ave., P.O. Box 7162 L i sc s i n Madison 1 53707 -7162 Sanitary Permit Number (to be filled in by Co.) 75 _ State Transaction Number Sanitary Permit Appli tion 2 772. 5 In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of t form to the approprta� I / unit in required prior to obtaining a sanitary permit. Note: Applica n fo- tate -owned S are Project Address (if different than mailing address submitted to the Department of Commerce, Personal information ou proved y 9c used for seconda o:es in accordance with the Privac Law, s. 15.04 1 m , Stats. S 6 / I lr(�L F-0 I. A,It tieation Information - Please Print All Informatio N/ Q parcel # . Property Owner's Na� 41._ OFF lV! Property Location Prol�erty Owner's Mailing Address (/ Govt. Lot City, State Zip Code Phone Number y J %,, Section rcfe on �0 N' R E th W II. 'Ir pe of Building (check all that apply) Lot Subdivision Name I nr 2 Family Dwelling - Number of Bedrooms Y� Block # ❑ 1 - Describe Use _ �_4� ❑ City of — CSM Number ❑ Village of _ ❑ ';date Owned - Describe Use own of 12- 6&4 _ -1 III„ Type of Permit: (Check o ly one box on line A. Complete line B if applicable) A ' El New System ement System ❑ TreatmendHolding Tank Replacement Only El Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision El Change of Plumber [I Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System /Com onent]Device: Checl Il that a 1 ❑ Non- Pressurized In- Ground El Pressurized In- Ground ade El Mound ? 24 in. of suitable soil ❑Mound < 24 in. of suitable soil ❑ 1 folding Tank ❑Other Dispersal Component (explain)___ - ❑ Pretreatment Device (explain) V. l hspersal /Tr eatment Area Informa Dis ersal Area P posed (sf) System Elevation Dear n Flow (gpd) Design Soil Application Ra wdsfl Dis Tsai Area Required ( sa l b � V][. Tank Info Capacity in Total # of Manufactu r Gallons Gallons Units U a � m New Tanks Existing Tanks Scpiic or Holding Tank Dosing Chamber VI 1. Responsibility Statement- 1, the undersigned, assume nsi ity for installation of the POWTS shown on the attached plans. MP/MPRS Number Business Phone Number Plumber's Name (Print) Plumber's n Plumber's Address (Street, City, State Zip Code / d) I . Count. IDe artment Use Onl Permit Fee Date Is ed Issuing nt Signs proved Disappr � ��� • OD ,��j„ ven Reas or Denial GGJ��++ I 1:9. Condit"10WOWNW aeons for Disapproval 3 64 e 1. `Septic tank, e�lUent fiRer and / S�{ fit. A L G e, dispersal cell must all be services F maintained 1 4J " as per management plan provided by plumber.• 2:. Atl 90(back regtArements must be maintained ; ex tae n comp e e e system and submit to the County only on paper not less than 8 1J2 x 1 inches In size 50313-6398 (R. 01 /07) Valid thru 01/09 PLOT PLAN PROJECT Shaun Bird ADDRESS 1008 192nd ave New Richmond Wi 54017 NE 1/4 SE 1/4S 5 /T 29 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 105.0 BEDROOM 3 CONVENTIONAL AT -GRADE •5 CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Grading is to be done divert 108' run -off away from system 106' B-4 105' 6 Acre Parcel p 104' Property Line 1313-1 102' 100' B.M.* ❑ B 10% Slope Drainage area Huffcutt Combo Tank B - Scale = 1 /4" = 10' Area 15' below grade Overflow 200' is to remain / / Easement to undisturbed River Road cleanout ST Old tank is to be Tank is to be properly bedded and pumped and buried provided with lockdown covers with approved warning labels Existing 3 Bedroom House 0 Property Line p Well Property Line Safety and Buildings commerc OV 141 NW BARSTOW ST FL 4TH g WAUKESHA WI 53188 -3789 Contact Through Relay t il eparhmnt se o n s i n www. www.commer isco nsin.go of Commerce wiscosin.gov Scott Walker, Governor Paul F. Jadin, Secretary April 14, 2011 CUST ID No. 226900 A7T'N. POWTS 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: 04/14/2013 Identification Numbers Transaction ID No. 1927725 SITE: Site ID No. 766160 Shaun Bird Please refer to both identification numbers, 481 River Rd above, in all Correspondence with the Town of Saint Joseph a gcncy- St Croix County NE1 /4, SE1 /4, S5, T29N, R19W FOR: Description: At- Grade, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1310293 Maintenance required; Replacement system; 450 GPD Flow rate; 42 in Soil minimum depth to limiting factor from original grade; System(s): At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01101); 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 At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), and the Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01/01) The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 ro 2 jh installation of float switches or relays that contain mercury. Please specify an alternative product p t yi' g_ sanitary permit ". y f M In the event this soil absorption system or any of its component parts malfiR c4gns so as t health hazard, the property owner must follow the contingency plan as described in the approve, ns. In a ition, the owner must comply with the operation, maintenance and monitoring duties as described In s� VIII of the at - grade component manual. A copy of this information must be given to the owner upon comp 46n of the project. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. SHAUN R BIRD Page 2 4/14/2011 A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. 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. Since y, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis- Osborne POWTS Reviewer 2, Integrated Services VSI�'codi� ,7633; (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: Kmv. commerce. wi. gov/ SB/ SB - BuildingContractorProffam.html Cover Page Shaun Bird Recelveo Bird Plumbing Inc APR 13 2011 1008 192nd Ave SAFETY & BUILDINGS New Richmond Wi 54017 715- 246 -4516 Date: 4/11 /11 Owner: Shaun Bird Location:NE1 /4 SE1 /4 S5 T29 N,R19W 481 River Road St. Joseph System type: At -Grade Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706 -P(N. 01/01) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and C t gency plan 9 -11. Soil test Shaun Birdg� Signature License u er 226900 a., F PLOT PLAN PROJECT Shaun Bird ADDRESS 1008 192nd ave New Richmond Wi 54017 NE 1/4 SE 1/4S 5 /T 29 N/R 19 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 105.0 3 BEDROOM CONVENTIONAL AT -GRADE •5 CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100° Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Grading is to be done divert 108' run -off away from system 106' AL B-4 105' 6 Acre Parcel 104' Property Line 11 13-1 102' 100' B. M. ❑ B 10% Slope Drainage area Huffcutt Combo Tank B - Scale = 1/4" — 10' Area 15' below grade Overflow 200' is to remain / / Easement to undisturbed River Road cleanout ST Old tank is to be Tank is to be properly bedded and pumped and buried provided with lockdown covers with approved warning labels Existing 3 Bedroom House Property Line p Well Property Line �__�.a� >._ uin t_ e�s.• r a+ _31A0 - _ - _ _ 4 _77 5 _55L Iftft / M ' At -grade System Sloping Site Cross Section and Plan View E „ Dimension Feet :� .ti r'�,. 'C■ �� r'$ r�r }r� r�,4 r r•�• f•r•r� ■r r.r r•r r■ }fir a$��� x � � �" � 't �' � � � ': '�� '" � }�r. }�'r �C�� ��r•�'� r r �' r'� r�rr 3• r r r �' B d 1/6 B W A rti S r ti r ti r y yS '� ti+r. r� �'�: r.��'rR ti. �' i'Y! � I 1 rti },�;ti� {3,��.� ,fir � ,��,�� r ��� `■ '� d�r•���,:�',:� '"'�''� �' :{,r�rt :'�� } r. D 2.0 I it r r•r•r r. r, r r r j r ■r•r. r r r r r r• I E _ 5.0 '. 'L L'L 1.{ L•'L ti� � ■`Y .�i • • . ■ iL.ti. .y rL • ■ ■.. •.-•.• F 0.5 _ ' L E � 1/6 B� W r. .rrr r r r r r .r Yir ii+ Wiw E _L B 1 _. L % Sloe — Plowed ,�� • = Clean aggregate = 4 in. sch. 40 pvc basal area rti: • Vit 2 %2 in. dia. observation pipe Lateral with 2" Topsoil Cap aggregate over pipe Observation Pipe Geotextile t � + G , With Cap Fabric =.s_ Ft Lateral Invert ���'� ■rti. r:r r ■y{ i � . '�•r�:�f$1. fr ti Topsoil C.ap .. • r .v i■vv ti .ti 'Cti•v. � r F C rs:sr:r:?': - r Ft Contour :r:'3■�:�:F +y�, .� I,� , j Tom D Plowed Surface C Slope Direction GENERAL INSTALLATION: The at -grade area is staked out along the destV.j contour.. Existing vegetation is mowed and raked off the site. The bates, area (L x W) is st ed out and plowed with a moldboard or chisel plow. Plowing may not proof: if the soil is wet emugh at the plow d4pik 1te: fi rm a '/4 inch soil wire when a sample is rolled between the palms of the hands, The A x B ar ek, covered by clean aggregate deposited overhead by, a backhoe.. Special 0�0 must be used whry�n pllacing the aggregate to minimize compaction of the plowed surfaces;.A the topsoil cap is placed, tivr, entire at -grade is seeded and mulched to promote vegetativ* grow ,limit erosion and protect fi cam freezing. The observation pipes are perforated in lowar fr inehes pfd- secured in place. 03/051gi „- Pressure Lateral Layout One Lateral — End Manifold 4 Threaded Cleanc .it Lateral Turn -up --10 Plug, Force Main X L Long Sweep 90 Bend Pressure System Construction Distribution Network Specifications Lateral Diameter Z In. Laterals are constructed of Schedule 40 PVC Orifice Diameter �" ;L In. pipe. Orifices are drilled perpendicular to X Orifice Spacing) In. the pipe with a sharp drill bit and face down. L Lateral Length) 5 9 Ft. Lateral turn -ups terminate with a threaded Force Main Diameter Z In. I cleanout plug and are enclosed in a 6 -8 inch Force Main Len Ft. diameter lawn sprinkler valve box. accessible from finished grade. ••••• Grade ••••••• ;Q ••••••o 6 -8 Inch Lawn Sprinkler Valve Box 03/051gj Page of Septic -Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer'_�� Tank Model Number Pump Model Number Total Tank Capacity 31 0 Alann Manufacturer f �' Max. Bury Depth Alarm Model Number Switch Type lye Filter Manufacturer To Dy Head (TDH) - Fe Filter Model Number Elevation Head Distal Pressure 3 Network foss r Minimum P ump Performance Required Force Main Toss — GPI'vll Ft TDH T otal S Outlet Manhole Min. 4" Above Gracie With Locking Deg ice. Inlet Manhole Manhole Min. 4" Above f Yrade < 6" Below Gr4& Sealed Watertight Securely Mounted With Locking Devi(-, Weather - proof �♦ Junction Box ♦ .r r unY Flushed Grade IN r 0 No rr Ohm rr NN NN NN ♦�- _" _. I � _ Vent Min. 12" Disconnect Above Gracie Meafts With Veit Cap �!� , Y Y Y Y Y Y I Y Y Y Y Y f i l y a, r Y y Y {!• , Y r, 1 y 1, a a i i Y a r ` . a Y a Yi / f a , a a I � y i,i r , �I 1,I r;l i�a Y l, a t �:1 a� ;1;t,r,a;{ II, Outlet Filter —._,,, � r•'_ _--a . Inlet inlet Baffle Y Switch Sp 4n and Reserve Capacity A Y, Tank. Volume = „ ' GPI ,p Dimension. Inches Volume Gal. B lll:rl'e (reserve) r.. j- 9W z .;r (alarm) B' 2 ,3(� Off'Elevation ., ' C (dose) C �. iY.'> .�"..�'� Ft ;.> (dam) D ..tottom D F[evatGion :X Total Ft { , s �;af Tr� i< r t 1 a a 1 a/ l a l l r f a a r 1 r l r 1 r s f I a l a 1 t a,a 1 r r t t i a {,1 I l e i i / I Y a,l f a t, 1 t, I,I i / I ••,,�_ r 1 r, r ,f,<, I, Y,<r. Y 1 / , I Y r , ! a,> l a� Y Y —ma a r a r 7� Y,4 > Y Y >'Y { . > > I Y Y a Y ♦ y a , y y Y I a `i 1`a r 1 f i t a/ I r f`I t 1 t o t r 1 a r r r r < a a r t a< r t t a/ 1 1 f 1 1 l e i <: < I a t r { I i 1 a r a r 1 1 r a r 1 � GENERAL. INSTALLATION: The septic/dow tank is bedded and back filled in accordance with [he manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer mar :not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padkck) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, .ind laid on stable soil to prevent settling or sagging, The force main is sleeved with 4" S,ch, 40 PVC to bridge the i enk excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 U Page of Sent By: W LaserJet 3100; 1 715 bbl OW ; ,arty- tr -.,o a.uur«n, • «mom l a t. I ii I 9 E H SERIES SUMP / EF'F'LUENT PUMP ism ..... - x 41.!05 8.6k1 � Q 0 not iat » saaaa sNNON laaasi 0400 R I K WOR a/ m WLIQ 400eal6 Y y I V v 3t.1 sst Olt fw slri :A l"W sm mUCbv► 4% 115 314 13o = 70 V 55 41 32 1110 OF of t1l i11.6/;0.lt 11"I X040 M *4 300 314 6.5 1000 70 64 55 41 32 as a0' 81 8.11 elimlsm M4&S MIR *W 04 115 So 1la 1000 70 01 a 41 a III in V IL" :lt&x t I YdiA3 m .93 Bd1 ag SS in 70 .. is .m M 19 ASA )!1' �� ail s1ti443at L1aANnrgO�rNW1 'LSMe Wt1AMIMM�fplll�alet�l >I/i1y7t 7A�I�IINIIIM�I1 I�d1 MiM p11w FLOW -- L1TER5JFIMA 0 1000 am 3000 Motor H Emoxy Coaaad cut Iron Ir�petler Material CN*OMW x •= to Imoguff Tm Closed Vow mute �a Power BJFW a+l moc wniw shalt utl Nitrite with carbon and ceflia fa cea 3 palm= Stsin}eaa :Qoeel - _ as SbsR �_ .._ - 9 w ft6w Mosel Upper Stem and Leww � r . Help Hearinga 0 20 40 64 Be rLow- GALL MS/0IMHE PUW PERFf ,R,�IA CURVE UWC WOdt P UMP CAM. 60a n)ftx 13K#- 116fdMWC144 730 7 Mow 40d47.7611 -fto 4NA MON wnwrwll iltt4eCtrlssuu mp.4:.w3: t.4�4ar ►otrn 4Nl 3 — W/00 ! G E,E1T P Page of — POWTS C?tNt+l fS p tjp�4 g �� Tam Cad ❑ NA Ft1 iNFOI�i11M'CWK J ct DNA Tank owner - t7 NA C1 NA i� p - d t�4 II Na jlumtw Of 8w"10— Puatp Tt c � Uftb �, p Tttulk Nutnbsr of C� �11Z� p •N , NA' EN*n lDe:ds toee► (teMil+�� .l umQ p Pump mot C3 Poe Fftr [tastOn 31crw t?r�t Un1t OW APPLI a°d�- t� mordbly �'a�e" f7 St;n WnWW F fl tnt(tx E �t (FO 530 mg/L ❑ N1e�� 13 OdISC Feak, ON & C re 5M tng1L 13 pion Ibe OW. cr.") Mot>tt�Y 8�, Ut*P a II 1nit�sut � p NA Si0 mplf- hI -9nw� '� ❑ Mound sbc1teerrtir� Sump+" ed fs� �) : 530 rng& C] L] Off= TdW s t 04 at�3 oorni ,,, aid Food 00 y n� v � �tdrd oa+sNwu � Y. inchtftarnOW E m ue l P a� ., h't S!lrl/tGe Fa�7'T .. S Event ❑ Monttr o 3 Os) (N[�ud�um :3 yns.} At least once ev'i yrs.) U tanK voturae f of tsnk(s) Whorl aoMbtned ytudge a nd sCUrn � of tank(s) © marsth* R *) (M*xarsiurse :� PU ult Clog At. least once every t�s) inspect rit*paaet 0811($) At Most onc* wry Q months D NA Glean rwifluentfow At 10Sst onoe every p HA Rnsp ��uenp. P sxyMMIS a sterm Ci tnotlttt* .._ . Al least orncs evarY twist " 1:3 Month$ 131�*) � DNA nugh 600161111 600161111 and e At least anc* any _ At MW once every MAC ,_�.......,- si ana c, the or terr�e;� ANC wCM01 s �y an iredfviduset 1 Inspeclaans cropb*s and � �trkcfod Sawars Pt�W t S frf*P Dr� tei.� cdy I ms s ' oert00,1 . Meow P t>.r' t r us t include s vts�t[ insP+t M n n °t the ge scum � m 1e afil snY lt,m UP ile 'rQ OPWO r. TO* °k ure -the vaturt�e of combieslud slud in k to cook the► r,ent t tzardmM ldrndly OW txe� or tes}e*. .'fix disiPill c8lKG) sthedt �► v lr of slfluent CHI. 010 or port,jkv d GlOwlt on" pondlrl0 of eftluertt on Etta ground sl o � � � y ,t y. adqM to the +�� s to d%Mft for fern�n0 n so requires the trrrrx:sdia ° oe mots ttfltte ttttlk ` Me 9fix": "m us a an;uat In aay taflk eRUWs W& t �h ;h NR eatt +i: Of tm W* SW be 18ffl� b _ and 7n1! t�rnent �,ponettts: 113, V�J; 1n Adrl� Cod, or prossudmd POWf S compote• p POWTS M b*gwr. Tie 91itt�ig of eff�nt SINS• of =n_t�ts or less. sha11 be . . 96t* ��t. oflwill� or �tt4ofmg t " 1431081 rrgulai autha wfihln 10 of W q Of � A setid p ropoStS be � pr ather ST ART [UP AND OPEMTIOAI am For now owain s It` awn bcdo at f�tmett# Wk(5) fiorthe P Of For 0m. � to ume of She it proo 'S andf . � J. tot may tenoode the Cetsttflent P anNor damage the dleepessal to US& tjsttt>WK1 h8 ft its oortbeents of the UUWW,) Waved try a 600'Sge s�rvtdng op*rabar �'or R up srou not occur when' s al - conditions are frozen at the infiltrative surface- is ISSt1D[ ed file e>gOeSs Symarn start sbCnre normal tnghwater levels. When �r purging pa t 1BnKs tnaY cogs) in one Sarge dose. �d oading the =d(s) and may result in the e+irater wr t be f VW this Z&Aaflon }rave the contents of the pub tank removed by a avo baCrarP arairfacs � to the effluent PUMP or coraw: t a Plurntmw or POVVrS Me�ttairrer'to e Secvkan O W • nWs f mtxe nom al levels within the PumP tank - a � and dtsW" c&%- _ Do not drive Of PaA Oyer, or other distlub ort�ompeO,, parrot drbffl or park VOW" over' mound or at- grade sail atwrption aMa- the area t 15 feet down sbps of 81W W a the perfonTMW and prolong the ,01! Red o •er �na� of the fol[ctrMg from the wasteMter stream may imp Witte butts: oortdoms; cotton swab's; d�g'ra� denial BOSS: of iris - fou W gip r, fruit and vegetable peeMs. ��e� greases T rim. "ides; Meat drs�r,[edacrts: fotrndort drtdrt {ar>ImP sanitary napkins: tampons: and illydtler sr>tterler brine. soaps; rtledXWOM 5; at !fig gr+oducw AsMOONNUE Taken out of service the ft�ltc ving steps strati taken to insure that the tlVt>sel► the PUW s:idlar is enilY Admtnlst 136ve Code: s u profs and SafietY abandoned i oomPrrarrce w3fh rh_ Comm 83.33. t�Nisoortsin ir piping to tanks and pits Shall be disconnected and the abandoned PiV a openings SP.alt�d A ` shall be removed and properfy disposed of by a Septa9E Servudng ()perator. ., . The caon6eiats of an ffir1iG8 and T� s Ajar pumpIng. 3Tl tanks Rnd F� SW be excavated and removed or their covers refs oved .and the void space filled with Boil, gravel or another inert solid material. c.j)N MGENCY PLA the if the l'owrs fps and cannot be r #oI[crmring measures have been. or must be taken to provide a node $pair�ed compliant repla mnent system t soil nt'ar+ea Fias deli evaluated and may be utilized for th location of a reptademen Cl Asuitabfe ntarea should be protected from disturbance and COMPOCdon and should to t absorption systmm The replaceme ed structure, lot lines and wells_ Failure to be inrringed upon by required sett from existing and proposed in the need for a new soil and s ps�oDect the rePla�rasment area vfi ,+-surf ite °evaluation to establish a sortable replacement ams Replaostrient systems must comPly with the rules in effect at that time. Q A suftab,e replacement area is not available clue to setback and/or soil limitations_ Barring advances In PCYWr: 71e ok gy a hording tarot many be installed as a last resort to replace the failed POWtS_ ite has not been, evaluated to idenf"sfY a suitable replacement area_ Ugon failure of the area i rS 2l iable a valuation mask be kxat,e a suitable replacement area_ It no replacement area s ava a holding tank n'lay' be inured as 8 last resort to replace the failed PpyYi"S_ removal of the biomat at - Mourod and st grads sell abson*0n errs may be recot:s st c in piaC� fie rul es in effect, the infli Tra&e suffaoa. R�sbuc Lions of such systems must c with the r at that time e<WARNI9G» TANKS jAAY CoNTAINY LET€,AL BASSES ANotOR INISUFFIC[ENT OXVGEhl_ � SEPTIC. PUMP AND OTHER TREATAT DO NOT ENTER A SE"Cr _ �1P1t FR OM THE INTERI(]R Q� TANK MAY B D FICULr `r T R IMPCi S1BL l". RESULT_ - RESCUE Dt A F ERG ADOMONAL COKMFJITS PoWTS MAINTAINER pOWi"S INSTAL -ER c tlilrrl2 ��� � �✓ / - . Dame 2u A./ Phone Phone / LO CAL AUTHOR Sl PTAGE SERVICING CIPERATOR (PUMPE r � � K: Name F � %/, Phone This d meets TW3 docrmant was dgRhsd � Ida s� of the r esn i�ke, Tirtarqustfe anti Watrshara County Zoning and Sanil3fi0n ifQQrl t does dot use mimmurn m quit en onto ai` &L Comm aa.Zk2)0)(1Xd)&(u wid 83.5t(1). C1) & (3). Wisconsin Aran*, Cade, Use of this doaanen C4t,mr Will) gaarantee the pedormarim of the POWTS, P Al I D Wisconsin Department of Commerce SOI EWk4A11Q.d REPORT Page —L of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code t County C � Attach complete site plan on paper not less than 8 1/2 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. �j QZ 3 0 — � p �O . o Please print all information. R ewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ( / 3 /j Property Owner roperty Location i I Wt. Lot 114S6 1 /4 S T� Lt VAL— S N R E (I 6w Property Owner's Mailing Addre I of # Block # Subd. Name or CSM# d APR 1 — _ q i Z State Zip Code Phone Number City ❑Village own Nearest Road ST. CROIX COUNTY �(J D II.A & ZONI OFFIC � 1 R'a ❑ New Construction Us esidential / Number of bedrooms Code derived design flow rate GPD eplacement / ELPublic or commercial - Describe: __— Parent material Flood Plain elevation if applicable General comments and recommendations: System Type K-, System Elevation 4 Boring # ° Pit Boris 3 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 J , Boring # F1 Bori C� Pit Ground surface elev. Depth to limiting factor in. 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 / /, r r, r� l !, i Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) 4 re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 j� 1 l 715- 246 -4516 Property Owner _ Parcel ID # Page , -- of Boring # . ❑ Boring a ja pit Ground surface elev. . ft. Depth to limiting factor ---,Z A�2n• Soil Application i ' ale Horizon Depth Dominant Color Redox Description Texture StrucUae Consistence Boundary Roots GPDNf in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. "Eff#1 "Efir ! ? Al ` Boring # Boring /� t Ground surface elev./ y Depth to limiting factor v`�� in. Sol Application bate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIN in. Munsell Qu, Sz. Cont. Color Gr. Sz. Sh. `Eff#1 TU 2 2 .:, off Q r � Z — "A E # ° Bon ❑Pit Ground surface elev. ft. Depfh W limiting factor in. Soft =;ate Horizon - NNA Dominant Color Redox Description • Texture Structure Consistence. Boundary Roots GPD/tf _ ar. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "EM Effluent #1 = BOD > 30 220 mglL and TSS X30 < 150 mglL ` Effluent #2 = SOD, 5 30 mg& and TSS _5 30 nWL 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. sao-e330(n.a160) Soil Test Plot Pla Project Name Shaun Bird S ird Address 1008 192nd Ave New Richmond Wi 54017 STM #226900 Lot ------ Subdivision - -- -- ---- D 11 /12/10 NE 1/4 SE 1/4S 5 T 29 N /R W Township St. Joseph ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey iron System Elevation 105.0 *HRpSame as Benchmark 108' B -4 1 105' 6 Acre Parcel ❑ 104' Property Line B-1 102' ❑ 100' B.M.* B-2 10% Slope Drainage area B- Scale = 1/4" = 10' Overflow 200' / Easement to River Road ST Existing 3 Bedroom House Property Line p Well Property Line Z Q O LU Q F F LL Q dWLL U ��o Z oo CO M p w o 0 0 J O U) LL LL U Z V CD CD U 2 U � � W W Q - z H J Z o U) C � W m c) g � r a (L io d�LL O �tz rn ti 0 0 N Z O H F- J_ J LL d � p W LL O �t N O O N r F- Q' 0 d a Y � Y U � O O Q � v J 4? U O 0 �O N a ® o 0 ® LL of O LL ® � O ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREMM AND OWNKtSW CER CA1`ION FORM Owner/Buyer c� �.z �✓ M Parco3. Id�►'fi City /staf R — W Town of a Lot # propatY Loudon A Sao* Sub�iv c� Vohune P # .ermed S nrvep Map # Volume "� —� par # -_____.. W Mty Deed # Loth idugifiable no �—�.I �SW use sad °� Y wee yeas+ s t he m"m by a BOOM" I i0prolpm mWUNSMOD ofpAnoWb* sss s assln SsnjWy - affioct .52(.1) sad in tww 12 - St � C0`apd�y s caste° f = dby the r espy subs 't Croix c �� p vat �t o,�c is 10 ands p'�p � {2) d'�e��� owl sysamm is isp :opm 1D with the fun Of sbzd$b w mss & V d� saw �� P1nS & I/we the u�i � pq Z o C° 0lDl ra e comQ ix CarouatY q swm bas been Mzd� Ccr�� ststm8 that � � �� t�aea y�r eaaa► ds�e• ssdao t� mss) °f ft Zaai�sB win sre true t the beat of �aY /°mr kt"°a'�'°dg °• 11we cetdb U of �° a � J. of Deus 01am Number of b DATE sxc�' OF APP its) is m � Y & Zomg ** *Any � * mstian that is� m" Y the R of D.6 C?� and s OPY Of** spy MAP if .. wi &this app Ma =eOMWw:ssa�Y dad f M use is m aft i a the wISMAY deed- (1t v. tis/os) STATE BAR OF WISCONSIN FORM 6 - 2003 922804 SPECIAL WARRANTY DEED BETH PABST Document Name REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between U.S. BANK NATIONAL 09/20/2010 08:00 AM ASSOCIATION, TRUSTEE FOR LEHMAN SAIL 2005 -10, EXEMPT #: NA REC FEE: 30.00 (Grantor), TRANS FEE: 198.00 and Shaun Bird, A Single Person PAGES: 3 * *The above recording information (Grantee)• verifies that this document has been electronically recorded Grantor, for a valuable consideration, conveys to Grantee the japror A rea & returned to the submitter following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in SAINT CROIX County, Name & Retum Address State of Wisconsin. Shaun Bird 481 River Rd. Hudson, WI 54016 030 - 1020 -30 -000 Parcel Identification Number (PIN) This is not homestead property Parcel 1: Part of the Northeast 1/4 of Southeast 1/4 of Section 5, Township 29 North, Range 19 West, County of St. Croix, State of Wisconsin described as follows: Commencing at the Northwest corner of the Northeast 1/4 of Southeast 114 of Section 5, Township 29 North, Range 19, West for a point of beginning; thence on an assumed bearing of due East, along the North line of said Northeast 1/4 of Southeast 1/4, 141.67 feet; thence South 01 degree 09' 32" East, 570.66 feet to an iron pipe; thence South 37 degrees 47'56" East, 564.00 feet to an iron pipe on the East line of that certain parcel of land described in Volume 422 Page 129; thence South 02 degrees 45' 13" East, 40.69 feet to the Southeast corner of said certain parcel; thence North 89 degrees 18' 03" West along the South line of said certain parcel 508.85 feet to the West line of said Northeast 1/4 of Southeast 1/4; thence North 00 degrees 26'09" East along said West line, 1050.71 feet to the point of beginning. Parcel 2: Together with a non- exclusive Easement 30 feet wide for ingress and egress from said Township Road South to the East 30 feet of the above parcel, the East line of said Easement being the East line of the land described in Volume 422, Page 129. Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances arising by, through or under Grantor, except: municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, general taxes levied in the year of closing. SEE ATTACHED SIGNATURE PAGE. THIS IS A 2 PAGE DEED. SPECIAL wARRANTYDEED 201007865 1 of 3 Page 1 of 2 Dated this day of - , 20 By JPMorgan Chase Bank, N.A. As Attorney -In -Fact .�% E 8,% U.S. Bank National Association, trustee for G . AT . �i Lehman SAIL 2005 -10 ac : t�� D' ; rn " t�MA V (SEAL) o 2 * B y: ., 0� ''•�Q ` Linda Rice UNITED ��`, Asst V a President _ (SEAL) By: AUTHENTICATION ACKNOWLEDGEMENT Signature(s) State of ss Authenticated this day of County. Personally came before me this day of _ TITLE: MEMBER STATE BAR OF WISCONSIN 20 the above nam (If not, Authorized by §706.06, Wis. Slats.) to me known to be the THIS INSTRUMENT WAS DRAFTED BY person(s) who exqAted the foregoing instrument and acknowledged same. Jeffrey P. Patterson State Bar Wisconsin No. 1005690 S Attachment / o�tary (Signatures may be authenticated or acknowledged. Both are not necessary.) blic, State of ssion Is permanent. (If not, state expiration date: * Names of persons signing in any capacity must be typed or printed below their signature. SPECIAL wARRANTYDEED 201007986 2of3 Page 2of2 ACKNOWLEDGMENT ENT State of California County of San Diego ) On �' `'� �� before me, R. Fregoso , Notary Public Linda Rice (insert name and title of the officer) personally appeared Asst. Vice President who proved to me on the basis of satisfactory evidence to be the pers whose name(e) is /a,?6 subscaed to the within instrument and - acknowledged to me that h /she/ ey executed the same in hi s : er eir authorized capacity), and that by h /her eir signature on the instrument the person(; or the entity upon behalf of which the perso acted, executed the instrument. 1 certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal- R.FREGOSO Commission # 1881299 i �: Notary Public - California z Z San Diego County Z Expires Feb 28, 2014 Signature (Seal) 3 of 3 Parcel #: 030 - 1020 -30 -000 04/13/2011 08:51 AM PAGE 1 OF 1 Alt. Parcel #: 05.29.19.868 030 - TOWN OF SAINT JOSEPH Current I-XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - BIRD, SHAUN SHAUN BIRD 481 RIVER RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): "= Primary Type Dist # Description * 481 RIVER RD SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 5.800 Plat: N/A -NOT AVAILABLE SEC 5 T29N R19W NE SE COM NW COR NE SE, Block /Condo Bldg: TH E 141.67 FT TH S 1 DEG E 570.66 FT, S 37 DEG E 564 FT TH S 2DEG E 40.69 FT, TH Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) W 508.86 FT TO W LN N 1050.71 FT TO POB 05- 29N -19W NE SE Notes: Parcel History: Date Doc # Vol /Page Type 09/20/2010 922804 WD 05/11/2010 915916 SD 08/22/2005 804142 2872/119 WD 12/03/2003 748107 2466/611 WD more... 2011 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/07/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.800 82,700 101,100 183,800 NO Totals for 2011: General Property 5.800 82,700 101,100 183,800 Woodland 0.000 0 0 Totals for 2010: General Property 5.800 82,700 101,100 183,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 116 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00