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HomeMy WebLinkAbout008-1079-95-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 Cham eau, Richard Eau Galle Townshi CST BM Elev: / ~ ~ ~ D Insp. BM Elev: lOd ~ o BM Description: ~. ~ l ~,~- n-~~.cl TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic C~~ ~~bU Dosing l+/ ~ v Aeration Holding TANK SETBACK INFORMATION TANK TO PXL W~ BLDG. Vent to Air Intake ROAD Septic ~ ~ ~~/ / /- .r (O Zo ~ Dosing t~-I~S Aeration Holding DI IMDfCID4JtrlAl IAI GP1DM AT1/11U Manufacturer Demand GPM Model Number / S 3 TDH Lift rictio~ Lo~ Sys HQati TD ~t Forcerryain Len t ~ Dia . ~ i~ Dist. to well _, , SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. CroiX sanitary Permit No: 430248 0 State Plan ID No: Parcel Tax No: 008-1079-95-000 Section/Town/Range/Map No: 28.28.16.421 B STATION BS HI FS ELEV. Benct}gl~k~ / ff ! ~ _J / 0 !V ~ / ®~ . 0 Alt. B M S.~G ~ h'+ Bldg. Sewe s~ ~ SUHt Inlet f6 fyj Z. ~ .3 9~ SUHt Outlet f ~~ Dt Inlet ~ Dt Bottom / Z /3• 77- Header/Man. _ hT ~ . 3 /~~.lp Dist. Pipe y ` , ~a. Bot. System ~ q5 Final Gra e /~ S ~lS /Olb . a St Cover ~ 1 S r~s-~,~ ~_ ~s p. d ~~~Z /.2- qi cIo~o BED/TRENCH Width / + ` Length _ ~ fJ No. Of Trenches / d PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ) ~ b ~_/ ° SETBACK SYSTEM TO P/L DG WELL LAKE/STREAM L C G Manufacturer: INFORMATION '~~' CHA ER OR Type f Syst~ ` / ~~~ D T Model Number. DISTRIBUTION SY~,TEIy Header/Manifold istribution x Hole Size x Hole h A ~ ` h ~ ~ ~ ~ ~ / ~ Lengt Dia -~ Lengt Dia Spacing - • (~ ~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ,~ Depth Over xx Depth of xx Seeded/Sodded Bed/Trench Center / ~ ~i Bed/Trench Edges Topsoil I;.,.~ Yes [.] No C~~1 Yes f-=' No ~_ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /N~1 /~ Inspection #2: 2 / Location: 2343 20TH A'v~en~ue~Bal~dwin, WI 54002 (NE 1/4 NW 1/4 28 T28N R16W) NA Lot '"~ Parcel N/o~: 2 .2 .-42/16 1.) Alt BM Description = r'~,t•'a"vvc~~~'~ ~~ ~~f -~~-t.~, ' "" "" .` ?~`~ ~ ~~~y[/(/t.,tQ~J' ~-ijili~.d~ 2.) Bldg sewer length = , ~ ~- ~/~~f~/ (~J11.~ j~L [~/ `/ ~~YL~ -amount of cover =' 6 ~ ~JC,,c~-~~-ry ~-~ v+;5~~1~ ~~lu.~L(,tJ S~I~ ,( r ~~p K~8 ~ eU ~ 0 Use otherls de for additional information. No ~ _!_ I ~ _ _L03 __ _. ~w~~~ ___ ! ~i`~ _ _ _ J ~~ SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. ~(iCrP/lD Spacing Vent to Air Int e ~2U / a / xx Mulched Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County ~ U ~ Madison, WI 53707 - 7162 ~~, O Sanitary Permit Number (to be filled in by Co.) i a II~~ (608) 266-3151 Department of Commerce er State Plan LD. Numb Sanitary Permit Application u ~ ~~~ ~ ersonal information you provide Code Ad Wi 21 i C 83 ` , p m. , s. th omm . In accord w may be used for seco~ary purposes Privacy Law, s15.04(1 xm) Project Address (if di8'eren~ing address) I. Application Information -Please Prlnt All lnformstion Property O is ame l~~9'~ ~ 1% /fir x~' Parcel # Lot # Block # 0~~~l07 9- d"-eat Property Owner's Mailing Address ~' ~*y 1'O~trOn ~ a, ~ ~' ~ ~. a34~ Z~ ~~ ~ ,.,~X! ,,., Section City, State ~ ~~/ /~~ Zip Code ~{A~Z Phone Number (~ n T ' ° N; RE o~N l " °" w ' ~ ~ j ` y) ~ ?{ ~ ~ 11. Type of Building (check all that app 't k,. l .' + Subdivision Name CSM Number Y or 2 Family Dwelling - Number of Bedrooms ' ' ' ` ~- ~ ^ PubGe/Commercial-Describe Use D ~ , L~ ~ ; -~ "•: ` "' ~ ~ ^Village~fownship of f; City ^ State Owned -Describe Use _ 111. Type of Permit: (Check only one boz on line A. C~ letd line~B'' applicable) + A' ^ New System Replacement System ^ dirig'Ta"'n~i 1leplaµcament Only ^ Other Modification to £xisting System B. ^ Permit Renewal f E i ti B ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New Owner list previous~er~t N~ber and Date Issued e ore xp ra on 1V. T e of POWTS S stem: Check all that a 1 ^ Non -Pressurized Jn-Ground ^ Mound > 24 in. of suitable soil "Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized ]n-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatrnent Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leac ' Chaurber ^ Drip Line ^ Gravel-less Pipe ^ Other explain) Z ~ V. Dis rsal/Treatment Area Information: Design Flow (gpd) Design Soil Application RaU~gpd~t) Dispersal Area Required (sf) Dispersal Area Proposed (sf) ' System Elevation ~y~ r~D o ~ , r 9 / (~a o 5 79 /oo -- Vl. Tank Info Capacity in Gallons Total Gallons Number of Units ~,M,aQnu/f~acturer (,{/.~~~t~'x~ /7 ~ //yl ~ Prefab Concrete Site Constructed Steel Fiber Glass Plastic Ncw Tanks Existing Tanks ~f ~ Scptic or $pidiag.Twde / `~ Aerobic Ttcarmcnt Unit Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assu respons ty for installation of the POWTS shown on the attached plans. Plumber's (Print) Plumber's Si MP RS Number O 9~6 ~ Business Phone Number ~ u ~ 7~~ 2 G .~z . Plumber's Address (Street, City, State, Zip ) Vll ount /De artment Use Onl Approved ^ Disapproved ~~Y Peruut F (includes Groundwater Surcharge Fee) ~` ~ Da ]sued ~ 1 g A Signature s) ~ ~, O ^ Owner Given Reason far Denial IX. Co/nn~d~-itions of ApprovaUReasons forDsisap/ ~ ~ ~ / / -s f ~~ (~ ~ttaca compterc pustas tco cue ~.oanry ourv r tur cec sysac~ uu p,.p.,, .w..a..,.... ~,..... , . SBD-6398 (R. 01/03) 0 9 ~ .9 ~ <~ , ~ .~ J ~ .~ o~ ~ ~ ~ C1' ~ 'J ~ 7 ~ ~ • ~+ ~ f - ~ ~ ~ ~ ~ o d- d J- ~ ~ ~~ s _d n~ n~ 1 ~I v 0 ~~~..J/ ~O z ~- d ~~ v-ti d J `~ ~~ ~~~~ ~ °d ~ !s ~ ~ ~°~ ~ ~ ~ m ~~ ~.:~ ~ ~ b ~ -? s s~ ~ r, ~~ I` . ~ --~~ _J JJ 3 ~ -N ~~ J 'S ~ ~ .~ ~~ . ~~ ° -+- ~ ~S ° ~ 9_ is o r~ / 1 3 .~ - 0 ~ ~ ~ ~ ~~ ,~ ~ ~ ~ y ~"I 0 ~ .I Jr ~3 sb~ J / "`~ -~ q ~ So N 3 a ~~ f ~ a ~,~ ~ 1 a ~ ~ ~.~ ~ r~ ~ ~ ~ ~ 0 ~ ~ ~- ~ ,~ ~ ,, ~, 1 ~;: ~ s o a i ~~ -. 3 ~i ~~ 0 ~v `n ~ ~ ~ ~ d' ~~ ~ ~ n i ~-r ~ ~' ~ w v ~~ /, 1 -~' ~~ S .~ ~ 3 ~ "='p `" s J . ~+ J s _ .~ ~~ .~ ~~ MJ n 'a v + d ;' ~ , .~ ~ ^ ~~ 9 ~ /~ ~ J~ ~ u ~ ~~ ~-,. ; ~ ~ ~~ ~ o u~~~ .~ u y ~ d S ~A' V ~ ..A ~ J SQ d ~adq~ ~~ ~ J ~ ~ ~ ~ ~ ° `9° ~ ~ ~ ~ o e~~~~ `'irr/ ~r~ ~~ '~ isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce. state.wi. us/sb www.wisconsin.gov James Doyle, Governor Corry L. Nettles, Secretary January 13, 2003 CUST ID No. L39462 TODD L SINZ T L SINZ PLUMBING fNC E5609 708TH AVE MENOMON[E WI 54751-5520 ATTN: POWTS Inspector ZON[NG OFFICE ST CROIX COUNTY SPIA i 101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01!1312005 SITE: Richard & Charlotte Champeau 2343 20TH Ave Town of Eau Galle St Croix County NEIl4, NW 114, 528, T28N, R16W FOR: Description: Proposed_Two Bedroom Mound System Object Type: POWT System Regulated Object ID No.: Identification Numbers Transaction ID No. 826846 Site ID No. 654820 Please refer to both identification numbers, above, in all comes ondence with the a enc . 887701 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans. • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of a septic tank outlet filter is requ-re a access opening used to service the filter shall terminate at or above fmished grade with a watertight cover. • 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. • Comm 83.22(7) - 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. Owner Responsibilities: • Comm 83.52(1)(a) -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 approv~ rfia~n'~n or as required under s. Comm 83.54(4) shall be considered a human health hazard. ofZdltlonally ~p~~ TODD L SINZ Owner Responsibilities Continued: Page 2 1/13/03 • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, /~`~ , Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing Richard & Charlotte Champeau -Mound Transaction # RFC s ~q F~~ 9FF N . FO ~'~ ~ 1pO~ ~~0~ soy` Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (01 /01) Pressure Distribution, SBD-10706-P (O1/O1) Location: NE 1/4, NW 1/4, Sec. 28, T 28 N, R 16 W Town: Eau Galle County: St. Croix Date: January 8, 2003 Owner: Richard & Charlotte Champeau Address: 2343 20t/f~ve. Baldwin~~JI 54002 Plumber: Todd Signature: License # MP 1 62 Attachments: 6748-P an Approval Application SBD-8330 Jansky, onsite inspection report page 1: cover 2: design criteria & calculations 3: plot plan 4: site detail 5: system cross section 6: plan view, lateral detail 7: pump tank exit detail 8: pump curve 9: system management ..,.~~hERCE ,...,~,un taF ETY AND BUILDINGS SEE CORRES NDENCE page 1 of 9 ~~ i Design Criteria yt'3 Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L ~` Bedrooms x 100 gal/bedroom day x 1.5 3 `'''° gallons/day hydraulic load In situ designed loading rate Depth to estimated high ground water Depth to bedrock Cross slope at system Force main length Manifold/header length Drain-back Lateral length ~ @ Lateral elevation _ Lateral hole size S~l Z in. @ ~b holes/lateral Lateral volume Total lateral discharge rate Network pressure compensation losses Elevation difference Friction loss Total dynamic head Pump/sip~xon 2 2. gpm @ Manufacturer ~ ~ ~«~ Design Calculations ~ ~ ~ 9 gallons/sq. ft. per day ~ '. ~ z in. ~ 3 ° in. 3 b to ft. of ~ Z in. 1aC-~ ft. of -• in. 33~t~~ gallons ~"~~~ ft. of ~ ~~ Z in. ~ °''°•~ ft. @ bottom of lateral 3 b•o in. ( 3. ~ ft.) Spacing ~ b holes total ~°'`3 gallons ~ 4' ~ ° ~'~" gallons/minute @ 3'S ft. head 1 ~oS' ft. zz.'~~ ft. 3.3 ft. @ 14' gallons/minute 30. b ft. 3 S~ ft. of head Model # ~ S 3 Dose volume ~•d ~ gallons Lift/sip#on tank ~~ ~ ~~~' ~ w"o - l.oo C-o....~,.o ~ ~ gallons Septic tank •~ •' ~ ~~ gallons Effluent filter ~Y~~~ rT e gz.2- ~4 ~3 t=1 Measurement pump on and off ~'.~' in. Height alarm from tank bottom ~~..~ in. Reserve capacity ~ 3 bt _ gallons specs calcs.res Page Z of ~ ~~ 9 ~ 9 ~ ~ .~ ~ ~~ ~ ~ ~ g0 ~ ~ i _ ~ C~ ~ IJ ~ 7 9 ~ ~ e^ ct ~ ~ ~ 0 ~ ~ ~~ 2 3 d ~~ n~ I °j~i ~.J 0 1 ~~~ C.,~ ..! !'N .! Q S ~.~ S ~~ t 9 "r ~ 9_ o os J / ~ ~ C,o ~ ~ ~ ~~ ~ ~ -~ L~ l V s ~~~ ~ ~ `~ ~"~ ~ ~ s a `~ ~ ~ 3 ~ ~ ~ "~ o ~~ t~ ~~ ~ ~ ~ J ~ s N f o o t {~ ~~ ~o~§ ~ ~ ~. 1 ~ ~. ~ ~ J Q # ~ ~ ~~ ~- ~ ~ V ~ 1~ ~.! ; ~~ 9 ~ ~~ ~~ .~ M ~ ~r ~ ~ M ~ d.. C~, fir- Y~ . ~ ~ ~ ~/, /,~fj~ ~~~'~ i ~;= :o o ~ ~ ~ 1 ~' ~~ `~ s -~ ~ 3 ~ J~ a ~ ~ ~ ,~ ~ ~~ ~ ~ .~ ~1 Cab MJ ~~ 6 vI + ' J . 9 ~ o n ~ 9 J~ /~ /~ ~; ~ u'i 1 ~ d ~ J ~ ~ ^{ 1 _ "" J ~ ~ s "• 0 o •' u ~ d y ~ ~ ~ O ~ 4 . i ~ . 4 V \J 1 .I C ~ ~ ~~~ s ~ ~ ~ ~ ~ ~ ~ ~ ~ o B ~ (~ ~ t : ~; 3 k r r z ~--- ~~~ ~~~ v-v ~_.~ ~ aj v~ .~ n ~ 3 '~ b ~~ ~ ! s. ~ ~ ~°~ ~ ~ ~ + ~ ~ ~~ ~~~~ ®~ 3 S „off J 'S ~ ~ -~ ~d d ..~ c./` S 5 {\~1/ V 0 3 d Y ~..~~ .j ~~.~ 'V `~\ -~ ~~ _n 4n .~ 3 ~~ JJ Q ~~ l'' ~ ~ --1~ o ~j r ~~ ~~ _ _. ~ ~ ~ ~ n u ~ ' V ct C ti 00 ~ ~, ~ ~ ^ a b f` n J I g0 s cY qq b V v ~ v v ~ v .~ ' T~ T T T ~ T T ' ~ \ f . 6 . n ~ ~ ' ^ r? a ~ yp ~ a v ~ ~ ~ ~ a . ~ S c3" ~J v~\ v _~ O t 1 ~- d o ' 1 J ~ 0 ~~ Z/ 6J, f ~ 9 ~~ 5 '; 2 y ~~ _~ : ~ ~~ ~ '' ~ =~ 9 ~ ~ ~ / ~ { i' ~ / ~/ T r ~J' T 0 ~-~j~ V Y J ~j .F ~~~ d n F"i2 ~~-- _ fF- - __».>_ - 1-sx S t tQ.+M C.. v~v s S ~ J ~e. ¢- i-~ c.,~ ~, ~~- ` (~ 4 1.~ ~ OrY ~~9 Y ~b-~'V ~ J ~~. \ ~ ~ ,. t oq.o tLtir.y ~o + o t ~'~ 1 ~ ~ ~ '~ 2. 3 ~~ 3 ~a~, b 1..bco; 1 s «SZ o.v a.e.. a' w '~----~ ~ ~•o ~,3 °j d `c '~.~ .o za. Q' C .. ,~ S ~ --~ Q ~ -~~ . ~~ -- ~ 1 0.h v ~ e.~~ !~_ I ~ ~~ g r i. 0 T ~ i.o ~ /~ ~~~~ ~' rte--.~Z~ -~I ~~~~~ -~ 13.5 ~ ~-$.o~ ~ IZ.S ~ I 1 oS'•o~ . p'• ~ S ate, v .~ o~•. w.a V 0 't L'. ` h.lt QiM- V ~ 'Y C/v- ~+.:...w. •T 1.S ~ • J I . * ~ J ~ ~ O S 1f u L. !L `O ~~ '~IZ^ ~~uL( 1~.n~ ~~..}~ 11 n OrCQ_ ~e.~ `~ ~~,01 1 S~Kw\ wOC~ ., 1 •S/ `.o~ ~ o~ , t+ ~Jl ~.~Q.r. ~o~o.w l:w~ ~ 3~O•o". ljl 2 lv ~ o ~ ~ ~~ ~-.~ ~~ ~ o~ 9 ,~ L Mn~w WEATNERPQOJF LOCKI-JG~GOV6R JUNCT-oH G~-CK D-~C.OVVICT-~ gq >,'4'. ,,. 4m PIPS 3' ~~~,7n;;~T r1U NOISTuRB~ED Pic SO1~' 24" t.D. w, ~I 4"40 MAHuOLE ' i VEhT,'' ~, M~- ins r n avrc~ - _ ow-~wc~ A 24.3 " Hc,:.c ~,. ~` ` S ... ~, SKE.T ~Nr-,S ._~ BAFFLE 4 c u PIYG ~ AL ~ 3' p.rrp 4 ~ E LT I O KS ~` C`~ v. ocK `p F ~"' m `Q'1-1- 1411' ~ -2r- O N - WtA:.'UC~ `,.ems ~ }+~~2rv h Ow'tl.a..~ ~ .~ I ~-'.JV-r~ D Pte' I ~~ ~ ~ I G o.YCRFT'c I _~, bcoCK I ~'~•c0 SEPTIC t SP~CIFI~CATIOIJS 14 •~ ~~' "~" 005E ~ ~~ ~ • TAIJ~ S MA-JUFACTURCR; " ~" IJUMBER OF OOSES; i25~ TA-JK SIZ C ; l ~~ - ~~t'~ FE K D~~ _ 1 GALL01J5 DOSC VOLUME ALAFh~1 ~"IAUUFACTURCR; S `~ ~~~ °t-i~vs IAICLUOIAJC~ 6AGKFLOW~ ~`~' `o ~ GA.~O~:S /'10DCL -,~UN4bCR: 1 ° ~ ~'~ ``~ CAPACITIES: A ~'`~'3 IuCHCS OK 43~,`b SWITCH TyPf; ~~~` `"`~o i' ~`-~~~- °Q nom. 8 = Z' IAiCHES OR 2Q.g_ G~.~O.,~ ~~-.MG MAIJU~ACTURCR; IS'3 C' ~'~ iUCNES OK ~'03 :,,,~ ~ MODEL 1JUMOfR: -~~= JWITCH T P ~'^~`-`~v ,,,, D~ ~ INCHES GR g~4;, b E: ~..., .,_ MOTE' PUMP AAJD ALARM ARC TJ 8C N111J1/1U1'~ DISCMAKGE RATE (~ •~ 4"'GPF„, INSTALLED O-..I SC PARArC CIKC.. VORTICAL DIFFERCAICC OfTWCCU PUMP Of/ AUO OISTRIDUTIOfJ PIPE.. ZZ'~-S~ v -JETWORK SUPPI.y PRftSURE ~ ~ ~ FEET t I 3a' + 31°x° BEET of PoRC[ MAIIJ X ~•qZ FT,~ ~ FECT + ties _ ~oOI[FRICT101J FACTOII. ~' EET ~ ~4 TOTAL, pyt,1AMIC HEAD = ~~'~~ F Er ~ ~~`~J ~ a IuTER1,lAL, DIMEI,JS101.1C 'o/ TA-JK: LE-.1C,TH \ J~,1 , ,WIDTH ; LIgUlO DEPTH ~ 2 9 0 a w x U Q z r 0 a 0 TOTAL DYNAMIC HEAd~CAPACITY PER MINUTE EFFLUENT AND DEWATERING i ~ MODEi. 152 !~I i53 I T Fee± -_t Meters ; Gcl. - ~ Liters ~ Gc! i L!ters ~ 5 '.5 69 ~, 261 ~, 77 291 !, 10 ~ 3 ? ~ 61 231 '~ 7G 265 15 4.6 53 I 20t 61 231 20 ~ 6.1 as ~, 167 52 197 i --, 25 --- 7.6 34 ~ 129 42 ~ ' S9 30 9.1 I 23 1 87 ' 33 ' ' 25 35 1C.7 _ _~ -LL ---y 40 ~ _ 12.2 j - I -- ~ =2 ~_- Lock _.~ Vcive~ ', - 38.0 F~ rl' _ ~ C '? ~~'~ Ot4508 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Owik-Box available for'outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 152/153 Series _ 152/153 MODELS ! Control Selection Model Volt_s•Ph Mode Am s i Slm~lex Du lex Nt52 tt5 t Non 8.5 . t 2or3 BN 152 t t 5 t ~ Auto 8.5 ! Included ; 2 or 3 E t 52 230 t Non 4.3 1 2 or 3 _ BE152_ _230 1 Auto 4.3 Included 2or3 _ N t 53 - __115 1 Non 10.5 1 2 or 3 _ BNt53 t15 1 A t 105 I I ded 2 3 , ~ o ~ -~- C~~iL-.-F~G :j 4-a i ~- _I~' I _~_ s~oe.+ _ _ __ _ uo ncu or SELECTION GUIDE E 153 230 1 I Non 5.3 1 2 or 3 BE t 53 230 t Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. ~ CAUTION 2. See FM0712 for correct model of Electrical Alternator E-Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. g ~~ ~ RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. --°' _~" MAIL TO: P.O. BOX 16347 Z ~~ ~ ~ ~~.+C Louisville, KY 40256-0347 O ~~' ~~ SHIP T0: 3649 Cane Run Road Manufacturers ol. Louisville, KY 40211.1961 QUa[/rY /~UMas S,vCE ~jr~~ O//A Ap /^O (502) 178.2731 • 1 (800) 928-PUMP http://www.zoeller.com /-L/,Y,/ L FAX /5021774-3624 © Copyright 2000 Zoeller Co. All rights reserved. ` `~ 0 80 160 240 320 , . ~ X30 ~-~~~ • , System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715-23~-2644, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flo~~ s into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants. the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contatrtinant load design criteria. 2 Install water-saving appliances whenever and wherever possible. 3. Repair even sirtall water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. if septic or pump tanks are no longer used, they must be properly abandoned. I I . I f~construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance I . The septic tank must be inspected every three years by a properly licensed person. ?. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. ~. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompam their specifications. 6. -I-he pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowtnobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. I I . Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain letha{ gases or insufficient oxv~~en. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.4 (3). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing. and, or installation of additional treatment components or conversion to a holding tank may be necessary. Page 9 of 9 isconsin Department of Commerce INSPECTION REPORT Plumber Name and Addre ~~ ~.:.~~F Unknown ~ ~.~ ~ Date of Inspection: December 19, 2001 Project Name: Champeau Use: Replacement Residential Legal Description: NE, NW, 28, 28, 16W Site Number: Subdivision: NA Municipality: Town of Eau Galle County: St. Croix Plan Transaction Number: NA San':tary Permit Nurrbar: NA Wastewater Flow: 450 gpd Persons Present: H. Grote, J. Sonnetag SAFETY AND BUILDINGS DIVISION Field Operations Bureau 13 East Spruce Street Chippewa Falls, WI 54729 www.commerce.state.wi.us cCallum, Governor Acting Secretary ,.. Certified Soil Tester Name n Owner Name and Address: Richard 8~ Charlotte Champeau 2343 20 Ave. Baldwin, WI 54002 (715) 684-3515 Henry F. Grote, CST E 4366 353rd Ave. Menomonie WI 54751 (715) 233-0398 Onsite soils verification at the request of the CST to confirm A+4 conditions at this site. The proposed system area is located on the best possible site on the property. Slopes in the area of B-4 to B-6 are 2-4% and this area appears to be a topographic high surrounded by natural drainageways to divert surface water to lower areas of the property. Atypical soil profile for this area would be described as: 00-06" 10YR 3/3 sil, 2m-cgr, mfr, cw. 06-12" 10YR 3/3 sil, 2m sbk, mfr, as. 12-16" 10YR 4/4 scl, 2m-csbk, mfr, cw. 16-20" 10YR 4/4 scl, 2m-csbk, mfr, cw, w/f2d 10YR 5/6 redoc conc. 20-24" 10YR 4/4 scl, 2m-csbk, mfr, cw, w/cad 7.5YR 5/6 and 6/3 redox conc and depletions. Recommendations for this site include the use of 24+ inches sand lift in a long an narrow mound design keeping the LLR as close to or below 4.5 gpd/ft as possible. In order to facilitate adequate mound length and a low LLR, it is acceptable to extend the mound past the soil borings by ~15 feet. Property lines should be established to ensure that the system does not extend onto the neighbor's land. If there are any questions regarding this report, please contact me. oy G. J sky Wastewater Specialist Ljansky@commerce.state.wi.us E-mail 715/726-2549 Fax 715/726-2544 Voice 0 sr a 2774 `,'F . ~_, _._~ cc: ®County ^ Plumber (~ CST ^ Owner ^ Other _. ~~RIGIl~AL '~ SOIL EVALUATION REPORT Wisconsin Department of Commerce Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. ~~ 1455 Page 1 of 6 Certified Soil Testing GG v~ oun Attach complete site plan on paper not less than 8%: x 11 inches In size. P ~CjG` St. Croix include, but not limited to: vertical and horizontal reference point (BM), dl coon a P cel I. percent slope, scale or dimemsions, north arrow, and location and distan to nearest road. ~ ~~~ 008-1079-95-000 Please print all information. ~ Mp,R R@~i fwed y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). `xG V \~ roperty caner rope Champeau, Richard & Charl,~~}-~ G vt. L NE 1/4 NW1/4 S 28 28 N R tb W Property Owner's Mailing Address Lo # Block # Subd. Name or CSM 2343 20th Ave. Ciry State Zip Code Phone Number ~ City ~ Village Town Nearest Road Baldwin ~ WI 54002 715-684-3515 Eau Galle 20Th Ave. New Construction Use: ~ Residential /Number of bedrooms 3 Code derived design flow rate GPD Replacement ~ Public or commercial -Describe: Parent material till Flood plain elevation, if applicable NA General comments and recommendations: Recommend state/county onsite to verify soils for possible installation of 6' x 76' rock unit mound on 97.7 contour as upslope edge of rock w/ 2.5' sand fill ^ Boring # Boring Pit Ground Surface elev. 100.4 ft. Depth to limiting factor 18 in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-3 10YR 4/3 - sl 2 m gr mvfr cs 1f/m .5 .9 2 3-8 10YR 4/3 - sl 2 f sbk mvfr cs 1 m .5 .9 3 8-18 10YR 4/4 - sl 2 m sbk mvfr cs 1 m .5 .9 4 18-24 7.5YR 4/4 f2d 7.5YR 5/8,5/3 sl 1 m sbk mvfr - - .4 .6 occaslona gy sl coa s on pe m nzon Boring # Boring Pit Ground Surface elev. 98.7 ft. Depth to limiting factor 3 in. Soil Appligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. M~.:nse!I Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-3 10YR 4/3 - sl 2 m gr mvfr cs 1f/m .5 .9 2 3-8 10YR 4/3 f2f 7.5YR 4/6 sl 2 f sbk mvfr cs 1 m .5 .9 3 ~ 8-16 10YR 5/2 c2p 7.5YR 4/6,5/8 sicl 2 m sbk mfr - - .4 .6 i I -- ,i ~ sic gra es qulc y o ,m,m r rom apparen m s , m r 'Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L `Effluent #2 =GODS < 30 mg/L and TSS < 30 mg/L ame ease not Ig e: um er Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation onducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 10/4/01 715-233-0398 ~,.. ,. Property Owner Champeau, Richard & Charl Parcel ID # 008-1079-95-000 , Page 2 of ~ 6 ^ Boring # Boring Pit Ground Surface elev. .99.5 ff• Depth to limiting factor 3 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-3 10YR 4/3 - sl 2 m gr mvfr cs 1f/m .5 .9 2 3-9 10YR 4/3 f2f 7.5YR 4/6 sl 2 f sbk mvfr cs 1 m .5 .9 3 9-12 10YR 5/2 c2d 7.5YR 4/6,5/8 sicl 2 m sbk mvfr - 1m .4 .6 onzon gra es quic y to sc , ,m,m r w p 4 , ^ Boring # Boring Pit Ground Surface elev. 99.3 ft• Depth to limiting factor 20 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 1 0-3 10YR 3/3 - sl 2 m gr mvfr cs 1f/m .5 I .9 2 3-9 10YR 3/3 - sl 2 f sbk mvfr cs 1 m .5 .9 3 9-20 10YR 5/4 - sl 2 m sbk mvfr cw 1 m .5 .9 4 ! 20-28 10YR 4/4 f2d 7.5YR 4/6,5/3 scl 0 m mfr - - 0 0 i common gy s s coats on pe s - ^ Boring # Boring Pit Ground Surface elev. 98.8 ft. Depth to limiting factor 22 in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz, Cont. Cobr Gr. Sz. Sh. 1 0-3 10YR 3/3 _ sl 2 m gr mvfr cs 1f/m .5 .9 2 3-12 10YR 3/3 - sl 2 f sbk mvfr cs 1 m .5 .9 3 ~ 12-22 10YR 5/4 _ sl 2 m sbk mvfr cs 1 m .5 .9 4 ~ 22-28 10YR 4/4 f2d 7.5YR 4/6,5/3 scl 0 m mfr - - 0 0 I common gy si s coats on pe s - 'Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L 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 (R.07/00) Certified Soil Testing Property Owner Champeau, Richard & Charl Parcel ID # 008-1079-95-000 Page 3 of 6 ^ Boring # Boring Pit Ground Surface elev. 97.7 ft. Depth to limiting factor 15 in. Soil Application Rate Horizon Depth Dominant Color Redox Oescriptlon Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-3 10YR 3/2 - sl 2 m gr mvfr cs 1f/m .5 .9 2 3-10 10YR 3/3 _ sl 2 f sbk mvfr cs 1 m .5 .9 3 10-15 10YR 4/3 _ sl 2 f-m sbk mvfr cs 1 m .5 .9 4 15-22 10YR 4/3 c2d 7.5YR 4/6 sl 1 m-c sbk mfr - - .4 .6 i occasions gy si s coats on pe s ^ g r, Boring 7 Borin # ~ Pit Ground Surface elev. -97.4 ft• -Depth to limiting factor 18 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-3 10YR 3/2 _ sl 2 m gr mvfr cs 1f/m .5 .9 2 ~ 3-11 10YR 3/3 _ sl 2 f sbk mvfr cs 1 m .5 .9 3 11-18 10YR 4/3 - sl 2 f-m sbk mvfr cs 1m .5 .9 4 ~ 18-24 10YR 4/3 c2d 7.5YR 4/6 sl 1 m-c sbk mfr - - .4 .6 common gy si s coats on pe s g Boring $ Borin # Pit Ground Surface elev. 97.7 ft. Depth to limiting factor 16 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-3 10YR 3/2 _ sl 2 m gr mvfr cs 1f/m .5 .9 2 i 3-9 10YR 3/3 - sl 2 f sbk mvfr cs 1 m .5 .9 3 9-16 10YR 4/3 _ sl 2 f-m sbk mvfr cs 1 m .5 i .9 4 16-24 10YR 4/3 f2d 7.5YR 4/6 sl 0 m mfr - - .3 .5 occasions gy si s coats on pe s - 'Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L 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 (R.07/00) Certified Soil Testing Property Owner Champeau, Richard & Charl Parcel ID # 008-1079-95-000 Page 4 of -g Boring # Boring Pit Ground Surface elev. 96.9 ft• Depth to limiting factor 17 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1 0-3 10YR 3/2 - sl 2 m gr mvfr cs 1f/m .5 .9 2 3-9 10YR 3/3 - sl 2 f sbk mvfr cs 1 m .5 .9 3 9-17 10YR 4/3 - sl 2 f-m sbk mvfr cs 1 m .5 .9 4 17-24 10YR 4/3 f2f 7.5YR 4/6 sl 0 m mfr - - .3 .5 occasions gy si s cos s on pe s - 3a Boring # Boring Pit Ground Surface elev. N 96.7 ft• Depth to limiting factor 11 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-11 10YR 3/2 - sl 2 m gr mvfr cs 1f/m .5 .9 2 ' 11-30 10YR 4/4 cap 7.SYR 4/6,5/8 7.SYR 5/3 sici 1 m sbk mvfr - 1f .2 .3 i ~ I ~ t is pit to o - an rea on and a s e visit, 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 P ' in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. ----- - i I i i i 'Effluent #1 = 8O05> 30 < 220 mg/Land TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L 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 (R.07/00) Certified SOiI TeStlng CERTIFIED SOIL TESTING Henry F. Grote, CSTM, CSP, CHMM Environmental Health and Safety Specialist E. 4366 353rd Ave., Menomonie, WI 54751 (715) 233-0348 FAX: (715) 233-0398 E-Mail: GROTEH~UWSTOUT.EDU November 30, 2001 Richard & Charlotte Champeau site 2343 20`h Ave. NE-NW-28-28-16W Town: Eau Galle Site consists of about 13 acres which is all a topographic low from all four compass directions. Site topography is gentle slope to NW with obvious law and wet ground to north and west. Heavy spring rain and snow melt floods drive by owners description. Existing system is apparent dry well located in obvious wet soils. Initial site visit was on April 17, 2001 under very wet conditions; topsoil obviously wet and near field capacity. General area to east and south-east of house was surveyed with 10 backhoe pits at various locations. Two of the ten pits were apparently clean of mottling for at least four inches into the B-horizon; eight pits lacked A+4". CST opinion at that time was that the site was suitable for a holding tank, but that possibly an A+0" mound, ideally with highly treated effluent might work. Owner requested a repeat visit when soil conditions were more suitable for detailed observation. Second site visit was October 4, 2001; the highest ground available to the south-east of the residence was explored. Soils report here covers the nine pits observed in October plus the closest pit of the ten April pits (B-3a). Soils are variable but can be generalized as well- structured sandy loams in the A horizon. The B horizons vary from sandy loams to silty-clay loams to sandy-clay loams of limited permeability. Due to variable soils, CST is reluctant to proceed without confirmation of at least six inches of suitable soils. Recommendations: 1. Request an onsite by county and state onsite waste-water specialists; home-owner should be aware that this will incur additional costs. Due to the shallow soils a backhoe will not be needed; hand pits should suffice. 2. Depending on conclusions reached during the onsite review, ground water monitoring may be indicated to verify depth to seasonal saturation. Ground water monitoring also incurs additional costs, may take more than a single year to be acceptable, and carries no guarantee of satisfactory results. 3. In the interim, the installation of a holding tank should be permitted to facilitate proper functioning of the onsite system. A 1250-750 combination tank could be used to minimize future costs in the event that a mound system is approved for the site. Cc: Leroy Jansky page 5 of 6 Certified Soil Tester Certified Hazardous Materials Manager Certified Safety Professional CSTM 222774 CHMM 1217 CSP 12129 J ~ j ~9~~~ 9o s o' ~ ~ Gr ~ ~ 'J ~ ~ ~ ~~ ~ ~_ ~ ~ ~ o ~- c~ ~ J_ ,~ ~.^ D ~~ s _d n~ n,, i 3 °~~ V 0 ~~ (.~ s ~_ d ~~ ~ ~/Q Y, { r c~ `.~ J d 3 3 ~ ~ -n• ~~ d ~m ~/l 0 dr d~ J S ~ ~ 3 0 t J J T s d v ~ '• + o ~~ N ar s n cr o! r~ ~ d r ~. 3 s ~ ° ~ '~ p v ~ ~ ~ •~ i ~ \ o x; \ ~ ~ ~ ~~ ~ r r ~ ~ j~~pp I ~ e0 ''^ ~ r C ~ ~ a ~~ ~ , V ~~ S: '~ ~ ~ ~ I ~ ____. ~ s T~ 0 fI ~~ ~3 ~\ ~~ fo o ~ ~ rl' w __ ~~ ~1 ~ '~ a u ~ d `~' .~ ~ ,a '~ ~, ,~ A 1 v °~ n ~ l' ~1 J d ~~~ ~~~~ O t . '~ ~.- ) JQ ~ d ~ ~ ,w ~' ~ ~ ~ sp e ~ a d q ~ ~f ~ ~ ~ ~ ~ ~ `~ ~ ~ ~ ~ n e~~~z 06.02 UU FRI lq:.~l FAY i1S 736 4638 ST CRY CO ZUNINC: S"Z' CROiX COUI~I'I'X SEPTIC TANK MAINTENANCE AC~RSEMEN'T' AND OWNERSHIP CERTIFICATION PORM QwnerBuyer L w ' Mailins Address -- - ~~ 22 t'' ~ c Proparry Address O~ ~ -- (Vcrification required from Planning Departmwt for new construction) City/State ~~w~ ~' ~ ~ Parcel Identification Number ~~~" l ~1q ~~5 ~~v I,,EGAL 1~ESCRIP'X'~ON ?l _ f f o~-I r ~l-~/., Sec., T~...N-R15.~._W, Town of , ~~.1 -~f~ 1 J Property I.,oeation ~ /<, ~_ 2 Cl~i#~ Subdivision Certified Snrvey Map # Volume _ .Page # Warranty Deed # ~3~ CJcJa~ ,Volume ~'O Page # ~b~ Spec house ^ yes ono Lot lines identifiable ^ yes ^ no fool SYSTEM M~.},IN'I'ENA.NC~ Improper use and maintetkwceof your septic system could result in its premature failure to handle wastes. Proper mai.o,tenatice consists of pumping out the septic tank every three years or sooner, if needed by a )i~nsed P~P~• Wbat yon put int° the system can affect the function of the scpric tank as a troatment stage in the waste disposal rystem. The property owner agrees to submit to St. Croix Zoning Department a certification form signed by the owner and by a masberplumbor, jourtcymanplumbcr, restrietedplarnbcr of a licensedpurriper verifying that (1) the on-site wastewater disposal system ~ in proper operating condition and/or (2) aRcr inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the Private sewage disposal system with the standards set forth, hcrsin, as set by the Department of Commerce and the P epztstmcat of Natural Resources, State of VJ'iscons ~~~thin 30 stating that your septic system has been maintained must be coin acted and returoed to the SL Croix County Zoning Sys of ~~ thrrc year cxpiratYOa date. ~ ~i ,~i U `~~ ~. c~ ~,,~,, -~~., - SIGNATCJRE OF AppLICANT ~~ DATE OWNER CER'TTF'ICATXON I (we) certify that all statements on this form are true to the best of my (our) 1m°wledgc. I (we) am (arc) the ownar(S) of the property described above, by virtue of a warranty decd recorded in Register of Deeds Office. ~. ;l DAT'B SIGNA'1'(JRE OF Appl-ICANT ~/ Any infotrnation that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. "`~`~ ...... •+ }<nclude with this application: a stamped warranty decd from the Register of Deeds office a copy of the certified survey trap if reference is made in the warranty deed DUGUMFNT NR. • ! I ~ , tYARRANTT OffD • ~ ~ i ( ~~ ~~(~ ~l!`/~ ~ THIS SPACi RfSERV'ED vOa RECORD+NG DATA ~}~~~~}r~y~ .y ` J J T1t1S DEED, mach between _ Cal ~ REGISTERS OFFICE Toni F. Christenson,-fi~s w e, ST, CROrX t0., WIS. D: Grantor Recd. for Record ihis_ 34th and ~,~~~-.~.d____E,__5.~~~~U _____,_ ~ dny of .Iu]Y__A.D. 1476 Grantee,., _ r Witneeaeth, That the said Grantor for a valuable consideration of One i _ _ dollar andnd other gp9d sand valuable consideration R~~"'~ ~' °aed' conveys to Grantee the following described real estate in St • GrOiX County, ~ RE URN TO State of Wisconsin: 'I'RAN~FER ~ ~~ Q/ ~ Tax Key s This is homestead property. FEs North 437 feet of the Northeast Quarter (NE's) of the Northwest Quarter (NWT) of Section Twenty-eight (28), Township Twenty-eight (28), Range Sixteen (16} West. Together with ell and singular the hereditaraenta and appurtenances thereunto belonging or in any wise appertaining; Ana Calvin E. Christenson and Toni F. Chr stenson, his wife, warrants that the title is good, indefeasible in tee simple and free and clear of encumbraecea]iit7tp( end will warcant and defend the same. E:ecutea at Baldwin,. Wisconsin thi. 29th day ,t July , I9 76 , SIGNED AND SEALED IN PRESENCE OF cEi""`''-~~''-~-'"%'L- AL) Ca vin E Chr stenson ~~ ~ ~: ~ ~~`-. CJ.~~ ,,, ~ ~ ~~JJ 7~- n.t ~ ..E ,-c'1! ! !f -C_ ` ~ ~~'~fx-` ~ /-. ~ f ~ •'/^j~-' j!', ~~, (SEAL Jeanne E. Veenendaal ~ Toni F. Christenson 1 l . ~~~~ (SEAL) Delores M. Vrieze (SEAL) 1 _. 1 I Signatures of authenticated this day of 19_, Title: Member State Bar o! Wisconsin or Othei Party Authorized under See. 700 06 viz. _ _,____ STATE OF WISCONSIN ~-~- t~~ ~ - _County. ~' as. Personally came bef~re me, this 9 - ,_____ day of __ ~~ 19_Se , the above named .y ~ a /~t~-~••~ ~ C-~ -i1,,;~:. ~.a . ~ , ~ mac; L ~ _ to me known to be the person who axecuted the foregoeng 1nsUument and ackn wle,lged the same~.J Fd :C 'F r~ , 1, 1 Ct t !i r.~ . /1 ~1/:l...t ~ , ~C ~. This instrument was drafted by "i~•~••.-•••• •'j~'' ~,_ ~.r-~ ~ ,.~ Adel Ene L. Hesselink