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020-1479-17-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 556368 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: Bast, Kernon J. & Don Ida J. Speer- Hudson, Town of 020-1479-17-000 CST BM Elev: Insp. BMGiElev: BM Des ription: Section/Town/Range/Map No: 36.29.19.3038 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 2 S gy 3. ~ r~3. d 99 ~ Dosing I/ V Alt. BM tN 6.~( ~D2,9 Aeration _Ld i Sewer 3 1 7~ 6 Holding ~-s St/Ht Inlet SLy, L~ _ / ~ 6 T(J yrlL`~-- 10 , TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet - Septic , Dt Bottom c > -70 Dosing 2~+ eader/ n. / /r Aeration Dist. ~S Bo System Holding q, cS- O l~ Final Gra PUMP/SIPHON INFORMATION t{/ 13 Manufacturer De and St Cover 1 h S I O / Model Number GPM TDH Lift Friction Lo Head TDH Ft Forcemain Length/ Dia. Dist. to well SOIL ABSORPTION SYSTEM - BED/TRENCH Width t Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /2,2 2 SETBACK SYSTEM TO P/L \kj BLDG W LAKE/STREAM LEACHIN Ma ctur INFORMATION Ty Of System: 1~ / HAM NIT R' C~Y 44 C~~l~ l -7 ~S Model Number: DI RIBUTION SYSTEM 1- 144,01 N Head /Manifold t-3 Pipe(s) Distribution x Hole Size x Hole Spacing Vent o Z:T~" N [ 2 Z $ / Length Dia Length Dia Spacing / SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of 7d_ed/Sodded T Mulched Bedrrrench Center nJ Bed/Trench Edges Topsoil 2 ~ Yes ~ No R Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / Z Inspection #2: / / Location: 612 Schwalenn Ct. Hudson, WI 016 (SE 1/4 SW 1/4 36 T29N R1 9W) Cottonwood South ' 7 Lot 17 Parcel No: 36.29.19.3038 1.) Alt BM Description W'~ - 2.) Bldg sewer length a -3 ?1 l ( Qp ,~G QiKGI Q~2~ ~b - - amount of cover = ti fd j~2~~ 1, _ ~Qvnjo Plan revision Required? ❑ Yes No Use other side for additional information. a%~ ~n1~✓ , - - - J SBD-6710 (R.3/97) Date Insepctors Signature Cert. No. PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarge RD Hudson Wi 54106 SE '1/4 SW 1/4S 36 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/19/12 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 860 # of chambers 42 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 94.5/94.4' 5' below qrade setbacks required by Vent WDNR n~ 104' >6" Quick4 Standard l of Cover Leaching Chamber r Q,~ with 20.0 ft2 of Area 10.2ft^2/pair of end caps 12" 4' Long Scale = 4~ Grade at System Elevation 34" unles of rwise g' note ~ ddA'~ - 56 ~ 7' 1 142 B.M. 127' -3' X 88' Cells B-2 ith >3' spacin 169' n s % SL ope I o I~ Pro B-1 30' ST 25' room ouse B-3 System is not to be installed in drainage Schwalen Ct. easement 533' Property Line All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. STEEL'S SOIL SERVICE 3 of 3 David J. Steel Kemon Bast 994 200th St. CST-POWTSM SE1/4,SWl/4,S36,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St Croix Co. Direct 715-760-0347 Cottonwood Ridge South, Lot 17 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1" = 40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations BI = 99.45 ft B2 = 99.45 ft B3 = 98.95 ft B4= S""' 1Q it 134A o+' f 3 h o~~~ ►fi~ ~ % ~6 1 II i i f ~ 3 <Y 107 ~7 1 1039.7 1037.9 X ` Mi41s~o~•. \ Ill N ! I k r , l ; loll" t + X Z 046.3 p 0 i i Z t- i r Q , uj ~ r 4 ru z p r- N rf ~ r ~ 10 8. ~ ♦i i ♦ CA ♦ 07 ♦ N, - 3.46 Acres f - 150786 sq. X .A. 3.4 1038.51 LBO 1040. X 3.59 res 156247 ft C.B.A. = 1. LBO=1040. 0 X 1 1039.4 IG O °~3 2.60 Acres 2.84 113304 sq.ft C.B.A. = 1.6 AC. 123840 sq. ft LB0=1041.00 2.39 Acres C. . . 8 AC. 103959 sq. ft LBO=1 0 = 1.7 AC. LBO=1042.00 O E 208.01 I I 1039.0 MOM 1036.4 Y/ I - ® P iiPTH ; =t i _ x'64 TS wL=1036.00 I IlORl NDPO 15 of C3 9S S H%=1 i -10 I I : BORING PR DEPTH 15' 8 I WET POND \ • RING PI DEPT I I 1 i I X TION 7-21 1.39' 1 - - - ----------~y------- Fa F- - Zsc:oZns vd.gCfkF, Safety and Building r i County~1 c 20'1 W. Washington Ave.. zg Madison. WJ 53707- s-Ift-y Pnr"Ul N.Mb (4u nn fuaA iL_.J mmer 2 L .5 57 onNumber Sanitar tWoA lieation State 'fransactiW-A In accordance with s. Comm. 83.21(2), pmcde, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note; Application forms for state-owned POWTS are Project Addres if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 1. Application Information - Please Print Ali Information Property Owner's Name Parcel # Property Owner's Mailing Address/ Properly Location / 303F C Cr r~,~ p-4Q Govt. Lot C/ 2 City, state Zip Code Phone Number section ~~ii'' e / trcle o T N; II. Type of Building (check all that apply) © A-1 Lot # u R~ 1 or2 Family Dwelling- Number of Be oms / Subdivision Name Block # l..p L cJ ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned -Describe Use CSM Number ❑ Village of _ Town of IQ. Type f Permit: (Check only one box on line A. Complete line B if applicable) Ystem 11 Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New last Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) Non-Pressurized In Ground ❑ Pressurized In-Ground At rode ❑ nd > 2Q i f uitab so 1 ❑ and 24 in. o'stutabl it~ ❑ olding Tank ❑ Other Dispersal Component (explii Pre eat rd Device lain . V. Disper sal/Treatment Area Information: W127 i Design Soil Application Rate(gpdsf) Dis ors Area Required (s* D persal Area Proposed (st) System Elevation Design Flow (gpd) I W .VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units 2 U H New Tanks Existing Tanks a $ a cg m y cm w C7 G. s-a Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- 1, the undersigned, ass sponsibility for installation of the POWTS shown on the attached plans. ~A s Name (Print) Plumber' ature MP/MPRS Number Business Phone Number zMe au Address (Street, tty, t te,'Zip Code) i J~III. oun /De rtment Use Only II Permit Fee j Date ued suing Agen Signa e pproved ❑ Disapproved $yy- ❑ Owner Given Reason for Denial J o .IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER; 4a (04 ? lot) l, $eptii:ta~d[etfhlant"Il+tsr t>tltd J . dispersal ;j must oN /o v0 0 l/h P"" , ti s.. p s for the system and submit to the ty only on paper not less than s to i 11 inehes in size $13D-6398 (R- 02/09) Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 10/19/12 Owner: Kernon Bast Location: SE1/4 SW1/4 S36 T29 N,R19W 612 Schwalen Ct. Hudson System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter SpecificatiokShe Signature License numb # PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarae RD Hudson Wi 54106 SE "1/4 SW 1/4S 36 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/19/12 BEDROOM 4 CONVENTIONAL XXXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK i MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 860 # of chambers 42 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 94.5/94.4'5' below qrade setbacks required by WDNR jL' Quick4 Standard 104' eaching Chamber ith 20.0 ft2 of Area 0.2ft^2/pair of end caps „ , Scale is 1 = 40 34Grad e at System Elevation s' unless otherwise noted 56' 7' 131' 142' B.M. * 180' 127' 2-3' X 88' Cells B-2 with >3' spacing 169' Vents 1% SLope Pro 4 B-1 Bedroom 30' ST 25' House B-3 System is not to be installed in drainage Schwalen Ct. easement 533' Property Line All piping shall be SDR 30/34, within 10' of tank, piping shall be Schedule 40. Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Mq ard Leaching Chamber ~i 4 PiaS -f*vvz", To be >1' above grade f end l ate Finish grade elevation Typical Installation 99.5' Vent Grade Vent 3' 4" 3' X30/34 Septic Tank 5' Long 1" 5' S' Long 119 Grade at System Elevation 3659 Grade at System Elevation Spacing 5' 2-3' X 86' Cells Same on other end Observation tubeNent At end of cell A 21chamb!erspercel B System elevations: A-94.5' B 94.4' t S f POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner' e r r' Septic Tank Capacity S~ al 13 NA Permit # jJ Septic Tank Manufacturer ❑ NA _5~tlg -3 DESIGN PARAMETERS o Effluent Filter Manufacturer `L ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units A Pump Tank Capacity al NA Estimated flow (average) al/day Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5) 60 c) al/day Pump Manufacturer lk! NA Soil Application Rate __7 al/da /ftz Pump Model 111 NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODS) <_220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODE) 530 mg/L In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) :510" cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA 'Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA -5 jZyear(s) Clean effluent filter At least once every: month(s) ❑ NA ~rearls! Inspect pump, pump controls & alarm At least once every: ❑ month(s) NA ❑ year(s) ❑ month(s) NA Flush laterals and pressure test At least once every: ❑ year(s) Other: At least once every: ❑ month(s) NA ❑ year(s) Other: NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) f Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the Lontants of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil 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 wells. Failure to protect the replacement area will 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. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name rte. Name. Phone 1J _,a? 6 Phone '7 F SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name ✓ X 1 - Phone C7 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.540), (2) & (3), Wisconsin Administrative Code. Page of :START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall betaken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil 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 wells. Failure to protect the replacement area will 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. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDMONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name s Phone 7/~ ,.~Z 6 t Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone 7~ This document was drafted in compliance with chapter Comm 83.22(2)(01)(d)&(f) and 83.54(7), (2) & (3), Wisconsin Administrative Code. LTER CARTRIDGE INSTRUCTIONS Installation STEP .1 Dry Ut the filter case Qnto the end at the outlet pipe to ensure it is centered under the access opening. If not, then either insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. F .-IEP 3 While the case is still dry fitted an the outlet pipe, measure the length of 'A-Inch pipe needed to bract, the filter to the tank end wall if utilizing the optional supplemental side support. If side support method. Jr. not utilized, proceed to step four, .3 For instailatlans utilizing the optional supplemental side support: solvent weld the 'A-inch pipe onto the filter case. If side support method is not utikzed, proceed to step four. g Solveht weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressinq down until the filter locks Into the bottom of ttie case. J y1 If a VRS switch is utili;,x:d: insert into the filter and lock b turnip r`•fe~f clockwise 900. by 9 ~EikY ,r , c Maintenance 1. The effluent filter should be cleaned every time the septic tank Is serviced. { 2. Open the outlet access opening to inspect the tank and filter. ` 9. pump the septic tank completely, making sure to remove the sludge layer on the bottom of the tank and not juat the scum and effluent. 4. once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the filter handle to dislodge the cartridge from the case.' 5. Slide the cartridge up and at it of the case for deauing. 6, if a VRs switch connected to an alarm Is present, the switch should be removed by turning counterclockwise 90° and cleaned with water only. 7. While holding the cartridge on its side (large flat surface facing down) over the actress oliening, rinse off` the cartridge with water only, making sure all septage> material Is rinsed badk into the tank_ ir•..t a. If VRS switch is utilized replace by inserting into filter and turning clockwise 90°. y b , 9. Insert the filter cartridge back into the case iRw~ M+ie,;, pressing down until a. . the filter locks into the bottoan at the case. till' . w x 10. Replace and secure the access 00811ting on the tank. i:- •.ilY ; + 1= ~ 4At :'$1r"trd r 1-.rqi- 9 r..r : S,~t' C.!_` %v:aS;ft,t.v'. t wwwbeamnsite.com 877-MLFILTERS (653-4683) SIrP'PIC TANS =K~II+I" '8 €AN E AGREB ENT - AND <}VNI C:'"If H`1£3 FOB ?wilerBuyer. ks iW isng Ad> ss , 9~1P LA 8n2r~ . I&*0 PzoPeriy Address ~a2 p ow Car- (4er a zpn mqxred from Pk ZOWWS Deztarm3ent for I*W construction.; - CityfState Parcel lderffcVdon Nu bet 0 210-N 'roPerty Loeat}on Sec. T f t ~h . ow of QJ~ Subdivision Lot d ied Survey l zap : VQJUMe: Page 9 Warmu l).eed # t9 Voluine, page r , Spec hortse Lot liras iatfle ..yes ~s- S T fl Jaa~ropei use an r ime 0 y6iir septic si sa e3x coild'tesulf in tts prenrduuae,fai to batadle wastes. Prflpar oohsists ofjn*bagoistrh6 sew. t24 everq .*90 or soosa, if needed,. by a lioenie+d pumper. 'What you put into tt sstextl earn ict the ft:rtctiort of septic tar3k as a rrea#tr3csat.slage t Ole rite disposal sytern Qwrter maintenaztce respofssibiiiilss art'spedfibd'in §C =n 83:52(1) gzd ip irba~ta 12, St cox CoiIPt11 Ord ace. The propeiiy bu+Uer agrees to su'bmit.to St. Croix Coitnty Pte: & Zoning Depaitramt a Certification forus, signed by the owner and by: a mastor plumber,- journeyuiat3 p}taa A>er- reskti phwbaz or a l[~nsed pun2peirverify€ag that (1) the on site.. vvast~wa4 .disposal system is m.ptaper aperatitag sotadltivzz and'or after inspection and pig (ifnecessary), the septic tank is less *4 l/3 fiil l of sludge:: _ Ilwwe„ the d eigned have.read ffie above zeiftrizemeats to d agm to maintai tke dVafe sewage disposal system with the Standards farih, h~ m-4 asset by the D,t b# Coma and,.tl:C oFNafittal 3tesouices, State of W iscAn. CexiEltlcatio that - sepm system has been a lamed naW be completed and remrned'to the St Croix County Planing & Zoaiug Depaimirt with 3t3 days..of the :thra;e year exp#Won'date: llwe certify that x311 siatemeats on d Vs form-are ttue.,to-6¢ best of myieut Imovrle dIge. li'v`e am/am the oumer(s; pf the property descTtl above by vhtne of a warranty.det6d #eco=iteti in i dDads Ofdic 6-. AP C i D t r ) ATE *sAay nifoznraatxott that 3s . iesntetl may result & the. sanitary permit being rsevoW by the Planning & zoning Deperwer3t, inchtdt 'kh is* pp}aicaziox# a,recorded wafrar y 6 d fz ci the ltegistsr of i?eeds C)face end a copy of the certified survey MP; r. 'reference js made in the wave iIdy, &-ed, . ` U 2 7 3 9 P 316 -78E.109 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., MI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 01/28/2005 03:15PH THIS DEED, made between Neil L. Wilcoxson and Mary Jo WARRANTY DEED EXEMPT # Wilcoxson, husband and wife, Grantor, and Kernon J. Bast and Donalda J. Speer-Bast, husband and wife, Grantee. REC FEE: 13.80 Grantor, for a valuable consideration, conveys and warrants to Grantee TRANS FEE: 4212.90 COPY FEE: the following described real estate in St. Croix County, State of Wisconsin: CC FEE: PAGES: 2 SEE ATTACHED EXHIBIT A I Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2'd St. - Suite l 15 Exceptions to warranties: Hudson, WI 54016 Easements, restrictions and rights-of-way of record, if any. 456780 020-1109-10-050 020-1110-30-000... 020-1109-55-050 Parcel Identification Number (PIN) This is not homestead property. Dated this 28 y of January, 2005. Il L. Wi cox * Mary Jo i oxson AUTHENTICATIU PUbAC ACKNOWLEDGMENT ,ary Signature(s) N~ ~C0r stn STATE OF WISCONSIN ) ST. CROIX COUNTY. ) ss. authenticated this 28th day of January, 2005 Personally came before me this January 28, 2005 the * above named Neil L. Wilcoxson and Mary Jo Wilcoxson, husband and wife to me known to be the person(s) who TITLE: MEMBER STATE BAR OF WISCONSIN executed the fore oing instrument and acknowledged the same. (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY *Cheri rows Notary Public, State of Wisconsin Peterson, Fram & Bergman -Steven H. Bruns My commission is permanent. (If not, state expiration date: 50 East Fifth Street, St. Paul, MN 55101 3/1112007 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 . U. 2 7 3 9 P 317 EXHIBIT A Parcel 1: A parcel of land located in part of the SW %of the NW '/4 and part of the NW '/4 of the SW '/a of Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; more particularly described as follows: Beginning at the W '/4 comer of said section 36; thence NOW 16'10"E, along the west line of the NW '/4 of said section, 1248.49 feet to the north line of Lot 1 of Certified Survey Map recorded in Volume 3, page 669 at the St. Croix County Register of Deeds Office; thence N63°02'59"E 148.42 feet to the north line of said SW '/4 of the NW ''/4; thence N89°26'58"E, along said north line, 1182.70 feet to the east line of said SW '/4 of the NW ''/4; thence S00021'37"W, along said east line, 350.04 feet to the north line of Lot 73 of the Plat of Cottonwood Ridge First Addition recorded at said office; thence S89126'58"W, along said north line, 10.00 feet to the west line of said plat; thence S00°27'24"W, along said west line, 2096.76 feet to the centerline of County Trunk Highway "N" and a point on a 1999.00 foot radius curve, concave southerly, whose central angle measures 7°10'30", whose chord bears N84°30'4 1"W and measures 250.16 feet; thence westerly, along the are of said curve and said centerline, 250.33 feet to the point of tangency; thence N88°05'56"W, along said centerline, 83.64 feet to the point of curvature of a 2700.00 foot radius curve, concave northerly; whose central angel measures 3°17'53", whose chord bears N86°26'59.5"W and measures 155.40 feet; thence westerly, along the arc of said curve and said centerline, 155.42 feet; thence N04°29'56"E 244.01 feet to the point of curvature of a 167.00 foot radius, concave westerly, whose central angle measures 34°24' 12", whose chord bears N12°42' 10"W and measures 98.78 feet; thence northerly, along the arc of said curve, 100.28 feet to the point of tangency; thence N29'54'1 6"W 274.22 feet to the easterly extension of the north line of Lot 1 of Certified Survey Map recorded in Volume 12, page 3456 at said office; thence N89°'12'45"W, along said easterly extension, along said north line, and along the westerly extension of said north line, 670.44 feet to the west line of the SW %4 of said section; thence N00°37' 50"E, along said west line, 496.89 feet to the point of beginning. AND Parcel 2: A parcel of land located in part of the SW of the SE of Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; described as follows: Beginning at the South ''/4 Comer of said Section 36; thence N00°27'05"E, along the north-south '/4 line of said section, 1216.78 feet to the centerline of County Trunk Highway "N"; thence S76°47'47"E, along said centerline, 1354.82 feet to the east line of said SW '/4 of the SE thence S00°07'02"W, along said east line, 897.02 feet to the south line of the SE '/4; thence S89°33'25"W, along said south line, 1326.80 feet to the point of beginning. T Oix COUNTY o CR PLANNING & G November 19, 2009 i Kernon Bast c/o Edina Realty, Inc. 400 South 2nd Street Hudson, WI 54016 Code Administration RE: Compliance deposit refunds for Cottonwood South '07 lots 715-386-4680 Section 36, Town of Hudson Land Information C,- Dear Mr. Bast: Planning 715-386-4674 1 recently reviewed the Board of Adjustment Decision for the above subdivision while Real Propel-ty processing a sanitary permit application and noted that you have compliance deposits that 715-396-4677 may be eligible for refund. According to Condition #5: Recycling "The plan shall be accompanied by a $100 nonrefundable staff review fee and a cash 715-386-4675 compliance deposit for the lot. The compliance deposit for the six lots under construction shall be $1,100 each, and the compliance deposit for the remaining lots in the subdivision shall be $300 each. The cash compliance deposit will be held by the Zoning Administrator until construction is complete, permanent vegetation has been established, and the project is found to be in compliance with the conditions of this approval, at which time the deposit will be refunded in full. Upon completing construction on each lot, the applicant shall submit to the Zoning Administrator photos of the completed construction and certification from the project engineer that the construction has been completed as approved to serve as proof of compliance." Our sanitary database records show eight (8) permits were issued whose POWTS have been installed and inspected. However, there are some non-compliance issues that must be resolved before lots 2 and lot-2 4 will be considered "complete". We need to obtain elevations and documentation of the building sewer and tanks that were installed on lot 24 without county inspecto and the mound on lot 2 does not meet the required setback from the north lot line. r.,,.' 2o/ b . When we have received photos that document completion of construction on each lot, your deposit refunds will be processed. S' ely, Pam-Quinn Zoning Specialist Cc: Brian & Molly Hayes, lot 24 property owners Andre Buechner, lot 2 property owner ST. CRO/X COUNTY GOVERNMENT CENTER 1 101 CARM/CHAEL ROAD, HUDSON, Wl 54016 715386-4686 FAx PZ@CO.SA/NT-CRO/X.W/.US WWW CO SAINT-CROIX WI US Visconsfn SOIL EVALUATION REPORT , #2003 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service Attach complete site plan on paper not less than 8/2 x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Q Please print all information. Rt d By Dat Personal information you provide may be used for secon oses ( ivacy Law, s. 15.04 (1) (m)). VA _ Property Owner G Property Location Y Bast, Kennon Govt. Lot na SE1/ , SW1/4, S36, T29N, R19W n r- \ Property Owner's Mailing Addres 6 Lot # Block # Subd. Name or CSM# 948 Labarge Rd. 17 na Cottonwood Ridge South City Sta Zip Code d umber city Villa a Town Nearest Road GR ❑ tY ❑ 9 Hudson WI 546a~ 7 -7775 Hudson Cty Rd N New Construction Use: ❑ ntial / Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: na Parent material outwash plains and stream terraces Flood plain elevation, if applicable na ft. General comments Conventional system, sytstem elevation 94.87ft. Trenches spaced and depth to code 4.58ft below grade. and recommendations: F 1-1 Boring # ❑ Boring Pit Ground surface elev. 99.45 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/1 none sil 2msbk mfr aw lvf .6 .8 2 13-26 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 26-35 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 4 35-110 7.5yr4/6 none ms osg ml na na .7 1.6 r !8 7 ❑ Boring # ❑ Boring Pit Ground surface elev. 99.45 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft: in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-24 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 24-39 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 39-46 7.5yr4/4 none scl 2msbk mfr cs na .4 .6 4 46-110 7.5yr4/6 none ms osg ml na na .7 1.6 / 5 y, y~ 56 (o * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 s30 mg/L and TSS S30 mg/L CST Name (Please Print) 5 n CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 10/20/2006 715-760-0347 SBD-8330 (4.07/00) Property Owner Bast, Kernon Parcel ID # Pending Page 2 of 3 ❑ Boring # El Boring ❑ pit Ground surface elev. 98.95 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-16 10yr3/1 none sil 2msbk mfr gw ivf .6 .8 2 16-24 10yr4/4 none Sid 2msbk mfr cs na .4 .6 3 24-33 7.5yr4/4 none grcos 2msbk mfr cs na .7 1.6 4 33-110 7.5yr4/6 none ms osg ml na na .7 1.6 I it I i ❑ 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/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Cy Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 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) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel Kennon Bast 994200 th St. CST-POWTSM SE1/4,SW1/4,S36,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St Croix Co. Direct 715-760-0347 Cottonwood Ridge South, Lot 17 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1" = 40' = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations BI = 99.45 ft B2 = 99.45 ft B3 = 98.95 ft B4 = 0.00 ft f 3 W`0S - r 1 nor~~G~tze r Z / r j