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HomeMy WebLinkAbout010-1033-80-010Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division t INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal inforrnation you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)1• Permit Holder's Name: City Village X Township Davis, Steve & Beth Emerald, Town of CST BM Elev: Insp. BM Elev: BM Description: /~ /1'11 GS t TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic t 4~ Dosing `~ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~~/ ./~ f 2~ t ~ ~ l Dosing ~ 7 Sa~ J ~~` Z t Aeration Holding PUMP/SIPHON INFORMATION /( Iv Manufacturer Demand ~ ~~ p„ PM Model Number ~~ ^ v~ TDH Lift Friction~oss Syste lead TDH Ft r ,,~~ ~3 , IZA Forcemain Len th ~ t Dia. Dist. to well ~ ~ ~ ~ SOIL ABSORPTION SYSTEM r,. \ ELEVATION DATA county: St. Croix Sanitary Permit No: 479283 0 State Plan ID No: Parcel Tax No: 010-1033-80-010 Section/Town/RangelMap No: 14.30.16.206A STATION BS HI FS ELEV. Benchmark ~'A.t~ fob .o /off Alt. BM Bldg. Sewer ~ ' SUHt Inlet 15 , 9d -35 St/Ht Outlet `~ ~ Dt Inlet ^~ ~ Dt Bottom ~~,Z / gp~~ Header/Man. ~. ~S . ~S Dist. Pipe „7`~ 1~ r l Bot. System ~, '~~ Q 7` ~ r ` J Final Grade ~ st Cover Q ~~ l 96. g 5 BED/TRENCH DIMENSIONS Width 1 Length ) ~ Of Trenches_ ~ G PIT DIMENSIONS \_ No. Of Pits =~ Inside Dia. '~„ Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: ~~ (~,~ _ y~ .~~-I ~1+ oi. Typ Of System: ~ ~ ~t ~~/ ~ UNIT Model Number: ~J ; I- tJ~ DISTRIBUTION SYSTEM Header/Manifold i/ Distribution\ \ Pipe(s) ~, x Hole Size x Hole Spacing V--en77t t~ir ntak~ ~ y Length~_ Dia Length Dia Spacing // Sell _ t'.t7UFQ v Dror:enro Svc4cmc flnhr YY Mromd f)r of-Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded/S dded xx Mulc ed Bed/Trench Center ~ Q ~ ~ O Bed/Trench Edges \ Topsoil Yes ~ s j No _' Yes ~ -] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Location: 1571 250th Stre Emerald, WI 54013 (SW 1/4 NW 1/4 1~4•^T3~0N R16W) NA Lot 1/ /~ 1.) Alt BM Description = i~tJ G°J~' `~---N.a~ ~/~.S t~- f~dG,I~S Oct r~ 2.) Bldg sewer length = Z~ 1 -amount of cover = 7 j Plan revision Required? ~~ Yes No ~ ~ Z~ I, ~~ Use other side for additional information. i____ ~ ~ Date SBD-6710 (R.3/97) ~~ Inspection #2: / / Parcel No: 14.30.16.206A ~~ ~`~~ Cert. No. - 361 W W~ii~N Ave.. P.O Naac 7162 ~--~.j~ 1 1~ion„rVt s3'Mh-7162 t~I766r311t IDS . ,. t-t d!` I;o ~ ~~- . _ ~~ ~~ ~ l~rr --(( X ~ b ~coai wNM Cars g31. Mla'M~. Chi ,,,,q,be~„etarreaWnrvMlrr~: ~ SOpZ , ~K; b~ J ~ ~~ ~ r 5~ ( S ., ~ ~ l 0/0 - 3- -olv ~ ~ .~ 7~i /~ Ub' fly, ` ` S w if- 1L:.~ .-:-;~-~-~ ~~~u~~ S~./?~ ~ n'1 .r ++~~ D ~ ~ ~1/C Li'iF11~w11f~1Dwif~"1tr~iirvEB~d~ dMiMs P°t ~~~ DW~ Q1+r1~-pro I - Ll~l4-.., Q~tO~i"Oe~a~siln C~ - G ~ ~ • ewe Mc w ~ ~ ~ D ~~ ~ Q o1Mr Mdlla~+o~~°` % ~ w.a ~. s. 1L) II4nNitRe~rw~1 ©IheasMF~ ~ ~ err» o~ 7ywAralNew . tn~dw~1 C11~a3ti~.d'aiirMssaY LIMwM~~tii..rwilMbMsoN O A>r~.e. ©si~e>I~a.w» 0 . ~ ~ 0 _ 'at Cltirclwr OAwwte'11iw1wt~~ bra 4 tr~+ D e~ ~ aMr Mwr llrr U , ~7 o ~ . ~. O oe~clle«~..arl>~ /r pc, C,,,~,~ „r~p.rwluRaues fYr ~ c~2-_~1 i . . SYSTEM OWNER: ~, ~~ `~'}( Septic tank, effluent filter and QQQ a~,~ dispersal cell must all be serviced /maintained ~~~ ~ as per mans ement Ian rov' lum er. ~/~ U . 2. se ack requirements must be maintained as per applicable code/ordinances. 3 4 ~uYei~ !Ur ~ G~4~1L~ S~ ~ a ~ ~ ~ " (~G-aUU~-BUJ ~ sa~9s c~. oi~oa-~ vim. 3 3 ~~ ~ p 3 . ~~,~~ ~~ ~'t G v ~.. ~- ,3.e.th ~ v ~'S S/w N~l/ s ~ `~ ~ 3 N ~ ~ G t~1 t a w ~ v ~ ~ r-'t ~ ~^ ~. ~ d ~G ~ ~ .~ ~ky e~ ~` [ ~- ~~~ 1GG A-C ~ 2 /~d~ /.Lt~ / ~ ,~ G ~ a ~~ ~v~ ~ 8~ '. ~~ ,~ ~ I~ A ~~ o0 4~~* ~ ~u~~G~ IVU ~a ~tc~ ~` ~~- Z3 ~Y $ ~ ~ 9' a 2 ~ G~QS ~ ~ ~.lG v ~-~, ~ J~n~.L t~ /~2 G c~vt ,~+ ~ ° .~' s t'~ `' N'1 ~, ~~,3'k~S°' ~-,2?-~~ 2~~~~ ~~. ~t ~ v t. ~- ~3 .~~- t, ~R v ~'s ~~~ ~~h ~Ut; ~U 5 S/w N/~/ s ~ `~ z 3 N 2 i G ~`'~ ~ r d ~ ~jG ~o w~ v~ ~ ~ ~-^~ ~ B,rh, ~' ~~~ ~- y,~~~~ ~t .~14ftCS /~~C- ~r ~~~ ~-t ~ ~ ~~.~ ~ ~ d ~~~,y~ud ~~t.~ ;f ~~ kse. ..~ 1_ _ _ ~L~ q ~ ~~ ,, j E ,7 I I~ ~~t ~_ ' ~ f, • s -1'! r ~~ t=L ~4,L _.~ ~~x~~ ~~ ~4 , G _~Gv ~~~ ,L '''~ W''~SG ~_~~U ~; /rat ~ ~°U r3 g /' ~ ~~ ZZ~ Z3 ~Y ~~,~,~Z~~,Qs . ~- ~ ~~ ~lGG ~~. r-~ s JAG, L t~,. 1~ ~ ~- 4-' n ~ `~ ~-° ~, S t~ `` `~ ~~,~23k~S~ Dose TarMc bMbm~stlon tAOldipoaMarwia+wrrNrp MbN and k~oidtp deMoe ead seeied weAerBpt~t Elaotrial ae per NEC 30D and -~--~ ccirrn 1x.28 WAC DMooir~ „~ 4 h. mNR Tank component la prnpah wrwd ~~ ~~ a~tlet location Fo~onneNf dMmeber ~ 2 h. :~ Dime ns It_ t3s8o ~ B ~.~' ~ 0 ;~ UU ~' Total ~ VWep hole a ardi- L. Aland Msnua SJE-Rhombuf* Controls Aland Model Number Tank Abrt 1 Pump Model der 3887 EPQB „_~ pmnp Must Deliver [~~~t~ ~ TDrI ~_ ~.~ i~d 6T9bTE85tLtN©8d ~~~~ ~~~ i .r ~~ tom ~~ • Et~ent systems w .~,, d .~ • ptiiN r~ in high hertrna~r: t~ t~ Plppt 8e#11ob aeMmeiM awi ~statitrfid~I • Ca~gp~ge~ ap iD $Q GPM. • 7oGi ! ap !0 3i 1set. • Disdtel~e sime:l'l4' NPT. • U1IeChGticet b~ Cecbon- BtINA-fif eleraa~. •Y~ 740'f { • ~~~~ stBirMess 81ee1. • t~apm6te o! ranahp drI-+~hovt 1n aomponen~a. Meer: t~4 She phase: 0.4 fP, i'fS Of210 , 6t! Hz X590 RPM. ~ h oeerloed w~ iWoenattC tseet t~Shgb Q5 NP, iibY,~tit,1~5QRPM, bulb In overload whit at~prrs~ie rear. P~oweroord: ipfioot stand tenhth. tB~3 SJfOW tee dtrae pnon~ Sw t!lree tx~g ~~iaSl ~ .~ (sNandard on EPD6). ~-aeoa~ardsPun~+a f+wuaga aooa FEA7't~ D~d~ w~1 pump o~ veava far SE®T p10A. ~. 1 Su6mersiWe E~aent Pump 3$71 ..~ :~ so _ _... itv~ CAPA~Cn'Y Goulds Pumps ITT Industries r Beat Upper and Tower ~~ AiiE11Ct- Ltd ~ c m~ members 6aAi~P,e~rckfsOrei fl~idwri. 0 Z 4 6 8' 10 12 ^MN~ ;flR1G~l~Q~~ SOIL EVALUATION REPORT Wisconsin Department of Commerce - - -•-,--~ - , - - -.__._...., Division of Safety and Buildings in accordance with Comm 85,1Nie. Ad-n. ~bde 1842 Page 1 of 3 Certified Soil Testing Attach complete site plan on paper not less than 8'/: x 11 inches in size.:?Plan must include but not limited to: vertical and hori nt l f e i BM t ti d di Coun y St. Croix , zo re a er nce po n ( ), {ec on an ° r j': ' ~ p l LD percent slope, scale or dimemsions, north arrow, and location and distartbe to nearest road: ' _ arce . 43 SM Pending Please print all information. Reviewed y Dat Personal information you provide may be used for secondary purposes (Privacy la~M,s...t5,@4 (1) (m)) _~ _ -, ~ '' ? 7 Property Owner Property Location Jungwirth & Manke, Charles & Rose Govt. Lot SW 1/4 NW 1/4 S 14 T 30 N R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1551 250th St. 1 Pending City State Zip Code Phone Number City %~ Village ~ Town Nearest Road Emerald ~ WI 54012 715-265-4811 Emerald 250Th St. New Construction Use: y Residential /Number of bedrooms 3 Code derived design flow rate Replacement 4 Public or commercial -Describe: Parent material sandy/loamy outwash Flood plain elevation, if applicable General comments and recommendations: install 643 sq ft leaching chamber trench @ system elevation of 97.0 for 3 br (assumed) 450 GPD NA Boring # -~ Boring ~' Pit Ground Surface elev. 96.7 ft. Depth to limiting factor ~ 74 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. "Eff#1 *Eff#2 1 0-11 7.5YR 3/2 - sl 2 m gr ds cs 1f/m .5 .9 2 11-24 10YR 4/3 - sl 2 f-m sbk dsh gs 1m .5 .9 3 24-74 7.5YR 3/4 - Is 1 m sbk mvfr - - .7 1.2 occasional gr/cob/st 0-74"; horizon 3 is often 0, sg, ml Boring # Boring /' Pit Ground Surface elev. 100.0 ft. Depth to limiting factor ~ 74 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D1ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 7.5YR 3/2 - sl 2 m gr ds cs 1f/m .5 .9 2 10-34 7.5YR 4/4 - Is 0 sg dl cs 2m .7 1.2 3 34-74 7.5YR 4/4 - s 0 sg dl - - .7 1.2 occasional gr/cob/st 0-74" - tmuent ~i = tsUUS> :iU < z20 mg/L and TSS >30 < 1 0 mg/L * Effluent #2 = BO < 30 mg/L and TSS _< 30 mgr CST Name (Please Print) Signature: CST Number Henry F. Grote z 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 8/18/2003 715-233-0398 ._ ... ~.~._.~ ~...1 Property Owner ]ungwirth & Manke, Charles & Parcel ID # 6.143 A CSM Pending Page 2 of 3 ' Boring # ~ Boring /' Pit Ground Surface elev. 100.0 ft. Depth to limiting factor > 74 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell pu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-9 7.5YR 3/2 - sl 2 m gr ds cs 1f/m .5 .9 2 9-24 7.5YR 4/4 '~ - Is 1 m sbk dsh gs 1 m .7 1.2 3 2~ 7.5YR 4/4 - Is 1 m sbk mvfr gs 1m .7 1.2 4 4 52 7.5YR 4/4 - sl 0 mvfr gs 1 m .5 5 52-74 7.5YR 4/4 - Is 0 sg ml - - .7 1.2 2Z ~ ~ ~ occasional gr/cob/st 0-74"; horizo~ often , sg, ml ^ 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 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 Consistence Boundary Roots 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. 0.2-~ SBD-8330 (R.07/00) Certified Soil Testing .' -J- 0 J n~1 L Zf .~ ~0 `~. J i d .. a 3 d f a ~1 V e f s ~~ r OS 9 O J d' t ' J 9 ~ ~. f .D ;~, 9 T~ ~ J ~ ~ 1 ~ u 0 d ,~ v o~ ~ ~ 1 ~' ..may / ti H a Y mss' "~ r~ ~' ~ --1~ ~ ~ - ~ ~ s rn ~ c~ r > _ M ~ / ~--~ ~ ~ v •o 4 I ~,~ F-~-.,_ ~ Y s 'Z 1 ~ s ~ 00 '~./ '~ c 99 ~ ~ ~n ~i _o n ~' ; t/~ f~ +- i ~. ,.a u v rte" '~ ~ M 3 -_ _ ~ s J ~ ~ ~ w ~ r ~ ~ ~ 3 ~ ~ ~~ ~ .~, ~ -~ u g ~' ~ 9 ~ ` v q i s o 3 ~ . ^ j' ~~ ~ J ..., o ~s N ~~~ ,.n 6 ~ Y Y.~ `Y ~+~} a N ~ I ~+ 2 N " MI 0 ~i~ a a v ~_~ d Vti~~v ~g'~xgz ^'~r`= ~~,~', Ef~T` ~~--,: U 2832 P 612 St. Croix County Occupancy Ai~dav/t Name - (Owner) Typed or printed being duly sworn ,states, under oath, that: 1. Hdshe is the owncr/pazt owner of the followin parcel of land located in St. Croix Coua Wisconsin, recorded in Volume o2~0 Page O / Document Number ~ 8 St. Croix County Regnster of Deeds Office: A parcel of land located in the5t.ry. of theme ~ of Section T ~ N - R / ~ W, Town of ~~-~..p , St. Croix County, Wisconsin, being duly described as follows (include lot no. and subdivisiodCSM or detailed legal description): L oT 'W` ,2, o ~ cs~ (~. ig/P ~s~) 798951 KATHLEEA N. YA[.SN REGISTER OF DEEDS ST. CROIK CO.. MI RECEIVED FOR RECORD 06/29/2085 03:38P11 AFFIDAVIT EXQPT t REC FEE: 1l. N TRA?IS FEfi: COPY FEE: CC FEE: PAGES: 1 Name and ReturnrAddro i~l~o ~ D~~~ g 2G~E i ZrwL"`2 Clrzo~/~ (d-t ~t'r"s 5~ 7 ~ olo- ~o33-8D-olo j owner of the above described property, I acknowledge that the septic system serving this residence is sized for a ~~, bedroom home, or a design flow of ~ g .The design flow is calculated by assuming 150 gpd for 2 individuals per bedroom. They a are currently ~oocupalrts living h this residence; ~ occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. i~lowever, l understand that if there are intentions to exceed the number of permitted occupants, the system wiN need to be modified to aooomodate any increased wastewater flows and/or contaminant loads. 1 also adulowledge that 1 will make this infomnation available to any future parties interested in purchasing this property. natea nas ~ day d ~5 . * S ~ AUTHENTICATION Signature(s) authenitcated n,ls day of TITLE: MEMBER STATE BAR OF WISCONSIN (If nod autltodZed by § 7l)6.t18, Wis. Slats.) TENS NrSTRtl1AENT WAS gRAPTEO 8Y ~-~ 2_ nrr~/L.~ (Sfynatures maybe authenticated or acknowledged. Both are not Y•) "THIS PARSE IS PART OF THIS t.EGAI ACKNOWLEDGMENT STATE OF WISCONSIN ) )ss• ~j. Crobc ~Y• ) P came betare me Ws ~_ day of p .~. ~ ~~, to ma knovim to be the pe~sw>(s) wfw ezoaited the foregoing instnxneM and adcnoMAedge the same. f ..~ Notary Public, State d r(lscoosln My Commission k permanent. If not, sta~ ~~~. Oats: 1l ' ~ -2~ a~f1R~AY ~~~ , - 00 NOT REMOVE" Thfs ~ must be oarprafed by submrfer. Qama a :enxr:.edross. and eld (X rpukrraq. Othsrlrrl~arnetbn such as the ~rauaes, ~-+. eh~ mays. prsoed orr a:Fs ist pps oilhe doarnsnf ormaybe p-scedon addxionar payee d the docurnerk ~, Use d/hfs oowrpage adds ors psye to yourrrocument and ~jf?D lb tris taoondirw Ilse. UMsoorrsrn STaEates, 5~ 517. $'r' CROYX GOUN'1"li SEPTIC TANK MAINTENANCE AGRFd3MEN'r AND OV~~RSHIP CERTiFIGATION FORM (/Buyer ~=5 ~~ l.S ~, 5p~17 Hwl~ Adams _ 1~~e ~ . Pro Address ~ Q ~ PAY d from Plannu-g Department fa sew eonstnvctvon) (Verification rcquiro ~ G U Parcel Identification Number _ ~ / U ' / U ~ ~ Cit7//State ;GAL ESCRIPT s ~0(O }~) 3 ~_R G w, Town o~ ~ ~ ~ ~' / . Property Location ~ '/,, ~.. ~ '/., Sec. ~ ` (, T ~ Lot # ~,.._.• Sbbdivision Ce~rhft+ed $nrvey Map # ~ L~ ? S~~ U _ _ .Volume C ~ -- Pam # • ~ ~~ t G 7 ~ 'Page # G t ws;,~tnty ~t # 7 ~ 1 ? ! ~ , voltant: ~ Spec house ^ yes CYuo Lot lines identifiable O'`yes ^ no SYS'~M MA,I 1~1~A~C~ c~rtd result is its prematuec fiitun m ltmdte wastes. Proper n~itf~ance Improper tvae and maintenance of your septic system if needed by a liem9ed p Wit Y~ lmt into thee ~ consists of pttt~ipg oat ~ tank ~~ ~° ~ or sooner, enn affect the o~n of the septic tank as a treatment stago is the caste di~sai ~~- Thee ag:+oes to submit to S't. t5+oirc Z~onaag D~ °. an-si~d~~~~ y °~ mat( ) Grp, j~y~nplnmber, resdyctedpb~~' ar a liowsedpumper is ~ psaper operating condition and/or (2) after inapoctian and pumping (if aocessaiy), t1u tank is leas than 1/3 fi11 of sludge. Ihve, the undersigned have read the shove requires sad agrte to maintain the pee3vate sewage diapoarll with dte staadat+ds sd forth. hotein, as Set by five Department of C~nmerx and the Department of Natural Resoute~s, State of wtscaosm~en ertatigg that your septic system bas boon maintained must bo comPletod ansl reiircnod to the St. Qtoix County Zoning days of the three year expiration date. ~, p~ ~~o ~ "~'~ DATE SLt~IATURE OF APPLICANT 4wNER CE~tTIFXCATION knowledge. I (we) aaex (are) tbo owner(s) I (we) ceRify that all sptrments on this form ue true to the best of my a ~oar~ Off. the pr~opeeity descrrbed above, by virtue of a warranty deed recorded is Register ` .. D Cl ,.~~ DATS SIt3NATURE OF APPLI e•sss~ es++w« Apy information chat is mis-rcprescatcd may r~u1t in the sanitary pecm~it beiop nvofacd by the Zo~ofag D• sa [sutler wIW tLis applleatlon: a sbnvped warranty decd from the Register of Deeds office s copy of the cectifiod survey map if rcfeeneoee is ~~ in the watranty deed i9d =QI 8b:89 S®-LI-9B POWTS OWNER'S MANUAL & MANAGEMENT PLAN Palle ~ of Z' FILE INFORMATION . . Owner ~f e v ~. ,41. ~ `5. Permit # -~ a ") nccutu oeQeruaTCaie Number of Bedrooms DNA Number of Public Facility Units ~~' ~ NA Estimated flow leverage! 6~ al/da Design flow (peak!, tF_stimated x 1.51 ` G O al/d Soil Application Rate ~ ? aUda /ft2 Standard Influent/Effluent duality Monthly average` Fats, Oil & Grease lFOGI 530 mg/L , Biochemical Oxygen Oemand iBOOS1 5220 mg/L DNA Total Suspended Solids (TSS) 6150 mg/t. Pretreated Effluent duality Monthly average Biochemical Oxygen Demand IBODsI .530 mg/~ Total Suspended Solids ITSSI 530 mg/L ~NA Fecal Coliform Igeomstric mean) 5 1100m1 Maximum Effluent Particle Size Ys in die. ^ NA Other: DNA ~'Valuas typical fa domestic wastewater and septic teak effluent. svs~ si~ctpcaTlONS Septic Tank Capacity, / Z v v aI ~ NA Septic Tank Manufacturer ~ . ` e.S eR DNA Effiuerrt Rker Manufacturer /~ - (va ~ ~ O NA Effluent F~ter Model _. / O v O NA Pump Tank Capacity ~'U d ~ DNA Pump Tank Manufacturer ~i eSc~ ~ Pump Manufactures ~ u ~ ~ ~ DNA Pump. Model ~ U y~ _ - "' `DNA Pretreatment Unit D Sand/Gravel F~ter ^ Mechanical Aeration D Disinfection D Peat filter D Wetland- - O Other: A Ois al Cell{s) n-Ground !gravity) D At-Grade D Grip-t.ine ~ NA O In-Ground (pressurized) ^ Mound D Other: Other:.. DNA Other: ^ NA Other: ^ NA V6G NIfY1~~GAIY\vG O V 7G Y . ~Y Ss ,-- ~c. ~(YI{,iT Event ~_ ~,sY ~~y ~+.~-.~..~i Inspect condition of tank(sl At least once every: D thlsl (Maximum 3 years) earls) DNA Pump out contents of tank(s) When combined sludge and scum equals one-third iY,l of tank volume DNA Inspect disperse! ceNls) At least once every: ~D_ ~ont~tst (tNaximum 3 yeas) f'Ye~' C7 NA Clean effluent filter --'.y At least once every: ~ ^ mo lel si . DNA Inspect pump, pump controls & alarm At !east once every: ?J O monthlsl ear(s) O NA Flush laterals and pressure test At least once every: 3 ' D m -this) earls! DNA ^ monthlsl D IdA At least once every: D yearlsl Other. ~ _ DNA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following Hcxntses or, certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector, POWT5 Maintainer, Septage Servicing Operator. Tank inspections must include a visual inspection of the tankisi to identify any missing or broken hardware, identify any cracks. or leaks, measure the volume of combined sludge and scum aruf to check for any back up or ponding of effluent on the ground surface. The disp~sat cell(s) shat! 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`effiueM on the ground surface maY indicate a failing conditwn and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third IY,1 or more of the tank volume, the entire contents of the tank shag be removed by a Septage Servicing Operator and disposled ,of in accordance with chapter NR 113, Wisconsin Admktistrative Code. AN other services, htchiding but not united to the sairvickig of effluent filters, mechanical or pressurized components, pretreatmem units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report ~aM be provided to the local regulatory auNtority wi~in i 0 days of completion of any servico event. - Page ~ of 2 8TART UP AND OPERATION ' For new construction, prior to use of the POWYS check treatment rankle) for the presence of painting products or other chemicals that may knpede the treatment process and/o(damage the dispersal ce1Nsl. If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to tree. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fNi above normal highwater levels. When Power is restored the excess wastewater w~i be discharged to the dispersal cellls) in one large dose, overloading the ceills) and may resuR in the backup or surface discharge of effhrent. 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 POWYS Maintaa-er to assist in manuaNy operating the .pump corrirols to restore normal levels within the pump tank. DO not drive ar park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb ar compact, the area within 15 feet down slope of any mound or at-grade soN absorption area. - Reduction or elimination of the. folbwing from the wastewater stream may improve the performance and prolong t'~ie life of the POWYS: 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 POWYS fails and/or is permanehtly taken out of service the foibwing steps shah betaken to insure that the system is properly and safely abandoned in compliance with dtaptet 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 shah be removed and properly_disposed of by a Septage Servicing Operator. • After pumping. aN tanks and pits shah be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert so8d material. CONTINGENCY If 'the POWT ails and cannot be repaired the following measures have; been, or. must be taken, to provide a code compliant replacemen stem: suitable replacement area has been evaluated and may be utilized for the location of a replacement. soil .absorption system. The replacement area shoukt be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed struMure, bt lines and weNs. Failure to protect the replacement area will resuk in the need for a new self and site evaluation to estabNsh a suitable replacement area. Replacement systems must comply with the rules ~ affect at that tone. ^ A suitable replacement area is hot available ue to ns. Barring advances in POWYS technology a holding tank may be instaNed as a Last resort to replace the failed POWYS. • I ~1 o ank e a~ ~ZOId18 ~ ^ Mound and at-grade soN 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 INSUFFICN~IIT 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 D~FICULT OR IMPOSSIBLE. AD~1'IONAL COMMENTS ..POWYS INSTALLER POWYS.. MANYTAlNER Name ~~ ~ St ~. Rhone. ') , / 5"',- G ~ `1- ~'' ~ ` t: Name Phone SEPTAGE SERVICINQ OPERATOR (PUMPER) LOCAL REGULATORY AUTHORI'1"Y Name Phone -: N~ne .,,,,r" C ( 20Ytll ~tl Phone ~~~-- ~~(p- (O This document was drafted in twee with chapter Comm 83.22ta1tb?i111d)Sifl and 83.SM71.121 !~ (31. wacota~n Administrative Cods• CERTIFIED SURVEY MAP Charles Jungwirth and Rosemarie Manke The Southwest '/+ of the Northwest '/+ of Section 14, T 30 N, R 16 W, Town of Emerald, St. Croix County, Wisconsin DESCRIPTION: That certain parcel of land being the Southwest '/+ of the Northwest '/, of Section 14, Township 30 North, Range 16 West, Town of Emerald, St. Croix County, Wisconsin, more fully described as follows: Beginning at the West Quarter corner of said Section 14; thence North (assumed bearing on the West line of the Northwest '/+ of said Section 14) a distance of 1309.03' to the Northwest corner of said Southwest '/+ of the Northwest '/+ ; thence, along the North line of said Southwest '/+ of the Northwest '/+ , S 85 ° 52' 08" E, 1325.60' to the Northeast corner thereof; thence, along the East line of said Southwest '/+ of the Northwest '/+, S 00° 15' 33" W, 1312.14' to the Southeast corner thereof; thence, along the South line of said Southwest '/. of the Northwest '/+, N 85 ° 42' S9" W, 1319.91' to the Point of Beginning, containing 39.697 acres or 1,729,192 square feet being subject to an easement for 250"' Street over Westerly portions thereof, as shown on this map, and to any other easements, covenants or restrictions of record. GENERAL NOTICE STATEMENTS: Note: Each parcel shown on this map is subject to State, County and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel contact the St. Croix County Zoning Office and the Town of Emerald. Note: A special exception use permit is required for the disturbance of slopes 20% or greater not identified on the approved plat or CSM. This permit is applied through the zoning office and is reviewed through a public hearing process by the St. Croix County Boazd of Adjustment. Note: The construction of the future access driveway for Lot 3 is required to be at the location shown on Sheet 1 to avoid disturbing slopes 20% or greater. State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owners, Chazles Jungwirth and Rosemarie Manke, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236.34 of Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true and correct representation thereof. Dated :August 1, 2003. - ~o~`SGONy~~ aDpQOO °~~o ~ 0~~ ~,LAU W N~ o MU/RpHY ~ o ~7'1 3 e ~ L~ENVILLE. ~ ~ V1A. ~ 1 O\o0F0 oL4 NO e$o~-to This Instrument Drafted by Mark W. Peavey SHEET 2 OF 2 Vol 18 Page 4656 . U 2709P 017 STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number I WARRANTY DEED This Deed, made between Charles J. Junt=_wirth and Rosemarie M. Manke, Grantor, and Steven R Davis and Elizabeth Davis husband and wife Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): That part of SW 1/4 NW i/4 Sec 14T30N-R16W described as follows: Lot 1 of Certified y Maps, `page 4656 as Doc. No. 747510. St. Croix County, Wisconsin. ~8~~~8 KATHLEER H. MALSH REGISTER OF DEEDS ST. CROIx CO.. MtI RECEIVED FOR RECORD 12/06f2009 10:20Al1 MARRAHTY DEED EXElf T N REC FEE: 21, 00 TRANS FEE: 151.50 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address ., ~ , ... r' - HUD/c7iV, 1,°JI 54016 Part of 010-1033-80-0 Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this ~ ~ day of November , 2004 ~ _ *__._-______--__-____ - * Charles J. un firth ~~~ * * Rosemarie M. Manke AVTIiENTICATION ACKNOWLEDGMENT Signature(s) Rosemarie M. Manke authenticat this ~$~~ of November , 2004 L~ * Krishna Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If no[, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Krishna Ogland Hudson, WI 54016 --- - ~ -- (Signatures may be authenticated or acknowledged. Both are not necessary.) STATE OF ) County ) Personally came before me this _ day of November , 2004 the above named Charles J. Jungwirth to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * Notary Public, State of My Commission is permanent. (If not, state expiration date: ~` * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co.. Pond du Lac, WI STATE BAR OF WtSCONSCN 800-655-2021 WARRANTY DEED FORM No. 2 -1999 Parcel #: 010-1033-80-010 Category Alt. Parcel #: 14.30.16.206A 010 -TOWN OF EMERALD Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * =Current Owner *DAVIS, STEVEN R & ELIZABETH STEVEN R & ELIZABETH DAVIS 717 7TH AVE S SO ST PAUL MN 55075 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 1571 250TH ST SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 6.143 Plat: 1835-CSM 18-4656 010-03 SEC 14 T30N R16W PT SW NW CSM 18-4656 Block/Condo Bldg: LOT 01 LOT 1 (6.143 AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 14-30N-16W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 12/06/2004 781718 2709/017 WD 11/25/2003 747510 18/4656 CSM 07/24/2000 626904 1528/589 GD 07/24/2000 626903 1528/588 WD more... 9f1A~ CI IMMARV Bill #: Fair Market Value: Assessed with: -- - - - - ------- -- - - 0 Valuations: Last Changed: 10/19/2004 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANC G6 6.100 42,000 0 42,000 NO Totals for 2005: General Property 6.100 42,000 0 42,000 Woodland 0.000 0 0 Totals for 2004: General Property 6.100 42,000 0 42,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code 07/01/2005 08:41 AM PAGE 1 OF 1 Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ~, . ~ 7 4 7 1 0 VOL 18 PAGE 4656 KATIILEEA H. M~ REGISTER OF DEEDS ST. CROIR CO., WI RECEIVED FOR RECORD 11/25/2003 10:45AM CERTIFIED SURVEY IIAP REC FEE: 13.00 COPY FEE : 3. 00 PAGES: 2 CERTIFIED SURVEY MAP Charles Jungwirth and Rosemarie Manke The Southwest '/. of the Northwest '/, of Section 14, T 30 N, R 16 W, Town of Emerald, St. Croix County, Wisconsin APPROVED Ph1wp1.,~` C~tO1X t:OUNTY MN1Q ilfld Parkr r`nm.r.~nu ~~ ~ ~ 5 2003 NORTHWEST CORNER SECTION 14 T 30 N, R 16 (FOl1ND'PK'rNAIL) , MoNI11dENr Is u~t i OF FENCE TO EAST m ~I N ~' s' ~~ .I `~ ~~ ~~ ~I ~~ G ~~ ~z; ~- 't ara.a.,~l„ ~„ .4r "j/~{(p(,q~p OWNERS ADDRESS r.~t'9-rsoou ,IaNTORIVEwnYLANDS IsslaSBiIASL EASEMENT o , o ~ Ewsesgld, Wl. 5013 •~ so ~ 6 ,_ ~`''" • 71 T CO r~ ~ ~ ; z 6.143 ~T 1 H~ N ~ 7.145 ACRES 31 41 SQ. FT. ~' ;xJ . • SQ. FT. r~i 7.097AL7~5~y ~`* I < 5.870 ACRES VR x,699 ~ ~ ~CL WM~ ~ ~ ~ / a6 ~ ut. FT. ~ ~ /j ;~', ~Q- eENC~utwRtc .. e , ~ ~ "' six 32~ ti ; ~ scuts [N Io• oaK _ ~ - ,r " ~ - ~ SrixE a Iz• owK b1 • 723.Q'1' n.EV.=73.63 ~ ` rrwvlGAal.s ELEV.=61.59' ~ ~ ,,gip/1 ~; 1291. ~ .i ~~*r •_ to ~~ ~~~ a '-N85'?Z59'W 1313.87'--- a~~o~ ~ N S. 59.7 CONTO I~ ~;~ wo~cESS SOT 3 toHwrrt) ~ I ;'~:~ DRIVEWAY 13.224ACi2E50R575,612 „`o.~ ; (SEE NOTE ~NCL SQ•FT. BENCHINARK v 3; ON SNFEr 2) 12889 AIRES OR 56R 1,438 5(,~. FT ELEV. 8323 ~~ r- 3 W; ~~ IEXQ R/N~ SO.T CONT ~ ~I g ~o~ N85'~25 ~~' ~"~~°-' g ~ W 1321.8 ' ?~ ' . ~'r 1289.12' y f _' ` •n 'O ti~-J a ~ aENCtiHtwnx~ 13194 AL~R~(EsS~- 5 4aR 77 ~ ~, ~ - via ~9 1 t~ oi; IOO.oo~D BENCI-v~fARKA (IX ~ ~' . FT, v "" I~_ (AawVmed>SPIKE [N Io• owls n.E V. = 9+.sz~ 1°I ss ~ ._ ~ r 76.7 CONT A/ ~ u. , ~o " I~~- toxwn,» O1 ~N~~c.- W 1319.91' ,~~t ~/iD WEST QUARTER COBWEB ~.Anrn - - - NB3°42'S9' W 52617.70' _ _ _ -- EAST ARTER CORDER SECTION 14, T 30 N, R 16 W ` Q(~((J~ (FOUND BERNTSEN ALUMINUM MONUMENT) UNp SECTIOIJ 14, T 30 N R 16 W -- -- LA1.7FD !A_N_ D~ (~ax~D r xiloN ~ NOTE- Ordioary High Water Mark of Wetlands N established by St. Croi: County Zoning Special~t on duly Z9, 2003. E 5 E 1" = 300' 300 200 100 0 300 Bearings are referenced to the West line of the NW 1/4 of Suction 14, assumed bearing NORTH. This Instrument Drafted by Mark W. Peavey LEGEND O Indicates I"O.D. = 18" Iron Pipe Set (Min. Wt. -1.131bsJlin. fL) sa Section Coraer Monument (as noted) - x - ledicatea Feace _o-o_ 75' Setback Line from Ordinary High Water Mark of Navigable Wetland OHWM Ordinary High Water Mark s Indicates Soil Boring Location it `SpONg~ ~ LAUR • MU 13 L~ElVVILLE ~• ~ •• WI ' . v a~R~O 1..AN~ 9 AUGUST 1, 2003 SHEET 1 OF 2 Vol 18 Page 4656