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HomeMy WebLinkAbout020-1479-08-000 GZp- 477- 69'- coO /��3e✓` 36 . 2-5 , 19 . 3629 NOTICE TO OCCUPA,N-r Inspection Report TtYt PASTO x YpQ tmliam Aayao- sie aW +�+aic DtY' dae. . aCetea ddaatp&re srir+mrasea theaa+>as ba ig r»agVa �.�#'t� Vm�miybs nrtlret ixwatd�yc pt ,° � Private onsite Wastewater treatment System/ P taBrm�o9a ae1a.6x cc mwwArtAr Individual Subsurface Treatment System '�S ri*a ° Prau4�u i(it a7 t+tl ar��.,a«�ha r ma P�rP�rr far as aa+Aat�da>na Thank you for aifowing us to help extend fhe life of your eysteml u�r m as wda *ilk VS&WAOft—»pra ar sb aat" y • Lot us know ff You have any q S: ���caT!a,Mc �f air aid uq aA Tkis it our You-Phww read ea afdmkitat of , ar , aaaaaA� wage. �tY}�a++r�iaa peawdta report to , fly k ak. Saro :nom&s _.Au,ma( ,os}) Installation LocatfOM O"er ¢ let Sara naairAb�cema da au m solar dYr is e�Yar+aN da aw JA �/ vrvw tixa�a is aYar.apge am dww le twtl of `� �y 1/x} 1 1`a f.A e sti'CE Lzr BOWL IrAw-rn S BE USED NO DKOIAME FROM WATBA SOrr=M St4<.tXD W INTO TW SYSTEM SO ANIMAL FATS.SUCH AS BACON CREASE,EARL.OR ANY area aLS 540LLD 00 INMTHE Cam✓ «> SYSTEM e ..* afpftmdPNun- ), ���r^��el Sa q NOORAIN $HOMO BELiSF (VmtW wd bekingsods is goad sabmB* AsajoUrtwn s4emirai*=dea-An ssm be used.bat Ant spVitoy bxautc d*y aro taxi to the bacteria ie the sy- } ATU Installed; A60 install Cate: No LIQU(D FASJUC SCAF"rE*,ERS SHOULD BE USED.(Thasa pradttas VpkWty 4mtlw gwderawy W004A t islet is rexk to ON banana Flsase use dr)-sh"tL) ATU Serial tltutrtE?eC NO HARSH CHMCAL$ORTO 5#R]AXI BE PUT St,'rO TW SYSTEM (j" "B Flpx inAppiat vryaBi Fos"?W'M7*et—i 4mfttn t pookAft t W-) �f Inspectil reement date. ECAt YNAP 4tAMWEM peow"M*mVemment do.LLG xes Y W.#5 PO eD7t 340,{AL'S WfoplOr rn1NF H ro raoagM�kris be VmW dao"Nm Ma.bait. _.L.-= T $88 455 8961 tN 2'62 +2178 PtR O NuMber F=$004 1232 Of 2a422.2419 arAacnai dart+®std b0 ad aacad rynmm sad aar far 00 dse°r E-Msit swosOpewwrooducWcon +�da VIOLATIONS OF THE ASOVE STANDARDS OF' GOOD PRACTICE Rta.butt MAY VOID THE PRODUCT WARRAN''Ty 11"'30 I it i i I �07305 Your state of the art treatment system Provides an ideal way to extend the life of F,y �" of pondkV your dispersal fold and recycle clears wastawater back into the groundwatsr. inswfisma can discover minor pn sits that could cause your dispersal asks to gniticant aey t"$ tNid ro >iTe gQ the water WI resulting in considerable repair or replacement costs. inspecting and slow tlrore is soma other lN'Ith with the stilt mwntalnktg your system property can tiro ea elify Woneasis its Me,save motley,protect k 091 cAtWd they do d gertaralty do not to is: Below are of this Items s we checked, Plans carefully and W us know if you have any quosdor& L. Treated wastewater of vOnt analysis; 60, �Ph, °F Temp. A Vkre this housing to the and the blower for iso treatxtseat, milk aM*ahova or unusual or tti far arricai below 7 may a i Pr and the tearing may P any hsl ovaksate Con ,Stem ,acrd cal txrrr o trot ap to be in good Circler, M.Based on out visual inspection,your system do"d does not to us to be B. The electrical pa nai switches and alarm were ct asked a do not seem to be end Properly with the Proper quantity and"My of w*sW~. working Property You,you septic tank Pumper or your system contractor may can any tine to discuss this n report Whonever your tank(s)needs pumping,ask your pwnpe to dean and replace C.The water fence in the T treatment u' d does not any of that MWs as needed,Check the integrity of the tank and its battles while it is mar to indicate,there is adatluatia air coming tr m the blower. empty. The tank(s)do not need to brs emptied completely because a Mai Itbiopicai D,The aerobic vent p Pear its the operating�. An aline on�bottom helps the tseatnent to restart qt r when the system is Put hack obstructed vent wit reduce treatmertt kivels.The vent holes or o into use paring should be equivalent to a 3"Pipe. We did not enter the tanks or use equipment to examine mound corm.Our inspection of your system included the primary observable indicators stet usually indicate E. Them was s n septic odor, When the aerobic system is working well,it the system is or is rest working Property, Our inspection certainly Cannot guarantee there receives to test the quantity and quality of the waste Wad it is is nothing wrong with the system or that it may ise sooner than expected. Tiostmest recanting,A odor is normal, y,on heavy use d Conditions' may change 0 titers are sig ' in wastsweler quw*Ly or quality. Read the notice on the back page for good wastewater Practices, C44 your syslem F.The water coming from the FASTTn uniti f was not dean, Clear water indicates installer or service Provider it suspect Problems with your systain or have any tlere is good quality water craning horn ire of prercess. Property treated questoft, waster should be clear of solids and may have a slightly cloudy appear We appreciate the opportunity to you safeguard your system.With proper G.S�i swipe depth b your ptb tank and it appears mannent !care your system can perform sabstaetceih for many pumPirg. The septic setting tank should be ptmaped in b rd water l in ins tank p Comments&Suggestions: pumper that each Compartment and tank should be pumped the septic sottlinl;compartment or talc needs pumping, H, The th tiro doers not r to be correct An Massed wow may i gtound mater may be entering the tank from your field or them may be leaks in your tank. A low water level also may mean your tarok is leskiog f. We looked for cracks or leeks in the lank nsers arc manhole rovers and do do not a to be nrm oal. may allow water fns enter your tarok and overload your d#wwl field. Jp�� Ate ~a~ TTOi County 'g ..X Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 53707-7162 IONA'~ 5~ 057 Sanitary Permit Application State Transaction Number In accordance with SPS 3$3.21(2), Wis. Adm. Code, submission of this form to the appropria vemm /V A is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are itte the Department of Safety and Professional Servies. Personal information you provide may be used for sec Project Address (if different than mailing address) purposes in accordance with the Privacy Law, s. 15.04(1 (m , Stats. , I. A Eication Information - Please Print All rb P 6 J Property Owner's Name , Pr r/ QP~gCoO~! P~ q1~' Parcel # Property Owner's Mailin Address UV7J y Z~ Property Location 3oz9 City State Zi Cod Govt' Lot P G~ Phone Number r= / /e„s, L Section b J L~ rcle o H. Type of Building (check all that apply) Lo T N; R E r W or 2 Family Dwelling - Number of Bedroo Subdivision Name Ok ab 1__ _L B k# 49 ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of kM-- awn of yam/ III. Type of Permit: (Check only one box on 116e A. Complete line B if applicable) A. ew System ❑ Replacement System YTmalZt/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) A ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil Holding Tank ❑ O er Dispersal Component (explain) •retreatmentDevice (explain) V. is ersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation U. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units 2 New Tanks Existing Tanks Cg y Septic or Holding Tank Dosing Chamber 7 N/ VII. Responsibility Statement- I, the undersigned, assum a ponsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's MP/IvlPRS Number Business Phone Number ) Plumber's Address (Street, City , State, Zip C de) ~-Vftl` oun /De artment Use Only kV,Ap proved p ve $erm~it jFee Da Issue Issu' gent Signa re ner Given Reas r Denial • Al u/ TX. CondiSWUPAVV for Disapproval n /I 1 Septic tank, effluent filter and 3, a~t~lQ.~. ! Fa/e, to Tb Aet.~ e dispersal cell must all be servloes 1 maintained r _ r as.per management plan provided by plumber. 1•~"' MQ''~ u~. atd' on . A4$ e~ack requirements must be maintained reto(ras Attach to complete plans for the system and submit to the County only on paper not ess than 8 1l2 x 11 inches in size INhq~y ~~a~. , SBD-6398 (R 11/11) Q PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarae Road Hudson Wi 54016 SW 1/4 SE 1/4S 36 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION Common septic BEDROOM 4 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 750 trash/Hoot system DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA # of chambers BENCHMARK V.R.P. TBD ASSUME ELEVATION 100' ❑ BOREHOLE O WELL * H. R. p. TBD Yost Drive Pro 4 Bedroom 30' House Trash Tank/Hoot System 100' 262' Sanitary Easement 445' Property Line Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 4/20/13 Owner:Kernon Bast Location: SW1/4 SE1/4 S36 T29 N,R19W Lot 8 Cottonwood South Hudson System type: Hoot Pretreatment System Page# 1. Cover Page 2. Plot Plan 3. Hoot System Cross Section 4-7. Maintanance and Contingency Plan Signature - z U License numb 26900 PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarae Road Hudson Wi 54016 SW 1/4 SE 1/4S 36 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION Common septic BEDROOM 4 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 750 trash/Hoot system DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA # of chambers BENCHMARK V.R.P. TBD ASSUME ELEVATION 100' ❑ BOREHOLE (DWELL *H.R.p. TBD Yost Drive Pro 4 Bedroom 30' House Trash Tank/Hoot System 100' 262' Sanitary Easement 445' Property Line V009-H 3113 95_v2_9z2_008 OLOZ *Nv (13SLA38 0 \ OSL*S IM '>1308 N301VLW OL AMH Sn 9LL£M Z anod-lsod 3ivo oloz avnNVr 31va -,`dnN` II OI1d3S w o Ugg 21nOd-38d „0-,L=„b L :31VOS WiS ~e NMvaa 313ND m OdO 009 b 009-H N \ w w o O W U F"I U) F Z cn O O a Om W m a O C/3 F- C.D Q a o ~Z. w o a Q U N pC; 6 C.) J Zv N w O LL O. ¢ x m vI-i m z>¢ p O V J3dps i j~ N ak f Q ° W. o O O N F- M F 0 m £ = CD LLJ N. \r~ ~a isz Y~ o a Q E 2 `o. WWro" W N~ a° CD U) V) VW) C.) X pQ y (n . M° ¢ p CD Y D~0 ZOwar Q~ Q Z 3 m U_ m Y WF_ W F- W -1 > Z N o z V I¢- U A - ~ Q - i J N N W U W F- Z Y w W 2 Q JUJ W~5 U r f- D 0: d o W svo us, F W „£9 do m N 7 I l o A (n r I E~ p W O „0l i O~ N x W o r \ 1 F w I I I svo w-V $ o ,99 do U J ¢ Z_ U_ <t „L5 z a ,OL Q N Y Z F- H10 T TREATMENT SYSTEM INITIAL SERVICE POLICY ~ n Our Company, p maintain the Hoot Aerobic System ~e xe M b //t `J will operate no located at~ G YJST" G6 t 8 Coo 1-4 (legal description only) Permit # for the period of 2 years beginning and ending This contract will provide for all required inspections, testing and service of your HOOT Aerobic Treatment System. The policy will include the following: 1. _ inspections a year/service calls (at least one every Jo months), for a total of V over the two-year period including inspection, adjustment and servicing of the mechanical, electrical and other applicable component parts to ensure proper function. This includes inspecting the control panel, air pumps, air filters, diffuser operation, and replacing or repairing any component not found to be functioning correctly. 2. An effluent quality inspection consisting of a visual check for color, turbidity, scum overflow and examination for odors. A test for chlorine residual and pH will be taken and reported as necessary. 3. If any improper operation is observed, which cannot be corrected at the time of the service visit, you will be notified immediately in writing of the conditions and estimated date of correction. 4. The Homeowner is responsib for maintaining a chlorine residual of at least 0.1 mg/L in the treatment system. This can be accomplished by using t tablets designed for wastewater use, NOT SWIMMING POOL TABLETS. Upon visit, if the system needs chlorine service provider will add them and charge the customer. If the customer fails in their responsibility to add the chlorine tabl are in violation of law and ap2by 'at action will betaken. Initials of Installer Initials of Homeown5. Any additional visits, inspections or sample collections require pecif ic Municipalities, Water/River Authorities, County Agencies the TCEQ or any other regulatory agency in your jurisdiction will be covered by this policy. At the conclusion of the initial service policy, the Service Provider will make available, for purchase on an annual basis, a continuing service policy to cover labor for normal inspection, maintenance and repair. According to state law, all owners of aerobic systems must maintain a factory authorized service provider for the lifetime of the system. With 48 hours of a request for service (weekends and holidays excluded), your system will be visited by the service provider listed below or their authorized agent. If there are any items which need correction and can not be immediately remedied, the service provider will inform the home owner, in writing, of the conditions and the estimated repair date. The HOOT Homeowners Manual must be strictly followed or warranties are subject to invalidation. Pumping of sludge build-up, for reasons other than due to warrantied mechanical failure, are not covered by this policy and will result in additional charges. By signing this form, both Installer and Homeowner agree to the terms of this policy. By signing this form, both the Installer and the Homeowner agree that the Homeowner has received a copy of the Homeowners Manual and the Installer has made a reasonable effort to explain all pertinent information to the Homeowner. HOOT is not responsible for service, it is the SERVICE PROVIDER indicated below. HOME OWNER SERVICE PROVIDER lu, l 1, S/ aJ Name Name of Service Com any Re r enta e A¢ ess /n, ~~~a ~ Address gy / y^ ( city 1, Phone 7S'at5e of Home er Signa f Service Provider and License -6- POWTS OWNER'S MANUAL & MANAGEMENT PLAN page - of FILE INFORMATION SYSTEM SPECIFICATIONS Owner / y Permit # ank Capacity al ❑ NA Septic Tank Manufacturer ❑ NA 3I=SIGN PARAMETERS Effluent Filter Manufacturer ~q Number of Bedrooms 9NA Effluent Filter Model ~ NA Number of Public Facility Units Wank Capacity s al ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer ❑ NA i Design flow (peak), (Estimated x 1.5) gal/day 4 O NA Soil Application Rate al/da /ftz Model G ❑ NA -laump 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) 5220 mg/L *A Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) NA Biochemical Oxygen Demand (BODs) s30 mg/L ❑ In-Ground (gravity) 0 in-Ground Y) (pressurized) Total Suspended Solids (TSS) S30 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 5104 cfu/100ml O Drip-Line ❑ Other: Maximum Effluent Particle Size ll3 in dia, ❑ NA Other: Other: NA NA Other: A "Values typical for domestic wastewater and septic tank effluent. Other: A MAINTENANCE SCHEDULE Service Event Service Frequency r r- - !inspect condition of tank(s) At least once every: I~Lmonth(s) D ears (Maximum 3 years) ❑ NA 1 414111 IPump out contents of tank(s) When combined sludge and scum equals one-third ('fa) of tank volume p NA Ilnspect dispersal cell(s) At least once every: p month(s) (Maximum 3 years) 4NA I-lean effluent filter At least once every: CI ❑ m year(s) ) NA ~ Inspect pump, pump controls & alarm At least once every: 6 ❑ yeoar(s)s) ❑ NA 1=lush laterals and pressure test At least once every: p 13 year(s)s) o NA Other; 0 month(s) At least once every: NA ether; ❑ year s) b A MAINTENANCE INSTRUCTIONS (Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master (!dumber; 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 1-agulatory authority. l,Nhen the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of [he 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, land any servicing at intervals of s12 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. 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 thElt may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thj: 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 bye discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluenlt. ro avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to thle 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 tPOn drat : antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat (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 propel-ly 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 scull, 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 complhont 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 requhled 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 rulesi 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. locate a suitable replacement area. replacement no eplacementparea is available a O holding tank may beeinstalledlcas ❑ mThe site ust be has not erformd been p 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 TREATMENT ANCES. DEATH MAY RESULT. RESCUE OI A TANK ENTER A SEPTI TI PEUINTERIOR OTHER A TANK MAY BE DI F CULT A MPIRCUM E. PERSON FROM OF OR ADDITIONAL COMMENTS ce POWTS INSTALLER POWTS MAINTAINER Name Name Phone J~ Phone --OZ y,~ [Phone TAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY , ame Name N r 2/ J e_ az _ s`• Phone This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. 8 1 4 9 5 0 9 Document Number Document Title Tx: 4121569 St. Croix County 977283 AEROBIC TREATMENT UNIT (ATU) BETH PABST SERVICING AGREEMENT REGISTER OF DEEDS ST. CROIX CO., WI tate Plan Transaction Number- RECEIVED FOR RECORD IXPJtA T BAS- 04/22/2013 2:47 PM Name - (Owner) Typed or printed EXEMPT Being duly sworn, states, under oath, that: REC FEE: 30.00 He/she is the owner/part owner of the following parcel of and located in PAGES: 1 St. Croix County, Wisconsin, recorded in Voluma~7c3V Page Q, IG, Document Number Z&( St. Croix County Register of Deeds Office: Recordin Area A parcel of land located in the SW V, of the Sf % of Section Z Name and Return Address T*-I_ N- R 941 W, Town of 14up t #4 St, Croix 10-Rili eA-6C County, Wisconsin, being duly described as follows (include lot no. and 9111114 LA RAW PWAO subdivision/CSM or detailed legal description): 11405M squaff LOTS CoivaQww& gouw - -rhwo OF wuOW 141141 - 08-ea9 Parcel Identification Number (PIN) 10T-C90% COUorrY - w yCoAJ % W Agreement Date: - 11 -Z0~3 As an inducement to the county to issue a sanitary permit for a POWTS equipped with an Aerobic Treatment Unit on the above-described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of SPS 383, Wis. Adm. Code relating to Aerobic Treatment Units (ATU) and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) technology. If the owner fails to have the POWTS and ATU property serviced in response to orders issued by the governmental unit or the Department of Safety & Professional Services (DSPS) to prevent or abate a human health hazard as described in s. 254.59, Stats., the governmental unit (St. Croix County) may enter upon the property and service the tank or cause to have the lank to be serviced and charge the owner by placing the charges on the lax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Slats. 2. The owner agrees to maintain a contract with a licensed POWTS maintainer for the life of the system. The POWTS maintainer will perform periodic inspections and maintenance as required by the manufacturer and the DSPS, including, but not limited to: the blower, electrical controls, and treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254.59, Slats. 4. The owner recognizes that the county, DSPS, or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. 5. The owner or the owner's agent agrees to report to the department or designated agent at the completion of each inspection, maintenance or servicing event in a manner specified by the department or designated agent within 10 business days from the date of inspection, maintenance or servicing. 6. This agreement will remain in effect only until the county office responsible for the regulation of POWTS certifies that the aerobic treatment unit no longer serves the property. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shell submit this agreement to the Register of Deeds• and the agreement shall be recorded in a manner that will permit the existence of the agreement to be determined by reference to the property where the Aerobic Treatment Unit is installed. Owner( s) Name(s) ease Print Subscribed and sworn to before me an this date: ~JI ~r`~ ly. Z o~ Note ri 0 is ' lure(s) Not ubl-ic- n- b5- Govern enta it 0 ci I Name, Title - Please Print My Commission Expires 0 ~ Governmental Unit Official Signature Drafted by: U) Cf WKbAj T. $4151' 0 Cr Personal information you provide may be used for secondary purposes [Privacy Law s. 15.04(1)(m)) - "THIS PAGE IS PART Of THIS LEGAL DOCUMENT - DO NOT REMOVE" This information must be completed by submitter document title. name & return address. and PI (if required). Other information such as the of 1 granting causes, legal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document Note: Use of this cover page adds one page to your document and $2 00 to the recording fee. Wisconsin Statutes, 59.517. OX . SIPTIC TANK MA33*kX AGREEMENT ~ . • ADD CON MAT CR CATION .FGA . Iviai3i g Addreit _ - I& AD ii Address WI . ~eri#iration ~ fpm 1'Ianaittg & ~c3r~ig Deisa~rtni~st fvr riev goiistian.) ~tt3!fS e:~ t1.~ ~ Percet Ident fcation Nwnzber QZCI ~ . Property LxicWoU 1l Sec. T A9 'fnwA t?f A✓ Subd~vlsion Wwaab Sacs . , Lot g CertMtA Survey Map Volume: Page i . . Wwmlty D.eed.# 'volume Page Spec house Lot iirizs idt~le ~ lnvt~oM we aw xmi a of our saptx sy could' su t'i~e its p fsiiirra; to.h adle'Kas#es. Proper znaiotenez ofptt yg out t3se'segt :taak every ft4 y ftt ors ifaee tl,-by a iiae cd ps~er. 'What you put into tile; system tain.a%ct the fuwtion of ft septic tm* as it areatrr t e 1 tv W;aWAiisposai'sysfertr: C)cv'= ss1austenauce respoasibiiities art specified iii $Co . 81.52 -1) and in a4tei 12.- St. ~Qr6ix Coanty. $urftry. Otdiumce. The 3~ properwowneur agrees to.bxoir.to 5± Croix County Piing & Zon'rrg Depaidnent a ter ificatioo foiw- signed by the owner and by:a maebor p1 aebei,. joumeyvian git . rest ecd phrmber.or a licensed lnsmper vaitm. g that (.3 ).the on-site.. v~ stcwatar_dicposal~ystem is in proper epesatitag ccxri oin 'or cz ft ' insimtiou atu3 puts (afrtecessary~),. the se}~tic t?stk is less than W. fun of studge.: Uvwe,'the rindersigned have read th,e above icgftements ltd ",to mah t the OhIte sewas a `disposal system with d ataadards.sa forth, hewn, as'. et by dk.IleY~artt=t bf Cam ca mid. t#to D%WMWAt of Xl'abZ*1 Res~cOS; Stste of Wisccinein: Cc>rirficatit,sratstig that your septic systrsn has been ztaiaed =W ,be coated and retarr3ed to the St Croix, County running Zoaiag. Dc t ~vithii3 3t3 da~rs.ofthe.il~iee year: expimaon.'date: Uwe't ernfy itcat ail state is era this foriive t~~ze.fo. a best of a>i8u~ is vvledge. V%v aw/r~ the o.waier{s; 4f +hC prou"descry ve,. by vitto of a Awral Itir deed rpco= ed in of Deeds (3ffre: N' S OF: APPLICAI~ T{S j DATE J mx~~ ,Y?nfarmatiou "th that is sf~ted may result e.sarritary'p eat& be zg rOVak$d by the Ftaonirtg .Zo> g Depait ne. irrc:iude;~ utr z aplrlirauoti a recordedyvs~trarcy did do ti>e ltegistes of Deeds , and a copy of the certified survey .map 6 ;refeiixm made in the iviretety.6eed. a UP OF =l........•ay C5 . °.°v > •R•a. >w••.r. E LEVA T `A,.o. •.A a•a.is.•aesas,•Aa ~ ~ •4'. 10.57 ,96 . assa s.s ..tw 189-434 I i -E 999, _ ~R'A4Yw w °T°^awT +e. ~'~na e. ^M+WS..ae Rive IY83*4642 1005.150 Aafva ^+.e ...gnwnee >..v, a........ wry aY~`b'.rs a.~ R aw .y `..w ...i> a°. = ..................A•.......................... ~.A Of a.=l..tffe. =Ay Rw =.1a.a aAV aa..•.. s.1.. S89*52'58'E 135.004 TLT 0,73 ACRES v FT. 0! 311909S(2. FT 0 1.00 8 co) p 3.27 Acres N c 142,341 SO. FTa mRnO C Kic OFMO O'~it+ GS , NBW52'58 V4' 150.00, 222.14: rARY SS; y ....aa..~.Y~..w.....~.asa..~a+arr le www..w..R.sa...aew.rR•a..~ .w.~ea..w... T S89"52'58'E 573.48' ° "~`'=+swws.~,~s> R.to..a«+...•.oa..a...ra.ssssa..wa: +ra:wr.sa..w7:..7.r,{•.wwwas.w.aF.Y..Y89*5Ca'"8.%575,sir; R/g .awwa.w awae..+.aae I WATER MARK 8 M ,3'r 372a7W N 8903325"E 1326,80° LOT CORNER 1S J SOU'K'! OCCUPIED 8Y TREE 1Jr]lpIS' J~ ~ III Lnz H D) - AL•4zb M1.Eq[a00s s~o M,EO•L0.00S 51'LEI ld.OLWMJtI ' ' .E4 'fb6 M.LOd0.00S Sri y acme u•cu OR roxxt : rc~olAn.zoLOOOE W 1 :6005 t ~ r g 1 ~ g .~ezoz M.Eacaoos g W sz I F' SE 09 N ~ all c~ I j5^ z r Ln z°~aoos i o Ole•~oz •eccai OrM AhML0.00S ♦ Sb~r c 1 ~ ti.R U 27 39 P 3 16 78E►109 `3 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Docurnent Number WARRANTY DEED 01/28/2005 03:15PE WARRANTY DEED THIS DEED, made between Neil L. Wilcoxson and Mary Jo EXEMPT 11 Wilcoxson, husband and wife, Grantor, and Kernon J. Bast and Donalda J. / Speer-Bast, husband and wife, Grantee. REC FEE: 13.00 90 Grantor, for a valuable consideration, conveys and warrants to Grantee TRANS FEE: 4212. COPY FEE: the following described real estate in St. Croix County, State of Wisconsin: CC FEE: PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2"d St. - Suite 115 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.-Wilcox4Gn * Mary Jo i oxson AUTHENTICATIIQ i UIp~~C 1n ACKNOWLEDGMENT Signature(s) ~O 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 ]clown 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 *Chen Town 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 3/11/2007 } (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 '/4 of the NW '/4 and part of the NW '/4 of the SW '/4 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 N00° 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 N89'26'5 8"E, along said north line, 1182.70 feet to the east line of said SW '/4 of the NW '/4; thence S00°2 1'37"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 S89°26'58"W, along said north line, 10.00 feet to the west line of said plat; thence S00027'24"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 N84030'41"W and measures 250.16 feet; thence westerly, along the arc 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 '/4 of the SE '/4 of Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; described as follows: Beginning at the South '/4 Corner 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 '/4; thence S00107'02"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. 4 - Bii-[wa Rwasaueo 9uouwnaba MWOMM OU NMI`" 89LYPB89lL +YVd 99919'I N rnlAQoa&i l0 9JMON&WO aHY91Holm 77,BYMO anoxe 809aom MAN 'NOav3vaoeu~zO9agoou190bu79wnt !9L►•869i(L+9XOHd JAIMUNNOYH O! 999HtlM 1,L08POHd w~ xHV9a s7elsuoaese,loM Sl anovO SO8a08Y8 BY9a7U18 NOJHNf-dgOSOSS:uMLA JWffdYS nOA RL706" HIMJ3O 89ao07V0a'1 OL 9aNYY1dYYaD 5000 a7flWPH1aY 8T•40W 6 . w~ .00 19" Hands lHacmfls YqC l ` 'PIYaWM1Ytl0 lVtla. 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DIMENSIONS, DEMONS AM MR ALL Y y i 4.OB•1$ APPMCARLBOOD900 RRRGUR R GROUPW NOT REEYOMAl-YOR ANY pWl OBTTH&R$3ULT3 YOU EXPECT WWW.$ROROUP•INC,Cov pppp PROJECT: WARNER 198NAORNDRIYB PHONT. 718-898-4781 NOMMOODIMIORREOTINPORMA4ION. 4 M WOODYlLI•S Wf. 61848 PA%7}f.BBA-47N9 DUILDERDRM)URUR 6ROUPOWAAW.RKHMAN°f[1PM HTR OPTHIS DMWING ANV DVPLICATIONB OPTHIS DRAWING iS ILLBOAI. 'IVDf' 181 DN[MVea B114LtlO8NDLLVJI•Id{Ia ANB bNIMVna 81144 a0 tfLtff9-ItL XYd 89079 'IM'97TIAdOOM aixDnlAdO:/axv B4aOle•rlvsemO anDeo sOeDOeee BUaa~nM In NOavlaaoaNlaaaaxoON[aOON1BBIW Jt6f-tfJ-fJL +aHOHd HAIHOH80YAtaI UHN7IVM 1ioaroTId Lnv xotlt'IBIBNOdRON Ot m aaoao 9OBn sMal no NOO'OHI•42090991AU /d d08dX500d &L7129$88ILL JRO ~ i C5 BfauO avow oLBONVrlanm saoOSlevOruar ST-90-9 ~I y O •rrva~oa~ Nanl~a ~y eN d110?IO dOX40Sdtl S?Ia Q7ll1S eHOI6[A9N SSNOO ZSdH-8HHd8 47IHQ'IIflfi Q 00 r7l a H a a w a a i , 'TJpa'1'I181 oN41AVN081N.LiO BN064wJndn BNMO a WV'tlN7eAYaO 8uLL d0 BBii•Ba9SLL Xvd Bd06a'utlwlzlA000M 0~0 scNUroxdw aNVBif(DMTIV MOxtl aDartoasa BaaDUn4 JBLFBBB-B[L ~NOHd xAIRQNxDY$SBt UaNUVM wgrona g ~l W NOl11*0 NIJaa81100N180 DNIBB[W µ ANYaD68'a118NOd6aa.40N 8l dn08b 808n098a8aaVlNfl IrOnnN7 dnONnNx'AL11M ,L08dXxnOA By7n6SitxN.B ~LxD 8T"BO.4 q ~ a O saaoD~vomw.aDNVewwooaaoDa~avanaae '1'IY 80d ONV8NDf8f0'8N0ISNaN10'BNOLtVDIdiDadB`MaaStlN Comm ajanosau sx'vQ7ing 6NOI6LA9a ~ssNO~ssva-a xs ~saazme m rrvdo xovsaxv Ld~vana.aaNNOncoaovawoo I7B g•fi .BIL I•~6 u$/T B- i ~A•~8 Nwnzoo ® ~ NBI(YIDO o !I w 011 a N n ❑ ❑ z .8/B 6•.OL e f Standard Eroslo n control Mar) for 1 2-Far>ily Dwelling Construction saes According to Chapters 1LHR 20 & 21 of the Wisconsin: Uniform Dwelling Code, soil erosion control information needs to be included on the plot plan which is submitted and approved prior to the issuance of building permits for 1- & 2 -family dwelling units in those jurisdictions where the soil erosion control provisions of the Uniform Dwelling Code are enforced. This Standard Erosion Control Plan is provided to assist. in meeting this requirement: Instructions: 1. Complete this plan by appropriate boxes on filling n requested information, completing the site diagram and marking 2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading. Water runoff patterns can change significantly as a site is reshaped. 3. Submit this plan at the time of building permit application. PROJECT LOCATION oST ORS.- t~uu.Saa -INSiN BUILDER :S A?& [.A1lD& Coy$"tQuCT ER NOS 7. Q Please indicate north by com letin the arrow. WORKSHEET. COMPLETED BY JrA&wJ BAS- DATE 4I 16121513 _N_ SITE DIAGRAM Scale: I inch Meet EROSION CONTROL PLAN LEGEND.. 1 'PROPERTY LINE, p EXISTING. DRAINAGE 1-177 TD TEMPORARY DIVERSION'" FINISHED DRAINAGE LIMITS OF GRADING SILT . FENCE STRAW BALES GRAVEL O VEGETATION SPECIFICATION TREE ® PRESERVATION STOCKPILED S 1 SOIL Pr<. b%%UZNAQrA < to,ow sowt Ply m EROSION CONTROL PLAN CHECKLIST 0 W V W Check (V appropriate boxes below; and complete the site diagram a Q with necessary information. ~ Q O V Z Site Characteristics North arrow, scale, and site boundary. indicate and name, adjacent streets or roadways. Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ Location of storm sewer inlets. Location of existing and proposed buildings and. paved. areas. The disturbed area on the lot Approximate gradient and direction of slopes before grading operations. Approximate gradient and direction of slopes after grading operations. JA ❑ Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices ❑ Location of temporary soil storage piles. Note: Soil storage .piles should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be covered with a tarp or more than 25 feet from any downslope road or drainageway. Location of access drive(s). Note. Access drive should have 2 to 3 inch aggregate stone. laid at least 7 feet wide. and 6 inches thick. Drives should extend from the roadway 50 feet onto the house foundation (whichever is less). J " Location of sediment. controls (filter fabric few ce, straw bale fence @r4 0-foot-wide vegetative strip) that will: prevent eroded soil from leaving the site. SNvs m#QL ~iQ6rp4~cW ' ❑ 14 Location of s nent barriers around on siW torm sewer inlets. ❑ j~ Location of diversion Note:' Althoug'h^'no ec quired by coder Lt is recommended that concen- d -5 d flow ( raihageVvays i! diverted (re-directed) around disturbed areas. AAand `runoff (sheeei . adjacent areas greater than 10,000 sq. ft. should also be diverted aroun disturbred areas. * ❑ Location ctices th will `*pplied to control erosion on steep slopes (greater than 12% grade). Note; Such practices Mdude intainingyexisting vegetation, placement of additional sediment fences,. diversions, and 're-vegetation by sodding or seeding with use . of erosiorycontrol mats. ❑ Location of practices that will control erosion on areas of concentr#ed runoff flow. Note: Unstabil* drainageways, ditches, diversions, and inlets shou be protected from erosion through use of such practices as`in-chan.nei fabrieor straw bale barriers, erosion control mats, staked sod, and rock rip-cap. .Wben used, a given in-channel~arrier should not receive. drainage from more than two acres of unpaveckarea, r one acre of paved area. In-channel practices should not be installed in perennial streams (streams with year round flow) ❑ 1~1 Location of other planned practices not already noted. r A - cit J m ~ V U' Indicate management strategy by checking (V) the appropriate box.. a - a Q 0 z Management Strategies ❑ ~$J Temporary stabilization of disturbed areas. Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1. and September 15), or by other cover, such as tarping or mulching: ❑ Permanent stabilization of site by re-vegetation or other means as soon as possible (lawn establishment). • indicate re vegetation method: Seed ❑ Sod Q Other • Expected date of permanent re-vegetation: Re vegetation responsibility of: Builder Owner/.Buyer • Is temporary seeding or mulching planned if. site is not seeded by Sept. 15 or sodded by Nov 15? Q Yes ❑ No 41A ❑ Use of downspout and/or sump pump outlet extensions. Note: It is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement D Trapping sediment during de-watering operations. Note: Sediment=laden discharge water from pumping operations should be ponded behind a sediment barrier until most of the sediment settles out. - I~ Proper disposal of building material waste so that pollutants and debris are not carried off-site by wind or water. Maintenance of erosion control practices. • Sediment-will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the height o f the barrier. • Breaks and gaps in sediment fences and barriers will be repaired imme- diately. Decomposing straw bales will be replaced (typical bale life is three months). ; • All sediment that moves off-site due to construction activity will be cleaned up before the end of the same workday, • All sediment that moves off--site due to storm events will be cleaned up before the end of the next workday: • Access drives will be maintained. throughout construction_ • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. For more assistance on plan preparation, refer to the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW-Extension publication Erosion Control for Home Builders. The Wisconsin uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through... the State of Wisconsin"Document Sales, (608) 266-3558: Erosion Control for Home Builders (GWQ001) can be ordered through Extension Publications (608) 262-3346 of the.. Department of Commerce, (608),267-4405-