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020-1479-11-000
NOTICE TO OCCUPAN 1' AWW Inspection Report a kdee rmttbs keA9wRr»uwtep56m1 . 5atyecs RA#T4+y�onm.Yar,cy to mad is frne,.yrse maa aP�r o �rc Yw:�trpmtm enre ffir�ewAaie ��[ arc+s?'r+wr. tl'+anwa. ` Private©nsite W" ter Trigla mart System I Individual Suksurfte Treemont S m tit ssViomi tu tw wxyau. bz iaaea s � c da t> Thank you foreffowfng us to help extend the iffa oryoursysteml utA ar • , cF Let us know fr you have any s. is m pbe eE siroda.to bt wet W&6(ow dw s0 as i "Mamm ae t&#s is our report to yofr_Please read t are Lily sw P4moss 'ratrarH�oroi6er orate t6a ut;a4e a aqy�q er,r�tatme eawa as des epee; tag.art a((WMMV lac Me a Fimeon;A 1 aed FAe abt Installation Location: Owner, +�3i may/+/^� PARa 1R06tACfS Gl f f V�e.raiie+wk4 ppa proea.w.Soem narid bicmeie da cat as aeAa.O'er'�ytporc wrd Wttafae em ees Ero'ldr wro W etleeab pwi`�worrtM�+*�roNxl ekes a Iag time w 4e,icduwe dw so tlr ixrwred tie sa or _f`"'`•°' waaty+tp. NaTacsr aowL TABL E7S sHtxn.D BE USFD MO DISCHARGE FROM WAIU S01rMERS SWX.a.D OO WO TM SYSTI2A.. J' NO ANUAL FATS,SUCH AS BM)DA OKSASZ.LARD.OA ANY MUM OILS SHOULD OD two Tkjx SY ors �wtwmxi C �� (� { A-'Ulndr. Sampling Weeded; /L/O #O DRAIN CL UJ$EK3 SHW LD BE USSC.(VwtW Md Wang iaiP is VMd dLL6stiRRe.As a Fin Cason dmTuW aeon cteamm can be uwd,but am because arc to=wNre �n4IY �5 bacrottN to the ) ATU Installed: 1 r ? Instep Data. NO UQUO FABRIC SMENMSMUMBSUSED.{7lrise Ps el hIM Y corsair yumstaary emmar4a whieb is toast to ow Weaa'k Ntane of*ya o ets.j ATU Serial Number. 1YO HARSH CNE19CA45ORHttXlttB gf.rUY Fh'tX?It1E:SYSTB►t (ih flaw.. wWei pld�t d - Itiidc tpmfcdaet ecsd Inspectio greement date: 12-42y'lel YM Home r Potw"M nt Co.LLC Y _ NUrtJ � . _.. PO9wt340 421 4YltW0 r .r M571i>21 Tot$111111455401 ot 2624W,4410 Falc 282 ct 2424824416 aaaiftab t1 do+tBr1. mrwe-Ww -thatwnned "Oft aadea. Far � Oa71 *PU WOMW Date Cotta VIOLATIONS OF THE ABOVE STANDARDS OF GOOD PRACTICE Amami MAY VOID THE PRODUCT WARRANTY /�—.,-7 3.a ram Your stag of the art treatment system provides an Weal way to extend the life of field, p M6° your disp9ml tali and recycle clean wastewater bock into the groundwater. gignificent pond- t mat.the WSW In Cdons tea d minor,pro that could pause your dispereal field or some ptnbiern olds the fail reaarfiUtg in cori elderable tefrldt'Of t eftentertt costs. ItSpsCdrig and tank aria they do 1 mainfal"yourvlu *tart W ft Ift save mom,protect K Vys vaatar wefts,and Maptove tits environment do ' Below are of the ifems we chooked. Please read olinsfully and let w know if you �'°" a have any q L• T 04,,...!c 1, F Temp. Dissolved t7 is requie f eerstrir r►tit0►it,pn si�nif w*above o A.YNe tte blawar to dean the After and OW-k the blower for below 7 may a t t p"ieseend loll tsrAi�114�8 y uunrt rat $. at I or I � help evaluate any con and i osnnio do do not to be in good order. M. on our visual y to us to be Working properly with the PWW quarley A09101011111by Of B.The eiedriCat panel switCrnas eras slosh were chocked ar�do not sawn to bat voce ele ical by you,yw septic tank pumper Or you syatm oorxr bow may CO any time to its ML"" report VVh anever your tank(s)needs puanPOV,ask your prunpo to dear and roptsce C.The r turbid in the BRp NAC3?n treatment dose not any fl as too' of d+a milt aria its baffles vie t it appear to indicate there is adequate air coming trom the bipwer, entity. Thy tarkfsl do root n i to be t-, f t�Ir sludge on the bottom helps the Ulastment to esr quickly titar he sysism is cwt back 0.The seraft vent POe lobe operating - An ift use, ObWuCW vent will reduce liestment is rats,The vent or oper inxg should be to exarmiM nd rxxrnponenta.Our equivalent to a 8' We dal not the or use equipment t W Ours inspecdon Of your system in#uded the ry oblauvable Indicators fit Thera was t e cot odor, When the system is well,it 00 is or is not wo*KV pnopetiy. our cannot guarantee Own receives to town the quantity ana quality of the vaisto load it is is nothing%TWV suit,th� that it a fail sooner than aaseect ed. T q tY- A musty odor is normal. Ny,on heavy use Moo tq Your Read to on the be&Pepe suspect Mb*-for goal seem S or mars any F: coning from.rte FAST" wane not dear Gear water 'treated or proves t you v there is good q be of, and may have s slightly Cloudy ap , Vve appreciate �, .VJiCa proper G. in your septic tank and it rs yours ma nu and owe your s satin fo•many years- d idre Thy c setting tank be when the s 25%to 3(ft of the vmSer depth in it*tank advise your Comments& puMM that each Conipartment and tank should be twmped wtrsn the septic wattling comparimant or tit mPirn51 H.The waetsr in the tw*Q dose not r to be Cared. An Wassioad water depth may gmund water may be entering the tarok from your gold or thane may be in your tank. A low water level assn may mean yon(tank Is baking. i. We for o in the tank risers and manhole covers and do do not appear to be nomial. Looks may allow water to onto r ycwr rannk and ovarkied your dispersal W, 1k� Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 563808 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)]. S-1 ��ilra Ili'far Permit Holder's Name: City Village X Township Parcel Tax No:-7 Bast, Kernon J. & Don Ida J. Speer- Hudson, Town of 020-1479-11-000 CST BM Elev: Insp.BM Elev: BM Description: ection/Town/Range/Map No: ,r-- rw 5 gNil —— n S70( 'r 36.29.19.3032 TANK INFORMATION ELEVATION DAT TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark Septic 0014 S �� :(� Dosing L4 H Alt. BM Aeration Bldg.Sewer `8a Holding SUHt Inlet 0/ St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic , �/ 1 Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot.System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Covert Ajq i/ Model Number TDH Lift Fric ss System Head ITDH Ft �S p X00 Forcemain ength Dia. J SOIL ABSORPTION SYSTEM BEDITRENC Width Length INo. PIT DIMENSIONS Ro.Of Pits Inside ' DIMENSIONS SETBACK SYST P/L JBLDG IWELL LAKE/STR HING Manufacturer: INFORMATION HAMBER OR Ty System: T Model Number: DISTFiIBUTION SYSTEM Header/Manifold Distribution x Hole S' ole S Vent to Air Intake Le is Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Fm] Yes ❑ No 5id Yes N No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#17 69 d / 3 Inspection#2: Location: 847 Settlement Drive Hudson,WI 54016(SW 1/4 SE 1/4 36 T29N R1 9W) Cottonwood South'07 Lot 11 r Parcel^^ No:�v�a36.?9.1 `3032 1.)Alt BM Description p/ ypv� a ^k 2XA c J� "'' " 199 f C o esi�= 2.)Bldg sewer length -amount of cover= 2 -1- 3ro Ate:cu,-r Lp Plan revis Required? ] Yes KNO © S Use other side for additional information. Date Insepctor's Signature Cart.No. SBD-6710(R.3/97) PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarge Rd Hudson Wi 54016 SW 1/4 SE 1/4s 36 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 6/10/13 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 400/715 Hoot System DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA # of chambers IL BENCHMARK V.R.P. Top of cleanout ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE SWELL *H.R.P. Same as Benchmark Settlement Drive SYSTEM ELEVATION common septic system All piping shall be ASTM D 30/34,within 10' of tank, piping shall be Schedule 40. Well is to meet all setbacks required by Pro 4 WDNR �' Bedroom House -7 Scale is 1" = 40' a,G unless otherwise noted k �b qq Hoot System jqo 1 ' LO �E 104- 40' cleanout sanitary sewer line for common septic system Property Line le cow ' County t_ Safety and Buildings Division 1''0J 201 W. Washington Ave., P.O. Box 7162 Sanitary etmit Number (to be filled in by Co.) ' `k rt Madison, WI 5370MII 1VED 5 356118 ~O4 '~RTION~~" Sanitary Permit Application l State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriaomt~yp{t„ 7 V0 I is required prior to obtaining a sanitary permit. Note: Application forms for state-owned PO es d``ttbb~~ Project Address (if different than mailing address) a may be used for secondary the Department of Safety and Professional Servies. Personal information you pro xw~ purposes in accordance with the Privacy Law, s. 15.04(1 (m , Stats. 07 1. Application Information -Piease Print All Information Property Owner's Name Parcel # k,e.11 5 6 s- AL f_3L 0 2 a- 9 <i - od 0 l Property Owner's Mailing Address Property Location ,30 ?2) y s ~~Q r Govt Lot CCi . State Zip Code) Phone Number Section 51Y N' R IE on ";,Type of Building (check all that apply) Lot # or 2 Family Dwelling - Number of Bedrooms Subdivision Name 6rte' r&.tAA_ ) 4 Block # ❑ Public/Commercial -Describe Use ❑ City of CSM Number ❑ Village of ❑ State Owned -Describe Use own of t/I4 (41 DA .III. Type of Permit: (Check only a box on line A. Complete line B if applicable) =N.-Syst- ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) Arm A ~E qP b' List Previous P it Number and Date Issued 3. El Permit Renewal ❑ Permit Revision ❑ Change of Plumber El Permit Transfer to New I Before Expiration Owner (O IV. T e of POWTS S stern/Com onent/Device: Check all that apply) TO ~Lou ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. o suitable soil ❑ Mound < 24M', f suitable soil 0 Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) C V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil A lication Rate(gpdsf) Dispersal Area It~~dd( (sf) Dispersal Area Proposed Lo 1 71 (sf) System Elevation ll0 5 g5.3 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units iu New Tanks Existing Tanks A•~ o At w Q 11G l~ o U ro h A w C7 0, Septic or Holding Tank G Dosing Chamber VII. Responsibility Statement- I, a undersigned, assum nsibility for installation of the POWTS sbown on the attached plans. Plumber's N e (Print) Plumber' e MP//MMPPRRS Number Business Phone N 0 `-C l ~/~'rO~ ~J Plumber's Address (Street, City, State, Zip Code) C G VIII. Coun /De artment Use Only Permit Fee D/ate stuefd 2 Issuing entSignature Approved roved ven on for Denial " ! IX. Conditions of A provallReasons for Disapproval w • A4.e.•~w~'eu o~ ~~e~xl rte,,,. ~a ` A ro f~Y t" Attach to compl lane for the system and submit to the County only on paper not less than 8 in z 11 inches in size SBD-6398 (R 11/11) o ,T,NR o Safety and Buildings 1, 141 NW BARSTOW ST FL 4TH ~ WAUKESHA WI 53188-3789 K~ Contact Through Relay www.dsps.wi.gov/sb/ www.wisconsin.gov SIMS Scott Walker, Governor Dave Ross, Secretary November 08, 2012 CUST ID No. 227990 ATTN.• POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON Zvi 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/08/2014 Identification Numbers Transaction ID No. 2170051 SITE: Site ID No. 785818 Cottonwood Ridge Common Please refer to both identification numbers, Cottonwood Ride South Lots 6-11 above, in all correspondence with the Town of Hudson I agency. St Croix County SE1/4, SWl/4, S36, T29N, R19W Lot: 6-11, Subdivision: Cottonwood Ridge South FOR: Description: Addition/Alteration to Existing Pressurizer) InGround, ATU, 6 Residence Object Type: POWTS Component Manual Regulated Object ID No.: 1400535 Maintenance required; 3,600 GPD Flow rate; 110 in Soil minimum depth to limiting factor from original grade- System(s): In-ground POWTS Component Manual, SBD-10705-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01101); Aerobic Treatment Unit, Commercial System, Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats_ The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment S emS",0 06kV% (N.01/01) and the "In-Ground Soil Absorption Component Manual for Private Onsite tew T nP Systems" SBD-10705-P (N.01101). SPS 383.21(2)(c)4. The application for a sanitary permit shall be accompanied with docum~n z 'toat the master plumber or master plumber-restricted service who is to be responsible for the installation or cation of the POWTS, has completed approved training on the proposed POWTS technology or method. SPS 383.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. WILLIAM C SCHUMAKER Page 2 11/8/2012 The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. Per SPS 3)83.21O2(c )5; Wis. A dm. Code, if any part of the POWTS management plan specifies required servicing or maintenance at an interval of 12 months or less, the activity must be recorded with the deed for the property. A sanitary permit may not be issued unless documentation that maintenance requirements for the POWTS technology or method have been recorded with the deed for the property. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VI of the pressure distribution component manual are complied with. A copy of this information must be given to the owner upon completion of the project. A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis, Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. i Owner Responsibilities: • SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4) shall be considered a human health hazard. • SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. WILLIAM C SCHUMAKER Page 3 11/8/2012 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Xcerel, Fee Required $ 400.00 Fee Received $ 400.00 Balance Due $ 0.00 Julia Lewis-Osborne POWTS Reviewer 2 , Integrated Services WiSMART code: 7633 (262) 397-6005, Fax: (608) 283-7481 julia.lewis`Caawisconsin. gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 6/11/13 Owner: Kernon Bast Location:SW1A SE1A S36 T29 N,R19 W Lot 11 Cottonwood South Hudson System type: Hoot Pretreatment System Page# 1. Cover Page 2. Plot Plan 3. Hoot System Cross Section 4-7. Maintance and Contig n plan Shaun Bird Signature License nu r226900 PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarge Rd Hudson Wi 54016 SW 1%4 SE 1/4s 36 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 6/10/13 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 4001715 Hoot System DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA # of chambers BENCHMARK V.R.P. Top of cleanout ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SettlementDrive SYSTEM ELEVATION common septic system All piping shall be ASTM D 30/34, within 10' of tank, piping shall be Schedule 40. Well is to meet all setbacks required by Pro 4 WDNR Bedroom House Scale is 1" = 40' unless otherwise 50' noted Hoot System 100' 40' cleanout sanitary sewer line for common septic system Property Line HODS" :31IJ 99te-gN-008 OLOZ 'N`df 03SLA38 o \ Z s- :21f10d-1SOd :'A a0 OIOZ A21Vt1NVf :31Va 091*9 VA '1008 313000UU N3aIVW Ol AMH sn 9K£M ldnNew OLLd3S :21nOd-3ad .0-,I-.* /l :31VO5 Ms :A8 wv8a Odd OOg b 009-1 N ~ Z O H g r Oz m U CL O Q LL v~ f- P= o v} Z u; ci C; ~O~ ~ HW~Bm~ 8 vi V) CO O LL- o . a 05 q V Cs at Z< o a 0 U o O LtJ N p N ~ ~ H o. c3 = V1 ~M.f n..nz ~ of . ~ 3v oU x qZ~ Q3m~i~i~~m 7d~ Y z o ~ s ~ J N W _ U Q r YY ~ ZZ (!1 O ~ r~5 W Q Y U ,,~II p to SVO w £S do I ~ ~ / I g o i to L L-- .J SVO .ti M I ss do V U Z ~ d .L4 Z .~4L OL ww z left, ' TREATMENT SYSTEM INITIAL SERVICE POLICY Our Company, 01'r u ✓LC //I will operate Ind maintain the Hoot Aerobic System located at .S T ~V r pegal description only) Permit # for the period of 2 years b i ing and ending This contract will provide for all required inspections, testinj nd service of your HOOT Aerobic Treatment System. The policy will include the following: / r 1. ^ inspections a year/service calls (at least one every (O months), for a total of 7 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 chl a tablets designed for wastewater use, NOT SWIMMING POOL TABLETS. Upon visit, if the system needs chlorine to the service provider will add them and charge the customer. If the customer fails in their responsibility to add the chlorine tabl ey are in violation of law and appro 'atA action will be taken. Initials of Installer Initials of Homeowner 5. Any additional visits, inspections or sample collections require by specific 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 watrantied 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 KeY a Q (\-'Bc~ ia~ C>/' Name Name of Service Com any R r to re A~ e8$ ~L~ Address C /;Ii J j S 7 a/ _ ci J Y city r Phone S' ature of Home er Signa f Service Provider and License -6- POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of ILE INFORMATION SYSTEM SPECIFICATIONS Owner ank capacity al # ~ al [3 NA Septic Tank Manufacturer ❑ NA )ESIGN PARAMETERS Effluent Filter Manufacturer ~NA Number of Bedrooms y 13 NA Effluent Fitter Model tf NA i Number of Public Facility Units NA ank Capacity ❑ IA Estimated flow (average) 1 I ;"dZ~ aVda Pump Tank Manufacturer O NA i Design flow (per), (Estimated x 1.5) al/da Q O NA I Soil Application Rate Model aVda /ftZ - O NA Standard IMtuent/Efftuent Quality Monthly average* Pretreatment Unit DNA Fats,' Oil & Grease (FOG) S30 mg/L ❑ Sand/Gravel Filter O Peat Filter Biochemical Oxygen Demand (BODE} x220 mg/L °A Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection 17 Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) A Biochemical Oxygen Demand (BODe) 530 mg/L ❑ In-Ground (gravity) C] In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade O Mound Fecal Coliform (geometric mean) 5104 cfu/100ml O Drip-Line 0 Other: Maximum Effluent Particle Size 36 in dia, 0 NA Other' AA A (Other NA Other: A "Values typical for domestic wastewater and septic tank effluent. Other: IAINTENANCE SCHEDULE Service Event Service Frequency linspect condition of tank(s) At least once every: 6 0 earts s (Maximum 3 years) 0 NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (A) of tank volume 0 NA -1 [1 (inspect dispersal cell(s) At least once every: D ear h(s) (Maximum 3 years) -O NA i lean effluent filter At least once every: O emons) ar(s) >14NA I nspect pump, pump controls & alarm At least once every: ears s) t7 NA 1=lush laterals and pressure test At least once every: 0 ears) O NA Jther CI month(s) At least once every: O yea s) NA ether A 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 iinclude a visual inspection of the tank(s) to identify any missing or broken hardware, Identify any cracks or leaks, measure the volume of immbined 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 I•egulatory authority. When the combined accumulation of sludge and scum In any tank equals one-third or more of the tank volume, the entire contents of j:he tank shall be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 113, Wisconsin Administrative Code. INI other services, including but not limited to the servicing of effluent filters, mechanlcal or pressurized components, pretreatment units, I-ind 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. Page of 4 I START UP AND OPERATION For new construction, prior to use of the POWT5 check treatment tank(s) for the presence of painting products or other chemicals theft may Impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of thia 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 bis discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result In the backup or surface dischargeofefio tnt. r poor to restoring To avoid this situation ntact a Plumber contents of the pw-np tank removed by a POWTS Ma nl tainer to assist In manually operating th ppu pocontrols restore normal levels effluent pump or r contact the area within 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, 15 feet down slope of any mound or at-grade soil absorption area. the life of the POWf ~a: Reduction or elimination of the following from the wastewater stream may improve the performance and prolong antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation dralin (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting P~ pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls and/or iIspe weth chapter taken Comm 83.33, out of ervi a the stn Admistepst shall be : ken to Insure that the system is properly and safely abandoned In comparer • 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 sail, gravel or another inert solid material. CONTINGENCY PLAN a code complignf If the POWTS falls and cannot be repaired the iollowing measures have been, or must be taken, to provide t system: ° d me 47~~ suitable ereplacem me t arouldabeb of elf orn dial rbance and utilized and should not be infringed upon by requi j d The replacement t area sh p setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result lthehreule~ in for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologW a holding tank may be Installed as a last resort to replace the failed POWTS. soll and as sit ❑ The site has not been evaluated to Identify a suitable replacementla area. If replacement area is available aOho ding tank may beeInstalleevaluaVon must be performed to locate a a last resort to replace the failed POWTS. ❑ Mound and at-grade Is absorption on ems systems may cbe r omply with the ctees in effect f oat that llowi tgme moval of the biomat at the Infiltrailve surface. Reconstructions N. DO LETHAL <<WARNiNG>> TREATME CONTAIN NOT SEPTIC, PUMP AND OR OTHER TRN EAT TM NK UND R ANY C RCUMSTANCES. DEATH MA RESULT. REESCUE O~ A ENTER A SEPTIC, PUMP PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. _ ADDITIONAL COMMENTS c 1110 e~r4 c.c,l2 G~~ .S POWTS INSTALLER MPhone mai Nae Phone r RITY r- LOLATORY AUTHO SEPTAGE SERVICING OPERATOR PUMPE CAL REGUL R Name RY Name 1/0 Phone J - Oz - 2 Phone = $ This document was drafted in compliance with chapter SPS 383.22(2)(b)(%d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. SPTIC TA..MA:'MAI~iCE AEs€T - OV N RIP M'tPiCATION 16RM Owner/Buyer lmai3a4g Address . 9q: Z4 60,6E P"A.W tujs 1 .I 'ti erty Address Sal'') 5Et "th kut I gasmd wr 'S4oIk V°'. t from Pig & Zmft construction,) CityrState ' _ WdSO+~ uUX Pa~t Idsrtif e.;i~dan Idamber KI?9 - (I - t7~a LEGAL X raptly Location _ ll4 : i/.;., Sec. ,'A T Z~ T _W T¢w~z of It'd Subdivision . SOtIRI' LoC Volume _ ;Pale Ceram guswey Moo, - Z 3 3C(I::;- Warranty Dee- d o Yoiti Spec horse .pis Lot Unesida t>t~ MUM AN-0- Ympsoper use acid rmtpe of your ssptia sye cod'ttt'i # tote fai€itrs to haaadie wastes. Pxnpcr tx tepattGS o~isrss of ptvppi" out the septac. tank svery t y"rs az.soaaer, if atsdecl, b3' s 3:c~sed putavrx. R'hat you gut tnto t sy stcrtt, can.af&et the ft ion 'of @ septic tink as e rcaat a fo ft avasae dfs}wsal'systetft U corer znaitits►na a county Otdi ce. respoasibiiitdes art specifted'14 §fi01= 52(I) and is ampter IZ - 4 The pio riy owner agrees to, sulsmit.to St .Croix County Pbankv & Zoning Depaidimi a cemlmciation 'tb* signed b'- the owner and by:a ae~stzr. pit,•3ottmeyrixa~a glkm'C.. restriv~ Zahn cn 8 liceaseti ptunper ~+ei~y~g ttsat tl j the aasits.. disposal system ~s in groper operatir.~•coz~tic~:'oi (2~ der' ins}~e~ticru aril gig (a#'inecessa*}}), :the septis'2•ark is Tess than it3 hull of sludge. . Uwe, the tituleFSig~ted hsve.read tlbe :above}uitetttents t a tQ maims tliiw n~ sewage disposa} system with thw siarniasils set.for11, heiefiti,°as'set.by tt of.Cosnmtccttd.t# tta►t of Natural itesoirces=State of Wxisctitssin ro the St Croix. Cotutty Pla~tning & . Certif catim hating that ydw septic systatn bia ' been tait~ed meat be contplMd and Tetarned Zoning: Dot within 30 days. of t13e :the ee year.expiration. elate: Uw.e fy that all siztements Eft t~#s forth-are tme.w. the bead of vViour ladowledge. V%v am/ne the Owner(s) gf the 'protietty desenbe:I.abrive; }vide of a warranty deed mcorded in kzgb* Of l Of rim N?yrr a -DATE S A TIIItB OF A~f'FLTCi~.~fi(S) . ~,.~*'~Any it fc tat}oii that as sms pieserlted mi y rat.. the sa tear}'. pec being fevWwd'.by the PbMing &.7,00ing Departmai:.. " lucfuAe ;vrith this applicaiioti a ri ciirded wwraPry deed f ihr'R:egiiW of Deeds Of co-and a ropy of the certified :surti ey if refere m is_made in tbe'Onivatity,deed. .8b•868 M..BS.MOOS , 96,6e I LP r74 5 F R 4~~ f rn ~G gG'Z. v M*Zsc ui P_ ml, , .r c 'o 'N ti tAj Vol, Q. 'y, CV ee tV) m _j CIO lko, ITL6L AZ"LL• .6Z'St>E lSl ,9E'0~ 4TU f '0£ \ 1 tV6.8OZ M,99.MOOS .8i ZV I I I 8162221 Tx:4132884 Document Number Document Title 980507 St. Croix County BETH PABST AEROBIC TREATMENT UNIT (ATU) REGISTER OF DEEDS SERVICING AGREEMENT REcCEIVED OR RE OIRD 06/14/2013 10:09 AM State Plan Transaction Number - EXEMPT REC FEE: 30.00 _ PAGES: 1 Name - (Owner) Typed or printed Being duly sworn, states, under oath, that: 1. He/she is the owner/part owner of the following pare of lan3i6 located in St. Croix County, Wisconsin, recorded in Volume,`Yage, Document Number dated/ a8 0~, St. Croix Count y Register of Deeds Office: Recording Area A parcel of land located in the 5W '/4 of the :SF- '/4 of Section, Tact NAME AND RETURN ADDRESS N - R 1_ W, Town of Av&w , St. Croix County, 948 14 &J U &40 vmw 6W Wisconsin, being duly described as follows (include lot no. and waSou,t,t1c 5VO1y subdivision/CSM or detailed legal description): kar 61f pt4raF OarAp ra SNO -'I'bKlQ of 004W - Zrl .CQ0,x CdV&rT QZO -14r-it- ow Agreement Date: t -26t3 WlSc"$V,) Parcel Identification Number (PIN) 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 properly serviced in response to orders issued by the governmental unit or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Slats., the governmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax 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 Department; 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, Department of Commerce, or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. 5. The owner or the owners 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 shalt be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall 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. OeArfw sy - area A - aftr PaMG Owner(s) Name(s) - Please Print Subscribed and sworn to before me on e: an L44,4 (q, Z b o State W?ublic SconSl fNotariz S ture s) Notary is ,d j U 27 39 P 3 16 '78r=lI0D KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO.. WI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 01/28/2905 03:15PH THIS DEED, made between Neil L. Wilcoxson and Mary Jo MARREXElPT # DEED Wilcoxson, husband and wife, Grantor, and Kernon J. Bast and Donalda J. Speer-Bast, husband and wife, Grantee. REC FEE: 13.00 Grantor, for a valuable consideration, conveys and warrants to Grantee TRANSFFEE: 4212.90 COPY : 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. 2ie 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. AV O-W II L. Wi cox * Mary Jo i oxson AUTHENTICATION p UlD~1C ACKNOWLEDGMENT o~a~y l~ ~rs~n Signature(s) N e1y;,~C 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 a foregoing instrument and acknowledged the same. (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY *Chen rown 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 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 N00016' 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 S00°21'37"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 S89126'5 8"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°30'41"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 Y. of the SE 1/4; thence S00107'02"W, along said east line, 897.02 feet to the south line of the SE 1/4; thence S89°33'25"W, along said south line, 1326.80 feet to the point of beginning. d a sK• V k=3 Fil x H r z _ 1 MAT6d1A4aPd01FID i;;R*i Mm"ADOM OFF POd A1J. d sU11ASIL SM&SAST CONSTRUCTION "VI81oM9 BUILDERS RESOURCE GROUP Z;;aa "~""aa MENA AITUCAM CM COMKIANCa 7D LDaAL COad& + Oxmion"mrsroumsor WWM.BRORObP/NCCOM Mnwm6ssCOabaso%WPI6NMflMeMMamL&MlANY pROJRCP HRLF RRBIDBxCR ladruafwnarva rxovs rladra ~rdl +ms~t0 s Dac°s"soT~HBOR1UttoD. (SPRINUMODELZ013) WoonvujaWLdfadd FAII11d•fdf-trfd a1RlbaMtssMlUSCSaRODPD1YNdALLMamgADODOeraoxTa oHttafasA AN8 ttosd oeTaw to -8114- 1'•a 814" . 4a ' 1/a" 9'•1 1,/a" r e'•i va" . r-s 6r4" S/W x E:l A ® ® YSI N ~jk R` i-H Sn~ ~~ax iA I's sl I I I I W-1 its" V8. 1'•6114" 1'-6 3!4" Fr 9UILDER: SPERR•RAOT CONSTRUCTION umlows BUILDERS RESOURCE GROUP "°`$°°A' '°"a µ~s A7PYA000BA(90TALL OOT&A1A1n APwmRoT N&1DMAM"AC UlACl0lAll, BALL O 'd AT%1CAHJZCDD{ TO LDCALCODA. Cpa L5~ oa!'TrbsNSSVLrdrovaerscr mvwaDaDOVwLVT»oox DDDmtp.ATSO,mo.mmDP~Oe,DTD.~,„.nu..,DaADT CA CW PROJECT:IMLPRE6IDENCE 100MA08ND87v8 pRol fM409•b7!! amwas 6 T'A:azaHrewxmlwimwDae (BPRINOMODELEOIa) riroObVYLaEMbcdse AA7GfJ!•NdaTaJ OPTWADAAWIN u CATWW80FT8WMWI DInLmAL 2'•D" 2'.0" 801.0^ ns Ro os vxar rd" •d R a. a § 891 OOlWON 60OP § Tao+~---eeq=6 av7 m a x'•2816" 5'-0" 01.9 d" _ _ RooPB>BaBRTBDq s'-o ai " s-a" 5'•0^ '-x a'.~ a" § STA7 O 1W al'.P lTAT § HnwrH ~ i BODPOIIN1gTRUlB Q b 8 7 a~ § W12ATMORDOPTRUMN W WI'I'BBUU.T n7 w Dqr R1RVBBq ABOVE i @@ L97 ~ G M. TIAOR GUIDIRTRUBB I `Q F D la m, or tin g 9 ~ I~gyj r~ ffi 02 02 ~o § r.r w ~ a-o" '•2^ a'-lo Ira" s'•a' w § § m § r § ' ~ as © I%muBB _ "x arl8usn p i y ABoP6 i»:7i cS 4qF 2 S lar aDm tl . em § vN O pa § ~ ~ A rBBL PULL D )K _ swDRWDW ROY aPB,r r DOOPTBUBBBlaI ~ BCBJI~POHtlry DPI; (PIwT UIM ~ l2'•0^ 8'•8" 10'40" \ J 12'•8" 251•8" 0'A" gg' C b rtlrnnRR,sPREn sasr coxaTRUCrrox R lox$ BUILDERS RESOURCE GROUP N u. Tie ol~B~on"~ bBMD„DB,rL APPLLCARLD CODs COIU7AA = To LORAL oom. 06rr8 a"MrarouBvZor WWWaWROMINCOO!( BDILDgB SRBOVRCBOROVPl0 NO766sPDNeRWBPWIARY 4 PROJECT. HUY RESIDENCE 188 NAOSNDRIVS PHON8f 7f!-!884781 umsmoRn87DRRSCI'DrPO1DATm (SPRING MODEL 2018) WDODYf "WL sass FAK nNlN7la Rr mum °n OGM~i° y°H''"ANOwuac,° T~8" 14'•9"D~emNeoNURNOaewnu.vamrx 16~_ " ArNa~eueem wnM RunrtulxooRraom ~ a q \ .2" 12 ~ q z'-a r2^ ~ Bo,A, 101'•6 v2" _4'-9 1/2" 101.61 2 V rr 1I YC ~ ~ ra M-7- m ~ $°m T•1" Spa" - as• rs• N s'•e^ s'•lo^ 3 § 9 '11100 'l 41 AWN= PNwDw DH "vp RO 80 RV'R96" RO"N'R U• go 88. n a^ s'•o" s'•s" '-r 14'•s^ s'•o" ~A 10'-4" 10'-0" Ma" " 38'-o" C>. BAILDERrSPELR-BAST0014STRUOT[ON Rav►atoNa Nara co•mACroxro rovPBnrAaaieAavOVAlu r BUIX,DERS RESOURCE OROUP •TBB At B.N a~PNB PD,~.a~~ P~,aNBANPrP~A,, GET s ArFWUSLB CODRPP1Y WOAOMM ' 8AO 1t8BULT8Y0U8$PSCT WR'fY.9 1 DPNDSAOaRCRaRWOUP 18 ORU WOTDNBeprveiDUB WA ANY PROJECT: KELP RE6IDBNCR 102 t0l BAO,&NDA1P& PXONM >Idfdd "840d?8rdl NURrNa oRlNCQ lNOppl{pCi'DryOppTAT[oN. 4A (SPRING MODEL 2613) WOODVII.L$N7•Sass FAX rta-688•frda oraenRAv°o.,Rwv°ocArroNewPw,rm00a"~ •10" 8 8 0" 8 0" ~ p - , ii Y ' V , S b ^ ij , ' rFLOOH CAHI'eeOPl OIMABtTO 47 yy 7AC90P m IIMHOF Aan'(O IF' i • T'7AC60PCONC e/Alf. u 1 $ $ pFYii ~i j; wnBAS01o WAUL iroro L WL BBw ' R @] w it.OSHaPiPa"n - wtnf,- rCOHCP"bT"NO 2 l 8RS 9a 0 lip I 18'.g^~~. 1 S- , , , x "tO= FAC® OP DIM ARE TO FOAM d PAC®OP ,p. 18,,0x WAL,SHIO L +(4~ 9 ~~n 4 , 18'•0" I h 1 g .._-_--_._.;.17._;---------- g i H O 84'-0" mtswA v.v. 86.0" ""W'" ~~FJyy BUtLDERs 1'1"""t-s"T CON$T$"TION '19 BUILDERS RESOURCE GROUP LV4 SWMQAM""OWDZW®MON1kD ONBANn ''L'• P'OHALL C1> PPUO A aeQ01PICA ANON LOC ALVCOtecoan'LAxctTO tucALOODIMACOne& 0 t P p OSTTUB RSBUL29 YOU6XPSC1' WWW.960R0UP.INGO0I( W19.MmmsuOR1NODoaoatternHOre7aPOw"eLSios AHF ~1 Z g P60J&CTs HBLF RESIDENCE i6a HAORNORIVB PNONad 116 esa-net MseLWMMPOu'non. en ($PRINGMODEL8018) wrwnmctgtie6#oab PAKitsua•t►ea 's"LU~° "AMt°tS GROUon°teoavNA LLMOM AND ws q1° OPT Parcel 020-1479-11-000 06/11/2013 04:20 PM PAGE 1 OF 1 Alt. Parcel 36.29.19.3032 020 - TOWN OF HUDSON Current 1K ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 09/25/2007 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BAST, KERNON J & DONALDA J SPEER- KERNON J & DONALDA J SPEER- BAST 948 LABARGE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 847 SETTLEMENT DR SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 2.490 Plat: 11-023-COTTONWOOD SOUTH LOTS 1/26020-07 SEC 36 T29N R1 9W PT SW SE & PT SE SW Block/Condo Bldg: LOT 11 COTTONWOOD SOUTH LOT 11 & COMMON SEPTIC SYSTEM BEING OL 2 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 36-29N-19W SW SE 36-29N-19W SE SW Notes: Parcel History: Date Doc # Vol/Page Type 09/26/2007 861243 AGREE 09/25/2007 861165 11/23 PLAT 01/28/2005 786109 2739/316 WD 10/30/1998 590369 1371/572 WD 2013 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 05/07/2008 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 2.490 400 0 400 NO Totals for 2013: General Property 2.490 400 0 400 Woodland 0.000 0 0 Totals for 2012: General Property 2.490 400 0 400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Standard Erosion for 1- & 2-FUMily DWellitly Construction sites According to Chapters II_HR 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 I - & 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 filling in requested information, completing the site diagram and marking appropriate boxes on the inside of this form. 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 sq-7 ql1"~71 11yii;. please indicate north BUILDER SPt~d-~ksrGdll~D~~~J OWNER ~RSY byoompletingtheannw WORKSHEET COMPLETED BY lk J SW DATE b1101Z613 1 - N - SITE DIAGRAM Scale: I inch = feet iI { III illili I' I 1 i l l? i I I l i i l i i i I ! i l l ! E i l l f l i l r l I i EROSION i CONTROL PLAN j 1 I s i! I! I I ; JL- LEGEND ' iF~ l Illii" 'si 1 1 ' I I r 1 i t i l l i i i PROPERTY LINE ' I I I i I ' i , 1 ~i I 1 I Y 1 I ; ; I I , I EXISTING ! , i I ! ! e ; 1 DRAINAGE , i! I I" i 1 I " 1 00 r ! 1 i 1 TD TEMPORARY DIVERSION i i i I i FINISHED DRAINAGE 1 i , i ' I , I i i 1 I l I I l 1 E LIMITS OF 0 I 1 1 i i i 1 t GRADING r SILT FENCE j ; f1F STRAW SALEES. i 1 1 I I l i i i I i i l i i GRAVEL I I 1 i 11 1 i, i l I I I I l i p VEGETATION I i l l i! i l i r i i ~'1 SPECIFICA:iON TREE i I l l i E i l i PRESERVATION i l i i, i 1 I ! r l I I I I l i r i i, s i I! ; I j 1 i i STOCKPILED SOIL I 1 i i i ; i 1{ I I~ 1 l I m cc EROSION CONTROL PLAN CHECKLIST UJ i- Check appropriate boxes below, and complete the site diagram LU 0. 0. with necessary information. C C U z Site Characteristics I North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. ~g ❑ Location of existing drainageways, streams, rivers, lakes, wetlands or wells. Location of storm sewer inlets. Location of existing and proposed buildings and paved areas. -rhe disturber) area on the lot Approximate gradient and direction of slopes before grading operations. Approximate gradient and direction of slopes after grading operations- Overland runoff (sheet flow) corning 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 5 inches thick. Drives should extend from the roadway 50 feet or to the house foundation (whichever is less)- Location of sediment controls (filter fabric fence, straw bale fence or 10-foot-wide vegetative strip) that will prevent eroded soil from leaving the site. ❑ Location of sediment barriers around on-site storm sewer inlets. ❑ Location of diversions. OWL* S er PWOL 5WM Be~ssnAi~`( Mote Although not specifically required by code, it is recommended that concen- trated flow (drainageways) be diverted (re-directed) around disturbed areas. Overland runoff (sheet flow)from adjacent areas greater than 10,000 sq. ft should also be diverted around disturbed areas. location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). Note: Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions, and re-vegetation by sodding or seeding with use of erosion control mats. ❑ Location of practices that will control erosion on areas of concentrated runoff flow Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in-channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip-rap. When used, a given in-channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In-channel practices should not be installed in perennial streams (streams with year round flow). Location of other planned practices not already noted. a: ~ J a Indicate management strategy by checldng the appropriate box. ~ Q U Z Management Strategies C] IKX 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 O Sod 0 Other • Expected date of permanent re-vegetation: 6VG abf; ® Re-vegetatiop responsibility of: 0 Builder (a Owner/Buyer i is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov 15? [3 Yes No j~ Use of downspout and/or sump pump outlet extensions. Note: it is recommended that flaw from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement. 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. 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 € the barrier. A 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). O All sediment that moves off-site due to construction activity will be cleaned up before the end of the same workday. A Ail sediment that moves ofd site due to storm events will be cleaned up before the end of the next workday. ® Access drives will be maintained throughout construction. O Al 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 Un"tform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook and Uw-Extension publication Erosion Control for Horne Builds. 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 Commence, (608) 26711405.