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HomeMy WebLinkAbout018-1083-23-000 c ~ 3 I ~ ~ ~ I ~ ~ 3 I A ~ fD y Q < owoo O 7 ' ? w c ~+ ~ ~ ~ N i N ~ m Q ~ ~ I a ° ~ N ~ ~ c I oa ~ ° ~ ~ ~ ~ fA N p ~ W v m I cn Z D ,~ a `s cu ~ D W a D '0 < 3 O .. °' ° ~ I a ~ o m = I c m o °0 3 ~ I o I ~ 'ova-°' OOO~S o w v ~ ° n N y I o ~ ~ ~ v, ~ m ~ ~ ~ ~ ~ .. ~ m N fl, of ~ .. 7 .. c 3 ; c ~ I ~ ~ O ~ c ~ ~ O 7 ~ ~ ~ ~ N ~ ~ C O ' n `~ N~ I ~ C ~, a cp ~ 3 ~ I Z m O ~ d c6 I ~ ~~ oa ~; I v = a O -O""i. ~ C m {{pp 6 A C r! ~ 1 y I w~ I ~~o °~ a I ~ F ~ 3 m a ~ ° cg ~.y- m 3 3 ~ _ y N 7 W y ~ y O d C a fD Vf y ~.~~ N fD y W y 'p O. t/r N N C O ~ ~ ~ I O 7 ~ 3 w ~ ra~0 N ° I '~a~? ~ ~' ~ ° .~ cc I ~ ~ ~ ?~•~v ~ N ~ d ( D aa~o , ° ~ d N O ~ W O ~ O ~ ~ ~. ~ O ~ O 7 N di O °o o- 3 d o ~'-,•~v d ~ ~. =-~o N ~ ~ 3 ~ 4° O ~ OD a in o ~ °' °o O O 'v' N ~ c 3 ~ °~ w ~ w N A CC ~ .'L A `Z ~ J m~°'I Z A Z ~ d ^. L7 Z R ~1 0 ~• O ~' 0 ~~ ~~ A W O N O A A Oq ~ O ti ~ ~°,, b ~ ' ~~'~ rtmentofconxr,er~ PRIVATE SEWAGE SYSTEM ety 'td'ings Division r" INSPECTION REPORT ~ GENERAL INFORMATION (ATTACH TO PERMIT) Pefsonel information yam, prrwic~ maybe used for secondary pixposes [Privacy Law. x.15.04 (11(mll Bo PermK Ho er s Name: ^ City ^ Vi06ge ^ Town o : • I _ Hammond Township ST BM Elev. tnsp. BM E ev.: BM Description: '' nn T g,nn# 2 2'-So,, ~~dC m'0. TANK INFORMATION TYPE ~ MANUFACTURER CAPACITY Septic c Dosing Aeration Holding TANK~Sf'TBACK INFORMATION TANK TO P/ L WELL BLDG. ventto Air Intake ROAD Septic n, 2 / ((o~ --~ NA ~n9 NA Aeration NA Holdin PUMP /SIPHON INFORMATION Manu'f,~ urer ,y Model Plum r TDH lift . _ ridion Syst For ain Length Oia. H OlL ABSORPTION SYSTEM ~ TR NCH Width / length IME .3 (o2,•SZ SETBACK SYSTEM TO INFORMATION Type o System: DISTRIBUTION SYSTEM b Header / Mani old [,~ N I Distribution f Length~Q~i Oia. ( teogtif emanc$ GPM 'm TDH Ft Dist. To WeN `Q~ ~ i . `I No'Of~Trencfies ELEVATION DATA IX rarcei i az rvo.: 18-1083-23-000 STATION BS HI FS ELEV. Benchmark ~ 3 `~ laZ•~(a 9 a , ~D BM Z•SZ. `19•~ ' Bldg. Sewer 3,$~ 9&•~ r St / Ht Inlet Sr ~ 3 Q • 3S' St/ Ht Outlet .S'j ~(Q , 53 ~ Dt Inlet Ot Bottom Header/Man. ~"`I ~- ~(~ ,a(~ ~ Dist. Pipe Bot. System 7.5 y. ~ 2 Final Grade ~c. ~f,-{yeti 3 •~ q 8 6~/ over Z ,qo , ~g No.Of Pits Liquid Dept P/ L I BLDG I WELL I LAKE / S.o`1• ~l LEACHING "'°"~ ~;_ I CHAMBER M e Num r: OR UNIT 1-H Vent To Air Intak w. ~r-5 ~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over ~ xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No 1\ ~~C~,OQ~ M1ENTS: -(-l~n,~,lJ~de code discrepancies, persons presenll~tj~Ction #1 •!~ /3fl/e 1 Inspection #2: r"1'-~ Location: 1732 97th Avenue, Hammond, WI 54015 (SE 1/4 NW 1/ Pheasant Hills -Lot 23 ~r~,~ ~l~S~( Cam' ~ s cf,.s ° / 1.) Alt BM Description = ~`~ ~ ~ , ig= 5,.,;n. /v , 3 0 ` _ ~`~ `~~/ 2.) Bldg sewer length = 21 ~ ,~b' Gr^^I" ~o • 3 z ~" ~ = 9 ~• ~ -amount of cover = ~ 8 ~a~ ~ ~.~+-~'~ ~ •lb N~ << - 3 Z ~ •SZ - 9~ 9~ Plan r rslon required? Y ^ No U other side for addit' s formation- l,~ 71O q y97 v'` ~„~ , Oate s edor i Signature p~~~ //~~ - ~ /1 " '~ S, GZJ+~RY~ 'tom/ +nc.u~ ~ ~ ` c _ b+'~ Svc `f ~'"~~ +`~"~' = ~ G~lt~ ~Sp r`Q.~1't3ce-n ~. ~..~r . r-- ~ Safety and Iituls!ings Division 1 62 '? C0~-'~~y ~ . i ~ ' ' ; 2 ~ 201 W. WashizY~tan Ava., P.Q. ~ox ~~'~-~' ~~~~ Madison, WI 33it)T - 7262 ~ ~ .-~ Y~ . r$Ste Address !'(ur ~ o Departm~erat at Commerce r _Q 1L,C---.---_..~ ~auita~ry Permit Application ~"~'~ z ~ t y m.asord wilfi bona g:1.2i. wu. Adm. GodQ, persoeni ittiarmadon you ~ + ' . , ~ Cbmck +t Itcvisian ~ ~ fttr Ptivac I,s-a sta. : ~ I. ApPItsatlan Itsfemaseka - Pl+esoe Prat lt31 Imifar~nattan ~ y.,__"w_,~ . / ,~ 5bue Piet 1.Fl, Numbar r ~ P'rgaarty Owaet~s Pitratse ~d FCE~VE ! Nambar~` Z 9. l ~ 5~7^s , -. Ptopetey t7Wlaet'/ Me~{ita` At~rmC CIS ? t - - "ty Lacataott c+aax ro / ~ ~ T /, S _ ` sT _ ~ u z,~ • s /~ z ~ 9' it iz t.'fy. s`tsaa Ztp Gods aria ~ ° , Natabar 3 $Seck Ntunbor ! ~ /~'` - ;" c,`` ?' ; ~.~.6..~. .r_. ~ ~ ~tbdswuioa Nmae r.SM Ntun~ai ' ! ~ i ~ , e _ ` `'- ! p~ may 0©h:-wsa v ~'" l~~ l/s• I a h, ~ . ,s - .. Ii. °1`ype of $ulldi;o; (check all that appty) I C1Ciry 1~'i or 2 Pt~+ lsweilit-~ - Nwnbet t F Bedtoorna ..3~ S~,t, i,,. ~ i j Ovui.~o ~ ^ Pu61i~ICaromssclal - I)etcribe i3se /tc ~ ~ i -"-""--1 ^ Stxte Owaod Ne:tYSt Rood '~-' f IiI. TyPe a!' Ptmar9tt (Check gutty otue box on Itste A (attmbetrftt~ schema for interrssi! ass). Cotnylete llae B rf applicable) A' i;~ l~ew 2 ^ Rrpieaeaveat 3Xrum ~ 3 "J Raplacxttunt of 6 ^ Addition to ~ Par Cotusty eaa S*~stem ' 7utk Qni Existin 5 nem $, { ! i Q Cheek if Siaaitsry Pettsttt PzeviautlY Issued Fetmis Nurnbar Date Issued ._._____..~. IV. fiype of Pettstitt (C~teck all that apply)(mtmberi~ scheme la for intetual tea) ~ 44Nan -Pstasuttsmd iss-C3rouad 21L1 Mound 47 Q St~»d Filter 5~ ^ Ganadarsted Wridaad 22 ~ Pnsasnrized Its-Around ~i ^ Hotdtn; Teak d8 ^ 5ia$te Fars Si ~ I3rip Line 43 ~ At-Glade 46 ^ Atrabie Treatasens lJrut 49 O Retircult; 30 © ~ V, t At~et I!zlot7trer~ti ou: d ~ G ~ < ~ r/~- fos.+~ ! Dasiga Maw {,~) D~pertel Area Dibgateal Mss Soft Appliradan PeKCalat4oa Rx~ m Elevatiots Fiaal Grade ; Re ~~d ~ Proposed ! S~yz ~ ~ FttooiQrsls.rThyslSq,i+t.} (adin.linGls) ~` ~ ~ Elevatio:~ 9 ~ ~, Qq. y `fS0 ~ , , ~- ~ ~ Sr (. ~ ~ ~ ~ y8'• ~ ~ boa, y yx, ~"~, ~p(a Ct~sacisy ie . 'fodtt Number Msnufactut+er Prefbb Sita 5tec1 Fiber ~ Plastic i t3tilao3 Ciatiuas of TYnkt Cot~rete Cotutructed + j Ctlass i t Ne+u ~ ~ ~ epos oe 'Cmle ~~00 ` ~ S ~ pL ' ~~ { ~ ice. Statematt- I. the ~ aannaes~e tros far e! the PQWTS shots ami the attacked Pisaxbar's Natty (PthW Plutalaer`e $i~tp-wn R3 Ntunber Buaitsess Phone Nsun6er ~. I ~~~ ~ um~~ ~ 1 ~ ~. ~ ~~~,,.~~, as ~ ~yd ~~ s- ~~~ ~ l Plmnlxt't Addeesr tstcaet. Citq, Stuo, ~.i' p Codes d ~'?d S c ~ K. ~~ '~r,..tJ .. ~ 1 VIII. Ca aram~t Approved ~ DiaypraYtsd Pee (mc'~udea tirc>xndWeatar $a ~ Due Ietucd Ian Aunt S1~L~ture {No Scempsl , f Q QwAar Ciive® Issidel Adverse ~ Z Z ~ d~ ~ r i ' . ~ TIC. Cattditioata o[ A /allAeasoiu !ar Die~pproval ~ / /~ ~ SYS~ ~ni° eXtutiC~ >2Y" ~rew~ Qwy Br~;wa.~ praa'e. ~j~S S a.~~ be t:ow W~t~S~ ~ ecJ~ . / / (py.. 1'tYN~.t!d Qkri~~ ihS~JCGir'oh . / ~` 1'i~ttV '~ ~1~ ictisfatl, ,~~gineOl ~¢t µ~.¢N.L~ a.G ~YCrS VCLObnN'~e ~ch5_ .wai"~ets ~'~romb odtl der tie r~nrem on ~ae~Da~ oel 2rs tlua s x u w !a ~:,~~;~;~1Bbyb398 (R. OS141} ,> ', ~~ Y •,~, -~ ~w~~ / ;,''/~ ~C`9~ b/~ SGQ~~ i `` --/~0 t 1~~~ ~~~ ~ cb~e ~~;~~w~ +,d3 ~5 .~" /~ ~ ~G `f ,~-3 6~,y~ us ~6tcl ~ 3~ cd / r f .~ y ` 'wiscbnsinDepartmentofCommerce SOIL EVALUATION REPORT Page~of~ • 'Division of Safety and Buildings In accoraance wim ~.omm rsa, vvis. rjarn. ~.oae County , n 8 1/2 x 11 inches in size Plan must th l t l l t it A t h ~ ~ r , . an on paper no ess a comp e e s e p t ac include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale ordimensions, north arrow, and location and distance to nearest road. ^" ~~~ Please print all. " fi~r nt"opi' R viewed by Date . ~ Personal information you provide may be used, r se or~deYy purpose y w, s. 15.04 (1) (m)). ` d 8/jp ~ ~ PropeQy Owner ., ~ ~~ Property Location "~ F-G /L -~. * `~,r~~r ovt. Lot ~ W 1 /4 ,(/(,()'/4 S (,~ T ZQ N R / ~ E (ar~ Property Owner's Mailing Address ' *~ ~ ' x - :`eg.. ~. t # Block # Subd. Name or CSM# City I State Zip Co g- ~, Ph 're ~tfc City ^ Village ~ Town Nearest Road - gyp] New Construction Use: ~ Residential / r r pfli~d---~n~~ - Code derived design flow rate ~~ 0 d GPD ^ Replacement ~ * ~ I~ Public or commercia - e: Parent material ( Flood Plain elevation if applicable .~i/~ ft. General comments t~/S~~ ..eCc~ U. 9~, 00 and recommendations: ~L~• ~~u' p~~ GQ I ~ Boring Boring # ® Pit Ground surface elev. . lU ft. Depth to limiting factor ~ in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 .~~ t( zs,-Z~ ~o I.2 Z Boring # f~~ Boring ~ Pit Ground surface elev. y~do ft. Depth to limiting factor l2O in. _ Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary R pots GP D/fl'- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Z /z ~ / y ~ - Gs s m-~~ ~ _ ~ z Z~- /G r~~o - ~i12 p / -- •--- ~ ~- /. Z 7.~ 5'•~ 81.6 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and 1 ~S < 30 mg/L CST Name Please Print) ature (ST Number Address Date Evaluation Conducted ~i elephone Number z!/ ~ ~o ~S_~ .S~~~Se~~./~Syoz ,~._ fS-1S- a/ 7~S-zy~-yao Property Owner ~/I~t Parcel ID # Page ~ of__~ Boring # ^ Boring ® pit Ground surface elev. ft. Depth to limiting factor ~~~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f(~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 t o-~ o r3/ _ Spy Zirr / -~~- cS 1vl - . ~. Z Co -/<v ~o r Y/ - L S -~r CS - ~ ~ / Z ~ ~ zy o f - S G rn ~~' C -- , ,~" q y 2y- ~~ ~~l -- ~ ~ -- - , ~ l z ~S.o s ~ ~'-4' ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 ~y - y/~/''V- V /N' ~/ ~~ ~(~' ,, ~ ~~ . ^ Borng # C • C ~ ~~~ ~~%~ "~ ~-- • Soil lication Rate ~ `~~~/~" " ~%~~ ~~ Horizon Depth V ! ~- Roots GPD/fF in. *Eff#1 "Eff#2 .. * EfFluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluen4 #2'= BODS ? 30 mglL and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) + , PAGE 3 OF 3 T`TAME ~~ 1 Q TOT# Z ~ LEGAL DESCRIPTION S~J ~ ~w14 ,S /CoT ZR ,N,R, ~ ~ E(ot~ SCALE: 1"= `7 a BM 1 ELEVATION /pCS. a BM 1 DESCRIPTION -(ap a ~ ~Pa~~a cfo~c>~'Sr' ~ BM 2 ELEVATION `~Fl l y BM 2 DESCRIPTION~p a~ ~~ert,u. ~~. SYSTEM ELEVATION ~ ~j, U y ___ ALTERNATE ELEVATION ~T ~ ~ ~ ~ CONTOUR ELEVATION q7.a~~ Q~I oG~ f Q oc~ N ._ X ~ - ~. c . / 6 DATE ~ ~9"- G~ wisc~nsin Department of Comm SOIL AND SITE EVALUATION Page 1 of 3 'Division of Safety and Buildings ~3RIGINA~, accord with Comm 83.05, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and d t St. CrolX roa . percent slope, scale or dimemsions, north arrow, an,¢ 4n-~nd distance to neares I'~ Parcel I D # r~ , APPLICANT INFORMATION - P/e a rint all inform~t~ . . p , . Personal information you provide may be used for cond~ry purpoSgb,(Privacy Law, s:~15.oa (t) (m)). ed B ~_ Date ~..... .-~~ 3 O Property Owner ,~ ~ .. - Property Location Bonte, Ron r Govt. Lot SE 1/4 NW 1/4 S 16 T 29 N,R 17 W Property Owner's Mailing Address i - ~~e' ~ Lot;# Block # Subd. Name or CSM# 1011 170th St. ~- ~~r _ ~ i 23 Pheasant Hills City State Li Code Rp~ 2`~D 5 ~ ' `' = ^ City n Village ®Town Nearest Road d 170Th St I~ 1 S 6 5 Hammond WI 01.5 . atnmon ~ Resid~ntial7 Numbet• ~.be~rooms 3 ^Addition to existing building New Construction Use: Replacement ^ Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate •3 bed, gpd/ft2 •4 trench, gpd/ft2 Absorption area required 1500 bed, ft2 1125 trench, ft2 Maximum design loading rate •5 bed, gpd/ftZ •6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 24" below contours ft (as referred to site plan benchmar Additional design I site considerations install 2 - 5' x 112.5' shallow trenches on contours for 3 br Parent material till Flood lain elevation, if a licable NA ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ® ^ U ®S ~ U ®S ^ U ®S O U ^ S ®U S O U w~~ uc~~-Rir ~ iv~~ r~~rvr~ ~ Boring# 26 _ Ground elev 99.4 ft Depth to limiting factor . > 72" 2 Ground elev 100.7 ft - Depth to limiting factor •> 60" i H Depth Dominant Color Mottles T t Structure Consisten Bounda Roots GPDIft2 or zon in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ry Bed Trench 1 0-3 7.SYR 2.5/1 - sl 2 m gr ds cs if/m .5 .6 2 3-14 7.SYR 2.5/1 - sl 2 f sbk dsh cs if .5 .6 3 14-28 lOYR 4/4 - sl 2 m sbk mfr gs lm .5 .6 4 28-45 7.SYR 4/4 - is 1 m sbk mvfr cw if .7 .8 5 45-60 l OYR 6/4 - s 0 sg dl cw - .7 .8 6 60-72 SYR 4/4 - sl 1 m sbk mfr - - .4 .5 aye 2y'~ '~ Remarks: 1 0-3 7.SYR 3/2 - sl 2 m gr mvfr cs 1 f .5 .6 2 3-10 7.SYR 3/2 - sl 2 f sbk mvfr cs if .5 .6 3 10-27 7.SYR 4/4 - sl 2 m sbk mvfr cs if .5 .6 4 27-60 7.SYR 5/4 - is 0 sg dl - - .7 .8 ~, 2~~•r b3.(r'~ CST Name (Please Print) Signature: ~ Telephone No. Henry F. Grote 715-665-2681 Address ertt to of esttng Dato CST Numtter Ref # P.O Box 57, Knapp, WI 54749 4/16/2000 222774 1062 Remarks: "Or`zsu' 4 nas constaeraerte gr ac coo PROPERTY OWNER: Bonte, Ron SOIL DESCRIPTION REPORT ~ Page 2 ~f, 3 PARCEL LD.# Certified Soil e'f"-sting 3 Ground elev 100.4 ft Depth to limiting factor • > 60" 4 Ground elev 99.4 ft Depth to limiting factor ' > 65' 5 Ground elev 101.9 ft Depth to limiting factor - > 62• Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh, onsistence Boundary Roots GPD/ftZ~ Bed Trench 1 0-4 7.SYR 3/2 - sl 2 m gr mvfr cs if .5 .6 2 4-11 7.SYR 3/2 - sl 2 f sbk mvfr cs if .5 .6 3 11-31 7.SYR 4/4 - sl 2 m sbk mvfr cw if .5 .6 4 = 31-52 7.SYR 5/4 - Is 0 sg dl cw - .7 .8 5 52-60 SYR 4/4 - sl 0 m mvfr - - .3 .4 Kemarks: ,(~((u,.. -. (~ .".,(w(.(..(..(,.~ ~. w ....,~...,...~......~ ,..... -.,-. ~ ~.,, ~b, ,.., ...,,...~.,,u~ ,....,.~. ~...,, .~ ..,..... ~.....a,. 1 0-5 7.SYR 3/2 - sl 2 f sbk mvfr cs if .5 .6 2 - 5-20 7.SYR 4/4 - sl 2 m sbk mvfr cw 1 f .5 .6 3 20-55 7.SYR 5/4 - is 0 sg dl ew if .7 .8 4 55-65 lOYR 7/3 - fs 0 sg dl - - .5 .6 ~ aY~ bo Remarks: °"` ~` (}"'(("("'(' /.J (A T/7 (a ~a m avn, w•a(~ . Vw.w(V(w(J 1 (41/T J( t~ 1 JVIy RIrA j WN WiV(A T VICE I V (n V/Y IIIGV3 1V, 1 0-3 7.SYR 3/2 - sl 2 m gr mvfr cs if .5 .6 2 3-7 7.SYR 3/2 - sl 2 f sbk mvfr cs if .5 .6 3 7-12 7.SYR4/4 - sl 2 m sbk mvfr cw if .5 .6 4 12-29 7.SYR 5/4 - is 0 sg dl as lm .7 .8 5 29-42 SYR 4/4 - sl 3 f sbk mvfr cs - .5 .6 6 42-52 7.SYR 4/4 - sl 0 m mvfr cs - .3 .4 7 52-62 l OYR 8/2 - fs 0 sg dl - - .5 .6 rcemancs:.......~.. T ..'~ ~' ~ ...,tl Ground elev Depth to limiting factor Remarks: .~ .~ ` N ~• ~~ ~S ~a~~ ~ s c,~ ~ 1 p to 0 ~-l o.~, ty.~ le-~ Z0. 2~~,~~' z~-~ ~K ~~ ~ ~o~~e - ~~\o~ P1~~ L~~ zs~~'~~ow~~~~~ SF- N~-Ib-1~2.g- l'~ `'.~ 1 o~...v~; 1'1aw..wow~ l+- ~ ,~,~ K E - Nw~ 1 y~ z.1z ~ ~ ten{ ( n QZ``~ 1~'h ¢~t.+o~.. Zf(~LRI to z,,~~lo~,.l~ ~~ b ~..c.~c. ~,o t i- ~~ ~3-3 ~lv~.o~ L~ so ~t~ .~° ~tia o ~~' CSZy ------___----C- ~.~~ ~1 (v`/~ ~ ~, _.. ~-4 ~H" a 4 F•Vr' .~ p ~"" ~.sa vaav~asw vv..-•-- SBPTIC TANK MAIIVTBI+iANCB AGREB11~11"3NT AND OWNERSHIP CBRTTFIGATION FORM ONmerlBnyer ,~a~ 1~ C , ~)~.Y1..~ ~ ~°.~ uor~n ~-fo-~n.es Mailing Address _,jD I I ~ ~Drt ~ St ~O-im ~Y~-.E ~ Z S~D ~_~ Property Address (Verificat%n roquired from Flanniag Depsrt~nt for new CitylState ~al^c~ ~c~ rC~ ~ W~ Parcel Identification Number ~~ g -' ~ O~~ a 3~D~~ ---, R1~~ DE.SCRIP~`IUN ~y P'topeity Location N~ '/~, .~~'/s, Sec. ~ ~ . T ~ N-R ~,~.....w~ Tows of J ~Y1n pn~0 Subdivision .,~ ~~~R-t H' t ~' S Lot # a3 _____ Cert#fted Survey Map # .Volume ,Page # Warranty Deed # v, c~~ o~ 'S y ~/ .Volume ~ ,Page # ~ ~O Spec house O yes D no Lot lines identifiable ~ yes O no Ingxoper tie sod mpanoeof Your septic syattm could result in its grr.omture faibu+e to handle wastes. Proper a~ aoa~ of pamping out the septic tank Ducey throe years ~ sooner, if needed by s iieensod per. wi~at ~ ~ i~o ~ can affbd the f of the septic tank as a trest~t stage in the wasae disposal sY~• The prapetty owner agrees to submit to S`t. t~+aix Zak D a won form, signori by the owtux and by a ntsstarpG j~~PI~Plumberaralieamsedpu»~~~(I~~on-sitcwastawatardisposalsyateaa is ~ prarpar operating oanditioa and/or (2) aRer in~oction and pmYgsin~g (~ Y~ ~ c tank is less than I/3 full of shxlgo. ~, t~ ~ Dave read the above ~ and agroe to ~ i?~~ s~bO®` ~' the standszds ~ ~. heeaay as set by the Dot of C,om~+x and the f~ of Natural ~ $taoe of Wise sin. C7anification g flnlt Y~ c has been maiatb~in~al must be c~mplebed sari n;~d to flea St. ("leoix County Zoning Office within 30 s of file three year expiration flat / ,' ~/ O Co SltibiATURB OF APPLICANTT DATB r>,wi~rn,R CERTIFICATION I (we) ctctify that all statements oa this form are true to ties best of my (our) lmowiodga I (we) am (are) the owner(s) of ~ about, b virtue of a wamtnty flood rocorded in Register of Deeds l'?ffice. SIG}AIATVRL; ©R APPLICANT DATE sssss« t being revoked by tht Zoning Department. "ass«« Any information that is mis-tepreseated may result in the saaitarY P~°= ss Indetdt fr[th this apgiicatian: a stampod warranty flood from the Register of Deeds office a Dopy of the certified survey map if raferenee is made is the warranty deed Prlvata Onsita Wastewater Treatment System Manage~renone t Septic Tank And Gravity ln-Ground Soil Aasorptian +~ p Pursuant to Corrtm 53.54 Wis. Adm. Code o~ u es ~c~ m~ ~~tain g ~ system w hint Systerrt (p(3VUTS) Shall InducSe filforrrlatEOn 8nd p tOVai #? th~a department, agent, the parameters of Coma 83 and 84, and the condt8ons of app Y or governmental unit. The approved plans and permits for system are an file at the county zonirtig or health department. This management plan complies with Comm 83.54~tawatd Tres rndent Systems 5Br~ nd Soil Absorption Component Manual for Private Onsite We 10x87-P (R.6!$3}. Table 3: Ma{ntananae once a year and clean at least once The septic tank shalt be maintained by atic tank shat b®Idp aced of l~n accardancs with under s. 281.48, State. The contents of the sap NR 913, I~lis. Adm. Code (Servicing Septic cr Holdi egT enCh Py pnv}esCor P ~ ~!~ rases lnterr.+aptors, Seepage Beds, Seepage Pjts, Seepag Restrooms}. The aperatirtg condition of the septic tank ash out cleaned ale necessary to ensure once every 3 years by inspection. The outlet fl to proper operation. The niter cartridge snotaid not be wheneemolved fpromv its enclosure If the retain solids in the tank that may slough off the fits Mound Syatam Msnagemon! Plan page Z of ? Pursuant to Camm 83,54, Wtfa. Atlttt. Code ~~t'~ nk shalt tae maintained by an individual certified to servics sagas tanks under s. 28t .48, Stets. The Contents of the septic tank ahatt be diepvee4 of in acacrdanw with NR 113, Wia. Adrrt. Ccide. The oporstinq condition of tM sepflc tan!c and outlet Biter ahaU be assessed at least ante every 3 yaera ay Inspection. Tha outset Eater shep be desnsd as necessary to ensue proper opueaon. The flltaar cartridge should not tie remawd unless provieisrns era made t0 retain solids in the tank that may slough oftFthM f!lttar when remowd fmrn its onciasuro, if the fllteur is equipped with sn etsnn. the t]tter shall bs sarvteed if tt~e !arm i; ectlvsted contfnuou~y, tnterrnittent alter alarms maY intliaate svr~e flows ar an impending ~ntinuoua alarm. The eepdc tank shall have its contsn#s removed when the volume of sJudpe and scun+ in the tonic exceeds 1/3 the flquid volume of the tank. !f the oontenta of the tank are not removed at the time of s viennial aaaesamant, ntaintenence penoru+el shall advise tea owner of when tlu new wuvice needs ~ be perlbrtttad to maintain has than triardrnum scorn end siudps eccurttulatbr in the dnk. The addttbn of bbbgkat ar chswmlCat addltlves to enhance septc tank prrfarmence la penerelty eat required. i'•owevsf, l! such pradcscts er. ueed Stay shatl be approved for septic tank we by ~,e pep~tnmartt of Camt~rca, 8at~aty end 8utldinge Division. e~h purrtp~(dcsir+p} tw+k ehaU be tnapeotad at leant once every 3 years. AB awttohes, alaserta, end pumps eha!I be fisted to wrdy proper o'poratbn. ff ar+ affluent filter ~ installed rvitnln the tank it shah be inspected anti sarv3cad as necessary. ~~b~ r ateru d 0~ mound. Pianittnpa maY ~ mede around the rnound'a paHmeter, and tea mound ahaU be seeded tired mutalted es necessary to prevent erosbn and to provide some prouCdon from frost penetration. Traffic (Other than far vegetstlve rnainhnenas) on the mound dt nOt reeornmended shoe soft compaction may hin4er tareaon of the tnRitrative surt'ace within 'the mound and snow t;ompaCtbn in the wtntor wtti promote frost penetntieon. Cok! wasther tnatatiauruna tC~bsnRebruery) dkrtate that the mound be heavYy mulched tar frost proteagon. lrsfiwnt quality Inks the mound syetern may eat exceed 23G mglf, ~OE?4,150 ~ T$$, and 38 mlyL FC6, Influent flow may not exoa~cl rnax~nwrn design flow spectated in the permit br this installatlon. 'C'has pressure dtatrltuifon system ie provlCad wire a Auahlnq point at ttte and of each lateral, and h Ds recpmmended that sate tarsier be flushed of accumulated sdid'a at least tees every 18 mar-ths, When a pressure resits performed 1t shou'd be compared bs the tnitlal :eat when the system was In+statled b cisatamine If orntce r~logging has accurred and if prff(ce alaanin6 la nlqutr~ed LQ maintain equal dlstrtbut>an within rite diiperea! cell. Qbtia~vatbn pipes within the dispareat anti shalt be checked for effluent psondins. Fbndin~ lavers shall be reported t4 tt'+e gwribr and any levels ebove 4 fiches oatuidared as an impending hydrsuUc laqure regvWng additional, more fraaquent menltcrinp. r ii aystsnt shatl tae operated in accardanee with Comm a2-M Wis. Adm. Code, end shalt maintained In suaardan~ ~~ 1ts' wrrtpanent rnenual ($8L?„105'i'1-P (R. t3lD6)] and laCal cr Hate rules partalMng to system malntananoe and mainNnence rept-rtlnp. ppNuua oppn~ shoula ever serer a septic ar pump terik sines dangerous gases may be Runt that could cause death. 8eptte and POMil76 aomponenb !shatl be in ecurrdence with Gomm &3.33, Wla, Adm. Cods wirer, the finks sro rro !Doper wad as 3eptlc or pump tank manhole risers, access risers anti Ocvere s#3ouid be Inspected tOr waist tightness end ac+undness. A~:C4SS apentngs used for service sod aeaeesntant shall be aeeted watEstight upon the eomptatfan tiE eenrice. Any openlnG .deemed unaourid, dehctive, ar sub)sat to failuro must be repiatad. Eacposad saes: openir~s greater than 8-inc?-rfs in diameter shau be second ay en etfecttve IxWr+p device to prevent aCCiQentaf or unautnortzed entry Into a wok ar aomponvnt. L • asp C to any of its rkmponents become deaectlva the tack ar component shell be repaired cr roplaceC to keep the syetesn to proper nperetinq conclltton. if t}te daring tank, lip, pump cvrdrats, slarrn ar related wiring t:eacmas defaatlve thrs dahclivs cerrtiponenl shell 4s tmmr+distey repaired or replaced vdth a companeru of the sues ar equal peeformance. tf the mound aornpenent faits t4 etxept wastewater or taaglna to discharge wastewater to tea ground surface, it wlti !» repaired or repisiGed in Ib' praazt tixaltlon by lncreaaing l~aA) rtf+ea ti toe leakage otxwrs or Dry rentovir++Q blotOgiCauy clogged adsarptlon and dieparsa! needle. and ntabd piping, and raplaCY~t said camponente as defined necesaery tb bring the systofrs into proper operatlng oonditMan. 4uaistitine an the ogeratd.or~ ar mafi:tertanca O~~~ttaia~ ~~pst:en ohauld be diret:ted t:o Lkte County Zoning office at `1.1~-' fib- y68 0 ar to cha 3.icenaetl plumbQr who instal],ed the system. . *rri~7t I~tsn r~rr ~r s~Opti01'irtk •tsC1 ~i Aixsorpt~On Contpvnont Piantnari vt da+~aotld tnlt and ahru~u i~iraltly over o- within ~ h!t at thv oor+nponont ~iwuid ~ o-VOldld lirufp rQOt intruaivr: into tt» oompan~= nyil obltr~ wlttlwltiW ~`' Cot'ttinq~nay' Plan in tyre i~vsnt at ~yetam te6iurr, ! nsw rfyttlm ooutd !! initailla in !r+ lit+e ans. Vvith tho lnstaiiattvn o! a diwr~tsr vaivl, the •xiatinµ •y~tlm aouid ~o !o! reused ~fi!!r ! period ~ ttvsa tv roar ~wata. ~ i! !~!! ~ awrntn rt;z~ai~ility t>a t~'liinbin th! •itlrrwtt! ~rnix ~'!! tror~ any piilntir-~ of trreoa, tbl1 !~. !n c~ayti- ~ i~iiut! o~«t~h! +~ri in~1 +l~yyiy~t~rn, thM lfy Mw wiii yid~e naldld: tf 711 `y t ~i iW. `1~~! 11/7 F ~ianll~ Qn ~ i~~~1 „~ ~~,lae 6flly ~i~ i~~! ~ iA ~ ~4 ~~~ it` etllrr~ta arw 1~ doetroysa, tt~ln an vth!! stew +f}yltlrna ttr~ aan ~ uaird, in whiot~, aoui+d rsau#t in added s>Igvlnls to tF+s propa~ty . Any tank avrrrr!r~st ~~ be dvr~! Irf ooaorda~ wig 41Vlie. Cod! ~3a~3, My qu~rtion: thin oodl, p}r+ii-~ var~aot your lovifii Zonir~ Oda or oar+#aat th! ~nr~kailinp pfumbar. j c ~r acne-,r~,~'er ~ ~, s~ ~~: ~ .u~, ~ ~"G -~ ,~ t „Z,! Yr.1.1~1PatiE 372 Dine M. Borate, as Trustee and Ronald C. Eiortte, first alternative Trustee of the ICari M. Utferts atxi i~sarina G. Utferts Family Trust, for a valuable consideration ~otiveys without warranty to Ronald C. Monte and Dine M. 8onte, `httstx~rtd and wife, Grantee, the following described real estate in 5t. Croix County, State of Wisconsin; Dme M. 8onte Trustee 'Ronald C. 8onte Trustee Ttxxnas A. McCormack 1020117" Akro. aatdwin, WI54~2 01&1034-60, -7p {Parcel Identification Number) The North Half of the Northwest Quarter (N '/: of 1WV'/.) of Sectiort Sixteen (16), Township Twenty-nine {29) North, Range Seventeen (1 ~ West. Dated this 24thtiaiy of t~larctt , 2/X)0. AUTHENTICATK7k Signattue{s} authenticated this _ day of , signature type or print name TITLE; MEMBER STATE EtAR OF WISCONSIN (If not. THIS INSTRUMENT WAS OA Thomas A. McCom Etaldwin, WI 540{ 6aos6s KATHLEEN H. IiALSH REGISTER OF DEEDS ST. CROfX CO., MI RECEIVED FOR RECORD 4f-10-200Q t0:30 A!f ~~ DEED CERT COPT FEE: T~RRIISf E~R~fFf : 2.00 RECORDING FEEL 10.40 1>lI6ES: l ACKNOWLEDGMENT STATE OF WISCONSIN ST. t~tOtX COl1NTY Personally came ttefore me this 24thtay of MaL'Ch 2000 Ote above named Circe M. Etortte, Trustee and Ronald C. Borate, as fiat attetnatitre Trustee of Kart M. UOerts and Katherina G. tllferls Ferrety Trust, to me known to tte the persort(s} who executed the foregoing instrument and ackrtowledce the same. signature type or print name Dale Jensen Notary Pubiic St. Crain County, Wisconsin. MyOCAmmissVgn is permanent. (If not, state expiration date: 11 1l ll Us .) 'Names of perskxrs signikg in any capacity stwuW be typed or printed lxtow dteK signatures. ~ .. .~ ~ J '- ~:~ t ~ t ~ :f:~ 4 .+ . ~~;'tv r .,~ , womw`m aaw..a.w Conw.~r c«a a i.c w+swnan aoo-sss~ F'HtASANI HILLS ~.t~CA~ T ED { N THE NE ! r4 4F THE N'rY 1 r4, THE E I r~ JF THE NW f r4 AND PART CAF THE S!N i r4 OF THE NN i r4, AND PART QF THE N~`J ! r4 C7F THE NW / r4, A~. ~. t N SEC T t Q!'J ! o, ': T. 29N. , R. 1 r'VSI. , TQWN OF HAMIUOND, S T. CRD 1 X COt1NTY, N/1 SCCINS I N IOOYM AyEM+E =E T ~~T 23 ~. ~ ~ 4V~ j ~~ .- ~.- ,,_. ~. ~~, ~. O T l 7 `°• r „ t+ .- . ,„, ,; SEA tit M o n o' ~ i V fre l3 I .r+t ! aK +Ar f ~ -------._i._._.._._ nA7 i I s.-.rt i «s i `_ i _~.. ..__..~.. 1 i ~ .. J 1 .__e_...~4- t -----.. -1------_......~..._.._.....__. a n --~ rr~ LpCAftOM =x[TCN si[ r r ra ~ s, r. sw.. •. + t!d . rar. ur wrr~s+ t 4Qf i4 frK [ J t/T!L tTl' EASE11£NTS s ~~ rr4 Ptu € ~ R 9vR +FD CA9t€5 ARE 74 8E Pc ~Cti h StrGt. 1NAT T.,E +HSTAtLATJt]N ASJUIp pryTURB tNY SURVEY STSt+E. p1 OSS7R€1CT Yt9iGfY 4LOhG AI1Y l4T C 1ME Ori STREET t tkE, THE plSTIsR6AMCE G-r• A SURYfY STAKE er ANr;wE tS A Y?Of.AT;_; 'JF' 5€C1141V 234.7E f!f iYJSCCw1SrN S7AT;T€3, UT!arTr EAS€~ENTS A~ N€~_' +M SET fORTH 4R€ r;ap 1hJE' t1SE 4f Pb`9L €C 8t7pt£S Ahp PgtVAr€ JTiI IT!€S NdV'k;i TN€ R1GNT TQ SERV€ Tq AR€A, t_ EGEkU ~d FOt:MD f' fACif Pt.PE 4 ~ SET 2'X74' lR4H P.*PE i/EdGr+tvG J. 6a l HS. PER L f tYff.lA' F JO T NO-€: SEi J'x2A' iRQN PrP€ nEt.'rNCNG t. iJ 195. °ER ! iN€AR F.?pT AT ALL OTNER caT cORhERs ti • UT?L tTlr EAS€-Ek7 (TYP, 1 ---T-- SHEET ~ __~ •-'~ ' l t • r ' '~'~••.. a.,,,•~ ~ Ja t a'E •A Y C tKA T i C+!'t5 -- - _ ---_ --_ 4 -- SEE ,~,~~ccY~r~,~ ~,~ - it O oc,i~'tr 3~.1.~~1~ ~~ ~~«: ~ ~ ~ ~ ~.~...a r~ ~a m~,~..+~r c~.._2_.______ i • M pY~..~ Jr~ Y 7 .ti _... ~'' ~iI ~ ' ~' q .i ~ ~~,~,.. ,~+....~ ~ ~. i ~1~ ~I µx~11~$8'3b" Qt"Nf i ~F63. BI>L- , ! : ~~. ~, J + p'3'S ' Ip . .. .- _. xs" 705.9 e ~ @-4'S `t. t ; ~ / ~5~a a ~ T . ~l __ iX ~, I -\"s - 7 1: 4 CR '~ >y ^i; ~ ~e . n .` i t }y~~(' .,, , i ~~062 $. ~ ~~1 8-'42. ~ `~ ~ s . '~ . . •'s' t l '6 ~~ .. ,Y ~ _. ....... ...... ..... X ~:J . s~'. v-: a ~ .. ..1 ~' Z~ t^ ;. ~4 s -`• 1058..' ~ i:'A 6 ~ tp57b.~ r. ~ J'^~\~ 4-. E ~ '~ \\ ~ n 1~ 4 ~ .v ~(. ~ ~~~~1 ~. ~e RY l \,} ~ ~ ~:'_ ~, E ° ~ 370.. ..i.,~ - ---- y ~~,~' ~`^---- ,.- , . r_ ~ t ~ n !Q ..+ .'~ _ . ~_ h t~ • y ~ ~ AC. S'`7' •~ ..ate • ~~ ,. `~s ;. ~ + 1083.8 ~ ~' ~,, $ :_ ~ ``! '~ .. ~ ' ~ `v ~ s k' .serer ' `~# ; ~. 'f ~ r ~ ~ , , ,' ~``'~. ~ ro 2'. 00 ACRES ~ ~ ..-~ ~~ ~ LOT 29 ~~, ~ ~ 8s, s2 i so:_ .~w, ;. .~ ~~~ ~ ~: Ems. t)O ACjt~S) .'i `. ~\ ` / ~ i ..it ~~ .} bps i~ r ~~ ,~ ~~T 1078 a °\ ~ i V '` e~y„ ~-. t'?~',,'~O ~ ~ ./ ~tF ~-~ ~\ _~ :.~- _ S 072 9 ~ ~ ~ f , a * - tt `~„f ~~ x w I :ry i ~ ..~-- 3 .. S1,~ ~ " v`! ~.~ .~ \. '+1f` .# f _ S ?~ •i t / I ~ , ,D - "~ ' ~: N89° 36' 01 " W 342. 42' +~ ~ ~ '1 ,. ' ,. I . I ' `. ro ~ ® ~ ~~ ~ ~ I ~~ w ~ N ~ ~ LOT 27 o~i ~ 16 :~ 1.89 ACRES , 31a. oo' / ~ co ,~ 82, 269 S0. FT. ~~ ~ ". ' N88°57' 47'W 370. 34' ~. ~v i o `~ , la ~ I ``~ w ~' 3 r ' `` ro - ~ ~" :~_ ~ ~ ~., LOT 22 ~ ., m : ~ w ~~. ~ N ~,, 2. 71 ACRES R o , ' LOT 28 0 ~ r r7, e8e so. Fr. M r 5p'~' 2.44 ACRES •~., r I r06, r36 S0. FT. I , ~t I r y F ' ~,O ~2 . ~ `9O ~ i 00,`. i® ~ i ro F~ ~ Rq0 ~(/S F,Q ' ~1 53, 1 433 • ~ al! sae°4i' i2•w ; LINE ~ N MATCH ~ ~ - ~ F% I6' ~ - I ~' w ' 6~, I ~ ~ ~ 3 ~,~ LOT 2 ~, 2.00 ACRES , / LOT 29 8s, s2r so. FT. t `SO' ~~ - -~~------ NWW_NW -~_---- NE=NW _~ -- ------------ I ---- _ _!_ ^ I / ~ N.a + 0 1e / ~ ~i ~ O ~ ~ a. .ice b I ~~~ ~ ~ LOT 3O \~ ,,~ ~/ ~~~_ , ~~ ~ ~ -l .,~,. / ~ ~'" ~ ~/ " i ~ ~ / ~~ ~~ ' ~~ ~ ~;. SH a,+;,;;,~:. wzy.~