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HomeMy WebLinkAbout018-1094-01-000 /�� �� 2 / A. � @ � + m 7 z E o S■ I e , Q0 / S. / CD -4 f / \ j \ §ƒ g @ 2 0 R: 0/ E § E § 8 U) § r— a , @ z > 2 A 0 E e >� R S. w . a \ 2 2 k � CD =9 k § \ i "-ft-MA / E 8 J 2 E CO) � w ° � M . / T V T % E- 7 0 0 0 8 ., Q -u § § g CO5 ■@ ■ @ a \ D J 0 *� tj 7 # �: z r 0 \ 0 7 E e �. =1 \ c ° / . w ƒ E F j \ �_ Z 0 � z R C 1 \ \ ] § F z 2 � 7 z % � » -4 CL §�D ) o8&& g= \ , �zz % �CA o gEƒ QQ E (/ rn =r ■ /� � oCA 2 CD 0 . CD Ol 0 t-j < t in 0 $ � §i ®2 � � . Parcel #: 018- 1094 -01 -000 09/08/2006 12:25 PM r PAGE 1 OF 1 Alt. Parcel #: 17.29.17.741 018 - TOWN OF HAMMOND Current FX ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner PHILIP R KOLLER O - KOLLER, PHILIP R 996 166TH ST HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description " 1659 100TH AVE OR SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.610 Plat: 2349 - PRAIRIE RUN LOTS 1/35 018/02 SEC 17 T29N R17W PT NW NE PRAIRIE RUN Block/Condo Bldg: LOT 01 LOT 1 1.610AC 996 166TH ST Tract(s): (Sec- Twn -Rng 401/4 1601/4) 17- 29N -17W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 07/30/2003 732752 2337/535 CO -AR 06/17/2003 726199 2278/386 WD 05/23/2003 722751 2252/340 WD 04/15/2002 676384 9/02 PLAT 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/06/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.610 23,700 178,500 202,200 NO 05 Totals for 2006: General Property 1.610 23,700 178,500 202,200 Woodland 0.000 0 0 Totals for 2005: General Property 1.610 23,700 177,400 201,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 10/21/2005 Batch #: 05-40 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 �, Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 430074 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide m y b usV f r s condary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: t City Village X Township Parcel Tax No: Midwest Equities LLC I'll Koaw Hammond Township 1 L — 0 / —(1166 CST BM Elev: Insp. BM Ele : BM Description: Section/Town /Range /Map No: C7D .p I X00.0 1 PtJ = CV_ 9 I 17.29.17. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � ' Benchmark • Q/ O -8 I r D rD. a Dosing Alt. BM •Io O - `'"''''� Aeration Bldg. Sewer ro L�.o `13.8/ Holding SUHtlnle��, '4o' I'• q} '? TANK SETBACK INFORMATION St/Ht Ou t 1.116 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet q2•4Z Septic 5D I } !S 3 S " ' Dt Bottom 15". 83 ?9- 03 Dosing , / > } � ro i 3 1 Header /Man. Aeration Dist. Pipe (o, S'1 Holding Bot. System _ n �•, i, / Q . � r - (1 Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number W 3(�L �' DH Lift I Friction Loss System Head TDH Ft ID Forcemain Length / Dia. Z Ir Dist. to Well SOIL ABSORPTION SYSTEM( BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 2 &P2 . 9 SETBACK SYSTEM TO I P/L fa WELL LAKE /STREAM LEACHING M Ma anufast INFORMATION Type Of S sty em: CHAMBER OR y 7i 4MA' UNIT Model el Nuu Number: 2 q DISTRIBUTION SYSTEM �j-{o rexc.0 R. a. �• Head d- Distribution x Hole Size acing Vent to Air Intake Pipe( ` ' r Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil i:j J Yes [ No J Yes :N, C M II NT ��j,(Includ ode disc s, persons present, etc.) Inspection #1: M / � Inspection #2: --- --� Location: 996 166th St Hammond, WI 54015 (NW 1/4 NE 1/4 17 T29N R17W) Prairie Run Lot 1 Parcel No: 17.29.17. 1.) Alt BM Description = �0` �jt`� 4 0� 0A 7 Q 6 -` q 2.) Bldg sewer length = C G�tO • s�a/� - amount of cover = 3 S u y , 42 Plan revision Required? ;: Yes XN0 3 Use other side for additional information. SBD -6710 (R.3/97) Date Cert. No. Insepctor's Signature r Safety and Buildings Division County Nv 201 W. Washington Ave., P.O. Box 7082 scvnsin Madison, WI 53707 — 7082 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 261 -6546 3 �d Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s 15.04(1 xm) Project Address (if different than � mailing address) I. Application Information — Please Print All Informal on Rt / 661 L--` S+ Pro perty Owner's Name Parcel # / ' Lot # Block # - JUN U 6 2003 openly Owner's MaXinll33dress Property Location f Chllv�Ur y4,�, /. Section _&/7 _ City, fate Zip Code one Number (cirgl o ) II. of Building (check all that apply) S ntt T N; R o� 1 or 2 Family Dwelling — Number of Bedrooms S Subdivision Name CSM�ber' C1 Public/Commercial — Describe Use 0 State Owned — Describe Use 2 ) , 3 , X q5- 3. J S ❑City ❑Vil wnship of III. Type of Permit: (Check only one b on line A. Complete line B if applicable) A ' New System ys ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B. ❑Permit Renewal ❑Permit Revision ❑Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV Type of POWTS System: Check all that appw Non — Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip ne ❑ Gravel -less Pipe ❑ er (expl 'n) S V. Dis rsaUTreatment Area Information: aL Design Flow (gpd) Design Soil Application Rate(gpdsf) DisperNI Area Required (sf) Dispersal Area Proposed (sf) System levation, . Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tads ^ � Aerobic Treatment Una 4 I� Dosing Chamber R IJ J� VII. Responsi bility Statement- I, the undersigned, assn a responsibility for installation of the POWTS shown on the attached plans. Plum 's m (Print)\ Plum s Si a MPIMPRS Number Business Phone Number Ph ber's Address ( t, City, State, Zip Cod ��X 1-3 llrlel k ;�Iz VIII. Coun /De partnient Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued I uin gent .) tun (No Stamps) Surcharge Fee le El Owner Given Reason for Denial � ��_ 12 Z� IX. Conditions of Approval/Reasons for Disapproval , &Zk (per tWer � c�D.t -�ers - - Ct � pV - C:O,--� VAA V1 I __ S � ,�A-+ I �un� Y ttach complete ptaffis tto tat counly'raly) he spstem on paper not less th gI x 11 inches In size - A-t( s a ' SBD -6398 (R. 08/02) -• � ! i I i ! j I I I i - � - - -4 1 -- ! -I kr " - o r r V � M h 1 _ rL Wisconsin Department of Commerce SQIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County CC'd X include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Re ' wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 I Property Owner Property Location 6 'lw Govt. Lot & 1/4 1/4 S 7 Tz N R E (o& Property Owner's Mailing Address Lot i Block # S d. Name or CSM# � f 11 - . r i -�-, pa n City State Zip Code Phone Number ❑ City ❑ Village ❑ Town Nearest Road yQ /S ( `W ST 794- -0 7Y3 -oar vet WV'WCt 1 / ?9 +ti [] New Construction use: R Residential/ Number of bedrooms . 2 - - G Code derived design flow rate G ° GPD ❑ Replacement 1 ❑ Public or commercial - Describe: Parent material Flood Plain elevation if General comments S C i v, (� 0 L-0-- I-r 7Z 4, and recommendations: YS � r � o � �,, Q g RECEIVED t '� L4 c CV` Boring f ,OUINI"Y ❑ Boring # , 4i NGc.w ` © Pit Ground surface elev. ft. Depth to limiting fact - - in / Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consist a o(indarj% N is GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 a-l2 (D BIZ S / 2rvaa rn I� 5 .$ v Z IZ - Z icy 414 5 t/ 2mc ffi-Pr 3 2-S. ld 4 L I rnS m v - �r L4 Fro II — — N tit 7. i 2 — o�. S C.6 -try I Z �. wv � r• , Boring # ❑ Boring o © Pit Ground surface elev. ft. Depth to limiting factor in. �- Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 O -t' tD r Z Sil c5 ! - ' '8 Z (a- to Yr 44 5d 2m, n cs 5 8 3 ZrQ l0 /(, LS (m5 m4r .cS — 7 . Z ` 5D- io 5 IL i NP N P * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 m9 /L CST Name (Please Print) Signatu � CST Number 3ch er t Z cJ Address Date Evaluation Conducted Telephone Number Z11 % S. L 5y0Z5 // -28- OI 015 )2q7 -LI6v 8' SBD -8330 (R07 /00) v - Property Owner Ngw 6115 Parcel ID # Page Z of 3 3 Boring # ❑ Boring , I ® Pit Ground surface elev. p9 3a ft. Depth to limiting factor te "' . Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i *Eff#1 *Eff#2 I 6 Iv r3 1Z 5i1 rry r rS I `� Z 16-2b lD I4 Si I ZmabK cs _ 5 3 - ro r I/(v L S M18 rnJ ( - 5 I• Z $ 1p jr slip — G A a. hmes — N P N P ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) PAGE 3 OF 3 NAME I LOT# t LEGAL DESCRIPTION/04 -1 X rU =Y ,S / 4 12 q N R , E(or)g SCALE: 1 "= BM 1 ELEVATION BM 1 DESCRIPTION o o 1 �0 v c �, e - BM 2 ELEVATION 97, $ BM 2 DESCRIPTION joe SYSTEM ELEVATION o Lam {r q 7. ALTERNATE ELEVATION Jo g j 3G L o ,,Ax r '? CONTOUR ELEVATION gg,3o d- q Q. 30 b.3 0 a'� P dlb D r (3 -z �m Z SIGNATURE DATE / Z — /S o l _ PAGE of ' PUMP CNhMBER CRO55 SECTI AhJD SPECIFICATIONS VEWT CAP 4 VCNT PIPE APPROVED LOCKING WEATNERPRoof'_ EAT IOAJ DOX 1 1 WHOLE COVER `NITN � 2S' FROM OooR, r WnN.IING LABEL WI400W OR FRCSH IZ'MIU. AIR INTAKE GRADE i � �. C01JDU1T- / � -- - ---__ -- -- PROVIDE I - - �- IAJLET AWTI.:.NT SEAL I I i I I I RO APPROVED JOIWT A I I APP PI E W/ PIPE PE CXTCNDiI $� I I ALARM EXTEUOIUG 3' O11TO SOLID SOIL I I I ONTO 50W0 SG. D I I C I LI_CV. - FT. b OFF 0 CONCRETE BLOCK R ISER EXIT PCRMITfED OlJL�l IF T AUK MAWUFACTURCR HAS SUCH APPROVAL 3" APPAoVED 6f.I>tiNG "w Gtr 'rr%►aK SEPTIC E SPEC_IFICATIQ1JS DOSE �` ) �,C/s' IJW B[R OF DOSES: -� PER DAy TA►JKS MALJUF'ACYURCR: TAA1K SIZE : Vi CALLOUS DOSC VOLUME �-� / INCLUDING GACKFLOW: ..r�,r�a 7 GALLON' ALARM MAUUFACTUKER :. MODCL NUM6CR: �� ��� CAPACITIES: A = IUCHE5 OR GALL Oki SWITCH TyPC: � ��A 8= INCHESOlt GAL L0U5 PUMP MAIJUFACTUKCR: l�c C,��IWCHES OR /� GALLOWS MODEL UUMD[R: _ �L� D - INCHES OR 1Z4 GALLONS SWITCH TYPE: �� =Male Ai�TE' PUMP AUD ALARM ARC TO DE MIMIMUM DISCHAKGC RAIL �� GPM -� INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFEREN nETWECU PUMP OFF A1,10 DISTRIP,UTIOQ PIPC.. _/S ._ FEET + MIIJIMUM NETWORK SUPPLY PRESSURE. . . . . . . . . 3 - 4 FLET + � - FEET OF CORCC MAIN X — F /o.)►r.FRIGTIO►1 FACTOK.. FEET TOTAL 09 HEAD -- Z:512- Fr-rr iUTCRAJAL MME.USIO►J OF 1AUK. LCy4C.TN ,w ID , ['II ;LIQUID cJEPTH :;IG ►JE .. LICEIJSC NUMt�C S -� OAY • �, . .. • .., M ®� ® " °MN■MNEEE■■NEEMENNE IN ., �is��NNsNNN►1 ■MNMNMENO�1iM ���:o ■■ ■NON ■NON ■ ►1ME ■ ■ ■ME■ �*,NEMEN►NNE ►N ■NNN�siNNNN ®■ MMEEMM■MNam" \EM ■E► E \■N ®■ ■ENNM ■NNNNN��i. ���NE►�� \ ■NEI ' ■MNNMNNNNENNN ►E \���i���l ■NM , mow■ ■ ■ ■ ■ ■ ■ ■■■■■■w■■ MODEL ,. ■ ��NNNNNNNNN�iiiNNNN ■ ■Mw�� ■ ■ww■ww ■■w■■ ■www■■w■ MOEMME ■ ► \■■■■■ MEMO MEN E ■M■EEM■ ■M■■E■ 'ME■EEM■M■NUMME■ MENEEE■EM woo m m i■ E i N ©N �w■ limmmmmm■ N■■EM■M iiiOhm M � INI MMMEM ,NNNNE►Nl �■■■EM EMEEEMOMENM■ ■■M■■ ME■■■■■■ MEE ■MEM ■MN E►NEE NNE■E■w■ N M EMM INNI M MEM MEN�E�ii�■�iMENNENNN i M ®iii NNNNiiiiNNIMEiiiiiw:NN I'O\ti TS OWNLWS MANUAL & MANAGEMOT PLAN Pogo lrl� ' i . FILE INFORMATION SYSTEM SPECIFIC TT Owner C septic Tank Ca acit al o NA Permit If } Septic Tank Manufacturer s o NA Effluent Filter Manufacturer o NA DESIGN PARAMETERS Effluent Filter Model o NA Number of bedrooms o NA Pum Tank Capacity al o NA Number of Commercial Unit ONA — pump Tank Manufacturer o NA Estimated flow averse al /da Pump Manufacturer o NA Design now (peak), Estimated x 1,5 gal/day Pump Model o NA Soil A>>li�:alion Rate S� �;tl /dn /ft Pretreated Unit Inl1uent /l l'I'luent (�unlity Monthly \vcr;ibu" ci Sand /0ravel filler l'I 1'r;t► I'iitvr F= It.s U k & Grwtse (I`OG) 510 Moclmni� Aerolion a W01;utd BiUQhQ1111Cal Oxygen Dcnu►nd (BODs) 5 220 mg /L o Disinfection 0 Other, Total Suspended Solids (TSS) 5150 m L Manufacturer Monthly Average ** Dispersal Cell(s) Pretreated Effluent Quality O NA *,In- ground (gravity) o In- ground (pressurized) �.10 mg /l• o At- grade o Mound Biochemical Oxygen Dcnr,�nd (BODz) g yb m Total Suspended Solids (TSS) <10 mg /L o Dri Drip-line o Other. Fecal Coliform ( eometric mean <10" cfu /100mL Maximum Effluent Particle Size '/v inch diameter Values typical for domestic (non-co mmercial) wastewater and septic tank effluent. •+ Values typical for protreatod wastewater. MA TEN N IN ESCHEDULE IE, A, C Service Event Service Fr e uenc Inspect condition of tanks At least once every o rnonths ears Maximum 3 r� Pump out contents of tanks When combined stud a and scum a uals one third % of tank volun Ins ect dispersal cells At least once eve o months cars Maximum 3 rs Cleun effluent filter At least once every o months a your(s lim evt Pump, pL11112 controls Se olarnt At least once uycry u months ours a NA Flush laterals and pressure lest At least once ever o mont o year(s) Gt'NA Other; At least once every o months o year s zrNA Other; At least once every to months o ears A MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certification st tad Sewer POWTS Inspector; POWTS Maintainer, Soptage Servicing Operator, Master Plumber Re ric , Master Plumbe P 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 t 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 tray indicate a failing condition and requires the immediate notification of the local regulatory authority, When the combined accumulation of sludge and ,scum in any tank equals one -third ('h) or more of the tank volume, the eat contents of the tank shall be removed by a Sk�pmgc Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other m.untenanee or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer, :' ' r , A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that my impede the treatment process and/or damage the dispersal cell(&), If high conoorin4ons are detected hay the contents of the tanks(s) removed by a septage servicing operator prior to use, Owner: System start up shall not occur,when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal high water levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact. The area within 15 feet down slope of any mound or at -grade soft absorption are. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONEMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replac ment system: A suitable replacement area has been evaluated and m'y be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need fora new soil and site evaluation to establish u suitable replacement area. Replacement systems must comply with the rules in effect at that time. o 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. "" o' The'sitefias`not °been evaluated to tdenttfy a suitable replacement area. Upon failure - of the POWTS a soil and - site --' evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. u 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 the time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO,NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLd. Name POWTS MAINTAINER Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone ST CROIX COU14'1""' SEPTIC TANK. MAINTENANCE AGREL'MLNT AND OWNERSHIP CERTIFICATION rOILM Dwzler /Bu Mailing Address Property Address (Verification required from Planning Department for new construction) j -, � City /State /� �f '12� � �,� Parcel Identification Nuunber L,FGAL DrSCRTP'PION 4 .`/ ` /,, Sec. T �N -IZ� W, Town of Property Location -,� Lot It P A CSC t. -k , t. , L -- Subdivision _ - - Certiifed Survey Alai' Volume _, Page It 2 7-�� Volume Page t/ `pVarranty Deed # 7- �-�- -- Spec house C] yes 1 no Lot lines identifiable yes O no Sy STCM MAINTFNANCIE maintenance improper use and maintcuanceof your septic system could result it its premature failure to liandle wastes. Proper consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you Put into the system can affect the function of the septic tank as u treatment stage in the waste disposal system. ication 11 properly owner agrees to submit to St. Croix Zonis gd u � ` ervertfyiug that (1) tl a on -s e waterdisposall system mastprplumUer, journeyman plumber, restrictcdplumUet or a hc.en p P is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the D ae ed rc lur o the Re source s, Croix State of Wisconsin- County Zoning Office wiUn 30 stating that your septic system has been maintained must be p days of tjic three year expiration date. 041 Pj,4 DATE NATU . Or APPLICANT IpWNFR CI+,RTIIf�I.Ct�TJON y ( ) g i (we) am ( are) the owucds) of I (we) certify that all statements on this fforinare tru co tit ill e of Deeds Offioce the property d escribed above, by virtue of a warrant ( i DAM S NA'I'U ' Or APPLICANT * * * * ** Any infonnation that is "'is- represented may result in the sanitary permit being revoked by the Zoning Department. ** Include with (Ills application: a stamped warranty deed from t11e Register of Deeds office a copy of the certified survey mall if reference is made in the warranty deed J 2252 P 340 722751 ti DOCUMENT NUMBER KATHLEEN H. WALSH REGISTER OF DEEDS WARRANTY assn ST. CROIX CO., WI RECEIVED FOR RECORD west Equities 05/23/2003 02:20PM , William E. Hawkins, Grantor, conveys and warrants to M, ��_ LLC, Grantee, the following described real estate in St. Croix County, WARRANTY DEED state of Wisconsin: EXEMPT # ( Z s 1 3, 6, 10, 11, 12, 13, 17, 18, 19, 22, 27, 30, 35, lA and 3A REC FEE: 11.00 Prairie Run, Town of Hammond. TRANS FEE: 594.00 COPY FEE: CC FEE: PAGES: 1 NAME NO RET RN ADDRESS S iGS 18- 1037 -10 -000; 18- 1036 -90 -000 18- 1036 -80 -000; 18- 1036 -70 -050 Parcel Identification Number This is not homestead property. Exception to warranties: All easements, restrictions and rights -of -way of record, if any. Dated this S 3 day of May, 2003. !/l /��' C• � Qr'�JL�� (SEAL) ( SEAL ) William E. Hawkins (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) / ) ss. COUNTY ) lJ J J' •1 J authenticated this day of 2003 Personally came before me thizJ 1 . .:8ay1ir' M p, 2903 the above named William E. Hawkins`'..Y (sinnature) to me known to be the persons(s) wh(i •e)0iu� the r foreg Vin instrum t and acknowledgb - -t a.,sdne.V (Name Printed or Type! J,' I _ TITLE: MEMBER STATE BAR OF WISCONSIN v si nafuze (If not, vn authorized by 5706.06, Wis. Stats. ) * Name r' ' d or Typed THIS INSTRUMENT WAS DRAFTED BY: Notary Public . t Leo A. Beskar My commission is permanent.' (If not, expiration date:) Rodli, Beskar, Boles 6 Krueger, S.C. P.O. Box 138 River Falls, WI 54022 SUUl Jy W t (CL �-"' a 255. 76' a 227.89' ' - I DRA I NAGS 14 14 !' 37 -� W ' - 357.88' ............... N�$:p7' tS5 W a. 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