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HomeMy WebLinkAbout018-1094-07-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Larson, Gar Hammond Townshi CST BM Elev: ~ Insp. BM Elev: BM Description: _ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic ~~/ 12~a Dosing ~~~~~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ '/ ~ ~S ~ Z 3 i Dosing t ~~ « ~D i 2 ~ i •• 7 Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~ Demand ~.S fr0 3 ~ I !_ GPM ` Model Number ~ ,, ns` v ) ,T (QO T'6~}i ) Lift ob Frictio Los ystem S Head _ TDH ~ Ft o. ~ 03 .oq Forcemain Length„ r Dia. t ~ Dist. to well ~ ~ r ~0' f county: St. Croix Sanitary Permit No: 429960 0 State Plan ID No: Parcel Tax No: 018-1094-07-000 Section/Town/Range/Map No: 17.29.17.747 STATION BS HI FS ELEV. Benchmark ZZ o .2 •0 0 Alt. BM '~~ / 02• ~Z Bldg. Sewer l0. ~ ~3. ~ ~ SUHt Inlet 11•~d ~ 2•SZ SUHt Outlet I ~ ~3 . (~ Dt Inlet J2.3 2.' Dt Bottom I b.~s 11 / ~•~~f Header/Man. ~ ~-~ ~ ~ . ~ / Dist. Pipe ~ ~t ~ ~l Bot. System 9~' ctYl Final Grade ~ ~- ~,- •~ ,~ I ~r t. -~ s . ~~ St Cover e SOIL ABSORPTION SYSTEM 131 a,,,,, c~ BED/TRENCH Width ~ Length ~ No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~, ZS ea. \ (3~ l SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufac yAA ~ INFORMATION CHAMBER OR I A+~"~ ~ Type Of System: / ~^ i / 2 / ' ~~ / UNIT Model Number: ~~ ~~ V DISTRIBUTION SYSTEM Header/Manifold ~~ h Distribution Pipe( x Hole Size x Hole S acin Vent to Air Intake Dia Lengt Lengt 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 [~ Yes ^ No -i [ Yes J No ~•O~Ma1~1lE~IT~S~in~clUude co disl~xg encies, persons present, etc.) Inspection #1:~Q~_, v Il ~/T Location: 991 166th St Hammond~~4W(t 1540/p1-5~__(~N~~W~~1/4 NLE 1/4 17 T29N R17W) Prairie Run Tot~7" , ~y~i 1.) Alt BM Description = ~ Q°~ ~w` c~,b0~~ .~' ~~~ " 2.) Bldg sewer length = 3~' ~~- - mou t of cover = ~ (pp ~~, 3 L~ hsrws p~p~ ~'. 2t~ --- ~ .~.~~-_~A___ -~ - - Plan revision Required? I Yes ~..I No Use other side for additional informatibn.~~ ~_ ~ ___ _ ________ SBD-6710 (R.3/97) ~---~r"""_` ~t Insepctor's Signature Inspection #2: --s`-"T-- ~• No. ` Safety and Buildings Division County ~ ? t r r 201 W, Washington Ave., P.O. Box 7082 I SCOOSIO Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Oe artment of Commerce (~8) 261.6546 yes ~q~ Sanitary Permit Application Stag Plan 1. D. Number , In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be wed for eecortdttry purposes Privacy Law, :15.01(1 Xm) Project Address (if di ent than mailing address) I. AppllcaNon Information -Please Print All Inform on ~,~ RECE ~.~~~~"~ '~ Property Owner's Narne Parcel N Lot N Illuek N _ ' oi~- ~oy~-ate t~ Property er'c Meiling Address roptxry Location (,~- ST. CROIX COU ~ %~ ~_y,, Section ~_ a ~ I City, State ZiP C ~elNQpber circle o e) II. a of Bulldln T~ N; R~E or(~ •~'P g (check all that aPP1Y) 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name C,S#4-Alunrber ^ Public/Comatacial -Describe Uso 3 ~ l ~~ - ^ State 0•.vned - Descn'be Use 7 bt/ ?j OCity ^Villa ~'fownship of III. Typt ,f Permit: (Check only one box on Ilne A. Complete Ilne B if applicable) A. ~ ~a~ ^ Replacerrteot System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renevnl ^ Ptutnlt Revision ^ Chmge of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner [V. T of POWTS S Item: Check all that a 1 Non -Pressurized In-Ground ^ Mound > 24 in, of witablc soil ^ Mound < 24 in, of suluble soil O At•Otade ^ Sirtila Pau Sand Filter LJ Constructed Wa4tnd ^ Prouuriud In-Ground O Holding Tmk ^ Pat Filter O Aorobic Treatment Unit O Recirculating Sand Filter ^ Recirwlating S Ihetic Media Filter chin Chamber ^ Dri Line ^ Gravel•leas Pi er (explain V. Dls rsal/I'reatmentAtea Information: Deign Flow (gpd) Design Soil Application Rate(gpds() Dispersal Area Required (st) Dis 1 Area Proposed (st) System Ekvadon ~/ VI. Tank Info Capacity in Total Number / ~ ~Ma~nuQfacturer Prefab Site Stoel Fiber Plastic Gallons Gallons of Uniu ~ ~~ `"~'~ ~! ~ Concrete Constructed Glass New Existing Tanks Tanks Septic or Hoklini Tank Aerobic Trcatrooot Unit Doalni Climber / VII. Rd onilblllt Statement- 1, the undenl ned, sumo responslblllty for Installatloo of the POWTS shown on the attached plans. Plumber' Name (Print) Plum a Sign ure ~ MP/MPRS Number Eiusineu Phone Number 2 lumber's Ad teas (Street, City, State, 21p Code) ~ ~~ ~ ~_ VIII. n /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (include Groundwater Date suod uing Ag t Signatur tamps) Surcharge Fec) ~ ~ ~ ~' O Owner Given Reason for Denial ~ ~ Q L!.li~i~ IX. (~o/ndltl/o)ns of ApprovaUReasons for Disapproval l .~~ X2~ '-1(O f ~~QucG~ 3 6 ti I.fitt S z ~.,~~~-~ ~~tou~-~- ~u~~/ ~~ _ ~~ ~~~~~ Pte.. D_u~ --k~ ~ c~?~~~ s ~ ~,~-yP~~ ~~~ry`,~=yam ~~,~.~, • ~f 3 _ ~ Attae- tompkle plan (to the Coaa' ^only) for t he ty:tem on pa r sot I r t ail x I I IaeAa la oltt ~ 3/ ,/~~ f SBD-6398 (R. 08/02) ~/ v Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings Page ~ of ... u..,.,,...~..,,., ....... .............. ...~. ,,...... .,,,..~ County ~ Cr Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must • o x include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. ~ ~ ~ 0 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re ' we by Date ~ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ ' 9 Property Owner ~ Property Locatio I Govt. Lot W 1/4NE 1/4 S/ ,~ T Z9 N R / ~- E (or)b Property Owner's Mailing Address Lot # Block # S d. Name or CS 9 ~G / ~a ~` ~ t -~ City State ip Code Phone Number ^ City ^ Village [] Town Nearest Road ~mwt cil wl Syal S (?/S) 79G- Z X45 . /oo-'j ~ , t o [~ New Construction Use: ® Residential / Number of bedrooms .3 ` y Code derived design flow rate ~ SZ ~ ~ c> o GPD ^ Replacement ^ Public or commercial -Describe: _. Parent material ~ • ~ ~ Flood Plain elevation if applicaJ>fe .C/f /!~ `" ., ft. General comments and recommendations: I sys•F{r-~ a/•C ~~ TOIJ 9'S~ • ~d Gc~w er ~ fl. oa ~~ ~ ~ L~ • P/-tt/~ 7?, P 9' ff• ~ ~ w ~ r ~J Sf 3 v ~ Gi _7. ~7 ' -(v r~.evl- 3 ~ `' ~>~a2tJ sys-~~n.. g R q+ °'`,~ t` ~- ~` i' "' ~ ~ n r^r.,n j Boring # ^ Boring ~. r C>; ®, pit Ground surface elev. 99 ~ ft. Depth to limiting facto, ~]~ n4!~'N Y ` ~-~tiNG(3pFtaE I Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Ropf~ GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I ~~ ~5__ ~-~ 5 g 2 ~ I ~ c~ -- 5 3 - ~ 0 mi - -- /.2 Z Boring # ^ Boring Pit Ground surface elev. 9 ZO ft. Depth to limiting factor _~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I 2 l'0 --- ~ b r c ..~ .~ -. ~ ._.. ~ -- nn 1 - ~ 2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number >~C.m ~~ch~ r7~er ~ - 253 ~ ~ Address Date Evaluation Conducted Telephone Number 2113 &~~'~. ~,wl 5y025 ~l-Z~'-UI ~?i~,~2y7~~oo8 SBD-8330 (R07/00) Property Owner l Parcel ID # Page ~ of 3 Boring # ^ Boring ~ Pit Ground surface elev. 9~ ZQ ft. Depth to limiting factor ~~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ ( r~ 2 c J • ~ 2 I c ~- 3 L m OS 1 ~ ~ •- I. 8~`` ~„ ^ 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/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 ^ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) PAGE.30F.3 7~7A A~F f~tc.~.J ~ ~' ~ ~ LOT# ~ T EGAL DESCRIPTION NW ~ N ~ i4 ,S / ~- T Z~l ,N,R ~ ~- E(o~ @~~ ^ ~~ I I ,_ ~~„ b-~ ~_ 3 SIGNATURE` ~ DATE / Z'~-S~ -°~ _~ i ~ ~.~~'~- ~~~i~~GE - I ~. \ __ _-- a ~ ~c ~ ~~~ -- ~, r Q ~ ~ ~ ~ \ ~ ~~ ~ ~ ' i ~ ~ ~~ ~. ~ ~ 1 ~ e b 4 ~ M ~ ~~ '~~ ~ ~ _r ~ std- aa° '~ .i u ~ p ~ ~~ ~ ~. ~ ° `~, a 5 ~ 3~ ~ ~ ~ M ~ ~ ~ ~~~~ ~ ~~ M V ~ i~ ~s ~ -mac -- - - - - - -- ----~.~_ _ ~ ~, ~ -~- _~ ~~ -, ~~. ~\ __ ~ l'-' -- - -- - --- --r- ~ ~ ~ y 11~ ~ e~! ~w~~~~~ ~w~~~~~~ op ~~ c~ ~ 1'~ L ~ \ O ~ ~ ~ m ~ ~ ~ ~; ~ ~, ~' b ~ ~ ~, ~ bb r~-~ 4 D, ~- ~ Q \ n~ ~. °`~\ ~9 ti 1 i ,~; Ll ~ ! ~~\ ~~ J ' ~ / I ~, i ~ j ~' -~ _~ -- ~- -v,~Y-~ __ ~~~~~~~ ~~ ~ ~~ 1.5. ~~ ~~ W U ~~ ~~~ ~. N ,~ O 0 n a ~ C ~~~~ ,,1~-~.sa„e Performance Curves ME'fERB FEET ~~,~ ~ubmers~ble Effluent ~'umps 80 -~ -1 - ~ ~ ~ ~ MODEL 3885 SIZE 3/ " Solids L ~' " - -" " ~ a 70 ~ WE15H WEtOM.. I .. ~ I -~- _ _._ ._ - -- _., _._ .._ I. - W E07H •-- ~. ~ 50 . - i 10 WE05H !0 W E03M b WE03L 0 0 ~ 0 t0 20 0 40 50 7 60 0 80 80 100 110 120 GPM ' ~ ._ ~ ~ ~ 0 10 20 30 m°/h cAPACIrY ~GOULDS PUMPS, INC, srxu ~+us rEw roac t3we METERS FEET 35 11 1 30 2b 7 20 O tb ~ 40 10 ~ 20 5 10 0 0 -?-- -~- ~ MODEL 3885 " _ 0 WE15HH_~ ~~ ~•- ~ __ - - SIZE 3/4 Solids i ; --~- ...,. .__ h-. _._j,_ ~ __ ~ ~ ' - ~ W EObH H . ;_.._.. i\ ~~-; ,`.~ ~ 00 EO 80 0 60 0 10 20 30 40 80 70 E30 90 100 110 120 GPM 1.~..... ..~.... _.. .. 1.,_._. ~ .._.._..._, ~ ~ 0 10 20 30 fl1~/f1 CAPACITY • 1986 Goulds Pump, Inc. EII~Otiw July, t 985 '" 0885 ST CIZOT~C CO~JNTY SEPTIC TANK MAINTENANCE AGREEMEI`1T •AND OWNERSHIP CERTIFICATION FOIUvI )weer/Buyer Mailing Addn 'roparly Address ~/ --T---,- (VeriCcation required from Planning Department for new ~ity/State ~~,.~.~.+~~ lti~~°~~s" Parcel Identification Number J v ` ©i~-~o9y- o~-~ LEGAL DESCRIPTION Property Location .'/., ~~ r~+, Sec• [ ~~ `~~2~N-R, /7 W, Subdivision Lot # 7 Certified Survey Map # ,Volume ,Page # Warranty Deed ## ~Z ~-~~ ,Volume ~~ /~ ,Page ## ~ 'S~- Spec house ^ yes ~no Lot lines identifiable ,~) yes ^ no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance 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 a treatment stage in We waste disposal systeuL The properly owner agrees to subuut to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition andlor (2) alter inspection and pumping (if necessary), the septic tank is less than 1/3 futl of aladge. Uwe. th undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set fo herein, as set by a Department of Conunerce and the Depariiuent of Natural Resources, State of'Wisconsin. Certtficatton statin t your septic, em has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da the three year ea ia..,,...,a.~. ~ l ~~ G A r APP ANT DATE ~R CERT CATION I (we) certify that ll statements on this form are taste to the best of my (our) irnowledge. I (we) am (are) the owners) of the, r periy described a e, by virtue of a warranty deed recorded itr Register of Deeds Office. IG Or AP CANT DATE • ** A y informs on that is mis-represetitcd tuay result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with th[s appticAlion: a stamped warranty deed from tlic Register of Deeds office a copy of the ccriified survey map if rcfercrrce is made in the warranty deed Town of ~`~-~~• 1'U\V'l'S UWNLK'S MANUr1L ~ NIANAGI:MiI:N'1' PLAN r~s~-1-~~~? ;,;~, , FILE INFORMATION Owner , .~' ~~~ ~._._ .~._.~ ^Permit N ~ ~,~.21arz ncerr_iu ael2eMRTFR~ VLiJiV1~ • r~.W .... ~... Number of bedrooms o A Number of Commercial Unit o NA Estimated flow averse al/da Desi flow eak , Estimated x I.S al/da Soil A ~lication Rate _ ';il/da /Il Inl7uunt/la'I'luunt duality Muntlily i~v~rab~* rats, Uil, & Gruusv (I~OG) 51U mb/t. Rioch~mical Oxygen Duuiund (80Ds) 5220 mg/L Total Sus ended Solids (TSS) <I50 m L Pretreated Effluent Quality O NA Monthly Average** ~ioche:mical Oxygen Demand (130Dx) Slt> ~»b/I• Total Suspended Solids (TSS) <aU~mg/L <10 cfu/IOOmL Fecal Coliform eometric mean Maximum Effluent Particle Size % inch diameter SYSTEM SPECIFY I Se tic Tank Ca acit al o NA Se tic Tank Manufacturer o N.; . Effluent Filter Manufacturor o NA ' Effluent Filter Model - o NA Pum Tank Ca acit D ul o NA : Pum Tank Manufacturer o NA Pum Manufacturer o N~ Pum Model o NA Pretreated Unit a tian~l/Gruvul I~ili~r to Prat I'ilivr ri Muuhunir;il /1uru~ian a W~~il;uiJ o Disinfection o Other Manufacturer Dispersal Cell(s) !t(In-ground (gravity) a In-ground (prassurizccl~ o At-grade o Mound o Dri ~•line o Other '1~' ~ .* >VAINTENANCE SCHEDULE Voluex typical for domoatlc (non-comrnorcia!) wastewt+tor and saptic taNc oftluant. Values typicttl foryrotratto0 wtutowswr. Service Event Servtce Fre uenc Ins ect condition of tanks At least once ever o months ~ ear s Maximum 3 vr~ Pum out contents of tanks When combined stud a and scum a uals one third % of tank volun Ins ect dis ersal cells ~ - At least once eve o months e s Mitxlmum 3 n Chun effluent filter At Icust onto ever o months Cur s !ns sect um ~. nnn ccmirols b'c ;tlurm nt I~tlsl once war o months uur x a NA Flush laterals ;aid ~rexsure test At least once ever o months o ears ~ NA .._ r., _ _ _. ...... ,.._..._ - _. ... Oth~r..,_~:.... :~. ~ -° _ _At least onct; ever 4 months a cars ,k9 N~ . Other. At least once ever o months o ears 1a'NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certificati~; Muster Plumbor; Master Plumbor Rostrlctod-Sewer; POWTS tnspoctor; POWTS Maintainor; Soptago Servicing Oparator. Tank inspections must-include a visual inspection o(the tank(s) to identify any missing or broken hardware, identify any cracks ar leaks,.. tneasure.the volume. of combined sludge and scum and to check for any back up or ponding of offluent on u ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes end to check for any ponding of offluent on rho ground surface. ~ito;ponding of effluent on rho ground stufaco t~aay indicate a failing condition-'and requires the immediate notification ofthe local regulatory authority. ~•~ ~ 'j%• ~ ~•~-' + '-• • ~ ~ ' ..:.. _. When~the combined accumuJ.~tion of sludgy rind scum in any tank equals one-third (%,) or more of the tank volume, the eat, contents of the tank shall be,~.emovetJ by a S~ptagc ScrvicitiY Qperator and disposed of in accordance with ch. NR._t 13, Wisconsin Administruuve Cade. Th~~sat'vieing of efflucnt`filters, mechanical or pressurized POWTS components, pretreatment components, and any other maintenance or monitoring ttt intervals of l2 months or less shall be performed by a certified POWTS Mai~c~ine/.:. . :~. A service report KMaull be provided to the local rv~;ul;~tciry authority within 10 days of completion of any servico event. S`1'AEtT`UP AND''ONIKA'1'lON ,.<, For now construction, prior to use of rho POWTS check treatment tank(s) for the presence of painting products or other chorrtieala that my mpodo rho troatment proeass and/or damago the dispersal cell(s), it high avneontrtttlgtta aro dstoc~od hu the contents of the tanks(s) removod by a sep~:.,•: servicing oparator prior to uso. ,: Owner: ~~Ll ~ /~ Page.~of~ System startup 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 rrN~terial. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for tine 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 for a new soil and site evaluation to establish a suitable replacement area.. Replacement systems must comply with the rules in effect at that time. v 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. -~--~ - tT= Tfie site' hasiioC been~evaluated to dentifp-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. o 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 OTI-~ER TREATMENT TANKS MAY. CONTAIN LETHAL GASES AND/OR INSUFFICIENT,OXYGEN. DO NOT:ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDERANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT, OR IMPOSSIBLE. ADDITIONAL COM1V,11EN~'S .. , ~~, POWTS INSTALL R Name ~ - Phone SEPTAGE SERVICING OPERATOR PUMFER) Name Phone POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Name ; Phone 7.~ - ~~i_" ~ /_r~~ "dl' ~~~~LitlSm:c1 r VC NT PIPE ? 25' FaOM DOOR, WINpOW OR fRCSN AIR INTAKE PUMP CN~MBER CROSS SECTIOIJ ANO._~PECIiIC^TIONS = VEA1T C/1- WEATNE RPROO F JUUCTIOAJ Box GRADE In'nl-u. >\ I AJ L E T 1 APPROVED JOINT w/ P-PE ~ CXTCNDIAJb 3' 0-JTO SOL10 SDII. CLEV. FT, 51L~w a~o(u-'~ ~f- i n ~ye,~~i,~~- A D C 0 li'MIU. I I i I C01JDUiT ~~_ /~PPIlOVCO LOCKING MANHOLE COVLR WITM ~ WAAlJIN6 LA6EL V ` ~~~ ~1 r~ROV~oc _^ I AIRTIGHT SCAL I I PU11P-~~ CoucRETC BLOCK y" MIIJ. 1 ~. ~ le~ r;lu. III ~~ ~I~ I ~ ~ APPROVCD JOIU' I ~ ~ W/ PIPC I ( ALARM LXTC-JDING 3' 11 ONTO SOLID S0 ~'~ ou f~~ b OFF RISER EXIT PCRMITfED OIJL.y IF TAIJK MAUUFACTURCR HAS SUCH APPROVAL ~" pPPKoVEa 6~DDIr~G t.,~r~dcr Tr•-s!t SEPTIC E SPECIFICATIOiJS DOSE ~~ IJU,^1BCR OF DOSCS: ~ -PER DAB TAUK MAUUFACTURCR: TAA1K SIZC:__.~r' GAL.LO-JS l / DOSE VOLUMC /2 I-JCLUDINCa pALKFLUW: ~~~T3 (.AI.LON:. ALARM MA-.JUFACTUR~Q' -S a ~4~~ ~~ ~ ~A~ 7R GAlL0u5 5 '`~ CI~PACITIES: A=~C1.~..IWCHCS OR~ MODCL UUMDCR: 9 ~ ' ~ ~ ~IUCNES OR ~=GALLO-JS Z B =_..c SWITCH TyP[: / 1 C ~ 1, I INCHES OR ~~'~7~ CALLOUS PUMP MA-JUFACTURCK: ~ GALLO-J5 Gl1iC CHES OR ~a ~ '`~ ~/~.L. ~ MODEL -JUMDCR: e'I . . IN O~ SWITCH TYPE; ~~ ~~~~e G.1a.C' ~1GTC' f UHP AUD ALARM ARC TO DC GPM ~' R C IN57ALLEU O!J SEPARATL CIRCUITS _. -- AT MI-JIMUM DISCHARGE VERTICAL DIiFERfIJCE DETWCCIJ PUMP OFF /~IJD DISTRIBUTIO-J PIPE.. _,~^ FEET ~- MIIJIMUM AICTWORK SUPPI`~ PRESSURE ~- FCET FT,/ FRtCTtOU FCET OF FORCC MAIIJ X~d•~ ~o~rr ~`~ FEtT FAC'rGR . . .+.. _ ~ TOTAL Dy1JAM.IC. HC AU = !~- FEET// I-JTCRIJAL. DIMEAJ IO-Ji Of '1'A-JK: LEIJGTM ~1r/IDT'H JjL-Qu-D GEPTN .~Z--. CENS :d~~~-~ SATE: E NUMOER:~ ':IG1.1E0; .~ __-_ LI . N 9p i' ~ I: ~ ~ ~ r. ~ 2 2 a \ R~I~ ~` `~ 0 wAy ~_ ~ i v i ~V~ n,~n '~ ` w ~~ ~ R1 O ('1 ro dp O °D ~ ~ r ,001 ~ n ,~ G\ \~~ (,~ ow a~ o ~ N n ~~ I g ~ w` ` < ~+ ~ v I ~ L' •~ \ ,~ ~ ro ;gym i ~~' ~ ` Z~ O ~ ~ I ' - ------,LS '8~ ------ -- ,91 '~9Z --------~ I O ® ® ~ '9 I 'ter ............:............... ........................... I w -A ~ v`' ~ w ~ I t0 y N ~. °' (p O (~'' ~ N ~ r" ~ W p ' w ~ ~ I c„~ ° ~ m ° ~ ' r*i ti ~ m ~° ~ ~ I - ,r, ,~~es ._l~a - ~ I '•• 89.1ss ,is~~£ -iN- ~ ~3JdN14210 '•• _ -- oo -1£ • i ~ I ,• -M , • 68 '1ZZ ~' ,91 '46Z p~.p, ,68'1ZZ ~ - ~Dv, I ,ZI 'L l6 ._ 3.£O ,6~o00S °f ,£9.942: _ ~- d3bd $i a W ---------------'-3.9Z ,t--eZOS ""----rn~ I ~ :08 ~£~ j 5~I -'~ ~ I OD ,1ti ,6Za _ - ..2 ~ ~ ~ 00 ~ o I ~+ a ~'~` ~ ~ w I • w "' .p I n o, Pry I a ~~ 0 m y O n .,,~ a ~~ y~ ~ ~m ~ ; I O~ „~ mo, ;+~ Q ~ ~ --~'i ~'n v rn l cn .;~a.J~, ® ................... .......... ................. ~ ~ I a# , .~~_,6B `1ZZ _ _ ~ -----,68'1ZZ ------- - - ,91 'S5Z y I ca---,~4'1 f 1 •=''r.,, ,9£'911 0 --- m f, - O P y y `f DOCUMENT NUMBER WARRANTY DEED Midwest Equities, LLC, Grantor, conveys and warrants to Gary Larson and C 1 Larson, husband and wife, holdin as i property, escribed real estate in St. Croix County, State of Wisconsin: Lot 7, P irie Run, being part of the NW 1/4 of the NE 1/4 and part of the NE 1/ of the NE 1/4, and part of the SE 1/4 of the NE 1/4, and part of a SW 1/4 of the NE 1/4, all in Section 17, T 29 N, R 17 W, Town o ammond. ~~~8zg KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. ~ WI RECEIVED FOR RECORD 04/21/2003 09:O0AM 1iARRAHTY DEED EXERT 1 REC FEE: 11.00 TRANS FEE: 119.70 COPY FEE: CC FEE: PAGES: 1 NAME ANll KE'1'URN ADDRESS ~~1~ ~r~U s-i 4~~- 018-1036-81-000 Sw~ Parcel Identification NumlZer This is not homestead property. Exception to warranties: All easements, restrictions and rights-of-way of record, if any. Dated this day of April, 2003. vv (SEAL) La r J. We Managing Member of Mi a Equities, LLC AUTHENTICATION Signature(s) ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. S~- CrO «C COUNTY ) (SEAL) (SEAL) authenticated this day of 20_ Personally came before me this ~ day of April, 2003 the above named Larry J. Wellens (Signature) to me known to be the persons (s) who executed the foregoing 'nstrument knowledge the same. (Name Printed or 1Yned) ' ' TITLE: MEMBER STATE BAR OF WISCONSIN Si nature; (If not, -T- Q authorized by 5706.06, Wis. Stats. ) ~~~~~~~ * ~ib~. u _ pGG~,,,`~ ~ (Name Printed or ~[Yaed) THI3 INSTRUMENT WA3 DRAFTED BY: Leo A. Beskar Rodli, Beskar, Boles & Krueger, S.C. P.O. Box 138 Q`?~ River Falls, WI 54022 ~~°1u v~~ ````>>11~ B l~/~~,,// r A ,~~ ,~~r1 `~'~ ECjy //flotary Public S'C C~ Net }C County, Wis. `~~~.' ~ .~~~~y commission is permanent. (If not, expiration date:) ~O~q9 ~ ~• .. y~ • ',///9 ~F~OF~ iW~aC`O`````` (SEAL) /~~ZG~