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Home My WebLink About018-1036-80-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safa:ty and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. Permit Holder's Name: City Village x Township Ness, Lar R. Hammond Townshi CST BM Elev: Insp. BM Elev: , BM Description: /~ ~ s r- ~ ` i/ ~ ~ D ~ 2 ~ c P~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic _ W Dosing n ~ `0~ ( y ~ w\ S( Aeration Holding Q / TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic \ +oO/ l ~~ ~S t Dosing ' -{~ Y~ l~ 3~~ Y Aeration _ Holding ~~,, PUMP/SIPHON INFORMATION ~J p~r~- p+-PS Su ri2.e a~ Manufacturer Demand U (/ GPM Model Number r ~ ~ , ' f TDH Li~ •` - o~ FrictioCf~t~' ss System He;~ ~H ~ Ft t0 tiJ /k ~, Forcemain Leg Dia. ti Dist. t Well ~~ 2 N o~ ~ ~ ELEVATION DATA county: St. Croix Sanitary Permit No: 405078 0 State Plan ID No: Parcel Tax No: 018-1036-80-000 STATION BS HI FS ELEV. Benchmark ~ ( /D . / ~~ ~ ~ Alt. BM ~j a~ ~ah . l~vcC l ( • la ~ /~ ~ ~ • 7`0 Bldg. Sewer / ~~ ', St/Ht Inlet ll- g ~ 2. 3 SUHt Outlet ~, Dt Inlet ~ Dt Bottomfi ~ ~ /s. 3 ~ g ~~ 1(,~ Head Ma _ ~~ / G • / Dist Pipe. K, I ' -~ Bot. stem I ,L t yt~/~ c ~ Final Grade s o, /ord. S `~. R S• 3 G SVIL AI35VRPTIVN SY51 EM BED/TRENCH DIMENSIONS Width ,3 ~ Length ~-~ /_ No. Of Trenches PIT DIMENSIONS /~ No. Of Pits Inside Dia. SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER O Mf ty ~c+ Type f System: / ~ ~ ~ / ~~ ~ U Model Nur DISTRIBUT ION SYSTEM 7- ~/_.~_,... 'L n.,-~ /.1n n.....1_ Headerr/M~ /i t' ~ Length Dia Distribution Yl°/K. _ ~ Pipe(s) f ~~y-,j+~(~b-~ ~ Length Dia Spacing x Hole Size ~~ x Hole Spacing Vent to Intake pt SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Only Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ a,, Bed/Trench Edges Topsoil ~ Yes ~ No [~ Yes j) No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ ~l / 0 ~Y Inspection #2: / / Location: 995 166th St Hammo^ 15 015 (NW 1/4 NE 1/4 17 T29NpR17W) Prairie Run Lot 8 Parcel No: 17. 17. ~ ~~~~ 1.) Alt BM Description =/ 0 ,~,~, , ~~~~r ~ 1 ~~a G~~ ~rf ~~~ ~ a ~ n, ~ 2.) Bldg sewer length = 2.~ / ~p s~s.,K,y.~ ('~ ~a{~.t,d vt~Y~^, - amount of cover = ~ ~ / Q~k N~ ~ 4 ~ ~" ~~ ~ ~ ~`~~ -1 f 1 I Use otheris de foruadditional in Yes ~r~ No I- ~ J ~ - -- - -- --_~ I --~~ I - - i formation. ~ _ SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. ' ~~'Yq.-ta-r ,~ M },s_ 4visconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must 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. Revie ed by Please print aii information. ~ J Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1 } (m)}. G' Property Location Page ~ of q~at~~ Property Owner Govt. Lot NW 1/4 ,f/G 1 /4 S (~ T Z q N R / ~- E (or Lot # Block # S bd. Name or CSM# Property Owner's Mailing Address ~ ~ ~ ~r~~r.~ ~ ~ ~ , / ~ State Zip Code Phone Number ~ City ^ Village ®Town Nearest Road City r'T`~ WI N~ G New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate `/So 3 - ~ _-- /'~G ~ U GPD [] Replacement ^ Public or commercial -Describe: Flood Plain elevation if applicable .~ ft Parent material General comments ~~ ~~~ S ~ ~ c~ ~ ~t v ' TG (~ 9(r ~ ~ ~ Y S e GG•Zo Low ~• ~G U and recommendatio . ns: ~ L ~ ~/fv, ~P 9G"9° ~~~~,~ 9G ^ Boring # Boring ~o ft. Pit Ground surface elev. -~~-.~ Depth to limiting factor in~ Soil Application Ra z ti i Texture Structure Consistence Boundary Roots GPDIft Horizon Depth on p Dominant Color Redox Descr *Eff#1 *Eff#2 in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~ J~ .5 ~, I p-to 10 3 Z L 5 5,1 m ~ 5 8 ~~ ~ ~ c5 . . 3 ~-~~4 ~nvt~ `~ ~ `~ m5 DS m I Boring # ® Boring Pit Ground surface elev. ~ ft, ~'~ in. Depth to limiting factor u t_.___-~ Redox Descri tion P Dominant Color Texture Structure Consistence Boundary Roots Horizon Depth in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. ~5 I v~ ~ 5 r I ~ r~~ m- I ~-IZ S, i 2 ~ z .2 - o to ~ ~.s o 3 ~-F~~ ID ~ ~-- *Effluent #1 = BOD. Name (PleasePrint) ~ ~: ~ ~iw ~..- i ~ ail Application Rate GPD/ftz *Eff#1 *EH#2 •~l .c~ 1-Z 3 ~ < 220 mg!L and TSS >30 ~ 150 mg1L * Effluent #2 = BOD$ < 30 mg/L and TSS < 30 mg/L CST Number Signature ~ ~ =~ m°" _ TolcnhnnP NUmt3er ;~~ --"'"'^- Date Evaluation Conducteo ~ _ _ %~~"4~ °~" ,~~~ , ~.\ ~;'°-.~ ~ _ .'.~+ { ` ~ ~ SBD-8330 (R07~41 Property Owner t-tG ~~ \K.1 Cl ~ Parce110 # Page ~ of 3 ^ Boring Boring # Qb, q Q ® pit Ground surface elev. ft. Depth to limiting factor ~~ in. Soil Application Ra 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 ~ ~-~~ ~ z 2 ~s -~ . 5 . S 3 -~1- r ~-t- (~ `--` mS I -- - . ~ ~. z Boring 1 Boring # ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rat Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ~ IZ' 30 1 U~t'r ~ .- S~ ~ ~ C_ - Boring Boring # ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Ra#E Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = 8OD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' EfFluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Conmlerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate forniat, please contact the department at 608-266-3151 or TTY 608-264-8777. SDD-5330 (R.07/00) PAGE 3 OF~ SCALE: 1"= ~7 ~ BM I ELEVATION /00 ~ „ „1 - e ./BM 1 DESCRIPTIOi~ 7~ ~ ~ Qvc P~ ~ BM 2 ELEVATION `I ~ 3 ~ BM 2 DESCRIPTION ~O-~ ~ ~ ~ ~C- f ` P `' SYSTEM ELEVATION }5~, 14 ~ ° CoW°r gt'S'2° ALTERNATE ELEVATION fir, 09~ 40 L °~ < ~- P•~' ~ a CONTOUR ELEVATION qq a ° a- I ~ • U --_ __ ___ ir~~, t~ ~-~ __~.. _ ~, DATE TEL ., .-. ~ a nJ V ~~SG s,~~ n Q I I ~G i6°°~` 16 °° ~ ~,~ 1~ ~ ,~ ~s.'~~ Z~ ~~ I ~~~ ~ n s,~t~ ~ ~ ~ c S9 ~ w N ~-YO,~~~ t~ s .3~ C Q o ..Pry-d s-~'1 ~~ u.~k ~~--~-- ~ ~"' w~ --~ -sys' . i ~ ~ ~r ~ ~~ '-~ ' Safety and Buildings Division 201 VJ. Washington Ave., P.O. Box 7162 City S ~ CY d c ~ > ~ ~ ~seo~ns~n Madtson, WI 53707 - 7162 ~ Site Adpdr~ess S ~~~ - Department of Commerce S' ~ -0'~/ ~~ISO~ / 7 ~ ~ Sanitary Permit Application sanitary Permit Number ~D~4 ~~ In accord with Connn 83.21, Wis. Adm. Cade, personal information you provide ^ Check if Revision ma be used for seco ses Privac La , I. Application Information -Please Print All Information State Plan I.D. Number , N Property Owner's Name SAY ~ 9 2~~2 Parcel Number Property Owner's M ' ' Address ST. CROIX C FFICE Property Location J ONING City, State Zip Code Phone Number Lot Number ~ Block Number Subdivision Name CSM Number ~'~'O S' rQ ~`Y. ~ ~. II. Type of Building (check all that apply) / ~ ~jjQ,. D'ri- ^Ciry or 2 Family Dwelling -Number of Bedrooms ~~ ~/ ~A/n~ ~~a~ 3a~ / ^Village ^ Public/Commercial -Describe Use ownship ~Q d.(J c ^ state owned Z z C~/ ~~.a J (/L % ~ j' k 6 ` t Nearest Road / Ov ~ n III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. 1 ~ew 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use S stem Tank Onl Eris ' stem Permit Number Date Issued B. ^ Check if Sanitary Permit Previously Issued IV. Type of Permit: (Check all that apply)(ntlmbering scheme is for internal iise)~ ~:~/~(E'$ // °'~ ~~ 44~Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Filter 50 ^ Constructed Wetland 3/~ ~Og. 2 22 ^ pressurized In-(around 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line rn~yjj~,{,tiy,., ~~~ G~'a"~'6'r'~~ ircula ' 30 ^ Other 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Rec tutg D' ersaUTreatment Area Information: ~~ ' rt r / - .',Sr e~u/Dtr~ ~ ~5 ~- - ~ V . Design Flow {gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevatio~ Final Grade Elevation Required Proposed Rate(Gals./Days/Sq.FtJ (Min./Inch) qG~ ~a, ~d / ~ ~(3 VI. Tank Info Capacity in .Total Number Manufacturer Prefab Site Steel Fiber Plastic ~ Concrete Consttttcted Glass ~ Gallons Gallons of Tanks ~~~ ~ ~ / ~-/'~ ~ Ncw Existing Tanks Tams Septic or Holding Tank _ /~~~ ~ ' Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for ' tion of the POWTS shown on the attached pleas. Plumber's Name (Print) Plumber's Signature 1tS Number Business Phone Number W; f~° v a~ 7~94~ 7~3' 3 -3l 1 Plumber's Address (Street, City, State, Zip Code) VIII otmt /De artment Use Onl _--- „_._ r......ea rte.,,;,,., eo.nr c;o..~„.... rnr~ Ctamnsl Approved ^ Disapproved oaauuay rcaaaut rw ~uawuuw v.........••.-.-- -- .. Surcharge Fee) L ^ Owner Given Initial Adverse X751 ~~~ ~ ~ / y ~ ~ti Determination "~~// p 1X. on oas gf Approval/Reasons fo>~ p royal S fo,~~ q,~-' ~j ~ • 0 ~"' ~~ Gt/~~ k'C ~ ~ ~~• t0 ~-~cti- u~(.~ r ~'~ -I" ~.¢~ ~~tc~'4'd °~"`' D,rl satil~O. vKCr~.~Q,a.J (tntiu•n~~,n, 3 b fb .~ 'Ir-la-r~~7~ ~~2 rum- ~ NI Attach complete Tana (to the C ody) for the em on paper' n less then 81/Z x 11 inches to sae SBD-6398 (R. OS/Ol) n Q ,~~usG s,~r~ ~~ ~ / ~~ ~ ~ ,~~+~ s,~t~ ., ~Z Gk~, ~,, ~yc ~,s 7o fiQ ~/ C~ s C • ~ W N 0 ~~ ~ ~ i n ~ '® "' i WisconsinDepartment,ofCommerce SOIL EVALUATION REPORT Division of Safety and Buildings ~~ a~~~~ Page ~ of 3 County ,.. C Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ~ 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. ~ - Q ,~~- - (,b Please print all information. iewe by Date Personal information ou rovide ma be used for seconda r ses (P i L 15 04 1 ~ - ~3 ~ y ry pu po p y r vacy aw, s. . ( ) (m)). GZ~~ ~,1~ Property Owner Property Location Govt. Lot NLJ 1 /4 ~/C 1 /4 S/~ T Z q N R ~ ~- E (orb Property Owner's Mailing Address Lot # Block # S bd. Name or CSM# ~ ~ / ~ ~= .~• ~ ~r~~r.~ n City State Zip Code Phone Number ^ City ^ Village ®Town Nearest Road / H~t~Y1 0 ~/l SYo(S (7/S`) 7YC~ -~ 1~`9 ,~ o~ /Crow c.C, [~ New Construction Use: ® Residential /Number of bedroom - Code derived design flow rate ~/.Sa ~G o a GPD ^ Replacement ^ Public or commercial -Describe: ',f --° Parent material ~`i ~/~ Flood Plain elevation if applicable ~%l~ r ft. General comments syS~P~ ~lt~,rGr~ 9G•~~ pow.<r ~G•Zo ;a~}` and recommendations: p "~' ~L,tC C~/i(!~ ~f / ~/'~~ Lvw<Ir' 9/i•G U ~r,-.~ l,;r~ T ~ Ov-ed q/o 2 q5 yo o~ ~~ u't''ti'tJf ~' `~'^~~ ^ Boring v - f -.rsc.q,x Boring # ~N~ ~" Pit Ground surface elev. ~~ ft. Depth to limiting factor ~"f ', in.. •=~~tty o I Ap ron Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ~ /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~ ` ~:, .,' ' ',r 1 *Eff#2 I p-to I 3 Z 5,/ ~ s I ~-~' .5 . S t, S9o- ~ ~ ti ^ Boring # ^ Boring ® Pit Ground surface elev. 99. ~ ft. Depth to limiting factor ~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ! O-IZ 5.1 2-rablr ~ c5 I v~ . ~' Z '2 - o fU 1 S; - 2 ~ - 3 3fl- ~ IU mS D -' _ . -7 / - 2 ~Jc-- -- -,-~zd -fa at' 3 . ` ~ A~- * Effluent #1 =GODS > 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 Sch e~ _~'~---.~ 25 Address Date Evaluation Conducted Telephone Number 2~~3 ~o~ oz 1 -2 -ai ~i Zy - yao8' ~~li-~~s~ ttt~~~~~/ . t Property Owner t-tr7l . \tclh 5 Parcel ID # Page ~ of 3 Boring # ^ Boring ®Pit Ground surface elev. 9~ ~ ~ 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 ~ -14 I Z 2 ~s -~ 5 8 2 I -30 I 4 __ ~i ~ rr~r c - . 5 ~ 3 -~ r ~-t~(~v mS I - - . ~t ~. 2. ~~ ~ (o " h ^ 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 i * Effluent #1 =GODS > 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) r • PAGE ,3 OF~ T~TA A~fF ~-~, ~ k ; n S LOT# ~S LEGAL DESCRIPTION ~tJ -~ ~ ~1~.~ ,S ~ ~- T Z4 N.R. ! ~ E(orl~ SCALE: 1"= ~D r BM 1 ELEVATION /DO ~ ~ BM i DESCRIPTION-/v~ o -f ~ z ~ Qyc ~~' ~ 2 BM 2 ELEVATION ~ 9 3 U BM 2 DESCRIPTION .~ ~ ~~. ~ z` pT c P~'~ ~ SYSTEM ELEVATION -~~ g4 ~ 4 ° Lower- `~~ ~ Z ~ ALTERNATE ELEVATION ~r~ ca~j4.4d L ou, t r ~G • Iv 6 CONTOUR ELEVATION q9 ap ~- 16C~• o ~n ~~ N _ t -~ , / ~ ~ C~ AG ~ .-~. ~ ~. ~~~ f~ «- w 3 ~ pf ~ ~ D N ~ 1I ~ .E ~ '~C e r 'E ~ ~ • .'1 y~ ~ ~ ~° ~ ~ .. a IJ ~~ e, ~ ~ ~~ m ~'~ •~ ~~ , II ~' , ~~ M ~ ~ ~ ~ ~ I ~ 17' e 0 m ~ ~ N ~ a... -. w.... ... .. .. . I ~Z u. ~~ O 3 w r ii i +~ ~ j ~ ~ ~ ' • CJa CA ~. i ~ ~ ~ ~ r` ~ N 4 X ! f'" j N '+1 ~' to tit ~ ~ ~~ t ~~ ~' _ ~• ~ ~ ~ ~ ~ RC! 'C c t0 G C ~ ~ ~~~ ~' _ _ .r ~ ~ ~ ~ ~ d `C G ~~ cn ~ g Q a® :~ ~~ ~~ +;~ ~ ,~~~m ~ ~cso '~~ a~ ~a~N ~ Q. ~ t7' t} ~ •'~- ~? ~ ~ ~ ~3c . ~ ~~? n o .~~ _ ~~~~ ~~. ~ ~ ~. V t7t t __.. I ~ 7 t i ~ v~.~'I ~ +' T~ II 1"~~l ;~ ~ n ~ os~. m ~i• . ~~ •~. ~:: _.. __ _ . ., hNner/Buyer Bailing Address ~~a~~ 'roperly Address ` ` rc '' - ~ (VeriCcation required from Planning Department for new construction) ~`i /State ~ ~ Parcel Identification Number ~~_~03~~ ~~ _~ ., ty LEGAL DTTSCRII'TION e Location ~_-'/,, ~~ '/,, Sec. ~7 . TAN-R..j-mow, Town of .~ ,-n ~ a.~~.,~ , Prop rty Lot # ~_. Subdivision r e'rr' ~ Oi~.r Certified Survey Map # Warranty Deed # ~77~ ~ Spec house ^ yes [~ no Volume .Page # Volume l ~ ~ ~ --~ Page # 2 ~ Lot lines identifiable 'yes ^ no + NANCE remature failure to handle wastes. Proper maintenance SYSTEM MATE Improper use and maintenanceof your septic system could result in its p a licensed pamper. What You put into the system consists og pumping out the septic tank every three years or sooner, if needed by can affect the function of the septic tank as a treatment stage in the waste disposal systeu~. the owner and by a The properly owner agrees to submit to St. Croix Zoning Department a ce ~~fri ~°e~+ Si gnw~as'th ~terdisposal system oume n lumber, restricted plumber or a licensed pumper verifying ( ) masterplumber. j y~ P () p P ~ tf necessary), the septic tank is less than 1/3 full of sludge. is in proper operating condition andlor 2 a tier ins ection and ump g C osal system with the standards State of Wisconsin- Cerhficatt°n Uwe, the undersigned have read the above requirements and agree to maintain the private sewage O~Ce ~~ 30 set forth, herein, as set by the Department of Conunerce and the Deparl+nent of Natural Resources, Zoning stating that our septic system has been maintained must be com feted and returned to the St. Croix County Sys g ee year ex iration te. ~ ~j/ ~ ~/ DATE ~ A~~ ~ APPLICANT _. OWNER CERTII+'ICATION am are the owneds) of I (we) certify that all statements on this fonndeed reco Bed iu Register of Deeds Officee. I (we) ( ) the grope describe bove irtue of a warranty ~ ~/ ~ '~.. DATE SI NA ~ 'APPLICANT ****«* «««««« Any information that is mis-rcpreseutcd may result in the sanitary pern~it being revoked by the Zoning Department. «« Include with this application: a stamped warranty deed from th ; ltf gcfcrence isemade~in the warranty deed a copy of the certified survey mat ST CItOI~C COUNTY ' SEPTIC TANK MAINTENANCE AGREE~NT •AND _ O ERSHIP CERTIFICATION FO1tM ~ Yoso fib' Private Onsite Wastewater Treatment System Management Pian Septic Tank And Gravity in-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Cade each Private Onsite Wastewater Treatment System (POWYS) shalt include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on fife at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soi! Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 7: System Design Specifications Sancta Permit Number 0 Number of Bedrooms Desi n Flow - Psak (gpd) 5~ Estimated Fiow - Avera e ( pd) ~ Septic Tank Capacity {gal) Soil Absorption Component Size (ftx) ~ 3 r-tv~. . T pe of Wastewater b:~,,,dd Domestic Table 2: Soli Absorption Cam onent - Llmits of Reliable 4 eration Se tic Tank Component Soil Absorption Component Design Flow -Peak pd) Maximum Influent Particle Size (in) 1/8 Maximum BODE {m L) 220 Maximum TSS (mg/L) 150 Table 3: Maintenance Scitedeale Se tic Tank Inspect and/or service once eve 3 years Outlet Filter inspect once a ear and clean at least once e 3 years Soil Absor lion Component fns ect once eve 3 years ~~ ~~~~ ,~/C~- Se~ic Tank The septic tank steal! be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be afeaned as necessary #o ensure proper operation.~,he filter cartridge should not a remove un ess provisions are ma e o retain solids in the tank that may sToua oh~~fFi-ester when removed from t ~ s~re:~-t~ Management Plan for a Septic Tank and Sail Acsorption Component filter le equipped with an alarm, the filter shall be serviced if the alarm is activated rx~ntinuouaty. ln#ermittent filler alarms may indioste surge flows or an impending continuous alarm. The septic tank shalt have its oontents romovsd when the volume of sr,~um and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the #me of an asse~aament, rnalntenance peroannel shat! advise the owner of when the next service n+sed~a to be pertarmed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected far watertightness and soundness. Access openings used for +s®rvtce and a~rsessment shall be sealed wa#ertight upon the compietton of SBNiae. Any opening deemed unsound, defective, or sub)ect to failure must be replaced. ,Exposed acxess openings groater than 8•inches In diameter shalt tea secured by an effective (ocklnq device to prevent acddental or unauthor)zsd entry into the tank. No one should •ttter a septic or other >ywtmst>rt or holdlnp #enk for say reaean wfthout being i'n full cornpltance with aBHA stendtrda for enhrl~r s conf/ned sprat. The ~bnosphen wl!!Nn the s±~ptfa ar other trrsb»er~t of holailrtg tank wry contain NthN ~rsss, and raraw of a person ttrota~ the Inter/or of ~-o bnk they bt dffllcuft or Impossible. lank abandonment shall be In accordance with Comm 83.33, iMs. Adrn. Code when the tank is no longer used as a POWT8 component, The soft absorption component serving this atructuro is designed to accept domestic wastewater from a residential facility. The limits of opsratlan of this component are Shawn in Table 3. Tt~ longevity of a soil absorption cornpanent depends Qreatiy on proper and timely maintenance, and system use within or below the limits of roiiable aperatlon, Oaod water conservation practices by sit oc~ccupants and the ir~stsilat9on of water conserving plumbing fixtures are key factors to extending the useful life of this component. The soN absorption component's opara8on must be assessed by inspecxlan at least or:ce every three years. The inspection shall include recording the levels of pandinp, if any, fn the obssrvatian pipes, and a vlsttai inspeotlon for any evidence of surface seepage ar discharge from the component. On steeply sloping sites, areas of erosion should be idenbfied and reported to tt'te owner for repair. The surlsce discharge of domestic wastewater ar sewage from the system is prohibited and considered a human health hasard, Tnaffic around or aver the soli absorption component should be avoided particularly during winter months, The compaction yr removal of snow raver over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but fa difficult or impossible to repair undtl weather aondilians improve. in general, soil compaction over this component wilt reduce diffustan a# oxygen into the sail grid dispera~l c:eil, which may lead to more intense, and earlier, organic slagging of the soil, •~'~ Management Pien for a peptic Tank and Soil Absorption Component Plantings of des~rrooted trees and shrubs directly over of within ten feet of the component should be avoided since root intrusion into the componen may Obstruct wastewater fi0w. Contingency Alan in the avant of system failure, a new system could be In'taNed in an alternate area. With the itlstellation of a diverter wive, the existing system could else be reused after a Period of three t0 four years. it !s the property owners responsibility to maintain the alternate aroa froe from any planting of trees., shrubs, etc, In case of failuro of the original system, the alternate area wi!! be needed. If eny trees, shrubs, etc. have bean planted an the alternate area, they will have to be removed at ~~ owners exPen~e. If alterrute area is destroyed, there are other alternative systems that can bs used, in which, could rosult in added expense to the property owner, Any tank abandonment shall be done in accordance with Wisc. Code 83.33. Any 4ues#ions rspardinp this cads, please confect your local Zoning pffice or contact the instaiiing plumber. ~c~ ~s t ~ ~ '~~ tc,.se C.~ t 5 ~ 3 $ to -» ~ tp 8 O ~c.~~...~-~. ~,.1~..~,. ~1. v~.~, b ~ ~~ (Z t S~ 3 `~ b ~ 31 ~ 1 DOCUMENT NUMBER WARRANTY DEED William E. Hawkins, Grantor, conveys and warrants to arm m and June G. Ness, husband and wife ae survivorship marital property, Grantee, t e o lowing described real estate in St. Croix County, State of Wisc in: oC Eight (8), P at of Prairie Run, Town of Hammond. ~7 ~8~~ KATHLEEN H. MALSH REGISTER OF' UEEUS ST. CROIX G0. , 1tI REC• RU 05-02-2001 5:30 AM .:,._. .-cam EkEMF•T a REC FEE: 11.00 TRANS FEE: 89.70 COPY FEE: CERT COPY FEE: PAGES: 1 18-1036-60-000 Parcel Identification Number This is not homestead property. Exception to warranties: AlI easements, restrictions and rights-of-way of record, if any. Dated this ~ ~ ~ day of April, 2002. (,_~~~F! (LClI'~J~ (SEAL) William E. Ha ins (SEAL) AUTHSNTZCATZON Signature(s) authenticated this __._ day of 20_ (s'a c ~ (gems Print ea or ]YDea; TITLE: MEMBER STATE BAR OF WISCONSIN IIf not, authorized by 5706.06, Wis. Stat s.) THZS INSTRUMENT WAS DRAFTED BYE Leo A. Beskar, Attorney at Law Rodl i, Beskar, Boles & Krueger, S.C P.O. Box 138 River Falls, wI Sa 022 (SEAL) (SEAL) ACIWOWL6D@tBNT STAT OF WISCONSIN ) I ~ ) ss. /- ~ COUNTY ) Personally came Lefore me this ~ day of April, 2002 the above named William E. Hawkins to me known to be the persons(e) who executed the toregoing;~nat rumeyl4 pnd acknowledge the same. :L lil4 l [~1"t-~'V/Jr ~ (gems Printed or xvneal Notary Public ~~ (~/]~-1~((.~ ~~~,...G[y}atyi, Wis. My commiss'on is p manent. Zf,n~ ,~xpi~r~it iOq d.:tc:) 0~-~~2- ~"Lvov ,F~ ~~~ S ~E. O ~ 4 ~~W`l ~ i- ~ 1~ O~t~ ~ J_ p I N Q: ~ I ~ I ~ ;~ ~ 00 20 : Z' ~Z ~4 ~ 's.~o'' g - . I-._ ~ : I I 233. so `"'~ 7 C i tp ~ S02' 17' 25' E _ ----------- ----- ~ ~ ~ I i- -~--- --_- --,'255.83' SOC ~` Q " ~ ~ ~ a ~ ~ co 255. 76' = 227.8' '~ , ~.. ~ ; DRAINAGE-7 ~ .. N -23~.s~ . 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