Loading...
HomeMy WebLinkAbout018-1094-20-000 ~ ~ m m ~ < < m co ~ co ~ m d ~ 5 ~. _ C ~ ~ ~~ w N ~ N m ~ v v a a iU o o ~ c c c o ~ G O U! Z D m « D ~' ~ ~ ~ c ~ N ~ O ~,, `"' O ~, ~ Z 0 ~ '~ ~ c c 3 3 a ~ m I m i 3 A z 0 p n W N ~ ~ N O 0} ~ ~ ~~ ~ ~ j' CC ~ i~ ~ O A N "O Q ~ ~ CD n N ~ G C (p N ~O - <. (D CD ~. CD N. c7 N T ~ O W 7 7 ? N ~ ~ ~ ~ y D O ~ f 07 ~. a I O. O O SU c N > > ~ D D ~ G ~ a n o- N ~ a r. o' N ~ ~ v o y. ~ N N 7 A ~ ~ O ~ N Q ~ ~ "O Q' (D c = ~ Qo m~o.~ ~ ~ u; .~v a~,v m _. ~ o_ m o s °'F.m ~ 3 ~ N O ,C-. 7 -~ N fD ~ fD n r: O i O (D V7 O ~ O G- ~ ~ O ~ ~ ~ ~ d ~ ~ f 3 '. 3 d C1 ~ 3 ~ ~ _ ~ I ~ C ~ i 61 ~ cp 3 3 ~ `•~ o A D _ -. o 000 = ~ °' ~ ~ N o0 ~ ~ ~ ~ V o ~ o a ~ N 0 0 a 0 7 a O t3 y ~ ~ w m o m a ~ a ~ OV ~ N ~ 3 N N ~ ,... °o o° _ t7 N r to N N ~ ~ ~ ~ 'L ~ O N ^. O O O a N N N ~ ~ v v ov A ~~ m ~ ~ o ~ ~ ~ cn ~ 3 °f r. m M D N ~ O N ~ ~ 7 N a N a ~ (Q _ ~ A y A N C .a ~ .. 7 a ,p ~ j W ip p C ~ ~, ~ <D ~ ~ - z RI ~ ~ Z m N ~ Z ~ ~ ~ v CD A W T C 7 O. a a 2 O N O O 'J A N C.,~ ~' Op V ~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety 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)]. Permit Holder's Name: City Village X Township Anderson, Robert Hammond Townshi CST BM Elev: f Insp. BM Elev: 8M Description• `~~-b~ $~o ~' 2 CsT TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic SE2. ~ vlro 6 s~ Dosing ~ J (~,~ u Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic 2S + -~ 2 S' Dosing t t « t.r Aeration Holding PUMP/SIPHON INFORMATION (Manufacturer Model Number ~Po i i TDH Lift Friction Loss System Head Forcemain Length ~ Dia. rf Dist. to well b 2 SOIL A PTION SYSTEM RENCH dth Lengt h No. OfTrench s DIME •7 f ' J 93.'r~ 1 ~Z l SETBACK SYSTEM TO P/L BLDG INFORMATION Type Of System: -~ 2S f 3g f ~r. DISTRIBUT ION SYSTEM ELEVATION DATA County: $t. CrOIX Sanitary Permit No: 408247 0 State Plan ID No: Parcel Tax No: 018-1094-20-000 ~j, . ilk ~' STATION BS HI FS ELEV. Benchmar 2 S. 39 )o3•go ~ q8: bo Alt. BM ~ - ~~ R~ ~ ~ Bldg. Sewer g. 20 4s. ~o St/Ht Inlet S•~o S, 2O' SUHt Outlet Dt Inlet Dt Bottom f Z.Zo / Q!• ~ Header/Man. ZS QS"-b $-. ~ pjst-?ihe. ~- 5 $.10 B• Sa ,S. y'r• t7 r Bot. System q•~} 9r• 9`f- 9`f- ~ Final Grade act, ` St Cover ~- 9~-3s' Of Pits (Inside Dia. LEACHING CHAMBER OR UNIT u Header/Manifold it ~,p/ Length "t '- Dia Distribution Pip (s) Leng Dia Spacing x Hol Size x Hole Spacing Vent to Air Intake ~ Q O 1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv Depth Over Depth Over xx Depth of xx SeededlSodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil (~ Yes [] No ~ Yes ~ I No COMMENTS: (Include code discrepencies, persons present, etc Inspection #1:/~/~~- Inspection #2: ~T Location: 979 167th St Hammond, WI 54015 (NE 1/4 NE 1/~29N R17W) Prairie R-un Lot 20 Parcel N :0.9.17.760 1.) Alt BM Description =~~ ~~ t~~`~` ~ ~6v-~+~ ~~ ~^- S~ ~~"~d~`~" ~+*+••~nr . 1 2.) Bldg sewer length = " 2$ - amount of cover = 18'_'+ •~~ 3`°~t~ ~ ~.5.- -~-- _~ Plan revision Required? Ye [~ No ~ ~ ~ ~ - ~ ~ `l Use other side for additiona rmIation. ~__..__ ___ [ _ _ _ - _ SBD-6710 (R.3/97) ~' -` t;Jr•~S¢.`•~''a- Date Insepctor's Signature Cert. No. /~ QSD~. t?O v [ ~+"~P t.~u~r2. . Safety and Buildings Division Count)' ~~ ` ' 201 W. Washington Ave., P.O. Box 7162 ~ f $~0~~~~ Madison, WI 53707 - 7162 Site Address ,t,~ 3 5~3~-~ ~ 9 9 S'I' . De artment of Commerce z Sanitary Permit Application S'°`tat'~ Po` ~ } ~ In axord with Cotamr 83.21. Wis. Adm. Code personal iaformatioa you provide ^ Cbce if Revtuan ma be used for seco sea Privsc Law si5. 1 m I. Apptit,'atlon Intormatlon -Please Print AlI Infarms-tloa State Plaa 1.D. Number Property Owner's Name Patce! Number .rJ~~Y nib- o9N-2o -~ .~(oo ddress ~ ~ - Property Owaer'a Mat'iing A ~` L'0~aan d1 ~~~~ ~fi! ~ -'-?~;iXCOa;:p~~f,,, /~~~ ~-u:S~ T~~N,Rl7 City, State Zip Cade Pbo~ ~F~F'~.`___ Lot Number o2 ock Number Subdivision Name CSM Number G°o77F"~r- .~ `~''d t1-~ ~ SJrO~~o r`Y'~ ~C f.G II. Type of wilding (check all that aPPIY) as. ~ S ^City ~,t or 2 Family Dwelling - Number of &ds~oamx ~ ^ViUsge ^ PubliclCommaroial -Describe Use ~ G~ ^ State owned t Nearest Road ' G~ 3~ X °~3• c~ ~ ffi. Type of Permit: (Chock only one box on line A (wtmtberItig scheme for internal tree}. C omplete line B if appIIcable) New 2 ^ Raplatxsaaat S~atrm 3 ^ Repfacemeat of 6 ^ Addition i4 Far Cotany tree `,' 1 ~ , aam Tack otti stain Permit Number Dau Issued. B. ^ Checlt d Ssaitary Penarit Pmviously Issued IV. Type of Perttlft: {Check aD that apply)(numberiag~cheme Is for Internal use) ~ 14--(~ . 44~Non -Preaauriud Ia-Gratnd 2I^ Mauad 47 ^ Sand Filter 50 ^ Constructed Wetlsnd 22 ^ Presauriz~ In~round 41 ^ Holding Tank 48 ^ Single Pass 31 ^ Drip Line 4S ^ At-Orsde 46 ^ Aerobic Treatment iT 't 49 ^ Recircula ' 36 ^ y, t Area Lafortnatton: Design plow tied? Dispersal Area Dispersal Aral ~ C~ 5oi1 plicatiou Percolation Rata stem £slevation ~ ~ornade „/~ Rat~rirad groposed Rate(Gala./Daysrsy.pt.} (Min.Mch) g33 VI. Taolr Leto Capacity in .Taal Number CiaUons Gatioaa of Turks Manufacturer Prefab Site Steel Fiber Plastic Coacreta Coastnrcted Glass New EaiNisa T Ttaks Septic or Hoklit~ Tank _ /~ (~ Q '~ y DesinP C~unnber VII. ili Statement- I, the undersigned, aastrme respansibWty for a of the POWT5 shown an the attached plans. Plumber's Name (Pr}nt) Phmtber's Signature RS Number Business Phone Number e. Zrp Code) t Plumber's Address (St[eea, Ctty. Sta // ~~ ~~ /~C~ C cGt !/ ~ ~' /~~ sG vIII. count !De ent Use O t Fee (includes Grauadwater . Date Issued Issviag Agent Signature (No Stamps) Approved ^ Disapproved ~~ e ~ g ^ owner Gives Initial Adverse ~~ ~ Detaratimtion IX. Conditions of pprovallReasons for L'-isappro~l ~ ~~, ' (~ ~ ~ ~,~~ ,~ „_Q,,,,~~~~~1., rl,,_.,,~,~,~ c~t~ tnticuVl~^'~ ~~ t o""~ .~2~~2 ~~t'~r ova ~-c "-' ~.S samplers t~ (to the Count, aa>y) for the s>>am oe papa s uca~'1~e~S , SBD-6398 (R. 03101) Rob~e~ ~" ,~,~,.~d~rSa•..[J ~Ot~d ~/ar`~'~`~ /Q~.c~ ~a~V.tl cif ~a,hrnaa:.r~~ -~ -- • ~ SGo~e- ! ' ~ ~l0 ~ ~~/y1/ l~~la'D . ° ~ ~~ix ~~/~ac 9P~ ~ D D /v" $Y D' ~+ Oto~Q ~~ ~~ C ~N ~~ Cl mfr ~ Spa-~C.~ ! ' ~ YD i r ~- Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT ~ ~~~ Page ~ of County Q ' 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. Please print all information. Reviewed by Date - Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ 2 Property Owner Property Location j 1 Govt. Lot ~(j 1 /4,fi~ 1/4 S J~ T Z~( N R / ~- E (or~Al' Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# y~~ ~~~5. ~o P~~- un City State Zip Code Phone Number ~ City ~ Village [Town Nearest Road /~cwirwnd wt S or (7/S )7GG-Z ~Q3 rri rn.on. /Go ~' ~G-c_- L ® New Construction Use: [~ Residential / Number of bedrooms 3' ` Code derived design flow rate 5/So ,~ Replacement ^ Public or commercial -Describe: Parent material ~• • ~ ~ Flood Plain elevation if applicable General comments ~ y,s~t ry~ G/c v • 93• ~'O 6°"'-'r 9 ~ y ~ and recommendations: ~ ~~ _ v~-t v, ~. -3. yd ;` "" t'": Y a ~~' ~~~~ ~~~;i~~Alt ~~~~' ^ Boring ~ '~~. _ ,'` `~ :.~` '/° . Boring # '~; ~ ,,yam.. ® pit Ground surface elev. ~ •l~ ft. Depth to limiting factor ~U~ in. ` ~ pl~'~tion 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 1 b-1 !(~ ~ I Si l 2 k ~ lv-~ . 5 . 8 2. -~~ `- 5L Vii- ~5 - • 5 9 3 - Id lco m S I - _ . ~ ~. Z ot11' q SO/ ~" ~~~ 3a- Z 3 • L .~ Boring # ^ Boring ~ pit Ground surface elev. `/~ ft. Depth to limiting factor ~d d 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 ~"~ ~ ~ ~" Sr~ Zr CS (V~ 5 .~ ~ I~} r L 2msbk r c5 r . ~ 3 -tom I~ h~ U I - _ 7 /. Z ~d' -~ - tmuem ~~ = esw5 > su < zzu mgi~ ana i s~ >su < i 5u mg~L R trnuent 1;<z = t3w5 < 30 mg/L and T55 < 3O mg/L CST Name (Please Print) Signature CST Number ch _---- ~ Zs3 so Address Date Evaluation Conducted Telephone Number 2113 $d T'' ~ . '~,P~~~-. /, ~~ .~ozs ~i- 2 g-o~ ~~~s)zy7-vat' ~~ Property Owner /~,C( 4/~ll~ ParcellD # Page ~ of 3 ^ Boring Boring # Iz:h Pit Ground surface elev.~7 ~ 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 o~28' D ,~ ~ 5il 2 r c I v~ . 5 8' Z $ Sy I ~4 ~- ~ c ~ -- 5 9 r ~o ~ 3 ~. 34/~ ^ 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 ^ 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 * 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~OF 3 ~, n ~~E ~-~tc,J F, ~ /~ S LOT# Za LFGAL DESCRIPTION al E ~N C ~ ,S / ~ T Z 9 ,N.R. ~ ~' E(or~ SCALE:1"= w BM 1 ELEVATION lQ6 • C7 BM I DESCRIPTION~~ '~l a ~~(~ dc. (~ ~' D ~ BM 2 ELEVATION R Y• ~ ~ BM 2 DESCRIPTION p o ~ ~ Z ~~ ~ UG P,'Oe- SYSTEM ELEVATION ~Q ~-cnc.1.~,93. ~o Gac.,G r- Y3. ~/o ~r 1~I.~'ERNATE ELEVATION ~3. `~~ CONTOUR ELEVATION ~J fS.OV s 9' `/. 0 O `~', o0 ~.-_ ,6,2 0 Nl ~ . Bpn( 18'.ov ~ 6.~ ~ d ~^ z ~'~ ~ SIGNATURE ~~ ~~---_ 'S~~GN^ t1.Cl '~' 'ft~ L)C~CCc~ ~~r: nq S ~ ~'Rcre~•5 wwst (--Tow ~o~-f-oar' cis S~hoWn Z-/ o vt , + ~ Private Onelte Wastewater Treatment Syst+~m t~snagement Pisn Saptlc Tank And C3ravity In-Ground Solt Absorptlor- Compan~ent Pursuant to Comm 53.54 VVis. Adm. Code each Private Onsite V1~astewater treatment System (POWYS} shalt include infam~atfan and procedures for maintaining the system within the parameters of Comm 53 and 64, and the coed'itions of approval by the department, agent, or gavemmental unit. The approved plans and permits for system are on file at th® county zoning or health department. This management plan implies with Camm 53.54, Wis. Adm. Cede, and the In-Ground Soil Absorption Component Manual for Private C7nsite Wastewater Treafirnent Systems SBD- 10587-P (R.6/99~. Tdia1~ ~. Q.re~am P1salnn 3DA~1{4CgtiOfl9 •~. ~MN.•i i• M yr-...• ~~~ Sancta Permit Number . _. __ Z _ - Number of 8edrelams Dell n ~ksw -Peak d `~S~"' Estimated Ftc~w' • Ave 8 d 3 ~o Sa tic Tank Ca adi ai ~ 3oii Absor' flan Com Went Size ft } ea T of VlJastarwafier Q mastic ~sw~~ ~. ~..a~ sis~n.~in~ [!nw~nenant . L[mits Of RAllabla Qpe~on pa`cer~ Se tic Tsnk Cam onent Sail Absorption Com Went Deal n 1=1aw -Peak voro R3 °' M8xlmurn int~uent Par~cie ize in 1 JS Maximum BOQ JL 220 Maximum TSS rn 15~ Table 3: ~r service once every 3 years a veer and clean at least once ante even 3 The septic tank shall ~ maintained by an individua{ certified to service septic tanks under s. 281.48, Stata~ The contents of the septic tank shelf be disposed of In accordance with NR 115, Wis. Adm. Cade (Servicing Septic ar Halding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, 5eepaga pits, Seepage Yrenches, Privies, or Portable Restrvoms). The operating. canditior~ of the se ti nd autiet filter shalt be assessed at least Once every 3 yerars by inspection. 'Th outigt f3ltefr hail be aieaned as necessary to ensure proper operation. The filter cartr~ldge s -rrot remave un ass provis ns era made to r' ~ In s'~"~fd~1n the tank that may slough off the filter when rernaved from its snrlosurs. if the ~. ,~ Ntanagement Ptan for a Septic Ta^k anc S4s: Aosorptbn Compar+ent filter la equipped with an alarm, the filter shah be aorvlcad if the alarm is activated xntiriuously. intermittent fi#tor 8larma may Ind#oate surge flown or an impendins continuous alarm, The aeptlo tank :haU have its oantsnta removed when the v~urns cf scum and aiud~s In the tank •xaesds ~t3 the iiq~id volume of the tank. #t the 4or<tsnt~ of the tank aro not removed at the time of sn assessment, mah~nsncs pereannei shall advise the owner of when the next sa+v+co needs to be perfom~ed to maintain is:r than msximum scum end aludpe aca~mulatlon 1n the tank, Manhole rtesn, access Assn and covsnti should be inspected for water tlQhb~oaa and aoundnaRS. ACOess eipeninga rued for aerolce and esanemsnt Ali be seahtt~d wetsrt~ht upon the oom~fet+on at eerrrlpe. Any opening dammed unsound, defective, or s~lb~ect tQ faltiiure must bs npNtced, ,Exposed aooaas opsnlnQs prsstsr than 8-inot-aa to diameter shati be secured by an eftsctive lookins devioe tO grovsnt aooidenta! or unauthori=sd entry into the tank. No ens atrould trtfu s aepflc or other #rwbnsnt or hotdfnp fertk fot~ .>sy reason wfttrout ire l~tl! ca~pibersoe w~h !?aNA a+taredonda llor ~ ca~r»d . Thy N~~ wJ~-!rt ~hr aep~ta ar air ~t~n! at htittdt~ tiutk mfr cottil~ln Iii! ~a~ snd natcuM of a pew»ira~ a~ 1n~rtor ~t th. ~in1c nHyba elMi~oult ar lrspoos~bh. .. Tank abandonment ahati bs In acoordancs with Gomm •x.33, VVia, Adm.. Cods when the tank Is rte br+~' used as a POWT'h campar»rtt, The soil sbaorption corrsponent prying thu etruatura la designed #a iaccspt domestic wastewater from a rssidentiai faaliity. The i#mits of operation of this component are +~hawn In Table ~, The #onQevlty of a aoi) absorption Component drpsnds preetiy on proper and timely malntettancs, snd system use within or beiaw the i#m#ts of roifabie o{~rat#on, c3acxl water conservatic~r~ ptraeotiosa Toj+ tll ooirupanta and the instai#atlon of water consenrinp piumbinQ fixtures sn key f~ilctors In extendlnp the useful life of this oamponent. The soft atuorpticn oomponent`a operation moat be saaeeasd ay inspeot#on at lee:t area every three ysan. The inspse~bn shaft inoiuda n~cordinQ tt~e isvs#N of pandinQ, i! ar,y, -n the obasrvation pipes, snd a visus# inspeodon foe any evidence of surface aespage or d~aahsrge from titre oor~ponent. an atN-p#y:iaping eltes, areas ~ eroalon sheuid be Identified erect reported to tt-e owner for repair. The auifsa d#acharQs ai dornsstia wastewe~ter ar sewage from 'fie system ii prohibited snd considered • human health hazard Tnaftic around ar over the soil absorption component shau#d be avoided partiouiarly durEnp winter months, Tht compaction or removal of avow cover over tip oomponent tray load to hydreu3ic failure by frsezinQ. This type of fatlure is usuaify temporary, but ~ dihicult or impoasibie t0 repair until weather condit#ons improve. in genera, soil compaction over this Componsrtt will educe dittualan of oxygen into the satl snd dlspersat oe11, VKhich may lead w more intense, and earlier, organic alo~ing o! the coll. ~~ Manapemsnt Dian for ! t3ept{clank and ~{I Absc~rpticn r~c~mmpnr+ant Piarttl+~s of dip-roc~rd trasa a*~d a~u'ubs dira~tly arar of wtti~±n ten thvt ~t' ttref ~nmpansr~ ahr~uld br e~oided aintw root Irarueion into the companef~t mrw{y obafivtt weat~water lk~w. Corrtlnprncy Plan ,/ _ {n tl~e evrr~t cf lyetlrn €atiun, a naw asyatlm could itir lnttal3lrl in an +~Itemate lrea. 1N1th trtia ~C irufA(lsifon of a diwerter watve~ th! lxietin~ aynrm could s!so bar rfv!!d ~`trr a err+od M, tl~r®n to Mean yrara. !t !a thr property ovmrra reapvneibility to ,main d» aitematr arla trs! tam een ,ent ~ ~ 1 any tree, rhrtaba,. etc, have bay piarttrd Oft tFtr a~tsmata arer, they wiii have to br rwrr-awd at PAY rx~sr. !f aitrrr-ata ara~a !! dr>r~ro eo thrrr are other a{tlmltive eystlm>i thrt can ba uasd, in which, r~ resu n a to thr proprrty awr~ar, Any tic abandonm~rnt ahAii ~r dour in aevordance with Wig. Cadr 83,33. Any queatione re~d~np thin dad•, piraaM contact your iacai Zoning O~Fice or clntsot the is»t+r111n~ piurrrber. ~ t~ a.1~,~.ne ~' 1. u~. rn ~ t rs ~,1 t S~ ~ gr 1. ~ 31 ~ 1 , ST CIIOY~C CiCDgJTV'1"Y SEPTIC TANK MAINTENANCE AGREEMENT •AND OWNI:RSITIP CI?RTII7ICATION rOIZ,M ~v~mer/Buyer ,_.__L Mailing Address 1?roparty Adares~ !? ll't >r yr 7 T'fi n (Verification required from Planning Dcparimerrt for new City/Slat i'P r2 ~ ~~ 1'areel Identification Number ~~~5 I,TG.AL D]~SCRIPTION atio^ .'/4, ~/~ `/,, Sec..~___,, `r--~-N-R~W, Town of ~~tn ~_~ Property Loc ..~~ I,ot #~ ~ o SuUdivisiota ._._.~4 N I~~--v_'~ ~--- ,, Volume ,,Page ~/ Certified Survey leap ~f , Volume ~ ~~ Page i~ ~y Warranty Deed # ~~<~ ~~ ~ -~ Spec douse ^ yes' no Lot lines identifiable l~ yes ~ no uYS'I'EM MAINTr1VANClC Improper use and maintenanceof your scplic system could restilt iu its premature failure to handle wastes. Propreut~thetsy~m consists of pumping out tl+c scplic tank. every tluac years or sooner, if trecded by a licensed pumper. What you p c:un affect the function of the septic tank as u trcatruent stage in tl+e waste disposal systeur. The ro ert ov~mer agrees to submit to St. Croix Zoni,+g pcpartrnent a certification fo on-s'i enwast waterdisposal y5 tin p p Y mastprplumber, jourtrcyman plumber, restrictcdplumbcr or a lice++sed pumperverifyiugthat (1) t e ~ ~ proper operating condition and/or (2) alter inspection and pumping (if necessary), it+e septic tank is lessthan l/3 fall of sludge. Uwc, the undersigned have road the above requirecnea+ts and agree to maintain the private sewage disposal system with the standards pllicc wittrin 30 sat forilr, herein, as set by the Department of Commerce and ton+Dcl dtand returz~cd to th eSG C oix Cotmly Zoning m ~~lf ~uon suiting that your septic sysleru has beta niaiutaiued must be c p days of ilrc three year expiration date. ~ fj '7 ~ i1 ~ e1. SIGNATURE OP A.PPI.IC,A.N`I' OWNi!;R CI;RTI](~ I.CATION I (we) certify that all stalcmc+rls on ibis form arc tn+e to the best of my (our) I:rtowlcdge. I (we) am (arc) the owneds) the properi do ribed ve, virtue of a warranty deed recorded iu Register of Deeds Office. !'~y~J -" ' ~ ~ l P l ~ v DATC SIGNA'T'URE Or APPLICANT ****,~,~ ****** Any inforrnatioa that is rr-is-represented may result in the sanitary permit being revoked by the Zoning Departrucnt. -e, m~, SSa l t`P *'` Include with this application: n copy of Il c cc ficd s~rvcylrrrap Rf rgcfercnceDis madef in the warranty deed 1ac~~' U5`f DOCUMENT NUMBER KARRAN~;r D$$a W. ~ Hawkin,9, Grantor, conveys and warraaes o Robert E. ergo 3rantee~ the following described real estate in st. Croix county, 3Cate o£ f0iecanaim; ~,~ ~~ . P~~ 14ot weilty {20) , raiz'ie Run, Town of Kemmond. t/~ . ~ ~Z7 A~) x6 ~~ 6rAisH REGISTER OF DETiD$ ST. CROIX CO. , rI RECEIV&D FOR RECORD 07-08-2002 11:Po0 AH Ef(E1~~f ## DEm REC FEE : 1,1.00 TRANS FEB: 98.70 COPX FBE: CERT COPY FEB: PAGESe ~ NAME AND RETURN ADDRESS y rf ~.~ I 9 ~h ~"~-~ T ~ ~7TF+C~ ~U~1F_ 61nlV _~i_h~// Thin is not homesCead property. ,Exception to warranties: 911 eagementg, restricCiorxs ana righCg-of-way of recoafl, ~,P any ~atad Chie ~ 7 ~ '1 i'('n~' day of ~yr~ aoo2. ~~ ~~l1~am E. Hawkins (96,Ai') (3Eb1L) AdTHENTiCAiION ignaCUre{q) ithenCicated tkAia day of 20~ at :Tx,E: MEMHER 9TAT$ BAR OF WISCON3INe eri tl oc d :f not. ~thorised by 3706.06, Oaia, SCata.) (T8 INBTRIIIdHNT 9QA9 DRABTgD gy~~ o A. Beakar, Attozney pt Law dli, Hegkar, Ho1ee ~ Kruegez, S_C. O, Hox 138 ve! Fa11a, Wx 54022 Part of 019-103fi-70-000 and 019-1036-80-000 Parcel Zdentifxcation Number (SfiA,L) (SEP,L) ACICNOWLBaGfIdBNT SE F WISCON3IN ) ~ ~~~ ) se , CuUNTY ) ~ tip, 11 personally came before me Chie the above named William E. Hawking .T ~ ~x~'~,~~~9~°d Y to me kno~+n to be Che pereona(g) wha ~ ~ ~• foreg g inatx'u enC and acknowledgE;. ' Qe~t~` ~ ~~~ Notary 4uDlic ~ COUt1ty, lai,~, My commiegion ii~9 permazient. (If not, expiratioD date:) ~% !' ~/ ct' ~W ......................... ,~; --- ® yob ~ 8 ~ I '62. 38'-------'~ © ~ . ~ y 3 3 ~ ~ W ~ ~ lBL 1 C o ~ ~ zOAD ~o ~ ~ ,®: N~ 162. 38' `'. ,e ` ~ ~ ~. • ' s~F i ~ ~ ~ it `3.06 ,~ :ZjN'- _,,,.~r•9d 9 ~6'/ ^ ~ ~ ~ N N ~ ~~ ~ ~' ~O°39' 03"W 2T5. 66' ~ J ~ 00 I .~ m' ` ~ ' ~ 8 .s61 3 Ob ~^• i • ,LZo9ON ~ I ~ y ~ ~ W ti o ,t / NVO o OW'' ~ti Q y cb 2 ~ ~ I / .. o .................................. ..... ~ o~ / 275.6 '---------- 3.52' ~ I ~ 3' 03"E s ~ ~~~ ® o~ ' ~ "V ~E"E T ~ ~° _ _--_~_~~ `moo ~ ~ - - _ _ _ _ __ ~~'soi9 I ~ ~ ~ ~ ~ ~ 4 ~ ~~ ~-~~~ '~ ~ ~ I / ~ •\ ~ ~ / ~ ;~• ~ / , o f ~' ~ ~,~ ~ ~' J ~ ~ ~~ ~.. h I ' ~ ~- ~ ~.~' +~' ~I~