Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
018-1086-27-000
(7 fq O 3 'fl n d ~1 c I ~ o ~ ~. A 3 ~ ;b. I ~ ~ ~ ~ c :: ~ ~ ~ ~ ~ ~ ~:- ~ ~ `1 I ~ O fA ~~,' 'D T. ~ Z (n .T, ~ T~ ~ Z ~ A ~ 2 N _0 e~ tr ~ I ~ ~ N <_ N rt ~ ~ ~ ~ N O N ~ m N 0D h..l SrJI rn a~ 3 ~ ~~ rn a~ ~ A m y ~ m 3 co ~ p me o p Oo me , O Oo ~ O ~ °D C ` 1 o° ~ n 7 m °o ~ ~ d ~ -I ~ v ~ 0 ~ c m c ~ c m c f7o o c A'+ I 3 ~ ~ H c ~ °o `~" _ N c v o ~ ~ `` ~ p I ~ cnz cnzD p; cnz uszD ~ am m ~ D ~ D N m ~ D co D y a o I c o, a ~ = o. a = c o rn ~ I ~ O O ~ O O '. rn~ D O `r I ~ ~ Z ~ ~ Z o o fD I y O ti O w w v y K c N~ 3 I I ~ .N. ~ ~ b 4 9: Z Z O O O a -' o ,Z7 ~ ~ ~ :t) .~ ~ ~ ~ ~ ~ N 2 ~ ~ ~ ~ cS m ~ N to N ~ 3 o ~ v, ~ o ~ in ~ ~ ~ ~ o~ o ~ ~ ~ ~ ~ ~ ~ ~ cn a eo , I m m m m °: ~~ O N N 3 .. N I ~ Q Q0. 7 f// I Z Z 'Y O O ~ '""M 7 fD O ~, 00 fZD ~ ~ .y_-., 00 ~ 0 ~ a C 7 I ~• c~ N ~ O =~ N ~ O a I ~ Q y 0. ~ 7 OO N O. ~ ~ N n 0 0 :U D O ~1 .p ~ I p 7 fQ fD p 7 f0 O O ~~c^o c 3~co c 3 I W ~°-~o m w ~°~o m o I n fD~y 3 a `D~y 3 m _ I o n~~ ~ o n "-' ~ ~ c A Z T - n ~' - n N N i .11 ~_ S< ~ S< ~ a, z o (D ~O. (D f~ fD ~ 7 I O x d O ~ N NO O d 'O O 0.'O (n -I N 00 t9 OD fD W ~ < CNO ~ I N a N a d~ ~ Z rn~ rnd ~ 3 a I °' coi 01 c°1i 3 ~ ~ I ay ay N ~ ~ (A N W I I ;yam cn > o m~ D N^~ cn ~ o m~ D ~°~ m~mm co -o ~ m ~ c ? y ~ 7 S N N ? p~ ? 7? N N C N N 7 Z ~~ N pNj 7 Z d 7C O 7~ O I"~ ~~ ~ ao o N ~~ ~ ao o ai ono ~-> > o~~ ~.> > `` I { `` '~~m m °'rn ~cc~m m am ~ n~ I ~A1 ~-~ y-~rn ~_~ NNrn ~ '?. ~. ~ ~ ~ fD m ?. m ~ n w I ~ a wa> >~o m ~ ~ ,~ cn ~ ~ vw a ~ ~ ~ v °' a 'b t ~... ~ t ~ S 7 n w g X 3 0 n N g 10 ,,., ~ ~ I O y 7 Q~ A c. ~ ~' Q~ O ~ ~"r' t I 7 O.'O <D 0 7 7 O.'O N p 7 O ~ I ~~~ ~v°c ~~~ ~~c I yA '~ I ~ ado =fD ~ ado -fD' o '~ ~ I ~ ~ ~ ~ ~, ~ ~ ~c ~" `~ ~ I o o b °o ~~~ ~ ~~ ~ ° I ;~ m 'm ~ ,ca ~ I o 0 0 0 0 0 ~' ~°~ ~ N r Wisconsin Department of Commerce Safety end Brydi~C+ Division PRIVATE SEWAGE SYSTEM 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 M rlie, Orlin & Jud Hammond Townshi CST BM E{ev: T V ~~ ~ Insp. BM Elev:' ~ ~ Chi BM Desc ' tion: ~~ ~ TANK INFORMATION ~'SG~~ ~ t-e'"''~'"t- -- ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic ~ ~QD Dosing / 0 Aeration ~ ~ ~ ~ ~ Holding TANK SETBACK INFORMATION TANK TO ~ P/L t_ ELL BLDG. Ve~ Air Intake ROAD Septic ~ i ( , ~ / C~ Dosing Q .~t~ / ~ r Aeration Holding PUMP/SIPHON INFORMATION hl~ Manufacturer Demand G Model Number r~ !~'' TDH Lift Friction Loss System Head TDH Ft Forrfem irt„ ~) Len / Dial ~ Di~ t~ elf r /~ ~-- . IISU SOIL ABSORPTION SYSTEM C A-S )IJC~ BEDITRENCH Width ~ Length " No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ , 7i ~ J..~ ~ ~- SETBACK SYSTEM TO P/L BLDG WELL' LAKE/STREAM EACHI Manufacturer. INFORMATION / CH B OR Type DE System: /~/- ~~ M / 2~l / ~ ~! (, ~~ 1 ~~ Model Number. Q~ DISTI~IBt~'Ctb1N SYSTEM G~'-~-iq.,.Q_ Y~~ ,Q.~,4 n,(ir.._. / 1 /-~.d.P/~.t/. ~ ~l1 ~ ~1 Hea r/Manifold Length ~7 N Dia y Distribution Pipe(s) I Length <~ ~ Dia (•~ Spacing~_ x Hol Size !i 3 j~j x Hole parting nt to Air Intake ~,~ ~ --> • d SOIL COVER x Pressure Systems ~nlv xx Meund Or At-Grade Systems Only t/~G~ ~~ '~(~Q/.L Ll~ o~ ~ Depth Over ./- Bedlrrench Center Depth Over Bed/Trench Edges xx Depth of _ (~ T Topsoil /~/ / xx Seeded/Sodded xx Mulched ~J- ),p ~ ~i ~ `~~ J O ®Yes o ~ 1'73s v COMMENTS: (Include code discrepencies, persons present, etc.) Inspec~,n #1~: ~~rs~/ ~~ / ~ Inspection #2:~/ 3~ /~ Location: 1601 86 h'4ve Hammond, WI 54015 (SW 1/4 NW 1/4 20 T29N R17W) H~mo~ n~ak t 27 ~ Parcel No: 20.29.17.647 1.) Alt BM Dlrst;rip i~ = F7U ll U I'1'1 6r .Sb~/ ~(( S `-~ ~~ ~ ~,~y~ ,,~ ~ ~i~,,ti'~C_~ / 2.) Bldg sewer length = ~/ ~ ~~'~ ~ %~ ~~~"; /"~`- ~ d ~v -amount of cover = ~ Wl~>~z• U - S(i(..t~ nn ~ ~~ 2 ` ~~ -~ Go7r~¢,z/~~ ~(77,~,~~~c.~.e~~ l~, O l~rYt-~' __ ___ _ • Plan revision Required? Yes No ~ _ / Use other side for additional information. ' 3 v ~ ~ ~ ~!%~ti~ w SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. County. .St. CroiX Sanitary Permit No: 420666 0 State Plan ID No: n/ v ~~ J 0 Parcel Tax No: 018-1086-27-000 Section/Town/Range/Map No: 20.29.17.647 STATI N 3 BSS, H~ FS ~E„{~V. Benc ark ^. ~ ~O / S.\~D Op ''O Alt. BM ,~ S•2~ 3~f~ ~ . Bldg. Sewe .~ 12.g7~ SUHt I et 3,03 ~3•Y~f ,~ SUHt tlet .Pi Dt Inlet ~ ~ Dt B.~ G ry ~ ,~' ,~,0 q Header/ an. ~ ti ( t0 rJ Disto ipe L /_ UJ ~ 1~ n ~ p m ~ q p I ' ~00 Bot. System ~~Z- s ~ (• S", Final Grade ~ ~ ~S' 0~3 ~ ~: 3 ~ (t. ~ ~1. 5G - 93~ 20 r Wisconsin Departmeef of Commerce PRIVATE SEWAGE SYSTEM Safety and ~`uildin~j Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO r RM{T) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 'ermit Holder's Name: City Village X Township M rlie, Orlin & Jud Hammond Townshi :ST BM Elev: Insp. BM Elev: BM Description: SANK INFORMATION TYPE TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic S ~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DAT County: $t. CiroiX Sanitary Permit No: 420666 0 State Plan ID No: Parcel Tax No: 018-1086-27-000 Section/Town/Range/Map No: 20.29.17.647 STATION BS HI FS ELEV. Benchmark ,!~ Alt. BM 'S Bldg. Sewer 12- 9~- St/Ht Inlet ~ ~.~~ St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover (-96 ' ~ ~3-zo BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O° S stem: CHAMBER OR y UNIT Model Number: 0151 KIl3UTIVN 5Y5TEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing JVIL GVVCI~ x Pressure Systems ~nlv Yr Mnund Or Ot_(;radp Systems Anly Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~ Yes 0 No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: C(r / V /t _.~~~ ~ Inspection #2: / / Lt~cation: 1601 86th Ave Hammond, WI 54015 (SW 1/4 NW 1/4 20 T29N R )Hammond aks Lot T-'-"" Parcel No: 20.29.17.647 1.) Alf BAS Description = ~ ~ r 2.) Bldg sewer length = ~ 5 f 1 / + +~' dt-`°f- w - ~ S _ > - amount bf Cover = ~ b ,bl ~ ° ;,'-~` ,6(eL PI revision Required? ? Yes .;t~l tUo ' - ` ~.- - ~ ~r---- ----------- i Use~pther side fior add~onal~ini*ormaflon. , r ~__,.__ - _ _ ~ ^__; '-___ -__ _ __ Date " ~ Insepctor's Signature Cert. No. ,~ Safety and Buildings Division County ,. ,~ • 201 W. Washington Ave., P.0. Box 7162 `,~'C~~~'1~ Madison, WI 53707 - 7162 Site Address ~G~ ~ De ertment of Commerce O / (0 0/ 0 ~ ` ~~~ Sanitary Perllllti APpliCatlOn Sanitary Permit Number In accord wiW Comm $3.21, Wis. Adm. Code, personal information you provide ^ Check if Revision ~~010 ma be used for seco oses Privac Law, s15.04 I. Application Information -Please Print All Information , RECEI c1ED Pl I.D. Number rty er's ]~T me ~ ~ ~ Par 1 Number Z ~ . ~ (~- (0~ ~, ~ JAN 1 p Zp - - erty Owner's Mailing ddress Pro erry Location 3 S7: CROIX COUNTY ZONING OFFIC '~ ~,4; S T N, R ~ City,. State Zip. Code Phone Number Number,,• / Block Number 717q Subdivision Name CSM Number Type of Building ( eck all that apply) ^City ~ ~1 or 2 Family Dwelling -Number of Bedrooms _ L ~~~ ~ ^Vill e ^ Public/Commercial -Describe Use ag ~ ~ A Township X 9/--Z ^ State Owned ~/fLt/ytol ~l~~f ~ S ~'h C~.,,~"dren.i ~3+Z Ne est cad W ~ m S- ~ ~t.a ^ ~/-^ - - tRv III. Type of Permit: (Check only one box on ine A (numbering scheme for internal use). Complete line B if plicable) A' 1 New 2 ^ Re lacement p System p 3 ^ Re lacement of 6 ^ Addition to For County use S stem Tank Onl Existin S stem B • ^ Check if Sanitary Permit Previously .Issued Permit Number Date Issued IV. Type of Permit: (Check ail num scheme is for internal use) ~r d 44 ^Ncn.-Pressurized In-Ground 21 Mound ~ y S 14~ ^ Sand Filter 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. D' ersal/Trearinent Area Informat ion: Q~ p~ -_ ~ _ ~~ 2 Design Flow,(gpd) Dispersal A~r~ea~7 JL i d Dispersal Area Soil Application Perco ation R System Elevation Final Grade ~ Requ re CIC C ~ PrODOSed ~ te(G s./ Sq.Ft.) • ( /Inch ~ ~~~ s, ~ 12 ~ 9 Elevation ~ 4 - ~- ~ } 4. ~ , /~P-7 ll=I- d-F- ~ VL Tank Info Capacity in .Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Tanks w/`~ A -I bb ° Concrete Constructed Glass a g /~' ~ ~~~d T nks Tacks 1j Septic or Holding Tank _ I ~ C Dosing Clamber I f YII. Responsibility Statement- I, the undersigned assume respons y for installation of the POWTS shown on the attached plans. is Name (Print) ® P MP/ ~RS Nu M m b er Business Phone Number ~ { //~ / ' / y/ /` r 1 P1 's Address (Street, City, State ip Cod YIII cunt /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued tng ent S' Issu' tgnature Stamps) ^ Owner Given Initial Adverse . Surcharge Fee) ~"'~~ ~ { 3 ~ ~2~~~ l t~ ~ Determination „_ i i IX• Conditions of AppxovaUReasons for Disapproval 'l~~-. ~ ,~° ..~,..~ ~.. -,v_ _,___ , ~- r ~ ~w w~ w~~v~ ~ yor we sys m on paper not teas than Sl/Z ~ 11,InsJtes in size ,/ U #~ "7s ~'I/'~ SBD-6398 (R. OS/Ol) '' ~ +~ Gan~~i~~~ Q~ ~ v~~"~~~ ~1Q,~ ~i%~ -s2~,~1 ~'~~-~J for,; ~- 3 ~ ~f 3 ~., f ~ ~ (\~) ~~~. w.~:~~ ~tr v. J~ 1 ~ `.Q~ Z.~' 1~10~ ~~~ww tn ~ (~ L1.1 b~TrJ ~ ~ ~J ~...n ; 1'i' w w. w 0 ~.0~ ~ n ~(~,...J~ ups((-t.-4(n~rS•z .~ r aJC~.~.w^+: l- ~~1.w 3 ~; ~ J-C7 ~ }\w Cq 3.Z~ ~ ~S«.l~ 1.. = 3 ~e.11 ~~u~.i 1:0y d \c. Sys d,,, a~ -1 ~ ~ ~S 30 \j (( 1 .~ . l-^124•z~ S~ ~e .~-Q...S 1 l ,b~J4 LYE" Siw~. / ` / 1o ac, K ~e.~~ 1 ~i~tily f i W ~ Q-1 fu, ~ ~'~ 1 ti ~as-O - 4'+O ~ C.o ...l,o iwti,~. 3u2,t' 6...~erso:l ~5' ,~lo ~ s~o e -~'aa \ ~.~. ~,l ,': I ~~ L~ •~ '' ~ '~ . ~ Q I,Z !~ \ ~~o i l~, ~/ ~ ~ '/r (~ s.z~ ^45.z) ~~b ~ .L..~/ ` ~si Lq s~ s ~, .Y O S . ~ 9 ~ 2-. ~ a c.1~ c.a-~ --.., 'w Z 1 .~ ~ ~. a~ S 3 0~ ~ . ~Cl ~ <<~ ~" ~~a~ S ~ a..x Q.`W C7N 1 0~ ~~;'w4. i 1r C h (~ ~"'~ (~ the , O ~ ~~ ~' Tpos~- ~~~ a i --~r .. ~ - isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 ~ TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary December 11, 2002 CUST ID No.225094 MICHAEL P ROGERS ROGERS PLUMBING N4563 320TH ST MENOMONIE WI 54751 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/11/2004 SITE: Orlin & Judy Myrlie Windy Hill Road Town of Hammond St Croix County SW1/4, NW1/4, 520, T29N, R17W Subdivision: Hammond Oaks -lot 27 FOR: ~ Description: Proposed Three Bedroo~ Object ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 ~yao6~-h Identification Numbers Transaction ID No. 818554 Site ID No. 654197 Please refer to both identification numbers, above, in all correspondence with the agency. ect ID No.: 885170 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the encl_o_sed apprevedTlans_- ~~_ _ _ .- -- Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner o.~he PnWTC PYr,laininn that periodic cleaning, of the septic tank out e ~ ter ~s required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. ~ • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52(1)(a) -The owner of a POWTS shall be res onsible at the o eration and maintenance of the P occurs m accordance with this chapter and the approved management p an un~'s. Comm 83.54(1). CO~l•~~~"T~. ~r~ . ~ ~ MICHAEL P ROGERS Page 2 12/11/02 Owner Responsibilities Continued: • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due. $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing • r t Orlin & Judy Myrlie -Mound • /, A ~ f ,;.'a ~' s v~, Transaction # _ ~?~~ ~, ~~0~ ~~ ,~ Construction Materials and Techniques ~ ~.,~~ ,~,~ All materials must comply with Comm 84 and be installed in accordance with manufacturer's ~ ~ ~ '~~ ~. specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (0l /01) Pressure Distribution, SBD-10706-P (O1/O1) Location: Lot 27, Hammond Oaks SW 1/4, NW 1/4, Sec. 20, T 29 N, R 17 W Town: Hammond County: St. Croix Date: December 10, 2002 Owner: Orlin & Judy Myrlie Address: 3624 Ashbury Road St. Paul, MN 55122 Plumber: Mike Ro ers Signature: ~~ License # MP 225094 Attachments: 6748-Plan Approval Application SBD-8330 page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management DtPART ~ ~ D ~V1S14N ~ MENT OF COMMERCE F Y ND BW(,41NGS sEF ~; ~kRES NDEIVC~ page 1 of 8 .~ Design Criteria ~ ti~ Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L ~ Bedrooms x 100 gal/bedroom/day x 1.5 "~ 4~ gallons/day hydraulic load _~yU~ ~ L ~. - l ~~ Design Calculations '' ~,o -~~- i' w S l f tom- Say In situ designed loading rate ~ • ~ gallons/sq. ft. per day ~,2 ,~~~~ s -}'r~ b` c~'ta~-- Dep estimated high ground water 3 ~ in. ' ~~) ` ' Depth to bedrock ' ~ in. v~e ,Su.r "-~ f{rti~ Cross slope at system ~ ~" % ~ `•°~ ~•X~ s ~, 5~,~~~ ~ s Force main length 3 ft. of ~ Z- in. ~ ~ ~ Manifold/header length ~'' ft. of ~ z in. ~ Drain-back iZ ,3 ~ gallons Lateral length ~ @ `1O.0 ft. of t`Iz in. Lateral elevation Lateral hole size z~ib in. @ ~ ~ holes/lateral Lateral volume Total lateral discharge rate Network pressure compensation 1 ~,~Se Elevation difference ~j?~ Friction loss Total dynamic head Pump/sip~non 4'4 gpm @ Manufacturer ~o ~~ Dose volume Lift/siplxon tank ~ ~ ~~ ~ ~~ - V ,, Septic tank ~ ' Effluent filter ~ ~•~ ~' ~~ Measurement pump on and off ~• ~ Height alarm from tank bottom ~ 3'~ Reserve capacity 3~Z; specs.calcs.res ~~•Z ` gallons ~-O ~-~ ~ ~ allons ~t~••Z (, c~ . o ~~ ~ 1o.Sco ~.S.og ~ •~s t 3.4 ~ / ft. @ bott ateral in. S` ° .) Spacing holes total gallons gallons/minute @ Z•S~ ft. head ft. ft. ' ° Z ft. @ z5~ gallons/minute 12 • ZZ z ~ ft. of head ~ Model # ~~ Z g ~ ~'~ gallons in. tn. gallons Page Z of 8 f 1 f S~z~~~ c~.osS ~ ~~~~-,o~ 1 ~ , Orb o ~ c ...~ a....Q c..•• 4,. ,.a '"I 1,~ ~ ~1 y~a~ lug ra..~...rv.~ ~, 3, ~ \ 1 '3 0.~ ' 0.4~, ~.~ j ~, 1 w..~ ~ b i••bco:` p ~ i«~ ~ J `~ r.. Q`O'M' 1 o.v o.a~ 'l~~ ~` .q 1~1 O`Yt', pV~ Ot~ V~ 0.yKw~~ \t7„ ~ ~. i J/ i, I i t J3~'O - fY ~(•O C-o w ~ 5,.. ! .. ~~i ~~~~ ,~5~ ~ ~: t l ~- Q . --., .al w ~ ~~ ~-3 ~~ 1 1 1 `~ T Z~ ~ `~ ~ v..w QM~ ~0.~ S ~ , 1~1~.2o-Z°~-1~ w ~ ~.1.«~~ p~~ ~~U ~......~ ~~w w.wok~ I ~ ~~~ (~ J~ u~(~-ty yr3~Z .a rvr~(~~•Sw:~ 2X~V ~ ' 3 ~', \ uro ~ 1~~ = ~~ ~ ~~'I `~`-'Q..\\ \ ( V1~.~ l: py L0.•\ t C to s91L ~.95 C9-wQ~ - ~ ~ ~ \S 3~ \J 1 .~ V , ^ ~ ~; ~r n } ~ a / ~' nn~ ~~ ~ S c`,t..~~ ~.. c~ w rmy S ~~ ~3' Z" l' ~c r 3u2,~' { 7~6"sw~sa:\ (~ 6„ ~e rso: ~ p `,1 do ~ S`oPf o - wo -,~,n~,.~., -~ay a~z ~, `~. ~, '~ . ,~, , ~'~o i ~'~ J/ d' ai ~~~.Z~ (-~ ~ 5 . Z, r\~~b ~ .L..~! 1~1-t 93• t1 L9 ~ _5 ~ h S `~ o .y U ~ ~ ,c,aM s.,,. ~03.~1 \ C.`2V ON ,~z, S~~ yO,~ fir/ 1^~M ~~`~ ~~ ~~ O} Cpw v.Y. i v G h Q ~"~ ~~ u~ , o ~ ~~1 G O /r ~'~~ --~ r--~ 1~" t c~. h V ; 2~w•. ~- K~s S• S' ~ T S`Io~ zt,Q, '_^.-~ ~L .~ .~ c~1' w i I , 1 t~a.b~ 1 N o ~ Q. ~, l 0. T ~ ~ L ~ QJV, v...', w a ~ ~~~ ~ w w ~ O i- M ~ C1t 1.~ ~.: O. 4~ La`~U~ ~uC obS~rv~~o., ~.a1~~ ~ be~~o». c~•~ roc1~ ~•.d~ ~.~ (~ t Prrv L s c_.~ \4o v+.. ``..' Ye `~ ~ e. 'Y Q... .~~ ~ 4 ~ c.: I ,/ ~`~Z Pic s~ 4.0 ~~ r 1 11 ~.~ , ~L ~ I S.c~~ I 5 •ca~ I I ~•O ~ I S .~ l ~L c9 • (7 ~ ti v .,. ~. t '^'~ ~1•. e..~ ~ Imo. ~-o C; ~.qt ,. ~ (( 4 r• Q t `~ / U a ~ t b o X¢ C ~ `r tw, `. v a{, ` QH,'F -- ' ~ ~ ~l'1 ~~ ~ u ~ 11 \ ,~1 \ ,, ~- / \ ~ JJJ a~ ~ i C'.~ s ~s . ., . . L k,T 15~~ra~~. lO.CKING~GOVCR ---~ avlcK D~~C.oyVtGT---1 Cr --~ aye ~. ~- ..,, g q b ; 4 ~, a" ~~,~~ ~ DIP6 3• n0 NpISTuaOED Soles 24`' I.D, t~auuo~ ,,~ r z" t WEA'CNERPRpDF n ~TLNCTiCh l ~ i'~ 1~ T i j7/~7i~,,'7 \ P „~ ~" 4 0 •, . ,` ~, ~ 1ti t wC~o ~ J A zz.z., N~ j j j ~ - _ pF~ctovvt.D. ' `" ~T 3~rrrJ ~~ ~FLE, ~ I ' ~' ~ Ktr E LT i O KS ~ '"`/ ~ K ~ ~ ~ - ~ U~ 2 ON i (I ~~ ~,~c.,. Leu ~~11 ~ ~1, ~o~z~ O~ I ' PWlP ~ i ~ ~„ I, Co~rueE-r~ I E ~ i' b~oCK ti . SCPTiC t SPEC.~FICATI01.1S ocsc ~ ;~~~ Tnr•.i•.S MA-JUFAC7URCR: IJUMBCR OF DOSCS: ~•3 PCi, C,,~ TN-JK SIZ C : 1 ~~ ~ ~'"° GAl.L01J S • .DOSC VOLUME ~t ~}.,Z ~ ALARr1 /"l/WUiACTUf~CR• S `~ ~}``'~-~~~ IWCLUOIWG 6AGKFI.ON~ ;,~-,,;ti; /'~OOCL -JUN•bCR; • ~ ° ~ ~`~ ``~ CAPACITIES. A c Z2 •'Z IUCHCS OK 3~2•\ ;,.:__,;, SWITCH TyP[; ~~y" "`b g ~ Z` i1.1C~C5 Oa 3361 _ 1 vA._ i~rr,P MA-JUFACTURCR: ~~'~" ` ---- c • S'g ~ucHcs Ok 9~•z~ ~~ _ _ ~ MOpf L -JUMecR; `~ Z ~u~•S v SWITCH TbpC; ~~"`~ " IJOTE' PUMP A1J01~l.AKI~ qRC TJ pC P''11-J11~UM pISCMARC-C RATC.-~_Gp/•1 INSTAILCO 0-J SCP~RATC C~I:... '_ vcRrlc^~ o~FFC~[tJCf DCTWCC-J PUMP OF- AUO OISTRIDU710-J PIPE.. 1~'q'~~ FECT 'n + M'uIh1UM -JCTWORK SuPPI.y PRCisuRE . Z'~ FCCT}°.~i + ~~ F'CET OF FORCC MAIK! X C_,3~ p~ ~ l,~? Z- ~ Z~ l0o-tFKICTIOU FACTOII.-- FEET ~1 ~~~ TOTAL. Dy''•.IJ~MIC HCAp \ g•ZZ FEET 11JTER1.1A1. DIMC1.1b10A1C •0/ TA1JK: LE1.1C,7N I_,~ ,.,_;W~DTH ~g1' ;UIQU10 DCPTH 3~ t~ a ~. ` !; ~. a -~ r~ TOTAL DYNAMIC HEAd/CAPACITY PER MINUTE EFFLUENT AND DEWATERING 0 a w x U a z r 0 a 0 MODEL ~ 152 153 Feet Meters j Gcl. j Lifers Gol. Liters 5 '..S i 69 ~ 261 77 , 291 f 10 ' 3. t j 61 i 23 t '. 70 ~ 265 ~, 15 4.6 53 ~ 201 61 231 20 j 6.1 44 ; t 67 52 I 197 25 7.6 j 34 ~ ? 29 I 42 I , ' S9 30 1 9.1 T 23 r 87 y 3; j :25 35 I ?C.7 t -- ~ -- ~~ 22 85 40 I 12.2 ~ ~ ^ ~ =~ r , I i-ock Vcive '38.0 F,. ~1 _6m_2~ C ~~ ;' ~ ~m~- ' - -- ---orasoe FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Owik-box available for'outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series _ -,_ ___ ___ 1521153 MODELS Control Selection Model _ Vol ts•P~ Mode Am s Sim lex Du lex N152 _ _1.15 _ t Non 8.5 1 2or3 BN 152 - - > > 5 1 Auto -- - 8.5 Included 2 or 3 E 152 _230 1 Non 4.3 - 1 2 or 3 _ B_E 152 _230 1 Auto 4.3 Included I 2 or 3 _ N 153 115 1 Non 10.5 1 2 or 3 _ _ BN153 - 115 _ 1 Auto 10.5 Included 2or3 E153 230 1 Non 5.3 1 2or3 BE 153 230 t I Auto 5.3 Included 2 or 3 A CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). i-- e ; 4 3 27/?~-if--...eta 5/g-~, ' I ', ; -n _ _~-'. ., ,- I'1 li ~~ sKZOen SELECTION GUIDE 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E-Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. w~_ ~ ~ ~ ~ RESERVE POWERED DESIGN ~ 0 For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. -~~'' _ MAIL T0: P.O. BOX 16347 ~- '' ~ ` ~~~ Louisville, KY 40256-0347 Manufacturers ol. . SHIP T0: 3649 Cane Run Road Z . Lr ~'~I l o Louisville, KY 40211.1961 Q~aurr PuMas S,vcE /y~y http:/lwww.zoeller.com ~ PUMP !O, 021778.2731. 1(800) 928-PUMP FAX (502) 774.3624 0 © Copyright 2000 Zoeller Co. Ail rights reserved - - - 0 80 160 240 320 System Management - Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. [f problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715-235-1 132, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General ~ Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . I f the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. ~. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. I I . If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance I . The septic tank must be inspected every three years by a properly licensed person. 2. I f necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. a. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. ~. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. 1 f the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 1 I . Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.~a (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing. and,~or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 POWTS OWNER'S MANUAL MANAGEMENT PLAN FILE O TIO Owner , Permit # DESIGN PARAMETEIRS' Number of Bedrooms I OOgpd/bedroom ^ NA Number of Commercial Units ~ NA Estimated flow (average)* gaUday Design flow (peak), estimated x 1.5* gaUday Soil Application Rate gaUday Influent/Effiuent Quality (NA^) Monthly Average** Fats. Oil & Grease (FOG) < 30 mg/L Biochemical Oxygen Demand (BODs) 5 220 mg/L Total Suspended Solids (TSS) 5 250 mg/L Pretreated Effiuent Quality ^ Monthly Average*** Biochemical Oxygen Demand (BODs) 5 30 mg/L Total Suspended Solids (TSS) 5 30 mg/L Fecal Coliform {geometric mean) S10 cfull00m1 Maximum Effluent Particle Size 1/8 inch diameter *Wastewater Flow Verification on and calculations: (Other than bedroom based) ** Values typical for domestic (non-commercial wastewater and septic tank etlluent. ***Values typical for pretreated wastewater. SYSTEM SPECIFICATIONS Septic Tank Capacity gal ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effiuent Filter Model ~ ^ NA Pump Tank Capacity gal ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model ^ NA Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) ^ In-ground (gravity) - o ressurized) ^ At-grade ound ^ Drip-line er: ^ Leaching Chamber Manufacturer Model Approval Stipulatio n Soil Application Rate_gpd/ft2 Area Req. Absorption Area Credit per unit ft Minimum Number of Chambers ^ Aggregate Design Flow/Loading Rate= min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA ^ "W.isconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ^ "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 ^ "Design of Conventional Soil Absorption Trenches and Beds". RJ. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ^ SBD -10570-P (86/99) "At Grade Component Manual Using Pressure Distribution" ^SBD -10567 P (8.6/99) "In Ground Absorption Component Manual" ^SBD -.10705-P (N.Ol/Ol) "ln Ground Soil Absorption Component Manual" Version 2.0 ^ SBD -10628-P (N.6/99) "Recirculating Sand Filter System Component Manual" ^ SBD -10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ^ S -10572: P (8.6199) "Mound Component Manual" BD -10691 P {N.O1/Ol) "Mound Component Manual" Version 2.0 ^ SBD -10595-P (86/99) "Single-Pass Saud Filter Component Manual" ^ S D - 10657 P (8.6/99) "Drip-line Effluent Disposal Component Manual" ~BD -10573 P (R 6/99) `pressure Distribution Component Manual" ^ SBD -10706-P (N.O1/Ol) "Pressure Distribution Component Manual" Version 2.0 ^ Drip-line Effiuent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE MONITORING SCHEDULE Service Event Service Fr uency Inspect condition of tank(s) At least once every ^ months ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one- ' d (1/3) of tank volume Inspect dispersal cell(s) At least once every ^ months ear(s) (Maximum 3 yrs.) Clean effiuent filter .~ At least once every D months ear(s) inspect pump, pump controls & alarm At least once every ^ m nths year(s) ^ NA Flush laterals and pressure test At least once every onths D year(s) ^ NA Valves At least once every ^ months ^ yeaz(s) ^ NA Other: At least once every ^ months =:^ year(s) DNA Page~_oI ~ WART UP Far new coasCruction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized, Toilet tissue is the only gaper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady .flow. by spreading laundry. washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the. dispersal unit may cause it to freeze up. ^ Valves Valves shall be operated in the following manner: arms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INFECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). tic Tanks Component Tank inspections must include a,visual inspection of the tank 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 backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank volume; the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated s is s`ecific~ .. Provisions are to e m e re so m e .Filter cleaning maybe necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. ^ In-Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and avisual-inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page Z of~ ' ~ ~,~ Mound, At Grade, In-Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or dischazge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure 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 anti pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all-tanks and pits shall be excavated aad removed or their covers removed and-the void space filled with soil, gravel or other 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 replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement azea 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 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 azea. Replacement systems must comply with the rules in effect at that time. ^ Asuitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank maybe installed as a last resort to replace the failed POWTS. p The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation t be performed to locate a suitable replacement area. If no replacement area is available a holding tank maybe installed a last resort to replace the failed POWTS. 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 that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES 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 PO STALL Name Phone - SEPTAGE SERVICING OPERATOR (Pumper) Name Phone K:IWPDATAIEHIPOWTS OWNER'S MANUAI..doc POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Agency Phone Page 3 of 3 Q1 i : 2 2 4wrlarBuyer --~~ f' Mailisig Address property Address ST CRCYX GULf~CZ`Y SEPTIC TA2~ t+'~~'~T"Y3N'ANGi3 aQl~Biv~N'I' ANI~ y! ~OWNEI~,fiHIP CER'I`IPICATI~IY FQRI+rI 5G L 1 i !'~ , i ~ ~ , A ~ ~n 1 6 `+'~1 (Vctifioation rccluired from Plantzing 13epaitilcat for new consttuotiou) City/State Parcel Idt>a~tification Ntunbcr ,~,~~ W ~[~~ nl.~"~ c ra property Looation ~ '/4, ~ y, gam, ~ T~T_R j 1 W, Town of Subdivision ~ Lot # . Cortfred Survey Map # Votttme Page # Warranty Deed # b ~ ~ l S ~~ Volume _ 2 0 `J 2 . Page # ~ ~" Speo house ^ yes / ~ no Lot lines identifiable ^ yes ^ no ~~'S~'T1J1K TENANCY Impr4pcruso andltaaintotutnecofy~ur septic systesu could result in its premature failure to hardlc wastes. Proper maintenance consists oP putxtping out the septic teak every tbrce years or soantr, if needed by s licensed pumper. What you put into tho system c~a affect ~e function of the septic teak as a treatmcat stage iu the waste disposal sys#etn. The property owaor agrCOS to submit to St. Croix Zoning Deputment a certifeoation fotZU, signori by the owner sad by a mastCr pluiaber, loumeymao plumber, restxictedplumber or a liccn~sed pumper verit~ing that (1) the on-sits wastewater dispas4l aystem ~ ~ l~-P~ operating coradilion sud/or (2) after inspection and pumping (if accessary), the septic tank is less tlaaa 1/3 full of sludge. IJwo, the uadtrsigncd Dave lead the about xeRuiremcats sr-d agree to melatsia the private sewage disposal systemwith the standards net forth. hareia, as set by tiro Department of Commerce and the peparlmoat of Natural Rosourccs, State of Wiac4psiq. Certiflce,tiop stAtiag that your septic system has boeA maintained moat be completed and returned to the St. GYuix County Zonsag Oflxce within ~0 days 41 tlLp three year ExplratlgA dale, SIGNA'IURI~ OF AFPLICANI' f'~ ! .3 0 'a DATg o C uT, r~~~,TrnN I (we) certify that atl statetnegts ors this form ere true to the best of lay (our)1~owlcdgc. E (we) am (are) the owners) of the property described above, by virtue of a warranty dead recorded is Register of Deeds Ot~iec. (3N~-TU1;8 0l~ AP)C+LICANT .~ /~~- DATB +•.«•+ Aray iafocinatiaa that is tnis-represoncedmay result in tt~c saaita omit btin revoked b the Zonin De artment. ~ P ~ y g p ~..«+* «' ~clude will: this appltcatioA; a stariipcd warranty dCed Mori tht Register of Deeds oilteeo s copy of the certi.ficd sarvey trap if rofercnec is itiade in the wartarity decd 71TJ __ Dec 27 02 05:1.3p HOMES DY OWMER NETWORK 1 BTATE 8i.1 op wllCON3lr7 FOxM 3 - 399t Ir WAIt&ATTTX DEED lhis heed, Dodo bctgsea H~olid Land. LLC. s Mheoeeeta Lloipd LiablYty CalnwwJ Gsaamr, ttad tM~ D. M rl~r ie atd Juditk A. b~idts, 6mbaad and wYe r - -- Grantee. Qlaelor, for a valeiebk coaaVdention, ooit+~s siad wergkats b Grwtet t1~11vw~iag described fuel u40e fa Sk Cnht Count!!. Stan of Whicanan~ ~ 27 Oda Sitbdlvieioi4Tosva of Huamoad, St. Caocc Cathy, aeleen wsloesx~-0oo 9a.d teaee[rdso t~amher(T31J- 'flue iettot yd~opa~Y= tie) tie ~ t< .. H. Pseeptiom t~ w~itraat;ei: Subject to aatee, taeemeetY,n:astietbae,~pvp~ aad eig5te of way of treeocd,'if aoy, "~ ;~; 1t1:~i3t~0~hYtSgtllIDltpdtOthOR~3'.W~riEbaliDII,pOff~lng,aeQOR4tfIl1i86dtiu~yybcsltownop16D~3t~ ~: Fismtroad dolts S3ebdlvlty0n ieogmded ~ Vol. a ofPLuq lfetae Z St. Cmbc Camtt<v Wiacosda. 4Le e'aaele{iw otthis decd, a idler el~tin;ed ar Implied are loioioed by the ®aator Lo the gtanfee, or aeproae in the chiil- q~pw,,p t{le cA3le~et8tinn er~ieested htveNt, that t3Hag the lash of SZ 6,1100.00. Wiled this 20th day of DatYabtr _21102 AL'TH6NT[CATIOfV Wtiratiawdesie~_dayof~._._ , 'ff['LB; A412~BER gTATB &1R OF WISCJJN~i ` (If sot, ardkeei2ed,"~ , gtadti.) '1T11,1 >tiSSRrSMBNT WAS UlU-9'1'CP SY Peel A„ Balgvn, Attoirogr d Law augr be maital or ac,knowydg«t, Both ere not aseewry.) 8ataaioed Ltued, LLC ~r ~~ . • Aiteals J. B*fYOe ACIOYQWLBDC1Vl~lw1' srwrE of w14CONBdN ~ ]Qaeaeey ~+'~ ~0'• PereerallY came before ms this 20th diy of tiectaeaber ,2002 theat+oyeeonidt Awsfs .8afil0ie tv 3DC lmonrn ter be the penoll(e) wow EittoCnad the fineQaigS insfmms¢t od selpriewJ~dec Ills same. ~.~~. 6s i*µ )sill A BaiBon PAULA. E:41LLUty ~ , Notar Puttiic,$gwp of W Mi~CMUfeloni7D~ii kgi, my Cakmissiaa is ds0uiq 3t .l ^ p.2 P slLao ofroo~ aipia 6k soy cepechy.t,arue le ryysd a prinud Mtaw their syneteeis - iruuuimr uses srar l~ o harmer reawsr~aow lieoFBSeWlfntec~aW~errepim oc me ~ soo+»riai T ,~ Wisconsin Department of Industry, Labor and Human Relations Division of Safety and Buildings SOIL AND SITE EVALUATION in accordance wiyx~~LMB !a~• , , ,Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in si include, but not limited to: vertical and horizontal reference point (BM , d percent slope, scale or dimensions, north arrow, and location and dis y APPLICANT INFORMATION -Please print all inform ' Personal information you provide may be used for secondary puiposes (Privacy L w Property owner F} V H a t e'D L>qN ~ c a~~ , c Page , of ? I ---- ~ f2~n,mu ..~ ~~ Coun ST G. iO0/ /` ~tion an~,' , r', '.~~ ~ ~ /~ to Barest road parcel L4. # O • ,~ ~ `~ f °~ d~ '~d sf~•d~ I• ~ ` ~:, -`~ Reviewed b Date _-- .~~~~ ~ - Iz ~ ~ ~ S'nN•~ 6h ~ tto~ ~~. Property Owner's Mailing Address tot 332. Mi+~N~SoTA s?: EAST lyo~ 2? City State Zip Code Phone Number ST• P~u~ ~ MN. ~ 5Slo I (~S~ )za2 •SSSS ~ City Horizon Depth in. ~ o'g Dominant Color Munsell ioY,2 .~ l3 Mottles Qu. Sz. Cont. Color -- Te • z ~o ,Q --- S /O .--1 O y ft f ra+s S 10y L L•~riesidential / Number of bedrooms 3 Addition to existing building []'(Jew Construction Use: ^ Replacement ^ Public or commercial -Describe: c ~~ Recommended design loading rate ~ be ~ 9Pd~ •7 trench, gpd/f12 Code derived daily flow 9Pd Absorption area required ~~bed, ft2_ 31S trench, ft2 Maximum design loading rat d, gpd/ft2 trench, gpd/fl2 Recommended infiltration surface elevation(s) Su ~ tt (as refer to ' e plan benchmark ~ / -~ _~~ ~~ il~Su ~ Ge Additional designlsite considerations ~/~,,, Parent material ~D EtS D Uri ~~NSF T~~~f Flood plain elevation, if applicable ~T- Conventional Moun In-Ground Pres re AT-Grade System in Fill Holding Tat S = Suitable for system ~,~ ~^ U ~ S ~ [] S ^ S L~ ~ S (~ U = Unsuitable for system ^ S LKU LL~~ SOIL DESCRIPTION REPORT Structure GPD/1 Boring # xture Gr. Sz. Sh. Consistence Boundary Roots ged , Tn Ground elev. ~3 •~-~-ft. Depth to limiting factor ~in. Boring # Ground elev. g3.~--ft. Depth to limiting factor ~]~in. Remarks: __ CST Name (Please Print) RpB~,R1"' 7~~~R~etiT Signature , o,oN,,.,,.o ,..,. ~~s•3$~•~rgs Remarks: }cc,-,~, _ocation . Q ( ~ ~ /4 ~~1/4,S ~.0 T 2 / ;N,R ~ X (or) W # ` Subd. Name or CSM# A-MMO~VD ~~'~~ N-eareest Road W ~ Z 0 Village . r,`-' .own I '~dC. I (/ d ~L iL o•/o iv,~3l 2. D • io ~• /d <4Y /hots -1~ Date ~~' "'u""'°' Address D Gf • l 3.14 ~ i4 3 7 5 .~ VM g 1 ~~ L ~'~~ SOIL DESCRIPTION REPORT PROPERTY OWNER j' Z /~AM~1oN~ ~~ ~S s ~gfl ' PARCEL I.D.# • ~ 1 ~ ~ t Page ~" of Horizon Depth i Dominant Color Munsell Mottles Texture Structure Du. Sz. Cont. Color Gr. Sz. Sh. Consistence Boundary - 2 Roots Bed ,Trench n. s 2 0• •s ~~ o p -.~ ~~ Si f h ~ ftf profs SGG S ~ ~ c s c ~ ._._. ~~ -. s; .~. ~ ;. . 2~ •3 ~oy~e ~~Z o„n,~rU~• Boring # Remarks: Horizon Depth Dominant Color Mottles in. Munsell Qu. Si. Cont, Color Structure Consistence Boundary Roots `~---~="= Texture Gr. Sz. Sh. Bed ,Trench Ground elev. ft. Depth to limiting • factor , in. Remarks: . Boring # Ground elev. ft. Depth to limiting _ _ factor in. Remarks: SBDW-8330 (R. 08/95) _` oc.~ x °2' '~ • -xy ° ~ ~ z-'~ ~ a~ 1 ~l~ ~~ W °-+, ~ A f Gv ~s % Gp T ~ . ~y~ ~ t ~, 3 W O ---•~ OL ~ ~ ~c ~ ~ \ _ ~ ~~ N w 0 .~~. ~, , ~o ~ ~ ~~ ~,~ 9~~~ .~.. .___-__ - 6.-~__ _ -~ c ~rn3 -- o -r, ~ G ~ o ~~ ~~° ~ ' ~ '" ~ ~ ~~ d w ~ ~ "~ ~ ~ ~ rn ~'' -t O r ~c ~ a ~ ~ ~.n ~ N G rn ~ o ~ ~~ p ~^ ~ ~ ~~ v ~ ~ b ~~ ~ -~ ~ ~i o~ •~ _~ i .`. ~. .. ,. y Private On-Site Wastewater Treatment System (POWYS) D ~ 1 tIndea and Title Sheet Owner: ~ IJ~ Project Name and System Type: ~,~ 1 Location: Street. Address ~ J Legal Descriptiaa-I -- a Township/County 0 6 ~ Contents: Page 1: Page 2: Page 3: Page 4: Page 5: `~( Page 6: -t' 1 „ ~ -t' 1 UPI l_~ Page 7: Page 8: Page 9: Attachments: Plumber/Designer, Credential Number: Date: J _ ~~U~ R ~GER.S' P.~, i~TMBING, INC. IV'4563 320T~f S~'12E,ET MENOMONIE, 1Wr 54751 PHONE: (7'15) 235-1132 FAX: (715) 235,0867' Fax Cover Sheet Dater To: r~.N-( Company: Fax #: 7/ S g~ - ~ . ,\` Re: / - - - ~ Pages: -~ Comments: F Zd Wd9~ :90 £00Z 6Z 'Up!' L980 S£Z STL 'ON Xtfd oNiewmd sa~ooa : woa~ ~.._~ ~..__.~.-__.`-. __u fib'-c~' - r. , _._.__.__. ._ -........... eJ~~. R+9M~ s `r.r. ~ , ~ _ l _ L'~O!'t t! ~ a ` v' ~ey~r,a 1 1 ?Atr_f__ ~ ~' 1 1 .,.T..,.,.-- • - - 1 -a~n , 1 ,~ r ~ -'°~y_ TAI ~ t ~ -..._ ._. _ r r ~ • ,~ } 1 _ O( r ,.rte, 1 ~r~a~ r ~a,~~ t `~. ~ ' ~ ~- ~'~ ate' -- ~ i ~ !~ . _. -- 1 r . ~ r ~, (- -~ .r w - ~ ~~ ?.~ 1 I Q 1 sJf~M[iE ~ ~eaewa~eNr e• c r laer'.J~a~sa Wo~R J 1 __". '~j.~l t 1 rmir ~w,rr~. ~; 4 1 1 ~ 1 1 - 1 1 r-.__.. .._.-~.....__.... _...1 r / . ~ r~' r r r r r ~ r r r ___._ ~ _... 1 1 rii r ~ i "~"' "~' 'i n1sN l1.8~ old ..---.r._. . - _.._ .~._ ____ _~...... , , _.. _ ._~ ..,E, .. -- ~~ ....... ~ - £d Wd~.£:90 £00Z 6Z 'u'~i' 2980 S£Z SZL 'ON Xtid JNIHWII~d S2I3~J0~1 WO~Id 4 M • ~ ' u ~' Zd WdZ£:90 £00Z 6z '~pf 2980 S£Z STZ 'ON Xdd ---I start r~ 'ta~-~ r~^^^~ .. «F~M7 cJ-•rrw .~a+i> JN I HWf lid S21~J021 W02~.~ . ~, /~ ~y.,9. _ _ . .~rnrw.~-.r-~ .. I ......ai~~r_.'' .. .. .. ~ i ,.. .t , ......._. ..._. ._ ...._ ...__....._ .'.~ ` ~ ~ ~ a ~ '~ q ~~ 9 ~ tt ~ .~ r - ~ ' i E ~ . IS Sf.. I t .r ~ I ~ ...... i pw ~ ~ ~ ~q li ~~~ R ~ 1 _ I ~ 4 .. Ir'~~ ]I'.O' .~ ......... i +• ~ ~ I ~ ~ ~ Mir a i ~ ~i ' ' '~` ~~i' ~~: ~!~ I ~~ (.~...~. !a '~ ~~ :a~fi 1Q ~~ . {~ 4'.O'' 1 76.1' t ~i ~ ~~. _ ~~ ~ ~~ *KS nor _~ ~ -„ ~ ,.~.. ~ hew ._~ . i ~.....:°} rvu:asAtloa ~~ ~i ~$ ;; Zd WdS£:S0 £00Z 6Z 'u~f L980 S~z SZL 'ON Xdd CJN I HW(l-ld S243Jaz! WO~Id .. .~ 6 f~ ~d Wdt~:SO ~00z 6Z 'Upt L980 S£Z StZ 'ON Xdd ~JNIHWfI~d S~I~~J0~1 W0~ld JINN-@6=@'S MDN @:~ : 1 1 JUD`f / <<~ ~~ (~ ~.~.. . \ ~~ t~ h~ ~ E~ I~ i ~ ! ~ -~~ ' _^ - I~I I~ ~ 1~ 1 ~ •-- ~~ ,i ~~ 1 ~I r ~~ ,~ ~ !~y ._~; ~ ~1, ,~ ~, ,, L_. ~... ,~~ :~ fi _~ ~~,' _~ -"T I I i ~J ~~~ !' r ~,; ~ ~ , ~ ~ ,` j I ,\, Jjj { ~\;~~~; ~z 1 s ~\ J i' ,!~ ,~r -~ i~ '' P. 02 '•"'~~^ J.C. CGh'6TRUCTION- TN s{ ~ ~ ~ ~r~inp aYCOPLa G~iioU :~.:~..• ~ { .,:.~„.:.'"^; °• .i ~•ra _ _ L:".".""'' y.:7..~'?.:W.w. .~...,. ~=s:.~.'~l7l rtJtlPC 1 ,..:•w w.:.~ o w M ~ ~'~ Q,4EVAT~ON& a 4 . ~~~.. ~t'~. °.....-~ • y , .. !{ ` ~ ~ _wr. rwr ....~ .... ..~ ....~... ...~..~....,,.•.. .~...~.m.,... ,., .rte ...~L._ .. _ ~ .; t•i - ~~ c• -- ~ ~ ri c ra ~ :~ : 1 ~ .r ~ ~ :u -r ~1 U N. L 1 f'1 f`1 'i F: ~ 1 t ~~ ~~~~ ~` Ni ~~G "l/ ~ ~ ..5 /_ ~ ~~~ _ 1 .~ ...~.... ~~~ ~ I- ~= ~ ' ~~- ~. } atlg '~~y=, ~~~ ° i t~~ .Y ~, ~. Z~•. lo~ bl~. ~~} i l i'7 r'. b s ,. ....,,.........~v.._._~+..... s ~~ .rw.oa ,i.C. CON6TgUGTiON- _. -.~.... _- _ vwmo aapu;: CW:^u'W ......,.,,, , ?+is .IJGT €IC ., ~, _ ::rf~`.~''L4'",{y,".'.;r~.`,t'Y'L•:r .. :., w, ::............. ....~ I(tII[s`~) ~'"u~S~.. R.+.":i 'iiT:'. "~.«3~ ..,. ~„::T 1LSu'.S~ yT:„+ IRAY~ 1....P' ~IN ~~00~l~ ~~` 1.:...~ I.~. ~`~ ~.i~'.~~•~~~^t:_r ~.t.~.-ns, ..' ~~~.:: ~w •.. r. J HIV - k3 b - k? J I' 1 4J (Y 4? ~~ L .[: J ~J L+ 1 N ~J It: 1. i fY I' 1 "f K L i t C~ 1 :~ -r ..1 ti ~ • ~ v r- ~ -+ t I, 11' ~°p ~ '.~ r ~~a~~~iaa7 ra t F'y F j~ ~ m Y ~~ Ag ~g ~ ~pEf if~ ~ p 3'T.~ Z 7,.-~,p3 ~'~j~ fly ~~ I '~iC i ~ ~~g ~ ~ F ', I_ IA ., e ~ ,~ ~ ~_ ~ k o F~ i~ 1I fl x Z ~'~ ~ ~ ~4 -1 N ~ y \* i ~ + .~. \` `` ,~` I i r ~ ~N al ft i• ~, I ~~ '$~ \~'' ~ i ;s i ~I ~ ~$$~ 15yaa~K ~ I ~~~G ~I~O `gg~~' ~~ , rM„ ~~0 ~ gg ~~~n~~F WI ~6 ~~ °z ;'` T' rn~ ~ ~ '' ~~;`, o~ ~~~' q ~p ~{ ~~ ~ j3 ~ ~~~~ ~~~~ 1 t { rt1 ~,,` ~`y ~k 4 ~ ~ ,r it ~ i ~ ;I `~~ rte' ~ ~. .I ~: `moo ~~ ~ ~~ i~~ o'!a i i I v a ' J.G. GON'rTH4GTiDIv T•1! .JUDY i.~. irj! ^~ Bw~Dlhu ~ECro~cO 6 u ~ ILL' ~~~ ~~~~~~~ ~., a e~~~~ !~ ~~4~~1~ ;~ ~ Ia ~~~c,F'6 ~ r~ F ~ e a i• ~ ~~~~ ~ ~~ ;6~~~ i~ ~~~~~~ ~~ J ~~ ~~E ra?'k S s F -s~ ~~ ~~ w.*Up n,u.o~ar. ^+F'ena ...~:tJ«".L.~SY''K!fv '.~^`•,;,T :"v.•,'.:~ ..~_ ............. ~s:aaiti'P '~e.r ~, Ww ....... Dec 27 02 03:17p HOMES BY OWNER NETWORK ., ~+ '~ ~! 1NldasnaN Capearnad ®! I^d~y SOIL ANO SITE EVALUATION ~ t ~ 2 t.aa dlld F4dnn ii.iaplo~o CNald>rteA 6ga+yantl vw.rovs h.eawdancv wdt~ a, iLHq 9l.DO, YW~. s-.aal/la,wnu aw r•n en vaoa.Ital uca vta• v u:. ~ s I.ar. ln.or.. PIS n.~ `O1""' ST• Cii°O! 1 ~ tei Wa,6~d na! IbNW ~ vaAkd and refmnM Islarenea 9alnt lekl~ draatYb~ ad pare/M pYp.ow`air~~nsforli.+l~.~rndlaafrp.n~~wncsbnsacesf~eiM. glgall,D.I • o~ • is • as ~PALICIINTWFOgMA'ftON-PbvuplnllN7nlornsvttan. vP ~ Dw vMMt! aiLrrrstbn www/tonrrs. va.a ler.t~dpy NCeto ~f.~,1.., i. It a6 N 1 F.SI~ 9n.atr~ Nv,. BBD GAN e a o~ ~+ ~ r„~/~/1».v 20 *29 ,lap /? td.~w 3 ? t1 $~/IIO~ r. wn .a tnl: ilacrrt smo. Nams o, cats ~~~ Hiw~~sdT~V sr. ~~sr r~tc~ ~~ ~ ~ ~,e~r~ o~}•,t-.~' , iron zlpto0e Prtanarium»al ~~~~ sr• ~. Mu. ~sral ~~St~zzt~S~s3 ^~ o~,! Y.~ .,,,~ Irio ~'I4.arcenblNian u..~ Q~rswnna~Nu>MhnaNurloanu 3 ~ronaal~wvadalw ^ 1M~I.aMMi ^ aaNtc d ean~naayW • o0acl~OS: 4btlsOHkMfslyllow.~~Wa R.eo~MNWOeafpnb.NnBMto 7 .0.0pdilf~jv.~ti~ ,te.a~... wv.raa b.e, u? 37S u.rcn, +~= wsml~rw d.slw wearo In•~• ~ ' '~ ~wlr~. voaa' gaepr~nsnaaelafu.uen wrMco alarula,M} . -3 tt tN reNRtl w.lr. pan ~.~q Addrowl de/l~n1Aw nn.l0.~.,bm PHentwMMro1 IeEat ~f~lSI7 ~~~~ T1~1s ileedwln.larailan,g00p11ta0N~~...~4 S BWpG.h+olraa~ wnUaral InQsorntl ~P A • ~ Ys~~ oM u ua.sulre to gMlna ^ s~ O u D v C~lu D$ D s [~'fi'~ U s wwen.ua.a neenor 60ting M .~. 93.~z..*. oaolh b ~~ kefar ~~ NaA=o., O.P+h in. Oo•r+1~aM Coo Yonaod YMeltlaa tdMU6 8ruawa tL. 8z Cant Cttor Gr. Si. 30. t~a1lN.la.oo Bu.ndary Ilook~ Bad , IoM 3j t o t 1 s Sri Z sb li,1 !f •K~ .S •s ro ...... c. ~ _ ~ , 4 tf ,yvfx GC ~ . ~:. a„~,~: ~Z Q~,~w aa-iDle a8lTl~k ~ 0 o r z c ~ I ~ti -- -- .~--. rats sdm 3L~in, liarnelks• C8t Nana Canna vw„q R~RT 21~.~~'C f Cdt7~ 61W'~tve .~ ~~ TaraQhane taa ua... OG~ •23 , gf9 xm43 5 p.2 hunl~ q.wOa CoaauHanu Kf U't1a6 Rd. ~>er, Wk. 3a01s Dec 2^ 02 03:1?p HOMES BY OWNER NETWORK ..I s .~ oaera'Tr otw-een ~ VN B i 1~f~ ~ »A%ii 50N. DESCRtP't'ION aEPBRT r~aea-t.a. lDj'~Z Ndtiho~v+~ ti+kS $Ogf~' S .+~, ~ ~ ~ror>d ~] ttZa, OMho Whrrpr~ 1-Mer ~~ ~,?-d3 NeAten p WO' br. perrhrNC01L OiwusN+ mid Ou. Sz. CpM. Cpow truer 1m:awe Gr.3s. Sa. Cw+ogWKa M~ Roots ! fM . Trrrdr .~.+o s Mo fs tG 7 Z:. 3 ioy 4tL ' .'Tl~. . Pemtarb~ anrkrg r ,; 1 ,~,r. , (baud tAar. ___,. .~- N. C~rpMrb ' NiN1h~ trgw ,_,~_In. {LQ11Bfllar. Boring 1 werw rln. .._. it oaMa ~ amwrp irerrsr DsrrOr r. pOrftNMld7ler Mmrru Mober a. 6a. Carr Ce1s, TerWr Sa,Klrn' Gs~sNrpr Or. bi. ~ C>nrrsu- neetf Ore . T -- Mar, -_~". Remarks; eor+no tl ,,. OroM'0 rlw. Ft. OrNn 1s urMraO ipersr -M' f;OnbltW p.3 ~DWISiO {R. OWS~ Dec 27 02 03:16p HOMES HY OWHER NETWORK p r v* •~ -..~ i ~ ~~ * L ~. h ~ i r-- s ( t w~ Q o ~ ~+ ~~ w . ~ , c ~ iV `'~. ~ / ~ ~.. ~' ~ ~. ~`''. ~ -~ ~.. b ~~ _ .~ ~~~ C ~ ii ~ G ~ -v ~ ~ ~ ~4 ~ ~ ~ G ~ 'f1 ~- ~ ~ ~! ,, i ~ ~ ~ ~ r.- b ,,,~ r vs Q .r .~, ,......-----~, ~'~s r ~a r ~ . - ~ ~- `~ ~~ ~~ ~ y ~ ~~ R ~ N ~ ~ ~' r• ,~ c ~~ O Z p O 4 ~ h / ~ E Jf .~.--.,.mot-L~..-. Q p.4 1 1 i Dec 27 02 03:19p HOMES HY OWNER NETWORK w .y ~ !~ So'x3'~'~F 302 OS' Q~ - ~ t 1 ~, r. i.OT Z4 ~ ~ na` ~. ra'i a ~6.a96 S0. Ft. r"i N d t .n ^ ~ z t r ~ ~' t .47 ACRE S n. " ~ A 3 W n ~~T ~'~3'2~'Y 30Z ~` + ~ ~ ~ ~ ., ~oY ~~ :,~ ~ a ~ n Fs. ~ 45.498 5 a r r ( ' ~.~7 ~ayR~S ~ ~ ~QT 26 ~ ~ ' ~ a356t S0, F~• t .00 ACRES w r `~ • ~ ~ 33 33` ~`"~ ; ,~O~xs ~a ' 1 t 'A?S~ 6 Ol•w 303 ~y' t~~ LET ~~ ._.. .+ e ' ~ t ,13 ACRES o ~ •~, g r '` N) `c ._ - ~~ _._.- ~~ __ :-- _... --- ~....~.. +~s~ ,,. caa. SEC. ZO T2+fk. Rt7M. ~? 4t+E NJStAIU-71GF1 ~8tE5 ~,1tE io 8E ~~ ~~40~+ A~a~G ~-+ ~ ~~ t~ ~ St~iu~S. UM~~ Fi.SEdc`~ /~5 =36.32 OF MPISCdis~•~~ ~~5 A1~iD PR:u+~'l'Ef~'~IG ~ T ~ ~,~-. p+rT O SE~~ . ' a ^}-:.: t T1R Kgy~rtFS Y~ ~ s,:;. ,:. ~ RRE~S - 9+' ~n~ psi 1s ".~+'=~ ~* ~.,~,3~.~: ar~a5 p.5 ~~ i ,~. ~~ ,'. ;, ~~ ,~ ;, ;y it ~~ c ~, sT cxorx CovNTY RECEIVED M { f ~ SEPTIC TANK MAINTENANCE AGREEMENT ANA .~NPJ 0 3 2003 OWNERSHIP CERTIFICATION FORM sr c~olx cuuNrr -~~ ~~ / ~}/, , , 1~~~ ~ ZONING OFFICE OwnerBuyer ~~ r ' ' ,1 1 1 V.V Z _ Mailing Address J - ~ Property Address l to D ! ~~ ~,,..~, (Verification required from Planning Department for new construction)( ~/ --nn ~~//~~ City/State ~ Parcel Identification Number ~~~') r I D~(D r~l ~ Uli(J LEGAL DESCRIP~TI~I,,O~~N /~ /~ Property Location /., /., Sec. T N-R I ~ W, Town of Subdivision s+~~_~~ . A,, ti Certified Survey Map # Volume ,Page # Warranty Deed # Volume ,Page # Spec house ^ yes ~ no Lot lines identifiable ^ yes ^ no SYSTEM 1l7AINTENANCE / ~~ Improper use and maintenanceof your septic systc `~~ ~~ ~ se to handle wastes. Proper maintenance consists of pumping out the septic tank every three years pumper. What you put into the system can affect the function of the septic tank as a treatment s ~ ~ The property owner agrees to submit to St. Cro ~~~~~ on form, signed by the owner and by a mastprplurnber, journeymanplumber, restrictedplumber c l) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspectioli auu Y,,,•,1,,,.~ ~.a uw,.ao.,.,,, ---., ..sptic tank 1s less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, hereiq as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. ~I++IA`TUBE OP APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ ~~ A'Tt3R8 C3F APPLICANT /a /3//a2 DATE *'~**** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Departrnent. ****** ** Include with this application; a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ~, ~ • ,~ Marion Standaert ~ ~ ~ Subject: Tank inspection Lot 27 Hammond Oaks Location: Hammond Start: Mon 6/16/2003 4:00 PM End: Mon 6/16/2003 5:00 PM Recurrence: (none) ~_-_ 20.29.17.647