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HomeMy WebLinkAbout020-1479-04-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 569541 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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 Parcel Tax No: Bast, Kernon J. & Don Ida J. Speer- Hudson, Town of 020-1479-04-000 CST BM Elev: Insp.BM Elev: BM Description: /� Section/Town/Range/Map No: IJ—Z G o 1 36.29.19.3025 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. i Septic J / Benchmark -3- 7 103. 0 �• 3 Th -� Qea.... F '� Z1 Alt. Be,� Go /• Aeration Bldg. Sewer 3 �. . P Holding St/Ht Inlet A/•4 'T 1 p , w TANK SETBACK INFORMATION St/Ht Outlet L(,-7 • 3 TANK TO P/L �yv 1EL BLDG. en to Air Intake ROAD Dt Inlet NG� nr� Septic 9 / 2-14 oo Dt Bottom Dosing Header/Man. -3.5 Aeration Dist.Pipe S: 9y• , 2 Holding Bot.System ..►lr- 9". S 3 yS Final Grade PUMP/SIPHON INFORMATION It Manufacturer Demand St Cover 5 O r GPM �; o J Model N(Ifber TDH Li Friction Loss I S s ad TDH Ft Forcemain Length Dia. Dist.to Well SOIL ABSORPTION SYSTEM L BEDITRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS '3 1013 3 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: �, 1 INFORMATION CHAMBER OR Type Of System: t UNIT Model Number: G o,w er..�`a 15 7Z 1 Zlo Z6`7 ©�;c�.�• Sie DISTRIBUTION SYSTEM �— Er' e(S we-4 �'Z`7.1• / -�>1'R ers Header/Manifold I Distribution x Hole Size x Hole Spacing in\ Vent to Air InJ�ke Pipe(s) d/J� Length Dia Length Dia � Spacing----- � '�' S SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of d/Sodded xx Mulched Bed/Trench Center / Bed/Trench Edges\y T Topsoil�` Yes 0 No Yes No tp COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 870 Yost Drive Hudson,WI 54016(SW 1/4 SE 1/4 36 T29N R19W) Cottonwood South'07 Lot 4 Parcel No: 36.29.19.3025 ( J 2 1.)Alt BM Description= FI� ,` � u� � S � �� �Lim ( h"a A-- 2.)Bldg sewer length= 2-4 lk-- �–: .,L- b - -amount of cover= / C d;V_ ( ! a 7 3 a� G1 ..fin Plan revision Required? ❑ Yes � N(o ( < 35 Use other side for additional information. � � — - - Date Insepctor Signatur Cert.No. SBD-6710(R.3/97) PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarae Rd Hudson Wi 54016 SW 1/4 SE 1/4S 36 /T 29 N/R 19 W TOWN hudson COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 4/10/14 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 890 # of chamber 44 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter E] BOREHOLE O WELL *H.R.P. Same as Benchmark 99' 450' Pr erty Line B-2 SYSTEM ELEVATION 94.4/94.1 5' below qrade o AL 74' All piping shall be SDR 30/34,within 10' Vents of tank,piping shall be Schedule 40. 1' 2-3' X 90' cells with>3' spacing Scale is 1" = 40' 1 unless otherwise IF 28' 110 noted B-3 Please note: if soils are found to be more fine than listed on the soil test,a.5 loading rate will be used. 1' 3% Slope Pro 4 Bedroom 80' 2(� 20' House 23' 1 \ \ B.M 74' 98' �avr•!Z_ 150' Vent >6" Quick4 Standard - of Cover Leaching Chamber with 20.0 ft2 of Area 4' Long 2 .6ft^2/pair of end caps Grade at System Elevation 34" Yost Drive ,rte,•, County �. Industry Services Division �ro) 1400 E Washington Ave Sanitary Permit Number(to be filled in by Co.) P.O. Box 7162 Madison,WI 53707-7162 9 Sanitary Permit Applications state Trat�acti umber Ina n e with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appro pate gov unit is required prior to obtaining a sanitary permit. Note:Application forms fir state-ownedS are s a Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information ott�jde may 'ASe�,for sec u ses in accordance with the Privacy Law,s.15.04(l m),Stats. �+� CO- ✓ f� 1. Application-information-Please Print All Informatiion / / " 2 0 i> Property Owner's Name Q Parcel# FL G {Ce Property Owner's Mailing Address �� Property Location �6 2 S) Govt.Lot City State Zip Code Phone Number Y4,J2;:� A, Section S n-W I. ype of Building(check all that apply) Lot# ��. 1 or 2 Family Dwelling-Num to f Bedrooms Subdivision Name /0 MI Ite Block ❑Public/Commerciat Describe Use ❑City of ❑State Owned-Describe Use CSM Number ❑ Village of ?'�Ow of III.Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ystem ❑Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) B. ❑Permit Renewal ❑Permit Revision '❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV a of POWTS S stem/Com onent/Device:. Check all that apply) Pressurized In-Ground ❑Pressurized In-G pund. ❑At-tGmd ❑ Mou d>24 in. f suii le ilil•�vime un 2�4�'�suita_bleJ�°i �f ❑ Holding Tank ❑Other Dispersal Compone exl'S ai f O �� ❑Preireatn xp in}�_- V.Dispersal/Treatment Area Information: Desion Flow(gpd) Design Soil Ap n Rate(gpdsf) Dispersal Area Required(sl Dispersal Area Proposed(sf) System Elev io 60 , � f �� ✓ / 7 , VII.'Wank Info paciry in Total #of Manufacturer Gallons Gallons Units � w e V y New Tanks Existing Tanks 0 4 rev ° o,U Septic or Holding Tank Dosing Chamber 7 VII.Responsibility Statement-I,the undersigned,assume rA ibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's MP/NVRS Number Business Phone Number Plumber's Address(Street,City,State;Zip Code l 3 z A Vill.County/De artment Use Only' pproved El Disapproved $ /i�t—Fe7e Date Issued El Owner Given Reason.for Denial d / 5,' X.Conditions of Approval/Reasons for Disapprov I SYSTEM OWNER: 1.Septic tank,effluent filter and �j ��d GvwC je. dispersal cell must be serviced/_maintains /I/#V. 2409 /e{{t° as per management plan provided by plum)er. 2.All setback requirements must be maintain d (M Q�te -� as per applicable 66@ Wbre*Wm 0&ns-for thgs s an s it to the County only on aper not less an in x 11 i�nc�hess In size ` SBD-6398(R0313) Wc�g{16 ,��. fa is l��• �f,Qa�(,� 1044.s X I ' o 464 10428 ® 64, X ING PIT DEPTH 15' _ 1065.7 -ILTRATION POND BORING PIT DEPTH 15' .\ INFILTRATION POND 10 .6 HWL=1048.00 °ho — kc 1 sq.ft N87°04'32°E 97.47' 4 AC. ,X .ray X )50. o V,048:S��y` b� 1065. n U" a3 4 3 105 .7 2.00 AC 7 515 ft 2. res C.B. . = 1 AC. 2.00 c 87125 sq. 1 LB0=1 0.00 871 sq B.A. = 1.1 AC. is B. =2 AC. M L =1050.00 `03 N �I I 1066.7 �fV is X 9 iO 0 1 I O OI Z I I I I i 1 _- O_ I I 1245,4_A 7 ROAD 37 _ _ _- - _ 201.89' 1 4 )U OT 1 z 1067.1 73 R 1,909 Q. FT. 1069.1 X X 1 2.9 0� 0 Q N x g 7 1071.6 3.27 Acres 142341 sq.ft 2.00 Acres 150.00 A. =4.8 AC. 87125 sq. �"r �+ 2.00 A 1074 C.B.A. = 2.0 AC. 8 sq.ft A. = 2.0 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 4/10/14 Owner: Kernon Bast Location: SW 1/4 SE 1/4 S36 T29 N,R19W 870 Yost Drive Hudson System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications S, et 8-10. Soil Test f �r. Signature License nubl3er#226900 PLOT PLAN PROJECT Kernon Bast ADDRESS 948 LaBarae Rd Hudson Wi 54016 SW 1/4 SE 1/4S 36 /T 29 N/R 19 W TOWN hudson COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 4/10/14 BEDROOM 4 CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 890 # of chamber 44 IL BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark AL 99' B-2 SYSTEM ELEVATION 94.4/94.1 5' below qrade 450' Pr erty Line 74' All piping shall be SDR 30/34,within 10' Vents of tank,piping shall be Schedule 40. 1' 2-3' X 90' cells with>3' spacing Scale is 1" = 40' unless otherwise IF 28' noted B-3 Please note: if soils are found to be more fine than listed on the soil test,a.5 loading rate will be used. 1' 3% Slope Pro 4 Bedroom 80' 20' ST 20' House 23 B-1 B.M.* 74' 98' 150' j4' Long nt IF Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps 3 4" Grade at System Elevation Yost Drive Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 5.6ft^2 pair of end plates Finish grade elevation Typical Installation 99.4' Vent Grade Vent 3' 4 Septic Tank]jK 5' S' Long 1�� Grade at System Elevation 3 6 Grade at System Elevation Spacing 5' 2-3' X90 ' Cells Same on other end Observation tubeNent At end of cell A B 22 chambers per cell System elevations: A-94.4' B 94.1' P-.. #1990 SOIL EVALUATION REPORT Page 1 of 3 Visconsin in accordance with Comm 85,Wis.Adm.Code Steel's Soil Service Department of Commerce Division of Safety and Buildings County St. Croix Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must Parcel I.D. ZQ include,but not limited to:vertical and horizontal reference point(BM),direction and percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Dal Please pr" Revi d BY y �E,IV�sp(Privac Law,S.15.04(1)(m)). Personal information you provide may b used f Location Property Owner NOV o 6 2006 Govt.Lot na SW1 SE1/4, S36,T29N, R19W Bast, Kernon Lot# Block# Subd.Name or CSM# Property Owner's Mailing Address na Cottonwood Ridge South ST.CROIX COUNTY 4 948 Labarge Rd. City []Village �� Town Nearest Road City Stat zi Code Cty Rd N Hu Hudson WI Hudson— Hudson 715-386-7775 600 GPD " New Construction Use: Z Residential/Number of bedrooms 4 Code derived design flow rate Replacement P Public or commercial Describe: na Flood plain elevation,if applicable _na ft' Parent material Silty selent and underlying reddish sandy loam till spaced and depth to code 4.33ft below grade. General comments Conventional system, system elevtion 103.66ft.Trenches and recommendation ' Pi�U� Sft es 4! SG>•ii 7�C '�,L- O R.GJ W Boring 99.35 ft. Depth to limiting factor 110 in. Soil Application Rate Boring# Pit Ground surface elev. ____— GPD/W Structure Consistent Boundary Roots Dominant Color Redox Description Texture *Eff#1 *Eff#2 Horizon Depth Qu.Sz.Cont.Color Gr.Sz.Sh. in. Munsell none mfr Cs 1vf .6 .8 sil 2msbk 1 0-11 10yr3/1 none sicl 2msbk mfr cs na .4 .6 2 11-27 10yr4/4 mvfr na na •7 1.6 3 -110 7.5yr4/6 none Is osg 6 eo 5 ' Borin Application Rate Boring# —] g Ground surface elev. 99.35 ft. Depth to limiting factor 110 in. Soil GPD/ft2 Z Pit Structure Consistent Boundary *Eff#1 *Eff#2 Horizon Depth Dominant Color Re Sz Description Texture Gr.Sz.Sh. in. Munsell Qu.Sz.Cont.Color cs 1vf 6 8 2msbk mfr 1 0-12 10yr3/1 none siI mfr gw na 4 6 sl/scl none 2msbk 2 12-36 10yr4/4 none Is osg mvfr cs na .7 1.6 3 36-84 7.5yr4/4 mvfr na na _7 1.6 4 84-110 7.5yr4/6 none cos osg I n -)I.11,,o *Effluent#2=BODS<_30 mg/L and TSS<_30 mg/L *Effluent#1 =BOD 5>30<220 mg/L and TSS>30<150 mg/L CST Number CST Name(Please Print) Signature: 248956 David J. Steel Date Evaluation Conducted Telephone Number 10/10/2006 715-760-0347 Address Steel's Soil Service SBD-8330(R.07/00) 994 200th St.Baldwin,WI 54002 Prop"Owner Bast, Kernon Parcel ID# Pending Page 2 of 3 Boring# ❑ Boring ❑ pit Ground surface elev. 97.85 ft. Depth to limiting factor 110 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 1 0-14 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 14-43 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 43-110 7.5yr4/6 none cos osg mvfr na na .7 1.6 5z 51. ❑ 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/ft2 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/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 I *Eff#2 *Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODS<30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R.07/00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel Kemon Bast 994 200" St. CST-POWTSM SW1/4,SE1/4,S36,T29N,R19w Baldwin, WI 54002 Lic. 9248956 Town of Hudson, St Croix Co. Direct 715-760-0347 Cottonwood Ridge South, Lot 4 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement,it may or may not be suitable for your use. The location of this test may or may not be as shown,as permanent lot lines were not established at the time the soil test was onducted. Legend N 1"=40' =Benchmark Ele. 100.00 ft Top of 3/4"pvc pipe • =Alt Benchmark Ele. 100.00 ft Top of 3/4"pvc pipe ❑ =Borings Boring Elevations B1 = 99.35 ft B2= 99.35 ft B3 = 97.85 ft B4= 0.00 ft �ft 63 -q7 ,33 �;. FILTER CARTRIDGE sap 1 pry MC that low cheer•,tarp rata and of Out uutitt wpe to mature it arc tPeu moved!ruder tit.move"al+wnanq• tf trMet,ttagp lt$trer blrMrrC triuYe papa!irtttxr riot pipe Hwuerrb lira eutirrt or troi>reht wWid Wu&)aiddNitNral piMt"a Fret uut let A7rKp a Whik UK 1:406 is WJb d*Y"tttd cal that"iet of 46-1 Ndr pipe heeded to butte,tits fl14r to tin tank shd waq if umrlrg the ulrHotrtrr YiNlpjmmemw tilde!support'Tr rddu W4*brt hrgtired.lr nut utiri¢W, orotund to a**"- S•YF.V.3 For tr%*gM terra ttkatii�dwrtg toe etrtioireii MU le r eiuerat vmM the%-ihcir pipe arch►tire,iiiuer ca�!r �qd a t 8J Fs ha# ul"b",prateeei to d ep foul. 5e1vtht WOW the Met carte alto lhll ataliet Wm., iaearre ate tiller � t crwttidgp iatu the Cale,iarttlsiltg °" ►`. thn eaaw. down Uletii tits biter tatdca itttu tiro batetwtr If b VAS luwitrdr is tttiiratsd: it soot into the�arld tack by turning dodnwir t Wrl t�tlt,r., 1. The of"Murtt law shautd he ddib led eve srrrvkerri. rY'Barre rata tlWk;tank to z. opeh the autret xcrosa epuhbrp to the taMtk cad Kkar, w 5. iAur»p tr tha mmptic tmwrk�k"khg$Or$to rwruma the siudgre yer ae the bamem of attar tank 0"d nut Deal the sclera and tMuseltl a. ua r tote eMqutrirt hrvet hunt Lana iotvwt'ed belewr tht:i"VW W tree 'AdW pipe.Handy pall up uh the tNWr hrndte to dislodge the } curttltiapr fivut the ca". 5. -4hie tile,te!rkwod up and at le of the r Yqr&illy duirdny. w• C fY a VHS Sw"c9urr KWd to an edarta i5 WOSMit,the swlti h n stiuuW be rwnw"by t"Ang ue UMsrdudmW"AP End deuarad ; with w*er unit', i. WW huldWo the wartridda on ft"tidt •' down)Quart•abe amem (ieON teat Ne*farvik s,Me»lita�,'riltitl lilt tftts tlutl9dar;!t►itrt wtrtuY t atilt',rrwdrirrg aplre aN ate+rrertrfwet is rirt!eed bilck hetu tale tar+k. t •,, it'., a- tf VRG mwrtsh rs ttdhmd,ftPk t by iiteiOMft rata Wr aMld :. _..._i. tawniwg d d ackpA Hr1". Vp s. Yhsart the titter!cartridge back inbo the a",iefQWi v dom.urml �k the Hiker WOW Itrarr the baWavo u!f rite cairn. , ia.wpiara serum tFro acmai bola*'"ran uhs tank..y Br tr•�K'�l"- 'rt:'75:4N"RG1ttd 'kr�;•. •iA-J' t'at•i..W.44008- .t• ..l .•r«b.ws i YID •4R1 win W.bsmrffbdtlW.trara W WL"L" (fir:34583) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page . of FILE INFORMATION SYSTEM SPECIFICATIONS Septic Tank Ca Sj aj 0 NA Owner Ke!n_C0 1_✓ Permit# Septic Tank Manufactuter NA >. Effluent Filter Manufacbl rer_ �1T/c.J ❑NA DESIGN PARAMETERS -- Number of Bedrooms 0 NA Effluent Filter Model _ t, >- ❑ Nk Number of Public Facility Units A Pump Tank Capacity g f�NA ,, al�... Estimated flow(average) aUda Pump Tank Manufacturer C] NA _ Pump Manufacturer Desi n flow(peak),(Estimated x 1.5) LTD auda '! r, Soil Appiicafion Raise aUda /it2 Pump Model `. ❑ NA Standard Influent/Effluent Quality Monthly average" Pretreatment Unit` NA Fats,Oil&Grease (FOG) _<30 mg/L ❑Sand/G-avel,Fitter Q Peat Filter Biochemical Oxygen Demand (BODs) 5220 rng/L ❑NA EI Mecharical Aeration ❑Wetland Total Suspended Solids (TSS) :5150 ling/L ❑Disinfection ❑Other: - Pretreated Effluent Quality Monthly average Dispersal Geli(s) ❑ NA Biochemical Oxygen Demand (BODs) 530 mg#L -Ground(gravity) Cl In-Ground(pressurized) Total Suspended Solids (TSS) 530 mg/L' µ ❑At-Grade ❑ Mound Fecal Colifotm(geometric mean) 5104 isfulloonit%° ❑Drip-Line _ ❑Other: ❑]NA her: NA Maximum Effluent Particle Size X in dia. . her.Other: — ---- NA — ------ - Other: *Values typical for domestic wastewater and septic tank effluent. l ��, NA MAINTENANCE SCHEDULE Service Event Sorvice Frequency Inspect condition of tank(s) At least once every: aftsis) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third(l )of tank volume _- O NA ❑ month+s) Inspect dispersal cell(s) At least once every: earls -_ (Maximum 3 years) 11 NA Clean effluent filter At least once every: p month,s) ❑ NA earls; . 13 month(s) Inspect pump,pump controls alarm At least once every: 13 year(s -- _ NA _- �— -- -- Flush laterals and pressure test At least once every: �manthl s) NA p years)_ _ _- Other: — At least once every:_— p year s)s) NA Other: NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber;Master Plumber Restricted Sewer;POWTS Inspector;POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks,measure the volume of combined sludge and scum and to check for any back up or ponding of effluent or the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to chect:for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third or more of ti ie tank volume,the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechar ical or pressurized components, pretreatment units, and any servicing at intervals of S12 months,shalt be performed by a certified POWT3 Maintainer. A service report shall be provided to the local regulatory authority within 10 days of ccimpfetion of an!,service event. Page__of START UP AND OPERATION For new construction, prior to use of the POWTS'check treatment tank(s) for the presence of painting products or other chemicals that 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. During power outages pump tanks may fill abave normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s)in one large dose, overloading the cell(s)and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of then pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Piumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal ceps. Do not drive or park over, or otherwise disturb or compact,the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scrap:.; medications; oil; painting products; pesticides;sanitary napkins;tampons;and watt+r softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 63,33,Wisconsin Administrative Code: e All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shalt be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure,lot lines and wells. Failure to protect the replacement area will result in the need P for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules In effect at that time. ❑ A suitable replacement area is not aviiilable due to setback and/or soil limitations. Baring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed PowrS. ❑ Mound and at-grade soil absorption systems may be reconstnected in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the pules in effect at that time. «WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN 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 POWTS INSTALLER POWTS MAINTAINER Name 4 Q - Name IS t�� Phone ?�f �_ Phone SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Name _ — / Phone Phone This document was drafted in compliance with chapter 8PS 383.22(2)(b)(1)(d)&(f)and 383.54(1),(2)&(3),Wisconsin Administrative Code. ►` fit` � ►.► .,,h � � � �f '.<M 7? t 11 Et r ix Pt." d'l Flt x• �' ¢ gel- i_' a♦i-+>4 s t � , r,r ' :< m:: z,t 'c as a tt►r :�, ® � � � � � � R#" S 9✓1 ►t s Y° # t t t e.E ♦�. .,v.. s:a t e a w ,.�ecc-n r: z�:ce,tt ■r ll�:fr{,{ =�t r:ki+Y Yt„+..'k_`k. Q _ybf{i �6II ♦t_"t a is Y.tp 9x3 :� ++"4t.�ts S liG.3 L' .•C...♦ MKt�.:MQ � i4lti':a f t✓. ► 4 t Env k e 7)77 t tS: •x•„< *• x=.�» ®y,.a�u is c. #ttff �t � •s s _e:> ! �a r y •r _ ss^ 1► s t.—�x .+aair. +r t + ?t+-< x¢-t�.». �% is m> e a ,ta:e.r s�t �,yt,a,t cs• `w,w s i 411, t t. ,7 :t [f:' Xf --fi+yid'i (p-�21 :td i tk Tfi:CX M':tkt i9 aJ -Y' t 1. f: it k t` U O• A�:C pt w} Tt,S{'.dt r+•�. Y :2Y�! Yn� w+•;t ItD,.t6 t f.YS.f w.^A�t Wes. Y:.t t .►y }! sst.a.*_ro t`tY a tt• 1 tn;.. wx .¢t=i�v a +1wi<s�n si .2f.f fieb•..•♦ 71 tft 11 a t t =;half` t t � n a •td-,tu at!s � r a !t Y :r(♦E i i°a t,« f t[i:. ,d€-C..i(t..rG4 ti: a f tY i 4 a 93 Yd� a. PI J i _ Y.t� ;.-Ac?-. �1 ► � � � a ►!=»e tt++""" W»-e ai t t#ii Y 5 7� ii #::t.# L 1:.3 i �'.J,. 4 �..'.-;rt i !I*-^ .qtr►wr_.» m R 9k t'in't:t kt: !.. ftlt;'t -vd �..•rrt QS.( at; --:� S4 Ilk#i T�?t(gas. !"' i4°: ►::f1 -# sit i # .dt t ►.i _►• tb t� P a ►t frt ►.8a f 4 ) -0..i _®' R'''b 1#:it. 4t � 'A ¢ �«..b�„ �X9.. '-c.a sa°P t E' i►+..► r. tt'.-t U 2 7 3 9 P 3 16 -7861 09 ,3 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI STATE BAR OF WISCONSIN FORM 2-2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 01/28/2005 93:15PH WARRANTY DEED THIS DEED, made between Neil L. Wilcoxson and Mary Jo EXEMPT # Wilcoxson,husband and wife,Grantor, and Kernon J.Bast and Donalda J. Speer-Bast,husband and wife,Grantee. REC FEE: 13.00 Grantor,for a valuable consideration, conveys and warrants to Grantee TRANS FEE: 4212.90 COPY FEE: the following described real estate in St.Croix County,State of Wisconsin: CC FEE: PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Edina Realty Title,Inc. 400 S.2"u St.—Suite 115 Exceptions to warranties: Hudson,WI 54016 Easements,restrictions and rights-of-way of record,if any. 456780 020-1110-30-000... 020-1109-55-050 Parcel Identification Number(PIN) This is not homestead property. Dated this 28 y of January,2005. r tl L.—WilcoxiGh Mary Jo i oxson AUTHENTICATION pUb,1C ACKNOWLEDGMENT Signature(s) Notary fit;jCQrS1n STATE OF WISCONSIN ) ST.CROIX COUNTY. )ss. authenticated this 28th day of January,2005 Personally came before me this January 28, 2005 the * above named Neil L. Wilcoxson and Mary Jo Wilcoxson, husband and wife to me known to be the person(s) who TITLE:MEMBER STATE BAR OF WISCONSIN executeil the foregoing instrument and acknowledged the same. (If not, authorized by§706.06,Wis.Stats.) THIS INSTRUMENT WAS DRAFTED BY *Cherrlgrown Notary Public,State of Wisconsin Peterson,Fram&Bergman—Steven H.Bruns My commission is permanent. (If not,state expiration date: 50 East Fifth Street,St.Paul,MN 55101 3/11/2007 ) (Signatures maybe authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 . U. 2739 P 317 EXHIBIT A Parcel l: A parcel of land located in part of the SW'/4 of the NW V.and part of the NW'/.of the SW'/4 of Section 36,T29N,R19W,Town of Hudson,St.Croix County,Wisconsin;more particularly described as follows: Beginning at the W'/4 corner of said section 36;thence N00°16'10"E,along the west line of the NW'/4 of said section, 1248.49 feet to the north line of Lot I of Certified Survey Map recorded in Volume 3,page 669 at the St.Croix County Register of Deeds Office; thence N63°02'59"E 148.42 feet to the north line of said SW'/4 of the NW'/4;thence N89°26'58"E,along said north line, 1182.70 feet to the east line of said SW'/4 of the NW'/4;thence S00 021'37"W,along said east line,350.04 feet to the north line of Lot 73 of the Plat of Cottonwood Ridge First Addition recorded at said office;thence S89'26'5 8"W,along said north line, 10.00 feet to the west line of said plat;thence S00°27'24"W,along said west line,2096.76 feet to the centerline of County Trunk Highway"N"and a point on a 1999.00 foot radius curve,concave southerly,whose central angle measures 7'10'30",whose chord bears N84°30'41"W and measures 250.16 feet;thence westerly,along the arc of said curve and said centerline,250.33 feet to the point of tangency;thence N88°05'56"W,along said centerline,83.64 feet to the point of curvature of a 2700.00 foot radius curve,concave northerly;whose central angel measures 3°17'53",whose chord bears N86°26'59.5"W and measures 155.40 feet;thence westerly,along the arc of said curve and said centerline, 155.42 feet;thence N04°29'56"E 244.01 feet to the point of curvature of a 167.00 foot radius,concave westerly,whose central angle measures 34'24'12",whose chord bears N12°42'10"W and measures 98.78 feet;thence northerly,along the arc of said curve, 100.28 feet to the point of tangency;thence N29054'1 6"W 274.22 feet to the easterly extension of the north line of Lot 1 of Certified Survey Map recorded in Volume 12,page 3456 at said office;thence N89°'12'45"W,along said easterly extension,along said north line,and along the westerly extension of said north line,670.44 feet to the west line of the SW'/.of said section;thence N00°37'50"E,along said west line,496.89 feet to the point of beginning. AND Parcel 2: A parcel of land located in part of the SW'/4 of the SE'/4 of Section 36,T29N,R19W,Town of Hudson,St.Croix County,Wisconsin; described as follows: Beginning at the South''/4 Comer of said Section 36;thence N00°27'05"E,along the north-south'/4 line of said section, 1216.78 feet to the centerline of County Trunk Highway"N";thence S76°47'47"E,along said centerline, 1354.82 feet to the east line of said SW'/4 of the SE'/4;thence S00°07'02"W,along said east line,897.02 feet to the south line of the SE'/4;thence S89°33'25"W,along said south line, 1326.80 feet to the point of beginning. bA3S3K1:100/lMS3M:fO3NnIM7 CO•LSB 2.00,L0.00N vr 66U co cc -cc '00 0 In 0 ¢ tF OD firszlp maua.00S 49-ovz A%ZUOAM 571613 UO-004 9V 0029Z -El ER i M.ZGLMS c 0 co 'wlzvmzuQms — K11- 90I'"TZ DE'GK E6'OZL ILE'GLZ 46TOZ N6MLO.0 0, td ;,= .I ox it 8 U) 001 t lu 0 0 ALP I 0-C- 0, Ono , x , CM W cs V FZ 2 Lu immu 0 60,91; !2 AT= /4 (4 CIO ATM A StUndard, Erosion Control 6r 1�- E-7 2-FCAr i y DIAlel ing Construction sites According to Chapters ILHR 20 &21 of the Wisconsin Uniform. Dwelling Code, soil erosion control information needs to be included on the plot plan which is submitted and approved prior to the issuance of building permits for 1- &- 2-farnily dwelling units in those jurisdictions where the soil erosion control provisions of the Uniform Dwelling Code are enforced.This Standard Erosion Control flan is provided to assist in meeting this requirement. inAructions: 1. Complete this plan by filling in requested information, completing the site diagram and.marking appropriate boxes on the inside of this for MT . 2. in completing the site diagram, give consideration to potential erosion that may occur before, during,and after grading.:Water runof;patterns can change significantly as a site is reshaped. 3 Submit this plan at the time of bui ld=ing permit application. PROJECT LOCAnON 1105 04, Please indicate north BULDI=R 6wf- 6A3'>r Laa►O c QQ3f OWNER 4A3r by completing the arrow. WORKSHEET COMPLETED BY__JAJ PSG DAB Zoi SITE DIAGRAM _ �. ►� Scale: 's�ec4a=-0 feet c ¢ j ! Ij ! IiI i .jl jI I { I ; I � 1 j I' it EROSION L I I I i j I I I ► ! j j ii! I 1 1 CON a ROL P� I LEGEND f W-11 PROPERTY LINE 1 ! I ! j i I i I { I i __�EXISTING l I I I I I I l DRAINAGE i I 1 I TEMPORARY t.. D DIVERSION 1 I j i 1 j f t i i 1 I ! ; j t WNW I t FINISHED i --� I I i i . 1 .I I I I ! I j i I . DRAINAGE LIMITS OF ! ! i GRADING , I 1 1 1 I I I I a. F 1 L (i E_ 1 Ij I I . STRAW BALES i ; ! ! L. j 1 4 i I i i ►; j I i j ! f i I GAVEL 1 VEGETAATnON 1 IN j I 'j 1 ! t I t .SPECIFICATION . i i IM I t 1 ; j i ; i II PRESERI/AT 1 t N O ! { i t i I .I l 1 i i l i i i if l l i STOCKPILED SOIL i t ! I I I I 1 ! r I I I i a r 1 I I ! IIII ! { . I It � jl I Ii11 _' � I ! 1 { iif I1 jilt ; EROSION CONTROL. PLAN CHECKLIST Check(V) appropriate boxes below, and complete the site diagram with necessary in.ormation. I- 0. Z. : Site Characterlistscs North arrow, scale, and site boundary: Indicate and name adjacent streets or roadways_ Location of existing drainageways, streams, rivers, lakes, wetlands or wells- Location of storm sewer inlets. Location of existing and proposed buildings and paved areas. he disturbed area on the lot Approximate gradient and direction of slopes before grading operations: Approximate gradient and direction of slopes after grading operations. L� Overland runoff(sheet flow) coming onto the site from.adjacent areas_ Erosion Control Practices 0 Location of temporary soil storage piles Note: .Soil, storage piles should be placed behind a sediment fence,a 10 foot wide vegetative strip, or should be covered with a tarp or more than 25 feet from - any downslope road or draiinageway. Location of access drive(s)- Note: Access drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide and 5 inches thick. Drives should extend from the roadway 50 feet or to the : house foundation(whichever is less). )� Location of sediment controls(filter fabric fence, straw bale fence or i foot-wide vegetative strip)that will prevent eroded soil from leaving the sate: Location of sediment barriers around on-site storm sewer inlets. t� V, Location of diversions. Note:. Although not specifically required by code,it is recommended that coricen- trated flow.(drainageways)be diverted (re-directed)around disturbed areas_ Overland runoff(sheet.flow)from adjacent areas greater than 10,000 sq.ft should also be diverted around disturbed areas. Q Location of practices that will be applied to control erosion on steep slopes(greaten than 12%grade)_` Note: Such practices include maintaining existing vegetation,placement of additional sediment fences,.diversions, and re-vegetation by sodding or seeding with use of erosion control mats_ ® location of practices that will control erosion on areas of concentrated runoff.flow- Note. Unstabilized drainageways,ditches,diversions,and inlets should be protected from erosion►through use of such practices as in-channel fabric or straw bale barriers, erosion control mats,staked sod,and rock rip-rap-When used, a given in-channel barrier should not receive drainage from more than two acres OT unpaved area, or one acre of paved area_ in-channel practices should not be installed in perennial streams(streams with year round flow). C l Location of other planned practices not already noted. y indicate management strategy by checking (01)the appropriate box. 0 a Management Strategies V z [� Temporary stabilization of disturbed areas. Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding(between April i and September:'€5),or by other.cover,.such as rping or mulching. Permanent stabilization of site by re-vegetation or other means as soon as possible (lawn establishment,. indicate re vegetation method: Seed Sod (�Other Expect ed date of permanent re-vegetation- 7tII�Zm ® lie vegetation responsibility:of: *�d Builder ®Owner/Buyer Is temporary seeding or mulching planned if site is rant seeded by Sept. i 5 or sodded by Nov 15? ! Yes [3 No Use of downspout and/or sump pump outlet extensions: Note: it is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement_ E Trapping sediment dung de-watering operations. Note: Sediment-laden discharge water from pumping operations should be ponded behind a sediment barrier until most of the sediment.Betties out. Proper disposal of building material waste so that pollutants and debris are not carried off site by wind or water; Maintenance of erosion control practices. Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the height o f the barrier.,. Breaks and gaps in sediment fences and barriers will be repaired imme diately. Decomposing straw babes will be replaced (typical bale live is . three months). 3 m All sediment that moves off-site due to construction activity will be cleaned up before the end of the sane workday. ® All sediment that shoves off-site due to storm events will be cleaned up.. before the end.of the next workday_ Access drives will be maintained throughout construction_ All installed erosion control practices will be maintained.until the. disturbed areas they protect are stabilized. - For more assistance on plan preparation, r Bier to the Wisconsin Uniform Dwelling Code,the DNR Wsconsin Construction Site Best Vianagement Handbook,and UW-Extension publication Erosion Control for Horne Builders_ The wisconsin.Uniform Dwelling Code and the Wisconsin Construction Site Best!management Handbook are available through the State of Wisconsin Document Saies,(608)266-3.558_ Erosion Control for Home.Builders(GWQ00-j)can be.ordered through Extension Publications,(608)262-3346 of the Department a,Commerce,(608)267-4405_ s