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HomeMy WebLinkAbout020-1170-95-000 I ❑ ❑ ❑ ' c $ �! w Q Q Z y{ b Z m Z O`Q w .r O Z to ' mo o Q' H ui W m �m m 2 O LIJ € �� �= € cV S E z 4 i ;5 0 t3 z s a zt 16 � CC •� Hag •� �� �8 t`� ry 2 �\ m O N W .�. _ X tll N cal - N C � l0 O L 7 C � Ti .L { y �, O Q. y c� c� m� y �� H 0 0 m w O mkt U E E � m w of a m E A m m a m W = �E E �� �� �O « n W DI z U. w ZZ 0 LL z — 4�% —,woo U cn 0 W Z F- D U ` W V' c N m U) J o; Z N Z u) N w O p _ W = Z U) H Z J U a o gam_ U Q q Z w 0 o J C7 C� m O > W } U) 0 � V CI) w 7 z o� 0 x FL 4 w F- 0 ko�� 2 1�� • W 0 w w m Z Z n. (00 Z Q 0 a 0 N - 0 n n n F C ., c y Q d G c RE O c ». 7 , _ 1 CD A y eo n eD G h. � W N C/1 9 ° X 0 y -0 Z O a 2 1 (A y a 2 01 (/7 O N D� W C C N a ^�" 3 n N N a O n N O CO i CD m CD W e o O CD N C �. O p co " O CD 00 cn 6 3 go y j 3 y y j o ° Oj c g c o wl cn Z D F_ cn v y a CD 118 D n m to d 'a. `•� c o o' 'm o I Co CD 3 0 = j a f 3 0° o ° m f Z i N CD W O) I C. O W ? < !� N 0 0 2 y CDD 0 0 2 (�/� O„ C N N C m O C 3 .. w y Z z z o 000 H� 000 co m M� f v v o 3 � v v o co m CD o _ o = 79 °o a m CA N <• 3 d N < CL CL z z _ zwz ° zaoz = D o' O I = D o' O v 0 v ° 0 v m c m � c m' • ( CO N 0 ^ C C ' m �. I m � 7. i N CD O. a 3 7 n 3 7 o D 3 D 3 A Z CD N i M @ a v a � 0 1p -i v A A - CD W m CNO a 3 CL z C " C z ;o y z N i CD S a w w ' I � Q m y Q CD o_ I m c a 0 m o: � o: 3 n p �I D) C O D) CD D) C 0 4 = c0) z a o ( n N co n O N N N fD C 0 a� a < m m � o I ag O A O O CD CD Op N l0 EA O (A O A+ O O O CD y � 0 CL 0 CL ti Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 93 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: Huber, Michael Hudson, Town of 020- 1170 -95 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: X63.67 S lL �oJ� 07.29.19.1065 TANK INFORMATION I ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 9 C5 JtZ.S 1 U3,0 Dosing Ali f Aeration Bldg. Sewer Holding CA SU Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes E No [] Yes :D No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / I Inspection #2: Location: 351 Highview Drive Hudson, WI 54016 (SE 1/4 NW 1/4 7 T29N R1 9W) Edgewood Estates III Lot 96 &97 Parcel N : j 07.2�9 j .19.1065 1. Alt BM Description A..; 2.) Bldg sewer length =� } oS �,� t ��-� Gad. b� :� •�� - amount of cover bU_ Plan revision Required? ❑ Yes ❑ No (D o 3 q 7s Use other side for additional information. Date Insepctor's Sig ture Cart. No. SBD -6710 (R.3/97) 0 N O 0 Si $ 0 C r1 c 2 3 !� � I 0 (n 3 Z m = = ° ° iV • N 07 vi O ° 0 N N O W n V N M-4 N d. co f�D p 14 fD� 7 (O '"S W 3 C 0 C p V CA N CL > 7 $ j 0 0 c O 3 o cn ZD = C/) zD m 2i I m co D V' a � I co D �' 4 �� =r I =3 co < 00 < c n c ° a CD c ° 2 3 O O co v w 0) 0 < o o CD z c m lei H N N C ° t°J� C N 2 c I y l y T ''. � �+ 0 0 o 000 � 000 �r CD � � a4 � • ► f o _ o = $ m Im I � 0 7 I 9• a I � y__ N z c yo 0 Do v o o v 0 ° v j m to m y y �• A m 0 (D CD 0. m M c N W CL O. a 3 3 3 0 z � fn tb � (A to A 2 0 o cn D a v D a 1 y v a a A 0 m� V o 0 A Z 0 $ z m W w �' A N CL - C 0 �_ (D d d C c ',.. o a �� 0 a CD cog m N fn N o A c A a� A < a I I �� O R N Q d CL ° o I I to A O O ~ (D N hp 0p ° O ° O '" ti O O L ti County Sanitary ,Per p ' CROIX COUNTY WISCONSIN In accord with 15.04 St. Croix n CEIVE ® ZONING OFFICE Personal information you provide may be us purposes ST. CR IX COUNTY GOVERNMENT CENTER [Prjvacy Law. S. 15.04(1 Xm)] u G 4 4 21 05 (7 1101 Carmichael Road r Hudson, WI 54016 -7710 5)386 -4680 Fax (71586 -4686 Attach complete plans for the system on paper n t lessAA8.P es in . e. County Sani rnit # ❑ Check if revision r 1. A plication Information - Please Print all Info ation Location: Property Owner Name 114 (,(f 114, Sec _ / T N, R E (or Property Owner's Mailing Address ~ Y Lot Number Block Number City, State Zip Code Phone Numer Subdivision Name or CSM Number 6 57 - VY.1 3 7 7 E5 7 7erS aZ I II Type of Building: (check one) amity ❑ Village ®Town of ® 1 or 2 Family Dwelling - No. of Bedrooms: 3 ❑ Public/Commercial (describe use): ❑ State-owned Nearest Road Ii. Type of Permit: (Check only one bo A. Ch ck box on lin if applica e) �� Parcel Tax Number(s) A) 1 1.[] Repair 1 2. Reconnection 3 ❑Non-plumbing 4. ❑Rejuvenation Sanitation Permit Number Date Issued B) S —/ — O ® State Sanitary Permit was reviousl issued a -3 IV. Type of POWT System: (Check all that apply) on- pressurized in- ground [3 Mound ❑Sand Filter ❑Constructed Wetland V ssurized In- ground Q Holding Tank ❑ Single Pass ❑ Drip Line At rade 11 Aerobic Treatment Unit ❑ Recirculating ❑ Other Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation. 7. Final Grade Required Proposed (GalsJday /sq.ft.) (Min.finch) Elevation SO IVA , d 1 o 1. Tank Information Capaicty In Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks • . ❑ ❑ ❑ ❑, 4 t Ii. Responsibility Statemen I, the undersigned, assume responsibility for repair/ reconnencUon /rejuvenatio�nstallation of non - plumbing for the POWTS shown on the attached plans A license is not required for terralift repair or the installation of non - plumbing sanitation system. Plumbers Name (print) Plu Signature (no sta ps : M PR o. Business Phone Number t 1, w, Plumbers Address (Street, City State,Zip Code) r tes Ill. 'Coan `Use Only Disapproved Sarntary Permit Fee ate Issued uing nE S�gnatur stamps) Approved Owner Given Initial Adverse Determination X. Con of ApprovaUReasons for Disapproval tt t r� �.,a�a. g «t x y y V x = y t ,. .t+- ¢ ,;• E � A « {S qin "k r :. f k;`�.+ T 1 r nf' '� "`�' h` a .. 't H .: J •s'^` - ''," � ,. ;,t. •_ 1 Kg � 1 -- 1- - ' -- i _ It I 1 _ 1 1 I —•— I 77 � 1 .. _.. i .14 3 �_--,� —:_iii � —� � • � - - !3o c'Ff �eS S, ysr� ri No I I i ; p , cr i 1 s 98 ./©® I �A` /.. ¢� I 7- - 1 I , 1 1 1 w — r/z r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division , INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 420325 0 GENERAL INFORMATION 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: Huber, Michael I Hudson Townshi 020 - 1170 -95 -000 CST BM Elev: Insp. BM Elev: BM Description: 60 -D 4QO. o V Z" 3m -k- / TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �rw Benchmarks g ,9 ! T 7 /Db , o Dosing _ /03. o'] Alt. BM O Aeration Bldg. Sewer � �� S Holding St/Ht Inlet Z'psv dr,' a OCR J7 TANK SETBACK INFORMATION St/ utlet v O • .3 /00- (o TANK TO P/L W L BLD Vent Intake ROAD Dt Inle ir Septic r � C t--7— Dt Bottom Dosing 1�► He d r /Man. Aeration Dist. Pipe Oj� p r 0 ` Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover Model umber TDH Friction Loss System Head H Ft Forcemain Length ett— SOIL ABSORPTION SYSTEM a ll BEDITRENCH Width r Length Q No. Of Trenches PI D E SIGNS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS b 1 — SETBACK SYSTEM TO PILXJ JBLDG I WEL LAKE/STREAM LEACHING Manyfjtturer: INFORMATION CHAMBER OR V.7 1 Ty Of System: / t ' UNIT Model Number: ' 1 'F DISTRIBUTION SYSTEM 4 w 4t:�- t I Header/Ma Distribution x Hole Size x Hole Spacing Vent it lgt`ake Length a Length Dia � Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only - ZXe h P'f. Depth Over _ , nLQAI� Depth Over xx Depth of r7e�odded xx Mulched Bed/Trench Center Bedlfrench Edges Topsoil �. FS-1 [� N No bQ o A Yes JIM] COMMENTS: (include code discrepancies, persons present, etc.) Inspection #1: / / ­� Inspection #2: Location: 351 Highview Drive Hudson, WI 54016 (SE 1/4 NW 1/4 7 T29N R19W) EdgewoodLot 97 Parcel No: 07.29.19.1065 1.) Alt BM Description = jT- Cbvex 2.) Bldg sewer length 17 0 - amount of cover = q t Plan revision Required? 0 Yes O 22 l Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Si nature Cart. No. Safety and Buildings Division City 201 W. Washington Ave., P.O. Box 7162 '5• C,l�!>l)C Vise6nsin Madison, WI 53707 - 7162 Site Address Department of Commerce 8 -l9 -o 4/90 S� 3S( Ff(�tEF�t �R. Sanitary Permit Application Sanitar P N 3zf In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary ptuposes Privacy Law, s15 I. Application Information - Please Print All Information , ` : State Plan I.D. Numb Property Owner's Name Parcel Number Q 5 - Property is Mailing Address ; Property Location / D L ;. , � o I � z —° l4 !4; S 7 T & Z Y N. R City, State Zip Code Phone Number Lot N ber Block Number Subdivision Name CSM Number s yo G _ oe H. Type of Building (check all that apply) ❑City K(1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public/Commercial - Describe Use ,'Township ❑ State Owned ( j 3 r x b 2 Nearest Road III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B R applicable) A. 1 C& New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use stem Tank Only stem B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) —(#V 44Y3. Non - Pressurized In -Ground 210 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In -Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Lane 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Ot V. tment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate stem Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.FL) (Min./Inch) Elevation yso NA - 9'Y go 9,. 7 5 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or HoN ft Tank _ L�FAF 1 Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for POWTS shown on the attached plans. Plumber's Name (Print) P 's Signature M$ RS N Business Phone Number a C; a&a / r J Xl�_ _ZJ - ' 991 6 Plumber's Address (Street, City, State, Zip Code) 5S6 A L Le v IVIEW 7k V Cozen /De artmen Use tZY Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse `N' Determination IR. Conditions of Approval/Reasons for i pproval e Ana& compide tb+ (to the Cants aoll) for the 0t001 on papa not teas d= ma : u tact« to size SBD -6398 (R. 05101) S ? ffdQC FfOLES' �5YST?-- 68',3! ~ -- - - -- — -- - awo -.- - - - -- _ - - ------ - - - - -- -- - - - -__ _ - -.__ _ifs. _ _- - n i - -- A- - /OU I p ,goo aio Ile !'s YSIW �c -fir -- - - --- — �- - - - -- III 'B t � f31"1 t( 4 0 n s� — - - -- 111 -- - r 1084 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference pant (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. R viewed By' Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). Property Owner Property Location Huber, Michael Govt. Lot SE 1/4 NW 1/4 S 7 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd, Name or CSM# 120 Meadow Drive North 97 na Edgewood Estates III City State Zip Code Phone Number - „_J City �j Village !l Town Nearest Road Hudson WI 1 54016 1 715 - 386 - 1566 Hudson — ,; , ;'�° hview Rd. 16 New Construction Use: tj Residential / Number of bedrooms 3 Code derived design rate / 4 GPD Replacement Public or commercial - Describe: "' o Parent material Outwash Flo in ele%ltw , if app na General comments - and recommendations: Area is suitable for a conventional system with a 0.7 gpd/sgft Pible s elevation for Area I is 94.00'. System area is on a 17% slope. Boring 2 ❑Boring # ' Pit Ground Surface elev. 96.96 ft. Depth to limiting factor m., � � Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bou ` Roots Gf'Dfft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 1 0-5 1 Oyr3 /2 none Is 1 fsbk mvfr cs 3f,1 m .7 1.2 2 5-20 1Oyr4 /3 none Is lfsbk mvfr gw 2f,1m .7 1.2 3 20-34 7.5yr4/4 none Is Osg ml gw 1 f,1 m .7 1.2 4 34102 10yr514 none ms Osg ml — .7 1.2 4�f.o Boring # A Boring 16 Pit Ground Surface elev. 96.66 ft. Depth to limiting factor >103 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Str Consistence Boundary Roots GPDIft in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. 1 'E 1 0 1 Oyr3 /1 none Is 1 %bk mvfr cs 3f,1 m .7 1.2 2 6-17 1 Oyr4 /4 none Is 1 msbk mvfr gw 3f,1 m .7 1.2 3 17 -27 7.5yr5/4 none ms Osg ml cs ----- .7 1.2 4 27 -103 10yr5/4 none ms Osg ml ---- - -- .7 1.2 i Aq ' Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mgA. ' Effluent #2 = BOD <_30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: T, CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 9/19/01 715- 549 -6651 Property Owner Huber, Michael Parcel ID # Page 2 of 3 37 Boring # _j Boring 0_-1 Pit Ground Surface elev. 104.71 ft. Depth to limiting factor >101 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10yr3/2 none Is 1 fsbk mvfr CS 3f,1 m .7 1.2 2 4 -19 10yr4/4 none Is 1 msbk mvfr gw 2f,1 m .7 1.2 3 19 -36 7.5yr5/4 none ms Osg ml gw 1f .7 1.2 4 36 -101 10yr5/4 none ms Osg ml - --- ____ .7 1.2 F-1 Boring # I 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 QP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # _j 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 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 Hiatt moto+iol in �n alts+matP fnrn,ot nlP.,cs+ rn�t�nt thn rlPno.tmPnt of lJlS2_7!.(._'21 G1 —T AnR -')AA-2777 83 ' ins NN 1c p Q Pi_ vF a „ �vG L, >an, oa' /YID ,., a?/ „ 044- Z— 113, 1 rr/ /44 -4— 1 r4Lw �v►y ly 1 L6 a S 1.. /vt0 CS 7/'2 3•? ? S/•?l`� � //e,, ae erg 4" .S7o .Lr 4-- ZV - C7 a S l & y liYG✓y S 7 ALH,Sl.�o POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa of FILE INFORMATION SYSTEM SPECIFICATIONS Owner PA iGA*b` Septic Tank Capacity M3 al ❑ NA Permit # zo 32,E Septic Tank Manufacturer U e6lt_S ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units �OA Pump Tank Capacity al A Estimated flow (average) O"O gal/day Pump Tank Manufacturer YINA Design flow (peak), (Estimated x 1.5) g al/day Pump Manufacturer $a- Soil Application Rate Q . gal/day/ft' Pump Model ;*NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ,ZNA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD :530 mg /L Wln- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :510' cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 3 ea�� '(s) (Maximum 3 years) 11 NA r — Z ❑ month(s) ❑ NA Clean effluent filter At least once every: W year(s) Inspect pump, pump controls & alarm At least once every: L3 mo nth ❑ year(s) l ❑ NA Flush laterals and p ressure test At least once eve ❑ mo year(s) ❑ NA P ever ❑ years) ❑ month(s) Other: At least once every: ❑ year(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, i measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check 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 (Y or more of the tank volume, the entire contents of the tank shall be removed by disposed of in accordance with chapter NR 113, a Septage Servicing Operator and Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. f - 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 above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one ll 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 the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade 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 scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water 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 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid 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: IN 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 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 available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ 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 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 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 Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.5411), (2) & (3), Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIl' CERTIFICATION FORM Owner/Buyer ir- If A L L /40/3r a Mailing Address D JLI�lsuj fist M-0, -A . row Property Address (Verification required from Planning Department for new construction) City/State T7 Lw Q Zs A< U21' Parcel Identification Number - O g LEGAL DESCRIPTION Properly Location 3.6F 1 /., , U& '/4, Sec. _�, T N-R. , f _4V, Tawn of 14 Si a l Subdivision ��-I gEeez a e D E S TA r� S `T1T . Lot # 92 Certified Survey Map # , Volume . ,Page # Warranty Deed # Volume Page # Spec house ❑ yes Ll no Lot lines identifiable 93 ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. randb a certification fo rm, signed b y ent a rm, Y the owner The property owner agrees to submit to St. Croix zoning Departm � maswplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is 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, herein, as set by the Department of Commerce and the Department of ivatural Resources, State of Wisconsin. C: r'•:fic. -uon stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning OfI•ice within 30 days of the three year expiration date. S/6 / Z loF 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 th property described above, by virtue of a warranty deed recorded in Register of Deeds Office. / 61 3ICIN `TUBE OF LICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. ** 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 ".�L 141.2fut 599892 STATE BAR OF WISCONSIN FORM 2 —1982 KATHLEEN H. WALSH WARRANTY DEED REGISTER XOF DEEDS DOCUMENT No. RECEIVED FOR RECORD 03-23-1999 10:00 AN Donald G. Link and Susan K. Fox husband and WJ AKTY DEED wife as survivorshi marital property, EXEMPT R CERT COPY FEE COPY FEE: conveys and warrants to Micha G Huber and Jacauel ine A. TR ANSF ER FFEE. 110000 Huber, h usband and wife as su rvivorship Marital PAGES; p ro p ert j' i THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St. Croix County, !: The First National Bank of Hudson State of Wisconsin: p .0. Box 187 Hudson, WI. 54016 ;i 020 - 1170 -95 �' PARCEL IDENTIFICATION NUMBER Lots 96 and 97, Edgewood Estates III, a rural subdivision j located in the SE 1/4 of the NW 1/4 and in the SW 1/4 of the NW 1/4 of Section 7, T29N, R19W, Town of Hudson. ii This is not homestead property. (is) (is not) Exception to warranties: Subject to easements, reservations and restrictions of record. ay of March A.D., 19 99 d Dated this y� (SEAL) (SEAL) DONALD G. LI1SK ^ / * ( S c" (SEAL) (SEAL) . SUSAN K. FOX AUTHENTICATION ACKNOWLEDGMENT State of Wisconsin, Signature($) ss. St. Croix County. Personally came before me. this day of authenticated this day of 19--- March 19 99 ,the above named Donald G. Link and ••+`�������.. Susan K. Fox ��♦ TITLE: MEMBER STATE BAR OF WISCONSIN �� te r, y a (If not, S � whc& Tt �8in8 C' authorized by §706.06, Wis. Stars.) to me known to be the person i � •- �� . d h inswme�tt and ac no e a te a P U B LI C ' e D THIS INSTRUMENT WAS DRAFTED BY r STEPHEN J. DUNLAP C S. Notary Public, St Hudson, Wisconsin Croix 4 t¢6b4t4 M commission is p ermanent. If not, state"�fl�fNaTlon date: (Signatures may be authenticated or acknowledged. Both are not Y l- D _ � � ) � necessary.) - • Names of persons signing in any capacity should be typed or printed below their signatures. Wisconsin Legal Bw* Co.. Inc. $TATS DAR OF WISCONSIN M&Vausee. Wis. F.— No. 2 — 1982 WARRANTY DEED 6, 136.55' reI 89'11'20 "w N 89'11'20 "E 196.76' ( 260.99' co I CYI I 1 � I I m o 9 I o 94 �; o I In o w v •+ o � N ° o w s E. W V s certif 89'11'20 "E andin N 89'ii'20'E ! 204.31' w 260.99' � N ?ped 4• c 1 c SW 1/ I Z wn ha of .. I I 96 Ial on of ( cv a In ,OCT i U in , )rnrQe I � N 1 i as' 1 ine o I I 2' ROUND IRON PIPE I sBt li 2" ROUND IRON PIPE N 87' 48 .E "E_ 48' 12 "E 66 1 261:fin ' ,00d D' alp 1 i�85 • $ 87 48' 12 '538.86' I 9'25" unpla CURVE DATA TABLE 1 34 11 E ection raal Arc, Chord Chord r i'41 "E gle Lenob Longth $e&ttftg es II. 30 95.9,$1 S14 379 "W S6!%I: *t gewoo 0ri00 1.64 1 64' re feet 10 *00" 94.34' 93.90' Ai?9 °16��Z0�� '. r ltgp "y� :. Sg9 ments. 30'00" 118.4 #� 117.87 N99°26 E+0 R 869 such p 24 81.40' 81.21' N82 °29' 17 "3r dariee 5'54" 37..04' ' 37.02' . N 4 .-17" N N2® °1$'4 I have 043 235:39 .. 159:.23 ' , s of Wi 4 50.37' 49.,E #' udson `57 29.27' 29.11' 16�52'0!�'NT same. 42,00" 35.68' 38.30' 7 ' 3 S'V W 1 34 3*. 31' 34.05' 8&Z °39'48 "� 1 24 "S.S" 7q Zq' '' dd the 53'00" 58.:04 - 54.79' S79°Q75[#�► 8a8o3'2fl!'11�t+ • 53 +00" 76.79' 7#1.:.44' _ S?9�7'S0"Nl' 388� ZD'� . 'R .53'00 40.47 yes 40:37 38°2 4 53'00" 56:46' 56 - 32' S8°Z2'04't $ S 1 34 3consin 19'38" SD, 131 58. X13' N't°3,5'Z.3" W . Se Wi 3'22" 6.33' 6.33' N14 ison - --