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HomeMy WebLinkAbout020-1380-39-000,soonsir~ orrpartment of Commerce PRIVATE SEWAGE SYSTEM afMy and euildngs Oivisan INSPECTION REPORT GENE; RAL INFOR{I~AT1tON (ATTACH TO PERMIT) Peraorsal information you provice may be used for secondary purposes [Privacy l.aw, x.15.04 (1)(m)]• Permit H e~ s Name: ^ City ^ Village ^ To~nrn o Hudson To shi T BM E ev.: Insp. BM E ev.: BM Descriptio Q . !7 p`t ~ ~~ i r- ~- ~ArvR ~rvr~Km~-f i~rv TYPE MANUFACTURER CAPACITY Septic ~ ~- i r D - Ae on Holding - TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Airlntake ROAD Septic Q ~ ~ ~S ~ Z - NA Aeration NA olding PUMP /SIPHON INFORMATION Man rer errand Model Num GP TD Lift Friction tem TDH F orcemain Length Dia. Dist. SOIL ABSORPTION SYSTEM ~ ~ _ / / _ ELEVATION DATA ounty: St. Croix Sanitary Permit No.: 3 1 State Plan ID No.: Parce Tax No.: U r138'D ~ 39-000 STATION BS HI FS ELEV. benchmark , 3 b ~, 0 . 3 3- Bldg. Sewer ~, ~, / Ht Inlet 9; ~ ~ ., / Ht Outlet D Header /Man. !o .~Z Dist. Pipe k !0.95' /j , b~ Bot. System ~ 17. a S ~ Final Grade ~ 6 , O p t cover S 3 w n w BEO / R C Width Len th i No.Of Trenches v PIT No.Of Pits Inside Dia. Liquid Depth ME 3 ~ 3. S L DI SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING Manu adurer: INFORMATION Type O / CHAMBER M e Num r System: y ~S OR UNIT DISTRIBUTION SYSTEM Header / Manifo ~ ~ I Distribution Pipe(s) ~ i ~ I x Hole Size I x Hole Spacing Vent To Air Intake length ~ Dia. Dia. ~ Spacing length ~~s /(~~ /~/~ SOIL COVER x Pressure Systems Onty xx Mound Or At-Grade Systems Only Depth Over Depth Over epth Of xx xx Seeded /Sodded xx Mulched Bed /Trench Center g ( Bed /Trench Ed es To soil P ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: ~i /%L/o ~ Inspection #2: / / Location: 705 Old Hopkins Place, uds , WI 54016 (NW 1/4 SW 1/4 11 T29N R19V~ - Homestead-1st Addition -Lot 3! l.) Alt BM Description = ~o~o o-~ ~~oc~ 2.) Bldg sewer length = 3~/ / -amount of cover = ~c/Lr 3., e~s~r ~a~~~ ~/a/HQ's /r`i..s ~a~tlirl / ~~'~ z~ ~~' FVVrr- G~ Cam( Plan revision required? ^ Yes ~I No Use other side for additional information. ~- Z SBO-6710 (R.3/97) fla a nspedor's Sig lure Cert. No. ~ ~3 ~ G~~'S ~ ~~ 5 ~' ~°`~~ ~ ~ ~ .~(~ IZ~ 3`/~ ZS~ Parcel #: 020-1380-39-000 01/13/2014 10:20 AM PAGE 1 OF 1 Alt. Parcel M 11.29.19.2365 020-TOWN OF HUDSON Current ❑X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-CAFFIN, JOSEPH G&SANNA E JOSEPH G&SANNA E CAFFIN 705 OLD HOPKINS PL HUDSON WI 54016 Property Address(es): *=Primary *705 OLD HOPKINS PL Districts: SC=School SP=Special Type Dist# Description SC 2611 SCH DIST OF HUDSON SP 1700 WITC Notes: Legal Description: Acres: 2.620 SEC 11 T29N R1 9W PT NW SW HOMESTEAD 1ST ADD'N LOT 39 2.620AC Parcel History: Date Doc# Vol/Page Type 06/15/2005 797662 2822/632 WD 07/17/2001 651297 1681/307 WD 01/23/2001 637259 8/31 PLAT Plat: *=Primary Tract: (S-T-R 40%1601/4) Block/Condo Bldg: *08-031-HOMESTEAD 1ST LTS 27/41 020-01 11-29N-19W NW SW LOT 39 2013 SUMMARY Bill#: Fair Market Value: Assessed with: 247312 251,700 Valuations: Last Changed: 07/18/2012 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.620 47,200 198,600 245,800 NO Totals for 2013: General Property 2.620 47,200 198,600 245,800 Woodland 0.000 0 0 Totals for 2012: General Property 2.620 47,200 198,600 245,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 543 Specials: User Special Code Category Amount 070-OTHER CHG SPECIAL CHARGE 50.00 073-DELQ GARBAGE DELINQUENT CHARGE 62.30 Special Assessments Special Charges Delinquent Charges Total 0.00 50.00 62.30 r ~ ~ S+ ~~ ~{{jpK,~ S anitary Permit Application Safety & Buildings Division 201 W. Washington Ave. ' In accord with Comm 83.21, Wis. Adm. Code See reverse side for instructions for completing this application ~~ PO Box 7302 Madison, WI 53707-7302 iseon5fll personal information you provide may be used for secondary purposes (Submit completed form to county if not t)epertment of Commerce [privacy Law, s. 15~1.)(l~i ,~ state owned. ~ Attach com lete tans to the coun co onl r d. s of less than 8-1/2 x I 1 inches in size. lication State Plan 1. D. Number d u~ ~Wh, State Sani Permit N ber if revision to vy lx ~ ~~ ~~ ~ `~' ~ A lication Information -Please Print all Information. ~`~ I' ~' 'a I ° Location: i . .. , ; .. Property Owner Name j "`_ ,~ f ~ on property Locat !~/E or N T Z~ / ~ / ... ,~{{ ~'• ' S 0`I ~~. t± ~.. L ~~-~- .' -` n ~ i n e. ,~ , l/4, S . 1 r. Y(~ Lot Number Block Number 1 PropeRy Ownu's Mailing Address - ~ 5Y LRpIX ; / ~ ~. ,, t3 0 ~* t s I ~ `,~"" ; ~ .Y f _ Subdivision Name or CSM Number Ph City, State. Zip Code / / ¢~ ~, .~ ~~ h ~ • ~ ~~~~, ~ ~~~ D ` T $ r 1 t0 ~ ; ~ II. Type of Building: (check one) ~ t-- °~~ ' . ~ f B d ^ vitl ge f N ~~ SQ ! •T rooms : ~~ ~~~ ~ ~ e ^ 1 or 2 Family Dwelling - No. o t ~y ~~ J j 1 own o ^ Public/Commercial (describe use):_ ~ ''r `~~~$ T~~' ~ ~~ f~ 5 L.~G - _ l7State-0wned Nearest Road ~ ~. ~ 3 X to(,1F-usEes s ~~.~-~ Parcel Tax Numbers) III. T e of Permit: Check onl one box on line A. Check box on line B if a licable 5 6. ^ Addition to A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. Existin S stem stem S stem Tank Onl Permit Number Date Issued B) ^ A Sanity Permit was reviousl issued ply) ~ D-e µa~ m~~o S (Check all that a t T S p em: ys IV. Type of POW Filter ressurized In-ground ~~(,'~ / ^ Mound N ' ^ Constructed Wetland Line ^ Dri art-p :. ".ass G ifoldin Tank ^ Sing Pressurized In-ground .1-~~~~~.}IF$' 3xys it ^ Recirculatin U c p ^ Other: n Treatment ^ Aerobi ^ At- de Disl-ersal/Treatment Area Information: ! i !fate V 6 System Elevation 7. Final Grade . l I . Desibm Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5 lZ~ uir Pro se Rate (GaIsJ y/sq. ft.) ~D© eD ~Z •.~ ~. L VII. Tank Capacity in 'Coral # of Manufacturer Gallons Gallons Tanks Infortation New Existing Tanks Tanks _ _ ~~~T ~ ,~. i ~w i ,,vF / 5 E ~~ 8.~ G /D ° F~ ~ Q-- ~ -- VIII. Responsibility Statement assume res onsibiti fur instal!atior, of the POWTS shown_on the a?? the undetsi ned [ , , Plumber's Nance (print) C'lamber's Signature (ng,gtamps): MPMPRS N ~ ~G[ ~ ~ ~ '~ Z. '~ ` Do N ~ c~ ~~r ... - ~ ~- , ~M l 1~ .~ ~ plumber's Address (Street, City, State, Zip Codc) IX. County/Department Use Ouly ^ Disapproved Sanitary Pemrit F~ (includes Groundwater Approved ^ Owner Given Initial Adverse Su argc Fec) ~S ~ Determination • - X. Condiliuns of Approval 1Rcasons for Disapproval~~~~ _ .}_ qqq tom` ~ ,~~f`o_L- ~~,' ~. `__ r~M.IA~ ~ ( ( ' Cb~^^ f ~ ~ ~ . Perco a wn MinJinch) ~ Elevation . ~ ~- p -1 ~o ' p~j ~ ~Q' ~ Prefab Site Steel Fiber- Plastic Con- Con- glass Crete structed ^ ^ ^ n ^ ^ ^ ~ . ° ached plans. J. ~, ,~ ~ ;Date Iss3uend lss ing Agent Si t e (No stamps) '~ J"'0~ ~U.~u~ S; I ~0. r ,~,- r-ccow~. ~ ~-°-- (~ tit , 7a P o f Z'' 2 ~. ~~ ~IDa,da~ 4 4 ~ I A Q ~SS~~n~-'" I ~~ ~ ~ ~:1 ~ ~ ~,, ~-~ ~ ~ ~ ~ ~ ~~ a5 / ~~ 2AGE '~l - ~!J !Z aDr't~ a c-Sf'~~T ~q'Xg~' , - LS - l2co ~ ,~~ ST i _ -,h/`~ ' ~ L~ ~~ .Sca L 4- ~iy y /d ~ ~y s T~,,,~j . gG. vc ~~ ~~~ ~~ 2 ~~ 3~ i2 / ~~ REc~i `~ ..~ S~N~ f~ ~fiIN40F~~~ ~ ~,. ,~ ~ 9 `~ S~~ rv~ I ~ ~ ~ ~ N o fvt_F rr ~,i ~ ~ D~• ~ 3 9 ~cS-o~uHotlclNS ~ll4C~ p L't ~ m ~'' /~c'oN ~If~E ~ ~, ~ i oo,q~' '~ T3 nA : ~ ~r ~~ ~'° ~~to~i sta,~E ~~~ ~ ~ Z~(p~ ~'_ ~~ 0 V~ -- C, E ~ E ~V i~ Sc~ ~ E 'ice': lv~ ~` Sy sT~/'~1 F I . ; 1 ~ c T~• Ao2-N ~ 5 ~~ 0~ ~Z. S t~ 3 L pRAiN ~ ~~' F~SM~ NT \~ - ~/ :.~ ` ~~ ~ ~~~ N ,e"` ~~ r~ \ c " ~ t3 r ~ -< i • '~ B-S .,~F~~2. ~~,3:~ Y ~~ 17 13-Z `a ~C/ ~ '° _ ~Z ~~~~<<HE ~'" e ~ r S I~ ~ j ~! - ~ .~c. S~ ~J~ - ~M~t >ttE~,~ s ~'' ~` 3D - 7~T ~! L , 3n ---.~ ~ `1 X 3G f } ~ ~ovSE 4 - ~EvRdaM ~N~ ll ~ ~- S ~~ i r e ~8 u S` r V ~~~~ ~ ~ L /Oa A X71 TF,1.. -~n~v~ ~ ~~,~~4=~ r•,~~a-fir _..~ rr!u ~c~t ~ 3 ,° ~oS-oruHo9~r~~ ~c~c~ f~ L't }~ IYl Z /k~ON t~lf~~ ~ f, ~ r 00,47 GAL p }-IoP k IN `_ f L f1c ~ ~Nul ~or2NE/L ~1. = Io0,0o' ~~ ~~ `~ ~ ~~- ~E~F~V~ Sc/a c ~. ~~U': /v~ n•~:o2~NG. S rte. vx~ p~ '~,Z., S n 3 L ~(ZAirt -~ bE f~SME N7 %/ G d~ ~ ~Z 3 Z~Q't ( ~ ~,~ \ `,~ \ ~O ' I `JI F ~ F ,2'_ ,--~ 3" 3 % ~ X17 13 - Z 1 ,r .~-` 4 -~ ,~. t2-•T/L~1~<<~E / r~~~~ ~ c,' l1 rt /~ c., i ~'/ X 36 ~------ I y~ ~iEr~RaaM ~N~ l ` c- s ~~ ~ T ~~~~=~~ ~~~~ ~~ , L ~~ w/zip ~+~ ~ iaa~ ~~~~rr,~ i . ~ ' Wisconsin Department of CAmmerce. Division of Safety and Buildings SOIL EVALUATION REPORT in ~rrlvrlnnrc.ui}h (:rmm Rri Wic ~rlrrf C:nr'IP 1305 page 1 of 3 A.C.E. Sal & Site Evaluations County Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, a ante to nearest road. ~ ? ~ . . 020-1012-40 ID# 11.29.19.548 Please print all '^ o .-' ,,- Reviewed B Date y Personal informatbn you provide may be u fet~~Rdndary pure (Privacy Law, s..115~04 (1) (m)). Y , ~ . ,~. _ Property Owner Pr Location U Miller, Sam Govt' Lot NW 1/4 SW 1/4 S 11 T 29 N R 19 W Property Owner's Mailing Address ~ ~ p ? n~ Lot- . Block # Subd. Name or CSM# P.O. Box 151 ~r ~ Rpi;K 9 1st Addition To Plat Of Homestead City State i1f` a Phor~IpRrber - City ;.;~ Vllage Tam Nearest Road Hudson WI `,. Z~~ ~~-i~fi9'_`~ r Hudson Packer Drive - ~, -, i/J New Construction Use: Resider p4"u ' 4 Code derived design flow rate 600 .J Replacement ~ Public or comma - ascribe: _ Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recommendations: Do not include silt inclusions as absorption area is found at system elev. while installing system. Increase trench length to compensate for any excluded area. GPD a Boring # ~ Ponng Ground Surface elev. 101.61 ft. Depth to limiting factor > 134" in. Soil Application Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' p 1 0-12 10yr3/3 none sl 2msbk ds as 2f,im 0.5 0.9 2 12-20 10yr4/4 none sl 2fsbk ash cs 2f 0.5 0.9 3 20-28 10yr4/4 none s Osg dl cs if 0.7 1.2 4 28-82 10yr5/4 none s Osg dl gw - 0.7 1.2 5 82-134 10yr6/4 none ~ s Osg dl - - 0.7 1.2 ' t alkie e€ sc~ ~J" - 5th" x 3~-in wiaif~< ,. ..; .:.. elev. while frtstallitig system. Inctea~ trench length to canpe~sate trn arty excluded arm. ~:, . , . ^ g Bai 2 Borin # ~ Pit ~ Ground Surface elev. 100.94 ft. Depth to Limiting factor > 133" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 1 0-14 10yr3/3 none sl 2msbk ds as 2f,im 0.5 0.9 Z 14-21 10yr4/4 none gr.sl 2fsbk ash cs 2f 0.5 oA 3 21-33 10yr4/4 none s Osg dl cs if 0.7 1.2 4 33-88 10yr5/4 none s Osg dl gw - 0.7 1.2 5 88-133 10yr6/4 none s Osg dl - - 0.7 I.~ ' Effluent #1 = BOD 5> 30 < 220 mg/L and TSS > < 150 mg/L * Effl nt #2 = BODS< 30 mg/L and TSS <30 mg/L CST Name (Please Print) Sign re: CST Number James K. Thom son _ ~c ~-_- 3602 Address A.C.E. Soil & Site Evaluations ate Evaluation Conducted Telephone Number Osceola, WI 54020 9/19/00 715-248-7767 ~- . PropertyOwrrer Miller, Sam Parcel ID # 020-1012-40 ID# 11.29.19.546 Page 2 of 3 Boring # ~ Boring ~ Pit Ground Surface elev. 100.52 ft. Depth to limiting factor > 130" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ GPD/ftz ____ *Eff#1 *Eff#2 1 0-11 10yr3/2 none sl 2msbk ds as 2f,lm 0.5 0.9 2 1i-19 10yr4J4 none sl 2fsbk dsh cs 2f 0.5 0.9 3 19-26 10yr4/4 none s Osg dl cs if 0.7 1.2 4 26-85 10yr5/4 none s Osg dl gw - 0.7 1.2 5 85-130 10yr6/4 none s Osg dl - - 0.7 1.2 ,~ t 27" _ ~~ " in wi Boring # <-~ Bonng Pit Ground Surface elev. 99.19___ ft. Depth to limiting factor > 132" in. Soil application Rate Horizon th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots = p *Eff#1 `Eff#2 1 0-23 10yr2/1 none 2msbk ds as 2f,im 0.5 0.8 2 23-44 10yr5/4 none 5 % ( 2fsbk dsh cs 2f 0.5 0.8 3 44-54 10yr4/4 none ~s Osg ~, dl cs if 0.7 1.2 4 54-91 10yr5/6 none s Osg dl gw - 0.7 1.2 5 91-132 10yr6/4 none s Osg dl - - 0.7 1.2 'tt: fourxl east of: >~+rtrilie ~ vr' rw ude silt' as is f trends #s'. "~ -°~~` . ~~ Boring # -~ Boring Pit Ground Surface elev. 99.41 ft. Depth to limiting factor > 128" in. Sal Application Rate Horizon Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots ' `Eff#1 *Eff#2 1 0-17 10yr3/2 none sl 2msbk ds as 2f,im 0.5 0.9 2 17-38 10yr5/4 none sil 2fsbk dsh cs 2f 0.5 0.8 3 38-47 7.5yr4/4 none Is lmsbk ds cs if 0.7 1.2 4 47-90 10yr5/6 none s Osg df gw - 0.7 1.2 5 90-128 10yr6/4 none s Osg dl - - 0.7 1.2 Sil ' Sul~of .7]", - " in wi tRl: inclusions a, .~. ~: e. 7 ~ S r~- S~ ~°~`~ cam--'b ~: C~-- r; - z, - d I . +~. `Effluent #1 - BOD 5> 30 _220 mg/L ana i as 30 _ mg/ 1~..~-~~e-~~ o,,.. ate- e.a~.~-- s ~,~r~S P S ~ ~ * Effluent #2 = BODS < 30 mglL and TSS < 30 mg/L v~~ 1 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 608-28777. Q~ ~~ z-s Q,e ...~" ~_ crG~-~~c~sie~s a p~ `14w- `1Se~ f~ST as ~,r c~~S~~ ~ ~'"„ Z~~ v 1; 3a Pte) ~1~i-~ 'property Owner, Miller, Sam Parcel ID # 020-1012-40 ID# 11.29.19.546 _ Page 2 _of _ 3 $ ,_, j eonng , Bonng # Pit Ground Surface rev. 100.52 ft. Depth to limiting factor > 130" in. Sal Application Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots : p *Eff#1 *Ef(#2 1 0-11 10yr3/2 none sl 2msbk ds as 2f,1m 0.5 0.9 2 11-19 10yr4/4 none sl 2fsbk dsh cs 2f 0.5 0.9 3 19-26 10yr4/4 none s Osg dl cs 1f 0.7 1.2 4 26-85 10yr5/4 none s Osg dl gw - 0.7 1.2 5 85-130 10yr6/4 none s Osg dl - - 0.7 1.2 ~~ # ~ Bonng Pit Ground Surface elev. 99.19 ft. Depth to limiting factor > 132" in. Sal Application Rate Horizon De th Dominant Caor tion Redox Descri Texture Structure Consistence Boundary Roots : p p *Eff#1 *Eff#2 1 0-23 10yr2/1 none sil 2msbk ds as 2f,1m 0.5 0.8 2 23-44 10yr5/4 none sil 2fsbk dsh cs 2f 0.5 0.8 3 44-54 10yr4/4 none Is Osg dl cs 1f 0.7 1.2 4 54-91 10yr5/6 none s Osg dl gw - 0.7 1.2 5 91-132 10yr6/4 none s Osg dl - - 0.7 1.2 Boring # ~.~ Boring Pit Ground Surface elev. 99.41 ft. Depth to limiting factor > 128" in. Soil Application Rate Horizon De th Daninant Caor Redox Descri tion Texture Structure Consistence Boundary Roots p p *Eff#1 *Eff#2 1 0-17 10yr3/2 none sl 2msbk ds as 2f,1m 0.5 0.9 2 17-38 10yr5/4 none sil 2fsbk dsh cs 2f 0.5 0.8 3 38-47 7.5yr4/4 none Is 1msbk ds cs 1f 0.7 1.2 4 47-90 10yr5/6 none s Osg dl gw - 0.7 1.2 5 90-128 10yrfi/4 none s Osg dl - - 0.7 1.2 ',~,'1 S ~ ~ a~i. ~°_`-gyp ~`^^' .~ ~ ~ - tom- ~,,, ~ ~~-. ~~S -~ ._ * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mglL and TSS <30 mglL 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. 1 • ' L~ 8, ~ : 70~o aF'Z'' i ran /ot5~fa.~ ~ .w. Corner- /ot 38, Eled.• = /x•97' ~~ !-~op'~; nS ~~a Ce ~~ c.~, ~ ~p o{2 ~'~~on lot ~ta.~ of h. u' Corner' /o t 39. RSSttrriPA~ ~2~!• _ /G~.G7D ~ d ra; n~ttii2 e-a.5em¢n t B~ 83 ~ ~ ~ ^ ~ g2 0 'o ~ ., 81 P~. 3 0~'3 P. /off 3 4 oF/O ropnscd l ~EAald . fo /~ ~0 ~ O ~ i~»lS ~QQCJi T . O f f~ucSOn, ~.CraifcCo•~~1. ~- s~ ___ ~,~--~ 3q ~ y STS ~i.. ~G,~ o 3 ©- G ff ~ ,~12 g~,e, ~ rr~.~A 3 "x S S ~~~ Z ~~0 36 J 76" ~ I 7 GaD C-~L-J OO OO OL-] OD .r7- ~ ~ o 00 00 00 00 0y° o© cnarnber ~ ©0 00 00 oc~ ~ coo 00 00 oc~ c~c~ coo 00 ~ r~o 00 00 00 00 00 00 ~ ©o 0o coo 00 0O oo c°o ©~ oo ~~ °O ~~ ~ ~~~~ ~ ~~5-~~ End ~liew - 34' member BioDiffuser Specuicat~ons ~ ~ ~~ ter; ~le,~,~-m, 1 // V,-_J /fy~'^vy'~~ V ~ersal End Cap s .. Private Ottsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number ~0 Number of Bedrooms Design Flow -Peak (gpd) a0 Estimated Flow -Average (gpd) ~ Septic Tank Capacity (gal) 2, e,~ Soil Absorption Component Size (ft2) ep ~ g!D 4~ FF~sdrt_ Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Absor tion Component Design Flow -Peak (gpd) 2(~D 1 z' as. Mks Maximum Influent Particle, Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 ~ Tab le 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se and outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filte shalt be cleaned as necessary to ensure proper o eration. The filter cartridge shou not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the . `~ ~~ _ Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other Treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding fank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ ~~ ~`~ t ~'" ~` ~ ~`" Mailing Address ~~ x. ~- ~- ~- Property Address o .~ ova NoP Ic:ks (Verification required from Planning Department for new ~ ~ /4 CAE City/State ~ /~ .So ~ W 1 Parcel Identification Number LEGAL DESCRIPTION Property Location „~ '/+, S W '/4, Sec. ~ ~ , T ~ ~1 N-I~ ~' W Town of ~~ ~ OS a ~ subdivision N a rot E S ~"~ ~ ~ 1ST .,p 0,D ,Lot # ~_. Certified Survey Map # !~ 3,7 'Z-- s ~ ,Volume g ,Page # 3 ~ Warranty Deed # ~Z 2- (~ ~ ,Volume ~ 50 ~ .Page # ~ $' Spec house yes ^ no Lot lines identifiable f,~C yes ^ 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 fuaction of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, joumeymanplumber, restrictedplumber or alicensed pumper verifying that (1) the on-site wastewaterdisposal system is is 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 Natural Resources, State of W isconsin. 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 expi tion date. p ~ /a? ~~ SIG OF APPLICANT DATE ~. •~:~Oi~NER CERTIFICATION ' t'(we) certify that aii statements on this form are true to the best of my (our) knowledge. e ropt;!'ty,.described above by virtue of a wamanty deed recorded in Register of Deeds Office. C .w SIGNATURE O1: ' PLICANT I (we) am (are) the owner(s) of ~l /~~~~ i 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 /d~" SCAT,E BAR OF WISCO~NjSIN FORM 2 - 1998 WY R~~t1~AGE~S~ Documem Number Mark D. Rosencranz and This Deed, made between _-. ---- Christina Rosencranz, husband and wife, _ _ - - - Grantor and Sam E. Miller, a single person, - _ _ _ _,- ---^_ _-_-- _____! ---- -_J Grantee. Grantor. fot a valuable consideration, conveys and warrants to Grantee the following described real estate In St. Croix ~ (,ounty. State of Wisconsin: 622 1 23 KRTHLEEN H. WRLSH REGISTER OF DEEDS ST. CRQIX CD., WI RECEIVED FDR RECORD 05-01-2004 10:00 AM YARRRHTY DEED EXEMPT !f CERT COPY FEE: COPY FEE: TRRN5FER FEE: 900.00 RECORDING FEE: 10.00 PAGES: 1 r~.::. ,...., ..... Name antl Relurn Atldress First Federal Savings Bank LaCrosse-Madison 201 South Second Street Hudson, Wisconsin 59016 020-1010-(S0; 020-1012-40; and 020-1012-10 Parcel Idenliliratlon Number (PIN) This 15 -homestead properly. (Is) (is no[) Part of the NE 1/9 of SE 1/4 of Section 10 and Part of the N 1/2 Of SW 1/4 of Section 11, ALL in Township 29 North, Range 19 West, St. Croix County, Wisconsin described as follows: Cotlttnenciny at the SE corner of the NW 1/4 of SE 1/4 of said Section 10; thence East 2739 feet; i.hence North 610.5 feet; thence West 1419 feet; thence South 544.5 feet; thence West 1320 feet; thence South 66 feet to the point of beginning. Excepllons to warranties: Subject to easements, reservations and restrictions of record. a ~ day of April 2000 Dated this (SEAL) __L'C=7~- ~"~~ (SEAL) • RK D. ROSENCRACI (SEAL) / ~ ~ (SEAL) CHRISTINA ROSENCRANZ AUTHENTICATION ACKNOWLEDGMENT Signature(s) Slate of Wisconsin, ss. ~: St. Croix Cou ~' Personally came before me this day of authenticated this day of April 2000 ,the above named Mark D. Rosencranz and Christina Rosencranz, ~,Htaa4rtt . T[TLE: MEMBER STATE BAR OF WISCON $ ~~~- ^ ~' _ to s ho executed the foregoin me kn wn to be the person g (lf not, Stats ) Wi 706 06 t • N~P' t5'; ~`~ ~ ~ inst nt nd acknowledge the . s. . . authorized by § _~*q~,~M\O.~ ' M~" I L x THIS WSTRUMENT WAS DRAFTED BYr~. •£' ' ~ ; . ; ;: • c' ; STEPHEN J. DUN LAP ~'~~1~•'~\;y~~ -- "' Notary Public. State of Wisconsin Hudson, Wisconsin My commission Is permanent. (]f not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not __. necessary) • Names of persons signing in +ny capadty mun ee ryped or printed below Uiev signan,re. 5'iATE BAR Wiswnsin Legal Blank Co., Ine. OF WISCONSIN Mawaukea. Wis. WARRANTY DEED FORM1I No. 2 - 1998 c~ .~~ U! ~, --- .~ _ w - N89'33'14'E 186.55' ~ N86'S9'27"E 126.48' ~ \ I £y# \ ~. r P ~ OLD~:,l~°EIPKFNS.~,P_LACE-- xu ~ •t+FF89'33'14'E 189.03' M `~ N86'59'27"E 131.60' ®1~ `~ \\ .~~0 ' \ 1------- 96.09' ~~ \ ~6 \ ~~6~ ; { 35.51' ~ \ ~ \ \f - - ~ ~ ~\ .k -\ \ ~~ ~ \ 1! S89'S1'43"W 225.44' `~ \ ~ ~ \ S89'S1'43"W 225.67' ^ ~ 20' DRAINAGE EASEMENT ~ ~ ~ 7O pAC ;LOT 6 Q ~ j DF~AINAGE ~4,SEMEN'1; - -------- ~ ~ ~ ~ f ~ ~ ~ ~ H EVE = 901.00 \ gN~p I I i ` ~ \4g .` W W .~ ~~~~ s ~' O r ~ 238.43_ i ~584'46'S2"W 330.82' ~ , ~ ~ ~ N N ~ y O O W o { Z Z ~ .n LOT 39 ~,, ~ LOT 40 °' N 2.62 Ac. ~ ~ 2.27 Ac. ~ ~ °o ,~ 114244 sq. ft ~ 9$956 sq. ft 3 91 z o 0 co ~ I cn z ,n I ~ 3 ~ N ;2 ° ~ N BENC~i MARK TOP OF ~ ~, 0 3/4' IRON PIN. 't, con EL ATION = 944.09' 19 7 USGS DATUM ;. ~« ~ ~ -- 749.41' - } '+ ~ ~ ~ 224.08' 190.37 a1'32"w '~ o SOUTH LI ~, ~W 1 /4 - SW 1 /4 OF SECTION 11 ~ o { I O N ,/~ \ { NEST CORNER ~ °* ~' FOUND MONUT AS NOTED '°'~•~~sw coR'Nw 1/a~ OF THE ~ HOM_EST_EA 1., T29N, R19W ~'' SW 1 %4 uINUM w I \ ~ LOT 7 ' 1 MONUMENT o --------~-- rn \, LOT 6 ~ \~\ iT c ':r o~ s M a a trS O MI7 (V ^O ~P~~ 1 . ~ .y{E ~ ~ '~\. . ~ ` ` M '~s'lgZ y ~/b~ ~a0,g4y~N 'Wr , \ ~ mss. b3NJb ` hr`~ __ ni ,:~; o °Fb. y, I ~ 33' ~ 33' i 6~. I ICI a, I z; I =W ~W ~~ // 1 M 'M aniaa a3N~vd '~ 3 ~ 0; ~ a .n n m i o~ Q~ z •- ~I N~ / Wi 2 n: ~ ~ ~ / o U N / O / \ / i N ~ / Hi O; ~ / ~. / ~u r 0 z~ h « _ - ~' z- ~ z ~u Sz °Z'i~ z 25'S0'E 1320.86' ~!~~ July 13, 2001 1 STFederal Pam 201 So. Second St. Hudson, WI 54016 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4686 RE: Septic Inspection for SAM Miller located at 705 Old Hopkins Place, Homestead-1st Addition (Lot 39), Hudson Township, St. Croix County, Wisconsin Dear Pam A septic inspection of the above referenced property was conducted on 07/12/2001. This property is located in the NW 1 /4 SW 1 /4 of Section 11, T29N R19W, Homestead-1st Addition (Lot 39), Hudson Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a four(4) bedroom home. If you have any questions regarding this, please contact our office at (715) 386-4680. Sincere) .... a~ sn.rt Jo Sonnentag Zoning staff /g m cc: file l%: