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026-1296-15-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574357 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Oeverin , Kenneth J. &�10, Richmond, Town of 026-1296-15-000 CST BM Elev: I BM De n ti n: �� ,pp Section/Town/Range/Map No: /10 � �r . la-,STa�t_�./ 07.30.18.1546 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic y,/ Benchmark Dosing /_ /.,EJI Alt. BM '_ � A ` 1-1 av Aeration r" �+ ,...�.._w_w. �J 1�/ BIG Sewer� 3v3 r Holding iC TANK SETBACK INFORMATION St/Ht Outlet TANK TO I �P/Lf- WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic t7/ / a/ y_ Dt Bottom ` 19 fA�1�t76P.:. 4 Dosing I Header/ Aeration Dist. Holding — Bot. System -7 n PUM IPHON INFORMATION t FJ�aIS'rase / Ni—anufacturer Demand St Cover-&15 4 �f GPM C��,' ° Model Number ! TDH Lift Friction Los System a TD Ft jy �/{�j Forcemai Lenpth�A f is Dist.to Well y <Y ,,,_fi fir` ;".. �? *�° 19 / ,' C 11 1 ld'V L4 l SOIL ABSORPTION SYSTEM e dC f cJ 1,�erL v,�`,Lea . ° ah-.aA BEDITRENCH Width Len th No.Of Trenches PIT DIMENSIONS No.Of Pits! Inside Dia. Liquid Depth DIMENSIONS ' s1 SETBACK SYSTEM TO V P/L BLDG WELL15,f LAKE/STREA LEACHING Manufacturer: INFORMATION BER OR Type f Sy m: I I f Ll Model Number: P DISTRIBUTION SYS EM tea/ erg. Header/M tol Distribution �f x Hole I x Hole Spacing!/ V to it IntA r+ Pipe(s) I IF ,! fiht Length is Length Dia Spacing SOIL C VER x Pressure Systems Only xx Mound Ift At-Grade ystems Only ` Depth Over Depth Over xx Depth of �- .K�Se=eded/Sodd d xx Mulched Bed/Trench Center BedlTrench Edges Topsoil es ! No j. Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / Inspection#2: Location: 1635 97th Street New Richmond,WI 54017(NE 1/4 SE 1/4 7 T30N R1 8W) Country iew idge Lot 15 Parcel No: 07.30.18.1546 1.)Alt BM Description un"- 5;- rv— , - ' 2.)Bldg sewer length= � cl I /�A�(jyi Uf/14jy,,C_yv 1 C"L(� -amount of cover 1 J Plan revision Required? Yes No Use other side for additional information. Date Insepctor's Signature Cert.No. SBD-6710(R.3/97) PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 SE 1/4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX ' SYSTEM ELEVATION 100.5' 8/3/14 BEDROOM 3 AT-GRADE M IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark 245' Property Line 96 ' B.PLI Grading is to be done to divert run-off away from v system B- 1 \�y S/ d B-3 Well i s to meet a l l WDNR setbacks 5 Slope 97th St. All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. / 100.5' area 15' below system is to Huffcutt remain Combo Tank B-2 undisturbed &q ( l'L //I 2� Pro �I�Y�U`^ C) Bedroom House Line .Tank is to be properly 317' Property/ �' . ?bedded and provided and provided with lockdown �'tr 11 savers with approved warning labels PUMP PERFORMANCE PUMP PERFORMANCE 318'.1Z&314-SOLID PASSING CAPACITY vMMMMN MOMMEM GEM M= WOMEN ■MO■■■■ ■E■■■■N o°°�°�■°ee°vo°o°000°v°©° ., �■■■■■■°°°°o°°°°°°°°ems■°°eo�av® o® - \■\EIS■\■■■■■■■■ �������� .. �■\EII►�■\NOON■■■ momma°ao�ma°ooaoo ��■11■�■■■ ■NONE 0 Imam 14 o0v°ov°amv0o00v° ■1IN1�■!■■►�N■O■■ ovo�oo�voo� .�oo� o0v®©m0vov0�■m��v° Be\►\II■INN 05\■MEN omo®o.°®°omomoo.o° OMEN aavao0■avo°®�omv° aaaamoaao�o0®mom �1154►!1\1►\11■\■■\\\MEN E\11\111\lEEO■■NOEM °a°a°ae°°°e°aeo®°aa°asav� \1►\II►�1\\■ ■■■\■■ ��`��`►_1�\i\\NOON\BEN '����.��■■��.� AN �!\\\NNE\\E ■► 9011.`t\,\MEEE\■ ... r Model 18514185 should not be subjected to �,,� ■N11\12■I0L OR ■EN■\ ' _ H. ■■f ifiE■■■O■■■■■ .' explosion proof pump,see®000Fmm O©0000°O°°000000000005°0©O SEWAGEAND DEWATERING OOODODDDOD000000®°©OSS©0°0 ®000000°0000©DO©°0000©00°O omssssasassso0000v©°©o°�°° 1 ,�■■■■■omssasssasssassso°ovovov°° ovsssasssassssasssoo©o©o°v v®sssassasossssassoo©ovv®° v®ssasssssssassassssas000v ■',■■■■®®sasas°sss°ssasassosasoo ■��v■►\■■■■■■■■■■■■■■■ 92-M■■n�■►■■■■■■■■■■■ �■■.R. ■■■.■►�■■■■■■■■■■■ mom ON ■ice ■■■■■■�■■■■■■■■■■■ . . -\�■v�7■■ ,�.�■■■■■■ ME NON subjected lo less than 15 feet TDH. Safety and Buildings Division �iX 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) 2� Madison 07-7162 r i I D � .. s �Adrutary Permit Applicattof— StmeTrease�onN In accordance Mp 8321(2),Wis.Adm.Code,submission of this fomr to the appropriate gove mnental unit S$ is required prior to obtaining a sanitary permit. Note:Application farms for AM owned POWTS are submitted to Project Address(if different than mailing address) the Departmeut of Safety and Professional Some& Personal information you provide may be used for secondary r purposes in accordance with the Law,s.15. 1 m Stets 105- 7 -7 ,S-ir. L Application Information-Please print All Information C Property Owner's Name Percd# t � 0a 6- Property Owner's Mailing 1 hlI�l4l 4, Al Property nP r Govt Lot city,State Zip Code Phone Number / / Setxion vV1� '4 cacie OEgPN II.Type of Building(check affilat apply) Lot# T N; R E W 2 Family Dwelling-Number of Bedrooms 1,5 Subdivision Name -3 �3e Q w�It�O SE'- Block# Cl , ❑Pubfio/Commercial-Describe Use pact { ❑City of ❑State Owned-Describe Use CSM Number J°"�" of of ' III. Type it: (Check only one box on line A. Complete line B if applicable) A. System ❑Replacement System ❑Trout ment/Holdin Tanis g Replacement Only ❑timer Modification to Existing Systmn(explain) B• ❑Permit Renewal ❑Permit Revision 0 Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Dame Issued Before Expiration owner IV.Type,of ffw-TS S Com eent/Device: Check all that a 1 ❑Non-Prrssmiaed In-Grand ❑Pressurized In-taro t Grade ❑Mound 2:24 is of suitable soil ❑Mound<24 in.of suitable soil ❑Holding Tack [I other Dispersal Cvmpmeat(earpbrio ❑Pr&cftment Device(explain) V.-Dispeirss VIreatmcntArea Information: -u -yt Desi Flow(gpd) Design Soil Appli aVioR dst) Dispersal Area Required(sf) Dispersal Area // Proposed(st) Sysbern E{amtion VL Tank Info capacity in Total #of Manufacturer � Gallons Units New Taoka Existing Tanta Septic or Holding Talc Dozing Chasoba O VII,Responsibility Statement-I,the undersigned, a reaponrimity for installation of the POw'T'S shown oa the attached plans, PI s Name(Print) Plun i8tumue MP/MPRS Number Business Phone Pumber ti Pl umber's Address Street,City,State,Zip Code), l` / I s coon /De artment use Only Appr m M ❑Disapproves] PeJr K Feces Date Issu(e�d ' Issni6g Agent Si � ❑Owner Given Reason for Denial L 0 / DL Conditions of Approval/Reasons for Disapproval SYSTEM OWNER; .Shd", i ee, ® i ! -4(-17 ' 1.Septic tank,effluent filter and dispersal cell must be serviced/maintained 14 ' -� as per management plan provided by plumber. 2.All se as/per�applicable c "?"q.Mfor'thesMW sub=kt0 Caua�t9 only orropw jet Im ua.esr x Iinehni■sift t-YL.a a TL SBD-6398(R.11/11) O.,mRTf,.- DIVISION OF INDUSTRY SERVICES yti�' Tp 2331 SAN LUIS PL STE 150 ad GREEN BAY WI 54304 Contact Through Relay 3 r. www.dsps.wi.gov/sb/ www.wisconsin.gov 4ssroNAtiSw Scott Walker,Governor Dave Ross,Secretary August 19,2014 CUST ID No. 226900 ATTN:POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 08/19/2016 Transaction ID No.2445551 SITE• Site ID No. 805081 Oevering Homes Please refer to both identification numbers, Lot 15 Countryview Ridge above,in all correspondence with the agency. Town of Richmond St Croix County NEIA, SETA, S7,T30N,R18W Lot: 15,Subdivision: Countryview Ridge FOR: Object Type:POWTS Component Manual Regulated Object ID No.: 1498253 Maintenance required; 450 GPD Flow rate; System(s):At-grade Component Manual,Version 2.0, SBD-10854-P (N.03/07,R. 1/12),Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01/01,R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code CONOTT10NI requirements. APPROV No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,DEp.T OF SAFI stats. SIGNAL The following conditions shall be met during construction or installation and prior to occupancy or use: PROFES DUV piViSIO�N OF 1N Reminder(s): Q • Pursuant to outlet filter product approval stipulations,maintenance information must be given to the owne f the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access openin used to service the filter shall terminate at or above finished grade with a watertight cover. SEE CORRESP • The slope indicated on the soil plan and the site plan may be based off an incorrect elevation.The actual slope may be less than indicated. This will need to be verified in the field and the system elevation may need to be adjusted accordingly. • The mound system and septic tank must follow setback requirements per SPS 383.43,Wis.Adm.Code. A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. SHAUN R BIRD Page 2 8/19/2014 , In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, Fee Required$ 250.00 n This Amount Will Be Invoiced. When You Receive That Invoice, Rachael E Huempfner Please Include a Copy With Your POWTS Plan Reviewer,Integrated Services Payment Submittal. (920)492-7728,M-f 7:45 am To 4:30 pm WSMART',code:7633', rachael.huempfner @wisconsin.gov cc: Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. RE�EIVED Cover Page AUG - 6 2014 INDUSTRY SERVICES Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 8/3/14 Owner:Roscon Properties Location:NE1/4 SE1/4 S7 T30 N,R18W Lot 15 Country View Ridge Richmond Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01) Page# 1. Cover Page NLLY 2. At-Grade Plot Plan 2D 3. At-Grade Cross Section :TY AND SERVICES 4. Pipe Cross Section/Pipe Layout TRY SERVIC� SQ/� 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan ONDENCE 9-11. Soil test 12. Filter Specifications ��, I Shaun Bird Signature License numb 226900 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 SE 1/4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST.CROIX SYSTEM ELEVATION 100.5' DATE 8/3/14 BEDROOM 3 AT-GRADE XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark 245' Property Line R6 r B Gredi ng is to be done to divert run-off away from 99.51 IN system B- 1 NW B-3 Wei I is to meet all DNR setbacks 5% Slope 97th St. All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. 100.5' Area 15' below Z system i s to Huffcutt remain Combo Tank B-2 undisturbed Pro 3 Bed roo m House 317' Property Line Tank is to be properly bedded and provided and provided with lockdown covers with approved warning labels s r XY W 1-y' r 4- s-a t 1�• �� f �•Y -- a <�.. l � .'� WA � y�"�-egy'r�"k'►d►t.`a'�°��$'�!�'*Ay`'.�14s a _,.� ,�rr�!!l _. - ��r.-w.+`�*. �` � a_�!w�1a►'iM�.��►��1�._1�.��.�����►��ti�' i �i •1r z, a 7��'"r��a�. t - . eJ -. e \ S 1 t i !S t i t t .. i i S • � 1 ''��`.s• +. �" �''r'�.., .. .. .. 'S :ems on Force Maiiii h � � ' ,y. I. 10 0, S1 f 1 F IMPA ' Z . In. .,,., �►V �� 2 Ia.; Pte- ,� � �� _ ''!'�• .: .:. : . • 44TT' :IWA Lawn ►e f •. m spooffica � fiom s P�.. pt .0 C' Tom'.. � . - ` � � • :.,Y •Tom;, .. .�' • � ; Ate' dtac.:B Tppa `Fot To* y.. �QIMiIQ'• . . �, 3 Ft TDi�I Ta1ai IN.MIA. 4-AbowCON&W�ih '4"k1 f3rde 6"BEAM Gr it ..� Grab y +".nom. yb SwiW-b f •.. A V .•5• 1J e' �• Si (erne �i. .s 3 7� .+,, � ._ . •.. �►• � +^. viii �� s weep Tmk. Role . f D; - Dvs�'io , ► TOW "*Js Wdl sod Bi .ffi M1Ni U1C w.a p t �Y aot mw=:Ilir im 11W .oa sa.w wdbX ar :'� .' ►'i�.�iesv�'�'�*' AO. C�t► ' the t�ntc �,c,r,�,p�►� ai�a.ti�p aioi!uos u�said . Bie�fio�� :fir �3f�a1�y.. b?•o• of �� ---------- --- w I I I I I D [] C I � r -1 � D � H I . ♦-I O, I --I � m N D I z td 47' B' I D mo z �_; 3" 44' I n �z - IOC, t) iv < O A m z V))-, On 4T u m �� O)C O--{; m 10� i °, w I 20' 2' - m m D z 7C r om D ^F N d� nz C3 � u n u C3 z o A N 90 A A r 4 M Q r N ! N M ❑ < A Z c� 1D N ri Ll O O .Z1 D S O C < ❑ D D m Ao � N ❑ � x O � N 6' N n £J Ll D A y Z.Z1 C D m b D A.Z-. mZ nZ D 3 ❑❑ M D(7 H m C 2 n � r Z n> m m bO - y .Z) -y f�'1 M oN ❑� o cz ;am fu m z y-4 �3 ciw y n mm mm D m cyA Dd r� 0 m D£ ym 45' 10' n == Db y, 42' °� < ty ° mz 3-4 [3 dA m m Z r❑ w D A L1; r m O ❑ n 1 .Z)❑ £ �p m n �� Cl) m n ;o D ~ I_ ❑ >r z .D z c cn o r D z D y O Z PROJECT, 4154 123rd STREET fU CHIPPEWA FALLS, WI 54729 a N.P.C.A. R11RED PLANT 1,000/600 GALLON HUFFCUTT ;R" (715) 723-7446 ■ (800) 924-1516 L.62 MEMBER OF: PUMP OR SEPTIC TANK C 0 A C R E T E.In C FAX (715) 723-7111 IN www,huffcutt.coro M 7 NATIONAL&MSCONSN PRECAST CONCRETE ASSOCIATIONS wog' } }fny MM iiL-EZ SI Xtl3 U�•33 tl U 0 SNOIVIOOSSV 31380NOO 1SV33dd NSN03SM 4 IVNOILVN NNtll J11d3S 80 dWnd (U :d0 2138W3W �a�� 919I 426 (008) w 9bbL-E2L (SIL) RONJOH � N011tl'J 009/000'i h e En 62LK IM 'SllV3 VM3ddIH3 1NVld 031311x33 '\/'�'d'N go^ 13381S p-A£Zi bSlb 1133r Odd 13uno I I ao v i 0 �D LO n .6E 6E .8L � d w z 3 ^a- in n o c ¢ W M C3 v ch t� Q ~ _ P4 Q O CL m I I I .L9 I I I .ZL I .8L z z w IL ¢a aQ- Q- >- W 3�.33V9 fU v I I 13�N1 i -a 4 p it ll IM WOO 0 AM Wt- CJ d ,�ti1 i POWTS OWNER'S MANUAL A PUT PLAN Page of owner fi�?Ot�MATlON SYSTEi� �2 r S Tank Cry O NA Permit# {— Sepdc Tank.Manufeoraar 0 NA P Etdua d FSw O NA Number of Beni+ ere 3 O NA Efluent Ftiber Modal O NA Number.of 'Pump Twk Cape ty. ❑NA- E I iIOIM �3lJp Pump Tank AAA 0 NA 13 NA I Design-flow I Sal Applosion:Rate ; Pump Modal D NA StarrdN IrarrertbEffkrerd GusRy Mores average* Pretreatment gnat ).NA Fafis;"OI&Grease .(FOG) s30 a*& O SanntdK3ravel Ffier , 17 P"Fltar . Biodtemkad oxygen Demend (tea) 5220.mgk D NA 13 Med Aera*m t7 wetland Total Suspended.Golds (TSS) 9-150 mglL D Diefnfediort D OdW. lPrebaded Eiluerd.Qualty MonNy Cew) 0 NA Biodranticed oxygen Dernand (BODs). s3o mgll. / D tn.Qrouna Wa tly) 0 ImOroutd(preasur aed) Total Suspended Golds CM) 530 mglL �> NA 0 Mound Fecal Cofotm(geometric mean) 5104 du OOml \ 0 Ddp-Lire 13 OUer iAMrimrxn tefter>t Pw§do Size 16 in die. 0 N D PIS► NA d1 0 NA "Values typlcst for dorneetlowas&&dw w d�sspW tack Wkent. cxhsr DNA �. . tleririce t�rrt condidon of twnk(s) (IArudnrewn S yeoe:). 0 NA At least ones artery: s (Pump out car*m*oftask($) When conniAned sludge and scum equetle or d of Is*v6km O NA Insp dispersal Owe) At least once every: tea) (lNudrrttun 3 years) ❑NA ect Ore et�tent idter At het once every: 1, 0 VOWS) D NA I nsped.pump,pump controls a atann At least once every: 3 s s) 0 NA ftmh Nierals and pressure test At least once every: D ) DNA every: � s DNA a NA I�a�blArlct:u�sneuCnol� . llrt%ecdlorts of surd cl#paraa shaft be rnsrde�by an individual coatrykV one of rate fotivwirrg DOWN"or.certiOons: Master IPkM*w.MWW PNunber'PAddobod Sewer;POWTS lnspecbor;POWTS Msdr ,rer,Septage Servicing operator: Tank irmpectlons mrmt kwkWe a v*W kapac*m aE the 1ar*s)to idyl any amassing or broken tm*mv,loom►any cracks or leaks,nwasure the valuate of gantbkred afudge and so=and 10 doedc\for any beds up or pending of eMuent on the Wound sumacs. The dispersed oel(s)anal bey Wwstly br Odad to do*the Wnuant levels in the'obaervatl n Pipes and to drsdc for any pondrp.Of SGuerd on the ground ar dkw. 't ttie.por of stlivarrt.on the'gr and surfaoe marl indicate a oorldon and. re p*M the bmWi le nvtlNGOdon of the loco hVUMM • . Mien the contbkred accumulation of sludge and sawn in any tw*equals one#rird(16)or more of the tank velure,the entke aor*w ft of jfta lactic $hdl be removed. by a SeptW SwA dng Odor mad disposed of in accordance with dwpler NR '113, Wieeonsht Admk**Wn Code. An other mvirres,amo ng but not bn bed to the servto .of effluent figef%media k d or p reused cornponenb,.pro astment unls, end amr servicUtg at laterals of Sit morft,shat be pw%mred by a oertfied POWMMMkftkw. A ssrvics report shel be provident to the kXXd re cry sataltoritit w a 10 days of comer of any senrios event. I Pape of START UP AND'OPERI► or other Metdcad tta#t '� s for tltis presence of For new corgi law to use of Ow.POMtTS c retJc } a are delsobed tanre tl+s oortisnts of the may•Wqede the P snarls t*s)rernmd by s septW mvidng PdOr IMM see fraaen at the�adam system start shall not occur when s =t Mm. d:ihe eoecssa wed"ater.WIN to Is V0 ian*s A QWA Rmnal W&*&W When P the.beota�P or �eRluent. During Power oufa�s PWnR �the OWS)and me9t Operator Whr�`raswbv pciwer.to Me die flue os1(s)h or►a dose, tardc wnwad.by a s To avdd this Pt S to sWA In � °PUMP kola to egalws non�al sit pump within the pump tank; othersdse disturb or compact.the,area vrilhln Do not dries or Park WA c tantos and.dispenid odNs• Do not drive or Park 15 fleet dawn sbpe�w�►mid�at-waft,�� mean+malt #w pertiomia�e�P�rg�°,�of the P $: Re kaw or a of Vo tot m"tom the. dental ftW � list: baby;ape;cipa" buuK cwndomar ocilort � m� $ pei� °N; peir!li Prodvals' snthio s; fOA and Oegat011 P � (sump Pump) waist; Peaiddw sardsn +and weer so mar brhe• ABANDOWAM the fodowha s sha�N be taken to lure that tie s�arn is,ProPe1h► vwren the PoMVTS taNs andlor is panwith dw► ��q�s-Code: and eddy. Boned In ow nplance • AN P phg to.tanks and Pits"be.dMeonneded and the abandoned pipe owkw of by a 8909P.SwAckv Operator' • The crer+tena otaN tanks and Pita shad be rerrkwed ard.proPefi► and the void space a"wit so. • Attar p m*-4,so-briks ands be.�and mmaved or theb COMB t or M hurt soma CONT OMY PLAN have been, or must be taken, to pmaNide a code Corr If the pOVlf M fsb and =mot be repaired this ftowkV : awn: a *0 abaorpdcr+@WSW ` p suitable area'has been a mkuftd and may be Wind for the d� uRain try "*ad M*�on should be proiec IW ftm and t w area wl�reseal h the rreled wftdas*om a dgift and p vpoeed Vie,tot and web. �D yt .WU .V*Riled in for a.now a*and sib w Lion to a suife� atu elfsrtati! time. B De4;.h POWTS Udlino1w. a O A scd�le roplaoerr+snt aroa is not able due is eett>acAc arxttar �' WAN twvc may to hsww ae s msort to the tamed POW TS. a sot and sift:evskoor WOO, Upon f ilium of the.PQVM . has not'been walveAed io kkt l s area��area is.aewbbts a holdtn9 b0 w neat be perf vred.to a suitable repisoemant lest reeatio°rneplece the wed POWs. � h0 renro�at of the M at the M and at-grade aoN� !�be � P �. sy�ms must oorrcph►with the Haas h sNact at that ttrae. «MfARNINt3» AND OTl.1ER TIEeAT1rENT TANKS MAY OWITANI LETHAL GASSES MUFFI=ff�M• DO SEPTIC.PUi( UNDER ANY CgWLUUA NM DEATH MAy RESULT. E O ' ENTER A emu.PUMP tREATMLMT TANK pi�ON pjt=THE INTMOR.OF A TANK MAY SE DST OR �. Af�DI C AINER POMIff8 tNSTlwi-LER NNW i ►me � Plans _ Ph" ' � OKRA Loco. ► �"ot�r'r , Nam o ✓rt� Ph" 6 POP document was draAed irf'aoir os Oft 383.3M(b IX )W Md'sssst 'C�&(8), ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT y AND OWNERSHIP CERTIFICATION FORM Owner/Buyer. (,� 10 � L� U Mailing Address 1, a Property Address - (Vr erttt 3�r�utred from Plannin�g d��Zo City/State .en.in2�g D` nl or new eonstructton.) _.'..._�. - ---rParcel Identification Number 6�2 LEGAL DESCRIPTION Property Location % T Sec. _ ---__ , a Rl W, Town of F Subdivision ('10 Certified Survey M Lot# ap# Volume r--- Warranty Deed#� ()�:7 S -7 ' page# _ --_- - Spec h Volume page# our no Yes � ---....�.. Lot lines ident table SYSTEM M es °O A►INT'EN'ANCE AND OWNER CERTg�ICATIUN Improper use and maintenance of your maintenance consists of septic system could result in its re the system can p function our the septa tank ever Premature failure to handle wastes. prop affect the fitnetion of the Septic Y��Years or sooner,if needed,b Proper "esPonsibilities are specified in Co ( }and in chapter stage m the waste disposal system. Owner What you put into § mm. 83.52 1 apter 12-St.Croix County sanitary maintenance The property owner agrees to submit to St.Croix Co Ordinance owner and by a master lumber o County planning&Zoning wastewater disposal system is inJ Proper operating r er'restricted plumber or a licensed a certification fo less than III p per°Pem co Pumper verifying signed by the full of sludge. ndition and/or(2)after inspection and u ' g that(1)the on-site P raping(if necessary),the septic tank is I/we,the undersigned have read the above re standards set forth,herein,as set by the De 9Crements and a Pee to (:ertification stating arhrient of Gornrnerce and the D maintain the Private sewage disposal system with the g that your septic system has b ePartmem of Natural Resources,State of Wise ZO�g DePlutmnt within 30 days of the three een maintained mast be completed and re onsin. Year expiration date. fined#o the St.Croix County Planning& I/we certify that ai!statements on this form are Property described above,by virtue of a true to the best of my/our knowledge. I/we am/are the owue s ra°tY deed recorded in Register of Deeds Office, r( )of the NUMber of bedrooms �IGNft F APPLICA NT(S) ***An DATE Y information that's misrepresented may result in the sanitary permit being revoked by the planning with this application a recorded &zoning Department. *** reference is made in the warranty deed.. �'deed from the Register of heeds Uf6ce and a copy of the certified survey map if (REV,t18/QS) 1 PA FILTER CARTRIDGE INSTRUCTIONS Installations STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is cente r ed under the acce s s opening. If not then either insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. STEP 2 While the case is still dry fitted on the outlet pipe, measure the length of 3/4-inch pipe needed to brace the filter to the tank end wall if utilizing the optional supplemental side support. If side support method is not utilized, proceed to step four. STEP 3 For installations utilizing the optional supplemental side support: solvent weld the 3/4-inch pipe onto the filter case. If side support method is not utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressing down until the filte r locks into the bottom of the case. STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning clockwise 900. Maintenance 1. The effluent filter should be cleaned every time the septic tank is ., r serviced. 2. Open the outlet access opening to inspect the tank and filter. u 3. Pump the septic tank completely, making sure to remove the sludge layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the filter handle to dislodge the cartridge from the case. 5. Slide the cartridge up and out of the case for cleaning. 6. If a VRS switch connected to an alarm is present, the switch i should be removed by turning counterclockwise 900 and cleaned with water only. • 7. While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water only, making sure all septage material is rinsed back into the tank. 8. If VRS switch is utilized, replace by inserting into filter and turning clockwise 900. 9. Insert the filter cartridge back into the case, pressing down until the filter locks into the bottom of the case. 10.Replace and secure the access opening on the tank. BEAR ONSITET"FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY Bear Onsite filter cartridges are warranted to be free of defects in material and workmanship for five(5)years from the date of consumer purchase. BEAR ONSITET"Filter Case-Lifetime Limited Warranty Bear Onsite warrants the filter case will be free of defects in material and workmanship during normal use for the period of time the original purchaser owns the product. If a defect is found in normal use,Bear Onsite will,at its election,repair,provide a replacement part or product,or make appropriate adjustment.Damage to a product caused by accident,misuse,or abuse is not covered by this warranty.Improper care or malfunctions resulting from units not installed,operated,or maintained in accordance with instructions provided will void the warranty.Proof of purchase(original sales receipt)must be provided to Bear Onsite with all warranty claims.Bear Onsite,is not responsible for labor charges,removal charges,installation,or other incidental or consequential costs. In no event shall the liability of Bear Onsite exceed the purchase price of the product. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page f of Division of Safety and Buildings in accordance with mm �Adode Coon P Attach complete site plan on paper not less than 81/2 x 11 ches in indude,but not limited to:vertical and horizontal reference int(BM),dir . Parcel I.D. percent slope,scale or dimensions,north arrow,and locat n and Vince to nearest road. Please print all informa on. ��VV1I 2 ,> �00� Revie by O//ate XX Personal information you provide may be used for secondary p ses�Pykaw,s.15.04(1) Property Owner /NG 1Locati n �, 01/451/4 T � N Rf E( w Prope is Mailing Add t Block# Subd.Name or CSNV �a , 7 At-K.A . ltd-# /S ��u City State Zip Code ❑C ❑ dlage To Nearest oad r�rNewConstruction Use:VWZesidential/Number of bedrooms •N Code derived design flow rate GPD ❑Replacement ❑ Public or mera_al-DD scribe: ___--__. -- -----,------ — Parent material / Flood Plain elevation if applicable �/� ft• General comments and recommendations: y5�~e A,.,�l�V f:47CV1� l S � pr S tt� 7� iV# 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/ft° in. Munsell Clu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2 ' Boring# Boring ` ,l / Pit Ground surface elev.�ft. Depth to limiting factor-�/� Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Ou.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 'Eff#2 c5 Se- Y/ I ,c ' ,, cx r, 'a- - - •Effluent#1 =BOD >30:5 220 mg/L and TSS>30:5 150 mg1L `Effluent#2=BOD <30 mg&and TSS<30 mglL CST M ms(Please Print) _ CST Number Sig Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401 S—o;o— r' 715-246-4516 Property Owner— arcel ID# Page of a Boring# F1 Boring Pit Ground surface eiev. ft. Depth to limiting factor Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlFE` in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 2 2 2- Q r- C 2 r,-,s W-_ — �--� t r^ a 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 .Eff#1 'Eff42 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. Boring F-1 Boring# Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Sal Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Etf#2 I Effluent#1 =BOD6>30<220 mg/L and TSS>30 1150 mg/L `Effluent#2=BOD,<30 mg/L and TSS 130 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. SSM330(RAMO) Soil Test Plot Plan Project Name Country View Ridge LLC Sha ird Address P.O. Box 176 New Richmond Wi 54017 TM #226900 Lot Subdivision ivision Country View Ridge Date 5/20/05 NE 1/4 SE 1/4S 7 T 30 N/R18 W Township Richmond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron/Nail System Elevation 100.5' *HRPSame as Benchmark 245' property line 80' B.M. Scale is 1" = 40' 30' unless otherwise 45' B-3 noted B-1 5% Slope 0' 105' 99.5'13-2 10' 317' Property Line Iliillllifffiifffl111f11 f fl 111!If 11 llllli Ilil Ili{ * 9 0 0 5 7 1 2 900571 STATE BAR OF WISCONSIN FORM 2-2000 BETH PABST REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD THIS DEED, made between Country View Ridge, LLC, a 07(22/2009 08:OOAM Wisconsin limited liability company, Grantor, and Kenneth Oevering WARRANTY DEED and Amparo K.Oevering,husband and wife,Grantee. EXEMPT t Grantor, for a valuable consideration, conveys to Grantee the following REC FEE: 13.00 described real estate in St. Croix County,State of Wisconsin: TRANS FEE: 541.80 PAGES: 2 Lots 3, 4, 11,(5 17, 18, 22, 25, and 26, Country View Ridge in the Town of Richm nd,St.Croix County,Wisconsin. Recording Area Name and R rn Address: Oranzo O ering PO Bo 79 New ichmond,WI 54036 See attached addendum Parcel Identification Number(PIN) This is not homestead property. Dated this K day of �:Cb 2009. Country View Ridge,LLC,a Wisconsin limited liability company r J C! . * * By: ORAA17.t] DFa) h)L= * * By: AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) COUNTY OF ST. CROIX )ss. authenticated this Personally came before me this � day of DD Yj' the above named Country View Ridge,LLC,a Wisconsin limited liability company to * me known to be the person(s) who executed the foregoing TITLE:MEMBER STATE BAR OF WISCONSIN in nt acknowledged the same. , (If not, �'�� t �� ,.... ,* authorized by§706.06, Wis.Stats.) �(, THIS INSTRUMENT WAS DRAFTED BY * �l Robert L.Loberg Not ary Public, Stake of Wisconsin My Commission is permanent. (If not,state3pi�dtion_cy Loberg Law Office sw/ SFA7235 X33 (Signatures may be authenticated or acknowledged. Both are not necessary.) P signing Y capacity types P g sT�'rS *Names of persons si nin in an ca aci must be or rioted below their signature •. .. ... WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 1 of 2 Tax No.026-1296-03-000(Lot 3 Country View Ridge) Tax No.026-1296-04-000(Lot 4 Country View Ridge) Tax No.026-1296-11-000(Lot 11 Country View Ridge) Tax No.026-1296-15-000(Lot 15 Country View Ridge) Tax No.026-1296-17-000(Lot 17 Country View Ridge) Tax No.026.1296-18-000(Lot 18 Country View Ridge) Tax No.026-1296-22-000(Lot 22 Country View Ridge) Tax No.026-1296-25-000(Lot 25 Country View Ridge) Tax No.026-1296-26-000(Lot 26 Country View Ridge) 2 of 2 �fanW ' rr Sf � f f F r ff LA t t S40*49"46" ..a. t 6 *4 E 8 ` 245-75 Ilp V" „tsJ F f f VJ A a '• 6R *" A g i r 15 1 f r r w ! r gf rfa f r` �-. 87,111 sq.ft. r . c acres I 00 � k % FF. rsr . ' S.�7'04" `2'sr� � � 1 a 82,01" 80,87 Y lY F �6Jp E �4 1.85 LB�g r 6p 0 - ` T 86 Cn Lo S57104 2"E'le, . ,,� 75.�`.�" X79 --- � �� 14 � l 130,693- sq.ft. tA 8 3.000 acres 90 a LBO 959,00 ; to Lo Ca ' ;,,•f'� � IN89 6 2-E M28 39°52"'x"