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020-1400-09-000
AEI . ZOO ~ January 16, 2008 Mark Voss 768 Packer Drive Hudson, WI 54016 RE: House sale, Town of Hudson, St. Croix County Code Administration LOt 9, Hopkins Estates Subdivision 7L5-386-4680 Parcel # 020-1400-09-000 -Computer #11.29.19.2499 Land Information ~ Dear Mr. Voss: Planning 7L5-386-4674 You have requested the Zoning Office review your existing house plan for compliance Real Propcrt}~ with the state sanitary code (COMM 83). When remodeling or adding onto a dwelling, 7is-3s~-4E~77 the homeowner is required to examine whether or not the planned modifications involve an increase in design wastewater flows to the Private On-site Wastewater Rec~~cling Treatment System (POWYS). ~' 15-386-4675 The house has three (3) bedrooms up and two that were later finished in the lower level. This resulted in a total of five (5) finished bedrooms. The existing POWYS was designed and installed based on wastewater flow for four (4) bedrooms with a maximum occupancy of eight (8) persons. Technically the POWYS is undersized for the number of bedrooms within the residence; however, current occupancy does not exceed the design wastewater flow for the POWYS. An Occupancy Affidavit is required to disclose the disparity between number of bedrooms and septic system sizing to any future owner(s) of the residence. The affidavit has been submitted to the St. Croix County Register of Deeds office for recording against the deed prior to issuance of a building inspection certificate from the Town of Hudson's building inspector, Brian Wert. The original system was installed in November 4, 2002 by Brady Utgard, MP#220357. The POWYS was found to be code compliant at the time of installation, after a revision was submitted for a change in system location. Inspection reports and sanitary permit documents are on file with the zoning department. To prolong the POWYS lifespan, the septic tank should be pumped at least once every three years or when the tank becomes 1/3 full of sludge and scum. The effluent filter on POWYS installed after April 2000 should be backwashed as needed to prevent clogging of the septic tank outlet. In addition, water conservation measures are recommended, such as repair/replacement of leaking plumbing fixtures, reducing shower time, running the dishwasher only when full, avoid using a garbage disposal, using a wash machine with asuds-saver feature, etc. ST. CRO/X COUNTY GOVERNMENT CENTER 1 lO 1 CARM/CHAFE ROAD, HUDSON. Wl 54016 715-386-4686 FAX PZC~CO.$A1NT-CRO/X.WLU_5 WWW.CO.SAINT-CROIX.WLUS The long-term fiunction of your POWTS is dependent upon proper maintenance of the system. If this POWTS should fail at any time in the future, the system will be need to be inspected by a licensed plumber or POWTS maintainer to determine if it requires replacement according to state code requirements in effect at that time. Any proposed remodeling and room addition projects must comply with all applicable building codes. Please contact the Building Inspector for the Town of Hudson to obtain a building permit prior to beginning construction. Should you have any questions, please contact this office. Sincer Fr i G~n.~ amela Quinn Zoning Specialist Gc: Brian Wert, Building Inspector file ST. CRO/X COUNTY GOVERNMENT CENTER 1 1O 1 CARM/CHAFE ROAD. HUDSON, W/ 54O 16 715-386-4686 FAX PZ~CO. SA/NT-CROIX _Wl. US W W W. C O. SA I NT-C R OIX _W I_U S I~M~IUIU,~INI14MII~IIVNI~ 867305 Document Number i Document St. Croix County Occupancy A>~davilf /~'J~RX ~. ~vss Name - {owner) Typed or printed being duly sworn ,states, under oath, that: 1. Hdshe is the ownerlpart owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume 21 S' Page 3 S (a Document Number? ~ W S 7D St. Croix County Register of Deeds Office: A parcel of land loc~a~ted in the %, of then E '/, of S ion ~ ~ T,~~ N - R !-~--- W, Town of ~- U.D SO /~ , St. Croix County, Wisconsin, being duly described as follows (include tot no. and subdivision/CSM or detailed legal description): ~ S rv '/ ~ SE~y t-l~~K /n!5 ~ 5 Tl-F-rES C oT ~' KATHLEEN H. WALSH REGISTER OF DEEDS 5T, CROIX CO., WI RECEIVED FOR RECORD 01/16/2008 10:10AM AFFIDAVIT EXENPT Ir REC FEE: 11,00 PAGES: 1 Name aad Return Address `~ ~IAQl1 v~,s ~(~. rC C ~ n , wT s y u / Lo D20- i~~0-G7- taoc~ ~ owner of the above described pro , t acknowledge that !fie septic system serving this residence is sized for a bedroom home, or a design flow of O gpd. The design tiow is caiq,dated by a uming 151) gpd for 2 individuals p~ bedroom. Thet~e are txlrrettfly_ txcupatrts Mring in this residence: ~ occupants axe permitted based on the design flow. Therefore the septic system tyervktg this t+es'Idenoe is code compliant. However. ! understand that if ffiere are intentions to exceed the number of permitted occupants, tfie system w~! need to be codified to acx;omodate any increased wastewater flows and/or contaminant loads. f also ackttowletige tfiat i will make this information available to any firture parties interested in purchasing this properly- Dated this ~ t'' day of >~'4.w--~r-~-,~,r 2 v c~ g *~~~I-ri.~ Jos~3 AuTHEI+TICaTlot3 5lgnatun3(s) aulhenitcated this day of TITLE: MEM6Ef2 STATE BAR OF WISCONSIN tK ~ au0todzed ny § 706.06. Wis. Stets.) T-tts r~.sTRta.tsxr was ot~n sv U~~~ ~o G- SAC i~s.~Sr' (Signatures maybe auC~enticated or adcnowledgad. Both are cot necessary.) At~cNt~vut.~oc~teNT STATE OF WISCONSIN. ) _ )~• came before me this J_lG.,_ day the a~ ~_ tome tatown to ba the petsotti{s? wtw exed+ted the toregoin9 lnstnxnent and aciaiaMiledge the same. . ~jj ~~~~ G.. `a -kid ~ - - -a,, J ~pF Notes Stated ~ nsln ~. e~iladon date: 'THi3 PAt3E IS PART OF THIS LECsAt. DOCUIr1ENT - DO NOT REM011~" 71,is Y>1~flon mus! bs oorrpbre6 by sub~ml<fer. and f~ jll i+A+Aroci1. OtliorhOtxrr+a0ior, such as the sag lsaOsl dGion, era may hs pborrd on ~ tirstppe d trie daotxnent orrtay be precsd on eddltlvrwlpayds d Ehe Jocutna~E. dg~ lJse d tl~is oot~erpaye sdds one page b your doctrnsar< a~ 52.00 to Eris iecYaidlna tree. Wfmoa-dn SraWfe~ SD St7. 1 of 1 Wisconsin Department of Contnerce Safety and Building`Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)i. Permit Holder's Name: City Village X Township Bast, Kernon Hudson Townshi CST BM Elev: ~~ D Insp. BM Elev: ~ ~~a BM Description: i ~~ P v c, ~ ~~ z TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic - Dosing Aeration ~ /1_ ~~ /T Holding TANK SETBACK INFORMATION TANK TO P/L ~l~,,4,~r WELL f BLDG. Vent to Air Intake ROAD Septic > f~f / ~ Dosing 2 ~ ~ ~Y`vt Aeration Holding PUMP/SIPHON INFORMATION t,N 2UPIS ~~ Manufacturer ~ i3 V"`'" - Demand GPM Model Number /~"~O~ ~~~ TDH Li~ ~ ~ Friction Loss •~~ System Head ~ TDH Ft ~`~/ Forcemain o' Len h Di ~~ t I s ~ Dist. to Well D, , N SOIL ABSO TI SYSTEM / ~ BED/TRENCH DIMENSIONS Width ~ 3 Len th // ~ -~ No. Of Trenches SETBACK INFORMATION SYSTEM TO P/L BLDG W Typ~Of System: i _ /I ~/3 f '?~ /1~l ELEVATION DATA County: St. CrOIX Sanitary Permit No: 420426 0 State Plan ID No: Parcel Tax No: 6 Lo- l boa- o~-~ STATION BS HI FS ELEV. Benchmark / .3 u /off, l a ~, ~ Al~~ d a ~~ ~c3.r S<• 9~ /~ Bldg. Sewer ~ ~~ ~ ,z ~~r ., J S Ht Inlet ry .~y SUHt Outlet J- Dt Inlet Dt Bottom ~ ~ s 2 Q ~.v D 0 He r/Man. $.~PiW~ i ~ f~ 1 'f ` ~ Di ipe Bot. Syste ~ ~3.y Final Grade ~• - ~s.~ St Cover ~3 ~ 9 . ~ ~ ~ PIT DIMEN NS No. Of Pits Inside Dia. Liquid Depth LEACHING CHAMBER OR UNIT . ..~h DISTRIBUTION SYSTEM -h'11ht ~}. 3{'h -- ~at'~"afs~r~r+-~> 3~ ~ ~-~-F ~ fj/l U2r~Q-c0 fold Header/Ma/ni L Distribution PIp s) ~ ~ ~~Nt ~ ~ / x Hole Size ~ x Hole Spaa Vent to Air Intake ~ ~0' n - Len th Dia ~ Len th Dia S acin ~ 9 ~L 9 P g SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Only Depth Over Bed/Trench Center Depth Over Bed/Trench Edges xx Depth of Topsoil xx Seeded/Sodded r~ Yes ~ No x I e I ,~; `Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /r / /~ Inspection / tl (~,~ ~ -/ l Location: 768 Packer Drive Hudson, WI 54016 (SE 1/4 $E 1/4 11 T29N R19W) Hopkins Estates Lot 9 Parcel No: 11.29.19.g9At"' 1.) Alt BM Description-T~~a ~S F~~~1~- Y/-~-vt~-~ ~P.v~C,ry4c~.e~ ° t ` 2.) Bldg sewer length - ~°' 1 ~~'t~' 'Yt0'6t~ ,$ S~'~ ~ ~ 2 t7Z ~ - amount of cover =~j „G ~ u ply ~,~;~. y~lok-- ~ sys-~t-~ v ~~ ----- - Plan revision Re uired? Yes No /v~~r /_ /! ~^jt r Use other side for additional information. ,-_-__ ( ~__ O~ ~:~~~--- ~' (~--_~__. _- _ ___-; - - - --- SBD-6710 (R.3/97) Date Insepctor's Signat a Cert. No. 3~ GYtGIn+v ~ '~ ~ G~~ ~~~ ~ ~~ r /~~~ /~~o a~ 1~ , :_ ~~~~ lis ' ~ ~ 1 ~ ~,~ 1~~.~~ = ~~~ ~s ~ ~~ ~-~s ~ L. I/~`~ ,~ f /~~~ ~~ ®~3/~- l = !ao ' T~' ~ old "~~ ~ Sy7=l= 9a~3oi ~~=~s. s- ~~ Su,-`-M b _-` ,~ -~ ~b~ ~~ ~ •~; i _~~ ~ i ~, ~ ~, ~ ~, o, ~ ~' ~ o; a i ~ P o~ ~ .- 9' ~ o; W ' O I ~ U; n ~; ~ ~ a~ ~ ' ~~ f ;8 I ~s f ~~ I i ~ I ' W I~ I ~~ I z " I '~ I ~ ~ li I~ i ~ ~ I ~ ~^ Z ~ ~~ • ,_ ~ ;~ ~ -~ ;~ ,~ ~ ~ ~ ~ . ~. ~, . ~ • ,~ ~ , ~ ~•, .~ ~ ~~ ~ .~ / ~ `\ ~ . ~•~ i ~~ •~ . ~ ~\ ~ ~ \ n ~ \ ' J ~ 106J4' ~ ~ .. [ ~ 3 ~..\ ~ -,. ~~. W O ~~ ~~ O ~~ mn l'O ~$ ZO A n Q ~ ~~ $~ mn ~ ~~ U 3$ _~ '~~! ~o ~~ ~~ ~~ 'n ~~ 3 N .- ~ eta ,_ ~~~-~ ~. ~ -. _~ ~ ~~ ., ~ ~. ~. ,,.` \ ~ ~` ~'~ ~ ....~ ~ W Q N ~ d • 1' • ~ ~•\ ~. i~ ` '- ~p ~ '~ '. l _ .\ N O Z~ ~ ~ _ ., ~ '~ ~ ! • , ®'~ I ~ ~ '~ '. i ~ r J~ ~ , j ,3 ~ ~.• '. -! ,. TM~ -r ~,: Z~ ~, -~ ~ y ~ ~ ~.. v ~- ~ n ~" _ /' i ~ ~•• ~• ~~' ~ / \ . ~• ~. ~ ~/ ~. i i ~ j .~, -. ~ ~/ ~. ~~•.oos n --~ ~ i `' ~ 3 tt Irp~s ~O 3M'1 Mt H1f1pg - FLL!!pN (~ I ( I ~~~ ~ ~ i ~g~! 1 ~Z9'LZ L 1. ~S•EEvOON ~ -Parcel #: 020-1400-09-000 .; 01/16/2008 09:36 AM PAGE10F1 Alt. Parcel #: 11.29.19.2499 020 -TOWN OF HUDSON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O - VOSS, MARKS & LORI B MARKS & LORI B VOSS 768 PACKER DR HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description ' 768 PACKER DR SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.460 Plat: 09-015-HOPKINS ESTATES 020-02 SEC 11 T29N R19W PT SW SE HOPKINS Block/Condo Bldg: LOT 09 I ESTATES LOT 9 2.460AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) Y ~ I 11-29N-19W SW SE Notes: ~~ ^ ~~, ` f ~ ~ ~ ~ ~ ~ ~ Parcel History: Date Doc # Vol/Page 03/28/2003 714870 2185/356 Type W D - ' ~ ' ~' ~~ S y 11/22/2002 699523 2057/40 06/20/2002 682172 9/15 WD PLAT 2008 SUMMARY Bifl #: ` f~' Fair Market Value: Assessed with: ~]/~ 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.460 76,800 293,400 370,200 NO Totals for 2008: General Property 2.460 76,800 293,400 370,200 Woodland 0.000 0 0 Totals for 2007: General Property 2.460 76,800 293,400 370,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 10/03/2006 Batch #: 06-15 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Safety and Buildings Division County ~ ~~ ` 201 W. Washington .O. Box 7162 . ~ j(~-{ isconsin Madison, W 5370 Sanitary Permit Number (to be filled in by Co ) Department of Commerce (608) 66-31 --..~d,~~~~ • i/a / 7 t0 c ' ~' n , , Sanitary Per A state Ian LD. Number In accord with Comm 83.21, Wis. Adm. Code, onal t i u provide ' ti may be used for secondary purposes Priva w, sI )/. ~ - Pr ect Address (if different than mailing address) n ~i , [. Application Information -Please Print All Information !n/G Oar/~E) ~ ~ ~ ~{~ Property Owner's Name arcel # t # Block # l Property CO /wn(e~r's Mailing Address ~ Property Location . / ~ ~ ,~~ %. Section ~ ~%. City, State Zip Co de tuber Pho ne Nu , , _ ~~ ~~ 11 / 57~~~ ? / J8C4- 7775 T~N, R~EcIe~,Lte) ~~ (check all that apply) e of Buildin II T g . yp -Number of Bedrooms L/ Dw llin ~l 2 F il vision Name c CSM Number i Subd g or am y e ' / e ~ ^ Public/Commercial -Describe Use (~.>~ ' /i ? ^ State Owned -Describe Use ^City_ Villag ~ wnship of III. T ype of Permit: (Check only one box on line A. Complete line B ifapplicable) - ~d ~ A' .~ew System ^ Replacement System ^ TreatmenUHoldin Tank Re lacement Onl g p Y ^ Other Modification to Existin S stem g Y B• ^ Permit Renewal ~ermit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner yav yap - 9- 30 - a o ` N. T e of POWTS S stem: Check all that a l Non -Pressurized In-Ground ^ Mound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment U ~ ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter Leaching Ch ri Line ^ Gravel-I P'pe ^ (e a ) V. Dis ersal/Treatment Area Information: Desi n Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispers I Area Pro sed (sf) System Ele ation. ' ~OC~ ~ ,~ ~ s 3 3~ ~ , ~_ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber las c G211ons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank ~ ~~~ / ~/~-/`-`~~ `- ~ ~ ~ n ,,,. Aerobic Treatment Unit Dosing Chmnber ,~ VII. Responsibility Statement- I, the undetsi ned, assume respons' ' it r i Ilation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbe Signat a P/ PRS Number Business Phone Number ,~y u~ ,~ aa6 ~s-~ ~~s-- a~ ~-~y~ Plumber's Address (Street, City, State, Zi Code) VIII. unt /De artment Use Onl pproved ^ Disapproved Sanitary Permit Fee S.includes G ndwater Surcharge Fee) It / h ~ t Issue ~ Is ' rg Agent ignat a (N nps) '•L~ (Q (J ~7 ^ Owner Given Reason for Denial [X. (:onditions of Approval/Reasonslf~or~Disa~pproQval~ Q ~ /~~V]~,nlV~Vf/ llr~v~ ~V ~ V ~V- I ~ ~ ~ ~~~ ~/ 4 ~ ' S~ ate" c~',~~-d ~o/a3/d ~' • -Sy-S~' rte' S~,~,~'-Q~ « y`o "2. ~ ,~u~~- . o~ ~' ~ f ~. -~~~ Attach compylte plaru (t~6e County Doty) for the system on paper not tens than atrz x 11 tncncs r~su ~~~ SBD-6398 (R. 01/03) y /~-~ ~~ ~-P ia~o ~~~o t.~-~-.J -iao z~. a8 ~ , :~ ~~®~ //s ~ ~ ~~~ ~~ _ ~~ y5 a~ ~-~.~~ h~ I `- ~~ ~ ~~~~ ~,~ ® 13/x- l = ~©o ' T°~° ~ Ala' '/°u c- 5 y 7=l = 9a~3o' ~ a = 93 3°' COMBINATION SEPTIC/DOSE CHAMBER TANK & PUMP SPECIFICATIONS PER COMM 84.25 CODE CHANGES 2/1/2004 Access Opening, not top of cover, must erRend to a point ne greater than 6" Below Finished G}ra'de Cover vuith WCl4'l'F~ Locking Device ~j~, (typual) ` %ul l.p~NEt' ~EV~J E>z ~ ~ . . > 3o ifi x.42 ~a O ~. iNSI)LA~E Min. 23" Access Opening >~I ~ Oulet Effluent Fitter Inlet Baffle Access Opening, not top of cover, must e~dend at least 4" Above Finished Glade . ~(~~ Y ~ ,,~ ~ pn~ 'S~ ~PPr?e~rtrD C~1 ~ rFinished Grade fiZ" r- Min. 23" Access Opening ~.~ ./~ J//~f 17t V i 2 "~i/G ,>~,p c~i~i,4 ~N ~ .Union ~,eoVE.A }~/O~ ,3 PT. _ ~ ip1#~ O/v`1 d ,COL-/~ SO/L C 3 ~~,Sa.,1d orq r+~ve.l On~gg un e1~ u~~~l, c~2h~2r 2„ ~o~er man Pdc~P.s / Two ComparFment SepticlPump Tank /~ ~ ~~ j,~. o n ov~side 5ccia/.Cs~ SPECIFICATIONS TANK MFR: ~1~-~`t- DOSES PER DAY: TANK SIZE: SEPTIC v~ Ob GAL. DOSE GAL. ALARM MFR: _~~ MODEL # G, Switch type: PUMP MFR: ~ G, MODEL #: ~Oa S SWITCH TYPE: ~,~_ REQUIRED DISCHARGE RATE ~~ GPM DOSE VOLUME: ~~ GAL. (INCLUDES FLOWBACK & <20% OF DWF) CAPACITIES: A = C1,,,S~ICHES = / ~a~l~%GAL. B = 2 INCHES = `7 ~ GAL. C = I~, ~~d~1CHES =GAL. D = ~_INCHES = Ias GAL. PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) _ ~ ~S FT. MINIMt~M NETWORK SUPPLY PRESSURE (DISTAL & NETWORK PRESSURE) _ + -~- FT. /~S FT. OF FORCEMAIN x / /~ FT./100 FT. FRICTION FACTOR ...... _ + /~ a~ FT. TOTAL DYNAMIC HEAD (TDH) = r ~ FT. INTERNAL TANK DIMENSIONS: LENGTH ;WIDTH ;LIQUID DEPTH ~ MP/MPRS SIGNATURE: LICENSE NUMBER: ~~ C.~s-~ OULDS APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: '/~" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/z" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor; •EP04 Single phase: 0.4 HP, 1 15 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 1 1 S V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTW with three prong grounding plug. Optional ZO foot length, 16/3 SJTW with three prong grounding plug (standard on EPOS). PUMPS • Fully submerged in high grade turbine ail for lubrication and efficient heat transfer. Available for automatic and manual operation, Auto- maticmodels include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermoplas- tic semi-open design with pump out vanes for mechanical seal protection. MFTFRC ccc. for 0 a w x v a Y 0 J 0 Submersible Effluent Pump .. EP04 & EP05 Series ^ EP05 Impeller: Thermoplas~ tic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water.resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING S P • Canadian Standards Assoaation ,_ File # LR38549 Goulds Pumps is ISO 9001 Registered, -~ vu 50 GPM CAPACITY ~' Z003 Goulds Pumps EHectwe July, 2003 83811 10 12 m~/h Goulds Pumps ITT Industries 1194 1Nisconsin Department of Cflmmerce SOIL EVALUATION REPORT p~ 1 of 3 Ditiision of Safety and. Buildings. in accordance with Comm 85, Wis. Adm. Code Steel Sat Service Caurty Attach complete site plan on paper not tens than $'~: x 11 inches insize. flan mast SL Croix ll1CIUde, bUt.nOt (lrnrted to: YEttICai2C1d trOI7ZOntatrefelerlCe pOUrt (t3M), drrectron and percent slope. scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. (j2O-/ ~ -Q'a Please print all infu~aaa~1. A~ ~.~~ Re ' By Date Personal infcxmatiai rou provide may used ~ ~ ~Frivacy Law, . 15.04 f1) tmH~ / 6 PCOpertyOwner ,,,a PCOpertyLa:atlon Bast, k~emon "A „+,~ I_' vk Lot SE 1l4 SE 1/4 S ?E1 T 29 N R 14 W Property Owner's Mailing Address ~ # Block # Sutxi. Name or CSM# -948 Labarge t2d_ 9 na Hopkutsfstates City State Z Case -`,~; City ~Fdlage ~ Town Nearest Road Hudson Wt 54016 715-386-7775 Hudson Packer Dr. yr New Construction Use: i>~ Residential /Number of bedfooms 4 CalederlHed design flow rate 600 GPD Replacement Public or c~nmercial - Describe: Parent material Outwastt Ftaxl plain elevation, if applicable ~ General comments and recommendations: System elevation 94.10ft,trenches spaced and depth to code 3.flOft beknro grade vA'L S S Win, ~ S"?~t.r,~D T ~~. ~ `Sv2~iz ~-~+ ~ ~i 3.2 ~ ~" ~I2. ;3 , a~ ~ 2 i ~~ ~ $~~# ~~ Pit Ground Surtace env. 97.10 ft. p ~ ~+~+g fac#nr 96 in. Sod ApQl~on Rate Horrzon Depth Dominant Color Redox Description Textwe Structtxe Consistence Boundary hots GPDHt2 'Eff#1 "Eff#2 1 0-18 10yr3/3 none sil 1 csbk mfr gw 2c .4 .6 2 t8-32 7.5yr4/6 none Is osg mvfr gw 1 f 1.2 ~ 3 32- 7.5yr4/4 none. cow osg ml na na _7 1 ~ Q l3cx ~ Ba~rug # ~ Pit ~ Graurd surface elev. 97.10 tt. to limiting fadAr ~ in. ~ ~ Rate Horizon Depth Dominar~ Cobr Redox Description Texture Structure Consistence Boumiary Rents 6PD/R= *Eff#1 `Eff#2 1 0 9 1 Oyr3/3 none sil 1 csbk mfr gw 2c 4 .6 2 9-48 75yr4/6 none ms osg ml gw 1f .7 1.2- 3 48- 7.5yr4/4 none cos osg mt na na .7 1.6 tmuem ~~ = tsvu ~ au < «u mgi~ ana i ss >sU < ~ 5U mgi~ ~ Effluent iF"L = BODS< 30 mg/L antl T55 < 3l) mg/L SST Name (Pl~e Print] 'nature: CST Number David J. Steel - 248956 4ddress Sfeel Sal Service ~ Date Evaluation Caxiucted Telephate Number 1564 CR GG, New Richmond, Wt 54017 10/23/2002 745-246-5085 Property Owner Bast, Kemon Parcel ID # 20-1013-80-000 Page 2 of 3 ~~# ' ~~ 91.00 Depth to lim ft iting factor 96 in 1.~ / Pit Ground Sur#ace elev. . . Sod Application Rate Horizon Depth DominantGolor Redox Description Texture Structure Consistence Boundary Roots GPD/ftz 'Eff#1 'Eff#2 1 0-9 1 Oyr3/3 one sil 1 csbk mfr gw 2c .4 .6 2 9-48 7.5yr4/6 none is osg mvfr gw 1f .7 t 2 3 48-96 7.5yr4f4 none cos osg mi na na .7 1.6 ~~ Rnrinn # ': Boring ' Effluent #1 = BOD ~ 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 assrstance to accxss services or { I Bcxino # Boring David 3. Steel CST-POWTSM Lic. # 248956 f `QI jy3 ae~~" ~i/r'~r ~ ~-~.~i7~ 1~ , y~ ~ s~. ~~w Z `~~_'~~~ ~~-13-aL .~i Page 3 of 3 STEEL' S SOIL .SERVICE Kernon Bast SE1/4,SE1/4,S 11,T29,R19W Town of Hudson, St. Croix Co. Hopkins Estates !ot 18 1564 Cty Rd GG New Richmond, WI 54017 (715) 246-6200 (715) 246-SQ85 Legend 1" = 40' ~ = Benchmazk EL 100.00Ft Top of '/z"pvc pipe • =Alt Benchmark E1.99.35Ft Top of %s" pvc pipe ^ = Bprings Boring Elevati~s Bl ~7.lOFt B2 ~7.lOFt B3 =91.OOFt B4 =OO.OOFt ~ 65'. 5b' ~~~ ~~ Fd ~, Y.... 4~ ~~ i~ 0 ~~.w(.aF e~pt~e ~ <~ -~.~ ~` Safety and Buildings Division 201 W. Washington Ave.. P.O. Box 7162 CO11~' ~ ~r~L ~ ~- ~eons~n Madison. WI 53707 - 7162 Sine Address po_ ~ tment of Commerce q 3 D -D ~- 9 Dp ~ 7lP Sanitary Permit Application Sanitary Permit Number ~ ~~ ~~ ~ In accord with Cotiun 83.21, Wis. Adm. Code, personal information you provide f . ^ Check if Revision ma be used for ses Priva Law, s15. 1 m I. Application Information -Please Print All Information ~ ~ " ~ ~ __.~..s State Plan I.D. Number N f'~ rty Owner's Name ~ r 3 Parcel Number Q Z 0- f (,~ .- QG~ L y ~ ~ a ~:~ ~ ~~ a~ roperty Owner's Mailing Address ~ ~ i Property Location l J City, Stan Zip Cade ~<"~~" 'P6orie Num"5'er "- Lot Number Block Numbe' ~ ,L d 7 Subdivision N , CSM Niunber r ~ S S o03 a b-s7~~ i~ II. Type of Btn7ding (check all that apply) ~ E.7~ !U ~~/in/ I~E~I~ / £3~2 ^Ciry ~~ ~ ~1 or 2 Family Dwelling -Number of Bedrooms OLV i ~ ^Village ~ ~~~``~ ^ public/Commercial -Describe Use ~ownship ^ State Owned ~ ~ r- ~ / 7 / ` / N t Ro ~ / 0 ~ use). Compl a line B if applica le) ~. eme for internal : (Check only one box on ' e A (n a ' permit III. Type A. 1 New 2 ^ Replacement System 3 ^ Licearent of b ^ Addition to r Co use stem Tank Onl Exis ' stem B. ^ Check if Sanitary Permit Previously Issued Permit ber IV. Type of Permit: (Check all that apply)(numbering sch a is for internal e) a ,Q ~ / o a/I~OS f~~~~ U 50 ^ Co tied Wetland ~Sf}- .~ ci{ 3~ 4~ Non -Pressurized In-Ground 21^ Mound 47 ^ Sand F' r ~ ^ prey ~~,round 41 ^ Holding Tank ^ Sing)E Pass 51 ^ Drip Line f _ C'l~tA~+~-~J 45 ^ At-Grade 46 ^ Aerobic Treatmeru U 't , 49 R irculating 30 ^ Other /'K.w.-. V. D' rsalPlYeatment Area Information: Design Flow (gpi) Dispersal Area Dispersal Area ~ / Soil Appli, ti Percolation Rate System Elevati~• ~ Final Grade ~ ~S $ " Elevation~~ ) (Min./Inch) Ft l~ /Da R G Required Pro)~osed~(r ( _ . ate( a y / 7- / „ D r`.' ( `~ VI. Tank Info Capacity in .Total Number Gallons Gallons of Tanks Prefab Site Steel Fiber Plastic ; Manufacture ' Concrete Constructed Glass y New Existing ~ A - / l Tanks Tanks Sepdc or Holding Tack 5 r- ~~~ Dosing Chamber i Rtsponsibi7tty Statement- I, the undersigned, a responsibility for ' lion of the PO shown on the attached pleas. VII . er Business Phone Num b S N ' b er um s Si ! /ivIPR Plumber's Name (Print) Plumbe Q Plumber's Address (Street, ity, S ,Zip Code „~~ r C VIII. oust /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Is Agent Signature (No Stamps) r,~,, ~/ ayApproved ^ Disapproved Surcharge Fee) l ^ Owner Given Initial e~dverse ~aa ~. OU ~~~ /~ Determination , / ^ 1X. Conditions of ApprovaUReasons for Disapproval ~~~~~~ v~ /~e'Q~:'~ slO~~f!?.Po. 1 SCE i ~ ~Z~t9~"G~' ~t.~G~ Ga%(~ Git~GkC `~ .~-a wca-,~~ ,a.GV`,~5~ r:s SD i . ~`~ ' ~ . `"~ c~.os;?~. -r-o ~ ~o q3.3 -qa -na,~d -1-~ -t,~t,t~ ~.oGe~za~- of ~/~t' ~ Z ~ ~"Q , !~-m~' S'LovE rnRy.S~ ~ ~ ~`~ ~ ~r° -ftiu~'~ ~ ONw SGururn-nom s ,_ _~ _ . _ - ,, ~ _ . _ ., . ,..~, _ i ~ ~,,,._ ,-„ , _ . A /L-ie _ • / /~ i7cOM , <r s/ %~-v , H-C M,C.T AcA-/J ~`~°~~~ ~5~~ S D~J-b398 (R. OS/Ol) ~v. ~ ) ~ ~•yt/vt, ~ ~, `T 3 f Z ~~'/A?1~U7~f~?N ~~.8 KS ~~1 {'~G(JL~ ~/~UPti~~ u~ Gvi;l-~ ~~ ~~ ~ r ~~ ~ ~ ~~ ~- ~ ~ ~ ~ ~' ~ ~ ~~ I ~ ~ ~~~~~ ~~r'~ ~~L~dX ~/ ~~ ~ ~ j ~~a Lo~~ ~ su~,~~ ~~ y~ ro ~ ~ ~'~' ~~'~ ~, vi/ L . ,2 ~~~ ~c \3 ,~ ~~ 2n~ b.~~ B 2 ~ 8~` I~'~~ i~~~c?5 7 i~ ~ ~ ~I~'~ ~~-~ ~~ ~~ ~,~. ~ -~ ~~ a oil ~ (U N--~D i ~~-~-~ ~~ ~70~ ' ~~ `7b ~- _ __-_ oonsin Department of Commerce ~siori of Safety and Buildings SOIL EVALUATION REPORT Page ~_ of ,~ ~„ a.........a...•,......, .....,..~... , ..~..........,...... County ~ L (, Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must 1 indude, but not limited to: vertical and t[~izontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. / 3 - - aJZ~ Please print al information, evie by Date Pe[sonal information you provide may t1E used f secon~p~ Law. 15.04 (1) tro))• C~~ ~ 9 3~ property Owner rty Location K~ ~ n ~ n ~ -~ P vt. Lot 5 (; 1/4 SE 1/4 S ~( T 2~ N R (~ E (or W Property Owners Mailing Address ~~ of # Block # Subd. Name or CSM# ,( ~ L ~ ~ ST. CROIX COUNTY /) S C Ct J City State Zp Code ICE ^ City 4 ~Ilage ~ Town Nearest/Road ~ u o 1 S~IOI~ c?~S i3~S~-~~75 ~-vds o/1 cKP~ r c Q New Construction Use: Q Residential / Number of bedrooms ~~_ Code derived design flow rate ~ S ~ - ~ ~ 0 GPD ^ Replacement L ^ / Public or corrtmerdal -Describe: Parent material ~ (~ 7 W CaS to Flood Ptain elevation if app icabfe ,~~_ ft General comments Sys few e(e tl r 7~ P $~ , S o y,' ", ~ ,- ~5 ~• 3a JJO ~.pT L //~/~~ie/l+~S and recommendations: ` . P(~ J , ~-U ~ ~~r, ~O ~ ~ .o / S3 5• ~d ,~•/~ (,v f-/~ ~3 /L! S ~~ ,.---- O~Tfl,CS GD r - 2 0 ~ f3 ~Na~ ~ 1 ~'Iot-1-IPA S-I~ 3aI~ Ndfi~c~c~ 3~" I ~GrVI~~~C. ~,v/o.~< /s - ^ Boring ~ ~~r /.~-- Boring # r--[ .. ~ s--- -•- rZ ~n u .,__.~ .- •~-~~-- _--•-- l l (` ._ /~ 7~j~'/(/ ~' J t'ii v~wnu am~a~.c ~~~.. . i, , ~.. uc~+u~ .., ~u,uu..y .a....n ~ ,-~ ~. Solt Appliption Rate Horizon Depth Dominant Color Redox Descxption Texture Structure Consistence Boundary Roots GPD/ffz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0 -~s I - ~ 5( 2vvl s~ K /~- ~'r C 1 v F . S f Z ~ /a t, ~ - L wi ~r CS - , 7 ~~2 - d-ll L ~' ~ os iM I -- - . 7 ! . Z Z Bing # Bonng ° ~ Pit Ground surface elev. / ~~ S ft Depth to rindting factor ~ ~ Q in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ~ ~ (D I o n SI K Wl~r C S I v • S'~ o-~ o ~~ - Si K f~ CS - ~~~ _~~~ to `L -- ~ 5 d wry - ~ , ~ I• ~ ~ 'Effluent #1 = BODs > 30 < 120 mglL and TSS >30 < 150 mg/L ` Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L r+uoress ~/ 5 vale ~vaiuauon wnauc[ea ~ eiepnone rvunwCr Z~~ ~~ `~ ~: Sov~terst°~' tN( S`yo~s- I-(~ o Z his 247 4008' ~' ' ~~ ~s~ ParoellD # ~ Z ~_~ Boring # ~ Boring pit Ground surface elev. ~ ft- Depth to limiting factor ~_ in. Sal Application Rate horizon Depth Dominant Coor Redox Description Texture Siruchue Consistence Boundary Roots GPD/ft~ in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. "Eff#1 'Eff#2 I o-i o ~ -- ~' r w~a'~k ~r ~ S v ~~ ` Z I- ~ I o ~ o - I wr~~' SK 0 S cS -- -' _ ~S ~ 7 I~ Z ~ ~ pit Ground surface elev. ft. Depth to limiting factor in. Sal APP~~ Rate # ~ tion cri D d Texture Structure Consistence Boundary Roots GPDfftz Horizon Depth in. Dominant Color Mansell p es ox Re Qu. Sz. Cont. Coon Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # ~ ~~ Pit Ground surface elev. ft. Depth to limiting factor in. Sal Application Rate i t C Boundar Roots GPD/ft~ Horizon Depth in. Dominant Caor Mansell Redox Desrxiption Qu. Sz. Cont. Coor Texture Struchue Gr. Sz. Sh. ence s ons y 'Eff#1 'EfE#'L • Ettluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mglL ' Etfluent #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 608-266-31 S 1 or TTY 608-264-8777. ssn-s33o ~e.o~roo~ s PAGE 3 OF~ NAME ~ G.5 T~ LOT# ~ LFGAL DESCRIPTION 5 ~ - ~S~ L4~S I ~ T Z~ ,N,R, 1 Q Elor~ SCALE: 1"= CIO ~ BM 1 ELEVATION CUC~, ~ BM 1 DESCRIPTION 11 u ; l i " ~ `~ .e ~ yr BM 2 ELEVATION (6U ~ O BM 2 DESCRIPTION ~ a ,' ~ ~' .~ ~? ~ ~~ ~ ~- SYSTEM ELEVATION ~ P ~ ~ • 5 ~ G~~ ~ ~ ~ ~~ ALTERNATE ELEVATION ~Q ~ ~ ~ ~ ~ Lyw ~ ~ ~ S. CONTOUR ELEVATION `(j~1, ~ -al. ~~ ~ Y3, 3C y~ ~~ S ~ ~O~n/~~ ~~ ~~~~~ / ~ Tf-~/S S~/Q D • l -tom o~~ ~i~~ N ~~ ~~ ~, ~~ , ~; ~~,~ a~ ,- \1 ~~,~ 3°~ ~ \~~ ~ ~~ S~' o~s~. ~~~ ) i ~~r' S ~ 5~ ~~ ~° b~ . -3 S~~• ~~ - ~" :--~l!' 2 3° q SIGNATURE ~- DATE I Z ,/i ' O ~o~ ~ sT CROix CouN1`Y SEPTIC TANK MAINfBNANCB AGg~~3MBI`1T AND OWNB,RSHIl' CERTIFICATION FORM property Address (verification requin~ frmn Y~annruS ~~~ ~' Parcel Identification Number ~0 - ~~/3 ~U City/State ~~%~~~ lrll' Loc;atioa ~ ~•, .~~ 1/,, Sea ~ T~N ~- `--+-w' Town of Lot # Subdivision ~ ~ Page # Certified Survey Map # .Volume ^.______-- ~~ ~~~ .Page # f ~ r warranty nud ~ ~ 3 ~ 7 C~ volume ~_____ Spec house ^ yes ~no Lot lines ideatifiable~yes ^ no ~.vcm~nAr Mst~nrl`I+NANCE to bandlewastes•Prol~ce ~ 1 impiopornse aadmamtenanceof yoursaptic systcmcouldrosultn~ p~~, ~t y~ ~ ~ ~ System out the septic tank every thrceyears or sooner, °0~ of ~~ a tank as a treatme~ stage in the wad ~P°~ cam affa~ the fuadion of the septi b ~ owner and by a a certification form, signed Y The property owner agrees to sabmit to S`t. Croix Zoning ~~ , that (1) the on-silo wasbewaterdisposal mas6CtP~~7°~Y~PI~'restnctedphunber or a lice»dPv~~g the septic tank is kss than 1/3 fiilI of sludge. ~ ~ proper opcratmg condition and/or (2) after won and P~P~ (~ nom)' to maindain the private sewage disposal with the standards ~. ~ mod have read the above regn and agree azt>n~ of Natural R ~~ of Wiseonsin• Certification set for8r, herein, ~ set by the DeQardneat of Commerce and the Dep ~ returner to the St. Croix County ZomaB C~ ~~ 30 stating that your septic system has bean maintained must be complend days of the threw year expiration data. Zvi OZ- DATB SI(#TTA APPLICANT QR"~R Cl/, RZ'yr+ i(;ATION our knowledge. I (we) am (arc) the owaei{s) of I (wc) certify that all statements on this form are truer to o ee best ( ) of Doeds Officer. the roperty descn'bed above, by virtue of a warranty deed record DATE SI TURB APPLICANT' s««««« red may result in the sanitary permit being rovoloed by tho Zoning Depar• «««««« pny iaformatioa that is mis-toprasen ~ of Doeds office ~« Indade with this application: a stamped warranty deed from is made is the vvananty dad a copy of the ceztifed survey map POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of " 7/ FILE'INFORINATIO Owner Pemnit # ~ ~ /_ DESIGN PARAMETERS Number of Bedrooms ~ ^ NA Number of Public Facility Units ^ NA Estimated flow laveragel l~ al/da Design flow (peak), (Estimated x 1.5) ~ al/da Soil Application Rate al/da /ft2 Standard Influent/Effluent Quality Monthly average" Fats, Oil & Grease (FOG) <_30 mg/L Biochemical Oxygen Oemand IBOD5) 5220 mg/L ^ NA Total Suspended Solids (TSS) <_150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) 510` cfu/100m1 Maximum Effluent Particle Size Ye in dia. ^ NA Other: ^ NA `Values typical for domestic was[t~e//w/~~//t~e/r~and septic /tyan~k effl/uent~ ~~~~r~-emu ~~~r ni+ur~~~1 ~ / //// // ~/~// / ~/K/ SYSTEM SPECIFICATIONS Septs; Tank Capacity ~ p~ al ^ NA Septic Tank Manufacturer ~ ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model D ~ ^ NA Pump Tank Capacity al ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model ~ ^ NA Pretreatment Unit ^ Sand/Gravel Filter O Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ^ NA Dispersal Cell(s) ^ In-Ground (gravity) ^ At-Grade - ^ Drip-Line '. ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA gIM11~ r Lr~/V~IVG uvnwvu= ~ -~ Service Event Service Frequency Inspect condition of tankls) At least once every: ^ monthls) (Maximum 3 years) ear(s) ^ NA Pump out contents of tankls) When combined sludge and scum equals one-third lY3) of tank volume ^ NA Inspect dispersal cellls) At least once every: ~yearl 11s) (Maximum 3 yearsl ^ NA ^monthls) ^ NA Clean effluent fiker ~~~ At least once every: year(s) ^monthls) ^ NA Inspect pump, pump controls & alarm At least once every: ^ year(s) ' ^ month(s) ^ NA Flush laterals and pressure test At least once every: ^ yearls) Other: At least once every: ^ month(s) ^yearls) ^ 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 tankls) 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 on the ground surface. The dispersal cellls) 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 IY,1 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, 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. Page Zof Z~ START UP'AND OPERATION For new construction, prior to use of the POWTS check treatment tanklsl for the presence of painting products or other chemicals that may anpede the treatment process and/or damage the dispersal cell(s1. If high t~ncentrations are detected have the contents of the t~klsl removed by a septage servicing operator prior to use. System start up shalt 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 cellls) in one large dose, overloading the cellls) 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: ^ A suitable replacement area has been evaluated and may be utilized for the locatwn 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 resuh 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 Name Phone ~ - ~ .- POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) EGULATORY AUTHORITY Name Phone LOCAL R Name Phone C~ ,, This document was drafted in compliance with chapter Comm 83.2212)Ib11111d1&lf) and 83.54111, 121 & (3!, wsconsin Administrative Code. ' Vr;~..1~46PAGC1U9 630707 STATE BAR OF WISCONSIN FORM 2 - 1999 WARRANTY DEED Document Number kEGISTEk OF DEEDS ST. CkC?IX CG. ! WI This Deed, made between Wallace L. Billy, s/k/a Wallace Lee RECEIVED FOR RECORD Billy, a/k/a Wallace Billy, and Katharine M. Billy, a/k/a Katharine Billy, 69-28-2000 9:15 AM a/]c>'a Katherine Bitl ru $jrs.t'>and and wife, fIARRAHTY DEED Grantor, and Kernon J. Bast and Donalda J. S eer-Bast, husband and P EXENpi N CERT COPY fEE: wife, COPY FEE: iRAHSFER FEE: i36°'O° RECORDING FEE: 10.00 pRGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): SW1/4 ofSEl/4 of 1 I-29-19, EXCEPT South 198 feet thereof, St. Croix County, Wisconsin. Recording Area Name and Retum Address ~n_tnta_Rn_nnp Parcel Identification Number (PIN) This is homestead property. (is) i~}id(1 Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~L`t~ day of August 2000 AUTHENTICATION Signature(s) Wallace L. Billy, a/Wa Wallace Lee Billy, a/Wa Wallace Billy, and Katharine M. Billy, a/Wa Katharine Billy, 1 a Katherine Billy, husband and wife, authenticated this day of ~U . Kristine Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by ~ 706.06, Wis. Stets.) G~,.,~! • Wallace L. Bill , a/k/a Wallace LeP Bill , a/Wa Wallace Billy _ r • Katharine M. Billy, a/k!a Katharine Billl , a/x/8 Katherine Billy ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. County ) Personally came before me this _ day of the above named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Oglaad Hudson, W 154016 (Signatures may be authenticated or acknowledged. Both arc not necessary.) ' Names of persons signing in any capacity must be typed WARRANTY DEED Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: •) Ir(ormelgn Pfolss6ioruls CompYy, rood du Lx, NA an0855-4071 l~ or printed below their signature. STATE BAR OF WISCONSIN FORM No.2-1999 ~ Q ~~ ~~~, ~ ~, a~ , ~ ~' 9' I ~~ o~ I nn~ I o ; ~' O~~ ~ ~; a Ip P~ ~ o~ ' N I r ~' ~' ! Ioo~ ~ n ~ ~~ b ~ ~' ~ a~ ~ a' °~w I ~ W ~ ~, $ F ZS ~o '~ I I~ ~ ~! i ~ i~ I I ~ I ~ I I ~ ~' ~~ ~ ~~ ~~11`z II 3~ _~ -~ 0 -~- oc ~ ~ ~~ z~ o ~ ~ ~~ i .~_. N Q ~ ~ 11 I I ~ m^ ~~ ?~ ~ ~ 1 • ~ I ~~ • i ~w ~ ~ ~ .~, ~ ^\ ~ ~ .. ~ . '~ \ ~ ~.~ ~'. X124 '~ ~'. ~\ ~~ ~ ~~ ®~ ~ ~ ~~• '~ ~ ~ ~~~ .\ • ~` '~ ~~ y~ O ~ Z~ ~~ ~ *. Q.- m II ~ ~ ~~ ~~~ W ~~ U Q c~ Z^ ~~ ~^ m II N~ ~ Z~ ~ W 11 3g r~ I~ m (~ ~'03'W ~~ ~~ ~ i 106.74' ~ ~ ~ ~ .\\\ ~~ ,~ -~.~_ d \. / ~ .~ ., ~~o .. 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