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HomeMy WebLinkAbout020-1402-09-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Buildinq Division Sanitary Permit No: e. INSPECTION REPORT 405190 0 GENERAL INFORMATION } (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Bast, Kernon I Hudson Township 020 - 1402 -09 -000 CST BM Elev: Insp. BM Elev: BM Description: /0010 /D v , 9 Gt�� -� kill TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark CNU?�� 1 2 o Dosing��� Alt. BM C Aeration Bldg. ewer ?J Holding QVI-It Inlet TANK SETBACK INFORMATION St/Ht Outlet �. fP `I ?. 3 TANK TO P /L WELL BLDG. Ve t to Air In ke ROAD Dt Inlet Septic � ! / � � �/ Dt Bottom j Dosing He r /Man. Aeration Dist. Pipe r'S I /D•lo qb 3 Holding Bot. stem (� , I .c��" . Lk ILI Final Grade PUMP /SIPHON INFORMATION (off Manufacturer Demand St Cover GPM .D Mode TDH Lift on Loss System Head H Ft Forcemain Length ell SOIL ABSORPTION SYSTEM BED /TRENCH Width Leng ( No. Of Trenches PIT DIMEN� No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Q � \ SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM EACHING Manuf r: INFORMATION T e Of System: // CHA uNER OR Model Number: ` / // DISTRIBUTION SYSTEM Headerr /M� Distribution � � �� x Hole Size x Hole S a ' g Vent to Air Intake��„ // Ci t 11 Pipes) or r �— 4 (2A ,-...I Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only /01 All. Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil (j Yes lJ No I_i Yes [ No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 1 / D / b Inspection #2: Location: 788 Starlight Ave Hudson, WI 5400(166 (SE 1/4 SE 1/411 T29N R19W) Misty View Lot 9 / Parcel No: 11.29.19.2520 1.) Alt BM Description = Ca�� -- ; k&/ W lwt`��' 4 w�[�` b7 �j L(,tQ ►^ � Q VA tied/ 2.) Bldg sewer length = 2 - amount of cover c. �� 0 �� ,�,� 0 r� �� , WA2 Plan revision Required? w Yes i / I, I Ise other side for additional information. - X Date Insepctor's gnature Cert. No. 710 (R.3/97) Z--�� r (? arm �� 1- ec, -u '� SyS -� ci("'l ��ws E�( � gZ'�" `S��' � mi- CG�lcrr►LP.t'�y tU and—Buildings Division COMM 201 W. Waaiwogton Ave., P.O. Box 7162 ST. CROIX N VIscons i n Mme. Wl 53707 - 7162 Sim Address Department of Commerce - / / -O X— 31/ S— 788 STARLIGHT AVE. Sanitary Permit Application Sanio Per Number In accord wills Comm 8321. Wier, Adm. Code. penmal iofotmatim you provide (C6ect N Revision mg be wed for taw, $15.040)(m L App5cath lafermadon - Plane Ptriot AD Infaeoatlon Sae Ilan I.D. Number ) Property Owner's Name Parcel MA ZS20 KERNON BAST 020 I Z - o 9 t�� Prop" Owner's Mania Address -; Propem Location GOV. LOT 948 LA BARGE ROAD x . .!, NE if SE %;S 11 T 29 N. R19W B City. Sae Zip c t ZC `' Lot Number 9 Block Number HUDSON, WI 54016 715 -381 -8275 &'M/°a10°Name t SMNumba MISTY VIEW IL Tyree of Building (clawk IA that aWy) ❑ci 19 1 or 2 Family Dwdbg - Number of Bedrooms 3 TO 4 ❑ViWge ❑ ftblidCommercial - Dewribe Use 11 HUDSON 0 State owned t O N"" Road 2 31 x UO& JENNY LANE III. Type of Permit: (Check only one boar on line A (numbering scheme f or hsternal Wise). CamPttde Hue B If applicable) Only A 1 f%cw z 0 Replacement Sysaem 3 0 Re*cemmt of 6 0 Addition to gOr a.e SYMM T=k B. IV Chest if Saoiary Permit Pra+rioudy lsatred Permit Number Zk� - 7 39D Dane Iswei/ IV. Tyree of Permit: (Cbwk aII appbyx atdwwe is for ante nal me) � o 4 � "fl ;oo, Pressmined b4round 210 Mood 47 0 Sand Filler 50 ❑ Constructed wetland 22 0 Pteawriaed In4round 41 ❑ Holding Tam 43 0 Single Pon 51 ❑ Drip Line 2 45 0 At-Grade 46 ❑ Acrobir. Unk 49 ❑ Rwhp&Wvg 30 ❑ 01her V. Area Tnfarntatian: a IOD Desia Flow Wd) Dispersed Area DWersal Adia Sold Application Percolation Ram Phvabon CVA9 carafe 600 Ptopowd RsWGakJDsys/Sq.FL) (Mia./imb) 95.0 AS PER Elevation r 857 882 .7 �S PLUMMER rem! VI. Taatk Info Capacity in Total Number Manu6ebtrer Prefab Sue Steel Fiber Plastic Gdkm Galkws Of Tlmlea Concrete Constructed Glass New Esipag To" Teaks Sepdeor TW* X - / WEISER X Daft Choriber VII. %temmt I. the tmdasiaMed, aas®e for htun of the POWTS sbowa on the attached PbobWs Name (Pmt) Pivm6er' Number Business Phoa Number TODD FEATHERSTONE 242514 715- 381 -1704 Amices Address (Street. City. Staee. Code) P.O. BOX 467 HUDSON WI 54016 VIII. Use Onty Approved ❑ Dlaapproved ) Fee (mdudes Gmandwater Due Lashed taatmg Agent Signature (do Samps) ❑ owner Given land Adverse . 0 y Deaermiaatioa T Card& ions ,W A"rawal/Reasaw for Dianpproval I (� �`0 ' e w gs a -� �n - A�aat C•ee0t- w�aae to SySI_ J dg��a. c�..a..v) * *e an �e1i�X alt =11i.otiu. arms ° SBD- 6398 � (R. OS /Ol) SITE PLAN FEATHERSTONE EXC INC 368 TOWER RD HUDSON WI 54016 SCALE 1@1 - BM i IE XVATION o BM :RIPTION-* & Q2 n ow S J BM 2 MDATION — BM 21 ES( :RIPTION ( — - -- SYSPE E.EVATION, 95 i SY TYPE Aswuer►1.s. 1 r — 0 NT . ELEVATION_& 0 a f la Is ,Jig i d 7 r SITE PLAN FEATHERSTONE EXC INC 368 TOWER RD HUDSON WI 54016 NAME fijcaC LOTS 9 LR[.AL MUEMON AM :f<6F I &S Y1 T Zt -N -lt � SCALE- 1 " == yo BM 1 E X'%*ATl0N 40 BM 1 I ES(;RIBTIONAa &$b Daw Js •' BM 2 MEVATION — BM 21 ESC:RIPTION t — -- S YSTE E.EVA 95 I SY TYPE L7swuew�,s. i _ Cow $m . ELEVATION_& rla2.e a-W3 4 p a (,.b.�51G `� D a -3 y r U i l I I i f w i - -- - -4- ; ��•• � I - --� ! _ L 4 i 1 ! : Wisconsin Department of Commerce SOIL EVALUATION REPORT Page - of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County C ' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by Date Personal infomraGon you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 0 o ,,,Ax6,,--- . 04 ItD Property Owner Property Location e Govt. Lot N 1/4 S E 1/4 S // T Z N R /f E (or) Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# S 7 S So rvVgn t r .�,' .' ' e f.✓ City State Zip Code Phone Number ❑ City ❑ Village © Town Nearest Road S I ( WE 38'1 -80 7 vot Tann A n-C ® New Construction Use: (3 Residential /Number of bedrooms T Code derived design flow rate f & 4v UO GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material (J (J+Wc k Flood Plain elevation if applicable ft. General comments and recommendations: k r� /Yi�� sysf�. Su�f� -��— e.eeLI- laa, 1 Boring # ❑ Boring ®pit Ground surface elev. 1610-70 ft. Depth to limiting factor /3 o in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I O -z /eye 31 _ s %� m ob YK'�Y- CS y S Z Zo -yo o — .3 Q-2-1 rn slo '{ o ,- 6 - ms o.s q ran - - • Z RS•� 1 ao . i0(p .Cdr Boring # ❑ Boring ® Pit Ground surface elev. 1 01.30 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 I 6 - /a X /-3 /Z — S / a� prx-(� Gf ! v�- , S" . r Z /0 -36 / S'G/ W, ' - c — , y 3 36er ms CIS4 m� / Z Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number AdUina Sc r <3 Address �/ S --y Date Evaluation Conducted Telephone Number e /t 1J k4� S -So.n t��- / �_ 3 - o - pis -may �- 1 9 I Property Owner 81 CC6. r Parcel ID . # ��� / Page. Z of 3 5� Boring # ❑Boring Pit Ground surface G' -3. ft. Depth to limiting factor /IX In. Soil Application F Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl' In. Munsell Qu. Sz. Cont. Color ", Gr. Sz. Sh. 'Ett#1 'Etfl a -� Z 3 �'1 ►tna b r- G S I Ir-� . 8 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. R. Depth to limiting factor in. coil Ap plication F Horizon Depth Dominant Color .RedoxDescription...... ,Texture _Structure Consistence Boundary Roots GPD /ftz In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'EM F-1 Boring # ❑ Boring ❑ pit Ground surface elev. it Depth to limiting factor In. Soil Application R Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD /ftr in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'EtM ' Effluent #1 = BODS > 30 < 220 mg/_ and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/l, and TSS < 30 mg /L The Dcpartment 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. SB0.3))0 (807/00) PAGE 3 OF 3 NAME f4 LOT# LEGAL DESCRIPTION ,yE XSF X ,S P T ZR ,N,R, t E(or SCALE: 1 "= y� , BM 1 ELEVATION /(X>• O BM 1 DESCRIPTION i BM 2 ELEVATION BM 2 DESCRIPTION gy m` - - 1 SYSTEM ELEVATION 95. SYSTEM TYPE ( CONTOUR ELEVATION , p /,a a - teZ.O + - Im3.O �G 0 o2 ,0 10 3 6 r . F1' r ' i r 9 SIGNATURE DATE r r -- Safety and Buildings Division County — I J 201 W. Washington Ave.. P_O. Aux 7162 Nvisconsirn Madison, WI 53707 - 7162 Site Address �,,,, . �, r Departm of Commerce � z a D� �� S,� C� A^ „ > � 16 dfT ! m� Sanitary Permit Ap iication Sanitary Permit Number 4 0 In acc(.nl with Comm F3.21, W iK- Adm. Code, personal information you provide Check if Revision N _ t n_ay be used for secondary purpnses Priv La , s _ ©��'✓T L/O�'t�1� I. Application Information - Please Print Al( Information Siaic Plan 1. D. Number Pmperty Owner's Name �i - Parcel N er _ Cz JUN 2 0 2002 Property Owner's Mailing Address rty Location ST. CROIX COUNTY 3 17 ZONING OFFICE Arr� fA, S T N, R City, Slate. r'tI Zip Code Phone Number Lot Number Block Nu r . ;? S Subdivision Name C5M Number [j lU` C/C U. Type of Building (t'ltet II titat apply.) t� DC «t 1 or 2 Family Dwelling -Nam of Bedrooms __ -_- _ O Village O Public,-'ommcrcial .. Describe Us . .0 State Owne+' Townshi .0 Nearest Road Ili. Type of Permit: (Check only one b on dne A. ring is for erns! use.) (Complete line K, if a T A. �M NewR rment of 6 ❑ dWon to _ 2 Q Replacement $ steno Fnr Cotmty use S su;m nk L•x ng_System —_ $' IClrcck if Sanitary Permit Previous) rmit Number Date Issued IV. 'Type of PO�VT em: (Check that ply. umberi s for interns! u se.) ZW;ctjand -%e . r' 44 round L. ❑ Non -Pr nd C Mourxl 47 Sand Filter 50 0 CcrosI 22 U Press;r ed I I O HoldingTank 48 o Single Pass 51 ❑ Drip .- � 45 f7 At - Gt e .46 camien nit 49 O Recirculating 4'M 30DOther V I )ispee r r m ormation: ✓ Q B _ Ir+ign rlovr (gixi) i3isf,ersa ea j llis rsal Area Sni plication Percolation Rate stem Elevation Tina) Grade 4kc g Rcqu;rrti I Yrup.>.�cct Italet .!13ays1Sq.ft.) (Min.11rtch) Elevation VI. 'Tank Info Capacity in t/ Tbtal Number Manu ter Prefab ne Steel Piker Plastic: Gallery. _ Gallons of "ranks Concrete Constructed Glass hew - Cxisting Tanks 1_atills — -- Septic or ileldin8'ra11 E/--=T - -- - llaiine t:hamher — V ( l/�� VII. R State I, the atlas oft PO rro an the attached plan PlumltVr� Name (Print) P Number Business Phone Number Plumber's Address (Street. City, e. Code) I a V ITT. 1 Count .0 - tmcnt Use __ v (f)r tile_ ? Disapitrov Sanitary Permit Fe ( eludes Cirnundwater �le Lssued Usuing gent Signa o Statttps) xovtxt C1 Owner Given I t Adverse )�I A to r pt Sterchar a Fee) wp _ Determination _� S ) Z2� 2 IX. Coni !Ions of AppravallRea6ML; for Disapproval CAW Vr4;04MCe Attach omplete plans (I.* the County only) ror the system on paper oot less than 8112 x 11 inches In *9 1 t N r r i r AV .0 lop _f wa "MAO% 0 0, `, do - f • s � R� • r � t 13 As • S z r n ti �. iL I • s •` 4 r • r ..ara � � ��olrarL � '' ... i f 1 N M L • +q 4 i 1 • w r s w 1 •• �ti 1 rn 4L 0 ti iL I "'t lo'ZS�GI r 7—I12-9C Wisco eo Qapartrnent of commerce SOIL EVALUATION REPORT Page I of 3 Division of Slfety and Buildings in accordance with Comm 85, Wis. Adm. Code Count C Attach complete site plait on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest mad. Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z Property Owner Property Location Govt. Lot 5> 1 /4,SE 1/4 S/ T Z J N R E (orl Property Owner's Mailing Address Lot # I Block # S". Name or CSM# 1153 6 e Trot q i vie City State Zip Code Phone Number ❑ City ❑ Village [+¢Town Nearest Road UJI IsA oljo (� New Conshuction Use: [;3 Residential / Number of bedrooms 3 - y Code derived design flow rate S O d GPD ❑ Replacement ❑ Public or commercial - Describe: 14 Parent material v -�ura 5 h Flood Plain elevation if applicable ti General comments s)( 4--e M 1J 9(, • a 0 and recommendations: j4L.�_ -e it , QS G6 "'- '���}'0 y ` rr nol r '. 00UNTY a Borin # p Boring Pit Ground surface elev. D I ZONi G CFFICE Wl p9 `1' fL Depth to limiting factor iry..� i lion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bou " v GPD/ff'- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 •Ef#2 I ) r3 z Sit r C 5 Z 9 - 5" 3 ZS -48 .� .�0 D Borin # ❑ Boring ® pit Ground surface elev. 9 k, ro fL Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff? in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 I `Eff#2 I a —lb Z S" 1 cs S -E `f `f sit 2 .5 8 3 6 —) yr�lc� ry).5 — -- 7 / 2 Effluent #1 = t30D > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Pry — — Signature �� C Number cr G Address Date Evaluation Conducted Telephone Number 211 $0'`' I Property Owner Parcel ID # Page . Z of Boring # ❑ Boring ® pit Ground surface elev. 79 Yo ft Depth to limiting factor �d in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. i 'Eff#1 *Eff#2 In-I 16 r -:'J-2 S il Z r,r-bk m-Cr c s ) V- 5 • 8 2 1 15-'N 1hVr — SO I 2 mab rn r c 3 -Ibg 10 r`f _ m 8s F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft Depth to limiting factor (n Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 'Eff#2 Boring # ❑ Boring F Ground surface elev. ft Depth to limiting factor in. ❑ Pit Sal Application Rate i Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ` Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD- 8330 (R.07M) 1 Property Owner Parcel ID # Page Z of 3 Boring # ❑ Boring �,/ ® Pit Ground surface elev. / q / 9 o fL Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOW in. Munsetl Qu. Sz. Cont Color Gr. Sz. Sh. I *Efl#1 'Eff#2 d - I S r 3l — Si Z m4'r c5 1 Vf 5 8 IbV OILI — Sj I 2-,,,xbk yylfr c5 rn s s I — – . - 7 1 1-2- Boring # Boring El El Pit Ground surface elev. ft. Depth to limiting factor in. So 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 'Eff#2 F -1 � # ❑ 9 F1 Pit Ground surface elev. ft Depth to limiting factor in. Koji 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 'Eff#2 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = B013 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SOD -8330 (R.07J00) PAGE 3 OFD NAME S ��' LOT# 4' LEGAL DESCRIPTION SC �SF_ t4 ,S �/ T Z y ,N,R, 17 E(orl� SCALE: 1 "= f7 BM 1 ELEVATION /pc) • c) _.r BM 1 DESCRIPTION 4G p o 0. 4 1 .7- N BM 2 ELEVATION f3(. 90 BM 2 DESCRIPTION fi 1 �- ►-� Z ' �, e C SYSTEM ELEVATION QG •y y L ALTERNATE ELEVATION 9'S• a — CONTOUR ELEVATION J $. So X Ol t R ..A ■ 3'2 .3 t a Z 3 S SIGNATURE DATE O( Q 2 � t _ 3L. S - a Private Onsite 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 (POWTS) 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- 10567 -P (R.6/99). Table 1: System Des i n Specifications Sanitary Permit Number / Number of Bedrooms Design Flow - Peak pd ena Estimated Flow - Average ) 40 Septic Tank Capacity (gal) J. - Z Soil Absorption Comp onent Size (ft) Type of Wastewater Domestic Table 2: Soil Absorpitio n Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Com rent Desi n Flow - Peak �gpd) 464;0= h C E Maximum influent Particle Size (in) 118 Maximum BOD m L 220 Maximum TSS (mg/L 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and dean at least once eve 3 years Soil Absorption Component Inspect once 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 o #the se to nd outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filter hail be cleaned as necessa em proper operation. The filter cartridge shou not removed unless provisions are made to retair"o. s 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 standard s for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be 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 dogging of the soil. 2 CONTINGENCY PLAN rose a cods compliant If the POWTS fails and cannot be mpalred the following measures have been, or must be taken, W p rcptatement system: Jp may be utilized A suluble replacement area has been evaluated utilized for the location of a replacement $oil absorption and r \ system. The replacement area should be protected from disturbance and compaction and shodd not be Mtr1ne0 uPtm tsy required setbacks from exbting and proposed strymm, lot tines and wclbs. Failure to protect the replacement area will result In the need fora new soil and site evaluatlon to O$UNsh a sultable replacement area. Replacement systems rnust comply with the rules In effect at that time. O A suitable replacenunt area is not available due to setback and/or loll Itimltations. 8arrirtE advances in POWTS technotop a holding tank may be Instated as a fast resort to replace the failed POWTS. G The site has not been evaluated to Identify a suitable replacaltcdt area. Upon failure of the POWTS a soli and site evaluatton must be performed to locate a sultable replacement arta. If no rvplacerrunt area Is available a holding tank may be Insulted as a last resort to replace the failed POWTS. D Mound and at-grade soil absorptlon systems may be reconsovcted In place following removal of the biomat at the Infiluadve surface. Reconsuvctlons of such systems must comply with the rules in effect at that time. < < WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSIS AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TRIEATMJWT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A YANK MAY it DIFFICULT Olt 1MPASCIRI (- ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Ph*" his /_4 y Phone SEPTAGE SERVICING OPERATOR 1 LOCAL REGULATORY AUTMORITY AQ Name ;400cy 7 t✓ ro ' o n Pbnnr /S" - Monagement Plan for a Septic Tank and Soil Absorption Component Plantings of deep -roo ted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. 3 Jun IS 02 99; L?04 Chad ti l ee pA.;E t o FROM CM1.%%-4 F£AAYHEA.4Ti S4. CHAD (ATE. 06/1W2002 Tim $. a 3eE 34 AM A 16 r moax COUNTY Sp,p 7C TANK MAIN'ONAWR AORE SMBNr AND 0WNE',RSHIP CE3RTIMCAMN FORM Owmffluyer Kwom .T 0451 Mailing Address 9a�P e� epo . Ivhrros�y tvr s+vot Property Address (VeffWAtioa rcwimd frown Plaatimmg Depubeeme for new aoestcudion City/Stato �r� t. Parcel 1&. ifaratioa N..ber v '1- �_°r• -� �X Gwr. tNr M Property Lacatiou j I f , T-0 N R JI—W. TOWD of NNpsaJ G Subdivision Lot # -` Geadned ;3arvey map It _ Vowm - Par 0 wts routy Dftd N _ `,Z o voume 72 p # 3 y r . Sp haaw 0 yes l;1 lAt tunas ;doW6ttMIC Of y" a no SYSTEM HAmmm —c-E byaodk�rastes.>•iepet Impowarasaamal o[ barsr aa7►alesooaldaadtis *. - - � eassiat erpampieep oast 6c me0c stook eorory edwo.lm or •mo4oc if 000dedy s liomserl paapes. iVbat poi r e immo doe amt owber dig f CC Arr smpde ft* es a heeNetaaa shpt i . so wails dilpellit aratra. The paotecdy omm mpgo so sdmw to SL Oeta raft Depa*mmat a Owufi=dm Slow, WV" by the ewmw aow by a mmo ploa6a,. eim ieleApirmt - rj - �(!)asesdeo w�fEMa�adrtpOdt:�MC� b is proper epMft aram,&d t• s0WK (2) Surat 60PBCCM ewd pw t rawmar of Sepsc lark is taw dtaa In fou of shy wars, &a VmdmhwdkAw ld dm Amm aegwnmbms mad off=" amoit tk die paivaeo aa"ge 66pod Sydm wig dour . alt, � &ry i3e rt Qte;foa>eaao aadl tlss pepaetmuad et Natousl Resoanct�, Slide of Wiseotatia. t#ao aft-6m I h~s lr soa�t bg aod>tod /o d+e St. 4�oiae t7oamty T�i� 4�ios wi�sa 30 DATE tae) oa> * dRA on am ttoh Jacm awe bm to do bat of eery (oho) bwatedoe. I (are) em (on) die asmea(a) of abetre. of ty dew weadod is Iteswer of Deers 01 t:e. (W DATE — A"y WOUNWO&ft "h ss#- retptW -Vftd MY res alt k ells aoitW Pena Leiei w» V atod by *0 Zaft Dept la de& with ebb app' odeOr a ctiomped war><aaty bed freer 69 Et Ww of Deeds OW" a of ac ctni 5el ao m WV if IttercOM is atade is the warranty daod V igll n ° _f STATE BAR 01 4SIOWN FO&5 A998 Es 6 1 9 •x. WARRANTY DEED xATHLEEH H . MALSH REGISTER OF DEEDS Document Number ST. CROIX Co., wI RECEIVED FOR RECORD This Deed, made between 06 -17 -2002 12:30 Ph RTCHARD p STOUT and JANE'" R cmnnm husband and Wife, � � WARRANTY DEED EXEIPT i — - - - -- _ — _ _ Grantor, and KERNON J nnGT _ REC FEE: 11.00 TRANS FEE: 191.70 — " — - COPY FEE: _ CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St_ Croix County, State of Wisconsin: Lot , Plat of Misty View, Town of Hudson, Name and Return Address St. Croix County, Wisconsin. it l IGYV Leal 020- 1013 -30 -000 020- 1014 - ln -non Parcel Identification Number (PIN) This i s no homestead property. (is) (is not) Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Dat this _ 151 day of May n 9 1� S •S (SEAL) �t / - "� .. (SEAL) Richard O. Stout Janet P. Stout (SEAL) _ (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, S5. St. Croix County. authenticated this day of Personally came before me this 1 5th day of May 2002 , the above named R' -ha d O - Rt and Tan P Stout TITLE: MEMBER STATE BAR OF WISC pis .�r; _ to (If not, E M. BARRON me known to be the person S —who executed the foregoing authorized by §106.06, Wis. Slats.) Notary Public instrument and acknowledge the same. \ State of Wisconsin THIS INSTRUMENT WAS DRAFTED B Janet P. Stout 135 Awatukee Tr. /l'I Hudson, WI 54016 Notary Public. State of Wisconsin _ My commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary) ' Names cf persons signing m any capacity must be typed or printed belew their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.. Inc. WARRANTY DEED FORM No. 2 - 1998 Milwaukee, Wis. • 06/fB/2002 09:54 EDINWEFILTY 93818296 N0.840 902 2.00 LCW LOT IS 1Q3t' ',L'R>EVA7tQN�;,, .' '�.� ` _,� • q1 224• •,� � � NWT Oy!•�0, lf� ` i' •� !' � i � -. _ — _ ._ — — - �.''� -!' . \� LOT 11 i 2. EEL OF 013.00 bF R b0cFL p (.� ` a do Kom gWATpN Off••, T � •006.90 V, \ \. ''}' �' 1 , f. r y r a, NWL ! 1 I 1 + 1 i y i . �� �' � a'�a LOT •__ r 6'00 , �__ -•^ - 5..• _ 1apT $ t dT TEMPORARY .CUL -OE - SAC PA 003.00 06/18P 10:04 ED[NAREALTY 93818296 NO.842 902 Il or f r te;' •• � a a `•• ;. ... i ts WON OWN, W wa a _ i t t f f ! • f r