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HomeMy WebLinkAbout020-1435-04-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH iC~ PERMIT) 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 Fassino, Michael J. Hudson Townshi CST BM Elev: ~` ° Insp. BM Elev: BM Description: ~ ~ ~ /OD. 6 ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Ph L~ ~ a b~ Dosing ~ /~ W a~2 i,'~.(X Q~ *~ / ' l 7~'~ Aeration Holding TANK SETBACK INFORMATION TANK TO `P/L L~ WELL BLDG. Vent to Air ke ROAD Septic D~~ C ~ ~'\ / n ~ 0 '- Dosing Aeration Holding / V PUMPISIPHON INFORMATION of/~ s~ i,~,aF-~, ~~hc~1 Manufacturer mand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Lengt Dia. Dist. to ELEVATION DATA county: St. Croix Sanitary Permit No: 453132 0 State Plan ID No: Parcel Tax No: 020-1435-04-000 Section/Town/Range/Map No: 11.29.19.2704 STATION BS HI FS ELEV. Benchmark ~ ~ /0 2 ' Alt. BM ST /~~ Bldg. Sewer 3a 3 ~ -e~5~ ~ . 9 /' D 3. St/ 7~9 '02 . ~ SUHt Outlet T- ~. .~-, ~ / a Z. Dt Inlet ~- Dt Bottom Header/Man. / 00 Q~ O Dist. Pipe ~~~ t ~ , t % ~Gt. "3 Bot. System v!9 ` / [ 2, ~ (~ 8.3 Final ~ r~ i G J yf. ~ /~ /r7 ,oaf St Cover ' ~ ' ~ Ir~y z~ ~ d g~ 3 5 SOIL ABSORPTION SYSTEM ~L fi/nol/1( ~/~/--~.;c1`~// BED/TRENCH Width 7 Leng No. Of Trenc PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~~ ~ SETBACK SYSTEM TO P/Ls BLDG WELL LAKE/STREAM LEACHING Man _ INFORMATION CHAMBER OR yl Ty Of System: Ord` .r \' , , ~ UNIT Model Number: IBUTION SYSTEM ~vw ., ..i_ -Imo.-,„ n„,~~I- I ~~tJ Rw ~(~t ~. ~~~ Hea er anifold / Distribution /~ ~ /. ' ~- Hole ze / ~ X ~) r Pi x Hole Spacing Vent to Air Intak h / N a s) y ~ U ~ ~ (~ / Length Dia Length l~ Dia Spacing SOIL COVER ,r., t ,,, ,_ x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Onlv ~/cL C.~I.FiiywL~~~~"'` Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedfl'rench Ce ~, ~ Bed/Trench Edges Topsoil ~ Yes No Yes No ~ - - ~ WUw1' `3l 0 W ' COMME S: (include c de dis epencies persons present, etc.) Inspection #1: s/ 2 / ~ Inspection #2: / / Location: 1024 Labarge Rd Unknown (SW 1/4 NE 1/4 11 T29N R19W) Joshua Hills Lot 4 "` P ~elpNo~: 11.29.19.2704~D~ 1.) Alt BM Description = S~tj ~/(:~ ~~ ~ ~~'~~~ (~~~~'`~`~~"Q~,,~~~j ys'7~~Q~'~'`' 2.) Bldg sewer length = 3 ~ ~-~ 5~~~ ~i~%c-slit,/ C~Q.l~`"'~--- - amount of cover = ~ ~,{, /~ ~~~ Plan revision Required? Yes t~No Use other side for additional information. SBD-6710 (R.3/97) ~- --._....- - _ - - - - -- - r i2 Date Insepctor's Sig ature Cert. No. ~_.___. ~T_ - ~~-rt-- safety and Buildings Division -- ~ 2(;1 W. Washitt~ton Avg., P.4. Sox 7I62 ~ ,'s~~n~~~ + _.,.; Department. of Commerce _ ~ .. . . _ ~~ Cou[ity f .._.~~_ s~ ',moo .' k i anitary Permit Number (to be filled in by Co.) S ~S3 J3~ __. . .__._ _-. . _ Sanitar Permit A lic t y .~ ~~ ~ ~o~~ ~~ ~~~ Plan 1.D. "amber In accord with Comm 83.21, Wis. Adm. Code, per nal information you provzdc may be used for secondary purposes Privac I.aw, s15,,Q~~1)~:k ~ - L, ~~ .~ , C,h.)ve Ji)~~1 _ __ _ Project Address (if diffzrent than mai;ing address) (( ii Application information -Please Print A31 finformati .-~...•----~• _ .~~. !____ _ ~ ~ / ~ z t ^ ^ ~ ~ ~ E ~ ~ ~ hrt6~tK- ~~ ~'~-~ _.__. Property Owner's Na the m Parcel ,y of / $iock ~ .~ ~- . , ,ten __ _ ~ P ' T -•-~ `~ roperty Owner s M ailing Addr s property I.ocatitm '' 75--7 ~~ ~~t' . ~ 1/ Cit S ~-~~ C~ Y ~' ~ ~ ~~~ k,Sixtion ~ ~~ '~.~ y. tate Zip Code Phone {number ~ .,._ -y~ ~ ~ ~ (circle T ~q N R ~ ~ E W I of Building (check all that apply) / ; t> 1 or 2 Family Dwelling -Number of Bedroants Subdivision ;tame ~- PubliciCcunmercial -Describe Use ~` _ -- - ---- ---- - - - ~~- State t?w[ted -Describe Use _~_( 2 ~ e~-~s '~ _ -- -- , O -`J u- a ~------ f s _ 1~ -~~s ~ ._ - ?City-~~Village ownship ofe~'~„l1 IiI. Type of Permit: (Check only one box on line A. Com fete line B if applicable) ~~ . ~ ~ _~ e a~p A• -r New System ^ Replacement Syst- em r~ TreattnenVlioldingTa~k Replacement Unly `Other Modification to )rxistin S stCm g Y B• ~ ^ Permit Renewal ' ^ Permit Revision j ^ Change of ~ ~I Permit Transfer [o New 4 fist Previous Permit Number at-d Date Issued B ~ efose Expiration 1 Plum}xr Owner j r~r. T~ I . pe of POWTS System: (Check ail that apply) _ _ ~ ___ __ _ _ _ _. - ____ __ __ -._ I (~tnon -Pressurized In-Ground ^ Mound > 24 in. of swtabic soii L1 Mound < 24 iu. of suitable soil ^ At-vrade G Single Pass Sari Filter ~ J Constructed Wetland ^ Pressurized lr.-Groutzd ^ Holding Tank i7 Pea[ Filter ^ Aerobic Trtattnent Unit ~~ Racircnlating Sand Filter J Recirculatin S nthetic iyledia Filter .~,~ _ w,,,,_~ Y Jy.l.eaching Chamber ! ~ Drip Line ~' itrayel-less Pipe ^ Other (explaia) V, Dis real/Treat nt Area Informationo_ _ _ -~' '- -~ 17estgn Flow (gpd) Desi n Soil A. ltcation Rate(gpdsf} p s f ey persal Area Pro stem 1~)evati~~ "~ -" B Pp • persal area R wired (sf) pis ! G i am.. _ h ~ ~ .r__..~ ~ -___• ~Vi, •1'ank Info _ Capacity in Total ! Number 1lanufaCturerl _ Gallons ~ Gallons of Units ~ ~ ~(• ~ /oQ.. G ~ I'reY`ab Site Steet Fiber Plastic Concrete Cunstructcxl ~ Giass New Existing ~ Tanks ~ TatticE ----_ __• FSc tic o ni H _ p r o ng Tank ; F ~ ~ /~ / •~S'e v I Aerubic'rream~rnt Unis '- ~• -- T _ ___.~^.__. __ I ~ Dosing Chamber -~•----~__.-. ~._~_~._.._.. _ i _ _ f . _ _._ _ VII. ReSponslDility Statentept- I, fete undersigned, assume respotssibf_li_ty tvr ' allation of the PU1i'TS shown on the attached plans. Plumber's Na the (PrinU ~ Plumber's Si gnature M MPRS Number _.. t ----i /~ ;~ Business Phone Number I Plumber's Addre ss (Saeet, C i[y , State Z ip Code) -- ~'---- --• p ~ ~ ~ ,~ / 4'C ~ ~ ! II. Count /D~ cpartment Use O~ _` - ~ - ._ __._ ------ -, - r .~~ __ --. ~.~pOraved [' l Disapproved (Santtary permit )~te (inetudes Grouzxiwater ,~ ^ Surcharec Feei ' en Reason for Denia! _~_~ 2~ ~ IX. Conditions Approvall i - r - _ -__ D~ sued I sai r\ylent SignaNre (No Sn ~ , ~)~ ~~ / ~ ~, ^ - , `~ A~]~lt_ SYSTEM OWNER; 1 Septic tank, e~1u®r~t filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. Attach caatptete ptans iW tie County Doty) roe toe system ou pspKr not Ee~ thap 81/j x t 1 Ittt'bes lp 3ize -"`--"""~ SBb-639818. ~t /~~~ ,~~, ~ t ~ ~ n ~'' I ~l k a <<~~ r .I ~, ~'~ ~ -, ~~ I~ ,~ Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVAL~IATION REPORT in arrnrdanra with Cnmm R5 Wis Adm. Code 1319 Page I of 3 Steel Soil Service County Aitach complete site plan on paper not less than 8'/2 x 11 inches in s¢e. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. . . pending Please print all i orm yy++'°[[ --- ~y ~ t' ~ R • wed By Dat ~~ Lf5.04 (t) )). Personal information you provide may be used for ndary p ( 2c 0 Pro a Owner M~~ ~ ~ l Prope Location 2~Q n ,, Bill & Liz Fe Govt. t na SW 114 NE 1/4 S 11 T 29 N R 19 W Property Owner's Mailing Address ~ , , T ~'h Lot # Block # Subd. Name or CSM# GIX COU~!7 1026 Tanney Ln. ~(ar,,. ,, _ na Joshua Hills City State Zip Code Phone - City J Village ~/ Town Nearest Road Hudson (WI 54016 715-381-1240 Hudson Labarge Rd i~ New Construction Use: ~ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement J Public or commercial -Describe: Parent material Sream terraces and pitted outwash plains Flood plain elevation, if app licable na General comments and recommendations: System elevation 100.65ft, trenches spaced and depth to code 3.OOft below grade. ~ ~ FER Leo -' 9 C~ ~ Borin Boring # --j g ~..- i/ Pit Ground Surface elev. 103.65 ft . Depth to limiting factor 120 in . Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/2 none sl 2msbk mfr gw 2f .5 .9 ~ ~ 2 8-15 10yr6/4 none sicl 2msbk mfr gw 1f .4 .6 . ~- 3 15-21 10yr4/4 none cos osg mvfr cs na .7 1.6 4 21-50 7.5yr4/4 none Is osg mvfr gw na .7 1.2 . ~- 5 50-120 7.5yr4/6 none cos osg ml na na .7 1.6 „ } «~ /co . 6S 36 ~~z Boring # J Boring Pit Ground Surface elev. 103.65 fl. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Descdption Textun; Structure Consistence Boundary Roots GP D/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-14 10yr3/1 none sil 2msbk mfr gw 2f .5 .8 2 14-19 10yr4/4 none sl 2msbk mfr cs 1f .5 .9 3 19-120 7.5yr4/6 none coslms osg ml na na .7 1.2 ~ t * Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 3U mgii_ CST Name (Please Print) Signature CST Number David J. Steele~.:.~.~C 248956 Address Steel Soil Service ~ Date Evaluation Conducted Telephone Number 15(14 CR GG, New Richmond, WI 54017 5/14/2003 715-246-5085 (P ~- Page 3 of 3 STEEL'S SOIL SERVICE INC. !~ ~~ David J. Steel CST-POWTSM Lic. #248956 ~~ '-~~3 Bill & Liz Felling S W 1 /4,NE 1 /4, S 11,T29N, R 19 W Town of Hudson, St Croix Co. Joshua Hills, Lot 4 1564 Cty Rd GG New Richmond,WI 54017 Bus.(715) 246-6200 Fax (715)246-9372 Legend 1" = 40' Benchmark Ele. 10(~,QOFt To of 1/2" PVC pipe Alt Benchmark Ele. 99+SOFt op of U2" PVC pipe ^ =Borings Boring Elevations B1 = i03.65Ft B2 = 103.65Ft B3 = 100.O5ft B4 = OO.OOft ~ I 1 -,__ ~. ~ T [`~ yy ~.,,yj:i ~ ~ ~W, +~...~..,- ~r..vr.~~ 4°~ cz vaNl FSPE 1a~, ~rx. ~.~~~~ ~~~~ ~ ' e5' :~RO~± nOO~ FRESH AIR INTAKE ~: N:~(~W ~~ ~__ ~'{hTSHE rRA,T!E .«~~Lit.S wA': ER "I`TG `ri T SEALS ~pPROV~~ f~P~ ~~ ~I~TO S,7t,1 D i~aj. F~ MP v"rp ELEt~ , ~~F T , h ~~ t _.~... ~, ~E ~f A1"~?FRARO~F ~Lxc~xo:~• Bax '~Z"!'H CG2v'Dtl2T A PPRD'd iD N.AAiN~i£ ~G'J ~ W! PADL~?C.~C ~ WARNYNG =ABED . ~ r...1~ ~ , ,, GA S• i z + ; ~~ T,~GHT , SFAL ' + ; f ;. AI.M i ±ON ~ ~~ ~ ~ ~•V, t i ~" APPRCi~'~'D BEDDING UN3EA TA?~TK ,.. ~;,,;ECz~:cA: ~ :se`s aL':'7IC r ~OQE ' ~"A:VK ~IANJFACTJRER: 4,;NK SIZES : SE'?"':O DOSE MAI+7U~'AC'NRER: MC~AEL NJl'1$LR s SW2TCH TYPL: ~ -~ ~" CI RISER --~ ,~ ~ X 6 1 ~ ~` ~ ~ ,...~ i. ~ ~.,... -L't~.... GAL . dc~ GA. ~, . .+~~,~ s '„~ MAIVtJF'AC~'URER; --~ SWI:'CEi I''YPE: '° ~.Q':~iRED DISOtiA,RGE R.A.T '`~ ~ ~P4« ~P ~ '~/AFPROVEn JOIM'f'S wrth APP~QYfO PYF~ !~3{'y . }O~Ki1'~!?~ JViriV, SOIL, '~* RI'5ER EXIT P~.arsxrrE~ ax;,Y IF TANK MANUFACZ"JRER i~AS APPROVAL ~ON~RETE PAD h"~MBER DOSES aER DAY: ~l~/ .^.OSw VOJJ:~E S~;C~JDTNG ~`LUz~iBACK:~~~ GAL. CAt'.~ri:IES: A . .:i iNCI?E5 =..~.~iGfCi..,......aelL. 8 ' .,...,? Th'CxES ~ ~~GAi~. C = ...~..,, rNCHES _ GAL. D ~ • ~c,tC H ES = „j,,,„~GA t,, , PUM.r' ~ A:.~gx?rt ~+IRa hG AS EA i LHR 16. Z3' '~'A,^, ART*CAL ~~FFr`~i£!v'~:: HE. ~':INZM7J1"f NE~-ORK S6~pPLy PRES$LREGs ~`«AivD•DISTP:BtITTON PIPE !..? 1"EE:' ~a ,. FEET FORCAIN X ~ ~'~ FTl1~Q F:"" •fR:~ ~ .....~,..il~ FEET T c~N FA ;Tt1R FLrT T~0"°«qL ^i°NAMiC ~iEAt~ s r E~~ 'id£RNAi: DIM~`:,'S.t7tiS OE =t~'M? Th'ti'}:: '~wr~.~'^'" „~„'..~~ i.. 1 b ~1er7 :r C1rLt+ l ~G i~~ • ~: W EtiG T.y ----~--- ~ wI D TH --.-- ; D I MMER r---~ ... • ~- ~r~-~-••..,...., 5peoAipoyy deeip~c9 lot ~t E'~uait; Wh-etem~ .~ r ~t~'~iu1e'h nW . ~~~ y.• aim. ..~ ~ ~ toil Made: ~ b 21 ~ M~~eCttt t'ar' NPT. eau: wbon• ~111Y11~M , ~ai`i~j rontlnuoue f~J meet ~ «Me • Gt~ble ~ rvnnlrq to ~I: x'01 e~~ ayoebptry: ~ CeMo~ My m 80 dpM. ~ Tp~ MP to i1 Net • MM~f ede!~s• ~U~I~I~~IIDMIIIiY~~' ~e ~, ~il~~~r~ • wteneni: 300 ienee ~ ~ sleet, ~ ~ Mqa; C.a H? R1~Ot1f, dQ -N~, t 56p Y ~ r~R, 11014 ~t i to V8 ~ o++eee: 0.5 HP, buir n overion0 w~ M~ ~t n~c ~e0fd: sa roa ~, tdVS s~ro ~~ ~ ~nq ~ 8r5 SJ7W vetch tM~M E~AO~jf~O Dfu4 .~ • quay wb~ner~ ~ ~ grade t~rbMN Oil >~ tuOrioWan end Ml~ient Met trenefrr. I eldRare end ~1~~ w'wt d 71M 4M1ry. N~eri~i meclMr ~~ for °W~ wpn +oNOee • Melpr MOWI Ceet iron forte ~~ ~Oih. Mid dv ` ~ ~ ~Npnft~~hen k 1wMd-+~Chment read 4D' eno w~Nr +~letlira. ^ IetMr~t; DM mQ lower tw~ eartrg Y I~T1N~ ~ ~~ tCSA (1e11d n1e~ numbers end to 'F' ~ •,~.~ 4 ~~ ~ 7! aY1A1 ,__ STANDARD CHAMBER Qui~k4 Standard Chamber ~'+-- ---------- --- 52^~~ }~- ------ --- 48" - (EFFECTIVE LENGTH) ,~ „ l_` n T'~ l~ =~ 11~ ~~ i~ ~; ®l~ ~1 r, ~i SIDE. VIEW MuJtiPort End Cap FF?ON7 VIEW 1 ~i. ~l r r ..., .r:U S , ~,r J, ~Y", '~,r}° F ~.• ~~'i;,;q~t~'r6'~ ~~ Quick4 Standard Chamber Nominal Specifications , Size (W xl x H~_ `34" x 52"x`12" l:ftective Length - _ 48" Invert Heighi g° r~ t •~j , r ,r~~;l i t~ ~i~,~ ' _~I-, sIDE vls=W TOP VIEW Multipart End CaQ Nominal S ecift ailons Size WxLxH 34°x16"x12" Invert Height. 8" or 1.25" INFiLTftA,TQR_SYSTEMS. INC STA~tDARU LIM17~D W~~QA_N~Y tap h sI ucUnat ,rt yrcly of each chamber, end plate, wodga 3ni ONx+r acc(sa'Or'y manufaettxad hY hd gratu• ; 'L1N6`{. wl~en'nsl7Netl a, ui Otl9r9l?2t ' le'v.hf.ln of , o^cRa srtohr. system in axordanoe wi!n of Itfatc;'s mslructia,s, i, warrauad to the o+y",a{ D rh,+asee ('Mntdar' agansi rkif9~~frw ram„{tes~,'uc. Dort wv;kma++s»~, for .art9 year From the tlete lhdt (l1a seUlN; pP,rmil L I>gUed IUr ;tla gpp,+ir cvS19n1 cGntadunr] Itvr I hlkt~, ptovi[Ier!, hoi{+!ver. that ifa seplk pertnN is trot requred G appkatda law, lhs Wanan:y praiM w,li 4egrn tlpon th9 dale ItH` ~n5ta1alion of rite septic system riJmrnerrc:76~ ~.+~ a t!rrr..i59 its wan3nty riglHs, HpMar must nGti!y InNliralq Ir, vriting a? Ns Gtirporgte Heddgl:•8rt9rS 'n .,`d SaYbr(gk, iAnr43cf~ut within !iMean (15) day, et the a119~ed datac4. InNNrator will Supply ~ra]lacrameni UnNS for VNts de!erminrxf hY Inliltralu to hs co+Rr9d h`Y rh,i6 ..united VJarran!y IngNtatpr; Irabliry spar:;tialty exchlda5 tha r.dsi of rernpval antllOr inslallahpn o"he 11nN5. (1;.) 741 Ibil. fC WAHHANIY AND F'cM[t71[S !N SUDFARAGRApFI fat APF e.%ClU:iiV tlk-F!= Atli- NO OfHEtd WARRANI1ES WITH ,ESp[CT TC FH~ JN+Tr, i`JG-I (DING `;01HIPLiED Vr~ARRANTIES l~ eAEFCHAFlTRDIU"1' OR ATNE3o fpR A ^PitTiCrI,A1~ pUSf'(`,SE- (r,) l ftl:. ~:r rated Warran','r shall be VOW It amy part oV the chamber System is nn,rutarlr:red hV anywta other Ihart InlMralru. Fhe '~ imired Warany does rxtt aelat.,d to %ncd9nlat, cDrlsequanlia!, sp9ck31 or lndirecP danages. r~tBtrator yr„~rll not t tqt k, In osnanws or liquida~rd d?rnaRe: 'r r~hrdrr q ,us6 of prod rhor and r,rOfits, labor and rnaler4als, wernaad costs, or Cthgr brses rr axpa+ses rnr,r; r -spy au Holder or any thrrc 0.=etv Spe.;NrcalW e.*c'~udsd hem I imiittl Warranty cxworags am damaga to the Urvts ckle to onllrtary wear and tsar, aNeration, acr,;dent, m;wse, nhrse cr naglact U, the Untls; 'ha Units 6aing subia:ted f~ vahickr iraNrc or other mndilk,ns which a+a no! psrniMW by !I"i install&liDrr i•rslru-.tkMa. railum re maintain the minimum grt urki :b•+ars v±l ICdh to Iha inatailaUOn instruClldn6; tha plar_ran~t Cf impnipn+ m~31w'dti info thv, sygtCnr ttxl[aining tlrn Unlcs; faittre of Iha Unts o the t>epllc s}5lem due to Improper siting or Imprapar cizirs~, ez~sf+va wa'er ace ..,prupor gma:>A°. cFaFr,sal. err imtko"er ppar Iron: W nm orwa ave..t not cauaerl by IM;Iirator. This lnnNerf Warranty Walt b9 void it Iha ,Holder ri' is ; OnpN wryh al! M L'~e terrrrs set to h In N+is i)mitatf Wa ty, F,r• ,er in nn e+s~nl ,hall InNllmlor ba respnn6ibk lur any loser cr damage In R,,^^. Hdhder, the Urrils, or any IrnM UFlny Esltfrr Inxn rn5talation cr ship- mry,l ,r t ern any product l;a+~lgy afa+n5 0l Hold9r a any ltdrd ty3'.y. For this Lhr~atl Warranty tc appy iha Jnhs must ne mstallgd at acmrrlarze wrh e,A sr`a r:a,dlNrns required by sist9 3^d ideal codes: all What ;tppfcahe laws; anC Intiltrata's instaFai'i"l fislruulrcns. 4n Nn 9LVescnta'I.~e OI Intl7tta:gr has the :111t1',()nIY (7 changn nr axlend this L rcniter' Wartenly NO W9rrani4 at?t1'ue,^. 10 arty a.']rty Othnr !l,a,, rh9 Orig:~ na Nov.cr. "!n ~ tu7 r repro6e Ns ih9 St T1Ck]rd {,imNeri W;n'ry,tY uNaad by IrN!tratrx, A'imitaf number Cf stalFS and ccuntme ha.„>; d!tlc~rent wanenty rarnrlre- ^.tar Is A- y Per:+:aser ul Units shr+uld ccnl.3ct Intl{tratx's ;,urpcra!a HsadnutMare in r)f.t Sa'rtvrx-9c, Cp'rSetYicut. i~rior'C s,.rrh purcyatr?, t0 Obtain a cot v he af~fNicable warrafNy, and shot+ld GaratUlly rand that Wa+renN pgpr b the cun. hose ut Unes •~ ~• SY~T~MS INC Environmerrta/ Onslte Wastewater 5olutrons`" 6 Business Park Road • P.O. Box 768 Old Saybrook, CT 06475 860-577-7C00 • FAX 860-577-7001 800-221-4436 . .., .... ..,~., ..,.;,r r,yrrr, o,r r^ tar, aacsu,rYn, :7,21J•J,tl44 lanadlanaaferts 1,39,959 SJGA,Sf~f ~lherpatentspsnd!ng. Irh!.irator Equauzer and SideW:cder are r.;yistered trademarks of lnfiltraior S}5!aTts it+;, k;filiratnr is a mglstefed tradrrna~k in trance. Inftltrahu Systems Inc. .: a regis'era;i trademarK in Mexlco, Contax. Contour Svrvel Ccnnecttnn. Ancro~aachh,p. PoyTi,N, 5~,.npts,ck. char.,rorspaoer, Poai~ock, CZuickCUt, Gtu=ckPlay ^~ ~~~~A a~~d Ov. is4 are :rademarks of In6Aratnr bystams Inc, ®2G03 InhNrator Systems Inf.. printod NI U.S A- QO7 t203HP-U SECTION VIEW POWT3 OWNER'S MANUAL. ~ MANAGEMENT Pi.AN Page of . ~.sa~l~ Owner S3 l~ z- OESIQN PAt~AMSTLRS Number of f9edrooms '~{ L7 NA Number of Pubgo Facility lJnits h ~ NA Estimated flow (average} __._. al da Design flow (peak), #Estimated x 1.5) ~/~ d aUda Sop Application Rate al/da Jftt Standard Inf#uentJEffiuent Quality Monthly ave rage" Fats, Oil & Grease (FOG) S30 mg/L Biochemical Oxygen Demand #80DB} 5220 mglt. L7 NA Total &uapended solids #T5S} 5160 rttgll Pretreated Effluent IIwallty Monthly average Biochemical Oxygen Demand #BOD6} s30 mglL Total Suspended Solids #TSSi SSO n'+g~ ~ ~ Feca! Coliform (geometric mean) X10` cfu/'i00m1 Maximum Effluent 1>artic[e Size 3~ in dia. C3 NA Ocher: ~ NA "values typical tot domestic wastewater and septic tank effluartt. $1rST~M SP~4rrwH ~ wnv Septic 'Tank Capacity ,~ ~ ah DNA Septic Tank >tanufacturer ~ NA Effluent Fitter Manufacturer ~ ,~ ^ NA Effluent Filter Model d' C~ NA Pump Tenk Capacity al ~ NA Pump Tsnk Manufacturer r~~ v~'Y C7 NA Pump Manufacturer t„~,u 1 DNA Pump Made! ~ 0 NA Pretreatment Unit ~A ~ 9and/Gravel Fitter O Peal Fiber ^ Mechanical Aeration ^ Wetland ~ D~infsction O other: alapersal Cell#s} ^ NA 1~tn-Ground (gravity} Q ln-4fround ipressurizedi ^ At•6rade L] Mound © Drip-i»ine [7 Other: Other: NA oth.r: A Other: ~tJA MAINTEtI}ANGE SCNEDtJLE Servile Event Se rvice Froquenoy Inspect condition of rankle) At least once every: 3 ear s) s lMexfknum 3 years! ^ NA Pump out canterlte of rankle} When combined lrludge and scum equals area-third (Ysf of tank volume ^ NA )nspeat diapsraal cells} At least once every: 3 mort~(s} (Maxlmuln 3 years} ex(a} Ci NA Clean affluent filter At laser once every: .l monthls) ,'0'° arts) Q NA Inspect pump, pump e:antrols S alarm At least once every: ..---- ~~ si O earls} O NA Flush laterals and pressure test At least once every: ~--- ~~ial ® aerial DNA Other: At least once every: ..._ ~ ~~(s} ^ NA Other> Q NA MAINTENANCti: INSTRU CT10NS tnspsctiona of tanks and dispersal ceita shelf b® made s,y en individual carryMg one of the fotbwinp Ilcenaes or certlflcattons Master Plumber, Master Plumber t~estricted Sevvsr; PQWT5 Inspector; POWT5 Maintainer; Septage Servicing Operator. Tani inspections must include s visual inspection of the tankla) to identify any missing or broken hardware, identify any cracks or leaks measure ihs volume of combined sludge and scum and to check for any back up or ponding of effiwnt an the ground surface The dispersal ~~~iis} shall bee visually inspected to check the ef#iuent levels in dte observation pipes and Lo check for any pondinl of effluent on the, ground surtace. The ponding of effluent on the ground surface may indicate a failing condition and requires thi immediate notification of the local repuistary authority. When the combined aocumuiation of sludge and scum in any tank equals one-third iY,} or more of the tank volume, the entire contents of the tank shaft be removed by a Septage Servicing Operator and disposed of in accardarws with chapter NR 113 Wisconaks Admintstrativa Coda. Atl other services, )nckiding but not limited to the servicing of effluent filters, mechanical or pressurized compor:ents, pratreatm:irn units, and any servioinS at intervals of S72 months, shall be pertormsd by a certified POWTiS Maintair-ar. A service report shaii be provided to the local regulatory authority withac 10 days of compiotion at any service event 'apo~ enlieJislulwPd ulsuoaslM'!E1 S lL} '11109•£8 pUe Il1~BCP34i}iglitltL'68 u,u,o~ Jeideyo y3lM eoutrydwoa ul ps>leJp eeM weuxaoP s!sli ~~ °~ euoyd 1V 1(~ ,, •~N AtlaflHtfil/ AaO1M"itiE?3a l~'OOl Itl3dWfldl aOJ.V!l3d0 OfMI~l/1a~S 31DV1d~S euocld eweN a3NlV1NIVW 81MOd '~ '~ " ~ ~ ~ ~ euayd a~'1'lV1SN! 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Subdivisisn ~o~ Certified Survey AKap # ,Volume `--- ,-Page # VFarranty Deed # ~ 5 ~ 6 ~~ .Volume ,.~~5~~`~,-, Page # ,~,~`• Spec house ^ yes ~na Lot lines identinabie,~ yes ^ no sxs~Md~~xANCE Improper use sad maiateaaace of your septic system could result is its pretaature failure to handle wastes. Proper maintenance carlsists of purnpiag out the septic teak every three ytars or sooner, if Wended by a hceased pumper. What you put into the systera can affect the function of the septic tank as a treatment stage in the waste disposal system. 7'he property owner agroas to submit to St. C:raix Zoning Departmtnt a certiScatioa form, signed by the owner and ty a masterplumber, journcyrnanplumber, rostrictedpluxnbex or alicensndpu:zrperverifying that(1) the on-site wastewaterdisposal system is in proper operating condition and~`oz (21 of per inspection and pumping (if accessary), the septic tank. is less than 1~3 full of sludge. owe, the tutdersigaed have read the above requirements sad agree to maintain the private sewage disposal system with the standards State of Wfsconsin.' Certification set forth, herein, as set by .the Dopartrraent of Commerce and the Department of tJatural Resources, stating that your scgtic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. _ ~~ro ~ DATE SIGNA ®F CANT (~,WN~'R Ci~~tTIF CAT I (we) certify that all staterrrents oa this form era true to tY!e best of my (otu) l~ot~rledge. I (we) am (are) the ow~er(sj of the property described above, by virtue of a warranty deed recorded in Register or Deeds Office. ~ 1 r ©~' ~'v3'~'`~ DATE SIGNA OF CA.N"T Any information that is nzis-represented may result in the sanitary per~ni? being revcked by the Zoning Department. * * `*'" * **+~r~* ** Iaclado with tWs agpllaatlan: a stamped warranty deed f~om the Register of Deeds office a copy of the certified survey map ii reference is made in the warranty decd s'r cIt©Ix.cot;~T~' SEFTIC TAtiK :~1AII~'TENANGE AGFcEEMENT AND OW';~IERSHIP CERTIFICATION' FCRM ~ ~53~P ~f95 STATE BAR OF WISCONSIN,FURM,~ - 1949 Document Number WARRANTY DED+ D This Deed, made between William J Felling and Ri;zabeth E Hurlev-Felling~)?and and wife Grantor, and Michael-J. Fassino and Marv C FaSSino husband and wife r-- - Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee ttte foftowing described real estate in St. - County, State of Wisconsin (if more space needed, please attach addendum): Lots 2, 3 an 4, Plat of Joshua Hills In the Town of Hudson, St. Croix County, Wisconsin. ~- 757688 KA'CHLEEN FI, 4iAtSN REGISTER QF OlaED5 ST, CRO I K CO. , M I RF.CEIYED FOR RECQRD 03/26/2804 18:80AI[ NARRAMTY DEED EJlEMPT # REC FEE: 11.00 TRAMS FEfi: 810.00 COPY FEE: CC FEE: PAGES: 1 Recording Area ~/' r"G'' et~urn~Address ~!- 020-1435-OZ-~Q,~(„~0-1435-03-000, 020-143_$-0¢400 Parcel Ideatification NumEer (PtN} This i~ not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ay of larch - _ _ , 2004 AUTHENTICATION Signature(s) authenticated this - day of ~~t~s~~~``,~~' V-T ~ ~-- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 7Qb.Ob, Wis. Slats.) THIS INSTRUMENT WAS DRAFTED BY ) ss. - 1~ _ County ) Personally came before me th' y of March the above named William J. Felling and Elizabeth E. Hurley-Felling, husband and wife to me known to be the so (s) who executed the foregoing inst t~nent and ackt9o IeAggq the satno. _ -v ---- Attorne Kristine O land ' ~.~._ r --.____Y. _ ._ - - ~_ ------------- ---- ...- -- --- -~---~-- .,_.~____- Hudson, WI 3401G _ Notary Public, to of My Corttmi~slsion is rmanent. ([f not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ~-t~__., ~ •) Names of persons signing in any capacity must be typed or printed below their signature. information Professionals Co•, Fond du Lac, Wt 3TA1't5 BAtt OF WISCONSIN 80b-ti53.2021 ~{,A~p~y IyRRp FOkM No. 2 -1999 ACKNOW LEDGME'N'f STATE OP __ __ _ ...--_ _-__ .. __. ) \ R ~ H p~ z ~t `~ ~ J ~r °~ j ................... ~ ~Z U ~/ ~ ~ ' - 97.97 ~ ~' ~ ~ ~ ......••• -~ G~ $ ~ ~ ~ c~ ~ ~ ~ --~..-rr; ZAP ~~,.fG G 6 S 5 ~ .~ ~ O~ ~ ~ \ b YZ \ ~ .~ ~~jj ~ H ~~. {~~.I W {7.1 N ., o ~ ~ g ~ g ~~ v ~ M w ~" ~ A `-, U ~ O N N O O N N O ~ N a0 I ~ O ~ ~ j ~ ~ ; ~T pl ~ al - ~ o ;13~ MM ""~~\ pw~ ~~ ~I '° 3;N H o' = o ~ v I _ -_~ -_V~J oZ CSI // o , 8 QI// ,90'£52 -+,L'9 ~ I A9'6L ,8S'£L l .58'5£ l / ~ I ---~c----mac / u I ~'O ~ 9 3.~O~50bO0N ~ I , ~ ~ T 1 / QI ~I I _ I / ~' I I __ OI I ~~ b0~1 I ~~\ di I ~~ I \\~~ I I OI ~~ I ~I. ~~ I I ~ ~\ i - - ~-