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Home My WebLink About020-1378-08-000 ~ n ~ m a, o ~ < J ~ ~ 7 (~ I Na3 0 0 W ~ A , C ~ O m I N Z D m co D y I ~ n ~ ~ ~ ~ ~ L I I I o ~ ~ =+ I ~ ~ c c 3 I a 7 I ~ N I a -. ~ 0 ci 3 I y^=~ W 7 ~ ~ O ~ O O N ~ O ~ ~ N w ~ N C w 7 fD ~ a' o m m ~ I ~I ~ ~. I ~ O 1 N . ~ I ( D ~~ I \eAi ` -~ v I v I I ~ .v~n.m w y °. a I ~ o vm ~~~~m ~~y~mm m ~ , n ~ < w y d ~ 3 3 o v, ~ 7~~ N d y N rSN as c ~ ~ ao I I m °m ~ Sri O ~ N . m a~ ~ ~ ~ I _ ~ ~ ' m n ~ wmy., H ~ K ~. Q O ~ ~t-p .C 3 o ~ ..o w a y ~ ~O m +~ ti ~ ~ N ~ I ~ O I o ~ m I c °o ~. f 7 W 3 ~ A ~ ~ C7 ~ ~ ~ ~ ~ r ~ ~ ~ , gin :. ~o o ~ O ~ ~ A n a N Q N ~ ~ ~° J ~ ~°~ ° Nww n A ~ O W C V O ? O ~ r. ' 3 fA C N ~ ~ a ~ a J ~ ~ N ~ O O O O l~ l1 ~ * ~ ~ . !r ~ 3 ~ O O O `~ ~1 d ~ ~ y N a g ~vvv ~ _ ~ N ~ ~ d _ ~ ~ 7 ' -' ~ 3 ° ~ ~ n cc ,. Ui „ cD ~ = c T S 7 Q n c '~ N~ a 3 °' AZ a O T ~ J ~ M d 7 A (Z 7 W ¢ N W a ~ ~ z ~ O ~ O ~' fA ~ m C W Z ~ ~ A c a 0 A b A w O O W b ~' 0o e A ~ 3b ~ p6,,,'s ~ Ne` . ~~- w ~~Ll .,a,,,~.,~,;-E- ~~ ~~s ~- fie. e~ . 30~ W R.NE Supply Inc. Hudson, WI 386-5525 1-800-325-5675 ~!* f Wisconsin Department of Cpmmerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s~5.04 (1)(m)J. Permit Holder's Name: ^ Cit ^ Vil1d e ^ T n of: P.C. Collova Builders, y Hudson piownship CST BMElev.:- Insp. BM Elev.: BM Description: b q . o r (03.0 ~ re CST = S(.~.- .~- Io;~ TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY Septi ~ 7 ' `~~ Dosing ~ ? Aeration Holding TANK SETBACI(INFORMATION TANK TO P/ L WELL BLDG. vent to Air Intake ROAD Septic ~ NA Dosing NA Aeration NA Holdin PUMP / SIPFIUN INhUKMA 1 iUN Manufac r Demand Model Number GPM TDH Lift Lriction stem TDH Ft cemain Length Dia. Dist. To well 3) SOIL AB~QRPTION SYSTEM l 3 .L l3 ~ 12 ~ ~ r~ eiwi,l~i~G_~ TRENC Width ~ Length No. Of Tr ches PIT No. Of Pits Inside Dia. Liquid Depth DIM 3 3 DIM 1 N SYSTEM TO P/ L BLDG ELL KE STREAM LEACHING Manufa urer: r ..~,, ~~i~l~ SETBACK INFORMATION TypeO CHAMBER OR UNIT el Number ;t System: ~~'~^'v . _ ac ~BISZRIBUTION SYSTEM ~'s ~) ([ fi / ~s 4:'~,r,2~.ec~? ahr ~a~~ c~- ~a ~~~ Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No CO~M~NTS: (I ~I de ode d~SGr p C @S, qe[s l~r a ill'yc°~l~ll'rl' r' "'L'' "" 111ov.,V~1V11 rr~.. Location: lOZ~Moon~eam Roact, Hu~son, W~~4U~~ ~ SE 1/4 12 T29N R19W) - Moonbeam Ridge -Lot~~8 ~,~~Q~ 1.) Alt BM Description = ,(~, I, •~`~~ ` c~' '"_ ~ 2.) Bldg sewer length = ~ ~~~, ' [ p S !-amount of cover = y 2 • o ~ y t ~ I a • `F D =9~ ~' - 2'~~"~°` ~ Plan revision requi d? ..Yes ^ No ~ 2 v , Use otf`i~er• sidpdpe for addnitional infor ation. 0 lah f~'~,~.~.V C~ s~t~ Date ~ D-671 (R.3/97) C ~ r~ ~ t,^ • N ~-~-~'~ t° yi-i l ~'.-st- ~P+rue,~t`.~. s. STATION BS HI FS ELEV. Beng~I~~V1 O•°f-.~ /03 /U3,0 ~~~ ~d~ Bldg. Sewer t~.S --~ St / Ht Inlet y$.g~ . ~ qY, c~' fit St/ Ht Outlet ` S• to , ~-fi r Dt Inlet Dt Bottom Header /Man. ~-- Dist. Pipe Bot. System ~~} ~ ~~~ 102.,37 2, c(b-LS ~-~, Un Sdc..~ County: St. Croix Sanitar~P~Sr~it.No.: State Plan ID No.: Parcel Tax No.: OZO~ [32'-68- nao 12~2..q~L9, 23`l~ S.~o:.9~F8 ~ Inspector's Signature ~ Cert. No. N• rcw.s,..~ ~rece,v~0. N~,s"7w~~± `YC~v~Q SOIL COVER" x Pressure Systems Only xx Mound Or At-Grade Systems Only ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: L ,:_ r " L(p BBrit. ~ARltar•ti' PermiC ApnitCatton - i Safety & Bu'sidtngs Givts,o ,~ In acct*~ +~,t%~ Cortrt 83.21. ~';s Adm. Code 201 W. Wasiaington A.vt :+ee revtrsc s~d~ far instructions far cor^ple~in thss a h~~at~on i PO 13ti~x ?30 ~ g pp Madison. Wt 337n7.73C a~a~~~~afi~S/l~ j Perser,al inforr.~ation you provide mad be used for seconder` puraoses I 1Sunmit completed farm to cau~u} iCr i (Privacy LaH s. t 5.04;1)(m>~ , state own. •~. ~ .~•..., nn .•e.~wr not . ! /2 ~. 1 1 inches in s te Sanitary - •ntit Number . i7 Cheri:-+~'•l~is~ott•+~rn'iouc application - Cau . -~~ _ •S t/t ,State Aran f. A. Number ,~ . . I. A lic~tio Information - Pieast Print ali Information Locatifle: R~?r canes Noma v t ` Property Location / / "~CE~vLo 4~ _~- +t~~Cld ~~. ~~t ~'~/~~ ,?'° ~ ..~GJff4,~F 15.5 To? ti. R~ or PropertyUwner'a Meiling Address T- -- -TT r l• Lot Number Stack Number .. ry, 5tete Zip Code .. Pho ~ ~~ Subdivision Neme or C5A4 Number ~" [[ G'.tC~ $J' ~Q l>% ~;' IO~I}h~CaFF \i f.~ ! ~ ~a N'~ ~. ~ .1L II Type of 1?Juildink: {cheek one) ~ ; ,. , . ~ ~ I or Z Family Dwelling - No, of Bedraoms:,~,_ \` ~, r {~ ± ; ~~ ~ o City ~owngar 0 Public/Cottunerciai (describe use): r<d~.~S>,~J O State-owned III Type o!* Peraait: (Cherie only one box on line A. Check box on line B if appiicabie) Nearest Road ~o~ ~ ~ A) 1. ~iew System ~. C1 Replacement 3. O Replacement of 4. Q Addition to Parcel Tax Number(s) ~ - S em Tank6nl £xistin S stem oaa-iers9o-~ 8) Permit Number a zo _ i37,~' _ 0 8 -ocs o bate issued D A Sari Permit was revious! 'issued /Z - 2 9 . ~ q -' .Z3 Y rv Type of PC-wr syetemt {Check aIi that apply) !~ -300 ~1on-prosautzad ln-ground 0 Mound ^ Sand Filter d Cottatrvcted Wetland D Pressurized In-ground ~ Holding Tank lD Single Pass O Drip Line ero~'c Treatmem 'nit O Recirc' acing D Other: A O At-grade ~ ~ ~ 3 x. 1 i ,. - _ 3 V Die erslaUTreatntte ttt Area lnfornnaiion: !. Daebgn Pbw s a~, iapersal Area a. oil r~pplietttian S ereoluuxs 6. System levatian 7. in rode . AJ MtnJineh} o e ~~tia~ R~ulro (-25kt' Propn°•~ ~ Rate (Gals.! y/ d 2 VI'faak Capacity in Total ~ of Manufacturer Prefab Site Steel l+iber- ~ Plastic Iatarttaation thllons Gallons Tanks Con• Cott- ~ g?ass '~tw Existing crate structed Tanks Tanks ,SC f~ G .,~~ ~~ ~.l~gtrvrJ i ~ VII Itesrpont:i611ity Stsittement +~ wsd assume a onsibilit for installation of the POWTS Shawn the attached lens. t Name int Plurrtbar's igrtatwe (no atampa): P a. Bea nua Phone Number yll.`a/ac S~:liu.ma~t~ ~!S-3~G^321 ._,..... Plumber's (Street. icy, ~ tp 'r) `7 ~ N mot/ rw (/ VIII Coupty/Department Use Only O Disapproved 5anstary Permit Fee Qactudes C,rau water ate (sorted issuing Agent Signature o stamps) ~I,Approved , O Owner Given initial Adverse Stu a~ Fee} ~0 0 ~ -25-? ' . . Determtnstion S T~K. Conditioiae of A prove! /lieasoae for Di~napproval: n _~ C~ ct~_ ~.,, ~ ~ ~jp~^^q : S regcu~l61 B.h. ,r:,.tn~-- ~ -~o vomit ~~ rv~,S~ ~ rn,0.,,w~;a.(,rna~ as ~ axxa. l~'~ «-- s ~"' (~, 2 ~(,`~z ~ ~ G Zf Z' ~ ~ x s ~~ SBD-5398 (R 0"1100) ~ 3~ ~~~' - -- } ~3 ~'i ~ n P p p ~ ~ A ~` ~ ~ ". 4 R Q 0 ~ ~ 9 t ~ 0 ,~ \ ~~ I~ I "J ~~ ~y, ~ ~~~.~ ~~ ~' ~ _,-. ti~ scan:; . u~i wur~uiu u. Vonrm~rce SOIL NIVU SI-l~~ LV~1LUIt1'('IUN D(vislon of Safety and buildings bureau of,lntegrated Services in accordance with Comm 83.09, Wis. Adm. Code .. Attach complete site plan on paper not less than 8 1/2 x 11 inchss in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ~~- LyZL ~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. It Page ~ of ~_ APPLICANT INFORMATION -Please print all informatior>r. Reviewed by Date Personal intormatioo you provide may bo used ror secondary purposes (Privacy Law, s. 15.04 (1) (m)). L Properly Owner '' Properly Location ~~a _ C.U ~ ~'~>~`~il Govt. Lot Sw 1/~~ 1/a,S (Z T Z~( ,N,R (C{ E (or)~ Property Owner's Mailing Address Lot t1 BlockN Subd. Narne or CSMN City Stat Zip Code Phone Number (~ City ^ Village ^ Town Nearest Road r ~Uh~e,n7 i L.vy- i ~ •/c~/G I (~/5 )S~/4- S~r-~ ~- 1-1.,ti~-,-~, t ,,,~ ,....~ >-.. ~....,, If ,.! [~ New Construction Use: Q Residential / Number of bedrooms 3 - ~l Addition to existing buildiny ^ Replacement ^ Public or commercial -Describe: Code derived daily flow _ C30 gpd _ Recommended design loading rats _=bed, gpd/ft? ~ _~ trench, gpd/f t2 Absorption area required ~_~Lbod, (t2 7 s ~ trench, tt 2 g g ~ bed, gpd/fh ~ Irsnch, gpd/fl2 Maximum dosi n loadin rats _= Recommended infiltration surface elevation(s) -{o P Q ~ • 7 U Lcrw z r 9' U• U ~ It (as relerred to site plan benchmark) Additional design/site considerations ~~0~-f 4 G• CJU ~v wtf ~Cr• C3 d Parent material _ ~~'}'w G- S ~ Flood plain elevation, It applicable _ /U !~- ft S Suitable for system Conventional Mound In-Ground Pressure AT-Grads System in Fill t-lolling Tank u = unsuitable for system [~ s ^ u [~ s ^ u Lt's ^ u [~'s ^ u ^ s ~ u ^ s [~ Boring # ;- ,. . ~4 Ground elev. 9~~ft. Depth to lirnlting factor R ~._in. Boring ## ~; ~ ~~ . ~;~? Ground elev. p'S.90 it. Depth to limiting factor ~In. SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mollies Texture Structure Consistence Goundar Roots GPDlit2 tn. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh• y Bed ,Trench Z 12.-6IL O ~# ~ ~~ ~ ~_ ~ ~ 1M.t r LS ~ S 6 .~ 1-C . • 1 O t- ".. 1M.~ CSC !mil ( ~- ~ ~ ' t~-_ Remarks: Remarks: CST Na11me (Please Print) / Signature Telephone No. t'K~#11 <~~li)Il'~'r ~Cc'r'• ~- ~~~/~ ~'~~~'" ------- --•----- ---._._. (1~~,-~~_` _r ~~ Addres~sj , ~~ CST Number r PARCEL I.D.q Depth to limiting (actc~ lCJ in. Boring rr ~: ri. ~} Ground elev. It. Depth to ~~ limiting lactor i Horizon Depth Dominant Color Mottles Texture Structure Consist nce B d R ots 2 in. Munselt Qu. Sz. Cont. Color Gr. Sz. 5h. e oun ary o Bed ,Trench ~ az lo. ~ 3 ~ I ~b -, w. ~~ _ 1 t- F ~ ~ ~ Remarks: 1 0 -to I ~ ~ I S. a~ t% tM r- ~_ ~ y ~ ~ ; E: ~ V-4Z, I U 4 .L ~~ ~.~A b ~ t~ t= ~ ~.S - ,~ .~ 4 2-w I~ y R y I b . w~s ~_ ~~_ _CS-- - ~- '~ Remarks: Horizon Depth Dominant Color Monies Texluro Structure Consistence Bounda Roots GPD/ll? in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench 1 ~-I i~R3 ~ .5, z~b~, i~~~=Q '-s 1~t r- sY~ Z lt was ` 4 `~ 5 ~ Z,,.~,~ti ~, t~ r, ~S r ~ ; ~~ _ Remarks: n. Remarks: SBD-8330 (R.9/98) '' PAGL:_~ UP -~ NAME C'O~ ~0~~ LOTH C~ L[iGAL DBSCRIP'I'ION~•~.d'/aSt='/~,S ~Z~'Z~{,N,R ~~ G (or) 1;N'~ SCALE: 1"=`~~ - --_.-- 13M ! ~a.EVA'I'ION- _ f~)_v __ ' I3M I DLSCRIP'TION I~c4; ~ ~~~ ~ ~ e s f=(a . ~'`~ f~.~-d-~- ~, c ~ :~~ ~;. 13M 2 GLLVATIUN ~U~'- C~ ~} 13fv1 2 DESCRIP';'lUN ~ra ~ ~ ~'n ~ ~~ 1~_f~~d.a ~' ~~'~', ~~~ i+ SYS"i'L:M CLEVATIUNyP~e~C), 7U Gc~, ire(' ~~U~~ '' AL:1'ERNA"1'G ELGVA'TION~pper yL9•GUGctu~r 53'~'.UO CON'1'OUIt f'sl,[:VA'i'ION.____-~~~ .----__-_-_ ~; - i- _ K ': :~ ~~~ ~„ <. ~ ~# ry ~4 ,~ _ / s1cNn~ruliE ~% -~ - - ~', ~. _ ._._. ---- ---- -- - ~A•rl. 5 -G'Ll ,,. ._ .~ v l ~i ., ` ( \ n ~~ ~ t S ,~ G`~~ ~y~~ - ~ ~-~~~' ~ I~~~ r~ ~. ~~ ~ ~ ~, ~` C~ ~~ ~~~~ , ~~~ -- ~~ ~~ :~~~ ~~ ,.,~. ~~= :=~-- '"•Wiscohsich Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page ~ of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ~~}- Lam, percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D. # APPLICANT INFORMATION -Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Cl_~ Z~U Prope Owner Property Location C ~ ~~ Govt. Lot 5~ 1/4S~ 1/4,S ('Z T Z ~ ,N,R (C~ E (or)~ Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 'C`ity Stat Zip Code Phone Number ~ City ^ Village ^ Town Nearest Road I~VDSOn' w~= s ~ c~/6 ~ ~/5 >S - 3' ~ v~sc~rv ® New Construction Use: ^ Replacement Code derived daily flow ~ gpd Recommended design loading rate ~_bed, gpdJft2 ~ .trench, gpd/fl2 Absorption area required ~._bed, ft2 7 s~ trench, ft 2 Maximum design loading rate ~ ~ bed, gpd/f12~_trench, gpd/ft2 'i Recommended infiltration surface elevation(s) -~ P Q y • 7 0 Gcrw -e r q~iyC•~a 0 ft (as referred to site plan benchmark) Additional design/site considerations ~ ~~ f Q G ~ ~~ W ~ O -I • a d Parent material ~~'~"~ ~- ~ ~ Flood plain elevation, if applicable /tl G9" _ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system [~ S ^ U ~ S ^ U [~'S ^ U [j~'S ^ U ^ S '®U ^ S Boring # Ground elev. 4~ft. Depth to limiting factor ~in. Boring # ~~ Z Ground elev. 9'S~o ft. Depth to limiting SAIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Structure i B d ts R GPD/ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Cons stence oun ary oo Bed ,Trench ~. li-yL o y i 4 ~' S , b ~, ~ ~ `S - . s ' . 6 z la ~ ~ os f~l! c- '~ Remarks: ~ 4 6 '~ -MS w. ~ cs - ~. ~ yo. o ~ in. Remarks: ~- CST Name (Please Print) 'gnature Telephone No. Address Date CST Number ZJ13 ~6~ ~. :~n-1zr~-t-, c.~J~ .~~td~ _ _ 5-7-~ Z533d`~ Residential /Number of bedrooms • 3 -~-I Addition to existing building ^ Public or commercial -Describe: C `' ' SOIL DESCRIPTION REPORT ' PROPERTY..It1WNER Page ~ of PARCEL I.D.# Boring # 3 Ground elev. 4y~tt, Depth to limiting factor ~in. Boring # y Ground elev. R• Depth to limiting factor ~~yr in. Boring # 5 Ground elev. 4~~t. Depth to limiting fact r ~~ in. Boring # Ground elev. tt. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench 1 -~z toy 3 _ Sl ,ab w. ~ ~ tlF ~ .~ Z Ib 4 ~ Si b iM 1=~ C.S , S ' i .,so 5~-~bo °r3~ , Remarks: i o -~o i -~ I 5 - t~ v~ ~ ~ v F- . ' . 6 q,.E-qo. a ~ ' $4 0 , Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots PD/fl2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench 1 0 -r Ifs ~ R3 3 S~ Z,r~wbt` t~ F 6L LS ~ v F .5 ~.~ 3 -Ito `~ ~ t~nS ~^\ ~S - Remarks: in. Remarks: SBD-8330 (R.9/98) PAGE~OF 3 NAME ~d~ ~O ~~ LOT# ~ LEGAL DESCRIPTIO '/aSi='/4 S ZT N R E or SCALE: I"= 'ABM I ELEVATION _ /GYM- C~ ABM I DESCRIPTION -nu; ~ ~~~ ~ ~ ~~~ ne ~/Y -BM 2 ELEVATION VDU- C~ ~~ ~M 2 DESCRIPTION ham; ( i~n ~9 QOKe~cQ~ ~ SYSTEM ELEVATION~oDer yU, 70 Go~~ef y0, Oct ~ ~ _ 1-- - ALTERNATEELEVATION~eQcr~/o.oc~Lckt,,~r g9;UO K CONTOUR ELEVATION ,itJ~~ 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 (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Tahlp 1 ~ Svctt~m Desian Specifications - -~ ----- Sanitary Permit Number } 98 Number of Bedrooms 5 Design Flow -Peak (gpd) Estimated Flow -Average (gpd) Septic Tank Capacity (gal) .5~ Soil Absorption Component Size (ft2) G/. 3 ~' Type of Wastewater Domestic T~hln 7• Snil Ahcnrntinn Cmm~enent -Limits of Reliable Operation ........... .........-~~.r-.~. . __...r-- -- Septic Tank Component - Soil Absorption Component Design Flow -Peak (gpd) S i , 3 z Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 Tahln ~• Maintanance Schedule Septic Tank ^~ Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or ofher treatmenf or holding tank for any reason without being in full compliance wifh OSHA standards for entering a confined space. The afmosphere within the septic or ofher treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank maybe difficulf or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 S`L' CROIX COUN'T'Y y ~ SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSIiIP CERTIFICATION rORM Owner/Buyer p. ~.. c b (~ oVA 6 I ~I n S ~.N ~ Mailing Address -70~ ~v . ~C d : a~' /~v/~su•v l.v L 5 ~-v 1(~, Property Address ~~ /Do?fi o ~~ (Verification required from Planning Department for new construction) City/State,~~TU~SQ/~ ~ ~' ~ f Parcel Identification Number ~-~~ - LEGAL DESCRIPTION Property Locationn~~ % ~ %., Sec. ~ T~N-R~W, Town of Subdivision /'/ 40~~~ / E Lot # ~• CertiCed Survey Map # Volume _ Page # ~ `r Warranty Decd /{ ~f .Volume Page # Spec house ^ yes t~no Lot Wies identifiable yes ^ no ~ SYSTEM MAINTENANCE Improper use and maintcnanccof your septic syslcm could result in its prcniature failure to handle wastes. Fropcr maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Depaztment a certification form, signed by We owner and by a masterplumber, jotuncymanplumber, restrictedplumber or a licensed pumper verifying that (I) the on-site wastewatcrdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed arrd rclurned to We St. Croix County Zoning Office within 30 days of the three year expiration date. _~G: C~~~ SIGNATURE OF APPLICANT Q ~~, DATC OWNER CERTII'ICATION I (wc) certify that all statements on this form arc true to the best of my (our) knowicdgE. , I (wc) am (are) tlrc owner(s) of WY p~o~rty-des ve, by bdriue of a warranty decd recorded in Register of Deeds O(Ticc. .,n t . ~.../. _ n _ APPLICANT ~~~~~ DATE ««««««~,Aryt,_iEtf6rmation that is mis-represented may result in tl~e sanitary perniit being revoked by the Zoning Department. «. «««« «* Include with lids application; a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in ll~e warranty decd ~, von ~~92PAGE 629 STATE BAR OF WISCONSIN FORM 2.1999 Document Number V~''ARRANTY DEED This Deed, made between James A. Fls,6er aad Rosemary F. bt-~ ll, t/Ws Rosemary F. Fia er_ nfh as...,~e .._~___ Grantor, and P. C. CoOove Builders, Iac., a Minnesota Co ration, Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St, Croix State of Wisconsin (ifmore space is needed, please attach addendum):o~~~ Part of West l/2 of SE1/4 of Section 12-T29N-RP9W described as follows: Commencing at the NW corner of said SE 114; thence E 763.1 feet; thence S 1980 feet; thence W 103,1 feet; thence SW:y to a point 165 feet E of the SW corner of said SEI;4; thence W 155 feet; thence N2648.0 feet to Place of Begtntung EXCEPT Lot S of Certii~ed Stu~vey Map recorded in Vol. 14 of Certified Survey Maps, page 3788 an Doc. No. b1675S, St. Croix County, J Wisconsin. Recording Area 61 ~ggbg, KAi'NLEEN H. WgLSH RERISrEtt OF DEEDS sr. c~orx ca., wr RECEIllEO FOR RECORIf ~ ZsP4i Plf El ~ ~ . F~: FEEL TRAlfBFER FEE: 451.70 PAIMB FEES 10.00 Name and lPeUirn Address DAVID J. ESTREEN 304 LOCUST ST. ;~a~ HUDSON, Wt 54018 020-101s•7o-000 & t}ZO-l0iS-90-000 Parcel Identification Number (P1N) This is eot harrtestead pmpetty. Exceptions to warranties: Eastments, restrictions and rights-of--way of record, if any. f8) (is not) Dated this '~~'"day of February Z~ AUTHENTICATION Signature(s) Jsmea A, Fisher aad Roaemary F. Campbeti, f/k/a Roge,,Flsber, both atn4le eersee^_ da of February 1 ~Y t M ~R STATE BAR OF WISCONSIN authorized by § 706.06, Wis. Stets.) James A. Haber sema F. Cam bell, flkia Roeema F, Fisher ACKNOWLEDGMENT STATE OF 11VISCONSIN ) S&. County Personally came before me this day of the above named to me k»own to be the person(s) who executed the foregoing instrument and acknowledged the same, THIS INSTRUMENT Vt'AS DRAFTED BY Attorney Kriatida Ogiand u aoa, Notary public, State of Wisconsin (Signatures may be authenticated or acknowledged. 90th are not nrcessary,) My Commission is permanent. (If not, state expiration date: Names of persons signing in any capacity must btu typed or printed below their signature, ~ ~~ } WARRANTY DEED 5TATEBAROF h~fonnalbnProfNalanehCamprny,Fatldulse,Wl WISCONSIN ~,~,~, FORM No. 2.1999 LOCATED IN PART OF THE NW1/Q OF THE SE1/4 AND IN PART OF THE SW1/4 OF THE SE1/4 OF SECTION 12, T29N, R19W, TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN. W ~ N1/4 CORNER ~ `` 1~~ 9EC.12 "'t' 4 ~~ ~ 6®4 8~ \ ~ ` ~ „~ ~~ -6(~'f- 1-~t~5 I 1 1 e i _ .~ ~y i 1 1 1 1 e~ ~;~ ~1 ----- I 1 ~I ~ 1 i $i ///~i ~~ ~1 ~ ~ 1 aov_~ i 1 ~I I 1 1 -- t--.`~1 ------ n,o~ ~ ql ~ 1 1 s 1 1 ~1 i ~~~d~~ augVEroq DOVOLA8 J. TAHILR 8 b N L/WD BURVEYINO 272 WALNUT BTAEET HUD80N, WI egU~6 PRlPAgEO FOq: P.C. COLLOVA BUILDE'I18, INC. 706 COUTT ROAD 'E' HUDSON, WI eao~e S09"67'2B'E - - - -~r - - - -' ~ -~ 1880.84' E1/4 CORNEF SEC. 12 1 " = 100' \~~