Loading...
HomeMy WebLinkAbout020-1378-12-000' n fA O ~ ~ o ~ I ~ ' 3 n ~ ~ ! m , ~ m ~ ~ ~ ~ 1 ~ .~' ~ ~ n ~ ~ ' ~ ~ ., ~ ~ ~ y r~ C!> ~ T. in Z o ~ ~ ~ N oN <C ~ I ~ ~ ~ < c ~ v, ~ a o N I~ ~ A O ~- t?a O ~ ~ A y ~ j ~ C C v N N ~ IoO~ '~ ~ Q 'i' ~ N ~ C O A C N C O C7 O ~G ~ ~ 'O ~ 1 7 N O ~ ~ O O 1 C v ~ 1 ~ 0~ - ~ {1 ~ ~ O O ~ ~ '.. 00 ~ p O OD ~ '. ~ N 00 i .ll ? v ~ v ~ o ~ N N o ~ v ~~ (7 ~' cn j ' o I n = ~ ~ n c ~ 1 ^. O O O o '; ~ I I ~ N N N ~ ' ^' ~ , o N fop N ~ ! N -s d ~ ~ ~ ~ I ~ ~ oNi ~ 1 1 = ~ m a ~ ~ ~ ~ c ~~ ~ Z 3 Z I C ~' ~ o O n ~ 1 N v ~ c o N < ~ ~ 1 ~ O ;U ' cn 1 o ~ ~ ~~ I x m (~ °' m ~ ~ ~ I ~ ~ I v ~ ' ~ y'a -i to Z m _. O N ~ ~~ ~ , ~ ~ n ~ ~ ~ ~ ~ A Z ~ ~ , a n C W ~ I ~ ~ N I 2 a ~ i ~ Z ~ p ~ i A :t) -p O ^' ' In I ° N ,,,, m ~ ~_ . , z ~ _ ? ~ ~ _ W Q O CD Q !. < G O~ N ' ~ T p LU C ' I I m ~ a N CD N N C 6 V Q ~_ O '~` i r •.. I w tv ~ ~ ' ~ A d4 O ^ V ~ Q ~..~ ~O O fZ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GEIVERALyINFORMATION (ATTACH TO 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 Limas, Rand Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: ~~ Q / J TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~c ~ p O d Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Syp/ 2y' - Dosing i Holding-- "" PUMP/SIPHON INFORMATION Manufacturer Model Number TDH Lift ,A Friction Loss S~ . -I Forcemain Ler>,gth r Dia. ~~ -F Z SOIL ABSORPTION SYSTEM BEDITRENCH Width Length DIMENSIONS 3~ SETBACK SYSTEM TO INFORMATION Type Of System: DISTRIBUTION SYSTEM Ft i/st. to Well I GA o. Of Trenches '~ L P/L BLDG WELL OR Header/Manifold / ~ Length_~Dia~ Distribution Pipe(s) ~ ~ Length S Dia ~ Spacing ~,~ x Hole Size -~ x Hole Spacing ~- Vent to Air Intake SOIL COVER r Praeeura Svslams Anly YY Mnund Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~ Yes ~ No ~] Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/~ Inspection #2: / / 5 Location: 1047 Moonbeam Ro/a~d Hudson, WI 54016 (NW 1/4 SE 1/4 12 T29N R19W) Moonbeam'/Ri '{ .~ /Parcel No: 12.29.19.2351 1.) Alt BM Description =`~ 0 T ~~ irt~ y_ ~ ~`~ /I "~' r ,^-~f ~ - i `i ~ ef,S // ,, // /i 2.) Bldg sewer length -Z,q P t"'w~ '~'V~~ 1.V~iOrarr.~' vl CeG' - amount of cover = > 2~/'' ~ °r/'P ~'~~~~^"- p k- SC~%uf.., 3? 0 6~~ r vat~~~.- p i p ~s~~`ss{,r.~/c~ t~ ,~,~,,~o G k~rv c ~l ~ O Plan revision equired? Yes ^ No Use other side for addition information. Date Insepdor's Signature Cert. No. SBD-6710 (R.3/97) ELEVATION DATA county: St. Croix Sanitary Permit No: 395244 State Plan ID No: Parcel Tax No: 020-1378-12-000 STATION BS HI FS ELEV. Benchmark S 5 0 (4S Alt. BM s y /~ . v Bldg. Sewer 6 5t/ t Inlet / z. y .s SUHt Outlet Dt Inlet Dt Bottom ~ l6 . os ~ - ~' Header/Man. * 9. / j / Dist. Pipe L ~ 9 '//~yS~ .y Bot. System L- ~` ~ !b. zp 9S. 3a S: Final Grade 5'.9 f9,S-~ Cover z ~ ~3_ ~r -/ ~ t~- ~ Dia. OVC/ 7 C S~s ~ ~~ ~D ~ ~i/'~c, S r~,,~ i w C d /'/`C~~~~`"/ r 6 flr; v.~ ~ r S ~GE S; c ~~~ dh ~c ~a~ ~`~,,,~ , ~~ Sr~w.. OPc~a,~i~-. ~1/a 5 G~~o~yy ~ ~ ~ f ~~y~~ ~o- ~~t,J~` Uv~?'h%~- t, .. , ~.. ~7 . .~ ~~ ~1. {,;~, ~;~-~ ~~ S (""""" 5afery and k~ui;rlin~s L;tiis;cn C01~'~' ~ 20: w. w~s!lla~ton ~-ve, . P.O. Boa 7162 ~~ ~~ ~~Q=~.~. -~ ~~~r'd~~j~ Madiron, att ~s7o~ - ~t~ ~ s!!~ naa~+ pe r ent of ~ mm r • /O~? /n~a~J ~aa, ~~ 3~unf ~t ~~:M~ 395Z~f `( teary Permit Ap ~ ; ~ ~~t to ta01d With Caeeae n.2i. Wis. Aden. Cods. Ya ptpvs~s \, ~ {.war a warw~ ~~~ ~ °f ~ ~('~- `;` ~ I.D. Ntunbnr r.. ~ I. - !rlnt Ali ~ ~_ i~roperarowe>fr's •one ~ .. ~ 1 ~~~ :. ~ , ptra Knmbe~r la . aq • 1 R• ~ 3S~~j d r ~~ >6 f rya th 57" Q 3a ? ~"~~ ~c~rrEri~ p~,,~~ ~ ~ ~; .r/~ ~ SE ~ ~ s ~ 1 h ~ / ~ City, dew ! , (~ Nu~near ubdiv ~ C.SM Number Q, ~ SSr,~ ~ 7GLs.!/ yre~ /p ~g ~ ~ r--~~---,..r~ ~x. Typlt aC ~alnaswr tchtc~ t>u ~ y-ply) / ~ ~... ~ ~ 0~+ ~i ~! Oc x Awsilinui - Nua~t of 3tedrnonos .,,~ ....~.....-...- ' j~Vpitr ~ i G Pubiia<Gba~mraiall • Utt ~~,. - _ ~--__~ - wrtthi ~..J .....~ G awe 4a~ed p Kuetet ~ Type 0[ 34rlatltr (L'3s~1c ~ ow box as 1la~ A ~bes'tl3~ eahsasa for ~tttelrAAl uta). Cae»~ ifae 8 i! xppliotbls3 A~ ~ how ~ ©~ gy~q 3 ^ ]~epiecemeat of d C Addidon ce ~ ~ vtt S ate Date issued ~~' a. 0 Cb~ u ~ Famlc Nwaber Type ( ~ that tpA187~btrb3~ echtm+ u Car interaoa we? -?~ ~'I°~ 17 ~ Stnd Feitsr SO ~ Coatt:n~agai Wayand ~ W~~ ~ ~ramd i0 Maned 5'p', p~.,~J 1 3~ ~ Paeluelxed Is•Orpaod d1 ^ IWiclJn3 ?salt 41 ^ siase Pius Sl L~ Drip Ltas y"''" ~ Q ie Taattneac Unit 49 ~ Aseitcu! 30 © t ~ 43 ~ At +~r~ c ? G ~ ~'•~ ~ Dupergi So App3les oe partolsden Rats dyasam FJs t Flnst Crra~e 3~5"~ ~ 3~~-~). Ratr(Mk.lD~ysiSq.pl.) ~ (Mip.Rgcb) 8levation C Tvlk b' .Tats Number i Ma~suts~auer ! 8 m toe! ;Fiber Pluac Gsisae Ot Z9alcs ;, L"aessss COCasbuCSed ~. Olsss :' ----t • ~ ~ - Ada r ~~-- ~-----~ VII. Y ~ ~ assmew fmt at Sbt 84VYT8 ebawlt as ~~ > Number ' 1 ~~ s teeot. ~ p Cade) 7 JAG v~ ~i GL S'~J!~ ^Y4 e~y ptani~ Net {latlv~t Ototladwwe uauug tnt i~atuca r1r'e amps) i ~, Ap}~aavwd Q moved SWehtt;e Fse) ~ D Ownrt t3trts 8~l A4w:a • . ~ ZS ~ ~ ?,00 ~ --------.~ .d* for D;NSpptevai ~ ~ n r _ 5~-1+,,.~„ f„~ C,~`~"""--" ' f p . ~ ~ f'~ Seti"~S ---~ kin i+'D~~~~V 1~M' W~oi'/ l;~ 'D I O p `~ ~ o v ~ v ~ ~\ ~ ~ -. _ ~ ~~~ - ~\ ~ ~~~ mo.'s ~y~' ~' ~~ ~D/ t M E].. sq~yw sY ~ Z'C f 9~1'/.f /~Fi~ V .s' y ~~ .~ ~ oc 1 ry a ~ V _ ti0 30 ~~ .b~^n l°~°} • .L ~"~:~: ~~ • ~ ~ v D ~ D ~ r \~ ~ ~ . ~' v ~~,'-S ~ y~i' D ~ ~) ~ • - ,~-~=-- M ~c \~ V b ~ ~' /' ~' ~~ e~/ ~. ~ ~. ~ Q .~ d ~- v •~Oj~n ~~ c r~ ,: ~~~~~ "'~ Wisconsin Department of Commerce division of Safety and Buildings SOIL EVALUATION REPORT Page l of in accordance ~ntn t,omm eso, vvis. Ham. was ' ~ County < f /~ /?, ~ s ~ T 1. r V t Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan mu but not limited to: vertical and horizontal reference point (BM), diredion and inGude Parcel I.D. , scale ordimensions, north arrow, and location anddistance.to nearest road. percent slope , Please print a-1 inform n, ` _ `,~ . ~~"~ by Date ~z~ Personal information you provide may be used for seconds .~?pwses (Privac~w. s. 13.04 (m)). Properly Owner j ~ E~~/ Bropertg , lion 1l ~ U ~ ~; ~ Govt. Lol._.. ~ 114 S E 1/4 S T Z R N R~~ E (or) Property Owner's Mailing Address ,_.~ `-` t ST ~ I ck # ~ Subd. Name or CSM# Q " ~X Q ~ ~ - l L c Q d '(~ tCt. TC ~ City State Zip Code Ph b~ ` ~h ^ ^ Village Town Nearest Road .~ w yo this ,r '~ ~ Yt'l ~ [~ New Construction Use: ~$ Residential / Number of bedro Code derived design flow rate yS~J~~ O ~ GPD ^ Replacement ^ Publ'ic or commercia{ -Describe: Parent material ~ U-~ ~C l~ Flood Plain elevation if applicable _~,~~¢ ft• General comments ,rc)/.Sf Gvyt f.~ti(/ ~ ~ "/ , SO and recommendations: T ~I t Boring Boring # qq ~~ [~ pit Ground surface elev. ~ ft. Depth to limiting fador ~(~, in. Soil licaition Rate i D h lor t C D i tion Redox Descri Texture Strudure Consistence Boundary Roots GP D/iiz Hor zon ept in. nan om o Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ o /~ 3 - ~ '/ ~~- C S ff L /o-y0 l r - S~ ~ Zm ~r C _ . 3 ~a s yr~3 - SG ~ ~ -- 5 ~ s~-nv - /nS D.~ ~ ~ / .~ - ~/~ ~. . Boring # t~~, Boring Lsf' Pit Ground surface elev. `~~• .SO ft. Depth to limiting factor /~_ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Strudure Consistence Boundary Roots GP D/ft? in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-`~ 4 3l - Si ~ Z ab~ `-'t-~r v~ ~ ~' f ~ WZ ~ I ~ - Z,n / ~"'~-fir ~S .. . S- - 9 ~ ~ ~'0 Q r ~ l0 ~" /1'J 5 ~ -- - l 0 ' Effluent #1 =SOD > 30 < 220 mglL and TSS >30 < 150 mg/L 'Effluent #2 = t3VU < 3U ~~ and i ~~ ~ su mgrs CST Name (Please Print) Signature CST Number zS-.~3G~' '~ ~c >~ ' l Address Date Evaluation Conducted Telephone Number z/~ ~ a ~/- a ~7~ zy~ - OdB~ Property Owner ~O ~ 1~Y °L Parcel ID # Page _~, of _~ 3 Boring # ~ Boring 9 Pit Ground surface elev.q 5~ ft. Depth to limiting factor ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff? in. Munsell Qu. Sz. Conk Color Gr. Sz. Sh. 'Eff#1 •Eff#2 _ y l -- SG~ ~ - ~ S' ~ Ll l ~ l S l ~ ~ - G~/4 Boring # ~ Boring ®Pit Ground surface elev. 9 • ZrJ ft. Depth to lirr-iting factor ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Descriptor Texture Strudure Consistence Boundary Roots GP D/tt? in. Munsell Qu. Sz. Conk Color Gr. Sz. Sh. 'Eff#1 *Eff#2 - // l4 / z - .S '~ Zrrrarb~ ~~" ~ r/~9- r CS' /v~ ~ .S- ylo -//U o to - f~ ~ - . ~ / Z .Y , ^ Boring # ~ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Cobr Gr. Sz Sh. 'Eff#1 "Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #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 608-2G6-3151 or TTY 608-2648777. SBD-8330 (R 07/00) ' PAGE ~ OF~ NAME C O Ilovc, T OT# / ? LEGAL DESCRIPTION(w ~ ~ i4 ,S -Z T zq ,N,R,I q E(or~ SCALE: 1"= y0 ~ __ BM 1 ELEVATION (('O • C) BM 1 DESCRIPTION ~, ~ o ~ F_ n_G-~ ~~'~ _ a { ~U . cd. G . BM 2 ELEVATION ~_ j(~C~ • C~ ~. _ BM 2 DESCRIPTION -(a P a-~ ~ a f ~ L `'~¢by uti I,..rcv r~o.( SYSTEM ELEVATION 4 y- S~ ALTERNATE ELEVATION ~yrS~ CONTOUR ELEVATION •(lo ~(a ~. 6'"" Z ~ d ~ir N Q'`~ n.o sl~,~-~- 1 -1- _' 1 SIGNATURE ^ ~~-r -S B 3 a ~us~`- ~ ~ ©~'~°~°C < ~ t ~~ 1 f D~TE S~ - ~ 3 --O/ ~ ~~~ ~ Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Page ~ of 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 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D. # APPLICANT INFORMATION -Please print all information. Re sewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner ~ Property Location ~~- ~ l~'~ Govt. Lot ~~ 1/4 5~1/4,S ~Z T Z C~',N,R ~ E (or~l Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# c~5 C ~ . ~ ~ 2 f~(1c~r, City State Zip Code Phone Number ^ City ^ Villa a ~• Town Nearest R (11 )5 - u om New Construction Use: ^ Replacement Residential /Number of bedrooms 3 _ y Addition to existing building ^ Public or commercial -Describe: Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 ~ O trench, gpd/ft2 Absorption area required bed, ft2 7 p~77~ trench, tt2 Maximum design loading rate ` ~ bed, gpd/ft2~trench, gpd/ft2 Recommended infiltration surface elevation(s) [ C~~ 7d ft (as referred to site plan benchmark) Additional design/site considerations ~'L''~ ~'~ ~ ~ ..//,~,, Parent material (,U-t-w G S ~ Flood plain elevation, if applicable ,i(/~I ft S = Suitable for system --• •-_...._.._. ...__.._ _ __ _ _ U = Unsuitable for system ~ S ^ U '~ S ^ U (~S ^ U ~S ^ U ^ S (~ U ^ S ~' U Boring # Ground elev. Q~~ft. Depth to limiting factor L_in. Boring # Z Ground elev. 9G•C p ft. Depth to limiting f ~~ in_ SAII I'fFS(_RIPTI~N REPORT Horizon Depth Dominant Color Mottles Structure i d B ts R GPD/ft2 in. Mansell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. stence Cons oun ary oo Bed ,Trench ~ ~-i3 I~ 3 - ~S ~ r~r C s I v - ~ - ~ ~ • 8 Z ~ I ~ I3 ---- ~ S I rr~r ~ ~ - -1 ' . g 3 lD `--1 lcv -- m S D ml ~ ~ - ~ Remarks: - 3 t_S Im Illm L i~-~ ' .~ 2 I ---- S I m rr~r L 5 -- . ~'.~ 3 ~-n lt~ `I 10 -- mS I ~5 -- . ~ ; . ~•8 ,B ' Remarks: CST Name (Please Print) 'gaeture Telephone No. Address Date CST Number 2113 ~J~' S-I-. Sc~merSe~- ~) ~~o~S 5-~- ~5330~ SOIL DESCRIPTION REPORT PROPERTY OWNER Page ~ of PARCEL LD.# ' Boring # Ground elev. 9G•3dtt. Depth to limiting factor /t in. Boring # y Ground elev. ~1•Sdit. Depth to limiting factor ~~in. Boring # 5 ~' Ground elev. 9~tt. Depth to limiting factor ]Lin. Boring # Ground elev. ft. Depth to limiting factor in Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ~ Trench ~ b-ra 3 ~ - L r,n~ r C S ~1 ~.~ 3• 4•z Remarks: I o-~ ~~ 3 ~- ~s 1 m ~s I.~-~ `1 ; . 8 Z H- 1D r ~ 3 ~" LS ter cS - .~ 3 =113 . `~[ ~b ~S ~ ~ ~S - ~ ~ ~ . ~' Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/tt2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench P aaZ ID 313 -- t_5 l~ ~S lv~ :l ~ . Z t z ~ t y ~3 ~" LS ~'r cs - `1 ~ ~ 8 3 -~t o ~t(~.o - - r~S ~ 1 c5 ; ~ 8 (v ~. Remarks: Remarks: SBD-8330 (R.9/98) .. - ~ , PAGE~OF~ NAME i2.p ((O trot LOT# 1 Z- LEGAL DESCRIPTIONSti '/iSE `/4,S IZ T 2 ~,,N,R 14E (or) SCALE: 1 "= J(JC~ BM 1 ELEVATION ~Q U ' U BM I DESCRIPTION nay (! ~ ~ ~f(~creld+~' w/ Floa BM 2 ELEVATION COU-6 BM 2 DESCRIPTIONhp;/ ; ~ 2Y ra.r.stctrr~:(os~4~cr ~,Jl~l~ SYSTEM ELEVATION ~ Z , ~ ~ ALTERNATE ELEVATION q~' O~ CONTOUR ELEVATION ~/ 64 /L - r x~ ~r (tE~~ !v A g~ m ~~, ~~ e 4 :.N ~ d ~~ ~F 4M . ~ .s ~. ~b " m $~ ~ ~ ~g ~~pp 9. ~ S a~ ~~ 3~ ~ o.. py ~~ ~ ~ C~ ~~ ~p 9en9 4~ L 3~ ~S R a ~~ ~ ~~ ~~ ~~ i hC N rl R'~ d 3 a N A t~ i) a 3 m A d a N rn £ ~! W ro ~nn w lJ ~ 0 A N m 3 H ~ ~'~? ~. ~ ~ o /1'. \Y X ~_ C7t N ~ ~ N ~ u: ~ ~ W r4 • t 41 A ~I ~~°n •btn~,er, ,~ ~ „ .~ W {1 1 r ~~ [[~+AA" 1 v, r~ .:. n ~ ~ ~ ,.. N Q l~ y a Q ro 1 ~'o ~ • ~ • '~ a ~?o ~''= @~-a ~c~ 1 ~ ~ j ~ c ~ }~ N ~/ ~ 3 Y/ a~ c~ ~ a~ ro ~ ~ ~~ o '~ c ,- g -~ ,~---7 ~ ~ e~ m v „ v u~~. ,~o o~ t4 ~ ~. ?N {Z' ~ C. ff ~ ='• ~ ~ ~ ~~ ~° 'c ' - , 1 ~ w ~~ ti ~ -. ..r r ~ ~ ~ ~ ~ a o. ... CD ro 4 M ~~ i, ~.~ _~ ~~ n O a y m c`~~' ', ~ ~~ ~v ~ ~rn -s rn m ~--- I ~1Ye-t 1 i "•----~ ,~ Private Onsite Wastewater Treatment System Management Pian 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- _T_ Design Flow -Peak (gpd~ Maximum Influent Particle Size (in 118 Table 3: Maintenance Schedule Se tic Tank ins ect and/or service once eve 3 years Outlet Filter ins ect once a year and clean at least once Soil Absorption. Com onent Inspect once every 3 ears Septic Tank The septic tank shall be maintained by an individual certified to service septic #anks 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 nd outlet lifter shall be assessed at least once every 3 years by inspection. Th outlet flits all be cleaned as necessa to ensure roper operation. The filter cartridge shou not be remove unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Table 2: Sell Absorption Component -limits of Reliable Operation ~s ~+ ..~ 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 wifh OSHA standards 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 maybe 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 clogging of the soil. 2 1 ~ Managsmeni Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over of within taett feat of the component should be avoided since coot intrusion into the component may obstruct wastewater flow. Contingency Pian !n ttte event of system fsilure, a new system could be inssalied in an sltemate area. With the instaliatlon of a divsrter naive, the existing system could also be reused slier a period of three to four years. It is the property owners responsibility to maintain the aitsmats area nee from any punting of tress, shrubs, etc. In case of failure of the original system, the alternate arw will be needed. if arty trees, shrufoa, etc. have been planted on the sttsmste arse, they will have to ba removed at property owners expense. if aitemsts area is destroyed, there an other altsmatsw systems that can be used, in which, oould result in added expense to the property owner. Any tank abandonment shell be done in accordance with W(sc. Code 83,33, Any questions regarding this coda, please contact your local Zoning OfNoe or contact the installing plumber. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSI~IP CERTIFICATION FORM Owner/Buyer ,,~~~~~, ~ C.7 Mailing Address ~ ~ J Property Address / ~ `~7 r~ T sT ~r~ ~ o ~ ; ~~~~~ ''~~6-c-~'( -~.~u~''1r (Verification required from Planning Department for new s~s'rz~ CitylState f4,~ ~~~d,~~~~~ Parcel Identification Number Ll"?d ° /,~ ~'~"/~- Go~O LEGAL DESCRIPTION Property Location ,~/~"~ '/,, S ~" %,, Sec. / 2 , T 2 ~ N-R~W, Town of ~~'" Subdivision~~/ Certircd Survey Map # Lot t~ i z Volume ,Page ~ Warranty Deed # G.5-DfS' 9 Volume /~73 ,Page # 5~~.-. Spec house ^ yes (~no Lot lines identifiable Hayes ^ no SYSTEM MA.IN'TENANCE Improper use and maintenance of your septic system could result in its prematureSailute to handle wastes. Proper 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 Department a certification form, signed by the owner and by a mastcrplumber, journeymanplumbcr, restrictcdplumber or a licensedpumperverifying that (1) the on-site wastewaterdisposal 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 We private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and We Department of Natural Resources, State of Wisconsin. Certification statin that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 of the three ear expiration date. t w - 7 /s/or SIGN OF APPLICANT DATE OWNER CERTIFICATION I (wc) certify Wat all statements on this form are true to the best of my (our) knowledge. I (we) am (arc) Qic owrrcr(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. . ~/ ~j~l A OF AP ICANT DATE ****** Any information that is mis-represented may result in tlic sanitary permit being revoked by tlic Zoning Deparhnent. ****** ** Include with this application: a stamped warranty decd from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty decd VI?i. ~.f~73PA(:~ 524 I STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY DEED This Deed, made between P. C. Collova Builders, Inc., a Minnesota Corporation, Grantor, and Randy Limas and Emily Limas, husband and wife, 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): LotMoonbeam Ridge, St. Croix County, Wisconsin. Recording Area 65x0159 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED Fit RECORD 07-OS-001 9:40 AN WARRANTY DEED EXEMPT t CERT COY FEE: COPY FEE: TRANSFER FEE: 184.00 RECORDING FEE: 10.04 PAGES: 1 Name and Return Address Alpha Title, 1325 E. 79th Bloomington, Inc. St., Ste. 1A MN 55425 020-1378-12-000 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this 1j~ day of July 2001 * * AUTHENTICATION Signature(s) P. C. Collova Builders, Inc., a Minnesota Corporation, by P. C. Collova, President authentica ed this7 day of July 2001 s Kristine Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) (,1~) (is not) P. C ollova ail ers Inc. * P. .Collova. President 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 Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ('~ 3r,,1~ •) * Names of persons signing in any capacity must be typed or printed below their signature. ~nlonnation protassionals company, Ford du i.aa w1 80n•{655-2027 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 m~ z 0 ~o N i V a O N ~~, ll~~ CN ~ ~~~ ~~ON~~ ~ NN .Q~ ~:_z~~cZi ~Z2 ` = ~r ~~ \ I w ~ ~Cu ~~ ~ ~ \\ ~ ~ N?3o ~Moo~ \ 4544•. \ '~~ ~ F 3as ~ ~M~Ra .~.. ~\ .~2, ~\, 0 ~ ~. ti ~~ ~ o q~,O ~ Ra~~c F~sFMFNT . x i ~ ~ ~ N m r o 0 111 ~ m z o m ~ fl1 a ~ m Z z O 0 a, ~ z D ~ n r Z m M[~p~44C~D ~Q~]D~ O~G]C D ~ ~7 C `^t' M 1 JU~J ° ~L=.1UlllJ ~~D~.l L7 I BEARINGS ARE REFERENCED TO THE PLAT OF MOONBEAM RIDGE ~~ ~ ~ ;~ ~$.~0 9ZN 8t~6 O / -• ~6g6 / 256/ m . X <-~w' ~' r • w ~°z N N (.J OO~ Xiv ~ II = •X ~CW37 - w ~ m ~ r ~ mz ~ r I~~ _~ _ o / o~ C7 D D ~ ~m / • . _ _ ~~~. v ~ ~ \ ~ '18"E 597.39' G~~W~ ~- \ (p x A ~ O \ °' D n C") d Z7 Z :U 2 2 I'l D C (7 D O f d 3 i7 ~TJ --I •-' bd r b d D C (T1 I"'l N .Z7 Z f d D Gl f*1 Z ~ Z '~ Ll 2 c~ ~ r ~ ~ m 2 ~, 0 z Rl '-' Z •P N C7 o ~ o ~p W .- IU e W p ~. C11 ~ o N o ~ o ~~ T,p ~~S ~ -DI C N D (~ O~ Z n -~ W c m ~ ° j ~~ O cn m N o Z 00 n m m V ~ I~ C~ ,~,w V! C 2p~ZpmO Oooy~~ ~ C ~w0~ paid m W 2 2 Z ~ m D W m m ;~~~~' ~ c~c ~ ~ ~~~oz A =~~ ~ ~ D~oD ~~Z 70 `°o ~ p Z°~'m a ~w ~ ~ ~ ~v ~ ~ ~ O z z ~o ..'~ m~~ Om ~x°_ ~o~ XZ-~t n~0 C~~ ZN2 ~4Z my~ N z ~ 0v ~m~ Z~ i ~ ~~m ~ ~~ ~N~ I~mOmm ~vN~ ~ O Q ~ ~ ~ ~~N ~7 'nom ~ mm~ Z '~ 5Z J O N 3 N t0 O Z W ~ ~~ O ~Z m mm \/ O ~v v ~' m~ v?