Loading...
HomeMy WebLinkAbout020-1393-18-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO~PERMI,T) 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 Miller, Sam Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing n _ r~ /'~ (~ '- Aeration _ Holding TANK SETBACK INFORMATION TANK TO ,~(L ~ WELL BLDG. Vent to Air Intake ROAD Septic , ~ ~ t t ~ ~ `-GV / v O Dosing Aeration --, Holding PUMP/SIPHON INFORMATION Manufa turer __ _ __ - -__ -- Demand M Model Number TDH Lift riction System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM - .~ ('~~jw~/„_Dn ~,/ ELEVATION DATA couniy: St. Croix Sanitary Permit No: 430364 0 State Plan ID No: N ~{ Parcel Tax No: 020-1393-18-000 Section/Town/Range/Map No: 12.29.19.2391 STATION BS HI FS ELEV. Benchmark ~~ ,~-/ // (od /, / /~~` O Alt. BM 5fi GU ~~Z ~ ~ 11 Bldg. Sewer g~ ~d3./ S t Inlet ~~ 3 dZ. z S t Outlet ,~ q ~~~. ! Dtlnlet ~ Dt Bottom He_ ader/Man. I~ I of $- Dist. Pi ~~ ~ / fi 1~ti- Z ~ ` ~ Z ~ ~. ~ $ Bot. System ` I l S Final Grade 3 ~ 7_ b st~0[Er ~ ~~~~ 3'-7~ i o 7. ~ ~ ~• ~ y~ ~ y~ X02-~ BEDITRENCH Widt r ,r Length 1 No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS h I SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREA LEACHING CHAMB R Manuf t t 0 1 I ~~ ~ G' Ty Of System: 6yt~.P ,~ ~v~ ,~ 125 I ~ / NIT Model Number: DISTRIBUTION SYSTEM He=r/Mapifo /, Distribution ( ~I ,,- ~e~f Pipe(s) ~ ~~` / '~ ~ x Hole Size ~-~- x Hole Spacing_ ~~ / Len th Dia Len th Dia 1' S acin ~ `~ ~ ~ Z g g p g SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center S / Bed/Trench Edges Topsoil I-1 Yes (] No L_. ~ Yes No _ COMMENTS: (Include c e discrepencies, persons present, etc.) Inspection #1: / Inspection #2: / /_ ~- Location: 869 Charlie Ryan Hudson, WI 54016 (SE 1/4 SE 1/4 12 T29N R19W) Moonbeam Ridge~st(A~ddition Lot 18 Parcel No: 12.29.19.2391 1.) Alt BM Description = `~ ~ C~f ~~ ~~~~ ~~~ ~~~" ~-P~ < ~ ~~ 2.) Bldg sewer length = ~ U ~~~~""'~-" ~ /rte-~->`-. -amount of cover = ~ , 1, ~~i U '[ '- _ Use othesls de foruadd tional Yes ~ No ~® II II ! ~G ~ ~ 2~--~ ~~~ ~ ~ ~ information. _ / 6~ ~~_ _ G~~~"''x" _ ~.1'i~?~1-~ __ __ ._ _ ~~~' / SBD-6710 (R.3/97) Date Insepctor's S' nature Cert. No. ~~ Vent to Air Intake oL 41d- C:f~clx-~'- 6.0.(~ ~ Safety and Buildings Division . County Q/~ ~ " l~ ~ C s~' ~ ~ ~ ` 201 W. Washington Ave., P.O. Box 7162 L. t ~scans~n Madison, W l 53707 - 7162 Sanitary Permit Number (to be filled ' y Co.) De artment of Commerce (608)•266-315: ~ ~ 3 Sanitary Permit Application state Plan LD. Number /VI In accord with Comm 83.21, Wis. Adma COde,~ptrsonal information you provide maybe used for secondary Purposes Privacy Law, s15.04(lxm) Project Address (if '8'erent than mailing address) ~ i ~e 1. Application information -Please Prtnt All lnformatIon ~~ , IVED ~~9 c ~h Property owner's Name S E P 1 2P 2 003 ~ ~ `°t ~ ~ 3 ~' ~'~ S~,y~ ~/LL~. Property Owner's Mailing Address ST. CROI X ~ty~.ocati n R q~ ~ + (~ .~!. S~ ZONING ~ F 1 O Section ~~ '/~ City, State Zip Code Phone Number ~ , v~S S~DIs~ ~ ~~ ~ ~ 7 ~ T~N; R~E l~ /Q~ 11. Type of Building (check all that apply) y~ L ~' ~u~ T `~ , / 1 or 2 Family Dwelling -Number of 13edrootns w~ _ _ S~u/b~division Name /~ CSAM Numb~:r s r ^ PubliclComnmercial- Deacribe.UseC3 t. / ~/Gie ~ K .•d l ^ Stau Owned-Describe Use ~ ~. ZS'~ fi It / ~t~~ ~ c( r ^City_^Village~I'ownship of /L{~/p~^/ • I 111. Type of Permit: (Cbeck only one boz on line A. Complete line B if applicable) A. New System ^ Replacement System ^ TreatmentJHolding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revisi~ ^ Change of ^ Permrmit'hansfet to New list Previous Permit Number and Dale issued Before Expiration Plumber Owner 1V. T of POWTS S stem: Cbeck all that a 1 Z - EFL C TE _ Non -Pressurized !n-Ground ^ Mound > 24 in of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Crrade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized !n-Crround ^ llalding Tank ^ Peat Filter ^ Aembic Ttratment Unit ^ Recirculating Sand Filter ^ Recirculatin Synthetic Media Filter hin Chamber' ^ Dri line ^ tmivel-less Pi ^ Other (ex lain) V. Dts rsal/Treatmeat Area lnf matron: / D ( ~ ~ -- Iksign Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (yf) ~ S stem Elev 'on g ` ov / Zov l2 / }. - SU esso Vl. Tank Info Capacity in Total Number Manufacturer Prefab Sit eel fiber ;antic Gallouss Gallons of Units Concrete Constructed Glass Ncw 8xiuing I ~ ~ Tanks Tanks I S~:ptic or Holding Tank 2`^ 1~'~ ~/ ~ I Aerobic Treacmcn[ Unit DoWing Chamber VLl. Responslbill Statement- 1, the tinders ned, asattme rwponslblllty for lnstallatlon of the POWTS shown on the attached plans. Pl um ber' ignature MP/MPRS Number Business Yhone Numbs s Hama (Print) Plumb c's S c ~ j ~ A ~ ~ ~ /', //C C ~ ~ Ylo-~~ i~~~'v-"'c./ r Z ~- ,~1~ .~ ~o t;0 ~2 ~ ~~ r~ ~ / Z 7 i Plumber's Address (Street, City, State, tip Code) ~ L~// (~ ~/ n ~ ~ ~~ ~ ~V7© t ' 6 t-TV L_ C`htJt~ ova ~f V1Ll. oun /De artment Use Onl proved ^ Disapproved ~~'Y Permit Fee Includes Groundwater Surcharge Fee) ~ Od Date suet., ~ , suing Agent goat e ( a s) ^ ~ ~ "~~11 2 3 ~ Owner Given Reason for Denial 1X. Condltlons of ApprovaUReasonsSor Dtsapprovy~'~s ~~/GfJ v"`~ ~ ~t~(~~/ ,/~ ~ /~ YSTEM OWNER; '' ` ep lc ank, effluent filter and C~ ~, S-'~ ~~J dispersal cell must all be serviced / maint lned as per management plan provided by plumber. All setback requirements must be maintained as per applicable code/ordinances. ~~ ~ 3 , ~3-/ Attach complete plow (to the County only) for the system oo paper not Icas than 81/2 x 11 Inches in s[xc SBD-6398 (R. 01/03) ,, , o- // ~~~ ~6, ,N .~ r~ i Z 4o cq c s r w~z~t~l q . boa r-; I t ~v ~~ ~ L~ 0 ,~ \ ~~~ z _/ \~~ ~~ ~. ~`- 3 ~ v ~ ~~a ;~Q ~.~ ~/ . LC.iq y - / ~. y S~~v-~ r /V. _ 7.75' ~3)X 3 K ~1,2~ /~av~s /~ ~a//r 9G . So n, b~ rs E.4~L1 rr~,,, ~ ,( Q~ ~ 3~- T•~'t/ - ~~ ~ ,zy X94 7~ ,~,,..~.~ °'~z z s o ~ 3 S~ ' ~,v. sue, ~~) ~~~~a 4~' ~~~ ~~ ~ ry~ , ~I 3~ ~~~~~~ , ~k aG~ b~~~; ~ ~' ~~ q, ~ ~~ ~z4acAc^sr ~/~~~~ A•~OC r ; I t ~.v ;,./ ~~,~ c ~~ -rv~ ~ H a ~ tom. =-r /~ Ti3 w~ E ~ . 9 ~, ~y ~ 3 ~ ~, ' ~~6 spa i. ~J`\ t, . / i S CA-c. /~ • 3-TK..F~1~~-s BioDif f user Sp-ecif ication~ ..~ s TcT~, 4 i I L-/ { ~~ Chamber ~~ w P Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATIOf4 REPORT Q Page of~ m accoroance witn L;omm oo, vns. Ham. wue County <.i~• - Q ust i Pl i h ~ V ~ ` an m n s ze. es Attach wmplete site plan on paper not less than f3 1/2 x 11 inc include, but not limited to: vertical and horizontal reference point (BM), direction and p~ I,p, ,,//~~ ' Q2 ~ G-'. ' ?)G~'3, ~ g'~~ 6 percent slope, scats or dimensions, north arrow, and location and distance to nearest road. 1 Ctr~ ~ r~ Please print all Information. R ewes b Date Personal infortnalion you provide y be used fors condary purposes (Privacy Law, s. 15.04 (1) (m)). ` ~ Q Pr efty Owner ( Property Location ~tl., ~ - Govl. Lot 5 E 1i4 5~ 114 S ~a T ~ N R ~ E (o Pro er's Mailing Address 7 b 5 Lot # I ~ Block # Subd. Name or CSM# ca ~ d c .. ~ ~ ,-F City State Zip Code Phone Number ^ City ^ Village ®Town ~ e ~t o Po3o~tp R a~ v~5o ~YS ~ ~--~- o0 New Construction Use: ~ Residential / Number of bedrooms Code derived design flow rate ~ S ~ GPO ^ Replacement ^ Public or commercial -Describe: Parent material __~ 1~- ~- ~ C.-~ ~Vt W 4 S ~ Flood Plain elevation if applicable ff• General comments ~J ,y ,,• 5 ~ ~, 9Q t '(• QE 1V Cti ~ S ~O ~` a ~a.C..~ S r '~e p .and recommendations: ~ a- ~ s V5 g C s T o1 ~ T. 3 9 3, 8 g ,rI (97.78 ~ R~Plac..~~.C~+: T'.Y ~ a i, tr h Boring Boring # pit Ground surface elev. ~ bw~. ~bft. Depth to limiting factor i a a _ in. Soil lication Rate Horizon Deptfi Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDJft: in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 l o- o'1R3/~. L of 2 r aF 5 ~' a~-ss 7,sYrtr o - s L* c ~ -- r . ~ ~~ /02.0 97- 7~' - Sl ~~ ~,-~ • , ~ . ~• 4- ~ ,' j ~;' ~ , ". ` ^ Boring ~ Borin # ' g ® Pit Ground surface elev. _ ~' ~ ~'~ ft. Depth to limiting factor.' --y----tom-a in oil tion Rate D h i t C l D tion Redox Descri Texture Structure istence Con Bd~ntli3ry Ro~~ ~` Horizon ept in nan o or om Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. s - ~`+ ~F~~ 'Et#M4 'Eff#2 . - 3J --- L dF~ ~ w 4 r etc ,~ , $ ] b_ ,~ 0 . t S y `l `Effluent #1 = BOD > 30 < 220 mg/L and TS5 >30 < 15U mgrL Cmuern n~ - o~,~ _ ~~ ~~~~ a, ~~ ~ ~~ . ~- • ••~- CST Name (Please Print) Slgnatu CST Number ~,r ~.. 1 a ~ ~ y Address oZ ~ o „~, ~.~ s.,J}- ~ ate Evaluation Conducted Telephone Number .__~ ~. ;~. ~.r0 f ~~~ • . _. PropertyOwner.~j`- LQjI.Q• 1~L'r S Parcel ID#...R~~~y~_ Page ~ of 3 Boring # ^ Boring I ® pit Ground surface elev. ~ 9'b~, ft. Depth to limiting factor ~ p_ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 O- ~0'1~3~ -- o~ G M r Q a ,s _~ 7.SyRy SL s k ~ r- w . S 3 !(~- 7,5Y(t ----' .ZFSb4L r G I~ S g-~~ Sy(sr.s y f a FSb h~v~r -' '' s ~I Boring # ~ Boring Qq p t~ [~ pit Ground surface elev. _ 7 /. / a ft. Depth to limiting factor a ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Mansell Qu. Sz. Cont. Color Gr, Sz. Sh. `Eff#1 'Eff#2 1 o.t, loy(t~l~, sc_ aFG~ rn aF .5 d1-X~_ ~. 5`{(Zy y ---- L ASS k. wt r C 1.4.1 1 J F . 5 a9-~~ s ~~/y ~ ~ stile M~f•~ --~ - ,5 , ^ Boring Boring # Ground surface elev. _ ft. Depth to limiting factor in. ^ Pit Soil lication Rate i H th D Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIff zon or ep in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 'Effluent #1 =BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L 'I'hc Department of Commerce is an cyual opportunity service provider and cn)ploycr. [f you need assistance to access scrvrces or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (0..6/00) ., Property Owner ~j ~ `Q. I ~O ~. ~ u . ~ P Cr' Sr ~~ ., ^ Boring ~ 0 Parcel ID # ~C1~~~. Page ~ of I l e~ owmy e ' /. V ® pit Ground surface elev. _____ ft. Depth to limiting factor ~n• Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. Soil lication Rate GPDIff 'Eff#1 'Eff#2 3 O - ~~-~9 .~9./~ ~0 y~3 ~. 7.5y2y 3 S ~ R s `I ~" -----'"-' 5 L F~ o? G a~S~~- of FS b M r r wt~r ~ G -~ ~~ ~' ..~ . S . S . . s ~1 u ~ri~ pq p ~~ # 7 / / ~ ft. Depth to limiting factor a ~ in• [~ pit Ground surface elev. __ ~ Soil ication Rate t i nda B Roots GPO/fg Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. ence s Cons ry ou 'Eff#1 'Eff#2 ~ -~i 7.5 YRY to _ "'1 ~,g3 ~ r G t.J 1 ~ d1-~q ag_,~ ~. 5`I~y y 5 ~sJy --------"'.. --- - S ~ ~ FSS t~. ~~r5bk. wt r M~ f.• C t.~.~ --r ~ J~ -- ~ 5 , 5 u ~~ Boring # Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate ^ Pit Horizon Oepth Dominant t.olor Redox Description Texture Structure Consistence Boundary Roots GPD/ft? Gr. Sz. Sh. •Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color ' Effluent #1 =BODE > 30 _< 220 mglL and TSS >30 < 150 mg/L ' Eflluent #2 = BODS < 30 mg/L and TSS _< 30 mglL "f he llepattment of Commerce is an cyual opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the departtncnt at 608-266-3151 or TTY 608-264-8777. g8p-U3o (R.6I0o) ~ ..~. (~ s ~ '/y 5 E ~y~ Stc . ~~~ T a9 n:, ~ l9' cam,? SGa i e : I ''_ ~~ ~ 3..1 ac.r~ . . ~` ~o~ b / c3 ~o ~ 3 5 v ~ ~. K ~~~~y~ „--`~'"' o ~ ~ , fT . c, ~~ ~ ~-?~ ~~~e ,~os+ ~ ~ .~ ~ ~ J t I:~ ~~'' ~ / I I~~ ,, T To b~..,+ P ~ ~ ~ s ~, .~ 7 'r ~ ~ .,.._ .. ~• ~`'' / ~ . y5 ~ t b a~k o~ ~;-~s Q __ ~~ - ~!~- ~~ r _ ---~- • ~, 8rn ...._~,~_ j3aY , _~ ~ ~vo,ao ~~~ V ~r~ ~ '~' ~ Q ~" a ~- ~ "".~~-..,.. ''~---~ ,~ ~ ~ba,$e' B3 9g,b~ '~ ~~{ 94,9$ r,4 - ~ . T2oN. R1~W OF PLAT BOl1N0ARY . S (961,356 SQ FL) D >rrtan aAn ooNloln :NATION IHD N ~~ +wrsersAacur+e ~ FASE-1o+r 0 onn's at swPa WEAT610LOPE YATiA iiTiN710NARFATO .Ti11 LlAE BiVATgN ,011 WAT91lME flNAl10N 7",A OR fi01OBR 01141 DO ANYI1l10 .QUID WTI WIT11017 GI410E TNO 711 Of m ~wPr7w®oolwrel+e~lwe >~os AAD tOiL wosloN RIJ1 FOR r. 71M aauoes sir t NoT 1n1IfFCTo ,UPON, OOOfAIICf WOL ALT6111d0, F111N0 VATOYI, !19 P'4Nl7l3 .N MR' P'O~lO 118. WA~iR ONAINAOG OfTpiil, W ~TO1 :0. WATd7 011V6R0, OEMM ON O1Wi i a 6D pOVEWAY WIH CORNEA SEC. t~ seo'si~ ~g \ LOT Zi ~ s.s i-c~ies ~i ~l \ cs.f acAea~ ~ ~ QI I J ~~ H.W.L .0323 . 1 • ~` ~,>d H.W.L ~Xfa 1 CURVE DATA TABLE NUL10 Hi hd1~ OMrd M1010wd OPVFW CMrC ir7~OMO tan00,TV7i7101n T~riprM 01a Ot X0.00' 07'000' N00'VIO.01M 100.0x' 100.00 N00'09'1~'1N NOOVPJfW CZ iR.00' O6'01'OM NOOYO'10'W 1Ol.N /01A0 NM'M' Wltl9YI1RV C7 107.00' 2T060r N10NNw OD11' 10.71' N~1Yf/0W ND1'ON7T os an.aa 1r~s1r Noah~~aw s1.v s1.sr Nol7oss7s N11v7n1w U LOT 17 ~~ _~~~ ,~ s „cues, ~~ i X flt7p/ d~~ ~ ~~ ~':~ O 1o1a3 i ~ ~ I~ i` i _,,i~~ ~~~ i' i -_ I ~I pl ~I i~P~ X ~ `` fuac- eWiMYOli: DOtlOLA{ J. 7JIItl 61iN LAND suRV6 sa:o egos a»u surR tot ST CROIX COUNTY c~ SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM ' OwnerBuyer S~'~ Y~ /LLE,~ .. - Mailing Address ~ e X ~ ~,S ~, /~ ~ ~ Property Address 8~t'oy ~ r % ~- (Verificationrequired from Planning Department for new construction) i City/Skate ~y ds ©~ t.V ( Parcel Identification Number b Z o - (3~ 3 ' ~ ~ " `y ° d i. LEGAL DESCRIPTION i 23~ ~ 1 S ~ y., Sec. (z . T Z5 N-R ~ 9 ,Town of f~/OS o ht ~P~' Location ~~ /., Subdivision Moo K b~_.~ fe ~~ ~ sTF4-~ Ai ~-'•o h .Lot # ~ 8 Certified Survey Map # ,Volume .Page # Warranty Deed # ~ Z~ ~ ? ~ ,Volume Z 2 $ `{ .Page # tA9 ~ Spec house] yes D no Lot lines identifiable,$1 yes ~ no SYSTEM NiAINTENAl~CE Improper use and maiateaaneeof your septic system could result in its premature failure 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 masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-sits wastewaterdisposal system is is 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 and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. p /~yio PLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this forni are true to the best of my (our) knowledge I (we) am (are) the owner(s) of the property described abo e, by virtue of a warranty deed recorded in Register of Deeds Office. 4 O` / F LICANT DATE Any information that is aus-represented may result in the sanitary permit being revoked by the Zoning Department. *"«`« tMi«•t •* Include with this appllcatlon: a stamped warranty dud from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ~,~~~"~ ~~ ~ ~ ~ ~,e~~~ ~ ~~ ray ;~U> z a~~ Private Onsite Was ewater 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- Table 1: Sy Sanitary Permit Number Number of Bedrooms Design Flow -Peak (gpd) Estimated Flow -Average (gp~ Septic Tank Capacity (gal) Soil Absorption Component Size Tvpe of Wastewater Table 2: Soil Abso Design Flow -Peak (gpd) Maximum Influent Particle Size Maximum GODS (mg/L) Maximum TSS (mg/L) r. I i Z 1/8 150 Table 3: Maintenance 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 se ~ and outlet filter shall be assessed at least once every 3 years by inspection. T e outlet filte shall be cleaned as necessary to ensue ~?~"~ 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 m Design Specifications o ` ~~ O G -zz. So lam Domestic on Component -Limits of Reliable Operation Septic Tank Component Soil Absorption Component /~ , 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 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 fhe 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 // , // - ;' ~ ~ Management Plan for a Septic Tank and foil Absorption Component Plantings of deep-rooted 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. T ~ ~ S ~ S Q S '~ S"ta~ -+~ ~o r c~ ~ - BGa~/'~`~^ o'D.~ ND L~ ~ 4` ~~1~. ~4~ !~!a ~'Q•~` 0.2 Q W,~ 6Q ~5~~ it S/S~Q'v~ °-~ 5 C ~ C,/~~ ~ Y ~~ L ~ ~ y Zo /~ , h q 1 1 3 ~ ZZ84P 696 ~~68~8 STATE ..r+R OF WISCONSIN FORM 2 - 1998 KATHLEEN H. MA1.SH WARRANTY DEED REGISTER OF DEEDS $T. CROIX CO.a YI Dceument Number ,__ __ RECEIVED FOR RECORD This Deed, made between Brian E. Wert and Joann 06/23/2003 09:00AM i_ Wert, husband and wife, NARRAHTY DEED EXElPT i _ ,Grantor. REC FEE: 11.00 and Sam E. Miller, a single person, _ TRAKS FEE: 240.80 COPY FEE: CC FEE: '! PAGES: L Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate In St. CroiX County, State of Wisconsin: Rc+crn.7iny F,r,., Name and Return Address ~~; First Federal Capital Bank 020-1393-18-000 Parcel Identifiratan Number (PIN) Thfs 1S nOt homestead property. (is) (is not) ' Lot 18, Moonbeam Ridge First Addition in the Town of Hudson, St. Croix County, Wisconsin. Exceptions to warranties: Subppject to easements, reservations and restrictions of record. Dated this ~L'~ day of Jtuie 2003 (SEAL) iSa.~~ C • ~t~(~N~- (SEAL) BRIAN E. WERT (SEAL) _ (SEAL) JOANN WERT AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated this day of , State of Wisconsin, ss. St. CrolX County Personally came before me this ~f day of June, 2003 ,the above named Brian E. Wert and Joann TITLE: MEMBER STATE BAR OF WISCONSIN (If not, h' me own t e the person s authorized by §706.06, Wis. Stats.) '-, ~ i ttvme acknowled e th Y THIS INSTRUMENT WAS DRAFTED BY ~-: ;~ '- ~ ~ ~s Stephen J. Dunlap ~,,~~.;,~ "r- [o who executed [he foregoing ' Notary Publ[c, State of Wisconsin HlldSOn, Wi$consin ~ My commission is permanent, (If o[, state expirat on date: (Signatures may be authenticated or acknowledged. Both are not __y/~/~_ ~.) necessary.) ' Names of persons signing In any capacity must be typed or printed below their signature. _ ~ ~ ~ ~ ' STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Ina ' WARRANTY DEED FORM No. 2 - 1998 Milwaukee, Wis. `~, ~~ `'i~e~ X59 S/t~ /yf ~.« F-~C ~ i~ ., .. ~o ~ ~~ ~P ~ D ~~$ ~ ~° ~~ . ~ ~~~ ~Q ,cam \ v $ ~ iGP I~ ~ ~ i~ ~ v ,~ ~ ~~ ~° ~d I ~ `~ ~ v ~~ ~~ ~ \ ~ 502°32'41 w 199.1 i~ i ,,.vim - !~ r ~. ! ~ 1 1 ~ ~ ~ ~ ~ '. ~ Q ~ ~ ~• ~~ ~' V < .. \ \ os ~ ~~ \ .~ ~ J \\ ~ $~ \ ~ j r , \ ~~ ~ ~~ \ ~ Om j ~ ~c \ ~~ W \ \ \ \~\ '-'-------- 473.91' 3( S00°01'09"W 780.14' ~souni~ .~ d04 9 ~~ i~--------,----------------- ------- ~ ~ ~ ~C~o~o[~o G°31~C~OG°3DC~D UM MOdo 9 4~_ PC~o 3 i i ~ ----- ~ ~ i~ o I d04 4 d04 ~3 ~ ------- I .~-