HomeMy WebLinkAbout040-1298-40-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
572869 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Creative Homes, Inc., c/o John M. Eral Troy, Town of 040-1298-40-000
CST BM Elev: Insp. BM Elev: BM Des iption: Section/Town/Range/Map No:
j - ( CS 1 09.28.19.1722
TANK INFORMATION ELEVATION DATA
HI FS ELEV.
TYPE MANUFACTURER CAPACITY STATION IBS
Septic jr. ! ~QDd Benchmark ~ 99, 3
~
Dosing 11t) we" J t F: L,... 3 / Alt. BM
Aeratien e J Bldg. Sewer
•7 ~ 7, z
Holding St/Ht Inlet
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic ~y zb Dt Bottom /f./ cZ
Dosing /V , / Header/Man. S Q L
Aeration Dist. Pipe 9f J•
i
Holding Bot. System -7-7 96'/o Z-
q3.
PUMP/SIPHON INFORMATION Final Grade 3.6
Manufacturer Z e, ~Le~ Demand St Cover r /I• I q~
GPM
Model Number 5_3
TDH Lift Friction Loss System H TDH Ft
J2.ty 32
Lel3 . Dia. I/ Dist. to Well
Forcemain
1 .41 AA
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Ot Inside Dia. Liqui epth
DIMENSIONS 3 r? Z J
SETBACK SYSTEM TO ' / P/L BLDG WELL LAKE/STREAM LEACHING Manufact~Jr.
INFORMATION CHAMBER OR ~ tG~,'1
Type Of System: UNIT Mode umber:
DISTRIBUTION SYSTEM 7_344-43 = yl. ~o~~Jz
~ng Vent to Air Intake
x :Hole Sizes x Hole Sp G4
Header/Manifgld / Distribution l
y \ `
Length 5 Dia Pipe(sLength) Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded/S xx Mulched
Bedfrrench Center G; Bed/Trench Edges Topsoil !LYes [E No es No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 406 Glen Ridge Rd Hudson, WI 54016 (SW 1/4 SE 1/4 9 T28N R1 9W) Glover Glen Lot Parcel No: 09.28.19.1722
1.) Alt BM Description = r ~ Hu' x / 01 4~.fi
2.) Bldg sewer length = 26
- amount of cover = 4/6"
Plan revision Required? Fm] Yes o ~
Use other side for additional information.
Date Insepc s Sign Cert. No.
SBD-6710 (R.3/97)
PLOT PLAN
PROJECT Dannv Schnackv ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125
SW 1/4 SE 1/4S 9 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX
SYSTEM ELEVATION 94.7/93.8 4.6' below grade DATE 1/29/15 BEDROOM 3
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 933 # of chambers 46
Ilk BENCHMARK V.R.P. top of 3/4" pipe ASSUME ELEVATION 100° Filter BEAR Filter
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
150'
378' Property
B.M.#2
10' @ 102.14'
Additional boring will be 20' 99' t~
dug to lower system 10, 97' v
elevation to a suitable
depth! B-2 Glen Court
Scale = 1 /4" = 10'
4-3
9 , 2-3' X 94' Cells with >3' spacing
10% Slope
B-1
6'
101' B
0 20'
S
30'
Pro 3
Bedroom Glen Ridge Rd
House
Zb
All piping shall be "SDR 30/34, within 10'
of tank, piping shall be Schedule 40. )C
CO mty L
Safety and Buildings Division
B 201 W. Washington Ave.; P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.)
p 'y Mso~V11 ,37 2
sip ~~1~ 57Z~~~
" State Transaction limber
ermit Application
rt ~'P
in accordance with SPS 383.'.1(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit
is required prior to obtaining a sanitary permit. Note: Application fortes for state-owned POWTS are submitted to Project Address ( different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
ores in accordance with the Privacy Law, s. 15. 1 m), Stats. 6 ~~Glti
L A lication Information - Please Print All Information parcel
Property Owner's Name L ~►n
~lC) lV (JV~/
Property Location
Property Owner's Mailing Address Z \J
0--, r J Govt.. Lot i
city, state Zip Code Phone Number 5(,t~ ;4, Section
p y~ ) , le one
I.CJ L4 T Z N; R E
II. ype of Building (ch all that apply Lot #
2 Family Dwelling -Number of Be Subdivision Name
droo _ ~~~~p
6L ~ Block#
❑ PublicJCommercial - Describe Use n• 11 City of E LZ5 11 Sta
te Owned Describe Use CSM Number F1 own Village of
of
2 Z ~l ► 51- Cell t,tJ
III. Ty of Permit: (Check only o 6e box on line A. Complete line B if applicable)
A. ew System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
List Previous Permit Number and Date Issued
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New
Before Expiration Owner
W. T prof POWTS System/Comp onent/Device: Check all that apply)
esized In-Ground El Pressurized In-Ground ❑ At-Grade El Mound > 24 in. of suitable soil 13 Mound < 24 in. of suitable soil
sur
❑ Holding Tank ❑ er Dispersal Component( I ) Pretreatment Device (expl
.l
V. Dis rsaUTres ent Area Information.
Area Prsed ran Elev on
Flow (gpd) Design Soil Application Rate( dsf) Dispersal Area Required (s D730
t ~ ~ a
V G
ank Info Capacity in Total # of Manufacturer
V1. T
Gallons Gallons Units U h
o T v
New Tanks Existing Tattles [ '
U ;n o cn i Ci
Septic or Holding Tani: j
Dosing Chamber
VII. Responsibility Statement- 1, the dersigned, assume r n ' ility for installation of the POWTS shown on the attached plans.
Plumber's Si MP/M?PRSS Number Business Phone Ntanberr /
Plumber's Name (Print) j ✓ ) ~ '~L,~< L~ llr~~~.~
Plumber's Address (Street, City, State, Zip Cod)
3 Z~ ~-.k- /vA
VIII. ountvlDe artment Use Only
Permit Fee Date sued Issuing, tSib Signature
Xpproved tsappro S Ll 36 15
er Given Reason for 'al J
TX Condtt~Ygasons for Disapproval 3~ ~S
1 • Septic tank, efflux filter and
dispersal cell must all be services ! maintalneSt ►~J
mber.
as per management plan provided by plu 5
2. a 1`s0 k requirements must be trraiMairiesl, J
as per appi"We code / ordir>ancss.
Attach to complete plans for the system and submit to the County only ae sper not Less than 8 to z l l inches m size
SBD-6398 (R. 11/11)
PLOT PLAN
PROJECT Dannv Schnackv ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125
SW 1/4 SE 1/4S 9 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX
SYSTEM ELEVATION 94.7/93.8 4.6' below grade DATE 1/29/15 BEDROOM 3
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
1000 gallons LIFT TANK SIZE DOSE TANK SIZE
MOUND SEPTIC TANK SIZE
HOLDING TANK SIZE LOAD RATE •5 ABSORPTION AREA 933 # of chambers 46
BENCHMARK V.R.P. top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark 150'
378' Property Line
B.M.#2
20' 10, @ 102.14'
Additional boring will be 99'
dug to lower system 10, 97'
elevation to a suitable B_2 Vents
depth! Glen Court
Scale _ 1 4" _ 10'
9 B-3
2-3' X 94' Cells with >3' spacing
40'
10% Slope
-1
6'
101'
B.
20'
S
30'
Pro 3 Glen Ridge Rd
Bedroom
House
All piping shall be 'SDR 30/34, within 10'
of tank, piping shall be Schedule 40.~C C) p o
Cover Page
Shaun Bird
Bird Plumbing Inc.
1432 120th St.
New Richmond Wi 54017
715-246-4516
Date: 1/29/15 Owner: Danny Schnacky,P
Location: SW 1/4 SE /4 S9 T28N,R19 406 Glen Ridge Drive Troy
Manuals Used: In-ground absorbtion system (version 2.0)
Page#
1. Cover Page
2. Plot Plan
3. Chamber Cross Section
4-6. Maintanance and Contingency Plan
7. Filter Specifications eet
Signature
License n er #226900
PLOT PLAN
PROJECT Dannv Schnackv ADDRESS 707 Commerce Drive Suite 410 Woodburv Mn 55125
SW 1/4 SE 1/4S 9 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX
SYSTEM ELEVATION 94.7/93.8 4.6' below grade DATE 1/29/15 BEDROOM 3
CONVENTIONAL XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46
Ilk BENCHMARK V.R.P. top of 3/4" pipe ASSUME ELEVATION 100' Filter BEAR Filter
❑ BOREHOLE O WELL * H. R. P. Same as Benchmark
378' Property Line 150'
B.M.#2
20' 10 @ 102.14'
'
Additional boring will be 99,
dug to lower system 10, 97'
elevation to a suitable B-2 Vents
depth! -2 Glen Court
Scale = 1/4" = 10'
9 , B-3
2-3' X 94' Cells with >3' spacing
40'
10% Slope
-1
101'
B.
20'
S
30'
Pro 3
Bedroom Glen Ridge Rd
House
All piping shall be SDR 30/34, within 10'
of tank, piping shall be Schedule 40.
Cross Section of Infiltrator Quick 4 Leaching Chamber
Typical cross section for 2 of 2 cells '
Quick 4 Standard Leaching Chamber
with 20.0 ft2 of Area per Chamber To be >1' above grade
5.'6ft 2 pair of end plates
,V Finish grade elevation
Typical Installation 100.3'
Vent Grade Vent
3' 4" 3'
X30/34 Septic Tank
5' Long 1 11 5' S' Long 1 91 3699 Grade at System Elevation Grade at System Elevation
Spacing 5'
2-3' X94 ' Cells
Same on other end Observation tubeNent
At end of cell
A
B
23 chambers per cell
System elevations:
A-94.7'
B 93.8'
ST. C.'ROIX COLTN
SEPTIC T ANK MAIN ENNNCE ri(
-2 ?F..MI ' f
AND
OWNERSHIP CERTIFlC ~"TIC.N I'ORM.
Owner/Buyer - - C~,1Z C ' c
Mailing Address,,-,--,,-,__, zn,_ '7,,p /7''%c.? r t 1 _ -'~1 -
. ~a4
Property Address
(Ve ificatton required fiotn 'lanru ng Zoning 1)ehatt~nent for new atusiruc.ttun.)
Cif /State ~ - Parcel Identification in -iper ~
LEGAL DESCRIPTION
N //W, Town o(- ~f
Property Locataon ,(w1-) e- sec
Subdivisi0sl ( r~~ t? CC'~~.o [ ,ot .
Certified Survey Map # _ _ Vt lutrte' Nagc ~t .
Warranty Deed VGtutne Page rr,
Spex. house yes ru,) l .ot lirn~ identifiable. yes no
SYSTEM MAINTENANCE AND OWNER CERTITICAIJON
Improper use and maimenwice of your septic system could result in its pr,rmature faihtre to handle wastes. Proper
maintenance consists of pumping out the septic tank every three yetus or sooner, it 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, wasic disposal, systerti. OWrler maintenance
responsibilities are specified in §('onun. 83-52(1) and in Chapter 12 -St. Croix County Sanitary Ordinance..
The property owner agrees to subtrut to St. CCOix County Planning do Zo ng 1.)epartrnent it certification fitrnt, signed by the
owner and by a master plumber, journeyman plumber, restricted plurrtber or a licensed pumper verifying that (.t) the ort-site
wastewater disposal system is in proper operating condition and/or (2) after inspcc,ion and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
I/we, the undersigned have read the above- recluirenients aixl agree to maintain the private; sewage disposal systeni with this
standards set forth, herein, as set by the Department of'C'onttneicc and ill(-, DeParttr,enc of Natural Resources, State of Wisconsin.
Certification stating that yolu septic system has been marritaitted mast be coinpletc, l and i:etiaried to the St. Croix County Planning, &
Zoning Department within 30 days of the three year expiration date.
)/'we certify that all statements on is foun are true to il~c hesi of tt»; our k uowlccige. liwe atti/are. the ovvtter(s) of the
property described above, by virtu,, of a arranty decd recorded iu Register of l)ee( is Office.
umber of bedroom § 3
SIGN OT DArJ ~
***Any information that is misrepresented may result ill the sanitary pennit being io.! vobed by the Planning & Zoning Department.
}//elude with this application a recorded warranty deed from the Register of Deeds r--jffice and a copy of the certified survey neap if
reference is nrade in the warranty deed.
(REV. 08/05)
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
SYSTEM SPECIFICATIONS p NA
laro
977E d G6~ Tank Manufacturer:
~
Septic O Dose ❑ Holding Volume: J (gal)
`NA
Tank Manufacturer:
DESIGN PARAMETERS
Number of Bedrooms: `3 0 NA ❑ Septic ❑ Dose ❑ Holding Volume: (gal)
Number of Public Facility Units: gLNA Vertical Distance Tank Bottom(s) to Service Pad:~ (ft)
Estimated (average) Flow : (gal/day) Horizontal Distance Tank(s) to Service Pad: '15L (ft)
(TD Specific servicing mechanics must be provided 'rf vertical is >15 feet or
Design (peak) Flow = (estimated x 1.5): k-3 0 (gal/day) rEffluee:nnt ontal Is >150 feet. Specific instructions to be provided on back.
In Situ Soil Application Rate: (9daylft~) Filter Manufacturer. ❑ NA
Filter Model:
Standard (Domestic) Influent/Effluent Monthly average Manufacturer:
Fats, Oil & Grease (FOG) s30 mg/L p /
Biochemical oxygen Demand (BOD5) s220 mg/L C1 NA Pump Model:
Total Suspended Solids TSS 5150 m L Pretreatment Unit
High Strength Influent/Effluent Monthly average
(FOG) >30 Manufacturer: 4NA
(GODS) >150 mg mg/L IA ❑ Mechanical Aeration ❑ Peat Filter ~
SS) >150 mg/L p Disinfection ❑ Wetland
Pretreated Effluent Monthly average ❑ Sand/Gravel Fitter ❑ Other.
(BODs) 530 mg/L /`~"'A Soil Absorption System
Ground (gravity) ❑ In Ground (pressure) ❑ NA
(TSS) 530 mg/L -pl V
Grade ❑ Mound
Fecal Coi'rform (geometric mean) s10" -
to dia. ❑ NA [3 Drip-Line C1 Other:
Maximum Effluent Particle Size
Other:
Other: NA ❑ NA
MAINTENANCE SCHEDULE Service Frequency
Service Event y
hen combined sludge and scum equals one-third of tank volume
Pump out contents of tank(s) ❑ When the high water alarm is activated
❑ month(s) (Maximum 3 years) O NA
Inspect condition of tank(s) At least once every: year(s)
At least once every: `S mo inks) (Maximum 3 years) ❑ NA
Inspect dispersel cell(s)
j month(s) ❑ NA
Clean effluent fitter At least once every: ( year(s)
r- ❑ month(s) :::rNA
inspect pump, pump controls i3< alarm At least once every: ❑ year(s)
month(s) Flush laterals and pressure test At least once every:. ❑ year(s) ❑ month(s)
Other: At least once every: p year(s)
❑ NA
other:
MAINTENANCE INSTRUCTIONS licenses or certifications:
Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the to a following ng l icO Operator Master Plumber, Master Plumber Restricted
Sewer, POWTS Inspector, POWTS Maintainer or Sep g Servicing p~ (pumper), any crack Tank inspections must f include a sludge and scum and a check for any back missing or broken
hardware, grrou or ponding of effluent on the g d surfaces Tor le he aksoil
measure the volume ing effluent
aP gacondition~and forrequiresany immediate
absorption system shall be visually inspected to check the effluent levels in the observation pipes
on the ground surface. The ponding of effluent on the ground surface may indicate
notification of the local regulatory authority. of the tank volume, the entire
When the combined accumulation of sludge and scum in any treatment tank equals one-third (X) or more
contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code: pretreatment units,
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components,
and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. GMW 005 (02/05)
Page of
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other
chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are
detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. under these
in one largedose ca sing an
Pump tanks may fill above normal the eater wastewater willrtbe discharged to the soil absorption restorati
have the
sitUation
this
conditions is not recommended, as the excess s avoid
overload that may result in the backup or surface discharge of effluentand dam~go resiagng pow' to the pump or contact a Plumber
contents of the pump tank removed by a Septage Servicing Operator (pumper) prior
or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank.
System start up shall not occur when sal conditions are frozen at the infiltrative surface.
not drive or park over, or otherwise disturb or compact, the
Do not drive or park vehides overt tanks and or soil at-grade soil absorption absorption system. area.
area within 15 feet down slope of any and prolong the life of the treatment
Reduction or elimination of the following from the wastewater stream may improve the performance dental floss,
tanks and sal absorption system: acids, antibiotics, baby wipes, cigarettebutts, condoms, cotton swabs, degreasers,
~oline, greases, herbicides, meat
diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, g88,
scraps, medications, oils, painting products, pesticides, san"ry napkins, solvents, tampons, 'and water softener brine discharge.
ABANDONMENT
When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is prop y
and safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator (pumper).
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil,
gravel or another inert solid material.
CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
l absorption system.
repla ent system: and
for the
utilized
may be
! suitable replacement area has been evaluated
from d sturbance and co mpaction wand should knot be~thfri g1ed upon by required
The replacement area should be protected setbacks from existing and proposed structure, lot lines and wills. Failure to protect the replacement area will r with the rules in
for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply
effect at the time of their permit issuance. system cannot be
C1 A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption rehabilitated and barring advances in POWTS technology, a holding
tank may be installed as a last resort. ure of the
site
and
P0VVTS
evaluation ❑ The site has bow t locate a to identify a suitable
noo replacement sea islavailable a holding tankmay be installed as a
replacement area. replacement
must be performed
last resort to replace the failed POWTS.
❑ Mound and at-grade soil absorption systems may be reconthsttruN1e edd in place afollll at ing removal of the biomat at the infiltrative
surface. Reconstructions of such systems must comply with WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK
SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY
RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE
ADDITIONAL INSTRUCTIONS:
POWTS INSTALLER POWTS MAINTAINER .
Name J Gc c.~
EName
Cl )J) ,
-a 7 Phone n J "
~)J J fj
SEPTAGE SERVICING OPERATOR LIMP LOCAL REGULATORYAUTHORITY
ER L c ~
Name
/ q
Name Z2==_Z2y2' 4&
Phone
Phone '5f1 -
This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections
Comm 83.22(2)(b)(1xd)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
FILTER CARTRIDGE INSTRUCTIONS
Installation
STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is
centered under the access opening. If not, then either insert more pipe into the
tank through the outlet or solvent weld (glue) additional pipe onto the outlet
pipe.
STEP 2 While the case is still dry fitted on the outlet pipe, measure the length
of 3/4-inch pipe needed to brace the filter to the tank end wall if utilizing the
optional supplemental side support. If side support method is not utilized,
proceed to step four.
STEP 3 For installations utilizing the optional supplemental side support:
solvent weld the 3/4-inch pipe onto the filter case. If side support method is not
utilized, proceed to step four.
STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter
cartridge into the case, pressing down until the filter locks into the bottom of .
the case.
STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning
clockwise 900.
Maintenance
1. The effluent filter should be cleaned every time the septic tank is v_~~w x
serviced.
2. Open the outlet access opening to inspect the tank and filter. ~ t
3. Pump the septic tank completely, making sure to remove the sludge -
layer on the bottom of the tank and not just the scum and effluent.
4. Once the effluent level has been lowered below the invert of the s ;
outlet pipe, firmly pull up on the filter handle to dislodge the
cartridge from the case.
5. Slide the cartridge up and out of the case for cleaning.
6. If a VRS switch connected to an alarm is present, the switch
should be removed by turning counterclockwise 900 and cleaned, F ,
with water only,
7. While holding the cartridge on its side (large flat surface facing
down) over the access opening, rinse off the cartridge with water
only, making sure all septage material is rinsed back into the tank.
8. If VRS switch is utilized, replace by inserting into filter and
turning clockwise 900.
9. Insert the filter cartridge back into the case, pressing down until d °r
the filter locks into the bottom of the case.
10. Replace and secure the access opening on the tank.
BEAR ONSIT - FILTER CARTRIDGE - FIVE-YEAR LIMITED WARRANTY
a. i >e free 0. Ir d~c Id`
6 a: Or6i`.B fiiCe= tarsi o r, ere
~or..;«rn_.. Nom: _hase:
BEAR ONSITE- Filter Case -Lifetime Limited Warran Y
bkear Cmgrc-. warrants e hfte• rase ::d1 he. .et .I_.t.
the v :nal purchaser owns the vociu_,-
is faun: In .iJ rnal u5 Fea 0".sI wl far` o
i - v a 7c^ r c, a e s r .,gee r. I
aG,7r c. ate BOIL st:-en Ja Ida t a rc,ot w,..11
i.- tri a . a - th Ins t vn um'S Pot a 0: ,al nt pr~In fr n- w. r;: re r r - Ine s,
'Y a n Pl 1, Sf 1o1ra. sales :e F `7 ..li _,me, IUe df Or it- all..
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1007223
BETH PABST
REGISTER OF DEEDS
State Bar of Wisconsin Form 1-2003 ST. CROIX CO., WI
WARRANTY DEED RECEIVED FOR RECORD
01/29/2015 8:00 AM
Document Number DocumentName EXEMPT # N/A
REC FEE: 30.00
TRANS FEE: 224.70
THIS DEED, made between Michael E Mankowski and Karen Mankowski PAGES' 1
married to eadli"other
("Grantor," whether one or more), **The above recording information
and Creative Homes Inc. verifies that this document has
been electronically recorded.
& returned to the submitter
("Grantee," whether one or more).
Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area
estate, together with the rents, profits, fixtures and other appurtenant interests, in
St. Croix 'County, State of Wisconsin ("Property") (if more space is Name and Return Address
Return to:
needed; please attach addendum):
Burnet Title.
/ 5151 Edina Industrial Blvd. #500
Lot 4, Plat of Glover Glen, Town of Troy, St. Crow County, Wisconsin Edina. MN 55439. 1
Attn: Post Closing
040-1298-40-000
Parcel Identification Number (PIN)
This homestead property.
(is) ' not
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except:
None -
Dated
(SEAL) (SEAL)
Michael E. Mankowski * Karen Mankowski
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT-
Signature(s) STATE OF
- ) ss.
) .
authenticated_ on 4
Personally came before me on 14
the above-named Michael E. Matkowski and [Caren
TITLE: MEMBER STATE BAR OF WISCONSIN Mankowski married to each other
(If not, to a known to be the person(s) who executed the foregoing
authorized by Wis. Stat. § 706.06) e t aclaao dMthee #-LL I NDA MAE ~CRAEMfR
Ne"v Put
THIS INSTRUMENT DRAFTED BY: in ewer
Burnet Title-Scott Tranby, 5151 Edina Industrial Blvd, b 0oi~~ 1Eq* aim 91,zoeo
Notary Public, State of Wis#500 Edina, MN 5
5439/ 14-19087 My Commission (is permanent) (expires: )
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED 0 2003 STATE BAIT OF WISCONSIN FORM NO. 1-2003
* Type name below signatures.
St. Croix County 1007223 Page 1 of 1
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REAR ELEVATION 1-10
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L or Properly Owner Parcel ID H O 7 t~ • /v(D / • Page 2 -of 3
florl"g o u Boring a
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Soil Application Rate
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Effluent #I = RODS > 30 < 220 mg/t. and TSS >30 < 150 mg/1- • Effluent #2 = ROD, < 30 mg/l- and TSS < 30 mg/l
The Department of Commerce is an equal opportunity service provider qnd employer. If you need assistance to access services or
• need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SRb-R) Jfl rR F/fMl)
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M.
'Msconsin Department of Commerce
110slon of Safely and Buildings SOIL EVALUATION REPORT Page / of
in accordance with Comm 85, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1112 x 11 Inches in size. Plan must County S7; ~~0/
Include, but not limited lo: vertical and horizontal reference point (HM), direction and
percent slope, scale or dimensions, north arrow, and localion and distance to nearest road, Parcel I.b.
Please print all Informatlon. Reviewed by Date
Personal Information you provide may he used for secondary purposes (Privacy Lew, s. 15.o4 (1) (m)). /s--
owner ` l! 7/21/06-
Property Property Location
RF Re/•-ff S Govt. Lot .SW 1/4 56' 114 S T 2 N R /
Properly Owners Mailing ,Address (m) W
3 p O lot # Block # Subd. Name or-~SpAfL
7 / G/o 0ER G/,'--•v Z AGf eS
City State Zip Code Phone Number
/JUP5O~ s ❑ Cily ❑ Village ® Town Neares( Road
T~ ~U/. yore (~!s , 41
2(p • /Z y3 ~tPa
New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate yS0 - ~pQ'a GPb
❑ Replacement ❑ Public or commercial - Describe:
Parent material d(JJfAejf. Flood Plain elevation if applicable
General comments fl.
and recommendations: S.G~
3 MAY
1 5 Z002
ST. CROIX COUNTY
/ Boring # Boring
q~3o q .
Pit Ground surface elev. fl. Depth to Ifmlting factor ` In,
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CST Name (Please Print) Signature
R0 34EIP T 7/6/P! CLi7- Z 2 ( 3 ?S er
Address
• Date ~Ealuaualldn Conducted Telephone Number
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Private Sawage Consultants Zp~ 2
655 O'Neil Rd.
Hudson, Wis. 54016
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ORIGINAL
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pSollAApplicallon Rale
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r Boring #
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Effluent #I = BOUs > 30 < 220 mg/L and TSS >30 < 150 mgA- ' EMuenl #2 = BOD$ < 30 mgn- and TSS < 30 mgn.
1'he Uepartrnent of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
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Ulbricht & Associates 9
Private Sewage Consultants
655 O'Neil Rd.
Hudson. Wis. 54018
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