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HomeMy WebLinkAbout020-1447-16-000cousin Department of Commerce PRIVATE SEWAGE SYSTEM fety and B{lllding Division • INSPECTION REPORT GENERAL INFORMATION (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 Wolfe, Jeremy & Traci Hudson, Town of SST BM Elev: Insp. BM Elev: BM Description: aD • O S / ~ .O S ~ CST- Nl.~ Z TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER w/P P~s2s- C-~. -~ l CAPACITY Sept ( ~ ~~~ ~fl Aeration Holding TANK SETBACK INFORMATION . en o irnae ep is ~ 40 N ~~ r osing ~ _1 O r ~` $„~ r -` era ion o ing PUMP/SIPHON INFORMATION anu urer eman GPM o e u er i nc ion oss ys em a o ce in e g county: St. Croix Sanitary Permit No: 488128 0 State Plan ID No: ~ ~ Parcel Tax No: 020-1447-16-000 Section/Town/Range/Map No: 15.29.19.2847 STATION BS HI FS ELEV. Benchmark ~~ ~ .2pr' JOO `~,0~ Alt. BM Bldg. Sew r 5,3tts~ ~ ) 1~3~ St/ t In 1~ Q a C `~S f t t u et ~' ~~ b ~ o ~ . ~O$ n et 0 om ea er an. h ~ ~ /~. ~ I • t~ 1 o . ys em /2.2~' ~ ~ • 16 f 1I ina ra a 93~ / ~ 1 over ~i ~ ~ N.. ~•/~ OQ•.2g1 S~ ~z WVII ~~~v ~ - Sr ~~a a~ 5.18 0 .2Sf i X ~ w..- nrr .w~ _ .mac ~~i~' ~'t~~` e- - - DIMEN ~ 1 ~ ~ ~Q' INFORMATION CHAMBER OR ~•~ s ~v ~ 3r ~ qSl A / UNIT UIJ 1 RI~U 1 IVIY J 1 J 1 GIYI \ l ~ .- .~wV ..1CleC ND~\ Wil ~~11AY +G 1rlYC~`V W ~ ` M '{dp(~ _ vv~(y.{.{,{,~C 1 Lt hs Fipe(s) ~ l01 Dia Lengt L is Spacing _ ~,_~.. ovu.. vV r ~~~ R r~GSDUIC JVDlC111A VI~IY nn vva•uw v. r...+•..r~ -~---•••_ _.- Bed/Trench Center Bed/Trench Edges Topsoil w I `.~ Yes ~~ No c _~ .n 'i l', Yes ~ ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ -~P inspecuuii +rc. '~ Location: 667 Timber lane Hudson, WI 54016 (NW 1/4 SW 1/4 15 T 9N R19W) Coyote Ridgege LoC16~ Parcel No: 15.29.19.2847 1.) Alt BM Description = `~"'~ Q'' ~'~ °b r~5 "`" ~°r'V~~e"~S) 2.) Bldg sewer length = $'21 -amount of cover = ~ `f'Z-~ s°'~ ~~~Pilt~( . Plan revision Required? Yes No ~. ~' 2 - j Use other side for additional information. -_ 1 ~~ - ---- natar - -- - e . SBD-6710 (R.3/97) 1 T ^/) ~ ! ~ ~ ' ` ~~ ~^ f ` . Safety and Buil ings ~ ~ _ ~,' ~,~ 201 W W hi ounty m m . as ngton ve., P.O. Box 7162 ~~~~~~~~ De artment of Commerce Madi (608) 2 6 3~~~~ 1" 2 ~ ~ %~ ; ~ Sanitaz Permit N ~~ ~ filled in by Co.) Sanitary Permit Applicatio s ~ ~~ ~ ~ «: ~ ~; ~.~,v state 1 ,an l.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information _ may be used for secondary purposes Privacy Law, s15.04(lxm) ro~ Address (if different than mailing address) I. Application Information -Please Print All Information ~ ~ ~~ + /~ - 1 Property er's Name Parcel # Lot # ~ ~ Block # - .._ -/lv- Property er's M ' g Address Property Location ~ City, State Zip Code Phone Number _ %.,,~%,, Section ~- (circle ~~( ~ ~ ~ II. Type of Building (check all that apply) Tc ,/ N; R E of 1 or 2 Family Dwelling -Number of Bedrooms ~ Subdivision Name ,CSA4~ittnr~- ^ Public/Commercial -Describe Use ~ , " ,~ ^ State Owned -Describe Use ^City ^ i e ~ownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ^ New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner ~Q'~i 7 Q 13 ~~ u ~--0 IV. T ofPOWTS S stem: Check all that a Non -Pressurized In-Ground ^ Mound > 24 in, of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media FilterLeaching Cham r ^ 'p Line ^ Gravel-less Pi ^ Other (explain) V. Dis ersaUl'reatment Area Information: C Design Flow (gpd) Design Soil Application Rate( sfj is rsal Area Required (sf) ispersal Area Pro osed p (sf) System Elevation ~ ~ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units ~- P ~ Concrete Constructed Glass New Existing - ~ Tatdrs Tanks / Septic or Holding Tank r~r9 Aerobic Treatmcnt Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume sponsibi6ty for installation of the POWTS shown ou the attached plans. Plum r' ame ( ht) ~ Plumber' Si MP/MPRS Number Business Phone Number ~ -~ ~ ~ - Pl bet's ddress (Street, City, S , Zip C e / ~ ,C~ l VIII. Conn /De artment Use On Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Iss ' Agent Signet (No Stamps) ^ Surcharge Fee) ~~ Reason for Denial IX. Conditio of pp a ~1 SYS ER; 3 > ~ E-~ t S 1 o I o tMA ~ ~-(t S ~ ~~ J 1 Septic tank, effluent filter and _ -- ` dispersal cell must all be serviced /maintained - as per management plan provided by plumber. c ~ .~ ~ - ti:~ ,~ ~ ) yyy tiC 2. All setback requirements must be maintained _ - __:-:J-_._-~ ~ /~ ~ as per applicable code/ordinances ~ ~~L~ X j~ QA / .,r ~ ~~ `~~ , . fps ~ C.2 s, y kXM wmtxcac p..®t~v wo ~.vuncr onry),ror me systtm on poper not teas roan arts z r i ~ocnes ~n sae SBD-6398 (R. 01/03) ~3/8~,1o,c~ry ,~,~ ~. . b+'~' ~ ~;~ / ~'~ ~ / / `~~i r ~` t ~~f' ~,~ES ~, ~. j ~: s"'/ ~. l 71 r p2 `~' t ~~ ~ ~? ni / v ~~ ~~ / ~~ ;. "~ ~ ~.~ ~ e , ~, -_1~ ~- ~ .~ ~~>tl~~~~i~./f~ ~o~, et' I ~~,;,v~..J.e s M~KeF.~ /DO.O.S ~ -,/G~ ~~ ~'v~s ~~~~ .~ c ~d~ ~~ ~~ I .~ ~--- 4,Z ,~~/~-sw,i~//Sz~~.s- ~-~9~~~~ / ~!' ~l,t ~c pY ~~-.~ ~ ~./ j ,d/~ / / ,O~~G,~ ~. 1 1 ri~ ~ I ~ '~ ~3~B~-A,c~~y ~r ~~~~ ~~ s-~E~~ / ~~~ ~,~b~ / ~'~ ~~ :-~ alp //-sw/s~ sLe ls'= ~a9~ n°/~,,~ ~_ ~~5~ ~~ !~ ~. r t ~~ ~. % ;, ,>i ~~ ~ ~ ~ ~~ ~~ / % y~ ~ y ~~ % ~\ ~ ~ ~~'~' =~; ~ s i~ /~ ~ ; _ ~~ f/G nk: `! !/U~~ ! ` ~U~9 r 6~ S/~L// ip.l~' ~~ ~~ 0. / ., ` ,Q / ~1 / /',~ J~A 1J L1fC~ ~~%7~r//~~' T'~p L~r / // rd~ 1.,,7.C S MTi ~ ~~ ~©~. ~-~ ~ ~ "- -~D 'sct 1 ~. SJ~.~c 3~ ~~~~ ~' ~~ C~ ,// N ~1mf ~~ ~~~~~ ~~ ~~~ ,,, ~ ,~.--- - ,~ ~ ..~~~ g~©,/~ / . .0~.~.~4,~ ~. /~r,~,.~.~fi 1 ~~ I I ~ Safety and Buildings Division ` s m 201 W. Washington Ave., P.O. Box 7162 County ~ iieeEt> WI 53707 - 7162 ~scons~n Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266-3151 , / ~~ 1 z Sanitary ~~ m A~p C~IV E~ State Plan LD. Number In accord with Comm 83.21, Wis. Adm. Code, personal inf nnatio you provide may be used for secondary purposes Privacy Law, 15.04(1 Xm) Project Address (if different than mailing address) 006 I. Application Information -Please Print All Information NTY ~ / Property Owner's Name arcel # Lot # f Block # / Property Owner's ling Address property Locati Ci S h'> Zip Code Phone Number ,~. ~, %•, Section ~~ ~ cucle T N L O I R~E o~ , • II. Type of Bu g (check all that apply) 1 ~,a; ti, ~ oo r, ~~ ' //~~ ~~~ 1 or 2 Family Dwe - Number of Bedrooms ~ L,..dG ~ ~r ~ ~ , iivisionName @SitvfiVIIPfi6ei , ^ Public/Commercial - rite Use a ~--,~ Q `o,,.~. ^ State Owned - Describe U `j i ~ a( ^City ^Vi age Township of III. Type of Permit: (Check ly one box on line A. Complete line B if applicable) A_ ~NewS ystem ^ Rep ement System ^ Treatrnent/Holding Tank Replace t Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Re 'ion ^ Change of ^ P ransfer to New Ltst Previous Permit Number and Date Issued Before Expiration Plumber Own IV. T ofPOWTS S stem: (Check all t6 a Non Pressurized In-Ground ^ Mound > 24 in. suitable soil ^ Mo d < 2 . of sui 1 i At-Grade ^ Single Pass d Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ ing Tank ^ t Filt ^ Aerob' reatment Unit ^ Recirculating San ^ Recirculating Synthetic Media Filter Leaching Ch ^ Dr~ n G 1-less ^ Other (explain) '~ V. Dis ersal/1'reatmentAree Information: 5 Design Flow (gpd) Design Soil Application Rate( al Area Requ' Dispersal Area o ed s tr - pos ( y levation ~~ o ~i, y~ ~ //©~~ ~ ~,~- Q ~ 3 VI. Tank Info Capacity in Total N er Manufacturer a Steel Fiber p]~c Gallons Gallons nits .~ cret Con cted Glass New Existing Tanks Tacks ~ c1 ! ~ Septic or Holding Tank .~~~ ,~ ~ ~ , Aerobic Treagnem Unit Dosing Chamber VII. Respo sibility Statement- 1, th udersigned, a ume responsibility for installati of the POWTS shown the a red p ~ s. Plumb ame Print) Plumber' Si ~ MP/MPRS ber B n one Number ~ ~ ~ / - 5:~': / Plumber's Address (Street, City, , Zip C e) \ ~~ -- ~El ~ VIII. Coun /De artm t Use Onl ,Approved ^ S~itarY Parini Fee (includes Groundwater D Issued Issuin gent Sign o ^ ersaiGenR for Denial Surcharge F ~, IX. Conditions Approval/Reasons for Disapproval Slfs t3VNNER: 1. Septic tank, effluertt taker snd dispersal cell must all be.ssrvlces / malntairtsd as per management plan provkled by pkuttber. 2. iAU selbactt requirement: must be makttained as par atppAcabia code / a~nancea. ....~.......>+~.~ p..m tw we ...uuury onry7aor me system on paper not hs8 man aril i I1 ~ochB to Si7.t SBD-6398 (R. 01/03) POWTS OWNER'S MANUAL & MANAf3EMENT PLAN FILE INFORMATION Owner Permit # ( Z DESIG~~ PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ~'NA Estimated flow (average) (~;~ gal/day Design flow (peak), (Estimated x 1.5) g"GC yal/da Soil Application Rate gal/day/ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) <_30 mg/L liochemical Oxygen Demand IBOD~) <_220 mg/l ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand IBOD6- 530 mg/L Total Suspended Solids (TSS! 530 mglL J~NA Fecal Coliform (geometric mean) <_10" cfu/10 0rn1 Maximum Effluent Particle Size % in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent, MAINTENANCE SCHEDl1LE SYSTEM SPECIFICATIONS - r~atae _..,L.- or Septic•Tank Capacity Septic Tank.Manufactu~er ~~Q ~ . s' ag I C NA C NA Effluent Filter.:Manufacturer ; G NA Effluent Filter Model ' ^ NA Pump Tank Capacity- dal C~VA Pump Tank Manufacturer .e'`NA Pump. Manufacturer ANA Pump Model ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aor~rtion ^ Disinfection ^ Peat Filter U 'rJetland ^ Other. !~ NA Dispersal Calllsl ~ In-Ground lgravity) ^ At-Grade ^ Drip-line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: _ Other: ^ NA Othar: ^ NA Other; ^ NA Service Event Service Frequency Inspect condition of~tankls) At least once every: ^ mgnthlsl ~ earls) (Maximum 8 years) ` ^ NA Pump out contents of tank(s1 When combined sludge and scum equals one-third IY,) of tank volume ^ NA Inspect dispersal celllsl _ At least once every: month(s). ~ (Maximum 3'yearsl ` yvarlsl ^ NA Clean effluent filter At toast onco ovary: ~^~, year{st1 sl ^ NA Inspect pump, pump controls & alarm At least once every: ^ month(s) ^ year(s) ~`j NA Flush laterals and pressure test At least once every: ^ month(s- ^ yearls) " [ANA Other: ~ At least once every: Q month(s) ~ '~ ',p;NA OwnerBuycr ST CROTX COUNTY Stit'"rl(' ~rANK MAINT[iNANCE AGREEMENT AND OWNf_RSHIP CERTIF(CAT10N FORM ~ ~ ...._.l r~. e '. ~ ~ ~fl Mailing Address ~~ ( t l;~ k-' ~---L~2..~-~ ~~.-~ ~c-~Sc~ Proporty Address i >v£::.. ~ 1 ~'` ~.E:~ ~.,~,_ (verification required from Planning Department for new construction) C+ty/State ~4~ ~ ~ t'urcel Identification Number ~-- ~5l7-~f ~o ~ iG ~, FGA L DESCRIPTION paap dtunutn+ ayi u~ apew s~ »uaia}ai }i dew ~(anms pa~~ua~ ayt 1o eJoa o a>y}o spaao ,io aa~s~Sa~ ayt woi~ paap ~(wal+r.~• p~+iiuets a ~uo~ira!(dds siyi 4th• apn(aut .. luswLeda(I SuwoZ ayt dq Pa~(oear 8waq truuad,Ctetlues ayt u~ tinsar ,(ew patuasardars~ut s> tayt uo~-ruLO}u~ ~(nV .•~.•. ...... 31rQ .I.Nd~I'Idd O 3Z1. VN~J i i ~~ ~~ a~9}O spaao }o iats~8ag u~ paploaai paap dlUOrrr,~ r ,(u anu+.. dq •n~ yo pagerasap ~tuad ayt ,~ (S~aU.no Sul (aJE) ~~ (aM~ I 'a:lpotMOtt~( (]n0) ~Cui )O tS?q ayi O) ]RJl aJ\ lu3Q) Sll(t UCH 51U JUt~ICIS I(C ltyt ~(}luaa (aM~ I NOI ~I,L2i 2Ii1NMO 31rQ 1.Nd~I V d0 • N'Jl ' ~. ~atbp umtei~dxa uad aa~yi ayi }o :p Ot ufytlM a~iJ}p BwuoZ dtuno7 tl~or~ 't$ ayt of patutu~r puQ paNl~urua ay tSntll t~, u.citl!C~N uaaq sCy WaIyAS ~itdas nod itgl ~ugtlts o Wasuu>:daQ oyt pua aasatuuloa }o iuawuedaQ ayi ~(q tas it'utaioy 'yuoj ias n c ' N } i saau+osa~ (ss aoltc~r}luo~ u~cuoas~M }o aieig etods~p a$tMOS ats•ud ayt utYtuceat of aa~8e put siuauiar~nbar anoge ayl PaaJ a^sy pau8is-opun ayt •aw/( sds a l t spjepuats ayt ytiw+ u, ~a~pnls }o Ilol Ell ueyt ssal s- xtcet a~tdas ayt •(diessaaau }-j Sn-dtund pae uottaadsu~ .rat}e (Z 1 ru/}xtr uo~upun~ 5uetei~lo iado~il u~ st t BntJC}u~A,adtund pasuastl :,o laywntd parautsai •~agwnld uctudawtw('sayutnld ratsrtu e y u,ats~{s tesodstp,auMatseM au>:-cia ayt (1) t tua~ t iua~uedaQ 8wuoz xwj~ •tg ut uwgns of saai3e iaumo +(iiadoid ayl • tnt ~} ,ion 3 ,;q pus ratw-o ayi dQ pains ~utatads Iesods)p aiseti- ayt ut a8eis tuawicaii r se duet audas ayt }a uou~ury ayt e~a}}a uc~ ~ 'lwoos 1o aead aaiyt dt~•~a >tttct andas ayi ino 8tudwM }o sistsuo~ aau d q pap } ttuisds ayt otu} ind nod ity/Ifl ,adwnd pasuaaq o of alrslie} a~niewa~d sti ur t(nsai p(~os uratsds a~idas rno.i,ya aaueuatu~ew Quc asn iadaidwl ur ~ y saisaA. alp o~ueuatuleuf yadaid !1 1~t~1NIVW W;~.LSAS ou p sa~C a~ggypuap~ sswt toy ou ~¢j sat p asnoy ids ~ paged '`-~~~:~~ atun~o~ ' q paaa iCiuBi~gAA # a8t.d ' awn(on ' q dey~ 6an.inS paI{~zsa~ . ,..~. ~ to unnoi `M~C?I'PI~.L ~ '~aS ''/1 /}~ S `'/1 f~/jl uoil¢ao-( ~(µado~d Page ~ of STARTUP AND OPERATION For now construction, prior to use of the POWTS check treatment tank(s) for the presence,.of painting products or csherchemicals that may impede the treatment process andlor damage the dispersal ce111s1. If higfi concentrations are detected have the contents of the tanklsl removed by a septage servicing operator prior to use. - - = - " System start up shall not occur when "soil conditions are frozen at the infiltrative surface... _ ....: During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) .and may result in the backup or surface discharge of effluent. To avoid" this situation have the contents .of the pump tank removed by. a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating-the pump=eantrols to restore normal levels within the pump tank. ~- Do not•drive or park vehicles over tanks grid dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve ties performance and prolong: the: life of the POWTS: antibiotics; baby wipes; cigarette butts; condones; cotton swabs; degreasers; dental floss; diapers; disinfectants; 'fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softenerbrine:..-. - 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 properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: ~? • All piping to tanks and pits shall be disconnected ~~nd the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.' • After pumping, all tanks and -pits shall be excavated and removed or their covers removed and the void spade filled with soi{, gravel or another inert solid material - "' c "°' ` ` " CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or most be taken, to'provide a code"compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replac®ment =-soil absorption system. The replacerrient area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing .and proposed structure, lot fines-and we{Is. Failure to protect •the'reptacpment-.area .will reault in the need for a new soil and site evaluation to eatablieh a. aultable replacement area. Replwoamen~iryatrAls:I)'lust ,~,:,. comply with the rules in effect at that time. - -" ~ ,h,.,_~- •~- ^ A suitable replacement area is not available due to setback and/or soil 4imitations. Barring -advarttps ~ in 'POWYS technology a holding tank may be installed as a last resort to replace the failed POWYS. _; ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWYS asoil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available ~a''holding tank may be installed as a last resort to replace the failed POWYS. ^ Mound and at-grade soil absorption systems may be "reconstructed " in ,place following removal -of the;*biomat- at-the infiltrative surface. Reconstructions of such systems must Comply with the rules in effect'at that time* :~ `p =~ : '>t ~~ :~ < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN.. p0 NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM.THE INTERIOR OF A.TANK MAY BE DIFFICULT OR IMPOSSIBLE. ..<-. ,-,- .:-~..u..,.,.-.;~,~..a:....:.~--, .- {- ~ ADDITIONAL COMMENTS `" .~i~ POWYS INSTALLER / ~a .~, POWYS MAINTAINER I k Name Phone ( 7~5;,, `~`~,~'--- ~1.~~ ~ . , r .. _ SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY '~' ' '~" Name -Name. `"~ Phony Phone This document was drafted in compliance with chapter Comm 83.22(2-(bl(t l(dl&(fl and 83.54(1-, (21 & (3-, Wisconsin Admin(strative Code. -Name ;;., rr •~,~ ., :~r. Phone ~ .a~ ~;r . Page ~ of _~ .START' UP AND OPERATION For now construction, prior to use of the POWTS check treatment tank(s) for the Rrasenca of painting .products or other ohemicals that may impede the treatment process and/ordamage the dispersal cell(s-. If high concentrations are detected have the contents of the tank(s1 removed by a septage servicing operator prior tv use. - - System start up shall not occur when -soil conditions are frozen at the. infiltrative surface..... • .- During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal celfls) in one large dose, overloading the ce(lls) and may result in the backup or surface discharge of effluent. To avoid. this situation have the contents of the pump tank removed by. a Septage Servicing Operator priorto restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating-the-pump controls to restore normal levels within the pump tank. "' " Do not drive or park vehicles over tanks acid dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at•grade soil absorption area. - Reduction. or elimination of the following from the wastewater stream may improve the performance and prolong- the; life of the POWTS; antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine:,..- ~- ABANDONMENT }'. , . When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to-insure. that She system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.' • After pumping, all tanks and-pits shall be excavated and removed or their covers removed and.tha void space";filled with soil, gravel or another inert solid material '', s "`' CONTINGENCY PLAN tf the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code`c4mpliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement.^soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed-upon by required setbacks from existing .and proposed structure, lot lines-and wells. Failure to protect-the'replacement-area-will result in the need for anew-soil and site evaluation to establish a,~ouitable replacement area. Raplydcemett~€«yRtems;r)#ust comply with the rules in effect at that time. ' ` '~ °""'"°'"'" "' ^ A suitable replacement area is not available due to setback and/or soil limitations.... Barring'.adv,anCSs in'`POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ;;r Ll The site has not been evaluated to identify a suitable replacement area. Upon- failure of the POWTS asoil and site evaluation must be performed to locate a suitable replacement area. if no replacement area is available ~a holding tank .~.. _:. . may be installed as a last. resort to replace the failed POWTS. ;~ ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal-of the~~biomat-af`the infiltrative surface. Reconstructions of such systems must comply with'the.rules in effect'at that-time: -~~ 3v-- ~ ~• { «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN.. p0 NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. ?RESCUE OF A PERSON FROM THE INTERIOR OF A.TANK MAY BE DIFFICULT OR IMPOSSIBLE. --.-. - -- -- - ~---..•u~-~ -~-•;F--• ADDITIONAL COMMENTS ~ {' ~~ ~ ' x r~„•, a . •s::~. . ;~, ..: - POWTS INSTALLE~ / r~-~~,- POWTS MAINTAINER Name ~`C/ .',_ - ~ ~// / ~.~r 7~' Phone I ,~~~. ~Z.~f ' c ~/,~/~ ~ A SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY - ~~' k "~ `'~~ Name Name ,' t , Phone Phone This document was drafted in compliance with chapter Comm 83.221211b1(1)Id)&If1 and 83.64{11, 121 & 131, Wisconsin Administrative Code. Name - ;, , Phone ;r bY~ ~~;r~ ~ ~ ~~ i i ~~! / ~~ -- ~~t ~at s ~,? 1~/ / -,C_ `_ ~ / /~ ~~ ~ ~ r - ~ ~, "~ ~' ~~, ~ ~ ~ ~y ~' ~ ~ '? ~ ~~~ / /'~~ n ~~~ y~ ~ °~ ,~ ,~~.x~1 t1Z~c,~ l~ ~~9-~~s~,vl~P.~- ~~ / o ~ .. -~ ~~~~~/~.~~~~~,ePl"~l.~z s~~ ~ /DO.oS~ ~ ~~=moo ~s~~ 1 . ~~' ~i~J ~`~~-sw~~, sic J..~'- y"~9~ Jf°/`~~ ~` h~,~s~ ~ ~~ „U ~~~~/}~ ~ ~~~ ~~ ~~ d. < \ ~~ a~~ ~~ Ypr~` ~~~~ ~gD, ~~i ~~~~~ ~ _~ RECEIVED ~ 3 wlsao~in oeparansrn of SOIL ALUATiON REPORT ~ ~ t)irisiort oFSai~yand Bins ~ ~~?~,~ .viRs. Adm. code collntY S T Gf2 Dt x.. Attach silo plan mt not ~Bc1~t~97r1d~es ip siae. Pla~l must indude, txt not load ia: veriicai tt~oert . dlrecNon and p~ t,p, SSE- ~ ` ~! petcettt~ope.st~leordxlea~tstons. w+,esuestroad. Please prhtt ap lr~rmatioa. Revievred by ~ /,3 Persolw hton~tiole y~clr provide m.y a wed rxsaoalaeYr amuses ter taw, s. tsl~ t~) ta+l1- N t~? S SECT • ! PlapeAy`O/~wr~ Props+tyl«~Car+ / IC~lE3V0~l1 ~A''J~' ~ Cicvt. trot IVW 114Sw 114 9~7 T ''~ ~ N tt ~~ 4{0~ W Property Ownee's Address ~ i~of # Bbdc # Stibd. Name a t~INfl E.v N ~y Grp • ~r4-/e G"~ ?~~ ' w " C'o y'o T"E" ~ /D6~-,E' •, sm~ Phone Nut+ber ~ ~r O v~ ®so~ ~ ~f•UDSo~ tv/. Sypj(P ?ISM 38~•~'J75 /fvDSo.J r3Ar~i~.r1 ~~ - New coniarudion use:J~ Residet~i ~ iwm~ber of bedrnone 3 " code derfired design'raw tale ySD '-' O'a cPa 0 ~ ^ Put>fic cr oonraenaal - Des~xibe: Panuit 1»aleriat _ SA,At07,~/ , pOTUJ,~ Flood Main ale~r~on # app6c~te I~ tt. General wctrriertfs ~ ~ • ~a~~ ~57~ /~'!~/'j~~.e l~A'e ~~ /~U friPOV.C~v .. ~ s I / 1 e«~ ~ ~ y~~ SJr > 1~~ tom., qq Plt cu~na sllrli>os ele,-. . Ir. uepQl w ~e >~ el. Sai ~ i•brizoe tit QominarK i~sdOx Qespiplion Taxlue Sfrudue C.a~fenoe Bouidary Roofs in. Aiklne~ tht. Sz Cont. Color Gr. Sz. Sh. 'Et~'I 'FJbC2 / o•? /oY,e3j GS /fSj/k ~ S ~ 3 • ~ (• Z ~ • ~ ~~ /~ Y 9,<i4uelE ~S /tint ~s / ~ (• Z 3 / • 0 ?•S YR ~-- S ~, ~ X211. c.S •- ~• Z. o - s D - ~• roB L`' I ~l lit c~iasv~e~. n b ~ ~- sa t~fe tiort~ Oe{et- UomMant ftedo0c tJe9aipdon T'e Sbuduie Goleltce Boundary iiooAm t3P DA'i< ~. Mur>seC Qil. SZ. Cant. Cdor Gr. SZ Sll. •Etitxl 'Eti#2 ~ o-~o ~o ye ~ -- ~s i s ~s~ ~ ~ f . ~ ~. z 2. O • ~ 3 i o YR Y -- ,qa2 GS ~~ cs ~ ~ • ~ ~• Z io S D c• ,~ ,31, E11h1erK #'l = BtM ~' :~ < 2ZO rrigtL 8nd Ts$ >30 _< 1 5ti mgt1. ' tBlNlerlt t12 ~ Bt3C <.~ TSS < ~p mgR. ' `~ it3E ter- zt tb ~~ c~ ~ ". ~ Z ~ 3 s Private Sewage Consultants 2812 1 Clth Ave. ~/N S J~/2 TOT~G ~~ O 0 Spring Valley, WI 54767 Z p . to ~.7 . Z o ~ D~ 2.D • loi7 . 34 • t~ Zo • ~©1'7 , y0 • ~~ ~'~/~~o~ T.~~-s 7-- Pa~~# ©eo""~ ~ ° /~ c~ 9 CP Pit Ground surface elev. ft. u y ~Yo TE ~~~~ Z 3 ~ ~ Floriaon Oeplh Darranant Redox DesaKrtien TexNre Strtrchrre Cor-sister-ce Botmdary Rooffi tea. ~ GPW(F in. Mtx~sefi Qu. Sz CcrN. Color Gr. Sz Sh. 'Etf#i ~f(#2 o• /o G S ~ CS ~ (. Z a~~ ^ Pit Ground surface elev. ft. ~ 9 factor . ~. SoN Rate Florizon Depth Dominant Redox Description Texhxe Struckue Consistence Roots GPgVf! h Mcn'isell t1u. Sz Cont. Color Gr. Sz Sh. 'f1 ( 'Eff#2 # ^ Borx~ ^ Pit Graxtd surface elev. it. le krrtitirg favor in. Sol Rafe ttaizan Depfh Dominant Redact Oeaaipliort. T Sbucdx~e ~ Botmdary Roots ~ t1u. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Etftt2 f HAuetrt ~ a tea' ~ `-710 ntgl~ ~'~ _` 150 ~- ` Eflb~rtt #2 = BC1Ds <_ 30 m811. and TSS = 30 ntglL The Department of Commerce is an opportunity service ptevider and employer. If you need assistance to access services or need material in an ah~rttate fennel, please contact the department at 608-266-3151 or TTY 608-214-8777. sen-aw~noo> ie `~ co yo Tom- ~~~~ r~~F+a•Y Owner --- P~rrai in i! Ds..s ..s ©~ ° ~~ y 9~ 7~~ - - Pit Grawld surface ter, ft. ~ b 1J factor h c,~ Rate Horizon Depth Dortlinarlt Redox Oesaiptjon Texture Strlxtelre C~ortsistence Baendary Roots L3POltF ~. MunsteG Qu. Sz. Cunt Odor Gr. Sz. Sh. 'Eff#1 'Eff#2 3 Z~ . S mil/ L S ,ice cs -_ ~, 2 ~° ~ -- S D . ^ ~ ~ ~~ Pit Ground surface elev. it. to faa« • h soy Rate Horinorl .Depth Dominant Redax Description Texture Structure C~or>sisterroe ry Roots GPDfiP h Mexlsep Qu. Sz. Coat Color Gr. Sz. Sh. _ ~ 'i1 ~ 'EtJ~2 ~9 # O ^ Pit C'. su~aoe ~. ~ Depth to:limiting factor in. Horfaon Sol Rafie DepQl Oornklara Redox Desaiplfort. T Shvctexe Carlsisterloe Bourldsry Roots G h MuttseN t1er. Sz Corti Cobr Gr. Sz. Sh. ''Eti#! ~ 'EirrE2 • E-fA1,re[1R tl;'1 =BODE > 30 _ ?20 ~• T$g >3Q < X50 ~, ' Fit #2 = BODs < 30 rrlgil. and TSS < 30 JrrglL The Department of Commerce is an opportunity service provider and employer. If you aced assistance to access services or aced material in an alternate format, please; contact the depattrnertlt at 608-2ti6-3151 or TTY 608-264-8777. . oplsooo> - :.~ ~~~ ~--.+ ~tJ ----~`~" ~~ W ~L ~~ ~ 5 3~ ~ ,~ ~ n ~~ ~y v la P% Dr~! /~ ~ • ~~~~ ~ sf .~~,~ P ° aes~g~.~g ~a4~°`~~~ \ 5 ~. ~ . Saga \,~a~~a i ~ es 50 -~ Z, o,~Qefi` zs°~~a~ tee ~~~ ~aooe r~~P ~'`e~a ~~SS ~~b~~c ~e~a Fo ~a~~. ~~~a Goy ~~eteaQPye. ~~6~ Red ~~r `~~ `~'`2~ga~`~Q2 51~~~`L' ---~ ~'~ ~ ~`-- . T~ p a ~o~ v~~~`~~~ 5 ,~~ s ~ `' ~' P' ~,~~r ~ ~~ ,~,~ ~ dos ~- /~p'~~ 1' ~°~ ~ o ,~ ,, y' r /Ofl ~ Ao ~ D~ r 2 ~ ~ .a '/ ° ~~'~ r: i o ~~ H~ ~~--- ~- b ~~ .~,.__ ..---° ~3 ~- ~I • - ,~,~~~ p~,T'S' g~ 0 fl ~°~~M U..29y~i~`_~~586 STATE BAR OF WISCONSIN FORM 2- 2000 WARRANTY DEED THIS DEED, made between Wade Raddatz and Gwendolyn Raddatz, husband and wife, Grantor, and Jeremy Wolfe and Traci Wolfe, husband and wife, as Survivorship Marital Property, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Lot 16, Plat of Coyote Ridge in the Town of Hudson, St. Croix County, Wisconsin. Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. * ndol Rad 020-1447-16-000 Parcel Identification Number (PIN) This is not homestead property. Dated.this 15th day of December, 2005. * Wade Raddalz AUTHENTICATION Signature(s) authenticated this 15th day of December, 2005 * TITLE: MEMBER STATE SAR OF WISCONSIN {1f not, authorized by § 706.05, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BV Peterson, Fram & Bergman -Steven H. Bruns 50 East Fifth Street, St. Paul, MN 55101 (Signatures may be authenticated or acknowledged. Both are not Necessary.) •Names of persons sighing in any capacity must be typed or printed bebw their signature 8 ]. 4 4 Q>' 1 ItATNLEEN H. MALSH REGISTER OF DEEPS ST. GROIX CO.. liI RECEIVED FOR RECORD 32/16/200a 09:40A)'f 1iARkAHTY DEED EXEMR~ REC PEE: 11.00 TRANS FEE: 407.70 COPY FEE: CC FEE: PAGES: 1 Recording Area e and Return s: ina Real tt e, Inc. 0 S. St. - Suite l Hu t.~ 488 5 ACKNOWLEDGMENT STATE OF WISCONSIN ) ST. CROIX COUNTY. ) ss. Personally came before me this December 15, 2005 the above named Wade Raddatz and Gwendolyn Raddatz, husband and wife to me known to be the person(s) who e uted the foregoing ' ttument and acknowledged the same. Pamela J. (ioalet *Pamela J. Goulet ~ Notary Public, State of Wiscons' My commission is permanent. (If not, state expiration date: 10!11/2009 ) ~~ WARRANTY DEED STATE BAR OF W iSCONSINi FORM No.~2000 . ST CROiX COUNTY $f ('Tlt: TANK MAINTCNANCE AGREEMENT AND OWNf:RSHIP CERTIFICATION FORM ~WneTBityer ..~~ Mailing Address P Address >v~.s.. l t ~-^ c.l S C~iV ropcrty - ~ (verification required from Planning Department for new construction) CitylState ~~'`''~~~''~-~ ~, Parcel Idcntificetion Number ~a~~ ~ 1~z1 ' '~~ ~ v~G ~'/., ~~/ '/., Sec, ~, T_..1.N.R~-W, Town of c-^-i . Property Location ~-~ ~ y~ Subdivision C.~..-~ `/ ''"~- ~-` _ IC,.. ( D (rte' ,Lot # T ~ ~° . Cetrtitied Survey Map p ,Volume ,Page # Was•rancy Deed # ~/y~f~l ,Volume .Page # ^~ Spec house D yes ~ no Lot lines identifiabSe yes O na SYSTEM MAINTF.NANCF } P y ~ w r rnamtenancc Improper use and mainterwnce of 'our se tics stem could rcsutt in its ematttse faflure to hsndie astes_ Frope consists trf purrtptng out the septic tank eery three yeses of sooner, if needed by a licensed pumper What You Put into the system can affect the function of the septet tank as ~ trwtment stage in the waste disposal system. The property awntt agrees to submrt to St. Croix Zoning Departirtent i certtftcation form, signed by ttre owner and by a master plumtter, jourtteyntao ptuntbcr, restdcrcd ptunthcr ar a hccnsed pumper Ycritying that (t) the on-site wastewaterdisposat systcrr t4 in praptt operating condrtion antUar t 2} after -nspc~tton at-d pumping (it necessary}, the septic tank is less than t!3 full of sludge. l/we, the undersigned have read the about tequiremerits and agrte to maintain the pnvsto sewage disposal system with the standards set forth, herein, as set by the Department of Commute and the: Department of Natural Resources. State of wisconstn. Cenrficauun statrnF that your septet system has been manrt:+«~: d rnuat be rnmpleted and retumcd to the St. C'roiR County Zenirg Office wrihtct 30 da of the three year cxptratiun date. . 1G~~~tIRE OE A ICANT DATE OWNER CERTIFICATION t (we) certify that alt ststemems ~~n this form arc true to the best of my (our} knowledge ! (wej am (ate) the owner(s) of the pony described ab vc, by ~-rnuc of , ~~uramy decd recorded in Register of Deeds Office_ / G~ ~.~ ~ i ~ a~ ~"'` 1GNA RE O FPLICANT DATE ...... ~••r'• Any information that -s nits-represented may resutt rn the sanitary pcrmtt being revoked by the Zoning Department ...---~-rc...~ `. --- vl 1`' •• Include with this appticauon: a staarpcd ~~•arTSnty deed from the Register of Deeds offite o copy of the cettifitC survey map if reference is made in the warranty eked . PUWTS OWNER'S MANUAI. & MANAGEMENT PLAN Nage.,._,[. of ~ ~ILE INFORMATION ~ f- .~ Owner ~~ ~`~~ r,~,~ / f' Permit ii DESIGN PARAMETERS Number of Bedrooms ~ ^ NA Number of Public Facility Units r ~.'NA Estimated flow !average) pp gal/Gay Design flow (peak!, (Estimated x 1.5) ~~Q ~lal/da Soil !application Rate galiday,'ftz Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease IFOG) <_30 mg/L Biochemical Oxygen Demand IBOD,,1 <_"220 mg/L L7 NA Total Suspended Solids ITSS) 5150 mglL __ Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand iBODb) 530 mg/L Total Suspended Solids ITSS) 530 mg/L ~NA Fecal Coliform (geometric mean) <_10a cfu/10 0m1 Maximum Effluent Particle Size - % in die. _ C7 iVA ~ Other:.... ^ NA *Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ,~~~ ~ ag I C OVA Septic Tank Manufacturer S C .VA Effluent Filter Manufacture r : G VA Effluent Filter Model ~ C ~iA Pump Tank Capacity gal C~VA ___ ______ Pump Tank Manufacturer -C~`NA Pump. Manufacturer ANA Pump Model [~' NA Pretreatment Unit ~ NA ^ SandlGravel Filter ^ Peat Filter ^ Mechanical Aor~ition (_a :~/atland ^ Disinfection ^ Uther: _ ~ Dispersal Ce(lls) ~ ^ NA >~ In-Ground (gravity) ^ In-Ground (pressurized) ^ At-Grade ^ Mound ^ Drip-Line ^ Other; _ Other; ~ [] NA other: ,~ . ^ NA Other: ^ NA Ip1f111~ 1 ~.111I91~VF yv,. Service Event Service Frequency Inspect condition of tankls) At least once every: ^ month(si ~ earls) (Maximum 3 years) ^ NA Pump out contents of tankls) When combined sludge and scum equals one-third IY3) of tank volume O NA inspect dispersal cell(s) At feast once every: month(s) (Maximum 3 years) year(s) ^ NA ~, Clean affluent filter ~ At least once every: D month(s) ~__ ~-year(s) DNA _ ~ s Is) ~1 NA Inspect pump, pump controls & alarm At least once every: D year( ) Flush laterals and pressure test At least once every: ^ month(s) ^ year(s- f:3; NA Other: At least once every: ^ monti,lsl ~ ~ ^ Year(s) `D NA Other: O NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following {icenses or certifications: Master Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tankls- to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or pending of effluent on the. ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any pending of effluent on the ground surface. The pending of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined .accumulation of sludge and scum in any tank equals one-third iY3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and~diaposed of in accordance with chapter NR 113, Wisconsin Administrative Code: ?' All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, 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 uut~~unty within 10 days of completion of any service event. Page ~ ot._~ START UP AND OPERATION For now construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(sl. If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. - System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal celllsl in one large dose, overloading the cell(s) and may result in the backup or surface discharge or effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore. normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area, Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the. life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; <;otton swabs; degre~sors; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; tl~cat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine: . 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 properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:. ~ - • All piping to tanks and pits shall be disconnected ~~nd the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • 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 Cod9 compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil: absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot Ilnes and wells. Failure to protect theiraplacement area.will result in the need for a new sell and site evaluation to establish a auftable replacornunt area. Ropleroamen~isystwms.rnuat comply with the rules in effect at that time. ~"' ~ ' ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advan~CQs In `POWYS technology a holding tank may be installed as a last resort to replace the failed POWYS. ^ The site has not been evaluated to identify a suitable replacement area, Upon failure of the POWYS a 5oit and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available ~a holding tank may be installed as a last resort to replace the failed POWYS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the ~biomat- of the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time; • _+~ r' a .. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN... DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSt6LE. -.. - .< ~--...~..- --- .- , . ~y ADDITIONAL COMMENTS '~'~ er , ^ . POWYS INSTALL POWYS MAINTAINER Name ' ,. ~ Phone . - ~ _ Name Phone ~ 7rk.. : , ... SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY '~' ""'' -Name Name ~' `,' . Phone Phone 7i~ = ~~/ --~//_ S~if This document was drafted in compliance with chapter Comm 83,221211b-1111d1&Ifl and 83.64(1), (2) & 13-, Wisconsin Administrative Code. m LOT 7 3 ' 3.18 ACRES ~~ ,~ ` 138393 SQ. FT. `., .~ ~, ~, `~ 2°'' ~~'~. ,~ ~ ® ; ~R .: :' ' ~'`'L `r" ,~ ~~ ~ ~ .~` ~. ~. /, ,~ -;= /' ,,. /~ ' ly , .~ ,' /" .' ` ~/ / ~, ~~ ~, /, ' ' / .~ i ,' ~s ~~F ~~ YA ~~' ~~; fie) BENCHMARK ,- gp / , ~' ~ TOP OF 1"IRON PIPE ,, ~'~'`' /' ,~ ~~. ~ aQ4;',~~ ELEV. =868.62' / `,e `e~S~ /' ~ ,` Ls ._._,~'~~ (,LOT 14 ,,''/ ~'`~~`'~/'/,~1'~~~`~%,'/ ~ .._._._._. ._ ~ 2.05 ACRES '' / ~ ' ~, ~`~ ,, 89484 SD. Ff. ~.,' /,/ ~ah~ ~,.~' ~ ; L.B.O. =866. ,~ /" ~~ ~~ ~ ,' / , ~~ ~ j ' v ~ , /" , ~ ~ _$ 3 ~ '~ /' '~ LOT 17 a4Q ~ ~ ,' ~, % ~ ,' ~/ ~ 2.43 ACRES o >. ... FT 8 _...... ~; ;- ,/ 2,~;' 105829 SD. . - /' ,-' r= ~ `~ ~ti ,~$,' ,' ~,.' a~ ~g _r ~ , ------ _n, ~.~ ,.-J sa RAO TEnnP. . ;; \ ,. ,~ _~- '~ LOT 7 5 2.70 ACRES 117457 SQ. FT. v LOT 16 ~ 3.45 ACRES 150143 SQ• ~• ~ ~..B.o. = ss2.so z BENCHMARK ~'° TOP OF 1 ° IRON PIPE J% ELEV. = 875.44' boa ~: `~4'- -~ / ~ -ate r ' ~` ~'e y ~, 4e 1,z R~ s Z i •~ S ~; u . ~ LOT. 2.15 ACI 93595 St 381.29' - ~-X x X X.~-..max x X •X ' Parcel #: 020-1447-16-000 04/13/2006 09:03 AM PAGE 1 OF 1 Alt. Parcel #: 15.29.19.2847 020 -TOWN OF HUDSON Current j Xj ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/27/2004 00 0 Tax Address: Owner(s): O =Current Owner, C = Current CaOwner O - WOLFE, JEREMY & TRACT JEREMY & TRACT WOLFE 667 PINE TIMBER LN HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description " 667 PINE TIMBER LN SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.450 Plat: 10/17-COYOTE RIDGE 020/04 LOTS 1129 SEC 15 T29N R19W PT NW SE BEING COYOTE Block/Condo Bldg: LOT 16 ' RIDGE ( 04) LOT 16 (3.45AC) Tract(s): (Sec-Twn-Rng 401(4 1601/4) 15-29N-19W NW SE Notes: Parcel History: Date Doc # Vol/Page Type 12/16/2005 814401 2944/586 WD 04/06/2005 791568 2779/189 WD 12/06/2004 776369 2671/112 VRNC 07/27/2004 769938 10/17 PLAT more... manna c~ iseneeov Bill #: Fair Market Value: Assessed with: 0 Valuations: Description Class Acres RESIDENTIAL G1 3.450 Totals for 2006: General Property 3.450 Woodland 0.000 Totals for 2005: General Property 3.450 Woodland 0.000 Last Changed: 10/25/2005 Land Improve Total State Reason 124,000 0 124,000 NO 124,000 0 124,000 0 0 0 124,000 0 124,000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00