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020-1370-35-000
ry, a °~' ° ~ ~ ° h ~ i ~~ I ~~ o o~ ~ ~ ~' ' ~ a 0.' I i ~ ~ h y ~ y ~ N y O N a C ' O O C I N y w O ~ Oi M C 'O ~ ~[ • > C d 0 0 ~ !n L y ' ~ w U O C O y ~ d t0 N y~~E~Z I f6 O t A ~~dN ~' U~ Y y 7 C I y y~ d X I o N d~ d ~ ~~a N o' ~ ~ ~ wC = T G?> N .. N _O~yw ya >.~N C y N ~ N E ~ w ~ O. . 0 E N l0 O ~ v°ia y c o m I ~ L aa°i °L d ~ Z ~ ~ 7 L ~ Z fUC ~ ~ L O 7 ~ 'O f 0 (0 C ~0 O~ dV 7 N~ C~ ~ N lL 3 G O O V y 0 f6 ~° ? c a ° ~ I {L C t w ~ ~ U ~° i - ~ S 3 ~3 I 3 ri n i O Q W DL'O~d' Q m aN.~N ~ ~ ~ ~ rn 3 U E I Z E Z ~ g I = ° ~ g ~ ~ ~ 'o o E v z ~~ z I a m I ~ a m '- I o I o z 'a = _ ~ I ~ 'u iri t=- ~ ~~ 4' a~i Z g' a°i c ~ ~ -o I c ~ { E V N C '~ N ~ L 'j ~ N N ~ ~ y U N ~ •~ 'O fy d p N CO N C N Q _ ; a ~u O ~ I n. ~ o ' w J I 0 ` { Z ~ Z Z Z v f0 N Z c ~ ~ y ~ O ~ ~ I ~ (V 1~ ~ .. ~ CEO ~ .. ~ p $ f `6 ~' s ~ 3 ~' m~ ~, `° o I~ ' m m ~ v ~ w a ! c o o s ~ ~ f A N N a E ~4 ~ ~ o o a { ?~ t o tJ 1 o t ~ rn w~J M r t 3~ 3 o-I c~ r r r 3 3 3 I n. ~ •N i aaa Z o ~aaa ~ ~ N I I I (mil ~ p N M J V ~ M M y C S I A N N '' ~' J N Z Occ ~ O U G 0 O I (O O _ U ~ ~ > 00 1Y 0 .. N ~, m c 4. 0_ 7 m I! ~~ d o~ ¢zin ~ m v Irv °-' m y Q ¢zin L " is ~.9 ° I°' ~~ r 0 0 ~ y y ~ d fA C ~6 C ~ y fq y C ~ ~ 0 O ~ ~ O C ~ ~ ~ ~ a $ ~ I ° ~ l M N ~°- 7 'O C -O N ~ O V ~`" M~ O m~ y O J d -°o O y N ~ ul ~ O y O • y~; O~ 2 U My 0 Z C W ~ (n I J M O Z ~ R O ~ w V C~ v~ w ~~ ~, ~a I ma `1v ~ ~ °' ° ~ c :: ~ I c ~ A C~ a~ ~ O N V ,~ N C~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division c :.- 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 Coulter, Eu ene & Am Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: ~~~ ~~~ ~'/ v C am ~ ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic , , \ ~ ~ w ~ 5 Dosing Aeration Holding r TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ hro ~ ~ ~ 1 ~ j 1 Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand PM Model Nu ber ^"r ~ v~ ~G V TDH Lift Friction Loss S ystem Hea TDH Ft Forc ain Length ia. Dist. to Well Y f~ SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit No: 430277 0 State Plan ID No: Parcel Tax No: 020-1370-35-000 Sectien/Town/Range/Map No: 16.29.19.2201 ELEVATION DATA STATION BS HI FS ELEV. Benchmark / ~o.O 7 Q~,D, ~ d (~ • Alt. BM p Solr-rk r3fCQ. 'tF ~~a ~'"1. 0 ~ U jp . Bldg. Sewer -o.~ ,q SUHt Inlet . ~ ,s. ~. StlHt Outlet ~ ~. 9~ ~ Dt Inlet Dt Bottom He der/Man. we ~1- a. i .Pipe 4a-a~ ot. S il~Or s /y. v.7 Final ra e ~1,7~ 9.3s St Cover ~, BEDiI'RENCH Width Length No. Of Trenches -_. a-- PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS y, ~ / ~~ 5 P I ~ -"'~ SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREA LEACHING CHAMBER OR Manufacturer: /~ ~~M ~j]-,~ ~[~ ~~ l ~s Type Of System: _ w C(Syt t}~,vt ~ P 3 Y ~P~ I ~{' ~ UNIT Model Number DISTRIBUTION SYSTEM Header/Ma ni fold ~ Distribution Pip s) P ~ x Hole Size x Hole Spacing Vent to Air Intake ~ ( Len th Dia 9 -11_ _~ 9 ~ ~ ~ P 9 Len th r` Dia S acin ' SOIL COVER r . ~ I 1 n _ ~r~Prpscure Svs4Pms Only YY Mnund Or At-Grade Systems Only Depth Over B d/T h C t Depth Over xx Depth of xx Seeded/Sodded xx Mulched renc e en er Yes Yes No COMMENTS: (I~clude code discrepencies, persons present, etc.) Inspection #1:~1~1~ 3Lh7Gara:.~~ ' ' T Location: 976 Parkview Lane Hudson, WI 54016 (NW 1/4 NW 1/4 16 T29N R19W) Parkwood Meadows Lot 35 Parcel N2o: 16.29.19~2~,2,,0{,1~, 1.)AItBMDescription=~~ ~ Fpy,r~.tt(;I'~a7h ,(~!'d.~i~'"b~~ , 6~.~J W~~~S Ih jr~ ~-"_- ' 2.) Bldg sewer length = ~ ~ P ~ C U ~ _ " ~ l ~1 ` ~ , - amount of cover = ~ ~ ~ ~ G.~~~ ~ ~ SOS ~7 ~ e a (~-~ Q~ ` Plan revision Re uired. I Yes No j 8~ ~5q8~~ Use other side for additional information L~ `! LO ! V~J _ r _ ~_ _ ____ _ _ _ _ SBD-6710 (R.3197) Date lnsepctor's Signature Cert. No. Safety and Buildings Division County ` ~ 201 W. Washington Ave., P.O. Box 7082 ~~ ~ T~~d / ~~~ onsrin Madison, WI 53707 - 7082 Sant Permit Number (to be filled in by Co.) De artment of Commerce (608) 261-6546 '1 ~ ~t Sanitary Permit Application State Ian I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ~Y ~ used far socondary Purposes privacy Law, s15.04(1~-~ ~°~""""' .i ~ Project Address (if differe»t than mailing address) ~ # `t' I. Application Information -Please Print All Informatio " ' °" ,~[ /~ -~1- I P~~v,E~ L~r Property Owner's Name ~ r ~ c s ~ U ~ , 5 Parcel # Lot # Block # a- e.v ~. o~ / fcr d Prope rt y 's Mailing Address ~ k Property Location - ~ ~ j a / ~ '" ~ ~'' City, State Zip Code Phone Number /a Section _ / ~a ~~ .SD ~ r r 3yQ~l~ ~ ,~Jcirc,e~ J T QN R II. Type of Building (check all that apply) ; E o~y 1 ar 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number ^ PublidCommercia!-Describe Use ,fC i.r ~s~pw ~s ^ State Owned - Descn'be Use ^City ^Village ownship of III. T ype of Permit: (Check only one box on line A. Complete line B ifapplicable) - ?p ~ ~ .. ~S .• ~ 2p~ '*' New System ^ Replacement System ^ TteatmenUliolding Tank Replacement Only ^ Other Modification to Existing System B• Permit Renewal Before Ex ati i Permit Revision Change Permit Transfer to New L' t Pregvious Permit Number and Date~Is~siued ? GD+ s ~~2 'wS~ ~ ~ 3 p r on Plumber ec . • vft . +~ f. IV. T of POWYS S stem: Check all that a 1 -- Non -Pressurized [n-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 ^ Recircuiating Synthetic Media Filter ^ Leaching Chamber ^ rip Line ^ Gravel-less Pipe ^ Other (expl in) V. Dis ersaUTreatment Area Information: a.,~ ~. Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required (st) Dispersal Area Pro rem Eleva ~ 0 mod , 7 ~~ X0.8 ,~ VI. Tank Info Capacity in Total Number v Manufacturer Prefer Site Steel ibex Plasti Gallons Gallons of Units Concrete Cons ed New Existing Tanks Tanks Septic or Holding Tank ~as~ / `~ e s- Aerobic TrcatmeM Unit Dosing Chamber ,,/ 1'~ S60 0 f e vl VII. Responsibility Statement- I, the undersigned, assume responsibility for inst lation of the POWTS shown oa the attached plans. Plumber's Name (Print) Plumber's Signature P PRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) ~~ ~~ 7~ O ~ 77'~ ` ~ ~O VIII. Coun 1De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater S h F Date issued ui Agent Sign re o Stamps) • ^ Owner Given Reason for Denia{ urc arge ce) / IX. C ndittons of ApprovaUReaso s for Disapproval l ~ - ~ Cltyl-hJC t ~ Z~ P~,y---~ t~e.tn's~Dy, 3 ` Y~~x ttv.R.t~u '40 ~.aCP` `~ ompkte (ter the Coca r the p s the 1 :11 Irc fa s / SBD-6398 (R. 08/02) b b ~ b . a J ~ i ~ ~~ ~ U ~ ~3 ~ z ~ ~ _~ ~_ ~~~~ ~-~ J ~ ~ =~ ]~~ ~ ~C~ / ~ ~^~ :~ °.' ~. ~a b S`. if `~~c6~ ~~ ~~ :~~v :~ U N v h b ~ ~ 1t ` b u ~ ~ °<< ' ` ~- S j a 1 O `~ M o ~' D '~ v 1 3 u 0 ., :~ N v ~i ~n- J 'c. ~ ~ ~ ~ ~ Q ~ ~~ G'--' ~ a1 ~ • is ~~.r ~ U y ~.~ .. ~ ac ` b s ~,~ c~° ~~ ~~ \ .a~' \ i POWTS OWNER'S MANUAL & MANAGEMENT' PLAN p.~e of srli.E INFORMATION Permit ~ ~ .~30 ~~~- I --- -------- ir.~rr++w,~.~.w D>:810N PARAIA>:TER8 Number of 8sdroame ~ Q NA Number of PubSo Facility Units DNA Estimated fbvr (average) ~Q'Q aElda Design ffow Ipeakl, {Estimated x t .5i ~~ ® ar/da Sol! Application gate slide lit Standard Inffuent/Efftuent tluaEty Monthly averaga~` Fats, Oil 8 Grease ti=OGl S30 mg/L Bboltemical Oxygen Demand it30Da) 5220 mg/L O NA Tote) Suspended Solids tT881 5150 mg/L Pretreated Effluent Quality Monthly average Bioohernloal Olcygen Demand (8004) s30 mg/L Tatad Suspended Solids tTBSi S30 mg/L DNA Fecal Conform tgaametric mean! 51Q~ cit~ll0t)ml Maximum Etftuer-t Particle Sise Y~ in dla. DNA ' ~ NA °'Vatusa typiosl for dorrarstic wastewater and septic tank effluarrt. 8Y$TEM BPlrCiiFICATi0N8 Septic Tank Capacity ,2 ~J al !~ NA Septic Tank Manufscturer O NA Effluent Filter Manufacturer d.e iA3 NA Effluent FNter Model ~rf p NA Pump Tank Capacity ai DNA Pump lank Manufacturer r .5' ~, ^ NA Pump Manufacturer ~s,~,u/ a NA Pump Model ~ O NA Pretreatment Unit ^ Ssnditiravei Fitter O Msahanicai Aeration a plsinfeotion D Peat f=alter ^ Wetland o other: 0 NA Dbperaal Centel Q in-Ground tgravlty- t3 Ai-Grade d i?rip•Lins DNA Q in-Around tpraswrizedl D Mcund U Other; ther: C1 NA r: d NA Othe*: DNA IIAAlN F laic UY.E Service Ewnt Serviw larequenay inspect condition of tankta) At least once every: 3 rrwn ' tMaxiraum S yoarsl ^ NA Pump out ootttents of rinktal When combined sludge and scum equals one-dzird (Y) of tank volume ©NA inspect disponai cetital At !oast once every: ,~ m~tht>~ tMaxMnunl S years;' ri) O NA Clean eMlusrtt filter At least once ovary: ~• more ai arlaf l7 NA inspect pump, pump controls S alarm At least once every: .- m0~ _) © anal Q NA t-lush tabrads and prsswre test At least once every: r-- anon te) o al DNA °~: At least once every: ..~ 0'"0 ~~tsl ©NA c-tl,er: a NA MAtN11~lAMCB IN$'t'RIiCT10NS tnspecdane of tanks and dispersal cells shall be made by an indivldusl carrying one o4 the foibwing ncaniee cr cortification: Master Plumber; Master Plumber t;estrioted Sewer; POWTS In:pector; POWTS Maintatnsr; Septage &ervicing Operator. Tan inspsctlona moat include a visual inspection of the tank{al to identify any rmissing or broken hardware, idMtHy any cracks Or Isak: measure the volume of combined sludge and scum and to check ter any back up a ponding of effluent on the ground surface "rhe dispersal oetitsl shall be visually inspected to check the effluent levels in the observation pipes and to check for any pondin of effluent on the ground wrtace. The ponding of effluent on the ground wrfaoe may indicate a failing condition and requires th imrnediata notification of the bcal regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-thiM tYat or moro of the tank volume, the entir contents of the tank shall be removed by a Septage Servicing Operstor end disposed of in accordance with chapter NR 11: wlisoonsM Adminietrathre t,,ode. All other services, including but not tirr~ited tc the aorvicing of effluent inters, mechsnicsl or prossurfzed components, pratreatmer units, end any servicing at Mtarvals of St 2 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the coca! regulatory authority within 1t) dalyal o! aortiRletior- of any szefvice event. Pag© ___~ of ~, STARTUP AND OPEAAT{ON For new construction, prior to use of the pt?WT5 check treatment tar-k{si for tt,e presence of painting products or other chemical: that may impede the treatment process andlor damage the dispersal cellist. if high concentrations are detected have the content; of the tar-klst removed by a aeptage servicing operator prior to use. System start up shad not occur when soil conditions ors fraxen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater wilt bs discharged to the dispersal cellist in one large dose, overloading the cellist and may result in the backup or surface discharge o effluent. To avoid this situation have the oontents of the pump tank removed by a Septage Servicing ~paratar prior to rostorint power to the effluent pump or contact a Plumber or POWTS Maintainer to assist ~ manuaily operating +~e pump controls t: restore normal levels within the pump tank. Qo not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb err compact, the era, within 1 b feet down slope of any mound or at-grade soil absorption area. Reduction or siimination of the following from the wastewater stream may improve the performance and prolong the life of th+ F't~WTt3; antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; tat foundation drain (sump pumpi water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil painting products; pesticides; sanitary napkins; tampons; and water softener brine. Al3ANDONMEN7 When the POWTS fella andfor is permanently taken out of service the following stops shall bo taken to injure that the system i properly and safety abandoned in compliance with chapter Camm 83.53, Wisconsin Administrative Cade: ~- All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of ail tanks and pits shall be removed and properly disposed c# by a Saptage Servicing Operator. a After pumping, at! tanks and pits shall be excavated and removed or their covers removed and the void space fined will sail, gravel or another inert solid material. C4NTFNQENCY PLAN It the f'OWTS fads and cannot be repaired the toiiowing measures have bean, or.must be taken, to provide a code camplian replaoement system: ~//a p A aultabie replacement area has bean evaluated and may be utilized for the lacatian of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be 'snfringod upon b~ required setbaoks from existing and proposed structure, lot lines and wails. Failure to protect the replacement area wi result in the need far a new soil and site evaluation to establish a suitable replacement area. Rep{acement systems mus oomply with the raise ~ effect at that time. D A suitable replacement area is not available due tq setback and/or aoi! limitations. Barring advances in POWT~ technology a holding tank may ba instailad as a Isar resort to replace the tailed POWTt3. D Q Mound and at-grade aoi{ absorption systems may be reconstructed in plane following removal of the biomat at th inliltrstlve surface. Reconstructions of such ayatems must comply with the ruins in effect at that lima. < <WARNIN~> > SEPTIG, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN t.ETHAI QASSES ANDlOR INSUFFICIENT OXYGEN. DO NO' ENTER A 6EPTiC, PUMP OR OTHER TREATMENT TANK UNDER ANY CiRCtJMSTANCE8. DEATH MAY RESULT. RESCUE qF , PERSON FRAM T1iE iNTERtOR OF A TANK MAY SE DIFFICULT OR (MPOiI<EIBLE. ADDITIONAL COMMENTS - POWTS IN8TALLER Name ~ ~l/~'ac ~••~ elf G L~ Phone ? / - J" '•- .5' ~:' POWTB MAINTAINER Marne Phony SEPTAGE SERVICING OPERATOR tPUMPERI LOCAL REGULATORY AUTHORITY Nsme Name C~ C ~"#~'r Phone Phone ,s. 3 This dooumant was drafted in oomplianca with chapter Comm 83.22t21tbiii 1(di&lft and 83.54111, t1i 8 t31, Wisconsin Agmit,tstrative erode. ST CI~QIX COU~'TI' SEPTIC TANK :VIAII'~'TENANCE AGREEMENT t?wner~Buyer Mailing Addr~ Froperky Address r- ~Vi~~GU ~ih 11 ~~~ .. (Veri$cation regwred, /from Planning Department foi slew construction; GityfState _ ~Ylli(~SD,(~ ~/l0 / , Parcel Identification :vuanber 0 b - 1 ~7 p - ,35' - oQD ,2201 l<EGAL Dl~-cc~TloN . Property Location ~ '/~, ,~,1, '/,, Sec. iG ,, T,~,,,N-R,~,~,W, Town of ,{~~~lsd.,rJ Subdivision ~a rki~u (~1 c ~; r ~ ~d~o ~r ,D ~ ~ ~ r~ ~it1F Lot # ~. ' o-f J udse~+t, s+-- Cro~~x' C , ~it1:Z . ~.-. .~ Ceridiled Survey Map # , Volume .Page # Warranty l~~ed # __ ~ :~ ~ ~ J~' ~ Volume ~~,.~ d ~, Peggy # ~0 S Spec hoe:se C~ yss ~no Lot Lines idcnaifiable D yes ~ na SYM MAIN'lCENANCE Improper woo sac! mai:~aanco of yaux septic system could rdsult in its premature failure to handle wastes. Proper tnaintenan:~e consists of pumping otrt tlse septic tank Query throe years or sooner, if needed by a licensed pumper. What you put into the system aaa affect the function of the septic teak. as a traMtaeat stye in the waste disposal system. 'xhe property owner agrees to sviamit to St. Cmix Zoaiag Department a cextiiicatlon forth, signed by the ownar attd by a tnasterplwnber, joRtrrneyatatt plumber, restrictedplutnber or a licensed pumper vadfying that ~ 1 }the on-site wastewaterdisposal sygtam is in proper aperatiag condition satdfor (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the ttttdersigned have read theo above r~irerstents and agree to maintain the private sewage disposal system with the staadat3s set forth, h~reia, as set by the Departtrteat of Conunerce and the Dcparttnent of Natural Resources, State of Wisconsin. Certification stating that year septic system has been tnaintaiaedmusr. be completed and returned to the St. rroix County Zoning Offfce within 30 days of the tbxee year expiration date. ~( ~ ~~' 03 a 4F APPLICANT DATA g~1~ER CRRT CA'T`I(ON I (we) certify that alt atateznents on this form are true to the best of lay (our) knowledge. T (wc} am (are) the a~~rr(s} of the party described above, by virtue of a warranty-dead recorded in Register of Deeds Office. SIt3N OF APFLICANT DA'1'1: ****** Any iafortuation that is arnis-represeryted raay result in the sanitary pea;rtit beit~ revoked by +the Zaaitt$ Department. ****** ~~~~~ *'~ Include with. tl~la appllcatlaa: a stamped wsrrauty dead from the Register of Deeds affic$ a copy bf the certified sutvty map ii nferance is made in the warranty deed ANII 4W1~ERSHIP CERTIFICATION FORM J 2230 f' 2OS ' I 'S"fA'fE 13AR OI' WISCONti1N DORM 2 - 1999 Document Numhcr WARRANTY DEED This Deed, made between LaCasse Custom Homes, Inc., a Wisconsin Corporation Grantor, and Eugene T. Coulter and Amy J. Coulter,- husband and wee Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 35, Plat of Parkwood Meadows First Addition in the Town of Hudson, St. Croix County, Wisconsin. -~ ~ rz, 1 ~ rz, KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIx CO. , MI RECEIVED FOR RECORD 05/05/2003 11:3OA?l MARRANTY DEED EXEMPT # REC FEE: 11.00 TRANS FEE: 206.70 COPY FEE: CC FEE: PAGES: 1 Name and lieturn Address (~~ ~Z- -Gi Sl 020-1370-35-000 Parcel Idenlilication Number (PIN) This is not homestead property. . -- Q~) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this 28th day of April • Signature(s) AUTHENTICATION authenticated this day of 2003 L Custom Homes, Inc. a~~ ~l~ ~~~~~~ rt ACKNOWLEDGMENT STATE OF WISCONSIN ss. County Personally came before me this 2$th day of _ Aril, 2003 _ the above named I.aCas Custo domes, lnc., a Wisco isin orporation by its n C to me known to b rson(s) who executed the foregoing inst nt an . -k~ Icd6ed the same. Nc airy Public, State of Wisconsin n~m~-~ssion istpcrmanent. (II'not, state cxptrzti~on~te: Rno'gpetar ~D~ .pBevers T[TLE: MEMBER STATE BAR OF WISCCJ~~IN Ub~IC (Irnot, State of Wis~nsin mtthorizcd by ~ 706.06, Wis. State.) '1'il1S INS'I'RUMIiNT WAS WRAP"fGl) 13Y Attorney tCristina Ogland Huclson,~1V1 54016 (Signatures may he authenticated or acknowledged. [3oth arc not necessary.) • Names of persons signing in any capacity must he typed or printed below their sig~ure. ~ ~ Information Prr,(essronals Company, Fond du Lac, wt S'fA'1'1? I3AR OF wISCONytN eo0ass-zo2~ V1'ARRANT'V DF.F.D NORM No.2- 1990 F~ [_ ., r. m 4 x A Q T ~= W . • ~~~ ~ q3 ' ? m K q O . - N ~x ' ~ y 'v Q z m . t 'S S' - a m 9 ~c Y~ ~ ~ _ L 9 m n v ~S 5 ~ NO n ~ ~~ :M NO ~?t ~ 4 elf )T. ~ V ~ ~ N _ ~ .~ S O ~ ~ ~a ~m ~ ~ sj M Ofd z i S i i~ ~ c ~~- A ~ ~i r i .mn • 0 W C m Q' ~ 3 ~ S 2r ti ~ ~~ ~ q O ^ ~ 3 N ~ V ~~ ~~ ! ~ ~3 V i ~~ .Y ~~ if c tD O IV c~ p~ ~ _ ~ ~ cfl S X •~ ~ ~ e X ~ . ~ . i! ~ a Q (n -=~ Q W ~ .- ~ a ... ~ m ~. w -+ CJt 'a N x ~ N 1 ~ o ~ . w s ~ • • ~ ~ ~zO~r c ~co~ Ica c J C ~' ~~v<cQ ~ Q. ~ ~ (~ C ~ ~ ~ ~ Q ~ ~ ~ ~ ~ ~ L'~] `C p Q. N O' ~ CD d ;~ ~ s m `,C i ~ ~ , O ~ ~ ~ ~ ~ °~ . s~ a~ `~C ~ ~ to a ~ ~~:~ a - ~~~~ y C =,?3a. .~~,. = ~. ~~ ~ ~ ~~~~ _ c ~ a s~~>> m N tQ. `V t T7AG~ -~ OF ~ ~~~ ~ ~ ~ Y tl) ..J b T ~ 1wo7q i ~ ~~~ ~ n ~ ~~~ _ O ~~~ ^i p ~ (a~D n ~~{ ~~ ~~ ~II ~~ 4D Invert i 1'-- '~.? V J. ~~ Z.:_ - .r 'rC'I~Di~ ~.~~~ ~':':.~+s ~L~ ^ "SS 4~+ OI VENT PxPE 17" MIN. ABOVE GRADE ~ s 2~' FROM DOOR, WINDOW OR FRESH AIR IAiTAKE ~r FINySKBD GRADE uf~ CS RISER . 6" 18" IN' !L£T WATER TIGHT gyALS PPR4VED ~ ~IPE J' -!~'t4 SgL1n iOSt PUMP OFF ELEV • ..~~ T' WEAYkERpROOF APFROV ELF JUNCTI~CN SOX MANHOLE COVER wITH CCN~VIT wi PADLOCK ~ ,,.,...WARNINQ LABFwL - ;----~,~ MIN. t~eaaw •~•-~ * ~ :• ~ „_,., . , t ` 1 '~" G IGHT ~ ~~ PpS0~EW17N JOINTS p 5EAL t ; ~ QO P 1P~ PO Y --~-- ~•~ - ON T N ~ SOLt~ SOIL. . ~ , C ~ r ~* gYSER EXIT OFF • -~ PEgMITTEI? ONLY D I F TANK MA1-NFACTURER HAS APPROVAL grr ,pppgpVEL BEDDING U~SDF.R TANK PECIFZCATZCr~s SEPTIC ~ FACTURER: ~' ~ TANK MANU TANK gI~ESs SEPTIC F~ GAL• Aos ~ ,,,.tea...... GAL . ALARM MANU~'ACZLIRER = „~ »~-- "'"""` MODEL Nt,1M8FR _ ---" SW I TC K TYPE ; ,.,,,.~jZ~G-~-~ p~U~p MANUFACTt~RER s r _..~-~M ~SWITCK TYPES GPM ONCRET£ ~`~ Nt3M8£R D05£S PER DAY : _,_~ D43E VOLUME ~, LOWSACKG l~9 ... GAL ~ xNCKEB ~ .~ yC..,,.?..~..GAL. CAPAC 1 TI ES . A ~,,.. 8 , ~ Z INCHES R.,.~i~..,.--~L' C ~ ...~.» INCHES s /C~,.~8-_GAL L D : ~ xKCHES * J~~GA PUMP 8 ALARM WIRING A5 PER ILIiR i6."3' WA REQUIRED DTSCi3ARaE RATE ~. 'gUTION PIPE 1~ FEET . ~ '""~ FEE VI',RTxCAL Y?IFFER£NCE BE'TW£pRE SUREOFF SAND •AIS'r'R; CTOA FEET + MIN3MVH NETWORK BUPPLY FTI1G0 FT. FRICTION FA EET ~, ~d~ gEET gORCEI~IAIN X ~~ TDTAL DYNAMIC KF~D ~ . TER ~_ ~' ~--- ; WIDTH T NT'ERNAL D LMEN SI CN S OF PUMP TANK : I,IQL ID ~~...~-~~~~~-~ ~'~y f 1, LICENSE NUMBER STONED: ~~_ DATE : ,,~~,~ ,~n~ C~ ~~ c~ f~ APPLICATiON& Specifically designed for the following uses: • EfilUent SyS#BmS . • Homes • Farms Heavy duty sump • Water transfer • l3ewatering SPEGIFtGATIDNSS Pump: EP04 • Solids handling capability: g/a` maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. • Discharge sue:l1lz`NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUfJA-N elastomers. • Temperature: i{)4°F (40°C~ continuous 140°F (60°G) interrrtitteni. • Fasteners: 300 series StalnleSS Steel. • Capable of running dry wwthout damage to components. Pump: EP05 • Solids handllnQ Capability: ~/i"maximum, • Capacities: up to 60 GPM. • Total heads: up to 31 feet. . • Discharge SlZe:1'r~t"NPT. • Mechanica! seal: carbon- rotary/ceramic-stationary, BONA-N elastomers. • Temperature: 104°F (4(3°C) continuous 140°F (60°C) intermittent. ~ 1995 (~O~dds Pemnps, kx. • Fasteners: 300 series stainless steel. Gapabie of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 11511, 60 Hz, 1550 RPM, built in overload with automatic resetr • Power cord: l0 foot standard length,l fi/3 SJTO with three prong grounding plug. Optional 20 foot length,lfi/3 SJTW with three prong grounding plug (standard on EP05j. ME7'EFiS FEET 10 9 30 8 25 nJ 7 v e ao 5 0 15 -~ a ~ 3 ~a Goulds : ~aU~_. ~ ~~ ~ Submersible Ef#~uent Pump ~~ ~ 3871 EP05 00 • Fully submerged in high grade turbine oil for lubrication and efFicient heat transfer. Available far automatic and manual operation. Automatic models include Mechanical float Switch assembled and preset at the factory. FEATURES ^ EPfl4 fmpetler: Them~o- plasticSemi-open design with pump out vanes for mechanical sea! protection. ^ EP05 impeller: Thermo- plastic encioseddesign for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion- resistance. ^ Motor Housing: Cast iron for effiaent heat transfer, strength; and durability. ^ Motor Dover. Thermoplas- ticcover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resisfant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY 11STlNG Canadian Slai~dards a:so~an (CSA listed mode! numbers end in "F"or "AC".) 1 r,,, „ i i f ', ,~ ~; fj ~~ 1 ° _ '~ ~ 1 J~y' I t . ~ v ' .~ ~'~ j _ ~ ~ n e ~ n wnu 7V GV Js! 4V uv tiilrm f1 2 4 6 8. t 0 12 mom <; . Effective May, 1995 ', ~ m0 _ __ ~ ~a,s~' .~ ', ~~ i i f i ~` ,~ { ._ ._ . _ ._... ~--- ---- ' ,OOt ~ ~ AIL----------- ---- _~ I III `~ ,SS'ZlZ o I ~ ,tiF•9 AS•06l ~ I ~ I - ,6~•6t~i~ M ,~ l S ,OOo~bO N ~ M i I 61 M i M31~~1~dd M I ~ I .6ti'i~tiG 3 „lS ,OOatiO S I 01 ,i~S•SOZ ,SS•Z l Z -, 0~ I 00 I - _~ ~ O ~ - ~I----- °---- Y ~~ I ~I ~ I z ~' ~ tai f ,OOL ~ M ~ i I U 3 1 `t I ~ w _ w~ ~~ I rn v vi o co Ui i~ I~ ,° I 3 ~ cOa ~ v> ln~ "?. U M I o°~° Mrno N ~o ~ Um ,dl o o u~ a, a ~r ~ ~ o~ ~ ~irn ~f- --------- ---- :• o N~ Z I I ^ W'SI 2J M i r7 j Z O I ~ Iini. 2 Z a (O Pam Quinn From: Rod Eslinger Sent: Friday, August 01, 2003 3:46 PM To: Pam Quinn; Kevin Grabau; Jennifer Emmerich; Jon Sonnentag; Jane Hansen; Marion Standaert Subject: Lot 35, Parkwood Meadows, Sanitary Permit HEADS UP: The sanitary permit for lot 35, Parkwood Meadows, Town of Hudson, expires on August 27, 2003. The original permit was issued on August 27, 2001 to Richard LaCrasse as afour-bedroom system. The plumber was Brady Utgard. Bill Schumaker might request a transfer of the sanitary permit to install the system. Before we sign off on a transfer permit verify that the permit has not expired. This permit is flagged in the sanitary database. Rod Rod Eslinger Zoning Specialist St. Croix County Zoning 1101 Carmichael Road Hudson, WI 54016 Ph. 715-386-4680 Fax 715-386-4686 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT 4 G~ INFORMA (ATTACH TO PERMIT) Personal) i ation you pro ' may be used for secondary purposes IPrivacv Law, s.15.04 (1)(m)1. Permit Holder's e: La Casse, Ri d City Village X Township Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK I RMATION ~Ir TYP MANUFACTURER CAPACITY Sept' Dosing Aeration Holding ELEVATION DATA Inlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding Inlet Bottom Pipe PUMP/SIPHON SOIL ABSORPTION SYSTEM BED/TRENCH Width Lengt DIMENSIONS Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE! LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spac' Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x PrPSSUrP Svstamc Onty YY Meund Or At-Grade SVStG~Or11V Depth Over Depth Over xx Depth of ded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepencies, persons present, etc,) Inspection #1: / / Inspection #2: / / Location: 976 Parkview Lane Hudson, WI 54016 (NW 1l4 NW 1/4 16 T29N R19W) Parkwood Meado Parcel No: 16.29.19.2201 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = County: t. Cro' Sanitary Permit No: 3 State Plan ID No: Parcel Tax No: 020-1370-35-000 BS I HI I FS Plan revision Required? ^ Yes ^ No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) ~~ a i o ~9 ~ Safety and Buildings Division County ,.. S ~ ~ 201 W. Washington Ave., P.O. Box 7162 . ~ ~ ^~~~~~~n Madison, WI 53707 - 7162 ice Address Department of Commerce Sanitary Permit Application Sanitary Permit Number 3 ~ ~ a ~ ~, rn accord with Comm 83.21, Wis. Adm. Code, personal information you provide ^ Check if Revision ma be used for seco ses I'rivac Law, s15. 1 m I. Application Information -Please Print All Information ~ .~ ~ ~'~, State Plan I_D. Number Property Owner's Name ~ ~,~ _., 1 Number Property Owner's Mailing Address 1 ~' Pto rty Location ~-U s ~ ~ ~~~ ~p ~ ~~~~ ~~ ~ SL N Lt(14: S ~ N. R / ( E City, Stau Zip Code Numbe~~k ~~~ ~ :` 3 ~ Number ~ ~:~~y ~C , °'`f ubdivision Name CSM Number ~ ~ C1~ ~~ c~ ~ ~~~ ~ -- r- 7 ~ ~~ ~ ~ (. / f C II. Type of Building (check all that aPP1Y) L/ as r'sw _ QCity _ ham- ~ 1 or 2 Family Dwell' -Number of Bedrooms ^Village ~ ^ Public/Commercial - De 'be Use o P ^ Mate Owned D 2 3 ~ ~ _ ~ _ J Ne Ro ~/ _ ~ ~ D~v-r ~ ~~ ~~' Permit: (Check only o ox on line A (numbering scheme for internal use). C lete line B if a plicable) f III. Type o '~' ~~ ....yy ~ 1 1,61_New 2 ^ Replacement System ^ Replacemem of 6 ^ Addition to For ty use S sum Onl Exis ' S stem B. ^ Check if Sanitary Permit Previously Issued 't Number ~ i IV. Type of Permit: (Check all that apply)(numberin heme is for internal use ' 44 Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Fil cted Wetland 22 ^ pressurized In-Ground 41 ^ Holding Tank 48 ^ Single s 51 rip L e 45 ^ At-Grade 46 ^ Aerobic Treatmem Unit Rec' acing 30 er V. D' ersal/Treatment Area Informati on: Design Flow (gpd) Dispersal Area Required Dispersal Area Soil Applic Percolation Rate m ElevationFinal rade Proposed Rate(Gals ays .Ft.) (M' ch) ~ _ ~~, Elevation ~D~ ~~~ r s~ ~~ ~=a=9d.6 VI. Tank Info Capacity in Tonal Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 7 l ~ ~~ Dosing Chamber VII. Responsibility Statement- I, the undersigned, a responsibility for ' lion of the POWTS sho the attached plans. Plumber's Name ) `~ Plumber' i ~ MP RS Number usiness Phone /Number l ~!,~/ ' ~ C ~' "/l ~ ~ ~Cs~ O ` Cd / / ~ f~ ~ ~J Plumber's Address (Street, Ci Ste, Zi/p Code) VIII. Count /De artment Use Onl Approved ^ Disapproved ~~Y Permit Fee (includes Groundwater e Fee) Surchar Date Issued Issuing Agent Si (No Stamps) g ^ Owner Given Ini ' Adverse ~~ '' Determination 1X. Conditions of Approv ons for Disapproval ' ~ . " /,1.4.~ t S ~ °'"' _ iS~s~~~ \ r- yna.~~n~""~" P Attacu complete puns (to the ,aunty only) nor me sys~em vu twpca uw .~ ...a.. o..., ~ ...,.....m .......~ SBD-6398 (R. OS/Ol) ~E~~"'~ ~ - ~ t T~..~..~ a ~- ~ ~o ~- ~ ~c /~ ~~ ~ ~ ~~ '~ ~~~~ l ~ ~ ~°~~ ~.~~ T~ ~-l =~ ~~~ a = ~~ ~ ~- ~~~ a ~~, ~,~ , .~ ~ ,: ,7 1~ - ~ ~U~ 3~f~ C~ ~' ~ ~ as ~~ ~~ ~ ~ l'~ ~~ o3S7 93,0' rd =Q~.60 y_ ion U%D~ ld~~ ~- ~-io r _~. ~ ~J ~ ~, ~~ ~ 1 ~. ~- ~ ~~u~~-- -~ ~ ~~ ~~ ' l~~ ~~- ~a~357 i ~ rd = q~.~0 Y W~onsinDepartmentoflndustry, $OIL AND SITE EVALUATION REPORT Labor and Human Relations Division of Safetv 8~ Buildinos :_ _____~ ...:.~ ,~ ~ m .,~, „~ ..~:,, w.a.... n...~,. Page 1 of 3 ~~~ a.,~.,.,....,.. ,~.., ..,.,.~ ..~ ..........,..,~ Ix~ er not less than 8 112 x 11 inches in size Plan'must include Attach com lan on a let ite COUNTY ' ~~' , ~ p p p p e s not limited to vertical and horizontal reference point (BM), direction and % of ~bPg, scale or --,-~ .~~`i dimensioned, north arrow, and location and distance to nearest road. f_, ~, '~ PARCEi f.D. # , ~ `' - "~ APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION, ~ ~ ~~,~ 4 D BY R V W DATE ~ ( PROPERTY OWNER: LaCasse Custom Homes Inc. -ROPERT~Yr~LQ,L~j F ,. .'. ~?~ LEI-N~lOO~t ~114;S; 6 T 29 ,N,R 19 ~E (or) W PROPERTY OWNER':S MAILING ADDRESS 521 McCutche n Rd. LO : ' 35 BLOCK # :ina :~ SUED. CIA OR CSM # 1?~r -` od Meadows First Addn. CH dson, WI. 54016 ZIP CODE (HQ~ ~UBMgE~405 ^CITYHu^dson OWN NEMAcRE`vSuTt peon [x] New Construction Use [ ~] Residential / Number of bedrooms 4 [ ]Addition to existing building (]Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 •8 trench, gpd/ft2 Recommended infiltration surface elevation(s) 93.60 ft (as referred to site plan benchmark) Additional design /site considerations trenches spaced to code 4/00' below grade Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system U =Unsuitable fors stem CONVENTIONAL CAS ^ U MOUND ~] S ^ U IN-GROUND PRESSURE ~] S ^ U AT-GRADE CAS ^ U SYSTEM IN FILL CAS ^ U HOLDING TANK ^ S ® U SOIL DESCRIPTION REPORT Boring # .................. ................. .................. 1?': Ground elev. 97.6 ft. Depth to limiting factor +90" Boring # 2 <`> Ground elev. 97.6ft. Depth to limiting factor +90" Depth Dominant Color Mottles re T t Structure Consistence Bounda Roots GPDlft Horizon in. Munsell Qu. Sz. Cont. Golor ex u Gr. Sz. Sh. ry Bed Trench 1 0-10 10yr3/3 none 1 2msbk mfr 'gw 2f .5 ~ .6 2 10-3 10yr5/4 none silt. 2csbk mfr gw if .5 .6 3 36-9 7.5yr4/6 none cos Osg ml na n a .7 .8. ~~ ~aZaiKir+.+ ('Z.D a MM w.~ 93•~o r ~ ~~`~ P --._, `48~ ~ 08 Remarks: 1 0-8 10yr3/3 none 1 2msbk mfr cs 2f .5 .6 2 8-36 10yr4/4 none sil 2msbk mfr gw if .5 .6 3 36-9 7.5yr4/6 none cos Osg ml na na .7 .8 ~s o Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. Ave. w Richmo d W 4017 Signature: _ .. Date: 29_99 CST Number: m02298 PROPERTY OWNER LaCAsse Custom Homes SOIL DESCRIPTION REPORT Page? of3~° PARCEL I.D. # 020-1028-90 ' Boring # :..,:::3:::. Ground elev. 95..7 ft. Depth to limiting fac+90 Boring # 4 Ground elev. 93.4 ft. Depth to limiting factor + ~~ Boring # .. 5'~~~' Ground elev. 93.4 ft. Depth to limiting factor +84" Boring # .................. ................. Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence ~~ Roots GPD/ft in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer~ 1 0-11 10yr3/3 none 1 2msbk mfr cs 2f .5 .6 2 11-3 10yr5/4 none sil 2csbk mfr gW if .5 .6 3 36-9 ~-- 7.5yr4/6 none cos Osg ml na na .7 .8 9l. ~~ `~• y/ ~, Remarks: 1 0-10 10yr3/3 none 1 2msbk mfr gw 2f .5 2 10-2 l0yyr4/4 none sil 2msbk mfr yw if .5 s .6 3 26-8 7.5yr4/6 none co ~ Osg ml na na . 7 ! .8 R . Sao Remarks: 1 0-6 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 2 6-32 10yr5/4 none sil 2csbk mfr gw if .5 .6 3 32-8 7.5yr4/6 none cos Osg ml na na .7 '.8 Remarks: Remarks: STEEL'S SOIL SERVIC E Gary L. Steel LaCaSSE Custom Homes, Inc. 1554 200th Ave. CSTM2298 NW4NW4 s16-T29N-Ri9w New Richmond, WI 54017 MPRSW-3254 town of Hudson. (715) 246-6200 lot #35-Packwood Meadows First Addn. This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted.. N 1"=40' BM.= top of 1" pvc p ipe C el. 100.00' Alt. BM.= top of 1" pvc pipe ~ el. 98.60' tt~~,, ~.'1 n~ `\ Gary L. Steel ~29-99 ~~ '~ Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Design Specifications Sanitary Permit Number ''j`~S 2 Z Number of Bedrooms Design Flow -Peak (gpd) ' ~ Estimated Flow -Average (gpd) Septic Tank Capacity (gal) ' Soil Absorption Component Size (ft2) - Type of Wastewater Dom tic Table 2: Soil Absorption Component -Limits of Reliable Operation ~ T Septic Tank Component Soil Absorption Component Design Flow -Peak (gpd) lZ ~I Z- ~- Maximum Influent Particle Size (in) 1/8 Maximum BODS (mg/L) 220 Maximum TSS (mg/L) 150 Tab le 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 Seatic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic k and outlet filter shall be assessed at least once every 3 years by inspection. The utl t felt r shall be cleaned as necessary to ensure proper operation. The filter cartridge sh be removed unless provisions are made to re a~n so i sin the tank that may slough off the filter when removed from its enclosure. If the Q.~, . , 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 the tank maybe difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 • ~ a Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shn~bs din:ctty over or within ten feet of the component should be avoided since root intrusion into the ~ponent may obstruct wastewater flow. '~~,~,, ~ a, .,. ,~ ~ ~- ~~ q ~~~ m N~ P,~-~- ~''`~ c ~~s~ a~ ~ - ~ 9y.~ ~fi ~~-~- 2 G7i5) 3g~-y~g~ S'1' C1tOIX COUNTY SLl''1'IC 'TANK MAIN'I'I?NANCL AGRLLML~N'1' AND OW1Jl?1ZSIIII' CI?!t'I'II~ICA'1'ION I~OItIvi Owner/Buyer ~ ~ ~ ~ j5.~ Z-~,•r+~.n .~ ~ /~v~' Mailing Address _~ ~3 G©. 1~ fQ (~ ,;~.,t,~~ V-}' j.. I'roparty Address (Verification required lion- 1'lauuiug Ucpa-tu-cul fur ucw coast City/StAtc _~~ ~~ I'~u~ccl l~lcntilicatic~n Nuntl~cr 6 ~ C~ -'1 :3 7~` ~S-~o C~ LrGAL D)JSCRII''L'ION Properly Location ,~..i~, %,, ~~J -/,, ,Sec. 1~, '1' Z~1J-lt l~W, 'Town of _ ,~Lc~-~~'y`~- Subdivision ~j~j~-~"I (I,~~ y~re.~~~ S ~ ~~~,(~~" Lot ~r~ ~_. Certified Survey Map Il ____ , Vc-lunlc , Page ~l Warranty Dced # _ ~~ y~ ~ ~ ~ ~~ , Voluntc "' Pabe i'i ~~. Spec house Q yes l~no Lot fines irlcntifiahlc ~ycs ^ no S~YS'1'LM MAIN'1'I~NANCI~~ Iu-proper use and mninteuanccoCyuur septic system could -csull iu its prcu~alu-e I'ailu-e to handle wastes. Proper maiulet-auce consists of pumpLtg out the septic [auk evc-y th-cc yca-s or sooner, if needed by a licensed pumper. WI-al you put into Ute systeut eau affect tlrc function of the septic teak as a UeaUncnl stage in the waste disposal syslen-. The properly owner agrees to submit to St. Croix Zoning Ucpatlu-enl a cettificalion form, signed by We owner and by a ntaslerpluwbcr, journey[nan plumber, restrictc<I plun-ber or a licensed pumper verifying that (1) the ou-site waslewaterdisposal system is iu proper operating condition and/or (2) alter inspection and pumping (if ncccssa[y), the septic teak is less Utau 1/3 full of sludge. I/wc, tl-e uadersigucd I-ave read U-e above rcyui-cments and agree to maintain the private sewage disposal system with We alandards set forW, 6ereiu, as set by tht: Department of Cuuunercc and the UcparUucut of Natural Resources, State of Wisconsin. Certification stalIug that your septic systetn ltas been maintained must be completed and returned to tl-e St. Croix County Zouing Office within 30 days of tl-e three year expiration dale. / 1. GNA'I'UR Or APPLICANT UA'1'L~ O«T1ER CLRTIhICA'i'ION I (we) certify that all atatcn-cnts on Ibis limo nic Inic to tlic hest of my (our) k--owlcdt;c. 1 (wc) atn (are) ll-e owuc[(s) of the operty describe above, by vi-tuc aC a wa[ranly deed [eco-dcd in Register of !)eels Oftice. ~, of S GNATURE O ~ I'PLICANT' DATE *!**** Any i[-Cotmatiou that is mis-represented may [csull in II-c s~nilary pcunit icing revoked by the Zoning DeparUneut. ****** ** Include will[ thts applicallon: a clamped warranty decd front tl-c Register of Uecds office a copy of II-e certified survey map if reference Is wade In the warrattly deed ~o~ ~.7t~OF~~E X71 • STATE BAR OF WISCONSIN FORM 1 - 1998 • I WARRANTY DEL'D Document Number I ~ This Deed, made between Howard LaVenture ThrPP-f i f the ~~) interest in and ArlpnP T aVanttira Tmn-f i frhG _12J~) interest in, as tenants in r•ommon~ Grantor, and LaCasse Custom Homes Inc Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St . Croix County, State of Wisconsin (the "Property"): LOT 35, PARKWOOD PIEADOW, FIRST ADDITION, TO1~1N OF HUDSON, ST. CROIX COUNTY, WISCONSIN 653964 KATHLEEN H. WALSH kEGISTEk OF DEEDS ST. CFtOIX CO., WI RECEIVED FOk RECORD G8-15-2401 1:30 PM WARRANTY DEED EXEPiRT H 17 CERT CORY FEE: CORY FEE: TRANSFER FEE: RECORDING FEE: 14.00 RAGES: 1 Recording Area Name and Return Address LaCasse Custom Homes, Inc. 573 County Road A Hudson, WI 54016 non t 2~n ~S nn Parcel Identification Number (PIN) This is not homestead property. ~§~ (is not) This deed is given in partial satisfaction of certain land contract dated February 19, 1999, and recorded in Volume 1404, Page 616 as Document Number 598116 which was subsequently assigned by assignment dated May 28, 1999 and recorded in Volume 1431, Page 352 as 'Document Number 60323. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except all liens, covenants and restrictions of record, if any and any liens or encumbrances created by act or default of the Grantees and will warrant and defend the same. Au ust ~nnt Da[ed this 15 _ day of ~..~~~ (SEAL) (SEAL) * AUTHENTICATION Signature(s) Howard LaVenture * (SEAL) ~~/G~~xci /~~~~.~-~-~.r o ~ (SEAL) * ACKNOWLEDGMENT Arlene LaVenture authentic this day of August , _2.0.0.1 * Samuel R Cari TIT TATE BAR OF WISCONSIN State of Wisconsin, ss. St. Croix County. Personally came before me this _ 15 day of August _,2001 .the above named to ~...,.......,, do rho narcnn s who executed the foregoing ~'--`-Jf7js ~ { 21 ~ ~ , 911.` \ ~ ~ -S!., i ~ ~ ~ } i '~ ~ t~ ~ \ 1 ~/ ` ~ ' 1 `\ / LQ 1 - X , ~ s 1 12.0 ~~~ 1 92.4 fi-4 j ~~ ~0~~ t ~~ i 1 . ~ ~ ~a 1 ~ ~' s ~ N~ X39° 6' ~0" ~~ ' ~ ~- 1` `` ~ ~ _ ~ 4 4.96E ~ ;~ , ,' i t M~ 1 ~ ~ ~ ~ f IJ ` U ;' ~ m i ~ / ~ ~ '~ t J ~ ; ' / i at - i~ 893.0 ~ /~ ;-' i i 5/ % ~' ~ o x ~ I / rl ~~ ,~ t ~ 1 r'Qi3i `, / ; ~ , , ; ~ 2:b0 ACID %~ i ~ ~ ` r ~ ~ 1 ~ /` ~~~ Jr / i j E f' ~~ x f y l X2!6. 5'k~ .~'~ ! 894 / '~ 4 ~ ,_ ,/ J ~ ~,~ '•v~---' i' ~ ~ / G ' c~ cj0' ~ i ° t ~. __` ~! ; ~ / c-~, ,, i` 917.0 t , r. J,; _~ ,- l ( o . // ,; 1 x ' ----=..~ t 33 3' 917.7 .. 1 .3 ~~--,~~... _ _,_. 89°4fi' OBE fi.fi0' - I r WITH A ~ N ~NDWAL I ~ .{ FL IN=~6 AST 28 -18"i CMCP WITH ~` l FL OUT--~pg,~~ ~ APRON E DWALLS I\ =9 i 3. 1 ~ ~' E S T CK LtNE ~ .., I 910.7 _ _ ~_ r ~ - ~ - ff .7. _ -~' 911. 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