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HomeMy WebLinkAbout020-1370-46-000p ~ ~ ~ 'O ~ N C! eD 'O A7 H~ ~ ~ ~ ~ ~ ~ r: I ~ ~ ~ ~ ~ I ~~ Z= Z c c~ _~ N ~ ~' N. 7 y p V, dy N p H U1 ~ .~+ tD (D N ~ N O ~_ ^~ N y 7 ~ ~~ 7 ~~ O ~ ~ N ~ O ~ n .Z~1, ~ ~ O~f ~ O C N ~ 3 N ~ _ pp r. ~ ~ ~ y ~0 p O p !~ C ~ a ~ v D - a te I ~ ~ ~ y 4 -o ~ ~ W II ~ O o ~ v°, c°n '~" V ~ ~ ~ cNO cNO ~ tai o~ o o~ n o c '~+ ~'p N N fD 3 ;'!' Q a .~ I a c o m OOOo M ~~ .~ c ~ -' ~ ~ ~ Orq I ~~ ~ (3 (n N y ~ ~ M •• ~ ~ ~ ~ 7 ~~ d n .. ~ N Q y O zaoz I - DSp i ~. oai ~ ~ ~ 0 ~ D ~ N ~ y fD ~ fD ~- ~ ~ ~ p fl: N ~ NNlil y_ y~ ~ C J O N I °-' oIIi v ~ ~ a W ~ y ~ CD' ,,,,~ ~ °' O a ~ ~ ~ ~ ~ -i N OZ ~ O > > D p Z fD 7 I v QED n ~ A~ 7 I z ~ I 3 0 ..,, a I z ~ ~~ c ~ ~ ~ I ~ ' p ;- Z 3 '0 3 ~ ~ I ~y y f ~ A I y •3 m ~Z D c 3 p x ~p a I ~ ~ m < ~ a ~ o a~ c°na', co ~ v ~. I naiNO~~~ v c I - \ a~ ~ c ~ o ° I v I ~ f d ~ c ~ ~ ~ I o`<N a~ ~ 4, s f A ~cfDdav ~ ~ o N ~ ~ O ~ ~ r o~ °0 3•~ Om y i ~~ m w I omf~m o 71 ~ ay m D. c°n I ° ~ ~ ~ o 'b v r ~ I aro t~v A ~ ~ ~ 1 ~ ~' '"~ Wisconsin Department of Commerce PRIVATE SEV-IAGE SYSTEM Safety and Building 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)]. 'ermit Holder's Name: City Village X Township La Casse, Richard Hudson Townshi ;ST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION CAPACITY ng TANK SETBACK INFORMATION TANK TO P!L WELL BLDG. Vent to Air Intake ROAD Septic 2 a -(' ~~ ~" ~ ~ ~ _. Dosing .__ Aeration ---_ Holding _-''- PUMP/SIPHON INFORMATION Manufacturer .__ _ Demand _-- - ,__ ..._ _ ~ GPM Model Number TDH Lift Frt n Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL BSORPTION SYSTEM T NCH idth r Length No. Of Tren DIME 3 CZ SETBACK SYSTEM TO P/L BLD INFORMATION Type Of System: ,~/ q Coh~• ~2s~' ~ f DISTRIBUTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 405115 0 State Plan ID No: Parcel Tax No: 020-1370-46-000 STATION BS HI FS ELEV. Benchmark Alt. BM 5; J~o.s, ~ 3 ~`~ ~L Bldg. Sewer SUHt Inlet SUHt Outlet ''' (0.(00 Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System ~, Z ~ZS-- Final Grade ~~~~l/~~~ ~~~ ~Ff ~' St Cover ~; -~ faa -t- ___-- Of Pits CHAMBER OR UNIT Depth Header/Manifold Distribution x Hofe Size x Hote Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Onlv xx ~,",ound Or At-Grade Svstems Only Depth Over Depth Over xx r~•epth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ ` Bed/Trench Edges Topsc'~ ,i: Yes ' No ! Vii, Yes i m~ No ~ I COMM,,E/~NTS: (Intl ode discr ties, persons present, etc.) !nspection #1 ~ ~~i~~Jr inspection #2: .2~-c~r+~-L~ ~ 'lam ~-. -~~ Location: 979 Parkview Lane Hudson, WI 54016 (NW 1/4 NW 1/4 16 T29N R19W) Parkwood Meadows Lot 46 Parcel No: 16.29.19.2212 1.) Alt BM Description = 2.) Bldg sewer length = C ~~ out-&~ ~ ~"•t,P j~~~~9p~ ~..~ r't'e. -amount of cover = ~-f -- t~~,~~-Q-Q.ou1~,s~.~t . , ~-''7 _ 3) 141( a~5e~~a-f -~. ~ ~`Fr~ Y 1e~ ~,r ~~" f~°'~ IU~.Q-r~~ a b _ ~ .,2Qrec~a.,ti_-!M'r's c~ sys~~'w' ____ i I Plan revision Required? i~ s i .__._;! No i Use other side for additional information. ' _ ~ ~ - _ __ - Date 4 Insepctor's Signature Cert. No. SBD-6710 (R.3/97) ~l ~b n~~J f0~~ ~~©/,,,J ~ rf/ /'/~ t~ i ~' E 1 Cam- --~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ i~ ~ ~ n ~: ~ ~, .. p, _ _ ~~'~~''~j O Z~ ~ ~ O N i ~ m N `C ~• O w O ~~ Q p fl. CD N ~ N ~ p Cfl '~ ~ 7~ ~ ~ i m R O. S 3 N p ~ O O r. i 3 N ~ li p O O ~~1 fll N d ~ l~l d ~ ~ cn Z ID O. !~ ~ W a c_ ~ ~ N fD t~ (D ~ O ~ i _ 3 ~ d ~ 91 ~ ~ ~ ~ ~ y N ~ ~ ~ a s ~ v q I ~ 00 ~ ~ d vN o ! $' '~ ~ 3 y ~ ~ ~ I ~ °- .. N I D D Z w O Z O ~ ~ `~ I ~ m m a ~• w I n fD c ~ I ~ ~ ~ _ rn o ~ Z ~ ~_ _ I A ~ ~~ N G ~ ~ r. i 0o v ~ ~ 6' Q ~ it > Z ~ `~ ~ i A ,T~1 i 3 :"•' ~ c<o C`~p U! Z I ~ G \ ~ ~ A Q c I - ~ G O ~ C p Q it y I wZ h ~a fi fi h ti W N O A N O ~ i ~ Oq o0 i ~ co ;~ rs~ O ti N o ! ~°, b : Safety and Buildings Division Cam' !' ~ r 201 W. Washington Ave., P.O. Box 7162 51 ~ *!/~-v"~- ~~seons~n Madison, WI 53707 - 7162 Sine Addter~ss De artment of Commerce )~ oz~ Sam/ Zlo 7 / ~`' Sanitary Permit Number Sanitary Permit Ap lication .~S ~~~ In accord with Comm 83.21, Wis. Adm. Code. personal information you provide ^ ~Ck'if Revision tna be used for ses Pri Law, s15. 1 m $~ Plan I.D. Number I. Application Information -Please Print All Information property Owner's Name p EG' Parctl Number ((p . 2q , ( . Z-Z( Z Cif--~-~- Lf~ I~ bZ0 - '-pu,o Property owner's Mailing Address MAY 2 3 200 Property Location/ / / S ~ ~ t1 ~ (,v7k ~Sli: S! tO T N, R ~ E City, State !7- Zip Code Yh ~IC~ Lot N r Block Number ZONING h.Fvtivisien Name CSM Number ~~ ~ / v 7~5 ' /d/ ~ r .Type of Building (check all that apply) a5 ~ 4 ' ^City -Number of Bedrooms ~ lli D il ^Village ng we y ~or 2 Fam ^ publiclCommercial -Describe Use ownship ^ State Owned ~- D~ ~~ ~• N Road III. Type of permit; (Check only one box on line (numbering eme for internal use). Complete line B if applicable) A 1 New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use m Tank Onl Exis ' stem Date Issued B. Permit Number ^ Check if Sanitary Permit Previously Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44~Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Filter 50 ^ Constructed Wetland 22 ^ pressurized In-t3ro-md 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Dtip Line 45 ^ At-Grade 46 ^ Aerobic Treatment U ' 4 ^ Reciietilating 30 O r .~ ~ V. D' rsal/1~eatment Area Information: - Design Flow (gpd) Dispersal Dispersal Area ) Proposed 9 DZ'~) g '} ~ - Soil Application Rate(Gals./Days/Sq.FtJ Percolation Rate (M~.~h) System Elevation Final Grade flevation 5 / //,~,,,, ~ 0 / ~ ~ ~~ q A ti 1 I (I/ ` Prefab Site Ste el Fiber Plastic VI. Tank Info Capacity in .Total Number Manufacturer Concrete Constructed Glass Gallons Gallons of Tanks New Existing Septic or Holding Tank D .--_ ~ (~,t,.~vp-- Dosing Chamber VII. Responsibt7ity Statement- I, the undersigned, asstmme responsibility for tion of tbe POWTS shown on the attached plans. Pl r' Name (Print) Plumber' Signa RS Number Business Phone Number ~ GC~~ 3s ~ ~~s-a~8 -6~~ Plumber's Address (Street, City, State, Z' e) ~~ O ~ ~~ ~ 6 0 VIII. Corm /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ^ Disapproved Surcharge Fee) ~ ^ Owner Given Initial Adverse ~ r~ -~ ~ '- Determination chi ~.~ ~tio~ o~PProvaUReasons for Disa~prgval -i `~ ~ ~ ~~~yQ,t ~~ ~ ~~~, . ____- u ~„t Attach complete pleas (to the County ody) for the aytt~ on paper ~t lean than 8112 x 11 Inches In aze cRr~~~4R Rz OS/011 ,r V a~ - -' ~/ ~ ~ l gas /a o f N ~ ~- ~t~- ~ ~B~ ~~~~~~~_ Dr ii ~~ .~- ~° ~ ~ ~- ~ ~ ,~- x ~°- ~~ 13.3 ~.- U~ aa3s7 -~ v 3-06-1995 8.30PM FROM 'f;ROP~t~l110WNFF! LaCasse tlystam Hanes, gam. DE$CgiPTIO~N1~REPORT PAiACEL LD. ~ 02r -90 1 ~ ~ ~f E ~quf'j ~S ~ /~.6~ ~ ~~ Boring # ' Ground elev. 99_Sft. DepUt to lirtritlng factor *~~~ Boring ~ 4:~ Ground elev. ~ ~- Depth to limmitirg factor t90,• BOrln9 # 53 Ground elev. Deptlt m 1~rrrriting t~tar ~ ~~ P_ 3 Pane ~? of~ 3 Horizon Depth ln. Dominant Color Munseii Mottles ~ Qu. Sz. Cont. ~Golor Texnrr®. Structure Gr. Sz. Sft. ~ ~~ R~~ GPD/ft g~ ~, 1 0-10 10yr3/3 none 1 Zmsl~k dsh cs 2c .5 .6 2 10-3 10yr4/4 nc~e sil 2a~bk dsh gar lc .5 ~ ~ ~.6 3 32 10yr5/4 c2d 7.Syt5/6 sil M rA gw if ~ np .2 4 44- ~ 7.Syr4/6 none cos Osg ml na na .7 .8 Remarks: 1 0-12 10yr3/3 Wane 1 2a~bk dsh gar 2C . .5 ' .6 2 I2-3 10yr5/4 nee si~l 2,u~slalc ~ d~k~ ~x lc , 5 .6 3 35-44 10yt5/4 c2d 7.5yt5/6 sil M na gw na nP `.2 4 7.5yr4/6 name co Osg ~ml na as .7 '.8 ~ `~ J 7 m/ ~ _ T Oe. .Lw- 1 0-12 ~ 10yr3/3 Wane 1 2aushk dBh gw 2C .5 ; .6 2 12--3 lOyrS/4 nose sit 2ms)bk, dsh gw le .5 .6 3 34-38 18yr5/4 c2d 7.5yr5/6 sit M -..-~.~ as g~ l~ np `.2 4 38-9 7 , Syx4/6 naurte ' ro , Osg ml rta ria . y ~ . 8 ncmancs: Boring # .~_ Ground .. .. . elev. n i ~ ~ --- b~~ facts ~~ .V- a9 - ~~-~ ~ iaso ~ ~~~^ ~o ,IBS = ~~ r N ~.a ,~. ~ ~~ ~ ~° 1% ~ ~ ~ ~' 13-3 i~ U~ a~3s7 ,, U Wisconsin Department oflndustry, SOIL AND SITE EVALUATION,..REPORT .._ „ LaboCand Human Relations nivisinnnf ~afaN&Ruilrlinns •_ _____~.--:.~ n 1.n .,.,..~ ~.ae'~~i w.J._, n_..1_ .{ Page 1 of 3 1 1114VVV1V •..~.1 IVI 11~ VV.V V,f]".IV+. ~v.~....vvvv ,~~ ~ COUNTY er not less than 8 1/2 x 11 inches in siz Attach com lan on a lete site f `_~ ~ut ~ari-must ir~ftt'lf~. St. Croix p p p p d not limited to vertical and horizontal reference point (BM), direction and aefslop scale dr `:'_, ~~ ~ PARCEL I-D. # .dimensioned, north arrow, and location and distance to nearest road. "' _ 020-1028-90 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMAT r ,-± '?rs REVIEWED BY DATE PROPERTY OWNER: P')a ION 19 ! W 29 6 ` W~~ LaCasse Custom Homes, Inc. $(or) ,N,R F 1/~V4J rat/4,S 1 T ,GpVT. LOT N .., PROPERTY OWNER':S MAILfNG ADDRESS 521 McCutcheon Rd. L T-# 4~i BLOCK # na _ SU~3. NAME OR CSM # -Parkwood Meadows First Addn. C~pE y~ P CI Hudso 1 05 1~ N381E 5 ZIP ^CITY ^VILLAGE MOWN NEAREST ROAD 7 540 6 4 n, WI. l Hudson McCutcheon [~} New Construction Use (~ Residential / Number of bedrooms 4 [ -] Addition to existing building j [Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate . 7 bed, gpd/ft2 .8 trench, gpolft2 Absorption area required 858 bed, ft2 750 trench, ft2 Maximum design loading rate • 7 bed, gpd/ft2 •8 trench, gpolft2 Recommended infiltration surface elevation(s) 95.10 ft (as referred to site plan benchmark) Additional design /site considerations na Parent material outwash Flood plain elevation, if applicable na ft S =Suitable for system U=Unsuitable fors stem CONVENTIONAL ®S ^U MOUND ®S ^U IN-GROUND PRESSURE ®S ^U AT-GRADE CAS ^U SYSTEM IN FILL LAS ^U HOLDING TANK ^S g]U SOIL DESCRIPTION REPORT Boring # .................. ................. .................. ................. .................. 1 Ground elev. 99.5 ft. Depth to limiting factor +90" Boring # '.;, ................. Ground elev. 99.5 ft. Depth to limiting factor ~~ Depth Dominant Color Mottles Text re Structure Consistence Baxxiar Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color u Gr. Sz. Sh. y Bed Trer'~d'~ 1 0-i0 10yr3/3 none 1 2msbk dsh cs 2c .5 ~ .6 2 10-38 10yr4/4 none sil 2csbk dsh gw lc .5 .6 3 38-90 7.5yr4/6 none cos Osg ml na na .7 .8 Remarks: 1 0-12 10yr3/3 none 1 2msbk dsh gw 2c .5 '.6 2 12-37 10yr5/4 none sil 2msbk dsh gw lc .5 .6 3 37-96 7.5yr4/6 none s Osg ml na na .7 .8 6° ~ 5 ,n S`f Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 200th. Av New Richmond I 54017 Signature: Date: 10-1-99 CST Number: m02298 PROPERTY OWNER LaCasse Custoan Hermes, gam. DESCRIPTION REPORT Page? of.3 PARCEL. LD. # 020-1028-90 Boring # ...:: 3:» Ground elev. X9.5 ft. Depth to limiting factor .pan ~~ Boring # .... 4 Ground elev. 99.4 ft. Depth to limiting factor +90" Boring # ... 5 Ground elev. 99-.b- ft. Depth to limiting factor +90" Boring # .................. ................. .................. ................. .................. Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Color Mottles Texture Structure Consistence Borx>dary Roots GPD/ft in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-10 10yr3/3 none 1 2msbk dsh cs 2c .5 .6 2 10-3 10yr4/4 none sil 2msbk dsh gw lc .5 .6 3 32-4 10yr5/4 c2d 7.5yr5/6 sil M A`A gw if np .2 4 44-9 7.5yr4/6 none ~,s Osg ml na na .7 .8 Remarks: 1 0-12 10yr3/3 none 1 2msbk dsh gw 2c .5 .6 2 12-3 10yr5/4 none sil 2msbk dsh gw lc .5 .6 3 35-44 10yr5/4 c2d 7.5yr5/6 sil M na gw na np .2 4 44-9 7.5yr4/6 none o Osg ml na na .7 .8 u Remarks: 1 0-12 10yr3/3 none 1 2msbk dsh gw 2c .5 .6 2 12-3 10yr5/4 none sil 2msbk dsh gw lc .5 .6 3 34-38 10yr5/4 c2d 7.5yr5/6 sil M na gw if np .2 4 38-9 7.5yr4/6 none co Osg ml na na .7 .8 s.L,t Z Remarks: Remarks: SBD-8330(8.05/92) +~ i ~ . . ~ STEEL'S SOIL SERVICE Gary L. Steel LaCasse Custom Homes, Inc. 1554 200th Ave. CSTM2298 NW4NW4 s16-T29N-R19w New Richmond, WI 54017 MPRSW-3254 town of Hudson (715) 246-6200 lot #46-Parkwood 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' ~I.= nail in Cherry tree Cel. 100.00' Alt. min.= top of 1" pvc .pipe C el. 99.70' L~ ~,~. pl . Gary L. Steel 10-1-99 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of FILE INFORMATION Owner ~~ Permit # ~~J DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units '~NA Estimated flow (average) d Q gal/day Design flow (peak-, (Estimated x 1.5) gal/day Soil Application Rate v 7 gal/day/ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease iFOGI 530 mg/L Biochemical Oxygen Demand (BOD5) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand IBOD51 <_30 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) <_10° cfu/100m1 Maximum Effluent Particle Size Ye in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity a ~ al ^ NA Septic Tank Manufacturer ~ ^ NA Effluent Filter Manufacturer ~ ^ NA Effluent Filter Model ~ ^ NA Pump Tank Capacity al A Pump Tank Manufacturer [~NA Pump Manufacturer NA Pump Model ~ I~NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: L~'NA Dispersal Cellls) ~In-Ground (gravity) At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ~A Other: ~NA Other: ~ NA nnenur~~uen~r_~ cr•_W~niu F Service Event Service Frequency Inspect condition of tankls) At least once every: ^monthlsl (Maximum 3 years) yearlsl ^ NA Pump out contents of tankls) When combined sludge and scum equals one-third IY31 of tank volume ^ NA Inspect dispersal cellls) At least once every: ~ ~ yeas' ~Isl (Maximum 3 years) ^ NA Clean effluent filter At least once every: I ^ month(s) yearlsl ^ NA Inspect pump, pump controls & alarm At least once every: ^monthlsl ^yearlsl ^ NA Flush laterals and pressure test At least once every: ' ^monthlsl ^yearls) ^ NA Other: At least once every: ^monthls) ^yearls) ^ NA Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses 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 ponding of effluent on the ground surface. The dispersal cellls) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding 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 IY31 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed 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 <_12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page Zof START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal celllsl. If high concentrations are detected have the contents of the tankls) 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 ceII1s) 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 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; 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 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 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 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 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 a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil 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 at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <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 IMPOSSIBLE. nnniTinNO~_ COMMENTS POWTS INSTALLER Name Phone '~ _ ~ 6 O POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ,S?", (~~'~, ~ Phone / / ~f!" - - ~b ~ y(~ This document was drafted in compliance with chapter Comm 83.22{2)1b11111d-&If- and 83.54111, {2) & 131, Wisconsin Administrative Code. S'1' C1tOlX CUUN'1'~' SI?1''1'IC 'l'AIJIC MAIN'1'LNANCII AGRI?LMLN'1' AND UW1J1?ItSIIII' CI?It'1']I~ICA'1'ION 1~OItM Owner/buyer _ I I~CGSS~ ~irn. ~~t Muilin~ Address ~ 73 Go~~I,T_,2~1 ~ ~~~~~ I'roparly Address (Verification tcyuitcd lions Planning i)cpatttncnl tilt ucw cnnsUucliou City/Stale _1'~~~ 1,,~ ,^ 1';lrccl )tlcntiiic;llion tJtlnll;cr LI~GAL llrSCRlI''I'ION Properly Localiatt , j~t~. '/,, -~. '/,, Scc. ~, 'I'_ Z~C N-IZ~~W, 'Town of ~ on SuUdivision ~~~~+~ '/~t4.~~C~~S. ~ SQL. t Lot l1 ~. Ccr•lificd Survey i11ap /~ Vc-luntc 1'ngc ~! Wnt•rAnly llecd ~r _ l0 7 ( / ~ 8 , Vc;luntc 1_~~ , I'al;c ~f ~~~, Spec house ^ yes no Lol Ilncs itlcnlili;tl~lc ~cs ^ no ~SYS'1'I!:M MAIN'1'I~NANCI!: Intproperuse and maiutenauccof your septic syslcut could tcsull iu its ptewalute Ibiltne to handle wastes. I'ropermaintenauce eonslsls of pumplug out the scpllc tank every thicc years or sooner, if needed by a licensed pumper. What you put into the systeut eau atT'ecl the function of the aeplic teak as a ttealntcnl stage in llte waste disposal system. The properly owner agrees to submit lu St. Croix 7.oning Dcpatlntcnt a cettiticalion fonu, signed by the owner and by a master pluutber, journcy[nan pluntbcr, [csU iclcd pluutbcr ur a licensed pumper vet ifying That (I) the ou-site wastewaterdlsposal system is iu proper operating condition and/or (2) ancr inspection and pungting (if necessary), the septic tank is less tltau 1/3 full of sludge. 1/wc, the nndcrsigncd have react tltc above tcquitanarts and agree to ntainlain the private sewage disposal syslent will the standards act forth, hereby as set by the DcpaiUncnt of Cnnuucrcc and the Ucpatlnicul of Natural Itcsourccs, Stale of Wisconsin. Certificaliou stating that your septic systent has been nrainlaincd nwst be cotnplcled and [ctuurcd to the Sl. Croix County ZonLtg OfI'tce within 30 d f the tltrec car expiration data SIGNA 'UR r APPI.ICAN'I• DA'rL~ Oti'YNI~R CLR'I'II~ICATION I (we) cetUfy That all stalcnrcnts on this tinnt are true to the best of uty (nor) knowledge. I (we) ntn (are) ti-e ownc[(s) of the rapcrty des ribcd above, by virtue of a warranty decd tccutdcd in Itcgislcr of Uccds O(Iice. IGNA'TUR OC APPLICANT ~ / ~~ ~ Y UATL~ "*''+* Any iufonnation that is mis-tcprescnicd quay tcsull in the sanitary pcnnil being revoked by the Zoning Department. ~~"~*** •'~ I[tcludc wllh this applictttlon: a stangtcd wauanly decd front the Itcgislcr of Uccds oflicc a copy of the certified survey ntap if [cfcrcucc !s niadc its the wanauty decd u l.ssy P os8 STATE BAR OF WISCONSIN FORM i - 1996 WARRANTY DEED Document Number This Deed, made between Howard LaVenture, ThrPP-f i f tha (~/5) intarPar in and Arl^^^ T aVPntr~rP, T<~^-f { fthS (2/5) interest in as tenants in r•~mmnn Grantor, and _LaCasse Custom Ho*^~° Inc Grantor, for a described real estate in _ (the "Property"): Lot 46,.)Parkwood Meadows First Addition to the ~i,r.,~ of Hudson, St. Croix County, Wisconsin * Ar^ 1 coca T a~lonrure 020-1370-46-000 Parcel Identification Number (PIN) This is riot homestead property. ~s~ (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. ~ 3 Z3 (o Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, Indefeasible to fee simple and free and clear of encumbrances except all liens, cgvenants 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. Dated this 16th day of Mav 2002 (SEAL) (SEAL) * * valuable consideration, conveys St. Croix * Hr~~arA T nVantnrP „~ ~~~ ~ ~ (SEAL) 6 7 9 4 7 8 KATHLEEI~I H. MALSH REGISTER OF DEEDS ST. CROIX CO. ~ MI RECEIVED FOR RECORD 05-20-2002 10:45 AM NARkAN'TY DEED EXEIP'T # 17 REC FEE: 11.00 TRAAS FEfi: COPY FEE: CERT COPY FEE: PAGES: 1 Name and Return Address AUTHENTICATION Grantee. to Grantee the following _ County, State of Wisconsin (SEAL) Signature(s) Howard LaVenture Arlene LaVenture 2002 authenticate th day of May ~ ._ * R. Cari TiTLE~ MEMBER STATE BAR OF WISCONSIN Recording Area LaCasse Custom Homes, Inc. 573 County Road A Hudson, WI 54016 ~ ACKNOWLEDGMENT State of Wisconsin, ss. County. Personally came before me this day of ,the above named to ~ UKHIIVHbt 1 \33' ~ 3, 'AREA 1\ ,. ~` \ ~ ~ 44 ~~ ~ \ ~ ~ ' 3.402 ACRES ` r'~,-° ~. ~ ~ . ` 148,191 S.F. N~''~ ` ~~ ~`~ 891.0 (H.W.E.) tS ~ \ ~'_ ~ ~ ~ ~ , ' \ c^ ` \ 69°~3 275.00' \ \ ~ \ ` n n .\ ~\ ~ \ IN 1 ~ \ ~ ~ .\ \ ' o ~ 2.248 ACRES .rl ~ 97,935 S.F. W .M 14.96' N -, Y W ~ N 89°46' 00" W ~ Q Q ~ 523.32' I ~. J I I~~~I ~~ ~ M ~° 46 ~ry 2.258 ACRES I ~ ~ I , 98,344 S.F. 480.00' 205.00' W ~`' ~ N 89°46' 00" W 50' ~ n ~ n ~ 511.98' 0 _°o 150 ~= I °°, ~ I o I o ~ ~ z ~~ -S - - ~ • ~ ~ - - 2.46 ~ ACRES • NI 6'6' IN 107,182 S.F. °o 33' 33' o0 0 _ . ~ , ~ ~ ~ 499.34' 1 _ _- (V M M N O O c~ _ ~ O N co N tV M rn M W r M 0 O O ~CHEON ROAD ~ N 89°4s' oo" w ~ ~ 3" W 1313.87' - T- - - - - - - - - McCUTCHEON ROAD ----I----------~__--__--_--~----------- I - I I I I I U~ PARKWOOD MEADOWS ~ I i ~ C~.t~tpa~I i I LA -- ~ ------ ticr~~~o I II ~t yy~6~ , I I I Y ~, ~,,~~Ster ~1` ~ I I \`~ II 4 I 3 I ~ '~'fi~~~ - - I I I I ~ ~~~ l I i , OUTLOT 1 --T)