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HomeMy WebLinkAbout020-1479-07-000 pNmrgtr County Safety and Buildings Division S C 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) T P S_ y Madison, WI 53707-7162 5-nc? -7 ~IOfyAi- er S-sT, p Applied ion - State Transaction N In accordance with SP,9is bode, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m , Stats. (3sf Nm L Application Information - Please Print All Information (7 Property Owner's Name Parcel # 020 - I Ll -79 _ 01- 001 I4-0, A,5+ Property Owner's Mailing Address y~ Property Location a1 LakAp-cR how Govt Lot 3 6 2 Z~) City, State e Zip Code l Phone Number S W 1/., S Section 1 t (7 d n c~ t0 T a4 N, R _B .w II. Type of Building (check all that apply) 6~ Lot # o'1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name - -50 WOD V-Ooe:e e- c~ Block# o 6 t) Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of Town of WOO OA1 III. Type of PermillE (Check only one box on line A. Co plete line B if applicable) A. New System ❑ Replacement System XTreatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 1 oMo < 24 in. of suitable so' . - lb U ❑ Holding Tank ❑ Other Dispersal Component (explain) (explain) S V. Dis ersal/Trea ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation oo VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ° U New Tanks Existing Tanks 2, c 2 Septic or Holding Tank d b 1 S q~ 111 ty-t K Dosing Chamber 1 VII. Responsibility Statement- L the undersigned, assume responsibility for installation of the POVVTS shown on the attached plans. Plumber's Name (Print) PI Signature MP/MPRS Number Business Phone Number Plumber's Address (Street City, State, Zip Code) n VIII Coun /De artm Use Onl ~ ?is-~< Permit Fee Date Issue Issuing a Signature proved q~j5 rven Reaso for Denial IX Cond teasons for Disapproval :3)l ; l v ~ fi" dw~2 / tank, eftent filter and I cett must all be services I malntained' mane ement plan rovided b lumber. V--,\ 41 as per 9 P Y P 3. setwk:requirements must be tnaintained as per applicable Code / ordinances. Ca t e uO5 4- Attach to complete plans for the system and submit to the Co ty only on paper not less than ma z 11 inches in size SBD-6398 (R- 11/11) Ab ~ I 9 `dos T) 6 Lo~ ~ v~ iI r 'USA i `i Red~c,or~, ~ I~vM~ Q rz. j vt L, c, aa~ 4oy dos (Jo-b IC c 0 P y CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: KK-W 0 1,3 &St; Owner's Name: l1 11 I Owner's Address: Mbs1 t~l N Li,b t~ 44 ~S-bN W ,i 5I , Legal Description: _ I S I) y S 3 4 TAI t i Township: JAW) ~ a N l County: 3A. QP-OI`k Subdivision Name: (~A(J QU G S41~ Lot Number: Parcel ID Number: O 0 1 1 ~U ll u Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Designer/Plumber: -J I Nx ~ b~YA,, -P, y lo License Number: Q O( 1 U Date:Q c~d S Phone Number Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01). Page 1 V,evmoo bp~A WR s S 1`I LAW- '869 ` OS~ J)ka~ urasoU l~lIsc. ~ IAWDSOW lki)S(-. L0- I~oo~ Sys~tw, ~a~,k Red~oor~, Qrtj ~C 301A M L'.~. a~~4oy 2--of START UP AND OPERATION Page ' For new 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(s). 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 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 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. p~ T N/j,~ alua ' a o mg ank 111011L C1100. 11 be ' e ai e . FfZD}~131T>1~• lJ=D2- N>~✓ Cp/uS772tJc--A D1J ❑ 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. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name j 1M a~ Name D S b~ Phone 1 S_ 3 6l d.~ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name P Name CIh ( wU N 20 (l ~ Phone - cl~s' Phone This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner e O ~S Septic Tank Capacity 400111S gal ❑ NA Permit # Septic Tank Manufacturer JI14 ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer jlh L~ ❑ Number of Bedrooms aNA Effluent Filter Model ❑ N Number of Public Facility Units -5~ NA Pump Tank Capacity J, NA Estimated flow (average) gal/day Pump Tank Manufacturer O NA Design flow (peak), (Estimated x 1.5) (Ob gal/day Pump Manufacturer NA Soil Application Rate gal/day/ft' Pump Model NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODr,) :5220 mg/L ❑ NA ~K Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODS) :_30 mg/L PQ In-Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) :_30 mg/L ❑ NA ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) 510" cfu/100ml ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: R B month )(s) (Maximum 3 years) ❑ NA year(s Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA 3 19 year(s) Clean effluent filter At least once every: ❑ month(s) 11 NA 0 year(s) Inspect controls & alarm At least once every' ❑ month(s) NA pump, pump ❑ year(s) NA Flush laterals and pressure test At least once every: ❑ month(s) ❑ year(s) Other: At least once every : ❑ month(s) NA ❑ year(s) 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 tank(s) 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 cell(s) 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 (Y3) 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 :512 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. M~ VT~ vaoa-i :-nu 95ti8-5N-008 OIOZ 'Nv 03SIA38 O \ :anod-lsOd •:3Lvo otoz xavn7p ava os1ti9 VA 'HOOa N3aivw 01 AMH sn 9UCM 111f1NVYY 3LLd3S W :anod-3ad .o-,L=.r MvOs aws '-AG rw.vaa ~l3W ado 009 V 009-H v=i O H V) U Z O a g m ` U. U Q U ° •N<.• H 3 8 m p0 v to m a J a O U- ILIL a o z O= _ W NOO\.. Q Z~Z Y~ S L( x Q ~3°m~iXHIMM ~ x p a z $ A ° J N N W _ U 8 U ■ O N SdO.$I 2~r .r a w „£S do r I I'~~ I I U I ~ ~ I g r 8 IF M I i l a svo $ O L_ L-J .99 do 8 a: a U „bL "OL Y Z H AND- C) wbrii R. ' L. S . " 7E T FO aWDMYauytr. noIai2ing q a merty Address `l ftv4 Tc#eetificafiM Mube a2Dt+~f' ;T 29 NitQTma6f. : . visio Su Co~aaee ~acrri►ti Lot # '7. s~erdSet! tp # ` . Valun~,: - ' ',page # ~ ~ • WsiTmq S* ya V SX~ l14~~)Iwi:"1t€411Yf pm= a6d grope 0$8 of YM up* 8}~ti8ta CO1Lt iii its S~ilf lp 1' ~rRSCs_ Pmpar =Oft of PftVftEWft' $ m t is 9my t ysttta qr" Xtieoded, by a *wWpater. %U you PmE moo the sum caa af£bct thes septic c as R Ms e fo ara~e'ti at system u / . - tbititias ate s sf sd ini Ft 83:52(11 ad in Owow 12.- ft C obt Comty Seigaxy l Ot The p* OpetWLOw= t, tl*Mhto !i..C C Wy Pig $ ZOWW DV=mai oersd`at ftim, wdby *e owner and by,a mftr pi jofty p pltm~aoe ce a lies ed putaper ~g ~ij tbo c afire.: ~ . system ~ i3t ' fipes•Stiag iidnt for (~}'t~tc iaspectian aed p,g (~Y)+ rite se~ticrar3: is kss that 1!3 full ofsladg~. ; ► , law road &e. 6m►c a ~r► t Oval a s wav disposal system with tba ~_set .1e, as aet b tttc . Y irft eircc sid;ko ~t of'NoxdR om St m of Wig: . YQ'W s bm beeea mo$ft be aw*~ftd aid t dd the St,omb rC.oaaty P A U caft tft an suers an this fnxm art tt:Ea ofmlrlow awa►1. 1r'ni►e aiod€are ov+eerTsl she t + 'virtue of a *vti* da_~--- trf Deeds:Ci~ce IJ{mss APPLICANT(S) I OF DATE "r y; do mk*mu d May of t1re. s~ b~$ r~vok~d by tie P~nm~utg,~ •~ttng lsxclu witc this a iicazaoo a r~aart~d vv~iru:zy fi M 60 A of Dm& Oland a con ofte caffed stuly MV.if ,~f~eaceis xraadc @a the v~taireiatyoamd. POWTS SERVICE CONTRACT The proper operation and maintenance of the components listed below will significantly influence the performance and life expectancy of the POWTS (Private Onsite Wastewater Treatment System). This agreement authorizes A.C.E. Soil & Site Evaluations, L.L.C. personnel (Service Provider) or their representative access to the POWTS components during regular business hours to perform regular inspections and routine maintenance of those components. It is herby agreed by and between Purchaser and Service Provider that in consideration of the payments provided for herein, Service Provider will provide a manufacturer trained and State licensed inspector to perform periodic inspections of the POWTS components as set forth below. Service Provider will prepare a written inspection report after each inspection containing any recommendations for the operation, maintenance, and or repair of the POWTS deemed appropriate by the Service Provider. A copy of the report will be provided to Purchaser and the appropriate Governmental Unit. Service Provider will supply additional services, parts, or labor only after authorization by purchaser. This agreement does not assume any responsibilities or obligations that are normally the responsibilities and obligations of the purchaser and does not cover any costs associated with operation, maintenance and or repair of the POWTS. In no event shall Service Provider be responsible for any special or consequential damages, including but not limited to, loss of time, injury to person or property, or incidental economic loss due to equipment failure for any reason whatsoever. This agreement shall remain in effect for a period of two (2) years from the date of POWTS installation, and will be automatically renewed each year thereafter unless amended or cancelled by either party with 30 days written notice. This agreement may be cancelled by Purchaser only if replaced by a service contract with another service provider authorized to inspect and maintain the specific POWTS components in question. l Purchaser agrees to pay Service Provider the sum Of 125.00 per inspection. Four (4) inspections will be provided over the first two-year period at six-month intervals. Payment for the first four inspections will be included in the cost of the POWTS design. One (1) inspection per year will be conducted thereafter with inspection fees billed to the current property owner at the time of inspection. POWTS DESCRIPTION: Wieser Concrete tank with Hoot Systems "H-500A" pre-treatment unit, pre-treated effluent discharged to common pump chamber and discharged to In-ground dispersal component constructed in compliance with In-Ground Component Manual, SBD-10705-P (N.01/01). POWTS Location: Lot: 7, Plat of Cottonwood South , located in: SW SSE of Sec. 36, T. 29 N., R. 19 W., Tn. of Hudson, St. Croix Co., WI, Parcel #020-1479-07-000 Owner name and addr Kernon B 948 g oa Huds , W 54 6 ~IlgJzals (Owner ature (Date) Service Provider: A E. Soil & Site Evaluations, L.L.C, 40 Pa on Lake Road Osceola, 54020 ice Provider signature) (Dat Instrument Drafted By: James K. Thompson U 2 7 3 9 P 31 6 '7&r=>1O9 ~3 • KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., W1 STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 01/2$/2905 03:15PE THIS DEED, made between Neil L. Wilcoxson and Mary Jo MARREXOPT # EED Wilcoxson, husband and wife, Grantor, and Kernon J. Bast and Donalda J. Speer-Bast, husband and wife, Grantee. REC FEE: 13.80 FEE: 90 Grantor, for a valuable consideration, conveys and warrants to Grantee COPYSFEE: 4212. the following described real estate in St. Croix County, State of Wisconsin: CC FEE: PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2'' St. -Suite 115 Exceptions to warranties: Hudson, W154016 Easements, restrictions and rights-of-way of record, if any. 456780 020-1109-10-050 020-1110-30-000... 020-1109-55-050 Parcel Identification Number (PIN) This is not homestead property. Dated this 28 y of January, 2005. Il L. W' cox * Mary Jo i cxson AUTHENTICAWN` ?1L010 ACKNOWLEDGMENT a~► 1. ConSignature(s)C' ~Sl~ STATE OF WISCONSIN } cy s' ` ' ST. CROIX COUNTY. )Ss. authenticated this 28th day of January, 2005 Personally came before me this January 28, 2005 the above named Neil L. Wilcoxson and Mary Jo Wilcoxson, * husband and wife to me lmown to be the person(s) who TITLE: MEMBER STATE BAR OF WISCONSIN executed a foregoing instrument and acknowledged the same. (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY *Cheri Town Notary Public, State of Wisconsin Peterson, Fram & Bergman - Steven H. Bruns My commission is permanent. (If not, state expiration date: 50 East Fifth Street, St. Paul, MN 55101 3/11/2007 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) 'Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 U 2739P 317 EXHIBIT A Parcel 1: A parcel of land located in part of the SW '/4 of the NW '/4 and part of the NW '/4 of the SW '/4 of Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin; more particularly described as follows: Beginning at the W '/4 comer of said section 36; thence N00° 16'1 0"E, along the west line of the NW '/4 of said section, 1248.49 feet to the north line of Lot 1 of Certified Survey Map recorded in Volume 3, page 669 at the St. Croix County Register of Deeds Office; thence N63°02'59"E 148.42 feet to the north line of said SW '/4 of the NW '/4; thence N89°26'58"E, along said north line, 1182.70 feet to the east line of said SW '/4 of the NW '/4; thence S00°21'37"W, along said east line, 350.04 feet to the north line of Lot 73 of the Plat of Cottonwood Ridge First Addition recorded at said office; thence S89126'58"W, along said north line, 10.00 feet to the west line of said plat; thence S00°27'24"W, along said west line, 2096.76 feet to the centerline of County Think Highway "N" and a point on a 1999.00 foot radius curve, concave southerly, whose central angle measures 7°10'30", whose chord bears N84°30'41"W and measures 250.16 feet; thence westerly, along the arc of said curve and said centerline, 250.33 feet to the point of tangency; thence N88°05'56"W, along said centerline, 83.64 feet to the point of curvature of a 2700.00 foot radius curve, concave northerly; whose central angel measures 3°17'53", whose chord bears N86°26'59.5"W and measures 155.40 feet; thence westerly, along the arc of said curve and said centerline, 155.42 feet; thence N04°29'56"E 244.01 feet to the point of curvature of a 167.00 foot radius, concave westerly, whose central angle measures 34"24'12", whose chord bears N12°42' 10"W and measures 98.78 feet; thence northerly, along the arc of said curve, 100.28 feet to the point of tangency; thence N29'54'1 6"W 274.22 feet to the easterly extension of the north line of Lot 1 of Certified Survey Map recorded in Volume 12, page 3456 at said office; thence N89°' 12'45"W, along said easterly extension, along said north line, and along the westerly extension of said north line, 670.44 feet to the west line of the SW of said section; thence N00°37'50"E, along said west line, 496.89 feet to the point of beginning. AND Parcel 2: A parcel of land located in part of the SW '/4 of the SE '/4 of Section 36, T29N, R1 9W, Town of Hudson, St. Croix County, Wisconsin; described as follows: Beginning at the South '/4 Corner of said Section 36; thence N00°27'05"E, along the north-south '/4 line of said section, 1216.78 feet to the centerline of County Trunk Highway "N"; thence S76°47'47"E, along said centerline, 1354.82 feet to the east line of said SW of the SE '/4; thence S00°07'02"W, along said east line, 897.02 feet to the south line of the SE '/4; thence S89°33'25"W, along said south line, 1326.80 feet to the point of beginning. PREPARM roph COUNTY PLAT ° LOCATI COTTONWOOD SOUTH q N Nq IN PAWT OF 7Nt OF rsVylµ OF 7Nt ttt/4, W PApT OF TNt tt7/6 CF TXt iWtµAND PAgT OF ~1111~OR TNt l7p 0..., Nt iW1/1 OF ttCT10N H. T"N, A70111I, TgIYN OF MUDtON, dT. OIiOIX COUNTY, VWGCONtINI INCLUOMO LOT 1 OF CCRIIFIRD WgVEY MAP wtOCFMM ti %'CV.W t 0. PAOt test. ew++an~.e~ rxn~w.wewleHO,re i ele.mvr•slon earn eoeime,weeq mwc nsrime rrxnsrwnm Mcm xuoeOAwame ~aw.'~ier LOCATION GKETCN PxOnees,ia,w w""w.•e.wiawu r'"'esria - ioua~rwwrewwmrw,eoeAx *MO.e serr.mexnerewewrwe,. .~°AOw~r..rrreowwer.rr ~w+ Mw~.w~ire"'rnw.X10~e .~.n'rI"r.10r,naer..reew . ,~rtlw`~waaaur weds ,e~Meroee~i.AaOr1e~werAee I mlow 1 I I I 1 I F_-------___i I Pori anmWom f; LOT ti 1 ; 3l"L[474EIDLAOt®e 24 I p ~ , 25 r / r 1 SAM 23 p r se.c 3 p LpOO 2 ga f ....w . s w"..~...±....ew N•.~~ ~ro...r.. - ~,4 - Aaq .rrrrr,rrue 11 >i OUTLCTI .A C~wrw we.rA.e.e.A q q tl fm wngrt 7 °"'rq'e~"q A YwK Y.een 1wtlA~ !IU ••.....,~r.elr~jey • • • 1rt~NMA Vn~ IaMVy Yw ww _ ewmw 1 e wmurrnrwu. r~ I~®~w ~ I ~wwrwr a i~wnA ewi.~ll Q6N' ym LAN➢Y ww. Msrn r~exirAnenrw a.IpeAwwAerd iaigw~ rri xwwgie• s~w~av i T. 7 e,wr1 OF..IIYie Seca ndard Eros~or~ Ca~tr~a lr~a~r~ or 7 -FOM[ y D'Wejjfng Co.h-,StrU ion Saes Accvrditag to Chapters ILf-lIt 20 27 of the wsconsin Uniform Dweiljng.Code; soil erosion control inforrr►atlon needs to be included on the.:l~lot`plan which is cibmittecl and:approved rive to the Issuance of i3uitding permits for 1-. &i femlly dwelling, units in EMidse jurisdictions where the.sail erosioh cont~'ol prpA.0ol.s of tf a Uniform Swelling. Code are errfarced.. This standard:. Irroston Con of Piar . is,prowided to isssist.in meeting this. regairement : _ Instructl+onsc 1.. Comptete this plan by filling :irt requested:infarrnation~ completing the site diagram and. marking a .Propnate boxes_ori:thc inside of tiiis:form: 2. Irt completing, tide'-site, cllagrain, give consideration t:6 .potential erosion that tx aY occar before during;. anq after grading. Water runoff patterns can:change signicatatly as ,a site is reshaped. 3. Submit this plan at the dine of building permit application. PROJECT LOCATION ..131Jii.DE9 Y.f plesiselritlMat~north. 0,1IVNER ~4fliVO by ovrriplatirig i}tegrow. t3lt WORKSii-SET COIVII?LETED'BY T,y, BAQ,r- DATE 3. I Z4 j 2b ,SITE.DiAGRA~M a . Scale.-I Inch ,..:...feet E RO IQN.. CONTROL PCAM LEekIND: PROPERTY: . ":LINE:. . EXISTING' - DR~MNAGt: .TEiVtPQE~4RY . 'TO DIVERSION . FINISHED . - DRAIN 0E 1 98 CAF: GRADING T-r sitfi: FENCE. STRAW _ Mr DRAM - ::SPECIFICAT ON SPRE5ERVA't70N STOCKPILED I f, 1A 8018 ' tEXttY1N6 (,11L~li~i'r2'f uJ . RSIJiVONTI~L AL:A>~( CHECKllST' Check . aPpro jiria A boxes below, and: romPiete the site diagFatn . n, wnecessary Inn rmation. Site ~Chararter stirs . North arro ; scale, acid .alto bounds Indicate "and name: adjacent sti ets or roadways:. C1. Location of existing drainageways; streams, rivers, lanes, wetlands or wells. LaCation. of stbrcrl sewer inlets;. Locati+on bf existing acid proposed buildings and paved areas. Tli'e: distui*O,ma: on the lot . Approximate" gradient and direction of slopes before grading operations Approximatk gradient and direction of slopes afEer grading, roperations. D.. Overland runoff (sheet flow} coming' onto the site from: adjo ceiit areas. . Erosion Control: Pracfiices ❑ Location of temporary sail "storage -piles: Note:. Soil Storage piles'should"be placed behind.a sedirnentfence, a:i0"foot`wide vegetative strip, or should,:be covered with a tarp. or more than 25,feetfrorn any:cl, vrWope,road::or dtainageway, L~acation of access drive(s) Note: Access drive should, have 2 to* 3 inch .a99re9ate„stone laid at :least 7 feet.~nndp " w and 6 inches thkk: 066 should. txtend from the roadway50 feett,or..to the house.foundatioii. (whichevers Tess):, O Location of sediment controls " (fiiiter,fabric. fende, straw Dale fence. or 10 foot vvi e : vegetative strip). that vVili" prevent .eroded"soil from leaving the site: Location of.sedimerit barriers around on-site storm sewer. Inlets. . fuaty, "mss /Vq C7 1 Gocatton.of dlverions ES'681r1~N~; 1Vote:. Althoug. not specifical1Y'.required 15y code, It is recoriamended that concern tra.ted f cW (drainage" fi be' diverted ,(re-directed) around disturbed areas,: Overland: runoff sheet yeses ( }from adJacent areas greater than 10,066 sq:.ft.. . should also. be' diverted "around disturbed areas. © Location of: practices. that Will be appHed to control erosion on steep slopes.: (greater ttiap an.. 7.96 grade). Note: Such practices include rnaintalning existing.vegetation , placement of ar)ditionaf sediment fences P' ersions, and: re=vegetation by sodding or seeeiing th use . .:of erosion. control 'gnats. Location 0 practices that will- control erosion on areas of .concentrated runoff flovV.. Note: :'Unstabilixed drainageWays, dltches, dlvarsions, acid inlets'should be clod frorrrn erosiorr throush use of such practices as rn-channet.fabric or straw ale :barriers, erosion control mats, staked. ,sod . and rock ii " rap. When "used, 'a given in chariKei border should not receive drainage from more ;than two acres.' of. tinpa vedarea< or one acre of Paved .ar+ea. In-channel pMttFcss should not be' " installed: in rennI I stn:ams""(streams, with year. round flow). © Location of -other plan6- d: practices not already noted. rQu 1.. Inditate'mar~ageni . ropNte x. ent $"ey'byOecking (se): the app bo r w u © Management Strategies • :z Q Temporary stabliizatlun of disturbed' areas >~lote it is recommended that disturbed acres: and soil piles 1efE inattide fQ- extended en "ods of time be sta(biflzed seeding n April 1 and September 15), or bYo ther cover, sucWas tarping or M Iching. Permanent stabilization of situ by rev tion or other means asj soon.: as tomibie , _ : . (lawn establishment) • indicate mwegetaticin method:. Seed Sod Q.tither. • .Expect ec} elate of permanent re-ege6l3on• ~IZoi~ T • R vegetation responsibility i6f: f~ Builder s Owner/Buyer . • Is temporary, seeding or muichingialanned if site is not seeded by.: Sept. 15 orsoddec! by Nov., 15? Yes' No O Q9 We.4'-d6wnspoErt andlor surrip pump outlet eztens oris. ,Note: h Is recommended that floWirom tlowriq')ors and sump pump outlets be routed throw h plasdc.drairtagap!peto stable' areas spch as eSMblished.sod or 9... Pa.: Q ! Trapping sediment during de-watering operations.. Note Sediment laden'discha a waterfront um in operations shouFd lye ponded behind a sedlmerit b rrlger until. most off the sediment settles out:. ' Prop *"Al of building matedAl,waste sty that,poilutants and.:debns are. not,cameQ off-site b wind,or water. [ Maintenance of erasion control practices. SedIment will be removed from behind,sediment fences and, bahriers'. before it reaches a 4epth'thit is equai tb half the Height o f tkie.:banier: • ..Breaks and gaps in sediment fences and barriers will be ie aired lnTme- diately: iaecorriposing straw: bales will be replaced (typical bale life is: three marrths}.. All sedimehtthat r dves.ofF site due to construction activit)r a~vill be cleaned up before the end of file same workday All sedimentthat moves off s1 tid. ue to.storm,events:wiii be cleaned.up. before the end of the t1eXt workday • Access drives will be- maintained throughout construction-... • All installed erosion contriil.practices.will be maintairred.untiithe disturbed areas thiey protect are stabilized. For more assistance on: plan preparation; refer to the Wisconsin Unifam) E)wel(ing Code; the t NR Wa[a~sin Construction Site hest Management Hanilbaok; acid UW=extension publication Erasion Cantrril lorHome BuUders: Ttie' W;coruln.Unifnrm bwW#V Code_and ifie: Wlscorlsirr"Constitrc ion SlteSat Management Mandbwk are available tiro h the Suteof Wisconsin Document Sates, (608) 266:3558; Erosion C66W.foe 1 tonne Miid~rs (~WQCKt1) can be ordered through Extension publications,' (608) 262-334a of the Department of ~onimer!ce, (60$~ 26~-4403. i 8 2 9 6 0 7 3 Document Number Document Title TX :4243380 St. CPOIX County 1010590 BETH PABST AEROBIC TREATMENT UNIT (ATU) REGISTER OF DEEDS ST. CROIX CO., SERVICING AGREEMENT REC EIVED OR RE OIRD 04/15/2015 4:08 PM State Plan Transaction Number - EXEMPT REC FEE: 30.00 k0?N0~ COPY FEE: 2.00 Name - (Owner) Typed or printed PAGES: 1 Being duly sworn, states, under oath, that: He/she is the owner/part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume 1371 Page 6-12 Document Number $9a 3rq St. Croix County Register of Deeds Office: Recording Area A parcel of land located in the 5w '/4 of the SE'/4 of Section Name and Return Address T~ N - R 1C_ W, Town of WyoSW , St. Croix K N • aASr County, Wisconsin, being duly described as follows (include lot no. and q14? LA 8AQfA ROM subdivision/CSM or detailed legal description): WosAw, wr 54o1b Covn~^{ Lori pcAmr OF C0Tr0QuJW4 SDQTO , 10wa of 00060670 OZO- ntificc t 07-000 Parcel Identifation Number (PIN) 'Sr.M%x Cowiry i tgrsccw #A) Agreement Date: Ll'10-7015 r As an inducement to the county to issue a sanitary permit for a POWTS equipped with an Aerobic Treatment Unit on the above-described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of SPS 383, Wis. Adm. Code relating to Aerobic Treatment Units (ATU) and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) technology. If the owner fails to have the POWTS and ATU properly serviced in response to orders issued by the governmental unit or the Department of Safety & Professional Services (DSPS) to prevent or abate a human health hazard as described in s. 254.59, Stats., the governmental unit (St. Croix County) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. The owner agrees to maintain a contract with a licensed POWTS maintainer for the life of the system. The POWTS maintainer will perform periodic inspections and maintenance as required by the manufacturer and the DSPS, including, but not limited to: the blower, electrical controls, and treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254.59, Stats.