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HomeMy WebLinkAbout020-1415-30-000Wiswnsin Departr~nt of Commerce PRIVATE SEWAGE 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)]. Permit Holder's Name: City Village X Township Sienna Cor Hudson Townshi CST BM Elev: Insp. BM Elev: BM D 'ptio ~_ D OD'd TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic l~~~Ct~ v ~~' v Dosing xx w ~~U ~p~ ~ ~'~Y Aeration ~~~ Holding TANK SETBACK INFORMATION TANK TO P/L EL BLDG. Vent to Air Intake ROAD Septic ~ / ~ / ~ ~ / ~/ Dosing ~ iv-s Aeration Holding - PUMP/SIPHON INFORMATION (~-l-r-~w,~->'~ Manufacturer ~d J/a~~ ~, _ J ~L 4[ nXClti Dema GPM Model Number TDH Lift Friction Loss m Head TDH Ft Forcemain Dia. Dist. to Well y' St. Croix ary Permit No: 430458 0 Plan ID No: I Tax No: 020-1415-30-000 mfrown/Range/Map No: ~ ~, 20.29.19.2621 STATION BS HI FS ELEV. Benchmark QQ S/26'~ 8~ ~ /~Q a Alt. BIVI f r 2, ay/ i' ~~ ,.~~ Bldg. Sewer ~ (~ ~ ~~ 3 -~ SUHt Inlet 303°- ~ (0 8 a -9~ SUHt Outlet ~ vim- /~ fj ~ .• ~ q ~' ~ Dt Inlet ~ B ti" t_,~(.xr~,_ ~~ -v/ ~ Dt Bottom i- - - ~ Header/Man. Dist. Pipe ~? ~~ , ~ Bot. Sys em ~ ~~ rpp d0 Final Grade N 7 ~N/~ ~ / ~ W Y St Cover /~. (/ r~ 9 . d SOIL ABSORPTION SYSTEM 1 ~/~i>'.f9.it~/_~~t ~ /~_ ,.~._ .. ,/_ BED/TRENCH Width / ~ Len I No. Of Trenches ~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~/ SETBACK SYSTEM TO P/L BLDG WE L LAKE/STR M LEACH G anuf / ~~~ . INFORMATION CHAMB R OR Ty Of System: / ~j py ~ r Model Number: DISTRIBUTION SYSTEM Head ifold Length Dia ~i1~ Distributio I ~ , Leng h ~ Dia ~N Spacing ~ x Hole Size x Hole Spacing ~ ~/~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv Depth Over 1 Depth Over xx Depth of xx Seeded/Sodded '~ ~ Bed/Trench Center 3 Bed/Trench Ed es g To soil p ~ Yes [] No C! Yes IJ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~~~~~~ Inspection #2: / / Location: 750 Martin A~v~enlue udson, WI 54016 (NE 1/4 SW 1/4 20 T29N R 9W) The len Lot~~7 Parcel No: 20.29.19.2621 1 J Alt BM Description = w~~ / / ~l/ V ~ ~ -/ (/~ ~v/'"`-- ~ ~~~L~ ~ ~ or, 2.) Bldg sewer length =r (~ ,~,~ ~ tj p=f~Yvt 6~ ~^ ~f 7. ~ / yr.. -amount of cover = ~ ~~ ~~7it'cv".+~ ~~~~, ~'a~, lu ' _ _ ~. ~' ~~~ Sir, ele Vr.~h~, > q ~ I a3 3 - --- - -- - __ Use otheSrside for additional information. o ~ _~ ! ~ ~I' ~ __ ~%~~.- (r~fiYt~~ __._ _--~ ~ ~ _" ~ / ~ _ 1 ~ - SBD-6710 (R.3/97) Date Insepctor'~ i ature Cert. No. ~.o-t",,~-~~u~---~ 3 ~=~ezJ C~6-ers - soda ~~er~ -Y / r/ Vent to Air Intake ~ Cam.,`, 6.~r ~.. ~ xx Mulched CVY1satt'ithGt~~~~{ Ca~tsi.r~in~F.fi~~ ~ ' Safrty and 13ui:c1in5s O~~isic~n ~! t'ounty ZOl W. WashinSton Ave., P.O. Box 7162 s~ ~~1ro ~ ~C i /~~~~~~~ Madison, Wi 53707 - ?162 San:utry Permit hutnber (to be filled in by Co.) ~ De artment of Commerce (6D13) 266.3153 3~ S~ Sanitary Permit Application State Plea I.D. Number eraoaal infortrudon you provide Code Wi Adm 83 ZI I C id d . , p , a. w esar . a eceor e t'nay bt used for aecotxiary purposes Privacy Law, a1S,04(1)(m} Protect Address (if dt erect ttwrt mailing addroas) , ,/ ~'~ ~~ ,`/' ~' ~ --7 ill J ~ ~QJ ,,~ ~ ~ (~ I. AppBt:atian Information - Please Print All Inforatatla~ Pt~a'ty Owner's NA me ~ 3 S E P 2 2 2003 ~ Parcel ~ ot- Hio~ ±f ~~ / is ~ ~ w C y- - S Proporty Owner's M sling Addrea S rty Location . 2!v Z/ City, State Zip Code ' ~~~`Na, yri.,~/ S Y3S ~3a -835 =~ ~Q ~ (circle T ~ N; R ~Q E o~ . Type of l3t>dldiaR (check ell that apply) ,~ d b f S D d il ll Subdivision Name CSM Number rooma wtt iag - Num er o e y /~' or 2 Ptun ~~ ibe Use D bt /c i ! ^ P ~ ~ escr otttmerc q - u ic ^ State Owtud -Describe Use ~ G~ ~ li~zti~-O,. (]City_^Vi11aSe,Q~Township of_z~~ i III. Type of I'etmit: (Check only one box oa line A. Complete !!ne 8 !f applicable) ~' New System ^ Replacement System ^ TreatmantlHolding Tank Replacement Only ^ Orlur Modification to 8xlsdng Sysum B. ^ Permit; lienewal ^ Permit Revision ^ Change of ^ Permit Transfor to New List Previous Permit Number and .4ate issued Aoftm Stcp{rsuton Plumbs ~ Owner rv. T of lPOwTS s : che~x all chat a ~ ~Noa -Prewurized Ln-Ground ^ Mound > 24 in. of suitable soli ^ Mound < 24 in, of -vitable soil ^ At•Grade ^ SirtSle Pans Sand Filter ^ Cotutructed Wedsatd ^ Pressurised ln•Ground ^ Holding 7enk ^ Peas Filter i~ Aerobic Treatment Unir 0 Recirculntttse Sand Filter ^ Recircula S ttthetic Media Pilmr Chataber ^ D Line ^ Gravel-1 i er (ex lain) V. real/Treattpatt Area Inform on: Design I=low fjpdj Llaigp Soil Application Rs Dispersal Area Required (sf} Dispersal Area Proposed (sf) System Blevat'to as, - ~~ ~ ~ ' o~ D ~ ~ 7 ` VI. Tank Info Capacity in GaUam oral Gallotu Number of Units Manufacturer l/1// ~~ ~ Prefab Concrete Site Constructed Steel lass Plastic Now IxlsdttS ~ Teaks T Sepdc or Holdlny Tank ~ ~~ ~ ~.',~5~~, Aerobic Treatment Unit t)oeina Chamber ~'~ l ~e ,~v y ~ V3I." Statement- L, eh# under ed, assume resporaaibWty for inatallasloa or the POWTS shown on the attached Plumber's Ns me (Pri»t) Plumber's Si gttattire ! PRS Number Business Phnne Number ll.'s .Scfia~-a~'eY f/ ~ aa~~ Q ~ 7~5'- 3aq`G'-3121 er's AAdre ss (Street. City, Sptu, Zip Code) Plumb g , / ~p ` ~^ (/ ~ wJ ~ © ~~~ ~ ..v ~ ~ (/ P v cotrne ~ ant ue onl Approvkd ^ Disapproved Sanitary Permit Fee (includes Groundwater Da slued Ia rtg Anent e S ps) Surcharge Fee) ~' ^~ ~ V y ` (D ~ ~ t ^ Owtbr Given Reason for Denial of U ~,~{g~t}H~Approval/Rees ! r Diiapprova! ~ s'ac..{~J ~ °' ~:aP:~Cdz~ 1 Septic tank, effluent filter an 3 , ~L ~ ~ f -- ~~ ~` ed /maintained Cll.~`G(.• I II must all be servic disperse ce / " ~~ ~ as per management plan provided by plumber. ~ Z -~,o ~ ( ~~ (~~~y~~ ,~ ` ~ ( .~ ,E~ ~~ c 2. Ali setback requirements must be mai ta~• ~3 ~ ~3~ ~ ~~ / di ~ li bl d ~ ~ nances. (,~ ~ or e ca e co as per app ` t 3 /`ld'L~ SBD•6t398 (R. Ol/03) Attach tlamplate play (to the Conoty only) for the system oa paper Mot lees tLaa til/Z x tt It-ettee is sW ~,~/,ye~ G'~ ~,d ~C o r.~7 T~l~ ~.1.~.,y %w.,~/ a~ ~u..~sod ~~~ ~ ~.~ i~a. d ~1 ~ Py~ p-~ ~d / ~ ~~ ~ p? ~~/ ~~ ~? ~~G !D 0 ~ 1 ~~~ ~,r ~r'~ ~A1; ~r ~ ~. s G 4 ~ ~ ~ 1 2 ~~ e gf't` • ~x ~' ~(Lf P' ~pT Z(o L e~~ ~/~ 5~ Qy..`v t ~,r~ J' ~S,ee- ~ 3 0~-•~ ~1•u;~ s~i'l ~~'~- ~,.,, .~~- a~, ~~~ ~<{,~,~~. ~~ ~,d ,c o 7~ ~ r~~ ~,1~.,~ ~~~.~ o~ ~li.,<sm~ ,. ,_ ~, ~~~ 1~i° ~7~~~ j~~/~3 2 Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8%: x 11 inches in s¢e. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north amaw, and location and distance to nearest road. Parcel I.D. Pease print all infonr-ation. Reviewed By Personal information you provide maybe used for secondary purprues (Privacy Law, s. t 5.04 1 m)). ~ F-.______.__® ~...-m------~~ -~~ 1107 Page 1 of ' 3 Steel Sal Service St. Crooc Date ~~/o Sienna Corporation Govt. L NE 1/4 SW 1k1 S 20 T 29 N R 19 W Property Owner's Mailing Address r 4ot Block # Subd. Name or CSM# 4940 Viking Dr, Suite 608 5 ~ ~ ~ ~ 2 ~ ~ 27 na The Glen City State Zip C PhoP~ Nurser t~ , _ ; dY Village Town Nearest Road l~c~r'n MN 5543 9y"2 ~~?iD$ ~i;; Hudson Carmichael Rd. Property Owner ~ r „.:: ~ .. r :~ s §s'.:~. " r Location Yi New Construction Use: ~_ Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial -Describe: Parent material Pitted ouiwash Flood plain elevation, if appli le--~~~ General comments (f5~ 0 -S {-tv~- ~ f 5•~ - ~~ l3 and recommendations: System elevatio 9.52ft, trenches spaced and d th to code 5.58ft below gra e s~ ~~'. s ~ I"Q .~~..~ P~ ~ ~o y A•c-rt~ia-t. ~'.1 ' ~ ^ Boring # _ Boring 103 rr Pit Ground Surtace elev. 95.10 ft. in. Sal Depth to limiting factor Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 'Eff#1 ~Eff#2 1 0-12 10yr3/2 none sil 2msbk mfr cs 2f .5 .8 2 12-32 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6 3 322 10yr4/4 none scl 2msbk mfr gw na .4 .6 4 42-55 10yr4/4 - c2d 7.5yr5/6 scl 2msbk mfr cs na ~ .6 ~ 5-10 3 5 5 7.5yr4/6 non e m s na na ~~ 1.2 ml o sg ^ , /L }~ ~--~~/~c~/j V~ i' V -iv / / r~ ~ ^ /,. ) pj ~,~ ,+ wr~"~U~~ l~r~. ~V!/il.!/~J~ /~// ,- A ~ /'~%~~~J~~ y~ G/ I7~~V i ati...~~~W~~/~~ // ( //~~ k~~~` 'T{/ l` .~- \ Boring # ring Pit ~ ~ Ground Surface a 95.10 ft. Depth to limiting factor 103 in. Soil Applicatan Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIftZ 'Eff#1 *Eff#2 1 0-22 10yr3/2 none sil 2msbk mfr gw 2f .5 .8 2 22 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6 3 42-72 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 4 72-103 ~ 7.5yr4/6 none ms osg ml na na .7 12 ~,,"~~,~f%1~~~:- -~-L;~~- - ~~ _s`~ w/ ~ s ate. rr.~e. 3 y! /~pp 'Effluent #1 = BOD 5> 30 < 220 mglL and TSS >30 < 150 mglL "Effluent #2 = BODS< 30 mg/L and TSS <~0 mg/L -5~7~/~-. CST Name (Please Print) Signature CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 917/2002 715-246-5085 Property owner Sienna Corporation Boring # 'Boring /!' Pit Parcel ID # Ground Surtace elev. 92.20 Pending ft. Depth to limiting factor 103 in. Page 2 of 3 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Cons~tence Boundary Roots GPD/fP *Eff#1 *Eff#2 1 0-12 10yr3/2 none sil 2msbk mfr gw 2f .5 .8 2 12-30 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6 3 30-51 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 4 51 03 7.5yr4/6 none ms osg ml na na ~ 12 ~'~ t' Cr?(p l/ /D~~ n ^ Boring # Boring Pft Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD S> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 =GODS <30 mg/L and TSS <30 mg1L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or Borins~ # `Boring Page 3 of 3 STEEL'S SOIL SERVICE David J. Steel 1564 Cty Rd GG CST-POWTSM Sienna Corporation New Richmond, WI 54017 Lic. # 248956 NE1/4,SW1/4,S 20,T29,R19W (715) 246-6200 Town of Hudson, St. Croix Co. (715) 246-5085 The Glen lot # 27 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for I your use. The location of the test may or may not be as shown as permanent lot lines were not N established at the time the soil test was conducted. f S ~90~~ 26 0. ~ 3 ~ ~ ~o.~ y~ x, f~ q . 2d~-- IJo rfh ,,~ ~-..o ~{- !. ~ L yam/ 0~~ ~3~ ILA` iy~ z SYS ~ M ~ /+~ zGd.9y p sow~ti "_ S!a ~ .~ = t3< ~r"ar f; f L . ioo . oo.~~- (oho e ~ 1 ~` 5 ~c~ L ~ ~ ~.Q /t~~~nG~nc~r,/•lf £~..r1z.20~d- "loP o~ ~~2.` ~/c.(~i'Dt `~ 13ar~'~ y S ` J3ar,'r 5 ~/«.fi•c ~ s ~l: ~'r~of~ -- Q3 = gz. z~~y ~~~ .~ 9-7 a~ 170. ~ fps ~.o E- ~'~ __..~~ Z r,7 dry } r n~` ~7 ~'^ 7•/~~• /~~1}'~ ~'~r'1`T •.r.Q~'try,~w „~~„i;`I~w af:,~X C+ :GI`s.:' b4'1i ML~IZ ~~+:.a C'v1r r.11 Vi'1 .'1.1/ u wear •Vi,ar.~+t mow. -...-~...... ~w.•..~...... .~. ,~~~ :. 4 °' CI V EN i rrPE 1?" M+N . ~iSOV i G:~ADE ~ > 25' FROM DOOR, WINDOW OR FRESH AIR ;.NTAKE FINISHE ~aRAl:!E 4 "' C I RISER -----~~ I~ }-- jMiN.- 6„ MAX. I ~ , !~ i,i T ~PR~Y~~3 'IPE 3' 3~'t`o say rr~ iO:L / ~~~ A; ER TiG riT SEALS T1,,,.~,,,,,,, ~~ A B 4 ...~." #, C POMP CFF kLEV . ~MFT . ~~ - - - - .~ - - ____--------- -.~ 1 ~-- W€Al'N£RPRgQ~ JL'NCiION 8^vX WITH CONDUIT ,~ ,~ ~~ ~ F t n ~ ~ /{ GA ~' _ , T]:GHT ~ '~ SEAL t f ..• i ~ {ON' ~ ~, ,. _ ~ , Or: j , :i APPR0~1 ED ;4ANHOLE CGV ER W / PADLOCK ~ wARNIr~~ :.as~~ ...._. ~ .f rc.: ~ . a~ ~AF~'ROYED aal~'s wr~~ 1~P~OVEO PCP 3' ,~~0 SOIt~, SOS. ~~ RI~~ER EX: T PRRMrTTED cN~.Y zF TAr~x MANUFACT'JR£R hAS APFRQVAL 3" APPRaVED BEbDING U:tDER TA!vK ,_„ PECIFICATS~N5 SEPTIC r DOSE TANX MANUFACTURER : ~, cQ~,, _ - ThN!! SiZLS: SEP~'XC ~,~~d ~ GAL. DOSE B'ov Gp.L,. ~L.AFc;~ MA1Vi3FACfiURER: '~~` MODEL NUMBER: aWITCH TYPE: ',~ MANiyFACTURFR : MODEL NUMBER SWITCH TYPE: ~~ ~~ --~.~.r.~......... 'E~?:~ iREA Di SCHARGE RAT ~ Gp,~ ~ON•~R~TE FAD 1~"U?'~RER D4~ES PER DAY: ~~~ .^.OS?" V Ci,UME X ATC L.11DI.uG FL4~~BACK: t,S9 GAL. CAPA~I,IES: A s ~_ INC:?ES = ..sA1.. b = ,~,.~ I~,'CHES r ....~~... ~AL C = ~..,, TNCHES ~ !~,8_~__GA;,r . D = ,,,~ INCHES = ~~, G?~L. .......... PUMP ~ gLARM S~tIRIhG AS : ER ILKit I~.Z3 WAC '£RTICAI. D;FFERENCE $Ex~ OAF A.'~D DI'STPxBUaIOhT PIPE T MINIMUM NETWORK SUPPLY PRESSURE !~ rEE. ' ..~.r.,,, FEET FORCEMAiti X 2 ~Q FT/? 00 ~F:'.. . r^ . F~£fi FR".T~ON FACTOR .~ FEET T.O".'.4L D~'NAM:C HF1iD F E„T :'rTEItNAL DIMEh ;It~tiS OF F(,'MP +Ah'k: L,E~"G+iy `".._._' i WIDTI~' .----~ ; ~T ,ETER 'Y at~--.w I, i C E,V ~ F RL`M E iF.: ~.?~' f~~?d ~ A : F ; -- 18 ~ ' "'__ ~rWiAT1YAa Spe4Mosfb designed for the followtrtq usae~ ' S~~ trystems ' ~- duty sump ~~n afar t~Cl1CATiQIIs ~: EP04 • ~4t~mhe aapabiifty~ ~~ • ~'abt heads: up to 24 feet. ' »ladtar~pe stae:l'l~' NPT • ~ sal: CarbOA- BU~(Ylleq~omers. ry. • Te~7pefifure: 104•f (40•C) continuous 144•F (80'C) ~emdttent ' seMe • Capable of runnkq ~ to Puotp: t~ • dmt~rir+G Eity: • Tg3ailhladt' ~ 1 s ~ . ~ ~1oat o~>• • ~~~~ ro: 1 ~ ~rrnrasrst ~.J C 7s+~ cioultl~ Pte, N+o. ' FlStin8f6: 300 8ef1e8 etsirNlQS steel. t dryry wAhoutd darne~pe to camponems_ Motor ' Ei~ S~1e~ phi. 0.4 HP, llGi v. 60 Mt, i 5S0 RPhll, poet in overiroed with automatic reset. • EP05 Sin le phase; 0 5 liP, 115 V, edOHt,1550 I4PM, buiR in overload with a~omaltc reset Power cord; i 0 foot atal?dard lertpth, ie~s SJro with thre0 prp~ Oroundinp plenOth. 61'3 S,lTW with ~~ P+'o~ Droundfnp plug (standard on FP05), ~ ~~ c `~ ~ ' l:urly sttbrrrer~ped ~ hbh C ~ tixbittl ae for iubrlaal9ort and eftlclent heat trertster. Available for atttoata~c a~ ntanuel opeAga~ Aaiu~ne models htoloda tlMdgAlpl Float Swttsh eautalad eae praeet d the f~tery. f~ANR6>lr C Stmt n n rnechanlcd aai pratecdon. ^ EPW I tlec Thermo- p~dC eeompd deeipn for lrnprored p~mance. h ~rn~wpola~ lt~a: Ruoped superior st~~ ~ comaelan retestertce. ^ Mebr NOWtn~ Cast iron for etflr~nt tuuttt~~, ttb+ergth, and durabilily_ fii Melor florae iltennopiaa, float ~O~~ndle Rte. ^ I'war C~+ele: Severe duty rated of and wet8~ ralstent. ^ searlatis: Aet and IOwer heavy duty bbl bearfr~ constry~lon, ABEIICY U3~IM0 ~' ~~~soYtloe (CSA toted model numbers end En 'F" pr SAC'.) ~y.... A „_ .., o x 4 e . so tt nNrr Ffb--24-~~+Sl::.i 14 ~ ~3 :~ : ~NNH ~ur~1-~ ST CROIX ~ ~ ~~gggMI3I~T ~FTIC TANK AND Ori~TN8R8I•LIP C8R'~~~`Ox FORM Owa~aa~ b ~ ~ 2- Su r~ ~o~ ,Addrans t ,~.,_ ~,S-4 «,,- ~ " ema prp~~y A~~ Plsa~iaL DaPee4o°at toc ~' (ycdltr~aania4~sfea~d. ~ ~dC.~ ~~'~ ~ ~ 36 ~,{Up.SphJ Lt/~ Parcel Idantion Nwmbar 0 CtitY!&~s~ a ,~ ~ o T Z9 H _ ~ q ~y~ T,~ of r,,,,,~,.,_..----- n ..._,,..~ ~/., ~ ~/ai 5x. ,.ter, .~--- -+R.L~•-- ~P~Y / . Lot ~ ..~--' Subdivisi~ ~ ~-• `- `- ~, s~,~-~ ~p .~ pro ~ r 3 ,. ~ p ~ Votv~e ~r„~,dty Deed ~~ tias~ i~~i6isble ~ ~~ t7 ao ~p~e ~i yes ^ ae ~ f~hue as ~,,,rtrs. ,~uotma~t ~ ~ oi' your saPdc ~ ~ ooso oa~z. ~ tee i~ bury a pt~ ~ Y°a ~ into t5e sYQ+ca~ twee jnesn a ~i tb~c ~ p~mlcrt~a eaeats~rt sewie m ~ .rra:te diopoesl *~ a ~otm. a1t~ ~ ~ oaf ~ by a ~ p~p~ly owr~ a~ ~+ ~~ b St. Gtaia ~i~+a~ ~~tvati~ ~ tt~ ~° m~ ~~ ~°°m a oc a yttmadp~ ~a1c l~ tee s~ 1/3 ~ of t as~plv~~,~a>~stta~~P~, teP~' , ~ pemp~ {{~ ~oeyralrS-~~ t~ tap4uo lc la gr~ ~~g ,~,tdido:i sodJor {Z) sQer ~egiee to te:afx~A ~ ~ ~~ ~ ~ ~aa be ~~ st o ea dae $i f~OUC Cody ~~ ~°c rim 30 ~~ D1-'~ itism •ttr tau m ma beat at'tnY (a~~ y~°Nkdi~~ a vairati$- da~cd cea<ude8 is ~t+e~ a[ ptwd~t a~• i (w~) ~ (~ti} the oaa~t~ of ,~L~ .~~r~. at-sad ttisy nsvlt it: the tanEtari Rs~s bni-ag rev'oltsd by doG ~~'°~' nOp~t, i~ ass-leQtea ihie. tl~a y>~e ~adtia st~gf~ eet tam 1te.ee~s+. ~ rice by the - ~~^..- AnY y~,R,,o.N.. ~.- +• i~ciudc wttb this appiiew~loa: a . ~' ~°0d t~ Lba ~g~tet< Of ~~ 0&4G a aa~y of the eessl~~ ~°Y ~P ~~~°pO° i~ eel is eu ~a deed TOTAL. P . 02 P4W7S OWNER'S MANUAL & MANAQEMENT PLAN -1LE INFORMATION Owner Permit # ~ ~ ~~ u~lvry r~ac s c.w ^ NA Number of Bedrooms Number of Public Facility Units A Estimated flow (average} 'Q al/da Design flow !peaky, (Estimated x 1.5} ~} d ~ aUda Soil Application Rate ~ r al/da /ft~ Standard lnfluent/Effluent duality Monthly average' Fats, Oil & Grease {FOG} 530 mg/L Biochemical Oxygen Demand {80Ds} 5220 mg/L ~ NA Total Suspended Solids {TSS} 5150 mg/l Pretreated Effluent duality Manthly average biochemical Oxygen Demand iBODs) 530 mg/l. Total Suspended Solids (TSS) 530 mg/L ~ NA Fecal Colifomt {geometric mean) 510° cfu1100m1 Maximum Effluent Particle Size Ye in d'sa. ^ NA Other: ^ NA "'Values typical for domestic wastewater and septic tanx erfluent. Page ~ of 7/ ' ` Service FroqusncY 8ervics Event men s) • ) O NA t once every: t A ~~ ~ (Maximum 3 years ar{s} Inspect condition of tankis) oas t e l ^ NA ume When combined sludge and scum equals one-third {y~} of tank vo Pump out contents of tank{s} ^ month{s) ) ^ NA t once every: At l . {Maximum 3 years ~' 3 ~ eaNs) Inspect dispersal celilsl eas O months) ^ NA Clean effluent f)ker • At least once every: ~ earls) ^ month(s) ^ NA inspect pump, pump controls & alarm At least once every: ~ ^ year(s) ' ^ month(s) ^ NA Flush laterals and pressure test At least once every:,, p year(s) j{s} ! ^ NA Other. At least once every: ~' 0 egg ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an indiv}dual carrying one of the following licenses or certifications; Master Plumber; Master Plumber Restricted Sewer; POWTS {nspectar; POWTS Maintainer; Septage Servicing Operator. Tanb 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 pondini of effluent on the graund surface. The ponding of effluent on the ground surface may indicate a failing condition and requires thi 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 limbed to the servicing of effluent filters, mechanical or pressurized gompanents, pretreatmen units, and any servicing at intervals of s12 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 ~ of ~~ START UP AND OPERATION For new construe#ion, prior to use of the POWTS check treatment tanklsi for the presence of painting products or other chemicals that may impede the treatment process andlor damage the dispersal ce11ls}. If high concentrations are detected have the contents of the tanklsl removed by a saptage servicing operator prior to use. System startup shalYnot occur when soli 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 cellist in one large dose, overloading the cellist 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 dispersai cells. Do not drive or park over, or otherwise disturb or compact, the area within 16 feat 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 protons the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pumpl 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 andlor is permanently taken out of service the following steps shall be taken to insure chat the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shaii be disconnected and the abandoned pipe openings sealed. • The contents of ail tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. ~ After pumping, ail tanks and pits shaii be excavated and removed or their covers removed and the void space filled with soli, 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 re cement 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 wilt 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. Q A suitable replacement area'is not available due to setback andlor soil limitations. Barring advances in POWTS technology a holding tank may ba installed as a last resort to replace the failed POWTS. ^ T site h n site tank e ^ Mound and ai-grade soil absorption systems may :be_ reconstructed in place following removal of the biamat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > ENTER A S PTICNPUMPHOR OTHERaTREA MENT 7IANK UNDERI ANYTCIRCUMSANCESD! DEATH MAY) RESULTYGRESCUE OFOA PERSON FROM THE lNTERiOR OF A TANK MAY SE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS onarrs tat~cYet t ~a ... Name ~~,~'C~0.,~~-'~~. Phone ~ ~ ~ - POWTS MAINTAINER Name Phone SEPTAGE SERVICINC3 OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Ste. 0) ~ Name , Phone Phone This documan! was drafted in compliance with chapter Comm 83.221211b11111d)&lf1 and 83.54(11, (2i 6 (31, Wisconsin Administrative Code. .x.~ -ter,-~r~ ~,, ~.. ...u.. ,..~.. 1 • STATE; BAR OF WISCONSIN FORM 1 - 1996 •* ,: ~ ~ WARRANTY DEED Doaxna,t tJrentxrr ~~1. 9 797P~,I 613 This Deed, trade txtwccn Bane Corporation, _ a Minnesota corporation _.... _._ ,..,._. -.._... _ __~, Grantor, and _Sienna Corporation. a KipnegQta corporation ___,,, ._.,__ ... _.. _.. .__ __.. ......, Grantee. Gramor. for a valuable consldera[lon. wnvcys to Cra~ree the fo11ow1rtR dcsu•;bed rr..il cxtate in St . Croix Cnunry. State of Wlscortsln (the "Proyxrty`): See Attached Exhibit A Together with all apfn,r[enant tights. Utle and Interests. 6664ar4 KATHLEEN H. WALSH REGISTER bF DEEDS ST. CROIX CO., WI RECEIVER fOR RECORD 12-21-2001 3:10 PM YARRRIITY DEED C~T COnY FEE: cant FEE: TRa~fER FEE: 9~.+0 IN6 FEE: 47.00 Recnrong Aran .._.......:~._:... ___._:.::.:~.-._a_ Name and Ravn Acldrasa U ni~r~zlr ~ ~t~ 5`1Gb 5 me+ar~'i ~~ ~ ~uit~, 'poi _ (~liti+ine ~I~oanka~u 553' 0 2o-lo4s-3o-o00 Pmcd ItlentiaCaGerr Nrrrraar {PBV) This 18 not hotttesleed p[oper[y (ts) ps not) 20-1048-60-000 20-1048-90-000 20-1049-90-000 20-1050-00-000 20-1050-80-000 20-1052-20-000 20-1052-70-000 Grantor warrants that the title to the Property 15 good. Inricfeasible in fee simple and tree and clear of auwnbrarxcs except See Attached Exhibit B. Dated this 20th - _ day ~ December 2001 Bane rporation (SEAL) by Jo M. Nassef ~~ Ite of Executive Offi (SEAL) AUTHENTICATION Signature(s) authenticatod this _. , tlay of _,. , TITLE: MEMBER STATE BAR OF WISCONSIN (If ml, authorized by §7c1F.06. Wis. StatsJ (SEAL) . (SERI,) ACKNOWLEDGMENT Minnesota State otiNtleroTtstR- ss. t~ .-...ti~.c -Y Cqurnr. ` Personally cazna before me this ' ~~+ day of December ._ 2001 . ~ abo,~ „~,,,a,t John M. Nasaeff, Chief Executiv_e,OEficer ~of _Bane Corporation, a Minnesota corporation M '. _ ., ....._. _ .._ . __ Io rtt~ krwwn to be pe~ wlw exaxuted the foregoltrg inslnttttent and ._~w1 same. TruS INSTRUMENT WAS DRAFTED BV ` ~ J ft~Y e' ~'gLf.AF~R Lockridge Grindal Law i'irm i~ woornstowwratcarataet Tnn Was6.fn~*-:_AUrnu.~Sauth- • ,.~ Minneapolis, MN 55401 Publtc,StateofWlscotum y commitalnn is pcnntuunt. (If not, were expiralitm dau' ($IQnMw'es nmy be auttwtnceted w~ xknowledQed. Bofi are nut Jenuarv 31 „ 2005 .) necessary) _ _ rnn W pe:wn nanuyt In axy cspYCxy ,roar tr ryprA or rwLAru 4eluw Iha :ppwrrtr. WARRANTY DEED STATE. lAR OF WISCONSIN wtseen`In wtW ak.A Ca.. Inc. FORM No. 1 - 199a Mtwtagoe, wr.. ~, 5tr-~-~ee~ Y^~. ~ 797PA~E 6.14 Fle No: 85 - 04900 EXHIBIT "A" A parcel of land in the Northeast Quarter of the Northwest Quarter, in the Northwest Quarter of the Northeast Quarter, in the Southeast Quarter of the Northwest Quartet, in the Southwest Quarter of the Northeast Quarter, in the Northeast Quarter of the Southwest Quarter, in the Northwest Quarter of the Southeast Quarter, in the Southeast Quarter of the Southwest Quarter and in the Southwest Quarter of the Southeast Quarter, all in Section 20, Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin, more fully described as follows: Commencing at the west Quarter Corner of said Section 20; thence North 89 degrees 25 minucQS 02 seconds Easc, assumed bearing along the East-West Quarter line, a distance of 1319.52 feet to the point of beginning also being the southwest corner of the Southeast Quarter of the Northwest Quarter; thence North 00 degrees 36 minutes 14 seconds west, along the west line of said Southeast Quarter of the Northwest Quarter and Northeast Quarter of the Northwest Quarter, a distance of 1325.15 feet to the southerly right-of-way line of the Chicago-Northwestern Railroad; thence North 79 degrees 56 minutes 29 seconds East, along said southerly right-of•way, a distance of 451.00 feet; thence northeasterly a distance of 807.03 feet, along said southerly right•of-way, along a tangential curve, concave to the northwest, having a central angle of 09 degrees 54 minutes 03 seconds and a radius of 4670.25 feet; thence North 70 degrees 02 minutes 26 seconds East, along said southerly right-of-way, a distance of 429.04 feet; thence northeasterly a distance of 445.52 feet, along said southerly right-of-way, along a tangential curve, concave to the southeast, having a central angle of 14 degrees 30 minutes 21 seconds and a radius of 1759.75 feet; thence North B4 degrees 32 minutes 47 seconds East, along said southerly right-of•way, a distance of 7.57 feet to the west line of Certified Survey Map in volume 12, Page 3302; thence South, along said west line, a distance of 703.32 feet to the south line of said Certified survey Map in volume 12, Page 3302; thence Easc, along said south line, a distance of 593.00 feet co the east line of the southwest puartQr o£ the Northeast Quarter; thence South 00 degrees 26 minutes 06 seconds East, along said east line, a distance of 1127.21 feet to the southeast corner of said Southwest Quarter of the Northeast Quarter; thence South 00 degrees 26 minutes 55 seconds East, along the east line of said Northwest Quarter of the Southeast Quarter, a distance of 192.71 feet to the north line of Certified Survey Map in volume 15, Paqe 4172; thence South B9 degrees 37 minutes 27 seconds West, along the north lines of Certified Survey Map in volumQ 15, Paqe 4172, and Certified Survey Map in volume 15, Paqe 4173, a distance of 1113.42 feet to the west line of Certified Survey Map in volume 15, page 4173; thence South 32 degrees 43 minutes 57 seconds East, along said west line and its southerly extension, a distance of 591.64 feet; thence South 07 degrees 13 minutes 18 seconds East a distance of 323.01 Feet; thence South 08 degrees 41 minutes 11 seconds East a distance of 413.63 feet; thence South 08 degrees 43 minutes 31 seconds East a distance of 229.88 feet to the north line of Certified Survey Map in volume il, Page 3126; thence North 89 degrees 52 minutes 10 seconds West, along the north lines of Certified Survey Map in Volume 11, Paqe 3128 and of Certified Survey Map in volume 12, Page 3292, a distance of 68?.86 feet to the northwest corner of Certified Survey Map in von: ~ 7.97P~r,E 615 Volume 12, Page 3292; thence North 01 degree 24 miautes 30 seconds East, along the northerly extension of the west line of Ceztified Survey Map in Volume 12, Page 3292, a distance of 5.66 feet to the easterly extension of the north line of parcel recorded in voiume 1390, page 163; then South 89 degrees 30 minutes 27 seconds west, along the easterly extension and the north line of parcel recorded in Volume 1390, Page 163 end the north line of Certified Survey Map in Volume 3, Page 776, a distance of 508.92 feat; thence North 00 degrQQS 07 minutes 56 seconds East a distance of 1003.47 feet; thence North 89 degrees 54 minutes 15 seconds West a distance of 270.16 feet to the west line of Certified Survey Map in Volume 5, Page 1317; thence South 00 degreees Z7 minutes 53 seconds East, along said west line, a distance of 193.97 feet; thence south 89 degrees 16 minutes 33 seconds West, a distance of 533.93 feet to the west line of the Northeast Quarter of the southwest Quarter; thence North 00 degrees 36 minutes 14 seconds west, along said west line, a distance of 820.23 feet to the point of beginning. SEP-20-2002 09 ~ 21 S 1 ENNH CURE' y7~ ts,s~ r~s r. a7 ' ' ' ' von ~ 7~~~rAGt ~.~ 6 Exhibit B to Warranty Deed dated December 20, 2001 by and between Bane Corporation ("Grantor") and S;en~a Corporation ("Grantee") 1. Building and zoning laws, ordinances, State and Federal regulations; 2. Restrictions relating to the use or improvement of the premises without effective forfeiture provision; 3. Reservation of any minerals oz mineral rights to the State of Wisconsin; 4. Utility, drainage and roadway easements which do not interfere with Buyer's proposed development of the property; 5. L-ncroachtnent of Qwest Comtnttnieations, Inc. fiber optic cable along the northerly property Iine; 6. Agreement between Bane Corporation and John and Pearl Gies dated August 22, 1997 to exchange property following final determination of the location for Carmichael Road; and 7. Ameritech General Non-Exclusive basement Agreement by and between Bane Corporation and Wisconsin Bell Telephone Company a/k/a Ameritech 'W.iscvnsin dated December 10, 2001. TOTRL P.05 ~1 1 1 ' ~~ 1 1 1 11, ~ • ~ , ~ ~ ' \ ` 1`1' '\ ` 1` ~ '~ ~' i 1 .~ ~'' ~ . ~ r.-.... . ~ ~ 1 ~ ~ i ~ i i' ~ ~ ~ 11 / ~ / / , ~ ~ / ~ /~ i~ -~ i~ ~ . ~- ~ ~ ~ ~ .,. ' ~ ~ r•-~ • ! I. r 1 . .-~.• ~ 1 •. ' ~ v . ~ ..-+, 1 1 ~ ~ ~.. ~ 1 •1~ . 1 1 . 1 ~" •1 ,u ~~ ~ ~ ~ ~, y \ . ~ ~ r'^ ..1 '~~ \ '~ 1. ' 1~` (tom/I11'~ .1~1 ,"] 1 V) I . 1 ' ~ ~' ~ \ Z 1 ~ ~ / 1 ~ \'' `1 ~ ~~ ~ .~, ~ ` ,\ 1 ; / .., , ~ „~ j , ~ '~ , 1 , ~ ~ •~ '~ ~ ~• • ~ 1 ..... ..~ ~ 1 1 ,I 1 \` ` ~ / / / I 1 k a I • ~ b 1~ f- 9 '~'~ ~ t _ ~.,- .;` ',~~ ~ -- ,k r / r t 417 ~ ~ .', ea ' `t/1 _.L_ _u. ` • ~` l! \ 1 ` J _ i i / / J ~. TT -. - 1 ~ 1 I , l 1 \ 1 • ~ / r q .. :. .: r r i 1 ~ - _ _ _ i ~ ~ • t~~.^. / 1 •` ' ` .t- _ • ` .. 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