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HomeMy WebLinkAbout020-1398-16-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)i. Permit Holder's Name: City Village X Township Siwik, Dominic & An ela Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: m u~5/~!i'1 '~'Y'n ~~ ~ (;~~ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit No: 420755 0 State Plan ID No: Parcel Tax No: 020-1398-16-000 Section/Town/Range/Map No: 22.29.19.2476 STATION BS ~, FS ELEV. Benchmark Alt. BM .~ offa m o~ s~al'rYl abo-~ S ..~ g y~• ~ Bldg. Sewer X - wee.. ,~ ~o~ ~,, est. ~./~ 9 SUHt Inlet ~ -2 i n vCr „_ 6, 6. ~ - - - I ;f uy !' o, z - 6 ~ / v ~' -~r» /h Z t b r 0'h Header/Man. ~ V>A ~'~ ,~~ 77`1 tm .BfrIL r lo3•bl ~,I.~ 9~•~b "' ~ above .h ~ (~. ~ 9~ • ~/ e ~G ~~ h~ 7•~~ 9~.5 St Cover / 2 (terse f- t'v~. /o3.3~j . s 9~-~ ~~ O ~C ~I LYI 2.8 O O. S~ Gun c ~-t<e >~ r $. S. 2 s''a o>~y rude ~ c`ns c~hYn PIQ-- 3 qs' 99.39 BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes [] No n Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ Z Z/ ~ Inspection #2: ~~ /~/ 0 Location: 825 Ross Rd;~Hud~son, WI 54016 (NW 114 SE 1/4 22 T29N R19W) Pheasant Run 1s t 16 Parcel No: 22.29.19.2476 1.) Alt BM Description ='~~f a rn ~S'1 d ih q ~-f -z~ ~b~Gt ~/~~.2SLl ~~ ~~ ~f ~~j0'e V/ p Obs _1 2.) Bldg sewer length = \J `~ le-~- ~ P i~GC e Q oGr 35' h. ~~d~tfr~n ~ ~~ ~~~ ~r ~-~ds ~~ ~ ~~ -amount of cover = ~ / ~ " CZf h.~yta.~- i PPS' ~~ Lef 3 3 3 `' ~ u ~ • Z" fa/ S~svld ~ Cu. ~ ~. Use other side for additional information. _.__ i__-1-_ ~ ~ _ - .-- _ - _ hG~!~ ---...--' ~~- - - --~~' Date Ins ctors Sig_~tye Cert. No. . ~ cr~~-e-~dh• isno~ vis~6/c- e~,f'~ie-r~`~'t-dCrioY dY'g'~c~t~-`eti N~-~ ~ ~1~'-~,~-f~ ~'~~s ~"v' ~~-d ~' ~ ~- ~ P~/~~ ~ sue, ~~ ,~ Z ~ ~~ ~ r~ ~~~ ~~ ~ ~ -~ -rte ~~ p ~~~ ~ ~m ~~ ~ ~ ~ ~ ~~~ ~ October 27, 2004 ~~~~ ~.~.~~, Dominic and Angela Siwik 825 Ross Road Hudson, WI 54016 ST. CROIX COUNTY WISCONSIN ZONING OFFICE 5T. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4684 Re: Septic tank re-installation, Permit #420755, Hudson Twp. Dear Mr. & Mrs. Siwik: On 9/27/04 you notified the zoning office of problems with your septic system, which was installed in April 2003. I had performed the installation inspection, but was informed during our conversation that the tank had been moved from its original location and the permit file no longer had valid elevations or a plot plan accurately documenting the layout of the private on- site wastewater treatment system (POWYS). Comm 83.26 (4) requires the county (government unit) to maintain a written record of each inspection, including location of POWYS components, date/time, and findings/comments of the inspector. The original inspection report is only accurate for the dispersal area elevations and location with regard to required setbacks. The plumber responsible for the POWYS installation, Bill Schumaker, admitted that he had overseen the tank re-installation without a zoning department inspection. He stated that he had called the office in May 2003 and was told by another inspector that we were too busy to inspect the change. Comm 83.26 (2) (c) requires the master plumber maintain records of inspection notifications with date, time and the name of person contacted. He should have contacted me directly since I had knowledge of the original installation and given notice as required in Comm 83.26 (2)(a), which provides the county with a 24-hour time frame in which to inspect the POWYS before backfilling or covering is done. I agreed to come out and update our permit file by obtaining new elevations on the tank and tie them into the system elevations taken on 4/25/03. On October 7~' I met Bill Schumaker at your property so he could verify the elevations taken. We compared the system elevations from the first installation and obtained the outlet elevation on the tank by removing the manhole cover and shooting the top of the Zabel efFluent filter housing. The elevation of the bottom of siding on the house was taken to provide a means of evaluating the pitch on the building sewer pipe. The siding extends approximately 2 inches below the top of the concrete foundation above the building sewer. I was allowed access to the house interior and attempted to get an accurate measurement from the top of foundation to the top of the sewer pipe. Unfortunately, now that there is framing and insulation covering the wall, I could not measure with 100% accuracy the exit elevation of the pipe. It is 21 inches below the 2"x4" wood framing, which is approximately 18 inches below the top of concrete foundation (I subtracted 3 inches for the top of the S~w4 -Page 2 framing). If this measurement is correct, the building sewer elevation is at 97.16' and the inlet of the septic tank is 96.83', which provides 0.33' of pitch on the 35 ft. building sewer pipe. According to Comm 82.30-3, a 4-inch diameter pipe must have 1/8 inch (0.01 per linear foot of building sewer. The building sewer appears to be ~/a inch (0.02 less than minimum code, however difficulties in taking measurements at this point in time could result in an error of +/- ~/a inch. Comm 83.26 (2)(a) states "no part of a POWTS component may be covered nor any POWTS component put into service until the governmental unit or department (state) has had an opportunity to inspect the system". This is a case in point for having an inspection of installations, which provides documentation that the system meets requirements of state sanitary code. The tank relocation in and of itself did not require a revision to the sanitary permit because it was not a replacement or addition to the existing POWTS. However, the building sewer length was increased to >30 feet from the connecting building drain and, according to Comm 82.30 (il), the pipe must be insulated with 2-inch polystyrene foam if the sewer is less than 42" below a surface that won't be cleared of snow. The tank inlet is 33 inches below grade. During the re-installation, the building sewer pipe was improperly connected to the tank with the inlet end inserted too close to the interior bafFle. This resulted in a blockage and eventual backup of sewage from the first floor 1h bathroom toilet. You informed me that when the tank was inspected and pumped out, the pumper discovered the inlet pipe was too far into the tank. Bill Schumaker was present when the pumper used a tree trimmer to break off most of the end of the pipe to clear the blockage. There still is a jagged end of PVC pipe extending approximately 2 inches into the tank at the inlet opening. I recommend this be cut off so the pipe is flush with the tank opening. A couple options exist in this situation: 1) The sewer pipe can be exposed from the porch out to the tank and additional measurements taken of its angle before covering with insulation, as long as it meets minimum pitch of 1/8 inch/foot. Have the pipe checked thoroughly for any damage or constriction points. 2) The tank can be lowered to provide the minimum 42 inches of cover over the inlet pipe, which would automatically resolve the concern over pitch on the building sewer. 3) Do nothing and add insulating material over the building sewer and tank inlet area during the winter months. I've enclosed an information sheet regarding efFluent filter maintenance to avoid any backups related to a clogged outlet filter. Don't be tempted to flush baby wipes or other'~flushable" products that may either clog the building sewer pipe or efFluent filter. These do not degrade and have a tendency to be a source of problems. If you have any questions regarding my findings and recommendations, please feel free to contact me at the Zoning office. Siwik -Page 3 Sincer ~~ Pamela Quinn Zoning Specialist Cc: Bill Schumaker, master y Jansky, Regional Sanitary Permit file plumber Wastewater Specialist, Dept. of Commerce M~ ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT ST. CROpC COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson. WI 54016-7710 phone; (715)38G~1680 Fax (715)38G-4686 To: ~~~ ~-~ ~ /r/1/1/~.9~1e-vl/ Ftnm: F~uc ~ Pagex 3 -f- ~-m.Lf ~.~ Phone: '~ l S"~- ~ 2 (o '" Gate: (0 Z Re: CC: ~ Urgent or Review ~ Please CommenE D Please Reply ^ Please Recycle ~ ~ ~`~ ~- ..r. -- ~,,.,._- .~' draft letter attached Pam Quinn From: Dominic Siwik [dominic@xdsi.comj Sent: Friday, October 29, 2004 9:59 AM To: Pam Quinn Subject: Re: draft letter attached Mike Fassino Baypoint Development 757 Packer Dr Hudson, WI 54016 ----- Original Message ----- From: Pam Quinn To: Dominic Siwik Sent: Friday, October 29, 2004 8:58 AM Subject: RE: draft letter attached Page 1 of 3 We can use both a laser measurement on the pipe as close to the house as can be excavated (minus 7 feet under porch) and check the angle with a standard level to see if the bubble is enough off center. Please give me builder name and address and I will mail out today -----Original Message----- From: Dominic Siwik [mailto:dominic@xdsi.com] Sent: Friday, October 29, 2004 8:55 AM To: Pam Quinn Subject: Re: draft letter attached Please send a copy to the builder. Can you get dead on accurate information once the pipe is exposed? ----- Original Message ----- From: Pam Quinn To: Dominic Siwik Sent: Friday, October 29, 2004 8:33 AM Subject: RE: draft letter attached Yes to your clarification questions - I was trying to break this down so there would be a good understanding for all involved. Regarding procedure, Bill likely has no record of his "notification" phone call and discussion with Kevin, which could have happened as he said and it becomes a "he said" type of problem. Kevin has no specific recollection or documentation either way. As I stated, Bill should have contacted me directly and scheduled an inspection with 24 hr. notice. The activity did not require a revision of the original permit, but we really needed to document the new tank location and elevations for future reference. Plumbers are no longer required to provide as-built plans, so whatever the inspector writes down is the system documentation. Kevin and I discussed this situation - it would have been so much better if it was way good or way bad, instead of being such a close call. I don't think the state credential folks would treat this as a violation, even without the written record of notification on Bill's part. Your builder, Bill and the excavator are guilty of being stupid and careless. If they had gotten past the ire over moving the tank and just done a "better than marginal" job this wouldn't be a problem. Do you want a copy of this letter sent to your builder? -----Original Message----- [Pam Quinn) 10/29/2004 draft letter attached Page 2 of 3 From: Dominic Siwik [mailto:dominic@xdsi.com] Sent: Friday, October 29, 2004 7:47 AM To: Pam Quinn Subject: Re: draft letter attached Thank you for the follow up Pam. Few follow up clarifying questions and next steps: 1. It is pretty clear that Bill did not follow the proper procedure in re-installation of the tank without a permit and or inspection. Is this correct? 2. What are the repercussions for Bill and his personal and or business license? 3. It is clear to me that three things need to happen: • The line out of the house needs to be insulated. As a result a trench needs to be dug in order to insulate the pipe. During pipe insulation the pipe should be inspected for damage of any kind. This could have been avoided with proper inspection of the tank after re- installation. Is this accurate? • Based on your professional expertise and according to your measurements the building sewer appears to be 1/4 inch LESS than minimum code. Taking accurate measurements is difficult because the pipe is not actually exposed. This could have been avoided with proper inspection of the tank after re-installation. Is this accurate? During reinstallation, without zoning department inspection, the building sewer pipe was improperly connected to the tank with the inlet end inserted too close to the interior baffle. As a result we experienced a blockage and eventual back-up of sewage from the first floor 1/2 bathroom toilet. This could have been avoided with proper inspection of the tank after re-installation. In your professional opinion this pipe needs to be cut off so the pipe is flush with the tank opening. Is this accurate? At a minimum the pipe needs to be exposed and the sewer pipe needs to be cut flush with the tank. While the pipe is exposed can you get an accurate reading? Sounds like we need to coordinate a time with Bill to expose the pipe and while that pipe is exposed we can get accurate measurements and decide from there if the tank needs to be lowered. ----- Original Message ----- From: Pam Quinn To: dominic fxdsi.com Sent: Thursday, October 28, 2004 3:20 PM Subject: draft letter attached «Siwik 10-27-04 letter.doc» Hope this addresses and documents the situation accurately. 10/29/2004 draft letter attached Page 3 of 3 • Will mail it out and send you the filter maintenance information in case it's of help. Should the builder be copied and if so, please let me know mailing addess. PAMELA QU/NN, ZONING SPEC/AL/ST ST. CRO/X CO. ZON/NG DEPT. PAMQ@CO.SA/NT-CRO/X. W/. US 10/29/2004 Page 1 of 3 Pam Quinn From: Dominic Siwik [dominic@xdsi.com] Sent: Tuesday, October 26, 2004 4:26 PM To: Pam Quinn Subject: Re: Septic / Dominic Siwik Great. Any way to add the third item of concern in that letter which is the improper installation of the pipe that was sawed off? ----- Original Message ----- From: Pam Quinn To: Dominic Siwik Sent: Tuesday, October 26, 2004 4:07 PM Subject: RE: Septic / Dominic Siwik I'm drafting a letter to you, copying Bill. According to my measurements, it is extremely close -the pitch appears to be .33' instead of .35' fora 35 ft. building sewer. I'll document what I've got and let you decide how to proceed based on minimum code, etc. Even if it doesn't appear worth the trouble to drop the tank elevation, the pipe still needs to be insulated due to lack of cover. Will try to get the letter and inspection report completed Wednesday. -----Original Message----- From: Dominic Siwik [mailto:dominic@xdsi.com] Sent: Tuesday, October 26, 2004 10:01 AM To: Pam Quinn Subject: Re: Septic / Dominic Siwik What was the final assessment. ----- Original Message ----- From: Pam Quinn To: Dominic Siwik Sent: Friday, October 22, 2004 8:16 AM Subject: RE: Septic / Dominic Siwik Yes, I'll talk to him before I come out - I hadn't discussed the other concerns with him since I hadn't yet confirmed that we do not have insulation or 42" of cover over the intake pipe at >30 feet out from the foundation. -----Original Message----- From: Dominic Siwik [mailto:dominic@xdsi.com] Sent: Friday, October 22, 2004 8:03 AM To: Pam Quinn Subject: Re: Septic / Dominic Siwik Importance: High Good morning Pam. just to keep you in the loop I had a conversation with bill this morning at 7:50 A.M. and invited him to join you for the resolution of the outstanding issues. He stated that he was only aware of the reshooting of the slope from the house to the tank. I told him that there was three issues that I thought were going to be addressed today. those issues being the slope from the house 10/28/2004 Page 2 of 3 to the tank, the insulation of the pipe from the house to the tank, and finally the review of the pipe that as cut from the tank to the field. He said that this is the first he has heard about the other two issues. He said that you have an inspection with him today at 9:00 A.M. and that he would have a conversation with you then. Can you ping me back if you receive this before your appointment at 9:00. Again, thank you so much for your diligence. ----- Original Message ----- From: Pam Quinn To: Dominic Siwik Sent: Wednesday, October 20, 2004 2:25 PM Subject: RE: Septic / Dominic Siwik Dom - I think I'd better just plan to come out, dig a hole over inlet pipe and verify elevation based on my previous calculations plus check the depth/insulation on the pipe. Once I have that information, I can require the tank to be moved unless Bill can prove otherwise...which I don't think will happen. I don't want this to linger until the weather makes it difficult to impossible to dig the deeper hole, etc. I'm booked on inspections Thursday, but can do it 10:30 or so on Friday a.m. Please let your wife know that I'll be making a little mess at the tank, but don't need indoor access. Thanks, Pam -----Original Message----- From: Dominic Siwik [mailto:dominic@xdsi.com] Sent: Tuesday, October 19, 2004 10:24 AM To: Pam Quinn Subject: Re: Septic / Dominic Siwik Has Bill set a time yet to get this taken care of? - Original Message ----- >m: Pam Quinn Dominic Siwik nt: Thursday, October 14, 2004 10:08 AM bject: RE: Septic / Dominic Siwik He said he was pretty sure the pitch was OK, but couldn't tell if he was concerned or not. He did not say that he checked the angle of pipe with a level or shoot elevations at time of tank re-install. As long as he plans on coming out, I can pin down both issues and know that the Dept. of Commerce is in support of any changes to make sure that both the minimum pipe angle and depth of cover meet code. -----Original Message----- From: Dominic Siwik [mailto:dominic@xdsi.com] Sent: Thursday, October 14, 2004 9:58 AM To: Pam Quinn Subject: Re: Septic / Dominic Siwik Was he responsive or indifferent? ----- Original Message ----- From: Pam Quinn To: Dominic Siwik Sent: Thursday, October 14, 2004 9:49 AM Subject: RE: Septic / Dominic Siwik 10/28/2004 Page 3 of 3 I talked to Bill and explained the need to verify elevations on the actual inlet (get out the shovel) and the top of the pipe leaving the house foundation. Told him my calculations show only 1.5" pitch. I didn't go into the aspect of adequate cover yet - I will address it when I ask him if the pipe was covered with insulation and that he may have to excavate to put foam insulation over the building sewer to compensate for shallow installation depth. Anticipate early next week (Tuesday hopefully) and will give you advance notice. I told him this needs to be resolved ASAP. -----Original Message----- From: Dominic Siwik [mailto:dominic@xdsi.com] Sent: Wednesday, October 13, 2004 8:42 AM To: Pam Quinn Subject: Septic / Dominic Siwik Importance: High Thanks for the fax Pam. Just to let Bill know, I have already calved Diggers Hotline and the yard will be marked by Monday the 18th. 10/28/2004 >C~ Pam Quinn C~~/-- 379 ~ 5 0 ~ S From: Jansky, Leroy [fjansky@commerce.state.wi.usj Sent: Wednesday, October 13, 2004 7:31 AM To: Pam Quinn Subject: RE: Problems with a flat building sewer ~ -M ~ ~Z• 3p(~ I )~~~ ~ ~ .~~,~W-~hD I . b. I g `~ rn c`rt . be la tv ~. ~~- I would ask the installer for detailed (e.g. pipe and final grade 2 ~. ~Z~/ynl~` ~,h G,K elevations, location of piping, length, etc.) plans on this portion of the ,si1(lbcJ Dve~-.~ ,~G~•ec project. It must absolutely meet code standards such as minimum 18" cover 2., ~ ~ 3~~ SeG~~n liaeds begining at the foundation (insulated or not), insulation in areas were ~Sf ~~~ )~ns~ snow / cover will be removed that are not >42", insulation on piping longer Z //~' ~ ~~ h,k than 30 ~ ft and <42", etc. ~~ ~;'.~r~. l: ~ ~~~ ~ ~~ ~~~ ~ ~- ~~~ Leroy G. Jansky, Wastewater Speciali ~ ~ ~(j ~ ~ /~. Y '~~~" , DComm - Safety and Buildings ~ ~ ~ / ~ ~~ ~,~~~` ~~ ~ ~ l ~; ~ ~~. ~- 13 East Spruce Street ~ ~~~'3~ ~ ~? ' Chippewa Falls, WI 54729 ~ ~,~ti~'`~ = .~~~ - '~~~ ,, l _ f ~ ~j'~ (715) 726-2544 Office ~r. _' _ ~, - ~,~ ~~ ~~ - , 2~> r~~~~~_ (715) 828-5902 Cell ~~b ys~~ ~ ~ -~- ~_ _ / ~~"''~ (715) 726-2549 Fax ~ ~ j _,~~F ~~~,~~ /~ - ~., ~ - '~_ ~ ' ~~~ j~/• ~l lrl,S~p,~~~ > -----Original Message- ~ -~' ~~ ~~' rs -^ 1~%~ ~~v ~.~~'~/OD,~`f > From: Pam Quinn [SMTP:PamQ@CO.SaQ~it-Crdix.WI.US] rr _ > Sent : Monday, October 11, 2004 7:43 AM 2~ ~ ~~~'~° `'i'f ?-~ ~`~"~ "' %~- ~' c r > To: Jansky, Leroy ~'° ~~~~- > Subject: RE: Problems with a flat building sewer ~,,.-~ ,--~, ~~ > Thanks - it seems stupid that no one checked this out during the first ~~~i.%'~ ~~~ {; ~ > tank re-install! They already have a jet pump in the basement to handle -L--~'V, ~ 61_c~`_ ~C ' ~- > walkout level bathroom - I didn't even address the fact that there is - ~ A._ ~ not •' - , ; •.: > 18" of cover at the house foundation (although the lst 5 feet 'ar'e covered ~ ~ .: k r-~ ~. , . + ~ ~ ~ . , , > by the concrete porch) and not 42" at the inlet on a >30 ft building ~q ~ Su r-~A i~~ s~~--~ > sewer. However, this may be taken care of by dropping the pipe down to ~ > the new(est) tank inlet elevation:-) 'I'r > -----Original Message----- ~ `~~ ~ ~ ~/I ~' k ~ -'~ v~ ~, > From: Jansky, Leroy [mailto:ljansky@commerce.state.wi.us] ~D~ crl( ~. d y== > Sent : Monday, October 11, 2004 7:13 AM ,' n " ~- ` -- ~ ~ ' r~ ~I j ~ > To: Pam Quinn ffir-~ +~~ > Subject: RE: Problems with a flat building sewer ~/ r > 1~ de ~~ Zx~s , > There must be 4 1/8 in. (0.345 ft) drop in the building sewer pipe "~~''"'•~ ~~`~/-Sr from > the > house to the tank inlet. If there's not a minimum pitch, the solution is > simple - reinstall the tank at an elevation that is acceptable. One other > solution might be to install a sanitary sump in the house to pump all the > wastewater out to the tank - up hill. I'll be on the road today (Mon) so > call my cell if you have further questions (828-5902). 1 Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT County: St. CrOiX Sanitary Permit No: 420755 0 State Plan ID No: Parcel Tax No: 020-1398-16-000 Section/Town/Range/Map No: 22.29.19.2476 GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. 'ermit Holders Name: City Village X Township Siwik, Dominic & An ela Hudson Townshi SST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION mho /?.t.>, /1 ~ ELEVATION DATA TYPE ftAAN A~ U ER CAPACITY Septic ~..~ Z J Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD / Septic S ~~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GP Model Number TDH Lift Friction Loss` Head TDH Ft Forcemain Length Dia. Dist. to We STATION BS H[ FS ELEV. Benchmark Alt. BM U~ a ~ ~ ~ ~ ~ 6 SUHt Inlet ~ ,/ 7 ~-~2 S t Outlet ~~ ~ ( ~~~w o, y ' ~7/ GS `~ ~, ~ ~ Dt Inlet /I ^ / ~- ~ Dt Bottom Header/Man. u ~ P y~ 0 Dist. Pipe ~ 1)~ .tiI' Bot. System ~ ~~ ~ ~ Final G_- rad~ Sc G~ °' Z ~1 q . 02 Z / ~~_, . lv. ~ '^" s .~. ~ ~ SOIL ABSORPTION SYSTEM <~('~vv~.Q__ ~- h~ ~G~c-,-, ~,C~ BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UY I~ ~ ~/ UNIT Model Number: DISTRIBUTION SYSTEM rq~ ~~~" ~Q.[=~- ~ l~ ,~i-~1~ ,~J- /1T ~2Iz Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intak Pipe(s) ~~ Length Dia Length Dia Spacing 7 $OIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bedfrrench Ed es g To soil p L Yes 1= ] No [] Yes ,[~~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ ~ /~/ ~ Inspection #2: / / Location: 825 Ross Rd Hudson, WI 54016 (NW 1/4 SE 1/4 22 T29N R19W) Phe sant Run 1,st -Loft 16 Parcel~N/~o:~,22.29.19.247,Jii 1.) Alt BM Description = f '~L(~V ,.~'~/G~~ t-l/Y~i.1 d~.-~I "`" "''^-' T~~" 2. Bld sewer len th = ~ 3 ' ~~U~ _ l ) -amount of cover = ~ (,(,~~~J ~'`(~~ /~' ,, ~~~`~ ~~j~`e I ~~'~~~" `r--~/~J ~~G;x~Yl dPt~-~ _ _ _ _ _ _ _ _ _ _ -----T Plan revision Required? ~~1 Yes ~. ~ No ~, Use other side for additional information. ~ _ I __ _ _ I__ _ i_ __ SBD-6710 R.3/97 Date (Ins or's Signature Cert. No. ( ) ~~~'~ ,~o iXa.v,'c S ~ w ~ ~ /r ,t a fi /lQ ~ e ~s ~,~?~ /t~Cc .~ /o.r/.r~ d l' /-/,~ ~IS-s .cJ sue/ ~yD'~ ~.11Y1~<< c /G0: a ~~12~ "vac Y9-3d /1~ a°~~'~_q ~~ ~~~~ ~6b~a0` ~~'' _ o~ _ ~ ~~ •~ s~ ~~ ~; ~~ s : GW'~ ,~ `~~ 6 . . cG ,i ~/D i ..2~-v~ Fwd ~'"~ 1~f~ W ~~ n~ m d m m ~' 3 3 O m ~ Q ro p o p l y cNnc m c c,o O Q A 7 7 ~ ~ ~ 3 ~ cn z cn z D m w' D ca D ~' c ~ a n. W - O ® '. O N N Z -~ c " c ` v x ~ `~ ~ ~ G < GG < N O. N N ~ ~ O o O N C W fD a ~ `D z N v 0 ayS~yo-N-•o-~SSSCOm~o~p~v~a~ D N ~ O fD d C, p: O N N N O7 N N O ~ fD fD (D ~ CD O- ~~ ~ ~ ~ ~ fD y `2 0. a fD A 7 ~p O. O. Q v >• < `G N N ~ 'y" N fOD Q i C\~ i '~_ ~3 0 ~ (D Q y N~ N (D Q~ 01 O a F 7 N~ fQ n~ (D ~~ Z o-< fmm~• m~~comaa a ~ ~o ~m nm o~ m m Wo 3~v m g o 0 0 o d~ o m O D v y~ 7Q 0. ~ `2 N N 7 O y W -O ~ O -p y W !A d ? N N A ~ X (G S y fD CD 7 0? N ~- O O O O. N O y~ N 0 3 t0 2 N cCii (np ~~< N f~~D n d. N O 0 0 fQ ~. O N ~~ N ~- '~ ? C ~ N y O C O Oj N O S O. ~ Q O. m-5o m m o x'm a"m m~ o'p •ooco ~ m m ~. Ul N _ ~ ~Zm m O x o< ~+ voi °:. Q~ y o cn W O S ~ m~ Oo ~~ 3~ m ~~ v a~ ao ~ aA ~C ~n~~OOn fSD~~~<.O. ~7 Wj ANN o~ d n~cn ~,a> > ~o.~ o ~'c o v o aav m Wo $. ~ o o s N W f a o 3 W o ~a m vow ~ ~m y coo w m m o'er ~-a~cc -'v+ o. _~ o ~ o m b9 H3 ~ O O O O L c~cno c ° ~ ~ A co ~ ~ ~ 3 3 ~: .~ O ~A (n O ~, ~ ~ ~ v 0 7 n 5 ~ Q° ~^ w D ~ m ~ a a m w N A W ~ CNJ1 ~ O O O N O O a C o. ~~~_ ~y~~ ~vvv,~, 9 d y O 3 °-' tD .. e=i C fA Z j ~ a ~' m' a ~, .~ m ~ c =~ N ~ N v a o ~ ~~ C 7 o. W ~ a 3 O '• 3 ~! z f A C C 7 a ~ m o o ~ ~ m v d ~ A = N O C N N a N o o •`o '' ~ ~ m ~~au N ~ v O y ~ b ~ $ -o N O C ~ '.'. LT .. ~ S coi v c fA -~ -~ to j T A Z O .. ~ ~ Z N N O A .Z7 ~ ~ m ~ A d A~ ... r-i d O "'! o°O. ~1 ~• 0 0 N ~ O A 0 m 4 A 0 a aro ~°~, ~ A ~.. ti O yby d ~1 Pam Quinn Subject: 420755 -new tank shots for as-built Start: Thu 10/7/2004 2:00 PM End: Thu 10/7/2004 3:00 PM Recurrence: (none) Wisconsin Department 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 Siwik, Dominic & Ah ela Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description/ ~ ~~ ~,./_ ,,- / ~j,,~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ` ~ a s?~ Dosing ~ ~ ~ ~ - Aeration Holding TANK SETBACK INFORMATION TANK TO / P/L~ , J~Lt~~ WELL T BLDG. Vent to Air Intake ROAD Septic ~ ysv ~ ~ ~S ~ ~~~ Dosing Aeration ldi H o ng PUMP/SIPHON INFORMATION Manufacturer Demand G Model Nu er TDH Lift n s System Head H Ft Forcemain th Dia. Dist. to Well county. St. Croix Sanitary Permit No: 420755 0 State Plan ID No: Parcel Tax No: 020-1398-16-000 Section/Town/Range/Map No: 22.29.19.2476 ELEVafiION DATA STATION BS HI FS ELEV. Benchmark ~ i ~, p2 io y. Z /bo. J Alt. BM BI . Sewftr/bC 4! SUHt InletU~~ -~3 ~' 04*~- - .3~ ~ ~ "/~i.7~ q~, s~ St/Ht Outlet Dt Inlet ~- ./' Dt Bottom derNMa ~ Q 3 1• ~ ~-god 'oPip~, Z ~.U qy~ D Bot. System t e G~. Gi G v, ' Final Grad O `L St over ~~ ,'/~ r ~ l I t SOIL ABSORPTION SYSTEM ' ~ VS f S.P~i.t~-`~~-c~_ BEDlTRENCH Width / Len th No. Of Trenches PIT DIMEN No. Of Pits Inside Dia. DIMENSIONS ~ ',- -1 ~(/ ~ ~~~ ~-.. ~~ INFORMATION CHAMBER J7 Q' - >7 7 Typp.pf System: ~ ~/ ~,i.. / ~~ U Model Number: ~//~1,1,-,'i, Y DISTRIBUTION SYSTEM 3 K'a ~ b-e r Header/Manifold Distribution _ x Hole Size x Hole Spacing Vent to Air Intake l ~/ Length Dia Length Dia pang (M s~ u, F~ V11ti SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only /~~' ~ ~> Depth Over , p~/ Bed/Trench Center ~; ~'1/"" ~ Depth Over Bed/Trench Edges xu Depth of Topsoil xx SeededlSodded xx Mulched Yes No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ ZS~/ ~~ Inspection #2: / / Location: 825 Ross Rd Hudson, WI 54016 (NW 1/4 SE 1/4 22 T29N R19W) Pheansa-nt Run,,1~st/L/,ot~16 t - ,' ,,, aP_a/rcel No: 22.29..1'9_.2476 1.) Alt BM Description = 5~ ~~-~~ ~-~hS`F^;~-~' ~ /1X~'`~'~` ~ G~'~-' 2.) Bldg sewer length = ~ ~ -amount of cover ~-' t tie y ,~ a;~f~~ f~~~n~ ~ Plan revision Required? !~ Yes No ~ ~ ~~jj 5 Use other side for additional information. i ~ IZ_~I~`- --~ GL~Yti+-~ _-~ SBD-6710 (R.3/97) Date ~ Insepctor's Signature/ _ ~ / ~~ ~ ~/ 2 pert. N t .,...~.J-._.~_... ,___ ,: • .r_ ___._~ S~>e:y a~td 13uUditib~ I)i~i.~icn ?0t W. Washington Ave.. P,C~. Box 71b~ ~r~ ~ Madison, WI 5370"I -',162 ,~ ,/~~ i ;6GS)25b-315: ~rtment of Cammerct= ~ --- ---- Sanitax'y Permit Application m ..~., .,~„ n*C~Ps.. in accord with Cpritm 63.2E Wis..pdm. Cade, persorta ' - :--~-_'- may be used for secondary purposes Privacy L~ . a1S~~~~ ~ ~r~ f ~ ~9 I. E4pp~ittatfottInYorm~on -Please Prink All Information ... T+rnneRV C•WrtCr'8 Tra Ina Gity, t)wtter's IvI ~9~ '~~ e `~ l ~, (; ~ , , ~ „J'Jtliy 5attitary trmi~ ldnmbet !?:~! be ?t;l to by Ca.1 ~ Stag Platt I.D. Number -- prci~4cldrass (if different that. taailin~ ~z s 2~-.,~ ~. Parcel ~~ 3 ~-~ Lot ti Z1~ h ~ ,~t'.-::arm r _ ~~---- property Location i ~C,~ l Zip Code P_hong Number ~ C,~JI.t" q~j ~~~ ~,,,~ W ~ ,~. 6l ~ 1~r2-'1g9~~~85' T 2`~ *~; R-~-~E~°~wJ 1 IL Type of BWltiing (check all that apgly) ~~~,a%t-OV"`~'"`- '~' dame CSM Numl~r SLR' /V J ~ 1 or 2 i atnily Dwelling -Number of Bedrooms -_ ~ 1 ~~ Q. ct-St~ ~~' a ~~ C FubliclCommercial - pescribt Usc 5 '~ -~ ------~- r^~ ..... ~ ~ ~ ~ ! City I~Village Township o?' ~I~~O.,f/ J State Ow - ~SCribe U e _ III. Type oP Per!snit: (Check Daly one box on tine A. Co plate line B if applicable) ~~~ Naw System ~ U Replacerent System ~ TreatrttentlHeldirtg Tank Replacement Qnly j ',~.~ Qther Modifiuatian to Existing Systerr_ l -----~-------~ ~,,,... ----------- L1st rrevious Per7sit Number and Date issued 13. j ~I Permit Renewal ~Pextnit Revision ~ Chsnge of ~ ^ Per;^tit i ransi'er co Ne•.v ~ ~ L ~ ~ ~ Plumber I Owner ~ ~ ~ ~~• ~ _~ Before Expiration __ 1V lype of rvn as ,~yp~.,,... ~.....,..... ».._...__ --~cr- - Non -F'ressuriz~d Tn-6round~..J Mound , 24 in. of'suitable soil ~.~ MDUnd <. 24 in. of suitable soil ^ At-Grade ^ Sitt~le Pasa Sand Fiicsr i 11. Cortstrucad Wetland ~ Presaurized In-Ground ^ Holding Tart:< U Peat Filter ~.. ~arobir Treatment *Jnit ^ Recirculating Sand Fihnr ~ u Recireulat' S tuhetic Media Filter Leachin Chamber Dri Ltne J Gravel-less Pie ~ Other (ex li<inj /. ._._.. V. Dis /Treatment Area Infer ~ on: Ch.. r-, e rs Design Flow (gpd) Design Soil Applicatior. Rate(gpdsf) DispersalQArea Required (sfl Dispcrba. Area P pvse~ fi y~SE1~~n ~dl~ '~ ' 7 s~ ~ ~`s~ 'Steel 'Fiber !Plastic 'VI. Tank Info Capacity' in ~, Total I Number riianu~acturer prefab Si:e ;Glass ~ } ~ oturete ; Conainteted i E Gallons i Gallons a~f Llaits ~,t f~~~, / „ Q /1 ~~~ i ~ i4eW j };.xiating %~'`"G'C r` I i ~ T'snks Tanks ~~ --- j Sentic or HoMina Tank 'V i I ~J ~C /~ ! l -_ ~ /.~ ~a~~ Y _ ___~~_.~-----a- ! i VII. Reesponaibl ?lumber"s Na tl:e ~l• ~ ~~ .~ ss d~ Statement- t, the undersigtted, assume responsibility for Ilation of the r OWTS shnwn an the attached Plans. ~t) Plumber`s Si gRa re ~~ ~ .p lPRS Number Business ?hone ;ru:nber a 6~ry o?~?y'T~ j7is-38'G-3/~/ ttoet, City, Slats, Zip Coda) , Approvgd ^ Dlsapproveti ~ Surcharge Feed ~ ~ °~ Z rl Q _ _ ^ Owner Given Reason for Denial ~ __ 7 LK. Condltians ~ Approva2lYteasons far Disapproval ~ ~~~ ~~~ ~' y Z~~3/ s-~ Gam' abut-~ (pia-K~ vim= ~~~d''`°~-~,IC,-~ y ~-' 03 .-tme6 e„~,~tete ot,~ae (te the Cauntr Daly? for the system ea paper aot Ices than 81f1 x 11 inches is size .~ .a~..w r~naf rR A~ lA9i ~Olyt~t 1/,`G S ~ G~ r ~ ~{. .~ d ~ ~(o P"/~ e ~S ~~,v~ /~~ ~ ~d.r/~` d /_ ~'7~ ~.5'e .~ ~~'Olic ~D4; ° ~~2! `i~~c 9Y-30 /1~ ~y6b~a~ 1/' ~Ve ~ ~~~"~_~ ~~ ~~~~ C~'~Y ~~ ws ~ ~,~G ~~, i s % ~' ~~ (J~ Q,~'~` V ~'4,Q3 .~~'G~io`m'beVST~G~ ~ f a ~ _ '~ cv t`"c G ~, hx ~ ~-~ ~ i~o _ _L. _. _ , _ -,_ -_ ~-~ 7- Z ~~ .~~ ~~'y' SOIL EVALUATION REPORT wrsoonsin Department of Commeroe oivisiotr of Satety and Baftditrgs ~ .~ Conerr as, wis. Adm. cone Counh+ Attadr r;omptete see plan on papernotless than8 t/2 x ~ 1 ixdres aA atze. Ptah must irrckrde. trot rat Ihnited tx vertical acrd troriaorxat rebrstres poirrrt (i~M), direcnorr and pmnel tD. . sole or ~mensio~, horn, arrow, and ar~norr ana distance a nearest road. Phase prrYrt aa~ h~ornrstton. 81~"red Farsonsr i~atien Y~ v-a~ ~eY be arssd for secondary P iP-iraaY ter. s. 15.04 tt) tm)). -- ~ I LrC)l~( ~/. ~ Owner ~~.~,w.~ ......a..... ~,~ 114 1M S7.ZT2~1 N R ~"~ E( W Property owner, ilAai'rrg nddre~ lat # i #F Marna a csr~ • 2Y7 (~ ~ r tip 003 ~ ~ o Q Teem Nearest Road A .. p New corrsktx:lion use: ~ R - / Nd code aeraed desigtr taw rate L/ C'o / / 0 Q GPD ~ ~ ~ t~Hc or commetda! - Der~a'ibe: Patent materiel `~)U A a~~.,.y~ Fbod Plain elevanar s~abie •~/ / I ~ ft. Gerrerat corrrrrerns S Sit' m ~~~ v ~ 9S' S o "'U~'L -S ~~ av arrd re~omtt~nr~orrs: y t.~rs~:~- y , ~ , ~ . ~~~ 9y / ~~ ~ Y~ 9 ~ D'~ 0 Pit Ground st.taoe ekv. ~ R , ~ lector ~ 2 r a• ~, Rata ~#~~ U t R t Hortzon Depth in. Domirrerrt Color Mtnsetl Redaor !)escxipnon (~u. Sz.:Cart Coar Texture Stnrcgxe Gr. Sz. Sh. Corrsiseenoe Bourrd~y oo s 'Etili`1 `E1~12 z f y - s; ~ ~ Z ~ _ y 3 2~_~2~ ~D I~ i S O< .- - -~ 1, 2 ./- ~ ~ 5 ® '~ U i~a ~ ® P ft Ground surlaoe elev. ~ ~ 6 ft- a TacAor ' © ~. Sol Rate r R d D i 4f Textue STntclt>re Carsistence Boterd~- Roots GPDIf~ .horizon ; Depn- in. Dominant Cdor trlurseq ot e ox estx p . Qa Sz. Cant Color Gr. Sz. Sh. . `Ef~1 'Eff~2 -ro ~r~ 312 -. ~~ - 2 ~ 5 1 „~ . 5 2 r ~23 ~~ yl - s ~ ~ ~ 2.-~5 ~ ~ S - 3 ~ ~o y~l~ s © ~ ~ ~ • ~ ~ ~ ~ ~ ~~ G ' - -- --- -- - - - --- •~,~,.~,>3p"c~~lZtl rtrBll e/W rte` a.~(rc7WrR~IL cnw~mw-w+c~- 3 ..q... .~~_____~_ CST Number CST Name (Please Print) _ Q } ~~ - Date Evafuat+on ~ Telepfwne Ntanber } r Prover o~ r~~ ~~ _ v , / e«~,s 3 ~ ~ ~ >Z No~imn Depth oon~nt ~. tlu. s:. Cover I lO r3 2 - 2 LI - I~ ~ - ~ -12 ~Z~v~`I~(o _ ~l to ~ - ~ 2 ~ 3 oepth to nmirr~ raaor ! 21 ~. sa ~, exatre stntc~ue Cot~ettoe Bout>d~- c~o~ ~. ~,. ~, 'Ei~2 s. ~ c ; I ~.~ . 5 , ~ Sri) ms cS - -~ S 054 m1 ~ - 7 ~-2 ^ ~9 ^ ~9 # ^ Pit Cxoundsurtaos elev. ft. Depth b ~ factor in' Soi Ra tlotmon Dept Dani+sit Redaoc Description Texture 5>tuctixe Consisf~cs ea~- Roots DAP in. Mursei Du. Sz. Cont. Cobr Gr. Sz 5h. 'E1~1 'Etiif2 ^ 8orirg ~ Q p~9 Grdrttd arface elev. tt. Depth b ~ factor ia. Soi Ra Fiociaan Depth Daccicant Cobr Radox Descrlplbn Textue 91ru~ce Canaietenos Bourcdery itools in. tltxcseM Clu. Sz. Cant Cobr Gr. Sz. Sh. 'Ei~1 •EfF1F2 • fluent ~'1 = BODS> 30 < 220 mglL and TSS >30 <_ 150 mg1L ` Effluent 92 = BOOS ~ 30 mgil-and TSS 5 ~ ~- The Department of C:otcunecce is an equal opportunity service pmvider and employer. [f you Hoed assistance to across services or nced material is an alternate format, Please contact the de~rtment at 608'266'3151 or TTY 608-264-87TT. ssc~:owca.e~wo~ PAGE~OF~ NAME: ~,• LOT# / G.ry LEGAL DESCRIPTION:_1/4_I/4,S_T_,N,R, E(or)W SCALE: I"= L~~ ~ ` ~rrl ELEVATION: /OU • d ~. BM 1 DESCRIPTION: /cl~ ~ _~ r' DO t«. ~• P e BM 2 ELEVATION: ~, •~ BM 2 DESCRIPTION: ~&7 ~.~~ ~ r ~r~ , G~ e SYSTEM ELEVATION: ~ ~ • ~`G T SYSTEM TYPE: ~o,1u-c/~-h'~na~ ~t ~c ~,ti ~ ~ z ~, ~- - r ~, ~- ~; p-r ,~ __ -_ ~'r N ~; RI Q-2 !~~ 5 c• t,c SIGNATURE: f' ~~ DATE: ~I ~ a ~ `~~ r T p'" ~j ~' ' - SOIL EVALUATION REPORT U _.----- _-' ynt;~+ DneM of Commerce ~ }~ a! Satety and Buildings he a ~ Comm 85. Wis. Adm. Code C~nH ;Q~,~1` ~Y • ~ P ~ ae~ ~ a in: ~ 1 ~ demon anted Woad. i l.D. ~ ~~ AttaCli ~ ~' °" ~` reltenstsos t ~ 1. ~ {ode. but noc ~ aa~ ~ ~ n and distance to nearest p~ s wJ'" pescantskrps Reviaerad ~Df7flAtfOR. I~'ess~e prat a~ to !be used iqr seeandiry patpotes {Privacy ~• s.15.W1(1) {m)7~ pry! yeionraubn reu Pf "~' PiGPstht ~O~~on r qro t~umer ~j1 r 9A~ ,v,'c. S!~/fC% ~ Lac t(4 1~1 3 T hl tt is {or) W ~~ '`[ ~ ~# 3 Govt. . , i ''htY`~-1 l `r,~ \IC~ ~(~~~k~ It X1`11' . _. m ew.t, dt S~~hd_ Nacrle CI' Cam. r~ ~ ~ e ~-~ l Road i~ ~ ~;'[~ };{ 1 Number of imdrooins Code dewed doai~ ~ J- [~ Pubiic or oammemiat ~ e~ --- __.__..~...-------~--^- ~p{acisment _,_,_,~ ft. ,; ,1. Flood Pialn elavada'i ~' appili'~ble _ rv , ~~ C „ ~~ S. G ~I parent mai -- +Genrrra{+aarnmm~ts ..~ y..S7~-~''/Yt ~'~T' l,/ , ~, quid ~f' ~ `I(Z ~~ ~ ^ t3otsri9 C/y ~ Pic (3roixideurlace~ev.ll~..i.1_~ d- 9otin9 # ~ >pi8 Ground aur~ce elev. ,7 .,{ ~ Q ~. 08Fih ra S iatta--- ~~ ~ `~ kr. ~ ~ tec~or_,,, ~~ tn. b~ -' ~ ~ ~ ~~ ~ b ~~'~ p~f-~- owner f~r'~; - '~ - ~r , -~~I w ~ _. --- ,~ 2 ~ 3 u # ~ Pit e3rexlmd sttrtace oepd, a titniting taceor ! 2 ! ~. ~ Rate tiot~on Depth i~rtNmttrtc Color n Texture Sdttcitero Consistence 8otxedaey Roots GPdlFf ' EI~2 kt. Qu. Sx. too for lir. St. Sh. ~ 'EtP~! ~'~ c~~r.3~, sr1 ~~ 1v~' -5 -~S Z r' . _ I~ .~ 2 i tL~ v S nSc r-~ ~ _. _ ? 1. Z Y G~ ~ -s-qs 3~ - ,5 r l~~ ~ BodnB ~'" •,,~"~ Q Piq %Gewured SUt{817e) slew. ft. ~ B tBCtOr x''• Hoeizon DoenY>rret Color Redax Deedlptior- Texttrte Sttuctare Conaistereca Baemdsegr Roots in. iMtxeseN flu. Sz Corn. Cobs Gr. Ss. ~. ~ GP '~Rle9 Rete D,'fP '~2 i ~ Pit Gretxtd surface elev. ~„ tt. Depth ~ factor .e lte. ~~~ # ~ ~~ Sol Ilwtlon Ras Hariaae Depth Domknst+t GWar Redox Desuiptlore 'rexleene Sauaters Coresistsreeas Baaetxiary Roofs t3P in. Mt~esa flu. Sz Ctxei Cobs Gr. Sz 3h. 'f1f#1 •~ ' E #1 = BQl)g > 30 < 2'IO me~li. and TSS >30 <_ 45U mgll. ' f t'F2 = 9QQ, S 30 emgli,. and TSS <_ 38 mgll. The Department of Cottemetce is are equal opportmeity service provider and employer, tfyou teem aasistanca to access setvicxs or teeed material in an alte;tieate format, please contact rite department at 608-266-3I5! or TTY 6Q8-264-8?77. sen•essote.mrom ~, .. PAGE,~OF,, NAME:~:~~LUT~ ~ ~=" LEGAL DESCRIPTION:~1/4~1/4,S T_,N,R,. E(or)W i ~ SCALE: t"=~ " L? ~~~ ELEVATION: ~~~ - d BM I DESCRIPTION:~c~~ r a' C BM 2 ELEVATION: ~~ ~ ~ BM 2 DESCR.IPTION:• ~_.~ ~ ~YC ~~~ SYSTEM ELEVATION: ~ ~ • ~~ SYSTEM TYPE: ~c~ ~~~.~^~'i ~ ~a~ i c~ ~ ~c ~~ fir. .. t LCd `~ ~M..~ { ~~~~ r~ / ~ a~~ , -~ ~, / sf ~9~ ,~' ~, a~ .3 5 r. ~,~. SIGNATURE: DA'TE' ~~ i I fn ~ ~ ~ j .2 Cn a„' '0 'D j Z S ~ ~ ~ y R N ~ ~ ~ y tD (D ~ N C ~ ~ p O y N c ~ ~ b o y l o ~ ~ > > o -ap ~ > > I ~c tc ~~ m I ~ ~ I I v Cn Z v7 Z D ~ cn Z u) Z D m cn' D cs~ D y m cn D co D y I ~ n, a W ~ a a W .+ .. I ` O O i O ~ ~ ° ~ Z Z ° cn cn v ° cn to ~ I v c c 3 ~ c c~ I ° v m I~ ° d m m m m m m '7 1 11 C1 N G < N < < z 3 ~ z 3 3 o_ o_ I I ~ O nni ~ O ~ ~ ~ I m m I C C W N W fD d ~ a. ~ ~ O ~ O ~ fA ~+ N M N N j. _. A I y -.. I ~•~,~ ~ m-o~o ~ ~ ~ a ~•5 I~ ~ m-op y ~ ~ a m m m r. c~ m' m ^: I ~.~ wmv~,~ Vi'm` ~ ~•~ ~o'~~•y m m ~ ~? _ (D - y O d N S A W N, (D - (~/f O d C7 7 N~ 0 O N p ~ Z ~ N~ cn n~ (D ~~ Z o A a ~ 3 m o fD A p• a 3 a~ o ~ o 00 ~ m~ o ~ ~ o a ~o m Vl W -O ~ O 'O y W y ~ ~ \ ~ y W -O ~ O 'O y W f/i CD O y y X~ O .~ ~ ~ O y y O~ f0 ~y wocn wvw "` ~m wocn wv~ i p p a N 6) .~ ~ p 7 d N m~ (D n (D ~• c~D 0~= N p O CZ ^~~ ~ O~ 7 N p O O p OptO ~y ~ O ~ ~O(O ~ y~ cn vs Wm ~ c3n ~~ ~ m ~ I aA ao ~? ~°-A ~ WO7 ANN .Z7 W j NN N Cf O O N f'f O A •P c j p (Oj ~ A A C 7 d W '~ Sip N CAD fOA '~ S~ N N N p O O O O O ~ ~ O O I O O! O O ~• .. L .~i 3 ~~' ~ 3 A 3 ~ ~ ~ ', Cf ~ •O ~ ~ d ~ A ~ ~ ~ O N N p N N V ~ ~ N O CT 0 ',I ~ ' ~ .~ 7 ~ CD '~ ~ 3 j• 0 ^~ ~ v O y m O y y ~ I ~ O I I .. ~ D d a ~ I C. v ' o N A W W CJ\7 01 O N N N 0 o a Q 3 ~ 1 • 2 •• ~ 000 ~ i °~ m wvo o ~ jI ~ rn '' • ~ ~ K I 3 s, ~ K y C (A Z ~ ~ ~ a E °1 m ~ a y ~. y ~ c _~ N fD d d O j Q I A ? ~ O ~ a ' A Z ~ ~ W ~ li Z N N ~ O a ~ ~ ,: ~_ z A 17 3 ~ m m ~ U! Z r2 A A ~ II I d tU r"7. O ~s '.1 T C 7 'I a ;~ N (O ` ,• O ~• A a ro N V O .p M ti V y ~ Safety and liuildrngs Division ~ ti~tY ' „ 201 W. Washingaoa Avc., P.U, Box 7162 )"Cra ~~_ . ~~'~a~~,n Madison, VVI 33707 - 7162 „ Sito Address a d R s R ~ De artment of Commerce .os - ~~ 5anjitary Permit Appli sanitary Permit Number ~a' ~ ti t 21 l l ' id 83 Ad C d C Wi ~~ ~ ~ ~~ a t . a e, parsosa rnur w t omm . m. Yn accor s. Q Cbecit i4 RevisioA tna be used far a Priv law s15. 1 I. Applteatfon Informatton -Please Prlat A,ll Inforrttation M A S Z ~0 3 ~ $~6 ~" I.D. Ntttnber rty Owner's Name sr. ~olxc, uiv, Parcel Number oZO-» 1 a48~ tb-ape NQ ~ GlCG? s NINGOF ICE - 01~. lQr e~NZ . Property Owsur'a Mailing Address Property Location /lCl ~ ~~t/.-e ~ v-G, i4.S~~• S T~Q N R~~ City, State Zip Coda hate t Number `~ Block Number vision Name CSM Number f~u~s~.r/ GJ ~ ~ /D'~,G. ~,a ~ ~ 2 5 2003 ~ ~ ~ ~a,/ 7sTm~d ST _ GROIx COU~iT Y lI: Type of Bufiding {check all that apply} try ~-• ~1 or 2 Family Dwelling - Number of Badroo ~7 '~I OFFI -E ilia e g G~ ` o C(~s~ ~I Q PubliciCommercial- Dascn'be Use ,i~~v ~vvrnr~~ D t ownshi ~~9~.ii/ 1 - I Q Stau Owned ~ ~'`~~ I~ l'i~eG~rN~/t¢.~ 1L~earest Road . 3~ ! 12' +" 12 ass ~o ~ r~- lII. Type of Permit; (G'he o y oae box on line A (numbering scheme for internal use). plate line B if Iicable) A' 1,~NeW 2 ^ Replace ni System 3 Q Replacement of 6 ^ Addition to F ounty use ~ S stem Tack Onl Existin S stem 13. ^ Check if Sanitary Permit Previo Issued Parma Number D 1V. Type of Permit: (Check all that apply umbering scheme is for ' rnal use) _ ., 3(0 3~. ~~~ 44 f Non -Pressurized la-Ground 21^ Mou Sand Filter 50 n Constructed Wetland 22 ^ Pressurittd Tn-Ground 41 Q Holding 48 ^ Single Pass Sl Q Drip Line `/Z~ ~. ~~~~ 45 ^ At-Grade 46 .n., Aerobic Trea nit 49 ^ Recirculating 30 ^ Other V. D' rsal/'I'reatt neat Area Informati on: ~ T t'~ ~ Design Flow (gpd) Dispersal Area Dispersal f~~ So pplicadon FE ) /S /D Percolation Rate llstch) (Min Sysxm Elevadon Final Grade / Elevataon Required Propo l l J ~% . ays q. Rate( . ~ ~ . ° ~Sa ~`Q~2 r~ 7,~ t ' ~/a~- yam. yd /~- '~'I. "I'anlt Ingo Capacity ' Gallo Totai Gallows Number of Tanks Manufac r ~ ~ ~ ~ ~ ~ ~ Prefab Concrete Site Constructed Steel Fiber Glass Plastic New S~ttStiitE ~ , , '-., ~. ' lI 1Z~'' T Tanks Sepsic or Hoktiag Tank ~ (~ •~ ~ ~, 1)osiag Chamber . Respo7nsfbility Statement i. Wa tmdersigaed, assume rcaponsibWty for on of the Powrs shown oa the attached pleas. umber's Name (Pritu) Plumber's Signaerte PR5 Number Business Pbone Number ill. ~~ s' ~.~ ~~ ~a ~ ~~o ~ 7~s s 6--3/~ Plumber's Address (Street, City. Smpa, Zip Code) '74 S'c c ' VIII: un / De artment Use ~ ~'~ ~ Disa roved Sanitary, Permit Fee (includes Grouaeawater Date Issued gent Signature o Stamps) PP pp ^ Owner Given Stritial Adverse . Sure a Fee) Z2 S Qi ~ Z to (j ~i ~~,~ ~ ~~ ~ , ~ ~ ttninatioa . Canditlons of Approval/Reasosrs for Aisapproval D h/ ~'~ ~;i;,~,~p~S~~y,Z~iy~~~ ~'~,,~' ~ l`~ ~~ ~iyz' ' '.~ ~~ - s ~- ~ W~-~`~' Vw ~ ~ C -~2a~d ate- OK adoC a. fide ~ ~uli~ Z a~~ ~ ~,t,a tr. yt-,. ~Zw(,~ r~- , ~ G~- ~ Attach mptate ptasa (to Coaap owl,.) ror tlu a~taan paper ant lea Clam 8 u lecher to (Y 3 SZ SBD-b39$ (R• ®5l~1 ~; /~( ~-, (~(Q,,,,,, . t ~dJ-?/~iG Si`~i`.~ ~/.~J% S~~~s'c< a ~. T-2Q/P~~ "O~.r/ Ofru,~s~,/ ~~~ y s~u~~ , -~ ~o . c a ~ ~ ~~r~ ~~ ~``~~ i~~/ -~ P F t$~` ~~ 4,~~~~ rC 1~~2G ~, 3 ~ d'v ~ ~' • ~~ ~,~, x ~. ~/~~~ ~~ soy ~ ;~~~~ ~`~' 1 ,~~7n! ~~G' ~'~ `w,•`~ ~J.r,~J% s"i~.~~/ sc a a ~ 7-2Q/P~C~ fOu/it/ G~Fr~~S~/ /~d~/G y ~'j12 i~a ~ ~y ~d~ /~ .,~~ ~~ . 0 ~~ .` ~, -~ ipso 4J ~~ 4~ ~'r d ~~ p~~ ~d~~~~-,~ -lido i ~ L x~'y~ '~~s- r B3 . +Wiscar:R~ Oepartrnent of Commerce ~ SOIL EVALUATION REPORT ~ page ~ of 3 `Division of Safety and Buildings in accordance wish Comm t35, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 ~d,es in size. an rr~ C E I ~ rp X indude, but rat limited to: vertical and horizontal reference point (BM), d' and parcel I.D. percent slope, scale wdirr>ensions, north arras, and location and distance nearest road. bZU~ ~ 3~~' ~ ~' °~~ JUN Q 3 p~ Date Please print all information. Persona! infomnation you provide may be used for secondary Purposes (Privacy Law s. 15.(11 x r t ~F.;rv ~Yyt- ~/3 ~~ ~ 3 ~~ r Govt Lot v(/ 1/4S~ 1/4 S ZZ T Z N R f~ E (~) Property Owners Mailing Address ^~ Lot #- Block # .Name or CSM# q I-~ o~ (1.~ T (Y City State Zip Code Number ~ ~ ~ ~ ^ City ^ Village (~] Town ~ tSoa ~~ ~(pllo (~ l5)3~(n- New Construction Use: ~ Residential / Number of bedrooms ,,~= Code derived design flow rate ~ GPD RepNacement ^ Public or cornrnerdal -Describe: Parent material 6 U 4 S ~ Flood Ptain elevation ff applicable ,(// ~ ft. General oamments ~ ~ y1 e(c v 1G n-2Q d me-CJ~ G ,`~e•.r/ ,g ~ and recommendations: D ~ 4-- e ~v~ a Boring # ^ Boring m ®Pit Ground surface elev. -1-I ° ~~ ft. Depth to limiting factor in. Soil Appliption Rate Horizon Depth Daninant Cdor Redox Description Texture Strudure Consistence Boundary Roots GPD/ftz in. Munsefl Qu. Sz. Cont. Color Gr. Sz Sh. "Eff#1 "Etf#2 8-I i 3~2 Si I k rn c 5 ~ ~' . 5 •~ 2 l~- -3y iU r ~~I - Si 1 2 -~ ~ 5 ~ I y Iw - I -- - . -I /. Z ~2 `~ ~ ~ri ~t~c~~,G~t. d~ ~-' ii ~q .Z„ Boring # ^ ®p fl Ground surface elev. (~~O ft Depth to limiting fador ~ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/RZ in. Mansell Qu. Sz. Cont. Color Gr. Sz Sh. "Eff#1 "Eff#Z I t~-8 Its. 312. ~t1 2 r cs Iv - -$ 2 i c~ y ---~ s~ I 2 r ~ s - 5 _li0•Q ~ $ h `Effluent #1 =BOOS > 30 < 220 mg/L and TSS >30 _< 150 mg/L ` Effluent #2 =BOOS < 30 mg/L and TSS < 30 mg/L CST Nance (Please Print Signature ~ CST Number /-~arh ~)hv ;- = ~-. 253 ~' 1 Address Oate Evaluation Conducted Telephone Number 2113 ~ ~-. S~m~'SQ+,_ 1-~5 ( 5~©Z_~_ l- i~ - 62 ~~7~5)Z~7- yam' ~ . Property Owner V-~~~ Parcel ID # /~ ~~ Page ~ of 3 a Boring # U i Ground surface elev. W ' ~ ft. Depth to limiting factor 115 in. Pit / Soil Application Rate hue St Consistence Boundary Roots GP D/ft2 Horizon I 2 3 Depth in. -12 12-2$ ~ ~ Dondnant Color Murtsefl la 3(2 Redox Description Qu. Sz. Cont. Color ~-- Texture S ~ 1 Si ~ m ruc Gr. Sz. Sh. 2mo1~k 2mc~- m~ m tim [ ~ s CS -- ~ ~~~ _ 'Eif#1 . 5 . ~ 'Eff#2 - g g 1. Z Boring # I] Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in• Soil Application Rabe Horizon Depth pominant Color Redox pescription Texhue Structure Consistence Boundary Roots GPD/ft~ in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a Boring # ~ ~~ ^ Pit Ground surface elev. ft. Depth to limiting factor ~- Sal Hpplication Rate Hor¢on Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots GPD/Ftz in. Munsefl Qu. Sz. Copt Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 =GODS > 30 < 220 mgfL and TSS >30 < 150 mglL ' Effluent #2 = BODS < 30 mglL and TSS < 30 mg/[. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R07/00) PAGE~OF~ NAME ~s -~- LOT# I h T EGAT DESCRIPTION U W ~5 L la ,S Z Z- T Z`t ,L~I,R. i °~ Elor)~ SCALE:I"= ~d BM 1 ELEVATION /00.0 BM 1 DESCRIPTION~.~~'$fCe( ~oo( (~ ~~~ ti BM 2 ELEVATION /Oa • d l BM 2 DESCRIPTION ~ a~ %l ! ~i~c ( ~PaJ ~ ~~ ~t~- ~ SYSTEM ELEVATION 9lo r y~ ALTERNATE ELEVATION q (y ~ ~ 6 CONTOUR ELEVATION ~tJ~~}- _ -1- _ ~~~ ~~~ $~2 8~~ q~,~, Ib~~ ~,o i qb ~} F dl ~~J (ob' (~~. 2b /I ~~~' 2-~ k u.. Sv/~e-t ~-a=~~ ~f r~.~t~;~ ~~° 1C~~ ~. w aacex~- r ~o t ~~ 6 a n > ~,~ ~^ ~` ~ Z~ .~ '~lo~ ATE ~ -ZQ ~ 2 SIGNATURE .~ ' 1r ~ • v _ PAGE~OF~ Nt1M ~ ,c.s -~- T OT# I ~j LEGAL DESCRIPTION ~y w ~S L 14.~S z z T Z`t ,N,R, 1 °f E(or)~ SCALE:1"= ~/6 BM 1 ELEVATION /Q4.O BM 1 DESCRIPTION~~.~~ ~$~ce ~ ,~o~ ~ I~~_ BM 2 ELEVATION_ 10a • d BM 2 DESCRIPTION'~p o~ ~/~[t S1~o~ ~ocP ~ ~ ~rtl ~ SYSTEM ELEVATION `I(~ ~ yD ALTERNATE ELEVATION ~ (~ ~ ~ (S CONTOUR ELEVATION ,U~~J- a$ ~Z B ~ B~ e - 1 + - w aa~ p,-c~ N . ~g-Z a+~ ~ ,b g-3 ~~~ z' ' DATE ~ -zQ ~ ~ SIGNATURE 4 ©~ OwnerlHuyer Msxlin~ Address ~ ~ ~ Property Addro`~ (VeriRcattoa required from Planning Department far new ,i,~ .~ ~ ~ Pazcal Identi&cation Numbs' OZD - /3~I~- l!v-~v ~~ '/,, Sec, o~.+ T.S~~..N. W, Town of v~ .........• Property Location ~-'/`- -- Subdivision s•r cRaix covrT~~ SEPTIC TANK viAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM tJI.M ., , Lot # ~,.r...• Certitted Survey Nlap #~ _......_ _ ,Volume _ + PsSs # ~~ v~'~trranty Deed # „~~~13 ``d,. . Volume~~~ psBa ~ 2 $~ ~y~ D y~ (~~ Lot linen identir3able~l~yes ^ no Iutproper we sad mtinteaanceof your septie,tystera could result is its premature fiilure to handle warren. Proper snaiatEttasxce cos:sists otpumpistp out the septic tank awry three years or spotter, if neadsdby a licensed pumper. What you put taro the systeus can amt the ltinasation of the septic teak u a treatment stage in the waste disposal system. The property owner agrees to submit to 6t. Croix Zoniisd psp~est a certificadan form, signed by the owner and by a mastarplttnsber, joucaeynlssnplu:nber, restiietedplusabn: nr a lice»wdpurnpervetilyi~ that (1) the on-site: wastewatardiaposal system is is proper operating condition attd/°r (Zj titer impaction and pusraping (iY aeaessary}, ~ septic tank is leas than 1/3 full of sludge. l/we, tlve uadetsigaed, love read the above requirements and agree to maiattia the private sewage disposal syste>zr with the standards set forth, herefn, u sat by the Del>at~atestt of Commerce and the Depardment of Natural Resotuce:s, State of Wisconsin. Certification stating that your septic systasa has been sxtaisstained assort be oompletod sssd returned to the St. rroix County Zottin~ office within 30 da f Lila yew+xptraaa- dam. X DATE 9IQNATURB OF CANT 1(we} that t11 atstessseats as this foray ars true to the best of my (our) knowledge. ti3t above, by virtue of a wxrtassty deedrecorded in Reglfter of Deeds Office. X o>r Appx:tcAxr ONA 1 (we) asr- (are) the owner(s) of G~ DATE »*+w~+ Any infbrnation flat is arils-represented sway zssuh in tho ~lgnitaN permit being rovaked by the Zanirsg Departmont. +"'*''" ~'" Ynclude wltb tbls application: a stamped warranty deed horn the Register of Deeds ofYice a copy of the certified survey map ii referonce io made in the waaanry deed 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 fn-Ground Soli Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- Table 1: System Deslon Specifications Sanity Permit Number - 55~ Number of Bedrooms Desi n Flow -Peak ( pd} ~ U Estimated Flow - Avery e { pd} ~ D Septic Tank Capaci { al / Soi[ Absorption Component Size ) 2 O Type of Wastewater Domestic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Com onent Soil Abso Lion Component Desi n Flow -Peak gpd) Maximum Influent Particle Size (in) 1/8 Maximum BODs (m /L) Maximum TSS {m IL) 150 Table 3: Maintenance Schedule ~- ~ „ ~ ,; , Septic Tank Inspect and/or service once eve 3 years Outlet Filter Ins ect once a ear and clean at le ce Soif Abso tion Component Inspect once eve 3 years a r s Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stets. The contents of the septic tank shall be disposed of in acxordance 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 tank and outlet filter shall be assessed at least 2-3 once every 3 years by inspection. The outlet filter shall be cleaned as necessa to ensure _praper operation. The filter cartrid s ou d not be remove un ~ n ade to ~Qa'1~S retain solids in the tank that may slough off the filter when removed from its enclosure. If the re~C.flrwyti,pii~(Q. Management Dian fp- a Septic Ta^k era Sci: A6SOrptign Compa,nent --~..,. titter is equipped with an warm, the filter •haii be serviced if the alarm i~ activated .onxirtiuous?y. Intermittent titter alarms may 1ndlCete surge flows or an impending con#lnuoua starer,. The eeptia tank shall have its contents romowd when the volu>ne of scum end sludge ltt the tank exaeeda 1/3 the liquid volume of the tank K #ho canterrb of the tank aro nct removed at the #lrrie of an aeeeearnent- makttertsnce persona®! sha(1 sdviaa the owner of when the t-axt service r~seds to be t to maMtafn less then maximum scum end e#udge acx.umuistJon in the tsmk. Manhole dears, erxeaa risers and covers should be lrtspectOd for water tightness end stwrtdnl~, Acores openinge used for eerofce and esseument ihatt be aaalsd w~atergght upon the t,0lnpletion of eenritly. Any opening deemed urtsaund~ detective, or eub~aat to ~ cause be repleced..Expoded aowae oper-fr~ga gnatsr than finches to diantetrr sheet be sec~srad by en s4~!aosivs lookirr~ dwlce to prrevent s!ooidentei or unaud erdry !~ ~ .. a or other lrwbtiart or h+aidln~ teetk 1br No oar alwuld enter a any rwrsort wltf~out belr~ to eat! eompl~enee r~ tit s~tenatlerd+s for e~n~rlt~- a oa~l~ apace. the ~tntaa~han- t+vltftln !!~ awe ar ofher b~+~ttirrilant of h~i~ t~uNr Aay ea~lbtta etlai rwr:ct~r 4f e pewtoa !~ =h~- ln~rlor ~ tqa b~ enay ~ ~~ ar tMpota18/i. Tank abandonrrrertt atoll be lrti soaardana with Corm 83.33, Wis. Adm. Code when the tank la no Igngar used as a PO-WT8 component. The- sail absorption component serrrlnQ thin struaturo It deslpned tc acaep# domestic wastewater from a reazldantlat laclsity. 'The limits of aperatitx+ of this oomponar~t are shown in '~ab(a 3. longevihr of a ea}i absorption component depends greedy on proper and #imeiy meln~nar4ca<, art! system use within ar t»~w the timlts of callable operation, 4o+ad water flanservattc~n pceotices by ell ocacupan#s and the irratellat(on of wataMr conatervln~ p(umbin~ flxture~r ere troy factors ~ ex~ndin$ the ueaful life of this nrn~ The sail abaorptlan aampona»t`a operadon mtiut be aeeaseed by ir~gpecdlan et (east onaa evrry three yer~, The lnspectian shall fn+aluds ncatding e» levels of pandlnp- ~` any, in the oba~rvation pi~s- and a v(suti irlapeCdOn for any evidence of surfers aespepe or d~schsrge frQt~rt the cornportont. Ors steeply stoplr~ steel, areas of ercul~ should be ldantl~ed at'+d reporwrd ~ fihe owner for repair. The suAaa dlaGsarQe of dornestlc wastewater or sewage from t!~e system is prohibited and considered • human l~wlth ha:rrd, Trafpc around or aver the sail absorption component ahoutd ba avoided pattlautariy during winter +~nths, The compaction Ot ramous! of snow cover over the component may lead to hyaraullC failure by frosting. This type of failure is uaueiiy temparery, but ~ difficult or lmpca}sbia t0 repair until weather conditions improve. In genNral, soil cornpectian aver this c,porntt wi{S redur~ ditfu~an of oxypan inteo the sots and diaperaai a{}, which may lead to m~e tn~snse- and ear(lert orpartic cbggtng of the sail. Z Managamrnt Plan for a Septic Tank ans! 8oi1 Absorption ComponRnt Piantin~ of deep~rootid tnea and ahrubt dirrctly o~wr of within ten hit oi' the component iiri'-outd be Iwoided ainoe roof intruaicn ir~o the comment rney cif way stow, Cantin~ency Plan in the uwnt of system faiiun, a new e~y~tam cold be }rntaUed in an iltrrf}ate arse. 1lVttfi ttu inataitat,r~n ~ a divsRer vs;va, the axistinp syasem could also be roomed K~ a partod o! thrsa to tour yawn. it is the property oNm~'~ re~tor~ibiiity to maintain the eiternitte area froe any piantinq N tree~r, shrubs, etc. in ~ of failura oi< the oriSinai ayslern, the aiterrfaN- area wa! t» needed. st ~ treq, ahn~aa, etc. hNte barn ~iafrted 4n tt» eiterns~t arer, they wilt hevr to be rarstovsd at property awnen expen~4. if a{tsmsta ana is destroy+K:, there are other aitamatiw systems thMt cts't be used, in which, cx~uld rssuit in added sapii~e to the proP~ ovrnar. n9 th ~ ~!~ a~olyour iioor ~nl~ wa or ~ i~aii gyplumbar~. e ~ c~v~.~crn w.~,+~. ~ y t l - 5~ 3 ~ 4 ~ 3 ~ ~ ~ 'R. ~l v,.ew,1~ ~ N U 1393P [91 STA"I'E BAR OF tISCONSIN I~piZM 2 - 1998 WA1212AN'1'Y DEED KeTHLEEN H4 Uocuntenl tJuniber MALSH STGICROIX CODEE~ 'T'his Geed, toads between __Kf<)<nC7n ,7 ga and ~ RHCEIYED FOR RECORD ..____._-_-- - _ ----, Dona.lda _J..__ _ _ ~P_Q€~'-Bait..._.....huslzand.._and_,wife._ 05-17-2002 10:80 All --- _.. --- IIHRAfINTY DEED Grantor, ,nrl Dominic_ A ,Swi1~ and. ,~rige,h~. D, Siwik. _.......-.. husband d REC FEE: 11 00 _ an w_.;~~ __ _ - _. . ?RAMS FEE: 144.70 _ _ - - .._ _ . COPY FEE: - - CER? COPY FEE: Crnntm lur a ~aluahlc cunsldcralion conveys and werrants to Grantee the foilowhtg d PAGES: 1 «r,u~~rl ~.al rstate of ._St. Croix - ----..___._ County. State of Wisconsin: Lot #16, Plat of Pheasant Run 1st Addition n,"c~nriingae,, Town of Hudson, St. Croix Count y, Wisconsin NamaendRelamAdaress -' l+ rY~-tY~~ 1_>r•~ ~ 3~. t'Yrnrtc~:3atc~ Sfi --~~10~ _. _;; ~3~ ~ ~ - ~ o~~. Parcel Identiticalion Ntsnber (p2Ny II Thls~.s .no homestead property j' (Is) (is not) I Exceptiutts to warranties: roadways, easements and covenants of record Dauxi rids ___]"~___ .__ day of M- ay -- . ----1~-~_ _: ~ _ (SEAL) __.___ ~__.._------ _ (SEAL) AlJT1iENTICATION Signature(s) ._-,.~__...._._-.. autbenticaled lh(s _.__-_ tlf' ^° ,•••""' ° " ""~`~' - ~DIA~QE~fiB>~flftflPF _ __.. __ _ .._. _ Notary Public ___ _ -restate afi~lttf~sc~t~s2~.,.,,...,,, - TffLtr:: MEMBER S'I'A"I'E 8AR OF WISCONSIN (If nut, ._.._--- ___ authorized by §7pG.OG, WIs..Stats.) THIS INSrtiUMENf WAS oRAFTF.U BY .__ Kex.nnn.~.__.Hast_.__.--. _`- (Signanu'es nkty lw auVhenlicated or acknowledged Both are not necessary) ACKNOWLEDGMENT (SEAL) (SEAL) State of Wisconsin, ss. ~ St. Croix JJJ County. Personally came before me this 12th day of l May , 2 0 0 2 the above named '' Kernon J. Bast and Donalda J. Speer-Bast ~~ - I [o l ate known to be the person s who executed the fore oin ` instrument and acknowledge the carne. g fl ii i !4 ~: Nolary obits, Slate of Wisconsin I~ My commission Is perman~e~nt.~ `(If not, state expiration date: • hlar~.~. „~ psi s,ns Jt;nlutt i.. nny r.aparliy nnni IM ~yl.wi m' prlnlM Glow dwar airnaiuir - ~ ~' t•.nll P.n r,~rt uI.CU 5TA'iE gAH OF' 1VISCUNSIN f 012A1 Nu. Z - 1878 Wiswruh legal &mw Go., Inc. '.. rAAwa„yee Wye • PRELIMINARY PLAT OF: PH EA A T R N F R T ADDITI LOCATED IN PART OF THE NW1/4 OF THE SE1/4 OF SECTION 22, T29N, R79W, TOWN OF HUDSON. ST. CROD( C J ~ Nina 1 ~ ~ Q ~ I ~ , I = v~ ~ p~' I ZONED AG-RES~SENTIAL I ~ i ~,, I o ~ I Z S` 6 o I~ OO Ir C~~ IIIQI N i l?q e~ G3MMn ~ dp`7 9 I ~ I Si ~r~ o ~ - - - C~'~ U rM. I Stl Z - - ~ ' I 1~/0O L~,• 9 9 X19 I ~€ ----------~°------- I ~ 0 ~ ~ I I$ I~ L N €~ o I I nu I ~ Ig o I rBgNPPEPaIND I ~' a 6 I NORIHl1EOFlHENWINOFIIEBEIN ~o~®v~oerna+ I ~ g 3E 493 Z N8g'00'29'E 861.38' I rop „ Isevaotntreet.o% T rwoeePPEtrouo N88 69' 'E860.87 l l~-H.w.1..92oa N~twtw, oae rffr -` ~ fwowuasu+®romaN ' ~2' H.W.L = 292 ! 8BIC1W11c 925.0 ' I ~~~~~ ~ toPwt•tnoNPPE ~ `*' ,'OP OF,•.WN}PE L u.eo.s. w1uM oP taa ~. 6EVA7gN ~ EBBS/ u.s.caa oArtlBy)P ttI?r EIEYAIgN ° ~'~ ~ I I ,~ 20 ~ ~ ! ~. I I H• ° MMBMUM BOLDING ELEVA710N = 931 s0 2.68 AC ~ 9 '` 00 AC + ~ 2 _ ,rte (,.6 Ac) ""~cl , . t ~ ~ __ ~ -~ ~ t~ ~, ~ ~ '_' '_' ~ ` MNVMAUM BOLDING + • `' ~ ~ ` ELEVATION = 927A i \ + ~~\ ~~ = + \ is ~ • ` ~` + ; 329' ' t Ae~- ~~ ` : ; ~ ; t O t ~ ~ ~ t. N ~ H.w.l_ _ + 10 "'r ~ c!~ ', 19 99eA ~ , ~ ; ~_~~ N 2.08 AC + ,~ i/ j 1 2.2o we (~.8 ) ~ (2.0 AO) ~\ ` 1+~ ~ : MINIMUM BINDING ElEVAT10N s 910.00 ..: i bt i ~; • ~ ; i ~ o ~ in1 ~ Y ._ ~ o ~ Z Z J ~V \ . IttNWy cenMy tlrt the ~ a under my t e7 eale M tlIs __._ _ 878'__._.__.__.__._ -'--' DEDICATED TO THE PUBLIC I ---ROBERTS LANE----}-j _.__.__.__.__._ 97B' .__.__.__.__.__._~ ------------------- ~ 133' ' ~ 0 2.03 AC + t ~+ ; m MNMUM BUB.DING ELEVATION -9275 + Jt H.W.L.823.5 17 2.02 AC ' (1.6 AC) MINMUM BUILDING ELEVATION =9275 •, yto \ .• t ~~ %12 '~ ~~'`• 2.33 AC `~~/` M9VIMUMBU9DING ELEVATION =9275 °..,. ~ Ba 13 3.80 AC (3.8 AC) MINIMUM BUILDING ELEVATION =9255 ~,\ `~,~ . '~ ~\a ,\ •~~ \ • \ t L. ,1 ;; ,' t + i' B ~~ + ~ i XF i ~ ~ I t ~ ~ o-Y 21 Ac a~•A~ (3.7 AC) ~ ®~ MGJI?6~5~7i I OO1'97IgL~DD _l3' ~' ' ~ ~~~ H.W.L=908.0 2.06 we (2.0 AC) /4 076AC r (2.9 AC) MINMMJAA BIMDNJG ELEVATION = 910A0 z.o3~Ac (2.0 AC) 14 s !a ~_ 2.09 AC - - (2.OAC)------ ee woE AtXE88 ¢ASE-te+r PDR aevEwAr ~ ~' --~_ S89°T2'46'W 1289.77 \eD'~ORA"r~#B''iCTOBE NErov®IRON noAO ocrBi+aioN. 601lIH WEOF TlIENW1NnP i,E SEI/4 ~ ~ ~ MUYJP6G~~ ~7@D --6pI~DD ~3 -~--------- ~--~ OO Sr~JL~G3~_ ZONED AG-RESIDENTIAL 51µ 00WER BCCIION II ~p~tGg~/,`G S i ,W ~ C. ~ ~ ,l t1 ~ ~ ~~8 GzS cf ,v~ ~C[. ~ ~d,~~ 4 /- /~/!~ a~<'D ~c/ s ct~~.! ::yD~ ~~l % !~lic 140; d ~~2! ~aac ~'Y-30 //~'t v' ~% Y / ~S~S~f' r`r c ~l,`T`h~~-btY' ~J~~D ~3 a?~G~iamlie~sTfa l ~~ i~ ~-3X ~~~Ye-/Gl e3, i /gi ~~ ___ /~~i~3