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020-1437-11-000
o ~; 4~ N ti 1~. O d N O N C i -D a i Er •~ O N .~y ~~ V • ~h ~O V t.~,v t G O CC _0 C 1..1 ~~ a3 .~, c~ A~ V j ~ W i'', z ~ ~j '~. O ,. a~ E a ° c m ~ O LL C (0 t U c 0 N ~ .~ 0 d d a m O Z d' ~ c U ~ ~ O O Z ~ O) ~ ~ N N y ~ N N U a~ d U C o ~ Q ~, Z I- Z ~, j', ~ R E ~ ~ ~ ~9 ~ d - N y ', ~ a 'w w a ~ d >, o ~ O a Y ~ j FN- H F ~i=,0 O O ~ a a a a ~ o m ~ m o 0 N J V =' O O ~ N eN~- = N M ~ O O U ' S m -a . y c ~ «~ ' N N N 00 ~ i ',. E N C O cp 3 O N O I', > ~ '. N O ~ ~ O C ~ r ~ N O N ~ a W O N = ~'. Q ~ O T ' "` E a. E d ~ ' ~ a >. a d :~ m ~' E ~ ~ ~ ~ ~ o m = '' 3 U a~ ', O y U -o o ~ o O ' ~ . ~ I c O ~ I I i~ I I I z° I v c c ( ~i O Q I I ~ V Z IA O .. w 0 N a d m c 0 . U C ..N. ~ O O ' a~ ~ ~ I ~ a Ch .O ~. ~ i N ~ ~ m m L 0 O ~ ~ ~ a U ' p I O_ Q Q Z m Z .. ,~ N ~ l0 E N R C _ ~ _ y ~ ~ O ~ C ~ o 0 d o i a ~ ~ w I~ N N N ~ m ~o I z ~ ~ ~ Z >, O O O ~, ~~a a a m o w. o N N = v O .~ <~ ~ O O ~ a~'i ~z m ~ v ° ~ ~ ~ :°. N N i ~ N N C O p E 0 ~. v ~ m ~ ~ a 0 O > ~ N ~ U 3 _M ~ O ~ ~ C C N ^ ~ N N _ O u1 Z '~ >. ~ N Y ~ U cn vai W Q v o ~ a a w c ': O in V ~ °o 3 0 O ~ a~ c O a E a m ~ c a o Z ~ ~ c O L '- U -o y Q ai C a, .~ O N L E >~_ a~ Y t6 ~ E E ~ ~ _ a cn 0 Z c 0 .~ U O z M c 0 U 0 z N C O U 0 z 'D N '-' `~ E .~ n7 ~ c O ~ to ~ Q Z U3 O ~ N c O d O o N ~ O ' ~ ~ N C ~` ~ ~ N N "O ~ 93 ~ - ~ U q N Z ~' d O Z cn 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 As en Develo ment, Inc. Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: f UD.O~ CST $~~~ TANK IN ORMATION ELEVATION DATA county: St. Croix Sanitary Permit No: 488289 0 State Plan ID No: Parcel Tax No: 020-1437-11-000 Section/Town/Range/Map No: 22.29.19.2716 TYPE MANUFACTUI~ J Q UF-~a , CAPACITY Septic ~~. ~z oa Dosing Aeration Holding TANK SF~TBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic > ~+ ` y Dosing Aeration Holding Pl MP/SIPHON INFORMATION M nufacturer Demand Mod Number TDH Lift riction Loss System Head TD Ft Forcemain Length Dia. Dist. towel STATION BS HI FS ELEV. Benchmar / t ~ ~ d~ • ~ ~ ~ O ~ Alt. BM Bldg. Sewer ~.,3 ~ (~~ ~ S 1 SUHt Inlet ~ ~ I ~'. I ~ + SUHt Outlet ~.~ $S 0 ~, ~0O Dt Inlet Dt Bottom Header/Man. Dist. Pipe Ib ( S ~• But. System .~ a .lo •~r~i Final Grade ~3~ /o3.rs..l St Cover p ,~.~WS l•~ ~ o(v.D Z.o ~.~s IF~~ C(111 ARS(1RPTInN SYSTEM 1 .. n ., 1 nwe lAtJl- RENC Width 1 Length ~ v No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DI S 3 p Q • SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactur r: CHAMBER OR INFORMATION T e Of Sy tem: / ~ ,_ + ~ ~ UNIT Model Nu~bgr: _ 1'11CTCIQIITIAAI CVCTiGIUI + Header/Mamtl4 Distribution x Hole Size x Hole Spacing Vent to Air Intake ~ Length Dia_ Len Spacing ( v Cnll /'f1VCD .. o..,........,, c.,~~.....~ n.,i.. .... Mn•~nri nr A4_(;rarla Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil L;, ~i Yes ~ _,; No f Yes I~~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~~// ~ /~(z Inspection #2-~T~ / ' Location: 688 Heritage Way Hudson, 154016 (SE 1/4 SE 1/4 22 T29N R19W) Kelly Es tes L 1~ No: 22.29.19.2716 C S,~ , / Q~ .~ ~' 1.) Alt BM Description = S'T• , ~~''~ ~ ~ ~ ~ ~ ~'~ Y. O " ~ ~ '~'~'~`n~ 2.) Bldg sewer length = ~ l~ I ( R,(op -amount of cover = 4•Z-~'{" ~~"~'~ • 1~ A ~J S ~_ ~ ~ , i _ -- ~ I PI r ston Required? es , ; o ' ~ ~ ~ ~ ' Use other side for additional info ati ~_- (~~~ -_ __ ~~~ ~~"~ - --L 1 _ _____. Ise ctor's i Cert. No. t ~ ~ n P SBD-6710 (R.3/97) • ~--~~ ~ ~ ~~ __ _ -. ~ ~~ ~ . /A PROJECT Aspen Development Inc. SE 1/4 SE 1/4S 22 /T 29 ~ ~- PLOT P ~~ ADD S 1687 Woodlane Dr. Woodbury Mn 55125 N/R 19 W TOWN Hudson COUNTY ST. CROIX 7/31 /06 BEDROOM 4 MPRS Shaun Bird 226900 DATE CONVENTIONAL XXX IN-GROUND PRESS CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers 36 ,BENCHMARK V.R.P. TOp Of 1 /2" pipe ASSUME ELEVATION 100' Filter BEST Filter BOREHOLE O WELL * H. R. P. Same as Benchmark ~~'~~J~~ ~, / 85' ~ ,~~p6 ~ tiop6 P~~'~ ~ Go~~,.~~ ~V, ~ 0~~~ G~O~~ s~ . SS' Pro 4 Pro 4 Bedroom House B.M. #1 L B-4 20 133' 15 ST B-2 SYSTEM ELEVATION , 40' 11' B.M. #2 84' 61' _ _ 130' ~~ B-3 2-3' X90' Cell with >3' Spacing 66' Vents )' 7% SLope B-1 Cleanout ---- Well is to meet all setbacks requ~~dns~~esigned Using WDNR Conventional Powts Manual Version 2.0 Vent >6„ Standard Biodiffuser of Cover Leaching Chamber with 25.0 ft2 of Area 5' Long 11 " 3 6" Grade at System Elevation Heritage Way ~ ,QED Wisconsin Department of Commerce OILi~L"t/'A~UATION R PORT Page of Division of Safety and Buildings ((~~6 in accordance Comm ~Wi~. Ad~~Code c Q County J ,~ Altach complete site plan on paper not less than 8 1/2 x 11 ches in size. Plan p~sr1"~ indude, but not limited to: vertical and horizontal reference int (BM ~®'t~{v~dn"d_ arcel I.D. percent slope, scale or dimensions, north arrow, and locatio nd d~nce to near Please print all information. Reviewed by Date Personal information you provide may be used ror secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location // Govt. Lot ~ 1/41/4 S2 T Z N R~ E (o W Property Owner's Ma ing Address Lot #~ , Block # utxl. Name or 7 ~ ~~ ....~~ C 1 C City ~ / ,State l Zip Code -Phone Number ^ Ciry~ ^yllage wn Nearest Road ~JJ _ //_ ~ i _ , _ Construction Usey~_Residential / Number of bedrooms ~ Code derived design flow rate -~y `~ GPD ^ Replacement ~~ ^Public or co er 1-Describe: __._____ nn / __- Parent material ~ ~~.C/ ~~4y Flood Plain elevation if applicable /1/~ ~ ----------- ft. General oorrvnerlts and recorrunendati/o1ns: System Type `-'~ N System Elevation Boring # ^ Boring ~ X12 0 Pit Ground surface elev. ~ O ~ t~ ft. Depth to limiting factor tn. Soil ication Rate tiarizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 'Eff!#2 Ong # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BOD > 30 < 220 nxtlL and TSS >30 < 150 mg/L 'Effluent ir1 = BOD < 30 mg/L antl 7 ~ < 3u Rlg/L CST Dame (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ,~ ~ O 715-246-4516 ~~ Property Owner Parcel ID # Page of Ong # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting fador ~n• Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting fador in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure ~ Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring Bonng # Ground surface elev. ft. Depth to limiting fador in. ^ Pit Soil lication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 'Eff#2 • Effluent #1 =GODS > 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent #2 = BODS < 30 mglL and TSS < 30 mg/L 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. Sa0.8330 (8.6/00) Safety and Buildings 'sion 201 W. Washington Ave. . Bo 162 County ~ ' fa) Madison, WI 53707 - Sanitary Permit Number (to be filled in by CoJ ,SCO~~,~ (608) 266- 1 !?l ~ Z, Department of Commerce to Plan LD. Number Sanitary Permit Application ~_ et p sonal i ormat [~ d d C i r r ~` e, per o m. s. A In accord with Comm 83.21, W ~V EU JJ~" GG 5 0 Project Address (if different than mailing address) f~tnt~+ , may be used for secondary purposes Privacy La , s 1 I. Application Information -Please Print All Information J U L 2 7 2006 ~~ ~~ Property Owne 's Name ~ ~~ ~ ~~~ ~ T. C I ~ 0,~.1NTY ~ (./ S ~ ;^ Pazce] # Bock # S.ea, pi~,Dt.a~ ~ . Property Owne/r's aipling Address / ~ ~ n roperty Loca ~F y J~ ~/ Section , ., ,, City, State Zip Code Phone Number /.,..~ _ ~ ~~) ~ /l JJ~~ j . ~ ~~ rcle e ~ , l~ U N; R E W T II. Type of Building eck all that apply) Subdivision Name CSM Number or 2 Family Dwelling -Number of Bedrooms ~ t t ' r~ ~ o" 1/ ~' l ~ ~S . 0 ^ PublicJCommercial -Describe Use / (~ ~ ~ ~g ~„ ~g G L~ ^City_ illage ownship of tom/ Ce. ^ State Owned -Describe Use ? iJ t 1II. Type of Permit: (Check only one box on line A. Complete line B if applicable) Q ~ -~~~} 7 • ~l 'd A. stem ^ Replacement System ^ Treatment/Holding Tank Replacement Only -~ ^ Other Modification to Existing System ~ List Previous Permit Number and Date Issued B. ^ Permit Renewal i i ermit Revision ~ hange of Plumber ^ Permit Transfer to New weer ~ ~ ~ ~ ~ ~ ~ f rat on Before Exp .--~ J IV. e of POWTS S stem: Check all that a 1 Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil and < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In- and ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter / ^ ~ ~ Recirculating Synthetic Media Filter ing Chamber ^ Drip Line ^ Gravel-less Pipe ^ Oth t er (explain) V. Dis ersal/Treatment Area nformation: Desi Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s~ Disp~al Area Proposf (sf) System Elevation v / ~ ~ d/ ~ ,~ ./ ~CTD ~ ~ , C~ i l VI. Tank Info Capacity in Total Number Manufacturer of Units ll G c ast Prefab Site Ste Fiber P Concrete Constructed Glass ons a Gallons New Existing ~ 8~~+ ~, ~" ~` Tanks Tanks Septic or Holding Tank ~ 2 Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersign me responsibility for installation of the POWTS shown on the attached plans. Plumber's Nazne (Print) Plumber' re MP/MPRS Number Business Phone N ber ~~ Z~ ~'t ' ' c5 ~.~ ~~-' Z~ 6 T o ~ ~ .~ 71.E Phnnber's Address (Street, City, State, Zip C ~ ~ o~ ~~ VIII. Coun /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date sued Issuin ent Signature S ) 'Approved isapprove Surcharge Fee) ~~ ~b 7 ~' ~(P iven Reason for trial-- IX. Conditions of ApprovaUReasons for Disapproval (~ (~ SYSTEM CVilt~lER: 3~ I~7 tJ .~ d~-~- ~M.t~~ ~Cav • ~ ~Jr+>u.~ 1. S~ptlc hnic, eMusnt filter and a; f~--. Ctt (~c~r~~ i ed W ~ ~ IM i t a n n dispersal cell must all be st>rvites I ma U as per management plan provided by plumber. 2. All setback reQuiremeMS must be maintained as per appNc~Cle code / ofdinihrlces. Attach complete plans (to the County only) for the system on paper not less than 81/2 x I1 inches in size SBD-6398 (R. 01/03) OT PLAN 'PROJECT Aspen Development Inc. ADDRESS 1687 Woodlane Dr. Woodburv Mn 55125 SE° 1/4 SE 1/4S 22 /T 2 N/R 19 W TOWN Hudson COUNTY ST.CROIX 7/25/06 BEDROOM 4 MPRS Shaun Bird 226900 DATE CONVENTIONAL XXX IN-GROUN RESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE •7 ABSORPTION AREA 900 # of chambers 36 ,BENCHMARK V.R.P. TOp Of 1/2" pipe ASSUME ELEVATION 100' Filter BEST Filter BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 260' 40' 61' B.M. #1 11' B.M. #2 Property Line 84' 133' B-3 2-3' X90' Cells with >3' Spacing B-2 r`Y~ Vents 0' Pro 4 Bedroom House ST Heritage W, 7% SLope 100.6/100.0 5.7' below grade _ 130' _ Well is to meet all setbacks required by WDNR Plans Designed Using Conventional Powts Manual Version 2.0 66' B-1 Vent >6„ Standard Biodiffuser of Cover Leaching Chamber with 25.0 ft2 of Area 5' Long 11 " Grade at System Elevation 36" Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Dischar a into system is not exceed those required as per Comm. 83 ~.------ CoA#i~ e c Plan fails, determine cause of failure, use alternate area and install new tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715-246-4516 St. Croix County Zoning 715-386-4680 Pumper Tom Mondor 715-246-5148 Shaun Bird #226900 WisconsinDepartmentofCommerce PRIVATE SEWAGE SYSTEM Safety and Building DivisiGh ', INSPECTION REPORT GENERAL INFORIV~ATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: As en Develo ment, Inc. City Village X Township Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: TANK IN FOR TION TYPE ANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. nt to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION ®\ Ft Forcemain Length Dia. Dist. to well SOIL A6SORPTION SYSTEM County:. $t. CrDIX Sanitary Permit No: 488260 0 State Plan ID No; Parcel Tax No: 02 437-11-000 Section/Town/Range p No: 22.29.19.2716 ELEVATION DATA STATION BS Alt. BM Bldg. Sewer SUHt Inlet SUHt Outlet Pipe System I Grade BED/TRENCH Width Length o. Of Trenches PIT DIMENSION No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO /L BLDG WELL LAKE/STREAM CHING Manufacturer: INFORMATION C BER OR Type Of System: IT Model Number: DISTRIgIJTION SYSTEM .ir \ Header/Manifold Distribu ' x Hole Size x Hol acing Vent to Air Intake Pipes Length Dia Len Dia Spacing RAII RCIVFR / ., ore~~...e c..~~e..,~ nn~.. v.. Mnund nr AfhradP Systems ~nlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil i~ Yes o ~ Yes ~ No COMMENTS: (In de code discrepencies, persons present, etc.) Inspection #1: / /. Location: 688 Herit ge Way Hudson, WI 54016 (SE 1/4 SE 1/4 22 T29N R19W) Kelly Estates Lot 11 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = Inspects #2: / / Parcel N 22.29.19.2716 Plan revision Required? ~ Yes ~ No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) s ' Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County ~Gy~i~ sCQ~~ `n Department of Commerce Madison, WI 53707 - 7162 (~8) 266-315 , Sanitary Perrnit Nu r o be filled in by Co Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you pr may be used for secondary purposes Privacy Law, s1S.04(1)(m) roje ct A ddress (if different than mailing a dress) / p I. Application Information -Please Print All Information / (Q b ~ /-l ~~~ ~~~ u Property Owner's Na me Q~ ~~L~ /~ 7 _ U O 3 ZOOS ~ Parcel i/ of Block A' ~ 1~ Property Owner's M ailing Address ST. CROIX COUNTY Property Loc n ' ~~ J~' - O Z b 2 v~~~ ~ ~ [ ~~ ~ Ci S ~i, ti.Section . ty. tate Zip Code Photte Number 6' ~ .~ ~-S~'/a ~ L~_ ~~~ ~~C~ circle ~ ~ II. Type of Bui 'ng (check all t t apply) L/ ~~ ~ N; R E 7 Subdivision Name CSM N r b _ J or 2 Fattuly Dwelling -'Number of B oo s ~ um e ~ ^ PubliclCommercial -Describe Use TT ^ State Owned -Describe Use ~i~+'L L ~-- _!~- ^City`^Villag~Township of.~y`~~~ III. Type of Permit: (Check only one box on lin A. Complete line B if applica )~ __. _..~ A T I New Systen>-- L~ ^ Replacement System -T ~ reatmenUHolding Tank Re cement Oniy - ---- ^ Other Modification to Existing System i B. I ^ Permit Renewal ^ Permit Revision ^ Cha of ^ F u Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber O r 1V. T of POWTS S stem: (Check all that a 1 -j /~~. __~/-~L 'ZL.T- ~Non -Pressurized In-Gr ^ Mound > 24 in. of suitable soil ound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized l n -Ground ^ Holding Tar ^ t Filter ^ Aerobic Treamtent Unit ^ Recirculating Sand Filter ,, cc ~~ ^ Recirculating Synthetic Media Filter 1L~lU.eachin r ^ ri Line ravel-less Pipe ' O (ex ain) _ _ _ _ V, Dis rsal/Treatment Area Information: f? Design Flow (gpd} Design Soil Application Rate(gpdst) Di rsal Area Requir (s Dispersal Area Proposed (sf) S}~tem Elevation s~~~ ~ ~ 1 ~~ ~ .~ ~ J` / s~ ~ gar. VI. Tank Info Capacity in Total Nu r Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of its Concrete I Constructed f Glass New Existing i I j ~ I- Septic or Holding Tank Tanks Tanks a~ , ~ ~ _v © ~ ~% Aerobic Trea[men[ Unit ~ ~ ~ ~ Dosing Chamber ~~ / ~~r~ ~ ~ Y VII. Responsibility Statement- I, the tend igned, assume responsibility for ~ [Iation of the POWTS shown the attached plans. Plumber's Na me (Print) Plu is Si gnatur P/ PRS Number 9usiness Phone Number _____ ~~ Plumb er's Addre ss (Street, City, State, Z' Code) /y ~ / , ~)''` /,//+ t - VIII. aunt /De artment Use On Sanitary Permit Fe (includes Gr~p dwater Date Issued ssuing nt Si na (N Stamps) i Approved ^ Disapproved Surcharge Fee) ~UiT„ U.~ i-~ ~ ~ G~%~~ ~ ^ Owner Given Reason for Denial `(,(f ~'~~C~1/l't- j IX ~ ~ ~ rLg~~raval/Reasons for Disapproval ~~/C~~ /„ , ~,2~fi~!%1 ~ ~G,~ryt-P/Zi ' 1 Septic tank effluent filter and =~LXiG dispersal cell must all be serviced /maintained ~ ~~GZ~ . as per management plan provided by plumber. ~ ~~, , ' ~. ~ / > ~O ~~ 2. All setback requirements must be maintained ~,SVs.~~yy~ ~!XX~/~[a cep n jti~~ ~D E~- as per applicable c d / di ^ o e or nances. /J Q~ ~ `-` _ `~~_ r~ / ~ __a~~-~ ~~.~~9' ~/-) cul~_~ztaQ rl? nl /nz~ nttacn complete ptaas (to tae Gotmty only) rot the system un paper notrless than 8112 x 11 lacats in s9ze -~ ~~ a (1 'v ~~ ~. z ..__....._..__ ~ _~~ J~Q 'r ~~ ~-~ h ~ ~~ ~, ~. f,. ~~ ~ ~~ ~ ~'~ ~~Q e ~~ ~ ~, ~~ ~ ~ a ~` ~ ~ , ~ o, ~ ~ ~ ~, 5 ~ ~ e ~~ ~ ~ o ~, ~ ~ ~ ~ h^ fi e y ~ ~ ~. ~ ~ ~ w ~ i ~ ~ ~~, ; ,~ o a SFFTIC TANK E PUMP CHAMB~h C1~G?SS S~CT~ON P.ND SPECIFICATIONS 4" CI VE~JT PIPE 12" MIN. ABO~~ GRAI~~ ~ WEATHERPROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE -- +,,, WITH CONDUIT MANHOLE COVER "' ~ W/ PADLOCK ~ FINISHED GRADE WARNING LABEL ~n CI RISER ~ " ~~-4 M7N~. 18" IN. 6" MAX. +~~ .• ~~ INLET ,_. ~ , ~r ~ ~ WATER TIGHT SEALS ~ GAS- ; ' t ' T ~ l /APPROVED A ~ ` SEAL ~ JOINTS WITH iPPROVED ~ --~- , ~ ; ALM APPROVED PIPE 'IPE 3' ~ .,,...; ~ ~ ON 3' ONTO )NTO S(}LID ~ ~ SOLID SOIL TOIL PUMP OFF ELEV . FT, ~ OFF -~* RISER EXIT ~ D PERMITTED ONLY IF TANK. _: MANUFACTURER HAS APPROVAL 3" APPROVED BEADING UNDER TA~T1C CONCRETE PAD SPEGIFICA'~IONG SEPTIC / DOSE TANK MANUFACTURER: ~~~.5~~ TANK SIZES : SEPTIC 1 ~;,~ Q GAL . DQ5E ~ bb _ GAL. ALARM MANUFACTURER: Le"~~~.gt~ MODEL NUMBER: `p i.r~/ SWITCH TYPE: ~~„~c. PUMP MANUFACTURER: ~^~~ MODEL NUMBER : ~' i~ d SWITCH TYPE: m~eRC REQUIRED DISCHARGE RATE y ~ GPM Ni.IMBER AQSES PER DAY: ~ . I30SE V4~JME INCLUDING ~~~ -GAL. F LOWBAC K CAP~ICITIES: A = ~'~ INCHES = LI~~6AL. B 2 INCHES = 4 ~ GAL < C = 0 INCHES = ~$ GAL. D = ~ INCHES = J ~.~ GAL. PIMP ~ A1aARM WIRING AS PER I LHR 16.23' WAC VERTICAL DIFFERENCE BETWEEN PUMP Q~F AAiA DIS~`RIBUTION -PIPE ~~ FEET + MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET + ~ D FEET FO~tCEMAiN X ~~FT/~QQ I'T. FRICTION FACTOR =FEET TOT~~ DYNAMIC HEAD - FEET INTERNAL DIMENSIONS OF PUMP TANK: ~ENG~'H .~ ; WIDTH .-~' DIAMETER s~~Qur~ ~ ~ 8 " ~ ~ G-,~L pee 1 ° SIGNED : :~~G-~'----_.. LICI~NS~ 1!1t.~MBER ~~~ ~,~ l7 DATE 1/88 • ~GOULpS PUMPS Submersible EfFluer~t Pump 3871 EP05 APPLICATIONS • Fully submerg~J ((n high d t l ~ GPti6lmpeller. Thermoplas- l ^ Bearings: Upper and lower Spedflcaliy designed for the gra ur e xne ail tQr lubrication and efficient tic enc osed design for improved performance. heavy duty ball bearing construction following uses: • Effluent rystems heat transfer. ~ Casing and Base: Rugged . • Homes Available for auEpntatie dnd ~tRm1°plast~c design provides AGENCY LISTING • Farms manual operatipn. ~lu~v- super~pr ttre[tgth and corrosion ce Q#~ta ~, c sta~rds ~~~ • Hea d sum vY mY P matic models in~lyde , r p • Water transfer Mechanical FIo4t ~vJ~~ • Dewatering assembled and presgt ~t the factory. SPECIfICAT10NS • Solids handling capability: '/+" maximum. • Capacities: up to 60 GPM. • Totat heads:. up to 31 feet. • Discharge size: 1'/:" NPT. • Mechanical seal: carbon- rotarylceramic-stationary, BUNA-N elastomers, • Temperature: 104°F (40°C) continuous 140°F (60gC) intermittent. • Fasteners: 300 series stainless steel, • Capable of running dry without damage to components. Motor: • EP04 Singgle phase: 0.4 HP, 115 or Z30 V, 60 Hz, 1550 RPM, built in overload with automatic reset. •EP05 Singgle phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, buih in overload. with automatic reset; Power cord: l0 foot standard length,16/3 S11'OW with three prong grounding plug. Optiona120 fioot length, t 6/3 S1TVIf with three prong grounding plug (standard on fP05?. FEATURES ^ EP041mpeller fihermoplas- tic semi-open design Wf tiI pump out vanes f p- merhankal seal protection.:,; METERS FEET ........, _... ,.,..,............. 10 _a '_ e L s 6 20 "" ~ "° 5 I -._. ....._ a t .,.....' ....... o ~- ~ 3 tQ l..:~._..,,,-~..___.. A M_.+tsfAr Iiclusing: Cast iron #ar efiflpant heat transfer, 5tre11~t11, Jind durability. t Motor CpKer. Thermoplastic cttVef wit~~iitegral handle and float swittt4~attachment points. ~ power Viable: Severe duty ~ted oil and water resistant. .,.r.:.:__. _..r.._~...... ..... ~ ~~ ~ _ _. i _. , _,.... i r (CSR listed model numf~ers end in "I'" Or "C".) Goidds Pumps is ISO Soot Registered. GPM _....._....._..I i i }.:...., _~.._.... _._...t .. .....EP05.. i I ~' ~ ~ ~ ~ z ~ t.., :.... _. .. . SC.:.,...._...__,.t. E.. .,_,.„...~.... ._... .. _._. _.. . .. ~ ~ ; 1 I . ........ G.. .. ,._.... .:. _.........__ ..~ ._... ._ __ ~.... _ . _. _.. 0 1p IO 30 40 50 GPM Q 2 ±} 6 8 t 0 12 m~/h CAPACITY Goulds Pumps 02000GouidsPumps ~ ITTindustriies Effective February, 2000 ~~~jjj 83871 ~~` ~'~~~ rnr .~.r~. ..w STANpdAp CHAMBER Quick4 Standard Chamber ti:,` - ------....___..._......_..._.~.... 52•..-----.__.~ i (EFFECTfVE LENGTH) ~--' ' ~i ~x j i i ~ ~ ~'~ --- -..__..r...i I i .' ~' ~~} Stl~ VIEW MuitiPort End Cap .-_ I __ _. - ~ ' , '~ ~ ~~"' 1 ~ - ,~, ;~ ~a~ i _ ' ~,, ~ i ~` 't ' - ;n, ~ 11 J ~ I' ~i ! ~ ~t ~ ! r >. _ ~1. ~.._ FRONT VIEW {,:. > 1^: i- ~ ~ , pl I ~- ,{ i ~ ~ r i~y_ _ .i. _.:~_ '' ~~ SIDE VtENJ TOP VIEW Size fW x L x H - _.~__._.34" x 52" x 12' -- -- ---- Ettsctit~e ~.en~cn fig- a! snvert Height _,~.____,__„___ :,~ .„M>sit~Poil~~~d Cap'hiosninel Spacitiaationa ~ `_ .~ _ _.._._. lnveri He~~h' ______a 8" or 1.25° __________rw._~---- 1 N 1.1~117~..4~IEig~-~'~X ~NFI~ IAl~I4~i+ SY~I1~M$41.C,l.~TA_.S~A9l~ . I i n. 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Hax .f68 pid Saybrook, Ll {1~;d7ra BC1U X51?-7030 • fAX 86v-5+'7.10()1 80p•'2Z1-4436 ~ e5!t 9,5V t,971' L 7td.',t},;, tl.tltS.776, 5 tL4Q M6 fi,01 it 5,A47,11E; J ~i ryrrYn ln,' i J~.~. J~7.OAr '.!yg,C~y,5.33 K~i'I~g u,lulplo'sY' rb rc: a°>s : ,xA.~ armor l.talhntrs a~an9. .r, , I btf"F:u tr YkiR~9' Ut, ~P'i~i y r tri6wnrd'~P Qt InMlretrn vi etp~'t I^~~ SAdirelW ~3~ k. (atr~rhtrM$pi1~9f. POrtL')C~, (,.tiN7~+ ~. ~a, an.l SscwvJ;~c[ar prs rpgrtiW iKJ rn5 Ilun N I,./~.r:rptg, F'Wkttl, Rrr.QA.OC: • purm5whet w xw . .~..,._ranr! trarirx'ra'K .n MCl,fA iiNTf(%J5 (~ „rrn t..l.u ~rrn .S~'.UArr44 i!'C. l~ftYhxl ~ lJ s.Q. AFCYCApC M/!p r.,~5 ~j ~`y1r'J ~~ L SECTfQN VlkW .. ! ~..___. V'A .~~ 1217 ? SOIL EVALUATION RERORT Wisconsin Department of Commerce ,~ - ~~ ~ s ~, O ~ P i of 3 Division of Safety aad Buildings in accordance with Comm 85, Wis. Adm. Code teel Soil Service Cou ~ r ~ ~ i ~- , Attach complete site plan on paper not less than 8'i: x 11 inches in sae. Plan must include, but not limited to: vertical and hor¢ontal reference point (BM), direction and ~...._._~...~ percent slope, scale or dimensions, north arrow, and location and distance to neatest road. Parcel . Pending Please print ati infom+ation. gy Date ?ersonal information you provide may be used for secondary purposes {Iy Law, s. 15.Od {1) (m)). ~ 63 'mss Property Owner Property Location Reliant Developers LTD Govt_ Lot SE 1 /4 SE 1/4 S 22 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 9900 Valley Cr k Rd. Suite 135 11 na Kelly Estates City t .c.~Cf ~ State Zip Code Phone Number City ; Village ~ Town Nearest Road MN 55125 651-731-3174 Hudson Heritage Way V' New Construction Use: fir, Residential /Number of bedrooms 4 Cade derived design flow rate 600 GPD Replacement Public or commercial -Describe: Parenf material ouiwash plains and stream terraces Flood plain elevation, if applicable na General comments and recommendations 75ft below grade : System elevation 100 55ft trenches spaced and depth to code 5 ~ I ~ 2 , . . t ~ ~ Boring # .__' Boring 105 ~ Pit Ground Surface elev. 106.30 ft. Depth to limiting factor in. ~ Application ~e Horton Depth Dominant Color Redox Description Textun=. Structure Consistence Boundary Roots GPDHtZ *Eff#1 "Eff#2 1 0-11 10yr3/3 none sil 2msbk mfr cs 1vf .5 .8 2 11-24 10yr4/6 none sic! 2msbk mfr gw na .4 .6 3 24-105 ~ 7.5yr4/4 none Is osg mvfr na na .7 1.2 r~_ ~. loo , i 4a~/.~ Boring # Boring 105 Pit Ground Surface elev. 106.30 ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= *Eff#1 *Eff#2 1 0-24 10yr3/3 none sil 2msbk mfr cs 1f .5 .8 2 24~t2 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 42-57 10yr4/4 none sl 2msbk mfr gw na .5 .9 4 57-105 7.5yr4/4 none Is osg mvfr na na .7 1.2 ~ ~- I `~/,~ ~ I * Effluent #1 = BOD ~ 30 : 27n mnlL and TSS >'irt < 15n mn/r • Ffni cant ~ . RCIr) c ~rl mnn and TAC c ~n mn/1 -- o -- -----~ -- ---...~._ _...__.._..- ---g=-...y-_.._.__ =_...a._ CST Name (Piease Print} Signature: CST Number David J. Steel ~ o ~ 248956 Address Steel Soi! Service ~-~-1/ ~ Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 10/22/2002 715-246-5085 Property owner Reliant Developers LTD parcel ID # Pending Borin # Baring Page 2 of 3 g Y pit Ground Surface elev. 101.90 ft. Depth to limiting factor 105 in. Soil Application Rate Horizon Depth Dominant Color Redox Descnp6on Texture Structure Consistence Boundary Roots GPDlft2 *Eff#1 *Eff#2 1 0-11 10yr3/3 none sil 2msbk mfr cs 1f .5 .8 2 11-27 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 27-39 10yr4/4 none sl 2msbk mfr cs na .5 .9 1 4 39-105 ' 7.5yr4/4 none Is osg mvfr na na .7 1.2 Borina # ' Bwmg * Effluent #1 = BOD ~ 30 < 220 mglL and TSS >30 < 150 mgll_ * Effluent #2 = RODS <30 mgiL and TSS <30 mgiL T'he Departrnent of Cor:~rierce is ar. equal opportunity service provider and eriploy°er. ff;ou need assistance to access sen~ices or Borina # 'Boring - - Page 3 of 3 STEEL'S SAIL SERVICE David J. Steel 1564 Cty Rd GG CST-POWTSM Reliant Developers LTD New Richmond, WI 54017 L1C. # 248956 SE1/4,SE1/4,S 20,T29,R19W (715) 246-6200 Town of Hudson, St. Croix Co. (715} 246-5085 Kelly Estates lot 11 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the soil test was conducted. Legend 1" = 40' ©=Benchmark El. 100.00Ft Top of '/2"pvc pipe L~ Alt Benchmark E1.100.O5Ft Top of/2" pvc pipe ^ =Borings Boring Elevations B1 =106.30Ft B2 =106.35Ft B3 =101.90Ft 2 ~i, 9'~ ` i o ~ o' (~ f' r 30' i ~~' 8~~~ I ~b~ '~~I, A~ l 7~ sib ~~ ~y. °3~ ~~s ~ ;n,~ ~~- ~ . io6,3 d~~- IQ -ZZ_ov ry ~, a. ~ E-1J . I ~ u L ,• ..__..E • Y . Z S Ngr / / ` ~ ~ / ~ / w 5, ~ 11 L, III •J t ` ~~~ ~ `\' r' $ % '"` ~- 1, ; : ` YY ~ u = \ ` ~ ~, ~ ', J~ N II ; : t ,, t '•~ is C D ~ .°r . ~'•. ~ R / • ~ ~ /" ~ i ~ ,' IC 7 ~: S rt~fr')''•,~ ~ ~ ~ _ f `y ,, $ ~ ~ ,o~. p TH ~ ~ ' j:' ~~; ! J 1 ~. ~. ~ `~ ~' III ~ ,1 ~ ~ 1 , ~N.ati ~~a, ~ \ ~ `' `i ; ! I r ~ ~ i ~. , - ~ p~~~'•. S i , , I {- 1 •~ '~~~ ~1 T. 1~ ~`~ ~ / /~ ;i~ ~~` `\' ~~~ ~ / ` .r~~r•,;~~-11~.1. Iii ~ri + ! f «~/ r, '. \~••iii... \ tic ~~ • •,~ it 1~~. ~- .~~ .~ i fi ~ ~ X117.!] ._-t , ~1.~ 1 '.I ~' 329.78 N03~7' ` ~~~/~' ' ~ ai a POt~,NG EASEYENT~~ ¢~ ~ ''', o •~^~~; I ~, ~{ ~~~ ~ 416.3 N01°0508:~~,. ~~ t, ,,. i I ~ ; ,. 1- ri m ~ '~jj~~I '~~ _ ``~\~~~~~ `~ .r~ ~'ticsT-.a~-u~' J,X ~ j ~ \ ,` '~ ~, I I Ix,t~.w\; .1 I- i v I 7 ~ ~ ~~ ` ~• . ..6~ /NGG, 1. GSrIPC~37I6 V ~• ! 2 _ ~ 1I \ K, ~/T 1 1 ~ I ter .t ,~ I ~ r (- I ~ s r ._ l I ~ 1 m ~q ~~ ~~~r: ~ ~ Rs Y5~ N~ ~ ' i oss ! 1 ," 1 6 IC7 N ~ ` i~ ~ 1~ N ~n9 F3 '~ ~ I i « t ` ; 1 /. / t 1 n - I ( ` sr j7~~~ ~ I ~ ~~~.1.~'~.~ ~ ~~' ~ 1 ~\ ._. _ ,/ 'i "f ~~J,F ~ raw ` ' 1- I Ride N ~--~-N- ~ ~ r~ i .-x i / •' `- ~- •--„`.~.-__!s - ~ _ ~ _ _ Js~a __._ - I ,. ~. ,...-7r~. y - •. '~ 503.12 N01°OS•06"W _.~~ .:,.. ~\ ' . _ ~ c~sr ur,e a n,t sour„tnsr awns ite, so. ~a w.. _._.x>su ~ -- M, Ic-, "_ u. Zb~D AG- RE ~" I ~,ou a.,,x, ~r ( ' O ( ~~ ~ J...,_:. , . > h m ~ o ~ ...~ ~~ S -~ Z -~ m ~ © ~^ 7 -+ Sin Lm AD ,~.'Zl l ~~ ~2 ;o ~~-r ~~ nA'~ r0 ` i GZ Z ( a 6nm Nc -im Z~ z~C~^~ I .,~ s ~~, pro ~~ yo =~ ~~~ 6 d ~ ~ ~ "~" o~ L _ _ s g z x Oz Om 6 ~ ~ ~~"$ ~ a - - ~ ~ ~nn ~ Z1 ~ o ~ p ~~a~ y ~~ n ~ ~ I A ~ ~ ~~~ OO I ~~ vim ~z Preliminary Plat of KELLY ESTATES ~~ James R. Hi~~, t«ww w a° swa.°a a«t« a a° f°raN°N awrb , a ,M S°ua.Nt aM« a tlr caa.o., w«,«. w ti s.e,a~ u, re.~ 7Y xpa, R°nq~ ,° MYS6 Twn el NuC~en. se. cn~. ee~.ay, ,tea,.., e, a„acne ! n,n,-,reee J e, ro,ir ST. CROI~ CUUIVTY SEPTIC TANK MAINTENANCE AUREEMENT ADD OWNERST-IIP CERTIFICATION F~ O'Rlv1 Owner/Buyer fi/~~-~ ~~ ~ Mailing Address ~lG'~7 ~ca_~~~.~~- ~s~ ~~ ~ e ~~.~',~~- ~ ~, Property Address __.~~~ ~2~/7,t~t:_ ~ ___ {~~erifcation required ftom f3lar~ning b'eI.oG ding E~enartment for new constnxcxiun.) City,~State _.____~_GU~~ Parcel Identification l~tunber ~a~ ~ /~~ - ~~-C~~/iJ LE AL DESCRIPTION ~ a ~~ ~ 1 Property Location-sue '/4 ,~.~ ;~4 , Sec..Z~ , T o2 ~ N Rm 9' ', Town) of ~. ~-cs..d _ Subdivision .~~1~.~-5'~ .V_._..___. _-.._. ,Lot # /l,- Certified Survey N1aP # .. _ ___ _____~~,_..~ .~_._, Volume _ ____ _ ___, Page # Warranty need # .__~._~ ' .~~ lJ-._._~.~__.._ _ ~_~_.___~ ~'altune ~/~a3~a,~~gC # Spec house yes nu Lqt lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CE~tTI~~ATION ~Y~Ir WI A I Improper use and nviintenance of your septic system could result in its lfrcmature failure to handle Wastes. ?:'raper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put inter the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Oumer maintenance responsibilities are specifted in §Canvn. 83.57(1) and in Chapter 12 - St. Croix County Sanitary Urdtnance. 'I'he property owner agrees to submit to St, Croix County Nla:u~ing & ?oning Departtn°nt a certification form, signed h} the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and~'ot (2) after inspr4tion ana pumping (if necess©ry), the septic tanlr !s less tl-an 113 full of'sludge. t; we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with tl7e standards sez forth, herein, as set by the Department of Commerce and the Department of ?attual Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and ratumed to the St. Croix County Planning etc Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of tnyleyur knowledge. I~we em/are the uumer(s) of hr property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number ofl~'d~rooms .~°_' a ~.~ SIG ATURE OF APPLIC~'~ ~ ,, 1~ATE ''`'"Any information that is misrepresented may result in the sanitary perrnir bring revoked by the Planning & loninft Department. '~* Include with this application a recordad warranty deed from the Register of Deeds Uffice and a copy of the certifted survey reap if reference is made in the warranty deed. tr~v. asms~ POWTS OWNER'S MANUAL & MANAGEMENT PLAN Gn ~ i~i~nonnnT~nu Owner l-D ~ ~~~ Permit # DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units NA Estimated flow (average) (~.~ gal/day Design flow Ipeak), (Estimated x 1.5) gal/day Soil Application Rate gal/day/ft2 Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) <_30 mg/L Biochemical Oxygen Demand (BODS) <_220 mg/L ^ NA Total Suspended Solids (TSS) <_150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand IBOD51 530 mg/L Total Suspended Solids (TSS) 530 mg/L NA Fecal Coliform (geometric mean) 5 ~ 100m1 Maximum Effluent Particle Size Ye in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Page ~ of Z Septic Tank Capacity Z al ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ~} ~~ ~ ^ NA Pump Tank Capacity ~Q ~ al ^ NA Pump Tank Manufacturer ~ ^ NA Pump Manufacturer ^ NA Pump Model ~ ~} ~ ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: A Dis rsal Cellls) ~/ ~ ~ ~ ^ NA n-Ground (gravityl~Gln-Ground (pressurized) ^ At-Grade ~_. ^ Mound ^ Drip-Line ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA i Service Event Service Frequency Inspect condition of tankls- At least once every: Z ~ 3 ^ earls) s) (Maximum 3 years) ^ NA Pump out contents of tankls) When combined sludge and scum equals one-third IY3) of tank volume ^ NA Inspect dispersal cellls- At least once every: ^ nthls) (Maximum 3 ears) Z 3 ~'° rls, y ^ NA Clean effluent filter At least once every: monthls) ^ year(s) ^ NA Inspect pump, pump controls & alarm At least once every: ^ monthls) ^yearls) ^ NA Flush laterals and pressure test At least once every: ~ ^ month(s) ^ year(s) ^ NA Other: At least once every: ^monthls) ^yearls- ^ NA Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the 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 cellls) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third IY31 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Rage 2 of 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(sl. If high concentrations are detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cellls) in one large dose, overloading the cellls) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, alt tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLA If the POWTS i s and cannot be repaired the following measures have been, or, must be taken, to provide a code compliant replacement stem: 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, !ot lines and wells. Failure to protect tha replacement area wi!! result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ~~ T alua ' a o ing ank be ' e ai a ~RU4~1181'Ti:1~ FOR- !J$l~/ ~NS77zU~?t D~ ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE, ADDITIONAL COMMENTS POWTS INSTALLER Name /~ . ~(//'J't /`~l~ ~Z Phone '~l - ~' ~ ~~ / POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ST. C l (~ ~ Z0~1'1~(/ " Phone "~/S- 38'(O_ (G This document was drafted in compliance with chapter Comm 83.2212)Ib1(1-(d)&(f) and 83.54111, (2) & (3), Wisconsin Administrative Code. State Bar of Wisconsin Form 2-2003 WARRANTY DEED Document Number II Document Name THIS DEED, made between LaCasse Development. Inc.. a Wisconsin Corporation ("Grantor," whether one or more), and Aspen Development. Inc., ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Lot 11, Plat of Kelly Estates in the Town of Hudsou, St. Croix County, Wisconsin. 8 1 66?~ KATHLEE1i H. MALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED 1?OR RECORD 81/23/2N6 89:3rsAl[ MARRANTY DEED EXElIPT i REC FEE : 11. @~ TRAIiS FEE: 296.70 COPY FEE: CC FEE: PAGES: i Recording Area tit NBme and Return Ad ss ~ ~- A ~ ~a~ ~~ 020-1437-11-000 y Parcel Identification Number (PIN) This is oot homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights-oi way of record, if any. Dated (SEAL) (SEAL) * *La se Develop a t, c. (SEAL) (SEAL) * * Signature(s) _ authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Attornev Kristina Ogland Hudson. WI 54016 ACKNOWLEDGMENT STATE OF ~~ ) c-~ ) ss. . ~ ~(tij~ COUNTY ) Personally came before me on~~7 .. ~..S.c~/ the above-named LaCasse Development. Inc., a Wisconsin Corporation to me known to be the rson(s) who executed the foregoing irt~trument and aa'knoed the same. Notary Public, State of ~~~ My Commission (is permanent) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM N0.2-2003 * Type name below signatures. Tracy L. TU rrle r INFO-PROTM Legal Forms 800-855.2021 www.infoprotorms.com Notary Public State of Wisconsin AUTHENTICATION Parcel #: 020-1437-11-000 o7iosi2oos 10:17 AM PAGE 1 OF 1 Alt. Parcel #: 22.29.19.2716 020 -TOWN OF HUDSON Current X_j ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -ASPEN DEVELOPMENT INC ASPEN DEVELOPMENT INC 1687 WOODLANE DR STE #205 WOODBURY MN 55125 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description " 688 HERITAGE WAY SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.486 Plat: 2149-KELLY ESTATES LOTS 1/21 020/03 SEC 22 T29N R19W PT SE SE KELLY ESTATES Block/Condo Bldg: LOT 11 LOT 11 (2.486AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-29N-19W SE SE Notes: Parcel History: Date Doc # Vol/Page Type 01/23/2006 816872 WD 03/29/2004 757836 2535/495 WD 01/17/2003 706202 9/47 PLAT 9nnR CI IMMeRV Bill #: Fair Market Value: Assessed with: 0 Valuations: Description Class RESIDENTIAL G1 Totals for 2006: General Property Woodland Totals for 2005: General Property Woodland Last Changed: 10/25/2005 Acres Land Improve Total State Reason 2.486 76,900 0 76,900 NO 2.486 76,900 0 76,900 0.000 0 0 2.486 76,900 0 76,900 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • ~~ O V N. ~~ .. ~ / ~ _V ` ~~t~' r . 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CauntT, a.cpnpr [lL ~~IICDC / CEIMAIR'DC / M ID~' ~ f ! ~ r - h ~0 ~ ~~ t I I 1 i i I I I I t f I ~~, F„~ r--• ~ ~ ~ ~ I f 1 r, L~ I J 4 ,~ ., _ . w ~~ T Zd Wd6ti:Z0 S00Z 80 '~aQ 1.L1~LLLTS9: 'pd Xti~ ~If1~ FOIS3Q 28!1341: l.D2l.~ ., .~ FRd1 :hEYB2 DE5IC~1 SH~IiICE FAX hD. :6517770477 Dec. 0B 2006 02:4HPM P3 i ~ ' ,_ ~; .~°~Z~ 6os I / / , ~ 3"0.45 Ii / /~ ' 1 / i ~/ i Zy0 1 ///~ m$ ~~ ~ 1'~ // m~ °vr,~*, 1 ~ ~ `~ g ' I M r ~ZA iI Q a ~ c~ic~.. ; I m l,, yz .-.~ ~- ~ m F ~ I mc~ ao N o y A a- m ~ ~ 1 ~ ~ ~Ay iI ~~ ~ ~' . ~ ~j ,i ~ .,. ~~ ~~ ,. i ~-` ' ~``` ~' ~RLTA~~ 6-f ~ ~ ~ - ,i' .,U 1 3' ~ I N ~ 1 ~, 1 i ! V ~ (b i , I n~ 1 I ~ ~~ 1 ' 1 1 I `I~ ~ ~ I 1 ~ I 1 L- --------- ~ r N00°52'34"W 1 ) 1 I' ~ I I i i ' t ~ f ~ ' ~ ' i i i ' y ' t i,~ N~ ~' w y V tt^^ ~~ W cn ...~ w w ~ N Ow U~ IN coc a,R Wa S'-•~ ~ tO '~ ~ iii,, ~ ~ ~. c O ~ C N ~ ~. Q N" °,'~ ~. N o ~~ v ^• ` o ~ (.1 O ... ~ ~j ~ No .~,. ~O c ~ ~~e' o ~ ~ ~ any ~ ~ C . ..,. j O Q v 1 ~ b j, c~ ^.. 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