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020-1450-10-000
i Wisconsin' DenartmentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 506323 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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 Parcel Tax No: Water's Edge Construction Inc. I Hudson, Town of 020 - 1450 -10 -000 CST TF BM Elev: Insp. BM Elev: BM Descriptio Section/Town /Range /Map No: / 0 1 0 t6 65 22.29.19.2880 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. J! Septic Benchmark s t� 1 � 5 •� ��� mmhly Aft. B .tom %6 (a3 , to Aeration --- Bldg. Sewer (� +yL g9,v3 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet Za TANK TO P/ ll,, VVELL BLDG. Vent to Air Intake ROAD Dt Inlet 11 oCi�... N Septic 51 A 30 f > J?Aj / Dt Bottom Dosing Header /Man. f p f g 5 Z (p Aeration Dist. Pipe ' +6 9 4j . Holding Bot. System' '13 - (.S PUMP /SIPHON INFORMATION Final Grade 41c'+ Manufacturer Demand St Cove� � Model Num TDH I ift Friction Loss System DH Ft Forcemain Leng la. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width ♦ Length I No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. ___._ liquid Depth 3 y`1 3 � c� DIMENSIONS �, y ret� SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of System: } CHAMBER OR ✓�!'+ 14 /t / PT_ ♦ 1.t� Model Number: DISTRIBUTION SYSTEM Header /Manifold fJ Distribution x Hole &7 x Hole Spacing Vent to 'r Int Pipe(s) \ Zw� Length Z5 Dia Length Dia Spacing t.^ 37� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over d Depth Over xx Depth of xx es Seeded /Sodded xx Mulched Bed /Trench Center J D Bed /Trench Edges To -, � No Yes No 1_ , COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 642 Roberts Lane Nudson, WI 54016 (NE 1/4 SW 1/4 22 T29N R19W) Hudson Estates Lot 10 Parcel No: 22.29.19.2880 1.) Alt BM Description = 2.) Bldg sewer length r• - amount of cover Plan revision Required? ❑ Yes No Use other side for additional information. SBD -6710 (R.3197) Date Insepctor's ignature Cert. No. commercemi.gov Safety and Buildings Division County 201 W. Washington Ave., P . 7162 St. Croix sco ns n Madison, WI 53707— Sanitary Permit Number (to be filled in by Co.) sconsin t - i nepartment of Commerce sO Sanitary Permit Application Sta Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate gov enta unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POW e Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for second 642 Roberts Lane p urposes in accordance with the Privacy Law, s. 15.04(1 )(m), Slats. I. Application Information — Pm4e Print All Information REGEIVED Property Owner's Name ! Parcel # 020 - 1450 -10 -000 Water's Ede Construction Property Owner's Mailing Address S E P 1 1 20 7 Property Location 400 S 2 St, Suite 130 Govt. Got City, State Zip Code Pho e NE' /<,SW' /., Section 22 Hudson, WI 54016 - (circle one) II. Type of Building (check all that apply) 01-f— C A 1 Lot # T b N; R 19 W ® I or 2 Family Dwelling — Number of Bedroo s 3 PSG.,,. — Wo Subdivision Name Ce 10 Hudson Estates ❑ Public /Commercial — Describe Use „tiC ❑ City of ❑ State Owned — Describe Use CSM Number ❑ Village of 3 ; I / +_ 1 6 G ® Town of Hudson III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ® New System _ ❑ Replacement ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) System B. ❑ Permit ❑ Permit Revision ❑ Change of ❑ Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Expiration � 7 Q / Z! IV. Type of POWTS System/Component/Device: Check all that appl ® No - Pressurized [n- Grou ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: Design Flow pd) Design Soil Application Rate(gpdsf) Dispersal Area Required (so Dispersal Area Proposed (sf) System Elevation i 450 0.70 I'll' 643 ✓ $54 ( 7, q 1 93.56 ✓ VI. Tank Info Capacity in Total # of Manufacturer W 0 Gallons Gallons Units ¢ 0 New Tanks Existing Tanks " z W o u W 4 g F , W 0. � U 'n 0. Septic or Holding Tank 1000 1000 1 Skaw ® ❑ ❑ ❑ ❑ Dosing Chamber ❑ ❑ ❑ ❑ ❑ VII. Responsibility Statement- I, the undersigned, assume responsibilit3A f installation iA the POWTS shown on the attached plans. Plumber's Name (Print) P r s Signature MP/MPRS Number Business Phone Number Clarence Glotfelty 220728 715- 868 -5831 Plumber's Address (Street, City, State, Zip Code) N4955 Sunny Hill Rd, Weyerhaeuser, WI 54895 Vi . County /De artment Use Onl Approved _ tsa ve Permit Fee Date I ued Issuing ent Signat re caner en n for Denial $ O q 1 /07 IX. Condit1&VXj W4Weasons for Disapproval l /n�-- 1. Septic W*, alfluel t filter' and 3 1 � fe. ,�.ko .7 Sti 5 , dbpw" cell must all be services / maintained as per management plan provided by plumber. 2 AN se'back retirements must be maettained as per applicable code / o ea. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x I I inches in size SBD -6398 (R. 01/07) Valid thru 01/09 Li ao a �o Z o ca m N O a> W , 6. =O ' C w Jr' 87 O � CD cc N W 0))U =o O ir, 1) m Od 'sue N Z�ip`- O q U n I II Sc` ZF�d co z J Q m I i I I i Y wo a I � � I I I i I = i w I o � I i LL a o Z _ a' c N 2 N a J "Q N 1 w� 0c"T_ O 0 V =; N co _ � d E � gy po' W (D CD 11 o N m O �`15 U� W m Z � (� n II ScD a Cn � ■ �L z N g � 4D , I IL V N O a m I 1 I I a� I CO 1 N 3 �� a 1 �Y c I � I t I � � 1 1 � I o , CL I s Prey % 0v j� trc 4ONC 4/ -13 -0 Y. H005e - t o b- -ttl - _ �r�r�gtpI Co erce SOIL EVALUATION REPORT Page -L of J— 7VII � wilding in accordance with Comm 85. Wis. Adm. Code County G R D ' �eI Wplan on aper not less than 8 1/2 x 11 Inches In size. Plan must ut lim ' ited to: ve cal and horizontal reference point (BM), direction and p I.D. R,XpO,bcl Wdlme slons, n orth arrow, and location and dista to ne est r T. CO P/ se print all Information. vte d by Date Personal InfonnaUO you Drovide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 9 L &L 07' Prope CJI / Covrta�fi: Property Location W X("s E- L Co 91 A r U (A 0 ev Govt. Lot 0 E 1/4 SW 1/4 N R / g E (C. Property Owner's Mailing Address Lot # Block # SuW. Name or C DO o . Su c. 10 P1A,4 o F tf oJsoN Fs44e- Ci State Zip Code Phone Number C011 ❑ City ❑ Village ® Town Nearest Road V 5 1 W 2 ( - 7(5 014- •7 D `I A o 1u � (. •� n [ NewC onstruction Use: Residential / Number of bedrooms _ Code derived design flow rate _ L/ D T _ GIRD ❑ Replacement ❑ Public or commercial - Describe: Parent material 1t1G ,. D V C.J° o Q - f Lti3 e, S Flood Piain e:evation if applicable General comments S S U c5 S�► pr - f 'C I`e h (.,• S �` G�" S I r and recommendations: S5 3 - T, T. Y ' Z S; : �,3 93.Sb SAr, d T. 93,S L M Boring # ❑ Boring ® pit Ground surface elev. _ 99 39 ft. Depth to limiting factor °Z� in. Soil Application Ra;v Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eft #2 ' - a S.L' �S�K ,, e .� -a b�i R `11 "�°`v y vn b k s - r4� V yl -I R`U 1 L E71 _ 10 71 Boring # Boring Pit Ground surface elev. _ /�JD ft. Depth to limiting factor In. Soil IicaUon Rata Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G ?D /tf In. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. 'EffHt 'EfftJ2 G a b b rig - : L CTS -sa 7.5 YAS/ F 7.51 �/ f S� W k CG 1 F 1 40 5641 7,51 0 5c� - D J61 ' Effluent #1 BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = 1300 _ < 30 mg/L and TSS _< 30 mg/L CST Name (Please Print So g inature CST Number a� - 7y Lo re ? f ss- Date valuation Conducted Telephone Number ei WW ' ;;' b 0 0 •. r ' Property Owner ( V Parcel ID # _ Page 4 df —Y F3-1 — - Boring # ❑ Boring 9g 58 Pit Ground surface elev. D tt. Depth to limiting factor CM In. Soil Application Rate Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color z Gr., $z. Sh. 'Etf#1 'Eff#2 0 -25 1 1bJ s Pe Q , IX -08 1 1 L) %I AM I L I L , S k- . w L/ I , to S b tau 7r� yR r QA F D �`--} v F -1 Boring # . ❑�ori g ❑ Pit Ground surface elev. h. Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff #2 a Boring # ❑ Boring ❑ Pit Ground surface elev. __ ff. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff #1 'Eff#2 'Effluent #1 = BOD, > 30 _< 220 mg/L and TSS >30 < 150 mg& ' Effluent #2 = 80(), , < 30 mg/L 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 altemate format, please contact the department at 608- 266 -3151 or TTY 608.264 -8777. SB O4 330 (a.6=) ti y , �t� Property Owner �~ Parcel ID# Pago — 4 R'_idt Y _ F3-1 Boring # ❑ Boring / Pit Ground surface etev. 1 .9 q H, Depth to limiting factor _1GM– _ in. ` Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD/If in. Munsell Qu. Sz. Cont. Color �, Gr..Sz. Sh. •Etf#t 'Etf#2 en ^-R- -- F-1 Borin . ❑�ori g # g ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO /tf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - EH#1 'Eff #2 F-1 Boring # C] Boring ❑ Pit Ground surface elev. __ ft. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1tf In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EB#1 'Eff#2 Effluent #1 z BOD > 30 < 220 mg/L and TSS >30 150 mg& ' Effluent #2 z BOD < 30 rrQ& 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. sao-uro (a.60W) 3 Sec» as Tag R19u) oew;J, 6 v ac, rE lo+ Q o p 1 �Sol s �.� i„ �1 be4 . k- koe {? s fie. e rn a o p sk:�� - rile c b 0 v- y;t(,3) o� ZJ a y o Of SI � 9 CP 4 L Q A t o V) l z co CO r � s W 2920 E HUQ, THE SE 1/4 OF THE SW 1/4, PART OF 114 OF THE S W 1 /4, ALL IN SECTION , IUNTY, WISCONSIN. LATTED LANDS _ — _ — — — — -- — EAST -WEST 1/4 LINE '37'56"W 1301.09 426.31' 230.43' (A LOT 10 }: 2.002 ACRES 3 N N 87,210 SO. FT. �`� :� LOT 9 `k c c') L.B.O. = 910.60 �.� �ry 2.004 ACRES , f m y �y'` 87,274 SO. FT. L.B.O. = 910.60 .... ........... . .... ms s? — 155.8x' . '�`-- �� / • �A' '37'56'W 334.58' iOBERTS LANE '37'56 "E 334.58' 6 \ C4 9 ' mil. \ •` C t � u . . . . . . . . . . . . \ DRAINAGE j EASEMENT LOT S cn \ \ .c. N IT 15 8 A3 \ .000 ACRES = c HW� = 908.60 921.50 z 44 E 87,135 SO. FT. V- 4J m B SEME E SEB ENT V^/ L. B.O. = 910.60 0 , DRPJNAGE 812 LOT 16 w l u 2.001 ACRES 1 I ACRES ` w87,160 SO. FT. .60 L.B.O. = 910 SVRVEVOR: PREPARED FOR: Ub"Cl•S Z.WIFA PROPERILS tat HUDSON ESTATES `" `•"° =uR��` LOCATED IN THE NEI /I OF THE SWI /I. PART OF THE SE1 OF —SRI/4. PART OF THE NW1 1I OF THE SRI /I. AND PART OF THE SWI 16 OF THE SWI ALL IN SECTION XR, TY9N. R19w.. TOWN OF HUDSON. ST CROIX COUNTY, WISCONSIN. OLAINAGL IAM[ TA.Iri yaw ..-x ..N.i ...wt� 1.01 l cAlL IN a.tt I UNPLAITLDLANDS wtr.NUNe P9 127S 1r M LOTH LOT I I LOT two y T»YT.t ntl .aq.a.a 11 .r....... Rr. ♦ s a .w o .4 LOT 9 [ >nw a..• l.uT9 3131 Y/3 — 110173 L S w w \ l st T /LOTS " s I _ \� ♦ LOTI3 � a ra LuT lu LOT 13 IL �O n Mestww / U y / [nsr[rr r �LOT 177 • S g � N — ., >., / p o .. ... ... SOT -4A N. rsu. m mua.o.rt S LOT13 -- ii v iui• � CCtl I �} `~ d' � :.00..cRe. — — — — .. � urr II � rsrav R 1 79 Lpo UNPLA_pgD LANU6 Y / tl ll LOT 4 Y a �Y. d� .s..w e 1'a / LOT i SEE SHEET 1 w.n...o... o�r.e... TwrN .w.wsuR.R c.n..r.a.[. Doc#- 7739(-1 .T. �O01WM.L.I..I. AID,ONINO � � ss M 1 m �. a ` . 11O1o` L " u '" i� a ue �� o � ,� �.� �: a �,��m...[w..,.1 •• ����� � �•[�� max: �Tn 3XtfT 2 01 2 3M33T3 0 4 GRAVITY CONVENTIONAL DESIGN Index and Title Sheet Owner Name: Water's Edge Construction Address: 400 S 2 " Suite 130 Hudson, WI 54016 Legal Description: NE % - SW % - S22 — T29N — R19W Township: Hudson County: St. Croix Subdivision Name: Hudson Estates Lot #: 10 Parcel ID #: 020 - 1450 -10 -000 Index Sheet Page 1 Site Plan Page 2 Cell Cross Section Page 3 Maintenance and Contingency Page 4 Page 5 Page 6 Page 7 Page 8 Designer: Ce a esk ' .M Signature: License #: 265824 Pl ne : "� '74,- 403 -0726 • ;iht9t Date: 09/05/07 Designed pursuant to: In Ground Soil Absorption Manual for POWTS SBD- 10705 -P (N.01101) } GO llry CA U a GO it :. s• _ o II I 11 c U H POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pa of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Water's Edge Construction Tank Manufacturer Skaw ❑ NA Permit # X Septic ❑ Dose ❑ Holding Vol. 1000 gal DESIGN PARAMETERS Tank Manufacturer ❑NA Number of Bedrooms 3 ❑ NA X Septic O Dose ❑ Holding Vol. gal Number of Public Facility Units ❑ NA Effluent Filter Manufacturer Best ❑ NA Estimated (average) flow 300 al/da Effluent Filter Model GF10 Design (peak) flow= (Estimated x 1.5) 450 g al/day Pump Manufacturer x NA In Situ Soil Application Rate g al/day/ft z Pump Model Standard Influent/Effluent Quality Monthly average* Pretreatment Unit X NA Fats, Oil & Grease (FOG) <30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) <220 mg/L X NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) :!050 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Manufacturer Biochemical Oxygen Demand (BOD5) i530 mg/L Dispersal Cell(s) ❑ NA Total Suspended Solids (TSS) <30 mg/L ❑ NA x In- Ground (gravity) ❑ In- Ground (pressurized) Fecal Coliform (geometric mean) <10 cfu/100ml ❑ At -Grade ❑ Mound Maximum Effluent Particle Size '/8 in dia. ❑ NA ❑ Drip -Line ❑ Other: Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 U month(s) (Maximum 3 years) ❑ NA X year(s Pump out contents of tank(s) X When combined sludge and scum equals one-third (33) of tank volume ❑ NA ❑ When the high water alarm is activated Inspect dispersal cell(s) At least once every: 3 ❑ month(s) (Maximum 3 years) ❑ NA X year(s) Clean effluent filter At least once every: 1 . 1 ❑ month(s) ❑ NA X year(s) Inspect pump, pump controls & alarm At least once every: ❑ month(s) X NA ❑ year(s) Flush laterals and pressure test At least once every: ❑ month(s) X NA ❑ year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer, Septage Servicing Operator (pumper). 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 a check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one -third (Ys) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) Page dF START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may impede the treatment process and /or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting 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) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: X A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name GJ Smith Excavating Name Phone 763 -441 -8888 Phone SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Name St. Croix County Phone Phone 715-386-4680 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter START UP AND OPERATION Page of . For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may impede the treatment process and /or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting 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) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: X A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name 7GJ Smith Excavating L Name Phone -441 - 8888 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name FName St. Croix County Phone one 715 - 386 -4680 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter . - I IIIIiI IIIiI illli Ills! hill illll lIII IIlIII IIII lili .3 5 '- 1 }11 0 1 State Bar of Wisconsin Form 2 -2003 8 52 110 WARRANTY DEED KATHLEEN H. ;9ALSH REGISTER 0-� SEEDS Document Number Document Name ST. [POIX CO ,, 14I RECEIVE[! FOR RECORD 06/07/20t)T 11:30AM WARRANTY DEED THIS DEED, made between Grand Properties, LP EXEMPT I REC FEE: 11.00 ("Grantor," whether one or more), TRANS SEE: 294.00 and Waters Edge Construction Inc., PAGES: 1 ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ( "Property ") (if more space is v Q r ban V needed, please attach addendum): Lot 10, Hudson Estates. St. Croix County, Wisconsin. V s eeo l a wz 5 y02 wil 020 - 1450 -10 -000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated 3 t �G Grand Properties, LP (SEAL) ` (SEAL) * *M MG anageme LLC, by Michael J. Germain, its Chief Manager (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Grand Properties, LP by MMG Management, LLC, by Michael J. Germain, its Chief STATE OF ) Mane er j I ) ss. authenticated on 1 O COUNTY ) L--- Personally came before me on *Kristine O land I the above -named TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who executed the foregoing (If not, instrument and acknowledged the same. authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Notary Public, State of Attorney Kristine Ogland My Commission (is permanent) (expires: ) Hudson, WI 54016 (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 NO. 2-2003 • Type name below signatures. INFO- PRO" Legal Forms 800- 655 -2021 www- infoprofbrms.com 1 of 1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer E j - L— s�o r G Mailing Address V Property Address (Verification required from Planning & Zoning bepartment for new construction.) City /State Parcel Identification Number LEGAL DESCRIPTION V i(/� / "1 Property Location /4 , (�/4' , Sec. , T N R W, Town of / Subdivision ) - �S� , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house (9) no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by 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/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I /we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bed ooms �/ �� / v7 SIQN URR OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) ` g 9IOVSIM'�H'ZDI s'p+nsawa wsz SNOLLdA319 S9.Ld.IS9 NOSQCIH OI #.L0'I — -0tlp 3�d Ilm 8 $ r -4 $ y a ON m i N oirofil Y.s 39ag sxgd e ff�y� 8 Q E3 4 O 000 � Q w z; -- 4 91M IA X 5'W9S a^Id ¢ NVId NOLLdaNRO9 SUVIa NOSanH 01# IM 90-MN" K 'nvxa/•X�m anon • AIW&LLIIIK • TYLLPa 99 OMp 39N 4mw ill ' Komnu i smoo aoaa sIdg vncm 3 x'41 o�15 a z 0 a a: LL .P.R .O.K 1 1 I I ' I 9 a 9 I 1 ....... ee..• � Q a I R I a I 9 I s I ....................... ............................... 9 I c I I I i 1 4 . ................................................ .................... . i Q ? f ,PR I 9100 TM -W-H zot —S W.-S -*G om kMd'IgMl NIM MVM MOSCUIH 01* IM - 90, HDNV)J IVWMA�OOIHon •A�.+Mnw -IYLI,KiMaw IBM i2 N w LL c � ? V MAja L L � J 4 wwlm'® H +MS �'WUS 9 a^lPd pZ6Z Nouxw /MCA aould S3.LV NOSGaH 01#.LmI 90, HONW ° - IVI w3YD*W ld1'M ATM � W•IVLLNGIM -0iM 39k � $ m o e 01 $ .. o 3r 8 E = 3 a a y ss 13 f i l l , $ A T a Y 9t O ng el Mr, - -------- - - - - -- - z n a a: Oy OC 8 4 w r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety anc4l3uilding Division INSPECTION REPORT Sanitary Permit No: 479253 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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 Parcel Tax No: Grand Properties L.P. Hudson, Town of 020 - 1450 -10 -000 CST BM Elev: Ins p. BM Elev: BM Description: Section/Town /Ran a /Ma No: P P 9 P 22.29.19.2880 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet i Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM 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 Yes (] No ] Yes LL] No u COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 642 Roberts Lane Hudson, WI 54016 (NE 1/4 SW 1/4 22 T29N R1 9W) Hudson Estates Lot 10 Parcel No: 22.29.19.2880 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required. [ Yes ] No Use other side for additional information. L Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) and Build' s Divi sion Cou 201 W„ Box 7162 be partment of Commerce I 6 -3151Q Sanitary Permit Number (to be fi ?led in by Co j I Sanitary permit Appisca Scat Plan I. D. Number In accord with Comm 83,21, Wi Adm. Code, persotml inter tin rovidI I may be used for secondary purposes Privacy Law, s (1) R�� Z � 0 5 _ NON ��+� oject Address (if differetit than mailing address) !• Application Information - please prul IAli Property Owner's Na me # �TZ Ru Q . S L,J4N6 reel _ _Lot / Block �' tz G Property Owner's M ailing Address � 71� /�• t 14 k � �'� �!'� / ,� ®D Aroperty Ltxatior. "— , City, State � ---- -� � �� '>d.Section .2 Zip Code � �ot:e Number Ilf. Type of Building (check all that a ppl y ) ;2V circle oyl R / B or , aJ Sue It"w t T Y; K1 or 2 Family Dwelling - Number of Bedrooms �_�_ Subdivesion Name CSM Number f n Public /Commercial - Describe Use J State Owned - Describe Use 1--- ' -'— -- -- - -- ____ ��City EVillagex of III. T - -- - - - -I _ ��cJ�/ Type- 4f Permit: (Che only one box on litre A. Compl litr B i f applicable) A. 020 - I�FSO (f} - p17b New System j Replacement System [; Treatmen 1. t /Haldmg Tank Raplacejiisnr only ❑ Other Modification to Existing System I f __ __ B ` Permit Renewal Permit Revistar O Change of ❑Permit Transfer ro ew List Previous Permit Number and Date I ssued f Before Expiration Plumber Owner R'. Type of POWTS System: (Ch all that Ix - Pressurized In- Ground ❑ Mound > 24 in, of suitable soil Moutul < 24 in. ot'suitable soil U At-Grade D-1 Single Pass Sand Filter Construcred Wetland ❑ Pressurized !n Ground C1 Holding Taril, iJ Peat Filter Aerobic Treatment Unit J Recirculating Sarni Filter Ll Recirc ulating Synthetic Media Filter _ Leaching Chamber {.� Dri Line ✓71 Grave: -less Pip [] Other (explain) ' isAersa /Treatment Area Information. Design Flaw (gpd) Design Soil Application Rate(gpdsf) 7 Area Required (st) - 1 Area Proposed (sf System Elevatio VI. Tank Info Capacity in Total�TNumber Ma,uiitcturer _ Prefa Site Steel T Fioer T � Gallons Gallons of Utei � Plastic New Existing (wlZubQQ onc rete Catutructrd l Glass Tanks Tanks Septic c >r Holding ' ia.tk - - - lzeA l w, �s e lerobic Tteatnunr Unit — Dosing Chamber Resp onsibility Statement 1, the Undersi a Plumber's Na v surue reso sihlUty for atio of the POW TS shown on the att plates. �r me (PrinQ Plumber's Si gnaturc P/ PRS Number — --- �� Business Phone Number � f lea s ,1 �zz Pa' -311 r Plumber's Addre ss (Street, City, State, Zip Code) � ` — �2 i VIII, Count /13e rtnlent Use nnl Approved O Disa Saturary Permit Fee (' eludes Groundwater Date Issued Issuin Ageri Signature (No Scamps) + I Surcharge Fee) [ 4 [7] n Reason Denial i I�X. Conditions Approv I Val l SYSTEM R; C'� t �- S �- 1 Septic tank, effluent filter and L dispersal cell must all be serviced / mein nihert • S �l c.QCtA,49,tS all per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable codelordinances, Attach complete plans (to the Cottny only} for the systew on paper not less than 5112 x ! t inches in size O � � n b CA k r 3 o �• 'C-C) ti Il k � U C;O P * 4 b o V ti s � U I \ r� lV PROPERTY OWMER: Grand Prooaties, LP SOIL AND SITE EVALUATION 120, pa of 4 PARCEL I.D.# Tom sc6miu REPORT MEMO Discontinuous silt inclusions were observed in 131 with redox features. The redox features in the silt are present because the smaller particle size of silt holds onto the water stronger than the surrounding sand, it even has a stronger hold than the force`of gravity trying to pull the water down. The water that flows into the silt inclusion will not seep out until the silt inclusion is completely saturated and cannot hold any more, then the force of gravity can start to make the excess water start to flow. This is why redox features (mottles) are present in the inclusion. The outwash sand that the silt inclusion is deposited into showed no signs of seasonal saturation or high groundwater. "" INSTALLERS" When a ilt inclusio (silt ball) is encountered, the chambers that are installed in the silt should not be counted. More Lt�he bers shout a added to the end of the trench in sand to make up for the lower gpd /sgft rate of the silt. This way gpd / sqft rate of the sand can be used and the tam is only enlarged as nee ed. 7 0 0 TE - S 1 —eb-,' ar S i � ✓\c�.�A,c..cS,.�S � �- e-2_G� .R.v`C:2�e�- n� -Q.�� p-v� � 's 1196 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest mad. Parcel I.D. Please print all information. Reviewed By Date Personal information you provide njwbe uaodtor sr�ary omooses ( Privacy Law, s. 15.04 (1) (m)). Properly Owner Property Location C Grand Properties, LP ; Govt. Lot NE 114 SW 1k1 S 22 T 29 N R 19 W Property Owner's Mailing Address APR 2 J Z 0 U ll Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 10 Hudson Estates City a Zip C , Pt"Yy rnber I City I village O Town Nearest Road Somerset ' Of%447 - 59 0 Hudson Roberts Lane je New Construction Dce: IM Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable NA General comments and recommendations: Area is suitable for a conventional system. Possible system elevation for Area 1 is (high trench) 87.0' (low trench) 86.0'. Slope is 6 %. 0 Boring # Boring Pit Ground Surface elev. 92.80 ft. Depth to limiting facto 108+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff #1 *Eff#2 1 0-8 1Oyr3/3 none sil 1mpl mvfr cs if 4 .6 .a 2 8 -19 1Oyr3/2 none sil 2fsbk mvfr gw 1f .6 .8 y t~lb /I 3 19-28 1Oyr4/3 none sil 2msbk mvfr gw 1f .6 .8 ( 0 4 28 -39 1Oyr4 /4 none sil 2fsbk mvfr gw .6 .8 5 39 -57 1Oyr5/4 c2 � 7'S /2/8 sl 2msbk mfr gw 6 1.0 57 8 10yr5/6 none grs Osg ml — 7 1.6 7 rule applies for redox features. Boring # A Boring �� jI Pit Ground Surface elev. 92.80 ft. Depth to limiting factor 109+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff#1 fl1#2 1 0-6 1Oyr3/2 none I 2fsbk mvfr as 1f .6 .8 �q 05 2 6-14 1Oyr4/3 none sil 2msbk mvfr gw 1f .6 .8 3 14-28 10yr4J6 none sl 2msbk mvfr gw 1f .6 .8 D 4 28-59 1Oyr5/4 none grcos Osg ml IDS — .7 1.6 o 5 59109 1Oyr5/6 none s Osg ml — .7 1.6 x( Effluent #1 = BOD? 30 < 220 rng/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg1L and TSS <,0 mg/l. CST Name (Please Print) Signature: CST Number Thomas J. Schmitt �.�,jC 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 4/13/04 715- 247 -2941 'trrsi - trial 1 0-9 1Oyr32 none sil 1 ll_, mvfr cs if .4 .6 2 9-14 1Oyr3/1 none sil 2msbk mvfr gw 1f .6 .8 . f ' Page 3 of 3 Conducted by: Conducted for: Schmitt Soil & Site Evaluations Name: Grand Properties, LP Thomas I Schmitt, CST 227429 Address: 712 Rivard St. Suite 100 1595 72nd St. City, State, Zip: Somerset, WI 54025 New Richmond, WI 54017 Phone: 715.247.29 1 Subd. Name Hudson Estates c•- Lot No. /D NE 1/4, S[R/ 1/4, S: 22, T 29 N, R 19 W Towns? o£ _Hudson BM El. 100.00' A✓c A/ 4° Alternate BM El. F_? 6 ?Zo o , ,. /' Slope = % Contour Line El. /V A Scale: I"= 40' Ir 37 fl 6T3 Age �� >> Q3 9l 9 This soil report was done to fulfill a Zoning requirement. It may or may not be in a location that is suitable for your use. No permanent lot markers were in place when the test was conducted. �► - -- . . 4 N .fit ^ . 4�, CI : �rE Pr Pr `12" ylrr, 1$ ` FROM DOUR - ;- ABOVE GRADE b 4CATHFRPROOF FRESH AIR INTAKE N ;N�iQW OR JUNCTION BOX A PPROVED 'd:TH CC�mr -r MA. F0LE C'OVr1 F'IH "xSHE GRADE W1 PADLOCK 8 4" Cl R W RISER WA RNING ... G LAB t � of �" TiG`ri^' EALS i � WA.I'R S i .. + ° ..,.:.' ' GAS- a TIGHT F ` ,,�,, A SEAL I PO %PPROVED i JOINT$ WITH 'IpE 3' B ALM APPROVED PIPS XTO SILIo `ON 3` ,ONTO �dl•�. C ' i ++ SOLID: SAIL &PUMP OFF' ELEV . FT. ......OFr ' ; « RISER EXIT' D PERMITTED ONL! IF TANK MANUFAC7J3ER 3" APPROVED BEDDING V.\DER TANK HAS APPROVAL � OUN�RETE FAD SPECIF:CATICi�5 SEPTIC r Don . A.VX MANWACT'JRER : t.�er t:UMBER 40S£S PE R DAY: a� SIZES: SEr"'"'IC o� GAL. �- .. DO S- 1, VC:�J.�E 21�G�'�JD1"NG DOSE oo '""' GA.:,. FLatv$ACK: ..GAI- %LARM MAITUrACTURER: MODEL bliMSER: - CAPAwi «I ES: A eficv s *�.......�AL. SWITCH TYPE:..: g s 2 MANUF'ACTVRER; � ...... C MODE; NUMBER: ,� .,. INCHES GAL. SWITCH TYPE: INCHES ; GA L, EQuiRED DISCwGE R.AT �p PUMP ALARM k , ► '. R,I NG AS . ER I LIiR 25.23 wA ERT CAL DIFFERLNCE HE. OFD' AND DTSTRIBu- FaPE MINIMUM NETWORK SUPPLY PRESSURE . . rEET FEET FORCEMAZH X ���'c7 FT / , , . * . . 0 . FrET lOQ F:. FR. ?.," FA TOk 4 DYNAMIC MEAD "o DIMr AZT pUMp r �♦ L: . ER PUMPS E4 GOULDS Submersible Effluent Pump 387 EPO4 EP05 APPLICATIONS • Fully submerged in high al EP05 Impeller. Thermoplas- r Bearings: Upper and lower Specifically designed for the grade turbine oil for tic enclosed design for heavy duty ball bearing following uses: lubrication and efficient improved performance. construction, heat transfer. • Effluent systems ■Casing and Base: Rugged • H omes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion c�usdiao sta�,�soaaoon • Heavy duty sump matic models include resistance. • Water transfer Mechankal Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "F" or "C ".) factory, strength, and durability. SP ECIFICATIONS ■ Motor Cover: Thermoplastic Go" rumps Is ISO soot AeOte . • Solids handlin ca bil' FEATURES cover with Integral handle and 9 pa ny goat switch attachment points. ' /'° maxrmum. 6 EPO4 Impeller,. Thermopla5• IIIIII Power Cable: Severe du • Capacities: up to 60 GPM, tic Semi -open design with duty • Total heads: up to 31 feet. pump out vanes for mechanical rated oil and water resistant. • Discharge size: t' /r NPT. seal protection. • Mechanical seal: carbon. rotary/ceramk-stationary, BUNA -N elastomers. • Temperature: 1041 RK) continuous 140°F (60°C) intermittent. METERS fee* • Fasteners: 300 series 10 r — ---- stainless steel. , 9 - �► -- •Capable of running 30 5GPM �"'`"-�' dry without damage to a 2.s F► I components. Motor: i • EPO4 Single phase: 0.4 N17, >` zo M . _ 115 or 230 V, 60 Hz, 1550 s RPM, built in overload with automatic reset, 41 • EP05 Single phase: 0.5 HP, fPCs 115 V, 60 Hz, 1550 RPM, .. �._. built in overload with automatic reset. 2 EPO4 ._ • Power cord: 10 foot standard length, 16/3 . 51TOW with three prong L _ grounding plug. Optional 20 ° ° 0 10 xo 30 ao . . so Gvrv� foot length, 1613 S1TW with three prong grounding plug o z a a a 10 t 1 M (standard on EP05) CAPACITY Goulds Pumps t 2000 Goulds Nmps ITT Industries Erfeaiva Fetbruary, 2000 93871 ��. u►�ck4nw STANDARD CHAMBER — 52" — — Quick4 Standard Chamber -- 48" (EFFECTIVE LENGTH) ems/ - _ �1 i l r � 12 t SIDE VIEW SECTION VIEW MultiPort End Cap - - -- _ r — — 34-1 - -- SIDE VIEW TOP VIEW FRONT VIEW eY & ;u t �� >Quick4'Standard Gh�mb�h �Voml�al Speciflcatlors MuitiP�prl,�nd CapsNomigal Specifieations° �" ; Effective Length 48" Invert Height 8" or 1.25" Invert Neighs 8" _ INFILTRATOR S INC. STANDAgD LIMITED WARRpN ;a T.e SIr al t la{, 't; of N- }chamber end s,Sto P4i1 , rigrr a xl +hwr a x • Sury rnarlulac"tn3d U I kllrein "U '! 'J, wn n. irrelallecl And n of di1 of an - uc anCt c m in ec dah�e w It IMilydlnr s rrrstruclihns, is warranty d tc mo on I e petaled + )1 - 17.1 r uer at, and wn k sl it. &,. - ~ N_ the dak. Il:aS the _I k: g" rwrct ( "HokSa 1 xia.rMa ,laler.:tiva rI at I a Seplif. (eI'lllf c nut ferjtWed paIlrrl I9 rssueu 1, inn• neptrc 5y51H1n ctrllalll,ly' Itw Llnll9; UIOYIdtld. lgW9rH. try dPplk.able , pw, the Wy a N' pBlkr) Nitl pe[rNl upon , he dafo that Illata�L In 01 Tile Se {fC 8 /516n1 fA'11nlenceS- 7r a rcise i ts wa ra Ny nghls, W)k19r must iofity !nfifiralur I, l aI Ilc (;MWra:e Haacklu.alert; LI Oict Saybrook, Core(. A Lr w+!hnl fifteen N5) rJav nl tl C dlaypi A.fn'1 Irdardtor li supply <placemsr 1 unls for Urnts detiar ined by Infiltlai v to be covered by ohs Lhlaa i w -arty, , • r it +nrn!cr51ki6 Ry sperdl �aMy xcludas lhe,ast af+emoval arxly nrtrStaJatum ur Ule Unls. [Ili lh F LIMITI - D WARRANT ANC) REMFDI IN SjBPARAGRAPrl ta) ARE f1COL1, AVE If N_RF ARL• NO OTHER WARRANTIES WITH RESPECT T JN rb, INCLUi. 1I NO IMPLIED WARRANT ES OF M RI,HAN A6ILIT1 OR FI N1-S FOR A PAHTiCUTAR PURPOSE, SYSTE /� S I n f C (c} 7 hi dnile7 W Irretl shall b vG"t I' any pat of r e cherJoe system I m tnt' aciura oy ."`yor o e r"a than 1111dlr. dor. The Lirlllka Warranty rings C I v' I v o And pro nc Int her .w ix t e4E,nd Io irr de 1taf. C'nnsMlttanttal. Spgcaa v ixfirect da Wages. ih or a bran not tm Ia17e Icx prAtal r.: or riquldatect damaye , ik.dn� II d �11V�'OfifiBll'(i11 Q1JF11B tNa$�ef+Yat� )10I And Ldxr and rnaleria s 0-I II, Co.,' ts, ot bases or exlwnses n�cualtt try the HG3 it a w third party S , Wviticapy exc kr,led Lrnilni Warranty CirvFXatie a!e damage ]0 the iJnilS due to ord r�!y ') and lean, aaeratton, amldeM, Misuse. aouse or f letil Ct d 1''e U. nt Isar U'r rt5 t-no su6lacted to vphs;le 1rafliC or other catdiBCxts wh cl ire not mlttn-r by the nalaftalron i tsvur dolls: fl In rnaintaul the 6 Business Park Road " P.O. Box 768 , r n.r um ground c0wrS sal forth in the installation nstrt:cfrl the Plane Want of epm n to tils into the system rxmlaining tho Undo, lature of hrr units or the soot,_ system d,o to improper 0I or 6 ria, g, e..s- warn, sag I nc, � gmas lsal, e disc or imp .nor �atm: a Old Saybrook, CT 06475 �mY dher event not causetl t)1' kraltralor, m tact This Li Warranty ,two be veld U the Hillier Ie 1S to c-I -th all of the terms set forth In, this UnI b a arty. 860- 577 -7000 " FAX 860- 577 -7001 F" 'li in no even ,d 1.141 aror bo respwtsitLe Iur arN 1 or +lamage to U Holler, 11'a lJ its, or art rood Parry rast+kin7 (runt installation or ship- Q roar t all or Iron, any C odr::,N stab sly clarmS of Holder a arty ttird party. For rs IumiteYJ Warraln y 10 apply Ire Units must he inSI in acrordame 00 221 - 4436 wilt site cond Hors required by ala!e and'ocal r;odes; all 01,1I apolipW[ Ia; v and I. rk. aln Irts7a6WVon instructions. Q =,di No representative of infiara!ar has the a thurf'r In change or owerld th'r_c Lull 10 Warranty Iwo warty applies to arty party other liters Ire orsr 101 Holtler The abuvu 2PreS�nis !ne Sldruhrd Liniitea Wanardy oNsrerl by infitralor, A 1-, lx: Hurdler cr s41es Ana couooies have oirfyeru wanarYy rrxtuint- rnalts. An ry purclasFl of Ucds Snuuld conlacl InfiFlrator'9 Corporale Headqudrlers'n Oki Saybrook. Ccrnxa %Jt, Pro, to SuCh purchase, to W)tarn e copy of 1!te applicable warranty, and shoukf carefvly recd that wanon!y prior to the Pm;hase ul Unts. US Pate ts: 41,759,661; 5.01 5,156,488; 5,336,017; 5,401 5 4U a9; 5,511 UO3: 5,716,163; 5,588,778; 5,839,844 Canadian Patents 1,329,959; 2,004,564 Other patents penduu, InNholo Equa,;Zer and aldeWfndor are registered trademarks of I fritrator Systil Inc ;nfl ra Gr is a registered trademark in Franca. Inhitrator Systams Inc is a registered traderrark'n Maxzcf. Contour, Contour Swvei Connec,ton Mlctol-eac ,7 Poly uN,. Snapi ChamberSpacer, PosiLOCk, OOckCut, OuickPlay RECYCLEDPACER n,.r ;l,u .;4 am h- banner "e r,f _I__ I_ ,F1 —I Lr .r,._ n. I- - � . POWTS OWNER'S MAN UAL & MANAGEMENT PLAN Page of FILE INFORMATION Y Owner TIM SPECIFICATIONS Permit # q 2S Septic Tank Capacity z j al 0 NA 1 's Septic Tank Manufacturer 0 NA OESIDN PARAMETERS Effluent Filter Manufacturer / 13 NA Number of Bedrooms 0 NA Effluent Filter Model �Q' d NA A Number of Public Facility Unite, Pump Tank Capacity al 0 NA Estimated lbw aaverage} Pump Tank Manufacturer �r �, O NA Wa Design flow (peak), (Estimated X 1.5) al/de Pump Manufacturer � „,,..,� j p NA Soli Application Rate hump Model ai /d hzs 0 NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit 0 NA Fats, Oil d Grease (FOG) S30 m g/L 0 &lord /(3raval Filter d Peat Filter Biochemical Oxygen Demand ISOD $130 mg /L O NA 0 Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfecti a Other: Pretreated Effluent Quality Monthly average Dispersal Call(s) ❑ NA Biochemical Oxygen Demand (SOD,) 530 mg /l. 0 in- Ground (gravity) ❑ in- Ground (pressurized) Total Suspended Solids (TSS) S30 mg/L Q NA © At-Grade (3 Mound Fecal Collform (geometric mean) S10` cfu /100ml q Drip -Line Q Other: Maximum Effluent Particle Size K in die. Q NA per' DNA Other: p NA 0 NA 'Values typical for domestic wastewater and septic tank effluent. Ott 0 NA MAUNTEIiIANCE SCH OULE SerAce Event Service Fregmoy Inspect condition of tank(s) At least once every: 3 a a s, (maximum 3 years) C3 NA Pump out contents of tank(s} When combined sludge and scum equals one-third (14 of tank volume 0 NA Inspect dispersal cells) At last once over y ear(as) ( Maxmum 3 yews) O NA .� Clean effluent filter At least once every: onth e) 0 NA ear(e) Inspect pump, pump controls & alarm Al least once every: months) [3 NA Flush laterals and pressure test At leant once every: •-- 0 marlsl thla) 0 NA Other. month(a) 0 NA At fagot ones every: -� C3 earls} Other: Q 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 Maintalner; Septage Servicing Operator. Tank inspections must Include a visual inspection of the tankla) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to shank for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to chock 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 tY,) or more of the tank volume, the entire contents of the tank shall be removed by a Septago Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All ctliir services,'eickrding but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intst4als of s7 2 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completbn of any service event. Page _ J of START UP AND OPERATION I, ' For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dlsper$41 cell(s), if high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at they infiltrative surface. During power outages pump tanks may till above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal call(3) in one large dose, overloading the call($) 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; far foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides. meet 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 bhaptor Comm 83.33, Wisconsin Administrative Code: e AN piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. e The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. e After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: 51 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. O 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 retort to replace the failed POWTS. �� © T slt d site e tar am Piali 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. < <WARMNO> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN I.FTOAL GASSES AND OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDOR ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name , 4 /r l^ Name Phone C Phone SEPTAOE &ERVICINA OPERATOR {PUMPER) OCAL tIULATORY AUTHORITY Narnel Name ( C9-C IX Phone Phone This document was drafted in compliance with chapter Comet 83.22l21(bl0)(di&(f) and 83.5411), (2) & (3), Wisconsin Administrative Code. 06/14/20215 ©S' J _715.'413624 IFROM :SCHUMAKER 'PLLMB NC5 FRX No. i53663I 21 JAn. 14 2005 10 :d'2 aM P1 a, SBMC TANK MADaMAKM, AGREBMM4T AND OWNR$HIP CERTMCATION FM MsdUAShddreea, PrW" Adds „2 boa 6mm PI-* DW mw ft ww aotmueton),,,, Gtityl9eat� Portal Idioditeston M=bor Ozo —lV - o — Z uD hopoly E408dpA y�,s sv) /�� Seo. a , T2 J 9 � Ton of d ik d- D A� - �. - -- IAt 1.. COMAW survey Mop 0 va lvma Pa # irrrowty I1eed Volute Sim houm a YN 0 no Lot UM iderttifisbu'tryet 0 do AU33M = IMIOM mAbftI M9 of YOW Mp6r gswm wv3d nadt in ib ptw"tum EbjkM io h*A& wps I,hVpaUwnhw&Uw cao erect p �u►otiao of � tank every 6M Yvan of somr, if U@6d by a 4MW py , WU yot� pyt iM Iht qd= Wk u a veftat &V in true ware diepaotl rion 710 PV* ease a t ro submit to SL Croix Z=j DVugMt n ese{f adm 6= sIpW by tiw awnu and by a �rWnylaer,'wWk4 d pkmA*r act tnr<.a"Prmyt v IfYins dat (1) for a&tia wirm*ww4b pwW +9srem is t &PMtWX ooeditW* anWar (7) after hwp6 rctiae a,d pumpuSS (it ee40a g y). da wptiv auk is is" dws f a On of adop. Y" thA► met! boys and the *QT§ NVi sb Ud AP" to Mlbbdn 69 private sewW 41qoW sy0sm with the siaaft& +aet lotth. bezdn, �! nis by the DqwbM ofO+t trOO ad ON D"tt dW o(Nowtj Ilawas , ftw ofWicatsiL OpOlks6oe 69 You k0c r *m baa bw wimiaw mud be camplakad wA mto W 10 dir. It Cp iz C=W Zoe* Offm wbbm 30 days of At ttuae Year aqdmdm d a MKA OF APPLIC DAIS r t ( ) * a!1 WOM oat ddb toms IM etas to ebe bM of rity (OW) b #*, i (We) wp (IM) die tnvaer(r) of At p ?%7 dooribed above, 6y ruins era vrAmcsy daed reowW sn Rgisityof ON& Of fix. DATI AA)► iffOtlCls4q'It tiW iii Sept WWAd sway MUU in the tau. VY pstWt bciag rovokW by W UWM eVenwat. 1 1 # 046 4 �• �dade with ilde npptieottea; o #*Aq d "= daed from d W lsi ft of D"6 +ofide a WW Hw aweiiiad &MY M " ' MW&W is MWO is #too MKTMO load U 2 4 8 7 P 1 1 3 752tc9 37 � STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS This Deed, made between Willis D. SavadKe. RECEIVED FOR RECORD Grantor, 01/07/2004 11:15AN and Grand Properties, LP WARRANTY DEED Grantee. EXEMPT # Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin TRANS FEE: 13.00 TRA FEE: 3240.00 (if more space is needed, please attach addendum): COPY FEE: See Attached Exhibit "A ". CC FEE: PAGES: 2 Recording Area Name and Return Address 9 �I 020 - 1058 -80 -000 020- 1059 -00- 000, 020- 1059 - 10-000, 020- 1058-90 -0 00, Parcel Ident Nuplber (PIN) ti� This C? homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this _ ` day of W illis D. Savadg - AUTHENTICATION w Z C KNOWLEDGMENT Signature(s) STATE OF ) 5 1 ) ss. 4 County ) authenticated this _ day of _ Personally came before me this day of iA the above named Willis D. Savadge, SA TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ ' td mown to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) _ ; . nst"nt and acknowledged -the same. 0 THIS INSTRUMENT WAS DRAFTED B • • r , _ Attorney Kristin Oglan Hudson, WI 54016 �'�i • S1N • � tary Public, State of ulu� -- My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) * Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Ford du Lac, WI STATE BAR OF WISCONSIN 500 -655 -2021 WARRANTY DEED FORM No. 2 -1999 i U 2487 P 114 EXHIBIT A That part of the SW % of Section 22, Township 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin described as follows: Commencing at the SW corner of said SW % of Section 22; thence N89 0 51'27 "E, assumed bearing, along the South line of said SW %, a distance of 1298.51 feet to the point of beginning, being the SE corner of that certain Certified Survey Map recorded in Vol. 15, Page 4192; thence N00 0 32'31 "W, along the East line of said Certified Survey Map, being the East line of the SW % of said SW A a distance of 493.73 feet to the NE corner of said Certified Survey Map; thence S89 0 48'23 "W, along the North line of said Certified Survey Map, a distance of 31.25 feet; thence N00 °32'31 "W, a distance of 1447.58 feet; thence N89 °41'03 "E, a distance of 31.25 feet to the East line of the NW % of said SW % of Section 22; thence N00 0 32'31 "W, along said West line, a distance of 690.94 feet to its intersection with the East -West quarter line of said Section 22; thence N89 0 37'56 "E, along said East -West quarter line a distance of 1301.09 feet to its intersection with the North -South quarter line of said Section 22; thence S00 0 29'07 "E, along said North -South quarter line, a distance of 1318.71 feet to the SE corner of said NE % of SW %; thence S89 °4441 "W, along said South line, a distance of 649.90 feet to its intersection with the West line of the E % of the SE % of said SW % of Section 22; thence S00 0 30'51 "E, along said West line, a distance of 1317.44 feet to said South line of the SW % of Section 22; thence S89 0 51'27 "W, along said South line, a distance of 649.27 feet to the point of beginning. > IT W-T de y r .' a •a �}n, ,�� `w �',I s ,� �. r : E 40 O F r r s ter. o of ` r�s�r o,� err s�►�' t x s U �. 1 01V ►11i� ` ST. atoir GAD UNPIATTEDIANDS O%s Alp Uff 11- LM 10 prow 6a Fr. tAOi ��aw _ s•MS ��oMS � 4w f 9 Mo • ;000 ♦ ,r • • �rsalak�^?�k3 .. . 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