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HomeMy WebLinkAbout020-1472-00-0034 0 ~ ~ m o ti w e 0 0 N ~i ti i 01 •O o~ OA'1 '~ O •~ O N }~ v .~ }~ y •~ ~~ V ~`I~i _1 v 3 ~ ~ z rn N 1N-• fn C C7 O Z '++ ~ a- y H r y W >c m v U r~ 'a to J U ~i O CC W eo EO 3 F- ~ C N ~ N 2 ~ a a d •~ 'c tia~ A I ~ o ~ ° ~ c I I I N I I I ~ Z C tL C O 3 ~ I a 3 i° I I a~ Z w E I c m I O ~ ~ rn L c a~ O Z c ~ E ~ ~ U ~ m N 7 .= ~ N ~ N N `p c c O a m . ~ '~ I Z C Z ~ I ° E z ~ _ ~ ~ I _ N ` O d y r ~ ~ ` ~ C O ` ` o E °- I a a . r r U ~ I 333 °-c n o I a a a z y I I N N ~ 3 O N ~ ~ ~ Y O O - - ~ ~ ~ m p c a I ~ 'o ~, Q rn ~ d Q Z lA co I H ~ H C N C a $ E ~ I ~ N ~ ~ C N C • ~ N C ~ t6 N ~ ` 7 ~ C 7 M d ~ ~• ~ E C 'S C N OD r vivo z° Na Y ~c°n I :: € I ~ a I d a ~` c :: ~ ~ ~o O in v 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 Holders Name: City Village X Township Se uin, Jess Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER ~ ~ PL•SLS' ~ ` CAPACITY Septic Wl~i ISIS Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic > ~ r ~+ Dosing Aeration Holding j PUMP/SIPHON INFORMATION Manufac urer Demand M Model Num r TDH Lift ction Loss System Head TDH Ft Forcemain ength Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. C~OiX Sanitary Permit No: 488300 ~ State Plan ID No: ~~ /V' ~.~---- Parcel Tax No: 020- I~172 - ap - o'D3 Section/Town/Range/Map No: 22.2s. ~ s. zyG STATION BS HI FS ELEV. Benchmark S 3 3 S• 33 ao .fl Alt. BM Bldg. Sewer . a r 0 .3 SUHt Inlet ~,~.p ~7~.93 ~ SUHt Outlet . ~ ~ R~- 63 Dt Inlet Dt Bottom /" / Header/Man. g Bot. System Final Grade ~ 99 63 f St Cover 2•~ 02. RENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM S t 3 vty''riL°S ? J) SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufa~u er: INFORMATION CHAMBER OR J-N L-TR-~ Typ Of Sy'te~~~ VV ~ ~ ti > ~.I ~ ~ UNIT Model er: DISTRIBUTION SYSTEM Header ani Id. ~ P Leng Dia Distribution ip (s) Leng Dia Spacing x Hole Size x Hole Spacing Vent`to Air/ In~takg / , ~-~lJ SOS COVER x Pressure Systems Only xx Motind Or At-Grade Systems Only Depth Over Depth Over xr. Gepih of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ~ No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ''~"`t.P~/~~ij Inspection #2: Location: 834 GermainCLane Hud~s~on~,,,,W~,IQ~54016 (SE 1/4 SW 1/4 T29N R19W) Cedar Wins - arcel No: .29.19. 1.) Alt BM Description = S• I ~^'"""`'"" "~ C~'C~~6~-~-~~ ~ ~ 2.) Bldg sewer length = ~ ~~D ~ )p, p „ q~{:R3~ - amount of cover = (~ p ".-(- , C;I ~ -`' ~ ~~ to ~f = a S ~~ Plan revision Required? ~ Yes ~ No _~, , 7± • 3fl / ~ /_ ~ ~,~ I~' Use other side for additional information. '~`~ ~~ - SBD-6710 (R /97) Date ~ Insepctor's $iur@tur~ ~ - ~ Cert. No. ~ -- - -- _ __--_.~____. ._._ __ _._~-_ _ .___ -aafety and Buildings 1~ivision ~~ ~ 20' W. Washsngton Ave., ).0. Box 7162 l 716? WI 53707 ~ County l ~ !/'Q , ~.~ ir Number (to be filled in by CoJ P u i - Madison, ~~~~~~1~ Deparfrnent rf Commerce (~S)2Ci6-3151 ~ ----- - - __ ____.___. _.-__ _L___- ~. _ __.__ _-- erm tary n ~n ~UQ_ Saa~itary Permit Application In accord wi:fi Cotnrn $3:21, Wis. Adm. Ctx1e, personal informed u de State Plan LD. Number ~~~ _._.______..~.~j may he used fbr secondary purposes Privacy Law ) rojact Address ( different than r.~~ailm address) ~I I. Application Information - I"letase Print All I nta ~QO6 ~ ~,,~ ~ (,~ ~~ yy-Z~,t,~,i Property Owner's Na me P~A~j O ~-~ ~ Far Lot # Block >a V X~ ~' ~ 3 o~ ..._ _ --- ~~s _~u_t~ Property Owner's &i atimg Adt;r:;ss S operty Loc /~ '~~ ~ ~~ ~k's~ '/a,Section ~ 2 ~ ~ ~ ~ _ p Code Phone Namher 'M'iry. State ~ ~~ q~ rl'trCi2 0 f. J C D ~ `L ~ ~ lI. Type of Burlding (check rail that apply) ~~~ -. --_ - ~2~~ Subdivision ?Vann. CSM Nurrmtrer ~ ` G i ~ ~, 1 or 2 Family Dwelling -Number of Bedrooms _ _____ _ i'ublic/Comnter~ia! - I)r_scnbe Use _ _ _- .,~_~_ __._ ___.____- _.___ --"- L i State Awned - De,:rit~: Use ~ uCityr~~Veiiag~Township of~~,1'G:~P~' i ___ _ _._____._ __ __ III. Type of Permit: lf'heck only one box on line A. Complete line B if applicable) _ . ___._~___. -- 7 --~ --~. -_._ ;__.__ -.---- New System l ^ Replacement System L TreatmcntlHo!ding Tank Repiaceutent Only I L_' pcher Maiificatiou to F.xisru ~, System I _ _ _ _____ ~_--- - - ------- ` D. ^ Permit Rentwa~ 1~ Pertnit Revisior: ~ ^ Change of ~ L~ Permi¢ Transter m~ ist Previous Permit Number and hate Issued -~ ~ f . Plumber ~ Owner Before Exptratto>~ I I IV. T~ of Pd~'TS System:~(Check all that apply) o~ Q/ST.. C.~:~/1!_1 ~~ ~w~~`'~'~"""`~=_--_-_~___-~ ~- - ~Non -Pressurized In i'Sta~nd i.~ Mound > 24 in. of suitable s;ril ~ lvlound < 24 in. of suitable soil ~.~ At-Grade ~ Single Y•ass Sand filter j 1 ' _) Consiracted Weiland i_. Pressurized ln-Ground ^ Holding Tank ~~ Peaz Piper i~ Aerobic Treatment Unit i~ Recircuis?:ng Sand Filter l 1 Eff. _ nw_. '~i na.. r : I-; n.~.,el..lae.~ Airw ~~ : uhar lwv n(ain~ ' n ~ f rV. Ais rsal/Treatar~t~att 4rea Irtformatian: _~~-Qet1~~ r1!~r r .__ (gpd) Destgn ~?91 Application Ratetgpdst) Dispersal area Required (sfj I Dispersal Area Proposed (sf) System Cle. •.:inn 1 Design Flow .f _ Manufacturer Prefab Site Steel ~ Fi}yer P1ast ~ l N b i T ~ VI. Tank Info n ota Capacity _Ga_1cns Gallons _ ..r ~ um of Units Concrete Consuvcted ~ ~ Glass I _ - f ~:p[ic or Hoiuiag Tank ~ Existing New T :nk_c ~ Tanks _ 3 ,(_`-q ~~.___-_. ~ f ~ ~/ O~ _ ~- ~ _ / ~~ ~`_~- - ~ __L,_-----ter--~ ~`SCy -- ~ ~ -"--T-- l -- - --- --- - I `-- _ ~ Aerobic Treaunent IJnit i _ __._._._ __.__ _...__.- Uosing Charnt~er ~ __'t'~-~_ - ` ~ ~ ~ _~ } - I ~~ ~ . -~ j..__ __-~ ~~ ~ 1 e.~,B ~ _ ~ i_~ I ___ _--___ ' plans. on the attar hed ae respoaasibility for ' ~ llation of the I'OWTS shown VII. Responsibility ~tatenaent° 1, the a r~~iga,ea, dss r's Na me i:Print) - Plumber's Si gnature^ -~ '~ _ 1PRS Numixr ~ Business Phone Numbs Plumbe O ~,r~~ L r K ~l S~i~s e~'S/' ~ ~ •-;7j77Qp~ 1..?l s ~~C n 3__~ '_Z J- ~ Plumber's Addre ss (Street, t=i::J, 4tate, Zip Crxie) d .~O'./t~ / ~ ___ VII .Count /D8 arina_ent iJse ()nIy _ -_ ~ ~ -~+T- ~ - tamps] suing Agen Sign cure ~ TSanitary Permit Fee (i odes Groundwater Date Issu~ ~ Approved L Disapprt Fed ; ~ ~ c Surcharge Feel L / 0 / I ~ / ~ -- - - - , g~y O ~ _~~ 7 v / l~ _ _ ~.i Uwner Given Reason far Denial _ -~~.^L.--- ~ ' I.'~. Conditions of Apprrsval/Reasons for Disapproval ~ ~ ~t r~ ~~ L-J SYSTEM OWNER: v~,~~~;~ S' ~ /,(./TS (/1'1 ~ ~ G~~ 1 Septic tank, effluent filter and i dispersal cell must all be serviced /maintained ~ ~~~d ~~~ YtLG~h~ -~ 3 ~ ~~• 3 I as per management plan provided by ^lum6t?c ~ ~ o ~ ~ ~-„ _ ,0 E z. All setback requirements must be maintained as par applicable code/ordinances. plans County only) for the sjstero on paper not less than 82/2 1 inches in size ~ ~~ ~%/ Ze ~-S ,.111 ~ ~,s!'~ lad, ~ ~~ ~'~~ ~o~ . ~ ~t ~~~p ~ ~ti ,1 a~° .~ ~ ~ ~~ ~~~ s'~ ~~~- o'\~ V' ~~ ~<~--~~yl~- jnp aa~9Q4 dji' `~ eG ~~ s ~.s--~ ~, se l1 ~- ~_--- ~~1 ~~ ~_ u - ~ • Wisconsin Department of t;om erce SOI A N PORT Division of Safety and Building r~ ( ~ ~ ZQQ~ ~ 'i1f accordance with Co m 85, Wis. Adm. Code u County ~ ~ , Attach complete site plan on aperl~(t~(~icT'M inch sin size. Plan must direction and int BM) l f parcel I O , erence po re indude, but not limited to: ve cal a o zonta scale or dimen i , ~ and distance to nearest road. ercent slo e . . p , p Please print all information. ewew Personal information you provide may be used ror secondary purposes (Privacy Law, s. 15.v4 (1) (m)). Properly Owner Property Lon~rinn • ; ,~~ ~ ~~~1 rt Govt. Lot ~,}~, 1/4,~~1/4 S~ property Owner's Mailing Addresses j L # Block # Subd. Name or ~ C;liy (. 51w1' State Zip Codef Phone Nu~tmbe/rte 4#~~ i .~1 ~v.~ i1 ,I ~4a ~ ~=.~ Tli 1 _ I (Rl t J .c ~E^. ~~ ~ ^ C~ittFyJ Village Town !/ ~.i:-~/.yt~~ __. Page / of ~r- D~~~~~ /~~ !`'V ~t~ ~Dat d ( V~ T pt. N R~ E( ~ S ~~~~: Nearest Road I ~rm r~ ,-~,. >.. oe~ New Construction Use~Residenbal / Number of bedrooms~~ Code derived design flow rate ~'~.~/ ~ -_ GPD ^ Replacement ,/~ ^ Public olr com~raa~l.- scnbe: ------ -- j~ Parent material ~/ lc/a-~~ i L~--- Flood Plain elevation if applicable ~~~ ~'7" ---^---- ft. General oonuner>is and recprnmendations: ~~~ ~~~s7u~ ~,-~.~a~ ~~ ~ s~~~- ~le~ 95.E ~~~t~ U Boring ~ / -~ Boring # ~' Pit Ground stuface elev. fO ~ J ft. Depth to limiting factor in• Soil igtion Rate t T Structure Consistence Boundary Roots GPD/fF Fbrizan Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color ex ure Gr. Sz. 5h. `Etf#1 `Etf#2 Z 0 ~1 -~ D ~!-~ D ~~ -~- ~~ ~ ~. ~ ~' ~ ` .~ t-1 n anririrs ~. ~- ~i U e°nr>9 ~ - it Ground surface elev. ~ ~ ft. Depth to limiting factor r^• Soil ligtion Rate B d Roots GPD/it? Hor¢on Depth in. Dominant Color q MunseA ~- `I ~ Redox Description Qu. Sz. Cont. Color ~ - Texture S Structure Gr. Sz. Sh. ~5 G Consistence /-~ ) oun ary ~ o n. •Eff#1 ~7 `Etf#2 . ~, _ - -- • rm ..__..un . CAI" 1 ~ 'in nv~A 7nrl T.t'S < ~ r1o1L • Effluent #1 = BoU > su < ~ mgrs. arsu i a~ -a, _ ~.,~, ~~ - -- - - - GST Name (please Prirtt) r CST Number, Bird Plumbing, Inc. Shaun Bird 226900 Date Evaluation Conducted Telephone Number Address 715-246-4516 1008 192nd Ave, New Richmond, WI 54 17 ~ ~ -- ~ ~,- .~ 1~ Property Owner Parcel ID # Page of a ~~~ ~~~~ Pit Ground surface elev.l-~= ft. Depth to IimiGng factor ~ in• ~~ # Soil icatron Rate ti i D Texture Structure Consistence Boundary Roots GPD1f1? Horizon Depth in. Dominant Color Munsell on p escr Redox Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ (fir 3/ _-_ S m r mfr cs am J,~ '~~h ~ ~ ---__ -, S j r.~, 1 ~%i h ~ 7 .~ ~~ # 0 Bonng ^ pit Ground surface elev. ft. Depth to limitng factor rn• Soil ication Rate T t Structure Consistence Boundary Roots GPD/fP Horizon Depth in. Dominant Cd Munsell Redox Description Qu. Sz Cont. Color ure ex Gr. Sz. Sh. 'Eff#1 'Etf#2 [] Bonng ~~ # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Sal ication Rate . T Structure Consistences Boundary Roots GP DIfr: Horizon Depth in. Dominant Color Munsell Redox Descxiption. Qu. Sz. Cont. Cdar exture Gr. Sz Sh. . •Eff#1 'Eff#2 • Effluent #1 = BODE > 30 < 220 mgll. and TSS >30 < 150 mglL `Effluent #2 =GODS < 30 mg1L and TSS < 30 mglL 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. 3 seo•a3w (te.s~vol : ~ . ~ ~ Soil Test Plot P Project Name Dave Alwin Address 413 6th St. N l Hudson Wi 54016 ~/ Bi >TM #226900 Lot 3 Subdivision Cedar Win's Estates p~{e 12/12/05 SE 1/4 S W 1/4S 22 T 29 N/R19 W Township Hudson Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1 /2" pipe 5" above grade System Elevation 95.3/94.0 *HRpSame as Benchmark Alternate Benchmark Top of 1~2" pipe 5°~ above grade @ 100.0' ~~.8 ~. )' ~, i ~ I I I 0 M460O 4 9 ( I I I I GPG~~G~V'n14 G3Mfn~ G~OG3~74 -600 4 9 ~3 o DD ~40~ / . . LOT 2 / d °~ 2.61 AC. \ ""O'"°°a'o LOT 3 ~Q9DD 30O U`~ ~ 2.71 AC. / ~4G14C~ ~sn.-aosso _ \ ~ / -------- LOT1 3.39 AC. \ ^ • r ~ ~ ~ _ / 2.35 AC. , ,, ~ a~ q ,, ,, ~ ~ lip ~ ~ ~ ` ~ ~° / ,. / ~~ ~ ° ~ , ,.. ; - „ . ~ ; ,~ ~ __~ dart \ - - =- 1 ~ ~a~ ~, ~ , . \~ 1 \ \ ~ •\•20' ORAWAGE EASEMDIT ~ ~ `~ ~ ~ \~ ~ \ \ 1Q\ 1 U ~/ LOT 5 ` ~~ ~ ~ \ \\ 111111 ~ ~ ~ , ~~Ipl~ 2.18 AC. ~~ _ _ ~ ` \\ ~ ~~~% V LOT6 ~~ ~~ -' 2.01 AC. ` ' ` ------ LOT8 I ` Asa-aosso ~ ~ ~~=, ~\ 2.66 AC ~~p~ ~ ` " . i.ea-sos.so ~ ~ > ~ C'iIMDD ~ OOGvJ a.aa-cos.so ~ ~ ~ ~ ` a w L~i4Q4~ ---- _ ~ ~____LOT7 ~~ aTMCe en~ a~c -~~ ~ aa4~ 2.4d~A~C:_--- a~wu ,.e.a-a,a,o ~eo.w,a.,a ,oo m Ewa-a,aao tao m rnom, ~-ouao - - _ tsa-s,aoo I ~ ~ ~ ~ /' ,oo tix r~ ~.a,s.,o a004 9 6.~. 00 ao 9~s I uma,s.,o ~ f?QC~3f~ 2~ r ' I -- --- --i -- i -_ J i r ~9 I I I I I I I a04 9 _ I ~ I I I ~~ REMOVE EXISTING DRIVEWAY CONNECTION TO BADLANDS - ROAD. Nq 0 b v ~ 2~' FROM DOOR, `~IlJfjQ'rJ OR F'RE~H AIR I-JT"AKE .r..., t8°MIAI. fAfLET #~ ~~EV r: r C GRACE - ~ i ~ ~ ~-- COAIDUIT 9 PR4Vipf AlRT1GHT SEAL * ARAROVED JOINTS WIT}i APPROVED PIPE 3 ~ ~HTa SOLID SOIL PJMP -~.~ CoNeRETE e~acK 1 1 I --~ T y" MtIJ. !$" h11A1. 11~ I~j t ~'~ (f ~ ALARM I oN f of~ RISER EXIT FE.RMITr'ED 4AlLy !R TAAJK MAAIUPAGTLIRf`IL raAS sucH APPiiOVAL SEPTIC E _SPEGl~lGAT101~lS DQS E T!`il-tS MAIJUF'ACTUR1wR; 'e~el~' ~lUM® ~/' ER OF DpSCS:,._L~PER DAy TAAJK SIZE : -_ ~~'~4-_,,,~,,,._ 6A1..LOAIS DaS1R VOLtJM[ f~~ '3? ALARM lyAlJUF'ACTVRER; ~- a V ~~ ~~ rn IuCLU OfuG dACKfLOW~ GA~.GON! J'IODCL I.lUM~FR; I~~ ~ CAP11C 1TtES: A= °~~ IUCHE5OR ,Se~~.~GALL01J5 SWITCH TyPt: ~_ ~71 a° ~' ~^ 9 = +~.,IIJCHES bR y,° S GALL0~15 PUMP MAAll11`ACTURCR; ~°'~` l~S 3% G = 8~ 3 tIJtKES OR ~ W+LLd1J5 ~ //~~ ~~ MDDEi_ IJUMbER: --.._....C..L1 ~r $ D~ ~`~ IA1CHf.$ ORS... GALLDA1t SWITC-{ T`JPE: -.---~~°.~"~ }JOTS: pl}!4P A-JD ALARM ARt TO BE MIIJIMUM DISCMAItGC RATE 3".,,_,,,-~ .,~GttM If~STALLEO OA1 SCPARATC CIRCUIT'S yERTICAL blt:fER[IJCE DETW><CU PUMP OFF AA10 bISYR1DUT10Al PIPE.. , l . -~ FECT + MISliMUM uETWOf~K S1lPPL~ PRESSURE .. ~ ~ . ~ ; FEET ~ ~ , ~- ~_ i'EET OF FORCE MAIW X ..7°C~F~1t~QfLFKlCTl4i1 FACTOR. .,,y, ~ l~ G `FEET ~-- TOTAL CyWAM11C NEAP .- /y' ~yfEfiT tAITERASAL, diME1JS~C-dt OF TAIJK: LEAIGTN ~.~.;WIDTH ..,,..,.,.......,...~tLIgUID OEPTN Pn r. t ~ ~ _.___ pliMP CHAMl;~R CROSS SCC ~ IOtJ A~fG SPEClF1CA'flO~JS .. ~ VC A!T CAP ~ - t ~~\ WiwATHEKPR00F' AP~RUVED LUCKIAIC, .IUAIC.TI4l.1 BOX ~MAI~Hp{.C [OVER 12"MIU. 7 rs ' ~GOULDS PUMPS Submersible Effluent Pump 3 V ~ 1 EP05 APPLICATION5 Specifically designed for the following uses: • Effluent systems • Haines • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: '!e'"maximum. • Capacities: up to 60 GPM. • Tatal heads: up to 31 feet. • Discharge size: 1'12" NPT. • Mechanical seal: carbon- rota ry/ceramic-stationary, gUNA-N elastomers. • Temperature: 104°F (40AC} continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Singgle phase: 0.5 HP, t 15 V, 60 Hx, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length, 16/3 S1TOW with three prong grounding plug. Optional 20 foot length, 1613 S1TW with three prong grounding plug (standard on EP05). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto• matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical sea! protection. METERS to 9 a n ill s u a y 0 0 r 6 s 3 z 0 .. _ .......... ... ~: GPM 0 2 4 b 8 10 12 m'!h CAPACITY Gou(ds Pumps ^EP05 Impeller: Thermoplas- tic endoseddesign for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings; Upper and lower heavy duty ball bearing construction. AGENCY LISTING ~' CanadlanStalfdaidsAssoaation (CSA listed model numbers end in "F" or "C".) Goulds Pumps is ISO 9001 Registered. EP05 ®2000 Goulds Pumps Effective February, 2000 83871 ITT Industries ST.4NpARD C, tiifMt~ER . - 52'...- -- Quick4 Standard Chambbr i <r-~ •~~ r , , .~~"" r '~ ' ~~ ~' i_I r,% SECTION VItW Mu{tlPvrt End Cap ~,. " i 12.. ~ _ _ ~'~ , ri ~l~ ~ ;! __ I ~.,,~ ,,\ ~ •, 1 _ r 1 f ~ I' '' ,. 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All MII rraN1Y 0f Mu'cw/ •>• ~V Yr; at.lYr Ypp~,r;;ratl 1YWS !pW Y111f~T' Y •Itll%1YNWY]n T+Yt/4~l'Wli. r" ,C 5rrc 'JA%Sr ~i1Ps :fAthJdl :R iIfMA Y+CI laglY 0~• M wa!rJ<'•ry YtN~ Ks YM Isorl'; Jtrwr iMn f Y rrq" ;arils ,as I:i1 :rllMtonl'I to rnil'Ho x tlxllrnA tn~s Li, nitM We~rn^Ir real r d ~ r c I Irr! r.r, ~ rY , .. , t 1V firms 1m~w rhn .'I Mill ., drill AnnY&ti t'N.` ~r~NNYrr ~.rerrAluY rYtplVa• ~,,~ hY ml"uM0' A ' w £ nNexr, U.-rlr%Y:rx'•1tl nrrAr Iv Nr~' Iyper,Yy.), 1a OLIiNn a rlt _'43 ,.19~:111.'IM C,~ryt~l yRr4F/N~rrllnrr'. ~HYUAa~dHOE' M.11MMra10~ 3 ~»x i,yrr ~I ."WC. ., ~r:,. nrrr n:r[:~'ro~r ;>/ lJnis arnuio cw+ war~RMV ret~f nyt wwran+v PACs l011>B r- } ~ : ;,; ;.t udl aanl~c.~tre wMrerNYr Ynd ehwlA ' ~.-r-.--.... . • ~Y~TEM~ INC +~n1~~ fJ18M~1 ~~IM1[lalr "A'jp~U~0~1~ ~ ~l,J3r1IQSS ~8£1~ ~lC1Eit~ • P.U, f3UX I$$ O!d SaYbr~ak, E:T ~a7.~ 800-221-4438 a. 1 X41: S,SV t,9Q3 tb.118,r•4%','+='E~N,'11$t 5.tSl9,f11d fi,0~ 1, 5,d0'r.SIE; 3 G a, r ~ a ~.r7a, 5.158 SNP', 5.35 ,~'In France, urn{,.rta sW^rtr~,tary -, .1 IrWr l:alAn7o ~npYtg. r 1. {dfj; r ~ r~~ G`ftCtll, V/ti'~'~)r ,..,,<~ ~,. -~ ~ r , 3^&.P-fi' 71Y.'a.~ ~ IraC1MnM1<[• M 1ntSltaMr .,yel[rt ,; Inc. Hrfrttrata £ 1 t 6tP'ki)yIt err ~FaU0C81, p0~r ~' W7! rn::•r<u kcr~,.,~>.e• an<r h,r+wN r,dar are ragl6lerPrl Wnr01 (jprnlOGgfY`r N.,~rc~t.s;acren rg YdV~tlll, ,4r7:1(~tk: .. •furslerec, rralfm~:larM m Mheuo. %iOntWr, GP'PO<+ S _._ ,.... ~ orur~ In6{ErrS10I S~ssems 1rc. {~rirtdd G4 U S.A. a(CYCI.CiO(I1UtN tt ~~ .M ~r ~V ttV"V ~~ ` • ST. CRQIX COUNTY • SEPTIC TANK MAINTENANCE Ac~REEMENT AND OWNERSi•I:fI' CERTIFICATION FORM C)waer/Buyer ~e~'s ..5~° Q~c. ,~~tJ Mailing Address jls~ ~ w S-~~ ~ n Property ~c3dress ..~.~t~ _ ~~<r~cu.C1_~~~.....~_ ~'~ (~"erifrcation reyuirr+d from ~'larrtitrg d'c Ztttrin$ Ucpartmcnt tb ~ ew con Tian^j ~r~aAl ~ City%State ~~ ~~~ ~~L Parcel Identification Number ~Q~~.C ...__. _ __ L~~~~~~C Property LUCatlon S'~ '1. ,~l.1 `~fe ,Sec. ~~ , T 2g N R„„~~ Vlt, Town of F~~~®/ - Subdivision C r s L~ ?~ ~~~ 7ft U6 I.at # Certtfled Survey 1-iap # --- __..--_-..._ __...~......_.~._~ VolumE __. _. __ Pagt: # .__.._._m_ Warran ee # 3~? ~~ Va u e 7~~~~06~1'a e # tv P d _ ~._._..~_ _._.._._.._....._._,~._ _, t m ~ ~__.., 8 .__ .~. Spec house yes nu~, Lat lines identifiable ye~ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintarrance otyour septic system could result in its ltrrrrtatute failure to handle xastes. Proper rnauttenance cons+sts of pumping out the srptic tank every tlu~c~ years or soourr, if trrcckd, by d licensed pumper. What }you put into the system car. affECt the function of tl•re septic tank as a creatntent stage in the waste disposal sy9tenr. Owner maintenance respansrhiiittes arr. specified in §Comrrr. 8:;.52{ i) as~d in ir'hapter 12 - St. Croix (aunty Sanitary U*dinance. The property o~vtrer agrees to submit tc- St. Croix County Platuaing & zoning bepartm-nt a certifi~atian forth, signed by the rrtvner artd by a master plumber, journeyman piurs~ber, restricted plpmber or a itct`nsed pumper verifying that (1) the on-site wastewater disposal system is in proper operating conditiutr and'or (2) after uispe::tinu and pumping (ifnecessaryj, the sel!tic tank is Sass than 1'3 full of slud~te. G`u•e, the undersigned hack: Lead tkie above rcquu'esnents and agree to maintain the private sewage 3isposai system with the standards se; E'ort}t, herein, as set by irie llepartment of Commerce and the peparrmemt of Nattual Resources, State of w isc.~nsin, Certification stating that yom• septic system has been maintained must be cornpieted and tztttt'ned to the St. Croix County Flanning & ZUning Atpartmert within 30 days of the three year expiration date. 1;`we certify that all statdrnents un this fi-rtrt art !rue iv the best of tny?c~tzr lcnUwitdgr. l~we am(are tht: <~wtteri~? of ~hr property described above, by virnte of a ~v4rranty deed recorded in Register of Deeds Cyfi'rct. ''umber of bedrao s ,..3` ...__. ~ __. ____.__.~-..~ _ _ _ ~ ; 31 r~~ SI 1 ..~ OF I.TC'ANT(S) p.4TF +**any irafcirmation that is rusrcprebented may result in the sanitary pcntuc Ewing revoked by tl'e Planning & lanirg Department. **' luelude w.th this app.liLation a reeordedwarrarty deed front rite Register of Deeds Office and a copy of the certi2ied surrey m.~p if reference is rt~ade in the warranty deed. (kNV. Oti!OS POWTS QWNER'& MANUAL & MANAQEMEN7 PLAN Page ~ of ~ FILE iNFQRMATION Cg~c~.a,.. ~ VIM ~S"~ . ~...," 3 Owner Permit # DESI~Nt aeaerueT~rQc Number of Bedrooms S- p NA Number of Public Facility Units ~A Estimated flow {average) j"dc! alyda Design flow (peak), (Estimated x 1.5} Soil Application Rate _ ~ DSO' alfday _ !~ , al/da J+~ftz ~ Standard inftuentfEffluent Quality Monthly average' Fats, Oi! & Grease (fU~) <_30 mg1L Biochemical Oxygen Demand (BUDS) 5220 mg/L L1 NA Total Suspended Solids {TSS} <150 mg/l Pretreated Effluent rDuainy Monthly average Biochemical Oxygen Demand 1130Db) 530 mg/L Total Suspended Solids (TSS} <30 mg/l ^ NA Fecal Cgliform (geometric mean) 1 ~~1 A fCfc uti100mi Maximum Effluent Particle Size _ ~ Ya in die. J DNA Uher: '~' !~ NA "`lalues typical for domestic wastewater and septir, tank effluent. MAINTENANCE SCHi=DUtE SYSTEM SPECIFfCeTIANl4 Septic Tank Capacity ls'~,f" gal ^ NA Septic Tank Manufacturer ~j~`C~~, y !~ NA Efflu®ni Filter Manufacturer ~?a,6~ ~ U NA Effluent Fitter Model ~~ ^ NA Pump Tank Capacity rr'~Q al ^ NA Pump Tank Manufacturer ~ ~ C s' a: r ^ NA Pump Manufacturer / ~dct,~U~ ^ NA Pump Model _-_ ~C` --------- ^ NA pretreatment Unrt NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Dis sa! Cell(s) C7 NA In•Graund {gravity) ^ In•Ground {pressurized) ^ t-Grade ^ Mound O Drip-Line O Other: Other _ ^ NA ~'___ Other: .___. ~_._ ^ NA Other: ~ ~+ ^ NA Service Event Service Frequency Inspect condition of tanks} At least once every; ~ month si {Maximum 3 yeare} ear{s} ^ NA Pump out contents of tank(s) `When combined sludge and scum equals one-third ('~3) of tank volume ^ NA Inspect disperse) ce)Its) --- -- ____.__ _..___ _._~ At least once ever y' ~ ^~,~tonth{s) J~Xyearls) (Maximum 3 years) ^ NA Clean effluent filter -~ At least once every: ~~ ^ month(s) / 'year{e) ____ r~ O NA Inspect pump, pump controls $r alarm ,_._~, ~~~ I At least once every: __ , _._ ^ month(s) 0 year{s1 ^ NA Flush laterals and pressure test At least once every: ^ _ ^ month(s) - _ fl NA _..__..._.~~. ---- - - ^ year{s} ether: .. ~._ _ .- f _-~__--._.___._..._. At least once every: __.___. , _...._ 0 month{s} _.__ ~ o year(s) _._.___._ ^ NA T._ __-_ MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells she!( be made by an individual carrying one of tfie following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POVb`TS Maintainer; Septage Servicing Operator. Tank inspections must include a v)sual inspection of the tank,Es) to identify any missing or broken hardware, identify any cracks or leaks, measure tt-e volume of combined sludge and scum and to check for any back up or pondinp of efflu©nt on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check far any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (%3) or more of the tank volume, the entire contents of the tank shah be remov$d by a Septage Servicing operator and disposed of in accordance with chapter NR 113, Wisconsin Adm)nistrative Code. Afl other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 5t 2 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within t 0 days of complatian of any service event. Page __~ot'~/ START l1P AND OPERATION , For new construction, prior to use of the PaWTS check treatment tank(s) for the presence of painting products ar other c~i'emicals • that may impede the treatment praeess and/or damage the disperse! cell{s). !f high concentrations are detected have iPre contents of the tank{s} removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the disperse( cellls) in one large dose, overioading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Qo 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 ar at•grade soil absorption area. Reduct'son 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 tsump purnpi 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 PdWT5 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 sfiall be removed and property 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. CONTIf~QENCY PLA If the POWTS ~ s and cannot be repaired ttt® following measures have been, or must be taken, to provide a code compliant replacemen ystem~ suitable replacement area has been evaluated ancf may be utilized for the location of a replacement soli absorption system. The replacement area should be protected from disturbance and compaction and should not ha infringed upon by required setbacks from ®xisting and proposed structure, lot lines and welts- 1=allure 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 effrot at that time. ^ A suitable replacement area is not available due to setback andlor 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 net 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 rc last resort to replace th6 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, < < WARNIN43> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL DASSES ANDIOR INSUFFICIENT OXYGEN. 00 NOT ENTER A SEPTIC, PUMP OR 01•HER TREATMENT TANK UNt~ER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE D~IFFIGULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ~j,'il`a yy~ S'G~tc• ~,~,.~,P Y Phone ~ l „ 38'x'-~~l~l POWTS MAINTAINER Name Phone SEPTAQE SERVICING OPERATOR tPUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ST,CIeOt ~ ~ ~ , Phone "~l S'~' 31 ~0-~ ~p __.._. This document was dratted in compliance with chapter Comm 83.2xi2ilb)(t}(Qsg,lfi and 83.6411}, (21 & 131, WiBCOnain AdministratS,;~e Code. State Bar of Wisconsin Form 1-003 WARRANTY DEED . Document Number N Document Narne THIS DEED, made between ALWIN CHILDREN, LLC, a Wise'onsin limited liability company ("Grantor," whether one or more), and JESS P. SEGUIN and HEIDI M. SIME-SEGUIN, husband and wife as survivorship marital property ("Grantee," whether one or more). Grantor, far a valuable consideration, conveys 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 addendnrtt): Lot 3, Plat of CedarWin's Estates in the Town of Hudson, St. Croix County, Wisconsin. 830780 .KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED ,FOR kECORU~ 07/2b/2006 - 10:30A11 Y-AkRANTY DEED Xt>~'I 11 REC FEE: 11.00 TRANS FEE: 390.00 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address D. Peter Seguin IvIUDGE, PORTER, LUNDEEN & SEGUIN, S.C. 110 Second Street Hudson WI54016 i ~- 020-1059-20-000; 30-050; 65-000 8c 020-1060-20-000 Parcel Identification Number (P1N) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, reservations, restrictions and rights-of--way of record, if any. Dated July ~~ 2006 ALWIN HILDREN, LLC SEAL < <i~~' (SEAL) ( * * David D. Alvin (SEALS (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF WISCONSIN ) ss. • St. Croix COUNTY ) TTTLE: MEMBER STATE BAR OF WISCONSIN (If not, _ _ - authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Attorney D. Peter Seguin _ Hudson WI 54016 Personally came before me on July ~ T 2006 , the above-named ALWIN CHILDRE , Ll~ LC, by David D. Alvin to me known to be the person(s) who executed the foregoing instrument and owled the same. s f ~ - ~ N~TAfi1/ PUt3lIC Notary Public, State of Wisconsin ~~' My Commission (is permanent) (mss: (Signatures may be authent[cated or acknowledged. Both are aot neceaaary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM NO.1-2o03 Type name below signatures. 1 of 1 ~. r ~ PPE Folxa !r'~41'11 0.31• FlIOM -a1!!' IRON PPE Ii=OO~ ~ ~3 ~ p~/Q~' Old pC~~Q~Q[~~ ------------------------------ G~M~1 G~~G~~~ aDDO`~~OO ~1 ---------------------- (N89'12'45"E) ~-NORTH UNE OF THE SW1 /4 OF THE SE1 /4 LOT 3 2.706 ACRES 117.860 SQ. FT. L8.0. ~ 905.5 ~0~ ~ ~. i .\ ~~. ~ 20' W1~ EASEMENT LOT 4 2345 ACRES 102.1:55 SQ. FT. ~~ o ~~ D N~~~ V " I v s Gill ~~ ~~ -~ 1-1/4' IION PPE ~a Nto,3',.r~ 0.93' fitOM 9ET Z-3/b' MIOq PPE - - ~~~ ~ SURVEYOR'S CERTII I, DOUq.AS a ZAHLER, REa SURVEYOR. HEREBY CERTIFY coMPUANCE IMTH THE PROS of THE MASCONSIN STATUTE REGUUTroNS of THE TowN THE dRECTION OF ALMAN CF SAID LANO~ I HAVE SURVEYS CEDARWIN'S ESTATES; THAT REPRESENTS ALL EXTERIOR suBOIVISION a1- THE uNO PLAT IS LOCATED IN PART ! SWh /4 ANO PART OF THE S SECTION 22. T29N. R19W. TI CROIX COUNTY. WISCONSIN. OF LAND; DESCRIBED AS FO COMMENCING AT 1HE SOVTM SAID SECTION 22; THENCE ! THE SOUTHWEST QUARTER t s89.51.2r'w A asrANCE aF N00'29'07"W A DISTANCE OF NORTH RIGHT-OF-WAY GF E PdNT OF ~gNNING; TMEI RIGHT-OF-WAY S89'S1'2'7"w FEET: THENCE N00'29'07"MI FEET; 1HENCE S89'S1'27"W! , FEET TO THE EAST UNE OF ESTATES; THENCE ALONG SJ A DISTANCE OF 1110.1.3 FEE NORTH UNE OF SAID 3OUTI1 SOUTHWEST QUARTS:R OF SE DISTANCE OF 649.90 FEET 1 CORNER of SAID SOWTFSI SOUTHEAST QUARTER Olr` SE THE NORTH UNE OF SAID !9 THE THE SOUTI~iEAST Q13AR't DISTANCE OF 306.00 FEET 1 PLAT OF KELLY ESTATES; 71 UNE S00'25'12"E A LriSTANC NORTHEAST CORNER OF LC1 SURVEY MAP RECORDED 8i. AT THE ST. CRdX COlll'I1TY 1 OFFICE; THENCE ALONG fl!E i.. ~p•R~•A!•W 1 ~~ s ~.~ ~ s~ 11 ~-~--'- _~1 t i • ~ ~., w ~-~g~ L~ 6 ~ -_ / V