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020-1063-70-000
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I v c~ I ~ m c '~a ~ o m I .1' w ,O - VJ 7 - f0 C ti ~~ y N O c N~ C y L O.~d ~ ~~ y °~ I i3 ~-~a _ ~ v ~ ~ ~ •~ ~ I ~ ~ o ~ 1 ["., ~ o a~ c a I oY ~ ~ c Nc>?~w I m y~ c c I m ~a ~ °'•3 a I o o y 3 c Z I c z y ~~° ~ o I i E m i I a i c ~' c ~v I t ~ o o t o a; . o ~ ~ 3 ~ °-~~ I ~ 3 v ~ ~r~~ I n. d Q I=- ~w I E ~ Q c~ ~ cw m I I ~ I M M ~ N Z N ~ ~ ~ cn !. p !" p I z ~ €~ d I € d d m I N H N O O Z~ C C ~ U ~ r I. ~ > > '~ I a i Z a ~ °1 ~ I ~~ °1 ~ o Z N H ~ c ~ ~ m I c t U ~ ~ ~ ~ N ~ ~ N M I ^ N ~ > N U ~ N ~ 7 y (~ ~ ~ a ~ d ~ ` ~ ~ `0 3 ` ~ o I a ~ ~ r ~ m ~ I a L ~ ~~ I o a~°i c I o +- c ~ I Z m ~ Z 5 ~ ~- ° I I z I I ~ m ~ ~ .. d I ~ ~ Z` ~ N I rr .. ~ J ~ .. ~ _ a a '.g .~L. m I cc a '~a .~', m c I ~ ooa` ~~ I °ooa` ~•> ~ I > Z cc N to t /1 j ~ I ~ N W W j ~ .~ I c~ r r 3 ~ 3 acn I ~ ~ az ~ ~w ~aaa aaa z ~ +lJ ;~ I o ~, t ~ ~a a ~ •~ N y fn J U ~ ~ ~ ~ ~ ~ ~ 0 0 } O ~ 2 o N ~ '- I U ~ N ~ 'O N N ~ oo o o00 _ i m ~ a a ~ oo ~ c m ~ m ~ [D Q c I .-°o d~ Q~ cn m m ¢ Z in o { ~ 7 r~ I 7 ~ 1 O O `~ m y C ~ O 1-yl! C I 5 ~ I O ~ ~ O o~ 3 ao ~ •m ~ ~ a °o q i„ i,~'~ N H O t~i~ c Q ~ ~o N N O CG O C '. ~ ~ M O N Z N f0 M ~ ~ y ~ y 7 N C ~ W ~" .. O V1 ~ O O d ~ N •f0 ~ ~ O N 2 ll. ~ O Z C E- fn ~ O Z C d. ~~ O I ~ ~ .+ [ e~ V~ 'R '' ~ a a I ,_, M wit a ~a•~' d I ~a~ `N ~ ~ 3 ' I ~ o o~ ~ c ~ 1 ~ o _1 A vat v~V , Omv I ~' ', ' COMMERCIAL TESTING LABORATORY,. INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 •962 - 5227 ST. CROIX ZONING ST. CROIX C[[~A~iTY COURT ENIDSO~I, WI ATTNS TICS C. NELSQN 5401b ~~ REP~tT NO.S 07589/01 PAGE 1 REPORT DATES 7/17/90 DATE RECEIt~D2 7/13/90 ~~---/off, 3-- ~r~ Cotiform Bacteria/100 ml Nitrate-Nitrogen, mg/L OWNERS Michael Moline LOCATIONS 817 Bradley Dr., Hudson COLLECTORS M. ,.ienk i ns SOL~tCE OF SAMPLES Kitchen faucet COLIFORMS 0 /100 mt INTERPRETATIONS Bacteriologically SAFE NITRATE-NS b ppm Under 10 ppm is safe for human consumption. LAB TECF~lICIANS Pam Gane WI Approved Lab No. i9 4 Mean "LESS TF~!" Detectable Level t d~ ~ c~~~ _t 'L~ ~.y~cu .. ,r . j ~ ~Cc~ ,~~ - ~ ~~ i._ .i ~ .~ Approved byt PROFESSIONAL LABORATORY SERVICES SINCE 1952 ~~°a i ~,~ . ~-il-Fd f~~~4~ ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, NI 54016 Telephone - (715386-4680 The st. Croix county Zoning Office ofutionshe Realty Fis'msepand and water inspections to Lending Instit • private individuals. Gomcletion of th a form ess ~~-~ • Please provide the following information, enclose appropriate !ee made payable to St. Croix County Zoning Office, and mail, soongaswpossible afterefeeandaformsara received will be done as HATER TESTING------------"---------""----FEE: $ 25.00 (For nitrates and coliform bacterie)FEE: $175.00 HATER TESTING (For VOC~S) - FEE' $25.00 SSPTIC SYSTEM INSPECTION-----------""-- ` (Determines if system is properly functioning at t mo of inspection) %~~~~ ~, Property owner's name n ~ . Property Legal De Town of ______1/ of Sect on _,_,• T N-R Subdivision Name ~_ gt~x ~~~-- ~BER- ? I! so, list lirms Color of house. Realty sign by house?_,,,_ PLS1-88 INCLUDE, IF AT ALL POSSIBLE, A MAP, .e,COPY OF PLJ\T 900K, KITH LOCATION SNONN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacnnt, and has been so for some time, the water line must be purged by running the water for several hours before the teat can be conducted. HINTER TESTING: Many times water lines are turned oft, or sill cocks are turned off, making access to the home necessary. Ii this is the case, please make proper arrangements with this of t ice to ensure time when entry may be ~ainec~.n ~ ~,, Firm or individual re uesting serv Telophone Nun-ber~~' - - REPORT TO BE SENT TO: Closing Si9natu ,Pu d ~-ir-4d f~~~4~ ~~ sTSt~CroixOCounty Courthouse$ ~' 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St.r ineiectionsytooLendingflnstitutionshe RealtyeFirmsepand and Ovate p private individuals. CemD~ °} ~ ^*+ of this form ie °aa°n4' ~ a7 Bo that the vroverty .can be_ • Please provide the following information, enclose fee made payable to St. Croix County Zoning Office, along with form to the above address. Testing will soon as possible otter fee and form are received. appropriate and mail, be done as HATER TESTING-----------------------"----FEE: $ 25.00 (For nitrates and coliform bacteria)FEE: $175.00 WATER TESTING (For voC ~ S ) --FEE: $25.00,,,_ „__. gEPTIC SYSTEM INSPECTION--------""""--- (Determines if system is properly functioning at t me of inspection) i~~~ ~, Property owners name n ~ Property Legal De Town of 1/ of Section ~, T N-R -Subdivision Name FTRK NLtIfRRR i1X"'K SOX NUNB~? 7 If BO, list firm: Color of house Realty sign by house?_ PLFJIBS INCLUDB, IF AT ALL POSSIBLE, A MAP, .e,COPY OF PLa1T BOOK, MITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Tenting of residential water requires a sample that is fresh. If the home is vacnnt, and has been so for some time, the water line must be purged by running the water for several hours before the teat can be conducted. ' HINTER TESTING: Many times water lines are turned oft, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be ~ainec~.n ~ ~, Firm or individual re nesting sere Telophone Number - REPORT TO BE SENT TO: signs ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 July 19, 1990 Jane Cosky Edina Realty 1400 S. Lilac Dr. #200 Minneapolis, MN 55416 Dear Ms. Cosky: An inspection of the septic property located at 817 Bradley July 12, 1990. At the same time for testing. The results of that system of the Michael Moline Dr., Hudson, WI was inspected on I also obtained a water sample testing have been sent to you. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspections. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system is totally dependent upon proper maintenance of the system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, / ,- ~~/~'`~ Mary Jenkins Assistant Zoning Administrator cj t3UILT SANITARY SYSTEM REPORT __,__.- - ,,_a .: ` OW~~n ~ C TOWNSHIP SEC ~~T~N, R~W A:~DRES ST. CROIX COUNT WISCONSIN . :SUBDIVISION LOT ~~ LOT SIZE PLAN VIEW Distances & dimensions to meet requirements of H62.20 SH~t~* F.VFRYT'FiTN(_ [JTTt-TTrT 1 nn t-~rm n~c cv~~n,-,i _ _ - - - _-- iLL•L v l JLJ LLL l-1 .V- ~ _ ~~\) _.~ ,- I ~_ V {/ I % I ' I I ~ i ~~yy ~v ~Q, {~ ~ ~ ~ ~ I ~ ~ i I di ate N _L.~_ orth; Arrow i SCALiv : i ~~~%_~ ~' ~ ~ ~ SEPTIC TANK(S) ~ MFGR._--~ ~.~ , CONCRETE STEL'L~_ NO o rings on cover f Depth _~~~ PUMPING CHAMBER SIZE PUMP MFGR. MODEL N0. GALLONS Per Cycle TRENCHES N0. of width length area BED N0. of lines z... width /Z ~ length ~`'Z r area Z~ ~- depth to top of pipe NUMBER OF S p „PITS Outside diameter total pit area AGGREGATE ! ~~_ a / `~'~ Q , PERK RATE AREA REQUIRED ~~ /s"~' ~ AREA AS BUILT ~ Z~ Disclaimer: The inspection of this system by St. Croix County does not imply complete compliance with State Administrative Codes. There are other areas that. it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, e ted the County will make every effort to determine cau failure. GREASES AND OILS SHOULD NOT BE DISPOSED TH S SYTEM. ECTOR ' DATED C (~ PLUMBER ON JOB LICENSE NUMBER Z REP~JRT OF INSPECTIJN INUIVIUUAL SEWAGE SYSTEM • • _ - ! o ca#.i-o rc Sc; ~ S L S ec.t~.on SEPTIC TANK ~- ~`-' ' Size ga~..lone. Numbers o~ Compan~men~e fl.i„sxanee Fnom: Wei.! ~#. 12$ on gnea~en a.lapeo~0~ ~x ~TSPOSA! SYSTEM U.t-e~ance From: FIElV DIMENSIONS: H~.ghwa~ten _ fix. Wei.! ~#. Bu.l.ld~.ng~~~.t. N.ighwa.ten ~ fix. W.id~.th o ~ .~nench / ? • ~z. teng~h a ~ each ~..ine- ~~~~~. Numb en • o ~ ,e.i.n ee _ To~a.e. .length o ~ D.c,6 zance 6 ezween Ta~a.l abeonb.t.Lvn Requ~.ned anea _ PTT DIMENSIONS: Z e.inee 9' ~" fix. .l.i-nee ~ ~z. area ~~~`'7_Sx2 ~~2 San.L~an y Penm.~~t .~ S#axe SPpz~,c ~ :so S~. Cho.i.x County 12$ on gnea~en a.lope=~~z. We~.2ande Fz. ~ ep.th o ~ no ek 6 e.~ow xi,~e~~.n . Dep#h o~ Hoch oven fii.~'e Z--- ~.n. Depth o~ z~..2e be.2ow gnade~~~.i.n. S.Zape a~ ~neneh r'- ~.n pen 100 ~~. D ep~h zo b edno ck i ~~. Depth ~o gnoundwa#e ~z. Type o~ Caven: ap~ on S~caw Numb en os p~.~,a ve.2 anaund p~.~.a Yee na Ou~e.Lde d~.ame n ~. Depth be~2aw .Ln.e.e~ ~~. 2 Ta~a.l abeanb .ion an a ~~ . Anea nequ. -- ~~2 TNS ED By TTTL~' APPRD V ED_T_~~ , DATE_,~ 19 7~~ REJECTED ,DATE ~ 197_. z rn ~~ ~~ 9~ lean= : T-t~- IS I s ~~ sEY~N1~ EH 115 Rev. 9/78 ~s-r Q~NC O~v ~ Is ~-~~: ~'~ REPORT ON SOIL BORINGS AND PERCOLATION TESTS ~,E,¢ Rj~ f~~,,,_~/,¢i v _ - ,. WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES f5 N~ ~ 'Tff~" A~ ' P.O. 80X 309, MADISON, WISCONSIN 53701 ~~ .~F o>z14~N~L oN ~ !~ 1 ~ST~'T>` S7'" IF 8130? LOCATION Y4,.~'/<, Section ~~ ,T~N,R~ W, Township ordity ~~SO -- Lot No.~-, flock No. e~7F/k~ -~PJ/EY M,f~-p County T - C~~~ -- ~oIV ~1/~,1 LC-Y u~c'rvision IQame Owner's/Buyers Name: Mailing Address: ~y~~~ ~ ~`~C/~SON, (/(~( S'~O/~ TYPE OF OCCUPANCY:. Residence.-No. of Bedrooms 3 COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW~REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIO ADE: SOIL BORINGS ~0~?~~7°~ • PERCOLATION TESTS ~O~w~~9 T' SOIL MAP SHEET ~ NAME OF SOIL MAP UNIT ~U~~~-~T PERCOLATION TESTS. TEST M DEPTH CHARACTER OF SOIL HOURS - WATER IN H E TEST TIME INTERVAL DROP IN WATER LEVEL, INCHE RATE NU - BER INCHES THICKNESS IN INCHES SINCE HOLE 1ST WETTED OLE AFT SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P- f s~~ ~~ N,o~-~ ~`t~ ~ 1z 3 3 ~ P_ ~ ~ ~ ~ ~ ~ I. yZ oN 3 4 P-~ ~ ~ % a 3 .3 3 ~ P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, MOTTLING AND DEPTH TO BEDROCK TEXTURE NUMBER INCHES OBSERVED ESTIMATED HIGHEST , IF OBSERVED IN INCHES B- ~~ >9~ ~ v1 6 B- - v o ~ B- arc B- PLAN VIEW. (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location end square feet of suitable areas Indicate number of square feet of absorption area needed for~f~p,(Irjiag type and occu ~~ ~ • ~ ~~ • -Indicate scale or distances ,_ Give horizontal and vertical reference points. Indicate slope. ~ / yq$~ `~ / ~i ~~1 ~ ~~. ~ .. n _ ~ ~ • _ -~ .. ~ ~ ~ ~. ;.~'` r ~. ~/~,cl Colt.. LvT Z i O ~...lb..~~,~f-. ,r -1J ~~eo~.A'f-t e Al T~ ST' ~'' S)ENtH 59Pr Kra ~?V~T//'il'y '~ f2ou ~9 ~ L.i1(pr'I-r o ~ S l ~~.. ~. ~_ ~~~• S ~a•~~ . ~ ~ k 1 ~ i' ._ ~. i 1`(oT~ ~ SrTI= ~ 2~ ..~ ~, Q ~ SoM ~~ I z ~c~'~ Z i. ~_~ ~r~~ ~~ Y_ ~~~ e ,6'. ~- ~ ; ~ t __.: _m ' _.. pi-~ r ~ n ~ ~---- ~ -- -m- ~, WlscoNStnl R~PARTft~~~T aF' ~ LTH ANO S ~ .. ~~,7.ra `~"yIZ, ,- Pl. =~S~Q'~~•~~uREAt~4Q~ NMENTAL HEA1 ~% } ~_ __ . ~~;~A.~ t P.o. eox 3oa-- , MADISON, WISCONSIN 53707 • ~ ,~:. LOCATION:/ ' ~%,, Seca REPORT ON SOIL BORINGS AND PERCOLATION •~. .-- -• , ~ ~ P P y~ U C~ -~-/+, 'on c~.~, T'G>N, R ii'1 W, Townshi or Munici alit ' ' Lot No '-~,,.-...:,.., Slodc No ~~ ~~1~'T"1~ ~ t~~ ~ c~k? v~ ~• _ .. cpNnty _ . J ~-~ #~ ~ } -. h ,d~k~i~ Nam. ^-.~~ ~ ~ _..\ Owna~, ~ Name. ' ~ earl`,. .R~ t=i,, ,z.. - K Mailin Ad ~~ ~ ~ ~ Zcal~-.~v v ._ r~r.. y dress; v ~-~ k' -~-~-~ TYRE QF OCCUPANCY: Resident&_~.__._.,,,, o: a . _ oms _. .~ 0 N t .ed _ , t. . ~ .. y .~...~ EFFLt1ENT AISPOSAL SYSTEM EW ADDIjION REPLACEM .SATES pBS~RVATIQN~, 4' '~ SOlc Bpf31 M ~- NHS °~. ~~3~ / '7~ ~ P~RCOI.Aj~~N ~'EST$ r~~~~',~,~ i'..;,j SOIL MAP SHEET ~~ F '"`'°' SOIL TYPE ~~.~ -z_K: MA~. k~~'t~1"~ ~ ~'"' ~' ~- _ :. - ' ' . PERCnI oTIf1N TFATS .TEST NUMB DEPTH INCHES CHARACTER OF SOIL' T I HOURS SINCE HOLE WATER IN HOLE AFTER TEST TIME INTERVAL DROP IN WATER LEVEL, INCHES RATE BE H CKNESS I,Iy INCHES R 1ST WETTER 'SWE4,l,l-9lhi.. IN MlN4TES PERIOp 1 PERIOD 2 PERIOD 3 MI N/IN ` 1 ~! ~r . w as ~ , ~~ _~ TEST `~ TOTAL, pEPTN, pIPTI~ TQ GROIJ{HpWAT!~R, INCHES • `CHARACTER OF SOJL WITH THICKNESS, INCI~~"'"'~~~~. ~ NUM$ER ' ~ ~INCHF~„~;;'~" OBSERVEp " ° E$TIMATEp.HIGHEST (DEPTH.T,.A.~EpRQCK IP OBSEf~~/;,~,Qj,~. .,. ~, _ -.. - z . .,, , ~'{; . •~.. PLAN Yf ~W (LaGate percx11a1Cion~ast~,;rgi(.pore holes and Siuitahle soil areas ! . ~'-~; - ~~ : indicate ol1 ih$ plan tha iacatio,n and Square feet o>z suita~la arias.; Indic~ta d~!~?t?~r e f squarQ,~est of absorption area ~ ` needed far b~iil+~ins~ tvPa..~nd occupancy,. -' ~ . .. . _ Inrrlicate scale .' or distans~., -Giwp:.f}a~i~onta~ and.-vertical reference points. Indicate slope. -,•. sT-h tea' ^~' "~ ~~~.. ~ ~ r;, W~ ' ~ ; ~~ °~ ., ~ ~~,~. ~~• ~ ~ ~ r :,. :~,:. .~ .: , ,,, , . x.. ~ ,, .. _ ..--Y. . ~. '- ail yr .. ~. +s• i r O U c; . t ~ ~ 1~ .,' .. • - .. ~ -. :: t ~ .~. ~" State and County State Permit # ~S~ P ~ ~ ~~ Permit Application County Per # for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: ,/'yo /,c B. LOCATION: ~$' 6' '/, 1= Y4, Section ~ T~N, R~-E-itrr) W Lot# City _~~_ Subdivision Name, nearest road, lake or landmark Blk# Village Township ~v Sii~ _ s C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) Variance Single family ~ Duplex No. of Bedrooms ~ No. of Persons~_ D. TYPE OF APPLIAN~CES/: Dishwasher YES NO Food Waste GrinderYES ~-Pd0' # of Bathrooms! Automatic Washer L/ YES NO Other (specify) E. SEPTIC TANK CAPACITY ~~~ Total gallons No. of tanks p~.~ . *Holding tank capacity Total gallons No. of tanks New Installation ~/ Addition _ Replacement - Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) l 2) / 3) ~_Total Absorb Area G / 5 sq. ft. New Addition Replacement *Fill System Seepage Trench: No. Lin . Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length ~.~ ~ Width ~ Depth ~ ~ `~ Tile Depth 2 ~~. No. of Lines ~ ii Seepage Pit: Inside diameter Liquid Depth Tile Size y Percent slope of land ~' ~ ~ ~~ Distance from critical slope 30 I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME ~'c~ ~ N 5 ~ ~a,~ c ~ C.S.T. # /~~.$ -.~~~ and other information obtained from d W ~ G/" (owner/builder). Plumber's Signature 6t7 MP/MPRSW# ~O ~~/ Phone #~yj_SV'~~ Plumber's AddrP~S "Z'~"'~ PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). -- ~ t s __ _ ~® ~ ~ ~ ti ~- ~~''.m use ~~ ~~ ~~,' _ _ ~'~ . o~ i ~ '' ~ _ _ ~._ Y' J I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety a~1 Building Division . INSPECTION REPORT GENERAL INFORMATION (ATTACW TO PERMIT) Personal information you provide maybe used for secondary purposes (Privacy Law, s.15.04 (1)(mj). °ermit Holder's Name:, City Village X Township Sewall, An eline Hudson Townshi SST BM Elev: Insp. BM Ele:: Q BM De~tri ~vv~ Q ~e v FCC TANK INFORMATION TYPE MANUFACTURER S CAPACITY Septic ~ `Q-~ D d U Dosing Aeration Holding f~~~ / TANK SETBACK INFORMATION TANK TO P/L ~Qf~t` WELL BLD Vent to Air Intake ROAD Septic , > ~ o r ~ ~ , ~ (~S c av-- Dosing ~ t Vts Aeration Holding PUMP/SIPHON INFORMATION .t ~.A,-I-te ~G~szv Manufacturer Demand GPM Model Number TDH Lift Friction Loss ste ad TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ~ j} -}-- ~ ~ -}--~~ BEDlTRENCH DIMENSIONS Width ~ Length L ~ ` L l ~Of Trenches ' PIT DIMEN~ No. Of its Inside Dia. Liquid Depth ~ 'T 07 3 SETBACK SYSTEM TO P/L BLDG WE~I L. LAKE/STREAM LEACHING M~pu aetaj~r~r / _ L - INFORMATION CHAMBER O 'J"j Y~tYLC76 ~ (,~ rJ T Of System: ~- > ~aa > ~~' ~ UNIT Model Number: DISTRIBUTION SYSTEM ~~-yi ~, ~ (~~ ~ Header/Manifol /~~ /,, ~.Q y Length l~ Dia Distribution Pipe(s) G, ~.- Length Dia Spacing x Hole Size ~. x Hole Spacing SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems Only Vent to Air Intake ~~ 7~ CP S - ~' ltd ~ Depth Over Depth Over xx Depth of xx SeededlSodded xx Mulched Bed/Trench Cente I ~ Bed/Trench Edges Topsoil Yes [] No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/~ Inspection #2: / / Location: 817 Bradley Drive Hudson, WI 54016 (SE 1/4 SE 1/4 23 T29N R19W) NA Lot 2 ~ -` Parcel No: 23.29.19.2450 1.) Alt BM Description = 2.) Bldg sewer length =~Ql~ ~~ )hS ~,s~~ ~~ ~ ~ ~~ -amount of cover = '~I L th-.: V " - I G~'"~ ~'CII~/Yl~... Plan revision Required? ~J Yes [_` No j ~ I~ ~ ~, i I ~~~~ Use other side for additional information. ~___i--~__-~-" J -------- - ~~!~'~"`'Y ~ ~ SBD-6710 (R.3/97) Date Insepctors Sign ture Cert. No. ELEVATION DATA County: $t. CroiX Sanitary Permit No: 453382 0 State Plan ID No: Parcel Tax No: 020-1063-70-000 Section(Town/Range/Map No: 23.29.19.2450 STATION BS HI FS ELEV. Benchm ~-~f X06, ~ ~ ov . ~ alt. BM ~ `G ~ Bldg. Sewer sc~ ~ -1~ 3a ~ ~ +~-~ SUHt Inlet / n V ,S-Y SUHt Outlet ~ -~~ Dt Inlet Dt Bot~~ Y `7,YL Header/Man. ~~ Y ` Dist. Pipe (Z ti ,~ ~~ /dD~ Z Bot_ System T '6 .J S~ 2 3 0• S ~- Final Gra e St Co er ~ I'1 r 3. S I a-t lc.,o y J ~-~. ~ ` ~ ~7 ~ ~ i~'~ . C7 ~ y 0 ~ ~ N 0 7 a cnzD co D y ~ W n c o~ z 0 fZD ~ C < Q = N N 2 7 0 3 N N C ffl m amm~,~~-a m Q-+ ~ ~ ~°-vo- n~i Na>•~~ - mu,d~~ o ~' ~ ? 07 ~ N 7 ~ ~ ~ ~. N N Q . 7 ~ v ~•~~ d fD N ~ N ~ 7 ~ ~ ~ ~ m N . ~ O ti N ~ f N Q _. N (D ~. ,C,,, O d ~ a 7 d~~'~p C y ~- (~~/ 01 O 7 N b9 O O ~- n 3 ~ o Si ~ ~ A ~ ~ ,' ~ n 3 r1 1 ~ ~ ~ ~ ~ n ~ 3 ~ ~ ~ o o N ~ ~ W F I Wi Q a n ~ N - Q ~ J 7 ~ r~ C.J ~ C (C fD V ? O ~ C71 ~ fwd N ~ 'O ~ G b ~ a V ~' tom. a C c. ;~ ° ~° N w ° ~ rcn ~ a ~ .. ~ ~ 0 00 '' °~ ryry .~~ " - y ~ ^~ N ~ N N ~ '~ o D G ov {gyp , A N ~ ~ ~i 'O ~ I N ~ w A ~ ~ I cG ~ ~ ~ .r 7 W O 7C ~ 7 i C ~ H N ~ C .-. ~. ~ N r ~ .: ~- 3 N ~ ~_ D o A z ~ c ~ ~ ~ ~: Z A d ,' ~ ` m N W ~ ~ ~ Z O ~ M ~ ~ c H m ~ ~ ~ fD ~ (,p ~ I 3 ' I = I ~ , c i a , I i y i a fi ~~ O A O Op c p f0 ; ti q ~ y y /! D ./J oiTi ./ D ~z/ Dom, T Safety and Bui ngs Division County S' - ~ ~ ~ 201 W. Washington Ave., P.O. Box 7162 ] • iscons~n Madison, WI 53707 - 7162 Sanitary Permit Number (t be filled in by Co.) Department of Commerce (608) 266-3151 53 3 gZ . Sanitary Permit Application State Plan I.D. N umber In accord with Comm 83.21, Wis. Adm. Code, personal information you provide p ~ r " may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address tf different than mailing address) -~+ I. Application Information -Please Print All Information _~ ~ ~~ Property wner's Na me ~ $ • _ ~ ~ Parcel X Lot lY Block # - . o~c --~ oG3 - 70 - aao Property Owner's M ailing Address L r (, x ~ , ; ; , , Property Location 'k ~' 6 i S ~ 3 Ci S , , , ect on . tate ty, Zip Code Phone Number ~ ~ S 0 A/ s~/ a ~b `f ~ ~ ` •~ ,l -" G `~ / (circle one) II f B ildi k T ~~ N; R~E . pe o u ng (chec all that apply) Q ~ 1 or 2 Family Dwelling -Number of Bedrooms ~ ~3 /" ~ ~"'/(/i5C dA~~ Subdivision Name CS umber ^ Public/Commercial -Describe Use ~ S ~® ,2 ..r~~ ^ State Owned -Describe Use ~ a 1ST. ~ ~~ 1G~~ ^City_^Village i/slownship of /~~l,g~/ ~`~`"`` III. Type of Permit: (Check on one box on line A. Complete line B if applicable) A' ^ New System Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Other Modification to Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List_ Previous Permit Nuumber and Date Issued ~~~ Before Expiration Plumber Owner /4~ wYt~li IV. T e of POWTS S stem: (Check all that a 1 ) Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ olol ding Tank ^ P Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter // ^ Recirculating Synthetic Media Filter eaching Cha'tTSgeiU~ rip meGravel-less Pipe ^ Other (explain) V. Dis ersal/Treatment Area Information: ~ S ~ /"S~'d ~ -°-/00 S Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed ( yttem eva ton , ~~~ .S ~d~ 9~ ~ 9syo~~ ,~; ~~•so ' . ~ ,oo VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank /DQO ~~ s ~®N Aerobic Treatment Unit ' ~....~.. Dosing Chamber k--*..,„,....-.,.„,,,_,,,,,,,~ VII. Responsibilfty Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si gnature MP PR Number Business Phone Number Plumbe/r's Addre ss (Street, City, State, Zip C^ode) ~ / ¢-- ~ ~ VIII. ount /De artment se Onl Approved ^ Disapproved Sanitary Permit Fee Includes Grounder Surcharge Fee) ~ a~0 ~ ~ Da Issu ~ Issuin Agen Signa ps) ^ Owner Given Reason for Denial , lIX. Conditions of Approval/Reasons for Disapproval 3 JL - ~~i ~~ r~'~ ~ 3 R ' . SYSTEM OW NE : C~d'Ni~+--4 ~ .3 • ,j / 1 - Septic tank, effluent filter and n , al cell must all be serviced /maintained J~ LJ y ~~~ ~~ ~ ~~~L~ ~ ~~ dispers nt tan ~ a as per manageme - ac requirements must be maintained C~ ~ l~L ? ~ 1-3 2 ~'~ ~~~ . l ~ as per applicable codelordinances. 3 J, /,~ ~' ~ 8 f acmcn complete plans (to the County only) for fhe system on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 01/03) 7-,v, of ~u~~e~ ~tc~fl;~~c~ w~ B ~° ~ /a N k f a leg b a M_~_o_N__f_~.~ as ~-~ r CmorE -_u fry ~Wll ~;u,N aacn / -- Ct~ ~mk5~- _ ~,~S.oo t -- Q`~ ~;/~ 5~~~ 3 g,~ R~ ~o~ s l ~;s-t"~ ~cyll .. ~ ~~ rw~~ mn ~k ~•~~ ~ ~' ~ ~°~~~ "~- bo ~„~ e # ,~~ chi k~ ~ Ass ~.m ~' /OD,oo / ~y, _ ~~~ ~~~ ~ j s~ 000 ~ ~ ~r o , ~ ~oN' PN% ~~~0~„ ~ 3 N ~- yo ~- ~EX~~S~j~ 4 pne~E ~lv. /~' f p X00 2®'~S/Vl ~~SSI/.-'~®~ aE~i~i~5 W~~~ a. ot~l~~o,,aN sf~~' "ee wx B r `~` ~ / ~~ RB-,^ ~°~`T - __ - ~_a x ~/-a-~i ~l~ Sf.~ 5 s~~~"c !4 AI K '~` ~ ~r~ b a Mt a as d'am` r ~ ~dRwN unlra ~~ Ply ~~~ m ~ ~~~ ~eg° ,~ q Asp ~,~ ~ bo ffo~, e~,~i~ik~ -~ ~d i ~, o $ ~ ~r°' ~ 'oo GoN ~ ~~K y v~ use, ~----~- - ~~~ 11 ~ -_ '~ ~ 3 ~ ' 3 ! ~3 ~r ,~~ ,~ Q/ N i'~ y° ~ ,LFx~'sff~ t~Fae~E ~/d, ~/,~90~ So. f?•. f' Wisconsin Department of Commerce Division of Safely antl Buildings SOIL EVALUATION REPORT ~n ~nnnrrl~nnc wi4k~ Cnmm AS \Nic Arlm Crvlc 1807 Page 1 of 3 A.C.E. Soil & Site Evaluations County Attach complete site plan on paper not less than 8'~ x 11 inches in size. Plan must "" St. Croix include, but not limited to: vertical and horizontal reference point (BM}, direction and • ~ ~ Parcel LD percent slope, scale or dimemsions, north arrow, and,location and distance to nearest ~~ ~ ` " . 020-1063-70-000 ~ Please print a~11 info~'t o ~ ~P ~ ~ R awed B Dat Personal information you provide may be used for seconday purposes (Privacy Lew, s. 15.94 (1) (m 0 ~ , Property Owner .; (~ (~ ~ Property Location . Z ~ Angeline H. Sewall ' N R 19 W Lot SE 1M SE 1!4 S 23 T 29 Property Owners Mailing Address ~ ~ ~ ~, , ~~ ~.~ >; L # Block # Subd. Name or CSM# 3 Ll 817 Bradley Drive _ ~~~;~,iNG OF=FICE ~ 2 CSM Vol. 2, Pg. 541 Phone Number City State Zip Code ~ City ~ village ~ Town Nearest Road Hudson ~ WI 54016 715-381-6714 Hudson 817 Bradley Drive ;J New Construction use: ~ Residential / Number of bedrooms 3 Code derived design flow rate 450 1I' Replacement ~ Public or commercial -Describe: Parent material Glacial outWash Flood plain elevation, if applicable na General comments and recommendations: Install three trenches at elevations = 91.00', 91.50' & 92.00' using 22 leaching chambers. Install bull-run valve to allow future use of hydrollically failed dispersal cell. GPD a Boring # ~ Boring Pit Ground Surface elev. 97.35 ft. >104" in. i~ Depth to limiting factor Application Rate Solt Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#Z 1 0-10 10yr3/2 none sil 2fsbk mvfr cs 2fm,1c 0.6 0.8 2 10-15 10yr4/4 none sil 2fsbk mvfr cs 2fm,1 c 0.6 0.8 3 15-29 10yr5/4 none sil 2fsbk mfr cw 2fm 0.6 0.8 4 29-36 7.5yr4/6 none sl 1msbk mfr cw 1vf 0.4 0.7 5 36-48 7.5yr4/6 none Is Osg ml cs - 0.7 1.6 6 48-104 10yr5/6 none s 0 sg ml - - 0.7 1.6 ``~~-- 2 Boring # ~ Boring 1/ Pit Ground Surface elev. 95.63 ft. Depth to limiting factor >98~~ in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dlft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#2 1 0-9 10yr3/2 none sil 2fsbk mvfr cs 2fm,1 c 0.6 0.8 2 9-24 10yr4/4 none sil 2fsbk mvfr cs 1fmc 0.6 0.8 3 24-40 10yr4/6 none sil 1fsbk mfr cw 1fm 0.2 0.3 4 40-48 7.5yr4/6 none sl 2msbk mfr cw 1vf 0.4 0.6 5 48-52 7.5yr4/6 none Is Osg ml cs - 0.7 1.6 6 52-98 10yr5/6 n s 0 sg ml - ~ 0.5 1.0 H#6 contains 1/2" - 2" bands of 0 10yr Ifs at 10" -15" rticel spacing. Loading rate reduced to reflect reduced permeability o n associated G1~..(3 ~ - '~_~ .~~~ ~ / ~1 _ h with bandino. - - * Effluent #1 = BOD ~ 30 <_ 22/0 mg/L a TSS >30 < 150 L ant #2 = BOD ~ 30 mg/L and TSS <30 mg/L CST Name (Please Print} Signature: CST Number James K. Thompson ~-- 3602 Address A.C.E. Soil & Site Evatuations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceola. WI 54020 6/142004 715-248-7767 Property Owner Angeline H. Sewall Parcet ID # 020-1063-70-000 Page 2 of 3 Boring # - -.-~ Boring ;~ Pit Ground Surtace elev. 96.19 ft. Depth to limiting factor >99" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-7 10yr3/2 none sl 2fsbk mvfr cs 2fm,1 c 0.6 0.8 2 7-14 10yr4/4 none sl 2fsbk mvfr cs 2fmc 0.6 0.8 3 14-34 7.5yr4/6 none sl 1fsbk mfr cw 2f,1mc 0.2 0.3 4 34-40 7.5yr4/6 none Is & gr 1 msbk ml cw 1fm 0.7 1.6 5 40-60 7.5yr4/6 none s & gr Osg ml cs 1vf,f 0.7 1.6 6 60-99 10yr5/6 none s & gr 0 sg ml - - 0.7 1.6 Horizons # 3, 4, & 5 contain approx. 15% cobbles & stones. ^ Boring # ~ Boring J Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # ~ Boring Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Coni. Color Gr. Sz. Sh. *Eff#1 'Eff#2 'Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS<30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. ff 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. ,c ~` d C • L Est T,mde dQle~r. Q~ 1(.ouSc = /.2.5.x' r o, ,~ `U h k 0 0 ©4- E1u3~'~ we// EX~s~~~~ 3 6ed~m~, dwe/7~'n~ ._. ~~~.~~ J~' ~ ~~ d C\ J ~~w~ r--- i dcc-K --- -- -~ P~~~cl~,~,~.(c~ /~ '~11`~ o bf Q ban~i~/ ~ i ,~53 ~0,. q~• ~~~ ,_ ~4pP~. /oca ~.~n o ~' ¢XISfi , ~ ~ ~ ~ v bo#ar.,oFcc//=9t~~~ ~~~ ~~ ~~ Po% ~ S~t~ a..yC~T~a,~'ol.-;,o ed~.~ of 6 ohm ®~' S. ~i ~ ~SSar~ Gd e%v~ _ /GU Gtr.' ~~ •~jci~' tads ~te~~- ~ s e- ,: , 7°n.0~'fi<<co/san Sf.~roi~cCn~~J/. ~, 3 aF' 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~~ t,cJ et Mailing Address ~ / ~'' .~Jr ~ ~ e Y I~r Property Address (Verification required from Planning Department for new City/State ~ ~ C~ ~ d iV ~~ Parcel Identification Number 4 ~ B - / db ~- 7 Q " Bo ~ LEGAL DESCRIPTION ~ Z~~-C Property Location ~ '/, ~ %+, Sec. ~3 - T~,_N-R~~, Town of }"~u-~ S o /t~ . Subdivision Lot # 2 Certified Survey Map # _~ '~/ ~ ~ ~ '~' .Volume ~ ,Page # Warranty Deed # S ~~/` 3 4~ ,Volume / ~ ~~ .Page # b o q Spec house ^ yes no Lot lines identifiable [dyes ^ no SYSTEM 1~'IAAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, journeymaaplumber, restcictedplumber or a licensedpumper verifyiugthat (1) the on site wastowaterdisposal 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. Uwe, 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 Zoning Office within 30 days of the three year expiration date. SIGNA OF APPLICANT ~''~ l OWNER CERTIFICATION 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. Ou..h~ ~ . ~ , s:~.~~ ~C SIGNA OF APPLICANT ~~~c,Quh 1r7~ 7 _ DATE «««««« «• «««« Any information that is mis-represented may result is the sanitary. permit being revoked by the Zoning Department. «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty decd POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of ~~ FILE INFORMATION Owner S,~~jG} L~ Permit # ~ r ~-~' ~ ' ~ j~ ~_ '~ DESIGN PARAMETERS Number of Bedrooms ~ ^ NA Number of Public Facility Units J~'I l~A Estimated flow (average) p p al/day Design flow (peak-, (Estimated x 1.5) s~ al/day Soil Application Rate . ~ al/day/ft2 Standard Influent/Effluent Quality Monthly average" Fats, Oil & Grease (FOG) <_30 mg/L Biochemical Oxygen Demand IBOD51 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (RODS) Total Suspended Solids (TSS) 530 mg/L 530 mg/L NA Fecal Coliform (geometric mean) 510°~.f OOmI Maximum Effluent Particle Size Ye in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ~Q© al ^ NA Septic Tank Manufacturer ~j~ ^ NA Effluent Filter Manufacturer ~6,c / ^ NA Effluent Filter Model - l~0 ^ NA Pump Tank Capacity al ~A Pump Tank Manufacturer A Pump Manufacturer ~1 NA Pump Model ~A Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: NA Disper CeII1s) n-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-r«+~+d (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA NIAINTFNANr_F CI'_HFnlll F Service Event Service Frequency Inspect condition of tankls) At least once every: ^ onth(s) (Maximum 3 years) 3 (earls) ^ NA Pump out contents of tankls) 3 When combined sludge and scum equals one-third (Y31 of tank volume ^ NA Inspect dispersal cell(s) At least once every: ^r~ nthlsl (Maximum 3 years) ~ yearls) ^ NA s ,~ I~~~ Clean effluent filter ,v t least once every: ^ rr nthls) ,3 year(s) ^ NA Ins ect pum ,pump controls & alarm P P At least once eve rY~ ^ month(s) ^ yearls) NA Flush laterals and pressure test At least once every: ^ month(s) ^yearls) Lg-Aq Other: At least once eve ry~ ^ month(s) ^yearls- ~A Other: [g-RA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tankls) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third IY31 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page of START UP AND OPERATION - For new construction, prior to use of the POWTS check treatment tankls- for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cellls). If high concentrations are detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cellls) in one large dose, overloading the cellls) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, 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 replaceme system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area 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 on: to replace the i e POWTS. ^ h to h s n bee a aluated o i ntify a uitable replaceme area. U n fail of th PO a s it and site ev ion ust be rfo ed t locat a su' ble repla ment a. If no rep ent area i dable a ho tank m y a ins Iled s last r so to repla e e failed PO ^ 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 DIFFICUQLT OR IMPOSSIBLE. ADDITIONAL COMMENTS ~~.~,.~ /) ~/,~~~.r~c~r~u~__~~? ~ic~ .rte _ ,~ POWTS INSTALLER Name ~~ ~ ~ L Phone - ~ ~ '~.2 SEPTAGE SERVICING OPERATOR (PUMPER) Name ~ Phone 7/S _ 7 y9~ b t! 5 .> POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Name ~ f , Ctt i ox Co ct N~ 6 / /G Phone '~ / j - 38~-4/G $~ This document was drafted in compliance with chapter Comm 83.2212)Ib)1'1)!d)&If) and 83.5411), 12) & (3), Wisconsin Administrative Code. ~; . _ . ~~ JAN 25 1978 ~ '~^. ' ~ • d -~ ~ l ~GI O' COIVtYE(( Rea, :(~ 1 9 ~ of Deed \ a4 c /j y ~. S; Golx ~nl ~ ~~~ ~~ W,. 'lY. b~rc,,,.rn `,4 I~ , ~ -~z 346224 ,- _ 5T. CRO~X COUNTY CERTIFIED SURVEY MAP NUMBER . ~~1 PF72T OF" 7rKE" SE /~-¢ OF THE 5'E l~4 O~ SFC T l 0 /`I 2 3, TO Irt1~lSNl P 2 9 ~02~H, 2 A/VGE / 9 WE"S T, TO VV~! OF ~UQSO~, COUl~1 T Y 0 F ST C,eO/ X, STgTE QF- l/1/ISC~NSII~J ~. .... ~ .vt•N `~` 4.. ' ~ ~~ , • •' ~ RTT.I~ i RICHEY . ~ = S-1429 WEE3STER, ~ ~s~ WIS. ~ ® ~ •o ©••...........• J ~o ~2 ,~'~; E°,9'~ APPROVED ~~~ .~, JAN 18 1978 s1. cROlx coUNTY COMP~2EHENSIVE PARKS PLANNINf3 AND ZONING COMMITTEE o N ~ = BRA/ rS EN MON. , F D. 0 O _ / "x 24" 1.P. sEr, !. GB#~L.F. ~ Tails MINOR SU9DN1510 App;.vVA~ FOR AppROVAL OF ti\-AI's THE BRS1S FOR THE BEHRINGS 1N TN/S Su,QI'EY ppES Nei OR SEPTIC SY~TEN-. /S Ti2vE" Np,2TH Bf7sEO ON FI POLH2US ° y~T c E ~,¢ C02AlE~ SFCTlON 23-24 1 ~ ~ ' r ~ ~ Z ~ ~ O ~ $UIL~ jO N62•20. OBS6R I! f~T/QR! MHD~ FIUGUSI" 6, /9r6 LOCf~[. T~iYE N ©' m I REF ~ J^C/gL E / N ~ 20~' ~ j CV~vF TFI ALE v z Lr - 66. ' O 20 - - - o - ' a 9 2 - -o /-7 / 67. O' 2T2. l37•0 2 -S / o - -2 ! .00' o o .oo E~~E ~ ENE D~ 8~ o~~pEQ q.t9 5 L~~pS 23,2 425.2 0 •~ t~ p,,a '~9 ~ ~ QZ UN , SE o,,25 ~ Or F ~pE SE /~ X ~ 66 3p0.0 / ~ SINE ~ ~ - 1~3.g2 ~ LOT 2 )DES 0 /S`~'3 Nu~~ 3.8 f7CRES (~" r~ LOT / ~`S3 „ .,s, 0' ~- '~~' -f / gceES I ~ OI o ~ '~ ~ v~ .-0e Z~o.aa LOT 3 N N 3. q ACRES v~, W ~_ Cs~ m 0 .~ ~` ~' a ,. ° b. ~, _ -, .e ~~~~'° 181 8 3~`,,~, LOT -9- ~, 4.2 gceEs N~ w k~- ~n M N W o~ W .o o ~ %o ~~, q ~~o fix" V u,, Q~ ~~1 -~,: 2T2~ q4 - -~ ~ 'I I k. rn ~ti ~\ ; 0.~~ ~ ~~ w i M ~ o `.0 ~ '~Ol l:~hf) PAGE ~~ ; 11a(C fiat of Wisconsin Farm t { >!i1 ~ X59.3 )S ~ ~v~~kk+~~i~cY Da:F:D f A N i MO. ~ use 1r E . ~ • :Veil W. LeKander ~tnd f l'Eliti DEED,. made hctwecn Patricia LaKat?der, Trustees of the I.eKand•~r F:t:nily Crust dated April 1?, 1y93 Gruuur, I a„d Angeline H. Sewall, a married pPrSUn ~~ ` ~' a'~ ~r~~ y __ t "- ~`:- t GC T i J 1999 ~' 30 ~ :,. ,- t nu$ $vACE PFSERV ED FGq PECOri":NG OA ~ ' Gralitel'. ~~ NA!.+F AND RETUPN ADDf1E$$: WhTNt:S.'iETH, 'fh;U the sail Grantor, fbr n va:uahlc con~idcratiun ~ ~~ ~i,L ~?~„( {- ~ ,}-I ~ . conveys to Grantee the Folluwiog +kscribed real estate in St, Croix ~ L#~~~ S,;•,l ~~ ~ 5~1ta (,~ County. SWreof Wisconsin: ~ ~-;~T .~ d~(,<.j / 2 i)2U-1Q.~-Z4-000____._-- PAPGEI tDENTIFICATi^N NUMBER Part of the SEA of SE} of Section 23, Township 29 ;forth, Range 19 West, Town of Hudson, St. Croix County, Wisconsin +-zseribed as foliows: Lot 2 of Certified Survey Maps, recorded January 25, 1978, in Vel~lme 2, page 541, as Document ~fo. 346L24 and Except part to Town of Hudson in Volume 889, page 444, as Document \o. 465228, 5t. Croix County, Wisconsin. ~ T~N~FER E This iS homcsteaJ property. (is) (i~r'f~t) Together with all and singular the hereditaments and appunenancc, ei>rreunto 1~elooging: And Grantor warrants drat the tide is goof, indefeasible in fees pie and frrve and clear of encumhrances except easements, roadways and restrictions of record. and wdl warrant and defend the s:une. Dated this ~ day of October la 98 /f ~_ ._~~_ __ (SEAL) ~ ~ `/,- ~~~1i (SEAL) . Y Ne W. LeKander, Trustee .. - (SEAL) t-~ ~ I~L~%~EAL) ', + .. .. _ • Pa[ricia,_LeKander, TrusEe ~~`r' :~ ~, ~ V . v ~ ~ J •: t.: AUTNF,NTICATIO\ ACKNOWL,~L~. M;~i"ir _.. U r G7 Signature(s) STATE OF WISCONS[N -~~•.. i QJ' ' .y~lc Sc. Croix county. ~ ~ss, rs~ authenticated this Jay of 19 Personally came before me this 'l day of October 1998 the above named ;leil ',~. LeKander and Patricia LeKander, Trustees of the LeKander Family Trust TITLE: MEMBER STATE BAR OF WISCONSIN (If r,ut, authorized by Section 706.06, Wisconsin Statutes) to me known to t•e the persons who exec~teJ dre foregoing instrument a acknc ledjg~e the same. THIS INSTgUMENT WAS OFAFTED BY ~~~61 1S . _ ,~ ~ ~ \~j ~j~p Michael M. Forecki, Attorney. • Kathleen R. Vidaen 1((C,,.,~~VII {~ Eau Claire, it'isconsin Notary Public Polk County, Wis. (Signatures may be authenticate) or acktu,wledged. t3oth are not ,xcess..•y) b1y commission is permanent. pf not, state expiration date: • Names of persons signing in any capacity should be typed or primed below their sigtumrea: June 24, ZQQ 1 19 .) F ~ ~ E D ~ `~ ~ y ~! j 1 ~ D ~: ~ ~ ~ ~ d ~ i JAN 25 ~ ~~ ~~es K978 ~ ~,~ ~,.,. i,_ , d ~` ' a ~ R~Olrfsr KE(( of ®e~ St; C y' ~ t.9,. ab c k ~~ ~a ..~ 1S ~ o~n, Y~. ~ y, ~ c ~` 4 U ~ 2 ;- ST CROIX COUNTY , ~ SURVEYOR'S RECORD' ~' ~' Z ~' ST. CROIX COUNTY CERTIFIED SURVEY MAP NUMBER ~~1 PFl2T- OF" THE SE ~'~-¢ OF THE SE l~4 O~ SAC T l 0 I`I z 3, TO1rll~lS~-ll P 2 9 ~02T"H, 2 A/VGE / ~' w~~T, ~TOw~v of l~vOSo~, COUNTY OF" ST COI X, STF-l'T"E OF- V1~lSC~NSIN H• .~, S ~~~` .•tyN. ~ /9,a s`~ ., ., ,~ ~ ~~ '~ ~ APPROVED ~ ~ , s _• ~ RT T ~~ . . e s RiCHEY Q , ~„~° ,JAN L $ 1978 ~ 5-1429 E ~,~ CORA/EJ2 - WEBSTER, ; (~ v i'psr~ wis. •~.~~ ~ St. CROiX COUNTY v COMP 2EHENSIVE PARKS PLANNING ~j .. .• sscr/oN 2.3 Z4-~ ® ~ ,~•~~~•~~ •~~. s R~ ;~~ pPID ZONING COMMITTEE so O e®®o ~ ~ •eooso,oo~~o V ~ D N MD ~ ~°, ~ ~ . / I . = BAR NTS E y -,A1NCR SUBDNISION O ~ !"x24`• /.P. SETS /. 68#/L.F. THIS FOR O Q ~ - ~'1 ~ ~ Op ppp,.GVA~ APpROVA tv1-AN SYSt~, THE BRS/S FOR THE BEF7RlAIGS IN THIS SuQvEy SEPTIC DOES NJI V ~ ~ p ~ ~ /S T,2UE / Q,erH BASED ON R POLfIQUS OR C, 5~T c gU~l~l 70 t{b2.2 OBS~'R I/ RT/Oit/ MRD~- FFUGUSr 8, lQY6 GOCfTi, T~r~f~ N 0. ®' m ~ gEFER Scf7~E /"¢ 244' ~ C ,~ C UR vF Tf~ ,eLE a M V6 .2 T /- 2 G O - 8 - - 66. 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