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HomeMy WebLinkAbout020-1395-03-000~ o ` ~i ° I ~ ^V ~ ors I ~o ~ y I o a ~ o ~ I ~ ~ 2 I a ~ c~i m `y ~ r'n o rn E ~' i N I ~ a~iL^°'rnE m ' C C3 ~ N C U ~ ~ C ~ C ~ 41 I ~ O C O N O` U~1 I G3 ~ C ~ ~ ~ O ~ ~ C I H ~ C X "~' ~~ C N N U y I d V i ~ ~ f0 ~ 7 ~ Q I ~ _ j O a ~r~ ~ UL ~ m v m v ~ ~'~ o t L I -pp c i p > ~ ~ M it U ~ o a y p Z I ~ ~ ~ a N m 1L C N C` U N~ O~ I ,~ i ~_ N ~ ~ ~ > ~ N U ~ ~ C ~ ~ O lp 1 ,= a C L U U U C U Q W G. U ~. ~ U. U I ~ ~ ~ y ~ z ~ Z O C ~ ~ e- ~ V 'O Z d m N H Z i I I O o Z a i c ~ I v ~ ~ ~ ' ° ~ o I d z a N F- •- ~ Z I C 0 ~ 'O ~ `' M I N = ~ c ~ I a~ d ~ ~ g ~ r ~ o ~ I ° ' ~ ~ I I z u i~ 1 ~ z I ~ ~? co .. d ~o~ N I N 2 I ~ d ~ ` 4~ w N Y I c Lo ca ~ ~ ~ inr~ rr ~ ~ ~~3~ a~ o ~w Z ~ ~ 3 p (A fop e- N 0 fn J () ~ N N } N I~MN ~l6 O 00 ~ j a ~ o ~ m a I ° '~ ~ u, o ~ ' ~ f~ ~ m ~ vJ QZ m I O o a I c H c I v o ~ O I ~ N O C C C~ N 1 0 Q ~ r~ N I~ ti ~~ U 7 N~ C 7 N C N c0 I 4 Gj ~ ~ O N 2 i V M z 0. ~ fn I O y ~' ~" 'ak ~' I = ~ I \ v tit °' ~ a `N ~ ~ a Q~.c ~ c~ ~ ~,, rr, A iag ° ~oa ~1 t ic ~ Wisconsin Department of Commerce ~ ' PRIVATE SEWAGE SYSTEM Safety and Building Division ~ ~ '' INSPECTION REPORT GENERAL~4NFOC~MATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.0A (1)(m)]. ermit Holder's Name: City Village X Township ~arria a Homes Inc. Hudson Townshi ST BM Elev: Insp. BM Elev: BM Description: 1D/~ .3 al. 3 ,~/j'1 - ~g2~ CsT 'ANK INf=f1RMAT1[1N FI FVOTIr1N r1nTn TYPE MANUFACTURER CAPACITY Septic ~s g~' Dosing n / -t) l•(f'ln~.~() ~~ Aeration ~ Holding TANK SETBACK INFORMATION TANK TO ~ ~ WELL o'i BLDG. Vent to Air Intake ROAD Septic ~ „~i / / /~l ~ ~ i ~ ~ Dosing ^~ / c~ Aeration Holding _ PUMP/SIPHON INFORMATION Manufacturer De M Model Number ~~~ ~ I ~~ TDH Lift ~ ~ i'o Frict n Loss stem TD ~ Ft 0 , ` l • Forcerriain Len ~ Dia. 'l a Dist. to well /J~% !/`~ Y SOIL ABSORPTION SYSTEM BED/TRENCH Width 3a. Len ~ I DIMENSIONS INFORMATION DISTRIBUTION SYSTEM County: $t. CroiX Sanitary Permit No: 399527 State Plan ID No: Parcel Tax No: STATION BS HI FS ELEV. Benchm rk ~3 ~ L.w. ~~ Z /o~, ~D/. 30 Alt. BM ~~#~ ~ 9.3 (, . 2 Bidg. S er S. . St/Ht Inlet ~~. ~ y z i a y / SUHt Outlet ~_ r~ Dt Inlet ~ ~ Dt Bottom ~ ~ ~o • Header/Man. ! , 2) ~ G ~Z l~ ~ J Bot. System 2 ~ ~ ~' Final Grade +/ St Cover b- OfTrenChes I IPIT DI ' I ~f~~/ I' ~~~ I i CHAMBER OR UNIT i Header/Manifold Distribution/ t x Hole Size x Hole Spacing ent t it N ~ Pipe(s) ~[ I ~ , •'Cn ~ Z~' - ~'_ ~. ~ / Dia Length Length lD Dia ~Sp acmg SOIL COVER x Praesura SvstPmw Only YY Meund Or At-Grade SVSternS Only ~~ Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center , , ?j Bed/Trench Edges Topsoil ~ Yes ~ No ~ Yes [] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:,~/O~U /b~- Location: pending Hudson, WppI 54016 (N~~W,~1if4~~W' 1//4 25 T29N R19W) Scenic Hilis Lot 3 ~~ 1.) Alt BM Description P ~T ~~ ~ "---- n°`''~~~ ~S - ,,~/ 2.) Bldg sewer length = a /-~' ~ 1 ~ ~ t' g'~' ~~S ~ ~ ~~ "~ ~ "~f -amount of cover = ~ 3 i ~~~~ ~,~~ ~ ~~, U Plan revision Re aired? ~Yes No / ,, c`y/ Use other side for additionation. ~ W OJ SBD-6710 (R.3/97) Date Insepctor's Sign are Dia. Inspection #2: / /. Parcel No: 25.29.19. C,u~- ~', 3 -~K~l,~-s- 'vim ~~ C~rt. ~No .I,z~~ Intake s-, .: t ,; ,,. ~. .~ ~~1 ~J r APPLIGATIOI~S Specifically designed for the following uses: • Effluent systems • Homes • Farms Heavy duty sump • Water transfer • Dewatering SPEGtFICATIOiYS Pump: EP04 • Solids handling capability: s/a" maximum. • Capacities: up to 55 GPM. • Iota! heads: up to 24 feet. • Discharge size: l'/z" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, i3UNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) irrtermittent. * Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: g/a maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feel • Discharge size:l'fi" NPT. • Mechanics! seat: carbon- rotary/ceramic-stationary, BUNG N etastomer5. • Temperature: 104°F (40°C) continuous i40°F (60°C) intermittent, d~ 1995 Gtotkls Puns, hoc. r7" ,~ GoGi~s F~~__ ~ of ~ r - G ~'~~-~ ~, /.s Submersible Effluent Pump ~~ ~ 3871 EP05 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. • Fasteners: 300 series stainless steel. • Capable of running dry wdhaut damage to components. Motor: • EP04 Single ptease: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Sinflie phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload w'~th automatic reset. • Power cord: l0 foot standard length, i 6i3 SJTO wi#h three prong grounding plug. Optional 20 foot iength,l6/3 SJ'IW with three prong grounding plug (standard on EP05). lu{EY'ERS FEET io~ 9r so 23 a ~ c, s 2c N Z 5 0 15 J 4 ti 3F 1C Available far autcmatic and menus! operation. Automatic models include Mechanical Fiaat Switch attembied and preset at the factory. FEATURES ^ EPO4 impeller: Thermo- plastic Semi-open design with pump out vanes for mechanics! seal protection. ^ EP05 impeNer: Thermo- plastic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion-resistance. ^ Motor Hansing: Cast iron for effiaent heat transfer, strengtfi, and durability. ^ iNtator`~over. Thermoplas- ticcover with integral handle and float switch attachment pants. ^ Power Ca61e: Severe dory rated oil and water resistant ^ Bearings: Upper and lower heavy duty bail bearing construction. ABENt:Y LISTING ~• canadian stasdatds Asso~aUan (CSA listed model numbers end in "F"or "AC°.) I ~ ~~~ .. . F ~n t o ~ 3 0 4 0 5 0 (3PM ~. ~ r ~ , 0 2 4 6 8. 10 12 m°/rt 1, ~~.. . EibCliv May,1995 ,„ SEPTIC TANK ~ PUMP CHaN!BR CROSS SF:CTiUN ANA SPECIFICATIONS ~" CI VENT PIPE 12" MIN. ABOVE GRADE ~ WEATHERPROOF >_ 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT W//`PADLOCK ER FINISHED GRADE ~ ~ WARNING LABEL ~, ~+ CI RISE ~~ --~_~_~;~~ MIN. 18" MIN. 6" MAX. ~` '~~` `; , ~~ .. NLET ' ` i `, GAS- i ' WATER TIGHT SEALS T' GHT ~ - APPROVED A SEAL ~ JOINTS WITH .J._. ; ALM APPROVED PIPE pPROVED ~ B ~ ~ 3' ONTO N70 SALIO f ~ ' ' ~ ON SQLIO SOIL OIL ,~, ! ** RISER EXIT PUMP OFF ELEV. FT. OFF PERMITTED ONLY D IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC ! DOSE ~~~~~ TANK MANUFACTURER: ~~!~,~ NUMBER DOSES PER DAY: TANK SIZES : SEPTIC l.~.~' GAL. DOSE VOLUME INC LUDING "~ DOSE ~ GAL. FLOWBACK: d?6D GAL. ALARM MANUFACTURER: "-"~"~ MODEL NUMBER: SWITCH TYPE: PUMP MANUFACTURER MODEL NUMBER : SWITCH TYPE: ~~D~LQ X~n ~ ~. v ~ YC ~ ,~ .L<Gl ~~ ~~ - N2 ~cr ~ CAFACITIES: A = D INCHES = .3~ GAL. g~ 2 T NC HE S= ~~,_„_,,,,rGA L. -~~ C g INCHES =~~ AL. D - ~ INCHES =_,204 __-,GAL . PUMP ~ ALARM WIRING AS PER I LHR 16.23' WAC REQUIRED DISCHARGE RATE o? ~ GFM VERTICAL DIFFERENCE BETWEEN PUMP GFF AND DISTRI$UTION PIPE ~ FEET MINIMUM NETWORK SUPPLY PRESSURE ,.~6-FEET + `7C1 FE£T FORCEMAIN X old FT/140 FT. FRICTION FACTOR .`. ?~.? FEET TOTAL DYNAMIC HEAD /, FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH~_____; DIAMETER _____,_, LI QU Z D ~ ,38` ~ ~ S-~1~~/~ ape r / ~' SIO~£p: .~~~_ LICENSE Iv~JMBER: ~~'~`~~~ DATE: _,~~~~~~~ 1/88 _ Safety and Buildings Division County S ~~ ~ ~ 20t ~V. Washington Ave., P.t7. Box 7162 . ~ i X ~ w ~~~~~s j~ Madison, WI 53707 - 7152 Sit~;ddrass De artment of oommerce G - 6 -0 Z S3/y ° + n S ~ k Sanitary Permit Application S""a" Permit Number Ia accord wilt Comte 83.21. Wis. Adm. Code, personal inforwadon you pmvido Check if Revision ~~~ ~J.-~~ eta be tread for Privac Law a15. 1 m I. Appllattiaa 1[ttfotmtttbn - Plettee Prhrt All llnfoarnation State Plan I.D. Number , I A /~/ ~} Property Owner's Name Parcel Number ~~-~y<<~ -~ ~.~ ~ o~ -~.3yS- 03-~6t> Property Owaer'a Address or Pro p ty Looadon ~ 017 Ce 7..5 d S~ 1l ~f"~v ,~l//~ ' ' ( .~(N cif yi;S To~ N.R ~. Stau Zip Code Phone Number I.ot Number 3 Block Nu~bsr RECEIVED Subdivision Name esHl Ntttttber Sr%'Gl ~Ja~e ~ ,tJ SS~~ .S'~ ~~~~~ ,' s II. 'I~pe of BuiWinS (check aU that aPPb'} - z0~2 QCicy ~1 or 2 Fattdly Dwelling -Number of 8edtnotns ~ QV~ 0 PubiiclComtnercial- Describe Use Z UNTY GtGI•S~J.~ p~~~ 7 ~ n !~ ~ranrat.Ml~LL .71YK. V^i~ J 1 ~ p ~ ~ aC ~D s :-Y III. Type of I'erntlt: {Check only one box on lice A (nttmtierhtg scheme far iaternai usel. C~iplete llne B if applicable) A' i ,New 2 Cl Raplaoemem System 3 ^ Replacement of 6 ^ Addition t4 For Country tree stern Tank Oa! Etds ` S stem B. ^ Check if Sattiury Petutit Previously Issued ~~ Number Date Issued IV. Type of Penait: (Cheek all that apply}(nttmberlog scheme is for laternal ~ ~ 3 /x / / 44~Noa-Presstuit:ed In-Grouted 21^ Mound 47 ^ Sind P~ltu 50 ^ Consaructed Wedand ~S~~a~~ f 22 ^ Pressurized Ia Ground 41 ^ Holding Task 48 ^ S'tagle Pass 31 ^ Dtip Linn 45 ^ At-Grade 46 ^ Aerabfc Tteattttetu Unit 49 ^ RecircWa ' 30 ^ Other V. D Area Informati on: 3 c ~-~ b~ ~ ' Dew Plow (~ Dispersal Area Diapcrsa! Area, Soil Application Parwlation Rate System Elevation Pitnl Grade Required Proposed Rane(Gals./Days/Sq.Pt.) (Min./Inch) ~ 7 s/ Elevation ' 7 s0 T67/ l~~l ~ 7 ,i ..~~ ~~ ~o~~ .~ Vi. Tantk ltnfo Capachy in Total Number Manutacturec Prefab Site Steel Fiber Plastic Gallot>s Gallons of Tanks Concrex Constructed Glass -7 ~~ / _ /~ 6 ~.~ ~ ~~~ ~ L-rri TuYte Tact , . Sepdc or lioldit!< Tank ' Dosiaj Cbuttbar VII. R IIi Statement- I, the tmdersigsted, asstame respmsib~ity for on of the POWTS drown ou We attached Plumber's Name t'ptiot) Plumber's Signature !tS Number Business Photo Number ~~..1(<<;~.1s-+- ~~~i~.~hr a ? 4~ZD ~l5'- 38''x' -~/a c Plwnber's Addtross {Sheet, city. state. Zip Code) /d7~ S a .~ - VIII. Cotter /De artment Use Od Approved ^ Disapproved Sanitary Petmlt Pee {irtclttdea Groundwater Date lasued Is Agent Signature (No Stamps? ^ Ow~r Givaa Initial Adverse Surcharge Fee) ~ ,~ ~ /~ `~ ~ b ~ ~ Gt Detertniatttion ~ r Df. Condltiaats of ApprovaUReasoas for DisgRpr9val ~u~~ std ~ ~ u~~-~r.~h~ P~/ fGf !ED Ul.~ ?a C~rrvJ'L y W~,~2~~:o»u-n~1~ ~D ClL~4-i/i,~JG- Attaeh eotaplde plant (to the Cocoa only) toe the sydetn oc papee not lea x ii lecher in slna ~t7¢. ,y~,~tl~/,~L~ ~ ~i tom?-- C1 Q/ ,~~' ~8 ~a°~~ ~u a ~~ ~UUs t ®P P ~~ • ~ BINS ,MTh Z. bf~ ~ 'S, ~~ C. .~ .J {/\\~\`L Y ~/a ~f.<< c __ -~, ~ ~ ~~d~s -~ may, ~ \~/~~f~~-- ' sr cRalx courrrx SBPTIC TANK 1~fAA~iTKNANCR Af~RLEMLNI' AND OWNERSHIP CLRTiFICATION FORM OwaarBu ar ~ ~' ~r' >c ~ N , Mailing Address G ?Sap ~ -~'rllt+u'adk~ ,~' l~ - J/en ~~tG/~~.dw yuh S5'E3-~ Praporiy Address v l~ra~~tx- 2ao~owS ©~ (Ycrlficaflott toquired firm Planning Department for new (~ty/Statc dV ~ s d_ Parcel Identification Number G ~~ ~ ° ,~ Od (1- /395- 03 -DOS ~Et,3AL. DESC1itII'TIC)~I s,~r .~-~~c~v~ L,t9~-/ v.c/ Can 1.~, property Location „`~,'/•, ,~'h, Sec. ~ T ~°~ N- ~~ W,~'Town of ~-~,b~`~ g ~_./ Subdivision S~ ~ ~ N , <t`S Lot # 3 ,5 / ~ y ~ ~ ,Volume _ ~ D~ - Pie # a-`7 c~ ~- ~~a~I f ~1 `~ C:erti~ied. Survey Map # wat~anty Deed # ~ V~ $" 4 0 „~ ,Volume .Page # Spec house ^ yes l,~ no T,nt lines identifiable ~ yes ^ no ~YS M~-YlY'I`ENANCE lmprvpet Use and ma,intetuuxxof your septic systnm eonid result in its premature failure to handle wasoez. P=+ope o ~tenance eausists o£ pumpiu$ out the septic tank every three years or saonet. if needed by a licensed pumper. Wbat qo put ~ system can affect the fitstctioa of the septic tank as a tccaZarcnt stage in the waste disposal system. a certification form. signed by tlu ovmer and by a ~ property owner agrxs to submit to S`t, t~obc Zauing Departmout maskCrph 3~y~ Plumes, Apr m a uansed puz~ ~ that (1) th,e ou-site wsstewstesaisposal system is itr prapcr operating oonditiou s~or (2) aftex inspection and panoping Ctf ~), ~ septic tank is less shalt l/3 hull of sledge. Ifwe, the nndtmigaed have road the above Tcquiremeats and ngrae to tsraiatain the private sewage disposal system wiW 1be standards set faith, herein, as set by the t of Cammarcc and the Department of IZatural Resources, State of Wiecansia. C~stification stating that your scptk been maintained must be campietod and returned to tare St. t~oirc County Zoning Office within 34 days of `~ 'on date. ~ 1 SIG J F LICANT F (/` DATi3 li statcm+cnts on this foam are titre to the best of my (our) Scnowledge. I (we) sm (are) the owner(s) o 1(wc) oettify th,c pro des 'bsld vc, by virhrc of a warranty decd recorded in Itegistcr of Deeds Office. c ~~~ 5 ~ , S'-22--02- A AFFLICANT DATE . Any information that is mis-r+elsresented may result in the sanitary permit being revoked by the Zoning Department. «*«*"« f ««+++ "` Include with this application: a cop oy f th see rtificd satvfiey map if cferenco is made in the warranty decd ~- ~'~ ..."" Sa~ery uzd~uildir.~s~,s:e~.... ~ Ceti _,;-~ ~ i r' -X ....._.---------~ ` 20 w. w,s~la~sonAti•e.. P.~~ 8a~?162 ; ,r,.~ ...... ~ ~siio~o~tslt~ ~ ~ , t ro tam' Permit Applf c~~on ~ ~ q sa 7 f t~11MObd prpt l'~I~ Y.?,f. ~• AIM• ir0ih ro>w1 ~ Y~ Prowids d C~4k if' ~vlolon ~ .,. < Nuo~ ti ~' 7 p ~ s ~.~ (.~ ce~YYrj ~ ~ ~~ ~ ~.~ ~ ~ Ntunou ~ .%. ~,,,.~~ ,~~. 3 ~~ as ~ ~ ; ,. .......~.,..-... s~ --~-wi y s or 3 lr~tpr ~ - s~iiu of iweroom~ _.,... ,.. -------~•-- a P~-bttolCea~taRai~ - Dr~bi UM to ,~ I ~2) ~ X 93 • ~ u ooh U? ' ~ ~ ~ ~ boat o~n btu r toz t~1 ur10~ ~ ~ ~ i ANw ~ Q~~ s ©p.Pitouo~gt at e G Aaat~ms w s ' ~vo • 2,© tii0~! t~1ut~ ~ ~ttsd FtiDU' ~~ S~ ~~ W~tiand I, ~J~taN rla~u~rd ~a s} ~ Dr~st~• ' . 11 G Pr'a~reb~ed IbQtaomd 6i ~ ito~ T1t~lc , , µ L~,~laglo Pw f -~ sts~o tt ' ~ ~ 3o D r ,...,.,,, c «,,. ~ . , yp~ rptu vision 1 pspei 4ra~ii PpPatrd AtMI ,l~,ydS~vpt.) p~tlo,ttgek} C/7 fj- G~ '~ ~lrv-don (~ ~~ I ~L ~ f/! ~`~ I `fir ~~µ ~~~ ~~~ !~~~ ~ ~ ~ 9~itu ! lsibnr PlkttiG HmeWr i ~ CtiYn11~ Caarteucsrd { '~ Qlnu ;; x{0111 0lTidtl , ~ ` ~rr~r.,~ ~~~ ~~.A1 /-~f, . ~~y~~l~ 1'G ~~ Sc: ~ ~ ~ ~ ` ~ _ ~ tit plptun (1ra ett~al} App~reaM ~ ~ ~arelalap FM) ~ Q ~t oiMM ~eittti AdwtM • I ~ ~ . (.t~ aka ~$ lS~; ' a{ aZ t^5aQ.~e~~ i ~«1r~ ~ cam- :'.~~,n.n:asp rQ:. t~crni~ ,:. ' Ala ~s ~ 'c ~~ m P S .~,y L .l v~ 3 .S~ el/8. ~: ,~i .~/~ .~~l.J~l` 14~~~~<'~..i SGa,~~ j f~v ~~ ~ ,Bsn / ~ ;~olr;1i1~~ d 8~r ~ m ~ ~~ ~b oil ~Q ~d tl b ,~~ o ~ 3 g6~~~~~ ~6 v ~,~ ~~t tit°b h •~ ~~, / iu~' . ~-~ ~~ l ~,,J~ Q/ ~~w,s -~ S-,'Tr r; ~S ~ "c ~l i' m f' .5' ~,v L ~ ,l U`~ .3 5~~ ~°/j~/~! ~1~~ ~ ~rC~.l/ t9 ~~% ~~GZ ~~'d./ ~GCL~~-1 rev G/~j. l , t r / //v ~r uh ~,~ ~~ i ~; ~u- / ; ~ • ~~ ~~: ~9 ~ m ~ ' ~ . J~ Q/ ~E ~~ 0~~ vN ~a tJ ~~ T`~ ~6D 3 ~e,~`e~ j i D 1~~4 Za~I ~,°Y s', ~~ T~ ~; gr,r ~~ ~a ~r~~ ~~ ~~~ -~ - V16scxnsin Departrrrerrt of Commerce - SOIL EVALUATION REPORT Page ! of~ Division of Safety and Buildings . In aoooraanoe wrm t:omm aa, rv~. nom. ~vae County - - ~ 11 81/ o Pl ust a i h i 5 C ol Z x om~ete site plan on paper not less than Attach an m es n s e. nc indude, but rrot Iknited to: vertical and horizontal (BM), direction and Paloel I.D.. . pendent slope, scale or dimensions, north arrow ' "~'a m nearest road. . s_>-_; P/ease print ; ; \ n. by Date ' ~ Personal &~rortnatbn you provide may 6e fi~dary aY Law,` .15.04 (1) {m)). , fib?~/~ ply p ~ - - P rly Location ~ .~ ~ ~~ M - ~ ~ . ` ~ Lot c.J 114~(f UJ114 S Z,; T Z `j N R ~ q E (or) t V~ Property owners Mailing Address 1 ~'. , Y ~ X ` # Block # Subd Name or CSMI/ City State Zp Code ,.P11 F1C;E ,~:ti~\ ^ City ^ V~lege (~ Town Nearest Road -; T !, - ® New Coristrudion -Use: ® Residential / Number of `~ 3,=`J~ Code derived design flow rate DSO ~(o O Q GPD ^ Repiaoertrent ^ Public or oommernial - Descnbe: Parent material OU fL~a.B ~ Flood Plain elevation if N / f4- ft General cornrnents ~ ~ S ~ ,,,.` e. l c Jai f ,b ~ - ~ E° ~~' ~'O1`•.° ~ q y4 ~ u and recommendations: ~ t~,l-` 2., I ~. J 0. ~4-: o r~ - ~ P 9' g' ~~j Low-e r q g - 0 0 tt~+ Pit Ground surface elev. 99' ~v tt. Depth to limiting factor 1 l h in. So~7 ic~tion Rate ~~ # t^~ ~g Horizon Depth Dominant Color Redox DesgiPtion Texture Structure Consrstenoe Boundary Roots GP D/1~ in. Mansell Qu. Sz. Coat Cobr Gr. Sz. Sh. 'EtT#1 •Etf#2 ~ e-~ r31z - S~ 1 2 ~dc m-~-- ~5 l v~ . 5 - B 2 15 - nzJ ~ `_ m 5 Cis rr, I - - /. Z- - 32•`f 8. a ®Pit Ground surface elev. u • 3 o ft. Depth to larriting factor. / ~„~,_ in. ~ ~~ ~~# ° ~~ . Horizon Depth Dominant Color Redox Despiption Texture SWdure Consistence boundary Roots GPI Nfl? in. Mansell C2u. Sz. Cont Gobr Gr. Sz Sh. - 'EfC~i't *Eft#2 1 p -~ (b Z ~, - Si) 2 mfr' ~5 I v ~ . 8 Z t_b_ ~ hS 1 ~~ Z a~' 9~ • St) ~ __.___ .6 • cai..e.,t ~r1 . itrlrl ~ 7n ~ ~n nv,A ~rvi TCS >~tl < 1 V1 moll ' Eltluent #2 = BOD _ < 30 rrrall_ and TSS < 30 mOIL CST Name (Please Print) 'grtature CST Nrxnber ~1 yy~ ~- ~,~ vV~at~ ~T- ~~ ZS 3309 qdd~ Date Evaluation Conducted Telephone Number Z ~ 13 ~J'`-~ ~4 4~-~r~-e~ ~ ~ ~ 5'~o2s G -/~ cam/ ~ 15- 247 --`I0~ ~- Property Owner F~LC' k~ ~ 1 Parcel IQ # . Page z of T 3 Bonrtg # U ~~ ®Pit Ground surface elev. /Oo• y~ ft Depth to limiting factor_ ~ ~ ~-_ in• Soil ication Rate i H th D minant Cob D Redox Description Texture Structure Consistence Boundary Roots GP D/t~ or zon ep in. o Mansell Qu. Sz. Coat Colo[ Gr. Sz Sh: "Eff#1 *Eff#2 1 0-l Z S ~ ~ ~V~ ~ ~$ .•-- 9~~ ~ ... _. ------ . ~ 'fib. ^ firing # ^ Boring - ^ Pit Ground surface elev. ft. Depth to limiting facbr in. ~~ icetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlf~ in. Mansell Qu. Sz. Cont Color Gr. Sz Sh. 'Efi#i *Eff#2 ~~ # o Boring ^ Pit Ground surface elev. eft Depth to I'urifirg factor in. Soil lication Rate Horizon Depth Dominant Cob Redox Oescxiption Texture Structure Consistence Boundary Roots GP D/fP in. Mansell Qu. Sz. CoM. Color Gr. Sz. Sh. *Eff#1 *Eflifl#2 "Effluent #1 =. BODS > 30 < 220 mg/i. and TSS >30 < 150 mgl1. * Effluent #2 = BODS < 30 mglL and TSS < ~1 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 608-266-315 t or TTY 608-264-8777. SBD-8330 (8.07/00} PAGE ~ OF~_ NAME -~ P` K-e-~ , LOT# 3 LEGAL DESCRIPTION.UcJ '/adl~J/a,S TS~T Za,N,R lq E (or~ SCALE: 1 "= y U ~LEVATION ~~~ • d BM 1 DESCRIPTION ~o Q a~~vc. ~ ,'nom ~ ~ BM 2 LEVATION ~ ~• Z ~ BM 2 DESCRIPTION -Fp ~ o ~ Z " Q UC~ ~ i ~P e SYSTEM ELEVATION{ q'7.5o Gowcr- 8700 ALTERNATE ELEVATION}op 9~•$6 t-owa,~ 9Y y0 CONTOUR ELEVATION /a.~wo.TgQ.y, Qg,oog7pd D 2-2 p . Ir ll i~ a'i ~1~~.1 Ga+ Sk4Pe K ~ ~- - ~ ~G, Z ~ FROM Schumaker Plumb~inq FAX N0. 7153863121 Oct. 29 2001 04:30PM P1 SCh~urriak®r Plul~'ribi'n~ ao7o scorn au wu~soN wi sao~s Phnn® 8~ Fax (7~S) 38~.3tz1 DA'1'~ : ~d ~ ~ ~ d f T0: ~ON \ 'tom FAX # : ___„ N0.OF PAC~S:.~i~ ~~~ ~~. SPECIAL, iNSr'RUCT{4N5; ~~ ~ .4 11 Y~ ~ ` i1 1~ ~~ ~-' 3 ~~, ~FRr~:.9~._ ~~ FROM: Schumaker Plumb.inq FAX N0. 7153863121 Oct. 29 2001 04:31PM P2 ,~ ~ Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity in-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWYS) shall include information and procedures for maintaining the system within the parameters of Comm $3 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- • ~ Table t: Syst®m Design Specifications Sanitary Permit Number °- S 2- Numbet of Bedrooms Desi n Flow -Peak (gpd) o•D Estimated Flow -Average (gpd) . Septic Tank Capacity ( al) ~ Soil Absorption Component Size (ftz) - .r Type of Wastewater Dom stic Table 2: Soil Absorption Component -Limits of Reliable Operation Septic Tank Component Soil Abso lion Component Design Flow -Peak gpd) I L- wJ ~k Maximum Influent Particle Size (in) 1/8 Maximum BOD,, (m L) 220 Maximum TSS (m /L) 15p Table 3: Maintenance Schedule Septic `fank Inspect and/or service once every 3 ears Outlet Filter Inspect once a ear and clean at least once eve 3 years Soil Absorption Component Inspect onoe every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113. Wis. Adm_ Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, SeepagE Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic t k and tlef fill shall be assessed at least once every 3 years by inspection. Th utlet filte shall e c eaned as necessary o ensure proper operation_ The filter cartridge shou be rerttoved unless provisions are made to retain solids m the tank that may slough off the filter when removed from its enclosure. If the J ~~ ` ~ Management Plan for a Septic 7a~k and Soii Absorption Component filter le equipped with an als~rrn, th® filter sha11 ba servicod if the alarm is activated cahtinuougly_ In#ermkttent flltgr alarms may indicate surge flows or out impending continuous alarm. The septic tank shall have lta contents removed when the volume of scum ind sludge in the tank exceeds 1/3 the liquid volume of the tank If the contents of the tank are nvt removed at the tim® of an assessment, maintenance per3onnol shall advise the owner of when the n®xt service needs to be performed to maintain less than maximum scum and skudpe aceumulatlon In the tank. Manhole risers, access risers and covers should be inspect®d for water tightness and soundness. Access openings used for servicq and aes~rnsnt shall be sealed watertight upon the rompietion of service. Arty opening deemed unsound, detective, or sub)ect to failure must be n9placed. ,Exposed access openings greeter than S-inohee to dtamet~er shall be Secured by an effectJve locking device to prevent acddsntal or unauthorized entry into the tank. No one ehowld inter a septic a other frsatrnen! or holdlnp lank tor' any mason withal! bolos In hill eornp/lann with OSHA standards ~ ent4t'la~ a conRned apace. Thv atmosphN'r wKhln tfis sept/o or other t~flrROtlt o!' hotdlnp trrerk may conaln tretha/ s~e~ and rescue of a person ttnpn the Intrdrlor of the lanlr Wray be dltheu/t or /nlpoas/b/e. Tank abandonment shall ba in accordance with Comm 83.33. Wis. Adm. Code when the tank is no longer used as a POWTS component. IIA ~ The soil absorption component serving this structure is designed to accept domss~c wastewater from a residential faGllty. The limits of operation of this component are shown in Table 2. Th6 longevity of a soil absorption ~mponent depends greatly on proper and timoly maintenance, and system use within or below the limits of reliable operation, Good water conservation prectices by ail occupants and the instsllaiJ'on of water conserving plumbing fixtures are key factors to extending the useful fife of this component. The Boil absorption compcn®nt's operation must be assessed by Inspection at feast oncx~ every three years. The tnepec~lon shall include recording ti7e levels of paneling, if any, in the observation pipf:s, and a visual inspection tar any evidence of sw1°at~ seepage or discharge from th® component. On steeply siopirtg sites, areas of erosion should be identified and repart~ed to the owner for repair. The surface discharge of domestic wastewater or sowage from the system Is prghtblted end considered a human health hazard. Traft'lo around ar over the soil absorption component should be evoldrd particularly during avinter months, The compaction or removal of snow cav®r over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary. but is difficult nr Impossible to repair until weather oondittons Improve. In general, soft compaction over this component wilt reduce diNuslon of oxygen Into the soil and dispersal relf, which may {cad to more intense, and ®arller, organic clogging o! the soli. Z ~d WdT~:bO ~00z 6Z '~~0 TZI~98~STL 'ON Xtid butgwntd .~a~~ewny°S W0~1d FR01''?~ : Schumaker Plumlainq FAX N0. 7153863121 Oct. 29 2001 04:32PM P4 .a Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted tn3es and shrubs directly over of within ten feet of the component should be avoided since root intrusion into the component may obstruct w6etevvster flow. Contingency Plgn In the erront of system failure, a new system could be installed in an alternate area. With the installation of a dlverter valve, the existing system could also be reused after a period of three to four ;ears. It is the property owners responsibility to maintain the altemate area free from any planting pf trees, shn~bsls, etc. In case ofi failure of the original system, the ~altemate area will be needed- If any trees, shrubs, etc. have been planted on the alternate area, they wil{have to be removed at property owners expense. If aitemate area is destroyed, there are other altem+ative systems that tan be used, in which, could result in added expense to the property owner. Any tank abandonment shall be lone in accordance with Wisc. Code 83.33. Arty questions repardinp this code, please contact your local Zonirtq Office or contact the instellin~ plumber. 5~--..,~ ~..l~~.n. t~~ v~tr, b - tv~ (~ t5) 3 ~ b - 3 ~ ~ 1 FROM Schum3krr P l iamb i nq Ff-u: PJO. 71~ 3121 ~ p. 1S 2991 05: ~'1 P4 S'T CROIX COUNTY • SBP'I'YC TANK 1~iAINrg3NANCB .Af3~ItLENIEN'T AND . OWNERSHIP C.EF`TIFICATION FARM /' /r>Uv12P s' X' 1C ~ / N t7VVQ6I/Bt1yCr (,•IC~I/'~'~~r Mailing Address lz 75"0 5 •~-~/ lw~i..~v ~ ~ AOt7 5~i l jcuz~. v- ti1~n ~'S'~'~ Propt~ty Address C~ty/State (Yerii•{cation roquired from Planning Department for trees .- Parcel Idenrification Ntunber ~ ~~ ~ ° t F(~AI• DF.ttSC1•tII'__'_I'I_C-11 s'[Z-r' ?-~{~~~K7~ 1. •l %.4'~ v.c/ t7 t.tr.~~ erl ~ ~ ~ N_ ~ W, Town of ~ o -rJ Property Location ~ /•, ~t~.-- y., Seo..~S . TEL R~ Subdivision 5 C iv ~ II..S Lot # Cert~ed Survey Map # _ . '~Toltune ._ .Page # o .Volume fs? ~ z .Page # 2$9 WatTanty Deed # ,~~~ Spec house ^ yes ^ no Lot lines identifiable ~ yes ^ no ~~ ~YSTI± 1VI MAYN'I'ENANCE Impt+opcr ttse and maiateaauioe of your septic system could result in its premature failure to handle wastes. Proper maintenance eocsists of pumping out the septic tank every throe years or sootier, if needed by a licensed pumper. What you put into the system can a8'ect the fiiaction of ttie septic tank as a tccatuient stage in the waste disposal system. Tice property owner agrees to submit do SL Croix Zvtring Department a oertificatian form, sig~d by the owner sad by a phtr, jotuaeyman Plumber tcdplumber or a licensed pum~Gr ~f'Ym8 that (1) the on-site wastewabesdisposal system 3s in proper operating ooaidition andJar (7) aftar i~ocdon and pu~ing Csf neoes4arY), the septic tank is kss tLan I/3 ffitI of sludge. Uwe, the undersigned bane t+ead the above rcquirtments sad agroe do ~ private sewage disposal system with the standards set forth. herein., a5 set by t#tC De~azhnart of Commerce and the Department of Natural Resources, State of Wiscons ~fithin 30 stating that your septic system has ban maintained must be completed sad returned to the St. Croix t:,btitity Zoning days of the three year isatioti date. Pic S O &IG T(fit~rt7F APPT.ICANT DA'l:'l3 awNFR c~RT~c~.xlonT I (we) oetflfy that all statements oa this form are true to the best of my (om) Smowledge. 1(we) am (ace) the owner(s) of th+c pro descrj above, by virtue of a warranty deed recorded in Register of Deeds O~'ice. ~ A OF APFLICANT UATfi •««.*~ ~y in£armation that is rats-represented may result in the sanitary permit being revoked by the Zoning Department. ««"«'`« t« Include with fkis :pp[tcRtion: a staged warranty deed from the Register of Deedg office a copy of tTze certified sarvey map if reference is made in the warranty deed pOCUMEN7 NQ. ,(f ~ ~ 6 ~ /~ y Q~/ +. I; c.-~__ __:.. _.__ THIS TNDEIVTURE, Made b ,.RICHARD -N. PEARSQN and JEAN M. ................................................................. PEARSON, husband and ife, i grantors.. of.. ,Sty _ Croix .... ................................................-Count ,.Wisconsin, ~ .............................................. y h teb conveys and warFants to..._CARRIAGE HOMFS XXI, INC. r a M~nn sota corporation, wnnn.r~xTY nrcTan STATE OF WISCONSIN-FORM 9 THI/ [PAC[ R[B[RV[D -OR R[CORDINO DATA WasIiiiig~on.._.._._ ....................................................~.~~raTTtee......_.. ofl~ --._.._:.... ._._.._----------------------••---...-------................County, or the sum of - _. _ . Qne_~ollar:-.and no1100,.,(~1.00) and other-good__and• valuable,__ R~T~RN To the following-tract of land in....,~~:...GrQ?:~ .............................................County I'- - .. .. , Wisconsin: .A~.1,..4~..~h~..N9is~kiW~iz~..Q4iart<~r,,,~) .,and„~vorth..iialf (N~) of the Southwest- Quarter (SW=d) of Section Twenty-Five (25), Township TwEnty~Nine (29) .North, Range Nineteen (19) West, St. Croix County, Wisconsin, except Lot One of Certified Survey Map filed June 29, 1994, recorded in Volume 10, Page 2782, St. Croix County Register of Deeds, as Document No. 518444. In Witness Whereof the said grantor. S.. haVe..._.. hereunto set:......_their,_-._____,, hand 5... and seals..._ this ......._ ...............•--. day of... ~aY...........---........................., A. D., Y~..2Q0~. BICiN'ED AND BRACED TN PItEBTCNCI, OF ,,.1 St~t~ of ~~,ta ~ :. Was ington ('nnnhv PPr<nna 'T~141u'fcW -v.,~rfi:+raau~va~ M': ~SO d ~' - day of--- --------- -- .Y (SEAL) i~__2Q01 217-M-COrporatiOn Minnesota Uniform Conveyancing Blanks (1978) Miller/Davis Co. ° St. Paul, MN 651-642-1.988 ` STATE OF MINNESOTA Ss. Affidavit Regarding Corporation COUNTY OF --__ ___-- -----__ __.-- --_ _. ____..-- being first duly sworn, on oath says(s) that: 1. (They are) (---- he is) the - - --------- ---- __ _.. _ ._ --- - -- -------- --------- and the ----- -____----- --- respectively, of _ ___ __--- _- ._~_Carriage_HomesxXl,_lnc- ---------=---= a __ __ .-Minnesota__ __ -_ _ corporation, the corporation named as -------------- __--- --------- --------------- --- ------ ___.. in the document dated _~_ __._________..__-~___, and filed for record _- _ ---.-- as Document No. ________-~____---__--___-- (or•in Book _ of _________ _-_.-__ -___--- Page _`_-___ ___.___-._-__-_._.__ ____.- __~) in the Office of the (County Recorder) (1CaE~kOt~iWq of _...._ _....._.___.._ _- __.__ .__.St. Croix__ ._ _._____._.---.__._._.. County, Minnesota. 2. Said corporation's principal place of business is at __ __. __._.___ ._._____ ._ .___.____-___.--_-.-_-~---------------- - --- -- and said corporation's previous principal place(s) of business during the past ten years (has) (have) been at 3. There have been no: a. Bankruptcy or dissolution proceedings involving said corporation during the time said corporation has had any interest in the premises described in the above document ("Premises"); b. Unsatisfied judgments of record against said corporation nor any actions pending in any courts which affect the Premises; c. Tax liens filed against said corporation; except as herein stated: 4. Any bankruptcy or dissolution proceedings of record against corporations with the same or similar names, during the time period in which the above named corporation had any interest in the Premises, are not against the above named corporation. 5. Any judgments or tax liens of record against corporations with the same or similar names are not against the above named corporation. 6.- There has been no labor or materials furnished to the Premises for which payment has not been made. 7. There are no unrecorded contracts, leases, easements or other agreements or interests relating to the Premises except as stated herein: 8. There are no persons in possession of any portion of the Premises other than pursuant to a recorded document except as stated herein: 9. There are no encroachments or boundary line questions affecting the Premises for which Affiant{s) (has) (have) knowledge. Affiant(s) know(s) the matters herein stated are true and make(s) this Affidavit for the purpose of inducing the passing of title to the Premises. ,- - Carriage Homes,~'~e/~ 7/ --- 'L. '` ` , /~ .. Subscribe d sworn to before me this ___~.__. ___ -- - ~ `-~.~ ~ .~~C.~'-- ~u day of _____.-._ _.. __~_.___________ _ _, ---_ _:. , 2001.....- _ .„ cvoar> nooce~. ~ _~ - - - ---------~----._...._ .............~.,,.,...~.~n.n ~" 4 .J i :i .;WC7Y' \ a"' q.'~u ,.T ICS"". !a'. ~l ~ . ~ I '~~ ~ ~ `' ;~' '~ ~rtl~r' ~ ;.;+s \ ~' I lcl=1 g0GD ~ 1~1, 1 . ~. 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