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020-1395-44-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 569545 0 GENERAL INFORMATION State Plan ID No: Personal information you rovide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: O'Malley, Dan & Jennifer Hudson, Town of 020-1395-44-000 CST BM Elev: Insp p.BM Elev: BM Description: Section/Town/Range/Map No: ( 15.-, 4lt,._4 � 25.29.19.2438 TANK INFORMATION 0 ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ,e ^A L Benchmar Dosing W6� Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet o- G/oa TANK SETBACK INFORMATION st/H� t Outlet /.51-7 ' � 7 ��• 7 TANK TO P/L WELL BLDG. Vent t it Intake ROAD Dt Inlet 7 Septic _ Dt Bottom (Zj Dosing Aeration N via- Z Dist^Pipe f yt�{j of' S" Z. Holding b'a Bot.System AOU- Final Grade w !11 p, PUMP/SIPHON INFORMATION 01� Vt Manufacturer Demand St Cover GPM �- Model Number TDH Lift Friction Loss Sys Head TDH Ft Forcemain Length IDia. Dist.to Well SOIL ABSORPTION SYSTEM ctkk, Wrl/Q BED/TRENCH Width Len th ) No. f Trenches PIT DIMENSIONS N0.Of Pits ia. Liquid Dep 0 th DIMENSIONS Z SETBACK SYSTEM TO P/L BLDG WEL LAKE/STREAM EACHING M r r: r INFORMATION HAMBER R Ty a Of System: i UNI Model Number: 3a � /1Dv DISTRIBUTION SYSTEM Hea anifold 'r Mistr(itbution e �� r x Hole Size x Hole Spacing ent to it Intake /A Length Dia "� V Dia S pacing _ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only © 1 Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center, Bed/Trench Edges Topsoil r7 Yes � No El Yes L�' No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / Z' / Inspection#2: Location: 729 Regal Ridge Hudson,WI 54016(NE 1/4 SW 1/4 25 T29N R1�9W))�Scenic Hills Lot 44 Parcel No: 25.29.19.2438 1.)Alt BM Description �h,s-�,(!JC�d � lNk4eLA'Q<�C,yi0 if 2.)Bldg sewer length a x 1.5-))I v o D SEPU -amount of cover / (idYK Plan revision Require Yes No I Use other side for additional information. SBD-6710(R.3/97) Date Insepctors Signature Cert.No. PLOT PLAN PROJECT Dan 'Mallev ADDRESS 729 Reaal Ridae Hudson Wi 54016 NE 1/4 SW 1/4S 25 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX SYSTEM ELEVATION 93.0/92.7 3.3' below qrade BEDROOM 4 CONVENTIONAL XXX AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gallons DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA 900 # of chambers 18 EZ Flows BENCHMAIR K V.R.P. Top of septic tank cover ASSUME ELEVATION 99.87 ❑ BOREHOLEO WELL *H.R.P. same as benchmark Regal Ridge Road New sytem is to be installed along side, below and downslope of old system Well 2-3' X 90' EZ-Flow Cells with>3' spacing �1 B-2 VentsL r'Ee0 o' k4 Existing 4 40' Bedroom House B M * 150' �I�- 25' t— B-3 '>3 0 f _ (rVgA_ s 20 cL 3% SLope 40' IF r? SAA B-1 �6> � b Q� Please note: system elevation is to be based on grade height,paperwork from inspection does not match elevations on soil test,I am installing the system deeper than the original install. Benchmark is to be 1st manhole cover @ 99.87' Property Line COPY County Industry Services Division 4 f' 1400 E Washington Ave Sanitary Permit N grb�filled in by Co.) P.O. Box 7162 Madison,WI 53707-7162 ` Stateif sa irn umber nitary Permit Application O&IM� 640/kc In accordance S 3.21(2),Wis.Adm.Code,submission ofthis form to the appropriate governmental unit address) is required prior aining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if di OP, g the Department of Sa ety and Professional Servies. Personal information you provide may be used for secondary F purposes in accordan e with the Privacy Law,s. 15.04(1)(m),Stats. s �t I. Application In rmation-Please Print All information Parcel# r Property Owner's Na e / Property Location Property Owner's Mi iling Address ( J � Govt.Lot City,State Zip Code Phone Number ''/<, Section _ one) T�iv; k/ EorW 11.Type of Building(check all that apply) Lot# Subdivision Name 2 Family D Iling-Number of Bedrooms �j�„ � ` Sl Block# (� ❑Public/Commercial I-Describe Use ❑City of CSM Number ❑village of ❑State Owned-D scribe Use �� own of Ill.Type of Per it: (Check onl o on line A. Complete line B if applicable) A' ❑New Sys m lacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) List Previous Permit Number and Date Issued B. ❑ Permit R newal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New �� Before Expi ation Owner �i IV.T e of PO TS System/Component/Device: Check all that apply) Q- Pressurize In-Ground ❑ Pressurized In-Ground e ❑ Mo nd?24 in❑Of syi{abl soi Mound in.of suitable�soil CX. :Mk 1'/feXtre me it evice(exp`latii) ❑ Holding Tank 11 Other Dispersal Component(explain) 3 V.Dis ersal/Tr atment Area Information: 0 Di ersal Area oposed Syst levati n Desi n Flow( Design Soil Application Rate(gpdst) Dispel rea Requir (sf) p /') J`a' C/Q � Manufacturer VI.Tank Info Capacity in Total #of Gallons Gallons Units c New Tanks Existing Tanks U in N yr ii t7 a Septic or Holding T k Z Dosing Chamber VII.Responsibility Statement- I,the undersigned,assum a sibility for installation of the POWT MpPRS Number Business Phone Number Plumber's Name(Print) Plumber's re f 1� r Plumber's Addres (Street,City,State,Ztp Code) / 3 Z Y Coun a artment Use Onl Permit Fee Date sued ssuing Agent S gnat roved ❑ Disapproved g ❑Owner Given Reason for Denial IX,Co b �l/Reasons for Disapproval Seep c tank,effluent filter and diS rsal cell must be serviced t maintained p as p r management plan provided by plumber. I All s tback requirements must be maintained A ac o 0 or the system and sub it to th n onl on ape not s n8 n x I1 nches n size I /� SBD-6398(RO 3 13) Cover Page Shaun Bird Bird Flumbing Inc. 1432 120th St. New ichmond Wi 54017 715-1246-4516 Date: 4/17/14 Owner: Dan O'Malley Location: NE 1/4 SW 1/4 25 T29 N,R19W 729 Regal Ridge Hudson System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pag 1. Cover Page 2. Pic t Plan 3. E -FLow Cross Section 4-6. Maintanance and Contingency Plan ,l Signature License number 26900 PLOT PLAN PROJECT Da O'Mallev ADDRESS 729 Reaal Ridae Hudson Wi 54016 NE 1/4 SVI 1/4S 25 /T 29 N/R 19 W TOWN Hudson COUNTY ST.CROIX SYSTEM ELEVATION 93.0/92.7 3.3' below qrade BEDROOM 4 CONVENTION kL XXX AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1250 gallons DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA 900 # of chambers 18 EZ Flows BENCHMARK V.R.P. Top of septic tank cover ASSUME ELEVATION 99.87 ❑ BOREHOL SWELL *H.R.P. same as benchmark Regal Ridge Road AL New sytem is to be installed along side, below and downslope of old system Well 2-3' X 90' EZ-Flow Cells with>3' spacing B-2 Vents 0' Existing 4 40' Bedroom House B M * 150' 25' S 5' 30_ 20' 50' 3% Slope 40' B-1 Please note: system elevation is to be based on grade height,paperwork from inspection does not match elevations on soil test,I am installing the system deeper than the original install. Benchmark is to be 1st manhole cover @ 99.87' Property Line c ^n o_ 1- Y C L (� y°0 W (D Z C n N cn = u- O (D LL O cr O V o.. L L O N co o d ° CL m m '. — Q 6 a 0 -0 cn LL v cn = o Q a> a u °'o 0 O . 0 Q C:) > Lm om V w O U o o' n 0 O o ai o o LL. N E E LL z © .,LL L ` W . . V _ cn 3 M . . w " o (n CL V ° O cn N N O L V POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of___--__- FILE INFORMATIOR SYSTEM SPECIFICATIONS [I NA Owner Tank Capacity ------ D NA P er Septic Tank Manufacturer ermit# Effluent Filter Manufactilrer 0 NA OF-SIGN PARAMETHIRS UJ NA Number of Bedrooms ❑ NA Effluent Filter Model I NA Pump Number of Public Facility Units ------ D NA .rage) Pump Tank Manufactumr Estimated flow(av ------_L_- V_9*hqay_ ___--- -_ El NA _------- Pump Manufacturer Design flow(peak),(Estimated x 1.5) __g�!Vd L] 0 NA 2 Pump Mociel Soil Application Raie '��Uda gal/day/ft NA Standard Influent/ ffluent Quality Monthlyy average* Pretreatmont Unit R is,Oil&Grease (FOG) _<_30 mg/L El Sand/Gavel Filter ❑ Peat Filter Biochemical Cxygen Demand (BODs) !�220 mg/L doA F1 Mecharical Aeration El Wetiand Total S uspended Solids (T$S) :5150 mg/L n Disinfection ❑Other: —------ EI NA Pretreated Effluen-Quality Monthly average Dispersal,3ell(s) Biochemical Oxygen Demand (BODs) <30 0 mg/L Tmr- `round(gravity) D In-GrOUnd(pressurized) C_]At-Grace El Mound Total Suspended Solids (TSS) :�30 mg/L. 0 Drip-Line FJ Other: Fecal Cc 4iform(geometric mean) :5104 efu/1 00t ...... Other: Ll NA Maximum Effluent Particle Size in dia. ❑ NA Other: D NA A ---------- Other. rJ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCES HEDUL.E Eervice Event Sorvice Frequency -7 ❑month's) (Maximum 3 years) 1:1 NA Inspect condition )f tank(s) At least once every: pump out contents of tank(s) When combined sludge and scum equals one-third(V3)of tank volume 0 NA _0 month s) Inspect dispersal ell(s) El NA )4, At least once every: year(s: (Maximum 3 years) c D monthi s) Clean effluent filter At least once every: ear s, ff months s) -.1 NA IrISPCCt Pump, pump controls&alarm At least once every: ❑year(s', ,___.__ -- -- -- —0 month)s) A NA Flush laterals and pressure test At least once every: Ll year(s) ❑rtionthi s) NA At least once every: ❑year(s) NA MAINTENANCE 114STRUCTIONS de by an individual carrying one of the following licenses or certifications: Master Inspections oft anks and dispersal cells shall be ma Septage Servi(,ing operator. Tank inspections Must Plumber- Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer; licks or leaks,measure the volume of include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cr combined sludg and scum and to check for any back up or ponding of effluent or the ground surface. The dispersal ceii(s) shall be visually inspected to check the effluent levels in the observation pipes and to checir:for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires th,i immediate notification of I the local regulatory authc rity. one-third or more of the tank volume,the entire contents of When the comb�ned accumulation of sludge and scum in any tank equals the tank shall be removed by a Septage Servicing operator and disposed of in accordance Willi chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, [nechar ical or pressurized components, pretreatment units, and any servicir g at intervals of-<12 months,shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of an%,service event. Page of START UP AND OPERATION For new construe ion, prior to use of the POW1 S'check treatment tank(s) for the presence of painting products or other chemicals that may irnpede the I reatment process and/or darrage the dispersal cell(s). If high concentrations are.detected have the contents of the tank(s) removed ty a septage servicing operator prior to use. System start ups all not occur when soil conditions are frozen at the infiltrative surface. During power ow ages pump tanks may fill ab3ve normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s)in one large dose, overloading the cell(s)and may result in the backup or surface discharge of effluent. To avoid this sitL ation have the contents of thii pump tank removed by a Septage Servicing Ooerator 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 p rk 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; condoins; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) ester; fruit and vegetable peelings; gasoline; grease; herbicides; meat scrape; medications; oil; painting products; pesticides;sanit ry napkins; tampons,and water softener brine. ABANDONMEN Vlthen the POWI S fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely aban oned in compliance with chapter Comm 83,33,Wisconsin Administrative Code: All pipir g to tanks and pits shall be disconnected and the abandoned pipe openings sealed. The cor tents 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 3LAN If the POWTS iails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant i replacement system: �its le replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. 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 imply with the rules in effect at that time. 0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may he installed as a last resort to replace the failed POWTS. El The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be perfonned to locate a suitable replacement area, If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. El Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surfac . 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 ANDIOR INSUFFICIENT OXYGEN. DO NOT ENTER ASEPTIC,PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DI;:ATH PRAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK 14AY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS ---- —--- ---- POWTS INSTAL ER POWTS MAINTAINER Name ?� 1 Name - Phone �-_� 6 Phone SEPTAGE SERVICING OPERAT PUMPER LOCAL REGULATORY AUTHORITY Name `� -- Name Phone t) Z C� �l Phone J- This document wa5 drafted in compliance with chapter SPS 383.22(2)(b)(I)(d)&(t)and 383.54(1),(2)&(3),Wisconsin Administrative Code. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently ,ervi g the Tc' residence located at: W' 0 /71�' �K - Section Z T_Zj N, R W, Town of N_ _ Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. _ast time serviced: —�� -z-c) !)i.d flow back occur from absorption system? Yes No (If no, skip next line) Approximate volume or length of time: gallons minutes ,-.apac ty: ! . j v Construction: Prefab Concrete Steel Other ;,, nuf cturer: (If known) ge of T n (If known) : 7`y n ture) (Name) Please print _ P2 � s' z6� ('Fl!tl ) (License Number) D,3 to Form to be completed by licensed plumber (s. 145. 06 , Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - – – – – – – – – – – – – – – – – – – – – – – – – – – – – Plumb Br (applying for sanitary permit) Certification: Tr; accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILA83�, dm. Code (ex cept for i_nspe tion opening ver outlet ba /�MP MPRS Zi LJ 6 0V Name cc,, Signatu / ST. CROIX COUNTY SEPTIC TANK MAINTENANCE.AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer :P-61 Mailing Address -7 P Qn^� Property A ess (verification required from Planning&Zoning Department for new construction.) City/State VU Parcel Identification Number Q —6�-?) LEGAL DESCRIPTION Property cation NE r/4 Su-2 r/4, Sec. ,T ?-9 N R�W,Town of Subdivisi oti C, _. , Lot# . Cerdffed S urvey Map# ,Volume Page# Warranty Deed# 1 �17� ,Volume ' ,Page# Spec house yes no Lot lines identifiabl yes no SYSTEMMAMENANCE AND OWNER CERTIFICATION bw er use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance nsists of pumping out the septic tank every three years or sooner,ii='nee"by a licensed pumper. Wbat you put into the system affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsrbiliti are specified in§Comm 83.52(1)and in Chapter 12-St Croix County SanitaryOrdirrance. The 3roperty owner agrees to submit to St Croix County Planning&Zoning Department a certification form,signed by the owner and b3 a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site wastewater d sposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 of sludge. V the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St.Croix County Planning& Zoning Depaitment within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s)of the property descdbed above,by virtue of a warranty deed recorded in Register of Dee,9s Office. Number of bedrooms I)TD14 GNA 1LICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. '"** Include with dus application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.08/0 993010 BETH PABST" REGISTER OF DEEDS ST. CROIX CO., WI Trustee Deed RECEIVED FOR RECORD Document Number Document Title 02/28/2014 10:51 AM EXEMPT * NA REC FEE: 30.00 TRANS FEE: 1065.00 PAGES: 2 The above recording Information verifies that this document has been electronically recorded &returned to the submitter j i Recording Area Name and Return Address Burnet Title 5151 Edina Industrial Blvd.#500 Edina,MN 55439 13-21579 020-1395-44-000 Parcel Identification Number(PIN) f i i St.Croix County 993010 Page 1 of 2 STATE BAR OF WISCONSIN FORM 7-1998 TRUSTEE'S DEED Document Number Thomas S. 3 rani k sind Michelle E. Baranick, as Trustees of Thomas S. Baranick and Michelle E. Baranick Revocable Trust dated Auciust 4. 2008 ,fora valuable consideration conveys without warranty to Daniel J.J. '11A Ile and ll husband n wi survivors i property,marital Grantee, the following described real estate in Croix County State of Wisconsin: Recordinq Area j Name and Return Address Return to: Burnet Title 5151 Edina Industrial Blvd. #500 Edina. MN 55439 Attn: Post Closing 020-1395-44-000 Parcel Identification Number(PIN) This homestead property. (is) (fa not) i Lot 44,Scenic Hills,in the Town of Hudson,St.Croix County,Wisconsin. i Dated this day of / Z� .2014. (SEAL) , _(SEAL) homas S. Baranick,Trustee Mic elle E. Ba ck,Trustee i (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT j Signature(s) State of Wisconsin, �I } ss. St.Croix County authenticat d this day of Pe onall f came before me this a& day of P 2014 the above named Thomas S,6 ranick and Michelle E.Bernick.Trustees of the Thomas S Baranick and Michelle E Baranick Revocable TITLE: M 11ABER STATE BAR OF WISCONSIN Trust dated August 4.2008 to me known to be the person who executed the foregoing instrument and (If not, ck ledge the ame. author zed by§706.06, Wis. Stats) THIS INSTRUMENT WAS DRAFTED BY Coldwell E anker Bumet/Robert Nicholson 1301 Cou a Road Notary Public,State of Wisconsin Hudson,VJI 54016 13-21579 My commission is permanent. (If not,state expiration date: (Signatures may be authenticated or acknowledged. ) Both are r of necessary.) LJNDA KRAEMER NOTARY PUBLIC STATE OF Wt CO itV � J��4 1 •Nartfas of pars s signing in any capacity must be typed or printed beiow their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co,Inc. TRUSTEE'S DE D FORM No.7—1998 Milwaukee,Wis. - ; St.Croix County 9930.10 Page 2 of 2 o p IF it O � m L o aacva I o E c N y C N 7 v M C> 4) C ` O M C p Q p p L L ? « C, V O 7 N CL w N O Q N �r O O Q o L w N C N CL 3 7 N 0 0 N O a a)csi 3 O= oa o c LL oo EYm uoi �.0 j 3 a>—o n y E %m CL o N as I 3 � Y z °o mm — m o ° = ° 3a � c(D N d 0.m (D -2 c ID N H d m y a m 0) �Sc�� aai v 'w �N ! p 2 c eh N o N D 7 fq N d 2 `O Q CO.G w N N F" d c o .. oE _aN ! N �_ = C C N N C V -ro N C of.0 (Op N y 4 o _0 E- 0 Q Z m Z N w _ _ 1n E U�1 N f0 Lo N of a) N G a al L (D O o o o d LL ! •N�w �' woaaa C rn c ,o v N J a 0 °O N R N N O } a 0 Z p o 0 o y 'q L — O N N N E (O co m IL�^ O Co C O pp N a N rn a) O N U W a) Q A (A Q ^l O ° p N N C O 00 3 o v m > ao v V N 0 0 'A - 7 C C 7 C m a N N N N t0 (O co m W O W a1 d :3 a to 00 O' N N 0 w 7 � E C L O N ce) • O N I''�, J et r Z N a a 'g U) a .� d C u a � �• r A o a o 3 3 ',3 ' 0 no F - � to L�sum yam 5't-'a b m 'tIIII7, 7,F '- �L'AOC�u0�d�iO�M i;;, 3N•rr�np5't�Or+, w � ��," i o�3 a �wm +fb= e 'SVOA&EdIII �i V a Ik as � +�� ��.. l.y�\\\\ i': ��• •,.,y /� ', � TM�`..Y° P•�'RRJTa�3&iRi iVj •b: 0' L Q �, s t �t ;J i n F e: q I W eau macs I � r \ f 1P t �rmaaasa�oi s � az�o3 5• ST. C �i T Y Land Use �S'C C112t4'�fL Planning&Land Information Resource Management Communit y Development Department MEMO Date: February 20, 2014 To: Ryan Magee, mortgage loan officer From: Pam Quinn, Zoning Specialist Re: Private On-site Wastewater Treatment System for 729 Regal Ridge, Hudson After reviewing the inspection report that was prepared for the above Private On-site Wastewater Treatment System (POWTS), I concur with Ben Morgan's assessment that the dispersal area of the POWTS, referred to as drain field trenches, no longer have the capacity to treat the volume of wastewater they were designed to handle. New in-ground trenches will need to be installed and connected to the existing septic tank, but state sanitary regulation SPS 383.45(2) states that"'POWTS treatment and dispersal components consisting in part of in situ soil may not be installed if the soil is frozen at the infiltrative surface of the component." Right now soil conditions are too wet and/or frozen to allow a code-compliant installation. The POWTS will still function to collect wastewater and has limited ability to infiltrate a portion of the daily flow. The service agreement between the current property owner and Darrell's Septic Service will allow temporary use of the septic tank as a holding tank for domestic wastewater and will be acceptable to this department as a method of waste disposal that will prevent health hazards until the necessary repairs to the POWTS can be made this spring. If you or Jenny Olson have any questions regarding this particular POWTS or applicable state and county sanitary regulations, I can be reached at pam.quinn(a)co.saint-croix.wi.us Phone 715.386.4680 Government Center, 1101 Carmichael Road, Hudson, W154016 Fax 715.386.4686 www.sccwi.us/cdd www.facebook.com/Stcroixcountvw cdd@ co.saint-croix.wi.us DARRELL'S SEPTIC SERVICE INC. 1547 18' Avenue River Falls, WI 54022 715.425.1025 -------------------------------------------------------------------------------------- Portable Restroom Rental-Septic Cleaning-Line Cleaning-Camera Inspections ------------------------—--------------———------------------—------------------------- TERMS OF SERVICE AGREEMENT The following Terms of Service Agreement is effective upon reaching both signatures. Between: Darrell's Septic Service Inc. 1547 18'h Avenue River Falls, WI 54022 AND: Tom Baranick Lc� Stone Lake.Wl 54876 Darrell's Septic Service Inc.will service the septic system acting as a holding tank at the Tom Baranick residence, 729 Regal Ridge,Hudson,Wisconsin.The tank will be serviced prior to the closing of the house on February 26,2014.The tank will then be serviced weekly at the rate of$150.00 per service.The service day will be agreed upon by Darrell and the new owners-If the system requires service prior to the one week date,the new owners must call to schedule the service at the rate of$150.00 per service giving Darrell's Septic Service Inc. a 24 hour notice. Service will continue until the new drain field can be installed. Every service will be billed at the time of service and mailed to Tom Baranick. Mr. Baranick will be responsible for all services rendered. We request that the balance on the account not to exceed$499.00.If the balance exceeds$499.00 it could delay the next service. If the balance is under$499.00 our due date is net 15 days. Darrell's Septic Service Inc. Tom Baranick Authorized Signature Mithorized Signature Print Name and Date Print Name and Date CROIX IRRIGATION LLC ESTIMATE 464 JACOBS LANE HUDSON,M 54016 CUSTOMER NAME: TOM BARANICK ADDRESS: 729 REGAL RIDGE HUDSON, WI 54016 PHONE: 715.699.1569 DATE: February 13, 2014 IRRIGATION SYSTEM TO INCLUDE: i DESIGN AND INSTALLATION OF RESIDENTIAL IRRIGATION WITH A ONE YEAR WARRANTY ON PARTS AND LABOR,AND TWO YEAR ON HUNTER PARTS. BASE SYSTEM CONTENTS: ESTIMATE TO REPAIR DAMAGED SPRINKLER SYSTEM AROUND NEW SEPTIC INSTALLATION. TYPICALLY REPAIRS OF THIS NATURE ARE AROUND $500-$750.A MORE ACCURATE ESTIMATE CAN BE PROVIDED ONCE THE SNOW IS GONE AND THE GROUND IN THAWED AND A WALK THROUGH CAN BE DONE i P i Tn-County Sanitation 1029 4" St. Hudson WI 54016 Tom Baranick 729 Regal Ridge Hudson, 'GUT. 54016 Mr. Baranick, An inspection of the septic system at the residence of 729 Regal Ridge Hudson,Wt. was conducted on 1/24/14& 1/28114. This septic system is made up of a septic tank,with an effluent filter. The septic tank was not pumped at the time of inspection. The fiber was check but was not cleaned at that time.The filter in the septic tank should be checked and cleaned at least once a year. At this time the septic system is not functioning properly.Due to the fact that a portion of the chambers that make up the drain field a filled with sand. On 1/24114 when the septic tank was checked it was noted that the level of the tank`vas higher than the operating level,this could have been caused by a clogged filter, or a clogged/frozen pipe leaving the tank.As noted the filter was checked at that time, this had no effect on the septic tank level. On 1/24 there were two inspe+ction ports visible for the drain filed trenches.Upon checking the port closest to the septic tank it was noted that there appeared to be ice close to the bottom of the trench.I took a long bar to check if it was ice in the bottom or just frost in the sand.Upon breaking through what turned out to be ice,waste water rose up to almost to the top of the inspection port, about sixteen inches above ground level, but did not change the level of the septic tank. At that point I check the other port visible at that time,noting the bottom was dry but was higher than the bottom of the other port. These ports turned out to be the middle port in the top trench and the north end port in the lower trench. On Monday 1/27/14,I was able to get from St. Croix county the inspection report and a rough sketch made by the inspector when the system was installed on May 6th , 2005, see attached On 1128/14,1 went back to the property and working off of the sketch was able to locate all six inspection ports for the drain field trenches. It's important to understand that these ports are not part of the waste water distribution network,no runs through them;they are just a way of looking into the trenches.The two ports at the north and south ends of each trench appear to be dry but full of sand and at a higher level than the two in the middle.As noted the middle port of the upper trench,the one closest to the septic tank in way over full.The lower middle port is dry and the bottom appears to be a the right elevation. With the limited use this home/septic system gets the top trench should have been able to keep up with any water corning from the Dome. It does appear that waste water is not able to flow down to the lower trench,but as noted above this is not the major problem with this system, As noted a portion of the upper and lower trenches are filled with sand not allowing water to distribute throughout the system. This drain field is made up of Biodfluser chambers that are sixteen inches high,three feet wide. Each chamber locks together to give you the desired lengdi of each drain field trench_ The water leaving the septic tank enters the middle of each trench and is supposed to flow north and south down each trench.Also they are supposed to be feed evenly, not one being used than the other.For the first eight and a half years of operation the middle portion of the drain field was able to keep up with the household use,but without installing new trenches this septic system will not function much longer. Tri-County Sanitation makes no guarantee as to the continued proper functioning or operation of the exciting septic system after the date of this transaction. Tri-County Sanitation recommends that the septic tank is pumped every 2 years. We also recommend bacteria be added when maintaining your system.If here is an existing garbage disposal,it should be used as lithe as possible.Also,powdered laundry soaps,and other non- biodegradable materials should not be run through the septic system. This pumping estimate is based on an average family of four,and can vary depending on the age of children,work outside the Dome, and use of a garbage disposal. Therefore,the future and prolonged life of this system is dependent on proper maintenance of the homeowner. By the sale of this roe you waive any claim against Tri-County Saa�titatio it's employee's or agents now or in the future on account of any damages alleW ly sustained as a result of any failure or other problems with the subtect sw stem from this surface inspection only. SBM'Irganl ely, ' t�� .—/ Tri-County Sanitation WI License# 81587 POWTS Evaluator-92009050 Parcel #: 020-1395-44-000 05!06/2005 03:34 PM PAGE 1 OF 1 Alt. Parcel #: 25.29.19.2438 020 -TOWN OF HUDSON Current ! X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * =Current Owner * LIFESTYLE HOMES INC LIFESTYLE HOMES INC 11200 STILLWATER BLVD #100 LAKE ELMO MN 55042 Districts: SC =School SP = Special Property Address(es): * =Primary Type Dist # Description * 729 REGAL RIDGE SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.281 Plat: 2438-SCENIC HILLS LTS 1/72 020/01 SEC 25 T29N R19W PT NE SW SCENIC HILLS LOT 44 2 281AC BlocklCondo Bidg: LOT 044 . Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-29N-19W NW SW Notes: Parcel History: Date Doc # VoIlPage Type 07/06/2004 767981 2610/503 WD 10/04/2001 658318 8/76 PLAT 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/29/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.281 34,100 0 34,100 NO Totals for 2005: General Property 2.281 34,100 0 34,100 Woodland 0.000 0 0 Totals for 2004: General Property 2.281 34,100 0 34,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ~ ~` ft ~ ~ ' S City Village X Township Carria a Homes Inc. J ~ ~ ~ Hudson Townshi CST BM Elev: Insp. BM ev: BM D ription: TANK INFORMATION ELEVATION DATA County: St. Croix Sanitary Permit No: 453091 0 State Plan ID No: Parcel Tax No: 020-1395-44-000 Section/Town/Range/Map No: 25.29.19.2438 TYPE MANUFACTURER CAPACITY Septic ~t n - ~ A f~c~.+w v Dosing ~ ~ ~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L ~ BLDG. Vent to Air Intake ROAD Septic 1 ~~-' ~ S I Dosing / ~ ~`Ms~p. 7~ 1 Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand PM Model Number TDH Lift Friction Los em Head TDH Ft Forcemain Le Dia. Dist. to Wen SOIL ~t,$SORPTION SYSTEM BED/TRENCH Width ~ ~ Lengt DIMENSIONS ~ SETBACK SYSTEM TO INFORMATION Typef~f System: DISTRIBUTION SYSTEM STATION BS HI FS ELEV. Benchmark ~ N^ 2 /• t ` ~~ J • ~v - ~y i + .~~ Alt. BM ly~ G~' ~Q {'(J~ Bldg. ~M a ~.~ / i~ l/ SUHt Inlet $.9 IS9~ t o t y1s yS~ 7 Dt Inlet ~- t Bott~ ~, ~~ He dr,g_er/Manr~ 4 1 G ' 33 y~-- fir-/ 6 Dist. Pie ~ (,~ .g'3 9s .~9 Bot. System i n 5,c„,d~ ~F- S ON,~t~ Firy71 Gr de '~52. t tl ~, . St Cover ~ ~ ~ r ~ ~ ~,I ~ ~~ ~ No. Of Trenches ~ PIT DI ~ ~ ~~~ L i~•c.p~aL P .n.~il.s__ Header/Manifpld Distribution x Hole Size x Hole Spacing Vent to Air IntakeUy~ / Length Dia Pipe(s) Length Dia Spacing__ J~ ~~~"~.Q/(~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~ d Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ Bed/Trench Edges Topsoil Yes No . _ ' 1 ~~ 'C7 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/~ Inspection #2: / ~~~~ Location: 729 Regal Ridge Hudson, /W~~I 54016 (NE 1/4 S 1/4 25 T29N R19W) Sceln'i~c,,H,,ills Lot 44 i(/~f1[1 Parcel No: 25.29.19.2438 1.) Alt BM Description = ~~' ~/~?~N k CO'1~"'~/~ ~~~,~,~(~2 ',~_ ,,/,, gyp" ~ ~/~..~~j~, G~~ /( l ~ ~ 3 1~,~,~ 2.) Bldg sewer length = 2 ~ ~ (~`~"' ~ v J„ . ~ I DY -amount of cover =~ , t ~ ~ ~ a nq,~ I,a~~ ~ ~"-•n d ~ ~ U B-~ 1' '~ Plan revision Required? Yes No / O~ Use other side for additional information. ~ ~ (p ~~2~ ~~~~if/l~1it~_ Date ~t Ins/e~p,,ct~o~r'sjSignat~,(re.~ Cert. No. SBD-6710 (R.3/97) ,/I/J ~ ~~~~ `~- " - ~r~^' ~,. ~~~. 6 ' " ~.. ~~ No. Of Pits Inside Dia. Liquid Depth ING IMariuf~r~ ~ ]~~ R tt Model Number: { I //1sti U 2. Safety ttnd I3nildings Division Courrty 2~l w. Washington Ave., h.o. llvx 7082 ST. CROIX J~~O~~~~ Arladiunl, WI 5371?7 - 7(1$2 ,Sanitary Pennik Number {w be filled in by Co.} (F~8)2fi1~546 S 3 Q ' Department of Commerce / + Sanitary Permit Application k Slat,: Plan I.D. Nurnller ,4 ~\ ~/ In aearrd with Came 83.21. Wis. Adm Code, pcasaral infamlation yr, provide 1 - /~ __ may 6a ILA }irt Tl' larrl~x Privacy Law, sl Pmjeit Arldr~s (if 1tTerast than rnailimg address) 729 REGAL RIDGE ~ Application lnformatioa -Please Print All Information •- - -.. Pn>~rly f)wa~r's Nanw ~ i !~ ~.~ "'' '~ ~ ~ X004 arcel # Lot # 44 Iifock CARRIAGE HOMES, INC. - .. _ _. __ _ i'tt>Exxty (Jwnox's Mailing Addrt~s ~ ~ ~' I k ~ ~ ~ ~ ~:-~-r PropeAy Locaraon ~ << ~ti~~ ~Ik i ~ - •2~3b 6720 STILLWATER BLVD. -•°~--~-- NE °,~ SW 1,, Sediar 25 City, State 7.ip Code Phone Ntux~cr , STILLWATER MN 55082 -- -- -'--- -- 6 1-439-2414 29 19~°`~) T N; R , or W Type of Baildiag (check sll that apply) II -- . y i-1~1 ar 2 Family Dwallotg - 'v'Im~wr of l3edroonls 4 P E R SUBMITTED HOUSE PLAN Subdavisiat Name csht Ntunber I~ Publi~Ca~utxrcial - C7acribc t l s c SCENIC HILLS ~ _ ,. s - ^ sa~t~ ow,r~»l t~Cribc t r~ JS T. C~ f:~s v5 / y 7-j ^Ciri_Llvillage f Xvbwnslilp or H U DSO N __ _ _,_ _ _._ ._ _.-__ _________ III. T ype of Permit: (Check only lure box on line A. Complete line B if applicable} _ _ _-- A_ ~~y L!P New System ~~ Replacanerrt System ^ Trnahnent/lidcling Tank. Repla«n+~lt llhly ~.~ e]fhcx iuloclificatiat to >Cxistiug System ~• ^ Pmnit Renewal ~ Pemlit Revision ^ Change of ^ l'ennit Tratt~er to blew list Previous PexmiE Number and Date issued lleturC 1'.JCI11rat1Un Pltunhear IY. T of P()W'I°$ S tem: Check all that a ! ~ ~Ncm -1'tcssurtzed lo-(iroutul Lj hlaund_ 24 il~ ol'suitatde scxil ^ Moemd < 29 ire ofsuitable soil ^ .9i-Grade LI Single Pass Sand FilrLr ^ CcxlsVUCY I'resstrrizcxi In-Ground U Hulding'C;ntlc IJ Peat Nituz l l Aerotric Treatrrlerlll7nir ^ ltacirwlatirrg Sand FiUcr U Recirculating Synthetic Media Fiber I~ I.eadringChamber ^ Drip litre ^ Gr-,tvel-lrss Pipe ^ CNiva (e v. n;~ rsttllTreattaeat Area lnrat~tratton• ea 'C4• c am ers ea. o a cam er - ___ - - I)esi~ 1~7ow (gpol LkStiga Soil ApNlicatio» Rnte(gpdcf) D,s}rrsal Area Re[lnir~ (cf) Diq+e+snl Ama l (sF) F.levatial 600 .7 ~ 857 872 A3-~- Y6 VL 'Panic Info Capacity in Tolal Nnrr~x.R Manttfacatrer Prai'sb Sita steel Filx~r~ .Plastic i tiaBlarts . f~llnnc nfUtsitc Canada (:omlruc;l«i Glass New Exastlnty T:mks Tsdts __ '~'~'~}'°Idr°glaal: X 1250 1 _ WIESER YES Aensbic Tnsalrvrc~ll tlni! i ~ rh1S1iM I~tWItt1Cr _ VII. Responsibility Shtemcnt- t, the tstietsiltrred, a9etrre respwerib'YM1y for bo o!•+he I~OR"IS eho+r. ov t`c.tlached plauul. Ploredxor's Nana (Prink) Plumber' -- Ml°IMPILS 1Vurtrlxi Huaitresa r4wme Niunfler l TODD FEATHERSTO 242514 --- ---- i 715-381-1704 P31-mbor's Address (64red, City, State, 'Lip C PO BOX 467 HUDSON, WI 54016 VIII. 11t /De >trtmert CTse On Sanatory Permit Fee includes Gronrrdwater Dale sluing Agem Si (No S rove U Disapproved 91ullw Pcc K~ 1 ~ G ~ rn ^ Owxur Given Reascxr for Donial ~ ~ t/ ' / ~~~ '~- _ _ IX. Conditions of Approva!lReasons for Dl~ a! ~ ~ _ _G~'~ ~' STEM OVyNER: ~~~~v /~' U Septic tank, effluent filter and `~ C1L p-~~/h- ~ ~ ° ll be serviced /maintained d t ll l mus a ce dispersa as per management plan provided by plumber.. All setback requirements must be maintained as per applicable code/ordinances IS~"~. Attach caeaptde phma (ts the County adrl t+,r the syslrm w Asper twi4 #cas Ilsa 81rz z it irrclies ~ sty r - ~7 Liti •-... . ~- ••--~..u~ • ---- ~~ ,~e~- .~ ~ .~ ,. . ~ ~~ ... _ • t~ r-- n~.~t.. Q~ - >> S ~i~- --- _'_ '-~ /os~~ .~F maw ~~v5~ ' ~1 y II I ~ ~~ ~° ~ ~ ~ - t~ . ~1 . ~' ~ 1~ - .z -~ ~. G~ :~ i a ~ ~~~ ~ ~~ ~ (oa- (c`r~- ~on~ _, - ~~~ . ~ l ~~ ` ~~ 5 S ~ 1 _ .. ~'' • oo. o ~r i E~ / ~ , L-AT ~ / ~ ~l0 . ~ o ~ i % ,ors ~~~ a3~a ~~ - y'8, 9 s SYSTEM CROSS SECTION MAN HOLE C~RAI~F ~„_... ,_,_~. 87.5 , _ ~ SYSTEM ELEV. '~_ 9~ 14 BIO DEFUSER CHAMBERS ~ t O ~, 87.5 0 0 14 BIO DEFUSEF2 CHAMBERS PID # NE '/s SW '/a,S 25 T 29 N,(; 1~E X44 gL_, $UgSCENIC HILLS C D V ~ T t~9 HUDSON ~/ ~ " 242514 INSPECTION PIPE 111Rsoasiri Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buibings Page r ot~ m aocoraanoe wrm ~ornm rsa, vvrs. rwrn. was st i a Pl 81/2 11 i h -- - sf. croi~ an mu x nc es n s e. Attach complete site plan on paper not less than inducts, but not limited to: vertical and horimntal reference BM), direction and Parcel LD. . ~ / 3 5S -~ ~ ' percentslope, scale ordimensions, north arrow. and ~id to nearest road. Sd p Z ~ Q Please print aN f n. R ~ by Date Personal information you provide may be used for ry Law. d: ~5. (1) (m)). ~ /~ 6 _ .:. Property Owner ~ ~". P Location -- ! __ ~ ., . Goyt N 1/4 114 S Z,S T Z G N R / E (or)1~ Property Owners Maidng Address , ~ _ L Biodc # Subd. Name or CSMIf City State Zp Code Pt1or>d.Nur~ING ~ ^ Ydlage [~ Town Nearest Road <S7i:LLk1«-~-cr VN~. ~'So~Z ( ~"(}, 34.-'.Z~!~~~ ~ s ,•.,~ c/ ® New Construction Use: ® Residual / Number of bed _~,_ Code derived design flow rate L,~SO l (o O O GPD ^ Replacement ^ PubHc or commercial -Describe: Parent material OU ca.l Ir. Flood Plain elevation iF to S~ 70 ~!G y D R General oommerrts S S ~ i1't e.l eJct,f,b n - i-o ~ 9y z.a Lower 3. ~ cs '~+~ 3~ .~,~- and rrrendations: ~ ~ .e, 0. .b >~ -~o P 93 . ~ a Lc~w 'e 9 3 30 71,~~ ~~ t ^ Borvrg Boring # Lly Pit Ground surface elev. ~f 30 R Depth b limiting lador _.G~_ in. ~ ~ n Rate Hor¢on Depth Dominant Cobr Redox Desa~tion Texture Structure Conuenoe Boundary Roots GP D/fl: , in. MunseU Qu. Sz. Cont. Color Gr. Sz. Sh. *Efflf1 *Eff#2 2 lb-9 I ~ ~ `- m 5 D5 I -- - . -~ 1. Z ~~. ti 3. `' ~~~ # ^ _. ®Pit Ground surface elev. q~ 3 ~ ft. Depth to limiting factor ~ I `~ in. Sod ~~ Horizon Depth Dominant Cobr Redox Desaiptian Texture Structure Consistence Boundary Roots GP DHP in. Mansell Qu. Sz. Cont. Cobr Gr. Sz Sh. ~ 'Eff#1 *Eff#2 I o-I to I`i ~ ~ ~s ~m ~r cS 1v-~ I.2 3 y i lv ~ ~i l m s s m 1 -- .:'~ l. 2 0 2 ~. ~ ~, 3 ~ G'Gc-,.- ~ .30 ~ ,~ ~ y * FfB,.ant iN . Rrxl ~ an < 97r1 mnA and TSS >3~ < 1 50 ma/1.. * Effluent #2 = BOD _ < 3Q nq-(_ and TSS < 30 mall. CST Name (Please PrRltj - - S' ~ture CST Number' SIG vy~ ~~ ~ w~ac-(~ e.r ~~~~~'~---- 253309 Address ~ _' Date Evaluation Conducted Telephone Number 2113 $~~'-' S~. Sor,~e~+,W) ~`lgzS ~'-l-G/ `IIS-Z`~~-40~$ Property Owner f~.. r ~~ ~ ~ Parcel ID # Page z of Boring # U Boring ~ ® Pit Ground surfaceelev 9~ Z ft. Depth to Itiniting factor ~ ~ n in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture SUnxtiure Consistence Boundary Roots GPD/fti in. Mansell Qu. Sz. Cont. Cobr Gr. Sz Sh: "Eff#1 'Eff#2 I o -15 1~ I - SL 1 r~..bk mom' ~ 5 l ~ l . `{;' -~ 2 lFj-I1~ - w~ S S . rn I - - _-j 1, Z ~~ # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting fador in. ~ ication Rate Horizon th De Dominant Cobr Redox Descriptbn Texture Structure Consistence Boundary Roots GP DJff p in. Mansell ~ Qu. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 "Eff#2 a Boring # ^ Bonng ^ Pit Ground surface elev. ft. .Depth to limiting factor in. Sal ic:ation Rate Horizon Depth Dominant Cobr Redox Description -Texture Structure Consistence Boundary Roots GP D/ff? in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eif#2 'Effluent #1 =-GODS > 30 < 220 mg/L and TSS >30 <_ 150 mglL ' Effluent #2 =GODS < 30 mglL 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. SBD-8330 (R07/00) ~. PAGE ~ OF~_ NAME -Q, Y~ K •,e- ~ I LOT# ~/~ LEGAL DESCRIPTION ti ~ '/4Sc.~'/<,S zs~'T Z9 ,N,R lQ E (or~ SCALE: I"= yU 1 _ BM I ELEVATION /UG • ~ BM 1 DESCRIPTION •{o ~o •~- l17 • pu c (J.• p e BM 2 ELEVATION ~ g • 9S BM 2 DESCRIPTION~~ ~ ~ ~ ~~ vc, PrO~ SYSTEM ELEVATION •bv Q~~ ZD t oW e r ri3.7o ALTERNATE ELEVATION to pQ 3. G y Lo ~{ ry'3.3 d CONTOUR ELEVATION q 7 3U ~ ~ S(• ~ _ R04 (7' W~• . . ~.~ • Z..~ ~~.~ 0 ~ M . (~.2 ^ Q s o~ ~ ^ ~~ 3 ~-~~ u,.,Q.~-~.c.~3 w `~ t ~' f~~ ~~~'• ~~ ~. ~c, .~ • ^ -~-~ o~Z V' ~ ~ o~b~ q~ ~inr.y,='^V a ~,k Q~„S~' ~ - ~ - G/ r __ N ,APR-16-2002 07 05 P • d~i05 ~-/ p L ~wl~V a[1 vv vas a a~~ SSPTCC 'TANK MaiN'rBNANCB AQA:~T - ANA OWN~RSNIP t~tTIFICA.'l"ION N4RM . i Owae>:lBuy~ 5 l~/~ . Ski G S~'a~ ~~~ ~REGAL~IDGE tVotifir,~tioa roquttnd ~ l'isuoiab t for >taw oaoatruetioa) ~~~ HUDSON, WI 54016 pal, Idtptification Numbs 020- / -mod prey I,ocaaon .,C~. ~r., ,~y. sec. 2 ~ T.? ~-x-R~.w, Town of _. ! /S - Lot # Subdivision SCE' C;crtfficd Su~it~c~ep 1VIAp # ~ S~r 3/ ~ .Volume _._,. ~ • p~ # Spot hawse ~ yes ~ no volume~2 ~ P~ # 2 ~ 9 I..at lines identifiable ~ yes ©no ~~ M'AYN'i`F.NAbiC~ teslute to baadia ~vastex. Proper ttse and scot: S"om ~P~ ~m eanid result in its pcemnt~e ort the eapblc task tverY ti:ree years or coa:ur. tf needed bJ a iiceusCd puuspet. QVhat 9~ P+~ *°io ~ ~'~ ooosista vFs tangy as tt ra8e is th4 Rrasto dispaul sys~m. caa affoct tlae fimsfiott os tha e ~,a lu+epe~iy aAVa~cr agooa to iubtztiit to St. f~rahc ZomnB Depaztun~t s cerQfiuti~m tomt~ t try ~ ownor ~md tyy a assstGtpinmbe~~P~'~~~~ar:licaisedpm~~~-~ (t~ ~o oa-theta ~ fs in pmp~ apdxtfag camdttiua a~d/ot; (~ a~ ia:poetfoa sad pig Ctf neaes~Y~ ~ mast !s less Nett II3 salt oT e~- ~. the omdcrslg~+ed !rove tCad t&e d~ave roq sad ate co t~ ~ ptivatc aewago dtep~l ~ ~ ~ `a arx iorcb4 hsxe~ is ~ by the tutcai of Cvtzui~ca and the Depattmcut of Natu~1 ~ b`t~ of Wisoaasia. Ce:tifiado ~~ t'b~ ~ ~~ ~ t~ccn malatained must ba ~ aIIdt+ctmacd to the $t Croix Gotmty 7Aaisg OffLae ~~ ~ da~rs of tht~ Yom' ;tatzan date. // _3/29/Q4 - pA'I'I3 APPI ICAM' Q~yNLft ~~~pZCA,'~'ION SmavgIedge. I vre am are) the awaei{s) of '-`~""° r ~y~~ ~y ~a~xits as this form are ixwe tc the best of my (out ( ) ~ t>~ P1O es~d by victae of a wa>3anty decd rococded m Itegicbes o~ Ueeds Qffice. 5/29/04 -.,-- pA'I'E ,4 OF APPLICANT t~YOkCd~l~C ZOdlt<$ ~' •s~srr ,.«..~ ,~ mtar~~ ~t;s ~-~tamay ~sutt is ebe ~icary p~ •• IQCiude wish tots application: a atatr~t ~vamaty daed from tlu Regisctt of 1~ office . . copy of tlu certi5cd aarny map if refereace is ttpde in rho avaxraaty deod POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2 FILE INFORMATION OwnerCARRIAGE HOMES INC Permit # ys3 D DESIC,N PARAMETERS Number of Bedrooms 4 ^ NA Number of Public Facility Units ^ NA Estimated flow leverage) 600 al/day Design flow fpeak), (Estimated x 1.5) 900 gallda Soil Application Rate ,~ afldaylft~ Stand Influent/Effluent Quality Monthly average" Fats, Oil & Grease IFOG) 530 mgll Biochemical Oxygen Demand (BODE) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) <_30 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) <_10° cfu/t00m1 Maximum Effluent Particle Size Y$ in die. ^ NA Other: ~A "YeNres typical for domestic wastewater and septic tank sffkl0nt. SYSTEM SPECIFICATIONS Septic Tank Capacity 1250 al ^ NA Septic Tank ManufacturerWIESER ^ NA Effluent Filter Manufactur~BEL ^ NA Effluent Filter Model Al 0 ^ NA Pump Tank Capacity al ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model (] NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ~,~IA Dispersal Cell(s) C~In-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ~A Other: .~ NA Other: ~NA aaww~rc~unw,rc cr•uGnr~rc Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 ~ earlsl(s) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y31 of tank volume ^ NA Inspect dispersal cell(s) At least once every: 3 ^ earls)(s) Y ^ NA Clean effluent fiker At least once every: ^ month(s) 1 - 2 l~year(s) ^ NA Inspect pump, pump controls & alarm At least once every: ^ monthls- p year(s) ^ NA Flush laterals and pressure test At least once every: ^monthlsl ^ year(s) ^ NA Other; At least once every: ^monthlsl ^ year(s) i~NA Other. c~(.NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Yank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal 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 14/011 Page 2 of 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). 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 celllsl in one large dose, overloading 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. 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 replacement system: A suitable rPnlanamwnt area has been eve _ Igd~d may be utilized for the location of a replacement soil absorption system. Th rea shouia~e-pfe~ecLed 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 I technology a holding tank may be ' stalled as a last resort to replace the failed POWTS. 1, ) he s' 'e s not b n evaluat t identi a itable re ement a. Upon failur f the POWTS a soil and site Imo-' ~alu tin ust b pert m to to ate suitabl repla me t are If no replace nt a ea is ail le a holding tank may inst Iled a last r sort to rep ace the tail S. ~ ^ Mou d and grade soil absorption systems may be reconstructed in place following removal of the iomat 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. 00 NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name ~~ Phone 7 ?~ (~ Name FEATH T Phone 715-381-1704 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKY'S Name ST. CROIX COUNTY Phone 651-436-5788 Phone 715-386-4 8 This document was drafted in compliance with chapter Comm 83.22(2}Ib11111d1&(f) and 83.54(11, (2) & 131, Wisconsin Administrative Code. ~4 v~~, 1fiG2P~G_ 289 6.48604 o~ ~ IVu~„eer KATHLEEN H. WALSH ' °Lim ~ ~ REGISTER OF DEEDS ~ar ~~•.(.~ "'~~~ ST. CROIX CO., WI RECEIVED FOR RECORD • Ob-18-2001 12:15 PM }..- ,' _ ' WAkkAMTY DEED .. EXEMPT N CERT COPY FEE: ' COPY FEE: • ~ TRRHSFER FEE: 9900.00 PA ~SDIMG FEE: 31.00• . '. Recordins Aru • 7Qame •od Re~rn Address L.a.~d. T; -i je ~ ~ r. c . 1 ~l op S •i ~ v c r (,.~ ~ e Zoc~ Nc ~..~ a r7~~n ~ M N SS/ l Z C72o - 1069' - 70 - 00 Pacrel Tamasntion N~ber OPII~ C7ZU--106Y-~SO•-r~Up' Q20 - i C~(oy -CIO - vav ~ Zv - 10'70 ' t7o - op0 C~20 - 1p70 ., tv `-oc~ . U 2c~ - j v ~b - Zo -mac) "THIS PAGE XS PART OF THIS LEGAL. DOCOHI~,PIT - DO NOT REMOVE" Yids iufocros$oa must be oomplated by a+bmieter: de~e~r eGfe ~e ~ rcean addrcrs and N ar +JYs trm'dnp elau+a, letat dsreaiPdon, ~ ~- ~il+Ya.dredl. Oder Jrs/orw.aoiara suet d«+~ IV~rc Vie of dtr avMCr pane adds sine pus ~ maid ~~~ d~~ ~ oR ad~doal pater of tl~e Wtrcrowin S~amues, J9.J17. W1i'DA 2N6 - - - - - ~. ~~ ' . ~ ~ DOGUMENT NQ. /., /Q / _0 • ~ Y ~ I - ` - ~' y ...... THIS IIVDF.TVT'URE, Made b RICHARD N. PEAR.SON and JEAN - M . PEARSON, husband and ~ife, .....~......._.. ......................__._.»..».. i ___ _ .... grantor»5.. oy...St...Croix-._-__-._.CARRIAGE HQ'~ES XXICoINC~ Wa unua, h~teb convc s aad warFants to........._---------------------------------------- -----_......---- M1nn~sota corporation, ....._.._--..._.„ ..........................-.._..____ ~j rautee._...._. of (~ ~asxl~ing~On.._.._ ...................................._•.....County, ~crr~34~ or the sum ofi~ ._....._.__ ......................................................... a png_(~Qllar,.,and_. no1100 -•.($1.00).. and., other- 7_~~i_. and.-.valuable .!, Rt;a,AN To ' ~i1~~S~~1~lQR.. •--------- ---------------------------•-----._...~~ - the following tract of land in....,~t.,...~t'4x--•---------- ------.........................County, :: Wisconsin: .A1.1.-0-~...~h~...N4~.tk?~!~S.k..4uar~er----ENw'aL-.`?-~:~a.--North _f-alf (N~) of the Southwest i Quarter (S4J~) of Section 'Twenty-Five (25) , 'Township 'Twenty-Nine (29) North, Range ' j Nineteen (19) West, St. Cxoix County, Wisconsin, except Lr~t One of Certified Survey '! Map filed June 29, 1994, recorded in Volume 10, Page 2782, St. Croix County Register ,~ of Deeds, as Document No. 518444. m .... In Witness Whereo€, the said grantor. S.. haVe...... hereunto set:......»their .•.--__ hand.s._. and seals.... this day of a A. D., Y~C..2QQ]. --..._.....--•--• •---.._.1~ ........................_..»..»....., SEAL) BIt3NmD AND A>DALED IN PREBSNCI. OF (SF1-L) ..t• ~........... (SEAL) .......................»............ y. (S F1x L ) to ~ --- St~LC of , • o Washln ton ..,,..,County. ~ Personally came before me, this-.~-`•=:~• da of...~...~;........_.--. A. D., ~. 2QQ1 ...».._.._...........9......._.... husband and wife, the above named RI~:rIAi~ t~. ynncnn~; and ,7EAN M. PFARSON, ......» .............................. to me lalown to be the persolxs.... who executed the foregoing instrument and acknowledged the same. a T1~IY INSTRUMENT Aq D ANTE 9Y ,, .~~ -A~&~MOUNTAIN `. Richard J. Ga~r>.e~, #2864 NorAR7 Notary Public, . ~~," NG.TA?Y PUBLIC-MINNESOTA County, Wis. ; 880 Sibley Memorial Hwy . , # 114 Bx"L My Comm. Expires Jan. 31, Zoos _ a ~_ , F~ nnm ~511fl-1736 bly commission (e'i _ ............................._........-~_........».............. -~'~--~-~--~- ($ection 59.51 (t) of Ne Wiscoruin Statutes provides that all iiutru:nrnu to be rtordredirehathahatl ePnrrna o(rtlhte p nonpwhottor goveon the nurses o1 tlw ptrantun, gnnrccs, wrtncs~K and Hula. Sca~::.-. `! i >~miluly mental a~enq wh;ch, do Red wcL instrument, rhall Le pnutc.i, :~,•rw rcca, ata;nped or wr~uen !bacon ~n a `vd^~ocn ~n nLoanl IItani< ComnanY .r .nn auTV nrpn S'I'.A'1'F ni' ~V I..C4NSIN WAIIM.'VTY DEED t iTAT[ OI WIiC01`>fIN-/ORY i THIS NACY IIYa1Na0 /OA •iGO~~ M*A 'i gd ^ ~ - - ~-~Od Ri Id-pf- x a O T S m n .e, SCALE: 1"= yU , BM I ELEVATION /UG • d BM 1 DESCRIPTION •lo ~o -~- ~ 17 ~u c Q•' p e BM 2 ELEVATION ~ g ' 9S BM 2 DESCRIPTION •{oo o ~ 1 ~ ~~ OvC, ~Jr pc SYSTEM ELEVATION'bp Q~~ ZD low e ~ • 70 ALTERNATE ELEVATION .b v Lo ~<r~i 3.3 a N 1 PAGE ~ OF~_ zs`Tzy,N,RlQ E or Z -~ 1