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HomeMy WebLinkAbout020-1439-52-000Nisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ' , „~ INSPECTION REPORT GENERAL' INFORMATION (ATTACH i•O PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ermit Holder's Name: City Village X Township Marquette & Lee Builders Hudson, Town of ST BM Elev: Insp. BM Elev: BM Description: _ 'ANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ~~CAPACITY ~ r ~ Septic ` f < ~. is ;.. ? ' ' . ~ Dosing Aeration o ding TANK'SETBACK INFORMATION . en o it n a e ep Ic ~? ~ ~ °° ; , ° - ..~ 1 osing i era Ion • ..,~ o Ing ~ - PUMP/SIPHON INFORMATION anu ac firer eman GPM o e um r i nc ion oss ys em ea or emam eng la. . -~ , i DIMENSIONS ~ ' `; .'. , -, ' INFORMATION CHAMBER OR ~_~ L [ '~ _ r .. UNIT 1 ^^ " `~ L/1~71 RI~V I IVIY ~ ~ .~ ~ ~~n Lengt}~~tid~ Dia e~,4`` ength `.~ ~____ . Sp~~'` _ _, . _.. _ 1 "~ ~:.._ t wf~ vvv~+~ ; x rressure aysierns vniy xa mwnu v~ r,~-v~auc .ayawuw v~~~~ ed/Trench Center BedlTrench Edges Topsoil I ~ Yes ~^_ j No ~ •,! Yes ;~ N< :OMM~NTSr (Include cede digcre~pgles, per;ohs present,_et~.) ,,~tnspection #1;~,N~% ~~~% - ~-• Inspection #2: ~-t--- t ~,ltS~.j Location: 877 .Highlander Trail Hudson, WI 54016 (SW 1/4 NE 1/4 25 T29N R19W) Indigo Ponds Lot 52 Parcel No: 25.29.19.2778 1.) Alt BM Description = t~'~'~"'"""~- ~~~~~^ ~y ~ ~~ / 2.) Bldg sewer length = ~ r'~ - amount of cover = ; ~r ~+ -,~ c~ ~ ; ,/{ ,_ ~ a • r "~ j ; '.` 1 ~s'.},,.i. iY'yt`. ~'9..t_i..: {'~ Ci ,:I..~ { ~'r~4 1 JeYn ~ r ~ - --- ~~- - __ Plan revision Required? Yes No ~ ; _~ ~--~I ~ i ~~-~, ~ -- i:- _ ,ice Use other side for additional information. I j~ 1 ". L_ ._j ~ ~. _ _ _~ , , ~~ B~ Baaattteee--- ~ ; --''~--- SBD-6710 (R.3/97) \r. - County: St. CroiX Sanitary Permit No: 488081 0 State Plan ID No: ,- • , Parcel Tax No: 020-1439-52-000 Section/Town/Range/Map No: 25.29.19.2778 STATION BS HI FS ELEV. Benchmark ° r ~ . ~ `~" ' tf >r,~ l , , ~ , r Alt. BM P, 1 Bldg. Sewer ` '' ~- 1'tS ~. t tlnet ~ `~ `~. ~ ~ ,, t t ut et n e ,, 0 om .ea er an. + _ h+-~ e,fs.-~.' Is . ~ , s ~ , d.~ ~,7.,,,A~ r--' ~ 3 S ~ ~ l ~ ~. `f r o. ysem ~ - ~. ~ ys--, `a~ ~`f ma ra e CQ U1:.- . over z Safety and Buildings Division P.O. $ox~162 Was(lington Ave 201 W l;ounry ~~ C,~ 0 /~ „ . Madlson,'WI 53707 - 716w~ ~'I ~''Cta11 ~1 Sanitary Permit Number (to be filled in by Co.) i I v (608) 266-3151 Department of Commerce State Lan I. .Number Sanitary Permit ~atxon~_..____..~_ ~it~vide i ~ d C e, o In accord with Gomm 83.21, Wis. Adm, may be used for secondary purposes P son i pe ivacy Law, s15.04(1)(m) ject Address (if different than mailing address) ~ f ti ~AR 3 0 2006 or I. Application Information -Please Prillt All In ol a G, n i~L ~~14l1 Property Owner's Na me ST. CROIX COUNTY Parcel N Lot b Block k ailing Address Property Owner's M Location , 2~.~.8 perty Pro 1 / D ~ ~-~'C' U~ ~kJ ~~ J t ~"CJ ~,G,~~/,,Section Z City, State Zip Code Phony Number m 5 b~ 9. 1+ Yl (/~/ C-(~o~ 6 / "7/~ D 2 ~~ /6 O (circle o e) T ~ N; R~E or~ T ll that a l ) k l ildi f B - Wtis pp y a lec , n ype o ng (c Per u II. ~ ~ Y " Subdivision Name CSM Number Lt o~ 0 ~.1 or 2 Fanuly Dwelling -Number of Bedrooms ` ~- ^ Public/Corrunercial -Describe Use t ~ ~~ o o ti~ s ^ Srate Owned -Describe Use ~ ~ ^City_^Village Township of ~1d~ III. Type of Permit: (Check only one box on line A. Completo line B if applicable) A' w S em ^ Replacement System ^ Treamurit/Holding Tank Replacement Only ^ Other Modification to Existing System B • ^ Permit Renewal Permit Revision - ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration --- Plwnber Owner ~ LfpQ ~ p.~ (~ 0 O 2 Z08 IV. T e of POWTS S stem: (Check all that a 1) L Y'eiN.~ t_kYX ~ 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 ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter eaching Chamber ^ Drip Lino ^ Gravel-less ipe ^ ~cr (explain) V. Dis ersal/Treatment Area Information: . /0 Design Flow (gpd) Design Soil Application Rate(gpdsf) ispe/rs~a Area Required (s>7 D ersal Area Proposed (sf) System Elevation g(~ 0 • 7J ~ ~ att.<CfZ 9S, ,~ VI. Tatlk Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units (re'~~Q a„_t tJD ~' oncrete Constructed Glass Ncw Gxisting /.' 1/_ Tar>}ts Tarucs QL fT~' - Septic or Holding Tank c ~ ~ Aerobic Treaunen[ Unit l~ Dosing Chamber Q ~ G~~ ~ D j~ - VII. Responsibility Statement- I, the turdersigried, assuule responsibllity for hrstalla[Ion of the POWTS shown on the attached plans. Plumber' Na me (Print) Plumber's Si gnatu • MP/MFRS Number Business Phone Numbs/r~~ umb Addre ss (Street, City, Swte, Z• ode) VIII. Count /De artment Use Onl ~pprovt;d ^ Disap roved Sanitary Permit Fee (ir Ludes Groundwater Date Issued Issuing Agent Signatur (No Stamps) (((( ~~~" Surcharge Pee) ~~ ~ ^ 0 eason enial IX. Conditions of ppr.o 1/ al r , SYSTEM OWNER: 3 ~ ~`~S` @-v. '~ p-LtG s~,~,r 1 Septic tank, effluent ' -- ~.m"'~ If __ ~- V filter and - ~~ . ~ t~ -~ , ~ Q s ~ .,~-~. 0. dispersal cell must all be serviced /maintained ~ 1 ~A~~- as per management plan provided by plumber. I 2. All setback requirements must be maintained ~t9~t~ ~ "t~ O1'~a / as per applicable code/ordinances. ~ ear, ~vut.~ I .:Z.~w w -`N,. -~ Attach completo plans (to the County only) for the sys m on paper not a;s th'n 81/2 x 11 ' yes ~~ s_ iza SBD-6398 (R. 01/03) t~~- 117•°, °•~Jilf,~~sn'1 . ~o ~~n7 s~~t..F j~~ ~~ N nc~ fi~~~L ~Ft6~ ~n ~,Wj- ~~ xN~ ~ w~ 'o ~~.eg~ ~ ~ 5P I60' ~~s~ ~~~. ~ .~~ P1~'~Pc ~' ~f ~Zbo ~+ ~ T /5 yy ~c~ v m 46 ~ ~s,s (,OPT ~ yj„~ ~~a~u,~ ~o ~~~ S~A-t~~ j~e .: d' ~ Dom- ,~~fl1L ~(6~ ~n o ~,%~ ~~ XN ~ w~ 'o gc~~.s~~ ~~s ~ ~~~P~~ ~ gZ 1~5 Qa~ici' !off oN.~,~ ® I2 bo 5-r ~~ s yy ~c.~ v m 46 ~ ~s,5 ___. T ~~ 1~ti,~ /~9 z ~ ~9~ ° ~/ Vlhscorroin Departrnent of rce Division of Safety and Bui ,a SOA~ITEPORT Page 1 of 3 acwroance ~.~~(o,~m~nmppaac,~vnaa~3s. corm. was m~'fi ~e~PYa~~lst er no 1 /2 11 " Attach com lete sfle a Cotnty ST. CROIX p p p include, lxd not IimRed to: horizon ref point (BM), direction and P~oel I.D. 020 - 1439 - 52 -000 percent sbpe, spte or dimensions, ow, and 'or~i'ltfl~~~;t®st Please priAt all info ~-- Re ' by Date - Personal information you provide may ~ used for secondary purposes (Privacy Law, s. 15.04 (f) (m)). Q Property Owner Property Lot~tion a ~ MARQUETTE & LEE BUILDERS LLC 0 Govt. Lot --- SW 1/4 NE 1/4 S 25 T 29 N R 19 Properly Owner's Maigrg Address lot ~ Bbdc # Subd. Name or CSM# 1820 Crestview Drive 52 -- Indigo Ponds Cqy State ~ Cade Phone Number dY ~ Village • awn Nearest Road Hudson, WI $4016 ~ 715) 381 - 5334 Highlander Trail New Construction Use] Residential / Nutter of bedrooms 4 Code derived design flaw rate 600 GPD Replacement ~ Public or canmer'dai - Destxii~e: Parent material outwash Flood Plain elevati~ if applicable ~~ ft. General cerrKner~s Conventional In-ground Trenches -- 0.71oading rate - to be designed by Roger Nelson and recommendations: ~ ~.St f. Address: 877 Highlander Trail ~~~~`~ t _ - . ~,4. ^ 1 ~dn9 ~ Barg tS u,~jw~i 1~. ~ a Pit Ground surface elev. 101.64 ft. Depth to grrrNtin9 factor 120 in. Soq Rate Horizon Depth Dom~arrt Cobr Redox Desciption Texture Stnxlure Consistence Boundary Roots GP D/fP irt. Munseq t1u. Sz. Cont. Color Gr. Sz Sh. *EtfaX1 *Eff~2 1 0-10 1OYR3/2 - 1 3f-mabk mvfr ai 3vf-co 0.6 0.8 2 10-28 10YR3/4 - sl 2f-mabk mom' as 2vf-co 0.6 0.8 3 28-36 lOYRS/4 -- fs Osg dl as lvf-m O.S I,0 4 36-120 10YR5/4 -- s & cos Osg ~ -- - 0.7 1.6 Horizons 3 ~ 25% gr; Horizon 4 ins 30% gr. r `/b .0 fob-6 ) 03. ~~ 2 Boring ~ u ~°"ng 1 x.89 120 Pit Ground surface elev. ft. Depth to Ierriting odor rcr. Sod Rate Horizon Depth Dorninar-t Cobr Redox Description Texture Stnrdure Consistence Bounder Roots GPD/Flz in. Mtmseq Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eft#2 1 0-12 10YR3/1 - 1 3fabk mvfr orb 3vf-co 0.6 0.8 2 12-28 10YR3/4 - sl 3fabk mvfr as 2vf-co 0.6 0.8 3 28-48 10YR3/4 - sl if-mabk mvfr cb 2vf~ 0.7 1.6 4 48-120 10YR5/4 - s & cos Osg dl -- - 0.7 1.6 .~-- Horizon 3 tme t5-20%gr; Horizon 4 l>ae 25-3fl% $r• * Effluent tf1 = BOD > ~ < ~0 ntg/L' and TSS >~ < 150 mgli_ * Effluent ~Z = BOD < 30 mglL and T55 < 30 mg/L CST Nance Prirrt) - - Signature ,~~~i~'~t~'~ CST Number M Jo Hollister Gl~~fi1`-a~ 224832 Address Date Evaluation Corx!<x~ed Telephone Number W9875 690th Avenue, River Falls, WI 54022 02 - 27 - 06 (715) 426 - 1775 ~~ ^~ prop ~. Marquette & Lee Builders (Lot 52) parcel ID # 020 - 1439 - 52 -000 2 3 Pam of _ 3 ~..~ ~9 Bor>rsg ~ ~ pit Crotusd slaface elev. 91.24 ft- Depth to 9 tacxor 114 ~ Sol ira>fon Rate Horizon DepUr Domirsarlt Redox DescripUor's Textue Strr>c~re ConsistenoE Boundary Rods t,,PD/fF in. Llu. Sz. Gont. Cokrr (~- Sz Sh. '~1F#1 '~fbE2 1 0-10 10YR211 - 1 3f-mabk mvfr ab 3vf-co 0.6 0.8 2 10-26 10yR3/2 _ sl 3f-msbk mvfr as 2vf-co 0.6 0.8 3 236 IOYR3/4 -- is if-msbk mvfr cb 2vf-co 0.7 1.6 4 36-114 I OYR3/6 - s & gr Osg ml - - 0.7 1.6 Pit t'~rOtuld surface elev. R Depth to 9 factor ~. Sol Rate Horizon: Depth Dorlsinartt Redox DesaiQtion Texture Structlrre Consistersoe Boruldanr Roots GP DAF in. MurueR Qu. Sz. Corrt. Color tar. Sz. Sh. 'Eff~1 "Eff#2 ^ ~9 ~ Ground surface elev. ft. Depth to IQrri>irrg factor in. Pit Sol ~ lication Rate Horizons Depth Dominant Redox Description TexHxe Stllx~lre Con~stenoe Botrrdary Roots t3P QAF ins. NltASSe! t]u. Sz. t;ont. Color (3r. Sz. Sh. 'Etli~1 'Effe2 Eflla~rst #'t = 80D5 > 3t) < 220 mgtl_ antl TSS >30 < 450 mgR ' Effluent ~2 = BODS < 30 nsSIIL and TSS < 30 mgA_ - s , r Thep arlment o1'~onrtnc,c~ „as, L t ~ t > , ..• ., -. -. .-.. Hoed material In an alternate ~OF€Ckat ~nlt`ace rESn4~c-f tier r~.~~,~~::-Sm ;• crtn a -_ SBD-%33ifYffi ~~71f1L'? .~ Plot Plan for Site and Soil Evaluation Page 3 of 3 Property Owner M~~u~-r-r~. Iwo ~~ t~u,~o~s 1"=40f~ Legal Description t..~r sZ, r.~,p-~o Pon,os _ (except where noted) sw !~ OF THE NEi~4, SEC zs~~'z4~1~ R !9 w ~ ~u~ a~ = Backhoe pit }I-U~~1~ ST . Ct~J~ CO U i~l'h~/ . U~1, SCOJJSit~ -+..~-~' North '-K qL tt~GN«c~ i K~iL, t ~ ,n~ox . t~ c 'fb ~JES~r pl+- a ,,~ ~`~~~~ -~i ~ ~~ ~, ~W OO~S~ Site Location: ' ~" • k° ~ ~~ ,. GCE \\ DwEU-`~ ~~K~~ ~ mysy' ~' ~ v ~; z• ~Y ` °~'-"- /aooo f.00' ~r~Z ~~ w.S,P a 6.00 ~.40~ ~~ Y.oo~ g`ct'1.'1E' _ 2.Op' a~.4u4' z.zzo ~c.~~ s ~o~p W'E1.~.'t~ ~ 7so' F pdDM rta+E. ~~ /tND 72S `FROM TANK Z Plot Plan for Site and Soil Evaluation Page 3 of 3 .Property Owner M~~u~~ awn ~~ t~~s~~r~s 1"=40f~ Legal Description ujr sz. ~p-~o ~on-DS (except where noted) sw /~ o~ mE Nom'/~, sEC ~.-r Z4N, R -~ w, -ro~~ b~ _ ~ackhoe pat }t-t,t~5p~ ST Ci20~K ~OU~.1't1/ U~1iSCaN6~1~• ,...~.~ ~ "' R qL ttiGk~,r~rc~ TR,4i~„ POSt-it® Fax Note 7671 Date pa°ges~ To 11A 14fZ ~ ~ ~D LL I STKL From '~ ! ~ Co./Dept. Co ,r G(10( Co~Y 20x1/ Phone # `t'Z~P ' ~~5 Phone # ~ p, , ~~ r Fax # [.~~.¢ ~ $L Fax # ~~ , ~6 ~~~~ ~'~. i ~ ~~ ~~ s ~PPR4X • 2 i.S c- 'N WEB PN' a'3 ,nr' ~ ~ QB~ z.S~l' ° leb..oa ( WoOoS~ .oo ~~~Z~ 6.00' a4o' W ~~AO"*~ Y.oO~ ~`srt.~E' 2.00 r ~.4L24' ~ROF~08Ep WE~~-t+o 6E 73C~ F ISM rtR'E NC1t1~3 ENO ~ZS `FStaM ~~K a41e -4~ ~ s .~ e ~ ; c,,~-- rII ~S ~ on ~ '~-~ Porn I~'~~ ~_ a, c. c.wr~R., X16 .~ ~ ~~~~ ~: ca = x C Site Location: -~,, S C ~~~ ~ ' ~-- ~~""`°~~ - s 3~` o ~ _ ; ~ b ~~0.~~- k~ -tom ~- ~*~ Z . P; P--...~. ~~w+6E Dwfeu-~~16 ~~K~~ N4S4' s~ North z.zzo ~~~ s ~ 1 c o-tn,~- ' ~ afl ~~' ~ ,'~ ~s~~ .-~ ~ . Z ~- ~~' Mar 24 06 10=54a ~1 ~G~`v~o R 4 tio~6 MaR ~ ~x~°~N-~~c s~~~R° / owner 7154264827 Hollister's Soil Testing Mary Jo Holl"inter W9875 690 Avenue River Falls, WI 54022 (715) 426-1775 (715) 426-4827 Send to: sr. cRo~X c~ty . ~~,N~ From: Mary Jo Attention: ~~ l ~ Date: Zy MAR - Oho Office Location: Office Location: Fax Number. 3S(o -y ~~ (~ Phone Number: ^ Urgent ^ Reply ASAP ^ Please comment ^ Please Review O For your Information Total pages, inGuding cover. Z P - 1 __ 1K~~~ -r1~ Car.~trt~ J~,,4~ aC~~ U~.~l~}t-Z [k. J~.~~l.e opt T.bu ~. r~c,(n rr~an.,k a~ -~v~ch ~nnanl~ c~ -~'~.c ~.~rGt ~,hx~ '~ Z - Q~,scc~ Mar 24 06 10:54a owner 7154264827 _ P-2 ____ ~t Plot Plan for Site and Soil Evaluation Page 3 of 3 Property Owner /y~~~~~-n-~ ~,an LEA ~~v.~~~r~zs Legal Description ~r sz, ~~~~o ~ ~i~; ns SiN ~4 OF THE N6~~~1~ 5cC ZS~TLy1J~ P 1~ y.i~ TbWwl c~~ G~~~~® ~~ ~ ,~Op6 MPS ~ ~X~°~'N~~c ~o / S~'G ~ ~ i ~1pPRo1(, 2 u ~~"~ r~ 'fD ydesr p-~ \ _ _ 9soe' ~r~e~ ~i.00 ' a 9~4p~ u' w~O,a°""~ V, oo~ __~..., ~ 4Z.oo' ~.412y ' Site Location: I"=40,f~ (except where note = Backhoe pi ti SC~K-Si1J - '' `~~ ~~ C/L /t1GkL,itnl DE./; TTtAiL Uk ipso C~tR1-6E O wE ~.~.~ ~e ti,~'~itGeo,cP ~s~.Ke~~ ~'.~ ~eD 104,54' K~ . Zm~• a ~ ~~10'2.5'/' ~ /abOO' North Z. zzo ~csz~ s ~1420PO~~iep WEL~~'o BE 7 ~O' FROM TR~e NeN~ ENO 723' FROM SANK Satety ana,3 1 6~D ashingto Ave ~ ~ L ~~ 0 /x ., tir Mad1S tau 53707 - 7162 ' Sa tary Permit Number (to be filled in by Co.) CC1 ~i~l f1 I ~ 608) 663~~Eg 2 3 200 ~~~~ Department of Commerce Sta Plan I. Numb/e1r / \ ~ ~ Sanitary Permit Applic I ri ST. CROIX COUNTY ~L~ ~. C.• ou provide l informati n n i d C ~ y so a c, pe o In accord with Comm 83,21, Wis. Adm, may be used for secondary purposes Privacy Law, s15.0 'ect Addr (if different than mailing address) ~ ~ 77 I. Application Information -Please Prillt All Information ~a uy~ rr~ ~~ ~~-~L Property Owner's Na me Parcel N~ 2~ Lot b S'2 Block N t~w~.l-f-~ ~- L ~~ -cc~~ m ~~-s _ > 3 -sz - ao~ ling Addr ess Property Owner's M a Property ovation i ~~ rr City, State tl. ~ ~ W ~ Zip Code ,r~`l~o ( Phone Number ~lS 3~' ~3 3 ~ 2 q' /GY ccir~l®) C.02~ 7 N; R E o l ) ( : k all that a h ildl f B T I y ~ g,~, ow. pp n c ec ype o u I . Subdivision Name CSM Number 1 or• 2 Fanilly llwelli,l Number of Bedrooms S - ~r r 0 N ~ ~ DJ 6 ~ ^ Public/Commercial - Desc a Use l ^ State Owned -Describe Use ~ ~ ~ ~/ ^City_^Village IL'ITOWnShI f ~ n~~IW III. Type of Permit: (Check only ie box on line A. Complete line B if applicabl A' New S s[em y ^ Replacem System ^ Tr•eam~elit/Holding Tank Repla meat Only ^ Other Modification to Existing Sy tem B. ^ Yermit Renewal ^ Permit Revision ^ Change of List vious Perini[ N ate Issued ^ Pern Transfer t e Before Expiration Plumber Owne 1V. T e of POWTS S stem: (Check all that a ~ ~ ~ Non -Pressurized In-Ground ^ Mound > 24 in. of suits a soil ^ ound < 24 in. of s table soil A Gra ^ Sin P s Sand Ater ^ Constructed Wetland ^ Pressurized In-Ground ^ Holdin ank ^ Peat Filter Vic Tr n t n,t ^ Re lati Sa filter ^ Recirculating Syn[hetic Media Pilter ^ Leaching Chamber ,p Line ^ Gravel-I s Pi tJle plain) (( ~ l~'~ V. Dis ersal/Treatment Area Information: Design Flow (gptl) Design Soil Ap lication Rate(gpdsf) Disp sal Ares equired (sf) rea opo d (st) yst anon ~ ®~ ~ ~ q/..~ ~ t CCf~C VI. Tarlk Info Capacity in Total Num Manu Curer refab Site Steel er P as[ir Gallons Gallons of its W ~ ~ P_~ R„_ oncret Consu-uctcd Glass New Existing z~ _(_ ` Tanks Ta,ilts ~ - Septic or Molding Tank ~~ ~ ~~, Aerobic Treatment Unit Dosing Chambrr ~ ~~ VII. Respollsibility Statement- I, the u~ rsIglied, assuule respons ty for hutallation of the POWT own on the attached plans. Plu~~ ~ m~rint~~, , ; p ber' Si gnature MP/MFi~Nwnber Business Phone Number Plumber's Addre ss (Street, City, S , Zip C e) ~c~ .t ~~--- ~- i VIII, Count !De al•tmen se Onl Approved ^ D' ove Sanitary Permit Fee (fir lodes Groundwater Date Issued Issu'ng A t Si na re (No S Surcharge Fee) / ^ 0 en Reason for De ial ,2c` ~p IX. Conditions pp . / al SYSTEM OWNER: 3~ ~'~' ~4 t~~`C S 1 Septic tank, effluent filter and t ,~,,;r~ d~c~~~Z.~~S dispersal cell must all be serviced /maintained ~' r as per management plan provided by plumber. `~ ~~- ~ ~ S~ ~~, '~~,{~. 2. All setback requirements must be maintained as per applicable code/ordinances. St~S~ .___ ~,,"M~. ~ ~ ~ Cif 5 ~~.w~ S~ ~e.0( Q , 2 ~tt~'>`Rt' ,,,,, ,,,..(;`_ 5 Atts~h gompleto pl s o thr only only) fw• the systrm 3fi"paper n t less than 81/2 ~C 1 inches in size ~QDSIe~t $~Or wtE,[rr Cs9•vr'f~ t_ p(_+t„u •}o STCQa/K C+~tLu4~. ' ~_ ~~ r ~-., ~w ' T ~ ~~~> ~ ~ .~ ~ 0 y '~ 4 k ~~ f,~_~a~ ~d~ ~Z Z~~ 1N r o~ T ~Q~ Si s s d~ R ~ ~ ~ "t , .! `~ ,_ ~ ;, *:. ;' ~. `< .~ M. ., ~ ~wS~ ~~ ~ 1274 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page t of 3 Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code Steel Soil Service 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 north snow, and location and distance to nearest road. scale or dimemsions percent slope Parcel I.D. , , pending Please --°••-°°•-~ I'v. ~ ~° ~ iewed B y Date Personal information you provide ay be u rif~~tirdesPrivacy I~aw, s. 15.04 (t) (m)). , 2 Property Owner ~ s Property Location ROSAMJI, L.LC ~ r~~+~ ~ ~ ~~~)~~ Govt. Lot na SW 1/4 NE 1/4 S 25 T 29 N R 19 W Property Owner's Mailing Addres ~ Lot # Block # Subd. Name or CSM# 2141 Cty Rd. C ~ ~~~~ ~X C~~_~~'`~_i ~. 52 na Indigo Ponds City ~ J City ,J Village ~ Town Nearest Road New Richmond ~ WI 54017 715-248-7071 Hudson Highlander Trail i~ New Construction Use: ~ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement _f Public or commercial -Describe: Parent material Sream terraces and pitted outwash plains mment l G Flood plain levatio{~, a pli ble na S l ~~ ~Attl6't ~ ~ S'am' ~'f co s enera and recommendations: system elevation 91.60 ft, trenches spaced and depth to cod 6 elow grade / ~' ~~~ ' Q,~.d cv.~ ~ Boring # J Boring 140 i R li i t 1/ Pit Ground Surface elev. 98.10 ft . Depth to on a e n. Soil App cat limiting factor Horizon Depth Dominant Color Redox Description Textun: Structure Consistence Boundary Roots GP *Eff#1 D/Ft~ *Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-7 10yr3/2 none sil 2msbk mfr cs 2c .5 .8 2 7-17 10yr4/4 none sl 2msbk mfr gw 1 c .5 .9 3 - 7.5yr4/4 none ms/cos osg mvfr gw na .7 1.2 4 72-140 7.5yr4/6 none cos osg ml na na .7 1.6 2•b a ~ ~~ COS <35% coarse fragments = 36" & " ~ 9 / ~ ~ c >35% - <60% = 60 below system ~~ Boring # ~ Boring Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 140 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GP *Eff#1 DIft~ *Eff#2 1 0-8 10yrL/1 none sil 2msbk mfr gw 2c .5 .8 2 8-36 10yr4/4 none sicl 2msbk mfr gw 1 c .4 .6 3 3~ 7.5yr4/4 none sl/Is 2msbk mfr gw na .5 .9 4 72-140 7.5yr4/6 none cos osg ml na na .7 1.6 ..-- * Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 =GODS < 3D mgiL and I SS <_;iu mgir_ CST Name (Please Print) 'nature: CST Number David J. Steel t---~ 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 4/25/2003 715-246-5085 ~~ ~~ .~ -- DoT utu~Y ~, a~ sF. ¢ _,_..~- -.- ...J ..;.._ carte ~-~ L (~.ol~ Ac>,/~ ~. -- ~-" rs~s _~ *AY WiE ~/ /~~.~'f,'w ~+~ --f-IlGN1-A~ 19.as ~ . EASEt~t'ITS AS (1EPICt7~ ." ~'^ r+ +~aove trtaEle,~ s~+olw. ~ -~ ~ ~ f ~9~ --' ~ ~ ~ .~,~~'' ' ,.,/r''`te ~ _~-~-~.s~. ~ 9!611 sr. _____-~_~,. _/ •~' .w % /-ms"s"-~""~..-~ ~ i - ---- --:..116.13 1.7'S -~- `~ ~ ~ tST1~4 S.l: ~/S (~ N ~ ~1,~ ~ (a.eoo AG) ~~ ~ ~ ~ ~~oa kY • 52 n _ 1 ana c --~ ~~ _ ~ -. -~ _~ ~~ CSI -+I . ~s v ~.,1 ~- ++o or~uN+czi o ~i ~~ ~`~ ~/ n ~ .~%~.~. ~~V.«' 92. ~ r ~~ a.swir o - 9s7! ss~ ~ ~ __ 1 r~ i . - ~.~mon-seaaa' ~, sra ~ ~.aa~ ~ ~ ~ `~~ ~ ~~ a.art-sw ~s~ ~ ~ ~prsT~'~ s°' 9' ~ . ~ i 1 ~~ i ~ 1 ~~ i ~~ l 1 1t ~....-__ ME1LAtO.-.».•l ~., ,,,,~, ; - ' __~. ~rrrrrr.i .:•.. . ~ f~-- ~~ November 25, 2003 James Rusch James R Hill, Inc 2500 W County Road 42, Suite 120 Burnsville, MN 55337 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 • Fax (715) 386-4686 RE: Shoreland Zoning District /Indigo Ponds Subdivision Dear Mr. Rusch: Certain lots of Indigo Ponds may require a County Special Exception Permit for filling and grading due to their location in th~ Shoreland Zoning District. The lots include: 36, 37, 38, 39, 40, 41, 45, 46, 47, 49, 50, 51, 52 and 53. Lot 53 is currently under review for further subdividing. If the building site is located within 300' of the Ordinary High Water Mark (OHWM), has direct surface water drainage to the ponds and exceeds the grading limit that is allowed by ordinance in the Shoreland area, a Special Exception permit will be required prior to commencement of construction. Affected lots whose building site is beyond 300' from the OHWM of the ponds will not be required to obtain a Special Exception permit. Please note that on these lots an erosion control Ian must be reviewed and approved by the Zoning Office efore the issuance of it for e p lar lot. It is preferred that the erosion control plan and the sanitary application be submitted to the Zoning Office at the same time to better coordinate our review. If you have questions or concerns, please feel free to contact this office. Si rely, Rod Eslinger Zoning Specialist RE/jh CC: Town of Hudson, Brian Wert file EROSION & SEDIMENT CONTROL PLAN ` Site: 877 Highlander Trail., Lot 52, Indigo Ponds Subdivision, Town of Hudson Owner(s) Marquette & Lee Builders Parcel # 25.29.19.2778 Under St. Croix County Zoning Code 17.70(3)(b) 5: "The (Zoning) Administrator may attach ~' reasonable erosion prevention conditions to a permit approved for issuance." Wisconsin CodeAdministt~uol~ Admin. Code Comm. 21.125 requires the building permit applicant and/or landowner to follow 715-386-4680 ,~ erosion control procedures and maintain them until the site has been stabilized. ~;. Land Informauon;':& The Owner is responsible for notifying all contractors performing construction on this site Planning ' ~ that an Erosion & Sediment Control Plan is in effect and the following activities will be 715-386-4674 required in order to maintain compliance with the plan: Real Property ,- 1. The primary source for construction site runoff will be the house foundation excavation, 715-386-4677 r~ driveway, and any soil stockpiled until final grading and stabilization is complete. Recycling a Septic system installation adds to temporary disturbance, but establishing cover on 715-38G-~~G75 exposed soils will prevent erosion. Apply seed and mulch as recommended in #5 below. Maintain existing vegetation wherever possible to minimize erosion and sediment movement. Surface drainage flows are intercepted by a stormwater retention area and F~~~ the proposed septic system is >300 ft. from the pond(s). 2. Intercept and route contaminated runoff into stabilized vegetated buffer areas by "'` ~ creating temporary diversions graded ALONG CONTOUR between construction areas ~,~~;. and any potential receiving waters (includes drainage ditches and retention basins). Do not allow diverted runoff to be directed into surface water conveyances. (See Temporary Diversions specification sheet available from department) 3. If excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of other '~~' products may not be necessary. However, silt fence, straw wattles, or other approved sediment control products will be required if sediment cannot be contained on owner's property with diversions and vegetative buffers. The POWTS or Building ;~`~ inspector may evaluate ESC Plan effectiveness and make recommendations to owner for *j any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public :~Y road for heavy equipment; this includes cement trucks, well drillers, and other ' `~., contractor's vehicles that access the property during construction. This helps avoid ~,~.~:, G-~"' - muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points. Sediment tracked on public roadways must be removed at the end of each workday. ~_? ~~ 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation - do not wait for final stabilization and/or landscaping of entire site to ~y cover exposed soils on the system. When late-season weather conditions will not permit ~~~~. ~~ PZC~CO. SAINT-CRDIX. Wl. US ST. CRO/X COUNTY GOVERNMENT CENTER 1 101 CARM/CHAFE ROAD, HUDSON, Wl 54016 715-386-46E WWW.CO.SAINT-CROIX J ~ r seed germination, a heavy straw mulch cover will prevent erosion until vegetation can be established. Erosion control matting can be applied any time of year and, if installed properly, will provide protection even if seed germination is delayed. .~ ~~~. _~~,~_ _~~~ ~~...,,~~..~w ~,~.~~ ~,~ .~~.~. ~.~a. .a~tr The owner of record during site construction will be responsible for compliance with the ESC P .Please feel free to contact me with questions regarding erosion & sediment control product i ion. PREPARED BY: PAM QUINN, POWTS & SOIL EROSION INSPECTOR #6650 ~(~,~~ Owner acknowledgement of ESC Plan requirements: _/_/2006 (Please sign`and return original document to Planning & Zoning Dept.) '~~;~ '~' . ~: ,. _~a. ~... „ , ~«a. ~. ~ _ _ _ ...... «_.~.,,. _,W ST. CRO/X COUNTY GOVERNMENT CENTER 1 1 O 1 CARM/CHAFE ROAD, HUDSON, Wl 54016 71x386-46E PZC°~CO.SAINT-CROIX. Wl. US WWW.CO.SAINT-CROIX COMBINATION SEPTIC/DOSE CHAMBER TANK & PUMP SPECIFICATIONS PER COMM 84.25 CODE CHANGES 2/1/2004 Access Opening, not top of cover, must extend to a point no greater than 6" Belomr Finished GyraIde toner vuith 1VvCA'rN Lockin~q Device ~ X (typual) ?ui Li,~~JGr St W ~1Z > 3a i=l: ~qy,, Tti15U~ PIS ,__-_. Min. 23" Access Opening Outet Effluent Filter ~ Inlet Baffle Access Opening, not tap of cover, must extend at least 4" Above Finished Glade . ~I~~ ~~ a~ ,8 r _ Y~~ ~ ern fFinished Grade I ~Z ~+ Min. 23" Access Opening ~rat~z"~ .MrN!~~ vrh i rviTH if ~'p/c S! ~ .Union 2oYE.A ~~P~ ,3 PT, ~~ TANK MFR: W ~ L ~ ~~ 3 "Sav-d arq ravr- un er ; with c~eh,~er 2"/aver ~lhah ed~ps :ntSepticlp'umpTaek ~~ mss.,, ~~,A~ on ovfside GUaI~) SPECIFICATIONS DOSES PER DAY: DOSE VOLUME: 1` • ~ GAL. (INCLUDES FLOWBACK & <20% OF DWF) TANK SIZE: SEPTIC ~ ~ GAL. DOSE GAL. ALARM MFR: ~ ~~f CAPACITIES: A = z ~ $INCHES = GAL. MODEL # ~~1 ~ Switch type: B = 2_INCHES = / ~ Z. GAL. PUMP MFR: ~C9' LLB- ~ C = _INCHES = ~ ~ GAL. MODEL #: _-P ~ ~ 'I / SWITCH TYPE: ~- D = _INCHES = ` Z3r GAL. REQUIRED DISCHARGE RATE GPM PUMP & ALARM WIRING PER COMM 83.43(8)(e) VERTICAL DIFFERENCE BETWEEN PUMP OFF & DISTRIBUTION PIPE (LIFT) = T FT. MINIMUM NETWORK SUPPLY PRESSURE (DISTAL & NETWORK PRESSURE) _ + ~_FT. 'z~'} FT. OF FORCEMAIN x OFT./100 FT. FRICTION FACTOR ...... _ + - FT. TOTAL DYNAMIC HEAD (TDH) _ ~b FT. INTERNAL TANK DIMENSIONS: LENGTH ;WIDTH ;LIQUID DEPTH MP/MPRS SIGNATURE: LICENSE NUMBER: ,~~ ~ Z,6 ~~~ Qc.,c.~-~f-~ ~ ~ ~3~«~s Quick4" STANDARD CHAMBER Quick4 Standard Chamber SIDE VIEW MultiPort End Cap TOP VIEW FRONT VIEW Quick ~S.tagd~ ~~h,a~tllbei?~Ngmin~l~, pecificatiorisr. ~, .Size It'V~' ~,,~~ ~ ~'I~' ~r. ' 3~#L-X~5 " _ Etf~ctirie Le gt ~ ti ,~~r~~~~i~,<~,~ .~:~ ~ ~`:: -18 Invert Heigf~` "> 8 . i r A } ~ nultiP rt`End Ca'p` tJb ' ~ a ~q~ C l t y ' ~ ` . ~ w~, .o Q~, c : , i ,~~ - ~~. ; _ wart Hel~ht f 1 25 ~„ ~ ~r ,fit: INFILTRATOR SYSTEMS. INC. STANDARD LIMITED WARRANTY (a) The sauctural htegrity of each chamber, end plate, wedge and other accessory manufactured by Infinretor ("Untts~, when installed and operated h a leachfied of an onstte septic system h accordance wtth Infittretor's fnstructtau, is wartanted to the odglnal purchaser rHolder~ against defective materials and workrrlanship roc one year from the date that The septic permit is Issued fa the septic system containing the Units; provided, however, that if a septic perrrut is not required by applicable law, the warranty period wiq begin upon the pate that itistallation of the septic system cofnrrlenCes. To exercise its warreny rights, Helder must rotiry InNiretor h writing at its Corporate Headquarters h qd Saybrook, Comecticut wlihh fin6en (15) days or the aNegad detect. InfNtrator wiN supply replacement Units for Units determined by Infiltrator to be covered by this Umited Wananry. Infiltrator9 IiatiNiry spedficaly ezcWdes the cost of rerrwval and/or hstallatbn of the Units. (b) THE UMtTED WARRANT/ AND REMEDIES IN SUBPARAGRAPH ta) ARE IXCLUSNE. THERE ARE NO OTHER WARRANTIES WRH RESPECT TO THE UNITS, INCLUDING NO IMPLIF~ WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICUTAR PURPOSE. (c) This Umited Warranty ahaN be void n arty part of the chamber system is manuractured by anyone other than Infinretor. The Limited warranty does not extend to incidental, consequenllal, special or itditect damages. Infiltrator shall not be liable for penanleg or Nquidated damages, includitg kus of production antl profits, labor and materiels, overtlead costs, or other losses or expenses hctrred by the Holder or any thkd party Specificaly excWded nom Limited Warranty coverage are damage to the Units due to ordinary weer and tear, aneretion, accident, misuse, abuse or r>aglect or the Units; the Units behg subjected to vefdcfe traffic a other condttions wNCh are not permitted b`y the hstaNaton instructors; failure to maintain the minimum grpxrd covers set forth h the hstaflaton Instnrctons; the placertwnt of improper materials Into the system containitg the Units; failure of the Units or the aeptb system due to itnproper siting a itproper sizing, excessive water usage, Improper grease disposal, a Nnproper operation; or any other event not caused by hfikrata. This Umiled Warranty sheN be void If the Holder fails to compy with all of the terms set forth h this Limited warranty. Further, h ro event shay Infiltrator be raspon.Uble for arty loss a damage ro the Folder, the Units, or arty thkd parry resulting from Installation or ship- ment, or from any product IiabNiry claims of Holder or anry tNrd perry. For tMS Umited Wartanty to appy, the Units must be instated h accordance with aN site conditions requited by stale and local codes; all other applcable laws; and InfilVatw$ hstaNatbn hstructlons. (d) No representative of InfilVator has the aueariry to change or extend this Limited Wartanry No warranty applies to arty party other than the origi- nal Helder. The above represents the Standard LNnited Warranty offered by hfJtretoc• A Gmttetl number of states and counties have different wamanry rcaquire- ments. Arty purchaser of lktiLS stauld contact hNtrator's Corporate Headquarters h Old Saybrook, Connecticut, prbr to such purchase, to obtan a copy of The applhable warranty, and should carefully reatl that warranty prior to the purchase of Unlis. ~ . • ~ 0 SYSTEMS I NC Environmental Onsite Wastewater Solutions`" 6 Business Park Road • P.O. Box 768 Old Saybrook, CT 06475 860-577-7000 • FAX 860-577-7001 800-221-4436 U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116; 5,401,459; 5,511,903; 5,716,163; 5,588,778; 5,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer and Sidewinder ere registered trademarks of Infiltrator Systems Inc. Inflltretor is a registered trademark In France. Infiltrator Systems tnc. is a registered trademark 1n Mexico. Contour, Contour Swivel Connection, MicroLeaching, PolyTuff, SnapLock, ChamberSpacer, PosiLock, QuickCut, QuickPlay RECYCLEDPMER and Quick4 are trademarks of Infiltrator Systems Inc. ®20031nfiltrator Systems Inc. Printed in U.S.A. G011203HP-0 SECTION VIEW ._._~_-. _~. .___-~- - __.__. -----~c:~~ __.._.-_ ~__- SPECIFICATIONS Submersible Effluent Pump PE L GOULDS PUMPS APPLICATIONS Spedally designed for the following uses: • Mound Systems • EffluentJt)osing Systems • low Pressure Pipe Systems • Basement Draining • Heavy Duty Sump/ Dewatering . METERS FEET i ao r 10 35 zs 20 0 c 15 ti to Pump -General: • Discharge: 1'h" NPT • Temperature: 104oF (4Q,?C~ maximum, continuous when fuNy submerged, • Solids handling: '/" maximum sphere. • Automatic modeh include a float switch. • Manual models ava~able, • Pumping range: see performance cf:art or curve. Pk31. Pump: • Maximum capadty: 50 GPM • ~vlaximum head: 25' TpH PE41 Pump: • Maximum capaclry: 60 GPM • Maximum head: 29' TDH PESt Pump: • Maximum capadty: 70 GPM • Maximum head: 37' TDH ~'- 2 GPM t Ft 40 ~+ I002 Goulds Pumps Effective November, I002 BPE3t/41 7D MOTOR General: • Single phase 60 Hertz • 115 volts • &ilt-in thennal overbad pro- tection with automatic reset. • Class-B insulation. • Oil-filled design. • High strength carbon steel shaft. PE3t Motor: • .33 HP, 3000 RPM • 12.0 Maximum amps • Shaded pole design PE41 Motor. • .40 HP, 3400 RPM • 7.5 Maximum amps • PSC design PESt Motor. • .SO HP, 3400 RPM • 9.5 Maximum amps • PSC design :.:; ::'~ MooECS: PE3t aFa~, aesi ,~,:;1,,: Mh. ,33, .40, ,SO FEATURES ^ Corrosion resistant construction. ^ Cast iron body. • Thermoplastic impeller and cover. ^ Upper sleeve and lower heavy duty bail bearing construction. ^ Motor is permanently lubricated for extended service life. ^ Powered for continuous operation. ^ Ali ratings are within the working limits of the motor. ^ Quick disconnect power cord, 20' standard length, heavy duty t6/3 S1TW with NEMA 5.15P, three prong, 115 volt grounding plug. ^ Complete unh is heavy duty, portable and compact. ~ Mechanical seal is carbon, ceramic, BUNA and stainless steel. ^ Stainless steel fasteners. .:';::~~ AGENCY LISTINGS t . - ~~o .v.. ;;;;'. C US Tasted ivo UL 778 and ~~-~~ C'SA 22.2108 Standarcfs :~::' BY Gnadvn Standards Assocl~fon FIe NLR3t{5d9 :, :~ Goukk vamps a iso soot R4yictRred. r--~--r.- ...--LI..] Y QG3~ ~o 70 GPM 80 95 rn3/h GOUICIS ipUR1p5 ITT Industries (~ ~~' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page L of Z FILE INFORMATION Owner ~~ ~-~.~ ~-~ Permit # O DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units --- ^ NA Estimated flow (average) (~ aUda Design flow (peakl, (Estimated x 1.5) ~ al/da Soil Application Rate al/da /ft2 Standard Influent/Effluent Quality Monthly average" Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BOD5) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean- 510° cfu/100m1 Maximum Effluent Particle Size Ys in dia. ^ NA Other: ^ NA *'Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ~'~ al ^ NA Septic Tank Manufacturer Gc>j~ ^ NA Effluent Filter Manufacturer -~ ^ NA Effluent Filter Model ~ ^ NA Pump Tank Capacity CS~ al ^ NA Pump Tank Manufacturer l,~l ~~~~~ ^ NA Pump Manufacturer ^ NA Pump Model ~ ~ ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ^ NA Dispersal Cell(s) ~, In-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA MAINTENANCE SCHEDULE Service Event Service Frequency fns ect condition of tank(s) p At least once eve ry~ ~ ^ month(s) (Maximum 3 ears) ® ear(s) y ^ 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: ^monthls) (Maximum 3 years) ~ year(s) ^ NA Clean effluent filter At least once every: ~ ^monthls) m year(s) ^ NA Inspect pump, pump controls & alarm At least once every: ^ month(s) ~ year(s) ^ NA Flush laterals and pressure test At least once every: ^ month(s) ^ year(s) ^ NA Other: At least once every: ^ month(s) ^ year(s! ^ NA Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s- to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and 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 IY3) 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. cnnw t~roti 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 celllsl. 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 cell(s) 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 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 andJor soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ^ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ® ~fL Jl/ ~GSr'"J Phone 1" _. ~ 7 _ t"'~~~ POWTS MAINTAINER Name Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name ~ ~ Cp2.0 / C4u ~v Phone `~~ 3 $d gQ This document was drafted in compliance with chapter Comm 83.22(211b111i1d)&If- and 83.54(11, 121 & 131, Wisconsin Administrative Code. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT ' AND OWNERSHIP CERTIFICATION FORM ~ OwnerBuyer ~, ~-~ ~ ~e- f ` ~ ~ ~ t~«~ ~ ~L ~ O ~wYEiZ Mailing Address ~ ~'/Q Cy'eS~U u~Ge,~/ Q~~t' i~-~ ~ _ Property Address ~ o ~ S L ~1 cQ~ e -~ (Verification required from nning & Zoning Department for new construction.) City/State ~~~~~ w~~ Parcel Identification Number ®Z ~ ~~ 3~'_ s2 - o a b (. ~ ~-~') LEGAL DESCRIPTION f J .. Property Location ~~ `/4 , /V~` '/4 ,Sec. ~,~, T ~N R~W, Town of ~'~ ""'J~~ /l~ Subdivision ~ ~ ~1 ~~ (T ~/~'~~ ,Lot # ~Z.. Certified Survey Map # ,Volume ~- ,Page # ^_ Warranty Deed # p l ~ T V l7 ,Volume ~ Page # ~- . Spec House yes Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Ihve, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 1/we certify that all statements on this form are true to the best of my/our knowledge property described above, by virtue f a warranty deed recorded in Register of Deeds Office. Number of bedrooms TURF OF APPLICANT(S) Ihve am/are the owner(s) of the Z /Z3i D~ DATE ***Any inforniation that is rnisrepresented may result in the sanitary permit being revoked by the Plamvng & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. OS/OS) State Bar of Wisconsin Form 2-2003 WARRANTY DEED Document Number ~~ Document Name THIS DEED, made between Rosamii LLC ("Grantor," whether one or more), and Marquette & Lee Builders LLC ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is please attach addendum): of 52 flat of Indigo Ponds in the Town of Hudson, St. Croix County, Wisconsin. ------- *Rosamji, LLC 020-1434-52-000 Parcel Identification Aiumber (PI1V) This is not homestead property. (is) {is not) Exceptions to warm 'es: Easements, restrictions and rights-of--way of record, if any. Dated 1 (SEAL) (SEAL} ~ ~ Signature(s) authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stet. § 706.06) ~,~ ~; ~,,~ THIS INSTRUMENT DRAFTED BY:~ti .~~~~\®~'' ~~.'~ `,. { '~ ~° Attorne Kristine O land ~ ~' ~~' ~' ~ '`~~~ -• „r~`4 Hudson WI 54016 ~ ~"''•` ~ ~ `'~~~'' E3 1 E3.4 ~jl ~;, KATHLEEN N. WALSE! REGISTER OF DEEDS ST. CROIK co. , wI RECEIVED FUR RECURD 02/13/2006 20:2SAl~l WARRANTx DEED EXEU1Pi' # RBC FEE: xx,~ TRANS FEB: 488.70 GQPX FEE: Recording AI)~ F'~; Name a~ etu s f ~ ` ~~~-,. ~.,~~- 5~or~ MENT ~ COU]~'Y . ) Personally came before me the above-named Rosamii• to me known to be the person(s) who executed the foregoing insti~tnaent and acklxtliv]trdged the satne. ,. ~ ., - ~ Nbtafy Public, State of titJ~J `~ " My Commission (is permanent) (expires: / ) ~~. r (Signatures may he authenticated or acknowledged. Both are not necessary.} NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY H)ENTIFIED. WARRANTY DEED ©2003 STATC BAR OF WISCONSIN FORM N0.2-2003 AUTHENTICATION " Type name below signatures. INFO-PRO''"" Legal Forms 800-855-2021 www.infoproforms.com Fage 1 of 1 1 f~fiq..r...~ T http://www.landsted.com/communities/commimages/indgponds/sitemap-Ig jpg 9/20/2005