Loading...
HomeMy WebLinkAbout030-1088-60-002 ~ a o C o 3 0 H ~ O v M o C U N N ca N i~ c U I x c6 ON N (6 > N 0)N 0) ~o cu O O V M a) C Q. C ca y O Y N Oyi c 2(D L E` ~cOO u'E 'O U a U 0 a) a cvj M N r a) -0 'E E 0 co o a o O h 1-I o a) -O U r` a) ri \ 7 n Z 3. C L m U 1J O (a m e m' m ~i: u LL c (U n (D D 3 O` ) C E ,n m a) r-I 4-1 C? Co 'P 0 3 a) > w. ) z 3 o 3 Cl) H Hi ~t- v a) Z N \ I C rn W O CU O N O c N 00 C) a) 0) a) C:) LU Cl) M I- Z d co vo; v 111 as J .w c \ 'Q O z v' 'o - a~i Z a o) c): to F- a) T ) a) N N o 0 0 co •V O N w rZ N a) a) a) R+ O .L-. r- • (n L fn M a L. m O H 4-J q 0 o N Q 3 rl O Z co z •rI N N 11 M Z N ~ Cl) o a) C H ~i co > W J Q. CL a) Chi V] U Lo a y a) O O p ❑ d L a L ) Z M > C. in . a (L a te IL 7 O 2o m ao ~j fq J U o o a) v O } D O O M ITV ! 2 N O O O O O W 4 O N N N N O O 7 -O 0 (O a0 (D O) CD (D C n' N .N- 00 6 N a) O ~(n o U m« ¢ 0 3 C C N N O C) U O M N C O a) 3 (D D) M (D O O O H N (D C 0 a 0 0 0 0 0 J•' \ O M L O O C '0 N N N N N V 'Ln C6 O- co N C Lo (D 00 (o m O O N ` a) ae 7 N N r- 40. 6 NO C O trf U Z a) (O W C Lo w a) O C a) ery~,) ~ M C) 7 O N N O U CF) • 1V O M U) V O Z N 2 H (n V v~ d ~a ~ a at _a L CL L) • c~ a d u d y c c c w Q 0 a E 0 (n U Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT ) OWNER 1~ TOWNSHIP r4 , w . j E :V SEC. i~ T ~-j N-RW ADDRESS I~,c ST, CROIX COUNTY, WISCONSIN u A So rl y U'-) I' . SUBDIVISION LOT n LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM A 18 r) -k~ G ~ZYv: -z L C 1 / 1 k INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point usedj~ Elevation of vertical reference point: i l ~ Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings used: 'rank manhole cover elevation:/ Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front ,w Side,0 Rear, O & ~r feet From nearest property line Front, 0Side, 0tiear,® feet Number of feet from: well t ~~_building: (Include this information of tie above plot plan)( 2 /reference dimensions to septic tank) SEE NEVEIZSI•: S 11)F * v PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: i i Pump off *itch elevation: Gallons per cycle: Alarm /Manufacturer: Alarm Switch Type: Nu/Aer of feet from nearest property line: Front, O Side, O Rear, 0 Ft. Number of feet from well: _ / Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench:, 7 Number of Lines: Width: Length:~_ Area Built: ri Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, Rear,0 Ft Z Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT i Size: Number of pits: Diameter: Liquid deUtEi: Bottom of seepage pit elevation: Area, ilt: Has ei er a drop box O or distribution box O been used on any of the above soil abs~rbtion sytems? (Check ono. . 1 j HOLDING TANK i Manufacturer: T/ Capacity: Number of r4/ngs used: Elevation of bottom of tank: Elevatio/y~/ of inlet: Number/of feet from nearest property line: Front, O Side, O Rear, O Ft. i Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: 7 ZI c, ~ Dated: -ter Plumber on job: - 7 Or License Number : 3/84:mj DEPARTM~_NT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INdUSTRY, c DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 7969 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION. TOWNSHIP/ £tPA-ETT`Y: LOT NO.: BLK. NO.: SUBDIVISION NAME: C 4 ~a /TZa PI/R M (or) W sG - COUNT /BUYER'S NAME: AILING ADDRESS: C u I Yi S ~c~ L USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: ROFILE DESCRIPTIONS: PERCOLATION TESTS: P Residence ®New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONnVENTIONAL: MOUND: I' IN-GROUND-PRESISIURE: SYSTEM-INn-FILL HOLDING TnANK: RECOMMENDED SYSTEM:(optional) If Percolation Tests are NOT required DESIGN RATE: [Floodplain, an y portion of the tested area is in the under s.H63.09(5)(b), indicae: indicate Floodplain elevation: _ PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) r I-7 or B 17 - N > ( Sze i.n ~a B f? 3 ~J r J IV 0 AJ F z 25 OR 4Z I ,L _an z . 2.- 6 .5..5,1. II4. S" bn•1,63C~1-~.1.. 1 5 LzrisLo l.& 5.4." .5. /00 _Zzl~ A, B - . r f)d L S yh,~-k er .n- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH P- I 0 z o /O P_ 7- 'V0 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 18 TZ© ZrI 25r , ( , ":~r 40 jot J C Y ~Q' ( T'- Z.- r+ ~'4?46>3 d N rn A A4 4- Lo-41+5 E i I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: 3-g -8~ ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 'Id CST SIGN TU DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester, DILHR-SBD-6395 (R. 02/82) --OVER - I sa € ; E ,U" g t `s aa d , . a . x ~ 0 I P, I t, 0, ~3t 1`' ..€tl § E Sit 3 ( ar^'e€ r.3 ~tt~{. f.,, . ;F1j} 3 r€. Gay ,s ~ .1 a3 A:. ` L. b 3_' haxs ka c, G ~ , a. j i. t,O s <i t=;F s. t„ E ,3 C! .,,ep a 3ovvIt end a, P,~ k,.!,`tr Oild, .<...s :l£ E1 <E?}:,,(l,9, s. :k,-Lt ' p - c oval ~r"? dot-S €r t eke pl [b .~k io .6 ~I qtr t t.td"t~fi~' fir' Ut LJ$t E~ -i~.i:,t ° i"s'f f - £ k c - r«= t, ts. t I r 3= E 1, q i n ev= q, t I u~ `yt ~ , i x E - V i n €:ti of ``t aiy r r2,14 Asor u~ ~ IUL 5 GV,1 5.3o -~30 U) v Q- V4- S Al- S ~a I ldoo~al. Kt Q-3 ,L~D 0-4 ~ e Z coo' d-, ~b !!J~P, PE- 9- 07 le'U DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 796f, f, BUREAU OF PLUMBING MADISON, WI 53707 CONVENTIONAL ❑ALTERNATIVE state Plan l.DNumber Holding Tank ❑ In-Ground Pressure ❑ Mound (If assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER'. INSPECTION DATE. Roger Rulien R. R. 2, Hudson, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.'. CST REF PT. ELEV NE SE, Sec. 30, T30N-R19W, Lot#3, Town of St. Joseph Name of Plumber. MP/MPRSW No Gary Steel 3254 QSt. Croix san,t'49450Umber. SEPTIC TANK/HOLDING TANK- MANUFACTURER.. 1 LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.'. WARNING LABEL LOCKING COVE PROVIDED PROVIDED 9- -J G YES ❑NO ❑Y ❑NO BEDDING: VENT DY~jVE NT MA T L.. HIGH WATER NUM ER OF ROAD PROPERTY WELL BUILD NG. VENT TO FRESH ALARM. FEET FROM 1 LINE. F i f AIR INLET ❑YES NO ❑YES ❑NO NEAREST DOSING C MBER: MANUFACTUR R BEDDING. LIOUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO UMBER OF PROPERTY WELL BUILDING VENT TO FRESH GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. [NEAREST (DIFFERENCE BETWEEN EET FROM NF AIR"LET' PUMP ON AND OFF) ❑YES ❑NO SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing N(,TH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LE TH NO OF DISTR PIPE SPACING COVER 11 NSIUE DIA SPITS LIQUID I / M AL TRENCHES PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PI DISTR. PIPE DISTR. PIPE MATERIAL. NO. D TR NUMBER OF PROPERTY WELL BUILDING. VENT To FRESH BE LOW PIPES. AR+OVVE COVER ELEV. INLET ELEV. END/ C PIPE SS FEET FROM LINE/ ' I -7 AIR~WL-fT: 7 Z Lam- NEAREST- /Ll CCJ - MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ❑YES ❑ NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH; BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED. ICENTER EDGES ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL. NO. DISTR DISTR. PIPE CIS FRIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEV.. ELEV.. DIA. ELEV. PIPES. DIA.: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑NO ❑Y -ONO COMMENTS PERMANENT MARKERS: OBSERVATION WELLS: PROPER BUILDING. f FEETBFROMF LINE ❑YES ❑NO ❑YES ❑NO NEAREST II ~ G1~ ~ I 7 /bu ! i / Sketch System on airi in county file for audit. Reverse Side. SIG ITLE DILHR SBD 6710 (R. 01/82) a y O C M' O e» yr O h y o c N C' d5 U N p O O C C 7 3 E LL C O O Ti a 77 3 M ~ m > z N C C'O rn w o N O C 7t 0 Z N d ..0 ° w a co N Cl) O z U co O O O N O Z C -O O V 00 N _ C Z m u7 F- ~ ~ E N ~ E U U ~ U J, M d Q) V) N (i3 Ui U 0 L I d N 70 N C .a O w m O_ p.~ o o a vrJ z m z c R E J cn ~ N o m C) N d N 0 v o a .0 y~ c a~ tidJ~ z co co O O O •nw m _ a a a C -T v o o co OD o z 0 ° O° w v C N p C, fl 2. m d N U) U) y, O 3 M N C O QI R O U O j1 O O r" 0 0 O U O !I!! O O r .~`.i cp N p) OJ .n C O O t,Lfl y 0 M 0- O cn cD O pp N N O m rn U m c m in c3 O O OC O '6 Z 'S7 .N- co q -j O M- ? m O E r `C • CL V w + E C C 3 o m 3 o C U a O va U Parcel 030-1088-60-002 12/15/2006 09:43 AM PAGE 1 OF 1 Alt. Parcel 30.30.19.320C 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - LINDSTROM, KYLE J & JANET C KYLE J & JANET C LINDSTROM 384 CTY RD E HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 384 CTY RD E SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 3.390 Plat: N/A-NOT AVAILABLE SEC 30 T30N R19W NE SE LOT 3 OF CSM Block/Condo Bldg: 5/1401 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-30N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 741/159 07/23/1997 698/536 2006 SUMMARY Bill Fair Market Value: Assessed with: 169283 284,900 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.390 98,700 148,500 247,200 NO Totals for 2006: General Property 3.390 98,700 148,500 247,200 Woodland 0.000 0 0 Totals for 2005: General Property 3.390 98,700 148,500 247,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 213 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ~ Wisconsin APPLICATION FOR SANITARY PERMIT ILHR G °'~'~^ixCOUNTY oEPRRTmcnT ov (PLB 67) UNIFORM SANITARY PERMIT # In DUSTRV, LRBOR 6 HUmRn RELRTIOnS -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROP!nOWNER ~~`~~f MAILING ADDRESS l PROPERTY LOCATION C`FFYc' C 1 /4 r 1/4, S p , T,30, N, R f i $ (or) W TOWN OF: sz= LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER TYPE OF BUILDING OR USE SERVED L~,1 or 2 Family Number of Bedrooms. ❑ Public (Specify): THIS PERMIT IS FOR A: New System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity - Manufacturer: C I-KS 1 IF THIS IS AN ALTERNATIVE SYSTENv1 COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total # of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): Z c) , ; 60 A Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Print): j Signature: ./p MP/-MPRSW No.: Phone Numbed: t_`l q- L, • ZZ J Plumber's Address: Name of Designer: A) COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: 7 ~ ❑ Disapproved } Qi~ ❑ Owner Given Initial i, / PJ Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit application must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city, village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable. 10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system, depth of the system, type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan, drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin. APPLICA'T'ION FOR SANITARY PERMIT S 'J C - WO 'I'll LS al,pli.cation tuna 1S to be ~umpletc,d in Lull and ti_i.gnud by Lire ownur(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property - ~ 1 , Location ofProperty ?4 ~4, Section C N - R W Township Subdivision Name Lot Number Pr,~vious Owner of Property w~~' Total Size of Parcel - Date Parcel was Created Are all corners and lot lines identifiable?- Yes No is this property being developed for r(.~sal_e (spec house) ? Yes No Volume and Page Number as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Wamnity U,,cd 2. Land Contract L.t Other recordings Ii led With Cllr, Register 01 Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays oI the reviewing; process, If the deed ~tescri.puion references to a Certified Survey Map, the the Cert i I i ed Sig r-vey Mal, r-equ i rr,d . PROPEI:I Y OWNER CERTIVICAI ION I (we_) eeA,ti,{iy that ak'k s,taterrtents on ,t1t,,6 {Ioltm a.ie Vaw tc: the bast u' mlf (uuft) know.eedge; that I (we.) am (ahe) acre owneit (a ) u6 the pnope!Lty daCA- .bed in .thli s irtoon.riati.on {damn, by vi'ntue u~ a w"Lan-ty de.e.d neconde.d .6t the O~Aice U~ the. County Reg.,S:, CIA o ~ d e. Ms " Docurnen-t No. ; and that 1 (we-) 1-m me.ntty owq ..the pnopose.d 6ite bat .the 6ewage C Po5a~ 3yStem (on I (we) have obtci.ned an Fa,~evwnl., to nun w-4,th =tile above. dmnxled ptugwt-ty, 404 .tile curt,sVLucti,on o{I said sy.61em, and the ecune hab been daty h.econded in tire O~jA,('Ce o6 the Cauntt' RegiS-ten 0~ Dee-d~, (LS vocartte- tt No. ) . SIGNA"TURE 01 OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) f .f DATE SIGNLD " DATE SIGNFI) y S `L' C - 10 5 Y y SEPTIC TANK MAINTENANCE nCl:l'.EMENT H St. Croix County OWNER/BUYE, ROUTE'/BOX NUMBER _ Fire Number t J e M ,e~i C I Y/ STATE 1. 1 P PRUPL:IZ'tY LOCA1'10N: =4i Section CJ i N, It 1 W - - - - ' Town of F 1 St . Croix County, - - - - r- _ ^ . Subd -ivis.ioa Lot number Improper use and maintenance of your septic system could result in i its premature"failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank puniLeF. What you ptit into the system can affect the function of the septic tanl< as a treat- ment stage in the waste disposal system. St. Croix County residents mum be eligible to receive it i,Fant for a maxi.ill um of 60% of the cost of replacement of. a failing system, which was in operation prior to July 1, L978. St. Croix County accepted this program in August of 1980, With the. requirement that owners of all nr_w systems utr,ree to keep their system:; propel-iy The property owner agrees to submit to St. C' 170 ix County Zouiug a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or_ a 1.icensed pumper veri- fying that (1) the on- sate wastewater disposal system is i11 proper operating condition and (2) after inspection arid pumping (if nec- essary), the septic tank is less than 1/3 full of sludge and scum. Certification forth will be ~;eiit approximately 30 days prior to three year expiration. H 0 I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposat system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- w meat of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED D ATE 6 St. Croix County Zoning Of t ice P.O. Box 9f, flammo4frd, W1 54015 715-7-'16-2239 or 715-425-8363 Sign, date and return to above address. I