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HomeMy WebLinkAbout020-1085-70-000Parcel #: 020 - 1085 -70 -000 09/22/2006 09:40 AM PAGE 1 OF 1 Alt. Parcel M 30.29.19.345A 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): O = Current Owner, C = Current Co -Owner O - GAGNON, MARGARET M MARGARET M GAGNON PO BOX 1625 HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 758 CARMICHAEL RD SC 2611 HUDSON SP 1700 WITC Description Legal Description: Acres: 2.800 Plat: N/A -NOT AVAILABLE SEC 30 T29N R19W SE NE COM SE COR W ON S Block/Condo Bldg: LINE 322 FT N 0 DEG E 420.8'N 85DEG E RESIDENTIAL 323' TO E LINE S ON E LINE 444' TO POB Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) EXC P345E 30- 29N -19W 270,100 NO Totals for 2006: Notes: Parcel History: Date Doc # Vol /Page Type _ V j -=4 � �j �Y,�� �j 7 � 03/11/2004 756361 2524/536 QC 73,800 196,300 270,100 778/72 Woodland 725/82 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.800 73,800 196,300 270,100 NO Totals for 2006: General Property 2.800 73,800 196,300 270,100 Woodland 0.000 0 0 Totals for 2005: General Property 2.800 73,800 196,300 270,100 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: Batch M 141 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: City Village X Township Gagnon, Margaret Hudson, Town of SST BM Elev: r Insp. BM Elev: BM Description: d0 I I OD .a' CST 1 = Q� TANK INFORMATION LEVAT N 15ATA TYPE MANUFACTURER CAPACITY Septic Uo (6sC� o� Dosing � s + > Aeration S TDH Holding 'ction Loss System Head TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic � s + > C S TDH Dosing 'ction Loss System Head TDH Ft � Aeration 1 --- Forcemain Length < -0 Dia. f , Holding St/Ht Outlet INFORMATION PUMP /SIPHON INFORMATION Manufacturer / Demand FS l�ek�5 ,/' GPM Model Number Inside Dia. Parcel Tax No: C S TDH Lift ,r 'ction Loss System Head TDH Ft � M9/ 1 --- Forcemain Length < -0 Dia. f , Dist. to Well St/Ht Outlet INFORMATION SOIL ABSORPTION SYSTEM ( 1 rRamd-P.r 4*7hk County: St. Croix Sanitary Permit No: FS ELEV. 499201 0 State Plan ID No: Inside Dia. Parcel Tax No: Alt. BM 020 - 1085 -70 -000 Section/Town /Range /Map No: 30.29.19.345A STATION BS HI FS ELEV. Benchmark 3•cy'0 Inside Dia. Liquid Depth Alt. BM (� Bldg. Sewer II.3 , 92.ss• SVHt Inlet JBLDG IWELL i'2•� 9/• 90 St/Ht Outlet INFORMATION Dt Inlet CHAMBER OR L'it(Li4'fl9CL Type Of System: b Dt Bottom 1 3 8" t > iS UNIT Header /Man. .-_ a0 i 9�•Jo Dist. Pipe C 7- 96 • e, Bot. System Final Grade St Cover Qf- S:I :C.ti.� � 4.2-o 91, 70 f or Ca.43 RENC Width Length + No. Of Trenches Vent to Air Intake PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM NS ? (� SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR L'it(Li4'fl9CL Type Of System: b + 3s fi 1 3 8" t > iS UNIT Model Nu er: .-_ a0 C DISTRIBUTION SYSTEM v Header /Manifold U Distribution a Size Ix Hole Spacing Vent to Air Intake Bedrrrench Center Pipes Topsoil ED Yes E] No . cc / �J Lengt Dia Length Dia Spacing SOIL COVER v Praccura Svctnmc Only vy Mnund Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xx See ded /Sodded xx Mulched Bedrrrench Center Bed/Trench Edges Topsoil ED Yes E] No [-] Yes [:] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: U 206 Inspection #2: – Location: 258 Carmichael Road Hudson, WI 54016 (SE 1/4 NE 1/4 30 T29N R19W) metes & bounds Lot Parcel No: 30.29.19.345A 1.) Alt BM Description = S �T(waltl) 07 v�e.n CbL'*JS- 2.) Bldg sewer length = �$ - amount of cover = S•a + ( Plan revision Required? Yes No Use other side for additional information. §@D-671 (R.3/97) 3 C/ � Date '�� Insepctor's Signature Cert. No. es, (,1ej2 Qn .A.v� , ,e i Safety and Buildings Division 201 W. Washington Ave., P.O. Box 716 G G 1 If Project Address (if different than mailing address) _ I Got 'eh .'4 J Non - Pressurized In- Ground D Mound > 24 in. of suitable soil ❑ Mound <24 in, of suitable soil 0 At - Grade ❑ Single Pass Sand Filter 17 i X Constructed Wetland ❑ Pressunzed l Ground ❑ Holding Tank O Peat Filter 0 .Aerobic Treatment Unit L Recirculating Sand Filter Re Synthetic Media Filter J�f Leaching Chamber 0 Drip L ine ❑ Gravel -Io P ipe C1 Other ( lain) _ _ _� V. Dls rsaVrreatment Area Information^ - _ _ � � B( t3Z� Design low Design Soil Application Rate s Dis etsal Area Re Dispersal Area Pro System Elevation " 8n (gPd ) g PP ! .$I� U P eq s (f1 p � VI. Tank Info Capacity in Total Number Manufacturer a Site Stec', Fiber Plastic Gallons Gallons of Unit W - �W n 1 Concrete Constructed Glass New Btristiag { t V J T 1 Taaks SapticorHoldingTank /d�'�1 `c 1 `L?✓ Y + Aerobic T7es"rant Dosing I i t x - s I VII, Responsibility St atement- I. the und ersigned , ass responsibility for last ation of the POWTS shown on the atta plans. Plumber's Name (Print) Plumber's Signature P Piz S Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) VIII. County /De astment Use O nly I(A roved ❑ Sanitary Permit Fee eludes groundwater Date Isaued sue g 4grnt Signaturr '0 Stamps) pp/ � " \ Surcharge Fee) Reason for Benia! -1-= -- �� ZOD�o IX. Conditions - \ SYSTEM OWNER: ) ^ � 1 Septic tank, effluent filter and 0�`y0 dispersal cell must all be serviced ! maintained lob -t as per management plan provided by plumber. I C-U-/ 2. All setback requirements must be maintained , , _ � ,(� .� (� -� as per applicable code /ordinances Attach Complete plans (to the County only) for the system on pnoer niitjess ) that 8112 ches in Oze p ,r 1 i 2 . ,�SLay�.UQT SBD -6398 (R. 01 /03) _0�. �e4vmt�l h�a �� o /ev"'x(f 3,6- 'Gl �JG�4/IJD.,J d71 G' VA ti 7 Wisconsin Department of Cpaper L EVALUATION REPORT p of S I 3 Division of Safety and Bull ati ce with mm 85, Wis. Adm. Code Count site a S,[ . Attach complete plan s in es in size. Plan must include, but not limited tt e erence poi (BM), direction and Parcel I.D. percent slope, scale or arrow on and distance to nearest road. ©z 0 "'Og a all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Q Govt. Lot SE 114W 114 S T N R E w Property er's Mailing Address Lot # Block # Subd. Name or M# City State Zip Code Phone Number ity ❑ Vllage own Nearest Road 142d SQ r , W t S ) X o t'�rrK ^�htae_( New Construction Use& Residential /Number of bedrooms . 3 — y Code derived design flow rate Q U GPD ❑ Replacement Public or commercial - Describe: Parent material � CL-C' (n I Flood Plain elevation if lcable ft. General oomments S yS7e r� •2l �' 11 r 3 jf r Pj ��(� �'° O I'\ V and recommendations: FT Boring # 13 Boring � � 12 Pit Ground surface elev. ft. Depth to limiting factor 146 in. S61 Amliratinn Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM *Eff #1 *Eff#2 ������ o� 14 ❑ 7 Boring # ❑ Boring ,,�'� �-- Pit Ground surface elev. �_ ft. Depth to limiting factor Z in. Anil Amliratinn Rate * Effluent #1 = BOD > 30 220 mg1L and TSS x.30 < 150 mg/- ` Effluent #2 = BOD < 30 mgt and TSS S 30 mg& CST Name (Please Print re CST Number J a Ad / ` / Dane Evaluation Conducted Telephone Number Qu. Sz. Cont. Color ������ * Effluent #1 = BOD > 30 220 mg1L and TSS x.30 < 150 mg/- ` Effluent #2 = BOD < 30 mgt and TSS S 30 mg& CST Name (Please Print re CST Number J a Ad / ` / Dane Evaluation Conducted Telephone Number r Property Owner O A Parcel ID # Boring # Boring ❑ Pit Ground surface elev. ?7 - 60 1t. Depth to limiting factor rz in. Page 2 of _ 3 Gnil Arlin inn AMP- Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 *Eff #1 'Eff#2 So ZM S Zkw-� r c — I Boring # Boring 1:1 Pit Ground surface elev. ft. Depth to limiting factor in. Snil Amliratinn Rata Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 'Eff#2 'Eff#2 F Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Sal Aorlication Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM *Eff #t 'Eff#2 * Effluent #1 = BOD > 30 s 220 mgA- and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg1L and TSS < 30 rngA_ 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- 8330rest. (RAM /00) PAGE 3 OF 3 ' NAME I'hrAj3; LOT# LEGAL DESCRIPTIONSE 1 /a11F- /a,S 36 T z.q fQ E(OR)IM SCALE: I" = go , BM I ELEVATION /Qc). 0 N BM I DESCRIPTION BM 2 ELEVATION BM 2 DESCRIPTION SYSTEM ELEVATION M Ae-lo SYSTEM TYPE the SIGNATURE DATE /0 - z - SLPTIC T ANKS PUMP CHAMBER CROSS S£ CT1UN AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE 8 >_ 2 5' FROM DOOR, WINDOW OR FRESH AIR. IN,A ,,� FINISHED GRAD£ 7 4" CI RISER 18" IN. 6" MAX. NLET �.... -,.- -� WATER 'FIGHT SEALS PPROVED IPE 3' NTO SOLID OIL PUMP OFF ELEV . FT. WEATHERPROOF FUNCTION BOX WITH CONDUIT GAS- TIGHT A, SEAL 4 __ — III ALM B ' ON D OFF APPROVED MANHOLE COVER W1 PADLOCK S WARNING LABEL --- 4" MIN. * f t /APPROVED JOINTS WITH j APPROVED PIPE 3' ONTO SOLID SOIL RISER EXIT PERMI:`TED ONLY IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED. BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: eS�'r____ NUMBER LOSES PER DAY TANK SIZES SEPTIC 1 GAL. DOSE S6 GAL. ALARM MANUFACTURER: MODEL NUMBER: SWITCH TYPE: .arc _- PUMP MANUFACTURER: MODEL NUMBER: �✓ _ SWITCH TYPE: REQUIRED DISCHARGE RATE DOSE VOLUME INCLUDING F LOWBAC K; 1,W GAL . CAPACITIES: A e INCHES = 3GAL. B = 2 INCHES = .5''i2 GAL. C = $ INCHES = GAL. D = (o INCHES = _ & GAL• PUMP & ALARM WIRING AS PER I LHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE /.a FEET MINIMUM NETWORK SUPPLY PRESSURE � � r rEET .10 . ` . � 7 I'EET FEET FORCEMAIN X.G FT /1DQ FT. FRICTION FACTOR 7 FEET TOTAL DYNAMIC HEAD INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH; DIAMETER_ LIQUID I3E�"!`A� f ' D �' e lG',&, l , l SIGNED: --:�,,,_?F'"� LICENSE NUMBER. .2�2 ?9I' DATE: - 1/86 R GOULDS PUMPS ■ EP05 Impeller: Thermoplas- tic enclosed design for improved performance. ■ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ■ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ■ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. r Power Cable: Severe duty rated oil and water resistant. 3 871 EP05 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECI FICATIONS • Solids handling capability: 3 /0" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1 1 /2 " NPT. • Mechanical seat: carbon - rotary/ceramic- stationary, BUNA -N elastomers. • Temperature: 104 (40°C) continuous 140OF (60 intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EPO4 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTQW with three prong grounding plug. Optional 20 foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ■ EPO4 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. METERS FEET 10� 9 8 d 7 x v 6 a 5 c Q 4 0 3 z 1 0 0 2 4 Submersible Effluent Pump 6 8 ■ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING a . Canadian Standards Association (CSA listed model numbers end i n "F" or "C ".) Goulds Pumps is ISO 9001 Registered. ipM m' /h GoUldS Pumps tr 2000 Goulds Pumps Effective February, 2000 83871 <& ITT Industries SrANPARO CNAMSP Qulck4 Standard Chamber If 34" ,SEC "ION VIEW MultiPort End Cap 7 12' 34%— - FRONT VIEW 48" (EFFISCTI[VE LENGTH) 1 � ' �� 1 JI I y 1{ . 510F VIEW �f �7� SIDE VIEW . I allicM Standard CfiiMw 9iMli6lP fl Size M x L x Hj 34 x 62 x 12' — Etfactive LeNth 48" ower Height T ., 11 v 16 TOFF VIEW 34 x 16 X 12" 1n�Hfi h! 8'oi 1,25' Inotilvlowfoo P -"O oiwlv rovideer"'t Ulos ARF W~v C, mr+. Agmv N : No fW10W ,J" F0 !I k of f6wb* ".= orj W6 a .r l v As. Xx)l Ir. 0, 1a1 JA : MA-gov !Wawa "wMao M* c �;oms. 0, e. 'd no W AN i4r** lalAhl L=X W owe, thy It Ida-vo th, `= 41 4w 'q * t 4=lll v l 6 tAW t"O 00 'y' INIMM 500 0-1V 41619 and lww GEM. V oVw $PC W-S 140 Wor dr*0 U) V VV, q lk" 110h IMU'M 9.r.�x A,"v W Namonlywol" 10 ow�;A pu 4p Miwaiv J.06 ��.%A PA4 SAN' 5,40 7t Pon"U. ?W4 LW" C,�•Acn K wI ""%flkto C , (v0 lrgrlar>rrr'k� .M Pro* in U U SYSTEMS INC & On** ftsww&w "utims" 6 Bu-qi*ss Park Hood • 4'-0 Box 7 % , Old SaYbMk Cl C1164 L7 5 MU 577-7000 ' W 66() t) � 7• r0() 1 WO*221.4436 'ji Ore " Aw ) -V FILE INF Owner POWTS OWNER'S MANUAL & MANAGEMENT PLAN page of I Permit /1 49 9 Z O l D ESIGN PARAMETERS Number of Bedrooms 3 ❑ NA Number of Public Facility Units �'� NA Estimated flow (average)7O g al/da y Effluent Filter Model Design flow (peak), (Estimated x 1.5) Pump Tank Capacity At least once every: g al/da y Pump Tank Manufacturer Soil Application Rate al /da /ft Standard Influent /Effluent Quality Monthly average' Fats, Oil & Grease IFOG) 530 mg /L ,_._ ❑ month(s) ❑ ear(s) Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA Total Suspended Solids (TSS) 5150 mg /L ❑ NA ❑ In- Ground (pressurized) ❑ Mound ❑ Other: Pretreated Effluent Quality Monthly average ❑ NA Biochemical Oxygen Demand iBOD 530 mg /L ❑ NA Total Suspended Solids (TSS) 530 mg /L ❑ NA Fecal Coliform (geometric mean) 510• cfu /1OOml Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity CS ®C al ❑ NA Septic Tank Manufacturer �'� ❑ NA Effluent Filter Manufacturer f ❑ NA Effluent Filter Model f a ❑ NA Pump Tank Capacity At least once every: a l ❑ NA Pump Tank Manufacturer shy ❑ NA Pump Manufacturer G ❑ NA Pump Model ,_._ ❑ month(s) ❑ ear(s) ❑ NA Pretreatment Unit O Sand /Gravel Filter ❑ Mechanical Aeration ❑ Disinfection ❑ Peat Filter ❑ Wetland O Other: ❑ NA Dispersal Cell(sl ❑ In- Ground (gravity) ❑ At -Grade ❑ Drip -Line ❑ NA ❑ In- Ground (pressurized) ❑ Mound ❑ Other: Other: ❑ month(s) ❑ year(s) ❑ NA Other: ❑ NA Other: ❑ NA _ Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 months) (Maximum 3 years) ear(sll [3 NA Pump out contents of tanks) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 13 month(s) (Maximum 3 years) 3 wyear(s) ❑ NA Clean effluent filter At least once every: 1. / � year ear ly) (s) {] NA Inspect pump, pump controls & alarm At least once every: ,_._ ❑ month(s) ❑ ear(s) ❑ NA Flush laterals and pressure test At least once every: 13 month(s) ❑ years) ❑ 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) shalt 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 (Y3) 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. Page of START UP AND OPERATION - For new construction, prior to use of the POWTS check treatment tankts) 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 tankts) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cellls) in one large dose, overloading the celils) 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 soli and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. 1A ❑ T sit h d site e tank ❑ 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. DU 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 � t /�. � u ,,,,.., yr a�G 1 - Name Phone ? r . _ _ &i�e Phone SEPTAGE SERVICING OPERATOR IPUMPER) LOCAL REGULATORY AUTHORITY Name G(o� A �• Ce��n �o Name 54. Phone Phone 3 iio 10 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)Id) &If) and 83.54{1), (2) & (3), Wisconsin Administrative Code. FROM - �SCHUMAKER PLUMBING Ow "Ijyar G Al o N MaiU tg Addt _ T o ti OK (v a �; - * SO Y) W-r st 0 (Vitifueatrm nquisod dram p far ww alylsw j s sDr) ParcW ldaWftsfion Number O;R O -io a 9 - o00 (, 3 '}5s1) P'c"IY Location '-"rIr- %., ' K Sec. -y • T gi' N R,,,/ _W. Town of t/.4,40 cmtwed SUVOW Map # FAX NO. :7153863121 Oct. 02 2006 04:16PM P1 BT C"EK COUN,IY S MC TAW MADMNANIC8 A�1t8 NT AND O WNMEV MRMCAUON FORM LeA .l Cl i41 VIA # 7," G 3 Il Spec bout ❑ yea ❑ no Voluma . - - Pap # volume 52 4 ate' , pogo # Lot # sue_. Lot Liner i4entlflable Q ya D no lmpenper we aasd nudstawwcofyow septic. syt+ww c UW r"at 0 im paaanoata a Mwre to W w& wastes. ham snainaeaataae aaonaisaa of pumping out the Sep& tents ovary tyotrDe yaw or sa w, if t s*W by a haamd pat Vw What you pant into the system cam a!lb" 60 fanodaa of &c mrft twatc $a a fteMweat ftp is the waase dtsposd syoftm TU peopaoiy a Ww agreoa ao submit nay St. Crok Zooing Depumreat a audGeadon ftm,, dgwd by the owner and by a a4aster pinmbar, jowm*y+maxtpI=bw, MetedpIwaberora lion -c4paugwr as dying that (1) the a wdee enasta $Wdispeest wyotam IS iA PI"ar opwaba g cooditim aaa8/402) atios in�iao and paranpig6 (if steomsary), the sop& tank is Was *An 18 t';lsll of slvdgo, 3`hire, the asassadgaed have ttmd as afyM nommem and agree to nabbb dye psiv ae sewap ORMW ovum wdh do staaadanb net Poem, Greta hk as set by dye Depoftat of Coma*= aaud *a Depwtoant of'Nauw Raaa aes, Sbte of Wor t. CartftAtlaa IMMS that ymu aaptfc nib= has bran msbftbnd ,ayust be toanplmd #24 tae wwW to dye SL Cks& C MW Zoas bg Offm within► 30 days og tbs three dare, SIGMA OP AP4 UCAMS •••• DATE Q C cAax I (we) Caft that A aaftsmats an this foam aft tno to the beat of mfr (am lmwl . I (we) ants (arse) *0 ovruer( of *rrapetty descti , by virtue of a watapty dcad recorded in Register of Dee& G®ce. WNAg= OF %"IJCAW DATR 404004660 Aw i a�� =} um" ^^, sais- teperseew may rewia in Ow sowitasy Pa:cmi►t bayiaQ tovalaed by tt►e ?.00Uag Depastaesst. *040** 'e W"C W16 thb apptita WIL a Amosd watnWy dead &mr tW RmVWw of Dee& ot'See a aopt► of 90 Ortille4 =MY OW if =*now Is wAb is die wsm ty dead U 2529P 536 STATE BAR OF WISCONSIN FORM 3 — 2000 QUIT CLAIM DEED Document Number This Deed made between Mark Joseph Gagnon Grantor, and Margaret Patricia Gagnon Grantee. Grantor quit claims to Grantee the following described reai estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): See attached Exhibit 1 Together with all appurtenant rights, title and interests. - 7 ffi63F--- 1 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 03/11/2004 10:30AM QUIT CLAIM DEED Y. # 3 REC FEE: 13.00 TRANS F'cE: COPY FEE: CC FEE: PAGES: 2 Name and Return Address Marc A. Johannsen, Esq. Lommen, Nelson, Cole & Stageberg, P.A. 80 South Eighth Street, Suite 2000 Minnea olis, MN 55402 30 29 19 345A Parcel Identification Number (P{N) This is homestead property. Dated this —�A day of 2004 *Mar J. Gagnon / AUTHENTICATION Signature(-s) aut t' e-d this, day of L- . ; 2004 TITLE: MEMBER STAT ,BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stars.) THIS INSTRUMENT WAS DRAFTED BY Marc A Johannsen Attorney Lommen Nelson Cole & Stagebera, P. Minneapolis, MN 55402 (Signatures may be authenticated or acknowledged. Both are not necessary.) ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. _County ) Personally came before me this day of , the above named to me known to be the person who executed the foregoing instrument and acknowledged the same. Notary Public.. State of Wisconsin rely Commission is perm�alent. (If not, state expiration date: 'Names of persons signing in any capacity must be typed or printed below their signature. QUITCLAIM DEED si vm BAR OI WISCONSIN FORM No. 3 — 2000 U 252` P' 537 Legal Description Grantor: Mark J. Gagnon Grantee: Margaret P. Gagnon Part of SEk of NEk of Section 30- 29 -19, described as follows: Commencing it the SE corner of said NEk; thence S89 on the S line of said NE�l 322 feet; thence N0 parallel with the E line of said SEk of NEk 420.8 feet; thence N85 323 feet to the E line of said SEk of NE thence SO on said E line 444 feet to the PLACE OF BEGINNING. Subject to easement for access road over the N 25 feet of the above parcel. Together with the easement to overflow certain adjoining premises and to enter thereon for the purpose of repairing and maintaining such overflow facilities which easement is described in the doc. recordein344e office of the Register of Deeds for St. Croix County, in "324 ", pag EXHIBIT I -i -