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HomeMy WebLinkAbout020-1353-12-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division • INSPECTION REPORT Sanitary Permit No: . 395187 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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 Parcel Tax No: LeBrun, Gabriel Hudson Township 020- 1353 -12 -000 CST BM Elev: Insp. BM Elev: BM Description: 1 c� , D I k OO. o I _ P v� 9 L.e.c. =- cST ,,, ( TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ' �, Benchmark 474,3S-10g. l.Q -� '6 `oLf c5 3 S 10'1) • D Dosing Alt. BM 51D Aeration Bldg. Sewer 7., 5'5 Holding 'St/Ht Inlet 9. 0.. TANK SETBACK INFORMATION St/Ht outlet S,g ` TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet .___________—" Septic > '.,5 (Xl 3 1 - Dt Bottom _ Dosing �� / �� Header /Man. Aeration Dist. Pipe !_ f�•4r c1,40 m 0 .35 — " 16 11.$5" Holding Bot. System 1 R. 3411.35 Final Grade s ,' ' t k',. �� 3S • PUMP /SIPHON INFORMATION Grade / r " - i) G • gy Manufact rer Demand St Cover a...12, 1 —1 — GPM b Model Numb TDH (Lift ' ion Loss 'System Head H Ft i. Forcema' . Length Dia. i fo IL ABSORPTION SYSTEM .1) dA 1 ) ' ` ,k . 1 ) BEDITRENCH Width 1 L ngth No. Qf T nches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 , / 3 SETBACK SYSTEM TO P/L ( BLDG WELL LAKE/STREAM LEACHING MMannyk turer:�� INFORMATION CHAMBER OR colt" =NS W l Type Of System: t 311 ( - ) . _ �. UNIT Mode(Number: .._) DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake er S `1 Pipe(s) .` 34 / Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes 0 No 0 Yes 0 No / COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ki / V im/ of Inspection #2: -- �... Location: 644 Hillary Farm Road Hudson, WI 54016 (SW 1/4 NE 1/4 36 T29N R19W) Cottonwood - _ � P • , •' ' • • r 1.) Alt BM Description =�fr ' � t , S }aw �2 ., . '• 2.) Bldg sewer length = 31 I o O T "'Q`' �`' 93.0 amount of cover = 9 S ' 92 • St' v Q 14 -1W -�V C . q •0 92 .a Plan revision Required? 0 Yes No 31 ‘ 1 ,—` Use other side for additional informs n. �\ ' _ .. r ► _ _ `'_ Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) f . (,-s (4. CP 51 rt 1 . — - ------- . Safety and Buildings Division Coun.y 201 W. Washington Ave., P.O. Box 7162 51 ce. 4 / X l ig sconsin Madison, WI 53707 - 7162 Tte.ddr Department of Commerce ,, /X-t-' 1Z(.4 /K 4429 ry Permit). . bet Sanitary Permi a t Application 375 I In accord accord with Comm 83.21, Wis. Adm. Cods, personal information you provide 0 CI ,eck if Rai may be used for secondary purposes Privacy Law, s15.04(1)(m) --- I. Application Information - Please Print All Information i c / ' -, State Plan I.D. . bet 1, .- - k , ,..' ' --( Property Owner's Name , t -.Parcel Number -2 ,(. .2i . rit ( 2: ' tizav0 ' /3 z Property Owner's Mailing Address ;b 1.' Property Locado • 30 / u/.9-e.AJ-f-0 Lif/ve ttili ks. ,,, , t- " • 3 Ww Wei 36r 2 ___,..—.. _ . . ,..:1z..L.)Lkil City, State Zip Code 'hone 111211wr Lot .\ tuaber / --) !, Gal \I t riper 1 Ve.1:1% . —f_...c7 Subdivision Nam- : SM 1, amber LI47Y CA NA) 515 - 77f2 • ,, , co b ra . II. Type of Buildhtg (check all that apply) •- k * p.- . -' •2-- ---' oar/ Vitt or 2 Family Dwelling - Number of Bedrooms A-S 1,6we_passte. OVikage .. 0 Public/Commercial - Describe Use li . - t U. /9 5 DA 0 State Owned t -/()35( -C1 Neart st Road • (.,)4 . 13' /C" Si• ZS ' M t(i- Aig y In. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Completa line B I! ,;.,. A. 1 g 2 0 Replacement System 3 GI Replacement of 6 0 Addition to For County use System Tank Only Existing System .. 1 `■ ed B. 0 Check if Sanitary Permit Previously Issued Permit Number Date IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 Non -Pressurized In-Ground 210 Mound 470 Sand Filter 500 Constructed an 220 Pressurized In-Ground 41 0 Holding Tank 480 Single Pass 51 0 Drip Line 45 0 At-Grade 46 0 Aerobic Treatryt-Unit 490 Recirculating 300 Oler _ - - - V. Dispersal/Treatment Area Information: ? 7 LE( cA-P ( V-/ c+ "9 - Design Flow (gpd) Dispersal Area Dispersal Aiea -' Soil Application lAiFithiPercolation Rate Sys_tem i dot t C ■ , Required Proposed Rate(Gals./Days q.Ft.) (Min./Inch) W .7 3 , .iat.L., 9f 7- 5 0 / 7 i 6 5 63`f 7 A 9 2- VI Tank Info ity in To Number Manufacturer Prefao Si i , e1 lei ?Iasti: ons Gal ns of Tanks Concrete Consa _ik nd 1 .11s: New Existing Tots Tanks _ ____,____ Septic or Holding Tank /6,( ,_________.----t" , ____ Dosing Chamber . . — 1 -,.. ---, ' VII. Responsibility S „ , ement- 1, the undersigned, assume resperibility for Instillation of the POWTS shown on the a 0 ued 's Name (Print) 7 Plumber's Signature MN - N /OMumber Bt t ,s .1 P.. E NE-uel/ a? _ I . ?:.7 7/5-- 2- 7.7 i3' r's Address (Street, City, State, Zip C .-- LC-5 t-•” es - 444 Lo t .3 (( vm. County/Department Use Only g Approved 0 Disapproved Sanitary Permit Fee (includes Groundwater Date Issuld Is ii Agt. ,. Sigu • (No s,"tamp • arj Fee) 60 0 Owner Given Initial Adverse Surche Determinalion $) 22-c At/c.o./Xi 206 ‘ .Ae IX. Conditions of Approval/Reas ns for Disapproval ( lergemAii, +0 he_ , 4 st Javolto.,.. ,,t Att. s -Iv S 0' Lkr-riasz_ " c..woleus.r ; , ss -timit- #. eile)--Nae/m.c4deu4td 44 pi& mmAAAft=tr. recaohatmkedi . Attach complete plans (to the County only) for the system on paper not late than 8112:11 aches in ste; — • . z SBD-6398 (R. 05/011 pLo+- PLAN ,/1"-,3-01 (a 4.- A c 6 eu,J jv LL 8M #0 /tth2. y ©� LI- Z Hof -•1 €q I \ PAP . 40i 410 R/ Afc sA- ///f L L AP zbcc97 FL 0 4- puriv „/ so ► 6A-Be ti A r t c y L E g& U rJ / /1‘ . 8 i ,lls' 40 f-MLA-Ay 6) ' " o f 64 ft—k. twat i 2 loe vA-►� /6t1 P � \ C� j L L 4(p Z• Wisc nsin Department of Commerce SOIL EVALUATION REPORT Page \ of - ' Division of Safety and Buildings ' in accordance with Comm 85, Wis. Adm. Code _ County ST , CR.t] l i Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must k include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. O'O _ 13 S 3 — \....z Please print all information. Re iewed by Date Personal information you provide may be used1for secondary purposes (Privacy Law, s. 15.04 (1) (m)). D, Property Owner G3 t � N `-] Property Location �' a 13, Zo01 C) 0 TS g \ - } U Wt t ' S , 1 &.) C . G e k 4 , - g e t S W 1/4 N E 1/4 S -1 6 T 2.°i N R j E (or1�1N) Property Owner's Mailing g Address Lot # Block # bd. Name'gr CSM# \. - S S \ JLj 6 S N _ - \ Z - Ct� LAJcy RVb 6 City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road h ii 1.._Pr1zE I h-" I S 5,5 0 g 1 (76 3 ) Z e O- - Z. ° I -1 V/ -I-v S O fv 1 1+t1.. \t,L1 FAittvi R.D . a New Construction Use: «" Residential / Number of bedrooms U Code derived design flow rate 80 0 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material G L-Pce_l fit., 0 (.11 - 1-..) f\ H Flood Plain elevation if applicable ' ft, General comments and recommendations: R .O I•'l )l L> 3 cL--i-LS r L�°ce.l� 3' x 6 L S, La./ 6 w/ t 6 tn.) Ll'S 01= -tGtA 0 .-+s' f\-co -r s t.DtrIAJI/o zit L ei,* c'e kt2s 'P it c--L.L,, Q - m aQ-. 60 1 c.t Per erve4 ).JD . 1 Boring # ❑ Boring ® pit Ground surface elev. q, 6.S ft. Depth to limiting factor > l0 2. in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I o - 1p1 1z31Z z ! - siI .‘f sbl -c mufti- 0 -5 - .S . 8 Z 7 -4 g lo'-va_31 r - s i 1 am Sbk Yrt'fl- c_3 . - 5 . '3 L1$_1u2 -- ISLirz3iq - S o S9 yr) \ - . t. z I Boring # El Boring ' ® Pit Ground surface elev. Q 3.3 ft. Depth to limiting factor ? 44 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 •) n_ S )0�►9.--zt2 — L 2.-Q-9 v. mv'Pti. °L - .s .9 Z . s -kko 16'1 R z6/2 — \Ps \e-sbk m \J' c--S — . L{ , b 3 up-99 - 1.3yrz_31y - S 0s9 r► 11 - .1 t.2 , 1 ' Effluent #1 = BO; > 30 < 220 mg/I_ and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) a n dignature CST Number Arthur L. Wegerer , Y� ./ {,1'Y J_ NV 1 � 220254 Adder [W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. i•iain St. River Falls, trWI 54022 - 1-4-0 1 715 -425 -0165 Pro a P rty Owner �- N Parcel ID # 0 ZQ _ 3 S 3_ t 2 Z 3 Page of 3 B oring # ❑ Boring . Ground ° I.°l - ? G o d surface elev. 0 ft. L � I I Depth � Pit tit to limiting factor ® P g c or in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ' i ' 0– b 10 1 IL 2. LZ — L - t,4 -9 ►r v4 -- 0, S S -' - g .., Z b_15 - z , S`i225f3 — 1•FS lc..sbk my-P- - ..4 :.6 .., 3 ZS. in - )..s , t23iSF - S O sg wl I - ,- z a,4- R3 -o Boring # El Boring I 12 Pit Ground surface elev. a b - 0 ft. Depth to limiting factor ? °L9 in. Solt Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 ' •Eff#2 0 – W-ttz --z. L 1 MV' - a., - S _i9 ._.. z 5 -33 `I.SyR 2.S/3 _ 1 \ !- * »1 v`P-t- Cs _ - Li -6 3 33 -9.q "Is`iit i y _ S O 39 m I — -- t_2 4 /8V I ❑ Boring Boring # El . Pit Ground surface elev. ft. , Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots, GPD/ft ; "' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1' ` •Eff#2 *F' I A . • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L R ' The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access' services' or ' f. need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608-264-8777... -, San -330 (R.woo) PLOT PLAN Page 3 of 3 Scale 1' = 1111 - 1 Lp� _..t LOG O 0►v `7 _1., 3 t lMDl_A Pv.0 PLP'E t:77 - L1 , 6U • o `P awltf -2. _ 8.4 s 11J Vrt Prl. et �T kR'TL-: C el-LS I o qb ►•\ E - - SO1.0$' • a — I 715- 425 -0165 220254 CST Signature Date Telephone No. CST No. Job NO. Wisconsin Department of Commerce SOIL AND SIT VALUATION ( Division of,Safety and Buildings -�. Page t of 3 Bureau of Integrated Services in accordance with 's. IL 8.1:6e ; Wis. Adm. Code _ Attach complete site plan on paper not less than 8 1/2 x 11 inche in size. Plgin,n S� bounty r> c include, but not limited to: vertical and horizontal reference poi (6A�, directi�rt anil �- Ni percent slope, scale or dimensions, north arrow, and location acid di�tance to nearest road. ' 4: 3 1 cel I.D. # I a .7 1939 APPLICANT INFORMATION - Please print all inf'prmation. Sr CROix /. 1 • we b Date Personal information you provide may be used for secondary purposes (Prit(acy Law, 1 5 p „ 1 lqqg Property Owner Property Lo6t on t (� t f+ l � t ) �l 1 3 OL.Yi 4 . .Go " 1_c (or)6 . &kJ 1 /4MAJ 1 /4,S 3.6, T eq ,N,R /er E (or) Property Owner's Mailing Address ~ — ram — Block# Subd. Name or CSM# 1,' S3 A � - `vi:- . _ ❑ City I Z. et t nc Q Xl 2\C o City State Zip Code Phone Number ❑ Village Town Nearest ad vA `,C\ I L 1 5L{0 lC 1 ( 1544 -- to - r 3 I tl rbOn 1 Co4 -tr ' New Construction Use: 2 Residential / Number of bedrooms _ 3 L I Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: / Code derived daily flow 04) gpd Recommended design loading rate r - G' bed, gpd /ft . trench, gpd /ft Absorption area required - bed, ft Ja7..) trench, ft Maximum design loading rate bed, gpd /ft ✓6 trench, gpd /ft Recommended infiltration surface elevation(s) vee r , 7 4 4 1.0 9 P 60 w -4 r is 5s0 ft (as referred to site plan benchmark) Additional design /site considerations 4z-1 9 oo ( Parent material (11(k _1Ca I (' t. )TV. Ih Flood plain elevation, if applicable .f./ YFi - ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ® s ❑ u ® S ❑ U Q S ❑ U] S ❑ u ❑ s K] u ❑ S K] U SOIL DESCRIPTION REPORT Boring # Horizon De Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench t I 0 -3 lOyr L > t.n sc f`(1 1 _ c,:� 1 f' . i .. 8 z 3-t t/ T — �-IN L S t n- j � m I CS . 144 . -1 :. e Ground 3 (12-qtr ■ D.p r ' (1(0 rn S c3 rn ( ( - ` - - elev. 9'iP___ ft. Depth to - , limiting factor r l.rn in. Z7'9 vi , Remarks: So w\e. 42 /1 testa,,/ 11 eec1 h 4,-e ho-o_ i- °V e r 4 / 4rc.... lo ynce,iii.u'A- 1 55 ` a -C Qu t-4.4- C Boring # 1 U-(p 161 r3/2. - - L 3 /1- c A [ c 1-C- .- ',, 2 - (o. IDyr ( -I iq L S ( rrl5 j m) c I v F .1 ; ., 3 (co- -q7 /0 y r 9 / ins L3 ill 1 cS . - 1 . 8' Ground , elev. q_a ft. Depth to . limiting factor 91 in. Remarks: CST Name (Please Print) Signature Telephone No. Akm ,5c hu fn4ker �' ( , 17 -ciao Address Date CST Number y0 $ e der SI 416 L t .56/11 e I /.4)/ , `E — /S' - 99 25•3309 PROPERTY OWNER 31Q V SOIL DESCRIPTION REPOR Page of 3 PARCEL I.D.# Boring # H orizon Depth Dominant Color Mottles Structure G D /ft 9 Texture Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0- 1 /0y, -3/ L ,ms m/ !C • -y7 /()yr N LfS I rn ( cS 1v1 Ground 3 ( {7 -4 /Oyr 4 11(e n 65�j M C5 ^7 elev. JJ q$.76 ft. Depth to limiting factor ,Z/ Av 9/r in. 1 \0 Remarks: Boring # 1 D-4 l(\ r 312- 1, y )9 /0 ( i . - 1 g �{ Z R -L lOyr`l /4 CAS 1ms rnl c s 14- 3 3 �� 10yr916 �� <� t C- S - . �t • Ground elev. gff.soft. Depth to limiting factor 94 in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # o— ().(r...._31 ) . Z m 5 7Y� 1 C. S 1 �1 b C L S `I-((O (o r y L_-FS I m ji m I c S I v-L` 5- 3 /0Y0 - 11(t) tY)I C3 1 . Ground elev. - 9S, 80 f Depth to limiting At' g4 factor in. Remarks: Boring # • .......:.:..... Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) . • . 1)q°1 t 3 (43 V 519c) G Z o'(4o Q dt scp.�e c I' = hq ; I , ' dual Ll vv. Eleu. too c� 11U; 1 (t, p yr Z-2ICV • BUG • C� // 4014 �/ ^ Sys�cw� zlev, ¶,tro vPPE.r g �1Lf, l e(L_ QS: °d .1.4, ,4 K. L c, a t Ben • DML • • • a • } »� Qy r V m w a A C N m if. :3 „.z i k R m 5. Z \ % 4 o ▪ a y — _— I 1 a.t W '� Y g A v N A _ Q i Qu o _ ~'� a a m .. � w -+ z O _ F= b7f8i i � 7 0 �1 'E I 1 ____ , ga o Y QQ a til) - 0 CO o R l 4 m vyvv N J '„ cn H g f ff _I .._ 2§ � v V I [ - - - 1 I N CD o Cn N c?Or a _- j m cQ c — a c = c m — _ x c 5 m c�- m c1) -Ti _— - --- R r" n ? 0, a w _� gi a g , - - -- _ = c' afro -, m CD 1 i 1 � ,f i n C O O r« (n U — a CD 1 U (D 0 C -. iv O -, V ZS Sil (0 N I N (�D cn fv - _i 1111 -- co 7 ( O N W O a* O -- - -- W CQ x C ( ....i. Sy � M — --- = =_ v p Cr O j CT n J `C P 0) x ( � O 0 P O < W — �— o 0) C Q — - . _� -r O n.) Al �� c� _ D -- Invert 17' --► c co • n 3 o 0 • 6A 5 koc 8R-(A/k) Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity hi-Ground Soli Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System m POW/T8 shall include Information and procedures for maintaining the system within e (POWTS) the parameters of COMM 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wts. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Orrsite Wastewater Treatment Systems SBD- 10567 -P (R.6/99). Table 1: System Des • n Specifications Sands Pewit Number Number Of' • rooms S on , - eak �,•d - 7S� Estimated e .Y �a7T Soil Alma DOA • - . 1 T ; .,of " lewater Domes is Table 2: Soil Abso • + on C • • .vent • Units of Reliable 0 • eration S; -tic Tank Com. «nent Soil Absorpfon Component -�-� Design flow - Peak bpd) 16 � � f 118 a per6igg1 Maximum Influent' P Size in) Maxus B'• rn• /1. 11111111111111111111111. 220 Maxinlim TSS (mgiL) 150 Table 3: Maintenance Schedule •.c Tank 1 , • •, and/or service once eve 3 ears Outlet Fitter In .Y .. once a - - r and clean at least once every 3 ears Soil Absor • tion Com • neat Ins • once eve 3 - Septic Tank The septic tank shall be maintained by an individual malted to service septic tanks under s. 281.48, Stets. The contents of the septic tank shall be disposed of ?r: accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumpirg Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic .- ,k and outletfllter shall be assessed at least once every 3 years by inspection. - outlet fi r. shall be cleaned as necessary to ensure proper operation. The fitter cartridge • not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the Jr, • Management Plan for a Septic Tank and Soil Absorpton Component • filter is equipped with an alarm, the filter shall be servicec if the 3lar is actiYatec° continuously. Intermittent filter alarms may indicate surge flows or an imperdi ig continuo The septic tank shall have its contents removed when the volume of scum and siu:.ige in the Tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of an assessment, maintenance personnel shall adv se the owner of wren the next service needs to be performed to maintain less than maximum scum and sl_:dge accumulation in the tank. Manhole risers, access risers and covers should Le inspected for wee tightness and soundness. Access openings used for service and assessment shall be seat( watertight upon the completion of service. Any opening deemed unsounc, defective, or subject to failure rnust re e b.. replaced. Exposed access openings rester than 8- inches in diameter shell be secured b P P greater by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA stancierds for entering a confined space. The atmosphere withia the septic c>r other treatment of holding tank may contain lethal gases, .a nd rescue of a person from the interior of the tank may be difficult or .impossible. Tank abandonment shall be in accordance with Comm 83.32. Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatl, on prep: and timely maintenance, and system use within or below the limits of reliable cp :ration. (bad water conservation r ti c,_ s � eg p ac ices by all occupants and the installa of water ..�n�en�..� plumbing Y P ., � g fixtures r es a e key factors in extending the useful life of this component. The soil absorption components operation must be assessed by inspction at least once every three years. The inspection shall include recording the levels of p if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion ;ho.,ld be iaentified and reported to the owner for repair. The surface discharge of domestic tvastevv,eter or sewage from the system is prohibited and considered a human health nazard, Traffic around or over the soil absorption component should bE3 avoided particularly during winter months. The compaction or removal of snow core: over the component may lead to hydraulic failure by freezing. This type of failure is usually terr por:ry, but is difficult or impossible to repair until weather conditions improve. In ceneal, sot compaction over this component will reduce diffusion of oxygen into the soil and dispersal Nell,, whi :Th may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorptior :;ornpc :: Plantings of deep -rooted trees and shrubs directly cver or within ten fer of the component should be avoided since root intrusion into the component may obstr wastewater flow. L ,o eL S a Ai 7 Co Al C 2 6 -F %r� t _:> 3 01/04/1995 00:21 7152737753 NELSON PLUMBING PAGE 01 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Gabe & Nanc LeBrun Mailing Address 301 8 Valento Lane, Little Canada, MN 55117 Property Address 644 Hillary Farm Road, Hudson, WI (Verification required from Planning Department for new construction) City/State Hudson, WI Parcel Identification Number 020 - 353 -12 LEGAL DESCRIPTION Hudson Property Location sw ' ' /s, ICE %, Sec. 36 , T 29 N 19 W, Town of Subdivision Cottonwood Ridge , it # 12 • Certified Survey Map # , Volume , Page # Warranty Deed # 648983 , Volume 1665 , Page # 255 Spec house 0 yes 13 no Lot lines identifiable X1 yes D no SYSTEM MAC NCE 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. The property owner agrees to submit to St. Croix 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, u 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 Zoning Office within 30 days of • e three . ex • - ratio ate. • `d`�- 7/ ice GNATURE 0 • LIC DATE OWNER,C$tfFICATION 1 (we) certify that all statements on this form are true to the best of my (our) knowledge. 1 (we) am (are) the owncr(s) of the pro- - y escy d a. ve, by irtue of a warranty deed recorded in Register of Deeds Office. `a Q �,, DATE S r` � ATURB � ,' PLI �' � C��� I; Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. • • Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed • 07/18/01 DYED 12:35 FAX 715 386 4687 REGISTER OF DEEDS w)02 N vei• 1665pnG,• 255 STATE DAR OF WISCONSIN FORM I. 1999 t)`a $ J at Documaat Number WARRANTY DEED RA'IHLEEN H. WALSW REGISTER OF DEEDS This Decd, made between " Mark R, Kaisersatt and Debra L. ST R eV ECEFVE D F CO., WI , husband and wife — _ OR RECORD -- -- -- _____ - — 06 9:30 AM Grantor, and Gabriel John LcBrua anp Haney Herman Leitrim, WAFT WARRANTY DEED husband and wt e3 su or so marital r c EE: FEE: t+xop COPT FEE: ^�_ TRANSFER Fr Et 2Z4.7o Grantee, ____ _ RECORDING MGM FEE: 10.00 Grantor, for a valuable consideration, conveys to Grantee the following described teal estate in St. Croix _ if more s • County, State or Wisconsin ( is needed, please attach addendum); ReeortNng Area • 40 111 !at of Cottonwood Ridge in the Town of Hudson. St. Croix County, Nance and Berton Address •assn. KFiISTINA OGLAND ATTORNEY AT LAW P.O. BOX 358 HUDSON, WI 54019 020-13S3-/2 Pared Idenifiestion Number (PIN) — —' Thk Is not _ homestead property. ■ Exceptions to warranties: Easements, restrictions and rights -of -way of record, Irony. OEI (is not) Dated this I 6 1 day of June 2001 _________________ — ..Ad—f.—.24.." - • M k R Kaaaaalt e _ • Debra t.. Ka.ersatt AUTHENTICATION ACKNOWLEDGMENT ` Signature(s) Mark R. ICaisersart and Debra L. Ka(sersatt, STATE OF WISCONSIN ) husband and wife . ) ss• authenticated this — -- --- County ) y of Jaao , POI Personally came before me this day of _ the above Warned e Krist_ � n a O land TITLE: MEMBER STATE GAR OP WISCONSIN _�.. "" - - Of not. to me known to be the person(s) who executed foregoing authorised by $ 706.06. Wis. State.) instrument and acknowledged the soma. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristin Opland _ _pds_ °n; WI"�[� - Notary Public, State of W(econsIn � — (Sipnuwres may be authenticated or acknowledged. Both are not nreessary.) My Commiaion Is permanent. (If nut, state expiration dote: •Names Or • --• — 3 persons signing in any capacity mum be typed or printed below their sianeture• •e...Won fmNasioeat. 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