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HomeMy WebLinkAbout020-1353-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County ' Safety and Buildings Division . INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitam Remit No.: Personal information you 'novice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)). 1 Permit Holder's Name: ` ❑ City ❑ Village _0 'Irmo State PIan�ID ■r e .i 1 �� • , Q / • 57z Parcel Tax N ' 8M Description: l f • ;II .•• • . "----" L. 1 -' 4.v' 020 1353 30 000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Wft AS (OU U Benc hmark O. - z e . � - 6O c.,� Aeration Bld g. Sewer (I( 3 Q Hold 't Ht Inlet sW d 3 , a TANK SETBACK INFORMATION w, / Ht Outlet V r• TANK TO P / L WELL BLDG. Air I to ROAD =� Air Irttaktr EMEIMIIII Septic '7c/ I � � /°''`k // , NA D • osing // - NA Header/ Man. ■� Aeration -- ---.,....._ NA Dist. Pipe 0 .. /o u Qa - d'7 H ing �_ Bot. System L 1 PUMP / SIPHON INFORMATION Final Grade k a .� / v3 6 , factu Demand St cover C " id S- `/0 Model Number / G TDH I Lift action stem TDH Ft Loss Forcemain 1 Length Dia. Dist. SOIL ABSORPTION SYSTEM 1/ �NS �� � �� BED E Width Length No. Of Trenches PIT No. Of Pits Inside Dia. I Liquid Depth DIMEN . 3 ' 6 7 i z DIMEN 1 N LEA HING Manufa ur r: SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM I N'ig�,i INFORMATION Type Of j , o e u ber: System: c1hV X / 2' \ _ -7/ (9 1 S„:(46-A /.".,aw DISTRIBUTION SYSTEM Id°" 7 Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length ' ? / Dia. y n Lengthto /• i. Dia. IVA- Spacing AJ,. 'V4 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: /'t / 7/00 Inspection #2: / / Location: 876 Alex Lane, udson, WI 4016 (NE 1/4 NE 1/4 36 T29N R19W) — 36.29.192030 Cottonwood Ridge -Lot 30 1.) Alt BM Description = e ->% 0c f: ,.,_ y" co/ # 4 F -1% 2.) Bldg sewer length = zo n - amount of cover = 7 / f 3 . \cLse..tf:._ p; 5 :Ns74. l /ro' ih 2"ti el/4.,.,4. 4#, Plan re visio n re fi red? ❑ Yes p NoMII= - ---- -- Use other side for additional information. ,' , N R„y4.,, 7 SBD -6710 R 3/cJ ) ( 4.. 3/117 Oat Inspector' � nature Cert. No. si? 4\max Lax 'e 4Pw • Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. Wisconsin See reverse side for instructions for completing this application PO Box 7302 ' Personal information you provide may be used for second purposes Madison, WI 53707 -7302 Department of Commerce (Submit completed form to county if not [Privacy Law, s. 15.04(1)(m)] _ state owned.) or Attach complete plans (to the county copy only) for the syste l�p p rill than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number ❑ Check if,pev st vi s- l t3bi State Plan} . Number I. Application Information - Please Print all Infor ation / '' ` tip'' • ocation: Property Owner Name ` ' `�� p rty f:: r/ -, /7/e.,.7 v�' operty Location /e)-7-y- �D/?�C S`" 1 ( 13 VS 7U f — 1/4 -i /4, S361.•<7,N, R P E - (eV` Property Owner's Mail:A Address T j� at Number Block Number .„:2 . Z,- / /0..G.-0 \ , '' ' OpjyttGt.� ,.fs, O City, State Zip Code Ph e) ie 7t 0 , Subdivision Name or CSM Number II. T ye of Building: (check one P g � one) ❑ City Ai, 1 or 2 Family Dwelling - No. of Bedrooms : ' — o`7K, P ' l c ,Q. lm oG ❑ Village ❑ Public /Commercial (describe use):_ / Town of ❑ Stated h< C75 , _2,44 / � G 2-2 . .. � cc�l�ll/ t w +� Nearest Road f f (< " ` ( Parcel Tax u mber s) `� —.-re, II . eck only one box on line A. Check box on line B if applicable) 'XG . 2.19 2_o 3 Q A) 1. $.New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued 1 ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) 56 Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevatiop 7. Final Grade Required Proposed/ Rate (Gals. /day /sq. ft.) (Min. /inch) - 'I t _ (01.1 Elevation e , 7ZO 75 --7-47. �r ®Z C rclrt T2 10/.0' ! og`. T / o.S: p i -, , VII. Ta Capacity in Total ' # of ? Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ,ti°� G — /d / 10 e e ks— ,P"' ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Pluum�b Name (print) P1 Signature (no stamps): MP/MPRS No. Business Phone Number �C/ /-yt- rl/� /� 15 r „� az®r' / 0 3-7,,•- 7 ��. � ?-4-- Pl er's Address (Street, City, State, Zip Co' -, , /'� -' � ,4L..../...__ -) �� Z f �� .sue moo/ IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date ssued Issuing Agentigna (No stamps) nll Approved ❑ Owner Given Initial Adverse Surcharge Fee) � H ' L Determination / " t t / S / Co ditions of /Reason for Disapproval: , CP y � b Z - ` ,�,! -' /Kci (J' / j 1 6e. 64,..f'1- Mau.. .-4, -- e-i S c f ro d rzse -1,, Wtw►44..; .1/ we // s € 7' .. s K.cl... 4r (2e` ,(Jre P !i i et)- I pey,/,o 1t4 i)'1 - Ail 4 , 4G► Sr 31..4 1S =tiro 1.2- 7 31S - l•ty : )1 -s/7 11/4 7,2t1, 4ur. 3�- lafA:;)n IAt,a1 - 1- ,A.nA. t."-v r1 rrv►1,+4 invs1 `r 5 ta- (A; 1 e } MO A l 6 1. c�Lu,D�JI,. s rdl t (eWro� -4 t iG s T - ki ,.,rc r L.-r -.4 �(! �O ,J SBD -6398 (R. 07/00) 3 &e/> -) , '77 - .2 . Z: LOT PLAN 1'Rw1:c "i . /LC/7� /,4e$ /7. ADD1tI3SS � /7/ e �,e-,, .� i 4 �`✓C — �'7 � 1 /-1 S /'1' N/R W '1'0 ze � COUN'1'1 MPRS Byron Bird Jr. 220527 j -i ...C..:;/ DATE / 7-17-52-1 BEDROOM ,-� CONVENTIONAL )OO( IN -GROUN , PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZ � TANK SIZE DOSE `TANK SIZE HOLDING TANK SIZE LOAD RATE / a ABSORP'T'ION AREA TI of chambers , k BENCHMARK V.12.I'. 0 --' - 2e 4SSUNIE ELEVA'T'ION 100' 1 BORE11OLE O WELL xH ®.R.P. .1: oU..9 4" , 4 / / / - _, ow Vent SYSTEM ELEVATION ��,. f — 1d) /-,T ----2 _ 1 Sidewinder High ' . Capacity Leaching of Cover Chamber with 31.8 ft ^2 per chamber 6' Lone . 16" 34„ Grade at System Elevation k f i.oi . , . 4 . 1We'(I (. ca. (,1„4( G/ VI )49 / 4 s S z-f 6k c,k S fA,„0I S !4s / ( - f2. 1 1 \ 0;. / 3&'/ ' T X 13 _,�_ / i . • r i '� e , ,,rid 1 5e 1b64G S "QA' ZQ4 \ t \ \ \ \ '\ \ \ \ \ \ .117 \ a . \ 1 *. \ \\ N. I. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 ot Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontgLrgfere ce-point (BM), direction and Parcel I.D. percent slope, scale or dimensions, northyr V arld foksatiov a,n distance to nearest road. 0Z D—, 13 53 - 30 0 ie d by Date Please pr/ Information 7 /� Personal information you provide may b�US d r secon p bses (PnvatyLe ,. s. 15.04 (1) (m)). . r G� ' .� ti( I / r / S/ -sy Property Owner f ' ` o : . .. Property Location �(+ / /// Terry Alan HcxrrPC, i�7T -1 %v ` ' ' ; ' ' `? Govt. Lot NE 1/4 NE 1/4 S3 6 T2 9 N R 1 9 i (or) W Property Owner's Mailing Address l D :; r `. ; �� . ? u f, - �iLot # Block # Subd. Name or CSM# 132 DeMont Ave. E. ti, N• 4 30 na Cottonwood R, dga City State Zip t e•' , td e f / ❑ City ❑ Village ® Town Nearest Road Little . Canalda,l�N. 55 ' Jjt�f " Hudson Alex Ln. New Construction Use: I Residential / Nu lt;7S i r bad ns 3 Code derived design flow rate 4 5 0 GPD ❑ Replacement . ❑ Public or commercial - Describe: Parent material outwa;,h Flood Plain elevation if applicable ft. na General comments and recommendations: trenches 4.50' below grade, spaced to code Boring # El Boring 1 ® pit Ground surface elev. 10 5. 4 0 ft. Depth to limiting factor + 9 6 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 I— to •.•- fill mate •, • - . _ 2 11 -23 7.5yr4/4 none fill material gw 1f np n p 3 23 -38 7.5yr4/4 c2d 7.5yr5/6 sil M na qw na .0 .2 4 38 -96 7.5yr4/6 none ms Osq ml na na _7 1.2 Sly . DI 2 Boring # Boring 1 0 5.2 0 © Pit Ground surface elev. ft. Depth to limiting factor + 1 1 0 in. Soil A. •licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0-11 10 r3 3 none u • .MONIIt►}' ._ 2 11 -2I M ...- •_ mfr MEI .5 9 3 24 -40 10yr5/4 c2d 7.5yr5/6 sil 11111111 na • if .0 2 4 10- 1117.5yr4/4 none ms Os. ml IM it PL . MINIM Effluent #1 = BOD 30 < 220 mg/L and TSS >30 < 150 mg/L ffluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signatur ^ • CST Number ...rte Gary L. Steel _ fc !/ 02298 Address Date'Evalua •n Condu Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 10-24-2000 715- 246 -6200 I • Property Owner Terry Alan Homes Parcel ID# 6 l3 S3- 3 o Page _2of_3___ Boring # ❑ Boring 3 Pit Ground surface elev. 1 01 . 8 O ft. Depth to limiting factor + 1 1 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 *Eff#2 1 0 -10 10yr3/3 none L 2msbk mfr gw 2m .5 .8 2 10 -24 7.5yr4/4 none sil 2msbk mfr gw 1m .5 .8 3 24 -32 10yr5/4 none sil M na gw na .0 .2 4 32- 1107.5yr4/6 none ms Osg ml na na .7 1.2 Borin # ❑ Boring 4 pit Ground surface elev. 1 01 • 8 O. Depth to limiting factor + 1 1 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10yr3/3 none L 2msbk mfr gw 2m 5 8 2 10- 2C10yr4/4 none sil 2msbk mfr. qw 1m .5 .8 , 3 20- 4C10yr5/4 none sil M na gw na .0 .2 4 40- 110 7.5yr4/6 none • ms Osg ml na na .7 1.2 Boring # ❑ Boring ❑ 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 Effluent #1 = BOD > 30 < 2 2 0 mg/L and TSS >30 < 150 mg/L ' Effluent # 2 = B0D < 30 mg/L and TSS < 30 mg/L 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. SBD4330 (L6I00) • f • STEELS SOIL SERVICE gt1 ary L. See Terry Alan Homes, Inc . 1554 200th Ave. New Richmond, WI 54017 STM2298 NE4NE4 S36 T29N - R1 9W MPRSW - 3254 town of Hudson (715) 246 - 6200 lot # 30 - Cottonwood Ridge I N 1 " =40' BM.= top of SW lot stake @ el. 100.00' Alt. BM.= top of 1" pvc pipe @ el. 102.30' 0 kC `,7gv l • /o 1 a -- -.______,___ �C Amy _,. s +cam -_ 3 ` Mr `3, . ;C 1° (_ 2- fc\ 6e qP c 3s6 , 2 e -7 / Gary L. Steel 10 -24 -2000 .. SI LR ) �a7,y 1 ■ _, --- 'lease print a ll nformlitJrohr I Revie ed by Date ztx + 'fit i� I �( 1: ( c j for secondary purp�se(Pr a ivacy 1 1 ) , ( , ) J� Property Owner 1 `., ,' i S. ,, k °,R,,,rop-• Location (/ Q \ C_.f 1 / rd 3l � -- i s •vt. Lot , p 1/4, E 1/4,S 36 T zq ,N,R ! q E (ore Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 135 A aiL \\ er Tr- 3U C -Von 66 k\O0e City State Zip Code Phone Number ❑ City 111 Village i Town Nearest Road' 4aCk341 I t 15 LA Ali (c> I (`115 )5- 1q40 - 131 i4 1A01 or 1 0+y 12 . N . New Construction Use: El- Residential / Number of bedrooms (3 - Addition to existing building ❑ Replacement Et Public or commercial - Describe: Code derived daily flow LOU-) gpd Recommended design loading rate , 1 4 bed, gpd /ft . S .--- trench, gpd /ft Absorption area required � 0 ' .0c-) bed, ft / trench, ft 2 Maximum design loading rate • 1 1 bed, gpd /ft • J / trench, gpd /ft Recommended infiltration surface elevation(s) 7 7. ZU ft (as referred to site plan benchmark) Additional design /site considerations Copi.4D Ur -e-le, V 9' 61 . Z U Parent material ED\0.0 OLA OU Flood plain elevation, if applicable .t/ /4- ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S Nu ®S ❑ U ❑ S Ni U ❑ S iki U ❑ S ® U ❑ S Did U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 . in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 1 8-9 lbyr 3I 3 Lt_ Ifi-Y11 mfr. C , 5 I P . t1 ; • 5 2 " -2 16 r 1 • ____ - - S (-& rn i c $ — • g Ground 3 2 : 1-3 iP 16 - '-i 14 Fir t. 5p- '1)6) `1 .' i � T -\ e-- i L S N p . N p 95.ZOft. 7 -----„,,, ? , Depth to limiting factor min. Remarks: Boring # n b-$ i�yr,3/2 _ -- .4... l rr(r<b� CY r- C_ ; 1-c' - y • 5 8-2'4 1 G yr y (a Si 1 2. ..tile, m P,' c. 5 - . - 4 3 2`132- 1,0 yr 1 -114) i'lr `{ .r.")yr Lilta S'( rt.-i e .i c nlp top Ground 9y9nft. N 7(AAid ( . . 6,,o_d1,--(1,__ . ( Depth to limiting _ ` ° a,,,�:Q� C factor I 24 in. Remarks: CST Name (Please Print) Signature Telephone No. .,\ .c.- A (,,-nA k €r /� . � �— 7 /s' Z 7- yoo (Fr Address Date CST Number 4!o - Y" n. �r - .sf. -rte ..3U, rs -~ w/ s ye, �.s 5 g4s • -}- SOIL DESCRIPTION REPOR PROPERTY OWNER AS to U 1 Page L. of PARCEL I.D.# Borin # Horizon De Dominant Color Mottles Structure G D /ft 2 9 Texture Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench o -5 I(y 3/2 SL \mohk mPr C-s I C `t ; .5 2. 5 -14 I t0yr 4 hp — 1 rr c s ` . 5 • tv Ground 3 2J -30 In `lIto rip 1.5yr q /t S; I 3n me-C: cs _ Ivp NP Q ele v 7 ,.,, Depth to limiting factor 7<{ in. Remarks: Boring # ........................... .......................... ........................... .......................... Ground elev. ft. Depth to limiting factor 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 # ........................... Ground elev. ft. Depth to limiting factor - in. Remarks: Boring # ........................... Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) PAS c 3 643 .5. u to 30 - Seale.- „ 60 , no■ i n I L ” C ktrly awl 1 el-Co. loo -O " aaK (3 H1 Z el-cv. /oo .V Sy P. lcr• g7.Z 36 Con-1,0,1r- e.12 r. 9G.40 . &ma 1 l C 13m so • Fro Wy 04,1 z. • 0 I 3 • 14 4-4- 41 v • . a z Cat1Vr∎ ward IQ i clo e. -4-r • i Private.Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within 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, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 37 019 1 Number of Bedrooms 3 Design Flow - Peak (gpd) yl� Estimated Flow - Average (gpd) Septic Tank Capacity (gal) 1 DO c Soil Absorption Component Size (ft 37? ), i Type of Wastewater Do mestic PP Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption component _ Design Flow - Peak (gpd) /oSo 37 -7- 'P Maximum Influent Particle Size (in) ' 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should 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 I Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge 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 advise the owner of when the next service needs to be performed to maintain Tess than maximum scum and sludge accumulation in the tank. Manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured 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 standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, 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 greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, 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 should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 • Management Plan for a Septic Tank and Soil Absorption Component Plantings s of deep-rooted trees and shrubs directly over or within ten feet of the 9 P Y component should be avoided since root intrusion into the component may obstruct wastewater flow. I en"- a --z-6-kui arA-e. 1 6t, CiS g o - 7 1 - ,W6 cr. CZ' 0444 3 NOV -07 -2000 TUE 12:41 PM CB BURNET MPLS S FAX NO. 6127212272 P. 03 • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP C',RTIFICATIONFORM Owner/Buyer 1 ..Q � 1 ! r r a E(Qi4(l 6S -r1_ie Mailing .( Address � � Lf 1` � L �+ p S Q L �_, - ' � Cam' . _ 4/J L -O n€ Property Address + --- -- v / (Verification required from Planning Department for new construction) tion) City /State I -5 Parcel Identification Number o„2_0- ;:2) LEGAX., Y] MSCRIETION Property Location '�, — Y Sec. , T I -R , W,, Town of Subdivision L^° � 3 0 LC -41 i9-Yt u D(t^D '21 e. , Lot # Certified Survey Map # —� , Volume _ , Page # Warranty Deed # 40 5:0 9.5" , V olume /5 -� , Page # Spec house 0 yes i n no Lot lines identifiable p' yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance your septic system could tesnit in its prcmaate a to handle wastes. Proper maintenance consists of pumping out the septic tusk every dace years or sooner, if needed by a licensed pamper. What you put into the systtmn can affect the Amction of the septic tusk as a treatment stage in the wam disposal system. The property owner age to Submit to St. Croix Zoning Department a certification farm, signed by the owner and by a master plumber, journeyman p1 umber, nnatiotedplumixr or a liccaacd pumper verifying that (1) the on wastewater disposal system is in proper operating condition and/or (2) s aer inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agn c to maintatin tiro Ovate sewage disposal system with the standards set forth herein, ea set by the Department of eonmserce and the Department of Neural Resort mxs, State of Wiscenain. Certification statin . that your septic system has been maintained must be completed and renamed to the St- Croix County Zoning Office within 30 ,ys• • • the three year :. date. 1 L M� lb 7/00 S cN i - OF el DATE • • ./j1' ti M IR/ _r . I (we) certify that all sea • • is on this are true to the best of my (our) knowledge. b (we) am (are) the owner(s) of awls •• • etty described abov • , deed recorded in Register of Deeds Office_ 4. 4! 1/ / / S1G ► OP PL DATE . 4. rr• Any info • • ion that is mis- represented may result in the sanitary permit being revoked by the Zoning Depanmant. s• Include with this application: a stamped warranty deed front the Register of Deeds office a copy of the certified survey rasp if reference is made in the warranty deed - , 9d WdOSsLO bl�OZ EZ '��S 90LS9t : 'ON Xdd 0N11t OX� 111O>1 . WOLIA STATE BAR OF WISCONSIN FORM 2 - 1998 62958 ' WARRANTY DEED KATHLEEN H. WALSH / REGISTER 4 Z C C ��� T. CROI OF DEEDS Document Number 1,1" 55 PAGE ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between 11 -03 -2000 9:45 AM RICHARD f)_ STOUT and JANET P STOUT, husband and w i f P , WARRANTY DEED , Grantor, EXEMPT if CERT COPY FEE: and + r. . ► 'eV ► _ „ ∎ I∎ • _ • ! • 0 r _ obi COPY FEE: TRANSFER FEE: 166.80 RECORDING FEE: 10.00 PAGES: 1 , Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St . Croix County, State of Wisconsin: Recording Area Lot 30, Plat of Cottonwood Ridge, Town of NameandReturnAddress Hudson, St. Croix County, Wisconsin. ' "! EAGLE VALLEY BANK, N.A. 1301 Coulee Rd Unit 2 Hudson, WI 54016 i I ii 020- 1353 -30 -000 !I Parcel Identification Number (PIN) Ij This is not homestead property. ! (is) (is not) I I I ,, C II i I I; 1 li Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. LL I Dated this - / day of y et .iffie t• 2 0 0 Q .1 ii RA J f (SEA p• (SEAL) * Richard n_ Stout * Janet P_ Stout (SEAL) (SEAL) ' * * AUTHENTICATION ACKNOWLEDGMENT I i Signature(s) State of Wisconsin, Ii ss. St. Croix Count. li authenticated this day of Personally aore me this / day of i n , 2 0 0 0, the above named Richard 0 Stout and Janet P Stout * I' i TITLE: MEMBER STATE BAR OF WISCONSIN to II (If not, me known to be thes? S ,t�q fcuted the foregoing I authorized by §706.06, Wis. Stats.) instrument and . _ - ; TE C kiL ONSIN !' „ KERNON J. INSTRUMENT WAS DRAFTED BY . BAST, I Janet P. Stout 1 I 1353 Awatukee Tr_ � .r�r -� Hudson, WI 54016 Notary Pu• ic, State of Wisc." n My com issio is„ permanent. (If not, state expir tion ate: (Signatures may be authenticated or acknowledged. Both are not .• U A' •) necessary.) ; ' Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. 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