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HomeMy WebLinkAbout261-7000-11-009 11-9 i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y: Safety and Buildings Division INSPECTION REPORT 51 CQo f GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. L a Permit Holder's Name: ❑ City ❑ Village ❑ Town of: S ate Plan ID No Vt3 O U> CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: vo.a� Oib.p TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic L,3 &,G {(. S 2G Benchmark 2 -&-C (o Z, ( a0 .6 Dosing Aeration Bldg. Sewer Holding St /Ht Inlet p So TANK TBACK INFORMATION St/ Ht Outlet (p,�jt� q'b • 30 TANK TO P/ L WELL BLDG. Air I to ntake ROAD Dt Inlet Air Septic S NA Dt Bottom Dosing NA Header/Man. Aeration NA Dist. Pipe ; I•(.a Q4, op Holding Bot. System 1, 93. r PUMP SIPHON INFORMATION Final Grade f Manuf cturer Demand �µD Coq/ 2•�a 6o.20r Model Num r GPM TDH Li L oss on System Ft I F emain Length Dia. f Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width t Length / No. oq f Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 • Sti 1 1 DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Ms acturer: SETBACK CHAMBER 1001F —LA S&e-s INFORMATION Type O , Model Number: N System: Co mv; 3 � yb OR UNIT . O DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe x Hole Size x Hole Spacing Vent To Air Intake 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include ode discrepancies, persons present, etc. t • t,& --JS Ste. ko6sQ.�. ��...;� .�.�. bV-,�... -,9 cka-w. 6ar-1. Plan revision required? ❑ Yes JK No Use other side for additional information. N• fib/ SBD- 6710(R.3/97) tp C �� Inspector's Signature Cert No 1 ADDITIONAL COMMENTS AND SKETCH �• SANITARY PERMIT NUMBER: j � _ m �m� g r _ � < jj WAA F . € .e.«- � . .m m, _ J_ m. L $ .... t __w a _ _.. 1—T- �_.. �,.. a € i Pa t� y # i 0 s } e„ € �.,�,.... T. w S i j no 2 � € r 4 ��..:... :. <m a $ A f Y S t € 1 i i t W- 4 ._ _ p :, i.mn. w0 m . a w �A w €.. -. t a ti wy °• � — C m _ . 1 -4-- j -0-4-0-4 . __ �,...,a w.. 3 .. ,,..�e _ ..,gym ._. n e I a � 1 € , y d � 1 E € y € { .„ 7 a I �. .< I . — a a b mmm.m e ,.....,..:._ tea, �.. �` . .�.�.........°..,.'_ e..,,e.° ..... .. . . ........z:,...., e . ._,., m,....,.<ve. �........... �L........., � ..... .< ,..� ....� I Satety ana Isutlaings urvislon t_,kJu11t I ^ D 201 W. Washington Ave., P.O. Box 7162 Viseonsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 430 293 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code in you provide T OM =�Tr may be used for secondary purposes I rivacy R t ) _ Project Address (if different than mailing address) I. Application Information - Please Print All Infor nation Property Owner's Nam Parcel # Lot # Block # s ew 44 Property O ner's M ailing Address _ ` ,. _ _,_ Property Location � � 1 � /s, [7�J City, State Zip Code Phone Number --�— S ?,,2- _Y�— (circl ne 11. Type of Building (check all that apply) T N; �� E W r Subdivision Name CSM Number U 1 or 2 Family Dwelling - Number of Bedrooms !AP ublic /Cornmercial - Describe Use 2 e lM� 1 f17 State Owned - Describe Use ><rty_E]Village Township o� III. Type f Permit: (Check only one box on line A - CorAplete line B if applicable) -� 'ew System ❑ Replacement System ❑ Trearment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑Permit Renewal ❑Permit Revision 11 Change of El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner I IV. Type of POWTS System: (Check all that apply) on - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At- Grade ❑ Single Pass Sand Filter i ❑ Constructed Werland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Re lating Sand Filter ❑ Recirculating Synthetic Media Filter thing Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explai 5 1 S e V. Dispersal /Treatment Area Inform � Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Are Proposed (sf) ystem Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass i New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit / ' A7 Dosing Chamber I VII. Responsibility Statement- 1, the and i ed, assume responsibility for installation of the P W°TS shown on the attached plans. Plum / p er's Na me (Print) Plum Si gnature MP /MPRS Number Business Phone Number Plumber's Addre ss (Street, City, State, Code) o I VIII. County /Department Use Only Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater ;Date Issued Is Agent Signature o Stamps) Surcharge Fee) I ❑ Owner Given Reason for Denial Oz �A3 IX. Conditions of Approval /Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, efuent filter and dispersal cell must all be serviced / ma intained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. 1 Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 vis.onsin www.commerc .wis ons Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary August 13, 2003 CUST ID No.226900 ATTN.• POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/13/2005 Identification N87 Numbers SITE: Transaction ID No. 897000 Gary Wold Airplane Hangar Site ID No. 663314 New Richmond Airport Rd Please refer to both identification numbers, Town of Richmond, 54017 above, in all correspondence with the 'agency. St Croix County SW1/4, SWIA, 524, T3 IN, R1 8W FOR: Description: Nonpressurized In- Ground 77 gpd. Object Type: POWT System Regulated Object ID No.: 915576 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Component Manual, SBD- 10705 -P ( N. 01 /01) ". • Comm 84. 10, All materials used in this installation shall conform to the provisions of this chapter. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the Q' installation, operation aintenance of the POWTS. C O J l tt Since Fee Required $ 175.00 Fee Received $ 175.00 r- 61, 1"L Balance Due $ 0.00E F Thomas E Devereaux is Plumbing / POWTS Reviewer II , Integrated Services (715)634-3026, 7:15 am - 4:00 pm Mon. - Fri. WiSMART code; 7b33 tevereaux@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 7/24/03 Owner: Gary Wold Location: SW1 /4 SW1 /4 S24 T31 N,R18W New Richmond Airport Hangor 11 -9 System type: In- ground absorbtion system(conventional) Manuals Used: In- ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Conventional System Plot Plan 3 -5. Maintanance and Contingency Plan 6 -9. Soil Test Signature License num r 226900 p1j.S. Clonally y Y M CE :NT OF C D ILDINGS SAF ORRESPONDE ;C i { PLOT PLAN PROJECT Gary Wold ADDRESS 476 208th Ave Somerset Wi 54025 SW 1/4 SW 1/4s 24 /T 31 N/R 18 W City New Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 7/24/03 GPD 77 CONVENTIONAL X00( IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 261 LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 186 # of chambers 6 BENCHMARK V.R.P. Hangor Siding Bottom ASSUME ELEVATION 100° Filter Zabel A -100 ❑ BOREHOLE O WELL +H.R.P. Same as Benchmark SYSTEM ELEVATION 92.9 5.5' below grade Vent >6„ Standard Biodiffuser Alt. BM Bottom of Siding @ 100.0' of Cover Leaching Chamber with 31.1 ft2 of Area Plans Designed Using 6' Long il l, Conventional Powts Grade at System Elevation 34" Manual Version 2.0 Entire Parcel is own and leased from City of New Richmond Property has no Scale — 1 �� — 4 0 � lot line setbacks. The hangars are on a 100 year lease, lot lines need not apply. Tested area has 0% Slope and thus no contours Tank is to be properly tic system is to bedded and provided Hangar 1 1 -10 serve toilet and with lockdown cover 77 Gpd r floor drain with approved warning 2 employees label and 1 floor '{o waste only! A catch drain basi n is not be i nstal led and Alt. B.M. B.M. * attached to system 1 - 3' X 38' Cell Vent 0_ Weeks ST B -1 B -2 B -3 Ai rport Rd. Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use alternate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird #226900 pOWTS OWNER MANUAL & MANAGEMENT PLAN Page of SYSTEM SPECIFICAT(ONS F(LE INFORMATION Septic Tank CaPacitY at ❑ NA Owner G�� f1]k �c° Septic Tank Manufacturer �-��� ❑ NA Permit #. 2 Effluent Filter Manufacturer, ❑ NA NA DESIGN PARAMETERS NA Effluent Filter Model �r`'" L9 C7 ❑ Number of Bedrooms m Tank Capacity at )"A Number of Commercial " ' �' mercial Units .�, .� �� P u p . aVda Pump Tank Manufacturer Estimated flow (average) ump Manufac AM Design flow (peak), (Estimated x 1.5) aVd R al/da lftz Pump Model Soil Application Rate pretreatment Unit A Monthly average` Influent/Effluent Quality p Sand/Gr✓dve! Fitter [I Peat rid Fats,. Oil & Grease (FOG) :520 mg/L ❑ Mechanical Aeration ❑Wetla Biochemical Oxygen Demand (BODO 420 mg/L ❑ Disinfection ❑ Other Total Suspended Solids (TSS) 5150 m /L Manufacturer Pretreated Effluent Quality Monthly average" Dispersal Cell(s) v ❑ In (pressurized) S30 mg/l n -ground (gravity) ❑Mound Biochemical Oxygen Demand (BOD ❑ At -grade Total Suspended Solids (TSS) 53o mg /L ❑ Other Fecal Coliform (geometric mean) 510` cfu /100m[ ❑ Dri ine Particle Size Y inch diameter � values typical for dornesfic (non�ammercial) rrastswater and M septic tank effluent Values t for pretreated wastewater - MAINTENANCE SCHEDULE Service Frequency Service Event Maximum 3 yrs.) Inspect condition of tank(s) At least once every ❑ months ear(s) When combined sludge and scum equals one -third (Y,) of tank vol Pump out contents of tank(s) ? ❑months ear(s) (Maximum 3 yrs.) At least once every Inspect dispersal cell(s) ❑ months earls) At least once every Clean effluent filter ❑ months ❑ year(s) ACN Inspect pump, Pump controls & alarm At least once every ❑ months ❑ year(s) z KNA At least once every Flush laterals and pressure test ❑ months ❑ year(s) ❑ NA Other. At least once every �ONA At least once every ❑ months ❑ year(s) Other_ MAINTENANCE INSTRUCTIONS n one of the following licenses or Inspector POWTS Maintainer, Septage Inspections of tanks and dispersal cells shall be made by an individual ca certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS s to identify any missing or broken Servicing Operator. Tank inspections must include a visual inspection of the tank( ) hall be visually inspected to check the effluent l evel s the ne Identi any cracks or leaks, measure the volume of ooms fined sludge and scum and to check for any bar up hardwa fY round surface. The disperse ce () nding of effluen or ponding of effluent on the g ndin of effluent on the ground surface• The Po authority - in the observation pipes and to check for any po g requires the immediate notification of the local regulatory ground surface may indicate a failing condition and req tank equals one-third (l;) or more of the tank volume, the e and scum in any e4 fin accordance with ch. NR stud accumulation of 9 rand disp o When the combined a e Servicing Operate entire contents of the tank shall be removed by a Septag g 113, Wisconsin Administrative Code- onents, pretreattment components, and any The servicing of effluent filters, mechanical or p ressurized POWTS comp rformed by a certified POWTS Maintainer. other maintenance or monitoring at intervals of 12 months or less shall b d of completion of any service event A service report shall be provided to the local regulatory authority N 1 for the presence of painting products or other START UP AND OPERATION PO San� tr dispersal cell(s)- chemicals that may impe If high concentrations afe For new construction, prior to use of the odamage the disp im de the treatment p moved by a septage servicing operator prior to use - detected have the contents of the tank(S) r Page o! System start up shall not occur when soil'conditions are frozen at the infiltrative surface_ • During power outages pump tanks may full above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cells) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator Prior t6 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 ouelimination of the following from the wastewater stream may improve the performance and prolong the life diapers, of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss' Pe disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; ot4 painting products; pesticides; sanitary napkins, tampons; and water softener brine. ABANDONMMENT shall the taken to Insure that the When the POWTS falls and/or is permanently taken out of service the followin g steps system is properly and safety abandoned in compliance with ch- Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents n all tanks and pits shall be removed and property 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 Boll, 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 welts. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable re lacement area Replacement systems must comply with the rules in e _ effect at that time. advances in POWTS p s. Barring o available due to setback and /or soil limitation 9 A suitable replacement are t technology a holding tank . may be installed as a last resort to replace the failed POWTS. 0 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. O Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Recons tructions 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 OXYG DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER s • -, Name �, %c, u �✓ ,, Name >1� r ✓� i , , Phone Phone ,� t? /�n rX SEPTAGE SERVICING OPERATOR UMPER LOCAL REGULATORY AUTHORITY i Name �- Agency '1 ' " ; h � ,� ; 411 ,cam 7�'�? > / � Phone i - _ Phone % /,,-- L� /, — / This document was drafted by the staffs of the Green take, Marquette and Waushara County Zoning and Sanitation agencies. This c meets the minimum requirements of ch. Comm 8322(2)(b)(t)(d)&(t) and 83- 54(t), (2) & (3), Wisconsin Administrative Code. use of ails doc ument ument d does not GMW (210 1) guarantee the performance of the POWTS. I e'o 7�f \ �f f -aB 2 D G) ® 7#§ k 'A CLJ$ k L g EK= �«& @ ��ee£ W Z.bi 7 %�§Sg O -G� M k ESE F §k$ Co- 04 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of If iwsion of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code t County � . 0� O J X Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Pa I.D. 4D percent sl ope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information eviewed by Personal information you provide may be used for >iecondary purpo865 (Pnvacptavr; e. t'6,04 (1) (m)). Property Property Location r Govt. Lot 1 /4 l j i t ,)I /4 S T 31 N R (or Property Owner's MailinyAddress Lot # Block # Subd. Name or C SNW V eel -J t c t A rq r y City State Zip Code Phone Number ity ❑ Vi ge Town Nearest Road rue 1 New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement Public or commercial - Describe: ��i•���.Q _ /f��Jd? -r✓"'� __ Parent material OL�.o_ Flood Plain elevation if applicable f ✓0 ft. General comments �G� =� g and recommendations: 5�� ! 2Z . � 9 d . l —f 19 � © Boring # Boring a pit Ground surface elev. � Y , Yft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 izm & Z oZ— Ong # Boring A Pit Ground surface elev. ft. Depth to limiting factor in. 50 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 i / �� ��� �� ✓ 0 Effluent #1 = BOD > 30 1 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) r CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation C ducted Telephone Number 1008 192nd Ave, New Richmond, WI 540 s 715- 246 -4516 �1 i Property Owner _ Parcel ID # Page of 13 Boring # ' j Boring Pit Ground surface elev. &"-- ft. Depth to limiting factor ' O in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Con Color Gr. Sz. Sh. 'Eff#1 'Eff#2 . 2 03 • Z F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 F-1 Boring # ❑ Pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 mg/t_ ' Effluent #2 = BOD < 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. SBD -8330 (R.W00) I. Soil Test Plot Pla Project Name Gary Wold S Bird Address 476 208th Ave Somerset Wi 54025 STM #226900 Lot 11-9 Subdivision N.R. Airport Date 7/24/03 SW 1/4 SW 1/4S 24 T 31 N /19118 W City New Richmond F1 Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of Siding System Elevation 9 2.9/92.8 *HRPSame as Benchmark Alt. BM Bottom of Siding @ 100.0' Entire Parcel is own and leased from City of New Richmond Property has no Scale = 1 = 40' lot I i ne setbacks. The hangars are on a 100 year lease, lot lines need not apply. Tested area has 0% Septic system is to Slope and thus no Hangor 11 -9 serve toilet and contours floor drain n 2 employees and 1 floor waste only! A catch drain basin is not be i nstal led and Alt. B.M. B.M. attached to system 0 13 13 B -1 B-2 B-3 Airport Rd. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer �,tia -�-t/ leaf U Mailing Address 6 -5 L4'), Property Address (Verification required from Planning Department for new construction) City/State Parcel Identification Number LEGAL DESCRIPTION Location - ft-' %4 S� K Sec. T F/ N W, of Property , .�, 11___ Subdivision Lot #c� / Certified Survey Map # , Volume �- . . Page # +�WW �G , Volume 'e Page # Spec house O ye�no Lot lines identifiabig,6yes C1 no SYSTEM CE 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 ma Wplumber, journeyman plumber, restrictedplumber Ora licensedpumper verifying that (1) the on site wastewaterdisposal 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, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days o three year expiration date. , e! �� V", , � 1 SiVRATURE OF APPLICANT ° DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of described above, by virtue of a warranty deed recorded in Register of Deeds Office. :r SIGNATURE OF APPLICANT J DATE « «ss «« Any information that is mis- represented may result is 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 HANGAR AREA LEASE THIS AGREEMENT, made and entered into on the date indicated below by and between the City of New Richmond, State of Wisconsin, a municipal corporation, hereinafter called the Lessor, and Skywalker Crane, hereinafter called the Lessee. WITNESSETH: WHEREAS, the Lessor owns and operates an airport known as the New Richmond Municipal Airport and said Lessee is desirous of leasing from the Lessor a certain parcel of land on the said airport, hereinafter more fully described, for the purpose of: aircraft storage WHEREAS, the Lessee will use the below described property for the purpose of storing aircraft and shall conduct only such aircraft maintenance on its own aircraft as performed by the Lessee or by regular employees of the Lessee. NOW, THEREFORE, for and in consideration of the rental charges, covenants, and agreements herein contained, the Lessee does hereby hire, take and lease from the Lessor and the Lessor does hereby grant, demise, and lease unto the Lessee the following premised, rights, and easements on and to the airport upon the following terms and conditions: 1. Property Description Lot 9, Row 11 of the Airport Layout Plan - New Richmond Municipal Airport. Leased Property equals 5920 square feet 2. Hangar Construction The Lessee shall have the right to erect, maintain and alter buildings or structures upon said premises providing such buildings or structures conform to the applicable requirements of the Wisconsin Department of Industry, Labor & Human Relations and pertinent provisions of any local ordinances in effect. All plans for such buildings or structures shall be reviewed and approved in writing by the Lessor prior to construction. 3. Terms The term of this lease shall be for a maximum of ten (10) years commencing on July 1, 2001 and ending on June 30, 2010. 1 From: Kristi Stone .At: Emery 3.. Karrigan, rc. mar .J: 5039413' -13 To: Gary VA'Gd Date: 4:23!03 31 :22 M Page: t cf 11 251 SW 153rd Drive Y aE r - E , r; Beav,_rton, OR 97006 KAN '� hone. (643) 941-8009 e ` 213 JR. ? �x. (503) 941 -8013 F ax From: Kristi Stone To: 7kywalker '�W old Pages: 11``a Company: _C ane Date: 4!24/03 e °^ Fax: (715) 247-4677 Subject: Insurance Proposa / Phone: (715) 247 -5438 Confidential No.e: Informat!on in tris facsirniie is confic entia :ar., n e" c `or use �by'he indivdua! c -r c ti`t named above. If you received this teleccloy in error please immed.:rtf *; er'ione us a`rrd return the original via U S 'ostal Service Message: Hi Gary Following is our Insurance' Proposal for your General Liability and Inland Mari4-ilzoverages. I have just the one GL quote right now but am hoF.inq .o hE ve another quote later today. `•e However I didn't ant to wait too long to at lest get y, u this. As soon as I hear from the other under vrr'ter,,I ,, mill tali or fax you that quote. Aftef a ic'cing this over if you have a: iy questiuns just y v � me a call. <kristi 4. Rent The Lessee agrees to pay to the Lessor for the use of the premises, rights, and easements herein described, a yearl, rental of ten (10) cents per square foot for the land leased; for a total annual charge of $592.00; payable on July 1 annually. It is understood and agreed that the rental rate hereir:, specified shall be subject to re- examination and readjustment at`the end of each three year`period of this lease, provided that any readjustment of said present rates, or as same may be amended hereafter, shall be reasonable. 5. Non - Exclusive Use The Lessee shall have the right to the non - exclusive use, in common with others, of the airport parking areas, appurtenances and improvements thereon; the right to install, operate, maintain and store, subject to the approval of the Lessor in the interests of safety and convenience of all concerned, all equipment necessary for the safe hangaring of the Lessee's aircraft, the right of ingress to and egress from the demised premises, which right shall extend to the Lessee's employees, guests, and patrons; the right, in common with others authorized to do so, to use common areas of the airport; including runways, taxiways, aprons, roadways, and other conveniences for the take -off, flying and landing of aircraft. 6. Laws and Regulations The Lessee agrees to observe and obey during the term of this lease all laws, ordinances, rules and regulations promulgated and enforced by the Lessor, and by other proper authority having jurisdiction over the conduct of operations at the airport. - '- 7. Hold Harmless The Lessee'agrees to'imld'the Lessor free and harmless from loss from each and every claim and demand of whatever' nature made upon the behalf of or by any person or persons for any wrongful act or omission on the part of the Lessee, his agents or employees, and from all loss or damages by reason of such acts or omissions. 8. Insurance The Lessee agrees that he will deposit with the Lessor a policy of comprehensive liability insurance upon 90 days written notice from the Lessor. 9. Maintenance of Premises The Lessee shall maintain the structures occupied by him and the surrounding land premises in good order and make repairs as necessary. No outside storage shall be permitted except with the written approval of the Airport Commission. In the event of fire or any other casualty to structures owned by the Lessee, the Lessee shall either repair or replace the leased area to its original condition; such action must be accomplished within 120 days of the date the damage occurred. Upon petition by the Lessee, the Lessor may grant an extension of time if it appears such extension is warranted. 10. Right to Inspect The Lessor reserves the right to enter upon the premises at any reasonable time for the purpose of making any inspection it may deem expedient to the proper enforcement of any of the covenants or conditions of this agreement. COPY 2 4 From: Msti Stone At: Emery & Karrigan, inc. FaxID, 5039318013 To: Gar/ Wold Date. 4/24/03 0':22 PM Page: 1 of 11 "r ' -' "575 SW 153rd Drive r EmIERY Leaverton, OR 97 A r Rhone: (503) - -5009 ext. 213 MAIGA'� I 'll , ax: (50 1 8013 nsuranceSpeciallsts Fax ws From: Kristi Stone To: Gary Wold Pages: 11 Company: S kywalker Crane JV Date: 4/24/0 F `x: ;715) 247 -4677 subject: imiran(I.A Prnpncal/SkYnA/alkPr fi hens: '715) 247-643S ll Confidential Note: Information in this facsimile is confidena and in *.en for use b; the mcliv dua or entity named above. If you received this telecepy in error, please immed)dfely telephone as an turr �he original , jia U S Postal Service. r Message:' Hi Gary Following Is our insurance for your Ueneral Liability and inland Marble cd rages. I have just the one GL quote 0"ht now but am hoping to have another quote later today. *« N However I didn't infant to wait too long to at least get you this. Ar, soon as I hear from the other underwriter I wjlfcall or fax you that quote. After look, ilg this over if you have any questions just give me a call. KrisW f 11. Taxes The Lessee shall pay ail saxes or assessments that may be levied against the personal property of fle Lessee or the buildings which he may .erect on lands leased exclusively 'io him. 12. Suns The Lessee'agree's that no signs -or advertising matter be erected without the consent of the Lessor. 13. Default The Lessee shall be deemed in default upon: a. Failure to pay rent within 30 days after due date; b. The filing of a petition under Federal Bankruptcy Act or any amendment thereto including a petition for reorganization or an arrangement; C. The commencement "of a proceeding for dissolution or for the appointment of a receiver; d. The making of an assignment for the benefit of creditors without the prior written consent of the Lessor; e. Violation of any restrictions in this lease, or failure to keep any of its covenants after written notice to cease such violation and failure to correct, such violation within thirty days. Default by the Lessee shall authorize the Lessor, at its option and without legal proceedings, to declare this lease void, cancel the same, and re -enter and take possession of the premises. 14. Title Title to the buildings erected by the Lessee shall remain with the Lessee and shall be transferable. Upon termination of this lease, the Lessee may, at the option of the Lessor, remove the buildings, all equipment and property therein and restore the leased property to its original condition. 15. Snow Removal The Lessor agrees to provide NO snow removal services to the Lessee's leased premises in the hangar area. 16. Lease Transf The Lessee may not, at any time during the time of this lease, assign, hypothecate or transfer this agreement or any interest therein, without the consent of the Lessor. Co P11 'If 3 From: Kristi Stone At: Emery & Karrigan Inc. FaxID: 5039413013 To: Gary Wold Date. t/24J03 01:22 PM Page: 1 of 11 ,-575 &W � 53rd Drive �1 n m. R BraVertc - i, Ott.: 9'7006 KA .�. NCIPho e: 1 9-11-8009 ext. 213 Fax: (503) ;.-41 8013 . I nsurance Specialists Fax From: Kristi Stone T G ary Wola Pages: 11 Company: Skywalker Cra ne Date: 4/24/03 ax: (715) 247 -4677 Subject: Insurance Proposal / Skywalker ph e: (715) 247 -5436 Confidential Note! Informat'on in this farsimile is _ nfirg-nti2l and intender' fo a by -he indili dua :�r enti'.y named ahnve. If yeu received this telecepy in error, p!eae Imrnediateiy telephone LAS and retu he original ✓ia U S Postal Service. Message: Hi Gary Following is our In ranee Proposal for your General Liability w id Inland [- Aarine covera I have just the one GL ote right now but am hoping to have another luote later today. However I ' 'n't want to wait too long to at least get you this. As :goon as I hear from the other underwrit I will call or fax you that quote. After oking this over if you have any questions just give me a call. Isti Wisconsin relative to tl =e operation or mainte'iance of the airport, the execution of which has been or may be required as a condition precedent to the expenditure of federal or stated funds for the development of the airport. Furthermore, this lease may be amended to include provisions required by these agreements with the United States or the Stated of Wisconsin. 19. Arbitration Any controversy or claim arising out of or relating to this lease or any alleged breach thereof, which cannot be settled between the parties, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the dispute rendered by the arbitrator(s) shall be final and binding on the parties. 20. Floor Height The Lessee agrees to erect a building on the leased premises with a minimum finished floor height at least six (6) inches above the finished grade of the taxilane nearest the front of the building. 21. Taxiway Access The Lessee is prohibited from operating automobiles on runways or main taxiways. 22. Parkin Automobile parking must be on Lhe leased premises or on designated areas of the airport. cc ) _ - Opy ry 4 From: Kristi Stone At: Emery & Karrigan, 'rc. FaxlD. 5039413013 To: Garl Wold Date: 4/24/03 01:40 PM Page: 1 of 11 M 2575 �M RY SW 153rd Drive ter, z Beaverton, OR 97006 KA .fit ► GA N r Phone: (503) g41 8009 ext. 243 ? Fax: (503) 941 -80, 1 Fax �nV'W11.a1 tW'W Specialists I From: Kristi Stone To: Gary Wold Pages: 11 C pany: Skywalker Crane Date: 4/24/03 F (715) 247 -4677 subject: Insurance Proposal / Skywalker Phone. (715) 247 -5438 Confidential Note: Information in this facsimile isnfidentia' and in *ended for use the indiv dual or entry named above. If you received this telecopy in error, ple immediateiy telephone is and return the igiral via U S. Postal Service. Message: Hi Gary Following is o Insurance Proposal for your General Liability and Inland Marine coverages.. I have just the on L quote right now but am hoping to have another quote later today. Howe r I didn't want to wait too long to at least get you this. As soon as I hear from the other and iter I will call or fax you that quote. Afte _Iooking this over if :you have any questions just give me a call. Kristi J i IN WITNESS WHEREOF, the parties have oereunto set their hands and seals this day of 2 U n.. Z op 'Z. _ _, in the City of New Richmond, St. Croix County, Wisconsin. LESSOR: �LD C � Airport Manager, Mike Demullin6 LESSEE: I COFN Gary . 17. Airport Development The Lessor reserves the right to further develop or improve the landing area of the airport as it saes fit, regardless of the desires or view of the Lessee, and without interference or hindrance. If the development of the airport requires the relocation of the Lessee, the Lessor agrees to provide a compatible location and agrees to relocate all buildings or provide similar facilities for the Lessee at no cost to the Lessee. 18. Subordination Clause This lease shall be subordinate to the provisions of any existing or future agreement between the 'f essc c and the United States or the State of From: Kristi Stone At: Emey & Karrigan inc. Fwd D: 5039418013 To: Gar/ Wald Date: x124/03 01:40 PM Page: 1 of 11 t' YiM r 2575 SW 153rd Drive Em.E—Ey & Beaverton, OR 97006 K R IGAIN I T r Phone: (503) 941-80 ext. 213 ✓ Insurarce Specialist Fax From: KristtStone To: � Wold Pages: 11",. Compa Skywalker Crane Date: 4/24103 F (715) 247 -4677 Subject: Insurance Proposal! alker Phone: (715) 247 -5438 Confidential Note: Information in this facsimile is coy ntiai ar d intended for use by the individual or entity named above. If you received this telecopy in error, please iDOhediate lephone us and -eturr the original via U.S. Postal Service. —� Message: Hi Gary Following is our surance Proposal for your General Liability and Inlan ine coverages. I have just the one quote right now but am hoping to have another quote later todq . Howeve - didn't want to wait too long to at leaat get you thin. Ao 000n a;5 1 hear from the other unde it l will call or fax you that quote. After looking this over if you have any questions just give me a call. Kristi