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HomeMy WebLinkAbout261-7000-16-009 16-9 ,Nisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division "- ` INSPECTION REPORT Sanitary Permit No: 463432 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: X City Village Township Parcel Tax No: Jacobson, Matt City of New Richmond 261- 7000 -16 -009 CST BM Elev: Insp. BM Elev: BM Description: 1' Section/Town /Range /Map No: /Q'b S by 24.30.18. TANK INFORMATION ELEVATION JiAT A TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Z Benchmark Dosing Alt. BM Gb J Z• 7 Y Aeration Bldg. Sewer L 5• $9 Holding St/Ht Inlet S� &, RS H TANK SETBACK INFORMATION St/Ht Outlet •7$ J'7 • d TANK TO P/L WELL :BLDG. Vent to Air Intake ROAD Dt Inlet Septic / ! / Dt Bottom `J Dosing Header /Man. 9(c, ZZ Aeration Dist. Pipe Holding Bot. System Final Grade // PUMP /SIPHON INFORMATION 1 ; 1$ ✓do Z Manufacturer Demand St Cover Model Number J TDH Lift ' tion Loss System He TD Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S6 ' 1 J`G� � ~- � � SETBACK SYSTEM TO J P/L JBLDG IWELL LAKE /STREAM LEACHING Manufa e INFORMATION CHAMBER OR � Type Of System: /6' 1 / �� UNIT Model Numbe e,� a DISTRIBUTION SYSTEM Header/Manifold / / Distribution x Hole S' -1 i Len e x Hole Spacing Vent to Air Int ke ,jam Leng V P's ns) \ g� ' Z v C7 th Dia Length 1 Dia ` Spa SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only 0-3-A- Depth Over / Depth Over xx Depth of xx Seeded /S dded j xx Mulc d Bed /Trench Center 5 3(c Bed/Trench Edges ` Topsoil NI-11 1 Yes No es No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / / Location: Row 16 lot 9 New Richmond, WI 54017 (SW 1/4 SW 11/4 24 T30N R1 8W) New Richmond Airport Lot 16 -9 Parcel No: 24.30.18. 1.) Alt BM Description = -A CQJa�.— 2.) Bldg sewer length = 5 - amount of cover Plan revision Required? Yes No / bs Use other side for additional information. l � Date Insepctors nature Cert. No. SBD -6710 (R.3/97) ` Safety and Buildings Division only ro ME 201 W. Washington Ave to Madison, n, 5 G► � S nary Permit Number (to be filled in by Co,) Department of Commerce 266- 1 4 �,343Z Sanitary Permit Applica i N? 2 tUU J jStat an I.D . Number In accord with Comm 83.21, Wis. Adm. Code, personal informati "you provide �;QNT ! = l*►S . IQ may be used for secondary purposes Privacy Law, s 15.04( )(m) R 10E Address (if different than mailing address) NING OFF I. Application Information - Please Print All Information Property Owner's Name Parcel # Lot # Block # -� Jr4 � Db s�� NIA Property Owner's Mailing Address Property Locatl of w� rcc,� City, Y State Zip Code Phone Number .Sc, %4, � " Y4, Section H. of Building (check all that apply) T N; if/ E W 2Family Dwelling - Number ofBedrooms Subdivision Name CSM Number Public /Commercial - Describe Use 2G,u r u• .. �// / y 1� i7 r ❑ State Owned - Describe Use City ❑Village ❑Tow1lship o III. Type f Permit: (Check only one box on line A. Complete line B if applicable) A. W System El Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T e ofPOWTS S stem: (Check all that appl on - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil [I Mound < 24 in. of suitable soil ❑ At -Grade Single Pass Sand Filter I Coned Wetland 11 Pressurized In -Gr and ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filt aching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) e16/ V. Dis ersal/I'reatment Area I ormation: Design Flow (gpd) Design So� Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) ystem Eleva: n VI. Tank Info Capacity in Total Ns ofUni umber Manufacturer Prefab Site Steel Fiber Plastic Gallons llon Concrete Constructed Glass New Existng i k,>, I Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility State nt- I, the undersigned, esponsibility for installation of the POWTS shown on the attached plans. Pr' ame (Print) Plumber's Si a MP/MPRS Number Business Phone N4mber l Plumber's Address (Street, City, State, Zip VIII. Coun /De artment Use Onl pproved ❑ Disa Sanitary Permit Fee (ilipludes Groundwater Date Issued I suing ent Sign o Stamps) Surcharge Fee) \ ❑ er G" anon nial IX. Conditions pprov easons for Disapproval SYSTEM OWNER: °- 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained �� ,In, � QS( ) 36 u as per management plan provided by plumber. I,o�.e. 9 2. All setback requirements must be maintain -�— as per applicable code /ordinances A (ft- Attach complete plans (to the County only) for the system on paper not less than 8W x l I inches in sire f SBD -6398 (R. 01/03) Safety and Buildings 4003 N KINNEY COULEE RD commerce LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.w w ww.coe.wi.gov/s sin.go / Department of Commerce iscosin.gov Jim Doyle, Governor Mary P. Burke, Secretary April 22, 2005 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: 04/22/2007 Identification Numbers Transaction ID No. 1127181 SITE: Site ID No. 697168 Hanger 16 -9 Please refer to both identification numbers, New Richmond Airport above, in all correspondence with the agency. City of New Richmond St Croix County SW1 /4, SW1 /4, S24, T3 IN, RI 8W FOR: Description: Proposed Commercial Non - pressurized In- ground POWTS Object Type: POWTS Component Manual Regulated Object ID No.: 1014122 Maintenance required; 77 GPD Flow rate; 115 in Soil minimum depth to limiting factor from original grade System: In- ground POWTS Component Manual, SBD- 10705 -P (N.01 /01); Biofilter 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. 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 "In- ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10705 -P (N.01/01). • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • This approval does not include plans for the general plumbing systems or sewer piping leading to the septic/holding tank that may be required for this project. See section Comm 82.20, Wis. Adm. Code, to determine if plan submittal and approval is required. • The plumbing for this project discharges to a private sewage system. The approval covers only domestic /sanitary wastes directed into this system. The Department of Natural Resources must be contacted regarding the treatment and disposal of all industrial wastes, including those combined with domestic /sanitary wastes. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. P.O.W - r CO /I didojg S llj� A � _ — • • 4 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 4/15/05 Owner: Matt Jacobsen Location: SW1 /4 SW1 /4 S24 T31 N,R18W New Richmond Airport Hangar 16 -9 System type: In- ground absorbtion system(conventional) Manuals Used: In- ground absorbtion system (version 2.0) Page# 1. Cover Page 2. System plot plan 4.Chamber Cross Secti 5 -6. maintance and co ency 7 -9. Soil Test Signature License num 226900 RECEIVED REC r R®VE® DEPARTMENT OF COMMERCE APR 18 2005 DIVISION OLAAFETY AND BUILDIN�S SAFETY &BUILDINGS SEE CORRES NDENCE PLOT PLAN PROJECT Matt Jacobsen ADDRESS 101 W Graham Roberts Wi 54023 SW 1%4 SW 1 /4S 24 /T 31 N/R 18 W City New Richmond COUNTY ST. CROIX SYSTEM ELEVATION 95.0 5' below qrade GPD 77 CONVENTIONAL )OCX AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 800 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 248 # of chambers 8 BENCHMARK V.R.P. Bottom of Siding ASSUME ELEVATION 100' Filter Zabel A -1800 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Scale = 1/4" = 10' L Line ST Well o B.M.* B-1 Pro Hangor 2 employees, 1 floor Drain Lot Line B-2 77 gpd 3% Vent Slope B - Airport Rd Calcs: 77gpd X .7= 110' ftA2 of of absorbtion area, /31.1 ft ^2 per chamber = 4 chambers, I am going to use 8 chambers in case another hangor may want to hook up to this system, and I have the room! Lease lot line, all hangors are owned by the city of New Catch Basin is not to Richmond discharge into septic system, septic system is for domestic waste only! r Cross Section of Standard Biodiffuser Leaching Chamber Typical cross section for 1 of 1 cells To be >1' above grade Standard Biodiffuser Leaching Chamber Finish grade elevation with 31.1 ft2 of Area inn n' V _ / Typical Installation Grade A en, 4 " f�30/34 From Septic Tank " 34" Grade at System Elevation 1 -3' X 49' Cells Same on other end Observation tubeNent 3.25' y/ A 8 chambers per cell System elevations: A -95.0 T PLAN Pa °t — _ MA NUAL 8� MANp►GE Pptf1(TS OWNER'S MA SYSTEM SPECIF[CATtONS X& a l O NA Septic Tank NA F� uipORMATt (,p - C v � cTantc tAanufacwrer L ❑ NA Ownef t Fitter M ennif �� 3 Efflue Model ✓, ! P Effluent Filter Mod a t p Capadh� Nu Unit Of Be d f I0011116 s d NA p Tank Manufacturer Numbef alld wed flaw (wag aVd Pump Nlanufatr X 1.5) Design flow {) it}. (E allda Pump mo nt Unit _ ❑ NA Pretre O Peat Filter Sop p pp t ' Rafe Monthly gage 17 San dIl Filer p Wetland uen yEffluertt Quality G) S30 rngA- p Mechanical Aeration a other FSts,�Oil & Grease BOOS) 220 mgA ❑ D'ssinfection �Odhemk�l OMen De surized) So ds (TSS) 5150 m Manufacttlrer Total Suspend average" Dis [sal Cett(s) ❑ tn- ground (pres Effluent Quark Monthly n.ground (9r p Mound P� en Demand (SODO �0 mg/L b At grade c3 other g hemigt Oxyg Solids {TSS) 530 mg p Q ine tiraste+�t r end 4}.apRSTlerCr� Totat Suspended 510 cfu/1 pOmt f values typl� for dmes>x E Fecal Coliform (geOn'eti'c rneanl y inchdiameter W* e trr ue nL wasr M Effluent Paltcie Size .� values types ror pre�� Service Frequency Maximum 3 yr5.1 MAtNTE�CE SCHEDULE r(s) Ev ent p months E every of tank volume Service At Least once a �' and scum duals one-thrrd ( inspect condition of tank(s) When combined sludge r ( s ) (Maydmum 3 Yrs ) of tank(s) At least once every [3 111011 ths Years) Pump out contents lnsped disPefs� cell(s) At least once every p months 0 PIA p months ©yea<(s) NA Clean affluent filter At least once every y ear ( s ) p centra Is 8� alarm p months p y Insped pump. Pump At least once every ears) p NA Q months � Y Flush lateral and pressure test At Least once every s ) ❑ NA mo nths p � once every C3 odor At At lea ou licenses or an ind'Nidual carrying one of the following MAD IN STRUCTIONS persal cells shall be made by �-S tnspecWr POWTS Maintainer, or broken e Sewer; pp s to idertr* any m i ss ing or broKen of tanks Plumber Resin on of the tank() for any back up Inspectio : Master Plumber: m aster ed sludge and sc " • ter ns must include a visual Inspection m and to ch Secvidrt9 Operator. Tank inspec measure .the volume of combin check the effluent levels or leaks, cell(s) shall be visually insP � Pond h g of effluent on the ardw iderofy any crate round sotto+✓!_ The dispersal round surface- suthority- or tng of effluent on the g c h ec k for any ponding of effluent on the 9 lion the of the local regulatory to Tres the immediate nobfica k volume. i and and nrqu more of th tan R in file � ' pipes d Tin condrtlon one - third (i� or „vim ch N a fa g is on ante ground ndcate m in any tank egos sed of in accord d surface may mutation of sludge and stzr Opera tor and dispo When the combined accu b a Septage Servicing entire opntentS of th tank shall be removed Y ent components-, and any to Adminrs"bYe Code• pOWTS components. pretreat#m Maintainer - 113, Wisoons mechanigl or pressurized ed by a certified POWTS of effluent f0m. of completion of any service event. eM The S�n9 o r monrtodng at intervals of V months or less shalt be pe oth malntenanoe t r utatory autho 10 days rity within de e9 A Sen repast shah P rovi ded to the loco presence of painting products or other treatment tanK(s) for the P if high COncW"6ons are START UP AN D OPERA rior to use of t he pOV1(T check disp ersal cell(s). cdon, prior P rocess andlor damage the lisp tor, pr t use - For new �OnStfU a the treatment p ding opera chemicals that may impel of the tank(s) removed by a Septage servi detWed have the contents ' conditions are frozen at the infiltrative su ce• is restored the s hall not occur Mier sor tt>� taighwater levels. When power and may result in the excess S tern. s t a rt uP tZi above no o Yedoadng the CON Ys may ose, a tanks one tar e d removed by 0 9 arts t pump c e ll ( ut the F o utages P the dispersal ce1() tents of P f law V to situation have the con or POVVTS Maintainer to During discharged this Pftfmbear , Kasw" a of eflcsent To mower to the effluent purt►P or �� re � 'a rface badWP Or e Secvidns oPp P mg h is to restore normal levees w� in manually oP Is. Do not drive Or park aver, or otherwise disturb or oompac. assist i • over tanks and dispersal ce[ Do not, drive or park mound or at -grade soil abs&Mtion area - 15 feet down sko >,f oily ter stream may improve the performance and prolong fhe fife the area within from the wastewater, dental Boss' diapers. Of the followin3 tte butts; condoms; cotton swabs: degreases: Reduction our e l i mination a vegetable peefirtg l�as�ne =grease; hert"es; meat ti'o6m; baby wiP� of the POWTS: fat Sn bl rida6on dish (sump PumP) water, fruit tampo *and Waler softener brine_ on; Fairututg Products: pesfr id sanitary napKir►s; scraps. rnedicafions; shalt t r taken to Insure that the ABANDOIoMEN ntty.taken out of service the followin 9 stet's in safe A Code When the POWTS fails andlor is Perez Hance with ch_ Comm 83.33. 'IN�►s system is propedY aid ly abandoned in comp nings sealed . shad di- be connected and the abandoned Rife a servicing Operator. An Piping to tanks and P removed and property disposed of by a Septag The contents of air tanks ' and pits shall be and the void space After primping. ail tanks and Pits shalt be eXCavaied and removed or their covers r filled with soil, gravel or another inert solid material_ CotM14GENCY PLAN aired the following measures have been, or must be taken, to provide a code If the POWTS fails and cannot be rep sa p t re placement system: n evaluated and may be utilized for the location of a replacement d should not suitable repiacement'area has been a n system The replacc ement area should be protected structu tot lines and compaction Failure to be infringed upon by required setbacks from existing and propo n by area vwlll 1eSult in the need for a new soil and site effect t -bl i a suitab protect the replaceme Replacement systems must comply with the rules in effect advances in POVV itatiol Barring replacement area is available A suitable replacement area is noi i ed as a last resort to r Place the fa deed POWTS- the POINTS a soil and technology a holding tank may be o failure not been evaluated f° iden a sortable replacement a rea upon rea ilable a f� The site haste gate a suitable replacement area- If no replacem t a en •/� site evaluation must be pail a last resort to replace the failed POWTS- n removal of the biomat at holding tank may be installed as be reconstructed in place foflowi g A ound and at -grade soil abso[pti°n systems may sys tems must Comply with the rules in effect at that time_ infiltrative surtaM Reconstris ns of such sys <<wARNINt>> TANKS MAY CONTAIN LE HAL NYC CUMSTANCES. DEAT MAYG SEPTIC PUMP AND O T HER TRF�►TM�''T SE NOT ENTER A SEPTIC, PUMP OR OTHER TRt�,TMENT TANK UNDER ANY oo 1q, LT_ • RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY B E DIFFICt1LT OR IMPOSSIBLE ADDr oXAL COMMENTS POWTS MAINTAINER powrs INSTALLER Name Name Phone Phone SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORrfY Agency / Name , -•-�- �� ��r p Phone - 71 Phone Cade. Use �S doormen! meas This Qowmeiit was dratted by the sbtfs of the Green hake. Marquette and Waushara County Zoning and Sanr�ai7on a nt does not uinerttents of rn Comm 83_ )(t)(d)&(n aM 83.S40 ). (2) 8&. (3), Wisconsin Adrriinlstratixe e of ails docume the minunurrt tioq GMW (7101) guarantee the performance of the I& r RECE�� Wisconsin Department of Commerce 9, (� �N)f� E REPORT Page of Division of Safety and Buildings �� rd i in accord 111 85, is. Adm. L Attach complete site plan on paper n less th�WA FILE n size. Plan must County include, but not limited to: vertical and rence point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Review by Date 7 Personal inforrnation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location ll �� Govt. Lot v W 1/4 5L,> A T 1 N R b E (o Property Owner's Mailing Addre Lot # Block # Subd. Name or CSM# City State Zip Code Phone Number ❑ village XTown I Nearest Road �Kvew Construction Use: 0 esidential / Number of bedrooms Code derived des'gn flow rate GPD or Public commercial -f Describe ,9 ,o _ / L! /?r -!��✓ ________.__ __— Parent material / ~ /'!X /C�n� -r/�. J Flood Plainn elevation if applicable zWd ft. General continents and recommendations: Boring # ❑ Boring Zpit �� Ground surface elev ' 4 . Depth to limiting factor/ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 O -Z p .3h - t/ 04^)- - - •s/ �b ® Boring # ❑ Boring RI-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 Clu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *EffY2 'Z. � R• Effluent #1 = BOD > 30 < 220 rAg& and < 150 ' Effluent #2 = BOD 130 mg/L and TSS < 30 mg/L CST Name (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715- 246 -4516 1 Property Owner _ Parcel ID # Page of �# E] Boring Pit Ground surface elev. Z ft. F �l Depth to limiting factor _jt_ 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 Z... 0 3 s .� a S rn f r✓J � � 1. 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 `Eff#2 Boring # ❑ Boring F ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication 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 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD 130 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. seo-esw (e.6100) Soil Test Plot Plan Prdject Name Matt Jacobsen Shaun Bird Address 101 W. Graham Roberts Wi 54023 CSTM 26900 Lot 16-9 Subdivision NR Airport Date 4/15/05 SW 1/4 SW 1/4S 24T 31 N /R W City New Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of Siding System Elevation 95.0 *HRPSameasBenchmark Scale = 1/4" = 10' Lot Line Well o B.M.* B-10 Pro Hangor 2 employees, 1 floor Drain Lot Line B -20 77gpd 3% Slope B-311 Lease lot line, all Airport Rd hangors are owned by the city of New Richmond Catch Basin is not to discharge into septic system, septic system is for domestic waste only! ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTI / FICATION FORM owner/Buyer Mailing Address Cr Properly Address (Verification required from Planning Department for new construction) City/State Parcel Identification Number L LEGAL DESCRIPTION 2 / property Location, � r �-'�/ /4 Sec. Sl� /� _ 1¢rti Lot # /D Subdivision Certified Survey Map # -- ---- -- , Volume -- .Page ---- -. ---- , Page� Warranty Deed # , Volume 11 S pec house ❑yes no Lot lines identifiabl ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle y u p intee m into consists of pumping out the septic tank every three years or sooner, if needed by a licensed Pumper- can affect the function of the septic tank as a treatment stage in the waste disposal system. p owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a The p ve that (1) the on -site wastewater disposal system ma ster plumber, journeyman plumber, restricted plumb or a lic pum ng (if pu m p er nfyng the septic tank is less than 1/3 full of sludge. is in proper operating condition and/or (2) after inspection and pumping (if necessary), s eptic with the standards Uwe, the undersigned have read the above requirements and agree to ta the private sewage Natural Resources, S of Wisconsin. Certification set forth, herein, as set by the Department n ent of Commerce and the Department Offi within 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning ASIGNA hree y expiration date. r DATE APPLIC ANT OWNER CERTIFICATION I we am (are) the owner(s) of I (we) certify that all statements on this form are true to the best of my ( our ) knowledg g • ( ) the property descr above, by virtue of a warranty deed recorded in Register of Deeds Office. DATE SIGNA APPLICANT D arbment. * * * « «« « « « « ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning ep «« Include with this application: as opy o s the r ce rtified deed y map Regi r is made in the warranty deed l HANGAR AREA LEASE THIS AGREEMENT, made and entered into on the date indicated below by and between the City of New Richmond a municipal corporation, hereinafter called the Lessor Matt Jacobson mafter called the Lessee. I 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 Descripti ot 9, Row 1 of the Airport Layout Plan - New Richmond Regional Lease Property equals 6400 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, 2000 and ending on June 30, 2010. t / / SSG / ,• ` f� `\I�j\ / � W / F / z i C 37 � s o w Z_- r . e1F� /i o o �F � J It I s "v —•y I ' °� --�j o 0 U N • I n � ■ o n uJ L-3