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HomeMy WebLinkAbout026-1118-17-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Saf9ty and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 515094 0 GENERAL INFORMATION 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: Flatten, Curtis & Maxine Richmond, Town of 026- 1118 -17 -000 CST BM Elev: Insp. BM Elev: Description: Section/Town /Range /Map No: BM I / 13 db m G 5 01.30.18.697 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Acl Alt. BM F; 0 16k_ 625 c,��QQ I- S /07- 4. Aeration V Bldg. Sewer Holding St/Ht Inlet l � 7 I Al, $ /& Oec St/Ht Outlet % g 16 y-, 0 TANK SETBACK INFORMATION TANK TO P /L, WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. B . /6 . Aeration Dist. Pipe g', 10 /6/ 3 Holding Bot. System 1 4 31160-51 PUMP /SIPHON INFORMATION Final Grade , 79 1 Manufacturer Demand St Cover Z Sg PM C M,15 1i6 10,5 Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length ist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length 1 No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. uid Depth DIMENSIONS '` Z i __T �1_11 SETBACK SYSTEM TO U P/L JBLDG v �WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR EL rhk Typ Of System: r 5 0 �3 UNIT Model Number: once v J 7 DISTRIBUTION SYSTEM Header /Manifgld Distribution x Hole Size x Hole Spacing Vent to r Intak Pipe(s) /b 4- A � 4 Lengt Dia Length Dia Spacing qua SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over 1 xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil"--. E No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1406 174th Ave flew i hmond, WI 54017 (NW 1/4 SW 1/4 1 T30N R1 8W) Willow Valley Lot 17 Parcel Parcel No: 01.30.18.697 1.) Alt BM Description = (^J I �L. ✓�- 4— L_ .5 ` _ D -,, 2.) Bldg sewer length = � -&A � Cu te daf % cx(& L-JI , 7 5a.�•.�S .{� ! .S - amount of cover ' = 1 — C,4— Loo Axe, 7, rl Gk— Plan revision Required? E] Yes SKNO ali Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Sign ture Cert. No. COfl' me1a@.W1.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ��, C, ` ' a n Madison, WI 53707 -71 j� amtary pmnu� 7 � D (to be ed in by Co.) Sanitary Permit Application tate Transaction Number In accordance with s. Comm 8321(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit Note: Application forms for state -owned POWTS are Project Address (ff different than mailing address) submitted to the Department of Commerce. Personal information you provide in be used for secondary purposes in accordance with the Privacy Law, s. 15. 1 m Stats. L Application Information - Please Print All Information Property er's N e JUL Parcel # S p Property Owner's Mailing Address Property 7a oc� P VINNMVG e O COIJNTy Govt. Lot City, State Zip Code Phone Number O FFICE n W y., S VJ /,, Section I � 0 W� � � � `(1 S 1 v (circle one) EL Type of Building (check all that apply) Lot # T3 N; R w 1 or 2 Family Dwelling — Number of Bedrooms I ] S�u"bd�ivis* n Name ,) \ Block #! l v� 1� ow V o 1� `f? PubliclCommerciai - Describe Use � � �.. City of P7011 - Desedbe Use - M Number ❑ Village of I ® Town of in fete line B if a A New System Replacement Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) System B. F1 Permit Permit Revision Change of Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Expirat IV T ype of POWTS System/Component/Device: Check all that a 1 Non- Pressurized In -Ground LJ Pressurized In- Ground U At -Grade U Mound > 24 in. of suitable soil 11 Mound < 24 in. of suitable soil Holding Tank ❑ er al Componen xpi ' ❑ ent Device (explain) V. DiiiiersallTreatment Area Info ation: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) DiispersAArea Proposed (sf) System Elevation 150 1 15 o 0 1 1 0 0 8 , 9 o �2 VL ank Info Capacity in Total # of Manufacturer , Gallons Gallons Units U y New Tanks Existing Tanks x oldmgTank �0© 000 UJ °,� 1 ( S Dosing Chamber Li Li Li VIL Responsibility Statement - I, the undersigned, assume r po 6ty for installation of the POWTS sh the attached plans. P bet's Name Off Pl 's Si M#1 RS umber Business Phone Number r I 5 1 Plumber's Address (Street, City, State, Zip Code) Coun /De artment Use Onl Approved _ Disapproved Permit Fce D7 Iss Sr _Owner Given Reason for Denial S 7 Aj�� DL Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as er manag ement plan provided by plumber. 2. All setback requirerAt ~b l and submit to the County only on paper not less than g W z 11 incites in size as per applicable code /ordinances. SBD -6348 (R. 01/07) Valid thru 01/10 \ a t Rot R � N w \f� Ste; �I,� s, j T 3p u IQ I W f sT e W � QR C� W"O n � I W� s y U 17 �� o w V a� �� o� 17 Iqo�a 10 ®0 ;e., c,�,�s� �pb� (ok S�5 �� ►� ; c�1� �Icx�l - �b - /aa mo . Ys 1 aa0 7 / — O �bt� 8rn f Iv > i on' c c `IMP ;c psti@ ot( lbL 4 A lT Brr C� ro.: n a suv�w�. N X`( To ico" 1 G_ / 1 /x3 �. /07' r ° Ds 9L '(n 3 "7 Ecopy 0 , C.r f 1 i ts S EZ'1203H 440 96 PP `�> � ,� � .POPPPO POPPOPP OPTPPPO vvs "�_ vvvPPPV it PPP `.'r w ... •., a 71� TP4. 12 `t, PvOP ,'�'. t;� ' � ^_ A � POT 24tt } PPP ' - .'"t!., •_., ..4� PTO VV 4 W V V Ir IV 11 4.625" v e Pve PeP 1 it 1/2 Circ. = 18.84" P o !v. v OPi O:PP vvv •oP PPTP V v • PPeV WW T .- -VVvvvvv VT. PO PPTPO PBeVVVW ..b TPPPV!l.PVV PeVPVVW P PPPT.V PVPVTP TTiV.e.- --- --24 s Bottom 36 Void Volume Soil Interface Ares }n- 12 Ft. E, Void Coefficient in A99MPIC given at 57.4 %. Sidewall (2 SidGwalls) 2. l 8 8 nin = 3.14 t2ig O.D, of 4" pipe = 4.625 inches iR 2.3t25in Bottom 2.00 Void volume per linear ft. = 3.14 • tfr = 0.117 ft' 12"m /fr Total Soil interface Area S.1 SQ. - O.D. of rsntercyiinder =1'2.5 inches Void volume in a 6 • .3125io . ggregateofcentercytinder =�3.ta 6.25i •�t2inlft) -3.14 2 (t?mtft ): S7a =..422 fY O.D. OfOuts de cylinders- 12 inches Projected Trench Area Void volume in outside eytindcm = 2.3.t 6m l 574 -.901 ft' Sidewalt Height= 1z in. "2 - 2.00 Sq.Ft. �12in/t1J Bottom = 36 in. - 3.00 Sq.R. Void volume at bottom between cylinders : t2ix �( 24i. bin )_(3 1 Gam l t ft 12in i fr i2ia 1 ft �,,} = 0.215 fe Projected Tre tch Area = SAO Sq.FL Void volume at outside bottom corners (112 of void volume between cylinders) 0.215 ! 2 = 0.108 fe Total void volume - 0.1 17 + 0.422 + 0.901 + 0.2 t 5 + 0.108 ffi 1.763 cubic ft t ft Gallons per ft = 1.763 X 7.48 = 131 cations Per linear ft. EPS Aggregate Trench System EZ1203H R ing ­lndustrial Group 65 InduWlcl Park Rd. Qakfand, TN .18060 ' SCALE FILE kAmb EZI2AJH - vat SHM. i of 1 11-27-01 I Rot fAc v\ W \[� S, , 301J I w `lay eo�,rt R ©�� �• m ®n�. /s T e r t s 1 1��o Ual�� y o� l 7 I L{o �a 1 *7y IOoo ;(.. c.9��s��1 p�t lok sus �� ►� ; Ool� —�0�1 vZ - I r p- v\cv4- t Q /Oo .its 1 / _ o NbLfl� /D ?' C , f x > CIO / Q A4 /oN c o. n ^, 3 �°�` Wisconsin Department of Commerce SOIL AND SITE EVAJ.UTfQN Page 1 of 3 vision of Safe' and Buildings �,. � � � �' g in accord with Comm 83.9K,,1E". -.(�o, t�;�„ .. Environmental By Design Attach complete site plan on paper not less than 8% x 11 inches in size. Plan i un aA include, but not limited to: vertical and horizontal reference point (BM), directl /� ^ .,� $t. Croix percent slope, scale or dimensions, north arrow, and location and distance t est roa APPLICANT INFORMATION - Please print all informafio R By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. (1) (m)). I / Property Owner rty LocatWUNre Derrick Construction Lnc... ZONINGCj /A 1/4 S 1 T 30 N,R 1R W Property Owners Mailing Address Lot / Blgc . #..; me or CSM# 1505 14wy 65 Willow Valle City State Zip Code PhoneNumber City ❑ Village ®Town Nearest Road / Vd 7 New Richmond W1 54017 Richmond I 140Th St. ® New Construction Use: M Residential / Number of bedrooms 3 ❑Addition to existing building �— j Replacement ❑ Public or commercial describe :1:::t C I- 'V G'''_'t Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpolfts 6 trench, gpolft Absorption area required 900 bed, f1 750 trench, ftz Maximum design loading rate .5 bed, gpdff .6 tr ench, gpdffP Recommended infiltration surface elevations) 101.38 ft (as referred to site plan benchmar Additional design / site consideration system could be installed at a depth of 100.45 using infiltrators at a loading rate of .7 & .8. System area 1, 2, 3 Parent material Loess Over Glacial OutWash Flood plain elevation, if applicable na ft S= Suitable for system Conventional Mound In - Ground Pressure AT - Grade I System in Fill Holding Tank U= Unsuitable for system Z8 u U 0 S El u I u S Z U N S u U I u S N U ❑ S 0 U SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Texture Structure Consisten Boundary Roots GPDfft= Boring# I In. I Munsell I Qu. Sz. Cont Color Gr. Sz. Sh. I I Bed Trench i 1 0 -6 10yr3 /2 - sil 2msbk mfr cw 2f 5 6 2 6 -12 1Oyr4/4 - sil 2msbk mfr cw if 5 .6 Ground 3 12 -20 7.5yr4/6 - 81 2msbk mvfr cw - .5 .6 elev 104.48 ft 4 20 -26 1Oyr4/6 - cs Osg ml cvv - 7 8 Depth to 5 26 -5 7.5yr4/4 - ES, 2msbk mvfr cvv - 5 6 limiting factor 6 50 -90 7.5yr5/4 _ s Osg n' - - 7 .8 g� _. Remarks : "J_�e 77 7 n 777 7 % ; S 2 .': 1 0 -11 10yr3 /2 - sil 2msbk mfr cw 2f .5 6 2 11 -23 1Oyr4/4 - sil 2msbk mfr cw if .5 .6 Ground 3 23- 7.5yr4/6 - sl 2msbk mvfr cw - 5 .6 elev 104.95 ft 4 33 -96 7.5yr5/4 - s Osg nd - - .7 .8 Depth to limiting factor >96 Remarks: CST Name (Please Print) Signature: Telephone No. Thomas C. Nelson 715- 246 -2454 Address Environmental By Design Date CST Number Ref # 1432 120th Street, New Richmond, WI 54017 1/20/99 227387 189 PROPERTY OWNER: Der ick Construction Inc. SOIL DESCRIPTION REPORT tss Pa 2 of 3 PARCEL 1.104 Environmental By Horizon Depth Dominant Color Mottles Texture Structure nsistence Boundary Roots GPDZnencch in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed 3 1 0 -10 10yr3 /2 - sil 2msbk mfr cw 2f 5 6 2 10 -25 10yr4/4 - sil 2msbk mfr cw if 5 ' .6 Ground elev 3 25 -39 7.5y74/6 - sl 2msbk nr& cw - 5 6 104.65 It 4 39 -92 7.5yr5/4 - s Osg ml - - .7 ? .8 Depth T limiting fador >92 Remarks: 1 0 -9 10yr3 /2 - sil 2msbk mfr cw 2f .5 .6 - 2 9 -24 10yr4 /4 - sil 2msbk mfr cw if .5 .6 Ground elev 3 24 -44 7.5yr4/6 - cs Osg ml cw - .7 .8 104.65 It 4 44 -92 7.5yr5 /4 - s Osg ml - - .7 .8 Depth to limiting factor >92 Remarks: 5 1 0 -13 10yr3 /2 - sil 2msbk mfr cw 2f .5 .6 2 13 27 1Oyr4 /4 - sil 2msbk mfr cw if 5 .6 Ground elev 3 27 -55 7.5w4/6 - is Osg ml cw - .7 .8 104.01 ft 4 55 -92 7.5yr5 /4 - s Osg ml - - .7 .8 Depth to limiting factor >92 I I I I I I ! I I Remarks: Ground elev Depth to limiting factor Remarks: . ; - • E BY DE 51G N 1432120th STREET, NEW RICHMOND, WISCONSIN Last saved by Thomas Nelson 715 - 246 -2454 Willow Valley ; ` PAGE 3 NW % SW %, SECTION I T 30 N. R 19 W TOWNSHIP Richmond COUNTY St. Croix Wisconsin A l� b� 1 to 4 � \�� b qq ' 1 V _ -TO bJ n f� w SCALE 1" =40 Tom Nelson BM 1. NW LOT CORNER Top of iron pipe ELEV. 100' V 227387 BM 2. Ground surface next to wood lath w/ ribbon ELEV 102.65` s Parcel #: 026- 1118 -17 -000 10/06/2005 12:55 PM PAGE 1 OF 1 Alt. Parcel #: 01.30.18.697 026 - TOWN OF RICHMOND Current X! ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - FLATTEN, CURTIS E & MAXINE CURTIS E & MAXINE FLATTEN 1724 CTY RD A NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 1406 174TH AVE SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 1.748 Plat: 2633 - WILLOW VALLEY 1 99 SEC 1 T30N R18W PT NW SW WILLOW VALLEY Block/Condo Bldg: LOT 17 LOT 17 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 01- 30N -18W Notes: Parcel History: Date Doc # Vol /Page Type 04/08/1999 600908 1417/227 WD 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/20/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.748 29,100 0 29,100 NO Totals for 2005: General Property 1.748 29,100 0 29,100 Woodland 0.000 0 0 Totals for 2004: General Property 1.748 29,100 0 29,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 12/04/1998 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ Lm Mailing Address Z - (��t t- � � j �A i , �.�yy V-1,C. }rvt b tL Q Property Address 1 4 10 k. 0 `1 AAYE (Verification required from Planning & Zoning Department for new construction.) City /State D- [.Cart MO t � \ &4arcel Identification Number o J LEGAL- DESCRIPTION J 1 O . ��17 Property Location V4" / , 4 �W '/4 , Sec. , T ' N R 1b W, Town of �I t rvi ° �_k® Subdivision \N, t � � w �� y.�'�/ Lot # 1 . Certified Survey Map # , Volume , Page # Warranty Deed # 6 IqD , Volume [ 4 , Page # ZZ� Spec house yes no Lot lines identifiable yes no I, SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix . County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 ro er operating condition and/or after inspection and in if necessary), the septic tank is P P F g 2 () P PAP g( rY) P less than 1/3 full of sludge. I/we, 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number bedroo SIGNATURE OF APPLIC (S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if referenceas_made_in the warranty deed. (REV. 08/05) POWTS OWNER'S MANUAL & MANAGEMENT PLAN P age I o f FILE INFORMATION SYSTEM SPECIFICATIONS Owner c s Septic Tank Capacity al E3 NA Permit # Septic Tank Manufacturer �, �,-, ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer �a ❑ NA Number of Bedrooms 3 0 NA Effluent Filter Model L 5 0 NA Number of Public Facility Units NA" Pump Tank Capacity a l 13 NA Estimated flow (average) 3 p al/dl Pump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5} A4 s a t /d Pump. Manufacturer NA Soll Application Rate i....> al/day/fe Pump Model NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit POA Fats, Oil & Grease (FOG) 530 mg /L 0 Sand /Gravel Fitter 0 Peat Filter Biochemical Oxygen Demand (BOD 5220 mg/L 0 NA O Mechanical Aeration 17 Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfect= 0 Other; :P_Le3r[eMed-Ef8uentQu eltf -- Biochemical Oxygen Demand (BOD 530 mg/L r Ground (gravity) !0 In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L NA 0 Mound Fecal Coliform (geometric mean) < fu /100m1 ❑ Drip -Line 0 Other: Maximum Effluent Particle Size Y in dia. 0 NA Other 0 NA Other ❑ NA Other DNA * Values typical for domestic wastewater and septic tank effluent. Other O NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: months) ear(s) (Maxknum 3 years) 0 NA Pump out contents of tank(s) When combined sludge and scum equals one -third IY of tank volume 0 NA D Inspect dispersal cell(s) At least once every: months) yearts)., (Nlauciuruum 3 years) ❑ NA Clean effluent filter IV;G1� At least one every: o month((}), 0 NA yearls) 0 month(s) Inspect pump, pump controls & alarm At least once every: 0 NA D year(s) 0 month(s) Rush laterals and pressure test At )east once every: 0 yearts) 0 NA Other. At least once every: E m ye ar(s) 0 NA Other: . ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licensee or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS inspector; POWTS Maintainer Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a- failing condition( and requirw1he Immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servucing of effluent fliers, mechanical or pressurized components, pretreatment Z . and an s shall be performed b s A service report shelf provided tothe local regulatory authority withirn i 0 days of crornpletion of any servk:e event. Page -a—,of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of .pang products or other.chem that may impede the treatment process and/or damage the dispersal cell(s). H high torrcentr ors are detected have the cow of the tank(s) removed by a ssptage servicing operator prior to use. System start up shat( not occur when sod conditions are frozen at the 'infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be d" . . god to the dispersal co(s) In one large dose, overloading the call(s) and may result in the backup or. surface urge of effluent. To avoid this situation have the contents of the .pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Mantainer to assist in manually operating the pump control 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 sal absorption area. Reduction or - elation of the following from the wastewater, stream may improve the performance and prolong thelfe of the POWTS: antibiotics; baby wipes; cigarette bunts coigns; cotton swabs: deareasers; dental floss; diapers; disinfectants: fat: foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grew; herbicides; meat scraps; madications; oil: pasting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls and /or is permanently taken out. of service the following steps shall be taken to insure that the system is property and safely abandoned In conmptiance wig chaptef Caron 83.33. Win_ Administrative Code: • All piping to tanks -and pits shag be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, ail tanks and pits shah be excavated and removed or their covers removed and the void space filled with soil, grave( or another inert solid material. CONTINGENCY PLAN If the POWTS fails anti cannot be repaired the following measures have been, or must be taken, to provide a code compliant system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system; The replacement area shookl, be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot.Cnes -and wells. Failure to protect'the replacement area will remit in the need - for a new soil and site evaluation to estab8sh s.suitabie replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soft limitations. Burring advances In POWTS technology a holding tank may be Installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation riost be performed to locate a suitable replatamernt area. if no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade sod absorption system may be reconstructed In pie following removal of the blomat at the I : surf ace. Recor of out syste c rules:m.ef ict_atthatt&ne, - < <WARNING> > SEPTIC. PUMP AND OTHER TREATNIENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICiEIT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TRFATMENT TANK UNM ANY CIRCUMSTANCES. DEATH MAY RESULT ftESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE._ ADDITIONAL COMMENTS POWTS MST POWTS MAINTAINER Name rS Name Phone 1 -7 mom SEPTAGE SERVICING OPERATOR (PUMPER} LOCAL REGULATORY AUTHORITY Name Name Zp n Phone Phone 'nos document was drafted in =npliance with chapter Comm 83.22(2)(b)(1)(OW) and 83.54(1), (2) & (3). Wisconsin Administrative Code. VOL 141. I'PAGE227 v WARRANTY DEED G►C7U'9[7$. ' STATE OF WISCONSIN — FORM 2 KATHLEEN H. WALSH REGISTER OF DEEDS DOCUMENT NO. ST CROIX CO., WI it RECEIVED FOR RECORD This indenture, Made this 7th day of April A.D., 19 99 ii 04-08 -1999 10:00 AM between Wm. Derrick Construction, Inc. j WARRANTY DEED a Corporation duly ii EXEMPT 11 organized and existing under and by virtue of the laws of the State of Wisconsin, located at i! CERT COPY FEE COPY FEE: New Richmond Wisconsin, party of the first part, and TRANSFER FEE: 75.00 Curtis E. Flatten and Maxine J. Flatten, husband and if RECORDING FEE: 10.00 wife, as survivorship marital property PAGES: 1 I! part ies of the second part. Witnesseth, That the said party of the first part, for and in consideration of the sum of j! to it aid b the said art ies of the second art, the receipt whereof is hereby confessed " THIS SPACE RESERVED FOR RECORDING DATA _- P Y P P P Y j and acknowledged, has given, granted, bargained, sold, remised, released, aliened, conveyed j NAME AND RETURN ADDRESS and confirmed, and by these presents does give, grant, bargain, sell, remise, alien, convey and confirm unto the said part ies of the second part, their heirs Curtis E. Flatten and assigns forever, the following described real estate, situated in the County of 1 1724 County Road A New Richmond, WI 54017 St. Croix State of Wisconsin, to -wit: !i i; i! ii X21 C11 Nom- P�' c�- 026-1 PARCEL IDENTIFICATION NUMBER OZ6 -llig t� Lot seventeen (17), Plat of Willow Valley in the Township of Richmond, St. Croix County, WIsconsin (IF NECESSARY, CONTINUE DESCRIPTION ON REVERSE SIDE) Together with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said party of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. To have and to hold the said premises as above described with the hereditaments and appurtenances, unto the said part ies of the second part, and to their heirs and assigns FOREVER. And the said Wm Derrick Construction, Inc. party of the first part, for itself and its successors, does covenant, grant, bargain and agree to and with the said part ies of the second part, their heirs and assigns, that at the time of the ensealing and delivery of these presents it is well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all incumbrances whatever, and that the above bargained premises in the quiet and peaceable possession of the said part ies of the second part, their heirs, and assigns, against all and every person or persons lawfully claiming the whole or any part thereof, it will forever WARRANT and DEFEND. In Witness Whereof, the said Wm. Derrick Construction, Inc. party of the first part, has caused these presents to be signed by William H. Derrick its President, and countersigned by Mary Ann Derrick its Secretary, at New Richmand Wisconsin, and its corporate seal to be hereunto affixed this 7th day of April A.D., 19 99 SIGNED AND SEALED IN PRESENCE OF Wm. Derrick Const ction, Inc. Corporate Name President William H. Dery.,ick COUIy,TED: {i Secretary ar Ann Derrick State of Wisconsin, ss. St. C roix County. Personally came before me, this 7th day of April A.D., 19 99 William H. Derrick President, and Mary Ann Derrick Secretary of the above named Corporation, to me known to be the persons who executed the foregoing instrument, and to me known to be such President and Secretary of said Corporation, and acknowledged that they executed the foregoing ' strument as such officers as the deed of said Corporation, by its authority. NEIDI L. DILLEY ' Notary Publio THIS INSTRUMENT WAS DRAFTED BY r Wm. Derrick Construction, Inc. NAR Heidi . Dilley New Richmond, WI 54017 Notary Public, St. Croix County, Wis. My commission (expires) (Q1 March 24, 2002 (Section 59.51 (1) of the Wisconsin Statutes provides that all instruments to be recorded shall have plainly printed or typewritten thereon the names of the grantors, grantees, witnesses and notary Section 59.513 similarly requires that the name of the person who, or governmental agency which, drafted such instrument, shall be printed, typewritten, stamped or written thereon in a legible manner.) STATE OF WISCONSIN Wisconsin Legal Blank Co., Inc. WARRANTY DEED — By Corporation Form No. 2 Milwaukee, Wis. ' 1 I 1 WI VAL 1 SAM L L --- — — -- -- — 2 N 15 14 •y �1 18 a 17 _ 96 ,.e .� Am :a AC n Lt Ie Aar BAMMXZI 2 4W � Ell �_ sa AM ._ to co ._ .__.._ 36c• 252' �s