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HomeMy WebLinkAbout026-1121-16-000 Wisconsin of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix Safety and Bui;dinq Division INSPECTION REPORT Sanitary Permit No: 408203 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: / Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. � Permit Holder's Name: City Village X Township Parcel Tax No: - 7 Halle Builders Inc. Richmond Township 026 - 1121 - 16-000 CST BM Elev: Insp. BM Elev: I BM De cription: 16 -0 �(�n TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing /) Alt. BM 16 /asp Aeration Bldg. Sewer � • /lo Holding St/Ht Inlet . f0 TANK SETBACK INFORMATION St/Ht Outlet ,I)O• TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet D7' Septic 2 3 3 i I / Dt Bottom Dosing J a e /Man. Q� �p � Aeration ist. Pipe O.f.t Z I o yq.r�1 Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover M Model Nmb er i" j /� a � • TDH Lift Fr n Loss System Head TD Ft Forc Length ia. Dist. to SOIL ABSORPTION SYSTEM BEDITRENCH Width f y, Len th No. Of Trenches PIT DIMENSION No. Of Pits Inside Dia. Liquid Depth DIMENSIONS J / 3 SETBACK SYSTEM TO I P /LS JBLDG WELL/,,p; LAKE /STREAM LEACHING Man ctur/er� nt INFORMATION CHAMBER OR �7 Ty e„pf System � � � 7 UNIT Model Number. DISTRIBUTIO / N SY - : ;1 / / 3 4 3 Header /Manifold JlDistributio5j I x Hole Size I x Hole Spacing Vent t Air Inta Length ke � y PipeSpacing - s) � Dia Length �/ �— 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 lBed/Trench Center I ,� Bed/Trench Ed es To soil ' –� g p Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: X3 1 U Inspection #2: / / Location: 1714 107th Street New Richmond, WI 54017 (SW 1/4 SEE 114 5 T30N R18W) Partridge Run Lot 16 Parcel No: 05.30.18..73311 1.) Alt BM Description= sT �VG 2.) Bldg sewer length = - amount of cover O.� 3& Use other for additional information. Plan revison Re quired? Yes Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) of t o 2/ e9 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 NViscons Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce it (Subm completed form to county if not [Privacy Law, s. 15.04(1)(m)j state owned.) Attach complete plans (to the county copy only) for ystem, on paper not less than 8 -1/2 x 11 inches in size. County ani Permit Number heck if revision to previous application State Plan I. D. Number I I. Application Information - Please Print all InforjnatioWECE1Vi=n I Location: d T. Property Name Property Location �/p� �.O 4V 1/4 X.. 1/4, S .S T30 ,N, K/ E (or Property Owner's Mailing Address Lot Number Block Number m G y ST. CROIX COUNTY �la City , State Zip Code n mber I Sub 'vision Name or CSM Number Type of Building: (check one) (J ❑ City JX I or 2 Family Dwelling -No. of Bedrooms : ��2W �'( ❑Village ❑ Public /Commercial (describe use):_ �c� ATown of ❑ State -Owned 1 I&r) - Q� , 7 3} 7 g 3 9 Nearest Road /0 7 os Wj r � Y Oyt� - Gv 1!9 3 Parcel Tax Numbers) 6 Ill. Type f Permit: (Check only one box on line A. Check box on line B if applicable) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to Sys System Tank Only Existing System Q Permit Number Date Issued WA" Sanitary Permit was previously issued J6 1e 7A F W IV Type of POWT System: (Check all that apply) G( Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ar,+/1 ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line -3 ❑ At -grade ❑Aerobic Treatment Unit 3 ❑ ❑ Ot e V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6.S Elevation 7. Final Grade Required -Proposed ✓ Rate (Gals. /day /sq�) (Min. /inch) y Elevatiop !�/•�-� "/ / /Zs' /'�G� VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks w lc � ❑ ❑ ❑ 11 ❑ VIII. Responsibility Statement I, the undersigned, assum responsibility for installation of the POWTS shown on th d plans. Plumber's Name (print) PI nature ps): Business Phone Number �� 1 71-5 - -.2�8= ko377 Pl umber's Address (Street, City, State, Zip Code) �7- Ad S7r 40i 1,✓ S O0 IX. County/Department Use Only i ,; l 641 C 0 Disapproved Sanitary Permit Fee (Includes Groundwater DaNIssued ssuing Ag5pt Signa tamps) ' pproved ❑Owner Given Intttal Adverse Surcharge Fee) Determination X. Conditions of Approval /Reasons for Disapprpval: SBD -6398 (R. 07/00) 7 - 3 0, „ j I �I _ s% I � I J � OF OAF - 99 - �- I_ I j _ I I I � I I I a i I J _J f I �— �1 • � � I I I j I I I J i I l I I i I ' I I I- - -� 1 1 I IN N ' r J I 1 IED• Ate up aSt� i i i I - - j roy, v A b e , - Abv p � T �s�GGu IAg COD i 'I q' ,I : I I I I i t I i I : i I I I I I i i I i i "L s a I i I I i I I I I I I I I : 11 I I I r I I I I I I I r r I ; r ! I - - -i -- - � I I it i L I Yl I i I I i I r i ' I : : - I f 1 I I i : i� ' I I I I I e t I �II II ;!', � I �I I !, � I � II►1I 11 - � X11111111111,.,, I�.� 1 1I'�I II!�Illlll�hillhll'lllll`I I' I i � � umno��nim !nm 'JI,I I II� IIIIII, "III ��I ■■ '` 111 II! d� Ill' ' � 11�IN� 1= I 1I1I'll!II. !!I fi�, ICI Ii► - Il��. 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Washington Ave. See reverse side for instructions for completing this application PO Box 7302 14scons Personal information you provide may be used for second purposes pP Madison, WI 53707 -7302 [privacy Law, s. 15.04 Department of Commerce ()( 1 m )) (Submit completed form to county if not 7 — O Z 35 1 state owned.) Attach complete plans (to the county copy only) forth gss than 8 -1/2 x 11 inches in size. County State Sanitary Permi NNumber ❑ Chec if revREOW150icatior State Plan I. D. Number I. Application Information - Please Print all Information Location: l'7 J /07 S7 Property Owner Name JUN 2 1 2u,07 Property LocatUo && &AL I ST 0 1/49 1/4, S S - T,36,N, IrE (or)(0 Property Owner's Mailing Address / ZONING OFFICE Lot N umber Block Number 7 A City, State Zip Code Phone Number Subdivision Name or CSM Number Type of Building: (check one) / 38,Q,� ❑ city ML 1 or 2 Family Dwelling - No. of Bedrooms: ✓ / sd� tTown of ❑Public /Commercial (describe use):_ &/ ❑ State -Owned y r�Z �HEr W y q Ta 7� ci s 3 / X So 9- 3 x (v P Neatest Road 167 Parcel Tax Number(s)©,6 —#,-, _ r III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. (gNew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ' B 3/ Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass Drip Line ' ❑ At -grade ❑ Aerobic Treatment U ' R ircul V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. Syste Elevation 7. Final Grade ao Required roposed Rate (Gals. /day /sq. .) (Min. /inch) gcJ, pq L Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing G(/ /Z 1m crete structed Tanks Tanks S /boo 7 -L I ---- I r 1-1 0 0 0 -- 11 VIII. Responsibility Statement 1, the undersigned, assume responsibility for installatio of the POWTS shown on d plans. Plumber's Name (print) Plum stamps): RS No. Business Phone Number Da,4,�r,. ajk � Z�1 Plumber's Address (Street, Ci State, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Is c ent Signature ps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination ao� 5 • �� D L X. Conditions of Approval /Reasons for Disapproval: 1) 13 1!1 LbEv 7b ee Vl DE �&M ED Wt1 w/ AU M3' - aWt fi U- sTCCZAw lGlL11 s-1Z.- � Rtme 7A-6J4 cry -SC4- 4ig'Dut.;w— t4 PeP- M -K. 5ftt%- 2) A-r f,XMaieeS . - XM /N #J tA g6`Suj - *,q a r-04 A SN4l1.dt.�E7� rR�r� sysrsm for n vS 7 74a Sm. iNr�rc -� � eaT J2 Nj ,/. —50,1e- A70R or— G��SP°��� sric.c� SBD -6398 (R. 07/00) s _ e n i „ o Cp. = y 771 2. 3 _¢,,,� go 'toy ✓ Sw col Olt Ilk F3 AU /o r . �t 1D r© ms�0 O c �� w Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County S t 7C 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 Parcel I.D. / percent slope, scale or dimensions, north arrow, and location and distance to nearest road. oa 6 -- I I a' — A� Please print all information. evie ed by ' Date Personal information you provide may be used fors Gonda 29 w, s. 1 5.04 (1) (m)). Property Owner Pr erty Location Po / pp . 4? Ite Q U I � � ( Go t. Lot r ,,,,t' W 1/4 r J� 1/4 S T .30 N R I $ E ( ) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM 1 11 6q ST. CROIX C00N i'Y I LL— l - fr;J t IS(,1y) City Sate Zip Code hone City ❑ Village (j Town Nearest Road �� iJ.,e W► 5yo�? ('715) 2Yh - 6a1 _ t`AMO 1 b -r S-t New Construction Use: Residential / Number of bedrooms - Code derived design flow rate q 50 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material 4 ?1 - , a T .. I t Flood Plain elevation if applicable ft. General andrecommen n - -t .3" S'u '75 j REIVGI, S For ea.c.t, 5 ale ; and recommeT r(.94 g� ) �' - T, 3 � 98.$7') (�A7Kr�a� ; F Si4e-1; - r•a ( 1 9.v0 614 Z : - r 4 ( 98,50 T,3 C 99. Q3') - t;5 C'S,10 11cc F / I Boring # ❑Boring Pit Ground surface elev. �Q4, ft. Depth to limiting factor 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 l a -� to qR� L. F� s a s F , y !� 9 - 7�5 IR'` '� S y ms�3K S w I F -3 30 - 7,5 Vy14 S a F58 9 85 W j uE . .9 � P1 Boring # ❑ Boring X Pit Ground surface elev. 011 ft. Depth to limiting factor S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 i s -9 10 �I R YA - - L o?P&R s (fit 5 o? F 5 , s q -33 5 'l A qIV L 3F58k d CW .5 .9 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 _< 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print Signature CST Number 17 4/i Address Date Evaluation Conducted Telephone Number a716 cM An( LftN gal 54024 &0-6 1 X 15 - a y S - 3,5gg SBD -8330 (R07 /00) Property Owner Y4 ir4 I t e /3U; N err Parcel ID # Page o� of F3-1 Boring # Boring / 0 D Pit Ground surface elev. ' D 345 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0- it, Io4 3 1a L, JF&,R d s as aF a io- ib a y 5 14 L .$ 3 16 - 1 yR wl't - '4e; "y KAW 11VF .s .$ ❑ Boring # ❑ Boring p Pit Ground surface elev. /02 I ft. Depth to limiting factor 7 Q in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 -ia ) 6 y j e 31.q SL r ds O's F 1 .S ,9 a )9-3 10 y' 3 5 L ar56K 5 W 1 F . 5 ►°I 3 3q- 5 qR SL I rsal< L4 • b ON. 2 .2'' o 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 GPD1ft 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 < 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.07 100) I 5 W Y SE Y-1 Sot.. s, T 3 0 k), iR. l$ YQ t /, b c L/ a c r c. C 5-t' t" o1 a 17 .1 Co T � a-t- -�oe �M 1 Sv -r of Nw Cor Ql BM Svrv 5t o + n o pt^ � a � \ J r s c 3 s' i �p 0 +M Io3,87 1 yoo.y9 63 /o3-9S' I o� • l�� � �`� i ba.QS � r 01/08/01 MON 16:30 F_AX 715 386 4686 ST CRX CO ZONING Z 002 ST CROIX COUNTY SEMC TANK MAINTENANCE AGREEIVffiN ` AND 1 ,� OWNEI smp CBRT�CA=N FORM Owner/Buyer /.0 maivn Addre ///3 - - - Properly Address _ (Verification required from Planning Department for new cvustructivn) „_ . City /State Parcel Identification Number LEGAL, D ESCRIP, TION Property Looatl %-� L V;, Sec. S' ',C z! N 1t -W, Town of Subdivision eat # Certffied Survey Map # . Volume _..,.. ,.Page 4 Warranty Deed # , Volume Page's _ �— Jot —I6 �Gba Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ uk g Kg= MAE TENANCE Improper use and mainteaanceof your septic system could =Wt in its premature fa me to bud e wastes. Proper maiutcoance cimsists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. ' That you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal systc= The property owner agrees to submit to St, Cmix Zouitig Department a cettWcation form, s gk..icd by the owner and by a mastorplumber, J=uoymau plumber, mstdoW plumber or a hcensedp=perverb mg that (1) the on-A v wastewater disposal system is is proper operating condition and/or (1) after inspection and pumping Cif pessary), ft septic tank i ; less than 113 full of stodge. Uwe, the undmigaed have read the above requirements and agree to nmintaim the private sewage diq is �a.1 system with the standards set &4 hereia, as set by the Department of Commerce and &a Department of Natural Resources, Stmt ; of Wisconsin. Certif=6011 stating that your septic system buss been maintained must be completed and returned to the St, trobu C-o Mty Zaairlg Office widdU 30 da of the throw iration date. 7 i�z� az C*NAVM P APPLICANT DATE oYMR CE 11CATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. (we) am (are) the owner(s) of the pwpetty described above, by virtue of a warranty deed recorded in Rz&tcr of Deeds Office. 1 l SIGNATURE OV APPLICANT DATE *•s' *�` Anty infonmdon that is mis- represented may result in tbo sanitary peruat being revoked by flit ?AMing Department. * "' #"" �« lnelude with this application: a stamped warranty deed from the R,egigter of Deeds office a copy of the certifiied survey map if reference is made in the wan tuty decd i I ST CROIX COUN'T'Y SEPTIC TANK MAINTENANCE AG REEMENT AND OWNERS CERTIFICATION FORM OwnerBuyer �P G L'� L k e (� 1 n c- Mailing Address 3 4 w u ` I Mao I C J K l C f }rl o tJb , LL S `/U I Property Address le nn II (Verification required from Planning Department for new constructio City /State I e�w �� o t C ") Parcel Identification Number D2a " 117- A LEGAL DESCRIPTION Property Location ' /., S ' /., Sec. S , T N -R W, Town of 1G 1'1 M D M Subdivision ?n- 4T�-\ a t� , Lot # I Is Certified Survey Map # , Volume , Page # Warranty Deed # ,CJ /0 3 , Volume ' � � Page # � Spec house ❑ yes g no Lot lines identifiable 0 yes ❑ no SYSTEM MAINTENANCE 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 masterplumber, journeyman plumber, restricted plumber or a licensed pumper 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 of the three y ear expiration date. l4'v �—J LQ / ZO 162 NA 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 the property des cribed above, by virtue of a warranty deed recorded in Register of Deeds Office. (�O l ?0 / U?- GNA OF APPLICANT DATE * * * *** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. *« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of 'l am FILE (NFORMATJOIq A SYSTEM SPECIFICA Owner Septic Tank Capac /6'0 al ❑ NA Permit # a Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Man ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model ®a ❑ NA Number of Public Facility Units .. �' A Pump Tank Capacity a l ❑ NA Estimated flow (average)a al /day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) y�C7 gal /d2 Pump Manufacturer ❑ NA Soil Application Rate gal/day/# Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil & Grease G) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD <220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L A ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: El NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every; E3 month(s) (Maximum 3 years) 11 NA O0 ear(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y�) of tank volume ❑ NA Inspect dispersal cell(s) At least once eve 3 ❑ month(s) (Maximum 3 ears) ❑ NA P P every: � year(s) y Clean effluent filter At least onc4Q every: ❑ month(s) ❑ NA ovg year(s) Inspect pump, pump controls & alarm At least once every: ❑ mo 13 ye ar(s) ) ❑ NA Flush laterals and pressure test At least once every: ❑ month(s) 0 NA ❑ year(s) Other: At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses 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 requires the 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 servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page 2 '0 f START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil 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 discharged to the dispersal cell(s) 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 Sept+3ge Servicing Operator prior to restoring 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 or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Ali piping to tanks and pits shall 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, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS ails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replaceme 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 wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable 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 soil limitations. Barring 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 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. ❑ Mound and at -grade soil absorption systems may be reconstructed in place fallowing removal of the biomat at the infiltrative surface. Reconstructions 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 OXYGEN. 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 E e m ��f f S 'A Name ne 7!L' 6L G4 T Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone Or 6 — 7 "6 p0 This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1 1, (2) & (3), Wisconsin Administrative Code. 1452PAGE 609363 KATHLEEN H. WALSH DOCUMENT NO. State Bar of Wisconsin Form 2 -1982 REGISTER OF DEEDS ST. CROIX CO., WI WARRANTY DEED RECEIVED FOR RECORD O6-27 -1999 9.15 AM YARRANTY DEED Wesley W. Halle and Linda R. Halle, husband and wife, convey C COPY FEE: FEE: 15 and warrant to Halle Builders, Inc., a Wisconsin corporation, the TRANSFER FEE: following described real estate in St. Croix County, Wisconsin: RECORDING FEE: 10.00 FADES: 1 Halle Builders, Inc. 1113 Highway 64 New Richmond, WI 54017 Parcel ID No. 026 - 1019 -10 -000 The Southwest Quarter of the Southeast Quarter (SWl /4 of SEl /4) of Section Five (5), Township Thirty (30) North, Range Eighteen (18) West, EXCEPT Volume 728, page 136 as Document No. 407700, now known as Lots 1— 26, Plat of Partridge Run, in the Town of Richmond. This is not homestead property. Exception to warranties: municipal and zoning ordinances, easements and restrictions of record. Dated this day of August, 1999. We ey W. Ae / Lin8a R. Halle ACKNOWLEDGMENT STATE OF WISCONSIN ) ) ss. ST. CROIX COUNTY ) Personally came before me this.46 day of THIS DOCUMENT DRAFTED BY: August, 1999, the above -named Wesley W. Halle and ON L, "A44 . da R. Halle to me known to be the persons who Judith A. Remington cj Bx ted the foregoing instrument and acknowledge REMINGTON LAW OFFICES )P the e. P.O. Box 177 tjQYAR� New Richmond, WI 54017 '7111111 Public Stat f Wisconsin IPA O Commiss xpires: q-/,L-" 9rF OF W1`'C' � - .. . � - ---7. 1.U9U ACKUi I 1 __0000- __�_______ -- -- - v 47,496 SQ. FT. -100' o v N89'55'31 "E 339.53' : ! ` � I 9'08'47" W 660.00' ax cOtx'fy �'$gis#el 162.19 323.3 I 627.00 17 I S89'08'47 "W 705.56' Z 1.024 ACRES 44,582 SO.: FT. j 33'I33' N 00 I I 7 1.014 ACRES �,�^ O) N89'55'31 "E 2 0 44,147 SQ. FT. N 1.017 ACRES . , • �ro� L._._._._._! 44,277 SQ. FT. w? • h I 0 16 L • •.�. I I -- ��• / �• 'v� O I 0 1.004 ACRES I I N7778,05 „W ��tti''� �. 'O 43,714 SQ.: FT. I 1 � i..,. I 80 ; / 9 ; N89'55'31 "E 260.20' j 15 • 1 I N I 1.009 ACRES ! � • / 1.061 ACRES Ns 43,948 SQ. FT.- 1, N W .` �` 46,217 SQ. FT. _ j�s "17•w I a W / DO I 0' Q ` N 1.028 ACRES .. ��� I . ' .0) z I � 44,779 SQ. FT. • ; I ( S89'55'31 "W 204.54' 1 c I p V S SEPTIC SYSTEM1, ! y i X50' 50�: EASEMENT I t - - - I = rw if) W TO LOT 10 I L 0 : N W CY N : ' O ,n ,� j N89'55 31 E 2 0.20 S89'55'31 "W 208.68' ! N (n N ! 1 I `- : I W 3 I N N I I ~ 14 1.047 ACRES Q - - : o 0 o I 45,612 SQ. FT. g N r- I 0 5 N °z N N 1.034 ACRES I 45,033 SQ. FT.: ' i I I N ?.127 ACRES 49,112 SQ. FT. : 9'55'31 "E 204.54' N89'55'31 "E 26b.20' N I I IN I I w —.� 13 —ioo' 11 i ' "w 222 3,• i ` \ `��• ti •• • •' . 1.038 ACRES • I 5'14 t A 1.013 ACRES ^ 45,210 SQ. FT. I '44,124 SQ. FT. ' `% �'• I �� � ,' S89'55'31 "W 2 I I 1.826 ACRES � FT 555 So 79 �• -•- - - _! ,. . j N 12 S 89'55'31" W 331.70' 0000- - 000:0 -- :. 000:0 - -. =r .t.102'ACRES... I I 1 } RETENTION AREA •: '- !' 33' 33 �� _ N 0 0 0 0 . I 48,010 SQ. FT. . QNI 979.10 ' g° I I i -- -- • - -• -- -- '9.1�' -- 1452► 230 6�936� W?!.. KATHLEEN H. HAt.S11 DOCUMENT NO. State Bar of Wisconsin Pas 2 -1982 REGISTER OF DEEDS ST. CROIX CO. WI WARRANTY DEED MIVD FOR Rte!! *V-19" tits a ; WAVMTY K9 am! I is Wesley W. Halle and Linda R. Halle, husband and wife; convey � fir FEE and warrant to Halle Builders, Inc., a Wisconsin corporation, the 7V SM FEET following described real estate in St. Croix County, Wisconsin: PMs �: 111.0 Halle Builders, Inc. 1113 Highway 64 New Richmond, WI 54017 Parcel ID No. 026-1014. 10400 The Southwest Quarter of the Southeast Quaru r (SWIM of SEl /4) of Section Five (5), Township Thirty (30) ?forth, Range Eighteen (18) West, EXC Volume 728, page 136 as Document No. 407700, now Imown as Lots I - 26, Plat of Partridge Run, in the Town of Richmond. This is not homestead property. Exception to warranties: municipal and zoning ordinances, easements and restrictions e f record. M Dated this day of August, 1999. W W. e } L' R Halle _ j • n 19 0 1.065 ACRES 1 I 1 -' 0! 46,370 SQ. FT. 20 M N89'55'31 "E 341.43' 1 I i c y ,j.� 1:194 ACRES W J I I 52,011 SQ. FT. 1- •– •– •– • –.– w , w ul 18 CA S89'55 �31 "W 237.65' ;n 1.090 ACRES O 47,496 SQ. FT. ! I •� -100' I I 1 100' N89'55'31 "E 339.53' • I I 21 I I 1 ' 1.006 ACRES 323.37 1 43,837 SQ. FT. 1.024 ACRES 44,582 SQ. - FT. j 33 j 8 �� � r•- • -• -•- S89'S5�31 "W 240. ' �^ 1.014 ACRES °i N8955'31 "E 2 ! I I 1 ti 44,147 SQ. FT. ,�v ........... ; I I I • L ._._._._._I I ,r� I I h L I 22 g 16 c j 1.042 ACRES 00 1.004 ACRES I I I 44.967 SQ. FT. \ �• '� 43,714 SQ.: FT. I I � I 1 S89 *W31 " 0' W 243.6 y N89'S5'31 "E 260.20' I ao' 9 15 ; N ° ; ' :23 I / 1.009 ACRES ; ! m N i 1.06 ACRES iys 43,948 SQ. FT. W I I 46.217 SQ. FT. �l p� s >>'• ! w '- 1.025 ACRES \ x I a a 44,566 SQ. FT. , O j Q I S89 "W 204.54' � a , 0 o o SEPTIC SYSTEI�1. cn = ° z Lv 50� E LOT 10 I$ o r. I i_._._._._.- I in I ' 1 1 S89 240. �' 24 New Richmond, W&COn.5 1i Lot Prices & Directions on reverse side 1 s , aa3 A CRES 44370 SM Fr. �•- - �- I 20 341. 1 ! 1'l 94 ACRES 52,81 i0. R. 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