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HomeMy WebLinkAbout026-1126-43-000 r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM 'Satei�•and Buildings Division Cou �St. Croix - • INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sani Personal information you provice may be used for secondary purposes [Privacy Law,.*. 15.04 (1)(m)]. '$t@0 AWe.MWfY8iel ❑ city ❑ vKfthfdPYCI'Ybwnsh p State Plan ID No.: CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel W- 01:126-43 -000 141 1 o / TANK INFORMATION ELEVATION DATA I-I `tp`p_�'h frV TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �Se r Benchmark 3 Z 6 0 Alt. B Dosing .S-� Bldg. Sewer Alt Holding 0/ Ht Inlet - ,TA NK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Ventto ROAD Air Intake Septic y '� Z ' NA Dt Bottom 1 U, pY . ( - S 3 Dosing y �. 3y NA Header / Man. .2. ? Qs 3 Aer NA Dist. Pipe y M Fs - f' •1 - t3 Holding-- Bot. System M M . r, t S 4 'l GL �y S PUMP/ SIPHON INFORMATION F �ti 3 y _ O Manufacturer Demand Model Number �3 GPM tJ(� y / , Aw TDH Lift SSA Friction Z System TDH [ t Loss Head Forcemain Length �S' Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED RENO Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DI Z • �� DIMENSION SYSTEM TO P / L BLDG WELL LAKE /STREAM LEA Manu ctu er: SETBACK CH A B INFORMATION Type Of / Model Number: System: 6h % j LS t 3 NIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe($) x Hole Size x Hole Spacing Vent To Air Intake Length IL Dia - � Length 42 -9 Dia. Spacing ± S A Z4 444 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 InS eCt10 #'CJ Yes/ ❑/ No In S era lft #21 No / L WMMENTS: (Include code discrepancies persons present, etc.) Location: 1458 166th Avenue, New Richmond, WI 54017 (SE 1/4 NW 1 4 1 T30N R18W) - 123018804 Water's Edge -Lot 43 �() 04 v" "i"'a" /l d :+' 3 "" c"e 4 1.) Alt BM Description = 4*p a-f 4 jj'a C-4 2. Bldg ewer le = 3� ' s) 'P�"^"'L`'' w'!1 �KGrca.sc doss .+o(wh..� �a g 9 tic✓case li of cr ez 3 K.'nL"1e - amount of cover= ?yz" / °?' 3, � 114 r; Wep � 4� � -� 5v 5 •k�w.. ►Nev� '�4'7un, 5 1��. -�a �•Y.y S S; Plan revision required? ❑ Yes M No Use other side for additional information. 7, / SBD -6710 (R.3/97) Daiw inspector S Cert No. i i i a 0 lb s I � �1 Slew. �S a S�enituy permit fto mead W 6321, WIL Ache. C ft W t WA C �Q Soe r:YCrJe sidt Am a its o p the ooa pt a +� f�ik.tioa PQ 8oac 73 1 YOU p w4& away be mod for mmo ty pwpoam Madiolk Wl 5370' 73,02 Imo► tJ1% a. t S.0glX I (Sabatit coaWicoed form to oamuty if rm ebo ert slot dm, 112 x 1 Batt oaraed. b b'esee 1. I• A lk�dog llnf 1Anatlett - P t�lIB all TnfOlOtaL10A p Ownx iilma LOCILt.al` 1 . ou m S P#oPwty Wasaft 8 � R t Lw �, snta zip r 3 Al 9u6¢visios rt.aK or CSM Nwabor m 'Iy#oe of Ruuditt0: (checlt one) D Cih 4 5ta �ts�(�� ( Na of 8odtooraa . O - TTo" m T of Peratit: cbc!A Oatm boot oat lint A, cbftdc box on lire 8 da tiabk A) s. 8) Mmk S. 6 FUJ A didgiti to SYMM IV. T e o[PQWT NA Z : (Chock an east apply) `� riaod i, I ❑ 14sund 0 Smd Filter O Coutruaw VAdw d gA 0 Howba Tads Q Mn& Pus D Drip Unc V. D 0 Actable Tan u U nk O 0 Otber: tm t Areal :tormstlOm• 4. go Appom O© 500 j .tU } p v vn: �`ank r A- 9 to l9 r O it10n ( in N or 806 S AbQ► Manic NIVW con. T pEtf: steurxcd l Lakf VbL O Sdetcount Par +af ibe POyYTS rltiarra as do atmcmd Wit. Sbft Zr p 4 partnre.L Use onty S b QtMWWAdvem Aee (Jomuaas aow•dw�eer nree 1a ASw c of Approv fitessom � ,<i� (. n ksti. u. �,,,,,,,,,Q -?tom Zsy�nue u`eMaQ �� y — y X11 \ .. 7 Al �; r ST GRO COUNTY 11�NNG OFFICE I 1 � I � � f ' 4 4 .-t4 Ls Tc QA r ' � � i tj I � � E } � � I /r 6 ' NOV ------ - ------ ---- -- 30 J4 Aila t-m- 77 ,eA ...... —4 i 1 � s I t : 1 f i , I � � , , ; ---------- i V , ! i i f t � j f �' i I M � I � � I I '. i. i I I l I ,' � � �_ IVA .. I , i + i � i I I ; I i i i _ _ _ _ � � _ � � __ , -- � -- -�- t - �� - - -- I I I i ! i- j i I �.__. � __ _ - — - i - - '- - - t - — ' � ____ i � _ � � i I ; f i � I � i I � i i i I , _ � f � i � I � �. I ` j j � '�. � I I �, � I i � '� i i � ' ! i � � .. i �_ 1 I � ' I � r �. _. _ � , .. __ .. _._ I - __. ._ _ .. _ _ .. i { i i � i i + ! � i � j i i � _. ..._ _ _ ._.. �_..._ .... _. � _ j -. _.. _� .._. _ _ _. 1 I I � � .. �_ � �� i.. _. 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ABOVE GRADE 6 WEATHER PROOF, ? 25' FROM.DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE. WITH CONDUIT MANHOLE COVER 4" CI RISER W/ PADLOCK E 6" MIN. ---- WARNING LABEL ABOVE GRADE �� f— �-4" MIN. 18 MIN 1` WATER TIGHT SEALS GAS- + TIGHT i + [ 7 AT 4 A►o A SEAL i PROVED =I PIPE�f --l-- i ALM INTS 4J/ CI ONTO B ON 30LID PE 3' ONTO � OLID SOIL iQ IL I � PUMP OFF ELEV . $6G FT. « - C r OfF *+t RISER EXIT D PERMITTED ONLY IF . TANK . . MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: W I - e c,.p c:s NUMBER 'DOSES PER DAY: - TAN SIZES SEPTIC K;OZ) GAL. DOSE VOLUME INCLUDING DOSE v7 s GAL. FLOWBACK: GAL. ALARM MANUFACTURER: CAPACITIES: A = INCHES = .L /3 GAL. MODEL NUMBER: `ul +v SWITCH TYPE: B = 2 INCHES = -? GAL. PUMP MANUFACTURER: - coo - " 3 w 60's ''°` C = 'yi3 INCHES = G * GAL. MODEL NUMBER: g�5 SWITCH TYPE: D = INCHES = GAL. REQUIRED DISCHARGE RATE 6013 GPM PUMP s ALARM WIRING AS PER ILHR WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE 16 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . ... . . . . . . 2.5 FEET } 1 Z& FEET FORCEMAIN X +0 /100 FT. FRICTION FACTOR'. FEET TOTAL DYNAMIC HEAD = = I ) FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER LIQUID DEPTH S . 1 ,y, � JL i f "t I T V. ,x t SR 3 4 1 6 t O N =i S p C: Q U m to D tO A A r T) tl - 0 (D C- G cn n tJ t vi ca n C O n O Fy w � rn Q p v) to a. v ra c� ca x a " 3 � 5 6- ( M PO �t— Invad 1 V---? J t Goulds Suirla #Sib #e Effluent Pump 3885 arMtiw, 1 i s APPLICATIONS • Overload protection must smooth operation Silicon can be operated continuously Specifically designed for the be provided In starter unit. bronze impeller available as without damage. following uses: • Shaft: threaded, 400 series an option.. <' - , .. ■ Bearings: Upper and • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing Farms • Bearings: ball bearings type for maximum efficiency. construction. • Trailer courts upper and lower. 2' NPT'discharge adaptable ■ Power Cable: Severe duty • Power cord: 20 foot ys rated, 01 and water resistant. • Motets far slide rails terns. • Schools standard length (optional ■ Mechanical Seal: SILICON Epoxy seal on motor end • Hospitals lengths available). • CARBIDE VS. SILICON provides secondary moisture Industry Single phase: • •'h and stems h HP –16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket Effluents y with 11 % V or 230 V three Stainless steel metal parts, damage and to prevent oil Prong plug. BUNA -N elastomers. wicking. SPECIFICATIONS • % -1 % HP –14/3 STO with ■ Shaft: Corrosion- resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. Y4' maximum. 0 %-i % HP –14/4 STO phase models to guard • Discharge size: 2' NPT. with bare leads. On GSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM, listed models – 20 foot on accidental reverse rotation. • Total heads: up to 123 feet length SJTW and STW ■ Motor. Fully submerged in SP Canadian Standards Association TDH. are standard. high -grade turbine oil for Mechanical seal: silicon lubrication and efficient heat ul undetwritets Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide- stationary seat, 300 a Impeller. Cast iron, semi- ■ Designed for Continuous series stainless steel metal open, non -clog with pump- Operation: Pump ratings are parts, BUNA -N elastomers. within the motor manufacturer's • Temperature: out vanes for mechanical seal recommended working limits, 1041(40 °C) continuous Protection. Balanced for 140 °F (60 °C) intermittent. �s�_ • Fasteners: 300 series stainless steel SERIM3885 • Capable of running dry. 25 80 SI ZE: W sou RPM: VARIOUS without damage to - 4 5GPM components. 70 v 1 sFr Motor in Single phase: _ _ Eo • % HP, 115 V, 200 V, 230 V, 5 i 60 Hz, 1750 RPM; Y HP, Z 15 115 V, 60 Hz, 3500 RPM; 0 40 %HP- 1% HP, 230 V, 60 Hz, 3500 RPM. S 10 30 • Built -in overload with automatic reset s ' • Class B insulation. * ffi — I I I I Three phase: :10 • % HP –1'h HP 200/2301 0 0 2M 460 V. 60 Hz, 3500 RPM. 0 to 20 30 40 50 so 70 80 90 too 1t° 120 130GPM • Class B insulation. I -- _ I I 0 10 20 30 m CAPACITY 0 1995 Goulds Pumps Effective May, 1995 Q� a3? 76 ►' 6 6 e.. Sanitary Permit Application � _ In accord Wilk Oman; 23,21. pp Sae ieverae side tar k"hocdoaa ft PO Dox 7302 ► Persoaai you prorWe auy 6e tar s000adsty Mme. WI 33707.7= dapituawin .Co►rinierc� PWP� (Prtvacy LW. s 1. ] 1�T �' ( fout to county itaot sat@ owned. C x 11 Shoe I. R I. App headat Lutormetlon - Finn Print an bdormation Pea" Ow"W NNW Eroc�sion 2 (lu ,->kv -A � -,s m` c v ' G OP IM N s [ ).T R� w A- CIM r4 f MwftNun* r )6seerCR4Naaber 7 i5 a c7 M m 2 o f NL efe)ed�n as {" s "" o� I3 Pabli� (deserftusek — w"u P�a►.ns . i rasraor O saw -ova ; Now Rand L L I A III. T of PatsnEi: one box on lice A. Cbeck box on line B if k able A) 1. 19 Near Z U Rophommat 3, El Reel or 4. S, tip 13 Addlition to S tam Trak 8xisti S) 1:3 A fcM wus N. Type of POWT Systiam: (chwk all du apply) O Mound O Saud FWw O Consuvacd Wtdand C3 D It Tad) O S n&k Pass O Drip tine O D Aerobia Tnausest Uhk O O Otber. V. D ttn of Area Isforiaatlon: . 2 I. r &S"mftvadw # P+eP Rate IR? (} 81awlen Soo s VILiNuk ift. Taal dot � Paflb site ftd i Phstic �� tatormatiea E1611008 CwD= Tub ton- oar- a1a» MW s ores Wooed �t Toab czs 13 D O O D VIIL Respowibillcy Statenuut eke asaane for a[We Pt3WTS skoaaa 0+e stlrekod owes 165:37' 1 S -a (o - 5 135 Pkra,Em'a AAlras (SaeeR � � Ix. Caanty/Department )Jae Only D D&appecnod l Ilea tl v�oA. are Day lawny Ammar (No atia�pa) Appmmd D Oaaner iDvras laitial A�dverm eD ZS f ZS. ondltioas of Ajtptawai tR ator prarai; W LA- (A (apt LV ,- a -Kkq-- got ■■ E�' ■ ■:�'■ ■ mo ■ no t1F� �Kr1T�1'a ■ ■ ■ ■ ■�• 'tnT +T���wa71�ik NNW ME X. ■!!t ■!�,, !�!I�! .... �!! � ■ ■! ■■■■ ■■ ■ ■■ ■ ■r�■ ■ _ a ►®■ ■■■■ ■■■E■■■ ■ —IAN 2Tji■■■/ ■■■ ■■■ ■■■■■■■ !� - M MMEME . Nov., ■■■■! ■■ ■O ■ ■ ■r■ ■mr!r■■ ■■■■■■■■■■ ■■■ + ■E ■��!_ M ■■■i ■SSE ■ ■S!■ ■■■■■■■■ ! "M SOMEONE mom ■■ii�iir ■ ■■ ■■i ■O ■! :- ■ASS 1, . ■■!�� ■. ME' on ISMEs ■■� ■ ■fit ■ M M ■1 ■ ■!'■ ■1, ■■■ ■■'� ■fill ■■ E . KINME 0 MUM Ism Emig a 0 ENE ago in A 0 ■1 ■ ■ ■■■ ■ ■■ ■ ■ ■ N�Sl�!■ ■■t■■■■■ ■■ WON ■ ■■ ■ ■ „ ■ ■ ■ ■■ 0 "his ■ ■1 ■ ■ ■ ■i'i ■ ■!! ■ ■ ■����■ ■■ ■ ■1_�!'■E► ■■i■■■■■■■■ ■ON■�i■!� . ■ ■■■� ■ ■■ jjjj ■Oi ■■■O ■ !® ■O � ail I { t - I (5 _ ; 1 t i i r if A 60 4 __ _.►�1._ ��1=` �_.. _ 301 —v —}- � -- i ' _ � 1 y � , I r _ � s t � I I I i 1 ! f � i 1 . I 1 1 , r- T r 1 1 ! t i I i I r r— , ........... ; - -}-- -� I j -!--- I __ I r I I , I 1 I , , i , _ , , i I JA ' I } I , , I I r ._ I J i # 1 I i i I ; i I I , , L y i ; I � 1 - -- - - - -- .� � r r I , I V IA . I - - -- -- - - +- - -- - - -- I i 1 + 1 ! I ' h , , i , T , I , a J j i I I I + I I ! , , l , r ; r I 1 1 1 I P I 1 — V - I j j 1 , r I ' I , + I , 1 Wisconsin Department of Industry SOIL AND SITE E V A L U AT 1 Ea Page 1 of 3 Labor and Human Relations Division of 'Safety 8 Buildings in accord with ILHR 83.05, Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. n ust iWii?de�ut Croix not limited to vertical and horizontal reference point (BM), direction and % td pe, scale or 2�(�Q PPIPA I.D. # f' l z6.. li ZtO 4 j dz>� dimensioned, north arrow, and location and distance to nearest road. ,, 1 ndi z ..+yo• • $D'i'- J APPLICANT INFORMATION PLEASE PRINT ALL INFO RMATIO o 5N FF�G R ED BY DATE PROPERTY OWNER: ON Derrick Const. , INc. G S 12 T 30 N,R 18 j (or)W PROPERTY OWNER':S MAILING ADDRESS LOT # 0 . NAME OR CSM # 1505 Hwy #65 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY (]VILLAGE (MOWN NEAREST ROAD New Richmond WI. 54017 (71J 246-2 [xJ New Construction Use k I Residential / Number of bedrooms 4 [ ] Addition to existing building j J Replacement [ I Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd/ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate _ bed, gpd /ft gpd/ft Recommended infiltration surface elevation(s) 95.60 ft (as referred to site plan benchmark) Additional design / site considerations trenches spaced to code 4.00 below grade Parent material outwash Flood plain elevation, if applicable _ na it S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ®S El I OS OU ®S ❑U CRS ❑U ®S 0 ❑S f7U SOIL DESCRIPTION REPORT O� � � ZtND Depth Dominant Color Mottles Texture Structure Consistence Roots PD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Be d Trench �- : 1 1 0 -8 10 r 3 cs 2m • S 2 8 -27 7.5vr 414 none 2msbk mfr gw lm .5 .6 ,5 Ground 3 1 27-78 7.5 r 4/4 none ms osg ml gw na .7 .8 • } elev. 99. ft. 4 1 78-84 10 r 5/6 none ms osg ml na na . 7 .8 Depth to limiting factor +84 ' Remarks: Boring # 1 0 -8 10 r 3/3 none 1 2msbk mfr cs 2m .5 .6 .6 . S 2 8 -22 10yr 4/4 none sil 2msbk mfr gw lm • Ground 3 22 -96 7.5 r 4/6 none ms oscl ml na na .7 .8 • } 99.6. ft. Depth to limiting �g factor +96" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. AvA.New RichmopO, WI 54017 Signature: Date: 6 - - 2000 CST Number: m02298 PROPERTYOWNER Derrick Const. Inc. SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # Pending Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounclary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends — . S Ground 3 6 -88 7. 5yr elev. 9 8.8 ft. Depth to limiting factor 3 q- Remarks: Boring # 1 0 -10 10 r 4/3 none ,5 .6 ,S 4 ....... 2 10- 84 7.5yr 416 none 7 1.8 • �- Ground elev. 9 8.1 ft. Depth to limiting factor +841 1JZ 3 Remarks: Boring # —13 10yr 41 none S1 2zvsbk mfr cs 2m . 5 6 5 2 13 -29 7.5 r 4/4 none sl 2msbk mfr 9w 1m .5 .6 3 9 -95 7.5 r 4 6 none Cos os mvfr na na .7 ;.8 •� Ground _ elev. 9 8.1 ft. Depth to limiting q y 5-7 fa ctor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) ;F STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, INc. 1554 200th Ave. CSTM2298 SE4NW4 S12- T30N -R18W New Richmond, WI 54017 MPRSW -3254 townof Richmond (715) 246 -6200 lot #43- Brushy Mound Lake This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. 71#e location of the test may or may not be as shown as permanent lot lines were not established at the time the teat was conducted. N 1 " =40' BM-= top of 1" pvc pipe C el. 100.00 Alt. BM.= top of 1 pvc pipe C el. 97.70 � h PJf � r �0 3gp Tw ID` \\ 3 / 0 n Gary L. Steel 6 -27 -2000 L JA V 1tA uU Gt►N l !y1 PrM to 4nsite Wastewater Treatn*nt System jMnagennent Plan SOPVC Tank And Gravity in- Ground Soif Absorption Component Pursuant to Comm 83.54 Mlia. Adm. Code each Private Onsite Wastewater Treab lent System (POWTS WAN InCl rde intorrnation and Procedures for maintaining the systern within ttre Parameters of Comm 83 and 84, and the cations of approval by the department, agent, o g� ° � � The d PUM and permits fbr system are on file at the county n9 department. This management plan Complies with Cornet 83.54, Ms. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsft Wateweter Treatment SysWns SBt 10567 -P (R. MS). Tafsf! 1 Syst Permit Number of f bdrocxns Al fans �•( ) � Peak Estarrafed Flow - A ( o Tank Sob Sire o T of Oorrrestic Table 2: $off . UM is of Rentable Tank son Des' Fla" - Peak i �� inUtrera Parlh Size 1/8 Mttxknum 220 Maxknrnn TSS ) 150 Table 3. MaIntatumes S dodtdo Tank andkx servicae once 3 Outlet Filter f once a your and Mean at least once Gym 3 SON � once 3 yews SWU Tank The septic tank shag be maintained by an Individual cad to service septic tanks under s. 281.48. Stats. The cons of the septic tank shall be disposed of in accordance with NR 193, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumpir►g Chambers, Grease Restroorns) . Seepag �Pa9o� Seepage Trenches. Privies, or Portable The operating condition of the septic tactic and outlet filter SW be assessed at least once every 3 years by inspecWn. T SW be to ensure pro�r The f ter carbtidge be removed unless provisiorss am to retain solids in the tank that may sbUgh off the tiller when grad from its erx*ure. If the 05/02/01 WED 10:27 FAX 715 988 4888 ST C2i CO ZONING WJVU2 Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the After shall be serviced If the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge in the tank exceeds 113 the liquid volume of the tank. if the contents of the tank are not removed at the time of an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation In the tank. Manhole risen;, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the c ompk tion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or other fresbnent or holding tank for any reason without being in lull compliance with OSHA standards for entering a contfned space. The atmosphere within the septic or offer troabnent of holding tank may contain teahal gnaw, and rescue of a person Aram the Interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. soil Abso n Comeonent The soil absorption component serving this structure Is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful We of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell. which may lead to more intense, and earlier, organic clogging of the soil. 2 Manage Pim for a S TatW and W AbscxPt'On Coff" e of deeorooftd trees MW s h" j b S dvqM over or voMm ten W Of th PW" mot inMWAM kft t h e mn p w wt may obsVWt wastewater a xnpwont shouId be avowed Sinm flow, 3T. CHJI,& ZjNiki� = 386-4b`80 plumber - 'Calvin Powers - 'e Replacement site will be that soil tested area by C3T ( # Replacement site must be left undi3tuxbed, or managerient/ contingency plan mlist be modified and filed with the zoninz office, outlining the steps to be taken in event of septic systeT, failure. 3 A� i ST CROIX COUNTY `�''✓ SEPTIC TANK MAINTENANCE C AGREE E '�( F AND OWNERSHIP CERTIFICATION FO wne u �(ou�p O rB yer M'Zj" e7x-s /lil i t_. Mailing Address P Q &x, V4 S /k--zj Jef C MQ " 5�0 Property Address 14 S 'b IG to l4 -�,�� N c� r✓ - ^ M (Verification required from Planning Department for new construction) City/State )Vc� )el L � parcel Identification Number Z ! f — 43 --o 4 Q LEGAL DESCRIPTION Property Location 5e' %4, N VV V., Sec. T O N - R i8 W, Town of / MO NCO Subdivision WA-jtj'yS �Et) V G Lot # 7 Certified Survey Map # . Volume , Page # Warranty Deed # 6 4 Z S 7 . Volume 1L l 3 / . Page # P Spec houseXyes 0 no Lot lines identifiable Eyes Il 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 fimction 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 master plumber, journeymanpl*nber, 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. 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 Zoning Office within 30 days o e three eaz expiratio date. SIGNATURE 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 pr fly desc 'bed abov b virtue of a warranty deed recorded in Register of Deeds Office. IGNATURE OF APPLIC 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 r lfl l PAGE 169 �64425�5' STATE BAR OF WISCONSIN FORM 2 - 1998 KATHLEEN H. WALSH - ,curnent Number WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between David L. Naser, Grantor, and Brushy RECEIVED FOR RECORD Mound Partners, LLP, a Wisconsin limited liability partnership, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee 06 -03 -1999 9:30 AM the following described real estate in St. Croix County, State of Wisconsin (The WARRANTY DEED "Property "): EXEMPT # CERT COPY FEE: See attached Exhibit "A" COPY FEE: TRANSFER FEE: 1047.60 RECORDING FEE: 12.00 PAGES: 2 Recording Area Name and Return Address Hendrick W. Van Dyk VAN DYK, O'BOYLE & SILER, S.C. Post Office Box 127 New Richmond, WI 54017 Part Qf 026.1037 -30- 000:026 - 1037 -95 -000 and 026- 1038 -10 -000 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Subject to all easements, restrictions and covenants of record. Dated this 28th day of May 1999. *David L. Naser * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) David L. Naser STATE OF WISCONSIN ) ) ss. County ) authent' t d this 28 thday of May 1999 Personally came before me this day of I I 19,_ the above named W _ to me known to be the person(s) who executed the foregoing * Hendrik W. Van Dyk instrument and acknowledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) * THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin Hendrik W. Van Dyk My Commission is permanent. VAN DYK, O'BOYLE & STLER, S.C. 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