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HomeMy WebLinkAbout026-1126-44-000 r ' + Wisconsin Department of Comm County: erce PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463017 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)J. Permit Holder's Name: City Village X Township Parcel Tax No: Brushy Mound Partner hip Richmond Township 026- 1126 -44 -000 CST BM Elev: / Insp. BM Elev: BM Description: 4- Section/Town /Range /Map No: CFO. 0 B'D 16 ?VC, = , C � LAA � 12.30.18.805 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark � � Z �- ( 02.8p OU . a Dosing Alt. ' I �F 6.(0 Aeration Bldg. ewer ll - OZi Holding St/Ht Inlet T NK SETBACK INFORMATION St/Ht Outlet `�•z9 q3•57l TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic y r 3 2 / Dt Bottom Dosing Header /Man. Aeration Dist. Pipe V -10 1 Holding Bot. System o. Sa i o n I D / T Final Grade PUMP /SIPHON INFORMATION Manufacturer GPM Dema St Cover S �Z I / Model Number - , TDH Lift iction Loss System Head DH Ft Forcemain I ehgth Dia. Dist. to Well SOIL A ORPTION SYSTEM f S piCr B DIM S D ENCH Width ( Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. T uid Depth SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Man acturer: INFORMATION CHAMBER OR - Type Of System: s UNIT Model Number. r v + `1 DISTRIBUTION SYSTEM Header /Manifold tr Distribution x H ole Spacing Vent to Air Intake Pipe / Length Dia Length is Spacing I 5 b + 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 Ed es To soil g p Yes [ No Yes j No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:�/f Inspection #2: Location: 1430 166th Ave Unknown (SW 1/44 NW 1/4 1 1 - 2 R1 8W) Water's Edge Lot 44 Parcel No: 12.30.18.805 1.) Alt BM Description 2.) Bldg sewer length - amount of cover = ^5 w� °''�e� +�2a t wWZ ".(� V an revision Required? Yes X No Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. I� 201 W. Waslui a Av r � P.O- Box 7162 ` \. I D e artment O CO mmer'e ) 26 6-3151 - z004 Permit Number (W be filled in by Co.) � mha_.>• }��p s U 3 o r � `"% �t Ap • NING UN7', Planl.D. Number to a--d wkb Comm 83.21, Wis. Adin, Code, atay be used for Pra al you Provide - secondary Purposes Privaey Law,. s15.04{Ixm) Project Address (if different titan mailing adtlresc) I' A� �a - pkilige pitiM Ail ItafornstW)ota — _ POPem owner's Na me i - Parcel / r Y Block A Property owner's ailing Address I f^ i Cl ct - I N Property C.acadon City. State li p cane Phone Number - r I 's a (� (circ1�' ?C l Typt +� IIt>niliri (deck taU thot aPPl7) T N: RE or 2 Family Y Dwelligg -Number of Bedroom Subdivision Name CSM Number PubiiclCnmmncial - Describe Use - -_ __.._ ___.__ -- u l State Owned - [J I t - -- Q ❑Village XTO nship of � M Type of (Greek artily one box tta Lae �e g ) _ New System ❑ RePiacemeta System ❑ TreatmtnUHnld' Tank tng Replacemeax Only i_� Other Modification n to Existing System i Permit Renewal Permit Revision L I Number Change of Permit _ Livt Previous Permit and Date IssueA Before i �n g ❑ Transfer to New Plumber p�„� i Iv. of Powys : tea - PrOL""'med "round U Monad > 24 in. of suitable soil I_j MouM � 24 ia. of suable sal IJ At -Grade i) Si Constructed W n* Pass Sari Filter etl" U Pressurised to ( U Holding Tank I ! Peat Filter I_I Aerobic Trearrncm Unit LI Rxcirculatintg Sand Filter ❑ Recuctula SYtahetic Matta Filter ❑ Chamber. U � V . Drip Liar fAGra"Cl -less Pipe ❑ Other (explain) ' Fto {�� Soli Apnpticaonw llltiuC gpdsfj Dispersal Area Required (sf) -- — © Dispersal Arta Proposed (sf) System Elevation 1 1 9S oo 9,R VI. Tsank Info Capacity in Total Number GaHons Maratfauurrr Pre fab Site Steel Fiber Plastic Gallons of Units Concrete Constructed New Existing Grass Tanks Tanks -Septic Holding Tank ------ - Aerobic Trratmnp Unit VII. ResponsoAhly Stott - 1, the �y flow the POW IS - Phunber's Na me ) 's Si goamm firer shmis on the attached plans, M RS Business Phone Number Phumber's Addre ss (Saver, City, State, Zigr Cade) s� s Approved ❑ Disapproved Saruitary Permit Fix (includes Groundwater Dare Issued [ssu' Agent Si Surclarge Fee) $tn gnalure o Stamps) ❑ Owtrer Givat Reason Caa for Denial 0 IX. dS)tiosas of Approval/Romm for DbaMmval SYSTEM OWNER: 3 . 5 . , I 1 Septic tank, effluent filter and t r ts -►� �-- dispersal cell must all be serviced I maintained I n, as per management plan provided by plumber, 2. All setback requirements must be maintained C-,Ak S as per applicable code /ordinances. --W tar d. "8k= ns prpaa -,a - tla - P 4 n�o �.S S w ! /y w `1� s c T'3oJv w 'e J 4 nn At � af�0 Oab -11 a b- y y cx�c: IaSa aQ S �;�. /iui i Der. 1 �f 3c'> q o2� sr,, r' "pvIL p: e s, <� R1 O Sz a e � v J P Q. 4- I �i - � & V\- �„ �Q� � ��eU u Yl.S/ F+�uS� l�IC;..cJ{� ��1.^�i1�Fli_3 �J G'i ` fV � t::. �jcJ � (����•� f 1'� (J�-� IV Y:,.:.: ��cScer►�a.1�, c� SY t 7 �L � Me - l S i ��c:X 1a 0.Q S-e ;c�ii, �s l,er• ) 3�= 1toCv�" 4c:lr 'Pr \ Sz � G � O 3 6D P r E s ' vYteoo"gn Dwwt n" of Cenmem VALUATION REPORT Pop —L at 0**Moaserwwviamnp j ts.oao�desso" wish c5aan, � �lld� cm,,, i �Rww"d l�s lmvl%6llxIIIk blAw.RM -s VINO r+ uelsl, airaae�aars+oc �Ao.L l . .ed nssieswsrw ooisr Prepsi PhmmePriot+M`' iA G ,0 0NI by Dow MwwMww�a.�.a�+.wgN.w.+rrwoerf�► hiss. t�ll� d�,.1 �n0► porsner arts r ounCl O"ruRR leaf S lad iMNM S T 30N R ( $(iar} trot le 8loolc • Nine as S u w ps Sub ago ph omww TVM tie�nsst flood" E IDI, s LS 't ti I 4L lu NIWCM JWM tAW(a R dil ddl*maw col oome CodeduMddomwsawmm Rlpbmmkt ❑ Pokeraa a d- l- oeeoN� f'� eetnroMaei -_ go L's �sa f�ooaf�eMs"ilweioi ltappkWe ,() a Ow asd nixesnemdo�onse: � Ste- Ei qa ❑ / a �' pit clsaasa wd oo.les► / 5 .9 a u"ow a � 0 ftaM Z g � JI � 11:111,10 oosawosst fiesMatOno"= TO&M SNUChM ClookbWe RnWdol A le• mWom Qx. ac Gone Caw o� ss. sk •ell •epf� O -5 /o r 312- C5 I$ f< I�1 f �r G'S D 1 7 3 /D r b Q mI W 6 U r — — �� El. 2- fn ®aamele C eo ft ft QFaWW Gurftw4ftw. !2415? it o pn a lr�, t.aor � rn w . : wle "°deans 7 17 QL &L CWL Color er. ss.» d AD ,. m7 3 1 D t • 1�1. > <?�9 aglL aea TSS rlD_< 1d0+apl! ; 130 mqL mW TSS: 30 not 3 "aar""" oeM ewiron l�releaea _ PTwp t h N•�� �r s /� ' oR 7 7is a coS • r ,I � • � 1 ®��" � � ^ � � �� ®� � �iZ . � l���l�j���� �l��i�a�7�! �r� � .�������� ■ � ,. ■ � 1 __ r •' - 1 �' - ♦f ,x .0. 1 �l w ■ rr��■■� ������_ c... . .r _ , r :..., :� r ,. �, _ . r.. D �� s �,� .� �,s�R�,��,�, m� ��►d �q r`,o s �.% DI s aT�o fu tQ I w T • © - �oic (( �S W 4Te rs �q Q. �0� S'Ya r 7 �� Cr motkl 1 S7 Coo ��C 1430 I Lo Vo l vp— � Sew' l " = r- h SafetY and Buildings Division County — - — 201 W . - s Washington Ave,, P.O. Box 7162 "ns n Madison. WI 5 3707 - 7162 Sanitary Permit Number ( to be filled in by Co.) De artment Of Commerce (608) 4/t 3 © / SF"tau Permit Application State Plan I.D. Number In accord with Comm 83.21. Wis. Adm. code, peraotrl information you provide may be rued for secondary purposes Privacy Law, s15.04(l Xm) Project Address (if different than mailing address) I. Appillicatim Inn l - >� An Iar y 3cb ) t o� h A v - . Property Owner's Na me SEP 3 2004 R r 14 Bl ock �� Propeny Owner's M ailing Address I. C R O I X 0 0 0 N 1 Y petty Location ` ZONING OFFICE City, state W , N w �, �._ Zip Code Phone Number ir Ili ` T N. R E Of B ) II. Type BOA (cheek aN that apply) f �" or 2 Family Dwelling - Number of Bedrooms - -__ —�- _ �— Subdivision N Ntun ❑ PubliclCotnmcrciai - Describe Use El State U $ —_ -^ I �C Village ownship or l C) III. Type of Check only one box on fine A. enq) to fine B if applIcabLt) A ' New System ❑ Y Replacement System ❑ Treatment/Holding Tank Replacement Only (filter Modifte:ation % Eatisting Sy B. ❑ Permit Renewal it Revision U Mange of ❑Permit Transfer to P Num and a Issue) Before Expiration Plumber Uwtten IV. Type or P'UW'I'S : (C an that a ) AF AF ?Non - Pressuriud 1n-Ground ❑ M 24 in. of suitable soil U Mound /FiLl f suitable soil ❑ le Pass Filter Constructed W eiland ❑Pressurised in-G nil 11 k ❑ Holding Tank: Aerobic tment ' t culatittg S Filter ❑ &circulating Synthetic Media Filter ❑ Chamber ❑ Drip Line less Pipe ❑ Odwi r (e ) V• Da Area Iafatr>aation: N. w• -- Design Flow ) Design Soil Application Rate( Dispersal Area (sf) Dispersal Area Proposed (sf) ystem ton l �C� 00 ;. Vi. Tank Info Capacity in Total Num Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Unite lVj,0...810. Concrete Constructed Glass New Existing, /� 1 Tanks Tanks 1► ref Holding Tank t /t Aerobic Treatment Unit Dosift Chamber VII. Respotwbitily Stag- 1, the nespensimmy for of the POWTS shown an the attached plans. bar's Na ( I bumbcr's Si iftME Business Phone Number i ad �7 tSQ Phsmbes's Addre ss (Street, City, State. Zip Code) Zctca � K i VIII. Use wt Approved ❑ Disapproved Sanitary Remit Fee (includes Groundwater Dane I Issuipg Agent Signature (No Stamps) El Owner Given r genial Surcharge Fee) IX. Cotaditlans of Appro for Dlsappa+oval - SYSTEM OWNER: 3 � O � IL'�^ 1 Septic tank, effluen ter and 0lnU& ) dispersal cell mus II be serviced /maintained as per manage t plan provided by plumber. 2. All setback requ ements must be maintained as per applicable code /ordinances, w i Attack — uplaft yktra (to tree Coamy aal71 tar tae symm an papa not roar rhos a112 x 11 hodw &s sire v f K I - - �PI� � New - t o -,►6nmon�L, RIAMbIn l /ZT Cm x a� I( � Ste. 0 i c vx 'N /• 1�1 17 T1 i�V4�o�1� f 5� Cro �X .� ��� oaco�lfat,�yy -ooa a� rasa �t� - -r op "P� ft « 3S S70 s„ o 0 di r oil s i l • r Wisconsin Department of Industry SOIL AND SITE EVALUATION -R. Page 1 of 3 L - Nbor and Human Relations lion 6f Safety 8 Buildings in accord with ILHR 83.05, `rAdm.�``d��e((�� \ NTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. a ust i St. Croix not limited to vertical and horizontal reference point (BM), direction and % e, scale or 00Q P I.D. # dimensioned, north arrow, and location and distance to nearest road. ' 3 2 pending APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATIO o st GJNa� y ED By 1c f'43.1 0 (i PROPERTY OWNER: TY L11 i Derrick Constr uction, Inc. G _ 1/4 W, *,S 12 T 30 N,R 18 2 (or) W PROPERTY OWNERS MAILING ADDRESS LOT # L IKt # U tftY N AME OR CSM # l_0 PTE@. S " 1505 11Y. #65 44 n E66116 CI Richmond, WI. 5401�ODE PHONE 246-2 ❑CITY ❑ 320 Ri chmond ]TOWN NE AREST ROAD St. [x] New Construction Use V, ] Residential / Number of bedrooms 4 [ ] Addition to existing building j ] Replacement [ ] 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 • 7 bed, gpd /ft - - 8 trench, gpd /ft Recommended infiltration surface elevation(s) 97.80 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 ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ®S Ell. ®S ❑U ®S ❑U ®S ❑U ®S ❑U ❑S INU 1 SOIL DESCRIPTION REPORT TJ NJ Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon Y 1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 -10 10 r3/3 none 1 2msbk mfr cs 2f .5 .6 � 2 0 - 10yr4/4 none sicl 2msbk mfr gw 1f .4 .5 Ground 3 1 23-35 7.5yr4/4 none sl 2msbk mfr gw if .5 .6 S elev. j 1 4 5 -96 7.5yr4/6 none co s Osg ml na na .7 :.8 ,�- ---. Depth to .SO limiting I V r factor o cd r + 96 Remarks: Boring # 1 0 -11 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 S __.2_... 2 11 -26 10yr4 /4 none sicl 2msbk mfr gw 1f .4 .5 , 3 26 - 90 7.5yr4/6 none co s Osg ml na na .7 .8 .� Ground elev. 10 ft. Depth to limiting b • 8 $2, factor +90" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. ae., New RichmonO, WI 54017 Signature: Date: 6 -21 -2000 CST Number: m02298 it 1 PROPEWYOWNER Derrick Constructio DESCRIPTION REPORT Page? of PARCEL I.D. # pending Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourclary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 -10 10yr3 /3 none 1 2msbk mfr cgw 2f .5 .6 2 0 -17 7.5yr4/4 none scl 2msbk mfr gw if .4 .5 Ground 3 7 -84 7.5yr4/6 none co s Osg ml na na .7 .8 elev. 1 Depth to limiting factor a 6 +84 Remarks: Boring # 1 -8 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 4 2 -15 7.5yr4/4 none scl 2msbk mfr gw if .4 .5 3 5 -90 7.5yr4/6 none co s Osg ml na na .7 8 Ground elev. 9 8.9 ft. Depth to limiting 2 L factor +90" Remarks: Boring # 1 -11 10yr3 /3 none sl 2msbk mvfr gw 2f .5 .6 S 5 2 1 -28 7.5yr4/4 none co s Osg ml cs if .7 .8 3 8 -88 7.5yr4/6 none co s Osg ml na na .7 .8 . Ground elev. 10 ft. Depth to limiting factor +88 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) r STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction Inc. 1554 200th Ave. CSTM2298 s I WI S12- T30N - New Richmond, WI 54017 MPRSW -3254 town of Richmond (715) 246 -6200 lot #44- Brushy Mound Lake This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. eN r1 " =40 -I�M. =top of 1 pvc pipe @ el. 1 0000 ' Alt. BM.= top of 1" pvc pipe C el. 103.35' 2 $ V 0 O A _ Gary L. Steel 6 -21 -2000 • Ids . O 1 Q Q \ - i O • po WE ,.�`' • , � r �� O .i - O .. R AFA ( I ' tA i/IDJII, .rii 1 lil I/ �IOI(/,I VMS 1 - ! EZ1203H t I •ii ., • { ' i i . - '� •. ii iii ' •.♦ � ... -. ..i iii► ti• j, 1... .. ii.iil. i7♦ �.ii 12 " V 4.625" ,.. i + ... VV !f V v .:: j W VV Of WV ��w 112 Ctre. WV v iii ii siw riiriii�� r �� �srioi -` -- - 36 " -- 12- 112" DIA . qyp. ) Void coerr, V"ft ru s 7 4%, "t ? ;Mpt ' 4-6Z5 jxjV, tic,r. #I (F Siden,>at) Id .ati fi " �� - � I ��. =3.t4=j 2...) 7 2 :Stis 12in 3.i3 BUCOOM � C).B. oft�ler _ � -90 Vag mlrrere w s of TN.at Seat laerfsee Area �� t f!. i c s�tt.reY�fer _�) i. •( a_s,,, 3J, ') t ?io/y ") ia.}w r. ate ( t;ar 422 W ofp Cyttudera - t2 twc 1 Vwd v01m rr rn a,"k cyt F"'`Jected Tread, Area 1 t SiIIe�rat! Heeg}tt ° 12 m f rt ` 2.tM 5q.Ft eat •otumr at iwrs, fF is ! bcw°wcrr. sk�lttry�.� .. 24a py� l f r 9 01totrr = tb pQS4.Ft. �R (' 12inl i2i4tR l �).1 aa 0_a5 h• = I. h tt2m, Ar - ojcrtttd Tre.ci Arc. t �-t1ui votyryxt ar ' c °n 'crs t t t? of voi 5.00 Sq PY. void t Fotat 'O d v@tucft - 9, ! 17 • usn� txtwiso cptr^de+s) 0 Z t S > _ u '08 ft' t} -i22 + tt.9pi + U _ 2 15 7W Gallon P, R> t 78) X 7 - 4� ^ p t } .n � i f i �r EPS Aggregate Trench System r� t E21203H Rim I f 65 du �strictl Group ow � (( 65 d�jN Po Rd. I FkE NAIL. E21203YF -+rat SHM. 1 Co f . v ppWTS OWNER'S MANUAL & MANAGEMENT PLAN P — °t z" WFQRMA SYSTEM SP ":rA ❑ IkA VTa nkmanufwhmw Manufacturer � I owner 5 ��w oss ;❑ Holding Vol. gal Na PARAMETEfi^s p Dow 0 HoIdift Val. girl Number of Bedrooms El NA E] S Q NA Efifluert Fitter Manufacturer © r e v� C 0 NA Number of Public Faulty Units Estimated taverega) flow OO Effluent Model -� _ Pump Manufacturer Design ign (peak) flour = (Estimated x 1.5) SON application Rats Pump model So monthly average* av erage' A Standard influent/Effluent CivaNtY p S liter ❑ pent F#ter Fats, Oil & Grease (FOG) 530 mg/t cad Aeration ❑ Wetland oxygen Demand (BOD 5220 mg/t- ❑ NA [3 Mechsni Biochemical T Suspended Solids tTSS) 5150 mg-/L Disinfection E3 Pretreated Effluent 0"O ft Monty average Manufacturer rer ❑ NA Dispersal Ca Biochemical Oxygen Demand (SO D,) COWS) ) 30 mg/1 r G CO {granrityl ❑Mound 0 wGround lWessvxized) Totd Suspended Solids (TSS) 53o mgn.. ❑ NA At -Grade Fecal CoMOM (ge rues) 510• cfu/1 OOmi p Other: Drip -Line Maximum Effluent Particle Size X in die. ❑ NA ❑ NA ❑ NA Oder. ❑ NA 'Values typical for tic wastewater and septic tank effluent. AAAt lT5h ANM 81 t ULE senrkse Frequency y Service Evert mont 8) (� 3 yews), ❑ NA inspect condition of tenkla) At least once every= 3 When combined sludge and SCUM 0 one - third (K) of tank volume ❑ NA Pump out contents of tows) � When the high water alarm Is OCOVated � At least once every: month(s) (Maximum , 3 years) ❑ NA irnspect dispersed c IRA ❑ mornth(s) ❑ NA Clean effluent filter At bast once every: 1 - month(s) ❑ NA inspect pump, pump controls & alarm At bast once every: O s) 0 nwntfi(s) ❑ NA Flush laterals and pressure test At bast once every: E3 is) 103 rrwnth(s) ❑ NA Other: At least once every: ❑ yes) ❑ NA 0ttndr: MAINTENANCE DlSTRUCTIDNS one of the following licenses or certifications: inspections of tanks and dispersal ells shall m POWTS levade by a pectd t , Septage Servicing operator 1pumperi. Master Plumber: Master Plumber Restricted Sewer. ) to i ar broken hardware, identify any cracks or Tank inspections must include a visual inspection of the tank ls) to iden any miming fluent on the ground leaks, measure the volume of combined sludge and scum and a check for any bade up b or rvatiog n pipes of effluent and to check for any surface. The disperse! c ell(s) shall be vis�y � to cheek the effluent levels in the o pondling of effluent on the ground surface. The porvdirrg of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory audmdW' one ttn'ud (y,) or more of the tank volume, the When the combat accumulation of sludge and scum in any t tank equals NR 113, entire contents of the tank shall be removed by a Septa" Servicing operator end d reposed of in accordance with chapter Wisconsin Administrative Code. , or pressurized components, pretreatmerr All other services, aududing but not limited to the servicing of effluent Stars units, and any servicing at intervals of <12 months, shall be performed by a certified POWTS Maintainer. service event. to the local regulatory sut wd y within 10 days of completion of any A service report shay be provided GMW (2 /02) START UP AND OPERATION Page For new construction, prior to use of the POWTS check treatment remits) for the presence of pair d that may the treatmentg products, solvents or other have the contents of the tank {s) removed by a 99 S e r tl ing op the son �ispersat cxl)ts1. tf high �n� WO detected prior to use, SMOM start up shag not occur when soil mndtti W am frozen at the infiltrative surface. During wdwtded w F outages p�R tanks may fit above normal Nowa W lavels. When power is restored the s to the Celts/ in one large dose and "" ovwk)sd them fadtarge of efttuent. To avoid this situation have the contents of the pump tank removed Servicing re surface to ►eatming power to the effluent pump t p or conne a Pkm*w or POWTS MairMww to assist prior controls to restore normal levels within the pump tank. matey pump Do not drive or park vehicles over tanks and dispersal oafs. Do not drive or within 15 feet down slope of any mound or at - grade son! area. perk o • or otherwise disturb or compact, the area Ruction or elimination of the following from the wastewater stream may improve the Ped0nnance and m : cotton swabs, prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts, condoms foundation drain {sump pump) ...j� �j peelings.- dia / r � s. � di . s �, irr � fe ,� ct y ar _ ►t � s; f / a �� i; �� "mo products; / �. fruit a � A/ ....w..�, Dings. fM *M- O`..eI /IG{NWVOs, �'c.`.!.`./ madio NI oil; sanitary napkins; tampons and water so eri i{/a/ b r ine. ABANDONMENT When the POWTS fafs and/or is parrmanerrtly taken out of service the following steps shall be taken to insure that the Property m and safety abandoned in compliance with chapter Cflm 83.33, Wism mdn Atlmi *fra*m Code: system is • All Ong to tanks and pits shall be disconnected and the a bandoned pipe openings sealed. • The corgairift of an tanks and pits shag be removed and ProFerlY of a disposed by Septage t or. • After pumping, an tanks and pits shat) be excavated sad Servrcrng removed or their covers removed and the void space filled with sal, gravel or another inert solid material. CONT1NGMCY PLAN If the POWTS faits and cannot be repaired the fo#owartg ngalocemant system; measures have been, or must be taken, to provide a code compliant A suitable replacement area has been evaluated and may be utilized for the location of a system. The niplacefrmt area should be protected from tfstunbance and cornpention wW placement sort absorption requmW setbacks from and proposed Structure. lot Cares and waft. faiitrre to protect the replacement , �� �n by resuk in the need for a now soil and site evaluation to a suitable ent 3 area will comply with the rules ar effect at that time. replacement `s Replacement systems must [7 A suitable replacement area is not available due to setback and/or soil knitations. technology a holding tank may be InetaiR as a last resort to replace the hated POWTS. advances in POWTS The site has not been evaluated to identity a suit" replacement area. Upon faire of the PO evaluation must be performed t repis WTS a sal and site o locate a suitable cament area. If no replacement area is av VVTS a toiling tank may be trtstaR as a last resort to replace the foiled POWTS. ❑ Mound and at soil "grade absorptwn systems may be reconstructed in place following rermoval of the biornat at the infiltrative surface. Recatatructions of such systems must aanpiy with the Ries in effect at that time. < <WARIIfNG> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR CIENT OXYGEN, pp NOT ENTER A SEIFI C, PUMP OR OTHER TNEA7MENT TANK Utz ANY C�ANCt . DEATH MAY PERKW FWM THE FOR OF A TANK MAY BE OFRCULT OR WWOMBLE. tiESUf.T. RESCUE OF A ADDITIONAL COMMENTS EMITS NVSTALI,ER POWTS MANItTAANER Name Name S [ Phone , SEPTAGE SERVICING OPERATOR'' pp LOCAL - REGULATORY AUTHORITY HORtT Y EdaphwCoafnmrn ` l�C Name Phone Phone S This was draped by the staffs of the Green lake. Marquette and Wauahara Count/► Zoning and Sanisstion agessaes in compliance with .22t2)(b)lt)(d)&M and 83.54(7), (2) & (3). wisconsin A ar Code ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer � Sl�u�t S l�j 1'l/I�au rl9 pP - t,S Mailing Address Poo ' .)" K 1-+r, �"ZN �—t n�,c� esl�, .r S 4 I, Property Address I 4 Q I �0 (Verification required from Planning Department for new construction) City/State �L j Nw 1 � Parcel Identification Number Otto — L I Lk — 4 4 — 0 Q a LEGAL DESCRIPTION Property Location '/,, �� /,, Sec. T � N -R � W, Town of Subdivision _ �&T�l Lot # Certified Survey Map # . Volume , Page # Warranty Deed # G<3 ` -- z r , Volume 4 , Page # b Spec house )<yes O no Lot lines identifiable )yes O 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 foam, signed by the owner and* by a masterplumber, journeymanplimber, restrictedplumber 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, erein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification . stating t your tic system has en maintained must be completed and returned to the St. Croix County Zoning Office within 30 days e e ye e SIGNATM OF APPLICANT-DATE OWNER CERTIFICATION (we) ce that all s nts on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the p cd 'b d o y vi a of a warranty deed recorded in Register of Deeds Office. 8 t 2 a o NATURE OF APPLI ANT 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 i .(...JA31PAGr 169 i&0.4:2!!5'7 STATE BAR OF WISCONSIN FORM 2.1998 KATHLEEN H. WALSH iiment Number WARRANTY DRED. 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 OG -03 -1999 9:30 AM the following described real estate in St. Croix County, State of Wisconsin (The WARRANTY DEED "Property "): EXEMPT N CERT COPY FEE: See attached Exhibit "A" COPY FEE: TRANSFER FEE: 1047.60 RECORDING FEE: 12.00 ' PAGES: 2 Rewrdinz Area Name and Return Address Hendrick W. Van Dyk VAN DYK, O'BOYLE do SILER, S.C. Post Office Box 127 New Richmond, WI 54017 Pnff of 02 1047.40.000- 026 - 104745 -000 and .000 Parcel Parcel Identification Number (PIN) This is not homestead property. i Exceptions to warranties: Subject to all easements, restrictions and covenants of record. Dated this 28th day of May , 1999. *David L. Naser * AUTHENTICATION ACKNOWLEDGMENT Jou 031 grog 'poEpo!MOqos JO LlOt5 =i ' LZI Yog :a�ep aopendxo oie9s 'you ;� '�'S I UMIS v Xv •luoaemiod q aojssTmmoo AN xAQ =A ', msaoosiM jo ornS 'o?Tgnd KmO Au CRAY G SVM ('nlnS 'sIM '9C NrsHoosLM ao n •omvs oqp oBpajmogos pna lnomnnM x Q UVA 'M )IT lmo8ajoj oip poinom oqm (s)uosiod otp aq of aMOUX am 01 POUM anogt Vp — 6I ' . jo Cep s p om ojo}oq omao X11wooeaad 666 T � s 4,2 gZ P �eo}�QOgme ( Alunoo 'SS - ( N16400STMdo a.Lyls .1asBH •'I pxASQ (s)omtea8►S 4 CC rl rt w CD M S) -" 5 ti a C fD n ID rD CD rt N rt rt `C Z o : `�° o oa d En o r `c oN e C: M 1 ID w m cn c rD n O o a "� o O K '�* ... 40 0 cr (D C Q(D rD O r n , rP n rrD r O • D pr : U n° o n n En a o' O o O rD "� oq CD cn O cn rD rt 140th Street Q Sr �. 7 r - 2.21± ACRES „ to uou !��U. r i . ;..•`' sv AREA 70 MEANDER LINE. ra 1.88 ACRES �,,.•''`' . L O r 36 74,109 S0. FT, ,." / 0 / AREA TO SHORE: "�` 1.70 ACRES 84,754± SQ} FT. , .•'"` 1.95± ACRES " Un AREA TO MEANDER LINE: 0�; 9 68,361 SO, FT, t� a 15 r r �r 0 1.57 ACRES S89 "5244 "W O ti 95.39` N 84 '41'09"W f 1 74.74' '.. TOT AREA 8',8'70 SO, FT. .88 ACRES F.F ".E, 986.0 LIp - 'ter• s,� i . " 76 -g r J 4 g8� w w ARIA: f co H.W.L. 4 SQ. FT. ♦'# - '� '�� , E. 973. H. W. L. � ?! -- SA 2E i co • '� � TOTAL AREA: 976.3 0 i �' cy 82,607 SO. FT. �`••M ' P 1.90 ACRES �,•• " / �P� 1 �..•• F.F.E. 986.0 .... ................................. .... ........ �' !