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HomeMy WebLinkAbout026-1153-22-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safet%+nd Building Division Sanitary Permit No: INSPECTION REPORT 430674 0 (ATTACt TO PERMIT) State PI ID N . GENERAL INFORMATION . s Personal information you provide may be used for secondary purposes [Privacy Law, s.1 b.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: - 7 Oeverin Homes Richmond Township 026- 1153 -22 -000 CST BM Elev. Insp. BM Elev: BM Description: Section/Town /Range /Map No: 19.30.18.1160 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic ��'�G f�✓ ©� ® Benchmark �U • v Dosing Alt. BM Aeration Bldg. ewer 2. Holding St/Ht Inlet do 9 1 ' TANK SETBACK INFORMATION `Z I O St/Ht Outlet , TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / / ^ / / Dt Bottom - .�-�- Dosing Y p( Header /Man. Aeration Dist. Pipe v Holding Bot. System $ S. � Final Grade PUMP /SIPHON INFORMATION 1 4.go Rg�3 Manufacturer GP ^and St Cover kX4 i t l WA 1 Model Number l Ot. S�g9 _ r TDH Lift Frictio Lo System Head Ft Forcemain Length Dist. to well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length 2 / No. Of Trenches P!T JWNSIO NS 140. Of Pits Inside Dia. ILiouid Depth DIMENSIONS SET rK SYSTEM TO P/ BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFOR ATION CHAMBER OR Type Of System: / / > UNIT Model Number: �] 66 DISTRIBUTION DISTRIBUTION SYSTEM VWI Header /Manifold Distribution x Hole Size x Hole Spacing V�giaaAir- kkake - -- g �11r// ��� Pipeg(s) p 9 Length a Len th is S acin 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 c� o COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:/ 3 / d'7 �illl�+i �{�eGtierf9J�: Location: 935 146th Avenue New Richmond, WI 54017 (SE 1/4 NW 1/4 19 T30LN1R118rW) Glen p View flLot 22 ,, Parcel No: 19.30.18.1160 (, 1.) Alt BM Description= C rJ l/Y / C"'`"" (/I•u 2#t n 0Vt4 -tA4" J1 (JILA 2. Bldg sewer length = amount of cover = �/ 6V. ' . &AM 3) 3' �tuvt, I�j,oQ,c oP.v 1 �� ra Plan revision Required? Yes too SCI q (,o Use other side for additional information. bs (3 Da a(f Date Insepctor's Signature Cert. No. SBD -6710 (R.3197) � � � -, „� �� y f5,.r .l �, , ��- ...._ ,..�. #r �� h � �' �.�; `� 201 W. W Ave-. P.O. Bmk 7162 N VIscooWn Wh&wim6 WI 53701- na S�itaty Plet Dim (ro be wed in by Cot Department of Commerce (64266.3151 0 &Rfta " SM Pin LD_ 1a =pad vim Cam= 83 ?a. Wa- Adw Ode, PeaoM iI in ym p bvidc may W teed far sera -dart' gcaposes Pmrary r s- ors testy i ry FoJaj Address (tfddfmt data mtiip address) L Appficafion Iafw=ahata - Phwe Pritt ANINhMOROM _ / 6 �A/. PmpetWowaer's Ma me AY ( . Imt. / 9 Block . 3 l0a � a l u o — 4� PtoperW Owner's M tffift Adilress �- _ Laeaooa .fr ,P -r&-*- ,,dqC '- - �_ Cut', Sbme Zip Code Pb= Number H. THM of Boaftg (dwa an an& appllp) T R R w - p.�� l e t . t`2v:,2� ❑ 1 or 2 Fawly DweNbC - Number of Bedtootos 3 � Soi�e3sio- Naome CSa1 M-mber ❑ Pubfid Catummdal l - Describe Use k/ ❑ Stme Owned - Desaibe Use _ Ocity Ovabse wownswo of EL Type of PWm*: (Cldech milly oche 6aat as bw A. Cmpbft Tore B if appkdAd A ' �lYev System ❑ Repiaoemmt System Q TreamreadH -ldetg Tart llq�oemem Ody ❑ OA-r 1[odi6cado- a E>kit�g Sfsoem D. ❑ Permit Rtatewal P Revtsioe O Cba-W of OP iI Traos6= ro Men ' Paevimts Permw PhwdPw tad Dare blued Bdore EM rstim Pb m bet Ow-er - 1 IV.jEEOr1POwTSSySw= 036ett aS diet ) G/= LL!' _ ' . Y' - z ( T C tier - Presmlwd ialbwOd ❑ Ua=d > 2a bL of - =R ❑ xmm < :. of 3a*k sai! At-Gnde ❑ Ser*e Pas S=d Fmer ❑ Comnttctod Weduud O Ptesariea j*Csramd OHOjftT O Peat Fitkr ❑ Ataobw Tre newt Uwt ❑ Rec=d=W Smd 1I ❑ R cwc dat wg Syrm Mc Ueda Firer WlCcarJtiB Ck maer O Dr1p Lie O (iasel6les Pipe O Offer ( V. DignuallfrredmW Area hftmarnw Dedp Re!, WQ DWW Sol APPS Arat > 00 Dftzm 1 Ares Plkaltot M S>mm o L- / FS / VI. Tank We C48ft in Tani PI 'P PseSi Sire Steel Fber Plastic G r afUnits +� �j _ ,� L: Camsete Ca- snared C.hss ) I Taft Tads -1mo 0' A:-G septic --Howwgqwk Ora / / ekwaer- i VII- ReVenAft Shamemt 4 the to.dasiBp* Fir ibslalbui u stn a POW n sa I w the truack d plans. - -. PbtmbW-s Na me (hi* Si �e bafteRS tffaber Busieda Pime lY�tmber PA Pawber's Addte = csueec. e�t zin a 1L L�7 yo t - ale fterW PMT & P is Tt sf s - 5GE - (737 AM Saitsy P4smil Fee a Dmae htt-ed ' . Airati (No Sra -pe) j Swdwp FW) ❑ owner Giwm Rew,a far Det" V IS. Codd�tivtis SYSTEM OWNER: 3) S i co ougQ - do 9 Septic ta*, effluent liter and ---- �a dispersal Cisll musto be serviced / maintained Q OAQa ./ as par manageme plan provided by plumber. `« °- 2. All setback requirts must be maintained asow applicable code /ordinances. Agotb o @& doCa•lym" fir dasjskm m paper -ot hw mn SW z n iris is site S Law \ r r V/ LiT �z Z T,y aF u!. coNce c S40S p Av SOD I V V wtLL R� Ale � L / _ � � :. T. pctN[� LoT LoN✓6d ' � /RDA ' 4 l�f Dv �?/ QS / �fr yard C A�/j'Fil�rS c 1 k Q fz i/ gtr.�'� /{s.w7 _ lG.}�•LL• / "a �jl9 r c®z�• l fi = t�vierrl� %, p ctNV LoJ" LoN✓6X t.a /RG.b C/-Td ,� '� Q • fr poj ' • � L !d• 7s ' FGr�GB� t I f Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 812 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. 0.24 Please print all information. R wed by Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). Property Owner Property Location ,c—z,W Govt. Lot Wo 114AW 1/4 S T . 3j . N R/,p E (or& Property Owners Mailing Address Lot It Block # Subd. Name or CSM# � ,6JC sit/.' L.tie • 2 2 — .d City State Zip Code Phone Number ❑ City ❑ Village 2'7o Nearest Road R New Construction Use: [Residential /Number of bedrooms _ Code derived design flow rate 6e1'd GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material OuTk/�t1 fi Flood Plain elevation if applicable _��/� n• General comments and recommendations: ��vi7rL ❑ Boring f Boring # Soil Application Rate © Pit Ground surface elev. �_ h. Depth to limiting factor � in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Ou. Sz. Cont. Color Gr.•Sz. Sh. 'Eff#1 'Eff#2 I 0-7 71 - ZZZ L 2a .o Z- 7 -.;1 7 AS L S Z 7-002 Ft z B oring # Boring ❑ Pit Ground surface elev. •G tL Depth to limiting (actor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 _` ,S- �- 21st 0 D L F 2f ,r- j isc / l G S e 3 „r- s SG hr L G S p �•S - s - a S ®sG S o - o - l a y sF *02 ._ — _ G Z Effluent #1 = BOD, > 30 < 220 mg1L and TSS >30 _< 150 mg/L cent #2 = BOD, < 30 mg/L and TSS < 30 mg/L- -- SST N#me (Please Print) CST Number �� � .2 z d ation Conducted Telephone Number Address Fogerty Plumbing & Perk Testing � /L�• /0 f , Owner Parcel ID # ® -24- -24— II-S3- 2 -0'0'd Page of Property - ��d1LE��' El Boring � Boring t3 # Pit Ground surface elev. _ -F1 ? _ ft. Depth to limiting factor &I in. motion Rate - I Soil Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. Eff #1 •Eff #2 ' El Boring Boring # y� Pit Ground surface elev. ft. Depth to limiting factor )n• Soil Ap igtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 *Eff#2 in. Munsell Qu. Sz- Cont. Color Gr. Sz. Sh. Boring ❑ Boring # Bo Ground surface elev. __ ft. Depth to limiting factor in. rJ pit Soil ication Rate Horizon Depth Dominant Color Redox Description Texture: Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 I Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 BOD < 30 mg/L and TSS < 30 mg1L 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 608g56' -3131 or TTY 608 -264 -8777. SOD -8330 (RAM) l FOGERTY PLUMBING & PERK TESTING 28 8 McKenzie Rd. pooner, WI 54801 (715) 635-9609; 5) 749 656 i 6vT i Fax (715) 63 28 I i aow � rr ry F��rT rr .r 7 3o rr Y /�• G . w - wa rt G �s v f- L ouvD vT cB�� C) 4 - s:T �I Fxcrc z v -rr 5 ys / fo re,. 3 v. jW \ 1 _ 3,s H o QQ tri r o II II II ►-• 0. CD CD ►� En CD CD t� ° `N u i CST CD CL - it .,.�... b .. , ` 'C3 CD ` s •; - i N '? QQ ter CL CD CT CD CD - •i _ <- --- W \ \ O \ yy CD CD tzl rf• ~ Q'e \ \ YF. oy. \`_,Y OCR CD CA OC C O o ' ° in CD , cn 0 -n II II 0 ,", °o M � m l co N CD V �� ;�� cD w N II W �3 �c o co ` 201 W. WasbMiripoa Ave.. P. S Z Macwo, mmy St Ptrmb Mambo (w be OW by Co.) Department of Commerce � Z6Cr • �3� (v� `� Sanitary �� � E8 d Sts Plm LD: Mother In accord wI* C m m U=. Wis Add CWb. ptasoms1 r>my be used for seoondazy purposes Privacy law. s15 q) 51. C?- ,G O FF \C Ad&= Gf offi t sban address) I. AppGCabon Infants ubom — Please Ps AN hWonewdom Pmpaty (hruc s; Na tae Panel f / )r Bbck eC lwle�S' Property Owner's id affing Address Pk ty Locatio 'fm �v.Qc E C&'r �"j (Sly. Store Zip (7odc PI Number vs ' � - E. Type of Bs Wing an that appl>) ("a 01 or z t Number - ofBedrooms 3 5. 0 PtddiclCottmerd - DownI e G 0 Stare Owned - Desml Ilse - OKEe [ funs ip of _ T' HL Type of Peter "Rick a* one TIme & CWwO to Tme B W appliaW A. New System O Replsoemeot O TiammdBddmS Tauk only On Oarer Modr6r dlom so Exasetg B. ❑ Permit Reverm O Per Revaiom O � of ❑ Pa -- Trmk r b Li6t amt n me Bali re EM"jom Owner - • IV. of POWTs Systimoe (C4e & an am awnOW0 Q - Pressurised 1m- Geoumd O Momtd > 24 im of smitalie 0 Mound < 24 L &- ❑ 0 Cam unclad Wemnd O Prmnr®d bi• womd O 1 dWkg O Prat Fi er e 0 F 0 R Symbedc Media Fiber gLencbma O Drip - pipe V. Area 21 Lor ' K i. — ,s ,I` txL It Desip He! (Ipa) is SON 11 tiskad Am Ar P► I (st) C - l• y elsa VI. Tauk Info csp m*y in Tsai N 'P Fsied rastic GaYoms GaBmar' of Urfa New Exkft - Tads Taft I od Aerobic Twauna t Unit Doft - VII. Reqwms&TRy Sfaaartmt 4 slre emiessiBpei, > fir ilda0atiam dare POyP1S ffie attad" ptmss. - -- Pbumber's Na me (Pried pmeme h9ofti S Pii®btf Piome Namber Ply W.s Andre ss (Smem (Ay. Ztp ftedy PkMdft & P*& Test VIII. 2 Saosery Pr emit Fee Groudvgser Dime lined - Apmt Stmsps) O Owner Giv Realm for I% Contititioas of ApprovaVBessoes RW SYSTEM OWNER: 1 Septic tank, effluent filter ` m & dispersal cell must all b rvi d / maintain - — as per management pl provided by plumber. " 2. All setback requirements must be maintainedL/ /pf as per applicable code /ordinances. Aaxti � t�s � tie �i� � �� w Paper eat rein line sort z Il ineLaa sine 0 14 0 0.� M , r I i 9 L� 1 I `� 0 � I " O � s M a . mil" Wisxinsin Department of Commerce SOIL EVALUATION REPORT Page of Division of safety and Buildings in accordance with Comm 85, Wis. Adm. Code n County 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 Parcet I.D. ( PA D percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re 'ewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location 44- �A 1 r /_ �� ✓L Govt. Lot tp 14 S / T N R E (o W Pro ps Owner's Mailing Address Lot # Block # Sub Owner's Name or M# City fate Zip Code P one Number ❑ City F-1 Village XTO Nearest Road New Construction User Residential / Number of bedrooms .---- Code derived design flow rate "y'-) GPD ❑ Replacement ❑ Public or commercial - Describe:_ -- Parent material l�liC/Z`�{/ a �) /✓ Flood Plain elevation if applicable ft. General comments endati �✓ `' and recommendations: t (❑ �^^g# El Boring Cn pit Ground surface elev.L% ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 - Eff#2 0- / & � Cr � -3 iLa F—:21 Boring # Boring Pit Ground surface elev �& /Z ft. Depth to limiting factor � in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 / O 0 Myr2-�2, S C- QYV'42 Cs m • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 Tb Effluent #2 = BOD 5 30 mg/L and TSS < 30 mg/L CST Flame (Please Print) CST Number Si Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 -? �� 715- 246 -4516 Property Owner _ Parcel ID # Page of F 7] 3 Boring # [] Boring Lf ] � 0 14 pit Ground surface elev 1 ' s ft. Depth to limiting factor _ in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 d` U lO ✓ �'/ G �' his d�j 1 3 �`-� F Z F-I Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil plication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 'Eff#2 Boring # ❑ Boring F ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 Effluent #1 = BOD > 30 < 220 mgIL 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 -6730 (8.6100) Soil Test Plot Plan Project Name Lakes and Hill Development Shaun Bi Address P.O. Box 10598 White Bear Lake Mn 55110 CSTM #226900 Lot 22 Subdivision Glen View Date 7/18/03 1/4 N W 1/4S 19 T 30 N /1318 W Township Richmond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post g 1 Sys Elevation 90.9/89 *HRPSame as Benchmark Alt. BM Top of Survey Iron @ 97.3' Scale is 1" = 40' unless otherwise noted Please note: survey was not completed at time of testing, setbacks from lot lines may Pro Town Road change. Installer must verify all lot lines and setbacks before installation. Please Note: Tested area may not be suitable for desired buildin g area. Check system location 312 Property Line before excavating. 97, 95' B -2 AL 30' 30' 10% Slope 20' B -3 0' B -1 100' 11A .M. I 569' Property Line M. t cti ^ rA as i a� I � •. , - •.: . N U 3 Cd 0 71 _� it - � !•p .• °••.•� 04 VP • � p,, II II II W co ol 4.4 on o � H POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Septic Tank Capacity = 2 D al ❑ NA Permit #�.� Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufactures Z �e O NA Number of Bedrooms 3 ❑ NA Effluent Filter Model _/0 — Dd ❑ NA Number of Public Facility Units XNA Pump Tank Capacity al Q„NA Estimated flow (average) al /day Pump Tank Manufacturer [I NA Design flow (peak), (Estimated x 1.5► galJday Pump Manufacturer i NA ZS Soil Application Rate gal/day/ft' Pump Model O NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit DrNA Fats, Oil & Grease (FOG) 530 mg/L ❑ Sand /Gravel Filter ❑ Peat Filter — Biochemical Oxygen Demand (BOD 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dkgwsal Cell(s) ❑ NA Biochemical Oxygen Demand (SOD 530 mg/L / )q In- Ground (gravity) ❑ In -Ground (pressurized) Total Suspended Solids (TSS) 530 mg1L a NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) 510 cfu /1OOmI ❑ Drip -Line ❑ Other. Maximum Effluent Particle Size e ' die. O NA Other: ❑ NA O ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Ott: ❑ NA MAINTENANCE SCHEDULE Service Event Sew Frequency Inspect condition of tank(s) At least once every: 0 ea l(s) (Maxmutm 3 years) ❑ NA 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 every: 3 [3 yyeearrl s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: El month(s) ❑ NA �- JR year(s) _ h(s) Inspect pump, pump controls & alarm At least once every: ❑ ❑ mont mont) C],NA Flush- laterals and pressure test At least once every: ❑ m ❑ y eaa r(s) r(s) ) Lj.NA Other: At least once every: ❑ month(s) _ a NA ❑ year(s) Other: Q 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 fairing 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. P PPP' U. 2 'i 9 S P 2 7 4 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO.. WI WARRANTY DEED RECEIVED FOR RECORD 01/21/2004 11:55AM This Deed WARRANTY DEED HILLVALE DEVELOPMENT, LIMITED EXEMPT k LIABILITY PARTNERSHIP REC FEE: 11.00 TRANS FEE: 134.70 COPY FEE: CC FEE: GRANTOR and PAGES: 1 O�r' .e GRANTEE WITNESSETH, That the said Grantor(s), for a valuable Name and Return Address consideration conveys to Grantee(s) the following P'v4r Oct —( ( 3CO described real estate in ST. CROIX COUNTY, _ _ZZ OF WISCONSIN: PIN # C)Z(o 115 < R>`N> ✓1�,aJ� .7� � ,ea /rC G' U UA: f/ Ibis �; ► ✓ >� This is not homestead property Together with all appurtenant rights, title and interests. Grantor warrants that the title to the property is good, indefeasible in fee simple and free and clear of encumbrances except easements and restrictions of record. Dated this2z• day of January, 2004 (seal) RICHARD NELSON (seal) (seal) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN COUNTY OF ST. CROIX authenticated this day of Personally came before me this ae•day of January , 2004 the above named RICHARD NELSON Title: Member State Bar of Wisconsin to me known to be the person(s) who executed the foregoing instrument and This Instrument was drafted by: acknowledged the same River Valley Abstract 1200 Hosford Street #201 ,_ Hudson, WI 54016 Notary Public, State of Wisconsin My commission expires: / —,3 /— a ✓� MARLENE J. NELSON NOTARY PUBLIC- MINNESOTA My COMMISSION EXPIRES 1. 31.2005 5 ���� � ''_ 2 8 8 9 9 15 � �OS� H N J a. -;� � 15 ,. Sizb3 a 7 . in a '0 6 ?. 5 `fir 74.037 S.F. (1.70 ACRES) �� $� \ 2� �� � � L.B.O. EL. 923.00 _ c� � w 13 ' 14 \ \ 105,605 S. F. 74,551 S.F. •• \ \ � \ (2.42 ACRES) (1.71 ACRES) • L.B.O. EL. 923.00 L.B.O. EL. 923.00 N / (V2 \ \\ � �� • GC(`•?:4 �`n1..r'!f`J R���'��°t' o � - F.!�r�3 / i i ��\ �. \ \ / /yam \ 256,84 15 _1 Ar�� 9 . 4 w ' 1 - w 256.8 1 S79'441 9 "W 21 -- 21 22 d 67,789 S.F. DRAINAGE 89,518 S.F. (1.56 ACRES) EASEMENT j934:10 �° .06 ACRES f Y I 35 , L.B.O. 6.10 1 N27' 0g,4'• W 569 . 0 5' N I %2 ' ' ! ____ ' � '] S8919'36•E 170.29' J 23 [942.30 `S4 105,364 S.F. 170 (2.42 ACRES) N�7 < i L.B.O. EL. = 936.10 _ N79ro 49 5.01 33 24 . I 78,673 S.F. 01 i � (1.81 ACRES) Q; � Q; A178 :31'1 o , o � i Page of .3 ART 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 cents). If high concentrations are detected have the contents of the tanks) 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 Septage 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: • All 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 fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant repl;7 t system: 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 ones 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. 0, 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 following 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. #221180 - 28288 McKenfle Hdr. .SDOOne WI �dit[I'I �� �IId�tTAINER (715) 635 -9609 W/ � POTS INSTALLER Name 1 �� v Name Phone S .- — '3b� Phone = — 'of 41 SEPTAGE SERVICING OPERATOR, fPUMPER) LOCAL REGULATORY AUTHQRITY -� �r q� /&A Name Narrle l 71 C" ca I NT ( t Phone Phie This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. INSTALLER'S NOTES: RECYCLE GREASE! Do not pour grease down the drain. Your septic tank and filter will not handle it. NO BLEACHES! Do not introduce bleaches into your system. The bacteria in your septic tank is what makes your system work. Bleach kills the bacteria. When that happens, your septic tank will no longer function correctly. This will cause premature failure of your system. WATER SOFTENER! Do not run the brine solution into your septic tank. This solution has a high concentration of lime (that's what makes your water hard). The lime tends not to settle out in the septic tank but goes directly to the drain field. Lime is an excellent. sealing agent, and yes, it does the same thing in your drain field. Think of your sewer system as you would your car. Treat the attached information as you would your car manual. Remember, also, that your car requires regular maintenance. 'Cart must be exercised as to what you put into it. And like car, your system eventually will wear out. The question is - how quickly. If you have any questions, please call: Dave Fogerty _ 715- 749 -3656 - Roberts 715- 635 -9609 - Spooner If you have an emergency, and you only get voice mail at these two numbers, call Keith Knutson at 715- 796 -5436 - Hammond I have read the attached information regarding the construction and maintenance of my sewer system. 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