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HomeMy WebLinkAbout026-1153-26-000 epding Division of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix S ilding Di , INSPECTION REPORT Sanitary Permit No: 488010 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: Martin, Michael I Richmond, Town of 026- 1153 -26 -000 CST BM Elev: r Insp. BM Elev: BM Description: Section/Town /Range /Map No: 1 76 f 0 % • yo' ' C ST` cwt. 2- ' ' cb'� 19.30.18.1164 TANK INFORMATION ELEVATION DATA TYPE MANUFACTU ER CAPACITY STATION BS HI FS ELEV. -(rte � - 9141� Septic F � (,2$O � Benchmark Z 5. 1 3 / " ) 01. 53 Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet o' 1 3 TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic S, + Dt Bottom �.Ino l �.D }� 2�(p •� Dosing �� T 14 ' Header /Man. J 1 Aeration T Diet Holding Bot. System Final Grade i PUMP /SIPHON INFORMATION Manufacturer Demand St Cover . �p GPM x.68 �3 1 ?3 Model Number *­ S3 �� rn l p ro 3 r TDH Lift Friction Loss System Head TDH Ft h�4_ Forcemain Length t Dia. Dist. to Well k ZO Z ° - SOIL ABSO RPTION SYSTEM BWik EINCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME 3 1 g� � 2 SETBACK SYSTEM TO P/L BL WELL LAKE /STREAM LEACHING Manufactur INFORMATION Type Of System: t I CHAMBER OR r.d Model Number: DISTRIBUTION SYSTEM J ICJ t Header /Manifold y Distribution x Hole Size x Hole Spacing ept to Air Intake w- \ Pipe(s) /1 Length ' Dia Length is Spacing 6 S SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of 7 eeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 9 p [] Yes ] No ❑ Yes El COMMENTS: (Include code discrepencies, persons present, etc.) inspection #1: DAL• LO 2,OD S inspection #2: `� 1 Location: 1455 92nd Street New Richmond, WI 54017 (NW /1/74 19 T30N R18W Glen V' I ! 30.18.1164 `ro � 5T4 . C��. 1.) Alt BM Description = Q _ 2.) Bldg sewer length = 3 'f C � �^^) E�1 2 33' (( 3r - amount of cover = �{$ " $�.Q c:uv.e�-. - �/ 3 ) - 4, a. v � �� . ��o.qo 11• Plan revision Required? VN 2 � / L 7 S � Use other side for addition mformati I / - Date I Signature Cert. No. SBD -6710 (R.3/97) 1D • t � j'1 ' I Ct�65 -�s.'t z/ d Buildings Division County n 11 NI m 201 W. Washington Ave., P.O. Box 7162 scons�n Madison, WI 53707 - 7162 Sanitary ermit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 88 d' 0 Sanitary P r plication State Plan I.D. Number In accord with Comm 83.2 1, Wis. Nk Co erso i format may be used for secondary pu es Pn sI5.0s ' k'� `' Project Address (if different than mailing address) I. Application Information - Please Print All Infor ion DEC 1Y5s 77- S4 Property Owner's Name Parcel # Lot # \ Block # ST. CROIX Coma, 11 Property Owner's Mailing Address r, , �j -- Prope cation / / J v A�5_ ' /., IVLJ/., Section / City, State Zip Code Phone Number < / , J C{ O rc one) I1 . ype of Building (check all that apply) N; R Subdivision N C 2 Family Dwelling -Number of Bedrooms Numl El n , Public/Commercial - Describe Use V ❑ State Owned - Describe Use ❑City ❑Village ip of ) (, III. Type o ermit: (Check only one box on line A. Complete line B if applicable) p _ 1/5 - 26 - 1 - 1 &44) A. ew System ❑ Re System y ep y ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System B. ❑Permit Renewal it Revision El Change of El Permit Transfer to New List Previous Permit Number and Date Issued Before Expirationz Plumber Owner IV of POWTS System: Check all that appl Non - Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ound El Holding Tank 11 Peat Filter El Aerobic Treatment Unit ❑ Recirculating Sand Filter El Recirculating Synthetic Media Filter ng Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis ersaUl'reatmcut Area I nformation: Design'Flow� Design Soil Application Rate(gpdsf) Dii al ea Required (sf) Dispersal Area Proposed (sf) System Elevation �, v � , VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Ste Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Z J Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigns ap4me responsibility for installation of the POWTS shown on the attached plans. P bet's Name (Print) Plumber's a MP/MPRS Number Business Phone Number - a 7 FOMD 71 �rZ S� Plumber's Address (Street City, State, Z' od VIII. county /Department Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature Wo Stamps) Surcharge Fee) El tven Re for Denial 6 Q — p 2� Zao IX. Conditions of r a eG , ;e --[o fa-k //, - Attach complete plans (to the County only) for the system on paper not less than 8111 x 11 inches in size SBD -6398 (R. 01/03) PLO PLAN PROJECT Michael Martin ^ DRESS 1915 W. 6th St. New Richmond Wi 54017 1/4 NW 1 /4S 19 /T 30 18 TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 f DATE12 /20/05 BEDROOM 4 CONVENTIONAL IN -GRO PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 90.0/89.5' 4.5' below qrade setbacks required by Plans Designed Using WDNR Conventional Powts Scale is 1 = 40 Manual Version 2.0 unless otherwise noted Alt. BM Top of Survey Iron @ 96.4' 461' Property Line Chambers are 5' from Property Line Forcemain is 2' from property line 200' B.M. Alt. Huffcutt Combo Tank Vents B -1 B. 30' Vent 30 >6 „ Standard Biodiffuser of Cover Leaching Chamber with 31.1 ft2 of Area Pro 4 B -3 Bedroom 6' Long 11 " House 40' 34" Grade at System Elevat on 7% Slope 20' B -2 170' operty Li + SPE CK ICATIONS r Cry )ss SFCTIC: ADD gEP'fIC TANK PUMP CliAMB --R WEATHERP 3F APPROVED 14TH. ABO 'VE GRADE; jUNCTTON BOX iHE3LE COV ER �'= G VENT PIPE I IA1i301 4R WITH CONDUIT W1 PADLOCK & MOM DOOR, WARNING LABEL FR£a� [A IN TAKE 7 l lnd f Iit f :: ; `:D GRADE ,. �t X. b. u ,... -:: is Ml1i- INLET ' - L-ti'a S' { , TIGHTt a D ,WATER TIGlir SEALS � SEAL � JOI iPI PE ALM 3LTf�R -- $ ON SO L I D O SUIL APPROVED PIPE 3` C EV + FF t SMID. I L - FT - 5QT! PUMP 4FF EL ►--- D BEVDING UNDER TANy � CONCRETE PAD 3- APFROVED SPYCII'ICATI0335 D DQSE 1+Ei1i18F.R DOSES PER SEPTIC ! GAL - FAC'T�3RER : 13(35£ v 4; I ME FH�BACKK: TANK MA S- GAL- GAL. TANK SIZES: SEPTIC _ GAL. � � i3�iGHES DOSE S CAPACT £S: A _ �� �1.-- - - GAL- B .2_ INCHES xX� L �xs� = e � - � � CAL- SWI TCH TYPE: � _--- > R£R : D INCHES =A:_ _ Pump FACTU ��"� i5.23 WAC MODEL NtTt#B£R = I i EiR SWITCH TYPE s? E ALAR PutH W':RING AS PER CnH _ FEET oISCI'IARGE RATE DIS ZSU -rION PI - � FEET RE4uIR Hp OFF AND - - - - FEET EEN - - FACTOR E - FET VERTICAL DIFFERENCE BETW Fg ;CTTOH M II�It4`i3H NET QRK SDPpLY R£S_l_y- T/ IQ g FT�TAL D�NgMZC HEAD . FEET FORCEMA�N T , y DIAMETER wl L£?�GTH D IIRENSI ONS OF PuM? TANK: LIQlj ID �_. -- -----" INT£it1�RL �z Di LICT:NS£ NUMBER = SIGNED'- z/BE TO' AL DYNAMIC HEAD /CAPP ! PER MINUTE W HEAD CAPACITY CURVE LIFFLUENT AND DEWATERiNG W; MODELS 53/55/57/59 25 Model I 53/55/57/59 I I I 6 20 I Ft. Meters Gal. I Ltrs. 5 I 1.5 4j i63 3 1 31, 129 5 O ; 1 j I z 4 —i j 15 4 -6 19 72 ~ j o 19.25 ft. (5.9i-) \ 10 I Shut —off Had r O E p� 2 5 ! _. i 3 5 51-6 5/32 --� - - 1 4 5/8 '/2 —11 1/2 N,p T C) i 10 20 30 40 50 U.S. GALLONS i I I 3 t 5/16 LITERS 0 gp FLOW PER MINUTE 009e97 4 1/16 - A! APP LA s. yw Variable level float switches available. Variable level long cycle systems available. Available with special cord lengths of 15', 25', 35' and 50'. -- (ji -Alarm systems available. 10 t /ts ! _� Duplex systems available. i i ' d i 3 3/32 l ^ sKSSe I Single Seal Contr Selection Listings red Model volts Phase Mode Y I Amps ' Simplex Duplex CSA ul 1. Integral float operated mechanical switch, no e)demal controlreg level - 53(55&M57/59 . 11 It 1 1 Auto s.7 t --- Y 2. Single piggyback variable level float switch or double piggyba 53155 & N57/5e 1 ; 1 Non 4.7 2 ! 3 or 4 & 5 Y Y float switch. Refer to FM0477. BN53 115 i 1 Auto 9.7 N Y 3. Mechanical alternator "M -Pak" 10 -0072 or 10 -0075. BN57 115 1 auto s.7 4. See FMO712 for correct model of Electrical Alternator, BE53l57 230 1 Auto 4.8 i Y Y L 57/5 230 1 Auto 4 -a 1 —•- Y Y 5. Variable level control switch 10 -0225 used as a control activator, with Eledrica p53/55 & D i 57/59 230 t Non 4.8 2 ! 3 or 4 & 5 Y Y Alternator (3) or (4) float system. E53/55 & D Single piggyback switch included. v cwunoN ,, vmationon additional Zoeller products reierto catalog on Piggyback Variable Level FloatSwitches ,FM0477 ti .;a,� L crr = r. as dro„ V y s�o Idoedo ^e'Y ras r ass fd .a o1;ow a s c'u'p rc 4ftemator, FM0488; Mechanical Attemator, FM0495; sump/Sewage Basins, FM0487; and Single Phase ,e c,; �- zr , ,_,�, _r:� � _ _,t,..... 4 .. 'np ControliAlamt Systems, FM0732. sat factor is engineered into the design of every Zoeller pump. For unusual conditions a res erve tY MAIL TO: P.O. BOX 16347 Louisville, KY 40256.0347 Manuracturersof.. SHIP T0: 3649 Cane Run Road n Louisville, KY 40211 -1961 QKW17YRIAW SNCE A17 ® (502) 778.2731 928 -PUMP PUMP !O. FAX (502) 774 -3624 — --' - - -� 0 Copyright 2002 Zoeller Co. All rights reserved. Sr; and uildings Division County 201 shi V a Isconsin adr WI F` IE anitary Permit Number (to be filled in by Co.) Department of Commerce 6 8) 26 - �`°� Sanitary Perm' p ea ionNO V 2 3 200 tate Plan I.D. Nu b In accord with Comm 83.21, Wis. Adm. CoaWers o inforn ation you provide maybe used for secondary purposes Priva Law, sl .04(1)W) CROIX COUNTY oject Address (if different than mailing address) I. Application Information - Please Print All Information / S� Property Owner's Name Parcel # Lot Block # C, all /'n ,�, �. Property Owner's Mailing Address Property Lo City, State r Zip Code Phone Number `�'• �`'� '��, Section 3 y N; RE II. Ape of Building (check all that apply) 4 W) Ole a o e1' Sib rn Subdivision Name v C Number Family Dwelling - Number of Bedrooms ` �) El Public /Commercial - Describe Use O u5�- Q� / Jo (- vi () !L V I ❑ State Owned -Describe Use Z& k5 vu j` ❑City ❑Villag.AT wnship of III. Type of Permit: (Check only one box online A. Complete line B if applicable) A ,v stem ❑ Replacement System 11 Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System im B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV a of PO S stem: Check all that a 1 ,ry , urized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In - and ❑ Holding Tank El Peat Filter El Aerobic Treatment Unit 11 Recirculating Sand Filter El Recir culating Synthetic Media Fil ing Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) S y V. Dispersal/TreatMent Area formation: Des- Flow (go) Design it Appli ion Rate(gpdsf) Dispersal Area Required ( Dispersal Area Proposed (sf) System Elevation Z VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Oieel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statem - 1, the underi; d, assume responsibility for installation of the POWTS shown on the attached plans. Pame (Pri PI Sign MP/MPRS N b Business Phone Number Plumber's Address (Street, Ci , State e) Z W 04 0 Coun /De artment Use Onl Approved ❑ Sanitary Permit Fee (includes Groundwater Date Issued Issuin t Sign (No Surcharge Fee) !� D(� ) 1 7 A `J for (J IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: I, Septic tank, effluent fiker and dispersal cell must all be services / m Wnhiined as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable co ! ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/1 x 11 inches in size SBD -6398 (R. 01/03) J/TN/R OT PLAN PROJECT Michael Martin ADDRESS 1915 W. 6th St. New Richmond Wi 54017 ' lt4 NW 1 /4S 19 8 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/20/05 BEDROOM 4 CONVENTIONAL XXX IN -G PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 IL BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 90.0/89.5' 4.5 below qrade setbacks WDNR required by Plans Designed Using Conventional Powts Scale is 1 „ = 40 Manual Version 2.0 unless otherwise noted Alt. BM Top of Survey Iron @ 96.4' 461' Property Line 200' M. ease note: survey was not Vents completed at time of testing, 25 ' Alt setbacks from lot lines may B.M. G change. Installer must verify 4 B -1 f 11 lot lines and setbacks b ore installation. Vent �1 30 >6 „ Standard Biodiffuser of Cover Leaching Chamber with 3 1. 1 ft2 of Area B -3 6' Long 11 ” 7% 40 34" ' Grade at System Elevat n Slope 20' B -2 25' Pro 4 17 Y roperty Li Bedroom 15' OST House ,,4 .; 4PRESSURE PLAN PROJECT Michael Martin DRESS 1915 W. 6th St. New Richmond Wi 54017 114 NW 1/4S 19 8 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 11/20/05 BEDROOM 4 CONVENTIONAL )0()( IN - CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE ns LIFT TANK SIZE DOSE TA NK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambers 28 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 90.0/89.5' 4.5' below qrade setbacks required by Plans Designed Using , WDNR Conventional Powts Scale is 1 „ = 40 Manual Version 2.0 unless otherwise noted Alt. BM Top of Survey Iron @ 96.4' 461' Property Line 200' M. ease note: survey was not Vents 25' Alt completed at time of testing, setbacks from lot lines may B.M. change. Installer must verify 4 B -1 11 lot lines and setbacks Vent b ore installation. 30 /` 611 Standard Biodiffuser of Cover Leaching Chamber with 3 1. 1 ft2 of Area 13-3 Long 11 „ 40' 34” Grade at System Elevat on 7% Slope AL 20' B -2 25' Pro 4 17 Y roperty Li Bedroom 15' OST House wiiscohnin Department ofCommerce SOIL EVALUATION REPORT Page of Divisiotyof Safety and Buildings ' in accordance with Comm 85, Wis. Adm. Code County . n t' r � 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. 6 Z (a - // 53 ' Z (o -too Please print all information. I 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 / I � /_/ S- / - P� Govt. Lot sllR �!t /4 S T N R E (o (W Property Owner's Mailing Address Lot # I Block # Subd. Name or M# City tate Zip Code Pone Number ❑ City ❑ Village XToltn Nearest Road New Construction use:A Residential / Number of bedrooms 3/� Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: -___- ------ .- _ - - - -- - - -- Parent material L G4 Z`CG/ cL <� /✓ Flood Plain f elevation if applicable /—y//5 ft. General comments �v rJ✓ x�'v �� �0 " and recommendaendations: / UU 9 # Ej Bor ing C C.. Bori �s { \ J ft. Depth to limiting factor _� in. Y surface elev. g Hl � Pit Ground _L_L_ p n9 Soil Amlication 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 I •Eff#2 o -, z io 3iz m - S 12 d ,-s — � !< m -� , 9- ,3 z S`f ® Boring # (1 Boring _l } pit Ground surface elev. / - ��- ��L� ft. Depth to limiting factor 1 � fl m. 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 1;? v 1Y1 f a m IA41 42 ` �0.0 41 0 Effluent #1 = B00 > 30 < 220 mg1L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Nam (Please Print) Si to CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401 � �� C, 715 - 246 -4516 Property Owner _ Parcel ID # Page of a Boring # ❑ Boring , 0 Pit Ground surface elev. Depth to limiting factor �in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0 - 10 0 3 1 �-- !� rkl .c J ' I _" � Z 5 - C L � � mFr '� V , i s ^^ n Q CL 7 �- z a Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil licabon 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 a Bodng# E] ❑ Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPDIff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'EIW 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. SOD4330 (R.6(00) Soil Test Plot Plan Project Name Lakes and Hill Development Shaun rd Address P.O. Box 10598 White Bear Lake Mn 55110 CS #226900 Lot 2 6 Subdivision Glen View Date 7/18/03 1/4 N W 1/4S 1 9 T 30 N /R W Township Richmond Boring 0 Well PL Property Line County ST. CROIX B r VRP Assume Elevation 1 f t. Top of Steel Fence Post System Elevation 90.0/89.5 *HRpSame as Benchmark -Alt. B Top of Survey Iron @ �6 , Scale is 1" = 40' S . unless otherwise 461' Property Line noted 200' .S Please note: survey was not 25' CIA completed at time of testing, setbacks from lot lines may M. change. Installer must verify 40 ' B -1 all lot lines and setbacks before installation. 0 ' Please Note: Tested area may not be suitable for B -3 desired building area. 40' Check system location before excavating. 7 % Slope a� 20' B -2 92' 93' 94' a 0 c e) 2 w v 2= fir• a 2 - ¢ r ] ¢ 7 ]> H c u a Sj �ZO � ; r 1 3 6 x +.1 STREET � ki Qu u .o a n4g r - -- - - --- V1 Y I 2 SO/1/ o I r- - ' Z ? bar ot W W Z \\ cli WO m• mr� \ W Q QO.O �+ d O U N M ;; ,; o o i,,, a 3 N Z O z N m W��o X 00 504'n m ♦26.5' 3 C H z : W t • 1 .i N < u`i o F-- Li La. 0 m V my J O I \ C4 m 2 14 , 0 LL. O � Z _X m N a��" e L \\ mo <� .Q W I-- V 312.3 3 a N W ,• N — N M m l[� = Z \ 1 N �o� Z LL. O \\ N m. Wbli ' j O LL. V o m• ! 1 p = I— W V 04 I N Q �� , 1 • m its a LL. a �': 1 3 a `� �Oc� £o`•�ts d 1 , I Lr•� m a N M e>, ®I by .m N I • N z �• N m I m I I is _ N • � M I j I �uW �k n • .ap - j n .a 1 Zi Ji w `• Z! o � C, ¢ Q1 t `K.9stoN gl <t�, n a N � ao N / _ y � r N O Maintenance and Contingency Plan for a Septic S stem Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. is a into system is not exceed those required as per Comm. 83 ontingenc Plan Option #1. If ystem fails, determine cause of failure, use alternate area and install new tem i sted replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 1�2933P 631 t� 8 1 2855 KATHLEEN H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO.. WI Document Number Document Name RECEIVED FOR RECORD 11/23/2005 12:15PIN WARRANTY DEED THIS DEED, made between Hillvale Development Limited Liability Partnership EXEMPT i« REC FEE: 11.00 (" or, whether ne or more), TRANS FEE: 137.70 d Michael Martin nd Rory Martin husband and wife COPY FEE: CC FEE: PAGES: 1 ( "Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address int , in St. Croix County, State of Wisconsin ( "Property ") (if more space is e ed, ase attach addendum): p Lot 26, P t of Glenview in the Town of Richmond, St. Croix County, Wisconsin. 5 7:!�r Parc idan"ieatipn 1�r„ bern r (PII This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated (SEAL) °" s (SEAL) * *Hillvale Development Li it�Liabili ers hip (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) j authenticated on STATE OF ! V A ) ) ) ss. Ste% COUNTY ) * TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me on , (If not, the above -named Hillvale Development Limited Liability authorized by Wis. Stat. § 706.06) Partnership to me known to be the person(s) who executed the foregoing . THIS INSTRUMENT DRAFTED BY: instrument and acknowledged the same. / Attorney Kristina Ogland Hudson, WI 54016 Notary Public, State of k4 >4 My Commission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED © 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 * Type name below signatures. INFO -PRO"" Legal Forms 800 -655 -2021 www.infbprofonns.com MARLENE J. NELSON Notary+ Public•MinnOWe '� :: • My iion Es�nrE Jtln $1, 2010 f 11/02/2005 15:09 7152467227 HALLE CUSTOM HOMES PAGE 01 ST CROIX COUNTY S1971TC TANK MAQT MNANCE AG"EbMNT AND OWNERSFgp CERTIFICATION FORM owner/Buyer r Mailing Address _- ftLs� Gi property Address Lf Vd St' htie W (Veri£catim rap,, ed from Planning Department for new coaatrnetraa Ci /State .. Parcel Identification Number — d - `7'l`� LEGA DESM -17 N r � 3D N �W, Town Of trt10 h- property Location ' /,, W,_ V4, SW- � T Lot Subdivision 1 �-- - Certified Survey Map I Volume - . Page # , Warranty Deed # ( Z I � Volume Page # Spec house O yes V no Lot lines identifiable tR yes D no SYSTF•1V1C NAJyCE twoe fmdum to handle wastes. Ytopra maintaaance Improper use and tstaiatenancc of your septic system could result in its pleura W1aat t into tha M= consists of pumping out the septic tank every throe yeses or sooner, if noeded by a Uve� Pte- yo � can affect the faction of tlx: septic tank as a treatment stage iu the waste dispo581 "Cm` The propetty owner agrees to sabmit to SL Croix Zoning Department a cestirication font, signed by the Owner and Iuanba, xeclricted plumber or a licensed p"+gr Ong that (I) t� o ,4* wu ma.StCCpluoiber, joarney»nF� nary the septic tank is 160 than 1/3 full of sludge. is in proper operating condition and/or (2) after inspection and pumping ( above requ � the undersigned lave read the irements and agree to psaiatain the private sewage disposal m with the standards sd forth. hetein, as set by the Department of Commerce and the Depastmesst of Natsnal Resources, State of Wisconsin. Certification tic tern has been maintained must be compktod and rett=od to the St. Croix County Zoning Ofoce within 30 stating that yoar scp sys days of the three year expiration date. s DAM SIGNAPJPJB OF APPLICANT OWNER CELt1 CATION knowledge. 1(we) am (arc) the owr,et(s) of 1(we) certify drat all sutemeets on this form are true to the best of my (out) the property described above, by virtue of a warranty decd recorded in Register of Deeds Office. Lo I go 4S x DATE S G [A OF APPLICANT •4tt +r Any information tUat is mss. represented may result in the sanitary petit being revoked by the Zoning Department. • «...+ •• Include with Uds application a skimped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty dad III � ��!�I � I i Ilillllil:�nl ew ! 1 1 ���IIIIII IIIIIIIIIIIIIINII I lie illlllllllllllllllllll � i li �� g o o is on Ili n � n � ,nn llllli�lll 0111 1111111111 '.11llllll'.II�II ■�', ' I I �, !i; � uuuunnunnuu ��;: II!I1 11 IIIIIIIIIIIIIIIIIIIII ion so lo go ii00 �� I t ', i � ,� ,; � IIIIIIIIIIIIlll�11(I ■ � it ',;,� (: � � ��,;IIIIIIIIiIIIlIIIIIIIIIII � 'rll■ ■■Ire■ ■o ld 1 1111 II I II I � � �.I�iA rr"h ■wra i��l ■■w ■■■■■ (! : IIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII , �I III IIIIi�llllll�lli - � � III I1111fIIIIIIIIIIIh �������������a lllmulNllllllillllllllllllllll nnumuuuunuwrnno.... 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