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HomeMy WebLinkAbout026-1060-20-200 r - Wisconsir Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division P INSPECTION REPORT sanitary Permit No: 463449 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: Waldroff, David I Richmond, Town of 026- 1060 -20 -200 CST BM Elev: Insp. BM Elev: BM De cription: Section/Town /Range /Map No: II O � -�6 4 20.30.18.296620 TANK INFORMATION ELEVATIO DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. i Septic Benchmark �i(Ja � ? Z 5 �. o Dosing n 4`/ Alt. BM V - Aeration � Bldg. Sewer a , g Z 25 Holding St/Ht inlet 6 1( . 1 6 TANK SETBACK INFORMATION St/Ht Outlet (.7 TANK TO �P�/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic > _ �Q �i Dt Bottom S i Dosing �K Header /Man. 7:3< Aeration Dist. Pipe ` - 7 bs {� - ►/ Holding Bot. System I b Y � PUMP /SIPHON INFORMATION Final Grade o o IaA S �i • I O Manufacturer Demand St Cover GPM i (� Model Number lo ery TDH Lift Friction Loss stem Head TDH Ft Z Forcemain Length Dia. Dist. II OfF -1 SOIL ABSORPTION SYSTEM (7 C✓ a" U 9 BEDITRENCH Width Length No. Of Trench: IT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / 3 g SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM EACHING e O Manufacturer INFORMATION T f System: r 6 f HA UN OR Model Number: IBUTION SYSTEM ,p,, c{ �t _ i� 4- C- Hea anifold Distribution x Hole Size x Hole Spacing Vent to Air Intake, Pipes) /' �V Length Dia Length �/ Dia Spacing .J� SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only _2A11 J Depth Over Depth Over xx Depth of xx Seeded /Sodded xx ulch Bed /Trench Center [ )'� Bed/Trench Edges Topsoil < Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: T� l inspection #2: Location: 1486 County Road A New Richmond, WI 54017 (NE 114 NE 114 20 T30N R18W) NA Lot 2 Parcel No: 20.30.18.296B20 1.) Alt BM Description= I o�"�' � / yl °Sam �� 2.) Bldg sewer length =22 ' S C - amount of cover = > m It .Q�,�,,� S� C&,pA , & Plan revision Required? / :, Yes ��� Use other side for additional information. Date Ins: p ct i natu� 1!!�tCert.No. SBD -6710 (R:3/97) Safety and Buildings Division County /� 201 W- W. Washington Ave., P.O. Box 7162 con s in Madison, WI 53707 - 7162 s1 CY'a `'4 Sa ' Hilary Petmu Number (to be filled in b Co. + Department of Commerce (608) 266-3151 y ) Sanitary Permit Appli IRECEIV °° State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal inf ou provide may be used for secondary purposes Privacy Law, s mj Project Address (if different than mailing address) L Application Information - Please Print All Information L C V P � Q_ I Property Owner's Na me OFF /CE Parcel q Lot # Block k �,D�� -c, �J� %�ie �/� � 3 p � - /a(oa _ 26 -zcr� L . Z�(� ! Property Owner's M ailing Address Property Location City, State Zip Code _ Phone Number Z -syy G� d i (circle o ) II. Type of Building (check all that apply) T , N; k�E o � l� �� JS�. �a V11 1 or 2 Family Dwelling - Number of Bedrooms c y Subdivision Name � CSM - Number ❑ Public /Commercial - Describe Use es' , - ,x:2 05 - -_ 1 1 957 I G L 1 State Owned - Describe Use ._ I..� 7 / Citv_Villa ownship o ge�71T III. Type of Permit: (Check only one box on line A. Complete fine B if applicable) A. New System ❑ Replacement System C Treamient/Holding Tank Replacement Only ❑ Other Modification to Existing System l B, ❑ Permit Renewal U Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration P Plumber Owner Type of POWTS System: (Check all that apply) _ Non - Pressurized In- Grou ❑ Mound > 24 in. of suitable soil Mound < 24 in, of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑Peat Filter ❑Aerobic Treatment Unit ❑Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter XLeaching Chamber ❑ Drip Line Gravel -less Pipe _❑ Othe (explain) V. Dis rsal /Treatm Area Information: t ,� i Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation i VI. Tank Info Capacity in Pa y Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank r Aerobic Treatnun e- J r t Unit - Dosing Chamber I / VII. Responsibility Statement I, the undersigned, assume responsibility for ' Ration of the POWTS shown on th attached gl ans. _ Plumber's Na me (Print) Plumber's Si gnature P _ PRS Number Business Phone Number a?�?74' O' 71 S'3�� -3x21 Plumber's Addre ss (Street, City, State, Zip Code) VIII ount /Department Use Onl Approved rave Sanitary Permit Fee (includes Groundwater Date ssue Issuing g t Signature Surcharge Fee) - n en Reason for U IX. Conditions of Approval /Reasons for Disapproval s 3) YBTEM OYYIt�R: t � � I fYMr t1 nd A&:t, l &. eo a t/1 �. �_d f1 e cell must aN be SmiM I maintained ss per man men an rovided by plumber. 2 JW ffllikk requirements must be mai atn 1 Y as per applicable code i ordinances. Attach complete plans (to the County only) for the system on paper not less than 8112 x It inches in size SBD -6398 (R. 01/03) I I � I •�1�4'l1N0 M�Y$y'� PA l � �� v Ql f7 CI \ i �D v G �G 4� �,a I vliisaonsin Department of Commerce SOIL EVALUATION REPORT Page _ of _ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Cow Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must Ji C YU include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 2(e - /o, fo O Zp _ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Reviewed by Date Personal information you provide may be used for second Pu J4" a #04 (1) (In w 1 �p�I Prop L tion rte' `7 t 5 Pro weer V2 �pvi erty Lot ` /�/ F 1/4 1j1 r- 1/4 S Q p N R E (or)® Property Owner's Mailing Address nn L Block # Subd. Name or CSM# 139 l er f 'A ' h 7 City State Zip Code Village (RTow Nearest Road Juci-T)n I L)-) I 5q 6) (O New Construction Use: R Residential I Number of bedrooms Code derived design flaw rate YS 0 a GPD ❑ Replacement ❑ Public or commercial - Describe: �� -�— - Parent material Flood Plain elevation if ft. General comments - y y C e v✓� C j - eV . 46f SO LOIN t �t'D . �6 Q� gl- and recommendations: Boris # El Boring Boring ® Pit Ground surface elev. �y o' ft. Depth to limiting factor _ in. Sol A 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 SL Z - 7_19 tC7� 3Cp LS ( ,., Jr• cur I I Boring # Boring p Pit Ground surface elev. � L t L- _ ft. Depth to limiting factor 12- in. Sol A Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPDfffr in. Mumsell Qu. Sz. Cont Color Gr. Sz. Sh. - Eff#1 - Eff#2 1 0 — 10 Yr ,313 SL Zkn5 LS Im5' my r cur - 1.2 3 Z -1 l 0 r -f btv Effluent #1 = BOD > 30 < 220 mg& and TSS >30 150 mg/L ' Effluent #2 = BOD < 30 mg/t. and TSS <- 30 mg/L CST Name {Please `�� ') Signatur e CST Number yh- AL W9 Address Date Evaluation Conducted Telephone Number 11 02 r YC� t Properly Owner _ Parcel ID # - - -- Page of _ -- ® Boring # ❑ Boring pit Ground surface elev. ft. Depth 6o Kn ifin g factor in. Rate Sol Application Horizon Depth Dominant Color Redox Desc ripti� Texture St Consistence Boundary Roots GPD/ffEff#2 in. Munsei Qu. Sz. corrt. color Gr. Sz. Sh. r -3 3 SL 2 C5 IV -C , 5 8 5L 2r,r, sbk r C v.r 3 2 -iZ 1 / _ QS ml ❑ Boring # ❑ Boring ❑ ph Ground.surface elev. ft. Depth to Wrd*V factor in. Sol Application Rate Horizon Depth Dominmrt Color Redox Description Texture Structure Consistence Boundary Roots GPDfff In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. - Ef #1 '011#2 Boring # ❑ Boring F El Pit Ground surface elev. ft. Depth to Irrniling factor in. Sol ication 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 • Eawj t #1 = BOD 30 <_ 220 mgk and TSS >30 <_ 150 mgfL ` Effluent #2 = BOD < 30 mg1L and TSS <_ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an altemate format, please contact the department at 609-266-3151 or TTY 608- 264-8777. SOD-8330 (R.07/00) , PAGE3OF3 ` NAME: Cdr (ct IrA�; LOT #_LEGAL DESCRIPTION:MI14-�IF114,S,70 T_3�,N,R,-Le SCALE: 1 "= - / ELEVATION: 10(), y ff BM 1 DESCRIPTION: �-,6p o t BM 2 ELEVAT�'ION: I W 0 BM 2 DESCRIPTION: kp,. d=� I T rd (\ 0"4 v l/ SYSTEM ELEVATION: $(,S SYSTEM TYPE: C ©/� Uey� -� Ib ✓�a( �, y 1 1 ° 6 / �lx� A D SIGNATURE: i Wmcbnsm Department of Commerce SOIL EVALUATION REPORT Page or _3 Division ofSafetyaind Buildings In accordance *0 Comm 85, Wis. Adm. Code Attach complete she plan on paper not less than 8112 x 11 Inches in size. Plan must C>ro i 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. Please print aN Wo p Reviewed by Date Personal information you provide may be used for second ry perP t� �r�s ®UA (1) ))• Property Owner II ..�^ rr `` (� Property L lion V2 l.C_.C_l o r c4 �' MAR 2 dot /�/ F 1/4 /� -114 S 20 T p N R E (or)® Property Ownees Mailing Address 4'Er_1 Block # Subd. Name or CSM# 1 e r (�.I ST. CROIX CO City State Zip Code ity 0 Village [SPTown Nearest Road 1�0 New Construction Use: Oa Residential 1 Number of bedrooms 3 _ y Code derived design flow rate ; J S llv a' a GPD 0 Replacement 0 Public or commercial - Describe: Parent material _ O -S t Flood Plain elevation if applicable ft. General comments .Sy Cj e w -, e l -eV e 46 5 �7 . SO LOwtr 9 Sa and recommendations: F 1 Boring # ° Boring 12 ® Pit Ground surface elev. �y" • O W ft. Depth to limiting factor _ in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eft1 `E o-1 1 0 SL 2 s rn� cs Z - ID Co LS ( mv� 3 7 l.2 F i l Boring # ° Boring Pit Ground surface elev. , r . ft. Depth to limiting factor 1 Z4 in. Sob Applica Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If in. Munsefl Qu. Sz. Cont Color Gr. Sz. Sh. '0191 *M2 SL ZiYl rrSc CS ( v 5 Z 10- 10 [n I — LS ImS Mq n' Cw – Z (,2 3 2 -12y tv ry l cv — O rn — r: Z Effluent #1 = SOD > 30 220 mg/L and TSS >30 150 mg/t. ' Effluent #2 = BOD 1 30 rng/! and TSS = 30 mgll. CST Name (Please ) Signature CST Number 2�1 369 1� �=VW Address Date Evaluation Conducted Telephone Number !l 3 _s4 A cl - t � o s- I Properly Owner l,�aldro�'�' ParcelID# Page of ® Boring # ❑ Boring �j ® Pit Ground surface elev. ft. DePTf, t Wrrt�g tailor i 2 3 Rate Horizon Depth Dominant Cola Redox Descriptlon Texture Structure Consistence Boundary Roots 77( !* in. Munsell Qu. Sz. Cont. color Gr. Sz. Sh. 'Eff#2 v - g f d 3 -- 9 L k rv,t C 5 l v r , _8 2 -24 I0 SL 3 -I Boring # ❑Boring ❑ pd : "qroundsuiface elev. fl. Depth loo Writing factor in. Sol Appkadon Rafe Horton Depth porn rant Color Redox Description Texture structure Consistence Boundary Roots _ GPDM in. Munsell Qu. Sz. Cont. color Gr. Sz. Sh. 'Eff#1 'Eff#2 I ❑ Boring # Boring ❑ Pit Ground surface etev. ft. Depth to limiting factor in. Sol Application Rate Horizon Depth Dominant Color Redox Descriptbn Texture Structure Consistence Boundary Roots GPDKf in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#t 'Eff#2 i ' Eiuuent #t = BOD 30 <_ 220 axA and TSS >30 <_ 150 mgfL '.Effluent #2 = BOD <_ 30 mglL and TSS _< 30 mg& 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. SOD-8330 (R.07100) II i PAGE3OF3 NAME: a.tc(r0� LOT #_LEGAL DESCRIPTION: I /4�/FI /4,S T�,N,R,JL or)o /J r SCALE: I "= / ELEVATION: 106, 6 l® N + BM 1 DESCRIPTION: ©C3 -t ( '+ QJri Q� — pq BM 2 ELEVATION: f 1 , (9 0 BM 2 DESCRIPTION: -lop 0- I rt T ro n P "4 e v V SYSTEM ELEVATION: 4,19 V, Sd /,c oer &, S - 6 SYSTEMTYPE: CaIIU�N�'hb✓�aI j V ` 1 ,ICA,`, 1° r L Q_ ,l A10 A SIGNATURE: - DATE: © ' ell SURVEYOR: - - - -- - -- - PREPARED FOR: 'OF Wk DOUGLAS J. ZAHLER DAVID WALDROP: 'C S & N LAND SURVE`/ING, INC. `398 RIVER ROAD Alt CO DOUGL 2920 E�lLOE STREET HUDSON, WI 54018 S J. HUDSON, W! 54016 ZANLE Z 5- 2145 7a a ,s�3 z HODS Ni 14 COR_ NORTH LINE OF NEC SEC. 20 THE NE114 SEC. 0 •- l -- N89 °4 9' 21 ' ' W 2585.2 3' V 1371.48' � 1213.7¢' , i LEGEND i M ROADWAY SETBAC LINT j • •• (100' FROM RIGHT- F -VJAY) 1 • ti . o -- EXISTING FENCE 2. .� FOUND ALUMINUM -OUNTY SECTION CORNER ONUMENI } r \�� FOUND 2' OUTSiD DIAWTrER IROM PI j SET V OUTSIDE DI 1ETER 8Y Q 18" LONG IRON PIP , WEIGHING 1.13 LI PER UN_ R FOOT ` �o>' i •��i S �- PROPOSED DRIVc Y 3 a � � s �. o LOT 2 1 p- � 2230 (S7,129 23 C. Rvw A'So 2.000 FS v ° ado (87,129 SO: F' EXG. PIN i 7 0 LOT 1r s 2.230 ACRES s r _ (97,129 SQ. FT.) INC. RPA' 2,000 ACRES Oa s (87. .23 SQ. FT. EXC, Rh. a z o �6 6► ' G � ' w m LU LL mz LL in ¢ O N Z LL L 66 WIDE DR'VEWAY EASEMENT RECORDED f j gyp, / / 2 ��N�� ' R Q IN VOLUME PAGE m z c CP ' ;� ' SCALE IN FEET 1" 100' 1 = , 100 0 100 THIS INSTRUMENT DRAFTED BY: WILLIAV K.ANE JOB NO. 6136 -135 DATE 04/1012 SHEET 1 OF SHEETS L'd 1099 -61rS -SIG JJO -aPIRM atlnC WLS:II SO 9a - i SURVEYOR: PREPARED FOR: DOUGLAS,' 7}V -ILCR DAVID `AALDRGFF && N LAND SURVEYIN INC. 598 RNER ROAD j 29 ?0 FN! 017 STREET HUCSGN, WI 54015 HUDSON, 1NI 54016 SURVEYOR'S CERTIFICATE I, Douglas J. Zehler, Registered Wisconsin Land Surveyor, hereby certify that by the di ction of Dave Waldroff, I hcve surveyed, divided and mapped part of the NE1 /4 of the NE1 and { part of the NW1 /4 of the NE1 /4 of Section 20, T30N, R 18W, Town of Richmond, St. roix I f County, Wisconsin; described as follows: Commencing at the Northeast corner of said Section 20; thence N89'46'21 "W along t e north line of the Northeast Quarter of scid Section 20 a distance of 1213.74 feet; th rce S00'13'39 "W a distance of 429.22 feet to the point of beginning; thence S35'36'07 "E G distance of 485.55 feet; thence S5z-'23'53 "V4 along the centerline of County Trunk Hi way i "A "a distance of 400.00 rce!, UJeiiLe N33'30'07 "W a disiunce or 485.65 feet; thA_,1ce lI N54'23'53 "E a distance of 400.00 feet to the point of beginning. Above described pa el contains 4.460 Acres 094,259 Sq. Ft, Above described parcel is subject to right —of way of County Trunk Highway "A" and subject to all eosemerts, restricVons and covenantc of record. I also certify that this Certified Survey Map is a correct representation to stole of tl exterior boundary surveyed and described: that I have fully compiled with the provisiars of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of St. roix Count and the Town of Richmond in surve Y and mapping some. Douglas J. filer L 45 y Date S & N Lan 5urve ing CO) DOUGLAS J. 2520 Enloe St. ZAHLER Hudson, WI 54016 5-2145 HUDSON, l WI3. s� I i j i Each Parcel shown on this map is subject to State, County and Township laws, rules Ind regulations (i.e., wetlands, minimum lot size, access to parcel, etc.) Before purchasing or developing any parcel contact the St. Croix County Zoning Office and the Town of Ricf Mond for advice. i THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6136 -05 DATE: 04/10 /2 SHEET 2 OF 2 SHEETS E'd 1099- Gips -SIG JJOJPIWM aiinr QLS :I1 SO 92 Jdd 14 210 6 aL a 77� K4tiTHL H. WALSH REGISTER OF DEEDS WARRANT I DEED- ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between Edward Merkt a /k/a Edward J. Merkt, a single 12- 20-19" 10:00 AM man, Grantor, and David J. Waldroff and Julie A. Waldroff, husband and WARRWY DEED wife, Grantee. EXEMPT 0 Witnesseth, That the said Grantor, for a valuable consideration conveys CERT COPY FEE: to Grantee the following described real estate in St. Croix County, State COPY E E 645.60 of RECORDING FEE: 12.00 PAGE 2 Recordin Area Name and Return Address BAKKE NORMAN, S.C. P.O. BOX 50 NEW RICHMOND, Wl 54017 (see attached list) (Parcel Identification Number) SEE ATTACHED SCHEDULE A. EXCEPT Lot 1 of Certified Survey Map recorded in Volume 8 on page 2299 as Document No. 464655, which was previously deeded to Grantees by Warranty Deed dated December 26, 1990 and recorded on December 28, 1990, in Volume 889 of Records on page 435 as Document No. 465220. This deed is given in satisfaction of the Land Contract dated December 4, 1990, and recorded on December 5. 1990, in Volume 887 of Records on page 615 as Document No. 464663. This is not homestead property. Together with all and singular hereditaments and appurtenances thereunto belonging; And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, highways, utility rights and reservations of record, and will warrant and defend the same. Dated this �— d October, 1999.. `Edward Merkt a!k/a Edward Merkt AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE of WISCONSIN ST. CROIX COUNTY Personally came before me this ' /"5 ' M day of October, 1999 the above named Edward Merkt a/k /a Edward J. Merkt to me authenticated this day of known to be the person(s) who executed the foregoing in ument and ack ledge the same. signature P signature type or print name type or fir 04. 0 TITLE: MEMBER STATE BAR OF WISCONSIN rE roix County, Wisconsin. (If not, ermanent. (If not, state expiration date: authorized by §706.06, Wis. Stats.) v . /e-o 0 THIS INSTRUMENT WAS DRAFTED BY * Namesrperson g in any capacity should be typed or Timothy J. Scott rip(g$ olyJhei ig ures. BAKKE NORMAN, S.C. Pu�L S (Signatures may be authenticated or acknowledged. Both are not 0 fr iS�O,�e necessary.) Infmmatlon Professlonais Company Fond du Lac, W.S .O Sin 800- 655 -2021 i' ry Af IEO -. 1 SCHEDULE "A" Real Estate Description of Richmond. St. Croix County. ll (A property located in the Town Township 30 North, Range 18 West) 1, The Southeast 1J4 of Section 17. west 1/4 of Section 21 lying North 2- Ali that part of the Northwest 1/4 of the N known orth and West of the abandoned railroad n S ortatio Company (h railroad right • as the Chicago and Northwestern Tra p of way). 3, The Northwest 1/4 of the Southwest 1/4 of Section 21. 4- The North 112 of the Southeast 1!4 of Section 20 EXCEPT that part located Northwest of the abandoned railroad right of way. } The Northwest 114 of the Northeast 1/4 of Section 20 5 . ortheast 1/4 of Secti b- The East 1/2 of the N on 20 EXCEPT that part located Southeast of the abandoned railroad right of way. parcel 7. The Southwest 1/4 of th Noo wa ren Bad and Shirley Baderr in the warranty desc in the c ter f deed recorded in the St. Document County t No. 422339. of Deeds Office in Volume 7b8 0 Records on Page 594 g All ihat portion of the abandoned railroad right of way described in the conveyance from the Chicago and Northwestern TrAnsportation Company o. 383796. to Edward J. Merkt recorded in Volume 662 of Records on Page 349 as Document N Parcel Identification Numbers: Section 17 026- 1050 -40 -000 Section 21 026 - 1063 -95 -100 026 - 1050 -50 -000 026 -1064- 40-000 026- 1060 -60 -000 028 - 1050 -70 -000 Section 20 026- 1060 -20 -000 026 - 1060 -30 -000 026-1060-30-110 026 - 1060 -40 -000 026- 1062 -70 -000 026- 1062 -80 -000 026 - 1060 -50 -000 026-1060-50-110 rM u�c7k4 STANDARD CHAMBER — 5z" Quick4 Standard Chamber (EFFECTIVE LENGTH) LENGTH) 1z° ~ ® I I 34 "- - S!DE VIEW SECTION VIEW MultiPort End Cap — — 12 „ i 16 "��_ I i — " r SIDE VIEW TOP ViEW FRONT VIEW 'k - Quick4 Standard �Chambe - :Npmmal�S ecificati' 8-' }tlmj - ,� , $ ' �� z � ,, rr °'�` ^ E r Ili, :end C p nal Specifications x YE >r�q Size W x L H 34" x 16 x Effective Le 48e Invert Height 8" or 1.25" Invert Height 8 ,r INFILTRATOR SYSTEMS INC STANDARD L LjjEg WARRANT (al Ire 'trctctwal Intayrily w a- h chamber, arrd pWte, wecrgo era other e�t.osso y c a utaulured try Ifi i rate ('Una, }, When Installed alxl operated 'rr a react 15101"1 Of an onsita Supt, s'ystQn` in aCOOrdanC with I,I 11 n ; i, l t m wa r,rt t <xf to rho U g 151 pwchasar ('I agaihut dafOi t— nL ter al a wn ril rkmalrstup In, aw year horn Ilia date !hat the scpi" per I t , i s Ire ao{tl'ic syrtern canaYltntt Ina 44u1s: provided, nowe —,, ilaf 'I. septic perms n: not rarluha(f i.W apPacebh law, Iha wa,rantY periaf 11 ucgin uWn iha kLa t p1n;aNatiun or my ;eplic system, Canrnances. To axon 11" ifS, Warrarnny nghts, i-bMer must not'fy ,fitraiw n rd y m i(s �u pasta freadcludi Ok1 tlayhrOok, Crvrne *Lit within Rttean (15) ffin - (I41 Of ew aleyed CII Irhhmtw will supply placonwt Ih & for Unr cfai( r n-d ny t f mt<ar to be'Cbvpra(I by this' W."'my. , • r tnf l atwk kaWly of erdn:afty a %C)WfaS me Cost CA 'On ""a Wd /01 nSII of the Urals it.) THL -PATFD ✓yAn 1ANTi AND REMEDIES IN SUBPARAGRAPH (a) Ann ekx;i U "dWE it II_FYF. M1E NO O1HER WAFy'1ANTIES WITF4 RESPECT O Mc JNi r5, We LUOING NO !MPLtEO VV OF iv�RCHAN fA81LITY OR 1`1 I nth WR A PARTICULAR: PURPOSE. SYSTEM INC tn; .i arty shall ue void d any part of the chanlhel system s ma. u owed L v :ni xMe other than ktilhalor '(Ire Limited Warrant P n I i ni(ed W y tyros yr to Ulm Ill p ,v 4 ltj, wj and hi aiai, spacial w ad OOS damage, Inkltr s x a 1uf I krr tranaltirl4 w ligpxiatad drxna ©on inrhrdirg loss of EnvlronmWbif Onside Wa st ewater S�futlone ltrodJC liar and m,I L rr and ma7eriais, n ardead oasis, or older losses cr a+tlM Sris r C d, d by it). Wick,, w any lhlnf party. SWiliealN e:.c uded I!om Lgnil rt Warranty am damage to the units due to W vy Wear and fear, allarallwt aUadant "W". abuse or "act of the vh ts. r nfl be6n9 of fo in to inst It Ira!G or other s: th Wlecn a,a nor pnLJtlai by Iha insfaliation Iosiructbns', ffrd x to maintain the 6 Business Park Road � P.O. Box 768 mine ruin ground (trysts s<rt hxin in the {nstaNatlm instruction tno pfacarnra^ �r irr;wopw malarial, into the ,yatern cnhlaaurg the lkkts: lalure or Iha ant, w trin,altic sYateml due �mgxoper ate,g w vmmpa �i :,n __ warm aeaaa, anPropm 9nWA eispnsal, or improper operation; or Old Saybrook, CT 06475 any rthe, evOM not .ausad by Infikrator. Ibis Lambed Warranty shah be w 0 d the HukY r Was to cwnpy wim all W tea terrcs sot Lorin in Ihls lontau Warranty. 860- 577 -7000 • FAX 860- 577 -7001 F,rnlue, in no evun itlJll Inellralor nn reSponsior" tw any k 'ss or Uanlage 10 Hader, the Units, Or any third pally resulting hen inatalslion or ship- 800 rnent, Cr hem any product iItiomy claims of Holder w any thir Party For fhii U , itod Wananly to apply, the tklits mnat be inslatiad In acC�ordanco wi Of Site conditions required Fry slate and kXal codes; Wi o7ner applicable laws; and inp{Irator's inStaflallon ineli'uchuns- ' p1) No reprosenlalive of AtiNralor has the autluxay to change oc axl tt: Ih5 Li+rntad Warraty. No war applies to" parry other Ilien ae odgi nal Holder. Tho atimo represents Iha Standard LimAed Warranty oaerorl by Infnlreta- A tanned nunuW 01 stares arid counties have different warranty requim- ntente. Any pun:l Iasnr Of nulls should contact IntgUatoYS li. pcealo H in CIO 5iYU-Mok, e mroclicut, prior tO SuCh pwU11088, to Ordain a copy %f the app�.iceblo warranty, aid mould camkd{y road that wanantY pew to the purchase of Unit,. U.S. Patents: 4,759,661; 5,017,041; 5,156,488; 5,336,017; 5,401,116: 5,401,459; 5,571,903; 5,716,163; 5,588,778; 6,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pendir Infitrator, Equalizer and SiCto tndel' are registered trademarks or Infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc. ',s a registered trademark in Mexico. Contour, Contour Swivel Connection, Microl-eac'ning, Polyruff, Si iapLock, Chaml'rerSpaloer, PosiLock, QuiekCut, Qu ickPlay RECM90PAPEP and puick4 are trademarks of I,Mtltralor Systems Inc. ® 2003 Infiltrator SyS1en1S Inc. Printed in U, S.A. I FILE I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of NFORMATiON SYSTEM SPECIFICATIONS Owner Septic Tank Capacity Qd al ❑ NA Permit # Septic Tank Manufacturer O NA DESIGN PARAMETERS Effluent Filter Manufacturer � ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model � �d O NA Number of Public Facility Units ❑ NA Pump Tank Capacity O al O NA Estimated flow leverage) �fs"Q g al/day Pump Tank Manufacturer 3 .� y O NA Design flow {peak), (Estimated x 1.5) 0 al /day Pump Manufacturer � C3 NA Soil Application Rate al /da /ft2 Pump Model O NA Standard Influent /Effluent Duality Monthly average* Pretreatment Unit O NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (SOD 5220 mg /L ❑ NA ❑ Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfe 0 Other: Pretreated Effluent Quality Monthly average Dispersal Cells) ❑ NA Biochemical Oxygen Demand (SOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) S70` cfu /100m1 0 Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. 13 NA Other: 13 NA Other: ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Eveat Service Frequency Inspect condition of tank(s) At least once every: 3 months) (Maximum 3 years) ❑ NA ear(s) Pump out contents of tank(s) When combined sludge and scum equals one - third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA 3 w ear(s) Clean effluent filter At )east once every: month(s) ❑ NA . earls) Inspect pump, pump controls & alarm At least once every: .— ❑ month(s) ❑ NA O years) Flush laterals and pressure test At least once every: O month ❑ ye (s) l ❑ NA Other: At least once every: 0 month(s) e ❑ NA Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(sl shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. 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Aew 1841 81901W040 40410 ,10 slonpoid B ;o aougsoid eyi JO; (s)luei Iu9 4o94 SIMOd 941 ;0 esn Oi iosi ' M0u J N011V aNV do 11iVIS 10 98ed ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT • . ► AND OWNERSHIP CERTIFICATION FORM owner/Buyer / =` Mailing Address e , e A -- Z l Property Address (Verification required from Planning Department for new construction) city/state Parcel Identification Number LEGAL DESMnOO Property Loeatiorl . ' /., � !., S T �'� N-Rr, W Town Subdivision Lot # Certified Survey Map # 7� Volume l Page # --! Wa fauty Deed # (p15 3 Volume 1Y 77 . Page # z /� Spec house ❑ yea a no Lot lines identifiable 1. yes ❑ no Improptz use ate maintenance of your septic system could result in its premature failure to bandle wastes. Proper maintenance eoaniats of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. Wbat 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 Departmenent a certification form, signed by the owner sad by a ===plumber, Journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system Is in pamper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the underWped 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 bas been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. - a) SL" � V L�5 SI MATURB OF APPLICANT DATE I (we) certify that all statements on this form axe true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the propaty deacdW above, by vhtw of a warranty deed recorded in Register of Deeds Office, SIGNIVURE OF APPLI I DATE 0 * 00 ** Any i"onution that is mis y �8 Depart - represented may resent in the sanitary permit be revoked b the Zo nt. +• Include with this appiteattow. a stamped warnaty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I ' Parcel #: 026. 1060 -20 -200 '05/06/2005 03:21 PM f PAGE 1 OF 1 Irr9p rcel # $0,�30.1.2qG2 y, ,�., Q26 - TOWN OF RICHMOND ! � ST. CROIX COUNTY, WISCONSIN ptiort Da "Historical) Dade p,# Sales Area Application.# � rr�lt # Permit Type ' t I i t 00 0 - r r r TaxY'Addeess:. C t Owner(s): " = Current Owner tt * WALDROFF, DAVI� J J & JULIE A O ff J'& ig JULIE'A WAL6ROf F f 398 RIVER RD 'HUDSON WI 54016 Dis icts: SG = School SP = Special Property Address(es . Y * = mary Type Dist # �escrlptlorr � * 1486 CTY RD A , SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.230 Plat: 1695 -CSM 17 -4514 026/03 SEC 20 T30N R18W PT NE NW & PT NW NE Block/Condo Bldg: LOT 02 BEING CSM 17 -4514 LOT 2 (2.230AC) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 20- 30N -18W NE Notes: Parcel History: Date Doc # Vol /Page Type 05/08/2003 720532 17/4514 CSM 12/20/1999 615773 1479/210 WD 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 07/01/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.230 29,700 0 29,700 NO Totals for 2005: General Property 2.230 29,700 0 29,700 Woodland 0.000 0 0 Totals for 2004: General Property 2.230 29,700 0 29,700 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00