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HomeMy WebLinkAbout026-1173-36-000 Parcel #: 026- 1173 -36 -000 12/06/2007 07:54 AM PAGE 1 OF 1 Alt. Parcel #: 20.30.18.1390 026 - TOWN OF RICHMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/21/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - OLSON, LANCE & SALLY LANCE & SALLY OLSON PO BOX 416 MINONG WI 54859 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description 1443 109TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 2.721 Plat: 10- 036 - WALDROFF MEADOWS IV 020 -04 LOTS 2514 SEC 20 T30N R18W PT NE SE BEING WALDROFF Block /Condo Bldg: LOT 36 MEADOWS IV LOT 36 (2.721AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 20- 30N -18W NE SE Notes: Parcel History: Date Doc # Vol /Page Type 03/06/2007 845904 WD 05/11/2005 794658 2800/609 LC 12/20/1999 615773 1479/210 WD 07/23/1997 824/221 more 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/21/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.720 31,300 0 31,300 NO Totals for 2007: General Property 2.720 31,300 0 31,300 Woodland 0.000 0 0 Totals for 2006: General Property 2.720 31,300 0 31,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ti e p °� 0 ° 6q y M C a o o � � � v �.~ O n o tl N U C O v E v y v . c i @ C'7 N O o6 07 C > -O N O N y c O 0 U p u jC?E L : C UAL 7 p O U -0 � zs CL F•. O'N DOL O! v) O to C � TO @� O p m N 7 @) U E U LL C Q� a) LL c y O c O E O O Q) aE)YE Ey. N a) co - o E m co a) r Q N 0 3 u Q U U iR D I > z " z w m U 0 ;3 O R v o Z N " a m a m co o z �* c .0 3 0 1 c0 U a) Z d Q - O) CI Q a) I C O E @ E N o U 2 y� .. N > 3 N p1 l�,1�1 4 ai U' y C c Co co 0 CD d @ L N "C €o N N N I U c +.. O 0 0 O z E Z Z c Z p N z o 0 c @ co E LO LO w a) a) co m G @ u N @ (D r E E 0 c a` E as CL h Q O w !n fn N L u !n fA N 2 4 ►+� z> = 0 0 O a = 0 0 0 d N • N (o @ a. a a a a a O O N ^ N N !n J U O O C O O a) Co N Z @ N N } cn cn @ .- - @ N � nJ� O O .O v -O N Q z 2 Lo c U N C cl Ai O r p N C c © :C Q c ca a) 1 2 :3 7 O tl; O O O O ° o v C14 0 3 w cu c c L@ m A � ;_? n. O o 0 C N F- O tq j N @ @ m N M 4 7 i v J ° a ; o > r, d a) > , cc) n c c _c ° a v .., o N E = E 7 c rn 0 c >> L N N 7 O m @ O m CS U a) a) U • �' ° N 2! F cn o d z F` c) o Y Y rJ) E a a zx a .. a > •• a r > • R n u d y d y c L A U a 2 0 w U 0 (n U Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building - Division • INSPECTION REPORT Sanitary Permit No: 499284 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: Olson, Lance & Sally I Richmond, Town of 026 - 1173 -36 -000 CST BM Elev: Insp. BM Elev: , BM Des cri ion: Section/Town /Range /Map No: G.1 M 7i 20.30.18.13 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic D B enchmark /1 � 7 Dosing Alt. BM Aeration Bldg. Sewer Holding t/ t In l l et ( S EH Outlet TANK SETBACK INFORMATION /h 7- l 17 S TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet / Septic i f S I 7i Dt Bottom >g ZL 1 Dosing eader an. r, � 21 c 5, Aeration Dist. Pi e St1l. r q.3/ 4 aY Holding — Bot� I D, 3, S'_ Final Gr e `� PUMP /SIPHON INFORMATION I - o �1 �C►h (e - 7' �{ Manufacturer Demand St Cover GPM Y 01 Model Number TDH Lift Friction Loss System TDH Ft Forcemain Lengt ia. Dist. to Well SOIL ABSORPTION SYSTEM d (� Ge�1 BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: 1 INFORMATION CHAMBER OR Type O ystem: r--3 UNIT Model Numb N ZR UTION SYSTEM ►� -P� a Header anifold Distribution r x Hole Size x Hole Spacing Vent to Air Intake S S t. / Pipes) Lengt Dia Length ­70 acing Spacing / 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 Yes No Yes 7 :N,] - 67 COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1:/ Inspection #2: / Location: 1443 109th Street New Richmond, WI 54017 (NE 1/4 SE 1/4 20 T30N R18W) Waldroff Meadows IV Lot 36 Parcel No: 20.30.18.1389 1.) Alt BM Description = , "" � 0 7 2.) Bldg sewer length = 2y • S , - amount of cover Plan revision Required? Yes tip Use other side for additional information. Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) I t:Ornmerce,wi, Ov Safety and Buildings Division County g r= 201 W. Washington Ave.. P.O. Box 7162 Madison, WI 53707 -7162 Sanit Permit umbe (to be Bled in by Co.) sr N z Department of Commerce Sanitary Permit Application State Transaction / Nu m ber In accordance with s. Comm. 83.21(2), Wis. Adm. Code. submission of this form to the a te emi ental unit is required prior to obtaining a sanitary permit. Note: Application forms for st WT are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide ma for dary p urposes in accordance with the Privacy Law, s. 15.04 1 (m), Slats. I. Application Information - Please Print All Information Property Owner's Name Parcel # Property Owners Mailing Address 20 V Property Location F R �+ o Govt. Lot �. C �v City. State Zip Code Phone Number , /, /a, Section CROtX COUNTY (circle one aW R. Type of Building (check all that apply) T N; R E I or 2 Family Dwelling - Number of Bedroom�s" Subdivision Na e Block # � c ❑ Pub] ic /Com mercial - Describe Use El City of 41 Z ❑ State Owned - Describe Use CSM Number ❑ Village of $Town of III. Type of Permit: (Check only one box online A. Complete line B if applicable) A. ❑ New System ❑ Replacement System y p ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System (explain) B List Previous Permit Number and Date Issued ❑ Permit Renewal ermit Revision ❑ Change e of Plumber 11 Permit Transfer to New Before Expiration Owner �� I a d IV Type of POWTS System/Component/Device: Check all that apply Non- Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in, of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (st) Dispersal Area Proposed (sf) System Elevation / — �2 VI. Tank Info Capacity in !` Total # of Manufacturer Gallons Gallons Units o a New Tanks Existing Tanks 0 a U Septic or Holding Tank Dosing Chamber VII. Respons' ility Statement- I, the undersigned, assume respon ili hor installation of the POWTS shown on the attached plans. Hum�52(p int Plumber's igna a MP/MPRS Number Business Phone Number P'.umbe {:Address (Street, City, ate. Zip Co e) 3 VIl I aunty /De artrient Use Onl ed El Disapproved Permit Fee Date Issued Is ting Agent Sign )ure — : \ppro ❑ Owner Given Reason for Denial O 9 Q IX f f$Wiog r *Rroval/Reasons for Disapproval naq s 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained y� as per management plan provided by plumber. Z All setback requirements must be maintained as per app1lcablqAjm9J4qGQkV1M for the system and submit to the County only on paper not less than 8 1/2x 11 inches in size SBD -6398 (R. 01/07) Valid thru 01/09 3 M cn v I 0 _ 7 Paz J C.1 ` 1 L � b Ri r I I I i CA � I i I I L coftlmerce.Wl.gov Safety and Buildings Division County t i cepartment 201 W. Washington Ave., P.O. Box 7162 sconsin Madison, Wf 5 3 7 07 -7 1 62 Sanitary Permit Num er (to be filled in by Co.) of Commerce a Sanitary Permit Application State Transaction Num In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary ur poses in accordance with the Privacy Law, s. 15.04(1)(m), Stats. 1. Application Information - Please Print All Information �f C rty Owner's Name Parcel # RECEIV Property Owner's Mailing Address pI r1 rop Location JAN 2 G 2 o Govt. Lot ° 7 ode RU X City, State Zip 5T Phone Number y , - , L Section 1 COUNT (circle one - � T N: R E o> IL Type of Building (check all that apply) Y I or 2 Family Dwelling - Number of Bedrooms Subdivis on Name Block # 'ublic /Commercial - Describe Use U ❑ City of �e ❑ � Mate Owned - Describe Use CSM Number Village of Z e Town of 111. Type of Permit: (Check only one box on line A. Comp to line B if applicable A. A New System ❑ Replacement System g p y y p ❑ Treatme Holdin Tank Re I ement Only El Modification to Existi lain B. El Permit Renewal El Permit Revision ❑Change of PI ber /rmit Transfer to New L t Pr i mi N d D sued Before Expiration er IV. Type of POWTS System/Component/Device: Check all that a Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ o _ 4 in. of suitable soil El 4 in Mou . of suitable soil ❑ Holding Tank Other Dispersal Component (expla -.� 5 Pretreatment Device (explain) V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdst) Di er Require st) Dispersal Area Proposed (sf) System Elev ion Z I< VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanks Existing Tanks y c Y a U n y rn ii. C7 w Septic or Holding Tank i Dosing Chamber VII. Respo9pibility Statement- 1, the undersigned, ssume respon§ibility for installation of the POWTS shown on the attached plans. Plumber's me ( mt) Plu r' Signatu MPlMPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) VIII oun y epartmeni Use Only Approved ❑ Disapproved $ Permit Fee Date ssued Issu g Ag t Signature �� (/� 11 Owner Given Reason for Denial Z( Q 7 " ' " � IX. Condition of Approval/Reasons for Disapproval n !O� 0 �yeale—, TEM OWNEF : ,,' �., optic tank, effluent filter and �YtCt/4 `� ispersal cell must all be serviced / maintained _ i s per mana ement Ian r v' mber. 2, 1NIT setbaCk requirements must be maintained as per applicable code /(V *MQ 0QWlete plans for the em and submit to the County only on per not less than 8 t/2 x 11 inches in siz: —" Eie CJ�"`' SBD -6398 (R. 01/07) Valid thru 01/09 S1/� dt�s c/p 7t w �. O CA w �► JO a-P i a , Q� o Q { w f Wisconsin Department of Commerce SOIL EVALUATION REPORT p 1 O f 3 Division of Safety and Buildings � </ in accordance with Comm 85, Wis. Adm. Code County St. Croix Attach complete site plan on paper not less than 81 /2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Pending percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Rev' ed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). G —4// / Q Property Owner . , Property Location David Waldrof R`rt Govt. Lot NE 1/4 SE 1/4 S T 0 N R 18 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or OSM# 398 River Road 5 k, j` 36 - Waldroff Meadows IV City State Zip Code Phone Number ' ity []VIlage ■Town Nearest Road Hudson WI 1 54016 ( ;T 9-6601 144th Avenue New Construction UseE] Residential / Number of bemis= `:3 to 4 Code derived design flow rate 450 to 600 GPD droo Replacement [] Public or commercial - Describe: Parent material Loess over outwash sands Flood Plain elevation if applicable ft. General comments LI/jy�d aft, and recommendations: 3 I` R • 11 1❑ Boring # Boring Q Pit Ground surface elev. 97.70 ft. Depth to limiting factor >90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 1 0 -6 10yr3 /2 sil 2msbk dsh as 2f .6 .8 2 6 -21 1 4/4 sil 2msbk dsh cw if .6 .8 3 21 -28 L 10yr4/4 - sil lmsbk dh c - .4 .6 4 28 -33 7.5yr4/4 s Osg dl cw - .7 1.4 5 33-47 7.5yr3/4 gs Osg dl cw - .7 1.6 6 47 -90 7.5yr5/4 s Osg dl - - .7 1.6 2 Boring # ❑ Boring 98.30 >90 Q Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -7 10yr3/2 sil 2msbk dsh as 2f .6 .8 2 7 -15 1 4/4 sil 2msbk dsh cam' if .6 .8 3 15 -22 7.5yr4/4 is Osg dl cw _ .7 1.6 4 22 -90 7.5yr5/4 s Osg dl - - .7 1.6 y b 51 b ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/- and TSS < 30 mg/L CST Name (Please Print) Signature_ CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI September 8, 2004 715- 246 -2454 r - ffMeadows IV ldaro Properly Owner W Parcel ID # Pending Page 2 Of 3 3 Boring Boring ❑ g 0 Pit Ground surface elev. 93.15 >92 ft. Depth to limiting factor in. Soil nGPD/fF Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef#2 1 0 -7 10yr3 /3 - sil 2msbk dsh as 2f .6 .8 2 7 -16 4/4 - sil 2msbk dsh cw if .6 .8 3 16 -92 7.5yr5/4 - s Osg dl - - 7 1.6 F-1 1H Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. u Soil — Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *042 F-1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. 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 * Effluent #1 = BOD > 30:S 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = B013 :5 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. SDD- 8330Test (8.07/00) Wald roff Meadows IV 'k Lot 36 A 161" 1- fi t q41 qL br41 : Z375 -, 3-7 N04 A /70 • Scale 1" = 40 Bml Top o iron pipe 100.00 BM2 Invert of culvert 96.70 -Way 19197.70, cb�' 1 (4 7 3? B2 98.30 B3 93.15 Thomas Nelson 227387 IAS IOBAt.MC 2.393 ACRES °f 104,230 SQ. FT. 44 LOT 43 LOT 42 CRES 1.500 ACRES SQ. FT. a 65,345 SQ. FT. N 1.500 ACRES 65,344 SQ. FT. , .................. ..... ............................... ..... ........ ..... . _ � /..+ o _ 589 9'36 "W 354.57' +do +'' /+ � 1 / 33' 1 33' 1 I 1 ................ ............................... .,.............. • LOT 38 �•� I LOT 37 2.461 ACRES 1 j, 2.198 ACRES ? �o0 107,183 SQ. FT. a I 95,764 SQ. FT. • 100 YEAR WETLAND L.B.O. - 948.0 • — �' o (� — — FLOOD PLAIN LIMITS H.W.E. = 946.0 ELEVATION = S8 w — • - A L.B.O. — 948.0 944.5 col 7 455.37' w F. =57 W4 __...... _ N 9 °49,4 j „ I N I �-•. .� _ _ _...� "" �N89'21'13 W) I I 20' WADE 1 �►g .... I RAANAG� ' I Z 1 I EASEMENT I I � IN z I I W7 1 cq J T LOT 36 r w N — :2.721 ACRES 1. 1 '118,525 SQ. F l ( J J I M.W.E. = 946.0 S- m g L.B.O. = 948.0 47p 7 Z ►•a Z 8 � 0 / ✓. / ,n Ni > it�y / LOT 35 3.495 ACRES • 4 1 ire �'� �t• `. 152,236 SQ. FT. M °b � 1 �M i' ''• L.B.O. = 946.5 rn .a� `LOT 34 �� 1 .. n .... ....... x \ �: ML ,J p / — — 71L- ' n x /- .....". ..� .. v N I •If .. v O 3o a i 0 Lo 1E y x � o•1-e � I 1 *2 tAT v NON NAVIGABLE WETLAND OD I I to � I 5 , 0 294' DOD 359' S00 5 688.08' W g (sOO- 04-54"W "SAT) o Al � _ LOT 2 n + C.&M. IN VO - - 13 PG_3 C :3 s ao o n �c o > �n co3 rno 4AN-26 - 12:22 IPM L OND , 0L$0N 713 466 2642 P.ttri ST. CROIX COUNTY SEPTIC T AN K MAINTENANCE AGREEMENT AND OWNERSI`IIP CERTUCATION FORM Owner/Buyct _LAN (�'E uno� ��aRwy Q Mailing Atitit'c•srf �„1'a!«o�_ 1�e i�y... � r• t , /�� tno ��t3I� ��$ �q Prapcny Add1'(1S-J S1 10 9 4 b tVcriiicatit >a r►yuifed frrutl !'lstnrtirtg & Ll)nin f —�� , , - -' — L LkpJrintrnl tier ncK <On+tt'tictiixt,) .- �...._ Particl ltlrntiticaltil►n IVtttnbc:r'., � Z(e 1 1'1, 3 - &C�AL DKJ' Rll. 10 PrOperly LAWitlion N E ._'A S E y. , Sw, Z4.. T 'Ap, R W, Towll of R _ Sub►li viiunn W q I rot' C M ea J o ws IV Lot s Ccrtifi -M Survey Map ii _ _ . _ t Vnlulnc —, Pag e# Warranty heed # _ 7g 4b.5% 2 OO (_ Voluinc Page # __(p. . Spew h enraC ycr ® I.vt littea idenrif iable ycr no SYSTEM H= Yff Nq,NC 1N: ANTI' OMMB CERJMf Inq,ru{►cr uxc and meinhMOnrt O f ya ncpife oytitew would rexim io its premature lidlurc to h4ndie w;tstes. p,uwr mairttcoonce consist-1 of ptl++tNtins taut the septic tank every Ihrra yearn or woner, if needed, by u iiccl, d purnper. Whitt you rat Into rho e,yxtanl ca►tt nfferl the ttutrtiun of the Vgltiv ulak a. a tn:atutcnt xtage if, the waste disprsul system. Owncr mainrenanvc ret,ptrnrihiiities a.re :,yccilFect In mCorrutt• lt3.SZ(IJ rtnd in Chaptor 12 • St. C.'roir Gvuttty S1trriteety ordlrwn�,e. 'ilrc property owner ai rws to ktihlnii to St, CMIA Cvurty T'lanriinit dt 2:nning+ D)ep,rrtrnent a certwvidi )n 4111n, signed' by tht: dwnesf and 5y a DWOr Plumber, f ou aeyrtinn plumt>dr, rwrl d p1wittler or a lieented pumper verifying that (i) the on. ift wastcw"wr dell "alt syanent lY In rroper op<rsring condWon and /ter (2) after InTlIcTion unQ rnitn in tt' ucessary), the septic tttttk is kia elrur I full of cludtte, r. 8 1 1w., tlta undcrilglutil have read the abevv Mquitttrwnts and art'er it) maintain tht private %a"ge disposal !;yvem with the siandanir vt (orth, herein, An dct by IN Drpurtment of Contrncrt:c 11"d me l)e-purtmem of Nalural Reset ;trces, State of Wisconsin. Ccltificwtirw klwing that youi t o ptic system hab txcn maillbliucd MUM he colttplek d an4 tViuriled to 1hC St Croix Co;rnly lotting Deporhttrnt within ?o ii.tyt ortht. titter; year expirattiun date. pinuming t4c Uwe ecrtify thttl all .tatemell" un this form arts true tO tile.: ht st of rtty /our knowledge, f /wc an>fart the nwnrr(s) of the p +'gtxlty denrrihed abvvu, by virtue. of a wtarront dood reevrdcd in Regislty or Tads o l ec. Number or bed SIONATt1RE APPLICANT (' S) DATE " "any inl'uretw:itep that is rtrisrwcscmel7 Rimy rt-wit in tlic sanitary pe:rntit ltCit[j; nweti;erA ley Ihc. Planning Q Inning Lkjtat7n1Cn1. » »lt Tn� lode wi ttt rhiN ODplic"id- A recorded warranty tkvd from tiro t Restsler (tr I)cectis Ut1i.e > +nd n copy eC t he acrtifitlf %urvey ,,,,pit 100"I VOCE is ntndV ill lift wlrYanl� dre4• INU'V, ppNlt� POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _Z_ of FILE INFORMATION 3 SYSTEM SPECIFICATIONS Owner , Jr Septic Tank Capacity ga l 13 NA Permit # a Septic Tank Manufacturer G s ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 5 ❑ NA Number of Public Facility Units g NA Pump Tank Capacity al 0 NA Estimated flow (average) gal /day Pump Tank Manufacturer j2-NA Design flow (peak), (Estimated x 1.5) gal /day Pump Manufacturer , NA Soil Application Rate t!�7, gal /day /ftz Pump Model J' NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit _-id-NA Fats, Oil & Grease (FOG) <_30 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 Dispersal Cell(s) 0 NA Biochemical Oxygen Demand (BODd 530 mg /L gln- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) :530 mg /L XNA ❑ At -Grade ❑ Mound Fecal Coliform (geometric mean) :_10 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once ever ❑ month(s) (Maximum 3 ears) ❑ NA y' y ear(s) y 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 0 year(s) Clean effluent filter At least once every: ❑ month(s) ❑ NA year(s) a ❑ yea ) ) aspect pump, pump controls & alarm At least once every: ❑ m ) - NA =`.:s laterals and pressure test At least once every: ❑ month(s) ANA ❑ year(s) V At least once every: ❑ month(s) ❑ NA ❑ year(s) 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(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 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. 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 :_12 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. Page of START 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 cell(s). If high concentrations are detected have the contents of the tank(s) 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 manual) operating the um controls to Y P 9 pump 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 replacement system: A 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 lines 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. ❑ 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. ADDITIONAL COMMENTS POWTS INSTALLEft POWTS MAINTAINER Name Name Phone _ Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Name r Phone Phone This document was draftee c:�- pliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. ' 8 0 0 P 6 0 9 794658 KATHLEEN H. WALSH State Bar of Wisconsin Form 11 -2003 REGISTER OF DEEDS LAND CONTRACT ST. CROIX GO., NI (TO BE USED FOR NON - CONSUMER ACT TRANSACTIONS) RECEIVED FOR RECORD Document Number Document Name 05/11/2005 10: 00AM LAND CONTRACT EXEMPT # CONTRACT, by and between David J. Waldroff and Julie A. Waldroff, REC FEE: 17.00 husband and wife TRAILS FEE: 149.70 ( "Vendor," whether one or more), CC CO and Lance Olson and Sally Olson PAGES: 4 ( "Purchaser," whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance of this Contract by Purchaser, the following real estate, together Recording Area with the rents, profits, fixtures and other appurtenant interests ( "Property"), in Egtreen & Ogland St. Croix County, State of Wisconsin: Pr 304 Locust Street (�J( Lot 36, Waldroff Meadows IV. St. Croix County, Wisconsin. ro•, Hudson, W154016 10Cl� Purchaser agrees to purchase the Property and to pay to Vendor at place Vendor directs Part of: 026-106440-000 manner: Part or: 026-106 Identi fication the sum of $ 49.900.00 in the following Parcel Identification Number (PIN) (a) $ 3,000.00 at the execution of this Contract; and This is not homestead property. (is) (is not) (b) the balance of $ 46,900.00 , together with interest from the date This is a purchase money mortgage. hereof on the balance outstanding from time to time at the rate of 8 % per annum until paid in full as follows: Commencing on June 4, 2005 and on the same day of each and every month thereafter monthly payments of principal and interest shall be in the amount of $344.14, paid by the Purchaser to the Vendor, provided the entire outstanding balance shall be paid in full on or before May 4, 2006 ( "Maturity Date "). Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. CHOOSE ONE - °° ^*T rc CHO SEN, OPTION A SHALL APPLY ❑ A. Any an ❑ B. Any at v I\ ❑ C. There CHOOSE Or U J SHALL APPLY ❑ A. Any , delay the due dates or ch terest is paid in full. h to B. In t payment so long d � P Y as tl }� e� tonth to month shall be t U A5 seen had the monthly State Bar Form 11 -Page 1 2.393 ACRES LOT °f M 104,230 SQ. FT. 14 ' 43 ' LOT 42 M RES id 1.500 ACRES N I FT. c 65,345 SQ. FT. N 1.500 ACRES P $ 65,344 SQ. FT. I le �� ..... ............................... to n o — —'_ . _ — • ffg-bc — — _ %•.� / oe i S89 354.57' i 33' ! 33 I I ......... ............................... as ........ i LOT 38 I LOT 37 ./ `�� 2.461 ACRES N. 2.198 ACRES �• 107 �. i ,183 SQ. FT. a i 95,764 SQ. FT. 100 YEAR WETLAND L.B.O. = 948.0 .� FLOOD PLAIN UMITS 't 1 H.W.E. = 946.0 / ELEVATION i N H L.B.O. 948.0 t I 944.5 I •� N a i I S87b0 I 455.3r o ---fi -- N 9°49;4' "W I N O g l I 20' �• N8971 13 W) WIDE @I 6 11 RAINAG& • EASEMENT .) Go 1N Z J :LOT 36 Ix :2.721 ACRES ®_7 W ;118,525 SQ. F � I J ! H.W.E. -- 946.0 r m g — A4 L.B.O. = 948.0 oo Q / Z Z O c ►� LOT 35 W - •A ' 3.495 ACRES �" Q • ��' 152,236 SQ. FT. .'� • ° O L.B.O. = 946.5 1 9} 1 o v o�