HomeMy WebLinkAbout042-1004-70-200,
PRIVATE SEWAGE SYSTEM
OAW St. Croix
amePieey oMaic.m..ca
INSPECTION REPORT
ryx nxv
806983
GENERALINFORMAIGON
(ATTACH TO PERMIT)
el wmp N..
wwn Inl �IFmxr�. •15 XDeMtl
m vxpe T
a n..
Lod Klinger
TOWN OF WARREN
042-1004-]0-200
aM Ei.,.
an Fier.
n.n.
x.nme e03.1
Q—z G
9.18.38A-30
TANK INFORMATION
ELEVATION DATA
MANUFACTUREIS
CAPMm
STATION
IRS
IN
FS
ELEV.
Sept"
w, s.,_.
coo
roman
s. T1,
xl•
n.7
G
a di.. S,
An.Sr44p, C
peel
emg sel.e,
p D
dZ Alo
SN nln
m.o5
�
TANK SETBAryCK
INFORMATION
Su Ouliel
y �
l\
/Ad O
TANI�\
U;4;
ROAD
qin
Sepllc
'
A
K
/
gApew
\
\
m
xot,$Ni an.
S.4
cm,
ti111
AmRp.
5.4
cm 44
same
Lot Sel
4.41e
9l.%
PUMP/SIPHON INFORMATION
Fiml ANN,
f•y
"-dj
amnare,
sell
Sl Go'sow.
Y
adz •j
a Le,pNGRIA
A, ,I
E3
SOIL ABSORPTION YSTEM
Np
n+NZ
I �
�e.nAMW
ww al
qqnn
ivUnM alrO PdD
CY%
vein
LAFEISiRFAM
uxiT CH�MOa
1
Mw N"r
DISTRIBUTION
SYSTEM ARIA. 2 Yl D$(eT
✓S
�
p.l
p 'l
Ate.
°..;I`� p
SOIL
COMMENTS: pnmetemeUievepeneee, persona p,,l sly
Location: 11D 1ID7H Si
1) UI BM Deal
2)SMInNN- �s
.amu nor,- "d
/d
M.I l
pica 1e
N
` ly
A,,,l d, fw1Alw W
Lf�
SSAV10lxseal
Inspection Xl. •� In
teel
ll 4dak Q^
h S�M °GiSi
ae F,
Spa
�
N-0
smnr
e a e
201W gb IP.O.Boe/162 ymLL.yrtmm f a�kMGq
es 2048
1 Wi 6
�ea6�g3
Permit AppLcatlon
e-mCNN,o
°� M We Ae���me mMr�mU,.r
"°rM1 r , md�(+eee amwew.aa�f
%mr wai
:zf;Md
m
L Anoti Ynol r
4p PlnaeR f° °
_
nwup'Pme r
//Of
L—.. tMnvSFPg _
P °°'"� 0319,
14. 38R-3o„
5!o sy-6 d✓e
SV� _ F1 H' x!Z( Ee-04/
n lYn !Baia °a (rn k liue.el»
i,
BeNee
❑cin'm
❑Nee ow°m-uimm.DnCSLZDvilleel
1 F ln. e¢t�i G.� +� 9a<a o3 Dq fd fro.°°r_Wo•r..._ ._.
m Type e _ r a-
_sm..
mwe.. s�
_
❑ .° wi J `c c..o sr (w.i°)
❑iw�, ma
❑Pen,°w.,;nn
,e„ra^ Nw,en®ai»�. i-..
enpCNN=
'fYrc°rPOW158aNeel
ly I im• tlutan°v)
qN° ❑r.nw .a o,,,.U,e. ❑W.a> .ba ❑Men,a<,. n. nr.w.°n.w
❑"wam,rn namom�ai�(widm :]eaP-..�,❑.n�yfwemi
V. Dia nWhWneN AULfo.mati°n: _.. —,
I+�n1a5'bn a .n n9 =Pmaa. .a error
�r®al ow New,
Rom, '��'
VLin41°W C4e.' ._.---
w M®u4mw
_ s5 _
—. _ MeavxM1N
umbSNarc(ttivl PM°WYSiSnnw.
°1 T N &moor
W:er,:g.~< S�Rc, h,.e k�r I����12zra� GSC_a bo-6.Cs
—na'aeamo�ryvaf
[vyimgzmcwq — nnn�aa
T r �yf 2 ml N���.,vY✓ w,' ,5_•/o C
cE w NO
'/F95.mii
oa/8
IX. c°nN t D PP al
r. F mm t q
s� F /l�/ 1 5�e ti
e�ou e
a. ce�
ce e o m
x .P+ate •�.+ t L.ad {NJw �.
woaeax to un0 I Yp
DEC 0 S 2018
Devele mem
Lomm innv
CONVENTIONAL COMPONENT DESIGN
Naeieanal APP§®eon
WDE[ AND TIRE PAGE
PMecl Name:
O rs Name;
�..n W' /l I /�✓ O. I'
pMeM1 AENsse:
//4( ! ao 7-
Legal oesmpmn:
N bi
TOMnship.
.f+ir '6L/ YY'YLJJ
GounN
SuEOivlem Name
UA Numum
�✓.
PMvallDNumbar.
OZ g- 7q.3
page mdez am
Paga3 Pak Man
Pege3 Sham Smr98Clcse-S
Pages Fab 5a
page Melnuenance lMomnGvi
P80e6 Managettenl Plan
Pager $L Great Sealc Tank Meinknanv. Form
page Wu h Des]
Payee CSMaPIaI
N rnenh:SNITeud&Houae P9ro
DeegnerMumMf
(41 e, wr 5GkN Ueonse Number a.Q74`r�
Da(a;
�ZL Pbore Number
/I �
%tlaWre / llder,—Jj. �
� rLNN bMmul ery vmm Le seo.toro Mmxmr
�y
{gTMy
rg
�\ .
wyn
10�ri
^a"_ /, wr_ /a53/Ta9
Ak�
Q�Y '
r
eh-
3'A� bzvs i'
p3
otmP
SRH Absa p
4'ScryMuA 4p Flne aRGe /�
WMVeCeP
L99a` g R '
Cbember y q
Sylaam Ekveryen 1I1
•I�
�� fl Jr ry
Sol] AlditoMffonptyttada pl,tn_ow
na n
1111111, IIII elllIIIIIIIIIIIIIIIIIIIIillllllllllllllllllllllllllllllllllllllllllll@Ile lllllll-
ChaMbers
L.._pim � _
Ililll IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIISIIIIIII-
LeaeblSM— e� —p —ft o.
ManufaCWrer And Motlal 6ra�rk fs
EISAReting ?s' egftper Chamber Soil Applicabon Rate
L 9pN q fl
So 9pfl Daelgn Howe r4r Soil Application Reif e .?O EI$,564= Chembem
2lowaof dF Chambers each. 1
POINTS OWNER'S MANUAL Bit MANAGEMENT PLAN
MIe
Own..
$Nine Twkeapw"
1600 gal
am
Pem,itT
waft Tank ManWuwm
Lot /L
0NA
OUlu" PANMIETBI$
EHluem fihm Mwmfacamr Q / l-a c N
DNA
Number of Hammon,
0 Its
EHluem fine, Model
4g-g "
O NA
Number of pulls Fe Units
0MA
Pump Tank Connote
am
0Re
EatiMMd Ilow lnv sal
yy
Pump Tank MCM car
0 NA
Detlpn How IpeW, Reabraue x 1.51
NMa
Pump mmoa m
0 fU
$all Applkelbn Pate
dea IW
Puma Memel
p NA
Shall afluaNEHkant Ouakry
FM, Oil IN Gwen IFOGI
&oeMrMo l Oxygen Dwnne 019 1
Total Suspended Sai 1TSS1
Monthly average'
530 Oscar,
5330 mB/L O M
&160 ugh
Pm oM Unit
O SUW/Gnvel Filter
O Marshall Aembn
0 D fenkn
0 Peet Finer
O WedaM
O Omer.
O 1
PrttteMei Effluent Quake
wmhMinel Orymom OemeM IRON)
Teel Suspended $cede ITS51
Fecal COIKw leewmWc meenl
MwNJy werege
00 mph
530 ml
slM elWiMnl
0 NA
DMMw Cables)
Of MGrmold Igrav'MI
0 AtGrada
0orykire
O NA
O lm6raune MidersuNadl
0 Mau"
OO[Iwr:
Maximum ElNumt PmDele Size
Kin die.
0NA
OsNa'
ONA
Omen:
0NA
M'a"
❑NA
`V,al Tel In, brmeMc woodland, men web tank address.
00W0
NA
3eMw Event
SarNm ft pw
Inopem c,nditim of tarn l
At Iw once save:
0 momblel Ikminepp 3 yeadl
Dan
pump out cmdnta of under
Man combined "go aM arum glee amtbkd III of back voume
O NA
Impact 4mwrom mklel
AT Mein once wen
0 rMa l Me mum 3 yval
0NA
Guano luau HHer
At Ford once every:
On tel
Mvvil
0— NA
In p t pump. pump comMe & Ali
At Mast ants every:
0 on
twMal
0 NA
Hush INemle and pressure ten
At bear once wary:
0 m al
p HA
kaBe
At war once were
0 Wa 1meel
O NA
0 NA
MAIMENANCE INSTRUCTIONS
Imam inns of Menke and dinevel calla shall be made W an MaMduse canyon one of Me fallowker Beaches or aMHkalbne:
Meurer Plumber: Mercer plumber Restricted Sewn; POINTS In,cecln: POINTS Melnmmx: $epipe Servicing Opersaw. Tank
ncluds o visual imanaro m of me Fal lq m Hendry My ranking at brakes beNwo, Identify any crake or Wks,
Mora the volume of combined sludge and m a anybe scuand to check Far ck up of Pending M aMunT on rho ground suffers.
Tea empo,"I culler shall M vi,uWly inspected a deck Me effluent levers at the chile lets plow and to check In MY p ilV
It effwmm on the general wdws. The molding of effluent an me ground Ordew may InekaM a heirs condition and Total me
immediate Oorflewmn of local resanwy sumaie
When ma cwneaed accumulation of sludge and sum In my bank al onemW III or mere W the rank yaum.. the make
a of the talk shall M Abdul by a Spurge 3emicing Operator and accordancewad ad
ed of in accordance cr Not 113,
Wisconsin AdmNiennM Open.
All giber mmkes, inclumry but net limited m the servkin6 of eflusne Army nmchanictl ar pmvmuae compann4, pretr cat
unln, and any Foremast at Inervele 0 513 mol shall be performed by a mafied POWTS typica t.
A serves roam shall b "WIN to me bc& rwlame uM women 10 days M appea lcn of any asperse event
Poq_ol
START UP AND OPEMTIOB
For new aanttnoNan, prior M use of Ina POWTS Moak Vehement tanklel for the presence of pail YatlucR or Mllx a im s
Met wry mpwo Me" ma pmcom andw, damage Me diommal glib . If high err van ns we detected have the contents
Of Ma mxlN Moved by a east"• bMcing opal PNono use.
6pram anti up shell not occur when awl conditions en frozen at Initiative surface
Daring power Counsel pump mks may in wove morm ll hknwC,h mveia. When power is restoW Me a wee ear will be
dl•charwe to Ma dowieael Cenm in AM large done. overloading the aNw and law reach In the beaku0 at sw
surface discharge of
affluent. TO wok this aitaalim hew the Contents of the pump tank removed by a Sapt"a Sei al Opwncr will to rem¢ ng
power to tier effluent pump or cmtkt a Money, or POWT6 Meinalear to aaaut st annually operating Me wrap controls to
mmusior normal levels welun the pump tank
Do no new, or park whisks over tank• ak dwri Trato Do not drive or pea over, or 0nmwiae disturb On canpect, the met
within 131eel down slam a any Record or rt-Crepe soil absorption eras.
Nedupllan or RiminWan of Me fallowing It= the wtermer or imam may knpmve the performance and Tommy Me life of the
POWTS: annblinal baby whim: NARTA al l oandb s; camn swabs dayelurA danw note: dlaaea; clandestine: fit;
foundation drain Iwmn Wmpt wan; Wit and will PrOalnpe; gasoline. prawn; witnesses: meet snake, myclons is; oil;
pal podupkA "Shearson sanitary napkes: tuppope: and wear wNMer brine.
ABMDONMEM
When the PONTB fails entl/a is permanently taken Do% of Bary n• Me feral stew shell ba taken to inNre Met Me system Is
pap}l and wllly eba om In camltlkece with Chapter Comm 83331 WImoNN AdminNn•dv Cotle;
• Ad "ping to tanks and Too shall be dleconnM•d and Ma abandoned prs openi"a a ad,
e The contents of all Inks and pha shell be red ed and property di aC of by a Septepe 6emwmg OPORACK
AM1w pumpers, all lane entl site shell be excavated OR rnnOved or their rove rmwetl aM the Vold space filed with
Tail, grovel a another Inen sow m0eMI.
CO waffiCY PLAN
ry W POINTS fib tied cannot be wall the kllpwing measures hovw bean, ormust be Taken, to pmvke a code compliant
❑ A vT npinemnt Ter Ru ban evlwted and may be d c m lacnbn or er a"Inwne u ell ebWrm by
wet•m. The alfrommI m aboultl be p structure,
tram skepticalean eM ter FecMn and shereatent the
pl NM m open in
resukp ••eb from now wit
an arm we! mrunrto a la[ Ines entl walla. la W to rmeant ebe nmecmyst mm will
maul[ v Me the mark
a new roil entl •iM •vlueNN to eMovb1IM T suitable replernnam uae. Replacement systems mutt
comply with the rub
�n Mae.
❑ A won"laemt area la nor
site
due to
BTRins edvin POWT6
Vocational a ax ry be�.ld as aaR To Arm The ruled Poys
✓A w
a
Team i "An tank
flW
❑ Mwntl tad swodt all =tia[ian wpTma law T reconstructed w in oleos plowing affect
t that
of Me hlomrt at Me
inNltnNv Turing. RnaMnctiona of such Tyeesmov mual comply wIM toe rules in affect e[ [M1et time
«WARMING»
MMO, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANWOR INEItFNCIF OXYGEN, US NOT
ENTFA A BATC, PUMP OR OT M YI TMMH TANK UNDER MY CIRCUM"MCEB. GFATH MAY M%ULT, RESCUE OF A
PNMOM FROM THE MTERWR OF A TANK MAY N RMROULT OR IMPO68MLE.
g MBTALLMt MANT
Name 'u,a.., s,O6.. II lama
Pump
B "E BMMMG OPERATOR IFIIMPFAI GU TDRY AOTxGM Y`
x. wee G
Mena rim. 1i—
TW MeummwM dnXM n comdurss win ehagn Germ Rg.11121MINUIRIMO EM 83 Still, MI8131. W1mMM MnklauaNv Cotle.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
I 0W1 ][IIP CERTI/FIICCAThom FORM
OmIfflD4yef bore `y hh `L�l Vl9 �GV (�p'"Iy1
Mailing AaaresS� ��`iaanP� aa.{ot�;� W1 Sgooz (CwfmwA cAaveeS�
PmpMy Aaarcs�_t{9l
(Vended ian requirm from Planning&...wy..�Pw.uau fmnewwnmuction.)
city/stntssi'Ay� Parcel Isemificmion Number 042D -too
LEGAL DESCRIPTION
Pmpetty LocafionNW Y,&W LA., Sm. -a , T Zj_N R_LB_W, Town of W0.YVeisl
CnIMvi'i"Plnstm4 %.
CeI4 ea Sum" Map N
Sb{Z
D3
,Yobnne ZO
.Page#
SDZ(o
warrmrtyneeax h53b
13S
(before2007)Volume ^
Page#
Spechouseoymmo Lot firm isemifiameWyesOno
SYSTEM MAD TEN'ANCE AND OWNER CERTIFICATION
ImproNr n%RM maintenance of sow septic System mina mulr in is Premature inshom to hate walks. Raiser
.imenenae condab afpunpmgaartlie septic rmik elm Muse Yeas nr seonu. irn«aea. by.license#Pamper. wbmym Pminm
Na arnem can aH ttlk duration of the sephe wikas a vemmenr skge in ebe wane aiepml arakm, fTmer mainkoance
rapomlblliXa ae specified in 19PS 3B3SP(I) aM in Gnppr 12-SL Croix Cowry Sanihy Qaumncw
Ire PmPscY osesw ap/ees to anbmil an Ss. Clou Counry Plawing If Zoning Deprlinme acertification fusm, sued by to
wntt and by a msMer Pbanber, lnomeYmnn Plumber, #Meted PWmM w a licensed PmnPaT verify ing W m (I) IM w-sile
weMewaterd es0fal sY.tkm is in proper epmatmg condition anNor (2) after inspenim and Pumpicif (ifrocesvmy), the sepde bNe is
less than Ili full ofshalp.
Ilwe, she Uea ignm bale read the abovercgimnents and Won 0 mainnin lk private sewage dispnanl system with the
mndnds oat tomb, bacon, us sel ny Mw Oepartnent ofSafiy And Rof ionm Swices and the Oepennmm o(Napaat Resourtes,
sma afwir�onam. cmdoratian wdngmetrnweeptm #roam naa M1een m.mmmm m,u[be canpleted aw rmm�ea mtm sh cmix
canmy Flemming a unmg awrtmem wire m so dam of the mac yea exPimtiao area.
Ilwe wnirysove,b Wemmhonus IAmaatroededfin fmylowknowledee. IMe uNam uw owrar(s)ofma
pmpMydesaibetl nMve, by liana ofe �%manrydem rttaNm m Ae&skrofDeetiv Once,
Numb Z 1
ATCBE OF APPLICANT(S) DATE
"'dnY information mYt is minepresemm nvY rewlt in theearilerypennil heinSm'n4m by tM Pleonmg@Zm�mg DePmOnmY. Sea
neoren wire ee is made Nis inflationn recmdm wartanry deed firm me RegimerarlleeQ Office and #copy o(the mtifim.uwrymap if
rckmnin she wamnty deed.
(REV.bVIS)
MODEL HOME *20 (NOTE)
ELEVEN FLOOR PLAN
CEILING VAULT REGION . LIVER. DINING A ST,...
TRAYED CEILING REGION LAUNCH BEDROOM
1p�mk MEN143ERR
HME M�� 420 MI &IS 71��17�
m_irtiil
ml
MODEL HOME 1{20 (201&19)
FRONT ELEVATION
Lev 2
e•-o•
eve
® ® a_o•
o, o,
MODEL HOME k O (301&10)
REAR ELEVATION
5 /12 PITCH
- —_ Lev —el 2
— _8•_0_ V
Lw 11
0'-0" u
MODEL HOME #20 (2018-19)
RIGHT ELEVATION
CS'f—aai8_ 30m
awd l r ,i r VA �Oy amrverm6.wm6e SOIL EVAI NATION REPORT '+�wtiw. rommes. wa. enm ew. P
m .,eum md.,mwwrnun.rbne trz.rro- n..w.wn mmon.C0i'ry
�d�M1'irn"+rouleneM1��prrere�v�IIamI.Untlip ��
P°"'^+�ro..aa.ardor.wm.,nonrvrw.mE .Vb, Ml4un®bn.areerma0. GeW I.D
Ptx6. Mne.nmmlr„ayw,. __ O`!Z— 4M 76_�
9xeaaprtneNy.Omupe
❑�
®Mr akuNsuMm.lw.snwry n. D.pe,mFnlmVle9i�LuL F.
6dFp. O xnv ---.��
® Pri aun6.m M..
�e�s�.la►�m�r�rx�o�®
MAP
VW9�2MMAMM
�O,,tv—,�& P,,,IIUM_/atZ yZwo- Ln 3
e,Mva Ij m+w
µ, Pll q gPtli'l 4e>�
mmr�ac�_e��aom
❑ o
❑ Pit we a,,nme
'u eoxnr ❑At
-Efilutwe rl. SOD, -Y S ma mgl vd Tiot ID t, ^9= '6IDwA 4. WD.! W„oM1and Tse_mlloi
1@Dtim lmt ofCununerte is enaQuc�eFgwmnlryeerv'vn poridetena:mamr,,. �fynu nadvpv4n�etouacv.ervi�e[,r eem m,leti,l in c dti l k r],00 000130 the GMnmwt u 608.166-1131 ce T 608461
PAGE -.1—OE-1-
NAME I.OT# LEGAL D // 8 T N R E( )W
SOALC
BM 1 ELEVATION /G',J
BM 1 OEacRIETION Jc0 0l /�=-D.®{ 1
BM 2 ELEVATION
BM 2 D[DCRIPTION {q
SYSTEM ELEVATION/I
SYBTEMTYEC LOnglz) ,,.