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HomeMy WebLinkAbout032-2119-20-000W..D. dcaama. $sl oM Wang Dial GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) D32-211&2 D 111111 RilBJ TANK SETBACK INFORMATION n M'1 I,1 k T TANK TO e WELL l im An IN Downg s N ROM nP, HoMing Not s+m°Al 6 95.4 PUMP/SIPHON INFORMATION Fall Tiat — — 2S l Dw,,nd Ra.e 1 p,3PM b.1 9G.Y5 T.;, 92. z ig Ran It. oM > m� 06, _ �� ssTER To eLa m1P 5 T D. p — - Ohl Edgm. COMMENTS prwmee wee ebvP.rcl•• all ... t ON) iypal2 Z. L/lC/ Pawl°°xsl0�5/.2 �9 lu�� I11S v iid" j(JJa�.,,/, b✓yy1 zlSal np.eaanal ,.�3�� C�.e•;,,p} 1-eeY.O .n. �YXP1 oF Co.ee Uw�MO i Ran see-a„e—va /�/-. o \�n Asia Ina°my Waxen o,v,,,an 1900CWssh,ngmn Ave anon \\ { PO B°e] E maa,.aa, xa sa 716 „er "glalea C°1 �nry�b�q . DEC Oq 2018 Cl \' sSerti oK t Applica4on sle eN„mm„alee.pp, squid m.ot'0 lax. m^�my "min rv�'ap.nIdl,oa m:m.at.rvl�.m,am �� «Inm m aacfa1 �lu.a a"I pnwned FgamnntnthePrI.tilm,155oc alb ° aP,o.d.mmn=m,�f.e,� ° I Apo Me lalmm.ua"—Plea" Penn All lnf°ewf eU. t neffe sN°m. Aa e 032— ZI °Pemow"+. n,.m°en anm l"°"°"d6.31.1 .la y Z NW ...I /wseep°a1 n gun N IT N h/l 5` 01 CIS .337 5 5 I55 ry A a T F IT ala bl, y' ar2 F.rmin lraelu- Nmae.earae n j ,Anne poyw PIS -F linn mBm°aAO.�,n1g-eM1xkeetlNl "W ❑ CIA eF 0Am,0."9-Doubt111 ❑9,Ileseaf nm Nuene. z 3"a + zzzl cb.�..1p�r moan°` �ol.ucx sst' Ill Type° (Che mI dean on line A Complete line B if Applicable) ❑wP�emmtgyn.m ❑Tremneinflating Tenkl ,acememoaN ❑ ct,,, AI .... A,eCum,ns„Im,(«pl.,a ❑Petmn kea...I ❑P.mmxNean ❑ CempealPl°mee. 0Patent ,maapmmNem Lim ANANIASPean, NumberIa Dee,I II Be (Anner 1 .¢Mfam aenWenee eeeekanm". e==°, dunzed a- 0AtInane ❑m°ma ratan ° < n funt.>«I L,a0F n.mpt,A ...lmont I rat Ana mu 6em,an le I(Ada �s6,Lppen ww n en o�me,a,w awmmaon en a eRs p 1 grgyF .N an 7 85 5r gmryi n T.nk man ,nae.nat eti "IalLepo"IM1I11ry Aubm.nr 1. m° unaenkmd...me Ard.P le . ne vllvrtS.Iwwao.Iw.weha l..a %� SfFF �i7X IM P0.zn2 anode meef Ata 7K,.4g1 -3458 0cv(Bnµ CM.'nAe"P....1 .19 D. Box 565 g�SS(Z WI 54009 "Ilia an denei 6 J70 m is b lS Den, lmn.an. fa. ongppn.alad y - nmli.n,Nvmm� 3� 1. .e,..«<.,� 1Q(Fa. � /pR9 onwd�. 4n dell bv. r .nadepenewo➢mm..aljw�, p� •� 4) AjItl a1- it aW' 24ab.k l.tWa'wn.da "e1altue: ..Mry{btlaa . SP6639S(R pg/11) +lwn lnao A)ukj& wo7 22 1�INECIFr 'joWN OF �OMEIKEI Q vJy Mp?-5 z23zlZ � 36�CilMPn1C '7DPov In7 STILE SE trn C�a�i CL D'FLT TDP GF -(EE tZST EL IDS rs 50�1 gDk'IuLi ❑ 4 copy CONVENTIONAL COMPONENT DESIGN PesipantlY fpp°otlon WDE%MIOI plkGE a ersNameRyWINNO AW\1F6 Ill �vy Rvra Dli AltoI UZ J�u oal 1.V1 51 01 Le9tl°evvIjaw NW'll NVAI SZL 731 rJI1Zl9 W roa laho --�o u.E2s� T =WM. 37 CRUI)L ;uealsrelon Name Nfi ()A I---G ot Number. ZZ =anal ID Number. 032. L119. Z�7- 000 Paget Inpea Wtltle Page2 Plot Plan Peyes 4serrm Sorg S omns«egn Page4 Filer sosa Ppe5 Mainneru elnbmialkn Pagee Management Plan Pagel a Cmu CN Sepec Tank Mamas Fgmr Page warranry Ceao Page 9 CSM or Plat Fpacemxlb ScATeN & House Plans eelpner/Pamiber SE:F f- 1=� jwnse Number MPRS Z9Z me Pnm93r1 e Number -715 N1- b °nabaeQA V �7 ugwpwauam k nw In-0mulq SW /3wmtbn Gamarom wnuMM PGNrs Vxaen xo eBP+gP°1 Ma+M I p . P1 ilawzr rnpN i$�S l,ol 22 1'INECIFF -jp Wl❑ OF Somcws-.51 ,4 � -jy Mpgs z23Zyz ti , �I I I ac�ruua,<�t �rot�oFrn7sT�x� � 1oiCc�zwoi CL IW' , L KT OK TEE iZUT EL ILD .34 _4)1 A 'Sa W ❑ 40 `aN� 9B.5 fl resew �fq wTa,—u' _fl _fl `0 fl WVMer McMoeM 11�RLIKa(OR Q11�1� Mugs" Zo ofkCIM f " ppftWm RAY •� gpd"I m00mip runt i1 Bd Rft ♦ Z) MAM tt� cbwmfl J/ ]1W�tl [.1 Z Mamben YN. 3�1, 0 t amil � • ivy � $ y : Its N i I POWTS OWNER'S MANUAL & MANAGEMENT PLAN Mail Tank ManuhCualimels6 ❑Nag W-sebbco[lbunowine) vdane IZ50 Pamnr MMp1EM8 CE810NPA NMw Tank Menula4 tlm, m ❑ Septic p Owe M Hddlq Vdune rage N W d Pa s Ll ❑ me NunbadloalsCFa9lry Wlta 0W1 VW,mi DiMarc Tenk M=(s)WS Pad an Horizontal Olstalce Tends) b See Pad td m It No 'emerge luat be arranged rabbe) a Melt Is slag had Or EatlmNaddogega) Rokk q00 reeWryl CBBlgn (seemed FlOW(Mlmd x15) 0(] OerMeY1Sol Mbglmv to ae pMdM bn bva In arm Solo 01l on Face , fins m') Emuant Fina, Mam,redual LIGETIMc ❑� EMua11 FIIta MMM I SlenEaE(Ccmeatk) Influwl uw MOMIIN M'erega m..Il aea Iron OpA MaluYedura Framp&¢malOe�ema A aeSumarks,�s Pumpill him k4 Wrmue EMus MpM creel P,M,YOnsent Ifni 1FW1 >a�rip't Menu/gwer kh lam) ill M" eY ❑M .medal goal over raw 1N" er peas"a �fNn °o door FlNremed Emgent MaanN arernae IkCN) em Mi Sys Abxxpeon Synen FSM CWmm meunMCfrm�l One LiJn arM deal❑Irw,num lwaeeuel ❑Noy ❑glp.r.rc 00m Madnun EMUBM PamtleSre �mde ❑NA onxr pp� oiler 01M rvlw Eaft" ServlCe Fremenry mlvaf ral mmblpetl elutlga eM added whale prlatM1N (li) of reek volume n tee high vMer alone le headedan Ntenlany every LYmW+Re)MI (MUM=3y"m) ❑m al [Nile)t Orre eval mwrye) Sv«n) ❑re)aMrt WhoMani :W�t olraeren �NM) oNA)panp rut bode every pp my.r�,) ❑�ppralaKilewaY ❑P )1w2evy 0haThi rb ) ❑rU ❑ ru MAIMENANCEINST MnOW Inspeorl Or tal and Heal eteorphon Vdws sMl the made by an Indlet call One Of Me Mlmnng Ilmnaee or wN0®ream Mesta Randall MSMl Plumber RO81nc1M ben'M, PAWS lnspMIX, P(hN1S Mardalre Or Srylege Sol Operator (puTPor) Tank my low more Ixlude eased lnHpedlon cline tanks) modentity any missing as broken nmdwera, idwtllyanyvacsaInks. Magargurethe voume of cpndned sludge and esum and a ched for any back up or pending ofeMuall on the ground euRace Trends eheorpron system shell gradually hapWp to dAecktne thereof levde In MCObsdvabon pipes endtO dhedrtor any decoding INeMuenl on the ground agency The depend of emusnl on the yrouna surfacer may mdkece a failing condnlm and rapprea the Immedme mtlllnlmn of the lore) reguldory authonty NTen the ccmAned accumudal d began eM wm In any leealment tank aluels pISNN (Jo or happy of Me lank name, Me bare coments Of the tank stall be mmW ddy aSoybean Manuel Operatortpumparm Here ddlxgykd of In KmrWlm War loser NR 113. NA nsln Admeidmbve Co al Ma MMams, M Wgg W M Imdp to the rmndrp of effluent nand, medlar p performed canppmh a9zmd wNa. .p.m uMdng m iaa.als daiz mplMa. beau ce pammrMJ by a ®mmm Pow1s MNnt&wr A ssace rep.'I slog Ip podde11o1Mlml rq^uldory aNMeY'arlM1n 30 drye dmndck'+r reap Maw ereM Gsm¢W IreOA Pal STARTUP AM OP MIN For ntw CadruJm Wu to use A the PLWTS tl twWe brut[) ra the Omen or (amvg prorate aoFv4 a Itl9 drenlds a �alimam IM1aI may Impy¢ V4 pubngrl pm¢e6 BrrNp LL mega Re sal aleerlNon system. R M1yil0.vVlbBKK ere P.,p near, nave the wmmte dtn¢UNm)l la er beer a Sgtega p or due OpnAa (pampa) pnorto use m.,rep bnxa may en above moans( mgnwala levee ale to ebnw or erne to panwalmreaeventual R on dpoxa'amen Nme mmonara not re¢onmenaw. aswe e.ceaawasrescharge fnuentaa mthasaloMeMayr To send ergstuaean have ere that may resort m me ed by a surfaceptnef al.anarga Or (Inxi ens damage to me system To ewie p or wayfinoe have the tentsit Mapangranir[mwenanaBBpt]¢Sanml pump pabr(pumper)rmse toueny MWwertomepumporw wore Planner Far PGWtS Mambina m assist In manually operelirg the pump wnvds uMll norms' dAuent Iwele as rwtwelwiNmme Wmp lank Go np dnBwp vengp raw Ways or the woe absorption system Do cot GnveIX qRo ..IX MPw dMrb a OT Me area Mltrn is Met Owe Ycp oI BM mwm or a:FaOe [al ermrgm um. RW1 on a♦lunimmen o11M Idloveng ham tor, x lavate small may Improve the rMamemn eM p rah Itre life Of fire PmMmt WU am eel elevato wl Hys en scours, "bmm, baby all owe a Cutls. anIXme anon Or ti r®asnmUl floes di¢ QairlgJgte, MR& IwNeem Jan f nual Or deSage. M1et and vegetable pR,Ns Senate, grwa baseball meet [o M m lackey ON panting pW Wa, pmeodw sarday reµine advwy, tempars, and ueta wfiaer here dwryinget AMANOONMEM WTen the POVIS tale ware, IS pe"mane err Mken we of saves the follmnng Stage wall be team to Insure Nat Me ryrten le pBpNly mN mealy abandoned In wmplsmer all a Came W v.w con MmlN"a Cp Al l altomines lab and other wn a worpren added a Nal be d[mnnMad and Me eWny'Ied pw W nA WIM The commb of al Onto and an she m removed also woWly Emmed of ny G Segepes org Operate, dampen I After manprg, all thin[ ant row shNl be exu TM and removed or the, w removed am Net W4 Argen, filled v.M [al grant or another Form said material CONTINGENCY PUN If the POWTS fab and armed be romima the NllOang wri have Of or only [e tal Be prone[ a has compare teplx A set ayfan ❑ P e mpla repbmmea shoe has bsaI evdufrom and may tp wind M Me laradd S o l mpbb'naN edl eueapAm equan The repbmment area shade be prWeRM from dNurberca and cwnpatlim eM Should nM be InlnngM union by reTumM eMaN[kan etlairrg eM popowN ebWure, IW eMe and wd'b FSIOBtOeMg me syMwsmuam oymht funeed bamw[dleM Sib maludlm to EeINAIMBwitede replBmnmt area RBpAemem [ysiens mu4 ¢mpy'.nN mB Nlw In e O A whadt, a tinedl all aalwrve e Orientala 8 , aallatle due a u a ho arlda col y ad iiow N the B rform ayron tvlmt be raabllrbfal aq gmrp aHBn�In POViT$ tMnpogY a Mldry lark may ha argellp as a e[Ircnt ❑ The vie has cot Mm malualM to ldaNly 8 susses replemma2 arha Vpan IaNre of tiro P0.415 a wll am vte e+aludrm lasarmo mreple�tine f.iee we�sreplawtlmt arm vno,wla¢enemarm lw a.eheaee naaing lama m.vMm[mum awe o Mound and st-grade Bolt adwryeon systems may be reconsWaed in owe Mlmnng removal of the dame( al the other vet SureW Remnamutlions of such WSmla meat comply WN Me rules in Owe at that time. WARNING TREATMENT TANKS PUMP TANKS. AND HOLDING TAN" MAY CONTAIN POISONOUS GAMBIA OR lMK e✓�!a!\lr SOFFICIEM O"GEN TO SUSTAIN LIFE NEVER EMM AM TANK HMI AM CIRCWSTANCE OE/rTI WY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAAY� NOT ME Po5.41BLE �/�/ AMTI MLINSMUCTKNI9 3.3 ET/ X'—bet rI MW IMTALL R POWTS MAINTAINER po( NPPo'�Aqj-3a SEMAGE MpMCING OPERATOR %NPER LOCALRE6IRATORYAMOMTY Nee Hone Plme Phone 7 /� The sexual wm eane by N rem d In. cnn b4,Mew, old WaMCnnmy PONTe voual Al In CWPeertwin assume combs MYgxllbNtNdafflad ee.e.ltl, lzt a lG. Wem.mrJmhamMwcme ST. CROIX COUNTY SEPTIC'I ANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ownerfeuyer NOrAmpn }tomes Inc. ����ww Malting Addre% G�pp..�1 N(tn Dr. -#1Dz tNd&pnl Wt �JTn(/��fF Properly Adire Ani 1e2h1� f�mPxirt Im WD26 [H (Ye bewion rtgweed from pmming�gncimmumnf nemm�wrveu� otysrme 9mtma � ParenIdentification nber—D32-2-111— 2D—DDD LEGAL DESCRIPTION Property Location 112 IIry uA, Sec 21-, T 2j—_N RILW, Town of_plel Subdivision Plat Pine, Mi-w zubd1VISIQYa _ .I.aI#22 Certified Survcy Map N Volume , Page # Warranty Deed# (before 2009)Volunne , Page # Spin haaeoyeaom Lou lines identifiable Oyeson, SYSTEM MAIN ENANCE AND OWNER CERTIFICATION Impropern, ended or you septic ayale could result is pa mfailm ohandle w Prior or paurmag utm, serum wtevery thre pica or sooner, ifneeded, by failure prmderswhwyunwlrole maintenance system n arcew the taproom mail aelc are ns n express stage m Ne%saw dnpsal system own maimemaua res�netbib<s are fpcnned in g[PS 183521IIaml11CMplerll- St Croix County formry Ordinance e Tee property nv rasree up mlome m St Croix County Preparing &2omne Department mho, nform,signed by lee aasee raM byanasmr plumMyowncyman plumber rn died plomhrorallee^sr9 pnmpe-en%u^....Meldedma code«dl�oflludge mpmacr open mB mMumnand or Ql aflennspeeuon and pumping Llneyl am ttPu he c Jr is Ie:atn>n IIS roll of sludge r l• Inve. IM umemented lva,c read (Ire above «gmmmmu and agree in reunion nee prune sewage turmoil system wh t the warrants tit fern herded, m set by dnc Delpal or sar«y Are Pruy aim Service, and fie flap mimnl of Natural Resources, Sankef0.lxomm Cemission:rma on your scene system has beano mimme mine ne empirical are returned to me Sr Crom Cowry Planning & /nnmg Department wMm 10 days of the Wu year expiration dam Eye orally (list all samovars '.it rass Gem an We b in, lied of myarr knowledge I wnrMare Nc:wings) of the property twcnbed Mod, by orur claw only deed recoNW an RegnlrofOvd, ORe Number of bedrooms �.. iGNATURE OF APPLICANT(S) DATE "Any num mmm tWt he air s¢pr,,cnoxl (nay result In the country Pemut bring assured by tine Planning & lumng Telephones "' Include with this application it ccurded warranty deed from Ibe Reactor of Occds I1Rme and, copy of the citified survey map R reference us made m the war my deed H LEI I C.S.M. 61 L PG. 3035 N A Z N ------------------- OF PINE CLIFF ]UTLOT 1 21 L4 ars 3n 2 oce SEE �M °& M45 AC) 23 3411 xi n. Mice Y LOT 1 C.S.M. VOL. 8, PG. 2128 5 Y 5 J OWNE NICHE PINE C/0 4 103 ME �03 M. 4-_---- -----' u o10arni""`° SOIL AND SITE EVALUATION a offs.reNemaeeae9, Pow al3 Pivx. tr model smr.n in accordance WYhslHiReJ 09. wiz FtlmCC�We PI Slorpe Incet OF dimensions, "one.""..rear m' 1110 art i FordI�4"pp���o, �Sf C/O i.( APPLICANT INFORMATION-Pkxee PHn( all 11rddaiNmllltln. 16 I999 PO?� ��+I�'��i�oe n"yen lnecl /X' y,f^a,rh,v �. n70� v yw,..�26 T31 IOF V IF(a& o Net,Mr. re "as PO /lox 326 Na /as,cli y score be cone "e umW,pipe. ®Tam uea RmnJam.�e' m u OisN zvr St 6t.JSt ®NaeGrer.nr.arer u,. ® sensorial I ForalIf attended. .attar rat®rep wN.p ❑R.Passal ❑Pw,tvc,me<,e.i fee p isms, deme cow oU a xmtmtaeet aep"ie.m"q rate 7aet ppMp•u _ at rommnm area maa�rea�T7 as, na 7� an I. re"mem taemtar pane� tte gpdv • 8 Inal, ecdme tooa.ae.e mpire�m ataee aie..uonc.eIt (as rerrae to and Pico amchmart) r n. n.ae"an a�N iI��,Il_�atwPrp— 9p 18 � nae adronde. a ender aP• cmmmW I MCW In Grwmt I AT Grant SV9tmm Fit Haan"]iapk roetrnem ®s On al Ou ®son As ❑o pat ❑u ❑e �u SOIL DESCRIPTION REPORT Bona at moment o yrvcrart e.ry P Ira GO S, Cost Color In a."% N.4 N sr SL air caanntaat Bamf6e ln� ccn Zm ,�Bad rr. _ 2 Ir.27 m .S . wan"^ 270 tip % 414 L591 /mst..t' /ryc cut ✓f .7.8 GtPrero — mna, >7brm Remarries Ronn9 X _ I -/v /�'Y /Y�_ LS 117�5 k L Cw Zm 2 7 IY-Jt 'T 45 mrbC IN c� 2m , f .8 3 d o ,srR SdGr Dms G C w I f 7 .8 co s% A Oms 0 1 mL 7kneeng . a Call >', a° " R mar IDDf/'Her. (Pb Poqop cprelme festal No 7�5'2Y7teral °""39�-/9za,lr s ir., wz v=i ii✓ PROPkPTV OWNER pl, Clr apart ,0in SOIL DESCRIPTION REPORT P.R«, t R k Lot �a Doing P 3 mini 41 II Dai10 n � », Boring a Y 91A Ir Crynim wyrnaing �IIZI Boring p S pink � a Gar NA,. Gu Si sort Cm _ sai G, Sr 5" omvneu Rama R,ar 9p Timor �i2 Lk5 1MfM 101 cup 2 3 R-27 1,d1w IYA I M9(+ Gki 2n 7 73 ZSYBY _ Nq N� m 1. - tC6 0ASy Oni /�+� cw In .7 8 any 7o,(I s i• 5 Remarks 9 /O"R iy S%R �t 7rM NA_ L / i"Ibk IMddk omsf DmS _ ,„�a. cw 2�, , .S .0 Y'l_8 A/A II t,� 6,v �M 3 x NA �A l S�c� S, c4. tin .7.8 y bNIA 7. yg f m � — — ,7 .8 Vl,. �y Remarks Homan � mean re"I Gorr pu SMO""t r l,, �kb b s unum Or Si Sk smenm,wk aMkbe Rinits GeE i I Z 3 y :e B ado /%8' i✓ A'A /tiSGF iSX& pinny Onr� 14vO co, 1m , ,S,6 lo-2Y /�i/fYx _ �/� 1UA Nl L moire ML cm 2m �w7v 7S,11v Sec. S qw /✓F - .7.8 .�.8 vua 7nR 6 m� — GrIlm 13„ elm loan �van L b %III'" Remarks ti Boring N G, firmGmang fmmr 10 Remarks an) 83W (R 07MI Pxwtnr Owxen /I/IC (:i✓ F/✓OVTA}'Q SOIL DESCRIPTION REPORT P.VICELLDe _ Lo-t2e) SonngN 3 �n .wwc Boning V 6muN M Dpin b 12 'Y.e 71-7 Rai P•e•�a j eni fglw Am" D. s. m cww i'""' SLULa Or s. Sh B �� c0 3 Son T,.wf I 12 /oiA'W L S lm M /nor. C w n 3 k-27 /D/iY'/ NA L ai»fbh MV(r 6w 2i 7 3 zLjj >SYAY ✓cr oa Az Cw !f7 ,B 7dU 7sYR/a 5 Onel me — -.B n I 5 Ran,en<s m.tbk m a. lcc yn 2 v-ie L se& cw IM Yn 7tM d6f lh d y ZrYR i� SI � !Wm UMn In N.urx1 W S. Gnt Cab Tealve Connor® bvNw P Orgore EM T I Onto /0/.P %y 1414 L /7hSdt My Lr.. m Z 7Y /O/X%z 3 K9r 7f R� A S.iGf ms /nL 9" /w4' .7.9 r-uo 7n"R a S On /n 7000 1 Re eM v^ Boring # Gmund Penn III Remaris �uyr,3gf3 P'neC4(ir paf&Sa.P jvwkv S 6N?/9u BranrP. dr Somernf rul Cst.a3i3/Y A 3wA�.,e rop of Lordke SE coney EL./cb,o to A4,,4 Br �tL. /OY 7f _ L.oY. war 4 4r bti SY,' 21111111'