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HomeMy WebLinkAbout018-1099-34-010 (2)gal aural polmnemm PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) ti FIT all N. D. w.au n MSTRIBUTION SYSTEM xw� sw munmue �opono) SOILCOVER un"am only All and, Mr Ended I.. man I Top" on 0 M1 COMMENTS' Tolle Pnnceenoe one proem at')/�+cea LBldg aWon Va]102NDAVE�o \y\p\` 1)Ceaznpllca Plan Poison Rml Col Yes No ) IOO rm11en01n u oldermeHe eellwnnlCnb mtllon SW4 la(Sms11 a °al hall sgmmw Can ne Frr--,, i775Rvvsn 54N-Zi - i(8 rya aeauy 6.R n I, t�.- MAY 1a 1om AlW Warurgl`m tP0171M - _ nx Iu4 rrIM v MU, l ` mandate '1� P 6z�{�o/ m ty Sanitary Permit Application " 'L" ir.,.""'"" _ _ .mtla.....,..r. r 3099Aet =T . 1R. y, R�kkea. . 1. a.Rar„w mwLruk .. ruser, P..rei.emworwrw.rl�—rlw.mwl rkiwar�a:i.�m��r�xrikr..``a�l 1743102nd Ave Ii Atifflakifflumlabrn.lba-PbePhr An labrm.rbn� rmw.ryoure r xrr. lC RcZerlP it IZ 3 018-10951-30-010 rnwmcaus,. real am. — b°p'^Im'"'o919 n.syyA 625 Hanger RC Ha090r 17-3 New Ridwnwd W SE tl r.. ynan6 r as cme hiEslervwm Hammon Po �w1 r A n IerNI sb R— 11 '1)pearB•Itlbylehtk.Il Nv1 1 �r� x sz.wrl.,...rl wires ut^ ew Rkge lal AEtl ' ❑Iw.,�.r...m �— ❑pru.ouam IA.rmuss vswxrwlu�1fO; ❑vn.Ror 16 _ Rrrr,,..a HRRIIRom V.8 .Is1s mar •:Kw+b e..wllwA cu.P1e. 11w u 1 ❑,orrr parasol ❑barn, R.,..... ❑nina,"rlvo.uu ❑,.r,rr k.rm.,x 11APsoloo, wo,I uniwar krual Z'f3 6/2s/re• IV. isu41101 elawCasw•.arle.rla: -M' a e.a ❑x...pr.n.o.. ��.,.... o».,,,.... rµ, ...❑ _ _ .fog mwr. ❑.. L.oe..rr.mm.e,rr Qam�l— v.el.ivVr.. ml Ara.— o•Ipd,wvµyr oil ra.uur assafflikent an „ray9 mx.p�tarp 450 ,dO 112 1250 VI i.•k lab vrryrn #of ✓ x ao 'osGd ruc •libi reunion 1000 NSeRer ¢° wa Hu.,,... cast 606 am 11. Repn.ihYiy L.srw•1- L rp...s..bN KeM KnuMsan <20.173 9271501b St Robert WI. M02 vnL caoo Ne Vessels ussa �a 1p in o 6 p wUmkkk- uz, IX. ro•a4ms WYmm"a OWpPrn.l 'i �w� .EC (1Y.w MUI t YSLEMOWNER �iT ). 1r>Y�a�r septic tank effluent fillerand apparel call must mconcealkmandarrat w a sNA W as per traducement plan reeked by plumber�uI u./ w s . MRe vn>meara ,Inn {e •.✓*Yr °weoss Sanilory Site Plan \ For. Robert Perkuu Lot 34 0 Phexant Ridge Ist Add, \ Parcel in the SE114-SW114 \ Sec 9 719N-RI7W FN#1743 Town ofL morel -Sr. tors County PropnsedYslYS'Ai-Crode \00_ 5=•bock Moved DupersdAreaw1a System Co iowmd �\ Elv ms of 910' 97 50' l� \ 96,50r 9100' \X/\ \ Pro➢osedD d Badmm H "Sch 40PVC Proposed Wieser Conenne \ W01000-60 MRL'ombtnmron \ Tumw1 PoliyLok P45I5Fdrer \501Setbxk Prgn+eell"Sh 40 PVCFM. LN 3i Ek elms D*m I &Acre (q{.p\Mt Pipe C Imsw of9] W (V iw•TapNwuM Rn �� /a0•Sue �WS:= IX of103MAw oUrnixGvi DIVISION of INDUSTRY SERVICES :,\ GREEN MYATIPLSTEt6r es j CinnamTnroughStay Itl p�� nap rmro. wlemwmenmume'icBeen Wait", 3womm, .Om� 4un OUYlme,se q May 21,2018 CUSTID No. 224059 ATTN. PO97751mpenm KEITH E STONER ZONING OFHCL KEITH STONER SOIL TESTING SANITARY DESIGN ST CROIX COUNTY SPIA 3322_0 WOODCREEK RD 110 I CARMICHAEL RD SIREN WI 54972DINA HUDSON WI 54016-7I09 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES 05rzU7020 Idrntlluuon Numbers Tnoutlbn 10 No J09&gl SITE. SIIe IO Nu N9MI Petkms Please ref wMM1 Ramidicnion numbers. 1743102NDA,e pMva in pill drn[e x'IN Net ere Town ofHammantl A Coca Ccwn' SET <, SW I'll 59, TJ9N. RIIW FOR. Decnlnlon Residential Al-gndnNew Consou[uon Object Tyye FOWISCompowm Manual RegulanWOR"IIDNo I76I064 Mmntenmmt ulred, 450GPOFlaxrne, 38 in Sol[ mlmmum depth to hmmng farm firm optimal gods, Systems) At -grade Comp MtManual.Versim20,SBP10954.P(NO3'07R I12), Pressure Distribution Canporcm Manual Vet 20 SBOIG(s-P fN W V I. R 1012). ElOuem ghat The submittal desmbed above 6es been reviewed for cmbmwat coed npp6m01e W Istumm Administrative Codes aMWN[msm Smins, OF suMnmal M1u been CONDITIONALLY APPROVED This system iswbe [ansuu[ud am mmusi m ucordance with the enclosed approved plans and with any canponem msnual(sl referenced ups" The owner, as defined In chapter 10101(10), Wisconsin Smwttt rs m rnmelple for compliance %ith all code rrywrements No person may mankind or wmg as plumbmg m the xum unlesr Inimical m on , by the Department per a I45 W. soms The following conditions shall be met during constitution or Installation and prior to occupancy or use Key Items- POINTS Design Approval Thu system Is to be constructed and lueared Io accordance with the approved plans. and the "At -grade Using Pressure Distribution Component Manual tot Private (Irma Wastewater Systems Version 20- SB610g5C-p P(N 0109) WRh new construction, it is recommended not activate the pump in the dose tank until the tmW arc pumped prior to homeowner urethanes. Wastewater generated from mnlntlnn cleaning of equipment antl ImH author lip over monar" tbn products shall not he macharged into the drains d'nchaming to the private noting wastri trimmest system (POINTS). Waste generated shall be probably disposed of withal or off site, OE Any All grmeq,leaves and shrubs steal l he Far and removed prior to lMng the surface for implitwn to PR OF present marling under the dispersal arm D)1Q91iTm Prior to construction of the dupnul area, cheek the moisture content of the sod to a depth of a inches Smi and tvmpxun8 alv m I wdlresult l wam,g(li,nifilumhom Gra,11y ofbewPointers, ll Pointe, moisture content can be do4smsned by rolling a Vol sample between the hands If it mils into a I/<- inch vases u lnl 1. xro.[a Rgl linable the site is own Poet m prepare I it ennobles. site preNtauon can pmceN If the site is lou Poet to prepare do not proceed until it dues • Cleamm; shall be handled per SHIPS 38233. • Insulate bmWmg sewer beyond 30 feet per SIPS 382.30 (1 pfc). • SPS 38351(I per The management plan for a Pi shall specifically address the Among reservoirs of an aerobic or mn ble treatment are or a holding mnk where either of Me following conditions ist Ixhe Mown of the hank It located more Mon 15 feet be sin the edition when Her Widlithe wtl is located, 2 The bricapart of the Mark P Mcglard am Man 150 par Moshisgualls trout where the counts, oil a locconed (All weather xry is rued ma) be meapor st to address veoaind d ahommmul Expenses)) • Provide surface water dispersion around the tmtmentunw and at-grntle dispersal rnmpcomm. • Thewr net uresponsible lot the operas maintenance eofine privateonire wastewater treatment system TM WTS) maccordance and SPS 383 and the approved management plan • The owner of a POWTS SM1NI be responsible for ensuring that access opening covers remain locked or secured except for norsum cunlua ion mamt,ou,,er tin mg furrows • Owners shall motive a copy of the mumpnan,apeman, and mam¢narce menual and' or sources mound for Me POW TS described in this app^^al • Provide a ropy of the approved POINTS plans and this knee to the owner. A copy of the approved plans, pecifications and this lever shall be on site during constructions and open to inspection by amonced representatives of the 0epadmenl. when iney uelude local inspectors Allpermtb required by the mile or the [coal mu cigpalhmy shall be obtained prior o commencement of wmlrutltonrmsullmmvoq:ralum In gratitmg din approval the 1)iv of Nereus Services ,the nghtI requiechanges or additions should conditions moss coding them ,cow art for Wade compliance As per give pals 101 I2Rr mining in Ibis review shall reline tM dminaer of the responsibility for MonsPmg a safe budding, mcotwe or compiuni Inqume, conyming His core wndence may he made to me at the telephone number listed below, or lithe address on His leverdidad shall provide a copy of Nis letter and the POW TS management plan to the cone and my Fee Regmredg 250,00 This Amount Will Be Invorted WM1en You 0.aerv<TM1at Invoitt, Please Irclude a Cap> WnM1 Yon vision of lydusq Sm¢es Pa)mrnl5ubminal 3JSpm Wi5MA0.T rods: ]d33 cc Edwin A R)lor Wastewater Specialist, (715) 634 3484, Mon -hi, 8 00 A M -d 30 P M Kenh 6 Knudtmn, Knushoon Plumbing (Plans Mailed TO RESIDENTIAL AT -GRADE DESIGN Prior uNzear- Sloping SlAr INDEX AND TITLE SHEET Protect RCtMt Perems AI -Grace Mound Sy9km (Deeper Robert Perkms OGUrtss 625 W Hisser Rd Hangar 173 Nev Ridlmmc WI 54017 Pro"M Accreeaa]43102nc Ave Le9el Descrlptlon SE114.SW114S8c9T29N4l7W Township HammOrM County St Chow SubcrmlOn Name PhgauM Ridge let Acd WIND 34 Parni ID Number 018,1099.3ill Plan Transaclan NumSer ,ON ONALLY Index sheaf Paget OVED Calculations Paget 5' FETY AND At -grade drawings Page t,p, ALSRVIOES Laterals and dose lank Page ,� dT YSERVICES Specifications Page 5 /. Management& contingency plan Page 6 Pump wive 89pecibcabons Page] Plot Pan Pace a NLE Oe9prer KuvNE Sroner �sS0N81rr"Oi License Number Deagrer t5]SLO) Signature xeii[itil�' Phone Number 715E53-2324 p-15]5 2 Date D&IO Bran,,.,.g9y ` aa'q�F9lpMpiM (p,��/� pwsuanuo Phgrry ede Comnent �IAwe1M981�0 w POVJTS SOD!w54P(N 0 and Path SSAMP Putlaodsm 98Danish of Pressure Edification Nervi or ST - SAS t019¶ and WIA) Presure Oi91n[Win Compucnl lAvnual Vtt 205HD.1070 (N 01011(g Wnm r OIOL¢I I%[(. ^�V�D page of 8 INDUS I HY SERVICES PRESSURIZED AT -GRADE DESIGN At -grade Design Workabeet- sloping side Flows and Ske Mae Enlry (r or e)10.0Design werlorcomflow bi Saturated washo ler blow (go) % Design wastewater Bow (gptl) % Site noes ape contour else belowor(in) (n) Dept u mumlifi factor(in) In-situ wit unification rate (epdmz) Distribution Cell Information (1 or 2)Influent wastewater quell Linear loading one Thrift Ensures absorption width (f1) Max spectra width Permitted go 12150 Aggregate length b) Pressure Distribution Dame Eldry be or a) c center or end lateral connector 2 Number of Intends 0.1% Onfice diameter (in) e g 025 Pews. 1.83 Enamored office arguing nn 2SO Forwmam diameter (in) 374 Fordimain flow velocity(Neec) 25.00 Fomamaln kingtr in 91.00 Pumptank lowaroil(0) 455 System hand T) x 13 509 Vertical A(it) 070 Full luss(fl) OAO In line Fiker Loss (it) 1092 Too dynamic bond (it) Designer must select one lateral diameter Lateral Mame[er Selection I In y ofnMDoes lorcemaiit dmin becks yarat nDes orcenm8 highest poinl2 NA For�mmn tlrainCack (gal) 5x lateral voq volume(gal) Minimum does volume(ga0 System deman0(gpm) GMlomancn Cakuli (optional) Total Tank Carl (gal) Tefel Working Liquld Depth (m) Gallo (enter result in tell G48) Treatment Tank lMomlatlon 1000 se tic lank capacity (gal) Wieser Concrete Manufacturer Effluent Fiber Informal Posole Fster manufacturer PL-i126 Filter model number Mae Tank Information W3A Doan tank capacity (gal) 16.8 Dose lank volume bill lid) Wieser Complete Manufacturer Protect Robed PerRms At- rode Mound System Tmnsectnn Number Page 2 of 8 ATGRAOE PLAN VW A A 9Wn �0 xMwM 0 Tzo B�1R ,Nn ,t Dort o C 500fl Ezdon �500 n W coon �e A „25.nO fl^3 0 �L Oplowed area L.W T AT4RAOE CROSS SECr10" m oedetL�L® /L_Wo-l �.r m c::3 Bin Ngmqsa� Mass p �� RoteA padi A,GMe MwM SYstem Tylyaction Num0ef PRESSURE DISTRIBUTION AND DOSE TANK Lwerel OLa9wm - Wnter Connectlon �x—raw; r� ua.sar.e.maPrcrw WbYNrIMbMab rr1aT4.Ye]N r.w.�wawrmma.aa.Ma .wrryq.sp • •i.mavrmnw.rawnstgrq 4 SgcMulLwr 0156 ONBnetllemelerpm Center Lateral connection punt x 1 a Orifr .parn91X) NumM IeMale 3a Onficearleleral PLateral lerom (II) 183 Lat discharge rate 9pm) 161321 Lateral tlmmeter(m) Fomemain diameter pn) W6 Sys dieGarOe ate(gpm) Forcemam Ler(it) 1092 MR(X) TyPlul Pump ChamMr Lai w.nnarp,,f _F �— mm+�el.memirg a.xa Tam omwmml. Nbm.h Pmem.+mw met nman r r rrrec3wam X/ Aopmm e 8V88145300w C i.mlJ py MCXx Whom A vmmarR- ,° A 2031 Ml2 nu.mm neaamlear c B 20 3J8 g .^mi als 36 66 n.mw 0 100 1680 91833fl C Torah J59I fio34 n.gen Y B.Nry um.r renli I 91 wft EPOada Pump rnodHnmotr T�kAlxt lua NarmmWNnurnEer Project Roper! Porter At Gale ldj Syswm Transaction NumM- Page 4 of 8 At9ratle Seabm Maintenance E Classrarthen Smofficationst Savro Pmvgers Name Poxes Sennatpn Plpro ]15248-5]3B PoN?S Rryulelo's Nave 51 Cmrx G[un 2onln Pbona 715355u4500 $nMM Flons, and LandM Desgn Flow - Peak 450 gW Maximum Influent Pril Size t/5 In EobmeM FlowArm300 Bud Maximum BOD5 220 mg/L Septic Tank Cal W00 gal maximum i 150 Inni Sol AbwVon Component Sea 11250 K Maalmum FOGI M mg/. Type of Weslearma pam"i Maximum Fecal Coiform I 10i chul not. Saptic ads Pump Tank Effluent Filth Pump and Conimis Ala m Pressure SKlam Mound Omar Ins arl eervi¢cance e 3 e is Inspect are clean at Mast orce 3re Tesldnce" J Offli EMT Men Laterals should be flustad are Dreall tolmd eve 15 himi for porming antl Mai ormis a,e 3 e MMc II n Construction and M I Gbsen2lgn pipes are sletred and materials conform M Table BPS 3B4 30.1, IWve a walahght Cap. and are sGwreb in M shown n me allrace comp snenl menua 2 Detain cell Memel onnbrms to SPS 30130 (61(g, Wrs Adm Lode 3 AH gral and pressure pigng materials mnbrm b Me r ui a nb In SPS 3B4, Ws Apia Code 4 Tillage of me bell area rs ednmplished whir a most Loam W Coal pwas 5 The atgrede sirruture and honer disturbed area volt The sPoded are m AwMd1 to gelMt sou er0sion and help reduce frost penetration 5 Areas within 15 feel Of the dommucpe Me will be prol¢Cted from mmpacuon ] All other wnsbuc110n detects am as per the atgrade wmponenl manual SBD-10854-13(N 0310]) Finished .............. ............... Grade 68'Dlenminer Lam —� Threaded Cleawut Spinkkr Valy WX PIu9 or Foal Vai Distribution \s Long Swell 90 or Tw0 97 50IT 45 Degree Bands Same Diameter as Lateral Project. Boben Pastas At- Grace Mound Syalem Tmn¢eepon Number Page 50f B At -grade System Management Plan vunuvnl ro BPS Y] Bar Wla. Man code The 'yes" "all R rvrJM rn amprel010 BPS 303389Me fom Cob vM afiall malmeM In xuaNan¢uMr Iremandb-mpmem ate of IWysIX. OYOp�wmrr manerul11),I nbnanm nparongce Campbell hanal for 305041 WM IX poll hipprody If vmrµcw Wmp YnY uw Nrgpwquaa may m premnnew mW mrrewN DOWS",noxm unXavMrrCvamnrmaXttln mNarvz Mn BPBb3]]Wn.Pdn CmerrMnlMM1rMvmmbgerupl se ry nenls Seol Sakned PUMP e� en muers euq be rnapeffa vnAlyg nM soon Omaaepenrpa upent der n, wce wbrgoruPon Nemnpelw xervorn PnY9nneq Metres urmeuM.Mwlee, �F x® geagagrew meumerer WOM rmrN SYmMbdw Mrry Or oeucelo pretendmm eaealw vned entry lnroaleommponenl. Sforan M xge!nna anal oe mwdearea by an rmvqub Mail 10 mrvp III take undo. 20148 Stud. The mrbrb W the mpoc nor Stan be mWood Of In Homent wnIi It Iran irme dark I wan byapWR 11 Amen M m Ce lonernmgu al of the e xdank and maker NMthe r 0Y neNMrmrlXageaneuN nd [e remorse unbsaDswne oY pel m®aswuglr MrMefiwonwMn mmoowalmm o enWure II mugs-]wa 4 xn¢J X,re Nrm aaanaua mrgnwary Inermatmr HreraYrmamaynnumwrp brag an.mprglymnonuoum all tank If the deal cnnlarea vankNamm a mmmee�l intmedapartiall aaweem Mmammen®per...leel yel�s IOulaetM ovmendia walloya 'M of owkq.rs f�brrsiann m,,maw an Be une am MaoeePororeab gainux nytM ttparromoanointment gerenlry ml eWrrm. Xofnw,IaW pm]u9 Iry)lanksnallee msmclea al kaxr orvear¢ry]wvrsn NlautrMe Barms,eM pond"aSallNbeMto w.rygrryr aUrawm Xan NPuarrl fryernreLha wmm an lank ASNYM menetlM arM mrwp]sammxary AtaeM and Forel ladvaltuddificark"M No Way, Or e atlmM al mayor maIIM endure ld ende s pwm. oil the almWN a II mmea addmufifiend ki"mam to thew" Pe ermen a be to grab ems wW¢gn Own hml llralmmo mayor lwl®onnM wgnvure"interior on Ile Mire and nmmmeMm sarm eoi mnyown may under dmmmkk of rM n5arelm noon w ,n Re wmpewlmrnme arv.krvm promdelvr rynxnum Ceq maloer lnslvllabom lCbmmaFadamdrealmletmew- from mvl9m^wxnummayngtermr330mµeC4 5rable ryl pr]n5 ]0 anal Tra t0 ryn fOC nor rp cryyrM "afar ngnM oemee aTunn SnermM may mer¢m mamrrrmmypPaw n ayxlemya Drovgea wm a rluaengppim gNeeno olmcn Iberal arb Nle nmmmenoMlutleaN IMnlm Spun Waccommulnedbugeallaunnwemaramonma W e aYetem&Ic arl eto aesrmbe SarTmwggry lluemu°fa enenoerlfi®°tleo nme lda ngNM bbmni°In.nmwiueltnleneb mn eal.Dereo ml wn here comment asap l eemail ida hy OSak elHadualWm Mie Pomeq tman ataa ary amondr b tbwea', vrb any ewe worn a mnmrr�e.�ae as an Immneirg nwrbgalmn rmrtrre aDalmrel, monxmwmmonnn„p Operational I If may mqe taw or wry of AS ttmpanb Ixmne oe6nn the IeM by wwrerA Mrand n wnpe2ob hand, man ski in door hournating comanew Iftramlytana, pump Iam or related woing oemmea n®rmal the national corm bl&I W rmmmlvMY MPANMwmplvuaunuacomrymnlolroemneormual Poormenm if fe®g2b mnmreol fare to al vaveraur of bel to daberpe vmlwaM to lM mal border A WN ae rmeeadw rµ ,n Intel ey at Yq m r0Mkf wpm auq lle readapt of gabayreq Our wnor w g nprop and regernrg gnwwre l ab mW remmry to oary e SYbemrrmor oPomarg mndilnn Bee Pooke 5 of the prn Or lue ore and met n of of deal RlWl'e rcyNabnnd xmw prorgx Prolatl Rotead Perklns AtGretle Mound: Traneacten NumLer Page 6of 8 rag, 9 nc a Wastewater METERS FEET u ACM CW OhISe1M MW= MFMen Munn Gef MF Vtle #� CMry FMeI InNM Canmvtlm 0=4 OnlxrM OffI SaR4 yNe M 14 u s/R5 w If Knil a M11A[ W Vf'd:Mea: 31/95 wFnF 10 IR IS' # EM13N. 230 10 Menus enuM _ EMUFM Nem nl 8,051IF 0 Mn}xl Mtiutl 3¢/f0 SEIMfEi 52 Mtgite'i1 33/104 W1e 10 %9 n amxl 22110 A�s9* 1 s�Up F PJ' o� II,Po \ n�DlH a„��D BC o�cLF�I 1O4 S,Z, Ate) J��B q� TM4 � e �'z4r yl � PGlj �, i �P�PAr \\�.16y{�h'.iyye 4\T� 4f44r ). 9 "V*17fi Soil Test Plot P_ tQ Prolsot Nf UftnoFWm yTnwt Ackinm 10111TfM SL He rbd W Sgp18 IATM 822690D Lot 34 Suhdlylslon Phe a Datv Ofm SE 114 SW 1/4S 9 T 29 WR17 W TOrrnehip FI&rxllpltl ❑ Smfog 0 won PL Pmp"l countysc Croix SM w VRP Aesuflfe EWmWn 100 & TP of Wo PM System Eleretfeh me, •wwo 9enw eaemnnrwe o` A ST. MOM COUNTY SEPTIC TANK MARJ'1£NANCE AGREEMENT AND Robert Perkins M mgA� 625 W. Hanger Rd. Hanger 17-3 New Richmond Prapu yAdAess 1743 102nd Ave. (Vn�fiee4mrWmmlfiom Pl®m6Rlmog ncPvhnvl �l Hammond W. „_a, 018-1099-34-010 LRGALDRSCWMON Pmv Locamm SE s SW y s<c 9 T 29 NR17 w, To wo or Hammond sl,naro,g,oP Plat Pheasant Ridge 1st Add Laln 34 Cvtlfieg Sarvey Ma # _ Vole Pageq WanaslyD #_ — _ (Wun2007)Volvalc _,Pne# gPZMus[lymmo Ic�lmn Wrnu(enk0>vOm SYS TE ANCR AND OWNRR CRMTDION ImP.nP=�.,c.nam.immm�or]ma..epaeay.mm wmleannu �n �nP.m,wmm lvlurelo lwmmwu+� P�qu waorpwroegwa messPw.la�e.ny wreer«x«a«erec a� dm, M.I�emm Pwac� wm� ro�wr�nu me ryuc uoc aHm the lux4m orlbc.vytic dokv W&ei mtliap.salayacm. Owou �mm�msec rcywwbiL4¢art apecdid in 4CP5 383 52(1) aal mCTyuv 11-4 [:,wx (:luny $mM1ry ONmoee IM ptc�yaxmm vgmmmbm�tmy Oou Couory Plmomgd ianmg Mpamrnacrnibmann(«m vgwtl by lM v ma bYemssln PhunM,l^^^�Y^m^Plm.bm.rtMcum PlwbvwancrnvJPuniPcc vm(yin8 WIIIJIh or.bnt l .urysmmism PmMx NmaungmawonanNa(2)nPu wp¢�wn antl Pumping laneccasvry), iheuPut uea �5 Im' Wm IA (WI lof ofslvtl8e laa lne anamwP>'mnaz.min.aro.e.q�i.em.�n ma.Pvwmm.n.a�n me P.�.mx,a...b m.Pmal.val:w.wm pe suotleeav ml lwlkhvun,u sn bY�NMw��lu(Sa! YA^a Flof�mW SwmwaM inel]gwnimrnf NamnlRwww, smen Pill"' m r<ro-fcamn. tLu30 rcptc anrn^naa bcrn mmnuinm mua be complcmtl zm relimr2mNe se GYnn Crnny Plamog$ZuumBGM1wua®l witluo ]o asya or We W¢yw mpuNw�&¢. Ihe[en�ry wl al avamm4 onrNi rmmaa uue mrxnm Mmylwmm�.,laagc vacawme avowmmlal of�he Pm W N ana.aa nbwe, by waw or a w.wanw ma �n,em m Reg:.m nr rRma maw Nv®bv afbellrovmg 3 SIGNATURE OF APPLICANT(S) DATE .aapaYmlm®ow Wwarmv+T�lwr wy remh in IM1e eonurypo®1 nuogmokol try ltr PhmmB ®ZonioB = xac In.n.new�lh Wis appWaurm a ranrdaf sxneory ticoi 4om We Reg�w.aafDeeN OB'ice utl a copy M We cvuG Auvveymvp �r nfoena u o W e m the wunnrY Eee]. MMM !91QIn III 111 0 0 f m EV ITI w v It ZV l _ 1 Q'T f �I �� ECEIVED SII 0 %RI q y0MAL EVTLUATION REPORTt p 3 ezxamm � I•`�� rcwp bw ON �v�m.num.m 4L ew.no.. u {— — •e.en w.e,me�.vm.� nil ❑W ow e..rNm I 1 Irk -111L Puuummm.pc�ma. �n.rMY I. vW❑ 0 .a" � IDNI Gr JuueuMv ' ;n uMblMh N= Y/ F u.ru_.... I I I...lp u ea.e 97 i a V M® ©® um I_!JFTM�+J�F�S��fI ©nam Ormpmreq WUmm mm mm mm mm mm mmm� oe I omm Tie Oepuoeml of Cm e is m,sr ee,, Fm,,&r me employee If rou wlw.w and meWelme. uellmwe is equal lmwt. yleee emun LLe 4prnent a W9.166.111'lem M WWI 777 IIIIIII v ur�rr�o�eF���r�s�sa © a�rrarvnor�F AWAM © I//R�f��PL�i�7sJIG�s'/!i7 Fmml uutruf�ru�uuuuu ❑� ❑ , ao.R...®.>.E a..n...o.m . rrr 08��®�ooOm uu�u�u�uuuuu uu�u�u��uuuu uu�u�u�u�uuu uu�u�uiuuuuuu uu�uuuu�uuuuu uuu�uuuuuuuuuu E�wER. m7,>ID<tmn6l N19B>]lyiEOnN EMR. ,�xmpLeelR<fi^vti mesa.km�.rcemmm..,,ew•.�aowm.�n.... ••v �n,..a..o�mR W3151 w...�. M-. 97....ma.w wExa.nsi e m me.xadEm Soil Test Plot PIaJ Protect Name Ulkrls FamllyTmsl S t� Address 1011 170dt St Hammond WI 5np18 -5ST Y2269D0 Lot 0a Subdivision Pheasam RI098 Date WM7 SE 1Ge S W 114S 9 T 29 "1 T W Township Hammorq ❑ BorISS O Weil PL Property Line County 61 L x BMor VBP ASSWne Elevation 100 D. 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