HomeMy WebLinkAbout026-1122-11-000 (2)Whow"WormemlyfDoest PRIVATE SEWAGE SYSTEM
Carl
St CFO(%
Owed rude, Part INSPECTION REPORT
yeraryRri
624949
GENERAL INFORMATION (ATTACH TO PERMIT)
yel Plan lD No
an lPrrLev SGMPLMI
Farm' 11111�ft N.M.
Cry uIA Las
P o
.ITa.N
Gary & Kathleen Eggen
TOWNPOF RICHMOND
026-1122-11-000
RMee.
1110 ory1 L,No
mr, Local
cnmdwuRano... p N,
30.18.747
TANK INFORMATION ELEVATION DATA
TYPE
MANUFACTURER
CAPACRV
STATION
BS
IN
FS
ELEJ
Sepllo
Ben.hi
Caging
An SM
g Sewer
Holding
BVw Il
TANK SETBACK INFORMATION
SVNi Mle1
TANKTO
P&
WELL
I BLDG
V.tllAlrinl,G
ROAD
De Inlet
Saps,
BeEnrom
Owing
Twi
Kdtling
Bat Syahm
PUMPISIPHON INFORMATION
Fall Gmae
ManuladwerD,m,nd
GPM
No Good,
TOH
GP
on LMas
HART,Heatl
TDH R
I'lood"m MGM
not wwal
SOIL
No OU pits
tried' Did
Loss goal
-r1
�
HAMBEROR
SOIL COVER . Honeywell ANww rely Me grand 0, Anymore WNharry. Cal,
cepxmv
do Lear or measmCded
WERE!
n.m Came.
Ea..
a Ad
U N.
A.
COMMENTS: Ilneuee codeeismpsnoss pamnspresem,sm) Inspsniwxl Insµllon AD
1)AIUT BM BeBe..pllonH AVE
2) Bldg eermrlengN-
amoamaFaan-
Plan rtwvm RegalMa [G vee[i N
ae faraedew,,nmri
SBuenBrame 0)R.31 De, InurylY.Sipn.lws, can xo
JUl 1� 202� 1 m+w w..nn" P o�eo. 7182 62q
Y m w 5z
❑m.s,�
.mn.., I o.am�...�,m I o a,.,,..rv�mee I ❑...
ea.. vA..om aim
flQL
InkL
plv HoifierummFmm�{Sypm (aphin)
❑nwm. oswm.uewm,�.m,r'ono.,e.0 _I TT
❑r,.o...w w, e. r.,.wm (E i7 LZ
ewn"�ai If
wsouwvs:d,`m
o.,.r®
oao I rt
>t
✓sue= � � 4\GOf,
LZO
(/jlidgL/J S� ILII9 /��
Pltl R en Bnx
MA
Pg—of _
private OnSlte Wwbivinter Trentment System (POINTS)
Index and Title Sheet
Dwtier's Name �1f Y LL?fe"J
Site allmus 7 /7' ig(P5 AIEw ¢(C tf mo NO
Locatton. Lxt L� �la'k, SubNviiloNCSM
(IFLL LiraF µalga i£FLL ES✓tifg
being PM of the 'U 'A of the JaJ N, Semon i, Town-.kLN. RmBe�W.
rows of RICH--we^j0 Sf,Ck,, coanty. Wl
Parcel ILcntiBcanon a 62 Z 6- . I I - 'o
Destp N accordance with Deporsment of Safety a Professional Services (SPg) Wisconsin
Admitdsmibve Cade ch SPS 381 thmugh 389 and 391 Design manual(cboose one)
❑ Hob bbq; Tmk Component Manual P'ER 3 0, SBD 10855-P (N 03M. R 1/12))
Kb-mund Sod Ab TUDttComponent Manual ISBD-IW05-P(NOIMI)I
Contemn Page I
Page 2
Page3 /V5,
Page4 tpijjejc 4( /NG/Lfrth�aL
Page S.-F.F'vK eFle-F+Ffe.r �..✓
Page 6'�/bM'1F4 N1 H-AA!
Page T
Page 8.
Page 9
Attachments nr
Plwnbermeeigner /C a4C r_0 �t/�, ku/ S,grcd. /!// A61-
Cadential Number 44,9 2�6�9Z Date 7—L6—Zo
�/j/07/ /15�,a� Jf•�d„wwo
A4/ lLt1lV
— or 2— Family Dwellln In. round Soll Absor stem z-ce��l!n��wnvenuarnwi
Dairy wahewner FwwlDwF1 —,/ a+ a 1so v/bedroom
D' SPSTable3044H 1, 3,or31
Design Loading Rate 1DU11 or S011 AppllC tlon lUt • to
8 _
Required 0lslrlbuton cell area =DWF {?wd +DM gpd/fe
atbambers• Required Dlsvlbutlon cell area Tt' 7 M1'/unit EISP = --/�� ber=
Chamber Manufacturer and MopeP
Actual DlAdbumen cell area• Required cell arch a /�� ha/unit EE^SA End Cap Per•,e+o1v,�.L
//1>
r Schedule 0 PVC
vent pipe with vent rap
12nAesmimmum
--E M1 __:iLh
Trench separation teaching onamber Width
Sall Cover
1Inch Chamber xelght
yn Elewhon
73 hrollmmng factor
�h
Modify
bender/
M1
Leaching Chambersr
design as
tt¢nN 3
need
needed
� a mN Header
Sch �03
"
`gtli�M1wa endcamps
�fl
Ito �ey Pk
Draw Q foraVern antl *
for ob:ena[(on Pipe above. meywlll be looted from
the end of the wll
Vent pipes SNIT be Sef0 e40
WC and Men it at least 121nches above finished grade.
ONervaagn pipe that mend above flnlshed gratle must also be 4 Inch Schedule 40 WC
iQmckel Plus Standard Chamber side and End Views
i —re,°n u.wm,
MIT
Quick4 Plus All -in -One 12 End Front, Side and End Views
r 11vy
ellm —7
0.T
I Qmck4 Plus All -In -One Periscope
J
Wooden,
ITF
r 1x rlrvvBai oden,.
{I Quick4 Plus Standard Chamber Specifications
8 e (o H) N-x53-xl2-(85crnEEl35crdl InvertHil - ,..,.. 0 6 6 3 8,0', 15.9'
Eflen Length, - _ 48 (122 cm) (1 6 m, 8.4 < 16.5 cm, 22.6 an)
WWWw
w�... HTESTED .r..e. .a.. �....A...ma r....o,e.. M.r ..�.y� k�
END MEMEDIES IN
TOM,rSSEN � EDWE�EDWorl„��..�sw W.ES.:NrI WEEdMyAW.4r�-U.PURPOSEINE INFILTRATOR'
5yortend inc
Iwo 6und ss PCM1 Rey • P 0 &+ 75B
dor Sproperanddo®rNeelUSEMEN Oitl Seydmk, C109196
your El lure E, IN. I' old Werne Foreer , HE Wood MWI dooduer W WITH . be IN Ed or . Monere 10 H . low 1. Noter Ed or B 6) 597 7" - F M 15 T/.'/ W I
Won WE Un ey
U....eded eed, r.aano.u.u. edrun r, lru ur End SEE em m.. a ONE mm=.ex.,.«e.+nma BOO.RR1.4Na
�,r WN Wool en..mled wm...Nor ,. n.NEW . we me u.ue w,,.NT NEW .nm, row in n, ee, U. 1.WE www lntlltretanystemr[am
No no xoded
i My, ✓b. ,...ems } ..,
e
ST. CROIX CCUN1'Y YOAINv OFFICE
CERTIFICATION STADEMENT
FOR UTILIZATION OF AN EXISTING SEP^IC TARR
This is to certify that I have Inspected the Septic tank n esently
I jnq the 24f/ / /pfyrv/ r esidence located an
4. �� i, Section , T J N, R/�? u, Town
2)r aM lD Upon inspection, I certify that I have found
the tank and baffles to be in good condition, And it appears t0 be
functioning properly
beat tram serviced: _
Did flow back occur om absorption system?
— Yes FpNo (If no, skip next line)
Approximate VOIUAe or •_eengtn Of time gallons nutea
Capacity: /O ee
COnstrUCtlOnPrefab COnOrete-K. Steel _ Other
Manufacturer: (If kt two): We -&Kr
Age of Tank (If known). ,j -z {.-LOOo /
(s' gnaeU ta) jNema) la e pant ✓✓✓
(litl .45� zz6�s a
(Lrcense Number)
oats
form to be completed by licens6d plumber (s 143.06, Wisconsin
Statutes) or Licensed Disposer (Is lU Wisconsin Administrative
Code)
pitcher (Applying for sancta ry permr t) Cat to fieatiom
In Accepting the above statement regarding existing septic tank
Onditton, I Certify that the tank to the be OI my knowledge will
oonford to the requirements of ILHR Sl, WIS. Add, code (except for
impaction Opening over outlet battle)
Name -/G'Te &jdpo SdaO Signature Z0
y-- MP/MPRS 2L6 Y9y
In -ground Gravity Management Plan
IMPORTAll
is osm Mihn inymuntl erewbly awmm s/WlderaaW etiie W ire pupeWel PUMrW W wnlanalee Punwmb
requirements of SPS=41114WIaa. Rlbnln. Code. Pummpl "PS 3B.1S212), M. Ramin. Code. thusayatwn awl
be wnaideed a bmrain;Zth 1a3eid if nd moinWilled In ecPvdzJM* MM bo approved mNmgemem DINT.
Fun mama Palm Si did, W.crMmy�'bas angel be perW+nad by 8 repkmred Polly9 Whoalner In
aannernerriand ao de
DiarderealA �--j�O����M11113
Design now• //
_�LL.. Cpd: 80DaSMmi TSS518lm8CC'; FOG S 30 mi
InjelLon Checklbt INSPECT EVERY 3 YFARS
otypeause
wedaYaum
mama fatlon (le. Ode«, ban cmpwnle, SIC)
a macM1uelialP� lewl�eeemelre cmetion ,ekl��•etc)
o Alas edlrne In enaxW.treaonanl maland MY anlMNpn appurterence(a)II.e., tlWaullmlarW 1p[a!)
o nwlecl or inPW+r use(I.e, uo IN deeps cape rep wail WNWM eml
emm of gaol rq In lateral Men cell Paw at "N
o chei lMuWa B - If Model (i.e., PUMP rccy(dmg, dead SW hswinge. elc)
ebdrlc&cmwoams - a IWPIIMWe(Le, Mng, annmkons, aw8c8m, antrowV" oammal UP;)
cetlw)
o dlMabO,,I,I"wlM"o alkaplugglrq freeaeulalalerelNSmlwaeWre-
c wRBW ducnege of MnueM an Mwww l lYk.A Malructmemw
nowninsinamce Cbeckkt MAINTAIN EVERY B YeARS(an when me W)
o s•duhen c+ntl dou^mnklel etlPtl a Pumped by a Partial tapi eemk'w WN W1,M Wwall&28148 M.
w rdjuYlal b)I�mGrefIlifis In Me PagWCfCN)OPWe�'aa m(b NMe Rt1d Wlec R6'ni anCodis «
o Finland ntMs)"Ii be lnsTwyM awry 3 yYNW Oren he tlrenm wan realism to n "MY
umwalwa Wilda Mosel wmragand Y.ecevnrniwa.A®^^ang Pelea will awayagrgerinan ti
menus
SYe1em maintenance rep«m owl M *umm and, proper local Bacammem unit In e¢waarw wits
Spa dam Mac. Admin. Col+. Repel are aompdpem }all um orme8unclwn m:
N«nedllmmew«mmpanv. A)VO4o: 774I4r-y3 phout 765 Z71-4444
Local gwacrmnt but pryme, 7/s 3'96 VACAO
i gwIrmlWl iwt Mandl ,.,21P 5`f0/Z
Any deNdke panpt Nlaeer or ndof akllaedlaNPelreaaeor ng don idrorellygrull erals Out comply roSp8SPS M. A M Mmin.
N Product be or pNWlal M1eAelKn of VenPOWf9may his uW UnisysapSiev�ea by Me dm nit
PIn
acCPNanos will SP9 9". Mec Mmin cwe.
COnVrgenoY:Pgn
In the event be MY Altl uemmam amponerat of UJ PdMS a be repaired, It bell a mpkmd punuantan
a plan labeled to Ne appropaMe apencyardreWaea4. appr It naWinlround6ssaalwmPmsntb W
abandoned and replaced by a ademmPlyrig Iepeael ampen preodea'm
SvcM_m Abondthimont
If use of Una PANTS N dawminued, it MN a Mandemaa In accordance wllb SPS 383 33, Wuc. Morin. CWe.
lloae, Milli
SEPTIC TANK AIAPI'fENANCE AGREEMENT
AND
OWNERSHIP CERTMCATION FORM
Gary Eggen
hh11111W Atulnae 1107174th ay. _.
1107174th ave
j"Ifinan mryuN fimn P,mng Zb Depumrea,m mrmumarns,-
01a Suns New PoChmond Ni Pamel ldentlibatlon Nabob,
1 PClal. DF.SVRIPTION
1'nr,w.h l,Wallon .. Sec. _. T_N R_W. Toven of__._..
Cen,F,ed Suntr Map k
Wnrrunrf Deed p
spbmae e. m
�Vollune Payca
Volume Pep
la l,m iaexrluble >e, m
SYSTEM 1116LINTFN ANCF AND OWNER CERTIFICATION
Irryn,gn uu aml numreune of,nw repnc.nwmeawa mWtwm pewrvre fulur<ro FUNle+un. Pr.ger
le ofrurry•ue in, the umc Mill Mrs mn elm Yea.cam.n,xi by, e.nuea innger Whir r.r Vn rnx.
rk enram fen efl'mt the Nwtlm of dw ennoc mk u e Ramrnr enK mrk wr<armmel eynern rlwnn mwr<vrc<
K•rvnnrmhne...e.me�rw rn seoom. a_ .:, l),m m ebePn.II. s. enm emwnswnr..y rAermme
ik pn•ptnY eoxr aprtn b.u!®r b A Cram CwMy PYmq h Lwrn{ Depvn¢nY cemfulwn 4wrry uyn.1 pp Oi
xr arv! pY a rmam plwYrer.lourrre)'mm plmlee. retoicrN plum m e IimN purger mntyue rNr l l l r4e on,rb
sn m15a nebm u m preKr ry nm¢ canaimo avdw(3) eltr mgsme eea pwgwe lilnecet%I, rk.eptr: ml e.
,x,n I � rw1 Olaaen.
1 ae. the uNnnema bale pai rk A,,, «yuve® a,el all b na lmm rk;mal, menage aupoul ty,Ym wrar rk
emelaN. W rmrh kmn ea an by nu pepumem of Cnmmnce aM all pew ®ea, or Normal Re,ouri hu¢•d wrvmem
Ceeeirenwn.brmp rkiIourme" gnemha,kenm'WiliiMeal be 011104141 aM eennrca an Ne St Cram Ui ay PWmmeA
Zmury nryvarnry w'rrhm ]O Lp of rk Wcc pv ezm^aoa clue.
t'ne mmry Wr AI anrermu od'n n. lmm am nue,a Ik burl of mYloM 6nwIM5o Vw'[ aMv<rk ovmrly ill rk
MWMY hxnkE above. by,vve /r bhM rttmhd gReP.m orDad.ORm
Num mow C
SIGNATUT OF APP IC IANTS)S) DAIS
... Any lnfamuwo Oull u mi.reprmm,etl nely bel inn a, Panne, lane, noolea by eba PYWy t 2mm lhpnabi
Irwluae web his oppl¢veon a man" wumnly aeM Sam rk Regiaue orpmcl.Oflae aM a copy of bar «NfIM away map n
reference is mean in am wunonry Jena
Commerce
Nlwenam Departmentperson
Grove am eorcr
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION
(ATTACH TO PERMIT)
PwaonNxxwmsw mow°•E• man oe,n+a le.exaw,y
N Promises,lee's to refixed),took.
IF
W,INan m
m IR Mlb'iPrZterdup
"tR).0'•
of
arw°
_ CSr LYkl
TANK INFORMATION
ELEVATION OATH
TYPE
MANUFACTURER
CAPACITY
STATION
SePU[
Bm[hmark
a
Corning
A t.
Aeration
Bltlg Sewer
Holding
St/Nt Inle[
TANK SETAIIINFORMATION
ft/Ht Ounet
cm, fit Croons
Y5 I l'bumponow
ELEV.
TANK TO
P/L
I WELL
BLDG
q e
ROAD
Ott Inlet
SePNf
3l
`
Dt BMW
Doun9
HeNn/Men
Aeration
A�A
p,tt Free
J
9r.xq'
Holding
eelHot
Still
'
lily
PUMP/ SIPHON INFORMATION
R,nal Graa
iol
yN'
Manulectur
a mentl
Gt Puwr
Model NumMr
GPM
TDH
Llk
ontern
TDH Ft
Force in
Length
Des
SOILIBISOePTION SYSTEM
!K 1BEN
wmhengm
N}
xo Olnm
you.
PUM oeom
SETBACK
SYSTEM TO
P/L
BLDG WELL
LAKE/STREA
LEAOIING
anuE u le
INFORMATION
ryaI
CNAMBEP
m Clptl.
"j
1 r
OR UNIT
DISTRIBUTION SYSTEM c1N.1.:. U
Lewtlijes a �. a wny nlo„m.
SOIL COVER a Pressure Systems Only as Mound Or At -Grade Systems Only
Demon Dra,
ewnore.
in
M
eimeaaa❑
..❑Le'/n
eo
asalr,enm dine,
m(al
T�oJw
xu rynaao x°
COMMENTS: (InGudemccediscrepancies, persons present, etc 11 Inspection NI: Op 12. uuoecnona ,
Location: 110]1]4th Avepoe, New Richmond, W1540t](NW 1/4 SW 1/44 130N R18 M 3018 721 West Side
Winding Trail Estates .Lotll _yyam 16 9
1) Alt BM Description erTH,�+T"— a" ai wE.QyKf CY Asrax. e.a NU�s 1
i.) Bldgeewm length BS. oB
LoTnnvy—.4i 5.1twevi. s9
Plan rei instrument Yee Here
Use or", side for additional information EFGS6047a11"n euxamraaayw.e
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER
IF
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ti
1
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7 I I
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�`YbO'neM °apei°"'"d0oin"°1Ee SOIL AND SITE EVALUATION
BI of 9eleryutlPeae_re_
a.eNdleeoma 9ervloneugs w maaomance vnN Comm 8309, We Atlm Code
aban lled e,VnicAlnd l.morrolW lllncno( in,d vlen
c°"'I✓
blt W mnbl Mnancep (BM), tllxtim&q
And
pvicemaoP.,.ma
I,dOOrp,vMknd,
`
S/p�X
Wrh An
oralm..nom,llonn eem,,.nelo<.nee.�e aeuz. me.er.n lo.a
vemxlG.x
eaca—/2Z—p—CUD
APPLICANT INFORMATION-Plaeaaptll ;II%1'
Xe ervetl% GeM
Pnora. mey4uwbrrw c$y IPAwglew,a ledf9lmll
3di-
PromMO+mem^
/��
��AAP?
Pr ry Lamtlm
/ivl
mg, Ilx �11x,6 Tye,N,P E(067
MBII
'"'Yp crs MI Address ( —
Lalx Sum Mme or utqoA
G ZIP Gca. ww
AJ Jr�«
0 � T ml lbea
[,A S .
�Nrvr CcmW[Wc We �;1Pglden6allNum ` e Mmlm roetlennu %Ialre
R.wemmmr ❑PeMmmwmmemmi rav,moe
coaaa.m.e evM lbw eg�o neonrr, eoegn bmma reb _oea. ceav*��Jr.nm, pPaR
noeomnmerw rpwrW woad, X2,1�renM. n2 �n uln emlan lomna reu.� bed. �S_lrelw,pyM2
exlm
RammmeMar bnlX.tlm Woods al am(a y n(ec roklrea Ibpurnenaunn)
Pawn" mlgrarn ¢d¢d 9x/ 'utwT C'ILImM
Penm meunel �a�Jee/eta SJ own elwelwr,napquaeln /✓ X
6 . arnOdA greyclem
Cor, Aa al WUM
In Preewna
RTGMe
b In FlI
Xcalry Tank
U . oneuliakbr ryalem
6 ❑V ❑U
rGbrow
yp$ []V
;s QU
❑6m®Gl
IDS .153U
Gmem
Depar
WI
lecror
3f
Ronng N
SOIL OEBCRIPTION REPORT
RelraAs.
EFFINERM
MAAPMKA�w
��
Rama".
Soil Test Plot Plan
Project Name /�/r ��+ns f/t� Byron Bird Jr. /
Lot l—Subtllvlslon Dale %1T
1i4f,.1/4SilTi1LN/HZ�ZW Township
� 13011 n9 Q Well PL Property Line County
OM of VRP Assume Elevation 100 It.
System Elevation 9y 5— •Npp sill
ai+
b�
o 9•I
z� p n le
al f r
1 b
a7'
b-
ft. got
n
Scalel/4"=10R When Dumenslonsaren'Istered