HomeMy WebLinkAbout020-1487-07-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM (County .St. Croix
I
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s 15 04 (1)(m)].
Travis K. David
CST BM Elev Insp BM Elev
I Up Or f
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
Dosing
J `
Aeration
Holding
TANK SETBACK INFORMATION r Tea c lam,/ px
idaam
PUMP/SIPHON INFORMATION
Manufacturer
Lift
SOIL ABSORPTION SYSTEM /2o )/,,'Aa n , L, prc
TOWN OF HUDSON
Plan ID No
020-1487-07-000
4.29.19.3098
STATION
BS
HI
FS
ELEV
Benchmark
G.Y'� All
/
G.%b
ItXp.(a(%
ion. Z
Alt. BM
Bldg Sewer
g 6'
gg•rPo'
SUHt Inlet
SVHt Outlet
Dt Inlet
Dt Bottom
/
Header/Man
)3•(00
Q? �O
Dist Pipe
I'4�
.1�0
3•0q2.
Bot System
t5=�
! p
,9.l
Final Grade
�e1.�51�
�
Ie�
q(o•lo�
St Cover
-7.20
BEDlTRENCH
DIMENSIONS
Width I
7Z
Len th
(((JJJ 4PI
No. f Trenches
JBLDG
PIT DIMENSIONS
No Of Pits
Inside Dia
Liquid Depth
Q p
SETBACK
INFORMATION
SYSTEM TO
IWELL
LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Iman ct rl
Type Of System
-.-� 311
� 3
/
/
Mode Number
0
UISTRIBUTIQtN SYSTEM
Header/M nif
tt
Distribution
x Hole S¢e
ole p
Vent to Au tak In
Pipes)
Length Dia
Leng Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Svstems Only
Depth Over
Depth Over
xx Depth of
xx Seeded/Sodded
xz Mulched
Betl/Trench Center
8edlTrench Edges
Topsoil
Yes No
Yes G No
COM ENT \Inciud code discrepancies, persons presegt, e`tI Inspection #1 IZ / +� n� Inspection #2
g n Q 4�f�Q° CZ,aa� y �t e,.. r s !/id
�^
oca6o :g 6 AVIN ASS_
1.) Alt BM Description = I f
2 ) Bldg sewer length = n. Iffl � --q� r-
-amount of cover= > tZaf 5& ` � t - . CpLAal r•
il
Plan r her rde for fired? Ye �ji Nlo (y I
Use other side for additional or aticn.
at (n� ^—�In/$epctor's Signature I Cart. No
SBD-6710 (R 3/97) { l epc y L� .l'iV�'V'•^�� -
01
PROJECT Travis David
1/4 SE 1/4S 14 /T 29
_ �> (A-T RECEIVED
Ply DEC 0 9 2021
System PLOUPLAN
_ AD'ESS 2238 Namakaoon St. Hudson Wi 54016
N/R;/ W TOWN Hudson COUNTY ST. P CDD
SYSTEM ELEVATION 5' below qrade
CONVENTIONAL >M
.� 12/8/21 4
DATE BEDROOM _
CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 12551{allons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1216 # of chambers 60
BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION too' Filter Lifetime Filter
BOREHOLE O WELL *II.R.P. sameas benchmark
All piping shall be ASTM SDR 30/34, within
10' of tank, piping shall be ASTM F891
K12
10,
3-3' x 82' cells with
>3' spacing
5% Slope
389' Property Line
60'
Scale = 1/4" = 10'
Pro 4
Bedroom
House
99.5'
B-2
Z]ac�ement
B-3
90,
45'
3jf
-
40'
0'
B.M.*
' Vent
>6„ Quick4 Standard
of Cover Leaching Chamber
with 20.0 ft2 of Area
5.6ftA2/pair of end caps
4' Long 12
10 Grade at System Elevation
M
101.5'
Gavin Pass