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HomeMy WebLinkAbout032-2003-80-110 y (D o a o , 0 3 0) 0 o� d O O C O C '0 O d N y N d O m c c N 'O co N c .'` c E N @ y T O O a d (0 U N O N y d Q .cam. Q N _ j O O L N N y N co fl_ Y N 4 N I N O N E U (9 '0 y O V O 0) V 0 (1 Z O O c ' N c N L N LL .3 m LL c0 N . c y C Q w N E Q m ._ U (6 N (D `- Z N Vl O Z _ O "' O E E ° w a m a CO F z c� a c C9 - m O Z b' c c w ! r O _ N a 2 d ° c o a c al a a) E @ E III N m O N m Q N ' = N N N O N •} r N O L 0 O a o w 0 m O N Q O= Q Z m Z Z Z o •• Z C) c 0 c E E m E N N � N� d LO C .a w ! U) C. 'M w c O 00 W N i N c > 41 O C p ° a c a a O > O o a -0 o a N Z '�! F - I - H O I '6 F" H H O V Z N 0 0 0 w 0 E 0 0 0 0 z° w = a a a s c. o. a F .. rn rn �' 3 0 0 °� f!! J U Z O) Q) } Z N N } Z Q7 (n CO O LO - (n O O = 0 E O � w m LO m a LO v Go - OD a a N N Q A Q �-• N 3 M ' C W 7 W 3 w r O 0 0 O N C N C l \ O U C C U N ( N E 0 04 04 V i - N N 0 0 (D c N N m o m m w o O N c L' o o cn o z z ✓� a; m m a a`, a t a a L: a .� a y 4) rr�� +. E c c c Cot A U a 2 O 0 v 0 m 0 I it •.. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St, Croix Safety and Building Division a Sanitary Permit No: INSPECTION REPORT 405158 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan I jZNo: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Wittstock, Allen Somerset Township 032 - 2003 -80 -110 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark + Dosing � � V Alt. BM A�^_ Aeration 67 Bldg. Sewer - D __ `` nn 5 , GS Holding St/Ht Inlet t TAN SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 1140 r TS + It - Dt Bottom `� f �� ZG- �� Header /Man. ` rcw Aeration �I:, «' 3•ZG' Holding 1 13ot. Syste IZ•s� (z,$I �I• (•fi Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover e GPM Model Nu' 2 8•D3 {(p• TDH Lift ction Loss System Head T Ft ,ll 1 $.2°� • a` r Force in 7gth Dia. is . to Well SOIL PTION SYSTEM Sfif/TRENtH Wi t L ngth + No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DI 3 I t T 1 SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufact er: INFORMATION CHAMBER OR S� Type Of System: y �! UNIT Mo I Number: ! 11 lC. 3 y (CM �r DISTRIBUTION SYSTEM N f(L to s . Header /Manifold u Distribution x Hole Size x Hole Spacing Vent to Air Intake -�ea' 5 Pipe s) Q t Length Dia 1 Lang Dia SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil I ICI Yes ,] No Yes � l No COMMENTS: Incl c dis epencies, persons present, etc.) Inspection #1 / 05 AVVf Inspection #2: 4- ' f �.� Ar' ( .tom Parcel No: 01. Location: 1782 85th St Somerset; WI 54025 (NE 1/4 NW 1/4 1 T30N RI 9W) NA Lot 1 30.19.477A10 Z 3 / �- 1.) Alt BM Description = /� 2.) Bldg sewer length = L4 - amount of cover = C4 P f I Plan revision Required? I � Use other side for additional Yes ` No information. _ SBD -6710 (R.3/97) `�✓ a 4 S Insepc�Signature Cert. No. Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 visconsin Madison, WI 53707 - 7162 Site Address De artment of Commerce _U z S� /s Sanitary Permit Application Sanitar Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Checcif Revision may be used for secondary purposes Privacy Law, s15. 1 m I. Application Information - Please Print All Information State Plan I.D. Number ECEIVE® --' Property Owne 's Name Parcel Number 1 Property is Mailing Address Property Location 17 _ 1 ST. CROIX COUNTY ,4 'A; S T N, R �� City, State / Zip Code Lot Number Block Number Subdivision Name CSM Number II. Type of Building (check all that apply) / ❑City J0 1 or 2 Family Dwelling - Number of Bedrooms 7 ❑village ❑ Public/Commercial - Describe Use L cc kownship 11 J State Owned ' Nearest Road I 6 Z-ZA (qo Yem of Pe t: (Check onl one box on line A (numbering scheme for internal use). Complete line B if applicable) Ne 2 , Replacement System 3 ❑ Replacement of 6 ❑Addition to Tank Onl Check if Sanitary Permit Previously Issued Permit Number Date Issued . ype of Permit: (Check all that apply)(numbering scheme is for internal use)--V 44kNon - Pressurized In- Ground 2111 Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispe rsalPTreatme Area Information: Design Flow (gpd) Dispersal Area Dispersal Area oil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min -flmh) Elevation �,vz- - W, 9's 5�� - 6 4 ci in Total Number Manufacturer Prefab Site Steel Fibe r Plastic Vi. T Info ty Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Dosing Chamber VII . Responsibility Statement - I, the undersigned, Wurne responsibility for installation of the POWTS shown on the attached plans. Plumber's ame (Print) Plumbe 's Si MP/IvIPRS Number Business Phone Number r� Pl is ddress (Street, City, State, Zip Code) VIII. Count /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) XApproved ❑ Disapproved Surcharge Fee) 8a ❑ Owner Given Initial Adverse ?� Determination 22S 1X. Conditions of Approval/Reason for Disapproval }� 11 S�� -� �^�r�1 tt AS4/ Attach complete plaw (to the CAnnity oW for the systen on paper not lew than Un x 11 ,4 SBD -6398 (R. 05101) ® �,F„�� //ism yS�od s,aY.✓,1� ,,� �' r�•� - ,�li�.o � _ , AZ' A i Al 0 a h - I w�� 1141V- 1ViJYV -5;Z, . Se /Vk vJ �d�ei✓a L�� �� /'� , II � � ,¢ -,gyp „� �G /� � /��i�.�rs �✓��/�.� 7© s�� ✓moo �,�: / /��,rs , r AiA b K 4, W kf i t Wisconsin Department of Commerce SOIL EVALUATION REPORT Page — L — of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must � 7�, include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all informati �� (� Reviewed by Date Personal information you provide may be used for se ondary pRi6 1Uc7, -., s. 15. 4 (1) (m)). Property OyvQqf Prop rty Location UN 0 7 200 Govt. of 1/4 1/4 S T N R E (oyff Property Owner's Mailing Address -0 Block # Block # - Name or CS ST. CROIX COUN FIC City ne State Zip Code Ph E] City El Village Z Town Near eft Road ZLL JZ New Construction Use Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement // ❑ Public or commercial - Describe: Parent material T� Flood Plain elevation if applicable ft. General comments and recommendations: Boring # Boring Pit Ground surface elev. —2�L, ft. Depth to limiting factor - c in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 �^ /- of 9'/• `tS � Boring # ❑ Boring ® Pit Ground surface elev. 9Z , - 2� ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 3 Al Z s Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 _< 150 mg /L * Equent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Na lease rint Signature CST Number Address Date E ua ion Conducted Telephone Number b c D SBD -8330 (R07 /00) - r 5 Property Owner _ Parcel ID # �aD e /� Page �� of Boring # ❑ Boring .L ft a Pit Ground surface elev. 9 . Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. qont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 d F71 I I F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # ❑ Boring El Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) AG* 7���: r W - X19Ld /ate �k I 0'I 9y 449 i ao :t9L � L ifm uSi J Y8, n i ,C � b _ GJ�z 11 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Nasr FILE INFORNVATION SYSTEM SPECIFICATION �> Owner s Septic Tank Capacity al o NA Permit # o S S'8 Septic Tank Manufacturer - o NA Effluent Filter Manufacturer o NA DESIGN PARAMETERS Effluent Filter Model o NA Number of bedrooms o NA Pump Tank Capacity al j9 NA Number of Commercial Unit ig NA Pump Tank Manufacturer -w NA Estimated flow (average) gal/day Pump Manufacturer a NA Design flow (peak), (Estimated x 1.5) e Z 5 gal/daZ Pump Model 5 NA Soil Application Rate gal/day/ft' Pretreated Unit Influent /Effluent Quality Monthly Average* o Sand /Gravel Filter o Peat Filter Fats, Oils & Grease (FOG) <30 ing /L n Mechanical Aeration o Wetland Biochemical Oxygen Demand (BODs) <220 mg /L o Disinfection o Other: Total Suspended Solids (TSS) <150 m L Manufacturer Monthly Average ** Dispersal Cell(s) Pretreated Effluent Quality C NA )4 In- ground (gravity) o In- ground (pressurized) Biochemical Oxygen Demand (BODs) <30 mg /L ❑ At -grade ❑ Mound Total Suspended Solids (TSS) <30rng /L o Drip-line o Other: Fecal Coliform (geometric mean) <10 4 cfu /100mL Maximum Effluent Particle Size '/8 inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. ** Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Fre uenc Inspect condition of tank(s) At least once ever o months ji� ears (Maximum 3 rs) Pump out contents of tank(s) When combined sludge and scum equals one third ('/3) of tank volume Inspect dispersal cells At least once every 3 o months —Z ears Maximum 3 rs) Clean effluent filter At least once ever o months earls Inspect pump, pump controls & alarm At least once every o months ❑ year(s) ❑ NA Flush laterals and pressure test At least once every ❑ months a ears to NA Other: At least once every ❑ months ci y ear(s) o NA Other: At least once every o months o ears ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third ('/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that my impede the treatment process and/or damage the dispersal cell(s), If high concentrations are detected have the contents of the tanks(s) removed by a septage servicing operator prior to use. Owner: , /l5 11�.: e cif Page,2 System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal high water levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact. The area within 15 feet down slope of any mound or at -grade soft absorption are. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONEMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: o A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTAL POWTS MAINTAINER Namel Name Phone I Phone SEPTAGE SERVICING OPERATOR PUMPER) LOCAL REGULATORY AUTHORITY Name Name Phone Phone ��� SEPTIC TANK MAINTENANCE AGREEMENT w St. Croix Country `✓y . OWNER/BUYER o%✓' ..,w� `t "E -,y -' _ o ,/ Fire Number o ROUTE /�dX NUt�ER ' n S ' ' 1c.27�Fa•a S7`� � d / ZIP s�oL r CITY /STATE : &de �s�1` bd��` � w PROPERTY LOCATION i fit, �W Section T � N, R�W, Town �,����s� /,,� St. Croix County, Subdivision ! Lot number Improper use and maintenance of your septic system could result in its premature failure:.tp handl e wastes . Trooer maintenance con- sists.of pumping oiA:, ie.septic tank every three years or sooner, if needed, by a license $e t'ip, tank pumper What you put into -the system can a}fect.the "runct on. oP the s ppitic. tank as a treat - ment , stage in the was 'tia system, St. Croix Count yy residents'•m„Z be eligible to recieve a grant for a maximum of 60% of the•cost.of replacement of a failing system, which was in operation prior to 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that .owners of all' hew aysr'ems agree to keep their system properly maintained. The property owner agrees to. submit to St.. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or..a licensed pumper veri- fying that (1) the - - site wastewater disposal system is in proper operating, condition. - and .(2) •.after inspection and pumping (if nec- essary) the septi.c�aank is 'less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year 'expiration. H I /WE, the undersigned have read the above requirements and agree F to maintain the private sewage disposal system in accordance with the standards set forth, herein, as..set by the Wisconsin Depart- r ment of Natural Resources. Certification form must be completed and returned to the St. Croix, County Zoning Office within 30 days of the three year expiration.date. SIGNED j4 - - -/I DATE St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386 -4680 Sign, date and return to the above address. ST. CROIX COUNTY WISCONSIN PLANNING & DEVELOPMENT PLANNING SOLID WASTE REAL PROPERTY ZONING 715 - 386 -4674 715 - 386 -4623 715 - 386 -4677 715 - 386 -4680 O August 24, 1993 Bank of Somerset Attn: Kristen PO Box 220 Somerset, WI 54025 Dear Kristen: An inspection of the septic system for the Allen Wittstock property, located in the NE, of the NW, of Section 1, T30N -R19W, Town of Somerset, Lot #k1, was conducted on May 13, 1993. At the time of the inspection this septic system was found to be code compliant for a three bedroom home. Should you have any questions, please feel free to contact this office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator mj ST. CROIX COUNTY GOVERNMENT CENTER • 1101 CARMICHAEL ROAD • HUDSON, WI 54016 ti o FILED AUG 171989► H JAMES O'COPMLL �{ w 01 0M W St «obc Q0., VYI 45069th 0 CERTIFIED SURVEY MAP _ o R Located in part of the SEh of the NWa and in part of the NEka M of the NWo, all in Section 1, T30N, R19W, Town of Somerset, 0o St. Croix County, Wisconsin. N O I C' t CA C. N OWNER o A N} Corner of Stanley Hale Section 1 4j 41 O -0 6757 Lamar Avenue S. 111 Iron Pipe Cottage Grove, MN 55016 d h V N W � � ` Unplat ted Lands � co a, c o+ O O O N �, N82 °0510911W 527 .60 1 N A ' ^ i c o 514.581 ss' �f ° I A c 13.021 W " LOT 1_ N 135,098 Sq. Ft. Including R/W N M CD 41 N 4 f o f v i c 3.10 Acres ° O O . N ., c 1 CD z Ji O 132,078 Sq. Ft. Excluding R/W N 3.03 A cres 14.20' „ 508.55' W North Line of the SEJ N89 56 522.75' Cn of the NW} of Section 1 f (Recorded as N8900411311E) r. Lot 1 d f io Certified Survey Map o o ° - - a+ 1 G O C I ••+ 1 L • I of �N Vol. 6, Pg. 1530 N W 1 C ” 0 1 1 c 1 - --- -- --- ---- I 0 co J 4. f f (Recorded as S8900411311W) co '"' _ 170.6 S89 °56' 22 352.09' W a° 336.44' N s �' 15.65'— – 1 O N 0 1 O t O y = L O I = �1 LOT 2 Cn � f �f co SCALE IN FEET * m 148,922 Sq. Ft. Including R/W �f N LC I a 00 3.42 Acres M 0 100 200 300 v 130,680 Sq. Ft. Excluding R/W �ga9CO co 3.00 Acres Ul) I f ac Co A a ♦ ca N O N Ln >' 1 o f L LE �'.� M o ` > .-, I L . I N M 1 d I o .! I S89 336.4 ,. 1407 i �; 66' PRIVATE ROADWAY EASEMENTS / ,� 1 ., Y HUDSON, r� S89 °3 3 5 11 E 35 4.54 1 ! 0 N o Su' Unplatted Lands --- - - - - -- - - - -- W 4 - Ol "7 co LEGEND APPROIVED ^ C° Section Corner Found CD 0 • 1 Iron Pipe Found AUG Si Corner of 0 1 x 24 Iron Pipe Set, weighing CC�r�H��c •_;� :,,;;.: -<;;, .;,, Section 1 1.68 lbs. per linear foot. County Section Monument L H Vol. 8 Page 2140 L4')IA, �v AS BUILT SANITARY SYSTEM REPORT OWNER �,' TOWNSHIP SECTION - Z4 N - 2 W , ga"-, 9 4 l N -P- - ADDRESS iS� G Z���.1 ��. ST. CROIX COUNTY, WISCONSIN 7 A SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 1 (SK c F ewG INDICATE NORTH ARROW BENCHMARK: Elevation and description: , o J //' f-/" d Alternate benchmark SEPTIC TANK: Manufacturer: Liquid Cap. M Rings used: Manhole cover elev: J N, $_ Final grade elev� /r5 , i Tank inlet elev.: / Tank outlet elev.: inD,�2l No. of feet from nearest road:Front , Side , Rear__Z Ft. A From nearest prop. line:Front , Sided( , Rear Ft. I�ZL No. of feet from: Well 96 , Building: 1 (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump /Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons /cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side_, Rear_Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed: (_ Trench: Seepage Pit: Width Length rS0 Number of Lines: Built -� Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to to of i r r e: �r No. feet from nearest prop. line:Front , Side , Ream( Ft.� No. feet from well: ae) No. feet from building �9 HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: c5` �3 ,� PLUMBER ON JOB: 2 j LICENSE NUMBER: <j 6 /90:cj L( G Li r' i part TE �ry'�'�+:�' 19 •p AI T YST 'EM NTH ST. County: Y Labor and Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village X' Tow of: State Plan ID No.: rn S n ev nsp. .: BM El v.: e ' BM Description: Parcel Tax No.: 6, C PA TANK INFORMATION ELEVATION DATA A9300018 S� /s /f3 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic „c Benchmark ry / Dosing Aeration Bldg. Sewer Holding St /Ht Inlet �, , /bOi' >6 TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Vent to ROAD Dt Inlet Air Intake Septic /y 5 NA Dt Bottom Dosing NA Header/Man. cj / Aeration NA Dist. Pipe, _�- Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Lriction; System TDH Ft ad oss Forcemain Length Dia. H Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION �, D ` DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O � � CHAMBER Model Number: System: e,� /S ` //C/ X2),4 OR UNIT DISTRIBUTION SYSTEM Header / Manifold J Distribution Pipe(s) j x Hole Size x Hole Spacing Vent To Air Intake Length r Dia Length .� Dia. Spacing fo SOIL COVER, x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over % • Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 0 LOCATION: SOMERSET 24k3 1- .19.392B,NE,NW, LO'#o1 85TH ST. F �- r Plan revision required? ❑ Yes ❑ No Use other side for additional information. I” ( �f! SBD -6710 (R 05/91) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code couN STATE SANITARY PERMIT JL -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ � 8% x 11 inches in size. C ec FA lan pr lous application - See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION ,1�14 A/ LLr_V, w A If 1 % 'la, S Z T , N, R E (or PROPERTY OWNER'S M I ING ADDRESS LOT # BLOCK # 4 )). Z/a" 2 - -r- ,� Z1 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME R CSM NUMBER I. TYPE OF BUILDING Check one CITY NEAREST ROAD I ( ) ❑ State Owned O VILLAGE: []Public ®1 or 2 Fam. Dwelling-# of bedrooms PARCE TAX NUM - III. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 11 ❑ RestauranVBar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Office /Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other' 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 N Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. ATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /d y /sq. ft.) (Min./ rich) ELEVATION Feet Feet VII. TANK CAPACITY Site INFORMATION in allons Total # of Prefab. Fiber- Exper. New xistin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks I Tanks structed Se tic Tank or Holdina Tank Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for install ion of the onsite sewage system shown on the attached plans. Plumb 's Name (Print): Plumb is ignature: ps MP /MPRSW No.: Business Phone Number: J % 1 Plum r' Address (Street, City, S te, Zip Code IX. QGUN USE ONLY Disapproved Sanita Surcharge Fee) Permit Fee (Includes Groundwater Date Issu e Issuing Agent Signature (No Stamps) Approved ❑Owner Given Initial A7 7 Adverse Determination /0 1 X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS t r 1. -. -A sanitary permit is valid for two (2) years. , 2. I lieuf- sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608 -266 -3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete ## of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1 -7. VII. Tank information. Fill in the capacity of every new and /or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the-county; E) soil test data on a115 form; and F) all sizing information. , GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigatioris'and establishment of standards. SBD -6398 (R.11/88) APPLICATIOH SANITARY PERMIT 8TC -100 Thio application form Is to be completed In full and sign by the ovner(s) of the property being developed Any inadequacies will only result In delays of the prtmlt Issuance. -Should this development be intended for resale by ovnet /contractoc,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------------------- Ownet of property /C /.!W/ ft,� rJ I7 5/ - VC Location of property S 1/4 _-/ 1/4, Beetlon _ A / T 38 N -R Id 41 N W Township ' �:; Q = .esfT Mal l ing address O S '� '���'•� S r.��Er" Address of site XZG< Subdivision nave Lot number Previous owner of property _ S7N`��1ey 4:F_ i9•vy .�i9.•e!/ yi9�G Total size of parcel , Dane parcel was created _✓�� ��'�� Ate all cotnets and lot lines ldentlflablet X Yes N o is this property being developed for resale (spec house)? Yes X No voluwe „9X and Page Number as recorded with the Register of Deeds. -------------------------------------------------••---------------------------- 1NCLUDS WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which Includes a DOCUMENT NUMBER, VOLUNa AND PAOE NUNBtR, and the REAL Or THE R8018TER OF DEEDS. In addition, a certified survey, it avallable, would be helpful so as to avoid delays of the reviewing process. It the deed description references to a Certified Survey Hap, the Certified Survey Hap shall also be required. ------------------------------------------------------------------------------- PROPERTY OWNER CERTIFICATION 1(ve) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (ace) the owner(s) of the property described In this information form, by vittue of a wartanV eed recorded In the Office of the County Register of Deeds as Document No. Oj ? • I and that t (We) Presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to tun with the above described property, for the construction of sold system, and the same has been duly recorded In the Office of the County Register of Deeds, as Document No. ), lgnatute of owner -' 810( a Co -owner (If Applicable) ate of Signature Data of Signature i %� % x . ,. <�� :J ° \ \� > :f; �� \�>� � &� \ � « / \ / \� %« » �� » � \ \�� \� / . \ \����t���� � ®� §?\ � ©�. �Z� % . ��>� \\ / ��,�: :< �. 3x °° . . �� \� � % \ y , � .�. � �� a ! . \ ®� «��� % \/?: \� t� \: ,����� \��� 2 � x »y¥ » :�� 9 . \� � \ °� � ? 2.\ , �� \� ±�� �} �� �« ? y�2±2� } »,© . � \� . ?�� �� .. � ^� � �� 6 � / \ ` 2 �� w z� « � � �/ .. } \ / \} 9 § � � w � /� . »� � % d � ©�� \� � ^' ' � . ^ \ �.:�: . ..., % »4 i K **Sao FILED AUG 171989► 3 JA O 'CDtV1iELL 4 450690 CERTIFIED SURVEY MAP t 3 Located in part of the SEA of the NW and in part of the NE r N of the NW4, all in Section 1, T30N, R19W, Town of Somerset, 00 St. Croix County, Wisconsin. U) o i o s L L 10 OWNER d -0 NJ Corner of 41 41 Stanley Hale Section 1 0 6757 Lamar Avenue S. 1 Iron Pipe -0 0 Cottage Grove, MN 55016 N N U N C f0 y 3 U!IPlatted Lands N o - - co C" o N O � V O N8200 527-60, N ro c o 5 14.58 r 60 6fi' I s l M � d � c c o d ... 1 3.021 W �I �� •I m - In _ O d 411 tAl dl " LOT 1 _ _ - W M J I O 1 3 - N LO � O 4- I • I N 135,098 Sq. Ft. Including R/W N 1i p ++I O 3.10 Acres oN N I "' CI O O N UI O Z J; C:) 132,078 Sq. Ft. Excluding R/W 3.03 A cres 14.201 508.55' W C D North Line of the SE} N89 522.75' N of the NW} of Section 1 (Recorded as N89 Lot 1 c nI • 1 Ln Zi �o Certified Survey Map o a � i --- - - - - -- - - - - -- - -- o CD 1 ca l I LI) c i N Vol_ 6 Pg. 1530 N N rn ° o i I a l OI I ° C JI NI OI Cn Cn (Recorded as S8900411311W) co J J 1 -y Oil 170.66' S89 °56' 22 352.09' W 1 336.44' 15.65 `" o ° O vi 0 1 _ o s z a-' O L O I a -01 LOT 2 ,Ili 11 C � SCALE IN FEET m 148,922 Sq. Ft. Including R/W j 1 , N J, 2: 00 3.42 Acres J, 0 100 200 300 N m 130,680 Sq. Ft. Excluding R/W g` ��6¢QaQS7:+3 s c 3.00 Acres Ln mI z 4. 41 1 O I • ° S., N O N LO 1 1 O I .O w O 0 col N +,.'f M Z ++ 1 S89 0 31 1 35 "E 336.4 J 01 g -1467 1 66' PRIVATE ROADWAY EASEMENT / •1 y 73 HUDSON, i o 1 n L i 0 i S89 31 35 E 354.54 1 to WIS. r� �' I MM'►�'•'' '� ^fi r,'' • U I < 0 C sof 1866 � Unplatted Lands --- - - - - -- - - - -- W N 4-� T l!) @ LEGEND O N APPRovEb ^ 0 Section Corner Found o ° • 1 Iron Pipe Found AUG 7 SQ�9 �r '< Sj Corner of N 0 1" x 24 Iron Pipe Set, weighing c0mpf✓t Section 1 1.68 lbs. per linear foot. County Section Monument S F- Vol. 8 Page 2140 -imoc p �G Qt�OO -1 mI ' or,— '-m0 2 � �-+ OXCCD % N pm7oC � ➢m m - -� ; D > cnrzzm < Z a ornN -rA ""000M ow o ;? xcn 0(1)0 -C a� m n3cQe:z x c z O - n �L MIMZ EW• 1 0 i0m in m '" 03 � z w M O W 74 ?' m to g O lvl T T to 5� ° 4(00%0 + zo-- �0D n $ ' r:roo Z vmo-! I'D O 7D m < 0 �-• _ c o vrnrl W- z(AD (" t0 Z N 2 H..r m j. 1C 0 ;! OHO• in m m I CA 'Ui N 0) 3C 4 E .A T U) 3< --1 m v O ^I n'1 VD a n a M Mm -i r� , -0 < o in r oW Z r ; X m r Zm 0 ;� m a fTi Cf <y m m V D %M W z 0 p r a m —" 3�p W W > io o N -` 70 D v v M W N X70 4 "i m > 0% .AM O Zp rn 2 N mcrWWN OVS O O m n v; m a, O AAODN m < x _o N OP.)(A0 �° o D in N j O-rD -4 r -4 UI r z O m D •'� U n D r r< a m m -4 m cir m Z z M -C V 4 m N cow— z N a -a �. , m o ti0 m $ .T)70 - M W - V AANO m s O Q Ut W C•l o o y s s 'i M "n O mD �m 1 ! 1 ! 1 $ (n f� N to 3 m - -- - - - -- - p Q a o D m o g� > z n m �n In m N W O m D ODNa wNM - 4 > m a � -r J oNft) 0 mNNr1l ° X m 00 W%00- roj m oW00 UloOO+ ° < D � a X M cn s_° d �� D o 7om2-�O r O m w '..R • r a, � .1 F < o n O 3 _ m O M 0 Z O a O 0 < O N O a - ` O D D m m y m En I] a o T M D Z Y T x ^ m m _ m w O m o <z ox - M Mo A �>�` T o m w� F)� r m z NO I RI n m s r n z z O z a N r >° m U C1 wN p -< m 30 ° r O M W m N Z O ° v 0 v r m m m 0 - + D - O s D O CD z a Z . o ,m O > ... T N n D 11 X "'- a 0n O z zt N f ' "O 0 z C v 3 b I O D Zc t0 00 �D 33 PA 01 W (A i G 9 m r Idl303H XVJ V ION ONV � XVI Wf1aNVHOW3W V SI SIHI SEPTIC TANK MAINTENANCE AGREEMENT w St. Croix County a OWNER/BUYER ��%✓' -�-`� - , w � 0 ROUTEitoX NUMBER ' ' 03r" - lc.2/� 5 Fire Number o d VD CITY /STATE ZIP R M c..1 PROPERTY LOCATION ' _ , �F/GJ Section T 0 N, R�W, To", d� a�i�r St. Croix County, Subdivision Lot number Improper use and mainenance of your septic system could result in its premature failure to' - handle wastes.• Prover maintenance con- . sists "Q pumping ouC the septic taizk every tf�xee years or sooner, if needed, by a 1e'en'se' "s'e "t'i , •tank uin er. What you put into the system can a eat e• fun o - t e•svptic tank as a treat - ment'stage in the ''Aifta'd sposal system ": St. Croix County residents'•m�*be eligible to recieve P grant for a max bum of 607. of the• cos't.of replacement of a failing system, which was in operation prior to 1, 1978. St. Croix County accepted -this program in August of 1980, with the requirement that .owners of all* new ' sys't'ems agree to keep their system properly maintained. The property owner agrees to. submit to St.. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or.•a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating: condition =and •(2) •.after inspection and pumping (if nec- essary), the septic tink is 'less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H I /WE, undersigned have read the above requirements and agree F to maintain the private sewage disposal system in accordance with N the standards set forth, herein, as..set by the Wisconsin Depart- ::r ment of Natural Resources, Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED a L DATE f —z S St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386 -4680 Sign, date and return to the above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS ' INDUSTRY,. '" DIVISION LABOR AND P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS 0115, MADISON, WI 53707 (H63.g9(1) &Chapter 145.045) LOA TOWNSHIP /MLjb{ LOT NO.: BLK. NO.: SUBDIVISION NAME: l NE / NW 1 /4 1 /T 3o N/R 1960 VII Somerset r.b COUNTY: OWN ER S AM : M N R SS: St. Croix Hall & Siekmeier 1 6757 Kamer Ave., Cottage•Grove, Minn. 55016 USE DATES OBSERVATIONS MADE BEORM%: COMMERCIAL DESCRIPTION: ( M"=T 5mesidence .3 n /8' EbQow ❑Replace. L 8 -3 -89 n a RATING: S- Site suitable for system U- Site unsuitable for system CONY , MOUND: ( - IN TANK: RECOMMENDED SYSTEM: (optional) ®S OU ®S OU 2S OU 70S OU I 0S ®U I conventional II Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.1­163.09(5)(b), indicate: class 2 l Floodplain, indi Floodpla elev n/a decimal PROFILE DESCRIPTIONS page 27 OnD2 BORING TOTA L P R NDWATER- INCHES HARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER D ELE EST. TO BEDROCK IF OBSERVED SEE ABBRV. ON BACK.) B -1 6.92 101.40 none >6.92 .67bl.1. 1.58bn.sil. 4.67bn.s.1. e .2 7.34 102.70 none >7.34 1.17bl.1. .92bn.s.sil. 5.25bn. s.l. 13-3 6.92 102.10 none >6.92 .58bl.1. 1.17bn.s.1. 5.17bn.l.s. B- 4 7.00 100.70 none >7.00 1.08bl.1. 2.00bn.sil. 3.92bn.s.1. B.5 7.08 101.5Q none >7.08 1.00bl.l. 1.83bn.sil. 4.25bn.s.1. B. PERCOLATION TESTS TEST DEPTH- ' WATER IN HOLE TEST TIME RAT MINUTES NUMBER INCHE AFTERSWELLIN INTERVAL—MIN. PER10132 PER INCH P- P. see desi4i, rate P P•. P P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation. reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 98 .36 1r( IP+I: z 1 I T A C. .� 6 ° Ir I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my, knowledge and belief. -c NAM pr nt ; TEST§ WERE C MPLETED ON: Gary L. Steel 8 -3 -89 ADDR S CERTIFICATION NUMBER: PHONE NUMBER (optional): _ 988N. Shore Dr. , New Richmond Wi, 54017 2298 1715-Z46-6200 CST SIGNAT DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR•SBD -6395 (R. 02/82) — OVER — F i I I t I ! r I I I �' ' - -- _ - -- -_- T - 4 I 7 _ i � I I , I i I - - - -- - _ r ' - -1 i -- - -- : I I , l I p r I � I r T I � I I I I I T � , I Y I I � i j i - ---, i 1 _,_ __ ��; i i j - - � - - - -- _ . - - -• - -- _ _ - _ _- i -_ _ _ - _. __ -- f_ -_ i - -- __: - -T- - -- - i _ , _ _ ,_ � _ ___ .__ - - -- - -- -- -- - - - - -r - -- - -- ___ .. _, -- __ } PAG C of ..�« • C�0 ss• S� C�101, p�' A 3tI, f o 1U Air IN i / 101► Ally • ►►u�sUM Pipe ,r� , YWww G oo d e v Voss 640, 1 �t►fi� - • /vl �'"/� Ile � 1010 ' 110• Ct A10e.e ►Ir 1' Cool MM 1110 IMeI ONe• VON Pipe ' moth IN! O/ i/erMll• Covet" O.N PM iM••N• .. fits lot 1 •' A►p•►ele • II•&$sib ripe • ►wlwele10 Pip 41#1 � mow,...,, • "Ce.ple► iawle•11•� AI • /1011 p1 01 i�•1•e• . Pru(�o�tp �11ne.` 9�ae�e WIL FILL' 0I3TRiBUT101.1 PIPE APM0,11:0 S•IIipwrIC COVC 2 " OF1� 6 GRCGA'fi;. -►� I'1ATi=R1 ^t- OK VOF STRAP. ,{y OR MARs1. P.Ay ELEV. O F2, Eft ' ►t'bq` V -tl /i AGGRCGATC �i. 0I S T R 115 UTI 0 U PIPE TO pC AT I,CAtT IWCHES 9CLOW 0RiG;IwA1, • .;AOE AUV AT LEAST &O IWCHCL BUT LIO MOPr. THAW 42 IuCHCS IDELOW FINAL. MNcIMUM DEPTH OF CXCAVAT100 FROM OR16WAL WILL BE 111KIMVJ� pE T11 O E CAV S P F ATIoN f fZ01� o�',IGII�gL GRAPE wit-L. 6C �� INCHE 31 G 1.11:0 : LIGCIJSC 1JUMBCIi: ,-- �1 _ 1•` DATE: - REPT131 SOMERSET ST. CROIX COUNTY ZONING PAGE 1 05/12/93 08:44 REQUESTS FOR INSPECTION WORK SHEETS FOR: 5/13/93 AREA: MJ " Activity: Ab300018 5/13/93 Type: CONV93 Status: PENDING Constr: Address: SOMERSET 28.31.19.392B,NE,NW, LOT 1, 85TH ST. Parcel: 032 - 1081 -40 -000 Occ: Use: Description: 193358 Applicant: WITTSTOCK, ALLEN J & JUDY A Phone: Owner: WITTSTOCK, ALLEN J & JUDY A Phone: Contractor: O'CONNELL, KIM A. Phone: -------------------------------------------------------------------------------- Inspection Request Information..... Requestor: Kim O'CONNELL 15 Phone: Req Time: s : pn' Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION -------------------------------------------------------------------------------- Inspection History..... Item: 00012 FINAL INSPECTION