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Home My WebLink About018-2019-09-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Budding 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)j Permit Holders Name City Village Township C&J Builders Inc I TntA/KI 4. TANK INFORMATION TYPE MANUFACTU CAPACITY Septic 2-+y 1-, Dosing V'kievto^bp Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG Vent to air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia Dist m'Nell SOIL ABSORPTION SYSTEM OFHAMMOND ELEVATION DATA E mmmm f I BED/TRENCH W1dth Length No Of Trenches PIT DIMENSIONS No Of Pits Inside Din Liquid Depth DIMENSIONS SETBACK SYSTEM TO I P/L IBLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR Ty Of Systain Model Number UNIT UIJ I KICU I IUN SYSTEM � Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing OUIL %,UVGK x Pressure Svsfems Only r. Mri—A nr at-n—do c.,.t— ri ak, Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulchetl BedrTrench Center BedlTrench Edges Topsoil - - -Yes Yes No No COMMENTS: (Include code discrepencles, persons present, etc) Location: 1645 72ND AVE 1 ) Alt BM Description = Ir'ntu✓t l 2.) Bldg sevver length = t - amount of cover = Plan revision Required? [ Yes * No Use other side for additional information. _G I_u �_ _ SBD-6710 (R 3/97) Inspection #1 Inspection #2 No " On t ai 7 coop Coln 1405(5f ✓!j�/ r'5 -�4ar wyu-r I�0-(- 4Ir /r s IS nature Cent No snpj-a 0.1 I - 3-7 9 S 1. County Safety and Buildings Division St. Croix $ I%I 2ot 20 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled m by Co ) P$ 04 Madison, WI 53707-7162 Coun rolx Ss it Applicati Sale Transaction Number sub 072001397-C In accordance with SPS 38 .21(2), Wis Arlan Code, fission of this form to the appropnat govert Protect Address Qf different than mulling address) is required prior to obtaining a sanitary permit Note Application forms for state-owned PO I'S are Submitted m the Department of Safety and Professional Servies Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s 15 04(1 m), Snits 1645 72nd Ave I. Application Information - Please Print All Information Property Owner's Name Parcel 4 C&J Builders Inc. 018-2019-09-000 Property Owner's Mailing Address kProperty Location 316 Kamloops Place Gnyt Lot SE y, SW / Section 29 City, State Zip Code Phone Number River Falls, W. 154922 715-222-9731 (cucle one) IF 29 N, R 17 E or X II. Type of Building (check all that apply) Lot a Subdivision Name I or 2 Family Dwelling -Number of Bedrooms 4 9 '1 , P° Rolling Hills Farm Iock4 ❑ Public/Commercial - Describe Use ❑ Qry of El State Owned -Describe Use ❑Village of CSM Number `_. R Town of Hammond III. Type of Permit: (Check only one box online A. Complete line Rif applicable) `t New System ❑ Replacement System ❑ Treatment/Iloldmg Tank Replacement Only mg a lam) ryslem 11 % aLI'NIX �,d 3'10 B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New ist Previous Permit Number and Date Issued Before Expiration Owner 624908 08/07/20 IN. Type of POWTS S stem/Coin nent/Device: Check all that apply) ❑ Non-Pressunzed In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound 124 in of stumble soJ ❑ Mound 124 in of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment [kwce (ezplam) HOOt 600 V. Dispersall,Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdst) Dispersal Area Required (at) Dispersal Area Proposed (sf) System Elevation Existing V t. Tank Info Capacity in Total W of Manutacturer Gallons Gallons Units o's U ' New Tanks Existing Tanks a V rn v h e- O a Septic or Holding Tank 400/921 1 Hoot/ Wieser X Dosing Chamber 1250 1 Wieser Concrete VII. Responsibility Statement- 1, the undersigned, ass me resat . ibility f rintstalliatirs. of the POWTS shown on the attached plans. Plumber's Name (Print) Plu 's Sig a MP/MPRS Number Business Phone Number Keith Knudtson 3 651-470-1737 Plumber's Address (Street, City, State, Zip Cod 927 159th St. Roberts,Wi. 54023 VIII. Coun /De artment Use Only �APpmved El Disa Permit Fee ed Dale Issued Is in gent SignaNr ❑ O en eason for Denial !N up STEMS i it Approv Reesonaim-Hisappreval Septic tank, effluent filter and dispersal cell must be serviced. /_maintained ik (0 ✓�'�"ti• `� YS� as per management plan provided by plumber. `_11.r1,,.V` QPLK All setback requirements must be maintained ) a5 pet dppn i,duro yfbukh'dfYDmplete plans for the system affinbbmit to the County only on paper not leasthan 8 to all inellim(n size �t) ��- SBD-6398(R. 11/I1) a �.OPI haus� p, N,e.�s pans sc- 0� _ ? Project Name: CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE C&J lot 9 Owners Name. C&J builders Inc. Owners Address: 316 Kamloops Place River Falls, Wi.54022 Legal Description: SE 1/4 SW 1/4 S 29, T29,R 17 W Township: Hammond County: St. Croix Subdivision Name: Rolling Hills Farm Lot Number 9 Parcel ID Number: 018-2019-09-000 Designer/Plumber: Date: Page 1 Index and title Page 2 Plot Plan Page 3 System Sizing & Cross -Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test & House Plans Keith Knudtson License Number: 648443 10/03/2021 Phone Number (651) 470-1737 Signature Designed pursuant to the In -Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01) Page 1 PU �o �2- ZI?20q Y4 YL �_ L T"- [� 8 O� GY� "C, /- b-/I- �0 0 p,O%.:�5 , homes sr-a.e- _ + Z-z f) S,+ ZOA C'. .....,,.. N .O[w..YWMbRnwnMORaMK•wPM�IFa W+.n Ne wlwnM `.~ ••��": ^��4�• /Mr.14011MfQM.RIwn IMI M/.M YLWYC101A40 Mw.P 11l I�IwnM '!WV�7'" ll MWIAb YL1pM L.4.Wl!•111rI.Y.1pM.P rrtl10,R O04 CAW1�.11Y1f)COI.W. 1`' Jill �•. � �. Pry ill;' � • �'�1,f11�, �� ... w.n. Itl10w�1 � • • �• �'- Sr '. %��' ' r' �. ` }� �r AI.W ) •�` . •, •may � ` ` J LOT 1. A4, I 4i 6 's UYO. r�.� II�W.4iG1[IYO..v 11HR, RIM w ^� .r � .A •ti�ROi44M,.wW W=w.(�. ��-a' WI�.�_.�. A ~.W.4bW_ . 0 0 4 A 5Q 1/_EW j: A h-b00 A TANK SPECIFICATIONS DIMFNS:ONS _ 4 .A_ WA_L J_ R/1TTr)M �5' T O 4' MAN�;AL 12* 4 z4' I, PLACTC RSE; HE .NT 'C Ice' J J WD-H 74 112' 0.D BFI OW INLET. 57' O D I •ANKS ARE YAn.,F A�-iREp TO MEL' OR EACFE^ ASL ---1227 RFOU.REMEN-S I it I IGUID LEVEL, 51 WE BHT 11.135 LBS W $ 1� ? W N`LT A4. JJ ".LT = z 4' _AS'-A-SE.AI -A' ❑?D_ OR FQ,.AL Li CC�TR u+ EESIGN #8 ^', FFFR, C TANK Mk DESIGN 0 NY A,, fIBER) c cm CUSTOMIZED TANKS FOR CJSTOM TANKS CONIACT WESER CON(_k[TT. W H< W Eq z z L < 8 DRAWINGS SUBMITTFD FOR APPROVAt_ _ II Y DS � PS May 10.2018 HOOT SYSTEMS, LLC RON SUCHECKI 2885 HWY 14E LAKE CHARLES LA 70601 Re: Description SEWAGE TREATMENT APPARATUS Manufacturer. HOOT SYSTEMS, LLC Product Name, (tra la 849 H-SERfES HOOT Model Number(s) H-500-A (MAX DWF 600 GPD) Product File No: 20180134 DIVISION OF INDUSTRY SERVICES Pkanbin0 Pioik.0 Review RO Ow 7302 Madam, vveoonaln 53701-265e m• CmWt Through Relay Goverrior Scoa walker Laura Gutierrez, aearatary the specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters SPS 382 through 384, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code This approval is valid until the end of May 2023 This approval supersedes the approval issued on March 12, 2013 under product file number 20120398 This approval Is contingent upon compliance with the following stipulation(s). • This tank must be designed to withstand the pressures to which It will be subjected. • The manufacturer must keep at the manufacturing plant a set of plans and specifications bearing the department's stamp of approval. The plans and specifications must be open to inspection by an authorized representative of the department • This product may not receive backwash discharge from a water softener. Water softerier twciewash discharge must be discharged in another method acceptable to ohs SPS 382 and 383 (formerly Comm 62 and B3), Wis. Admin. Code. • The maximum daily wastewater flow, which may discharge through this product, is 600 gallons per day. • When this product receives wastewater from dwellings, It will produce an effluent quality with a maximum monthly average value for SODS of less than or equal to 30 mg/L, TSS of less than or equal to 30 mg/L TSS and F.O.G of less than 30 mg/L and fecal coliform of lets than or equal to 10,000 cfu/100mL • Plan review for the installation of this product must be obtained from the department in accordance with SPS 382.20 (1) of the Wis. Adm. Code. • This product must have Installed a department -approved effluent filter capable of filtering particles of 1/8 inch In size or larger. Sa0.10564-6 IN 10107i File Ref: 18013403.00C Hoot Systems LLC May 10, 2018 Page 2 of 2 Product File No.: 20180134 Table 1 Maintenance, Inspection, Pumping Requirements PRODUCT/ Models H-500 600 aVda Initial/Startu Inspection/ Maintenance 2-yr. service agreement wlmanufacturer Ongoing Pumping Cycle And/Or Requirements 2-yr. pumping (trash tank only), unless more restrictive by local or state regulation, for aeration chamber, see inspectron results Back -Wash Cycle NIA Efnuent Performance Levels NSF-40 Cfass _ BOD5 Credit For Downsizing Distribution Area YES Fecal Credit For Reduction Of Vertical Separation I YES Additional Comments I none • These tanks shall be fitted with locking manhole covers in accordance with s. SPS 384.25 (7) (h) Wls Adm. Code The manhole cover must be secured to the riser using screws which are not standard or Philips head to be considered an effective locking device. • These tanks shall bear warning labels, that are visible after installation, that conform to s. SPS 384.25 (8). • The tank is not recommended to be installed where saturated soil or seasonal high ground water tables are indicated between the bottom of the tank and the ground surface. • BEDDING: 34nches of compacted bedding shall be provided. The bedding material shall be dry, sandy loam material, or coarser s V2 diameter in the largest dimension. BACKFILLING: must be compacted at s 6-inch intervals. Backfill material shall be free -flowing soil or gravel 5 4 inches in diameter in the largest dimension. The department is in no way endorsing this product or any advertising and is not responsible for any situation which may result from its use. Sincerely, en W. Schlueter Plumbing Product Reviewer Department of Safety and Professional Services Division of Industry Services Bureau of Technical Services (608) 267-1401 Phone (608) 267-9723 Fax glen.schlueter@wi.gov E-mail Private On -Site Waste Treatment System (POWTS) Inspection Agreement The correct operation of the equip men noted below significantly influences the I Fe of the wastewater system Periodic inspections will help wend the Ilfe ofthe system and prevent the need for costly repairs. The agreement authorizes across to your POWTS equipment by a trained and authorized technician, during daylight hours, to provide regular mspectlons and routine maintenance to help assure the =n,,r mem: Is working properly It is hereby agreed by and between Purchaser and hnudt, , Pltiinbmg and Contracting that in consideration of the payments provided for herein, Knudtson Plumbing and Contracting will Provide Me services of a factory-tramed reps esentative to Perform penouc ti peawns of the equiprnery dad• r�hed beit,w r nudt or Pbcmb.ng and Contracting will prepare a written ref'o, r onei , ". 1, in ,cebmamitic,,, of tie -xcert to the Furclia:er This report will outran, recommendations for soy operat,tin and mamtrnn're deemed approp,ate by thx Inspector This agreement does not assume any responsihibbe, for ohiigation, that are normally the responsibilities of Purchaser and does not extend to cover any costs that may be associate with any recommendations made under this agreement. In no event shall Knudtson Plumbing and Contracting be responsible for any epecial or consequential damages. Including but not limited to lots of time, Pour} to person or property or incidental economic loss due to equipment fadu-e or for any ether rea.on whatoe... Knudson Pirborng and Conlre.ting may supply addrttcnal services, parts or labor only after authoriza4cn by Puchaser This agreement shall remain w force for a period of _1_ _ year, date tin _NJ ay_ __ _ 2020 and will automatically renew each year thereafter for one year tinier ran. Bled oy arth, art, with at le,, 3u.aya wit;ter notice This agreement maybe canceled ov the nurd,,, only rf replaced by a; rvice ag,en-ei,t witr an astnunze d servi-.e provldt,° he egirp,Tl-tit bst,d hwsa hrwdyon f"umb rg are I_,ntrart •*at delay =anceI fi.ture Inspect on, If pe ycnent ce cc tries at least 2 1.,,n past d. e ""'Id" :nspeC;onS. Assa_.a?tin ae ce, to pity d;,: ^ = u .,I a CC ,er ear, he use ; annual ins oecto, ,riy acditnna tritm, _, _ei.i.e. �c,un c aLI be Filed n.• rm,a and rr a: er al on r, atit= Equipment Covered Under This Agreement _ Description Model No. Serial No. Install Date ATI I'S Hoot or Micro-Fa=1 Knudtson Plumbingand Contracting Signryi_ 927150irSt , Roberts, WI 54023 651-470-1737 Location if different from system owner system O Signature - _ _ i'•�-J �}.:/QAl l�rle __ --_ Rcbcg Hills . eowneq AssI.^anon hi. C _ � '7_ � / Street n fib Ko (S �� Fh7ine�3,7—�/9� C1ty. State &/ZIP I Fax Y�jVeA t3)U I!.</,I-5 iy'7 Z� Emil -`E't��V-S�J��'�a<a�t 1-- Title St. Croix County AEROBIC TREATMENT UNIT (ATU) SERVICING AGREEMENT State Permit Nurnber - C &t J Builders, Inc. Name — (Owner) Typed or printed He/she is the legal owner of the following parcel of land located in St. Croix County, Wisconsin, with their deed or document of ownership interest recorded as Document Number 1140261 St. Croix Register of Deeds Office. This Property is described as follows (include lot no. and subdivision/CSM or detailed legal description): Lot 9, Plat of Rolling Hills Farm in the Town of Hammond, St. Croix County, Wisconsin OR: ❑ See attached deed copy for legal descriptions Agreement Date: _11f oCT ao}( 8 2 IIIIIIIIIIIIIIII III 8 4 2 7 6 2 Tx:4721892 1141148 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 10/ 1412021 09:29 AM EXEMPT R: REC FEE 30.00 PAGES: 1 14�;, KAMW t Vex Fall Number (PIN) As an inducement to the county to issue a sanitary permit for a POWTS equipped with an Aerobic Treatment Unit on the above -described property, we agree to do the following: i 1. Owner agrees to conform to all applicable requirements of SPS 383, Wis. Adm. Code relating to Aerobic Treatment Units (ATU) and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater "treatment System) technology. If the owner fail$ to have the POWTS and ATU properly serviced in response to orders issued by the governmental unit or the Department of Safety and Professional Services (DSPS) to prevent or abate a human health hazard as described in s. 254.59, Staffs., the governmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stets. 2. The owner agrees to maintain a contract with a licensed POWTS maintainer for the life of the system. The POWTS maintainer will perform periodic inspections and maintenance as required by the manufacturer and the Department, including, but not limited to: the blower, electrical controls, and treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described to s. 254.59, Slats. 4. The owner recognizes that the county, DSPS, or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. 5. The owner or the owner's agent agrees to report to the department or designated agent at the completion of each inspection, maintenance or servicing event in a manner specified by the department or designated agent within 10 business days from the date of inspection, maintenance or servicing. 6. This agreement will remain in effect only until the county office responsible for the regulation of POWTS certifies that the aerobic treatment unit no longer serves the property. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the Register of Deeds, and the agreement shall be recorded in a manner that will permit the existence of the agreement to be determined by reference to the property where the Aerobic Treatment Unit is installed. Owner(s) Name(s) - Please Prinksb� m Subscribed and sworn to before e on this date: a-e a-� Notarize Owners Sign atu (� Note WI$CD Governmental Unit Official Name, Title - Please Print My Commission Expires 601 JULIE A. Community Development Department �a-' o(p,pETERSON � Govern tat Unit Official Signatum Draped by: v O�gRYePJO r 1, "\ Persoft5l information you provide may be used for Secondary purposes [Privacy Law s. 15.04(l)(m)1 ' ..' upi j id' w i A s I t .&•o y n n b a _____., 77- d- ------ :r �- OA ° LL Z E N • nr Y a-- --nL • r•-c u. �� f al� l o Y � L7 u iwpu+ "d , A e 00 r � 3 c 1 E N T7 J ......., ...L ... I P� (p, ..owe .ti % 'n i� • 1 i Contractor Guidelines for ATU Septic Homes The septic system for this home will depend on the proper functioning of the Acrobre Troanncnt I imi (A117), which is designed to treat and degrade solids prior to discharge into the shared septic system As contractor/builder, please observe the following construction guidelines: • As part of design and construction, arrange for water from sump pumps to go to an extcnml discharge Backwash from water softeners should also If- discharged externally, as doing ai will extend the life of the septic system. Note. Regulations pruhibiL fumacc condensate from listing discharged extemall) • Garbage disposals are not recommended • Avoid allowing any inert construction materials such as plastic, rubber, cigarette fillers, handagcs, rags, cloth and towels to enter the system. Likewise, prevent conslrucfaon chemicals and toxins such as paint and paint thmnun solvents, etc, fmm entering the system • Contact Knuetson Plumbinh, and Cwitt acting prior to siting house grads, in order to confirm that adequate fall will esist to all(ns „rag itv flcns heMccn the house the AT(' and the shared septic line (which may be as shallow as 4' iris lies) Im.orrect siting may require an additional pumping station and incur significantly higher costs. • The At U manufacturer does not recommend tank installation in frozen ground, and it will be done only at the contractor/bmldcr's request and risk. Installation under these conditions will likely also incur added costs related to requirements such as snow rcrnoval, frost ripping, etc. • Prgeu warninn: Water trou, fumacc condensate Imes ur other sources including sinks and toilets, entering the syste n during winter construction can cause the tank and componentt_u) fn:eze and fail as there is nu bacterial action at this stage to generate heat Use a salt sump it) treat this water prior to entering drain lines Contact Knucitson Plumbing and Contracting tar a description. Builders failing t r 4�cis, c Wts precaution may Iic liable for system repair and or replacement due to freczinp Whriicvtr possible, keep interior i..rtcr lint, turned off during winter until the time Of accupanC} • I anks must be pumped prior to hnmu,wntr occupancv Fnr qu¢Uons regardmg these , anon. I ian pu idchnu, c.all- Knudtsoo plumbing and Conracnng, 651-370-1737 the show r�uidelincs: Rolling I tills Lot to p ST CRO UNI Y SANITARY SYSTEM File An OMee Use Only —�' OWNERSHIP/ADDRESS FORM er=er•a212021 Community Development Department will utd¢e to s mfo'matOn to piov;de the property owner min information regarding operation and maintenance of your new or wplacemont as itary syM, I I his information will be orovided as part of our ongoing efforts to protect pubbc heath, your well, groundwater, surface water, property values. and county ICSources Once thrs , c,npleted fo•m i 1d ed..cational information will be sent to you cy enai'. /�� OWNER/BUYER INFORMATION Owner,rl3r;yel _ C4 S _6l Q-� 11QC - Ma hnq address_ Op'/statetip_ ;l�,i �3( _ �_ 'foZZ_ Phone Number (regwred7_ Email Address(requ,,d)�Ei y�� r�-.,,,e45 ,-t •E_ _ _ __ Parcel Identification Number ifolldorthe_iop,n`„ il „n, NEW SYSTEM: LEGAL DESCRIPTION Property Location 1 ' , ' Sec.7 , - 1^u -own o- Subdivision Plat �� .�-!,(,//S �."irl _ ---- wt = Certified Survey Map # Warranty Deed # _ 11L —,before 2OC6)Volume _ Page n Number of bedrooms _ �Spec housexyes D no lot Imes dentifiablex tier O re � [ OFFICE E ONLY Ne, 'roperty Adds, & ZI eI i hIs form must be submitted n,th ;l1 Fr-oze Dr site V✓ote, rreotmeat System POl4'75; r.Cphcat:ons New System: Irlclyde r,, survermno "'eremvr �a mnn.:y D"cinument Depa,trnent Bann Jse Dins n 71; 486 46bn St G�ix Courtly Go,clnmen' Center c e cdd2 enn v "�-Z'S-12�0 a* --�� "71 C..�rr,ch ae' Food H��son 'N' S40t(, ,; --- 47 - Sanitary Site Plan - -- — _ - 48 ------ Yor. Rolling Hills Farm Residential N9000CC'`A 128 19 72nd Ave. __ _ PropertyOwners Assuciation LLC 6371 64 48 ------ C4 0 RollingHills,Farm Dutlot I ftSE 14 -S;V114 Lots 8 I l brr o LEIV Sec. 29 T29A'417W Tci►4'n — -- C �iOz -- - - LOT 7 sa R C N hr- J S T v LOT s LOT LOT N LOT :: _ < " 10 F•' 8 1 1 _- J 21.781 SC FT k' \ ��, HM OUTLOT 1 29 56 ACRES 1,287,641 SO FT i PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION Rolling Hills Farm Owners Associahon TOWN OF HAMMOND 018-2019-78-000 . ..De, I,, rI I':r .I rJr. b i r'1 rtv 292911-12I8, TANK INFORMATION ELEVATION DATA _.:., fir;., ,:. ..; .. ., - - •, ram. jt �y� I k.r.(_1 ✓«. Y';�f ! C # 7 F ,''bar 'J •1�% �"!� �'l 1 St Croix 624908 TANK SETBACK INFORMATION'L ,G' ?lUa� �✓tof� ?Kl�' ?.�,'i Iv"75. 75 — 3 4 I_ PUMP/SIPHON INFORMATIONMar - r wv AlI, Fdfxfr•. nun 1!wr L SOIL ABSORPTION SYSTEM tltOaH WC#1 -- ..•...:: r.�-^•�-S•n •. PIT D:MENSfON'.�'� --�— ... DIMENSIrINS Zi 1Ei I ' SEI{LACK `,Y;SiL6i lU _- -1 tiL'JJ Vlt LAK, :,i t,# f 0. it -ACHING VA a.�i'n�•a INFORMATION`-- .._ _ ,. ___ - CHAMBER OR DISTRIBUTION SYSTEM _ -.Y.IPA SOIL COVER pr suue Svztcros Univ •x Mauna Or AtGrnJo Svztcros Oniv r ! r vY1 ArMu .VY� __—_-•� -{fy.1y I __ _ _ . __ 4- �\ 1I'lo io- Ed .,y t,� fveMhn+tr♦b••1n ! C_ _- —_ n � ! L_ ^� 11 ?� ` x f.. t., Y,.. t•, .\- t COMMENTS. ..:::. _:, ! . ;, t,., , •. r,:.,,..., : -, .. , .. :n k "}.• ,'i t2/Ic ,•, L ,,. r ;,. r , t'�Xy�fft"-4 Tc 4'V.0 I'Ier u�. ..nr?.•Ir reds ., �hu � ?� -�/1 v:/ ' ( )-' � /�1��11: '�� J i.V .I-.o . •.Y„r. 1.^._ti,!Yl tl f•rr ..I'.i/// , • f.'�,. �'� / ,r.i' r ��COUNTY � �'� � No. OWNER PLUMBER TOWNOF SEC ,T_ AND/O LOT W PREVIOZ C. ua15Wc.# 64103 N, R BLI SUBDIVISION 633977 ERMIT 1vo.62Y9o* L•Ts1 xy 145.135 til WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. to; Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact tht:county aNthority. ISSUING OFFICER - DATE PERMIT EXPIRES ' - LESS RENEWED BEFORE POST IN PLAIN VIEW ��t THAT DATE VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)