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Home My WebLink About020-1053-60-250Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM 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)] Permit Holders Name: City Village Township Matthew & Lindsay Miller I TOWN OF HUDSON CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing fV r Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ,'Lt 7�7 '/� �J l Dosing Aeration Holding PUMP/SIPHON INFjOgMkkTION --------- M nufacturer t9emand PM M el Number TD Lift Friction Loss Syst m Head TD Ft For main englh Dia. Dist. to Well SOIL\A"ORPTION SYSTEM ELEVATION DATA STATION BS HI FS ELEV. Benchmark Alt. BM ArAf G J Bldg. ewer Q• q 5 / CY St/Ht Inlet V J SUHt Outlet l.3 I'•/S t Inlet B om Header/Man. IN.'S .S 89. 5 Dist. Pipe Bot. System S Final Grade St Cover MWW-ffrGM?0— � BED!TRENCH DIMENSIONS Width /j . 5 Lenglb 47 No. Of Trenc es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P!L IBLDG IWELL LAKE/STREAM LEACHING ufa INFORMATION T Of System. i� 1 I g CHAMBER OR M el u e : DISTRIBUTION SYSTEM �� Header/Manifold IDistribution x Hale Size ole Spacing V nt to Air Intake Pipets) Length Dia Length Dia S ng SOIL COVER x Pressure Systems Only xx Mound Or At-GradoSystanos Only �1 Depth Over i Bed/Trench Center .--., 'J - ` Depth Over 7 k Bed/Trench Edges I xx DePVof Topsoil xx Seeded/S xx Mul —] [J Yes No Yes J No COMMENTS: (Include code discrepancies, persons present, etc.) Location: 486 JACOBS LN 1.) Alt BM Description 2.) Bldg sewer length = - amount of cover =y 3o Plan revision Required? Yes, No Use other side for additional information. Date SBD-6710 (R.3/97) Insp ctiQn #1: Inspection #2: �Sfro+�� t1o��c a o i �ts��0� ,, el{�w - S i'(,1N1 ��jI��}�lA�'� �'i b o �o ✓1�+r �1�`' �6 T�'tS+BIOW Insepctors Signature /�'464 Cart. No. �0. 4,AAfv -.aci — na— e) �_ Industry Services Division 4822 Madison Yards Way County t - �Q (of '= I I % �UL Madison, W 153705 P.O. Box 7162o� L Sanitary Permit Number (to be filled in by Co.) Madison, 370 716 Ilk roi i Splicatioll State TransactionNumll N accordance with SPS 383 ° Cade. submission of this forth to th it is required prior to obtaining a sanitary permit Note: Application forrrns for stnteowned POWTS are wdn Wy the Departrornt of Safety and Professional Services. Personal imfurmenion you provide may be used for secondary Address (ifdifferrnt Uurn mailing address) Pmpasrs in accordance with the Privacy Law. s. 15.04(I xm). Slats. I. AppMestion lafornutfoa - Pkare Ptritot All lnformaidoa Property Owner's Name Parcel Al 0010 _ Q Q — w4 s ►1e -oo Property Owner's Mail�ing�Addrej ss jj Piny Location L,�, T JAGoVs A)j� Govt.Lot S E ,,A s r V,, section :� (j City, State 1S /.ip Code ybl t� Phone Number ens 1-ao7 3� 94 Q9N R / E or W 11. Type of Rulkilag (cheek all that apply) Lot x I or 2 family Dwelling— Number ofBedmoms 13 Subdivision Name �uW iclCommercial — Describe Use CS h') Y 0 P 3 OLO Block q try of 'illage of Lade (honed — Describe Use CSM Number �bC ! IOs Z Iwo" of 1AbSM Ill. Type of POWI'S PNMW. (Check either New" or -Replacement" and other appdcobk or Mae A. Cheek one box oa Yee B. Complete Use c 11 a Mable A. P�Ncw System eplacerIkent System ❑Dther Modification to Existing System (explain) Additional Pretreatment Unit (exphm) B. El"olding Tank In -Ground 1__f't-Grade Mound Individual Site Design POther Type (explain) (conventio C. 0 Renewal Before Revision ge of Plumber ❑I'rooster to New Owner ist Previous Permit Number and Dale Issued Expiration IV. DkpasaVTreamteut Area and Tank Information: Derr F� (g$d) Design Soil Ap ,1wznon RatgM sf) Drgrersal Arca Required (sf) goo Dispersal Area posed (sf) S Elevation 84 0. H 9d.5o L 89 sb Tank Information Capacity can Gallons Total Gallons k of Units Manufacturer Ncw Tank$ Fxisting Tanks UOI Septic err Boldan ing Tk N $ O W 1 S� =Ir--ilm cbw*" CUzi ert .gMNe Q V. Re spon"ikgy Stateweat— 1, the aaderdg•ed, ==me for hefa•adon of the pOWI'S shwa on the ainti ied ptaas. Plumber 'm ( t PI Si MP/MPRS Number Business Ptnooe Number a' um e� L 7a�9oy '115�3`vb'�b�rb Plumber's Address (Street, City, State Zip�'odc) 10'20 Aw I � k; AunSoR VI. County/Department Uselloully AA�uisa Permit Fee (jgtj,)a/wed Lswr' Agent Signature O Given Reason for Denial Conditions tiApprov ppl4o"I 3\ /� SYSTEM O J t a rt01 1. Septic tank, effluent filter andCACQ e dispersal cell must ft I Lm?. bflpll plan pi ovi �r �} as per management plan provided by plum d m ) 2.All setback requirements must be maintained lye p v�4e P as per applicable code/ordinances. •-�--� —---r�•� r•�• •�• � y..v w sww w oe a.wwy rru) M trier mar rs tar r 1/! a t I iaxfes i tla SBD-6398 (R. 03/21) be,56 'Aap ri N obeer S2td 4-13 -1 �t�Sa2iuno� �u� tble xe Pa4s j° w°-}° is )(?1tw4-NZ9C 6!1 W-9 +6d Kfacotmiltj k 1jwG-Xa-t �"'1710a s 4t4l#'.xg OS•6g 7 oq-Q b - +1 ljt `W h U S N 1,14 M a a �� d N �W 4-011 a *Roam ONNN%AddiM Lmodamatowr Sir T°mm"Ir �46SON I U b r�3 = i Mb �Y Flofi'hs� pap P204 F br9p ! --- -gym T SE C hk C$►$tip� ` weTin*,ft pqps CS4�Ple� 3oQ7est� fi�sap� - mite out as .��_ -plot MAP NPimom.: mAAte,k) 4- rjNdS R m, LCJCA i o N ; � 06� LoA 13 5�s�'�M l-F q L - a 9.50 F-X, t,Ny 4 ftj TDX RI+ e.m I -op J (= 13vNch M40- Blum of S�diNy i�ssum+d �Iev 100.0 a -TiQm6os 3 0; a 3(-bvr\ bars r1bAT"4hc�) r ��«bS L ifn �6urnt-es6y, Ctc.mm aaa9ay N T aHf B.M. Top 4 f�h-w?- Lot %tpke sejRv- 95.;tq 0 q0i ma Pal qK�.. MnavrtOM in PW=, Orrrage jam" & tr/xM Ater Nducrs 4 A ON. of Pab" k e. PL-525 Filter PL-525 Effluent Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-12Z, the Polylok FL-525 has an automatic shut-off ball installed with every filter. When the fitter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. _ Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. Pl. 51; Nlaintenance: The FL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alum, the owner will be notified by an alarm when the filter needs servicing. Servicing should be donne by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is property aligned and eotrTletely inserted. 7. Replace and secure septic tank cover. 1/16" Filtratii Amc rm switch tional) :cepts 1' PVC terision Handle Rated for 10,000 GPD 525 Linear Pt. of 1/16' Filtration Stots Ac rpts 4" 4r 6- SOID 40 pipe Certified to ® NSF lANSI Standard 46 Gas1)dlector Autoatatic Shut -Off Batt � A wt thddour 1,mArtl Itcr.:V.tnn Extend G Lok " Polylok, Zabel k Best filters accept Easily installs the SarrtPilto® switch and alarm into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: Wn.765.9565 Fax: 203.284.8514 www.polylok.com IN -GROUND DOSED -GRAVITY DISPERSAL AREA Stepped Elevation Trenches with Quick4 Standard-W Chambers c 3-ft Trench (down -sizing cr it) min. ,7 saL Coves► TYPICAL TRENCH 'r CROSS SECTION VIEW min, trrid (No Scale) I .4 (typ .q� Highest Trench Lowest Trench (es applicable) a Provide minimum 3 ft \i. � n ft y—� S b ft; eparetbn beMreen trenahss. System Elevatbne � �i Q ft ft.. ft Qu1ck4 Standard-W W/ End Cep (typical) (Show location of Inlet / outlet pipe connection on plan view.) low �. ----yB-------yam---- o 190 (bpi MOW" l 1r*W Per MwAd d warti / Mnbuodorr. ft INSTALL PER TRENCH: j� a Quick4 Std-W 0 20 fP ElWdhember ■ � - pL tts + _L Pain of end cape ® 8 ft' EgWpW w 5, ft' * Proposed EISA pert ench �' }t' TYPICAL TRENCH PLAN VIEW (No Scale) �A 3.0 ft (typical) �—QulcW Standard-W Chamber (tYAC01) (mrd by Wftlor sy"-M kn.) WFA pumalt b rnnut"ro ra 64budbrn. Required Infiltration Ame ■ cU)0 ft: x - a _ trenches a Proposed Total EISA= 730'! fe Distribution Method: branched manifold Y,YII Pg3of11 VMsconrin DepeArtnarrt of Sefely and Prolessional Services Division of Industry Services SOIL EVALUATION REPORT in accordance with SPS 395, Wis. Adm. Coda Courtiy Mach complete site plan on paper not less than 8 12 x 11 inrxles in size. Plan must incklde, SL Crobc but not lirrpted to: vertical and horizontal reference point (BAD, direction end percent slope, Parcel I.D. scale or dvnensions, north arrow, and location and distance to nearest road. 030.2016-10-100 Please prhK all in/omneon. Reviewed by Ref #2678 Date - 11-1 .un ym prume may ve umo lOr seconcwy purposes Law S. 15. 1 m Property Owner Property Location ❑ Matthew & LvKhm ke" Govt. Lot SE % SE Y. S 20 T 09 N Rig E (or) W Property Owner's Me" Address Lot # NO& # Subd. No. or CSM# 406 Jacobs Ln. 114 1 ue I r_cu VA W D. av,a City State Zip Code Phone Nnurnber I ❑ city ❑ VMW ® Town Newest Road Hudson VN I 5401E I (651) 207-3399 Hudson I Dorwin Rd ❑ Plea' COrtisfirclion use: ® Residential/ Number or bedrooms $ Code derNed design flow rate 450 GPD ❑ Replacement ❑ Public or car... w ieI - Describe: _ Parerd mdKW Glst:ial Outwash Flood Plan elevation if applicable pg ft General corranents and rerornimar dons: Site sultable for Irvgrvund POINTS with 0.7 gpd/agW design loading nab (0.5 gpd sq. tt reconvio% d). Recortrrrrleed system .nhtirative surface eevaton io be 90.50' a 89.5d. a Borx9# El Boring ®Pit Grand surface Mm. 9122 It. Depth /o irrlb factor>JW in. _.- Horizon Depth In. Don hwg Color MunmA Redox Descrow Qu. Az. Cont. Color Todure Strlrettae Gr. Sz. Sh. Consislerloe Boundary Roots GPDIW - '001 'E1102 1 0-9 10yr.32 now sit 2/9r mvfr c1a 2v/.f 0.6 0.8 2 9.15 10yr4/4 none gr sl 21sbk ffw* 0w lvf f 0.6 1.0 3 15.40 10yr4i6 none gr Is 069 ml gs - 0.7 1.6 4 40-47 10yMB none s ti gr 0eg ml cs 0.7 1.6 5 47439 10yr4/6 none s 040 ml gs 0.7 1.6 6 W109 10yr4M none s 6 gr Osg ml - 0.7 1.6 EBorkng # ❑ Boring ® Pit Ground surface elev. 93.92 ft Depth to tirr tV factor >JW In. Horizon Depth In. Damirwnt Color Mlxlem Redox Descripbon Qu. Az. Cont Colo Texbue Structure Gr. Sr Sh. Con sWerros Boundwy Roots GPD/Ft1 _. LR1 'EfM2 1 (16 10yrd/J none ail 2/W mvfr ce 2trnic 0.6 0.8 2 6-13 10yr4/4 none sI 2msbk nr* cw 2im1c 0.6 1.0 3 13-17 10yr4/4 none Is 089 mil gs tfmc 0.7 1.6 4 17-M 10yr4i6 none s 099 rrd ow 1v/,f 0.7 1.6 5 30-71 10yr4/4 none s d or 089 ml go 0.7 1.6 6 71-102 10yr5r4 Ilona s 6 gr 089 ml - 0.7 1.6 CST Name (Please Print) SON*" CST Number - - -- -- - -- - James K Thompson 30021 Address Dale Evaluation Conducted Telephone Number 340 Paulson Lake Lane Osceola VA 54=-5413 May 8 2022 1 Z48-77B7 ,IA"JR 11 (HUM15) Boring # ❑ Boring ® Pit Ground surface elev. 95.46 ft Depth to knftrg tartor >1 W in. Q. e....r� o...., Horizon Depth In. Dominant Color Murrell Redox Description Qu. Az Cont Color Texture Structure Gr. Sz. Sh. Corrialence Boundary Roots --- GPD/Ft' W 'EfM1 'EfF#2 1 0 9 10y m none sil 059 mvfr cw 2vf,fm 0.6 0.6 2 6-15 10yr4/4 none st 111 mvfr cw Ihm 0.4 0.7 3 1546 10yr4/6 none Is 059 all cs 1vffm 0.7 1.6 4 46-72 10yr4/6 none s & gr Osg ml cw 0.7 1.6 5 72-W 10yr5/4 none s & gr. Osg rm 0.7 1.6 Boring # ng El Rat Ground surface elev. _ ft. Depth to uniting fader in. Soil Application Rate Horizon Depth In. Dominant Color Murrell Redox Description Qu. Az Cont. Color Texture Strudcca Gr. Sz- Sh. Consishince Boundary Roots GPU*f 'Eft#1 'Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. _ ft. Depth to frrrttirg factor In. SoIlAppfication Rate Horton Depth In. Dominant Color Munaett Redox Descriplion Qu. Az. Cont. Color Texture SMjctum Gr. Sz- Sh. Con� Boundary Roofs GPWW ,Eff#1 ,EfIP2 Effluent 81 = BOD, > 30 s 220 ng/L and TSS > 30 s 150 mg/L • Effluent #2 = BOD, > 30 s 220 rngA and TSS > 30 s 150 mg/L Av. o.4 - ZWdpf rcayr ,Iid .5694. aW r !KS27 r r i T 6/RS�y. r r i , r 1 r r/ ��A�d � _ sryc�.c4;uT br a,6r�rG.•a� fw d.�ts+► �fS�.dr.�+, Ii�fic:nad t!lt.Z""�7j .. !E E31:.n i 6ed c Is✓. : C�sru- rd.st 4 f rj Sw/ tfe�ur.{so.4p'6 E�s6�_.Snd� W NW nb7/.r�ry�rrEJ' Lot a a s..r ✓.r ze, &3q, SEf tea, T.,tl/ll .P. Nw, T , oI'�G4aftw; scc aSlrCa,.,�� b�,�gs.iS.cras g.3� ST. wry SANITARY SYSTEM t" ts: Afyon. OWNERSHIP/ADDRESS FORM mM Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your welt groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. 0WN8VBUM 1NFORMATM Owner/Buyer — Mailing Address City/State/Ip — Phone Number ( Email Address fre Parcel motion Number Q 36 - a a) L - 1() -16o " (found on the property tat bill) Property Location _�t'A , 51� '/4 , Sec c;�(). T O 9 N Subdivision Plat Certified Survey Map f 0M I Town of P ► 5 C 4 . Lot $ �. Volume 2-9 Page # 63ryb Warranty Dead # 1130 3G 3 (before 2006)Volume . Page Number of bedrooms _ Spec house 0 yes Ono lot lines identifiable40 yes 0 no New Properly Address (staff h dams) (VenfKatim of new addrest requmW tram Con muray Devebpere t Deparurm t far new corWncuoa) 1 (Date) This form must be submitted with aU Private Onsite water Treobrwt system (PO WTS) apphcations. New Sys fndude with this firm a reo ded warranty deed from the Remoter of Deeds Owe and a copy c(dw odted survey trap if reference is made in the warranty deed Cotm►undy Development Department — Land the Division 715-386-4680 St Croat County Goverment Center 715-245-4250 Fax cdd0sccmkaov 1101 Carmichael Road, Hudson, W154016 myw.srocwi.00v 6STI�o22-o`�q Wisconsin 7on q_Professional Services d Page 1 of 3 Division of (� C �7 D __f •{'X44 \SOIL EVALUATION REPORT 3 1 2022 In accordance with SPS 385, Ws. Adm. Code County St. Croix Attach compleer not less than 8 112 x 11 inches in size. Plan must include, but not limited gqnt��al reference i�oint (BM), dired'an and percent slope, Parcel I.D. D2A -scale or dimen,',dhd f SGon and pistance to nearest road. Rei #2678 Ple afli Iforrnatlon. Personal information you provide may be used for secondary purposes Priv, Law, s. 15.04 1 m Rev by Date 7 2 Property Owner Matthew & Lindsay Miller Property Location Govt, Lot SE '% SE '/. S 20 T 09 N R 19 E (or) W ❑ Property Owner's Mailing Address 486 Jacobs Ln. Lot # 13 Block # Na Subd. Name or CSM# CSM Vol. 28, P 6386 . City State Zip Code Phone Number Hudson WI 54016 651 207-3399 ❑ City ❑ Village 1 ® Town Nearest Road Hudson Dorwin Rd. ❑ New Construction Use. ® Residential / Numberof bedrooms 3 Code demred design flow rate 450 GPO ❑ Replacement ❑ Public gr corrimp-rcial -describe: Parent material Glacial Outwash of r^C Flood Plan elevation 9 applicable pA ft. Z ovL. K General comments and recommendations: Site suitable for In -ground POWTS with 0.7 gpd/sq/ft. design loading rate (0.5 gpd.sq. ft. recommended). Recommended system infiltrative surface elevaton to be 90.50' & 89.50'. F 1 Boring # ❑ Boring ® Pit Ground surface elev. 93.23 ft. Depth to limiting factor>109' in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az, Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots na.awn r�aav GPD/Ft2 •Eff#1 •Eff#2 1 0-9 10yr3/2 none sit 2fgr mvfr cw 2vf,f 0.6 0.8 2 9-15 10yr4/4 none grsl 2fsbk mvfr cw 1vf,f 0.6 1.0 3 15-40 10yr4/6 none gr Is Osg ml gs 0.7 1.6 4 4 q3L 10yr4/6 none s & gr Osg ml cs 0.7 1.6 5 47-69 10yr4/6 none s Osg ml gs 0.7 1.6 6 69-109 10yr4/6 none s & gr 059 ml 0.7 1.6 2 I Boring # y� j I El Boring L� ®pit Ground surface elev. 93.92 ft. Depth to limiting factor >102" in. Horizon Depth In. Dominant Color Munsell Redox Descrption Cu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots �suo w.�uw rwav GPD/Ft= •Efl#1 •Eff#2 1 0-6 10yr3/3 none sit 2fgr mvfr cs 2fmtc 0.6 0.8 2 6-13 10yr414 none sl 2msbk mvfr cw 2fmlc 0.6 1.0 3 13-17 10yr4/4 none Is Osg ml gs lfmo 0.7 1.6 4 17-30 10yr4/6 none s Osg ml cw 1vf,f 0.7 1.6 5 30-71 1 Oyr4/4 none s & gr Osg ml gs 0.7 1.6 6 71-102 10yr5/4 none s & gr Osg ml 0.7 1.6 CST Name (Please Print) ignat CST Number James K. Thompson �-- 30021 Address ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane Osceola, 54020-5413 Ma 6, 2022 715 248-7767 �,,u aau-a�ov tnuano/ .04 E3 Boring # ❑ Boring ® Pit Ground surface elev. 95_46 ft. Depth to limiting factor >106. in. Horizon Depth In. Dominant Color Munsell Redox Description Du. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 a •ER#1 •Eff#2 1 0-9 10yr3/3 none sit 059 ni cw 2vf,fm 0.6 0.8 2 6-15 10yr4/4 none sl 1msl* mvfr cw 1fmc 0.4 0.7 3 15-46 10yr4/6 none Is 059 ml cs 1vf,fm 0.7 1.6 4 46-72 10yr416 none s & gr 0sg ml cw - 0.7 1.6 5 72-92 10yr5/4 none is & gr. 059 ml 0.7 1.6 ❑ Boring # LJ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eft#1 •Eff#2 F1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth In. Dominant Color Munsell Redox Description Ou. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 •Eff#1 •Eff#2 Effluent #1 = BOD, > 305 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 = BOD, > 30 5 220 mg/L and TSS > 30 5 150 mg/L ti Sa,le 1eAA • Exdsf�?� ��..dc • �ocaE<d p''�.3b� 7e „f�tt� ew d iC.`ndsay Gd. B. T o Mbar r►f%//si�dropt/Ey E/v✓r K27' S/B/a �COks,Cn., �a st# �. � f{kdson, �i syo/c O Lct 13, a s.y ✓o(. Is, &,3 Sexl-wevsf Sea& c.�ocd<d Bx ,Q 9� T , ofF bi4s 56.4o"yCa < blf,' y x iSa Iles dr,,o cd Jl.. . E/c% = E,r."s£•� To Scp�cE.+�t'd dry c. t U. be �9Zi1 c �� %liSCcMcd G(lc!� sliYD.QD� � ES�nt I Eed < (t✓. �t 6u:/drny Su.vc,. I ber!/b0M C Scz Cobs Zanr q. 3 MQ C.dNWtJ� C90& couNrY � � 1vo. 644754 STATE SANITARY PERMIT PREVIOUS,NO. �— OWNER m rrrtftw k M*fty MILLSK PLUMBE TOWN SECT_ AND/OR LOT EXPIRES LIC,#_22r.jq6q BLOCK SUBDIVISION CHAPTER 145.135 (2) 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. (d) 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 the county authority. ISSUING OFFICER - DATE UNLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)