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HomeMy WebLinkAbout020-1406-01-000 0 y O y m 0 r� o d* c d o (D � 0 (D A # (D CD 3 - m n N O N 0 o W 0 C W N `C �• (D 5. d N OD Q y CL N 'O �I 7 b3 O CO ( (n N C: (a i G9 O 7 7 - ' A M N W 7 (O O N N N CL 6 (� y D -I N p 0 0 C n 7 j J O o 0) a 3 0 _ D o 10 3 N W p p O D m v v a o a cn c� o o N_ W 3 p 4 a) - lot N N@ Z O N l'►r O W L { 0 N O N ( 0 0 o (/) O C O N .. cr F C - D A o n o N 3 , G CD a . �q I :: y v � m (D ID (D y W W N N C C O 7 0 CL 0 z fl • / � Zz� o 0 ._ % D D o 3 o '+ m �N O n 7 03 O 0 0 0 W N CL o c o a c = Z N CD 'i (A O 7 3 z (D CL p cn A 0 K 3 S ya Z 0 0) y d C 7 (D (n (D y C� N W 01 m C O <a a'; z 3 'o o z cn CD Z� 3 * f° CL z $ CD W a I °ohm 3 D p N (D y p_ y N N O C°m3y O a N Z N m 4t O a ) W - . D � 3 y 0 y y .r.�O V _M N N (D N O 7 N R :3 co O y 7 L M1 W a O W O twl O n r N O O y V I A O ti ( p� ti w e» O e O CD a f' Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 NViscons Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce p [Privacy Law, s. 15.04(1)(m)j (Submit completed form to county if not state owned.) Attach complete plans (to the c ounty copy o fo the system, on paper not less than 8 -1/2 x 11 in ches in size. County ,� State Sanitary ��t umber ❑ Check if revision to previous application State Plan I. D. Number (q ? 7&2J) I. Application Information - Please Print all Information Location: Property Owner Name Property Location 1/4 /vim, SI�3 > T.- R< (o roperty Owner's Mailing Address L9rNumNr Block Number City, Stat Zip Code Phone Number SbbdWision Name or CSM Number A - 4 - ". C /�� � 1�4- II. Type of Building: (check one) [I city )9'-' 3 � 1 or 2 Family Dwelling - No. of Bedrooms : ❑ Village ❑Public /Commercial (describe use):_ own of ❑ Sta -Owned 71.0 eazest Roa g{,t, « � � O � (Z )5� Parcel Tax Number(s) III. Type of Permit (Check only one box on line A. Check box on line B if applicable) A) 1. ONew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Numb _ Date Issued A Sanitary Permit was previously issued �c Y IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground Amound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5, Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks R ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name int) Plumber's Signature (no stamps): MP/MPRS No. Business Phone Number el Plumber's Address (Street, City, State, ode) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) fZApproved ❑ Owner Given Initial Adverse Surcharge Fee Determination f MOM 3 2100 X. 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Division of safely and Buildings In accordance with Comm B5, Wis. Adm. Code County Gr C K0 I Attach complete site plan on paper not less than B 112 x 11 Inches In size. Plan must Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. QZO— 133 0 _� percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Date Please print all Information. Reviewed by Personal intonnatlon you Provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) Property Owner Property Location g1,{0 5 W 1!4 N W 1!4 S 2 3 T 21 N R I 1n► AL Q property Owners Malting Address Lot # Block # Subd. Name or CSM# �' TKI t� \A/�l lJk1� Z — ��61uci2 EA1 ESr��E 5 G(y Slate Code Phone Number Q City ❑ Village $) Town Nearest Road H\ADSCw Uja; 5401b n 15 3K 1 - Zi�7 3 Nur>.50A li�lt�fLpFF 1 GO, New Construction Use:® Raskfeal !Number of bedrooms 3 Code derived design flow rate L4 ❑ Replacement ❑ Pubfic or commercial - Describe: ff Parent material Q;- ( 1 A L Flood Plain elevation it applicable General comments and recommendations: � X � 6 F, ST Gam' � o ovr y 'r Boring # ❑ i3oring '� F] tr pit Ground surface elev. _ 1t. Depth to limiting factor In. " Horizon x e Texture Structu Consistence Boundary Roots on De P th Do minent Color Redo D s u1 p do n in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. P CT T 1 +r 1 ►� S p ILA— 5 TIdN _ ►k 1 �t 1 a EM A G MOTS P-rT 2,6 O ;\)M flSS s� ST l i Boring # ❑ Boring I ❑ Pit Ground surface elev. _ —_ ft. Depth to limiting factor In. ICa11on Rate P Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfR In, Munsag Qu. Sz. Cont. Color Gr. Sx. Sh. 'Eff#1 '092 Effluent p1 = BOD > 30 220 mgrL and TSS >30 5 150 nV& ' EMuent Q ■ BOD < 30 mg1L and TSS � 30 rngA _< CST Name (Please Print) re CST Number Address l Date Evaluation Conducted Telephone Number voggl5 b `AVM . R\vEt2 FA t.-LS %.ksr sSH Z- IS I k z — � S Page Z, o£ ' Scale 1 "= 64' . � t Ckn.s' o+v _rL , toe 8' as , - �.. Loo • p` - o w� o � �Qlm" eV: Tvjo.rc}{ CL.�O� 9 LR.ldp� C'L 48 � Oa N(ST Q.criPh�T oR �. � b�.4Tsn•B 'Sl}�5' �k"� n Le v d• � ~ � C'L qy C is ea�.Slvvv �'L.gq.p' o eo'rT�l+y oF`T4ewcH � - Y_»o NoT ez �� 10 p .p• Lr1lA0� 11�p' o Zt PVC ri1N. 0wS tom, Wv "t , oKI w /s`ttez o � - - -- MQ a L C PRIVAT EWAGE SYSTEM S vo Con di ' nally APPR DIVISION OF SAFETY AND EUI S 4 ;�\ SEE CORRESPONDENCE CL � ' NOTES 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation-pipes with approved caps. ( - : E — required) 4. septic tank to be Loma 6Sb gallon capacity manufactured by 1-1 % D W em`j g P ec f r 5. Bench Marks o 6. Divert surface water around mound to prevent ponding at the uphill side. b ' d PLO2 T 869 T L SN31Honwa R w8nas0 ' 0 ' u e0b : 90 To 62 Rew r J fety sconsin Depart ,ent of Commerce y: arN PRIVATE SEWAGE SYSTEM Buildings Division Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryPerm. IX Personal information you provice may be used for secondary purposes [Privacy Law s.15.04 (1)(m)]. 33 Permit Holder's Name: �/ a/� ❑ City ❑ Sll% Town of: ate Plan I�.: u I CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: pvc- - 0 RI TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosi ng (,A) eA_<, U� } Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet 3 X5.63 Air Intake Septic 1\!m 6 as NA Dt Bottom b•Zo t2 13 � /Z Dosing -5.0 NA Header / Man. Aeration NA Dist. Pipe , $ �S • t, io 2_. Holding Bot. System 6 t3� ( / T / Z 10 PUMP/ SIPHON INFORMATION Final Grad r,,, ;ti( \ [Z_ & ^� Manufacturer Demand f v ,�•� � � c�>er 3 8�y 3• 69 tro •So' Model Number �$ �`0. GPM b � ,� 2 '10�� D �• 30 / TDH Lift F riction t S stem ; TDH' r '15Ft � 6 -i5 -e( ' r 1 L oss �}. \ H' 1 v I L z lad- 1(3b- % Forcemain Length 255 Dia. 2 Dist. To Well 't0'°� �S ��� .� SOIL ABSORPTION SYSTEM B Width f Len th No. Of Trenches PIT No. Of Pits Insi d Depth DIMENSIONS 5 s DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LE I Manufacturer: SETBACK INFORMATION Type Of CHAMBER de Number: System: `' �8� �(vD OR UNIT DISTRIBUTION SYSTEM e L Header /Manifold Distribution Pipe(s) Hole Size x Hole Spacing Vent To Air Intake Length Dia. � lf Length 3 N ia. Spacing ?j(a A 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 ❑ COMMENTS (Include code discrepancies, persons present, etc.) b� 9 �O / 10 c ` -1 i- v LOCATION: HUDSON 23.29.19.1726,SW,NW 718A WALDROFF FARM WEST SIDE) Plan revision required? ❑ Yes ❑ No `S - �p ra., Use other side for additional information. O� 1S , � IT I I I SBD -6710 (R.3/97) t>• Lu�L'S Inspector's Signature Cert. No. I r � � ADDITIONAL COMMENTS AND SKETCH , SANITARY PERMIT NUMBER: e e � € e e } S e E e -€ a f f � 9 d 3 e P i a .., ewe e _ �m k � i i � � t .... .... ...b.. ...c.... .. ..gig.,.. m e. € 4 F. 1 E 4 ee I ,. { e 3 c � t € 3 t v e ...�...� 3 � e E ...g .,ee . L e.e. e. t me 3 g € em e -.{— ........ e ..,,.... ve.. ,. ew .... �. .. sue. ....... #� .... 9 € F t ie 3 r 1 Z7 / l�riz .S Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 14sconsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce it (Submit completed form to coup if not [Privacy Law, s. 15.04(1)(m)) ( p �' state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x I 1 inches in size. County t Number . State Permit ❑ Check if revision to previous application State Plan I. D. Number y 9 (YZ+6u I. Application Information - Please Print all Information Location: Property Owner Name Property Location 2 r /t /4, S, T ���1, Iii ( (or W Property Owner's Mailing Address L m r Block Number 1 0 - Z 1 -z City, State Zip Code Phone Number S ivi ' n Name or CSM Number„ II. Type of Building: (check one) ❑ city ;EF 1 or 2 Family Dwelling -No. of Bedrooms: ❑ Village ❑Public /Commercial (describe use):_ F rown of ❑ tate -Owned c/dS c r r pQ . Sfl Nearest Road K } up-Q Parcel Tax Number(s) • III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. IELNew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Z Date Issued A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground �UMound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks 1U�7� ( ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume resp onsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's S' n ure (no stamps MP/MPRS No. Business Phone Number _ zz Plumber's Address (Street, City, State, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) (,Approved ❑ Owner Given Initial Adverse Surchar a Fee) Determination M 0 X. Conditions of Approval /Reasons for Disapproval: SBD -6398 (R. 07/00) p r n v RZ r r •o - D p D 0 0 m 2 C C- 0 m V) ZO x T v W `\' W ' S m CD CD oo cn �� ��p . c cn 9 L -I p N d('� a m m� Z q P C�b m L 70 ,. , O z n gRr m M O cn W G Ul m `1, c a y O C� O Z6 z m f`, Z �N z ° H m ° -� m v m � vcn � G� C v y 2 Z m �JZ/� N D 2 p 1 c r0 < Z 00 Z o N� ti m m U W P m ° z I D 0 D N " n m Q m x V 1 o m O O z -� m j D y m m v m Z m Z x N 0 < v' O co V II �m ° a m o _ 7 1+ D z z T :Z :E O co p D m < < O m 7DOC) O mM cn O CO A m c en -n m�, > � c c c '1t o •1 r- 7�0 m m m m 00 70 m Z D c vi vi H D m C O p D 3 Z 1 9 < r z O � ,, V r C7 m m m m D m .+ Z 0 0 0 0 c ^ p D c '0 � m' (7 y ' 1 -I { (� d y -•I m m m V v O m = Z m D N Q C Z m O z v m I m 0 c m m o9 m 1 Z H m 0 70 o c °c° W z -I a m d o #° 0 c co a m m c S m C y . � Z r � N r� 4 I � i � � U I l • 3 ti Z£5'oN'000Z'ludy j23s!2od . W � a�m;o 2N o o co N p 3 c -" v v V g c w . m t@ y tD v— D ` N!A a ll � D 40 an :° fn c- D m ° ? o n O N $ Coo�� n a r to a CD 3 lu o z rp c _ �a 1 3 �3 ° 3� .. ;u V o aC V/ -n °-= d (' l n m o Z O I o > m � v -0 ,,, �n z D y 1� o v A 3 Z a m N < m m f a X - 0 m w 0 m a Z a c M C j N D 1O co M n m 'n .c —h W m ° C M r. < � _ y 0 m d m o H m M o S �w0 C m M eo 7� m o Q OIDm © �J 3 •aSBd aplZ uo umogs jaasillall pus a;sp ggnwga 4u—n0 (a -nIoA pa;uNd aas) axay Islawoun xIpusddy Co wiuoo 931dawyg0030.LALgKLddd3Q ELI ' I ' zis'oN • 000Z •judy'iazsiAaa W 3 �3 3a C�m� � Imo Smw CD N A. to . D to ' a D ` vi a 6� � � a r � o > > TL � N rL wD Z ao , �,n0 n c rA eo�� n D o I�I`. y g cov P o m ` j m o m N 1 cr a c z B N o 0 3 z n v� m X �a a lu CL v � C -n o 6 w \ a = O c ;� �• U Z c R 3 <.. � a 3 a L 6 T 1 to N rr d a n � w �; O a a N �n� n � n C a o 01 -n a a m v o M CD o \J0 m�d m o M \ O a o 'v1 o { c > c O G �.J a o r $ b ' o 09 c a > a 3 •a3ad aglJ, uo u.Hogs la;sI3ajI pus asap gSnojq ; ;uaunj •(auinloA pa ;ul.cd aas) ;xa L lalawoun xlpueddV gg uuwoo gngglnllnl00 dO.LNHKLHdvgQ ELI Safety and Buildings Division SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue In accord with ILHR 83.05, Wis. Adm. ode P O Box 7302 Department of Commerce . Madison, WI 53707 -7302 ! Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. ,Sf O/ • See reverse side for instructions for completing this application State Saniitttaarryj- y Permit Number Personal information you provide may be used for secondary purposes ❑ check if revl�on co pre application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name Property Location O 1/4A(4) 1/4, S 3 T , N, R� ip�r) W '.. Pro erty Owner's Mailing Address Lot Number Block Number Cot , State Zip Code Phone Number Subdivision Name or CSM Number ,�� o al 4r O /�' (74r 7 6-.S" Ave, S� I. TYPE OF BUILDING: (check one) ❑ State Owned 0 �t Nearest Road t1, Public 1 or 2 Family Dwelling - No. of bedrooms ° Tow OF �/y o/sv 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 23 . I q , 1 72(A 1 [] Apartment / Condo o� /330 — ;Z 0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash S ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. LY 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 Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 M Mound 30 [] Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 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. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation �O S 9� 3 / 6 i �' 1 0 " Feet �O` Feet Cap acit y VII. TANK in gallo s Total # of Prefab. Site Fiber- Plastic Exper. INFORMATION New Existing Tanks Manufacturer's Name Concrete strutted Steel glass App. Tanks Tanks F icTank r ❑ Pum Ta amber p ® El C1 ❑ ❑ I ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (N Stamps) MP /P440NK No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): 3 dV 6:-XeI cti d L' j4t-1 l IX. COUNTY / DERARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issu Issuing Ag t 'g a ure (No Stamps) proved E] Owner Given Initial Surcharge Fee) �� I Adverse Determination ICSII� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, plumber t INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a 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_prio,r 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 and Buildings Division, 608- 266 -3151. 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 on 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 for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /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 81/2 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 a 115 form; and F) all sizing information. "' SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) fora number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. I Safety and Buildings 2226 ROSE ST ti LACROSSE WI 54603 -1905 Vi sconsin Tommy G. Thompson, Governor Philip Edw. Albert, Acting Secretary Department of Commerce October O1, 1998 CUST ID No.267341 ATTIC• Jim Thompson WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 ' RE: CONDITIONAL APPROVAL - -' �` a !a Identification Numbers APPROVAL EXPIRES: 10/01/2000 6' t9g Ls? ST Cgp� Transaction ID No. 149580 SITE: Z ON OFFK se refer ta Site ID: 161059 bothridentafication numbers, > ^� ti St Croix County, Town of Hudson , % % 1 ! v ' above, in all correspondence with the SW1 /4, NWI /4, S23, T29N, R19W a en Lot: 2, Subdivision: Eevergreen Estates Richard La Casse, Duplex FOR: Description: Mound Westerly Site Object Type: POWT System regulated Object ID No.: 427626 Description: Mound, Easterly Site Object Type: POWT System Regulated Object ID No.: 427627 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. incerely, DATE RECEIVED 09/25/1998 DENNIS R SORENSON ,WASTEWATER SPECIALIST FEE REQUIRED $ 360.00 Field Operations FEE RECEIVED $ 360.00 (608)785-9336, MONDAYS 7:OOAM- 3:45PM BALANCE DUE $ 0.00 DSORENSON @COMMERCE. STATE. WI.US I ' Page of 6 MOUND SYSTEM - \ 0000 FOR 5�Q 'L GQ Q�� • A - 3 BEDROOM RESIDENCE F SP LOCATED IN THE S W 1/4 OF THE Nw 1/4 OF SECTION 2 - 3 , T 2 6% N, R q W, TOWN OF c.�.. V COUNTY, WISCONSIN. (w�TLSRJI•�/ S 1T�� -- -- INDE% PAGE 1 'of 6 TITLE SHEET ti 2. n U z4 PAGE 2 of 6 PLOT PLAN - PAGE 3 of 6 PLAN VIEW -CROSS SECTION. "PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR L th- C-3 sE C.k-\,S Mm iv c . PREPARED BY WEGEFZEF2 E3 C3 I L . TEST I NG AND. N a{l44NlF/j DESIGN SlER`1 I CE col►s 'r',,........,, spy P.O. BOY 74 421 K. KAIN ST. ~� RIYQ? FALLS. Ul 54022 arrrHUR L 715- 42`.x-0165 w �915 R P R fuSWORTH, •M...wM IG1 IN JOB NO. - Z PLOT PLAN Page Z of 6 Scale 1 "= 60' p- BYE-E1.1oe$'oly P . - �1. 10u •p' �1� 4�1. q - 7.S 'oN ztinv� ��c o Z<< z u t V. 0 0 cowla�xt �.. L�•S 8 �. 1,uo - 6 � *mi- eaw►P o 8'Z lob 8.3y \ �' B• - - - -- / - -� 'M1s '41 h _ 9S• 1 84 �Y s ft"�vv. j_-t • q ` �DO NOT AtVPN1;[ L - '03.0 R • \ J c7X2 0�4NR.9 X113 PI StSlf� \�l0' Otr Z'` Ply c F =.Mt. gw 1- W\.3 o� La 3 o rp KQ � - - -- VC �a .a PRIVAT EWAGE SYSTEM s APP R ® DIVISION OF SAFETif AND BUILDI S \ SEE CORRESPONDENCE •o wet L oR 1 _1& U to l3 l� S a v.) 01= t}tjvS ; - LoTZ. NOTES l.-Elevations shown are existing ground elevations unless otherwise noted. g g 2. Install permanent markers at end of each lateral. ( Z required) observation pipes with approved caps. Z required) 3. Install 4 o p p pP s. P 4. Septic tank to be Lnoa 6Sb gallon capacity manufactured by t!� 5. Bench Marks SLOE f)2o VE 6. Divert surface water around mound to prevent ponding at the uphill side. f - Page Approved Synthetic Covering rysTM c 33 Distribution Pipe Medium Sand .r�H G Topsoil F Elev: }-r t. 5 p 3 b ' \ % Slope Force Main Plowed Trench of 2 " - From Pump Loyer Aggregate Undisturbed D \.p Ft. Soil E \, •oS Ft. Cross Section Of A Mound System Using F 0A Ft. I Trench For The Absorption Area G -o Ft. A S Ft. H I• S Ft. B S Ft. I � S Ft. Linear Loading Rate= �,Z GPD /LN FT 0 S Ft. Design Loading Rate = Q j GPD /SQ FT K 1Z Ft. L cl Ft. W Z8 Ft. 'C' f o Force B K Mai A W i i - oPP USLTE Distribution Trench Of Pipe Aggregate Permanent Pi pes J Observation Markers PRIVATES GE SY EM (Anc hor s securely) Con itionaelly A P P n DIVISION Of SAFETY AND OUILDINGS Mound Using I Trench For Absorption Area SEE CORRESPONDENCE Page Of Perforated Pipe Defoll 0 End View End Cop . �. ) Perforated l bps PVC Pipe �' as Install Permanent-marker at end of each lateral \ Notes Located On Bottom, Are Equally Spaced Q / \ End Cap * ti PVC Force Main Distnoution Pipe Lost Hole Should Be + Next To End Cap Distribution Pipe Layout P 3y. S Ft. PRIVATE`r X Inches Y 3b Inches c sy Hole Diameter I / S' Inch Lateral Inch(es) Manifold Inches (� Ar ;A# BUILDINGS Force Main Z Inches #of holes /pipe I :. �1usNCE Invert Elevation of Laterals \D2. Ft. b x Z_ Z8 - S Gh►� -I Place 1st hole ) 6" from tee with succeeding holes at 3 intervals. Last hole to be next to the end cap. Combination Sep.t:ic; Tank and - PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS PAGE S OF 6 - NEWT CAP WEATHER PROOF JUWCTIOAJ BOX ti`GI. VEIJ7 PIPC APPROVED LOCKING � 10 I FROM DOOR MANHOLE COVER wrM AkDOW OR FRESH wARNIWG LABEL. T KE Z co}aDu�t' K UJ A a AI s "I r q _" r lJ I M ft . X b r I M KaRA I � y�Ims�e mo PIPC PROVIDE -- IWLET AIRTIGHT SEAL sZ M v 3 APFL�S I I I W p � A I I I APPROVED JOIfJ P {�� JOI I II W /C.I. PIPEOR1t'C PKLI�.z. PI �� i Fi 1 ank construction I it c ol t IA ��comply with ALARM v 1,3.15 and 33.20 I a ot p�V1S��N CLE+ FT PUMP -� - -� OFF 01 pRRE D COIJCKETE BLOCK 3" APPRovFD RISER EXIT PERMITTED OIJLy IF TAWK MANUFACTURER HAS SUCH APPROVAL gEDp SEPTIC f SPECIFICAT - 10KJS 005E _A. bWt�� p>>��S WUMBER OF DOSES: PE T Z' 9 L J R DAy TAIJK MANUFACTURER: ` TAWK :,IZE IOVO bSO GALLOWS DOSE VOLUME t ALARM MANUFACTURER: S S. - l'tlZO &"S`I�1S IAICLIIDIAJG BACK /LOW: ZO G ALLOWS MODEL WUMBER: l NW CAPACITIES: A_ INCHES OR 3B(, &ALLOWS SWITCH TYPE: �Llkmoluy� B= IUCHWOR GA LLOWS PUMP MAWUFACTURCK' - C:*'i\ -bS C- 1Z INCHES OR ZO y GALLOWS MODEL NUMBER: 3 61) ei;�,O S D- �' INCHES OR �OZ GALLOWS SWITCH TYPE: NOTE: PUMP AMD ALARM RC TO _E MINIMUM DISCHARGE RATE �'P''b GPM INSTALLED OW 5EP&RATE CIRCUITS VERTICAL DIFFERENCE DETWCEN PUMP OFF AIJO..DI5TRIBLITIOW PIPE.. 1'4-So FEET + MINIMUM METWORK SUPPLY PRESSURE . . .. .. 2.50 FEET + 3l� FEET O F FORCE MAIN X �—F�orr.FRICTIOU FACTOR_. �9 FEET TOTAL 09UAMIC HEAD = '21.99 FEET Pump chamber DIAMETER 3 8 IIJTERGJAL. DIMLWSIOKI� OF TAWK: LENGTH _ ; WIDTH "' ;LIQUID DEPTH BOTTOM AREA 231= GAL /INCH AS PER MANUFACTURER - 17_0 GAL /INCH Goulds (:)or-: b • Submersible Effluent Pump r 3871 EPO4 EP05 u "J* APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Mot ousing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for ient heat transfer, following uses: • Capable of running lubrication and efficient gth, and durability. • Effluent systems dry without damage to heat transfer. Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor. Available for automatic an and float switch attachment •Farms • EPO4 Single phase: 0.4 HP, manual operation. Auto c • Heavy duty sump g P 1550 models include Mech al Points. 5 or 230 V, 60 Hz, Float Switch assem and uty •Water transfer ■ Power Cable: Severe d • Dewatering R built in overload with preset at the fact rated oil and water resistant auto c reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Si phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 1550 RPM, construction. Pump: EPO4 built in ovedo with ■ EPO41 eller: Thermo- • Solids handling capability: automatic reset. plastic mi -open design 3 /4" maximum. • Power cord: 10 foo with mp out vanes for AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 TO m anical seal protection. • Total heads: up to 24 feet. with three prong group p SP• Canadian Standards Association • Discharge size: NPT. plug. Optional 20 foot P05 Impeller: Thermo - g ed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with lastic enclosed design for n "F' or "AC".) rotary/ceramic- stationary, three prong grounding plu proved performance. BUNA -N elastomers. (standard on EP05). ■ ing and Base: Ru d • Temperature: ther astic design pr 104 °F (40 °C) continuous superior ngth a 140 °F (60 °C) intermittent. corrosion r ' n • Fasteners: 300 series METERS FEET ni • stainless steel. 10 • Capable of running dry without damage to s components. Pump: EP05 8 • Solids handling capability: c 2s 3 /4" maximum. W. • zt.g9 Capacities: up to 60 GPM. 6 20 • Total heads: up to 31 feet. — • Discharge size: I1/2 "NPT. 5 • Mechanical seal: carbon- 15 rotary/ceramic - stationary, _j 4 BUNA -N elastomers. o. Temperature: 3 oky 104oF (40oC) continuous 140 °F (60 °C) intermittent. 5 1 OL 0 10 20 30 40 50 GP 0 2 4 6 8 10 12 CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 w •J r r AM It f A d . I De� p oknen! � ck'd'"�'• SOIL AND SITE EVALUATION / 3 ILabor and Division of Be" and &lldings in accordance wkh s. ILM 83.09 ft. Attach compleN sMs plan on paper not less then 6 tl2 x 1 I Inches M she. PMn must Courtly 5T G�O� x Mdude, bill W imlled fix ve&W and hahontal reference poMt IBM). dked m and percent slope. scale at dmensbne. north arrow, and bcdon end distance to nearest road. Parcel I.O. p e"01$3 APPLICANT INFORMATIO lion. Rsvlewsd by Dole rereonel InfonnNlan you rosy be used for secondary lmn al (MAW few; 11mD• Properly owner 1.Cr- roperry Location O vm /0V Govt. Lot Cpj 114 /vW 1/1,8 23 T 2 9 ,N;R / / E040 property Owner's Address F-jS K RIM– . ot / a a 1 337- N I NNCdvr + 5r • K Z �l/ERCr.P�e'•V �STif TES Gty state Zip Code Phone Humber Nearest Road !r! j! ,2 ST PAUL_ MIMA l;SIoI (G1zlttt Town Nsw Construction Use: Residential / Number of bedrooms 3– q Addition b exislkq bt"vg ❑ Replacement NSd – ❑Publo or comnrerdal • 0eaalbs. Code dedved daily low (O 0 0 gpd Reconenended design be ft rate Z bed, gpolt .*3T- Meech ppd* Absorption mea mpoired SOO Med.11 -50 Men h, n s Maxim" design badrq rate bed, ppdnF — Meech, gpanls neconenended tninrason surface elevations) SEE Pf 3 n (as referred b ene plan bendenark) Additional dsslgrJalle allone T ES % 4rF-1 -t°E4 uiA�—=s &SE 0 1' MOLD s y-TTe: —' 1 .7 Y/As J Peranmmmw S Gf 8 - �' / /oT - S4t -rjF - /o -r-ys • N �- s plate elevation. WOW* 3 = SutiaMe for system Conventi "round Press T System Fill T onk u ()ns @me for system CI s [3 s❑ u us Q'u O s C•Y�i [Is SOIL DESCRIPTION REPORT Boring p Horizon Depth IN dnant Color Motile! Texture Structure Consistence Bound" Pools geW Mr munsell Oil. St. Con. Cobr Or. Sc Sh. Bed . Trend /0 yR3 /L s /[, zfS&- .m7w cs z l/ 33 /eY 3 /t/ — SiL fS& ,rte {.2 as / S • G � 3 'Y to 1 U Depth to Imlling fa • > 1 T- -g—in. Remarks: Boring ! C5 /7 2- - /0 Y 3/ S/L Z s ,C .$"7* Ground Z -5 1 /1 0 M D"M to Wnftq s G ., �� sG /cL p .Z �•3 ` W G factor r (3i—M. Remarks: CST Name (Please pf" Signature T No. • ROBERT 2(L(32 dA 7/.� Address .e O'eis CST Number Associat es private sewage Sewage Consultants tt++r .r 6550'Nall Rd. \Eu v a Hudson. Wis. 51016 ST CR ~ 1 COUNTY f i ZONINGOFFICE Wls-�osisin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page / of 3 Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and l J 77 r-RaI x percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. APPLICANT INFORMATION - Please print all Information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (mp. Property Owner Property Location `/ 4 `41VP 49611 . Govt. Lot SW 114 1/4,S z T 2 9 ,N „ R / E (or)(0 Property Owner's Mailing Address 67.4S Lot A Blockil Subd. Name or CSMff �ho U- . z �vER��PEC;v �sr• 7 33 Z N � NN�sorh- Sr , , City 1� State Zip Code Phone Number Nearest Road //IV/! /2 9 ' I AU L NfN� 5 510 1 (612-) ZZ - 5795-5 ❑ _GiV ❑ Town clM� k�� y R, . New Construction Use: Residential / Number of bedrooms 3 - Addition to existing building ❑ Replacement ySv ❑ Public or commercial - Describe: - Code derived dally flow & 0 0 gpd Recommended design loading rate Z bed, gpd/fl 3 trench, gpd/f1 Absorption area required 50 bed, ft2 Se - trench, It Maximum design loading rate � bed, gpd/fl ' trench, gpd/t Recommended Infiltration surface elevation(s) SEE / D Y ' 3 It (as referred to site plan benchmark) T Additional design /site conekkkrations rf-5 4EK 54!5 G/�t- /-?Id GAUP S YS 71 y /J Parent material 515,5 8 ” P /'��0 T 5 A7_ 45_ 10 Flood plain elevation, if applicable S = Suitable for system Convenrtiion�al , M_ouu In- Ground Press re AT- Grad System in Fill Holding Tank U = Unsuitable for system ❑ S I� U L�J S ❑ U ❑ S L (U El S Ly'U ❑ S [ ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Consistence Boundary Structure Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Bed ,Trench 0 -// ioYtf z f She A,YW 33 lb Yle 31 -- S/� p fS`J& Ground 3 - c/ /O yve LS 17 C�S GGtJ 5 ; elev. ioi. Ott. /O f'� ��,,,e - Depth to limiting factor > I� , In. ; Remarks: Boring# /0Y14e 3/ SQL W 1'5e c5 / 7`' . 5 2- - ,/0 yX z 56.e u , 755e 2 s Ground / L S W S a S s . Co elev 1 00 .�o ti. S -� / S / wig �8� 16 YA 5 SIC e-'- Depth to C. limiting C, factor M -In. Remarks: CST Name (Please Print) Signature Telephone No. TZOP,ERT ?,4L6121 CAT Address Date CST Number Asso ciates A/ 1/. �� / �flv CST Z- Z Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 rU1a C , l I V L M PROPERTY OWNER SOIL DESCRIPTION REPORT ' Page of " r PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure VD/ft In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots 3 Bed ; Trench lI /o yk �Z SQL A""I' k ��,, f eS /� . z , . 3 z - zo of . z • 3 Ground C L / �� Depth to / // Ce limiting S 3 _4 �o S! factor _ /00 V2— ' $SS Remarks: Boring # Ground elev. n. Depth to limiting factor In. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots G D In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Boring # Ground ft. , Depth to limiting factor i "' Remarks: Boring # Ground elev. ft. ' Depth to limiting factor I" ' Remarks: SBOW -8330 (R. 08/95) M J I J r tve T' 4 o % oiz a l� . N o� C N a r �l1 P `I r • 4 Vi � � w 'A p U3 o IA rn Y � c C C rn Q o - N � o W ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ownerffinybr 17 4( a e Mailing Address Ve 11,4 Af M y v Property Address (Verification required from Planning Department for new construction) Cit3atate /(41 cx ,o K lam,` 5t oli Pa=IIdentificationNumber y .2- D -/ -72© --moo LEGAL DESCRIPTION Property Location -'i' Y4 N4/ y,, Sec, ,3 , T�N R. Zf W, Town of 114 a�5 Subdivision Certified Survey Map # Volume Page # vW Warranty Deed # Volume 3/ - Page # J cg / Spec House .0 yes 0 no Lot lines identifiable_ 0 yes ❑..no �MAINTLNANCE - ofY sys kuooddresaltmitspr +emadu+�fa�=tohandlewast=ptq ermaim6eaanx consists of Pua4 ag cat the septic tank cvmY three Y = or sooty if ucoded by x Yiceased What yon pat.in to 8r+e_ system can affect the - function of the septic tok htatment sup m the vaswT= po The PrqP=Y owner agrees to submit to SL Crobc Zoning Department s calif cation form. signed by the •owner and by a P ]O=x7=p mnder.restdctedpb =baoraliceesedpampervet{f *$rat(1) the on-site is in PmPer operating condition. and/or (2) after inspection and rf .0 ), the septictank-is less tbaa IS #alI of stodge. Ywc. the mod haveaoad the above requitements and agcy to maintain the private sewage disposal system with die standards set fotSi, herein, 'as set by the of Cann== and the Depattneat of Piataral Resoarces.�State of Wisoonsin.. 0a4cation that YOur SePtic system has ban mainbdnod mast be completed and reduned to the SL Croix County Zoning Office within 30 days. of the throe year expiration data, SIGNATURE OF APPLICANT DATE OWNER• CERTIIrICATION I (we) certify that all statements on this form are trne to the best of my (our) knowledge, I (we) am (are) the ownet(s) of the Property described above. b Vitt= of a warranty deed rocordod in Register of Deeds Office. SIGNATURE OF APPLICANT DATE « « « « «« Any information that is mis-represeatod may result in the ssnituy permit being mvolmd by the Zoning Department «««« «« «« Include with this application: a stamped warranty deed from the Register of Deeds orrice a copy of the certified survey map if mfcrence is made in the warranty deed STATE BAR OF WISCONSIN FORM 2 — 1982 604�C]S WARRANTY DEED KATHLEEN H. WALSH kEGISTER OF DEEDS ST. CROIX CO., WI DOCUMENT NO. RECEIVED FOR RECORD LaCasse Custom Homes, Inc., a Wisconsin 06 -04 -1999 9:30 AM corporation, WARRANTY DEED EXEMPT 0 CERT COPY FEE: COPY FEE: conveys and warrants to Bruce J Moll and Joann L. Moll, TRANSFER FEE: 168.00 'hu sband and wife, RECORDING FEE: 10.00 PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in County, The First National Bank of Hudson State of Wisconsin: 915 Davis St. P.O. Box 28 Hammond, WI. 54015 020- 1330 -20 PARCEL IDENTIFICATION NUMBER Lot 2, Evergreen Estates in the Town of Hudson, St. Croix County, Wisconsin. This is not homestead property. XJNX (is not) Exception to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of May , A.D., 19 99 Home Inc (SEAL) By � , e M (SEAL ) III * * Richard W. LaCass , President (SEAL) (SEAL) * AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, St. Croix ss. County. authenticated this day of 19 Personally came before me this day of May 19 99 the above named LaCasse Custom Homes, Inc., by * Richard W. LaCasse, President, TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Scats.) to me known to be the person • � 'cc tt4 �ing • �.•• �� instrum nt and ack wled a the s rQe. THIS INSTRUMENT WAS DRAFTED BY N Y LE Attorney Kristina Oaland h • • Public '• Cou � natures may WI 54016 Nota P Hud , Notar � •. �� � (Si be authenticated or acknowled ed. Both are not My commission is permanent. (If 'ijp�,q�c 2ta.exptt'�t` �0ate: necessary.) Y g — o'l •�� +�n � • Names of persons signing in any capacity should be typed or printed below their signatures. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. WARRANTY DEED Form No. 2 — 1982 Milwaukee. Wis. 1 . . /4 OF SECTION 23 - NOO 0 04'51 "E, 2655.76' . I N00 04' 51 "E m v o L- m , 11 MAP m x . M c o) 0 11 z z N A o jz ' PG. 3234 `•° D 1 w ° I< 1--A -- - - -- r o 10 Z - - i m � � j0 I � i0 W LOT I �(n 1--i OD �? � G� K � N N IM 71.53' 6 1 IO�o j� S00 "W 457.12' I 240.00' 160.00' 57.12' — 400.00' — r 100 NORFLExo DRIVE O -� F (,A L wm / 9� ®W 4 ` Q w I *1 O 1. rn 4N -� O N �_ y N D a co \ w n to x r -� z m I. I fT1 n a \ 4 1 o m` m 0 w o IZ 1 `� N U 0 \ � K \ m 1p 1 " r ' I CD - o Fri Vu it a 10 Rn I0 a \� O IC \\ \� I 1p6•g6£ _ IG7 1< W CD CD \ \ b5 °6 m Im , IN 1 < M Cr �> .° CD \ 0 . V, O\ loo' CD xv I �Z Z A ' rz O w" p cn w R wNWo y �'> m N wDmD Z m 0 N N n n r 3 s a ' � O z Ot . O� D N ` Z z o co . t0 - W - to ry ° ° w N N N - o D I o ro N M m C) r O O O � S05 0 48' 11 x I � 377.68 , - OD a co , u c i w I w l Z o � I In l HE M HEAD CAPACITY CURVE EFFLUENT ENO I \ ■ ■ ■ ■I�mmmm ®�0 ®m�m�m ®m • � ®��m��m�� ®� ■\ ■ ■ ■I�ommmmm ®gym ®mmm ®m�� ®��m� ®� ® ®�� ■\ ■ ■ ■I ®m�m�m�m�m�omm ®mmm ®�� ®��o� ®� ® ® ®� \■\ ■ ■I��mm�� ■ ■ ■ ■� ■ .ii ®mmm ® ®m�m�m ®® ■ ■ ■ ■10 ®m�m�m�m�m������� ®moo ® ®�m�m� ®� \`■\Nr ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ■ \I \\ ■■■■■■■■■■■ \�� ■1� \ \ ■ ■ ■ ■ ■ ■ ■ ■ ■■ l"q \\\1111\\\■■■■■■■■ less than 30 feet TDH. i .. .. pump, .. Industrial NEV ■I■ \\xm■ ■ ■ ■ ■■ column-explo .. 11631 Vsk \��I \`1111 \ ■ ■ \\ \NOON■■ ■�i \I1�11■ \ ■� \NOON■ Mooing 1►\!\\ \■■ \NOON■ ��I ■11► I\ ■� ■\ \NOON n � "�� \I1� \NOON ■\ \NOON Ni \:!111► °I1 \\■■■■\■■■ V�mol1` ■E ■ ■ ■ ■ ■ ■ ■■ M HEAD CAPACITY CURVE SEWAGE E ■ ■O ■O ■ ■■ ■EMMMM 1111FEER1■ee . ■NNENNNNNEim� ®oomomo� ©mmm® ®mop ®ammo B- 8■N01 ■N ■ ■� ®� = == ©mmm ®000m ® ®o ONE ■■►G ■■� = = = =mo mom ®® 1 o� ■ ■ ■ ■� ■ ■ ■ ■ ■ ■ ■ ■ ■■� ° mm m 1011 Model 293/4293 should not be subjected to less than ,_� \ \�� \ ■ ■���■ ■NONE■ 15 feet TDH. ..4 MKIN NONE MEN ■ ■■■ ■ = ■ ■OMEN M■ FROM MOLLS UTILITY SERVICES LLC FAX NO. 7157965695 Jan. 12 2001 10:18RM P2 - w wkae-inDswtnw SOIL AND SITE EVALUATION R&ORT U � l� sad rw�nsr AoAm�r� oiwwm of in anwed walla. ILAR 83105. VA*. AdM COW AbsA w,aw4&te aft plan bee paper cops leas thm 01? ze v t7 i"tW in si'PJan muds imh de, bL! St.. C6r'OiX na wises so vat wO Itedr r%W retemme poirit (8*,, dkod on 410 % 0 dbve. **W W PA>�"bL damsio . nonh wmw. am to calb a n m ess Amb m Abafte Mack 020�1390�2D wd APPLICANT INFORIRATIbN PLEASE PRINT ALL IMPORHATIOW GI►TE MAIN PAOPpA?Y' IOcATIQIq �_.__ J RiAIN LaO s W, e,Or gy 14 W WA 23 7 29 AJI 19 AW) YO . P�Y t� L7]� ADD%W LOT #s BLOCK; �JBD. 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