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HomeMy WebLinkAbout018-2019-47-000Wisconsin 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. 5 15.04 (1)(m)) Permit Holders Name City Village Township C&J Builders Inc Jeff Husby TOWN OF HAMMOND TANK INFORMATION 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 A Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA BM IDt Inlet St Cover es- thgs— BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No Of Pits Ins,da Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO PIL JBLDG WELL LAKE1STREAM LEACHING Manufacturer: INFORMATION Type Of System. A�wTl��l�• ITIA�• A�iw UNIT Model Number: Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipets) Length Dia Length Dia Spacing Dep Depth Over Depth Over xx Depth of u Seeded;Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil _ Yes No Yes No %-,UrA1dItP11 S: (Include code discrepencies, persons present. etc.) Location: 742 161ST ST 1.) Alt BM Description = 2.) Bldg sewer length = • amount of cover = Plan revision Required? r, Yes No i Use other side for additional information. SBD-6710 (R,3/97) Date Inspection #1: in-pctoYa Signature Inspection #2� Cart No %-,UrA1dItP11 S: (Include code discrepencies, persons present. etc.) Location: 742 161ST ST 1.) Alt BM Description = 2.) Bldg sewer length = • amount of cover = Plan revision Required? r, Yes No i Use other side for additional information. SBD-6710 (R,3/97) Date Inspection #1: in-pctoYa Signature Inspection #2� Cart No 4N- 2o22— 3& 1 �' `.. ECE0 V `z0 s Divisio 'z0 St Croix Sane tary Permit Number (to be filled in by Co.) ` �_ Itl W. fi on Ave., P.O. Box 162 i '= SEP Madison,177-7162 1 !!// -.�'t w �I ti1. e ransaclion Number In accordance with SPS 3 u. mission of this form o the appropriate go ental unit is required prior to obtaining a sanitary permit. Note: Application forms for tateowned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information y u provide may be used for secondary purposes in accordance with the Privacy Law, s. 15. I m Stats. 742 161 st St. Hammond 1. Application Information - Please Print All Information 0-1�, A N Property Owner's Name _ /� Parcel k 1/!� y C&J Builders Inc. Jeff Husby ` 018-2019-47-000 Property Owner's Mailing Address Property Location 316 Kamloops Place Govt. W __ �LJ� y�%, sectiorn City, State Zip Code Phone Number River Falls, Wi. 154022 715-222-9731 r ?ircle one) T�N; R EorW II. Type of Building (check all that apply) Lot q i I or 2 Family Dwelling - Number of Bedrooms 3 47 Subdivision Name Rolling Hills Farm Block ❑ Public/Commercial -Describe Use ❑ City of ❑ State Owned - Describe Use ❑ Village of CSM Number —� X Town of Hammond III. Type of Permit: (Cheek only one box on line A. Complete line B if applicable) A. Q New S stem y ❑ Replacement System ❑ TreatmentMolding Tank Replacement Only El Other Modification to Existing System (explain) B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration carer 615461 6/9/2020 14 Or„ti IV. Type of POW7'S S stem/Com ent/Device: Check all that a ❑ Non -Pressurized In -Ground ❑ Preswrized In -Ground ❑ At -Grade Mound > 24 in. of suitable soil ❑ Mound < 24 t e soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (expl ') Hoot 600 V. Dispeirselfirreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation Existing VI. Tank Info Capacity in Gallons Total Gallons q of Units Manufacturer `� U in g a Nese Trdu Existing Tacks rn u. t7 tepee m Hddmg Tank 400/921 Wieser/ Hoot x Dosing Qr.nber VII. Responsibility Statement- 1, the aadeniped, assame respos ' 'lity WAstonation of WT5 abown me the attached plash. Plumber's Name (Print) Plum S;pat MP/MPRS Number Business Phone Number Keith Knudtson 64t3443 - 1737 Plumber's Address (Street. City, State, Zip Code) 927 150th. Street Roberts,Wi. 54023 VIII. Cons /De srtment Use 0nIV Approved ❑ Di ved Permit Fee D(e Iss n gent Signature 1 ❑ yen for Denial f /'� V r J� Z ZU IX. Conditioes o p cos foFDiYPProval 3 ,� �� 46r5 j rove S� n SYSTEM OWNER: /- 1. Septic tank, effluent filter and dispersal cell ?`U� Z must be serviced / maintained as per r.� ot� e 5D 111a11GaCl n lei n Niai 1 Nrawmpneiiii nazi moan n one a.oaoq any eo paper gar rep pm a in a I] neap n are 2. All setback requirements must be maintained ® ssn 6jaii .�iR�iii�ble code I ordinances. s 14rer�-fkt ----- IST91 13 3 1 o IWf1116 3�!!� yc .23' �O O`&J•t rv%� �QJ( �p4 k eGO. ��o%'.e%�e L e f- N*#*rr•o2/ flp4 Lam g Ili'J,4s Fewol 7y,2 r sT,,&�t �ar r[le yea rtT' i.�i [ 01$- 04>Ip._ rGt << /..^ Xo. ,,,Cop Project Name: Owners Name: Owners Address: Legal Description: Township. County: CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE C&J Builders ATU Jeff Husby 361 Kamloops Place River Falls, Wi. 54022 Hammond St.Croix Subdivision Name: Rolling Hills Farm Lot Number. 47 Parcel ID Number. 018-2019-47-000 Designer/Plumber. Date: Page 1 Index and tide Page 2 Plot Plan Page 3 System Sizing & Cross -Section Page 4 Fitter 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 09/29/2022 Phone Number (651) 470-1737 Signature Designed pursuant to the In -Ground Soil Absorption Component Manuel for POWTS Version 2.0 SBD-10705-P (N.01f01). Page 1 Av'z ICYD / ilp-pppr r7i.'�i P(�.,7 yvy Gr17 4- 07 Lid �pv -I^r420 0,14 Eo�E �T M'"S° T R E E T 1615 JJ NTY SANITARY SYSTEM FOffice ile use only OWNERSHIP/ADDRESS FORM �;wwr 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 well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. owner/Buyer Mailing Addn OWNER/BUYER INFORMATION G+ S 6u l l d x-s , z rw, 1(v Jt�iZ KP#ALoo City/State/Zip ' ' • Pho N ben 7 ne um (n�urred) -1 l 3 I Email Address (required) J 6y �T" Parcel Identification Number (found on the property tax bim NEW SYSTEM: LEGAL DESCRIPTION Property Location _'/+, _'/, , Sec. T __N RW. Town of hzot-A fir_*_X1 - L Lot It Subdivision Plat: d Ivey Map # Volume Page # Warranty Deed # (before 2006)Volume _ _ Page #_ Number of bedrooms 3 Spec house Kyes O no Lot lines identifiable OE yes O no E ONLY New Prc Address Z (V"*fi Ww of new address r tamed kom Community Department for fWw construction) t© ZqZZ (oes) This form must be submitted with all Private Onsite Water Treatment 5ystem (POWTS) applications New Systwm tndude with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is mode in the wonanty deed. Community Development Department - Land Llse Division 715-386-4680 St Croix County Government Center 715 245 4250 Fax rdd®sccwi.(i 1101 Carmichael Road, Hudson, WI 5Q16 wwMscovi oov Contractor Guidelines for ATU Septic Homes The septic system far this home will depend on the Proper f mctianmg of the Acobw Treatment Unit (A1% which is designed to treat and degrade solids Prior to disclarge into the shared septic system. As wider, Please observe the following construe.tion 90�. As partof design and eonstrrcRon, arrange for water from sump Pins too go to an edanal d>�ge. Backwash from water softens should also be discharged externally + as doing so will extend the life of the septic system. Mote: Regulations prohibit fbmace condcnsxtc from being discharged adcnally. • Garbaw disposals am recommended. Avoid allowing any mud OO°stuebon maim such asp rubber opricue c and tatxins rags, ckrtb and towels to enter the system. Lalcewise, prevent construction such as paint and paint dMMcM solvents, etc., from entering the systfm. Contact Knodtson Plumbing and Contracting prior to sttmg house grade in order to cmfrm that • adequate fall will exist to allow ggavity flow between the house, the ATU and the shared septic line (which may be as shallow as 42 inches). Incorrect siting may require an additional pumping station and met r sign' high costs• The ATU Manufacdurer does not recommend took mAWxtjan in fimm ground, and it will be done only at the contractodbuilder's request and risk. Instillation under these eCRddMS Wdl likely also incur added costs related to requirements such as scow removal, frost nPPmg, etc. • F w Water from furnace condea>saae lines or other ' ludimt s_in_ks� apt_ iM the s_v = during winrta coon can c lw OK tank atud Q9O>S 14 fi,�5zc and &L as tb= is no bacterial action at this stage tome heat. Use a ash sump to liana this wilier prior to enU=g drain lints. Contact Knudson Plumbing and Contracting for a description. Buikkm Who to observe this precaution may be liable for system repair and/or replacement due to fiu,>dng. Whtmever possible, keep udcr of water lines turned off during winter until the time of occupancy. • Tanks must be Pumped prior to homeowner oearpanq- For questions regarding these construction gaadch"es, call: KmOtson Plumbing and Contracting 651-47a1737 I have reviewed and understand the above guidelines: Rolling Hills Lot # Private On -Site Waste Tmatrttettt System (POWTS) Insp C"M The awrect operation of the equipment noted below significantly influences the life of the wastewater �eeerrnr*ent periodic inspections wUl help extend the fife of the system and prevent the need for costly repai m The hours, to authorizes access to your POWTS equipment by a trained and authorized technician, during dsYIW � provide regular inspections and routine maintenance to help assure the equipment is working ProQer - R is hereby agreed by and between Purchaser and Knudtson Plumbing and Contracting that in consideration of the payments provided for herein, Knudtson Plumbing and Contracting wW provide below. the services of a factory�raared representative to perform periodic inspections of the equooent described below. f the report Plumbing and Contracting will prepare a written report after each inspection and provide a copy of the report at the Purchaser. This report will contain recommendations for any operation and ma'tnterhanax deemed appropriate by the inspector. responsibilities of This agreement does not assume any responsibilities for obligations that are normally the endatinsmade under purdtaser and does not e�itend to cover any costs that may be associate with any recommendations Plumbing and Contracting be responsible for any special or this agreement. In no event shall Kr>tadtson or r tx incidental consequential damages, including but not limited to loss of time, inlury to person Plumbing and Contracting economic loss due to equipment failure or for any other reason whatsoever• may supply additional services, parts or labor only after authorization by Purcagreementrs, beginning 2020,and will This agreement shall remain In force for a period of _1 Yea with at least � days written renew each year thereafter for one year unless canceled by eitlw Party notice. This agreement may be canceled by the Purchaser only if replaced by a service agreement with an authorized service provider for the equipment listed below. Knudtson Plumbing and Contracting may delay or cancel future inspections if payment becomes at least 15 days Past due. Periodic Inspections: Association agrees to pay Knudtson Plumbing and Contracting $_200.00 per each houses annual Inspection. Any additional testing or services required will be bilked on time and material amounts. - D esciPtiOn ATLrs Hoot or Micro -Fast dpnMlnt Covered Under This Agreement — Model NO. 52" Mp. Install Date Location N dWenytt from system owner Knudtson Plumbing and Contracting 927 150* St-, Roberts, WI 54023 651-470-1737 SyStefil f _ --- Signature: {toping Hills Homeowners Association Inc. Street city, state & ZIP Fax: Efttiil. Date: Ho T www.hootsystems.com January 1, 2022 RE: Service Provider/Installer Certification Wisconsin Hoot Systems Hoot Systems, LLC (Service Provider/Installer) Keith Knudtson 927150t^ Street Roberts, WI 54023 This letter is to serve as your official certification as a "Hoot Certified Service Provider/Installer" for its Advanced Treatment Units. Keith Knudtson has been listed as an approved service provider/Installer on our listing for the state of Wisconsin. They have successfully completed onsite training on multiple sites and engaged in trouble shooting methods and solutions. Service Technicians have been trained to service and inspect the functionality of our products along with proper installation guidelines. As a "Hoot Service Provider/Installer" we have agreed to continually educate Keith Knudtson on all aspects of our product line. Respectfully Submitted, R Aaron Yonts Regional Manager Hoot Systems, LLC. o+ A t 4" CAS . rANKa AP2E MAr `1 j NEW eoo GPo oRA�oe H-600 A' TANK SPECIFICATIONS 4' CAS DIIAENSONS: WALL: r BOTIM 3' WANHOLEI 124 & 24• I.D. PLMMC RISER HEIGHT; 700 O.D. POLYLOK 12" ACCESS LID (TYP) LENOTH 106' D.D. WIDTK 74 1/2' O.D. BELOW INLET. 57' O.D. LIQUID LEVELI a1' WE10HT. 11,135 LB& " SET RISER (TYP) INLET A ID OUrA"n 4 CAST -A -SEAT. (CAS) BOOT OR EQUAL COVER: MIX DESION f ((NO FIBR/R�) TANKi MIX DEMON CUSTOWED TANft FOR CUSTOW%TANKS OONTAOT VAESER CONCRETE Ise d DRAWINGS SUBMITTED FOR APPROVAL APPROVED 6Y SHEEr APPROVAL OAT[: PRODUCTS N[mlBY[ Ha 'T hOW A HadDWtlEias _ is T S H-Series Gravity Treatment System Green Choice Applications: Single and Multi -Family Dwellings, light commercial, Churches, and other similar Residential strength uses. Performance: 98% Reduction CBODs 99% Reduction TSS 99% Conversion of Ammonia (NH3) Feca! <1,000 w!o disinfedio^ Range of Sizes: 500, 600,750 & 1000 GPD High pwfonmenice, low cost~ enwW effklent trea/awent system The H-Series Gravity Treatment System provides high performance at a price comparable to most entry level ATU's. Producing effluent of less than 3 mg/L on CBODs and 2 mg/L on TSS, it far exceeds the secondary standards of 25 mg/L on CBODs and 30 mg/L on TSS. Wrth these results, many locations allow reductions in disposal areas between 2S and 40%. Because the H-Series completely transforms ammonia Into nitrate, it is best suited for applications with rich organic soil content, surface plant growth and depth to groundwater to prevent nitrogen pollution of the water table. Simple installadom reliable perforiioance, low cost of ownership This level of performance is enhanced by Its simple installation, energy efficient performance and low cost long term maintenance and ownership. The systems components are assembled at controlled manufacturing fadildes, rather than in the field, to ensure reliable performance with local support Made of locally available and manufactured concrete, the H-Series features an energy efficient linear compressor that uses less power than an average light bulb. Its polyethylene clarifier hopper is made of recycled milk jugs. Choose Hoot, and you make a sensible, decision to protect the environment as you protect our most precious resource, our water Drainfield and Vertical Separation Reductions With gravity flow discharge, the H-Series allows you to dmoose your disposal application from conventional lateral lines, leeching chambers, other alternative drainfield materials. In some areas direct discharge Is an option as well. Reductions of vertical separations to groundwater and impermeable layers such as rock range from 1 to 2 feet Make the green choice for wastewater treatment Your wastewater system is the most expensive and important appliance you will ever purchase. Don't settle for just any system. Protect your family and the environment with a Hoot H-Series System. Wieser Conerebe Products Inc. 1,800-325-6456 vwvw.wies Homeowner Guidelines for homes equipped with Aerobic Treatment Units The septic system for your home depends on the proper functioning of the Aerobic Treatment Unit (ATU), which is designed to treat and degrade solids prior to discharge into the shared septic system. To avoid breakdowns and costly repairs, please observe the following guidelines: • Avoid allowing any inert materials such as plastic, rubber, scouring pads, dental floss, cigarette filters, bandages, hair, mop strings, lint, rags, cloth and towels to enter the system. These materials can build up in the tank, resulting in system malfunction, clogging and premature pump failure. • Do not flush or drain chemicals and toxins into the system, as they kill the microbes necessary for treatment. These include paint and paint thinners, solvents, drain cleaners, automotive fluids, fuels, pesticides, herbicides, fertilizers, metals, disinfectants and sanitizers. • Paper products including disposable diapers, paper towels, baby wipes, facial tissues and moist toilet paper are not designed to dissolve in your on -site treatment systems. Neither will excessive amounts of toilet tissue decompose. • Limit garbage disposal use to food waste that cannot be scooped and thrown in the trash. Do not put animal fats and bones, grease, coffee grounds, citrus and melon rinds, corn cobs, egg shells, etc. down the sink. Also avoid putting spoiled dairy products and yeasts from baking into the system. • Do not put medicinal materials, automatic disinfection tablets and similar items into the system. Also, septic tank additives generally do more harm than good. • If possible, spread laundry practices out over several days, rather than one "wash day," so the ATU can more efficiently process the water as it enters the system. Liquid detergents are recommended over powder, fabric softener sheets are preferred over liquid softeners. Use bleach sparingly, at half the recommended rate. • Clear water waste from dehumidifiers, HVAC units, gutters, whole house treatment systems and sump pumps can increase the flow to both your on -site system and the shared system, leading to shorter life. Both clear water and backwash from water softener regeneration should be discharged to an alternate outlet. Talk to your contractor. Do not disconnect power from the unit! Your ATU is equipped with an alarm that will notify you of a malfunction. If the alarm does sound, for diagnostics, service and repair call: Knudtson Plumbing and Contracting 651470-1737 Pqp2QPZ jsa�. i dW AbtW 29li �MQ '1 � � 1)e ip�l � bEiif� n�+hai�stwsrara baonm�e ss�ilh _i. $P$ �i�'��$ M�i�i4. WIraft am met$ 01, ernl VSrtioir �tsE �t d bwi!ei womaw. ii�10�plibet 'Rie skis neE �amsaenped b bei beiisiad � � At I $�+� yes t� be8unntlYsi�eka�fi6- + Yiw Wawa or MEf glpl6i�' iA lA H� �sk�e a�ompnded otac4iss��� �a13�l�a: Wf � � i3r gravel s & *hm in Wmriefer ri IA. IddkWMdit The � is Jn no wilrel�P�► smell vd�ucti ►ter �x,R�t� . ot h"" IL 4 f 0 F1 St. Croix County AEROBIC TREATMENT UNIT (ATU) SERVICING AGREEMENT fate Permit Number - C & 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 115%33 St. Croix Register of Deeds Office. This Property is described as follows (include lot no. and subdivision/CSM or detailed legal description): Lot 47, Plat of Rolling Hills Farm In the Town of Hammond, St. Croix County, Wisconsin. OR: C See attached deed copy for legal descriptions Agreement Date: Tx:5127178 1159925 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 10/ 14/2022 09:04 AM EXEMPT *: REC FEE 30.00 PAGES: 1 G0.S vVildexa SNC-, a f& le a n j ego Ps P,...<►c_e_ R(vc-&FA){C.ekJZ 561sasO-N, (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. 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 fails 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. Stats., 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, Slats. 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 ins. 254.59. Stats. 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. w s) Name(s)- PS £ f J S L 7 Subscribed and swom to before me on this date: Notarized Owners Ssina s) No blic GovcmmenW Unit Official Name, Title - Please Print My Commission Expires 00 w Community Development Department (�� U(a - ePV �l N.N Govern tsl Unit Official Signature . Drafted by: _ Community Development Department PETtRSON Z `O ro con mrorrnauon you provide may De used for secondary purposes Irnvacy I.aw s. 15.04(1)M4LI O p St. Croix County 1159925 Page 1 of 1 ® M- 99 �E l u� -- Fuz--: - --- L .,. JE�LI■■�Q�� .� i I"qqM �o"Mm i SmI go ' 11 I all i I gym.. oR A5 rr- 1 k O r� ✓ .�?✓r✓_fir✓.� .�r✓r✓�r�V�✓ �r✓A✓: '✓?+��✓•r '�?y?✓,? o00 o00 e 0000 0�DDO �•A;A;4;A �•A:A 8 u i B c J ]BUILDERS I��II� ill��{�I'I�'I�' NEW RIGNMOND SPLIT 15 I� f �� q� Sanitary Site Plan For: Tyme Properll¢s.LLC R411ing *11s Farm Oitfiot 2'. Lois 46-49 Parr o -the SW114 Sqo. 29 T19N--RI7W Town of }tpmmojird , St. Croix County ' 40E 2.32'ST • WELL DWF = WO gpd z IM ELEV. 40 1075,88 Hod H-WO Nt LOT 48 FT. 21,781 SQ. 297• VELL DWF = 800 gpd t6 LOT 4721.781 SO. FT Ji Sar. 40 PVC • WELL 740 DWF = 800 gpd L21,78TISQ. 46 FT. J 3 g 19r'W 243.89' LOT 45 N 72.80W' ^& �O 1072.49'' H001 H-e00 eprs.pa� Scar. 40 PVC rO Hoot N-am W tl+o/sePte 'r &h. 4o PVC 1064.1 �S Ss9s N87008'43"E 180.521 .�. SOT s�dF Past 2 of 9 h� do %Y7' ST \ Op, 0 JO0 0401k Scow (rem) s0 h a OUTLOT 2 \ 42.71 ACRES So e4 _,\8f30,35a SO. FT. of pipe pe . 1 OB7.84' DWF o11000 gals. /t 80 . 7126 sq. A. M. - 141 8\ Lon 4&46 Typical of each lol will be 4' Sch 40 PVC Bldg. Sewer 4' S_ch.40 PVC or Astm D•3034 PVC Corwcyanoo Plea, Proposed Duplex 2' Sch. 40 PVC F.M.'s FT# 2084 fT/ 20115 Tnp of Wood Hub Top of Wood Itub ant Flev - 106857' B2-_46 Flev •106t2R B1-L46 O 106729' 10652t' 1064 28' BIL 1061 2t' 1066.14' 1 I o62 It' Proposed Wieser ConcreN WLP1250 MR w/ Duplex Pumps w/ Simtech STF-100 Fillers O�sai PI/ 2092 Top of Wood Hob Elev. ^ 1061 67 f? Site is an open slope W/e few small trees. Proposed 8.0' x 141' Mound Dispersal Cell located along the 1084.28 corlbur w/a System Elov. of 1065.11' 6weonen ow.tn.nt of Carrowce Safety and. BuadM Drweorr GENERAL INFORMATION Personal information you provide may a used for setaaary Peme H~s Name Rollinq Hills Farm Owners Associatiorb 6 111:11.1 PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) purposes (Pngcy Low, s 15 04 (1)(m)l TOWN OF TYPE MANUFACTURE CAPACITY septic Dosing lnh c s.,�- Aeration Z Sir.t-lto, f TANK SETBACK INFORMATION PUMPISIPHON INFORMATION Air F'�t"P '25.a2 Manufacturer ow Demand GPM -- y3 Model Nun1Da L � 4 TDH L�'8Y Friction L System FJ*adC L T H - �Ft Forcemain $, Dia.,Z r. Onst byyaf A -A SOIL ABSORPTION SYSTEM SEDRRENCH WAN L DIMENSIONS 8 L ) J 5'� JAI, I AA IT10N SVSTFY FLFVATION DATA Punts St. Croix I 018-2019-46-000 argeMap No 29.29.17.1246 75 r 4S.z#3 FS ELEV. O Fmti HeaderMarwbW t r Dis6ibution N . .Hob Su:a �, ■ Fbb Specinp Vert to Ar Inhke Lergm y ' Dy ' lDv •y 8 Do I Spacing—jL z ` CAII [_AVFR - e..�..— a n. r ... ss....t n. Atr-...t. tx...t..n. r]nhe f rI" I I "L�r- w BeeRre11L1fCenMr � 0"I l Over , � SedJirench Edges -7) Z is Depth 01 �� Topsoil 7 )2, v SeededlSoMed Ay" � No >a 1A11U1ed VYee � No COMMENTS: pndude code disaepenaes, persons present etc) 4 P,-k S Cm G• h/ Location: 740 161 ST STcL 1.) Alt 13M,Desaiption - 6g � L j A 2.) BWg ttewer lsrgth - C er+hr.q�./ S cu.*-r - amount of cover - �K, / r�l (hs pCvi'1 t0 K Plan revision Required? L Yes No (_ 1 rJ j Use other side for additional informabo SBD-l710 (R 3197) Date rwl Inspectionill dr 4,1zG K4 Inspection e2: MsepUor pn Cert NO STATE SAS r�l 44Z ro/ RMIT d5re - - PREVIOUS NO. -� OWNER I PLUMBED _ eo`yrn TOWN OF ' SEC T' • AND/OR , 8 CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the unitary 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 unitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a unitary permit. (e) Renewal of the unitary permit will be based on regulations in force at the time renewal Is sought, and that changed regulations may impede renewal. (I) 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 1 SUBDIVISION the permit, please contact the county authority. fur UTUQRIZEp ISSUING OFFICER — DATE �Z'L PERMIT EXPIRES P,1A.Pd1%0,,V 1NLESS RENEWED BEFORE THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)