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HomeMy WebLinkAbout026-1290-07-000v sm e.s.A ll a Coy.. PRIVATE SEWAGE SYSTEM eM.M.M Bwxmdx� INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) v«.w bM.m.F.w Po+w..r w..r Mr...am.n wmo...IVIu.M w.. I.w n nmu TYPE IMNUFACTURE' FfS -10 CAPACITY STATION BB XI FS ELEV. s.Puc _ �� IZBD ¢ Berlmmem (d 5.�o z?P) D"Ing CAv✓�i®. u An. BM Aarm Blep. sarwr clyl' 9a.Bo' x� suMbW /3so gz.zo TANK SETBACK INFORMATION buNI WCM TANK TO PIL MLL BUDS V.nuAr MUM WO dlN.l SBplc cI Y IXBAUM b.pD I Uo. c( .l } X.MWIMn. �•�D DI.3o' AM.n DIM PM. fp r o l,� BM. srM.m �r,f� Jo fDD.CKjr PUMPISIPHON INFORMATION W Yr 7 W' I Mc rs. M.nul.nuer dm. GPM 3a.3D sl cow b•vo 9q.f0. MWeI NUmMr �E y 1 a rox Lm� JJFrwMnpgFO tt .I.qp a `YS5 ��1 TS eF 2.� 03.o I ForwrrlMn LmF IDDpr SOIL owexelo ie L^E°' Ned*�.�w. PIT MENSINRANo d Pn u.a. MaFM 11 D/ 3 DEAACR SYSTEM TO PIL IULCG LL IgREI$iNFAM LWN INPd1MATId1 Tmd=Y.I.nI CNMNM W M.MNr mB /I I] / UNIT f1ON UTSTEM L4' H,mdKAvftW YFpAwmi r �I��If .NU Bw •xW E V.mlo Avunu Lxlom�_Px )IN 5{.D 1 I`Y 3� S32 M�ml�e d. sw.v SOIL COVER R Pmsum S"wirs orlb .. 1151ne or Al.Gr.e. A..xrrr. d.X COMMENTS: IInWe. wee ex pMM. .ew.) Im BT Y(ImpEmbn# /1>J a 83 WLlt M+-�NNd: ��I�iVY1 Q C...laLrr/ Toz YQ tf?w F�� LPc.eoA: d. 4BTX ST � �nw��/ (((,,,��-��� ���--- e p— t.)NIBMOe.mp.m• I •�—. { �I���� �N/L�✓l�vt/�CTL�I VPLUII✓1 3}�l[ r`Sors wl(q.dne�Lr2 (PrD r��PQr&�� 1[/�✓u�'4-�2T6t \l) (%I��T(�',I�(j'// Iy�n\) W CtlIM.N. buieMbn.l❑YM iJann.tlNo 3 __ Pill $771� a %L �oe and �s P"r I2Dz3 "z�s V� / ha ve'O'� G9 25� z*=�� r ' rmmp.im mvy Suinsim tinny 4812 Mstiwp YP Way S.niury Pmmi NwdnlW h611MmtyCp.) Mpiw%W1534M5 •l V SU2072 BLtliwaw5 6y5'y8s ", ennitApplication '°"T"°'@oNumb" tomFjpoqpum - - iZ 20L8rS`F—e. m I w:. Mn. tea.. lutim� Orlin ahem. w.mmne nqui (Min m Utl:n, 0 air yP.m: New: AppliaMi rmu a MIVN POwTsue wkmilKON pnpO(Mm..oral&rnNbn wJio{tlYm) wOwMm..ms.mnwpmrniOw sp.i®. aO.uew rea�ws .morarly w.Nemma..ro m. Pir a.,,. u. ykwmumyop 1linm sm. iH 29'i� E Plopp •.Nme �IZ F%mill OK A) i XCIZo t. —0 —060 ngmy .MUIryAamw Fmwm -T f�u, sman� co.wm ziptoos Mum NNnbr oA1 wl 6 alb ` -/sa L_u Np T SO P E SUWlvl.en Nun �Ior3Fnsy D.ullap-NunbuofBemomu Ba F �WliurDrmmsrtii-DmmAVu Af Ci"f we PxW-Wumo Uu illwof CSM Numu Of p.n �xiAlS A ND E Y 'E evsyuun aplummm symm F+utinp sr.l.m l..plun5 Mdamad nme.unm wn(..plain) p' �IONiryTW �N.Gmuu ^�JIIwrMWia[uwnm �'.t.0.W Moutl PAiugW Siu Wipe Qnr TyyelapPinj nmanaw5 C. Mmwd �Rrvi.in ornumer ❑fm.abNen Guns in Pauiow Pmme Nunbr utl Ma Brsi F.;a Mn Dui Po.IepO DpiP sail Apple aKamso aquiM(in Dop"Am (so Sy .wn ry p7,S 60 4m9. TW eJmWim .ninjM OWmr Tom Cdlau aof Unit Mow u p-Sy GHO �PfW p.YT . fF� { 0 Nr Tmlu nnogTW ` N d t� 'vNdmig7m 1"s, ( UJI Dwsmoml. — /� ( Ne2 .F 1 10 MmbM1 (Frio) rmmv'9 wpuNrt MPII.IW Nuobr Busim Hurt Numbr nn.e.•. Ismq ciy. saw, m a fY M O IFn Rle 0AyeM sipume !^ Orm Ww rm sin / Z COMiewuo A 1 M OWNER: 3)O.0 i sM DSPS' MmLL•v�.� . Sal*tank,filler antl tlispepff cell _ OAJRl��S (3�Fstj�,.� beserMuent aiSleCas per mnlbebeMaiggenvot J1�I • t!!ll w�!•n.GP��'N�yUA-d,2�Pro fS s.^ wEe++Wwn+t plan rovi Ibff mwtbe Vl � t1lWM3�sw`TO Al SsMad( regregluilnNnems rnwnlainetl P . 7 0 B00All0cQ a iiy giin "Wmm ManpM ll �yAl51ALL.5a IT �- 56Ei� f 1= 0' a - sp �{i➢ii jai le eli�D §e►, ►l 0 O J A 3I� � YIR Ln 0 0 J Wmom Rpmrnl of %for •�:I�^f 'mrl9anc+ GwiooarLWmyS 2 blydiYaA.Way m2ay Pogo. none02 2Atlism w3 s»oT '� b 1 November 29, 2022 CUST ID NO. 1330832 RYAN GARY BECHEL 779 SPRING CREEK AD S RED WING, MN 55066 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES. I InM024 MUNICIPALM: TOWN OF RICHMOND ST. CROIX COUNTY SITE: �MOROAN � 1414 129TH S I NEW RICHMOND, W154017 LOT OT LUNDY'S NORTH LOTS SW 1/4 SE 114 S22 T30N RIBW TOWN OF RICHMOND FOR: Design Wastewater Flow Value: WO Bedrooms:4 Limiting Factorial: 36' Maintenance Required: EOlurnt Filter Film, 608-i -2112 Wm m,,, Enid. J,pxux r.emu u.n Tony Every, Governor Dan Honda, Secretary Identification Numbers Mu Review Ns. PWTS-112202850.0 Application No-'. DIS-112257396 SBe IDPhk SI7-11M14 Pleaw Mer to all iderthficatrm numbers in each comespondm" wiN the RPutrnmt. APPROVED DEPT. of BURY AND r11JfEEegNAL "MACES DANDU N M NWnTRY MoNsot 1. L.✓ `LLRCDmRE10101NCE Mound Component Manual - Version 2A (May 2022.2027) Pmwre Distribution Component Mmuel - Version 2.1 (May 2M2.2027) SITE REQUIREMENTS • A full act copy of the approved plankspecifiufionc and flue letter shell be onoile during communion and open to inspection by aulhpind reprmantatrvm of the Department, which may include local inspectors. A Deputrnml electronic tamp and signature shall be on the plans which are used at thejsk am for conwudm. The following conditions AAR be me during construction or installation and polar to occupancy or use: Procne dispersal area pnor and during consrucuon to avoid dismrbance, completion and use of the site With am construction; it is "commended not to activate the pump in the done tank unfit the tanks Are pumped prior to homeowner occupancy Wastrwater generated from contractors clearing aequipment and tools and/or left over co mmmlm products shall not be diuhmgdinm Nedmnsdiwhwpngtothepnvwematewage wrummmtsysmm(POWTS). Wategmentdshalbe properly disposed of m-ate or of site. Any till gresim, leaves and shrub shall be col shm And rammed prior to filling the surface for installation to prevent mating underthedispermlarea. MllmosemganicmmerWtobe medfr POWTSDispend Aru. Dive" surfs" water from all POWTS Ama. Prior m "mtrucHoe of tie d'npersd area tech the tee'wmn content of the Boll to a depN d8 inches. Smearing and computing of we soil will result in reducing the infiltration capacity tithe sal. Proper and moisture content can be determined by rolling a soil temple between the hands. If it rolls into a 1/4- inch wire, the site is too wen to prepare. If it crumbles, site prepenfim can paced. If the ate is ter wen to prepare. do no proceed W61 it dri". All piping shall confmm to SPS Table 394 30.3 and SPS Table MUM 1 muti" building sew" beyond 30 feet per SPS 392,30 (1IXc) • Well setbacks; to meetchs. M811@812 • Tank Installation to follow all manufac ure's recanmendations. • Verify property lizi priorto insmllmon • Pump Floan to be sn ad verflkd per approval plan. Any changes may malt in pump rmeingto main TDB and GPM Speelficatbm. • Areas that are occupied with rank fragments, one routs. sumps and Insiders reduce the amount of nil available for proper treatment If no other site is available, crags in the basal area of the mound mug be cutoff at ground level A larger fill area is necesmry when a nyoftheohmseondihonsaremC nterW.nprovidesufcimt infiltrativearea Owner Responsibilities • The msrtentownw, and each subsequent owner, shell receive scony M mishear including instructions rcldng to properuse and maintenume of the symem. Owrten shall receive a copy of the appropriate operation and maintenance mutual and/or owner's mutual fro the POWTS ch a xibed in this approval SPS MS1(li. • In the event this soil abmrption win= or sty of its component pinta malfunctions so u to create a health hmard, the property owner mum follow the contingency plan as described in the approved planes OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions mating u proper use end maintenance of the system. Owners shall receive a copy of the appropriate operation i M maintenance manual and/or owners manual for the POWTS desmlbd in this approval and • In the event this soil absorppon symem or my of its component pens malfunctions m an to cure a health hoard. the property owner mum follow the contingency plan as described in the approved plans. The submittal dexribd above but been mimed for conformance with applicable Wisconsin Administrative Coder and Wisconsin Stetutm. The submittal bushman CONDITIONALLY APPROVED. Thiswmem is to be conmumed and locaudinaccordance with the enclosed approved plans and with any compound manuals) referenced above. The owner, u definedin chapter lot a I(l(D), Wisconsin Stearns, is responsible for compliance wide all code impingements No person may engage in or work in plumbing in the sure uNus licensed to do so by the Department per s.105 06, guts. All permits required by the mese a me local municipality shall be obtained prior to commenument of comtmnionvins W lmordopentim. In granting this approval, the Division aIndustry Swim reserves the right to require changes or additions, mould conditions ant: making them necessary for code compliance. As per state guts 101.12(2), nothing in this review shall relieve the designer of the responsibility for deigning a safe building, structure, or component The Division does not sake responsibility for the designer ammmc0on of the miewed isms. Inquiries concerning this carnpatdrnce may be made to me at the contact information listed below, or at the address on this letterhead Sincemly. Fee Required: S250 W rrr� q� Fee Radved $250.00 Jr.w VoWale e 'eeis/ BalanceOue. WIND Tim Varier Lam Refund Ex $0.00 POWTS Plan Reviewer Division of Industry Services Phone. 608-51"134 Email: rim vandedast(u)wiacwgin.gov F ADVANCED F N V I R O N M E N T A L Property Owner/Client: Jerom r & Morgan Carey PIN: 026-129007-000 Site Address: 1414129THST,New Rlctlmond,W154017 County: ST Croix INDEX ft 2 SITE PLAN Pg. 3 SOIL DISPERSAL COMPONENT Pg. 4 EFFLUENT DISTRIBUTION LATERALS 5 TANK SPECIFICATIONS Pg. 6 DOSING AND PUMP SELECTION Pg. 7 FILTER MAINTENANCE Pg 8 MANAGEMENT PLAN PS 8 MANAGEMENT PLAN Pig 10 SOIL TEST PA 11 SOIL TEST Pg 12 SOIL TEST Pt 19 PLAT APPROVED urm.xonmrowx.. owoxaranmrerv� L- 7 . L.[ DES/GNPARAMVERS 1. Wastewater Type: Residential a Bedrooms (residential): 4 Estimated Wastewater Flow: 400 gpd a Occupants (per caplls flow): Design Flow: 600gpd Public Facility Flow: NA &S)E UA770N. POWTS Type: At -Grade Limiting Condition Depth: 36" Treatment Level: Maximum System Depth: Above Grade Code Required Separation: Contour Elevation: 97.00 Soil Texture: Limiting Condition Elev: 94.00' In -situ Soil Application Rate: Land Slope: 5% Dispersal Cell Loading Rate: At -Grade Component Manual (Version 3.0) Pressure Distribution Component Manual (Version 2.1) Rl'AR D. D-2263- 111� 7 SIGND11/35�2022 RD WNG - WNn� "�UADVANCED ERINMENTAL LLC 40 SIGME 779SpdngCreekRD&RedWingMN(651)327-0070 i*"�rling, n1110, ►l O J S* ?S' 0 V CD O J a 1 i MOUND DVSPER54L AREA Obs. pipes % I L I A 10.0' F 9.3" J 4:6" 5.1 IS60.0' O 6.0" K 7.6' D 6.0" N 12.0" L 75.1' E 12.0" 1 15.0' W 29.0 30.1 Observation Pipes (1/1Oth of B) 6.0' Dispersal Area Required: 1500 ft2 Absorption Width (A+q 25.V Dispersal Area Proposed: 1500 ft2 Dispersal Cell Media: 1/20-2-1/2'Aggregate oamawie Fe 99.27' f4 98.10, 3•-23-Apurewie t'1. Y'• .—_ ASW C-33 SANG � 97.00' S% \ aw io Pi ng s.na OBSERVATION PIPES s row -type w sliybp up Fmi*W Grace (mu 6saenenl PSW to PVOppe Tope gpen N ilweer 0-nmi w e0ove flnbMd 9ufle (1'minlmum) gnii �•-3-•e'Npm arwoeC 90• eperr Ani wn g oewca innipawe (Tonal Nnpe) sumo |I x § SEE �||| § | f� § Lq i ! � ) , in } zr ! � ■) |« ai , 2 I� TANKSPECIRC477ONS • MiNmum cover -6inches; Mmimum cower-8 feet(unkss specified by manufacturer) • All manhole covers shall eehn0 d Inches above final grade • h the tank a within 2 feet of final grade. insulate file IM W an R-Value of 10 • MMlmum 18' of mverwuirvdowe Adings r, Insulate Hgrmhr>30'toW and< 42•lmm pmde or y< Wafrom grade untler all high try row clmred arms fdnveways etc.) • It forcemein"I have a'LNook' assembly. drill a wmp hole In me'hoolf • Building sewer. No 9N. keep 3 feet between 45'S. maintain 1 inch In 8 het (1%) slope, Install Clean" 99.00' %.Sry o.w ovKwwe 9mw BUY v...r..• w. er..Crw� .r 5-1W I raw T� a/• 70y, 86.09' Iv,wwam wwew» 85.00' a nww ew Tank Manufacturer/Model: Wkwr- WlP1M/_B.OPMR Filter Manufacturer/Model: Bae[-OFSO _ _ Panel Manufacturer/Model: WE Rllomttua -Tank Aktrt 1 NLP1200/800—MR TANK SPECIFICATIONS Ise Kw aae r onm sa•• aiw. . Cnr Srn z ¢ oe i II t usT-A_Kr I�I II v usT-A_:w •I INENOT uWtOCPk0 a m IIII CKV• 0,170 us h� a �TNio 'Ctl�?NX a II amr a EWi u t. un-c-sv SOOT a EW4 IIII 1 ra[T II WM Wn[.m AMe'. e e✓•u w ICA STATES mT pQ IOTSln IIII YWO C~Tv' rM(( M124 f lar[wc Mfw_ e C uw/"Ahb fat IN Vaa Tw CM K USED AS'. m KeM/KrnCTpw4Up>M/rIT�'W n OR cvaT ga Y M•i T . "I KWAI /r IY.YLK.K o f B w TTTw w i caTACT wESP m•oe¢ 0 I d IY � y4 J�J� C ---1L__��� VE• „ tY, ti PSTr PAD DRAMIxGS SUBMITTED FOR APPROVAL — 1 ¢/ 1 ua uweAcnm m u¢T u r>.® AfK c-�1T Kaimo•R / pwwe ! > . {iaLU 0 ��: o | LIM it 2 . ' <mo0:2 x: § � Id j § § - k � 2 2 � � && | §§2\� |!! goo ~! $2%/)§ k§§ 22 �00� / ■f�\ �»klk= ktka �eAZE-o . /K() /za860 | | !!! E v � � s� v= fitt 0 ta, '• 9 ` ®il�li� \� fill aid, . gig lilt oatfill tea e ilia dS _ �Zi FO jig 1 a ji 1 j lAlat 1 dI $����i• _ii� 1 "HIP t1t3y 1 pp 1 J� fit EE! 1 O y 1 1 1 Jill, lilttl` 1 O fas © Ia331 N .A-8: MANAGEMENT PLAN The owner of this Private Crude Wastewater Treatment System(Mtl ) shall be responsible for as perpdual operation and maintenance pursuant to requirements ofSPS 382-384, Wisp Admin. Code. This management plan scandal" operation and maintenance ece ftma necessary t0 eneure bnglerm system performance. Tasks that should as performed by the homeowner act slammed. Pmfossbnal management tasks snap be performed by a registered PCAI S Malntamer in accordance with SPS 383.52 (3), Mm Admin. Code, however, it Is the homeowaer'3 responsibility to ensure all tasks get accomdlshed In a timely Monet. Pursuant to SPS 383.52 (2). MM Admin. Cade, this system shell he eonsldereda human heats hazard If net maintained In accordance wan this approved management plan. ► Keep this Management Ran with your Septic System Owners Guide. ► Keep codes of all pumping records, maintenance acbwUes and repair Invoices with this document. ► Review this plan with your POWIS Malntalner at each visit: discuss any cnsngss In product use, so Wines. or water -use. Number of Bedrooms Deslgn Flow Won) S0il Loading Rate(gpd/O') Standard Effluent Quality Effluent Blologcal Oxygen Demand (SOD) 220 ply Total Suspended Solids (TSB) IN aY Fats. Oils, Greases (FOG) s0 ill/ Treated Effluent QuaBry, Biological Oxygen Oxygen Demand (BOD) _ _ - all Total Suspended Solids (155) - aY Fats, Oils. Greases (FOG) - ay 800 Septic Tank Capacity (gallons) OA Effluent Filter Manufacturer Effluent Fitter Model Pump Tank Manufacturer Pump Tank Capacity (gallons) Pump Manufacturer Pump Model _ Dispersal Cell Type Repair leaks pompty. Regularly check for wet or spongysoll amen iyour soli treatment area. Contact servica provlder If Issues arise. Confml burrowing animals (gophers, gmundhogs, eta.) Keep bikes, vehicles, snowmobiles and other IMMC off tr bKmkyk t area. Alarms - Contact your service pmfesskuMl Wary alarm signals Unt Rher- cheek for lint buildup and dean when necessary. if you Do rot have one, add one after washing machine. Caps -Make sure that all Ceps and lids are Intact and In piece. Inspect for damaged caps often. f or replace damaged caps. Pretreatment Unit DescrlpUol levels -Check sludge/scum/effluent levels In an system Recommend n Mnk(s) daub be pumped. PUMP all irments every 36 months at a minimum. t tank Inlet and buyer baff es by applicable) dralnfield emuent levels of appiceble) Dump and same system functions of applkebye) t wiring for corrosion and function is sppacabb) aminnew laterals (a applicable) event counter/elapsed time meter and evaluate water usage mdObcd to system design flow. dissolved oxygen and effluent temperature In tank. for surradng of effluent or other signs of problems. Inspection pipes are cappad and infad. e homeowner with list of management results and any action �PoW/SREGLIWOR: BTpabrCXN*ZmftC6Ep/ AWRES& 1161 Lfmykl!aianyA2&ftl116O MdWA W51616 NO a (715)30646M HM k S7AR7LP& OFVM77ON Prior to system operation, Check septic/pump tanks for me presence of painting products or other chemicals that may Impede the tfeatini process and/or damage the dispersal cells. If high concentrations are daunted. here the Contents Of Me tank removed by a licensed septic professional prior to use. System startup shall not occur when soils are frozen K me InBltrathe Surface. QUainigggWILAdill Pump banks may fill above normal Mast water lards for system utilizing pumps. When power is restored, the excess wastewater Wil be discharged to the dispersal Cea In one large dose potemlally resulting in owri0ading of the cells. Backup or surface discharge of effluent may also result To avoid role situation. It is highly recommended to have Vie contents Of the pump tank removed by a licensed septic professional or haw a septic professional manually dose the system to return the pump tank to normal Operating levels prior l0 festering power. D not or" of park "Secure over airy septic system COmporlems. Do hot di park over. Of otherwise dlsWrb Or Compact the area within 15 feet downslope of any mound or al Cade system or secondary septic system site. AlA/N7DgANG£1 Inspections of finks and dispersal grails shall be made bran apprOplbtely licensed OeMdual of business. Tank mspeabons must Include a visual Inspetmon of the tanks) to Identify any missing or broken hardware. Identity any cracks or leaks, measure the volume of combined sludge and scum, and to check for any backup of fording of effluent on Vie Court surface. Access Openings used for seMce and assessment shall be sealed watertign upon completion of service activi a. env ingotind/dammue access onanlna• Shall M replaced Immeeiaroly. The dispersal cell($) shall be visually Inspected t0 Check Me effluent [vets In the Observation pipes and t0 Check for any ponding Of effluent on We ground surface. Ponding of effluent on the ground surface may Indicate a failing condition Mat requires Immediate attention by a licensed Septic professional. Tanks must be bumped when sludge accumulation Is exi 121nchas Of Me bottom of We outlet bane, or whenever Me scum layer Is within 31nOhes of the bottom of Me outlet bathe. In no case shall total sludge and scum wlume occupy greeter than 25%of the tank liquid capacity. The effluent filter shall be cleaned as necessary to ensure paper operation. The filler should not be removed unless provisions are made to main solids In the bank that may slough ark the filter during removal. If We filter Is equipped with an alarm, the filter shell be serviced V me alarm is activated continuously. IntermMnt fiber alarms may Indicate surge flown or an Impending continuous alarm and should be evaluated by a licensed septic professional. Pre-treatment components shall be maintained and seMCed by a licensed Septic professional according t0 Me manuPoGlurer'$ recommendations. QON/7NOENLYPLIAfS ifthe septic tank. Or any Of We components, become defective Me tank Or component shall be Immediately repaired of replaced according to Me original system design specifications. If a dosing lank, pump, pump controls, alarms, or related wiring becomes defective. May shall he Immediately repaired or replaced with components of equal performance. If the soil treatment component fails to accept wastewater or discharges wastewater to Me ground surface, it shall be restated or replaced by; Increasing basal area (If tce leakage occurs), rebuilding the component at Me secondary system site (a Identified), or removing and replacing biologically dogged absorption and dispersal media and associated piping. If repairs or rebuilding Is not possible, a new soil and site evaluation must W performed to local a suitable replacement area 0 one has not already been Identified. If no replacement area Is available, a holding tank may be Installed as a last resort replacement POWTS. ABINDONA/EM VMe septic system falls and/or Is permanemly taken Out Of seMce. Vre ewtem shall be abandoned according to SM 382-384, Wisc. admin. Code abandonment regulations. Requirements include: -NI piping to tanks shall be disconnected and abandoned pipe openings sealed. -The contents of all tanks shell be removed and disposed of by a licensed septic professional. -Tanks shall be crushed IS filed. or removed. -A septic system abandonment notification shall be submitted to the appropriate local governmental unit. WANN/N011 SEPTIC, PUMP, AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC TANK, PUMP TANK, OR OTHER TREATMENT COMPONENT UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ALWAYS CONSULT A LICENSED SEPTIC PROFESSIONAL BEFORE DOING ANY WORK RECEIVE .; p De 1 vamr�oynrvacm.�u JAN p, l PORT aw.ia� .ia eam . „ oe���000 ©Urar.�rr�c�w�'r��r.�-��r�n��'��.a OB FEW ®ioO ■COME ea■e r�r�Fr.■�■a.� ©t�rts��n��i■e■�Fr. QMy vrfiIA[31�.7Ri'►Il�l�■�!C!!R�FIE11141/. �'�n���■�a■r� � mm�����■�■u����� �. F 10 v oe Pop —a ■ ORION lalaiRRE ■V M,e ,amjm Re&"=8 m_IMMOL •Auee•BW,�]pmpt N18f 550 npL Te peplum efCemmte k u 41 Wimrq nuke Pw�uE nzobYl+. ISYou meJ eWma n nar Mrvim a mM nWniYv n Ylmvue (vem4 Olam mWp IYe n bOLl661151 a TTY 60F]641)11. Pape 11 . Soil Test Plot P1 project Noma Environmental Holdings LLP S Bird Address 706 19th St. Hudson WI 54016 CS TM 4226900 Lot 7 Subdivision Lundy's Nonh Data 121114 S 112 SE 1/4S 22 T 30 N/R18 W Township Richmond Boring Q Well PL Property Line County ST. CROIX k` BM or VRP Assume Elevation 100 n. Top of 12' Pipe System Elevation 97.1 •HRPSameas Benchmark Alternate Benchmark Top of It2" Pipe @ 103.3' $Cale is l" = W unless otherwise Please note: soil test noted my not be suitable for owners dmired building location, Soil Property line test wits; done to satisfy mning requitements,plesse verify system location beforeeacavaung. 5%Slope F M 164' Property Line Sr. CRo IJNTY SANITARY SYSTEM File R' OWNERSHIPIADDRESS FORM c'"bmdce Use rb 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 INFORMATION Owner/Buyer Morgan and Jerome Carey Mailing Address 511 Prelne Lane City/State/Zip Hudson, WI, 54016 Phone Number(regu:ed) 715-781-1509 Email Address ("uirea) Morgan.teske95QFgmell.cgn Parcel Identification Number 026-129a07-000 (round on the property tea be) NEW SYSTEM: LEGAL DESCRIPTION Property Location-fidY., -!Za-+A, Sec. 2 L TAN RX—W, Town of 1116V na✓e Subdivision Plat 1-� A.J qe d)OA.N/ .Lot s7. Certified Survey Map a Volume Page+ Warranty Deed e (before 2006)Volume Page e Number of bedrooms �_ Spec house D yes lno Lot lines identifiable Eyes O no (OFFICE WWMLT / New Property Address I4I4 In A-4E L46W (y1s) wMllutlm IMw a44mrrMWM Fam CwnmuYry Gwlepmrn urpvvnmrMnrwcanNMla.) IZ Ole aa This form must be submitted with oil private Onsite Water Treatment System (POWIS) applications. New System: Include with this form a recorded wurromy deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department - land Use Division 715-3664M St. Crow County Government Center 715-245-4250 Fax cddrmsccwi aov 1101 Carmichael Road, Hudm WI 54016 www.sconiaov �—Mz"... JaAaw* � p� P411 I $q p' d e e �3 a t a Lam..... r h r h r IL i L r ,6 r 6 r h 'fi 1111111111pp,1I Irr11 11I 111I!'l l I :'n1 fil 11 •f �' ' fit Ill aa.kewO i J 5, 0 4 2:24 9 .1115G: MOD. 4 Mail I U m CD RECEIVE 2 w.m�awn.aacm.M'. BAN 0 EPORT Py I aL pwa�as.i«r.ae,+uw. 'n. Hill / ®IS9.Ro m r . aA r Tr. ®K=ii © ©��E��/JG�,'IJ[�iF..�JmI4'a ©7Mr/��EVAVM .�43r7A42FAWAVinIWA Pmpmry D. — Pvgl ID Pace © • ' FIV ©®E� ©�r�r�r�rr�e�■®r.���e®® • �M oBf'����000 oe����000m E91or991•BDD,a Op<p0 nq'>•�Id TSS a30<1<.Ympl 'E9Yw9R •900,<0p mpl.lM TSS <]Orgi The Degrhnevl ofCammerte ism equl wpmmni7 rttvice provider and empbYer. Ifyop med nvi.YM<b uceu urviw m med mueml in m mimune foment pleue amim the dep nt in 609-263151 or TTY 09-1649"7. Soil Test Plot Pla Project Name Environmental Holdings LLP S Bird Address 7061eth St. Hudson WI 54016 CSTM #226900 Lot 7 Subdivision Lundy's NoM Date 12/l/04 S 1/2 SE 1/4S 22 T 30 N/R18 W Township RiGhmond Boring Q Well Pt, Property Line County ST. CROIX % BM or VRP Assume Elevation 100 R. Top of l/2° pipe System Elevation 97.1 •HRpSameas Benchmark Alternate Benchmark Top of 1/2" Pipe ® 103.3' Scale is 1" = 40' unless otherwise Please note: soil test noted may not be suitable for owners desired building location, Soil Property Line test was done to satisfy zoning requirements, please verify system location beforeexcavating. 5% Slope � 2 F a 164' Property IM 274' Prouerty Line $qx S T $JIMit Ali 1 CqCi � �ypig s! VVgig f 11 wo a a 4 PA O a