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HomeMy WebLinkAbout032-2126-10-000 (2)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)[ TANK INFORMATION ELEVATION DATA TYPE YANVFACTU R CAPACITY W i , Septic W r' �OE— Dosing 0 n L 341 Aerati oldin TANK SETBACK INFORMATION TANK TO I PIL I WELL I BLDG. I Vent to Air Intake I ROAD 1 I"os'rg 1 11 1 7-z,�1>t&D'I >1sO' I PUMP/SIPHON INFORMATION Model Number �57� TDH Lift Friction Loss System He d TDH Ft Forcemain Len%Dia. Z of Dist. to Well ABSORPTION SYSTEM Width Len / No. Of TmrMM MENSIONS (2)` FELL SETBACK SYSTEM TO PIL BLDG INFORMATION Type Of^ System: 1Y1 /o I / D �' is ■irtii� 1/� r i a im ' it �r?�.�� ' • I CHAMBER OR UNIT DISTRIBUTION SYSTEM — c=`�e�� HeaderlManlf tt Datribution I (/'_IL ( x Horle� ize x Hole Spacing Vent to Air Intake 9th rO 1 Pi 9s) pe g 3 G 7� r r G / Len Dia —7— Len th Dia S rt 3 Z 2 •O RAII rnVFR ra....••.. Q...+..... n.n.. . u •.. d n. Orf..A. Raaeam. nnh, Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil No Yes r❑' Yes ❑ No `COf JM TS, , (Include cole discrepancies• persons present, etc.) Location: 1704 41 ST STYIV 1.) Alt BM Description = r 2.) Bldg sewer length = at - amount of cover = 7- IIVr. Sod Plan revision Required?❑ Yes Jam' No�— Use other side for additional information. Date SBD-6710 (R.3197) 01 In p`c¢Qrta�1� ff!f���LL Inspection) 10/r/2 l-.2— 1 ='&_`Ta = IoL80 f insepctoes Signature Can. No. •�� mQ--/%n �4 lilj — h)' oaA dvg RECE V Mad Cotody lot, a�;wry Madison,ox QI 1� AUG 04 2022 33 P�o Baa'16� Sdry 14rmrt Nuabs (to be Mad in by Co • �.yt w(s �) `f �f 7 �3 s ar tP 't Application �"' �'"� In accordance a of lbi: form to &C Omit 'E matted prior r rtbtaiig a a.ilary parraL WW Applidi n bms for slat f m d POMrtS Qe atbmiaae so the Depmnomr ofSaRty ad PtoLtaimW Services pommel (eiotarmfan You provide amy be used fQ seoorrduy ma"rn - Q U7-01 6 � - e Project Addtea/ (ilddfmarY the awl addten h* ) MCcwidrQe liver,a lS.01(!xm) Stet: I 4 L A la*enatioa - ltlrltaea pirla All QWuNaliaa Roperty Owaer's Name Parcel A tvD w l.oR ELLrI�Ksor� 03z-zrZ6--lb-660 Dt%WW Ovroer's Mmlitg Addrea Property ' . O ST g � CoraOort city. State Zip Code PhorreNumber tour ( « So VW �i U ZS SW ill. Type of �Yd4g (aback as Hat apply) lot M T 14 R f 9 101 or 2 Fatuity Dwelling- Number o Z SubdNvioo Nme ape �ttb wXommercmd - Describe Use r ) Bled ti C -mz— mce Owned - Deauibe Ux CSM Number of ty i iw of aemor 3oMERstLT' UL Type of 1'OWl S if'araaik (Ckadt Mawr' ar •Rapiaerseal' cad aHar applcable N 6s A. Ckatk ace Ms ow I(taa )k CattapW We C A. Sytaem �n1E1a S)O,D",er Modification m EAming Syean (a rplair) Preadhemn flail (eaplao) a (''�,_,� L_1 ""'s T ❑bl�rounat-(',rode Incim ml Site Denim TYDe (off) (corrveraiunw) ZBRmrewalBefore ❑Mv..ofP� ro New Pre ices Perm Namboraod DmeP° , C 0nr. resO cat Ana sad Tam& Design Flow' (gpd) Deign Soil App(icabw f4r.(�rvat) Are 16egrOW (so Ditporrl Are hapred (af) _ Sryalem 9ev�aa 5d 450 Turk Infarrooticn �Ik4n New Tad m Eriaiy Twb Tail Gl"o"a i of Unim Maatbcaear t �Q- n f _ iIII ISM,I'l I-IIM ���aa�a�ali ■its Wr� V - - - r// 7 woer�nrra eMOa M �e adeay preNumber's Name(him) Baeireos Pboae Number -TE �- zz_ z'i Z 15 41 3�15 a Adibeas (Soeer City, Sale. Zip Cade) ._ .6. 3o K 5 6 S � , hIl 'i009 rwm X7-�d �13 r DfuaDetriel : � Zb ZZ Sigetat SYSTopash-3Skvv--` Voti l'" tXe 1. Septic tank, effluent filter and dispersal cell must be serviced I maintained as per management plan provided by plumber. 14) ,�,(f & n �; • „ tkn PS Uyt�M� /�(� f� d^l--tan• 2.All setback requirements must be maintained J � •`^ pw�O'"`+ � r as per applicable code/ordinances. �tC.Q Atre►rse*IseiWftarrrrrseer• 80,ftkte eeb�Iplfe Is�-�,,t}}W:II rYa� lo SBD-639g(R.0321) �` i I'�j+r� 1 o. 0 ;y� 1\V,N Z� x'+t1V`1N��3Q 9-18-,QC] ���i ll�l?�l l ���►'dlN1�Ji►3 11 �7`dbd � rn /.17 NOS 15 ?r3\IOS hit h��r►S N��71`113 V Z�`1 -� JN3214(`�V IJ N1 N rJ 5- Kevin Grabau Subject: PLOW- -644773 - - Fox-- El I ickson Location: Town of Somerset --"RED" Start: Wed 9/14/2022 8:30 AM End: Wed 9/14/2022 9:30 AM Recurrence: (none) Organizer: Kevin Grabau Categories: POWTS 1704 4151 Street 032-2126-10-000 05.30.19.1129 Scheduled on phone with Jeff Fox 9-13-22—"RED" t ectf� at �e August 3, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-08-03 Plan Review: PWTS-082201766-C JEFFERY V FOX PO Box 565 Dresser WI 54009 SITE: Andrew Ellickson 1004 41 st St. Town of Somerset St. Croix County SW, SW, S5, T30N, R19W Total Amount: $250.00 DIVISION OF INDUSTRY SERVICES 2850 MIDWEST DR STE 104 ONALASKA WI 54650 Contact Through Relay httpi/dsps.vii.goviprDg rams/Defauh.aspx www.wisconsin.gov APPROVED DEPT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Tony Evers - Governor Dawn Crim - Secretary FOR: Description: Three Bedroom Mound System \ Sloping site Mound Component Manual - Version 2.1 (May 2022-202), 450 GPD, 24" depth to limiting factor, Maintenance required, Effluent filter, New construction The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 114- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • See SPS 384.30, WAC for all sewer piping material requirements for this POWTS. • 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(2)(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. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M Swim POWTS Plan Reviewer WI DSPS - Division of Industry Services (608)789-7892 0erry.swimCcilwi.00v MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Wittatock Owner's Name: Andrew & Lora Ellickson Owner's Address: 1704 41 st Street Legal Description: SW1/4, SW1/4, Sec. 05, T30N R19W, Township: Somerset County: St. Croix C,,,d O1 #r APPROVED Subdivision Name: Chabre DEPT W SAFETY MO MOfESSI SERVICES DMSON OF RIOUSTRV SER ES Lot Number: 21 Block Nub'' _ sag COMESPONDENCE Parcel I.D. Number: 032-2126-10-000 Plan Transaction No.: Page 1 Index and tide Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Designer: Jeff Fox License Number: MPRS 223242 Date: 07/20/22 Phone Number: 715-491-3458 Signature: V jX Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11112), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manuel Ver. 2.0 SBD-10706-P (N. 01101, R. 10112) Version 7.0 (R. 11/12) Pagel of 7 u AIJDR1-W +- LoR tS ELLIL' KS&W I-OT ZI c NA a icF- S*JI(H 5W'14 S 5 T3LD NIR i4 M/ Tna;l�f na- 15�:pN\FlZ5PV ST 020h► QT'I �y q+7 l�3Zy2 MP R-S Lz )Dec- Hi K II -- 1 rk�vs�. B � If II t?£NCEIM0.R'`IC kit 1`iAll I IN; DCk%6L6 E LNG iat�nN�c 4-Z i ►3 '3 B I P. ti 1 L - 4 T l �5 t C6 Mound and Pressure Distribution Component Design Project: Site Information r Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 9.W Site Slope (%) 96.40 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd/w) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information e Center or End Manifold 3.00 Lateral Spacing (ft) 2 Number of Laterals 0.156 Orifice Diameter (in) 2.80 Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 30.00 Forcemain Length (ft) 90.10 Pump Tank Elevation (ft) 4.55 ystem Head (ft) x 1.3 0 Vertical Lift (ft) 0.55 Friction Loss (ft) 0.00 In -line Filter Loss (ft) 11.90 Total Dynamic Head (ft) Note: Sand fill (D) calu/ah" assume a Table 38344-3 "U sdl treatmerM for fecal colllonn of <= 36 inches. 6.00 Cell Width (ft) Are the laterals the highest point in the distribution Y network? If N above, enter the elevation (ft) of the highest point. 8.33 ft2/orifice Does the forcemain drain back? 4.89 Forcemain Drainback (gal) 67.51 5x Void Volume (gal) 72.41 Minimum Dose Volume (gal) 29.08 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection options choice in. dia. options choice 1.25 x 1.50 x x 2.00 x x 3.00 x x in. dia. 0.75 1.00 1.25 1.50 2.00 3.00 Y Gallonslinch Calculator Treatment Tank Information Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) ITotal Working Liquid Depth (in) Wieser Manufacturer gal/in (enter result in cell 1 49) Dose Tank Information 800.00 Dose Tank Capacity (gal) 22.00 Dose Tank Volume (gallin) Weiser Manufacturer W ittstock Effluent Filter Information lifetime Filter Manufacturer 8 Filter Model Number Page 2 of 7 Mound Plan and Cross Section Views L Mound Component Dimensions Affl ft � E V in H 1.00 ft K 9.19 ft B ft/ F in i 11.64 ft L 93.37 ft D in G ft J 5.41 ft W 23.05 ft 450.00 (ft) Dispersal Cell Area 1 ,322.77 (ft) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1110 B Cabs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.19 (ft) G ♦ I H ....Ery...... •I it I F 97.90 (ft) Lateral 97.40 (ft)—.* ? :: Invert Disper sl Cell Elevation D 4 a 96.40 (ft) Contour Elevation 9.0 %Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell See lateral details on 1❑ _Topsoil Cap 1.5 ft Page 4 for number, size, and spacing of laterals. 02 Subsoil Cap " © O %*O Laterals are equally e ASTM C33 Sand Z / T spaced from the 8 Tilled Layer c ,' 0.5 ft Typcal Lateral © distribution call's ©� Aggregate + o --♦� centerline in the distribution cog (Ax8). Project: Wittstock Page 3 of 7 End Connection Lateral Layout Diagram YN CfMN oVN nN slon 4/.Turn-up vdball valves X plNnout plug P ANlrN&is ut wdwVK61 1• X�J Ho4tsd+lwonPh#b0tr0m•rlh`P'"61 ? «N+b spsc+d r— Faco mxr corrwdron via rarr a Gloss to mxrtoN Y ww oolr+ Laterals 3 forceman Sch 40 PvC per :PS Table 384 NJ-5 Number of Laterals 2 Orifice Diameter ff 0.156 in —i s/3L Lateral Diameter 1.50 in -- Orifice Spacing (X) 2.83 It — Lateral Length (P) 73.58 ft — Orifices per Lateral 27 Lateral Spacing (S) 3.00 ft — Orifice Density 8.33 ft'lorifice Lateral Flow Rate 14.54 gpm Manifold Length 3.00 It — System Flow Rate 29.08 gpm — Manifold Diameter 1.50 in Total Dynamic Head 11.90 ft Forcemain Velocity 2.97 ft/sec Dose Tank Information LoclurV 00rer with wwrwng Mel and locknq device and sealed watertight Electrical as pejNEC 300 and —� SPS 316.AC Disconnect 4 In. min. Tank component 1s properly vented e,— A location atione outlet Weiser Ca aci B00.00 Volume 22.00 Manufacturer Gallons gal/inch Dimension Inches Gallons A 19.07 419.59 B 2.00 44.00 C 3.29 12.00 36.36f 72.41 D 264.00 Total 800.00 Alarm Manuafacturer Rhombus Alarm Model Number MJ Plugger Pump Manufacturer Zoeller Pump Model Number bn151 A B C D tank. Pump Must Deliver 1 29.08 gpm at 11.90 ft TDH Forcemam dwmeter ---1 2 in. Weep hole or anti - siphon device P_ urnp off elevation (it) � �— 91.10 Dose tank elevation (ft) 90.10 Project: Wittstock Page 4 of 7 Mound System Maintenance and operation Specifications Service Provider's Name Jeff Fox Phone 715-755-2461 POWTS Regulator's Name St. Croix County Zoning Phone • � u is i.0 Design Flow - Peak 450 gpd Maximum Influent Particle Size 1 /8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft' Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Service Freguencv Inspect and/or service once every 3 years Should inspect and dean at least once every 3 years Test once every 3 years Should test month) Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years onstruction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum-up Detail Finished Grade \ �r 6-8" Diameter Lawn �J� Threaded Cleanout m Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Wittstock Page 5 of 7 ptw PI Ir1MM CURVE Irwin s1!'Imm olimi I "'°M'm� ... 10 �t WiscortM-Daiwiment d C4mmeme SOIL AND SITE EVALUATION Mmon of safety am &**w Bursar of kMepraded Services in accordance wdh,nKrt �a Adm. Code Aftch complete site plan an POW M IM than 8 IJ2 x 11 Indies In a. Plan county :,dude, but not *nftd to verticaland horizontal reference point (i 4dLmW cfion -1 ... percent slope. scale or dimensions, norM snow, and location and c ance to riot~ road. Parcel I APPLICANT INFORMATION - Please print 811 kdbny yftn. Pwwww WmmbDn YM WOVWO Flay be used for sownftq wpow (Prwvcww, ii, I I Pap —A— of 3 I Govt.- to _Sr4j 1/j5C4.J 1/4,S T.71d N.R Property Owner's M*NV Address L& tw - - Block# Subd. Name or CSMO 13 fGla-Z\ City state zip code Ph" Number 0 City 0 VMaW 0 Town 40"Or" ROW wolbso N IW--r- I'SeinilS ETI;- Now Conslnrcllon u.: Wrasidential I Number of bedrooms Addition to ex**V bwIdkV Replacement C3 Public or cwwwclal - Describe: Cade daily sow pod wd Reconvnerkled designIoerruW rate - Wd, d* --6 bench.WW Ab5wptjonarea rqqWfqd /-ZOO bed. ft2J�00 ftqnCh,fj2 Mom, d9sW"*Vrate Recommended infifirwhon surface sleva"s) Yo it (as reftrmd to site plan bwvhnwk) Additional dwoVisite Parent Material •Flood plain elevation. If applicable S - Suitable for system CWAM",*l Mound In -Ground Pressure AT -Grade system in FIN Hobft Tank U - unsuitsole for system, Os Co Os Ou Os lau I Ds Ru 13S Ou [Is Boring 0 fto- around Slay. 15--10 tL Depth to a." Boring # 13 Grand OW. qih-r- Depth to wtwv Motor SOIL DESCRIPTION REPORT MWMI�, 111771MEM, Remarks: r, ®HP. MUM 0 1 CST (pleft" P" or" Telephora No. N1 f )l-V\ Address Dais CST Number fy\Cj;!fz)ET 0 PROPERTY OwneR PdRCP1 LD.e SOIL DESCRIPTION REPORT Boring P El (Gourd Depth to WTAWV feclor Boring ft C3 Ground elev. h. Depth ID knWV factor __in. e .fin MIM M ME �M= ®W"lamal f Remarks: Remarks: 1101zon Depth I DominrM Cola Mottles TasUws Svuctue Coon� In. Muneell Ou. Sz. Cont.Cola Gr. SL Sh. f3ohRhdefy �� Brf Trx Boring 1 Ground elev. —ft. Depth to know factor Remarks: Boring ff Ground elev. n Depth to Yrr iq factor —�' Remarks: SSD4= (R.9M) PAGE_�,7-OF,3- NAME fihj-�- LOT# Z•I LEGAL DESCRIPTIONSw '/.s«'/. SST3a .N.R 14 E (orn SCALE: 1"= IOC) , BM I ELEVATION 100.0 BM I DESCRIPTION ea:l ; "tL dw. c 1 BM 2 ELEVATION 100-0 _ BM2DESCRIPTIONn.j:. 1:&mk wirt. SYSTEM ELEVATION �i 7 • Y d ALTERNATE ELEVATION CONTOUR ELEVATION __ G N T eS-oo ST. NTY SANITARY SYSTEM File #: �'.+6u0 11sI, Office Use Only OWNERSHIP/ADDRESS FORM Crnot•d2/2a2t 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 Andrew & Lora Ellickson Mailing Address 1704 41 st street City/State/zip Somerset, WI 54025 Phone Number (required) 612-730-3739 Email Address (required) andrew-ellickson1 @gmail.com Parcel Identification Number 032-2126-10-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location SW t/4 SW t/4 Sec 05 T 30 N R 19 W, Town of Somerset Subdivision PlatLot # 21 Certified Survey Map # — Volume Page # Warranty Deed # �I 1 2S'� (before 2006)Volume . Page # Number of bedrooms Spec house 13 yes O no Lot lines identifiable O yes 0 no t L OFFICE USE ONLY �^ New Property Address 1� L4 s ST ( % .n !>lrr� - (Verification of new address required from Community Develop t Department for new construction.) g/$ z (S ff Initials) (Da ) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty 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 715-386-4680 St. Croix County Government Center cdd@sccwi.aov 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax www.sccw1.00v IErf ELEVATION I/a* - 1'a MONT ELEVATION u+• - Va 0.0 POLO= CONC. FCL")ATION 91.1 Iw CLUNG O M" Lr4a a -I Iff COUNG o urmmvm FOR BIDDING ONLY NOT FOR CON5TRUCTION ������IIIIIIPIIIIIIIi I i FFI-r K*t f ELEVATION 1AY - V.p` m11a IQ III a'8 � AAMMv & EOM ULKVW I I. w I 1704 410JWOW-I0Ow70t. %A 54025 "XMW&Lo" r FOR BIDDING ONLY NOT FOR CONSTRUCTION ml 14 rr �.. wwr. rr rr'rr�n�S..r .�i .wwwirrrrr R /!l-IROOrPIAN IJ4'r I'1TW %RENT r�a.a• 14,30 -- — NON -NAVIGABLE — ,I OF 1929 SW CORNER WETLAND SECTION 5 ut'QND.O.T. W/Sc7 NOTES PER TRANS 233: O �� OF No Improvements or structures are allowed between State Trunk Highway 035 & W o y right at -way Ilse end the highway setbedc Iine. Improvements and structures include, S u�� but ere not IlmRed to, signs, perking areas, driveways, wells, septic R Zsystems, :� drainage facilities, buildings and retaining wells. It Is expressly itPC'ISMUS OFFICE S 40HUDSON. Intended that this restriction is for the benefit of the public as SC, CROD( CO. WIS. provided In section 238.293, Wisconsin Statutes, and shall be enforceable , Rmmt �;,�� by the Wisconsin Department of Transportation or Its assigns. Contact the Wisconsin Department Transportation oflip(V �A.D.aft of for more Information. The phone rat' 9 o'cl1 ock_&M. Record number may be obtained by contacting the County Highway Department Volnew i. Co s mkt of Corrunercie SOIL AND SITE EVALUATION Division of Safety and Buildings Bureau of integrated Services in accordance with - q3 08; Adm.. Code Page -A— of Attach complete site plan on paper not less than 8 1/2 x 11 inches In z . 'Man m tr * County include, but rat limited to: vertical and hodzoMW reference point (B 3`�EIVEO x percent slope, scale or dimensions, north arrow, and location and to nearest road. parcel I.D. # Y APPLICANT INFORMATION - Please print al! Info l n. sr -WAX Review / Date Personal information you provide may be used for secondary purposes (Pdv�Y 15. ` 3 Z O Property Owner Property Locatiopr -, \C_ �ovi. i1l�c�J 1/4,S j T ,N,R �� E (ef / Property Owner's Mailing Address L Z # I Subd. Name or CSM# 13 CRY A A =c FW State Zip Code Phone Number ❑ C4A' ❑ Village ® Town Nearest Road w nfS ('CIS) yy -Gz3i 6 t ��Na�,•:« New Construction Use: residential / Number of bedrooms 3 " Addition to existing building ❑ Replacement Pudic or commercial - Describe: Code derived daily flow gpd Recommended design loading rate bed, gpdr,lz /��� trench, gpitV Absorption area required / Z Q c) bed. ft2 00d trench, ft 2 Maximum design loading rate bed, gpt tW__' C2_tren ch, gPd' Recommended infiltration surface efevabon(s) q 7 `l"o ft (as referred to site plan benchmark) Additional design1sfle considerations l°ovt/evr fK0 Parent material +• Flood plain elevation, if applicable it S - Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U= unsuitable for system ❑ s Cio U W3 S ❑ U ❑ s O u ❑ s ® u ❑ s ER U ❑ S ® U Boring # Ground elev. 9s _"' tL Depth to tlimiting Boring # 13 Ground 913o ft. Depth to limiting factor .36 in. REPORT us Mottles Qu. Sz. t. Color =Mow* Remarks: R ®. , fr�s Remarks: (Please Print) IL Address I �mf �N .'S Telephone No. 0- Z y r - e/O e B CST Number ZS 3 -3 D c-( Nev) od? PROPERTY OWNER PARCEL LO.# SOIL DESCRIPTION REPORT Page of Boring # 3 Ground elev. 96_40tt. Depth to limiting factor 7-� in. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. Depth to limiting factor Horizon Depth Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texturein. Structure Gr, Sz. Sh. Consistence Boundary Roots z Bed Trench I lu S t bk H^ Fe C i 6 3 Z to lit 11v.5 Pii CS — Remarks: Remarks: no Mottles Qu. Sz. Cont. Color -iruc re Grt SztuSh. in. Remarks: Boring # t Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R.9l98) Rfv ed L s PROPERTY OWNER SOIL DESCRIPTION REPORT Page of PARCEL I.D.# Boring # Uwwwon eeGlIrr�ovvund A6Yott. Depth to Yrnldng factor �_in. Boring # 13 Ground aw. —ft. Depth to *nNft factor _In. Boring # 13 Ground ems. —ft. Depth to Iffitkv factor in. Boring # Ground slay. —ft. Depth to factor —in. Remarks: SBD-8= (R.9M) ME M = 0 . � milM. Mm .. MRIM [i�-1 �®O Remarks: Remarks: Remarks: PAGE_? NAME 5 jou-�- LOT# 7.1 LEGAL DESCRIPTIONSw ''/.sw'/. SS"T3a N R Iq E (orLw� SCALE: 1"= lOC% BM I ELEVATION 100- 0 BM I DESCRIPTIONAd:l;A%" LLei.v%L.(/Lla? BM 2 ELEVATION_ jc)o-O BM 2 DESCRIPTION nw: I: A $'1$r(s,M SYSTEM ELEVATION �i 7• y�% ALTERNATE ELEVATION ,riff CONTOUR ELEVATION _ G D l A �T�couNn STATE �ANI� 1704 41. OWNER i NO. 644773 X ARY PERMIT sr �,,,,," P VIOUS NO. �� /I ����^�^R� /aI4 N PLUMBER TeFF F;Y. LIC.# 2232 Z TOWN OF It SEC S ,TAN, Rjtlto AND/OR LOT 2 1 BLOCK PERMIT EXPIRES SUBDIVISION ISSUING OFFICER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow lustallatbo of the private sewage system described is the permit. (b) The approval of the sanitary permit is based on regulations In force on the date of approval. (c) The sanitary permit is valid and may be renewed for ■ specified period. (d) Chauged regulations will not impair the validity of a sanitary 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. (f) The unitary permit Is transferable. History: 1977 c.168; 1979 c. 34,221; 1"1 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. - DATE UNLESS RENEWED BEFORE POST IN PLAIN VIEW DATE VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)