HomeMy WebLinkAbout020-1481-09-210Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)],
Permit Holder's Name:
City Village Township
James & Kathleen Dorgan
TOWN OF HUDSON
CST BM Elev:
Insp. BM Elev:
BM Description:
Too p� ,
TANK INFORMATION
I ELEVATION DATA
TYPE
MANUFACTURER
CAPACITY
Septic
We `S -e
Dosing
ion
!� er
NhIrg
TANK SETBACK INFORMATION Z�+ Z`0�'
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
y��y1
Dosing
Aeration
AOOOOO
0000? e00000,
Holdi g
PUMP/SIPHON INFORMATION
Manufacturer
Demand
GPM
Model Number
TDH
Lift
Friction
1
System He
1
TDH Ft
Forcemain
nth
Dia.
Dist. to Well
SOIL ABSORPTION SYSTEM !&' Pk4&6<r Vgn�?A on &^6*
County: St. Croix
Sanitary Permit No:
651344
State Plan ID No:
Parcel Tax No:
020-1481-09-210
Section/Town/Range/Map No:
07.29.19.3067F
STATION
BS
HI
FS
ELEV.
Benchmark
LfM
10"4
100
Alt. BM
Bldg. Sewer
� rZ
10182
SUHt Inlet
U, it
1
t Q0r12
SUHt Outlet
Dt Inlet
PQ P
Qe�2s
71
T2
Header/Man.
te�
L' �
a
o
7.711.7
Dist. Pipe
Bot. System
7 /
Final Grade
/ 7
�e
1G-Yf�,7
St Cover
/
J
103.15
BED/TRENCH
DIMENSIONS
Width /
Lengtfy i
No. Of Trenches
Z
PIT DIMENSIONS
No. Of Pits
1000—
inside Dia.
Liquid Depth
SETBACK
INFORMATION
SYSTEM TO
P/L
BLDG
WELLLAK /STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer- `�' ,
.LAf���`
Type Of System: �
n ���
�
C
�
��
5
J
Model Number:Q,;
L�g
oftft
DISTRIBUTION SYSTEM No Qec \Venn**
Header/Manifold Distribution Ix Hole Size x Hole Spacing Vent to Air Intake
Fj_11Pe(!r
Length _ Dia Length Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only
Depth Over
Depth Over
xx Depth of
xx Seeded/Sod
Seeded/Sodded
xx Mulched
Bed/Trench Center
Trench Ed es
o so
Yes
❑ Yes ❑ No
COMMENTS: (Include code discrepencies, persons present, etc.)
Location: 1083 AUTUMN OAK LN
1.) Alt BM Description = 4 (,
2. Bld sewer len th = rt 1'� - `0 +k
9 g 7�
- amount of cover =
Plan revision Required? ❑ Yes ❑ No oe
i1
Use other side for additional information.
4 3
Date
SBD-6710 (R.3/97)
Inspection #1: 1W14 /-V Inspection #2:
e go
}6A& 64-6 AnWA loc4or% clog&- +&-j 4U cock
+
G
� � G
Insepctor's Signature Cert. No.
fAl 2-3 - V7
Industry Service.� Division Coumy
e
4822 Madison Yards W'&y of
tx
� Mead"� tn, 1 3705 Sanitary NrTnit NumK!r (to be filled in by Co-)
P. . Box 716
Madison t 53707-712 512IV�
Sanitary PeApplicati orl State Transaction Nwnt)ct.
In Lxa ctndance With SP 3 121 �� �, �Vls- Add. Crate, subm ission of this farn G to Uie appi: opr iatc soverL�tt ent-al �n.it
is r�:`4� di red prior to ob inim a nit permit Note- Application forms for state-ownedPQ 'I- a , ;U hmated to Project Address (if di ffercnt ihanmaiI inn add.re -�)
the Difpa: tment of af* and ProfessionW Services, Pef-,so nzd inforr a6on you provide rnay be used for iccon.d.iry
I�rIF-liIS S in JCCofdar ce -Aitb the Prig' Law, S. 15 4( l p�.77 �_ St.:11S
I.Application Inforn1Matl�ln — Please J.'gat All Information
11ro,i! C hv, •r NameA/
Property Owner's Mailing Address Prope rty 1. o ation
Gout. Lot
City, State Zip Cade Phone Number
ZIP j W0171 jr.�-
'�0 , SectionfTy
11- °l' E:� 1sailrIrc�el iill t1iuta1�1�11 �� It T
', _
�I I ��,: 1 � o ��..r ��� .: � edr rr�sSubdivision Name
e
�PubI Lc/CurnFTICFCLai — Describe Use R1 I
EJStLl�lc Oxvnej - 1X.),11'r 1,L)c Use �ICity� of
GSM Number V.1I ]ale of
Al
4XI'mwi. ci f /V
1.I1• ` ` �1j-C (MrP0IN'T-S Pvrmit.- ((.1ve-c1q: eIih-ej' 1)1 i` naen'a oid oth-ei- alllrliryal l ire e A. 'ht rw bos�.(in line It. Complete hirte C 1iA.
I`
Ali r�r fa le.
d..
` }st[]Repilaccmen[ Sv,,i.Li [her mkI," l_ Istin� y'�:�'", �,���;:T.air�:� Additional Pr iI c rUnr it (explain)
aolding TankIn-GroundE)At-Grade EIML)Ufld [ndividual Site Design Other Type (explain)
(conventional)
t E]Reneww Before 0 Revision 'hange o IF P1 U rn tic r Elll'rmsferwNe" Owncr ist Previous Perm rt fief urnbcr wid late Issued
I V. Dispers.al "rtstment Area an d TKnk I rafo imation f 6 ' Trw
DL 1J .ei 1=[4)%r, d Design oil Application Ratc(gpdlstDispersall A.rcla Requilicd 'si Lets crs.il Ar, a V
'4711
I Ctil'-nicity irl Total #ref I rufacture.r
1 ilak InIIJ1 rt1a.tsnn I Jal lops Gallons Units *� � �
i ��:1►s � :sting Tanks �� ' �;Rer- L a, ;'"
. C n LZ
Septic or Holding Tank
I -r-Q,
Dosing Chamber
1111LI f ji- Ise. till t 1 � T �
� � �L9L:�LL ; f cr�L° l t �'� a hnwrr L,11 €a,lr
. `kame I. I i rut) Plumber's Sign e.
�'� � 1.l 'a a w Phunc Number
-`
pu.mr's A� � ��� ( Street, Cily, State, Zip Code)
axmy epartmentt Viral1- nnit Fec IdaA[)pr4�-vCj ❑ : isappro-ve i '" ` a�� Issued Issuing Agent i nature
II
SYSTEM OWNER:
3- 1� �►ceMe(I� a.��e�, e s Glow �-� �{-h,e �j0�-r �� ��-1�u�1�
1. SeptiC tank., effluent filter and dispersal cell
'�c4M He n e l g or3 PCVF� -gyp `tic
m u st be servi ced / ma intal reed as per
ma ►gage nit plan provided by plumber.
. Ali setback requ1rem enu must be m intained
as per app bl code/ordinances,
Al1.1di m c(If11',110C I)JAI1S for 41IL 9V&`tlk 'lllil SU111111r L,.M I��,
Property Owner/Client:
r�
James & Kathleen Dorgan
Site Address: 1083 Autumn Oak LN, Hudson, Wl 54016
M Y ADA A I Y— 11
Pg. 2 SITE PLAN
Pg. 3 SOIL DISPERSAL COMPONENT
Pg. 4 TANK SPECIFICATIONS
Pg. 5 FILTER MAINTENANCE
P. 6 MANAGEMENT PLAN
P. 7 MANAGEMENT PLAN
Pg. 8 SO I L TLST
Pg. 9 SOIL TEST
AP
M
Wastewater Type: Residential
Istimated Wastewate r Flow: 300 gpd
SOIL & SME
EVA L UA
Dosign Flow: 450 90
POWTS Type- Non -pressurized Conventional
imiting Condition Depth: 108"
Maximum System Depth: 72'1
Contour Elevation: 100.001
Limiting Condition Elev: 91.00,
Land Slope: 9%
P111: 02C481-09-210
Courity: ST Croix
Pg. 10 SOIL TEST
Pg. 11 SO I L TEST
Pg. 12 SOIL TEST
Pg. 13 SOIL TEST
Pg. 14 SO I L TEST
Pg. 15 SOIL TEST
# Bedrooms (residential): 3
# 0 c c u Pa n ts (per capita flow) . -
Public Facility Flow: NA
Treatment Level: Effluent I
Code Required Separation: 36"
Soil Texture: FS
In -situ Soil Application Rate: 0.5 gpd/ft2
Dispersal Cell Loading Rate: NA
POWTS DESIGNED PURSUANT TO:
In-Gi-ound Soil Absorption Component Manual (Version 2.1)
---------------
'New 3 bedroom home. No he business. No sewage ejector/gr0ider PUMP Proposed. t3) 62'
l i nfiltrat r Quik4+ trenches -with "stepped"' gravity distribution. "Installer may alter individual
,Trench lengths and elevations as necessary so long as a mininiun-i of 180 lineal feet of trench is
S
[)stifleda
' nd system depth is at least 36" and does riot exceed 72". Maintain all building, well, iif' C 0 N
:property 11ile setbacks."
RYAN G.
9mm
SECHEL
D-2263-7
10 31/2023
PRESCOTT
F
SEC H EL 22 63 7 ESCO�) T
AN
IS
ADVANCED ENVIRONMENTAL LLC
CS I G
W1 1932 56 0 TH A VE. PRESCOTT, W1 54021 (651) 32 7-00 74 "'IfIF161100
Designer: Ryan Bechel
Certified Soil Tester-. 1330832
Designer of Engineering Systems: D 2263-7
BM1 = 100-00
Top nail in 2-trunked
hardwood tree
(51 11 a bove grade)
700pul Q E a V Due* 11
T ; op 43" PVC pipe
(z4 above grade)
COPY
0 2023 Advanced
Environmental LL C.
All rights reserved.
*A U ProPertY lines not (D 13 e n ch mark
drawn are - I 00ft from 4� rnso-H Boring N
syste" 6
\�oMG MovE�
_F`01 411
sch 140 PVC
L/Cs} �n QcTerV
Wieser WLP1000
w/ Best GF-10
Septic Tanki,
I
Meser 1 Xr - ors s i!7-," , le-compartm e,,i t tail.
-8w1 GF- 1 C1 %1 reWirod, rewrn mwrido-11
-0-0 nit rwft cl_ water sources 141to septc tank
UUUUMM
Soil Treagm rio ktvu:
-1 rgm-rd 'COMW a! �,j! -c-nth 0.5P&t1;GMd.,9te
-(3) 62 1 nf 14-2"fY QL11
TI
Co.
T2 96 0C`
5 T 94 OC� CC�7j
4+
IF
-Deto r ;a 30n -git' cawv don Vert)
MI
-Gmvltl Dr&_6; J ji.,
4'scm I cr SDP- k-m*
`Inge ap may Lae drop bDm chstribmn
-.- � -wrtm as 'drop "es' in lieu cl dr0butiom
*
^44 9 rib evaluated J�eC-Cte
12110117 by -
G
,Ynaurn blrO' LCCATION MAP (not to scal'o)
1076
0 B ' Infiltrator
RD
**Well to b located >50ft Qu i Trenches <
FREPAREL) FOR -
from soil treatment area & (1-5 chambersltrencN
James fit Kathleen Dorgan
>25ft from tanks** Site Address
1083 Autumn Oak LN
Hudson, W1 54016
I PID: 020-1481-09-210 1.1 Acres
sc A I
Legal: Lot 21 Wspering Oaks
Phase III NE 1/4 SW 1/4
011 S07 T29N R19W
30' Town of Hudson
OwUfmd SbAsmwrt rr& qtwhwn hm bom dift and woakx&W In 000mknm oft Sksta wA Loexil oodw T�; MA 1180bim rxxt m 1i pinytectad from debmtomm ancVor oarnpmAian end aftw corffLruct[w. Scale: I" = 30' Date- 10/25/213
40 MWANTY 1 WKX THAT THS SYSTIN WILL CCKr*" TO FUNCTICN INCERNnUY. Symtwn n-K* be - mKiii0fthmi PMAM Yom VA*M 17VIEW111"i-1111111111! p1w for infomrobw on propw oav _wW mckrNemnmi.
Designer: Ryan Bethel
Certified Soil Tester. 1330832
Designer of Engineering Systems: D 2263-7
aM i = ioo.oa
Top nail in 2-trunked
hardwood tree
(51 a bove grade)
700pul Q E a V Due* 11
T ; op 43" PVC pipe
(z4 above grade)
0 2023 Advanced *A U PrOPertY lines nOt B e n ch ma rk SYSTEM NOTES —
Environmental LL C. drawn are 00ft from Soiti Boring N Septic Tank,
All rights reser1 ed. systern" maser 1.Xr - �rs v7g le-compart-ne,,it tail.
Bririg, ris rade
,8w' GF- 1 C-1, J.,,m %1 rewired, rewrn mwridol)
-0-0 not r%.,!e cli_- water sources into septc tank
Wieser WLP100t
w/ Best GF-10
am==
Soil Tre a amr ii i t ktvu:
I rgm-r d 'o—OWW', i,-, a 1 �,j! -c -Atth 0.5P&t1;G0d.,9te
-(3) 62 1 nf 14-2'YQL11- —
TI �P y
.Z) T2 9601C" Co., x
T3 94 OC� .0 CC-7 j
Q5 ry o F
Ct)
C� r3 j4C) cawv don VerA)
(3 -Dept to resq.. 30n
1\1 M 1
C�
4'scm RIX cr SDP
In
ga rrmy Lae drop bDyw chstriboon
hr,,, -wrim as 'drop "es' in Is cl drobutiom
OF
*Borin evaluated I
I*
9S 11�
17 h
y
Shaun Bird*
C�
Zz
'08 B M 2 (3) 62' Infiltrator
Quik4+ Trenches
"Well to b located >50ft
from soil treatment area & (1.5 chambers ltrencN
>25ft from tanks**
's SC A
011
30,
OwUflW Sbxismwrt rr& qtwhwn hm bom dift and wo*um#W1 in now-donm wft sksta wA Loexal oodw T�; SA 1180bim am mm af pmt� from &RLM-bomm anit/or *ZrOW&M end &%W corffLruct[w.
W WNWffy M MW D4%T THN VSTM "UL Cwnwx M nmenciN lKxflway- Symb" "* be - M***N& ftww ymr "own p&nr for Woffroldcm on pnVw oov _ffW nIckrNemnmi.
.0w
.WW
d_V
age
glop
.01
LICCATION MAP (not to scal'o)
1076
t4lLjq. L RD
FREPAREI) FOR-
jaff*s fit Kathleen Dorgan
Site Address
1083 Autumn Oak LN
Hudson, W1 54016
PID: 020-1481-09-210 1.16 Acres
Legal: Lot 21 Wspering Oaks
Phase III NE 1/4 SW 1/4
S07 T29N R19W
Town of Hudson
Scale: 1 30' Di3te- 10/25/213
APF A
�1�1�►�W�H��al�l�i
100-000,
k1i
_-A
Plan View (noscale)
ayfff WITS
HI I WINE I WE 1111
ill
Dispersal Area Product: Infiltrator Chambers
Dispersal Area Model, Quik,4 + STD
Product, EISA Rating: 20 ft2
Total Number of Components: 45
Distribution Method: Branched Manifold
31
Minimum Required D'ispersal Area: goo ft2
P ro pi p r a I Area (incuding end caps) * 918 W_
Screw -type or
slip -top cap F n'shed Grade
(mulched & seeded)
4" SCH 40 PVC pipe
Top of pipe to terminate at Topsoil cover
or above finished arade 0' minimum)
X 6" slots
.ipaced 900 as
Anchoring Device
(Toilet flange)
Cross-Selction View (noscale)
99-00
NATIVE 13ACKFILL
(12" rnin Wical)
9 5. 00,
Infiltrative
Sur -face
..........
Mil mum System Depth: 36'
Maximum System DeDth: 72"
■
............................................ ........
98.00,
NATIVE BACKFILL
(12" min lypcal�
94-00
TANK SCCA NS
Minimum cover = 6 inches,- Maximum cover = 8 feet ('unless specified by manufacturer)
All manhole covers shall extend 4 arches above final grade
If the tank is within 2 feet of final grade, insulate the lid to an P-Value of 10
Minimum 18" of cover required over building sewer; Insulate ff greater > 30'long and < 42" from grade or if <
60"from grade under oil high trafficIsnow cleared areas (driveways etc.)
Building sewer. No 90's, keep 3 feet between 45s, maintain 1 hich in 8 feet -slope. install cleanours
at the building connection and every 100 feet of a minimum
100.50,
C lean Oul
99-50 97.33'
4- SCH 4 Bldg Sewer
Tank k M a n ufactu re r/ Mod e I: Wieser - WLP1000-M R
---------------- --------------------------- ---------------------------------
Fi It r M a n ufactu re r/ Mod e 1 -9 Best - GF-10
-
----------------- — ----------------------------------
P a n e I Ma n ufactu re r/M od el: Not requ !red - (SJ E Rhombus Teak Al e rt 1 recom mended)
-- - -- -- - ---�.A*----------
P.
I
':i DE VIE
4-
WLP1000—MR
TANK SPECIFICATIONS
WALL. 2 '1 12.
8CT7',')M SEPTIC Sw
YA%H0LE: 24- C, ;'1141LCAS' C-CiNCREIE- P HP
4FIG"T.- P,A1 COVER $1 1/4y
-,ENG-,4 10.4" C.D.
b UNLL f U.
M 7
k,A )T[ FT.
Nt FT A .
4 "�-Abt, A--,>LAL BOOT Urq UA-
9
GASXET, CAS7-III-SEA1. 5C-QT OR EC,,
Ci
,NLE t AND iAJTLET BAFF�F- A%D 971,TES
FL
*15CICNS'N, SU 'MAI 0-J
'MICR STA7�S 'SEE CkiA;�—)
OUP` AP ACI ;?7.53 GAL/%4
"OLL)ING 7ANK,
AC"'UAL ��AVACP Y: 1.30try GALL,ON5
1A-TS1(1N 8' CD� (j%%-SA*JRA1tD S--XL
IANX CA% BE USLD AS
'Co'OVER. MIX EELS 1N #45 �NC FIB,14q)
LAS
'AN#( Mi X DE45,(�4 010 (STRUCTURA.- FIKR)
C-USt(W1}jam L- IANKS
VOW C9STOM loPL-NO(S C,DNIACT *fSEP CCINCREIP
I
CL
DkAWINGS SUBMIIIIA�
FOR APPROVAL
VAN(JFA -TjRED TO IEEE -OR EXCEED AS-U C-1227 REWIREMENIS
Panp. 4
Installation Instructions for the GF1U Filter
Stop 1: Locate and reffmNe
the septi c to n k tom, on
the outlet side of tank-
R;q
�4�
!Step4- Glue the filter case onto
the outlet pipe. Ins eft the filter
cartridge Into the case. (Make
sure the fiftw 1:5 completely
inserted Into the case.)
BEST
�`J
Stop 2: Before InSU I I atl,on,
place the filter case on to
the outlet Pi P-e - Make -sure
the case is positioned so
the filter ca n be removed
from the t a A f cK ma I nte-
nance and seryke
rsI
L3J
Stop 3: For in sta i I ati o n 5 that
require or desire additional
5 uppo rt. Of aiddWo na I support Is
not needed, go to Step 4) Glue a
sectiort of I' Sch. 40 pipe to the
two hubs located on the bottom
afthe case and, the hub located
on the side of the case.
Stop 5: For Insta 11 ation s whem- It wl I I
be dtfficult to reach the handle, pla c e
1 w Schedule,40 pipe Into the W on the
hardle and extend it to height that will
nuke It easy to remove the Nt&.
D
Installation of an S.. as s rwo sWom cmily tin sop* Unk
6 extsting system. mo" bo p,,ntW prkw to Mstelladm.
am EW TA MOT "i
Maintenance of the GF10 Filter
A time frame in which septic tanks are serviced is Bert by state and local codes.
Al though th ey may be drffe ren L most reg u latory agendes suggest two to fi ve
years_ We recornnx4nd the G F 10 fi Itef be [leaned lien the is tank s norrna Ily
r. le -a reed a nd pumptw.( or a s no,- _
WARNING: If the liquid level in the tank is above the top of the
filter, p u m p the tank prior to removi n g the fi I te r cart ridge.
0 CAUTION: USE RUBBER GLOVES WHEN HANDLING FILTERSI
S top 1: Fkrr� the septic tank cover
and pump the tank If necessary to
p revent any so from escaping to the
field when the filter is remcived.
. i5l
0
0
Stop 2-1 Poll the filter
Step 1. Whill-e holding th -e
Step
Stop 4: 1 nsert the cartridge
h an, d I ii� d nd sir dc- the her
fikeir cartridge over the
back Into the case ma ki P g
out of she case.
access open i nq of th e ra r) k,
sure that it is properly
trinw the ca; tr id g e off wi t h
aligned -a rid corn pl ete ly
fresh watet. Take care co
Inserted r n to r hQ Iasi?.
make sure all solid riaterial
falls back Into tfi(9 tank
�' BEST
TECHNOLOGY
3 Fa IrSeld 131W, Wa I I I ngford, CT 08492
1-87'►-766-Fa)c 203-284-8614
J
�i
V
CHI,
The owner of this Private nsite WastewaterTreatment System (POWTS) shall be responsible for its perpetual operation and
maintenance pursuant to requirements of SPS 382-3840 Wisc. Admin. Code. This management plan Identifies operation and
maintenance activities necessary to ensure long-term systern performance. Tasks that should be performed by the homeowner are
Identified. Pro fesst-onal management tasks shall be performed by a registered POWTS Maintainer if; accordance with SPS 383.52 (3),
Wisc. Admin. Code, however, it Is the homeowner's responsibility to ensure all tasks get accomplished in a timely manner. Pursuant to
SPS 383.52 (2), Wisc. ArYmTn. Code, this system shall be considered a human health hazard if not maintained In accordance wfth this
appro ved m a nage i n e i i t p la n.
lo* Keep this Managemerit Plan with your Sepic System Owner's Guide.
lo- Keep copies of all pumping records, maintenance activities and repair invoices with this document.
Pok, Review this plan with your POWTS Maintainer at each visit; discuss any changes in product use, activities, or water -use.
AIA NA GOWEN T FREQUENCY
Design Parameters
Number of Bedrooms
Desigi i Flow mod)
Sail Loading Rate :gpd/ft)
Stan(jar(i Effluent Quality
Effluent 1
Biological Oxygen Demand (BODE
12 2 0 mg11
'Total Suspended Solids JSS)
15 0 mg1l
Fats, Oils, Greases (FOG)
3 0 mg11
Treated Effluent Quality
Biological Oxygen Demand (130D)
- Mff//
Total Suspended Solids (TSS)
M494
Fats, Oils, Greases (FOG�
M&/
Max Effluent Particle Size (in)
IL/8
System Speciftations
3 Septic Tank Manufacturer Wieser
450 Septic Tank Capacity (gallons) 1002
0.5 Effluf:,nt Filter Manufacturer Best
Effluent Filter Model GF40
Pui,iip Tank Manufacturer
PLImp Tank Capacity (gallons)
Pump Manufacturer
Pump Model
Dispersal Cell Type
Pretreatment Unit Description
Homeowner Management Tasks 11 Professional Management Tasks
Check oistef i, look) for leaks In toilets and dripping faucets.
Repair leaks promptly.
Regularly check for wet or spongy soil around your soil treatment
area. Contact service provider if issues arise. Control burrowing
animals (gophers, groundhogs, etc.)
Keep bikes, vehicles, snowmobiles and other traffic off treatment
area.
A/arms - Contact your sen�lce professional if any alarm signei.:.,,.
Lint Filter - check for lint lujitdup and clean when necessary. If
you do not have one, add one after washing machine.
Caps - Make sure that all caps and lias are intact and in place.
Inspect for damaked caDs often. Fix or re lace darnai�ecl cai)s.
Effluent Screen - Check and clean per manutc-)cfurer
recommendc-alof1s.
7110.11
NA
Per Instalfer
Per Installer
LIQuicl levels - Check sludge1scum, effluent ie�,els J'n -ifl System
tanks. Recommend if tanks) should be pumped. PLIMP a//
compartments every 36 months at a minimum.
-inspect tank inlet and outlet baffles (if applicable)
�Check drainfield effluent levels (if applicable)
I Verity pump a n d slam sys te i n fu i i ctions (if applicable:
W1
Wng for corrosion and function (if applicable)
Clea n dra I n field la te ra is (it applicable)
Check event counterlelapsed time. meter and evaluate water usage
rate l compared to system design How.
Check dissolved oxygen and effluent temperature in 'tank.
Check for surfacing of effluent or Other signs of problems.
Verity Inspection pipes are capped and intact.
Provide h o m eo wn er with list of m a nage me n t res lilts ri n d any a ctio n
frif [;-Ij W] I
POWrSREGUL4TOR: Sr0w&L0o%unjjeZ&?1ng0fi1ce
A DDRESS- I 101 Qif michael RD Safte 1". Hudsw,, W &W16
PHONE- (715),3864680
.................•
....... . ............ i ............... .......
Pa nap fi
S M R T-UP & OPERA .RON
For now onswiction: Pr[or to system operation, check septIC/pUMP tanks for the presence of painting products or other chemicals
that may Impede the treatment process and/or damage the dispersal cells. If high concentrations are detected, have the contents of
the tank removed by a licensed septic professional prior to use.
System start-up shall not occur when soils are frozen at the infiltrative surface,
DurlagAmer outages: Pump tanks may fill above normal high water levels for system utill7ing pumps. When power is restored, the
exces s wastewater wi 11 be d Ischarged to the dispersa I ce 11 1 n one I arge close potentia Ily result] ng in overload i rig of the c e I Is . Ba cku p or
surface discharge of effluent may also result. To avoid this situation, it is highly recommended to have the contents of (tie pump tank
removed by a licensed septic professional or have a septic professional manually dose the system to return the pump tank to normal
operating levels prior to restoring power.
Do not drive or park vehicles over airy.septic system components. Do not drive, park over, or otherwise disturb or compact the area
within 15 feet downslope of any mound or at grade system or secondary septic system site.
MANNA NCE INS 7RUCRONS
inspections of tanks and dispersal cells shall be made by an appropriately licensed individual or business. Tank inspections must
include a visual inspection of the to to identify any missing or broken hardware, identify any cracks or leaks, measure the volume
of combined sludge and scum, and to check for airy backup or poncling of effluent on the ground surface. Access openings used for
service and assessment shall be sealed watertight upon completion of service activities. Aiiy un5QUO"Q&Qtjye, a,QQes� QL)e'ning5 5bal I
be replaced immQdia
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of
effluent on the ground surface. Ponding of effluent on the ground surface may indicate a failing condition that requires immediate
attention by a licensed septic professional.
Tanks must be pumped when sludge accumulation is within 12 inches of the bottom of the outlet baffle, or whenever the scum layer is
within 3 inches of the bottom of the outlet baffle. I n no case shall total sludge and SCUM volume occupy greater than 25% of the tank
liquid capacity.
The effluent filter Shall be cleaned as necessary to ensure proper operation. The filter Should not be removed unless provisions are
made to retain solids in the tank that May SIGUgh Off the filter during removal, If the filter is, equipped with an alarm, the filter shall be
serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge floras or an impending continuous alarm
and should be evaluated by a licensed septic professional.
Pre-treatment components shall be maintained and serviced by a licensed septic professional according to the manufacturer's
recommendations-
COAWNGENCYRANS
If the septi c to n k, or any of it's tom ponents, become defective the tank or component sha 11 be immediately repaired or repla ced
according to the original system design specifications.
if a dosing tank, pump, pump controls, alarms, or related wiring beconies defective, they shall be immediately repaired or replaced with
ccri'iponents of equal performance.
If the soil treatment component fails to accept wastewater or discharges wastewater to the ground surface, it shall be repaired or
replaced by; increasing basal area (if toe leakage occurs), rebuilding the component at the secondary system site (if identified), or
removing and replacing biologically clogged absorption and dispersal media and associated piping. If repairs or rebuilding is not
possible, a new soil and site evaluation must be performed to locate a suitable replacement area if one has not already been identified,
If no replacement area is available, a holding tank may be installed as a last resort replacement POWTS.
ABANDONMENT
If the septic systeri fails and/or is permanently taken out of service, the system shall be abandoned according to SPS 382-384, '-,vi sl�.
Admin. Code abaBoon nient regulations. Requirements itICIMie,
- All piping to tanks shall be disconnected and abandoned 1.,Ii pe openings sealed.
The contents of all tanks shall be removed and disposed of by a licensed septic professional,
-Tanks shall be crushed & filled, or removed.
- A septic systeni abandonment notification shall be submitted to the appropriate local governmental unit.,
WARNING11
SEPTIC, PUMP, AND OTHER TREATMENT TANKS MAY CONTAIN DIAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER EPTIC TAN K, PUMP TAN K, OR OTHER TREATMENT COM PO N EN T U N DE Ai CIRCUMSTANCES. DEATH MAY
RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ALWAYS CONSULT
Pang 7
orYNTY SANITARY SYSTEM
OWNERS HI PADDRESS FORM
FUse fy File 4:
Office 0"C e7
CrwW 212027
It
Corn mun'l'ty Development Department will utilize this 'Information to provide the property owner with
information regarding operation and maintenance of your new or replacement sin itart' system! This
information w111 be provided as part of our ongoing efforts to protect public health,yourwell, groundwater,
sou fface water, property values, and county resources. Once approved, this completed form and educab oreal
I
information will be sent to you brnail.
I-
�'Gy X, t
Owner/Buyer,. 6.
# .1
Mail i nq Aaaressl, L-1 01--- t� AC- -k.�
14 ..... jeve�city/statelppd 545 C) I up
02 L ul
Phone Number (requirect)
I -2P VO YW-�
E lair Address (required), rc'j, j 0-4
_j
Parcel Identification Number
(found on the p rope" tax b ill)
NEW SYSTEM: LEGAL DESCRIPTION
Property Location 1Z4 1/4 Sec. —1 T' ?,��-N RZ- LJV,. Town Of
?
S ubdivision Plat J'� Lot* 2,1
Certif 1ed Survey Map # L
Volume- Page
Warr n ty Deed # (before 2006)Volume P a g e #
Number of bedrooms Spec house 11 yes X7 no Lot lines ldentifiable)M yes 13 no
OFFICE USE ONLY
New Property Address �3 �
(Vefificafion of new address required fmm Community Development Department for new constructilca)
A 11 �) � 1 117-!) q.,V
L
(Staff Initials) (Date)
This form must be submitted witfi all Private Onit e Water Treatment System (POWTS) applications,
New System: Include With this form a recorded warro n ty deed from th e Register of Dee ds Offit ce and a copy of the certified
survey mop If reference is made in the warranty deed.
Community Development Department - Land Use Division
715-386-46K St. Croix County Government Center 71,5-245-425,0 Fax
1101 Carmichael Road, Hudson, Wl 54016 WWSMV-1'.Qov
!)Licumert Number
THIS DEED, made between
Sharkey Design Build LLC
("Gtantor,' whether one -ov more), and
James Dorgar- -ind Kathleen Dorgan
*Grantea,` whet her,,.n:'� oe"w(klµe
WARRANTY DEED
L)
Grantor, for a valuable Qonsill'.''r" 47-tj-,)n, onveys to Grantee the following described real r ,
With the fixtures, }profits, rents And other appurtenant interests, in
Saint Croix L.j n ty tate of Wisconsin ("Prcpu�rly") (if rnore space is needod, please
attaclgj I".
Lot 21 c W his eriri Oaks - Phase III r St, Croix Cou nty, Ksconsin.
115AMMIUMIll
1163143
BETH PABST
REGISTER OF DEEDS
ST, CROIX CO,t W1
RECEIVFD FOR RECORD
01/17/2023 0S:01 AM
EXEMPT#:
RC FEE, 30.00
TRANS FEE 300.00
PAGES., I
**The above recording Inform atioll
verifics that this document has
been electronically recorded
& returned to the submittter
Recording Area
Ntnrne ard Return Address -
Executive Title
11112 86 ffi Avei We N cl,
Maple Grove, VIN 55369
0 2 0- 1 4c� 1 20 0
Pa"cel Identification Numba..r �P�'N)
This is not homestead property.
G,rzinlo,q warrants that tie title to the Property is good, indefeasible in fee simple arcl, free ar%,d c!Far of encumhrances except-,
k7
Dn 'Cj'.
Shaikey Design Build LLG
By: 1�
rl e, V
Ljdoh"S lap
AUTHENI-ICATION
Signature(s): Sharkey Design Build LLC authenticated on
TITLE: hTM61fR STATE BAR OF WISCONSIN
authorized byWis, Stat. § ID6,06)
THIS INSTRUMENT DRAFTED BY:
Fixecubve. Tit1c
2550 University Ave West . Suite 265S
St. Pail, MN 55114
F.ATW&X61V H 101 lei Wr 4' 2 k I
STATE OF Minnesota
County OF
1, Li ride Dannen, a Notary PLIbiir, for the County of
Ramsey and Slate of Minnesota, do hereby certify that
John Sharkey, Chief Manager of SharkQv Design Build,
LLC personally appe-c-Iffed before me this, dlply and who
swore or affirmed to rne thap., Vie contents of he document
are truthful and accurate to U-ie bestGf her knowledge and
belief,
-,7
Vq,v'ithe ss r)y riql:�i rid officialS a[, this the Z��. of
"7 1 D(7,1(�GfjjbOrl 02?
S �Y
Notivy Pub1W
of N' rrio
skw Exp"16's
N,
31,02-1
L! 21 V .2
jW AMD
My Comaij:sSion Eq)ires:
" S L-AL)
(S iq riatwas t-nay 6 u� 'mth G-.16 r- at li"d (3 1, �"ktl ovq lodge, d. Both are 11 of I I El cemery.)
"Type rI,-jme s-:r
St, Cror-' C.0Ljni:'y 1163143 Pac
FRIONT ELEVATION
4 R IG�-IT ELEV .T I ON
FK ELBVATION
w
u
P& P
AS NOTED
oa zm_m
W KVW.
Olo11)
Rig #
l
3
Z
4z
as
qpw
ab
DORGAN RESIDENCE
MALN LEN'El, PLAN
>
Z-
RJWLNTL&L IRILT14YUCLY LXWC
wl %4116
ITIM Prjw OMNI. Ww W - $ i
IM
DORGAN RESIDENCE
UFFER LEVEL PLAN'
[7, 7M
Esalcry NATO IS
M4
MINNUM BUILDING SETdACXS:
FRONT SO FF.
SIDE 10 FF. WHNII1 UM.
23 FF. COMINNED MN►IM tM
REAR 23 FT.
DIMENSIONS ARE SHOWN FROM LOOT
LINE TO EXTERIOR FOUNDATION WAIL
rm.wmf ADDI E .
SCALE: 1 P101 s 40 FEET IM AUTUMN OAK LANE
MUDSON, WI 54016
D 40 S0
VH(TICAL CONTROL DATUM: NAVD 1+,1iK
NORTH
it C
qO/309
oORClkk
r ' LEGEND
I i FOUND IRON POPE PER PLAT OR AS NOTED
•
WOOD HUB SET AT 10' OFFSET OR
ON IHHLDING LINE EXTENSION
12 FF- UT*M EASEMENT
DRAIINAGE EASEMENT
I
�I ALL EXTERIOR BWLDMiG CORNERS
MARKED WITH PIN FLAGS
FIELD WORK COMPLETED: 4/16/21
7
f�
AljTjj%V
A A)VE
powm -• ` WITTSTOCK BUILDERS M" 000000 111111 MNV WON
LOT 24, WHISPERING OAKS PHASE IIII m `, •"• `°"°�'
�� sw:�10* 1iYt.xprrrq Oai:.
NESW rj EC 7. 729N. R t9W. TOWN OF KFOS�")fi. S F CRCKC CC�tlNTY. W6AR-C7� SIN or �
HOUSE STAKEOUT PLAN h&�� w w 8n� ,.�,.,.., ,,, mul
,
Ptge 11
Wisconsin Department of Safety and Professional SeMoes
Division of Indus" Semi
SOIL EVALUATION REPORT
In accofdance witti SPS 385. Wis. Adm. Code ceountv
Attach complete site plan on paper not less than 8 1/2 x 11 inches In size. Plan must include, ST Croix
hul not to" verlical and horizontal reference point (BM), direction and percent, slope, Parcel I - D.
sclalt, of dimensiom, north arrow, and location and distance to nearest road- 020-1481-09-210
Please print all infornwition. Reviewed by Date
Personal information yo.0 p ovide may be used for secondary purposes (Ph Law, S, 15.04 1 J,(M I9&V111 k#=
Properly Owner Property Location -
James & Kathleen Dorgan Govt. Lot: NE %, SW S 07 T 29 N R 19 VV
P ro pe ti V Address Lot EPock # Subd, Name or CSM#
1083 Autumn Oak LN A 21 Whispering Oa,ks Phase III
City Slate Zip Code Phone Number El city 0 Wage M Town Nearest Road
Hudson JWI 154016 (763) 354-0743 1 Hudson IAuturrin Oaks LN
Hew C o n -M rtjcWn lase: Residential / N u rnber of bedrooms 3 Code derived des �(iw rate 450 GPD
Replacement Public or commercial — Describe:
Parent rT, at e f, a I Loamy 91 aciotiuvi a] sifts over sandy outwash (Roshod s.1) Floodplain elevation if applicable NA ft-
G e n era I c of n m e, n ts a n d r ecorn men d a ton S. Hecornmend in -ground *conventionar rrench(as al ',' 8" - t F' depth wrth 0 5g POM 2 loading rate
LF = >108* (observalk)n exleni)
Bor 1 ri g # E] Baring
W pit Ground surface clew 100,25 ft. Depth to lirriftg factor >1 10 in,
S6.1 Annliration
Horizon
Depth
In.
Dominant Color
Munsell
Redox Descripbon
Qu. Az. Cont. Color
Textute
StrucWr,e
Gr, Sz- Sh,
Consistence
Boundary
Roots
3C-Vf
GRAD/Pt`
"EMI
*Eft#2
-- ---------1
0-8
7.5YR 313
1
21-msbk
mf r
CS
0.6
10�8
2
B-13
7-5YR 4/4
s
Cl
2msbk
Mfi
gs
2m-v f
1 M-VI
0.4
0.6
3
13-33
5YR 4/4
S1
I csbk
mf r-mti
CW
0.4
0 7a
0.7
1 .6a
4
33-46
7.5YR,5/6
IS-S
Osg
MI
9W
1 f-Vf
5 (5% rock)
46-78
7.5 Y R 4/4
S
Osg
MI
CW
0.5
1.0
6 (5- 1 o% rock)
78-110
7.5YR 514
L
S
Osg
M I
0.7a
0.6
.Horizon 5 h4l
at 1- cm thiF
k 5YR 414 Is le elf
ebands: lGading rates to
1 1
borizon reduced
to rened pmeritial
M for sjowe4ffluent
move+nt
I
Boring #
Boring
Fait Ground surface elev. 9570 ft. Depth to limfting factor >1 12 in.
IRrsil Anrifiratinn Rats.
Horizon
Depth
In,
Dominant Color
Munsell
Red Descoption
Qu. Az. Cont. Coicir
Texture
Structure
Gr. Sz- Sh.
Consistence
Boundary
Roots
G PINFIr
*Etf#1
*Eff#2
1
0-7
7-5YR 3P2
I
I- it
t 1 f-msbk
mfr-mf'l
CS
3m-vf
0.4c
0.6
2
7-17
7.5YR 4/4
SO
2mabk
Mfi
gs
2m-vf
0.6
0.8
3
17'-35
7-5YR 3/4
IS-Sl
Osg-i msbk
mvf r
gw
2m-vt
0.4
0.7
4
35-53
7.5YR SY4
IS-S
05g
MI
MI
gw
1 M-Vf
0.5
1.0
5 (5% rock),
53-112
T5YR 514
S
OS9
0.7a
1.6a
Ime
Some oc" sloilay
Hor i zo n 4 c4ta
irved 1- 2c
thick 5 Y R 4 A 1 s I
I I ae bands (loading rites
redtc+
ba ids of gIrs
�ere obsery
in Honzoi
5
M-Mirl =-* "MEMENNE16242 �=idrJTMP& I
CST Name (Please Print)
signature
1
— — ------- --
CST Number
Ryan Bechel (Advanced Environmental LLG.)
4q
1.330832
Address
Date Evaluation CondLpctad
Telephone Number
W1 1932 560TH AVE, Prescott. VV 154021
1 W25)23
1) 327-0074
ZD bL)-tiJJU t KU4� I D)
Pane A
Boring #
E) Boding
K pit Ground surface elev, 97.,00 k
. ..........
Depth to limiting ta ctor ;" 1 .08 in.
fqM Annfir-tAce%n
Hon*zw
Depth
In.
Dominant Color
Munsell
Redox Description
Qu, Az. Cont. Color
Texture
Sure
Gr. Sz. Sh
Consistence
Boundary
Roots
Roots I
GPD/Fe
*E.ff#1 *Eff#2
1
0-8
7. SYR 3/3
sil
2f-msbk
ruff
Mfi
CS
CS
3m-vf
2mM
0.6
0.4
0.8
0.6
2
8-14
7,5YR 4/4
CI
2t-.maok
3
14-2-1
5YA 4/4
IS-SI
OSg-lcsbk
mvf r
gs
1 m-vf
0.4
0,7
4
21-30
7. SYR 4/4
is -If $
Osg
MI
gw
1 MM
0.5
1.0
5
30-42
7.5YR 4/4
IS
OS9
M1
CW
1 f-VI
0.7a
1, .6a
6
42-57
7.5'YR 5/3
S
Osg
M1
CW
O.,7a
I .6a
7
57-108
7. 5Y R 514
S-Is
O!sg
M 1
0.5
1.0
'Some occasional bonds of grs wefe observed in Honizon 7
BLiring El Boring
El pit Ground surface elev, tt. Depth to limiting factor in.
Horizon
Df,pth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz- Sh
Consistence
BOL,indaT-y
Roots
GPD/Ft
*Eff#1
"Eff#2
Boring # El Boring
El Pit
Ground surface elev. ft. Depth to limiting factor in.
Horizon Depth Dominant Color Redox Description I Texture I St ru ctu r e I Consistence Boundary Roots
I In. I Munsell I Ou. Az- Cont. Color Gr. Sz. Sh, I I I
* Effluent #1 = BOD, > 30 0 mg/L and TSS > 30! 150 mg'L " Effluent #2 = BOD. � 30 s220 mg/L and TSS > 30 S 150 mg/L
Soil �pRlicatiqn Rate
GPD/Fe
__7 - F_ ff#2
* E rf ;# 1
COMMENTS -
Soil test was conducted to relocate POWTS to east side of lot to accommodate proposed home
location. Initial soil test was completed by Shaun Bird on 12/10/17. It should be noted B2 of
Shaun's soil test was adjacent to B1 of my observation pits. I did riot encounter any fine sand or
very fine sand in my B1 test pit. B3 was the only observation pit in which I encountered loamy fine
sand and fine sand. No very fine sand horizons or inclusions were observed within the my test
Pam, q
SSM
i Designer, Ryan Re el 2023 Advaiiced *All property lines not BeTIchmark VTENOTES
I Certified Soil Tester 1330832 Etivil"ronmental LLC_ drawn are >I 00ft from Soil Boring N 5SVfic Tarsk:
Designer of Engineering Systems.- 0 2263-7 A It rights re. served. 4 systemo
100.010
Top nail in 2-trunked
hardwood tree
(51 11 above grade)
PUITIp Tank:
Soil Tru,inne"I Am:
at
BM2 96-80
XK'.
3T1 Sz�
Top - PVC 4 p4i pe Vor Po Q5 WO, of
It .01 4pp
(24 above grade)
�b
C
�0
z'
M!, I i -i but Ion
V 01%
J
6)
*Bonngs evaluated
12110/17 by
Shaun Bird* LOCATION MAP (rot to scnit�
0
IL
BM2
iz IRD
Well to be located >5Oft t,)jL.jjz 'AD
PREPARE[) FO R
from soil treatment area & Jjikmes Et Kathleen Dori3an
tt from tanks** Site Address:
1083 Autumn Oak LN
\&I p Hudson, W1 W16
SCA1 F t PID: 020,1481-09-210 1.16 Acre
Legal: Lot 21 Whispering Ocks
t I Phase III NF 1/4 SW 1/4
S07 TN R19W
304 Town of Hudson
THW qpbrn hm bow dveirdd wA ovakxftd In sim dw= vft Sbft =W Local On wA hwbiw anse mat i prubmtod r dWftm-burVD* mWor ourpoakn 69om and dftw cunGtnKM0M Scale: 1 30' Date: 10/25/23
4D %WRWff 13 MAM "T TM FfSTM WILL CDNnNM TD PJMMM KIMLY. 9 Pan4a 10
)vhm mud be pimp" ankAdho:1. PAOso yov WOwr(s mawgimpm-rt pkm %r ktormatkm an propw ocre w%d aciiiiiFtwxx
Mvzmn Depadmw om.nvmx SOIL EVALUAT!ON REPORT'' Page 01
Safety amd Stxjdwv�
in aocomLance wiiwi (,:;jm m 8 WVfus ka m Cwe
2 x rvhe:s i r i size rir, rnist
Afta,d) Cocnipic le 34te pjan on papef no( jess ftn 19 1.r < -7
lf)dWe, W no( lunted U) ve(tcal and hmZonfai reference point (BMI, der ec:-,on wd parow 1, 0
f to nears%* oad WC41?1! SkM�W, she or doww-Ans. north arrcw, and 1000W-1 4nd dfstan(A r
31
Please print all information. Reviewed by Dal*
PW*0ftW Infoamalm rw mrowde m&y be um6d kv SarorwfarV purpumos (Prwmry L0,0 a 1$ 0-4 11) (fh��
LOGd;ICTI I L3 C', ^ x
tow G" LCd ftj 1A T f F -,A
PrupqM CWWS A*Jre m Lois 610C* M . &Jbd NaT* Of CSAW
MWV Ad
L
/F
CdY Stme --2i�p-CcoT—Pt Nur-%Oj*Y E Nvare-.sl Road
- ----- - -A TA
MP-
uW KRW&dentW " NunbW of be*owt CxxJ40 Oenvod de s b9n kw rate 90"1 V/ GPD
Ll Replammem P 01 MqmvzxW DeWoc
Pwont rriMcmilal
Fbw Fjloc-t cievabon d,3D0cab,e
11to W ft 4F
grid i WUXI ViversdaWrLs
0 Sonng
)&4, P I 1
Ground sew,ce ewv
Grour)co suTfacu elegy
Depth to UftEvig tad of
Depm ILI 111rtbrq laKirw in
Efflumt a i -- Boo - YrxA and TSS ;P 30 15 mcIL EMoonl JW2,7- 600, < 'K rV1 ane- TS3 < 30 rtx)l-
CST Name 'Please Print)
-S,; I N t i rnbe r
Bird Plumbing, Inc- F'1hatin Bird 226900
Dak: E.,wriduAl r,:"] Te-for" Number
1432 120th St, New RICher ond, W1 54017 715-246-4516
Page 12
PTOpn Chvvwt C �
Bo" a 0 Bonng
.117 #% . e' rru irw4 ir.
Page — _ cA
&*ng At an'r NL
ElP GFZY'-,Fl 5(,T*a,:-rePI(IV 04
De-pt-itri Irm-iN in
-r - I Scx! Af"K;atK30 RaIP
FkMon l3eprt Nx-nirlant C;64:x Redox Desmpton k, A 1,01 t-�Arrk C�Sterlce GPON
Boundaty Roots
11rO k, unscl ..0 SZ GD& "E"S I 'E"2
L3
Bonoq x Bei r ng
0 pll Gfwnd wrjacre olev. CkmAh to lirr4n&- tactcw wl
'lepth Domirunt Coky Rix Oescripbm T#.,xUe SMX*" Cormigence Rools G,R^
MunseU Qu 5j Cxmt C'"or Gr Sz. Sh *ERV 1 *Eff*2
A
4w d
Elnu&l t BOO} -- Yj -c 2.20 mql- avi T SS 3c, ,: 1 sc rT Mue-rA SOD, '� 30 runt " TSS � 30 mql-
The Dcpument of Com m cr c � j 4; an cqua I 011 P�Of tLl. 111)' «-ef % lCr PCO", Ider and crr.pA'u Yci, If yov nced assistancc to acccss scrviccSOT
R-1 7
nccd vi'mm"k: .11 13,j fll��rtlalr firnwt, pkasc coriuct me depv-mTY tvil at 608-26h-I 151 or 1-608-264. . -, j
SaD UY, f 0 161V 1
Page 13
Project Name NWP Holdings
S()I,l T'Cst Plot all
S I I a I I 1"I
Ulluzib '1844 River Ridge Rd,
Hudson Wi 54016
(1'1�14NI #226900
21 SubdWision WhisI)enriq Oaks III mate 12.*` 1 -ill 7
1/4 S W 114S, 7 T 2Q N/R19 W Township Hudson
Rimno County ti I - UHUIX
0 N1 ell 14. ProperlN Line
k IINI 1ji- \ 1 1, Assume Elevation 100 it. Top of 3.14" pipe
System Elevation TBD
*HRpSame as Benchmark
Page 14
Fa,,:;e I ',
SI GM COUNTY
........ ... .. . . ... . .... .... .... ...... .. . . . ...... .....
.. ........
. ...... ...
. ..... .. .
U7%
RAN
SFER/REN WAL NO
OOWNERI �a�h`�e� Vo�yaq
1
♦ AUTHkjR1Z-j j
............. ...........
I 11IN -rr-.dRMI'I' EXPIRES
SBD-06499 (RI 1/20)
CHAPTER 145.135 (2) WISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit.
(b) The approval of the sanitary permit is based on
regulations in force on the date of approval..
(c) The sanitary permit is valid and may be renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(e) Renewal of the sanitary permit will be based on
regulations in force at the time renewal is sought, and that
changed regulations may impede renewal.
(f) The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: 1f you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
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