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HomeMy WebLinkAbout651383 032-2193-11-300Wisconsin 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: Freddie & Alissa Gray City Village Township TOWN OF SOMERSET CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURE w y CAPACITY Septic ODD Dosingi L7 a•0' f� s � � �""`'C 4 [o[.�taP Ae ra Holdi TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic I 3� 1 l� Dosing Aerati 7 Hold'n PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Num er TDH Lift Friction Loss System Head TDH Ft FQeie-m Length Dia. Dist. to W SOIL ARS0RPTI0N SYSTEM 1-Z D 1 D_ _. I - ELEVATION DATA County: St. Croix Sanitary Permit No: 651383 State Plan ID No: Parcel Tax No: 032-2193-11-300 Section/Town/Range/Map No: 06.30.19.1649 STATION BS HI FS ELEV. Benchmark 1.3q IOI,3'� Dd.D/ Alt. BM Bldg. Sewer i SUHt Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe n � Bot. System Final Grade 93.8Y St Cover F_. BEB/ ENC dth NoVOf Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 77ength / !O Z SETBACK INFORMATION SYSTEM TO Type Of System P/L 1 I BLDG 2 J IWELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer: Model Number:` DISTRIBUTION SYSTEM Header/Manifold it 11-ength 1j L' 5D Dia Distribution Pip Length s cing x Hole Size x Hole Spacing Vent to Air Intake -.11 yq SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No pMMS: (I clljde code iscrepencies, persons present, etc.) Inspection #1: Y/.S-b.Z� Inspection #2: L ca ion: 340 172ND AVE ((JJ 1.) Alt BM Description = 1 0 gS f ���� i [���e[[ v_ � aP.i.K�LyQfs — �p ,�Q CQ 2.) Bldg sewer length = .2qE S j � �,A SC. Ll-'r tQ . s - amount of cover = ref .f- , 11 Is A .9, I $ • sue-(. 4e' Aurrs.3 Plan revision Required? ❑ Yes ❑ No Use other side for additional information. Datt Insepctor's Signature Cent. No. SBD-6710 (R.3/97) (_ `�IJ G S ejA1M�Q 3 �j ° Industry Services Division C:ounly f��(f_�2�_ CIO 4822 Madison Yards Way Madison, Wi 53705 PA- Box 7162 Sanitary Permit umbcrltn 6e fillcYi in by Co.) JAN 9 2�24 Madison, Wl 53707-71 5' StC t Application Starr Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this torn to the appropriate gcwernmcrttal unit Project Address (ifditTerent than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department ol'Safety and Professional Services. Personal information you provide may he used fur secondary purposes in accordance with the Privacy Law, s. 15.040)(m), Slats. 1 l t Print Information I. Application Information — Please AU 4/1 __ ._... Property Owner's Name f Pro Parcc :r - Property Owner's Mailing Address ,- Property Location - i y Ciovt- t.at �4' Section City, S y, tote / ? ' Zip Code Phone Number L r i N R F n U. Type of Bail (check all that apply) ,Q� Lox a �l nr 2 Family Dwelling Number afBedrooms � Subdivision Name ? Sp$� aubticlCommercial - Describe Use _ 1` l Mock h D- itv of Slate Owned -- Describe Use FT Village of CSM Number �JC-, ED'own of�— [Il, Type of PUWTS Permit: (Check elther "New" or "Replacement" and other applicable on fine A. Cheek one box on fine R. Complete line C' if applicable.) A. ew System []Replacement []Replacement System er Modification to IA1surig System SexplainI D.Additional Pretreatment Unit rexplain) Il. DNolding -lank EDAt-Orade Mound Individual Other Type {explain) c v i C. D Renewal Before D,kevision hange of Plumber P- .Transfer to New Owner isr. Previous Perm it'Jttrnbcr and [7atc Essued Expiration IV, Dls treatment Area and Tank information: 2 X b = 2 '{ Design Flow (gpd) Design Soil Application Ratc(gpiVsf) Dispersal .Alrea. Required (sf) Iyispersal Area Proposed (st) System Elevation L'apacity in 1'otal a of Manufacturer Tank Information Gallons Gallons Units hrK Tanks Existing Tanks Srptic or Holding Tank Dosing C harnbcr ® I V. Itettpo siblitty Statement- I, the undersigned, assume responsib' ly for Installation of the POWTS shown on the attached pLanL I'lu s NaVellnnt�k t ?Plumber , Si / MP.!MPRS Number Business Phone Numivr I - ,_1 I r s A'dA ress Street, City, State. "Lip Code„ VI. County/Npartment Use Only Approved ed Permit Fee Date. Is1sued Issuing Agent Signature C7 ChvmcrCiiv n for 5 Sj�� 1�30/202 ( onditions of . pprov SYSTEM OWNER: 1. Septic tank, effluent filter and dispersal cell g k s rnn C -b—t 6-p— must be serviced I maintained as per ®� ©c��Q°n^"�'�'�`¢ R•0.�. 1°r s Nno�Qa ltie management by plan provided plumber. 2. All setback requirements must be maintained as per applicable code I ordinances. Altach to complete plans for the systetn and suhrn{1 to the County only on paper oat ku than s 112 % 11 inehex In sire SBD-6398 (R. 03Iz 1) 9�11 COPY 4 B-3 of soil test extended deeper RECEIVED by Plumber/CST O'Connell APR 15 2024 _ r OT, CROIX COUNTY COD Property prvr►er Parcel ID 0 Page . of 7 1:11Boring # ❑ Borkv I Pit Ground surface elev. —� fL Dapth to Ym3tlng Wor / 45 in. Saif Atfolication Rate Boring # 0 Borir>9 pit Ground aurface elev. ft. Depth to limiting factor in. Sad Application Rate Ef luent #1 r ®OD , > 30 t 220 mg1L and TSS >30 < 150 mgA. ' Effluent #2 = BUD e < 30 nV1L and TSS < 30 rnglL The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3 t 51 or 17 Y through Relay. sap-MUM11111) Elevations and sketch by plumber O'Connell MIESEInnovation, Quality and Service Sice 1965 R 010 1 IRETE wieserconc rete.com 9�,, , /, /-- �'6 , C���` p 1 J7J� AT N w' L> W C as /� J9) v ' —1 I WNVENTIONAL COMPONENT DESIGN ROSWMtW ApOku tbn INDEX AND TITLE PACE J, owases Nam: t�oec:riptlan: — — &bdMolon Nome: � , Lot Number: PWCW t0 NUK*W, Page 1 Index and We Page 2 riot Pbm Pegs 3 2�ft.& Cronawkm Pagan r Page 6 mncs tr*rin Vcn papa PInn Page 7 pope Papa a CSW or Plat AlbMhMw R: SON Ted & HOuw Fbm Dole; Phone Numkw - J_e Dud M to � baQ�o�pM1 �oU Co�NMn»M Nq�i ipr PdYViS Vlrnpos is 8�W1dJQ6�p ¢1.4'{IM}. Pap t 9�11 W. 4' ShcM" 40 PVC v«nt Pto w1h v*t Cap �— LIt --�ft ft Finer tirade 92 , z !}� ft �--- M E bation Hill IIIIIIIII III IIIII IIIIIIIIIII Hill IIIIIIIIIII{111ilillfili1ilifliiiiilllf,��111i11� - i !!({lf�!!I!!lf!!f!flfflllfflf{ffflllffffllflil111llfffflff{flflffliffffflflflllf�ffflll�- .: Manufacturer Ana Model .2�—t?L�e . EISA Raft ,;-�2L aq ft per duwt er Sol AppUcaHon Rate . % SIOMQ ft ppd Dw pn Fiow +7 , Soil won Rate d EISA Chambers 2 rows of chambers each. Pape 3 of IPP40 -.--x' y ,LTI I�. 6;, oJ;rirrs'^ Pra2s! Dra:n:y' Zabel' A Division of Polylok Inc P1,-`325 Fillet The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. I t altive";: . Rated for 10,0W GPD (gallons per day). 525 linear feet of 1/16" filtration. r Accepts 4" and 6" SCHD 40 pipe. Built in gas deflector. Automatic shut-off ball when filter is removed. o Alarm accessibility. • Accepts PVC extension handle. PL-52."i I►istaflat ion: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. 1%16" llilh,,mion `';Iok Alarm Switch 10,000 GPD (Optional) f,,7 Accepts 1" PVC i a Extemion Handle Accepts 4" & 6" SCHD 40 pipe PL-525 Maintenance: DO NOT lttgv_3tfer_t water level a,y. above t ae;sj�c. The PL-525 Effluent i ters wt operate a icient y or several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. n' 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank, not into filter .:;:s ` 6. Insert the filter cartridge back into the housing making sure the filter is properly and completely inserted. e l Polylok, Z Best fil rs' ac n P � y ��� Polylok, Zabel &Best filters accept 7. Replace and secure septic tank cover. the SmartFilterg switch and alarm. Rated for 10,000 GPD 525 Linear Ft. of 1/16" Filtration Slots Certified to NSF/ANSI Standard 46 - V Gas Deflector Automatic S hut -0ff Ball i'iend c;� I o!" , Easily installs into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com POWTS OWNER'S MANUAL & MANAGEMENT PLAN Pages] of FILE INFORMATION Owner Permit # DESIGN PAftAMETERS Number of Bedrooms ❑ NA Number of Public Facility Units DNA Estimated flow (average) gal/day Design flow (peak), (Estimated x 1.5) c ,� gal/day Soil Application Hate , -7 al/da ift' Standard Influent/Effluent Quality Monthly average" Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODS) 5220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE,) :530 mg/L Total Suspended Solids (TSS) 530 mg/L ,6 NA Fecal Conform (geometric mean) 510' cfu/100ml Maximum Effluent Particle Size Y. in dia. ❑ NA Other: ❑ NA "Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity gal ❑ NA Septic Tank Manufacturer C� ;� ❑ NA Effluent Filter Manufacturer Pic ❑ NA Effluent Filter Model _ S.. ❑ NA Pump Tank Capacity gal EKNA Pump Tank Manufacturer ANA Pump Manufacturer NA Pump Pump Model , NA Pretreatment Unit ❑ Sand/Gravel Filter ❑ Mechanical Aeration ❑ Disinfection O Peat Filter ❑ Wetland ❑ Other: NA Dispersal Cells) 1Yin-Ground (gravity) ❑ At -Grade ❑ Drip -Line ❑ NA ❑ In -Ground (pressurized) ❑ Mound ❑ Other: Other: ❑ NA Other: ❑ NA Other: ❑ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ monthis) (Maximum 3 years) fJ year(s) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y,) of tank volume ❑ NA Inspect dispersal call(s) At least once every: ❑ month(s) (Maximum 3 years) year(s) ❑ NA Clean effluent filter At bast once every: ❑ month(s) L&ear(s) ❑ NA Inspect pump, pump controls & alarm At least once every: O month ❑ eaarrl(ss) ) ) B1 NA Flush laterals and pressure test P At least once every: ❑ month(s) } ❑ year(s) ®NA Other: At least once every: ❑ month(s) 0-year(s) $NA Other: O NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank Inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cells) 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. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer, A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW 14/01) Page /I of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankis) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cellist and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name Phone POWTS MAINTAINER Name Phone SEPTAGE 8ERViCINa OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Phone Name S J� Phone --_ This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&M and 83.54(1), (2► & (31, Wisconsin Administrative Code. I rt-T—tiivA I CON I'V FPUNT I IMF MAILfVl- RI FU�ING A N r b-, Ibf-frJNGV, )FPfF?LIVEL F CK )IDDING ONLY NO 7 [OR CON51 RUC 1-10N ldh Fat;lff ELEVATION UO-- P-0- 0 CS A E O I 1 lFir j. FOP, &IDDI G ONLY KDT I -DP, NSiRUCFION n tl i i �.xxn to x �s N9RN. rV 'C d N 1 a• b]L)DIYG ONLY f-C K- 4ONS IRLIC FION . 4 i ( a cacn+ �.. _ r • i eenx� -.-is 1 ,. f t �... 1' /fir/%:% . ;wry ". ! � S ... �' ..•_ � � sa"� � i V� o �+ li•�r. J ':tAIN I t J�+xi� lain'5 Pro+nng Room k Freddy & AIL%sa Gray s .w� Lot S0, White Plne Sedge-Sd0 177nd Avenue fomersel, WI54025 'R BIDDING ONLY e� No l FCJR CONS f I,l1C rIUN q a [) ,;Z r ..e...7 ..-aa m�......-, .-. Innovation, Quality MIESEand .Service .S'ilrc•c 1965 R DDHORETE wieserconcrete.com Maiden Rock, WI (800) 325-8456 Pond du Lac, WI (800) 641-5937 Portage, WI (800) 362-7220 Spooner, WI (800) 336-3416 Roxana, IL (618) 251-9210 Wis- Dept. of Satiety and Profs Sefvicft SOIL EVALUATION REPORT Division of Safety and �$ q 17�J in a�rdarrlae wkr15PS 3$5, Wis. Aim. Code County Attach complete site pram on paper not less than tt 1r2 x 11 inches to size. Plan must Include. but not limited to: wertkai and horizontal reference paint (BM), direction and Parcel I.D. percent slope„ scale or dimensions. north arrow, and location and distance to nearost road. � Please print all lydw adorn Rcw wed by Pereorui Voonnadw you proMe may be uscd 1w sevowWy pwl (Prnrecy tsw. 3. 1 5.04 (1) (m)y /a Property Gomel Property Location - / Govt Lot i 1/4 („ 1A S T Property D nner's Mailing Address~ Let # Bkx* it Sttd. h larrw or CSMtli Page of >n N R E (ot) W City State Zip Code Phone Ntanber ❑ City _ ❑wage Mown Nearest Road New Construcbm Use: 0 ReWential 1 Number of bedrooms Code derived design flow rate t , c GPD 0 Reptac t (3 Public arxiar morcial - Describe: Parent irnaterial/-f .�_�', f� {�`h-I - �i�}?/,` ,I� — Fk)od Plain lT apphca'ble � �� l � -... ft. Genera) Cdrrunellts ( j �"` �i jYd � �(} 'vt � 1 Of y�� G andmcco nendalMI$, ��`� `�110 2(Y 6► +Q'r'tD+1 D C) - ._ :.1 Pit Ground' surfers oleo. ' ft. Depth to r9 lector � 1n. Horizon Depth Dominant Color Pmdox DescrOton Texture struc " onsisrence in_ Mansell Qu. Sz. Cent Cofer Gr. Sz. Sh. .{ t n r 91,210 �'e W-i2/ti►_42- * tElBoring ``tl ' L'J Pit Ground surface erev. Depth 10 limiting factor Horizon Depth Dominant Cara( Redox Descripbon Texhxe Structure srster in. Munaell Ou. Sz,, Cont. Cokx Gr, Sz, Sh ------------------ q f. 2D Sta,q �z.y • E_ftwit 01 = 80C , > 30 < Y20 mg& and TSS >30 � 150 n ot. CST Narpe (PiEwasa Print)- so-atu4- Address. in 1-11 ,.I . �AM"VA- Rate Roots GPDM ' • Effluent #2 50D 10 mcyrL and T S 30 mgrt_ r,T Number Date Evaluation Conducted Telephcoe Number SBD-83 30 (RI 1, 1 i �Flom - 1► w MA Fiaieon DeOr� 1=01011 lied,, Daeoefplbn Ou. Ss. C & Cow w��Wa� VAR M. �//i17./'il• �__—_ �__-- __---I L.J BAV S 0 Qoark! ,irk= dev. R owm b in" ptt Mmm Dept Doninnt Cobr RadaK Deeorlpron Tankm SUucira h MMn*W Ou. S& Can. COW G r. Sz Sd. L 1_l1__ lirm—w,m __-- __-- __m_ �_-_ _M-_ �Mmm __-- _-- �I ok • -71 y. COUNTY PLAT O WHITE PINE LOCATED IN PART OF THE NORTHWEST QUARTER OF THE SOUTHEAST QUARTER, PART OF THE SOUTHWEST QUARTER Of AND THE NORTHEAST QUARTER OF THE SOUTHWEST QUARTER, ALL IN SECTION 6, TOWNSHIP 30 NORTH, S88043130m 2177 79' 309. 28' _ 866.44 MONUMENTED EAST - WEST 114 LINE—� �� 294.26 - 259.15' 177.94' - - 60.15' - - 71.19' - 75. 08' 79.29' 139.89' 81. 75 o N. -4 �1-1/4` OUTSIDE DIAMETER IRON PIPE .� 332.98' N w 60' A °' v . v 'n O w c'- ---, S56°19'22"E m ^ p501E d NSA 316. 80.62 � ^ �pSq 53 �•-" " 65 S i 287. .. v� N85 33 58 E N56°19'22"W--j �0 �-7.75` 585.33'58"W_�_, 8� \1y, F 85. au 41.95' �i1 q` 74.00' g� Q 2 23.36'--� ,--18.59' �� la1' 93.%-V 585'33'S8'W 185.68' Z� j `�a85la,w Z r �a = S1a.pS'o9 I co 4r o ; ;"• 6. up. `31 ° °rn 32 tin 139,4S1 SQ. Ft "� l�j 13S,0S1 SQ. FT. 1p \� 175,958 SQ. FT. co 14 3.201 ACRES �z +� ° : N 3.100 ACRES �W a �u'�, 4.039 ACRES 10 , o� J _ _ ��'- 34 10 135,257 SQ, Pr.�'—N86. 44 09 W Sg2 43 �iy 3.10S ACRES 532°10'57"El Zw i'74.05' O OIL go 6 i y 2 i SBSi"32'?6"E 107.6° '6� ,� I 3_ 45.78'� / � DEDICATED TO ` ti`� N7 90.2s�' ��'k 26.6i' " X COUNTY NOG STATE SANITJ�RY PERMIT 3 Lp 172 Av6 . y 1 ; ! I TOWN OF f�2w4e6e-r SEC IT r Nq R -F.,/6D AND/OR , r BLOCK ENE X 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: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. riAUTHORIZED ISSUING OFFICER DATE /a THIS PERMIT EXPIRES- t21 /2og-6 UNLESS RENEWED BEFORE THAT DATE SBD-06499 (R11/20)