HomeMy WebLinkAbout020-1280-70-000
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AS BUILT SANITARY SYSTEM REPORT
OWNERiL'g:,LFiV k f' 4A/M/a-M 3. ZLL±j!ECrOWNSHIP JL650AJ
SECTION .3 `,l T R'? N-R 19 W
ADDRESS !?06 ST. wix S7 A/_ ST. ~CROIX COUNTY, WISCONSIN
Se7y~/ 4_4 Syo/
SUBDIVISION_ CIA.6et- 111ZZ S LOT /O LOT SIZE wA
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF.SYSTEM
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~ntov Qax y" s«r Sao Sew~iP x"Ve
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ol.I T 1~/SP6cT)vN Aj► O ~JpOiQuVe Q (o
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/f vc S/Je 3s EFf ~,,c ~.v r 41Aj
Sc~v,TrJ ~6~vPcPTY1,,N~ INDICATE N R H ARROW
~a s< <E
BENCHMARK: Elevation and description: -515P cvr /
L YOd. 00
Alternate benchmark A✓A
SEPTIC TANK: Manufacturer: wiES~~ Liquid Cap./O&O GAZ.
Rings used:-/-Manhole cover elev: .3s Final grade elev: 99-y Sy_
Tank inlet elev.Tank outlet elev.:
No. of feet from nearest road:Front , Side Rear Ft. D
From nearest,prop. line:Front , Side , Rear ~Ft. 9lr'
No. of feet from: Well GSA , Building:
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufact.: Pump Size
Elevation of inlet: Bottom of tank elevation
o elev.: Pum off elev.: Gallons/cycle:
Alarm: Man.: Switch Type: Location
Distance from nearest prop. line: Front, Side, Rear_Ft.
Distance from: Well Building
SOIL ABSORPTION SYSTEI 9~ aS.
E4,E f{
Bed: Trench: B9~o?5-seepage Pit:
X Width: s - Length GC Number of Lines: / Area Built-j!~-ZQSq-r-r,
9ov ' 9g $
9. X Exist. Grade Elev.A 97•0o' Proposed Final Grade Elev.;97.39"
Fill depth to top of pipe: ' = a•'/"0, 87 a./°'
No. feet from nearest prop. line:Front , Side Rear Ft.lle-111
No. feet from well: 7~ No. feet from building
HOLDING TANK
Manufacturer: Capacity:
No. of rings used: Elevation of bottom tank:
Elevation of inlet:
No. feet from nearest prop. line:Front Side Rear Ft.
No. feet from: Well , building , nearest road
Alarm Manufacturer:
INSPECTOR:
DATE: a/ PLUMBER ON JOB:
~O~S
LICENSE NUMBER:
6 90:c •
/ 7
.
i
i o`~'" gepartmeU o lOc~ustry4 29 19 PRI~IATeSE IVAGE SYSYEMDIE LANE County:
`Laborar`d Human Relations INSPECTION REPORT
' Safety arf Buildings Division ST. CROIX
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION 180264
Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.:
ZILLMER GLENN R & BARBARA J HUDSON
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
C r 020-1280-70-000
TANK INFORMATION ELEVATION DATA A9200344
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark /dj,ci)
D
Aeration Bldg. Sewer
i
Holding St//Wf inlet ,lJd 96,E
TANK SETBACK INFORMATION St/ ,W Outlet 9 07'
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom
Dosin NA Header/Mar.
Aeration NA Dist. Pipe A-V
44-
Bot. System
Holding
i 01121m.-I
PUMP/ SIPHON INFORMATION Final Grade
Man cturer Demand
Model Number GPM
TDH Lift Friction stem TDH Ft
oss
Forcemain Length Dia. Di
SOIL ABSORPTION SYSTEM
BED/TRENCH Width s Length i No. Of Trenches PIT Inside Dia. Liquid Depth
DIMENSIONS DIME I N
LEACHING M u acturer:
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM
INFORMATION Type o CHAMBER Mode N er:
[System :,,cc~.c ?7 OR UNIT
DISTRIBUTION SYSTEM
Header /MwF"iOd Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
I _LL Length 6,3 Dia. Spacing
Length Dia.
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth OverU xx Depth Of xx Seeded/ Sodded xx Mulched
Bed/ Trench Center Bed /Trench Edges 117 - Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, 9tc.)
F ~ U/>l I
Ld/h~ d"?fT [Y~f/'!'24t.C P t""-% r.~' 4{ J~~G .'t~j"" ~ ~ ~1 1 ' ~~.•ny~<_~ t[_
P Cr<_.
I,
a- t.= • eel cs 4,'~.r ~^~f 1... r. {rc.r1C
.,yj.. "'7't....
P l 4 f
Plan revision required? ❑ Yes to
Use other side for additional information. /n 102
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
s
i
P:iLHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code C
STATE SANI Y PERMIT
-Attach Qomplete plans (to the county copy only) for the system, on paper not less than ❑~~r1~o ~
8% x 11-inches in size. c k o p evious application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
£jll ~ A Y. J/a, S 3 41 T , N, R/? E (odWD
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
o ST rl?,., 4T-. A/ /O AAA
CITY STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM~ /NUMBER
OSG.4I Syoib ~tS 313' -73/ t~/<LS
CITY NEAREST ROAD
0 :2j ]
II. TYPE OF BUILDING: Check one)
( ❑ State Owned ❑ VILLAGE E ENE
❑ Public ZSJ 1 or 2 Fam. Dwelling- # of bedrooms 3 PAR L TAXI BER(
III. BUILDING USE: (If building type is public, check all that apply) 019 ,0 /119C060 70
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 120 Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1 X New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 Seepage Trench 22 ❑ In-Ground 420 Pit Privy
13 ❑ Seepage Pit Pressure 430 Vault Privy
14 ❑ System-in-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) A 'M 61S' ~EATIOfI
,e
7SO y3 sue, r'r. SOS Q. rr. - r/ 6 9 V - 97 66et o 41W yY~`/! oo eet
VII. TANK CAPACITY Site
in allons Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank /000 14900 / LcJiAE S"
Lift Pump Tank/Si hon Chamber . El El E1 El El El
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name Print): Plumbs Sign ture: ( St MP/MPRSW No.: Business Phone Number:
~P~s.
Plumber's Address (Street, City, State, Zip Code):
S T// 4 Swv C✓l 5- v/
IX. C LINTY/DEPARTMENT USE ONLY
❑ Disapproved itary Permit Fee (Includes Groundwater Date ssue issuing gent big ature (No )
Approved ❑ Owner Given initial Surcharge Fee)
Adverse Determination y~/e / 0
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. 'Your sanitary permit may be renewed before the expiration date, and at the time of reneAal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (S9D 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
It. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 8% x 11 inches must be submitted to t) a county. The
plans must include the following: A) plot plan, drawl to scale or with complete dimensions ocation of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
E.reas; and the location of the building served; B) horizontal and vertica! elevation refsirence points;
C;) complete specifications for pumps and controls; dose volume; elevation differences; friclJon loss pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a nurnbr-r of
regulated practices which can effect groundwater.
The monies collected through these surcharges are Uz.ei for rnorritoring groundwater, ground-
water contamination investigations and establishrnerrt of standards.
III
SBD-6398 (R.11/88)
i
STC-100
This application form is to be completed in full and signed by
the owner (s) of the property being developed. An inade
will only result in delays of the Y Quathis
permit issue
development be intended for resale by owner/ ontr chtor,i(spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
r-
owner of property ~ei~n ~~~r 17•r a ~:~-.rte J 1 lnoelr
Location of propertyhb5'1/4 Sc--) 1/4, Section 3
-L, T.~LN-R
Township
Hailing address l I -06
Address of site xo-t # lt~ , l
subdivision name _zu~
Lot no,
other homes on property? yes No
Previous owner of property
Total size of parcel , I
Date parcel was created ~~(g
Are all corners and lot lines identifiable?
--L -Yes No
is this property being developed for (spec house)? Yes _!!~No
Volume-%~±gnd Page Number a?~5 as recorded. with the Register
of Deeds.
• I
------------------------------------------------------------------------I
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARIWITY DEED which includes a DOCUMENT NUHDER, VOLUME AND PAGE
NUMBER & THE SEAL Or THE REGISTER OF DEEDS. In addition, a
certified survey, if available; ;would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a certified survey Map, the certified survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I(we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of
the property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document Ito. ~rl$~
o~:n the , and that I (we) presently
proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for
the construction of said system, and the same has been duly
recorded ,4n the office of County Register of deeds as Document
No.
Signature of ~11.cant ' ' 'y~'~• Co-appl can`t
i ~~,o~y2 •
Date of Signature
Date of s gn ture
I
19'666
199
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* ~ DOCUMENT No. it STATE BAR OF WISCONSIN FORM 1-1982'1 TNi6 SPACE RESERVED FOR RECORDING DATA
WARRANTY DEED
454363
- tip.-- 1~ REGISTER'S OFFICE
This Deed, made between . Carmichael Residential ST. CROIX CO., WI
Group ---Inc----------------- Recd for Record
i : oo 1989.M
Grantor,
- D C L
and ._.Glenn R. Zillmer and Barbara J. Zillmer at
! d GHQ
I~ Register of Deeds 'i
Grantee,
Witnesseth, That the said Grantor, for a valuable consideration.--...
f onllar and other valuable consideration Sy CrOlx it RETURN TO
conveys to Grantee the following described real estate in _--.-l.._---------
County, State of Wisconsin:
Tag Parcel No-
Lots 9 and 10 in Cherry Hill Subdivision, Town of Hudson, St. Croix
County, Wisconsin.
rR SF; R
$ .06
This .._...1..... no_t..-_..__ homestead property.
7f:tK) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
And Carmichael Residential Grout-------------------------------------------------------- , Inc.
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
easements, restrictions and covenants of record, if any,
and will warrant and defend the same.
Dated this 13th December 89
day of 19.........
Carmic Residential Group, Inc.
(SEAL) (SEAL)
HY se I5
r
V?,~-~..Pe.sdent.
..-•-•-•-•---••--------•-••---•---•-----....(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
ss.
St Croix
County.
authenticated this day of--------------------------119 Personally came before ' me his 1-3.tb -day of
~ e Q-e 9 the above named
,7Qsoph D BJordal-•-•-----•••----------------------
TITLE : MEMBER STATE BAR OF WISCONSIN
~~~rr rr rr,,,, ~
(If not, _
authorized by § 706.06, Wis. Stats.) • .
to me known to be the person aD 1gecu -d 0145 ~
foregoing instriU3aat and ackriowi ge same. y
THIS INSTRUMENT WAS DRAFTED BY
.4!Qa~..,ph-- D-=:--B_iordal------------- / - -
* Terry Pirius
166 0 S . Highway 10 0, Suite 4 28-------- --••-:.-s........
t t C
Minr.,eaoo1is-,--.MN___--5-5.4.16--------------------------- Notary Public --------St Croix County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, stafte~ expirat'o~I
are not necessary.) Ma 30 •1 R 4 ~
date: -•----•--••---•---------•y•--•-----••--
*Names of persons signing in any capacity should be typed or printed below their Signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Lezal Blank Co. Inc.
FORM No. 1 - 1982 Milwaukee, Wis.
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER C 1,C m n 110, + 0-a-, l'hd
ADDRESS: FIRE NO:
LOCATION : A/,,Ix'- 1/4, 'Sw 1/4, SEC. 39/ T_2 L_N-R27 - W,
TOWN OF: f°Itititiz~-~ ST. CROIX COUNTY
SUBDIVISION: LOT NO.
Improper use and maintenance of your septic system could result
in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or
sooner, if needed, by a licensed septic tank pumper. What you
put into the system can affect the function of the septic tank as
a treatment stage in the waste disposal system:
St. Croix County residents may be eligible to receive a grant to
help with the cost of the replacement of a failing system, which
was in operation prior to July 1, 1978. St Croix County accepted
this program in August of 1980, with the requirement that owners
of all new systems agree to keep their system properly
maintained.
The property owner agrees to submit to the St. Croix County
Zoning a certification form, signed by the owner and by a master
plumber, journeyman plumber, restricted plumber or a licensed
pumper verifying that (1) the on-site wastewater disposal system
is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of
sludge and scum. Certification from will be sent approximately
30 days prior to three year expiration.
I/WE, the undersigned have read the above requirements and agree
to maintain the private sewage disposal system~in accordance with
the standards set forth, herein, as set by the Wisconsin DNR.
Certification form must be completed and returned to the St.
Croix County Zoning Officer within '30 days of the three year
expiration date.
SIGNED: I
I' DATE : 2-
St. Croix County Zoning Office
911 4th St.
Hudson, WI 54016
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page l of
. Laborand Human Relations
Division, of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION Q
Q CT t4L 1/45W 1/4,S34 T Z IQ N,R E (or) W
P PERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUB NAME OR CSM #
0 & 56. IO tlEQr2y {TILLS
CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VI GE WOWN NEAREST ROAD
(7,.5 3 - 73) 7 U Sow Emit of
W New Construction Use [()(J Residential / Number of bedrooms lit W t~. [ ) Addition to existing building
j ] Replacement ( j Public or commercial describe
Code derived daily flow gpd Recommended design loading rate 0.6 bed, gpd/ft2 trench, gpd/ft2
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate 3.'7 bed, gpd/ft2 6-'& trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design / site considerations
Parent material Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MO ND IN-GROUND PRESSURE AT-GRADE SY TEM IN FILL HOLDING TANK
U=Unsuitable fors stem S❑ U RS El U S❑ U S❑ U S❑ U [I S
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary RMB tGPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Trench
2I stn o. 6
S t 3 c r ri, e
Ground 11) f 1.6yie S 0.6 6._7
elev. z ~ 1 0.7
Cft 7_~fI. 3 3 M S
Depth to
limiting
ff a~ctor L L16 -IL
I Tw N 'TN C I Z e+v
7 7.Og
Remarks:
Boring #
y:;:;:; Y:Lii 4:•,:i J
Z 3 3 S i Z. C M e~~ C 1 0 A 10-S
JAY or-
Ground o., s b Yl r t 40.7
elev. 3 _ tl M l a. ~ 16-7
qr"vt. g, mye S/4
Depot to 51
limiting
factor
Z 1141
Remarks: ~ ~1 a1r bA 4 K
CST Name:-Please Print Phone: 6_ 0 O
gAk _Y 0144SO/N
Address: I U S6 iv ► S46 J p
Signature: Date: 9,(/,/g., CST NumberMZ4
PROPERTYOWNER zzlu-Md1V SOIL DESCRIPTION REPORT Page Z of 3
'PARCEL I.D. #
Depth Dominant Color Mottles Texture Structure Consistence Bour~ry Roots GPD/ft
Boring Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
4: S c o
16YO- 7, (%A Ground '1 S _ M5 C O.6 0'7
elev. Z. 3 r4$ n,!';
l Q. 6 ' O.
~s.,Q3ft. • ~
Depth to $ S O'~ 1116 fill I 0.6b.7
limiting
~ factor
Remarks: $Z c6ar4 w-o~ SANAS aF JA 4Z KE* MS
Boring # 'I
16 Y,
Ground
'
10 y4 3 $F~~5 C I 0.6:0.?
elev.
46' iive s 4 Z I I o•6 O
Depth to
limiting
factor
Ar 2 al ~&M& -5 n-, I 4
~
~ 1C11441 t /3'Gonl4 A-, LLPTU 6F $
Remarks: i arr r lb4 wAS 00 E4ST '5 i&t eR -A5RIt , -
Boring # Z ~.S s 0.6
D c
A /A C
4^: Y 4i,'i
4$" o ks 4 r,s n an I f .6 o •7
Ground
elev. 3 3 5 l 6.6:0-7
ft.
4 N,5 0 r~ 1 16-7
Depth to
limiting
1> cto~
Remarks: R~>r~ MATMAL
Boring #
ui>:Y)k4::1tiv:
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
MA IQ
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PROJECT
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MAXIMUM OF 42' ABOVE I
PIPE TO FINAL GRADE y ( _ _
SIGNED:
MARSH HAY OR SYNTHETIC COVERING I 1 1I LICENSE:
• MINIMUM 2" AGGREGATE ---I 4 I DATE: rs A~w
OVER PIPE
DIST91BUTION PIPE
TEE SOIL TESTING BY:
ELEVATION BED W AGGREGATE
•
BOTTOM PER SOIL BENEATH PIPE PERFORATED PIPE BELOW
TESTIS I CAT BOTTOM F TERMINATING
9,~s_ FT.
REPT131 HUDSON ST. CROIX COUNTY ZONING PAGE 1
09/2•i/92 08:42 REQUESTS FOR INSPECTION WORK SHEETS FOR: 9/22/92 AREA: JT
Activity: A9200344 9/22/92 Type: CONVSEPT Status: PENDING Constr:
• Address: HUDSON 34.29.19.1345,NE,SW, LOT 10, EDIE LANE
Parcel: 020-1280-70-000 Occ: Use:
Description: 180264
Applicant: ZILLMER, GLENN R & BARBARA J Phone:
Owner: ZILLMER, GLENN R & BARBARA J Phone:
Contractor: STAHNKE, MARK E. Phone: 715-386-2850
Inspection Request Information.....
Requestor: ZAPPA, GARY Phone:
Req Time: 13:09 Comments:
Items requested to be Inspected... Action Comments Time Exp
00012 FINAL INSPECTION
Inspection History.....
Item: 00012 FINAL INSPECTION