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020-1160-00-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567265 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Riddle, Charles& Lani I Hudson, Town of 020-1160-00-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: �G1� ✓� ' GS 16.29.19.915 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic e e,(c Benchmark 35 103 /6a 3. Dosing 1�fG z(, f Alt. BM / o J `7 . Bldg.Sewer � ' Holding St/Ht Inlet �• � / TANK SETBACK INFORMATION St/Ht Outlet ! Cn• Z TANK TO P/ WELL BLDG. ent t Air Intake ROAD 511rrtur IA--I �` Septic Dt Bottom 9J•� 7 .� Header/Man. 7 Z(o i 5d sa 7S /od Pp- Aeration Dist. Pipe .ci 7• `(�•Z5 Holding - Bot.System 11- $ , Final Grade ,3: 3 � • PUMP/SIPHON INFORMATION Manufacturer GP^and St Cover ;`l / J r� .7. 2 0�, 5 Model tuber _7 TDH LI Friction Loss ead TDH Ft Forcemain Length Dia. Dist.to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS -71 Z � � I-�_ SETBACK SYSTEM TO P/L JBLDG WELL LAKE/STREAM LEACHING Manufacturer- INFORMATION INFORMATION CHAMBER OR -r;,A f�w fw-, Type Of System '5.6 C�/ > �b /0[], UNIT Model umber.. L4 5 n DISTRIBUTION SYSTEM Header/Manifold/ IDistribution x Hole Size Ix Hole SpacW Vent tgAir Intak /1 Pipe(s) %,_ \ Z& Length_ Dia I Length Dia Spacing \ �. SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over . rr Depth Over xx Depth of xx Seeded/Sodded jxx Mulched Bed/Trench Center r 1 Bed/Trench Edges � Topsoil � s n No Yes No I COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 561 Spurline Circle Hudson,WI 54016(SW 1/4 NE 1/4 16 T29N R19W) North Line Station II Lot 24 Parcel No: 16.29.19.915 rud 1.)Alt BM Description= ' t `C, ZD J Q,.,— rL 2.)Bldg sewer length -amount of cover Plan revision Required? ❑s„ Yes No f / (O Use other side for additional information. fignature SBD-6710(R.3/97) Date Insepctor Cert.No. u A�fift ell es+ar pA a� W0 00.0 ai3x-1 r te 3 � rive �� 2�V. YYk { 7 n ti commerce.Wi.gov Safety and Buildings Division County 1 201 W.Washington Ave.,P.O.Box 7162 ...5i- Lealx I C "'O i I f Madison,WI 53707-7162 Sanitary Permit Number(to be filled in by Co.) Department of •Co , erce 5 (pi 1 to,S s State Transaction Number Permit Application In accordance wit n I(2 u.Adm.Code,submission of this form to the appropriate governmental unit is required ri . ..taini a sanitary permit. Note: Application forms for state-ownei4 OWTS are Project Address(if different than mailing address) submitted to t "I e.artme of Commerce. Personal information you provide may be used Secondary in ace m, ce ti the Privacy Law,s. 15.04 I m Stats. ' - 14 purposes [:r Y O( ), _I. Application Information-Please Print All Information 41/11, <� Property Owner's Name ftyrcel# Property Owner's Mailing ddress 9 :.j Property Location 4t/ Spin' y�� (i �j (/ of! 5 City.S to Zip Code Phone Number 1 , Ali; /�,� .- 1 `I )/� �� Y. /1r� /., Section �� Y' �' T o __N; R Eo W II.Type of Building(check all that apply) Lot 4 ( Subdi ision Name I or 2 Family Dwelling Number of Bedrooms _ C L �l l 1/X4/1 Block# JPfk Li'fL` 11?4-1f� ❑Public/Commercial-Describe Use ❑ City of ❑State Owned-Describe Use r-� l� CSM Number ❑ Village of Yl own of C.L3o/J III.Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑New System Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) B. ❑ Permit Renewal ❑ Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner '/C 4 41/Z(.4 gy IV.Type of POWTS System/Component/Device: (Check all that apply) Non-Pressurized In-Ground ❑ Pressurized In-Ground ?AC ❑ nd?24 in.of suitable soil ❑ Mound<24 in.of suitable soil ❑ Holding Tank a6her Dispersal Component(exp in) Q�" 44/01 i Pretreatment 14 Device(explain) V.Dispersal/ reatment Area Information: Z� c .W t l 2 ? k.' -ea.0A-- ---174: Desi n Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(st) Dispefsal Ara Proposed(sf) System Elevation VI.Tank Info Capacity in Total 4 of Manufacturer Gallons Gallons Units If o d New Tanks Existing Tan w ti a u d L -t rl )�V'Q' o`, ° cam v: w t7 a Septic or Holding Tank i 1.4 I Zu.i t k .4 4 4 9.2.5.44=irartiber VII.Responsibility Statement- 1,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plum is Name Print) Plu 's Sign..gn..S MP/MPRS Number Business Phone Number J ` ;, Q/.1.901-- 7rg 394 -goAz Plumber's Address(Street, ity,State,Zip Code f 010 �„ • I VIiI. 'ounty/Departm: t Use Only II 'pproved ❑ Disapproved Permit Fee �� Datesue. Is ing Agent Si_ atu 7 ✓ n ?ti�C/X ( e-e/i/l/1----- ❑Owner Given Reason for Denial / . Zd�� � IX.Cdr aC,Ala val/,Reasons for Disapproval 1:gebtld tank,effluent filter and ( rxis77</er seen C- TAI)1.- //✓s?ti rel) V di§pefsal tell must be serviced/maintained e -/217 f7 1v reg a(is. as pef rtlarlagement plan provided by plumber. �a/✓��/v� All setback requirements must be maintained aS Pet tipplicablre, ,+, a rlQess for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size SBD-6398(R.01/07)Valid thnt 01/09 CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owners Name: Owner's Address: „SfAcimk Legal Description: 5toly. J Vy_ Township: 14AI 0813 County: 51- Cx.ox Subdivision Name: Nb(Z41)))/U4 ,stpt, 5 Lot Number: Parcel ID Number: C:' 0-1 ILO -0 0-000 Page 1 Inde)t and title Page 2 Plot Plan Page 3 SystemSizing& Cross-Section Page 4 Filter ABC - Page 5 Maintenance Information_ Page 6 _ Nlanagement Plan Page 7 St. Croix Cty Septic Tank Mainten.ance Form Page 8 Warranty Deed • 48M-er-Ptat ore,kirRiqj Attachments: Soil Test& ' Designer/Plumber: .1;)Y1 g1i4 ia' Licerise Number: aD ,90kr Date: Phone Number 7 1S‘' 7(i 0 -01 )7 Signature 11 akin 1411 as Designed pursuant to the In-Cr I'd Soil Absorption Component IVIanual for POVVT'S Version 2.()St3Il 10705-P(N.01/01). Page 1 ,0-, ) , , o Aktne, chwzi-e. 4. LAN') 2i4d /p ZIT:el\ -861iiittees+er ptidx C; nik b lU nb, hN **4441941 sit' , u I3 .7, , 61 1 -. w / � t pain '4 11 RAN Vnl v Q i 6 I(1" lal crP`t".1 . xi I�► - out i3.r _, 3 pr0,� iw�e �� 2lty: ��'1 S?Ue�i — _„..„, ......,- Soil ildtiori S stem Cross Section 95*Oft - -- !if. • 7N-Y . ft Fine-I Grade 4"Schule 140 1 1 PIN Vi ipe I ° 9 - i ft lr v. HI Ve. 1 ,ar) ,--__:--,4------- - -- ,<--i--.2R,,, 430.0 0 14 (.( Chamber )1('\'' -"Y- — 4 .4^^..: ystenn Elevation ( ft _IL f t, q a 0 > 3 ft 89,00 L Soli ApsorationAystem riarglityg q i - I SA ft ''' ...„, (-- (Ci ., Aft lit ill:L; Ji H '::IH I I 1 ' I' ' 11111§111R ) > 3 il 1 , Leaching, 1 'Trench -1-1 ' / chambers --- s' IL 41H L..L TERM 11 Fil '.1:.':'t:. 1• 4T fl iTrencW2---1 Header _......._ - Vent Or ObservOon Pipe AO& II 1 Trench 3 T . LeaqingShamkter app.offeations 1 _ Li S 0 Man Ufacturer And Model ESA Rating 0 sq ft per charnb gd Design How,t % (0_ Soil A er . _______ _.,...... ......1.... SO ApplicaVon Rate gpri/sq ft pplication Rate oi.p EISA = 3 __ Chambers 1 ' L.__ . c) 0 rows of 19 chambars each. el, 3 -- ---------- Page 1 -- - PL,525 Effluent filter,.. Effluent Filters .. Folylok In& Page I of ri,,iit 'ily ofil i,,,,i,k,,,,.,..:.!.:',•..,•.1 „• ,.,•...,..-..:.,-...!:, , i Polylok Inc, 3 Fairfield Blvd,Wallingford,CT 06463 Call Ti Free: $ s is gawk palyiok,ctin vat,aro lie ;...;,„i-:•.0., - -,‘,.Product Details „,-- ,li,"444" 1,11'il,10 RP141;Pgi'illq"d;VII' „ 1 1 ''ri ilii1Pliri`i0P4Ogqiillin;;?!'!Cln'i'd!iit , ri\ I III,f," 4'llif,iii,1,1i1191;14/1111lAptilliri/i fil ■ / ,A, , 3 \ „ 01 1' 1 Lliiig.gl.tlq flit 1'0.i'il/.ul'. ')l't''!ir'' #1,1■I tip '4 19, pt/ 1 / ,,,, 0, li ‘• 7 4 6. r.. !' 4 AO . '.?,.101 111114ydriiTAioNit'.:,;',1,117* 1 I Pili■Ifli'P''':111'A'1 I. . Raising the bar in filter tachnoic ,11 0 PI IMOR:lil lifoill,,:i•o,,iff.No A gi; ,,.,4,,;46'i ea Ildhiiill..is:,00.,,;,,,,i,,l,A),04:!illilt.,,. , , , .., ,., ,,, , , r . . ' ■■ , , • . `,.,' .. . .,, ,,, , , i'rAle:P Pa'.:,':;tRIV:WI' . Rqt1,:,■2 PV.ATE;45NA:.,V,:.?. . *2,,-,Z, 4. .. F '41 ',..:ici44'44.rL erP■:. '';.61 T,;4 I 4-0:11,,P',1,11.,■r■ ! 11 tl'alif;tiije;;P.I'!ik'i&i, iHi.„..:::- 117;p1,. _,_.,,,, ,,i',,:h.rl 14 1.(H I(''q.:■,.!; PL $28 Effluent Filter .. . , , , .. .„ ,... ..... ,i. DeScription Effluent FilterS i •,,,„ „. ,.., • Ps/1°k,Inc is pleased to add its new commercial filter to Ito existing lino of quality effluent li,,!!!!„.11,,d.,,,,,a,..,1-4,,,,,,,tk:rf filters.The PL-525 is rated for over 10,000(.PD(Gallons Par Day)making tt one of the i • Qty la sl rgest COMMercial filters in its class,It has 525 linear feet of 1/16"ffitration slots. Like _er_ . .: . • '•:i Polylok FL-122,the new Polylek FL-5Z has an automatic shut off hall Meta Iled with ovary 'Thistributton soxo am •,..Figt i:,•01011. filter,When to filter is rernovoq for cleaning, the ball will float up and temporarily shut off w , the system so the efficent won't leave the tank, IVO oter inter on the trIrket can make that ACCe$SOrieS lliif'••I., claim' , 1 Piatlps„ amain's, Pump „A ,. . ,, . li 11„ 0,1 and Step Systems :„.„1.040,‘• ;Ali,•„7',,,,,n. gi Ordering Information 0 Request e Quote 0 Related Products -,,,,,,--------------.._ Yn.m.ru, seeks I oastiosta Irlipti400'41f. 1,----,-.9111,M,101,,,,,,,,,,,,,,,,rnMPrnAl Features I Baffles,Sanitary Te ' es 4 ; litSE , i Deflectors 1 .... .•I. Rated for 10,000 GPO(Gallons Per Day) !! .i3.• ' 0 526 linear feet of MO”filtration Reber Spacers Enlarge for deta ' * Accepts 4"and 6"SCHD,40 pipe . ils Handles and Receiven 4, Bviit in Qes Cellectcr • 0 Automatic shutoff ball when filter is removed ' * Alarm accessibility Signs • Accepts PVC extension hanelle , , . . 1 LantbOarilD i Drainage The PL-525 Effluent Filter should operate efficiently for several yeors under normal 1 Farms&Clamps, conditions before requiring cleaning. It is recommended that the filter be°leaned every 1.-----„,-0,0,------..„—.. time the.tank is pumped or at least every three years.If the installed filter contains an I elm sesiciu • optional alarm,the owner will be notified by en Alarm when the filter needs servicing, ' Servicing should be.done by a certified septic tank pumper or installer. Concrete Accassorles IVIaintenance instructiona:: ' Pressure Filters -------.--,,•,„„.,..,,, • I Or Crontrol Product 1. Locate the outlet of the septic tank. !-----------------,0000000, 2, lismoVe tank cover and pump tank if necessary. I Relvar,Lok and CIVIL, .& DO l'IQt!use Plumbing when filter is removed, i Asceasorles 4. Pull PL-525 out of the housing. 5. Hose off fiker over the septic tank.Make sure all solids fall 4s01 into septic tank, Rebar Saffelv end 6. Insert the filter cartridge back into the housing making sure the filter is properly ---------------"' aligned and .':,ornplately insemo. Deloorative Landscape 7 Replace septic:tank cover.PL-525 Installation:Ideal for residehtial and commercial "----------- waste flows up to 10,000 Gallons Per Day(GPL1). Technical Spectficatio; ' Installation Inrstruttions: r U.ANN,...010.....■, .........,....e, ■ . Related Prockmik 1. Lopata the outlet of the septic tank. I Pimp, Filter and Sun ,, 2, i41;)(r Al2lairM'RisPaElinel an 2. Remove tank covor and pump tank if necessary. 3. Glue the filter housing to the 4"or 6"oitilet pipe, If the filter is not car l SmortFlIterml COMM' thn access opening...I'se a Polylok F.xtond fl,Lclk I°or piece of pipe to1:71tderufrilldtec'r 1 4. insert the FL-525 filter into its housing. .r. 1 h tin //■Au r1 (1,, i, (990 E .'NI "?../ 4 (iA ,1 Tr`1(41 rie,f'cl;1‘1! 5“.'''t"‘')Pyr■rh)/-1' ir1,-7:".1 lAki I I :; l)1 /17 ..i,i .1 )n Uc 14 1010 9: 12AM No. 3066 P. 2 ,.....b. )2, 0 m —I ....-y.. • ,,,,,,.::"..,:..,-....:...-...........;.,::::;jiiiiiii.. . ...,•,..,,,,,,,,,;.,,,,,'.,-.;,,,::::::..;:.,,,L,,,,,,,,/,,,i.,,,,:,,,,.;:::,,,.:://::',,.,:i:,,, '‘,, ,,.,.,,,...„f;:.;',,,,,.."?;" . c, rn ^gcar" l l� 1! ,, l ! ` m Ir i (/�g r,} ri ;,; J111r ,/ /r ?' ! l,,lrr / lfr 1lp, (4, ::-1 r---''� '"�+ � "!'1 •r+ryJ � �/r f �� ,lr•'ill rf f q �� �v�,,^s\,m ��o.;:✓ //�... -y eu ,'� I— l �'r �14�r/ll��r�/r !�!!� r ll�r°, o1 r/� t��� C'7 .^.A /r r l 1r'fl i '/ r'7 r :i r r.. 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'XI T ',,r.:;, 41,,, —r 1IN . •a..---7.7=--. , ec rn .,-..= N..) 0 r- --i 2: en cz , co C") rc,,,,1 ej) nc ' co -to CD N, -10 p ec. 9 m a C r" '11 m m ---1 rn °a f, 11 ca Fri 0 A 44* ,A1M. ,,`, .Z24 0 ‘=' 7,,, 1 Z .\ \ 43, ■• \ \ \\my // • h..e, ...It ........ .-.-__,._,..,, k CS) r -,-..■ j--- ■ IIIIIIIIIIIIIIIIIIt i ;,,----,4i777=4"7.-------", ..- --.4- \ . 1 - ----- 1 ., -------- _ 1lLmi ik ) i ir i,_ ,..„,,, ;. ., ,,...... 1 , ■ - I ,I 1..0. 41 IL1 ..-... ,,,,„,,,,,,,—.. ,^= -- P ,,,. ---________7-------,,,a,!AVV , ''''' i'C'-',.7 m f , CI. EA . 1 . .,--- 0 ,. 12_11 r> ,.....„, -_.... p! 1.— III 0 , , j e if II II + . ) ill P hi ---, - ■4 1' N 1 g ;2 co k r . I I : ----- -19j. c1 c Nov-11-2010 10 45 AM St Croix County Plan/zoning 715-3$6-4686 2/2 START UP AND OPERATION Page of For new construction,prior to use of the POWTS check treatment tanks)far the presence of painting prodkstats or other chemicals that may impede the treatment process and/or damage the dispersal califs). If high concentrations are damned have the contents of the tankfs)removed by a scptage serviding operator prior to use. System start up shall not occur when soil ooneitions are frozen at the Infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restated the sheen wsstew titer will be discharged to the dispersal cell(s) in one large dose, overloading the cells) end may result In the bookies or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Cperstor 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 perk over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or et.grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance arid prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental flans;diapers; dielrtfecterats; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline: grease; herbicides; meat serape; medicatlona; oil; painting products;pesticides;sanitary napkins;tampons; and water softener brine, A?ANDONiMENT When the POWTS fells and/or is permanently taken out of service the following steps shall be taken to insure that the system Is property and safety abandoned in compliance with chapter Comm 83.53,Wisconsin Administrative Coda: • Ail 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 Rootage Servicing Operator, • After pumping, all tanks and pits shall be excavated and removed at their covers removed end the void apace filled with soil, gravel or another Inert solid material, CONTINDENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or most be taken, to provide a code compliant replacement system: b A suitable replacement area has been evaluated and may be utilised for the locetian of a re)aiteeme t soil absorption system. The replacement area should be protected from disturbance end ecrepraatien end should not be infringed upon by required setbacks from existing and proposed atruature, lot lines and welts, Fsiitare to pretest the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area, tepiacament systems must comply with the rules in effeat at that time. 0 A suitable replacement area is not available due to setback and/or soil limitations. Marring advances in POWTS technology a holding tank may be installed as a last resort to replace the felled POWTS. O The site has not been evaluated to identify a suitable replacement area, upon failure of the POWTS a soil and alto 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 soli absorption systems may be reconstructed in place fallowing removal of the blomat at the infiltrative surface. Retsonstruotians of such systems must comply with the rules in effect at that tithe, <<WARNING>> SEPTIC, PUMP AND OTHER TFIEA.TMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFiC1ENT OXYGEN, O'O NOT ENTER A SEPTIC,PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCE$. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COM`ENTS POWTS INSTALLER � �:: POWTS nlrArtuT�w : - Phone to —0 Phone SEPTAOE SERVICING OP ATOR( u P- _t7CA1:REGLATCRV 4iT„fFrr 1 11h:3 - Phone 11 Phone IIIINMERINE S 0 This document wee dratted in aompliaryce with aheptor'Comm 33.22(2)(b)(1)(d)&(t)and 53.54(1),(;)&(3),manansin Administrative Code, A. [ Nov-11 2010 1D ' AM St Cr DIX County Plan/2onlog .7153,sm ,46S6 1/2 Owim POINTS 0, WNEWS MANUAL e&y:A_ NsApt:p:EANITt,.,7 in.,,,,...i .d .f , FiLe INPORMATIe: to; 8 otlo Tank Capaolly 00 1 la,k1...sal 0 NA— C ,Dll ' , 1 , Permit..if : ......-..........001 aaptlo Tank Menutectit r.H. Aiar • i k• Number of Fladroorns 3ii LLL, : Mfflttent Fitter Modal ,...,, , _ Number of Publlo Faollity Unite ter*.64 ' Pomp Tank.Capacity ._............. --.......—.. — __ , ni_ w Carrara e) 0 4) _I* NA g$titmed floo , . imal 1 i Ptetip Tartk Meragfectivar - 1 Design 7VV, (oseich ( ttimetarl i<1.5) Rellay, Purnl4 Mallutnturor NA lit " -- , Soil Applaettan Fate .*1_,....c.L,., ay ityala ' Pump Itilotial NA , Prwreatment Unit ---- , NA Standard Influent/Effluent Ovallty Monthly avaraos* Feta, Oil(it Grose IFOO) 31)trl1/1, V 0 Sand/Grovel FIlter 11 Pan Filter Eilochemiael o • oen Domand illi20a) 420 moll- 0 NA . 0 Mechanical Aeration 0 Wetland Total$usperithal Solltb (T$S) %150 rno/L, ' CI Vairrfeetloo 0 Other: ; Pratreateri EffIcent Quality Monthly average ' Cilaperaal Collis) 0 NA 1 5lochernical oxygen Demand figOiNI r4S0 moil-. " N)-0,:round (graykyl n in.ersurial (preeearizern Tarot Soapended Belida (TS% 4n me, NA , 0 At4irodo 0 %tend j Fatal Califerm(gesmetria mem)) :V144 ,, ,. 0Orni ; 0 Drip-Una G.1 Other: Maximum Effluent Partials Size g yo in ale, MI °4111411 0 NA , °than 0 NA '.. 0 NA ' other: CI NA itvaica Typical'far dolma*werewetot end lePtln leek effluerit, IVAINVINA .., a 6 .DOLE St4M011 1000.00111600".$018Witilow..... , V. 67" tt eatleV 1 Swett avant Impact condltion of tank(s) At tam onos avan,r. -.;$1tv" I.All.m...:.:z.............,_nlik-...1WitIM 2 Yong) 0 NA Whan aorddrteal sludge ertd sown mete Ont4thlrol (yo of tank volurno 0 NA pump out nonteota of tarskia) M*ermr---• .......-,,---^,m"."".",.."..,..,,•`",..^..............^.7 jim F--, At Wit onoa avory a ,„ 7...-:.,,i , Maxim 0 NA um 3 years) Inspect disporssi noll(s1 motiiii'.(4 0 NA Clean affluent filter At least OW eka3M , ( El rnetititit r NA ', 1 Inspow:Farnp, pump oontrola&elerm At'ineat canoe evenj: 0 war _ Hush larerMo and pressure test At loast once eVEIN; P :,0.iitc lin Oth At er; ittlat Csrme suety; P' ■ Othall IA NA IVIAINTWANCEINSTRUCTIONS tnapaptcns cr tang and dispordel owns shall by •roads lAy an inevidual oarnytng one of the+ follovelto litensea at' wertlflegione: Mr Plumber; Meter Plumi)ar RostrIotad Sower: PUNTS inspeaton PM T8 Wailihteirier; Malittgt Serktiting aowator. Tank inopootlons must .odlude$vlaual inapeatian st,che taak(al'VI Identify any rnng or broken hertilworo„identify any oreaka sr Volta, maaaige the volottte of orembined siwdtle en ci 0mM Anti 1:6 riled'for any hes14 up sr Footling af ottani:qn ths grauritt eurface, T ditparael aegis) Shffill he ViSLIelly impacted to &sok the affluent SVela in the ClhettVetttn pips*anti to Ott*for arty partno of effluent on the ground surface. 'The ponftno of affluent on tho ground surface may inoiloote 6 feNi a/nOlthIn end retrutree the Immediate notifloation of the local regulatory authority., When tho oontined anoumutatlan a $ludgo and ecturn in ony tonic equels shoothirel (3161 or form of the-teak vaime, the entire oontenta of 'Om tone ahan T. removed by a Sepine samaing Operator and diapaaatt of Itt IfOotglanne with ehelger Nti ii$, 1Miactonain AOminlettetiva Cotle, All otar,$arxtlaaa,Including but not limited to tha servietng of affluent filtrs, macho:Val or prassurle84 nompronen02,Proitrommsnt units,aritil any tatvierm at irtterVele of'4;1,2 months, shall be rieTformod!lay a oellfloal'PMAITSIVisintoinar, A Aarvkla report she he prOvIded to the local ramulatory avilharlty within 10 trays mi ommrslotton crf IMF tileMee avant, GIVIVO t4/L11) 15 5 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _.I?ja iZLt.l L_ L U . (1 Mailing Address Spu rkiAP. i CA€ Property Address (Verification required from Planning&Zoning Department for new construction.) City/State ; vitas O Parcel Identification Number P2-6 -i i C} CO-01) LEGAL DESCRIPTION IAProperty Location s�l t/4, S �/4, Sec. / (0 ,T a IN R. W, Town of �f(7 • Subdivision Plat: N oit \'1 Nt S 1)4 Lot# Y . Certified Survey Map# , Volume , Page# Warranty Deed # , (v© (before 2007)Volume /1'D , Page# j'� Spec house 0 yes,Zf no Lot lines identifiable 0 yes 0 no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in§Comm. 83.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department 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/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 full of sludge. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Commerce and the Department of Natural Resources,State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning& Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s)of the property described above,by virtue o fawa warranty rr n deed recorded' t5' in Register gt of Deeds Office. Numb7roo G_ - _i 6i1/13 SIGNATURE OF APPLICANTS) DATE ***Any information that is misrepresented may result in the sanitary permit being r evoked by the Planning&Zoning Department. *** include with this application 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. (REV.09/07) . ..,,,_. . . As. r STATE BAR OF WISCONSIN FORM 2 - 1962 0 . 560276 w4w0L,Ty prim,. :! . 13L 1 .."4 .:7 pp!. q9 !. . DOCUMEHT NO. . REGISTER'S 0; I !',f Donald J. Stephens and Lori J. Steal:Alas>, , ST, CROIX CI-Y.,WI ' 1 • '0. husband and wife, , '1•4447 tm Etewrt, :I 4: !• — JUN 2 1997. ,, conveys and Warrants It) Charles L. Riddle and Lani R. Jacobs, !,I i . t ott 8:30 A. NA : a4yi ./a Lani Jacobs, husband and wife, as suryoTship , 1. $ marital property, 11 • t: il riegistarot Deeds _ id li 1: -- II 11 Trit...SPACE nESErIVED FOR R(CORTING DATA 1! _ ,.., ...__. _.... NAME AND RETURN ADDRESS li the following described real esiate in St. Croix .County, ii leiyA,,,,r i U State of Wisconsin: !! 11 9 -9.)V2 .. a IL . . li il i I. I il - 1 I! 020-1160-00 ,r- 4 PARCEL IDENTIFICATION NUMBER i 11 li Lot 24, North Line Station II in the 11 0 Town of Hudson, St. Cr,.:ix County, Wisconsin. li 0 11 11 11 !!.-.. li $ II I I! ,, „ II ;1 11 11 II , ii il 1 11 This is homestead property. 11 I (is) (is not) Ir ri II Exception to warranties. II ir I. 11 il1111 Subject to oascments, ,-,.=..,-vations and restrictions of record. ti ;1 IDated this I 30th day of_ (SEAL) May ,A.D., 19 97 . j _ II .(SEAL) I li * . DONALD J. STEPHENS It 11 ■ 1 ..er- (SEAL) (SEAL) .: 1 11 LOR J. STEPHENS 1 11 1; 11 1: tt AUTHENTICATION ACKNOWLEDGMENT- I; 11 Signature(s) State of Wisconsin, !•: ss. , !, 4 il . St. Croix County , 1 11 authenticated this _ day of , 19 . 11 Personally came before me this 30th day of IJ • q May , 1921_,the above named. il -4 it 1 Donald J. Stephens and ,k !t ., Lori J. Stephens, li III LE:MEMBER STATE BAR OF WISCONSIN ____ ri rr (If not, - authmired by§706.06,Wis. Stats) !! .,.. !! - . . . ,. _ ri to me known to be the person S _who executed the foregoing r: re ir ' Anstru nt and acknowledge th-sam - -. . , - .. THIS INSTRUMEN T WAS DRAFTED BY i'....::;, 1,1 t r. .- , ..,:: A i STEPHEN 3_ rult..tr.piP 1.7'.."-. ' -.-•"" .=`;';', -.F:.ie - e 1.----,ut3t-‘ c.... ,,-;IF - Virginia ...s.±......PGnrttaan . Hudson, Wisconsin____ - •:&„."...- 0 Notary Public, St. Croix _County.Wis. (Signalures may be authenocated or acknowledAed Both arc nor'. My commissrm is permanent of not, state expiration date: nt:Cess.uy% January 30. 2000 ,-I-9- .) . . N.rrirr..,“i.......,:4,11Ing!r,.ttl, ,,T.It It $hould b■typed or printed lido.their stem We, STATE DAR OF WISCONSIN vhscons.Legal 81.3r.k Go.w wARRAN IN Orin Form No.2- 1982 p , i Milwaligee.W., ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certifyfthatl have inspected the septic tank presently serving the Cil OitliS i- LPN) 164.411 residence located at : cj (,4 IA, ME %, Sec. Ik4,)k4, , T a9- N, R 11 I W, Town of 1,1tt1.Wl County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good con it ' n, and it appears to be functioning properly. Last time serviced G is 13 Did flow back occur from absorption system? Yes N\ (if no, skip next line. Approximate volume r length of t ' e : Capacity: /b10 �b y gallons minutes Construction: Prefab Concrete Steel Other Manufacturer (if known) : - -ttik LJP1Sa Age of Tank (if known) : NA 11011 0 1 s h, gbi,t►V,-011)el (Signaof - ) ■ (Name) . Please Print (Title) MP �� a4 vi • (License Number) [ 1 ) G )3 . (Date) Form to be completed by licensed plumber (s . 145 . 06 , Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my knowledge, will conform to the requirements of ILHR 83 , Wis. Adm. Code (except f inspection opening over outlet baffle) . Name )TY 'b14m-Q-ei ft Signature MP/MPRS -c;) ,eld'y 2341 Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3 Division of Safety and Buildings in accordance with Comm 85,Wis.Adm.Code A.C.E.Soil&Site Evaluations 1 County Attach•• • t i• , • • less than 8%x 11 inches in size. Plan must St.Croix include, z1.. 'r.< .ontal reference point(BM),direction and �p "*• •::. road. '°P ./Parcel I.D. -, a ,north arrow,and location and distance to nearest `�� 20-1160-00-000/ 9i S `� Please print all infonnation. S'Fp Re y . Date Personal information you provide may be used for secondary purposes(Privacy Law,S.15.04(1)(m)). 00, 0 � • “A„,04,‘... I c/ 40/(3 Property Owner Propertyt_ tion j � Charles&Lani Riddle Govt.Lot °,/:,1-061, SW 1/4 NE 1/4 S 16 T 29 N R 19 W Property Owner's Mailing Address Lot# Block#'N Subd.Name or CSM# 561 Spurline Cr. 24 North Line Station II City State Zip Code Phone Number City Village ✓ Town Nearest Road Hudson 1 WI 1 54016 I 651-356-0018 Hudson I Waxon Lane New Construction Use ✓ Residential/Number of bedrooms 3 Code derived design flow rate_ 450 GPD V Replacement Public or commercial-Describe: /7t/ ae4 jm( 76*/ Parent material Glacial Outwash Flood plain elevation,if applicable Na General comments and recommendations: Si . = :• • • •• • =•-- _-II. Recommended loading rate=0.6 gpd/sq.ft.. System elev.to be stepped"down hillside at 48"-54"below existing gra•=. 2 aQ 4 {, �46 1?3 w 1 Boring /` _AtegALeGrrt,�.v't e/c2�A.'it 11 Boring# �L�tJ ✓' Pit Ground Surface elev. 90.61 ft. Depth to limiting factor >102" in. Soil Application Rate Horton Depth Dominant Color - Redox Description Texture Structure Consistence Boundary Roots GPD/ft• in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-12 10yr3/3 none si 2fgr dsh cs 2fmc 0.6 1.0 2 12-31 10yr4/4 none gr sl 2msbk dsh cs lfmc 0.6 1.0 3 31-42 7.5yr4/6 none gr Is Osg dl cw 1vf,f 0.7 1.6 4 42-102 10yr5/4 none gr s Osg di - - 0.7 1.6 2 Boring# Boring V Pit Ground Surface elev. 86.10 ft. Depth to limiting factor >110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/It= in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 none si 2fgr dsh cs 2mf 0.6 1.0 2 6-14 10yr4/4 none si 2msbk mfr cs 1 fm 0.6 1.0 3 14-22 10yr4/6 none gr Is Osg ml cw 1 vf,f 0.7 1.6 4 22-52 10yr4/6 none s&gr Osg ml gw - 0.7 1.6 5 52-110 1Oyr5/4 none s&gr Osg ml - - 0.7 1.6 *Effluent#1=BOD5>30<220 mg/L and TS >30<150 rhg/L *Effluent#2=BOD5<30 mg/L and TSS<30 mg/L CST Name(Please Print) nature: CST Number James K.Thompson �. ,„O�--- 3602 Address A.C.E.Soil&Site Evaluations / Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane,Osceola,WI 54020 8/16/2013 715-248-7767 • Property Owner Charles&Lani Riddle Parcel ID# 020-1160-00-000 Page 2 of 3 3 Boring# Boring 94.34 ft. Depth to limiting factor >106" in. Application Rate ✓' Pit Ground Surface elev. Sod Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-5 10yr3/3 none si 2fgr dsh cs 2mf 0.6 1.0 2 5-16 10yr4/4 none si 2msbk mfr cs 1fm 0.6 1.0 3 16-34 10yr4/6 none Is Osg ml cw 1vf,f 0.7 1.6 4 24-6U� 10yr4/6 none Cr") Osg ml gw - 0.7 1.6 5 60-106' 10yr5/4 none s / Osg ml - - 0.7 1.6 P n i p c e c/ 6o r e(g ` 5 y5 -Plo, , 52" f ` et - ' Boring# Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 Boring# Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont Color Gr.Sz.Sh. *Eff#1 *Eff#2 • *Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODE<30 mg/L and TSS<_30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R.07/00) A.C.E.Soil&Site Evaluations • 30.% eta/cra-6or1/o%4 -a-cvfdeh' i'a cye . -Gan/in1rince, a o .�•����: 'eel''a.23�/ .iii......-r • Cl4les4t ia.,i£'J14 5W S/04 r'/,'rte c NA E1 as ar), wl. 004, 0 At.2 A4i0(/jo ime.56-6onlr swyyi E 5ac./6, 7'z9i 4/y(.v.j 7 . a.4 $41,‘.215 0,-7, 3 E.1 I07,a., ,.04 pc/. a ozo-//!oo-oo-ova �,f 0 U(vz. SPuf fI H\ ... ' C;/'C1< ,. 9. Q w00d . EPY " Opt Weees 0. Cone.S.i E/e'4l h TWO S 4 � 1*.sty Of.M41 • : 4 .g @ IfV - Approx./ca-64n a,/ s Eyis-E;n' Y N% tX1.3&1 3yaierrt..Ac alive µfall - � \ sa,Ate el a dd ., ��,N ♦ . 4 ert 92.0, co- I I ■Avr �. .! �. , I q py • ` r 9� Scatter 'Y ,[` c -z.t.,.. i` - A.Pror•ox. /oca.4r04 of'64I7;ed eon!niarb-ca-'6i),1 Litt. a.,, 4 1114: & o{ dtr, "ri✓ac AO/Ce.• A5.5“,st d eLev! =/oo.00' 6. 3old • \ o 7 § _• \ § 0 G ® E __ /. &2 \ \ 7\ ƒ� ` 4 « f¢$ « : a� S o- \ Ak-6A, E o\.coc a. o : ® - f fx2 $ -• bw ? _2 - o2o ) moo= .5 72 @a n « t 5. W E ce { • J k § - \,- 0 § k u) k 7 I / } k U 5 e 'S : j. & q q § Z I C , 0 00 § _ k m 7 ) z \ o \ . . E ) £ k @ \ o , 2 ) tt 1.1 \ § § 2 ) '03 # z L - I- 1- _k k_ A . \ § § § -� S 1 § aaa 2 12 Ni- :-0- - 1 J q I ) _/ / p tit � ) Z. a $ / a a \ ! e © 0 = o � 3 R f § » c a » I I ] a_ a e_ � I \ / • - J ƒ f 0 ® 9 ° ( r ; f : t § Q § 2 \ : \ 8 .O a a / CO / \ / m e • § c = o § •¢ - , e @ m - 2 e - m « § i S v U s = ) a Q a e = R 2 \ $ » ! 0 $ a c ) E c o - - '� ... G e f ƒ $ o J $ f / 2 j i • z k J # 1 k a 1 - , _ : Parcel #: 020-1160-00-000 01/31/2006 07:51 AM PAGE 1 OF 1 . Alt. Parcel#: 16.29.19.915 020-TOWN OF HUDSON Current X ST.CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner O-RIDDLE, CHARLES L&LANI R JACOBS CHARLES L&LANI R JACOBS RIDDLE 561 SPURLINE CIR HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *561 SPURLINE CIR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.730 Plat: 2216-NORTH LINE STATION II SEC 16 T29N R19W NORTH LINE STATION II Block/Condo Bldg: LOT 24 LOT 24 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 16-29N-19W Notes: Parcel History: Date Doc# --Vol/Page Type 07/23/1997 7 1242/592 WD 07/23/1997 ' 692/82 • i , 4444 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 92780 294,600 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.730 71,900 228,600 300,500 NO 05 Totals for 2005: General Property 2.730 71,900 228,600 300,500 Woodland 0.000 0 0 Totals for 2004: General Property 2.730 49,800 163,500 213,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 305 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 ' po fv„fida, ?) — So,() s-fq>/EAis ii 4 s Form - S T. C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER .-01/1/ . AA,soN TOWNSHIP #UPce,A SEC. /6' .T27 N-R 4S ADDRESS &441dtP— / P . ST. CROIX COUNTY, WISCONSIN NO 4et //U7SOA ZV/S • SUBDIVISION .7A-7-404.1 l� LOT LOT SIZE Z 3 ��ls PLAN VIEW Distances and dimensions to meet requirements of H 63 • SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM s ceME 1 : 3 ° ga° 16'7it---- 7t,?c' 13,1 z �57r T M r - `, ap . 5e .. f F 6U- r ` V 5� �N Dp S o uDa= 1 5' s/�.0fT r r 4 o r % ,...4' r r `� of . r r r �) TG TA' V 8 35 \,o A 5° 2a � 3 ,' , • S ,EI,_ --- , . .• D,,;p INDICATE NORTH ARROW /" Soc p SO,QEyOR's- ,CM /fir BENCHMARK: Describe the vertical reference point used _" 66"NE-4 LOr Fr • Elevation of vest cal reference point: 100 ,U Proposed slope at site: J7-749 90 SEPTIC TANK: Manufacturer: eve-e-4-5- Liquid Capacity: /, a270 f - Number of rings used: 70YG FT / (21') Tank Tank manhole cover elevation: �0 Q Pr. Tank Islet Elevation: /°Y. L/0 Tank Outlet Elevation: /d3. �� F� Number of feet from nearest Road: Front,®Side,O Rear, O > 26. O feet • From nearest property line : Front,OSide,ORear,O 33-- feet FT. Number of feet from: well I y , building: • (Include this information of the above plot plan) ( 2 reference dimensions to septic tank) SEE REVERSE SIDE• ► # PUMP CHAMBER Manufacturer: Liquid . .acity: Model: Pump/Sipho. '.nufacturer: Pump Size EleVation of - • Bottom of tank elevation: —r•r- Pump off switch el- •tion: Gallons per cycle: Alarm Manuf- urer: Ala witch Type: Numb- of feet from nearest property line: Front, • Side, O Rear, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: /�, -(�L^ & ) • Width: / L' Length: / Number of Lines: 2_ Area Built: /I Fill depth to top of pipe: 4/)- /A- U— Number of feet from nearest property line: Front, O Side, r,O gt • 3 s Number of feet from well: — 1.2O Fr Number of feet from building: ,1•0 (Include distances on plot plan) . SEEPAGE PIT Size: Number of pits: Di-u- - • Liquid depth: :. - =•u of seepage pit elevation: Area Built: Has either a drop or distribution box p box O O bee n used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: Capac' . Number of rings used: evation of bottom of tank: Elevation of inle • Number of feet from nearest property line: Front, • * Rear, QFt. Number of feet from well: Number of feet from building: ' Number of feet from nearest road: Alarm Manufacturer: Inspector: ,,SYIE SEPTIC MLUMBINC CO.- 3-Dated• Plumber on job:: " 3 O'NEIL RD.,HUDSON,WIS. 54016 / j ROBERT ULBRICHT MASTER PLUMBER LIC.NO, 3307 M.P.R.S. License Number: •":STALLER&DESIGNER LID.NO.00663 3/84:mj rMNTOF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS &HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53367 �I 61YCONVENTIONAL iii ALTERNATIVE State Plan I.D.Number: (If assigned) ❑Holding Tank ❑ In-Ground Pressure ❑Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Sherm Peterson ahad Rd. , N. Hudson, WI ?-3-eV BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROMIt LAN: REF.PT.ELEV.: CST REF.PT.ELEV.. SW NE, Sec. 16,T29N-R19W, Lot#24,Nothline Station II,Town of Hudson Name of Plumber: MP/MPRSW No. County Sanitary Permit Number: Robert Ulbricht 3307 St. Croix 49464 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER 9 PROVIDED: PROVIDED: 13 1 svry ! Uq r 5 /04. 0) [YES iii NO OYES ONO BEDDING: VENT DIA. VENT MATL. HIGH WATER NUMBER OF Y✓ROAD: PROPERTY WELL BUILDING: VENT TO FRESH C I ALARM 'FEET FROM 2 / /' LINGb I AIR IN LIVES NO OYES ONO NEAREST =� /f-o S l> YV� DOSING CHA BER: MANUFACTURER-. BEDDING LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ONO OYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL. 'BUILDING VENT TO FRESH (DIFFERENCE BETWEEN 'FEET FROM LINE AIR INLET: PUMP ON AND OFF) OYES 0 N 'NEAREST- - • SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE"" the soil is dry enough to continue.) ' MAIN' ontinue.) MAIN° CONVENTIONAL SYSTEM: WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING. COV � �/ INSIDE DIA.. #PITS: LIQUID 'B TRENCHES ENCHES. M , PI1 �_ DEPTH. GRAVEL DEPTH FILL DEPTH DISTR PIPE IDISTR.PIPE (DISTR.PIPE MATERIAL NO. ISTR NUMBED of PROPERTY WELL BUILDING VENT TO FRESH BELOW PIPES. ABOV Et§ EL V ET.ELEV.END: PIPES. LINE AIR INLET: 6 551q & 37 277 1 ‘7 MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. OYES ONO SOIL COVER(TEXTURE PERMANENT MARKERS: OBSERVATION WELLS OYES ONO ❑YES ONO DEPTH OVER TRENCH/BED 'DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL: SODDED. SEEDED MULCHED: CENTER. EDGES OYES ENO OYES ONO ❑VES ONO PRESSURIZED DISTRIBUTION SYSTEM: :,WIDTH LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER. B �E H TRENCHES eIIE m9:MANIFOLD PIJMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: 'NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: °ELE V.. ELE V.. DIA ELEV. PIPES DIA.: • "�.yVA�t' AM I I;�p iI �r� f;HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED IRf ( fOL PLANS IA ttl' OYES ONO OYES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: cll, FEET FROM ❑YES ❑NO ❑YES �I Q tI EA rt;-^^ I I , 04 ' I �� '11 5. 5 i ' ,. - � L..- L...SLi I 1.3,,i Is -9 0 0244-6, . D Qt- ,,.,. > ,4) Q "Nxk. l 5 ,..e 5 avy lik ketch System on a,[. 2/( �,1 = county file fora dit 9 3 Reverse Side. , 2 SIGNATURE TITLE: �� 7 o J DILHR SBD 6710(R.01/82) ■Wisconsin APPLICATION FOR SANITARY PERMIT - D ILHR -_COUNTY -OEPRRTmEnT't1F (PLB 67) UNIFORM SANITARY PERMIT# - InDleSTRV,LRBOR&HUmAn RELRTIOnS ,6/-ems )f/ 4 o�LJI. D O - eta-s • ,, 9 4L 11 —Attach complete plans in accord with s. H 63.05,Wis.Adm. Code for the system,on paper not less than 81/2x 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT _ PROPERTY OWNF,i � MAILING ADDRESS n 5�iH / e78 So,J 6�4-h�v � , A/4 t).psin A.) 4) !.S PROPERTY LOCATION qq CITY: 54 1/4Nc/4, S/� , T2-�, N, R /f E (or ) OWN . • /UDfa'c] LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER 21 /llo, //:v e 57 4Tio,J - . SA Uit /boo- C/iee...e...e U44_ TYPE OF BUILDING OR USE SERVED ^c 1 or 2 Family Number of Bedrooms: V ❑ Public (Specify): THIS PERMIT IS FOR A: NNew System ❑ Tank Replacement ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. .j Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank ❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued . ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity /Q'era / Y Lift Pump Tank/Siphon Chamber /pd. Holding Tank capacity � Manufacturer: W& ,CS � !✓-e_ CC— • ��G ) ,?i e.4,..10.Jv l.G.)/ ..3' IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSE Snuare Feet): 6// 6i / /Z/'r,7 L) Private ❑ Joint ❑ Public I,the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Na a of Plumber (Print : Signatur MP/MPRSW No.: Phone Number: ,13t'i T q/04/re 7` i �^- _ 3307 (7/5 ),J .P/P5 Plumber's Address: Name of Designer: 3 #1 ODsa..0 0► s - Sya/Ce COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: t Disapproved �Cl Ir C� 1/-076 'IV ❑ Owner Given Initial �, � ` 7 Approved Adverse Determination Reason for Disapproval: Alternate coursels)of Action Available: DILHR-SBD-6398 (R.5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing,Owner,Plumber • INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398 To be complete and accurate the permit a pp lication must include: 1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in a city,village or town); 2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment,30 seat restaurant, etc.); 3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks. 4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of square feet to be installed; 5. Complete the section on water supply; 6. PRINT the name of the master plumber or master plumber restricted who will install the system,circle the appropriate license classi- fication, place your license number in the space provided and sign the permit in the signature block; 7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the permit; 8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation. Failure to comply will void the sanitary permit. 9. This permit may be renewed, and at the time of renewal any new criteria in the Wis.Adm.Code will be applicable. 10. A new permit will be needed if there is a change in,estimated wastewater flow, (number of bedrooms,etc.), location of the system, depth of the system,type of system. 11. All revisions to this permit must be approved by the permit issuing authority. 12. A complete plan including a plot plan,drawn to scale or with complete dimensions. 13. Horizontal and vertical elevation reference points that are permanent and clearly shown. 14. Piping detail including pipe size, separating distances, distances between beds if appropriate,tank locations,effluent line from tank(s) to system, building sewer and vent observation pipe(s). 15. The permit issuing agent may require a cross section drawing of the effluent disposal system. TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit.Private sewage systems must be properly maintained.Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years.If you have questions concerning your system,contact your local code administrator or the Bureau of Plumbing,DILHR,State of Wisconsin. APPLICATION FOR SANITARY PERMIT . S T C 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. - Should this development "be intended for .resale by owner/contractgt, ("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. / SLry,..) . . . Owner of Property ,� Location of Property 5614A2 -- 1, Section AO , T 29 N R i el W Township /4, Mailing Address 31/A+'wa, ",&.)- • . Subdivision Name ?// e.-t.,/aX;€J ..1- LI.J4i,--y t — Lot Number 14/ _ Previous Owner of Property d L- . • Total Size of Parcel �, + a‹... Date Parcel was Created /q C o ' Are all corners and lot lines identifiable? XC Yes No Is this property being developed for resale (spec house) ? r Yes No Volume 5 PLIfSand Page Number 6 as recorded with the Register of Deeds • INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 3 S 6 3t/ 00-c,- 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. • PROPERTY OWNER CERTIFICATION I (We) ceAtiliy that aU azazemenza on thi4 tion.m ate time to the beat of my (oun.) , • fznow.bedge; ihat 1 (we) am lane) the owneh(a ) of the ptopen ty described in zh,iis .inbonma i.on botm, by vL'ttue 4 a waAAanzy deed teeotded in the O66.iee o6 the County Reg-idzen. of Deeds ass Document No. and that 1 (we) pteaentfy oun the ptopoaed bite lion the aewage dcapoaat ayazem (ot I (we) have . obtained an eaaemenz, to tun with the above deacni.bed ptopenty, On the conztJLactior, oli aa.id a ya.tem, and the )same has been duty teeotded in the O46.i.ce oti the Coun-i y Reg-listen oli Deeds, as Document No. ) . / 4ge- s NATURE (� OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) 1 Z/ - DATE SIGNED DATE SIGNED • t ik 3 5 I ° -1/. --1) • r };.i •. ; .;' • t •.. r • ai- '14°-r r"7; 1N fswm�'S?i�";rit / u 4-c•`n ' 8 s'' 1,:. ti- vY, N? ki i., .I,, i 'P ,,f�. id. I ` S ,.6 `:r S ' a' /I .1;'. r F � - y�� . \t `V ".I..1 1 ' t ..,r , IZrf; N I - z.-7-7 I..' I I 1 t' •N ,t' \` `'..+" j°�•cM ros + r , j� .J 'ui i• ��5. I ;i r 11.•'k'o, �„ (�?Q '\ r'", ~;oai•�' r.=a 1 o :b, ': •b •i g _ :# [ r7 12h 1:.11 �'1 , 4 OW III1. 4 ill?-•.5' N Mrr V. j rte.;sow eo'>r •ice'., .'.f F.• ,..:a :•I,'I • ^ ..,:re, O • er 'ffC C \° off'' °�j�8�"°'` •°•ua :; : 0 0 0 i° S F.i.r:.n a J• .i �" 1-1.-.1`--..r I ni t d In _ ,t k j 1 a:. F.TiRZ� °° u g88 sKYfi k 1 .....4',i.:2vF.R . '1 i D'• e.. b h:i 4 1I 4.Y ` M w 6r� yy' (p 'S�\ o .• T LOP w W N °j '^ W z N 04/ 1 , r ` •P : • Y 7 z• 1 • dy' ':-.! _ V c O-.,/,'", S ••1,O i . r Y':6'r 680 4'• •�. u . •° ::i z?ou • d.;°?�• a"1 Cr..' esti / f 1.. . • ,., v i .,.!'l `v o i e ''•c. ^ ul.. .. J,'0-. . N // G O 1 0 '•0 3 W. O I .f,%f!•., ,9:41,, • �:�q /J d'/ •4-a t 'a'a: . . • ' 41.6 a r ,. �• O\\ o t r u•i h',%,.' 7 D6ARTMENT OF REPORT ON SOIL BORINGS A �O° '�'�TY& BUILDINGS DIVISION LABOR AND n 0. BOX 7969 INDUSTF�Y, _ � , iV RELATIONS • PERCOLATION TESTS (115 qA F�F�MA'P • ON,WI 53707 HUMAN �� (H63.09(11&Chapter 145.045) 't 1, 12 LOCATION: SECTION: 'TOWNSHIPfMuNIGIPAL1 1Y: .LOT NO.:2.NO.: , V -.a N•I` /GN?t sw 1/4 1/4 /G /1.2? N/R/9 E (or0 71/vPSo� 2,, ,-.-7 9,A)- T COUNTY: . OWNER'S/BUYER'S NAME: MAILING ADDRESS: -',<' sf.�.o/n `��� sT>C�o,y�AVS ,,T s' L OE�T �'v #%,� ► syo/6 USE DATES OBSER • ,, NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: XResidence -3 4// NA- RI New ❑Replace P1L A-8 104;O FP RATING:S=Site suitable for system U=Site unsuitable for system XeS ✓ � ,P/ /s CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FI LL HOLDING TANK:RECOMMENDED SYSTEM:(optional) /L,C S2 © s ❑U Es ❑U , © s au ❑s EU ❑s MU etwvE4/7/o&14G. ti #ow 0,0 2 T, t J . 4/-04-s-. If Percolation Tests are NOT required DESIGN��RppA�TE:'ZoS'5Q,Fr. If any portion of the tested area is in the /� — under s.H63.09(5)(b),indicate: /€A aeg AA- • (O-'- i3 p Floodplain,indicate Floodplain elevation: ,�4 /,v DECii41' ( f-f. p PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-IN_.j_CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH L OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- / nc, r7/o ' 0 J•. / •y��P�AN . /S� J, ' .3N• ls� i 2• /.'i NU rCS ' •P3'�/,Iti. /s, �'0�' TA,vU- - .05 ' r > /1 . O ' 13'Plc. 4A) . /s / . /7 ' T,v 07 CS. B-3 /1.0 71 Yy no- B- 7 /2.9 /63.7Y 740- >/1. y ' •i3" Pi< 40. /s, • 5;" ' o e. es //, v2 , r4ti Pft7 CS B /o/7Z yr- >/l . o 'PERCO TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- .50/1, /?o,t°i4v6-5 .q Ao ss et)7).PE- 7-4-37- ,>t- P- F STf'i[SG/ 74-14' G`-,..1•yE=x T /S d s 6"/S r ,¢S P- /A)piCATED /A) Jo;/..- Sv,Pv� i /-o,�'r. II/41 < 7 P-_ P� /'.)E'/ ' T�1/3/ES -- A / i/9 f3i 1 I i'4-TES '(OP ,3 P- SA, P y S-fArrns 1 s > , -o w s j,.Q.. /IR n/p -�''�'� P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. J d M 6 44 �Q 4E- 47- 7 O , SYSTEM ELEVATION O R e / -n t- Jill:r E € 3 t E S � t i F - _ 3 _ _ __ _ _ I . i,j _ # i _ . 5l s f fi! P _ � N - i,P -1z- Ir--"a4,‘- , , , ; ' , 1 l i i i _ e i [ I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location+of the tests are correct to the best of my knowledge and belief. NAME(print): TIOMESTTE TESTING G CO. TESTS WERE COMPLETED ON: STATE APPROVED SITE_RVix.1.UQ,.r7( N_S(PFRC TESTS) CEFjJI ICATIO /O' ADDRESS: N NUMBER: PHONE NUMBER(optional): MINNESOTA LICENSE NO.00 63 5s -0.2- Vice 2.._ ,6--,pfe5" WISCONSIN LICENSE NO.55-03/1 2 CST SIGNATURE: RT.3,O'NEIL RD.,HUDSON,WI 54016 7- C 1_ DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. ).. DILHR-SBD-6395 (R.02/82) –OVER – r. INSTRUCTIONS FOR COMPLETING FORM 115 - SBD -6395 • To be a complete and accurate soil test, your report must include: • ' 1. Complete legal description; .2. The use section must clearly indicate whether this is a residence or commercial project; 3, MAXIMUM number of bedrooms or commercial use planned; 4.' Is this a new"or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbrr viations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; B. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9: Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11: ,Sign the form and place your current address and your certification number; 12•7, Make legible copies and 'distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. • ABBREVIATIONS FOR CERTIFIED SOIL TESTERS • • Soil Separates and Textures Other.Symbols st --• Stone (over 10") BR — Bedrock • cob — Cobble (3- 10") SS — Sandstone yr Gravel (under 3") LS -- Limestone — Sand HGW — High Gruundwate : cs - Coarse Sand Perc -- Percolation Rate men s — Medium Sand W — LrJrl • Fine Sand Bldg -- Building Is — Loamy Sand _- Greater Than `sl — Sandy Loam — Less Than "i Loam Bn -- Brown sil Silt Loam BI — Black si --- Silt Gy -- Gray cl -- Clay Loam Y _ Yellow c_cl — Sandy Clay Loam R — Red sici -- Silty Clay Loam mot -- Mottles sc Sandy Clay w/ -- with sic — Silty Clay fit -- few, fine, faint Clay cc --- common, coarse ht -• Peat mm — Many, medium ns Muck d — distinct. p — prominent HWL -- High water level, Six general soil textures surface water forlionid wea'ste disposal BM -- Bench Mark VI-3P — Vertical Reference Point • TO THE OWNER: This;:oil test report is the first stop in securing a sanitary permit. The county or the Department may request verifieLoton of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must he submitted to the appropriate local authority in order to ,`•ttrain a pernet,The tensely permit must be obtained and posted pi for to the start of :coy construction. • „ .REPORT.' ON SOIL BORIN&S t PERCOLATION TESTS INS' PLoT Pi M P lZo rECT r. C). La / 2 7 Poiac 4.4i,- ,Syr-7/0.1-- `, DArE to- "Jo,3 STEpt •.-s HOMESITE TESTING CO. ii i".3, O'NEIL ROAD BOB ULJ;J?1C� i '' ; UUSON, WIS. ._ 54016 C5T cc-OzY.Pz ;. *-fr- i PROPOSED MouSE MOST LIE 25 1' at itioir FROM ALI rfcr /9,EE95. pPoPos D WELL MVST LIE S4 Ft. at noir IciPOn ALL TEST 4,445. • = 114c.e bbF /v.73 Q = X/fT/A!6,- W ELG Xs Pt&- foC,4774w1 114aA ,4o t0 0,Q S‘avEL /,3AeES • Afteiz . BM VERric,nL ieritRtnicr Pour 7o ,' 11 5v'sPu4"roo01 3' k f 3 a•• -! o..•+ A) E. L o T IRO,J - 50/if) " p O p , r. U ? LEGEND f"-F- . eirvi11%O�ti o F I/f,i ,PE,. Dr /60 . D Fr . s This test site APPROVED -43 for a conventional septic system. r vim_ 1� n yiv 10 vERT \ok 1 . 35 P1-. a°11 a4' e2 do J C y T O l k /A) ' SyST€M ,, \ ° 4 4iRef /3,_ /3 - 83 ■R • ,,,k- 5 ' x" 4/7E4,4T/o,v /S MP�1 ' ' X40, A)L GerssAA,/; 17 -No i,Pr. la ,,4 k • 6° ,..• --�\ Tor 5 of L. To (la. C u T- ty 1‘ \� b \ a tBEA, o. . fu ck #t OFF fRopN NE tcalkg_ r °-', 026w.10 S4ops- To k, .r/.-AT- eFA *oWA) sP101\e, s;per , 0: ' il '''' ii - 4. • P18 a rposs ', s cA I E : I - Yo 151 SECT1(:tN PMT { .$S '. .....--/.--i‘i 01 �� Z ECG \Nit, li tJ �y e,s,,,,,, --: ‘‘ \ 53 ___CIt't • ‘., ..,3t1 -TEST".' BiLf? ..--''i s vet ker.. pi:-. Top lay io "�° tar ji '1? - Sci'i1, I1 r 1 6 : y SI frn( fl CJ ' t f lo � 7 11op ! S- 47ro a A w 44' AA3t.--- ' . -1?,,tcf„.e.),A5k-202Q1$4,' • i L/CE.VSI- 3345 Y I k 6 ,? Fresh Air inlets And Observation Pipe w; - soar resrt ac By HOMESITE TESS':NG ';s. r-Th., Approved Vent Cep i 1 RT.3, O NEit. 1RO,,-,') •-...a HUDSON, WIS. P-,4016 Minimum 12" Above Final Grade .,...,...,...„. e---- .....,... ___ fiiO/ - = '(2 Above Pipe + __� 4" Cast Iron lo Final Grade Vent Pipe i 1 Marsh Hay Or Synthetic Covering 2" 1„, -4, Mina 2 Aggregate Over Pipe Distribution j Tee �ttr'i4.v , Pipe ,0 ° ° ° ° fe l" " Aggregate Perforated Pipe Below 5* Beneath Pipe ° Coupling eTermnating' At o . .. ...�. ....� Bottom of ystn