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HomeMy WebLinkAbout020-1135-50-000~ o o ~ 0 M a ao 'c a 0 N n 1 d ti d • ~ N `1v • •~ O V r.~ r C O i FBI .p A ~ ': ~_ ~ Z I Z ~ ~ W N F- Z ii v c Y. c 3 N E ~' ~ M d N O a m o z a I v c v ~ d z v li o f/1 F- r ~ ' ~ ` ,,, " ~ I ' N I ' N : , v = C 7 _ N C d ~ C '~ ~ Z fn ~ Q C ~ ~ d N .. E N R d ~ d ' ~ a ~o oo ` o a i ~ ~ ~ ~ 3 3 O O O ~ a a a a ! ~ fA J U ~' ~ O O 7 N N ~~ N ' . ~p O o go ca 'o - > > ~ a, ', N w N ~ N C O O '_ N ~ N ~ ~ ~n p i F- ' ! (n ~ ~ c ~ W ~ aj O N N ~ '' U ~ 7 ~ ~ N O N = ~i, ' H d' O ~, :_ ~E d~ ', o ~a ~ a m . ~ i ~, m a E ~ ~ 3 ~ ~ va gl ',Ov~ti m °o 3 0 O ~ a~ c 0 3 0 m O N _N 3 N C ~ O ~ N ~ L y N C y .N-~ ~ C. E o ~ Z ayi m m ~ c c N «. o .0 N v v Q m m w c N E N .~ N L ~'' ~ L U ~ a a~ ~ N } ~~ m Q Z to 7 O U +~ ~ Z c Y i I I I I I o I U z M i C O ~~ O Z C N o I o I z_ y ~ '~ ~'~ a :: m ~ I U d 00 ~ C N ~ a ~ ~ 7 N_ d C_ N ~ ~ U ~ ~ - 07o-1J3S-SO--aoa . 2U•Z~i~1~7~6(oS S'I'. CItUIX CUUN'TYLUNING DEl'AR'I'MENT AS BUILT SANITARY REPORT Owner ~~~~.- ~ ~L'! ~ T~/~'G~ .31'(0 ' ~~ '~dd-rrs / / City,-State DSp./ /, b i~e~al Description: ; /~ I_,ot ~ Rlock Subdivision/C-£~vf-#` ~ ` ~~ '/~ ~'/4 ~ Sec.2.0 , T~N-2~W, Town of ~/ Venter h air intake v D.t o.~J SEF'I'1C TANK -- DUSE CIiAMBER -- IIOLDING TANK INTORMATION: Tank manufacturer ~ ~C'SC~ Size ST/I'C / Setback from: House WeII P/L Pump manufacturer Model ~ 2~2' Alarm location (1[O[,UIfVG TATdKS ONLY) Setbacks: Service road _ Meter location Alarm location. SOIL ABSORi'~1'IUN SYSTEM: ~~~~ C~~~-c i rf I • ~~ ~~`~ ~~ ~~„ ~~S t • ~' ~,v S Type of system: ~ ~ i Width `3 Length ~ 4 Number of Trenches 2" Setback from: House --~-L Well ~ P/L ~ Vent to fresh air intake ~' Z~t~' O ELEVA'TIUNS: o o ~~G~ S llescription of benchmark Elevation -~-~ llescription of alterna a benclunark D 0 ~ Elevation =/ ~ •. ~ ~ C~ ~. pf • o amt"G ~i•G h72 ~3r/~s~.u~ Building Sewer ~ S'T/Ii'I' Inlet /v ~' ST Outlet ~ ~ PC Inlet I'C Bottom Header/Manifold Top of ST/PC Manhole Cover llistribution Lines () ( ( - Bottom of System ( ) ( ) ( ) Final Grade ( ) O ( ) M~t~ ~z ~ ~ ~. - ~a 3 y2 y ~ s~g Date of installation / / Permit number State plan number ~~ Plumber's si nature 'L'2.~t 3 7S ~ g License number Date / / Inspector ~~iN t;~~~-~ 22.^ ,~ Ulbricht & Associates Private Sewage Consultants - 2812 10th Ave. PIN # o2cT~S •~YO Water Line ,.~ ~Fc~ ~~'~ Y 2 ~r 9 2003 =,~~ ~; `~~~,-vim _~w~,;-,. Complete plot plan M ST ~ J~~ ' I~°' t X10 • GvT" ---_____--------__b_..._.____ __.._.__._______._ L~:~~ ~ _ _ ~ ~' ~' 11 ,,S~~s ;a ~ ;o f q~,ya -- -- TX's ~ ~ 5 y ~ /3~`v ~ / i ~ i /y ? G~ ~ ~ I t I ~ ~ c~uvEcrE~ ~ ~ ( ~ r I L~Fr ~ i ~ t ~,~,~ G- i . - za ----,- ~ i..---. i ,--~ ~ , pus p t I ~ ~ J~ ; ~ PuG 1 r ~ ~ I ~ ~~~~~~p ,N~ ~ ~ + ~ ~ 5 ~"` ~ i Nth I x, w a~ ~ - -- - - - -- -• 5, 1'. T~~ ~ (ll ~ l~ ~~/ i J ti~ NEw p~ v(' ' v~ line. ~ ~~-~ o F ;w ~ 5, ~ 2. ~ o~ ~~~ ~ w~~ - - O CU ~ ~ C.r. ;; ~~#'~- rod or ,; zq~~c F~ ~~~~ n 13M ~ Z C~s~~ r~P ~, o, ~ ~ !~~-s~,v ~ 5 ~~ l~ t Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ' INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Trace ,Steve Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: ~y -M ` TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ' ~ ~ ~ O / ` l• Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift ~ tion Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ORPTION SYSTEM ~ ( ~Q, /TREN Width ~ Length DIM NS 3 (P8 --~s' SETBACK SYSTEM TO P/L INFORMATION Type Of System: DISTRIBUTION SYSTEM , No. Of BLDG WELL „~ I t ~~~ I So. ?/~ l La ~: ELEVATION DATA county: St. Croix Sanitary Permit No: 429958 0 State Plan ID No: Parcel Tax No: 020-1135-50-000 Section/Town/Range/Map No: 20.29.19 STATION BS HI FS ELEV. Benchmark ~ Alt. BM Bldg. Sewer SUHt Inlet /I ~,d{~Q~L SUHt Outlet ' Dt Inlet Dt Bottom fin. ~ Dist. Pipe Q°Q ~ 7•Li ~ Bot. System • ~° 9•zZ `13.90' ~ Final Grade St Cover '~e ~r~s ~. 3.9 q ~e~ ~ w.. ~ ~. q8 9•s r, Z' - e•a t7f'~" PIT DIMENSIONS No. Of Pits LAKE/STREAM LEACHING CHAMBER OR ~~ UNIT - = 8. d 91 q s". (2 n `-~ \ s~ Distribution ~ x Hole Size V x Hole Spacing Vent to Air Intake O"^ 7 Pipe ~~~~,,yy~~ Len ,Dia Length Dia Spacing ~ YRi avi~..vvtK x Pressure Systems Onlv xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx SeededlSodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~~ Yes [] No ~ Yes [ J No COMMENTS: (Include code discrepencies, persons present, etc.) inspection #1:~/Z? r/ ~3 Inspection #2: --F--t-~ Location: 432 Valley R d Hudson, Wl 54016 {NE 1/4 NW 1/4 20 T29IN_ _Rp1_9W_) -Willow dge 2nd Addition L t 56 Par 1.) Alt BM Description = ~o.P,~~"b ~a-k"^• ~~ ~~'~--(~°1~'•~ O~ I __/ i(H'~~ j ( ~ ~~ ~~ 2.) Bldg sewer length = f; 2~ n ~~'~r"` ~~""~~ -amount of cover = ? ' C il~G ~ y Plan revision equired? Yes No /~~ I~ 7 ~ r Use other side for additional information ~~`~Y-~ ~_ ___ _ ___ ___. ~ t ` ~~ ~__ __ _ ___~ SB -6710 (R.3/97) ` ~ Date Insepctor's Signature Cert. No. V U V' D Safety and Buildings Division County S T t!~ t? ~ ~- ~ ~, 201 W. Washington Ave., P.O. Box 7162 - I COI ~SIO Madison, WI '53707 - 7162 Site Address ~U dSD.tl U~ ~ ~D y Department of Commerce 3 Z S O/ Sanitary Permit Application Sanitary Permit Number In accord with Comm 83.21, Wis. Adm. Code, perso 9 ^ Check if Revision ~~~! ma be used for seco ses Privac w, sl I. Application Information -Please Print All Information State Plan I.D. Number N/~ Property Owner's Name 5~~v~' 7"~~+c~Y 3 Parcel Number ~ ~.O • //3 $' • SO ' Q~ Ix couNTY Pro~p/er2ty Owner's Mai~li/ng Address // ZONING OFFIC 7 3 Z ~/7 ~ (/ / ~jilJ ~ D Property Location N ~ '~ /v ~Si ~ S ~ T 2 ` N, R / ~ .,E~ City, State Zip Code Phone Ntnrtber Lot Number s G Block Number / ~U~~C'Q/t/ ~~. S /0~trp ~~~.JO ~ Subdivision Name 1:S#4-Nnrnber II. Type of Building (check all that apply) 3 ^Ciry ~1 or 2 Family Dwelling -Number of Bedrooms ^Village ^ Public/Commercial -Describe Use ~ 0~ ~1'ownshi // p ^ State Owned Z rt/ 2 ~ / ~ `7b Nearest Road ~~ !/~ ~ ~ j~~ > l~J III. Type of Permit: (Check only one box on line A (numberting scheme for internal use). Complete line B if applicable) A" 1 ^ New 2 Replacement System 3 ^ Replacement of 6 ^ Addition to For County use S stem Tank Onl Existin S stem B• ^ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44~Non -Pressurized In-Ground 21^ Mound 47 ^ Sand Filter SO ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. Dis ersaUTreatment Area Informat ion: Design Flow (gpd) ispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed ~ Rate(Gals./Days/Sq.FtJ (Min./Inch) Elevation VI. Tank Info Capacity in Total Number q// facturer~ Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks f1~~tQS LY~~fn oncrete Constructed Glass Naw Tanks g ~ ~ j I i/ ~ Septic or Holding Tank / ~ ~~ ~ r /C' /' Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's N e (Print) rz..~/h~%~T- Pluunber's Signature .i14P/MPRS Number zZ43 ~ s Business Phone Number pis • ~~a. •3 ~y Plumber's Address (Street, City, State, Zip Code) VIII. oun /De artment Use Onl Approved ^ Disapproved ^ Sanitary Permit Fee (includes Groundwater Surcharge ee) ~ ' Date Issued ~ mg nt Si lure tam ~ - Ps) ~ Owner Givea Initial Adverse . `~ ~~~ ~ ~, ' ~ ~' ~ Determination y ~ t ~17C. Conditions of Approval/Reasons for Disa ~~ro~val~ 'h.eGc~ ~ ~~ 1_ 1 ,c~ ~~le,~' ~/ "~'a GL~X.d v" ' 1~-e- ~ V 6ut.Q.Q ~ 1~'lS-~~u ~ i ,~n r_!. .~. _. _ X ~~iIA~~I. ~(/i(,(J?-~if~/YI, y (~fl ~'~'~b eo~ttplete (to the Conch oal~) for the gstem ou eas ~/, 81/2 s 11 it>5hes In Nse ~ • ~j ~i ~/ ~ . 05!01) ~~~G~u~-`~-~ ~'~" -- ~41.v ~ ~ Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT p~ 1 ~ 3 m accoraance mmm ~.omm aa, vns. ram. ~.ooe ~My St. Croix Attach complete site plan on paper not less than 81/2 x 11 inches in size Plan must . inGude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 22 ~ S~ , 4 ~v ~ 2 ~ ~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~J S Please print all information. R wed b Dat e / Personal information you provide may tme used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). "~ Property Owner RECEIVED roperly Location Steve Trace Lot ~ 1/4 NW 1/4 S 20 T 29 N R 19 E (or) W Properly Owner's Mafling Address MAY 0 5 20 03 of # _ ~ / " Block # Subd. N ~~~ _ ~~ ~~ r~ 432 Valley View oad i v l City State Zip Code Phone Number tiYVillage ^ Town N Road Hudson WI 54016 ( ST. C ~ NTY Valley View Road New Construction Use Residential / Number of bedrooms 3 ____ Code derived design flow rate 450 to 600 GPD Replacement ~ Public or commeraal -Describe: Parent material Flood Plain elevation 'rf appligble it = R ~n~l °0mn~n~ This site is suitable for a conventional system and recommendations: a Boris # Boring pit Ground surface elev. 98.85 ft. Depth to limiting factor >110 in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-10 10yr2/2 - sil 2msbk mfr cs 2f .5 .8 2 10-22 7.5 4/4 - sil 2msbk mfr cs if ,5 .8 3 22-50 7.Syr4/4 - ifs 2msbk mvfr cs - .5 .9 4 50-110 7.Syr4/6 - cs ~ Os ~ - - .7 1.2 "~ ~ - ~ ~ - 2 Boring # ~,,,~ 0 Boring 99.35 >119 pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ll? in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-9 10yr3/4 - sil 2msbk mfr cs 2f .5 .8 2 9-119 7.5 4/6 - s Osg ml - - .7 1.2 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mgA. and TSS < 30 mglL CST Name (Please Print) Signature ~,,7 CST Number Thomas C Nelson ~~ ` ~ .._ 227387 Address Date ~va~eti~~ Telephone Number 1432 120th Street, New Richmond, WI //`/ Zs ~L 715-246-2454 .., r ..,.,..,,,,, ,,,,,,,,,,,,, - ,~t,~~ ~01.3~1 ~ Z ~~ bra ~v~, ~ `~ ~ ~ ~ ~ I ~ Property Owner TRACEY Parcel ID # Page 2 of 3 3 Borin # ~"'~ Boring g ~ Pit Ground surtace elev. 96.73 ~, Depth to limiting factor >115 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0-11 10yr2/2 - sil 2msbk mfr cs 2f .5 .8 2 11-48 7.5 4/4 - sil 2msbk mfr cs if .5 .8 3 48-115 7.Syr4/6 - s ' Osg ml - - .7 1.2 ^ Boring # Boring • Pit Ground surtace elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/it? in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DffP in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mglL and TSS < 30 mglL 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. SB0.8330Test(R.07/00) • ~ D I"" ~ - ~.- , - --------~._.____._____.r.__.._..._~ .__.._._---~____-- ~ ~b' o r ~-~/~ ~ ~ ~ L w~ 3Z ~ /~ !~ b ~~~ o ~ x's r ~ D~ ~ .E ~~ 0~.~~~r ~~ o ~~QQO~Q ~ ~ 4Q ~ ~~~~' ~ Q~ ~~ O~ QOM ~O ~ QN Z VO ~~~ 2 ~~ V Vb ~~ ~~ ~T, ~oNA~~ ~i I ~' ~ ~ 0~ i ~. ,~ I ~ ~a ~ ~ ~ o ~, o s a' ~___--. , , ~ I y ~ i ~ ~ I ~ I ~ I ~ --~ I I ~ ~ I i f l ~ I I ~~ ~I I ~. (1`I y~z ~` I ICI f,5' TDI D~ I° ~ ~ I Gyp •~ o N I~.~- I ~~ ~ ~~1 ~Op'r I ~ t ~ ~o"'PG ,vim . . I I G ~,yT~ ~ . ~ ~ ~~ ~ I , I ~ S~ ~'~ ~ I I I ~ ~' ~ s~~ ~ ~ ~-1 I~ ° c~ ~~~ ~ ~,d v ~ I ~ o ~ -~£~ I ~~ ~A11?~ ~ DRap . - - _ NSW ~~ i~ NC+~ Gr~15 r~N Cr -,__ . • ULBfiICI-I1' & ASSO~IAT~S~ CQ. 655 O'Neil Road • ~-Judson, WI 54016 ' 715-386-8185 ~~ PROJECT INDEX FLAN IU ~ N~A- T/c~/-IG~~ geg..Des(gners nl Engineering Systems Private Sewr-ge Cvnsuharrls /vl ~ ~/ (-~ - ~,~ BATE PHONE /~(D ~ ~~3 O Avr)tiESS y3Z f/~//.~y ~//t'L/ ~..~ . ~Uvsa.~.~ s ~r'o QWNER 57~E-~f~ LEGAL llESCRIPTION L Q ~ $'~ ~j/`~(,v ~r%~ Z,yci,.e ~(-api/ PAN G20 • //~S Sf~ • 0''~ ~ /V ~, ~!~!, Ste. Lo, TLlr /Z/yCc TOWN VC `~~(~nso,~, COUNTY ~T. ~Qj/~ CsrM T: /!l~"LSON LOCAL 1-U'I'itURI'I'Y/ SUPERVISION .f T: ~j ~ 2a,~%~(r- ~L2~,~- , PROJECT UESCRIt"I'ION: `~~ . ~t ~x ~'S T i.v ,fir Po.~o~a /Z ~ X ~S 2. ' j3 ~o ~.. , Gv i ~( ~ G~`zT i,r/ j",4-~ T i ~ /~o S Si /~3 ~~ ~2 ~~ ~u~ R~-• zts ~' U% ~- ,~- ~u ~~ r/.4- /ate . ~.. Go oc ~.~~v /.:¢ ~,~- S 6 St-lac,, / N 2~4'%~~~ C~~/S'T~7? ~ ~'Sic>~ Ski ~~ ~u SfAGI-~ /~c- Co'`'mer . ~"°aa THlS POWT SYSTEM SHALL INCORPORATE PER COMM. 83.44(2)c A PROPER ZABEL FILTER MODEL # ~ , /~O ~ )~ ,I w M~Rs #~ Zz ~c 3 ~s .. 'R41~~ T 7,lG,a/ziGh 7- Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 Pg.l INFILTRATOR SIZING WORKSHEET '~ C~ (© ~ Pg.2 SYSTEM PLOT PLAN Pg.3 CROSS SECTION OF SYSTEM, WITH ELEVATIONS. <r l d I~ /VO G O/ L h'b o r ~~ .G1 ~ ~ ~ ~~ 3Z / N ~ ST ~o~'A~,~ ~ ~r i J .~ ~ ~ p z ~Q~ \ I ~ I ~ Q° ~ ' I ~ ~ ~~`~~ ~ ~ ~ ( ~ I o QQ ~ i ~ ~.~ ~°4 I I I I ~~~~ i ~ ~~I 'z y nn~ v I ~` ~'~ GSf'S' TD1 o I i ,~ ~ 3 I ~~ ~ i ~~ ~ .-u N r I I :_---- I D ~o p ~ ~ ~` ~ I ~ i ~ ~~ y~. ~ i I ~ I ~~~ ~~ I ~ I ~ ~' s't ~ ~' ~-1 I C~' ~ ~~~ ~ ~,b v J / ~' I ~ o / ~ ~£~ i I ~~~ ~ I a - ~AI~ ~ - w ~R p N~ ~ ~ ~~ i~ N~~ ZA~e ~ ~ r~N U- ~ ~ ~ . ~ ~ ~ ~ o ~ ~ ., ~ . ~ ~ ~ ~ ~ ~ ~? x k ,` '~C ~ ~ M "~ ~ ~ ~ ~ ~ I r M ~i o- ~ o- ~. © '~ .~ \ ~ V ~ r o~~ ~~~ ~ ~. ~ ~ ~ .` ~ h V ~ ~ ~ ~~a~~ ~ ~~~ v J ~ ~~ ~ I:. ., ~~~ (Q J ~ z °-' _~ w ~' ' ~z ~. .~ Q ~' ~ ~ `~ ~. ~ o ~ ~ •. ~` ~~ ~, ~91~P~a~~ oe ... -fi- ~r y8 ~~~ 1 ,. ~L ,, ~,v~~~x~l-a~E' ~ G ,~ Tp~ ~ ~~ .9/~f i~'Dlr~p U~,v 7- C,4/d ~~' ~NSpEc T/o,~ ~/~ ~ I/~/ sc~. Qo 9iP~~L Teti ~~ i/ i~ L~ ~LrL ' ,~~,~~D ~-~~~ ~ -~ s ysT~M ~%~, ~Z , o Cho ~ S S~ c Tio~ ©~ T~'E~vc~ls ,, ~~ ~~ ,~ 2lS'~'v (,-' ~N~i G ~~f'~4- 7-0~'S aR ~ i api ~~"~S~ AC'S ~1~~~, cq p,~ c i r y ~~S,~E~v,,,~~-,~ ",yo~,~ ~ 3 'x G ~~ " ~ o,u~- wi~ SQ ~T, r~id~.f"ov~,~ ~~~ilur j/ ~,1,~ S~'c T~'~.+r> 1 I~~ j ~,- y~ 1 d~ /2 ,, ,I N ~ y~ .Z_ /9Pf iPDrr~p ~/~ti T c~ jd U.~1 iNS~ ~c T/ov ~ /~Q- I iii sc~, Qo 'Z_ FiNi S QED ' 9iP~~~= 1~ . O T~~~ ~~ r/ ~~ ,~ An observation pipe may serve as a combination observation/vent pipe providing it terminates in the same manner as required for vent pipes. See Figure 6. .-Vent cap-~. Retorn bend • ~~ap ~' '-~ 12" min.,.. 12" rain. Final grade ~ Aggregate ~ Dislribrrliorr lateral typ. ~ f •'~ ..~.. M-. ~lE~ .~,.I.~~.~. _ I _ System elevation Figure 6- Vent and combination observation/vent pipes .~- Leaching chamber tops are at or below the original grade. Leaching chambers.are placed directly on the bottom of the distributions cell. The locations of leaching chambers are in accordance with Table 3 of this manual. Observation pipes are installed in the distribution cells and are provided with a means of anchoring to prevent them from being lifted up. Observation pipes extend from the infiltrative surface for stone aggregate systems or from the inside of leaching chambers to a paint at or above finish grade. The portion of the observation pipe below the distribution pipe for stone aggregate systems is slotted while the portion above the distribution pipe is solid wall. Observation pipes for leaching chamber systems are attached to the chambers in accordance with the chamber manufacturer's printed instructions, extend from a distance z flinches above the infiltrative surface through the top of the leaching chamber up to or above finish grade and terminate with a removable watertight dap. All observation piping has a nominal pipe size of 4 inches. See Figure ,° 5. I ~ Water tight cap 4"min. dia. `_ Top of leaching ,,Repair couplings chamber.- . 6" min. o:in. 4"min. Infiltrative surface ~ Water Closet Collar Bar(3l8" min. dia.) -uWNER's MAIN'I'AINCE Oy _ . ~~ SEPTIC SYSTEM POWTS (landowner ._ r maintenance of thisssrep°nsible for proper operation and servicing is necessarYstem. Regular periodic inspections and system, The owner is Yefor the safe healthy operation of. this maintenance/inspection 9vired by code to submit all necessary reports to the controllfng,authorities. SPECIFIC CONTACT. AGENTS ST G/C,D/,K G~~, 'zp,v/ * Governmental authorit / ~~ • Y/ inspectors: * Licensed installer maintenance ~~ ,~ responsible for providin Users manual: 9 an operation/ ~l S - 7-7'~ • ~ `~~"1~Z ~' Zl/~b/~iDZr7-.~y10/PS ~Z~3~~ * Licensed servd~ce / inspection agent other than installer: TiPi - cr/ --5.4~.~T~Tio.~, ~U,~ * Electrician for pump, electric controls ~ wiring units: IMPORTANT OWNER MA.PITENANCE RE UIREMENTS i• Winter traffic area s1:a11 not belPdding, shove ring, etc. " freezin permitted, or fro§t can/willopenetrate into the cell, g p the system. biscontinuos use winter. (a vacaction trip, resulting in no water use lead to freeze ups. in the can also ,~ 2 • Water " conservation needs to be exercisedf Or system can be liydrolically overloaded and destroyed, This svs designed for a maximum wastewater flow of '. }gem was yjr'D gals. daily. 3• POWTS are not designed to accomodate wastes • disposal unit, or an Any introduction of y °ther unnatural rom a garbage.. . destroy this system. , such waste materialsuwill overload.and 4 in a power 6':tage occurs, or a temporary overload of effluent~beins/ it may result cell, which ma g pumped into the recommended thataavlicensedmpact the cell (leakkge). It is allowing the pump to return tomdosinmpty the dosin Consult 9 tank, your installer immediately fortadvicerect amounts. 5• Neglect of the ve erosion getative cover (the cells insulation & traffic preventive) can lead to failure. REGULARLYIWATERnTfEsVroy t he system. It ISmpactioi~ or heavy the system beneath ISEGETATION OVER A SYSTEMNJCESSARY TO ' grass NOT sufficient alone tU Effluent in cover, maintain a 6• Periodic inspections by the owner necessary. Inspection or hie a into pipes and ports have beensincorporated inspeCtionyr,;~m~,°n the mound basal a.-.,.. ~____ ~ f ~~{~~ c~ ~~of 3 y ~~/y ~~y~ ~ec. Z~ -- ~ 2 5 ~ ;~ 1~ kJ ~~ a ~r~ I ~ ~ P ~~~e~~, ~ ~ie~ ~~1 ~ i a~ ®~ S I.~ 9~ P i~t q~,~~ a2 ~q.3s (~~ ~b ~73 M -5 G ,~ / ~~, ~ 3 ~ `~a.~~ ~~5~~~~e ~~~ a t~ k S Y1~t1 f a h Z27 337 S7' CRUIX CUUN~'Y SLI'TIC 'T'ANK 1~tAINTENANCE AGREEMENT ,._--_ ,. _ ANn -- OWNERSII[P CERTIFICATION FORM Ownerll3uyer ~f~~ ~~,f~-t'~~C/ ? ,~~~C~ ~7"~~t~y~_ Mailing Address ~ ~ ~ l.~'4r~C,~j (,~/~`7,t~ ~~ ~ ~f~~s~~ ~S ~/L~/~ Properly Address __ ~~~'" . (Verification required front Plarmirtg Deparlrnent for new construction) City/Stag Parcel Identification Nwnber Dz C~ LEGAL llESCR1I''I'lUN /13 5 ^ So ~ a~'v ~ ~tJ Property Location N~ Y+, N '/~, Sec. L ~ , T Z 9 N-2 ~y W, Town of ~U~~ Subdivision ~/ICJ ~i~~- ~~ f~-Dl~~ T/ O~ ,Lot # S~ Certl[ied Survey Map # `~ ~-" ,Volume ,Page # Warranty Ueed # -~~' get` ~ly , Voiwne ~ ~ 2 ,Page # 3 ~ ~ ~~ 3 c `] ~7~ 7a-r~ ~~ 3 3 ~ Spec house [~ yes (~ no Lot lines identifiable [~' yes O no SYS'T`EM MATN'I'ENANCE improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping vrtt the septic tank every three years or sooner, if needed by a licensed purnper. What you put info the system can affect the function of the septic lank as a treatment stage in llte waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certiCcation form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site waslewaterdisposalsysfem is in proper operating condition and/or (2) alter inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Ihve, 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. Cetlitication slating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of h three ye r expiration date. x ~ / ~' / ~i S[CiNA'I'URE Of AI'CLICAN"I' DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. ilre prop t described above, by virtue of a warranty deed recorded in Register of Deeds Office. Slt:r A'CURE OF PLICANT I (we) Am (are) the owner(s) o[ BATE **~*** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** lnclade tivlth tlds appllcallorr: a sta-nped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK -U~ ~yZ995~ This is to certiLfy that I have inspected the septic tank presently serving the~r-~~U~ ~i9-L~~`y residence locat: ~d mot: N U 1/9, ~~/ 1/4, Sec. 2'Q T 2l N, R~W, Town of H'e'lpsDi/ Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. p Last time serviced .~~C• ZOO Z '" ~/~~/` ~ 200 Did flow back occur from absorption system? Yes/~,No (if no, skip next line) Approximate volume or length of time: ~~gallons ~~_,minutes Capacity: ,~0~(~ _ Construction: Prefab Concrete ~ S eel Other Manufacurer ( if known) : ~t~s`~~ CS,v G~~.e ~ , Age of Tank ( i f known) : ~.,.a ~~fjFj~~ ~-- -1 (Signature) (Name) Please Print (Title) (Date) (License Number) Farm to be completed by licensed plumber (s.195.06, 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 for inspection opening over outlet baffle). jG~~-- z2-43'? 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