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01/18/2005 07:57 AM
Parcel 040-1187-20-000 PAGE 1 OF 1
Alt. Parcel 36.28.19.795 040 - TOWN OF TROY
ST. CROIX COUNTY, WISCONSIN
Current X'
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: T ner(s): Current Owner
EBBEN, JENNIFER
JENNIFER LUEBBEN LECK TODD
SELLECK TODD
66 WOODRIDGE DR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 66 W WOODRIDGE DR
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 0.459 Plat: 2237-OAK RIDGE ACRES
SEC 36 T28N R19W NW1/4 LOT 42 OAK RIDGE Block/Condo Bldg: LOT 42
ACRES Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4)
36-28N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
12/17/2003 749365 2475/629 WD
07/23/1997 429/396
2004 SUMMARY Bill M Fair Market Value: Assessed with:
27587 159,700
Last Changed: 07/21/2004
Valuations:
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.459 45,000 115,000 160,000 NO
Totals for 2004:
General Property 0.459 45,000 115,000 160,0000
Woodland 0.000 0
Totals for 2003:
General Property 0.459 25,300 97,400 122,7000
Woodland 0.000 0
Lottery Credit: Claim Count: 1 Certification Date: Batch 104
Specials:
Category Amount
User Special Code
Special Assessments Special Charges 00 Delinquent Charges 00
Total 0.00
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER- Ant SCMIN TOWNSHIP SEC. 3(y T Z6 N-R W
ADDRESS S Wt36~r. ST. CROIX COUNTY, WISCONSIN
S
SUBDIVISfON t, ft' ti LOT 4•Z__ LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of H 63
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
t '
v
.39
e
_X
-INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used
Elevation of vertical reference point: to Proposed slope at site:
SEPTIC TANK' Manufacturer: _s -YL, Liquid Capacity:
Number of rings used: Tank manhole cover elevation:.
Tank Inlet Elevation:
Tank Outlet Elevation:
,4
.
Number of feet from nearest Road: Front,oSide 10 Rear, O y ~ feet
PUMP CHAMBER
Manufacturer: Liquid Capacity: 6*4wis,,A
Pump, Model: Pump/Siphon Manufacturer: ``pp
G4- Pump Size $S'd
Elevation of inlet; p' Bottom of tank elevation: 8~5_C,>o
Pump off switch elevation: S & ZI Gallons per cycle: 120
Alarm` Manufacturer: S, J, tZ-r_-C_'TrL.O Alarm Switch Type: ~~t.Ee zA
1
Number of feet from nearest property line: Front, Side, O Rear , Ft vz/
Number of feet from
Number of feet from building: '
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
4
Bed: Trench:
c
Width:` Length: mar Number of Lines: ' Area Built
u
Fill depth to top of pipe: 43
Number of feet from nearest property line: Front, c
Side, O Rear,OFt
0
a
Number of feet from well: ! e "
Number of feet from building:
(Include distances on plot plan).
SEEPAGE PIT
Size Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box 0 or distribution box 0 been used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, ORear, 0Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
/ Inspector: 4 - -
j !E
Dated. ~ Plumber on job.
License Number :
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS
LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O. BOX 7969
BUREAU OF PLUMBING
MADISON, WI 53707
UCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number:
El Holding Tank El In-Ground Pressure ❑ Mound (If assigned)
NAME OF PERMIT HOLDER! JADDRESS OF PERMIT HOLDER INSPECT O D E.
David Sempf Rt. 5, Box 154, River Falls, WI 54022
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV. CST REF. PT ELEV.-
SW NW, Section 36, T28N-R19W, Town of Troy, LOt#42,Oak Ridge Acres
Name of Plumber. MP/MPRSW Nn._ Coumy Sanitary Permit Number
Paul Cudd 2739 St. Croix 79193
SEPTIC TANK/HOLDING TANK:
MANUFACTURER: LIQUID CAPACITY: TA K INLET ELEV. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER
PROVIDED. PROV IDED.
DYES ❑NO ❑YES NO
BEDDING: VENT DIA.j VENT MATt HIGH WATER NUMBER OF ROAD. 1PROPERTY WELL. BUILDING. VEN TO FRESH
/ ! ALARM FEET FROM LINE `7 Z AIR INLET:
❑YES O lr J/ ❑YES NO NEARES_T_
DOSING CHAMBER:
MANUFACTURER BEDDING- LIOUID CAPACITY PjPUMP,SlPHONMAN UEAC:TUREH WARNINGLAL?, ING COVER
P OV ED. I ED.
~cG~J ❑YES ❑NO
] 11
YES YES ❑NO
Pq
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL PN OPEHT JVVFLL G VENT TO FRESH
N BE OF
(DIFFERENCE BETWEEN - F T FROM LINE IAIRINLET
PUMP ON AND OFF) ❑YES ❑NO NEAREST
SOI L ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE 1111AMI TER 111ATI HIAL ANO MARKING
or excavation. (If soil can be rolled into a wire, construction shall cease until
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
BED/TRENCH WI DT LENGTH IN. OF DISTR PIPE SPACIN(; COVER INSIDE UTA -PITS LIQUID
TORENCHES MAT HIAL'. PIT DEPTH_
DIMENSIONS
GRAVEL DEPTH FILL DEPT
H l!'El!SIV TH PIP' DISTR PIPE DISTR. PIPE MATERIAL NO UISTH (~I UMBER OF PROPERTY WELL BUILDING: VENT TO FRESH
BELOW PIPES ABOVE COVER . IN LFI ELEV EN~~ ` pIpES FEET. FROM LIFVE7 9 AIR INLE
NEAREST--r 1` 4(/Z
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.
❑YES ❑NO
SOIL COVER TEXTURE `EHMANf NT MARKFHS OBSEHVATION WELLS
❑YES ❑NO ❑YES ❑NO
DEPTH OVER TRENCH BED DEPTH OVER TRENCH BED DEPTH OF TOPSOIL S()OOF IT ISEEDF I) MULCHED
CENTER EDGES
❑YES ❑NO ❑YES ❑NO ❑YES ❑NO
PRESSURIZED DISTRIBUTION SYSTEM:
BED/TRENCH WIDTH LENGTH NO.OF LATERAL SPACI77
L DEPTH BELOW PIPE FILL DEPTH ABOVE COVER
TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO DITR DISTR. PIPE UI S THIBU TION PIPE MATERIAL & MARKIN
ELEV.: ELEV. DIA ELEV.' PIPES DIA
ELEVATION AND G
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING CHILLED CORRECT LV COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
❑YES ❑NO ❑YES ❑NO
COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL, BUILDING:
FEET FROM LINE
❑YES ❑NO ❑YES ❑NO NEAREST
U-
Sketch System on in cou ty file for audit.
Reverse Side.
SIGNATU TITLE.
i
DILHR SBD 6710 (R. 01/82)
wlsconsln APPLICATION FOR SANITARY PERMIT
DILHR St' CrO1x COUNTY
(PLB 67)
OEPRRTTr
ammommmm 1EnT OF UNIFORM SANITARY PERMIT #
InOUSTR V, LRSOR & HumRn RELRTIOnS
-Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'hx 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWNER MAILING ADDRESS
David Sempf Rt. 5, Box 154, River Falls, WI 54022
PROPERTY LOCATION
SW 1/4NW 1/4, s 36 , T28, N, R 19 Rte) W OW O Troy
LOT NUMBER JBLOCK NUMBER [SBDIVISIONNAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER
4ak Ridge Acres Woodridge Dr.
TYPE OF BUILDING OR USE SERVED Q -Il
X 1 or 2 Family Number of Bedrooms: 3 ❑ Public (Specify):
THIS PERMIT IS FOR A:
❑ New System ❑ Tank Replacement ❑ Repair
Y Replacement Soil Absorption System ❑ Revision ❑ Privy
❑ Alternate System ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
19 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
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
Septic Tank Capacity 1000 1 X
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer: PZ`esent tank will remain
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure
Total #Of Prefab. Site Steel Fiber lass Plastic
Gallons Tanks Concrete Constructed g
Septic Tank Capacity
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
Class 2 945 954
® Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for inst tion of the private sewage system shown on the attached plans.
Name of Plumber (Print): Sig ure: MP/MPRSW No.: Phone Number:
Paul R. Cudd PRSW2739 1715)425-2049
Plumber's Address: N me of Designer:
Rt. 5, Box 364 River Falls, .WI 54022, Arthur Wegerer (576
)
COUNTY/DEPARTMENT USE ONLY
Signature of Issuing Agent: Fee: Date:
f ~ [ ❑ Disapproved
❑ Owner Given Initial
Approved Adverse Determination
Reason for Disapproval:
Alternate course(s) 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 application 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.
r
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
STC - 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/contractor, ("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.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Owner of Property rna Se m
Location of Property yJ~_-14, Section T N-R ! 4 W
Township
Mailing Address F. 5, R,
RIO -er
Address of Site 'S aim ~
Subdivision Name nzit ~,,,dLe Aey-es
Lot Number
Previous Owner of Property LA~
~C~ r c d
Total Size of Parcel 00
Date Parcel was Created ►C
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes No
Volume and Page Number _ as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A Warranty Deed which includes a Document number, volume and pa&e number, and the
Seal of 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 refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
I (we) eetrti.by that a,e,Q. statements on this Bohm sae thue to the best ob my (our.)
knowledge; that I (we) am (ane) the ownetc (,s) o6 the p to peAty dens n i bed in this
inbonmation botm, by virtue ab a waAAanty deed necanded in the Obbice ob the
County Regi6teA ob Deeds" Document No. 20 :jCj 1,1 ; and that I (We) pte3entty
own the ptopoz ed site ban the sewage u6pa system (an I (we) have obtained an
easement, to &un with the above desn bed pnapWy, ban the eonstnucti.on o6 said
.system, and the same has been duty neconded in the Obbi.ce ob the County Registers ab
Deeds, as Document No,
SIGNATURE OF OWNER SIGNATUR 4F CO-OWNE APPLICABLE)
t
-
DATE SIG # D DATE SIGNE '
Form No. 105 hl
r
r
' a
SEPTIC TANK MAINTENANCE AGREEMENT H
0
St. Croix County z
9
OWNER/BUYER y
E)oa) e rn p
ROUTE/BOX NUMBER sox Fire Number
CITY/STATE War FgRs , W ZIP_ ~~/vat
PROPERTY LOCATION: ` 4,) Section T 6 N, R W,
Town of St. Croix County,
Subdivision ~'r*"e A -eS Lot number
I
Improper use And maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank Bumper. What you put into
the system can affect the function of the septic tank as a treat-
ment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for
a maximum of 60% of the cost of 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 systems properly
maintained
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration. H
0
E
I/WE, the undersigned, have read the above requirements and agree z
to maintain the private sewage disposal system in accordance with x
the standards set forth, herein, as set by the Wisconsin Depart- v
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
y~ c I
SIGNED 9
C GF
DATE %4- St. Croix County Zoning Office
P. 0. Box 1_-Z7 9f
Hammond, WI 54015
715-796-2239
Sign, date and return to above address.
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DWA•RTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969
HUMAN RELATIONS \ / MADISON, WI 53707
(H63.09(1) & Chapter 145.045)
LOCATION: SECTION: TOWNSHI UNICIPALITY: NO.: BLK. NO.: SUBDIVISION NAME:
LOT
-*W1/ TZaN/R 19 E (or 71R r-Sy 4 z. - o tc Rib 6e / c,,
COUNTY: WNEFV BUYER'S NAME: MAILING ADDRESS: R~ S hjOOQR1LlGE pR1 UE
S~C'.cZU~K bAtv`O SEMPF ~lv~ - Li.s wi SVczz_
USE DATES OBSERVATIONS MADE
NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: 1PERCOLATION TESTS:
RResidence -2-S N-11 A ❑New Replace
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILLOLDING TANK: RECOMMENDED SYSTEM: (optional)
NS ❑U LZS ❑U ~S ❑U EIS OU ro S OU
F ers.1463.09(5)(b), lation Tests are NOT required DESIGN RATE: [F71oodplain, ny portion of the tested area is in the
dindicate: C.~-kS S indicate Floodplain elevation: N
PROFILE DESCRIPTIONS
BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-Md6N•ES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH tN OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- dl 4 q 9. S t~e~rJE ~poTo L4B' 3.1123\ sal TS ; ~•q 'Bn st l ; 4t.8' 3r ,e~ S
B-Z ~•6' ~9-Z' ~I C~ y 'ToS.oZ.S~
B-3 q•6' q9.3' r,y 'Tbyq'
B- s~ s L, 'h ~o Lt'c~-r~Z
B- S t~t~Z 3.o~i CLJB-
PERCOLATION TESTS
TEST DEPTH , WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH
P_ • A .
P-
P-
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. ~aT~p1q pF - eL. C IL/ . Z' C~~GE 9 iZ l Ll.Q1^
SYSTEM ELEVATION OE: ''eADER PIPE- EL. C! 6 - o ' Ct-, W-A "cove
; C
e
i - } i Lam- ux
-4
-77
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-7 441
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UoT 41._ _ sc^LE lp=tlo' - SEc 36
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.
6,
NAME (print): TESTS WERE COMPLETED ON:
~~`1T1vt2 L. 1k__~ ~G iig~ol 5-Z3-fib
ADDRESS: ~T 4 13ox ZZ` C-q TIFICATION NUMBER: PHONE NUMBER (optional):
~LLSwo~ w Sys oo~i S`)6 iS-~ZS-o1Gy
SIGNATAJ
c~
DISTRIBUTION: Original and one copy to Local Authority, Property Owne
DILHR-SBD-6395 (R. 02/82) - OVE
To be, )il "test, YOU
3. r
7,
r
T THE
'11AT" g
dares
Jer 3")
` PIP)
NON J' ^W ~~J -_~7-10 J ARID --7=CIF ICAI 10NU, -
VE Q T CAP
y-PI~_ I 1 I APPROVED LOCKING
WEATF!ER PROCF _ I 'HO' COVER
JUUC T IDKI BOX
= Kew DCCR, I -
Iz"MIU. i
,'f1"OwJ OR R E 5 H
GRADE -
COQDLJIT --FIN
r - - - - \Irl _
, PROVIDE
INLET - ELEV, `~Z,O AIRTIGHT SEAL I III
I III
i I I APPROVED LeltiT5
APPROVED' JOINT A I I I W/C.T. PiPE
W/C,PIPE I III ALARM EXTE~1DItJG 3'
EXTcND!NC- 3' I II ONTO SOLID SOIL
DNTO SOLID SOIL B
I Ow
c I
ELEV. FT PUMP-~ --J
OFF
D
CONCRETE BLOCK
X- RISER EXIT PERMITFED G►JLy IF TANK MAULIFACTURER. HAS SUCH APPROVAL
.5 PEC.IFICATIDUS
;OSE -
1,01ESIER 0c9'JC5',E7f=i ~2.U~LiCTS IJUMBER OF DOSES: 3.9- PER DAB
TANKS MANUFACTURER:
TA►JK SIZE : S'~) - GALL0MS DOSE VOLUME XZ~ Gav offs
S 1E C-TRO ia44STFrl S IPICLUDING BACKFLOW:
A'_ARM MA.I~:'JF?.CTUREZ:
~O1 N~ CA°ACtT1eS: A=-~5___'►~rNES OR 30 - ~a-'-CU5
;'1ODEL
SWITCH T~iPE' QIUMBER:
~`v2 ( B=- Z -_!N'NES OR ~O vALLOA;5
\~1``f~_ILS 6 'A1LNE5 ~ZO GAI.LC~:S
C-------
PuP^,P M,FfJUrACTURER: OR
_ _
S S
MC D E L N U M B E K. L/ D = ~y 1/Z 1►SCHES OR Z9/
SWITCH TYPE: MOTE: PUMP AMD ALARM ARE TO 8E
S1 iN5TAL LED ON 5EPARATE CIRCU!T.5
MINIMUM, C'~~~•~.R.:E RAC ~ GPM
s.bl
;ERTfCAL DirF=REUCE DE T W'-E►PUh p GFF A11D DISTRIBUTION PIPE.. FEET
^1!F lUM NE ; V.ioRK SliPPLy PRiSSURE . . . . . . . . . . FEET
\Q _ r -c-"-'T CF FORCE. X -.ZO F 00 FLFKICT IOAS FA:YOR-FEET
0TA! +j IC, HEAD = F
A- Gif1Et SI13►]5 CF TA►)K: LEDIC,TH ---=-WIDTH LIQU10 0 EPTH
OF) Co CD M 00 (D N) (3)
p O
0-1 - - - N
O
O - - - - - - - o
CY)
o CJI - - - - o
N
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N~--
CY, (n
in C) C:
> CO
o (n
cn
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CD ril
O
co
ll O _
ria
cn O
Cn
N
. N
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°
CO
CD N W 411- cn c3) co
TOTAL HEAD IN i%-']E-i"EPS
-Lb S,
CROSS SECT I DUI Or A BED S ~;S `N!
rt
V =iJT TAI P6- 1 ?3~V~
~X~S~NU flN~
1=t 1J1 }f a ~hjj~
_ y2 Nom;
I ~aC _e- SOIL F!LL r E OF GGREGATE
LDISTRIBUTIOU PIPE-7 I + /
APPROVED S~3QT H`_TIC COVER
P' E R. I A L OR 9" OF S T R 1.
1 (
OF,
9y.Z'~ 1~~OF/Z-ZI/2 AGGA~i;AT>`-/~~\•
L L E V. OF FEET-T
DISTRI5-UT101,! PI°E TO BE AT LEA5T 3a 1UCHE5 BELOW ORIC.IUAL GRADE
At„D AT LEASTED MCHES BUT QO MORE THAI) '-i2 IUCHES B-LO\.J Fiij-tj GnADE
J ~:~I?~~UM DEPTH C)F EXCA VAT10►.' F RDM ORIGItJAL GRADE LJILL P,_ _ 6 7 _ IIJCHES
tldJ,iMUM DEPTH OF EXCAVATIOU FP,OM DKIGIUAL GF,ADE WILL BL __6_O__ lt.)CHES
SIC-►JEC: _
~A -
7,~
K.~ ~f
Owner's name San. Permit No.
H63.05 PLOT PLAN
r
Show:
Location of building served Dosing chamber
Septic tank Vertical/horizontal reference point
aoas7 Z)t<-9iI•
Building sewer Q System elevation is ToPOFtib-9b
FAI Effluent system Q Well
NR Replacement system area Property lines w/in 50' of system
NA Distribution boxes Scale or dimensioned
Pump and controls: S S S. 6l ~T, Ll
Mfr. & Model No. Vertical Lift Size Force m in
a . o - S-7 _ \ZD v.,e_
Friction Loss T. D. H. Vol. Dist. Pipe Gal. per ,,Lin. Gal. per Cycle
Place check mark in appropriate box, indicating item is shown on plot plan below:
-
OR`i?1
LOT L.I" tF-: 2 O
Ell
yoI -
53' ~uSE
D 0
' D
P4C
n
4"PVC l7' G~2A, Fta0~ n
01SY2f8u~]UtJ AT ~,0~4 J•
PIA = ~ 1 1}R4 ~
~xlsT. loco JaL s``prxJ `rF-~}~
ZOO'
~LitLtL~ c+ Eou -x\ST. u~~e_ Z o 3~
OF
f'cCZA►,~OpN
By the granting •r of the above plan, or upon the evert of a subs.-cuer._
~rmit being rJ'1nty and the Jt,.:rol:Coi 'ttl' -.?^iRg AdliLlnLS Cdtt C, does
p._
i
not .3 Sit Or 101 l ?-Ie for any defects in C1 _ SCZC1fiCd .LOfiS, plan
iC'n ;i _ d-._ !1 C' , JPt, COnStC_,Ction, or i(1'i that may t'. l.t In or