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HomeMy WebLinkAbout040-1187-70-000 o co) 0 3-0o G o d f c d o ID > ° 3 ID V T v CD 1 a :m ID CD K 1 co Z 0 01, m III -I w l n fU N O W= o O A `C • v isO O n N cn r OD Of 'r'1 Q CD 03 N OD C O ID ° O O C 1 O CO 'p n Q A p O 00 CD O En O 3 CD 7 H ° 00 r M C Q ~1 cn m N Q o. N N _ T CD 0 -4 CD O CD ONp Ei < I O N C1 ::Z CD < a o r (a co co co 00 0) a) ;o 0 cr ~ v T v y z O n -4 o a c vi vi cn O v alp ~vv it ~ A 7 ID d 0 N I, C7 CD m N it D N 3 C) CD d M N Z O _ = co O O a ° O O v, N (DD c m N. v CD W ~ a a 3 z CD c Z Cl) O N p A n N CL A Z 3 O f0 -I W W CD ~ (A CL z 00 FF j CD v w m O _ CD (n 'n cn a CD CD 0 CD a- v o a a Z• N CD v c O fp 7 C)m CD - x a S. z ~ o • (D U' ' CD O N CD N o CO) U) o (D FD,E. ° - fi 6 ~ CL y CD m m A N CD N 00 A 3. N O C ~ (f] A N o 7 CO 7 C N O j O CL a O Op 6p O O O O W `2 b O 0- Parcel 040-1187-70-000 01/18/2005 07:58 AM PAGE 1 OF 1 Alt. Parcel 36.28.19.800 040 - TOWN OF TROY Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner ELLIS, LEE A LEE A ELLIS 54 WOODRIDGE DR W RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 54 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 R1 9W NW1A LOT 47 OAK RIDGE Block/Condo Bldg: LOT 47 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 36-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 04/09/1998 576850 1313/402 QC 2004 SUMMARY Bill Fair Market Value: Assessed with: 27592 151,600 Valuations: Last Changed: 07/26/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.459 35,000 116,900 151,900 NO Totals for 2004: General Property 0.459 35,000 116,900 151,900 Woodland 0.000 0 0 Totals for 2003: General Property 0.459 25,300 108,300 133,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 103 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form -STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER L.Ge r-_u-is TOWNSHIP Trial SEC. 3(o T ~N-R~W ADDRESS RT S O Daxotee do_ ST. CROIX COUNTY, WISCONSIN SUBDIVISION 4DKUC 4OGrc. LOT 4-7 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM f -p 4 I l oil F DxST.~UTZOr.3 11 t I~a~SE. INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used 4 AW -0_-- LQ*V_ A-i BA".~ ~ W Elevation of vertical reference point: 10p.OC)Proposed slope at site: X4'0 SEPTIC TANK: Manufacturer: ? Liquid Capacity: 1600 GlAtA,4mr,3 Number of rings used: _ Tank manhole cover elevation: 94;55• Tank'Inlet Elevation: ? Tank Outlet Elevation: Number of feet from nearest Road: Front,© Side,Q Rear, O feet From nearest property line Front 10 Side 0 Rear, O 25=0~feet Number of feet from: well y 0 jk , building: 18=0'' (Include this information of the above plot plan)( 2 reference dimensions to septic--tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, 0 Side, O Rear, 0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Ie`-d'4 Leng't'h: 53=0." Number of Lines: 3 Area Built: g54412 Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, © Rear,0 P't Number of feet from well: Number of feet from building: 5-r z-~ (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 O or distribution box ~ 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, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job : 4Len' License Number : 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION BUREAU OF PLUMBING MADISON, WI 53707 `PqCONVENTIONAL ❑ALTERNATIVE LPlan te I Number ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER. INSPECTI N~jDATE p Lee Ellis Rt. 5 Woodrid e Dr. River Falls WI 1~ 2f v, 1 "o BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: VA& CST REF. PT. ELEV SW NW Section 36, T38N-R19W, Town of Troy, Lot#47, Oak Ridge Acres Nami• of Plunilrer. JMPIMPRSW No.. County Sanitary Permit Number. Paul Cudd 2739 St. Croix 83805 SEPTIC TANK/HOLDING TANK: MAN UFACTU R LIQUID ~IACIT YTA NK INLET LEVTANK OUTLET ELEVWARNINED PLABEL LOG COVR g PROVIDDED BEDDIN V 9 ❑YES LINO ❑YES LINO N VENT MAT L. fl FlHR IWATER NUMBER OF ROAD. PROPERTY ✓ WELL BUILDING. (VENT TO FRESH FEET FROM LINE / _ AIR INLET ❑YES LINO ❑YES NO INEAREST1/`l DOSING CHAMBER: EUALLUNS FACTURER BEDDING LIOUID CAPAC ITV PUMP MODEI. PUMP SIPHON MANUFACTLIREH WARNING LABEL LOCKING COVER j NO PROVIDED. PROVIDED-. ❑YES LINO ❑YES LINO ❑YES F PER CYCLE: PUMP AND CONTROLS OPERATIONALNUMBER OF PHUPFRTY WELLBUILDING ~ VENT TO FRESH FERENCE BETWEEN FEET FROM NE AIH"LET P ON AND OFF) ❑YES NO NEAREST-__~ SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAME TER MATI HIAL AND MARKIN(, FORCE or excavation. (If soil can be rolled into a wire, construction shall cease until I the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH wIDrH LENGTH NO_oE DISTR PIPE SPACmG covEH ]INS115)In Mils LIQU U) DIMENSIONS 1 V - rREN s / AL: PIT DEPTH GRAVEL DEPTH FILL DEPTH DISTIi PIPE DISTR. PIPE DISTR. PIPE MATERIAL N H NUMBER OF PHOPERTV WELL BUILDING VENT T ) FHFSH BELOW PIPES ABOVE ~DVEH F I E V IINII Ft ELEV. END LINE - AIH INLET ~ 1 ~ FIE ETEAR / F EST--r .Z MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- ❑YES LI NO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TFxTUHE PFFiMANE NT MAHKE HS OBSI HVA iI ON WI I IS ❑ DEPTH OVER TRENCH RED DEPTH OVFR TRENCH. BED DEPTH OF TOPSOIL S(IUDF1) ❑YES LI N O ❑ YES NO CFNTEH EDGES SEE OF 17 MUL CHfD ❑YES LINO ❑YES LINO ❑YES LINO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH NO.OF LATE HAL SPACING (;HAVEL DEPTH BE LOW PIP( FILL DEPTH ABOVE COVE H TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD 61STR_PIPE MANIFOLDMATEHIAL NO UISif< I:ISTH PIPF DISTRIBL/IIONPIPE MAi1 MAI &%1AHKINI, ELEVATION AND ELEV ELEV DIA ELEV PIPES DIA DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED COHHECiLV J)V IR MA iEHIAL VFHTICAt I_ IFrcOHRFSPONUS TOAPPROVEU PLANS ❑YES LINO ❑YES LINO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF ~PL ROPERTV WELLFEET I"E' ❑YES LINO ❑YES LINO NEAREST Sketch System on Re in county file for audit. Reverse Side. G U E rIrLE DILHR SBD 6710 (R. 01/82) ;uisconein APPLICATION FOR SANITARY PERMIT . D 1 L H R (PCB 67) St. Croix COUNTY or~wRRTmenroc UNIFORM SANITARY PERMIT # InDUSTRV, LRBOR 6 HUM.I I RELRTIOnS ~"l(~05...,... -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8'/2x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER MAILING ADDRESS Lee Ellis Rt. 5,Woodridge Dr. River Falls, WI 54022 PROPERTY LOCATION %9% SW 1/4 NW 1/4, S 36 , T2$ N, F0 XX" Troy W TOWN OF: LOT NUMBER BLOCK NUMBER SUBDIVISION NAME NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER 4 Oak Ridge Acres Woodridge Drive TYPE OF BUILDING OR USE SERVED AW , D - 11 - 70-VC X] 1 or 2 Family Number of Bedrooms. 3 Public Specify): THIS PERMIT IS FOR A: ❑ New System ❑ Tank Replacement ❑ Repair LY Replacement Soil Absorption System ❑ Revision ❑ Privy ❑ Alternate System ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. 5d Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holdiny Tank System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued - El 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 1000 1 X Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: Existing Tank To Remain 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): PROPOSED (Square Feet): Class 2 945 954 a Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for ins ion of the priv a sewa a system shown on the attached plans. Name of Plumber (Print): Signa /MPRSW No.: Phone Number: Paul R. Cudd 'lre: MPRSW2739 1(715)425-2049 Plumber's Address: ame of Designer: Rte 5, Box 364, River Falls, WI 54022 Art Wegerer COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved 0, / • a ❑ Owner Given Initial 0 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 i 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. 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. Form - S T C 100 Owner of Property .Location of Property a) 14-AW_ Section T. N R 19 W Township T~® Mailing Address JS D x )sS 2 r cJ e2 V rA I-t.S (QJ=~S c , lFG 22_ Subdivision Name_ OINK l' p) s Lot Number LL 7 Previous Owner of Property Total Size of Parcel 10 n F-T ~Qo Fl-, Date Parcel Was Created Are all corners identifiable? Yes No Include with this a lication one of the followin : .Certified Survey Map .Deed .Land Contract, or .Other I;egal Document which describes the property PROPERTY OWNER CERTIFICATION I (We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. _:9fQ ; and that I (we) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the some has been duly recorded in the Office of the County Register of Deeds, as Document No._~7 SIGNATURE OF OWNER SIGNATURE OF -OWNER (IF APPLICABLE) 7-~U ~a GATE SIGNEO DATE SIGNED Form No. 105 H ~I I a r a SEPTIC TANK MAINTENANCE AGREEMENT H St. Croix County a OWNER/BUYER A H ROUTE/BOX NUMBER -57 460 Fire Number CI'T'Y/STATE /eZZJC_ PROPERTY LOCATION: S'UJ N e ~4, Section 3C. T,20' N, R W, I Town of St. Croix County, Subdivision E /~CQES, Lot number LO I Improper use 9nd 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 pumper. 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. C E I/WF., the undersigned, have read the above requirements and agree 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. A SIGNED DATE St. Croix County Zoning Office P. O. Box 29 ~?of' Hammond, WI 54015 715-796-2239 Sign, date and return to above address. v W r S m m 0 • t~D W S G C N 0 ri ° CD a 'cam 0 0ID COO oo cc ? 3 '(D 'o= 0 CM, C CD S ~ g wvo ~ ~;,i;,I ao _wvCD ~CDtA.<~A R :3 CD 0Ca 00 o w 0 cowo-~ s 3 w c w p o c= 0 13: 3'Z(0= c~ v= a0 w m ..,r w w ~ cn (D 2.8 - CD C),D ID r D < _ CDN~ 0Dc CD C) ~ A - w n A Cc: Cc CCDL * w -06 o -0 m O 49 o..a ~SD C ~CL =min o~vw N m W w~ w~ w~ Z 0 (a CD M CD CD CA (a ~c; !R =rgo~~ m was Err ?cw° m Ewa wwsaco~ N 'o vi w „r a c n (D C m CD In ° m m m v 3 Nz CD N 0 aw ~N 0 ~ "`DM ~'coQww _ o ° o W o 0=~cc a ANr`1 % 7 ( =D !i9 A' N w G CL o 0 c c c CL C w w w w CD . 0 m tn m a a$~ Cl. =0 <co0=CD3 e n 0~c -coa ~ov;MAca p9~ g aoa cc°w -4CDD--INS p s w n uJ _ a c a =r CD = o e9 ~ o ° 3 mph" C ~ am moo 3 c w N 3.a o < CD m ed z o 0 H D DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS N INDUSTRY, LA;,OR AND P.O. BOX 7969 PERCOLATION TESTS 1151 DIVISION HUMAN RELATIONS (H63.090) & Chapter 145.045) MADISON, WI 53707 LOCATION: SECIITION: Q TOWNSHIP UNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: Y. S bU 'N ~ 3l~ ' pH/R 1l E (or Tk~y ~7 - oA1-c 1~ DGE Acr?, `S OWNER'S BUYER'S NAME: MAILING NT ADDRESS: ~~-S ©~D21L~GE bR• S`C:gZljlX L ELLS ►Ut!sR. PALL-S W ! S~oZ-z USE NO, BEDRMS.: COMMERCIAL DESCRIPTION: DATES OBSERVATIONS MADE Residence r7E-E-DES~0LAT10N TESTSt_j lJ , RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) ®S ❑U 29 ❑U NS ❑U 0 S 2U ❑ S 2U s3'~vZ- k 3`n(Yu) 4, L ~ If Percolation Tests are NOT required DESIGN RATE: under s,H63.09(5))(b), indicate: C l LAS S Z EFIcodplain, ny portion of the tested area is in the indicate Floodplain elevation: I v ' PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-li *H" CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 1# ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 131 3 l~ • Z, S, ' ' 1~0~~ 7 8.z 1. UMYDfcB>,si)Ts9 IBhL;S,ol3n rnag S B- -1 B- B- PERCOLATION TEST 0 TEST DEPTH, WATER IN HOLE TEST TIME DROP IN W R LE NUMBER INCHES AFTERSWELLING INTERVAL-MIN. r RATE MINUTES PERIOD 1 IOD I D, PER INCH p_ P- 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. O`('-(~ OFIM-) 7 ;L9q' C1 ! 73 1, L~-OT SYSTEM ELEVATION L~FL. ga. z' _ P1 EL. N! a -E STA L F o %\4v `~-01ZIJ OF 7 i o s s _ E ~ Asa' ~ ~ orJ ~ S nld E - - r I . Z' "A77, 160 57 ~ ' E ~ i ( p' ILA- E _ g m r 3 E ~w i , I: fok1~C2 ZOp r 3 JO F ~ i } t y 31~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): TESTS WERE COMPLETEDON: _ W~c 7 - 86 ADDRESS: k -2--2 -6 NUMBER: PHONE NUMBER(optional): (-~-5 o D1 S~6 ~)s-yzs-ot6y CST SIGNA DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - h , JCTlOF ;OMPL TI "M 115 ® B - 6395 C To he a cr I u Urate s(" --!r report mp 1 a ( )I 2. this is r( !ncor commercial project; 3 - it USE r"ING TANK ONLY IF ALL, i completing the plot plan; to scale is prefers 1. A IV -)own, and are p i 9. Can c' percolation tc ti 1t . n the ap ox. 1e _ `ST E FILED WITH THE L X C-'_' `aIC IIA', _-RTI TESTERS d Ti B„j oor r. t r u l~ L t Si S *ci - C Y scl I; ntc 5 uY UL, y fff pt Peat rur;, _ ni Mack - p l-WL - Six general ail tires for li€1ui I BM VP T THE OWNER: This soil test report is the first step in y Th county or the Department may reonest ti c ition of this soil test in tl fit ~ s ,rrnlete set of plans for the private s, stem and a permit application m-, ariate local authority in order to t.et rr~it. The sanitary permit must be c' d d `ed 'or to the start of any construction. Cs"aner". r..m> Sa-n. Peym-,t "c;, H63.05 Pik)',' }'LIIN Show: Location of building served NA Dosing .chamber - t Septic tank lrJ Vertical/horizontal reference point Q Building sewer System elevation is Effluent system Q Well NA Replacement system area Property lines w/in 50' of system Distribution boxes F -1 Scale or dimensioned NA Pump and controls: Mfr. & Model No. Vertical Lift Size Force Main Friction Loss T. D. H. Vol. Dist. Pipe Gal. per Min. Gal. per Cycle Place check mark in appropriate box, indicating item is shown on plot plan below: Z,oo ' 1 ~c~81-y~ G ov GrtR R66 ~ -XiST7~1 G ETts1~ C Ftzo R i TTrUt-Zb R~1ft~N III 1►~ST~I 1. U\ i - ~ aQRrNprEt.~ j I S 1•'rvv ~E 1 ~ i 53' I i r--------r-- ~lo'oFkf~s`oU% LY•Jhll ' i o - b' 3 - - - - - - - S-7 ' - - - - ED ' ~ I ( - - - - ~ y„ PER~w~'R~ pv C ARP wELL 3 E }t al UFt'Sv a~STR1$v~eN P~i'eS L ~ >Ow~ 200 ~ 8►h - LL 99.y'ca.j -M T- or $v2i~ c-^L-e P ESTPrt By the granting or approving of the above plan, or upon the event of a subsequent permit being issued, St.CroixCounty and theSt.Croix2ounty Zoning Administrator, does not assume or hold itself liable for any defects in plans or specifications, plan omission, examination oversight, construction, or any damage that may result in or afte stallatio MPRSW2739 7/18/8 6 P7 24-s g ure ire NO. are P~~ 3 ~ n CROSS SECTIDJ OF A BED SYSTEM t V E1.1T TJ 1 1~ \ Z'' ~\30V ~1tJ~gll~D GtZHD~ - IF_:; ?mil 5 F)7~% F! N I Ski ~r SOIL FILL N 2°OF AGGREGATE y Pv c DISTRI BUTIO►J PIPE ~ _ APPROVED 591,1THETIC COVE .o 0 MATERIAL OR '9" OF STRAW ( OR MARSH HA' z-ZI/z AGGRJ:GATE.~ ELEV. O F g3.Z FEET _ S'E2 FaFZAT~D P1 A~ _Tp 120-T-1-oM DIP BsIJ DISTRIBUTIOU PIPE TO BE AT LEAST IrJCHES 6ELOw OIZIGII.IAL GRADE AUD AT LEASTZO WCHES BUT UO MORE THAM 42 ILICHES B=LOW FIMAL GRADE MAXIMUM DEPTH OF EXCAVATIOU FROM ORIGIUAL GRADE 1-JILL BE _ SZ ' - - 1►JCHES MINIMUM DEPTH OF EXCAVATIOFJ FROM ORIGIUAL GRADE WILL BC - - I►JCH1=5 ' SIGIJED: - ,a-t" Y--- LICEUSC iJUMBE R: MPRSW2232- UATC' 7/18/86