HomeMy WebLinkAbout032-2163-08-000
~car~ wn' o° ~o nme c_ PRIVATE SEWAGE: SYSTEM ! J= t
.a~°C. Bn: nUil(u:;c [/IV!SIJr ;j~nl'.2n "e Ti Nc~G v
INSPECTION REPORT 5gl 7O
G=N=RAL INFORMATION _Rlvli ..rate Ptar is r,:
• ,
_rsora: Inionriai;7r, vo: ;:,:wct-. rra~ CE Ls°~ °3r se:oncan Dumcse. 7,nva- _av:.. C~ rt) r;'. ~ AJ/A}
-
i~e'ml'. H Oers Na:-~_ Ir sir ~.~il!ace X :owran!c I °ar_ Ta N.
- vJ ~t~~SM '~o,Irr~eCse 03Z-Z163 - aq% -bbd
pier 'u!s: 3tv'. =:er Br,/ Ues a0¢or, IS'=do17ovm! ar?eiTvta Nc
TANK INFORMATION ELEVATION DATA Of) i 4,-1:)N
it W I C S~~ lb00 3_ncnmarr, U • 16+71 A5 3 . `r
sec / I 3z,0 q ~,M. 5IJ ~W ~GJ- 63 X43 .6%
I
Zak ~ / BIa~ SetiveG ,
F ~~t
-.-wd!nc in!e• j
IS:ii'. _~ut!e_
TANK SETBACK. INFORMATION ~ 17,77
(D: a:)ttom 3 a S. 3 ? q, 39
Fira S.aoe --r4
PUMP!SIPHON INFORMATION ~•~I
liv;anu;aowr Damianc rover
i
`Ivioo urnL)_-
t
_)ri -rl3ilor. ! OSS J)'SPff r1= - ~
i
SOIL ABSORPTION SYSTEM
3EUTr<cN~H I\^ !tl'n I r;d! I INC J` -'encnes ?Ii DIMENSIONS Nc J' i[s IrS,7e DIE
DIMENSIONS
i
SETSACK. =-tt TO al'_ I3_D- IVVE1 4k;='27R ,V%n CHINv IJa t: a T'~ .rte
~rA
iNF7RMATION CH.4M3EP 7P. Pit
yoe 2.3 a~ UNIT IJ:,~ NurnG3'
1 72
DISTRIBUTION SYSTEM t rt l I?/,j
tisac'-rAdanib0l[ ) 1-, _an:n[;-,r 7c!e low is i+v _ a:acln; 1 ent tc A:'/rrar:c
SOIL COVER x °ressure Systems Onh xx MDunc Dr At-Grade SvsTemS Dniy
eat ;,tie' I ro? Over la -Y r. r, s ceeoec'Sa:esc: Ip: Ivlulcne:
°_tl Trenc , n 16=_d iron. » ` :-oosol ~1 - N[ N:
OMMENTS: rlncwoe coo ❑sc _,encies oar>on: ores..=.n' etc rn;Ln tlor . Irsp~~t!or
_a:atioc. ?amel No:
l~I- 5rJ Descnotior =
amOLnL o; =iar rBV:310r. K°OUIr~!C? -'yes
\X NG 'S
:E -he- side i0' aodwzma InTOm-,avor.
uar_ !rsePC:J'; .:a[cr~ ..er, Nc
ci i.---, iL F.....o
Satety and Buildings Division I St. Croix
t ' d ~ ''1►~ 201 W. Washington Ave.. P_O. ox 7162 sanitary Per~tit Number (to be filled in by Co.)
RS Madison, WI 70_7 1
n M S$4 7&S
e
ST, aji ~tlId`Grmit Application : State',ransa tionNtml,
JoMMUN
In accords with SPs'I ';(2), Wis. Adim Code. subnuss:en of this form .o the appropriate governmental unit Na
is required prior to obtaining :t saniiar pennit. \ote: Application forms for state-owned POOPS are MJ,rnilted to Project Addre s (iF different than mailing address
the Department of Safety and Prot ssionaI Servioc., Posonal information you provide max; be used lorsccondary
u -oses in accordance with the Privacy Law, N. 15 04(l Xrn), Slats 5 3iile
1. Application Information - Please Ptint All Information
property Owner's tia o - Parcel
Nfandy Hanson 032-2163-18-000
Propeny Owners Mailing Address Property Vocation
2148 6Z rd St. Gott. Lot 1
Cily. State Go Coda Phone Number _NW_ t', SW tr'. Scctron 14
(c•ircie one)
Somerset. W1 _ 54025 (612) 94I~11062 T-31 N; R 19 W
11. Tj"of Building (check all that apply) I ^t
11 or 2 Family D%%vlling ivumher of ilcdrooms 4 8 Subdivision Name
Block k
, Plat of Gavin's Acres
j ❑ Public!Gtnmxroiat- Describe Use 1 y N.9 - -
❑ City of
❑ State Owned - Describe Uke CS&f Number V'ilta c of _
tt~• Na 'row. of Somerset
M. Type of Permit.: (Check only one box on line A. Complete line B if applicable) p
U P,cplacerrtcrn System Treatmer.U[IoiJingTsnk Replacement Only ~ Ir'f(Rlter Modification m lststtng System (etiptain)
A. ❑ New System
rte; ~te.,-,-, 3 fy ~~✓°C>,m.
- - list Previous Pe ut tm er an ate Issue
B, I I Perini* Renewal ❑ Permit Revision ❑ Change or Plumber ] Permit Transfer to New
Before Expiration Ctu•,mt
l 4533-7 1 -7 b
-1 1-1 Z
IV. Type of POV4'TS S}'stemlComponent/l)evice: (Check all that apply)
'cm- Pressurized In-Ground ❑ Pressurized In-Ground n Ai-C'nade Mound > 24 m. of sutable soil Mound 24 in. of suitable soil
❑ Holding Tani: ❑ Ulh r Dv I)LYsal Ccn:por.cnt (c\ ain)_ - - L Pretreat DcvicC (cxphnn)_ _
it ca s, existin %nhe! A- 100 effluent filter
Vtla
V. Dis rsaVTreal nut Area informations ttiltratur Standard 1'Iu5 chumix~;
Desist Flow ; gpd) Deign S;rl Appli,:ali:ni Rat p.pd' I Dis, . ca IR quirod (A) ispcrsat .atrca Proposed (sr) System Elevation
600.0 Gpd 0.7 G 'Sq. R -T4(L75 sq. R. additional sq. ft. proposed 97.00' proposed cell
4) 857.15 s q... ft. combined_ 895.60 s q. ft. combined 97.00' existing cell
VL Tank Info I Capacity in I'.~tal G of Manufacturer y ,
Gailoas Gallons Units s `v V '
Neu I anks c:cistirg Tanks v o
0 U r in s L G
Selticor xakimy,Tank 320 1,OG0 1,320 2 Wieser Concrete 1
Losing,:hamber - I
VII. Responsibility Statement- i, the and ipned, ass me respattsl6ility for imtal tiu■ of the POWTS shown on the attached plan.. _
Plumber's Name (Print) Plurr+r' sjgnalmc ' MP'.~iPRS Number 13usinese Phone Number
i
lames K. Thompson IVIPRS 30021 (715) 248-7767
Plumber's Address (Sject, City, State. Lip C,rdc, /
Air
340 Paulson LAe Lane, Osceola, W1 54020
Vi1• ounty/De "/Department Use Only-
_i--
4a'oved Permit } ve I)at, s sued Issuing rit Signature
cc)
5 gs.
5
vcn Reason for 1)cmnl a316
I?C. Conditfrli 1EXgAA EMeasons fnr Disapproval 1 1~ a l
1. Septic tank, esflccnt bite- vnd 3) w t ~ O 5
iic. s / rn~ nto' ec~ 6.~.; L, CAI`
c,isperc,.., cell rust all be s-
as per management plan pi ,riled by sit ml)Ei.~ tS
2. 'M-oelhick requirements trust. pe r-lairtt: irt:d ~•a y V~
t U
la pr appkeNe coda I x6narlim,
mtach to complete plans for the system and suhmit to the County _ on paper not less than 8 V2 x 11 inches in size
1 e%,*eL ~b Jr 'S *~~2J4 +or1
It rn
b~ I A.
i
v~
.5 7S.lvy ' y6 icf nd
5cI,rc4-'St
`~'1 r.:.a t B ~'i4 ~ o r i%4 1~-~ , ,~F'S
~w',, TA.C~x~T [iS L~
n
:-o 4
. ; .
ILI S C - Gr0/X
J
I
I
i ac '14t6r~
( V rv
vP
I p1 ~i(S~CCrtCQ '
.9 i
+ _ ' a'r ` . c : `_S•! ~nCrt ce ~a; tRh A(Q
dl~
Sf ctf-
(5,,,;,~sVr ~ •~~~aE o,.-Elvt'. E%cc`. of ~.po<
a;vf./ %a% CCJV Kr ~z
57'- G ;.vu-C oLG•~~i
j r . 6..► . ~ ~ e r c ~ ~ «c.~ < ~a _ _ - - ~ t/cs+~S a t 3 r 7S i~°
CIL"
7j, 7
Conventional POWTS Index & Title Sheet
Project dame: Hanson Conventional POW'TS Upgrade
Owners Name: Mandv Hanson
Owner's address: 21,18 62nd St., Somerset, Wjl 54025
Site address: Same
Project Location:
Subdivision: lot 8. Plat of Gavin's Acres
Legal Description: NW 1i4 SWA, Sec. 14, T.31N.. R. 19W'., Tn. Of Somerset, St. Croix Co., Wl.
Parcel ID 032-2) 16 3-08-000
Pagc I Index and l itle Sheet
Page 2 Site Plan
Page 3 Dispersal Cell Sizing & Infiltrator "Q-4" Chamber Cross Section
Page 4 Dispersal Cell Cross Section
Page 5 System Management Plan
Page 6 Septic Yank Maintenance Agreement
Page 7 Certification for I Itilization of Existing Septic Tank
Page 8 Parcel Map
Page 9 Warranty Deed
Attachments: Soil Evaluation Report
Mater Plu r Restricted Service: James K. Thompson, DSPS Credential 430021
Signature: -Z!,- Date:
Page I Of 9
thsign pursuant to In-Ground Soil Absorption C nmponent Manual for POW TS, version 2.0 SLID-10705-P (N (I I e0I1
1 -2, t tlr Sc~.d t
• C,ci st<i +1 ti a-/'.~C'C l %C JU ~ GPI
37.3
- t i S/6 (a3 nd
Lo C d, ~'~.e ~ o ~ Ot~ v, n S ~c rF'S
/oc% *y c 3.z .zJ~d ay-
i ~G~ 3. a~ 4 c r e.S.
ezti uJe /l'
0
r V ~ ~ r4 ✓y
i c xiS~n q G
jt Q~s;d&tee s
i
So-61.1 A-14 t<F/wcn~
3y, s'Yd~' 46 ouf/c.~. fico`. c.f ir.,oaf
.~2~
r.Nrnu.,G~✓ECr+r~/';03
~oz.C7'. ,''avert otawf~s~s yy.y~~ EX~
r i s Ca, c~vE < /ol o' _ _ - _ tics S o t 3,r 75 '.j/
"~-'/"&-v~-s
3 'r 6 3 ' w; ~:S •'r,',ft~ r
37.3. ~,7' -
Ilanson Dispersal Cell 5izin~,, L p<,,rade ( alculalions
~islin!, tlispcrsa) ( ell
( be;;r: ;,ttlslr: IuU -lllCnti utim;ilcd Ilo•t )i 1.5 ilesl n '.at:ton - 4,~()(;I: Uxl desl,--3n ilr,\ti
InhLraltt~ Capam.~ of natn;c soil -':1.? pd.sq. ;t. - 1
V)OI 11011 arr t rrc LAN(I ci4- 85 sc fl~ 33
4 Au~r,: piton aria as ilr;lali;:d_ ti_") 21) al It
Pnq)u.cd dispersal Cell
I J hcdro~~In, l( II-'1 -gallons cstinutcd tloi,t t(. s dcsi-n factor) = I ?O 00 Gixi ck _si ,n Ilo"I
Inllltr,itn c c;lp;iat~ of ium e soil = o 5 ,pd,`sq. It.
lbscrptiorn arli ,alwivd 011.1;[1 si
V-;orjxion area proposed: o5 2i: sq ll.
ililti-mor t)wA ; 20 01) sq fi. EISA I;cr ckinil%:, Ilaillrll(u i~u:cF. 4' na e;rp• ?I, sq :t. :-:III
1;(1 ul ft- - (I I::rir clldc,ip t,~ .10) 16(1() s(;- It Jhaniber- 14 chatnbcrs rcgmr%:d
',.tcnb,2r of ire:11,hes: 1 .r I cLantb~rs
I rench ~N tdih:
I rcnck Icnt~lh G3.(IW
lrrn;a;i-;ulr~ ''i rnio:i c~nt~r ~ rM
Qu~ck4
Ouick4 Standard Chamber 7------ - as
'EFFECTIVE LENGT+
12,
g' ' I I I III III Illil1it 111 ~I II It
MI I ra Eli
3; - -1 SID= VIE'.v
SEC-IC'J V EW
i
MultiPort End Cap , - _
1 ! r n u ,.i
1
- 3a^ - S DE vIEW TOP V EYd
rRC'1T VIFW
Quick4 Standard Chamber Nominal Specifications MultiPort End Cap_ Nominal Specifications
Size (WXLXH) 34'x52'x12' Size Mx 1x H) 34'x16'x12'
Effective Length 48' Irve t Height 8' or 1.25'
Invert Height 8° -
I
Soil Absorption System Cross Section
UO. ca ft
4' Schedule 40 Final Grade
PVC Vert Pipe
With Vent Cap f I
Leaching
Chamber
system Elevatior,
Soil Absorption System Plan Vlew
C,.3 ft
Leaching _ Trenches
Vent Or Observation Pipe Chambers
4' D~-i
lieaa~ i
Leachina Chamber SRNI cations
r'/vs s`E <J~.`~
Man ufacturerAnd Model
FISA Ratin --Z (-',0 ~ c:
g sq ft per chamber Soil Application Rate 0- gpolsq ft
gpd Desigr, Flow t C1, `6' Soil Application Rate + EISA = 15 Chambers
j ;W rows of chambers each.
Page of
('omrational I'MA'I'ti ~I;uta~~entcnt Plan
General
fhe comcntnonal septic s♦steal shall be operated in accordance ++ith SPS 182-184 Nkis. Achn. Code. and shall be maintained
in accordance ++it Ii component manual SBD- I(YCIS-P (NOI i01). All local and/or state nnles pertaining to s+stent
maintenance and maituemnce reporting shall be complied aitl+. Questions on tine operation or maintenancc of iltc mstem
should be directed to the inslalling plunnbcr, Jim Thompson at 1715) 248-776, or the Polk Comm Zoning Department it
'715) 495-9279.
Septic Tanl:
eptic tank sen icing mechanics comph ++ill► SPS 38:+.~ l(I)(e>. Septic lank to be located within 1.50' of sea ice pad. milt
bottom of tank to be 1 15' belon senIce pad clc+alion The operating condition of the septic tank and outlet filler sluill tx
assessed at least once even tv%o.ears by inspection. The; scplic lank contents shall be removed ++hCn the sludge and scum in
the lank exuml li the liquid volume of the tank. The contenls of the septic lank shall be disposed of in accordance with \R
I l.', Wis Adtn Code, by an indi+ ndual certified to sen ice septic tanks tinder s. 281.48. Stats. If the contents of the tank Crc
not remo+ed at the lime of a biannual assessmenl. maintenance personnel shall ach isc the o%%ncr of ++hen service will be
needed to maintain Icss (I nn I scum and sludge accumulation in the tank. The outlet filler shall be cleaned as ncccssar.
ensure proper operation. The filter cartridge should not be removed unless pro%isions are made to retain solids in 111c
that ilia' slough off the filter ++hcn removed from its enclosure. If the filler is equippccl %+illt an alarm. the filler "11.11
1
sen iced if the alum is nclkated Septic tank manholes risers. access risers. and eo+ers should be inspeclecl for ++al,
lightness and soundness. Access openings used for service and assessment shall be sealed v%alerughl upon the comp!
sea icc. .An+ opening deemed unsound, defective. or subject to failure must be replaced. Exposed access openings
than 8 inches in diameter shall bo secured by an ellecti+e locking de+ ice to prQcenl uccidentxl or unauthom-cd entn into the
No individual should e+cr enlcr the septic tank as dangerous gases na+ be present Ilia( could cruse dcaltn Scplic lank
nbandonntent slut// be in accordance ++ith ConunB 3. Wis. Adm. Code ++hcn [lie lank is no longer used as a POWTS
component. Tho addilion of biological or chemical additives to elllumcc septic tank performance is gcncr dl} not requircu
such products are used lhev shall be appro+ed for septic tank use b+ Itnc Depattnncnl of Commerce. Safct+ and Buildiu-s
Division.
Soil Absorption Cell
Trces or shrubs should not be planted direcit} on the soil absorption sNstem, The area abo+c and around the s+ stem should
hC seeded and mulched as necessan to prevent erosion and provide some degree of frost protection. 1'rallic (other than for
cgetali\ e ntainlcnance) o' er the system is to be a+oided. Soil compaction may hinder aeration of the infiltrative surface
ithin and abo+c the system and will promote frost i nelration during cold ++cather months. Cold ++cather installations
(,October-March) dictate that the system be liea+ih mulched for frost proicclion.
influent qualil} inlo the system nta+ not exceed 2)-')0m1,-)1 BOD5. 15O MG,'L TSS, and it) mfJl. FOG Influent flo++ ma}' not
exceed nmxinuun design tloi% specified in the permit for the installation.
Observation pipes ++ithin 1l►e dispersal cell shall be checked for effluent ponding. Ponding levels shall tx reported to tl►e
tmner. Levels above 4 inclics m(hcatc an imlxndnw, hvdnm is failure requiring additional. more ho(IueN incli lorin;o
ContinLene-* Plan
If the septic tank or am of its compoucnls becomtc defCcti+e the tank or component shall be repaired or replaced to keep IhC
,'stem in proper operating condition Excessive pondin4, %Whni the (lis; crs;:I -11 w 1l bC ri ntin;;lCd H iml;tilin_ r.Cn s'.~il
~ihsorption cell lo brim-, Ilhe sv slCni inlo propci, operalIn,.; condilic.m
ST. CROIX COUNTY
SC: K I ANK MA1NTFNANCE AGREEMENT
AND
CAVNERSITIPCERTiTICATIOV FORM
Owner/Buyer Mandy Hanson
%failing, Address _ 2148 62nd St'
Property Address Same
(Vcrificaunn required from planning & 7.ontng Department for nc\v construction.)
C ty'State Somerset, W Parcel Identification Number 032-2163-08-000
LEGAL DESCRIPTION
NW SW 31 31 19 Somerset
11rcperty Lnca t'on ';4 '14 , SCC - T ~N R W, Town of
tivdi~ tsi :,r Nat. Gavin's Acres Lot 4 08
Uertified Survey Map # Na Volume Na . Page # Na
a r-ranty Deed # (before 2007)Volume Page
5,pec house Elyes0no Lot lines identifiable Q ycs0no
1 S FEN1 N A N ENANCE AND OWNER CERTIFICATION
iuiprcper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
;,nice conststs of pumping out the septic tank evcty three years or sooner, if needed, by a licensed pumper What you put into
ik(: system can affect the function of the septic tank as a trcatn:en: stage in the waste disposal system. Owner maintenance
esponsibilities are specified in §SPS. 383.52(l) and in Chapter 12 - St- Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Flantung & Zoning Department a certification form, signed by the
ncr and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
aster', mer disposal sy stern is in proper operating condition and/or (2) aftc.T inspection and pumping; (if necessary), the septic tank is
Th,-T-, 1.13 full of shidge.
!eve, the undersigned have read the above requirements and agree to maintain the private sewage dispos:il system with the
Li, rit set forth, herein, as set by the Bicpartment of Safety And Professional Services and the DepaRuieut of Natural ResA)urces,
'state of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the tit Croix
aunty ?fanning & Zoning Department vvitlr n 30 days of the three year expiration date.
'we certify that all statements on thi. form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
described above, by virtue of a wa my decd recorded in Register of Deeds Office
N umbpr/W bedrooms 4 " .
SIGN F APPLICANT(S) DATE
*'*Any inf•Armation that is misreprescrttcd may result in the sanitary, permit being revoked by the planning & Zoning Department
Include with this application a recorded wur.-ani.% reed `t dlt ti-.c :ZC£IS:Cr <,i'Dee(i; (I h e 1:hi Ct,i'1 i> ~ :C CC11 iftC:1 i'y' 11
refercaice is made in the warranty decd
(REXr'. i) -1,12)
S I'. CROI.I' COUN'I-Y' ZONING OFFICE
CERTIFIGAIJON S'1'.1'ITAIE:NT
FOR ( 1 Il.llATiO\ OF I:\IS'I INC SIA "I I(' "1 1\'ti(S)
This is to certify that I have inspected the existing septic an&or dose tank
presently serving the following resideucc:
(street address) 214862nd St., Somerset, W; 54025 located
at: NW 1/4. SW a, SCCtloll 14 To%.%'1131 N, Range 19
IOwll Of Somerset St. Croix County Wlsconslll.
[ ,poll inspection. I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of SPS. 384.25, and it (they)
~il)1?~~li-~~l 1i-1 I-1~' ~l_IllClli~Illll~~ Ilf~+h~ll~.
Pld Ilox> back occur f o m ~jhsoiptltw system? Yes No X
11 t no. skip next I I lie.)
Approximate volume or length of tulle: Na gallons Na I11111uteS
I ank Capacity: 1,000 gallon
Constructiow Prefab Concrete x Steel Other _
\`lanufacturer (If known): Wieser Concrete
TaIlk (lf knoW11)- 12 years, installed 7115104
'onrmit umber (if knoNvn) 453371
James K. Thompson
iccnscd Plluribcr Si<<nature) (Print Name)
h:~~rs M 'I1S #3110; 1
(Title) (l,icen e Number) \11''(\;41IRS
1 oral to be Completed by licensed plumber (Dept of Safety and Prol'csslolml
Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed dispos r
(NR 1 1 'vVisco n,in Adn u)l ratly c Cede)
Rcv. ?~U l
oF7
7
# M J= 4Z)
IN PART OF THE SOUTHWEST QUARTER OF THE SOUTHWOUNTY PLAT) EST QU AND PART OF
OF SECTION 14 AND IN PART OF THE NORTHWEST QUARTER OFATHE NORTHWEST OU
ORTHWEST QUARTER OF SECTION 23, ALL IN TOWNSHIP 31 NORTH, RANGE 19 WESQ
I
NOTE.- LANDS NOR
" MA Y BE AN AREA
LOT 1 CONTACT ADJO/NIN
A TTORN£Y REGARL
140L.8, PAGE 236.3 UNPL A T i
- -N89003'49"E
N89'03'49"E
N89'03 441T 373.69'" x Bao'(
484.36'
(RECORDED AS 484.40) K k
$y
1 Y • J
o 80' RADIUS TEMPORAR Y ~ LOT 5 " 1%R CUL-DE-SAC EASEMENT
TO BE £XRNGU/SHED UPON
VOL .10, PAGE 2889 L4 EXTENSION OF THE ROADWA Y.
L b T 8 0 .u• I,
,3.02 ACRE c
1 , 4 FT. : v n
:
L4 I
A FIFO LANDS - p
- - - co N88'26'41 "E
Z 373.67'
O
Crl I
W : I G
0 0 ( ~
LOT 4
! VOL. 1 Q, PA GE 2889 0'
L4 -0- LOT 7 A
o) N. 104 ACRES z
co 132,45Z SO. FT.
I
i
p~ 04y
Lv i'G 1-I4hs-~n
f :2
2 tGp oL a " j?liL pe l1111~
ogG . 6 Ica, ~ •
I ~ Y'r `34b
l
1 osGR FAQ ~
S L m z
3 , a1 ~
si~~~-V sYs ~'G
°g - 3
col?*4
4,1
604
tGwY1 ~GMaRS!✓~'.
tom/? of
2 d'L
c
~t
l
looo
C, s f ~R
rJ- A ~vv a I
$ ~I I
S m
v sYs ~~G
Dg-3
G~
Wisconsin Deparhnent cf Cornr-ierc? PRIVATE SEWAGE SYSTEM County St. Croix
Safety and Building Divisicn
INSPECTION REPORT Sanitary Perm tNo:
453371 0
GENERAL INFORMATION {ATTACH jC PF,RMIT) State Plan ID No
Perscnal mfcnna:cni you provide may he used for semndarr pJrposes IPrivac/ Law, s.15 N
Permit Holder's Name: C'ty Village X Township Parcel Tax No.
Hanson, Eric Somerset Townshi 032-2163-08-000
CST BM Elev. In. BM EI lem Description: SNo:
/U iCo. Zr G~~T 1421.19.1400
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS yHI FS ELEV.
I • 11 6b r
Septic e Benchmark 7
Dosing Att. BM
.SLR . ~z 4,1Z
Ee Bldg. Sewer
4.75 ✓n k. 7 1eZ.%7
SVH1 Inlet 7, 17
TANK SETBACK INFORMATION SVHt Outlet 7, V5 ,/DS. 77
'x.77
TANK TO P/L WELL BLDG. Vent to AirtntaKe ROAD Dt Inlet
Septic 7/M' 1 y 15 Z4G, Dt Bottom ` \
Dosing Header/Man. 1.7 703 Cr Aeration Dist. Pipe I oyso
Holding Bet. System
lS"`a io z - gZ
PUMPISIPHON INFORMATION Final Grade -7 ZU /C!v • YZ 10, Z
P.larufactur Demand St Cover
GPM
Model umber
TDH I Lift Friction Loss System H ~:TDH Ft
Forcemain Length Dia. Dist. to
tiVe:l
SOIL ABSORPTION SYSTEM ACS
BEDITRENCH Width Length I No. Of Trenches 1,3 11.) 11 PIT ENSIONS No. Pits Insi a Dia. Liquid Depth
DIMENSIONS ~ J `
SETBACK SYSTEM TO P/L BLDG WELL LAKEISTREAM LEACHING Manufacturer r-.(~''tt 1, r
INFORMATION CHAMBER OR
Type O` System. r " r
I UNIT Model hJr.mber
G>.>1 air.
DISTRIBUTION SYSTEM
Heacer/Manifold, ~f Cistribution r 7e xHd VenitoAr take
Pi;ie(s) r
Length-I- Du,_t Length Dia Spacing \ ( C o-~~
SOIL COVER
x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over \ Ix x r, of xx S d.'Scdderl Ict~e~
Bed/Trench Cecter -7 Bed Trench Edges` Topsoil =
\ No No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: !~i U Inspection #2; / !
Location: 2148 62nd St Somerset WI 54025 (NW 114 W 114 4 T31 R19W) Gavin's Acres Lot 8 Parcel No: 14.31 19,14,00
1.) Alt BM Descripticn = S4,- C cJ ~5~ '
2.) Bldg sewer length= t i`4,,'
amount of cover = r l 5 ~ r _ t ~i - S J ~'A-~ Q+' _
-i Lnl~dtn CC.~~dd~~ f -
i
Plan revision ReGuireC? Yes No -7
Use other side for additional information. _ . t0 0
SBD-6710 (R.197) Date Insepct Signet a Cert No
1170
'Ab YOwa 11 Cabra•.v SOIL EVALUATION REPORT t y 3
d:.rtt.M ~•.F±-q4 ~.~a,w..•n Wrvn e! N1. M• CW. Tw•6e..t
~e•TmR1.b •r pew ammWM4'A.It •J....L'e MnrMr
rte4.•urq Y~w•>Mr~l •nl rrmr m►.o ovtlBr'. i•mm ao _ _ SI Gwf.
.•v..w..•u.w..~.a...•m..,...•Ir~,ea..<.or....~R.Y ~:.~•11~ ~..:I4-.rl
~w,e.n•..r a.ear~•wa erme..~,~.,s •I.m: %_%.(---1. sir - 7r/Sr z1~
Rn m•y Oi.. - Lcteew~ '
--EPAVatl•s LP 1 ' -1.,t HWIA SW1 SS 14 T31 Nk 19 W
.••ry Pra'. bYiy+aCw~ - _ - -__^DU1• 3.oe ran..u GSW
t RivaM_ yre.el. S.I. 300 B G-. All- _
Ctr YJ4s Zp COa :;q ISM.' T- Mang RWp
W" 9x(325 71 W47.%oo vR `JUm St
W N. CM01001, .I,• r R•epntal. v,*ar a beaaa.s _ y-_ fm a•nre sun tw...r 4 w --w0 pwXa-D-
w~. m.r..l n 4-h Nair. rasa pI4.. xwsw. a •w•o.e.. -
V4r'erYlrprnenb
w ~Rrm.e.m.. A,•e ...aaa[b br . -Nw4o1 .4h . o r Op~ql m^0 Mee I N.. e (15 cad'w+'- Po1.7tI0
eVom e*4. non f Arep 1 597 r0. Sipe b let, I I,+IN /.~1/tOtffM -/1 2 V w '
r4ti towel s„a.•,.•« 100.22 a lxgnb rwq brYa-.. -sd W.r..rr
..a na• Rw~... caw ..a. ~.R+p.. •w.>.• r m.Yer • Ya '-~fw, 'EM
W>.I d L. fs4 Caw 6 3:. 9n
' 3.9 'or" 1 3AA. mfr L 21 8
2 0.26 igaV4 Rene I 34b4 mk w it 4 9
3 %7eL73 r 57IraM r.ore 4 1nH. mvl' ^9•+ 7 1 12
4 3306 I&eA IIbIM M 0-0 T - 7 12
J- 7 ^ 7 3d ?y - J l c l~ a``,Utn- i Sa e i ti it ckd<- c~u ti
I_
a rn awna Swt.a •iw 10022 4 "3e -Sa wsrn.r
txpn to Irr4uq rwa
Nra• ' t'•1•• nw-n...:m Irc+]wNu• ia•m Jlr.>.. ...rrr 6u•bl..n Iby • 'EIYI!
w •ur of sn caa cm y s S.
uo 10,3,3 rune 1 2bpF ..r h 5 9
L 1i:41.~ IDr.4fi - rom a+i 214D1 nY pr it 4 e
rl 7'J1 j 75yr4.8 ron• b tm1 mv0 W ( 7 12
4 -06 10051b rone YR1 0e0 M - 7 12
I
•telwan.Im,>n<zr..,z.1 ..e rrn;>rr<•sa r.pl •t1NNt l2•euu°~Amyt a•W TSt~30 •qL _
iS- IanM Ie.YeY4 4•MI 49^Yl•a . 727{!0
MbeN T,a.:.dn.l !
w 3E.A2 w•eT Cw.L,a•e r S. 549 SaPN~.r'4•r -
»1•. Vw Tr•Y- vn !.a! 7 I S 8651
fYgprlY tI- Grm+0 fRCQCi•JC, _ Y•rp•1 IVf p4
a ✓ q b ~•o..+a s+rhpe•« - 39ot a dprbbrier .97
i 5.Y>.un~.•lei•
rbNn .,o.r..•4.m YLm D•cWon rmn-SAVnw ~-:aNre ea~r.r nnou fg1C
Wr4 Ou S. b. G L 9 i Smt 4elIT
I 0 18 " Y'll norr m I 24b. m+b r 71 5 8
2 I 1830 1~Yr4A4~rOY I 3hbk mF _ o•' If __.4
3 II 38.45 797r4fa nr+e v~2msnk R,r 0Y• - .6 A
4 4597 1tyr1'a 1 pp0~ I h 2rmt* 'I mfi .5 .0
I I I ~
Benr91 ✓ A p Gre+n05~+Yae 4Y• - 9957 _ e 0•mib Y.6r9IW> 48 n
I Ai Wai., v
R.bl. D:l 71 :v. 1-'.. v- ius• 5r- Unrvo mN.r rT01'
u.r n Cr Caa •m s L.Y. • 4611 T14:
1 0-14 10/r32 _ 7N•1 mt n 21 5 5
2 142+ 10tRV3 ia..e •ay 31r,e mfi pw 1! 5 6
3 24.711 IOYTltl
4 3&90 1 10yeW h 7110
1~
R4Harv+p ersRna euY4Y. W.. 1 0401! W Irranp IYGV ~
_ W mYM Qa L 4•>n -SYU~N.F• ..sere ewb.7 Ytp
I
'l:TI.e~1/'•]IlG >S;.+X,..yt..J rSC,IC•t 5!rt 'tTWn', •1•Y..V cl:•nbl •n0'S.`..31 mp',
i,.. Itya+rnar, ~f C<mirwnl3 Yn e4ue ~,tpr msev«fR"17: m~em2lo•d. lfycu xa ow a.rn-t Vraeu .m rcu
P"z 3,43
~!'~'1 ~ ~lJ o~ o? !r pr.~ ripe G~L~. 1~•~/
1/0 Al
r NA/
P~
R3 -
/off
~a 131
010 (13 -7.5 f
f aA j ih y G M,.R r r a p ar teS ~'eua Y ~Y arrt a S S c 1, r+a i
-71 ~e.-,.ard s~- ~s 7rM a~ ~f?1
Or"
Q 5o,~►ers~-#'i S'ir~~" rjo.~,e,rs.~~ ~°x~
O ~aurs ~C~t~es l7rs~ sN9° bGsr
Lo 4-