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HomeMy WebLinkAbout020-1077-60-000 (2) r 'AliIc u'ls 17cp a TtrTert of Ol nr T)Vr PRIVATE SEWAGE SYSTEM C0.u:y. St. Croix 5a'ePJ a'd 3un;llr3 Ox: igion INSPECTION REPORT Sanitary PCnnd No iATTACII TO PERMIT i 605102 GENERAL INFORMATION stair vlarI u: N, Per$W'alnfor --elicr y ,,u p'oVld-, m,ryb•''-svc'nt vcc'Jar/Vmpo5r5IPII'III LaN. 6 1504 i r, L111I 3114516 PP.-ml'. Holrers Na-'e City Vifage Tae.nsh p Parcel Tax N;r Hudson Soccer /Association TOWN OF HUDSON 020-1077-60-000 CSI 6M lev n6r iR•F -r Pld Dewr ptinr Sechu-o 1 mvr'RangeAI.1E Nr. 166 6.6 1 28.29.19.314 TANK INFORMATION ELEVATION DATA TYPE MANol-ACTURER CAPACITY S I A I ION BS HI FS ELEV. Septic q&Czu Qa•.chma'k r' Q~ac.` Zcbp 3 .S /~3. /do 14Q° j Al: HM r ` Bldg. Sewer / 1 IP zz. 'T 7, Sg i ( Holdng Stilt inlet `L-7 17 Stn Ou:~et T TANK SETBACK INFORMATION V • 97-63 TANK TO Pit WELL BLDG. Vent In v nb9.e ROAD Q6kAel 7 / .7 septic , DI Bcllonl zoo 7 isa AIL 5 /66 lleadel:W,ar $ $ 95 Aeration Dist Pipe CK Holding - Ent System D Neal Grace p 35 c1/' PUMPISIPHON INFORMATION N1aru`ac0.ne• Demand 51 Cover GProt,,,k. o lC 3•y /~o, Mode. Numuci TDII Lifl Friction Loss System He' ITCH Ft Forcemain I P.m) Dia. Drs:. lc'a.oll - SOIL ABSORPTION SYSTEM BED)TRENCH AiJt'l glh Nn Or Trerhes PIT DIMENSIONS N. Of Pt- Ins If Ja. I ~G~.~d [?eotr DIMENSIONS 3 6z' 5 t37 /ft ac.f..l SETBACK SYSTEM TO PAL HI DG WELL LAKE:STRHAlA LEACHING Mau JP INFORMATION lynx C?t :yslertt CHAMBER OR a UNIT p,tod Nurn DISTRIBUTION SYSTEM rQ I ( 4-13 Z~Ix3 n HT.'1-rMam'c D s:r buton hole SIZU VC' 1C lLcnyl'.7 L1 :)ni T.._ lnngtA Cia SC'dcir;~ SOIL COVER x Pressure Systems Only Or Mound Or At-Grade Systems Only Depths .r .I C_P 5'er D-p-h'f aSF-d-dr,cJctIc xx6rul5-CC BedrTr n, t- l x t l L Bp-17'p ch Ecges t ' Y• " N^ ~=s ! n 7 7 7 COMMENTS: iIrclude code discrepencies persons present etc I Inspection lot Ir )edion 42' I Location: y.;t ;;TY RD UU A I ~l~ D J- f✓Ol! y ti3 / -/`7 T -I 1.1 Nt BM Description = CXx~ / !i -~F, 2.; Bldg sewer :engm = 5' ~ I •Y fGD C✓~ Ir- - -amount of cover = ' a e7/; Plan revision Hequired'1 Yes o X N 18 Use ot her side for additional informatioon.lll Date InsepGlcfs Cer1 NC SBD-0710 IR. a~n: jkm v o q _ J -4" (.l ' Safety and Buil Ings Division St Croix $ P I'i JUl 18 2~~8 201 W. Washington Ave.. P.O. Box 7162 Samturl' Penmt Number (to he tilled in by Co.)) hda $ dlson WI 53707-7162 GoSloz State Inaacvction Number Sanitary Permit Appjlcatl 3114516 In accorclance wt b SPS lg: 2I1 kk is Ad+. Code- >uhmis~ionof do, tort to the apprnprime guremmenta! unit is nxikorci firer to nhtaminp a za: nl.n. -x nail Note. App.reutiun (urns for stile-owred POW IS are submltlcxl to Projec Addicss tifdiflrrcnt than mailing address) the Department of Safcb a::J Profs>nu:ul Ben zes Personal :nfonnatmn you pros'ide may he used for Wanda puq:xiw. in uczorduncc wrtF tw Pfny+C•: I im, s. I>.CZ4p 1 aunt, Slats 1. Application Information _I'I c _ m_ t: All Information 541 County Road UU Propem Owrxr'. None / Parcel.. Hudson Soccer Association 020-1077-60-000 y I'ronem owl is Nialloig Adcress P'operly Location ! _ . P.O. Box 671 Gout 10l Cap. Skits - Zi C"Jc Phone Number P NE NW Ncmmn 28 Hudson. WI 54016 715-650-1530 - lcircicone) _ T 29 R 19 Porte II. Ty pc of Duilding (check all that apply) Lm - ❑ for 21'atr,:k Dwciting- NUmher of Bedrooms Subdrviston\allw Outdoor Sports Facility - ~.PUhl1Ul'ommWe131_IkxrihUsc - UCily of Slnl hvneJ Describe Use C :SNI Numbe: ❑ N'illoge of _ - Hudson ~ Town of I11.'fy er pe of Pmit: (Check only o Ac box on line A. Complete line R if app icable) Z&Aa- X, \ew Sys0.•m Replacement System r Tmunientllulding lank Replacen•ew Oo:o ❑ Ollie, Mod+ficannn ro Es+sbnt. S<,teir (explain) md L)-l issue B. _ Permit Rcncwal ❑ Permit Revision r' qa1 Previous Pe°t1766eZr~55 ❑ Change of Plumhtr Prn'a I:unsfdtt In Sew (0 4D Bctbrc Expiration - ~Owaer J Check all that apply) XNon-PrC1SUN7,xJln rounJ Prcasu:zcJ In.-Ground ❑At(;ride U Nlound_ M in ofsonahle soil ] Mound, 2,1 in nfsuitehlc soil 56 Q )loldmg'lank Other Dispe• sai C'omponnt Iexplaml_ _ ❑ Pretreatment Ucvicc(explain) • 04 K N'. Dis emali7 re intent Area Information: - Dc,len H... (clod Dcmgn xoi: APphcit ton RakYpnds Dispersal Area Required ) TDispc Artyy proposed lsfl S) Stela Elevation Z / 1313 - 107(0_ t fy7 s/ N'I. -lank Info Capacity in dotal k of .Nlanuf„Currier Gallons Gallon, Urals < v c New Tanks Existing Tanks ~c f(((J ~ c ~ u a 2 ~'pLc vifnlzim~ _ X DLO VP& 2 Wieser X Dosing C l ark, V If. Responsibility Statement- I, the undtnigned, arauale tspoosilfilily to install lion of the 1'OH9'S shoo on the attached plans. I :umhcr',Namc (Prmll 1'.um snoc MP:NIPRS Numhcr Business Phone Number Lewis Bjork r 253976 715-231-7375 Pierher•s AJJrcss 15trcer, (ln'. Sta;c. An ('ode) E7818 County Road E, Menomonie. WI, 54751 VII County/Deltarlm_cnt I'se Only lpprco"i Penns 4~ Date I 'u Issuing 1 Signalum ~•:wt`t c;: Itcas.~.+~Jknial ~ /s+ _ , 7W IX.('ondiffih% sitar Lowe rri elrill ne -w_' aI_r csi riper,r)ar.ayerrertpleno .eaE Aunbe.'. 3> ~A~ 2. Al mftw* nbt;uw an s nuns( to maitb u.e 1 ~ r ( f M per WFBCIbIa co6i / :MiwrAll. ate_ ;N e -ee i N/ ~M lQ- . Arch to compiNt plans for the system and submit to tba Count, onh on paper not less tban a 1.x It tartan in si S BD-6398 (R. 11! 11) CHF(;i brJS+S A~PU:A4._" CH=:;k aG): rU AoFy~;ABL. SOIL EVALUATION Scale: 13,C30' 45 SYSTEM PAGE 2 OF~ SITE MAP PLOT PLAN 2 PROJECT NAME. DeSIGNrtan 13 13 GPu Hudson soccer Association ///111~~~111~~~ Aftacn design flow calculations fa cnnnre cal plans PROJ=cT AODRE55 C_T_H_ "UU' Hudson W Pipe Maienal i ASTM Standard (Tables 3B4.3G3 8 384.30.5; 111\\\~~~~~//%///II) Sonkwry Sewer 4" sch 4C BM Sym of + BM Ele•+atlon'. 100 FT na na bbce Maln; I BM b8fwrtpllo6 Gfetle q $R' Mme' Cf COnCrele DBC power trBMfarmer ~ Slone Gadienl!"Hi In9rnle ronn lry IMPORTANT: of I ouled Am8 2 W0l[ Symooi le acpllcadel'. 0 drawee e. rwn Show ground elevation wntouls a! suitable intervals, on tM eFV'oP^rn Itb -~•.r`~~G~i.4r-l2 y7. I 1! it l1 I l i ~ S~ ~ r I~ V60 ZS 3' to ~I q 'Col CIOL" >'fZ 6 U^ - - rZ" ~ k)uso' `v _ "'.rDIVISION OF INDUSTRY SERVICES 3824 CREEKSIDC LN D HOLMEN WI 54636-9466 S` Contact Through Relay 1 P p hnp:Rdsps vn.gov!progranisiindustry-services vw wSccnsin gov Scott Walker, Governor Laura Gutierrez, Secretary June 29, 2018 OUST ID No. 253976 M .N. PON'T.N Inspector LEWIS C MORK ZONING 01 FICF, LEWIS WORK LLC ST CROIX COUNT Y SPIA E:7818 CIY RD E 1101 CARMICHAEL RD MENOMONIL WI 5475 1-663 7 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/29/2020 Identification Numbers Transaction ID No. 3114516 SITE: Site ID No. 850125 Hudson Soccer Association Please refer to both identification numbers, Cth I to above, in all correspondence with the Town of I ludson St Croix County NL14, NWIr4, 528, T29N, ROW FOR: Object Type: POW"I'S Component Manual Regulated Object ID No.: 1780089 Maintenance required: 1,313 (iPD Flow rate: System(s): Other: Commercial System, Effluent Filter I lie submittal described abode has been reviewed for conformance with applicable Wisconsin Administrative (:odes and Wisconsin Statutes. The submittal has been CONDI11ON:ALLY APPROVED. I-Iris system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01 (10). Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, slats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "in- ground Soil Absorption Component Manual for Private Onside Wastewater Treatment Systems - Version 2.0" SBD-10705-P (N.01 01. R. 10+12). A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction,' instal IatioNoperal ion. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state slats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to line at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWIS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWI'S. LiAk1S( WORK rage" 5R9-018 Sincerely. Fee Required S 325.00 This Amount Will Be Invoiced. When You Receive That Invoice, Matthew Allen Janzen Please Include a Copy With Your Wastewater Specialist . Division of Industry Services Payment Submittal. (7 1 ;)340-0407 . WiSMARI code: 763, matthe" Jan zen u m i.gov r PAGE 1 OF 4 In-Ground Gravity Plan Index & Cover Sheet "E~F`Jt Component Manual Design References: Version 2.0, SBD-10705-P (N.01/01, R. 10/12) 11'10"i Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 Dispersal Area Cross-Section & Plan View Pg 4 of 4 Management Plan Attachments: Enclosures: Septic tank POWTS Application for Review Soil Evaluation Report & Site,Map---,y AN D effluent filter Print of proposed out door sports facility Additional information for sizing_ ERVICES Project Name /Description D" J,:~ ,TDY vi« HUDSON SOCCER ASSOCIATION_ Owner Name(s): HUDSON SOCCER ASSOCIATION _ Phone: 715 _650 -1530 Owner Address: PO BOX 671 Hudson, WI _ Zip: 54016 Project Address: CTH "UU" Hudson Govt. Lot: NE 1/4 of NW 1/4, Section 28 T29 N-R 19_E❑or W Township: Hudson _ County: St. Croix Project Parcel ID 020-1077-660-000 Designer Information Designer Name: Lewis Bjork Phone: 715 _231 -7375 Designer Address: E7818 County E Menomonie WI Zip: 54751 E-mail: lewisbjork@yahoo.com License Number: 253976 Remarks: Signatur Date: 6-3-2018 nginal signature required on each submitted copy. U t) S 91AJ ZDwr'l C44 1&-lSyr f / 5 L/lQl .Lt CHECK BOX AS APPIICALYE. CHECK BOX AS APP ABM. SOIL EVALUATION D Srale' V 30 45 SYSTEM PAGE 2 OF~ 60 0 SITE MAP PLOT PLAN PROJECT NAME:? Zp L~~1L55 75' DESIGN FLOW'. iJ IJ GPD Hudson soccer Association Attach design flowcalculabons for commercial plans. PROJECT ADDRESS: CTH "W" Hudson WI Pipe Material i ASTM Standard (Tables 384.30.3 8 384.30,5) Sanitary BAI Symbol BM Elevation: 100 TT N Sewer: 4" sch 40 Fore Man: na r na BM Descdpoar. Gnos ~ SW comer d conuele pad power transformer Slope Gradiew I%j heice4 roman q IMPORTANT: or Tested A": 2 well Sya of (d apoucasre): O a~ewlrq an anav Show ground elevation contours at suitable intervals. on/xrM apprcLprll~s-Ma /J / . 2 q7. r a ~ ~ SE gel V1tP #253976 C. t5 98,s 99 , ~ C - i X11,2 U)rrd f (m C aso x 3 s aso Pia = PAGE 3 OF 4 U o uj w a~ t s -i Z O a co M= ~gz co `a CL E N 6 N £ 2 c to N c a` 4 76 C) H LL N C J C r v c W ° c t f6 12 a) . (U 0 5=.o it lp N o w ¢ d U T C 11 N m ° R u 6 c C~ O re P c 5 - a V LL = w 1 } mn O C C O v~! • R o a V1 Z co 0) O O w W z J cli Q' U . • d II p Q W O 3 i i Q (n U cn Z > ~I cc w FL 0 c co o n I- 'I E o U co_ I I w N Q U I a cA LU o w u y ~ II J co - n I I r Q~ y I U U) C W o I w M w~ E~ I I ~ C ~ b U c Y `o I o co p v c o` I I rn T v co v v N I I II u • n u x \ m m c n _ o T T L~5 r 3 I N -T-{ j I a O w c° `n U U ~d`3 I I U w D O C ~zr ~ I I z o y Z E I: .I ui w m u C O N c r :I W o 0 11 U O C7 YW~ I. o U) - 'I 1 Z > ° a L~l a O W I. N I E 4-0 t C D PAGE 4OF4 In-ground Gravity Management Plan IMPORTANT: The owner of this in-ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc Admin, Code. Pursuant to SPS 383,52 (2). Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3). Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 1313 gpd; BODS S 220 mgL-'; TSS 150 nri FOG 30 mgL" Inspection Checklist INSPECT EVERY 3 YEARS c type of use age of system o nuisance factors (i.e. odors, user complaints, etc.) V mechanical malfunction (i e., pumps, valves, switches, floats, etc) c material fatigue (i.e., leaks, breaks, corrosion, etc) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i. e., exceeding design capacities, prohibited activities. etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i e., pump re-cycling. float switch settings, etc.) e electrical components - if applicable (i. c., wiring, connections, switches, controls. timers, alarms, etc.) o distribution lateral or lateral onfice plugging (measure lateral distal pressure - compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) c Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281,48 Wis. Slats when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113. Wisc. Admin. Code o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications- A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Lewis Bjork LLC Phone: 715-231-7375 Local government unit, St. Croix County Zoning Phone: 715-386-4820 Local government unit address 100 CarMiCheal , Drive Hudson ZIP: 54016 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383. Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc- Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval- A failed in-ground dispersal component may be abandoned and replaced by a code-complying dispersal component in a pre-determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33. Wisc. Admin. Code. L Lewis Here is some stuff. The association has said on an average league night there is 250 people there. In the concession stand area we will be roughing in for a 3 compartment sink and a hand wash sink. I have been told there are no plans for cooking on site. We are figuring on if they need a grease trap it will be set on the floor next to the 3 compartment in the future. ~ F~~ ~ ~t ,5 Vol„~{•; ti S ~S f O~'~~'Lt ~FSErcnv~`S Cwr lt~ l.CWQE ~ak - ~~,yhTnl Gys 5-76-3 41f10d-L`:OJ _al y(7 09Lk9 Nl 'N2Ca 113'.^, tlw 0. /A- -II 1 I-S,N Z oc, ac ac 3lvc ivnNVW OLLd3S 313NOOU3 o arod-aad .o-.,=,e nwos a,N..A:~ rw.vac 21W-OOOZdZM H 13831m Iw' w ~ 1- J v N Q H Q co J2: > J v O] O Z ° w ce CO °J V° _ = N N d N U a d z J N ° w k m< N Q ° J Z N N K ~ cai Km U Z~ a y N O a 9vmi ° °aa z ro a w4 < w H O N ° o> LL F- W °J O aJU J 0 V mJ o W W 3 LL 'f cc d ° NO m la-W 0 Z WU' N d oa U K K Q c c 0 L Q O Jh W W W 7 V v2 N CL -r a o I U M° O (0 -6 Q W°N N J~ NO Y n¢ O Li U -°O OO My~-y1 W MW V) ° a V a ? O: Q Ow W OU a NOO OH JF->~N ~'NQ 0 pp Ja °J Z~ NH oo wa wZN z S ° V 0 x z~ O W m=. nom. J~ N - Q n:i Do &0oa oow a w zwa mF °o OD 0 0 }y ZOJK ~ZUZ°OOUy~ Zc' ZOOF -C 0 U U ~OU Zw N~ Y Nam °U~S~tJmd3 QO a~- Z =oa UN MO Z W p yy! Q J J 07 a 9 Y >Z N F- O Z Z d O 0 z Uo F U J D I' i ~ ' I I ii < h I~ J I I. > .,9s I a 'I( O I w I~ N ICI ~ I - 'Gx' 1 I _tva a o I ~ it I I W o V I ~ M~ Z a ? lb ~ 0036 a Z _96 a u.a= ? m - , . V [ ll- ul n (r w L f or, l' CIl r5 1~ L) 4 1 ~ 2 V u.l J L. ,L- C a' Imo[ R. G'1 is, l l 4 I ~Jl- i I - I CI'. ''.I I I. 11 QQQ1)1 IP _ a, - - r. - tr a, ro • 1 %rr~ I -Quick4• Quil Standard Chamber i . I 471 I I I I I I~ i i l 1 r I I I l ~ I I Ili I ,ff ~X 11 1 fill 1. ;I I j ~ii1i1141 ~ II. i (EFFECTIVE LENGTH; MuMPort EndCap - - i I 1111 I 1 J t ~r I 6. I AI FRONT VIEW SIDE VIEW TOP VIEW Typical Trench VIEW - INFILTRATOR WATER TECHNOLOGIES, l rINFILTRATORI MTdtrata Weller Technologies, LLC STANDARD LIMITED Onin eld WARRANTY W) the st•utdual oh,q :y 0 Bach rhambet, end:al EZllow axtunced polystyrene ardyo• opla 4A q':i eAlxf llL r TSFSCi, dCCPaY]fy manL'aCiUled py lPiR.tIIX{110111',. MlHl irsialec rdoperatedlouleachtleldol / all plb.C S!il IL 9')8'%T II' 8 CerdellCB N't111 '.Illrl'A16 191UCtICnS, 6 N3TanIeC 10 the Glgna p: chase I Holde•-I aganst delaLVe mslelil and wotlcrawip for one year "oh, the date that K aJ Resell C pbrnN ie iSb lea for the aEpfK 9yetPn Oln:aif ng t"e llcite; p'04100d, hpMEVer. Mal _ I COVER BV 1 DESIGN BB(11 C Fill s not 'bQu'Iey by aWllKabltl lflN he Warfaf ty paled MdI LYMjIn LpOn Me dale Mat L' i'rstallal m the sl:ptw system commences. 10 exorcise its waranly rghts. Holder must nolily t fill ntu 1 unit ny at dE Coloonve Headgaano's'Ir Old Sa Ixonk, COnnect'.olt within fill * of I" alleged dell hill will supply repyoyl',eln Units [of Ul determined by it* INVERT 1151 dais Inlttratr to he rovrea by Mis limited 1Va+a '.y. IAr.,atp's ImF.ddy spacdiu7y exWdae the cost I` Of l&TtnOl old,& lnsla11a1gn of the Umis 3e• SPACING PER 0006. -mil 74' -I x-err mrs<re lb) THE LIMED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) APE EXCLUSIVE. THERE ARE NO OTHER'NAARANTIES'WUH RESPECT 70 THE UNITS, INCLUDING NO IMPLIED WARRANTIES OF MERCHAPITABILITY OR FITNESS FOR A PARTICULAR PURPOSE Qulekill~ Standard Chamber Specifications Id This Limped V13,,Zi y shall be svd it any part of Ired 31)l syateln a nanataMmd by any- Size 34"W X 53"L x 12"H one other than Wit1fato, The Limited Wananq' does not extent to ncdel consequential, spo- (864 mm x 1346 mm x 305 mm) cal a ndileot damages. Infilhala 11-14 not t e 112:10 toe Del es or Igo doled damages, null loss ce production ant Profits, labor and materials, mnrheao costs, a other bsses or expenses Effective Length y 48" (1219 mm) Intend by the Holder or any third oil). SPOOCsly 601,ded heir Lrr iod'Naranty coverage we damagb tell U,35 due to adlnary wear and tea'. ahil lol. awdr'l :r'wse, abuse or Louver Height 8" (203 mm) neglea of tae Unks; the IH,Its heing wblH nit to .x8ide traltc or othal mid:dns wench are not i _ _ THO•od I•d by Me hs•atetlor irsi lops la Gee to ma nlalr the minr um Jrwrd coven all loth in the v'staaalia'. Irshuet ears: Me placement of ffweal 'reeruls into tie systole come g the Storage Capacity gal (163 L) Unda filters of !1111 Uvt9 or the all SYalem ill to noontide, ving o, Imoi e, sl exce"" 43 203 all w-1a age i grease stall he a .unit ma• " opr lad or MYolhe b.b! ro cwcec by Invert Height i 8" ( ) Ts Lm ~ to ed Vlainmy shall . let Holder lals'.o con-ply ply wrh all of Me terns set InlihietW. T ';nth n tl1s Lmllao'A'ananty. Feltner. n rd cant 91411 h!It9lo Iw rOSpalsibb for any loan or damage :o the Hokar, the b,%ils.:a any tr fit pad': •e'u.kng bon irstaCmion or ahlonlenl. d hem any yodu-t Iiablily aims o' Holder or any thrd rwty. FerMIS Lrr4ed Wa•ranp• to apply. the " ,st be needled in accordance with at we mrd~tiona ee4wmd by sate are! kwsl codes; all :;'her apWeaOle laws; and hfiento's il on rill or A N~strnso herd: r'c.,~1 (dl fm i61NeeBnlalire of Infillalo has Iho autnaay'a charge o• axena Mrs Llmded V/a a lty. No Sox I53 Na' q applies to any party other than lte origins Holder, Tho above repreeel me Standard Old S nVocw. Cl NA IS Um'~ YiarOnty OMnred py LRMpta. A 4niMA rUTtler ol9ta:es and eOlnlas t'.avtl d41rr`I wa- 860-517.7000•Fa, 86 !,n-701 Poly requlnments.Any M•rchaser or Units shixid wl Infiltrators Co'po le Heatcuaner6n INFILTRATOR I-SOP221.4436 oM Stohrook, Connahd:,, all to vio pannase to obtan a copy of the appli^.abe wanalp'. . „ www.lnllilretorwslaccam and should c ai lly road and namely poor to Me mirchase ol Chile, ILR Paenr<s.J7E9,e SOC!>it; 5,'SEaaR.Sl S,dJi,t'b. S:IGIa SS•.N, T5716,16:\S.r. 6.81,&s thin Pal, 1.3 Ir42,O1 OMb Wmh osKLy. Irrrhrotnr, GTtW ail. l'w1i:Ad gal 1,fo'.Vn'n ire Iegv.we tr,ld eNrr~,•Fa Cf hall 9Velr Techrlcaagea haarev,ie,alo- i5 a rep, lred Ila(INnak n Frw'e.lr'1LMai '11Mletd Iblhwlopm a e:ep•fbea Uedsrark in MexfA. :n-txr AAVnluxneg, hayTue fhmt•+rSlwlce-, VUhiPvt. Puvlar a,ickCul OJrkWnYb^W4xJI rte SSeµ'hIWCA.re lraJn'raMn ollydRS.a Yhter Tbctnyrlle5. PcYr La, ie a Ondarark W POywk, In_. TUF-nTE a a-eg Vwrv 1, dr .irk d TVF-TITS INC. Ulba-RN Is a ImdamaM1 of WEA IN. v C16 Irl"ni" Wwo, ywhrel l l C Ab 4,%..ad P,,.1 rn U.S.A 02808IG M., M-11 MUM - a r e a l - r - : 1 1 ST. CROIX COUNTY SEPTIC TANK MIINTENANCL AGREEMLN F AND OWNERS] IIP C'ER'I'll ]CATION FORM OtvnerBuver Hudson Soccer Association Mailing AddressP.O. Box 671 Property Address 541 County Road UU (Verification required from Planning & Zoning Department toy new construction.) Cityt'State Hudson, W1 Parccl Identification Number 020-1077-60-000 LEGAL DESCRIPTION Property Location NE ,q NW Set:. 28 , T 29 N R 19 W.'fown of Hudson Subdivision Plat: Lot Certified Survey Map # Volume Page # Warranty Deed # (before 2007)Volume _ Page ? Spec house ❑yesdm Lot lines identifiable I7 yes❑nu 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 §SPS. ;83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning R 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 amPor at)er inspection and pumping (if necessary), the septic lank is less than l:3 full of sludge. Lwe, 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 Safety And Professional Scrv ices and the Department of Natural Resourecs, State of Wisconsin. Certification srating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Deparunenl within 30 days of the three year expiration date. I!we certify that all statements on this form arc true to the best of nw our knowledge. I. we am are the owner(s) of the property described above. by virtue ofa warranty deed recorded in Register of Decds Office. Number of bedrriums N/A / J SIGNATURE OF APPLICANT(S) DATE \ny information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty (Iced from the Register of Deeds office and a copy of the certified survey map if reference is made in the warranty decd. (REV. 041 12) ° ry Z i ry r rte' l ° AV 3 1 1 © 'L L1 t y~~. v CD J N V L LO ° T 3 N c °j ~ n ? ig 7 3 o, o 0 0. LL O N. © 3 . oo 3' fl I', k 17 - C d~ apP MI.i S e yY ` ~ O a O tjf~'¢_ o yy fIS Ai° • ,J A jj fla~F~ ~ a 8 ~ Q ~ ' 33 €s~ISS~~sE a P g H ~ g s g P3 0 -o a,x ~ 12 a 8 t! v i7yyry~pi jjw at 4 O ❑ O ~ o LLS La ~ rvviovi t J N f) a i 1 a as Ei 1 1 i~~s to it a. ~I i~ I tt ~s ~ ~ 6De t of commerce SOIL AND SITE EVALUATION DiAsion of Safety and Buildings Bureau Of Integrated Services in accordance with Comm 83.09, Wis Adm Code 1_ d-- Attach ocmplats site plan on paper not Isar than S 1/2 z 11 inches In size- Plan must I County include, but not limited to: vertical and lddzonlW reference point IBM). direction and -JT Ck Ii e percent slops, ecefe or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 4 C) (ep ,?z - /6'77- ✓ 661C> APPLICANT INFORMATION - P/aate print all Information. Rev awed by Data Perwrel informal n you provlds my be used for secondary WW M (Pavocy law. a Mot (1) (m)I, P openly Owrwr, ,t Property l.onCOn ` U r/Y,J' OoN. Lot fs,~ 1/4 /y~ J7/4.S ' T y N,R E Property Ownsfa Mail Inn Address l.ot a alocae Subd. Name or CSMd P, D. /Bow G~/ - _ City State ZIP Code _ Phone Number pSC.V1! L~ / ❑ Gy ❑ Vol age Town Nis sM Road r/ N C7- r' V ❑ New ConetNction use: ❑ Residential / Number of bedrooms Addition to wdsdng buikfkg ❑ Replaoamertl ,PTPub(k or commercial - Descnbe: Code derived dally flow gpd Rx nenended design loading rate Q^ bed, gPd*QA berldl, gwtz Absorption area required _ _._bed, dz_D_-_hench, h2 Maximum design loadalg rate • r -load. gpd* (o ? bye. gpyrys Recommended Infiltration surface eleveticnls)R~u ~ Z . Z AN S tt (as referred to site plan benchmark) Additlalal dealgnhite oonaideredons _ Fkwd pIWn Navatlon, I1 applicable h S - Suitable for system Convendonal Mound h1-Ground Pressure AT-Grads Syst«n in R 1 Hddlrp Tank u unsuitable for ayatem s ❑ u ❑ S ~ u DOS ❑ u ❑ S Iv u ❑ s ®u ❑ s Q( u SOIL DESCRIPTION REPORT Boring M Hodzm Depth Dominant Color Mottles Tedure Structure . Muneell Ou. Sz. Cont. Color Or. Sz. Sh. dery Roots 13 in. Consistence Boun Bed Trench Q -7 2 1 - L / M eh Z 4 0.S I 4 /MS SG I Ground 4°6 rt :M limiting factor lo 4-q5 K factor >.a'7 In. 'J? { I Remarks: Booing a Z/ - L rl r /st t^ Q S 2 0. 130. Grand I `(7.2 ft. Depth to It1aanryt~~o~rrp >zva In. Remarks: CST (please 1Print)~ / fo p [ ,e-VQrN'~ C A Y JC~Nry SQN ~OC) IiJ No. 0 -Data CST Number 7 PROPERTY OWNER 4oa66~ ~ 4SSrfSOIL DESCRIPTION REPORT t `r Z Page ct PARCEL 1.0.0 Boring # Horizon Depth Dominant Color Mottles Texture Structure Conslstance Boundary lioota GepM2 in, Munnsell Ou Sz. Cont. Color Or. Sz. Sh. Bea Trench Q' Yrl2 L Zrncr' C7s 6.4 N.'. L '5 -6 r ~c 6K ye 4 - 5rL i.., _ n,~r cs - 0.5:0, 6 Ground "'fin. , 4 /775 G 11,11 /r6' Depth to lector '>113 in. 4L r Remarks: yp Boring # 0-7 /6*2 1 - _L ZMCr M~r P 2 6,S o.6 ZI ioyie4jA 1/h_Qb M r GS - O f 8 3 4 - MS SG cs - Ground - il 4 4 /hs G 1-h Depth to IImlllrtg factor > 121 In. Remarks: Horizon Depth Dornlnant Color Mot"" Texture Structure Consistence Boundary noob GPDe in. Munsell Ou Sz. Cont. Color Or. Sz. Sh. Bed Trench Boring# Q 8 kZ b L 2 cr r 0'SO 6 L-S 6,14 3/3 3 /hs I cs - 7 Grand Q h. ? 4a.>s' ll Gq•Z JC.L Depth to limiting factor 9 in. Remarks: Boring # Ground elev. ft Depth to - - IlrMtlng factor _.-ln. Remarks: SBD-8330 (R.9198) . r .f ' ? PAtf- 3oP3 3oc+ I1u Fhoe,YZYLu~k I ivv\ ! LJt ~ 1~i ~ $racHMMttx•?oP aF RCBAQ F- + 5R IN 1~II N a 1DZ 1 BruJCd~7AQK• Sw COR~.ICR.OR. I i Cn~adlt~E-~e~.`4c 1 WLSTAC. 6 Etif8_5 39' $-S Euv . I ~ 1 E4SZLI 4 WEsTrrac~ 1 I a~ CoNCCU~oti ~.o~.~ i v I 1 4`_ N .i' 'Scat[ 1"-3e' ? Z V