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HomeMy WebLinkAbout038-1065-80-000PRIVATE SEWAGE SYSTEM " SI. s.r.n.aa...ew�.. CroIK INSPECTION REPORT ury wrmnxe GENERAL INFORMATION (ATTACH TO PERMIT) 630304 L rNtl wllumll pr.n ro xn DGnaltl Marllnp `" •" To..rmo To TOWN OF STAR PRAIRIE rt a038-106"o-000 16 31.18.263C TANK INFORMATION p cvenna nos ME MµUFACNNE0. WACiry STRl10X B$ FS ELEV sew'p E.npnm.m Gw.y an NE Holding SvM rmn TANK SETBACK INFORMATION svmawl TA NN TO P/L WELL BLOG rueinnrM gpAO glnlei TAX gBotlwn mw9 HeeMrM.n Aerevon Gpl Ploe aaug Bnt Spkm PUMPMIPHON INFORMATION EpmlG m M.nuhnurer RmenE Gm Sltwer Ton L Exmm� Ln.. sy.Mn N..e TOH F1 LeneN 101, let mwu YE EIATO OfALAMN x,n;UUTiQN5faTcm mran m. x»sire e.. inw L.�em_or._IxrMn 80IL COVER rrpnu'm system Oniy n Mponp or A44naa Usla on 1.w.M ONr we a6 Collor norm Ene. ii mC vee �'x _ COMMENTS: Imawe mw peoep.nuee. person. pr.eem. ea l In.peupn e1 Inxwmnez Lpurkn: 21461WTH ST I IAX ON Ektaww n 21 HMg 50~YgR -am"t M mwr Planrevmbn RICUIr f *Yet C:No VeeewreMror vpNnxl nrpmuW _ _ __ EEUeno rp lqp wx ma.Fo aSpnarwe Cm xv <an,.b — 3V >I r71. - stay aa�a�apaD ads / zoi vFwa.nagaa A.a.p o sail saddlaa.M 'o''' OCi 07.2020 y�B�IrZ9 . IF (9303 s LIM saa 2r2). 1 Asaaa,ada.APPi �,13z3� .nw� m mia .e, eava�moaspre.mre) ma°.,�aovwmu"am arpwie ma a �S s A �-ne. w,i mram Pcacysta m32-lobs sa w',ZaCe,, o ,L". ate= P a�Mi� fdxk.p rW4ppiY) ✓ mmwmNm. � renal ❑ ryl Dastarts teIAN e: 6193 rlf KICh.k11IpweLoro A Cemp4ative591ppil A symns o w,:so,.,sy® Is ass ooar stair ®ee....s (vyw _ ssan,al ocarnu� op.�ra�e�.n. "" 6P PAs..e. sv.T wwrss gall a.arma:., (d wA - ❑N®-e,�SA m.e,rea ❑'b..�pw�aw ❑e, uas _❑p,�a� ❑Ne®a<..dm .m o wam..a. oaaaoape.N V.re®Du ° ANu,utomra, °i�"° o� "' 700 0 0 na — a kal ao VLTan4NN Year r � 7 ' e�,y N. m immcn. rup /. S 5Z 7 MpwN ❑ a 4vA ndm$�p^�^^�^� � . A xa, oe yS w.ae.... pa• 3) Mil toMda L4P ?s>e' VSTEM OWNE Y{.��' Seats tarry muand t aipestar must bcsemmavplmp opuar W— as per management Pan piohLee r as perappacable vase%o�io'eu s seoe.39e (a uru' GY M O „YMY paW WyuM�w,WW 40U ia6t 09 2A INS loa”. s}. o(a5-g6-mo/ uc�,f L o e.m.a..... Dew ... - a.� �) • 7 Tnt40 �m vp,�bfll5u11110 roms�m.nn. ♦Nan1MM�1FLwewroms Im . aG wtYpyp�31°S4�f 049 i x �ennn+e�arum.PwrreY ^+ .,.L wrc- sem sea �, n� ;4 GHKei a,,,�uw6Rp4�_ System PLOT PLAN PROJECT iMamn ADDRESS211WOODaCSOlow sii 54025 SW IH May IJ45 16 /T 31 NIB 18 N TOWN Slarpi COUNTY ST Cii SYSTEM ELEVATION 9906/26/1E 4 DATE BEDROOM CONVENTIONAL AT -GRADE COMENTIONAL LOT HOLDING TANK MOUND ZEN SEPTIC TANS SIZE 1255 gallon LIFT TANK 56E DOSE TANK SIZE 765 HOLDING TANK SIZE Li RATE 1 0 ABSORPTION AREA 600 N of donedi none kk RENCANARR A.RP 1.5 top of pipe ASSUME ELEVATION )BY Fate( LIToD111E F111V ❑BOREHOLE O WELL -H.R.P BameaSbandfroark 100tE at Scale = 1/4" = 10' Pro 4 Bad oon House Area 15' below system is to remain �nelswmea Huffcuft Combo Tank A / 14% slope O� M Well is to meet all WDNR setbacks diventgis mto dodoneto B 2 \/ 98' Elvert rum off away from B M' B-1 system 635' Property Line DIVISION of INDUSTRY SERVICES dr--psi 3224 CREEW IDE ON HOLMNW umo-swc Y�ii' i- non lm.m wtacwP�9nm✓snan.nRome wl nN9 mat WYM•,G M" lwn GNW 3smear/ August OF 2018 CUSTIDNO 226900 ATTV POB pwrevon ZONING OFFICE SHAUN R BIRD ST CROIX COUNFV SPIA 1432120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017-6409 HUDSON WI 540167708 CONDITIONAL APPROVAL Ihmt(¢mon Numbers PLAN APPROVAL EXPIRES, ORN6rz020 TMRo onn lO Nw cIJZO,4 SITE Site ID No. 851674 Pleax refer le bosh tdamifcmim noun MN eMw n all cO ondan wtlM1 Ne 1001 H St ot 1 Town of Stu Prune St Croix Cauaty RWt4,NWl4 S16 DIN,RIgW L 1 FOR: Object Type POWISCumponent Manuel Regulated Object ID No 1787313 Maimmance reowned, (b80 0PD Flow ant SyNam(s) Mound Component Manual- Ver 2 O, SBD-10691 P HI0001. IT Pmsure Dmnbmlon GmWnenl Manual-Var20.SBD-IOIWP(N01'01 R 10,12), E0uwtFlher coOrstZI 01 The'U",IMl dessnhtl above has been mvlc%d fro confomance wish appltcWle Wisconsin AOsn'utive Codes P and W.xomin Slaums Ifiesubmnulhasecen CONDITIONAI.I.YAPPROVED Thusmem tsbbe=enavuaM Cv^ and located in accordance withthe enclosed approved plans andwm any component manuoh)relented above ISr The owner, xs dellnN in chapter 1010100), Wunonsln Statutes is responsible to, brilliance with all ee pR 't) requirements 17 No Noun may engiu m or v,A at Nummng m the sate miles termed to do so by the Depammem Fro s 14505. N6 mshe Imme dm ne use L This system u to be constructed and located in accordance with the approved plans and w'to the "Pressure Dnmbu4on Component Manual I" Private Vnsue Wmt,,atet I teatment Systems Version 20" SR0.1DONE IN 01101) This system n to be mnstruch, and Mated in mamrdance an the approved plan., and the -Momd Componnt Manual nor Prate Onme W anewset is"thm Version 20SBO-10691 P IN OINK inowndynal Inre 1T 1. slatx apriorum dot ou main n= clan inam avoid son ro=, =mpa=inrot n and if th.site • Ntth new a woUlmoiun. it is re=nninu Wed not to umate the pump in this dux, tank used the ranks arc l amgd pot can homeowner m=apan s. I� fleet <r4=carted from umea=in neanu;aLamemm and tmas and or le La r Igor Il inroad mmn soul=d..+hmemmnbt dvm msmavmemThe pnsr ruins YoSet"Attsm or t l .semen s . eat tPUD 1 l waste men rated slut he pannoy dnpowd,f I . • Any ue gnue,Import, aadshrum.hml be=at shoo and removed prior o Ming she wrfua for Dinosaurs to pevom mNme uMer th=dropeml sea. T MI S RmxU Ppvt BMoil Prior to most million oft he diorama area, [heck the menders Con4nt of the sod to u degh or inches smearing and compacting is"et wit I'll resml In reducing the in criminal capacity of the wtl Proper wd an M dea mmm by nrlhne a wd,empty cement me hands If rally into a na- inch couponthe site IT too our to prepare l f a crumbles site prepmauonw forced 11 IM1e see a too wet to trip.. do not pond until itone% Ell connotations shall comply with SP5316300 and NEC JW All piping shall conform to Si Table 31411.30-3 and SPY Table 384JLLS Inmlate bui leg mm ers Ms and M feet Per MPS 39E J0 Q I get A copy of The approved pions, spur Focal on5 and this lmormallI be..main during construction and open to in demand by authorized uttermostves of The LyporrenL which spur include local m micam, A]Ipmmre coconut by lhumte or the lose municipality shall be obtained prior n commencement of con5rruwon... allatmn isch,mnn In grunting Nn woman the Donlon of Industry such resmn the ,Or m real changes or Irmy should conditions arise making then necessary for code compliance As Per late aces lei 12CI nothing in this mnew ,ball unit, the all ,I the oritsibibry for designing ,sat, mining structure or ompomnt Inquiries concerning their correspondence may be made to me at the telephone number brand below, or at IM1e null on ton leinfl d The Topic left addressee shall moose a cops of this Inner and the w ick I S component Plan to IM1e aware and am others his we resontmible lac the maallauon common or reduce nance of the POWR Snnwrcl Pee Regwmd5 25000 � Ten You N eily eTWllnvoi[e. r INagnu Pleass In [I udne Copy WnlM1 Yaw Naaewmec MpeaMon Divisions ofIndustry -330gSemas Payment suEmtOal derl3 pgnera Moo-frn,]oovm -33U pm WiSMART mY: T633 nave wagner(ax cgov use, E,s,m A Tay tiny Narmorer Sp iab5l. (71,)634 34U Mundri a 00 A M -a 30 P M sol-'N R BUIC yan,.: 9167018 Prior to construction of the duperul arm check the motment content of soil m a depth of a inches Smram3 and COMmF=m4 of wel add xdl bea w rtducive the sperm ou Oman I D) 'not LOt Pmpn PC ran atdeterdeterminedob, mime a win s * Not the omaa If r ran mtn a 14-ueb rzs. me s� rb prepare Ifnmmnles Sw me ift an amount If me sic is car win 10 prmme, do ma related will it dri Electrical connect mnt'shall comply xitk SPS 3163H and NEC 300 411 piping shall conform m SPS Table 381 and SPS Table 38431F5 Insulate buJdmpewen Mvobd 30 fen per SPS 38 01 xo A or, of the approved lime nen8cations and OF, lime- wall be om,:e dom, construction nntl open to on by audeonzeA dpresenutrvbs of the Department wFv-0 mat include Firm: onwar rs AE pemu¢ - - ,qucmd by:ou mate m the local mumcmiln3 Imm, be ob®mc onorm mrwnmwmm: of -- - — mnmuction msallwon"enuon P eautm6this app rou no Dwrsmn of Indusm be, me, reeve me npF::o Famous cNnen or addnuns should ,mmucaft. wise manna wale LOT Formatm. Asp,. -sue mtS 1011ur]agm aft, are,¢x Shall rtbo eve the desi® f me rolloutresponnbmp ffoosenoritsenorita a safe budding sometimeor mmpwenc modules cowemag Cato wrrespond oic may be made to me a: C,eislephwe number boas hems, or m meaddross an Dos onvernedial lNc we rcleft add owe mall porlot a aw o: tors lever Ned 6, POY'TS management plan 10 We owner and my goal wM10 are r%sxF 3m for me awmwF:m uncommon ormvnmiu[< of me PC)U bmarel Fee Requuetl S n.00 5 1� Itva 4am L W all Be lrvnoatl NTreo ton Bettye Rw lmwmu �lnns I MaeIXt Plmse India a COC` 0.M 5ov Pare ester w,mWa Urmron of Indusm Smius Pavmmi 5uom, o 16081599-09H Mam OF'Wam.-3 i0 p.m RlSMART code-6-' era wafiner@wigm as FAxm A Ta>Ior.Inwic,ser. Specialist- i^.463436M, Mon -In$D0 AM-410PM Cover Page Shaun Bird Bird Plumbing Inc W2120th St. New Richmond Wt 54017 715-246-4516 Date: 6/27/18 Owner.Dorn Marlin Location: SWIA NW1/4 S16 T31 N,R18W Lot 1 100th at Star Prairie Manuals Used Mound Component Manual Version 2.0 (N.01/01, R. 10/12) Pressure Distribution Manual Version 2 0 (N 01/01 R 10/12) Page# 1. Cover Page 2. Mound! Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Secton 6 Pump Curve 7.8. MainNALLYtanca and Contigency plan ; JLD 9. Flter Specifications antl cross se Won YAND Attachments: Test .3ERVICES R� SERVICES Shaun Bird Signature License num 6900 Page 1 of 9 3E� System PLOT PLAN PROJECT DBO Mypn ADDRESS 21101 W sL 6ortrelsel W SCO25 6W 114 NN 1/4S 16 /T 31 N/R 16 W TOWN age promo COUNTY IT (•li SYSTEM ELEVATION NO' 6126118 BEDROOM 4 DATE CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons CITY TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1 0 ABSORPTION AREA 600 X of cMmEen none kk BENCHMARK V.RP 15- lop of pipe ASSUME ELEVATION IN' Filler Llfebme Filter ❑BOREHOLE D WELL 'H.R.P same 98 benchmark 100th at Scale = 1/4" = 10' Pro 4 Bedroom House Area 15below system is to remain undisturbed HuBcuR Combo Tank 14% slope Well is to meet all W DNR setbacks 96 Gvert Is lobe Ilona to Ll D-2 98' divert run-off away from B.M 8.1 system 635' Property Line I Mound System Cross Section and Plan View 1 I I Tj I Ai W j 1 1 I � tt K } B L = Topsod = ASTM C-33 Cap Material D sand fill Geotexhle Fabric 9 8. D FT Contour } L-4 Dimension Feet A n D K 7. a O $t Bt�L S:�{ 4 !� F G e I 1 K w Z Slope =Clean aggregate =4in sch.40 pre Y to YY in dra. () observavonptpe Slope Direction O_kt GENERAL INSTALLATION: The mound area is staked out along the design current. boosting vegetation is mowed and raked off the site. The memo basal area (L x W) is plowed with a moldboard or chisel plow. Plowing any not proceed if the sod is wet enough at the plow depth to form a Y. inch soil wire when a sample is rolled between the palms of the hands ASTM C-33 qualitysand is placed =m im ly after plowing. Send is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe Special care must be used when placing sand of less then one foot thiclmess to minimize compaction of the plowed surface After the topsoil cap is placed, the entire momd is seeded and mulched to promote vegetative growth, Iwn erosion and protect from freezing The observation pipes are slotted in the lower 6 inches and secured in place with robot or a closet flange 10/07Igt PageS-o Pressure Lateral Layout Two Laterals — End Manifold ded out 8 tg '"•" •.•'••• / sweep 00 Bend 37or,dam,W /1AL Dbtribu—uou twt�ork S eetficate Lateral Diameter In in 5/ n���n.' In Ft Ft Manifold Dmmeter onfice Dimmer X Onfir 8 L amnitL M old Force Main Diamemr In Force Main Urnith 0pr Pmsure System Comstraetio]PVC Laterals are rmhucted of Schedulepipe. Onfices arc drilled perpendithe pipe with a sharp doll bit and fiLateral win -ups teammate with a cleanoul plug and are enclosed'm a diameter lawn spookier valve box ac from finished grade.. ..... CimdC •••.�] 6-9 lrh lawn Sprinkler Valve Box Page 031051gj ...dive. Septic -Dose Tank Cross Section And Pump Performance Specifications I!!1[NS�/ltei �I S� Odri r .ir _�.•„ OWm Meohob b6m a'AboveGMe WV6 CaeOrIvbt Mevbole <5' Below (ha&ede Seek+d wmmama Tank Vob — ! OPI Dimmaioo. Inohv Vo Gel. (�)A el® H. 3 (dm) C , I — (dud) D 3 TOW Mmbobblo' 1 10 p Wilh lucklcti^6 Devoe IuvollovB __� t 12- ftvCw Wh6 Vml Boa ElevetlOn SB. i F, GENF,EAL INSTALLATION: ll a vepdd m b bNded sod bwk P exc 81 0 mwOfepOae out mmumum�or'e Podve[epPovel wepifu:mova. btaumum dwm Ofbkbeve ry vv m 0' be d without PM appr v . Mevhole covme ewoml io VW Pimtive to kme � � god ,,Bu l Piping m me Wea mE aO4a u of wpmKd mogul. cmemmd tome umk wuh wmd� bd oo Babb eW m Pm'mI walh�8 m eeBP^B11x fmm mean b ebeved wtih 6' Sch ae PVC m EMge me mk muvadm and me cbeve b eeabdwetn48hl Ebchial eernm muWlioswim NEC 3W ee0 Cmem le.2x. Page Zof0- Mu 280=SERIES 112 hp Submersible Effluent/Sump Pumps The Lbety�o ��pmvjdw a ,eete,�1ve.M1, F11120'Puntp W on-ske ~e eelZf � .1Wd haaoy�� wmp pq;Ittp DeSignetl �nd Ube�'s Unique 'Un�-B�- �Ung the �es M" prcvme y&tws & WI&IO wtom�Ze. All ModefS Featum. VGftx StOe M�Ier Nmftnu �e solds up". E�P�ercoatftiah Dktd� MeX1MUMflUidteiIt�W.JWF. 10, W.. 0 281 NVA M op� MA WA AhP W� �ORPM (�)�Spwc� a0awao1w Uarttpe(2oRi2� C4#41 c M CeMfi� Perf0m� C�- 2804kwi" I 0 M 114 1M 192 M M �PerMlnute D,�Mroml Data. We�ht 4 les. Hel�. 13- � �: 10 - (�l a� Minimum Sump Dh�t&= Modelmll 2� ... 14- �287WF .. 10- Fa�orI� �=I,M I UM on 95, 9.5. �Qft� 7- 0. �0. &10`td� POMS OWNER'S MANUAL & MANAGEMENT PLAN FNE WYVIWPINn Mmsr imk Oase�lY � PM120 Tank ManuhcNrer �DMIGN PARAMETERS nl Flfla MenuMCWrer ayU❑NA YFMMWN Oypa lank Woadry M Tank Manulepum' ryqDaUn lkw(ppaFJ, lEeSsaME. 1.5) mauMurer ONASOI AµYatin Rub !2��Tonk MMtl C amaM MUrlFab, On&Grese(FOG) 90ngIL 1NGe9wI FRr OPONPIryxDryyenP ard (BCOJ 4N rtpll aYcal AralYal OwetlaMTdsl SuspendedS dsjdR3) dlM s4n aOtlar.a MaPlahaelM EMwnl Oualdr Mci aw9ga yl Calls)Oxygen Demand (BODJ 00 mgd. muM (gnaw ❑ In91uuM (p'meuepow)Toll SuspemN Sods(TSS) 90 ngyL rade �AAc"FBIC form (gewmnoc deal) OWIv MBdnlum Efifteme FaNtle 3¢e Klntllaamebr Yn. MaziMemnruclrmmmxnb4 sW v.w.lBw�ds w+u.n.e...n.n. Seth Event Service Freguenry InspMmnditicndank(s) Nleast mp every 53 Ms aNs) (Matlmum 3 yea.) Pump W demands of ankle) wiled mmMneU aluE9e end Ben pllelswaihlN(gdMkvdume erspwmpMsamMil Nbatpva say Ommns Ra) (MaMmiona3 .I clmnamuax9ar abs[onm mly ! amonme qq Inspect poop, Pump wnOob&damn aleaslmw rely 01rcnN s) ONA FAun aWaa va pMaure el NWMpwa eeBlY ngrgb f) 0M Nbael plm sorry OmonMs Oyman(s) NA m'°r Atbal prom Every, ❑mmNe oyvaNs) NA MAWeQLWCE WSTRUCTIONB Inspections oftyinus Manandmaer,a mlb small Ge Mayor of an WM]ua Slowed VreI Svaticenusw RIEAGWns: Mafiarpumher OnsrPlumberdeah aSns Pouf Me Pedog POVJTSny mi Seldoges SeM]Iq Opeab. Tanx insFeabns musl4Mutleeviwal lnsryr0.^n Df Mebnk(s)lo klentlly any miza�pdrken Iwdwle, MCMty eery wa^lawbaks,mmsun Te sdume olrombi tlslutlge ad swm erg bdaG lwalry OxJi up w PvaYq ddMnnlm he 9mimtl euaw TMM1scercal m\'s)slnAMrswy xbpxM btlaak Ne NMVO buds a Wedherfacempp®el b rMrh Bands andmdeauomontlngmulsodem 11e pnWgd au Onfln gtamtl surface may ntlrale a tailing cmUNon end wiles Me ImmeEule nnhysWn of Na aced ragulelpy autlwvlly WMn Ms scandal deforualun of stage and avm in arty Wk equals mnd N Dill or more d Me done volume, Ma eamwnbna of Nn Mnk duA Ce remwnd b/ ¢ 3epUge Bavk4g Ope21w and F Gvsed d n asNa� xNb NR 113,Waccnsin Fdmmrsl2weC e Tin sourcing of eMuenl Green, me xal or p'essu feed POWT$mmFmenM, pevealpneMmmpwnnb, acl any dMr manlnnar�m or monilwn9 ad °s°rvas d 11 mans or Ise alw0 be dalwmal by a wNr9] POWTS MaMalrer. A saNj repaN drall be federal to near boI nwWbry sandhi wMm 10 Mass W ¢mplebn Of any Sidereal RTnt STARTUPNBOOPEMTION For redir m, per W use of Me PONTS elwckb'sMent aM(a) for Me preferred of painting products or oNer eMmka6 Na may imFNe lM lreahnent pwsasendsordamege the dlspsvl mils) Il tigd ¢mm�halbns are tletMl tiaaeMe¢nlMa dNe anFls)ridmdvl bsase0laga BavHn9 opeala p'd 10 Yee ' Pall START UP MO OPERAMN .yer yyrpiya ryul For I a'awb , Poor re Mar d Me POwF9 MxF beaereM dndin I UN Preaalu Or PaINIrV Pras1X w m.r irm.a. m. MalmMn wn¢...ww a.NNEa ae aNpMw �usl. n Hen mnMrlN.nwe o Mamma N.a m. mNM. M me brute)Man up by hat when (Moral soarer) Mae uP:B mrunro Malay Bobsl fa eamalel Ma Mlu is,e aunen. J u.;re IF aNdil Munro fall in me/ IX a normal IN meer Im'ela. `May parser IWP me am W d Wn be n a=all bmay MUaepnadIn, inonehype heuoKrbae:rN ne«ofa rMr S`MMf WLp and, do iimiUP � M�� Mllwwp do, M WUMoma Mvapl "FM or Meal IAenl Ielne�i m�wastl F mmweP/�ap•r�e K Ne P' P co Nd. to rive nmael N ,s mp w DXMo IM Wny talk dry OO M hM or MUM wrWeaMal "of ale vtl dXwul may N nor arlw Or pars oror w MwYe altlulb w mmpcL Ule ales WNlr 15be16 ara rn Mary mouMatlng dor Man neMn l@rse aMd w w an Fares, MNe lolbwine horn Na weal to a s, Try smallBiala ord dal me eM Poo be Ne Ulllle On dM eMl PUMP) Ceby tw a, tl May bWe, rortlalna. 01mn eweba: aegMaele, Mental thee, uiew tlN iM s 1eL buMNpro aMn ptlWeeemminllryn and aki Imppe. and Wbw bMC prmfe. Mrbltlaea, meal auaW, melbllma W, Plralrq pWlact. ABAYOONYENT wan the PO S lane anderIe prmaentoy saidn aN of urvrm tM MleMn9 areas Mall be mien to Illavn the PE mbm N Papa and Portly abandoned m mTgNrcs i Manor cmmr) ea li, Vllamndn ndMnlarnllve Cade • MPpgburte wn Fib Yux be alo-nnetlM aM NeWnaw9 Was Opaarr}mWd. TnE anlnenb mMll.nx..ne lma+ral mramvm am pmperly maposam WasepNp servlcoy oPemw Anx nM saw l Or emav m nkPlm abeu m azur.lea eM rgmrea w m.lr mwl. mnwea .na Ye wN Maser) nnea WIM1 Mont. pmmi u ran mvledvl If /fir a POWIS NIIs and cannot tt onal IM lolWHrp meeul r P e red rlwe Men, o muM be mxen, b a oMe mmpApr Tapia wt antaa. ❑ A pYbLN lerllaxdays May nes Men aRmaM and may be IMI6ea for rM bmbon OF a rapWa and amuplM Men 1Te np� nee Mail M praecbd bom. Ferrari and m'nvxJYn and Myl M M M yr) M reVUM1ed uma&a hdnedellry end propmMeM1uaum, blllneaand welh Fellu2 ro01eI0p mErepY¢nlnr ar®Nl mull In lM rNd M a May MA and Mrn ewlwlbn to MUM111naoulmN repNcernent arms RaMaed eyabme MUM mneN vim IM Man In e Oat Nat time 0 ineuM tosmlay bei w Nor duebaMNO ran pFU IMbGau Reap allerKa In N!if$M11rWdSYa //-nine tons may M IIWtlNa a..l..l man m rmmeena Nn.a Powys -XIb.MenaamtIonevNveletlrowelly a urltede O& if nolmlarea uponer is ar Wme a mod acN nM ern"IWIN ' rTuN be perfunaaro lomleeeulMbNleplNo'nvd Ym. if no replacement arB9 if evelleXeebtldbp sA ray Mlnelellaq IN W ruM m repb¢ me b-W POYRR. IMnd end aF$ada nil 'wwpllpn ayeMu may M ruvielulM m pram mlbelre; nmovM or me tlomel M the mRUN l'M Muth® RemnalrlcboneNwdteysWne mual nmpN WUl tna Tuba in eR•Mtl Net Hmn «ayARNIN UM ENTM PUMPfil OWNER C,MWWTREERM TANXSMAY UNDER LETHALO/ MCU. IXSUFFIONNTONYOEX. UE IA EXTERN BEPTC, WNPWOIOF ATANK MAYBE M IIRRlR1YYCIROIINSTANCES. OFATM INY RfBULT PMCUE OWN PERSON F0.pN THE INTENOR OF A TANK MAY BE UIFRCLILi OR IYP08810LE AOOITIORAL CCMNINiB _ POWLS INST/ ER PoWTS WIW R bill 7TO bare ,S/' Phone 1 ?Ii_ -i h I PMna 1p-- ") SE7AOE SERPICINO OPEMTOfl !MR LOCAL REODUTO Y TIM) 1Y NYM r L N91ra a .- mXemnaYwsaaM in mnplanu Wmuapar NeaevamlbNlllaµm Mu aaaeNU mapl.wlmeMwNieMONa. V-V NOIIDfS V2v007L0z ST. CROIX COUNTY SEnlC'TANK MAINTENANCE 11GRF.FMENT AND OWNER,SHIP CERTR+ICATION FORM Omter/Ruyn ✓ O�OIr� a./ Mathafg Address_Z�L/l1n Ptuperty Address �yy _� (VeMwmoeequued film Plmwog& rDepertrcol fdr oozmcaenl CItY/Smta._ #-�w-L 'J �Pai ldentlffuulou Number03}K---/Ph LEGAL DESCRIPTION Property Inwtlow_.g /.f 5�/ N R/YW, lowu of Subdrnvun — Igtq'''1(( CerWied Survey Map#_ 3e�"l� V(home_ Warranty Did#�1 Wittae Page# Rpecboum ym Ip1 Imlw•acaufivbm�no SYSTEM MADVTENANCE AND OWNER CERTIFICAI ION [ng use and memmvam. of Ycm aepni cold"matt mIX'®me fuM1ue w handle camea, feet e9¢Ifpuupug wl tlrrWue off muY them Years ofmmw.e.d umbl. by ahwmlpunqa tVhat yoo pm Wit the cAtean can affect the fai oftlle supra mkas a 4eamemahm,m the wave WspwNsamnr Owmmgmimnce eeecwblldles ue epxlfiutl m§Cava. fl I4(IJ amlm CMPmrl2-bt pmz (.nunlY Sw4ry0eSwmc TI¢ Pmpvly Owrct mmm, m "hrnuo Sc Gan Luuen Plmm"g & Z evg Impaetaot a c : Wiunw faith vgned by i and by, name Plunien leumeyuun Plumbeerz iJW PlmMv o, a lest playa meat that f l) ho ml-pp ImmaneIlifW etelod6u mpmpu muemg cmAhm ao oe(2)after mspe, ^nd� ppmtm ^g Id nayhbby), the uphe aa me, fle We uatlmW W have eua itm aEweleymmaau¢ Intl mreu in mmam ahe Wart:cw'aev dupasJ snlnu wine Wa bill, Imam,11 "1 by the Departmental t nnnrce o ca me and themaot of h�amen Reewtw Sam, of wam. tme Caffiuean m man, thal ymn mpl,c mama no bee, mnmumed mat he wvpletat cement to th st Qou Lamm Pbmtmg& Zonmg lbPummut Inman 30 days of the they year,mmtum on, flee mrtfy tAeoall l on chat &m In ma nst nrmof ymm um.loagu vwc.m.m Ae owov(m)o[tM PmommaeacnMue,by teda4tca wa(rmty accl maniacal a Regalee fOwb OF Number of b s 7 OF APPLICANT(S) �DATE� ... Any ammeti on that a tmmrepmemen may whole In the cammry poomt bemg acted by the planning & Lmmg Ikpumtem aa, facade with Was appbeanon a eectdei wurenty, deed from the Regtsa, ul Death Citbse maj acopy of the cent mm, map,[ mitetence is much m by, w man dead (REV.OWS) • nw�9,. tr ra.< on nrrenpp.ppvv ucer, n., r.t3aR i• AAA .w, �o R..n.I.Y..Rw'.,e, L nYui G.(4c6Y�./.i � IL//Oil�rrf5-M.® A/n^r /.r.6•�rP QaG+m.Ld n.+ ,nee 0/rPn✓ lb.:Y..�32P . Jb✓�� Ie� Ito �Id r4Y'�aI ,asP, Bra Ih'xL•/oprc PhJ 4e 2 /3 3w IV �^ 6�q � ° 6/ ) -©- - \ /�\ ql. _ L. I . I - I •. I __L 'tJ Mi. 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