HomeMy WebLinkAbout020-1489-00-180 (2)
nC:pann,e :otcnn PRIVATE SEWAGE SYSTEM St. Croix
Sa'cc/ a-d 6u11d -g C aslc-'
INSPECTION REPORT Sa•Ia" PL.. 'rl"
605200
GENERAL INFORMATION (ATTACH TO PERP;11Ti :a:e clan c r,n
°msonal mlom•. a ro- . p ,e ce -iag be used fot scron_ar, numcr":-I wwy Law. s 15 Oe i t n;l
p", l llotdr , N:wn C; Village Te'on;h, 'ar_el Tae No
Kernon Bast TOWN OF HUDSON 020-1489-00-180
C sI L'61 i. ev. I-,. 5V ul.r: ➢R"a, ^iybun Soceo-tTCnn+Kanye'1.'ap NO'.
10.29.19.3121
TANK INFORMATION ELEVATION DATA
TYPE I:I.-.N..FACfIl CAPACITY STA71ON OS HI ~S El
Seplic 3encnma'k
Dosing At. DM
Aeration Glog. Sev.w
Holding SUH1 Inlel
SUHI (010
TANK SETBACK INFORMATION
IAV'K10 RL „__L BLDG ve^1 to Air finals. l 01 Intel
cel7hc GI Hollnrn
Dosing HeaCer: `.1an.
Aeral or, 't)is[ Plato
H.Ici7g Hcl. Syscr•i
L I na I Grade
PUMPISIPHON INFORMATION
manulacmter Denan:t St Cover
GPM
Model l T.)H 1ifl l Loss Syslcal ••cac TJH =1
ro'Cemair• Leng'h D.) :o Aell
SOIL ABSORPTION SYSTEM
BED/TRENCH v`: dl' . =ny:h OI Tnnmaws PIT DIMENSIONS Nc Of a tr: nsidc Gra Liq, d Ca:1lr
DIMENSIONS
SETBACK SYSTRvI IG n!I RI DG 4YL__ I AKP1S!HLAIJ LEACHING !A:r'ula:lure r.
INFORMATION CHAMBER OR
"ype C' Sy rem'. UNIT MC<ol N.~xr
DISTRIBUTION SYSTEM
Ilcadr Vd tz-❑ Jlsbibuvon -oL 5¢c xHOln Spacm~ `rer. to Ar ntekc
= aetal
Len.;P_ Cln .eng:h 'Jia 5oacmy
SOIL COVER x Pressure Sysloms Only xx Mound Or At-Grade Systoms Only
Evpoh (};er Oep'n O'er xx Cebt' If xx Seedccr So:i:lyd ex Mull
becTre -Ca See 7l Emgos ToGSall
rnr. rleJ Yes ~ No
COMMENTS: (Include code discrepencies, persons present etc.; rmpccNOn A' Irspectlon #2
Location: 1054 HOPKINS DR
t.i At (30 Description=
2i B cg sever Iengtri =
amount of cover =
n:an revision l fed? I Yes Nc
Lse 7I96t s'. de IOr accri-ra. in`Orn'ai or. ! :)a•e e - - --1- In5eDG1r.Siynalurp
Con . No
cowdy ~
Safely and Buildings Division s,
' Q \X
l 201 W- Watlengton Awe., P-O- Box 7182 S~IimY Puma Number
lilJed is by Ca)
r Madison, W 53707-7182 (to bc ,
d l ~ W D ✓!~J
J F 'lt At'PSlate T pf~lber
a'' 1,I3PS'3MUM. IV-- AU- Cork sabrmnioo of This Corm to the appropriate
dIc obbirling a sanitary puma. Y~tar sweowrxl PO &oWYSs'areemmeatal mat p+ggt AOOtess (d
submitmd b ot
> alt Of Safety ad Pmfettrtami Service. YOU pmvkk may be wed for
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ARPiicationfnfrmatioo-PletsrPrint All
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Pr[rlnrry Ow+Ier-s Name
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pmPd'tYOn 62d --/Q69-16 -616
GGo Lf~~a~ 1"(~ YLocatm
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of Balldmg (ehcth all fit aPidY) Lot g T N; R ~E or
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family Dwdamg- Mad= of l3s,iw.I ( V Subdivisimt Name
❑ Pobsc cial_ Desa13e Llsc Ok 26 NL,- Block IVVJ , N c U 1 tt I `f S~ p(~(~ .
- ° ❑ pof
❑state owned _
DnmeSe CSlvt Number ❑ V71aof
IITown of
=217-4
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A. System ❑
Replacmrmt System Q Tmatmem/Holdit o Tank Repiamaent Only FJ CRIM ModiSrabpa ID Fig SyaWM (~yb)
B ❑ PermirRenewal ❑ Permit Revision ❑ CMoge of Phan Cr ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before &Vuatioa Owner
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CONVENTION-AL COMPONENT DESIGN
Residential Applira!ior,
NDEX AND T7L.E FE
Project Name: i\~ R~ fV
Owners Name:
Owners Address: .
Legal Oesrrintor:
Township, u n 5 l')10
Co:rncy
5ubdivi,ion Name - }gyp J 1
Loi Numbar.
_
Parcel iO Numtser
page i ItttlERa o tallr_
Page - Plnf ?haJ -
Page 3
_ System..^irr~& Cross_~r_e~Silsn ~ I
Pay; 4
Page 5 _ hsainrenance lnror o
Page 6 tai?raremen; Plan
Pane 7 SL Croix Cb Septic Tank-?-- t M f orm
Page & _ tMarrant Doe;
Page 9 _L_-
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Technical Specifications
PL-525 EFFLUENT FILTER (COMMERCIAL)
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AND
t" N IMUP CERT IRCATION FORM
. :NWI* Add 4t utL -
Adtitess Pe,•h Pt 1, skl PW (OS~ ~ 5.
ti equand tivm P!a►mmq 3 zomeg Dwwunem floor new oooiswxt3on
in:SSte ` WJ05al IUhVs.&&) Parcel idmti8ation Number
l EGAi DFSCRIMUNI
L ota i _ < . &rj%, ` . Sec- ( 0 . T 7'Q N R_,(9 1W, Tower of 11.~
sadi,iott 1ao~ws Qt~1tEtL Lot r l$
CertiIIed Survey Map _ Volume page a _
WRrmatyDeed 1 Volume Page?
Spta-. boast m rot theta ids x
SY-ST$M MALNTFN&MM A.ND OWNKR CUMC&M `t
bmWWcr,= and *ommoze of lvta wPOc svum could result m is tsemtm[t halite'ro nIC& a5ms- Pro4a
. of umm-rog out 3e septt orals every thtee rears or so®ez. ff eroded, by a bossed paper- What you put ml^
~bc xysteat cm afxt the %moon ot-ttr septa torah as a « tneot Stags m the wam duspoaal SyOwns ma>memn-cc
reopoozLt~ ne sPta`ai in $Co= &3.D7 i) and m Clem 12 - Sc Croix Ctuatr SsaRery Ordmmcc.
'Stier oteFern- o4ve agrees m submit b St Groot P}saoittg d Ze:`ing Department a'~ forz r-er.<d ~hc
owner and by a mestec gttmeb3, ioemeyamt: Ph~z~bec. Rs's;csed pimtba or a tiomsed der ye'ifYa•B itrat lt) ~e on-s~se
>aste..aeQ dugosat sysrm ts m pmpm aoeeaung caodi0ae mbar (2) after mWctien>nd FMS (if Oemoery). the septr mnk L~
ins rhaa 113 fell of spode.
L`'M the uo&W &Wd have read me above regtmemems and agree to ourno m the psale s %vr- disposal System with t--
stmdtt3s = fault hereut. ss M by the Dgsotmeut of Comm = and the Dquaneot of Naftaal Regouro . Since of vr=Omw
CerzSatim staling that your saps syst= tins been mtdaramcd must be oo®teted and +tmmod to the St. QM Cotmry Ptaarcg &
Zan De m== w- thm 30 days of the duee yea omitatiac daft
Use InMfy sat til staseseem on this um e'er trw d tae bat of W,mr knowledge. Iive amlare the ownet(s; of 2c
aoaerty d.,* ed above, by vans of a wartamy dad recorded to Regsl.~of Dead OSx.
1\wwbes of
It eq
i OF APPLIC.' INFA-S) DATE
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SOIL EVALUATION REPORT x2c65
~rt:'lil ll't,. '.(~"nn,rrC'aC I ~on:)arr. II nrr" 's s nd'n L_.. __-,~a~e 1 cf 3
Gidiri01 of `a`CPy arc G.1 Id.r._us Sleets Safi Sen: ce
County
corl:ae'e sre ❑lar on caper rill lass !har AY> x 11 inches r sae Plan mist St. Cro -x
i r a Ae. t0 rn ii 1 t c to : ea and ,:,!von•a retererce point B%-1:, dvect(ori and
I -1: slope scale :n din .1 Sor15. north arr otv aA Ioc3lion antl ..islarcc In rearest 'oad "af0el LD.
Please print all information f'erdiny ~r
~I„n„)" Pro, IF may ne us..d nor"'nrle"44 q-•.•-~!• 1-g.1
I'•nperv-'tFzf RECEIVED Iit rpeify l rx nhnI
Bast, KcrIf on Go,[ . Lot n;a S'o"J1i4. NLIA, S'0, 12CN Rlr',1i
r'•nperty Ci-ner s 'w1a I no Address Lot # 5--'l Ir,d. N ame or CSfv#
400 S. Second S1. JUN 2 1 201 -'-j- rill dopki'rs Pra:ce 1St Addition
G1'v SI e Zip Code =hone Number C.tv L'Illage Town %carom Rdac
SlCROW CCUNTY
Hudson V1 54016 115 386 C21 IMrIson Scot Rd
Nev: Corslr_lction I..se: Res den: alt VxmPru A Dedroor,s 4 Code ]orvod design flovr-ra:e 600
Repacemert Puhicorcommorcio -Je>cicc. na ;q Q
Pirent material orha"1h Pcoc p an elevation, if applt able \ na ft
General coma en Cor vvntional system, sys rrn elev Ion 92 291t. Tien -ties spaced and depth to cod"-4-14titlew grade.
rid eccmmendaliols
L.t_ ~Li3C~'• /•~r7~
1 r # 6orrg 1~ cr " I'V ^
da
;-.it ~""Oi i 1 . I rfac±: c I ~ 9$.00 ft Depth td IimiOny factor 120 m Soi AppheaLOn Rate
Ipcmrl Deoli Domina'n Conr ucdux I: esc:nP't'-'R-`exture SlrudRre Co"lsistence 8xndan• Roots GPDifY
r. \4urse I Ou. SZ Coll. COlor 3r. SZ S1. 'Eft=' =_nx2
1 0-19 10yr3j2 none I 7i,a* rr`r 11, .6 .8
2 19-5f.~ ICyr4;'4 none sic 2•nsok Ir`r n:: .4 .6
3 50 121 7.5yr4:r4 none Cos os9 ` ml a ri .7 t.6
So"ing # He.utr -
pit ^'cl.r d SL IfaIF Olr, 98.OC' it Gep:'110 IM di n:l L,(t::t 12') In SOil AOpl'c8i'or Raze
HOVnn Dedlh Dort ran: Cc of RCdox GeBm ptta'I rex'..re (iIL¢:ICre Cnnsisi=t'e'e 3cLrda^~ R00:3 3PJ1':'
ir. Mjisell 0a. SZ Con:. '.odd Cif 8Z. Sh '11'2•
1 0 20 lOyr3:r2 none 511 7msbk mfr Ch if .6 .8
2 20-44 :Cyr4;'4 n,-n(, Sid 2rnsbk elft a'da na .4 .6
3 e"1-68 _Cyr44 lTOne eos o=.q 'ill aya na .7 1.6
4 68-120 yr4 6 none Cos osg } rill rla na .7 1.6
LID
sl 61o
SIII rrr.Im I> ::I:e to :exturea (,:.rn i._s n Lnn!nn 1 r. i L I Irmp1 r .1^s to ^9 trChrf.
"Crr.on:#1=OCC > M 1220 r1y:_an:: ISS:>3C 15C•n4 L 'enLUnd N2= IlOJ 3: m crL and TSS <30 rng;l
T tdirre .Il ase nr rti - `ignatur9: CS- Nurbe"
D+ li l Steel 248956
dd css Stee 's Sol Se,: cc Date lcvoua' r,r- :_,,,d ,c:1,1 eledhore V¢mner
l:seG lttstsl Vow z;.::ru•lmn ^1 s40" 6r1 1i200' '15 760-0347
Propody O'n'no 6act, Kernon aarcel ID it pealing page 2 pf 3
L ' 13or ro # Ccring
-1 Fit :'3ro'Ind surace elegy. 98./0 fl . Depth to I. n•itinq !anon I2C r ~Soi Apnhsatinll rate
1'rrizvn Oep:h CnrCl'1Mnl Col(Il Redo, Desc,intion texture Jlructi,re :n5i SI09CC BoU9dary Rows I;:'I)iIII
19. NLnsell QU S1 Cort Color G' S1 SI` 'Ff'.y' •F'}ii
I C-17 10y'3i2 lone sil )Irsbk mfr cs if .6 .8
2 17-40 10yrr14 none sicI 2msbk rnfr CS na .4 .5
40-12O /.5yr4 4 none cos rsy ml ni na .7 '.6
a _
Honng
0 Hnnrg9 pI l rni,rdsurfaeeelev It liepa:o rnrtingfcctcr
nl Apphcahn~ Rate
I, rr:n t Ih 7nlt ran: Co or Redox llescnption Te KtU'e Stfuc',re Conslslen'e j'.urii.-a't h.ulS f
r. txtursell Ou. Sz. Cool. ,^,ctor :Sr S. Sh. L tttt
enrrtga Rori'tg
Fit Ground surface e'e,.' fl. Cepur to in Irrq IH r'r~r n=.n IiC91pn Rata
h o'i<cr Dcplll llornmart color Redox Casa plerl lfextt.re Slr•tcture ~ta'sis;ence 6'ounoary R-ts GF'D fP
:n. mursell Oki. Sz Cott. Co or Cr Sz 51 'e`W •a•::
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it ccC it :'.'i '-r :n :,II III11, ; nn IT. I .tx 0 ont:r _ 1 he Jq.e11 11 Ii11, 1,
STEEL'S SOIL SERVICE 3 of3
11IN id SIM Kcrcnn Bait 1396 141st Si.
('ti l -P( M, I 11\1 S`k 14 H 4.S l in l 29\.R 19" kw% Richniml, %A1 540I7
I.ic • 24899 I oml ol'I ludkon, tit. Croix Co. Dirca 715-760-0.147
Hopkins Prairie Ist lddition I of 9 Fax 15-246-03 IS
1
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Legend V
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I np ON 4- p%c pipe
• \It Benchmark Id 99.73 It
i op on4- p%c pipe
.Borings
Borings I?legations
B' 98.00 fl
13' - 9$.(ifl it
B; 917" I'l
114 400 11
6
rr
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fJS
h C
G. / V Acres O (+J _
Y
117761 sq. ft.
0 LBO = 922.0
C.B.A. = 1.3 AC. = „ w 17
2.53 Acres
K- - 110,234 sq.
557.42' DRAINAGE EASEMENT LBO = 923.
HWL = 920.0 I C.B.A. = 2.0~
NID /Ir ~ I
0 2.67 Acres
G?
O 116,356 sq. ft. I_. Z
a LBO = 922.0 N 3005,
C.B.A. = 1.3 AC.
0 rc; 16
550.73' 99,071 sq. I
N C.B.A. = 2.1 A
IL
N O
0 10 ~.to
r
00 0 2.28 Acres
0 1 99,334 sq. ft.
O LBO = 922.0
N C.B.A. = 2.0 AC. b
476.02' 0p Y 15
d~ 2.27 Acres
11 98,952 sq. ft
C.B.A. = 1.4 AC.
2.23 Acres
a 97,050 sq. ft.
gi LBO = 922.0
N C.B.A. = 1.8 AC. 3 W_
3
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p 4TN
N w
U
351.26
14 2t
2.31 Acres O
12 100,456 sq. ft.
LBO = 924.0
2.21 Acres C.B.A. = 1.5 AC.
96,155 sq. ft. > N
LBO = 922.0 N
C.B.A. = 1.6 AC. 9y
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