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HomeMy WebLinkAbout022-1076-90-200 (2)Convertat Observant P PRIVATE SEWAGE SYSTEM SL. CIOix Ams, am Read onulen INSPECTION REPORT rvP.nnaxo. R1534] GENERAL INFORMATION (ATTACH TO PERMIT) aim ioxe Remonal Normal you pi arney NO Al for ,n O. 4 1)i,d4 Pa.' masThomas�Je&Diane R. Gallagher Nrfulr TOWN OF KINNICKINNIC i.m Ne 022-0WR-90-200 ax N... Apra, N� A. mlCie`P _ MWn�2]28N1R 429A 20 TANK INFORMATION ELEVATI NOATAS' 'M TYP taANVFACTiMIT cAPACNY STATION ELEV. sePeeE ' 4v' Woes... /04p eeznman 9.09 /t7.1 9 Lot oouXe (ACId An. e�J 10.79 ` aii 1 F. ^,wJeO ZitlW A/IiD BICB.cenet G i a•` �'. Hall Air �,N TANK SETBACK INFORMATION Arm owel rvD TO Par WELL Ill I saPnc >im �s 19 _ onom �x MAK, 75 2 iT 3d JRO� HN&ae,Man. r, ) 14Z. W05 Audiame 5 1 s.Al jdl I III Sot%$to, ajaLit PUMPSIPHON INFORMATION Final Grade Z,9 vol, L; Renxtenuer Dul ;e) GPM fit Cover P 0 14.54 MarelNumber er mE s. T 4,L ol. H iY , rdmm�lw� nmm new 19.42 A)4(Fl. I .4 /a•/ P"w",Lei' & ue2NLou'.." 75 T SOIL ae 3 ilf 9 1. fbe.h jl Pit ad. `P,Ht xNA eN apsreN ro oesu=9arQ. n Pil mo N145 wEu zba rcErsrREAN rr uxiT Iva. 6 P s �e� . oaalN°, �e aid s iNbe al LPAUO5o. eprong SOILCOVER As ren,n<.,,e• 2 7 ,...e Am' � oP..,, oNo , um COMMENTS: (Include woe uNmeePeal Pexone Pleamt Al I)AtSM�"Pi'�- i6eal � zl weep e11iAl- )t I Hance; Md, orrNeaa°sIcnNrn'Ar 6 z5l /9 ArmulaPOut n.x InePactia t: IxePeeial CIT4 d- Lac%s ✓a s 41dual all ^mtn... t "S 5.5 at ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Stree address) 294 CD}' located atY., S E Y., Sectiov �`j ,Town�N, Range_&-W, To of xinnidk;hn�t St. Croix County Wisconsin. Upon 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) appears) to be functioning properly. p Most recent date of inspection or service I W A Did flow back occur from absorption system? Yes No_ (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: OD Construction: Prefab oncreteXSteel Other Manufacturer (if known):W.eStP Age of Tank (if known): )003 `Tlwv, as {� ll,�rwC (Print Name) 99WO (License Number) MP/MPRS / P 7 (Date Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 r,2rr'rllM41% iS.Q t 1 3 2015 �wuba+:trnK $T.CRO/`� II tt JUN �Qt ..a.:ww um�w 1o153y7 ._'--�� cnmit Applicatior7 NPr ��arr......R+ ' . (.F)i /4'5 Pi w..�_..s 11� o.� TnoN�1s��D�rwE R. GnccA6}iFJc Oz2-/o�v-ga-zoD 14. Ya9 .a8. �—xgeYer i'J V /LS NtU- S Ia5/-H?669// i 2P ly t=�[� 6 T),.It�rt�.bd•Jt�. q.Yl W. ❑w�-omrw _ ❑rais Oor-oorus •+iss Y.n.nbc 2 i0✓- A'7}Zj G . V/6 G130L NNICKWRIC IX. xll....b�l M1C1Yw Yti...tetl.t `Onmw�uayuntgY®soy w ❑x..syw� wipr✓Ar Ou.u.s6mnesosYO O rn.. ❑wr...e.. ❑a..san.w OwaiwYex.. ¢eu Om4Hoez3/ 7-/z-Oz M xwr�mu.cA.a x®.mmo.,e O...mi. ❑.tr.a..rrr.d Ou.a.arr.w:a vtxrr �: it ...s o m tt.®•tr rrrr.rr�oner..�r--" _ ZZY/cy 7is_yzS 4)sP q/9/ni4 jia"hpVE 7Liu�q FAI, WI Syo22 vm p w... `5m IX Ytl otwwu.ws.i.m.az.. T T_,. L No IN ,A PAA3- _R/.v� orF S,K� III 44�0 dOY+ /G•a9 I� Siglt: /"go .. • Of's 5046 PITS 7HAM5 J, .UTAv r<• roqu.acHe2 IA15 07.N. = Ou- 107"V-00 A 0 /II^1'A4F rpuuAyngll {� _ 3 tom• ___. v� pt.oT i a.5.30dA Nv aA.�3' 11.53 i unm%n r�1in Yi°` q i00 "F 20 3ess,(iE/iF'v-. 6 m it'c pi Fs .e�' ,FJ19 0*r^. Cs19 I�vs> 3 5 qy� /00.19 A W Alopt i/ Aopi x' \ aP o ToP / ? / 9. /sn ✓,l yy, t�lcopy N Aw: � 3x Nor<• - °p�IJ$/s>• Uq O5n Sax . PAGE i OF 5 In -Ground Dosed -Gravity Plan Index & Cover Sheet Cim 20, Sf D-10 IN hers, R. M Version 2D, SB610]05-P (N 01A1, R. 10112) Pg 1 of 5 Index & Cover Sheet Pg 2 of 5 Plot Plan Pg 3 of 5 Dispersal Area Crosa-Secfion & Plan View Pg 4 of 5 Pump Tank Specifications Pg 5 of 5 Management Plan Attachments: Enclosures: Pump Curve POWTSplication for Review _Pum secs SW Evaluabon Report & Site Ma rlftr" m WAx ,1x�D >+ TANk Are IEv IrMabapca Project Name / Oeecrlptfon -- T//OMAWS�7—i JJIANS%. cLdr�ff>32 Owner Name(s): — Pbole: Owner Address: I L:7"N11 R vs FA/ zip: t9yozz Project Address: SAME/ I—IFI1 Govt.Lot:= �kNrJ1/4or 5E 1f4,Sectbn 27 T�_NR IY EDer W,LII Township: courtly: SCLZpi Project ParceIMS: C27--lD.lb-9D-ZD(� Destgner Information DesignerName: glary Jo Huppert pllppe:715 _426 _1775 Designer Address: 28497"Ards rs Court Daribuy, WI Zip. 54830 Email: h6lisla lesign@Wllook-com License Number. 1859-1D7 Remarks: zu(my (Z) 3,Ag1j '7JZ"OYE—s Signature: 2�,iL!/ aP•r•��a+d mwwewwr T10"s 3. D/AAC /.'<. (IPA u ACNc7Z N /as ,IA..T 022- 107490-00 N �+ �` g�fk3 _ � 4s oux� cwr+'ER ✓•ouunknaJ CJ RA? ,off,. arfr TT yGl. A n aeartx auu nnrr A ioG. PLOT P1Aa. apj 6or. /G,i9, _ �,�p• �Sp$uiLT aA/Oo 300A Too]-' woo, IUGer (J� i 3a.o n!m_.Gle/ d7. i3• _. - Al. 1 aN I00P.c. n O ilk/t �G ptpo `el . o N H. b1413m o50 As 5 gll,l %r a0 ` •� l� 6t ,�sps�i� . I / a Ip AW: /•'30 ewer.. .. Of's sere P+Ts % sloe Z swX. rN.o•c4. (R�SNST a✓s> 'FsWs" /sr P4 Ayr, Oek . IN -GROUND DOSED -GRAVITY DISPERSAL AREA Elevation Trenches with Quick4 Standard-W Chambers 3-ft Trench (down -sizing credit) I a CI COVER 1tlp"I TYPICAL TRENCH CROSS SECTION VIEW ew No Style) IM Pm de mrsmum 3fl MigRme Trento baewt Trench les applbeMs) eaperetlon Weveen trenches. System Elevam , 00. 3V ft: ft: ft: ft; ft oulcw sulwno-w wIEM Cep (Bgwv booton a lnse l outlet ow mnmmon on plan vbw.l awn TYPICAL TRENCH Ml�oall m.uun•, waken. PLAN VIEW r ____ __—__- _______yf_________ _ (No Scale) IA=30ft L _ J 11 tMN e y�____ iy B=1ft > MW�'+II Nk-.sip e. gce♦y,�Me Ioutda sleideraw CFlamear m INSTALL PER TRENCH: geOH'=Id f�.sa.45ukrte or lnplal y/ s ,l x 4, /8H N u Iv when m,e�.w�.^N O d 23 Qulckesto-w®zorc ElsAJ"mler. H6/0_ n' 18yrZ=9Z rye•. T / P.Inaend Mps@Gft'Etsalo&yu 4y��/n m C� 3X9Z 7AEx�IE— pM N ry =Proposed El5r1 per0emRl=&ft, RequlredlallMonAro•� It. Distribution McMod: x Z trenches = Proposed Total EISA = R3z ft' distn",on box ISy.yeF 5 _ xxmx exo srarnanoxs _— so, A- PC VENT PIPE ,r• HIM AVOID CRUDE. ru,.RU DER oor T.vN THAN IN°:E °I.Dor OR ? AICRIDN DOE APPROVED IRA erT s F iiSE I Pvc"iO" No0f1_ d _ eo u ]'b SD onA/_ SU i-1.1 o sor re 3_r 0, orm PUMP Drr Ev o E �11'g0,10 E APPROVED BEDDING UNDER TANA xnE nwKOVAE OIEYJf �W _ sPECIT CONCRETE PAN I DOSE %0IN X MA AC,DR .: lai+w 4LI40 KDE sPER DOSE C/UALDOVE owx1 INCLUDING�. w /Y6 . R �{,M iPAT CAPACITIES A. zo LIGHTS . jvo _"L ME INCH MAWr;ATjRCA )om� NEYERi , 9aINCHES , GPM PUMP I ALAR" HIRING AS URT¢el. IT ESTATE env sTx TE Pu/9 FEET MINIMUM i $ECT PnRCOMMIN vN.cs41piw rnlcrl READ > HIRE IMPERIAL DIMENSIONS or Cliff, PARK LE TMo{5_';WIDTH B✓"; CIAMEEm/ LIQUID DEATH Yo'— Tyorp UMuvE rok'LUDO' be D" /°G Fe/tcC HAi.I 33 M _ Aroy , 11 of Dep1Q ;dw prsA gox_ /00 50 /5 s .p ROPnc TANA, PING CMAN43.44 In m1 &h.IL He ANDI Pun .. SHARP DORMAN .+, 9 "i i .....P.I.I ols: _P5 xof ME40 Series M"M 4/10 HP Effluent and Drain Water Pumps Performance Curve PC �C �Is 1 Baum, wm.wo¢. PAGE 50 In -ground Dosed -Gravity Management Plan $/YYn IIW�IpIq lepvb NW btWITXtlUbtlNPa0MI0CY ge�lunilin a¢wtlmcV NM 8P8 31935 �Yx. RM� Catic�R�pnl sy mnpwwR Llw ar b: rien.e�ia.nrarm>tpmy: /6% lam% %vn' -71ll yu "59 J QuicA-4 INFILTRATOR The QuickV Plus Standard Chamber of 0ulck4 pM1whl , C.nnrec hhw washP is horns W ro15-tleg .right orb It is prwMe opd lnsWlafkn llmtiblut The Wu 4%us Af-infirm 12 Erdc ," the Qui6t4 Peds M availabe weh this cfmmEa, provid"ifcreaserf flashily in syYan ondryrmbons. ofts�Standard Chambet QUICK Plus Standard Chamber Benefits: Two min, mkr iha tshw Aty am supawr sbaglh • Ativarmed mmmdre cmrectiorm • IenpHr9 menhmsn Mows fix quirk irmUteftmm Fwr-loo[tl her te%tht are ®sY to harcPs atl iie+aA • Sfgpwte why loads A 16,0¢e Ibs/vJe wiU tY d cover aba Qukk4 Plus All-i"m 12 Endmit 0ukk4 Plus All-twom Pen pe Mehl S WLs 12"H Benefits: Benefits: (486 mmaf948 mmsa4s mm) , May be uaeO at the and doh.roer Abwa fm raised imer[Ir®MIIhngts a wttte raw for m inkVauSet w un be . iBO• dkmpwal irdetd 49•orgavry irmtWWrrv&f h •MN-tr hcwamcl hfenna '12"�asetl overtk iJ®Ifor aniA �Hsw rnrmwcdmalciwaerrwnwkh appfiath m w M nark) cemef feel, w m ytmn.IMm ro inkNng at ere eras Mchambermwa ebryreraarAy •CeMw-feed co Pion allows fix 42 gd(in U e y frotallation of serial tlgViyykri t.alrp snawna 'Plmrdam AimP ucMa LbWtliH tle ei"�rel &T 03my,5lZr Pnml. flPl%1kfmM. 12T PZ1mM Ntle3. eIId60fIW w�aen IXl4meeg 10uick4 o..r....ra.,:ars FAON�NEW %pE NEW QIIIW %us R&m-CtiUb PRkm�P `wuorlM�Oneo.uclraAnwl mrritYPvillwPlrOiibMMnP YM1asw_ �sra.s. rb.mrMw4�w.rYaaw �ilTnYaYw1`riP�retY.MYeYeraW V I�wrl.r4r�.�rurewrTwrarr w'arel l.. rr�..YrN .Rrt.rwwN wrYb�,ra.rw I �YvioYPbNw+rrgPYurYpmrabYYor srwr.�w.rsmrb�rprwww.w err M1Www4faTwxYYSY W 4Pr.dmPaYYriP9T tl �YrxYrrr.NwaruraurarYr MY4re. �Y �wrRYrr.rrwrgrrrra�.m .. p�YW®WMYPIYw0�9H6woM�ww�r®x[mBE Q rs1 i r INFILTRATOR' �Y �YrrYb.uP.PT/rOorwYmwr4w�e YrbYMewwbYYYYwY> WargalruwYuwwwb.s4eW rua4PYesa rPw wrw.b.✓.P�..rrw.wP.Ywi.4 s pµ 9ailyy.YYylWwya.grew.yv Y wwY��rYa.Tr. W4werars¢1arYY. YYYYIn!FYPeruwvsvmrn.MraTitbrwY� Yrrrrbr.bwYY�Pw�rweYrYbr.b.e .: we.:u"r'srd��:arr�w"°or1e4a `r�.agweewrw.a�`w.uY�a+rba �r"wseYr.Prr'' �. �v+w� wrurrpevp.ru.rwrse. .srMrrwmtY�YweYar q royrraF./IirNrwe46tl.pvwtlYiinNtlsry w Mror N4iwb.WYtlVw�tlwibaww Yri.Jie raa.y�..rr.bT.rT.raur arrweb.r ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 7 kie - () I Mailing Address Iihff\\PyN. JS Property Address Cam/ (Verification required From Planning& Zoning Demarcation for new wnstrinum.) BOO City/State &VCR FAus kaT Parcelldentifiwtion Number OZa-/O]L-fl/-etR?- LEGAL DESCRIPTION NF § Poperty Locazion-2�LWY,, 5E F,Sec.2�,T 28 NR /P W,Townof /teWyAgiffool Subdivision NA Fort # -11` ' Certified Survey Map If 680/6,0 _ VolumePage# '/3o> Warranty Deed#__ RR/9Q�_ ,Volume Page# Spec house D ycXno Lot lines ithudistakoKyes 0 no Impmpee oy,"in mfyw yept,"Youn, could rams In is hoommay falut to hmdleo o, Pro of farmers out me retire laid everyMe le yours or sooner, iw maintenance froemse, by a lnscipampcu NTalvoe rylinta the system wnor e aReu the oncti a of the repay tank as attourem some In the waste disposal system. Owner mawenans responsm lities are attacked in ¢Comm. 83.52(I) and in Chapter 12-St Oelx County bamory ONirercn Slet property .term ages to submit to St Croix County famous & 7cfang Ccpanmcm a cutifiaation form, signed by she comes and bye reader plinijoameymmi phuabuontmomplumbu or a lavand pumps onansig met(1) New Sao tar disposal system operatingis In properoperatingw editionindoor,(2) aftencopeulon and pumping (if nacessary), me septic tank to lees 0e, m hall oftlmge. Vast, the aMensimed have mad WcaWve tcontmeaan and ammo to maintain Ibe private sewage dlsporsl oyswm with the umbers sent ready, herein, as set by the Department or Conscious and the De ailment of moral Reservoir, state ofseasoner I Cenlfiwtion ruOng chat you sepia Coma has been mahnnhvd most be wnrol"l and returned m the St Cod County luxmiag& young oepanmMMlbin 30 days of use three year moon date hwc cuury that all rutemems on this 6ml uo tree m the best of mortar knowledge, vwemNxmeowao(a) ofmc ptn55H armyofrmay deed recorded in homes of Deeds Office. NuCANT(M DATA ^"My information for u missepmened may soh a, the oxemry RTMh boingmroked by me Planrdng& seeing Depmhaw. Include Wth Nlsappll®don a recorded economy deed from the Rem rtnofdmds Opicemd a copy ofthe offend survey in* if mfrsence it made in the wananly deed. (REV. avast APKNVII 'M aR%HNRG Tt`sr R'eNMT y,Ppas 9'.zz-az waaWraw. SM EV�MMN REP T 57 ATM % KN..'� r+.n.adJJ. TSM TMXtf�.y_•, u6 .sE ,x el],W,TV ��ii GPM60. (R✓./L PI.YHi ��"—_�.aor o•.. v,- Ki✓/. /R6f—GV sY n p�n A x "AC-la",.ai,..W�= ILLS tL R¢A6T iSJ✓T r M l4L eY � 4Tr R_ QTAYZT']y�. _ aR .,t Sr'c TGS/' (✓g ip w r ",". y'Sv.fly,(Jp)) Oi0 NO)"i.a4/u W 9/bX' j(4 L /(9(F W{4[ Jo ku 5 ®m... . Oar.. P Ji J C 1 SiC 7 }S -� SC /rtOT!y e5G ICOR224, .r /Fb . s nonce L/dRn Tm �,5 IF J61 ORIGINAL b� I (I.Ll �Z.Z$ �u.Ck score-/,•30 Iiti ne"TDB% Ig �D .✓clry e> � 6, r,f, 9r ��.. ®i��ow�ri ua WI lm����ns�raei+ 11 sMmr�®aa�� MOMMM r:ir�nnm�na�rrz�n� loam �p1�114!4©1i�7%'n7i�Tia� 101L UMM IWWNW llm d . is; io r""2:ae rGuv a: .C_ of ✓ _,� ti F ' 9i. CALLS CTVNT� rM'rNG DUACTT1WiT Ial AS BUILT SAWAftJuroA'r 11rRs.Mll/� mo �� T�KaLe�U wncD /b.;ti� yril� '. new 0g9�1pqHm�vr.A 'N' Ida r_'L Bbk= "0 ✓dic. /g. Yae1 �_ %RL 14�eM-11 Td-N ga_W, Puna GN j PHIL,r]bJL f0 • IXX MT Je.mv �TAMK- ]BUILDING TANK UNINDOUNIATIC01- a.,..xm.$ww VAR Nm. .murmves`es°xi�mtrt M/ 6 M>5D uv M si awry 1r: 6mYp�� evb Ra rrtmtls wmlin Mpe krAm m.r�HTRdr4f With U.w �me—eymi xrba4an 2 sn.3 �.® ew. ATION Csr5 ary BBC NN # L Sg ----- /oa.5e' mm4Aa.re..b.n o®ya.nmw emsm.t roero raN� e�.em�. as BB.4 8a.ff wnmiw SUITT mn - srunM mhi 4G.Y9 •. v r B°%u !`996 U�, ,. ; �,rsx N.aN. to Ris<S g '7oj-1c T°1 +P Wow R6 mia..rsMr r prar, � LkN r � v x=TN NIr4' wi x.ra.lt_r.mu...•e., y� 13�Awm.. �ae1- I.yeaw SOUNEu frjy u.�nr coRPE« tall dos. / DZ N [CS ZONE A