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HomeMy WebLinkAbout020-1189-10-000 (2)ideas and a.Bn.Div nmnm,..•rc PRIVATE SEWAGE SYSTEM St Croix INSPECTION REPORT rvevmnxn. GENERAL INFORMATION (ATTACH TO PERMIT) run,o xn. 617717 Perna i ou p,Qvi may 11 Rodger L &YMoni<E RbCollinson n ryen° „•e ..nm, r..x e �.. . TOWN OF /H/xxUDSONn a 020-1189-10-000 C5i /D di' LJG {ie�! rna.e. r n adi�• uM2829. 191187 TANK INFORMATION }YPE MPNUFARUPEn GpnG1Y STAT,ON^ G FS ELEV . ac,�, w coy l 11 mr.c /eo aluE o F! es Lot CP •4 98.4 u ldg Seds, TANK SETBACK INFORMATION UHI0wn S.o 94 e inrvrc To E_ BLBG. oao <I sepoe >25 L71 7 aI a as. q'; HIlooanp tM a <, en. Tell Pere NpmltN Al. syal<, PUMPISIPHON INFORMATION T01IGmee y.5 um 9G.5 GPMa� w er CA 'Z .lam aI a. LF all Needed, TO orLwe Sot la c at IQ 011 SOIL ABSORPTION SYSTEM Nm3 ,.J%r,�oGaA o,u`e n. oL, =o, P.,n\ xPOT�iw pMp Tf$,a' PLL SLUG WELL Lpl(EASTR EAM nwyLlyut /1�! 1 _ >r°r'M,kwiL I Well 1r411�w Fi Miq Nia DISTRIBUTION SYSTEM M..,,IA aw ,,.. yl = az x�,.. 4 a °�r a� p�.� n,.i .Deana °4vMa 501E COVER rd..a Only 11 Mde, ad Or YUnn<Sal only Tnn OOrger" : Imaw<cmee,sa<al.... all pi its lnapeNonat I ..pl1Orl Laanon: TARTAR MR OVA' CeJsi.. t) All BM UUs...pllon= %rFsn re �11..._ Ce,�E, 60r.a 'y Bggsewe ruled_bi+1q al otruled- I! J UsesnmPar ataam�rem ❑vre l I!O 1p mm r tw mpnaunmrneaon liffi napadNI urnsuf <AV—aal9 22n InJunry&rviovcA y x in4on A16 Awn ud, S /O i, OCT 04 2019 o ° `)163 vlf)p nuY u M '^'��) s.�/77/ MWIm 116E !G(` 76efi1 Sanitary Pemut Application NAmt (��I.i, AXIS pm°m m x.IS r.r And Irr sTtit SAS Wm1. ,vv 11"Id"-MUM f'a L A uvaon orAll mfIlmal . ,... rca -n_�1f: o2D- 189-/a�wo _ pmpm,la.m as.ay. . 7 '� kAr kr G'r�.le mw ., n c m Tro. s,•,•3oN • _ • om Wdxd67- SOS La�e T d9 N. I ew9✓ H. Typ. N BUMM" 1.6xk.0 Wn.pplr) min m..r),m,Ir� 9-xm orxm�m, 6q m 4.we ,I1 ❑ W61k,Commm�lvl-hxnYL.. ❑C.xm ry �m IS z. V /b.lb •.m.,pr m,Ao5 1 �IX „, III.TypevrpvrrI lChmk o.'o LeA Co„plg11nv8 Yvppllalp ❑tm, �fl[y.mm tm..ix n 1'mk x.p6vm.m emir ❑Am Mmus.vm m ra s mnlnpmN D PASS ❑p.lm.x.IIALA ❑oA9, rNuun ❑_.. ,..f,.mi+ BAS ry CAA, I iz+4�a/I.Nm ZS/49/ .rro T .mvwva..: o 6o a.m.�mm,l.dl..vom. " I.. m..6 ...gym �' <�.. or..,,ml At lim, oMAnd12 .. 1 ❑Mmm<uIS awri l.®p ❑» I�.mpmm,l�sm, m,mm,lamlmmm. -__ V. 1114 .vrmM ..::' p M��.hmi..va, xa,. �I.v ml•u sx,. q5vMn.WApp IF,.wl V1.Tmk1E. -m,1 I I MmpM , .w1ES.L%1mA 6 a A ao s U� em,..xev.,Tw TyVy_ m .rm.m VII. .JWNy 91.Ys.1-1.�4umnge.ynmm n�pm.exlhrvWmWI.W..Ime YOW5S.6mm 16e.nu1W p.n. Plvvuw'a xumry6.p M'a u a..57428SZ Z)3m " 7 mIt I%. caxml. Iffn �ppmml s.N. LSO F.�g _"`aae',. �w npvnanwcmmeiP Awme 2 Mob-F mS.As.'.mr na. �MFSImN.aY11:rX`wlrn�� 9906396(p-pW14) NO iI W�vq, N vH, NrC¢Yy Esec. sw qx +nl' � '-�I Bell pno.K qo.s' �.�s . 1.rka<ro.�etis z :('o q'+a,v.,k Et �.wtn ..I_17e . vn.r d.r.,.4e VS it a{aryµk{ �"b��t alpaK /PJE In -Ground Gravity Plan PAGE 1 OF Index & Cover Sheet Component Manual Design References: Version 2.0, SBD-1070SP (N 01101, R.10/12) Pg t ofel Index & Cover Sheet Pg 2of4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View Pg 4 of 4 Management Plan Attachments: closures: Filter basin specs _. __ PpW_ Application for Review Filter spec Soil Evaluation Report & Site Map Infiltrator specs Project Name / Description Rodger Collinson Owner Name(s): Rodger Collinson Phonr.812 267 -1185 Owner Address: 787 Hahar Circle, Hudson, WI Zip: 54016 Project Address: same Govt. Lot:_NW 1/4 of NE 114, Section 28 ,T29 N-R 18 E❑orW❑✓ Township: Hudson County_ St. Crain Project Parcel ID e:. Designer Information Designer Name: Keith Hairings Phone: 715 703 3777 DesignerAddress: /0.5 FGLeipiae. ./ Zip: '5-1y7.;17 E-mall: -d ..d tpFM51ii /r WAco, Can.xn11111M,,,ar, 1r•ma,bmr. License Number as Remarks: Signature: - i^eawew Date: a^ fm llW`ra, NtUy.Sea. .$,4d y ' rJwn c� fMrJSeY. `x, _.�_. ... 3 -r8'7 W- So ll so:I • - i<.rc of se S hcO.o 5 i.fYti*W ee'iy ,cnb krM eRis�'"� _rt�s�c5 e f: Ur�y e„y;r ^C� zk8<ipl��nNok��i<Y LZ IN -GROUND GRAVITY DISPERSAL AR septic TanMs, Marvelst Yell_cwac.=eow*amine�mawv Uniform Elevation Trenches with Quick4 Standardhambers d,pl.an,(,l„eM„,K,t 3-11 Trench (down -sizing credit) 1.000 g. _gal _wI —w III Ftier Mewrokae- �� ETwnFill In SOIL WVEfl All, TYPICAL TRENCH - CROSS SECTION VIEW 4—pg (NOSwIe) Prwge minimum 3fi Spern Elevation=�-5 fl seperalon MNrean lrentlas (Vi ll Oulcka SdNap-W wlEnd tiI,° Ishow bcetion of Inlet ousel pee mnnemm on pan new.) e><Ct.�a TYPICAL TRENCH PLAN VIEW em M� (No Scale) r____ _----yr-------er---- ____ , . TA=3.01r - -------yr-------yr--- 1 - (kill D e= 6a n m (npwp Quiad Sunmm.W Chamber W INSTALL PER TRENCH: )rvdd) O ��mewierm.mrswi.�..ixw T 16 Quickd SidINQ20W EISVGam[p-326 pr Eeer a�.. om. a.ns p + 1 PI of end MM Q B M EISAILer. w = PnIllel EISA per well v 326 W Feyuimd lnAltra nArp-6e3 dr Distribution McMW: x 2 trenones IV Proposed Total Ell 652 W branched manirok In -ground Gravity Management Plan PAGE 4OF4 IMPORTAM' The Owner of Nie inprouri gravity, system shall be reaponstle for its pegnuel Operation and maintenance pursuant re recuiremenre of SP53113Bq Wed averad Cotle. Pursuant to SPS 383.52(2). Mac. Admin. Cotle, this system shall be mnsiUmetl a human health havaN if not mamhined In accordance with this approved management plan. Furthermore, all Inspection and maintenance actindee Shall da performed by a rsglehretl PONTS MainYlner in accordance wit SPS 383 52 (3), Wac. Atlmin. Code. Maximum D1Mddi Area Operatil Limits Design Flow= 450 epd; BODe5330mi TSS51S0mgL"; FOG 530 mi Inspection (In[ INSPECT EVERY 3 YEARS • YPe of use • age a system • nuisance IaUors (I.e. wbrs, rear complaints, ek.) rr mschahml matfuncton n a., pumps, valves, switches floats, ek.) natty and ancmnnburon appuneance(s)(I.a. distributor r crop paper it use (I.e., exceeding design ce ps ide, actual activities. east in i iddburon mu morW doting So- r Equitable (e.. pump r dydin9, float switch semitone, arc.) h-ifabothrable0.e.. wog, nnMione, switchedc wlatlerem,alenne etc) rIahrs Orriiceplugging Imenum tat ldiAnipmmre—wrnpmehd"ign Epeesic n) Maintenance Cleeckgst MAINTAIN EVERY 3 YEARS (or when necessary) Saw a an shall Le puthpad by a counted sapraye servicing icing opalicensed under a. 281.48 Wa. O Bbb, when the volume of wild* In the 1IOxcesme-Minl(113) Me liquid"Itrm 0 Me WMa)w as required by Iecu ordinance, astral W commerce anal be pursuant on NR 113, WIx. Adnln. Cape Effluent flft4Sl shall be inspected awry 3 years and shall be burned when nxeWry W remove any accumulated aciding s acco to manufacturers specifications . A seryM iung period will always be greater en 13 months. System maintenance nporb shall be submitted to the Proper Iwl government unit In accordance was SPS 303.56 Wisc. Admin. Cotle. Gabon say component failure or assumption to: Name Ofmdlvaual or comwny_Advanced Septic Phone. 715-703-8337 Local government ulnt St Croix County Zoning Phone, 715-386-4680 Loral gmernshent unit appeal saw. Any derfai part W the system shall be re uii ed replaced or mmovM pursuant so SPS 383.51 (1), Wed Admin. Code . napeir er repbumens a failed or ma funini ring components star comply wrt SPS 383, Was Admin. Cade. No PrWun ter Uemral m physical restoration W the POWfS they be used unless approved by the department in accordance with SPS 380, W sc. Admin. code, ConNnpmcv Plan In the event Nat any fared treatment component athis POINTS cannot be appeared. it shall be replaced pursuant to a plan Submitted to the eppropnal agency for review and approval. AfanedinyreunddapeaelmmponentmayW abandoned and replaced by a oodecomplying dispersal component in a pre-neamnned area of suitable rib. SWMm Abandonment If use Of this PONTB're discontinued, it shall be abandoned In accordance with SPS 383.33, Wsc Admin. Cotle. A THIS AREA MAY BE FILLED WITF' CONCRETE FOR ADDITIONAL WEK 1 A 3.10 4.50 Drainage and TULTM, M[. IMOF xCwll Y4 EUdO. Nluels 60W7 Septic Products TELEPHONE: M).RO.1011 TOLL FREE: SOLIU.7m FAX "T&W.E001 Material: Copolymer polypropylene Color: Green 24" RISER LID 24 - RISL - GREEN A 0 za.so 026.20 -- 2.60 SECTION A-A.� Material: Copolymer Polypropylene Color: Green Drainage and Septic Products PART NAME: 24n RISER BASE iTn EPHONELFASK: M PART N. mae. Co 120 :nm, nnnoi. wwT FAK: N7..ss : nw 24 - RISB - GREEN HITE �rew� OINSION OF INRISFPY&FAVI(£B PrvMv DE IbNzn. WlamuMalm rma PO a��$ y ifY: CmWATNeuMWW beer sales, Goosmar Nee rude, sawwry March 12, 2014 LIFETIME FILTER LLC MIKE HORNBACK AB CLIFTON HALL COURT SHEPHERDSALLE KY Wide Re: Dmoiptim: SFNAGETREATMENTFPPARATUS, EFFLUENT FILTER Menu2aWre[ LIFETIME FILTER LLC Product Name'. LIFETIME EFFLUENT FILTERS Moral Numbads): LT let LT Ilt6, LT IM AND LT 1 S6 R EE ATTACHED TABLE OUTLINING: FILTRATION bbE AND RATINGS IN GPDf Pnowd FYa Na'. 251C0045 The spaclbfaYons Cndlut plans for NN plum6ng product have Wen swayer t nd determined to be in canpial lca with tlspWs SPS 352 Through 3B4, W WwSf1 AdminimretWe Coos. and Chapters 145 and 1W W aanNn StaWks The Department every issues an approved bated en the Wisconsin SMWIea and 00 W iswlbF Adrenaline" Code. This appreval is valM until the end of been 2019. That approved Is contingent upon complencew in the mllwlnP aryuleWnLp): translation and servicing of Wen product must W in 0aordencv wrh the melulacWrers instructors. Away 0 the mOnUHchteh Instillation and sessions; IOnn sons must be green by the osmmr of Me syanm. Meinanerva reformative must be bean to the new at the bank 0xpMlning Nat Pt Out N 000M will W measures AMandate extending W grade meat be Inoveled over tie niter. . LWNTENANOE: Clean fiber at lnsixedeWpumpng lnarol. agachmenbs) to this letter see a echmMIA. The tlepeNnenl is In no way snbosing Nis product or any advertising, and is not responsible W any situation WI may recall ham ILL use Sleet GIF Jor�a,�N.S. POWTS 1WIcl Revawer phoM',(i 26T5265 Noc(W0)26T-gT1J emea: ben lones®wLgav Slb1lll £M.1Mll F*M YWiWI WC 20140048A FEC=;i ED FEB 6 _014 SAFETY & BUIDINGS &1 N41 am. 20140048A 4: 401 te 15.�. Installation and Maintenance Instructions Installation SrcpS OryM[M1eflllx ouon[a MenuNetplpegolry[o[toe Enln fltlE. Fnwrtlfb¢ntbedtllreNyuMer Me N[e nlnBllfw dPlpelsalrea vinal positimaddltiwalplpemayu to[ atltletll Sol ItutIfil the, atlElticnal all added supper and the two bottom supports: Mile the use Is 5911 dry fit to Me outlet pktq meaw re and rut Vesta le 40 she pl pe ts the length needed W depend (Ithe huhtmareptsmoldnlmothemeWthesldewallaodthelnsldetwrNtank. splveMwNd plpelntP tlx huMthat are gsmoltled onwihe ose. SIep3 blvM{xdtl µe axle Neaulletplpe.Inset lM1ef114rurWtlg¢Into Menu galMtlownonthe oNtlge a MII It loch Into place at Me horrors of nu. Srepe If III venom¢ gad switch: InantsNW Interne hok pr ,,Wdhl I= the tepNMelMe. Press, straight deem until it tom Isto pare Malnnnaw If Remove the taesa ltl a![h¢bnF. Noh:Toensuuundus blesulldsdonotmt Melenkandinto Me dnlnfleld,i tanksouldbepumpWoutuntiltM levela Auenth Wm MeougMl"lof Mervin. 2) To remoy the hear nrWdge from she that aa, pup up firmly on the handle either umlke tlhladglig Itfiomthe rinse (if u111WM avMlul read swnM, personal of swlM is opia,sef 3) Udy an ordinary prdm hol rinse the filter channelensuring all peaks saptye III b rernowd, 61 plaen the flpsh wrtrMge bark Into the floorose, pressing dom on Me urti until hlMU Into (dare. 51 Place the speaks Jd press Onto one tank etopped It15 pal re. RECEIVED FEB C NR Ideal Wool aSAFETY&BUIL!il:w M YMent rlieeevarN the nlwr will beeha✓ mmvlaaunnantl wrMaMb aerem Man normalumbOeenibstl she the myaW Foursrer wm al el III flew Ion'MN her in the avert m»R More PW ens per Meaet Wrtque mnpvevn rntbaNh wrr®m 4mreeaulrtauwn>trrmpwperunumaiNmrbnwrewXlne XnmpeLu¢rutrsyimriel,exedtlo-nwMxE pewMNi WONxwnanp. uM1umemervwmvrverwnWoinrvraewmvraeyramovenargnemaNn netts nagerbiwmnvarexelmw. l Quick4 INFILTRATOR' The Quick4' Plus water technologies Standard Chamber The QuickA Plus Standard Chamber offers manrum strength through 0 two oentm structural columns. This chamber can be irutalled in a 36-incT-wVge trMOh. Jot the orginal line of Dusted chairmen, e offers advanced connecting radio lllty with Its Cornour swivel Comma m^' which permits turns up to 16Eegrsm, right or die. It In airs eve mpl r in bur -foot Imgms to pravitle optimal inatallaban realbility. The Wck4l Plus Affuni 12 "power and the Quickf Periscope am eseable with this chamber, prOmmmre Incraasm trial in Swedish uwnagurprim, Maaltmtm SBmfiOt APPBOVPp in Oulcol Plus Standard Chamber Benefits: • Two nenwr structural Warned after increaeeE stability are superior strength • Advanced computing connections • tatching mechanism allows for quidir Installeilon • Four -foot chamber lengths are easy to handle and install • support where tootle of 16.000 plural with 12- of cove' Quick4 Plus All -in -One 12 Enecap Benefits: • May as used at the end of Charmer row for an Inlavornlet or can be handled mbiranch • Midulator connmtipn feature allows 'trial at the ends of Dumber raw Canter -feed oonnecdon allows for may Installation of serial distribution sys ems Plea connector colors Include slam, ends or top Ouicka Plus All -in -One Periscope Benefits: • Allows for m'iaed Invent InsWletions • 1 ea° direschanal lnieltling • 12- reined ii at Ideal M mnu applications "reamed bvtrelrtarwnow Asawaim m Pe.oea a Meechi f" �7/ gsclatlFPMOi Quick4. (tYICNd Plus Standard Chamber -_ __ �,w..n•nN CUNCE NO$Nl-Inull 12 EnEcap--. erramErew.. PMWURIHO PER Or to 1— _ --- It _ nimsF FRONT VIEW 810E VIEW (tested Plus All -In -One Periscope NPRORTERTEREETall III Thymene Tom Inner, Parent I Pat rem he R hol 1. the Pont In. on man our be Me an' Ol I Peet byron be am I'll A mor b 'OIL a T 1 .1, 1 Intel mejer OR Pare I boyeall E.1 '.Q rya II ii 1 W�RAWIES ER METCHARrof OR Truly R A Ron Murray L rn .,on elyhore, 111. 1 freent I a nor, army Term IT W, I PoPoodynny, are. o my In 0, �� � Mo Pro REP. 11 Ammy Opper my chat Ther then The agra into I .. beentran, In. marreenj INFILTRATOR'17 "-""' Or wl,n„been,.,,,,„, or Imbnoltalee One nIm,uuau..a. ItLaw„Ia arm Rome by Iran, „,tenor Unit 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 - (Steel address) c le located at (�/ /., 'A, Section �' �, Town 9 N, RangcZ2W, Town off} J , St Croix County Wisconsin. Upon inspection, I certify that I have found the mrik(s), In, the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service /D�/� 4 Did flow back occur from absorption system? Yes No / (if no, skip next line.) J/ Approximate volume or length of time: gallons minutes Tank Capacity: Construction: Prefab Concrete_ Steel Other Manufacturer (if known): Age of Tank (if known) Permit number (if known) ytx #H2/r/G S (Llcnsed lumber Sig tune) (Print Name) ndlt L. Z2 ( Z�a16z7 (line) (License Number) MP/INPRS 1013/IR (Dare) Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev.2/2012 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer '20*de. 6 11t f S ) Mailing Address787 ]�e ZR9 CA,w /G Property Address S� M F require (Vmifiwtion d from PlamlingffiZoning Department fornew conenuction.) City/Stem Z24odS� Parpelldeneeraz;on Number OaD -//8'9-10 -000 LEGAL DESCRIPTION Property Location ljfnlnla,Alk, r.Sd;,2jT�%NRLW.Townof %iI[or5a� Subdivision Plat: C&LLe ZZZZ/S rizu$ ,Lot# 59 Certified Survey Map # Volume Pope Warranty Deed# (before 200])Volume ,Page# sp,mmuse EbAsulo me lines identifiable pynone SYSTEM MAINTENANCE AND OWNER CERTIFICATION mastermind and meimemnce of your em,,,sum could,mr in eta literature failure to handle wado. Proper consists otramping ore the case tank was three years orwol¢p mounted, ma ed, by a licensed hun. Whmyaupm utin be system cao aReG the fife" Of me septic tankar a treatment moge, In Ihcwazm disposal eysmm_ Ownermaim eanw opommomes art specified in 4SPS ask5$q and 11Chapter 12-Se Gou County SanLmy Otdinanee. The memory owner armed to submit to St, ('tau County Planning & amid Depar mint a mtli rdsom 6tm signed by 0e owner and by master plumber, memoyman plumbs,, mviaed plumber or a liceved pumper verifying that (I) thew -site 'astewmter disposal system is in props container conEnion aad/of(2) after impaction and pumping Of necessary), the septic tank is Ira than 1/3 full ofsludge_ V,v the momeraned hake mad me above requirements and agmmo maintain the Instructors, disposal yn mwho the landatds set form, herein, as of by the permanent of SaRw And Prohssional Services and the Depmmenlof Natural Resources, Smtcof Wisconsom Cenitiution swing that your most system has been morainal must be mmpined and rammed he the St Cmix County Plats & renal Department within 30 days ofine three year expiration doer twe county that all mt"wild on tlds farm arercoe m the best of my/ow knowledge_ I/we aMerc the ownar(s)ofthe propeM dewribod above, by orate Of warranty deed recorded in Register of Deeds Office. Number of bedrooms T ��lOF A$ ] /Dl�l/9 DATE ++'Any inErvinion that is misrepresented may smit in the m imry printer being levoketl by the planning de ]going IXpeNnent.++ Ina'IWe with this application a rccomed wauvny dad from the Register of Deeds Once and a copy of testified survey map if references made In me wanamy saw. (REV. 04/12) F CE ROTATES 1 K ear. a I\ iE14i1 i\_/Of[I.22 e i xae ET•Ea SISSSillS 0,Ol` 6yR6 \ \ Sal/ so SI1 90805 1E.086 AC.I \ 916E9 M. 1 • � \ 1E.176 AC.I - - _ 8E603 51 87699 M. FE, MOOS AC.) \. I52Xag .S . 3R\ •y'.• (228 C A0.) .{leA. •I A. A. A. ._ 8926E _ 9 AC,1 I 14 glaois/ FORM - SIC - 10\\4,,,, AS BUILT SANITARY SYT REPORT y� OWNER )�'q / ���`� TOWNSHIP W4 I/v SECTION Z� T <7 SS N-R / W ADDRESS b'.A.. .Ja ST. CROIX COUNTY, WISCONSIN SUBDIVISION (Ll. r%o/6 55 4< LOT_1LOTSIZE PLAN VIM SHOW EVERYTHING WITHIN 100 PEEP OF SYSTEM "INDICKTO-OR"TM ARROW DENCIMARN:Elevation and Alternate benchmark SEPTIC TAKE :Manufacturer! Llw.k1 ` Liquid Cap. .0Zc Rings used: 0 Manhole cover elev:_Pinal grade elev: e_ S PUMP CMAKB M Manufacturer: it 19 Liquid Capacity: Pump Model: Pump/Siphon Manufect.: Pump Sire_ Elevation of inlet: Bottom of tank elevation Pump on elev.:_Pump off slow.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_. Side_. Rear —Ft Distance from: BOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length__. Number Of Lines:_ZArea Built mom Exist. Grade Elev. fY.o Proposed Final Grade Elev. Ci10 Fill depth to top of pipe: Z..6 No. feet from nearest prop. 11ne:Front Side Rear X Ft. 3P No. feet from well: 2L No. feet from building b HOLDING TANK Manufacturer: )bi) Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front_. Side_. Rear Ft._ No. feet from: Well_. building_, nearest road Alarm Manufacturer: INSPECTOR: PLUMBER ON JOB:.-- � CST dal9— a3a So C� �,a;q LJA._ C7 Pal.! M 3 rea nQ,`Q�lj n E�mSOIL EVALUATION REPORT S:S98 q�Katilmnedt,mm �pa ��"�o,at and ran/MYOy1R Sl. Go1K wfj oeeWrtery 1 L- Q1i1—/•/ 'Th A a, it Final or to —Lbd art PI Ponta M gevle byird mnnmIII El m. be •a9•/P / 401 Pro,tal? imr Priority11 ar Co(1'ns ors ®' Can Lot Not bf,' d8 69 N R /0 swkPenDMm a �n�xTlax IemcsMw h?mS se ne enmPholounrow ❑ary ❑"lase ®Tn.m Nabort I n eP S Con IIIJengnaewnle GPD WRepleeemenl ❑ PI Cannot PI 'i Flood Plan elearo, g^ ft �l„=✓OIC e Final adr,,mrande0on rKhlwl dve �.fa�par ur�� �I Id � ❑/ nex �p,� GmuMaunal 4". n. Deem 11 omnme f.amziE in, :a d 3 Deem -dl m�nani wn, Oo all a Wry 1 10lie t /YYl �o Rae o.aa, nnn .1 *a/.m pu. Fz Cont Oolar -'— s/ 5 5 s Or SzpnSh AF dm.Ok PIT rga¢�pence m mre' l of �b ei R!C If wN 'u, ,4 1.0 /.p /. 6 41 amne» tea° mbece ❑Pwit I elrv.24tw—sfl. Dart, mnina ream Myin. a Ol pin pomnan�Wor T enure Urn.. 0.nm¢ �n ee ry l m Rote p w Mun Oe Na SSom cm �,N� A. 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