HomeMy WebLinkAbout024-1040-95-050sup me B.l e.neio.emm Re PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
TANK
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System PLOT PLAN
PROJECT Eleanor Sctllloen Trust ADDRESS 5895 Smemary Rd Eden Pri ina Mn 55306
SW 114 ON 114S 32 /T 25 N/R 17 W TOWN Pleasant Valley COUNTY ST. CROIX
S1FT6M ELEVATION ill 1.7 sandliM 9118/19 BEDROOM
DATE_
CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TARE
MOUND SEPTIC TAKE 612E Had tell L= TANK SIRE EM TANK 66E 630
HOLDING TAKE SIZE An RATE 1.0 ABSORPTION AREA 458 0 of chambers none
,BENCHMARK ITILE Top of garage foundation ASSUME ELEVATION 100' Filter $IMPS(] [•'D=
❑BOREHOLE DWELL •H.R. P. same as ben0nmeh
Scale = lyP = 101320' Property Lin
Existing 3 120
W 60' B0' Bedroom
OWill Ho"
ISJ 5
S�l� YJ 1TNT �9A!GhM\
Vent
150'
HUB., pose Tank \C/E t"
``O / 1hO
HUB., �7Fe• fi
B.1
1 '
Grading is to be dome to evert
run-off away from system.
Area 15' below system
1A to remain
undisturbed
B.3 fIC
B-2
92.5' 6%Slope
9222
September 24, 0019
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES'. 2021-09-24
PlanR,w,W P%TS-0919019I
SHAIN R BIRD
1432 @OIhSt
New Richmond WI 54019
SITE: Eleanor 6ehllgen Trust
1614 County Red M
Town of Pleasant Valley
Saint Croix County
Total Amount:$25000
FOR:
DIVISION OF I NWI SERVICES
t[Rh& ChPetry
May rmmaw.en.rp ,.m..�Mmeo,
_JtS. bar rfSdaVCES
Mound Component Manual -Va.20, SBD-1069I-P
IN OINI, R I0/I2)
Pressure Distribution years... Manual - Vec 2.0,
Or 110706-P IN. 0 No 1, R Iof 2)
Oeawneam ISO GPn 6Bedroom, -Reo emm
Maintenance Rumored
The summand restated raw, has No, ewer for conformance w66 applicable Wisconsin Admmiswluve Codes
and Woomam Smbuha The ammival has been CONDITIONALLY APPROVED. This system is w be
emotional and lowtM In Mmudaoce w l@ILeenlrad epprwed plan, and wbh any wmponent unumm d
m%mnu.I Name The owngna tlomed 1, charter 101111Q 0), AVlsnoo,e Malmd, is responsible for resonance
ww all ante requirement.
No rerwn may engage In or work 0 dual In the Stab unless Ikm,W to do so by any Depanmonl No3145 A,
The owlormg Carl Arab be met durlog mosrmtloo or madiation and poor o ocwpanuy, or use
• PN,n, Aspenvl mee poor and tlurngma rodaandone mpa mu and wofthe s .
• Any tall measure, II and Austria;ahnll be Ma Man and removed prior to hunts theMITI for Installation to
prevent malting under the disposal area. All loose orgpnle malerual to be ,,,,d from mound morn
• Perot W of the&R a cheek them of has adeph or arcane Nelson' ad Man toy If 'It III 'IT "ALL I' byroad lomfilbabon oblo .nfthe you. Pm
nuld ...... bay an ba, cM,,m,,d by MHUR I Iml symple hat'ven the hand, If It Gary Into a A- inch Alan
then If it cm e n N! if the sue:, 100S tl t
raced umil it dries
• Abandon P ding System V, SPS 393,33
I DO I'd Goal Sl r • U'wercanrfaeewater am.. POWTS Awl
• All piping shall conform bSPSTab1e38430d and SPS Table 334,30-5
• Imelate building sewer beyond 30 feet per SPS 3823011XG)
• Talk Installation to folio, all manulacure's recommendation&
• Verify property line )prier A instaidle,
• Wen¢tMcks w meet ch& ORIII 1& 812,
• A met that are oauded niih rook hwniomm imuoma utuarl conMmdduu raaw lha aeu o frill
or prefer vemm nallder,m n mm
the front urvnaf In, M .fro 111or"1111
.g'mndlcxf Al w'girlll.m&nova ,. her tytin, core emtdlm or, Men ked, In pro, de
still ain until e Ii
Owner Responsibilities
Theamrent owner, and each mbsryuent away, shall receive A ropy of this letter including romi
wells to proper um and nothrenanu of the system, Mariana hall Tmuw a copy of the approp•ons, ope.Non
and maintenance manual and/or ow her' a manual for the P0WTS diax c In this approval SPS MMIR 1)
Into.. t this ,it ebm Tti,,numm or any of as em,himment parts maintains ea health
hamr3.lhe properly mvnetmost follow the stet ingenq plan as deserlbed In Teappmi plans
Awpyofthe approved plan, ryWnfi Cutiom and this mar ideal] be Onnum during connotation and Opal to
i ewhon by wohnud reprecr iVn of the Dodement xhicM1 may indence board msptttms. All wri6
required by the vale or local munldrallty shall be obtained prim mcMwr... mho of
wnYmcponlmstallSion/opemtion.
In gransng this anal the Divulonof lnduxry SeMms reason as the right to Iselma Ganges or additions should
conditions mice making them necessary for code wmplianue A,par gate how 101. 12(2), nothing in this mew
&ball nature the dedgnv of the vuslabillp for dnignlog a sale building, structural or comp.....
Inquiries uncemlog @Is correspondence may be made to me a the klwhone rmm me Plead below... at the addmss
on this latlmhaad
The area loll addressee shall rescue a copy of this lenrr and the POWs S management plan to the owner and any
others who are responsible for Joe mnmuaion. operation or hurricanes of Me POWTS.
Thanks,
r7 Q%rv✓u1
POWTS Plan 0. Safety
&— Westover Spxle
DeI
D ....
11, ti Micron
el Se liulluryices
ivi lion of Industry Sol
608316-6134
Cover Page
Shaun BIM
BIM Plumbing Inc.
C t`7,1L'
0
143212011h St.
_ . ,::., r rAC
New Richmond Wi 54017
L: mcs
715-246-4516
)�
I I
Date:9/19/19-.�.u.,�._�
CwnerSleanor Schitgen Trust
Location:SW1/4 NWV4 832 T28N,111N 1614 County Road M
Pleasant Valley
Manuals Used: Mound Component Manual Version 2.0 (N.01/01,
R. 10/12)
Pressure Distribution Manual Verpon2 0(N.01/01 R. 10/12)
Pages
1. Cover Page
2. Mound Plot Plan
3. Mound Cross Section
4. Pipe Cross SectioNPipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
]. Filter Specificaltons and cross section
8-9. Malniarce and contingency plan
AttaChment5aell test
Shaun Bird
Signature
License numthreflW6900
Page 1 of 9
System PLOT PLAN
PROJECT Eleanor SCbimen Trust ADDRESS M95 HCsemary Ad Eden Plains Mn 553415
SW 114 NW 114S 32 IT 28 NIB 19 W'1'0WN PlEanant Valley COUNTY 9T CROIX
SYSTEM ELEVATION 93AY 1.7'sand lilt! 9I18I19 BEDROOM 3
DATE
CONVENTIONAL AT -GRAVE CONVENTIONAL LIFT HOLDING TANK
MOUND ASK SEPTIC TANK SIZE 1000 gallons LIT TANK SIZE DOSE TANK SIZE 630
BLUING TANK SIZE LOAD RATE 1,0 ABSORPTION AREA 456 q of chembere none
hE BENCHMARK V. R.P. TOP 0l garage inundation ASSUME ELEVATION too- INIOP $IMTEC FIICI
❑BOREHOLE WELL 'R.R.P. smsasb nChmatk
Scale =1I4'=1P
1320Property
3 1 1
0' 40 80'
1 pall
dered j B.M.•
5r
Vent
150'
Huflcutt DEAD Tank 150,
A
1 '
Gratling is to be done to tliven
run -of away man system.
Area 15' below system
Is to remeln
unRlsuvrbeb
B-3
B-2
92.5' 4% Slope
92.2' 91.5'
."
Mound System Cross Section and Plan View
t Dissension Feet
IdI t A
ii B
k ! D
J.
�-7-4 1 G s
R u
I
i
K A
s � r
L
W
Slo
l— "I TOPsnd =ASTM C-33 _
_ t CaP Material send fill 'h W2 Aaggreiatc Q ob ernSion pipe s
Geofimide
Fabric
tContm 9z,-z oPlowed'Surface
Slope Direction
�e
GENERAL INSTALLATTON: The mound area is slaked out along the design content Ensfing
vegetation is mowed and reked off the site. The mound basal area (L x W) is plowed with a moldboard or
shims plow. Plowingrnay notpromedifthe soil is wet enough altheplowdepthto form aY. inchsoil wire
when a sample is rolled between the palms of me hands. ASTM C-33 quality sand is placed marronawy,
after plowing. Sand is placed with a tracked machine keeping 12 or mare inches of sand under me works Or
is placed overhead by a bamboe. Special Care must be used when placing send of less llun one fool
Wckness to rowmiu compaction of the plowed sur[ece. After the topsoil cap is placed, the entire mound
is sweded and mulched to promote vegetative growth, Iimit erosion and pmtect from f 'og. The
Observation pipes are states] in the lower 6 inches and wcued in place with rebu or a close[ Flange.
10IPl la
Page
Pressure Lateral Layout
Two Laterals — End Manifold
WE!1TIMl
Force Mein
28ar,'�/ 1>r I tw,
DUm"wWw on Networl S
ecifrcatmm
Laterel Denounce
Z
3��: _
[
In.
In.
In.
In
FL
Manifold Diameter
Odfice Diameter
A(Office Spacing)
L QLateradI
M sieniPold Len
R.
Force Main Diameter
Z
fie.
Ft.
Force Main Length
— Contempt
eamvt
Lateral Term -up —ios plug
L - Long
Swap
90
7 Bend
Freeness system construction
/ Letemis me constrnmcd of Schedule 40 PVC
pipe. Orifices are drilled perpendicWm to
the pipe with a share drill bit and fete down.
Lateral turn -ups terminate with a thoaded
cle viout plug and are enclosed in a 6-9 inch
diameter Iawe sprinkler valve box annessible
from finished Smile.
•a•• Grade • 0 •00
6-8 Inch Lawn
Sprin4lx Valve
Box
Page l ofo
03I05Igj
Dose Tank Cross Section And Pump Performance Specifications
rJ: MenufrcEuer /
� Madel Number Minimum Pump Performaua a W uwM
W Tmk Cgwcib 3n a OPIH bI ':RTDH
MaziWhi Mm.PMave Gaya" �•�
T
VmrMN. 121•
WlW tuekw�g UaNa
Above gyie
Wnah,,im a
\ F
Wiri Csp
Jwc4®001
ni 0
I
`--
W �'
Fwehptl ggye
—
Depth afCova_y
Prrr T
Dievaw
F
Means
......................
•:
Ie .;
swimws and ke.+a'vaG
ovum
Tmk Vo4�me=
OPI
_
D'mmsion IncF
Volume Gl
rwerve)A j�
l
A
(alum B 2
H•.
� Hale
Bw,w,wTed
Elev.O
6Ft D
,
fnee nppr nOfh The dose lank is beaded and beakfilled in accordance Wha iwe
loan in 'produm approval ryaifiaaliora, showman depth of bury as specified by the
ynot be castled wwhoutprior approval. Manhole wvws eapoSadto ®ade have
an eRxeve loohing device (padlock) installed. Piping at the iWa end omlm u of approves
mafenal, co we ed to We task with watertight fittings, and laidon stabled i m prevm aettline w sagging. The free mein is sleeved wiN 4" Sch. a0 PVC to bridge the motivation and is ualoi wmerdgbt Eleanhal servies complies with NEC 300 an Comm 16.28 W0, Ada. CMe.
031051g1' /
Pag< �pf
280-SERIES
112 hp Submersible Effluent(Sump pumps
ins Ussery Oserim
mpONrkgecoglarc�trve-mla-
nBe' Pmp Bn omsiN waste wmer gyyieme. fipwa
wmishangiereW le recqcumiremMcarsnleer Nord or mom mPpum,p
Delregrundunsays umauo vm-BoY modndms zeos.,(eg wiu pre,nae veers of reueble peawmgnae.
All Models Feature:
• vcrlm WsAe lmpelNr permittlne pasfe�Ws0lms
UPW%"
•O18 etainlmgaNOl robrgneH
FgmlleneMty ludkeigtl upper vq lowaz Cell
•••Bowtfinlen glbeeeel
s
a
Jremorse
-mgiainlaffi1%.Dianner0e rimm
•Boommu eNel Ipnparscm: I Wp.lh removable
• Mm]muT fluid lemperaNre;1 %0' P
YBO'6e005 coN Lenders
MMeI 10_5--2?5 (SI
]90 Sh,ud'd O ruer drum
[81 S4nLLVN OpMiel OmMN 0 ad
6 9M1ipvamral Orel WA
YS] SraxNp O deal WA WF
eedw2? `r VeM1nWNm,o nu�u reptionv orPM
E IMnMlaegleh ttN,cedere90.t
Motor SpeatlbaHona
%np fiOHx 3C6ppip
ON film, geoid lypoMmoa
00 Permermm BpldCapeviMr
8.0 emp(115V1
adanw l208rz30r)
POi7mmaaoe Curve; 2803eAes
0 8101520 k5ffiffisE is W WRM10
JA gallons Per Mlnu4
n0ffiL PerMnub
Dimemelonai Data:
wNBnC 2s W.
Hsidn613-
Me(mWMIry;10•(mWeIYB](
Minimum Sump Diameters
Mmho2r1.243... 14'
MWe1257VMF...10-
F swror
on lsvYModM%1�YY MNa
woo aS10 M
Tom of 1
0•
wu'�e•wweNs •®1MdyYYiavgre�bM�rel
n..w�.. �wam,amvwrall®rTea.M.H.m
Model Yal
Wiaes^ak
MWyl Y89
MWNYBT
ewticn
evn
1Mpe
wry
wM kn
met n.
0i� imp
With series
de (p10aV-ck)
s�fiwrM
aPapira-
ou0
Wilopemrein
a10-alem err
m'
®
c U us
Certified
_
1/seroNmw. ww Mas
Trwaeanua.6�� M.wvera tears
PMwsoo-Bas-Yam
sss meww-ram
.Mreamumpsmm
n,e,d.,.eed.ew,,,,,�>o„
wreb�� w��dr
;AG SIM/TECH HL
C6596 NRION Bev NORTH RG
ONE EI7Y, NI 4TI2
-ge'399-379N @X I-RI-`ctO7
POWTS OWNER'S MANUAL & MANAGEMENT PLAN
• .'
ly"TEM SPECIFICATIONS
s
SepticTenk(npaoly
ONA
legal -
Sepik Tank ManuhClwr
OC813N PgPAMEfPFS
EMueMfller MyMayurer
N
Nlvnlwd¢vJrmna
^ONA
EMua4FiMrMMeI
aNA
NUMrerofCtvlmercMl Unlls
Nq
Pump Tank Capadry
aKA
aNA
--a)offR
Tad Wnuka0ur
MenW leer
NA
Death Use,
Oaegn r: (Model(EeWwWa1.5)
SCOMpAatbn qeb
O NP
.PamP
Pump Abfal
aNA.
O O
lnfi eWMaant Oualib'
MMMAy abod"i
Pmbeabnent unn
Falls. 01 a Sma¢e (FOG)
90 mign.
OSawrOravelF ' 0Peat Fifer
emdlelyld lOxrypn Oamaw (Soot
gym urging.
0 ousehanlpl Auasal 0WeNne
Teal SumdMd3ofps (TSS)
1150 rL
a Wafternflon aOMec.
MamplacWrer
PretreaWE nt Ouairy ONA
MaM averye^
Domer¢alCal(s)
SpvMmky Ogyen Demand (ecoJ
aarr®A
o ln9rcona(yaNry) 0 ingmund(wrousurp nal
Tdalsuagmled sacra (TSai
flan mgh
0AtgrzEe -nd
Feel WMdrm (geometric eam
Slat GWImml
OEM hie ppllior
M um EMuant parCde sure
KMMalamerm
uatmaayamwlipa.mm..gm.„.uwnsua
�ma.ln.aa
aNsa'r�'naunmawbnw.
Service threat
Servltt Frequency
IwR'amndsono agi
Al bast ones every
OmmPa 9yuds)
(Matlmom]yn{
Pi oN mnante of finds)
Wren wwgpM sludge
and awm equals ma•NN(5)
of Who vaNme
IwpMN¢penaleslY¢I
At kvtmm ewry
0monln¢ ad
(Ma um Syn.)
Clean amtrou Mkr
minvonmevmy
0mods as)
lmi lwlmpi pump mntnds& alarm
Nb mmeq
3Oman audit
DNA
F1Jd 1s m6 and Inured lest
At Most once erey
0morms r(¢I
ON4
N Ma9 onm MM,
pmorMa Oymr(s)
Nq
At ba6lmmerery
OmcnNs Oyear(¢)
Nq
MAUNFNgNCEINSTMUCTIONS
IMp SOr Men add deep l CM mail be mane by en Inelrkleal fortylnq one of bra ISOMag rMawm or
mNNZWrve Mmbn Plumber, Maabr Plumber NesblGad Serer PONTS Md N,, peyr, Manorms,, Saptage
sMUMrp Oporebr. Tank brMoMons must Indude a vismi orbital of *a tank(a) b NenMy aM mq¢ilg or broken
wrdwam, Mandi My aecke Or Imes, moni the Mume Ot mmband Oman and seem and to coadr for My be i, up
ap NMCMuenlm Negmund¢ur m. The dmPor MON)shall banwalMma,eclsled btlmIXlba eMuml adne
goandein Meowemtionpm¢adob chxk onany PonsaMCMumlm Aegg ton The poMlrpateMuemm Pa
Mords emmmay IMiWbara Of mngeonawrn® MMuartur rice ImmadiebwMaEon of Me leant ws andsid..onry
Wwn Me mmGrred amumolauan narrowed
aw Man®r M anybnkg Om ona'iN (5) ss more or ri gn or ds wi , Ne
Inn,bankof In w ¢if AammalraWn cane.
mewn gaemmmfiftm metl�nkal or prasNrb¢d POWrs Wmpanens, Pmbealgmenl components, and any
blrlarm nwn Or monmurnatll ioraft Of 12 manna or hear Mail W petmmae of a mrMetl PUNTS MMWrner.
A mrMg mW Nan be Managed to Ina Lind tegulsmry aNbarTy warm 10 days or rompkwn or any Mini awm
STARTUPANOOPENATION
For max ttnrpucNn, ppr b use or Me pi Moore treaMenl brand her Ne rye¢erwa ormleral pmduata or other
mQr N that may lmrst the treatment pmam wit damage tla drsprtal mitt). If high mnm Om¢ere
deter G taue Me contents of the tourist mnovN by a septage sarvbng opuata pri to um.
Mge—a_.
START UP AND OPERATION
Firm rem mn dot. at b OR of tire pOVJl6 &I trealnred MIAMI M Has plpwrm Of palming plWu'u or dMreNNnlUr IM1NI
MR la ¢rem by a output, am
id h, edomW Me dlWg wl ORUC). II heancnlrellme am dmotl Nw Or vw� Of the
use
6yNem OR up MCI rel an= It al cclA mw fmvn me McIMtmew, Burk,
hne power udp ow pump teat may I, ahead name) nlAlM1wler Iced, Wngn power is RY off mmn'e^NoaaW RE be
eal dot see Antitrust di In one Carl does me ing me all end My muIn M Mal me, dam Wof EMLand
To rhad mi. wMUIMMCI day wmede M ME pump Mrs remw1 by a B"W Cmvdang 0",r ,prior b,m ng him, m tlY
e uanl pump or conMR a Pluer or POper MCMleker N mat In menuetly pPonOng IM1e pomp w+ooM1 to u n M Imle
rvlNln Ne pump bank.
00 nW dqw or pars who mor rent we tlepw ¢Ile. Nam Are or Pars aver, M a1Mrt M i of wmpaf Me am w hin
15 Me Maul etape M Yry mooed or MI Boll ebo mares.
Reduction ur Amended N w pI g Ithe"amaWl sham may Img me pedomuncemA mlmA Me Me M and PORTS:
en dl army wIPo•: mil bulb: WMMv. m Emma: Mgr W W" MR; Ypperq dlNnfOOMI, IeL bung o eNn
(sump pump) w w. WX and vmgdede Mareir', gwUne, times horki C meal says; me "; or Oh proeucP'.
pernudee; remmry Mil lampne: and show mflaner blame.
ABANDONMENT
WMn he PO%WS IOR enebrla pmmmeml mat Mof emlm Me bllMng ebpe ebell M lawn b InEup IMf Me eylem b pmpajd
OR safety abandoned M a pllmX xM cbapbr Cwnm yal Wlmner, MminRhNw COMI
• All plprq WlarFe c'Itl pm MYl ae alamnneaedeM MeeMntloned ppaopeNny awbd.
Thl, M rmeu sense and pea YUll hmnwee and pmpMalepoW Way a BepY9e$0mhg C"MWarmi .
Allb penpNp, ellsptle mmeeM ate enell p exuvelee Me IBTrved ar tlbp raven 2rtwvM ane th wW ws'n flMetl WI WI)
¢.arnwr Ih M nrl.
Cif Me P SITS PLAN
If pi p ntw kl4 aM cannot Me mplrM iM lolloxin0 measurer men Sven, or moat M bkeM1 b Praha a mde wmpbpm
mplammAmeyadm:
1] A ewiffill
Optimal
ra l.c ww arc. Me been Cmdf MYated
may be and cobr phrn and W . rybmmxit mu l pewplba rywtln.
The nplaOn M area and
pro be sal Wulw hoot bhlwMnw and all to ma Awed M be IWnq.e ups t h aneed
Ne Imm and CIA eM panted a Uh alai fundamental repl. Pollute to pMadMrepH¢menl eieevNireautl IniM need
dot It Ml and nlle ewluaYm is mkeMM1 a aulddlereplcemrnl ems. fteplmpaml MNme mun mmplywXb Ina mleq In
0 Olt it"
A WMW MMemmme Me nor MIa Am to aeNaG anebr soli Itrameom. MOOD Mwnmrin POINTS IMWVa
IWding uM may W ImuwM to a has rtevnm rep earn In. fled PQY RS
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1bWARHIl
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL DABBER MMR INSUFACIEHT C%Y N. DO
ENTER A SEPTIC, PUMP OR OTHER THE MEW TANK UNDER MY CIRCUMSTANOES. DEATANAYRMIULT. AWCUEC. A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSI
Po 5NETALLER
POWTB M/dMNNER
s
Phl JA
�
Phone
TCTrau
sooner
LU OLRE00t Y^IIHORRY
Name
add
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MCCOMU (l)MNm
End Us MCI) A g ul. wm•m MnNWmefie•
0tt)ic9
ST. CROIK cOumv
SHP= TANK MAINTENANCE AOREEMENI
AND
OWNERSHIP CERTIFICATION FORM
Own¢/Buyer F/Lex� $C�/
Meiling Addrow��T Y✓� 121/'L�/i /—
Pmpmty Addcws
(VmdF TcwJRtd&Zm Dgw9amtrmoz,IV wn)
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I,RGAL DESCRiP'ftON
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SDbdivisioe #
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SYSTEM KAINMANCE ANDo OWNERCERTIFICATION
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Catificauon Ooo g that ym¢ septic ay4m hu L memmna N mum be conpletoivvdmOmed to WS A Q GuoY Pkn ias&
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(REV.gw
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I havg/inspected the septic tank presently
serving the �� Ly--{,��TJ—� residence located at:
,jLt%4, �✓ Section 3rL q2� N, R—L2—w, Town of
Upon inspection, I certify that I have found
the tank and baffles to be in good condition, and it appears to be
functioning properly.
vast time serviced: A6Y(61�U+Ri C/`V I G
Did flaw back 0c cum froabsorption system?
Yes � No (If no, skip next line)
Approximate volume or length of time: gallons pinites `
capacity�/Vzm-T7
Construction: Prefab Concrete J` Steel Other /
Manufacturer (If known): �/au�', . ��✓
AACfk /L (If known):yk4sgd. /1
L /(
gnature) (Name) Please print
/4do25— zz�yw
(Title) (License Number)
faregate
Form to be completed by licensed plumber (s.145.06, Wisconsin
Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative
Code)
_ _
Plumber (applying for sanitary permit) Certification:
In accepting the above statement regarding existing septic tank
condition, I certify that the tank to th best of my knowledge will
conform to the `eq ements of ILNR 8] in. Adm. Code (except for
inspecti Opens war outlet baffl
Name n Signata MP/MPRS —
CST-e2a 19-605
LPN 092019 0
a m4ad Gonn.mSOIL EVALUATION S �F ORT P.e.—m_
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CST Name (Please Print) CST Number
Bird Plumbing, Inc. Shaun BIM 226800
Audi
win Bwmmm�ennendaa luepmna xene.�
14321201b 51, New Richmond, W154017 715 2464516
IIIPrt---pnl Omner_ IID# Page _p_
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need ms¢nal in an h,male fomur, plwe [mun rte dryamnenr It 606E66-3151 ar l W&364-8PI.
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Soil Test Plot Pla
Project Name Eleanor Schitgen Tmst
Sh Bird
Address 6895 Rosemary Rd
Eden Prairie Mn 55346
#226900
Lot ------ Subdivision --------
D 1/3/18
SW 114 NW 1/4S 32 T 28 N/R17 W
Township Pleasant Valley
❑ Boring Q Well PL Property Line
County ST. CROIX
kk BM or Vats Assume Elevation 100 ft.
Top of garage foundation
System Elevation TBD 'HRPSame
as Benchmark
Cty Rd M
Scale is 1" = 40' Property Line
unless otherwise
noted 120
exisdog3
Bed oom
40 Acre Pemei Haie
ST
Shed
B M.*
too'
92.5'
0 B - 11 9L5'
4%Slope
Area of poor A + 0 soils
/ B-3
e 4jN'/ l