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HomeMy WebLinkAbout040-1235-70-000 (2)crar sxmm e.ueme onus. Fe PRIVATE SEWAGE SYSTEM MPI.n St Cr01X INSPECTION REPORT SWI GENERAL INFORMATION (ATTACH TO PERMIT) 615498 n.la^n¢ un r u p. tnwTlJosh M�M Kimberly 0 Cowen TOWNOFTROYFeel TAN -70-000lTo exowsor_&UPI Sand6 77 NI 19 1103 TANK INFORMATION POPE MAuusnL-NxFA GwALnv ___..... _PARB as EF Mtil ///. d(x Tpemp ;<SA�, ;Li,µ NoTANK SETBACK INFORMATION L 9f 0 TANKTO PC AN SLOG Ar,1Aminzl of si 7z r3 — ! (i 1L mxng e.,,N,n on new DIt Pope BOI Styr Sr.I PUMPSIPHOM INFORMATION GPM"' sl ce li... �a /. 97.99 — x.6 90 6 Fl — B9 905 es STEM at. pxs; ,..xm nx Nos wEu I uKErsTR n1/,�EAMcm UNIT Wagner DISTRIBUTION SYSTEM 3u0411. 9}9_ /; lWair SOILCOVER I PM&SUM EdwardsI nn Oral um,0 my ,alCo. q wry' TmuPAN. vie i � . e,5 1 No - COMMENTS TAIM wealeueunun pri Poll on Local WaeLLeea o I Url Eu Be one,- 664� 21 nwu rn Yox,eer-�yi5�/ -Iin ..y e Uner elxde Oreempna�r�n saon III�IX NoI Use 19� Peps Xl Igpepllans as 4nS J �� 3� A - — ✓ll'oiol �c Sr.eRo1F o 24 ZM9 wwew.=.w a }n Sanita FcXmi�=Appllimion 1e°' y in K/me D COWU py0-I z3S �-Ooo 533tIc13&<F go n3 04i4b504 0/lp Z9 K 6 i]'IaJa7 VY�1 T i�N l�l X 1P1. .�...-r.-wr.r 3 cats 46 C04h Owx�wi-omaw Otirr ❑y.y�w+_pmr� � Ow�r 2 U' EZ FI Hxw _.'rgpy m rw r..re ..yw �r.wr uv... s.wmw ❑r..� w/r.w>,w o,�-w.nmu.e....w.mw.ue ooe.�.sr.»r,/ww ry oaua. 5 D.b � , Y9I qt vo.a � W.�a avw/a CCpp Y� y eeee I IESBC I m ars�r � rrron�rwr.r.r� n-& 100 IN30 -715/I ZW �rzeu/ 2H5 C.T.H..SS Rllti( FA /,�S GC m ❑ of r+. IX MYrwwr _"+LS u per.v�aµmn WMe •m 14�MM�glr. rt •�. .Y.6/^:MEbl1 xwor/. mw PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet ca,wns,xw 1=W(Nn rwrw.nsa: Vsebn 2 p. Sa0.10105-P M MNt, R.1d13) Pg 1 of 4 Index 8 Cover Sheet Pg2of4 Plot Plan Pg 3 of 4 Dispersal Area Cross -Section & Plan View P9404 Management Plan AttwAwnenb: ms FiLW sR POWS Appl"UM for Review STEI s Sal Evatuaaon ROW & Sts Map E W s e E VInL15 5 A < R [K ewuF%P 14 1@a Nana I Mwdpdm o.mw Mema(4/: Taw/Af VMeMrD tnWEAJ owner ww4reps: 533 [[[m.T RO.. F/UOSUAI 2b: 3/0[b P[otett A40R4: E 6ovL lat=_<E 1Md 5W 1M.Se 633 T-ZLNR-11.E❑vW To p: -FKaY Crory: 4 (Wix praleet Penal Ok 010-1Z35-70-000 CaalVwr lYrea: AAww I-HueeC Paaw: 215-a j.- DrlpwAe4raa:28491 K.Uw AK1H � CI Ox9 V Eynwl: Moll d+�dcs an�ni.+InoK.Cu+� 4aenaa pumMr. 8S1-nel Rwrarlw: �/`LQ CCc!'t/S7�j�v{/,,. PAGE 1 OF 4 In -Ground Gravity Plan Index & Cover Sheet o x yneme nfen„a Demon Resum e vemlon 20,S 10i M0101, R. 1W121 Pg 1 of 4 Index & Cover Sheet Pg 2 of 4 Plot Plan Pg 3 of 4 DispengW Area Cross -Section & Plan Yaev Pg 4 of 4 Management Plan Erclosu a Oeeer naprelly TC�H diF k4bW n /'jerk' Pnmra:==_ Ow rAOprpa: 533 feL6FKr RO /-) D /j zip: pragmSAtlER6a: (S E) Gov Lint se 1mcf 5WO 1I4,Sectern T-ZL"-A-E❑NW® Tnr✓nehip: TROY cma4Y: 4GR0/Jf Pryectp*rmwiM� 044'1235-70-060 Daslgrer lydormadon pwrgnm twee: N1 M� S,+iuff r Pnprre: DaN9nerAWrasa: 2249 K�Je AK C4 Ou1R R� add Eirma: hall'��des ein G.. n.+ImK.eom rn Llunaa nlrealat BSA-o0� 1 / n� , //X �f �a PLOT PLAN Bp.�.J�•� LOT 9p co"T,7 wo$ 1 ez 8c SIDEWIM D60. k1sw 4NcDY q*� IAFI110.Alpll (,IlAh6ll. EL. 91.3� -T�z L&F 70SN•KIN COWAN Y ly a a �Y � Yb rv, 3 � Y � d.ca � • N•^ e4fLL tp 75 A en T. &*K 91Pe EL loe.o' S,.IG 4o' l—^ It Qa a -- IN -GROUND GRAVITY DISPERSAL AREA Hdim Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down -sizing credit) riionii+ e IL�Ii�: _:� != Now (No Scale) TYPICAL TRENCH Ieo.Imme dlNNlwwxe a�x..w+m qm W+l Ew ai3(NG leek TSN(s) owmw�o=�r1 IN rlwk 9s/ s.ek Tmlll•)Me..(.r Aboi G l mmAxrrnK l Fftw•.k+: lu m,.✓. L,IFs£R Fly" eA.V(3T O RVAMNN PIPE OETNL mmow 4*FW Flow solow PLAN VI I•e :,.., (No Scale) Pe11aeW Lawral _ •PBuMl /D fl iIYCKIII ",U(:UA�m INSTALL PER TRENCH 9qp, dl LLIIB� q 10-fl NunleseaflREIENW•y�fY IKF/Or=/fC=L-� (rMgl�blymv kel %// I.CFIYYE WrwM m mxvruuma Xxbmla� 1 � iflWMes®]6k E6VwX•�IP [213A 43 IrM lranimm Ar. Q00 Y oYo n Meelod: . PrnWM PL44IMr IerIIT•M � MW y AIIIIIIIIIIlLIFILa hW 13.K IN -GROUND GRAVITY DISPERSAL AREA""'""""" M IDWE5TEKi 4iilisrm Elevation Trenches with EZ12O3HP Bundles 3-R Trench (down -sizing credit) ^,w TaI eINA.,.a. y222 pe —"1 —.al _, ADDIA elN.nl^No.u..o•a 1 l Rka.LK I nei ..w.naru,xmN• 12Z m°"qe.. 1 TYPICAL TRENCH Abw/ . WJIF s FIL7AK GAV1d4EA� CROSS SECTION VIEW OBaEXVFMN ViE GEiul en••I:a.ae�-�27i1 P,wle. mnm"man •"d•••� M Yo se „�5:..�•� TYPICAL TRENCH 1"°"°�"'a°"°^^oawm.�d.,+.,....1 PLAN VIEW '^'•^^ "„e „^p � (No Scale) ^-e /0 Pala"I.J Ial" ,� _ 4 (la11:911 IMdI 14M 1 .• ..� •e..:.: ,. m..�.• A.3 c n > d1 In I• -- a..�� n w,.Nw+• �N � 4Y' tea, e LR: •Y r/�n INSTALL PER TRENCH. 9ao,'i0 ns.l�uo,T,l uEnstN�nl 0 q1a11 P.Jn O50MEu9/✓u+. J 5t n' ID'n/0 =IBL -L .usXV' m"e bl,�r..n"n+•mil -t 6a NnOesO %6k E18Nun.�n' (i).iw SY�IiE1tYF ' ��/.�J..4v�a...uar� . PmM.MEL4P {a'VNv.N. Y5: n' Wyulrt^Innll,Mon Ns. r� n' midlwwn MONW. L enncha^. PIMMS a TONI EISA" We, n' Aaaa Pls*rngrt/aV l3iS PAGE 4 OF 4 In -ground Gravity Management Plan IMPORTANT: The vanx d they"rpvd Sunni sry shadi pe revert inb for M1s Iprpetua oPorelKn and m nlenYKe ty151W11m requirement& of BPS 302361 Wpm Anrnn Cow Pursuam Is BPS 38352(2) Wow Adman "a his wall sMll W mnestal a human health narela If net maintained In occurrence With INS asp tided management plan Furinempre, en iruwcate and maintenance microwave span me wdr "ey a Mwl POINTS Metabolism to Accordance wom SPS 33352131 Wlsc Mnvn CCAn Maximum Dispersal Awe OcoMina L mft Daslgn Flow a 450 yPy, BOD, 5 2M mi TSS 5150 mpL'; FOG 5 30 up" Inso on Chercip INSPECT EVERY 3 YEARS type a use ag a a m ae almalf U e odmeusammaann arc) meaunulmif e. mBe,pampa, Whose, mercuric, Iloele, ahj a mxla ffatigueelooks breaxa, mrrc..m, am) e iwor ilpi use Vasa ngadveaManYal parmappunarlama er ire tll9rimuroon/trm myeel M21ac1aimgoper re tie rsca6ana 0o Wo wawnma&.Itmnialee aavNn.elct • etl&n M panarg In tlisnWfion inn pli« lir &bane • ground lrl comarones-n if marslah a wnwrg promonmiswddhaps aaa oat • electrical r al�rm nl& lateral plugging Wrong con ns, a preir mm coasts to , agency, ek.1 asmdaon lethal or lalerY diF plugging (measure Memel Baal preswra mmfaelo OeaBn eppfc¢pm) o amnaw discharge aani,emmwwaea backupinto mniwra aerww gMMnance Cheoxllat MAINTAIN EVERY 3 YEARS (or when necosa ) 8eonc and dose Wnxlel Shall AS punpM by a owned septege vertical sprelm liwne under &28108 Wos o Slats When the voume of sai In metanxlej Small Woodall (113) me Seem volume of this bMM)or as rqutra]ryto lordmrirs Ds lofcontentsstallaepe ,tWNRt13,Wiw Aaron Coda. EMuadRlb ll5hallOiWtOMdnrB 3css antlatio tlear¢]wMn ne4ggary tO remove Yry mNmletl muds a¢oraig tO mmnN%tumisspttitkanons ANrvicrg pancr wall Mwey&be Bneler men l2 means System melMenana mp NS Nall No suamM So the appear local government unit In auordmew wine BPS 38355 WIsc "min Cade Report tiny corthop follunw rreNurrctlon to Name ainaov4uala company MIKERODEVVALD Pnoa. 715-425-6200 I government unit SIT CROIX COUNTY COMMONITY DEVELOPMENT Phone 715-386-4680 Local gcvwrment ern wovew COURTHOUSE, HUDSON, WI Bob 54016 Any tlefectie part of Bay weem shall be moratreq replaced, W rorrmva] pursuant to BPS 33351(1). WIK Allah CMe. Repairorreplacementtitfabledormallur mingm mn%healmmplywm SPS3 .Nov Mmin CWe NO lxorket Ic craft or orwiscal ta3 bw W me PDWTS may by moved unless ygoww by me dayartrrbntn acm me wnh BPS 384, Wpm when CMe Criminal Plan In the event Nan any form usua nl warren tit of mis POWIS owned bandmaster n dull No Shawd document to e plan suburan to true apIXopraa agency for renew and approwel A(ailal inyround dispersal rnmmnenl may Ee abandoned and raplaW by a We -complying capnul control in a pre determined area of suitable was SMem AOBndonflwnt It use of this PowTS w downward, n shall be amararkal in mccorrariw wNi BPS MIS 33, 1 Pdmn Cale. :aO: YLLa::assa far_RVL: a.v3 n......... � � :.er a• n-a -f,Qa e�e'Ra vie �-i Too ' �NST4i L 4TION INS d:.. .. Air MAINTENANCE INS I RUCTIONS Us uve,.n eauvCmsa 1,.. :....: 4 • 0 r r all t'_y ,d:'K�Y�ii3 friteW rlV� '. DETAIL 13 Al TER CANISIEB DETAIL WAmuNG uaa mg NS Ras w AROWATE LOCAnCN SEE DETNIS, 1-2-] / rs• yy p' a CONCRETE SEALANTS TV � OR EQUAL FOR ALL JOINTS � / (SEE DETAL 5) k TOP VIEW WA EEL CRAN ZINC PLATED ppp LOCR SEE DETAILS. 1-3-3 CASt->-gAL t In ' CASE IN FITAR PL RR SEDETAIL A' [AST -A -SW %i I CAST IN MSE 5m � 'R a4 A C SIDEsREe* xo 1 � �1 INFILTRATOR • Nways da& I and Leeof i • Bundles are Quick to Ins[ill. sewrg m:'e or heary mmpnery arM labor, • Modular consLucton ahead conflgureLoro to march trench daranaarrs for mast system shapes end ores • Engineered for optimal storage and absoryton ega,,ea • Pbntly b cord"' mealy shinier situ and around deed m tu,d5,4, • bghtweent system IS ceded for reCaus aM"2he sees • Easily hand earned into IsosiLm redocng tore arrb labor • 5or 10' lengths vnM ample snap, Internal couplers • Easier :s anup at the sob site xM the elimination of stone • Mamifadumd from mycled matenate rather than a mmM naNrat tesourra. • A vide vane] of diameters are cohnguratons to mad am irstellallon pmteii s rieeda • Pppreved In many tnnonshx-s mih an mveaaM cfbcier¢y Iatng. Iejall draintield sn, • 13acxea %'tire Ieade, m the Chine wastewater. hill EZI her t l'Ohir 12®efenq tneWlal inalnrNprra Of Cuatc mer MmCq Call Infiltrator $ypo-ru W I (Ane7'neV. _a �o„r_..r. • Bundles a _ our-. _ ,"a S, at _3,.a.,r- .4oe�an. vnh. .c _ eFc L gntwet t K er to eoar,an ,ienoc=tee e • Eas and car,iet imc �namon re_ -- _ n_ ITT, d n_ c le v —c r_ e r _ _ _ 10 1A EZI'. . FM1 teCllayl es6r5[aTe rnyGllaSon lnshuWofrs M cu3tUT[, Yrvrm. Cdll iMrI4Ctar SMMS at ttOO 69.1755 Uflou? by INFILTRATOR I, 9^GY PIpe Aabms fIwIZOnMI$�glq 09G1P-GEO I'X1IVGEO 0705H-GEU lW -GEO 1NI3n-GEO I:V,9H GE0 �01P1££0 MILPP-GEO 09oaH-GEO TIXG GEO lM3HP- 1001PGE0 1401P-UG GEO 13J3H-GEO '00]li-GEO Ixy1H-GEO Ip5H-GEC I40"tH GE0 iC01 LPP-GEO Varbcy F 10(✓N-GEG 005Y-GEO-GEG "ACV -GEC iSv+Wti t003✓GEO t',O'N- 1?GEC IOOGi.GEO 'Gp31-GEO GEO -'.I(11iGE0 t006V-GF.0 12p'{y.GE0 luply-GEO �SaEG i sum.aemu..meu.umn..an..n...,.oip,m,r xm, r. iu.u.r.m.. a b' u � my ue w.mme mss� r�igw . no.e�ar..en m.we'w. INFILTRATOR' Cq SWAY, R rri!'3 .,........,._.......,-'... _:..µ...TA. 11 1ea5 Fev nse .. :._.. w... ,._...._._......__.r. www.mnMP.com ,._�., .___. ......._..... _..._._�, _,.,._„._ www.mnnrnar.vn.m..cam Far hcMbl .a no , in� Inalruglpu w cu. or earvic., cell Infl a4 r $ Ss MS et Bp0.699 7759. -' 48 "o w i 49 RI JI it LOT 20 ASCM. E^ R .- Hms" Wl- ]M1•n. • 761 50 fi 45 se21 su r. Y _�II xfii n Ea-E 6 66' I J NSO I �xi-I �46 L I I / 47 \ 48 110.E6i 60 i EE / 49 00; 23 c! N'N I LOT zz sl _ 8 ZI � CI _�_ 21 sYw.m amYN•4mnm PRIVATE SEWAOESYSTEM INSPECTION REPORT GENEEULINFONMATION (ATTACH TO PERMIT) �T✓ma�W en+m�mbwpwinymumb ®myRaparyn.aey sp NXmIL LVMM1SO e6 KIM TANKINFORMATION ELEVATION DATA °°''6T. :e.mg a 3 u.n, uKi TYPE MgNVEgRURER WAOTY STATNNI RS IS ELEV WP4< Poa •.Mn /allg / DRIn 6ae4en Bb9 Saa'er lidding ®lE InIR ti q/. 9a s TANK SMACK INFORMATION t WOUJet TANKTO PIL WELL BLW a ROAD Ol inlet SeP4t N' XA Ol Bottom DRrng NA Wederl Man Matum XA Dist Rge Xddrrq Bm swom PUMP/MPIION WFORMAl10N Af Fwl6atle '/ MmulNWrn [Romm CREW11 � Mo r) Z Ll maim s r T4x It ERRmaln I Lm • q Tm RT I uKEISTKEw rµ Ml•AIX SYSTEM TO POIL I BLDG WELL 1MEMMpTNR1 I urA'wl Y' 34' /J AMM# OISTRIBOTIONSYSTEM Yw ..rn 1� w nn<'!S o.. L' +o.w •IicN...� SOILCOVER .[Pressure systems Only u MRek Orpt6nMSlstems Only wwna.., oo hn ntw.. < o.�m aw n..'noxe COMMENTS: IMaude Wded[Kr me paowflrwnt.et<1 WO TION: TROT 3.211 TSB�9N 5D GII9ERT ROM - COUNHLYNOOD W 66 C-X>WaAt K'w iAsf;iy" 2* In4�-+:ems RanmrYme .we res or XO VNOIxerYde lw MdivaW InlRny4m $IQIrOIRYI/I aynweyYye %.I ay'y�� S= 9RRN,�e1Fi°'^ SOIL AND SITE EVALUATION REPORT Midi 3 PMmm�elYYYa Bali In amom v1161LRR AS 03. Wb Mm CMe Q Atledl m�Nlmawle pmmnRmmr vd lambmA IN xilpicm In We Ran rmommLL, yI MYmiMblwMaind M1nmvY vlmmv pv RN, dmmonaml%W WW/eaYv d,xmaM mNnw.utllmnm.M Wnb An.uM ptl ( APPLICANT INFORMATION -PLEASE PRINT ALL INFORMATION I� to Croix PASULL YIN n lL mvElnrawwl PI cTa[d Stout FIW EIRYQN{R8 YVLMIMRFM 1353 Bratukae T[3. rRm Laun u GOT Law wd3 l' 20 .RR 19 SNIP Loal 6 a. PJO QjLV Wood BIAR aG GCE RSNENJ WR Nudaov NI. 54016 Q151549-6731 L kI RY CveavDv Li R®Ydbllanwamnms 3 I AEdRebmgNuiE I i Redl®Im+ A I R ffl mW m CWL ya/M 450 Me Mbmeaw ampr taided .5 W.N4R_6aM.(LgAR aEvMsIePRLR 900 bed b'Tm LM b' wFamdwPbaY9Ge.�5_LN.R4P2��RMYNE IammPdJ min Waves "Pace {al 91.1fi Cle iaMYbOGn GenYy M1bY iftmaY —alt. Aire, 90.36• matr el Paw nW wtreM ftMYaaN.'4YVdMttlY m R "asu uouBs01os 5 $so mo❑smus ` AyN YN SOIL Ibnon BKaI OmnaR Cobs WM Laac Or&Cu[Cgv TAM Bbwbn O6a Bn Ca�IG Boamz lb[y OPDJmZ gb 1 li 1 2 1 2m1 b[r If .5 .6 2 11-25 10r 4 .Ip tittle mfr I[ .2 .3 3 5-34 1 [tl4 c2 ZS [5 0 Laid 4 34-Ed 10 4 1[e I®lk M[ IS Sells .6 BOIng A ll I r2/2 none, 21,S1t Lair de, if .51.6 ®I 22 IT-D 1Dyr4/4 mlu 2pet mzr pz if S 0eeN 3 -36 1 r9 4 el 2Gtk mfr .6 4 36-84 10yW6 Tona Ire IN.5 .5 -� 4 anq m[[oa _ Caeb LION Pm�m�la amatilYegYII Cary L. stal RM1mr TI i246-6Xq 6PYle 200tnLamd, k. 5_401T W2298 We N item. -24-56 SOIL AND SITE EVALUATION REPORT Po1d� Dr...ISNPr%+aw In aoxo mm, axRx b ••vr..�m'P�drtr� Nm812[il imM ✓. va Wnmp'xiin hr w+ fRt9, aim. w x d a+wlsyr u Croix DM�.V. 6•�r1 ma mm W bNw.atl6Mmcsb rex® m�1 APPLICANT INFORRATON-PLEASE PRINT ALL INFORMATION PONRrr pRER FN6 IaA�ON Rvctvard 5couc WSAL v455 T' 28 A.P 19 JVIN PRJFFAfYONNERSNALIetnTrl. 1353 Rracukee Yrl. Iplt VIIF� q6 < ypp W1E �qWE Mood Gtt, NuSEAT dPLPKXE 549AP xI. 54016 7151549fi]31 XFAIE9TgWdaon i Yotxp W. KI PAY GomLKLm II®IN Pvam Numbxobmxoww 3 llwdsnnwlM wap I IPowwow I I Pud<ammremil oavOz G6Ev6W dr/M1w.' 450 Od Pa9nnMphgilyN�! .5 h9.9WN-'_6tTYn� 9�d ARapMNvnOAN] W W12750 VenN T' LN.mm A.P�ryNOri .5 M,9R=Al2�Prft'I'nn- 0.mmaVN1�l11xiuv6vNNii{:I 5 l nil. n•nNeYa FNa�'W�W� b9b�PA®>t: dNaremNoe ait. a s=690 36• eretm Al. P.sl mtlea ounaffih RW pPa NnabvA#ra<=na R wr�g :'.J�rq t4� Ei a 3a SS LJRvx IDS OU 05 ®u . 05 mu 79. ORKnu PAN 94.X DEEP A DY EbbNR 13 DRAWN AN %.68 IL CIPI +84•• SOIL DESCRIPTION REPORT � OION in Dinunm Color MNc T9aWn SWASW wolsell a SeytGb Of 4 S Cp68m BanMF RyO GPD/ Be] mmilml l it 1 [2/2 none 2o¢ix &Sr if .5 .6 2 11-25 1 r4/9 Ai lfm4 mfr if .21.J 3 25-34 1 [5 9 c2 T.5 r5 8 e1d m ox gw CIA nplm- 4 J4-80 10 4 4 ncffa Ifs trslk mvfr na na .5 .6 I m 1 1T 1 V2 rme 1 2 Sbk nor :f .5 .6 2 1]-27 _ Lpyr4/4 aicl 2®M Air ev If 4 .5 3 27-M 1 4 ' Dow al 2 Ux: Mr 4 J6-R9 beN/6 Ifa Ge9 Mr na ul 51.6 RwTub wra-RUMn L. S[eel P.w ]1i246di00 2ro[8., a Rltl'oiJ, v1. W17 110229R SNdrrr Da, fBt Nry 4-2496 STEEL'S SOR. SERVICE GaryL Stcel 155,E A� CSTM2 PSGaN sTw6 Mew RMmm W W11 MPRSYJ3350 SEASWA , (715)2b W y loG %46-C mEry' SM3 N 1.M , BYtcp of 1• v l Pfle a el. Im. y T �2 T k i ( y o5� ll P Vey, ro i e- zr Gry L. SCeel 43456 STEEL'S SOIL SERVICE Cn L Ssl 1554 Am (;y'IIR2gA R1da[C siwc 1b/IhlIIIIUX1. W W17 MPRSVJ3251 SE�M6 p 59�-TLBN-AtWtown (7 5)2W W y lot #q6�Cry Nro9 N ucCcp of 1• ¢teQl pi{¢ ®el. 1W' dry G 5 4-34-56 ST. CROIX COUNTY ZONING OFFICE CKRTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose teak Presently saving the following residence: (Streaaddsess) 535 KMO lOCated at 5E Y., SW Y., Safion cJ Town zp N, Rmge / W, Town of St. Croix County Wisconsin. Upon inspection, I certify that I have found de mdc(s), m the beat of my knowledge, will conform m the sequireoarm of SPS. 384.25, end it (they) appear(s) to be function ng properly. Did flow lack occur from absorpdm system? Yea No (if no, skip noun; line.) Approximate volmne or lmgW of time- gallons_ minutes Tank Capacity IDCD Construction: Prefab Concrete k Steel Other M®rJacmer (iflaown). "Aursaw pl' Si Aga err teak Qfktgwa): Paca (if we) ;laFg 1 rE Rww o.� ioe sed Plumber Signature) (print Name) (Title) Q.iomae Numbeo wrmPRS C7-zo. wq (Date) Form to be completed by license! plumber (Dept of Safety end prole ed and Servmes Chapter 305 and s. 145.06, Wisconsin Statutes) or bcaued disposer (NR 113 Wiscomin Administrative Code) Rev.=012 ST. CROIX COUNTY TONING OFFICE CERTIFICATION STATEMENT FOR U nLIZ TION OF EXISMG SEPTIC TANKS) Thu is in certify thin I have inspected the "ishng septic arid/or dose tank presently saving the following residence: (%iedaddreis) S35 (9tLg� zL located at 5E v., �J v., Section cs , Town z4 N, Range H W, Town of Tl(dV , St Cmix Cowry Wisconsin. Lipon mapection, l cerbfY that I have found the unk(s), to the best of my knowledge, wtll conform to the teauirmants of SPS. 384.25, aid it (they) appears) to be funerioning properly. Most man dale of inspection m service Did flow back aceur from absorption system? Yes_ No (if ter, skip next line.) Approximate volume or length oftime:_gallona minutes Tank Capacity -0ca_ Construction: Prefab Concrete X Steel Oyta of knwri a—srg9 FYF sf Age Tank Age of Tank (if wn): py_ Perini v(if own) 3r54R8 ? tt c Ram A icenaed Plumber Signwee) (print Name) FLALA&r2 95I3sy it e) (License Martial hf/MPRS Mae) form to be completed by licensed plumber (Dept of Safety and Professional Servrcas Chapter 305 and s. 145 05, W swnam StaNtes) or licereed disposer (NR 113 W aeonsm AMtinialmtive Code) Rev. M012 ST CROIX COUNTY SEPTIC fANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer M514 It Yncett cebop&rd Ma111nC Addrm - N m9 FY 1 S{Lan. s Dsit: May b Propeny Addmm 533 G Ib .� folocia lvvlrc.lral inform rim Pinola Dg neat tw now emw¢lmn) 1 Cly5lme N&iya l,� 5016 Parcel ldenuGcatwn Numbs D{'O-I g -�)O L .NDJE!3CRIPTION Propi Locanou L, 5w, A, See j_, Ta7iEl-N-R1�W, Town of 22e4 Sulnllvisnon jpN'b b wta4( CertiBrd Snrvey Mao p,Volume — Pay[ Warranty Deed p l556A `32. vohnme M& plan 341 5p r M1onal O yes W' Lol byes rdeatGab4 Ergs ❑ an SX5TEM MAINTENANCE tou,u If mnrnperu umlm kelvin wldr if in stow lure ee it wo sin Well lh Nmlfw of We �mvow si nk a baronnow ,• I rat nf� der lua tprmpe WM rw psi into ye.ye� rrylr spBe�ld.e dlgmJ rysrcm Ific prmerly nrwncr nareni to nrbnnl l0 51 Cmnv Lonna Deymw a r cemfcenw film, egmi by Ile your aid by a un pinnnlrcrn111 ncy^nen robot re lent plonnb,me Lcenmdpmrryer ren(Pna tint C l Ile o, ne, emkrduldlryatw n probe oM,nog'mdWbn.aww M e0o ib,Il aM bumOm6 Gf vzitiay), file Spite Yrkn be, Wu in full of stadia, 11" 11' "oellaned bile lead Ibe strove renmlmnlltl..d agrt to owner 4k prtv.rt tevye tivpowl ry min wbh Oe aabLrN at fall al Is vl by the Deybnenl Of Om tiorme am the Depum¢m of Nlo ml Rowena Sol, of W nwvm Cenlfwnon inlet Iba pw I'M"'Yam, by, hen notarial melt to mmplod ails yu nil to Ile 51. Cmu C y dainty Dlba enhuM deal If the throe yen ¢pmWo any, GNA A I n 6 dnr4A M DATE G d1K)amly pan Ill by vimnoninnmraee lemonenloofelf taut,owladtle Offim. l(a<).m (am)we o.aalU sip n`e rrnr+nr aamrnhe.eova, by Ynmu or...tmmr this reomm na Raynan at ease. arra zc, f GNA F P IC a DAl'E ••ease Any 4 at nl ttmietare�netl may tvhb m the simply final being pooled by the Zinnia RpeblRm...... '• insert[ was Ihb blind...ilan r rallied wbaoy dad fmm the Rainer M Deed[ Mice e rnpr of bw looped swvel nap if refieoa a ,d, be no.wwy hm '1 2353P 130 St. Croix County Occupancy AMdoWt K,r. QcrW'D. Ce �o Nunn-(O r)Type mPM1 MCq MY �'nvrn . Mpu. uq�r aPN. tl W `/ 734433 �id�y Un=mH. r B MIMM a a. R. oon m41 yl M. MUM m� M/Y/i Mtb&N YTIWYIT pW I RK M, Il.r PYii: I P : le U Fre# Add:#�onl _.. Is fta P"U&4 0003 r rrerr :urY�Mllrm�v. Yrl� Mrrslwmswee•nw yp�]OSG..