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HomeMy WebLinkAbout020-1376-27-050rte PRIVATE SEWAGE SYSTEM w..M1. St. CIO)% EASE Al ewm.e a.ao. INSPECTION REPORT AGNIEvxo. 61]]20 GENERAL INFORMATION IATTACR TO PERMIT) Pieao No. Parrynal inforeation you provide U at be used for recandes aegFLACY Los 6,s oe plpnO cm nlno< eTAPE' ex SWeetgraasePTOPerties LLC (RIChard %I TOWIIN OF HUDSON 020-13]6-2]-060 LA sx end n e�l 2 e o�nrun p 1429 10 2288A T dF �l IR.v� TANK INFORMATION ELEVATION DATA TyPE )MANUFACTURER GPPOITY STATION BB I HI I P6 SEEM. X We At R Bldg. sAde mains IlnsuM0TANTBETBACK INFORMATION S .NTANK M�L BLBO. vegrwgl nu O 6el kl\41 Briu >ZCS /9L j3 _ DEBO ��n 2ex9e.oUnit P, AAC 93.9 PUMPISIPHON INFORMATION ..... Ireee 3` ,mmar GPM Bl Ce.A 9B, / tonsilNTZ LMOA Fly UICE AFuell SOIL ABSORPTION SYSTEM Ps BLN WE/d81 ,axT�ki.N:Mw.1.,o,Q, IN :ET"CK , 4D UNIT - 5h DISTRIBUTION SYSTEM eepMeekp PoI HISo•omd y oeul�� �sgeem Ll An An SOILCOVER ea5vauma OnN oepnwe^ nu� «eee An Moric..,. F$ eeo.r �I �ended Gxo a ❑xo des COMMENTS: III wee OPLOPPncea. person¢ pnunt At mepeate 1 ''1 peis a LOCO" 885 ERASER LN ptl'J>WQ. ,nbYa,i n I)AveMBG"i,p 2raleg e�leAgen_ E+�eYlSyek...L ie eau. ijedi III-eoll /V ref m Iw. e( � h�� < , uIA, reap Rro',�denm�mde,n� 'lld I24 19 6 w,. END M,p,R s,� L iGnf Mtn -Will -335 - Wu b.a�e9r Uirieun e«mn 201 W. W VMuelavAw l O a171Q & Crux i/�/�ar s4Vnsin Mwaiwe. WI�YOY-;1Q F1M /maleW (5nk1T ' i77ZO De 8rnrent OfenMMOna Sanitary Permit Apolica aa, ve.I D rvem m.�Mwucw„m W1. Aemc�M in1 .. Pmm �P ) �¢/�.aere„ 6'91M A. 111119 Wear/ �s 885 Fraser Lane mmm�ma eMmmnw ..,1aw 11im) APM9ae1lelem..admo=P w Frill All marMfim - EF..1aAa.,,e.x.m IH7rom Su e114 /1.LOLi 08 2019 DAO-137G-27 ro2 ✓ vmre,n w,ae me. me Aae.� 1au.a I .29. .12 H �NWM IM3 AnMell Trad ✓.NiEiw 14 ce.sur, Hudson WI 60016 ]16649b]31 29 lgama T N.e It. IYPe`f1uWu8febee4ell rEW,ply) n ' p1w M - m.m, 14.Ofd 5.6u„pan Neme lbM NumEe iblMiimO NumMrM a 9wrel GreaW] Fa ran ❑eve,.cm.mand-oe,aeus � ❑suuomet-ees,m um Ml+'nem O'rmmmpm ewrm � H. nPeoranow:(Ch raw:,wr1 TMMxrfHaJeng Tank RAwcIwao" [ ounMMr..aa,in;.s:rM� a [M oN,ma xa.e..n Oche ova,. , aN tl`g7a3MMIjae Me/io H raPar .1nd1. N 0 N�.ry u 0 IAM 12432 eIaMar Il 0MwM. e.,oii oArG,M osimi. lass um ema o ,�..� Ae [Han [Pm [Arm m� [.M�.a,WmsaF.„o [ mw iM w e.x �rn1a u mPOHap mwem�se m.MMW [1a. Ma0C. Mimeo lmMMewiaw v wMlA 1Apoli F Ia r BM M weWN mw®IAMae. p0 Duerr 0p svm ME1,M1on 900 7 12857 12918m®1(�90,Y 95.61 VI. Tank InE nufewrer M,, i, ftrl Clcxar rMtNnaTa ✓� Tla abirn Seelar l-L,a,uMenye.a.—...emvo.wnnr^.1.1. .MpN w � Ke1l11 Hatlngs P2I05] ]166]9-2058 .z e J nssChilrarela 105 Street Ced W1 54I2] VIIIS" NA'amaaatreel vale�eae rm am eel Cw Oe 6"ma�.k1 n.aMarm..a,.,�r mq ua !ve pp LI 1x. cnuailmeenuPOME e. forOluPomval 1 1. Slow, m "'k M i ,u:x 3. Af Vaelk,m'mcertamv.l uv renEA as law ap(sr2laotl: /011Tw.:. SH[-6348 (R.01103) Richard Stout Lot Z] Sweet Grass Farm NW NW 14 39N 19W Hudson Township ASTM r" PVC St. Croix County Diversion Valve p Benchmark is Grade at PVC Set By Designer E1. 100' BE = 95.6' or Lane Scale 1'=40' rn 965 o Ex 6 SR Duplex A100 1 pir�#Ajlr G 64 r�Qve All vens£"serabti an tripes tob Otherpiping . ITMII to be 4" p.TM Ii1 3U34 �I �I Me 3 Sotba • 1315' I I tIt . hu "1Coh'r +600' Private Onsite Wastewater Treatment System Title and Index Page project Name: Stout 6 BR replac irm Owners Names Richard Stout Owner's Address: 1353 Analukee Trail Hudson, WI M016 715 541L6731 Legal Description: NW NW 1429N 19W Municipality: QTown, ❑ Village, O City of .Hudson.,. County: St Gmix - SubdivisionN Sweet Grass Farm Lot Number: 2] Block Number: Parcel I.D. Number: 020-1376-21.000 Pagel Tire and Index Page y .0( �a Page 2 Site Plan S'•�J.,s + lf! as Page 3 Septic Tank Cross Section ftis.2LOT Page 4 Zabel A100 Filter y„h+b Page 5 Infiltrator 04W S Page Infiltrator D4W Specifications Page ] Cross Section, Plan View & Chamber Spedfications Page Management Plan Page 9 Management Plan Nameof Designer Lyc"Misionat Telephone Number: 215720-8352 License Number: D-1133 Date: 10-5-2019 Desmad Pursuam To The Following POWTS Component Manuals Add SPS3a31.33 InGroundSoil Absorption Component Manual SBD-10567-P (R 6199) NIA Page 1 of 9 Richard Stout Lot 27 Sweet Grass Farm NW NW 14 29N 19W Hudson Township 5t, Croix County ASTM 4" PVC Oj014 Diversion Valve p Benchmark is Grade at PVC et By Designer El. 100' $E 95.6' er Lane Scale 1"-40' f•14] FA100 6 BR Duplex 2000 Gallon Septic �.���{I.' G Tank By Wieser w/Zabe'i 11 i' Filter '�1t 'ltl/l� 64 Q4W infiltrators ''I' 1111 All vents and observation Pipes Ci to be ASTM Fe91 4" PVC .66' II'll All other piping to be 4" ASTM D3034 PVC 1111 30' Meets all BPS 383 Setbacks 1t 4, 11�11 I' 4 If if I /I a ll, +600' 151, flLMR AN BAFFLE <I — �II i x WkET SIDE n w TANK SPECIOCATIONS yz' 007W SEEM HIAVT SAW SA (Am "LOS) 4A SEAT A SNAALSCAT ER Mk ,,c.A* ou� BAFFIN AND i EASN, E°�aGo�. USED AN Nnawm 8 AS unu^TURArze xi TASK AM n lu �N 4./ly lVMl w 9wo- TANK IN UNION A� ,a a..uwf oM�«xENS EN)BwtIt PDL�DK.4 � Zabel lifters G- all O0 pit I,i Alto Filter 1/16" Filtration 8' and 12" Democrat This Nter named for larger homes, multelamily homes or light,mmemal sAtings whemmernaked flows or lugher quality refund is trimmed. The A100a Seven is noted to handle flow: am, from 1a)) to ROO GPD eal- Amble in tare, different howlhs d 'Ih, Al 0Tl28enere Installed inmere headed, from anyother Ntv on the market is Sad to handle flow rates firm 59W to 1[CW GPD, The Atop-12 Foresail, be used in a y,"Ieation. independent crowds, basshown the AnIhEZ series choreloor TES in by56W%and6 Insigny 'the Allei12 SomeFl fi ,dreble, an a and Mc wilablc 18,2fi aM 3T lengths The A10Tl2SeneaA avaJable in20", 9" d36 4mwdv. �.ou rimer A300 Filter 1/32" Filtration Pand 12" Diameter The finer 1/32" level of Fli o-ador adhered with ds A3W.e am mmkv Wn the parent fing�of uent filter for smau gem, hap sophistically, coke femrels, laundromats and other oppNmfod, where We suste dal solids or, premaThe AW shown affas flow mta of 17�7900 GPD_'I he A3uo42 forest personas 1/32' filtration and has men shown to room FOG by a muJ, as 5698% For A3UhlZ cedes offers flow stet of 3Wossai GPD. The A9tlJ-12us him mandfor carps waslerealef syskms which require omen level of rcmmal. Tre A3Walo""him "conlable N l2",26"and or Iammes They A300-12Same bIan is avail able In20",28"and 36"Imlow NTt 1600 Fiifer Atilt Filter 1/69" Flhadon 8-and 12" 6aner, _ Fee A600ia Ydeat nor specialty applkatmm where very foe flmoon is required and low flaws are exp"tad. Doe to fine, 1ioth level filtration every A600 comes equipped wife Son,ninflerk, switch and alarm. The SwuntilboolD vitshprovdmedication Iam q filter 'redrvics, filtration Mrawbuff,buff,ntel ukende mbl anal ism, _A ' [ a Y drops requial in die tank for proper S Fltett9 operation. Fee AWOSean" filth it available in l8'.26"and yrlocedo. The AW0.12 seems is available is 20", 28" and Ieddea. The, AYA offers flow rates betwcen 1000,4500 GPD. 1i1 �p a• a�t -I _amn I-Nr' 76; 9%; C QO%Ck4 INFILTRATOR The Quick4®Standard Chamber rryj— auil Series Buick4 Standard with MultiPort EndCap The Quicwls Standard Chamber The in a 36 wide trench and Is ideal far curved a straight systems. It features the patentpendingContour Swivel Connection" which permits turns up to f 5v, right or Ieft. The Multiioort-r anon allows multiple piping options and chromium pipe fittings. The chamber's four -font length pmvlthes optimal Installation ge hell . Chamber Benefits • Advances oamounng connections swivel up to 15. MI or aft • LaYning mechanism spends for ql Installation • Fast -foot mambas as easy to handle and irwlell • Tie QucW Standard ChumEaz concede wheel baits of te,UU Ibaaxb won only 12" of cover • Great by the lMervationel Aasoclatlen c�\ of Plumbing and Mxbanical Officers tonal ` l MultfPort Endcap Benefits. Tencul word rescue ltm-Is provide a tgM it Mine fora �["1 I happen in inkissioutlets allow I for moral piping flumbfity MEW • Ellmiratm pipe Tittings The an super ens of the Quasi Sanaartl chamber �� t nPPnovEon V/ Quick4 Wlck<BbnmM Mminher II""II�"I'"I eE NSN NO r FRONT NEW SIOEVIEW TOP VIEW Toical Trenck Ylew o NOW Fill 1 RMIFFIFIN PM Sin 34"W x 53"L x 12"H (364mmx1348mmx3b mm) FIfwBN laiptli 48'(1219mm( IavM XHBM 8-(20mm) 51alOr GpaYll 46gal(1631.) ment"M w003 mm( INFILTRATOR` WMINDI in Qm� i..n.... YrN cydxNRcvbL wsmm num '"a`m M o�awmmn uwn�nNllure N01M mmE Exwrmu of xmcawneum' of FI FOR a anoip.uq KRONOR RvNNN.wm'^k II n 1, mwnhm +nvm '. n p n �1mfipmewioemmn mmrnm�ammmMmams n�.�m RION �no _ %N DyN`: 091 mmn.m nv��imen�a.msomrrwo-s NrmwmN. rs NUm1ydXu,a.nNo RNM, m in nemnvwm eInIbII ologies I ecnmcal Services Department for assistance at f-80f Soil Absorption System Cross Section 100 fl &7cVV Pr Flnalcrzae vm Ppe96.6 ent Cop fl Leaching y 95.6 Chamber fl ~— Syslem Elevation 3 fl 3 f Soil Alasorgation S"Wrn Plan View IIIIII:IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIILtlllllll• Vent Or ame"aumn Pre Cb has IIIIII?IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII®•I Leaching chamber SpeclrcaGgns 4 ? p MannMaclurer And Model Infiltrator 04V • YUO . EISARafing 20 sg fl Per chamber Soil Apphibbon Rate .] gptllsgfl 900 9Fa design Flow♦ Soil Application Rare t 20 EISA= 69 Chambers 2 mm of 32 chambers each. Page 7 of 9 Poi OWNER'S MANUAL & MANAGEMENT PLAN Pew e of 9 China, Richard Stout Tank Menu(act Weiser ❑NA I'llwall ■Seals¢ ❑ Dead D pending wL2000 gad DESIGN PMAMETERS Tank Manulacl DNA Nwnbmaaebmoms 6 ❑ NA ❑ Septic D Duae 0 Rdalna van At Numperolpublk Faptty Une DNA Elnlent NoarMmalaMrer Zabel DNA ESLmebllawage)now 600 slaw Elguml FiNOMOMI A100 Downs bal raw = dEwmahad 15) 900 W Pump himulaent, pump AkEel the In SW Sal Apalrad, Wb ,] Vida ma StanavElMluenOEMuentOml'Ty Monolyathadn Pmomirmnt UnM DNA loss, OIl B Geese tFOG) dog mA ❑SmWGmv&baby, DPeet F%er Blo¢Mmlml Oappn Demand SON) iNG MWL ❑NA ❑ andualnral Annual ❑Wenand Temp Suspended Body ITSS) S150mt ❑Olemreclicn lanulal ❑Other ptelrealed EAuem GoalMantM1Navxaae Beausoleil Oxygen Demand (BON)' mOL OSMWICell(s) DNA Trial Suspended Sake, (ISS) 530 mgM1 DNA OleStwnd lgtavily) ❑ In GrwM tpreasmodal Feoal Copal hismreNc mean) Sloe W/10nm1 DAuGmde 0DXli Deal ❑Cal Mazimum Bment Padkle S¢e '{In ma, ❑Np aver. Dew odM /N VeWae lyplolbrdmvticwevbwa¢ranenes4arenkslAuns 0 NA Sena¢ Ece t SgNu Frepum y added mndpon M rankl¢) At once every, D^o^ma minimum d"al ❑Np 3 Pump mat annual N hnan Sam, warmed al and uum andi Dawdled NI) off Nnk sham, DNA D Man the high wale, gam is xrkmat In¢peamwea.Ical(¢) almmmm ewrv: 3 �yw,(sl by e) IMeslmum nywhal NA clam amuminlrer Al lean onine 3 :^'°mm a) ❑Nq Iml Wmp, memo mnaola& slam. Al him mca"wor anual0 DNA FlueM1 lebmle and paessme lest pl l,WMmovy, �RaYsl°) p m Switch Diversion Valy Pllmponm symed 3 jmarl¢)a) DNA Dow IS bay MAINTENANCE INSTRl1CnONS Inspeabne d banks and dimmed cells abal Ce made by an Individual muing we of the lollumng leaves on mdinatims'. Name, Pll men: Mazi %umber ResNtled Sel POATS Inspedtor, POINTS Mutual Seemed Servicrq Operzlo' handm )_ Tank Inscectrm must Input, a Drank impamom of the dnkno he idenaly any missing or broken pardwam, pen Ty any d ands or Iwka, nadayeand Me wlhom of usual sludge and swm and a Axk M any bear up w p»ding of eMuent on Me pound surtade The methanol mills) shall be visually inspept 10 ched, Me effluent keels In the obs , pips and to china for any pondlrg of ¢Munk Cn Me genre wmal Tic pondina of eiment on be emend adder, may mdlute a tuning mutual and rpulres tie immedpN notl0®eon d the all reyuglwy metal aftun tyre xmdmd ascumuImon D sludge and awn In and aemment link one, mi N)w mim, of be Wit wlume, the make eels he Me bank Ntll be renwvm by a Sewage Servipng Opened, and disposed dIn ascwdanm Add Tepter NR 113, hales in Adminumal Code. Ad Mar annually Intl Wing ME not limited a the wMdng &¢Mart None Mante iwl w pressurised components, pumbso rent units. thalrepui spapaclaw It lmaphis of 12 months or law mgune disposal avoided on the deN tenanting man ^aw reguniremmts, A mi happen shoilN provide] to the local mg,ked uppery whin 30 days of mmaeYon of any seniro," GMw flSNtl STARTUP AND OPE prior tl' 9 d9 For flex Hart ion prier 10 me er the POWI$ ease Manage m la l Pis For me rpremts) U h o! palming p ns are eN ed a Omer the Thermagas WI may impede removed by 0Menl pr boy areas w ut a Ibe aul0ispersal ¢Ills). X fign mn¢n4a6anc are nelMep have the mnlema of II I bhall m ,narbyn seplegetians ng Wvown at rlorroum Sycta'n s1 a In u¢ur en mail wnEpions ere how al lbe infiNalive surlac,. III van d man Nmg alu paw dllaaea Pump awka may if aMve nomul high arerarlweb when power la mamreE ue al wesrerebr mall be dla agd to Me dmffl adds)In OneIsse dome and may emsard lMm mounting in the backup or aur4ca appeal of effluent To avoid this siWadon have Me dental of Me pump lank remrved by a S p e Serviang Opaabr ptlor to re Mng prewar to the affluent pump or mn4R a Plumbs, or POVRS Mabbire b assist In manually offluti the pump m is 10 mature nomad levels When Me Pump bank. Oo may Crete Of park veMrJea over banks Red pimperral col OO not I or park over m NherwNe dlduld or=put the ores wflhm 15 find dol sbpe N any mound or at snide mail several area. Reducdm by elimination ad Laos bllesing horn the swa4waler ahmm may lmpuve be pmkrmance and prolong the We of Me PO arrif diaper MMiolux: baby selves: ugarem burmi ammoms: scan awabcfl i Caeree¢ra: rlema oss: s munbwhni pal Lawrence dram Icump Oil C¢Tage: hen ark vegemae cedmyq Image, ereacei hekmitlas: meat soaps: medl¢bonc oil; pautna prWurre mocpas: s u bery napkmy permul, antl water¢oven bnna. ABANDONMENT When TO Kal taps arl parmaneMy taken W bl aanro the /dloseing aby shall be dken to Incum Pat the system Is pmcedy e ones aWndmal in compliance wind chapter Cunm 83.33, Wuwnyn AMffldMeWe Chad'. • At Opera"nks and are shall pe tl'ucmented and Me abandenatl pine openings ualM. • The ccnhnd mall tans antl phc shall bash and pmpady favored of bya ScplaJe ServldngOperator • Alter pumping, all finks and pits mnal be euanbC and removed or Pen rvrxrs romo+ed and Me void'paw final wind map, gaaal or anPPuInsist .wid mortar CONTINGENCY PUN I/ the PoWTS gets ark corms ba shall Pe /dlovAng measures may Men, w must p bkan, to pmvtde a rode compliant repa¢ trydem: ❑ A uhahb rowaeemem area has been evawded aura may be miwd banebases OF apartment got abawption ry m.me replawmeN area she'd M wotMed form saturant and wmpaalun and Naudflat bei Mmsyd upon by Rw and W&I From exlsbne ,it pmpo¢d structure, her norm a" laal Full to protect the repbaemem area wet resub in Mom fora mi and are awWatlon or ea4WSM1 a matdda rewasmem emu. Rewawmam ardema m'G frovi M me ores in'POOL at that time ❑ A suitable repa¢aert area is not available due or cePaM al red l,mm Fal advances In POVITS Forma pry a holding park dry bri mdllM as a lest resort d repb¢ Me risen frobal Tha ptabas nmbeen "v Ualetl d ldent/y a suidda replamm tared. Upon leilud W Me POWI5 a 5dl end ai4 be nmalktl as a fast resort TO replaced the tub POSuMblNVIC menl area. Ilno replacemslarea is ava4blea M1dtliy bank may 0 Mal and at9mde sell asetseat may be overestimated In pa bllrmna removal N Me III at this nhNapve sureu. Reconstructions Mauls ayrsbms must comply Mu the Mel in eaves at that use. •MMXIXG» SEPTIC, PUMP AND OTHER TREATMENT TANNB MAY CONTNN LETHAL GASSES MDM INSUFFICIENT OXYGEN. 00 NOT ENTER A SEPTIC, PUMP OR OTHER ME EM TMK UNDER MY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF PERSON FROM THE INTERIOR OF ATAXN MAY BE DIFFICULT OR IMPOSMBLE, POWLS INSTALLER POINTS MAIMAWER Name _ Keith Hari Name Phone ]15 5]9-2856c TS ]03-833J SE"ESER ING OPERATOq PUMPER LOCAL REOULATORY AUTRORITY Name Olbright IT ASSOCiateG Name St. Croix Count ZOnin phone 715 703 833J Phone ]15-386-4680 This bournist wv CIPdd of To CMppm deal Zol Cya nl Inw hive OAT MapW Cann 3],]213MCN1NdWt also &LSyIA(2)813), tYuwnaln AdmimauaAw CMa ME LOT 1 S� Lorao ..^._ LOT 2: 94` 4 LOT 26 4 LO, 27 R sscnw LOT 28 6 LOT 29. / / acuewrter Q / 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: (Street address)—yt p a p nJ located at [Vw Y, Section_'g' Town��N,Range]?W, Y., Town of a = 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. Most recent date of inspection or service /V 4 q Did flow back occur from absorption system? Yes_ No (if no, skip next line.) 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) e/N6S L tense lumber Si hamre) (Print Name) MA S-�za�1/-"'—� c�aUo37 (title) (License Number) MP/MPRS (Did are> 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 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Q44 r l Mailing Address 8U]c� Property Address ✓HsiNF (VmfOton yet aired from Planing&Zoning Department for new companion.) City/State`gba560J l,Ci— Parcel identification Number 0201376'a 7-Li 0 LEGAL DESCRIPTION � q Property Location UGl A, Q� A, Sec '�i 4, T � / N R�LW, Town of i'&ZCp .5OM1J snbmvlsion Plat ,Craig CerfiDed Survey Map ,Volume Page# Warranty Deed # (before 2007)Volume , Page # sped ho'WElOs o Lot lines idemieable Dyesl]nc SYSTEM MAINTENANCE AND OWNER CERTIFICATION Impmpetusead malmersnoe ofyoet septic ryemm eeuld rcsWt In in prtmewm (alma lm hantlle wssms. Proper "Onsomannem S of pumpseptic parking Out me k every three years or sooner, if needumped Location, by a licensed pWhat you me into the system ban the Nna Lon of the mode Imik as a insurers singe In the waste dopmal system. Owner in ... iodide tcspmuiblllties and specified A paid. 383d1 11 "din Chapter IZ- SC Croix Cowry sanitary Oklnanoe. The pmpeM owner agrees N submit m SC Cmia County Planningper Zoning Depammenl a unification form, signal by the my end by a master plumber, journeyman plumber, asuiated plumber ora IicensM pumper verirytcg than tl) me omit, tuyerdisposal ryetem is I proper operating card con and/or(2) me Inspmdon no pumping (if nueuator me iornkIs IRs Wan 1I3 full ofmudge. Far, the undersigned have rail We above requirements and ague to maintain We proved wwage disposal System with the It"Jims vet fang hnein, as set by We Department or Safety And Pmfessienal Services And the Department of Natural Peeomes, Sate or W oomsom (retaliation acting Natyom'spite system has been amounted most be completed and mumed m the SC Croix Comay Planning &Zoning Department within 30 days ofthe three y mexpiration dale. 1/we certify beat all members " p1sfoor m1frem the butmlmy/our imemodgn l/we aMere We ownege) ofWe o rdeM described above, by virtue alga sy4manty dad recorded in Register of Deeds Once. Numberofbedragands J �erL.vn �D) 3)(9 SIGNA REOFAPPLICANT(S) DATE "'Any information that is a mreprnemed may men It in the moves permit being revoked by the Planning & Zoning Department •' Include with the and libation amwNW waanty dad from the Reg] nor Deeds Once and a copy of the certified atvey map if reGrtnee Is made in the wanmry dad. (Rein. a/Ia) sw;xw,nmme lxawiwm. Sol Dinmco..wa PRWATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION NTTAON TO PERMIT) TANK SETBACK INFORMATION ETANK PIL wn u.oln w MT . � iil pm _W uo'xoeom 3 Sj.n. EAxCx 6V6TEMT0 pIL fi1LG WELL W(E5}REM1 vaMKee9r 019yMm S.�NIt' S� till 51+ ^IBI >IW' — uxlr Qual • Pnv.um Syvlmnv Only u Sound 0. uarWe Sy lnv Only COMMENTS: Ilwnee ox. d.�..P.naee. pieon. Pevnl. ne.l lnvxenimam Ofl22/ OI m.Will� Lauticn: US diode, 5 �w WOI Kuen.Wl 6W16WV4NW1Ix1<T]6NFI6W18wT Grui Felm W3) P,ml 1<.ffi181]B9 1.1 at sm Dia l As T. wrisQa wr) S.�(�iw �Jru�c 2161eBel,,w10 M= IH dew.= Inn+. C-LA 9kJA7 __ve P.-PQ1.—lo-' G.tr 11 S v t' 3)�Aj hyw EA'. ilia (R,6t Pss— PNnmmalmRngMMf ... oNe � r_.—... Vu omv vlhb MpA ^ 6menelP.aml P'� 'd'MAw _p �.sonewm c No. aNmk,as urempmcarmxta SOIL AND SITE EVALUATION y _ate Bure.nalmm�remesamm In mw)ance wim Comm 33.09, Ws. Rtlm. Co" RW[n mmpabgb PWlmpyurmllesslyn Bl2xll lr[Ige In&xa PWipen CunN IMuee, nN na Imbed A WN and Mmmmftl Mnaze Pate PHQ, eneNmsera Distant wup, suek aeimenslms, mnn woe. eM salon up N eb qo Wm w]. PemilD.e APPUCANT INFORMATION -Pixy tlid I tlax.�- nrne,.ea oab r.anitien.Imywcaw,,,.r Mn.emr m®.WI realjl 1. .AWlrx--- 10-11 -1CA swparty wma fa- nn �y pSd �(y 1N.(Krl1N.15 7S TLa ,N,R (j EIMFIYI Propmyo neM1lxks P)raw `T. we.. BkW sm. Nam.acww Z= �• 27-/ SF,x 4 Cm sbx MPGO& PnmsN ]-Ib ❑wYes Dd iar wuesl Fold an tau old tllg by9- 131, on ®New Consk ppl Ipe'. [�PWPknnp/Numbol M]Imns IJdNmbs Mingibi Cl Replacement ❑PupkamnnanM asi CN. MNW dYlyflwycd eW Fesanm Wei i rW Zded. NdsP 'seven. aFMP IDw Mwelre lsd! a be zs n .na F1vYnum eeYP kexii We _�_Gd. opT—LwA, wo1P mnema)elnnllremn aMaw assessors) `%S.ZS (ta Mesh] to N pen nwknmalp nmlmrel ai wnweemnan. Fuml meraW__il✓�T'/a3k Rze pW almbn, if isensi fl S Canwniknel Abu) Implwd Rwue AT-0rMe Sysomn U UreuM1pabreyYsm i DO `&a ❑U FTS ❑U ;S DU ❑8 r ❑s ®U SOIL DESCRIPTION REPORT W E011110# Iknxm Dent Wnn ia Ss. Wi asi nom SP hl re BSn ass Trent 13 1 o-IZ 9l I r os P .Z'.3 Z 2-# — '.5 am 5 sees.ease W"Jz— OA WKO PAbP WNIR S7504 SOIL DESCRIPTION REPORT RWELIDA BoAN N Dew 9$11n, D.Pmb Boding a 13 D.�pm In i�i ia ii■i�sa�i�ii�_ Ramada: i�ekr�o■®nw�a®®n�� iii♦�■ii�i�i ii��Dl■i�iiii■ ii��i�iiii• Remarks: A' k ©�eaa�rr©i ©asclvftp4�M�■�nesi mml �ii m iiti�i�iiii• Remarks: ii��i�iiii• ii��i�iiii• r T PAGEIOP-3 NAME LOUZ7 K yyT&YA IY N _ SCALE: BM I ELEVATION tW.0 6�)JESCRIMION�^o gi A e L� IN BM 3 ELEVATION 98 Z7 epESCMPnONAO SCi^m. ep. e:e �Gu^ SYST ELEVATION IS2 S ALTERNATE ELEVATION 9 S. Z S. CRolx . 551 18S6Tx4sr 109 DccupAuox AFF16AVI rREM PABST REGDSHER OF DEEDS DEE IT CROux Co., On 11/011=owo;:31P4 EXE•,P,• �.laeroxIm, NOV'042019 w.c � ,e.eeREV I He/see gupo,^�n.cw.lsmuc lmvxn9 �tlafbd bt-Aepn $.'. °vi•"ml�_� /aou3/:s cmv cel.nre�mrero.w Rw�W,Tol�n�n�-`✓Ai'L CT91e 5lJMafSeWn /'I T� 1r�liMlwa ant �lw �Iwasie�a6,Y�1y� sway cewn cex..uuni A✓ba✓.Tr-. L-at Z�%Se✓Eei'�RAss Fnmvl: 1TU-sYSTFM 13-'�{{We [�.�.;iEp fV ����a A 50(HgTyE a�� THIS C[CV MEM I51( �uRRM A4 qy�,F T�„THF U�EQiciT }%R�(ESr lM c(/JA�. Chad!i 33_�egrt e �rwe..e�m>.Msm.l_ Rm..a iT -T.T Me b..- .TANwT P $tAer arwRpFy���Bt 3„Pspral.�b � -?Y4—Rmae�amfm��_ Mtl3S�� � L7� e�+nvn y0.e�yyu�1® me 'lemft,n.c