HomeMy WebLinkAbout038-1197-10-000 (2)Y of and a11119 Di Carl
GENERAL INFORMATION
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
(ATTACH TO PERMIT)
TANK SETBACK
INFORMATION
MM7
PIIMPISIPKON INFORMATION
me.ra:er
Demena
GPM
on Lmai 6pbm tieon
emel L.nen< � ma r_.II
SOIL ABSORPTION SYSTEM
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DISTRIBUTION
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SOIL OOVERa x Reeeure
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11 all Or Ai cyl Only
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COMMENTS: Bndi node ene:neemlas. Peod:m Preeem. n,(
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Location: 1307216TH PIE
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witary Permit Applicatio
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1W7216th Ave
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Brent
038-1197-10-000
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dispersal mn mssl pe noticed l meantamed %u
artmanagement plan proy,l ys gamed[ '
2. ANlli mc,a maa s must be mem:amoa
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CONVENTIONAL COMPONENT DESIGN
Residential MOlo4on
INDU AND TITLE PAGE
Pool Nam
Awe sewer
O nees Name:
Brent Anne
owneroAWlea:
1307 2161h Ave
New Richmond Wi.
Legal Deacnpllo¢
SW1/4NW1/4S 13 T 31N RI8W
Township:
Star Prairte
County:
St. Croix
Sub0ivMlon Name:
Pine Acres
Lot Number
40
Pascal ID Number 03&-1197-10-000
Pagel
Intlex e1M MN
PaI
RWPIan
Page
Syalem Sizing A CmasSecton
Page
Filler Sµws
page
Maintenance lMormelim
Page
Management Plan
Pager
SL Csau Cry Sepbc Tank Memo Faml
Page
Wananty Lord
Page
CW or Pat
AtbGlmelb: Soil Test & House Plans
Deagner/Plumber. KciN KnudEro �Lmosep Number 648463
Gate: /; /i //y Phone Number (651)4]0.1939
o
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h,Nn,o{uunl W he w o sN Ntmpni Comwnem Mnutl W lgMs Vmm 20 Sa6107b IN 01N11.
eryel
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Soil Ab"irellon SValmn Plan View
III
MEN
TO
Manulxmrar And W
EI3A Rating 2000 ap R per Member Soil Appllulion Ram O.]0 ppl*tl
600.00 Mb 0eagn Flow+O.'IU 20 Soll ApllpEpn RR + EISA=4300 Cbembxa
Y rowsa 22�UU Mamh eaM.
POINTS OWNER'S MANUAL & MANAGEMENT PLAN Pane 1 he
0'^Tw Nfenl Aune
F3epdr
Sam, Task Capacity 1255 al pNA
amaa
Tens m.nuearn.a Hulfcul 0ru-
o616XPMNhTE16
HMnt Fha Maul B231 pµp
Number of Piamom
4 0 NA
bell Wlx Mdld p NA
Numb, of Public Fcdsry bass
0 NA
Pump Talk Crummy
Emmated flow larmal
jjj awe,,
Pump Tank Manufacture Ltf{1q
Ossipn flow Ipeakl. IEMnmea x 1.51
600 ape
pump Mamfix ura K XA
Soil Appfce m, Pete
alp "
Pans MoudI - 9KNA
Sawamtl m i,wWw"M Oueiry
Fee, Oil & Gsao IFOGI
Nor apical Oryaan uenaM fidal
Total SummdM auto 1TS51
raw"weeps•
90 mul
420 myL 0 NA
5150 m0/L
Personal bar isisNk
a Swahili Fhs 0 Peel tine
B Mechanical Amamn 0 Wgbnd
0 madman, 0 OMa.
Promote Etemser uuYM
Mosperical Oryyn Dol Ie00.1
TMY Suspended S,W, RSds
F,mv Gsfamm me manic mw)
MonW/ axspa
530::l
90 srglL 0 NA
s10a choul Oval
EJ CNtlel 0 NA
yrews (rea yl 0 lnGsmma(persona l
p AIGr m 0 Mound
p4lrle 0 (Usher:Mewnum
'"flowerPeNNe Sue
a in air. O NA
0 NP
0la
0tla' o ru
v.l,Y tyPiwlbmr®a�w.m..mar.e arm w1awfamn.
amu
a Ewnt
Sam,d po apes
mapcl wnamm nrtvtlal
At Iowa onpe every:
p' l:isl IMminum3yawl
ONA
Pump war [^mama M tmklsl
tym, emotional laws, and can ryuala pnaNte IKl Mask vokne
0 No,
Impact ffp wpolls)
At lost mda seems:
L sani[eall IMm 3seen
0Mor
clean MWem Nber
At lost drawwW
oMr[snorhaI
pNA
mama: PUMP, Dump la&aWm
At kern once seedy:
Um anal
0 sash')
prom Lmala and mr, mes eat
At tan once wary:
0 �eW
m,14A
Oman,
At lean moo away
O sus 41x1
pNA
ono
b N
MaWipAX44 INSTRUCTIONS
accurate of tanks and dermal cobs shell be male by an ma'Al cmrykB one of me comment [trance , cmtilvaeom
Mount chamber; Mam, Probe, F®rtea Awm; POWIS Impedances, POW15 MLLnaiiw: SptOn Sumatra Opaelrc, Tend
inapectlmc Must Include a visual inaPoclkm of the tmmosl to nearby wry handling broken Usual St ua ly any worse or baker,
sins the volume of comrma l spare and mum are to chat for any back up or pondirp of amuast an are award arfce.
Try dmann Model :hell be Naelly invested b check am Mnwn level, in Ne momentum, mirye am m check for ury cal
m stem, ro the mound surlay. Ton faMlna d eMwnt m Ne ywM mvf� wry Maan a hJMa camXtion eM rquuc Ne
mmW'mn nMiFceron of roe local repsaMry, wMomy.
When the combimd memorandum, of worst am mum in any tank musk petard isal her am, 01 she tank schmt. She entln
of me hank droll a mandral by a Sa any, 3ervc nmo g Ocar en discount M in ecwadenw who chapter at 113,
Wisconsin contents mnsin AaminavaMe Com,
AN orw servaea'mcumma lial IirM•Em the emvlcm9 of effluent fined, mechanical m Weameag wmwnnt, preneeurmt
arms, par any moaning H'Mtavek M S12 monthsanal[ be p r ompa by a csM"xd P(l Mammm,
A pinny report mal porkeed to No Used ryulamry auMorily where 10 day, of ewnpedon Many pumps avers,
Papa Zoo v
STARTRAITON — For
. ..Caref Oc[ion v e of Me PONTS Nark aeearan VIkIN fan Me pMM Of former prdouma m OMer MkMddm
that man impede Me tmr Wt ymcma antler amp, Me ai¢perd nMl:l. x high comentramne me.Natal home the counsel
or the Iandel romwe0 by a uptpe werviana am am prier to use
sy,tm Stan Is ,hate nm San when mY Cantlhione are much rt Me Mmnne Panda,
During pose oulap,e pu'rp twice my Nu Woye hared huhwTa boas. grim power le reabm Me uc® wWew wi m
mule ed to tlw dmayar l venial in ors large doze, omrbMbe the uolsl and may result in M, hcNp or mmee amain of
afNum , To hre Mie elruaCen hays tee omte of a» more com shoved by a Septa, SNvlang Oparmm door to renwip
Power, m do a m ghee or omaa a Number Or MOATS kernel to net in mmuder W®amng the Wrap anooh or
rmmm nmmY simple wlMin Me pump tank.
Do me tlMe in park v,hidm woo tanks and dispersal ends. DO not drive or pN vx. m Mmwise dimM or compact Me am
wiMOt Is Rod down slope of any mound or ethanol sail M on area
mountain or donadoh of Me fallowing rrwn NOW waetawMa Nam may d^pmm Ma pMo le and prodwp m, E, M the
PONTS: a tts m: why seem: assume oust¢: cmaorm Pane ¢Pane: aegreana; darn e f l didwe; dminfimmrm; fee
Mundabn San sump wmpl wM: Man aM vpemdk Wnmai dial grace; herticdre; moo[ stands: M�icmlo : oil:
incident; ao kupts; prebod m, bondary npkine, teems, am mew aoftmm eke_
ASAMOOMMPNT
wrap the POWF3 fans mder to pm mill are out of midim Me fabwmp steps Nail he oral to ems MR Me sygem is
pmpc y and Wendy owmandl in wmpllenm Palm Neptm Comm 83,33, Ism ohm Abninst WO Code:
• All pipng a tanks end phz MNI Ea dsmnnpt and Ma Wmdmal pope epmM9W smsi
• Tha mntmta of ell tvnNs and pit¢ ¢hall be rmwW aN popa'lly tliapoaed of Oy a Seeded Servicing Opvamr.
pmer purawl dl imks and pia shall be exervaW am removed or shim mmmm remmW ,M dy wolf apace aI,dwith
nil, gavel a mnma men mid Paul
CoxTIm UJNC PLAN
Ir he PoNTs film ma adman Le hipaaed the !allowed mevwm hem bmn, .,.mart be term. m mumd, a code Compaam
Mohammed syaem:
o A aul mpla emmet in, nm been amounted and may be INf¢ed P, Me bcadon of a MFepemmt loll abwpvon
Small The Mpbwmt shwa
n or, W tropical from d,sMRcance and mmpn and should not be MN Men by,
m Wabill More "Who and pmpoWM suudi nit lines me wal,. Failure a prmm, May Mpim went woo WIN
Me had fan, new Sou and a" wa m" toNobel a suitable mplacemmt au. Replammmt Sysm a neat
comply wah Me ml" No mat at Mid May.
❑ A duel Mpiwwr t am IS Pat Wed le due W maia antler Met nmuadev. Omnp aivanar SoPhoil
/ technology. heading took may be'vadelbd asalan report to mud, Me teem P(parl (en slob - e a'EDH18)IE1� FLCN CONS/RUC3LDN k
❑ Mound and rtgMde soil ebmrdem, symnm may be reconsduttM in mm, palbeing reempw a of Me bhmM a, Me
infumal A.l Nmcon9mttbnz of such rynmW must mmpN wM Me now in dumb or Md rime.
<<W R xO»
sBllc PGMP Ax0 oTNEA 1PFAlMEXT TARNS MAr cONFAM IFFHPL GAb6E6 AxoroR NSYFMYEH! O%rOEN. DONOT
ENTER A SFPIIC. PUMP OR OMER TIFATMEHF TANK GMDEII ANT CIRCOIMTANCM. OEATN MAT NESOLT. RESWE OF A
PERSON FTNM THE IXTEgOR OF ATANK MAY E g OULT OR IMPoSC .
FOWFS IMSTALLFR POINTS Mf nmm
Nma I Keith Knudson xme
Marc 651470-1737 mad
SEPTAGE I ERNCING OPERATOR IPIIMFEItI LOCAL REGULATORY AVFIpMiY
Nme Powers Liquid Wass xame ST. C I 2Wl
hp ]1524657313 Pen, -71S- 38(w- 0 D
TMe auhmam we Shaul N lempLam Ask ehnta di mn w.l]IznWn Ul atl Bit, IZI IS 01, Minion AAmn®ueWe tide.
S'I'.0 OIXCODN'lY
SEPTIC TANK MA W TSNANCEAGRFESIENT
AND
OW EMHIP CEKTIFIGTION FORM
DIR„ Brent Aune
eee,b..,,,,,„ 1307 216th Ave
gP A 1307 216th Ave
(VWiPm>mv FRe6om Plu®em IDOWg Uepmlmwfmncw�Mu)
cily/Smm New Richmond Wi. PmW tamriEURmNuok,c b $-//9»O .eGa
LFcmf. NESCRUMDN
PPMrL mSWu,NWA,Ste. 13 T31NR18WT.,FStar Prahre
sumivisim Pw. Pine Acres �gk 40 .
C.eP1iRMSuaveYMaok .volu .PORek
0ef 2W)Volume IPugek
bpcNimDyoGbo Wlmv JaiNhkp)e0no
ImP.opeurcme melmmu'.eofYom%ptlaryshmmWeaoNw W P=mJmeluluremhaoelewuRi. Paopv
iffioFWmPmBOW W vgYCImYeYaYYrte)mmimev.Rmhd. bYe4,evMPo^�PQ- Whoam�PW iWo
me q9®m.Batmefaxaiw of WeupoOoku.00MeYtlyeiome num di¢uvlryum OwuemWlmma
rtspwvibibim m mN9M M SSP.s si.5f(1) W M mepa l3-9c 6odCmuy3enimgpYm�-
lLa PaapMy oanwepmbaubmtlm3LQoo-Couoly Pl.®iog R] Wog Depulmm emm(wim6em.aippW hYme
.wmwM.�md�mb..imemra'•ovamnre...m: ePo-ehrea..limeeao�mw�egmnlpm. m..ire
ice.Ounuroul.Pwm umwoeu^w•lire®eOimuNm O) WlmimpeoJovaoeP�Pi^g lifmvv.n).wmplkuok u
. m..lA wiora�mg..
P.w wa.om:i�a saK yea ma obore am W mmmu.m .yre m moemio m= wi..m m«.ge eim�l.Ymmo wim me
m,e.wmfwh, maW.u.f by m=neryenwnts.rtynneemr 'onalswimwa.ugrN Nufwm.11emum.
9ueof Wwmdn. CenJ®emq.livgmnpmegec sysumhu�munu�-e mw MormpleMmiaaunmlmahse 0W.
(burly Plan.ieg RTmlug CeOeNoml Miu30eryao[memrtey.veaPLvnu Evtt.
l^.emm'ymY WI.WIe mm�� fmmueummme6enof�p/ovhmwl Agv. lMe em�uem. owa.(.)ofine
Pmprty hxnteeeMw. by vikueofev{vmYe.��'fEee inllgiskaoflketa ORR. '
Nonbero JJ
SIGNATURE OFAPPLICANT(S) DATR
..•,fm•INwmNoumYLm�RtlmaYamuLLlnme unfiuY Pum46tigrevahni by me Plamiog BPeuiredPNmmt •u
ImJwM with mia aPolia W^o a rtmNei wua®ly tleM fiam 0e RgiPa of Oae.L O®m aoi a mpy ofW a aN(Ktl auvry mp if
mr.rem.bmweem.wmmWrae�.
PI -WM)
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)lsro elan A.e located
at: sw /., nrz 1/4, Section 13 Towns' N, Range 18 W,
Town of sa,a sme St. Crow County Wisconsin.
Upon inspection, I certify that I have found the tank(s), to the best of my
knowledge, will randorm to the requirements of SPS. 384.25, and it (they)
appear(s) to be functioning properly.
Most recent date of inspection or service nzls
Did Row back occur from absorption system? Yes NO
(if no, skip next line.)
Approximate volume or length of time: gallons 15 minutes
Tank Capacity: 1255
Construction: Prefab Concrete x Steel Other
Manufacturer (if known): aWwt
Age of Tank (if known): 13 m8
Permit number (i wall assess)
✓7 -
KelVh"WM,
(Licensed
Plumber Signature) (Print Name)
(License Number) MP/MPRS
1111111s
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. 212012
KLAND_ CEMETERY
ASSOCIATION
N lee of Qtklme
G ok" Aprcklkn
S89e07'04"S
631.94
aesv
1_,aw141__ -
1.77 acres S
42
M952 n.n.
1.51 acres
i
5>a�SYt a
40
145.606 m1.n.
3.35 ocres
in Ow
pmf o
emn of -
PRAIRIE
North line of SW 1/4 of NW 1/4--
of Sec. 13. T31N• R18W
d
qq��
691.92'(rec.)
all
% q, S89e07"04"B
691.98 (maces.)
w
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ar
e
36
170.462 sa.R
3 91 vcrw
\we �
39
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PMNIITE=GESYSTEM �„^M^ St CmIN v 1
sirNa.+erwrelmn, RMPECTION REPORT se..rnrmnw. a88pSp 0
naemu uvnuueTnn (PTTALN TO PERMIT)
Ilal]4Y4Y1]'.
3GI[COVEA _ ��� � nByWVPJy nYoln IXM�GYS3aMISOp
SI mmAew+ Kml e v a vn
COMMENTS: Ilnewm a rsnervu+.wrsworwti.ele.) Irepab+Nt 4 Isr—I K /rycaa'un C'_r_
t OW tDl]E1dlr Arenw Hax lNlmanE. M 5Wj? MIR 13PI14 RIM MAvee lMtl v� Pawl Na 13. 3118 I=
u ul Ma oe.�ulon=Toej o-..•.eln 1w.N oAe �ld-reawl
z l6Ya eaw.Ngn= IS
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Ntlmfi Rpilnnldfmrmw SOIL AND SITE EVALUATION Fia i dl_
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aLM.eE asl/la 450 ppd IiemnRiaMOreNnbzAndt! w6r�MmM1,9tar
moon MMq*W W andr-j4j,_I h.T �atynba*gr 7 0e4war .9 aanm, war
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Soil Test and System PLAT PLAN
PROJECT 1l9un Cuekln H[Tes ADDRESS 1113 Hm" New REnmwd W W17
1/4 MY 1/4S 13 /T 31 N/R 10 WITHIN; Sompni hs COOKIE 3T.CHOU'
MPRS Shaun BID12269W DATESM°/06 BEDROOM °
CONVENTIONAL SEE IN -GROUND PRESSURE CONVENTIONAL LET HOLDING TANK
MOUND SEPTIC TANK SUE 1256 9adkoS SFr TANK Sim DOSE TANK SIZE'
HOLDING TANK SUE LOAD RATE .] ARSORPf ION AREA 900 i of iLmBe JCkk %
RENCRMARK V.R.P. Top o19bN Force Poet ASSUME ELEVATION IM' FYl4l ab3gIKZW
❑ROREROLE O W R.R.P. Semeas RaPAmeM1
Rg1eM1y uw mrigm ELEy T1ON 91.&813 5' CBkw OIRtlB
Plans Designed Using
Conventional Pown Well ism mad oil
Manual Vemion 2.0 setbacks mquired by
WDNR
B.M..Aii.. B,Al To d
y Dun 495.9'
AD' 20'
B-1
3%Slope
Vent 30'
Igo'
B-3 �.
Plvpeny Line 2-3' X 90' Cells wiN>3' Spacing
PNn4 Propeny[ine
Bedroom
Home
Van
>6" Standard Biodiffuser
dCovd Izechiv6 Chamber
'N 31.1 f¢dArea
6' Long 11"
Gmde at System Flevadon
21 DAve