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HomeMy WebLinkAbout032-2146-50-000 (2)w PRIVATE SEWAGE SYSTEM 1. CI01% svrery vne ealei.el.I^^ INSPECTION REPORTGENERAL INFORMATION (ATTACH TO PERMIT) 617779 'P^ .II M Shannon RDUCklGwrye ciN +�l•eaNOF$OMER$ET50-066 .,. 9.1296 TANK INFORMATION ELEVATION DATA MANUFACTURER CAPACITY STATION 0S ELE,. gre Enrol LBM Sell Bldg. Sever IOIn9 (Inlet TANK SETBACK INFORMATION SVWOucet TANK TO I SPILL RLDO twzrinr glMt oI Pace sm.m PUMWSIPHON INFORMATION That Gnae Ne ...r Grhm Sl Cover PI lencerman Lenoir U., no 1-11 Type Of $l IS Numle, UNIT mm DINH Over depth, over - h of S..,rdl When COMMENTS. anaueeooaeemomoenct Pan ne pnunv old Inspecdontt Interested we. Local 2121 s.TH ST 1) All NM Petrel - 2JBlqewmlength orrount of sever � - FEE Condition Required? L Yes N Use older see he Se del nto,mafion. LLL SEC 6710 gmop Cx 11,.2nnaSpmrvn c.rt No Slilu- act q _ 37 2vla6uolsmn dnesE vl� POtW WMy1m Art P.O. Box]16P sW�ry hwOrvmM(mhfillelvgcy MCE'sm, ]0]-7163 (o1777Z lszms {{ <om�ama emit Applicatto �cmmnnen. 6ngm m resymopws ee xtidm un ebm, A.Igllnewrmms Pm, mosde o nwl -µryas GrYxnmt Memulln6µxem) al5ef many pm� mtmmm Y d<mPMUM�"ZI �,Me1.W L Iutloelnlwm.tlmPnv lulwm.tlouw Pmavryovvc'o xw / Shannon R Ducklow 32-1642-60-0gA vmPnrwea.M.:lms... roper t 3 L w wl6 6E M SW m 16 I, best use ® ZICs, IIIII xumen .. 54016 aS4Yrd/('o.'� L'1}Pem 6Wltlloyex¢I. 0 IM1J tril r 31N, em In e %kl a.zp.mur n.a��me-rv�xorR 3 5 sister. ✓ .r Oak Haven n ❑PmlvcommN...l-w.ssure ❑cgee CAM xrmre ❑smxwm-m m'I. N„ ❑vin.var z D;B. G.5}L.5 a',,,, 6ameA1 C<As w IB. Typz (Cl wlIt but al, am CamPIN III, B a"pidel ry X ❑rvm smm =elmm.sm.m mamerw:R.y.am�m� aob ❑pmm MmawmmalmBsy.m(wl..� B. ❑puma Net..I mWrelIm.oum ❑ma Ro"ne.❑CM1cttumk ❑�n.mvmeWomrv. ^ rv'" III, bell Jusl 372 IV. ME MelSB.Mm/Cm el/neNu: JvI ¢«m..P.xml,J gamma onm.mryMl..rmaoW DAll ❑Moms mo w oMmme<,.„w .afnwm a ❑HitTm. mu�Puol ❑.�maoe.�1.„rywil 11.111 mattAwmmm.mill osIfFs.lea �m m Sold Apgloem RuttA n ngew rmr.Raymeilm e .w pmw.mw 650 .] LY ` O• 19.1na lWo �✓r a1BJ 6 ll u YaW� yyyy .mred I./ qq 1 btlo o sCrr npin 6uumne L W..me ur.raepm. m. ro udeWV �Mp/Jp0.5u PlonbvYxemelPan P omem im6m mma PM1aexmhr Countryside Plumbing & Hall g 1.� 6 7'rels emm.. (s�cey. smcmpcNJl 321 Wisconsin Drive New Richmpnd WI M017 11 .m Intensely m J ❑ p- u I($ Ixom. ❑ M /% I w IKC b. WaPProrJ }� 5� � ` �I $IZ �.ai 1.5¢�NBBIIR®aoe. MkbmbMuenlnlderxlde 'xJ Y.�. abpnsalbe[ mmympfme"c �I 1.• aspernmanutrumentpla i. �•• .: B eC 576 2All bears&nyu SmuslNManlalrese 11i ber appllbudejpmmel 6B663981RI Np Driveway Home Diverter valve Garage N Parcel id 03221C -SOLN Replacement list m Heyman hight rich 94 low trench 93. Bentlt mark by 1 iw\o mench 65 t long each 6.5 ez flows. fxlsongsepticsVatem Replace current filter with a poly Iock 525 filter Priam Name'. owners Name. CONVENTIONAL COMPONENT DESIGN Reagmial AplAUOon INDU AND TITLE PAGE Shannon R Ducklow Shannon R Ducklow owners aadrea:: 1/1/ eiYiL t, Cees, O'spe A w Legal Cosemption: SE 1/4, SW 1/4, Sec 15 T31: R19W Township', Somerset CounK St Croix SubEiviaion Name'. Oak Haven Lot Numbao 5 Parcel IT Number. 032-1643-80-000 Page 1 Index and We Paget Plot Plan Page Spern Sears O Crose"enion Page Filler Speu Page Maintenanu lMormetim Page Management Plan Page] St. Cmix CN Seek, Tank Management Form plane warranty OmO Pape 9 GEM or Plot AthGlmeMa: 861 Te610 House Plana Dmignertmumber Countryside P&H Liceme Number 664913 Date: IIII82019 Phone Number (715)246-2660 Signature/.fy�J revived µrweM m lM lrvOwM SMldam Cmwnm xynuvl ml Pnwm VmM 2 0 am, IWpaP IH.too I N Parcena 03zzla-50-000 Replacemen[SYA an Elnatlon bight rich 9a low trench 93. /V�(�/ _ Ben<M1 marktoPo (pwGnegFapMbE Tw\a trench 65( Mang each 65 at Rows. I poly 1e ML ABSORPTION SYSTEM 0EIAIL I GMVELLEU LEgCNING UNIT ngw_el_ Plejxt Name: " An iV L No.otWs Ia's Parcal A cal wine /2_Ta.lwa/?niA n ag Length 125 _.an EIBAPsrcal ,n call swing jff�wn Tooted El" ZZ101 lay mo Gavelle Leaching Unit Mannlecturar. 7. e�eA a% Gavelmre Loathing Unit Mean: A] /0 aL'P. �tb,� 7s+(i TIrplul crow. semen Flnlmm 6rNe�fl \ Ohxrveg Plpa MM apapproved!ca cap or vent ........... 3�P Sell lsackflll Oeobagle Fmric J Tn Inflllrtllre 3utlero 1 1 Z LlmMng Factor �y 41110 Slatba and Anchored vaml ................. OEservmon Plpa Mth Cep PlumEmlpaignar Sgnafure: License Y: 66if7/3 Map /irsry A <'110.I6mi75AIIL TRAVEL 51614]O 33.02 BB9M "e-1 O'SILI F+. ER axFIDI- 'P Fr PE IMI_ -L- FL LED COI IdCP'4EEE I ILL 1 IL p / A ul' II IIIII IiII )'llLI "-' ull III p��L�V ill illd� I IlliT IP I I'll11 io�� Ili IdI�II' i� �JII'� ., >n9(NL� �I'lu'illll'� !I w ILL. j u n uuI — II Ill '"II ILLI�IU Ill IlL�Illl l�I l�' r n I III I I n IIIIUUIN urIIIIIIIOIIUVIIII BALL PUSH ROB �• FACTORY INSTALLED SECTION A -A I A MATERIAL- FILLED POLYPROPYLENE .I— Q 66'p6flon) SEAM BALL 4AND S FACTORY OPTIONAL BUSHING MATERIALHOPEINTPLED PIPE OunET MATERIAL PVC THIN WALL PIPE) ART NO PART . N142 R OR OPTCNPLFLOATSWRCX POLYLOK PL- 525 - 625 CUTAWAY(FOR 110 ARTW.3M2FIEU vgmxB.901uEUR Fal OWNER'S MANUAL & MANAGEMENT PLAN Pula I If? owner rZalle. a at dot Mum; Tenk Centel N DNA "'MyI ypuc Tenk Ma'mfanuer 0NA OE9oX PAPAMET EM HSum Flbm Menulaulwer O NA Number of 9etlmama 0NA Effluent flXn MetlY 0NA Number W Wbk Ideal Unm 0NA Pump Tank Cammiry al NA EArp l flow averel 7al gWM, Pump Tank Msmfimmw all verger law (peak), I6Yene[tl v 1.5 Ypa Pomp Manuhcturer All Mill Appbutlm Pete / gmadmi Pump Mntlel pju MandaM lnfluentlENYmt Ouakry FOA 00&Green ROM 6bYnmlul OxyOn Demur(KDu TMel Suspended 3oIMa(TEN MSMM wwpe• AO pall 420 Del 0NA At 50 mal Preo-eabne+t UNt 0SMAMmal Often OM=chMmo Amptin 0Dii,m m" OPW Rhw 0WerMnd 0Oth" (}NA PrmVMWJ EMuent OUYiy &omentral Oxygen Demand(M Tmfel Samue etl Solids ?35) Famed CarlIOemmeous men' Montry amine 230 mph 9O mg/L S1 V cIW10Cnrl O NA DMperW CNllel DI Owl IpavNyl 0 A\Gmd, D Dn0 Damp- 0NA DImGmind IpressuvW) 0 Mound D ON w: MmJmn Ef mt P"cle Soe K F per. 0 NA hadykah0 NA 0 NA 0p`' 0 NA real M dame"WMn mM WOO tons aMumt m" 0NA Sourvicer Event SeMM F m mm, p Intl nntlHm olbekl[I At luen once wry 0 noel N'nl (Matlmnm 3 you) 0 NA Pump un amen of tal When compared sludge of mum equal onsMktl ()A) of tmk mkme 0 NA Ingm d paml wills) At lent onm every: IMalmnr 9 yam[I J 0 NA CMma om fire, At law m,wry: 0maMl4 ONA MWep Wmp, pump cu 01,&am, At least mum av[ry: 0memmi[I �r de, Del lm, end ponurutM At low on"mW 0TNA mom,At lu up, Ivory;OVeWelsl I�'W 4TIDA MARNITNANCE IXSTRUMON3 Mady,I If mark, and ahpemal calla NYI M an by narrowed Del one of the anions flamerm s or fed Oeons' Rmark,umba,; Menx Plumb., Rwncmi &,,f POWTs In ill Po'Ms M ,: Septem Sorming Do",,. Tank n acres a Nauld inmxtim of LM to lM to ibendfy, any Moore o, bmken reform, lderal am racks or leeks, e the volume of combNM sludge and mum and on=hxk for My Ack Do or peeving If Ideal on Me ground oven. The dw ,ml caller p ll be v'auYly happened to Army me offil Mal, in me obmrvaslcn pipes and to Lack far my pondAg or offluent n Me around aMfm,. The pondina of riu a on me ground surface may numb, a aging=wdfi lon and mew=M me �mmoed, an 10, or the Are regulatory marmby. omarr2 anof mass and a bank pal ethiN 1 l o eml e M me ery , the morar of me Sunk shall enmowtl by a yptpe yrvebg Opir w me disposed of In a cafarm same chapter NR 113, ill Aeroiavetrve Code. All aNv nrval featuring DN not rimmed w me ecturna p of ef,ml firm, mmhmkL e, pravumed ommponmem, peaemmmt mm, and any eervrng at Deal of $12 Months, shed h, performed by a cafMo POWl3 "®molder. A serves report SW M Provided to ma IM11 regulatory eufoorby WmeM 10 aM Of mmplemm of my 2w c, aunt STARNT UP AND OPERATIOPNa Zat Far now consume on, Wior to use of Em PONTS check treatment tmklcl far Me presence of peintinO products or other chemicals that may Monte Me iwlmmt Win and/or tlmi that diepenal called. It high mncentretiom we dtte bear. Me owes Of Me tnklel remweb by a "grade erviWg opwaMr poor ro Itm. brsem tax UP Mall not Dolt xTm toll contlhlom an human at the anti Samoa, During Wow wMgn PUMP tub may full above normal hianwnw beet. Mn power is rmmb the excess was ewnw bell N discharges in the mapewl 0e11191 In a" IBM, ace,, warloMing Me mma and may result in Me backup or mari discharge of eNlu,m. To noa this Ntuaan have may conbrrt¢ M Me pump funk FMWW by • se o Sami operator prior to r omg Poor to Me Iml pump w contest a PIAMI or PoWF$ M musi M moth In marina y open g me pump ewrole he ra nmoN levels within Me pump tent. Oo but des• or pact vahkl,e over mks and ifief ini O et bemm, time or park oli or othelwhe dC or wpfee aw woman tb fen down elope of ray anima or argued full atmosphere are, RMuchan w elimination of Me forowarm from Me wmewa[er abeam may imprwa the pwimmmce and prolong the lira of the PONTS: antihbtiw: baby wmm cosmic, bulg: wr ms, eoown swab.: demmem•: dental Noaa: diapm•; diamfeeGmG fail: fmmmuon drain Iwmp pump) cum«: hum and vesse la pall gmline: gnus: herimides; meat scram: madicamury: oil: peireng pmdu rl pegiodm... Mary napkin i pus: and water mfianx bombe. A NOONMMT When Me PoNTS fade wi is pnmmently taken am of mrrfm W fancying rtye Nall M III to incurs Nth Me smomm notably and MOM abandoned in cwnpllance with chapter Comm 33,33, Memnm AdminiNaWe Code: • All piping to tents and pits Now be diawnne and Me abandoned pipe toning. mass. • Me mmams of Al rank, and Pus SIMA be MMOVW end property dispomd of by s Se mad sommag OpwMr. • Am, pumping. •u nnka and pits shall be excaveM] and remww w Mar coven renewed end Me void .pace Filed with nil, gravel Or another inept mlid rmal CO MGEMCY PLAN If Ma MATS fail, and ca l M repaired Me falowhg meuuru have base, ar.muE be take, to Davits a code cwndbm replmemmt eymm: 0 A a ¢able mmusimmem na m ben ben valuated emay be uulttl for Me Arc of a redr rpt abwbn Wanem. TherepJau mtsea Naukbe protecbd hum diaNbmm and mmpirman and should nN a InMngW upm by requires samcb hem Marion@ and pmpoxii •oucmre, let lined and w&I,. Failure to pmmn Me repleemer area will I,tat M Ni and forcall and .he Mvalaatmn to establish a Was replacement arm. Rrolxmem Mmms muss mply wife Me ranmneXecl Me thin Man. 0 A mhetb aplmmm .m available duo to mWna wk d/or mg limiwo. Barring na Wvawas 'Fal mi twhwbgy, hong tank cow he ins W as a last m—ft to Mond Mo MnW POINTS. (nk �RDkfID1lE11 F6I'A/ LLNSTRUGTLOrJ ❑ Mound and ss-grade foil absorption .yaGms may be rmnmuctW in piece following removal M Me Islamic at Me i mfihrRrv. surface. Re D,n ons of such systems must comply w col. M, , m ettxme. t.t Met li <<W v Ne>> SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN IFRNL G"M ANDNR INSUFFICIENT OX OM, DO NOT INTER A SEPRC. PUMP OR OTHER TREATMENT TMK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSM MOM THE INTERIOR OF A TANK MAY BE DUICULT OR IMPOIN IE. ADDmoNAL COM MTS MINIS VISTA POINTS MAIMAINM Name Memo Pam/ Paw _ ZYl- Phone SEPTAGE SERVICING OPERATOR IMMPEN LOCAL REGNA "AAUT MD C Name Name S l ZQI�(/J FaresPhne '7(S- 34G- 6 o TNl dimrem may den mm.mqumen was WMr COMM D.Ze2smllAdilnand 62.64llb En S fs1, wmsu.w AdmNbb•m, Code, ST. CROIX COUNTY SEPTIC TANK MAINTENANCE As AND OWNERSHIP CERTIFICATION FORM owner/Buyer Shannon R Dueklow Mailing Addres 2(]/ eI`VK 54"owrzgE 4/ Property Addre L2/ S'y fie 1 "/as fvenfiaanon regnirea tom platmingazon�ng rrcp.mnetd for .l City/State Hudson, WI Parcel Identification Number 032-1643-80-000 LEGAL DESCRIPTION Property Loeacon SE idSWy Sea 15 T31 NR19 W, Town of Somerset Substitution Plat Oak Haven pot* 5 Certified Survey Map k , Volume , Page M Warreuty Deed* (before 200])Volumc ,Page* Spec houu Dyespm Inl lines identifiable p ynOno SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper"" and mdWmMee •fy ,acidic Anem ,,to meat mile premature failure to handle wood•. Pmpv s olpumping oNNe uptid Mkeverytbrce}'daze ataoouer,ifncoled. by a licensed pumper Whoymputinto the sye and al most the Nration of the septic lens as a treatment stage in the waste aide m•I vymm. Owner reimenaue reapomAlbfio w spe•Ifled In §SPS.383.#f ) and In Chapter 12- Sa Cmbt County Sm amy Criminal, The prop" owner agrees m submit to St Cmix Cowry Planning @ Zoning Department a cenifilown mrm, sited by be ox+a and by a muter p1mi possession mber an pl um ber, restricted a licensed pumper ven fyi fag that (1)the o,,site tship terdos•I system is In pro",,air" /(2) after Disposal" Old Pumping 6w fnesary), the septic Club is less lben Ili of ofsludge. Iset, the undersigned have read the above foummms and agree maintain the Mortimer, mspaul system your the mnamd•Con Son , heated, a• vet as are Depnnmert ofdefery AM Pmf Donal Services and be Department Of Norma Resources. Sue of WisC"n•in Cenilica im among that your septic trades has been mvinuined most he Contained uM rtWmedm be Se trou C"uRy Plmning@Zuroo Depuhnemwt//��ttm3ild•y ftbe Nteeyearexpisommtime. Pam many tlet allday no form vrcwemthe her[ofmy/car knowledge. 1/weeMeromeowner(v)of1Aa prim"i 'hd above, by sin aorta airy decei m ,ci Register ofineds ONa. Nn rnrnwmnma 3 " ATE 9IONATURE OF APPLICANTS) DATE "'Any integration that is misrcprcssnrN may result In As sanitary pmmit being revoked by me Planning& zoning Oudirment ^ Im'IWe Our this apptieafor a rrrvped commonly deal film be Regi ell of Dcear uffme and a copy of the cenilM sum" map if rcmwre is guide in the wamnty tied. nuss u1D - - —----,------- _+iW,iso•w 1490.- ,.� u-70WN ,--- 09.54' .� �- 350.94' ---------- 2120T f p o� mol v a�50 i u' SW„'50T E wz a80.9t y; l0'99 gsgr '�M•09,1L00N Q, �1 `mow t 05.9S 212.02' ------S00400'31"E 2671.18"-- R.NW,1'WW LANDS ------- S00'00'31"E 5325.19,------ ORNATE SEWASESYSTEM "M' St Grow INSPECTION REPORT4u 388BET S a LINFORIMTION (ATTACX TOPERMITItr�R, "^o' Y`vi:a'IM mavWwabeaWry YlumloMp W,afRNlf!*B. �^ Cb VWT mnNb law. KrulchAS hartl T.BMnaM �r+ SomanHTawnRRlR 1 OBR3tL8-0pLGA I(TANK INFORMATION ELEVATION pATA TYPE MAKIIFPCNRER CAPACITY STATION BB 111 P8 ELEV Sepik V<..k5 IwB e.nMaw z B.Bd ol.ao' MInA RM yell. .r. rr' AaMnan RnA. SaMw p e4-Lo XWIreSm Ian 4.2e ei TANK SETBACK INFORMATION BW110aW le3.pa TANKTO Ph WELL BLDG. VMM4104,011nM SoMa 01BOMm Omlry XeepvAm, A.Nlw 5v GIs. Pp e XW^i Btt Byebm 94e 1e0 So. . POMPISIPRN INFORMATION N'a G' )IBIZ . q!± MaWNum CeMw MoI Nu BM4 XUC q G4. MS. MUMMEIGA wm3, PITIDMENSI oPan e GIn% C 11,41. BVSTESM 11FORTION BLCG WELL LAXF/BiRFAM W �5 SYSTEM GWlmwavwlmll rvalesvNs 1I BZRl SOIL COVER Ina 0µ P+Ngov uNMna xwvsmf wm C. I•.'ob Eap® [My" AN, O raa O w COMMENTS: pnduaemeeeuvepenwelweme PwenL elo.l Iwwo6s tt'�Qi./u^1 ImwM 9:_/J_ Laotian: N]I yyrylYwl%�mw/M. M�M�N618E �1�NeW 1y/<Il i.]L1 RIMIMALN! _ 183I.I9.190 1.INl BM OeaulPltt,' �R•- i��ev�:RWtiI PW� 4i Wa-P4* — �"PcM.-�M! C :�'°ef=L�'-� zlaeA.wvwpN-.,.IS amou olww- ale"y%Wig PMnmmEnwP.'mT Ove�� uww..nwa.wlwnM ggnnlPl Dow oerii+nla �1 6e,fama,N y,is,�ka�l"r'°°cj`"p"!-/�'^.e� E, .wee,, o:wmwa<mmrew SOIL EVALUATION REPORT SVM1baM Bu(dMpe MdN wrpeb NbgmmPnpyMbn Pv.elRitlin •• �••�' Mtlb1a.WMMUYepb:wMmlaMMhmb11 Meee P...mewe.ebxwamwarva. nNM aoo+/,aM GNasaprintaNln 'il w �9 P.wwamm.awadPmum.Le.m.af,,..e rP.Pm••fl /{ felt 1 n �^"Sf.0 O/1( m c+b laA PmPemu*�e G 0 _ m, 1N ✓1N3 fi NR/ E P¢gffy Oxrel MGipe dtl,\ MFtl SUM. Nv n b emY l .i Q7i ❑NbT rvnmfgw] cwawaw eeamalrvunaeraeeaime.cm.mlree assynnon roe YS6 GM❑NePl ql l7 weLo>w.m,,.ml-w.w •Iwnn•Nn Genial aemwmm:,aauw. SS/+.-� e%rtzt�a'� /� 66 SCF 6i S�� �e/ �/je/✓/lGi � �j m�Ptl ��IN 6'wM uuW Hvr. L(�R CegE bImIW M1NL/L SM P+PomYanl IbNm Mtlf Cdaf M.mell WEw Ow.tlPEm pu. Se. CmL Cdw 3W Gr. Ba.A ComYbm 2w Fwb CaPtt' 'EMM 'EM3 /' �e— F21 f * .1 coo eewnaf...w Lai aom MMverylaaof/ le. sari `Emmfa.GG0.>tlo «zo„Mx ae iss,m<fwmyL 'E1m.mm-eoq. wfayLaearssasoffe�. Cfi��^ aee PonU CSi NUMw %VEma nr � � OaNE4wtlmCcnEUNa 22TMeaa�NumLf m,����,.o�„w✓,�,��..:r3'oi� aX-�� 1rr-age-yri.6 SBaM faaM, ■ ,.. iC ©WIT, ©gin®mm. mm® ����•mm�umm�mm mm WA ��m■�immm.�m�mm ��m■�mmm�����m EMuenlxl-BW,a]0,Zen ,gl am i99130< 150rgh •EMun[R�09O �30rrgl eML98�T mda. i4e Depmnenl Of Cmamuoe ie su equal oppo.wnity mr,"pravNa and employer. 1( you need Miocene to eaa eervixa or need maternal on eelrcma¢ (mmaL plena wnt+n Jrc depamoentno W8-266-3151 orTW 08-360.8777. For K Soil Test Plot Plan Pmtact Name wdtKreahky Stu Gddmes 705 Cly Rd E Hudson Wl 5016 t7ffTM d226900 Lot 5 Subdivision Oak Haven Dale 2/8M2 SE 1I4S W 1/IS 15 T 31 N/R19 W Township Somers t Bmtn2 Q Well PL Properly Line County ST. CROIX BM w VRP Assume Ekvellon 100 et. Top of Steal Fence Pool System Element" 99.OM6.6 •HRPSW1w W Snnrhmedt NS BM Tcpof Wood Nut@101.2' Id I :TT iATIM 4 'Inf W Ali