1984/06/15 - SANITARY - SAN - Other

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sen 667819B111Ple tonal 11 1 ' Detach And Return U STATE OF WISCONSIN D Upper � DIVISION OF SAFETY& BUILDINGS portion Of This farm With BUREAU OF PLUMBING 201 E.WASHINGTON AVE. RM 178 Any Return Correspondence P.O. BOX 7969 MADISON,W 153707 608266-3815 DATE: 05/24/84 PROJECT: Anderson, Larry - Residence 2 ( ) NE,NE,19;37,18W Tn Trade Lake Byron Bird, Jr. Burnett WI Route 2 Grantsburg, WI 54840 P LAN ID. # 84-02818 DETACH HERE PROJECT NAME Anderson, Larry - Residence PLANID. # 84-02818 This is to acknowledge receipt of your plans and specifications for the above-indicated project. Preliminary review indicates the requited fee is$�n. Fee Received is S .30'00 ❑ Underpayment —Please submit the additional fee. ❑ Overpayment — Refund forthcoming. ❑x Plan accepted for review. ❑ Plans being returned. ❑ No fee has been remitted. Plans submitted with no fees will be ❑ Additional information required.SEE BELOW. held in abeyance. I. Plan Submission ❑ Complete data relative to anticipated use of bldg. ❑ Additional information shall be submitted in duplicate on ❑2 copies of PLB 60 enclosed. less specifically noted. ❑ Deed restriction required II copy). ❑ Plans not clear, legible or permanent. ❑ Condominium declaration. 0 copy) ❑ All information submitted shall ba signed,dated and scaled or stamped in accord with Section H 63.08(2)(a)Wisconsin Administrative Code. ❑Affidavit enclosed. IV. Holding Tanks ❑ Profile of holding tank showing vent, manhole alarm and r manufacturer if precast. Complete construction details if II. Pressurize Distribution Systems(Mound or In Ground Pressure) site constructed. ❑ Application for use of an alternative system signed by owner ❑ Holding tank agreement signed by owner and local unit of and notarized. (1 copy) government (ample enclosed). ❑ County onsite required (1 copy). ❑ Design calculations ❑ Reason for installing holding tank.Soil test or statement for pressurize distribution. ❑Soil boring & percolation from county (1 copy). test data. ❑ Plot plan showing location of holding tank with lateral dist ❑ Cross section of system. Cl Pipe lateral layout. ances to any building, wells, water service piping, water ❑ Plan view of system. ❑Plot plan, course, lot lines, swimming pools, all weather service road, ❑ Verification of Exception Status Form by County. (1 copy) Etc.Provide benchmark with elevation reference point. III. Private Sewage Disposal Systems V. Litt Pump ElGround slope with 2' contours in entire area of soil absorp- ❑ Calculations for total lift pump discharge, head and gallons tion system extending 25'on all sides. pumped per cycle. - ❑ Elevation of permanent reference Point (benchmark). El Size, length&depth of force main. ❑ Locetion of area suitable for replacement system - provide ❑ Detail & model of pump or automatic siphons including soil data, size,pump curves,drawdown and average flow rate GPM. ❑ Plot plan showing lot size and all lateral distances from ❑ Cross section of lift pump tank showing pump()or sewage disposal system to buildings, lot lines, well, water siphon(s). course,swimming pools,water service piping, Etc. ❑ Construction detail of septic, holding or lift pump tank if ' site constructed or tank manufacturer if precast. VI. Systems In Fill (Fill must be placed prior to plan submission)- ❑ Construction detail and cross-section of soil absorption ❑ Total area filled (fill to extend 20' beyond edge of trench system. before side slope begin). ❑ Soil boring and percolation test on 115 completed by cer- ❑ Depth and type of fill. tified soil tester (1 Copy). ❑ Copy of onsite report by county or district staff.