HomeMy WebLinkAboutISTS Permit
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APJ>f,ICATION FOR INDIVIDUAL SEWAGE TREATMENT SYSTEM (ISTS) PERMIT J
, - S-CJ.3 RCP ?t-C'5SuY~ /Ylt!'_<A'l,i!(
COUNTY USE ONLY' COUNTY USE oNLY -------':------------- COUNTY USE ONLY
TWP/e;) PVln r L ~ "" , ,_ Date Received )1- CJ 1- ~ I
ProjectAd~s 11i'.:?'7 ~Mr'i"'2l(-'L-tt/C.e /LO{ /l/tU/- '~'.' Permit Number I ~-e--7~c('"
City/Zip -f( iff L- ~ ; ,\ t.y f Receipt Number ~ ~
SiteEvaluator~,^-, Installer_(~u (OJ' Fee3s'6. ~
Septic Tank Size as per design kubmitted and approved _ Is-/')~ 2 - t!. ' t .. ~ New ISTS Replacement I./"
Pump Tank Size as per design submitted and approved /(J/J") oll"'~~' Percolation Rates ')'7.:Z 7, ;;:2'7
Drainfield,Size as per design submitted and approved (below) Garbage Disposal yes v no
- . Number of Potential Bedrooms "I
Jb'Y SO' /lOr}L,(!,EO 5:0' ,r IS'S';'/UOBI1SE: Depth to Restricting Layer /..;},,'
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Are there any wetlands on property?
Wetland Replacement Plan attached
Recommend: Approval
Yes
Yes
Disapproval
No
No
Will any wetlands be impacted by proposed project? Yes No
LGU Exemption # Please attach copy of exemption,
Signatore of Township or City Clerk
Date
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- COUNTY USE ONLY --------------- COUNTY USE ONLY ----- COUNTY USE ONLY -
ISTS Setbacks: Building (tanks) ~ (drainfield),.70 I Lot Line~r ROW/Easement Lake/Creek/Wetland Wells So I
, Approved ~enled By Scott County Environmental Health, subject to edsting regulations and the following conditions:
1. Verify and maintain all required setbacks and elevations.
2. Protect (fence off) the primary and alternate drainfield locations while any building construction activity is occurring
on the site and maintain fencing or some other a. . ,,' ,ro barrier ifthe drainfleld could be damaged after Installation.
3. Install rock bed on contour and maintain at least 36 inches between the rock bed and the water table/mottling.
4. Protect sewer lines and system from freezing.
S. Divert surface water away from or around the dralnfield area.
.. 6. Sod or seed the area as soon as possible upon completion to prevent son erosion and damll&e to the drainfield (for late -
season installations, hay or straw can be substituted until sodding or seed~ can be done In the'spring).
7. JlIis perml~';,valid for 12 mo,nt7hs from the '!,ate jssued:..L . . '.. tJ d
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Date /~- (J,S- 0/
Pink - Applicant
Gold - Township
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