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030-1088-60-004
• • ° i 2 ° b'1 2 c C 3 AI. I T I _ _ m I c m m o �' o o (D m I o m `� o o W w ay > am y -c 3 a m 9 o`oQ d Z d M -I 7 N O ° y N m c d y a c I c c A c m 7 o mm b A� h to a o N u n a a�i 3 l p A I v w ° w °, J cc :o a n � W m e a 9° o o °c a° o o N3 w`o° O O ` A O \ O v m ooa ° wwa yo c Z 000 000s- o co 0 CD ° CS 0 CD o v aOD O o d••aN � I = CL N I o I O D- '___�� O Dam O E T J u ( M co CD = C C (= N O N I n a m ° w a I n 3 3 z m m cb j N c a A Q z o oo� j m w o o CL a A z °o $ m m I 3 3 I y v I w� p W m Q 3 S n fD 9i m o m_3 0 I ° 7 ( D C z a 9 z a 9 d N N N M y CD o o �'o' q c _5-�_ a, m CD o �' s Qa A ? c I A <0 O S 7 O W v CD (A w I � I O O b m o c o Q c 00 Parcel #: 030 - 1088 -60 -004 01/24/2007 12:32 PM PAGE 1 OF 1 Alt. Parcel #: 30.30.19.320E 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner GEIR Y FRIISOE O - FRIISOE, GEIR Y 368 CTY RD E HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description * 368 CTY RD E SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 4.100 Plat: N/A -NOT AVAILABLE SEC 30 T30N R19W NE SE LOT 1 OF CSM Block/Condo Bldg: 5/1406 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 30- 30N -19W Notes: Parcel History: Date Doc # Vol /Page Type 07/19/2005 800690 2845/390 FD 07/03/2001 650131 1673/416 WD 07/23/1997 1045/300 WD 07/23/1997 808/242 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 169285 260,700 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.100 88,900 137,300 226,200 NO Totals for 2006: General Property 4.100 88,900 137,300 226,200 Woodland 0.000 0 0 Totals for 2005: General Property 4.100 88,900 137,300 226,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 525 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 rn p En I c I o; 4 0 I � I o I N I t I � I � I M I I m I c z I U. c o v E 3 ¢ I � � I a I rn w E �c 4.; g I Z V` I or I am M 1- Z g c tP o z z g c o z Q v o I ` 3 •O a 0 0 p O Z C Z O I N Z Q m N I �- N E 4) *� a 1 c - $' I g °o a N if o� Z •N oaaa �, I IL ` W C o N v 4) I U) J V 0 0 N O p to I O �f O Z 0 aD CO, 00 w a A N I f0 9 Q n fn O I v w v o c a c I Q O w O E T O N= d D co a o H � c m n 0- 0 c, r inn 'o C l I-- N N V 0 O M ii.y O a a N E N 0 w= cg O C, o .a °r° d N V C C N *4 A o N rn o h o (D .R c=i Y z_ Z Y d 0) O Cl) CO M O V d €€ a • a u a rr ` � iv E c o �1 A 0 CL o vU) P 4 Tt N., w, Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: • 395182 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal informacor you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Ke ulis, Raymond St. Joseph Township 030 - 1088 -60 -004 CST BM Elev: f Insp. BM Elev: I BM Description: , 30 • �• � Qr &W( ��O W•0� S TANK INFORMATION ATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet t St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet eptic 1 ( Dt Bottom 'D osing Header /Man. Aeration Nat Riprt - reps Holding Bot. System V ct O'1/L PUMP /SIPHON INFORMATION Final Grade Man 4 G W ) acturer Demand St Cover Model N ber � «6& �. Ct.' j 5 J = 6.15 ITS TDH Lift Friction Loss System Head TDH Ft t t out 10 = 5'• $3 'I't-ft I F skernain Length Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length 1 No. f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 4Z .So SETBACK SYSTEM TO I P/L IBLDG WELL LAKE /STREAM LEACHING Ma ct�r.�l �. INFORMATION CHAMBER OR SOY^ t Type Of System: 1 1 UNIT Model Nu DISTRIBUTION ST M Q �„ Header /�Manifg stribution x Hole Size x Hole Spaci Vent to Air Intake, ! ��/ Pipe( ' � Length y Dia _ Length Dia Spacing �l SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx S Yes 0 No Yes I� No El COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 08 // C Inspection #2: / Location: 368 County Road E Houlton, WI 54082 (NE 1/4 SE 1/4 30 T30N R19W) NA Lot 1 Parcel No: 30.30.19.320E 1.) Alt BM Description = 10 2.) Bldg sewer length - amount of cover = Cwt 3, � CJC � — I� C7't • i� � L M' � (�•�K �A•AS � �`t� (Q�jL N Plan revision Required? Yes J No Use other side for additional information. T SBD -6710 (R.3/97) Date Insepctor's Signature (;ert. No. leis °� Aw 5 G s U S 1 1) 11 It -}- 84.06 t) i3vy 13. � S�•69' Z) 12 51 IZ.% QT- 29 / Z ) 13 = !3 - }� — �•9g' ) J1 - 11 8b o0 V°� Sk?i tP r u Q/ / v *NO 1 C�� amleu6l s olodasul aleo (L6/E'a) ML9-a8S S a leuog jai apls day ;o ash ONV sak ❑ nnbaH uolslAbJ veld 1 � , Sbq ''� 1 , = JanoO ;o;unowe - f► = 4l6ual jamas 6P18 (•Z �g S e, S G"�"r►ar� ( -V/(Y = uo4auosaa w8 31b (' 4 30Z '64'0£'0£ :ON laO�ed 4 lob VN (MUM NO£1 OE V 4 3S 4/4 3N) ZBOVS IM `uo;lnoH 3 peon A;unoo 99£ :uol ;eao'1 :Z## uol ;oadsul � / Z / 8n :4# uogoedsul (O a ' ;uasaid suosiad 'salouadaaoslp apoo apnloul) :S1N3WW03 ON ❑ sal ❑ ON ❑ sal ❑ posdol sa6P3 4ouail/Pa9 Jolueo 40usii/pag P xx PeppoS /papeaS xx ) 4ldao xx ian`O 4idaa JOAO 43dea Aluo swa ;sAS apej_ - ;v jo punoW xx Aluo swa;sAS einssaad x 113A IIOS 6u!oedg is 436ua� ✓/ eia y ;6ua� O ad! a�lelul a!y of luau ��-PH x azlS a1oH x uoiInq. lsl 1ol!ue /�apeaH `r , fi ' 1L-1 W44SefN N011nalalsla � lwn ^_ �v2t � � '�O ,al � ' + 6)p :ja�gw'nN�1'3 W :wals�(S 10 ad (1 :J __) u N ONIHOV31 V4VMlS/3NYl i 119M J 8 - 1/d Ol W31 NO Na 813S f SNOISN3WI ' 0 4ldap p!nb!� eta aP1su� slid b0 oN SNOISNMa lid Sa4oua� gl6ua-1 43P!M ON3 W31SAS N011dMOS13V IIOS •elp yl6ual ule jod » 13 Hal peaH wa ;sAS ssol ! 3 411 Hal agwnN IaPOW W JanOO ;S puewad �aa Oe #nueW NOUVWHOdNl NOHdIS /dwnd opea0 leu!3 welsAS ;oe 6u!PIOH adld IS!Q uol;eaaV •ue[nl /JapeaH 6ulsod GS lalul ld OVO2l aMelul HIV of luaA '0418 113M 1/d Ol MNV1 NOIIVWZIO=INI N3VI313S MNb'1 laRnO lHAS lalul lHAS IOH James •6p18 uollejev I1 n W8 lIV 6ulsod 1 N )ljewyouee, S o!ldaS 'A313 I Sd IH 98 NOUV1S Ill3VdV0 uaun10V3nNVW 3dAl viva N011t/A 13 9 NOliVWHO -qN1 NNVI vwnqm F,1,40 , ,2 ' )C' •a4 :uollduosaa W8 A W8 Asul Aa13 W81SO V00.09-880VIDE0 14sunnol Li esov;S puowa uN `slln a)l :ON xel lased d!4sumol X a �l!O :aweN s,JaPlOH MwJad '[(w)(4) yO"Sl's'Me Aoenudl sesodind Nepuooes iol pasn aq Aew ap!noid noA uollewuolu! IeuoSied :ON a1 ueld alelS (11W�(3d Ol HOV11V) NOIIVWNO:]N1 l�� 28456£ :ON liwJad tiepueg 1210d3?1 N01133dSNl uolslnla 6w X10.io ')S :�unoO W31S.AS 30VM3S 31VARld aaawwoOloluawlj h :7d 15 4AM,e Sanita Permit Application Safety & Buildings Division In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 Wi sconsin Personal information you provide may be used for secondan, purposes Madison. WI 53707 - 730' Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if r state owner Attach com let e plans (to the county copy only) for the system. on' ` a er not less, than 8 -1/2 x 1 I inches in size. County t State Sanitary Permit Number 0 ,Check if revision to previous apprication State Plan 1. D. Number C Iro 3 z _ . I. Application Information - Please Print all Information t Location: Property Owner Name Property Location d a_ , W� A�o GCiC.Gp ,�u., :; y�. lUL 1/4 5& I/4, S T 3 Z),N. R or Property Ow is Mailing Address 0 Lot Number Block Number City, State Zip Code Phone Nuintdr Subdivision Name or CSM Number % S! II Type of Building: (check one) ❑ City )K I or 2 Family Dwelling— No. of Bedrooms ❑ Village • Public /Commercial (describe use): Town o • State - owned III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Near t oa A) 1. ❑ New System 2. (Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel lax Number(s) System Tank Only Existing System 650 — /D — (00 ^ 00 B) Permit Number 3 0, 30- /9. 3 2o Date Issued 11 A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: '/ etl, C, v �GU141, J, er V Dispersal/Treatment Area Information: r. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals./day/sq. ft.) (Min. /inch) I �,f� Elevation 6©© 4 406 , roe �, g3 ✓ ,v • 7 '� 3 f3 VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ' / I OJI C ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plu ber's Name (print) Plumber's Signature (no mps): MP /MPRS No. Business Phone Number 6 S 2 Y 7/ — 772 - — 7 Plumbe s Address (Street, City, State, Zip Code) A U Z VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued I Issuing Agent Signature (No stamps) P q Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination 1 Z,, Cw IX. Cond itions of Approval /Reasons for Disapproval: l.� SySteN� 7e �P %nS�t��iC� �y���� �y3�� 6 P /W OVi4r�nA,� llrG�e QIOI�O/ 1/1.1�i Cdy�pllV (, Z ) �Ve tw kS7 �P /Nr7 6�Pv� `10 c""" Soi� Y�G7GtYIS hPOr Lar Z r 1�o e a S- SBD -6398 (R. 07/00) JOB L TIMM EXCAVATING Route 1 BOX 192 SHEET NO. OF WILSON, WISCONSIN 54027 CALCULATED BY DATE (715) 772 -3214 (715) 386 -5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE P/ - 3 :._ .... .......... ap�3 5 b .. 0 o r ..... ..... , ............:................. ............................... .... .... .. ..... .......... p `l ... , ... j. ,... ...; E . �, ....... ......... .. .. ... . .... ti 1 of rt ..........:.... I ...£Ir.�.n Sm) — ....... .. ..... .... .... J .. .... .................... .... ... .. .... ... Ja e �\ �V�.. �! ... . ;........ ; .... .. \4,a' .... 1 ..� L1/fr ....... ..................... ........ :....... ........ .. J ... .. -.. ..... .... .. 5 -..- 0 .. : .... ... .. ... .......... ; .... .. .'__ _ .. ...... . ......... .............. t r' 1. ..... ... .. .. ....... i pp ....... J . r f 2 � T Q I / W ,f £L g� ...,,..,.,� ...F _.. ... _. __. ._ .. .. :........... ... I ... ... .... ........... Z / i;g * W� 1 PRODUCT205 -1 ®Inc., Groton, Mass. 01471, To Order PHONE TOLL FREE 1- 800 -225 -M r ORIGINAL 1340 SOIL EVALUATION REPORT Page 1 of 3 r,w on�Dep rtmenfi>aT, Co erce ivisio Certified Soil Testing ` and Buildings;,, in accordance with Comm 85, Wis. Adm. Code C ounty Q ttach comp play on „(japer not less than 8%: x 11 inches in size. Plan must St. Croix induV, bt ited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Rrce s o tale or dimems,ions, north arrow, and location and distance to nearest road. �( 6 4 Phase print all information. R ' ed y Date R Pe ormation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). O y wner Property Location re/S oft Govt. Lot NE 1/4 SE 1/4 S 30 30 N R 19 W roperty r s Mailing Address Lot # Block # Subd. Name or CSM 368 CTHW E 1 1 McKinnon CSM City State Zip Code Phone Number IN Cit Village J1 Tovin Nearest Road Saint Josep w �oy I WI 54082 715 - 549 -6949 St.Joseph CTHW E New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe Parent material san /loamy o utw ash Flood plain elevation, if applicable NA General comments and recommendations: install 4 - 2.7'x 62.5' stipulation 1099 chamber trenches @ system elevations of: 87.8, 87.0, 86.0, & 85.3 FT] Boring # Boring Pit Ground Surface elev. 91.9 ft. Depth to limiting factor 90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP5/ — W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -9 7.5YR 3/2 - sl 2 m gr mvfr cs 1f /m .5 .9 ✓ 2 9 -22 7.5YR 4/4 - sl 1 m sbk mvfr cs 1m :3 3 22 -40 5YR 4/3 - sl 2 m sbk mfr cs 1m .5 .9 4 40 -90 5YR 4/4 - Is 1 f -m sbk mvfr - 1 m .7 ✓ 1.2 ✓ q.� ❑ Boring # Boring ja Pit Ground Surface elev. 91.8 ft. Depth to limiting actor • 84 in. 9 Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -12 10YR 3/2 - sl 2 m gr mvfr cw 1f /m .5 ✓ .9 2 12-43 10YR 4/3 - sl 1 m sbk mvfr cs 1m A : f B ✓ 3 T-43-84 10YR 4/4 - s 0 sg ml cs 1M .7 ✓ 1.2 ✓ 4 , 84-90 7.5YR 4/4 c2d 7.5YR 5/8,5!3 scl 0 m mfr - - 0 ✓ 0 ✓ AX 41 { S .s{ 4 111 / YQ �S.' Z / Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ” Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST N ame ease Print)i na re: Number Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 6/28/2001 715 - 233 -0398 I it I T Property Owner Huntress, Scott Parcel ID # Page 2 of 3 ❑ Boring # 11 Boring Pit Ground Surface elev. 89.1 ft. Depth to limiting factor - > 90 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1 0 -11 10YR 3/2 - sl 2 m gr mvfr cw 1f /m .5 ✓ 9 ✓ 2 11 -24 10YR 4/3 - sl 1 m sbk mvfr cw 1 m k 3 24 -90 7.5YR 4/4 - sl 2 m sbk mvfr - IM .5 ✓ .9 ✓ horizon 3 has occasional inclusions o s Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPDV in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. ' Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777. SBD -8330 (R.07 /00) Certified Soil Testing A" I CEO 1 1� N �f 2.. DS I V \ � I Q M •� b C�ti'1 �'�1 {,. t YhTbt�*eG W.�oy c0+�.�� l 2. J v 2l AAA o c.o %^A,4, 4¢ w ( n m o ,.,. nom. �.�. � � 1T q , 3 Ss S' . 3 .�. t rb�� L. w•c : sk �•• `^ L C �� � • > � Jv' G ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the l residence located at: IV F V.., 5 %, Sec. T R )q W, Town of S/, h St. Croix County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced ax'e' 1 Did flow back occur from absorption system? Yes No (if no, skip next line. Approximate volume or length of time: gallons minutes Capacity: ldyo � Construction: Prefab Concrete k Steel Other Manufacturer (if known) : 0.Q-'L4- e,Q Age of Tank (if known): jq r n (Sign ture) (Name) Please Print I1 & / lks 2z &5 Z 5� (Title) (License Number) 7- //- D 7 (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my knowledge, will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name Signatur MP PRS ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address S(v (V required from Planning Department for new construction) City /State Z Parcel Identification Number 030 LEGAL DESCRIPTION Property Location /vf 1 / S� 1 /4, Sec. 36 , T .3-0 N -R /L W, Town of 5�1 Subdivision l s Lot # Certified Survey Map # ?' - 4 >5/ 7 , Volume . Page # Warranty Deed # k�50131 , Volume /6 , Page # y /(v Spec house ❑ yes 29 no Lot lines identifiable ,5- yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year eexpirati n date. l // bl SIGtiATURE Of APPLicki4TI DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by v' of a warranty deed recorded in Register of Deeds Office. SIG ATURE F AP ICAN DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed System Management Management this system is critical. As a condition of approval of these plans this system management section must be reviewed with the ownef, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Timm Excavating, 715- 772 -3214, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water- saving appliances whenever and wherever possible. 3 Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7 No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. ? Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8 Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9 Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 v0ll 1673pp. 416 STATE BAR OF WISCONSIN FORM 1- 1999 650131 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS :.T. CROIX CO., WI This Deed, made between Scott P. Huntressand Ann M. Huntress, RECEIVED FOR RECORD husband and wife 07- 03-2001 12:10 PM WARRANTY DEED Grantor, and Raymond Kepulis and Kathryn J. Kepulis, husband and EXEMPT N wife CERT COPY FEE: COPY FEE: TRANSFER FEE: 749.70 —.— RECORDING FEE: 10.00 Grantee. PAGES: I Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address Lot I of Certified Survey Map recorded in Volume 5 on page 1406 as Document No. 392047 being a part of the Northeast Quarter of the Southeast Quarter (NW 1/4of SE 1/4), Section 30, Township 30 Nardi, Range 19 West RETURN TO: TITLE ONE Town of St. Joseph. 706 19TH STREET SOUTH HUDSON, WI 54016 030.1088- 60-004 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is homestead property. (is) 00w) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except casements, restrictions and rights -of -way of record, if any. Dated this day of June 2001 • + Scott P. Huntress • Ann M. Huntress AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF ) ss. s� Cgo'X County I authenticated this day of ;I - o r 16- da Personally came before me this y of June , 2001 the above named • Scott P. and Ann M. Huntress, husband and wife TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ti. to me known to be the person(s) who executed the foregoing 1 - irr LLI!16u nt r acknowledged he sa e. authorized by § 706.06, Wis. StatsJ �; THIS INSTRUMENT WAS DRAFTER vu 7 Attorney Kristina Ogla 1+��SI tary.Public, State of d Hudson, Wi 54 016 d, y Commission is permanent. fff not, state exprrauon_Jate: (Signatures may be authenticated or acknowledged. Both'ate no ecessa,y.) �;' U- G -0.3 ) *Names of persons signing in any capacity must be typed or printed belfttheir Signature. wc,r to Pruress,cn 1s cwnpony. Fond a, Lac. W1 WARRANTY DEED STATE IiA1iOFWISCONSIN e00-666-2021 FORM No. I - 1999 AS BUILT SANITARY SYSTEM REPORT 0WNER j�iN� TOWNSHIP SEC .,20T1 I -R_Z ADDRESS , ST. CROIX CO NTY, WISCONSIN. SUBDIVISION LOT LOT SIZE c, PLAN VIEW Distances and dimensions to meet requirements of H63 / SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM - W4 0 ! I i m , In di Mti 1w - d - ft - F - H H y. BENCHMARK: (Permanent reference Point) Describe: of ver ve reference point C Slope at site: E levation t p 5 P � SEPTIC TANK: Manufacturer: Liquid Capacity: Number of rings on cover — Tank manhole cover elevation: „C,y Tank Inlet Elevation: 9G�7 Tank Outlet Elevation: PUMP BER Manufac er: Number of gallons _ Number of ga ump set for a cycle gallons- al capacity of distribution line gallon: size of pu head; gallon per minute horsepower ;brand name of pump and model number ; Type of warning device MOLDING TANK: Manufac er Number of gallons Elevation of ole cover ; Type of ning device SEEP IT SIZE; Number of pits feet eter feet liquid depth seepage pit inlet pipe - elevation bottom of seepage it elevation feet. SEEPAGE BED SIZE: number of lines width 2 length u_ tile depth EE g SEEPAGE TRENCH: width length PERCOLATION RATE AREA REQUIRED q7.Z AREA AS BUILT 11 6r INSPECTOR DATED _ �Z`! 3 PLUMBER O JOB LICENSE NUMBER 3�C�S- r ,392047 ST. CROIX COUNTY CERTIFIED SURVEY MAP LOCATED IN PART OF THE NE 1/4 OF THE SE 1/4 OF SECTION 30, T30N, R19 W, ST. CROIX COUNTY, WISCONSIN, NORTH LINE SE 1/4 UNPLATTED LANDS - - -- -- — E 1/4 CORNER 49'± w N 89° 55' 49" W 340.00' 974.58' SECTION 30 COUNTY MONUMENT 1+ N RILED v a MAR 281884 Z c: JAM Of Oommu Oo C b�YNr of M.* 0 Ic * m � �ek� �' o � - o 2 �I Ir ID r o SE CORNER I � m (D LOT I SECTION 30 I m I SEE COUNTY SURVEYOR 10 m N FOR TIE SHEETS. ^) 178,499 SQ.FT. (4.10 ACRES) I m INCLUDING R/W z APPROVED ID 1 0 162,295 SQ.FT. (3.73 ACRES) -A /Z Iz (n (n• EXCLUDING R/W o i Id m w a / a A w° /y W E JUL 61983 v /n, M / ST. Citax COUNTY COMPREMN3IVE PARKS PLANNING (p /r- AND ZONING COMMITTU Ib LEGEND w /z /p O - I " X 24 " IRON PIPE SET \ to Iq WEIGHING 1.68 LBS. /LIN. FT. THE EAST LINE OF THE SOUTHEAST QUARTER OF SECTION 30,T30N,R19W, IS ASSUMED TO BEAR N Oo 00' 01 " W`. U F 0 SCALE: ONE INCH EQUALS ONE- HUNDRED FEET 2� oV loo' 50' O' loo' 200' 300' F OWNER 10 6 WILLIAM McKINNON 2 \'19 4 520 S. DOUGLAS HWY. 9, GILLETTE, WYO. 82716 O F o ,p �o d�L G �s� o SIGNED DATE J` 0 3 ALL C.. �. NYHAGEN tp ALLEN C. N AGEN R.L.S. 1407 5-1407 K \ HUDSON, i a WIS. N o Su R Volume 5 Page 1 VOLUME 5 lAGE 140 ST. CROIX COUNTY JOB N s? 83-15 CERTIFIED SURVEY MAPS THIS INSTRUMENT WAS DRAFTED BY BARRY PALMER '1 AS BUILT SANITARY SYSTEM REPORT OWNER ��,� � � ,.� TOWNSHIP,y SEC ..3CTj,�N - LW ADDRESS ST. CROIX CO NTY, WISCONSIN. r SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 / SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM TV 0 #1141C r i a ' I di at N r h rr w 11 4110t, BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical reference point: �'�`C Slope at site: 7'.5 SEPTIC TANK: Manufacturer :[ =/� Liquid Capacity: a :( Number of rings on cover : Tank manhole cover elevation: Tank Inlet Elevation: 76,72 Tank Outlet Elevation: PUMP BER Manufac er: Number of gallons Number of ga . ump set for a cycle gallons- al capacity of distribution line gallon: size of pu head; gallon per minute horsepower ;brand name of pump and model number ; Type of warning device HOLDING TANK: Manufac er Number of gallons Elevation of ole cover ; Type of ning device SEEP IT SIZE; Number of pits feet eter feet liquid depth seepage pit inlet pipe - elevation bottom of seepage pit elevation feet. SEEPAGE BED SIZE: number of lines 3 width 2(* length -!55 ti 1 e ept SEEPAGE TRENCH: width length PERCOLATION RATE AREA REQUIRED 97,,Z AREA AS BUILT Ile'Z^ INSPECTOR DATED 3 PLUMBER O JOB LICENSE NUMBER _J DEPARTMr*T OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. 'Box , - 7 c69 BUREAU OF PLUMBING MADISONl.1 53707 � Ek ONVENTIONAL El ALTERNATIVE I State Plan I.D. Number: • ❑ Holding Tank El In-Ground Pressure El Mound Ilf assigned) NAME OF PERMIT MOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: William N. McKinnon RR# 2, Hudson, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN m Mc K1 n n Subdiviston REF. PT. ELEV.: CST REF. PT. ELEV.: NE SE, Section 30, T30N —R19W, St.Joseph Township, Lot 1 Name of Plumber: MP /MPRSW No County: Sanitary Permit Number: Don Schmitt 3205 St. Croix 38457 SEPTIC TANK /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.; WARNI G LABEL VPR OV R Gf P OV ED: I L YES ❑ NO NO BEDDING: VENT DIA.: VENT MAT L.. HIGH WATER OF ROACy PROPERTY WELL NT O FRESH . Z ALAR FEET FR�N f � ' INE: R LET. ❑YES NO / NO NEAREST 7 �' DOSING AMBER: MANUFACTURER J BEDDING - )UID LI CAPACITY. PUM OOEL. PUMP/ P O MANUFAC IRER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO ES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: N BE ERTY WELL 1 61-111-DING . VENT TO FRESH (DIFFERENCE BETWEEN F ET P LINE' AIR INLET' PUMP ON AND OFF) DYES ❑N EAR SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing IL ENGTH 1 . DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORC the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: EI:E1?/TRENCi'I WIDTH. LENGTH. No III DISTR. PIPE SPACING. CO INSIUE DIA.. 7RENCHES. T RIAL: PIT DEPTH: RAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. D NI)MgEF Q :PROPERTY WELL: BUILDING: VENT TO FRESH BELOW I CY ABOV O R l yi I ELEV. EN PIP LINE Q AIR INLE FEET T. 4 �h l C tC/L NEAREST v� -S �G ;i MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PRO IDEA DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems ake certain that it ON EVERSE SIDE. SHOW ELEVA meets the criteri for ledium sand. TIO S MEASURED. DYES NO OIL COVER I TEXIURE f P OBSERVATION WELLS ❑ DYES ONO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTH OF TOPS IL. SODDED SEED I MULCHED. CENTER EDGES. , I ❑YES ❑ YES ONO DYES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: �E 1 /TRENCH WIDTH: LENGTH: TRENCHES ATE AL SPACING: RAVEL DEPT BELOW PIPE FILL DEPTH ABOVE COVER: ll�tlE1�1�li11S '_:" - MANIFOLD PUMP MANIFOLD STR. PIPE M NIFOLD M ERIAL NO. DISTR. DIST . PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.: ELEV: DIA. - . LEY.: PIPES. DIA . 1.EYAT At11Q 10 #6 7 T ©N HOLE SIZE HOLE SPACING. DRILLZ7 S ECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED AIF()RMATi{4 PLANS: ❑ O 1:1 YES ONO COMMENTS: PERMANENT MARKER V OB ERV TION WELLS: UMBER OF PROPERTY WELL: BUILDING: FEET FR Ah LINE: �. ❑YES DYES El NO NEAREST CI. L�l ' Sketch System on Gi �• 1, Re in county file for audit. Reverse Side. L�� SIGNATUR TITLE: DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTAY, FOR SAM'TARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN U LATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/s x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale, Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H -63, Wis. Adm. Code, must be shown. An index page.or each page must be signed, sealed and dated by the designer. if designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Property / r / Mailing Address: A Property Location: City, illage ownship: County: C-' /a St- ' /aS '/4S30 IT 3 o NCR f E(Ora 5'71 Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: C G _ (if assigned) TYPE O BUILD Number of ❑ Public* ❑ Variance* ❑ Other (specify) Bedrooms: W 1 or 2 Family *State Approval Required. 3 TOTAL NUMBER PREFAB POURED -IN STEEL FIBERGLASS NEW REPLACE - OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY // — `/ ._ HOLDING TANK CAPACITY LIFT PUMP TANK /SIPHON CHAMBER 7 VA MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): New ❑ Replacement ❑ Experimental W Seepage Bed ❑ Seepage Pit l; ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Signat °, , PRSW a.: Phone Number: P lumber's Address: Name of Designer: JJY Sf J � � Z5` rf T 7- COUNTY /DEPARTMENT USE ONLY Sign at re of Issuing /Ajgenv�L� ff Fee: d d Date: SKJ_�j APPROVED Sanitary er Number: C..- ❑ DISAPPROVED �O 7S / Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67 -T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White- County, Canary- Bureau of Plumbing, Pink- Owner, Goldenrod - Plumber DI LHR- SBD- 63981R.07/81) L i Form - S T C 100 Owner of Property (,L /ISM ty'r '4'Z1V&4jj j Location of Property IVZ _ 1 4 14, Section YO ,T 3C R_Lj W Township 52 r f'lIZAW Mailing Address if T 2_/,( VAC ch/ (,✓>� !� /G' Subdivision Name W /LZlAeM C�//V,(/GW/ Lot Number Previous Owner of Property 1 .✓i��j.9M J!/) C' /�'/�f/U� Total Size of Parcel �, 3 Date Parcel Was Created T/O Are all corners identifiable? _ Yes No Include with this application one of the following . ,,Certified Survey Map .Deed .Land Contract, or .Other I;egal Document which describes the property I PROPERTY OWNER CERTIFICATION I (We) certify that all statements on this form are true to the best of my (our) knowledge; that 1 (we) am (are)rlthe owner(s) of the ro ert described in this P P Y information form, by virtue of a warranty deed Ce or�ed in the Office of the County Register of Deeds as Document No. I ; and that I (we) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the nstruction id system, and the same has been d ly recorded in the Office of the Count ister of Deeds, as Document No. ►. 4 s; OF OWNER SIGNATURE F CO -OWNER (IF APPLICABLE) D ZAZ a�. /� 5 /3 /t3 DA SIGN D Power of Attorney 4/1/B3 William N. and Phyllis m. McKinnon hereby appoint Rigger Ruelin of Saint Joseph Township, Saint Croix County, Wisconsin as a legal representative in all legal matters concerning the building of a private residence on the property now deeded to William N. and Phyllis M. McKinnon locat in Saint Joseph Township for a period of 60 days from this date. Roger Ruelin is hereby authorized to sign or perform any and all acts necessary to represent William N. and Phyllis M. McKinnon. witness appeared this day before a notary public and acknowledged this power of attorney as a voluntary act and deed. X AAAAAAAAAAAAA'4,AAA "AAAAAAA AAAAAA D RPDELLA M. BIERWERTH MINNESOTA RAMSEY COUNTY My Commission Expires Sept. 20, 1985 $ notary i�ey�remvsr+ rr�mevtltl cf �eYC b X ST. CROIX COUNTY CERTIFIED SURVEY MAP LOCATED IN PART OF THE NE 1/4 OF THE SE 1/4 OF SECTION 30 T 30 N , R 19 W, ST. CROIX COUNTY, WISCONSIN, NORTH LINE SE 1/4 UNPLATTED LANDS y --- - - - - -- - - - -- E 1/4 CORNER SECTION 30 N 89 55' 49"W 340.00' 974.58' COUNTY MONUMENT I+ N z 0 a 0 0 0 Iz N I - u -4 0 I r I2, r ° SE CORNER �� m ' SECTION 30 ` SEE COUNTY SURVEYOR z cv . Im w FOR TIE SHEETS. I n rn N ^� 178,499 SQ.FT. MID ACRES) Ir 1 vi INCLUDING R/W 2 ID 1 162,295 SQ.FT. (3.73 ACRES) A i2 lz Lo - EXCLUDING R/W G la rr- v IcA \_ v IN W E P y W '4 A ni /p w Ir LEGEND ca /D W ►2 O / O - 1 " X R4 " IRON PIPE SET Ip WEIGHING 1.68 LBS. /LIN. FT. THE EAST LINE OF THE SOUTHEAST QUARTER OF SECTION 30,T3ON,RI9W, IS ASSUMED TO BEAR N O° 00' 01 W C' a SCALE' ONE INCH EQUALS ONE- HUNDRED FEET �IX - °9X , 1 - 11 , 100' 50' O' 100' 200 300 �j 2� s OWNER WILLIAM McKINNON Q . 6 \��. 520 S. DOUGLAS HWY. >� S, GILLETTE, WYO. 82716 C7 I 'tp . d 4�etg F« '�a '( S IGNED DATE 5 u ✓ 8 ALLEN C. V O .r F• *`� ALLEN C. N AGEN R.L.S. 1407 1 r a ` iss. r✓0 I s ZZI �s :4 VOLUME ST. CROIX COUNTY JOB N° 83-15 CERTIFIED SURVEY THIS INSTRUMENT WAS DRAFTED BY BARRY PALMER i I SURVEYORS CERTIFICATE: I, Allen C. Nyhagen, a.registered Land Surveyor, hereby certify that by the direction of Bill Mckinnon, I have surveyed, described and mapped the land parcel which is represented by this Certified Survey Map; that the exterior boundary of the land parcel surveyed and mapped is described as follows: A parcel of land located in part of the NE 1/4 of the BE 1/4 of Section 30, T 30 N, R 19 W, St. Croix County, Wisconsin, further described as follows: Commencing at the E 1/4 corner of said Section 30; thence N 89 0 - 55' -49" W along the North line of the BE 1/49 974.58 feet to the point of beginning of this description; thence continuing N 89 55' -49" W, 340.00 feet; thence S 0 09' -19" W along the West line of the NE 1/4 of the BE 1/4 638.14 feet to the centerline of C.T.H. " E "; thence " tr f 37 E alon the centerline of C.T.H. E 212.96 feet g f , i thence N 14 47' -03" E, 835.09 feet to the point of beginning. Above described parcel is subject to a road easement for C.T.H. " E " as shown on this C.S.M. i That this Certified Survey Map is a correct representation of the exterior boundary surveyed and described; that I have fully complied with the current provisions of Chapter 236.34 Wisconsin Revised Statutes, and the hand Subdivision Ordinance of the County of St. Croix in surveying and mapping same. r , /:LL2N C. S -1407 1 d HUDSPN, i W {S. i I i /. I T T :i ' I I ow PP I 1 ep r ' AN I XTFRAIAT4� 0,P7I QL a I I _ I PAR'' t 1 11ON1 S *� q ' PI C O S A , I L I ; Yo e N' �/ Sr / i r . I : I , IJZ4 I I I I I IN NIM PP 7 , , O. 0 10 r i r r I r • I , I � I I � r I r i I - , : I 1 I I i r : r 1 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INQUS'fR "-; ` p *� DIVISION LABOR AND �" ERCOLA 1 ION TESTS (115) MADISON WI 3707 BOX 76 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: NSHIP/ IGI LOT NO.:BLK. NO.: SUBDIVISION NAME: 1 /a 3 /T3o N /R /y9(o TOW T To-s c N . Y E COUNTY: OWN A .�/ MAILINGADDRE / By ui �• Lves� USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS R esidence New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system G • Y/ r (.I U U/�'l d j� 04f , •is CONVENTIONAL: MOUND: IN- GROUND- PRESSURE: SYSTEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM:Ioptional) ®$ �U ®$ ❑U LAS ❑U CAS ®U I ❑S z U � � -el I If Percolation Tests are NOT requ If any DESIGN R ATE: f / y portion of the tested area is in the under s.H63.09(5) (b), indicate: /(� A Floodplain, indicate Floodplain.elevation: /� A P�O .ter F�LE DESCRIPTIONS BORING TOTAL/ DEPTH TO GROUNDWATER4NGH-E CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPr ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) /. / /•'� &] B- / 7, , ' �Q e 7, 3 Q S + cow -s ' B 2 ` %�: vue. 7. 0 ' • 7 G //S /. 7 ff .s .6 ed/ S + Sl B-3 7 o' x, /0,,_ 7 7.0 3. C) RA is . is'Br, Sic - B- 7 ` /�P�� o ' ' 7 /-(, A if e,� /, A 3 If t tS // Z 3 B.,- /-C/ 9 AA PERCOLATION TESTS TEST DEPTH' WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES NUMBER - We"tS AFTER SWELLING INTERVAL -MIN. PERIOD 1 PERIOD 2 PE RIOD PER INCH P- / .o - 30 c2 1 12- �2'/ .z 3 ' P- JL 3. b" ZJ0 3 c /' /'4 / .2 P-3 ,v' o 30 /' L /, a P P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION /•�' 43 4 e /0 COrme— J r I �r/�X►YP L HI ' AsSkHe F ��.0 C`{% s P /oNel: °1 D: P�res C, f ,001 6 u d F pr' 0 c _ �; u/► ,- �/ - a I /tiv r �f - -- I eA - ....... 0.4e� - i , t ( '/ 'r I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): / TESTS WERE CO ON: ADDRESS: / CERTIFICATION NUMBER: PHONE NUMBER (optional): // �Au, .�u �. u ctJ ctir I<Js , .S vol /.S % /S` 386 -S7 CST GN,ATURE: ll �G DISTRIBUTION: Original and one copy to I_ncal Authority, Property Owner and Snil Tester.