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HomeMy WebLinkAbout020-1342-10-200 c m o I . O zz 0 �v m .. ° c N ' H t s O (D CL � I b m � N I U N O N O E Z U f6 o I m L O U C C 7 N L LL O� _ U • Y O � U Z 0) 0 0) a s Cl) U)i a m I O z d ° C F I N Q O U U N 2 N 7 O O (2 y o _ O © O O Q „„, O N Z F- Z Z o _ E N r V LO y = > : Y o 0 N N N N U Cj • a a a Z a co �} N m O) ►iip O N O lA J U 0 rn rn Z o 0 0 Cp +y0 •� N 'O c O CC{ C) M C � N = O N C) 0 3 m y o o 6 0 0 t 0 0 L N — ~ Y C @ N _0) O .Ci O N N W N 'O C N O • } r �/ '1 � N N a� m N O a U L . O C) 2 'S co O — Z Y c U) O r I I ( .r ✓� d l0 d a a > • a w u y w � rr1�y E c c `�1 v a O in v 1 30� 3 /} r off•- �• � s��� ,�,s.✓ - t - T7 a d' 3C M N 0 0 N 0 Wisconsin Department Commerce PRIVATE SEWAGE SYSTEM y Safety and Buildings Division Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: ST. CRU Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. 338821 Permit Holder's Name: ❑ City ❑ Village IN Town of: State Plan ID No.: WEST LAKE BUILDERS HUDSON CST BM Elev.:- I Insp- BM Elev.: BM Description: _ Parcel Tax No.: It by • 0 1 "T' 54A I 020- 1342 -10 -200 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. i Septic AA4- P Benchmark g, 3 08,E j00, v Dosing 4#1 18 Aerati Bldg. Sewer O 0 - 31 - Holding ' Ht Inlet 30 oq-0 TANK SETBACK INFORMATION St /Ht Outlet r 103 TANK TO P/ L WELL BLDG. Ventto ROAD 9k in Air Intake Septic 3 O I NA Dosing A Header / Man. G • (6 } Aeratio NA Dist. Pipe L !G s V .-W Holding Bot. System L ! "76 Sri PUMP/ SIPHON INFORMATION Final Grade Man urer Demand 3,.{Z (py 'l} odel Number GPM T Lift Fricti System T Ft Fie Forcemain Length Dia. Dist. To well SOIL ABS PTION SYSTEM 4� 2- _*fJ�4 TRgNQjA Width Length , No Of enches PIT No, Of Pits Inside Oia. Liquid Depth DIMENSIONS a- IMEN I N SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHIN Manufac SETBACK CHAMBER INFORMATION Type Of ---« OR UNI o eI Number: System: 3 0 DISTRIBUTION SYSTEM Header / IV nifold tt // N Distribution Pipes) �• j► x le Site x Hole Spacing Vent To Air Intake Length Dia. T Length �� Dia. Spacing � > (7 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over [ Bed th Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center /Trench Edges Topsoil E] Yes E] No El Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) 16 h LOCATION• HUDSON 32.29.19.1836,SE,NW 516 CARRIAGE LANE (Q � 4vw � r ; " I � ` aAa& ff bu•� Ic�rs c � lu S �b1,•�.t.� a/^ "AW t't- Sys&, V Plan rev is require ?] Yes No Useh a � s' :: e..— 1 information. 4S O{ Csp �DSEU6713/ Date � ''", //� I p tor'sSi n ture Cert No. 4. 5� Safety and Buildings Division N*LSANITARY PERMIT APPLICATION 201 W. Washington Avenue consin In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 I , • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. v0 le • See reverse side for instructions for completing this application State Sanitary Permit Number 333&;L_1 Personal information you provide may be used for secondary purposes ❑ Check it revision to previous applicla (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name Property Location G a.'Afe 114 �j 1/4,S ,2 T .p ,N, R / E qfg Property Owner's Mailing Address Lot Number Block Number City, State Zip Code Phone Number Subdivision Name or CSM Number War d ,� PY f Y BUILDING: (check one) ❑ State Owned ❑ it Nearest Road Village Public & 1 or 2 Family Dwelling - No. of bedrooms �_ Town OF a .0 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) . 1 ❑ Apartment/ Condo Oda 1312�1�" 00a 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. rm New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System _______^ Tank Only___ ^ __________ Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 RSeepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 Q System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation Go Q d o v/r O4 Feet Yr, S�2 Feet 1 1 Capacit VII. TANK in Ca allons Total # of Site INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel Fiber- ass Plastic A Pp New Exist in stru T anks Tanks Septic Tank or Holding Tank f 10 ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ I ❑ 1 ❑ 1 ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: o Stamps) MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip ode): 6 e_ IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing A e Signature (No Stamps) rcharge Fee) pApproved ❑ Owner Given Initial �S� ' Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 111. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County / Department Use Only. Complete plans and specifications not smaller than 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. .dds�Av I �, 0 • S'cea�t l' =yD � `� b 3 � ti w f Wiscorssin of Commerce SOIL E EVALUATION Division of Safety and Buildings Page of 2 Bureau of Integrated Services in acco .09, Wis. Adm. Code J Attach complete site plan on paper not less than 81/2 x jres rust County include, but not limited to. vertical and horizontal •�Soint (B ` and f percent slope, scale or dimensions, north arrow, and and to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please pdn / n Reviewed by Data Personal information you provide may be used for secondary pu G Olb) (m))... !` • f rl t, f - Pr Owner ! ovation ii I 1f4 1/4,S T ,N,R(oW Property ownws Mailing Address Lot # BI # Subd. Name CS 7 City Stag Zip Code Phone Number qty Village (�] Town Nearest RoM 1 (71 _ 2—) U New Construction Use: Residential / Number of bedrooms Addition to ebsting building [] Replacement HPubfic or commercial - Describe: Code derived daily flow _(L go Recommended design loading rate _ bed, gpdJfl — trench, gpd/fiz Absorption area required ,Z_2&� ft f�9�Zr3 trench, ft Maximum design loading rate _� bed, gpoe __& / ___ trench, gpd/ft� Recommended infiltration surface elevation(s) it (as referred to site plan benchmark) Additional design/slte considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system Con Mound In- Ground Pressure I AT -Grade System in Fill Holding Tank U = unsuitable for system ® S ❑ U IDS ❑ u as ❑ u J ❑ u ❑ s I [Is C3 u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench l s a n V Ground elev. ' '2 aft. Depth to f limiting o. factor Z SIn. .lis •(o$ 39 .9 2 r{S { /i� l V f lJ Remarks: — Boring # /2+ ^ Ground elev. Depth to limiting Z3 • 2$ factor Remarks: CST Name (Please P int) Signa re Telephone No. Address Date CST Number C x J _ SOIL DESCRIPTION REPORT ' PROPERTY OWNER Page PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench Al r ai Ground elev. Depth to limiting factor 1 laA aj�,V in. "1 ' Remarks: Boring # IV zit' ZZ Ground elev. ft. ; Depth to \b limiting CA factor Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ` S Ground elev. Cl— .�ft . Depth to limiting factor }min. Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: SBD -6330 (R. 07/96) go, ax, e S' ' y ; 3 > /IOW / y'a j ! V .O�✓ /j7,a�,t',� � ��� / ��.f.�' /��.e - sec /�D v ST C ROIX COUNTY SEPTIC TANK. MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM, OwnerfBtiyer � 7' — /C, K & t Mailing Address _ U `rr) 1 4 - e �__... Property Address _ XXX ccc f gc5 (Verification required from Planning Department for new construction) - - City /State _._ + �l,�ct c, L4-;' 7' Parcel Identification Number LEGAL f)k. SC;xIP'IQN Property L Location ' " 1 %, q �'/4, Scc. , T? (_N -R.L1 1V, Town of �W- Subdivision (� Lot # X - M Certified Survey leap ## _ _ __ _, Votunic , Page # Warranty Deed # _....� S 1 12- t;7 Volume r �-. -� , Page # Spec hotise X yes 0 no Lot litres identifiable`�4,yes ❑ no SYS TEM MA Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper trainte riance 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 die waste disposal system. Tlie property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a niasterplu nber jourueyii tan plumber, restricted plumber or a licensed pumper verifying that (1) the on- site 'A-astewaterdisposal system is in proper operating condition and;'or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of slUd-ge.. 11we, the undersigned have read the above requirements and agree to tn.airttaijt the private sewage disposal system with the standards set foatl), herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stab g at your septic system has been maintained must be completed and returned to the St. Croix County Zoning Oilier.: % 30 drs (lie three year a irati da .. SIGNATURE OF APPLICANT DATE OWNE CERT IFICATION I (we) certify tha all statements on (iris form are true to the hest of my (ou.r) knowledge. I (we) an] (arc) the Ow- nEt'(s) of j ­ the operty d° ctibc.d ab ve, b t of a v arranty deed recorded in F�egister of Deeds Office. the I+ APPLICA MTE W* # *.+ Any information that is mis represented niay result in the sanitary permit being revoked by the 7_nniag 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 555130 ;i STATE BAR WARRANTYIDEED 2 - 1982 Q6 i DOCUMENT NO. VaL ?1Pa�� r I �7. CROIX :0., ;YI Mary K. Kral, a single person, FAC1 VA P-04 i FES 3 1997 j ! conveys and warrants to est Lake 96 ers, nc. , f) t �I 10:00 A. M Hvpisw vt DwU , I! !� THIS SPACE RESERVED FOR RECORDING W '. i NAME AND RETURN ADDRESS g !� the following described real estate in St. rOlX County, i Stage of Wisconsin: _ n� 0 ' 2 ( 0 1_ - 1 -10, 020 - 1093 -60;� �4 ��" 2 c i N P 10 N 1 K;A NUMBER ,I (See Attached Exhibit "A") ii Z ANSUR i; a This is homestead property. (is) ' �i Exceptiontowarranties: Easements, restrictions and rights -of -way of record, if any. I� 3 January A.D., 19 97 Dated this day of (i (SEAL) % -h- "' -- (SEW Mary K. Kral y ' i (SEAL) (SEAL) a ; i y AUTHENTICATION ACKNOWLEDGMENT T State of Wisconsin, Signature(s) ss. !� St. Croix n i, authenticated this day of _ , 19_ Personally carne before the this d a y of �jgl3 y 194Z_, the above named _Mary K Kral, a singl�t)erson, i TITLE: MEMBER STATE BAR OF WISCONSIN (if not, } authorized ty §706.06, Wis. Slats.) to me known to bej pe rson who executed the foregoing inst a wledge the same. { ;j THIS !NSTRUMENT WAS DRAFTED BY S It Attnrnav Krictina ORIand , i t s Httricnn�41T 54716 Nuary ic, C Wise (Signatures may be authenticated or acknowledged. Boot are not My o is rmanent. (1f nu, state expiran�o i d�ate: necessary) • Namn of petsons stgnt ^.3 i1 any capacity should by typed, punted below their signatures. + STATE BAR OF WISCONSIN W*Ww Legal Burin Ca. us. t trYe••' Ws WARRANTl' DEED Form No. 2 — 1982 j - wr�...:� ✓M JMM�" �..14I'. :.•R..s�: .Y lif. :. .. ... (Ad^ w N d� •. �4 Ito 171 U NW H �� �.OibcACDUWQ) O �Q wW0 •.+ i G WWW +j '� Om r, [ 0 z .� roz a p� w ww 4 0 $4 �+Om 0 ro ON 4J ao w d1 p �+ o Ch �e mW r4IWN W O ji N 0 C40 A W O %D 4J 3 .>> VAJ W'00RcnW3L►WA m �a0W•r rtv sum W 00:0 ��U giva�i��000w Wes= W .+H Ua N• -�Ar+ - a O � �> N O O f4 %Du1U) 3 10 M0 W K 4 00W'Or+ o C) C14 +� � c° 440 3co G 0.�3Wt/I O b0000 A m N O Dm W �� M W$4 W � 'd u m 0. ''/Q'� A _ y,4 z O -° o r\+v� m E--4 t71W W W U O Z 0 O Q W 0 W w lna) U W rn0 0 a 0 0 0 W W K E> _ w O H O .4 U m to a.1 co W Q '. O i N G�J A� m G, » d W-r1 J Id �f0 w � ro -4 � 0 W m W O O . CJ1 tE .0 ,►.1 � A! � O 41 41 13 Cam! m O w W 0 -4 >4 i-) m • A Cl e W . .0 O y �+ W U r/ _ M O W a.► y J.1 1J jC '� rn S � X o00 AO�a �, 3a0iWG""'aWivGWiUN OOfri o� Eo O WowWw W F UJ m >+ • 4 `° m .G'� u b - 4 E a •., C d' ♦ �o W A j .4 r w w 14 in W N rl V W W m .d am X ro W UN Ur1lflO W FS W • O O h W �+ y� d'w 0 -110 ••oW OWr�� 9A rt ,+ p, r U ra a m W b •,. _ �o %0 �o cc cn $4 :5 U �� O Zi O W Ua33W � y �•, ri U m W � - 4) W� R1 lA W J � rl C N N O O C,4 W W 41 O W O k O W w r♦ .. N N N • O O 0 U4 w4 Od'o � A. a z � C ot` n00 V 4 x m N �� m W.�W0 r4Aj %D z m 0 0 00H ro 3to .3 G,N ro N• 'b tTa, o+ma1m 3 m UT ZHro 'O m .- �•�C ar .� w'vU z O.HzWzWz w0 OM OU � 4+-,40-4 44 q O m N xE+ O Ow 0mp00H d1•r��1 000u0 WW�� •rl - W G." •d W a Z U� +� 0 0 �p y1yo t71 F3m000gWaW m O r. VA w • c E OWwuoa wH'�vWiii 4j 8 0 u F ro z r+ i � IE OF E SE1 OF THE NW1 4 66 TEMPORA X. X X X UPON EX i s, N ��\ 939 �i C* - / � 1.286 ACRES - : W) `,' Vj / v I : 56,014 SQ. FT. : � M 4lI NUMBER 1.190 ACRES EXC. R f W ; vi I " �' L1 5,829 SO. FT. cV . � 86'55 08 E 419.50 ' 7 EMPpRARY 7.90 p�l� `80' RADIUS CU L - DE -SAC ; N . .1.354 ACRES 0) Z N ••� S) 58,961 SQ. FT. ° I' 39 2 5 ,, 1.312 ACRES EXC. R f W I 57,127 SQ. FT. L 1 I I -IO y* � 2 � , %� I E-4 I w • / 2 � i � �. CO 1 '7 I � i /1.249 ACRES ; i •' A a� jn 01 I 54,397 1 _ �p l • / : X00• ; ;n I 1.141 ACRES ^ O tr I �� • • N 49,696 SQ. FT. N v m cv Q l a. .• 3 _ _ ---__ I I h 1 N 'N. o I �►1� �I ' A) 56 ~ I I • ' "� z/ to I N �o to T " N N `` 1.076 ACRES i 46,885 SQ. FT. I ' --- --- t� ---- --- • Q , �3 _-N 85'32' • E _w — 269.45. '•r_- m I 0 100' I i i I 00.•o — l 1 33 133' a� 1 N� V 7 - . In zo w w I 0 — 1.01 ES' �� I 44,116 SQ. FT; Lo jv� , o ,r o IQ 1.150 A RES �' �' S 88'49'43' W ' 50,102 SO. FT. rn JK • 12.50 to / I 100' �� I ( O 'o I Zvi I a aV O !�� j '� CNII \ I I \ 18 'n ` Etii U1� Ii �•` 17 1.456 ACRES m 1.395 ACRES �� 63,434 SQ. FT. 1 ` I ko; 60,745 SQ. FT. \ �j 1 c"1 I .J: w 1 8*49'43" E I \ u 57.75' I SOUTH LINE OF THE I A M7 TUr KI\AM 1A l Wisconsin Department of Commerce SOIL AND SITE EVALUATION ! Division of Safety and Buildings Page --- F-- of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code • Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and S �` percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information Re iewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 9/L Property Owner Property Location G,,' Govt. Lot 1/4 l 1 /4,S a T a ,N,R E (orC Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City State Zip Code Phone Number ty ❑ Village ® Town Nearest Road ❑ City d G I (7/ ? c s o (9 New Construction Use: DQJResidential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate J_ bed, gpd /ft 6 trench, gpd /ft Absorption area required Sao 0 bed, ft O o e trench, ft Maximum design loading rate _�5 bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) k ? ..2 0 It (as referred to site plan benchmark) Additional design /site considerations leery QAey' Parent material �n ;� Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure I AT -Grade System in Fill Holding Tank U = Unsuitable for system Xs ❑ U XLs ❑ U Rs ❑ U R.S El ❑ S 0 U ❑ S Ql U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence 'Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Ground 3 5� �' G '� L. 4,6 > e 7 . fi 9y_ e ft. Depth to limiting factor 1 in. Remarks: Boring # 4 3 m 4 - 1 16 )d 3 t �� s' G rp✓ r Ground elev. dft . Depth to limiting factor -in. Remarks: CST Name (Please Print) Signature Telephone No. O C 4e Address Date CST Number O S <' i SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Ground elev. ft. Depth to limiting factor in. ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # .......................... ........................... Ground elev. ft. Depth to limiting factor ' Remarks: Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) _j.��- oS•�.Cef; � ,�u.'�D�Brs �e ���1 � ',Uda►� �4/t.`���`s �v�,�/il/� t%'�i<.it'SO. �9 .,?a�'� ' ti Ca b �, t^ c Ax t- e e 72 F //- O !/ Sc/S 7` &At