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Home My WebLink About030-1017-95-000 (2)St. Croix County Planning and Zoning T tesrla.v, October 23, 2007 at 8: 00: 29 AAt Detail Sanitary Information Page ' of / Computer #: 030-1017-95-000 Sub/Plat: NA Section: 5 Parcel #: 05.29.19.76A Lot: 1 TN/RNG: T29N R 19W Municipality: St. Joseph, Town of CSM: Vol. 08 Pg. 2297 1/4 1/4: 1 SW 1/4 NE 1/4 Owner: Miller, Sam E 1172 Rolling Hills Trail Houlton, WI 54082 State Permit: 186524 Issued: 11/16/1992 POWTS Dispersal: Non -Pressurized In -ground Permit: New County Permit: 0 Installed: 11/25/1992 POWTS Detail: Bed- Seepage Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Issuer, Inspector As Built Tom Nelson Yes Jim Thompson Signed (_14 Yes Scheduled Pump Date Pumped 11 /25/1995 5/12/2005 5/ 12/2008 Plumber Other_ReQuirements Additional Notes Money Owed Strohbeen, Douglas permit name corrected - issued to Waldroff /Miller $0.00 but Sam is on deed. 1000 gal. septic to 18' x 60' bed in 0.428-rated soils Notification 04/20/2006 ,Parcel #: 030-1017-95-000 09/15/2005 08:16 AM PAGE 1 OF 1 Alt. Parcel #: 05-29.19.76A 030 - TOWN OF SAINT JOSEPH Current X ST. CROIX COUNTY, WISCONSIN I Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner 0 - TALLEY, WILLIAM A & JUDITH J WILLIAM A & JUDITH J TALLEY 1172 ROLLING HILLS TRL HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 1172 ROLLING HILLS TR SC 2611 SCH D OF HUDSON SID 1700 WITC Legal Description: Acres: 3.220 Plat: N/A -NOT AVAILABLE SEC 5 T29N R19W PT SW NE BEING LOT 1 OF Block/Condo Bldg: CSM 8/2297 3.22AC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 05-29N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 06/28/2005 798857 2832/079 WD 07/23/1997 990/600 WD 07/23/1997 901/305 07/23/1997 779/340 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Description Class RESIDENTIAL G1 Totals for 2005: General Property Woodland Totals for 2004: General Property Woodland Last Changed: 07/07/2004 Acres Land Improve Total State Reason 3.220 78,200 1451900 224,100 NO 3.220 78,200 1451900 224,100 0.000 0 0 3.220 78,200 1453900 224,100 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 119 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 AS BUILT SANITARY SYSTEM REPORT OWNER CL TOWNSHIP SECTION T N-R LZ-4w ADDRESS_1fe->,Z ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT. LOT S I Z E_ PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM . 04 To 10 //0 95. E LA_ L� aL 01/ T_ INDICATE NORTH BENCHMARK: Elevation and description :_roj�o(/z /01 I Egg— I.S.E. (OV14 W01 I/CA 0-0 P� Alternate benchmark_ToC:L —1 j" �1 : —3 . 3 S, ?.Z5 "� 1a.46� D-OWK &r. SEPTIC TANK:Manufacturer: w<1"4 _t" ---Liquid cap. 10 Rings used: Manhole cover elev: Final grade elev: 2 Tank inlet elev.: -----,—Tank outlet elev.: ce.-S-3— No. of feet from nearest road : Front —, Side Rear Ft./,?,/?, From nearest prop. line:Front SideV".. Rear Ft. Ao 7 No. of feet from: Well Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SECTION T N- R W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE NORTH ARROW BEN :Elevation and description: Alternate benchmark SEPTIC TANK:Manufacturer: Liquid Cap. Rings used: Manhole cover elev: Final grade-elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front Side Rear Ft. From nearest,prop. line:Front , Side , Rear Ft. No. of feet from: Well , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSH I P SECTION -S-- T -7N-R ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE NORTH ARROW BENCHMARK:Elevation and description: Alternate benchmark SEPTIC TANK:Manufacturer: --Liquid Cap. Rings used: Manhole cover elev:-- -Final grade elev: Tank inlet elev.: - Tank outlet elev.: No. of feet from nearest road:Front . Side Rear Ft. From nearest prop. line:Front Side_, Rear Ft. No. of feet from: Well , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manuf act. -. Pump Size Elevation of inlet: Bottom of tank eleVation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front Side_, Rear Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM Bed :��hvd /Trench: Seepage Pit: Width Length Number of Lines: -Area Built Exist. Grade Elev. Proposed Final Grade Elev. Z- Fill depth to top of pipe: No. feet from nearest prop. line:Front Side_, Rear'; Ft.�,7 No. feet from well: A91 No. feet from building 7�- HOLDING TANK Manufacturer: 41A capacity:- No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side ,, Rear Ft. No. feet from: Well building nearest road Alarm Manufacturer: INSPECTOR: DATE: PLUMBER ON JOB: LICENSE NUMBER: I �Z 6/90:cj LQi 'iWQL1$artA9P*PX1A* 29 . 19 , SWPHR(A P?EV�1AGV?f5f&Labor and Human Relations Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT} i Permit Holder's Name: ❑ City ❑ Village [Town of: LIR STe JOSEPH ev_: Insp. BM Elev.: BM Description: 'IbO " 6N) e4) '. & 0-7"9 Xk 17ANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P / L WELL BLDG. vent to Air Intake ROAD Septic >� / � � 9 NA D si NA Aeration NA Holding PUMP / SIPHON INFORMATION Manufactur Demand Codel Number GPM TDH Lift Friction System DH Ft Loss Head Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM 1. r ELEVATION DATA County: Sanitary Permit No_: 186524 State Plan ID No.: Parcel Tax No.: A9200408 STATION BS HI FS ELEV. Benchmark a e4fe4 Z. //f. Z07 Z�5' Bldg. Sewer St/)t Inlet St /,,W Outlet (, 5<1 Header/`- d ,S Dist. Pipe ' df , Bot. System lot Final Grade eveIf, 3r, S'� r v � /► Lle c - qrZ_ 5� e �, /-Oee.57 BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth -DIMENSIONSQ IMEN I N SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM L HING Manufacturer: INFORMATION CHA OR UNIT Type O-. ~ �/40 AA Number: System: �76- DISTRIBUTION SYSTEM H e a d e r e{ Distribution Pipes}/ eorxHole Size x Hole Spacing Vent To Air Intake Length _ Dia. Length � Dia.Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench es Topsoil ❑ Na COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HUDSON,5.29.19,SW,NE, LOT 11 48 ST. ctle44A V &VI 67tZ171 c12 %Z. GP�lan revision ❑ Yes required? q Use other side for additional information. SBD-6710 (R 05/91) Date Inspe or's 5ignatur Cert No. oe SANITARY PERMIT APPLICATION U 19=p4m In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SAN ITA"RM 'ITIT —Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. 1:1 C(hli®re o pr ious application —See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION — PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION a Q /J? //Ji ,f%t ilde- 15 4L Y4 I;IE 1/4, S 5- T Z/79 Nj R 1 E (o PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # S 1?9 4rr e9et-ol CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER e F 2— e' , 57, 11. TYPE OF BUILDING: (Check one M CITY NEAREST ROAD State Owned 0 VILLAGE : A E0 I TOWN OF: 1:1 Public I 1 or 2 Fam. Dwelling—# of bedrooms -:5 -PARCEL TAX NUMBER(S) 111111. BUILDING USE: (if building type i; public, check all that apply) 1 El Apt/Condo 2 El Assembly Hal! 6 El Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 FICampground 7 El Merchandise: Sales/Repairs 11 El Restaurant/Bar/Dining 4 ❑ Church/School 8 1:1 Mobile Home Park 12 El Service Station/Car Wash 5 ❑ Hotel/Motel 90 Office/Factory 13 ❑+Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) F�7 A) 1. VN New 2. ❑El Replacement 3. ❑El Replacement of 4. ❑El Reconnection of 5. ❑El Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other r;771 11 Seepage Bed 21 El Mound 30 El Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 El In -Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 El Vault Privy 14 El System-ln-Fill VI. ABSORPTION V1. 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 A REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION Ap S 7 S 19, &J X 1V /60 Y3 Feet Feet V V" 111. TANK INFORMATION CAPACITY in gallons Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site Con- Steel Fiber- glass Plastic Exper. App. New xisting Tanks Janks structed I Septic Tank or Holdina Tank 4, r- R F1 F1 Lift Pump Tank/Siphon Chamber --fl Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature- (No Stamps) MP/MPRSW No.: Business Phone Number: 19,o ,f 5 /a 5 �ecX e 7 Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY Disapproved nitary Permit Fee (Includes Groundwater ued Issuing Agent Signature (No Sta [LApproved Owner Given initial Surcharge Fee) Ee Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: I SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St, Croix County OWNER/BUYER ADDRESS FIRE NUMBER CITY/STATE.Z-Adl Y ` 19 -ZIP PROPERTY LOCATION:1/41 1/4, SECTION -W TOWN OF J , sto Croix county, I SUBDIVISION., /9'1�1 LOT NUMBER. 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 septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system, St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing System, which was in operation prior to July 1, 1978, St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. T * he property owner agrees to submit to St. Croix Zoning a certification 'form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1), the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum* I/Iqe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix Co, Zoning Officer within 30 days of the three year expiration date, S I G N E D DATE: St. Croix co. Zoning Office 911 4th St, Hudson, WI 54016 �4 4/40 F(I 5a Jj f \� 6 . S • /` M. 4S o t 1 39 39 3' I � j 4� PM O,f?.ATF-0 PIPE SCHEDULE 3034 C, PLAS11C PIPS--*� 3' 4* CAST VENT l NSyP ECTI M TF_E mI iW 4� CAST VFNfT x l o, f ..� S r iiRo N rlip[� O lJ T OF TANK HOUSF ( RI---f REt,4CE-) �� O � CAST VENT � � � � -- � �, -- �� _ ► � - `: - I RAW COVER 2-' (3RA E:L ABONJE PiPF CAST CAST 4� s-� ._ r-_ - - - �•-r4 �-� .•1 _..� ._._ _....�.__ -. _._ ! _ . .._ - . _..� w 1 _ -. �-�.. ^_ .e w- �. r +i ._.- +.. .ter w.�'� .- � _.- _ � � -. . - M. .. r � - �... . r. � -_. .- w__- r. �......., t....__r- 1000 Rfy-. Ct':MEJ- BELOW PIPE V4:" PERFORATED Pit' -)I-_ 3�" T NI►•C ,2-�� /iSir"EC-1110,14TEE y S T C - 100 This application form is to be completed in full and signed b ;the owner s of the g inadequacies ( } property being developed. Any inadequacies will only result in delays of the pormit issuance. ,Should this development be intended for resale by owner/contractor,(spec house), then Ia second form should be retained and completed when the property` is sold and submitted to this office with the appropriate deed recording. ------------------------ -------w--r---rw--r..r-r-----------w-------------- Owner of property % Gib / r i� Location of property,1/41/4 , Section, T___ Township . A Mailing address 3 8','✓� ✓ �o� . Address of site ' Subdivision name �, s, Lot no. / Other homes on property? yes No Previous owner of property Total size of parcel 3.2, 2- Date parcel -was created !� Are all corners and lot lines identifiable? ,' Yes No Is this property being developed for (spec house)? Yes No Volume `'i and Page Number20 as recorded with the Register of Deeds. 5 INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEALOF THE REGISTER OF DEEDS. In addition, a i certified survey, f available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. V , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of county Register of deeds as Document No,_a Signature of applicant i Date of Signature Co -applicant Date of Signature ' %• OLIENTIN WEINZIERL Chairman . 549-6739 TO 01F ST. JOSEPH ' CAROLYN BARRETTE 1st Supervisor , 540.6438 ' ROBERT ORF 2nd Supervisor 3W-2244 St. Croix County, Wisconsin CAMILLE GRANT Clerk 9-6261 St. Joseph, WI 54082 TOWN HALL Phone 549-6235 0R T V EWAY P ERM T T I have inspected the proposed driveway location for: Name: ... '.. ..f ....................:1.1..... ..�...� �.�........... _.................... .. JANICE DAVIS Treasurer S49.6459 JIMMIE TUMA Constnblo 549-6404 JANE BROWN Zoning Admin. 549-6470 DEAN ALBERT BIdg.Inspector 425-7907 Address . •... ».....T..... r...»....... . ...•...... .. »«.•............ •w..•........•..•..»......r..•_.a.._.............r....w•».»..«NNww....»f»««.»»w..r......w..w....w...wwww•.wN....w...«.«.•w••...».w...ww...•.www.ww.w.•»ww•w......N....«.•.N. •»•.. •�•.�.••� � N.� ••_.•.• •.. ••.»..»......•N_•__•� w. •« «..•••..•.•.. •....� WM«wwf.wMM..ww.1..N..••Nw«N..•....••..•w..w...w.wfwMwfw.M.«.wwY••..•w.i.w.Yw.«IMN.•..»»N!»..•.. Phone: 1 •..•. ..... •........... •......• ......... «..........•.................«................................... w. w................«.........a..w................•..........•»«•«.w.r.w....w••.r.N.4...•..w.•»...N•.w..«•....»»••».........N.«w.ww......».w.ww_•.•..w.«...««..... The driveway is located at .......-....,.......•.».....r'...�..f-..�. -N !.....« v / «w...w.«._.___......... ............. DAe W.Aflst.fae...........w........••...w.�1 ,1.......... •. ... ....•.»............._..•.»»....»...««.N...«.M.».».».N•.»..._«w...•.•w»»••.«»...N•»«».».«1.••.....i...1..••»N...MN.W 1..•w «•....�.. i. ..... �. .» .. ...................................................... .................................•................................... .. ...... •......... •............................................«..........•................r........ .»« w«..w•«•. Mww•. NM.». N «•«.» _IH«NNF_ «w..IH.w•..wr..1....•Mrfwr. •.N.N.N I have found the location satisfactory. Culvert: Xa?.........v7...... A�...�='..� _....1 P U d r ,o0J !.a ..... ................................«...«........«.«....�......................._.._.._�».�.. �.. ..........«...«.«....«_..._ Remarks: . �`.. .. "............... *.... .. /,0 tC.r� ! �- r �� i, .) -e� ..... ........................... ........ ........ .................«.... «.•«...•....•...•........._...ww._.«.....r•......•.•«»w.w.«.... ........ww »•«..»...N•.«..•.......w_.«.. IV .........«...... ................. .......... •.....•..• ... . ................ .. .�..• •�..... r.• ..•«.......... .•.. ........................... �«......«... ..... ............ I.N. �•..•..�.. ....w wNY•h..•.M•.M••..••1..N»r...N......•..•.wIM....w.•NM/N.N•.N.M.•.N...fw•..•N.N..iM... w...• Number. Town B a rd 40 Fee: ..4`'"0 . ��'� `%.•�.�.�r ��. �...r .•t. 1 .........»............................................................... ».................... ......_.»..........�.... .N. .... f � � Date : .. ....................... �� ? C'A Town Subdivision ordinance driveway requirement Section 6 D.7.q. All driveways from the edge of the lot to the buildings shall have a width clearance of at least 14 feet, with a height clearance of at least 14 feet, and shall be maintained in such a way so as t.o allow for easy emergency vehicle access'. Please notify NSP , St. Croix Electric Co-op, Wisc. Bell and Tel o- Communications when digging in any road right of way, Diggers hotline number 1-800--242-85 1 1 IL BORINGS A�REPORT ON SOt�IvrSiUN l_AE3t7F� AND (115) P.O. 80X !y';9 HUMAN R�LAT ONS PERCOLATION TESTS MADISON,WI53707 &S�'�'t-O' (ILHR 83.09(1) & Chapter`.45) _ L OCATIO : SE TION: TOWNSHIPIA Y: OT NO.. BLK. NO.: SUBDIVISION NAME. "' S14 1/4NE 1/4 5 /T 29H/ 19E4ur)'W St. Joseph 1 n/a n/a CO tNTY: __ QQI"j %!BUYER'S NAME: MAl LING ADDRESS: SL. Croix Dan Brown 1.174 Rolling dills, Hudson, W . 54016 - ---- DATES OBSERVATIONS MADE USE - EDRMS.: COMMERCl AL DESCRIPTION: R01 IL MMFfif�T1ATVS: �E� L ATI�N TESTS: �tesilence aew ❑Replace 10-24-90 n/a HATING: S= Site suitable for system U- Site ura;uitab_le for system ;ONVEN 1IUNAli MOt1ND: IN-GROUNUPRESSUA�: YEMM-1N FILL OLDING TANK �S ❑U S DU ffS EU FSU ESEU ECOMMENDED SYSTEM:loptional! conventional II Pr i culation !Tests ar=reqire.d DESIGN RATE: If any portion of the tested area is in the r s. ILHR 83.09(class 2 Floodplain, indicate Floodplain elevation; l%a d 1, PROFILE DESCRIPTIONS page 49 CoC2 ecima TOTAItELEVATION I)EPlli P H O R UNDWATER _ OgSERVEO_ INCHES SfiSL- - --� CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 7.U8 O003.70 7 . (}t3 104.51 none >7,08 1.00b1.1. 2.08bn.sil. 4.00bn.l.s. 1.17b1.1. 2,00bn.sil. 3.83bn.l.s. 103, 9l none iioi�e >7.00 >7.08 1.08b1 1. 1.75bn. si.l . 4.25bn . 1. s . aJ.��b -- 7.41 102.81 -103.16 none >6.b6 .83b1.1.`1.25bn.sil. 4.58bn.l.s. .83b1.1. 2.08bn.sil. 1.83bn.l.s. 2.67bn.m.s. none >7.41 BORING NUMBER B- 1 4 b g_ 5 B- PERCOLATION TESTS TEST NUMbEH P- P see DEPTH INCHES WATER IN HOLE AFTER SWELLING TEST TIME INTERVAL -MIN. DROP IN WATER LEVEL -INCHES - — RATE MINUTES PER INCH P�H�oo ti --- -- - f'l.B - -- esi mate - - - 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 hurl- [uijtvl a,itj VU10Wl uluvatiun reference puints and show their location on the glut plan. Show the surface elevation at all borings end thu directiu,r alld lwjcuut Of Iaiuj slop4. SYSTEM ELEVATION 100.43 _____ At i � I 9 co 1 A+ ! • T • 1 i tN 1, 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 pelief. NAME (print): 1(.;iry L. Steel -- ADDR ESS: 1554 200th. Ave., New Richuond) 54(�17 TESTS WERE COMPLETED ON: 10-24-90 ERTIFICATION NUMBER: PHONE NUMBEHfoptionaiJ: 2298 715-246-6200 -0 W,ow, _ o 0• UIS-1 HIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. OVER - Ills SUD-6395 (R. 10/83) -