Loading...
HomeMy WebLinkAbout020-1161-70-000 -0 0 Q c o ° o . ° O 6q d be a) 0 a I ° I o -o N N n N O N Oa i a $ tD z N O I O - N m w ti O C - w N a) U O (0 z c 3 N O LL O N Q) Q 7 C ' i 3 M d' m w z E rn 00 v T p z a m Cl) rn N F- Z O C O p O Z U Z o c _ o N H E o v Cl) a) cu N ~ N C? T L L O o c O O o w z F- Z o N Z Q _ c N ~ L CL 'co Y v v y m a) w 0 0 0 > co O a CL E N N 'It li N F- Cf) U) U) F- F- U O O CL 0) ►i 0 0 0 Z o o •►v ~aaa 0 a c lily g ~ M M N IIiAy 7 O N tf! U = - - rn v 0 0 O X O N J N 0 _ Y o o ~ ~ n N o aNO Q m CD o o E w c Q ° a c> o o v, 0 0 0 o o - a> CL c r a o O O w ~ c E c w v C14 04 04 m n ^ N lry~,j w O N co t -00 ~'V N N C Ln LO (D (h 30 ~ to E (6 U O F O • y„' O N 2 M- O -7 Cn c© w w V E z `m m y d a a y • ca a m .2 d c rr`iw~i E L c c _1 A va I1 0 N0 AS BUILT SANITARY SYSTEM REPORT OWNER il, ~ Y',41 TOWNSHIP___? SECTION_ T N-R 11 W R P`l "I ADDRESS Sd~1 ST. CROIX COUNTY WISCONSIN SUBDIVISION aZ !/~44!g LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~T IQOd N e C s INDICATE NORTH ARROW BENCHMARK: Elevation and description: Som.-~ czS , /S Alternate benchmark /1/e,16-lG- SEPTIC TANK: Manufacturer: Liquid Cap. /e9,0 -,0 Rings used:2-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__ -4Building: % S mss ~ (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 Manufact.: 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: Trench: Seepage Pit: Width: Length m.5' Number of Lines:--.L-Area Built 7Sd Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: 7 ~01 ~ No. feet from nearest prop. line:Front Side~, Rear Ft. ~L/ No. feet from well:_g Ge No. feet from building HOLDING TANK Manufacturer: 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 : /~.~~~•--___i~-~ LICENSE NUMBER:Z~'1k!~~ 6/90:cj I LQQ&Wsn lartrWWP§94u,?rry3.29.19.9 oAl lit LOT 25 WILL BRADLEY DR. Labor and Human Relations wtE WAGE SYtiTEM County: Safety and Buildings Division INSPECTION REPORTST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENITAL INFORMATION I , 186553 i-Permit Holder's Name: ❑ City ❑ Village [5t Town of: State Plan ID No.: HUDSON CST BM Elev.: Insp. BM Elev.: BM Description:. Parcel Tax No.: /b0~ ~U D ' J U fit( L;t~ B ~s' 020-1161-70-000 TANK INFORMATION ELEVATION DATA A93000 9 gf aiy TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic fP 47, 0 0Q Benchmark Dosing Aeration Bldg. Sewer S9 qy a Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet 7 g 3 c/ c/ p Vent TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet Septic !7 S~ ~C NA Dt Bottom Dosing NA Header / Man. gra 2 Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATIO Final Grade i 01 i„6 4 Manufacturer Demand Model Number GPM TDH Lift Lric 'on 5yestem TDH Ft Forcemain Lengt Dia. FFii Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH/ Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Typeof 7P-7-7 CHAMBER Model Number: System: 13eA OR UNIT lion a DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length '15 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 0 Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION:UDSON 23.29.19.924,NW,SE, LOT 25, WILL BRADLEY DR. Plan revision required? ❑ Yes Use other side for additional infor"tioh. 5 / (A SBD-6710 (R 05/91) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: =nalan, HR SANITARY PERMIT APPLICATION couIn accord with ILHR 83.05, Wis. Adm. Code ' STATE SANITARY PERMIT 41 ttach complete plans (to the county copy only) for the system, on paper not less than S% X 11 Ir1Ch@S In 31Z@. ❑ Ch lfYw, sion to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Gtr rd euj/-JQ S 2 T , N, R l~ E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 1 x Ae" e /Z 9b L.J CITY 11. TYPE OF BUILDING: (Check one) ❑ State Owned 0 VILLAGE : N EST RO M,6 ❑ Public 01 or 2 Fam. Dwelling-# of bedrooms PARCEL AX NUMBERkoy 111. BUILDING USE: (If building type is public, check all that apply) /`6 1 El Apt/Condo 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 S ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE(( OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. 9 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.E] 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 11 M Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ 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 75 d 15-6) 6 7 / Feet .0 Feet 11-/152) 1 VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank / Aje 5-1 F=1 F-1 Lift Pump Tank/Si hon Chamber 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: (No Stamps) MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): Q 76P 3-G o~ G✓ rte d IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa tary Permit Fee (Includes Groundwater Date Issued Issuing A an Si re =Nob Approved ❑ Owner Given InitialSurcharge Feel Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: ID-6398 (formerly -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber 1NSTAUCTIONS 1. A ~saQitarjTermit is valid for two (2) years. 2. Your sdMtary4 permit may be renewed before the expiration date, and at the 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 install on. 5. Onsite sewage systems must be propefl maintained. The septic tank(s) must be pumped by a licensed`' pumper whenever necessary, usually every 2 to 3 years. Y 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is,to be installed. If. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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. Vlll. 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 8% 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 grWndwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) f STC-100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit 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. -------1-/--------------------------------------------------- Owner of property Location of* pr(o~pertyW_1/4 x_1/4 , Section Z,3T_2_ 9 N-R 99 W Township Lidsori Mailing address _27sl _-Tas.;zL. zlJe S. ~0Al Z red , A1217, Address of site Lc[ U ax V0116 tt~dsOn TD,~n?Chi D subdivision name_ ~6X V IfQJ Lot no. Z Other homes on property? X yes No Previous owner of property Lay) L L.Li jga,,hk IV maril I-OxS Total size of parcel ~Q _rPS Date parcel -was created mart_~ 9., M2- 'Are all corners and lot lines identifiable? 2 Yes No Is this property being developed for (spec house)? Yes _X_No Volume Cfi9~ and. Page Number 191. as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if 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. yQyIS) , 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. y y I S I . 1 Signature of applicant Co-applicant 9 i Date of Signature Date of Signature Y x f t r. ~ t v ~r n ~ 1~1F a s L ~ , M 4 i WOO t Y a 1 J 3y a M ~ sir. 5 ~ St::~/G * J. ~ e C a . a. Iii S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER V.Qrn 16LUVI.r ADDRESS Zd ZSS f"D" X V t lke - Ai/lwa 23,07 SA-AFIRE NUMBER CITY/STATE u&'Ory (Ji , ZIP SSIQ/(, PROPERTY LOCATION: 1VAJ 1/4 ,1 1/4 , SECTION 2-3 T ZL) N-R__ZJ_W TOWN OF St. Croix County, SUBDIVISION L 6 Ilea LOT NUMBER _2S 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. The 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/tie, 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. III 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. SIGNED: DATE: 37-3 St. Croix co. Zoning office 911 4th St. Hudson, WI 54016 • S a N LAND SURVEYING • HUDSON , WISCONSIN 54016 715) 386-+2007 Nome John Currell Address 7582 Currell Boulevard Woodbury, MN 55125 Description Lots 23, 24 and 25, Plat of First Addition to Fox Valley, Town of Hudson, St. Croix County, Wisconsin. N ro I'i80°00'50'IW 448.031 r^ 66' _ U-) - LOT 23 r` N r~ Ln O N 3 ) U' M M M M N 3 N8p 22 36"E _ N N 0 - O ~ N 1 YI p O 2 to O N LOT 24 S89 °00'00"W 126.11' N660 ~ 4 ~ .yam ~h~o35 • W 396 8 Unable to set 31 corner; corner falls T'or'o on asphalt drive.` LOT 25 3 % if •r, \ ~ o N ' N O 4 12'S4nf % ,•O, ` 3g3•)61 ~P N89 3910511E 462.08' CURVE DATA Curve Radius Central Chord Chord Curve No. Length Angle Length Bearing Length (1 - ( 80.00' 8303915211 106.71' S25009' 13"E 116.82' Q2 - Q 80.00' 4803512611 65.83' S400581264 67.84' I State of Wisconsin ) O IRON STAKES DRIVEN County of St. Croix as. SCALE OF MAP I INCH : 200 Feet • IRON STAKES FOUND I, _ Allen C. NXhagen , registered Wisconsin Land Surveyorsdo hereby certify that on January 29 19, 0 , I surveyed the above described and mapped property according to the official records and that the accompanying map is a correctly dimensioned representation to scale of the boundaries,thot .all buildings and impr ovemenfa lie wholly within f1,~ dpry lines, and that no encroachments by adjoining owners appear ~~1► from said survey. OR. Map No. 84-57-190 A Ir,~:~J B. Drawn By F. 9/510 Wisconsin. Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of S Labor and Human Relations Diision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 7S-) Ce-o 1 riot limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPEL OWNER: PROPERTY LOCATION ow 16 L., op- / GOVT. LOT 14 W 1/4 Sr-_ 1/4,SZ~ T Z9 ,N,R 1? E (or) W PROPERTY OWNER':S (LING, ~DDRE LOT # BLOCK # SUBD. NAME OR CSM # i7S g JAs>tii i u!< A V ~ 25 ~ CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEAREST ROAD --dG ~~20J~ l~1 i6/z) -46SZ U ILL&A4..c Dit~v~{ New Construction Use ryr Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement 's [ ] Public or commercial describe Code derived daily flow S6 gpd Recommended design loading rate D bed, gpd/ft2 0.6 trench, gpd/ft2 Absorption area required 9S0S_lbed, ft2250 trlench, ft2 Maximum design loading rate C3 ,S bed, gpd/ft2 10. ~i trench, gpd/ft2 Recommended infiltration surface elevation(s) `7 2 . SO ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem CES OU 2S OU WS OU 5~S ❑U CAS OU I]S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends . 4 a 10 a? A 3 _ SL 1 r j'tit v<~'r 0 4 d .S Ground 97 4 SY CLL NP N 4N ft ) 0.-7 0.% Depth to limiting factor Remarks: Boring # „ yvi CA: 6:5 g Ground J, k 3 r O.? O elev. 9~ ft. Depth to I -Z ` 45 IbY~2 S ~0-c limiting factor Remarks: A s ~ ~`Q A -J L r +J Lo4 CST Name: Please Print \ S N Phone: 3~ G`O~S O 9UMY Address: ULtolj hSG..,ak)3Zrv Signature: Date: !1 E79'z CST Number:,4$±i:--IL4~ SLA-~ PRQPERTYOWNERyEe►J IOW14Ek SOIL DESCRIPTION REPORT Page L of 5 PARCEL I.D. Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baux~ty Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trencd p. L Z b r C 7, JOY s- Y~~ C Z OA ds Ground Z" b _ Z S b /h "7►0.S 0.6 elev. q.Zllit. $ 4'~ 3 s 1 1 o.7 0 2 Depth to limiting factor Remarks; Boring # . lay 16Ye z L 5b nrl~r C O. .S 3 ~r 4 a 4 S; L Z ; C 1 s o.~ 97- V"9 j6y A Ground elev. 7Ojft. ~t ~a 4 3 NIS" ) I 0,7 0:~ Depth to limiting factor Remarks: Boring # fi. l~ d- 3 S~ 2 s b M!!; C 2-1 7.5 Yl~ 4/4 t'1'1S Z M r C 1 .5 0.6 Ground elev. ~3n !dYA O.-] a %Lvft. -'Z iw Depth to 04 Yl s M4 O S 0.4 limiting factor Remarks: Boring # 4 Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) w~ uM~RK -Tap ov- 1 1.4i" Rmgape A-r Loy Cov ae a - ELEv - 100.06' ~ a S 1pA q 4 ~ % ca'r •a 6 ~ l ~ y c7 c ` Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 nd Human Relations Wt:,; of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code J COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but :S)- Ceb 1 not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT l4hf 1/4 Sr-_ 1/4,SZ~! T 29 N,R /9 E (or) W PROPERTY OWNER':S ILING DDRE LOT # BLOCK # SUBD. NAM OR CSM # -77s$ 3ArM))A AVE- 2S A CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEAREST ROAD 44 GP_-0-V& P1 4 &2 > -94SZ U u.~90A,110 v>f New Construction Use Residential / Number of bedrooms 3 Addition to existing building j ] Replacement Public or commercial describe Code derived daily flow Sb gpd Recommended design loading rate 0,S bed, gpd/ft2 0.6 trench, gpd/ft2 Absorption area required 90(]_ bed, ft2' SQ trench, ft2 Maximum design loading rate C3 .S bed, gpd/ft2 O • ~i trench, gpd/ft2 Recommended infiltration surface elevation(s) 92-s-0 ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem cgs O U WS ❑ U caS ❑ U WS ❑ U KS ❑ U ❑ S tl SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourtdaly Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxit ~.S 4a /D 3 5L / f- j'~t✓Tr / 04 Ground 7 SY Z CLL, f yt, f'Y'~' / h(>Q ~(>P Iv lft. Q" 16ye. *A aqv) 0.-1 0.'% Depth to limiting factor Remarks: '°"'h5 aP ~p~ R lE ske S>~nfp /A) Boring # ^ „ C CA ).-pdmq~ 6yk 3, L-2 4 16YA 2;/ Ground ~h R 3 L r~S O d FS elev. %a ft. Depth to l - 2 ° ',*1bYf2 limiting factor Remarks: A 5 ba CST Name: Please Print dUva-Y fNs Phone: Address: d (1 dSaU 1SLaW3~ 1~/ r Signature: Date: C8 /117L9 Z ' - ►g4 PROPERTY OWNER LE - 4W4 EP, SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench .X. L v:........:> Ground 6 4 - St 2 S b M 7+~ o elev. Ilk 19-3 74' 16Ye- 1~5 ill 0--7 0 Depth to limiting factor Remarks: Boring # 1680 2/Z Ile 4J4 ~5, L 2,,h, Gs 9 1 by P, Ground elev. Depth to limiting factor i Remarks: Boring # 4... }i f 6 ye d- 3' SQL 7 sJ~i~ Wt ► C 4.S 0 .L --5/A4/4 A15 Z, M4-1 At r e :5 0.6 Ground v Z 1" 7 elev. 1 0.7 O cu'lg ft. C!d YA 3 ►M5 CV) M Depth to 9 914 s M V O: S b, b limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) t 00 t r, .4- S~ T~4 led- \ 16 vI,,\ \ y Q y~ i Xsconsy Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Labor a Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 7s-) ceo i not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPEL OWNER: PROPERTY LOCATION q I L.,&) e-VP_ / GOVT. LOT 14 L.\) 1/4 SL- 1/41S Z3 T Z9 ,N,R J9 E (or) W PROPERTY OWNER':S MAILING DDRE LOT # BLOCK # SUBD. NAME OR CSM # 775-9 )A*,M), ~V~ 25 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEAREST ROAD dG ~~2oI& 1/Z) A-51 -94-S77- UlSo tLL $~2,aaLc IP_'VIE New Construction Use ( Residential / Number of bedrooms -3 Addition to existing building j J Replacement Public or commercial describe Code derived daily flow Sa gpd Recommended design loading rate D bed, gpd/ft2 0.6 trench, gpd/ft2 Absorption area required SQQ_ bed, ft2 2Q trench, ft2 Maximum design loading rate (5.5' bed, gpd/ft2 0. ~ trench, gpd/ft2 Recommended infiltration surface elevation(s) 92.S0 ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem 0S ❑ U MS ❑ U WS ❑ U VS ❑ U as O U ❑ S U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bounchy Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trends Z 4 a JO t 3 5 / r A J~Fr 1 0.4 d.5 sr Ground Z. CL[. ✓ i/ N N -7 4 lft - 1 0.? O.X Depth to limiting factor Remarks: ZtS 37 Ijpt"R JENSRe Sip /N L~ LAV&2 Boring # A A, 3 - SL n~ C CA: I 3 ~ Z 1 16YA Yh r 7 10.3 Ground ~Dh R 3 ~ ~ ' ~ O.7 elev. %71 ft. 04 Depth to 45 ~aY~2 .5 Al, 2 limiting factor Remarks: A S u-/\ I #J La L2 opt' CST Name:-Please Print Phone: \ S 3 4b o Address: 9A 4,1 C- ' &soU 1scoW3Zr~/ Signature: Date: !1 7 QZ't CSTNumb PROPEMOWNER YE~~ 1OW14Ek SOIL DESCRIPTION REPORT Page? of PARCEL I.D. # It Depth Dominant Color Mottles Structure Bed Tre Boring # Horizon in. Munsell Ou. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trends ~r. L Z b r C Z 0 3 Io l Ground Z I/ b 2 5 b /ir C O's 0 4 "14414 1.9 3 S 1 1 0.7 o 9~Zlit. $ 40 L 6Z Depth to limiting factor Remarks: Boring # A :w !0 b 3 SL b ►M~r C f D .4 o S 9-4 9 jbY A 4[4 Ground elev. CtE -01 f t. Depth to limiting factor Remarks: Boring # 2-1" 7.SY9'f CIS 2 M r C S 0,~ Ground J elev. 63" 16YA A-13 IM5 ! ~ 0.7 0 ft. Depth to M y ~ O. S V. b limiting factor .j Remarks: Boring # ii$S:Xa::3:eLJ'i Ground elev. ft. Depth to limiting factor Remarks: S13D-8330(8.05/92) t 1 _ ~Z yo7 1b V~h r4k 4r `Y ~i1 .y ~ _ y ycn