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HomeMy WebLinkAbout022-1048-50-300 N OO 0. 0 h ti O Co. d H 0. O N C! N N ti a) Q w ti C C ry d ca Y ti 50 r o~ T O •N i C M2 N C 02 o •C O N V1 CL O O C N E 0) ° C 07 N C CD N co co w z0) ..m> C - 0 0 0 C 3 113 ` N N LL o Co O w . N v .0 c o-0 o Q w CV M it co d N z E ao Z = o E z y y ao W n. m r Z .N o z a ° N a~ hh~~ o r+J E `o m c c to to to V O O O O O • N N ;w O O O 0 I6 N N N I I C O U 0 Z Z O N N Z Z 0 0 0 O CO j LO d N E wr O a0 N Q w LL l0 w U O la H d a) O o a ~I ai w Z ° a3 IN- IN- O LL •►"v 000 o N 2 Cl) co in J U = rn 0) N C r r O) N to a0 3 O) O O O 0 N O Q) 0 0 0 ~ ~ E N N N i - N N r N to 0 0 > N o3 O a CO N a~ Lo O V) N 01 U) 7 ai f." c O o 3 y c O RS M U I- ca v a) o ° 3 LO N 0 0 0 0 o N c 2 w •E o. c o 0 0 0 0 C v c ~y S o Eo a~ rn CI.w Y f~ ` a0+ O N N N Iz N ao 3 M 0) w v 1 L - c ai to o 0If) f N N C_ O N O E U • mil' O Y fA o z N z (n c CL 'IrJ r.+ E ` c c rw r A Cia2ouv 1 r ST. CROIX COUNTY WISCONSIN ZONING OFFICE r`r: r ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386-4680 January 7, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: Three onsite soil investigations of the Don Mueller property, all located in the NE1 4 of the NW1 4 Sec. 17 T28N R18W Town of Klnnic kinnic St. Croix County, WI. have been conducted with the assistance of Carl Heise, CST# 3314. This onsite revealed suitable soil for onsite sewage disposal to a depth of 24" while meeting the requirements of the A + 4" rule. Each of the three sites should be suitable for new construction utilizing a mound septic systems having 12" of sand fill. Should you have any questions, please feel free to contact me at this office. Ci)nc rely, I J K. Thompson ssistant Zoning Administrator cc: file ST. CROIX COUNTY nr. WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 January 7, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: Three onsite soil investigations of the Don Mueller property, all located in the NE1/4 of the NW1/4, Sec. 17, T28N, R18W, Town of Kinnickinnic, St. Croix County, WI., have been conducted with the assistance of Carl Heise, CST# 3314. This onsite revealed suitable soil for onsite sewage disposal to a depth of 24" while meeting the requirements of the A + 4" rule. Each of the three sites should be suitable for new construction utilizing a mound septic systems having 12" of sand fill. Should you have any questions, please feel free to contact me at this office. Ci)nc rely, J K. Thompson ssistant Zoning Administrator cc: file Y 1 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ~I ST. CROIX COUNTY COURTHOUSE .`911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 January 7, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: Three onsite soil investigations of the Don Mueller property, all located in the NE1/4 of the NW1/4, Sec. 17, T28N, R18W, Town of Kinnickinnic, St. Croix County, WI., have been conducted with the assistance of Carl Heise, CST# 3314. This onsite revealed suitable soil for onsite sewage disposal to a depth of 24" while meeting the requirements of the A + 4" rule. Each of the three sites should be suitable for new construction utilizing a mound septic systems having 12" of sand fill. Should you have any questions, please feel free to contact me at this office. inc rely, G J mes K. Thompson ssistant Zoning Administrator cc: file C.0 -X-18 3 FILED G / Cr gee L. c~ a . i v s'e~ 6 0 (L i 'z r rrr /L ; , FEB 161993► 9 "x ? . JAME;i t*0`011NELL 44ZL'~ -(cc_G U 22 - ivc/.f -S .3c 495052 Register .,Ws G, z r 4(.! / F St Croix Co., WI c ~ ~ Tz i2%& cv ~,t •~,'c-,~:c! ~ 3 '?z C ER T IF 1 E L~ S ~SJ1134 V4Q Located in the NE 1 /4 of the /4 and thof the NW 1 /4 of Section 17, Town of Kinnickinnic, St. Croix County, Wisconsin. T28N,R18W. Owned. by: Don Mueller 314 N. Liberty Rd. Berntsen cap River Falls, Wi.. „ NW5CO 4022SEC. 17 Unplatted Lands_ S0055 28 W 1920 C. SAM. . 89.921 ...55' \ I V-3- iPG. 653 S 89'12'33"E 701.61' ' pipe 683,91'-* = 17.70' \ N 1 /4 cor. .4' Sec. 17 i \ ®T 2 T28N,R18W V, L A\ N (Berntsen Crtifigd Survey Map- S O N 274030 Sq. ft. Incl. m cap fnd. ) J\ to- t6.2siAC,)R.0.W.. Vo_9~ ?g _2477 s A \ N 2 1 ft. E 5639 Sq v N •~N ' (5.664 AC. LIP / use N 81-49'41"E € w j°s. \ 66 \ \C& 444 , 66 z HARVEY O. :i JOHNSON \ z _ N66 27 08 E , -b T 3 2 HUDSON 33.00' \2 217.861Sq. ft. Incl. U Wks ,r ® ` R,. 0 .w.(5.002AC.) N °ig „~•~M~•,,.~~o~o°' 176496 Sq. ft. Exc ♦I,-* qN0 SUR`l~ 9~~ \ \ R•.. 01. W . (4.052 AC) • - N) *.~~It11a/C6~o~~0 \ \ s~ V I- zl o . ~ Q = Unplatted Lands- , N J~ 00 \'v of LEGEND po\ o cI Section corner monument (as noted). CL ~<y Q zl O 1"x 24" iron pipe weighing 1.68 lb s. CU lin. ft. set. o• " 4 • 1" iron pipe found. 1 1 0 h Fenceline. I South line of the 166'I Buib3ing setback line. NE1/4 of the NW 1/4 I Iw N (nLO ~~1 I aI Bearings referenced to the North- ►o e South 1/4 sedtion line, recorded m I ~I I as SO1°18'13"W. I Wcli > r► SCALE IN FEET 1 = 200 c~ M d 50' 100' 200' 400' } N Z I wl al LLI W1 fr+ 9L < fC :s F-I - flT ~,rr UI > 0 fL solo 18' 13"w S l /4 cor. 3462.54 Drafted by:-) wG Sec. 17 (Berntsen cap fnd. 492-2126 VOLUME 9 PAGE 2593 !.-fiV L n n 1141L7 • ~ ';CMG- .l~%~',~rn=~ ~1~ti Y 1i'' cir9i' l'sr y ; 7 4PR2 41992, JAM a ES 0 CO r ECl 482432 fter St Oft fo vd$ CO, W1 ~i CEP T I F I ED SLIP V E Y MA P Located in the NE 1 /4 of the NW 1/4 of Section 17, T2 8N, R.18W , Town of Kinnickinnic, St. Croix County, Wisconsin. Owned by: Don Mueller Surveyed for: Bryce $i Holly Ness 314 N. Liberty Rd. 316 N. Liberty Rd. River Falls, Wi. River Falls, Wi. 54022 54022 / ' North-South 1/4 section line. S1/4 Corner Section 17 (Berntsen cap) N1/4 i Corner LA2 "~Seton17 SO 1018' 13''W (Berntsen cap) 5209.99' A , 3 2.• A, Curve Data iv_ ~Z• „ _ p Q = 63053100" 2'~ W S .32.52 R = 9 2.0 0' z L = 102.58' CH S55°29'22"E 97.35' o J1 LO 7F I 8 all c0 243,391 Sq. Ft. (5.59 Ac.) ' Including right -of -way. Q i - 215,575 Sq. Ft. (4.95 Ac.) ~I °o Excluding right-of-way. 3 I;I N I M z I - ---10 0 ---s~ cv o ~o al m o n • I i m Building setback In WI W °o W WI line. 00 Hl L+ HI - 3 2 al Z EI N ,o a I 04 1 ~,I 21 N ~I Dj uui AR 2.) 44. V2.1 I a. C"M COUNTY s ~f r~ C "WVe fti1'o*q . z i Bearings referenced to the North- 2prftW z South 1/4 Section line of Sec, 17, P~rksCo ttas 3::l I 01 assumed SO1a18'13"W. 1f root+ a"Ied wAM6 30 days of 6 s' v eppeovarE dates 313,60' vwxbw N 01'06'31"E 328.05' LEGEND~a 00 o Section corner monument Berntsen UNPLATTED LANDS " (as noted). c o It 1x24II Iron cap* pipe weighing 2" Pipe 1.68 lbs. /lin. ft, set. o S00 55 " , Fenceline . O V 89.921 This instrument drifted by. 1 492 97 Vol,. 9 Page 2477 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR BOX HUMAN NDLATIONS PERCOLATION TESTS (115) MADISON WI 53 69 (H63.090) & Chapter 145.045) , 707 LOCATION: SECTION: =WNSH UNICIPALITY: OT NO.: BILK. NO.: SUBDIVISION NAME: I)E '/4Vd1 19 /Tab N/R ►P (or) W 3 rv COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: "y, Q'i o Do L Fa ` ,L USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: I PROFILED CRIP IONS: ER TESTS: ®Residence New ❑ Replace 1 7LATION 1 - q3 t 7 )0 S~YYh 2d °s k. Key RATING: S= Site suitable for system U= Site unsuitable for system C1 ly T►t / CONVENTIONAL: MI OUND-PRESSURESYSTEM-IN-FILLHOLDING TK: RECOMM NDED SYST M:(optional) OS U sU as u as Wu 0SRu mov If Percolation Tests are NOT required DESIGN RATE: I If an L y portion of the tested area is in the under s.H63.09(5)(b), indicate: v Floodplain, indicate Floodplain elevation: N PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- q (>-a" LT an S; 1 6 - f 2 X37 5 , ( I?- - 26 RA ,(3, Md 3j. 3 $ 9 YV 0 N e Z 8 w/al;W& 29- 31" 5; CLL -44 vxoTrl.~ a7 21' 31-3 1: 2 S 0-'0 /y4311 5;1 to-10" a-5; 18,41 1"21(3., 5L 99-54 2J16s B- 9 q9•O O L 4 5C6.L OaIOKSt W'tA jq&-,rt/N at 44 19, 5; 1 /4-21" 6.S;1 zq. 45"DA (3q SL 45-/-0" B- 3 G 8 gr).g NC, N C_ > 68 LT6h o,.J5/- t4coL5k Go-G8 aj~ 5014. / 1A0 6N-c- G O-IO`C-ya,. S'I 10'/(x` B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP N WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R PER INCH P- I Z0 SOW 11. 1 f/1" I 2!j P- 2 0 r.1 My yv 10~ , Y//. P- 3 0 0 ► 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 To OfF OETF(L'M~nSy W NCVy sots w% PES4NSIj _.T _ ..._L`_, 9~ v sc. c a I 1i 1 F 3 I j : r I I i ! I a3 E€ f ! t 0 Q ^ I X ._-_-_°I I 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 COMPLETED ON: 0, Mf I P. t► I - it - 61 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 10 42 S t . y _t, F tl t,4 5 44 t 13 21 A I -S_-4 -217 ' CST SIGNATURE: I i DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER- INSTRUCTIONS 6. COMPLETING FORM 115 - SBD - To be a commplete and accurate soil test, your report must include: 1. Complete' .::.1 description; 2. The use lust clearly indi( v other this is a residence or commercial project; MAXII r of bedrooms - merciai use planned; 4, Is th` ^ment systf 5= Cc rating be . SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHE.f SY' ARE RULED O' 3ASED ON SOIL CONDITIONS; 6, PLEASE use the abbreviations she `or vvriting profile descriptions and com[ - the plot plan; 7. 'P ~i A ' F`BLE diagram accu :luting your test locations. [drawing to scai preferred. A used if desi, e:#; n _irk and vertic I = i reference point are clearly shown, and are permanent; 0 to boxes as to da naries, addresses, flood plain data, percolation test exemp- 107 flood pl` iin, r°'cvation) does not apply N.A. in the appropriate box; 11. w, /Out' cUr ~I s and your certific:a En , ~r; 12, Ma' d distribute ,J, rL ALL SOIL TES MUST BE FILED kNITH THE LOC> ,L FY WITHIN 30 DAB 'IF COMPLETION, ABBREVIATIONS FOR CERTIFIED SOIL TESTERS So and Textures tithe ds (over 10„) BR - (3 - 10") SS G (under 3") LS - one H- - >u, dwater Rata in(] - Vf F-Ind Is I~lysand 'sl ly Loam I _ Bn Si - 'yam BI Gy ©am y - C' y Loam R :;lay Loarn not - ;y Clay w,' sic: - Clay fff R€ cc P - rnrn - n d P H L - ._xtures _ste disposal TO- T f ,c e D t request tl--_ pi ivate r..,+ applic; u y n orrer to y permit r ~..Js: ? any construction. I STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER I1[av k c~Gn ADDRESS 1650 1 ow ~1 HALL -0 I IR 4LZ S SUBDIVISION / CSM# U ~G S 4~5 Z LOT # 3 SECTION _ _T;:;~ R N-R I W, Town of k, ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM p web[ D ~ r2oT 1%bb 00 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this-form. Provide 2 dimensions to center of septic tank manhole cover. i BENCHMARK: F07 SJ, s YUE (aih'r L GC, ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING-.TANK INFORMATION Manufacturer: w j< S Liquid Capaci y: 0 Setback from: Well ;1 House Other Pump: Manufacturer ao;it Model# N R~ Size Float seperation Gallons/cycle: )2,6 Alarm Location k. I` -:SOIL ABSORPTION SYSTEM Width:` Length 47 Number of trenches Distance & Direction to nearest prop. line: I q o Lj Setback from: well: q House ss Other ELEVATIONS Building Sewer ST Inlet; 9 _'2. D g ST outlet PC inlet j i , % 2, PC bottom g3, Q `4 Pump Off 2q, b Header/Manifold y Bottom of system Existing Grade q g,2 Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: 37 INSPECTOR: J lm ~aa, 3/93:jt LQfC'eW10*3rtdfe~iNWI10k1ANIC,17, 21iRMAMMAW-W4" I) County: ,labor and Human Relations INSPECTION REPORT Safety and~uildings Division (ATTACH TO PERMIT) Sanitar mit GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State PI MARK ZTXW-jCqr_~?Mie ev.: nsp. BM Elev.: BM Descriptio . r s Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9300187 /6 5 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic (,(Jx~ cv C? j Benchmark 3 99 Cam? , ~c Dosing .r Yr 1. /d/ ~?(i Aeration- Bldg. Sewer¢ Q Holding St /)d inlet Z' A2,07 TANK SETBACK INFORMATION St/ F, eoutlet ~9 9/ ~v TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet / 702 Air Intake Septic NA Dt Bottom ~'n GdsE Dosing NA Header / Man. Aera ' n NA Dist. Pipe yOS y' C Holding Bot. System 7a PUMP / "FORMATION Final Grade Manufacturer Demand s'-r g ZOO' 20 Model Number r` 517 GPM a TDH Lift Lriction t~l System q, TDH Ft I~~`Forcemain Length qtr Dia. a" Dist. To Well X33 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length i No. Of T enches PIT s Inside Dia. Liquid Depth S8 DIMENSIONS 7 DIME I N SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Ma urer _ " . CHAMBER o e Number: - INFORMATION Type O e,,_>- System: Gam,., >>"✓U) SS AA OR UNIT DISTRIBUTION SYSTEM Mme/ Manifold Distribution Pipe(s) x Hole l ,r x Hole Spacing Vent To Air Intake Length t6 Dia. o~ Lengthy-2- Dia. ~ Spacing ,n SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 4 Depth Over Depth Over „ xx Depth Off xx See de odded xx Mulched Bed /Trench Center Bed /Trench Edges + Topsoil es ❑ No es ' ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) ) LOCATION: KINNICKINNIC,17,28,18 (TOWN HALL ROAD) l c- J ~C J _c 9 f/ 3 Plan revision required? ❑ Yes lo i Use otheuside for additional information. Q / A.3 s-- SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: • x 171 SANITARY PERMIT APPLICATION 01LA In accord with ILHR 83.05, Wis. Adm. Code COUNTY A ITA 4511, RYPE ~MI # -Attach complete plans (to the county copy only) for the system, on paper not less than STATE ~ S _ 8% x 11 inches in size. ❑ C ec i n to pr ious 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 iHao k i- S e st-k r'Tz. W 1= '/4 S 1 T 26, N, R 1 (or) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # JV C rv . r -tat KW d 3 1 it CITY, STATE ZIP COD PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 1(4it. 53G-03-7 C,S/11 V.3 PC-Z,63 445oS1L II. TYPE OF BUILDING: (Check one) ❑ State owned VILLAGE : NEAREST ROAD gy(pp(( l~%'** k..w.ai To U'. 14.11 R1 ❑ Public J011 or 2 Fam. Dwelling-# of bedrooms -3- PAR LTAX NUMBER( ) III. BUILDING USE: (If building type is public, check all that apply) a~a to 4 8 50 30d 1 ❑ 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 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 in line A. Check line B if applicable) A) 1. X New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 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 ❑ Seepage Bed 21 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 120 Seepage Trench 22 In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 140 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 Sa 37 5 3'~l0 ) . 2 ?7 9 9.9 Feet ► 01. Feet VII. TANK CAPACITY Site INFORMATION in allons Total # of Manufacturer's Prefab. Fiber- Exper. New istin Gallons Tanks Name oncret Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holding Tank 1600 1000 cks (arc Lift Pump Tank/Siphon Chamber, 8ov Sod) W&;" Co-.c- 0 Vlll. 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/ S Business Phone Number: cats p.}~use IP' 3 78 ~1S- 4 -21?~' Plumber's Address (Street, City, State, Zip Code): 1042 S, vHoe» Sr. ~.✓+r F.,L15 w, 54412E IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved SanitiVy Permit Fee (includes Groundwater a e ssue Issuing Agent Signature tamps) Approved El Owner Given Initial DV a~Surcnarge Fee) 7-J 9 V O- Adverse Determination ' X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety 8, Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. t 2. Your sanitary 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 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 systerri,`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. " 11. 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 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. 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 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 groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) e 4 MOVE THE EARTH t AILPORT EXCAVATING 1042 South Main RIVER FALLS, WI 54022 CARL P. HEISE (715) 425-2175 Owner MOUND SYSTEM FOR A BEDROOM RESIDENCE LOCATED IN THE N L~_ OF THE MW14_ OF SECTION _L l_, T28 N, RA W, TOWN COUNTY, WISCONSIN. INDEX PAGE 1 of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR Mav k. d Sue. Sc1►wa rTZ-. 631 q 4A TN 14vC rv. . Cty}Ta1 rwu 55428 /JPREPARED BY S9340516 e4a 09 .V~ CARL P. HEISE CST-3314 MPRS-3378 1042 SOUTH MAIN RIVER FALLS, WI 54022 . Y~ 2 0 ~ Cv . • 'PL oT PLR ~ 5.0 2 A wooed La'( 4AA, SG i "ab°ot gr goo" o0 pssan+ss 6L~ N+E 4O fro* N W heft ~\A •r► SIO'1 Qzvsu'CE Q All ~Sksa> ca uNrp, s*o,;;k g3 d O Q'' T4,~s o. `v 006A 1 AT 0 yes ~a Yvtow a ~vO r C o AL1- T r co. I$ 7.u \tc7~ ~y4 y7 ~ rev►+OVCd 0.t ~r~e O , wa JL p,,~ STv»+ps TO rCY~4~h h S ~qo 62 V2 \ AtKt-: makE SUM VAIL 1MOUNp ks Q~'.1E11tt_~ Gt, 'YIiE C.ONt~.t'1~ `a. f ZZ`S O\FF~CuIY TO TEU„ iAE9S-_ 4o a"{Q~°. P~ 81 C O•sw~w \ 10 eo, t:w~ B. VI w cck~ p`• "wi Gc any = 99 ty~...bv o • Io000M1- O wrwo Sc v.Yan/v 4 9 scl ao 2; es c S934051 b N eW p i G. a>l ~~djuit k. t l . 17~ Pj, 77 ~t r "Fy ..ia Ai { :6 u.i i l,f, " ~ ~_r; J 1s "'•b`~) ni v:r1t t ~ ;E fl i ~":W3 (~4lJ~Iid _~',r I hf~u Lil ~ f~f2li+i~~ 401 S~t'~Gr✓ 3 OF 6 41-M S'` or' --Si-row°pMorsh Hay, Or v, T~S,PROVEn Synthetic Covering Distribution Pipe r-. Medium Sand 9 Topsoil F JE g. 3 1 ` 4% Slope Bed Of Z - 2 %2 Force Main Plowed Aggregate From Pump Layer o o17 Cross Section Of A Mound System Using F ? 5 _Fr• A Bed For The Absorption Area <3i, F .~iwW, _~E A _ Ft. H Jam.'-T-T. r_ Ft r _ I 1.Z Ft. J_ Ft. ~1 1 '1 i t nr 1 i 3, 7 f o" i ~7- f iL I'iJ V F 1.S NOON G'~ ,.:r L Ft. f L~ > W _ ft. Obse~~y ion Pipe-,,., J B yK W -r------------------ Z2 z Distribution - Bed Of Pipe Aggregate Observation Pipe 9 Permanent Markers ~TRl3iL1Z~C. S~YH r. Pion View Of Mound- Using A -Bed For The Absorption Area Forlorolcd Pipe Dololl pa Ent: Vit•r -k- (FrrloroicG Y Ent% Cc;,- .y; •PVC PrPe t`°p~c^c` P~P.?'~?J =U7 Ni AiZY..Ft'Q O°dr~6 Lrlcr' tocolttd Gr. 6otlom, 3. ¢ I Orr E ouolly Spoced 1 PVC 'F6rct •Moin From Pump , Q . PVC MonilolG Frpt • ' i I) LisU touUOr• ~ Prpr Lost Kole Should be I • to End Cop I'd ran Nitribulion Pin Lovoul P_ S q, S 934051,6- x 48 Y Hole Diameter Inch Manifold " 2 Inches Force Main " 2Inches Laterel Inch (es) Holes Per _ _ 2 JA C 1 ~q ~ I ~!1~r't~t~~~~s`~Y ~9~ff{il ,i•~'y tai- •1 tj: i._ vr. r r nw.~ PAGE OF lO ' PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS' VENT CAP Sel' 20 4'C.I. VENT PIPE WC:ATHER PROOF APPROVED LOCKING 25' FROM DOOR. JUXICTION BOX !`MANHOLE COVER WINDOW OR FRESH I2'MIU. Alit IIJTAKE I GRADE I `0 MIN. _ 18' MIIJ. CONDUIT IO'MIN, ; INLET PROVIDE I 1 • AIRTIGHT SEAL I I ( ~ APPROVED JOImT APPROVED JooJTS w/C.z. PIPE L " I I I W/C.=. PIPE CXTCNDttJG 3' ~ 01 I II ALARM EXTELIDING 3' -014TO 60610 &OIL. 0 X35 ~ ~,~&y ak ~r ,ti•, it;;.' I 1 I ONTO 3oLID 601. L> ON u„ LLCV... F? PUMP iNti-4~ orF COLICRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL 1 IIPPf2oVR 66001 ~ SEPTIC SPEGIFICATIOLJS D05E T_ AUKS MANUFACTURER: NUMbER OF DOSES: 4 PER DAU TAWK WZC:~~.g00 GALLONS DOSE VOLUME At.AR MUUFACTURLR: Nt t ,`rOr IIJCLUDING BACK/LOW:_2.0 GALLONS MODEL NUMBER: 0LU CAPACITIES: A-_ 23:4 INCHES OR 425,6 GALLO ►1y a" SWITCH TyPL: Y^ g Z INCHES OR 34 -.4 G6LLONS PUMP MANUFACTURER:.._ Z oe I l e` C =/0,1B..I14HES OR 12047. GALLONS MODEL NUMBER: ' 9 0= 12- INCHES OR 218. 4 6ALLONG SWITCH TYPE: TA Circwra MOTE: PUMP AND ALARM ARE TO OC MINIMUM DISCHARGE RATE 0 1 GPM INSTALLED ON SEPARATE CIRCUITS -0 qq. VERTICAL DIFFERENCE DETWECBPUMP OFF AUD..DISTRIBUTIOU PIPE.. _►1. 9 FELT ♦ MINIMUM NETWORK SUPP61 PRESSURE 2 5 FEET ♦ 40 FEET OF FORCE MAIN X 1.38 FYo fjKICTIOU FACTOR.._ a"3 FEET •Lq TOTAL OyNAMIG.-H-t:Ap FEET IQTERNAL. DIMEW610w~ OF TANK: LENGTH ;WIDTH '72 ...._~;LIQUID OEPYH I B.2 GML~, . 5 IGNE0: LICENSE WUMBER: _378 DATE• L` a-,,~ 43 Y o f co ' zoELLER • w w W W Y. 115 34 - 110 fl~ 1 t~ 32 105• 30 100 - 95 28 90 26 85 LUENT 24 80 MODEL and Q 75 MODEL 189 22 TO 165 ITERING = V 20 Q ~ 18 60 C 55 _ J FQ- 16 50 MODEL Q 14 163 MODEL 45 188 12 40_ 35 10 DEL 30 M M EL MODEL 137 139' 8 185 25 mAX 0 MODEL 14 JS M bEL 161 . 4 T 10 2 MODEL 5 53, 55, 57,59 0 GALLONS 10 20 0 40 50 60 TO 80 90 100 110 LITERS 0 80 160 240 320 400 FL W PER MINUTE X8.08 GPrA S T C - 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), thenia second form should be retained and completed when the property'•is sold and submitted to this office with the appropriate deed recording. Owner of property May c Location of property N6 1/4 AIV%/1/4, section 1'7 , T Z8 N-R_.~&_W It s s % A/ ri/ /g Township Ki kim ; k'1' r1l'i ! 6.319 ,r-44-A A w IJ- 0 orj ~ s4a MAI 4-; i zi// 5) Mailing address X23 tvasssdo% =p~3 Fe t(g ¢D z C-7/55;f 2S /,s- lo~3f) Addressssite 1 0-J4- F;/,e R0016-6- AdS-0 i ~fe,' %/31 Mq:l; nq adpI ess 15 aelcIrPSS o~ S K- Subdivision name Lot no. Other homes on property? yes_,~_'_No Previous owner of property L/oH a 1 A of t o H ve- I l e Total size of parcel 'T ~c✓e S r f Date parcel was created ru4✓u ~3 Are all corners and lot lines identifiable? _ 1~r Yes No Is this property being developed for (spec house)? Yes N,'No Volume q and Page Number .2513 as recorded with the Register of Deeds. I2ICLUDE 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 I t Re ister of warranty deed recorded in the office of the Coun y g i Deeds as Document No. 4!? 6 3 Z , and that I (we) presently own the proposed site for the sewage disposal system= for -lily recorded in the office of County Register of deeds as Document No. All .1.0j\ 1 J gnature of aPPlican Co-applicants Date of Signature Date of Signature DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED pDR RECORDINO DATA STATE BAR OF WISCONSIN FORK 2-1982 496342 VOL 998PKE 102 REGISTER'S I Donald D. Mueller and Glcria Muelleri husband ST. CM . Reed (Cl`Recb .........and..wife MAR 2 3 1993 io:oo M conveys and warrants to ! ?rk__A_r__ $Ghwa.>. z _,i}rtei ••$ue__C------- 5c))WaxtX....)>u~bsrasi. and .>eri f e,.. aa.-aurvi varshi p-maxi tat. (J ao BxQ9tXtx....................................................................... RETURN TO real estate in St.........Crol........x County the following described , State of Wisconsin: Tax Parcel No: Part of NE 1/4 of NW 1/4 and Part of SE 1/4 of NW 1/4 of Section 17, Township 28 North, Range 18 West, St. Croix County, Wisconsin described as follows: Lot 3 of Certified Survey Map filed ~j February 16, 1993 in Volume "9", Page 2593, as PRANSF lk Document Number 495052. $ '5'r- FEE I This i..s not . . homestead property. (is) (is not) Exception to warranties: Subject to easements, reservations and restrictions of record. Dated this iA~p day of ............March 19...9.x.. -----------•--(SEAL)i..... SEAL) a DONALD D. MUEL R .............(SEAL) -------Je~ .4 . !...............(SEAL) a GLORIAMUELLER AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN as. St. Croix County. authenticated this ........day of. 19 Personally came before me this ...teif!'!`!0._.day of ------Ma rrh 19.93.. the above named - DO~'al`i D M"~ ~x..an...GIsx1a................. • Mueller TITLE: MEMBER STATE BAR OF WISCONSIN (If not. r~ authorized by 5 706.06, Wis. Stats ) _ _ in v( 1J *0 :;ate known to be the person who executed the ido Y ePUBluG fo ins fut and aI knowledge the same. THIS INSTRUMENT WAS DRAFTED BY . _ .............PTEPH~..:7:.....~:1.................•_.... . a Hudson Wisconsin---......._. Notary Public St._,CxQix................ County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is perman t. (If not, state exp' i da on are not necessary.) te. 4 19 sNames of persons Janina In any capacity should be typed or printed below their siiEnab•In,, WARRANTY DEED aTATS BAR OF WISCONSDY Wisconsin Legal Blank Co.. Inc. L_ FORM No. 2- 1982 Milwaukee. Wisconsin S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER BUYER M✓ V A V e e _5C_4'-J0'✓-~ ADDRESS 60 165-0 /OaJ,1 1 FIRE NUMBER CITY/STATE R. JC'✓ ~iy I I5' ZIP Sg-d 2 PROPERTY LOCATIO : 1~4 , M✓ 1/4, SECTION, T L6 N-R / ir W SE Y~¢ A/ LV YJ TOWN OF AA IG1~ t &4 n C_ , St. Croix County, SUBDIVISION , 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. 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/We, 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. SIGNED: DATE : ~c f l I I St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 - CID ^ l s FILED j FEB 161993► 9 JAME,,:"'CONNELL Rofttar ci Unds • , Z 495052 St. Croix CO., WI , CEP T I F I a he SE 1/ 4 of the rW 1 /4 N4ectpion 17 ; Located in the NE I /4 of the NW t /4 an'28N R 18W . Town of 1Sinnickinnic, St. Croix County, Wisconsin. Owned by: Don Mueller 314 N. Liberty Rd. Berntsen cap River Falls, Wi.. 54022 Unplatted Lands_ C. S. M. NW COR.SEC. 17 V 3 LPG. 653 SOO 55'28"W 1920.55'... 701.61 89.921 S 8 9 ' 12 ' 3 3 E 683.91 2~~ pipe - b1 N 1 /4 cor. 17.70' 1 \ Sec. 17 \ \ T28N,R 1&W \ LOT 2 (Berntsen \-3 `n 274030 Sq. ft. Incl. rn cap fnd.) R .O . W . N Cgrtifiad Suavey Map_ Ss ~ty\ '.(6.291 ACA V0_9i pg._247? 2\t?"256319 Sq. ft. E-Kcl. v S~• 15.884 AC.1 R .O . W 4 4 .86 ' z_ a~~~~G•~ `S~js \ 6 \ N 444.86' Y ~ J HARVEY G. Z '•~®lf 3 o JOHNSON 1 N86 ,E 8-1899 33.00, 2 217.861Sq. ft. Incl. w = HUDSON i w R.. O. W .15.00: Ac 1 W S \ 176496 Sq. ft. Exc ~ <~0~00°0 \ 4 \ R, O . W .14.052 AM Q1 r I if) X SUP Iq 11 NOo 0 J1 4118 Unplatted Lands_ \o vti F wj 70, \`T \ 3 Z < I LEGEND Section corner monument (as noted). to 1"x 24" iron pipe weighing 1.68 lbs. / \ \ O 4. lin. ft. set. 0 0 1" iron pipe foung. 1 Fenc eline . 1 M South line of the Building setback line. NE I /4 of the 1/4 1w N ~ M W 1 01`to IC v al . Bearings referenced to the North- 1-4 ~ 1 1 South 1/4 sedtion line, recorded to t 1NI as SO 1° 18113"W . ro tp ~IN1 1 1 SCALE IN FEET 1" = 200' v3i~o-1 ZI O' 50 100' 200' 400' j, PC N 3. ~ +~j I 1►~~01 t* DIV. OLT 8 6i IL C;I% to n •s3 g $ S0101e'13"W ' m S1/4 cor. 3462.54 Sec. 17 492-2126 Drafted by: ~1✓G (Berntsen cap fnd. Description A parcel of land located in the NE b/4 of the NW 1/4 afid the SE 1 /4 of the NW 1/4 of Section 17, T28N,R18W, Town of Kinnickinnic, St. Croix County, Wisconsin, described as follows: Beginning at the N1/4 corner of s Section 17; thence South 01 degrees referenced to the North-South 1/4 minutes 13 seconds West ( Bearing section line) 1747.55 18 feet; • th.,n ce North 07 degrees 31 minutes 34 seconds West 629.02 feet; thence Northwesterly 200.32 feet along the arc of a 420.00 foot radius curve concave to the Southwest whose chord bears North 21 degrees 11 minutes 24 seconds West 198.43 feet; thence North 34 degrees 51 minutes 14 _ - seconds West 357.40 feet; thence Northwesterly 168.52 feet along the arc of an 854.00 foot radius curve concave to the Northeast whose chord bears North 29 degrees 12 minutes 03 seconds West 168.25 feet; thence North 23 degrees 32 minutes 52 seconds West 554.05 feet; thence South 89 degrees 12 minutes 33 seconds East 701.61 feet to the point of beginning, containiricg 491,897 square feet (11.292 acres) more or less and being subject to all easements, restrictions and covenants of record. I, Harvey. G. Johnson, registered Wisconsin Land Surveyor, hereby certify that I have surveyed and mapped the above described property; that such plat is a trv= krue and correct representation of the exterior boundaries of the land surveyed; and that I have fully complied with the provisions of Section 236.34 of the Wisconsin Statutes, the St. Croix County Subdivision Ordinance and the Town of Kinnickinnic Subdivision Ordinance to.the best of my-professional knowledge, understanding and belief. otrc, 0"Oft, VIP Harvey G on S-1899 it H►.pVEY G. Johnson Surveying, Inc. 216 Meadow Drive North:: 'JOHNSON Q Hudson, Wisconsin 54016 5-1899 ` HUDSON MIS , ~ 9"9441* This map is hereby approved by the Town Board of the Town of Kinnickinnic. Ut Town Clerk GENERAL NOTICE Each parcel shown on this map is subject to State and County laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, ect. Before purchasing or developing any parcel contact the St. Croix County Zoning Office for advice. CURVE INFORMATION Curve Central Chord Chord Arc Len th Length Tan ents No. Radius Angle Bearing - N36°54'18"W 73.00' 73.67' N23°32 52"W 1 158.00 26°42'53 854.00' 11°18'22" N29°12'03"W 168.25' 168.52' N34°51 14"W 2 " N29°12'03"W 161.74' 162.01' N23°32'52 "W 1 3 821.00 1 1° 18 22 N34°51' 14"W N21° 1 1'24*'W 198.43' 200.32' NU753114" W ` 4 420.00 27°19'40" N07° 31~ 34~~ W n 5 451.00' L7°ig'40" N21°11'L4''W 214..0?} 216..06` N34°51` 14" W VOLUME 9 PAGE 2593 J~ (DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION INDUSTRY, P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (H63.090) & Chapter 145.045) LPOCATION: SE TION: WNSHI UNICIPALITY: OT NO]BLK.NO.- SUBDIVISION NAME: '/4Qd/ I /Tag N/R I (or) W ' , , -3 C: OWNER'S B Y R'S NAME: MA LIN ADDR SS: Do L' Fr~ t SZ, o jk .,?fl N, 5 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DE R PTIO rt~ I R M ESTS: IatNew ❑Replace ®Residence 3 tv RATING: S- Site suitable for system U- Site unsuitable for system M, Y TAo r, ` ONVENTIONAL: MOUND: IN-GROUND-PR ESSU S E 7Ili 1: ILLHOLDING(TTAANK: RECOMM NDED SYST M:!optional) rMs (2ul 2 S❑U ❑S U RE: SDS~U DS~U If Percolation Tests are NOT required DESIGN RATE: I tf any portion of the tested area is in the under s.H63.091511b1, indicate: N N Floodplain indicate Floodplain elevation: N 01 PROFILE DESCRIPTIONS r-Z TOTAL P H T R UNDWATER INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH DEPTH IN, ELEVATION OBSERVED HE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) a-8'' t_T f3., s. I 8 - ~z ~3~ 5 : I 12 - Za Qd X30 d 3L J~$ 9 of w w-44 r-071- , a12/r 31-3 l ~.r1 ~v o r, e 28 rubu~ 2e-a• s; UL d 0-#o d 13, is 10-'8" G-5;1 1$-41 R1 G., SL 49-54 ai57 S l q4.0 hl 0w c q 4 6CL.L d•hsc wTl4 fl sFri•~ at 11. / a- r{~ (tT f3~ 5; 1 14.29„ 6,5:1 Z4 45~~D1L C3 SL as•~o" B-3 G S q~.9 1J0 tvC_ G8 LT8ft vh J5L w1coWr bo-lie 6.5CLL B- B_ PERCOLATION TESTS WATER IN HOLE TEST TIME DROP IN WATER LEV L-INCHES RATE MINUTES TEST DEPTH NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P PERINCH P- z 0 r.! 1 44 1~ 10~ P 2 0 ~rv~~w P- 3 o f I 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. ) I X L J X SYSTEM ELEVATION To as OETFfL"N nsy w mer, sy, xv, miatueo 04A- 4 SYa. o f - - 55- t..l. 04-0 "a I C4 i _ I i N I 9 n► lAt r 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 belief. TESTS WERE COMPLETED ON: NAME (print t ` I cwsc, CERTIFICATION NUMBER: PHONE NUMBER(optional): ADDRESS: 71 f . 4 91- -.217 TA a-ILl- I a 4 2 S y ' ST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. fl\rFR