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HomeMy WebLinkAbout020-1260-60-000 n p3 °cfl I ON > CD I o a ~ I ~ I o I 0 N O I tl r I I I I C y U. C C O 3 = D I a a Cl) a ~ I rn W o Z d at c" H z d m o I o z er Z d Z U) z I v E M N N 7 p^/J1 ~ N I y a ~ m 2 4) c • a cn L g 0 o N a N Zco Z Q u, Z I N d tm C I 10 E N I 12 m ° Mn m Q CD c ) co W d 2 N O 0 0 C o G r G CL O L N I J a N § 3 3 a ) = Z~ ~ oo I •N aaa o y N IL 7 d1 7 N N o to J V= rn rn Z I o o 'D o I F M M O to 0 E N I '0 5 0 0 0 m a V) N m m ~ ~ a ~ fn fp U) H U) C O 0 H C O O O C Uto 0 N C j to co LO Ln 4) O OT C a C a O m tOD N R p N r N C m (D -t-- L d a, r :!r CD M M I N! m y N v H c d It *4 6 C4 -6 E o N 2 O Z N Z-5 VQ I ~ ~ = I ~ a s I I ~ - V v~ tea) a a ~_•E L: a • a ea d d c m .pv ' E v` c c ; R t A c~a~ iOU)o FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER--- M M I L L E R TOWNSHIP a V D S O N SECTION a I T a q N-R_Lf_jg) ADDRESS Roy 2$'2_ ST. CROIX COUNTY, WISCONSIN " ~ -s o v. UJ T . "-'G fi r) 14, SUBDIVISION _~rc,; V; 41 ke LOT ZD LOT SIZE -Off A6 . PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i ' 40 I I 1 o SS, 20 ZS~ 6giw t c Hot.<S ~q'Xis 6Z 1$X50 v WS 0- l v I / A 51,1 Id, 11y'V = ~D RM- Top aF /9 ~Ml~ ~u~ve.f'f Ora Kt~~a)►,1' ~ i • = 1 Do.oo BENCHMARK: Elevation and description: a~ tS'' C"/✓e ✓-f ?a; arts 4 00,4 h~~ Alternate benchmark-l-, 10 SEPTIC TANK:bianufacturer: Wes; Sri Liquid Cap. IDDO_ggj Rings used: Z Manhole cover elev: 4432-Einal grade elev: JIL.D© Tank inlet elev.: 7-11? Tank outlet elev.:- 7.7 No. of feet from nearest road:Frontx- , Side , Rear Ft.IG S/ From nearest prop. line:Front , Side, Rear Ft. 53" No. of feet from: Well ~ Z./ , Building: ZD (include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE LaIlL s PUMP CHAMBER Manufacturer: /4 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:[ooomt'o,al Trench: Seepage Pit: Width: Length Number of Lines: 3 Area Built 7Z Exist. Grade Elev. Proposed Final Grade Elev.621 . Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side Rear-Ft.'/3 No. feet from well:,? 7 No. feet from building S'S 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: LICENSE NUMBER: Aj / ^ y` Z .6/90:cj LION: HUDSON 21.29.19.1259,NW,SE,2I,PRAIRIE LANE,LOT #20 'Wisconsim Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 149316 Permit Holder's Name: ❑ City ❑ Village iP Town of: State Plan ID No.: BENOY CATHERINE & MILLER S UDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 020126060000 TANK INFORMATION ELEVATION DATA A9200151 6~p5- l~2 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark am G/ Dosing- 0/ as-* le Aeration Bldg. Sewer Holding St/Inlet 7. 44 OF 9XW TANK SETBACK INFORMATION St/ Outlet 01 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Do n NA Header k+*=. 3 g' Aeration NA Dist. Pipe Holding Bot. System Id t'S' p' PUMP/ SIPHON INFORMATION Final Grade 6.47, S, Manufac Demand 9~,/,3 / Model Numbet GPM kr.° ~1, 6C1 ► ' TDH Lift I on $yste TDH Ft Head Forcemain Length Dia. Dist. To wen SOIL ABSORPTION SYSTEM Liquid BED /TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Depth DIMENSIONS 1'e DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O On CHAMBER Mode Number: System: _c~ cJ 5 -l~Q OR UNIT DISTRIBUTION SYSTEM Header hRAaa+€e1~- Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length A, Dia- Length ~ Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over i Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center C V Bed /Trench Edges I Topsoil C] Yes C] No El Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) n Plan revision required? ❑ Yes 2-1o Use other side for additional information. , Q l SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e SANITARY PERMIT APPLICATION DILHR In accord with ILHR 83.05, Wis. Adm. Code COU~/ l~ • STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 1419 /(.0 8/s x 11 Inches in size. ❑ Check if revision 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 a ' Zm/ i o o e W Y4 S~ 1/a, S e.Z / T Z>, N, R I E (o< olf PROPERTY OWN R'S MAILING ADDRESS LOT # Z BLOCK # 7 o uJ 0/s dw-- CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 11. TYPE OF BUILDING: (Check one) CITY / NEAREST ROAD ❑ State Owned O VILLAGE ///L A/So I DD ❑ Public M1 or 2 Fam. Dwelling-# of bedrooms A AX N M R() ~Z Sq III. BUILDING USE: (If building type is public, check all that apply) O oho -)?,40-( 1 ❑ Apt/Condo 20 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. [2 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.E1 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 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 12. 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 ys'd Z, 47 7 ZO Q. ZS /--j 91.OC Feet S 3a Feet VII. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank / 0 00 / We" -e Lift Pump Tank/Si hon Chamber F1 Ll I Q___0 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 Signatur (No Stamps) MP/MPRSW No. Business Phone Number: .Ao,A 5TH k 6 Q,s_ r Z 517) -12- 2- 3 Plumbe s Address (Street, City, State, Zip Code): PO A- Z)- /(/4G1 ~r&~ r7ay~ r 411 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ED Owner Given initial 0 0 Surcharge Fee) Y-30 - 9.2 Adverse Determination 7 7 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber f INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 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 (SEM 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumpec 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 & Buildings Division, 608-266-3815. 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. 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 it the capacity of every new aid/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 13% 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) 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 a 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 _5a,r, f~e011K~ d°r.,eK Location of property/V/~l /4 1/4,, Section Z-/ , T_-2 9 N-R /LP I, Township It ro Mailing address - 2 G G '444.. o •ci pz: aa__ -~k a~ o h W O/L , Address of site Subdivision name Lot no. z o Other homes on property? yes X No Previous owner of property ,41Wo o L., sue, Total size of parcel 7, 3 r Date parcel was created Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house)? X Yes No Volume M and Page Number 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 REGISTL.R 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() the property described in this information form, by virtue sof oa warranty deed recorded in the office of Deeds as Document No. I the County Register of and that own the I presently proposed site for the sewage disposal system tem or I (we) obtained an easement, to run the above described pro ert f the construe p Y. or tion of said system, and the same has been dul recorded in the office of Count Re y y aster of g deeds as Do No. curve nt 4~OyaI Signature of applicant Co-applicant f? ~I U Date of Signature bate of Signature .,•-'rrrC_`'_'.. MO - CATA p•:,r„ ~ DOCUMENT NO. STATE BAR OF~WISCONSIN FORK 5.-190 TMs .PACs nasanvao Pon neeonoI t PERSONAL REPRESENI'ATIVE'8 DEED 410.4 Z1 ~ Harry J. Stewart ii «~);v Co., Wis. i; 31st as Personal Representative of the estate of March D. 19 86 ' . ~i LkL~..A~dXo..kBxse?i ! 9:45 A ("Decedent'), for a valuable consideration convoys, without warranty, to Verlyn.. E. _ Benny . and Cather.tne A. Beno as husband and wife as marital„ °-~t^a f'"'f' roe w l h i h f ur o shi Grantee, rraTV To the following described real estate in SC. Crl~ix •,•-•..County, State of Wisconsin (hereinafter called the "Property") : West Half of the South East Quarter of Section. 21, Tax Parcel No: Township 29, Range 19. .1vU„ psi, Y Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which the Decedent had immediately prior to Decedent's death, and all of the estute and interest in the Property which the Personal Representative has since acquired. Dated this Z8.01 ..............day of . . . .M11XS,i1 19_.86... I .........................(SEAL) ......."~.~:.:....r: 'V......... (SEAL) • Vis1.C.CY..:1.r....[.4M!?.F.C E.~.1► % Perwn•1 ReDrrlrnt•tive 1'nrsnn•I P,•prnrnlalive ~ C-- U Jj C)' AUTHENTICATION ACKNOW LEDOM1u~TLT O o J Signature(s) STATE OF WISCONSIN 7 ;Z Q l 41 1t ...CLQIa ...............County. 1 authenticated this ........day of 19.. Personally came before me this 2U1)...day of 19.80... the above named ,S Pc • v Rc _ en ...'rti..))s7.~.....:PX~k...•tat ve ilaX)')'...1..., t4w ••iIrt,. its f1>X l hc_tr ililks..~f..,1u1)I).Aldro tfy.X~ A..La.Csen, l~.•l arson., a .k Aldro TITLE: b EMIIER STATE BAR OF WISCONSIN a/k/;I, ,io_lln ALdr ~ (if not, . LaCRitlt authorized by ; 706.0r,, Wis. Stilts') to me k own to he the person who executed the fore) ,I instnuneut and ack wledge the same. THIS IN . TRUMENT WAS DRAFTI'D HV Lois A. Dlurrrly of III:YWufU, CARL t. 11.0.. Boy. •!w"!, liwlsuu, tel. 54016 Not~i-/> 1'uhli~ 5C. Croix County, Wis. (SignatHr- may he authenticated or ar•kimwl,-d:••11. MAI 1l}' ('an wi 4ion 14 permanent. (if not, state expiration S~= 'T LL' are not if ~arc,) datl•: U.~) kit •NArn.r D.~rq,•n: .,¢uiriy • • A' n a~. 1,.. ; i ~ ~ . .:.,..I 1.. 1•.., ,4. „ .i "I \'ll H:%It 01- WIG 11\,IN W:--n.in Lr¢•I itl•nk C.. hw. PidRSUNA1, REPRESSNTATIVE•S DE£U I'UIiM N•. 5- IV12 %IJw.ukro, W.S. SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYERSa..n A,%/ r i M 4,, R ,.+.~v ADDRESS: 7G fs g/a Ate,' ✓e...- FIRE NO: LOCATION: _/VU/ 1/4, 5/= 1/4, SEC. _T Z9_N-R /t TOWN OF: k s p ST. - CROIX COUNTY,-h SUBDIVISION: LOT NO. Z6 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 to help with the cost of the 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 the St. Croix County Zoning a certification form, signed by the owner and by a master 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. Certification from will be sent approximately 30 days prior to three year expiration. 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 form must be completed and returned to the St. Croix County Zoning officer within 30 days of the three year expiration date. r SIGNED: DATE : - z 9 2_1_ St. Croix County Zoning Office 911 4th St. - Hudson, WI 54016 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS 'INDUSTRY, DIVISION P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNS I / LOT NO.: BLK. NO.: S DIVISION NVE: Nwl/45E 1/ ~1 /T`7_9N/R1"iE lor)W ca S0r,; o ~a 5'► h COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: Sr CEO')( &4m M lue.e. USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFI DES RIPTIONS: PERCO TIO ®TESTS: `Residence f f -ew ❑Replace Z,4 9Z -z~ /Z N J k" ARCL i RATING: S= Site suitable for system -U= Site unsuitable for system - ILA ~~115 !T r ONVENTIO❑NAL: M~NS• ❑A IN-GROUNDP URE: IS YST E M-IN❑FILLHOElLDING TANK: REC~rEvN~E~S~,M~ptil) A REAtNc iv ~ 'LP1JJJ DESIGN ATE: I~ If Percolation Tests are NOT required If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: ~5 Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTAYW ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 110,~3 106,06 9"'IS LL7:5~ 14" 6CNLI119R,JaA454G,e DSO tRPIV M5 B- Z ~ ,75 Q'l$3 IJ 0 Z > 3 4 (1 to .%3 9'91-L.I fs" B1C1J L 2~* IS" MSi 4-t 69"$aa MS B- 4 Z 9 ,49 0 > d .~Z 3'7 LT S 3z'' 8,Q -s L S4. 810, Ike ~ ~ G ~ B- q7.7 / > 9. /9$LLTS 2 8aNL .72 8,00 M-S B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATPER INCH ES NUMBER WOMIllimll AFTER SWELLING INTERVAL-MIN. -PERIOD 1 PERIOD 2 PERIOD 3 P- O O l~ d `f , P_ 9 8 n - > > Z < S20 Momt(_ 97-76 P- P _ IL 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 point 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 v0 17 3 , i Z _ e eel , , _w. . TH D C Sul , t i E t , 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. NAM (print): TESTS WERE CQMPLETED ON: 99e ADDRES CERTIF C TIO NUMBER: P ONE NU BER(optional): 5, 1J, SA 0 1M r_j 6 CS SI URE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - INSTRUCTIONS F rl COMPLETING FP M 115 - SRO - 6395 To be a complete an~ ~curate s. " or.rr report inu , 1. Complete legal de 2. The use section must cl,:- `;z indicate, ~ this ice or -commercial project; 1 MAXIMUM number cif t Darns aa, csar' rcia ~mra d; 4. Is this a rrew car r sygenn; 5. Complete the 'ag ` arms. A SITE 13 _ FOR A F-',_ IN TAN . ` `r' IF ALL OTHER SYST , F..1LED OUT BASED CJ C NDITI&' Bi- PLEASE use tl- ons si ire for vtrit c, lie clescriptic is and completing the plot plan; 7. MAKE P- n u7 iy locating ~ locations. Drawing to scale is preferred. A senirate s=tc, r=:. f 6 . i,;ke sure y€a .r and v°a?:ion rya r: nc,e paint are clearly shown, and are permanent; 5. ?te all axes t names, addresses, flood plain i rcolation test exentp- ti 10. i Uwl as f'30- does nr- ~~ar .A, rte the appropriate box; 11. the ' ace ycarar er. id your certi,n.amber; 12. W e legibly and distril.od. ALL. SOIL TESTS MUST BE FILE[ WITH THE LOCAL ,',,L)" ' WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil S( I Textures Symbols st: - ; we (over 10") Bedrock cat) - Cobble (3 - 10") &rndstone yr Gravel (under 3") I - L,,nestone Sand -Qu ndvvater CS Coarse Sand ~ I on Rate rx Mediun) zunc s - F:n c Is Loamy -nd - U sl - Sandy Loam ` - L r Loam `sil Silt LoaYn BI c'y t, Loan, t rl£). P SCI s(, - y Clay Loam sicl '--1+_y Clay Loam trial bottles sc - Sandy Clay vv v"ith sic - Silty Clay fff - few, fine faint c - CI<ry - carr°x""° "arse , pt Pei. Mary, r In - - distinct: P prornine, 11"" High Six ertpz rac ,.,t;e= for iii- h F.° V ' ical R:ference Po'ant TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test it-) the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. SAM /b9-ZI~E~'~cATyERI/Y~ Qflyel PRAIRIE VrS7-A L pT #20 72.00 ' Se.e& %y' /o L (jo rc 3~d'a.•f I4,o~) Q ?c re- 5 ~r sl-,6d )jlem41: 72.00 -TOP ca~ CMP CuIVE2T prarfa- tea;htAALrk E1Y../oD.DD .tit P- 4 a A 0 a ti z Vb SE?TIc o E I Sys%"' ~ VENT ~ "14 a-r p.3 . i , LOT 19 L 0'T' 21 i I ; yd / L OT 20 1 ®{E 40 to _41 _ 13-1 \ 4 ~ - z_ I I ~ 1 ,7 3s HOUSE S ~aRa6E ,ss WEI~ I 8• a.m.-Top o~ 19~~CMt I Cv,lv~~t OranI&?&,Iwk . ~►v . roo.o' 1 1 o ' ~ --PRA I R I "t LANE__ i d ~ r A h \ i U '64 C) w U d. z LIJ ~ iI^a !I a_~. o~ o Vl '~4 a w ~ 4+ 3' 1 LIJ !~E ~ ~ j~` IEI 1~ W i !I) ~l 1 E~ * i;• ~ ~ !ll !l~ E( ~ ~ E Il' (!I ~ a i if U if Li I IE, U EI !il w i~ IEs I ~ I.' lid I U tC) Ld 0- CL~ a CL Fyn LJ I I~ ~ li~, ~ ~ I fI v 111 ~ r_ ( I+!j~ ~ ~ if f ij l ~I w G sif CL rL LI IE i z ~z ~ ~ 1 U , I+ i 1 If x 1 I ' I1~ ~ U 1 I ~ i i fl~ > z ~ ~1 U U 1 vai REPT131 HUDSON ST. CROIX COUNTY ZONING PAGE 3 06/04/92 13:56 REQUESTS FOR INSPECTION WORK SHEETS FOR: 6/ 5/92 AREA: JT Activity: A9200161 6/ 5/92 Type: CONVSEPT Status: PENDING Constr: Address: HUDSON 21.29.19.1259,NW,SE,2I,PRAIRIE LANE,LOT #20 Parcel: 020-1260-60-000 Occ: Use: Description: 149316 Applicant: BENDY, CATHERINE & MILLER,SAM Phone: (715)386-4143 Owner: BENDY, CATHERINE & MILLER, SAM Phone: (715)386-4143 Contractor: STROHBEEN, DOUG Phone: Inspection Request Information..... Requestor: MIKE Phone: Req Time: 11:06 Comments: Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION Inspection History..... Item: 00012 FINAL INSPECTION