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Vol. 13 Page 3726
AS BUILT SANITARY SYSTEM REPORT
OWNER- CYa ~~'v ~S (1 ~1 TOWNSHIP 0
SECTION - T J N-R --L- w
ADDRESS J_~' ST.,--CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE ~C C\
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF.SYSTEM
Li I!1;~:~;/
;v, j
dU
\1 C
INDICATE NORTH ARROW
BENCHMARK: Elevation and description: Alternate benchmark
SEPTIC TANK:Manufacturer: Wee -Liquid Ca
Rings used:. Manhole cover elev: I~~~Final grade elev: J I
Tank inlet elev.: • ( Tank outlet elev.:
No. of feet from nearest road:Front , Side , Rear Ft. From nearest, prop . 1 ine : Front , Side , Rear Ft .
No. of feet from: Well ~ a', Building: c~
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
i
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 Number of Lines:-3-Area Built-1.2 r11
~l
Exist. Grade Elev. Proposed Final Grade Elev.
Fill depth to top of pipe:
No. feet from nearest prop. line:Front , Side , Rear Ft.~
No. feet from well:_.:::,, ` ~ 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.
LICENSE NUMBER:
5 h~~ 7.93
6/90:cj
106,13
t''~ 9s I
5V 0 loo
P ATION: HUDSON 23.29.19.238B,NE,SW, BRADLEY DR.
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.: ST. CROIX
G GENERAL INFORMATION 171423
Permit Holder's Name: ❑ City ❑ Village)] Town o : State Plan ID No.:
BALSIMO TIMOTHY T & BARBARA RHUDSON 1 -1
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
O~'G~ 020106270100
TANK INFORMATION ELEVATION DATA A9200187 , Z3 Z
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic o~ ZQ Benchmark 8 05
22
Aeration Bldg. Sewer
Holding St/#f Inlet 9 72' .
TANK SETBACK INFORMATION St / Vf Outlet a °r , Z/
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic >16Z 2Sl NA Dt Bottom
p NA Header / Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manu Demand
odel Number GPM
TDH Lift Friction stem TDH Ft
L
Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width 6, Length ! No.Of~enches P Pits Inside Dia. Liquid Depth
DIMENSIONS IMEN I N
LEACHIN Manufacturer:
SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM -
INFORMATION Type O C&%V.L CHAMBER Mo e
System:~G~R~ J~- W OR UNIT
DISTRIBUTION SYSTEM
Header / MIGOMMW a Distribution Pipe(s) ~ x Hole Size x Hole Spacing Vent To Air Intake
Length oR Dia. Length _49- Dia. - qE Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over M Depth Over , ^^rr 'I xx Depth Of xx Seeded/Sodded xx Mulched
-10 - Bed/ Trench Center Bed/ Trench Edges '2.6 " `f Topsoil [I Yes C] No ❑ Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.)
'Tre.r-JL 4 , i 1-Y d ~c2 a ~~J. 'C.GvtC.~¢ c? C wt ^ ~.j~ / u/•~~
0,31 V
I 0z:
r~l.~-mod
3 9.35' , mss' St, ~y/?. Ss
Plan revision required? ❑ Yes [e~laO f q
Use other side for additional information. dam-
SBD-6710 (R 05/91) Date Inspector's Signature Cert . No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
s _ E _a
e.
E:01LHA SANITARY PERMIT APPLICATION couNTY
In accord with ILHR 83.05, Wis. Adm. Code S t C
I x
. STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than IsUo 8% x 11 inches in size. 6 hec if p v~icatlon
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROP RTY OWN PROPERTY LOCATION p q
I IN% fdmm -f. a IS MA v L W SQ T~ / , N, R / E (or
PROS TY OWNER'S MAILI(~ A¢Q ES r @ ' On LOT # BLOCK #
S It I1 1S~V 3 SVA1 `r h-1 I -A
C_ XQA`1014t-~ SE ZIP CODE PHO MBER SUB I ION ~ ME CSM NUM~R
f lvN ; 3 t lq q tmtc -t
1_0 V1 P
II. TYPE OF BUILDING: (Check one) CITY NE ST ROA I
❑ State Owned
IQ TOWN VILLAGE t, KA12 :VA t 149
❑ Public R1 or 2 Fam. Dwelling- # of bedrooms T NUM E )
111. BUILDING USE: (If building type is public, check all that apply) -
1 ❑ Apt/Condo d V
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. N 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 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTPJA ELEV. 7. FINAL GRANDE
REQUIRED osq. ft.) PROPOSED (Gals/d /sq. ft.) (Mjn./ h) i q ° Fr E sc
CC77 Z f Q icy., OC Feet ee
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank a0U {
Lift Pump Tank/Si hon Chamber 0 F1 Ej 1:1 E3__
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~Sig e: (No Stamp MP/MPRSW No.: Business Phone Number:
&A MW ►C &e~~ 3 v0
77berfdress Pr@et, Cit State, Zip Cod) 14 V j b ~j \ t C,
L 'fire d N JC J
IX. C LINTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Is uing Agen+Signature (No Stamps)
)
Approved ❑ Owner Given initial Surcharge Fee
L~^
Adverse Determination ~t7
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS '
1. A sanitary, permit is valid for two (2) years. r
2. Your,satnita y 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.
1 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 (S1310 6399) to be
submitted to the county prior to installation,
5. Onsite.sewage systems musf be property maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually`;ever'y 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the"
State of Wisconsin, Saffty & Buildings Division, 608-266-3815.
To bg 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.
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 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 +3h 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).cros ction of the soil absorption system if
required by the 4ounty; 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)
a t "
APPLICATIOH FOR SANITARY PERMIT
9TC-100
This application form In to be conplated In full and Signed by the owner(s) of
the property being developed. Any Inadequacies will only result In delays of
the ptrmit issuance. -Should this development be intended for resalt by
owner/contractor,(spec house), then a second form should be retained and
completed when the property Is sold and submitted to this office vith the
appropriate deed recording.
Olmer of propett~ /^?e a r~a✓b, G~i/S~~'r0
AIE ~y eI e SW e y d' 2 S
Location of property 1/4 1/4, Sectlon - „g3 N-R /q V
Ocean
Township
Melling address
s
Address of site
/ubdivlslon na"
Lot number
Pt evlcue owner of property /1~®1naw~ 4&arS /~w/f zs ~
Total site of parcel c?Y- 37 44.m s-.
Date parcel was created "7`C~7
Are all corners and lot lines Identlflablet ~,rYas _ 110 /
Is this property being developed for resale (apec housa)Tas =fro
volnne and Page Number Sa~ as recorded vlth the Register of Deeds.
-----------------------------•-w--w-------w--w--------- ---------w--------------
INCLUDE WITH THIS APPLICATION THE FOLLOWINCI
A VAARANTY DRtD which Includes a DOCUMRNT HUMBRR, VOLU K AND PAOt NUMaRR, and
the 8m or THE R9018TER OF DREDR. In addition, a eertifled survey, if
available, would be helpful so as to avoid delays of the reviewing process. If
the deed description references to a Cettlfled Survey Map, the Certilled Survey
Map shall also be required.
PROPERTY OWNER CERTIFICATION
I(Ye) certify that all statements on this form are true to the best of my (our)
knovledgel that I (we) am (are) the owner(s) of the property described In
this Intormatlon form, by virtue of a warranty ad recorded In the office of
the county Register of Deeds as Document No. d~ 17 g0 ) and that I (ve)
Presently own the proposed site for the sewage disposal system (or I (we) have
obtained an easement, to tun with the above described property, for the
construction of sold system, and the same has been duly recorded In the office
of the coynty peg ate f Deeds, as Document No.
r G.
s gnakuce of Owner 8 nature of co-owner (11 Appl cable)
fop C~ _
Date of Signature Date of Signature
pump
And
ie . of thhus~
a
T pps-no anBat l~etra B15 f.,,, ~,~rr, ,
Mom~
~tt~erital
suiviv~orshi
Me
jow teessi% pis of the accord pact.
nat t
mart are hw s1i in
of of the cud-pine AML Of the wn~ ve in I
1
in bald paid by the aid parties of the aacoed Put, the nwiPt
ted, barpioed. MK temb°d' td0wd' dim"
whereof is hereby confessed and sckaowledged. 6a3Ae. gives. mid
bargain, call, semtse. eela~ Sam ooa~
ooa~eyod and confirmed, and by these p~ta d°`"""' ' grant. 60 survivor of them, his or her beta and arm
oaf unto the aid parties of the secood part, in joint tenancy,
situated in the County of-•- r=°
foss~ the following described rest estate, and State of VW0119 o. to wk:
s1 1 /4 and part of the M 1/4
~located~ in part of» the NE 1/4 of the
parcel of land of Hudson. St. Croix Cavity, Wisconsin;
of the SE 1/4 all in Section 23, T29N, R19W, Tom
further described as follows: S890461 06"E along the east
ppaiencinq at the W 1/4 corner of said section 23 of thence
g>.nof this descriptia►i
t one quarter line, 1329.53 feet to the Point thexice S00°18'30"W SUM
Y• them continuing along said line S89°46'06"E 1404.93 feet: of Hudson, 379.63
the west line of Lot 30 of Flox Valley First Addition in the Town 1027.94
feet; thence S57°13'5 along centerline o°02a 29"66W foot along wide the west Private Road line , of said
feet; thence N83059'06"W 540.86 feet; thence N00 beginning. '
NE 1/4 of the SW 1/4, 885.00 feet to the Point of beg ed followfa:
Txgjether with and subject to a 66 foot wide Private Road MseDm t 9° d4escribescrib along the east-
oommencing at the W 1/4 corner of said Section 23, thence S8106"E (IF ruesABT, 002MI IN Da>♦OrtTrnoN ON RSYERe1 SIDE)
back) (on with all and singular the hereditaments and appurtenances thereunto belonging or in any wise
TV -
and A the estate, right, title, interest, claim or demand whatsoever, of the said parties-__ of the
' at Pam t is law or equity, either in possession or expectancy of, in and to the above bargained premises, and
4+ iitae part,
their hereditaments and appurtenances.
Haw and to Hold the said premises as above described with the hereditaments and appurtenances, unto
REVE1t.
To 1
of the d • • t te4ant Sad to the survivor of them, his or her heirs and assigns
-
the said parties 'ec° 1`tb` Lira,, part»
Aid the add
.
heirs, _
executors and administrators, do covenant, grant, r cut, and
her hei era to and with the said parties of the second part, the survivor of them, his .well seizedaof thet pns, that at the
above
yV],11. be
time of the easesliag and de~,very of these presents..._LDeY»
described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple, and
......MaetltwM re5tXiCwti.1=._.er
y ealxl are ads off rO°1e00eildiacumbrances r+hatever,
vin
lawfties f the secon
that the above bargained premises in the quiet and peaceable possession o of the said
the whole
the survivor of them, his or her heirs and assigns, against all and every person persons r
or any part thereof, - ' will forever WARRANT AND DEFEND. hand_-, and
In a/s~a Whereof, the said parties.... of the first part ha•---- hereunto set -_--their....
........-(SEAL)
sea1...*- this _ day of 19.88
gIONISD AND SEALED IN FREBBNCF. (1Fars
Frank LaPlanter
(5E♦►t)
(SEAL)
County.
S%t! of..............
19•-. 1..
Persoonal Personal came before me, this - 'day of _t4_enants in common, and A. D., each in
-
I3or[nan C,..Nlc~rS-•~3nd Frank IxiPlarte,.
ve named
the a
his cwn ri ht
to me known to be the person-... wh the ore oing in,-:.,n,cilt and .I }nnwlt.i i the c ,inw.
A
THIS INiTRUMENT WAS DRAFTED at m
M► cassava atsrea 1.00 , J
T llil I• -
John & Kay, Inc.
John
7582 Currell Boulevard
Woodbury, l+lnl 55125 t ctrm
(section 59.51 (1) of the n,aant:n ka. to pt+ t that a r° +'r r -u c 1
t I 3
the ntmet of the K d $rantori, caters, v t~ a r 1
snow its ~y ghrch, dratta ed such msr.umcrt, .ha.,l Fe p' ntr 1, I„<W r ~ n , r.tn I••'~til tfl.tok ~ot4pa I'' - .
'/tlMN7 yii!~M X_ ap Niiwauk•q;. '1M.
Perr MR
273C* feet; Ow- 800'18'30"!M akaeig the
1 »E ttfon. 30.4 fact to tho 9W cornet d IW
d.; this awmiptim= drnoe 1157.13'53`:
d Lot 30, 333.39 feet; t2wncD S13° 13' 57"8 alag .
iLt Lme, 70.03 feet to the W. Cotner of Lot 29 of said r"
tat tlrrioe 857613' 53"M along the tly line of said u*.. 39
tfl18.3+1- feetf ttWICI N99°59'06"N 105.36 feet; thaM 1K5?`
l is wbject to all emmmmts of record-
line of section 23
are referenoel to the east t. ane-9~
to 7srt 889'46' 06"E.
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SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER 7/ywf/ x x, /0 ;i.,.f:;H•`, f
ROUTE/BOX NUMBER Fire Number te,......,.
CITY/STATE ZIP
Yie
PROPERTY LOCATION: Section T- _N~ it--ZLV
Town of Soil , St. Croix C04
Subdivision , Lot number
r ~
Improper use and maintenance of your septic system could result 1n
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper. What you pyt Into
the system can affect the function of the septic tank as a treat-
ment 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 systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumbere
Journeyman plumber, restricted plumber or a licensed pumper vert-
fying,that (1) the on-,site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic 'tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration. o
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_Depart- 19
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Off:Lpe within 30 days. ,
of the three year expiration date.
SIGNED
DATE
St. Croix County Zoning Office
P.O. Box W
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
i
1.
sus- SHOU)s Acs BU Rk tittlei) T ✓~~y
Satet & Buiimngs Division
VVisconsin Department of Industry, SOIL DESILKIPTION REPORT P.O. lox 7969
V' . bor and 14uman Relations Madison, WI 53707
(Attach Soil Profile Location Map - To Scale - On A Separate, Signed Sheet) ) page of
Lg
~y ,~,E w iPE<S' -pct 3 T-o ¢ 13C D t2M s,-
tI✓~Z` y 5 7~61 nas
wuau Date F.Im ntun u:eor5.5 f ParenM/atefL peel-7~
us omtr Namt OP a, evs on
a- a /a oQwesater
usto
mtr rw js~Ls 7 7'U 7J~C U~lv E~~ r" /V y ystem L Ft(late m a ons Per q. ft. Per Da
Dante S~. O 1'X To%v aF f/vpS o.✓ - X02 T~~ °ue s
ystem eometrya Dept s~2Q P5 opean Aspect
~V`ci a `C SPC. Z 03 , 1tJ , e 1 f/ GcJ T,PeA) s - Z f d
Structure Remarks: clayskins loading
Horizon Depth Dominant Color Moults
In. Munsell u. Sz. Cont. or Texture Gr. Sz. Sh. Consistence Roots Bou~a ore==nd other GPD~.2
vfR cry
414
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vet Tio<J ~ ~ -
_ Remarks: clayskins Loading
Structure
Horizon Depth Dominant Color Mottles
In. Munsell u. Sr. Cont. Color Texture Consistence Roots Boun`dsa ores Hand other GPD/~h,2
o ~o o ye 3/Z - l -Fs o, fJ 5e of e ',~T,~y
s r r,P.11Z . s
13 ely'
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- - ~ Structure i Remarks: clayskins Loading
t Color Mottles
ll u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores Hand other GPD/ft.2
Horizon T7
3/3 /-ye v - , in
Zf
,y o,f, of fe
*So 7.5 Yoe 4/6 is D _ ~ f W
o - /0 r~ ¢/~l - SI l f 6 t /h4 -fle
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MAE
Loading
Structure Remarks: clays ins
Horizon Depth Dominant Color Mottles
tl 1 Munsell u. S:. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bounda ores Hand other GPD/f 0 Ye 313
Zf
r3 ly io ye y/ - / ~s 0,f, 2f s - , e
°ti /3y .y ~o ye 4/(Q
S -
y1f 4/~ is o c, 4,,,e
Y.
~i v~r~~ti /d3, S for a conventional septJO, system
Structure Remarks: clayskins -oadi, ;
1 Horizon Depth Dominant Color Mottles
In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores Hand other GPD`rt.2
S/ 1, f f s
o T /o yk 3/3 56,E 'Im f 2 z kx 13 f - 16 /0 VA y S/ 51K ek"
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2- V /of ~ S/lp - 1, fs o f, ie 4.1 - s
Cy y • p 75 YR -116 - -S s - s~ a
~p HOMESITE SEPTIC PLUM81NG CO. - ~L%St
865 O'NEIL RO., HUDSON, WIS. 5Q16 6 ROBERT ULBRIGHt
PS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S i
',,NN. INSTALLE i & DESIGNER LIC. NO: 008831 ! j ! t• ~ \
A'ddiUOnal Remarks.
7-e ?/S ILA- 'T,~t S wry Ia fax ~b i S Toeid o Ti a-v
~'l~ tJ~ Ti !"vS
le e,-o 44-
Other Site Features:
Date Sic ned Telephone No. CST
limiting Factorypepth: CSTCST Siynaturr ~
U10 0330 (N 01/90) 0 0,/44, Top 63 p►c--C
N,Gr,J' N G pAtq L-i 55 --z 1
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PL0T_ MAP
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FRESH AI1t INLETS -AND OBSERv11'PI(}N PIPE
CI;OSS SECTION
Approved Vent Cap
minimum 12" Above 05, ~rU
Final Grade -
16~ 30
9" Cast Iron
Above Piped Vent Pipe
To Final Grade!
Marsh Hay Or Synthetic Coveri.ng
Min. 2" Aggr.cg'
Over Pipe
Distributiop I -E--- Tee
Pipe
00
Aggregate Per'f.orated Pipe Delow
13cncath Pipe e, Coupl.i.ng Terminating P
Bottom of System