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HomeMy WebLinkAbout020-1152-90-000 ° o _ O o z a r 0 o N h ~ N (D wz~ y 0) co V y ' h V x y C ~ 3 LL m 'p p N Q r V > z N rn 0 O U) 0 Z y M N W d m N F- U) C C7 O Z d c d Z d' c p c ~ v OS N _~V N p N (D N • M'1Y1 a U) r O O Q Z CO Z ` ~I c N N p N Y CL m N L G a . c c cn o o - H H H U L` a O 3 0 0 • rv o a m a a m p= N N N v N! U > rn rn C3) a) c 00 M Awl C) o Q N N O O O ? E z N p Lc) C N n [L 00 N LO ~ N Q } 0000 7 O p O y C O O E C C) C co ® CO Q 3 Q U O N O 0) O O O O CO N 0 C d W 0 0 N ~ 2 y E c N N n 0 a) =3 N C r, O N u `n ~r F- Ln i y i../ O N -O 0 Ln N 1` O 0) :A E N U • h O N 2 2 O :n co c® ~ n d ro (D a a a • a a, 2 o E rr~~ L ~1 A u a 2 0 N v AS BUILT SANITARY SYSTEM REPORT OWNER 4 i" s_. sic 'rr<~ TOWNSHIP 4~ A/ SECTION ~T~;29 N-R l% W ADDRESS ST. CROIX COUNTY, WISCONSIN .I 1 SUBDIVISION LOT_ LOT SIZE r PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 4" i I r lri ~,9 l9 Efid I i INDICATE NORTH ARROW BENCHMARK: Elevation and description: Alternate benchmark SEPTIC TANK:Manufacturer: fi ',4 ' Liquid Cap. Rings used: - Manhole cover elev:Final grade elev:, Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front Side , RearXFt.,//~,~-~ From nearest,prop. line:Front Side , Rear Ft. No. of feet from: Well Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon 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_ Z Number of Lines: -5~ Area Built Exist. Grade Elev. 1,~1,7 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 37 I HOLDING TANK Manufacturer: Capacity: o 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: %lJ` PLUMBER ON JOB: LICENSE NUMBER: 6/90:cj s AT,IgN:~HUD~O~i 23.29.19.837 ' E BRADLEY RD., LOT isconsiA egartmento In ustry, PR(VATe S EWAG E SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GFNERAL INFORMATION 175651 Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: HESSELROTH, DAVID A & JILL D HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: /0010 ( S/0 ar-Q 020-1152-90-000 TANK INFORMATION ELEVATION DATA A9200311 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic a~ / c~ rJ max, Benchmark ~DY, C /O 6 , 0 Dosing Aeration Bldg. Sewer Holding St Ht Inlet V, 3F X06,-5- TANK SETBACK INFORMATION St/ Ht Outlet y 6 ~ po. a / TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic 1 a r a 1 NA Dt Bottom Dosing NA Header/ Man. Aeration NA Dist. Pipe F 2 Holding Bot. System ~,a z qg, 6 PUMP/ SIPHON INFORMATION Final Grade /o l_ 75 Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss Head Forcemain Length Dia. Dist. To Well SOIL A SORPTION SYSTEM BED / T H Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS d `a DIMEN I N SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O -,t&ti, CHAMBER Model Number: System: 14~;. f"t OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) I x Hole Size x Hole Spacing Vent To Air Intake Length Dia. I Length _~_a Dia. "1 I Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over J/ Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) -.j,, < j \P 3 I I Plan revision required? ❑ Yes ❑ No Use other side for additional information. ) ~~l ell I L1-7,- kd6 lalbl SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I LHR SANITARY PERMIT APPLICATION COON ` In accord with ILHR 83.05, Wis. Adm. Code U970 STA ANIT PER # -Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. Ch i isi n pr`vlous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFOR ATION - PLEASE PRINT ALL INFORMATION. PROPER OWNER PROPERTY LOCATION , N, R E (or)N T219 /9 Y4 t/4, S PRO RTY OWNER'S MAILING ADDRESS LOT # BLOCK # IJZI CITY TATE ZIP C DE PHONE NUMBER SUBDIVISION NAME OR CS N~BER Il. TYPE OF BUILDING: (Check one) ❑ State Owned 0 VILLLLAGE : NEARES ROAD ❑ Publlc ® 1 or 2 Fam. Dwelling-# of bedrooms - PARCEL TAX NUMBER(b) III. BUILDING USE: (If building type is public, check all that apply) C.;20 - - ~p 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. ® New 2.E] Replacement 3.E1 Replacement of 4. ❑ Reconnection of 5. ❑ 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 1Z 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/da /sq. ft.) (Min./' ch) ELEVATION - ' //Feet /Feet Coo I '4S 15 Z4 VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks / strutted Se tic Tank or Holdin Tank - O ` Lift Pump Tank/Si hon Chamber 1:1 -1 1:1 El I L1 1:1 Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for install ion of the onsite sewage system shown on the attached plans. Plumber' Name ( rint): Plumb 's gn re: (N11 mps) MP/MPRSW No.: Business Phone Number: Plumb 's dress (Street, City, State, ' ode): 2tj & IX. NTY/DEPARTMENT USE ONLY Sign lure (No S m ❑ Disapproved S ary Permit Fee (includes Groundwater a e ssue Issuing A vent ~s1, urcharge Fee) Ppproved ❑ Owner Given Initial ~(!v Cj ~M Adverse Determination j - E, z X. CONDITIONS OF APPROVALIREASONS 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. 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 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. 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 8'f 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-8398 (R.11/88) • APPLICATION FOR SANITARY PERMIT 8TC-100 This application form Is to be completod in full and signed by the owner(s) of the property being developed. Any lnadoquacles will only result In delays of the parmlt lssusnce. -Should this development be intended for resale by owner/contractoc,(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 recordlnq.- Owner of property 'JI ( 1 -4 Location of property = S'~ 1/4 Sr •1/4, section T" Township Halling address 7& 7 eO)6S&) 10r Address of site g `f Z_ e Subdivision name - - Lot number Previous owner of property Total sloe of parcel Date Parcal was created Ara 4111 corners and lot lines Identifiable? r,Yes _ No Is this property being developed for resale (spec house)? Yes No Volume and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWINCt A VARRANTY DYED which Includes a DOCUMENT NUMBER, VOLUNE AND PAoE HUNSER, and the SEAL OF THE RHaIDTHR 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 Nap, the Certified Survey Hap shall also be required. ---------------------------------------------------------7--------------------- PROPERTY OWNER CERTIFICATION I(Vs) certify that all statements on this form are true to the best of spy (our) knovltdgel that I (we) am (are) the owner(s) of the property described In this information form, by virtue of a warranty sad recorded In the office of the County Register of Deeds as Document No. !r/~~• I and that I (we) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of sold system, and the same has been duly recorded In the Office of the County Register of Deeds, as Document No. /7 A 1 ature of Owner Signature lol- Co-Owner (It ApplicaDie) Date o signature Date of Signature SENT BY:THE GILLETTE COMPANY ; 8-10-92 ; 7:18AM ; SPMC PLANNING DEPT. 2/ 2 bQCUMENT NO. STATE BAR OF WISCONSIN FORM 1-•-1982 THIS SPAC$ RE89RVED PoR RECDRDINO oarA WARRANTY lDEOCO von. T)~ m ~ n REGISTER'S OFFICE bed, made botween ~7dSEPt1 M; GUERTIN and ST. CROIX ca, W1 and wzf© MARGARET F. GUE.RTTIV hddforhoofd - JUN 251992 and_ Grantor, T1A.~'~Y)..A.-_.H~SSELRp?'H and JIT,L D._---•--" UTII, HIJSSELR„-------••.---- Cl~ x.1:45 A. M Grantee, ~013ttltOEDOil~i QSSlOt~7, That the said Grantor, for a valuable consideration_._ y RETURN Tp + coxive s to Grantee the following described real estate in _ t• Crpi x _ o County, State of Wisconsin ()avr®C 000 1`.rla/ Ark MA) 5V~'/ Lot 9, Plat: of Fox Valley in the Town of Hudson - Tax Parcel No.-.&M)_.//S i an FXE i This is,•,not........ homestead property. ?(4j (is not) Together with all and singular the bereditaments and appurtenances thereunto belonging; And................ Gran_ tors warrants that the title is good, indefeasible in fee simple and froe and cleat of eneurnbrancas exeopt and will warrant and defend the same. Dated this day of :•N~'r. 92 19- • .(SEAM.) (SEAL) -••-........-•-•-...,,.............(SEAL) JC)5 l'................... r~T (SEAL) * MW&T AUTHENTICATION ACKNOWUED034ENT Signature (s) /N1MiV4F~&74 . STATE OF Wi0eseilE m as. aixthentleated this ___----.day of.___-•---•-- V6y .._._______...••-----County. 19 Personally came before me this ilk -day of • _T V-. 19.11-. the above named Jc,Be h M Guer .._,•,P ,.tin,ar,d _MarcaY.et E. Guer- tin, husband and wife TITLE: MEMBER STATE BAIL OF - WISCONSIN (If net suthori~ed b y ~ 706,06, Wia. Stets.) to me known to be the parson who executed the THIS IU$TRUMEly7 WAS DRAFTED BV foregoing instrument and acknowledge the same. EiOLSTEN• & SCHUMANN P .A,, , 124 South sec- (Signatures - _ Notary Public County ...__~f°"+_3~ _ .not.. - may bo :Liithenticated or aek.nowledired. Beth My Commission is , lire not necessary.) Perm~nt. (i# not, state expirat~iosn date: 1.fi,• •Npr1788 OF tcrwia 8i nin c g t11 any CRV;Ldty khPUhi be typed ur printrd bran thmir Nfilunt,irp8, ~l~i~l±Y PU81•~Q MINNESOTA iiAMny COUNTY F:'+itilL4NTY nx~En a.m.. •+4. SEPTIC TANK MAINTENANCE AGREEMENT w St. Croix County H ~ rt OWNER/BUYER G sue(l 0 ~`1 Z :J ROUTE /.SOX NUMBER' t) rC Fire Number d CITY/ STATE ZIP S l co PROPERTY LOCATION:Sectioq,,? N, RW, Town of 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 con- sists of pumping out the septic tank every three years or sooner, if needed, by a 11cenbed' 's'ept'iF, tank p_um ear. What you put into e. function o, the "p:tic tank as a treat- the system can aFfect the._ ment'stage in the waste disposal system. St. Croix County residents*- may- eligible to recieve a grant for a maximum of 607. 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 's's~ terns agree to keep their system properly maintained. The property owner agrees to.submit to St.. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or..a licensed pumper veri- 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. H I/WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with the standards set forth, herein, as..set by the Wisconsin Depart- Y ment of Natural Resources. Certification form must be completed .U and returned to the St. Croix County Zoning Office within 30 days of the three year expiration-date. SIGNED", bLo DATE '~'Is h-L_ St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. DtPA' rMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUST DIVISION LABOR AND P.O. BOX 7969 HUMAN13ELATIONS PERCOLATION TESTS (115) MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: • S TON: OWNS HIP/P+44LLTY: LOT NO.: BLK. NO.: SUBDIVISION NAME: / N/R i E (or COUNTY: OWNER'S BUYER 5-NA "FE: MAIL N ADDRESS: 4<'A;G c USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DSCRIPTION: PROFILE NS: PERCOLATION TESTS: Residence 3 ~llew ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system ©J S STEM- N-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ONVE(~'N+TIONAL: MOUND: J IN-GROUNDPRESSURE: LJS❑U ❑S❑U ❑S❑U ❑S❑U r~ If Percolation Tests are NOT required DESIGN RATE: ( If any portion of the tested area is in the under s.H63.09(5) (b), indicate: 7i, Floodplain, indicate Floodplain elevation: ~rf PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED ES-1. IGHES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- Of) 11 >ae O /.3 ) LJ On% n dbf ~T - B- /O Y f 3 9 e n ~S 1 H t o+ li s 13- > B- 4 ' io2 .9 .v S,'l >7 / 8 / a, I M 7 G•M S s~ 1r 3 B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES ' RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD t PERIOD PERIOD PER INCH P- P_ P_ 3 tl _7 P- p- q PLOT PLAN: Show locations of percolation tests, soil bur;rrea ir.d the dimensions of ciiitable soil areas. Indicate scalo or distances. Describe wh 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 dire on and percent of land slope. SYSTEM ELEVATION r`- 7 i I l__ I ( I ' III ~ 1 I 1 N I' I , I I I I 1 ~ n if' !^t.r~1 '.I.~'<~ ~ ± F )r~ /C T ~r ~ ~Cr~r _ ~~t~ "'.'-fi~ O.t'L` I ,~r~ . I 1e 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 an4 belief. (print : TESTS WERE COMPLETED ON: 1. CERTIFI A O NUMBER: PHONE NUMBER (optional): CST SIGNATURE: w~ ~j.4 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILIIR-SBD-6395 (R. 02/82) - OVER - r,a ~ s~ v 4 \tl` i SL % r I ~ v 4~ 2 a N C0 E 0 to i d. %i M 0 C.) CM4 .0 &EF CLft HR )t W W c O i a v a c I ry l I o 3 C~ r~ F;'14 I , n 1,:;,~ y., ✓1~.!%~nrF,.lfc _ f. l~•~~ ~1~1, 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 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _L of Z Labor and Human Relations DiviAion 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 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. - Q APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPER OWNER: PROPERTY LOCATION _ Is - GOVT. LOT SE- 1/45r 1/4,S Ta N,R E (or) W PROPERTY OWNER'•S MAILING DDRESS LO # BLOC # SUBD. NAME ORlCS ((/'1~ CITY ATE ZIP CODE PHONE NUMBER ❑CITY I LAGE [MOWN N 5A EST ROAD ( ) /J % le [ ] New Construction Use pC] Residential ! Number of bedrooms [ ] Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate , --'71 bed, gpd/0trench, gpd/ft2 Absorption area required ~rcx~ bed, ft2/006 _trench, ft2 Maximum design loading rate bed, gpd/ft2~trench, gpd/ft2 Recommended infiltration surface elevation(s) .9A le 'r 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 ®S ❑U [4S ❑U 2S ❑U [M S ❑U ❑S OU ❑S EMU 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 Trer>ch . 7 'C' Z221 Ground _ elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: CST Name:-Please Print Phone: Address: 1 42 Z: Signature: ' Date: CST Number: I- 4~~21 1. 1 PROPERTY OWNER SOIL DESCRIPTION REPORT Page of . PARCEL I.D. # Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD%ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tre & Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) i i i f ; I Oda J t i I ; - - T - I ~ i : I ; 1 - ..T -T - - - - -r- --1 ; t R I T i I r~ I j i i ; ! ! ; ; : r j G I I _ I _ i t ' I I_ I i I I 1 I - T I I- I 1 1 j ! ~ , ~ I I I ~ I I ~ I I I I I I I I 1 ! ; 1 I I I 1 I I I- I r - r - i I I ~ I ( ~ I ~ I j I I i I I L I~ I I I I ' i I I _I I ! i_ Imo- I I _ I- --i = I - - _ 1-- i I i1 I I ; ; I I 1 ~ I I I I I ' ~ I I i I I ~I ' I ~ ! j ! I_ i_ I J i t I i I I I ~ ~ ~ ! ~ I ~ I I I I I I ~ ± ~ i 1 1 I i• I I I I I I I 1 I 1 , _ T. I i I I ~ I I I I I I I -t- i I ~ ( I li I ~ 1 I I I I i I ~ i I J I -r----T--- T-r- T--~ - T- T I I i I , ; ~I 1 i I I I I I I I r i 1 i ~ ; 1 ' I I r I I I I I I _ I l i l l i j l l l l i l l!! I I I l i ~ I I ! l i l I I - - - I I , i i I j i ~ l i f 1 ~ 1 1 1 _ I , I I 1 I I I I i I 1 I I I i , f- I 1 - i- j -j-~- i ~T~1- }rt---~------------- I . T-rl - - - I i I i T T r_ - ! - ' - I i i I I i li ~ ! i i I 1 I ~f 't ( ~ I I ! i ! I I ~ j ~ I h, I I I ~ I I : I I ~ I ~I ~q Imo' _.1---- 1 ~1~_-~ --~-i ~1--Jyerfwl!-- I S'~?G'~_i~- ~ I ~ ! I I I I I I I I i I I ~ I ~ ~ I I I I ~ ! I ~ I I I I I I ! I I ~ I I I I I : I r 1 I ~ I ~ I I I I ! 1 l I I'ly I~ I I { I I I I I I I I I . I I i I I ~ i I ~ _ ' I I i f I ~ i I I I I I I I I I I ~ ' ~ t ! 331 I , I I ! I j ! I I I I~ i I I { I I I ( i ~ II i - i~ I i , I I I - 1 I ~ 1 I --I I I ,I ~ ~ I I I ! I f I ~ ! I ~ ~ I I ~ i I I I _~4 I --I I _ I f I ! I I ! i ~ I I ! i I I ' I ! I I i I I f } ~ I I l I I I I I I I I ~ ~ { I ~ I I { ~ , ; i I - -41 'SIN I ~ I I I I I I _ I i _I - 1 I I I I I I j j I . I I ~ I - , V1, I j - I ; ~ I 1 I : ' I I I I l i I 1 I , 4 I I I I i i i f ! ~ ! I J I ! i _I I I I -I-=--- I i i i t A l i f l l l! I j I ~ ~ ! 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CROIX COUNTY ZONING PAGE 1 10/27'/92 09:02 REQUESTS FOR INSPECTION WORK SHEETS FOR: 10/27/92 AREA: MJ Activity: A9200311 10/27/92 Type: CONVSEPT Status: PENDING Constr: Address: HUDSON 23.29.19.837, SE,SE, BRADLEY RD., LOT 9 Parcel: 020-1152-90-000 Occ: Use: Description: 175651 Applicant: HESSELROTH, DAVID A & JILL D Phone: Owner: HESSELROTH, DAVID A & JILL D Phone: Contractor: O'CONNELL, KIM A. Phone: Inspection Request Information..... Requestor: O'CONNELL, KIM Phone: Req Time: 10:10 Comments: /0!'30 Items requested to be Inspected... Action Comments aSivr'~ Time Exp 00012 FINAL INSPECTION Inspection History..... Item: 00012 FINAL INSPECTION