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'DEPARTMENT OF REPORT ON SOIL BORINGS AN ~AF BUILDINGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (1151 BOX 7969
HUMAN RELATIONS \ / r1' ~a~ sA I WI 53707
(H63.09(1) & Chapter 145.045) 0 ,
LOCATION: SECTION: TOWNSHIP/ LOT NO.: BL SU SI AM •
Nom- ~ /a v,~ /T~3H/Rl8E(o K~r.~r~t c ~c) r.~~~► - r
COUNTY: OWNER'S Q1 *C-" NAME: MAILING ADDRESS:
r C.~~.u1Y~ So RFZ l V~ -7-v }-AL L- ` I 5~ Z Z.
USE DATES OBSERVATIONS MADE
NO. DBMS : COMMERC L DESCRIPTION: (PROFILE DESCRIPTIONS: PER OLA ION TESTS:
LJResidence 7 N A IRNew ❑Replace ! l I_$ N
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN_ -GROUND-PRESSURE: ISEIS YSTEM-IN-FILLHOLDING TANRECOMMENDED SYSTEM:(optional)
❑S❑U ®SS❑U U ❑SCQU I`Q!A
UFur l e=v2'Tti etc fS_DA/G i P u at S* B
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: 1 A Floodplain, indicate Floodplain elevation: N/A
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INN 6ES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTHtfd. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
>vo,.,L mot'CD 3_-' 0.-b'6'13nL-)s; z. I'ahNffAuy_Siljsa'13hSJ--i-6'$n
- v y 1; N.s~ B~ -Ys I- LS mss.
Z S • to " F`cnaoT sd 3.0' o •1' ~rc.GY13n LTS; Z. 3 ' 3>7 cl ; t .3' tan DOSS _S
L,_ / % S lZ-L S ,
3 S"31 ga' 14 rnoT_~ 3. 0.8' DYz6y n ` ls~ Sn_ L/ 13,7 3/U/6V, an 7,-
B- 2 'r at -6
6. 7 S I. I TS j 3-6 ' bn S 1 I J o 9 R11 S 13 1.S ' kA `R.S
. n c,l
B- S S .o'- SS II ~n e~ 3.z' 3-y Bl L 1. ' -r
Y -V C~ 3•S' `g4~r rI A6 711.o' BI L c> LI' `l
B 1 4. 1~0 ' u SS L3R Q q.y' s z.g' 04 a ' c,.9' kA &S,Ia 1?, 8 LA- Z' X20' tI n~o1 Q3.f o.'~'~s'Ihs> (TSi z•o'Y(i., r✓I;o.~'Bh
tlw/ (?eSj o.~'wh_fs
B- 9 S .Z' ~IU 1-~un~e; rn~T~ I.3' 1.3't3ns J S 1.6'til3Xc1C1hot ' o.S'Bhh1pS't.8'DIC D9usc
sl
' ' M-?--E PI'PPR-0J~LMA PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PER D PER INCH
P- 2 v
P-
P- cAj L
P_ ulJ V I L- 1
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. ~f4GE S3 ~e b Z 0
SYSTEM ELEVATION
t
s~ ~ a <ti~~Cu1 M ft ~'fs cyv` S
I i
,
f R7
i ,
«
3 ,3 i t ,
3 E
,
2S _
D
I I R I'J~ j
a ( s
3
1111 . .m._.
'-T-
F, 'R -
SGf~~~ ~`~=zoo' SE(/~ - Swl~y sic, t8
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.
NAME (print): TESTS WERE COMPLETED ON:
'Pi Z1v~ L. VvEG~Z <es-11-8V
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
t~T 13ov 'IzE, ❑-LLSwoFi_,ill, Sul 5(401) 5--) L CIS-L/ 2-3- C11 CST SIGNAT E:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) - OVER -
I
INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395
To be a complete and :<;urate soil test, your report must include:
1. Complete legal de . 'ri = n;
2. The uses prr rr rly indicate whether this is a residence or cortrmercial project;
1 AMAX'- -f bedrooms or commercial use planned;
4. Is -rent system;
5. t rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL
OT"' -Y„ ~,RE RULED OUT BASED ON SOIL CONDITIONS;
S. PLEASE use i'- :abbreviations shown here for writing profile descriptions and completing the plot plan;
7. ME A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A
sheet may be used if desired;
your benchmark and vertical elevation point are clearly shown, and are permanent;
9. C~ all appropriate boxes as to dates, names, t.adresses, flood plain data, percolation test exemp-
t ic ;'pro -te;
10, Y ch as flood plain, elevation} does not apply, place N.A. in the appropriate box;
11. S; op form place your current address and your certification number;
12. ,N11--!<,- legible c, ;)ies and distribute as re€luired. ALL SOIL TESTS MUST BE FILED WITH THE
LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION.
API ':VIATIONS FOR ( on [ED SOIL TESTERS
and T Other yrnbols
--r 10' BR - Bedrock
coin (3 - 10") SS - Sandstone
gr der 3"j LS - Limestone
*s HGW - High Groun€ ~:er
cs - t P~,rc Pe ~latic
n rr d < - V14
is Bidg r:<j
s f - r Th arr
sl - Sal TI n
'i - Lt r~ ~1r
"sal n~ 1s'ack
Garay
R _
S. mot -
wr -
s,ic - Silty Clay fff - i. faire
Yc Clay cc -
III _ Peat trim 1% errn_
rn - rVIuck d r,
p - ,:rent
H W L
- -
S'' I soil
id waste BM vl,~~k
VRP - Vertic-:l R cc Point
TO ~fJ
- y ~ ,un e is ~ st
Parcel 022-1051-40-000 04112/2007 03:59
PAGE 1 OF 1
F 1
Alt. Parcel 18.28.18.281 022 - TOWN OF KINNICKINNIC
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - SCREATON, DAVID R
DAVID R SCREATON
711 MANNING AVE
LAKE ELMO MN 55042
Districts: SC = School SP = Special Properhi Address(es): Primary
Type Dist # Description t~. a
SC 4893 RIVER FALLS < Cti. 1 )6
SP 0100 CHIP VALLEY VOTECH -
0/1 ~-j
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 18 T28N R1 8W NE SW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
18-28N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
04/01/2005 791105 2775/500 EZ-U
04/05/1999 600596 1416/72 WD
07/23/1997 2001/243 QC
07/23/1997 1165/560 DJ
more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 08/10/2005
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 20.000 2,800 0 2,800 NO
AGRICULTURAL FOREST G5M 20.000 50,000 0 50,000 NO
Totals for 2007:
General Property 40.000 52,800 0 52,800
Woodland 0.000 0 0
Totals for 2006:
General Property 40.000 52,800 0 52,800
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch M
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel 022-1051-70-000 04/12/2007 03:59 PM
PAGE 1 OF 1
Alt. Parcel 18.28.18.284 022 - TOWN OF KINNICKINNIC
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - SCREATON, DAVID R
DAVID R SCREATON
711 MANNING AVE
LAKE ELMO MN 55042
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 18 T28N R18W SE SW Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
18-28N-18W
Notes: Parcel History:
Date Doc # Vol/Page Type
04/05/1999 600596 1416/72 WD
07/23/1997 2001/243 QC
07/23/1997 1165/560 DJ
07/23/1997 871/319 more...
2007 SUMMARY Bill Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 08/10/2005
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 31.000 4,100 0 4,100 NO
UNDEVELOPED G5 1.000 100 0 100 NO
AGRICULTURAL FOREST G5M 8.000 20,000 0 20,000 NO
Totals for 2007:
General Property 40.000 24,200 0 24,200
Woodland 0.000 0 0
Totals for 2006:
General Property 40.000 24,200 0 24,200
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00