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HomeMy WebLinkAbout020-1280-10-000 Q 0 60 Qr " o o i r © ~ I N ~ ~ r N X J (V r O O C C Q7 C O I y ~ w 6 ° ~ Z w m C '0 LL O 0) N U Q 3 ~ I ~ m z E z 0 T z d a m co 'IT IN- U) I 0 z v c ~ ~ N I z d ° c fA I- r m O E a) y N_ 'n a) C CO 2 a) •N O d _ 6 N (7 O O N d q N z CO z Z O N c _ I m m ~ c_ N N m ' d U ~1l = i a Y y V N ~ LJO N m E ~y U v o FN- HF- do ►i `a O O O CL J co u (n 0) 0) } w*ft, o J ° ~ m a w a-) dm C ~ _ tA O O O O N E O O C N F- Lo I- © M U N L O O V W ~ L N N C Q N C N N a) a) f0 C O Z 'i O O I 04 3 ° N 0 'IT E L' .n- M 0 a) U • y,' O M 2 LL O I- U) ) w a L: a. 0 CL 0 E Q U a 0 fn 0 AS BUILT SANITARY SYSTE14 REPORT OWNER__ ,-TlnIy1 el- 157 ~~~-~r`- TOWNSHIP i S SECTION T--;? 2N-R~W ADDRESS Z6(- jSj 1&4V Aj ST. CROIX COUNTY, WISCONSIN TW i.c cQ5 c,-\ 57 el ir) SUBDIVISION _LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM a rf y ~ in IUe ~cl.. INDICATE NORTH ARROW BENCHMARK:Eleva ion and description: pJ (7d Alternate benchmark SEPTIC TANK: Manufacturer: { A'A-aA~/11 ( Liquid Cap. U-56 Rings used: Q Manhole cover elev: Final grade elev: Tank inlet elev.: 5y Tank outlet elev.: No. of feet from nearest road:Front, Side Rear Ft. From nearest,prop. line:Front-/-, Side , Rear Ft. 26 ~ i No. of feet from: Wellerer , Building: -3 (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: Liquid Capacity: i 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: /a " Length f Number of Lines: Area Built Exist. Grade Elev. ,A~'b, / Proposed Final Grade Elev. / 6a j ~ Fill depth to top of pipe: 0 No. feet from nearest prop. line:Front / , Side, Rear Ft./ No. feet from well: No No. feet from building LU 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:- ob PLUMBER ON JOB LICENSE NUMBER:---/5Z-3 6/90:cj L~CATIr~i: HUDSON 34.29.19.1339 SE NW LOT 4 EDIE LANE isconsm epartmentot Industry, PRIVAT9 S EVVAG E SYSTEM County: a n nd d Buildings Division Divi Safety sion INSPECTION REPORT ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 171495 Permit Holder's Name: ❑ City ❑ Village [%Town of: State Plan ID No.: ULTON, THOMAS HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: l 0 0 0 f b q 1S 1i) E dti P L o.nn 020-1280-10-000 TANK INFORMATION ELEVATION DATA A9200264 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 0 Benchmark j, 3 u- Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet q S L{ TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic 3 i NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System -7 ('4 PUMP/ SIPHON INFORMATION Final Grade p0 I Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Head Force Length Dia. Dist.Towell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM INFORMATION TypeO CHAMBER Model Number: System: l OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over 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.) Plan 10 TA- V ~ U revision required? ❑ Yes ❑ No Use other side for additional information. t ® SBD-6710 (R 05/91) Date Inspector's Signature Cert . No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ~&HR SANITARY PERMIT APPLICATION CouNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANITA PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 1`~ 8% x 11 inches in size. ❑ Check If/ev sl'i ort'to~previ 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 O Y)7 .5 tic~ n 50 Y4 NV14, S 3 T a N, R/?!MW PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # VA. Fb' r•~ CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 67% 1W 0-her r 901-5 ~ff- 11. TYPE OF BUILDING: (Check one CITY NEAREST ROAD ❑ State Owned VILLAGE ; f ~'Gdso ~ ~ ~ N . 11 JOWN RIF: F_ ❑ Public 191 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBEK(5) 111. BUILDING USE: (If building type is public, check all that apply) d O ~a 80 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. El Replacement 3.E1 Replacement of 4. El 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 N 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/day/sq. ft.) (Min./inch) ELEVATION 600 Qr.) l • yob Cl4S3(o SSFeet M 85 Feet 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 structed Septic Tank or Holding Tank a~~ 0Wm If __LH F-1 Lift Pump Tank/Si hon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Pri t): PI tier's Signatur o Stamps) JiP/MPRSW No.: Business Phone Number: Cod -owe e">1 /S~ 7/5 P114 S Plumber's Address (Street, City, State, Zip Code): 17 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date ssue Issuing e t Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) C' Adverse Determinationi 16 d X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety a Buildings Division, Owner, Plumber INSTRUCTIONS 1. ,A sanitary permit is valid for two (2) years. 2. Yowr 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 ithe permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be s~tted.to the coup prior,to installasign. 5. Onsi a sewage systems musf be ProPerl aintained. The sep#ic tan`k s must be. a a Y 'm ~ ~umped by a licensed pumJW,wFtgnever necessary, usually eery 2 to 3 years. , 6. If you have questions concerning your onsite sewage system, contact' yo'u-r focal code administrator or the State of VCNconsin,:4afotX, Bu, jl91n s DjvFsipn, 608-266-3815. _ To .t complete 111d accurate t" sai t_r Aermit application must include: r 1. {ProoeeMy ownerts name and mailln address. Provide the legal description and parcel tax number(s) of where the system is to be.Tnsta)led~, , 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% 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 rformanc.e curve; pump model and pump. manufacturer; D) cross section of the soil absorption system- wired 6)£ths county:,: soil test data orr.a=11'S form; and F) altsizirro'ioformation_ - ~Gi~blJ~NbWA'~'~~#`$`URCHARGE , 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. :,.The njonies collected through thew,., urcharges are rsed.for,mo_nitor+gg.groundwater, ground-` water contamination investigations and establishment of standards. SBD-6398 (R.11/88) APPLICATION FOR SANITARY PERMIT S T C - 1.00 r-- 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 A L- OAJ Location of Property 'r„ Section T 2-i N - R I W Township _ 1kD-&01V Mailing Address ~Ofo K~ Subdivision Name _ /I/ Lt-S Lot Number 4 Previous Owner of Property CA/ A41 Total Size of Parcel 3 ? A-c~3 Date Parcel was Created 1-17-91- Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes y No Volume 3 and Page Number 110 as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. PROPERTY _OWNER CERTIFICATION I (we) ccutt{,y that aft .b,tateme.n.ts oo. this Awm aloe •thue to the belst oA my (owc) hnowtcdge; that I (we) am (aree) the. owneh (b) o{ the pnopelay d"CAi.be_d in VUA i,nAo"Oa ion 4on.m, by vii t_ue o{ a wa,"an.ty deed necohded in the 066.i.ee oA the Couvity RegiAy-e, oA Veecd6 aA Do(.owevit No. 479'0$3 and that I (wel pn.". en t.Y_y own the ph.o pob e.d Aite. ~ oh, the. a ewag~aSa. -5yS te.m (on I (we) have ob,ta,tne.d an. e.aaeme.nt, to hun wi th- the. above. deSCAibe.d pnopehty, Aon the eonl5.0,ucti,on oA .6a.id AyAte.m, and the same, haA be_e.n duX y ne.eon.ded .in. the 04{gee oA the. County Re.g.u_tteA oA Deeds, as Doe.umW.. No. 108'083 SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) 7-R - 9?i DATE SIGNED DATE SIGNED 41 DATA FOR n~•~S -v THIS SPACE RESERVED RECORDING cP ~G ~,a oro WARRANTY DEED 2 _ 1982 M ENT NO. 'win l STATE BAR OF WISCONSIN FOR REGISTER'S OFFICE 4'780.8 ti~ ~ on ST. foXr R I eco d - Reed Sam E ' :Miller ~...a- .single .Pers 1~~2 M JAN 20 I . . at 8.00 ---------------.00 Joanne `u £on---and Thomas Registe0 &W rofDeeds convey-s•and and warrants to - - wif e.. husband Fulton tt RETURN TD -.county, ~ Croy-x . Tax parcel No:.....- the following described real estate in state of Wisconsin: the Town of Hudson, Hill in Lot 4, Plat of Cherry Wisconsin St. Croix County, S is not homestead property- rights-of-way This ----S- not) ions and (is) (is t s , re strict Basemen f any• Exception to warranties: o f record, i 19 9 . 2 January day ° 17th------------••..(SEAL.) Dated this - - - - - - - - - ..--(SEAL) Miller - Sam.. E-. . . (SEAL) . a (SEAL) LED dME AUTHENTICATION STATE OF WISCONSIN as St. Croix County. 17th.day of Signature(s) - pGrsonally came before me he above name 19_..... ,19 anuary day of...._... _ _ authenticated this l~iiTl er Sam WISCONSIN who executed the STATE BAR OF - to TITLE: MEMBER - to be the person - to me known and ackno ge the saMe. instrum (If not, ' .08, Stats. f re o' g authorized by § 706 8 DRAFTED BY Joy Inno THIS INSTRUMENT WAS Alice J Conn~unty, wi' • St iratic Lundeen 0 a exn p land b1~L'~ Std Notary Public erma "Kri- 11...ag Law MY Commission is p Toth 19__93-. Attorney - Both July ?ffafe--Of -V(risef~ri.•i+~ date: - dd. (Signatures may be authenticated or acknowle ge are not necessary-) SEPTIC t%MK KAL.ITZMANCE AGREEMENT St. Croix County OWNER/BUYER / {ioMAS J, L3014 ROUTE/30Y NUMBER, -70& ax~~ to E KJ Fire Num''b``er CITY/STATE. /~q0-%ON~ l Z IF s~f,0 P^OPERTY LOCATION: 5C 'Z. `yam Section, T 21 W, Town of z/y0Ss40 St. Croix County Subdivision Lot number. Improper use Xnd maintenance of your septic system could result in its premature failure co handle wastes. Proper maintenance con- siscs of pumping out the septic tank every three years or sooner, if needed, by a licensed seocic tank pumper. What you put into the system can atfect the Euncciun 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% uE the cost of replacement of a failing system, which was in operation prior to July 1, L978. 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 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 L/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/W E, 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- ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration dace. r SIC,ZED V • DATE St. Croix County 'Zoning Office P.O. Sox 1-27 Hammond, '.1I 54015 7L5-795 Z`9 5 i..~n , Jar.- nnc{ r~-ri,rn -n -ihuvc address. I ~ t DUST OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, , DIVISION P.O. BOX 76 LABOR AND PERCOLATION TESTS (115) MADISON WI 3707 HUMAN RELATIONS ULHR 83.09(7) & Chapter 145) LOCATION: SECTION: TOWNS H I PjftftIdML I TY: LOT NO.: BLK. NO.TCherr DIVISION NAME: SE 1/4 M1 1/4 34 /T29 N/R191(.,) W Hudson 4 n/a Hills COUNTY: C1MOM'S/BUYER'S NAME: MAILING ADDRESS: St. Croix Thomas Fulton 706 Fox Tree ln. N., Hudson, Wi. 54016 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DE CRIPTIONS: ER O ATION TESTS: RkResidence 4 n/a New ❑Replace 12-23-91 n/a (t C~~it dLG- 122 -!tr a~ RATING: S= Site suitable for system U= Site unsuitable for system l~ CONVENTIONAL: MOOU~UiiND: IN-GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ®S ❑U EiS ❑U DS ❑U ❑ S CCU ❑ S ®U conventional T ESIGN RATE: If Percolation Tests are NOT required If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: class 2 Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 66 OTIC2-EME BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH I !EVAON TIOBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B-1 7.00 00.60 none >7.00 1.00bl.1. 1.00bn.sil. 5.00bn.l.s.&gr. B-2 7.08 100.20 none >7.08 .83bl.1. 1.00bn.sil. 5.25bn.l.s.&gr. B-3 7.08 100.10 none >7.08 .92bl.1. 1.33bn.sil. 4.83bn.l.s.&gr. B 4 6.75 100.70 none >6.75 1.00bl.l. 1.25bn.sil. 4.50bn.l.s.&gr. g_5 7.00 99.50 none >7.00 1.00bl.l. 1.00bn.sil. 3.00bn.l.s.&gr.,2.00c.s.&gr. B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 7ERI0 D2 PER PER INCH P- P- p- se design rate 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 a n Il, he direction and percent of land slope. SYSTEM ELEVATION 96.85 . _ _ 3 € 3 _ y. 4 i E € 11 le, r E T 3 € Nf, ` € € ~D r ,t, m S` ' _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: Gary L. Steel 12-23-91 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 1554 200th. Av.e, New Richrlond, Wi. 54017 2298 1715-246-6200 CST SIGN E: Y'Al DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - M 4 y R 1CTl> IR COMPLETING FORM 116 - SBD - 6396 To be a co[ ~(I accurate you3, report must include: 1. Complete leg: description; 2. The use secti gust clearly whether this is a residence or commercial project; 3, MAXIMU " bcr of: be-'- commercial use planned; d. Is this a r, .v eplacentent 5. Complete the s€=itability rat : <+:s; A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE Rt., C UT BASED ON SO ONDITIONS; 6 EASE use "he abbreviatirx= s h,--re for viriting'r descriptions and completing tile: plot plan; 7, .E A Lr=r=lPLr= diagrar a jly locating yo locations. Drawing to scale is preferred. A a, she y >e used if c 8, sr{:. r' can point are clearly shown, and are permanent; 9. Co-l a boxes names, Tresses, flood plain data, percolation test exemp- tion, 10. If the . as flood plf on) does not apply, place N.A. in the appropriate box; 11. Sign the fc n ace your current ari E ;s and your certification number; 12. Make lec~` ' and distribute as roquired. ALL. SOIL TESTS MUST BE FILED WITI-1 THE LOCAL : ~J F '_Y tVITHIN :30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separ- s and Textures Other Symbols st (over 10"i Bedrock cob - C. 1 113 - 10") Sandstor,; gr ,der 3") LS - Limestc "s << II VV High C _ .ater cs C Sand Perc - Percolation Rate recd s n 1 <znd i Well fs 1 Building ls: L Cheater Thvn sl Lo:::,, _ Brown nil - Silt Loan, Black Si S. t {;.,f Gray 6 C <ay t_oan, Y - yello~,,F Cc` y Clay Loarra R Red sic! S ; Ey Clay Loan, rnot - Mot i,. sc - Sandy Clay w- witl.. sir; Silty Clay fff - few, -le J., p.c Clay cc comrflor-, C, pt Peat min - Many, rnediu,-i III - i LICk d distinci~ p - prominent HWL High water level, Six general Soil textwe~ surface water for liquid waste disposal BM BenchCark t VRP - Vertical Rrferance Point r~ 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 in 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. itl l'.nilllal Idl rll 1 _ _ _.vvs"' P.().13UX 7969 1(.II)O 11 Y, PERCOLATION TESTS (115) MADISON, WI 53707 LA11OI1 AND. IIUMAN RELATIONS • (ILNR 83.0911) & Chapter 1451_ _ ' _ IUVINSFIIP/f1JQ1~C}~} LITY I-OT NO.'F3LY,.U. SUBf71VISUNNnME' 1'"~j1CiN - 's€%TioHudson l 4 n/a Cherry Hills ~T2y_N~R19x~c(or1WI nnniLtN~ nDUr1€"s'': s i4 MI i 34 COUN1 Y: TUYEFi'S NnME. 706 FOX Tree 111. N. , Iludson, Wi. 54016 St. Croix Thomas Fulton DATES OBSERVATIONS MADE S S: USE - -Ormg-n"TPTTU : ISEN~8L7CTI~T>= NO'.B€DF:NIS.: co►~ER~ITC[J€s~€il~~1oN -;New ❑Repiace 12-23-91 n/a residence 4 n/a RATING: S= Site! suitable for system N°WE~s ?bSSFI=AI-IN•FILL 110LDING 7ANK: RECOMMENDEU SYST EM:(optionnil- :il 1~ NiI~Nbi.: rvioUNU' ~U 0 S ®U Conventional D S U 0 S ❑U~ UESIGN RATE: It any portion o1 tire tested area is in the If Percolation Tests are NOT retltrired~ Floodplain, indicate decimal' Floodplain elevation: r1/a under s. IL11R 63.09151(1)1, indicate: class 2 page 66 OI1C2 Ir On _ EXTE, ANU DEP1F g(1F;ING 10RA _ PROFILE DESCRIPTIONS 1. FP CH TO GR UNUWAT EFi IINCHES BFEDROCK IF OBSERVED (SEE ABBRV O-56 0) F1 ~ N BACK.) NUMBER DEP1141 LEVA7ION ROCK S . G ZEST .-TO B-1 7.00 100.60 none >7.00 1.0011.1. 1.00bn.si.1. 5.00bn.l.s.&gr• 2 7.08 100.20 none >7.08 .83bl.1. 1.00bn.sil. 5.25I)n.l.s.&gr. 3 7.08 100.10 ~none >7.08 .92bl.1. 1.33brl.sil. 4.83bn.l.s.&gr. B- B- 4 6.75 >6.75 1.001)1.1. 1.25bn.sil.. 4.50bn.l.s.&gr. 100.70 elope B_5 7.00 99.50 none >7.00 1.00bl.l. 1.00bn.sil. 3.00bn.l.s.&gr.,2.00c.s. gr• B- I PERCOLATION TESTS O E P 111 Al HATE MINUTES tESI IN WA1ER LEVE NC ES PER INCH URUP WERIN HOLE TES T TIME NUMBER INCHES AFT ER SWELLING..INTER VAL•MIN. _PERfU rEt~COO t P- - - P p. se esi n rate P- P- P ble so cent Descr PLOT PLAN: Show locations of percolation tests, howltheir location' onrther'plotSplan. Show the sareas urfacerelevationcalt all boringsaand theidirectlonbe what metal and vertical elevation reference points and s of land slope. SYSTEM ELEVATION 96.85 ( I E~. 1 r. C:1{k 16 V I t I or with twledge a urea an . methods specified in the Wisconsin G ).n. he proced I, the undersigned, hereby certify that the soil tests reported on this lotm were tests are ina ecby to in accord dministrative Code, and that the data recorded and the location cor to best my kd belief v TESTS WERE COMPLETED ON: E print : 12-23-91 L. Steel _ CERRTIFICATION NUMBER: PFION MERIoptionall: SS: 2298 15-246-6200 200th. Av.e, New Richmond, }Ji. 54017 CST SIGN E: Original and one copy to Local Authority, Property Owner and Soil Tester. R. 10/83) - OVER - r r ; i j i I I I I ~ I { I I ! ~ ! I I ; ! i I I 1 I I I ! 'Its , I , I j I ~f I I ' I ! i ~ ' t i t 1 - 40 J f I I I ~ ~ I ~ 1 I ! ! 6I I- - - -h t f - 1 1 I , II 1 ryk. 51 Lk 1 - I - to --ic&1-6r4C*l`Lf4mt 1 i (I 5 W C~o~+ !a la I ~ r I ! ) 1 I i ! + i I I i I I I I - I t i - I ' I a _ I ~ ~ I I I I I I I i i f I I {gyp I ~ I ~ ; I ~ I I I 1 I h I ; I - ! of - { I ~ I I I i I ~ I I -i - i r f 1 I 1 ' 171 _4i f a~ ~ i I ~ 1 _ f ~ ! I I I ~ I I I I I ! ! I . ; I ~ i ~ I I i i I I I I I ~ I I I I ! 5, f r - -r 1 it i I I t I I i i I I I ' i I I ' I E r ~ h I I I j 7-- - r r - 7 1 - -r - 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 - - - - _ - _ C r I i 1 i , I I I I I ~ ' I I I i I I I I ~ a I I I 1 I I ~ ! 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