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HomeMy WebLinkAbout020-1281-30-000 00 I Q O 0 v c > ! c 0 O I p N a. N i C O d CO 7 x Y Z N C 7 LL c co O 01 00 Q ~ I M V ~ z y rn U) e o v a co m w z i o z v c aUi Z dr ° y I w H r y 0 4 N N O [~1'a^J N N N C N 0 0 0 0 • w (D O a 0 N N I c o O 2 (1 o © O O Q O N z m z Z O N ~ C Co y O) II E O N N ~ ~ o O D o L V r - H H H O O IL U) O O O •w i aa.IL a O N (n U = o) m } ~N N N O ~I O i (D 00 'O O O .I N O d~ N cn co ~j ~ o o U w c Mri 0 0 E LO a) CL a C Cl U') 30 III O O) O O M M 17 co E W O Co ~ Cn = O N U'N oi 0 '0 00 C) co o ® ~ I y y M a x* a v r`i~ i a v c c~ "~.l ® U a m O in U FORM - STC - 104 v AS BUILT SANITARY SYSTEM REPORT OWIJER 5~,,, /✓J; TOWNSHIP SECTION S'y T N-R / W ADDRESS~oy ` Z g 2_._.- ST. CROIX COUNTY, WISCONSIN A o ,1 Gdl S`/9 / L SUDDIVISION~hie*/ y It"tZ LOT /S LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM R w Y Wa.11 40' }AOk S \ sg'k 5 A CIS S~ N i Ho i g~M, SP,'ks 'K P°st . INDICATE NORTH ARROW I3ENCIiHARK:Elevation and drescription:~ ?oj1 5S..-r4- CL 1=JGtgoo' Alternate benchmark 7oa s~- SEPTIC TANK: Manufacturer: ~Im;SQ✓ Liquid cap. 100v Rings used: Z Manhole cover elev: Final grade elev: ~ ga Tank inlet elev.: r~Z D Tank outlet elev.: ~.S No. of feet from nearest road:Front , Side , Rear Ft. From nearest prop. line:Front , Side , Rear Ft. No. of feet from: Well 90 , Building: 35" (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: 4 X 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: fie„ „w a .0 Trench.:. Seepage Pit: Width: Length 9'0 Number of Lines:-3 Area Built 7,747 Exist. Grade Elev./D,~ Proposed Final Grade Elev.~0,5 _ Fill depth to top of pipe: yo " No, feet from nearest prop. line:Front , Side , Rear/ Ft.) No. No. feet from well: No. feet from building .-dam 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: 09 12 LICENSE NUMBER: /,I 3I 6/90:cj AT.}(~N• HU O 34.29.19.1350 NW MARIE LANE, LOT consirS6epartmen~o lnc~ustry, PR' S`SYSTEM County: Laboand Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 171463 Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: MILLER, SAM HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: )'F' r 4i AL ,Z•'~Lk' 020 1281-30-000 TANK INFORMATION ELEVATION DATA A9200228 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark / Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet, TANK SETBACK INFORMATION St/Ht Outlet tl D , Vent irito ntake ROAD Dt Inlet TANK TO P / L WELL BLDG. A Air Septic i ~D r / NA Dt Bottom Dosing NA Header/ Man. 13,0 1 f Aeration NA Dist. Pipe 1133 97. V Holding Bot. System /y 3 PUMP / SIPHON INFORMATION Final Grade rO Sq :20,5-6 Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft Head Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /19 A.(0 DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING manufacturer: SETBACK _ INFORMATION Type O e ` CHAMBER f > / Model Number: System: f,.&A /I )b 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.) oft; % lo. Plan revision required? ❑ Yes ❑ No Use other side for additional information. L 6 SBD-6710 (R 05191) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: DILHR SANITARY PERMIT APPLICATION cou TY _P ~.HR In accord with ILHR 83.05, Wis. Adm. Code OU ` ~~.0 L* STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than / 7/ C16 8% 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 /Q/ %a 44., s 3 T39 , N, R / E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, ST TE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER !-so,~ t cJ~ f/D/ 2_7k c4e Ill. TYPE OF BUILDING: (Check one) CITY ~ NEAREST ROAD State Owned ❑ VILLAGE Ae Al ❑ Public IN 1 or 2 Fam. Dwelling-# of bedrooms. PARCEL TAX . NUMBER(S) 111. BUILDING USE: (If building type is public, check all that apply) p Z,p - /Z 8/ - 30 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 40 Church/School 8 ❑ Mobile Home Park 120 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. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 51-1 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. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION ` s59 7 ZO st ft 7 LO Sy fy- O, /o Z S 7 O Feet /4O> S Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank /000 w*-l 2 V- r-] 71 F] I r7- I _X~ R F-1 0 1 0 1 F] 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 (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: Dom S+e, o), 0 a-Q /11 je- 5 3 2 (2q7) 3 Z,3Plumber's ddress (Street, City, State, Zip Cod~eJ): ~ 0 OL lV 4~ I G 7 1~1 O b N KJ I S 7/ q IX. C LINTY/DEPARTMENT USE ONLY ❑ Disapproved tary Permit Fee (Includes Groundwater Date Issued issuing Agent Sig ture (No Stamps) *'Approved ❑ Owner Given Initial .00 Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-8398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber I 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, numbE!r 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 F 'anks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate pref-x (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; (Jose 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) S T C - 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 ;c.,„ Location of property-&E.1/4:54V 1/4, Section 35/, T_?:~tN-R /j_&] Township _,6e, 5'kA Mailing address gox # zgz Y., f se W r Address of site C ,ti fj,"// Lo f 0' /S Subdivision name..r.-,Aqr/V ---Lot no. Other homes on property? yes No Previous owner of property s* 41o a~F Nka~soo Total size of parcel 340 N-- Date parcel was created Z d -%L Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)?X Yes No Volume _and Page Number 3 Z 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 REGISTER 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 f(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. 41 S:0 OGg' , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. `/7 8o G 8' Signature of applicant Co-applicant Date of Signature Date of Signature ~t r DOCUMENT NO. WARRAM DM THIS SPACS NE9LnV10 FOR mo6esoum aM1A L, STATE BAR OF WISCONSIN FORM 2 IM vol. 931 PAGI 32 REGISTER'S OMCE First National Bank of Hudson, a United ST. CM WI 1 States Banking Cor . poratlon . . . . . Recd for hPod _ JAN 2p 1992 II conveys and warrants to ppIT._E...Miller.,._a...sipgle_.•. - 8:00 ...Person _ p.obN. d O..r~, - - f I r PE' UHN 70 II III .I the following described real estate in St ' CT'Oi x - _ ` _....-....._..County - - =1 I~ State of Wisconsin: Tax Parcel No: I. Lots 4, 12, 13, 14, 15, 16, and 17, Plat of Cherry Hill in the Town of Hudson, St. Croix County, Wisconsin. i Y Part of the SWI~: of NWk of Section 34, Towrship 29 North, Range i' 19 West, St. Croix Count!, Wisconsin described as follows: Lots 2 and 3 of Certified Survey Map filed June 27, 1989 in `.':.1. 11811, Page 2117, Doc. No. 449209. outlots 1 and 2, Plat of Cherry Hill in the Town of "udsoll, St. Croix County, Wisconsin. Y IIRA ID s-_'If P •f, This i s . nQt.. homestead property. (is) (is not) 4 Exception to warranties: easements, restrictions aril 1'1 F'j;tS-ol'-'play Y of record, if any. Dated this I 1....... _ day of lnuary 1992 F s Na io ^B k of Hudson, by: w _ (SEA 1.) / ISEAt.) _ [LL top \1 icE FRe-•~sIpt-^j I ; (SF:A I.) (slrAt.) r AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF R'rscoNSIN vy. ~r,oi„ .punt}. authenticated this .......day of.......... 11 er~rmalr; e:une before rue tj;1s day of inuar•, 0 , the above named . • TITLE: MEMBER STATE BAR OF WIS(ONSIN (If not . . authorised by (i 706.06, Wis. Stats.) to me kuotcn to be the person wim em-culed the fort- oy(IR instrum nt, rnd uck.ro~y(l+..e the .amo. j\\\ 1 (y T11d INSTRUMENT WAS DRAFTED NY\✓~` vri s . ..na_O~land Lundeen X11 L ~e toy 'or :Joy Connors Attorney at Law t . Cr'Nbiury pubp . - Notre r Public lirnty, Wis. (Si4natures may be authenticated or acknowicdyred. linth .1 . c'.rnuni"inn is ro nn::nb'jglB ( olVR1lg61n.ue;iratior. urc n A necessary.) date: 19 9 *Names of pemns sicnine in any caparrty .h-14 In• t)j_1 ..r rr:nr•.{ b. l~~w th•rr .irrunr,. ro.. WARRANT! DEED STATE BAR 01 WISCONSIN Wruonsrn Legal Blank Co . Inc. FORM No a- IY1te Mrlwrtukle Wuaonsin S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER_S~t ryJ ADDRESS23.0 Y - Z r z__ FIRE NUMBER CITY/STATE ASO n ZIp .Tyy PROPERTY LOCATION 1/4 ,5 t t/ 1/4, SECTION _3 y , T-2:1 N-R_~ TOWN OF Kli S M v' , St. Croix County, SUBDIVISION _Clierr~/ LOT NUMBER/ s . 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 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 system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater 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. 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 stating that your septic has been maintained must be completed and returned to the St. Croix Co. Zoning officer within 30 days of the three year expiration date. SIGNED: DATE : St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 I ~ DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR BOX HUMAN RELATIONS PERCOLATION TESTS (11J) MADISON WI 53707 0LHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHI /MUNICIPALITY: LOT NO.:BLK. NO.:SUBDIVISION N ME: rl~ '/a`)W V/ 94 /Tzg N/R/9 E (or) W NON l5 c~Qky Pius COUNTY: OWNER'S/BUYER'S NAME: MAILING ADDRESS: S-rC&)X S.am, MluCe USE DATES OBSERVATIONS MADE ~Tl NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: jPERCOVATI9N TESTS: Residence / /N l~ New ❑ Replace 1 .)AA 0 /91z. v~ SO )L S kz 66 50)Ls 8kCZ-- $u,~yumol~r- 7 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: JI LHGK: REC,~MMEN~NTIOSYSTEM: `(optiona S ❑U IX S DU (,y [S U 21S a~ ~l U 6V /QJ If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: C~Cs l Floodplain, indicate Floodplain elevation: AIA C PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 4, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 9.0 161-19 ► 04E_ g. 6? z ' S zrs r $,ie 5 B- Z .:,->3 /06 -11 40vJIf ,33 1-TS Z*,$ a A15 B-3 . o 99,0-7 r-64C > 26"' SL7_-5 N rhS B- q-00 9A-'70 der > 9.00 " Lstrs Sc Wg N M5 B- > rS 9~ ti$ n~ B- c~"f PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 4ftONM AFTERS WELLING INTERVAL-MIN. PE IOD 1 PERIOD2 PERJOD PER INCH P_ .10 No>J 4D 0 I,/-t- I' Z .7 I 1h P_ 7- /6640 114001L :Mb /b Z 7 Z P- 99,/6 r4ohlr- -Z.46 /b JA7 177- 1 z 4-2 P- P ELEOM / A S P- PLO PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zont 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 laid slope. SYSTEM ELEVATION E SCALD E F E 4 3 E •b 3 ~1' - i I, the undersigned, hereby certify that the soil tests reported on this "RMAKety 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. NA /a (print): > TESTS WERE COMPLETED ON: a~ aN JoWNsoj S~Rv~Y/ 1~v S u /?9z ADDRE S: CERTIFICATION NUMBER: P 'NE N LIMBER (optional): c,t~sa~ W► saw I 344~- CST SI TURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - • 1 INSTRUCTIONS FOR OMPLETI ? FORM 115 - S BD - To be a cc fete arid accurate soil te=st, You" rep{ rr. tuc3e: 1. Comp description; 2. The use secs w rust clearly indicate yv?loherthis is residence 01' cornraaeicial project; 3. MAXIMUM nu of bedroorns or GoCYlMM(,ial USE, planned; 4. is this a nevv ( ' i gent system; 5. Complete the rating boxes. A SITES IS SUIT"AISLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTE RULED OUT BASED ON SOIL CONDITIONS; 6, PLEASE use the ,,,ions sh, r; here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGI`_ ° n accurately locating your test locations. Drawing to scale, is preferred. A separate sheet ma if desired; 8. Make sure ye:rur bene and vertical t [evatiraia rrtference poin are rly st7own, grid are permanent; 9. Complete all app boxes as to dates, names, addresses, I percolation test exemp- tion if ap -r 10. If the ii,'_ <s flood plain ,;on) does not appl„ i in the <te box; 11. Sign the f your CLUI P'!t , td your certificrstion number; 12. Make le>giL and distribute as re d, ALL SOIL TE=STS MUST BE FILE[ WITH THE LOCAL_ A s Y WITHIN :30 [SAY IPLETION, ABBREVIATIONS FOR CERTI I SOIL TESTERS Soil Separates and Textures . C '-yrnbols si St:om- (over 10") BR Bedrock cob - Cobble (3 _ 10") SS - Sandstone fr Gravel (under 3") L a Lirnestor s - Sand ,-ligh c ,o ter r;s Coa-se; Sark f rued s - Mediom Sand is F=ree; Sar~r:z 4 ,<< Loany Sind I - n si ~,L-~arra ~ l_ u., BI . Gy G C, y scl C < y Loam sicl S,l- C ~ Loam mot - ~~:i i se - Sandy Clay sic, Silty Clay fff - few e, faint *c Clay CC -T . , Ouse pt Peat nirn - Mar , rnedium ni Muck d distir P P1, l WL f igF, ievel, Six gene€al soO to se. :e :eater `or !Ialu c waste d' pr; BM - Benct, (Mark /i P ej..tica poi nt 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. W 4 O ally p V1 W _ LL X11 ..~M ~ ef.) 1 ~ J ' I I ~M _ d N 1 I ~ ~ ~ d T I I a ill ~ "LL I i l h Y r Q d a_ ~ W ti M \ D~ 3 i -vp 3 J Q i ~ o I s- ~ sS? O 4 a ~y ~~1 V O ~ pr s LLk IN LU LLI O1 0 s` N d v) . ~ J ~n Cn O- Vi a 1 --y" V) rig ~J ~s~ -:z- ALL o i Lz1 F= as l L L.( O t OQ CL ry, LL a. Ld o x .-j U-1 N 0 W X U _I O V) G) U O -f o F~- r O F[f' ....mow. 0 x _y i LLJ l `a3 N i f CL Ui i L LIJ U CL l z I II ~II r~- J j!I L~! 1 ill f i ! ( I+~ iil C: 1 • ~~f ~ Ali " J I I I LCLL O ~r ! I'I +yI ~ ~ '1 ilk ll. Q Ii U Lri- co U~ Ili I ¢ ~ !il 1'I II. ~ ~il 1 CA, !J ~ f JlJ y; .u ~J iI~ I LIJ i I i'i I ~ " z i Il fi (l~ ; ' V7 I 'W I J' d tt L , REPT151 HUDSON ST. CROIX COUNTY ZONING PAGE 1 68/0-4/92 16:00 REQUESTS FOR INSPECTION WORK SHEETS FOR: 8/ 5/92 AREA: MJ Activity: A9200228 8/ 5/92 Type: CONVSEPT Status: PENDING Constr: Address: HUDSON 34.29.19.1350, NW,SW,CHERRY LANE, LOT #15 Parcel: 020-1281-30-000 Occ: Use: Description: 171463 Applicant: MILLER, SAM Phone: Owner: MILLER, SAM Phone: Contractor: STROHBEEN, DOUG Phone: Inspection Request Information..... Requestor: DOUG STROHBEEN Phone: Req Time: 10:08 Comments: Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION II Inspection History..... Item: 00012 FINAL INSPECTION