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AS BUILT SANITARY SYSTEM REPORT
OWNER ~v,_ TOWNSHIP ~f~is~~ rat
SECTION--Z~Z T N-R ~ W
ADDRESS td ST. CROIX COUNTY, WISCONSIN
; ,
SUBDIVISION L~,ri»z~i LOT'--.~_LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
- - X74 ~
s
F
yr, ~
INDICATE NORTH ARROW
BENCHMARK: Elevation and description: 7"Ab
Alternate benchmark
SEPTIC TANK:Manufacturer:S Liquid Cap.
Rings used: Manhole cover elev: 1C-2 sl Final grade elev: /
Tank inlet elev.: Tank outlet elev.:
No. of feet from nearest road:Front , Side , Rear Ft.
From nearest prop. line:Front Side, Rear Ft. //>'O
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:
a'
idth:~5- Length ZS f Number of Lines: 2_Area Built 7~0
Exist. Grade Elev. Proposed Final Grade Elev.
Fill depth to top of pipe: ,
No. feet from nearest prop. line:Front , Side X , Rear Ft. 5"
No. feet from well:_J~_No. feet from building S-
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:
J
DATE: y PLUMBER ON JOB:--Y'~'
LICENSE NUMBER:-,
6/90:cj
LOCATION: SOMERSET 14.31.19.195E,SE,NE,HWY.35
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Lal?orand H'urhan Relations INSPECTION REPORT
Safety and Buildings Division ST. CROIX
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-:
149284
Permit Holder's Name: ❑ City ❑ Village JV Town of: State Plan ID No.:
HOHLER, STEVEN R & LISA A SOMERSET
CST BM Elev.: r nsp. BM Elev.: BM Description: Parcel Tax No.:
032103940000
TANK INFORMATION ELEVATION DATA A9200132
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic r Benchmark
Dosing
Aeration Bldg. Sewer
S
Holding St/ Ht Inlet 3 p /0/.o
TANK SETBACK INFORMATION St/ Ht Outlet p VU, ~'3
Vent
TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet
Septic O 4 ( NA Dt Bottom
Dosing NA Header / Man. 1 / % 9 7, 75 o 1j
Aeration NA Dist. Pipe } 1? 7, L /
Holding Bot. System •(o /
PUMP/ SIPHON INFORMATION Final Grade /00.2 v
Manufacturer Demand
Model Number GPM
TDH Lift Friction System TDH Ft
955
Forcemain Length Dia. Fi Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width LengS S No. Of,;renches PIT No. Of Pits sid i Liquid Depth
DIMENSIONS -s / 4c-- DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHI urer:
SETBACK R
INFORMATION Type0 7 C/, / CHAM OR UNIT Mo INumber:
System:
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 revision required? ❑ Yes ❑ No
Use other side for additional information. E]i
k V~]
SBD-6710 (R 05/91) Dat Inspector's Signature Cert. NO.
ADDITIONAL COMMENTS AND SKETCH
.f ,
SANITARY PERMIT NUMBER:
SANITARY PERMIT APPLICATION
4~
DILHR In accord with ILHR 83.05, Wis. Adm. Code CouNTY
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / f qa&4/
8% X 11 inches in size. Check it revision to pr wous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORM TION - PLEASE PRINT ALL INFORMATION.
PROPER OWNER PROPERTY LOCATION
t ,c %a 114 1/4, S /V 1, 1, N, R )9 E (orW
PROPERTY OWNE MAILIN ~4DDRESS LOT # BLOCK #
f~ 4
CI STAT ZIP CODE PHONE NUMBER SUBDI 10 NAME OR CSM NUMBER
II. TYPE OF BUILDING: Check one CITY NEARE ROAD
( ) ❑ State Owned O VILLAGE :
❑ Public M1 or 2 Fam. Dwelling,# of bedrooms PAR L Ax N ( )
III. BUILDING USE: (If building type is public, check all that apply)
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. M New 2.E] Replacement 3. ❑ 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 ❑ 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) T~ 9G 7 ELEVATION
50 , 11 `j Feet Feet
CAPACITY
VII. TANK Site
in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New istin Gallons Tanks Concrete glass App.
Tanks Tanks strutted
Septic Tank or Holding Tank - r '
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for install tion of the onsite sewage system shown on the attached plans.
Plumb is Name (Print): Plumb 's gnat e: ( S ? MP/MPRSW No.: Business Phone Number:
Plum 'pr's Address (Street, City, State, Zip Code):
9
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater EDate Issued Is ing Agent Signat o Stamps)
'Cr Approved E3 Owner Given Initial Surcharge Fee)
Adverse Determination y
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/86) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
iNSTRUC:TIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the 'Jrne of renew~: i 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 cwnership or plumber requires a Sanitary Permit 1"ransfer/Renewal Forin (SBD 6399) to be
submitted to the county prior to installation
5. Onsite sewa[;e systems must be proptariy maintained. The septic tank(s) must be purr peel 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 adrni iistrator 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. lumber 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 mull 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
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 contaminatio,i investigations and establishment of standards.
y
SBD-6398 (R.11/88)
STC-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 Steve and Lisa Hohler
Location of propertyj,,g~ 1/4 AZ,~_,1/4, Section T-.:? N-R__L9~-_W
Township
Mailing address 689 Polk/St. Croix Rd.
New Richmond, WI. 54017
Address of site 215th Ave.
Subdivision name Koltff\q pjN Lot no. 3
other homes on property? yes x No
Previous owner of property Darryl Edward Germain
Total size of parcel 5.020 Acres
Date parcel was created kf ( )Q ~ s
Are all corners and lot lines identifiable? -1-Yes
No
Is this property being developed for (spec house)? Yes _.2(No
volume q)3 and Page Number [A3 . 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
I(we) certify that all statements on this form are true to the
bee st of my (our) knowledge that I (we) am (are) the owner(s) of
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.
#472894
own the , and that I (we) presently
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. #472894
'Si 9 nature
applicant Co-applic cant
9A
Date of Signature
Date of Signature
DOCUMENT No. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
STATE BAR OF WISCONSIN FORM 2-1982
'14.72894 VOL 913PAGE 23 REGISTER'S OFFICE ,
Darryl Edward Germain, a single person ST. CROIX CO•8 WI
Recd for Record
AUG2 61991
at 11:05 A~.' /Mn
Cry
conveys and warrants to . St_even...F3.:.-__H.Ohle.r...ajad-.Lis.a-_A....
Hohler.,--husband-..and•-wi-fe--.as...mar.ital........................ Register of Deeds
survivorsh p..I?rop~.i ~Y..........
RETURN TO
St . Gr0 X.
Count the following described real estate in County,
State of Wisconsin:
Tax Parcel No:
Part of SE 1/4 of NE 1/4 of Section 14, Township 31 North, Range
19 West, St. Croix County, Wisconsin described as follows: Lot 3
of Certified Survey Map filed April 18, 1975 in Vol. 1, Page 108,
Doc. No. 326432•
This i S not homestead property.
(is) (is not)
Exception to warranties: easements, restrictions and rights-of-way
of record, if any.
August 91
Dated this day of 19.---_....
(SEAL) (SEAL)
* Darryl Edward Germain
-•----------•---.....----••-•-•--(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN
-..I~arry 1__.Erl.~ta.rd---Gsrnoairi
ss.
County.
authent' ted this...._da of._August 1 1991 Personally came before me this ----------------day of
, 19 the above named
- . f-•--.----•------------•
* Kristina Ogland Lundeen
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, Wis. Stats.)
to me known to be the person who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
Kristina Cgland Lundeen
Aftorney at' I,aw
. Notary Public County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.) - date:
19--•---•••)
*Names of persons signing in any capacity should be typed or printed below their signatures.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
WARRANTY DEED FORM No. 2- 1982 Milwaukee, Wisconsin
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER Steve and Lisa Hohler
ADDRESS: 215th Ave. FIRE NO:
LOCATION: ",'E' 1/4, _F 1/4, SEC. T=ZL N-RW,
TOWN OF:
_ ~~~rr;~,Er'cf ST. CROIX COUNTY
SUBDIVISION: IQ(4(~I✓~C,'1. ~~Q( LOT NO.
J
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 to
help with the cost of the 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 the St. Croix County
Zoning a certification form, signed by the owner and by a master
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. Certification from will be sent approximately
30 days prior to three year expiration.
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 form must be completed and returned to the St.
Croix County Zoning Officer within 30 days of the three year
expiration date.
SIGNED:-
i DATE:-
St.
Croix County Zoning Office
911 4th St.
Hudson, WI 54016
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY DIVISION
LABOR-AND PERCOLATION TESTS (115) MADISOP.O. BOX N W 53707
HUMAN RELATIONS
(ILHR 83.0911) & Chapter 145)
LOCATION: SECTION: TOWNS HIP/m[rY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
SE 1/4 NE 1/4 i4 /T 3l N/R 11Nor) W Somerset 3 n/a Germain 46326432
COUNTY: OWNER'S/ NAME: MAILING ADDRESS:
St. Croix Darryl Germain 2100 Hy. 4635N., somerset, Wi. 54025
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DES RIPTIONS: PER OLATION TESTS:
residence 3 n/a 6Ivew ❑Replace 9-19-90 9-20-90
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: ISYSTEM-1 N-F I LLIHOLDI NG TANK: RECOMMENDED SYSTEM: (o~~tt aa
0S ❑U ®S ❑U CgS ❑U ❑ S EU ❑ S 9U conventional tre t iV down
If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the
under s. ILHR 83.09(5)(b), indicate: n/a Floodplain, indicate Floodplain elevation: n/a
decimal' PROFILE DESCRIPTIONS page 10 AIC2
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B-1 7.16 98.92 none >7.16 1.08bl.1. 1.17bn.sil. .58bn.s.1. 4.33bn.l.s.
B 2 6.83 99.19 none >6.83 .75bl.1. 1.08bn.sil. 4.00bn.l.s. 1.00bn.c.s.
3 7.17 100.20 none >7.17 .50bl.1. .92bn.sil. 3.83bn.l.s. 1.92bn.s.l.
B-
4 7.17 100.52 none >7.17 .67bl.1. 1.00bn.sil. 2.00bn.l.s. 3.50bn.s.1.
B-
B-5 6.59 99.77 none >6.59 .50bl.1. .67bn.sil. 2.50bn.l.s. 2.92bn.c.s.
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER NICOM AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R PER INCH
P- 3.50 none 30 3-2 3 3 10
P- 2 3.7 none 30 22 24 24 13
P- 3 3.50 none 30 3 i 3 3 10
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 at all borings and the direction and percent
of land slope. 96.70 upper trench
SYSTEM ELEVATION 95.42 lower trench
A, I
0110
0~ E
4-6 Ir -
r 5
40 f------
S, 0 2- I,40~es-5
E
E
3 E
3 f
I
E
r- -
E
3
3
1
a
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 9-20-90
ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional):
1554 200th. Ave., New Richmond, Wi. 54017 2298 15- -6200
CST SIGNAT
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
AN - A115-
IF A[ ..L
a-
!H
A
TO THE" C
-T L request
vt rif: ip private
r, Acr to
s~ v. .
.?`TFi /7 •m fi /,F_ is
326432
SCALE WEST,
200 0 100. 200 4.30 NE CORNER
SECTION 14
g. R31N, R19W
POINT OFBEGINNING
e
-p 87° 31' E N
166' 617.04
i 88° 59' 91°01'
SE 1/4- NE 1/4 3
I o° 4 C "Goo a
t_z N , 5.06 ACRES • 1
5 I ti M N 9 o WESTERLY RIGHT-OF
I Z WAY LINE OF STATE
15A 91°01' 88° 59' N TRUNK HIGHWAY "35'
I N 87 ° 31'W
v>
ASSUMED BEARING 88° 59 617.04 ° ,
91 01 CENTERLINE OF
I W STATE TRUNK
O HIGHWAY'35
I a g 3 WOO I'
o h CO r.
z 5.02 'n N N
°
- - ,n rn
i NORTHERLY RIG OF z~
WAY LINE
N 1028' E.- (66' 91° 01 N 8'7031' W 880,59'-
-(A
33.00 rn 617.04
.:EGEND E 1/4 CORNER
SECTION CORNER MONUMENT SECTION 14
0 1" X 24" IR671J Pl PF -
1.6.811/L1NEAL 100'1'.
V_I YLD FOR: EDWARD (77ERhIAIN, Lox 66A, Somerset, Wisconsin 54025
_;CRIPTION:
arcel of land located in the SE1/4 of the NE1/4 of Section 14, T31N, R19W,
T. o_ omerset,. St. Croix County, Wisconsin, described as follows: Commencing
t'.e :.F: corner of said Section 14; thence West 4.301; thence S1°28'W (assumed
rinl) 1860.88' along the centerline of present State Trunk Highway "35" and
o,.•t:-,erly extension thereof; thence N87°31'W 70.01' to the point of beginning;
`;1°28'ls' 712.00' along the Westerly right-of-way line of said State Trunk
,,av -55` thence N87°311h' 617.04' along the Northerly right-of-way line oya
fisting road; thence N1°28'E.712.00'; thence S87°31'E -617.04' tb the po;inning.
ertii that the above description and map are correct and that I have Tully
p1ieu•~;ith the provisions of Sec. 236. 34~of the Wis%~si Statutes.
I.: April 3, 1975
FRANCIS H. OG -882 ZI Map No. 75-434
:,SSI?Fh BEARING REFERENCED TO CF.N7FRLINE OF STATE TRUNK HIGHWAY 1135".
,,``~NU~ushr~ti
,~•~9p~j~~ FRANCIS H.
~ t -t(
0. o < s-eaz
e i-+ " RfVER PANS,
0i, Or
~,9js Volume 1 Page 108 7 >rY~ p
ti
o $.u .4
tj Z Y ~1,117
i
iii Ji':. D J lLr-7~t" fJrf - i'ir7 ~~1~-i~r~lvX /
- y / . 5~~,~~= ,rte ✓c~: c `?~/'~s 6~' ~ i
{
PAGE OF
Q ro S~C~IUI'1 p~ VC/STc'.n-1
Flesh Alf Inlel• And ObLetwallon Pipe
i
L~ Approviad Vah1 Cap
141nionuwa 62' Above
final Grade
20- 42' Above Plpp Coal 11on
To final Grade Vaal Pipe
Nareh Nor Or Synlhelk Coverlny
0
We 2' Aggregate -
.61 Pipe
0181fib Olga
Pipe a a o IC001RO Tam
`Banoal► Pipe Pe/loroled Pipe below
Te.nlnollno Al
Bollorn Of Syelara
i
l1 ~
~,~cJ..7 I owl
SOIL FILL
DISTKIBUTIO16.1 PIPE
• APPROVED aS`;WTIHETIC COVER
-MATERIM- OR 9" OF STRAW
2"0FhGGREGAIE----- - OR MARSH HAJ
Ell0F21/2 AGGREGATE
V. o Fr 1 EET
' - - ill
D15.1-RIg~UTI0kJ PIPE TO BE AT LEAST - 1mcHE5 BELOW ORIGIUAL GRAOE
AQU AT LEASTLO INCHES BUT 1.10 MORC THAW 42 MICHES BELOW FINAL GRADE.
MAxIMUM MrH OF FXCAVATicwl From oww► a 6xAvF- WILL BE --ZL: INCHES
111N mum PEP" of EACAVATION rAOM- 0~161NAL GRAGf- WILL BE ~ INCHES f
SIGIJED: ~ -
LICEUSC LJUMBER:
DATE-
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REPT131 SOMERSET ST. CROIX COUNTY ZONING PAGE 1
07/b6/92 0 )3'REQUESTS FOR INSPECTION WORK SHEETS FOR: 7/ 6/92 AREA: TN
Activity: A9200132 7/ 6/92 Type: CONVSEPT Status: PENDING Constr:
Address: SOMERSET 14.31.19.195E,SE,NE,HWY.35
Parcel: 032-1039-40-000 Occ: Use:
Description: 149284,
Applicant: HOHLER, STEVEN R & LISA A Phone:
Owner: HOHLER, STEVEN R & LISA A Phone:
Phone:
Contractor: O CONNELL, KIM A.
Inspection Request Information.....
Requestor: KIM O'CONNELL Phone:
Req Time: 14:07 Comments:
Items requested to be Inspected... Action Comments Time Exp
00012 FINAL INSPECTION
Inspection History.....
Item: 00012 FINAL INSPECTION