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HomeMy WebLinkAbout022-1072-10-190 a O o(n v N ~ N a 0., ~ I M ~ O X N ~ O 0 y d O O v o 3 I', ~ a I o °Z ,I, LL C y U v v 2 E 1, ~ M II Z °r° w O w z E o z N y d 00 (O N III a M N Z I O z ~ II E ~ I O O C L N 0-1 .2 O Z Z p- N O z Z N r, =4) E U) U) Z N > y 1- O LL 0 0 0 a •N 0aaa a a 0 0 N > 0) ~ U) rn 0) } V I- O N C T N 0 0 0 0 NOOp _ 0 E N N N O> O O O O (O O U a N M OD 0 !~1 aoo ~ `•3 I o o 0 3 c LO N O C C O Q H (6 L1 O O Ci O 1~ O N In cl, O U O O CL C. C -O N N N N N c t c E E c ~t o (o C W r r Y ~ I~ C L L d U (0 O W o O U N 01 d N C N O • N (0 C_ O O N E E U O N Y lL O z- 05O ! f y 1r \i ~ ib = E v~ `m c € a v ~ i! o L d • ~ Q 4f N C r`1v E c c .a3 "DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR SHUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION j~J Ntq SO(y~y' s~ e c . 2 6, T 2 8 - R18 State Plan I.D. Number: •4 ) j~ 4 7 (If assigned) Town of Kinnickinr El CONVENTIONAL El ALTERATIVE i Evergreen Rd. LJ Holding Tank ❑ In-Ground Pressure !/Mound NAME OF-PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Ve~ Tom Florer 564 Omaha Rd., Hudson, WI - - s BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CSTW. P r./EELLEV.: Name of Plumber: MP/MPRSW No.: County: .y Sanitary Permit Number: Thomas Wan 3231 St. Croix 148997 SEPTIC TANK/HOLDING TANK: ST. eCOLK-,- S'0' MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER / PROVIDED: PROVIDED: 9apl ISO 9~• 9S ❑ NO F-1 YES COO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO F ESH Eqj / f ALARM: FEET FROM LINE: AIR IN ❑ YES O q C-a ❑ YES [4 NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/9PFF9drMANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES 9-tq'0 SO . b_-'7'C G_ C? 9 L C [4~' S E] NO NO GALLONS PER CYCLE: MP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WEL ' - BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN ~I FEET FROM LINE: AIR INLET: PUMP ON AND OFF I f ED-VE~❑ NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: / DIAMET/ER: MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN lL 7 the soil is dry enough to continue.) r~ CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER PIT INSIDE DIA.: # PITS: LIQUID TRENCHES: MATERIAL: DEPTH: GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM:y Mound site plowed perpendic ar to c ec ex ure o e fil teria for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown un ope: mound sy ems to make certain that it ON REVERSE SIDE. SHOW ❑ YES [ NNo / meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; 5 EIJ- S ❑ NO ES ❑ NO ✓-~KC C2±= I DEPTH OVER TRENCH/ BED DEPTH OVI~A TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: o~~o rn vo ' 62&2,:aA c 2 ` BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: 3Z. 1) 6 w Aj DIMENSIONS T 4^7 MANIFOLD PUMP 0('F MANI OLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: j ELEV.: r DIA.: ELEV.: PIPE ELEVATION AND aI f 10,W C_ DISTRIBUTION H LE SIZE: HOLE SPACING: D ILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION a Ayr/ APB PROVED E PLANS ~J YES ~ Rfl YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ( NO ES ❑ NO NEAREST-~ r; 0 __7 a~ e- O .1 R t , ~ /!J .n-t'' /`1 6,171 AAA 44W- et n in county file for audit. Sketch System on Reverse Side. SIGNAT E: TITLE: SBD-6710 (R. 06/88) SANITARY PERMIT APPLICATION T®ILHR In accord with ILHR 83.05, Wis. Adm. Code o N STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ L~(g QQ 7 8'!z X 11 Ir1Ch@S In size. heck 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 WNER PROPERTY LOCATION /Luq P '/a S v24~ T P F-, N, R E (or W PROPERTY O NER'S ILIN~ RE & LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUM ER II. TYPE OF BUILDING: (Check one) CITY ~ NEAR ROAD ❑ State Owned VILLAGE C ~l h / ❑ Public ©1 or 2 Fam. Dwelling-# of bedrooms? AR L TAX NU ER( ) III. BUILDING USE: (If building type is public, check all that apply) 1 El Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 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. ❑ Replacement 3.E1 Replacement of 4. ❑ Reconnection of 5.E] 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 ~j C) 3 74~ ? 76 /f o 16,;1, S' Feet Dk d Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank dL> r j~J['S ~iS Lift Pump Tank/Si hon Chamber y O VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's ame (Print): Plumb ' ignature: (No S mps) M Business Phone Number: ti f~.bi 3~3/ ~a~ f 5 Plumbs 's Address (Street, City, Stat ,Zip Code): ~ ~ _ i~D~ i C 5 vj IX. C NTY/DEPARTMENT USE ONLY ❑ Disapproved S Mary Permit Fee (Includes Groundwater Date Issued Issuing em Sig "t7 (No S s) Surcharge Fee) Approved ❑ Owner Given Initial Advers termination 1 CZ) X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber • APPLICATION FOR SANITARY PERMIT 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 I~/A rXvfr Location of property V F 1/4 _1/4, Section , T gF N-R_~? W Township k I, 0 11 0 Mailing address p ,~J Address of site C9 Subdivision name - Lot number n y-- Previous owner of property Total size of parcel Date parcel was created j~ - Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes K_No Volume and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PACE NUMBER, and 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. ---------------------------------------------------------7--------------------- PROPERTY OWNER CERTIFICATION I(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. Z!~:2. n ; 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 said system, and the same has been dui recorded in the Office of the County Register of Deeds, as Document No. Signature of Owner Signature of Co-Owner (If Applicable) 3/ zI l Date of Signat1ure Date of Signature Nw sa. Warrmw Deed--Comm= (STATZ OF WISCONSIN) Pubnsb•d bY AM Clabe Book a 600MM OIL By corpontim (am 235.18, Wia. Statalr) ~ Yom No. 2, This Indenture, Made this 17th day of December , A• D•,19 90, between Erieksmith, Inc. a Corporation duly organized and existing under and by virtue of the laws of the State of Wisconsin, located at Lakeland, Minnesota Wimt, party of the first part, and Thomas H. Florer and Susan K. Florer, husband and wife part ie s of the second part. tMUntOOM, That the said party of the first part, for and in consideration of the sum of • One Dollar and other valuable conilderation to it paid by the said parties of the second part, the receipt whereof is hereby confessed and acknowl- edged, has given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents does give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said pan ie s of the second part, the it heirs and assigns forever, the following described real estate, situated in the County of St. Croix and State of Wisconsin, to-wit: All that part of the North'Half of the Northeast Quarter (N~ of NE-',) of Section 26, T28N, R18W, Town of Kinnickinnic, described as follows: Commencing at the NE corner of said Section 26, also being the point of beginning of this description; thence S88 08'18"W 979.72 feet along the north line of said NE-14; thence S00054'30"E 1310.56 feet; thence N88017'25"E 968.09 feet along the 'south line of said N~ of the NE-4; thence N00024'09"W 1313.37 feet along the east line of said NE-4 to the point of beginning. Subject to right-of-way for the Town Road along the south line and all other easements of record. Containing 29.33 acres. J?'AI~i cCogttytt with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said party of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. Zo babt anb to DOM the said premises as above described with the hereditaments and appurtenances, unto the said part ie s of the second part, and to their heirs and assigns FOREVER. Anb the %afb Erieksmith, Inc. party of the first part, for itself and its successors, does covenant, grant, bargain and agree to and with the said parties of the second part, their heirs and assigns, that at the time of the ensealing and delivery of these presents it is well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all incumbrances whatever, and that the above bargained premises in the quiet and peaceable possession of the said part ie s of the second part, their heirs and assigns, against all and every person or persons. lawfully claiming the whole or any part thereof, it will forever WARRANT and DEFEND. In Ulftntoo Mertot, the said Erieksmith, Inc. is these presents to be signed by Dennis, W> ,Erickson. party, of the first part, has caused i President .and countersigned by Richard Re igh Smith , its Secretary, at Lake 1 and , . Ni inne so t; &V*mXndn, and its corporate seal to be hereunto aszed, this 17th day of December A. D.,1990 . ERICKS Signed and Sealed in Presence of NIITH INC. Corporab Name r,4a*dennis W. Erickson ichard Reigh Smith .".I . U c / A lilll f,gYtNa. vit~wM aai Mta~7•) w n M W A+ f h ..S ti Q y o +Q+. n W O +•w pq Ir P b c X 0 es -v . Q Q• h n o ~ o C") a. o 0 1 ° c a• ~ A Id d • c ~ b w ~ ~ ~ C b o^ a o M Q I I q: _ NW ' puEZaxEZ liBal X10JO- lS £t7T uosxoz.ja • M sluuqu iq Ps;;sja I 6r `•a •Y ` sojrdzo aompumoo AR W 'A;an03 uO3VutusBM `or[gnd.fjejoN N fi' IC •utp Ngax3 UOISSIWWOO An ..j q`t NnOO NOIJNIHSVM P~ ~OS3NNIn - onend AHVION 19 _ _ 1138 'l VIHINJIO --r-7yIW2) -F Of -10 -0 f of 0 F I- it Popp ON •6;tjoq;ns s;r Aq `aor;sjodjoo pies jo poop aq; so sjoorgo qons se wournj;sat aarolaioF aq; pa;noaza Aagt uq; poSpa[e+oagos pas 'aogsjodaoO pier fo Ajs;ajosS pas ;aaptsajd qons aq o; a r►oaq any o; pas `;aawnj;sar 8aro8ajoi aq; pa;noaza oqm saosjad aq; aq o; aasoaq oar o; `aor;ssodjoO paarea aeoge aq; ;o ~3aj`7aS' ttlZwS x4VTag p. mp-Eg Pas';aaprsajd` uosxjDIJ3 •M siuuaQ 06.616-a -v •Iagwaaacl 10 4sp u1LT srq; `am ajolaq aarso 6[[au0sjad •Asono, uol',,3uTgPum sjosauujf4 %WmCapik )a nose ~ acrd ns~ ion. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER / l7 A2 Flo er ROUTE/BOX NUMBER FIRE NO. V, CITY/STATE & So/i lull _ ZIP PROPERTY LOCATION: &L1/4 N5 1/4, Section b , T_2LN, R-&-W, Town of lC1~1~1((' &AAI , St. Croix County, Lot No. Subdivision 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 $3000 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 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 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 form 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 Department 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 date. SIGNED ~J_~~u~ ~~t7Z ell DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LAPOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN-RELATIONS MADISON, WI 53707 (ILHR 83.09(1) & Chapter 145) ~El~tvAMA.,1 LOCATION: SscTrow: TOWNSHIPIMtff eW7 t Y: LOT NO.: BLK. NO.: SUBDIVISION NAME: A/E 1/ NE 20 JT2,:? N/RIB' E to /C'ic~•~AJi c-._ 1)&r? 7- DF GD ?i 5 COUNTY: R'S B PER'S NA Cy MAILIN DRESS: S{ 4ot .'30 Z o I ~,..QasSL , ,4 ;.J N . .S5 ^D 'f3 USE DATES OBSERVATIONS MADE ,New I R FI ~ DESCRIPTIONS: 1PERCOLATION EST 3.BEDRMS.: COMMERCIAL DESCRIPTION: [M,Residence OR ❑Replace 11f,4 Z _ q I? Jt9,JE' 3. 11 i~ -1 5c-5 q S{tOws AS 1Pki-3f►IEC.D 1.7 RATING: S= Site suitable for system U= Site unsuitable for system HOLDING TANK: RECOMMENDED SYSTEM: (optional) ONVENTIONAL: MOUND: IN-GROUND•PRESSURE: SYSTEM-IN-FILL CIS ©u ®s ou as ®u ❑s au as au ~a~~~ Srs 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: GGif S S Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS IIu i i'-f>Y L -t--F BORING TOTAL n PTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED ES I HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 33 8+3. co-opze s T.S. 1.5 OP-QAJ . B- / d ~oo•5y _3, D coor is / . /Co ' Ole• f B- °p-5Y, kE) t'5 y • O t o . ~D 133 a . you l?Le S T.S. 1.33' 00 - t A . 15) 0 .33 15 w e c T,j ~V;4 S. W/ ff+ op--sr. nofs EB- ' 1. 33'lr.9,,s. S T.S, ,f?' ^15,4. s .S 4-/. B-3 6/ -7 V Oko- SA) PERCOLATION TESTS EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD I PERT D 2 PERIOD 3 PER INCH P. 02 .2 Z P- P- P- _ c P- i Z G e 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. S11 NP i PoCfic /aTF_R-~ACX 10l lf+ SAa ©Z .S SYSTEM ELEVATION i i i 1 C0VAJ7Y y~ &7_41E,_- 1 '-5© TH NQTE A pM JiO Qj (,5 tj -A $T- 0f=- CIS APPADeer) .AOL)vp Si"tE il~ (S0 -tPPDtk 70 '46+0d4i Sur`f4tlt Fog 1f60Nn 5YS1`7_"Ms. r4 Co"'t p 1 -T Tt -r h~ w ~v~ wb~ ~p .ft_?fq .moo OA>E . _ l ._.100 hi-c ri o.v : Bit - -1 ,~o t r 9 eAr fop- S ATE 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 0 • HOMESITE SEPTIC PLLI•'v1BING CO. ((J~ S - 1 Gl o r ADDRESS: ROBEr ULBRIGHT CERTI YCO FICATIO NUMBER: PHOj;,N MB0(opt~nal): I . NO. 3X7 M.P.R.S. 1 .3 WIS. MASTER PLUME14 ~ If ;TALLER & DESIGNER LIC. NO. M3 CST SIGNATURE- DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ,DILHR-SBD-6395 (R. 10/83) - OVER - i. J r I/ 93~ 3 ~IaG/~~ S31 - 97 veRNc4L ~1 ~ f . APPRoX . Co 00 I i ( X = 1~epc s lres ( HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., WDSON, WIS. 54016 ROBERT ULBRIGHT c sT 2-1112-- '141S. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. P y l IMM. B!STALLER A DESIGNER LIC. NO. 00663 coif DTI ( ~ 5 . I I 1 oa , I krA) DEPARTMEIV'• ~F SAFETY & BUILDINGS INDUSTJ1Y, REPORT ON SOIL BORINGS AND DIVISION LABOR AND PERCOLATION TESTS (115) ~ ' f P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (1-163.090) & Chapter 145.045) OF Z A TOWNSHIP1Mt1NIG PA~1't LOT NO.: BLK. NO: SUBDI VISION NAME: A16 1/ / 24, /T z? N/R (9 E (or) W I< I A.►"1 'c,~i~v •L i 3 0 /1 et e s C NTY: OWNSWS/BUYER'S NAME: MAILING ADDRESS: 1?T(,a MINCE - - 15-17 13 n` S' . So . AP I Z o 1 H u OS o-J W lS USE - 7 DATES OBSERVATIONS MADE TESTS: NO.B DRMS : 1COMMERCIAL DESCRIPTION: PROFILE NS: PERCOLA TION I~Residence 2 New ❑ Replace ,yj9 2 57C59_2)_ SIKOWS 145 P14iAJiE1A. (S RUV JgUrN4s RATING: S- Site suitable for system U- Site unsuitable for system ONVE AL: MOUND: IN-GROUND-PRESSURE : S S EM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) SS I D titJ 1 O V S /q _ OS ®U EIS U EIS U ❑S DU DS I M ~ d~. p o u-4 L o,.),Ly of s t o u.~ If Percolation Tests are NOT required s DESIGN RATE: If any portion of the tested area is in the N under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: ° Z PROFILE DESCRIPTIONS Za7 DEC ; ,y F h Z; BORING TOTAL P H T GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED ES CHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- .07 , N-it S, ~7' ~ s w/ ~f 0R M . S ~ S ' Is S*"rUA"fAP' l• G(~ ' w/ ^u04"~ I~. Qltorl. oR'Wots Z B- ^CTiUE StE E 1%T- 2-P" .2 .3 2. 3' -13 t K. S) I, o' FN.IS w/ f'~f. oQ-y Y. hofs g. 7i 3 S / d 3,So 8 2 AT- I. I• G -7 tj I S r i.fit,.t f•-SJQ 0-t- 1. W ~ ,w, C. f'S r-. OR trots. A r B- 2 f IS h V LEO /f y /o 33' l.F IS wr f f. yy- Qw1 ~l y o .4 to / /~f i,v T T' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERT D2 PERIOD PER INCH P- P- P- P-- U (J 77 / 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. SYSTEM ELEVATION e061-APPROVED' ~ 40TF M -#p ` eonv®ranaI srrptie systems. i AiP [a ~'C4'S444o)00' I t - . b ~I sv°f'^ 6r- j N i I HO ESITE SEPTIC LU BIN/G CO J,_ _ - 55 'NCI RD. HUDSON; WIS .54016 T - - - WIS MASTER LUM ER R 1 7 MJP R.$.. pb Q r P L,4 A.) o S R S SI© 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 test§ are correct to the best of my knowledge and belief. NAME print : TESTS WERE COMPLETED O : 141 ADDRES : CERTIFICATION NUMBER: PHO E NUMB R(o tional): HOMESIA SEPTIC PLLMNG 04 Z'Vp ; 3 V6 S 1:1411 MaHlbillill CST S NATURE DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - 1 v )Rd -v sovgccv0d 00 0/ N 'OV ddb r ' swow / a M07 ash ~ did oot SS ~ 5y I^ o O i 9J O i P LA • Yl ,yn~l~ 53c o5~~.a c'oll 'mss r 0 i 3 ° ~s IT Sao zIt i~ Ali Le% o cvy O~A I-IECG1dM,}~✓ SAFETY & BUILDINGS EPARTMEkT (7F= REPORT ON SOIL BORINGS AND DIVISION 7969 ABOR AND 3707 MADISON, WI BOX 53707 PERCOLATION TESTS (115) ' 1 BOR AN UMAN RELATIONS (H63.090) & Chapter 145.045) OF 2- HIP/MUj.&W7 PPk1~'f' Ill, OT NO.. BLK NO.: SUBDIVISION EE TOWNS t z 4 /TzP N/R R19 E (or) W /~if 3 0 of ~S A R S: V p uE z NTY: DANCE ' /rOS S27 13 S'-F . SQ . ~P ~ `ZO' E DATES 013SERVATIONS MADE - 7 C TO New ❑ Replace [Residence ^ 5•C'S 92 Sl,~cw-s /+S p~hiN~'iF~d~ IS ' ~~uv~IQuEN+f ATING: S~ Site witsbIs for system U~ Site unsuitable for system M:loptional) SS i {SI- NV M UND: IN M-IN FILL OLDING TANK: RECOMMENDED ?th (~''~s u os u os 0 as ou Mofwo - s S 0 V L- O,31- If Percolation Tests are NOT required DES IG N RATEIf any portion of the tested area is under t.H63.1)9(5)Ib), indicate: PROFILE DESCRIPTIONS IN -DLC i M ILL - A. DEPT TO Q AND DEPTH BORING TOTAL H R N)WATER-INCHES CHARACTER OF SOIL WITH THICKN SS, COLOR, TEXTURE, DEPTH I IN. ELEVATION OBSERVED E TO BEDR<~ K IF OBSERVED ICE AB BRV. ON BACK.) NUMBER G 1 11 j, 0 bo ys , - ~s sTwt.,f 1. 211 5AWDY 15. p11ph, OR HOTS C iv s e- 1k Z 3 5 L o' Ra. (s w~ ftf. oR-yY Hots, B Z 3 5~ 16 3,So Ar 1•1 ' ►.'6 10, ~jp I 01? Pots. hr 1.0 w sr l~ t L p G to M f. , B- i ~ 1~ fit' S wf F7 r 3 yo o~.~y , 8 B- It Qa, ~~~y o~M w~ t- - .Z S T R_ A PERCOLATION TESTS DRO I WATE V -IN H S RATE MINUTES WATER IN HOLE TEST TIME PER INCH 7E7R AFTERSWELLING INTERVAL-MIN. . P. are be what osscr P-sca the horl PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable Show the surface Indicate etio alt all borings and she'd action and percent } ele tonal and vertical elevation reference points and show their location on the plot plan. of land slope. SYSTEM ELEVATION - - , em. , c, r~iaaat septic sy 6 F Sux f'it 4c 1 -.0 S o y t + ES E PTIC LU BI CO - - ~NEI RD. HUDISON WIS 5401 S IS. MASER LUM ER 7 M•~.R.~. 4 ~ _ . - 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 testl are correct to the best of my knowledge and belief. TESTS WERE COMP D O : AME print : - 4 a CERTIF~ICATI N NUMBER: PHO E NUMB Rla tionol ADD : Z/~ L. I S H0& SEPTIC CST S NATURE Mill Dow POAAJ 2"/ Property Owner and Soil Tester. _ `s,0•ro~QrrTInhl• nrie(nal and one copy to Local Authority, k. ' a .v )lb - ~ -vSotf3ocvod an}{ I =10 15+x-1xo~ddd Q~ ~o~b'Xo~ddb (707 l zg - o~ h A~ SS / Sy ~ oZ ~ SO~c o ~b • 10 V4 Sir o5a`a' C, of o ~(OA >07OY2 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS ~ INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (ILHR 83.09(1) & Chapter 145) S-t7j1i ~~Cltt~.yof.✓ LOCATION: SECTION: TOWNSHIP/MCfdM"0At1-TY: LOTNO.:BLR.NO.:SUBDIVISION NAME: NE 1/4 NE V4 .2-6 /T N/Rt8E(o W Ane T GF Coo elCce s i~ COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: S><.Gcof ~,~rs AiCl-sdA3 13o g 20 ( 1.APA-00...,~ , /4;AJA1. 5 5 d'r~3 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMM R IALDESCRIPTION: ~7I ROFILE DESCRIPTION S: PERCOLATION TESTS: [4,Residence 3 pk 4-- . New ❑Replace 114,4 12 _ _ fj,A_)E 'S' Iq Stows AS PlAiA-f1'~ c..D 1S RATING: S= Site suitable for system U= Site unsuitable for system 5c.5 4 S ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILI_HOLDING TANK: RECOMMENDED SYSTEM: (optional) S DU 91 S ❑U ❑S ®U ❑S ©U ❑S ©U '4'-4a U"o v srS i~ 4 I If any portion of the tested area is in the If Percolation Tests are NOT re wired DESIGN RATE: Floodplain, indicate Floodplain elevation: under s. ILHR 83.09(5)(b), indicate: e'kl °,S PROFILE DESCRIPTIONS IN 'b EiCj Mt L BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED ES IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1,33 'W.24' cavR.ct S T•S. ) I.-5 o B- 3,0 ~ovp is /co 0l'- as f f+ . w °m_5Y, kb is B- B-Z •d I ~6D. /mod ~O V33' ,DI(-.G. e6ufate. S _T'S, 1.33' ale-&4. Is) 1, 3 3 0 Is U)/ q e o 7,tj -;V;4 s. w~ CR-Sy..~ofs , B- 1. 331K•6,.,- S T- S, •67' -I3a. s y01 01-7y' - 2 8 B-3 0,0- SA). ► ►s' o~-aa. sI PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERT D 1 PERT D2 PERIOD PER INCH P. a, Z P- P- Z P- P- Z Co <o 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. SAAJ Po C#c tj k c~ w l ff S ~t a~ = /4 2.. S SYSTEM ELEVATION l i : i N 0 L)A.)r,> Si *TC , A I sa r4Ppey 2k _ To. 187- jlQ)+Sd-Aej SuifA Ot fob 1f60 ND. SSTt A-l h )V e Tt~-ST , ha w EU~ _ wpv w..hxU~ -.7o Qe OCR I F j J--- C> LA) let,- 4A)' 6A) S 10S.PeCT i o,J Rr( N 0" J 1E7 S ITE . 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 O HOMESITE SEPTIC PLU?OBiNG CO. ADDRESS: CERTIFICATION NUMBER: PHOd NUMBER (c tional): VIS. MASTER ROSEF?7 PLUMBER LI NO.C. NO. 3307 M.P.R.S. Z ~d L 3 6 "/pS te'"TALLER & DESIGNER LIC. NO. 00663 CST SIGNATURE- DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - r . /~-3 ~ l 1) SN,rlt .r U)'O ~ Y 1 93 3 0 Y 3 rya ~ ~ • E 53 _ P 31 87 SE -I Tot of (1 P'Pc ~y €leukro;~ _ /00.0 I i APPROX. 600, S ~lo~.vED FfeLv I X = 1P' epc S i1--s HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., FK)DSON, WIS. 54016 I ROBERT ULBRIGHT CST's .7 /V2- AR I'h MAy y "VIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. INN. WSTALLER & DESIGNER LIC. NO.00663 I_ 1 y ,Soil -IZ~5771 3 I DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS x(115) P.O. B°" 7969 HUMAN RELATIONS MADISON, WI 53707 (ILHR 83.09(1) & Chapter 145)/, LOCATION: TOWNSHIP/MlJ t F 4Vt*1 : LOT NO.:BLK. NO.: SUBDIVISION NAME: NE % NE 1/ _24/T2<? N/R100 E(o COUNTY: OWNER S B YER'S NAME: MAILING ADDRESS: SV,~Cor TPE.JNrs egor-0! 6A3 oto x 20 1 LAPA-O&A. ~ , ;,v ,v. 5-5 D 5e3 USE DATES OBSERVATIONS MADE NO. DRMS.: COMM R IA ESCRIPTION: DESCRIPTIONS: PERCOLATION 3 I EST : Residence 3 4-- K New ❑Replace 114,4y 1 Z _ r q ~ C 1 AS PI>IA3fl 5cS 4 Sflaws ~La ~S RATING: S- Site suitable for system U= Site unsuitable for system ONVENTI NAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ElS ©U ®S ElU ' CIS ®U CIS ©U OS ©U A0,6U.Ajd-;. srS7e If Percolation Tests are NOT required DESIGN RATE: I If an any portion of the tested area is in the under s. ILHR 83.0915)(b), indicate: Cl~'S 5 Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS IN TW~Ci A- L BORING TOTAL DEPTH TO R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED ES HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1, 33 ' D1' 8,-5. cavP.Sc S 'T- S. ) 1.5 041-0w. B- 3,0 coone Is ae. Qa . w f~ f B- op`SY, kbtt B-~. •d l ~(~D, ~bi ~O (133, 3)v G. edjPre- S 1'S, 1.33 ' a,e -ba . S O 1, 3 3 ' OR. Is w e a T,J `tV;-f s. B_ W/ fff op--Sr. nofs B-3 0/!7Y' .33' 1r•&,, S T.S.) .67' A3 S ~ S 6/- O- SA). 1 I S d~ - Q a. uw~ f 5 w B- -F f+ e fZ - S~ ~os`S PERCOLATION TESTS EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 P RI D2 PERIOD 3 PER INCH P- +Z o2 2- P_ p. 2- (0 P- P- .0G ro 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. J 0qN J)/RO C. SYSTEM ELEVATION Sam PI-87 0-:E_Pve~! ` G. 9_1 A, l T tioTE A) 40.M '1--oR ~s tA1C6N 1:A s-1- 0 .;s 00-00e-D AD v"i v Sl rc f~l s0 it PPerT12 70_: _ ~4 co-4 p )rter TEST ho w Ev-E_ Lt,bv QD 1txv _7 _';710 'fitCaO_Df;D ~ > v l u td~ N ON- s I`T.F- Y! LiJ$ LT i o.-J Qrt 20u ► a)-ep7-. 'ol 4c t(_T&~ 7 S ATE 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 0 • HOMESITE SEPTIC PLU'dBING CO. 655 ADDRESS: CERTIFICATION NUMBER: PHO NUMB (o tional): ROBEFi ULBRIGHT 1 Yd 3jCD ~5 PLUMBER '.MS- MASTER I .3307 M.P.R.S. d WSTALLER 8 DESIGNER LIC. NO. 00663 CST SIGNATURE- DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR SBD-6395 (R. 10/83) - OVER - 1 r • ~ 30 yNX~i ~ pDD~~ ~ y ~ ~l " • 1 93 3 31 B3 Pef. 't'T. S TOP OF pi pc y ~'IEUkTr0%~ _ /00• d i i I - I i I i r q~PRoX . (o 0O ~ ~Io~EO FjeLD I X = Pepe s iTr'S HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., HUDSON, WIS. 54016 2'Yd ROBERT ULBRIGHT 05'7 I 'NIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. i aNM. 'STALLER & DESIGNER LIC. NO. 00663 I o MPy z t ~ h a SAC a 7-, N k1FL,) gj, l f fix''` ~ r Pa bd w a for ,1 r FIX x _ x S3 4m F ..i y ,,tee V14;h 7!5 0 trio' Se f room A" r ONS17E SEW 40 22 look PPROV A ~caousTaY, LAO"" ~ C pEPAaTME N ~ , ~ Gag to rC e Page - Of _ Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand H C' Topsoil F -Ji D a ~ Main Plowed 0i:PA rMEr T AY, AND RELATIONS Layer I Af B Gsc D I Ft. SEE CORRE Did DE E 1.2- Ft. Cross Section Of A Mound System Using A Bed For The Absorption Area F .~5 Ft. G l . o Ft. A_ Ft. H 1. 5 Ft. Signed: ~J B 97_ Ft. License Number: ~d 3p~t K _f Ft. Date: L _ Ft. j= Ft. Al erna of Position y ~ Ft. Z) g ~p 4~ Force Main W Ft. L_ Observation Pipe--~ `i g K A I.---------------------- W --------------~I M • Distribution Bed Of i - 2.1-, Pipe Aggregate i Observation Pipe Permanent Markers Plan View Of Mound Islig A Bed For Vitae Absorption Area - y k jj{r 1 }2 Ji ~ ' At. 1 ONSITE SEWAGE SYSTEM }9e_Of_ Wnai4 4 4 coytt APPROVED N RELATIONS F INDUSTRY, LABOR AND NT PAR NGS THE 0 DE S ON OF Perforated Pipe Doted SEE CORR PON 'NCE 0 End Vro• )P9rf0r0l@'*d Ent Zeo PVC Pipe OP Noge Located G : :m, W S Are Eauoay Sa • ~ I e` PVC Fate Man ~ From Pump .7 Q PVC Monlfoid Pope Alternate Peeth" Ooetrrbuthon Pope Forte Main From Leet Mole Should Be Nn1 To EM Cep a P3~ £M Cep ~ Distribution Pipe Layout P 400 23 R S! = X Y Signed: Hole Diameter Inch Lateral / Inch(es) License Number: > Manifold Inches Date: 3 Force Main " Inches • Holes/ P/ PE _ PAGE OP PUMP CHAMBER CROSS SECTION AND SPECIFICATIOUS VENT CAP C.Z. VENT PIPE WEATHER PROOF APPROVED LOCKING JuNCTION BOX MANHOLE COVER 2S• F ROM DOOR. !2•MW. SIDOW OR FRESH tR INTAKE I GRADE I n ~ COIJOUIT ---l'o P i 1AILE'~" ONSiTE SENIAGA91 T SEAL i I I NNIZ _ I !PROVED JOINT A I I I APPROVED vC.Z. PIPE 1 w/C.I. PIP: tT[NDIN4 3' _ I ALARM CXTENOtUG I I ONTO SOut 14TO SOG10 SOIL e AP V, 1, AW 1 1 0w (~J~ C DF-P'ARTME z LEx-llL~~fT. PUMP - ..SEE CDA orF 0 `91-4 0622 CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER NAS SUCH APPROVAL wppitc•~ ECpw SEPTIC E SPED FICATIOUS DOSE TANK MANUFACTURER: 1 NUMBER OF DOSES: PER D" TANK SIZE: 7so ~ GAL~.Ow s DOSE VOLUME I S70 t a l .05 INCLUDING SACKPLOW: 1~~•~~GAi_:._ #lkLAIkA MANUFACTURER: MODEL NUMBER: CAPACITIES: A. 19 WCHES OR iCAL_.._ SWITCH TYPE: y B s I INCHES OR s~~ GAL_: PUMP MANUFACTURER: 0 INCHES OR -'.1LZ`1 4AL__: MODEL NUMBER: '1 - INCHES OR 1:01_1 GALL. SWITCH T`JPE: NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE GPIr1 INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. .26 FEET ♦ MINIMUM NETWORK SUPPLY PRESSS'UKC 2.5 FEET ♦ _ FEET OF FORCE MAIN 'A _L~F/oor%FKICTION FACTOR.._33_ FEET TOTAL WdUAMIC HEAD FEET IUTERUAI. DIMEMSIOWG Of,TAIJK: LE ~T ..;WIDTH ;LIQUID, 01"TH _ 91GtED~ DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, C DIVISION LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 539069 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNS HIPf#tfidtetPA-MY: LOT NO.: BLK. NO.: SUBDIVISION NAME: N€ y ti~ ~ 7-6 /TZ~H/R d'E (a) ~~tiic~i,~••~,.' c f~P o ! o ~9~t s COUNTY: OWNER'S BUY E: MAILING ADDRESS: S~ GPI X -ie!c s ' 'S6 Y, 1a / /Aoe&i4,vD. ~vti • SYO f-3 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: ER O ATION TESTS: Residence 3 8e 9- /'/r Q New ❑Replace J~~ a/- 3 4 ?9 SC $ S~ S I-/ S ?~~11~- It t LD 1S RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECD S- ❑s ©u ❑s au os ©u os ©u as ❑u If Percolation Tests are NOT required DESIGN RATE: 1 If any portion of the tested area is in the under s. ILHR 83.09(5) (b), indicate: G L SS Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS ),v W4/M4e --r+ BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-/ ' /02 .7y r .,s- 4-sy. s SOB • ~,j-Sy s) 1,12' OR s to .e , w SM70 -f. oR- 'CV, hOtS / Z ' ~ E~1S~ 'f r,t~ A~~ D yENO tJ .S , B- r ftr p' fy cov a "SY e-v . 00 /"Of 'yj B- Z 3.3 /o/. L9,301 IS w/ f f-A, a hOfS .,?3F,'467 SoidZ S . B_ lis B- 3r. 134. cev K a B- 3 y0 00.3 2 _.fy . MOrf S J3 ~ OR . IS w fz,u Srt A II SST. /-(D t!; /.Q' t4'jD&1) S . 6- PERCOLATION TESTS 4a0l St- S S]•~if 5' TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. -PERIOD 1 PERIOD 2 PERIOD PER INCH P_ y /r0 2- P_ P-z 2 /D / •3 P- P- Z 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. SYSTEM ELEVATION I ~ i x h r ! 7E' S ~fo . t 3 ~ I ._.I E.„..,,.,_. ---t._._ ~~Z t l ' [ r ~ ' ~ L< f 3 -re-s sir, t z l 1 i_0 PI ; - o _ • I E E ~ 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: HOMESITE SEPTIC PLUMBING CO. eq ADDRESS: 656 E)'NE116 RD., 1410SON, W& 54016 Rp$EF?i ULBRIGHT CERTIFICATION NUMBERI: PHONE NUMBER (optional): NO. 3307 M.P.R.S. 2 ~ a 02- 1 _~d ~p` p Q `/a ON. WSTALLER & DESIGNER LIC. N0.00663 Cs I GAG DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, ~7 DIVISION 707 LABOR AND PERCOLATION TESTS (115) P.O. MADISON, WI BOX 537969 HUMAN RELATIONS \ / 3707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNSHIPI#ttidt@t *tTTY: LOT NO.: BLK. NO.: SUBDIVISION NAME: /4 ,vE-t 4 7-6 /TLFN/R 16'E (o) *,0e o l O 9ccC S COUNTY: OWNER'S BUYER'S NAME- MAILING ADDRESS: sf 601 X !uai S LQ±'G SDa 6 ?d X 26 //fif'tW}.JO i ~/~fJN 9YO ¢3 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRI PTION: IT~FIOFILE ON A N TESTS: Residence J?Al- ~ . New ❑Replace Z/_ I` ~e? u,~ 3 JG ?k RATING: S= Site suitable for system U= Site unsuitable for system SC5 CD S-~djS 4S +~++ir:~u 1S ~!V ONVENTIONAL: MOUND: IN-GROUND•PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) o s ©u o s au o s au ❑ s au a s ou ~o&~~ If Percolation Tests are NOT re uired DESIGN RATE: _ 4 If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: G G4 S'S Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS. ),v W414/_ BORING TOTAL PTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED ES I HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- .1 t'o 7 r 7' 0-fy. 10-Sy ~2 OrP. $ / S y /oZ,7y ~o" tz (e . sk~fn f. oR- I, Aelt B- $A Z 3 / o N - fy cov,Fyt . 6 _ a'Sy t~ . B- 3 lOl o3 2)_ B4 ,1y- /S w/ ff-)P. 02-1 hofs 43" Fi aAF- B- IAA)DEJ SoidZ S . 0 31 , Aee $ I K ' t-S 'J7 . , B- 3 YO' 100,31' ' ~ . A3 ' OAP . 1 S w fc-..u srl r (I B- . PERCOLATION TESTS i~ 4,Woe,.t t5' 57e,1114-S TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH /+p Z IS .Z s P- P_ P-2 2 /D ,3 P- P- Z d 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. w (•Ff Sit ~ D Z D SYSTEM ELEVATION ;..39-- I..~4) r ~c# t ; I._. _ DI,T_ T. S J1,9>E Oar I ~ I ~ I u - i S o ;J - SST; 1 s TES T' ~2€%47 I IPE TOP, OF[ _414040-0-, 30 -7. 7 CLI i G ~ S 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: Q HOMESITE SEPTIC PLUMBING CO. S _ ADDRESS: 16 ` ROBERT ULBRIGHT CERTIFICATION NUMBER: PHONE NUMBER (optional): N0.3307 M.P.R.S. 1 y 0 rIINN. JISTALLER & DESIGNER LIC. NO. 00663 CS IGNATU E. -lot DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHRSBD•6395 (R, 10/83) - OVER - 110 fd/ a~ FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SECTION T N-R W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE NORTH ARROW BENCHMARK:Elevation and description: Alternate benchmark SEPTIC TANK:Manufacturer: Liquid Cap. Rings used: Manhole cover elev: 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. No. of feet from: Well , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE J J 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 Number of Lines: Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: go. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from well: No. feet from building HOLDING TANK Manufacturer: Capacity: i 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: LICENSE NUMBER: 6/90:cj ST. CROIX COUNTY WISCONSIN w ZONING OFFICE z_ x ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Mar. 26, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Tom Florer property, located at the NE 1/4 of the NE 1/4 of Section 26, T28N-R18W, Town of Kinnickinnic, St. Croix County, revealed suitable soils at a depth of 2.8 feet below which seasonable high ground water was noted. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator cj