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HomeMy WebLinkAbout030-2070-20-300 'o 0 4 0 0 M ~ "1 110 W 0 Z III ~ I I N ti O H O l~ N ~ O L ~ U ^O m N O U •C L 0 - ~ I N f0 ) w L_ m 2; o n Z a) C tr- LL r 3 N Q -O 0 ~ M 3 v I a~ o W Z y N Z « O e- M H Z I O Z :1 c Q' r N O ~ O a ~ I d c Z N F r ~ a) I c 4 CD I 41 (D M a j (D O U) C a to 1~ N O O O •N d L L_ m co N N O N Q Z I- Z 0 Z o a E a o CL - w ~ o 9 0 d t 0 0 o a ~ F FN- IN- a z v LO a ~ • 4i 3 a a a N J V 2 rn M > - LO C) CO 0 _ °o 0 _1 i cA O CO o E N N I L O e- 'O N d N O) C m N d CN a) O ~ ~ Q ~ (n f0 ~j O C V! C O M O C C O 0 0 0) 0) N H y a s U a O) O O U 6 d ~O n l l w N E E m a~i N N Q O C C n 0 C14 0) O O C tf) N c L 2 O O Ncl) C N FBI M M f6 ad+ 7~~ C N Y • O ' Cl) M in O o Z N n 2 (n y r v~ d •R @ a I it a a `1~i a ~ •c c c tw II _1 A V a ~II O N 0 dr~ 16 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP ST J O 57 SECTION 3~P T 3y N-R W ADDRESS 00"a. 60/ /257 ST. CROIX COUNTY, WISCONSIN So ST ~ , %?1Zx . SSa S SUBDIVISION ? LOT /LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i S~ ef~ e ~Q a' INDICATE NORTH ARROW " st-ee2 /Z~ ~ wt ua.y S~ BENCHMARK:Elevation and description: C.5-1 7'. Alternate benchmark Gl,`~ S CO AJ, Liquid Cap. /~D acturer. SEPTIC TANK.Manuf , Rings used: D Manhole cover elev:B=Final grade elev: ~?S'~ S ~3► 3 2 , Tank inlet elev.: M56 Tank outlet--e v.. > Soo' No. of feet from nearest road Front , de , Rear Ft. 4/0, r From nearest prop. line:Front , e 2,53, Rear Ft. y / .vo7- 1,0STit//&Q TU 0,47,, No. of feet from: Well , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE / 2 bs f y2 f- f , `rfT' 5-0 PUMP CHAMBER G D 0 D Gv~t'~'S O Manufacturer: Liquid Capacity: 20 /1,&- Pump 1 Pump/Siphon M nuf a act.• Pump Size Model: Elevation of inlet: 9.2 'z2 01 Bottom of tank elevation 7 ~ y 2 b Pump on elev.:90 ~ Pump off elev.: ~0'0Gallons/cycle: 1~a Alarm: Man.: kyA ~(M rr,~vRv Switch Type: r Zo,fT Location Distance from nearest prop. line: (Front ,s Side_, Rear-Ft. Distance from: Well `Building 33 Y,E-T Ta DST C_ SOIL ABSORPTION SYSTEM 2 Q~py~ /~p X Trench: X S Sr i Width: Length S Number of Lines: 2 Area Built ' ~1 3 Exist. Grade Elev. gg'~ Proposed Final Grade Elev. Fill depth to top of pipe: 410, No. feet from nearest prop. line:Front , Side, R No, feet from well:/00 No. feet from building ~0 HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevat of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Rear Ft. No. feet from: Well , ng , nearest roa Alarm Manufactur INSPECTOR: od. DATE: PLUMBER ON JOB: LICENSE NUMBER : 3 3 0? 6/90:cj U ~ w ~ o U o O, m m ~ Z C C -----i I 1 1 \ ` CA -0 LYN Ile 1 Io c Z ~ ~ ~ 1 1 ~ 1 ~`nt Zru= n ~ ~ 1 1 1 1 C ~ I I 1 ~ O ~ ~ ~ SG Cr ~ V t tV ~ fr ~SI Z7 v~ C~ Z O 70 rn ~ R 9 p N~ n ZI O cn s Q~l- ml w ~ N` n t~ o. O 0 4 rp 0 rt, Wish in Department of Industry, PRIVATE SEWAGE SYSTEM county: foLa6(=d Human Relations INSPECTION REPORT St. Croix ' Safety anG Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 149154 Permit Holder's Name: City Village Town o : State Plan ID No.: CST BM Elev.: Insp. BM Elev.: ` BM Description Parcel Tax No.: lJI) /Gb,G eLl 1030-2070-20-000 TANK INFORMATION ELEVATION DATA /O TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S C 6 ~ Benchmark G(J Dosing Aeration Bldg. Sewer / Holding St/ Inlet /,SS TANK SETBACK INFORMATION St/ W Outlet ' 9Ja,as' TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom ~3, 4' ~.4 Dosing NA Header. 4,8 5,0/2 -37 7/ Aeration NA Dist. Pipe Holding Bot. System 3 PUMP / INFORMATION Final Grade Manufacturer lice- LDemand r , - 6, f 0, Model Number p` 1.7 M :5,7- -u 7.q, 9(Q~ ' friction System TDHFt TDH Lift H 99 oss AA Forcemain I Length Dia. Q " Dist. To Well SOIL ABSORPTION SYSTEM RED/TRENCH Width ( Length / No. Of renches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S l a DI SYSTE T P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER Mo a Nu INFORMATION Type Of c" t'. System: 'trejZC. Zvna 5/Cz C OR UNIT DISTRIBUTION SYSTEM Header /-MaTrTfs4d i~ Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length !Z Dia. Length ~ Dia. Spacing /l SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only i. Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched No Bed/ Trench Center - ~b Bed /Trench EdgesD Topsoil E] Yes ❑ No ❑ Yes E] COMMENTS: (Include code discreppncies, ersons present, etc.) L A Lt 7'` I, G .~~c ~ ~ {9- ~ l / C.7~-_•k (%7 ~ V ~L. (L'a. C~e,, f6 n C. (j i' r f / Plan revision required? ❑ Yes p Use other side for additional information. SBD-6710 (R 05191) Date Inspector's Signature Cert. No. •~DILHR SANITARY PERMIT APPLICATION couN A906006 In accord with ILHR 83.05, Wis. Adm Code 57", C /t°Oj STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 8% x 11 inches in size. /hwYkf r ision to pr ious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. A/ 'of - PROPERTY OWNER PROPERTY LOCATION E,P Q/ hA.vZ_' /Uw WE- Y., s 34 T300, N, R 2 d E (o W PROP TY OWNER'S MAILING ADDRESS LOT # BLOCK # 30'10 uO,,44N Gult-l / dSej CITY, STATE ZIP CODE PHONE NUMBER 12 SUBDIVISION NAME OR CSM NUMBER A.pMk G~2oU~ /f • 55a7S S/ ~7y~ 11. TYPE OF BUILDING: Check one) CITY ~1 NEARESTy~AD ( State owned 3 ❑ VILLAGE : f4. 7ose7 21 -r `'t S T ❑ Public K) 1 or 2 Fam. Dwelling- # of bedrooms - AR ELT NUMBS ( ) III. BUILDING USE: (If building type is public, check all that apply) O 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. X New 2. ❑ 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 Q Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure t 43 ❑ Vault Privy 14 ❑ System-In-Fill ~~~iii Z 7-,eg.V C4v_v 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 r REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) LEVATION y5 3-'f .`9~ . 76 . `7 93. Feet FA' 4 Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New Existing Gallons Tanks Concrete structed glass App. Tanks Tanks (,V 51 Septic Tank or Holdin Tank M06 CO M F] 1 11 Lift Pump Tank/Si hon Chamber 00 1 VIII. 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: Ta4 T Zl`ib/c~ic~T~ ~-i 33~ 71S Plumber's Address (Street, City, State, Zip Code): &SS D IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa 'taryPermit Fee (Includes Groundwater Date Issued Issuing gent Signatu o Stamps Approved ❑ Owner Given Initial S 0 a' 9 p Adverse D termInation Surcharge Fee) 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 r 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. -------------7-------------------------------------------------- Owner of property -*-~-clw ,,9 213 P. 0' K"-\ N Location of property] 1/4 pJg114, Section , T 3 N-R_Q~ W Township ~r7 ~yeSe~D~ Mailing address 311 G C- fc en aC-A w H ~L Ny~ (Z f ro u,z S Mt\f, S075 Address of site o~T~A -54 . :5 Ja2SQro~ Subdivision name Lot no. Other homes on property? yes K No Previous owner of property p OJ .)C qnJ F40,je,rr-i Total size of parcel , 39y / -c.e--s Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes P"-No Volume& 68and Page Number 5 4 9 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 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. 8 and that I (we) presently own the proposed site or 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. c`? R 7 ' `Signature of app ~icant Co-applicant Date of Signature Date of Signature SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ADDRESS:- 3v v 7'"' S~- FIRE NO: /3 0co LOCATION: ~C~ 1/4, SEC. _T30 _N-RW, TOWN OF: 5T, ~o~s~oh ST. CROIX COUNTY SUBDIVISION: LOT NO. 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 c,~ DATE : e - v? St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 DEP c.RT MENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INQl,.,.?~Y, DIVISION , H M N AND 7969 LATIONS PERCOLATION TESTS (115) P.O. BOX 3707 (H03.09(l) & Chapter 1145.045) MADISON, WI 53707 _ qSI- t .C 'flufT SECTIO-177 TOWNSHIP/MUNICIPA,IT"; OT NO.: BLK. NO.: SUBDIVISION AME: a !4N 4 4 '/T-7aN/R20M,>r s'¢ ✓b. e. ,4 COUNTY: W NAME...: MA L A(? i~ SS t~ USE _ DATES OBSERVATIONS ADE rrrttt~~~ .B DRMS,: CO M D RIPT 0 ISROFI 1-9 DE N TESTS: ~Residence~ NIA New D Replace 7~ RATING: S- Si te suitable for system IU- Site unsuitable for system O Lt J S Tt_!U MCJ S -LJU N-Gn J QFUR~~S ST~EM-1 L H~ IN TANK: RECOMMENDED SYSTEM: (optional) If Perc.,l rtion Tests are NOT requirgd DESIGN -RATE: ~ If any portion of the tested area is in the I / lunder s.H63.09(5)(b), indicate: 7~ ' r-loodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING1 TOTAL ♦ f'TH TO C;R - WATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH , NUMBER DEPT}lNlt ELEVATION OBSERVEr r. HIGHEST TO BEDROCK IF OBSERVE (SEE ABBRV.ON BA K.) B / r ! 2 ) J• l~a~ 8 . 5lf! 0 , . 33 6h tk-f r O G'rr S v i 3 ~ ' f r , e x ~s' 9 v > x. s ~ B•,J, 3. 3 ~e-r,• o Sts l r PERCOLATION TESTS Dt.PTHI 'WATER IN hOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES IFJ.Flll I(\ SiE AFTERS EL LING INTERVAL•IVIIN. P R 100 RI D 2 3 PER INCH r--r 9/- Y4 PLGT r o,.,, rn,..,t;,_,n4 of perwo.,cion tests, soil borings and tho iimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori ~mc.l nri Vei:ncaj alevatiplt Reference Ta ints and show their location or, the plot plan. Show the surface elevation at all borings and the direction and percent YSTFM ~ELEI/ TQON 93r9Z' _ ~ t t I L ~ ~ 1 I ' ~ a _ I fly f ~ ~ ,..r.---- - _ i ► ; _ /o±~ ~,,,~,e.. . 44 I f ' I I { T 10, -f- , 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 Wiscons,) Jministrative Code, and that the data recorded and the location of the tests are correct to. the best of my knowledge and belief, AbtE (print : TESTS W R OMPLETED ON: uDRES - •WL . ~ CERT FI TION NUMBER: PHONE NUMBER(option;at):l -44 * 5r w/s, k CJ.` -S o 0' 7 t i G 3 CST SIGN R . V YRIBUTiOt1i: Original and one copy to Local Authority, Property Owner and Soil Tester. t ! 4,,•11130 6395 (R. 02/82) - OVER - 0C g ci 2 Z ~ W W ~ e23 ~r o caU3& 41. - LO h 4c g t x cA O IZS Lr) N o W O i U 1 I~ ~ I I ! ! Q .1 ,i II'. l i I •rw • r Fresh Air Inlets And Observation Pipe Approved vent cap Minimum 12° Above Final Grade ,tJ~, ff~f~ 4" Cast Iron j Above Pipe Vent 'Plpe -To Final Grade Synthetic Covering F(EV I r'4.~ OF Min. 2° Aggregate Over Pipe. DistributioL Tee Pipe 0 0 0 0 0 +o nR°~ QoX 61 Aggregate o Perforoted Pipe Below q Beneath Pipe 1, Q o Coupling Terminating At Bottom Of System ysTz,Aj 9 3• ~D HOMESITE,SEPTIC PLUMBING CO. 655 O'NEIL RD., HUDSON, WIS. 54016 ROBERT ULBRIGHT r1S. MASTER PLUMBER LIC. NO. 3307 M.P.R$• MSTALLER & DESIGNER LIC. NO. 000 J 2. JS i_ t Z, k PUMP CHAMBER CROSS SECTION ARID SPECIFICATIONS VENT CAP 4"C.I. VENT PIP APPROVED LACKING WEATHER PROOF JUNCTION BOX MANHOLE COVER ?_5' FROM DOOR, 12"MIN. w/ wA&AA) A/~E~ WINDOW OR FR$:SH I AIR INTAKE I !legpe `--1cl,41_10AJ 92 ' O GRADE I '4° MIN. Ait ~ 18" fy11N. PROVIDE I 'i i WLET AIRTIGHT SEAL I III 1` J/ _T UE I III APPROVED JOIN'( A APPROVED JOINTS INh~~CI~ I I i W~C I. PIPE lJ C•I. PIPE f I I I EXTENn.NG EXTENDING 3 ~O ALARM ONTO SOLID SOIL OIJTO $OLID $01 B I O~~ g5.31 ? i i I. I ow c ELEy. FT PUMP-~ OFF f D '1 AN BLOCK rj•0 RISER EXIT PERMITTED ODL.U IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E 5PEC.IFI'CAT10KIS DOSE TANKS MA4UFACTURER: l~~E~S C'O.u.G,PETE IJUMBER OF DOSES: 3 PER DA`d TANK SIZE : GALLOMS DOSE VOLUME 13'0 LEU~L 44eM INCLUDIWG BACKFLOW: GAI•LONS ALARM M444FACTUKER: MgQF.L NUMBER: Ly • CAPACITIES: A= 3 INCHES OR SZZ GALLONS S%~ITGH TYPE: ICE 2 C O R Y F IO A'r g = r,~ INCHES OR 3 el GALLONS PUMP MANUFACTURER: C= d'p7 ILICHESOR 1560 GALLONS MQQEL NUMBER: 'p D= ! a INCHES OR 32 a GALLONS SWITCH TYPEr~ ~ :f14jlIRA' 0-I-ReoRY Flo A17.5 MOTE: PUMPAMDALARMARE TO BE MINIMUM DISCHARGE RATE G= GPM INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. Z FEET "ri1A'k SiECS + MINIMW' tj NETWORK SUPPLY PRESSURE . . . . . . . . . . . '21~ FEET tcAC (n. 0 ✓ P + -5© FEET OF FORCE MAIN X Z'D S FYonFRICTION FACTOR.. _ * FEET t-40A) 5 Z -7 Afs. TOTAL DyDAMIG HEAD = FEET o u 'v'9 7-7 INTERNAL QIMEWSIONS OF TANK: LENGTH ;WIDTH -;LIQUID DEPTH n SIGNED: LICEAISE DUMBER: DATE: HOMESITE SEPTIC PLUMBING CO. ' 655 O'NEIL RD., HUDSON, WIS. 54016 IGHT ROBERT ULBR tiS. MASTER PLUMBER LIC. NO. 3307 O R & . OM . IJO LlC INSTALLER & DESIGNER " 3 of 4- r a I W HEAD 115 34 ~ 110 32 toy - CURVE 36196 - 95 28 90 1~ 26 EFFLUENT 24 MODEL and Q 75 MODEL 189 DEWATERING = 22 70 165 V 2G 65 a z 16 G 5s J 16 ODEL O 163 MODEL F 14 45 188 12 --40-- 35- 10 MODEL 30 137, 138 MODEL SEWAGE and 6 05 25 i DE TERING 6 20 MODEL 15 MODEL 161 4 7 W lo- MODEL ~11 2 5 53, 55, 0 57, SR GALLONS 10 20 30 40, 50 60 70 80 80 100 110 LITERS 0 80 160 240 320 400 75 ?2 FLOW PER MINUTE 70 20 G is--00- MODEL 295 LU f5 Z Is - 110 Q ~4 MODEL } 294 p. 12- J MODEL - F 1p r' 293 z~- O 20 MODEL - r` 284 - MODEL B r~0 282 q 15 10 MODEL 207, , 268 u ' 3280 Old Mlllem Lane GALI.ONf 19 20 30 40 50 60 1 70 80 9o 100 110 120 130 140 i5o 160 170 180 180 P.O. BOX 16347 Louisville; Kentucky 40216 ' LITFRS 0 00 160 240 320 400 480 560 640 720 (502) 778-2731 FLOW PER MINUTE .,,.M,,.!rb r Y~~..,~..r....„.,r...-..--.'wr.,.r.~.+u.r...wr.+.rr.......--~....-~.«-•-----.~~....-•-..-...-.... .~.-T.. / "97" Cast lion Seder CAPACITY HEAD UNITS/MIN • Automatic or Non-Automatic. Feet Meters Gal. Lirs. 5 1.52 57 216 _ is '/a H.P., 1 Ph., 115V or 230V. is Non-clogging vortex impeller design. 15 4.57 43 163 lik 10 3.05 51 193 ~j Passes-'it!-sphere). 20 6.10 27 104 • 1'/2" NPT discharge. Lock vale: 24.5' * F[oat operated submersible (Nema 6) mech- anical switch. 97 series • Automatic reset thermal overload protection. U( listed SC-2225 • Stainless steel screws, guard, handle and arm and seal assembly. • Watertight neoprene "O" ring between motor and pump housing. Assoc! rds Approval avaitabie N97, non-automatic, available packaged with a piggyback mercury float switch. r ° I b ~ G I ~ I 11, _ C • to i I i , a I W O' At- O 11~ ~ o L t I ~ d a y"~ C n o ' o I ~ ~ ~ p L N V ct\ ~ y .V p tF ha . z y _ s ! aion MAY 1 4 2004 -7 2 1 6 f+ 1 VOL 77 PAGE 4519 S.. CROIX COWM XATALM H. WALSH- Q1 r P REGISTER OF DEEDS CROIX CO., WI RECEIVED FOR RECORD 0o . o o UNPLATTED LANDS 05 15/2003 12:00PM h s Found North Quarter Corner m 1 Sec. 36-30-20 CERTIFIED SURVEY MAP o v RE FEE: 13.00 r- o 0 0 O (Aluminum Monument) o CO N m =0 ° (N00'03'1 3"E 499.57') W~ f STREET N00'29'49"E 499.63' 299.60' 200.03 w • < _ ~y < X500' 39'49" rn N O < p ® 1 -N3 N< c.il. w~ a 2 ,0 CO I O ®vw w w N O i I r y~I~~,. \<Q~ \~f IM \ ~W D „ Oaf s ~N! r- ~yt cN~~ ~C7 w z 0 00 I0 rCi O C O M„65,95.ZON \W'I I CA :GZ m • y i; _ C; 0 w ego* 4:t 0 00, rr, I p - 01~ O I ~~~1~~~ C (D 7- o IZ U1 p C ~0?f W I I~ C ~4 Is - 3 N I D - ^ N ~-4 Z OD W o" `v rn to tD a ° v v+rt0 IC7 ~ ~ W ~ 01 o `D Sol 051'27"W o 460.87' ^z a' 1> (SO1'25'47"W 460.87') 00 3 Z f 0 N ..p 1 1 O 3 OD 0 C ?1 :U O I C~ 00 N u a c0 O < I <O MOD (n000 - N 0 M -4 N3 UNPLATTED LANDS - w °o oz 3 a" 0 O I rv►- ~ ~ ~O~ ~ 0 o vi 0, M 0 m r, =r O 0L"3 o IN~1 _ ICD o O Co.. m c~-D ^ -1 co 0) ~ 0 c° ® O • 0 v N N J C-) 0 CD 1. N p I W N O CA v fi I i I C0 CA CD `t O A (ND O N tD - p~ I I I I. v co o n? ~°j N 0 / fD A OZ O~ 0 7 - tQ CJ1 \.\N \ / / / n O 0 fi ,o o m- cD N fD V1 b) 4:% rr, Z4 x o ^ co O M n~ W I `q- a s CD . 7 0 O Q rt Ill l ~t+V M to to a V- ::r TM f \ X 11 n A '>7 '1 C 0 /lJ o NP, ~I I o.° cc l<D O X • ...q.. • N~NN-~+ O OO Ga D 0~ CD (n vN(011W O o WQ.N-r I i 1 to w I (D < Ni co z 0 ~G p C tb m oo y m A c °9b °o. 3 ``qD o (D u' o to - (DD C (n C-4 0 M n N Q C(A (b v0) Ln (r C 0 =r m o no 3 p~ I I C aTNp rn ? 3 a O z o X't'o o l Cl) 0 O 14 ul CON VN r'-r M 9 0 -1 '=1rox-~ z 3 .1 I I Q) ? -~~A II N I N 0 OCn > b., 0 1MM CD v' N O O fD 3 ~~C N O fD m c° Q = O Vol. 17 Page 4519 ENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION PERCOLATION TESTS (115) MADISOP.O. BOX 76 N W153707 (1) & Chapter 145.045) (H63.09 TION: SECTION: TOWNSHIP/MUNICIPALITY: OT NO.: BILK. NO.: SUBDIVISION NAME: P 1/JV 4 3 t /T3o N/R20Ih s• ✓o COUNTY: OWNER'S BUYER'S NAME: MAILIN ADDRESS: _ USE DATES OBSERVATIONS WADE BEDRMS.: COMMER AL DESCRIPTION: PROFI D IPTIQNS: L O TESTS: -3 12 lL~lResidence New ❑Replace V G+~ gx IV F RATING: S= Site suitable for system U= Site unsuitable for system roi-lulmsoul ENTIONA L: MEND:IN-GROUND URE: SYIEIS TEM-ILHO~LDINK: RECOMMENDEDSYSTEM:(optional) lvlu SS k24UkS i U [2U 1 S 550 COA~(~GAH-/e7All~~ If Percolation Tests are NOT required DESIGNfATE: L 7 If any portion of the tested area is in the ;t I under s.H63.09(5)(b), indicate: 5 Floodplain, indicate Floodplain elevation: VA I PROFILE DESCRIPTIONS BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH, MW ELEVATION OBSERVED ST. HIGHEST- TO BEDROCK IF OBSERVED (SEE ABBRV. ON BA K.) ! x.33 ° 8~ 4 1 A." s • 75 h 5 , 7, ev s B- fps 91.0 S S. ~s 5,,8+/ J33 „s 191 B- 45~ ll. o pS, s s > 0' B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER I AFTERS ELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERI PER INCH i 7 R P--P 19 1/. D 141,4 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. SYSTEM ELEVATION 93, 9z ° z 1 /0 6f /IWO E 4 e i tN 004 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 W R OMPLETED ON: t jao at q ADDRES : CERT FI TION NUMBER: PHONE NUMBER (optional): S¢ ce k Jai 4~St ti. 1„1. S d 0 7 314 41'3/ CST IGNAT R DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER -