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HomeMy WebLinkAbout038-1157-40-000 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER t Q ' A C- TOWNSHIP SECTION_425~F_T N-RZ'j1 W ADDRESS T~ 71KA ~ ST. CROIX COUNTY, WISCONSIN SUBDIVISION -~ifir~o LOT--Z~60T SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM -1~4'c1 ~U T sr i 60 I 16= 3 ~LJ 0 ~o l INDICATE NORTH ARROW A L ` BENCHMARK: Elevation and description: Alternate benchmark SEPTIC TANK: Manuf acturer : G~c c /1-5 Liquid Cap. G~-z Rings used: v Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: 7, No. of feet from nearest road:Front_,A, Side , Rear Ft./S~ From nearest prop. line:Front , Side, Rear Ft. ©r , Building: :~Zo / No. of feet from: Well (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: Width: 445-IL e-1 - f" Exist. Grade Elev._Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side , Rear'Ft. 65- No. feet from well: No. feet from building Ile 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• LICENSE NUMBER: 6/90:cj 1715PARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: NE4, NW 4, Sec . 2 2 , T31- R18 NVENTIONAL ❑ ALTERATIVE (If assigned) Town of Star Prair L In- Rd- tl Holding Tank ❑ In-Ground Pressure ❑ Mound d NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Bernard Rivard 78th . 2 S WI 7 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. P r ST F. PT. El~ V `.3 ewW C.gY'r?ems- 0 .O Name of Plumber: MP/MPRSW N County: Sanitary Permit Number: St. C11.0-i-XI 149023 SEPTIC TANK/HOLDING TAN ' )y6 1w a .,er= , ?_3-'r&,972 / MANUFACTURER: LIQUID CAPACITY: TANK INLE ANK OU WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: C . ~U -•e"~ • 9D.~P(o 7 7 7o. -;?T ~ S ❑ NO YES BEDDING: VEfE'F DIA. YEKrMATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TQ RESH 7 / r AIR IjJLE • . e RM: FEET FROM LINE: ❑ YES ❑ YES NEAREST / DOSING CHAMBER: MANUFACTURE MODEL: PUMPPROVIDED: PROVD: ❑ YES ❑ NO PYES ❑ NO ❑ YES' ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY ENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: PUMP ON AND OFF ❑ YES ❑ NO NEAREST TH: DIAMETER: MATERIAL AND MARKING LENG SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing =FORCE or excavation. (If soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue CONVENTIONAL SYSTE. Z. 65-' F = 98491 WIDTH: C&dfflrM-. ~ NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH e t TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS /10 3 F--" GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE ^MAT RIAL: STR. 5AREST MBER OF PROPERTY WELL, BUILDING: VENT TO FRESH BELOW PIPES:ABOVE COVER: ELEV. INLET: ELEV. END: iiA rPI ES: ET FROM LINE,.~t~ AIR INLET: - T aZ vrV' ' 3 ~S MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: N0. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST I ICI I I Retain in county file for audit. Sketch System on i~ Reverse Side. SIGNAT RE: TITLE: SBD-6710 (R. 06/88) oci~ DfLHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY / Ea V -o /.,K 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. Check If revs to c pr us application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY PROPERTY LOCATION NER r U~ 111k1'/a,S T N,R E(o PROPERTY OWNER'S AILING DRE LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR SM NUMBE r/ 0 P G 4,~k 4 4fy Z& II. TYPE OF BUILDING: (Check one) CITY NEAREST OAD ❑ State Owned VILLAGE 4OWN OF: Ax I M R() ~ ❑ Public W,1 or 2 Fam. Dwelling-# of bedrooms A 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 30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 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. 1Z 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 ❑ SpecifyType 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 12.ABSORP.AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE 145-o REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION Feet Feet 1-11111-7-4 VII. TANK CAPACITY y Site in allons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New Existing Gallons Tanks Concrete structed glass App. Septic Tank or Holdin Tank Tanks Tanks G F1 1:1 1 1-1 Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsits sewage system shown on the attached plans. Plumber's Name (Print): Plumber's ignature: (No Stamps) MP/MPRSW No.: Business Phone Number: IPTumber's Address (Street, City, State, Zip Code): - Gc~ S 6 a IX. COU /DEPARTMEN USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater [Date ssue Issuin Agent Signature (No m ) Approved ❑ Owner Given Initial urcharge 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 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 cn system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in frame, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 3% 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 usec for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) I APPLICATION FOR SANITARY PERHIT • 9TC-100 This application form Is to be conplntad In full and tlgned by the owner(s) of the property being developed. luny Inadoquacles will only result In delays of the pztmit issuance. -Should thl6 development be Intended for resalt by ovner/contractot,(spoc house), then a second form should be tstalntd and completed when the property is sold and submitted to this office with the ■pptopclate deed recording. Omtr of property n r~ R*/ N bT Location of property _114 1/1, Sectlon ~a T 31N 11-R-LI-V Township _ StNr 1'r/9rlio KallIng address o?7`~f y17(ah wl 5- Address of site _ o90 7~ 57`. 57`i$r subdivision nas►a_ '>/'Vn ~r1 i1a///an L o t number 0-c Lzc 1 8P{ Pttvlous owner of property /7`5 oh Total size of parcel Date parcel was created Art all cotnsts and lot lines Identifiable? _LLY1111 _ No Is this ptopetty being developed for resale (spec house)? yes Y01nx4 `W$~ and Page Humber 3 as recorded with the neglstet of Dteda. INCLUD9 W1711 TH19 APPLICATION THE FOLLOWIM A VkAt1ANTr DRID vhich Includes a DOCUHSHT HUNBIR, VOLUXI AND PAOt NLrXltR, and the GILL of 711E 119(1I8TBR OF DRKD9. In addition, a certified survey, it available, would be helptul so as to avoid delays of the reviewing ptoctes. it the deed description teterences to a Ceztlfltd Survey Hap, the Csttifled turvey Hap shall also be requited. PROPERTY OWNER CHRTIFICATIOH live) certify that all statements on this form are true to the best of my (out) knowledgei that I (we) em (ate) the owner(s) of the property described In this Intotmation form, by virtue of it warrant deed ecorded In the office of the County Rtglster of Deeds ae Document Na, M&IW`.5~ i and that I (Vol pttsently own the proposed site for rho sewage disposal (or 1 (we) have sYsttn obtained an easement, to run with t)te above described property, tar the conettuction of sold system, and the same ham been duly recorded In the office of the County Regieter of beads, as Document No. signature of owner Illgnature of Co-owner (11 Applicable) - `f/- Jr A/ Date of Signature Data of Signature A..~.__ - - I' DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA i 462254 I STATE BAR OF WISCONSIN FORM 2-1982 REGISTER'S OFFICE I~ ST. CROIX CO., WI LeRoy, L. Knutson and Mary T. Knutson, husband Recd for Record i; and wife SEP 121990 of 8:30 A. M conveys and warrants to ...aE:>;naX.d P &..~R i vdx:d I a•vlm.o~ deeds ~i • RETURN TO ~j I~ the following described real estate in .......St. Croix County, State of Wisconsin: Tax Parcel No: i Lot "14" of the Plat of Northwood in the Town of Star Prairie. i This s__nQt; homestead property. I (is) (is not) Exception to warranties: ~ I I Dated this 10th day of Janua .fir...................................... . 19.9.0.... II I ' --------•-----------------------------------------------------------(SEAL) . ...(SEAL) LeROx Knutson I v~ . (SEAL) ---------------------------------------------------------------------(SEAL) '1.ahA • AUTHENTICATION ACKNOWLEDGMENT Ij Signature(s) STATE OF WISCONSIN St. Croix as. County. authenticated this day of 19 Personally came before me this 10-0 l._-day of J_anuamy 19...80. the above named nu.tsran--and--Mast'.. T.,--------- ' {Yl).i TITLE: MEMBER STATE BAR OF WISCONSIN (If not- authorized by 1 706.06, Wis. State.) to me known to be the person ;-S who executed the forego' instrument yaa" lfdge the same. THIS INSTRUMENT WAS DRAFTED BY 'Reinstra Van D k & Needham, S.C. :Tc?h . 201 South Knowles A :Ruth A. e, Box 127 .......................J....... ri New RichnlQnd_,.-.~T 5H17 Notary Public .::.!€t Croi 0 County, Wis. - ~y (Signatures may be authenticated or acknowledged. Both My Commission iq,pArti~nei nl➢t, state expiration are not necessary.) date: 1242 119 ) I •Na-es of persons signing in any capacity should be typed or printed below their Signatures. FUCITI~~ STATE FORK No. 2 WISCONSIN 82 BIN Stock No. 13002 cr ' SEPTIC TANK MAINTENANCE AGREVIENT ~ St. Croix County 0 014NER/BUYER w Fire Number , V ROUTE/BOX NUMBER-.--., 0 CITY/STATE ZIP 5Y PROPERTY LOCATION:' Section P a T_31 N, R_L? W. Town of S/,j~r PIYr St. Croix County, ,~~ac arm(. Lot number Subdivision ould result in se and maintenance of your septic system c Improper u its premature failure to handle wastes.- Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licens'ed' 's'e t'ic tank um er. What you put into of pumper. the-septic tank as a treat- the system can a ect the .un ment-stage ct on in the waste disposal system. St. Croix County residents•mma be eligible to recieve a grant for a maximum of 604 of the cost.of replacement of a failing system, whi_c was in operation prior to-July 1, 1978. St. Croix Countt this program in August of 1980, with t requirement accepted hat o e P owners of all new 's s't'ems agree to keep their system r p y maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or..a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating if nec- essary), (2).after inspection and pumping .he sP1 condition c.•tank is less than 1/3 full of sludge and scum. e Certification form will be sent approximately 30 days prior to three year'expiration. y 0 I/WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- ment of Natural Resources. Certification form must be completed b and returned to the St. Croix County Zoning Office within 30 days of the three year expiration.date. SIGNED 3~ DATE y_ __5__ ~7/ St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386-4680 Sign, date and return to the above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & B . IN~U,STI~~'; DIVISION P.O. BOX 796 H HUMAN R AND ELATIONS PERCOLATION TESTS (115) MADISON WI 53707 HUMA I LHR 83.0911) & Chapter 145) LOCATION: SECTION:? p~ TOWNSHIP 1UNICIPA/LLIITY: r OT NO.:BLK. NO.: SUBDIVISION NAME: UNTY: MAILING ADDRESS: d CZ r- 012 4 CZ 22~ !~O ' d If p 1l I~ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: TS: ,Residence New ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILLHOLDINGTANK:RECOMMENDED SYSTEM: (optional) (e~S ❑US ❑U S ❑U ❑ Stl ❑ S ZU 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: G/C,, -5Floodplain, indicate Floodplain elevation: . PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED ES HIGHEST- TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 7,2 44 - yy n - s -2- a-~ $ a oz Tat B- B- PERCOLATION TESTS 101- N TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES NUMBER I MAIM AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD PERIOD PER INCH P- 4~ G P- G 12 P- L 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. SYSTEM ELEVATION. 'rS .,,!I-r E. 3 AJE E 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: -:6- a _ ADDRESS: CERTIFICATION NUMBER: P ONE NUMBER (optional): 7 _ 6 CST SI N UR DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - h INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number: 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate meds - Medium Sand W - Well fs - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'sl - Loamy Sand - Less Than '1 - Loam Bn - Brown 'sil - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water Six general soil textures BM - Bench Mark for liquid waste disposal VRP - Vertical Reference Point 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. PLOT PLAN ' P,.90 ECT 4 ei-!4,,V X)Y' ae ADDRESS ~li o ll~f 1/4/S;L;?-/T~l' N/R `$'W TOWN COUNT - Co MPRS Byron Bird Jr. 3318 DATE BEDROOM CLASS PERC_/_ CONVENTIONALKW-GRO PRESSURE CONVENTIONAL LIFT_ MOUND_ HOLDING TANK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA PERC RATE--,-BED SIZE 16 Benchmark V.R.P. Assume Elevation 100' Location of Benchmark * H.R.P. O Borehole Well Scale = Feet O Perc Hole System Elevation Uent 12" Grade TYPAR COVERING 2' 12" 3' 4 6' 4O 3' I 6 w Sewer Rock i 1.2' ti r `V 6 6 - ` 'if