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A IOC k53 X
DEPJ%-RTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING
LABOR & HUMAN RELATIONS DIVISION
P.O. BOX 75143 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION
MADISON, WI 53707 State Plan I.D. Number:
NE 4 , NW 4 , Sec .10 , T28-R16 1( CONVENTIONAL ❑ ALTERATIVE (If assigned)
Town of Eau Galle ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound
o=r Go 1'
F fit-M4T HOLDER: FADDRIESS OF PERMIT HOLDER: INSPECTION A
Michael Jones odville WI Q iDG ,tY1.
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST F. PT. ELEV.
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Joe Stan 6646 St. Croix 135521 11 SEPTIC TANK/ : Z-2. Z ! / t f
MANUFACTURER: LIQUID CAPACITY: TANK INLET LEV.;- . TANK OUTLE ELEV.: WARNING LABEL LOCKING COVER
71 ED: PROVIDED: J C.
i:+_)'/-' ES ❑ NO ❑ YES NO
BEDDING: V 4W DI A.: VGAIT MATE: HIGH WATER 'NUMBER OF ROAD: PROPERTY WELL- p~ BUILDING: VENT TO FRESH
C, 0 ALARM: FEET FROM LINE: AIR IN T
❑YES NO ❑ YES NO NEAREST Ov L(/
DOSING CHAMBER: 5 l , . ? =r . l
MANUFACTURER: BEDDI - LIQUID CAPACITY: PUMP MODEL: PUMP/Sjv1ANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
Y11 CA ❑YES YES E] NO ES ❑ NO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WEL BUILDI G: VENT TO FRESH
v LINE: AIR INLET. ROM (DIFFERENCE BETWEEN FEET IF
PUMP ON AND OFF) 2 = ES ❑ NO NEAREST --3/ /
SOIL ABSORPTION SYSTEM. Check the so moisture at the depth of plowing FORCE LENGTH: / DIAMETER: MATERIAL AND MARKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.) f
CONVENTIONAL SYSTEM:
BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: -COVER INSIDE DIA.: # PITS: LIQUID
TRENCHES: / "1ATERIAL:
DIMENSIONS
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO(DISTR.+NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW PIPES: ABOVf- COVER: ELEV. INLET ELEV. END: } i`) PIPES: FEET FROM LINE: 7~ / AIR
NEAREST o, [(J
MOUND SYSTEM: ,,'S
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:
BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER:
TRENCHES:
DIMENSIONS
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. 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:
61-' ^ ❑ YES ❑ NO ❑ YES ❑ NO NEAREST
~ L#4-1 'S c,
I0.2S. I U. 141 A
Sketch System on et n in county file for audit.
Reverse Side. \ SIGNA RE: TITLE: /
Qr Gryt
SBD-6710 (R. 06/88)
SANITARY PERMIT APPLICATION
7DILHR 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 > ~
8% x 11 inches in size. ❑ cr~~'It re Is"o 4vious application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION.
PROPERTY OWNER PROPERTY LOCATION
4el Uki e-S E%.IV L,.) 1/4,S ) 0 TN,R I~p E(or)
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
WOO dv "H12 LA14Is 140 N14
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILDING: (Check one CITY NEAREST ROAD
State Owned ❑ VILLAGE eJ rk
❑ Public Z 1 or 2 Fam. Dwelling- # of bedrooms PARCEL TAX NUMBER(S)
III. BUILDING USE: (If building type is public, check all that apply) q 6` (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
50 Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. rA New 2. ❑ Replacement 3.E1 Replacement of 4.E] 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) I ELEVATION
4o o /240 ! 2 t', v 3. V Feet Feet
VII. TANK CAPACITY Site
in allons Total # of Prefab. Fiber- Exper.
INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tank Tanks strutted
Septic Tank or Holdin Tank m"d w.er t, G
Lift Pump Tank/Si hon Chamber I~
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plum is Signature: o Stamps) A PIMPRSW No.: Business Phone Number:
V~e_ 661
tic) 9- St k 0f, I Plumber's Address (Street, , State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
X Surcharge Fee) pApproved ❑ Owner Given Initial
Adverse D rmin i L
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
INSTRUCTIONS
z
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 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.
Il. 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, 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 name, 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 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 contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
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.
of property 14' JA e ~a eS
Location of property ~/~1/4 ~W 1/4, Section 1 U , T N-R IL W
Township ''k tf G- 4 11-
Nailing address L100d u t w~~S
Address of site n~ L-/e. c~ w ( l2 tf'l" 5
Subdivision name
Lot number N /4
Previous owner of property A( 2 (Pt t & R ex SG ki
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? 4***'-Yes No
Is this property being developed for resale (spec house)? Yes L/ No
Volume and Page Number J 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, 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.
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 (ate) 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. 5"'Y Q G•3 ; 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 duly recorded in the Office
of the County egi t r of Deeds, as Document No. ~s y4 3
Signature of 6'wne-tT Signature of C Owner (If Applicable)
-3a - 5 (2) . ' - '0o-'?o
Date of Signature Date of Signature
L._
Ii DOCUMENT NO.
j WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
STATE BAR OF ISCONSIN lO RM 2-1982 REGISTER'S GFE~~E i
. _ ST. CROIX CO., WI
Rec'd for Record
1JI AY 2 ~ 1990 M i
.-Rehert...Torgerso_n---and..Gay..7.a___~Q_ ge san_,-_-busbar~.d.. at 8:30 A.
and wife
I'
Register of0eeds
conveys and warrants to .Mael___L_.___JOns__and._Debra A._____
Jones.,___ surviyorship__ marital___property,
-
'r `I
RETURN TO 't.'1~L+1
w i
~6rl1Ji<~111~ Wl~;ap~
the following described real estate in St.,___CrO1X__.........County,
State of Wisconsin:
Tax Parcel No------------------------------- ji
Lot 1 as recorded with the Office of the Register is
of Deeds, St. Croix County, Wisconsin, in Vol. 8,
Page 2209, No. 458651, Certified Survey Maps, con-
taining 3.000 acres, being subject to easements
of record and including a roadway easement for
ingress and egress, being 66.00' in width as shown
on the referenced Certified Survey Map.`'';~'
D D
The Grantees' real property tax liability commences
with the date of 1-1-91.
i
f'
j is
I
This ._.....__J.S...riD.t____. homestead property.
(is) (is not) ii
Exception to warranties :
I+
Z :
Dated this day of -May------------------- 19.90....
/ i
/6r (SEAL)
. f •-•-••-•••--•....---••----(SEAL)
Robert Tor erson
I'
1/ Z. (SEAL) (SEAL)
I * ..GaX.. a.. Torger °n
I
AUTHENTICATION ACKNOWLEDGMENT
I Signature(s) Of __RQbZQJ_t___'~'4r_gQr$.Pn.-and__ STATE OF WISCONSIN
Gayla__ Torgrson---------------------------------------- Ss.
------•-------------County.
authenticated this day of------.•.May.-... 19.9.Q Personally came before me this ................day of
i.
19•-•---.. the above named
en X Y l
Qxl.__ G ,...I~ l~lg4
TITLE: MEMBER STATE BAR OF WISCONSIN
j (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-
ji
JQhn• G Nestin en - Att
-y
1i ,
$a~dwin, Wisconsin 54002
- Notary Public County Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.)
date:
i
j
*Names of Dersons signing in any capacity should be typed or printed below their signatures.
STATFORM No. WISC 82 SIN Stock No. ~ .3' 002
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER eh 4~~ V a h e- E
ROUTE/BOX NUMBER R. FIRE NO. (a ~4-
CITY/STATE'IA✓0 0 dv~'t WS ZIP 6-11014 f
PROPERTY LOCATION: N/P 1/4 A/ 1/4, Section id_, T2? N, R ~ L W,
Town of k G 4 / a , 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 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
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
7969
LABOR AND PERCOLATION TESTS (115) P.O. BOX
3707
HUMAN RELATIONS MADISON, WI 53707
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: WNSH UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
NE1/ NW 1 to ilr R 16 E (or s BFI(-L-c 1 - cS"
COUNTY: OWNER' BUYER'S AME: MAILIN ADDRESS: Z
ST. CR_1WK M 1 Ck-kf\ ~~1L S woopvi w) 540 13
USE DATES OBSERVATIONS MADE
NO.B D MS.: COMM IALDESCRIPTION: I-FFR-OFILE S: TESTS:
Residence 1 1'1. N. New Replace S -1 p_ 9 O
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional)
Ns ou Ns ❑u Ns au Ns au as Nu 1S')< awut-wrpi(U)~L aGb
DESIGN RATE: A 1
If Percolation Tests are NOT required If any portion of the tested area is in the
under s. ILHR 83.09(5) (b), indicate: -I~ • Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL PTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED ST. IGHE T TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- )l \23 101. S ~l Or~J L > l Z 3 SgE P'tGC- Z O F Z
130 101. S 7 130 t
B- Z
B- 3 110 aS.o LID
B- y °l0 CLS-S 1> 40
I I
B- S X35 \~o. 8 > 13S
13-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DR N WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 P RI D PER INCH
P- -78 5 1 3/8 )3/s 1 Sll6 14
P- L '11 g S 1/ ) leg S
1
P_ S 1 7-
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. ~ulT L. 95.0 P"E 79 AIil~n 60 S I I
'C't\-'1t~lufit~ 93.0
SYSTEM ELEVATION
i
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1 _
T.
N N& sip, ILA
IN
Stow wk. PRtaU11~ 1`D1~X1htM? y(L°cgv~R i V 51~
Oust; ~l''~"~18~0(u 1~►_1~~5 _,S. ~-o w115'.tt~D ~ !~?F1t~' _ - . ~ _ _ I _ . ~ _ . - ; _ - _ !
Fcs~z p~L h 1jU k 6E .
40
Y1 f.]; ovt3 1af1~L lj~~
SC~tI.@ ltl_tlp' _ SEC. l~
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 : AND TESTS WERE COMPLETED ON: S -I O'-9 O
ADDRESS: CERTIFICATION NUMBER: SLS_%4ZS_o ONE NUMBER (optional):
esTo oo S-)6 165
P.O, BOX 74 421 N, MAIN ST, RIVER FALLS; WI 54022 CST SIGNAT RE:
715-425-0165
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ~rCB~ 01= Z
DILHR-SBD-6395 (R. 10/83) - OVER -
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SOIL DESCRIPTION FORM
tta h S l 141 .0 ma On a So arata Shoat)
LINEAR LOAOT G RATE:
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LOPE;
Po
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FmC_.R P BY
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COUNTY/STATE Ste' C~4~ CCIUIUT~`f w~ VEGETATIVE COVE
! X1 M ZZ ! 6w DRAINAGE CLASS: O~ " t AJ Lib
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Lo DESCRIp a+:.fT• 01= NC
: ~tiwTJ OF ~U Q!~ GALLONS PER S FT. PER DAY: v
LOCATION f3
SOIL SERIES: rl G~ - S 1
PARENT FNTERIAL(s)/OEPTI
jy! so
STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PII •BOUNDARY REMARKS
HORIZON OEPIII MATRIX COLORS MOTTLES TEXTURE VAIML-
n, moist G r. Sz. Sh COATINGS
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OTHER SITE FEATURES/NOTES: ^
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LIMITING FACTORS/DEPTH.
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N ~
5 f6
~ L
~
4-1
O
a+
6' .
N~
~e
Owner's name San. Permit No.
H63.05 PLOT PLAN
Show:
P-1 Location of building served Dosing chamber
Q Septic tank UT V6rtical/horizontal reference point
I
Building sewer System. elevation is
F 1 Effluent system Q Well
EA Replacement system area Property lines w/in 50' of system
TJA Distribution boxes Scale = 1 1`=Lp~ , or dimensioned
Q Gou~.-oS l~uw+PS ~3 Z-~~
Pump and controls: 1 3
W t 0 3 M
Mfr. & Model No. Vertical Lift Size Force Main
-SA% F'r1 .51 FT- \Z,S.a 6rt~- 5D
Friction Loss T. D. H. Vol. Dist. Pipe Gal..per Min. Gal. per Cycle
Place check mark in appropriate box, indicating item is shown on plot plan,below:
T ~
~ ~ ~lb•of'
94 '1.14' 9.6.I S' LoT LlXleS
as`►,x
a
8 ck1 `E11 Pak - ED-S) 100. u' oxi
pi.,®ur \ / \ ~
t" 1 fZ.tYV Q I FE p
FF,
b ~
•
N N
M
v
e~
N 2
°V
a
02 i ►'t,3 itjE Per Le*\ST S o' -i~-o a ~p
F ~ Q Ar~D 1Ft7 L~~RST
2 $ ~ ~R~ v~ '1'~1~J hS _ .1'Pvc
10 ~ v ~ Q ~qop 6RL. lh t DW`°ST~Rti1 P Pv P c►tRMism PI~?ST
r a PRoQOS EP Dl~ I U 8' f
- ~20p 6P~C.. 1►'1 QW~3~'~1Z1'J (~12~~-CST
`'k'`' SE S~iaT ~ 1`Mult
By the granting or approving of the above plan, or upon the event of a subsequent
permit being issued,St.CroixCounty and theSt.Croix-ounty zoning Administrator, does
not assume or hold itself liable for any defects in plans or specifications, plan
omission, examination oversight, construction, or any damage that may result in or
aft install
?lumber's signature icense NO. a e
r 3
~6-r11GL~fc~ So►y fZ7 S V
pW'J LSL 'S !JA F'1C
' ~i~GE Z 0 F ~l
~I
CROSS SECTIDU OF A BED SYSTEM
t
F►tJ~9l1~D GT2AOE -
till ~VEIJT TAI (~6_ --.1Z" A-80y~
_t
SOIL FILL 2"OF-AGGREGATE
DISTRIBUTIOAI PIPE
APPROVED Sy►,ITNETIC COVER
MATERIAL OR 9" OF STRAW
\OR MARSH HAS
° to 0 F%t-2122 AGGRJEGATE ,
ELEV. OF 95.0 FEET-
- _P_ER.Eb1r~ATE~ _ P1 PE- ZO
Qp'1'TpM dF QEQ -
DISTRIBUTIOAI PIPE TO BE AT LEAST 60 IUCHES BELO ORmitIAL GRADE
AUD AT LEASTLO IMCHES BUT MO MORE THAM 42. IIJCHES B=LOW FIAIAL GRADE
MAXIMUM DEPTH OF LXCAVATIO►J FROM ORIGIIJAL GRADE -JILL BE -78 IUCHES
MINIMUM DEPTH OF EXCAVATIOIJ FROM ORIGIIIAL GRADE WILL BE IAICHF-8 `
51GIJED:
LICEUSC IJUMBER:
OAT r
• PUMP CHAMBER CROSS SECTION AMD SPECIFICATIONS' ~ E 3 of _
VCUT CAP
4*C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING
JIUJCTIOU 60% 7vj NHOLE COVER WITH
25~ FROM DOOR, RR NIW 6 LABEL
WINDOW OR FRESH IL~MItl.
AIR IAITAKE I
GRADE
L-L 9Z-S 40 MIN.
COWDUIT
WAIN. \
ICLET PROVIDE I
. 7 t's- Ay-25 AIRTIGHT SEAL I I i I ~ /
II v
APPROVED JOINT A I I I ( APPROVED JOINTS
W/ Ca. PIPE, ( III W/C.I. PIPEORPVC
EXTCNOIU4 3' I II ALARM
ONTO $01.10 &OI L 0 - i I
I
I I ow
c I I
LLEV.i?"_1 FT.
PUMP OFF
r..
O
C`t--00 CONCRETE 9LOLK
RISER EXIT PERMITTED ONLY IF TAUK MAUUFACTURC.R HAS SUCH APPROVAL I U00IN6
SPEC.IFICATIOUS
DOSE
1`'I t ~.J~S~t'sR1J PRk O hST 3- S
T/►1 K MAAIUFACTURCR: NUMBER OF DOSES: PER OAy
TAWK WZE. DOO GALLOWS DOSE VOLUME 1$~
ALARM MANUFACTURER' S`S',EL-lC`[ti20 S~tS`TEHS INCLUDING BACKFLOW: GALLONS
MOOCL WUMBER : lot Hw CAPACITIES: A= t 1' IMCNE5 09 yZ~ Z GALLONS
SWITCH T%IPC: "k1Z. c-AiR y Z B S?-S
= INCHEi OR GQA.LOW$
PUMP MANUFACTURER: G-%** ''s C s -7 INCHES OR X14-2 CALLOUS
MODEL CUMBER: M 13 7 D- )q INCHES OR 169- s GALLOWS
SWITCH TYPE: ~mcQR.%f MOTE: PUMP AMD ALARM ARE TO OE
MIWIMUM DISCHARGE RATE 5_GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE OETWEEC PUMP OFF ACO..DISTRIBUTIOC PIPE.- 13'33 FEET
t MIWIMUM NETWORK SUPPLY PKE$SURTTE~... 't FEET
♦ g~ FEET OF FORCE MAIN X 395 F/pppT.FRICTIOU FACTOR.. 3`I$ FEET
TOTAL OyWAMIC HEAD = \6'51 FEET
Dl PU`9 ETE1Z
IIJTERWAL DIMEIJSIOIJ i OF TANK: LENGTH °I L r ;WIDTH ;LIQUID DEPTH
t30T7'o E1 A a Em 6o 91 = z.31 = 'z . 3 4 c L- / rN CH
AS Pb'Tt -,M R lU U F k C-'%J TLtff G R A-/ 11.E C H
4
HEAD/CAPACITY CURVE
+ W
- W ~
1#S
I TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE
110 EFFLUENT AND DEWATERING
105
s 5335
' 100 SERIES 57-59 97 137.139 151 163 155 155 155 In
95 FT le Gal. Un. Gal. Lka.. Gal. Un. Gal, Oka. Gal, LIM Gal. Lb-w Gal. L1n. Gal LAM Gal. LYIK
5 43 183 - 56 ill' 104 394 106'401 61 231- 61 231 ` 155 d0i' 155
90 10 3.05 34 129, 46 174 79 1300 100 375 61 231, 61 231 148 550. 151 572
15 1-67 ; 19 72 35 133 ` 64 212` 91 344 60 227 60 227. 142 537 1456%
+-_2e 85 20 6.10 15 57 36 136.: 82 310. 59 223. 60 227 136 515'. 110 S30
~ 25 7.62 _ 8 30 74 280 57 218. 59 223 128 x164 133 503:
30 9.14 65 246 55 206 58 220 90 340 121.•156' 127 481
75 10 l21D - 46 IN 46 172 55 205 75 203 105 397 14 431
50 1524 21 W _ 33.125 51191 58 219:. 90 341 '00 379
70 60 1539. 15 57 43 161 36 136 71 260' 85 871
65 185 70 3184.,+ - 30 114 10 315 _51193 70
80 43914 53 ze 105 54 204
60 90 S. 37 140
100 ~f., K _.l 21 T9
_ • ~i G r' B 30,..
SS 163 110 wilm
Lock Valve 19' 23.75' 28' S8 88' 07' 73' 91' 110'
EFFLUENT & DEWATERING
Warning: Model 185 should not be subjected to less
leS than 30 feet TDH.
30, 25 Note: For Head Capacity on Model 112, industrial
20 column-explosion proof pump, see FM 219.
is
161 lea
1 137, 188
139
TN_ s SEWAGE & DEWATERING
GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 130 140 ISO 160 WARNING: Model 293 should not be subjected
-T to less than 15 feet TDH.
r~ } e4o 1
eo TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE
SEWAGE AND DEWATERING
7S
_ SERIES 262 266 267 2" 292 294 292 293 294 20
70 FT kt 'd Gel Lk4: G ( LIM Gal. Ltm Gal. Un Gal Lim Gal. LM. Gal. LIM Gal Law Gal. OW Gal.
5 $42. 90 361 - 128 484. 128 454 128 494 130 492 190 861- 140 530 196 7062, 225 552:
r_. 68 10 306` 60 227 89 337 89 337 89 337° 95 360 158 590` 124 489 181 086' 205 776
15 4$7 22 5 65 50 189 50 139 50 189. 63 x38 135 511 106 401 130 492 165 SMS 185 700
20 6.10 10 36 10 36 10 38 33 125 106 401. 89 333 119 450 150 569 168 036
$ _ 25 7.62 - - - 76 208 68 257 10640 . 136 $15 : 153 560
ITr~~4_ 30 ' 9.14 _ 43 163 47 178 90 340 121 469 140 E&V
1: aTrir4 55 40 1219 5 - 19 50 189'1 94 3% 115 435.
`*9 50 1524 - 58 220`- 89 337..:
so 80 16.2D 13 .149 59 zn
70 2134 - 25 95
45 Lock Valw 18' 21.5' 21.5' 21.5' 25' 35' 42' S0 82' IT'
35
,ioI
a
y+. 30 293
f 25
INN
F 20
282-
r" is-
292
10
8 412 261, 267, 268 264 284 295
Or
GALLONS 10 20 30 40 SO 60 70 80 90 V`100 110 120 130 140 150 160 170 180 190 200 210 220 230
1!TlItB 0 80 i o' IN 990 320 , 400 00 No 640 720 e00 no
t
•
8 1 3087
V%~~__ ~PAGE 5115
j REGISTER pF DEEDS
RECEIVED FOR~kECORD
11/28/2005 03:00P1!
`'F. CROIX COUNTY
CERTIFIED SURVEY MAP
COPY FEE:
PAGES: 2
CERTIFIED SURVEY MAP
LOCATED IN PART OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF
SECTION 10, TOWNSHIP 28 NORTH, RANGE 16 WEST, TOWN OF EAU GALLE, ST.
CROIX COUNTY, WISCONSIN: BEING PART OF LOT 1 AND 4 CERTIFIED SURVEY
MAP VOLUME 14, PAGE 3815.
NOTE:
BEARINGS ARE REFERENCED
TO THE NORTH-SOUTH 1/4
SECTION LINE OF SECTION
10, ASSUMED TO BEAR
S02'51'07"E
OWNER: - - - - - - - - - - - -N 1 /4 CORNER
- SEC. 10 FOUND
SURVEY CONDUCTED AT THE _ _ _ COUNTY SURVEY NAIL
REQUEST OF THE OWNERS: 'R - - - - - r - - CP' MIKE & DEBBIE JONES / EA ,"EAN
2447 50TH STREET C.5.rd_ N CL.
i, R L. Iy
WOODVILLE, WI' 54028 F.;. zz^
N
to
/ LQT 3_CaN1 Im
VOL. 14
I I PAGE_3815_
IN
1
\ \
F7A'ZT 182,31'
I I
L. " 1 cam
VO 13
F'Al,
3!115
5J I I
1.01 z._c~N1 I I
Vol 14
} nc r, )815 j I z
0
su z A
I N
W \ O N
L-
io
N
IOG Zpp N
LOT 1
rn 352039 S.F. Z
N
8.08 Ac.
r
R Y"~_t'7 !f'i m
' LOT 4 CSe1
VOL 1-F
P AG f- 3815
LEGEND:
• FOUND 1" IRON PIPE
SET 3/4" BY 18" IRON
PIN WT. 1.50 LBS./FT. - - - - - - - S 89'58'19" W 377.90' m
'COUNTY SECTION MONUMENT SOUTH LINE OF THE NE-NW
xl>I,.arl r;n Lnrns
(FOUND AS NOTED) 1c'
S 1 /4 CORNER
SEC. 10 FOUND
1" IRON PIPE
THIS INSTRUMENT DRAFTED BY JASON PAUKNER SHEET 1 OF 2
Vol 20 Page 5115
Parcel 008-1027-90-025 10/13/2006 12:01 PM
PAGE 1 OF 1
Alt. Parcel 10.28.16.141A-10 008 - TOWN OF EAU GALLE
Current ; X, ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
11/28/2005 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-owner
O - ALF, ROBERT W & HEIDI R
ROBERT W & HEIDI R ALF
2447 50TH AVE
WOODVILLE WI 54028
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 2447 50TH AVE
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 8.080 Plat: 5115-CSM 20-5115 008-05
SEC 10 T28N R16W PT NE NW BEING CSM Block/Condo Bldg: LOT 01
8/2209 3.OOAC FKA CSM 14/3815 LOT 1
3.OOAC NKA CSM 20-5115 LOT 1 (8.08 AC) Tract(s): (Sec-Twn-Rng 40 114 160 1/4)
10-28N-16W NE NW
Notes: Parcel History:
Date Doc # Vol/Page Type
12/14/2005 814249 2943/446 WD
11/28/2005 813087 20/5115 CSM
07/23/1997 1113/346 WD
07/23/1997 430/191
2006 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/06/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 27,000 196,600 223,600 NO 05
PRODUCTIVE FORST LANDS G6 6.080 8,100 0 8,100 NO 05
Totals for 2006:
General Property 8.080 35,100 196,600 231,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
CID
~o MAY 1 0 2000 . .
s FILED
FEB 2 5 2000 ST. CROIX COUNTY
KATHLEEN H.WALSH J~ SURVEYOR'S RECORD
Register of Deeds
St Croix Co., WI
SEC. 10
NYY ALUMINUM CORNER
CEP T-TFIED SUP VE Y AIA P
AL
CAP FOUND Located in the NE1 /4 of the NW 1 /4 of Section 10, T28N, R 16W, Town
T of Eau Galles; St. Croix County, Wisconsin, including Lot 1
t Sooooo'oo"E Owners: Mike & Debbie Jones of that CSM recorded in
1322.48' 3 v 2447 50th Avenue Vol.8, p g. 2209.
M ° Woodville, WI 54028 Bearings referenced to the
North line of the NW 1 /4 of
DETAIL N NOT TO SCALE Containing (and being a replat) Section 10, assumed to be
: of that Certified Survey Map S 0°00'00"E.
recorded in Vol. 8, page 2209.
UNPLATTED _LAN_D_S
\ T 50TH S 90'00'0"E 1322.48 VENUE
33.04' M 101 F4 $ 310.24'
9 *QQ'QQ"E 1322.44' 33.03
- -
- - 5X. 66T - - - - 1. ' ~a - - -say? 6 r - - 5~8- o: - 391 78'
NORTH LINE OF THE NW l/4 6 1010,66 O N00000 00'
y\ y 1 J' NI14 CORNER
~1 • 33.00
v 3 100'SETBACK LINE tYL ` N36717'40- E SEC. 10-28-16
COUNTY
d
Note: this private road ease- 3 166' ' N38o00'401E
\A / SURVEY
4\
67.17' NAIL
ment will service Lots 2 and 4.- 7- q M N FOUND.
i°N \ a9D,ododE p°~'41IIL ®T 3 I to
2_ \ .'218.88
0.37' 168.31' 3 JS r o I 1
omo 285.56'.....
S 0'00'0 "E
fL ® T 4
96.7 20f25'•'•
N ~
2 I
1,256, 178 Sq.ft.(28;'84 Ac .j lL®T a9411
N z including right-of-way. W N I 130,681 so.Fr.I
(U " to 217,800 S0. F.T' In 3.00 ACRES' a
1,222,799 Sq.ft.(28.07 Ac.) In 10 5.00 ACRES rn
I • I Nm N
W4 A N excluding right-of-way. !U tn to in vi
I m
r N I
m I N o~ cn
~fE Note: Easement recorded co gI to m I 6
min' W _ CrJr ao = zl
3
3 on CSM in Volume 8, page ° I n Q I
Co
2209. This will be N I to
LOT I ~ N 0 J ~
to N joint driveway easement for I ro I ?
2 Lots 1 and 3. to
N W APPROVED iI-• -0 300. oo,~.." •
of N
. I
O
ST. CROIX COUNTY z . N 90' 00' 00"W v O W
z Plannin - _:..ee r W CU N I
O N
(U pj Q
z r E B 2 4 2000 313.94. i
J S 90'00'00"E 2 ZI
If not recorded Within 30 days of LOT 3 ACREAGE
i W approval date approval shall be 140 , 09 7 S ft . 3.22 A13
null and void including right(of-way-
CL.~ 129,835 Sq.ft (2.98 A)i_
~I Note: Rock pile at SW Q:
excluding right -of-wayo
jI corner, witness corner 2
I found S02°55433"W 8.55'
~I from corner.
U~ SOUTH LINE OF THE NE-NW
S02°55'33"W S 89' 58' 19"W 1320.74'
8'55' UNPLATTED LANDS
LEGEND 3
o
ST CROIX COUNTY SECTION CORNER (AS NOTED). ~j
0 1'X24" IRON PIPE WEIGHING 1.68 LBS. /LIN. FT. SET. N ~
• /"IRON PIPE FOUND.
zM N
(R1 PREVIOUSLY' RECORDED INFORMATION. S114 CORNER
SECTION 10-28-16
® CURVE NUMBER. (1"IRON PIPE FOUND),
- • - . - OLD LOT l LOT L. lNE (C.S.M. V. B, P. 22091. '
SCALE IN FEET l 200'
O 200 400 600
This instrument drafted by'.` 4992656
7
Vol. 14 Page 3815
co
FILE?
2 MAY 1719900w 9
JAMES O'CONNELL
Register of Deeds
SL Croix Co., WI
CERTIFIED SURVEY MAP
ROBERT TORGERSON
Part of the Northeast 1/4 of the Northwest 1/4 of Section 10, Township 28 North, Range
16 West, Town of Eau Galle, St. Croix County, Wisconsin.
0 Indicates 1" x 24" iron pipe
UNPL A T TED LANDS weighing 1.13 lbs./lin. Ft.
set.
N90 00'00"W 2644.91'
NW COR. SEC. /0, T28N, 66' 50TH AVE. A OQ N 114 COR. SEC. /0, r 28 N, R /6W
R 16 W, /COUNTY - 1 66. 00, 1 r'-,V' /qA/LROA0 SP//f£ SETT
SURVEYOR'S MON.) 2Y68,77' 3/0.14
" 0- S 00 • 00' 00 "E 33. 00'
N LINEN W 114
N 00 • 00'00 "W N,.90/ 00 ' 00 "E 66. 00 ' \SG O NS/ I~
r V`~ I~
33.00
4 1 -
4 I ' LAU E E
ZI o ~ 20 do Z mW HY cc J 1713
I ~ 6~~•0o J I N '.,RIV FALLS, Jw
~e p r,~ F Wisc.
4
C7 ku
.44 LAND
~ I ~ ~ ~ I ~~111111+++fa
J I' 1 i q~ aurence W. Murphy
Registered Land Surveyor
SCALE /00'
j I \ 00 \ 0 25' 50' /00' 200' 300'
1
a ,
87.. 24 ' ~ 116.01' 3
00
N 90" 00 O 300.001
W C
2
I s \ LL q
14
p ~ ~I =h
ZI n ~ a
n N Q h ~
Owner's Address: J b L O T
Route 1 - a O W
Woodville, WI 54028 3.000 ACRES W ~tl I k
~.I 3 130,681 so. f7,
QI N h Q I W
Dated: 5-4-1990 I m o
O ~ p.l
2 M O 2 y
Z 111 ~ p
Q
W ,r
m ~
J ~
Q Z
APPRO D
N 90.00 00"W 300. 00' MAY 17 1990
UNPLA lTED LANDS ST Chi:cou. w
- ~OM~rC4•>sn~ PA,^4<3 PLANNING
Vol.--L_Page 2208 A~ZON'COMmi-m`
Certified Survey Maps
St. Croix County, Wisconsin.
SHEET / OF 2
Parcel 008-1027-90-025 03/28/2007 04:21 PM
PAGE 1 OF 1
Alt. Parcel 10.28.16.141A-10 008 - TOWN OF EAU GALLE
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
11/28/2005 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - ALF, ROBERT W & HEIDI R
ROBERT W & HEIDI R ALF
2447 50TH AVE
WOODVILLE WI 54028
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description ' 2447 50TH AVE
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 8.080 Plat: 5115-CSM 20-5115 008-05
SEC 10 T28N R16W PT NE NW BEING CSM Block/Condo Bldg: LOT 01
8/2209 3.OOAC FKA CSM 14/3815 LOT 1
3.OOAC NKA CSM 20-5115 LOT 1 (8.08 AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4)
10-28N-16W NE NW
Notes: Parcel History:
Date Doc # Vol/Page Type
12/14/2005 814249 2943/446 WD
11/28/2005 813087 20/5115 CSM
07/23/1997 1113/346 WD
07/23/1997 430/191
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/06/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 27,000 196,600 223,600 NO
PRODUCTIVE FORST LANDS G6 6.080 8,100 0 8,100 NO
Totals for 2007:
General Property 8.080 35,100 196,600 231,700
Woodland 0.000 0 0
Totals for 2006:
General Property 8.080 35,100 196,600 231,700
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
106 SAFETY & BUILDINGS
t DE^rrMENT OF REPORT ON SOIL BORINGS AND DIVISION
IN USTRY, - P.O. BOX 7969
LABOR AND PERCOLATION TESTS (115) MADISON, WI 53707
HUMAN RELATIONS (ILHR 83.0911) & Chapter 145)
OWNSHI UNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
LOCATION: SECTION: ` C gK.l Z1S ' ~ I
NE14 t4 1 o /T ?8 R ~6 E (or
MAILING ADDRESS: Z
COUNTY: OWNER' BUYER'S AME: W O~QU1 l w l S~{O
ST C l~1 h'1 `e'~ ~W
S DATES OBSERVATIONS MADE
USE PROFILE DESCRIPTIONS: E OLA
ce 4 TION TESTS:
NO. BEDRMS.: COMMERCIAL DESCRIPTION: [New Replace S _1 O _9 0 S-12-90
Residen N • -
YJ-2, 3
RATING: S= Site suitable for system U= Site unsuitable for system optiona
CONVENTIONAL: MOUND: ~ IN-G~Np-P URE: SYSTEM-IN-FILL llii5iDING ANK: RE CO ~ DOE e~l~H~~`~7O~7kL Q~
Q~S❑U NS❑ S UU (L/~NJS ❑U SI/1tU
DESIGN RATE: If any portion of the tested area is in the 1 I`
If Percolation Tests are NOT required 'v J'\
. Floodplain, indicate Floodplain elevation:
under s. ILHR 83.0915)lb), indicate:
PROFILE DESCRIPTIONS
BORING TOTAL ELEVATION D PTH TO GROUNDWATER INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
)vDAJkz. B S > LZ3 S PfVGC- Z. of Z
B- Z 130 ~o 1. s t ? 11313
B- 3 Ito aa.0 lit
ao qs.s `7 4u F 1,
B- y
7 l3s ll
B- S ~3S too • 8
B-
PERCOLATION TESTS
DROP IN WATER LEVEL.INCHES RATE MINUTES
TEST DEPTH WATER IN HOLE TEST TIME PER INCH
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. P~ 3/8 1 P; 3/g2 PERT 0
P- -78 5
S I
p_ Z O
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 ringsaand the ldirection and percent
95.0 !^'~.m
of land slope.
SYSTEM ELEVATION - 43'0 _e
14-
LOIN \ ~'Te l t RTE 3E~D sl~ W &L. yo %q ,
OVT),} 9E,slSLwM7
lDO, S
1tJ1 ~.ht1. 'o` C.
AV-'
LOP1• E
A
_ td _ a.
tN
74.
r _ k Sb'M R'aE.
t?En~uL 'ToP aF I,Z,tpGE ~l'n . . z, ~o src~
Pt~i W 1>F. Ir~Uy 4~L`GOVLR •t- ~ ~ . ~
(9UL~. 01;ST'~218vYi01u ~t AES A~~ - ~ 14
wtStk~ ~u~ _
_5~ . _ . .
00
L_12 -
Fot~ DRh1klh6E . LA
qt Sro,
SCPtI.~ ~tl _ ~O~
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.
WEGIERER S011 TESTING _::TESTS WERE COMPLETED ON:
NAME (print AND
CERTIFICATION NUMBER: PHONE NUMBER (optional):
-
ADDRESS: C-ST0 S76 LS-%4ZS-0[65
CST SIGNAT RE:
RIVER FALLS, WI 54022
715-425--0165 k6 e I fit=
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) -OVER -
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SOIL DESCRIPTION FORM
Attach Soil Profile Loca i ma on a Su orate Shse 1
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LOCATION: TbwT
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PARENT MATERIAL(S)/DEPTH
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01HER SITE FEATURES/NOTES:
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Signature Date CST N
LIMITING FACTORS/DEPTH.
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in. moist Gr. Ss. Sh . COATINGS
OTHER SITE FEATURES/NOTES:
PA G~ of
CST k
Signature Date
LIMITING FACTORS/DEPTH:
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' DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
DIVISION
INDUSTRY,
P.O. BOX 7969
LABOR AND PERCOLATION TESTS (115) MADISON WI 53707
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: WNSH UNICIPALITY: LOT NO.: BILK. NO.: IVISION NAME:
NE1/ NvV 1/4 1 rz J R )6 E for te 6[~l.L~ i ) I - COUNTY: OWNER' BUYER'S AME: MAILING ADDRESS: w I 5402_13
ST. CR1K M 1 C\E-L. 7Z L, 1uL S woo~v>
USE DATES OBSERVATIONS MADE
NO.BEDRMS.: COMM R IALDESCRIPTION: IPROFIL ONS: A ON TESTS:
Residence N EKNew DReplace S .1 p_ C1 O S- L 0- q
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: rYSTEM-1 N-FI LEROUDI NG TANK: RECOMMENDED SYSTEM: (optional)
2S ❑U LX1S ❑U xS ❑U LAS ❑U ❑S OU IS'Y--)o` 0_Wt_)30"1" WUAtL- aeo
D
If Percolation Tests are NOT :-SIGN RATE: required If any portion of the tested area is in the
under s. ILHR 83.09(5)(b), indicate: IV -Ia • Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED I HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- 1 \-L-Az 10 i. S ~13 OJ%j L- > l Z 3 SEGO pi~GC Z O F Z
> l30 It
B- Z 130 1.01. S q
B- 3 110 'q'6.0 y 7 l l0
B- y ao C S-S 1*7 40
B- S 13S goo. 8 > 13 S
13-
PERCOLATION TESTS
EST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
MBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERI D P R PERINCH
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OT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
PL
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. ILA 1T114L 95.0 ?"e 79 RN1160 SI I
SYSTEM ELEVATION r~t-'KIMI►WM - 923-O
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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 : AND TESTS WERE COMPLETED ON: S -l O-~
ADDRESS: D E SIGN SERVICE CERTIFICATION NUMBER: PHONE NUMBER (optional):
-sTooo S-) b S-4ZS-ot65
P,G, BOX 74 421 N. MAIN ST, RIVER FALLS . WI 54022 CST SIGNAT RE: 19
715-425-0165 II
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
W
SOIL DESCRIPTION FORM
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OTHER SITE FEATURES/NOTES:
S-10-40 o~OS7b f'n6~ ~ or.
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STynatula Date CST N
LIMITING FACTORS/DEPTH:
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