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FORM - STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER Sg.w^ Yh', Ou-(-` TOWNSHIPWa, SO-^
SECTION Z9 T °r N-R ! 9
ADDRESS Rox at- ZSZ ST. CROIX COUNTY, WISCONSIN
~lc~.t~so h WI S`7~0/~
SU13DIVISION-r4p.Zf (v 0;qw LOT_Z4~o LOT SIZE -T.GZ--
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
~~9°'. 2gx 42~~ F x ~ •I 4S.
~ II \II
~ D
R
S
n
d r ;S
1 ~
I
1/v I o
pa
S
~ ~.N~• `fdp dF c.M.R Z~ I1,=100.0
INDICATE NO Ti RRO
BENCHMARK: Elevation and description:-,e oft ZSe~~/r[rr7` cff S roi,jc~~
Alternate benchmark
SEPTIC TANK: Manufacturer: 3#e' Liquid Cap. /000
Rings used: Manhole cover elev: Final
_L grade elev:
Tank inlet elev.: Tank outlet elev.: ~.`r!D
No. of feet from nearest road:Front , Side , Rear) Ft. 'V6~
From nearest prop. line:Front , Side , Rear X Ft. 74"
No. of feet from: Well - , Building: 17 r
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
s
PUMP CHAMBER
Manufacturer: N 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 :<or *,,4;, Trench : Seepage Pit :
Width:/b' Length Number of Lines:_ Area Built(/0.477
Exist. Grade Elev.-72 7 Proposed Final Grade Elev. 3,75'
Fill depth to top of pipe:
No. feet from nearest prop. line:Front , Side , Rearj[_Ft.-?9
No. feet from well: 'V/ No. feet from building 3S
HOLDING TANK
Manufacturer: A 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:
q INSPECTOR:
DATE: PLUMBER ON JOB:
or~-
LICENSE NUMBER: r / 3
6/90:cj
dEPARTMtNT 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:
NW 4 , NE ,4 i Sec. 29 , T29-R19 X
CONVENTIONAL ❑ ALTERATIVE (If assigned)
Town of Hudson Lo 2Tank ❑ In-Ground Pressure ❑ Mound
'-N-AgEOF MIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE:
Box 282, Hudson WI /d -
BENC (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: C . PT.
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
5432 St. Croix 128722
SEPTIC VANK/HatDING TO $ 1M,, ( CoVtrz o .80' G,01. G~~v
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: T V.: WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED: g,G,
LSD eyZ,,r G d $S 29,26 YES ❑ NO ❑ YES NO
UER OF ROAD: PROPERT WELL: BUILDING: VENT RESH
BEDDING: t DIA.: v~ q MATL.: HIGH WATER MB
`C"~v.,/C.,CJ, ALARM: FEET FROM LINE: f AIR INLET:
❑ YES NO 7 Cet_5 'C, ❑ YES NO NEAREST-~ 7 ~S
MANUFACTURER: BEDDING: UID CAPACITY: PUMP PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
YES ❑ NO ❑ YES [__1 NO F-1 YES ❑ NO
GA S PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VER TO FRESH
(DIFFERENCE BETWEEN ET FROM LINE:
PUMP ON AND OFF ❑ YES ❑ NO hl
SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: RIAL AND MARKING:
or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN
the soil is dry enough to continue.
CONVENTIONAL SYSTER' 7,q : -7 5 Cb I/- = ,
BED/TRENCH WIDTH: L N OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID
TRENCHES: MATERIAL: 7H:
DIMENSIONS ~p CO Tit;'_
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE ATE AL: N DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
ER: ELEV. INLE ELEV. END:, PIPES: FEET FROM LINE: / r / AIR INLET: r
BELOW PIPES: ABO~ff OV T
E3 93 8.7~ tec. .(S/!N-p~2719 NEAREST ~S .3~
MOUND SYSTE ,5F
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 pets the criteria for medium sand. ELEVATIONS MEASURED.
SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS;
❑ YES ❑ NO ❑ YES ❑ NO
DEPTH OVER TRENCH/BED PTH OVER TRENCH/BED DEPTHS OF TOPS SODDED: SEEDED: ULCHED:
CENTER: EDGES:
❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
PRESSURIZ DISTRIBUTION SYSTEM:
BED/TREN WIDTH: LENGTH: NO. OF TRENCHES: LATERAL SPACING: AVEL DEPTH BELOW PIPE: FILL DEPTH ABOV COVER: 11
DIMENSI S
MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MAT AL: NO. DISTR. DISTR. PIPE DISTRIBUT N PIPE MATERIAL & MARKING:
ELEV TION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
DIS IBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INF RMATION APPROVED PLANS
❑ YES ❑ NO ❑ YES ❑ NO
MBER OF PROPERTY WELL: BUILDING:
PERMANENT MARKERS: OBSERVATION WELLS: 5AREST
COMMENTS: ET FROM LINE:
❑ YES ❑ NO ❑ YES ❑ NO
n in county file for audit.
ai
Sketch System on
Reverse Side. SIGNA RE: TITLE:
SBD-6710 (R. 06/88) /
DILHR SANITARY PERMIT APPLICATION cou
In accord with ILHR 83.05, Wis. Adm. Code
TATE SANITARY FERMI #
-Attach complete plans (to the county copy only) for the system, on paper not less than ❑
8% x 11 inches in size. c eck if Un ?,Op:.e ous 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
SQ % '/4, S Z T0P , N, R ~j E (041p
PROPERTY OWNER'S MAILING ADDRESS LOT # / BLOCK #
1-3, 0 * a8Z Y~
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
s G.~ 2 SYv fe Z7 04
III. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD
❑ State Owned VILLAGE
b
'PO TOWN a Za
❑ Public 1 or 2 Fam. Dwelling-#of bedrooms 3 PARCEL TAX UMBER( )
III. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 120 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. ® 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 91 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground 420 Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLNSER 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
/S 4'/ 8 0-7z- -4- 3 97' X0 Feet 6L9- /0 Feet
VII. TANK CAPACITY Site
in gallons_ Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holding Tank Da ~JG 4
Lift Pump Tank/Si hon Chamber
Vilil. 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:
Plumber's Agd/ress (Street, City, State, Zip Code): L L~ 7
{ g I ~ ~ ~ /
~L ~ X/ W A 1 A A t4l/
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater a e Issued Issuing ent Signatur No StaTPW
Surcharge Fee)
Approved ❑ Owner Given Initial
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 8 Buildings Division, Owner, Plumber
t+ t
INSTRUCTIONS
i
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 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; close 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)
T
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 3axn ANY E
Location of property ~ - 1/4 10 1/4, Section, T 2? N-R_Zq!~D
Township
Mailing address G ear 2 ~ 2,
Address of site
47
Subdivision name C ,777 ~.f
Lot number '
Previous owner of property
Total size of parcel S e !"'-5-
Date parcel was created / ( - /-7- F- -7
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house)? Yes No
Volume and Page Number 4107 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.
---------------------------------------------------------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. 4 7 ,-"42 3 0 ; 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 Register of Deeds, as Document No. 4f3 z Z30
rsE~3w &:m2"
Sign ure of Owner Signature of Co-Owner (If Applicable)
Date of Signature Date of Signature
I
f / YASI 49
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 11- 198a"seAt t R[eravrD FOR R[CORDINO DATA
: LAND CONTRACT
InlhWul An/IY.Nnb REG TER'S Ur~lCE
/ ITO fly USED FOR Al.l. TRANSA(•TIONS W1lFRF OVF.tt T
4 AM30 vn Mlo IS FINANI'F.D AND IN ()TTIFR NON-CONSUMER S1. Ckolx Co.. W'
VVVV At'T TRANSACr1UN91
rr,I p:>,cord
_T_ 1987
Noyenb#r.,1
Contract, b) and between . ruXXt:tit......kQ~19.7?S.tit1
1225 P M
...RukX..Rn~llq yr.. a sin&le woman at
(..Vendor",
whether one or more) and..Sr110..1:....M.11 t~.C Register of Deo_ds o0
("Purchaser", whether one or more).
Vendor sells and agrees to convey to Purchaser, upon the prompt and full per-
1 _ formance of this contract by Purchaser, the following property, together with the
rents, profits, fixtures attd;other appurtenant Interests (all called the "Property"),
4 in......C....GXQi County, State of Wisconsin: RaTURN To
West one-half of Northeast Quarter (140001st)
except the east 8 rods, and the Northwest
Quarter of Southeast Quarter (NWIZSEtt), except
the south 6 rods, all in Section 29, T29N, 19W. Tax Parcel No
TRANS`oA
C ~
$ FEE
to
This is ,not homestead property.
(is not)
Purchaser agrees to purchase the Property and to pay to Vendor at 208 8th St......... Hudson, WI
the sum of s 56..15.4r00 In the following manner: (a) Q..QQQr.QO.............................
at the execution of this Contract; and (b) the balance of E 23EJ, Q.OQ together with interest from date
hereof on the balance outstanding from time to time at the rate of.nine..X9X per cent per annum
until paid in full. as follows: Interest to January 11, 1988 shall to $1,320.29.
$80,000.00 plus interest on the unpaid balance on January 11, 1988.
$50,000.00 plus interest on the unpaid balance on January 11, I.M.
$50,000.00 plus interest on the unpaid balance on January 11, 1990.
$56,150.00 plus interest on the unpaid balance on January 11, 1991.
The above payments shall be made in addition to any payments made for the conveyance of
lots until the total price is paid in full.
All payments shall be by 2 checks, one to each Vendor for )4 of the full amount.
A 1 of .BealTase Ag6eemint h~l~ sso been algal dpgj t4i~ date11th
ovee ng ha once s e at In u on or the day of
r , Ilwrcer, to ell Ire ou s an I
Anuary 19.11.. ( the maturity date).
Following any default in payment, interest shall accrue at the rate of .19....... % per annum on the entire amount
in default (which phall include, without limitation, delinquent Interest and. upon acceleration or maturity, the entire
principal balance
Pmebsalrr a dese excused by Vender, agrees to pay msethly to Vendor amounts suffieient to pay rrnrnnably antici-
pated, annual taxes., RpwlNl R.MW*mentF, fire Rail rwplire(l imluraneio premiums when dtse. To the extent received I,~- Vendor.
Vander agrees to +.HAF pai#"nta to the" tawivatio to when due, Such amounts received by the Vendor for payment of
taxes, aFprAalttenta and insurance will be deposited into an sperow fund or trustee account, but shall not bear interest
w"Iessotherwise required by law. Any amount may be prepaid on principal at any time.
Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any
amount may bs prepaid without premium or free upon principal at any time after 19....... (OR)
" " r@F"OV42"le pro f.".
lhere-rrtav be ►IO prepayment of principal without permission of Veador.'r
In :he event of any prepayment. this contract shall not be treated ait in default with respect to payment so long
as the unpaid balance of principal, and interest (and in such ease accruing interest from month to month rhall he treated l
as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been
:Wade as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds
of insurance or condemnation, the condemned rremiset being thereafter excluded herefrom.
Purchaser states that Purchaser Ia satisfied with the title as shown by the title evidence submitted to Purchaser
for examination except:
Purchaser nereer to pay the coat of future title evidenct. If title evidence is in the form of an abstract, it shall
be retained by Vendor until th-- full purchase price is paid.
Purchaser shall beentitlcdto take possei,sion of the Property on the date h.reuf . lp
u .(•r,,,. (In ur,
LAND CONTRACT - Indiv'dual and r;Tt71' 141tit OF WISI-11%MN ?lure.„+' 1t`'I wAnk ro. Inr
Corporate FI1NN Xn. 17 IYOt
I
L
STC - 105 ri
w
SEPTIC TANK MAINTENANCE AGREEMENT rt
St. Croix County
w i
OWNER/BUYER
w
0
ROUTE/BOX NUMBER Fire Number o
t7
CITY/STATE ►y`,;_'*?ZIP "'f%J 93
PROPERTY LOCATION: Section aka T ? N. R
Town of St. Croix County,
Subdivision Lot number.
Improper use and maintenance of your septic system could result in
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 licensed 's'e tic tank pumper. What you put into
the system can a ect t e Function o the septic tank as a treat-
ment-stage in the waste disposal system.
St. Croix Count residents may be eligible to recieve a grant for
a maximum of 60% of the cost-of replacement of a failing system,
whi.cK -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 s't'ems agree to keep their system properly
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 condition and .(2).after inspection and pumping (if nec-
essary), 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.
H
I/WE, the undersigned have read the above requirements and agree o
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
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
a `f~?
SIGNED Z(;;Ai
DATE
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 & BUILDINGS
•IN•DUSTRY, C DIVISION
`LABOR AND PERCOLATION TESTS (115) MADISON W 7969
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATION: SECTION: OWNS,HIp /MtTr1rCTPAt+?Y: LOT NO.: BLK. NO.: SUBDIVISION NAME:
r4W ~4 r4L 47-9 /T19 NAM E (o W 1-4uhS6rj 2L ec)ES),o4s COU.,,Towilw
COUNTY: OWNER'SB'f'ITWS N* V E: MAILING AD R SS: 4u
t]c~T ~j~ oaa t1 j SA 61
6
RoIA 75pN ~1 ILL&iQ
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: 1COMMERCIAL DESCRIPTION: PR FIL D IP ONS: LATION T TS:
/ f~
FXResidence u~K New ❑Replace 3QLy 20 /990 ~Ly 23,
-S6) L_- 86ak 16 6G So ) I_s $ S _'T_ k'
RATING: S= Site suitable for system U= Site unsuitable for system
r ~~TI❑U. M[Z~. aUN JI❑~ ISYSTEM-1 ❑N-Fl ~ L HOLDING TANK: RECOMMENDED
Copy V &NT 0~Lptional)
® X'S o
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: CLd55 ' Floodplain, indicate Floodplain elevation: AIA
c~T PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH 15,, ELEVATION OBSERVED EST.Hl CHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- / 9.O% 9.01& -&-a3 /9 "SW 14 &.4 A ~~"BQa ~o► b~}! " ,ti s
B-7 9,7~ 99.S2- ~onJ2C 7 ~'S "$C,[_ TS 7' zoL 33'8a.. ms -M k K9 "Pp., r"S
B: 3 /62.4% 9.67 11"LL-rs i3'Be L. /o east, ►1"BaualLt 5~"$QN N►S
B- 4 9.So of o wjLr > 9.1so 31 "&CrS L 21IS*mM544e 3N5
B- S Il,so os.a3 rj(5tjLc > rl. so 9"$c.ScYS 24"I9P C_sNGtz 9/ 7$ Q,.)117 z4°~
cstiG a
B-
-c Vr PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INIWS AFTERS ELLING INTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD PER INCH
P. 1 .00 Qf 05.40 '1 > >Z <3
P_ d0 o io~,4o ~Z > > Z ~3
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 COAo
A
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I, the undersigned, hereby certify that the soil t is reported on i orm were m/adee d with the procedur es and methods specified in the Wisconsin
Administrative Code, and that the data recorded an he locatio the sts are comy knowledge and belief.
NAIAVO print): 1 TESTS WERE COMPLETED ON:
30Nr.1SoAJ "low' +ow ~R4&y /Ax tic ULY ~3 l94 d
ADD ESS: CERTI ICATI NUMBER: IP
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CST SI ATURE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
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