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Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER TOWNSHIP Hee rc awt SEC. C2_90 _T 2-y N-R / 9 W
ADDRESS ST. CROIX COUNTY, WISCONSIN
I jf u~ sue,.- W Z Sid
SUBDIVISION LOT a 8 LOT SIZE ~•O~c~/S
PLAN VIEW
Distances and dimensions to meet requirements of ILHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
w~~1
Q y~ bus
~ ~x Zy 10,
0, 1Aj_ 01
or- - - - I I g~
~ $7 l
~ 5
.Q B.M.
- INDICATE NORTH ARROW
BENCHMARK: Describe the vertical reference point used
Y_
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer: (jj of Liquid Capacity: 4=5 Oa
jjr,V
Number of rings used: Tank manhole cover elevation: a Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front 10 Side0 Rear, s feet
From nearest property line : Front 10 Side 0Rear, 0 j i b feet
i l
Number of feet from: well lc7 building: `L
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
SEE REVERSE SIDE
PUMP CHAMBER
Manufacturer: A -IA- Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Ft.
Number of feet from nearest property line: Front, O Side, O Rear
0
Number of feet from well: J
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: ion ~en.l ;ova Trench:
:4~~~ {
Width: Length: Number of Lines:__ Area Built
1
Fill depth to top of pipe: Lf~
I
Number of feet from nearest property line: Front, O Side, ® Rear,O Ft. s~V
Number of feet from well: 4 S j
3/ i
Number of feet from building:
(Include distances on plot plan).
SEEPAGE PIT
Size: A/A Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution box O been used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: QL Capacity:
Number of rings used: Elevation of bottom of tank:
Elevation of inlet:
Number of feet from nearest property line: Front, O Side, 0 Rear, 0Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
Inspector:
Dated: Plumber on job:
License Number:
3/84:mj
DEPARTMENT 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 u , NE-;,, Sec . 29 , T29-R19 ❑ CONVENTIONAL ❑ ALTERATIVE (If assigned)
Town of Hudson, LLI 'holding Tank ❑ In-Ground Pressure ❑ Mound
IT H L F PERMIT HOLDER: INSPECTION DATE:
Sam Miller F"Box-208, Hudson, WI 54016 (p- 1o2-F6 /6'60
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. LEV.:
Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number:
Doug Strohbeen 5432 St. Croix 135463
SEPTIC TANK/HOLDING TANK- .l 4,
MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTL ELEV.: WARNING LABEL LOCKING COVER
/ PROVIDED: PROVIDED:
OYES F-1 NO F-1 YES M NO
BEDDING: 111 IA.: 7-. MATL.: HIGH WAT NUMBER OF ROAD: PROPERT WELL: A BUILDING: VENT TO FRESH
ALARM: FEET FROM LINE: AIR INLET:
❑ YES O NO c ❑ YES NO NEAREST 7 C 3_2 P,4
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER
PROVIDED: PROVDED:
❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
(DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET:
PUMP ON AND OFF ❑ YES ❑ NO NEAREST -I►
SOIL ABSORPTION SYSTEM. Check the soil 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.) ;
CONVENTIONAL SYSTEM:
BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID
TRENCHES: / MATERIAL: PIT DEPTH:
DIMENSIONS -
/,S
r1
GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTFI, PIPE MAT RI.At, NO TR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW PIPES: ABOV~ COVW: ELEV. INLET: ELEV. END: 5/ NOC. PI ES: LINE: i AIR INLET:
„ / , FEET FROM /
NEAREST
MOUND SYSTEM:
Mound site plowed perpen Icular 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:
ELEVATION AND ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.:
DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO
INFORMATION APPROVED PLANS
❑ YES ❑ NO ❑ YES ❑ NO
MBER OF PROPERTY WELL: BUILDING:
PERMANENT MARKERS: OBSERVATION WELLS: iAREST-
COMMENTS: ET FROM LINE:
❑ YES ❑ NO ❑ YES ❑ NO ~
Je,
u
etch System on Retain in county file for audit.
Sk
Reverse Side. SIGN URE: TITL
SBD-6710 (R. 06/88) n c
~ILHR SANITARY PERMIT APPLICATION
In accord with ILHR 83.05, Wis. Adm. Code COON ;WJ
STATE SANITARY PERMIT
-Attach complete plans (to the county copy only) for the system, on paper not less than
8'f X 11 inches in size. Check i revision tc previous 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
S2 T N,R E(o W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
CITY, ST TE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
a OS i14 ~a V
11. TYPE OF BUILDING: Check one CITY NEAREST ROAD
( ) ❑ State Owned ❑ VIL
LAGE : c~ r t9~~v
OWN OF: A( P"s
❑ Public 'RI 1 or 2 Fam. Dwelling- # of bedrooms AR ELTAX NUMBER( )
Ill. 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 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. N New 2. ❑ Replacement 3.E1 Replacement of 4. ❑ Reconnection of 5.E1 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 Jr] 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 LEV. 7. FINAL GRADE
REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) C I ELEVATI9N
d / y 0.7-7 G AO- _406rFeet 99,Z Feet
CAPACITY
VII. TANK Site
in allons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
INFORMATION New xistin Gallons Tanks Concrete structed glass App'
Tanks Tanks
Septic Tank or Holdin Tank 1000 S % mt/ H I F] F-1
Lift Pump Tank/Si hon Chamber
Vlll. 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:
3 Z 4{7 S~ 3
Plumber's AIldress; (Street, City, State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin gent Signature (No Stamps)
Approved El Owner Given Initial Surcharge Fee)
Adverse De rmination / / V
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
r
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 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'f2 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.
SBD4098 (R.11/88)
'I
. 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 petmit issuance. Should this development be intended Lot resale by
sold second should
this office retained
with the
completed owner/contractotelopec
property Is then
appropriate deed- recording.
of property x122 6rh%
Location of property/j/-W 1/4 Section TaL-N-It 5!/
Township a
Melling address a 4 # Z A Z
Pit, n- aj;
Address of site cow.Ar % v%
Subdivision name "-55""4~
Lot number Z8~
Previous owner of property -16 ~STrkZ
Total also of parcel Z a
Date parcel was created 41 1 7 - si7
Jiro all corners and lot lines identifiable? as o
is this property being developed for resale (spec house)? _Y' as 0
Volu" U-2-and Page Number !74_3;~ 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 ORAL OF THE REGISTER OF DEEDS. In addition, a certified survey, It
available, would be helpful so as to avoid delays of the reviewing process. It
the deed descrlption tolerances to a Certified Survey Map, the Certified Survey
Map shall also be required.
PROPERTY OWNER CERTIFICATION
I(Ve) certify that all statements on this form are true to the best of my (our)
knowledgef that t (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. ge 7; ? z ;YZ j 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
1.
Of the County Register of Deeds, as Document No.-/ -Z Zz-2 0
=%4= 2Z~"
SI ture l Owner Signature of Co-Owner (If Applicable)
_y- (Cl -..r'v
Date of Signature Date of Signature
9 (49
DOCUMENT NO. STATE BAR OF n 19CONSIN FORM II - t9111-` Is a►At[ R[[1RV[D IOR R[COROINO DATA
LAND CONTRACT
E 1`•
. Iwal.u.al 0.04 Corporal. REG~~TERr$ V~f~C
he rye~(~ ITO nF 11SF.O FOR ALL. TRANAACTIONS WHERE. OVFR
43*223V ,-\n110 la FINANCED AND IN OTHER NON-CONSUMER $T. CkfaX CO., W~
V ACT TRANSACTIONS) . = trtl p:3Cofd
Rc:c
' Noventb~~,3,T,19.8.Z.--
ContraCt, b) and between . F.tIXX£At..1;....:1RRR.~!)13.nnd
.
..RukY...Q?ljjqY.a. a sin~,le 1225 P M
("Vendor".
whether one or more) and...Sr91Q.Fi.,..M.11~Q.C Register of Deeds
. ("Purchaser", whether one or more).
(~~n
Vendor sells and agrees to convey to Purchaser, upon the prompt and full per-
formance of this contract III Purchaser, the following property, together with the
rents, profits, fixtures and other appurtenant interests (all called the "Property").
(n.......~C.,..QXQAX County, State of Wisconsin: RcruaN To
West one-half of Northeast Quarter (10INVi.)
except the east 8 rods, and the Northwest
Quarter of Southeast Quarter (NW16 00, except Tax Parcel No
the south 6 rods, all in Section 29, T29N, 19W.
i "SJ~R
FEE
This is .not,. homestead property.
(ia not)
Purchaser agrees to purchase the Property and to pay to Vendor at 208 8th St., }ludson. WI
the sum of =.256,.150r00 in the following manner: (a) =.2Q..OOOr.QO.............................
at the execution of this Contract; and (b) the balance of = 23Fr 1 together with interest from date
hereof on the balance outstanding from time to time at the rate ounine..1;9X per cent per annum
until paid in full, as follows: Interest to January 11, 1988 shall ~e limited 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, 19b9.
$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 ~ of the full amount.
A ~ot RedlVse Ag~eemNnt h~1aass ~ adleo been sli lEdpota tIl1g dateb 11th
day of
rove a owever, le ell ire ou Ing ha ance a t e as in ull on or efore the day
....*Lmuaiy 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 1•
lPueebasert unleee excused by Vender, agreed to pay monthly to Vendor amounts sufficient to pay rvaronahly antici-
pateA annual ta.aee, a/ 4-iml a»w nw-%tf, fire and required insurance premiums when doe. To the extent received by Vendor.
Vander We" to i.pply payruents to these obligations when due. Such amounts received by the Vendor for payrnent of
taxes, agm, emenw and insurance will be deposited into an escrow fund or trustee account., but shall not bear interest
unieesotherwise 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. AnyL
amount may be prepaid without premium or fee upon principal at any time after . ......ii""'......, 19....... (OR)
there may be no prepayment of principal without permission of Vendor.'r A'
In :he event of any prepayment, this contract shall not be treated ail in default with respect to payment so long
as the unpaid balance of principal, and interest (and in +uch care accruing interest from month to month rhall he treated
as unpaid principal) is less than tl,e amount that said indebtedness would have been had the monthly payments been
made as fist specified al.oce; provided that "sithly payments shall be continued in the event of credit of any proceeds
of insurance or condemnation, the condemned premises being thereafter excluded herefrom.
Purchaser states that Purchn!vr Is satisfied with the title as shown by the title evidence submitted to Purchaser
for examination except:
Purchaser asrrecn to pay the cost of future title evidence. If title evidence is in the form of an abstract. It shall
be retained by Vri!dor until th-r full purchase price is paid.
Purchaser shall beentaledto take IpPsseB%ion of the Properly on the d~[t~ ht•reuf . 1P
•cr..., nu: for.
LAND -ONTRACT - Indly-dual and ST 11: 11\R toF WIFI'OV~I\ N'•r n l.•ra1 11:an4 fo. In,
►OH\I Nn. II (fat lln,•...+.., Ko.
Corporaa
OEM
i
STC - 105
SEPTIC TANK MAINTENANCE AGREEMENT rt
St. Croix County
r
OWNER/ BUYER fj~, 12~
ROUTE/BOX NUMBER Q,~zv Fire Number
ty
CITY/ STATE.
STATE .1,, I&L.,s mj ZIP o
PROPERTY LOCATION : Jt/W Section,29 1=-M , R_
Town of St. Croix County,
Subdivisionevss",, U, Lot number Zg'
Improper-use and maintenance of your septic system could result in
its premature failure to handle wastes. Prover maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed'se tic tank pumper. What you put into
the system can affect the function o the-septic tank as a treat-
ment stage in the waste disposal system.
St. Croix County residents may be eligible to recieve a. grant for
a maximum of 60% of the cost.of replacement of a failing system,
whi"ET 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'tems 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
if nec-
operating condition and .(2) after inspection and pumping
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.
o I
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 Depart-
ment of Natural Resources. Certification form must be completed •d
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
SIGNED C
DATE L
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
INpUSTRY, DIVISION
P.O. BOX 76
LABOR AND PERCOLATION TESTS (115) MADISO
HUMAN RELATIONS
N, WI 53707
(ILHR 83.090) & Chapter 145)
LOCATION: SECTION: TOWN HIP/Mtifd+@+PYkt-ITY: OTNO.:BLK- NO.: S BDIVISION NAME:
Nw l/ N~ 29 /T79 N/R►9 E (or /Z_ t z )S
COUNTY: C MAILING AD ESS:
SD'~»~OIX AM M1~A1~ I e~(Jv pbC~K NUdSv►.. Y~/ r ~~i1~
USE DATES OBSERVATIONS MADE
NO. BEDRMS.: 1COMMERCIAL DESCRIPTION: PERCO A } ES S:
Residence uN1~ eNew ❑Replace
"T 'T r 1
50t~s K 4 S,o1~.S
RATING: S= Site suitable for system U= Site unsuitable for system -PRESSU I STIOu ONAL: M s. E~ IN G~~ Ou RE: SY M-IN~FILLHO~LDING TANK: RECOMyVtMENDE T M:lopt`
If any portion of the e to ,gal)
If Percolation Tests are NOT required DESIGN RATE: Uu G L
tested area is in the
under s. ILHR 83.09(5)(b), indicate: C1Lt4SS ' Floodplain, indicate Floodplain elevation: 'V
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTHW. ELEVATION OBSERVED EST. I HEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B- 17 /00.69 0 tr- > 9 23"@«TS 70'~P, 1 7 "~QNc~~G~ do""BeN Ms
B- z 1,97 /01.4( NoNg > 9Z i~,.~~ s ► "BeN~ aNLS-~G>e 6o"~Qy r~,s ~1G>a
6- 3 k F7 /ol.tz No,N1 ? 8.11 7 ELLTS 19 M5 72'"8 NC5 GR
B- 4 LCI 09.E 00vC > -7 R.'le C '.9R,,L gaN >S II cst Ge
B oNI[ > 8.o6 cc" 6
B-_F_
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES
NUMBER S AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R PER INCH
P. 3.~5 Nic) k, I[ loo -10 >Z >Z, <3
P- Z S.zS 0j C'm V_ col- so 2 <3
P S.S /ol.Sco >Z >Z > 2 <
P-
P
_P_
PLOT PLAN: Show locations of percolation tests, soil b ings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show heir location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope. S
SYSTEM ELEVATION. 96 g
v„r g_
_41R_
/ 95 D
QJ L1CUMAR~. -iRo~ _Pr p~ Sc.nL>~
4-r 5 W LoT. CQ N ik k NEAR . /
4Z,
'rkLEA 14014 tt . Pk Av.°ta L .
So AS
1, t/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
Ad Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAM (print): 1 TESTS WERE COMPLETED ON:
N~~V~y JowNSc~~, SUB ->uVG%t Nt, /Nc- ~,Prelc 990
AD R~S~ECLN~ CERTIFICATION NUMBER: P~iONE NU~tN'BER(optional)
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CST SIGNATURE:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
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