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o ° ~ o 03 °<3 I 06-+ 0 ao ° I m n c rn c 4 0 o I o c cv o a~ x a in m (n m N (n m= Y any- a) OM c a) (D L) O = w .p ~ ° I m~ (p C NO 0 E I O O O Oa Y> V O U O A C N m y m O)~ N o 5 3: >m L) -,z o r- c 2? 0o I c E'er h a o a> 0i a"i rn m a> (n00M I N ?~o0 Fr Y~ CL N O -L U N W.- N' O y g Y O E° d m 0 U) En C Z •C .L+ L 'O C C Z y c= m C13 m '2 O O O.L _O m m a U O O u~ E€ c 3 Y Y y O O O Y O O Q (O N U a. E Q (c .m.. Z U I m 04 "t z y y CC) Cl) !I C = C v o E o Z a m I a m r~ IN- z o o E z c v o =oo w o I `y z of 2 c c Z to t- C o O N co O d M -0 0) 4) ca C O I N O :1 CD i N L L O ~ L = ° O r c O O z H Z I z I~ Z 6 ° I z Z ~N N C C d C V N N cl, E d CL •N O I (O d : O c It U) CD c ~i O p G 0 d L 1 Z; G o a N Eo bap Z~> I~~N E •N ~ I ~aaa Naaa I II d (°n ° CD m o N _ ° I= °D N J V rn rn Z m I~ ~ m ~ Ts IH ~ ~O I Naa - o I c Mao :25~ E N co 0 0 D (D E a = O 75 O O = N = w a I Lo m y m o (D c o (n aD m fl ° d ,n o Q> m to v ¢~in m O 0 0 c w c I y c C, 0 O O co m- I V a co y V d O o °M' oo U C c O C -O CD C a C N N a0 C (D `o y C d l y o O C N v co 0 lx' p °75 :z ~ o W Z C N a Lo y ai IL- rn co N r-- C N rn O y 0 •m U (D Cl) `O w E •m U O C LL ^^ii O O Y U. Z C I- d fn z r \ C: V t% d E a I E a • a j m a I d a .2 1 ~`Iv o 3 o 3 IS 'o t A t~ a O U) U 0 U) 0 Fora - S T C - 104 i AS BUILT SANITARY SYSTEM REPORT OWNI*s"i : _ _ F, r~""TOWNSHIP. l ' n t. SEC.: T "_j_D• N-R~W.' ADDRBS _.,~°t ST. CROIX COUNTY, WISCONSIN 8 46DIVIBION LOT, LOT SIZE PLAN VIEW i Distances and dimensions to meet requirements of IfLHR 83 . ~ i I SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM x/ 't _q vii Oki SE Sf1Ga'~".ACP. ~•,Csrii 1(3c3. 3 r zr_ t fit.: , • A~ i. ..w-.v- .r . w,. W.+.+r.•rMA•+a...a. .y.,,.. ;...aan • . . t. .S i4 i~~ ✓ ~ 'P ~1 , INDICATE NORTH ARROW • .,BENCHMARK: Describe. the vertical reference point used D7~c?rYl lJ lid f , Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer:, &l ez s ~.1~, Liquid Capacity: " "Number 91 rings used: Tank manhole cover elevation: • t- - -Tank Inlet Elevation': fy- Tank Outlet Elevation: Number of feet from nearest Road: Front, Side, Rear, O llse'' t feet From nearest-property line Front.0Side 0Rear, 0 /,-/0 feet Number of feet from' well building: (Include this information of-the above plot plan)( 2 refeizince dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: 0- 45 Liquid Capacity: ' Pump Model: Vy 5 3 Pump/Siphon Manufacturer: zd //Q• Pump Size 3 hp Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Pae- a /&"r" Alarm Switch Type: LPrc&,L;L -Number of feet from.-nearest property line:`. Front, OSide, ©Rear,© 'Number of feet from well: Number of feet from building:_ (Include distances on plot plan). . i SOIL ABSORPTION•SYSTEM Bdd:, Trench: Width: Length: .-'Number of Lines: z Area Built: Fill.depth to top of pipe: Number of feet f m nearest property line: Front, O Side, O Rear,OTt Number of feet from well: OZ~ N or of feet from building: 2 (Include di Lances on plot plan). SEEPAGE PIT ` Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box Q or distribution box O been used on any of the above soil absorbtion sytems? (C eck one). HOLDING TANK i; Manufacturer: X M Capacity: Number of'.rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: ry Alarm Manufacturer: ( 1 Inspector:. Dated: Plumber.on job: r~ License Number : 3/84:mj R L 'DEPART10 ENT 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 X State Plan I.D. Number: NIP, SW.;,, Sec. T28-R18 ~ CONVENTIONAL ❑ ALTERATIVE (If assigned) Cg Of_ KinnickinniC❑ Holding Tank El In-Ground Pressure ~ Mound P __j NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: I INSPECTION DATE: Randy Feyereisen Rt.l, Hudson, WI 5401 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF.-PI-ELEV.: /J t,J. fir /60.4) ` [/`p Name of Plumber: MP/ SW No.: County: Sanitary Permit Number: Roger Timm 3 24 St. roix 135452 SEPTIC TANK/H@1QK: MANUFACTURER: [QUID CAPACITY: TANfk INLE TANK Q)PLET E ARNING LABEL LOCKING COV5 / ~q PROVIDED: PROVIDED: w ~l ) l/s'.~°•v'' i~ . ~ r YES ❑ NO F-1 YES NO BEDDING: Y[1tlTDIA.: ATL.: HIGH WATER MBER OF ROAD: PROPERTY WELL: JBUILDING: VENTTO RESH ~ h( FEET FROM LIN ~ / AIR INLET 4-,sa, . f7, A RM: ❑ YES NO NO NEAREST J DOSING HAMBER: 43t&M MANUFACTU ER: BEDDING: LIQUID CA A MP MODEL: PUMPWAPH6NMANUFACTURER: WARNING LABEL LOCKING COVER /J PROVIDED: PROVDED: O UnC// L~..JC YES ❑ NO YES ❑ NO ❑ YES N V GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF ROPERTY WELL: BUILD ' VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM P LIN ; C ! AILET: 530 PUMP ON AND OFF = ll3 ES F-1 NO NEAREST ~ SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: ~ or excavation. (If soil can ' ti rolled ' wire, construction Shall cease until MAIN , A~7T~` c~ the soil is dry enough to connue /l.®, Gc./2 . 5 e e'/ CONVENTIONAL SYSTEM. ' ee~ U WIDTH: LE NO. OF T I ISTR. PIPE SP ING: COVER DIA.: # PITS: LIQUID BED/TRENCH TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE [DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET: NEAREST 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' 0-3 F. IV. t ;o& cF(d/- 7 71 BED/TRENCH WIDTH: LENGTH: 6"Q ~ LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: RENCHES: 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 INFORMATION HOLE SIZE: HOLE PACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO ' APPROVED P NS /./".:7z, ❑ YES ❑ NO YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROP TY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST Sketch System on et n in county file for audit. Reverse Side. RE: rITLE: SBD-6710 (R. 06/88) SANITARY PERMIT APPLICATION 9 Q 6 T DILHR In accord with ILHR 83.05, Wis. Adm. Code COON STATE SANI ARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than I 8i~ x 11 inches in size. ❑ check if rev sion'to p evio 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 0A , (d 0'/aSCJ'/a,S 7 TZ8',N,R IF (Or W P~RTY OWNER'S MAILING ADDRE LOT # BLOCK# CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER of , 1 m S m tl t_~ 1 z1 II. TYPE OF BUILDING: (Check one CITY NEAREST ROAD 11 State Owned VILLAGE r1✓1 I C fn 091Co ~,e _Ot ❑ Public V1 1 or 2 Fam. Dwelling-#~of bedroo Csj-ARCFI TA NUMBER(S) 111. BUILDING USE% (If building type is public, check all that apply) /O ~ /3 lJ 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 80 Mobile Home Park 120 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. ❑ New 2.0 Replacement 3. >1 Replacement of 4. ❑ Reconnection of 5.E] 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 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE 7 REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ► i q9, 00 ELEVATION J00 00 (o CFO a 1000. 30 -T Z 9 q.qcFeet /0J. 11f a Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holdin Tank t ~.Q1L ! C. Lift Pump Tank/Si hon Chamber 1513 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: ( o Stamps) tPLMeBaW No.: Business Phone Number: ?;4r ' j ) 2 7l 7 Z L 37.t Plumbel's Address (Street, ISO"L , State, Zip Code): r j/ b 2,- 7 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date issued Issuing Agent Signature (No Stamps) Surcharge Fee) 41 If 4 Approved ❑ Owner Given Initial~~- Adverse Det rmination JJ~~ e, C-hlagu 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 f * ; a 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 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. 11. 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. Vlll. 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 (A.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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property To Location of Property N W , Section , T',_ -R W Township Mailing Address Address of Site Sq {y~ Subdivision Name ..Lot Number Ibp ty9, Previous Owner of Property ~'a\m , JSZ_aL Total Size of Parcel Date Parcel was Created jk Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number 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 refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) centi,by that att statements on this bonm aAe tAue to the best ob my (oun) knowledge; that _1 _ (we) am ( cute) the owner (s) o b the pnopeh t y des cribed in tW inbonmati,on bonm, by viAtue ob a waAAanty deed neconded in the Obbice ob the County Regi6ten o6 Deeds as Document No. ; and that I (We) pnea eWy own the pnopos ed .6-i to bon the sewage d.i 6 pod s ys em (on I (we) have obtained an easement, to nun, with the above danibed pnopehty, bon the conatnuction ob said system, and the same h.66 been duty tecokded in the 046.ice ob the County Regi.6ten ob Deeds, as Document No. SIGNAT OIL OWNER IGNATURE OF CO-0 ER (IF APPLICABLE) 3 ao ~Q~ DATE SIGNED DATE SIGNED L - • DOCUMENT NO. WARRANTY DEED I~ THIS SPACE RESERVED FOR RECORDING DATA ~ I STATE BAR OF WISCONSIN FORM 2 -1982 ' 1 - - (17 REGISTER'S OFFICE ST. CROIX CO., WI l John Wil_liam__ Feye__reisen and Carol Ann Feyereisen, Reed for Necord l husband and wife as point tenants ;I MAR 2 8140 8:30 A . 11A conveys and warrants to .Randy J. Feyereisel and Jana__ L : Feyereisen,_• husband and wife as--survivorship__marital M Ryis19rofp property-- il I , _ i RETURN TO l it the following described real estate in S-1 Croix_____________ County, I State of Wisconsin: Tax Parcel No: 06 - - - - ;i Lot One (1) of Certified Survey Map recorded in Volume 5 of Certified Survey Maps, Page 1321 as Document Number 386751 being a part of the Northwest 1/4 of the Southwest 1/4 of Section 7, Township 28 North, Range 18 West, Town of Kinnickinnic, Ij St. Croix County, Wisconsin. l AN I! D ALSO 4yf Ii That certain parcel of land located in the Northwest 1/4 of the Southwest 1/4 of EXE Section 7, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, I' Wisconsin, more fully described as follows: Commencing at the Northeast corner of j! Lot 1 of that Certified Survey Map recorded in Volume 5, Page 1321 of St. Croix County Certified Survey Maps, the POINT OF BEGINNING, of the parcel to be herein Ii i described; thence S03°05'45" E 483.93' on the East line of said Certified Survey i' Map; thence N 90°00'00" W 333.16' on. the South line of said Certified Survey Map; h thence S 02°34'50" E 75.00' on the West line of the Southwest 1/4 of said Section 7; j thence N 90°00'00" E 483.84'; thence N 03°05'45" W 558.96'; thence N 90°00'00" W ' I (assumed bearing on the East/West 1/4 line of said Section 7) a distance of 150.00' to the POINT OF BEGINNING, being subject to easement over Northerly portions of said parcel for town road purposes, as now traveled, being subject to easements of ~i This s. no_t.......... homestead property. of record and containing 2.496 acres, more or i (ft) (is not) less. i Exception to warranties: ; I ! easements, restrictions and rights of way of record, if any. I c/ I j Dated this day of F9bKt1-4KY..-••-........ D 19.... 0.. I ----------------------------------•-----------------------•---•------(SEAL) ~John /"...(SEAL) William Feyereisen (SEAL) (SEAL) * Carol Ann Feyereisen I AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN I i J ss. ! ------------------------County. authenticated this day of 19--.--- Personally came before me this ...JS.a day of F_eb.ru_q.rv 19.90 the above named ' j I ; s John William Fe ereisen - - TITLE: MEMBER STATE BAR OF WISCONSIN Carol Ann Feyereisen - (If not- authorized by § 706.06, Wis. Stats.) to me known to be the person . S-------- who a la~ea~Ne 6 fUoin instrum tan c knowledge the dw F, THIS INSTRUMENT WAS DRAFTED BY Joseph D. Boles Attorney at Law W ` aSJ River Falls, WI --54022 (715) 425-7281 Notary Public yIf (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, 3)ata.rxpir,ation'-.*' are not necessary.) date: -Names of persons signing in any capacity should be typed or printed below their signatures. BAR ~iacrtt~r STATFORM No. W ISC 82 SIN Stock No. 13002 Form No. 105 1-2 t" C~ Y SEPTIC TANK MAINTENANCE AGREEMENT r~+ St. Croix County ° z r7 9 OWNER/BUYER PND\ ~w4X~lSar~ ROUTE/BOX NUMBER Fire Number ~dJ CITY/ STATE__ Q440n -ZIP IS-Y0 J (1~9 PROPERTY LOCATION:N L'4, _SW 14, Section, T_3L9 N, R_W I Town of K1nr1i C_ Kinflj St. Croix County, Subdivision r1oruQ_. , Lot number r)ortr 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 septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% 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 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. 0 E I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- 10 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. SIGNED DATE 3/ 0/ 70 St. Croix County Zoning Office P.O. Box1 Hammond, WI 54015 715-796-2239 Sign, date and return to above address. lrl 'f,H' IvlchlT OF RZIE-PORT ON SOIL BORINGS AND SAFETY & BUILUII~(i5 s!J1y'.J; fPY, DIVISION 17•BOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION: T )I-, OWNSHIP/ . OT NO.: IBLK. NO: SUBDIVISION NAME: I'M t svA Z8 1)I-, - - - _ / -7 %T N/R E for lNU) c tt=7A.1N i~ COUNTY: OWNER'S aV*E-R'S NAME. A TNG ADDRESS: ST Z_2Zbtx -Sottr.~ BEY ~sE57~'3 Trot yM 1 Hup'TOAJI L-J,. Sy011 USE DATES OBSERVATIONS MADE ROFILE DESCRIPTIONS: PERCOLATION TESTS DESCRI: NO. B : COMMERCIAL T O Residence .New ❑Replace rj.t~ -a3 Q-Z3- B3 RATING: S- Site suitable for system U- Site unsuitable for system ONVENTIONAL: MOUND: JIN-GROUND.PRK_: IS YSTEM.-IN-FILLIHOLDING TANK: RECOMMENDED SYSTEM:(optional) r ~S DU 'a S ❑U • NS ❑U D S GNU D SU z T,ZerJc.Ht`s-„ S rX 60 If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(h), indicate: N Floodplain, Indicate Floodplain elevation: - - PROFILE DESCRIPTIONS BORING TOTAL DER H T R UNDWATER•Itd S CHARACTER O SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH LEVATION gSERVED IGRES-r TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) _ EST. r 0.3' 8) s TS ; Z. o' GY Br s i 1 •3' 8n. S W/.. i - B- 1 . g' 9$.-l 1Jul i E »+oT'@ S. 6 ! yk Bm s ' o , z' LT ev, 'fr w G C S T o•y, Rl T47 73 S 1-Y' B- Z 3.0 101. y' tor, lU ~ > 8.0 ' ok. G n s I B Novo s o-y' 181 s:) I-S G4 Ba si) o-SS.J B- 100.8 ~oN~ -7.0' er__1 w -Z)ic.-s err>`•os _ a. s 'B.. S wl . D! B- y S .1 g s . 6' t~ 0>.,1 rn o'r ca S, o r o • B - S S C~• 9$. S~ lJOru~ tvt o't G~ 3-8 rr,~, B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INGIISS AFTER SWELLING INTERVAL-MIN. PER INCH P. Z z o' tJO 3n r 30 3/ ~i 17 P. 3 ~ . o' IJo 3 O P- R 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. Q cli 1 V • 99, oo Q,1 S St xrt f1 Gp SYSTEM ELEVATION CO• _ ` C~ '$.zo' I 'WSJ v. pt I►J' 1 FJIS FeJ .E I -01 PjT ° I 5, S ~ 1 yDU~ ' i 1 So' rh fT '2b!t-AJ G'Cft. F ~ f7 V)' x "St' _ - i e i,~ I I~. - 1 I3Ol SY77~l1~ 7%VLt-~ R1' - J i _ I ^ ` '•.-_a•,ts sl$ f l p~ 1 !''-1, - - + - ' - -r-- - - ! _ I r ' t N -:zp 4P I +vt _ I 1 rt 0c r , ' I i LJ ;----j---;, j - i 1 ~ 1TtR J1 _ - t + -s'' • ; -F- I i I i -TlL~v B3 SI416. I 1~ + I vI - t 11T C N E `%t = %40 1 E}c CST h S S!• "470 Sec. 1 1, 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: ;S- a3- 8Z ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): T~c~.n-~: y emu. 2Z6 ~1-LSwal~.: Lv 1. 54'x!1 1 •S76 7r5- y~S- 93y~ CST SIGNATURE, ISTRIBUTION: Origina: and one copy to Local Authority. Property Owner and Soil Tester. :LHR-SRD•6395 IR 071821 OVER - roe~u /vv v1skr1. TIMM EXCAVATING Route 1 Box 192 SHEET NO. OF Z WILSON, WISCONSIN 54027 CALCULATED BY DATE J Z~- 20 (715) 772-3214 (715) 386-5443 / MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE 4.. -'----r- ~ i ~ k r~... e , l r.r yy" . . F J/ f t . °r 66 ~1Qyr . r d r ~Q.t rr, 1 }.Y . :let Sz Scri K we 41 U~ Sit ~L t1" E/mss Dis{cv ce ~,~u>~r Lv!?f'~ Sk~ c,c4.~ k jjC1 f £ i rvo d . f rey4 <Ass z x PRODUCT 205-1 r' "~wG Inc., Groton, Mass. 01471. To Order PHONE TOLL FREE 1-800-226-638D fFFA HEA DI 115 34 C 32 10S _ CURVE 30 100 - 8S 28 90 26 --as- EFFLUENT 2+ MODEL and a O 75 MODEL 189 22 70 ILI DEWATERING U 20 i 53 - J 16 SC MODEL O 163 MODEL ~ 1+ 45 186 12 +0 - - - - - - - 10 MODEL 30 MODEL 137,139 - SEWAGE arAd. 6 25 - - --les DEWATERING 6 20 - I! - - MODEL 15 EL 161 4 10 - 2 MODEL LL S 53.55. - - - - - ~ 57, S9 0 GALLONS 10 20 30 40 SO 601 70 80 1 90 100 1,10 24 1- - - } { LITERS 0 SO 160 240 320 400 22 FLOW PER MINUTE 70 20 60- - - - MODEL - - - - - - - 0 a 55 295 W E - - -I-- - - S 16 I - 50 v g 14 45 M L - 294 Z > t MODEL - - -_--a-- J 35 ,0 293 30 - + Pa- ` Q MODEL 8 I i ; 25 _ MODEL 6 20 282 - i 15 -4~ 10 MODEL ZZ 7 ZZ / I f../ 2- ___,_267,269_ p 3280 Old Millers Lane GALLONS 10 20 30 40 So 60 70 60 9o 100 110 120 '130 140 i50 160 170 160 190 P.O. Box 16347 Louisville, Kentucky 40216 LITERS 0 80 160 240 320. 400 460 560 640 720 (502) 778-2731 FLOW PER MINUTE PAGE 1 0~ - , PUMP CHAMBER CROSS SECTION AND SPECIFICATIOAIS VEIJT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MAWHOLE COVER Z5' FROM DOOR, 12"MIU WINDOW OR FRESH AIR INTAKE GRADE y" MIN. CO►JDUIT--' I~"MIN. r , IA1L.F:l PROVIDE I - + AIRTIGHT SEAL I III I ICI 'i APPROVED JOINT A I I I APPRG: W/C.I. PIPE. I III rJ/(. T EXTENDIAIC. 3' I II ALARM ExTCrff ONTO SOLID SCI'.. 9 I ( UNT:^ I I ON C I I I PUMP OFF D CONCRETE BOCK LL Y8. ou RISER EXIT PERMITTED OIJLd IF TANK MANUFACTURER HAS SUCH APPROVAL 5PECIFICATIOus SEPTIC AND D2TANKS MAMUFACTURER: ks NUMBER OF DOSES: PER DAy TANK SIZE: - ODt'~O GALLOMS DOSE VOLUME ALARM MANUFACTURER: LCyt~7ur INCLUDING 8ACKFLOW: MODEL IJUMBER: CAPACITIES: A- 4 INCHES OR S'7 z3GF SWITCH TYPE: i~~trt•Gtr4 B= Z INCHES OR 77 GAS. PUMP MANUFACTURER: ZoNt'r C=(0 IrJCHES OR MODEL NUMBER: Z-63 D INCHES 0R ;O SWITCH TYPE: &tcNOTE: PUMP AMD ALARM ARE TO C-E. PUMP DISCHARr E KATE iD o GPM INSTALLED ON SEPARATE CIRCUIT VERTICAL DIFFERENCE BC1''W9EAI PUMP OFF AND DISTRIBUTION PIPE.. 130 FEET + MIAIIM4m NETWORK SUPPLY PRESSURTTE✓✓. . . , . . . . , . , _M FEET + FEET OF FORCE MAIN X FiooftFRICTIOU FACTOR.. 430 FEET TOTAL O'JQAMIC. HEAD FEET INTERAIAL. CIIMEWSIOAIC OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH Jr3_ SIGNED: z2r 3-zG-9v LIGEti1SE AIUMBER: DATE: . -117- N CERTIFIED SURVEY MAP JOHN FEYEREISEN Part of the Northwest 1/4 of the Southwest 1/4 of Section 71 Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. o Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. set UNPLATTED LANDS 6y6'TOWN ROAD L. E/W 1/4 LINE E1/4 COR. SEC.7,T28N,R18W, N90'00'00.. E 328.80' ICOUNTY SURVEYOR'S MON.) 1/4 CO R. SEC.7, T28N, 18W,1000NTY SURVEYOR'S io 'a ON.) ' m N90'00'00"9 329.10 3 F, 10 ^r e>.. ay m LED A UG 1983 JM= of t °D ftodw *f 94 CA* e1 a K LOT 1 = 3.672 ACRES `t o- UNPLATTED LANDS O 139,938 S0. FT. 907 ~ NET o 3.422 ACRES 2 UNPLATTEDLANOS m 149,082 SOFT. j b OD W 0 0 n v » M W LINE SW 1/4 MOBILE HOME F W N O O: O N to APPROVED Z o ~o 01 ~o AUG 0 31983 _ aW W ~ St. CROIX COUNT? '0 O COM PRUMOM PARS nAWWO ay 6s J>:. ¢ a .AND zows a CXMUAUM 2' N 90, 00' 00" W 333.16' SCALE 1 100' UNPLATTED LANDS O 30 100 200 300 SW COR.SEC.7,T26N,RI8W, (COUNTY SURVEYOR'S MON.) MOM" DESCRIPTION: That certain parcel of land located in the Northwest 1/4 of the Southwest 1/4 of Section 7, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows; COMMENCING at the West 1/4 corner of said Section 7, the POINT OF BEGINNING of the parcel to be herein described; thence N 90° 00' 00" E (assumed bearing on the East/West 1/4 line of said Section 7) a distance of 328.801; thence S 03° 05' 45" E 483.93'; thence N 90° 00' 00" W 333.16'; thence N 02° 34' 50" W on the West line of the South- west 1/4 of said Section 7, a distance of 483.72' to the POINT OF BEGINNING, containing 3.672 acres, being subject to easements over the Northerly 33.00' thereof for Town Road purposes, and also being subject to easements of record. State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by dirontoN the Owner, John Feyereisen, I have surveyed and divided the lands shown her with official records, Chapter 236 of Wisconsin Statutes and the Ordinance;Z* (*I'i~,.r"E`Y'a X i; o..• County; and that the above map and description are a true and correct repxg sen th s 69ENCE ~ MURPHY CC, Dated: 19 April 1983 g 1713 o ~i~/,.. M Nj► =:RIVER FALLS, `~V WIS Vol. 5 Page 1321 7Laurence W. Murphy •i, ~ LAND ~P Certified Survey Maps Registered Land Surveyor St. Croix County, Wisconsin AS BUILT SANITARY SYSTEM REPORT Y OWNER ► ~ TOWNSHIP SEC-_7 T Z-%-R IY-W ADDRESS j _ ST. CROIX COUNTY, WISCONSIN. ++J tai SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I- ~T D7S -tl ~ o . _ f C 1 ~I Indicate N r h rr w BENCHMARK: (Permanent reference Point) Describe: Elevation of vertical refereacu paint: /or> Slope at site: SEPTIC TANK: Manufacturer: _ _ Liquid Capacity: Number of rings on cover Tank manhole cover elevation: `l'ank Inlet Elevation: 'l'ank Outlet Elevation: PUMP CHAMBER Manutacturer: Number of gallons 10V6 Number of gal. pump set for a cycle-_/,V gallons; Total capacity of distribution lines gallon: size of pump Yv, head; gallon per minute- - , horsepower! 7?~ and name of pump _q4( ec and model number `_7 //p er Type of warning device HOLDING TANK: Manufacturer- Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE; Number of pits feet diameter fee;p liquid depth seepage pit inlet pipe-elevation bottom of seepage pit elevation feet. SEEPAQi BED SIZE: nur'iber of lines width length the dept SEEPAGg TRENCH: Wi.dt S length- 64? PERCOLATION i3A'TE_ _ AREA REQUIRED QUO AREA AS BUILT 6M INSPECTOR _ DATED--7- -14 PLUMBER ON JOB LICENSE NUMBER J i n ooZ is, L i G 1 5, 0 G T Now DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & NUM/pN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.b. BOX 7969 BUREAU OF PLUMBING MADISON, y111 53707 21 CONVENTIONAL DALTERNATIVE State Plan l).D. Number: Holding Tank D In-Ground Pressure ❑ Mound (If assigned NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: John Feyereisen R. R. 1, Hudson, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: NW SW, Section 7, T28N-R18W, Town of Kinnickinnic Name of Plumber: MP/MPRSW No- Coumy: Sanitary Permit Number: Roger Timm 3224 St. Croix 14-49420 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES LINO DYES ONO BEDDING: VENT DIA.: VENT MATL. HIGHWATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM FEET FROM LINE AIR INLET. DYES ONO OYES ONO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: OYES ONO OYES ONO OYES ONO GALLONS PER CYCLE: PUMPAND CONTRO LS OPERAT ZONAL: NUMBER OF PROPERTY WELL: BUILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing I ENUTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH NO, OF IDISTR PIPE SPACING COVER NSIDE DIA #PITS LNLE TRENCHES. MATERIAL: PIT DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BELOW PIPE&ABOVE COVER. ELEVINLET ELEV. ENDPIPESFEET FROM LINENEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- O YES ONO meets the criteria for medium sand. TIONS MEASURED. SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS OYES ONO OYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL: SODDED. ISEEDED. IMULCHOYES CENTEREDGES: ONO DYES ONO OYES ONO 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. JNO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.. ELEV.: DIA.. ELEV.: PIPES: CIA.: ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. OYES ONO OYES FIND COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: OYES ONO OYES ONO NEAREST Sketch System on Retain in county file for audit. Reverse Side. [NATURE: TITLE: DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR. SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 141,JMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8% x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. i Property Owner: [Mailin Address: 9a Property Location: City, Village or TonshUa. County: AJ % 1/aS 7 /T N/R (or) r A ~r Lot Number: Blk No.: Subdivision Name: earest oad, ake or Landmark: State Plan I.D. Nu7ber. e~ (if assigned) / TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)*~,~~~',~_Q~. Bedrooms: 1 or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY ' LIFT PUMP TANK/SIPHON C MBER - r- MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLAT104RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ;9 New ❑ Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit ❑ Alternative (specify) Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): 1:1 Private Joint ❑Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Na Plumber: _ Signatu MPJM2RS4W4yo.: Phone Number: PI4ih S AdQr9ss: Name of Designer: ! COUNTY/DEPARTMENT USE ONLY W ure of Issuing ant: Fee: Date: -9cf APPROVED Sanitary Permit Number: -c'? v / ❑ DISAPPROVED Imo-T 9 /7 D Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation: Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (R.07/81) a Forum - S 'r C 100 i Owner of Property ~)c~~y, ~ler~ ~'~P ,Location of Property jV. W k~_k, Section_j_ T.~g N R i g W Township- W ' Mailing Address 'e) A11A cfS0k) .64 0 Subdivision Named 04 P Lot Number row . Previous Owner of Property S 0.m e_ Total Size of Parcel Date Parcel Was Created 2,pr,'/ 190- `99 3 Are all corners identifiable? Yes No Include with this application one of the following: .Certified Survey Map .Deed .Land Contract, or .Other I:egal Document which describes the property PROPERTY OWNER CERTIFICATION i 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. ` c ` ; 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 some has been dul recorded in the Office of the County Register of Deeds, as Document No. 7f/_ NATURE F NER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED CERTIFIED SURVEY MAP JOHN FEYEREISEN Part of the Northwest 1/4 of the Southwest 1/4 of Section 7, Township 28 North, Range 18 West, Town of Kinnick:innic, St;. Croix County, Wisconsin. o Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. set - UN PLATTED LANDS 66' TOWN ROAD _t E/W 1/4 LINE E I/4 COR, llC.?vT24N,R18W, N90'00'00"E 328.80' (COUNTY SURVEYOR'S MON.) W I/4 COR. SEC.?, T28N, R18W,(COUNTY SURVEYOR'S MON.) L_ M - N90°00'00"W 329.10 9) oy ~ ?J. ~ y /0 9 = 4 N F M OI V M W CD LOT 1 = 3.672 ACRES V N 139,938 S0. FT. UNPLATTED LANDS O UZ.6 JTJ,? LA_VS NET = 3.422 ACRES _ m 149,082 SO.FT. v 0~ • e ;D W 3 C c n a n 7 W LINE SW 1/4 MOBILE HOME 0 M p f. W N 0 N 1- O 2 . < h p IA A z_z oc o ma y0 bs J .J,1 W 2N N 90' 00 00" W 333.16' SCALE 1 " 100' UNPLATTED LANDS 0 30 100 200 300 SW Con. SEC.7,T28N,RIOW, (COUNTY SURVEYOR'S MON.) DESCRIPTION : That certain parcel. of land located in the Northwest 1/4 of the Southwest 1/4 of Section 7, i Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows; COMMENCING at the West 1/4 corner of said Section 7, the POINT OF' BEGINNING of the parcel to be herein described; thence N (;0° 00' 00" E (assumed bearing on the East/West 1/4 line of said Section "j) a distance of 328.801; thence S 03° 05' 45" E 483.93'; thence N 90° 00' 00" W 333.161; thence N 020 34' 50" W on the West line of the South- west 1/4 of said Section 7, a distance of 483.72' to the POINT OF BINNING, containing 3.672 acres, being subject to easements over the Northerly 33.00' thereof for Town Road purposes, and also being subject to easements of record. State of Wisconsin) Country of Pierce) I, Laurence W. Murphy, registered Land Surveyor, ao hereby certify that by di the Owner, John) PeyerelsFnn, T have surveyed and (divided the lards shown her with official records, Chapter 230 of Wisconsin )t,atutes and. tape Ordinance County; and that the above map and description are, a true and correct rep~sen1 lithe W My CE "I v Dated; 19 April 1983 RPMY ? r N 3 r► • 8111 FAL Vol. Page Laurence 'w. Murphy{ LAND gv Certified )urvey 1`,1aps Registered Land a4rveyor ~4r St, Croix County, Wisconsin , f)r'D0,4t R 1FnITO F REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS y DIVISION I~ D O; LABP,$ D, s PERCOLATION TESTS (115) MADISOP.O. BOX 76 N, WI 3707 HUf~~I"Al~i R FiE~ATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/ LOT NO.: BLK. NO.: SUBDIVISION NAME: Nw 1/43"A/4 -2 /T'MN/RJS E (or(IN kLtiu )c k/,uN JC - - - COUNTY: OWNER'S BtP~E-ft`S NAME: MAILING ADDRESS: ST '!_Nz~ 1X HUDs4AJ) USE DATES OBSERVATIONS MADE i NO. BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: 1PERCOLATION TESTS: Residence Z - A- X New ❑ Replace I S-10 4A3 le- _2 0 3 RATING: S= Site suitable for system U= Site unsuitable for system t CONVENTIONAL: IMOUND: ~(IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) OS ❑U 'JS ❑U MS ❑U OS ZU ❑SEU z T'1'7_e7jctiL=s L-tnctj 5'x &o If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: T-13 N • Floodplain, indicate Floodplain elevation: - PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-I CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH -ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) r , 0.3' 8) s 1~_)_Ts_=Z• 0' G f .tab s(J j -..3 '_87 S- iv 0 5~e 97 - B 1 S.8' 9~.'7 uN C ritoTQ& S. 6 btic Bm s 1 sr S ' o . z' Ll- epi '(s A, Gy C SPOrs B- Z 3.0 l 01 , y' Nu lU ~ > 8 , o ' o ~ C~ n s l ~ ~rivo s _ o U~ 31 s.I T-s 1•C) G~ 13n sj) o.S Bn L , 5.JI B- 3 0 1vo •8 ~~Nt o ey, sl ( w ~k B 1 a>`., s S.1~ o.y' BI sr/ 15 j J- P.' _Gzs•il_~ B- y rs.i B rj C~• 98.5 ENE Y .3.8' s t h-,,. os B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER ING4-~ AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ z.o' 30 ! 's/~6 J ~~a 1 "A? l141 P- Z 2- o' 1J Q:1 3D 30 P_ 3 2,0' hJo 30 1 3~y /'~y 3~y 17 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. Q C11 Q. 1 S SibJ`[ t N UO SYSTEM ELEVATION O . U S'!6•30 I ci U($' ~ p 1Vt H l S_PT ~tZ !L -41 - - r - - - - t - L~€~2 _ i A -y L~tS ~_tL~ l S o' cSr fJ N~?z F7 V) TES TV -37 )JJ r- 71i ~°LC ViT -S J . s - - - - - - , • I I ' -1=4 _tST ~ I j` , IS, 1. Is of T B 4 i o H P o I , ~ I A ~1 'h Nei - - - - ' - lst ~ I-~~~es 6~I ' ~j I \{p t px cC,pT rt s S4tvwtJ l --l See. '1 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 1`w~~: iJSL ZZ6 uus ViJ vt> I . Syo 1) { 57~ 7I S- y ~S- 93 y / CST SIGNATURE: ISTRIBUTION: Origina; and one copy to Local Authority, Property Owner and Soil Tester. LHR-SBD-6395 (R 021821 -OVER - L INSTRUCTIONS FOR COMPLETING FORM 115 - SBD 095 _ To be a cornplet:' a-. ac:r:urat:: soli test; your report rrlust include: 1. Complete legal desc ;,.ion, 2. The use section must clearly indicate v herhr'r triis is a residence or commercial project; 3. MAXIMUM number of bedrooms or ccmam«;icial use planned; d. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL C.)THER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS i PLEASE use the abb Deviations shown here for writing profile descriptions and completing the plot plan; 7_ Iir~AKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may br used it desired; Make sure your tler_,.llrrark and vertical elevation ielF.ience point are c.le riti sim at)(," are peirnanent, Complete all apps or)i iate boxes as to dates, names, addiesses, flood ;)lair, ~j)-.-,cation test exemp- tion, if appropn ?L. f` th"~ iniorma?, (c"zcr- floors plain, elevation) does riot apply, pfac- i .A. it rr)c 1 Ir ;ai bo"' ; 11. S!n" the form and place your current address and your certification number; 12, Cc~,n~ I_gil)le copies and distribute as required. ALL SOIL TESTS MUST BE PILED WITH THE LOCAL AUTHORITY V,'17 HIPv 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separaies and Textures Other Symbols - Stcx. (ove: 10' BR - Bedrock r SS - Sandstone n co!l g; - Grav, (uncle: 3'•? LS - Limestone s - Sand HGVV - High Groundwater - Cnan>Sand Perc - Percolation Rate mt.t s - Vi"dit.,r., Sa v! W - Well Fir.o Sanci Bldg - Building Greater Than r. s1 Sandy Loam - Less -Thai, , Loan-~ "sd Silt Loam B' B,k Silt vrat "c1 - Clay Loam efiov, scl Sandy Clay Loarn sic: - Silty Clay Loarn nlot - Mioi+(es sc - Sandy Clay .vith sic - Sky Clay f fi _ i'lvli. tir,l c - Clay nt - Peat m - Muck d ciist nct 1' - prpirnri2~it H W L Hig'n vlatu: , Six general smi i ;xturos surface watt°: for liquid v,'4ste disrosal 6M - Bench 1, VRP - Vertical Rc:farence Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit The county of the Deuartment may request rnm ,i, h•i ~r'caticw cii tlli; ieid wioi to pennii It,lu,,nc• A the III iv~ - b,n1. ~'d3 t"tll ~ n;~)i i+ J',! .)P SUbmitif 1 1(!'II• a;~17r, ii I'H'd n ~rrl!'I try a Pi =ii,n -TI,_ I)liiomed and pi '.r `o th. slim o? A,), t l:cam. GUl~~il? - i Jos - ROHL & TIMM EXCAVATING SHEET NO. OF Z . 310 Arch Street z J HUDSON, WIS. 54016 CALCULATED BY - DATE_ Z / (715) 386-8664 , _ CHECKED BY B11iE_ SCALE ! FT7: a~ J J pca J j ~1 U 0~11 L R3 P F' . rr we. A 7k r 'Z• .7 e-t iot) #qKki dp / UCCT t 1 7 l.X~.. , 91 PRODUCT 2041 Ees Inc., Groton, Mass. 01471. i y JOB AN ROHL & TIMM EXCAVATING SHEET NO. J OF - 310 Arch Street HUDSON, WIS. 54016 CALCULATED BY m--DATE (715) 386-8664 CHECKED BY D*T£ SCALE VeAJ r R 1 / Rod G 6 f 1... L. 1 PRODW 204-1 ses Inc., Groton, Mass. 01471.