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HomeMy WebLinkAbout032-2004-90-110 ~Y o ~ °o I m N 4 o I ~ I o I 0 N N d 'O V O I I I I~ ~ I L) w v z° ~ I c ii c E I o 3 Y ~ I Q .o I M Z H z x ~ I O z I Ili m m ~~uwi o.m I o I o z a c cu I v co N t .C mI t0 N 7 a N N C O o Q Z co z N z d l0 C N ItV i N - Y! t0 > - f0 !~yy a C ~ U m °o O G a N 0 CD N F- N N Z ~ O N 3 ° a Z CD a 0aa y N Z toJU 3rnrn wv z o o ti~ (D N M M E O O 5 'p Q4 ! U) m N c a L M y N O .~.d Q cn co O O p 9 C Q o c c E O O N Fp- i ° rn n a c 0) w m E E -0 Q W p r L O 1 t t y p r N M E A V, N F- C • M O .M- O E E U ooco g o z'?~~ ~U ad cn ) a € a S e a • a d , m `Iv a E c c rw L) (L 0 U) Q Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP SEC. TN-RW' ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION ~1C LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I1HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM r c la? t Z-17 INDICATE NORTH ARROW ? r BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer:~quid Capacity: Number of rings used:- Tank manhole cover elevation: T Tank Inlet Elevation: Tank Outlet`Elevation: O Number of feet from nearest Road: Front 10 Side, Rear, O feet From nearest property line Front, 0Side,(DRear, O feet Number of feet from: well p! , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVFRSE SIDE PUMP CHAMBER Manufacturer: 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: Number of-feet from nearest property line: Front, O Side, O Rear, © Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: L' Width: Length: ( Number of Lines:_ Area Built: Fill depthto top of pipe: Number of feet from nearest property line: Front, O Side, Rear, It i Number of feet from well: Z 'C11 Number of feet from building: (In,-lade distances on plot plan). SEEPAGE PIT Size: 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: 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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest goad: Alarm Manufacturer: Inspector: t Dated: Plumber on job: License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABQR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 7 SW,-R19 T 2 State Plan I..Number: Town of Somerset L-J CONVENTIONAL El ALTERATIVE 9 1; t-b of- ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound ITAME-OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Tames Miller 901 Bernds Ave, New Richmond, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name /t Plumb A: MP/MPRSW No.: County: Sanitary Permit Number: Calvin Powers Jr. 1563 St. Croix 135435 SEPTIC TANK/HOLDING TANK: M FACTURER: ! 1 LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED, PROVIDED: ,-7,L." C f! D a. / ~J YES' E:1 NO ❑ YES NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH J/ ALARM: FEET FROM LINE: J AIR INLET: ❑YES 2 'NO ❑ YES ENO NEAREST ~ c4 ~ U 1- 1,51 CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: VUM70DEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND NTRO S ERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ Y S NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil m i tur at th dept of pl wing FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a Wire, ructio shat 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: M~RIAL: PIT DEPTH: DIMENSIONS y 0 1- , s' GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. D TR. NUMBER OF PROPERTY WELL, BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. IN E EV. END: PIPE LINE' AIR INLET: W q FEET FROM h 2 Z Z. / NEAREST 6 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: 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 COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST 0- 56 c- Retain in county file for audit. Sketch System on Reverse Side. A 5 : TITL . SBD-6710 (R. 06/88) P': SANITARY PERMIT APPLICATION !M MLHR In accord with ILHR 83.05, Wis. Adm. Code ~....,,~,.v 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. C ec if vial n previoua application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PR PERTY OWNER PROPERTY LOCATION S'F- 1/4 l t•/'/a, S 1 T N, R I ~er) W % PROPERTY OWNER'S MAJING A DRESS LOT # BLOCK # f3C ~ f, 11 51 ve, G/ CITY, ST [ZIP CODE PHONE NUMBER SUBDIVISION NAME CSM NUMBER ie-3, 112J 45'Li (4j1 0i 2"41 0 CITY NEAREST RO D II. TYPE OF BUILDING: (Check one) ❑ State Owned ❑ VILLAGE : C i e ~.T 7 ❑ Public TZ1 or 2 Fam. Dwelling-~#of bedrooms a PAR ELTAXNUMBER( )O aa` UO qQ ` / III. BUILDING USE: (If building type is public, check all that apply) nLIFO q-l o 1 ❑ Apt/Condo P LIFO 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. X New 2. ❑ Replacement 3. ❑ Replacement of 4.0 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 00 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.) (Mi ELEVATION J' 174/5- 19 L_6~ "1 ej Feet IO 'Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name oncrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank IL Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): i Plumber's Signatur . (N Stamps) NIP/MPRSW No.: Business Phone Number: Plumber's Address (Street, City, StgV Zip ode): Wt s C?I IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) Approved ❑ Owner Given initial Surcharge Fee) Q/~ qs-- 3 a `v Advers De rmi on X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-8398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS w 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. lt. 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 office with the completed when the. property is sold and submitted to this appropriate deed recording. --t-^------------I-,-n----l----------------------- I Owner of property .N G'tteS Location of property I E_1/4 Pil-' _1/4, Section T N-R_J2W Township 5-0,0-n P2I Mailing address go/ 13~lel-jo A L-P-. Address of site LZ ~yH+ Pr` s Subdivision name l a Lot number ~j Previous owner of property S4C, ^j y l Tai le- Total size of parcel ct C-/L {S 1787 Date parcel was created Aa4zaj-)7 Are all corners and lot lines identifiable? -Yes o Is this property being developed for resale (spec house)? Yes No Volume and Page Number M as recorded with the Register of Deeds. I _---A-=Ia ------19 B0 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, ~ce_r~tified survey, if available, would be helpful so as to avoid delays of the re ewing, 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 (out) 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. +A 5 5 94(n ; 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 rec ded in the Office of the unty Register of D s, as Document No. Signatu2A of Owner Signature of Co-Owner (If Applicable) a-dU -~iJ C;) -a"D Date of Signature Date of Signature _ • I DOCUMENT NO. I i 7 r THIS SPACE RESERVED FOR RECORDING DATA WARRANTY Dkk) 455996 I STATE BAR OF WISCONSIN FORM 2-1982 iff 01 863 PAr,,f 559 REGISTER'S OFFICE sr. CROIX Co., WI I~ Allan E. Siekm_eier, a_s_ t_o_ an undivided one-half Recd for Word II interest_.and_Stanley V. Hale and Mary H6:16 --r FEga 0.~~o husband an .._wife,_..as _~oint tenants, as to ari $:/0 M undivided one-half interest conveys and warrants to ..-James C. Miller arid.. Glri.. L. _..JQ. nt..lenants------••--•--•----------....---•----••-•-----•-----• ttagFslerofDei!ds I RETURN TO I the following described real estate in .....St-t_-•CYO1X .County, State of Wisconsin: Tax Parcel No: Part of the Southeast Quarter of the Northwest Quarter (SE4 of NWh) and part of the Northeast Quarter of the Northwest Quarter (NEk of NW's), Section One (1), Township Thirty (30) North, Range Nineteen (19) West, described as follows: Lot Two (2) of Certified Survey Map filed August 17, 1989 in. Volume "8", page 2140, as Document ' No. 450690. A N 5 bV4A AN 6 This conveyance is given in satisfaction of that certain land F~ contract between the parties, dated September 1, 1989, recorded !I September 7, 1989 in volume "850", page 470, Document No. 451299. II This iS not . homestead property. (is) (is not) Exception to warranties: SEE OTHER SIDE FOR ADDITIONAL ACKNOWLEDGMENT Dated this day of , 19.. Y', Neu, - 1~~~w._~...~,.t..~f-',• ''-'r--•-••-•---•--.....(SEAL) 7 .'/..(SEAL) * Allan E. Siekmeier Stanley V. Hal .-....--•-•--------------------------------------•-•------•--..._-.(SEAL) - (SEAL) ` ---Mary H-ale AUTHENTICATION ACKNOWLEDGMENT Y Si ature s STATE OF NMOOMN U`I 1$C.O N i hl I as. • y County. pp ~ 3 authenticated this day of 19 Personally came before me this ....Q.......... day of ~I Zf l~r t-/ 199.10 the above named All..n E Siekmeier l TITLE: MEMBER STATE BAR OF WISCONSIN (If not . aut horized by § 706.06, Wis. Stats.) to me known to be the person who executed the foregoing trr!ument and ac o /~;edge the same. THIS INSTRUMENT WAS DRAFTED BY Le~LL - - - Rnstra-r.__Van•-Dyk &..Needham. _ C... `j = ~ll~ l' . 201 South K owl s e, Box 127 Y _ N-ew._.Pl chmon Notary Public UP-14 C County, (Signatures may be authenticated or acknowledged. Both My Con; ission is perm ent. (I not, state expiration are not necessary.) date: S-111-----....... 5 . PLACE ,Names of persons signing in any capacity should C~p~f~YI` J. Of 101 be typed or printed below there signatures. Ptli/li~i-Slote Of ~+igC041s1+i ftAta bAtt Of tVt§0bN9tN StOt~C FA'J. ~ 3004 H.Cri2~lar FORM No. 2 1982 STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County S erL OWNER/BY" R ~G r+4 ROUTE/BOX NUMBER '74 FIRE NO. CITY/STATE /41•x_, i~,4~yp~. Ci✓~ ZIP >X6~ l PROPERTY LOCATION: ~E 1/4 W/4, Section _ , T_ Q N.. R_Z_q_W, I Town of ~ 0 k7--e ✓z&z , St. Croix County, sv, Subdivision Nplo_ , Lot No. O 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 • DEPOTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUS DIVISION P.O. BOX 76 INDUSTRY, PERCOLATION TESTS (115) MADIS ON W153707 LABOR AND HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP Y: LOTNO.:BLK.NO.:SUBDIVISION NAME: SE t/11/4 1 /T30 N/R 19k,,or) W Somerset COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: St. Croix James Miller 1901 Bernds Ave., New Richmoond, Wi. 54017 USE DATES OBSERVATIONS MADE NO. BEDRMS.]COMMEf5-!I'I;ITDESC R IPTIO PROFILE DESCRIP IONS: O A ION TESTS: Qesidence 2 n/a x tvew ❑Replace $_3_89 n/a RATING: S= Site suitable for system U= Site unsuitable for system roNVENTIONAL: MOUND: IN-GROUND PRESSURE: SYSTEM-IN-FILL HOLDING TANK: RECOMMENDEC tlOnaoptional) H S ❑U S DU , CAS ❑U D S ®U D S ®U - If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the Floodplain, indicate Floodplain elevation: n/a under s.1-1163.09(5)1b1, indicate: Class 2 PROFILE DESCRIPTIONS Page 27 OnD2 t BORING TOTAL& DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEX TURE, AND DEPTH NUMBER DEPTF- . ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B-1 7.25 102.27 none >7.25 .67bl.1. 1.58bn.sil. 5.00bn.s.l. B-2 7.25 101.30 none >7.25 .83b1.1. 1.00bn. s.sil. 5.42bn.s.1:. B-3 7.01 100.90 none >7.01 .92bl.1. 1.92bn.sil. 4.17bn.l.s. B-4 8.09 1.02.25 none >8.09 .67bl.1. 1.50bn.s.sil. 5.92bn.l.s. B-5 7.42 100.70 none >7.42 .75bl.1. 2.00bn,.sil. 4.67bn.l.s. B- PERCOLATION TESTS DROP IN WATER LEVEL-INCHES RATE MINUTES WATER IN HOLE TEST TIME PER INCH TEST DEPTH IN. PERIOD 7 PERT D 2 P R NUMBER INCHES AFTER SWELLING INTERVAL -M P- P- P- 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 LELEVATION 97.40 ~ , I I f . r a N 1001 2 - I 07v t o a I , i S, W1• ot~o rP_ iv I, the undersigned, hereby cortify 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. TESTS WERE COMPLETED ON: NAME (pri _ ~V 1 ~r cY S ) - 8-3-89 CERTFI~AT1 TIOfy NUMBER: PHONE NUMBERIoptionnl) ADDR : ADDRESS: 7 Ala wf ~uC,, y CST 15PNAATURE-, DISTRIBUTION: Original nn f one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 11102/82 ) - OVER - -,,y: I -j- - - - T--T - + - LA _ C 14 I IF J ` II 4- -t -I-- -~---I--+-- --T -i i'--r- inn I ~ I I ~ i I ' ' I I I I I i ',i I ! 'O 4 I -1_~- I I - I ~ I i I I I ; ~ I ~ ~ L T- i i I I~ i I I I I I I %J :C I i -I----' Ir IC VG I C ,i -r- - -~j-~~- - --i -r-- - L I I- Y (1 I- - ~ _ ~ - - i - - I , - ----~:-ter-=' 4 I ~ I I I ~ I I I I I I I ~ I I II I j - - I - trIr- I i I I i I I ~ ~ I ~ I L - - J--I - 1 -T- - - ± I ~ ' I I I I r I ~ I I t i t I j I I i ~ ~ i f i j I = -T_ - - - - - - I I I : l ~ I i ' I - r-- + - - - - - - - - - - - - - I I r I , I I I ! I i i I , I I I . _ I I I I I.. - - - - - - I _ f r - l ~ ' I I •Jaynesp1 Aer r- 70 PAGE OF /7n ~n~ / J y~lt` 7 1 CroSs e-c Ion p A S. 0-11 froN1 Ali Inlal•^^And Obbetvallon Pipe l~ Approved Venl Cop Minimum 12" Above FT roil Grod• 20- 42" Above Pipr _ 4" Coal Iron To float Grod• Vent Pipe Main her Or Symbolic Covering. also 2" Agprepole Over Pipe Oielilbullon Pipe o 0 0 - Tee each Pipe B o Perloroled Pope bola. ' Beneath Pipe o -Covpllny Teuminollnp At solloin of $1614M Prop o~eD F,n-1 ~nc~~< ' SOIL FILL DISTRIBUTIOH PIPE APPROVED 5-1plT'HETIC COV[R M AT f M- OR V 2" OF AGGREGATE !_OR MARSN HA'J OF STRAW (e OF 12-2'/Z AGGREGATE ELEV. OF FEET 3 3 DIST11161ITIOM PIPE TO BE AT LEAST o INCHES BELOW ORIGIMAL GRADE AAIU AT LEAST LO INCHES BUT KIO MORE THAI) 42 MICHES BELOW FINAL GRADE MAXIMUM DEPTH OF EXCAVAT100 FKOM aKlGINAL 6KAVF- WILL BE INCHES rJHJMUM ®rP rtt OF EXCAVATIOM MOM. 01(.IWAL F3R49f- WILL BE INCHE S i SIGHED: LICEDSE DUMBER: DAT E : 3-2--9C)