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HomeMy WebLinkAbout032-1041-30-000 o CD ~n O ° a 0.~ o M ti ti I ~ I z c c _ '2 i LL O o LL c L O U 0 ~ O i Q C v E z ~ ~ d I a co c 0 c C7 -O o z c w 3 N o avi Z d c F- O Z O c E r) N O O 7 O C •N d L O O O N Q O z m z o z N z I N N r j E c 0 fl w? « U c M LO o 0 O G n a o U) Z a> F- H H o 0 0 0 a z •rv _ aaa S: a ` B 4.; Q) c N E o to V U) 0) CD z m LO M`V N N O O O _ E N L 0 0 O Q D m O p N N Or ~ N Q w O ~ N ~ . O C N UI C O O U 3 N ° C C 7 O N N O O. E N N N U n- O O O M N O O. a C lv1 y' a~ ~ cE E m yQ N N I 4. 0 i O C L L t33 I~ O M 04 ` Li N z N I- H C N Or C14 0 c') 0 4 ~ Y w I _ E V ~ a ~a a a a a 'm a`+ +c a rr`Fwwv E 'c c C _1 A cci a 0 in v T . Io Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ~eo k7i ~ (moo r TOWNSHIP SEC. T N-RIT W Y '0"' ST. CROIX COUNTY, WISCONSIN ADDRESS fSr Q 6 UX 9Y'0"' SUBDIVISION ~J1 LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Af"'N~ J 31 s r" I i s . i U" INDICATE NORTH ARROW ~~0 0 BENCHMARK: Describe the verb..--al reference point used Elevation of vertical reference point: Proposed slope at site: SEPTIC TANK: Manufacturer: r 4ke Liquid Capacity: 16)01r' Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Read: Front ,0Side 10 Rear, O feet .From nearest-property line Front,OSideQRear,O I S~, feet Number of feet from: well. building: (Include this information of. Ite above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE 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, Q Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: GI S Trench: Width: Length: Number of Lines: o` Area Built: 7&0 Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear,O Pt. Number of feet from well: N Number of feet from building: (Include 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, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: [f 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 SW A~ , ec.14 T31-R19 Lob4 Stassign l.D.Number: CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Somerset HWY ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound . 35 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Thomas Moore 2 Bo548 Somerset 141 54025 /y-9d 'Old BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Calvin Powers r. 156 St. Croix 135420 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PO"end 1 0 0 0 PROVIDED: PROVIDED: YES ❑ NO ❑ YES NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH J N a Z AIR INLET: ' t ALARM: FEET FROM g LINN NO "1 C- I ❑ YES NO NEAREST ❑ YES 31 DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: 1:1 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 00- 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: WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID BED/TRENCH Q TRENCHES: M ERIAL: C PIT DEPTH: DIMENSIONS 2 - G GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. ISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIP S: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: LINE: AIR INLET: FEET /1 l1 ~ 3 61 / D I '4m / ol'9D 2 7 L -j NEAREST O- / So N 3 l .3lf 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: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DIA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: S J ❑ YES ❑ NO ❑ YES ❑ NO NEAREST 711 7 ~ Sketch System on /Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: i7 SBD-6710 (R. 06/88) f//~~ uw- R SANITARY PERMIT APPLICATION COON :EO& In accord with ILHR 83.05, Wis. Adm. Code I ZA - mommons STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than J,5- 8'f1 x 11 inches in size. f revisibn to 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 O n7 d no v -,e S kA, S /el L ON R /9 40(or) W/ PROPERTY OWNER'S MAILING ADDRESS LOT # K # )?R,2 e;,e% sy /v CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUM BPR me r . 5 L_j II. TYPE OF WILDING: Check one CITY NEAREST ROAD ( ) State Owned VILLAGE : S~ ❑ Public L',X1 or2 Fam. Dwelling-# of bedrooms3 PAR LTAXNU ER( ) III. BUILDING USE: (If building type is public, check all that apply) _ AOn2 _ -Sri no In 1 El Apt/Condo 2 ❑ Assembly Hall 60 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 1120 Service Station/Car Wash 50 Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify IV. TYP OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an P 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 El Specify Type 41 El Holding Tank 12 Seepage Trench 220 In-Ground 42 ❑ Pit Privy 130 Seepage Pit Pressure 43 ❑ Vault Privy 140 System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 97S CO ej&AA /OO;ByFeet ®3,aveet VII. TANK CAPACITY Site in allons Total ##of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete structed glass App' Tanks Tanks Septic Tank or Holdin Tank O L'a Lift Pump Tank/Si hon Chamber R F] VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Pr t): Plumber's Signatur : (No tamps) /MPRSW No.: Business Phone Number: Lccalw war h /~6 7/S 316 tuber's Address (Street, City, State, Zip Code): 3 Ovy q i IX. COUNTY/DEPARTMENT USE ONLY ,~y~ ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing Agent Signature No Stamps) Approved ❑ Owner Given Initial surcharge Fee) _QA _1U 1 v Adversi D t rmin tin a~_ X. CONDITIONS OF APPROVAUREASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS r 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: I.. 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; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system it 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 f S T C - 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 issuapce. 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/. D I'I'1 ct S r'-~ Location of Property S ;4 Section, T N - R ..G.- W fAmship Mailing Address Subdivision Name Lot Number _ T Previous Owner of Property Total Size of Parcel Date Parcel was Created p Are all corners and lot lines identifiable? 7 Yes No Yes No Is this property being developed for resale (spec house) ? I Volume 6 and Page Number S__i>_~~`s-recorded with the Register of Deeds i INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: { 1. Warranty Deed 2. Land Contract 1. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if avacri,would tosa CertifiediSurveydelays referenceshelpful of the reviewing process. If the deed des ption Map, the the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - -r - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) ce that aU Statements on this jojun ahe tnu.e to the beat o6 my (ou1L) fznow.~edge; tithy at 1 (we) am (cute) the owneh. (.a) 06 the ptopenty deschibed in this .injonmat.ion ~onm, by viAtue o6 a wWLAanty deed neconded in the 06jice of the County RegiAten o j Deeds as Document No. a? / ; and that 1 (we.) pnedentty own the pnopo.aed .6 to bon the Sewage poa bydtem (on 1 (we) have obtained an easement, to hun with the above dedcA bed pnopen ty, jox the. con6tkuction o6 said ayatem, and the same had been du,2y xecohded in the 06jice og the County Reg"id"ten o4 Deeds, ab Document No. SIGNATURE OF 0 ER SIGNATURE OF CO-OWNER (IF APPLICABLE) 91 DATE SIGNED DATE SIGNED THIS NO. STATE BAR OF WISCONSIN FORM 1-1982 SPACE RESdRVED FOR RECORDING DATA ' WARRANTY DEED ' 455231 ~61PArE522 REGISTER'S OFFICE Edward E. Germain and $T. CROIX CO,, WI This Deed, made between Recd for Record ' Ann Marie Germa>.n- husband and wife JAN 1J; • Grantor, Gt M Th 11:45 A.jj ,d omas P. Moore a d__yick?4.+,..dI44,._k~u~ka>~d end I~e. a CAti""~tJt'.J. urvivo=ship Irlarital ~roperty Register of Deeds Grantee, WitnesSeth, That the said Grantor, for a valuable consideration...... conveys to Grantee the following described real estate in ....St.-.Crolc.._•__•__-_- Thomas P. Moore and Vicki L. County, State of Wisconsin: I Woo5e Box 548, Somerset, WI I Tax Parcel No- Part of the Southwest Quarter of Southwest Quarter (SW 1/4 of SW 1/4) of Section 14-31-19 described as follows: Lot 4 of Certified Survey Map filed December 8, 1978 in Volume "3", Page 746. i i i ~i i 'ANSIL i i I~ i i I it This is not homestead property. I; (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And.... Edward__E. •Germain _-and Ann• Marie -Germain,__ husband_ and-wife• warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except i and will warrant and defend the same. Dated this 18th----_-----------_---------- day of . January 19- 90 (SEAL) Cf?~..L---•--(SEAL) - ( I * * Edward E. Germain - C • (SEAL) C1_~LCh.~._.525~ , c- (SEAL) * * Ann Marie Germain AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN SS. St Cro: - ]x----------------- County. authenticated this day of___________________________ 19 Personally came before me this __180day of January----------------------- 19_9Q--- the above named Edward E. Germain- and Ann _ Marie .Germain, - usband..and- if TITLE: MEMBER STATE BAR OF WISCONSIN (If not- III authorized by § 706.06, Wis. Stats.) to a kno n o be the person S who executed the regoi in trument and ackn 1 age t e sam THIS INSTRUMENT WAS DRAFTED.HY e First. Security Title . te Bear-Lake-------------- iT ~faplt~wood~• Al---- 551-I1V------ W0250----------------------- Notary Public --------.-County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) - p date: __19..2/- ) -a - ' *Names of persona signing in any capacity should be typed or printed below their signatures. ij WARRANTY DEED STATE. BAR OF WISCONSIN Wisconsin Leeal Blank Co. Inc. ROIL".f NA i - IeR2 ' H a STC - 105 r" r a SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County z ty OWNER/BUYER S/C.~rn ROUTE/BOX NUMBER_ _10 fay Fire Number CITY/STATE _906fiaiw zip PROPERTY LOCATION: S(,lJ !y, S•`'Jk, Sect onT- 3Z N, R ~.G=W, 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 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. Cr'bix 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 N to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- v 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. / SICNED 7P 1~4n DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. f. INDUS I'$/I OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, , DIVISION t;AND P.O. BOX 7969 E4 PERCOLATION TESTS (115) MADISON WI 3707 AN Fr ATIONS (H63.090) & Chapter 145.045) DIVISION NAME: LOCA I SECTION: ITOWNSHIP/MN30CKDOOCTY: LOT N=n/a SW 1/40/ 14 /T 31 N/R 19fNor) W Somerset 4 COUNTY: OWNER'S AME: MAILING ADDRESS: St. Croix Ed Germain Box 120 C, Somerset, Wi. 54025 USE DATES OBSERVATIONS MADE NO. BEDR COMM R A E CRIPTtON: PR N OLATION ESTS: (iesidence 3 n/a New ❑Replace I 9_21-89 n/a RATING: Ss Site suitable for system Ua Site unsuitable for system CONVEN I L: MOUND: IN- ROUND N-FILLHOLDIN(i TANK RECOMMENDED SYSTEM: (optional) gS ❑U g S ❑U ®S ❑U ❑S 91U ❑ S )ElU : conventional If Percolation Tests are NOT required DESIGN RAiE: class If any portion of the tested area is in the n/a under s.H63.09(5)(b), indicate: I Floodplain indicate Floodplain elevation: decimal' PROFILE DESCRIPTIONS page 10 GOC BORING TOTAL DEPTH TO GR UNDWATER•INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED ES HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B. 1 7.17 104.84 none >7.17 1.08bl.1. .92bn.sil. 5.17bn.l.s. B 2 7.42 104.72 none >7.42 1.08bl.1. 1.42bn.sil. 4.92bn.l.s. B 3 7.17 103.84 none >7.17 .92bl.1. 1.25bn.sil. 5.00bn.l.s. 4 6.58 102.32 none >6.58 1.58bl.1. 2.00bn.s.sil. 3.00bn.l.s. B. 5 6.84 101.43 none >6.84 1.50bl.1. .92bn.l.s. 4.92bn.m.s. B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATER INCH ES NUMBER INCHES AFTERSWELLING INTERVAL-MIN., PERIOD 1 PERIOD 3 P P- P- se desi rate 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. 100.84 SYSTEM ELEVATION - T l I ► - -i 1 4,E... I _ lilt . 0 ~ref j 1![he 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: Gary L. Steel 9-21-89 ADDRESS: CERTIFICATION NUMBER: PHONE N M ER optional): 988 N. Shore Dr., New Richmond, Wi. 54017 229 171-A ~20b CST SIGN E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -OVER - fl? iX-[ 1 ; i i I I I ~ i I I I , I ~ G/ QX~ a- 4 f I i I I I - -4-4- 14 - -i L I ! , I -r ----I----r---- ----1---~---}--i----l---~---- ' 1. I I ' - - _ - I i I ~ ~ I i l l ~ I I r I I I ~ 1- I I i I I - I I;, ~ i I I _ I I r I I I I I i ' I I Ch - - - - - i- - - -1- 1- I- r- i I I t L , i I Ell; I I ; . ~ I 1 ` I i - - - - I - - - - - - - - - - - - C - - - - a _ ---L--- - - - - - - - - - - - - I 1 - - - - I ' I - - _ I I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ I i I , I ; I I i i I i i~ • ' rn A.,-S Moo rte. PAGE OF CroS Sltr~lo,, A Ztro -Sys[en-) -.2,;x I' ) Frd►b Air Inlat► And Ob►arvallon pipe 1~ Approv►d vent Cop Minimum 12" Abor• Flnel Grade 20. 42" Above Pip' _ 4" Cost Iron To Final Grade Vent Pips Mash Hal Or SlniMtk Coverlny MIn 2" Aareale Owe( Pips OIelrlOullon ' Pipe - Tea V Apprepole Beneath Pipe ° perloraled Pipe below, o I-CoWing TaminallnS AS Bottom Of Slslem III ~.Icve.~ 1 on Fma2m, SOIL FILL OISTKIBLITIOVI PIPE APPROVED ,SJU -HETIC COVER r ~-P1 AT~It1A1 OR 'I" OF STRAW 2" OF /fi rj 9 EWE MARSH H A'j ~yy a~ fm OF 12 -21/Z AGGREGATE ELEV. OF /fJb. rEE7 DIS-1-1115JTIOM PIPE TU BE AT LEAST IIJCHES BELOW ORIGIMAL GRADE A►JU AT LEASTLO IAICHES BUT AIO MORE THAI) 42 INCHES BELOW FINAL GRADE MAXIMUM WN OF EXCAVATH)MI FKom OKIGrJAL 6KAK WILL BE IMCHES PUI41MUM ®EPrtt OF EXCAVATION FROM. OIKI41WAL CAW- WILL BE ~ INCHES i I 51GAIED: L I G E 1J S C AJ U M B E li : ~L~c~ DATE: 'Z ST. C\ OIX COUNTY WISCONSIN PLANNING & DEVELOPMENT PLANNING SOLID WASTE REAL PROPERTY ZONING 715-386-4674 715-386-4623 715-386-4677 715-386-4680 October 8, 1993 To Whom it May Concern: An inspection of the septic system for the Thomas Moore property, located in the SW -h of the SW h of Section 14, T31N-R19W, Town of Somerset, was conducted on February 14, 1990. At the time of the inspection this septic system was found to be code compliant for a three bedroom home. Should you have any questions, please feel free to contact this office. Sincerely, Thomas Nelson Zoning Administrator mij ST. CROIX COUNTY GOVERNMENT CENTER • 1 101 CARMICHAEL ROAD 0 HUDSON, WI 54016