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HomeMy WebLinkAbout040-1072-10-100 (2) h o°~ N c r 4 0 o a I N N O - c > o I W Q M V 0 O U N Q Co c d ~ N ~ I [r o O N Z 3 m c vi M w CL f0 E I z y z E °o Z `m d CO CNW am ' o I O z C o m 2 v l c o ~ c E v ch c rn y m y N C C a v o c p m Z m ~ Z co y c N t0 N co co W d N O° ° o c c a E a N Z > aN 0o l ° z o Y a a a a y p U) rn O rn O } M J U = 0 ° N N N T C) 0 w E co a) > m y c a N m Q} Q 4D (D C Lo U) LO N c CV 1~ C~ O Q C' Y c :3 0 d) c a ° V a O n N E m rn N y O ICI 6 N E C L 4 co 2 co O w E to U ~~i O H W O Z fA V ~ ~ ~ ' E I v1 d R € a ~x6 a `ate r V 4) 4) rr~~ b+ E 2 •c c w ~ ~1 A 00. j~U)0 FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER, l~Jyli4.t/ TOWNSHIP c/ SECTION ~6' T o?'' N-R19 W ADDRESS 2&0 (f n✓,- & ST. CROIX COUNTY, WISCONSIN SUBDIVISION ,t/A LOT / LOT SIZE h/A PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~°Pusc~ i ~Ro Aos~n I /0(90 (§Ac S~-vT-,c 43 Mn Key- n i -7-,+A t 1- )11114 / 0 Sp/K ~ 3 " /'C7P 1 .7 A ~ (-)uTxe-r AvU T. sD~~~ 6 (JE57 q C'<~il,vvu~~,~sPL,Aq~riv,J /(R a Amc, - g 3 ~~QU Qf~{iyr 4Aj/-D /~/~<J(d4T )LO SdCt7J/ ~~U~I~T~~~"tIC ~q rl a INDICATE NORTH ARROW o S~c•4~ E BENCHMARK: Elevation and description: „ram id Alternate benchmark SEPTIC TANK: Manufacturer: Gv~ts~.r Liquid Cap. ,twv G.~e. Rings used: O Manhole cover elev:/oo.io'Final grade elev: /c)c?. 12s' Tank inlet elev.:~5~ " Tank outlet elev.: No. of feet from nearest road:Front , Side , Rear L--Ft.-,20 From nearest prop. line:Front Side Rear Ft. S~' No. of feet from: Well W" , Building: X49' (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE 1 PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufact.: Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: Switch Type: Location Distance from nearest prop. line: Front_, Side_, Rear- Ft.-Distance from: Well Building SOIL ABSORPTION SYSTEM Bed : ,:~t-4e v g9.yotrench : Seepage Pit: Width:- i'~rl Length 36,' Number of Lines: 3 Area Built Ga5/s4.. Exist. Grade Elev. yp' Proposed Final Grade Elev. /o(~. go' Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side Rear No. feet from well: No. feet from building 3/ HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: ( v PLUMBER ON JOB: LICENSE NUMBER'S 53~1S' 6/90:cj iiO~/~ 131? Svc. 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 SE k , NEk ,Sec . 18 , T 2 8 -R19 Sf a assigned) 'Number: (I ~t I- I Town of Troy Lot 1 CONVENTIONAL El ALTERATIVE Ea ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound /4 ct 00 (9 ME OF-PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Jack Erdman 260 Cove Rd., Hudson, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. E5CEV.: CST REF. PT. ELEV I / a' Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Zappa Bros., Inc. 3395 St. Croix 128793 SEPTIC TANK/#o ►v er % I~~-/a' S/~' MANUFACTURER: LIQUID CAPACITY: TANK INLET TANK OUTLET ELEV.: WARNING LABEL LOCKING CO AR PROVIDED: PROVIDED: ✓ ` ~c.i / o%% 9 .7~ 8-~3 YES ❑ NO ❑YES N8' BEDDING: tFENT DIA. VC-Iff MATL.: HIGH WATER NUMBER OF ROAD- PROPERTY' WEL~ BUILDIN , VENT T FRESH ALARM: FEET FROM LINE: r lfJ AIRINf ❑ YES NO ❑ YES NO NEAREST-~ r t DG&ING-CRAIIIIIIIISER' /I MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: E:1 YES ❑ NO ❑ YES ❑ NO GALLO YCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIF ENCE BETWEEN EET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO N ST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGT 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 36 i TRENCHES / MATERIAL: DEPTH: DIMENSIONS - GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIP MA ERIAL: NO. ISTR. NUMBER OF PROPERTY WELL: BUILDI VENT TO FRESH BELOW PIPES: ABOVE COVE ELEV. INLET ELEV. END: F~~, 5 [ PIPES: FEET FROM LINE: / ® AIR INLET: / . 9 P 72J NEAREST )22 MOUND SYSTEM: CZ, 12 2,30' 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 O R TRENCH/BED DEPTH OVE ENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENT EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYST BED/TRENCH WIDTH: LENGTH: N • OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: THE HES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE M IAL & MARKING: ELEVATION AND ELEV.: ELEV.: DIA.: V.: PIPES: DIA.: DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: TICAL 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 ^ ( r e ~l rM LT's✓ , Sketch System on ,JTain in county file for audit. Reverse Side. LSIGNARE: ~ TITLE: r SBD-6710 (R. 06/88) c i • SANITARY PERMIT APPLICATION - cOU 7MLHR In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ / O/CJ y -`+f 3 8% x 11 inches in size. Check if r vision t rev ous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION Jl~ce ~ o /\/1/F~j '/a AJ9''/a, S /g T~4~, N, R E (o~ PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # Y A O o ✓ W /V CI STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 2U O S O-j G✓ i syv / ~3j' S'i -'A N II. TYPE OF BUILDING: (Check one) CITY ~ NEAREST ROAD ❑ State Owned 1771 VILLAGE : "/Tv y Ems,- Co v~ ❑ Public C91 or 2 Fam. Dwelling-# of bedrooms --,L PARCEL TNUMBER(b) III. BUILDING USE: (If building type is public, check all that apply) "lU ~U ' l V~ Vim/ 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 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. ~ 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 , 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-ln-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 yso /s - cf 3 9~ 9V 'Feet Oo• Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete structed Con- Steel glass Plastic App Tanks Tanks Septic Tank or Holdin Tank 022 ~~ov ! G✓iLS.Ef' Lift Pump Tank/Si hon Chamber El E] I F-1 El VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber' Signa re: (No Stamps) MP/MPRSW No.: Business Phone Number: Z,*AO,4 33 96' /S S S'16 -~gSd Plumber's Address (Street, City, State, Zip Code): 4W '_2 i 5 'r y S -t- Aj ,p go.v E-~J. ALA IX. C NTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue Issuing A nt Signature (NO Sta Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety s Buildings Division, Owner, Plumber s INSTRUCTIONS 14 ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tanks 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 8TC-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 ownet/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 Jo c - ~ j -,j j M Er d mC4,22 1 ) Location of property E 1/4 N 1/4, Section T j9 N-R_j.~_W Township Nailing address 160 o t/ t1 uc CA 0-1,1 Address of site See bovf. 0 Subdivision name EaSi WO (2C4 O'i I I g Lot number Previous owner of property Total size of parcel -36.7 ~C of S - Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yea 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 references to a Certified Survey Map, the Certified Survey Nap shall also be required. ---------------------------------------------------------7--------------------- PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. ; 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 s system, and the same has n duly recorded in the Office of a Coun y 1 to of Deeds, as Document,No. Sig ature o Owner S1 ature o Co-Owner (If Applicable) Date of Sign ure Date of Signature 14'ATRANTV DEED (Former Statutdr Form). STATE OF WISCONSIN Miller-Davis Co.. Minneapolis, Kinn. Form No. 8 W. 21 :11)154 94is Inbe tture, ✓tlade by Archie J. Waxon and Lois Waxon, his wife, drantorS , of St. Croix County, Wisconsin, hereby convey and warrant to Jack J. Erdman and June M. Erdman, husband and wife as joint tenants franteeg , of St. Croix County, TVisconsin. for the sum of One dollar and other good and valuable consideration the followin6 tract of land in St. Croix County, State of Wisconsin: Northeast quarter of Section Eighteen (18), Township Twenty-eight (28) North, Range Nineteen (19) West, (NEI 18-28-19). 1REGI-STHR.S OFFICE ST. CROIX Co., WIS. Recd for Record this-- _17j h day Of___Augnat___A.D. 19_59 David Hope Register of 4c~i &Deputy In Witness Whereof, The said grantor S havehereunto set the it hand Sand seal S this 14th day of Augus-V ..4. D..19 59 SIGNED AND SEALED IN PRESENCE OF '~(9t1;3L) A chie J Wagon F.. iltig / . Gavin (SE,lL) Lois WaxO] t /,L~~ (S7~'. 1 L) Harold Walbrandt Ietate of iorottsitt, ss. St. Croix County Personally came before me, this 14th day of August ,4. D. 19 59 , the above named Archie J. Waxon and Lois Waxon, his wife, to me known to be the person. who executed the foregoing instrument and acknozvledsed the same. t3 rr * Hugh F Zin } N Notary Public, St Crc~i x County, Iris. v Jib, commission expires Sept 12 , ,1. D. 19 60 J *Typewrite Name under each Signature' wo 360rt.E63L o n N~A~ OK ; C v. to O' U tt, 0) In n 1~ n C~ ~7 V. M O ~ 0 o ~o E..l c aQ y b 441 tz~ O R u Cb ! (p ~ddcess S T C - 105 c~ SEPTIC TANK MAINTENANCE AGREEMENT rt St. Croix County 11 H n OWNER/ BUYER \J ct ii I ~ Rd 0 ROUTE / BOX NUMBER S 0 C ~R d Fire Number 2 ~ b o ty CITY/ STATE ZIP LAO r PROPERTY LOCATION:'.'S 14E 34, Section. g T 1No R ! W, Town of TroV St. Croix County,' Subdivision Lot number Improper-use and maintenance of your septic system could result in wastes.- Prover maintenance con- its premature failure to handle years or sooner, sists of pumping out the septic tank every three if needed, by a licensed 'septic tank pumper. What you put into the system can affect tthe'tunct on o, the-septic tank as a treat- e in the waste disposal system. merit stag 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, 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 'sys'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 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. o I/WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- a' ment of Natural Resources. Certification fo ust be completed .d and returned to the St. Croix County ZoningPffA ce within 30 days of the three year expiration date I SIGNED I DATE 2-I f~ St. Croix County Zoning.Office 911 4th St. Hudson, WI 54016. 386-4680 I Sign, date and return to the above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS DIVISION • 'I(~bUSTRY C P.O. BOX 76 LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) L TI N: SECTION: j;ZTOWNSqIP LOT NO.:BLK. NO.: SUBDIVISION NAME: /4N V/ 18 /TZBN/R19,4(or W / CSM COUNTY: OWNER'S d7atdlE: A L N. AD C.7r cal X /1C1s; USE DATES OBSERVATIONS MADE NO. BEDR 1COMMERCIAL DESCRIPTION: PROFILE DESCFYPTIONS: FEqAT ON TESTS: [4klResiclence u K New ❑ Replace Qa 2 i r\ -so 1L5 GY~1C 4 56)Ls f - PLLOT lJ RATING: S= Site suitable for system U= Site unsuitable for system 0 : RECOMN ~rD~6S~TOQat`nalD ❑u : IS $ _ ~J EM-IN❑FILLFfO~LDING ANK r.-,S U I 1 Ks ON ENTIO❑NAL: MO D: ❑U IN-GROUND-PRESS F•~ If Percolation Tests are NOT required DESIGN RATE: - If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: I.CA r Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH jK ELEVATION OBSERVED EST. p 7EST- TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- lc> > 1.!'> g /0 LL S 13~ AN ~✓~@~v'SG AOCT+$~' ►~'is B- 17~ 100•' 0 rVOW 11"@p L rL 60•LTiRA. MS 03.3 !J > 9.08 9""BLLTS 0"Lr$0, jIV6 B- 9a L B-d $.4Z 104 Z8 > 8 ~Z LL S !3•$Q~, &KyS,a z? Tta..IMSSS g~„ B- Now e > &-e; LILTS 7"kb8 SI L S' O S~ L 6rC+~[r► J~ 1~ B ?,01-,&0 Ms PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER ZMSGE5 AFTERSWELLING INTERVAL-MIN. PERIOD 1 P RI D P PERINCH P- I 6.20 kakr io3.c6 > 2 Z < P- 3 6.00 o ia~.4o >2. >Z < 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 borin s and the direction and percent of land slope. g - _D /it!~ /.v SYSTEM ELEVATION 9,140 --40 J - P, z I 4~2.~ I Eps T N 12b' 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 rMPL JTED ON N i_` ~04NSa,-J JO~ySoN > EYINZ h►C 9 Z 96 AQ DRESS: CERTIF CAT ON NUMBER: PHONE NUMBER (optional): "~07 S Co>U o tso ti 1 1 "-A 0 t 6 ~3 A 't.4 tj 3- 0 CST SI TURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER - PLO 67 PLOT & CROSS SECTION PLANS o ZAPPA BROS. EXCAVATING INC T, PLUMBING UNIT PROJECT 0 CJEi.c Ew ~.JTf ov~G Al AA-) AP~~ To r~< cur c~~aL/-ou7 /~~ts ~te~r ~q Slo' ~~e LE Res D` Bfuc Aqr . SPIKE iA/ TeF e4 e✓, ion VENT ~ ;l BAs c,JesT ic~c,o Swr~c ►as )OeoPePTN TNI< w*NC.fsr ~ii?' ~,QvOI~T~ OU f 4zr Y as SD,P gS {O✓G Sfr..E P It E«~fLCNT ~ivL t E ~arN PiPvlPr/ /~/vE NO SCALE FRESH AIR INLET AND OBSERVATION PIPE APPROVED VENT CAP MAXIMUM 12' ABOVE FINAL GRADE 4' CAST IRON VENT PIPE MAXIMUM OF 42' ABOVE PIPE TO FINAL GRADE SIGNED: 14az: E" MARSH HAY OR SYNTHETIC COVERING LICENSE: ggpeS 33 MINIMUM 2' AGGREGATE DATE: OVER PIPE DISTRIBUTION PIPE ING BY: TEE SOZv,-K So,✓ Jb.S~ C ELEVATION BED 6' AGGREGATE • BOTTOM PER SOIL BENEATH PIPE PERFORATED PIPE BELOW TESTIS • COUPLING TERMINATING 22, V0' FT. AT BOTTOM OF SYSTEM .00'002 3„av.9ti.00 S '31 29 p o 5 o o Q m N to to O) co ~ Z M9£'6S . N 0£, ,b6Oti CEP T I F I ED SUP V E Y MA P Located in the SE1/4 of the NE1/4 of Section 18, T28N, R19W, Town of Troy, St. Croix County, Wisconsin. Owned by: Jack & June Erdman 260 Cove Road CURVE DATA. Hudson, Wi. 54016 Central angYA = 5321' 1211 Radius = 233.001 Length = 216.97' NE Corner Chord = N63°13'58"E 209.21' Section 18 Tangents = N89o54'34"E UNeLALT,LD LADQq_ T28N, R19W N36 33'22 "E~ s - - to o O Bearings referenced to the South line -East line of the 2 of the NE 1 /4 NE 1 /4 of Section 18, lL® Ir assumed 109,958 Sq. FtN89 16'20"W. to Including rto W 99,961 Sq. Ft. ..NI \-wayy 3 Excluding right-of-way z lD N /L W _ cn DRAINAGE -VNPLATTEU_ ( DITCH rn N - -L ' 01 ~ O IW-I 0 _C4 O ~ . O ai (V Z z N 89016'20"W O MI - 305.87------1- 4889.69' II EAST COVE R0 D - N 89°16'20"w tO N 69 0 16 ' 20"W 300.00 ' 0 El/4 Corner W 1 /4 Corner --Section 18- Section 18 [South - - line of the NE1/4 LEGEND UNPLATTFD LANIS - - St. Croix CounAy Section Corner monument 0 1"X24" Round iron pipe weighing 1.68 lbs/ lin. foot set. tN~Nflq~ SCALE IN FEET I" = 100' HARVEY Q. JOHNSON 0' 25' 50' 100' 200' 300' L S-'1889 HUDSON S W IS AOD n„r 0 Q COM BiLNSIVc RkRKS P This instrument drafted by: J .5j. 4901525A Vb I, lP~ a 3'~ `1 ,LEY IF THE SE114 OF THE NE114, PART OF THE SWI14 IE NE114, OF SECTION 18, T28N, R19W, TOWN OF TROY N ~ l~ ` 23 04C rsyi -Sao j C voads>'S r O r °r! MAT _ 4A, ~ K ` j; j I® s UpE Jv a e set n Also 24 ` Us ACao - DCA M1a o wma Cmam / Uo7 Atau tan Amt: ' ; Tnltl m rt. INA4mH. % 30 p 4 w i o ! C d 17A>~6MFT. i 1 25 ; I~ • \ c„nDOlloaiaun'OOT 9= AIM= ,QaO m R. N _ y tEUatmrr. ---;i` \ 4¢ '~~Kaa < W vl F2 ~t ~ ~ CDT' J 3 r < O 2m ACKS IA,AVra/t n , 1, U4.73a St. M z i tae Jam , CALLMW vallfwa CACC,OR O O 1 . nun M► M OIT7:YtltMO IKAKIAa Ella,TOlr-♦ Acm ran Aua kl ,uuTV m rT. Qyy = 1R.M m A. A 'VAS R040~~"~ ,♦♦;~i 27 = j F ai Ui 1 g $ 2.7-49 A ! u, g au"m^. AdL LOT I ,uA i • "mO1n,a~ CSM IN I ; g...-...- . z VOL. B. 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