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HomeMy WebLinkAbout042-1004-50-120 -0 0 o 0 v Fr a ~ I o I 0 N I' ery II' I ~ II A I c N O a Z (a c LL C U O ca 3 0 Q c M z " W E O ~ L I z c z 04 W l' a co c') 1- Z o I O z :!t C •v ~ ~ I' o N w CD z? m c Z H CD z _0 m N O = o C a) IL L? o 0 0 o a) ¢ w 00 N z co z z N .u vo N N _ N a° N N n m £ N IL LO CL co (0 a' o oo oo M y o a a N N 75 a) C) C) CJ ~4 16 It E 0 0 0 d Z O O V] 3 W W •N Haan. CL , ~ O ~ 0 U) Q) 0) 0) 0 z U) J U Z CA O wM M ~ a o I N ~l N X1 00 -O o o i~ o o W H U .-I C) o E a0 y a0 s 3 a c ~p a I U C j :03 (n CD 0 Q co C'r Cl) N y A rl Cii 1 'y i O O O C C 3 N U) 0 1 (n U) Q a a o0 00 r© ~°n o O a V M N N p o aD ~ c Eo Eo m a) v w H N O o Cl) or r 1` Q+ M C 7 ai c ~ e I- H = o rn N •ra I~ • m ea y E E ) to W 1. o o o z N to b N O R3 h r 41 rl 0 O O I £ O at r/] L L b0 0 z 'd {9 d a ac a }4 U O U a l y y c w ' a--1 J] `IV v E c 1 E 7 ,1] P4 4-J -H L rr~~ O R 3 o 0 -It Cd r 1 ~1 A U a O In v co 3 U p 3 0 a a i FORM - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER e.rJrt r=>~rt TOWNSHIP SECTION T -~c N-R_Z_~,i_W ADDRESS lZ c/ ST. CROIX COUNTY, WISCONSIN s r r r til ro-cf1j;> , 01- . LOT LOT SIZE 24 SUBDIVISION PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM j ~,2L f p e S. -3 - Al 4 `E INDICATE NORTH ARROW a BEI.W AR :Elevation and description: i dD % P T Alternate benchmark ioo a Gt1 • .2-:3 SEPTIC TANK: Manufacturer: U J E,-Cle-5 Liquid Cap. /dcQ Rings used: ,3 Manhole cover elevt~2~-Final grade elev: Tank inlet elev.: ()•63 Tank outlet elev.: No. of feet from nearest ad:Front , Side,, Rear Ft.-?67S _5( Ft. /U From nearest prop. line:Front , Side , Rear No. of feet from: Well J , Building: 4: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE 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:__Trench: Seepage Pit: Width: Length Number of Lines:Area Built Exist. Grade Elev.1'8 «1"~3Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side_A, Rear Ft. No. feet from well: 7O ~ No. feet from building /l0 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: J, DATE : 2 5 v PLUMBER ON JOB : LICENSE NUMBER: 1Y "2 6/90:cj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: NE 4-NWk, Sec. 3 , T29-R18 CONVENTIONAL ❑ ALTERATIVE (Ifassigned) Town of Warren Lot ❑2 Co HJing Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECT N A : - A W77-6 r7(4 -Josenh Gr IRt.4. New Richmond, WI 54017 BENCH MA (Permanent reference int) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELE V.: CST REF. PT. 47 Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: SEPTIC TANK/HOt-BR#04 k 3 . ,S fo o{~ o✓L~ 53 MANUFACTURER: LIQUID CAPACITY: TANK INLET EL AN UTLET EL WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ! f 5e/ ~V ~ 3 YES NO ❑YES t BEDDING: VEMT DIA.: ~VIENT MATL.: H H WATER NUMBER O ROAD: PROPERTY' I WEL / BUILDING: VENT O FRESH C u ALARM: FEET FROM LINE: / f AIR IN ET: ❑ YES NO !rr ❑ YES NO NEAREST 7~ k5 _ R: MANUFACTURER: BEDDING: CAPACITY: PUMP MO PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: S ❑ NO E:1 YES ❑ NO ❑YES ❑ NO GALLONS P CLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFER E BETWEEN T FROM LINE: AIR INLET: PUMP AND OFF ❑ YES ❑ NO NEA T ~ 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 0 TRENCHES: M_Aj EAAL: P PTH: DIMENSIONS 40 GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. IS R. NUMBER OF PROPERTY WELM BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER ELEV. INLET: ELLEEVV. END: 1,'. r/0 P.,/C- PIPE LIN//E E~ ~ f i AIR INLET: FEET FRM (o~~ till ' 07 3~ O /I ! J ?7 NEAREST-~ low f / d /.30 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 TEXTUR PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVE ENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ YES ❑ NO ED YES ❑ NO PR SS IR17FD DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: DIMENSIONS TRENCHES: MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBU E 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: 1AREST- ET FROM LINE: Sketch MBER OF PROPERTY WELL: BUILDING: ❑ YES ❑ NO ❑ YES ❑ NO System on Re" in county file for audit. i Reverse Side. SIGNAT E: TITLE: SBD-6710 (R. 06/88) + SANITARY PERMIT - APPLICATION 7 DILHR In accord with ILHR 83.05, Wis. Adm. Code CouN 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. Chkre to~ev 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 NJ - 1-1 ; 4, 4,j A i --7t IJa'/a,S T2_9, N, R E(or W PROP~TY OWR'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER a)l sTb /:z 11. TYPE OF BUILDING: (Check one CITY NEAREST ROAD ) 1:1 State Owned VILLAGE ❑ Public CZ1 or 2 Fam. Dwelling-# of bedrooms :3 PARCEL R.=W OF: AX NU O ~-(av ' at7 `~"►rd Ill. BUILDING USE: (If building type is public, check all that apply) O 3 y .-;~9. Z v 1 ❑ Apt/Condo 20 Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 80 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. 19 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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-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 L REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) C~ ELEVATION 7 `J c/` vs~ 8 7' ` Feet Cl Feet CAPACITY VII. TANK Site in alIons Total of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank C / C►r~i S ' ~,(JC~ Lift Pump Tank/Siphon Chamber I -LL+ El VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. iia Plu ber's Name (Print): Plumber's Signature: (No Stamps) MP/ PRSW No.: Business Phone Number: 'J S ~O 2 52 Plum is Address (Street, City, tats, Zip Code IX COUNTY/DEPAR ENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination 9 L 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 INSTRUCTIONS y 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. ll. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. Ill. 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.11/86) 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 ',j 610:&-.e14 ~istJ~ ~r~~,( 9~,b 4a72e, Location of Property Afa) 14, Section T 9 N-R~ W Township tt) Mailing Address "/?I G ,J r->, Ll)~ S S d J 7 Address of Site S t~ Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel Date Parcel was Created e22,Qu Are all corners and lot lines identifiable? X 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) cehti.by that att .6xatement/s on this bonm cute tAue to the but ob my (ouh) knowledge; that I (we) am (ahe) the owneA(,s) ob the pnopenty denschibed in this inbonmati,on boAm, by vcAtue ob a waA&anty deed %eco&ded in the Obbice ob the County RegizteA ob Veedb a6 Document No. ~ and that I (We) pnesentty own the ptopoz ed .6.c to bon the sewage diz pod system (on I (we) have obtained an easement, to tun with the above desn bed ptopenty, bon the constAuction ob Said system, and the same hab been duty neconded in the Obbice ob the County Reg.c.aten ob Veedb, as Document No.%cj SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) €3 DATE SIGNED DATE SIGNED f^ 7,7 77, h oo IANM..yy .•i•-..f 1!- • .M~. • .I~ iM ~ i~~~~y. R. ,i A' Ny..w f t . . d M~_ "OR qb N. ' n . p - - ~ Y ("AL) V. yy ' a Y 'C~? y yi 't' ~ r3" • rL: ' so=ro ~LS»~atstMS ~ R ST"m of wisWNSI r~ ~ ti.......Aim i-i.,,• 19..... r east Ydm+ 00 Awv*w srkw. .rM~rr`w+a obou be i'~+r..11~4R * r.r wp~1tr z H a STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z U 1-3 OWNER/BUYER `J(1~i-~ /~VY~ ~S2~s t'ir~ ~✓~i~i~~c~2~ ~ ROUTE/BOX NUMBER Fire Number .CITY/STATE rl s ZIP '7 PROPERTY LOCATION: /64i k, k, Section 3 , T N, R _W, Town of St. Croix County, Subdivision Lot number Z 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 I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H 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. SIGNED DATE BA -q C) 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. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS J(VDUST,RY, 1 DIVISION LABOR AND PERCOLATION TESTS (115) MADISP.O. BOX 7969 ON WI 53707 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: TOWNS~HI/P LOT NO.: BLK. NO.: Sl}J DIVISION NAME: NE: 1/ IJw /T7_9 N/R/Zl for I/~/b z i}.'~C r'C3 CO NTY: OWNER'S MAILING ADDRESS: T I tctiAeA. , fig S KT /Jbw ICItMouA S~pl7 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCR) TION: PROFI E RIPTIONS: ER O A /PNOTESTS: I 4 Residence ~N - KNew ❑Replace 'T7 97 A S-2 - INC 9 1~'c1c„`1 RATING: S= Site suitable for system U= Site unsuitable for system MjpFAnayT~~^J~ CONVENTIONAL: M~~• IN-GR )N PS RE:SYST~ I❑ U LHO❑LDINGTANK:RECDNVF+~11D10NAL S ❑ ❑ S U C I~.J> i If Percolation Tests are NOT required DESIGN RATE: C I If any portion of the tested area is in the NA , under s. ILHR 83.09(5)(b), indicate: tn(,►455 ZJ Floodplain, indicate Floodplain elevation: b r PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 19 ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B 19'si 9c ~o N g'S~ isn LSL75 Z4" 84,,L rS'$RNi l9 Ee- MS44k 9 '7 Cre.?tijt'll' !40$L1_TS ?O~18QNL Z6 ~1"kN WLS 9'6 ye"" r=S B- Z ip.4-7- 9?.14 NoUL >l0.4,7- 3 '[T$aN MS 7416R.,,C:4~Co4. C a B- 9►.?0 iVo►,j /41L05, 14"&P. L Z4"fQt,8&'S*4e 4<,-" /-r8Q, AS B- d q.zS 1.69 / 0149 > 9.I5 F B- J6.47- 23 NoNr: > S ~Z B- PERCOLATION TESTS c i TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER tMIZAt5 AFTER SW LLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ 1 S ,,?V) 14oNr 93.10 30 Z' z Z' z '2'/7- t 2 P- Z S,-to NON 43.10 30 > 3 3 p 3 <10 P x. n 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 anti 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 ELEVATION -673 O l . 9-3 $~..►cur~ aa~c- iioP of FILML.k PO_57r Qa P L oT L, n, t:: M I P-3 ` w. rOU,U~ 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 COMPL TE ON: W a~v~. Sa lJN~~ Ja Ai ~>U R V, E r' g 90 ADDRESS: i CERTIFICATI UM ER: P ONE NUMBER(optional): J 4a~ 9u~~a~v 34~ CST SIGfy r DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester, DILHR-SBD-6395 (R. 10/83) - OVER - MAP CER T I EI ED SURVEY Located in the NE 1 /4 of the NW 1/4 of Section 3, T29N, R 18W, Town of Warren, St. Croix County, Wisconsin. Owned by: Richard Hopkins Rt. 4 New Richmond, W i . 54017 I N I/4 CORNER NORTH -SOUTH 1 /4 SECTION LINE SECTION 3 I T29N.R18W UNPLATTED_ LANDS S 00'05032'W 290.50_ ( SOUTH) S 00 * 05'32 W II T - - - W 238.02' I 4560.61 I O - SI/4 COR. O O SEC. 3 olo I ~E.R.IlFL P_ boy Y 0) O -MA 04 I0 I VOLS. L t PAGIzi 121_ CU 0 0 U7 CY) in min I Q7.i ZI 1 (NORTH) S100'05'32"W 290.50' Az m 45.00-T 245.50' I ~ N I LOT I a) WI o 10 140,438 Square feet (3.224 Ac.) to 0 Including Right-of-way il- ° 1o 0 (31 a 1." 131,440 Square feet (3.017 Ac.) 3 CY) I . I Excluding Right-of-way n N L0 G I of t~ i m I'q 1 S 00'01'570E 524.75' Uj 1 z1I W 4 5.00' JI J 479.75, ci Q:1= m w l Zip I ul Z 1~- Q I I cat O) I ILO T 2 J M al I 129,277 Square feet (2.968 Ac.) z1 DI CIO rn 10 Including Right-of-way in ~ rn z Z C6 to 118,163 Square feet (2.713 Ac.) a z 50' a (N Excluding Right-of-way ~ I 0 45' 1 W Z' _j I 4 5. 0 (0' 477.09' x N 00001'54"W 522.09' Z o 1 '1 UN PLATTF0 _DAN2D o _ I rn= - I N M o N z Bearings referenced to'tHe North line of the NW COR. NW 1 /4 of Section 3, T29N,R 18W, recorded SEC. 3 as N89029100"E. LEGEND SCALE IN FEET 1" = 100 - SECTION CORNER MONUMENT 25' 5d 100 200 300 • 1° IRON PIPE FOUND 0S O I X 24 IRON PIPE WEIGHING 1.68 LBS. /LIN. FT. SET. -y ---of FENCE ( SOUTH) PREVIOUSLY RECORDED INFORMATION 490-1720 DRAFTED BY JWG • ~ /1~ II Ml ~J O e tI, v - ry rJ N ~q k ~n e d o Q fy) m r C tea' o, Q J 14 n 4 4 DePARMENT OF ~'F0 REPORT SAFETY & BUILDINGS INDUSTRY, ON SOIL BORINGS C AND DIVISION LABOR AND 64 S P RCOLATION TESTS (115) (?`~/,~tt 4 ` MADISOP.O. BOX 76 N WI 3707 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) I 4 LOCATION: SECTION: TOWNSHIP LOT NO.:BLK. NO.: SADIIVVIISIION NAME: Z Ce.. N E aw 1/ 3 /T I Z9 N/R1" (or VA P, er, CO NTY: OWNER'S 9114'! MAIL N ADDR SS: T cQ& Ik tCNrIQA a0PK1 S /Aw NIc%iA SgOr 7 USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DES RIPTION: R NS: AT N TESTS: Residence New ❑Replace S 4 S 90 'SO) 0- Pq NCf3 nl~C_l-1►J RATING: S= Site suitable for system U- Site unsuitable for system SOILS -PRESSU C T❑U . M _l IND: S aU IN -ZBV G 0 ND S ❑U RE: rYSTEM-IN~FILLHO~LDING TANK: ECOMMEND VFrJrDIONA~M ti nayTQ4-NGE4", If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the A under s. ILHR 83.09(5)(b), indicate: &AS5 ~ Floodplain, indicate Floodplain elevation: A' A PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH 1$ ELEVATION OBSERVED EST.HIG HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 951 93 -7~ 40 N > 9.s8 /S° csLTS Z4" 0L tS"614 14'8,e-ASV4e 1-r Cr$Qil/Ms B- Z to-42 9 .14 NorJ~ ? l0.4Z. /4"8Lgs ?0 &NC z6lekN wis 9"Gyc44~, r-s -cT 8RN Ms Z4 "ea..,cs~t" co,6 cok, B- 3 lfo.ox 9 1.?0 ti. > ~•0it 14'LC(5 14",8P. L 24"+Pd$QNS*4Ie 4S LT$rtN1~1SD~~ B- 4 qzZ /.o lvowr > 9.zs zo ')$cc.-M I1'*&"C 44''&,X ft-4~vk 36"hlsh FS B- ~S•~Z Z.3/ [40tyF > 8.4Z z3"'$~sc~s r7"eaNS~ z3~'BaNMS ~T$Q~FS B- PERCOLATION TESTS TEST DEPT~~il WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER 4OWS AFTER SW LLING INTERVAL-MIN. PERIOD P RI D -PERIOD PER INCH P_ 1 0 otIC 9170 30 1/2 Z' z -z Z (Z P- 2 S,-Zo Note 43.10 30 > 3 3 > 3 <16 P o oNet 9Z. 6 30 > > 3 <iO P- QL P- E~CVfaTtOj 4-r 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 ELEVATION -67.51 - - 4 7$ 1 !Alkh AV Q / p~r_ VIP 9 I f ~ 1 I , _ _ t-___ E 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 : 11 TESTS WERE COMP! TE ON: W4l2vk JD tJN~~ JD N NSA u R+/EY irve. S Qa ADDRESS: CERTIFICATI M ER: P ONE NUMBER (optional): 467 Secxwt, S-- ~urssa►v o G 34~ s~ ~ o CST SIG E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-61395 (R. 10/83) - OVER - IN INDUS DR-PARENT REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS NDUSTRY, DIVISION LABOR AND BOX HUMAN RELATIONS PERCOLATION TESTS (115) # 4` MADISON WI 53707 (ILHR 83.09(1) & Chapter 145) LOCATION: SECTION: p TOWNSHIP LOT NO.: BLK. NO.: IS V~ISI~OgN NAME: NE 1 ~W 1 3 /Tz9 N/Rlq (,rkEl Vx et lu Z C.. COy NTY: OWNER'S ~''flail MAILING ADDRESS: ST CQa 4k A#,A, WCO' s aw ►Ql 1 Mouh Sgvl7 USE n/ DATES OBSERVATIONS MADE NO. BEDRMS : COMMER IAL DESCRIPTION: PR F NS: PEHUUj_A N TESTS: Residence 41\16w ❑Replace S` 7 AO 'T/,Z/ 9 S ~ A, S2 _ hC $ 1"l Iclco V4 RATING: S= Site suitable for system OILS U= Site unsuitable for system/LS CONVENTIONAL: M_14~.❑U JIZS E]U SYSTEM-INFU I F]LDING TANK: REL.OhfVF►J lDUNA~MitA nTQtNCHE--~ S u S a - UU SS U C C If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the AI A under s. ILHR 83.09(5)(b), indicate: eLrQ~ M (~6 Floodplain, indicate Floodplain elevation: KA PROFILE DESCRIPTIONS BORING AL PTH TO GR UNDWATER-INCHES CHARAC TOT TER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTAj ELEVATION OBSERVED EST.HIG HET TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- t 9,5$ 93.7` 40 N > 9 5$ /-S c sc•TS Z4" o,,,L /S SR..,41-S 14 B0, MS-i4e -1 cr$aN/►+s i= s B- 2 ~0 4Z 9 .14 No>nllf > 16.4'1 14 %Lc rs 70 BQN L ZC) 19AN wls 9 "G Y '60, 3Sc" LT 6,ew MS Z4 ~6Q.,, c s 1&o, Co b CO ~h a- 3 ~.o~ 4►.3o I~o~~ > ~.o~ 14'LCTS M"BA. Z i4"ied$QNs*44e 4s ~r$/tNl~►sAl g B- qz• 9•zS 20'$4CTS 11"i6awt 44*'&, h7-MS-kA 36"WN7 FS B- ~5 `6•~Z Z•3/ NO > S•4Z 23~~$CSC?'~ 17"eRNS~ 2 8RNM5 38"CT$Rn~~'s B- PERCOLATION TESTS TEST DEPLH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER T4tiCkTFS AFTERSW LLING INTERVAL-MIN. PERIOD P RI D2 PERIOD PER INCH P_ 1 o, oN4E 19170 30 Z' z Z' z Z' 11 P_ 2 S,zv WGt4LC_ 93.10 30 > 3 3 T 3 </U P- 14,4o oNu 2.36 30 1? 3 </O P P- LNMTf O~ AT ~L. P- C. tPLOT 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 ELEVATION -67.g v i c i g xr_k6!AR.1c- loR 0 Qasr . 6~ W_.__ 4- -,1 r- r 6- r I 1 Scnc~ via f aA 4 i ~ I 1 I t I , E I l ~ 7 ' i _ _P•_.__. _ i - f- -IT 4 ' i _ _LA i \ 1 t I I f- i ( y i I ~ I ~ i I { 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 COMPL TE ON: W~e~r~ .~a uNsar~ Jo Nso u R~~v r ~ ~ 40 ADDRESS: t / CERTIFICATI r~ M ER: PLIONE NUMBER (optional): 4v7 SEca,~a S ~unsa rv W r Sip 1 ~ ~4 is%,6-4&F o CST SIG E: ~Tc" 80 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 10/83) - OVER -