Loading...
HomeMy WebLinkAbout020-1147-20-000 a o 2 CD � m j k o \ 0 . ( � � a � . ƒ } 2 7 � 7 � » n � o) q C,4 / § a m § \ c§ # / k k k \ { 2 = 7 7 N -� $ ) / E Q kmz j .. ) 0 ] k E } g 2 a > . � § _ " " a ) / ® _ k k EL LL t a 2 2 \ oB ' cac . Q ; k § $ ƒ \ \ j 6 ) 6 0 § _ / E J % , j D ; 0 = k \ \ R ■ ; � in / � / Q § co k . 2 ) r S a 00 ■ � e . o e e = a § } / ; \ ° 2 ® % a o i § \ k k f § 5 - - k @ 2f = § E m . @ m ¥ ' 0 2 0 ) _ ] \ 2 m : § 2 — , CL 1 a " » E ' k a § / J a 2 0 2 J Parcel #: 020-1147-20-000 08/04/20PAGE 1 OF^1 Alt. Parcel#: 26.29.19.781 020-TOWN OF HUDSON Current X' ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner O-FALLIN, MILES W,&SHERRY L WOODEN MILES W,&SHERRY L WOODEN FALLIN 773 MEADOW DR HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *773 MEADOW DR SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.615 Plat: 2077-HIGH MEADOWS SEC 26 T29N R19W HIGH MEADOWS LOT 16 Block/Condo Bldg: LOT 16 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 26-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 1243/374 WD 07/23/1997 847/453 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.615 77,400 122,500 199,900 NO Totals for 2006: General Property 2.615 77,400 122,500 199,900 Woodland 0.000 0 Totals for 2005: General Property 2.615 77,400 122,500 199,900 Woodland 0.000 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges 00 Delinquent Charges 00 Total 0.00 r Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER T � i'PV'/�C TOWNSHIP SEC. _ T,2 N-R _W ADDRESS ��� S�� yLo�� ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT l6 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i firrg w!F'e Y'j, Je r INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used —' l Elevation of vertical reference point: /per z Proposed slope at site: ZZ 7 SEPTIC TANK: Manufacturer: 4F-e Liquid Capacity: Number of rings used: Tank manhole cover elevation: ��B Tank Inlet Elevation:! rj-4, Tank Outlet Elevation: Number of feet from nearest- Road.: Front,Q Side,(DRear, O 7A feet From nearest property line � Front,0 Side,&ear,0 >5W feet Number of feet from: well AV W'e , building: �© (Include this information of the 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,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: V/ Trench: Width: /2 Length: 6'jg Number of Lines: 2 Area Built: 6'�2 Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear,0 Pt .>.eg- Number of feet from well: � 1,,eff w 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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: IJ License Number: $9 3/84:mj "t)EPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING DIVISION LABOR&MMAN RELATIONS PLO.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION AA.D V�165s7AZ, , 19tia an I.D.Number: 11VV�� [G L y ned) Town o Hudson CONVENTIONAL ❑ ALTERATIVE Lot 16 Kinney Rd ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: T_Z SPEC Todd Dierks '02 St . Croix St . N. Hudson [Name E CH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.: tt: i 7 (l it f PI ber: MP/MPRSW No.: County: Sanitary Permit Number: avi Fogerty 3289 St . Croix 128604 SEPTIC TANK/HOLDING TANK: MANUF CTURE : LIQUID CAPACITY: TANK INLET ELEV: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER 0PROV ED: PROVIDED: 0 U �, (o r YES ❑NO ❑YES O BEDDING: VENT DI .: VENT MATL.: HIGH WATER - NUMBER OF ROAD: PROPERTY WELL,: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE. AIR INLET: ❑YES VNO C i ❑YES O NEAREST�� DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: PROVIDED PROVIDED: PROVIDED:OVER E]YES ❑NO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTRO S P ONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH FEET FROM AIR INLET: (DIFFERENCE BETWEEN YE NO NEAREST�► PUMP ON AND OFF SOIL ABSORPTION SYSTEM. Check the soil moisture at the d h pi w ng FORCE LENGTH: DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire,construction s al as 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 ( �� TREN S: TERIAL PIT DEPTH:.15 DIMENSIONS /�� GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO. R. NUMBER OF PROPERTY WEL BUILDING: VENT TO FRESH BE OW PIPES: ABOVE. VE ELEV.INLET: ELEV END: PIPE FEET FROM LINE: U AIR INLET: ,'` NEAREST�♦ �� U 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: EOBSERVATION WELLS; ❑YES ❑NO ❑ ES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑YES ❑NO ❑YES ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH 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: �J ❑YES [:1 NO �- 3 �i Retain in county file for audit. Sketch System on TITLE: Reverse Side. IGN E: a J SBD-6710(R.06/88) � Zoning Administrator Thomas C. Nelson D�LHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis.Adm.Code COUNTY _,V- STATE SANITARY ERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than ❑ �/_ Q 8fZ x 11 inches in size. c/k if rev sion to prev i us application —See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION n % '/a,S G T,73P , N, R E(or PROPERTY OWNS 'S MAILING ADDRIrSS LOT# BLOCK# CITY,STATE ZIP CODE PHONE NUMBER SUBDIVI ION NAME O M 11-1 TY II. TYPE OF BUILDING: (Check one) CI ILLAGE: NEAREST ROAD MLQE State Owned �/ ❑ C, El Public LR 1 or 2 Fam.Dwelling-#of bedrooms -3 AR EL TAX NUMBER( ) a 6�/ III. BUILDING USE: (If building type is public,check all that apply) f11116 75'I d 00— �/� aO-W C) 1 ❑ Apt/Condo d 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) 12 "New 1. 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 REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ELEVATION 15-0 riv J 9r,5 Feet Feet 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 '— pp Lift Pump Tank/Siphon Chamber VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the onsite sewage system shown on the attached plans. PI tier's Name(Print): Plu er' gnatu $tam ) /MPRSW No Business Phone Number: vet L! �� iurre{'s Ad as(Street,Ci ,State, ip Co 1 UN /D EPAFITMENT US ONLY ❑ Disapproved Sl nary Permit Fee(Includes Groundwater a e Issued Iss ng gent Signature(No Stamps) Approved ❑ Owner Given Initial IY�P Surcharge Fee) Adverse Determination 'U 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 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. 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.11/88) APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property ( 7 �-�S ( tine /G1� Location of Property ;4 14, Section , T N-R W Township �5 S "� Mailing Address Address of Site Subdivision Name 4/ Lot_ Number Previous Owner of Property C Total Size of;parcel -bate Parcel was Created Are all corners and lot lines identifiable? K Yes No Is this property being developed for resale (spec house) ? Yes No Volume �CL_7 and Page Number 2 s3 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 Ci:RTIFICATION I (We) ceAti.by that att statements on this botrm aAe true to the best o6 my (ouA) knowledge; that I (we) am (ate) the owner(,$) o6 the psopetty deb cx bed in this in6osmat;i.on 6otm, by vi tue ob a wat&anty deed tcecotcded in the 066ice ob the County Register o6 Deed as Document No. p y ; and that I (We) pses enfity own the pnopoded site 6os the sewage d"pozat system (os I (we) have obtained an easement, to nun with the above desenibed pnopetty, bon the constnucti.on o6 said .system, and the same has been duty seconded in the 046ice o6 the County Register o6 Deeds, as Document No. za Zi,,, SIGNATURE OFQ O ER 4SIGATURE OF CO-0 ER (IF APPLICABLE) -DATE ,SIGNED = DATE SIGNED uocUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2-1982 450246 wo 847?AGE 453 REGISTER'S OFFICE x ST. CROIX CO., WI k Glenn A. Waxoq-and Vycella-M. Waxon, husbana.•ana..w fg_.. ReC'd f a/k/a Glean Waxoai or Record G 0 21989 ...... ........... ................:........ at 11:05 AM conveys and warrants to -Toad..W...Dierks-_...... Kristin._M________________ ^ ,•Richison•,--as-,jQn-t..•Gez3.aAtB........................................................... r - RepbNr of Deeds .....•-•---....••-•••-•-••-•--•••-•-•....•......---•--•--••-••....•...............•--•-•--..........--•.......--- j •----•......................•-..................................._.......•••..........-......._....._.-.......... .................................-..•. .......................................................................... RETURN TO '' 7 y .................•--•...-_-••--•-....._...............................---......•...........--..........-..._. ,. --_-..._-•-.•--.....-•-.•.--_-.-........... ...................•_ _...... sw St. Croix .•...Count -�..=.,the following described real estate in ........................................... ' State of Wisconsin: � '. Tax Parcel No: .............................. ,( F ' n � rY Lot 16, High Meadows in the Town of Hudson, St. Croix County, Wisconsin. 1j 4 a', 4 tr t."+S ..JI•t t ` '�g;" ,P9p•_' As c{w`t.�. ti :,� tkjr. �.�2`n .'�t'��if '•�•s`'�' i},'4•sF�',d- ry This 'homestead property �� r,�+'�S -r` �v �U���r`�`4 `1�'.. t yr� �tZ��� #o�, .{yrT r� h�^ •�^ Y 'y�Ay°i c�`µa ills{.: .+ ,. �5" 4,•{rk�, ', v � .I •� f:.:. 5,�+ r r c' w `a s J .} Exception; a santies ``Eae nts covenants and.restrictions ;:of "record.` 8 .2 , •Y ' T y .� .........�y 7 j 199 0. ...Dated this ay ,E .. Y4�;kr, .(SEAL) GLENN�A:' WAX_ON * ....................... .................................... µ .........(SEA -rGrC % /..^�`�`�;'+6" ° r``....(SEAL) ...•.....................•-•-------•--••---............._----..... AUTHENTICATION ACKN0WLEDGMENT,S`' I Signature(s) STATE OF WISCONSIN ....................................-....................................�,._... St. Croix ........................•.............County'. f� authenticated this ........day of........................... 19"..... Personally came before me this .- I.- -__---.day of --••-•---•................................. 19... ,... the above named -....----•--------------•--------.....-----•......-----------..._•-------------• Glenn A. Waxon - - -_...-•a-••........................................... Vycella M. Wxon TITLE: MEMBER STATE BAR OF WISCONSIN (If not- ............................................................ ....._•••-•------•_.....--•--•-•-••-....---....----•-------•._...---......._.... authorized by § 706.06, Wis. Stats.) to me known to be the person ............ who executed the i fo oing instru a d wledge t} same. ii THIS INSTRUMENT WAS DRAFTED BY ` . . ....-••-••..... . s..... ............................... Heywood & Cari by Samuel R. Cari P.O. Box 229, Hudson, WI 54016 Notary Public ._ County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is ernmA (; ��U F 'ra ion are not necessary.) date: ......................... __�_J.j1 tWyPUW..., 1J1 ••) •N ames of p _ ersons s i sin _i n an y aapacity'sh_ou_ld_b e typed or_p rinted below their_signatures. StBteflUMsmnghj• _ ;",r, ' ' STATE BAR OF WISCONSIN _ 6 'y� Wisconsia,LegaW§lank Co Inc ....w n M& •Y D�.i- + H W H a ST C - 105 r r a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d OWNER/BUYER � ROUTE/BOX NUMBER ��2- 54 C ? Fire Number .CITY/STATE- t)to ZIP 4�-y 0/� PROPERTY LOCATION: !&, k, Section T N , R W, Town of L�Uosoj 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 . 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 Ln to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- b 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 '(9 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 . REPORT ON SOIL BORINGS AND SAFE FY& BUILDINGS DIVISION HUMAN �iEL•ATIONS P AND PERCOLATION TESTS (115) MADISON WI 7969 (H63.090) &Chapter 145.045) LOCATION: SECTION: TOWNSHIP LOT NO BLK.NO.: SUB VISION NAME: �/ 1Z /T N/R E( ,ws COUNT . OW�'S U ER'S NA E: MAILIN ADDRESS: USE DATES OBSERVATIONS MADE r�` NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFIL DESCRIPTIONS:1PERCOLATION TESTS: �V**esidence 3 E�Kew ❑Replace RATING:S=Site suitable for system U=Site unsuitable for system ONVEN I IONAL: MjUN` N-GOUN D-PRESSUR : S(YSST.E�`M-IN-FtI'LL r19S 0LDIING TANK:RECOMMENDED SYSTEM:(optiona�� L'JJ �S E]U DS �Y �� I r If Percolation Tests are NOT required DESIGN RATE: If an �-- y portion of the tested area is in the under s.H63.09151(b),indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION P H T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, OBSERVED ES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- /None 8 . C 8' ' s t B- 2- 77 , g , "' �f �� /. r rn B- 3 7 S 79. L B- ° 2 d Ilk S f Y,� ' Mf.. B- , rro B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERT Q D 1 PERIOD2 p PER INCH P- I 3 P- P- 3 P. r 3 s 9 q 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 9s ' � l 47 f , { . : i /{l nnry Al- S. TN _ _ r i j < a c ' 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 COMPLETED ON: DAVE FOGERTY PLUMBING �- � ADDRESS: 03233 03289 CERTIFICATION MBER: PHONE NUMBER(optional): geft Hal g Road ROBERTS, WISCONSIN 340 Phone 749-3636 DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395 (R.02/82) —OVER — fit-- vi IM M v 1 � L A 9 Vl kA J � � �o Q r� •o i y I V i �k k { r 9S•L ry 1 i iy aEa" p UNPIATTED ^� 1AN03 ti"�g>:• - , EST LINE-]EI/4 N 0.16'1!"W 36746' 6401. . — 23).00•._.. w �__..____- tiv I Z V r� ASSUUED BEARINGS REFERENCED TO THE =ai� q ` f.° � !I rb �. � oS1�• MOnuI/ENTEO EAST LINE OF THE SE Ia, osN vv W p h I ,� I N •>1^ BEARING NORTH \ 'l A z 616, ul 1 p I 1 IN �____._N 0•Id q"W —1}1' � m ^^ I O r i n^• n P J25 0o' ID A ° 0 7 , T 1. CL ID o a > £ mi50•IB'I!'E"21474', ° p 0, �o•• ' FUTURE ROAD n e4 O �.O no- • O O • y @ O Q. G co( to O I Ilu °I4:'N 0.16'13"W" 30500'..•; m a x@ M o ° N 0.16'ro"w _ ; I I I H u e 'O � Q 30 O z TO 325 Do' IA @ I Io �� 0 3 0@ 3@ I I Iw.. O N < K ID `G O @C 1. O !D 1 1 < I I o _ 3 .O v pl I'I ••J : g. ' I 7� - N O -4 26204' Cl, N 0.16'1!"w 292 53 . N0• 6IS"W 3 c 31. C zoo oo' _TO X L70 • _ SIG N o -, @ m o 11..I ry. �yI� I h iA „ • i, -.. m O �O,O ,\ �©�.3iS' �^6 LIB °• _ ,o I D O U1 nT ol . r"a Tn. In• O O O o 'cD "". -- -1 •� . !! °ip• s v�'w -I N D•16'IJ"a Jze so'_ C 07 �q`/ jv'• Co. v JJ I .Y�,A c0 zi,✓ co �bv 'J�el'O I O - ' O O N °1111 I. --•r:rv.S'0'09'09"E. 36337 . ""' ' J•1 v�N 0 h c- , ..19113 e .' 776f i' • Q7u_ ..,10. C•03'D6 E,�4A6 77 N � 0. � I'^,y m � •• ;, �,�, 1� ter.. 4 z J6610' 00 o a� 326 V°m C :Y 8 UIN N 8 y1s •{P�1\\ i'. to (D a) ° o T O y O a I _- N 0. 17' W 0 422 22 IT m if 0 u m -zi m I 736 7T' '•.` w <� x A m m 7266 4 z g 40.03'06'E 60672' 1 I i y N w '464''/J'yy� ! Qi 1'P IS z °. ^ t ERTIFIEp tI Y%� nn ... ..VEY MAP I ', . RECORDED l IN U VOLME a ` l "' PAGE 731 � s r � � • i �I !�U i