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HomeMy WebLinkAbout020-1162-40-000 rC o a-°i °o d° ~ p o m M O C O N O 00 Cn X C � y N L C h d N b O -c C V) Y O >(U C Z > C 6 — LL c W O 0) Q o I 3 Cl) v i y z E � g °o °' (L m N H Z c O O z a c V O w d z :!t tT z U) H r C E "6 O 0I N M N CL O N ) y � O O •N L L O Z H Z w N _ z EN CL R .. o c _ y d W p c O G a L E U U N W N N E y 5 5 F- z •N � aaaa o _rn _rn �Ch 0 p C 0 O . E N O S m � O ♦♦d� d N V y C) tN 15 N � +9 O o0 0 —y H c cl Q c m E LO Oed ° y N O T � N 'c r O C co D d N O y CO y �n 01 y y CO cu •O i� O N 2 m N O z U) w a € O. C a • a m .2 m Parcel #: 020-1162-40-000 05/18/2005 11:30 AM t PAGE 1 OF 1 Alt.Parcel#: 29.29.19.931 020-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): `=Current Owner MICHAEL W&ELIZABETH M BRUESKE BRUESKE, MICHAEL W&ELIZABETH M 724 GREENBRIER RD HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description "724 GREENBRIER RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.030 Plat: 0200-COUNTRY HILL ADD SEC 29 T29N R1 9W NW SW COUNTRY HILL ADD Block/Condo Bldg: LOT 02 LOT 2 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 29-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 784/314 2004 SUMMARY Bill M Fair Market Value: Assessed with: 49014 233,300 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.030 27,200 153,300 180,500 NO Totals for 2004: General Property 1.030 27,200 153,300 180,500 Woodland 0.000 0 0 Totals for 2003: General Property 1.030 27,200 153,300 180,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 313 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 A� i Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER /" 6K4C t &tauke TO"MSHIP SEC. a / T -;?j N-R _W ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION 00Lc.n 4v -�J� A _ LOT Z LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•LHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM � s yv, Vie'',", I ....�� . --- INDICATE NORTH ARROW' Ora. e oe- _ er->. mac 'k BENCHMARK: Describe the vertical reference point used 4.� Elevation of vertical reference point: yJ p /�• Proposed slope at site: SEPTIC TANK: Manufacturer: __ l.0`° 5 Liquid Capacity: Number of rings used: 'emu- Tank manhule cover elevation: t Tank Inlet Elevation: &>q1b Tank Outlet Elevation: � Number of feet from nearest: Road: Front,Q Side Rear, ® /00 feet From nearest property line Front,0 Side.0 Rear,0 .3 f� feet Number of feet from: well �� building: l'.g/x (Include this information of t'ie above plot p late ( _2 reference dimensions to septic tank)__ f PUMP CHAMBER Manufacturer: dA Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear,© Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: 1, Len$'th: 60 Number of Lines: Z Area Built: Fill depth to top of pipe: 2 � Number of feet from nearest property line: Front, O Side, Q Rear,O Pt . Z Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: 1_i Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box 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: X�_ 2 S y Plumber on job: License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOFf&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,1 11 53707 NW4SW4,Sec. 29 ,T29N-R19W 1:1 CONVENTIONAL ❑ALTERNATIVE S Ite Plan I.D.Number. Town o f Hudson ❑Holding Tank ❑ In Ground Pressure ❑Mound j — I Greenbriar Rd. NAME Of PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Michael Brueske BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. 'IREF.PT.ELEV.: CST REF.PT.ELEV. I m t Nae of Plumber/. IMP/MPRSW No.. County Sanitary Permit Number: t+ Ro er Timm 3224 -roix SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER ('� 1"� PRr_O��V/I ED: PROVIDED: �.�,� VC)y,..0 ��,�p ���� ,L�'JYES ❑NO ❑YES ei o BEDDING: VENT DIA.'. VENT MATL.. HIGH WATE NUMBER OF ROAD:7 PROPERTY WELL: BUILDING. VENT TO FRESH f ALARM FEET FROM / I o v `I"-7 / J AIR INLET : DYES NO ❑YES ❑NO NEAREST / DOSING CHAMBER: MANUFACTURER BEDDING LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MA NUFACTIIRER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. DYES ❑NO ❑YES ❑NO ❑YES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL 1BUILDING ENT V TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moistureat the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE MAIN the soil is dry enough to continue.) ONVENTIONALSYSTEM: WIDTH- LE NGTH NO.OF UISTR.PIPE SPACING C R INSIDE DIA SPITS IL lOU1D BED/TRENCH' TRENCHES MA ERIA PIT i �' DEPTFy DIMENSIONS � ( ! / �" GRAVEL DEPTH FILL DEPTH UISTR.PIPF DISTR.PIP DISTR.PIPE MATERIAL. NO NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH FEET F BE Lqw PIPES ABOVE COVER fy,Ey I,r�}�ET EIS E —7 PIP E LINE y AIR INLET. I''a N X17 `1i! l � �, T�9 NEARESTM O �� `Lg �V A MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES 1:1 NO OIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES 1:1 NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH;BED DEPTH OF TOPSOIL MES SEEDED MULCHED CENTER EDGES ❑NO DYES ONO : YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BEDl7RENCH WIDTH LENGTH TRENCHES LATERAL SPACING: GRAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVER 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 I�IFATION :HOLE SIZE i IDLE SPACING DRILLED U)R R CTLV COVER MATERIAL: PLANSCAI LIFT CORRESPONDS TO APPROVED DYES F-1 NO DYES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL. BUILDING. FEET FROM LINE. El YES El NO DYES 0 N NEAREST \J / � Z Sketch System on C 17, L �' _ Retain in county file for audit. Reverse Side. SI NATURE: TIT \ DILHRSBD6710(R.©1/821, �C6-b (�, SANITARY PERMIT APPLICATION • OILHA In accord with ILHR 83.05,Wis.Adm.Code COU TY STATE SANITARY PERMIT# –Attach complete plans(to the county copy only)for the system,on paper not less than � �Q (Q 8%x 11 inches in size. ❑ checc evis7on to prbvious application -See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER I. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION. PROPERTY OWNER P��R99PERTY L.O•CfTION / WY, X., S T ; N, R / (O PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK# 7 2.14 6 f eg-N I QcL CITY STATE ZIP CODE PHONE NUM SUBDIVISION NAME OR CSM NUMBER YViIJ 11. TYPE OF BUILDING: (Check one) F-1 State Owned VILLAGE NEAREST ROAD ❑ Public N 1 or 2 Fam.Dwelling-#�of bedrooms PARE NUM R( ) III. BUILDING USE: (If building type is public,check all that apply) _ 'j�aa_, g0_dC 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. ❑ 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 aseepage 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 14. LOADING RATE 5. PERC.RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) ,+ CELEVATION 3 l� Feet Feet VII. TANK CAPACITY Site in ga ons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glace Plastic App Tanks Tanks structed Septic Tank or Holdin Tank LTD 2Gk Lift Pump Tank/Si hon Chamber 0 11 1 L1 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's Signature:(No Stamps) MP/MPRSW No.: Business Phone Number: Qr �' 7d�5; )-772 321 Plumber's fldd re (S ree,City,State,Zip Code): I ly,I A/f / - Z,(_,//�� ,,A e IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee(Includes Groundwater ate Issued ssuing Agent Signature(No Stamps) Approved ❑ OwnerGiven'lnitial 0(, Surcharge Pee) Adverse Determination G6/ 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 subrnVted to the county prior to installation. 5. --Ons.te 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. 11. 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, eic.), address and phone number. Plumber must sign application form. IX. Count.//Department Use Only. X. Count.//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) Y APPLICATION FOR SANITARY PERMIT STC - 100 his application form is to be completed in full and signdd by the owner(s) of the roperty being developed. Any inadequacies will only result in delays of the permit ssuance. Should this development be intended for resale by owner/contractor, ("spec ouse"), then a second form should be retained and completed when the property is old and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - er of Property M1C -)AE7.. EL12A�£T� 'gR.�ES�E Location of Property kk !7= l�, Section 2q , T2A N-R_L4; W Township tz ' Nailing Address '$ 8-M �-1ut�C�1' W\• ��b Address of Site &VAMMW?Ai�'�. 2� Dc� • y�� • 54��6 Subdivision Name ('AIJt MVA �MLX_ ,NA::1;jk-MN Lot Number -Two Previous Owner of Property -SQ"M G-ItZ�k(\ ULL'�Qv\C_k_O Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes _ X 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 T Wo1 CVOLti6y that at.t statements on eI"I 6onm ane true to Vie best o6 my (ouh) hncwtedge,; that 1 (wel am (ahe) the ownerc(s i o6 the phopehty deAcAi.bed in th.ie .in6onmation 6oAm, by v.ihtue o6 a waAAant deed necorcded in the O66.ice o6 the County RegiAtert o6 Deedsm Document No. �'ZE,'tt�- and that I (we) pnesentty ��'n t1�e p4oposed site bon the sewage di�spos sys em tort I (we) have obtained an Cast-Ent, to Aun with the above des cAi.bed prcopeh ty, Gorr. the constnuc Lion o6 said eystem, and the eame ha.e been duty keeo/Lded to the 066tee o6 the County Reg-tetel o6 Veede, 44 Vocumen,t No. ) . SIGNATURE Olt OWNER SIGNAT OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED r :4 r is ry t i 44 S+ {?4 ,l,,�ti r�;. r• 1"^ �.1 L.�...��°tY W,rvi�`�����-`.'ai+A�r5., ±,. 17'� ,AtSGgMEw NO STATE BAR OF'WISCONSIN FORM ! IM, •e►aes rod aecoaoiNe a►>Ta:. . WARRANTY DEED . s r�fie�d made beti►een ....�?Qh .. .;Rsyoae x k n...1...�?4rY.i�k i�rs $T. .................... ;dx" . , liagr t Grantor, s � Y'- �.di. and .,..Michael W...Brueske...and..Elizabeth..M.................. 1 s 5< A# <•gr�ieske. husband .and.mife..aa..survivorship marital...property .................... ............. .................... ........ .., , ........................................ ....... Grantee, S. . .............................................. Witnesseth, That the said Grantor, for a valuable consideration...... ' ... .................. ........ . .... . . ... . ............ ..... rttrvaN ro A ��'sr��r rt4 "* conveys to Grantee the following described real estate in .St•.•••Croix..•••...••. County, Statc of Wisconsin: A Lot Two, Country Hill Subdivision, Town of Hudson Tax Parcel No: .... v SF FEE . Y � 1 y � I I. it ' II I' f I� This .........�46...pGii..... homestead ro rt ' (is) (is not) P I� Y• Together with all and singular the hereditaments and appurtenances thereunto belonging; �I And.................. warrants that the title is good, indefeasible In fee simple and free and clear of encumbrances except �J iI and will warrant and defend the same. I� Dated this .............l St....... .. day of 14. ...., 19.. I' ... .. (SEAL) (SEAL) j t j • .................................................... ........ .... I L. ROR C .I... , (SEAL) lJ eA!l.S..... �'::..k.(SEAL) •..................... ................ .................. .... .. • NTHIA A. RORVICK !I ....... i .. +w AIIPBRNTIQATION AOHNOWLRDOMRNT SPATE OF'WISCONSIN I! ...............................................................................: S t. Croix County. a. i aathentlested this ........day of........................ .. 19...... Personal) camo.bef 1 t:. i July y ... ore me this . $ .....day of ....................................................................... JciYin L. 1987 the above namod ! ��Rorv1ck�and Cynthia` A •.............................................................................. Rorvt:�Cr...husbanc� and wife,, ...... TITLE: MEMBER STATE BAR OF WISCONSIN .: . (If not. .... authorized by 1706.00. Wis. Stats.) ..... ..... to me know*1(olb the Orson .:$...... who executed tho forefiu�g fiat _ n '�+Id nrknowledgo tho same. i THIS INSTRUMENT WAS onkMO BY 01 ........C...A.....R.x.Cjj.An§............................. ... .... -. a6at r....�.. C. . .. , ..... ..........Y ... ....... .. ............ . ... Notarl,Pbbllh a State Of ,.... .; . .�jr1tDQICv� Win. (Sirnaturer nm he authenticated or arknowledgcd. Itcth is, permunent.(Iff��s j�fpn are not necessary.) ! dam' r T. H L i Vf a STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d H OWNER/BUYER NlLCAP&-T-- kr Eb2-AT:-� 5 rn ROUTE/BOX NUMBER Fire Number CITY/STATE �y � �' ZIPr4ok6 PROPERTY LOCATION: RVV ''L, SW 34, Section 2 T �29 N , R 1-1 W, Town of St . Croix County, SubdivisionC-00VAC[A kkL Lot number 2- 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 , I 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 . yo I/WE, the undersigned , have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x H the standards set forth , herein, as set by the Wisconsin Depart- •o 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— 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 . N LL OLOI(N+G TA K:RECOMMENDED SYSTEM tIo`nal ^,�, ; , wlvK. 1 y' .1 �1 I} (� eq r DESIGN RATE, F tf any portion of the tested area is in the .r 3:.. Floodplain,incht ate Floodplain'elevation PROFILE, DESCklIPTIONS BORING TOTAL, A ER-INCH CHARACTER OF SOIL WITH Hl KN ,COLOR,TEXTURE;AND DEPTH NUMBER pEpTW'tDK ELEVR71�tSN LIVEQ TO BEDROCK IF OBSERVED(SEE ABORV.ON BACK) 5 say x . �,: #45` i/ N /3'�3L_SLTs /9. &+P SC. x 93 �+ � Q 5 q <,t; 75 q,$O /A CL`'$ n"9f ry L 7' QQ • fiCrr�A.. PERCOLATION TESTS •DEPTHS WATER IN HOLE TEST TIME D N WATER V •1 H S RA E MFNUTES NIJNIBER 'It1bCf4E5 :.At TER SWELLING INTERVAL-MIN. DER INCH P- r oo.z3 C19,4C. gal._ Q P. PLOT PLAN: Show Iocaticins of percolation tests, soil IXOi•ings and the dimensions of suitable soil areas. Indicate scale or distances.Describe what are the hori zontat and vertical elevation reference,points and show their location on the plot plan. Show the surface elevation at all Imrinlls and the direction and verceni of land slope. SYSTEM ELEVATION".' Qq.l b �M• c >4c� IPJ�= ' '�►T� LaovriON 1t3N Rue-4sc EL>rV� too-00 4* ,a►V� utJ ALToetq AT +I N SYSTEM ELI A-171 11 q•• r z s • x 94.10 0 .o '54LAL z f p d7 0", Ile Lor /4I R PaO�I�'.TY LIB 1,the undersigned,her oby certify that the soil tests reported on this form were made by me in accord with the proaidures and methods sluicified in the Wilconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge anti belief. I.ESTS WERE COMPt_FTFD ON:� ��6 ?TS,7 _ t:ERTIFICAIIONNIJMCiER. PIION�NlJMF3ERiuptionali: ADDRESS: 3�G�401 _ _ - . _ I 'fSl..- _ _.._._. -- -- - CST sir lni IJRE, DISTRIBUTION:01tilmol of"I III tecoiiy O) LIWill A,1111UIitY,f11111)1.11y ttwlll'1 ual t;•nf f1'".uri i I i i ' I Q o V1 NNiW �.�....�-- pS 3 R1VrR . ` �_' i �M •vaat__ � Gr �y �' � !' �� �i ii iii s v � a -���� � o A� � ��,` ,�-��+• "-�.`. pe , 0 p � Da i/ Pbssrn S 1/ M . f 5 �� For�e�a/ • e �1 ♦4 � 1 � � r SOB /1lic Gtete s l Y�c le SHEET NO. OF ~ CALCULATED BY �'� 7, DATE CHECKED BY DATE_ SCALE ...... a j ..... 8 ,• :aC�!uL� R a .. c`a c..... ✓ .. r d . ...__... , . ............ ........ PRODUCE 2041 e Inc.,Groton,Mass 01471. 1 .7: • �, � f ��� �ti: ���. :�- �trS.l � �s-/ �3 -:i�d`�� ,. _ ., --:� '`{ ,,� t� -� `,���. jt. �, � ,, -�. r .� ./ L