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HomeMy WebLinkAbout030-2009-90-002 M ~ O N c 0o a O c � o � I °p coo co �O _O c CD o c E w m I N '0 0E) a z > c € N m v LL o °'a(D 3 L) n r- 0 Q a v I � � I � = o v ° a m � Cf) o I O z c c in H z c � � I ` N N O co N Q N C •� R = O O O 6 Nz m z z l �j N V E C .. CL O. w O � 24 o o G G a` � d� ^N a O y ~ N @ zN > z° •N aaa a 3 0 N O O }}yy J V CO OOi 00) O z N O O 'p � CL (D N N O N O �p d m y N C ((D U) c +� T U A L d c . C O N C E LO N p O M N N C N O a N "O = N N C 7 N *4 N c) �j ..�+ 7 E E C_ (p • _ o m in ' Y � o z '� FO- � � cn I .. at c L: a E A Uai° OaiC� r Parcel #: 030-2009-90-002 03/03/2006 06:10 PM PAGE 1 OF 2 Alt. Parcel#: 34.30.19.386D 030-TOWN OF SAINT JOSEPH Current X_j ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner TODD M&MARY BETH JOHNSON O-JOHNSON,TODD M&MARY BETH 654 BEATRICE CIR HUDSON WI 54016-6934 i Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *654 BEATRICE CIR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 4.000 Plat: N/A-NOT AVAILABLE SEC 34 T30N R1 9W SW SE LOT 2 OF CSM Block/Condo Bldg: 5/1415 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-30N-19W Notes: Parcel History: Date Doc# Vol/Page Type 06/26/1998 581865 1335/266 WD 07/23/1997 1082/21 WD 07/23/1997 832/194 07/23/1997 801/59 more... 2005 SUMMARY Bill M Fair Market Value: Assessed with: 84162 335,100 Valuations: Last Changed: 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.000 110,400 194,400 304,800 NO Totals for 2005: General Property 4.000 110,400 194,400 304,800 Woodland 0.000 0 0 Totals for 2004: General Property 4.000 110,400 194,400 304,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 209 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 of Sr. � 3,0 p�z tr lout Land eq 8t r bo � 93 �•Ur , iba o � ° Page es �i Aju DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING LAAOA&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION /M11ADISON,WI 53707 State Plan I.D.Number: SW%,SE%,S34,T30N-R 19W Ul' ,l CONVENTIONAL ❑ ALTERATIVE (if assigned) Town a� St. Joseph ❑ �0 Holding Tank El In-Ground Pressure E:1 Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Tim K&UvL Route 1, Ptt.ez utt, W1 54021 1—,'31 _� BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Thomas A. Wang 3231 St. cuix 119408 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV: TANK OUTLET ELEV: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER iARES MBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: ET FROM LINE: AIR INLET: ❑YES ❑NO ❑YES ❑NO T DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVDED: ❑YES ❑NO ❑YES ❑NO I ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑YES ❑NO NEAREST 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: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING: COVER INSIDE DIA.: #PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH D1 13T PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV'INLET: ELEV.END. PIPES: FEET FROM LINE: AIR INLET: NEAREST—� 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 I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED I DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: 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 PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: j ❑YES ❑NO ❑YES [__1 NO NEAREST s — I Y Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710(R.06/88) Zoning Admd_ni6 tAa to& SANITARY PERMIT APPLICATION COUNTY (� DR.HR In accord with ILHR 83.05,Wis.Adm.Code S ATE SANITARY PERMIT# // 9 v4? —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES YNO PROP T NER L PROPERTY LOCATION f fleV yo S fiJ '/a� '/a,S T30, N, R Q E(or PROPEWf�ER' AILING ADDRESS LOT tBER BLOCK NUMBER S DIVISION AME (I Qe-e` CIT STATE ZIP CODE PHONE NUMBER CITY EST LA E APMARK �(1' fl W i L Cl VILLAGE; U e Il.—TOWN If II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) 1. a. 64 New b. ❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit# Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2) 1. a. Conventional b. ❑Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. seepage Bed b. ❑seepage Trench c. ❑seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED Square Feet): PROPOSED Square Feet): Q h aU 7 v(/Feet Wrivate ❑Joint ❑ Public CAPACITY VI. TANK Site in ga ons 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 yt J °y c ❑ Lift Pump Tank/Siphon Chamber ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumb is Name(Print): Plu Signature:(No Stamps) MP/MPRSW No.: Business Phone Number: la 3�3/ �� Plumber's Ad�s�(S;ree,City,Sta ,Zip C e):� ,/ , Na o esigner: VIII. SOIL TEST INFOR ATION CerfSoilTe„ster_(C�'(CST)Name CST# T's ADDRES((//S,,'(Street,City,State,Zip Coke) ! Phone Number: 6 , ijz I 'Road , R fig o � f�� t0 14 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sa itary Permit Fee Groundwater Date 1 wing Agent Signature(No Stamps) S charge Fee Psi Approved El owner Given Initial 20.6 Adverse Determination L W r X. COMMENTS/REASONS FOR DISAPPROVAL: bra SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT, APPLICATION TO THE APPLICANT: 1. This 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. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 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. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 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 where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in##1. Complete##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. 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. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'/z 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; dosing or pumping chambers; 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. GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground .,EftBr included the creation of surcharges (fees) for a number of regulated practices which Wisco ift" can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried rAsl2r is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) 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 C GC Location of Property �� 14 S F 14, Section 5 T J0 N-Rl / W Township � `�e � 7 — Mailing Address / Address of Site S ` Subdivision Name Lot Number Previous Owner of Property Total Size of parcel Date Parcel was Created Are all corners and lot lines i entifiable? Yes No Is this property being developed for resale (spec house) ? Yes —7Z 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. PROPFRTV OWNER CERTIFICATION I (We) cextiby that att statements on thi6 bonm cute true to the best ob my (out) knowledge; that I (we) am (ace) the owner(s) o6 the pro peaty des e ibed in this .inbacmat.ion bonm, by virtue ob a wavcanty aeod necotcded in the Obb.ice ob the County Reg.cdtet ob Deed6 as Document No. ; and that I (We) pne6entty own the ptcoposed zite bon the sewage di6p—ozat system (on I (we) have obtained an ea,6ement, to nun with the above dednibed ptcopehty, ban the construction ob said system, and the same had Jed d econded in the 0 b b.ice o6 the County Reg"ten o6 Deeds, a6 Document No. . IGNATURE A F F 'OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) TE SIGNED DATE SIGNED IT DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982; THIS SPACE RESERVED FOR RECORDING DATA �, ...... W� TY D qj,'444(90 EOOK OJ F��i This Deed, made between .......................................................... REGISTER'S OFFICE ST. CROIX CO., WI --.......:1`iei1._N.._..1�lor.ell-----------•---------------••---------------•---....._._.....----- -•- ReC'd for Record ---------------------------------------------------------------------------------------------------------------- ......................................- Grantor, N J A w 3 1989 and.....T-i_mo-th-y---L_._-Xe11er_-_and---Shail$-_M .A<e11e-r_......__._.. aT 10:00 A. M ..........h.usb an.d--- n d_..wi_F.e___a_s._ma r.ita.l..sur.v i v_or.shi_p..._... ------- p-r-oiler-ty------------------------------------------------------- ------ -L a Grantee, Register of Deeds Witnesseth, That the said Grantor, for a valuable consideration.__... --------------------------------------------------------------------- conveys to Grantee the following described real estate in ...St.._..Cr.oi.x......... RETURN TO County, State of Wisconsin: „� P,a rto f t^t h°e`SW 1/4 Of the S E 114 o f Tax Parcel No: ----------------------------------- Section 34 , Township 30 N, Range 19 W , described as Follows : Lot 2 , Certi,Fied Survey Map recorded May 3 , 1984 in Vol . 11511 , page 1415 as Document No . 393032 . TOGETHER WITH AND SUBJECT TO a 66 F oot r ' p ivate roadway easement as shown on said Certified Survey Map . S� �rE�l This ..... - hoxrie::tead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And.......Ne.k warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except I easements , restrictions and rights—of—way of record, iF any . i and will warrant and defend the same. Dated this ------- U ' y------------------- day of ------Jarl-Ua!'y------ 00 19__13.9.. (SEAL) -�-?.---.... -----------------------------(SEAL) Neil N. Norell --•--• • - ••------- ------------------------------------•----•-- ------------•-•-•----.-•---(SEAL) ----------------- --------------------------------------------------(SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) ------------------1% STATE OF WISCONSIN ss. Stf r4iX............ County. ���� authenticated this --------day of........................... 19------ pPr�ersonally came before me this -_.v( .day of . __...J; lira{vr.y--------------------- 19.89.. the above named --------- --------------------------------------•------------------------------- #-----------------------------------•------•--------------------------•-•---•-- -----Neil N•,---Norell TITLE: MEMBER STATE BAR, OF WISCONSIN -------•----------------•----------------------------------------------------- (If not, --•------•--•----••-----------•------ ------• authorized by § 706.06, Wis. Stats.) to me known to be the -_______-•__ person who executed the Min� instrur>�and a I n ' ledge the same. NT WAS DRAFTED BY Ogland Lundeen . •-•--••---- . ....... -•--- . -•-• -- ....... ---••----- at Law•--•--• .......................... * Alice J. Fle ALIIGELUREISCHAUER --------------••-------••-• ....................... Notary Public St-' Cr1 ry PUNIC-_County, Wis. Zuthenticated or acknowledgcrl. Both My Commission is perman�Ql@lOfilA6SCOl'ISh expiration date: -----------.June---1-1............................. 19.89_...) I in any capacity should be typed or printed below their signatures. STATE. BAR OF WISCONSIN Wisconsin Legnl Blank Co. Inc. FORM No. 1—1982 Milwaukee. Wis. ! J H z En H ' 9 ST C - 105 r H SEPTIC TANK MAINTENANCE AGREEMENT 0 0 St . Croix County z d 9 H OWNER/BUYER Tem ROUTE/BOX NUMBER I� , f Fire Number CITY/STATE � � S -® ( � ZIP � D PROPERTY LOCATION : 14, � � 14, Section, T „7C' N , R W, sZ Town of 571 @JQ �E���/' , St . Croix County , Subdivision Lot number O2 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 i 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 E I/WE, the undersigned , have read the above requirements and agree Ln to maintain the private sewage disposal system in accordance with x H 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 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 . INDU°3MENT F REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTV:'; DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 3707 HUflfiiyii�RELATIONS (H63.090) & Chapter 145.045) LOCATION:SG SECTION: TOWNSHIP/ OTNO.:BLK-NO.: SUBDIVISION NAME: 3 /T30H/1117 E (o ► S� �osEPh'— 12- .loo v COUNTY: , OWNER'S BUYER'S NAME: MAILING ADDRESS: !/�o/n Do U .�l10 E G L ,�%•.� �v://ac/ !�. f�vp_ JD,cJ /U/S Syni� USE DATES OBSERVATIONS MADE NO.BEUIiMS : COMMER�InL D�SZRTPTION: F1l�bE5�liiPfiiONS tsEfi�aLATION TESTS: %Residence ? //L ��New ❑Replace I D �� — Z I5CP j•2 7_7 _ sCS� 6,v.9��g -- lv��lz S.tivoy Sua srR�+r.+f� RATING: S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUNaPRESSUR SY TEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM:(optional) MS ❑UTw S ❑U OR S ❑U ❑S ©U EIS ©U �ovyE,�ro��� /�ceQ,,cos-so fr If Percolation Tests are NOT required DESIGN RATE: If any y portion of the tested area is in the under s.1­163.09(5)(b),indicate: I I I Floodplain,indicate Floodplain elevation: Fr PROTIL•E DESCRIPTIONS r BORINGI TOTAL DEPTH TO GROUNDWATER-17T&dES CHARACTER OF SOIL WITH THICKNESS. COLOR, TEXTURE, AND DEPTH NUMBER IDEPTH W. ELEVATION OBSERVED EST.HIGR—EST TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) 'Cl_.St , ,fj ',BN. 54, /.s- W-13A). s, B- D 103.30 �a- > O w B- Z 0 0 /�l.�D o- �.O •�3'Gy. SL, / op'c/•4N. S•4, 1.25-1 Ole. 5L , j -33 '�y. y1 Oe.. 4attA J- e-3 �a 103. 0 - 0 4.,/4-rez- s,zs-• B- P � 0 s 'a�-cr. sue ee l' av R,,.-P s .0 /o 3, yo her- AI , i•91' yam' B- fo /Oct.yp — I> 0 '33'dy i-, /.33' 13,t►.[., �s�/c/•aA,. sc- , .33 cy 13A'- o,e. r .e B- FT PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER L V L-INCHES RATE MINUTES NUMBER INQUES AFTERSWELLING INTERVAL-MIN. PER—LQo t o PERINCH P- P- O eta" P- P / �. . P- _ I T 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. &I-7aA-t BEd dye,f(4710 J To GiE 4MC71-1 a?.a FT de&43 tla7 C/tl- SYSTEM ELEVATION RtF dr. 4r tx"le04r/ov of 97 ?p fr- FCF ScE �TT�1��Z j �Gor �GA,J � a� �. � •�: 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 specilied in the Wisconsi Administrative Code,and that t i)j re�pUfe'},('t1 ':,yation of the tests are correct to the best of my knowledge and belief. - (� L[!(, jr. NAME print r ��OIH ;J��I E '�'► 'I�dC.� Co. TESTS WERE COMPLETEU ON: ADDRESS: CERTIFICATION NUMBER PHONE NUMB Ell(uplrur,al) HUDSON, WIS. 54016 -oL ,vF2 -- M '5/ - CST SIGNATURE: !�'`•�/` -- _ -•---. / DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tesler, DILHR SBD-6395 (R.02182) — OVER — CA,, n �J d r d �n � U X qh 3 c ' IZY 1 d-7d lcl ;/o/1 :io /Vou'vn.7/2 r�0 4 N 3931 d �y,, rd 1--757 >--�.� 1(v;iod �J�►!�d/3��� 7��/1d��� W9 • z!yoy ' it s-40vfl- -7-I3rn -9 1v11s1" O s1�d .�oya7do = • 7116 PeVoV_4 -?YOW �►o 05 .31'1 156 W 7IRM O 3Sod OSd 1 71 w Yo 1� .1Z all 1SOW 3004 v35odobd 910tTS • 'SIh1 'Nosnrw ' '►.�l:t.'t I!1 U09 aVOU 113hl,0 'E'1t1 'OJ ONIIS31 311S3WOH -7 Ice/b' 31 b4 Z_', ilsr�rnl d�soL 1� 'Q •= t 73s02�d N1f'1d 10�r' S� 1I05 NO 1%80-13isg1 Nolivlo) � 3d 1%80- ti 8 1984 Et D AY M � �^ J — JAME-3 0.IL CONMAI of i" l w �y, �* OUTH 1/4 CORNER - rj WI �� UNPLATTED LANDS SECTION 34 , T30N , R 19 W, - _ COUNTY MONUMENT 0D N spc Oq• r WEST LINE SE V4 N 000- 22'-20" E Iw SS 39>-p0 ,/ 585.25' p -3 I ,� _ , IV/s. 00''008,1E 3; O rn \ ` \ �� 5000 0'b 3• t W e,� nlm ` w/ N J ,y� ZWp ` 0) �So 66' 1a 33, m 1 \ to as 0 I O -0p F _I I I N s0�0 Ali o ;D v Z N . 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