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032-1042-10-100
er 03 M, pA c r� 0 N O O C Q a) (D (6 LO 3 CD o O 0.4) Z 3 m pp LL c rn d c N I v I� z iii I rn w E Z 0 I'' :% o I z '° a m w Z c O o z ? c w o fn H O N z c E -o I .O E Ch _�V N O O CT I d US y y C • p i IL I O N d w _ O Z 0o Z p z N � I N LQ M CO p N R � O LO C O C CL 'n a m c .�- N d i 4 2 p G d co < U •� E 0 0 0 a m z a maaa cc 0 N rn rn *i 7 O V1 N fn J U li OOi OOi } �p 0 m a N N N r)) N Nir C"" p Co N y O C) 0 — N C }� u o 3 pa o ,O N' O U 0 O O � '6 N C C Ua V - N U N N i O 0) N I C C 3 O O E c2 Z Z C N ! N M E E E E c T " E :3 �* a ` a w a m c �`Fwv +� E i c o _1 A ciao ONv • ST. CROIX COUNTY WISCONSIN ZONING OFFICE r a '�`r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 May 26, 1998 Kernon Bast 400 So. 2nd St. Hudson, WI 54016 RE: Existing septic system inspection for Bill Sommerfeldt Legal: NW A, NE %4, Sec. 15, T31 N-R1 9W, Town of Somerset, St. Croix County Dear Mr. Bast: On May 26, 1998, an inspection of the septic system on the former Bill Sommerfeldt property, 2174 60th St., Somerset,Wisconsin, was conducted. At the time of the inspection,the septic system appeared to be functioning properly. No ponding of septic effluent was observed in the drain field vent. The septic system serving the property was installed on May 16, 1989, and was sized for a three bedroom house. A Weeks 1000 gallon septic tank discharges to abed type drain field— 12 ft. by 52 ft. The system was inspected by staff from this office on May 16, 1989, and was installed as a code compliant system. To prolong the life of the system, remember to have the septic tank pumped once every three years or when the tank becomes 1/s full of sludge and scum. Other efforts to prolong the life of the system could be as simple as fixing or replacing plumbing fixtures with water conserving fixtures, reducing shower time, washing dishes when the dish washer is full, avoid using a garbage disposal, using a wash machine with a suds saver feature, etc. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. This inspection of this sewage disposal system was based on a surface inspection of said system, and did not involve any excavation or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. The water test results will be forwarded to you as soon as we receive them. Should you have any questions, please contact this office. Since ly, k d / Rod Eslinger Assistant Zoning Administrator ST. CROIX COUNTY � - -` WISCONSIN a' /< ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER poxunuru� „ 1101 Carmichael Road Hudson, WI 54016-7710 -= s (715) 386-4680 June 3, 1998 Kernon Bast Edina Realty 400 South 2nd Street Hudson, WI 54016 RE: Water Test Results for Bill Sommerfeldt located at 2174 60th Street, Tn of Somerset, St. Croix County, Wisconsin Dear Mr. Bast: Enclosed are the original water test results from Commercial Testing Laboratory for a water sample that was taken at the above referenced property. If you have any questions regarding this, please call our office at (715) 386-4680. Si erely, e CS/1 Rod Eslinger Assistant Zoning Administrator Enclosure sm COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800-962-5227 FAX - 715-962-4030 ST. CROIX COUNTY ZONING OFFICE REPORT NO.: 64075/01 PAGE' 1 ST.CROIX CTY GOV.CTR REPORT DATES 6/01/98 1101 CARMICHAEL ROAD DATE RECEIVED: 5/27/98 HUDSON, Wi 54016 ATTN: JIM THOMPSON OWNER: Dick Stout (Bill Sommerfeldt) LOCATION: 2174 60th St., Somerset COLLECTORS Rod Estinger DATE COLLECTED; 5-26-98 TIME COLLECTED: 10:00am 3OURCE OF SAMPLE: Kitchen tap DATE ANAL.YZED:5-27-98 TIME ANALYZED: 2:00pm COLIFORM,MFCC: 0 /100 mf INTERPRETATION: Bacteriologically SAFE NITRATE-N: 5.9 ppm Ah ve! to — P �'.._ •!� .r[n�?d'� �fiE �c?C?�• �c Ct�l:?c Pub(i•T I Conform Bacteria/100 mL Nitrate-Nitrogen, mg/L LAB TECHNICIAN: Pam Gane RESULTS: WI Approved Lab No. 19 FAX'U (;HIV: _ I PHONED ON. z� �- CALLEil: I� < Means "LESS THAN" Detectable Level Approved by: X COUNTY it oil N WISCONSIN ■■■ CROfx ZONING OFFICE coo ST",C OIX COUNTY GOVERNMENT CENTER OF�ICl• 1101 Carmichael Road Hudson, 4016-7710 (715) 386-4680 SEPTIC INSPECTION / WATER TEST REQUEST FORM Please Specify y desired test(s) & remit winter Outside water lines appropriate fee Outside making are often turned off with arrangements with this office to insure that a during necessary. Please make entry can be gained. 0 Water (VOC,$) 0111ater (Nitrate & Bacteria) 145, 00 Septic � Water (Lead Concentration) $50. 00 �• P� 0 Nitrate & Bacteria __ 21 . 00 retest Owner: �� � Ei(Q $15.00 Address:o?i-� Requested b IS, 0 5 c _ y; Telephohe �-tRS T Address: , A- Telephone W- ( c ZIP p�eo Property address ,�GFire N° & Street � �-da�9 Location: (��; ,3� 3, Sec. /s-- ) : oZl? sue: _ 1 Realty firm: ' T-�N� R [ W, Town of s�T 032.1©y2.lb• Lock Box Combo: I5.31. Iq aesA-�� Closing Date: ((—I—QB TO*PROVIDE A S BE COMPLETED BY PROPERTY OWNER KETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE O Water sample tap location: F THIS FORM* Is the dwelling currently occupied? Age of date last occu Yes 0 No / g septic s DPied• m0. ��p �9 Septic tank lastYstem: ,� ki Previous O Pumped by: -� owner s Name(s) : Date: 3 � - s�sfi Have Oan of the following drainage been observed? z-e�Cs OY Sewage - from house. 0Y Sewage Back-up into dwelling. J2' rS2� 0Y Foul odors. to ground surface or road Other comments relative to system operation: I certify that the best of above information is complete MY knowledge. let e and true to the P OWNERS SIGNATURE: 1/94 f OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION ti 1N KOO TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit-ion:=file?. PCes ONo Soil series per SCS Soil- Survey: sheet # Type of soil absorption- system: below grd []At-Grd ❑Mound Approx. size l7. ' X-5�! .4Gravity Mose OPressurized Ft.2 Bed ;❑Trench ODry Well _ = OHolding -Tank ❑Outfall pipe. OBSERVED DEFICIENCIES ❑Other ❑Unknown Septic tank ., : Setbacks. douse OWell_jj2�POrop.- line 62o' ❑Other Dose tank Setbacks: ❑House OWell OProp. line ❑Other OLocking cover OWarning label- ❑Pump/Floats OAlarm -;�,_OElec. wiring Soil Absorption System Setbacks: Aouse OWell 17,o�Mrop. line V20" ❑Other OPonding: ODischarge: General comments: INSPECTORS SKETCH OF SYSTEM LOCATION N Inspector Title s FILED 5`7810'7 Aa--, z 9 1998 . ' 2 R KATHLEEN H.WALSH - Register 01 Dceds St.Croix Co.,WI %�� ,- CERTIFIED SURVEY MAP '� �,�' Located in part of the Northwest Quarter of the Northeast Quarter, part of the Northeast Quarter of the Northeast Quarter, part of the Southwest Quarter of the Northeast Quarter, and part of the Southeast Quarter of the Northeast Quarter all in Section 15, Township 31. North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Prepared for and at the request of: NOTE: The parcel(s) shown on this map is/are subject to State, County and OWNER: Township laws, rules and regulations ( i.e. wetlands, minimum lot size, access Richard 0. and Janet P. Stout to parcel, etc.). Before purchasing or developing any parcel, contact the St. 1353 Awatukee Trail Croix County Zoning Office and the appropriate Town Board for advice. Hudson, WI 54016 Drafted by. Kristi A. Eylandt C. T. H. _ -----------S89'23'33"E 2669.29'----------- -------_ --S89'23'33"E 1186.11'--'��---- --N89'2333 W 1483.18----- I I NORTH LINE OF THE NE 114 OF SEC. 15 NORTH 114 CORNER I N SEC. 15-31-19 10 ° I (F-ND 2" 1.P.) �r NORTHEAST CORNER IC SEC. 15-31-19 p' r---KE T LINE OF THE NE (ALUM. CO. MON.) 114 OF 7HE NE 114 -<*,..• , M 4 AREA LOT 3: 348,615 SQ. FT. 8.00 ACRES I- G D C I� UyPLASTED SAND OF OWNER PROPOSED 66'1 WIDE ACCESS ASEMENT • — w SEE SHEET 2 S89-24'21'E 259.22' w - --0) sa \�\ SA o y r \ZO � \ O 0 \O �c O In a C pia ;r.d a d s rF ..,v rn ,-a:e r Ie I \\0 aWovv Sr Is be V z D 2 IZ Z \ ma and vad • t� \Cn v ° 2 iD $ 2 .+y SEPTIC VENT ^� I� A d'• 0 to rn Z [�i f$? SOUTH LINE OF THE Ir x' rn O IZ • /' ��=- rtl' i IN 114 OF THE NE IO (� UJ .,� .• r 1 4 co 14 0 I N ak a:.......... us; 0' _ % :::. U z 0 T �0 0 WELL NORTH LINE OF THE a, rn N SE 114 OF THE NE cn° a i� CENTERL/NE 114 M o� � DR/VEWA Y �^ o (TI D m = N86'38'23"Ev--, v I .ZZ "'�' 67.30' _ ni° \ ti I y 108.89 ■ �i y � C S86'38 25 W ter, Z �= I ern Ll ti ° n, o 00 C3 r1i C;J CS r1-1 -Z s O N G) AI .� M `2 ha Z I 00 ��1 rn un D W LJ N Z N S89'14*13"W 507.18' m LANDS OF OWNER �q+ls+t� UNPLATTED __________ LEGEND; +$GO�s�ti County Section Corner Monument of Record 1'} RONALD F. • Set 1" x 24" Iron Pi weighing P e �JOHNSON a minimum of 1.13 pounds per S-118e r foot.linen oo � AMERY. JOB #97050 (R14) ,• I WIS. + 150 o fso NO TH Prepared by. • �Q A & E � 1 •� GRAPHIC SCALE LAND SURVEYING & CIVIL ENGINEERING ,0#+o� SU 1464%% SCALE IN FEET: 1 inch = 150 feet e, �Mevr+► NORTH LINE OF THE BEARINGS ARE REFERENCED TO THE 0 Phone No. (715) 246-4319 , 109 East Third Street P.O. Box 325 NE 1/4 OF SECTION 15, TOWNSHIP 31 N., RANGE 19 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR S89'23'33"E. 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SURVEYOR ' S CERTTFICATE I , Ronald F. Johnson, a Registered Wisconsin Land Surveyor, hereby certify that by the direction of Richard O. and JanF•t: P. Stout, I have surveyed, divided and mapped a part of the Northwest Quarter of the Northeast Quarter and part of the Northeast Quarter of the Northeast Quarter and part of the Southwest Quarter of the Northeast Quarter and part of the Southeast Quarter of the Northeast Quarter all in Section 15, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin described as follows: Commencing at the North Quarter Corner of said Section 15; thence, on an assumed bearing along the north line of the Northeast Quarter of said Section 15 , South 89 degrees 23 minutes 33 seconds East a distance of 1186 . 11 feet; thence South 00 degrees 09 minutes 01 seconds East a distance of 1041 . 28 feet to the point of beginning of the parcel to be described; thence South 89 degrees 24 minutes 21 seconds East a distance of 259. 22 feet; thence along the arc of a curve, concave to the northwest, a distance of 147 . 57 feet, said curve has a radius of 333 . 00 feet and a chord that bears North 77 degrees 53 minutes 56 .5 seconds East a distance of 146 . 36 feet; thence South 26 degrees 31 minutes 56 seconds East a distance of 235.66 feet:. ; thence South 11 degrees 01 minutes 07 seconds East a distance of 238 . 00 feet; thence South 86 degrees 38 minul:es 25 seconds West a distance of 108 .89 feet; thence South 00 (legrees 33 minutes 14 seconds West a distance of 268 . 52 feet; thencr� South 89 degrees 14 minutes 13 seconds West a distance of 507 .18 feet; thence North 00 degrees 09 minutes 01 seconds West a distance of 245 . 30 feet; thence North 86 degrees 38 minutes 23 seconds East a distance of 67 . 30 feet; thence North 00 degrees 09 minutes 01 seconds West a distance of 448 .86 feet to the point of beginning . Containing 348, 615 square feet ( 8 .00 acres) . Subject to all easements, restrictions and covenants of record. Together with an easement for ingress and egress, along the shown 66 .00 foot access easement shown hereon, westerly, southerly and easterly to the Town Road ( 60th Street) . V also certify that this Certified Survey Map is a correct representation to scale of the exterior boundaries surveyed and described; that I have complied with the provisions of Chapter 236 . 34 of the Wisconsin Statutes and the Subdivision Ordinance of Lhe County of St . Croix and the Town of Somerset in surveying and snapping the same. 6t'6nald F. JG4fnson Reg . No. 1186 Date A & E Telephone # (715 ) 246-4319 Land Surveying &Civil Engineering P. O. Box 325 New Richmond, WI 54017 % co0 ti t RONALD F. �} JOHNSON 6-1+96 AMQRY. 6. e rrr�r..,. .srty�'�+ Sheet 3 of 3 L_ Vol. 12 Page 3443 LL <5 OfA-^A o� Parcel #: 032-1042-10-100 04/25/2006 08:36 AM PAGE 1 OF 1 Alt. Parcel#: 15.31.19.208A-10 032-TOWN OF SOMERSET Current IXI 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 O-DEVAN, DOUGLAS G DOUGLAS G DEVAN C-DEVAN TERRY L MURPHY- DEVAN TERRY L MURPHY- 2174 60TH ST SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description '2174 60TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC I Legal Description: Acres: 8.000 Plat: 3443-CSM 12/3443 SEC 15 T31 N R1 9W PT NE NE, NW NE, SW NE Block/Condo Bldg: LOT 3 &SE NE BEING LOT 3 CSM 12/3443 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 15-31N-19W Notes: Parcel History: Date Doc# Vol/Page Type 03/17/2004 756825 2528/41 QC 06/0311998 580268 1328/515 WD 03/02/1998 574085 1301/248 WD 776/191 more 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 8.000 73,000 354,800 427,800 NO Totals for 2006: General Property 8.000 73,000 354,800 427,800 Woodland 0.000 0 0 Totals for 2005: General Property 8.000 73,000 354,800 427,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 142 Specials: .User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 u N\ fd a'�+ o r� O'O W� y.0 y y = ^ vE"U N W yW Oz In MN.--� H >,.�+ yN y .d .? m ? .V � V m x3 z -°zw cno u� ��'oo o �b ay � •� c ° W ° G c W _ A o W v W o m c c a::3 b ° roe r x o N 11 c Q v OU v r o_ G yN'ro C o C. b •� .. 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CROIX COUNTY GOVERNMENT CENTER UpNflp1111HM '� 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 May 26, 1998 Kernon Bast 400 So. 2nd St. Hudson, WI 54016 RE: Existing septic system inspection for Bill Sommerfeldt Legal: NW '/a, NE 1/a, Sec. 15, T31 N-R1 9W, Town of Somerset, St. Croix County Dear Mr. Bast: On May 26, 1998, an inspection of the septic system on the former Bill Sommerfeldt property, 2174 60th St., Somerset, Wisconsin, was conducted. At the time of the inspection,the septic system appeared to be functioning properly. No ponding of septic effluent was observed in the drain field vent. The septic system serving the property was installed on May 16, 1989, and was sized for a three bedroom house. A Weeks 1000 gallon septic tank discharges to a bed type drain field— 12 ft. by 52 ft. The system was inspected by staff from this office on May 16, 1989, and was installed as a code compliant system. To prolong the life of the system, remember to have the septic tank pumped once every three years or when the tank becomes 1/s full of sludge and scum. Other efforts to prolong the life of the system could be as simple as fixing or replacing plumbing fixtures with water conserving fixtures, reducing shower time, washing dishes when the dish washer is full, avoid using a garbage disposal, using a wash machine with a suds saver feature, etc. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. This inspection of this sewage disposal system was based on a surface inspection of said system, and did not involve any excavation or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. The water test results will be forwarded to you as soon as we receive them. Should you have any questions, please contact this office. Sincer.elv. r Rod Eslinger Assistant Zoning Administrator r c 1� T. CROIX C O 15 rn p jr- WISCONSIN TY rr■ ST C �`�U ;, Rorx �� ZONING OFFICE 2pN NG o F Cc ST`,.0 OIX COUNTY GOVERNMENT CENTER 1101 Car michael Road E - z Hudson. WI 54016-7710 SEPTIC INSPECTION (715) 386-4680 / WATER TEST REQUEST FORM Please specify desired application. tests) & remit winter Outside water lines en t priate Months , making are often fee with arrangements with this office to insure that turned off during to the home necessary_ Please make entry can be gained. 0 Water (VOC,$) 0,Water (Nitrate & Bacteria $185. 00 (Lead Water )x_45.00 Septic $50. 00 px• Concentration) ' 0 Nitrate & Bacteria Owner: ,� 21 .00 retest $15.00 Address:o?l-� Requested by: KraSCT Address: ' Telephone Np. (�tS ZIPSS-- '�- •4 vp GC>t 7. s3 '5�275c2 a erg,sT Telephone W, ZIP S Property address Fire I� & street Td (�� �-°a�9 Location:�, '�j� 1 ) : o2t7� 4 ST Sec. / T Realty firm: -N' R W, Town of �,,,,�ges�7- Lock Box Combo: Closing Date: Gl6� 1�PROVIDE O BE COMPLETED BY pROpERTY OWNER A SKETCH OF HOUSE & SEPTIC SYSTEM ON Water sample to REVERSE OF THIS FORM* Is the dwelling location: If vacant, date last eoccu occupied? Age of se Dpied: Yes O No Septic tank last Pumped Previous pumped by: -� Owner's Name(s) : Au Date: Have❑an Of the following been observed? o Slow draina e Sewage g from house. DY Sewage Back-up into dwelling. O g discharge to ground surface Foul odors. or road ditch. Other comments relative to system operation: I certify that the best Of above information is complete MY knowledge. P and true to the OWNERS SIGNATURE: ' 1/94 DATE: f 0 60). f � . \ � � $ 2 \ Lo • � � LL ) 2 R . a 3 ) 0 < c � CO » R z 2 z z' 0 � z / § ) 2 § ) a co 0 ' ■ k 7 \ ) ) \ 7 \ � . � \ / Q 0 mz ) � N E n . o ® k � £ _ ) § 2 \ 3 k ) M ) ] k n k) FL� 5 ED, % & 2 ih } - k 0 a a a 7 \ 0 U)—2 u m cn _c ƒ 10 } \ . _ § a = E :3 N� N ! £ � §� � a 2 3 E 2 < » m m 8a $ \ � } $ E k § 0 ° k ° ° 0 K ° § § \ @ 2 £ a t 0 z 2 f ƒ § \ 0 0 2 k § ' £ o - m ' m o z 2 R e ■ m � k ! 0. L ; 4 . .� Cg E ) } @ a § / u a 2 o U) u . ' s FILLED JUL -- 8 , � ;=2 578107 APR 2 9 1998 ► ST CROIX COUNTY KATHLEEN H.WALSH - Register of Deeds SURVEYOR'S RECORD !� St.Croix Co.,WI .� CERTIFIED SURVEY MAP Located in part of the Northwest Quarter of the Northeast Quarter, part of the Northeast Quarter of the Northeast Quarter, part of the Southwest Quarter of the Northeast Quarter, and part of the Southeast Quarter of the Northeast Quarter all in Section 15, Township 31 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. Prepared for and at the request of: NOTE: The parcels) shown on this map is/are subject to State. County and OWNER: Township laws, rules and regulations ( i.e. wetlands, minimum lot size, access Richard 0. and Janet P. Stout to parcel, etc.). Before purchasing or developing any parcel, contact the St. 1353 Awatukee Trail Croix County Zoning Office and the appropriate Town Board for advice. Hudson, WI 54016 Drafted by Kristl A. Eylandt -----------S89'23'33"E 2669.29'----------- ----_ --S89'23'33"E 1186.11'-- fi --- ----N89'23'33"W 1483.18'--------- 1 i-� --- NORTH LINE OF THE NE 1 4 OF SEC. 15 NORTH 114 CORNER Iy SEC. 15-31-19 10 I ,ter NORTHEAST CORNER (FND 2" I.P.) d SEC. 15-31-19 (p —Wf ST LINE OF THE NE (ALUM. CO. MON.)(; 114 OF THE NE 114 rn AREA LOT 3: 348,615 SO. FT. 8.00 ACRES loa. i `G D c �� ��?�AII�D LgNl� QESI�NE� �Z<y ao PROPOSED 66'I WIDE ACCESS EtASE—MENT SEE SHEET 2 ,-S89'24'21"E 1 259.22'-,_w J+ �< - 0 a WD B v2Q� rr:,o;: "rid !2 m D ;Z \* i I LOT 3 �` \\0 &por)"Oas:;ar it be � nw and MOW Ili Z" o i� $ Z ® SEP11C VENT 17,0 v Im I O 2 vr- \= I HOUSE 0\ W SOUTH LINE OF THE rn v iz 1 X41/4 OF THE N£ Z v m= h (A M 0 I� � �L � NORTH L/NE OF THE Z o 2� IZ o W SE 114 OF THE NE CENTERUAT �p 114 M pmt� � DR/VE'WA Y (� N z z : N86'38'23"E--,\ v ( - 0 67.30'i n, � 108.89 Nri� °� ' ry I C S8638'25"W `I Z #U) 03 C3 co (0 2 A 1 C) I �' ���� Z m cn I p, �,�v En ,� o N C-� N Z N S89'14'1I"W 507.18' rn 1r UNPLATTED LANDS OF OWNER LEGEND yi►g'G0� County Section Corner Monument ' of Record 1 RONALD F. Q • Set 1" x 24" Iron Pipe weighing 'JOHNSON a minimum of 1.13 pounds per I 5-1186 linear foot. : AMERY. JOB #97050 (R14) I WIS. ; Aso o tso i Prepared by. • 0Q NO TH A & E 4� 4 -4 �� GRAPHIC SCALE LAND SURVEYING 3c CIVIL ENGINEERING �4e4:O SUR`i���r SCALE IN FEET: 1 inch = 150 feet Phone No. (715) 246-4319 �0•1► �N�BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE 109 East Third Street, P.O. Box 325 NE 1/4 OF SECTION 15, TOWNSHIP 31 N., RANGE 19 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR S89'23'33"E. Sheet 1 of 3 ,o Vol. 12 Page 3443 Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER sC�/TOWNSHIP SEC. T ;FZI N-R l W ADDRESS PZ ST. CROIX COUNTY, WISCONSIN �r 6o F Ste' cs 1- 3 y� SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 64L rdL HaLt yy ( 7� 1 � 1 , �3r i 6 INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used � ,p a�J�/Dc "'or�ero r4� Elevation of vertical reference point: /6, f Proposed slope at site: SEPTIC TANK: Manufacturer: — ¢ems Liquid Capacity: Number of rings used: r Tank manhole cover elevation: Tank Inlet Elevation: lS$� Tank Outlet Elevation: © o? Number of feet from nearest Road: Front,O Side, Rear, 0 feet From nearest property line Front 10 Side 10 Rear,(@ feet Number o //'/� ` f feet from: well building: A (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE 4 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,© Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: la Length: a Number of Lines: Area Built: z2 r Fill depth to top of pipe: -t` Number of feet from nearest property line: Front, O Side, O Rear, Ft ."7O Number of feet from well: �D GC..9 '1/ Number of feet from building: c22 (Include distances on plot plan). SEEPAGE PIT G a d e r� n c '✓° " " "„ ° �"� Size: Number of pits: Diameter: s 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, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector• Dated• lG �� Plumber on job: . License Number: 3 lQ 3/84:mj gpPA19TMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING +Y LAQOfr&HUMAN RELATIONS DIVISION P.O.BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION MADISON,WI 53707 State Plan I.D.Number: NE4jNE4fS15,T31N-R19W CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Somerset ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound 6 OLDER: ADDRESS OF PERMIT HOLDER: INSPECTION D T William Sonmerfeldt Route 2, New Richmond, tiJI 54017 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: Byron Bird Jr. 3318 St. Croix 119445 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: • !s YES ❑NO ❑YES NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM M^ LI AIR INLET: ❑YES 0 -4 C _ ❑YES O NEAREST�� �Wt✓ uq � DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: P PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO I ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERT ELL: 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: DIAMETERI RVVTERI L A D 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 PIT INSIDE DIA.: #PITS: LIQUID TRENCHES: �I MATERI DIMENSIONS r... GRAVEL DEPTH FILL DEPTH DISTR.PIPE I DISTR.PIPE _DISTR.PIPE MATERIAL: O. STR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV.INLET: ELEV.EN P: PIP FEET FROM L NE: no AIR INLET: W, j7,4 pt 1 NEAREST�0 8D WU L 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: OBSERVATION WELLS; ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED 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: 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: ❑YES ❑NO ❑YES ❑NO NEA REST 10,1 Sketch System on Retain in county file for audit. Reverse Side. GNATURE: TITLE: Zoning Administrator SBD-6710(R.06/88) EDILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis.Adm.Code COUNTY -e- I,eXK STATE SANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than //91/6/5 8%x 11 inches in size. ❑ Check If revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D.NUMBER 1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. PROPERTYg NER PROPEPTY L CATION / qr 50,7107 e-r /a GG%a,Sj�T , N, R / E(or PROPERTY OWNER'S MAILING ADDRESsS�,, i LOT# BLOCK# f tcJ X, CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 1A)I lirZ 0-97 I. TYPE OF BUILDING: (Check one CITY NEAREST ROAD I ) ❑State Owned VILLAGE ❑ Public 91 or 2 Fam.Dwelling#of bedrooms AR EL TAX ( ) DO8 A 111. BUILDING USE: (If building type is public,check all that apply) 1 T 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 El Mound 30 El SpecifyType 41 El HoldingTank 12 9 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 �1 REQUIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) �j ELEVATION 5_O to/ * �� L I f /!02 Feet Feet VII. TANK CAPACITY I Site in gallons Total #of Prefab. Fiber- Exper. INFORMATION New !siting Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App T nks Tanks strutted Septic Tank or Holdina Tank t 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. Plumber's Name(Print): Plumber' Signature:(No Stamps) MP/MPRSW No.: Business Phone Number: Ip Plu s Address(Street,City,State,Zip Code): p., r y o 0 IX. COUNTYIDEPATITMENT USE ONLY Disapproved Sanitary Permit Fee(Includes Groundwater ate Issued ssuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial urcharge Fee) c� Adverse Determination I 1 00 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 I ` 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. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic 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) STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Yjl(_u a-m -+-Loi s ROUTE/BOX NUMBER �2r. 2 box FIRE NO. Z3 3 2 CITY/STATE ,/V&W 40IC-0 KOIJA- ZIP X0/7 PROPERTY LOCATION: NE 1/4 NE 1/4, Section /s , T 3/ N, R W, Town of �.1+�,/— , St. Croix County, Subdivision , Lot No. Improper use and maintenance of your septic system could result in its premature fail6re to handle wastes. Proper maintenance consists 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 treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 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 verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after Inspection and pumping (if necessary), 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. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department 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 Q"0' DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address + 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 �Uicu47*7 F t Lvis ,4. SomrtaE/?FE�D1— Location of property N F 1/9 NE- 1/4, Section /S , T 31 N-R i9 W Township �enrr,PSFr Mailing address ir. 1 rev jir Nom! ,�icrrrkawo G!/1 �o i 7 Address of site �f- rncxsE r t Subdivision name Lot number Previous owner of property Total size of parcel /x•966 ate, Date parcel was created 3' Are all corners and lot lines identifiable? , Yes No Is this property being developed for resale (spec house)? Yes No Volume $3 7 and Page Number 37? as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. 4L4b 7"- ; and that I (We) presently own the proposed site for the sewage disposal system {or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of/the y�County Register of Deeds, as Document No. ) . Signature of Owneli Signature of Co-Owner (If Applicable) Date of Signature Date of Signature 446 143 Partial Release of Real Estate Mortgage—By Bank PARTIAL RELEASE .OF REAL ESTATE MORTGAGE — BY BANK THIS SPACE RESERVED FOR RECORDING DATA UftiCE ors: 8 t Fa I� .�r�:l'.'C Co., WI& The undersigned Bank hereby releases from the lien and the operation of a r a. is 1 nth t r - ---- a .D. Mortgage executed by William F. Sommerfeldt and Lois A. at,�:3____.—fir M. Sommerfeldt, husband and wife, as marital property with ,lames O'Conne>> R�NIr N D�� rights of survivorship RETURN TO: (ATTN: 1 BANK OF NEW RICHMOND 355 South Knowles Avenue New Richmond, WI 54017 to Bank and recorded in the office of the Register of Deeds County l q (Records) (4nlgge) ( ) of St. Croix Wis.,, Doc as No. 424903 , in(Vol.) 776 of(ModZi(s), on (page) 192 . only the following portion of the mortgaged real estate in said county, State of Wisconsin: Plat of Survey of NE4 of NE4 of Section Fifteen (15), Township Thirty-one (31) North, Range Nineteen (19) West. Commencing at the NE corner- ' of Section 15; thence South 00007111" East (bearings reference to the East line of the NE4 of Section 15, assumed South 00007111" East) along the East line of the NE4 also being the center line of 60th Street, 662.87, to the point of beginning; thence continuing South 00007111" East 517.12' along said East line; thence North 89023133" West 400.031 ; thence South 00007111" East 145.941 ; thence North 89025109" West 933.901 ; thence North 00009101" West 663.181 ; thence South 89024121" East 1334.29' to the point of beginning, containing 826,140 square feet (18.966 acres) more or less. Bank retains its lien and mortgage on the balance of the real estate (not heretofore released). Dated April 10 , 1989 [Corporate seal not required. I B NEW R HMO D Sec. 706.03(2), Wis. Stats] NAME N 1 J. A. Gre President COU TER ED: By �--- OFFICER * Gary Knutson, Asst Vice President STATE OF WISCONSIN, SS. St. Croix County. i On the above date, the foregoing instrument was acknowledged before me by the above named officers. NOTARY SEAL jrvix&�� * Robert J. radka This instrument was drafted by - Notary Public, State of Wisconsin BANK OF NEW RICHMOND My Commission (Expires) April 14 1991 (TYPE OR PRINT) - I *Type or Print name signed above. L --+ + -Rev. May'75 Stock No.11062 pEPARTM�NT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY, G DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.0911)& Chapter 145) LOCATION: SECTION: WNSHI /MUNICIPALIT LOT NO.:BLK-NO.: SUBDIVISION NAME: /T N/R E , - --- COUNTY: . / MAILING ADDRESS: ,� f!i!'»/X W 1 1/ O /ll�r e/d uI �/«c /�dria JrVl�/ USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: A I TS: Residence -� 'New ❑Replace /� RATING:S=Site suitable for system U=Site unsuitable for system ee r ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OL ING TANK: RECOMMENDED SYSTEM:(optional) ❑ S ❑U $ ❑U �$ ❑U ❑S BU ❑SCSU 615- If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b),indicate: Floodplain, indicate Floodplain elevation: !' PROFILE DESCRIPTIONS BORING TOTAL DEPTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED HIGHEST— TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- I 410 a_6 f3/sir -.>/ �6 /O(D L >� B- ,� 2 f 9. Jt✓tic �� o -S /.�- s'-off,��,S/��,�'d�•=� B- 5' 1.21 �.7s tea / r B- 08 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER AFTER SWELLING INTERVAL-MIN. p Rloo t P RI D 2 PERIOD PER INCH P G G P- 'T P- we to G L 3 P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION --------------__ a r B I j__ E IN zoo L------ E E jI i I r 3 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print): ITESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 7G CST SIGNATURE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. ' DILHR-SBD-6395(R. 10/83) —OVER — L F �. INSTRUCTIONS FOR COMPLETING FORM 115- SBD - 6395 To be a complete and accurate soil test,your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes.A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown he-j for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations.Drawing scale is prefered.A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9. Complete all apropriate boxes as to dates,names,addresses,flood plain data,percolation test exemption,if appropriate; 10. If the information (such as flood plain,elevation)does not apply, place N.A.in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st — Stone (over 10") BR — Bedrock cob — Cobble (3 - 10") SS — Standstone gr — Gravel (under 3") LS — Limestone 's — Sand HGW — High Groundwater cs — Coarse Sand Perc — Precolation Rate med s — Medium Sand W — Well fs — Fine Sand Bldg — Building Is— Loamy Sand > — Greater Than 'sl — Loamy Sand "'- — Less Than '1 — Loam Bn — Brown 'sil — Silt Loam 81 — Black si — Slit Gy — Gray cl — Clay Loam Y — Yellow scl — Sandy Clay Loam R — Red sicl — Silty Clay Loam mot — Mottles sc — Sandy Clay w/ — with sic — Silty Clay fff — few, fine, faint 'c — Clay cc — common, coarse pt — Peat mm — Many, Medium m — Muck d — distinct p — prominent HWL — High water level, surface water Six general soil textures BM — Bench Mark for liquid waste disposal VRP — Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit The county or the Department may request verification of this soil test in the field prior to permit issuance.A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit.The sanitary permit must be obtained and posted prior to the start of any construction. FLU 1 PLAN PROJECT ADDRESS Q�v2 G; ��c�i�•,au�� spa /� 1/4/S/ 7/T3/ N/R,// W TOWN .r��rs c COUNTY MPRS Byron Bird Jr. 3318 DATE BEDROOM-CLASS PERC�_CONVENTIONAIX IN-GROUN RESSURE CONVENTIONAL LIFT MOUND HOLD NG TANK NK SEPTIC TANK SIZE LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA _ PERC RATE BED SIZE /� hL Benchmark V.R.P. Assume Elevation 100' Location of Benchmark / S' 4Q1 * H.R.P. _ o 0 Borehole Q Well Scale = Feet 0 Perc Hole System Elevation �Z Uent 12" Grndp TYPAR COVERING 2" — 12" 3' 4 6. 4O 3. 1 6' Sewer Rock 12' 1 - Iy U0 _ fir, a, f�1'! Sle`✓.� ��o I b �f o �. 1