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HomeMy WebLinkAbout038-1159-50-000 C) 0 Ge. U) CD 00 13 75 (D ts U- 2 c,• CL a V) 0).Q cc 0 M Z m >, (6 CD C, LL CO -j CY) ci C) 0 < 3:C\l c Cl) CD z E CD 0 Cl) 0 z 02 c E (D (D • CL c 0 O z o <z -C c C\j E LO CL M co Ln Z 0 0 CL —ID Lf) a- U) 0 0 .0) IL CL 0 a. CL ca a) o 0 a) do 0) z cn m 0 0 0 as i?5 0 0 ca 0 -0 co <1 75 0 O C5 On U? E m c E 4 0 LO CL 0) 0 ': LO 1 0 C, to 0 N 00 0.2 ==i z 10, 65 i 0 at a L; IL C4 0 Parcel #: 038-1159-50-000 05/18/2006 10:30 AM PAGE 1 OF 1 Alt. Parcel#: 34.31.18.746 038-TOWN OF STAR PRAIRIE Current [X] 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 0-STATE OF WISCONSIN, D 0 T D 0 T STATE OF WISCONSIN C-DISTRICT 6 DISTRICT 6 718 W CLAIREMONT AVE EAU CLAIRE WI 54701-5108 Districts: SC=School SP=Special Property Address(es): =Primary Type Dist# Description SC 3962 NEW RICHMOND SP 1700 WITC ?/l/ z Legal Description: Acres: 1.100 Plat: 1974-GERMAIN &HANNER ADD SEC 34 T31 N R1 8W GERMAIN&HANNER ADD Block/Condo Bldg: LOT 05 LOT 5 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 34-31N-18W Notes: Parcel History: Date Doc# Vol/Page Type 06/09/2000 624575 1518/73 WD 07/23/1997 849/539 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations' Last Changed: 07/24/2000 Description Class Acres Land Improve Total State Reason STATE X2 1.100 0 0 0 NO Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2005: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: 122 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP /LX24, S EC. T �N-R A® W ADDRESS � r ST. CROIX COUNTY, WISCONSIN SUBDIVISIO LOT LOT SIZE o3A2,-f.t.&� PLAN VIEW Distances and dimensions to meet requirements of I•LUR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM �� -- F INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point usedq 164 V r Elevation of vertical reference point: ��_ Proposed slope at site: SEPTIC TANK: Manufacturer: �/lJ �'EfS Liquid Capacity: 5 Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: /d Z�3 Number of feet from nearest Road: Fron4&_Side10 Rear, O AM feet From nearest- property line ' Front,�Side,O Rear,O� feet Number of feet from: well , 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 uf:acturer: Pump Size Elevation of inlet: Bottom of tank elevation: I Pump off switch elevat Gallons per cycle: Alarm Manufacture . Alarm Switch Type: Number of t 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: Lenjth: Number of Lines: Z Area Built: 7S6"Z Fill depth to top of pipe: 2 Number of feet from nearest property line: Front, Side, O Rear,O Ft/c i Number of feet from well: —,!!5"9 Number of feet from building: .271 (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bo m of seepage pit elevation: Area Built: Has either a drop box or distribution box O been used on any of the above soil absorb ion sytems? Check one). HOLDING T Manufacturer: Crracity: Number of rings used: _ on nf bottom of tank: Elevation of inlet: T Number of feet om nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of fef!t from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: r� ' Plumber on job: License Number: aJ� �S� 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR 1 _ SAFETY&BUILDINGS LABOR & HUMAN RELATIONS ��-' PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 CONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number: SW,SW, 34, 31, 18W ❑Holding Tank ❑ In-Ground Pressure E]Mound (If assigned) Town of Star Prairie E 5 PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPEC I N A E: James Venhor 305 Willow St. , Somerset , WI 5402 57/0-3 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT. LEV.: - CSLT REF.PT.ELE Name of Plumber MP/MPRSW No.: County: Sanitary Permit Number: Gar L. Steel 3254 St. Croix 128635 SEPTIC TANK/ ��'" ' MANUFACTURER. LIQUID CAPACITY: TANK IN LE E'LE V.. WK OUTLET ELEV.: WARNING LABEL LOCK(NG COVFygI PROVIDED: PROVIDED �3 j .s (/GV 97 / 96. Fir YES 1:1 NO BEDDING. VENT DIA.. VENT MATL HIGH WATER NUMBER ROAD: PROPERTY WELL: BUILDING:JVENTTOFRESH I/ L ALARM. FEET FROM LINE: //// / AIR INLET: ❑YES NO sTi s ❑Ncr- NEAREST : Y°� 19 _%51 MANUFACTURER: BEDDING: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO I ❑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 LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BEfi1TRENCH WIDTH LENGTH NO OF D PIPE SPACING COVER INSIDE DIA #PITS LIQUID C f TRENCHES: / MAT IAL' DEPTH: DIMEN lows 7 !. GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR,PIPE DIST PIPE M TERIAL: NO.DI TR NUMBER OF PROPE RTV WELL: � ILDING: VENT TO FRESH BELOW PIPES r ABOVE CO ER��ELEV.INLET.ELEV.END. 0 PIPES. LINE: i / AIR INLET: / nn / r 7 VG FEET FROM N h � (� )- 9 .03 x�8� 5 Cdt� -r� NEAREST l y• 5 7 P 3o - BELOW MOUND SYSTE :� ' 1".I ^� 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. DYES 1:1 NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO DYES —]NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED. SEEDED. MULCHED: CENTER. EDGES. [:]YES El ❑YES NO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BII.� IL"N('v WIDTH. LENGTH. TRENCHES; LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER. ,`-MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: "ELEV.. ELEV.: DIA.. ELEV.: PIPES. DIA.: E#.E1'AT10 AND 4 lb HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED y f 0 7 +. PLANS: DYES ONO ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUNlIErR LRIOE E R T Y WELL: BUILDING: FEET FR-fNwM ❑YES El NO ❑YES El NO NEAREST o a�' Sketch System on Retain in S count file Y .le for audit. Reverse Side. aIGNATUR —G.. TITLE: sI s r`DILHR SBD 6710(R.01/82) Zoning Administratnr ®ILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05,Wis.Adm.Code COUNTY _ �..,,..,,r„� St, Croix STATE SANITA Y PERMIT –Attach complete plans(to the county copy only)for the system,on paper not less than a �� 8%X 11 inches in size. ❑ Check if revision W previous 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 James Venhor SW % SW %,S 34 T 31 , N, R 18 f(or)W PROPERTY OWNER'S MAILING ADDRESS LOT# BLOCK# 305 Willow St. 5 n/a CITY,STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Somerset, Wi. 54025 1 ( 1715 )247-3512 csm #398580 vol 5 pg. 1493 12/17/84 II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ff ❑State Owned o VILLAGE Star Prarie Golf Course Rd. ❑ Public Eh or 2 Fam. Dwelling–#of bedrooms 3 P EL Ax M R 0 3� III. BUILDING USE: (If building type is public,check all that apply) 1 ❑ Apt/Condo `P 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. El Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.El 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 OZeepage 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 450 750 750 .60 class 2 100.83 Feet 104.18 Feet VII. TANK CAPACITY Site in allona 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 Holdin Tank Weeks X Lift Pump X Tank/Si hon Chamber --- VIII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation f the onsite sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Si re:(No Sta ps) I&/MPRSW No.: Business Phone Number: Gary L. Steel 3254 715 246-6200 Plumber's Address(Street,City,State,Zip Code r 988 N. Shore Dr. , New Richmond, Wi. 54017 IX. VOUNTYIDEPARTMENT USE ONLY ❑ Disapproved San❑ Surcharge Fee)i ry Permit Fee(Includes Groundwater Date Issued Issuing Agent Signatu (No Stamps) Approved Owner Given Initial (7�7 � .. Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-8398(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: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 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, 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 owners) 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 James Venhor Location of property SW 1/9 SLd 1/4, Section 34 T 31 N-R 18 W Township Star Prarie Mailing address 305 Willow St. Somerset, Wi. Address of site R.R.#5, New Richmond, Wi. Subdivision name Germain & Harmer Lot number 5 Previous owner of property Germain & Harmer Total size of parcel 1 acre Date parcel was created 12-17-84 Are all corners and lot lines identifiable? x Yes No Is this property being developed for resale (spec house)? Yes x No Volume 849 and Page Number 539 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 warrant4de-A recorded in the Office of the County Register of Deeds as Document No. yy ; 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 County Regis er of Deeds, as Document No. ) . Sign ure of Owner Signature of Co-Owner (If Applicable) 3 A, Date of S gnature Date of Signature DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982 I TNIS SPACE RESnRVED FOR RECORDING DATA WARRANTY DEED 4509+59 ut ; 9 /A (y I REGISTER'S OFFICE ST. CRax Co., WI This Deed, made betwQen _________ _____ __ Recd for Record Edwar E . Germain , married - and •-•-•-.•----. --•-- AUR 8�g s _J ohn A. H a n n e r , married , as tenants in common • -- -------•-••-•.....•------•............................•--•----....__...--•---._.......•-•-_... Grantor, and..... ---•-•. . j F . James Venhor and Sandra Venhor , RegisterofDeeds Husband and wife .. --------•....................••--•--•-•--•••-•--......-----•......-- ...... --...... Grantee, Witnesseth, That the said Grantor, for a valuable consideration..._._ �I S . convey t C r o i x RETURN TO s to Grantee the following described real estate in .................................. County, State of Wisconsin: Lots 4 , 5 , G , and 7 , Germain and Hanner AdditionazParcelNo: _..__.............................. in the Town of Star Prairie . L� This is Not homestead property. (is) (is not) Together with all and singular the hereditanlents and appurtenances thereunto belonging; And ,,Edward E . Germa i n , ' ' nrr1vd John Manner , married ..... warrants that the title is good, Indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. Dated this ........._ A u 89 � ...24.....th.............................. day of --•----••- -•--•---.u..$_..s_._t....................................., 19..._..... .1 S� ... ..... �'.-���-�•.'I�J...._(SEAL) ...................•--._.._........-•-----.._..-•---........---.....(SEAL) Edward E . Germain t t v t-!�---- ---..� z .-...._.._.r._ SEAL) ( ----- (SEAL) ohn A . Hanner J t • ............................................................ . ...................................................... ......... AUTHENTICATION ACKNOWLEDGMENT i I-\ � J t So�r`, n^w,nnnnr � Signature(s) -----------•---•• .......................................... STATE OF•V18e0t SM so. E County. ` 1 authenticated this ____._..day of........................... 19....._ Personally Iamb before me this _....24_th--day of � � T j August 19•_ 8 9 the above named ....... . ._..... j •---••---••----------•---------------------------------------------------------- Edward E . Germain married - ..................................... ......•--. ._...t __° _r. •---•-..._---_-- a _ u .................................... ------•-•------••----•-- TITLE: MEMBER STATE BAR OF WISCONSIN John A. Hanner , m a r r i e -`�- - < r c E (If not, ...................... ..................................... t authorized by § 706.06, Wis. Stats.) to me known to be the, erson ....S...... who executed the ? z foregoing ins/t/jum ntCnowledge the same. z THIS INSTRUMENT WAS DRAFTED BY Jl� / a ^A Mh/�M /�MN� First Security T i t l e NOTARY PUBLIC-MINNESOTA -- ---------------- ----------- ----------- 2785 White Bear Avenue *.. ...................................... ............RAME*5Y-E',0W;4TY M-a-p.-t-e-W-o-�d-----14in e-s-ut-a...5-3-1-09------ Notary Public ........RamseX. -••-----.__.n �CBOinrtr,' y 1p(M991 (Signatures may lie authenticated or acknowledged. Both My Commission is permanent.(11 b9tpYi✓iYtI0tYvvwwvvv. are not necessary.) date: ......................-••---------•-------••-----......., 19......... *Names of persons signing in any capacity should he typed or printed below their signatures. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County R/BUYER James Venhor ROUTE/BOX NUMBER 305 Willow St, . FIRE NO. CITY/STATE Somerset, . Wi; ZIP 54025 PROPERTY LOCATION: SW 1/4 SW 1/4, Section 34 T 31 N, R 18 W, Town of Star Prarie , St. Croix County, Subdivision Germain & Hanner Lot No. 5 Improper use and maintenance of your septic system could result in its premature failure 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 / DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 d (715) 386-4680 Sign, Date, and Return to above address P TMENT OF / N REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS 'INDUSTRY, c DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (H63.090)& Chapter 145.045) LOCATION: SECTION: TOWNSHIP EQ 0W: LOT NO.:BLK.NO.: SUBDIVISION NAME: SW �IPFW 1/4 34 /T N R 181(or)WI Star Prarie n er COUNTY: OWNER'S AME: MAILIN ADDRESS: St. Croix Ed Germain Box 120S Somerset Wi. 54025 USE DATES OBSERVATIONS MADE NO.BEDRMS : COMM ERCIAL DESCRIPTION: P ROFILE DESCR P NS: O ATION TESTS: IR Residence 3 n/a ®New ❑Replace 9-2-87 n/a RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PR URE: S STEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) ES ❑U ©S ❑U EIS ❑U 0S ©U EIS EU 1conventional If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b),indicate: class 2 Floodplain, indicate Floodplain elevation: n/a decimal' PROFILE DESCRIPTIONS page 19 SHB BORING TOTAL DELTH TO GROU NDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER DEPTH M, ELEVATION OBSERVED EST.HIGMTT TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 1 6.66 104.88 none >6.66 1.33bl.s.1. 3.50bn.s.l. .33gysil. 1.50bn.c.s. B_ 2 7,25 104.18 none >7.25 •00bl.s.l. 1.00bn.sil. 2.50bn.l.s. .25gy. sil. B_ 3 6.66 104.53 none >6.66 •50bl.1. 1.33bn.sil. 4.83bn.l.s. 4 7.33 103.83 none >7.33 •75bl.s.1. 1.83bn.s.sil. 1.33bn.l.s. .25gy.sil. B_ B_ 5 6.42 103.88 none 5.42 .00bl.l. 2.50bn.sil. 1.92bn.c.s. 1.00gy.mot.sil. B_ 7 6.25 104.30 none >6.25 1.00bl.s.1. .92bn.sil. 2.33bn.s.l. .25gysil• PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 P F81002 P PER INCH P P- P- 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 100.83 '� ✓ _.... 4 U r 1` N 7 E 1" � l!l ( t E , 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): TESTS WERE COMPLETED ON: Gary L. Steel 9-2-87 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): 988 N. Shore Dr. New Richmond Wi. 5401 t15-9.4h-6200 CST SIGNAT "1. , DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR•SBD-6395 (R.02/82) —OVER — James Venhor • SW4SW4 S34T31NR18W Star Prarie, township X31 (3-1 100, fa )-22 T-NI k 1� /"0 CovP s44�� X00 ko-F . Co ,yy .60 4- A(G;a . eel re Dr. New Richmond, Wi. 54017 MPRSW 3254