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HomeMy WebLinkAbout042-1105-10-000 CD z, J > (D c 0 � \ � ts CL c 0 cn (D a) Z E LL c 0 Cl) z co w E z lu i 0 z k qtz Q) '2 'a 0) Cl) a) cc N CL a a) CD a) C/) Q \ ED < z z § ® k E 0 r 04 a) C14 .0 0 t! CL cc LO 0 Z 0 0) .2 E 0 0 0 0 z U) 5 0 CL (L 4j o co co 0 z co a-) D \ CD 0 0 E � � 2 � / - ! I � 0 0 (D CD r- 0' .00 Lq 0. MC 00 r- 73 -c- z (D 2 -0 (D C (D E 0 '6 ci 0 z j2 z Cf) U) : k cl LCL IL L: CL 9 CL E E 0 o= (wn 9z 0 ML M= 0 U) Parcel #: 042-1105-10-000 10/12/2006 10:00 AM PAGE 1 OF 1 Alt.Parcel#: 20.29.18.581 042-TOWN OF WARREN 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 O-COLEMAN, BRETT R&KRISSA J BRETT R&KRISSA J COLEMAN 1075 89TH AVE ROBERTS WI 54023 i Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1075 89TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 2.320 Plat: 2334-PLEASANT ACRES SEC 20 T29N R1 8W 2.32A PLAT OF PLEASANT Block/Condo Bldg: LOT 09 ACRES LOT 9 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-18W Notes: Parcel History: Date Doc# Vol/Page Type 01/17/2003 706292 2114/209 WD 02/12/2001 638342 1585/521 QC 07/23/1997 836/104 07/23/1997 831/266 more 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/23/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.320 39,100 104,600 143,700 NO Totals for 2006: General Property 2.320 39,100 104,600 143,700 Woodland 0.000 0 0 Totals for 2005: General Property 2.320 39,100 104,600 143,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 316 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 HCMESITE SEPTIC PLUMBING CC. 65�C'NEIL RD.,MkSON,WIS,54016 RO8ER'i ULBRIGHT "IS. MASTER PLUMBER LIC.NO 3307 M.P.R.S. r.'3TALLER&CESIGNER LIC, NO.GJWrM - S T C - 144 AS BUILT SANITARY SYSTEM REPORT c OWNER 13-eA Al � �,l� TOWNSHIP �61ftiq" / SEC. T N_R W ADDRESS dl� ill ' ST. CROIX COUNTY, WISCONSIN SUBDIVISION I 'S"4 5 LOT 9 LOT SIZE .2- S PLAN VIEW Distances and dimensions to meet requirements of IIHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM INDICATE NORTH ARROW 4 T N. w L-ot- CO�p,-�&R_ Top a f pt--&o-c- a BENCHMARK: Describe the vertical reference point used L- 12 S - / - /g- Elevation of vertical reference point: /00' Proposed slope at site: 12- /o LJEt'Ks �o �c,�e - PRopvcTs SEPTIC TANK: Manufacturer: -1 a) Liquid Capacity: Number of rings used: -2 y *)�4 ' Tank manhole cover elevation: Tank Inlet Elevation: /� Tank Outlet Elevation: 8 0 � Number of feet from nearest Road: Front S�i,d�e�r �'� � R/w 10 Rear, O (J / feet s r- 35 From nearest property line : Front 10 Side,ORear 10 feet W611 ,voT" A40, D f( P176`- ,vo Number of feet from: well , building: j / 5-7-,VP7Ev — (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE f PUMP CHAMBER Manufacturer: Liqui apacity: ' Pump Model: Pump/Sipho nufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevati Gallons per cycle: Alarm Manufacturer* Alarm Switch Type: Number of_fee from nearest property line: Front, O Side, 0Rear,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: 1t �2 (33 S Width: 7 Lenith: S y Number of Lines Z Area Built: Fill depth to top of pipe: y �� 3 ,/ wES7— i Number of feet from nearest property line: Front, O Side, O Rear It . � Number of feet from well: wF// X10 7- D�Ne-0 7� . Numb er of feet from building: (Include distances on plot plan). to id /k— /f7— Z-f✓/ S! 3v '44a-yy SEEPAGE PIT Size: Number of pits: Diameter: y Liquid depth: Botto seepage pit elevation: Area Built: Has either a drop box or distribution boxO been used o ny of the above soil absorbtion sytems? eck one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet f m 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: yInspector: Dated: / Plumber on job: License Number: HOMESITE SEPTIC MQ PLUMBING CO 655 SON,BI S 54016 G'NEIL RD., ROSEFi i ULBRIGHT 3/84:m j -.NIS.MASTER PLUMBER LIC.N0.3307 M.P.R.S. '.Ml j'STALLER&DESIGNER LIC.NO.00663 i piST P,�¢ of P;f 2��9 I � Tai' of %n TAP g 5, r0 CA s�. sySTf 2- S ' x ` w pR p f� -� �►p i Q ' Ik'8yp- _ 1 -- -- - -=oi 9750 `1 3 kpP� ;L -cR�,�`�'' -FF- - - - -- --- - --L- ssE'� 1St• s.x 52- sY cr `� ` f3Eva o 01 6 p 30 tl� 34' 5 303/ 4 Pu 00 Sol, VX v e Woos c D v OL �E e0 3 t3+�IPH S w Q/ Ppopvsev wet( M _ j v , 06 Lo-F co�a0�. to .---- { L/�val�io,J� Tor 4� OF ��- 100. 6 <:CD:l:- U -A4 SAr) ,r 30 IEA S A 13 T- A G-e s 14 S - 30 iL-T- HOMESITE SEPTIC PLUMBING CO. 650-O'NEIL RD.,14;MN,WIS.54016 ROBER i ULBRIGHT -AS.MASTER PLUMBER LIC.NO.3307 M.P.R.S. 'f * ii'3TALLER&DESIGNER LIC.NO.00W DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDING ' LABOF.&HUMAN RELATIONS DIVISION P.O.B�Ofy1X1��'7969�vyt7h' 7�'1 O ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES&APPLICATION LV;yl,.VL.4WISLV',T29N—rt!.OW State Plan I.D.Number: Town of Warren M CONVENTIONAL ❑ ALTERATIVE (If assigned) Lot 9 Pleasant Acres ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION E: Richard & Beth Schrerer 606 Old Mill Road Hudson 141 54016 4—jf'$C� 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: Robert Ulbricht 3307 St. Croix 119460 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: w ❑YES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑YES ❑NO ❑YES ❑NO I NEAREST—� DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES ❑NO ❑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: I 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 DISTR.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 EYES ❑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 DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑YES ❑NO DYES ❑NO L]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 COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROOPERTY WELL: BUILDING: FEET FROM ❑YES ❑NO ❑YES ❑NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710(R.06/88) Zoning Administrator SANITARY PERMIT APPLICATION EZ7:Q1LH-R In accord with ILHR 83.05,Wis.Adm.Code �TM/�_ _/• STATE PANITARY PERMIT# -Attach complete plans(to the county copy only)for the system,on paper not less than 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 I. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. PROPERTY OWNER o PROPERTY LOCATION p� PC% Alr%,S w T -7' , N, R `Q E ( WD PROPERTY OWE/�AILI ��ESS H LOT# _ BLOCK# CITY,STATE ZIP PHONE NUMBER SU /IVISION NAME ORTCSM NUn�E,R A� �.ra,t/ 05 'i E'1f Sl?N/ /f 11. TYPE OF BUILDING: (Check one) El State Owned ❑ CITY V EAREST ROAD �I�v E•h 1aT ❑ Public FV1 1 or 2 Fam.Dwelling-#of bedrooms PARCEL TAX NUMBER( ) Zd .. 111. BUILDING USE: (If building type is public,check all that apply) �/J� _//0 r /d 1 ❑ Apt/Condo 77• 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. El Replacement of 4. ❑ Reconnection of 5.❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure ,�/ 43 ❑ Vault Privy 14 El System-In-Fill 27 Z S ^ ✓ Q VI. ABSORPTION SYSTEM INFORMATION: 1.GALLONS PER DAY 2.ABSORP.AREA 3.ABSORP.AREA 4. LOADING RATE 5. PERC.RATE 6. SYSTE ELEV 7. FINAL GRADE REEQQUUIIRED(sq.ft.) PROPOSED(sq.ft.) (Gals/day/sq.ft.) (Min./inch) �T 5 ELEVATION J S 50, 0 • 1 Fee • Feet VII. TANK CAPACITY Site in aallons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper, INFORMATION New xistin Gallons Tanks Concrete stCon- glass App. Tanks Tanks Septic Tank or Holdina Tank X 11 1 F1 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's Signature:(No Stamps) MP/MPRSW No.: Business Phone Number: 14P6 ?�� /�iC 3307 715 Plumber's Address(Street,City,State,Zip Code): S 0 /ii✓E/-L. /W IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee(Includes Groundwater a e Issued Issu=Agent Signature(No mps) fu Approved ❑ Owner Given Initial Surcharge Fee) n'A v rse D rmin tin � /4. '� y—�� X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.11/88) DISTRIBUTION: Original to County,One Copy To:Safety&Buildings Division,Owner,Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 t 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, 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 S T C - 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. - -- - --- --------s`----/`--- ---SC --------- Owner ofproperty Location of property N r 1/4 1/4, Section , T -2—_N-R W Township Mailing address �® C d�� '��Itl 57 `f Address of site L9E*-X-4v7 6l S Subdivision name Lot number Previous owner of property Total size of parcel �,f Date parcel was created Are all corners and lot lines identifiable? __,,__Yes No Is this property being developed for resale (spec house)? Yes , No Volume 936 and Page Number/ v^ 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. t y6L3 0 ; and that I (We) presently own the proposed site for the sewage disposal system (or 1 (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 t County Regi,,�,er of Deeds, as Document No. ) . Signature 61 Owner Sign a of Co-Owner Applicable) /AF .j� Date of Signature Date of nature r, d ,y k r�" �� � � ,: � t �. >. ,�� :: 4.� ., �, e , '�� ,z � ,, r� 4r ,sy*a= ; �: STC - 105 i SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER *K- l X 1, kielAr 5e.116-ReA_ ROUTE/BOX NUMBER n d 6 Q �If�l IV - FIRE NO. CITY/STATEns�a/ /� ZIP 00,D f PROPERTY LOCATION: AIC114 AlZot__ 1/4, Section ��CJ , T 24N, R W, Town of 6dmerlt , St. Croix County, Subdivision P1s11N7— A/lE� �L !. Lot No. _ . Improper use and maintenance of your septic system could result in its premature failGre 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 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. / S I GN]w 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 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS _ INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) ' MADISON,WI 53707 P.O. BOX 7969 HUMAN RELATIONS (H63.09(1)&Chapter 145.045) LOCATION: SECTION: pp TOWNSpHIP OT NO.:BLK.NO.: SUBDIVISION NAME: 1 live COUNTY'/ 1� OWo R'/TUYEN/RA60 E(or)w IMAILINGADDRESS: USE P77 DATES OBSERVATIONS MADE j NO.BE!R;iMk COMMERCIAL DESCRIPTION: PR F S: N TESTS:. Residence 3 �� / New Replace I���'L / �_ �G �� �. 4 iAj7f,Q 7rS7- co.vpiTAo,v s : S&,UAjY 3co°F !. RATING:S=Site suitable for system U=Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) ©s ❑u as ❑u ©s ❑u ❑s au ❑s ©u ���vE-vT�ov�1L ?�tP�tiS w/ .CEO/° O D/ST v i -i If Percolation Tests are NOT required DES GN RATE:� If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: SCS w�rr Buele11�tRDT PROFILE DESCRIPTIONS BORING TOTAL DEPTHTOGROU NDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. I HES TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) 4 7,S' P.4' Qa• S• I.IS ' 73a i S ' u .0 At f)(. B- /�(� 92�/d" f� > /.� d!f •8N. Coo lait- S1 -1 134 ."• S� 3,e, T}.v cS /.D ' 3w. N . S 1,0 1 v� C o imo d-c s- ` �. S 'P D o oo' D ie Ae aa. s ( .S 8,0-yy. s,�, 1.S ' �,� 4a . B-3 9 9 '— ' y' e:evep rs & - - �e s• o T ti Vi-A Y es - 1, 32 �r aa.Sy 51 17 $N'Sr S� RAJ �S B- ta o-.e . T de, �a S, :S � ��, :A B- # PERCOLATION TESTS 4V CS ft $-f M-14f S TEST DEPTH. WATER IN HOLE TEST TIME DROP IN WATER L VEL-IN HES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD PER1002 PERI05 3 PER INCH r P- u P- P_ ` Z_ y 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. SrS 7-,-r-Ai A � : LpI,J �/pe�t)l� SYSTEM ELEVATION !T /{� / ? _S 7• -. r i I i I N 1 , , I t � u; r site �►�.'���t�'�C� ___ _ _ #off' a..convent ona1 seOiG I � I I 3 , I,the undersigned,hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin rf 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: h'',"IIESITE SEPTIC PLUPd6:NG CO. ' ADDRESS: 656 UNEIL RD.,HIQSON,WIS.54016 CER IFIC TIIOON, NUMBER:JPHONrNUMBER(optional); ROBER i ULBRIGHT WIS.MASTER PLUM CST SIGNATURE: ,MINN.04STALLER&DESIGNER LIC.NO.00661 �� I, DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. 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