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CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): '=Current Owner * ROBERT M&DEBRA J MEYER MEYER, ROBERT M&DEBRA J 356 WILLOW LA HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): '=Primary Type Dist# Description '356 WILLOW LA SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 0.330 Plat: 2629-WILLOW RIVER ESTATES SEC 19 T29N R19W WILLOW RIVER ESTATES Block/Condo Bldg: LOT 6 LOT 6 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 847/347 07/23/1997 720/541 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 48562 146,500 Valuations: Last Changed: 04/29/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.330 10,200 103,100 113,300 NO Totals for 2004: General Property 0.330 10,200 103,100 113,300 Woodland 0.000 0 0 Totals for 2003: General Property 0.330 10,200 103,100 113,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 112 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 ST. CROIX COUNTY ZONING OFFICE 911 4th Street Hudson, WI 54016 Telephone - (715)386-4680 The St. Croix Co. Zoning Office offers the service of septic and \ water inspection to Lending Institution, Realty Firms , and private individuals. COMPLETION OF THIS FORM IS ESSENTIAL SO THAT THE PROPERTY CAN BE LOCATED. Please provide the following information, enclose appropriate fee made payable to ST. CROIX CO. ZONING, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING-------------------------------- FEE:$ 25.00 (For nitrates and coliform bacteria) WATER TESTING--------------------------------FEE:$175.00 (VOC'S) SEPTIC SYSTEM INSPECTION � ` - ------------------FEE:$ 25.00 PROPERTY OWNERS NAME: w�cjV--r AAI D .Dt tBRI 949 9- PROPERTY OWNERS ADDRESS: 3M LOW&v 4449CITY: Eldos!!Al�LV'1 Legal Description 1/4 , 1/4 , Sec. , T N-R W, Town of_ Hufl3GN ,Lot No. 6 Subdiv`ision��/�� !ir.) i1Ai FIRE NO. LOCK BOX NO. G.)h _` �G Color of housed My/ Realty sign?_Firm: ��� PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP, i.e. , , COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time w n entry may be gai d. -TUb:5V*Vd, C�9�.t.. �vl�f tl4Ly`L�2. 47 7i6)Z3Z-Z#Z7 at 7is038'L-q34/ 1.7wa¢sOA�'S� Firm or indivi ual requesting services:Aggr[opb�, m , jr&MR y � &4) Telephone No. REPORT TO BE SENT TO: 4V,-.-W $AN1G DUO 49=yt ATl14�i15p CLOSIN DATE: Z, Signature• Fus&l r SEND COPY 40 0WA/s . AGSd "The Heardand§ Bank- For Home Loans. MET T"I f'7D Ml��� � FEDERAL B)V�Kfsb Juonnry 24 , l992 � Robert Meyer Debra Meyer 356 Willow Lane Hudson, WZ 54016 Dear Robert. & Debra : / As we discussed duriu-, -, our loan uq)Dlicutiou, you will need a water � test 'Lire days prior to The Loot musL be for Nitrates and � DaoLeriu. Enclosed you will find the form should �oo wish to use SL . Croix county. Bowe'er, vou are welcome Lo use Lhe plumber of your choice in the connt� . To be accept*ble tlie water test cau not be taken by you iudividoull>, amOO FRANCE AVENUE SOUTH°SUITE xun° sonNA,mw55*35-2OOO° PHONE<61qoun-53OO" FAX(61u)928-5«39 EQUAL HOUSING LENDER DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 TANK BUREAU OF PLUMBING MADISON,WI 53707 NU!%,NE%,S19,T29N-R19G1 �CONVENTIONALREPLACEMIDS�IIALTERNATIVE StatePln:d' Number (If aurgnedl Town Uj Hud6dn ❑Holding Tank ❑In-Ground Pressure ❑Mound Lot 6 GIiUow RiveA Estates NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTIO A Paut Heikk imen 356 Gl iUow Lane Hu.d6 un W1 54016 8-1 - BENCH MARK(Permanent reference poml)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT.ELEV. Name of Plumber MP/MRSW No County' Sanitary Permit Number Gl�c.2?iam Schu.maketc G382 112744 SEPTIC TANK/HOLDING TANK: MANUFACTURER. ILIOUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.- ROW DLABEL LOCKING OVIDED COVER DYES ❑NO DYES ONO BEDDING: __jVENTDIA.. VENT MATL. HIGH WATER ROAD: PROPERTY WELL. BUILDING. VENT TO FRESH NUMBER OF JAL FEET FROM LINE AIR INLET DYES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER T71NG: LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUF AC TIIR ER WARNING LABEL LOCKING COVER PROVIDED-. PROVIDED: ES ❑NO ❑YES ❑NO ❑YES —]NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONA L. NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH LINE AIR INLET (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) OYES 0 N 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 L\� CONVENTIONAL SYSTEM: WIDTH: LENGTH NO.OF DISTR.PIPE SPACING COVER INSIUE DIA �PIIS LIQUID 1�1 BED/TRENCH TRENCHES. MATERIAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR PIPF iDISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR NUMBER OF PROPERTY WELL BUILDING AIR NLET HESH BELOW PIPES. ABOVE COVER. ELEV.INLET ELEV.END'. PIPES FEET FROM LINE NEAREST= MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIDNS MEASURED. DYES ❑NO SOIL COVER ITEXTURE PERMANENT MARKERS OBSERVATION WE ILLS ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SE I,- MULCHED 1 CENTER EDGES. DYES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH. NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO DISTH DISTR PIPE DISTRIBUTION PIPE MATERIAL.&MAHKIN(� ELEV.. ELEV.. DIA. ELEV. PIPES DIA.: ELEVATION AND DISTRIBUTION VERTICAL LIFT CORRESPONDS TO APROVED INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANS DYES ONO E YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS. NUMBER OF LRNE ERTV WELL: 9UILDING. FEET FROM DYES ❑NO DYES El No NEAREST i Sketch System on Retain in county file for audit. Reverse Side. J. ; SIGNATURE. ITITLFFaning AUI/Ii t{.r,atot DILHR SBD 6710(R.01/82) `` /W7 1/l I- i JL • COMMERCIAL TESTING LABORATORY, INC. S14%lan Street, P.O. Box 526 Colfax, Wisconsin 54730 715 - 962 - 3121 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.: 18545/01 PAGE i ST. CROIX COUNTY REPORT DATE! 2/24/92 COURTHOUSE DATE RECEIVED: 2/20/92 HUDSON, WI 54016 ATTN: THOMAS C. NELSON 6 , OWNER, Robert !k Debra Meyer LOCATION*# 356 WiLLoa Lane, Hudson COLLECTORS M. Jenkins ? DATE COLLECTED: 2-18-92 L TIME COLLECTED: 2I30pm SOURCE OF SAMPLE: Outside faucet DATE ANALYZED:2-20-92 TIME ANALYZEDI2IOOpm t COLIFORMI 0 /100 ml Ij INTERPRETATIONI Bacteriologically SAFE NITRATE-N: 5 ppm Above 10 ppm exceeds the recommended Public Drinking. Water Standard. Coliform Bacteria/100 mL Nitrate-Nitrogen, mg/L � 9 •rt LAB TECHNICIANS Pam Gane •�.\IWEYENpfNr j<. (i'{ N WI Approved Lab No. 19 yAg t Means "LESS THAN" Detectable Level Approved by: ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconpin 54730 715 - 962 3121 800 - 962 8378 (WI) 800 - 962 - 5227 ST. CROIX ZONING REPORT NO.; 31605/01 PAGE 1 ST, CROIX COUNTY REPORT DATES 7/24/89 COURTHOUSE DATE RECEIVEDS 7/21/89 HUDSON, WI 54016 ATTNS THOMAS G NELSON OWNERS Paul Heikkinen LOCATIONS 6 WitLo ne, Hudson, WI COLLECTORS Mary .Jenkins - St. Croix County Courthouse SOURCE OF SAMPLE** COLIFORM*, 0 /100 *l INTERPRETATION; Bacteriologically SAFE NITRATE-NS 5 ppe Under 10 ppe is safe for human consumption. COLIFORM + NITRATE LAB TECHNICIANS Pam Gam 2 . WI Approved Lab No. 19 q; yap �F.AHDEVE/VOFY s0 v d� t Means "LESS THAN" Detectable Level Approved by'* ® PROFESSIONAL LABORATORY SERVICES SINCE 1952 ST. CROIX COUNTY ` WISCONSIN i a ZONING OFFICE r ' ST.CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON,WI 54016 (715)386-4680 July 21, 1989 Paul Heikkinen 356 Willow Lane Hudson, WI 54016 Dear Mr. Heikkinen, An on site investigation of the septic system on your property located at 356 Willow Lane, Hudson, WI was inspected July 20, 1989. At the same time I also obtained a water sample and submitted the sample to the laboratory for testing. The results of that testing will be sent to you after we receive them back from the laboratory. At the time of the inspection, the sanitary system appeared to be functioning properly for the existing use. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating 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. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system is totally dependent upon proper maintenance of this system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, qo*t Mary J. Jenkins Assistant Zoning Administrator MJJ/sa • / 'gyp k � � I.) ST. CROIX COUNTY ZONING OFFICE St. Croix County Courthouse 911 4th Street Hudson, WI 54016 ; Telephone - (715)386-4680 The St. Croix County Zoning Office offers the service of septic and water inspections to Lending Institutions, Realty Firms, and private individuals. Completion of this form is essential so that the property can be located. Please provide the following information, enclose appropriate fee made payable to St. Croix County Zoning Office, and mail, along with form to the above address. Testing will be done as soon as possible after fee and form are received. WATER TESTING---------- ---------------FEE: $ 25.00 (For nitrates and coliform bacteria) WATER TESTING FEE: $175.00 (For VOC S) INSPECTION $25.00 SEPTIC SYSTEM INSP $ ( Y properly Determines if system is functioning at time of P inspection) Property owner's named Property owner's address Legal Description 1/4 of the 1/4 of Section , T N-R Town of yyOJ"j ,Lj Lot Number _Subdivision Name &,�/cccxj Fi1.2`e�a FIRE NUMBER -1,M LOCK BOX NUMBER Color of house 0zX Realty sign by house? If so, list firm: C -.;?/ PLEASE INCLUDE, IF AT ALL POSSIBLE, A MAP,i.e,COPY OF PLAT BOOK, WITH LOCATION SHOWN, AND A COPY OF THE LISTING SHEET. Testing of residential water requires a sample that is fresh. If the home is vacant, and has been so for some time, the water line must be purged by running the water for several hours before the test can be conducted. WINTER TESTING: Many times water lines are turned off, or sill cocks are turned off, making access to the home necessary. If this is the case, please make proper arrangements with this office to ensure time when entry may be gained. Firm or individual requesting services: &' L ivEr� Telephone Number REPORT TO BE SENT TO: J2.64 tf Oe:,lq itJ d1�dt� cam/ Closing date c J— signature [� SANITARY PERMIT APPLICATION CO if OILHR In accord with ILHR 83.05,Wis.Adm.Code `� ' � A )/ Z,q�„,� o ,,,,�,,a STATE SANITARY PERMIT V —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 �Q 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ff rNO PROP�j'RTY OWNER PROPERTY LOCATION ✓ a u 4 Ale,' /1/ff i e ,t/!•�'/a L- ,S lq T;2 g, N, R E (oryW PROPERTY OWNER'S MAILING ADD ESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME floc✓ a�r�' / /l ✓r T CITY CITY,STATE ZIP CODE PHONE NUMBER O VILLAGE: NEAREST ROAD,LAKE OR LANDMARK --v aa0 II. TYPE OF BUILDING OR USE SERVED: !��� ` 5-d—ociii 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. ❑ New b.❑ Replacement c. .Replacement of d.El 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. Ya.l 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. 5dseepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 14. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): Feet El Private ❑Joint ❑ Public VI. TANK CAPACITY Site in allons Total ##of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic structed App Tanks I Tanks Septic Tank or Holding Tank ❑ ❑ ❑—A+- Lift Pump Tank/Siphon Chamber ❑ 1 E ❑ ❑ ❑ I El VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stamps) &WMPRSW No.: Business Phone Number: Plumber's Address(Street,City,State,Zip Code): Name of Designer: 9�5— VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# r v -� CST's ADDRESS( tree, ity,State,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S Mary Permit Fee Groundwater ate Issuin Agent Signature(No Stamps) rcharge Fee l� n Approved ❑ Owner Given Initial I2� C C ) J (/ �-1 Of -?. L Adverse Determination / ��/lll...000 // ((.�� X. COMMENTS/REASONS FOR DISAPPROVAL: SBO-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber i 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-propetly maintained: The septic tank(s) should be pumped by a licensed - pumper whenever necessary, usually every'2 t0 3 dears; 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% 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 At$r included the creation of surcharges (fees) for a number of regulated practices which Wisco EI1t5 can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reas0r�' ° 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) (��� f✓L- '/T'fc��i��,./ �/�/,,-v.�'"�f ..5�' /�'` %��'/�/�w� To��Ufs--��,�•s�,� �er� 1� `l/Y �Pv�r °{Q Pei 0 L 1 "NE US3 MENT OF REPORT ON SOIL BORINGS AND S BUILDINGS DIVISION InJ_USA°..;"' GG P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS �11J) MADISON,WI 53707 (1-163.090)&Chapter 146.046) LOCATIM:N S N: =hsc, UNICIPALITY: OTNO.:BLK.NO.: SUBDIVISIO NAME: '/1E'/ / Tz9 N/R/9*(or 6 wIL w �S T�s COUNTY: (OWNE R S A AI WILLOW 14E I PAUL 35 6 ZANE. Jl SQfv I -S40/6 USE DATES OBSERVATIONS MADE PCOM A TIO : S: Residence N� ❑New Replace Ll� �0 f(, O Iq 1�tcs z�k A<+< S7 561CS— -' C PC 141N�16LD RATING:S-Site suitable for system U-Site unsuitable for system( 14" $MS l_?U.. MSS CCU ING S ❑� EA 11:1❑SGC�� RE�ONyEn�TtONA?L 'fopc�'51 I If Percolation Tests are NOT required DESIGN RATE: MAST If any portion of the tested area is In the under s.H63.09(5)(b),indicate: CLASS I s Floodplain,indicate Floodplain elevation: /v �cF'T PROFILE DESCRIPTIONS BORING TOTAL UN ATER-INCH CHARACT R OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER EPTHT» ELEVATION OBSERV D TO BEDROCK IF OBSERVED ISEE ABBRV.ON BACK.) B- B- >14 -ZS 16 A/L_TS 64��RnBa S�t�le �ct�6 97�r84NMS i B- T fi I_J f LL. (-J xls PA R 114 L 0� R /h WAX B- TE Yom, •�, sE u 'Ln e , G , SdP1-1c TA l< B- ,A , B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME NUMBER l iB}IEB AFTER SWELLING INTERVAL-MIN. RATE ER INCH MINUTES P- P- P' SZ S T T"IS T1 %S 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 � . 'SYSTEM VENTS a0 All O f rP 3 P ^ (�� FA1�6I� SEPTIC. ? -`ANU. S4ALC �oUSr£ 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: jJ4.01 �U11N1�xtN �tSC.N wOJ _;`/rv[, iry Au4us--r)o /QQa ADDR S : CERTIFICATION NUMBER: PHONE NU BER(optional): L')c1 �JEC o►t �'_ rrt.L' U�S�P.� W i 4846O�O CST SI TURE: .i DISTRIBUTION: f)riyutal and one copy to Local Authority,Property Owner and Soil Tester. 'lll HR Sf3C)-tii95 IR.f)?�B?1 OVER - L _ DEPARTMENT OF REPORT ON SOIL BORINGS AND S BUILDINGS INt7rUS —" DIVISION HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 53707 11-163.09(1)&Chapter 145.045) M0ON: NS UNICIPALITY: OT NO48LK.NO.: SUBDIVISION NAME: %4�'/ 19 Tz9 N/R/ #or vAst, 1 6 - WiLL6w lee -R&ST4 s COUNTY: (OWN ER R S NAME: MAILING ADDRESS: i'?411 i44elKKI PA-)L 3S6 WILLOW Lr4NE v Soti l -;4o/6 USE DATES OBSERVATIONS MADE N0. : COM A DESCRIPTION: p C P Residence r/NK ED Replace I V� 101 17 O f b11.5 T�pk A<� S7 �oILS- rM C PLb/NV16Ob RATING:S­Site suitable for system U-Site unsuitable for system Q ,t Q{�n+'"'T rQ 1.J el L.INj IN ❑U y ❑YL ❑dG�� RECONyErNVDT"E'UN4L (optional) If Percolation Tests are NOT required DESIGN RATE: MUST if any portion of the tested area is in the under s.H63.09(5)lb),indicate: /'I t s ( Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL UN ATER-INCH S CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER DEPTH-W ELEVATION OBSE A V TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- B- / I 4.7-< 92.9 f4c,ovg >./4 .ZS /D ALTS 64 Rb& S-t6le 47cOb 97 Ct-84a�95-�< B- rE 4 Q L3 6 l_,_ (-JAS P4 R_I 14 L l_'4 U R<< /h k %,J AI B- S ys ✓h St f'1-7,S —T-0—jee bj 40d A CONA, S 6 P j'►C TA /< B- to F8__T TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES LEVEL-INCHES RATE RINOTES NUMBER If1*Fi88 AFTER SWELLING INTERVAL-MIN. PERIOD2 PER INCH P. P- P- tjoT hwuL. N/ / i5 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 INN 12 R � SYS-rfrM VENTS AU6' 1 w T CRD-' CoUNN ` ?ONINGOFFICI Q f F•41�6� �JL`f'flc. TA N K. SG-A LC (-IOUSC� 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 Administrative Code,and that the date recorded and the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: 4AVL'' S014 N) -�>oN ADDRESS: CERTIFICATION NUMBER: PHONE NU BER(optional): 46-7 SECoi�. fl- `_>rQ1 L-T U�JSuN 1�/I 34e4 3a6• �o�o CST SI TUREc �•� DISTRIBUTION: 0ii4imal and one copy to Local Authority,Property Owner and Soil Tester. 1)11 HR-SBD-6395 (R.0?/81) - OVFR - DEPARTMENT OF REPON°1 ON SOIL KItvub AND S te& BUILDINGS INCYJSiFR''�;'�"" . DIVISION LABOR AND PERCOLATION TESTS (115) MADISON W53 07 HUMAN RELATIONS tH63.091111 St Chapter 145.045) LOCATIONN SEC N: NS 0 UNICIPAUTY: OT NO.: LK.NO.: SUBDIVISION NAME- N '/4 C'/ /9 Tz9 NIN/9#(ar uasQtq 4.Loi, lei T COUNTY: NE : MAILING Q / `�i C ats 1 IA)L v S-0 N 18b, S O/v E DATES OUERVATIONS MADE . NO. OMMERCIAL DESCRIPTION: p { gResidence IA yvy ❑New } Replace Il � 10 / 7•�f v _ � Jd1C5 z�l AGs S7 561(5_ ^t C AjvNT-ILEL_b RATING:Sa Site suitable for system U-Site unsuitable for system 101W O X14' IONA,�t "FUND: IN -I -FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) �S Qii os ❑u 0S ❑V ras ou I ❑S ou C-6NVE,vrroNAL QEl If Percolation Tests are NOT required DESIGN RATE: MOST If any portion of the tested area is in the under s.H63.09(5)(b),indicate: L11-A S t s L Floodplain,indicate Floodplain elevation: e_cVT PROFILE DESCRIPTIONS BORING TOTAL A -INCHES CHARACTER O SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER TpIF ELEVATION BSE V TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B- B- / 11 4.7-< 9T ©Ng 4 .ZS /O BcLTS 64��RaBR S�tUe cod 97 Cr&eN�iS < ()Qt t t - LL (-JAI PA R l 1 A L 0 Y t^ R /40&STbktC U p B' YE S s •P-) St >M -rd de i^j 4odA CoNArrin Sdpric -rAsji< B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME V H ES RATE MINUTES NUMBER I*WN M AFTER SWELLING INTERVAL-MIN. PER INCH P- P- P- S S T m I M is 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 Z �� ,o Al, O a m � g W SyST6M VE/vTs A�� X o &fie f 15 ■ 6 m N 3z' is TN O ( 6ta �jlePi'l� -IAN V- ',Gg LC �ouSt� 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: /J44VEY 3arJ+v SoN Sc N ,QJir�'/rv�� I rv� /VUCa Y �o /9ee ADDRESS: CERTIFICATION NUMBER: PHONE NU BER(oprtonal): 4a� SE�o�,�- rear u�s�N Vi) 3484 _ 386- Ad80 CS_TS I TURE DISTRIBUTION: Ori(imal and one copy to Local Authority,Property Owner and Soil Tester. !-)If HR-SBD-6395 (R.07187) -OVER -- IN 'S Ttw,ENT OF REPORT ON SOIL BORINGS AND S BUILDINGS I HUMAN RELATIONS PERCOLATION TESTS (115) MADISON WI 370 (1-163.090)St Chapter 146.046) LOCATION: N: NS UNICIPALITY: OT NO.: LK.NO.: SUBDIVISION NAME: I� 1� /9 T 29 N/R/ / (or !,/►c c o L_ ,VC,ie E s;DoT t3 COUNTY: WN�R'S NAME: MAILINGADD 1i C-��7i► E't� r I'idUL �'SS4 WILLOW It v 5ofV 1 'j O16 U E DATES OBSERVATIONS MADE TNaaBEDRMS.: O PTI N:nce Nk ❑New Replace IP7RFILE -I'r+t 9'k� J "' C RATING:S-Site suitable for system U_-Sits unsuitable for system(� (�{�n+ ONVE rAM-1 S L.iV Ma �'Ll� IN` S aU J ❑�-FILL ❑ilG�� :RECOeyVEroTIO N L (options 11, If Percolation Tests are NOT required DESIGN RATE: MOST FFIodplain,ny portion of the tested area is in the /J under s.H63.09(5)(b),indicate: L LASS i tt l C indicate Floodplain elevation: r_C_?1- PROFILE DESCRIPTIONS BORING TOTAL U AT R•lNCM HA AC ER O SOIL WITH THICKNESS.COL R,TEXTURE, AND DEPTH NUMBER EpiH t3¢ ELEVATION BSE V ST.HIGH TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B- B- / z qy.f Nl>kit >./4 .2S /D BOLTS 64"Rb& 'S-f6 e 'CctJb 97 r-gem/yS-� B' a B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME RATE MINUTES NUMBER INWII! AFTERSWELLING INTERVAL-MIN. PEAIQQ j 3 PER INCH p- P- P- STS va T N! 1 S►Y 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 11 12 f SYS'tlzM �EN'r� 1,� r■ 0 m S1 G ()OG0 / f O � FAlt.b� SEPTIC , -'AN\L SG r�LC )�OUSLC 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: [JAIQlAx. StanN Au4 7 6 /gea ADDRESS: CERTIFICATION NUMBER: PHONE NU BER(optional): 46.7 ��� arJ - ',, �� i,�sv�� ► 3484 3€36- �o�a CST SI TURE: DISTRIBUTION: fhtguril and one copy io Local Authority,Property Owner and Soil fester. 'M HR-SHD-6395 (R,f)71E12) - OVER - f je CO) Pei �J 0 5� oa c jv }�h 1, ,,e w 0� I