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HomeMy WebLinkAbout020-1099-00-000 ( o ) 0 . % [ @ \ ; 0 ] . � $ � A � � ( � ■ � \ � ƒ � 7 � f Z C LL ) 7 3 ) J d I f § « E = m 0 § ± 2 § k a m E ) z 2 k \ CD @ :3 2 a) .� k / (D q \ D k \ � .. z k = � § / k k \ 67 § e k k k k k a) \ \/IL E \k a \ / \ \ z o G - £ \ a 2 2 a : § � co j \ § CO CO o ' eaa ® 2 k k 7 / \ \E§ \ ! J \ 2 a � ) % � J -» m A � © ` ; 2 \ 2 0 2 E n r § R \_ § CL § \ \@ K n k (n . ) ) E ) / ` $ 12 ^ ) } \ = e . . s o z q = $ G $ 2 0 § i f § R z _ z e ■ _ J i § ) .' k a 4-," w ) a § J j a 0 3 3 • Parcel #: 020-1099-00-000 02/23/2006 12:23 PM PAGE 1 OF 1 Alt. Parcel M 33.29.19.39982 020-TOWN OF HUDSON 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- RIEG, RICHARD O&CAROLE L TR RICHARD O&CAROLE L TR RIEG 641 PINE TREE RD HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): "=Primary Type Dist# Description *641 PINE TREE RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 4.290 Plat: N/A-NOT AVAILABLE SEC 33 T29N R19W NW SE LOT 2 OF CERT Block/Condo Bldg: SURVEY MAP VOL III PAGE 749 ORD Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 33-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/08/2005 799752 2839/289 WD 07/23/1997 745/560 07/23/1997 632/79 2005 SUMMARY Bill M Fair Market Value: Assessed with: 92175 263,400 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.290 84,200 184,400 268,600 NO 05 Totals for 2005: General Property 4.290 84,200 184,400 268,600 Woodland 0.000 0 0 Totals for 2004: General Property 4.290 41,500 153,200 194,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 106 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 a Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER �,G ,�,� Q,.'ems/ TOWNSHIP J.�� �'�s,�/ SEC. 3_ T �N-R W ADDRESS X� gjS,,t,1 ST. CROIX COUNTY, WISCONSIN SUBDIVISION �,5�/ UJ� ,� LOT LOT SIZE ��}"GLeye (_3N PLAN VIEW Distances and dimensions to meet requirements of I•IHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM vJ I � � r 6t INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used ,fame A ,5- E&I /_s Elevation of vertical reference point: ",!l Proposed slope at site: SEPTIC TANK: Manufacturer: 4445 Liquid Capacity: /O�7(YC) Number of rings used: _� Tank manhole cover elevation: Tank Inlet Elevation: *" Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side,(D Rear, O ( feet From nearest' property line Front 10 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 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,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: Width: Length: Number of Lines: Area Built:_Z� Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear,(Ft . Number of feet from well: � I Number of feet from building: P/wZ (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: 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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: - Dated: Plumber on job: License Number: 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING MADISON,WI 53707 �pl NW14 ,SE4,S33,T29N-R19W IN CONVENTIONAL 1:1 ALTERNATIVE State PlanA)D.Number: Town of Hudson ❑Holding Tank ❑In-Ground Pressure ❑Mound Lot 2 CSM Vol. 3 PG 749 INSPECTION DA E NAME OF PERMIT HOLDER: JADDRESSOF PERMIT HOLDER: Richard Rieg Elmen ort ��r�gg BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.P L V.: CST REF,PT.ELEV.. Name of Plumber: MP/MPRSW No.: DOU IV Sanitary Permit Number: William Schumaker I6382 St. Croix 106110 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET:7V. TANK OUTLET ELEV.. L LOCKING COVER P OV IDED. PROVIDED 9 / IWA`R_N_1KG_LA`I3 ES ❑NO DYES O BEDDING: VENT DIA. VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING. VEN O FRESH I ALARM FEET FROM LIN: / (AIR INLET ❑YES O 1—III ❑YES O NEAREST Il \7 DOSING CH MBER: MANUFACTURER BEDDING'. LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO ❑YES ❑NO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER 4PROPERTY WELL BUILDING VENT TO FRESH (DIFFERENCE BETWEEN FEET FROLINE AIR INLET PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH METER 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: WIDTH: LENGTH. INOOF DISTR.PIPE SPACING. COVER INSIDE DIA SPITS LIQUID BED/TRENCH I O TRENCHES ' MA RIALt PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH UISTH PIPF DISTR.PIPE DISTR.PIPE MATERIAL: NO.DI NUMBER OF PROPERTY WELL BUILDING. V NT TO FRESH t FEET FROM LINE AIReT BELOW PIPE ABOVE OVER. ELEV.INLET ELEV.END'./� PIPES S7 �7/ NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ❑YES NO SOIL COVER TEXTURE PERMANENT MARKER707NO OBSERVATION WELLS ❑YES ❑YES 1:1 NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES ❑YES ❑NO ❑YES 1:1 NO ❑YES NO i 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 DISTR DISTR.PIPE DISTRIBUTION PIPE MATEHIAL&MARKING ELEV.. ELEV.. DIA.. ELEV. PIPES ELEVATION AND DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL pLANSOAL LIFT CORRESPONDS TO APPROVED ❑YES ❑NO 1:1 YES NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS'. NUMBER OF PRO ERTV WELL: BUILDING. V u FEET FROM [DYES 1:1 NO El YES 1:1 NO NEAREST - -- 30 qS Sketch System on Retain in county file for audit. Reverse Side. 4 SIGNATURE." _.,]TITLE Zoning Administrator DILHR SBD 6710 IR.01/82) SANITARY PERMIT APPLICATION COON / Q 1TDJLHR In accord with ILHR 83.05,Wis.Adm.Code STATE SANITARY PERMIT# /o 6/!D -Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES NO PROPERTY OWNER PROPERTY LOCATION ,& �z 4,a, ,/4S ' ,/a S _ T , N, R /57 E (or PROPERTY OWNER'S MAILING A&bRESS / 9Q5 6Y; LOT NUMBER BLOCK NUMBER SUBDIVISION NAME G�.3e� �! •!j/ ST,.et7C�/J1 eNC%cYF ��� cxS� � � ��.3 �L/ 7 CITY,STATE ZIP CODE PHONE NUMBER El CITY NEAREST ROAD,LAKE OR LANDMARK Sys 6A� ❑ VILLAGE II. TYPE OF BUILDING OR USE SERVED: & ' OaG—/09?_ 40_&,V 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. X New b.❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more-than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2) 1. a. Conventional b. ❑Alternative c. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ee a e Bed b. ❑Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): Aff �Z// - Joint ❑ Public Feet Private VI. TANK CAPACITY Site in gallons Total #of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdina Tank v2 Lift Pump Tank/Siphon Chamber ❑ Ej VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system hoN on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stam ) /MPRSW No.: Business Phone Number: -3 3� a Plumber's Address(Street,City,State,Zip Code): Name of De igner: �l VIII. SOIL TEST INFORMATION Certi ied Soil Tester(CST)Name CST# CST's ADDRESS(Street,City,State,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date issuing Agent Signature(No S mps) Approved ❑ Owner Given Initial Su charge Fee /�j'7 Adverse Determination v'W " X. COMMENTS/REASONS FOR DISAPPROVAL: .. 1Gth L"Ct SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; ' 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8h 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 Bt�E included the creation of surcharges (fees) for a number of regulated practices which Wisco in. can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried re3S.l1tQ!. is used in your building is returned to the groundwater through your soil absorption o 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- f water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. 9 SBD-6398(R.03/86) APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the , property being developed. Any inadequacies will only result in delays of the permit ' issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property Location of Property M Li _ _ _1x, Section , T_ aq N-R Lj W Township - - 14%JS 0, Nailing Address T Address of Site OL I C S it (f G r .m A Subdivision Name _ C.� Lot Number 1, Previous Owner of Property al t•. ke Total Size of Parcel & Cr,e S Date Parcel was Created Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes No Volume 7V9_ and Page Number 560 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION i (roe) ce tti6y that of e statementrs on tit" 60AM ahe tAue to the best 06 my (out) hncwt¢dge; that I (we) am (ahe) .the ownerc(,s) o6 the propeAty deAcAi,bed in thiA .i"AcImaLion 6o4m, by vixtue o6 a waAA n.t deed hecohded in the 066ice 06 the Corsi ty RegiAten o6 Deeds ass Voeument No. ; and that I (We) p4"entty awn tl�e pnopoaed a i,t¢ bon the sewage di�spo�5 6 ye em (on I (we) have obtained an eaaement, to /tun with the above de�5c&ibed pnopehty, 6oA the eonatnucLi.on 06 chid eya.tem, and .the dame haw been duty hecohded Xn the 066iee 06 the County Regi.d.teh o6 Veeda, as Voewnent No. ) Aa SIGNATURE 09 OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED =tip► � k � c•fi � z , :' Alt L al i'. � r t. `:. Cdr 4, , .. M how R°f Al�' rHWyy I rC` a2 _ r� 11; Jib" somimp000mo a. k, t - 1 �� � �' a a •�«�F ,� 3 �"� `� r # rn k K 4 { JX VW +.��::•., try s H G H a STC - 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT Ho St . Croix County z d a � H OWNER/BUYER R{G�4,� M<<P C4 M ROUTE/BOX NUMBER Fire Number CITY/STATE 14 Li ;S C ZIP S14014 PROPERTY LOCATION : , _14, Section, T*'N , R _W, Town of F{t,_d$a^ St . Croix County, Subdivision CShr\ (krue,) Lot number. Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper maintenance con- sists of pumping out the septic tank every three years or sooner , I if needed , by a licensed septic tank pumper . What you put into ` the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St . Croix'. County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1 , 1978 . St . Croix County accepted this program in August of 1980, with the requirement that owners of all new stems agree to keep their systems properly maintained . The property owner agrees to submit to St . Croix County Zoning a certification form, signed by the owner and by a master plumber , journeyman plumber , restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping ( if nec- essary) , the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I/WE, the undersigned , have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x H the standards set forth , herein , as set by the Wisconsin Depart- ro ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning Office within 30 days of the three year expiration date . SIGNED 0. DATE l�� ld1+L1 d 0 •ice St . Croix County Zoning Office P .O. Box 98- Hammond , WI 54015 715-796-2239 or 715-425-8363 Sign , date and return to above address . DEPARTMENT OF REPORT ON_SOIL_BORINGS A_ND SAFETY & trU" -.. _ _ DIVfSIUr� INDUSTRY, C ^ --c - - --G LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.090► & Chapter 145) LOCATION. SECTION: OWNSHI UNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: �w �/ sE 1/4-�-S Ta9 N/R/9E I.,)W Dso►v z — csM Vol- 3 F9 9 COUNTY: OWNER" BUYER'S NAME: MAILING ADDRESS: G _�p� A 't A tl S-11-1-L-Fef' ST.�_ �.c11 x �, p )�� c�r'I�D o R t= A F$ t'�t_. S tt- X19�•r,6 �_ DATES OBSERVATIONS MADE USE__ NO.BEDRMS.: COMMERCIAL DESCRIPTION: (PROFILE DESCRIPTIONS: R ATION TESTS: ( sidence •New ❑Replace I /U ,f� RATING:S=Site suitable for system U=Site unsuitable for system ONVENTIONAL: MOUND: IN-GROUND-PRESSURE• SYSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM:(optional) ------— Z S ou I S- EUI ZS oU ZS 0U _CIS ZU_ v�'x-s3 ' -� [.'f Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the(. S Floodplain, indicate Floodplain elevation:der s. ILHR 83.09(5)Ibl,indicate: _r\ J I '-- � Percolation DESCRIPTIONS r NG TOTAL DEPTH TO GROUNDWATER-IN@044-S CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH ER DEPTH ISO: ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) Z.u 'Oh3>1LTS 2-o'$n L ;o S.6 k0o•9 lvoly� 8. 6 B- z t- s q 8,9 . > �• 5 B- 3 �`yr C10! •$ ' �i 5 (i. L{ ' B- B b.7' y X0.9 4 ; V7' vh S4^/ Gh B- 1011.Z' it >7-S'PERCOLATION TESTS `1' 'r S. S r r r TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P PER INCH P- P , p_ ►JO A'XJ G ek LL 61 C 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. $o-Tr­\�" of $eo S 1��6E 6 L LM1�ET2.T SYSTEM ELEVATION T-Q13• C) S.­7 \A RP 8 BHA/- In—100.0 'o+V r~K'3 fr-J60b' QSF►�o`S1E: wez�- m t _-__. _-- _ ._ `r��AQ 8h� Z-C—L. lD1,3'o>`► I��.K3��wOOD^_..: - BE PIT L..�`NST 50 5T'A hE w1TN �-�'T'?f V-Zl OF S`!S7fl-t h1Z0R -- ---- a.) y q9 S► �o�l'cTt'� $oo"O. eBso►V. _. y 9f q.S 9/ob Q . ►� m>= `Tri� SE cOS2l1EQ Or l rF& 00 1`$r �5 ►)W 1Iq- S E f/S/. 5'EC 33 m _ M IQI�nINL , �N cEE'1��"__ __. CftT)�J S k ET'C H s�fl g►0# Z' � 1-14 3 i ' qy.1 'a4•-I •5— I�s�1cR $ �x IST�ti G 6CUv,,p c rr4 .N_ CZ�nTu1.1$ _. S-LOSES N-r o yS-T-)a-1 M - x.!s,i z /o s Io , �o cz I� -f? r✓ _ z 1R°_ ZZ S�ALl` i"_ So' SF� J3 1, the unriersionad, hereby certify that the soil tests reported on this form were mane by me in accord with tho r,roredwes 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 knowledne and belief. NAME (print): ---- 1TESTS WERE COMPLETED ON: ADDRESS: CERTIrICATION NU",'PER: JPHONE NUMRER(:otiunal): CST S11-l" TUBE: DIST RIBUT ION: Or rg-al and one copy to Local Author ity,Proper ty Owner and Soil Tester. DILHR-SBD-6395 (R. 10163) —OVER —