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HomeMy WebLinkAbout030-1073-50-000 � 0 3 M ~ 0 N o a i � h °o N ti 1 tl i a �L i i N C i 7 N 3 d U CO CL v ) y O Z r 0 0 ° a m co 1- U) _ O O Z d v c - v O 0m Z o to F E O N CI N N •N O 4 O O Q Q N ZZZ a Z •• N y L .. ` a 0 0 o a g w Q fn U) U) j E U WSJ Z {y. N Lo S a O ~ O EL Z •N an. a a US or- US w ao N M O � O O J O O m N d N Q CA Z C/7 Q l0 L CO y y 00 3 li M H C E O O CVO H c N 0=. O N t Q .� r CA Sr tt7 M� °' M C N C N • n ;0\ v y„ O N (11 D: r O Z S �L U) .w Cd r+ cj1 d 0 #t EL I d • a m d d .2 l E c c �1 A cia2 1ov� c0 Parcel #: 030-1073-50-000 02/11/2005 09:24 AM F PAGE 1 OF 1 Alt.Parcel#: 26.30.19.256C 030-TOWN OF SAINT JOSEPH Current X' ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): *=Current Owner *REILING, ROBERT L&MARGARET K TR ROBERT L&MARGARET K TR REILING 1397 PRIOR AVE ST PAUL MN 55116 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description * 1329 BASS LAKE TR SC 5432 SCH D OF SOMERSET SP 8040 BASS LAKE REHAB DIST SP 1700 WITC Legal Description: Acres: 1.030 Plat: N/A-NOT AVAILABLE SEC 26 T30N R19W PT GL 7 COM SW COR GL Block/Condo Bldg: 7,TH E 1109 FT, N 33 FT,TH N 10DEG E 150 FT TO POB:TH N 10DEG E 150 FT, E TO Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) SHORE BASS LK,SWLY ON LK TO PT E OF 26-30N-19W POB;W TO POB Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 1107/141 QC 07/23/1997 830/613 07/23/1997 820/35 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 5352 250,200 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.030 167,900 78,200 246,100 NO Totals for 2004: General Property 1.030 167,900 78,200 246,100 Woodland 0.000 0 0 Totals for 2003: General Property 1.030 92,000 57,800 149,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount 040-OTHER ASSM'T SPECIAL ASSESSMENT 488.70 Special Assessments Special Charges Delinquent Charges Total 488.70 0.00 0.00 e � i Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP ��, I' r SEC. T 3'O N-R W ADDRESS )ele / ST. CROIX COUNTY, WISCONSIN v SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•I,HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM a ' o � o INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used 61��4 t Elevation of vertical reference point: /dp Proposed slope at sit : SEPTIC TANK: Manufacturer: Gc1cQ t �C.S Liquid Capacity: 116*Q Number of rings used: I'& Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,Q Side o Rear, O 16m; f�" feet r� From nearest property line Front,0 Side,©Rear,O feet Number of feet from: well ct' , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE r 1 i r PUMP CHAMBER Manuf a ct urer: 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, a Side, O Rear,0 Ft. Number of feet from well: `i Number of feet from building: y (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: X �d Width: �� Lenith: Jo Number of Lines: Z Area Built: 3 ry 0 Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, 0 /��\Rear, Pt . Number of feet from well: 2 Number of feet from building: (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 O or distribution box been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: a Inspector: Dated: Plumber on job: v� License Number: "S 3 2 ZSl r 3/$4:mj i DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOF#&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX.,7969 BUREAU OF PLUMBING thADISON,WI 53707 SE'4,SUI,1-4,S26,T30N-R19w KXCONVENTIONAL 1:1 ALTERNATIVE SltatePlaeo)D.Numbec Town o6 St. Jo,6eph ❑Holding Tank ❑ In-Ground Pressure ❑Mound 132nd StAeet NAME OF PERMIT HOLDER'. A PERMIT HOLDER: INSPECTION OAT Bob Re.%Z ng 1337 St. Cta tc Avenue St. Pau,2 MN 5510 /-3.0-$? 0" /S BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.. Name of Plumber MP/MPRSW No Cnunty. Sanitary Permit Number: RogeA Timm i 3224 St Cno-ix 1128 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKIN OVER ROVIDED: PROVIDED. L'16>.,R.�.•�a', /O� q�, 4 e Q b YES ❑NO ❑YES NO BEDDING: VENT DIA.: VENT MATI HIGH WATER NUMBER OF! ROAD. PR�RTY WELL. BUILDING'. VENT TO FRESH �/+ _ LI JAIR INLET YES�NO C.r ?e FEET FROM; q ❑YES NO NEAREST DOSING CHAMBER: MANUFACTURER JBIEDDING LIQUID CAPACITY 1111MI'MODIL jPU"P.1IP1ION MANUF ACTUHEH WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES NO V Y ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROP TV ELL BUILDING IVENTTOFFESH LE (DIFFERENCE BETWEEN FEET FROM "E AIR INLET. PUMP ON AND OFF) ❑YES 1:1 NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing I I[N(,TH JIIIAMI rE H A FH L AND MARKING FORCE or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: ,. WIDTH LENGTH NO.OF N111 SPACING, COVER :INSIDE.OIA -PITS LIOUID BED/TRENCH TRENCHES MATERIAL PIT DEPTH DIMENSIONS 3CQ J, I RAV L D H FILL DEPTH UISTH PE DISTR PIPE MATERIAL NO I_TH NUMBER OF PROPERTY WELL. BUILDING: VENT TO FRESH E OW PIPES ABOVE COVER ELEV.INLE( ELEV ENU PIPES :LINE A_IR ET FEET FROM Q\\FF `' +- ` o� t?30 .So �-1 I NEAREST---=�: acl 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 PFRVANf NT MARK FHS oBSEHVATION WELLS 1:1 YES ❑NO 1-1 YES ONO DEPTH OVERTRENCH BED DEPTH OVFRTRENCH RED UEPtH OF TOPSOIL SODDED isEE UEU MULCHED CENTER EDGES ❑YES. ❑NO ❑YES ❑NO ❑YES 0NO PRESSURIZED DISTRIBUTION SYSTEM: b WIDTH. LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH RE LOW PIPE FILL DEPTH ABOVE COVER 055/TR>:NCH TRENCHES. DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO OISTH UISTN.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEV.. ELEV. DIA. ELEV. PIPES DIA.: ELEVATION AND DISTRIBUTION. INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECT L V COVER MATERIAL PLANS LIFT CORRESPONDS TO APPROVED 1:1 YES ❑NO 1:1 YES E]NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF : � ;L PROPERTY WELL: BUILDING: FEET FROM G� t ❑YES 1:1 NO DYES 1:1 NO _ N AREST L Sketch System on , - ` Retain in county file for audit. Reverse Side. SIGNATURE' TITLE: C Zoning Adm-yU,6ptatot DILHR SBD67101R.01/82) �'�ILHR SANITARY PERMIT APPLICATION COUNTic7., C�D�� In accord with ILHR 83.05,Wis.Adm.Code �,.�.r.....°......tea. STATE SANITARY PERMIT# CO - —Attach complete plans(to the county copy only)for the system,on paper not less than STArE PLAN I.D.NUMBER 8.1/2 x 11 inches in size. —See reverse side for instructions for completing this application. PETITION rter 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES n NO PROP Y WNER PROPERTY LOCATION f; 31C%57 '/a, S T N, R L (or PROPERTY OWNER'S MAILING ADD SS LOT NUMBER I BLOCK NUMBER SUBDIVISION NAME CITY,S AT ZIP CODE PHONE NUMBER 0 CITY ' NEAREST ROAD,LAKE OR LANDMARK VILLAGE: C�C 3 Z II. TYPE OF BUILDING OR USE SERVED: 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.K 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. E1 Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP +s. In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ Seepage Bed b. Seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVYION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): —i—/ 17C v 7— v Private ❑Joint ❑ Public �J6 2 Feet 3 3 , CAPACITY VI. TANK Site in gallons Total #of Prefab. Fiber- Expp. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks / structed Septic Tank or Holdin Tank l(S'71� l v ❑ Lift Pump Tank/Siphon Chamber ❑ ❑ 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 St mps) MP/MPRSW No.: Business Phone Number:ZZ_Z -Plumb is Address(Street,City,State,Zip Code): Name of Designer: KA �- VIII. SOIL TEST INFORMATION Certified oil Tester(CST)Nam CST## �� !/ v 1. CST's��0p RESS( reet,Ci ,State,Zip Code) Phone Number: -0D 7 -3/, 6_J5 l /5 3 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Iss g Agent Signature(No Stamps) Approved ❑ Owner Given Initial �/ .•2. , Surcharge Fee ^ �G_& WZ Adverse Determination �(��� 0��.W (� 7 !L�•�/u X. COMMENTS/REASONS FOR DISAPP OVAL: SBD-6398(formerly Plb-67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber INFORMATION & INSTRUCTIONS-FOR COMPLETING 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. Prcperty owners name and mailing address. Provide the legal description where the system is to be installed; 11. 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; 111. 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 fora//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'/z 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 years of steady negotiation and public debate. The groundwater bill Ground Ater— included the creation of surcharges (fees) for a number of regulated practices which yylsCOrSfn'S a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasuir' is used in your building is returned to the groundwater through your soil absorption u system or the disposal site used by your holding tank purriper. a 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. SBD-6398(R.03/86) APPLICATION FOR SANITARY PERMIT STC - 100 his application form is to be completed in full and signdd by the owner(s) of the roperty being developed. Any inadequacies will only result in delays of the permit ssuance. Should this development be intended for resale by owner/contractor, ("spec ouse"), then a second form should be retained and completed when the property is old and submitted to this office with the appropriate deed recording. er of �e_w "- Location of Property , Section �i , T 3� N-R //� W Township Mailing Address i Address of Site Z le/Ise/ Gtr Subdivision Name All Lot Number &t/e-Pu,4 Let '� 7 Previous Owner of Property .yO��Ci�d �i ✓jam lj� Total Size of Parcel Date Parcel was Created 1,10 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes k No Volume and l _.._. Page B Number 3 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 POP-1 cv_Ati.6y that aU etatementh on x1 ohm ane hue to the beet o6 my (oun) hncwtedge; tJiat 1 (we) am (ane) tJle ownen(e� o6 the phopehty deAcAi,bed in VUA .inAolma.Li.on 6o4m, by v.ih.tue o6 a waAAan.ty deed h. eoh.ded in the 06 ice o6 the Countyy RegiAten o6 Deeds a,6 Document No. D O� ; and that I We) phebentty c.vn tl�e pRopoaed e.i,te bon the Sewage d Apoa aye em (OIL I (we) have obtained an easement, to Run with the above deg c&tbed pnopehty, bon the con,6 Auct on o6 aaid ayst", and the Same has b en duty keemded .in the 066•iee o6 the County Reg.iateA o6 Dee.4, as Document No. oho�( 1 . 316WATM Olt OWNER C/- SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED rt Survivor$hip marital grope X.,w� , r-•.. .,.........7- ........... ........�.�►..Y... '�'� �, lwt tlb aid Gro*r.toe W. . tii!° !s .. .. ... ... ..My `« - �. 1e�erlbed°reel�4A. �k. — Q *-.� t. tag at the Squt. 46v; thetm*-voxtkk"A 110 . tom. t►; I` user Aof s4 , . , located. AO jae driest property " g � � - y r ` '4 r ' H G N y a r STC - 105 a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County z d OWNER/BUYER �� ROUTE/BOX NUMBER { = Fire Number CITY/STATE ^ars��� T ZIP PROPERTY LOCATION : 14, �14, Section _2(< T _?e) N , R .. Town of_s �`. St . Croix County , Subdivision `j% Lot number /v 10 . 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 606 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 r. etluirement that owners of all new systems agree to keep their systems properly maintained . The property owner agreet 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 . yo E I/WE, the undersigned , have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth , herein, as set by the Wisconsin Depart- w 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 DATE 9 U/ 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 AND SAFETY&sUIL SION INDUSTRY, • DIVISION L"OR AND PERCOLATION TESTS (115) MADISON WI 3 097 HUMAN RELATIONS .09(j),&Chapter 145.045) IS ON NAME: LOCATION: 1$ H P/ UNICIPAITY: OT O. : SUBDI E '/ �6 /T3nN/Q�p Ior �`I S&/AN COUNTY; rcp,o I x L I �► U E DATE$OBSERVATIONS MADE r] NO.BEDM AL DESCRIPTION: PROFILE DESCRIPTION P FICOLATION TEES Residence UNK ❑Now Replace I56IT6�i, Z ! ► �- Z7,Si -- I�b C,E �2 - � ►cs �4z OA14A14 RATING:S-Site suitable for"am U-Site unsuitable for system N ,! IIN-GR(X)NDPREWUFT: I G TANK:RECO/M� MENDED SYSTEM:(optional) S ❑� S oV S ❑u Y S (:ot.t�/tN'TIOhJAI. TEL �NCS If Percolation Tests are NOT required D SIGN RATE: If any portion of the tested area is in the under s.1-163.09(6111b),indfcei Ltr1SS Floodplain,indicate Floodplain elevation: Q PROFILE DESCRIPTIONS BORING AL -1 C CHARACTER I I R,TEXTURE, AND DEPTH NUMBER DEPTH 1!p. ELEVATION TO BEDROCK IF OBSERVED SEE ABBRV.ON BACK.) q p f,b, MaT � B- C),-Z< 6� ��� Z� i• LT; / 'kc '-�L i6"' Ae S! INTEeF#Ct: Sa"C-►h aN it B- - I B. Z Ib.6� pl,>Z 'VbNti l�•�� ��f�CC :, / r atiS�C Sl 5"C1Be�C �� WM$aw B- B- 41 rLnxjti > f$ 53 "GLLTS / " 51 B- 0, 18P& C` In.3 c� PERCOLATION TESTS NUMBER DEPTH AFTE,WATER N INTERVAL -MIN. PER MINUTES P. I S, l0 • 6 3 'I>.Z > < P. -1 .zv 3 ?z >Z P_ q9.2 a Z �► < P_ P. ELLY nia AT L PLOT PLAN: Show locations of percolation tests, toll borings and the dimensions of suitable soil areas. Indicate scale or distances.Describe what we the hori- zontal and vertical elevation reference points and show their loceti e plot plan.n on the Show the surface elevation at all borings and the direction and percent of land slope. uP#'�R Tl<=isJ N Ll6.ro t GU_- SYSTEM ELEVATION ' S i�l i,,�N_-_ 14—CO W �Xlsrlac� 04� w C AA :O._ A4-biTt w I o f i l t 1 ;SO+ i }► tN 1 i o; L ( \ fi- I ........... 7 l I 1,the undersigned,hereby certify that the soil tests reported on VMS!this form liy 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 rmt : TE WER O LETE ON: 7A4 1C A R + ; 1 CERTlFICATIO NUMBER: PHONE NUMBER(optional): T DISTRIBUTION: Original and one copy to Local Authorltv.Property Owner and Soil Tester. D i LHR-SBD-6395 1R.0911` MPRS 3224 WI p MPCA 696 MN JOB TimmSHEET NO. OF Z' ' CALCULATEDBY � -;;f""DATE Excavatin g Co. CHECKED BY DATE R 1, Box 192, Wilson, WI SQ27 SCALE 71 S-386. 3 ROGER TIMM 715-772-3214 �. ..... , i ... .... . h r ei _ . . .. I , ............ ......... ... .... ....:....__. .. i ..... I i Zt i dy ......... L . rnonucr 20W 71m,Crtm,Mm 01471. MPRS 3224 WI MPCA 696 MN Job TiSHEET NO._ Z ,OF 2 Excavatin CALCULAT ED BYE ; DATE g Co. CHECKED BY DATE R 1, Box 192, Wilson, W1 54027 SCALE !.._..... ..... , ROGER TIMM 71&771-3214 I I ... .........i.................... !. . ...... . t.... ...,.. ! : r....... 1.. i. ..... ... III I-. ,.,... .�.. ......., ;_ `.. _ _..._ _.... ... ...i.... ., .. _.... r i C: �r .,._. ....,,._ .............. :...... ....... _.. _. .. .. ....... ...... ..:...... ..:.. .i... .. ... .... ............ ! ._.... i...._..;. d. _ ...... .. ..... I ... L... !.......... ':._... .,. ..i.. . .........}.. ..,......- .,... ...... , P11=12XI®Inn,w".MEL 0I471. 1 r � _ I 7 I C�� � � � ��� � �, �3 � � �l� � `i � � � �� �� � �� �� U L