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HomeMy WebLinkAbout032-1028-50-100 CD 0 0 qb e4 c 0 Co 0 c LL 7 E 0 .0 co < ce) CD z E CL co 0 0 z 0) z :!t c 0 z E '2 Cl) cc CD CL CO z 0 co a) <z 0 z E § C14 Lo 0) CN a. 0 CL r- U) co 0 .0 c < 0 L) Z > a- M '6 z 0 0 1 CL IL IL (D 4.; CO 0) CO 0 E co CO co 0 0 z its 'o 65 C14 04 a 0 LO m V .6 U) cc CN 04 o to c cc E E = c, C-,) 0 L) c r- (L 5 L? 0 0 00 Mr 0 ® C,4 0) V) Z Z 4 CD CD a 0 C\j co E E m ci 0 :3 z Ch 0 co 10 EL L: (L CL E 'E C o o IL 2 0 U) DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS !AB", IUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMIBING P.O.BOX 7969 MADISON,WI 53707 NE14,SEk,S9,T31N-R19W RRCONVENTIONAL ❑ a ALTERNATIVE Stssignnl.O.Number. (lf assigned) Town of Somerset ❑Holding Tank ❑In-Ground Pressure ❑Mound Lot 2 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Thomas Gunther Route 1, Box 354, St. Joseph, WI 54082 - 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: William Pfannes 6222 St. Croix 106090 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV_ WARNING LAB L LOCKING COVER PROV,.ED ❑YES ❑NO ❑YES ❑NO BEDDING. VENT CIA.. VENT MAT__ HIGH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. VENT TO FRESH ALARM FEET FROM LINE AIR INLET ❑YES ❑NO ❑YES ❑NO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING'. LIQUID CAPACITY PUMP MODEL. PUMP/SIPNON MANUFACTURER WARNING LABEL LOCKING COVER D� PROVIDED PROVIDED ❑YES ❑NO S Z� ° ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL. NUMBER OF PROPERTY WELL BUILDING VENT 70 FHESH LINE AIR INLET (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) ❑YES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: LENGTH. NO.OF DISTR.PIPE SPACING COVER INSIDE DIA =PITS LIQUID BED/TRENCH ` S TRENCHES MATERIAL: PIT DEPTH DIMENSIONS ( �G GRAVEL DEPTH FILL DEPTH DISTH PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTH. NUMBER OF PROPERTY WELL BUILDING VENT TO FHESH BELOW PIPES ABOVE COVER ELEV INLET ELEV.END. PIPES FEET FROM LINE AIR INLET 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 MARKERS OBSERVATION WELLS ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES ❑YES ❑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 DISTR DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MAHKIN6 ELEV.. ELEV.. DIA. ELEV.. PIPES DIA.. ELEVATION AND DISTRIBUTION HOLE 512E HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS ❑YES ❑NO ❑YES ❑NO COMMENTS: JPERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE ❑YES ❑NO ❑YES ❑NO NEAREST 1'op d - , VO i n fr Sketch System on } . Retain in county file for audit. Reverse Side. 0 SIGNATURES. TITLE Zoning Administrator DILHR SBD 6710(R.01/82) SANITARY PERMIT APPLICATION COUNTY 4� DILHR In accord with ILHR 83.05,Wis.Adm.Code as�,,,,,,,,,�,,,� STATE SANITARY PERMIT#16tlae 510 —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. "V//,A-�4 anti k) W y of�c ibn /� PETITION S 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. q/ FOR VARIANCE ❑YES ENO PROPERT OWNER PROPERTY LOCATION e f" % S T 3 , N, R / E (or) P OPERTY OWNER'S MAILING DDRESS LOT NUMBER BLOCK NUMBER ' SUBDIVISION NAME Depn/s ,�-rso„ CITY,STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD,LAKE OR LANDMARK VILLAGE: Ake TOWN OFF II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family f�edrooAP, 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.❑ 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. X 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. K.Seepage 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): RE QUIRED(Square Feet): PROPOSED(Square Feet): Q 6 Iiic9i 1" � 1,S r/ /5, Feet Private ❑Joint ❑ Public VI. TANK CAPACITY Site in llons Total ##of Prefab. Fiber- Exper. a INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete stCon-d Steel glass Plastic App Tanks Tanks Septic Tank or Holding Tank QG� e Lj 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 Stamps) MWMPfi'SVV1qtr.: Business Phone Number: ' -f-C? 6 Zz 15 5- 94 2- P ber's Address(St feet,City,State,Zip Code): Name of Designer: bx Vill. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST## -Cg-Ts ADDRESS(Street,Ci , tate, ip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY F-1 Disapproved Sanitary Permit Fee Groundwater at Iss 'ng Agent Signature(No Stamps) 14 Approved ❑ Owner Given Initial ( Surcharge Fee . Adverse Determination X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398(formerly Plb-67)(R.03/86) DI ST UTION: 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. i 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 81/52 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 Attar included the creation of surcharges (fees) for number of regulated practices which Wisco €n'S can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried is used in your building is returned to the groundwater through your soil absorption e system or the disposal site used by your holding tank pumper. € 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- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398(R.03/86) Y � 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 f oo /-I PI 'S J, 6--Ud7#6� Location of ro erty �� 1/4 1/4, S ction / , T�N-R�W A-J 0 P�"r ° P IN /`'-/ Off'TH•L� �id l�Y/ S E v Township 1 SG Mailing address v LA) % � Address of site � �L� / Subdivision name �U�S 0/✓/�/�"� " �^'�i L�sl�� .S�yvwor-)) Lot number 3, 01 Previous owner of property NlS;1 96ds'ad 1N(,t�u i✓ Total size of parcel O• , 7 w 1")�N Date parcel was created D Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes No Volume .21�� and Page Number as recorded with the Register of Deeds. --------------------- 0�-��------- c��__ 1 ty _gu --�q ----------- 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 (AW certify that all statements on this form are true to the best of my (vwr) knowledge; that I (-me) am (aee) the owner(W of the property described in this information form, by virtue of a warrant d ed ,recorded in the Office of the County Register of Deeds as Document No. ; and that I (4k-) presently own the proposed site for the sewage bispotal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, an the same has been duly recorded in the Office of the Co ty Register Af Deeds as Document No. ) . Signature of Ow er Signature of Co-Owner (If Applicable) %- // �� Date of Signature Date of Signature ,UM ,y a. �� � r,3_ ••Tg'�,Pd�eve e g .i or ' �r a � ., DO ham. f ttv <� Z r F� r � i ° O LLJ N y O d O 1 W y tY O L2 1— w 0 z c r; W o 0 H u— m ` '3u001hZo0ON ,ieaq o; pamnsse 6 uot;oaS 10 z gull.;sea ay; o; psoua.ropi gig s6ut,leag P---4 ° F- Ld W o N ° O I ca z V) N O � Q QA c _ _ _ Zo n- w �4�, c = saoy; o � q pau►+o spuej pa; ;etdun �o 0 oa o ° 'L o Co _ C- cn ,89'611 I c M \ Z z o ,20'96 y a+ 6.91.92 OUS _ y\ w _ _ c a a v\ a+ Sa.fed M b C4 \ La �.i oar` pie ;. ,°� I r`\ • o FS�q r O b- 'per J 2a, 3Va l °f -o\\ at, 0 06.y1, A5\20 :rnl O w v so\ v '9 �b . c123 r I J a 19. to o M Ln\to o m OF\s `�9 �. 'o 11 N I G\\ in 0 0 C4 LLJ LLJ y z -yip w O ,�F`�SQ �� 's /slZ9�s�N \\ W W aL LL s i Q arm._..- \`gi,ad+ 0 o „a£ zi H 3 tb0o1 s o •Od Q•\� 9\ v `) r: o .❑• Lo\ y W c S 3;:OU j, OT uot;oas 30 gull ;SOM W- ;£a ivoi � ?j--- --- 6 uot;aas 10 gull ;see \ I a \b m -0% J % °o� ra �3% °6 tO Q A Z r- W / pig HV oe G 4 ozi s u K c�LOA K .9 tv t i + 1 +i o C" o co co " Cl- + I + 1 + I uj Cl) y ~ C N / 'Ory/X14'C, aye' G a) Q o 0 La. V\ ° ryt ton n Z ��P / '1,'% X Q N O W = ►- Hp u.. 1. Q O V t l + I t ui cc W O •/ O v v v }- z O L7 w LLJ N Z 40- + 1 + I + 1 \\ t19 LLJ H O O O cli LL \ / C.14 L p Cl LA t? i. +1 Q J co A 1--• t— W ,. 0 to N y V" N .� Z tT OL rr N w a. O W. C O) 3 IJ.. a O S. LL- z a to to a Ira W W O N w 'C .� d rl N M V ~ 3 Z LLJ J U. F . p LY to I SURVEYOR' S CERTIFICATE I, Allen C. Nyhagen, registered Wisconsin:.Land Surveyor, hereby certify that by the direction of Dennis Benson, I have surveyed described and mapped the land parcel represented by this Certified Survey Map; that the exterior boundary of the land parcel surveyed- and mapped is described as follows: A parcel of land located in part of the NE; of the SEa of Section 9 .and part of the NW; of the SW;4, -of Section 10, all in T31N, R19W, Town of Somerset, St. Croix County, Wisconsin; further described as follows: Commencing at the SE corner of said Section 9 ; thence N00 024100"E along the east line of said Section 9, 1441. 83 feet; thence N14017140 11W along the centerline of the Town Road, 75.00,.__f_oet to '-.he point of beginning of this description; thence N64o'_A14 ' 43"E, 200. 81 feet; thence N19008' 45"E, 167. 91 feet; thence N89025136 11E, 502.47 feet; thence N00012124 11W, 900. 00 feet to a point 25 feet more or less from the water' s edge of Pine Lake, said point being the beginning of the meander line along said Pine Lake; thence S73036116"W, 96.02 feet; thence S34001146"W, 163.45 feet; thence S54037146"W, 49. 59 feet; thence SO4015 ' 18"E, 59 . 13 feet; thence S33042124"W, 304 . 66 feet; thence S68012117"W, 89 .50 feet; thence S47°09 ' 07"W, 163. 54 feet; thence S61005' 13"W, 224 .38 feet; thence. N67027 ' 04"W, 284 . 17 feet; thence N63025159"W, 188.54 feet to the northeasterly right-of-way of said Town Road; thence N55012120"W, 162. 73 feet to 'the centerline of said Town Road and the end of the meander line along said lake; thence S43030120"E, along said center- line, 860. 50 feet; thence S24010 ' 33"E, along said centerline, 60 . 00 feet to the point of beginning. Including all lands lying between the meander line described above and the :eater' s edge of said Pine Lake lying between true extensions of the east line (described as N00012124"W) and the northwesterly line (described as S49 053140"W) . Together w- and subject to a 66 foot wide Private Road Easement as shown c _s map, also subject to right-of-way for the Town Road as sh )n this map and subject to all other easements of record- That this Certified Survey Map is a correct representation of the exterior boundary surveyed and described; that I have fully complied with the current provisions of Chapter 236. 34 Wisconsin Revised Statutes and the Land Subdivision Ordinance of the County of St. Croix in surveying and mapping same. •1'iy `•i) � ALLEN C. Ly iJYHAGE tJ Z ILI S-1407 HUDSON, j Allen C. Nyha en date .e �ifq 5 U s ThheEroadway��fsho'w�iaso�n� this map is a Private Roadway. Ahy maintenance costs of the Private Roadway after its approval by the Zoning Administrator as a standard road, shall be shared pro-rata by the adjoining property owners. should the private roadway be taken over by a municipality as a public road, maintenance costs thereafter would be a public expense. L- STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. T1- C=a,) -T ROUTE/BOX County OWNERE-I� �t'1 d I`� �S ROUTE/BOX NUMBER 121 Pal Tz / FIRE NO. CITY/STATE / S� . ZIP7 PROPERTY LOCATION: 49L.1/4 1/4 Section , T_N, R W, � e Pe'IZT o NW of'7'� ;wyy of S&710-1 /o Town of o Qgg 7,g Z , St. Croix County, b�j J-J t s 1'J 6 od so-) Subdivision SvNW r:'tJO PIIJC , Lot No. 3,0/ (...r3K& Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three ar expiration. Y P 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 wit n 30 days of the three year expiration date. �._ SIGN _...___.__ ---- ,. �J DATE � ��/ — C St. Croix County Zoning Office /„ A-v 12 95-S P.O. Box 98 Hammond, WI 54015 (715) 796-2239 or (715) 425-8363 Sign, Date, and Return to above address 1 ,fax 35Y ST, To 3�&/ w/sC, SV O &2_�_ DEPARTMENT OF REPORT ON SOIL BORINGS ANU SAFETY & BUILDINGS INDUSTRY, CC DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (ILHR 83.0911)& Chapter 145) LOCATION: SECTION: MUNICIPALITY: LOT NO.:SLK.NO,�06 VISION NAME: #vh#1/Sw'/ N/R4E(o o a t �- 01 COUNT Y: E AME: .... IN ADDR SS: AS fwf✓ IQ121 194f 957A III V t' S902.r USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL CRIPTION: �� )TION/ STS: Residence New ❑Replace 4 !7 4/f 6 RATING:S-Site suitable for system U-Site unsuitable for system c /� ONVENTIONAL MOUND:❑� ING�J �� E: Sa�YSTEM-IN-FILLIHOLDING©� RIONVir� �/1I�11�,tion�l) F1 L ATE: I If Percolation Tests are NOT required DESIGN R� w I If any portion of the tested area is in the under s. ILHR 83.09(5)(b),indicate: R Floodplain, indicate Floodplain elevation: W/14 PROFILE DESCRIPTIONS BORING TOTAL P H T R -INCHES ACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERV D HE DROCK IF OBSERVED ISEE ABBRV.ON BACK.) B- /, 6.S s y ' o �8. 9It is ' ' -' B- Z 7.5 �# Ji-,33 3 �oyv Si is 6' N B- `7 ,67' 89 0o ' i ,v o, ' ' B-y 1 v 6► 7' 0 8 7' s ' [ 3,83 B-5 0' 6) L t o o r At 1. B,vs�. s B- 17 ,0' 6► 8 Roar 8' A a it [ .00' . o0' (ebm �llr PERCOLATION TESTS k TEST DEPTH TER IN HOLE TEST TIME DR I WATER-LEV L-IN HES RATE MINUTES NUMBER YOOS ER SWELLING INTERVAL-MIN. PERIOD P RI D2 PERINCH P- / •• .IS - au Is 7 r. P_ : o _ _. • P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. In care 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 a vation at all borings and the direction and percent of land slope. of SYSTEM ELEVATION 94?op 17 lei I St.,Isdf Zy� WAS nn , tee. a IN "I ISE 'CA �ti$tNff' 4 `NQP�oOSF LL r S�t I.0f/� N -.MOW _ ltd, 4,+ ' ICU, I r I,the undersigned, hereby .5 61t the soil tests reported on this form we a made by me in accord with t e 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 CO LETED ON: Ile ! I ADDRESS: CERTIFICATION NU B PHONE NUMBER(optional) I'd oes : sy t CST SI NATU DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SBD-6395(R. 10/83) -OVER - MINNEAPOLIS • 1113 East Franklin Avenue, Minneapolis, MN 55404 Phone: (612) 871-8321 LAKE ELMO BRANCH • 9242 Hudson Boulevard, Lake Elmo, MN 55042 MIC. Phone: (612) 738-0173 WHOLESALE DISTRIBUTORS F: FARGO BRANCH • 6 North University Drive, Fargo, NO 58102 Phone: (701)235-0230 Ortli kw ST. PAUL BRANCH • 1535 Marshall Avenue, St. Paul, MN 55104 Phone: (612) 646-6537 3 LAG , _ t hY �z Zz " r n� lot Ar��fi� '1E STANDARD REGISTER COMPANY,US.A. PACE of - EXAMPLE 18 - I CROSS SF-CTIOKI OF A BED SYSTEM r \\� EEO SOIL FILL DISTRIBUTIOAI 'PE-7 APPROVED MIMTHETIC COVER, • MATERIAL OR q" OF STRAW 2" OF AGGREGATE � ' � OR MARSH HAy y a'OF%t-P-', AGGREGATE ELEV. OF92d FEET__., DISTRIBUTIOW PIPE TO SE AT LEAST IIJCHES BELOW ORIGIAJAL GRADE AUD AT LEAST20 INCHES BUT AIO MORE THAN X12 IAIC.HES OELOW FIWAL GRADE MAXIMUM DEPTH OF EXCAVATIOAI FROM ORIGIQAL GRADE WILL B;E 6q INCHES MINIMUM DEPTH OF EXCAVATIOAI FROM ORIGIAIAL GRADE WILL BE INCHES 51GIJE0: LICEMSE DUMBER: DATE : Parcel #: 032-1028-50-100 11/15/2006 01:39 PM PAGE 1 OF 7 Alt. Parcel#: 10.31.19.137C 032-TOWN OF SOMERSET Current 1,X-1 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-TABER, DARREN E DARREN E TABER C-SULLWOLD JEANNE M SULLWOLD JEANNE M 2221 50TH ST SOMERSET WI 54025 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *2221 50TH ST SC 4165 OSCEOLA SP 1700 WITC Legal Description: Acres: 3.010 Plat: N/A-NOT AVAILABLE SEC 10 T31 R19W NW SW 3.01AC LOT 2 CSM Block/Condo Bldg: 6/1751 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 10-31N-19W Notes: Parcel History: Date Doc# Vol/Page Type 11/01/2000 632784 1555/276 WD 07/23/1997 788/437 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.010 57,600 239,000 296,600 NO Totals for 2006: General Property 3.010 57,600 239,000 296,600 Woodland 0.000 0 0 Totals for 2005: General Property 3.010 57,600 239,000 296,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 204 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 0 0 o a ° -ior- ti p C7 n M _ M 0 A -n v �-+ -P o o° H T x m ° o a 6-+ rn w rn a z T z "' ° �' a a d n � L N A y w CD } +� O Co 0 0 ° m ^' c 1+ 1 + I+ m Ga'� D -+ W - C ct, sy• m M rn w w n z / a � O O V n ° h-� N H" 7 9 ,'JC x C) O N \ I t 1 f of .y_. , C'k -n-i ' N .-. �-• m rn iQ2 .� -� o m Cn a x w N N i (A to L° � c i nab ��?'0`/ a_° cyi rr- D O O O ,'yQ -,q, �`/Ow 0 N G I t 1 + I + '.t p w Off, y�'d� p M a n M CA CD CD 4M to I+ v+ 'k 0 /OZ• N'o Z z i�2a /09 d rti -p o 1--4 a � A 0 00 too Or r o A o_ i � —1 �a i f line ne o section 9 1441.83' -� _ ( ~ d'\ _-_ N00°24'00"E ti?� Z yCO west line of section 10 ciao % a z o s m d,N �2 ul 4/06 09° y`-%o\ a m o CI) C13 10°z G o\ p m ate_ o rn --e °� az 7 N t� rn s mm C, a z �%o m��+. M :� SQ / o Co r z ao 3 smm �� \ \6, r �% 0C a T -on a -n+ 0 N�9°0at9� .e. �' O �O N \ OJ M ai m m r a z ,�o 7a.84s„fQ (�� 46- rn -4 -4 0� I Z O o 0 CD I C I• $ ` t0 A NO rn g to •L6 6 •\0 65 08\ ```s33oA2� %`t rn I 8 n4 6nn Oy S4?,, \ A A 4 O O O �s3 A 4� N .p / ♦/\ mow, W c 83.46.y N z o N M `� I .row orn 373°36'16 a. F' z z CD �N \ 469.57' o m 98,02 �1 N r i v ►�i a t= 779.88' cwa 120 12' a o i m ►�� N00°12'2 4"W w 900.00 25 -" v n n m 14 516.88' — ►+ o c -n w to p O c 2 O °J crj "' v ° _ mow. unp1atted lands owned by others m C7 n)° --------- -- ---------- ---------- - m -00) � > � rn n C1 d n1 < -n z D tT1 M -i ° Bearings are referenced to the east line Za N -� M * -zn of Section 9 assumed to bear N00°24'00"E. O o fn \_� D v m M O M Co cn -n I o Co s m N o W 0