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HomeMy WebLinkAbout042-1087-20-000 q0 & / ( � \ � ƒ � 7 § � � % } � 2 ] � § � 7 � � � i_ « § ® � � � § ) z t c \ 7 k 7 / E 2 . o / / § Q kcoz } .. E z � R � � to � ƒ E 2 $ S g & k 2 2 E L f k e ) � a a a « IL o U } k k 2 Bkk § 2 IL � � co § of a § % a < z m ] I � ■ � � 8 % ) 2 _ % Eto � '00 § � k) §\ § § / § j ) C _ \ k } , - 4 q & E m a § E E o- ' $ 0 2 ) 2 A � rA 0 CL ) k a § & j a 2[ U) 2 Parcel #: 042-1087-20-000 02/08/2007 12:39 PM PAGE 1 OF 1 Alt. Parcel#: 31.29.18.485D 042-TOWN OF WARREN Current X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner NANCEE F JOHNSON O-JOHNSON, NANCEE F 906 64TH AVE ROBERTS WI 54023 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description 906 64TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.620 Plat: N/A-NOT AVAILABLE SEC 31 T29N R18W NW SW LOT 1 OF C.S.M. Block/Condo Bldg: 6/1580 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-29N-18W Notes: Parcel History: Date Doc# Vol/Page Type 07/31/1998 584030 1344/395 WD 07/23/1997 1125/568 QC 07/23/1997 1100/079 SD 07/23/1997 744/542 2007 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/22/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.620 32,900 166,000 198,900 NO Totals for 2007: General Property 1.620 32,900 166,000 198,900 Woodland 0.000 0 0 Totals for 2006: General Property 1.620 32,900 166,000 198,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 307 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 � 2 41)5011 Ff LED SEP 61985 WEST LINE OF THE SW 1/4 PANIM&P S00°55'5611E / — I \ VicI I V) v, 376.441 n ti i s D 1N4Yi m CD m C7 C z n ►+ j< 1N � w II N \ C \ / V CD m z c) I+ o' n �T-t CD CD z w z ;� �' �' ,I� C.S.M. rn c c m I ^' o v 2, P• 492 d 3 3 O L,i m I V _ LO V O ---- - --"-- m " o C/) 1 w cIw° S00°54131"E co to � 7 223.271 rn o r CD N N00 0 54'31"W 66.04' 157.23' 3 w � D .• to v 0 0 Cr Ln O N Ln a a 1V c) o m -3 y m o CD N N r C.3 [7 'O m Ln w I O O o m ° m ►-� —i O X n O -tz ~--I � V c c ►—+ o n -V Z.-f„t fy C••) y z a m CD = o rn I 3 g BEARINGS REFERENCED TO THE WEST LINE OF o m THE SW 1/4 ASSUMED TO BEAR S0005515611E. c C\ M r c• o O 3 -rl ° '0154'31"E 231.56' ro x 165.521 c, m is < I C 'o m l w 17 o Irt N E 1-0 N IN I t--• cp lo_ + I a CA Cn .. 1 v \ I rt- O CO p 4-J •R Irt c to ►+ O) C,•) to I N O +O t0 17 - O g lo. to 'TI 1 O O Ut to t0 W 1u) N to v I N l a t+ O a O a V 10 m to W ~ rte•- I o z W O n n Ix a n i--t m r I o. m O Z N fy I to m - CD .G N d � Ito O 1--t -/ N W 3 O I O '' lN0 wO N N "I) y 'yf to 1� 'O Z p �► 1 t N n = Ln rt rt to to Itr a C= X C7 i 17 N _ N K � w 3 O m I2 3 - ~• m f-t N O . 10 � ~ Z •~ N -M i0 I C- O X 2 - 00 Irt O+ .y p IlT < - C7 C7 V IS T -I (.n IV r r _ IIo C•) N � to x p I o to O In m z N CD m 1 w ^ �1 co l7 I N t0 �+�( :{7 H lb O CD SEP 04 T995 s '. 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INSPECTION DATE: Steven Sourttam Route 2 Sax 12Q-A, Rabehts W1 54023 h/ 'dl) BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT.ELEV.- Name of Plumber: MP/MPRSW No.. Cnunry Sanitary Permit Number: G1iUiam SchumakeA 6382 St. Cuix 112802 SEPTIC TANK/HOLDING T NK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER Qn, PROVIDED PROVIDED. rL � ❑YES 1:1 NO -]YES -]NO BEDDING: VENT DIA.'. I VENT MATT HIGH WATER NUMBER OF ROAD PROPERTY WELL: BUILDING. JVENTTOFRESH ALARM FEET FROM. LINE AIR INLET'. ❑YES ONO DYES ONO NEAREST DOSING CHAMBER: MANUFACTURER rE I NG: LIQUID CAPACI TV PUMP MODEL PUMP:SIPHON MANIA AC TDHEEt WARNING LABEL LOCKING COVER PROVIDED: PROVIDEDYES ONO DYES ONO OYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF 'PROPERTY WELL JBIJILDING I VENT TOFRESH LI (DIFFERENCE BETWEEN FEET FROM NE AIR INLET PUMP ON AND OFF) EYES 1:1 NO 11YEAREST-­1111-1 SOI L ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing It E NGTH IDIANIf TER MATE HIAL 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 N PIPE SPACI N<I COVER JINIIDI Uln SPITS LIQUID BED/TRENCH THMATERIAL' PIT DEPTHDIMENSIONS GRAY L D H FILL DEPTH UISTH PIPE DISTR PI PIPE MATERIAL NO UIST I9 NUMBER OF PROPERTY WELL BUILDING. VENT TO FRESH BELOW PIPES ABOVE COVER El EV IN I ELEV.END PIPES FE1rT FROM LINE AIR INLET. 1 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 ITEXTURE PEHMANENTMAHKEHS OBS ERVATIONAELLS _ ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH BED DEPTH OVER TRENCH REU =TOPSOIL Sf1DDfD SEEDED MULCHED CENTER EDGES ❑YES. ❑NO 1-1 YES NO DYES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: ....?!WIDTH. LENGTH NO.OF LATERAL SPACING IGHAVIL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES DIMENSIONS___ I MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL NO UISTH DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING 'ELEV.'. ELEV. DIA. ELEV. JPIPES DIA E LEVAT IOU AND DISTRIBUTION HOLE SIZE HOLE SPACING DRILLED CDRHEC,T LV COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED IIUFORMATION PLANTS 1:1 YES El NO DYES El NO COMMENTS: PERMANENT MARKERS, OBSERVATION WELLS. NUMBER OF ', !PROPERTY WELL: BUILDING: _ FEET I41) FROfI& v -LINE: ❑YES ❑NO EYES ❑NO NEAREST 1 Z Z�6 -3 � � '7 / 1 b - Sketch System on Retain in c `9t'my file for audit. Reverse Side. -' SIGNATURE. ..-�' TITLE. .:. 9 AdmminiztAat DILHR SBD 6710 (R. 1/82) Zonis SANITARY PERMIT APPLICATION COUNTY /(?O/,Y,� DILHR In accord with ILHR 83.05,Wis.Adm.Code v STATE SANITARY PERMIT# —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. rFOF11`VACkRIANCE ETN 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. ❑YES ❑ NO PROPERTY OWNER PROPERTY LOCATION AnIffiWa sC.11#z1 Sa Twyk 4)1/4 '/4, S T , N, R j' E(or)(g PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY,STATE ZIP CODE PHONE NUMBER El CITY NEAREST ROAD,LAKE OR LANDMARK 1_4�0,g,3 02 VILLAGE: s- -. e— II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or'2 Family 3 OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. XNew 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. 9conventional 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. ❑seepage 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): e�3 ::;;/ ,,p f S l — Id, 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- Steel glass Plastic App Tanks Tanks Septic Tank or Holding Tank Lift Pump Tank/Siphon Chamber ❑ E] 1:1 ❑ 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) M/ V PRSW No.: Businesses Phone Number: /, r r !Zt r CF 3% Plumber's Address(Street,City,State,Zip Code)-- Name of Designer: c VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)tame CST## .c s T 3S- e-;? CST's ADDRESS(Street,CifF,State,Zip Co e) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved ❑ Owner Given Initial d� S r harge Fee Adverse Determination -#�I2 C-10 �'�� X. COMMENTS/REASONS FOR DISAPPROVAL: 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 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 $9F included the creation of surcharges (fees) for a number of regulated practices which Wisco iflrs can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried TBa`3Sl1CQ ' ° 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. '< 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) 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - w - - w - - - • - • • • Owner of Property — :�Teo,2 hYN ek- C Location of Property 1)L J it S�J , Section , T o��/ N-R Township 6"r V-, Mailing Address Address of Site IM1#11108 Nam Lot Number 3L C S ►-y\ o a i A `�l Pr !v ,ps Owner of Property W- , Coc l< Total Size of Parcel S 1, I S 0 S* Date Parcel was Created ^ Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? _ Yes .. ,,� No Volume and Page Number 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 Resister 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 (We) cVW6y that att atatementa on this 6oAm are true to the beat o6 my (out) knowledge; that 1 (we) am (cue) the owner(e) o6 the pkopen ty dee cA bed in thi a .in6o4mat.ion 6onm, by vi, tue o6 a waAAanty deed teeonded in the 06 .ice o6 the County Reg.i,aten o6 Deed6 as Document No. r-- ' y ;7 � ; and that I f We) p4e6 entty own the phopoe ed e,i to bon the a ewage d i,b poe aye em (o)t I (we) have obtained an eae ement, to nun with the above du cAibed pnopeh ty, bon the conetnucti.on o6 eaid e ye.tem, and the name had been duty necoxded in the 066.ice o6 the County Reg,ie.tex o6 Deedb g as Voeumen t No. y 1,?7/2 1 . SIGNATURE Of OWNER SIGNATURE-'OF CO-OWNER (IF APPLIC ALE) DATE SIGNED DATE SIGNED - t� a.s— 1b � lDD t c � 2� r � 3 1 !I j STATE: BAR OF WikONSIN ktikM 2' lOBz -r • -i I 14 4 PAGC J 4 ? REGISTERS OFFICE ST. CROIX CO., WIS. WILLIAM G. COOK and ANNETTE COOK, Reed. for Record this 25th . , husband and wi.�e I' d ofd ___ June A.D. 9 � Grantors.r..................'............ ......•............ .....---.............---••- of .30 A i (` ..................................................................... . ....... ................... STEVEN M SARNSTROM• and• �! - coneys and warrants to ........................... ...............,........_...........--• Ii KATHRYN M SARNSTROM, husband and wife as . Ipe"I ...................... . " survivorshi marital ro ert ..P P.,--.P.......Y._... . .......:.....................•---............._....... ................................ i ....... •............... .—............... ---•-- RETURN 10 1 .. ..... ....................................................................................................... . ........-....................................................... .. the following described real estate in ........St-....Croix...................County, State of Wisconsin: Tax Parcel No: .............................. A parcel of land located in part of the Nwa of SW; of Section 31 , Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin, described as follows : Lot l of Certified Survey Map recorded in Volume 6, Page 1580, Certified Surveys , in the Office of the Register of Deeds for St. Croix County , Wisconsin. (Document #405011 ) f AANSFM FEE This ............... homestead property. (is) (is not) Exception to warranties: Subject to easements, reservations , restrictions and rights-of-way of record, if any. Dated this .... ................ --•-----• day of v .... ��� _- ._. 19 $6. 1 --.(SEAL) IJ ;". ....(SEAT.) ill iam..G G. . Cook. .............. _...._.. . _ . (SEAL) C/)2 - ........_. _. ...(SEAT,) Annette Cook.. ... AUTHENTICATION ACKNOWLEDGMENT Signature(a) STATE OF WISCONSIN ........._._................................................................ St. Croix .County. 20th ............................ authenticated this ........day of..........................1 19...... Personally came before me this ................day of �.. June _..•-• 19... the above named ....... ....................... ------------ ........................... William G. Cook and Annette Cook .................. .--......... -- ............. ...................................... ...... -- TTTLE: MEMBER STATE BAR OF WISCONSIN ........................ (I(not. ................ ........................... --------------- ............._............................... ... .. uuthorized by § 706.06, Wis. Stats:) to me known to be the person ....... who executed the foreT;nin'g instrument and acknowledge the same. "(HIS INSTRUMENT WAS DRAFTED BY 'J ............... .• tt A E or GZLDLRT , MbDGE, • PORTEIZ& LUNDEEN �. g...........................__............... :................ N` � ,� Puli .'._� St Croix county, Wis. 4r•, (Signatures may be authenticated or acknowledged. Both My :oifTmission is permanent.(If not, state expiration are not necessary.) date:' I, , r - 3-11........................................... 19 90....) •Names of persons altnlnt In any ca —11-- should be typed or printed below their slg,ian,r". ' H 9 r STC - 105 r 9 H SEPTIC TANK MAINTENANCE AGREEMENT 'i► z . Croix County St d • 9 H OWNER/BUYER C ROUTE/BOX NUMBER RR's 6 CJ�S Fire Number__- CITY/STATE CSC ZIP PROPERTY LOCATION: N 5 �! 14, Section T -�q N, R__1-,_W• Town of (.�6-, , St . Croix County, Subdivision k Lot number a_ Improper use and maintenance of your septic system could result in its premature failure to handle wastes . Proper in out the septic tank every three years or sooner , con- sists of pumping into p P if needed , by a licensed se tic tank um per. What You as�o treat- the system can affect the function of the septic tank 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 systems which was in operation prior to July 1 , 1978. the St . Croix Countthat accepted this program in August of 1980, with 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 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 d sludge a d spcum- Certification form will be sent approximately three year expiration. s: 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 Depart- ment of Natural Resources . and returned to the St . of the three year expiration date . SIGNED D AT E T-�-af - - 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 . ?Y ! D. ERiT�OF �l hPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INi .- DIVISION LABC IC) PERCOL NTION TESTS (115) "� ' , HUM AN r,ELATIONS MADISON WI 53707 HUM (Hf. j90) & Chapter 145.045) LOCATION SECTION: -._TOWN- ili, - tTV: LOT NO.:BLK.NO.: SUBDIVISION NAME: Nw I/ �/ 3/ /t yy N/R (o ► l�•rt Rh'�,v 2-- CSA VO4' . 2_ (�. Yy'2_-:._ COUNTY. OWNER'S Ef9'S NAME: MAILIN ADDRESS: 5, •i to 1 X P/ . Co o� ,PT• 2 /3 o X /20-A `50 p Ea7`s �•�iS USE DATES OBSERVATIONS MADE NO.7RNIS.: COMMER IAL DESCRIPTION: FI I N A N/ 2e•rl Now ❑Replace /? l f?.- -us,c /,P- V V RATING: S=Site suitable for system U=Site unsuitable for system CONVE 4110N AL: MOUND: IN-GFSOUND-PFFESSURE: SE`STEM-IN-FILL HOLDING TANK: RECOMMENDED SYST M:loptional) ��M CU I ES OUT EIS EU I DS ©U CIS dU elvR�eu7 I1 'x s.2— If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b),indicate: C G/f S S :;c— - I I Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS fN _UCh4A - FT. BORING TOTAI I DEPTHTOGROU NOWATER-IF CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST,HIGREST TO BEDROCK IF OBSERVED ISEE ABBRV.ON PACK.) r 1.61 01F_40J. S /�' �,J. S, Opt'. ' tij4 S. B- / %S /a 3.1 f ?-to-_ > % S 7.0,? - �,�Al ' r. _c s d 6-,e . , B- /C�. O /O`f,sS, '/0 Q 7 9 , v v-CR y cs to ice+ 6:,e /- t� ' --7 . S p • 13 1k �. 04h SP 4e, 04 . B- y. lD /0•-1 s ntr > I OR 9 oQ -S. - 6­ - �! !/ C S B-S o- y I9 /.op" /3#-- /0,1 M o ff ' ,�, S/1 7. 2 3 ' r4,V g- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP.IN WATER LEVEL-INCHES RATE MINUTES NUMBER II` AFTER SWELLING INTERVAL-MIN. p=T p j r EI:L—U _�T �R56-�` PER INCH P - 1 a-`. _�¢ rt k' j.7'E_t - P- P. '�-- o'Z- •c°-G r' 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 horn 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. /j� ,/ (� /D /./0 , SYSTEM ELEVATION /l wy� , ,Ro►� 'V 14 E 1-0r COR$a•EK 40 f c�y I 3 S Pj ° I x ° /,,cc C S 7-ex ?s This te P3 N st site qp I ;fora ROV•iEp - or�yentjonat s 35 9i; At c system. 13 s, 113 Lo-r C I I LoT 2- /UO -d dor. LOT- 3 1 �D,POPD f�D NE uJ �O(.p WILD` 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 Adrninistrative 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 WE E COMPLETED Of r,rnnt.:,nt st.huh Nlurrlt;lrfi,i:u. _ C 1 CERTIFI ATION NUMBER: PHONE NUMBER (o ADDRESS: �i7Cir 10. w 513. 54 tom tionaq: S O 2 iaiErt uuilttr, r r„ , 2 3P 6 — / CST SIGNATURE: '�- MlrfPr. Irtrtni-l.l.it&UESIi;MfN L(C rlU.UUtiGi DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILI-IR-SOD-6395 (R.02/62) -OVER -