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HomeMy WebLinkAbout018-1067-20-000 7 0 2 C) . \ j k § ) ° 2 \ ]gf] ; =ƒ« E« f Co :3 § »=� o ) 0 o E] S k \$ x ° ° ƒ frE® C 7 LU'a o i \QaM&% Q) k 7 a . 550 ) R� &��2 $ zfk7&ƒ ° U. ) �)« % @E 2 ) o o=w _ ( - � \ ate=t=-0 E 7R7 § $ § § L k � � R a 2 / \ § \ z ƒ 2 \ k k / D z e $ E 2 2 E r 2 + \ . m -� ƒ / _ q o / 7 \ 0 .. z ƒ Ek £ k a \ \ S } _ \ \_ k k -W*A 4 ; k a a 2 \ o B � � § Q o 0 )CD z 0 ' $ E E § 2 E § / 2 / k J z .2) § / _ \ < 2 E L k k § § k \ \ § § § / r I I 2 § CD - E ; § $ 7 z z f ] \ 6 / § iX S o � § § .@ t G n = ; o m o z / e e ■ n \ ■ + z { 7 2 k § at IL k Euk kaf & J a 0 2 J Parcel #: 018-1067-20-000 10/16/2006 08:08 AM PAGE 1 OF 1 Alt.Parcel#: 30.29.17.458B 018-TOWN OF HAMMOND Current ST. CROIX COUNTY,WISCONSIN X i Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner 0-NYHUS, PAUL M PAUL M NYHUS 769150TH ST ROBERTS WI 54023 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *769 150TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 10.690 Plat: N/A-NOT AVAILABLE SEC 30 T29N R17W SW NW COM NW COR SW NW Block/Condo Bldg: E485'S 960'W 485'N 960'-POB ALSO KNOWN AS LOT 1 CSM 7/1917 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 30-29N-17W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 1088/339 WD 07/23/1997 792/132 07/23/1997 463/261 2006 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/14/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.500 28,900 145,200 174,100 NO UNDEVELOPED G5 8.190 7,600 0 7,600 NO Totals for 2006: General Property 10.690 36,500 145,200 181,700 Woodland 0.000 0 0 Totals for 2005: General Property 10.690 36,500 145,200 181,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 129 Specials: User Special Code Category Amount it Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 -R—FT 777777 C./ / L - / N4:32271 ..-� . �'*'j- 1�4 CERTIFIED SURVEY MAP Located in part of the SW; of the NW4 of Section 30, T29N, R17W, Town of Hammond, St . Croix County, Wisconsin. Note: This Certified Survey Map is the same parcel Note: This Certified Survey Map is not creating of land as described on Warrenty Deed recorded in a new lot and therefor no town or county approvals vol. 192, pg. 132 of the St. Croix County Register are required as per Chapter 18.02(4)(b) of the of Deeds. St. Croix County Zoning Ordinance. NW Corner of Section 30 f rd�o �&00 a��u SCALE IN FEET bow d Do* 0 100 200 400 *� Unplatted lands owned by others 6' ) North line of the SW} of the NW} of Section 30 N89°42 ' 58"E 485. 00 ' n' 452.00' I v " -I,, o ° I I`-33.00' �, d u v Iron pipe set at NW °' °' d .0 e `V corner of property L d 41 ( is 3 feet North of L ^' a+ O N F,I fence line. ,r- Cn - ' .° o ° o L 1 M 0 41 O �1 O' C E-+1I Y 1 d V Z N 1 U)l- 41 1 L N L 10 N V LI M o to LOT 1 m ° 0 oI OI C (O i o House En ® ❑ 0) i °1 rn Garage u O1 "' Sheds d l = V) ° ^' xisting Parcel CI vl ; N o o Barn=0 Silo - I� I3' Deed in Vol. 463, Pg. 261 '"� 4 ------------------------- 0 M Izxi'ro - - - - - - - - - -— - - -- N PLA'T'TER E-4Io Area Including R/W: Verne O'Keefe ++ I t 465,584 SQ. FT. Roberts, WI 54023 it 10.69 Acres Area Excluding R/W: OWNER I 433,904 SQ. FT. David 6 Darlene May 9.96 Acres Roberts, Wi. 54013 ��w 33. 01 S89042 ' 58"W 485. 00 ' ALLEN C. w NYHAG y1 I 6' I Unplatted lands owned by platter S' LEGEND .,, H�b.00 Y L LO M County Section Monument N efN•••�� /"� jy O 111 x 2411 Iron Pipe Set, weighing 1.68 lbs. per linear foot W� Corner of 0 111 Iron Pipe Found Section 30 —n-Existing Fence Line VOLUME 7 PAGEk 1917 This instrument was drafted by Fran Bleskacek Job No. 87-38 Ago C%RTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS QR& HUMAN 9ELATIONS PRIVATE SEWAGE SYSTEMS DIVISION X,' 69 ' ,�Q- '! BUREAU OF PLUMBING IVIA0ISON,—1 53707 SW,4, NW i14, S30,T29N-R17W bCONVENTIONAL ❑ALTERNATIVE IState Plan l.D.Number: (If assigned) Town of Hammond ❑Holding Tank E:1 In-Ground Pressure ❑Mound 150th Avenue NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Vern O'Keefe Hammond, WI 54015 xo" 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: Henry Nechville 3258 St. Croix 99039 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY. TANK INLET ELEV.. TANK OUTLET E EV.. WARNING LABEL LOCKING COVER 9( ` q PROVIDED: PROVIDED: p t "I�' DYES ONO OYES ONO BEDDING: VENT DIA.: VENT MATL. HIGH WATER NUMBER OF ROAD: I'LFIN OPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET,FROM E: AIR INLET. DYES ONO OYES ONO NEAREST ' DOSING CHAMBER: IMANUF ACTURER'. BEDDING: LIQUID'CAPACITV PUMP MODEL. PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ONO ❑YES ONO OYES ❑NO GALLONSPERCYCLE: PUMPANDCONTROLSOPERATIONAL NUMBER OF PROPERTY WELL BUILDING VENT TO FRESH (D IFFERENCE BETWEEN FEET'FROM LINE AIR INLET. PUMP ON AND OFF) DYES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing f LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until 'FORGE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO.OF DISTR.PIPE SPACING. COVER JINSIDE DIA.-. #PITS'. LIQUID W/TF ENC# TRENCHES: MATERIAL: PIT IDEPTH: .�t�#MENSICIi�iS- GRAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR NUMBER OF : PROPERTY WELL BUILDING: VENT TO FRESH BELOW PIPES. ABOVE COVER. E V.INLET EL END PIPES. LINE: AIR INLET. FEET FROM 8 3 NEAREST OUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM ,id furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE.SHOW ELEVA- ❑YES ONO meets the criteria for medium sand. TIONS MEASURED. :OVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS OYES 1:1 NO DYES ONO ER TRENCH/BED 7EDGES EPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED SEEDED-. MULCHED. . DYES ONO ❑YES ONO ❑YES ❑NO ZED DISTRIBUTION SYSTEM: WIDTH. LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: is MANIFOLD PUMP MANIFOLD of PIPE MANIFOLD MATERIAL: NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING: ELEV.. ELEV.. DIA.. ELEV.. PIPES: DIA.: t...°.:+.HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. OYES ONO YES 1:1 NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF °L O ERTY WELL: BUILDING: FEET . � DYES ONO ❑YESp p❑NO NE lvll vU U I �►I. 2C'01 L �.os Retain in county file for audit. , SIGNATURE: TITLE Zoning Administrator INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION • i 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 syster;­i, 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. Property owners name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: I" 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; Ili. 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'/s x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimen ons, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mlins/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 Corr monly 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 te included the creation of surcharges (fees) for a number of regulated practices which Wisco i sq, . can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried t a U.. e o 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 Thee loon es collected through these surcharges are credited to the groundwater fund adm;nis- iarec by the Department of Natural R<!sources. These funJs are used for monitoring ground- t v-..�att-, gv,�urJwater c:onternination in,,estigations and establishment of standards. Groundwat i;'s worth protecting. BBD-6398(R.03/86) couNTY QILHR SANITARY PERMIT APPLICATION girt' C l�a� In accord with ILHR 83.05,Wis.Adm.Code �.a.,..,..v.....�.o,� STAT SANITARY PERMIT# 9139 —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 �r 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES S NO PROPERTY O NER PROPERTY LOCATION _,/4 V +/4 S T , N, R E(o W PROPERTY OWNER'S MAILING ADDRES r LOT ER BLOCK ER SUBDIVISI ME CITY,STATE IP CODE PHONE NUMBER CITY NEAREST ROAD,LAK OR LANDMARK II. TYPE OF BUILDING OR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): Ill. PURPOSE OF APPLICATION: (Check only one in P. 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 O SEM: (Check only one in#1 and only one in#2) 1. a. 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: JCheck one) 1. a. El Seepage Bed b. See a e 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): $5 a U g'7 Feet Private ❑Joint [:1 Public VI. TANK CAPACITY Site in allons Total INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structe Septic Tank or Holding Tank A/05 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) MP/MPRSW No.: Business Phone Number: P umbe 's A d ess(Street,City,State,Zip Code): Name of Designer: VIII. SOIL TEST INFORMATION Certi ied Soil Tester( ST)Name CST# CST's ADDRESS(Street,City,State, ip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate issuing Agent Signature(No Stamps) Approved El Given Initial S h�ar�geF1e�,e Adverse Determination /0v �CJ �/• ' �^��� " ' 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 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/contractgr, ("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 ((� V- , Section r3C7 , T N - R Township � �t Mailing Address Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel Z 4% Date Parcel was Created Are all corners and lot lines identifiable? ----Yes No Is this property being developed for resale (spec house) ? Yes 4----No Volume _ :�Z 7 and Page Number 2&,,,, A/ as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: Warranty Deed 2. Land Contract .� 3. • Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION 1 (We) certify that all statements on this form are true to the best of my (our) knowledge;that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. -3 -'-7,57 t/-, y 4 and that I (we) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement,to run with the above described property,for the construction of said system,and the some has been duly recorded in the Office of the County Register of Deeds,as Document No. ►. SKiNATUR/E' OF OWNER SIGNATUR OF CO.OWNER F APPLICABLE) I DATE SIGNED DATE SIGNED r R } I " dr` /► { /I� -a c 4.. ! f r 1 k A d 5�1 �' !` � i*t 1"., • ■may r T ■ , _ mot^ I MV �tllf .'1''}`.. "'3.k b M44 A''i Y^y4 S !' (1�' M`G- •vi 1 4 t t A h` 5) - t.'P VA AI tl ■II�1F, 5 oTIATli`Q>1�Itt�plViI�FARAt9 ,r r M.RACK MMw"a"mama TWO 04MNTLM&Made by f REGISTERS..`©IFFIC!'�- IiT. CRQ{X CO:.W)s; Recd for ke oid this_21� N om' of St. �0x� coon wisQons#u,benbx; veyiMd a day Of__.�LW.Y _A.D,19XA.Vern D. M '°°�,Ke a at. �z34. M husband and wife 'as joint tenants ' ' ttrgl o o eeda St Croix AITIMN To ._. o County Wisconsin,for the urn of the love and affection of a father koF a son-i-n- law and daughter the following tract of land in St. Croix County,State of Wisconsin; . A parcel of land located in the Southwest'Quarter of the Northwest Quarter (SA of NWT) of Section Thirty-(30) , Township Twenty-nine (29) North, of Range Seventeen (17) West, described as follows: Beginning on the West line of said Section 30, 313 feet South of the Northwest corner of the Southwest Quarter of the Northwest Quatter (SWIG of NW4) of said Section 30; thence East parallel with the North line of the Southwest Quatter of the Northwest Quarter (SW4 of NWT) ;of said Section 30 for 4 distance of. 485 feet• thence South parallel with the West line of said Section 30 for a d stance of 337 feet; thence West a distance of 4$5 feet .to the West line of, said Section 30; thence North on the West line of said Section 30 for a distance of 337 .feet to the place of beginning. Containing 3.75 -acres, more or less, including highway right of way. FEE E EMPT IN WI'T'NESS WHEREOF,the said grantor ha_A hereunto set _hi a hand—and seal this 20th day of July ,A.D.,19 SIGNED AND SEALED IN PRESS CE OF ,��a�,z.�c,c� 4• (SEAL) nanie], A. OtConnell (SEAL) J Hughes (SEAL) uth A. Joh on (sE •) BTATS OF WISCONSIN, 1 --St. CrQix County, Pei' o y,carne befmme," 20tb deiY of b.,19-M. the shove named Daniel A,, OTConnalll,a single man IT tQ me known to be the pmon„$who executed,the 11440 1oR'tneN}tmen owl the lama I.TIV ' Tbtr Ip110At.de�fTed r� 3 �'r..`.,kr F 7 Sti• CirOi7Cp ^,F T,#, ', pie „•pi s i h rui`a, �'£i b"ti F+?H�, °7T;S'( �"�r""'�"""',S'e'?'�. rlti .ry1i.� r.,w 4 : 4�4. 1amMe,. .MMM.te r 00- w. llr r i WARPANTV assn-6TATE OF wir,oOxsu5 VoRat iv8A91t t 4T WWATO = 0.0.allttltl QO..YI►Ytliq H STC - 105 rrd ' a H SEPTIC TANK MAINTENANCE AGREEMENT o St . Croix County x d a H OWNER/BUYER 4'.&Aoi2- M ROUTE/BOX NUMBER Fire Number .CITY/STATE /�cz��ur �f '� �-4� R ZIP PROPERTY LOCATION: , A,1&1—�c, Sections, T ;22N, R Town ofQirr tl�• St . Croix County, a Subdivision_T Lot number_44. 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 , 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 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 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 y to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- •v ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning OffKpe within 30 days of the three year expiration date . SIGNED DATE S' 7, 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. BORINGS AND 0EPAR fCIAENT OF SAFETY& BUILDINGS REPORT ON SOIL BR INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS 1 1 1A) (H63.090)& Chapter 145.045) LOCATION:'" SECTION: TOWNSHIP/ML14WW-A. Y: OT NO.:GLK.NO.T5-SUBDIVISION NAME: li 1/ 1/ 30 /T 4 N/R/7 E(o W !/A.4Mon�G� p�'& of -/ .9� -f4w'-/ COUNTY: OWNER'S R'S NAME: MAILINr,ADDRESS: 5T.CQ of k E _ USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROTIFfUlE ION N TESTS: Residence r � ❑New %R� place I Dom,l'1 — C��� �k I cl _ '0J(. RATING:S=Site suitable for system U=Site unsuitable for system `J ( ✓�WE T rZS ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) ❑U IRIS ❑U IE S ❑U EIS DU EIS 1ZU �avv�c�iav,�/— T,PE.)C16'eS 4:o/ Rop o if Es . 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: C14 SS -0 _ Floodplain,indicate Floodplain elevation: Zj U SQ. RM PROFILE DESCRIPTIONS to l�tcirl.t( f-f BORING TOTAL PTH TO GR UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED GHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) ?3 f'dv. s�'� /.o ' $N- SI l,47 14ix. of B- y 7 D ?��,d'3 > 7O • � Is -� R 2. o' � ' sI 1, s' �twt -P0 5 � SAAJ B- , B-3 7,a ee,3S > 7 D A � RN. SI 3.0• i?..k SI r4 r- 70'w£4k- SS B-6// /6 [J r , ► 7 S ' 19e BN• Si , ,y� ' 13a. S(, 2.17 ' �� Ba , /c'� Is �rr �• �— _g. ( B,�- le++ Ci aE w L C x u SS w 'F ��• ©R-g y. M o-ts Ar 3, 11 ' B- • B- 7 71 > 7. S /0 .- 0t Ra . G 7 13,,,, 1 5 , V13 PAJ-Ra Sv,P�ACE ��b v of 'S PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER Ih AFTERS WELLING NTERVAL-MIN. PERIOD 1 PERIOD2 PERIOD 3 PER INCH /0 / 5/�'U P- P_ 1/- 0 410 0077 0 7 tl 2 P- P- D 1 0 1 Z I 1 L 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. 0010 SYSTEM ELEVATION NI•�-+�es1" TQEa�-G. i � • Low O ` { I , $/,/N ( , ,G�v 746144 Ilk 4 I , 4-c- 7­1 o - `PRopE� .t4BS0'i2pTior� ;' .F;F pFr �'%,S7 E' i 1 ld,e TU DNS?�!/ l2 CA rf u P,44 0$ P ! ft�4Q . TO ,P Yt�L N y PV, p�L Soi� I,the undersigned, hereby certify that the soil tests rel5di`ted on this form were made by me inIdordwith the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: HUMESIIE SEPTIC PLUMONG CO. hI 44, ZD— l / P , ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): ROBERT ULBRICHT Z y p 2._. p MINN.INSOLLER&DESIGNER LIC.NO,0060 CST SIGNATURE DISTRIBUTION: Original and one copy to Local Authority,Propel ty Owner and Soil Tester. DILHH-SBD-6395 (R.02/82) . . REPORT ON SOIL BORINGS & PERCOLATION TESTS 115 PLOT PLAN Project I.D. V Ce v D` /E'E t F� �'r"�/Ac iyE•v T S�ioT�c s'yS HOMESIN SEPNC PLUMBING M LEGEND Itt i0NEIL RD.,HMN,M&51016 ROBERT ULORICHT • Ba c kh o e Pits VO&MASTER PLUMBER LIC.N0.330710..1t t MINN.INSTALLER&DESMNER LIC.N0.W9 X Perc Locations C .S.T. 2482 0 = Existing Well Pre,) Vertical Reference Point To rro•1 A L 14 S D a fr 6,P&EAJ � E0 E Elevation of Vertical Reference Point Lot Line N� Foe- tRE O �R�a� S v s Tt st 1�� �^ Etit SCALE: u A0 Jac. fo--.. I 67005 6'0 C�HE va 5s• TECk / ' — s�I S0 ro + , REPORT ON SOIL & PERCOLATION TESTS 115 PLOT PLAN Project I.D. HOMESIiE SEPNC PLUMBING 00: LEGEND 01.1 O'NEIL RD.,HUDSON,M&51016 ROBERT LUPJCHT • Ba c kh o e r i t s MS.MASTER PLUMBER LIC.NO.3307 M.PItt MINN.INSTALLER&DESIGNER us.No.OM X Perc Locations C .S.T. 2482 Q = Existing Well &RFt� !9 = Vertical Reference Point : 13o TT 0 o f AL 0,1A • .5 'Dw6-, 6-tee E Elevation of Vertical Reference Point Lot Line e Sl/ow.J S roI` tREN GA ty 1A% ES{ SCALE: j�s voip � FEE✓ '- ,I � ASE lot th _ yT/tR1AS k �3 �pD vT /v - ' d i"Wd n it i