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HomeMy WebLinkAbout020-1169-40-000 v °^ n c � I N � I I I � I 0 0 Z LL C O Q 3 m Z 0) W C E Z T O i Z m N N W a m F cn c O O Z :!t C _U 2O H r N z N m may]^ N N _�V N CL O N N •WAWA _ O d U t6 O O — Q 4- q z z h1 Z @ E N _0 U) O y - N CL C co N a as a o 0 C m N o C e a E N N LO a (n fA V) U o 0 04 �n F- F- F- E „_ N N N d H O > O O O z O O • c a. a a N a O _ cn �i p y -3 00 n N W L) 2 rn rn Q o Z - O o o o m = W m ? m aNi is co ►�1� �' M 7 CO N VI C) O C A C i q C Q N v 0 L C CL O O � a) N a O ai 7 M itl 63 N N r r rn : O W N Z Z = N c0 to Iz •��"VV �' O CN O 2 (n O N in H co H ',ems^ U) a #t a m `i 0 a y rrw� � PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench: /C Width: 12 Length: 7D Number of Lines: �— Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side, O Rear,(Ft Number of feet from well: /,),5 Number of feet from building: q rl (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: I V Capacity: Number of rings used: Elevation of bottom of tank: ono f :inle Elevate t Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: J& _ \ Dated: Plumber on job: License Number: /, e5 .7Z2-i 3/84:mj Form - S T C - 104 i AS BUILT SANITARY SYSTEM REPORT TOWNSHIP SEC. T N-R OWNER /' W ADDRESS ";, ,l,,t ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT �Jl` LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•ZHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i's a,: / i IU INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used 4:7A Age, Elevation of vertical reference point: AAO Proposed slope at site: SEPTIC TANK: Manufacturer: C±LzL-5 Liquid Capacity: j GYl� Number of rings used: _ Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side,@ Rear, 0 feet From nearest property line Front,0 Side 0 Rear,0 �,b feet Number of feet from: well �, building: �',3 (Include this information of the above plot ,plan) ( 2 reference dimensions to septic tank) SEE REVERSE SIDE DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS BUREAU OF PLUMBING �e LUMBING P.O.BOX 7969 MADISON,WI 53707 SFrt4 NE%a Section 7, T29N—R19W MONVENTIONAL ❑ALTERNATIVE state Plan I.D.Number: (lf to Plan I. Town of Hudson ❑Holding Tank ❑In-Ground Pressure ❑Mound Lot 25-26, Ranchwood ADDRESS OF PERMIT HOLDER: INSPECTION DATE: NAME OF PERMIT HOLDER: � Don Suckowatey Realty 2nd Street, Hudson WI 54016 S S�B 7 t� REF.PT.ELEV.: 11.1 REF.PT.ELEV.: BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: i Name of Plumber: MP/MPRSW No.: Cou ty: Sanitary Permit Number: Roger Timm I3224 St. Croix 88485 SEPTIC TANK/HOLDING TANK: INI- MANUFACTURER: /^ LIOUID CAPACIT TA K INLET ELEV.: TANK OUTLET ELEV.: VID DLAB L PROVIDED OVER YES ❑NO DYES �NO \. NUMBER OF ROAD: PROPERT WELL: BUILDING: VENT TO FRESH BEDDING: VENT DIA.: VENT MATL.: HIGH WATE LINE: AIR INLET: ALARM FEET F OM YES ONO DYES FIND NEARS T OSING CHAMBER: 7.ATIRIAI.LABEL LOCKING COVER MANUFACTURER: BEDDING: LIQUID CAPACITY. PUMP MODEL. PU P/SIPHON MANUFACTURER. D: PROVIDED: ❑YES ❑NO GALLONS PER CY CLE: PUMP AND CONTROLS OPERATIONAL: NUMBEROF PROPELINE.(DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) ❑YES ❑NO NEAREST ND MARKING SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing ORCE or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN soil is dry enough to continue.) CONVENTIONAL SYSTEM: uoulD BED/TRENCH WIDTH: Y�LL ENGTH: IND.OF DISTR.PIPE SPACING OVER PIT INSIDE CIA 7 PITS DEPTH TR CHES'. ATE L' DIMENSIONS r / V GRAVEL DEPTH FILL DEPTH TR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: MIS, NUMBER OF PROPERTY WELL: BUILDING: V NI LE FRESH (' IPES-. . LINE: AIR INLET. BELOW PIP .F ABOVE COVEV.INLET.ELEV.END. FEET FROM l\ NEAREST—s 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 rrjedium sand. TIONS MEASURED. ❑YES NO PERMANENT MARKERS: OBS7Y E S ATION WELLS i i OIL COVER TEXTURE ❑YES ENO ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. S DDED SEEDED MULCHED CENTER: EDGES: ❑YES ❑NO ❑YES ONO 1-1 YES El NO PRESSURIZED DISTRIBUTION SYSTEM: FILL DEPTH ABOVE COVER BED/TRENCH WIDTH LENGTH NO.OF LATERAL SPACING GRA EL DEPTH BELOW PIPE TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFO D MATERIAL'. NO.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING ELEV.. ELEV.: DIA.'. ELEV.: PIPES DIA_: ELEVATION AND DISTRIBUTION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS ❑YES ❑NO ❑YES El NO PERMANENT MARKERS: OBSERVATIO WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: FLIYES / ❑NO ❑YE ❑NO NEA E T If ° U 0 � n _1a s Sketch System on J Retain in county file for audit. Reverse Side. TITLE. SIGNATURE: Zoning Administrator DILHR SBD 6710(R.01/82) Thomas C. Nelson r INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: j. 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. Tc 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; 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 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'/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 knowr as the groundwater protection law. This change in statutes was the I result of over 2 years of steady negotiation and public debate. The groundwater bill Groundo�ateC.T included the creation of surcharges fees) for a number of regulated practices which Wiscoriisin' can effect groundwater. The surcharc;u took effect on July 1, 1984. All of the water that bunt.e r asure is used in your building is returned t-; the groundwater through your soil absorption o system or the disposal site used by y.,-)ur holding tank pumper. a� 1 e. :non-_s ;�olltz tec thrcaugh these surcharges are credited to th= groundwater '.,r d a r, (rlis- U�-e: by ,I)e 7epartment of Natural Resources. These funds are used for (;ton torfng g,our�d f g(Qu?,; water contamination in 2stigations and establishment of standards �'s wort[-, protecting. �?3D-6393(R.03r36) D'L SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05,Wis.Adm. Code J7, I STATE SANITARY PERMIT# —Attach poftlplete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER •8%x 11 inches in size. —See reverse side for instructions for completing this application. PETITION ('�� 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES X. NO PROPERTY OWNER /J PROPERTY LOCATION t✓UNaicJ�` �� _5E 1/a �GJ /a, S 7 T L , N, R (or)'W PROPERTY OWNER'S MAILING ADDRESSO LOT NUMBER BLOCK NUMBER SUB IVISION NAM eJ/Z d S/ o25- 714,- 1 C_In/ CITY,STA E ZIP CODE PHONE NUMBER CITY NEAREST ROAD, KE OR LANDMARK a/ /r VILLAGE: .R, II. TYPE OF BUILDING cOLR USE SERVED: Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): III. PURPOSE OF APPLICATION: (Check only one in#1. Check#213 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. V-2 Conventional b. El Alternative C. E] 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: (Minute per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): '7`6 rA6 Feet Private ❑Joint ❑ Public VI. TANK CAPACITY Site in gallons Total #of Manufacturer's Name Prefab. Con- Steel Fiber- plastic Exper. INFORMATION New xisting Gallons Tanks Concrete stCon glass App. Tanks Tanks Septic Tank or Holding Tank Lift Pump Tank/Siphon Chamber ❑ I ❑ I ❑ ❑ ❑ 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 amps) MP/MPR Business Phone Number: Plumb is dress( treet,City,State,Zip Code): Name of Designer: > 2Z me VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)N We CST# d/ l/� D�inS.�►-1 3 P1 CST's ADDRESS(Stre t,City,St at ,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY �5j ❑ Disapproved Sa itary Permit Fee I Groundwater ate Issuing Agent Signature(No Stamps) LLy Approved ❑ Owner Given Initial 1' rchartge Fee Adverse Determination �a�'�� ��J -� 3—^�/� 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/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 K.a u:;C F-e Location of Property S r)Q , Section , T N-R W Township c:'►1 Nailing Address ti J �, Address of Site �A 2 Subdivision NameC�yl L h LUc9n Lot Number - (p Previous Owner of Property lax q 4h Total Size of Parcel 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 _77 J 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 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 (We) centi6y that att statement6 on this 6onm cute t ue to the befit o6 my (ouA) knowtedg e; that I (we) am (aAe) the owner(•6 ) o6 the pro peh ty dens cn ib ed in th a .inbonmation 6onm, by vi tue o6 a waAAanty deed tecotded in the 066ice o6 the County Regi6ten o6 Deem as Document No. qZ,3ZZ 5l ; and that I (we) pnesentty own the proposed site bon the sewage diespos .6y6 em (ot I (we) have obtained an ea6ement, to )tun with the above d6c4 bed pnope&ty, bon the constnuation o6 ,6aid .6y6tem, and the .same has been duty teemded in the 066ice o6 the County RegriateA o6 Deedd, as 'Document No. SIGNATURE OIL OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED A'r DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA 423224 . WARRANTY DEED 0 K 771 rtt','E 326 Mary Ann Windolff, A widow not remarried. REGISTERS OFFICE ST. CROIX Co., W IS. Reed. for R-aavd this-11th y of March A.D. 19_27 conveys and warrants to Dori Sukowatey Realty Inc . at p A Wisconsn Corporation. ' one dollar and other good and valuable ftoslar `4 Doode r,nn er lon. RETURN TO the following described real estate in St. Cro iX County, I_ State of Wisconsin: Tax Parcel No: _________-------_-.___-- Lots 25,26 the plat of Ranchwood in the Town of Hudson St. Croix County, Wisconsin. TOGETHER WITH AND SUBJECT TO ANY easements , covenants , reservations and restrictions of record. it i I I This is not homestead property. (is) (is not) I I' I Exception to Warranties: i. Dated this 25th day of Febuary 1s E37 4 (SEAL) X ---(SEAL) •Mary Ann Windolff i (SEAL) __(SEAL) I I AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN j SS. St. Croix _County. authenticated this day of 19 Personally came before me this 25th -_day of F''ehua.ry , 1987 the above named j I TITLE: MEMBER STATE BAR OF WISCONSIN � (it not, to me known to be the person who executed the authorized by§706.06,Wis.Stats.) foregoing tnstr ent and a knowledge the same. THIS INSTRUMENT WAS DRAFTED BY ����, � i — - — J • Donald H . Sukowatey` Donald H . Sukowatev Notary Public _ :_-County,Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. ot, stato expiration are not necessary.) date: July 19 -- • ts- 87- ) 'Names of persons signing in any capacity should be typed or printed below their signatures. F T P I WARRANTY DEED STATE BAR OF WISCONSIN Nelco Forms,P.O.Box 1075,G­­,1. tors Form No.2—1982 r-+ z • cn H a STC - 105 r r • a SEPTIC TANK MAINTENANCE AGREEMENT St . Croix County z Cl a H OWNER/BUYER dUVI 3 L& i,¢ ROUTE/BOX NUMBER Fire Number .CITY/STATE ZIP rjgy ,,/�, PROPERTY LOCATION: 5-L_k, it, Section 7 , T N, R W, Town of 1114_Sol , St . Croix County, Subdivision &'nch we . Lot number o25":2( 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 pdt 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. HH I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- b 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 . �o�„� Ka�- � p S I G N Eb, �/1 � DATE­ Ank I 2 1 St . Croix County Zoning Office P.O. Box 98t Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address . ! DEPARTMENT OF SAFETY&BUILDINGS INDUSTRY, REPORT ON SOIL BORINGS AND DIVISION /� P.O. BOX 7969 LABOR AND HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707 . (H63,09(1)&Chapter 145.045) L CA I E I WN HI MUNICIPALITY: T NO.:BLK.NO.: ION NAME: sE t 19 z5 26 — KdN�N Woo) Ij z9 N/R10 w �,�� �1 COUNTY: WNER R'S NAME: (�bm A ,J Cko►x 17o�SUK&WA-r&i kk4cr AU-LbIL /26 S�catDS-� /,,ubSoN SgOle USE DATES OBSERVATIONS MADE CO R PTIO PERU�AResidence NO.B DR : New S �7 UA1 K 71"0 3 9TR Mitkiii so',s K. V,r 4 T ILS SoTC2 ',ANTIA6,0 RATING:S-Site suitable for system U-Site unsuitable for system A�.IJZ, ' e NVEr TIONV : MOUND: IN- -FILL OLDING TANK:RECOMMENDED SYSTEM:(o tional) S ❑u ❑u _� S ❑V s ❑u ❑s ) /?EMCN�S WITH �QaPs If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.1-163.0915)(b),indicate: LASS (Floodplain,indicate Floodplain elevation: 'V cc T PROFILE DESCRIPTIONS BORING TOTAL GROUP D ATER-INCH CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER EPTH-or ELEVATION :gBS:, D TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.I B- ' p FS v cAl 6ZS /07•z'+ W,2� ZO��CT$Rrl �S 6''$ crs- z,"9j?t4SIL 4%&14 V:S 77�&PICS 4Gie B- '2 16 41 /(j5.64 6.47 3A"kb WF S -rGR'f�C,06 /"-R FSLL--r'S /Z"$RtASIL 39" a B- 3 q i7 /0&3 > 9,/7 9'!9IW0Srt6t 4o"tb$e4 FS 1;.,$CLTg /8"$2NStL 27•'BIlN F-k13 �Gt c� B- 7/7 ���.15� I�O►,I > 7.17 35•t�f Y FS w 50`�ti CaMSo�tDaTl� SNAI.E- +�R 7"BL(__'r 0'"&q 'c 40'*Ab&tJ F_MZ f4le CO B- 7.97 /QZ.471 t4ONE > 7,97- �i" Y SNbLE. ak B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN T R LEVEL-INCHES RATE MINUTES NUMBER 1 AFTERSWELL.ING INTERVAL-MIN. PER INCH P. i 3.69 r /66.0 30 76 'XIS 34.3 P- z c /07.11 36 1 ' ► 3� P- /07.3 30 'g14 s 46.o p- F-t Trc w AT P- w PLOT PLAN: Show locar ions of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances.Describe what are the hori- zontal and vertical eievat on reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction a d percent of land slope. SYSTEM ELEVATION �EIM QY - /03.00 ' St?L LtycAtl�N Lc'-I- Z& f • � , r 27 ee F ��, � •� � 1 _m__. +l t S orb T-771; ...v t • Z t. lJ/. YM b .r tN O 0- Ole 5 19 1 40 11t1t_4 vea A#.T&' "A-r& I N O U D S O N 6 . 1� SYS-ram(MauN4 R11w)'r.'M1iIDt i to r �b ��- P��1 Qa�1 �/Adc - r�t_�+rcT►oN'= fop.UQ'- I,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 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): p TESTTS WERE COMPLETEOD ON: -�Q��LC�� J�j►,(IJ SQ1� ICU��I� �U�+1�yme, /�� CERTARAITIO�NUMBEt8 ONE NUMBERIoptional►: ADD S: 38G- goFsa 407 SECOND 34$4r CST SI ATURE: a . DISTRIBUTION: 0oginal and one ropy to Local Authority.Prnperty Owner and Soil Tester. DILHR-SRD-6395 IR.02/82) —OVER - DEPARTMENT.OF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS DIVISION INDUSTRY, P.O.BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON,WI 53701 HUMAN RELATIONS (H63.090)& Chapter 145.045) LOCATION: SECTI WN HI UNICIPALITY: QT NO..BLK.NO.: S SDIVISION NAME: sE '� , z9 NCR i9 (o w u As�+� z5-z6 — > dk�H woaa / / COUNTY: NER S NAME: N S CP6 17oNSUK WAT&Y' 4L`i'y I,►rL.DE /2� SEcaNDST �ObSow i S'40IC DATES OBSERVATIONS MADE USE PERCOLATION TEST NO.B CO M A DESCRIPTION: : n l�Residence I�K XNew ❑Replace 1,�,Ap,.N 3� /7�� IM,4kil s /9�7 V SOdLS k. Vc 4 T "JC)ILS At. ,ll -�A�N1�TINC,O RATING:Sa Site suitable for system U-Site unsuitable for system An LJZ — rONVEN NAL: M U D: IN-GROUND- -FILL OLDING TANK:RECOMMENDED SYSTEM:(o tional) os ❑U ❑U S ❑U S ❑U ❑S 1 IPENCtI�S WtTN �aoAX$S DESIGN RATE: w'A Fu.ders.'H63.09(5)(b),rcotion Tests are NOT required If any portion of the tested area is in the 'V indicate: L,4g$ Floodplain indicate Floodplain elevation: PROFILE DESCRIPTIONS T BORING TOTAL R UNO ATER-INCH S HARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH NUMBER DEPTH�i: ELEVATION BSERV D UHEST TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) io"$t,LTS n;'@RNSA 40''$QN TAYeFS w Cel 6R B- 1 y.z5 /67.24. > a Z� ZoArew FS 6'#lRLLTS Zit"$QNSL. 4"iR'D 7"&vi �GI� B- Z 64-4 /05,64 !�(o+�>` ? 6 47- IA-kb M-F S -r6tVCOk "7tR ;0 &L-M 11"e1MStL 39"tev FS�cdb B- 3 �Jl 6833 1 9`17 4'$iMCsrt6t 4672n$e4VS 4."&&.T3- WiBeNStL z7''aW F-M S FUt c� B- 7./7 /0/-1ST doN� > 7./7 3s">�aEY ;rSW eSokC"UL1b^Te'6 SNALt- RR 7"6t_(.TS /r&q r 0*-ICD N F M!4 f6te Co B- 7,9 Z /6Z.47 oNE > 7,97- T B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER I AFTERS WELLING INTERVAL-MIN. PER1613 I p PER INCH P. I 3.69 fqMK I X06.69 30 ' ' 34.3 P. - i? r4aQ( 1674*7 3D 1 ! 34 P- 4 3 r4oay 1/07-37 30 "14 s 0 P. c P- PLOT PLAN: Show Iota ions of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevat on reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction a d percent of land slope. SYSTEM ELEI FATION �)�I►�RY - /a3.00' i Lo.-r. Z& LOT Lc�T Z4 LQ Z-5 ^.. ,� 2? y ') \ .,n. . Ll 01-p / JS ✓ r.� G^LIt� Y1 4-t _ �� '� 4 , /3 ra / 1'= 0' *,_4 Foa ACMkNA�rt� l N O U D S O N ` Arl ��„� V F SYSTeM l MSa41N�ICC4T!,1ilNDk 1 I 9_4 �'`gNt- 1 !�N �r Ali: ��zv�czl0►v,_ /�U.UQ' 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 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: /44NE-1 J N Son/ 'e1ZUk\1&r>'Nc. Inc MARCU G 087 ADDRESS: 1 CERTIFICATION NUMBER: PHONE NUMBERloptional): 407 ��.;b /Jua +v W I S�4a► 348 3e6 goFso CST S�I ','IAnnTURE: DISTRIBUTION: Ot i(jinal anti one r.npy to Local Authority,Prnperty Ownor and Soil 'fester. L)IL,HR-SBD-6395 ;R.n?/82) —OVER — DEPAR-TMENT.OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS DIVISION INDUSTRY, P.O. BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON,WI 53707 HUMAN RELATIONS (1-163.090)&Chapter 145.045) L A I SEC I WN HI MUNICIPALITY: QT N�BLK70.: St,�BDIVISION NAME: z9 N R 19 to W v Dso'\1 zs KdNcw wooD COUNTY: NE S NAM /�t'mt- C Ro I x bo'4 U r&WA-rf:i kk4crY A,31LI ERs l2� 5>Scn+vD ST �u DSow �i S90/C DATES OBSERVATIONS MADE USE — : 1� NO.BEDR : CO M S R PTIO Q 0FIesidence v�K 7*RT:N=ew =E:]Repl-,- /WAf --14 -3,!9 V M/tkq S /T%7 Sotcs K. G� 49 Sra tL S ScC2A+v'1_T iAt,o RATING:S-Site suitable for system U-Site unsuitable for system Nn�Z — R ��CONVENTIONAL: MOUND: IN-GFiOtJ -FILL OLDING TANK:RECOMMENDED SYSTEM`lo tional) S 0 ❑U S ❑U s ❑V ❑S i kENCra cr s w r-rN �QoP 8oatES DESIGN RATE: NA If Percolation Tests are NOT required If any portion of the tested area is in the 'V under s.H63.0915)1b),indicate: CLASS � I Floodplain,indicate Floodplain elevation: C PROFILE DESCRIPTIONS T BORING TOTAL R UND ATER-INCHE HA ACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER EPTH-tW, ELEVATION OBSERVED EST. TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) telLLTS ZS�'&N'S l q0"$itN/M ISnFS �+ Gel 6R B- F �,z5 /07.24 t y 8.2� ZOAT&W �S 6"1RLLTS zl"$R,ISrL 9"1R'b Q�t1PS 7^&0CS 4Gle B- Z 1641 /05,69 l�(a ? 6.47- M"kb M,F'S -C6*VSQk /"-kR 70 &LTS /2�'$Rr1 S,L 39" tJ F S Cdb B-3 .�? oa.3 > 9. 7 9'$t,Csrt6t 46 kb9W V S �"f8c c.TS �8•e�n�s c z��'s�/v F-M 3 �4� B- 7/7 /6/.1 dpgg > 7./7 SS'>hf Y FS w± S0*ACUSoL,bATE'► SNALt: BR p 7'%LL-rS /7"'8t2N t 0�•f1C>D N F Mi GR� CO B- j 7, / Z /oZ.47 ONtr > 7,9 Z- 1r/ y 'N0j%,LF_ $P B- T PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN R LEVEL-INCHES RAT MINUTES NUMBER I Noiro AFTER SWELLING INTERVAL-MIN. PEVIOD 1 0 PER INCH P. I 3.69 - 1/0('.0 30 7 7 ' 34.3 11074-7 16 1 _P7A 34 a P. i 4 3 1/07-31 . 30 _f14 = 46.o P- I F- P- P PLOT PLAN: Show loca ions of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevat on reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction a d percent of land slope. SYSTEM ELEI FATION 06' StTL L[�cdTll)N Lo-r z6 L cs-T Z4 L Q r z-5 ,,- �., LOT ^�, ZZ / 1 I aua: tN _ 65 /ao (,yrra RadC 13 t4o' Quad vea Aix&k"Are NO UDSON t SYS fCM l 1'�I2aCaNt1 ICECAN!T�IINDk 1 IOr grrj h��Ife N �rPk - F,_eV4-v0N`,- /06,00' I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: � MARCM G 98 7 -aQ �1 Jolt N sa�/ ADDRESS: 11 / CERTIFICATION NUMBER: PHONE NUMBER(optional): .40-7 'SEEK"'"- <1-1 ��/rr2�'��m W i S4n1� 34$x- 3$6- qo$o CST SI ATURE: DISTRIBUTION: Original and one cony to Local Authotity,Property Owner and Soil Tester. Dft-HR-SBD-6395 (R,(12/82) —OVER -- J .C�o� s��occli '1�ec� �y . Timm JOB SHEET NO. OF Excavating Co. CALCULATEDBY_ C Box 192, Wilson, WI 54027 e 1 � CHECKED BY____ DATE_�._`_ -0. SCALE am I 4% 111�v�1 Ge r ra vx Dell �' ka1,�_ J ' 4,-enck-FS S x ZL r erg L:30,1" 103 d 1 --.5 W A C'OVY- 1vv VI 5� t2 qr - .44 g3 - ° ,, , am 1�� ,�b►n �`�` E Ib© PRfp r v (iv.. 'w G w'MM 01471. Joe_ � SHEET NO. Z OF Excavating Co. CALCULATED BY DATE �"J . ,. R 1, BOX 192, Wilson, WI 5Q27 CHECKED BY DATE SCALE . { j ...... 'I �3� F r �Z'�f C '1 �L. �o. ! _ .......... .. .. A 10 .................................... .......... ......................... .......... , : Inc..C,iu Mexs DItA.