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HomeMy WebLinkAbout020-1172-60-000 � o � \ ! j CD 4 % C 0 k � m � \ � � R � � G i � 2 � ƒ z � ) � � ) � 7 � f � % � � 2 � � CD k z / / $ I 0 ) z :!t 2 \ % ■ § ® 6 $ / E 2 a T)o ^ 0) � k { c 0 (D \ z m 4) _ m E \ / CL m E _ » 2 o a _ \ © U) ■ � _§ 9 / \ k \ \ \ •� t � a a a § U 0 2 ] } CD ƒ W-AQ ' f a_ a C M \ k ® j \ j r 2 k # ƒ / (D 2 0 % / 0 § S (CDI CD � tq ' 0 \ k k 2 . § ! � n . — z z a ¥ d . 2 \ . 2 1 § \ i \ § § 0 c 2 ' I = o z _ e e ■ e � ® � 2. � \ % IL lowi � � C r o v L 2 1 o & 0 PUMP CHAMBER 4 t 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 di ptances on plot plan) . HtADt,R ' 10 .50 10),SV 11.KC� SOIL ABSORBTION SYSTEM Shot IUo do ENO /l 1. 6 o t ,}. Bed: � Trench: � D Width: I2 Length: 3( Number of Lines:_ ____ Area Built: Fill depth to top of pipe: Number of feet from nearest property line: Front, n Side, ( Rear,O Ft . _ Number of feet from well ('75l-� �Cx Number of feet from building: 7 (Include uistance6 on plot pla«). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box 0 or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: i Dated: Plumber on job: License Number: 3/84:mj Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT i OWNER P. n Q TOWNSHIP 4 / J SEC. � T Q / N-R I W ADDRES :10 ST: CROIX COUNTY, WISCONSIN Q SUBDIVISION a,111a a,1 ,1A LOT # 0 0 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H 63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 18k�� �e0t _ -Z _ � y � ot0 � f / 3 AJR00M IV INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used y` Elevation of vertical reference point: ( *� Proposed slope at site: ! (( � SEPTIC TANK: Manufacturer: Wf�t� Liquid Capacity: Gam! < Q �f um�bpr of rings used: , Q Tank manhole cover elevation: nn ank',Inlet 1:levation:1Vq. q7(, 0 Tank Outlet Elevation: I 7, 17 umber of foet from nearest Road: Front,Side,Q Rear, O d feet From :iearest property line Front,OSide,®Rear,O feet_ umbtr of feet from: well building: b (Include this information of the above plot plan) ( 2 reference dimensions to septic tank) uEE REVERSE SIDE Vie- DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&NUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BPi,7969 Ir BUREAU OF PLUMBING MAP ISONr yV l 53707 �'Q' SD4,SW�,S17,T 9N-R19W UCONVENTIONAL El ALTERNATIVE State Plan l.D.Numb- (If assigned) Town of Hudson ❑Holding Tank ❑In-Ground Pressure ❑Mound Lot 80 Willow Ridge III NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: IN SPE TION DATE: Moser Homes 213 Locust Street, Hudson, WI 54016 1-- - 4 3 (� BENCH MARK(Permanent refer(nce point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: ichard Hopkins 1059 St. Croix 92503 SEPTIC TANK/HOLD( G TANK: MANUFACTURER LIQUID CAPACITY: TANK LET ELEV.: WARNING LA L LOCKING COVER A P OVIDED: PROVIDED: �i .O$ NYES ❑NO DIVIDED: E ND BEDDING: VE TCIA.. VENT MATL.: HIGH WA H NUMBER OF ROAD: PROPERTY WELL: BUILDING: ET TO FRESH C ALARM: ' $ LINE (.1 S I J;IWINLET. tom!{ FEET FROM OYES NO ( —]YES NO NEAREST DOSING CHAMBER: MANUFACTURER: BE DING: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: YES ONO El YES ❑NO OYES ONO GALLONS PER CYCL PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WE BUILDING. VENT TO FRESH LINE AIR INLET. (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) DYES El NO NEAREST SOIL ABSORPTIONS STEM.Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil an be rolled into a wire,construction shall cease until FORCE the soil is dry enough tc continue.) MAIN CONVENTIONAL SYSTEM: WIDTH LENGTH: NO.OF D ISTR.PIPE SPACING: !NO VER ENUBER INSIDE CIA. -PITS LIQUID BED/TRENCH Z TRENCHES TERIAL: DEPTH DIMENSIONS $ J - GRAVEL DEPTH FIL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: ISTR. F PROPERTY WELL. BUILDING: V NT TO FREBELOW PIPES-. / AB VE COVER: ELEV.INLET.ELEV ENND: —7 G' ES' LINE AIR INLET IOZ.ye �a1,�2 � ( --► f MOUND SYSTEM: Mound site plow(d 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 TE%TURF P MANENT MARKERS. OBSERVATION WELLS YES El NO DYES 1:1 NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. O DE SEEDED MULCHED CENTER. EDGES. YE ❑NO DYES ONO DYES ❑NO PRESSURIZED DIST IBUTION SYSTEM: WI TH: LENGTH. NO.OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR.PIPE MA7COVER o.DISTR. DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING EL V.: ELEV.: DIA_. ELE V.. IPES DIA.. ELEVATION AND DISTRIBUTION VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION H E SIZE HOLE SPACING: DRILLED CORRECTLY. RIAL. PLANS DYES ❑NO El YES 1:1 NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING. FEET FROM LINE: / O DYES El NO DYES 1:1 NO NEAREST Sketch System on F3etain in county file for audit. Reverse Side. SIGNATURE- TITLE.. � - Zoning Administrator DILHR SBD 6710(R. 1/82) INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION , J J 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 pe•(mit 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: Property owners 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;.j X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8Y x 11 inches must be submitted to the county. The plans must include the following; A) plot plan, drawn to scale or with complete d.imensions, 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 e 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 6f over 2 years of steady negotiation and public debate. The groundwater biil Ground iWt. included the creatior, of surcharges (fees) for a number of regulated practices which yviscor4in`s can effect groundwater. The surcharce took effect on July 1, 1984. All of the water that burled reasure is used in your building is returned t:• the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. 0 The monies c:olle.ted through, these urcharges are credi?ed to the groundwater fund adminis- ,eren by the Department c)f Natural R�sources These funds are used for monitoring ground- t Watw, groundwWer conteminatio,i ir=•,estigations and establishment of standards Groundwate-, ti vc rtt protecting. SANITARY PERMIT APPLICATION CO1�� ` � DIL R In accord with ILHR 83.05,Wis.Adm. Code ST ESANITARY PERMIT# 6 s -Attach complete r lans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8'/s x 11 inches in ize. –See reverse side or instructions for completing this application. PETITION 1. APPLICANT INF RMATION-PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES � NO PROPERTY OWNER PROPERTYY LOCATION Mo5r.-t go Sic '/4.j U %, S T;2 9, N, R 17 E (or PROPE%Y W ER'S AAILING ADD ESS LOT AU B E R BLOCK NUMBER SU IVI$I N NAM f .r I 'Gll CITY,ST TE ZIP jDE PHONE NUMBER Y �� NE STJOAD,L OR NDMARK TOWN OF7 VILLAGE:S ' SG- 11. TYPE OF BUIL ING OR USE SERVED: Number of Bedro s if 1 or 2 Family —, OR El Public(Specify): CGMVgAdNA III. PURPOSE OF APPLICATION: (Check only one in#1. Check#2,3 or 4,if applicable) Vq 1. a. New b.❑ Replacement c. ❑ Replacement of d.El 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 Sys em 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.AConv ntional b. ❑Alternative c. ❑ Experimental 2. a. ❑Syste - b. ❑ Holding C.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fil Tank V. ABSORPTION YYTEM INFORMATION: (Check one) 1. a.Meep age Bed b. ❑Seepage Trench c. ❑ seepage Pit 2, PERCOCATIOl 4 RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUJR Square Feet): PROP SED(Square Feet): 00 `/Q_ Q Feet Private ❑Joint Public VI. TANK CAPACITY Site i allons Total #of Prefab. Fiber- Exp n . INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App. Tanks Tanks structed Septic Tank or Holdin Tank 1600 Q Lift Pump Tank/Si ho Chamber ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Prin): Plu er's Signature:(No Stamps) f MP/MPRSW No.: Business Phone Number:1101 b4s PlUgIbe r's A ress�re t,C9%, State,Zip Code): N e of D signer: X11 S C' C V N VIII. SOIL TEST It IFORMATION Certified Sfil Tester((ST)Name CST# CST's AD ESS(S re ity,Sfjate,Zip Co e) Phone Numbe : L7b Alfa S IX. COUNTY/DEF ARTMENT USE ONLY ❑ isapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) S rcharge Fee Approved ❑ caner Given Initial `6� 6Q cz�,vv //_��_�� � e /�� roc_ dverse Determination / p�� �J /V X. COMMENTS/1 EASONS FOR DISAPPROVAL: SBD-6398(formerly PI -67)(R.03/86) DISTRIBUTION: Original to County,One Copy To:Bureau of Plumbing,Owner,Plumber APPLICATION FOR SANITARY PERMIT STC - 100 This applicatiom 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 submit led to this office with the appropriate deed recording. Owner of Proper y Mo er Homes Location of Prol erty _SE 16 SW , Section 17 , T 29 N-R 19 W Township Mailing Address 213 Locust St Hudson , Wisconsin 54016 Address of Site Hudson , Wi . Subdivision Name Willow Ridge 3 Lot Number 80 Previous Owner b f Property B . & H . Development Inc . Total Size of Parcel Acre plus Date Parcel was Created June 13 , 1986 Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? X Yes No Volume - 7_75 and Page Number 136 _ 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 t avoid delays of the reviewing process. If the deed description refer- ences to a Cert fied Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - PROPERTy OWNER CERTIFICATION 1 ((#e) ceAti-6y hat aU 4tatement6 on .th.0 60Am aAe tAue to the be6.t 06 my (ouA) hnowtedge; that I (we) am (aAe) the owneA(.6 ) o6 the pAopehty de cAi.bed in th" in6okmati,on 60 , by viAtue 06 a wa Aa.nty deed AeeoAded in the 066.ice 06 the County Reg-us.teA o 6 Deeds ass Document No. 4 2 4 5 0 0 and that I (We) pAeb entey own the ptopoself 6-ite bon the 6ewage dispozat sy6tem (oA I (we) have obtained an e"e-ment, to A_wt with the above de cAibed pAopeJcty, bon- the eon-e.tAuctc:on 06 .6aid Ay6.tem, and the dame has been duty Aeeo)tded in the 066ice o6 the County Regi4teA o6 Deed6, a6 Document No. 424500 ) . SIGNATURE AG ER SIGNATURE OF CO-OWNER (IF APPLICABLE) ,f DATE SIGNED DATE SIGNED DOCUMENT NO. THIS SPACE RESERVED FOR RECORDING DATA 'I WARRANTY DEED � STATE BAR OF WISCONSIN FORM 2-1982 i ' 424500 775 1310 L B & H Deve�.4j?I11�27 ,_..I1.c.,... ................ Y.". ......................... 111th ----•------ -----•-••----------•----••---•.................. ................................................... 7 A�T'f 1 conveys aid warrants to .....�llWayn.e..Xoser.................. ......................... '. _ZZ.��S . •------------ ------••---........._.....•-----•..........•-----•. ---••--•--.._._...----••-----•.......-•------• ...--------•......................•--...-•--••---...........------..........................._................... iy I ... ...... ... .................................................................................................. RETURN TO .. .------- .. ----------------------------------- ... ..... ........ .-...---1X............ ...._... . St. Cro the following described real estate In ................................................County, - - - - - State of Wisconsin: Tax Parcel No: .............................. Lot 30,, Plat of Willow Ridge East in the Town of Hudson, St. Croix County, Wisconsin. w " 'R O This ---15---MA----------- homestead property. (is) (is' not) E ception to warranties: easements, restrictions and rights-of-way of record, if any. Datedthi -_-------- --------•-•--•----•---------------- day of ...----- ....--..Mar-oh...-- ---.......---•----- .............. 19.$.7.... B & H Development, Inc. , by: (SEAL) 411. ) ... `��.e���. �"`"a"1"�.'.._.....(SEAL Donald E. B j rnstad, President -- ....................... u......• ••-----. . ...... ------------------------------------------------------(SEAL) ... .. --...............(SEAL) William C . Harwell , Secretary- ._ _ . .... ......... ............. .... ... . - - ._. . Treasu. - rer AUTHENTICATION ACKNOWLEDGMENT Signature(s) --------------------------------- .......................... STATE OF WISCONSIN ss... .......O. ... _County. authentici ted this ........day of........................... 19...... Personally came before me trfii `"3_. ............day,of -------•-�--/�rn 19c the above.:,if> {osl TITLE: MEMBER STATE BAR OF WISCONSIN (If not- ..................... ............................... ----------------------------------------------------,.,}.� ..__........---= authorized by § 706.06, Wis. Stats.) to me known to be the �f___._._. person %dhu executed the foregoing i strument and acknowledge the Sallie. THI INSTRUMENT WAS DRAFTED BY t .> Krist na 0 land Lundeen _. Attorneyat Law "................ --------- ................................................... ................ ............................................................... Notary Public .......................... ..... .........County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration are not necessary.) date: ......................................................... 19.........) • I *Names of pe ns signing in any capacity shuuld be typed or printed below their signatures. _ WARRANT STATE, RAn OF WTSIInwgtN r-+ • y STC - 105 r" • r y ' si. is 'TANK MAINTENANCE AGREI?MENT St . Croix County v ' - y O NEIL/BUYER Moser Homes m ROUTE/BOX NUMBER Route 5 Fire Number CITY/STATE Hudson , Wi . 1P 54016 PROPERTY LOCATION : SE 4 , SW '•4 , Section 17 ,i. 29 _ii It 19 W Town of Hudson St . Croix County , Subdivision Willow Ridge 3 Lot number80 Improper use and maintenance of your septic: system could result in its premature failure to handle wastes . Proper maintenance cun- si • ts of pumping out the septic tank every three years or sooner , if needed , by a licensed septic tank What you put into th system can affect the function of Lite SuIltic tank as a Croat - meit stage in Lite waste disposal system . St . Croix County residents maw be eligible to receive a grant fur, a na_ximum of 60% of the cost of replacement of a failing system, wh ' ch was in operation prior. to July 1 , L978 . St . Croix County ac 'epted this program in August of 1980 , with Lite requirement that owners of all new systems agree to keep their systems properly ma • ntained . Th • pr. uperty owner agrees to submit to St . Croix County 'toning a C tification form , signed by the owner and by a master plumber , jo irneyman plumber , restricted plumber or a licensed pumper veri- fy ng that (1 ) Lite on-site wastewater dispusal system is in proper op rating condition and (2) after inspection and pumping ( if nec- eStary) , the septic 'tank is less than 1/3 full of sludge and scum. Ce tification form will be sent approximately 30 days prior to th ee year expiration . H 0 I/ E , the undersigned , have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x th • standards set forth , herein , as set by the Wisconsin Depart- v melt- of Natural Resources . Certification form must be completed anc returned to the St . Croix County 'toning Office within 30 days of the three year expiration date . -- - -- - ---- SICNEL D A'T E /-/ St Croix C .)unty Zoning Office P . O . ['ox 98 Ila ninio rd , W 54015 71 -7� 6-2239 or 715-425-8363 Si n , date and return to above address . DEPAR.TMEN1'OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS INDUSTRY DIVISION LABOR AND PERCOLATION TESTS (115) MADISON,w53�9 HUMAN f�El_l�TIONS (H63.090)& Chapter 145.045) t_oCnTlOry ! ' SHGTI N: T NS IIP IJNICIPALITY: OT NO.:BLK.NO,: SUBDIVIS ON NAME: SC /�i�/ 1 Tz9 NJR'IAior � sa►..J ' 86 - WILLo X116 7� COUN1 Y WNE 3'S LJYER' NAME: MAILING ADD SS: --x-r .e ,x o✓�L s 213 'LocusT USE ppI DATES OBSERVATIONS MADE NO DESCRIPTION: P ,A�N Replce L ❑ MhK k 20 40 lmokcp 2tT �oILS 1 56 50I1.'j �QVNAtT RATING: S=Site suitable f r system_ U=Site unsuitable for system C( O V N_ToIO-N Au L_1_MOU-_.O_:_au_�I_N, -G R 'Ns D-PRESy S U FILL OLD ING TANK:RECOMMENDED SYSTEM: ❑uSU a s cdM T7o a II Pe+lol It ion hws uc NO Iu uurd— — DESIGN RATE:^ 1 If any portion of the tested area is in the A under 5 V163 0f1(h)(I)) indlr au k�'Cr y Floodplain,indicate Floodplain elevation: jVA C_:�__. .._ . _ __ _. .._. l___ I PROFILE DESCRIPTIONS 11011ING 10TAI. ' DEPTH TO GROONDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NlIM6EI7 DEI'lll tiSl. ELF.V TION ORSEFtVEP E IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) __ -- — e'bK$QN SL TS Z l�7Bc K$1 lr 28"$ItnIS l L 8" .1�$?N GSt6+R B f > 9.9Z- Ilp,.tA"c,- e --- ,z•�BRNS�Tx" S7"LrRRN MS�E6 R � o�QaS,.bau B Z y_? io3 ?? dN > 9' 17 ' 3 aQ�t�� 3e"l—r& r M s4 — -- 9"$RNSLTS t43$�N Stl /9rLT$RN I`�S 13- /9,00 - oQ �4 -�U � ? �.oo_ 3"'s s�6 e s3'� ,T Bea DES .rtes, 13- 4 g �� /04 NOW- > 8.67 6f$enISL75 16fftrREW J�'S 4k 82"/31rKKts �G� �4us B- - o 9.OFD @ elklSL75/6"seN f6t za Imsm r1Z 63N&rKS*4>�r ter►+ Q:oB_ �06 .95 � Nr B c PERCOLATION TESTS TEST DEP1 H WA ER IN HOLE TEST TIME DROP IN WATER LFVEL-INCHES RATE MINUTES. NUMBER jrS AFT ,R SWELLING INTERVAL;MIN. p > �_p,�R! PER INCH P_ 1 3_06 �. Kw' 3 7 2 �Z P_ `L I t_ , 64.0 >2 r - P- P- PLOT PLAN: Show locatio is of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe vyhet are the hori- zontal and vertical elevatiol reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent r of land slope. BM !IQON pipe - Ar— co2NER L.or WV SYSTEM ELEVATION /b/.5o C�E�JoTlcnl - lvo.a� t kTF_kAMTC- 48.60 ' ) _ G7 _ _ - ! Lo r 9 La�r 8 S,Tr Loc�raJ 76' LoT 8a C7 46' •dn A...Bch a My.� �I �Nt.l� rre r •r e/t y / \ + , s " D �r a J- ro R + Jo irs /� qn 9f 1 L'77' 't. A I t r ® of a •f a i M Cr I 1 the undersinned, hereby P.rtify that the soil tests redorted on this form were\Viade me in acco d wi h procedor nd methods specified in the Wisconsin AdministrativP CodP,and th t the data recorded and the location of the tests are correc to the best o my nowledge rfd -Sef. _ TESTS 11 1j1J w) ET D ON: NAME(prinIP: — _ -- --- �j6' _ I Z� /9Ti7 I�AIvL lv U/.!nt 5rJ/� IRUsc11 SuIt�IE'/�/V6 /AtG M N _ -- ---- — CERTIF CATION NUMBER: PHONE NUMBER(optional): _ / -/ / 3�gt,. 386-4ogU 4C7 SE�o �T /^yC1��0� _.,'N I_ rJQ���Li _ -- C°iT,l ATl RJ E .......... (1111)1 IIIN r 1.rrluLr J HI:rnr•,rrl Nr Irl I/KJI fiUlhlJ111�.I1 n1/1!Ily 1)Wnef :Inrl:roll ll"•la'!. nm 4► nuI cthjL.!�� co s O oo m o 0 m Q� a 3 Y .EE y E 3 reo. zv .so N 3r02.9E.20 S .6E'v9E ° z a J CD F ^ CD (D O a a � n n LO n a E ai t 3rvS.02 n o-u SON 2 �+ ^ 3rLE.LE.00 S Q .BO'LLE m O w ti =I 0 .Bs osa .3 �! 3.T> Pp N o r1 rt 0 M.Ej,6e c,1 0; $ cu EW •Lj•s8E _ � i I I I I I _ t P B ' 67. L PLOT.._.A �� �, T ; 0 S S E Ci T. . _.���. R 0 J EC T ---- - - .13 L U M H E I-� WI, A.M E f�AM E 1; C AT O N `�._110 _ +-e- I=i C E ni S E =f = ,f. �_.t 3 _ ___. . 1 DATE � t PL Z—A P Brv► =1' coN l6+ a J 7/' ,y 4 t,l 79 A 0o4 L at F1 , t a r. VACA N t, A 8D i 6 d s u' i FRESH AIR II12LLTS AND OBSERVATI`(SN PI.PI; CROSS SECTION Approved Vent Cap Minimum 12" Above JKPAt ` Final _ Y MAX 4" Cast Iron a ' u » ; ' - Above Pipe Vent Pipe ." To Final Grade's _ Marsh flay Or Synthetic Cover:i.ng Min. 2" Aggieg'a L e _ i ' Over. Pipe Y istributio ,� Tee Pipe Aggregate Perforated Pipe Blow f Q Beneath Pipe —Coupling Terminating At Bottom of System Y { f I i 1 1 t I I I i j P # � 1 i 1 i `I I ti C` C7 45 i rqC t 4 'I I 7(( i �i i j I J 1