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020-1164-70-000 (2)
~ (') lq Q ' n N Q ' ~ ~ h 'O ~k .+ ~ ~ A ~ - - ~ ~ - 3 ~ .. ~ w w m c o rn o ~ o d N o h s ~ o 0 0 m ~ ~ ~ ~ W N x m ~ m ~ ~ o m 0 a °1 ~ ~ ' ~ _ ~ ~ ` s n. '~ N c c, 7 7 ~ y p N O W N ~- ~ ~ W p 01 ~ y ~ N ~ ~ CD ? v O ~ 7 O COi 7 W~ O ~ =~gs = ~ n > O j pp W O O I V~ i l ~ 3 O 3 W O ~ ° ° N C = c j o p ~ o ~ ~ m a o o ~ D ~ ~ - ~ m { ~ D y m ° c ? a 3 a ~ O .,-+ N N p N ~ ~? ~. c. a v w ~ o ~ ~ ~ N~ o o n A N ~~ p ~ N ~ C ~ p p y O O ~ ~ .. Q C ~ I N •~ 'p a 0 0 0 O O O a a' c ~ ~ ~~ A~ ~ ~ -t -i-~ y ~ ~m _~ ~ h cn cncn o c l~ tn (ntn ~ ~ ~a ~ ~ R ~ V D ~ ~ rn l ~ a ~ ~ ~ 0 0 - rn o ° _ m ~ ~ - yo ~ ~ ' ° " w m i m . m ~ 3 rn y ~ fp ~ - N .. N ~ v 3 m .. 3 .. y Z D ~ Z =' ~ Z D 00 Z a ~ ' v ~ m ~ m o ~ m m ~ o y N y CAD ar to i CAD y N C '~. C N ~ _ O N ~ a x n I ~ ~ ~ ~ co -I N y C a ~ G p J Z ap I ~ a i 'a is Z o .. y a Z -~ ~ W ~ ~ ~ ~ ~ a -, ~ ~ a -. ~ ~ .~ A z :U :: ~ {~~ O N C y .. Z .. ~ ~ A w m w A ~ S D ~ C d ~ _ ~ N ~ ~ d ~' _ N f y N 3 ~ a C .~.. G ~ ~ CC G ay • N ~ y ro c 0 y O ~ W O N T C O N 41 O A~ p. N - C . .O O O G ~ n 7 O C = W CD N O. N O N N n Q N N . j y ~ ~ N N ~ N N - ~ (D y N ~ ~ j ~ ~ ~ ~ ~ c y N ~ ,~ 'O O O _. ~ '. 0 01 N (Q y O O y ~ ~ N .~ n y _ y c . ~. o x 3 ~ °-~ ~ y ' N ~ ~ T. ~ ~ ~ O < O O O ~ ~ ~ E9 ~ fA 0 i O Ia. ~ O ! 5 RECEIVED S'I'. CItUIX COUNTY ZONING llEPARTMIJ T AS BUILT SANITARY REPORT JHN Q 4 2005 Uwner ~~Jv Lb ~'LcilJ /?' ~~' .s2. ~Z sr. cr~olx couNrr ZONING OFFICE ~d~l+css o /t'l ti ~ , Ctt}r~State V ~ Dti s ya r - . LP~aI Description: Gd T,S 5 S Slo 5 7 Lot Rlock Subdivision/CSM # ~Dy'e" ~ o oG7 ~ST.~'T-E$' '/~ NW+/+ Sul, Se~ , T~N-R~W, Town of U!~-SonJ . PIN # ©~O• !/G • 70.Odz """ "'-~ ~fi'i~~ ~ ~v~L ~-l~tAlvilSLK -- HULllING TANK INFOIUVIA ION: ~ ~jiES~2 ~~ ~ • ~-~ BSc Tank manufacturer Size ST/PC / Setback from: House Well P/L Pump manufacturer N Model ~ -' Alarm location ~ .. (IIOLbING TANKS ONLY) Setbacks: Service road ent to fresh air intake Water Line Meter location Alarm location l~vi c,~ .~ ~v /GTn,}•l~s . SOIL ABSORI''I'ION SYSTEM: TRE•~c~. c E//s 3 Type of syslern: Width Length Number of Trenches Setback from: House 7. ~ Well ~/~ p/L .33 Vent to fresh air intake i ELEVATIONS: 3RD [3M ~ Tap of ~y" ST'. Mh~ho~l.2~ ~~+~- gRov.~v~ - 9Cp• ?Z. Description of benchmark ~° T ~4M ~ -~~ Elevation Description of alternate benchmark 7'oi(~, D/C p~~" Elevation~7 3.Z, Building Sewer S TlIiT Inlet ST Outlet PC Inlet PC .Bottom _________ t-{eaderlManifold Distribution Lines ( ) Bottom of System ( ) Filial Crade ( ) ate. 13 - l~ ~.. Z, oo Top of ST/PC Manhole Cover ~) ~) O () () () Date of installation / / .: Permit number ~ 3 ~ ~ 7 N~~ - Slate plan number Plumber's signature License number ~'~'43 7 5 Date -7-7-'-~ Inspector PAM Q(Jl N/t~ (- b .5 ~'X/sr~~V (~ sE p,-~~ cn r~N~c ~ G~ r _ ,_ Compkle pbt pfm Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley,. Wl 54767 . ,~ S,T• 3 ~ T°P ~~ ~ y' ~~ ~jL7~'`- 3 3 t ~~7 zg o ~E~ I, c~ { 4 _ ~ iD~ a !5 ~~cr5 tB©a ~ ~ s. ~ O z~~ ass c.~ ~ Sew ~ ~i11~~ ~.-----*" 7i~ j~ W ~~G Tom' ourG~j ' 9~f yD, ~ .,-- C~~ ~D (~/- ~// E ~J~~~r `~ d~~ ------- ___ i ! - -- - __' i~ B ~~I VA~~.L V ~~ r,~ p ~~T o ~O~i~-~!7 Z ~ ~~ --- ~ ~~ i i . ~_.._-_ ~oP s~ ! q d _ __ 3 ~Xy~ _t_ __ .~~ / f - ~ _ _ _ -o ~ 3 sysrEM , $7• D!v ~_~-_--~~p-- ~ _ "To~ She/1S ~1-f~ ~ -- ~ r'- _.._..._ ~lo - ~ _ 3 ,rye ~ ' --_` _o r S~`S ~"~.R-~ , ~_ o - _ ~b ~G 3~ ,~ rop slams 33 ~~ ~ , Sys rE-, y S ~lS, ~s ~ -----.. Tod e~ /~~~. ~-~- ~7.3z' ~.---- ~~ ~ ~ __`-1S POWT SYSTEM SHP.i.~ INCORPORATE PER COMM. 83.44(2jc A PROPER ZABEL FILTER MODEL # A, /,oj~~ ~~ X /~ ,~ ~s5 T GQ y-- L-i~ve..~- r~ ~. .~~~ December 5, 1994 Mr. Dave Anderson Century 21 Premier Group 706 19th Street South Hudson, Wisconsin 54016 ~5-~~ ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Qua -~ I ~ ~`~-~v - ~ ~.zy, l~. ~X~- 9~~ ~l s~, ~, s~ RE: Water Inspection for Brian and Deb Chamberlains Property Located at 309 Harshman Drive, Hudson, Wisconsin Dear Mr. Anderson: Enclosed is the original test results from Commercial Testing Laboratory, Inc. for a water inspection of the above property. If you have any questions with regard to said report, please do not hesitate in contacting me. Sincerely, , ~ f ~,'?, 'L'~'ti~ Mary ~ J~ kins Assistant Zoning Administrator St. Croix County, Wisconsin mz Enclosure COMMERCIAL TESTING LABORATORY, INC. 514 Main Street, P.O. Box 526 Colfax, Wisconsin 54730 715-962-3121 800 - 962 - 5227 FAX - 715 - 962 - 4030 ST. CROIX COUNTY ZONING OFFICE ST.GROIX CTY GOV.CTR 1101 CARMICHAEL ROAD HUDSON, WI 54016 ATTN: THOMAS C. NELSON REF`ORT NO.: 75010!01 REPORT DATE: 1?/02/44 ryATE T:ECEIVED: i?/01/94 OWNER: Brian ~ Deb Ghamberiain LOCATION: 349 Harshman Dr.. Hudson COLLECTOR: M. Jenkins DATE COLLECTED i1-30-94 TIME COLLECTED: 2:15pm S~.1F1;E OF SAMPLE. Outside faucet DATE ANALYZED:12-01-94 '~ TIME .ANALYZED:?:44pm ~:, COLIFORM,MFCG: 4 1100 mt INTERPRETATION: Bacteriol.agicai.ly SAFE. NITRATE-~: < 1 ppm hove 10 ppm exceeds the recommended Public Drinking Water Standard. Conform Bacteria/100 mt Nitrate-Nitrogen, mg/L LAB TECHNICIAN: Pam Gave WI Approved Lab Na. 19 oE•\NOEPEI~pEN J, ~_` BO ~ D Jb''%,,a`tiA C Means "LESS THAN" Detectable Level Approved by: 0 PROFESSIONAL LABORATORY SERVICES SINCE 1952 PAGE 1 ~~F'3\, ~t W ~ ~ ~`i~~ t~ ;i c;~u~~ ti CC~~1'~ICE . ~p-~tN(30f ,,:A ., ~ . `~~S ~ -~ ~'~~ , November 30, 1994 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 Mr. Dave Anderson Century 21 706 19th Street South Hudson, Wisconsin 54016 RE: Septic Inspection for Brian and Debra Chamberlain Address: 309 Harshman Drive, Hudson, Wisconsin Dear Mr. Anderson: An inspection of the septic system on the property of Brian and Debra Chamberlain located at 309 Harshman Drive, Hudson, Wisconsin, was conducted today, November 30, 1994. At the time of inspection, the sanitary system appeared to be functioning properly. The inspection of this sewage disposal system was based upon a surface inspection of said system, and did not involve any excavating or chemical analysis. Accordingly, there is the possibility of hidden defects in the system not discoverable by this inspection. This does not in any way warrant or guarantee the continued proper functioning or operation of this system. It is recommended that the system should be pumped once every three years. Therefore, the prolonged life of this system may be dependent upon proper maintenance of the system. Also, water samples were taken. Once we receive the results we will forward the same on to you. Should you have any questions in the meantime, please do not hesitate in contacting this office. Sincerely, t Ma J. Jenkins Assistant Zoning Administrator mz ~_ `~ ,~ ~~~~ `= ~. •r ..,.,.~ •~_ , piMU1111~gM (- ~M~^ ~5-~'~ ST. CROIX COUNTY Cpl WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road ~~ ,~ ,~.~..-- _~_.~.- Hudson, WI 54016-7710 `~ ~~.-'~'" (715) 386-4680 "\ SEPTIC INSPECTION / WATER TEST REQUEST FORM \~ < 1 Please specify desired test(s) & remit appropriate fee with application. Outside water lines are often turned off during winter months, making access to the home necessary. Please make arrangements with this office to insure that entry can be gained. 0 Water (VOC's) $185.00 ~eptic $50.00 Water (Nitrate & Bacteria) 45.00 ~ Nitrate & Bacteria retest $15.00 Owner • ~ ~,Q,~~ Requested by : ~0-~- G'-r~ Address : 3v Address : 70~ °' /9 a-e-~- Z I P w~ ~e ~ Z I Pao !~ Telephone N°: ( ) Telephone N°: (~'f .~~L ~- P' 2-0~ Property address (Fire Np & Street) : ~ O g Location:~7N '„n/ ?~ '„ Sec. 7 T 2 N, R ~D W, Town of - Realty firm: ~ioZ-f Lock Box Combo:~,~~! Closing Date: ~sC. /`9y TO BE COMPLETED BY PROPERTY OWNER ~, PROVIDE A SKETCH OF HOUSE & SEPTIC SYSTEM ON REVERSE OF THIS FORM>f Water sample tap location : iv a o u TS / I>~ Is the dwelling currently occupied? .Yes 0 No a-~""`'- If vacant, date last occupied: Age of septic system: ~9~6 Septic tank last pumped by: Date: 1`~~~ Previous Owner's Name(s) : /y'p/1i Have any pf the following been observed? Other comments relative to system operation: I certify that the above information is complete and true to the best of my knowledge. ~ Q 0~.... OWNERS SIGNATURE: D~'~'~l~ I~ ~~ DATE: /'1~-9f~ 1/94 ~ /!'yam Rm v ~ ~~. ~~ ^Y Slow drainage from house. ^Y Sewage Back-up into dwelling. ^Y Sewage discharge to ground surface or road ditch. OY ~ Foul odors. x. i.. OWNERS DRAWING OF HOUSE & SEPTIC SYSTEM LOCATION 1~ , ~~ ~ ~1'._~ ~ ~~ s~ ~w _ ~ 3 ~ %''°""d TO BE COMPLETED BY INSPECTION AGENCY System design &/or permit on file? OYes ^No Soil series per SCS Soil Survey: // sheet # Type of soil absorption system: 8B low grd ^At-Grd ^Mound Approx. size 'X ~avity ^Dose ^Pressurized Ft.2 ^Bed OTrench ^Dry Well ^Holding Tank ^Outfall pipe OBSERVED DEFICIENCIES ^Other OUnknown Septic tank Setbacks: OHouse_~ ^Well_ /~ ^Prop. line r~ ^Other Dose tank Setbacks: ^ se ~ ^Well ^Locking ver_ ^Warning7 OAlarm ^Elec. wiring Soil Absor ti n S stem Setbacks: ^House 'V ^Well V OPonding: ~sCf)~ i General comments: ^Prop. line ^Other abPl_-- ~ ^Pump/Floats ^Prop. line / ^Other ^Discharge : _ IZfa~- ,~.~~, INSPECTORS SKETCH OF SYSTEM LOCATION r -- Inspecto ~~ . -~/``' Z5 Tit 1 e ,~r'1'f ~ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and'$uilding Division INSPECTION REPORT r GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Loken, Dan Hudson Townshi CST BM Elev: lD U' D Insp. BM Elev: / 6 ~~ (~ BM Description: ~a~h. TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~,~ /Dvo Dosing w ~~:- Aeration ~_ ~ /~~~ Holding TANK SE BT ACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION 1 ?~ ,dljl~, Manufacturer Demand _~- GPM Number ~ _ in Length Dia.Dist. to Well SOIL ABSORPTION SYSTEM ~ ~~ ~~-- ~~~ ~5., ELEVATION DATA STATION BS HI FS ELEV. Benc~hm_ ark ~ b , r -(fwr ~ n I ' O D' ..( I cab . a Alt. BM ~v p a~ Bldg. Sewer / '~- - ~71~ SUHt Inlet ~. SdHt Outlet Ds-per-- ~ to - Y 3 q 3 ~'? Dt Ofll U p ~ - 63 ~3 rt4 Header/Ma n. ( Sg ~ ~ ~Z Dist. Pipe 6~ a ~ 2 l g~ YG ,~S Bot. System t ] 3. 2 ~ . . Final Grade ~.~~e~-~. cep a 3 ~ ~, ~ v• ~ I St Cover ~ .y 3, 3S ~~- 3 ~~ ~~v~ ~~~t~.Lo~~ / BEDITRENCH Widt th No. O Tren es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS h ( ~ tb/ (~~ SETBACK SYSTEM TO P/L B WELL LAKE/STREAM LEACHI G Manufac er JJ ~ ~ INFORMATION CHAMBER OR ' l Ty Of System: ~~~ r I~ ~ ~ UNIT Model Number: DISTRIBUTION SYSTEM L ' ' .... finch .P~t.d ",J Head anifold / Distribution ~ x Hole Size x Hole Spacing Vent Length is Pipe(s) Length Dia Spacings ~ ~ 5 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ~+ No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: I ~ / Q / Inspection #2: / / Location: 309 Harshman Drive /Hudson, WI 54016" (NW 1/4 SW 1/4 7 T29N R19W) Edgewood Estates Lot 56,57 /J Parcel N~oy,07~.29.19.985 1.) Alt BM Description -~(~'~ o-Y Sa~'~-~w-vs'~ ~s-~{~Q~G~ e~ G~-~ h g ~"' ' ~ `~Ch y ,,/ 2.) Bldg sewer length = 15../ -[~~ ~~~ 3 s'h~c~ti~t. ~ wnd Gc - amount of cover = ~ _ , ~, , _ ~ / n ~,~~~ ~ /~-~ ~, l ~~.~, Plan revision Required? ~ Yes ~o ~~ t // i D Use other side for additional information. I 1 SBD-6710 (R.3/97) Date Signature County: $t. CrDIX Sanitary Permit No: 463257 0 State Plan ID No: Parcel Tax No: 020-116 - 0-000 Section(town/Range/Map No: 07.29.19.98 l~ /?~ 85- ~,Y Cert. No. Saft~y and Buildings Division County S -~-_ C ~ ~ 201 W. Washington Ave., P.O. Box 7162 isconsin Madison, WI 53707 - 7162 Sanitary Permit Number (tD be filled in by Co.) Department of Commerce (~8) 2 3151 3 a S Sanitary Fermit Applicatio R~'CE~ F ~ State Plan LD. Number ~/~ °~ rs infotmatio you provide e In accord with Comm 83.21 , , may be used for seco Pr~ s15. )(m) DEC Proj Address (if differ~t than mailing address) I. Application Information -Please Print All Informatton 3T CR U~x. ~ . ~~G y 70 • ~a d Property Owner's Na me G OFFIC ~R. ~~S • ~~~ ~ o,~~~v / E (# Lot # BSock # ss, s~, s~ Property Owner's M ailing Address Property Location • ~~S- 3 o y ~Ps~ ~-ti ~~ ~ .vuJ ~, s~Ju,section ~ City. State /,' / ~~So/(J K/ / Zip Code Phone Number 2 ~ ~y (circle o~) ~r W T N; R (check all that apply) e of Buildin II Ty _ g . p 3 rj, , c<~ n~ ~1 or 2 Family Dwelling -Number of Bedrooms Subdivision Name CSM Number G . ~~~ S r~~~ G~~~~~~~ C ^ Public/Commercial -Describe Use ~~ ~ ~ ^ State Owned -Describe Use ~ ~ I ST. Gr:I.(~S 7 ~ -t'~Gi'~ ^City_^Village ~ownship of - 3 :~ v III. Type of Permit: (Check only one box on line A. Complete ' e B if applicable) A' ^ New System Replacement System ^ TreamtendHoMing Tank Replacement Only ~ Other Modification to Existing System B. ^ Permit Renewal iration Before Ex ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New Owner Lut Previous Perm/it Number affi Date Issued t.j O C.~ ~ ~/ -"' p r ~ ) l IV. of POWTS stem: (Check all that a 1) Non -Pressurized In-Groutxl ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sam Fiber ^ Constructed Wetland ^ Pressurized In round ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sard Filter ^ Recirculating Synthetk Media Filter Leaching Chamber ^ Drip ^ ~iravet-less P' r (explain) V. Dis rsaUTreatment Area Info 'on: '" ~ Desiygn Flo ~gpd) Design Soil Application Rat~gpdsf) 7 Dupe ~ wired (sfj / _ Dispe~ / Proposed (st) 44 System Elevation gr±• D 7 " l r C B VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel •Fiber Plastic Gall Gallons of Units Concrete Constructed Glass )'leW E)t15[11fg /~ /J ~ // ~' /J ~ Lam Tanks Tanks , l~~(~77 ~~ Septic or Holding Tank ~-- /~ / /1?D1 ~ ~(/ Aerobic Treatment Unit / /)~/'_ "yG Dosing Chamber ~/ 7~ VII. Responsibility Statement- I, the undersigned, assume responcib 'ty for installation of the POWTS shown on the attached plans. Phmber's Na me (Print) [ 2t Lb 21''GL~7-- Plumber's Si re Number zZ C~ 3"t S Busittess Phone Number 7/S • ~~~z • 3 ~{ ~Z Pltunber's~~ ~ (~ , C~0 ta~ tp Cod~~ . J T /~- l/~ (l !/~` "~ / ~ ~ ~~ oun /De artment Use O Approved ^ Disapproved Sanitary Permit Fee (' chides Gronrxlwater Sttrcharge Fee) ~l ~~~ Date Issued Z~ I ing Agen Signature ps) ^ Owner Given Reason for Denial ~J v ~--' o / 3 ~ - -~~ ~ ~ iIIC. Conditions of ApprovaUReasons for Disapproval ~ ~ ~:2 ~ t-`~1'1 ~iY[ C~ - _ ~ % ~ ~ - ~ YSTEM OWNER: ~ 1 Septic tank, effluent filter an ~,C~~ '~ ~dn!t''~ ~~ ~'• d' i ~ ne us a e ainta -0 aQd~f as per management plan provided by plumber. - 3 ~Q~u.J~~ G~ S-~a'h~-r' U~~ lGC / /J - . 2. All setback requirements must be maintained ~f ~~ ~~ ~ 2~~d `~° Tv+~ ~ /ordinances d . ~~~ ~ J/_~~'~ e as per applicable co Attactt [bmplete plans (to the Couoty oaty) for tae system on paper no[ [ess man eai~ a as [ncues m s,ae SBD-6348 (R. 01/03) ~~ , .~-- ~W Q Q J ~ ~ a W W_ ~~ J 4' ~" ~~ ~ ~ My V •tT Z ~J 00 .2 Q ~~ N 0 L aw 02 k- ~ .~^ W~ J W ~ J ~ ~ 0 2 ~ F- ar ~ z Z V ~ A p - ~ d .~ ~ ~~ ~ =~Q ''t o ~° `' "~J ~ SUN 40 1~,. wow `~C V `~ w a ~aa 1'. ~a~ Q !~- ~ 'ill ~ Q ~ O0 ~~ ~ _ cno~w ~ f-- . m 1.~ J W 9 _O 3 -~ M ~i ~ ,~ ~, ~ ~~ ~~ ~~~~ p ~1~~ ~ ~~M~~ J "~ O ~~w ~ r ~ ~ , wa o ~ 6 ~ ~ ~~f ~ o ~ M o ~ °~ t------ ~ ~ in ~~ \ 2~ m ~~d- ~a Z~~ ~~~~ W ~- L Q ~ --- ~` 3 ~~ ZN ~ ~ . ~w ~~ ~.~~~ ~- ~ ~ ~ ~~ `~ m ~~~ ~~ ~ z ,~? ~~ ~Q o ~N o ~ i- ~, o ~~0 ----- ---------r ~ ~ = U ~~~-~~ ,; ~~ ~~ ~ ~, ~ , ~ ioi ~ ~ ~~ ,' r ~ ~ '~ ~ ~. O W 2 J W Q a o~ If ~ (~~ ` ~: ULBRICHT & ASSOCIATES CO. ' 281210th Ave. • Spring Valley, Wl 54767 Rte. S ~A°~,'g, 715-772-3442 - 'r PROJECT INDEX .V/ Dom. 13- oy PLAN ID # ~ DATE OWNER ~~~ LD/~E/y PHONE ~ ~~~• S2yZ ADDRESS 3 Q 7. ~ //~/ Sil/l/iT/y D~• /~DsON s ~~l LEGAL DESCRIPTION ^L07'S S S, SAP, S'~ ~' L~~Q Gt~poL7 ~ST~fT ,vcv, sc~, S-ec • 7, T Lf , /~ ~ q ~ TOWN OF '/ ~ ~`'S ~ ~ CSTM ~• ~~~R~G~.7-_ d S ~ 3 s T• c i~~ Sc, COUNTY _.... LOCAL AUTHORITY/ SUPERVISION s T• C~`'~ ~ ~' e'~'~. PROJECT DESCRIPTION: ~~ ,E?e~ /.¢~~,~E,~, T-- ~' Tic ~'ys~-~ ~n ~N ~ ~~,v`~, Gd Dom' Gflyp /i~.vT 7~ /~ DUl.~it9 S-~~.yC,~ - i.v ti,~ ~v .i =~lS PON/T SYSTEM SHALL INCORPORATE PER COMM:. 83.44(2)c A PROPER ZABEL . ~ - , FILTER MODEL # ~/ •~80 ~„ X ~D,, Pg.l INFILTRATOR SIZING WORRSHEET Pg.2 SYSTEM PLOT PLAN Pg.3 CROSS SECTION OF SYST~M, WITH rLEVATIONS. PQ . 4 ~~ ~~ ~~ u ~~ ~~ .. /~ ~ • ~~5~-O . o,~~/ ',~.~ T _ ~ ,SOBS v!/ v~l /~G.~ ~ s z--. ~ ~ ~o~~ MD/PS ~ ~z-l.¢3'l; ~oT3c-~T u~~~'~~ Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valle , WI 54767 t r c t ~„ m Di a 3 ~~ ~ ~. I i ~... "~ . _ "~ 1. ~} ~ '©~ _ ~ -. ~ ~ ~ ~ ~~ ~~ ~N ~ ~ _ ~ ~~ ~ ~ £~ ~ ~ ~ ~. ~ ~f ~ ~ ~. Ri __.~ r~ ~ - w ~~ ~ ~ ~ ~ ' 1 .~ ~~~,~ ~ ~ - ~ ~ ~ _~ ~ ~ ~ ~ ~ ~' •- ? ~. ~ ~ h }~o ~> %K ° O^ b ~ -~ W ' ~I 3 y ~ . r Z~ a i a yv.~~ r r- r~vr c. ~. ~ ~ Lrivc U Ui ~ cn v o, ~~ , ~ ~ /or ~ ! i,"~. ' ' o ~, EA ~ , q ~, ~ , ~ a? ~ /~ ~ , ~ d) ~ /i/ ~. ' ~I i ~ jo/~ /// '<~ ~ ~ o~ ~j ~ ~ 0 /~ ~ _ N V r.... ~.... ..~.. ~...~ . . ~..~ T V Y N i~ -~ ~ r Z ~rn ~. ~~ 7 4 ~~ C i~ (! //'^W~~''~~ W O v O 0 N~ O d3 Z W ~. ~G ~ ~ O y ~ m f r r k ~ ~,~-_, ~~-- :~~~~ ~- ~ ?3 N 3J ~ , Q ~ ®~ ~D ~ ,~ ,,, y'. n. 6 Y .. __ Z N V v W W o Arn ~ 00 M 3' ~' ~ 3 b O z~ o~ z,~ ~rn ~~ U Z J m~ ~ ~~ w ~ f ~ O x i~' ;~r~ /~!~ ~ 1 ~ ~ -~ z ° rn ro rr~ o d ~ N ~ ~ d ~. C7 ~ O r ~ z n nWp 3 ~- '~ e o~ N e 0 O O ~~f~~~ ~as~~~~r~,v ~' ~" n {, ~9iv. ~ 2 ' 1/l ~ y$ A~~~- „1 `y .. w ~,r>~~T,~GfT4iE~ ~ ~T. ` p i'S?~.~ure,-, ~ ~~~ OS . ~~ av fc/S~/J,~cT/d,,v f~/~ ~ 1!/~ .5q~, {o T~~ti~~ ,~ ^^ ., f~. ~ s ysr~~ . ~ ~~'o SS Sic ~ ion o~ T~'~~r,~G~~ 1r 1~ ~ ~ ~, ~c~*~~ ~~~.~~~ ~~`c.~~ ~ S~~ Ti's # T ~~ ,~11,t/. ~2 ~, 1/!/ „ 1 y~.Qo- Ng ~1- - - - ~y ~ "2~ f /iu~S/f~ED ~0 v ~----- T~~~~~ ,,~ -~ _ :;, ,...., . ._. ,, OWNER's MAINTAINCE-OF~3EPTIC SYSTEM . POWTS (landowner) is reponsible fvr proper operation and maintenance of this system. Regular periodic inspections and ' servicing is necessary for-the safe healthy operation of;this system. The owner is required by code to submit all necessary maintenance/inspection reports to the controlling ,authorities.. SPECIFIC CONTACT AGENTS s ~ C~O~ ~ C~` ~ * Governmental authority/ inspectors: Z O,J ~ j'~ * Licensed installer, responsible for providing an operation/ maintenance."Users"-manual: ~-- `* Licensed serve~ce f inspection,--agent other than installer-: ~iP/ - GT~ 5.4.'7",9-Tio,v ~t~~t j~~ ~tJ~(,-•-~ ~p . *, Electrician, for pump,-electric controls,. wiring units: Nl IMPORTANT OWNER MAINTENANCE RE UIREMENTS 1. Winter traffic{sleddin - area shall not be 9'.shove~ring, etc.) across the Permitted, or frost can/will penetrate into the cell, freezZnq up the system. Discontinuos use in the . winter, (a vacaction.trip, resulting'in no water use) can also lead to freeze ups. - 2•-Water conservation-needs to-lie exercised! Or system can be hydrolically overloaded and destroyed. This svs~em was designed for a maximum wastewater flow of ;/ ~~~ -~l-~-LL! gals. daily. ~• POWTS are not designed to accomodate wastes from a disposal unit, or an garbage,,: Any introduction of suchhwastentnaterialsuwill overload and` destroy this system. _ ~ ., ~. If a power outage occurs, or a pump fails, it ma ,res in a temporary over3oaid of effluent bein y ult cell, which may adversely impact the cell (leaki{ge)tplthis recommended that a licensed pumper empty the dosing tank, allowing the pump.. to return to dosing the correct amounts. Consult your .installer immediately for advice. 5• Neglect of the vegetative cover erosion preventive) can lead to failureeils insulation & traffic also can destroy t he system, It ISmNECESSARYrTOeavy REGULARLY WATER THE VEGETATION OVER A SYSTEM!! Effluent in the,,~ystem beneath IS NOT sufficient-,.alone t0 maintain a .~ 1 ~~cov~rr . ~• Periodic inspections by the owner, or his agents, is necessary. Inspection pipes and .ports ha~o ~...__ .- into tho ~.,..~__ W+soonsin O~bneM of OILF~~t~i~N PORT Page i ot~ o~aE+orsa~y~aeuG t (~~ ,~1 n r-~ LUU4 i J ~ ~y 'T " ~~~ ~ ~ ~ S . G RO ( rude. but not to: verscal and hot(aorgai peroent stops. sc~ a danansior~s, north am~v, and ~Oad. Paroei LD. ~ Za - I I (09- - ~ a '- paa Please print ai! infarrnat ion. tie o rro~onr~a ~a:~reawsdbrmoo~-o~•aosa:l~+~r~.s. ~so4t+)(~u1- ~ / LO/tE/l~ GoWtlot 1/4 SV~I7l4 S ~7 T 2 N R~~ E( W r Owners Address 5 o q 1-I a.rSh -~-~ 0.h D~ , .. Lot # t~tock # ~'s~b ~ ~ Subd. Name a CSMfx -tam 5 ~ Staff gale Num ber ^ ~ ^ V~lage Town NearestRpad W I ~ c 7~ N vDSon/ a,r hm ~ ~~ Q NewCarstructlon ilse:~• Resider~i / Number ct bedraorr~s _~ Code demrea Oow rate -9-5 O GPD Repisaement Q tic or aomrr~erciaf - oee~ tent maber~! /O~SS O l1 ~ S~No y good Mein etew~8on ~ app~abie Q cienerat aar.rwarts o vT W~-~ , and a ~ D ®pn C~oiard surface ekv. 9~ R Depth to fa~or,• q q ~ in. salt Rate Horizon Depfli i~. Darriiant fiedooc Dasaipdon t~rr. 8z Cont. Color Texture SbtM;iuia (~ Sz Sh cotes 8otadary Roots '~1 '~ ~ o-r~ IoYR - arnSbk fr s 3 -~' . (~ z l~l•2O ~ o '>'R -g' - 1 /C rn -Fr C W ~' • tO 3 0.9 Yrtglco ~ 5 I mfr W of ~~ ~ •O A•N!~ ~it~ ~' • ~O !1~' V I ~ ~h4 I v-~- ~ ~ ®~ ~ C,rotard surface elev ~•~ R '~ ~ b '~ ~' • -• Sol Rate ttpiaon Depth Oominarrt Redox Desaip6w~ Texture Sirurdure Consistence Botsdery Ruts GPDiff~ itt tlMx>seN Du. Sz CoM. Color Qr. Sz Sh '~ '~ ~ O~IO tDYR z/z - ~ k Ynfr ~ ~b •~8 2 ~o- ~o~RS/ ; l ~ mfl of 3 3 i u YR~/mar - / m v~ • a /•F ~ y- • ~ 3 ~/~ -. mfr a of • cQ ~ .o -~- ~oY1251 -- s m l - 1 /f •~ ' •~ -6~ i 12 E w~S TJIS Tl IOus ND ~ UP av9 Gt. ~~ ~ ~ 12121 ! '~H~S PITS EMI fI TlD Eflkrerrt tt'1= 80D > 3 D <~0 rtgfL and TSS >30 < t 50 mgA,. ' E1lfuent Ill = BO D = 30 rrgA. erld TSS = 30 rrglt. . CST Nerve (Please Prhq Siege ~ J E^~ ~Y u ~ 3121~itiT ~ address Date Evalve~on conducted Telephone Number 2r~12 iOT~ A~F ~a2inlti VaLLEV ~Wl D~ STh-.ZDa~- 7/S •772.39~4Z Ulbricht & Associates Private Sewage Consultants 2812 10th Ave. Spring Valley, WI 54767 ~~~, ~o K~ ~~ o~• i/~y~ ~o ~~ 2 ~ 3 ~ - u~ R k ~ Hp~ _ pepgl in. Da1i1R18d Mvn~ Red00c Oesorip6an Qu. Sz. Cad. Color Texlute StrlM~u,e t•ir. Sz Sh. CAffOe Y oo ' 'E~'1 2 q'3 0 51~ i t K a s ~f 3 -51 I D YR y/4 - S I fi' Q. 5 of , (p ~ • D 4 51 -! ~o R 5l~ I - aYf ~~ ~ • c~ ^ B«.,g~ ~ O Plt c~.~asura~ele~-. ~r. ~ ~ ~ ~aor ~ soi ~ ~` Horizon Dept in. Oo~r~ined ~Acr~ Reclaoc OesaipQoa GUt Sz Cad. Color TexAre Stn~cNse (Y Sz. Sh Canoe Bo~x~dary Rods 'Eti~1 a o ~ , ~~,. ~ ~b ~,. ~, Bale ~~ G'PDVlg Hartmn ~ Redaoc DesaiPtim_ Teodure Ca,,ae Bau,dar,, Roots Hortton ~ Tm,6ae ~,r~e Conroe -- yv~c~ - r~vrc rc. ~ r Linrc ~ ~ ~ b ~ o ~# ~~ ~ -d o ~) ~ ~ Z ~ ~' ~r rn rn U m~ w ~ 'N _ o ~. ~ ~ ~ N ',~ 'o ~) ~~ -W m r o ~ '~ c~ N A ~ ~ N,, c3~ ~ ~ ~ `" ~ , c° ~ ~ ~ n_ ~ .cfD ? y~~S~ ~r 003 o ~ -~ ~ o~~` 0_3 p ~e--- ~ ~ 6 m r r p ~ -_ ,, .. 2 ~~~ ~~ ~'~ . ~ °a t U ., ~ ~ __,_%, 3 F--- D ~' ;P r ~ Z...~ ~i, ~ -mi u w ~+ ~ ~.i __. y y ' .., ~ ~ o A m -~ ~ w o~ ~ ~ r~ 3 ' ~ N ~~ z~ ~ rn ~- ~ mQ ~ N ~ A rn ~' Z dZ vo r~ z ,~' n n tN p b 3~-b ~ ~ ~ ~ 3 ~ Z °i- • 'Q i% n ~. s 0 ~~ /~/2 . /~j~UdS o.~ 3 0 % ~~~5 ff/~ _ S ~ 5 ~ ~ s 7 ST. CROIX COUNTY ZONING OFFICE Gets. CERTIFICATION STATEMENT ~~~ S T/~-~~5 'FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the ~.~,~)',~~.° ~ O ~~/(J N ~ residence 1/9 = s ~ Z located dt; , - 1/9, Sec. y T N R l W , , f~UDsO•~.~ , Town of Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced ~~ • 20~ ~~ Did flow back occur from absorption system? Yes X No (if no, skip Approximate volume or length of time: ~~b gallons next line) ~ O minutes Capacity: /~'~ G~,QS . Construction: Prefab Concrete ~ Steel Other Manufacurer ( i f known) : L(j i~~,5'~ Age of Tank ( if known) : ~CJ'~~c /J~~D~~'D ~ --^ (Signature) (Title) (Name) Please Print (License Number) (Date) corm to be completed by licensed plumber (s.195.06, Wisconsin Statutes) or `Licensed Disposer-(NR-113_Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification _ In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, Wis. Adm. Code (except for inspection opening over outlet baffle). ~~--- Name~~}7j 7~~~ Signature ~• ~~~~~ e~ 1 ~X43? S -!f~'/MPRS 5 / 8 8 Ulbricht & Associates Private Sewage Consultants 2812 10Th Ave. Spring Valley, WI 54767 Parcel #: 020-1164-70-000 12/13/2004 01:47 PM PAGE 1 OF 1 Alt. Parcel #: 7.29.19.985-987 020 - TOWN OF HUDSON Current ^X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * =Current Owner * LOKEN, DAN M, & LORI J ANDERSON DAN M, & LORI J ANDERSON LOKEN 309 HARSHMAN DR HUDSON WI 54016 Districts:. SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 309 HARSHMAN DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.068 Plat: 1929-EDGEWOOD ESTATES SEC 7 T29N R19W EDGEWOOD ESTATES LOTS 55 & 57 56 Block/Condo Bldg: LOT 55 , , Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-29N-19W Notes: Parcel History: (~~ 5~ Date Doc # Vol/Page Type 07/23/1997 1109/185 W D 07/23/1997 716/572 9(1(1d CI IMMARY Bill #: Fair Market Value: Assessed with: -- - - - -------- -- - - 49037 209,000 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.068 33,100 128,600 161,700 NO Totals for 2004: General Property 1.068 33,100 128,600 161,700 Woodland 0.000 0 0 Totals for 2003: General Property 1.068 33,100 128,600 161,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 136 Specials: User Special Code 018-RECYCLING Category SPECIAL ASSESSMENT Amount 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 CJC6(,ti... j oocuMENT No. WARRANTY DEED TM1e e~ACL R[eLR\[D /OR R[CORO1Ne DATA STATE BAR OF WISCONSIN FORM 8-!ed>f r _ ' ~ • REGISTER'S OFFlCE . ~ ST. CROIX CO, WI Brian K. Chamberlain. and Debra L. Chamberlain, Rec'diorReoord husband and wife.r' Z T 1995 ................................... ...................................------. ........................ JaN conveys and warranq to ....1?all..M....~kEn.a..~..S~J0.Q~@.]?~'~RA. ....-..... X~• . \ . • ......._. ,.. a~.~es , ................. 'i W~~t. and..Lor .-~ ..Andessom a- .san ...... as..~4?in1i..~~nan~a..and..nab..aa..tananza..i.n..aQ:oman.A ..---.... A°~cfDeeds .. ..... .....................................h........................................................ ................ R[TURN TO ..................................._......:a.. ................................... _..- .................... . ................. ......................._....._ :..y.: ._.................. .........................-. the following dexribed reai rotate in ..=_..... .. ?I..._......._ .......County, State of Wisconsin: Taz Psrcel No :................._........._ Lots 55, 56 and 57, Edgewood Estates Subdivision in the Town of Hudson, St. Croix County, Wisconsin. I This ...... g ................. homestead property. (is) (is not) Exception W warranties: Subject to a/a/se/m~en~ts, reservations and restrictions of record. Dated this ..-.,..::.....l.U-`I%L/.~...-----•-;'....._. day of .--•--......_....~.---Janus?X .........................•--•--. 18.95... .....:...................:...............................•--._....--(SEAL) .....~~4!-~».!-1.~%~G!*.-~!~QS~~f-----.....-..-....-(SEAL) -•---•--• .............°---.........................------._...... • ...~ --.BRIA),i..K...CIi]~?A~LH31?.... _.._.........._ ..................................................(SEAL) .._...5./...~..l.~lll~ktiti^il:CnJLhM,.(SEAL) • ....._......°--•-•----------•-•-•--• ...........................•- • ---...DEBRA..L,.-CHAMBERLAIN---•-•-•---........_ AIITHSNTICATION 3ignstare(s) antbenticated this --.----.day ol ........................... 18_....- ACHNOWLEDOMBNT 3TATE OF WISCONSIN St. Croix ~ es. --------------------------•----......_Connty. Personally came before me this ----~'r[' ..day o! -----..__rTanudxy-------.~.._..__... 1955..._ the sbo~e names ........Stiam.1C.._.Chamtlezla in..and..._..._._~..._._._.. • ._._....11e1~a.L....Chamberlain. ..............~------.:• TITLE: MEMBER STAT>l: BAR OF WISCONSIN (It not- ---------------------------•-°------------•----......_..__. ...-•--------•--...----.._._......_..---......----......__...._............._... authorized by ; 708.08, Wis. State.) ~y a known to be the rson 5..._...... who e:ecnted the RQ~~~ Vy ~~L1 /going ent d aclcnowled~e the same. THIS INSTRUM[NT WAS DRAFTlD BY:I - ~QT~1 PUY1.w STEPHEN J. DUNLAP ~T~ OF W15G?N~JM-..-- - - ._..__.. ------------------°-----.. `/ ` ...-- .._._~ _- .____•_~_,. Hudsonr__ Wiscon3in Notarq blic St. Croix ...County, Wis. (Signatures may be antbenticated or acknowledged. Both My Commission is permanent. (If not, state ezpiration ara not necessary.) / Q date _ .-f-~-~-•------•---••---........._.._._, 19_Z~•) 3~ .~ _ ~1 1 sO.b3• - i aw aw ~~-~< _ O ~~ ss~r-~s#- ~ s-w ... .. ~~~~~ Off. C,~Ei) LETS r 37.38,39 ' ~• 8. 9 4~l,42,43 ~Il • R20 10, 11 44, 45, 46, 47 12,.13, 14 40,48,49,50 15, 16,17 51, 52, 53, 54 ~N.FT.fET i8. 19, 20 21, 22, 23 55,5b,57 58.59,60 E _ 24, 25, 26 61.62,63 Z~• 28. 29 6,65,66 `30, 3'i, 32 67, 68, 69 33, 34 70, 71, 72 _.r_ 35, 36 _ EASE~~~~~°. , OE LOT 4111+EE TasL - T - ;~ 't`angent 1 ~} _ B~~ Baaxing 1 ~ - ` ~~'~ ,. ~~+iE t~8~9°1 l X20"E '` • $~~°1~~l !~~'~°#452"W ,~ 't :_ , . .. ;` ~ ~$ 3~5©'fqi S89°11t~0"W~ ~~Z°36=20"1N 5~5°$7~26'~~ S17°iL3~tla"E S5°L6~16"W t~.b~' . I ~T?EO LANDS ;,- LOCH SECTION 1.2 ~ '~ SECTION • ~ _ S'1' CItUIX CUUN'I'Y S[;l'~'1C 'TANK IV~AINTCNANCL AGRECMENT ._-.~.... ANb - OWNERSHIP CCRTIClCA7'ION COILM ~iR. M2S . J7 w G d K~'~ Uwner/:3ttyer _ *T Mailing Address _ ~ O ~ /j~f}-/~,S' l7/''I~~(l ~ ~ . hropeit4a,~,Address ~ ,. (Verification required from planning Department for new construction) City/Slat:' ~ y~S O'J ~/ parcel Identification Number 02.0 • //~i y 70 • OaTJ LEGAL llESCIUC'~'lUN - . 9~,~,v ~ ~ ~ ' I'toperty Location Nom'/,, s~ r/~, Sec. ~ , T Z / N-R // W, Town of ~T UaS OiV Subdivision EDG'C"~OQD ~S' Ti¢-r-~ ,Lot # 5S• 54 , S ~ Cettlti:;d Sarvey Ibinp # Volume ,Page # W~rranly Ueed # S2 5 Z,~j b , Volwne ~~_, page # I $~ Sltech~ttse U yes jr~no Lot lines identiCable yes O no . SYS'1'1•;N~ ItiU,IN'I'ENANCE Improper use and mainlenanceof your septic system could result in its premature failure to handle wastes. proper maintenance consists of romping otrt the septic tank every three years or sooner, if needed by a licensed purnpet. What you put into the system can a[1'ect the function of the septic lank as a treatment stage in the waste disposal system. rthe property owner agrees to submit to 5t. Croix Zoning Department a certification Corm, signed by the owner end by a master plan-fiber, .Irnnneyman plamber, restricted plnrnber or a licensed pumper verifying that (t) the on-site waslewaterdisposalsysrem is in i+ropc~, ,peraling condition andlor (2) alter inspection and pumping (if necessary), the septic iank is less than iii ['oil o[ sludge. Ntive, ~hF ~,ndcrsigned have read the above requirements and agree to maintain lire private sewage disposal system with the standards set ford.; herein, as set by the Deparlrnenl of Commerce and the Department of Natuta) Resources, Stale of Wisconsin. Cedi[icaNon stating ~iraf your septic syslcrn I,as been nrairrtained must be completed end returned Io the St. Croix County Zoning O[tice within 30 ' days of the three year expiration dale. ~ ~ . l :3111 ~ l ~~'tt h [ 1 ICAN'1' - UI\T6 UWNLIt GEIt~'1T'1CA'1'ION ~ ' i (we) certify that all statements on This form are true to the best of my (our) knowledge. I (we) Am (are) the owner(s) of the properly. described above, by virtue of a warranty deed recorded in Register of Deeds Office, r 'rul:_~ ~ n hi; cnrlr ~ DnTli 'r'r r`*~ Aay information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. **~~~~ ~~ In;ir~!;e with this ahpiicaHon: a stamped wnrranly deed fr6rn the Register of Deeds office ,; a cony of the certified survey map if reference is made in the warranty deed Ulbricht & Associates Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT ~`~' v. ~ OWNER ,`~,,~ ~~I~, hN-,~;~;,,-~~ TOWNSHIP ~~' ,~ s/ SEC. T N-R W C" l ~ ~ ~.~ ~ Cc. ADDRESS ST. CROIX COUNTY, WISCONSIN p2~- ~ 11~~-~a-~ SUBDIVISION `~~..~~~AJ~y.~,~;~~';~/ LOT LOT SIZE ~- PLAN VIEW 'Distances and dimensions to meet requirements of ILI~R 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM _ -- __ _ __ ---~-r--- ---- ---_ -- ~ c,~ _ _ --- _ ~ ~,; u ~ ~ ~ ~ ~) n ~. ,, ~1 ~~ ~' ~~ `~1 1 ~_~ ~~ .~- t ___ ,- ----- __ , ---- ~, L _~ INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used , f~/%'~~ l-~ Elevation of vertical reference point: --rlji, Proposed slope at site: ~~ PUI~ CHAMBER Manufacturer: Liquid Capacity: f ,,,s 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, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: X, Trench: Width: ~:~ Len~th: ~;:~ Number of Lines:~_ Area Built: cam' ~,C Fill depth to top of pipe: ~{ ~ ~~ Number of feet from nearest property line: Front, ~ Side, O Rear,O P't.~, Number of feet from well: rL .f~ Number of feet from building: ~.~ ~~ (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: 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, OFt. Number of feet from well: Number of feet from building: Number of~.feet from nearest road: Alarm Manufacturer: DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING: LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS Dlvlslon P.O. BOX 7969 BUREAU OF PLUMBING MADiSON,'W}~ 53707 ' CONVENTIONAL ^ALTERNATIVE State Plan LD. Number: ' ~ ^ Holding Tank. ^ In-Ground Pressure ^ Mound (lf assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Brian Chamberlain 3909 65th Ave N. ~~1 7,Yn Ct. MN5542 -/~~~ BENCH MARK (Permanent reference poinU DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. LE V.: SW NW, Section 7, T29N-R19W, Town of Hudson, Lots~655-57, Edgew od Est Name of Plumber: MP/MPRSW No.: County Sanitary Permit Number: William Schumaker 6382 St. Cro' 75048 SEPTIC TANK/HOLDING TANK: MANUFACTURER: / - LIOUID CAPACITY. TANK INLET ELEV.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER ' /, ~/ 10 g~'~" P OVI D: ^ PROVIDED: ~' ^ /r ES NO YES ~,ti11N0 BEDDING: VENT DIA.: VENT MAT L.. HIGH WATER NUMBER OF ROAD: PROPERT WELL: BUILDING: VENT TO FRESH i ALARM. FEET FROM LINE: AIR INLET. ^YES ^,NO ^YES NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIOUID CAPACITY PUMP MODEL PUMP/ H MANUFA ER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ^YES ^NO ~ ^YES ^NO ^YES ^NO GALLONS PER CY CLE: PUMP AND CONTROkS ER no NUMBER OF PROPERT Y WELL- BU ILDING. VENT TO FRESH (DIFFERENCE BETWEEN f FEET FROM LINE. AIR INLET: PUMP ON AND OFF) ^Y NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the de of pl ing LE'vllTll DIAMETER MATERIAL AND MARKwG or excavation. Ilf soil can be rolled into a wire, constructions all cease until FO CE the soil is dry enough to continue.) M IN CONVENTIONAL S YSTEM: BED/TRENCH WIDTH: MM ~ LENC3,f1{M ` ~ ' ~ , NO. OF TRENCH E& DISTR. PIPE SPACING. COVER MATERIAL' PIT INSIDE DIA.. SPITS: LIQUID DEPTH: DIMENSIONS I v ~ _. ; .t _, GRAVEL DEPTH FILL DEPTH DISTR. PIPE DIST R PIPE DIST R. PIPE MATERIAL: NO. DISTR. NUM BER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES- >' .i. ABOVE COVER. , / ELEV INLET ~S ~ ELEV. END. - r, --~ ~ ~~~ PIPES: ~ FEET FROM , LINE. J~ ~ ~ ^ ~ G AIFµ{VL6T: / } ~~/~f(-/~ c~ NEAREST V -i. I MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ^YES ^NO SOIL COVER TEXTURE. PERMANENT MARKERS. OBSERVATION WELLS. ^YES ^NO ^YES ^NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED: CENTER EDGES. ^YES ^NO ^YES ^NO ^YES ^NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTN LATERAL SPACING. GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER. BED/TRENCH TRENCHES DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING. ELEV.: ELEV.: DIA.. ELE V.. PIPES. DIA.: ELEVATIQN AND DISTRIBUTION INFORMATION 'HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED PLANS. ^YES ^NO _ ^YES ^NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: ,~ v FEET FROM LINE: / ~ '` ^YES ^ NO / " ^YES r ^ NO NEAREST _a d ~ , ~ ~ 7 , . ~ :^~" ~t ~ ~+~ . 'mil ~ __-_- Sketch System on Reverse Side. DILHR SBD 6710 IR.01/82) w ~~ ~~.~ ~~., I J `) .> ~~ w'S`°nsv, APPLICATION FOR SANITARY PERMIT ~ILHR (PLB67) °EPggTTEnT °F rK)USTgV, lgB°q 6 MUTgn gElRTM7r15 w OUNTY UNIFORM SANITARY PERMIT # '~S'o Yf -Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8Y~x 11 inches in size. -See reverse side for instructions for completing this application. PLEASE PRINT PROPERTY OWNER r • Q H- MAILING ADDRESS .Q>7~s~ 6Sfjj (,LuG~// ~ / C PROPERTY LOCATION CITY: S , T N, R E (or TOWN OF. [/ T NUMBER BL K NUMBER SUBDIVISION NAME N EST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER =3 L-' PE OF BUI G OR USE SERVED ~~/Q _ /// or 2 Family Number of Bedrooms: 3 Public (Specify): ___.._~ ! ! 10 THIS PERMIT IS FOR A: ~..., .New System ^ Tank Replacement ^ Repair ~ ~~~ ^ Replacement Soil Absorption System ^ Revision ^ Privy ~ ^ Alternate System ^ Reconnection ^ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. ~ Seepaye Bed ^ Seepage Trench ^Seepaye Pit ^ Holding Tank System-In-Fill ^ In-Ground Pressure ^ Vault Privy ^ Pit Privy ^ Existing, For Which A Previous Permit Is On File, Permit # issued ^ An Existing System Thai Has Been Inspected And Is Compliant As Far As Soil Conditions. Total Gallons #of Tanks Prefab. Concrete Site Constructed Steel Fiberglass Plastic Septic Tank Capacity Lift Pump Tank/Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEfJI COMPLETE THIS BLOCK: ^ Mound ^ In-Ground Pressure Total Gallons #of Tanks Prefab. Concrete Site Constructed Steel Fiberglass Plastic Septic Tank Capacity Lift Pump/Siphon Chamber Manufacturer. PERCOLATION RATE (Minutes per inchl: ABSORPTION AREA REQUIRED (Square Feetl: ABSORPTION AREA PROPOSED (Square Feet1: WATER SUPPLY: 3 j"- ~ Private ^ Joint ^ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber (Printl: Sign'atu/re: MPRSW No.: Phone Number: Plumber's Address: Name of Designer: ~7 ~r COUNTY/DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ,~/ / ^ Disapproved ~ /~~~~r ~ ~ (,/~ J, ® / ` +~/ + y ~ ~ ~/ / ~y_~/ -f,/~ ^ Owner Given Initial (.V .GL r..1~1~~,~G•(,l~YNL ~J ///rrr ~~- i (p ~I Approved Adverse Determination for 'Alternate coursels) of Action Available: DILHR-SBD-6398 (R. 5/82) 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 ~>ro~~erty being developed. Any inadequacies will only result in delays of the permit is;;uance. Should this development be intended for resale by owner/eontractar,("spec Douse"), then a second forts should be retained and completed when the property is Sold and submitted to this office with the appropriate deed recording., (h.~ncr of Property __ ~_~.a~ ~~..y..~J~t~ location of Property ST ~ ~ k~ ~, Section ~ , T a~ N - R ~~ W 'T'ownship f~ ~~ Ma 11 ing Address ~~ ~"~¢~ ~~~~s~~- Subdivision Name ,~. )~.~____F~.! Lot Number~7TS S6 S'7 Previous Owner of Property ~c„u,,~ ~ ,n..~7a_~.,-l ~fi~ ~.n- ~ ~c.~> 'To'tal Size of Parcel ~ L'it~~ Date Parcel was Created ~ ~ ~Q~ y ~ ^ Are all corners and lot lines identifiable? ~ Yes No !s e.I,ls property being developed for resale (spec house) ? Yes ~~ No Volume ~ and Page Number /..3-- as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office Iii addition, a certified survey, if available, would be helpful so as to avoid delays cal the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PRUPERTy 0[UNER CFRTIFICATI~N 1 (Gle) ce~t%by -tha-t a.~-Q. a~ateaneYt~ an -th.i,a Bohm ane ~icue .to zh.e be,~.t a~ my (awc) IzYtuwkedge; ~tha-t 1 Iwe) am lane) the awneh(b) a~ .the pnopenty debehi.bed .in ~t~t,ia %t~bunma~%an bonm, by v.uttue ob a warvcanty deed neeanded .tn ~h.e Ubb~.ee ab the Cuuri.ty Reg-i.a.ten ob Deedb a.a 'DoeurneYtt No. ,~ ~ ; and .that I (we) ~~t e.~ e~~ tx y awn .the pnapoe ed a.it e bon the sewage po~e ya.tem (an I f ive l have [1~:t~I.-C.f?f'i:~ iii eQ-~~+ii~.r~, .ia 1tUn ~U-(.t`.il ,~:i2e a~UVC'. dP.h~.r(•~.~ei.~ ~7~'i,a~Qi'L.t~~ bJ ~ X22 cnYVSt/juc;;i.an ob da~.d .6y~~t'em, and .the tame Star F~een du.Ey neeanded .in ..the Ubb,c:ce ub .tlte CauYLty Reg.c~.te~c ub Deeds, a~5 ~ocumeYtt Nv. ~~_~~ ~s ,, _ _ . _ t .- - _ :~ ,. if t. ~-- ~f - T.- , -,~ .. - - --;~, '~ DOCUMENT NO. -_ _ ~7 a 4 Z„ ~ ; wAr DEED ' .::: TMU ...c. as,swiao e. ~qw ~ } ~'' ~: .~~? " ; BTATE BAB OF WISCONSIN F01t1[ !-~ ' "°'~` s , ~ 16P4.57~ ~F~ x ~t r :. .. "~ 4° 8• ~ H. Develo ,'~f~~~i :"TtalS OFFICE ; ~ ~ a. "ris~ons~nrcorporatioric~ ~ ............ '1Gr'aii• "T' CkC~iX CD•• 1~VI5, r b .... ..... ... ....... .....:.: " ..... ....:.. .. .. tort.... .' ~a'd t;.c Re;arti this 19th ~~ coavey~?~aad.pae+~a`ts to''f .'.~x~~n,.K .~.. .. .............. .... .~,~~ ~~ July A.D. 19~ '~ ~' .Fiitsb,atxl Md Wif ....laebra L. D.f~ ................. '~~ p ~ ~ ~.,, ... .. .. ~. `e~ :`~.3oint.tenants...~ ................(.C~.~s~X6~~... ~~ ' the folloMria! described nai, state i ZY~yII'1~r~tD~aa•,,~,,aa,,,,~~...• .. .. ~;.t,.j.,~ ~. .4~stab of w>+coasiA: ~ "" `''~~li••>S~~ I• C~RiX t7otuity Part vwf ~ ~ .; ,; ~ ' . ~ ~ .~ ~_ ~~'~ ~~ ,-_ ~. the 5~1 `NWT of Section 7, T2 Ta: Pares! No :......................._.-., ,, ~. -more fully described as follows;~~ ~~ Lots 55s~, 56 .&. 57------_--- - ~ , , ~. ~: ~ ~; »~.. - recorded Se of the Plat of Edgewood Estates, .; ptember 11, 1984, in Vol. 5 of Plats, Pa a 15 ~; ~~ ` -, : ~'.~. ;~, .. ,.. 9 , Doc. ~ 3960 ~ ~ r r} TOGETHER ~1ITH.,~d SUBJECT TO the Protective Covenants x:;1984 at 11: g0`~a.m., in Vol. 695, ;Pages-529-531 .~- °. Amendments To°Protective Covenants recorded Set recorded Sept 4 in Vol. 697 p ' Doc• 1396044, and the -• thins ' ages 166-172, Doc. ,1396609, which ~ 28' 1984 at 8:30 9 , that the aforesaid Lots are bein Provide a.m., ?k~containing at°aeast 43,560 square feet, and~thatethesia' among other darts thereof~ma COmbination the aforesaid Lotsnarebc°nnectedeto municipal sanitar ndividual Lots or Y conveyed or mortgaged until all of facilit.ies.. Until such connection, said combination ofsewer and water _~owned and used only as a single unified parcel for one ~{ and appurtenant buildings as described in said Covenants Lots shall be ",;.any of said Lots automaticall single family home, .:, rights and obli Y entails membershi Ownership of ` gations of, Edgewood Estates Homeownersand the resulting a~as described in said Covenants. ~~~ Association ~, ~ ~ Y °' This . ~.s . nod, ....... ..Inca, ~~,,. , ~, homestead property. _ ,TOGETHER WITH and SUBJECT TO gp .. t "easements, covenants, reser y'~'d- sil .~~e ~ yat~o~ ! l recorded documents referred.to:hereintbein ~f record. ister-of ~4,.: ~ ~; ;.:~+~ f~r~aic, ~- ~:.~ Qeeds :for St. Croix County, cvisconsinn the Office of the ." ~'~~` cad .this .. . 1.8'th y of .Jul _ °~' ~ . da b: s } ~ ~• ........... ,iB~_.& Y... ,.A~.,~.+tirc~~•~ ..~-s5~..~.i~`:CyaK,85.~~ ~~ r :; r ~ - .. i. ~ ~ . ' .. H Develo went .~ Inc.... a >oarp~~g9ii~ , ~ ~ ~ l3~: tc ~ _ ~ ~ Ck , BY i r 'a.s~~1.f.~.~„ .~/.__~~ 3 . is ; iv ~.%1 i3.~ ~(~ ~~~,'Rsa. i ~d'#~~ ~b 3~~ci~~cck_~ :~:~i„e,~r`~.- ~~+DpnB~d~_Fy.~7~$' 3E~ ~~ +~~~. ~ `~ ~ ~~' t~~-~~ r? z~.. . r ~, . ~. ~ ; , :.~~ ~ .. ~orns~ad, Preaidel~~~ ,~~ ~~~Gr~ l ~ ~~ ~ it ~k ~~'d.. ~',~~.n..~ ., ~c~~.:, ,~~ max- illia L ~ 1 = ~ maw Harwell, Secre~~ u ~ i,,,`$c o ' ; `, ti 1"#~ r r ~, ~ ti ' # ~ , <~"g~' ~ '4,'~t.-~-r'~+,1C.~L~? ~-;'LSDIi~[~ Di~k+.~ - h ~ ~,, '~ j 4 ~' `a~ ,STATE OF ~ ~ ~ ~ ~ ";r~ " +~ .WI~NgI~ ` z r r a H H O z d 9 H pn H 0 E z x H b STC- 105 ~~_ ~ SEPTIC TANK MAINTENANCE AGREEMENT ` ~ ~ St. Croix County OWNER / B U Y E R ~ ~~ ~~ (_ ~~„~}a,~.~~r ROUTE/BOX NUMBER Fire Number C I T Y / S T A T E S p~_r~Q P ~,.,r ,,,_ Z I P SCI f~ PROPERTY LOCATION: ~~ ~, ~~~ ~, Section, T o~Y N, R~W, Town of f'~ pt~„~ St . Croix County, Subdivision ~;?t~~ ~ Lot number ~~56 ~~ 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 m_~' a maximum of 60% of the cost of which was in operation prior to accepted this program in August owners of all new systems agree maintained. be eligible to replacement o July 1, 1978. of 1980, with to keep their receive a grant for f a failing system, St. Croix County the requirement that systems properly 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. 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. Certification form must be completed and returned to the St. Croix County 'Coning Office within 30 days of the three year expiration date. [j SIGNED YC~~,la,,,~r ~ ~ _ ~r.,,,t, D A T E ( ~Q ) S ~S S~ St. Croix County Zoning Office P.O. Box 9S- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. r - , ~; ~~09~~8 ` ~. .1 c~~PAGE ~~~~~ AFFIDAVIT (mEGI5TER5 OFFICE ST. CROIX CO., WIS. Reed. i+or Record this 17th STATE OF WISCONSIN ~ day of A~A.D. 19 86 SS at 10:45 A. ~ ~ ~___ COUNTY OF PIERCE ) James O'Connell haYw o! DNi. I, ARTHUR L. WDGERER, Certified Soil Tester, hereby depose and say: That I have completed a percolation test on Lot 57 of Edgewood Estates, located in the SW~ of the NWT of Section 7,T29N, R19W, Town of Hudson, St.Croix County, Wisconsin; That said percolation test ws.s-made for a proposed sanitary sewage disposal system intended to be installed on Lot 57; That said system is intended to serve a home to be built on Lot 56 of said plat; And that I make this affidavit to inform all future purchasers of Lots 56 and 57 of the possible existence of said system. Arthur L. Wegerer _C. S.T. No. 576 Subscribed and sworn -to before me on this ~ day of /~ ~ 2 ~ c ,1986. - Notary ublic, State of Wisconsin _ My commission £K~n~~ec (,-; ~-~ ) This instrument drafted by: Arthur L. Wegerer O H r 1D = 7 ~ m 1 v V N tG ~ G Z j m N D ~_c~ O ~e ~a m -~ 0 V ~~a~ ~~ ~ ~ O ~ ~ C (D o ado ww~ ~- w co ~ A3~Da om,. M 1"- ~ ~ c Z~ o c ~ ~ w N < ~N O N ~ C ~ Q: ~ ~ t/1 ~ w ?w o N m amA M 1 N~~Da QN m vi w a ~~o ~ c ~ m ~ a cnM ~ c 7 d w ~, w a " ~ N o ~~ ~ c ~ a~ ~ ~ a ~ ~ 3 ~ a ~: .. ~, ~ , f11 ? C C N 7C- ~ A A (fl 7 ~ ~SQ1 coww~,~~ C ~ ~ ~ d (D (D ~ p ~ N ~ ~ A U1 ~ ~ W O -~' (D 7 tD m 'c m Q, N ~~DO'mo~o o ~-~~~ w ~ ~ w a o ~ s`~~,~y ~ ~ ~ o °c~ Q~ ~ ~ o~oa~~ oho-.vv ~ w Acs c -~ .. ~ Dy an o .-. O N cD O f O .. aQ~ N ~~~~wN w f N ~ ~ ~ m w ~ ~~m ~~NONa O ~~~° n ;w?~wo ~-•~ > > w mysacc~ aN A ~ cn . v m ~ w 0 ~ n:cu ~ stn w~~~?; (D ~ -~ A W O cND c ~ ~ ~ ~ Q~~as~ ~cc ar?m ~ N ~ A tD O ~c~u-i~cw SC cp O .+O ° ~ o ° 3 ao ~ o ~' a o ~ ~ a 0 C N z a v z D "~ .,~ D m ~ ~ ~ c m n ~ S - a ~ m ` `` s ivy ~ w ^I 3 .~ o oQ ~ DEPARTMENT OF ~~1-0~~ OIV ~o'L ~0~1~~~5' ~`~~ SAFETY & BUILDINGS INDUSTRY, p DIVISION LABOR AND ~~RCO~~10~ ~ ~J~S (,~~,~) MADISON WI 53707 NUMAItl RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWN HI MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: ~~.~,~,~~/ ~~ ~ /TZ° y/R I°~E for ~~so~ ss-s~ - r=bG~wooD Esrf~TEs COUNTY: OWNER'S UYER'S NAME: MAILING ADDRESS: ~q~ 9 6 S 7}{ R V E • Iv. *~ I sue-. c4ti ~ x ~~1 A-,1 C~1 AI''1 I3 ~ LA I -~ 3~ o L_ F.~ G~-rU'T~'~ ~ M N 5 S ~ 2 9 rec NO. BEDRMS.: COMMERCIAL DESCRIPTION: ^ ®Residence "L ~ ~• Replace New RATING• S= Site suitable for system U= Site unsuitable for system DATES OBSERVATIONS MADE IPR FILE DESC IP IONS: ER LA ION TESTS: ~!-~l-$G t1-~-86 ONVENTIONAL: ~s ^u MOUND: os ®u IN-GROUND-PRESSURE: ®s au SYSTEM-IN-FILL as ®u HOLDING TANK: as ~u RECOMMENDED SYSTEM:loptional) ,Zt ~3Sr ~~~~~~Nh~ ~~ DESIGN RATE: If Percolation Tests are NOT required t~ Ii any portion of the tested area is in the ~ ` ' ^ , under s.H63.09(5)(bl, indicate: ~~ • `~• Floodplain, indicate Floodplain elevation: , v i'\ PROFILE DESCRIPTIONS BORING TOTAL D PTH TO GROUN DWATER-Ifd~~S CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH iW; ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED ISEE ABBRV. ON BACK.) 1 S.o' q5.6' 1vo-.~E 7 S.o' \•3~Dtc8n51`CS ~o.6~Bnsjl ~\.S~$h~1 ;y.6•~3n i--,Q=,! S B- -Z `1•~~ gy.sj tl > 1• fo' 0.7' 'r ~0.'~'8h IS'1•o~b1~c$nSi l • 3-2'bnsi ( z.. o' Br SI B- 3 q.3• \oo.s' tl 7 q-3' 0.8'0~~ sITS •e•s'QI, >~a~ s 4 ~.Z' 1oO.o' `~ 7 ~1-'2.' o•~'OtL3nSl~TS i\.1'8t~ SI I ~ O.-1'Bhs~i6'~~hM?~ 6- S .3' q~.~' tt 7 (~•3' o• .I ;2.0' ~, •Z..3' .r •~.Z' ~I • (0 8•~' 98• s ~ -t 7 8• ~ ' o• ~' -I ~ 1 • S/' ~~ I- 3 ' ~~ ~ S.3' ~r B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER fNE-F*frS AFTER SWELLING INTERVAL-MIN. P RI D 2 P R PER INCH p_ 3 6, g~ _ LsL. ~ o t. 3' G 3 P- l-'-S S 1`l •2.. I 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. 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