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HomeMy WebLinkAbout020-1151-20-000 \ o k Q § � § � _ % 2 0 \ � 2 � \ � § � £ � � \ i * m � \ � L f � ■ k \ k V q § $ a m § \ z 2 } J t g ■ w = E / � \ 0 { ƒ c $ \ k ) \ 1 2 \ » t E w i _ 'E 2 \ ) _ � 2 ■ (D � 0 # a � # o o a k E \ k k k L ) _ E m k � k 2 2 2 � IL k \ 0 k C,*- ƒ � 3 & � §E \ \ D o E C a \ k \ ƒ i (D 25 ° / 2 E , , § \ q % ] 0 a o � C-4 � ■ - a § \ q 2 \ c 0) ® � -� § § } if k o 2 = / ) ■ Af 2 2 a k CL k (D k 0 c u a ■ io U) u . s Parcel #: 020-1151-20-000 12/20/2004 10:56 AM PAGE 1 OF 1 Alt.Parcel#: 29.29.19.820 020-TOWN OF HUDSON Current ❑ ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): *=Current Owner *HARTMAN, GLEN R&DEBRA J GLEN R&DEBRA J HARTMAN 726 GLENNA DR HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *726 GLENNA DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.014 Plat: 2356-PRESIDENTIAL ESTATES SEC 29 T29N R19W PRESIDENTIAL ESTATES Block/Condo Bldg: LOT 11 LOT 11 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 29-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/20/2001 651724 1684/425 WD 02/23/1999 598253 1405/382 WD 07/23/1997 1080/612 WD 07/23/1997 752/495 2004 SUMMARY Bill#: Fair Market Value: Assessed with: 48906 275,500 Valuations: Last Changed: 10/26/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.014 27,100 186,000 213,100 NO Totals for 2004: General Property 1.014 27,100 186,000 213,100 Woodland 0.000 0 0 Totals for 2003: General Property 1.014 27,100 186,000 213,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 128 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 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: Width: j„Z Len the o Number of Lines: Area Built:—?'a y Fill depth to top of pipe: Number of feet from nearest property line: Front, O Side Rear,0 Ft . r" Number of feet from well: 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, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: il' �_ Plumber on job: License Number: 41-;�-? IF, x r Form - S T C - 104 � a AS BUILT SANITARY SYSTEM REPORT OWNER . Lim Ygc44r TOWNSHIP -�<<iG< / SEC. i29 T Z_9 N-R ZLW ADDRESS �a��' I✓i�r�_ ST. CROIX COUNTY, WISCONSIN SUBDIVISION ,,L�r.uY,r, s'1.OT l < LOT SIZE r/ PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM IX v INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site: / SEPTIC TANK: Manufacturer: h%, --�.� Liquid Capacity: /Ca,'7� Number of rings used: Tank manhole cover elevation: Tank Inlet Elevation: 2.71' Tank Outlet Elevation: �., S:? Number of feet from nearest Road: Front 10 Si.de,o Rear, From nearest property line Front 10 Side,O Rear,© Number of feet from: well building: (Include this information of the above plot plan)( 2 reference � r /I no()/& DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 0 Nb4DISON,fVI 53707 BUREAU OF PLUMBING ' EXCONVENTIONAL ❑ALTERNATIVE State Plan I.D.Number: SE, Std; ,;9, 29, 19W (If"signed) - ❑Holding Tank ❑In-Ground Pressure El Mound Toor14; resii ential Estates NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Mike & Sue Krager 905 Colonial Drive Hudson WI 54016 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.. Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: William Schumaker 6382 St. Croix 88482 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: (�U �oc TV /f �3r53 SYES ❑NO ❑YES lL NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH /� ALARM FEET FROM LINES + AIR INLET. DYES �NO ❑YES NO NEAREST 1T �b \` DOSING CHAMBER: MANUFACTURER. T ING: LIQUID CAPACITY: PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER _ PROVIDED: PROVIDED: ❑YES ONO ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WE LL BUILDING. VENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) DYES ❑NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing I LENGTH DIAMETER MATERIAL AND MARKING, or excavation. (If soil can be rolled into a wire,construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: LENGTH: NO.OF JDISTR.PIPE SPACING: COVER INSIDE DIA. #PITS LIQUID BED/TRENCH ` �� TRENCHES �� MATERIAL: PIT DEPTH DIMENSIONS a RAVEL DEPTH FILL DEPTH DISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO. STR. NUMBER OF PROPERTY WELL: BUILDING. V NT TO FRESH BELOW PIPES. ABOVE COVER: ELEV.INLET ELEV.END nnn PIPES LIINE: AIR INLET. NEARESTO ► l9S —JO aS 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- ❑YES ❑ meets the criteria for medium sand. TIONS MEASURED. NO SOIL COVER TEXTURE JPER"ANENT MARKERS OBSERVATION WELLS DYES ONO ❑YES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED. SEEDED MULCHED CENTER: EDGES. OYES ❑NO DYES 11 NO DYES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH. LENGTH: NO.OF 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 DISTHIBUTION PIPE MATERIAL&MARKING ELEV: ELEV.: DIA.. ELEV.. PIPES DIA.: ELEVATION AND DISTRIBUTION r NFORMATION 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 FEET FROM LINE: DYES N ❑NO NEAREST nn WzIQ 10A..�/ -7 rA ° x .53 Sketch System on Retain in county file for audit. Reverse Side. RE: r TITLE. DILHR SBD 6710(R.01/82) On Adminigtr—atgr- C.. Nelson INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT ' APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; . 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable; 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed if there is a change in your building plans, system location, estimated wastewater flow (number of bed- rooms, etc.), depth of system, or type of system; 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation; 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years; 6. If you have Juestiohs 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: 1. Property owners name and mailing address. Provide the legal description where the system is to be installed; I! 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. Compete ##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 13'Y2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form. --- ------------------------------------------------------------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more commonly known as the groundwater protection law. This change in statutes was the result of over 2 years of steady negotiation and public debate. The groundwater bill Ground ateF.- inci.;ded the creation of surcharges (lees) for a number of regulated practices which Wisco [It'S 0 can effect groundwater The surcharese took effect on Jull, 1, 1984. All of the water that buried reasutte' iF; used irf yo:.,r building is returned to the groundwater through your soil absorption �� o system or the disposal site used by your molding tank pumper. 0 non s :Mlle cteci through these urcharges are ci edited to the groundwater `_nd _idmirds- b;f s-ie _,apartment of Natural F--sources. These `unc�s are used for mon!tar ig c;rc,ur;•1•- t gy;-;,v dwater contamination in estigations and establishment of standards Groundwate­. protecting Gt 39& 3 03.'86; �ILH SANITARY PERMIT APPLICATION COUNTY � U R In accord with ILHR 83.05,Wis.Adm. Code U/ STATE SANITARY PERMIT## —Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8Y2 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 [Z NO PROPERTY OWNER PROPERTY LOCATION IV I j ,i '/45'4,1 '/4, S,2 TA , N, R lr E reo PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME c S CITY,STATE ZIP CODE PHONE NUMBER EJ CITY NEAREST ROAD,LAKE OR LANDMARK R VILLAGE : II. TYPE OF BUILDING OR USE SERVED: 1W ' (/O��— /16/—,-7(/ ' Number of Bedrooms if 1 or 2 Family X`�' OR Public(Specify): y III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable) 1. a. ® New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in##1 and only one in##2) 1. a. 9 Conventional b. ❑Alternative C. ❑ Experimental 2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ® Seepage Bed b. ❑Seepage Trench c. ❑ Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): d 00 2 X K /ay" 'o f,5—, Feet RaPrivate ❑Joint ❑ Public VI. TANK CAPACITY Site in allons Total ##of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank ❑ ❑ ❑ Li 1-1 Lift Pump Tank/Siphon Chamber VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Stamps) /MPRSW No.: Business Phone Number: tv, S c _sp 3 Plumber's Address(Street,City,State,Zip Code): Name of Designer: C So ,' Y VIII. SOIL TEST INFORMATION Certified Soil Tester CST)Name CST# CST's AD SS(STreet,City,State,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature(No Stamps) 51Approved ❑ Owner Given Initial Surcharge Fee � 2^ K;7 Adverse Determination; ��� 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%eontrac Wv, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property Location of Property S; k .5,V Section ;2 T N - R l 9 W Township Mailing Address moo/ ,Q a✓,-, S" Subdivision Name Lot Number fl Previous Owner of Property Total Size of Parcel 9 ire Date Parcel was Created Are all corners and lot lines identifiable? r< xes No Is this property being developed for resale (spec house) ? Yes X No Volume 7,5 �2- and Page Number '�,, 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 In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTV OWNER CERTIFICATION 1 (We) ceatiSy that aU 6tateme-nt4 on th,i,4 onm ane true to the befit of my (oU4) knowledge; that I (we) am (ahe) the owneAla� o6 the paopenty des cA i bed in thi6 in6o4mation Jonm, by vi tue of a wauanty deed neeohded in the Oi6ice og the County Regi4lteA o6 Deed4 a6 Document No. , and that I (we) p&eaentty own the pxopased site -jon. the aa:ge 'A�4tg-oa (OA I .(we)-,have obtained an ea4ement, to nun aith the above de,6-- .dbed paopeAty, Jo4 the con6t4u.ction o f aa.id a yltem, aAd the same ha4 been duly neco44ed in the O jjice o6 the County Req"t. en o f Deems, ab Document -No. SIGNATURE OF OWNER SIGNATURE OF CO-014NER (IF APPLICABLE) DATE SIGNED DATE SIGNED pppppv- I r STC - 105 y SEPTIC TANK MAINTENANCE. AGREEMENT c St . ,QCrolx(J County 9 H OWNER/BUYER - -- C° Q)8�b Eire Number ROUTE/BUX NUMBER — CITY/STATE Hudson, Wisconsin _ wZIP 54016 _ PRUPEKTY LUCA`l'IUN: NW � ,lti. Section_. 28 T_29 N , R 19 Town of St . Croix County , o .65 ` eA.fCSnumbc�r S u b d i v i s i n -•—J-�--- Improper use and maintenance of your suptic system could result in its premature"failure to handle wastes . Proper maintenance cun- simtm of pumping out the septic tank evury three years or suoner , it needed , by a licensed tunic tank LqtUer . What you put Into the system can affect the function of the septic tank as a treat- went stage In the waste disposal system- SL.— Croix County residents ma be eligible to receive a grant fur is 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 u,ystema agree to keop 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-Mite 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 . o I/WE, the undersigned , have read the above requiremen ts and agree 4A to maintain the private sewage disposal system in accordance with P" the standards set forth, herein, as set by the Wisconsin Depart- ^o ment of Natural Resources . Curtlficatlua form must be completed and returned to the St . Croix County Zoning Off1j:e within 30 days of the three year expiration date . . S I C N E U-�Y��c.� 7� DATE St . -C .•oix County Zoning 'Office P.O. ,lox 96 ilammopd , WI 54015 715-7 16-2239 or 715-425-8363 Sign, date and return to above address . r �r �o a� x � o 0 a o W I \ Ll wlav �o� DEPARTMENT OF REPORT ON SOIL SINGS AND SAFETY&BUILDINGS INDUSTRY, DIV1SiON P.O.BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON WI 53 077 HUMAN RELATIONS (H63.09(1)&Chapter 145.0451 LOCATION- S TOWNSHI UNICIPALITY: QT NO.:BLK.NO SUBDIVISION NAME: Sr. 1/4 5w"/4 Z9 z R #(o �� I/ — PktSr rA ST'47 s COUNTY: WNE q ST CRoIX Mix& Soo K4Q(IER C6C6NPAL1k /YU 1SOtJ IVi S4,0 � USE DATES OBSERVATIONS MADE NO.B DR 1COMMERCIAL DESCRIPTION: DESCRIPTIONS:1PERCOLATION TESTS: PResidence VN XNew ❑Replace 1 _14 M,4^ /9,&7 M�iteW 3 /9�7 SeSe[S &ae PAI,CCC Sole_S I8$ -6e1RrH^tVT RATING:S-Site suitable for system U-Site unsuitable for system rM M ONV N L: MOUND: IN• -FILL OLDING TANK:RECOMMENDED SYSTEM: optional) S ❑U [IS U C ❑U S ❑U 0 S M If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b),indicate: CLsQS$ = Floodplain,indicate Floodplain elevation: A/A PROFILE DESCRIPTIONS B6_R A O U AT CHARACTER F SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH ELEVATION V D N TO BEDROCK IF OBSERVED SEE ABBRV.ON BACK.) B' 1 qj< QTV NON L'_ y 6„ELStTS /6"h4 &e Cs<Gc s9"e.72AK Al If � r'B- z 9.53 48.41 No1vc > 9 Sa 6*tL'%L rS i/ tT$RNMStGR 97"$itAICU4e S �N s B- 3 io,6� 99.13 Nt 10.67 �''8«i S z7'&OV st6e �3 KbivMS16C 44"&tW6 SA /0,75 7'%Q-rS 1oND+;5��t6te zelaer4cS46e d! f Y st B- 4 /p K lUO.SS 466E ' B_S 7 ��c.Ts rz•'BaN M 5 �s'Gr 5, w o � A, ItfVV " � 9,Z�a ON�� `, S 1p'$ M-Cr:,4G W RDfLTeRNC-MS 14"&.M-C SiClR B- 66//4r18Qry C-M3 1�6R PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DR75P IN WATER LEVEL-INCHES RATE MINUTES NUMBER 11 5 AFTERSWELLING INTERVAL-MIN. PER INCH P_ r 6 o NoNic 9js'S5_ P- Z c 8,9 1 3 7 2 2 c'Z P- qoyi IJ910_ 3 Z < P- r T P4 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- rontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings end the direction and percent of land slope. SYSTEM ELEVATION k,oiAQV - q� Y .. VV .. � • ON11L4I1 Q O� Df N ' /ond C'n ,��,b o p�� a •� � V M� , 25 16 Nadso r ro n0 n�i u� u U'D 0:N' Crur nt�y Q 4v 5YSTEM C/.fi, Lnc. Es.S : :c+,a:: r� /�/ TtO tN _ . . . . . .emu .,r. .Luca J '. :�. 44e4% .L ss a,to L.oughns,� .I e^0 .w ;� reses,an ss.r.s 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. ME(print): TESTS WERE COMPLETED ON: ,� N M c 3 /?87 / 7 /,IA�VEr o NSo D CERTIFI ATION NUMBER:M6-4o8o E NU 8 (optional): 4o7 '56.�N Sr ubSQ Wt S40/b 9484 aRFvls&b M►kr?cu q /4��- tr,�tNG,ser�PErv � Sys-nm ELi.\/A1'1014 LOtn�L°k'Ch, DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DII.HR-SRD-6395 (8,02/82) -OVER - L ,O x d O 1 '�, � '• ��? to • M \ 1^ ' 2 `1 g o � • Yo, DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS INDUSTRY, DIVISION C P.O. 60X.7969 LABOR ANO PERCOLATION TESTS (115) MADISON,WI 53707 HUMAN RELATIONS (H63.09(1)&Chapter 145.045) NO.ISUBDIVISION NAME: .0 A SECTION.fTON: TOWNSHI UNICIPALITY: !/w1/ Z� /Tz R U s T�4T S /A COUNTY: OWNER' U AM E: AA ES S: 'ST C Rd,►x Mix.Li cit, i0AC-E k WIONIAL DATES TES0 OB13S W S40/t; USE ERVATIONB MADE NO.B DRMS.: COMM L DESCRIPTION: p S' Residence VN New ❑Replace NIAAGN Z /9�7 I►1A�t:N 3 / f TF7 SwLs P,ec r UG Sobs $X$ _&►ReN�+t�'T RATING:S-Site suitable for system U-Site unsuitable for system L M jr EM M C.&I-- _71 ONV MOUND: IN- FILL OLDING TANK:RECOMMENDED SYSTEM:(optional) Ids ou os wu its ou sou os 4 If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the �� under s.H63.09(5)(b),indicate: C LA-IS 2 1 Floodplain indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL P R U ATER-INCHE CHARACTER F SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTHI%. ELEVATION OBSERV D TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B- r 49.zt n(avrr 7< 6�/$�s LTS /6/fit $reNcn.16t S9"cr$lm AlS't4t `B- Z > 9S0 6'$CSLTS /1/4-r'$RNMSt6R Cn"8+NCs�ye �SSAN s B- 3 /0 6� 99, 3 N 10.67 �t�$�LiS z7/$ N �6t �� KB+zK msf6 t '*[�B�,rC. /o.7s' -7­&LTs /o"IK&N SL 2z~eeNeS46e CA i Yr s, arcs B- Jr jvm /00-S s' 46P4 , c-S 46A S 7"$4-LTS IZ"&N M S F'6y S t.• O Mr Al /^I WAA4 B- q.,-]� 9,-44. ©14 Er 9, S /O L M-CS lGeT, Rb*LTgRNC'MS AlkM•C S14A 66/14ri0nl C-MS �6R B_ Der- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER IBS AFTERSWELLING INTERVAL-MIN. PEAIOD 1 PERIOD PER INCH P_ / 6.oS IJo F CM-IS5, 3 >2 >2 >Z <2 P_ 3 >7 P- n 9.70 3 >Z P_ i _. r T P4QL P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION P+MOM - gZ,so qx • ' ; �. L[oT •Pi:A7 1`Lbtu ®Pl TAE oa y v :. • • VV .arup:C :!. k 1 t1� y,vian ` ,,•�• G shin Lt7CAT►ord 04 o6ci H. Lee, e/c+/ • (Ni//a.n ' ss •.fo Lo�i9hna ', 5�✓ �!i� /ev+e--.nun/ ,►►a9slh szs:` .. . 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. TESTS WERE COMPLET DON: NAME Jprint/: /?87 ? /14i2Vr.y 3oNNso CE FI ATION NUMBER: HONE NUMB (optional): A D --4d 6 3 64 386-4080 4o7 �coN S7 UDS� ( S CSTSI ATURE: Rt=V1S�D M►42CU 9 /gTs�' Jt►NC,SEIPENtb Sys-aw EliLJ►4T1014 �OtrJL't21C� DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. DILHR-SEtD-6395 (R.02/62) -OVER - �et'- OL S<< cw�eY' Age i, rb 11 7 6 m a CFO owl M `h m�