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HomeMy WebLinkAbout020-1097-12-000 -0 C) 4) c 0 t3 cn 0 Z E U. C 0 Cl) (D z E z 0 z » k V v) 64 0) $co c 0 z .0 C: U) i- E w '2 z 4) (D N 0.6) a) cc 0 0 a) c U) 0 0 0 z co z 0 z co C', 4) Cl4i m E m 4) CL 64) LO to 0 4) 0 CL E C) E 04 < 0 U) U) I Z CN > L) ■ CL U) 0 0 0 z 0 '� j CL CL CL CL c 0 U) 0 co co 0 U) -j 10 m a) I z zz C') '0 C') m a ci C) E C,0 -0 0 CD D Q) ca a. (D < >- 05 16 B C*4 c co ° 2 E 00 0 4) a- 0 CD 11 0 r- CN '7 C, I-- M 0) ii! . -1 A 4 CD r- 75 — 0 Lo N Z 4) r N E N vi :3 0 U) *6 g m 10 co 1: 00 0 z z U) m EL 0 i CL IL E 0 0 IL 0 U) PUMP CHAMBER Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size 1 { 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 i Bed: Trench: Width: fZ. Length: Number of Lines: -�Z– Area Built:! Fill depth to top of pipe: v Number of feet from nearest property line: Front, O Side, Rear,0 Pt . � Number of feet from well: Number of feet from building: 3 D (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: rm Manufacturer: t-1 Inspector: Dated: Plumber on job: T— License Number: 3/84:mj �►. Form - S T C - 104 AS BUILT SANITARY SYSTEM REPORT OWNER �_,y��Pl�S TOWNSHIP , SEC. T N-R W ADDRESS �� -5d,11 ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT ten--. LOT SIZE i PLAN VIEW Distances and dimensions to meet requirements of IZHR 83 i SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM w v2 INDICATE NORT ARROW BENCHMARK: Describe the vertical reference point used S,, s l Elevation of vertical reference point: l Q�_ °` Proposed slope at site: _ SEPTIC TANK: Manufacturer: �� Liquid Capacity: Number of rings used: —S� Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front,®Side,Q Rear, 0 feet From nearest property line Front 10 Side,O Rear,O �Q feet Number of feet from: well y, building: Z( (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE EPART NT OF fgDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION BUREAU OF PLUMBING P,O.BOX_-A969 MADISON,WI 53707 (CONVENTIONAL ❑ALTERNATIVE Stated) .Numbe assigned)(lf ❑Holding Tank ❑In-Ground Pressure ❑Mound NAME OF PERMIT HOLDER: rDESS R OF PERMIT HOLDER: INSPECTION DA E:Larry Ahlers ute 1, Hudson, WI 54016 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.: SE'-, NE14 S33-T2!fN-R19W Hudson Township Sanitary Permit Number. Name of Plumber- MP/MPRSW o.: County: William Schumaker 6382 N St. Croix 88472 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LAB L LOCKING COVER /v� .s A O IDE P IDED: NO [d)S YES S ❑NO YES BEDDING: VENT DIA. VENT M HIGH MAT R NUMBER OF ROAD: PROPERTY WELL: BU %ING: AIR INLOT RESH JALARM' FEET FROM LINE' ) OYES NO DYES NO NEAREST DOSING C AMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. PROVIDED:LABEL PROVIDED OVER ❑YES ❑NO DYES ON O OYES ONO GALLONS PER CYCLE: PUMPAND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING: VENT LE FRESH LINE AIR INLET`. (DIFFERENCE BETWEEN FEET FROM PUMP ON AND OFF) OYES ED NO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing 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: BED/TRENCH WIDTH: ILENU H: NO.OF DISTR.PIPE,SPACING COVER INSIDE DIA 1CPITS ILIQUID DE H �t TRENCHES /l/G— M ERIAL: PIT DIMENSIONS +4 GRAVEL DEPTH FILL DEPTH UISTR.PIPE DISTR.PIPE DISTR.PIPE MATERIAL: NO. STR. NUMBER OF PROPERTY WELL: BUILDING. V NT TO FRESH BELOW PIPjS.1 ABOVECVER. :�L T EV.ENp n ^,S Qs PIPES. FEET FROM LIN� ^I� LET. lFV /7�(�J !/ NEAREST �•Q 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. DYES NO PERMANENT MARKERS: OBSERVATION WELLS OIL COVER TEXTURE EY E S ONO ❑YES ❑NO DEPTH OVER TRENCHIBED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER. EDGES. OYES E NO EYES ONO OYES ❑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 UISTHIBUTION PIPE MATERIAL&MARKING ELEV., ELEV.: DIA.: ELEV. PIPES DIA- ELEVATION AND DISTRIBUTION HOLE SIZE HOLE SPACING: DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED INFORMATION PLANS OYES ONO DYES NO COMMENTS: E PERMANENT MARKERS: OBSERVATION EL NU BE OF PROP LINE:ERTY WELL: BUILDING: DYES ❑NO 10:01 ES 1-1,40 (/ NE T IIIJJJ Sketch System on Ret 'n in county file for audit. Reverse Side. SIGNATUR - TITLE. DILHR SBD 6710(R.01/82) 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 vyhenever'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 applica°ion must include: I. Property owner's name and mailing address. Provide the legal description where the system is to be installed, IL 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; Ill. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8'%2 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 ater included the creation of surcharges (fees) for a number of regulated practices which wiscorzin., can effect aroundwater. The surcharge took effect on July 1, 1984. All of the water that buried lrea SUri is used it,! your building is returned to the groundwater through your soil absorption u system or the disposal site used by your holding tank: pumper. a The monies coilectee through these surcharges are c edited to the groundwater fund adminis- tere,, by the Department of Natural Resources. These funds a;e used for monitoring ground-- t vitater, o!oum-lwater contamination investigations and establishment of standards. Groundwater, ' s wart! protecting. DILHF� SANITARY PERMIT APPLICATION COUNTY G'�v x In accord with ILHR 83.05,Wis.Adm.Code 57 �,.. STATE SANITARY PERMIT# ,9y7 –Attach complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. –See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION–PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES ❑ NO PROPERTY OWNER PROPERTY LOCATION s +� .Ce SOcr 1/4 � %, S 3 Ta14 , N, R E (Or)6 PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY,STATE ZIP CODE PHONE NUMBER TY VILLAGE: NEAREST ROAD,LAKE OR LANDMARK D/G Go II. TYPE OF BUILDING OR USE SERVED: — 10417-1,P-000 Number of Bedrooms if 1 or 2 Family 3 OR ❑ Public(Specify): 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. 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 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) �}F r,�r� 1. a. Mconventional 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. X Seepage Bed b. ❑seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): a, l Feet ❑Private ❑Joint ❑ Public VI. TANK CAPACITY Site in oallons I Total 4 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 l poo, 1❑ Lift Pump Tank/Siphon Chamber n ❑ VII. RESPONSIBILITY STATEMENT 1,the undersigned,assume responsibility for installation of the private sewage system show on the attached plans. Plumber's Name(Print): Plumber's Signature:(No Sta ps) P PRSW No.: Business Phone Number: Plumber's Address(Street,City,State,Zip Cod Name of Desig er: �'YArb' VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST## 4L't- 57:�, .2 y CST's ADDRESS(Street,City,State,Zip ode) Phone Number: y I-V e a 21- poi 9 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps) Approved Surcharge Fee y pp ❑ Owner Given Initial U(7 _ / Adverse Determination •UJ / Ids /✓ v r�►�G 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 i APPLICATION FOR SANITARY PERMIT STC - 100 i This application form is to be completed in full and signed by the owner(s) of the property bring developed. Any inadequacies will only result in delays of the permit isswa►►ce. 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 suld and submitted to tltis office with the appropriate deed recording., - - - - - - - - - - 1. w - - - - - - - - - - - - - - - •- - - - - - - Owner of Properrty Lucat tuu of Property 5,0 Is 114 Section I, T Q N - R /JW W Tuwnship Mail tub Address 0V7- / Ala dSgAl al Subdivision Name C Lot Number Previous Owner of Property ffc /� � ��'' e Tutal Size of Parcel 4. dcvca I)Jte Parcel was Created Are all corners and lot lines identifiable? � Yes No lb Lhis property being developed for resale (spec house) ? ! Yes No vulwne and Page Number as recorded with the Register of Ueeda INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract J. 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 Lhe reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey flap shall also be required. PROPERTY OWNER CERTIFICATION I (we) eeAt i.6 y tita.t a.t e#atemen.te on -thiA onm ane true to the beet o6 my (uun) kiiuwtedge; .that 1 (we) am (ane) the ownenldl o6 the pn.opexty deaeh.i.bed in .ti" i►►6u-unati.un 6onm, by vi tue o6 a wavtanty deed neconded in the.066ice 06 the Cuun ty Reg-i.a.ten o6 Deeds aA Document No. 7j•3 : and that I (we) p,qe,se►t-txy own ,the.pnopoaed d.ite bon the Aewage poa6a -6ya.tem ion 1 (we) have ub.tAuned an easement, to nun With the above de cA bed pn.openty, bon the eu►ytAucti.on o6 bai,d &ptem, and the same hab been duty %eco&ded in the 066.ice u6 .tile County RegiAten 06 Deeds, ae Document No. IV SIGNATURE OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNI:U DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING DAII WARRANTY DEED • w U87R3 91Q� !58BAGE_488 This Deed, made between .._- _Kenneth J. Kreye and ST. CROtX Co. X115; Karen Kreye- aka Karen A. Kreye2 husband and wife --------------------------------------------- PwoM. fur R-. orf] it:is- - I—St -- - ---------- ------ ----- - -- - -- - -- --------- ---- -- ----------- -- Grantor, day of _ OctA.D. 19 86 and_ Larry .Tay Ahlers and Heike I. Ahle rs�--husband 11 :25 A and wife e M. -------- -- ------ --------------------------------------, Grantee, �c�hlr d Dwd� Witnesseth, That the said Grantor, for a valuable consideration-._-__ --- -- ------- -------- --- --------------------------- ------- ----------------I------------------- I conveys to Grantee the following described real estate in .-_- St. Croix RETURN TO County, State of Wisconsin: Tax Parcel No: --------------- --------------- Lot Two (2) of Certified Survey Map recorded in Volume 5, Page 1483, as Document Number 397058; being a part of tre Southeast Quarter of the Northeast Quarter of Section 33, Township 29 North, Range 19 West, Town of Hudson. ` This warranty deed is given in satisfaction of that certain land contract dated the 12th day of January, 1985 and recorded on January 15, 1985 in the office of the Register of Deeds for St. Croix County, Wisconsin, in Volume 704 of Records, pages 135-136, as Document Number 399150. This --is not homestead property. $n€$ (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And------------Gr4ntor-------------------------- ------------ - -------- ------ warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations of record and will warrant and defend the same. Dated this - U--- -- October - ... - 19.86. - day of - - ----------(SEAL) * K nneth J. K e e ---- - --- --- -- ll ---- - lam(, ----- -- --- (SEAL) /,� - (SEAL) J * ----------- - -------------------------- -- - - * _.._.Karen--Kreye . . -- AUTHENTICATION ACKNOWLEDGMENT Signature(s) ----------------------------------------------- •----------- STATE OF WISCONSIN ss. ----------------------------- ------------------------------------------------- St. Croix --------------- County. authenticated this ________day of--------------------------- 19------ Personally came before me this __ ----------day of October , 19.86._. the above named •-------------------- ------- ---------- ---- ----------------- - --------- ----------Kenneth__J.__Kreye--and_-Karen_Kre -------------------------------- TITLE: MEMBER STATE BAR OF WISCONSIN ------------ - ------------------------------------------------------------- (If not, 1{?•Ry NUe authorized by § 706.06, Wis.- is. Stats.) _ .h/^" �i„ me known to be the p son _S-------- who executed the 1+ 1 egoln men a a knowledge the same. THIS INSTRUMENT WAS DRAFTED BY Steven B. Goff Attorne at Lay r 2 ---' -------------- ------------._ ._-. River Falls, Wisconsin 54022 OF V,il� .�. 7 _ -__.____C- ___... __ ___ ----------- ------ ___ Croix S --- - --- -----County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary.) / date: `-- �b'� -Names of persons signing in any capacity should be typed or printed below their signatures. STATE BAR OF WISCONSIN ^^ H.GMullerComparry� FORM No. 1—1982 Stock No. 13001 STC - lU . > SEPTIC TANK M�►INUNA CS ACKEEMEN'r o St . Croix oun� y > UWNEk/BUYEk� tth"�Li't�� kOUTE/BOX NUMBER s'aw/ _ -Fire Number -,--- _ CITY/STATE f�(c�-��.v,✓ 1�1 �` S '° T G 11' PKOPEKTY LUCATIUN :s,: 1, Section *W3T T N , N_/9 W , Town of�,��dn/ _ , St . Croix Cuuuty , Subdtvisiop Lot number i improper use. and maintenance of your septic bystvm could result in its premature failure to handle wastes . Prupur utairttenance Con- *16L4 ut pumping out the septic tank every thcve years or buott.-c , I it nat:ded , by a licensed sn tic tank ,ku!%L r . What. you put into the Sybtem can affect the function o'f- t4w septic tack as a treat - ment stage in the waste disposal system. St . Croix County residents M!!.y be eligible to receive a grant for a maximum of 60% of Chit cost of replacement of a falling system , which was in operation print ' _--. St . Croix County ¢LCepted this program in August- of 198U, with the requirement that owners of all new s sy tems, agree to keep their systems properly maintained. 'rise property owner agrees to submit to St . Croix Cuuuty Zoning; a certification form, signed by Lite owner and by a master plumber , journeyman plumber , restricted plumber or a licensed pumper veri - tying that (1) the on-pit* wastewater disposal system i,s in proper operating condition and (2) after inspection and puutpir►g ( it neC - ebbary) , the septic 'tank is less than 1/ 3 full of sludge and scum . Certification form will be sent approximately 30 days prig to three year expiration, o 3C 1/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- 'v sent of Natural Resources. Certification form must be completed and returned to the St . Croix Country Zoning Offkre within 30 days of the three year expiration date. SIGNED DATE r2 C St . Croix County Zoning Office P.O. Box 98 Hammond , WI 54015 715-796-2239 or 715425-6363 Sign , date and return, to above uddress . L > w INSTRUCTIONS FOR COMPLETING FORM 115 - SRD - 6395 ' To be a complete and accurate soil test,your report must include. 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 1 MAXIMUM number of bedrooms or commercial use planned; 4, Is this a new or replacement system; 5. Complete the suitability rating boxes.A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale= is preferred. A separate sheet may be used if,desired; fit. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; J. Complete all appropriate boxes as to dates,names,addresses, flood plain data, percolation test exemp- tion, if appropriate; 10. If the information (such as flood plain,elevation)does riot apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and your certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL. TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cols Cobble (3- 10") SS - Sandstone gr - Gravel (under 3") LS - Limestone '`s - Sand HGW - High Groundwater cs Coarse Sand Perc - Percolation Rate n ed s - Medium Sand W - Well fs Fine Sand Bide; - Building Is - Loamy Sand - Greater Than sl Sandy Loam < Less Than 'I - Loarn Bn - Brown sil - Silt Loam BI Black si - Silt Gy Gray "cl - Clay Loam Y - Yellow sci Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles w Sandy Clay w' - with sic - Silty Clay fff - few, line, faint Ic Clay cc -- common,coarse p1 - Peat mm - Many, medium m Muck d - distinct p -- prominent HWL - Nigh water level, * Six general soil textures surface water for liquid waste disposal BM - Bench Mark VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. DEPART,A'%ENT OF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS IN[3USTRY, G DIVISION BOX 76 LABOR ArjD HUMAN,RELATIONS PERCOLATION TESTS (115) MADISON WI 537907 9 53707 (H63.09(1)&Chapter 145.045) LOCATION: SECTION: TOWNSHIP MUNICIPALITY: LOT NO.:BLK.N .: SUBDIVISION NAME: s� �/VJ/ �� T�N R��E (o W /-�fL �-o z � G . s. . COUNTY: OWNER' UYER'S NAME: MAILING ADDRESS: T. C�OSx ��✓ti�Ty .��� �E .� / f-, CJ C7SO��/ N��• USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DES IPTION: PROFILE DESCRIPTIONS:1PERCOLATION TESTS: Residence New ❑Replace I .�_. / _ 8 4' ?- 84- RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK:RECOMMENDED SYSTEM:(optional) NS R S ❑u oSOU 0S au oS y]u If Percolation Tests are NOT required DESIGN RATE: q If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B-/ -7. �� �o o.s' — c:) � �i-7• � ' .� / r2.F3 f �'.� s �S �;J B- 0 1 E3. / ' 'o-¢.-7 8 . o ' �.; s i //. �:� rte.; 5 (�.ss B-¢ . C, ai. � � -7C, ins/ �/. SJ B- Jo 4( PERCOLATION TESTS g�,�,�,vsa2c�� S 4TT/2 E GO/KA TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ P- 34CD ..... �� P-_ 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. INITIAL 98.b0' SYSTEM ELEVATION REPLACEMENT 100.80' I ON IPE O DER HO E 33 14 _ AC SCALE 0, E ( I m - 1 3 E �- + z V ,V r i AOi, f COR. Lo r2 I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME(print): TESTS WERE COMPLETED ON: G-4c/.s'` E.•._. c E t-✓. �°L�l c.r.��'��y `7 —• G�— 8 '��' ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): "2¢¢Is— CST SIGNATURE: S¢c Z 'RIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. R-SBD-6395 (R.02/82) —OVER— CERTIFIED SURVEY MAP KENNETH J. KREYE Part of the Southeast 1/4 of the Northeast 1/4 of Section 33, Townsli.p 29 North, Range 19 West, Town of Hudson, St. Croix County, Wisconsin. o 0.8.11. LOT 1 OL.S,PAGE 817 I a —!.Y j UN PLATTED LANO8 1� e O M p b _ S89• 46'00"E 599.47'R(EAST 600.00') 299.47 ' O I e w 300.00, r0 $82 4'OS WW 153.50 O © 92.51'' NO ACCESS LOT& TO C.T.N:'NO �I Z ,4%`M% \qc Olv S � �'�ii ( c I t~ r LAURENCE': 40 ri ° <I m W MURPHY I. Z do - ri LoT& M N _ O ro 2.376 ACRES M J S 1713 �► 01 103,500 SO.FT. �' I 2 _ N�•:,RIVER FALLS,.;*, NET- 2.177 ACRES •ice F •'•.,••WISC.••.••• Q •0 94,6 17 so.Fr. • 9 J . z �'�•,�� LAND S��.•�� I a 3 ; n c I O OI c DUPLEX o e o, t .. S89.46'00"E 300.00 O) 8 a GARAGE h W O q W I 1~•I � m n ° o IJ W oI L a O GARAGE cc° b alp LOT I 3 I 4.744 ACRES q 0 206,634 S0.FT ft 2 NET i 4.389 ACRES O I 191„171 so.Fr. LOT 3 0 2.376 ACRES op N O 103,500 S0. FT. - n � "► a p 1 b N O Laurence W. Murphy -W IM > s Registered Land Surveyor ^ z u y W f0 O N > 2 99.4 7 3 00.00' a u o --NS9.46 00 W 599.47 R(WEST 800.00') N W u uNpLATTED LANDS SCALE IN FEET 1"a 100' O� g � b C O 0 50' 100' 200' 300' 01 y = O N ►� C O � Vol. Page ALL BEARINGS REF. TO THE EAST LINE OF THE NE 114 Certified Survey H It OF SEC.33, f29 N, R19W, RECORDED AS NOO.00'00"E Maps y C Dated: 31 July 1984 St, Croix County, Wisconsin o ; SHEET I OF2 _ O W V. r . sD O C OP o ®e S/ a � G v J .tee y �c Y l7'd� �h e� 5ysrcmr�a Filed g 19