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HomeMy WebLinkAbout022-1061-80-000 C) co 0 S a n d O I !D ~ it ~ ' ~ !IP 3 0 n a N e • 7' y O O/ C O N fD IV ~ *'4 CD 3 ° CD O v n CD 0 lA\ W O` C fD W y W y 7 O O C 1 A' CD SI 41 D) y 7 N o'1 W COO C, CD n S O N 3 0 0 o C I 7 y CD O co y CO r w (n~ID A 4 y y a m ; W c Q o iZ5 i3 p p 3 O C C Q L X 0) W o OVD V A I CA R c 3 y. o y w• 2 D W Z MA y (D CO) o ° D V~ 23 'o O c~ ° eD K) ! rn o ° Cil A A CC !ti I a o o O I O D B ° t*A . I ° CD cn @ 1 y 01 (D C I CD 7 13 I W a n 3 I Z CD ~ ~ p 2 CD A Z O CL G 0 I cn N m N o " Z o m ~ I g3i, Z ' CD A I W ~ I fl; a I w I 3 w C I o o a C C 2 y I S I y a. I I a I A I ~ I A I o I ~ I o ,b N CD A o a ,l . idw F DEPAFnMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 SE14, Sf'`4,S21,T28N-R18W CONVENTIONAL OALTERNATIVE Stare Planl.D.Number: (1f assigned) Towm. f Kit1nickinni.c ❑ Holding Tank O In-Ground Pressure ❑ Mound RivT Road NAME OF PERMIT HOL FAR: JADDRESS OF PERMIT HOLDER: INSPECTION DATE: Jay Clemens 691 Eaker Road, Hudson, WI 54016 /J -17--.0 7 //.L':~) BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: jC,5THL1-,1`I. ELI, V.. Name of Plumber [MP P/MRSW No.: jC..mY'. Sanitary Permit Number: Carl D. heise 3328 St. Croix 102773 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY. TANK INLET ELEV.: TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER ! PROVIDE D: PROVIDED. t,(~~'_.(_ '1 I U OYES ONO OYES fZNO BEDDING. VENT DIA. VENT MATL. 71GH WATER NUMBER OF ROAD: PROPERTY WELL. BUILDING. JVENTTOFFIESH LARM. FEET FROM LINE: AIR INLET YES ONO OYES ONO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING'. LIQUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL R P,R~PVIDED: YES ONO 113 0 Y11YES ONO ONO GALLONS PER CYCLE PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL BU17L TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE NLET PUMP ON AND OFF) OYES ONO 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 MAIN L the soil is dry enough to continue, i CONVENTIONAL SYSTEM: WIDTH'. LENGTH NO OF DISTR. Pi PE SPACING COVER INSIDE DIA SPITS LIQUID BED/TRENCH ~ C SJ TRENCHES h r MATtP IAL PIT DEPTH DIMENSIONS J eC > ` d, \ GRAVEL DEPTH FILL DEPTH DISTR PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR NUMBER OF PROPERTY WELL BUILDING VENT TO IHE S11 BELOW PIPES ABOV COVER. ELE V.INLET ELEV. END. PIPES LINE.1 1 ? ALH INLET FEET Z Z NEAR EST-i J IJ MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. OYES ONO SOIL COVER TEXTURE PERMANENT MARKERS OtiSEH VA TI IN WE ILLS DYES ONO OYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER EDGES. OYES ONO DYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH LENGTH TRENCHES: LATERAL SPACING GHAVEL DEPTH BELOW PIPF FILL DEPTH ABOVE COVEH DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL NO DISTR DISTR. PIPE DISTHIBOTION PIPE MATEHIAL & MAHKING ELEVATION AND ELEV.' ELEV.. DIA.. ELEV.. PIPES DIA: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS OYES ONO DYES ONO COMMENTS: PERMANENT MARKERS: OBSE TTOy WEL}S: NUMBER OF JPROPERTY WELL: BUILDING. FEET FROM LINE OYES ONO DYES ONO NEAREST j. a `i Q, J- ` Sketch System on Retain in county file for audit. ~j C' Reverse Side. SIGNATURE. TITLE i DILHR SBD 6710 (R. 01/82) Zoning Administrator j IRE% 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 questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material Complete for a// 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'/ 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 'aw. This legislation is more commonly known as the groundwater protection law. This change in statutes was the ? result of over 2 years of steady negot`'ation and public debate. The groundwater biii Groundwater - - included the creation of surcharges (t e>, for a number of regula ec )-actices which Jv'iscorkon's l e can effect groundwater. The surchar; 'onk effect on July ' 98 F^ ! of the water tha b t ie~ );ensure is used in your i. f It:.'l J is retu, n"^ gro,?pC,w i.te, system or the disposal site used fly ..sir °ytai< z',{s aeiL, r?t it,,. , ° ~y The moil ti! qtr ~sr v water, ;''s worth protecting ,Li-,-u:398 (R.03i86 i SANITARY PERMIT APPLICATION COUNTY ~T 9461)( L] N~ In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARYPERMIT# /0 73 -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 OWN PROPERTY LOCATION T~ e n Sr-- '/4 SL'/a, S T N, R J 8 E (or)o PROPERTY OWNER'S MAILING ADDRE S LOT NUMBER BLOCK NUMBER SUBDIVISION NAME er N C. S M. CITY, SATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD, KE OR LANDMARK k50n S ,JQ 0 VILLAGE : ` Ai II. TYPE OF BUILDING OR USE SERVED:°~ n Number of Bedrooms if 1 or 2 Family .cam blrrxs OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. X New b. El 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. I~OaF~ SYSTEM: (Check only one in #1 and only one in #2) IV. TYPE 1. a. j Conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. F1 Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1, a. ❑ seepage Bed b..ISI See a e 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): 4* / a 3, 0 8 g " 9 495 S -0 a ~a UP 419et Private El Joint El Public VI. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. Con- INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete strr cted Steel glass Plastic App Tanks Tanks Septic Tank or Holdin Tank oo /,O© tse~S Lift Pump Tank/Si hon Chamber TV 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) M Business Phone Number: av 1 9, cis 9 8 `7 .5-- 4,?S- 9 ► r7s Plumber's Address (Street, City, State, Zip Code): Name of Designer: I L v 57 (2111yd d- a /OQa S VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # La wt )l , 1M, 9,14 Ss CST's ADDRESS (Street, City, State, Zip Code) Phone Number: k* 6 o e F I Lcl s ~57 *-4 Q IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate issuing gent Signature (No Stamps) Approved ❑ Owner Given Initial charge Fee ; ` / ' Adverse Determination to 6C) PN 4_0 hj_ej X. CO ENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber APW APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property -J 7 gAi A~~,_____/~.~7 Location of Property 14, Section a-~ , T oZFN-R~ W Township ~J~ i~ ~~/1~~~✓ Mailing Address lwl Address of Site Lad- Subdivision 7 Name Lot Number Previous Owner of Property )CZ A,/ ~ • //c%/~ Total Size of Parcel Date Parcel was Created Are all corners and lot lines identifiable? _X Yes No Is this property being developed for resale (spec house) ? Yes _ No Volume 0 and Page Number L23 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) ceAti.6y that aU statements on thin 6onm au true to the but ob my (ou r.) knowledge; that 1 (we) am (au) the owneA(s) o6 the pnopenty described in this in6onmation bonm, by viA tue ob a waAAanty deed neconded in the 066ice o6 the County Regi--ten o6 Deem" Document No. ; and that I (We) pne~sentty own the pnopos ed site bon the sewage dispoem (on I (we) have obtained an easement, to nun with the above de~sn bed pnopenty, 4on the con,stAucti.on o6 said system, and the same has been duty neconded in the 046ice o6 the County Register ob Deeds, as Document No. / SI#7TUkE OF OWNER SI 106ATUI?X OF C OWNE (IF APPLICABLE) DATE SIGNED-- DATE SIG H.C. Millet Company Stock No. 13001 DOCUMENT NO. _ SPATE BAR OF WISCONSIN-FORM 1 p (~3 PA6E' 93 WARRANTY DEED THIS SPACE RESERVED FOR R RECORDING DATA i RE ASIM OFFICE THIS DEED, made between Robert H . Weigel and ST. CROM 00* WI& Esther D. Weigel, husband and wife, Wd, for Record 06 16th Grantor dev of Dec A^ 1.986 j and Jay R Clemens and Mary Kay Clemens, husbansi 8:30 A !6 - i+ an wife, as survivor-,hip m ri to property, AAA A.0-9 I Grantee,~ Wi t n e s s e It h , That the said Grantor, for a valuable consideration - - - Seventeen Thousana give Hundred and RETURN TO f conveys to Z~r thE~+toi~wi $ dreal estate in St - Croix County, State of Wisconsin:"` P.J'" . I Lot Three 3 of Certified Survey Ma filed November 12 Allver r . Vva*,sccnsm l 1986, in Volume 6 of Certified Survey Maps, on page 1740, i as Document No. 419164, in the office of the Register Tax Key No. of Deeds for St. Croix County, Wisconsin, being a part of Southeast Quarter of Southeast Quarter of Section 21, Township 28 North, Range 18 West. TMNSF FEE This is not homestead property. X($5~~i4~X Together with all and singular the hereditaments and appurtenances thereunto belonging; And Robert- $ Weigel and Esther T)_ WP; gP1 ,husband and wife, warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements reservations and restrictions of record; and will warrant and defend the same. Dated this day of December 119 86 I~ 6 (SEAL) (SEAL) * * r (SEAL) (SEAL) F Esther D. Weigel{ AUTHENTICATION ACKNOWLEDGMENT ? Signatures authenticated this day of STATE OF WISCONSIN l 19 ` ss.. PIERCE County. _ Personally came before me, this day of ii i December, 19A6 the above named ,j TITLE: MEMBER STATE BAR OF WISCONSIN Robert- H- Weigel and Esther D ? (If not, authorized by § 706.06, Wis. Stats.) Weigel h sbancl and wjfg~ I This instrument was drafted by ; r Charles E. White, Attorney at Law to me known to be the persIn recUted;t•Yre fore- ; goin instrument and acknowFe¢g d X7. e.-~ ' ;River Falls, Wisconsin 54022 ? jj (Signatures may be authenticated or acknowledged. Both 1.i are not necessary.) Nota y u is County, Wis. f l My o ion is ermanent. (If not, state expiration a e: , 19 - Names *Names of persons signing in any capacity must be typed or printed below their signaturejEF REY f,4, McCARD Notary Public - State of Wisconsin _ myCommission-Ex08, WARRANTY DEED-STATE BAR OF WISCONSIN, FORM NO, 1-1977 ' H 9 STC-105 r, r" a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z a L f OWNER/BUYER 77--A-3 M ROUTE/BOX NUMBER 7d54)C:7 ,6~ Fire Number J~l CITY/ STATE `&/,75 ZIP PROPERTY LOCATION:s'k, Section, T a$ N, R_W, Town of LLS St. Croix County, Subdivision Lot number Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you pdt into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 E I/WE, the undersigned, have read the above requirements and agree y to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- ~v ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. INSTRUCTIONS FOR COMPLETING FORM 115 - SRD - 6395 To be I accurate soil test, your report must include: 1. Complei I ascription; 2. Ti L. ; must clearly indicate whether this is a rest/ or commercial project; 3 NA ',XIMUM ri-,oer of bedrooms or commercial use planne ~i ONE 4, a new or replacement system; O h. 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; 0. PLI-A.SE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7- MA-- A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A teet may be, used if desired; ur benchmark and vertical elevation reference point are clearly shown, and are permanent; I all appropriate boxes as to dates, names, addresses, flood plain data, percolation test exemp- 1 appropr rate; 10, the information (such as flood plain, elevir i not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address certification riurnber; 12= Make legible copies and distribute as rear, ,LL 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 - S: one (over 10") BR Bedror~k coo) (3 - 10") SS Sandsi gr. - (under 3") LS Lim ~ s _ H Gh'it' - H' dwatr € cs - C and Pere Pe o Rate reed s - M 'gum Sand Uri _ VV,. I's Fine Sand Bidg - E is - L., . Try Sand > G ran `sl _ &,,idy Loam < L. ~'I - L, Bn - Brost, *siI Si Loam BI - Black si - Sipay - Gray CI C' !---11 Y Yellow sci - Clay Loam R - Red sic) - Si' Clay Loam mot Mottles sc - Sandy Clay owl` - with sic Silty Clay fff - fevv, fir c _ Clay c{; coninro t11 - Peat mm Many, m-, in - Muck d - distinct I ~ninerrt iw Six(: xtures a. for lirl wa to disposal BM - ich VRP _ Vertical it TO THE «~il test r _ 0w firs; n in Th county Department 'y recUP,St n of this sc ' fir A A cnrn, of plan- ivate stem and a ri _ „Ited local ar, order to J ~ r nit. The sar it mast: be ~ ';d posted p:, r t of arty action, w-e"(_i~ REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS MT OF DIVISION P.O. BOX 7969 ATIONS PERCOLATION TESTS (115) MADISON, WI 53707 (H63.090) & Chapter 145.045) ON: SECTION: W TOWNSHIP MUNICIPALITY: LOTNO.:BLK. O.: SUBDC I~10~ NAME: SE/4SE1/4 2J /T2B N R/B E for n K/NN/CK/NN/C COUNTY: OWNER'S BUYER' AME: MAILING ADDRESS: ST. CRO/X ✓AY CLEMENS R/ FARGO ROAD, RIVER FALLS, WI 54022 DATES OBSERVATIONS MADE USE PROFI LE DES =PTIONS: O ATIONTESTS: NO.BEDRMS : COMMERCIAL DES TION: tNew ❑eplace /0 BL /0- /3 - 86 Residence 2 - 9- RATING: S= Site suitable for system U= Site unsuitable for system CO VENTIONAL: MOUND: ❑U IN-GRQUNDPa_URE: SYSTEM-IN FILLHO TJ~NK: RECOMMENDED t. AND SYSTEM: (optional) LJS ❑U rL7J1S OS S nu El S S nu CONVENT/ONALAND /N -GROUND -PRESS. I N/ T/ AL REPLACEMENT If Percolation Tests are NOT required ri-GN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: CL ASS / Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL D PTH 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.) / 6.5' 104.13 NONE Bns/12.5'Jan //I.5'J8nsI(I.t'J an alw/ccpRmot11.4') B- 2 5.9' 04.03' Ir 4.9' 8ns114,99white Js w/fff R mot 1/.O 1 6.8' /07. 25' 'r 4.5' Bn s/ 14.3'1 white fs w/fff R mot 12.311 3 10- 4 .0 114.30 a 76. 0 an S/ 16.09 r 5 4.1' 113 25' an s t f3.1 'J while is w /!f f R mol 1 /.0 J B- 6 .6.5,'x, 114.33' „ 5.0' 811 s/15.0'1 Bns/:w/!ff GymoJ1/.5J 7 6.3' / 15.95' an s/ 1 3..3''1 whI to fa w/f/J R mot l 0'1 B- B 1.4' /09.63' rr 0.6 W. s/10.6 J to fs w/fff Rmot 10.8 J 9 3.8' 119.63' n 3.5 Bns/ 13.3;1 white fs w/ff f Rmot /0.3'1 B- /0 4.8' /04.75' ° 4, 3' Bn s / 2.2') on/ 12.19 white fs w/fff R mot B- PERCOLATION TESTS $0I L SHEET 63 ARLAND SANDY LOAM RATE MINUTES TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES PER INCH NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 P R D 3 //2 " 4 8 P I 2C 03 NON£ 30 4 „ 4" 8 6 4 //2 4 //8 P_ 2 2. / 3 9116" 3 7116 " 3 112" 9 P_ 3 /.91 r 3 //2 3 1/4 " 3 1/2 3 3/4 P- 5 r 3 P_ 6 0.91 d „ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope # 4 HOUR TEST . SYSTEM ELEVATION SEE SKETCH - r S IR. 0, w. TO N OA ~ w _ 333 V.R.P. / TO° /R ON rg/P AS UM D/ O . - 8B± 3I'ii3" 33.104' i a 17 m 4 4 3 ' 1 1. 0~ h tio, _ocU ED, / / 25 T 0 --4--t-- _ j{y~ y P6 , 7 £NHE L/ E t N 1 B4 1 '6' B3 1 _ 5. 7,0 PI 1 7 -EbE T 06 0 tR 12' AR ) I EA I i I E //5. 5' _ BAiCKHOE ?P/T _ . A ii RC OL' B?9 E /R 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods' specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. TESTS WERE COMPLETED ON: NAME (print): LAURENCE W. MURPHY l0- /3- 86 CERTIFICATION NUMBER: PHONE NUMBER (optional): ADDRESS: 53 - 2445 425-9032 R/ BOX 36 A , RIVER FALLS, W l 34022 C$T SI ATURE: 4.[.alrnic.aJ ' DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Teste DILHR-SBD-6395 (R. 02/82) - OVER - i CERTIFIED SURVEY MAP ROBERT H. WEIGEL AND ESTHER D. WEIGEL Part of the Southeast 1/4 of the Southeast 1/4 of Section 21, Township 28 North Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. E 114 COR. SEC. 2~, T26N, R/8 W, / IRON I>/PE FOUND) ~ ~Q T / I I LOTS I LOT J C. T- M. Vol. . , PAGE 9 'l9 DOC. '~i3iSt /J ` I N L/NE SE 114 SEI ,J4 Elfi' 22ND AVE. /RIVER OR/V~l 566.34'62"E 1 31 400. ~ 369 31 T- J. O3 333.04T~ O 0 #88131'13"W 1106.13' a b h m i W ~ a p8 " O O h BARN b Lore ?.05/ ACRES 341, 986 $O. F7. h NET+7.6/1ACRES SHED M 331,324 SO. FT. O N O G ~ ~ N h 0 W b w ry m 0 e N I ^ „ % DWELLING Z p 3 O v ~ r` M Z WELLING W : LOT / $ 3 LOT 3 o /y SHED ~ 0 ©O O /0.003 ACRES Q 111 1. C 11 13.376 ACRES O O 431,733 SO. FT. „ e O C 669,667 SO. FT. 1y POOL O NET- 9.764 ACRES N c~ v NET - 15. /20 ACRES = tl • O O 426, / 79 SO. FT. O ^ J 636, 6/4 SO. FT, p O Z o t M a Oki • ' Z O t O I ~ N90•00'00"W 406.71' I W I IN V s' 772.00' 4' f 333.00 S LINE SE I14 N 86.48'21 "W O?. 00' UNPLATIED LANDS SE COR. SEC. z/, T28N, plow, "IRON PIPE FOUND/ Dated: October 8, 1986 $G O N i~~ O Indicates 1" x 24" iron pipe ,`S~/V i y weighing 1.13 lbs./lin. ft. set. ~rf e o w° I LAU N Vol. Page S oe Certified Survey Maps . co W 713 = : ° W Q St. Croix County, Wisconsin " z••. w : h h W RIVER FALLS. d , ~ to lu 3 a WISC i 9 • J t . SCALE I"- 200' W88j,LANG W g 0 3o' /00' 200, 300' 400' J 0' 868A6/111 got,, m W • O Z N O Laurence W. Murphy : x Registered Land Surveyor sHEE r / OF 2 -f-FENCE J PA"MENTOF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS IADUSTRY, DIVISION LAWR AND PERCOLATION TESTS (115) MADISOP.O. BOX N W 53707 HUMAN RELATIONS M63.096) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP MUNICIPALITY: OT NO.:BLK. SUBDIVISION NAME: fE/4SE~/ ?1 ~8I N R/6 E (Or W K/NN/CK/NNIC 3 C. S. M. C NT Y: OWNER'S AME: MAILING ADDRESS: St CROIX JAY CLEMENS R/ FAR60 ROAD, RIVER FALLS, W/ 34082 DATES OBSERVATIONS MADE TO: PROFILE DESCRIP"ONS: PERCOLATION TES Residence 2 [ViNew ❑ Replace I /0 - 9 - *6 /0- 13 - of RATING: S• Site i N for system U■ Site unsuitable for system LDI s ~•❑U a~ E:rYSTEM-IN.FI IRA ~UL O11 SGCZ]t! RCONVAENTi1DONALYANDMIN-SROUNO-PRESS• s, 1NmAL REPLACEMENT If Percolation Teo*" NOT required DESIGN RATE: If any portion of the tested area is in the under s,H63.09151W,Indicate: CLASS i Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING A ER•INCHE HA A R OIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN ELEVATION 5T. HI TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1 6.5' 104.19 NONE IR+112.39 oRlf/.S'IfR:1ft./•)soI/w/ce,eRmetfl.49 8- t 5.9 04.0!' /r 4.9' fesi/4.9'lwhile f+ w/fff R MO? fl-O') 107. 8S' " 4. S' 1.9 4.3'1 while fc w/fff R "rot 12.39 6. 114. 0 0 !n s / /6.0'1 S 4.1' //J.Bd' f3./'1 white f+ w/fff Rme1/l.0'1 B'6 6.3.. 114. J!' „ S. O' on Si f5.0'1OR +/.'w/fff 6y metf/.SJ r 6.3' //!.!8' • S.J' eR c/ f S.J''1 wh/ to f+ w/fff R mel / 1.0'1 1. 4' /DO. 00' It 0.6 BR s1 f0.6'1 while f+ w/fff RAt at t 0. 1 ! J.Of Its. 65' R J.S' !R+/ tY.5'1 white f+ w/fff RNor f0.3'1 10 4.6' /04.79' 4.3' se +//2.2'18xI f2.1) wAlte f+ w ffl Bret . ARLAND SANDY LOAM PERCOLATION TESTS SoiL SHEET 63 DEPT WATER IN HOLE TEST TIME LEVEL-INCHES RA MINUTES NUMBER INCH AFTER WELLIN INTERVAL-MIN. PER INCH .t 1 x06; NONE 30 4" 3 //2 " 4 n 6 P. 00 4 112 " 4 //8 " 4 6 P..• 4 3 112 " 3 114 " 3 1 /4 ! r P. I. 0 ` 1~ H 3 //.0" 3 314 " 31121, P. S 0.1r d 4 /i'6" 4" 4„ 6 f 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 la)d elope. 4 HOUR TEST SYSTEM VATION SEE SKETCH I I ilr. 1 TO /RiON IPE~ AS rum to / O, S •R. Ol W. TOWN OAO D i _ t 66 I T I 117 ~ , 3 w ' , I / 4 -t--w- --f- - i-- , ~ ► dry 41 r v .P.- s#l Km 1 Po ER . t 0 ~ , ~ h °.Y tea, -I PALE ..5'.S_1/~1f0_// .,1J~ _ I ki..._. t , IO • y' ! I T fNL)HF ' BB 07 1, , tt 0 I 11 l yQ_ . SI//T.!AACA I ;a.}y4~_ ~H 03 84 t t N ELE~. P/l 7 . A r.. 5tb91 - - V R L i t, fDO sp. FI ~y t- 10 - All I 1 1'23 8' I„ AREA , I h ~ eA K oc +P17, 1 0 f 1 I've N /PEAS r I-i f►B9 i JJJ SP 7 L Ell, 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. NAVE (print): TESTS RE COMPLETED ON: LAVRENCE W. MURPHY /0- is- Ii ADDRESS: CERTIFICATION NUMBER: P40NE NUMBERIoptiona R/ ROX 36 At RIVER FALL W/ 340SS SS- 8445 480-OOSS G FT SI ATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Testa l DILHR-SBD•6395 (R. 02/82) - OVER - J E • CERTIFIED SURVEY MAP ROBERT H. WEIGEL AND ESTHER D. WEIGEL Pak c&-.the Southeast 1/4 of the Southeast 1/4 of Section 219 Township 28 North, Range .18 w*o*.. Town of Kinnickinnic, St. Croix County, Wisconsin. E 114 CON. SEC. t/, TtIN, R/6 W, / IRON PIPE FOUND/ S.Q,T1 hOz j i L OT J C• 8. M. VOL. 4, PA Or ! SO r-- - - t- DOC=Jilt /J I I N LINE of 114 sf a 6' 20 NO A VAN /RI VER OR I V ~ I I SII.3I'3t"E /IOs./O'R///01.00'/1 1 N 400 _ ~4P - 3`9.33 369. JIT-- y JJJ. 04 N88.3 T- /'/J"W //01./1'b ~ a a = b ~ W ~ a s ~ g a g o a BARN it LOT 2 ti ?.BJ/ ACRES 31 985 SO. FT. y NET+ 7. 6 ACRES SNED 33/,3!1 SO. FT. b O N p a a n _ ~ b ~ r w ro b q ~ ~ a s • m a h f OWELL/NB 0 3 CA al 8 DWELLING 3 LOT 3 W LOT / o SNED o _ a o a • 0 O /O.OOJ ACRES b • W ry /3.378 ACRES O O O 133,733 30. FT. ~ ` O t~ 88!,1!7 So. Orr. W POOL O MET + /S. 190 ACRES NET• !.781 ACRES - a a = St 858, 61I s0. PT. O O 0 a 7c ~ S N 90.00' 00"W 400.71f W y ~E 4 W J a W a M a 77:,00' I 333.00 S G NE SE //t N 88. 48' 2/ p W 110s.001 SE CON, sec. r"#, glow,(/ "/RON l/NrL A TTED LAN08 PIPE FovNO/ DRted: 'October 8, 1986 ,``~~Nttutu~~~~ w M as SSG O Ns~, W Olndioates 1., x 24 iron pipe S weighi'1.13 lbs./lin. ft. set. ? o o °a Vol. Per W U N c t W C•rtif~ Suv p maps _ L 713 a St. C i Comty, Wisconsin GIVEN F~ • ~~W'~: i ; SCALE r`" + 200' Awss~F~ LAND 0 so' roa : J Ica' o' ssN~11tt1e~~~' s w °o Laurence W. Murphy a a Registered Land Surveyor sHEE T / of 2 ti ASP ~out~ U e^?~ ck, c) C, A d A LaV cY q "ter U« r~ put i ) RP -'xo?6 S~i3z~~ ~`H f~c` )'c IQ 3.09 I P.45- 00. Do a$6o~~_ ike 'Ih r0r ~o`~ ~1 IlO,s - r - r----------r---~--U 9 , 3' o0 4 Z~,k 4 °P00 c wr O \ l oo n S° 5 `f I L o-}- w~ r ~ I r ~ i fJ 1" rct?oS~ \ i V Say Q- O cY1 i /~5 3s 4 9 -S ate=. i ST. CROIX COUNTY j WISCONSIN ZONING OFFICE 'D 796-2239 (HAMMOND) 7 r 425-8363 (RIVER FALLS) HAMMOND, WI 54015 November 19, 1987 Mr. Carl P. Heise 1042 South Main Street River Falls, WI 54022 Dear Carl: Please provide this office a copy of the As-Built for Jay Clemens located in the SE 1/4 of the SE 1/4 of Section 21, T28N-R18W, Town of KinnicKinnic on River Road. We need this information so our files will be complete. If you should have any questions, please feel free to give this office a call. Sincerely, 11) &A-4 Roxann Croes Administrative Secretary W CERTIFIED SURVEY MAP ROBERT H. WEIGEL AND ESTHL-'R D. WEIGEL Part of the Southeast 1/4 of the Southeast 1/4 of Section 21, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. E 114 COR. SEC. 21, T28N, RISW, / IRON PIPE FOUND! ~ ~or1 , I L OT z I 407 3 C. S. M- VOL. 4 P a NL/NE SE 114 SE/~4 66' 22ND AVE. /RIVER DR/Vf / S8B•34'32"E / --L 05. /D R / 5.001!1 4 02. 73 1 402.73' 369.33' ` 369.34 333, O 0 0 N88.31'13"W 333.04x- t, 8 N ~ M N ! N ~ m N NOV,~ F p ° O N o Ma o x')986 BARN •O~~~, t+o/r~y ~N' `Ki LoT2 4 Ay, A, , 7,851 ACRES 34/, 995 SO. F7. NET c 7. 6 / / ACRES R SHED M 331,524 SO. FT. ` 0 y) 7 0 y N N ~ N . m tp ~ b N CZ3 o N m m a b Q M F DWELL/NG b N yl Z 0 I O DWELLING o LOT/ a SHED 3 LOT 3 ~.I 15.378 ACRES O O /0. 003 ACRES tV 669,857 SO. FT, O p 435,733 SO. FT. O I~ I NET s 15. 120 ACRES POOL O NET= 9.784 ACRES N q °O 638, 614 S0. FT, p ° 426,179 SO. FT. 0 q ~I 231 x ° h ` N 2I f o a N 90.00' 00 "W 406.71 ' I \ Note: No further subdivision of Lot 1 y or Lot 3 of this Certified Survey A pay VED Map is to be allowed. R~iJ! Y N V N 0 11 1986 5r.::• -)iX COUNTY Comp'aHtN>1W PARKS PIANWN0 AND ZO IING COMMITTO _4' 772 00, 4, 333. 00' ~ SQL/NE Se 114 N88•4B12W 05.00' 11NPLATTED LANDS SE COR.SEC.2/,r28N,R/EW,//"IRON PIPE FOUND/ Dated: October 8, 1986 O Indicates 1" x 24" iron pipe *~~~~S`S~i~ W W C ON weighing 1.13 lbs./lin. ft. set. *v W Vol. Page 17)10 l-AU Certified Survey Maps W R o W St. Croix County, Wisconsin r-6 x(713 m W ~ RIVER FALLS,.:' J~ ~ ~ ~ 3 W ISO Q: SCALE 200' ~ ~ ca ,1!' Q 0 30' /00' 200' 300' 400 5870' `,•,I4D ~ANDW p 0 mWm. J o N Z Laurence W. Murphy Registered Land Surveyor $HEE T / OF 2 -7•-FENCE c T7! I ~ T n I v ~ fD ~ -N+ N `C 0 M O w 0 O O O CD O 0 co O O W N 7 O C a v f<D 3 O C A N 7 IV _'N.. ICI CD CD CO `r1 7 O OD O ^ CD N D) fA y N N N 7 A A C p p W 7 0 0 O CCD, 7 CL 0 (D n l m n 0 W c? 0 00 00 O) N C m O C O C W Z7 3 N H x N 7C 1 N C5 yy l~ J J r S, c ~ S; c ~ p ~ In D Ewa, ~ I (n ~ D a cO ; CD N N a (D y N G =1 03 CD CD c iv 3 n o o ° nom, c°n CD m o o rn A W s CD - - CD tai o oho ado o co co M N p e C.) w " o -4 -4 CD -n -n gg gg M N 0 4 N y n 1 o N D `ice .3 IA CO N G 1cr 0 O O h A H w O ? :3 CD CD N C ID N t0 fD 1D ID 3 N L N f0 ~j o 0 O n O ° y Er =r cn CD CD c c /y CD 0) am 7 :3. V y c fD C CD W n n n 3 3 Z CD ce m c6 -1 N O y C N C w y n n A z 0 z ~ ao W T M K) co co co z CL 3 a CJ) - y z y M < 00 ,w CD D a W a Imo' a xaNi0 0. 3 CD -0 0 ~I N N ~On p C s0fD 0) c d z a z a v o N cow o CD N o om m N C 0 y S a S_. z w ~ fD CCD T D S 3 < 0 8 Z N 0 1 N J CD \ N CD fi CD 0) =r 70C a •1 C7 Fd 7K O U1 co CD CO z 3 N it, o o ' b w < N 0 0 o 0 °o o °o o. parcel 022-1061-80-000 01/04/2007 12:51 PM PAGE 1 OF 1 Alt. Parcel 21.28.18.P333B2 022 - TOWN OF KINNICKINNIC Current X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SEVERSON, CHARLES G CHARLES G SEVERSON 1194 RIVER DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1194 RIVER DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 3.810 Plat: N/A-NOT AVAILABLE SEC 21 T28N R18W 3.81A IN NE SE LOT 2 Block/Condo Bldg: CSM VOL 4/959 Tract(s): (Sec-Twn-Rng 401/4 1601/4) ~Lrkv 21-28N-18W Notes: Parcel History: Date Doc # Type 07/23/1997 877/598 2006 SUMMARY Bill Fair Market Value: Assessed with: 179181 330,500 Valuations' Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.810 60,000 245,100 305,100 NO Totals for 2006: General Property 3.810 60,000 245,100 305,100 Woodland 0.000 0 0 Totals for 2005: General Property 3.810 60,000 245,100 305,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 00- co CERTIFIED SURVEY MAP T'O!-riN .PO.~t G7 WAYNE RUDESILL { ~I Part of the Northeast 1/4 of the South- east 1/4 of Section 21, Township 28 North, Range 18 West, Town of Kinnic- SOO° Op'G70" ~2e"' 75' m kinnic, St. Croix County, Wisconsin. ~ m \ z a✓ 9.-75'' _ 1 • Indicates 1" iron pipe found. ~Ap I o Indicates 1" x 24" iron pipe weigh- `~n (n~ ` N n O I ing 1.13 lbs/ft. set. O 0 U 000 DESCRIPTION: 0 I That certain parcel of land located in u N \ the Northeast 1/4 of the Southeast 1/4 8 I'I 0 Its- ( t~ of Section 21, Township 28 North, Range I mIV1t1~ 1' 18 West, Town of Kinnickinnic, St. Croix O nI NI County, Wisconsin, more fully described 111 O as follows; ° U Commencing at the East 1 /4 corner of said Q V`(~ ( `T Section 21, thence S 00° 00' 00" E I~ V 0 (assumed bearing) along the East line \ V I 28 '75' of the Southeast 1 /4 of said Section 21, 00 981.45' to the POINT OF BEGINNING of Q the parcel to be herein described; thence V I \ ~I continue on said line S 00o 001 00" E O 322-75'; thence N 88° 30' 35" W 1054.84,; 0 thence N 00° 31' 35" W 322.75'; thence oN , 1Y S 88° 30' 35" E 1057.80' to the POINT O - OF BEGINNING, containing 7.83 acres, more or less, being subject to easement nn \ I 7 over'the Southerly and Easterly 33 there- N x of for Town Road purposes. y I o yW~ ~o o Svc C/~I/It~G I~ Y' \ \ Y! m 7'_='8 fc~/8 A4, .q m ~ I ~ 00°00 'oo 0 ~ I m w 0I U 01 > ,A I~C I State of Wisconsin) 0 County of Pierce) S 00" '_E5~ E 3 zz•~s I, James L. Murphy, Registered Land Surveyor, a-- 8C-9.7.5'' 33" do hereby certify that by direction of the Owner, Wayne Rudesill, I have surveyed and 6 I divided the lands shown hereon in accordance I with official records, Chapter 236 of Wisconsin Statutes and the Ordinances of St. Croix County. ul ~In I and that the above map and description are a U true and correct representt,tion thereof. 0 , Q~ i, .~2 r O ~y 10 \ U V' ~,i James L. Murphy "•'v f~.. % L Re~' i tered and Surve o s ~IAM~S L. _ N ' o ~ ~P ~ r P ROWED - ~ MURPHY ~k I ? S 104 RIVER FALLS, JUL 16 WISL. Vol. 'IT- CROIX COUNTY S~Q.~~.~ `r , Page 959 CrJ'.'Pi;@HEN51Vc PARKu PLAN ,ria Certified Survey Maps ANO ZONING COMMIITtii 00 St. Croix County, Wisconsin ,*W, I XTIONS FOR COMPLETING; FORM 115 - SBD - 6395 To be a comple r accural your re,aort must include: 1. Complete legal c 'rr; . e use section rnrrst y ='rcate whether this is a residence or commercial r. ..MUM number or commercial use planned; 4. r s a nevi, or ra 1 1; 5. Complete the Sur; s. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE OUT BASED ON SOIL CONDITIONS; es. PLEASE use„ the abbrevia ion ,vn here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagr< ately locating your test locations. Drawing to scale; is preferred. A separate sheet may be usO i_ 'red; Make sure your benchmark a +ertical elevation reference point are clearly shown, and ar nent; 9, Complete all appropriate boxes as to dates, names, addresses, flood plain data, percolation tes exemp- tion, if ,props iate; I0 ` (such as {l-^rl ~ I} roes riot arse N q iii the appropriate box; 11, and place your c~.r your certifica 12. copies and distrib€ ~ as reelui, d. ALL SOIL T' 'T °.°°9ST BE FILED WITH THE L( t vUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st Stone (over 10") BR - Bedrock cull - Cobble (3 - 10") SS Sanc`,tone gr - Gravel (under 3") LS - Lit ~n ~s - ` nd HGW - F cs 9;411d Perc P .Jon reed s - i Sand VV fs S Ind Bldg - ''ng Is L y Sand > - Than sl dy Loam ail *0 - Loa rn BI - It Gy ' Clay Loam Y - Sanely C l-v 1 R - l Silty C` , L naot - l ' sc - Sandy Clay VV/ - sic - ty Clay fit t nr - ck Hij --1 soil textures r,= waste disposal I - I VRP Jct. Point T, DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR BOX HUMAN NDATIONS PERCOLATION TESTS (115) MADISON WI 7969 REL (H63.09(1) & Chapter 145.045) LOCATION: SECTION: OWNS UNICIPALITY: OT NO.:BLK. NO.: SUBDIVISION NAME: Nr--SEl/ 1/ 3, T z9N/R) SE (o) ~CC.I IUAI I C_ c - COUNTY: WNER'S UYER'S NAME: MAILING ADDRESS: «VT~ Z $O)C, ~S9 S~ • C Z,u UC Cl~~ G`rc 5 L`UZS~i~ w S vZZ USE DATES OBSERVATIONS MADE NO. BEDRMS.: eft DESCRIPTION: PROFILE DESCRIPTIONS: 1PERCOLATION TESTS: ❑Residence A. S~ ONew ❑Replace _ ZA_a-7 ~'7 Nu"~~;• C~►N1.~ tiv1fW1T -Tp j1UJ`m1.L~011-~T &t SIe~J1t l/J S ftp FOR- 14 I !R lam`RSWJt/ IjSE OK.1 Ly, RATING: S= Site suitable for system U= Site unsuitable for system `T)-nS `S IvA~- Cjpj" h L1ZC.L RL. V S e CONVENT ONAL; MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) SS ❑u NS ❑u ~S ou ❑ S ,emu a S .~u -'mq-jC,N 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: N - N. Floodplain, indicate Floodplain elevation: N ` PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INe"ft CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH Mk, ELEVATION OBSERVED EST. HI HEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) - I - S.% a6.6" ~'Vh-By"S11S3_o•8" Z. S Of 4-6' - Ivo>~e ? s•~' D1t s~~s~ z•o'8n ~-z.g - > 1 's B- 3 94 -Z' 1Jwje -7 S. ' 1.O I V b~c'bv%S B- z, . ~1' ~r 1 s 4 S,°►' q6. o' i-~on>E 7 S, q~ 1.p~ vb`aB~SI T5 $-rtL.:--- B- Bn Sl ' z.c>' 13!s B- S S. 6' 95-Z1 N ? S•b' OA' ~k $n S) L; 1.4'6>vS1;- Z•).' ~n l S _ G S.S' ~IS• 2' NONE C) S'~1-t8n S Ts ; \.O' ~1t6v~ I 5; Z.5' $n 1 fs; B- \ • Z. ' 'A rrrv Lf 5- J W L S P ~ rE PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER S AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P_ 1 Z. ' l~0 M o Z- Z- \ 1S/16 1 S Cq S 4 P_ Z 2. Z' Yvb 3'O 31 1 V Z 3/y 1-7 9S P- NC) ZQ 1 '/2 ~~1~ t(Z ~1S= P-- P- o 'TT2, Cr Z 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. iNlTlYcl >CQ7~ ~PCEj~ cl.P~t~►Fl~.~ SYSTEM ELEVATION ~'3 0 r ( i I r 1 4 ~~r# T4, 'F2.EP1vr T r. GE IAL~ 11 LT R4- i - ~Z C - tN .d G E ^`7 t~ y 4R if'1 t i T i f Il~tt~i I j ! E N i ~ i uV - g ~f t d i TS a " 2__._ sc~L~; ~ - 60' s tee. zJ 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: ADDRESS: R LIU~~ lJ 13pX ZZ CERTIFICATION NUMBER: PHONE NUMBER (optional): ~~L sltio w svoll S-)6 -)Is_4ZS-oi 6y CST SIGNATUR DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - L Parcel 022-1061-90-000 01/04/2007 01:01 PM PAGE 1 OF 1 Alt. Parcel 21.28.18.P333B3 022 - TOWN OF KINNICKINNIC Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - VANHEUKELOM, DUANE A & BERNADETTE M DUANE A & BERNADETTE M VANHEUKELOM 1198 RIVER DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description " 1198 RIVER DR SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 2.020 Plat: N/A-NOT AVAILABLE SEC 21 T28N R18W 2.02A IN NE SE LOT 3 OF Block/Condo Bldg: CSM VOL 4/959 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 21-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 05/26/2000 623722 1514/47 WD 2006 SUMMARY Bill Fair Market Value: Assessed with: 179182 361,900 Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.020 50,000 284,100 334,100 NO Totals for 2006: General Property 2.020 50,000 284,100 334,100 Woodland 0.000 0 0 Totals for 2005: General Property 2.020 50,000 284,100 334,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 08/23/2005 Batch 05-5 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r• s 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, Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: Trench:, Width: Len$th: Number of Lines:OA,14- Area Built: Fill depth to top of pipe: LJ~ Number of feet from nearest property line: Front, Side, Rear, 0 Pt 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, O Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: t~~2 Dated: Plumber on job: -eu-Z -~J)2ZZ= License Number: l~ 4221-9- 3/84:mj Form- STC - 104 r .r AS BUILT SANITARY SYSTEM REPORT A IC /r0 v" -l s ~ J SEC. r I T S N-R W OWNER ~liL zizs JA) TOWNSHIP k CL r/ L ADDRESS Z ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT !g LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•I.HR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM -60 ~e Zln. 8,4 D jgL ic.)LGL.L . INDICATE NORTH ItRROW B&:CHMARK: Describe the vertical reference point used Elevation of vertical reference point: Proposed slope at site:] SEPTIC TANK: Manufacturer: 2G'' ~/-~3?l Liquid Capacity: /JL06 (r} Number of rings used: Tank manhole cover elevation: _ Tank Inlet Elevation:/c4/a,/ Z Tank Outlet Elevation: Number of feet from nearest Road: Front, Side ,O Rear, O faet A~Y .From nearest property line Front,O Side,O Rear,( feet Number of feet from: well, building: (In(lude this information of tt;p above -jot plan) ( 2 reference dimensions to sept'ic' ank) „~v SIDE w _ DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMANS RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MAD ISON, W 153707 State Plan I.D. Number: NE ,SE ,S21,T28N-R18W CONVENTIONAL El ALTERNATIVE (it ass(ned) Town of Kinnickinnic ❑ Holding Tank D In-Ground Pressure D Mound River Drive NAME OF PERMIT HOLDER: T11DRESS OF PERMIT HOLDER: INSPECTION DATE: Chuck Spyprson te 2, Box 159, River Falls, WI 54022 ID al_ 87 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: ,Lyle J. Myers 6219 St. Croix 102785 SEPTIC TANK/HOLDING TANK: MANUFACTURER. LIQUID CAPACITY'. TANK INLET ELEV.: TANK OUTLET ELEV.. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED- DYES ONO DYES ONO BEDDING. VENT CIA VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL IIIUILDIN13. IV,,,,,, TO FRESH ALARM FEET FROM LINE'. Al. INLET DYES ❑NO DYES ONO NEAREST DOSING CHAMBER: MANUFACTURER BEDDING. ILIOUID CAPACITY PUMP MODEL PUMP/SIPHON MANUFACTURER WARNING LABEL LOCKING COVER PgOVI DIED PROVIDED: DYES ❑NO DYES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL'. NUMBER OF PROPERTY WELL JBUILDING VENT TO FRESH (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 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 INOOF D ISTR. PIPE SPACING. COVER INSIUE DIA 'PITS LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH DIMENSIONS GRAVEL DEPTH FILL DEPTH UISTH PIPE DISTR. PIPE DISTR. PIPE MATERIAL. NO. DISTR. NUMBER OF PROPERTY WELL BUILDING' VENT TOF HE S// BELOW PIPES ABOVE COVER ELEV. INLET ELEV. END. PIPES FEET FROM LINE AIR INLET NEAREST 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 SOIL COVER TEx TURE PERMANENT MARKERS OBSEHVATION WE LLS DYES ❑NO DYES ❑NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL SODDED SEEDED MULCHED CENTER. EDGES. DYES ❑NO DYES ❑NO DYES ❑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 IN O DISTH UISTH. PIPE DISTHIBUTION PIPE MATERIAL & MARKING ELEVATION AND ELEV.' ELEV.. DIA. ELEV.. PIPES DIA.: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVER MATERIAL PLANSCAL LIFT CORRESPONDS TO APPROVED DYES ❑NO DYES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL'. BUILDING- FEET FROM uNE. DYES ❑NO DYES ❑NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE. TITLE. Zoning Administrator DILHR SBD 6710 (R. 01/82) INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION s , 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, .uspally every 2 to 3 years; 6. If you have questions concerning your private sewage system, contact your local code administrator or the State of Wisconsin, Bureau of Plumbing, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; 11. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. Fill in' designer name if applicable; VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use Only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications not smaller than 8',h 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 Groundwater included the creation of surcharges (fees) for a number of regulated practices which Wiscor~ in's a can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater fund adminis- tered by the Department of Natural Resources. These funds are used for monitoring ground- t water, groundwater contamination investigations and establishment of standards. Groundwater, it's worth protecting. SBD-6398 (R.03/86) 01&.HR SANITARY PERMIT APPLICATION Cou (3 In accord with ILHR 83.05, Wis. Adm. Code STATE SANITAR ~ERMIT# -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 PROP TXc ER PROPERTYOCCATION y S , IV, R E (o W PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME E-&~Z 13on CITY, STATE ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LAIC LANDMARK tf 6;e_ / ❑ .VILLAGE : I tJ II. TYPE OF BUILDING OR USE SERVED: • 0991 _0CV Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in ##1. Check 2,3 or 4, if applicable) 1. a. XNew b. ❑ Replacement c. ❑ Replacement of d. E1 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. 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. ~ee a e Trench c. ❑ See age 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) : L A I,~ Feet Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in gallons Total of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank OL40 OX-)e-Z ' Z ❑ I El Lift Pump Tank/Si hon Chamber ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumb 's Na (P4+- Plumber's ignat e: (No Stamps) MP PRSW No.: Business Phone Number: / 93 znZd Plumber ddress (Street, City, State, Zip CodbK it Name Desi er: er> 16 ly 2- - -5y 12 C,Q Q &1Z e_ Vlll. SOIL TEST INFOR TION Certifie Soil Tester (CST) Name CST k' E 2 CST's ADDRESS (Street, City, State, Zip Code) Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved nitary Permit Fee Groundwater ate Issuin Agent Signature (No Stamps) Approved ❑ Owner Given initial 9/~ C^ rcharge Fee Adverse Determination ' IW ORS, W 14 ~ X. COMMENTS/REASONS FOR DISAPPROVAL: P laM &9j0,wdxd b~ C - hk130n SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber APPLICATION FOR SANITARY PERMIT STC-100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property Location of Property Ali- 1% S 1%, Section v2 I , T-2k-N-R~ W Township Nailing Address S-4/022, . Address of Site _ ~2jG / S Cf Subdivision Name i .Lot Number f~ Previous Omer of Property Total Size of Parcel ^ Date Parcel was Created / Are all corners and lot lines dentifiable? L/ Yes No to this property being developed for resale (spec house) ? Yes L/ No Volume and Page Number ~ as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A Warranty Deed which includes a Document number, volume and page number, and the Seal of the Register of Deeds. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I We) cv%ti.6y that aCt atatements on thus onm ahe thue to the beJS.t o6 my (oun) hnewfedge; that I (we) am (ahe) the ownen(,61 06 the pnopehty ducAi.bed in thiA •in6ohmat.ion 6o4m, by v-cAtue 06 a waAAa.nty d ed np,,c tided to the 066.tce o6 the Cc~mtyy Reg-usten o6 Deeds as Document No. 31 S' ; and that I (We) phebentty awn ih ¢ p4opoa ed Site bon the ~5 ewage d is poa d y-s em (oh I (we) have obtained an easement, to nun with the above d6cAibed pnopeA.ty, bon the conathucLion o6 aaid I o a ye , an th -a been d y heeon.ded .in the 066jee- o6 the Count Re •iat II D cLe , No. 9 6 y ems. SIGNATURE Op OWNER SIGNA OF CO-OWNER (IF APPLICABLE) c~► l 19 7 / DATE SIGNED ' DA • TE SIGNED H z e H . a ST C- 105 r ` a SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d \ a OWNER/BUYER 1~42" H /l / ra ROUTE/BOX NUMBER )e6 Fire Number CITY/STATE Ai~__ L.- ZIP J ~/d ZZ PROPERTY LOCATION: A_k, SE' k, Section .21 -A-, T U N, R l,' W, Town of St. Croix County, Subdivision - Lot number 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 may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. yo E I/WE, the undersigned, have read the above requirements and agree Cn to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- ~t ment of Natural Resources. Certification form ust a ompleted and returned to the St. Croix County Zoni 0 ith n 30 days of the three year expiration date. SICNE DATE St. Croix County Zoning Office P.O. Box 98- Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS \ / MADISON, WI 53707 (H63.09(1) & Chapter 145.045) LOCATION:. SECTION: OWNSH MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME: N~-=-SE1/a '/a zt /TzSN/R)SE(ol COUNTY: OWNER'S UYER'S NAME: MAILING ADDRESS: `ZbU~~ Z BOx 159 Sl-• eZu~X C`r1uC`cc ' L`v- ZSor.> ~ ~yt=`~ L.s 1 wl SYo~ Z USE _ DATES OBSERVATIONS MADE NO.BEDRMS.: ~t DESCRIPTION: (PROFILE DESCRIPTIONS: PER OLATION TESTS: ❑Residence - N A S L~ U t QNew ❑Replace L _ Z~_$-~ ` ZI 7 tJ~~~'• ~>~u~ wNW'W Tb 11JS1'14i-L-OI!ET4: -'30AJr`- JN S►toP FotL 1-1 S PFRSo~/~t_ SSE ~~~~y, RATING: S= Site suitable for system U= Site unsuitable for system C l~' N)Ib - C`..6" F7 L7r-CLh L V S t; , CONVENTIONAL MOUND: IN_ -GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) ❑5,ZU ❑S.~U 1 - S'x so' TZ~GH I'M ❑U CAS ❑U is ❑U H If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the f under s.H63.09(5)(b), indicate: N Floodplain, indicate Floodplain elevation: N PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-111 E~Rf°S CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH W. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) S•8' 016.61 tvo►JF -7 S- $I o-7) '-1C>tr-8v\ s)1 o,b,)grhSa ; ~•3.' hL~ 3•1~).I_ B ? S -6' tvoNE S D`rct--A S~)3 Z Ot h LC? i8~n 1 s B- S V~~c$nSlTs ; t.o.'_b1-~Q►• 5I ; ~.3'~~, S1; B- z. L!' -t r 1 s y S.°i' q6.o' 0o,-ll~ 7 S.9' o' vb~re~s1 TS ; ~.o'DkBn L; 3n L, - B- o' %I Bv% S1 ' Z.o' L3 iS S S. 6' 9S--V jvoN~ 5 S.b" o. Z> Lt'grn sl TS; Yl L; 1.L4 13 B- 8 n 1 S G S-S' CIS, 2' 1,3 F- > s. 5' o.g'~tz8>1s1 ►s; ~.o'~tzgv I s; Z.5' Sn 1 ~s; B- 1. Z 1 1A c-Toj Lf S- i w L S Pic r- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER S AFTERSWELLING INTERVAL-MIN. PERIOD 1 -PERIOD 2 PERIOD 3 PER INCH EL. P_ 1 Z. ' 110 3 p Z Z \ 1S/)6 ~ S q S'±- P- Z Z."L' Yvo 3~ 3) 1-7 95 = P- Z-o' NO vo 1 '~z 1'116 11 z 7 9 P- P- o ' ~"Rv C.~4 8 Z LP- 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. 11-% 171h C-Q7tq~JT ~'k 612, is &I~-- lE-j' SYSTEM ELEVATION ~►3•0 E 1JERR T I 1Ito 11D c~, N Doo R ~R 1 1 ! IRrcpvtCQn'T TTt:.~E$ ~ T'tZE►,f C~+I -t-, - h _~_..1W~ ~~.?G:fS77t•1 `a _ Yt~IVSE 3 tat S-r - Off- s 1 T G • S-tom t-0 cA'T-;D 1' --pr1 ~ B1 'trJ QF 1JE -~~E ~~1jc :~1 ►Tt i.ST.- 1 _ _ . SW ll~" -I TRE/u ~-t9 0~ - ~ i Iu Way S, b`~ 4 MEN L Stt ? s Rtv or~16 E - -J11 1 X'l : 60l S Ee. Z 1 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: RTN(,j r, L, wEGEZER -z) -S7 ADDRESS RvU~~ l~ t3pK -Z- -z. 6 CERTIFICATION NUMBER: PHONE NUMBER (optional): ~t_~sv~oR w s t 5~6 pts_Uzs- o/6y CST SIGNATUR DISTRIBUTION: 01 ,9mai and one copy to Local Authority, Property Owner and Soil Tester. DILHR SBD-6395 (R. 02/82) - OVER - S~ e~z \,s t fir i I a ~ ,-r: ~ti V t $1 r lZ~~tl Pig.- a 1 o 4 +ryl ` C171) C ~C Z'l ~ L4 • AS. BUILT ';ANITARY ;YSTEM It1?PUit7' t3WN ER c (A 1)ID 1~ s s & It S'1': C0 1X t: OUNI'Y WLtiCONS'IN. Sum)TV1STA LOT I..U'1' SIzF' PLAN VIEW Distances atict. dimensions to meet requirements of H63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM -r / • r J ~1 I x. sf - I dic'at Nr It rr w r B9NCHMARK: (Permanent refereit e• Point) (ma .7L *A El e v aCion of ve tica refercI)cu p01,itL SLope it site: SIEPTIC. TANK.t Manui:ac turcr. 1294 p laiquid Ca psic:tt',': . S Iumber of r-$ags on cfpver - Plink ,111ankU14 c.OVUt' '!Ic•vat lull ~f Tank Inlet EleyatIon : lank outlet 1''Icvat1On: PUMP CHAMBER Manufacturer. Number of git Lloits i f Number of pump set for a cycle gal Lures; I'utal capacity of s dfetribution l:'ines' aI1_0It :iiZe of puinl, bead; gallon per minute hor,ae power __;brand na,ne of bump and model number Type of warning device H6LUINC TANK: Manufacturer - N1an0ber of gallons El'avation of manhole- cover c 'hype of warding device 3Z1wPP,Gii PIT -SIZE; NUtob r 0f IilL6 f(!4t diameter feet liquid ale-pC suu) agc pit inlet l)ipu-ulevation bot om of seepage pit elcv;iI i~n fc et SEEPAGE BED SIZE: number of I iut widLI, Icligti1 53 t.ile dept11 tiEEPAC 'T'IkENC1i dtI l~n _h _ - _ 1'C1~CUI.A'' ION RATE AIZ1.A ,L2E(~U11<E1ly- Ak1,.A AS BUI1.,T _ DATED PLUMBER ON jOB LICENSE NUMBER a DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 799 BUREAU OF PLUMBING MADISON, WI 53707 tiCONVENTIONAL ❑ALTERNATIVE State Plan I.D. Number: ❑ Holding Tank 1:1 In-Ground Pressure ❑ Mound (lf assigned) NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Charles Severson IRR#2, Liberty Road,River Falls,WI `,/24/3 3 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN : REF. PT. ELEV.: CST REF. PT. ELEV.: NE SE Section 21, T28N-R18W, Town of Kinnickinnic Name of Plumber: MP/MPRSW No.: County'. Sanitary Permit Number: Paul R. Cudd 2739 St. Croix 38454 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER 1 93.23 PROVIDED: PROVIDED: 7 ❑YES ❑NO ❑YES ❑NO BEDDING: VENT ATL. HIGH WATER NUMBER ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM FEET FROLINE: LAIR INLET: ❑ YES ❑ NO ❑ YES ❑ NO NDOS ING CHAMBER: MANUFACTURER'. BEDDING: LIQUID CAPACI PU OD JPUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO 1114 1 ❑YES ❑NO ❑YES ❑NO GALLONS PER CYCLE: AN CROILS OPERATIONAL: NUMBER OF PROPERTY WELL BUILDING JVENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) //7E]TE S❑NO NEAREST SOIL ABSORPTION SYSTEM. Check the soil moi re at the depth of plowing I FNI, L1f 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: LENGTH JNDISTR. PIPE SPACING COVER JINSIDE DIA. P S' JLIQUID DIMENSIONS S Z TRENCHES G / PIT DEPTH. GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF WELL. BUILDING: VENT TO FRESH BELOW PIPES / ABOVE COVER. EL©EV. INLET ELEV. ENDQ' -7 ~j PIPES - ktrile 1 1 AIR INLET. FEET 7 ~F OS l V Z -2 / . / NEARESTO-i• _r-0 r Si7/ MOUND SYSTEM: Mound site plowed perpendicular to slope Check he texture of the fil aterial for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: moun Ys ms to m certai at it-_ ON REVERSE SIDE. SHOW ELEVA- m s, the iteria f ediu and. TIONS MEASURED. ,qy ❑YES ❑NO SOIL COVER TEXTURE PE ANENT MARKERS OBSERVATION WELLS. ❑YES ❑NO ❑YES ❑NO L.E OVER T RENCH/BED DEPTH OVER TRENCH/BE DEPT FSODDE SEEDEDMULCHEDR. EDGES Y ES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: WIDTH: LENGTH'. NO.OF LATERALSPACING: RAVE DEPTH BE LOW FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE FA FOLD ATER O ISTR. DISTR. PIP DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.'. ELEV.: DIA.. ELEV.: i ELEVATION AND ~ PI S DIA.: DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECTLY COVE MATE RI VERTICAL LIFT CORRESPONDS TO APPROVED PLANS: ❑YES N _ ❑YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE: H ( 3.1 i ❑YES ❑ NO ❑YES El NO NEAREST 9 6 + 3 . t ~ = 9 c1. l I b trl ~a n c...Q t,.-t tiQ,(, G1 ~ 95.3 8S $2 s,g$ ~92$ 7) 215 .9 1~.ob $s•aS la.~s 13.27 Sketch System on Retain in r`~MY file for audit. $S.$l Reverse Side. SIGNATURE'. TITLE: m . ' DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY &BUILDINGS INDUSTRY, FOR SANITARY DIVISION LABOR AND, PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/2 x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Pr: Mailin Addr ss: o : City, Villlllaa((gfje or ownship: ount t t/o '/4S iT CLOF N/R VE (or Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Land rk: State Plan I.D. Number: (lf assigned) TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: ❑ 1 or 2 Family *State Approval Required. C9 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS nOETE PLACE INSTALLATION MEN'r' .(Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ New Replacement ❑ Experimental XSeepage Bed ❑ Seepage Pit ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Na as L' ted on Soil est Report (If ther than present owner): Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for. installation of the private sewage system shown on the attached plans. LN e Plumber. Sign re: A%PtMPRSW No.: Phone Number: Plum er' Address: Nam of Desi er: - ' Od 1., 7 COUNTY/DEPARTMENT USE ONLY Signa APPROVED Sanitary ~Permit LNumber: 4iOAALfe 13, ture of Issuing Agent: Fee: Date: ✓~K 7'~d~ ❑ DISAPPROVED Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (R.07/81)' Form - S T C 100 Owner of Property Location of Property-.!/ G jj5j4, Section T "-N R W Township Mailing Address ` I Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel J' Date Parcel Was Created Are all corners identifiable? Yes No Include with this application one of the following: .Certified Survey Map .Deed .Land Contract, or , .Other Legal Document which describes the property PROPERTY OWNER CERTIFICATION r I I (We) certify that all statements on this form are true to the best of my (our) . knowledge;.that 1 (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed-recorded in the Office of the County Register of Deeds as Document No. _3!-S213 ; and that I (we) presently own the pro ite for the sewage disposal system (or I (we) have obtained an aserpe , to run with the above described property, for the construc ' sa) system, and the some has been duly recorded in the Office th Regi ter of Deeds, as ment No. SIQNA RE OF OWNER SIGNATURE OF CO VNER (IF APPLICABLE) DATE, GNEO ( DATE SIGNED f ~ kJ INSTRUCTIONS FOR COMPLETINr3 FORM 115 - SBD - 6395 To be ' accurate soil test, your rep, include: 1. Cornp! ascription; 2. The us lust clearly indiea- her tW sidence or C -,7, project; 1 MAX nber of bedrooms Mn 1; 4. Is ) _;ernent syo, . 5. :,,ility rating A SITE IS _J, LBLE FOR,- _`)ING TANK ONLY IF ALL 1S ARE RULE' C.; JT BASED ON SOIL COND: , 0. 1° abbreviations _ here for tiwiting profile descri, ns and completing the plot plan; 7.° LE diagram "y locating your test locations. Drawing to scale is preferred. A rr • ' ,nark < -erence pain e clearly shown, and are permanent; <,3. ; iate E30; addressr iin data, percolation test exemp- r flood Alai does riot appl A. in the appropriate box; 11 . , OUr current adci, y~jw certification 'r; 1 End distribute as ALL SOIL TEr ~3 IST BE FILED WITH THE . , Y WITHIN 30 DAY PLi TION. .EVIAI ~C ".,ERTIFIED SOIL T "_RS jd Textures yrnbols BR (3 - 10") ~7e (under 3") L atone H C° C Is Sand n `sl •'y Loam 'n L.. Grp Sii arc - ~idY t=a x r r:c _ i p, trim - rF s - ti HWL-I 13M erg- V RIP C u c r r st I J DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, - DIVISION P.O. BOX L HUMAN RE ABOR NDLATIONS PERCOLATION TESTS (115) MADISON W 573969 (H63.0911) & Chapter 145.045) LOCATION: SECTION: TOWNS HIP/M4N4GWA+_ t: NO.:BLK. NO.: SUBDIVISION NAME: vi 2-sel/ 1/ z-1 /T 74/11 LP, E (o I K,*3 I c rL_1 " i c LOT - _ - COUNTY: OWNER'S BW*ER'S NAME: MAILING ADDRESS: ST-tVZ11C, CHA LE-S Se,,)0tEwj ~o`T~E Z 'R LUL-S2. HrLLS, w/. S1E0Zz USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMME IAL DESCRIPTION: (PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence 3 ❑ New Replace Il 5-z3-g ~ RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUNDPRESSURE: S STEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑U 9S DU ®S DU ❑S ®U [Is ZU l$'>LS3' aim If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: C\ NS-S Z Floodplain, indicate Floodplain elevation: 1~ ' Q PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-WVCI*ft CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH Ift. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- l 8--t 1.9'ves-'t 'Zk8n K S 3 2.23h S) 0.9~~$n H~Rvy s~ r 9 Z 3' 1~>JE 7 8.7 3--7 L_T n 'ES ALL Iii c es GF Z-1,V``T``l ~k~„ `F$~ 2-3'an 0•6~~128n Ht~RuY S1 B- Z '~.4 9D LN6 N~ > 8 y 3 Y' t_ w sr7,rLL j'*-ve of s S N-3, vrs~ Dn l'fS;Z.3N3n•fs,Z•yD12~3nfferuySl; B-3 `a•5 9Z•9 NONN 2.5 w s of SS B- 8. 6' 9 p , 1J 01.1 1 .6 ► . 9' V eV-`t lb. VL 3 n l -f S ; 2.1 'Q n S l t2.4Z~ k--15K dvwuy 51; y-2 L~- W SP7 LL 't ec 4F S S B- tJ o I`1 S l l 5 O ~ Ow C C lei IYX• OF ~2~ B_ GOu Z oU~1 'ot S~?t-B Li 41v ID I FPES O SC aA ~hlt f1S NL I?D p12o u ! D E S~ PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD3 PER INCH P- P- F~. P- P-- 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. ~OT~~ O! p, ~3 Go`TM})atpl LD/{>H`T S SYSTEM ELEVATION z, , $ S •ao fT fill`I^tfE ,'co T Nose. } i _4- t _ - - i 6 ( D i TN { I { J, q t t----{.. _I_. ( E i Q ~lU z- 1 -4- I S G1~~ = Sc' L-~-~ APT ~S S Cfowly S~ r`1 Z. l 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: "P t 2 L . wtsC. S - Z3 _83 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): L/ Rizl ZZ/0 USAZZn w/. 5vol/ 5__)6 713 - El IS-93 E3/ CST SIGNATU E: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - ~F e tr S S 50e~L J c7 v. *a ~ ra r ~ E R a, CRO55 SECTION OF A B"ED 5~S-TV - t y --.ter"'.-.....' SOIL FILL 2,. OF AGGREGATE D15TR1BU71o►.I PIPE APPROVED 54LJTf4f_TIC LOVER r ~ MATERIAL. OR S" OF STRAW r OR MARSH HA`~ L:OFS'2-2t~ AGGP4 ATE -P --olz -To .ti ~l.EV.',c7F ,SS'At? FEET - Dj5TRI5UTtoI,# Pink Tq BC AT LEAST SQ AUCHES BELOW ORIGIQAL GRADE MiD AT L6A5T 40 1UC-HE5, 5UT mo MQR[ -rHAVJ 42 IUCHES Brt-DW FIMAt. GPLADE DL VJILt BE h,4AX1f,11.K DEPTM OF T-XGAVATIOQ FROM DRIGIIJAt_ GRA 11.1c m>`s ' P'IlMMUM D£-PTH OF EXCAVATION] FROM ORtG11.1AL GRADE Wltt.._ 6E 60 Itt3CHE5 r - to C a#G LICCUSE UUMbER: r . ~k~ t'C'~ZI..E~ SE'U~ ~SU►J CROSS SECTIDU OF A BED Z-0~' ACrS. rG# Tr- a- FILL` L SOIrv C. PIPE- ,gpPRtJVirt $419 lEc C.OVCK o r~ KkT E P IKL ; Dot S" 0 "S C R A1+J OK P CI OF 77 P ZZ AGGRJ: GAT IL E!~EV. ow= Ssoo,=EET nrcr,_ fit : , lacl t p►STiZLBUT1011 PIPE TU BC AT LEAST _ D WCHES BELOW OitiGlIJAL &K ADC AkJD AT LEASTZO ItlCHES BUT UQ MORE 7114Ai.1 'i2 IULHES BELOW Ft►JAL OftAC}E lhAXIMt1N% L7EP1'Fi OF ti=XCAVATIOU FROM ORIGI►JAL GRAD1 L>!LL BE. - iAl 1 S MINIMUM DEPTH OF EXCAVATIOIJ FROIN OKIGI{:IAL GRADE WILL BE ~ ' SI(~►1ED; LIGE 5