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HomeMy WebLinkAbout022-1088-95-200 ~ro x~d 0 (D Q G C n N O 3-0 n d p~ U) rt H O ai f,, C -1 a w a o (D b o o v U) H ` d o 4-~ o O C) L, CD z C:- co -0 x C4 p r+W9~, d 3 3 c p0ppm N 00 00 ED CD m ON 00 N N C Z 2 N A Nco O M En CD M 00 fD oo a co ~ E p m W C N 1 \ N a 7 O O y d' (fl ry o 0 CD -4 cn p M CD C n CO d o 0 t1i p o o N s a) - rt CD a 00 co I(~ N O V] ^V c cD c 0 (~y N 3 o O o a Co a CD V ~rn C, C4 l J co 00 (D cc -4 -4 Ch a 1 W wti rl w 3 C l~r r• o ~-d CL 00 _0 -0 v v N O (1 CD N -q 00 cc 3 a I _a N Z 0 a D D o I ~ O c o =r a h • CD c Cl) z N o -i CO) I N ,p z to o°i 0 F! I"T mNOo CL s z 0 B ~ ~ (n c 00 Z C.) I CO 0 CO0~o 0. a nVi CD o' =r m c m -'CD v oz a u, o' m > > m a a N a)33 Ocoa 00 7 O a O o 0 c a -.1O U > > a y a O n O Ga ti O N _ O CL a s A (D o m oro oho t0 A CD O o a, m c I ° a ,r DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADISON, WI 53707 nl.D. Number: ate Pla SEA, SW1-4, S30,T28N-R18W M~CONVENTIONAL ❑ALTERNATIVE St (lf a assignssigned) Town of Kinnickinnic ❑ Holding Tank ❑ In-Ground Pressure ❑ Mound Lot 2 Quarry Road 14 1 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: David & Mary Passe Route 1, Box 338, Hudson, WI 54016 It g-97 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN. REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: William Pfannes 6222 St. Croix 1 99084 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PR OVIDED. DYES ❑NO DYES ❑NO BEDDING: VENT DIA.. VENT MATL. HIGH WATER NUMBER ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM FEET FRO7LINE: AIR INLET: DYES ❑NO DYES ❑NO NDOS ING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED. DYES ❑NO DYES ❑NO DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL. BUILDING. VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) DYES ❑NO ]NEAREST-0 SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing 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. INOLOF DISTR. PIPE SPACINGCOVER INSIDE DIA.PITSJLIQUID BED/TRENCH THINCHES MATERIAL' PIT DEPTH: DIMENSIONS GHAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL BUILDING: VENTTO FRESH 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 TEXTURE PERMANENT MARKERS OBSERVATION WELLS 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: NO. DISTR. ID ISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.. ELEV.. DIA.. ELEV.: PIPES. DT: ELEVATION AND 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 LINE: ❑ YES ❑ NO ❑ YES ❑ I NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE TITLE: Zoning Administrator DI LHR 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 whenever, necessary; usual4y 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; ' Vl. 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 81/2 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 they 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 Wiscor4in's e 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) SANITARY PERMIT APPLICATION COUNTY 1ILHR In accord with ILHR 83.05, Wis. Adm. Code k V/ u ~„e . STATE SANITARY PERMIT # 9901?,z -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. ?7 _ ,,-Q6? -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES ® NO P~OPERTY WNER PROPERTY LOCATION J ► q/• CtSS-~- S~ '/a Sly '/a, S 3O Tc~~ , N, R E (orQq) PR RTY OWNER'S M NG DDRES LOT NUMBER BLOCK NUMBER SUBDIVISION NAME ox 3ALV - TY, TATE ZIP CODE PHONE NUMBER 77 CITY NEAREST ROAD, LAKE OR LA MARK ,CI VILLAGE u s /5-) 3 r.- 66d TQWN OR i s : VN, -L. h o II. TYPE OF BUILDING OR USE SERVED: - A0 • (f) S- Number of Bedrooms if 1 or 2 Family OR 11 Public (Specify): 111. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) .1. a. rKmew b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 1. a. Conventional b. ❑ Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e..AMound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. 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): 09-32-3z 7 1~07, Feet Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank Woo ~ e ❑ ❑ Lift Pump Tank/Si hon Chamber o o ❑ ❑ ❑ 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) MP/MPReMhNer Business Phone Number: it' 4 a 7/S 75.E 3%z PI Z er's Address Street, City, State, Zip C de): Name of Designer: X e-Y--- C" W / 0 0 VIII. SOIL TEST INFORMATION Certified Soil Tester (CST) Name CST # an a S A _ Ce CST's ADDRESS (Street, City, State, Zi ode) ( Phone Number: 1 s s- 99s~ r 1) IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) Approved _1 Owner Given Initial Sur~h~arg~e`Fee o Gam,,, Adverse Determination U. • X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber APPLICATION FOR SANITARY PERMIT STC - 100 his application form is to be completed in.full and signed by the owner(s) of the roperty 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 0QLV A /A(zv ✓ PCASS e Location of Property S . S W 1%, Section 3 0 , T;-C N-R W Township /)n, cK,nn,(. Nailing Address iLla~,~ AT 1 8oX 33 l,l.~ w S yo16 Address of Site 3/ 34 P.4p r,~ y d~ on sr-?h SAC Subdivision Name Lot Number IoT J c,021-4 S_=UeY fn,4P /XVT7 Previous Amer of Property / Q?pl N /~s n1'PhH4T;oz l iy<.s Ad _Ke Estate Total Size of Parcel i`2 . y Lee > Date Parcel was Created 4t le Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes X No Volume and Page Number 1~S yl 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 Nap, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I We) centi.6y that att statements on .th,!A olm ane hue to the beet 06 my (OA) hnowtedge; that 1 (we) am (aAe) .the ownen(s~ 06 the pnopehty ducAi•bed in this in6ohma.t.ion 6okm, by viAtue o6 a waAAanty deed kecotded in the 066ice 06 the Co~mty RegiAteA o6 Deedss" Document No. L?6To ; and that I (we) phe.bentey _q I aun a pnoposed site bon the sewage dLspoe eye em (o,% I (we) have obtained an eaeer+ent, to nun with the above deAcA bed p)topehty, bon the eon,6tAuctti.on o6 eaud eye,tem, and the acne h" been duty Aeconded .tn the 066ice o6 the County Reg.ie,teh o6 Vetch, ab Doawnent No. SIGNATURE Op OWNER SIGNATURE F CO-OWNER (IF APPLICABLE) DATE SIGNED DATES NED .,000MENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2-1M li 421; Eso - REGISTERS OFFICE ST I; . CROIX CQ,, WISr I! i l Reed. for Record this 2nd OI' uly Ii Hazel Hills Corporationf a Wisconsin corporation day ___J____.AD. 19U a~k~a._ Ha~e1..Hi11..Cnr~oration 11:35 i conveys and warrants to ba e.gd.MXY..p!?...Passer..husband and_wi. f.... wY1W N ia.p9ml.e y-................................... om, Zee RETURN TO la7Q ~~o S'~'osL _ St Croix I the following described real estate in .....................................County, State of Wisconsin: 1 I' Tax Parcel No- Part of South Half IS') of Southwest Quarter (SW4) of Section 30, Township 28 North, Range 18 West, described as follows: Lot 2 of Certified Survey Map filed June 22, 1987, in Volume "7", page 1842, (No. 53). •1 ttf;J~ ~ F FEE i ;I This homestead property. Akj (is not) Exception to warranties : i' Easements, restrictions and rights-of-way of record, if any. I Dated this ?m. day of J1.a1714'........ , 1987..... HAZEL H (SEAL)....... dEntAL) ` . Atte (SEAL) L) i' Ii AUTHENTICATION ACHNOWLEDGKRNT 1 II STATE OF WISCONSIN I I Signature(s) I _Pierce County. authenticated this day of 19 Personally came before me this -•-29th..... day of JuT . 19...87• the above named .._fla7.Pa..lI7.11►~. .._.tZ2SChC.k~_.3Y1G~_.:x~Yl A.. ' .gkp TITLE: MEMBER STATE BAR OF WISCONSIN (If not- - authorized by § 706.06, Wis. Stats.) to me known to be the ersolr4........... who executed -the foregoi i~lstr and ackn 1 e the same. THIS INSTRUMENT WAS DRAFTED BY - . • . Keith Rodl.i, Attorney at law T- ci 219 North Main Street !r/' -~.2..i ' ••C ~ 4 un vler-f 1-1-s;-jff --.3442-x Notary Public Wig: (Signatures may be authenticated or acknowledged. Both My Commission X (If not, i&te'erpiratib 1•r- ~ are not necessary.) date: el -~3 .:~1;. *Names of persons signing in any capacity should be typed or printed below their signatures. STATE BAR OF WISCONSIN StOCI( NO. 1$OOZ KC.111wisfConv" FORId No. 8- 1988 rn.rw..rw.r H z rn H a ST C- 105 r a H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County Cu, z OWNER/BUYER 1~GV+ r2f $c.X 33~ H C g[~ u r PA SS L 1 Y ll,.dso•~, dvi' S yC9 ROUTE/BOX NUMBER Fire Number Spy CITY/STATE R,ve~ ruilc W.sc~.~s: + ZIP S 2~ 1-0.rj`r PROPERTY LOCATION: 5 .SvV k, Section 30 T2,5~ N, R_3W, Town of A 6CSt. Croix County, Subdivision Lot number 1~IG~ ~i~C~ G(L7/51 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. H C I/WE, the undersigned, have read the above requirements and agree N 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 &6k pavk DATE ~~St ~sT Al _ Iq S-? i 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. I ISTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To a co accurate soil test, your report must include: 1. lr 'al 'e: on; 2. Section rni r ly it ether th' nce or commercial project; 3, MAXIMUM number mercial r_ 3; 4Is a,rs a new or re 5, Complete the rir^' °ITE IS BLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSI RULEE C . CONDITIONS; 0. PLEASE use the abbr i. Lions shoo ` rr p~ofile descriptions and completing the plot plan; 7. MA-",'E A LEGIBL` -..m acc - y ;0~-' ll m, test locations. D--,ving to scale is preferred. A rP sheet may your bencl• -k and v i :al elevation referent point are: y shotiin, and are permanent; uete all appropriate boxes as to dates, names, flood plain data, percolation test exemp- if appropriate; information (such as Hood plai-, e' rr=c~r7} does nt,; apply, place N.A. in the appropriate box; 11. 1 I)e form and place your current and your certification number; 12, ake legible copies ailed distribute ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY VVITHIN 30 DA `s 'LETION. /I 'IATIONS FOR CERTIFIED SOIL TESTERS ctures mbals i0"? ock 3") sir ;3V TO THE OWNER: 7-.e c r -t to s DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR P.O. BOX 76 HUMAN REDLATIONS PERCOLATION TESTS (115) MADISON WI 3707 (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TO NSHIP/MUNICIPALITY: =.:IBLK. NO.: SUBDIVISION NAME: E- %U/ 3 6 /TDPN R ( r) UNTY• O NER' R' NAME: MA LIN A D SS: rv ' a v , d a Pa 5'S - d __3 3~'` q s d L? C(J USE DATES OBSERVATIONS MADE NO. BEDRMS, : COMMERCIAL DESCRIPTION: New PROFI L DES RIPT ONS: PERCO TON TESTS: y~'Residence ~ ❑Replace RATING: S= Site suitable for system U= Site unsuitable for system J / D+ TI©U . M2OUND: 1S. a~ IN-GR1OUND-PRESSURE: SYS❑TEM-IN-FU F-ILDING TANK: R1 pe= D SYSTEM: (optional) IS M If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: I _N I-] Floodplain, indicate Floodplain elevation: IA,III, 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- ios, o y a sniff ~n s w ; D r ~ndS ti; ~Go. E a .sa ~o s; B- 3 3,75 D~~ . 7 5 ~5'ISIs ~~`oQn s~ 1 ~$o6h S a~, , &J'S.Ps 'S m r`S;r l 60 D 3v6 .7' • a 6S V, f. B" J .vUQ~Z A006 0 do BnS4~ S/IR1 3 ~D B11+1 A d*.5 114 - 5 1.06'akas rl S S ear Sat so B- ;2,50 0< gk 3 do B Sic w aro rs T .5~o PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TESTTIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PER OD2 PER-100 3 PER INCH P- 'P.06 A/QAJF 3 O .900 P- d 00 IV19AIf 30 " 3 P- . DU 3 A 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. SYSTEM EL p~ p . _a-~6' P!' ( 1 1 (04 l , e "4 iiwn f~ ! . ec i E ^^^--Y^ fir.. t I, the undersigned, hereby certify that the soil tests reported on this form were rnac a by r&i' lcord a procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are*t to the best of k owledge and belief. , NAME (print TESTS WERE COMPL TED N: ADDRESS: CERTIFICATI F,IN MBE PHONE NUMBS (optional): o -e J 4 S CO~~7``)) occJJvv V CST S TUBE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DJLHR-SBD-6395 (R. 02/82) - OVER - L r , Not. 001 • rs r, rj H Cb;I1TJ:kl1~) SUHYJi~I MlP • m $ s f Part of th4 9W 1/11 Of the 1 111`1 V sw 1/4 xad * th1 SK 1/4 of : o the Slit IA Y I of 9e o rt! OrA j0 11 Y i T 28 No 1 18 W, Tows of O o , Klaalair tu►lo, St. Croix ►n s \ Countro Misoonaln. Mo: ~ 1 1 own 1661 Yoodbnry Drive % Woodbury, M 55125 W • 987 Dated t Hey 20 1 0Indioatee 1" x 24" iron 1. ~ N .u• Pipe we'&Mng 1.13, lba./ +,i • , .111T. f t. ae 11r. . w u ~ tD ~ I w ~w w u ' ~ N w w ~ ►wi► ~F w w ~ 11 it 94 J V O N ` 1y ` JI w 1 ~ 1 t 3 I h Q ' ;G i 4A VZ 44 I I ~ o 8 m N Q O 1 l ti s • to g ° I„ ~ ~ 1. : g a o d h 1 ~I M v W V 1 w I Q O 1►\1~ v w i O W Q t; T®Z W p O 0 O h r I+ 04 w h 0 t0 Q, !y`M w w % v 00-2 JI :„!a I 1 ' ~ 001, /LAUREN 't 1►1~ c $ j AM i W MUR F - ► ~1,~-~ No r S 13 .;:..ay ER FALLS 9 • wisc. JQ. ~ ` UCEO \ LAN4 ~a.~tt~ I •:e .0. 41J a \ Laurence W. mu•pbp ~ ~ ; • 14 stared Land Surveyor 'r lip „ o 11 Vol. Page •'~'p o Car tified Survey Mi,~pa •4 I ~ r 3t. Croix COUn . W slc o tYr otlalz YW [Rri. s1v !n, Ito N,A/I W. COur r r a~.Il p ego#.s MOM./ w .+HEET / OF? SEP1i197 I a fry: ' ~ ~ ^O + s DE RTME;, . RELATIONS C C? c z r. X ~ CP r c~ k CP a \.I ~i c-- .S ~ q V , ot:) SC' ~Ya q~, 5 7 ilk v Page Of . 3 Straw, Marsh May, Or 87 06 Synthetic Covbring J _ Distribution Pipe i Medium Sand Topsoil 3 E p Slope ~P b pP~ K Bad 9f t Plow 2Force Main t t ed r 1 1 f 4 rag to Layer u r V, J' Ft. s Section Of A Mound System Using E ~ ~ 2.3 ~•yCr ~0NC~r° A Bed For The Absorption Area F~ Ft. G Ft . A Ft. H Ft. 6 ' Ft. License Number: _/)11, l L zK - Ft. Date: L Ft. P 1119$7 J _ Ft. ~E I 3 Ft. Force Main W . 9 Ft. L } t Observation Pipe I - B K A i•---------------------- ----------------------'t Distribution Bed Of 2r- 2 1 Pipe I Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area Page ` Of'- 87-06.883, Perforated Pipe Detail 0 En- View "w w' End Cop )Perforated y' PVC Pipe Holes Located On Bottom, S Are Equally Spaced q P S PVC Manifold Pips Distribution Pips Force Main Lost Hole Should Be Nest To End Cop End Cap Distribution Pipe Layout P F f. II R . S X = Inches Y _ Inches Signed: r~_ yl7,tr Hole Diameter q_ Inch , License Number: ~2 z Z S~`'~~M Lateral Inch(es) Manifold " 1 Inches Date. 1 7 6 7 ~c 5 ~ Force Main " I Inches j Y%'%1 CA~ : holes/pipe I0 Ynv'ert~.R evatio f Laterals /4 7, o Ft. tiUl 0 oo~~c~ t SEP I 11987 PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIOUS VENT CAP 87-v6883 4"L. VENT PIPE WEATHER PROOF APPROVED LOCKIIIIG 25' FROM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH I2"MIU. AIR INTAKE i GRADE y„ I MIM. mom ' IB"MIN. COIJDUIT L-- ~ 11~ _ K IAILET PROVIDE I - A? I~,~iA~ I III I rT APPROED APPROVEDEJOINT A `v p jE SevJPC ~s ( III W/C.IVP PEOINTS fXTENDIAJG 3' p~ E~L~Isz`~Ii~ !„~za I III ALARM EXTENDING 3' ONTO SOLID SOIL pC: ONTO SOLID SOIL O C r r; ,1 ~~;C3~~ I ( !,r 1~ pAw,~ .S ELEV./ - FT. a3 ;lV~~~ _ P OFF C, Q R$ E BLOCK RISER EXIT PERMITTED DULY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFICATIOUS DOSE TAWKS MANUFACTURER: 1, ,)Z 4 IJUMBER OF DOSES' PER DAS TANK SIZE: c, GALLOWS DOSE VOLUME . ALARM MANUFACTURER: lh,-!~~ O let-t- INCLUDING BACKFLOW: Q GALLONS MODEL WUMBER: 4 CAPACITIES: A= INCHES OR 531 GALLONS SWITCH TYPE: Y) P H C a r ~f B =INCHES OR GALLONS PUMP MANUFACTURER: 1 C=INCHES OR GALLONS MODEL NUMBER: D=INCHES OR 1GLlQ GALLONS SWITCH TYPE: /lr P u r MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET ♦ MINIMUM NETWORK SUPPLY PRESSURTT,E//.. . . . . , ,2•S FEET + FEET OF FORCE MAIN X F/ppnFRICTIOU FACTOR.-_ `d FEET SEP 198-1 TOTAL DyUAMIC HEAD = FEET INTERNAL. DIMENSIONS OF TANK: LENGTH 3 i ;WIDTH -;LIQUID DEPTH SIGI~JED' LICELISE MUMBER: Z 2 2 OATE'._G=L 510/2 Feature's Pump Impeller is recessed 'Tornado" tion is built in - three phase overload winding on seal. Metal parts are 303 Mercury Level Control (WHRA) type - operates completely out of in control box. stainless steel. 90* Operating V. volute passage giving full opening for Upper 0 Angle flow of liquids and up to 2" (50.8mm) Sleeve Bearing with Thrust Volute Case is heavy cast iron, epoxy 20 Amps at 120 V.AC., dia. solids: Wisher and Lower Ball Bearing are coated with support legs. Choice of 2" 15 Amps at 240 V.A.C., oil lubricated for smooth opertion, long (50.8mm) or 3" (76.2mm) discharge 4" Yellow Bulb Float, Motors (single and three phase) are oil pump life. flange. Float Lath. 4.o', filled for good insulation and lubrication Rotary Shaft Seal has carbon and Separate Capacitor Housing (single Float Dia. 3.5', of bearings and seal. No starting switch ceramic faces for positive seal. Body is phase) allows capacitor to be replaced Strain Relief 6th. 1.0' or relay mechanism. Overload protec- stationary, prevents string or trash from without dismantling motor. Dimensions q . . . .1..._.~ Lj.,: - T NPT FLANGE 304-6 Z NPT FLANGE, WHR (Manual) 432,6 rrm F' 216 _ ~-7- 7d+6 r 270 mm IfL5 6bM - ? " :{k~ t r ..744', Performance Curve r: CAPACITY LTERS PER RiINUTE y, ' 0 100 . • .200 304 , 4W "SOO . 600 SWt h j r=s 44 i 40 12 l 36 ; - 32 W ro . R LL a ty N r~ r yp 24 yy9s y yjO ?x 0 -20 o: A WHRA 12 DRAW DOWN 8 DIAGRAM 4 TURN ON, 20 40 -.60 80 100 120 140 160. i80 : G - cAPAcrry GALLONS PER MINUTE.: 4" (101 6mm) /r~43' " ~ Performance Capabilities M) FLOar _ BULB m y' 8" 2032mm) aRa~!u ~ovvru : Capacities to 175 GPM 662 LPM j ' Heads to 33 feet 10.1 M TURN Pump Down Range * 7 to 9 inches 178mm to 229mm Solid Handling Capability 2 inch dia. solids 50.8mm dia. solids kas liquids Handled Waste water 1 '7 61/, Intermittent Liquid Temp. 140°F 46.40C (158.7mm) i Motor 1/2, 3/4, 1 HP Electrical** 115, 230 V110; 200, 230, 460, 575 V 3d -F 1 Discharge 2 or 3 inch 50.8 or 76.2mm 'For WHRA - Automatic (Manual Pump variable with switch). "'For WHR (WHRA is for 115, 230 V - 1 phase only). MYM ST. CROIX COUNTY ~g WISCONSIN ZONING OFFICE a~'>K 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 August 28, 1987 _ Division of Safety and Buildings Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the David & Mary Passe property located in the SE 1/4 of the SW 1/4 of Section 30, T28N-R18W, Town of KinnicKinnic, revealed suitable soils at a depth of 3.75 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, C Thomas C. Nelson / Zoning Administrator rc k ST. CROIX COUNTY n~ WISCONSIN ZONING OFFICE 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, WI 54015 July 6, 1987 Division of Safety and Buildings Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the David & Mary Passe property located in the SE 1/4 of the SW 1/4 of Section 30, T28N-R18W, town of Kinnickinnic, revealed suitable soils at a depth of 3.75 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, "'M Lam, c"o t" Thomas C. Nelson Zoning Administrator rc WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of St. Croix Location SE 1/49 SW 1/4, Sec. 30 T 28 N, R 18 YTM W Town MbfiTt(WTTq Kinnickinnic Street Address Route 1, Box 338, Hudson, WI 54016 Lot No. N/A Block N/A Subdivision N/A Landowner's Name: David & Mary Passe The application for this site is for: rx-inew construction use. ❑ replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: to have one of the first five approvals guaranteed for this year. This is number - - of those applications. (Use one of the first five quota numbers ssueTfo_you.) 1XIone of the applications needing a quota number. The quota number assigned to this application is 59 - 12 - 8 for one additional homesite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. F.1for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. ]for an application on file prior to February 1, 1980. U for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: ❑ a failing conventional soil absorption system. i U a holding tank that was installed and in use prior to February 1, 1980. ❑ a privy that was installed and in use prior to February 1, 1980. If this is a REPLACEMENT SYSTEM USE and the Jot meets the criteria for a conventional private sewage sYstem check here. I certify that the above information is true and accurate to the best of my knowledge. Name Thomas C. Nelson Si re County Official Title St. Croix County Zoning Admini,t-r,tn Date _ ul.y h, 1 87 DILHR-SBD-6158 (R 12/82) STATE OF WISCONSIN-DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS - BUREAU OF PLUMBING P.O. BOX 7969 - MADISON, WI, 53707 APPLICATION FOR THE USE OF AN ALTERNATIVE SYSTEM Location: Township /YoNUUjiBJE: SE 14SW it g 30 T 28 N/R 18 X9fhWW Kinnickinnic Street Address: Subdivision: County: Route 1, Box 338, Hudson, WI 54016 N/A St. Croix Landowners Name: Mailing Address: David & Mary Passe Route 1, Box 338, Hudson, WI 54016 I (We), the undersigned, hereby make application for an alternative system on the above-described premises. I recognize that the above premises are not suited for a conventional private sewage system. If approval is granted, I agree to have the system installed in conformance with the Bureau's approval of plans and specifications. I further understand that an alternative system is more complex in nature than a conventional private sewage system and as such will require detailed inspection during construction and monitoring after the system is put into use. I agree to permit both county officials charged with administering county sanitary ordinances and Bureau employes or other authorized persons to have access to the above described premises at any reasonable time for the purpose of inspection the construction of or monitoring of the system. I further agree to either personally or by my agent contact the proper county official to arrange the time and date to begin construction of the system. I understand that this application does not permit me (the applicant) or my agent (the contractor) to begin installation. If the system is approved, the Bureau will send the applicant a letter of approval which authorizes construction of the alternative system after all necessary permits have been obtained. I agree to give notice to any subsequent buyer that an application for an alternative system has been made and if installed, that the premises are served by an alternative system and further agree to give the buyer a copy of this application. The Bureau accepts this application subject to this understanding and subject to all the conditions and obligations set out in this application. Signature of Applicant Date STATE OF WISCONSIN Subscribed and sworn to before me SS. COUNTY OF This day of 19 Notary Public, State of Wisconsin My Commission Expires: DILHR-SBD-6413 (N. 05/81) Parcel 022-1088-95-200 04/17/2007 12:52 PM PAGE 1 OF 1 Alt. Parcel M 30.28.18.476C 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 - PASSE, DAVID M & MARY M DAVID M & MARY M PASSE 909 QUARRY RD RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 909 QUARRY RD SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 12.690 Plat: N/A-NOT AVAILABLE SEC 30 T28N R1 8W SE SW 12.69 ACRES LOT 2 Block/Condo Bldg: OF CSM 7/1842 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 30-28N-18W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 784/125 2007 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/11/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 80,000 163,000 243,000 NO PRODUCTIVE FORST LANDS G6 7.690 45,000 0 45,000 NO Totals for 2007: General Property 12.690 125,000 163,000 288,000 Woodland 0.000 0 0 Totals for 2006: General Property 12.690 125,000 163,000 288,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 133 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 zoo i 1~3Hs ('NOW S,tlO,(3A1lnS .(1 N/!0o 1 U 'M B/!1' N BZl '0 £.03S '/!O7 MS •uTsttoasTM '.A.tmoD xTo,zO •:.S n° ti33. sdW AaAMS PaTJV~JGO "aRBdr~ ToA ~I \ aoAaAan tte POJO',18TIql~ r1l Agd•rtTAI M aoua.anlaZ . m w I ~ .f w, 40 n S~ld3 83 d~ I 1 1 * w % n I tl itsIH/1110 1" m I I I ~ 1 1 I I ~ 1 1 ch w o o a o 41 0 0 : fb u A IU U ` A N Q1 N ~ ~ • w n ~ ~ a Z! w ~ Zt n - IN l to 14 V y a jj to O r• 4f r I~ b O o O~ to \ 2 I I b 0 ri m nY,o ~ I I~ w o y o~ o „ ~ n y I I '1 I o n ~m ro ro t b ~p 1 ~ 1~ I ~ ~ I ~ 2T O O m2 O ~ ~ II III r 1q T b q 4 I I',Up U w . In o ~ y fb,Aj I I C) C; O q u n v1 O I to r~4\ I I\ M Y O ^ 000 I 1 O Z IN o°o ~ i ~ I I y y~ O 2 V I~ I b M W I~ O O1 d O \x'61 w~ a 6b N \ \ 0 2 •~as OW 'uTT` is a 2~ •°Z Z C o sqT CT, T eutt.IBtam adTd I M s' b uO.zT I,tz x 'IT sal.aaTpuIO l4'~OZy y y\ \M L861 'Z A'eW : Pa, •vcr w_ m r-M i o A A D j ~ Q o 0 c o 2 tb C) cz, 9ZT99 Uq 'AangpooM °c y Q y aAT•zQ A.zngpooM T99T I ro n y DQ 553lIQQFT S 12I: MMO w I ` W M o N y U v 0 1 w .a I c ~ ro~ m I~ 1\ - o a a o e, In \ a~ < 17 ~ Cv \ \ 3 w •uT9u00eTM 'A,tmoo ° r) §R11WW6'0►ac-402 ~ MV xTo.zO •49 'aTu o I *NWINV1J `k;Yd ~nr;ria~kavdwo~ N W uTx TuuT}I \ m Jo trmos 'M 8T x IN vZ S I o° t~iiflC?"7 ;iC~21J'1.S = w_\ 1 z \ l I Y U \ 'OC uoTq-09S JO ~/T MS au1. J ? ` \ S° VT as at4 pue t/T MS I a 1 ' f i I it G NnI" au4 jo VT MS at,. 3o wv i I Zb W ~o Q1 ~ m ~ y W HOZSVIOd1100 STTITI 'Eq? ,r'] l ~~.-.JdV CIVTAT A.IAKfI£; Q:7T,~; V.r,7O u £L 'L9L T cl ae'loe _,F /0 11~`b ~l U311 d7dNn o *MW , L86~'~, wvnr b . ~ I a INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To a complete and accurate soil test, your report must include; 1. 1 description; 2, Th ,tion must clearly indicate whether this is a residence or commercial project; 1 M umber of bedrooms or commercial use planned; 4. Is ar replacement system; 5. Corr_ tf _ 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 ""AKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A to sheet may be used if desired; are your benchmark and vertical elevation reference point are clearly shown, and are permanent; 0, -orr.,flete 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 not apply, place N.A. in the aplx; 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 '_'tiITH 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 cob - Cobble (3 - 10") SS - Sandstone gr Gravel (under 3") LS - Limestone *s - I HGVV - High Groundwater cs - I-J Pere Percolation Rate med s - Sand W Well fs F Bldg - Bu0dinq Is - Sand > Grca - °i sl - m < Less That' I Fan Brown sil - S Loam BI Black si - Silt. Gy - Cray cl - Cl Loam Y Yellow scl Clay Loam R - Red sicl I _ C- ay Loam riot Mottles S y Clay v -v / - voth Cay fff few, fine C cc _ c«mrno P, - gat mrn Many, r;, m - Muck d - distinct p - prominel H''VVL - High w,.; c 11 textures gar`,,:- -te dsposal p. cl: .,.<<1. cal R '?rence Point TO THE OWNI' f" Stop in sanitary permit. Thr :unty or the Department may, quest in the f-, d permit '^te set of plans for ~h- ivate stem )it application mus s=.,anaitted al authoeity in to rmit. TI perrnit must be p of gray construe 1. -4 DEPARTMENT OF SAFETY & BUILDINGS REPORT ON SOIL BORINGS AND INDUSTRY, DIVISION LABOR AND PERCOLATION TESTS (115) MADISON W 7969 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP UNICIPALITY: T NO.:BLK. NO' SUBDIVISION NAME: SSW INN, C COUNTY: OWNER' UYER'S NAME: MAILING ADDRESS: Sr. CROIX HAZEL HILLS CORP. /66/ WOODBURY DR. WOOD BURY , MN. 55/25 USE DATES OBSERVATIONS MADE rr ~I NO. BEDRMS.: COMMERCIAL/p~SCRIPTION: PROFILE DESCRIPTIONS: R O ATION TESTS: ENesidence 9 / New ❑Replace I //-/8 - 86 NOT CONDUCTED RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) EIS OU DS ❑U DS ❑U OS ❑U ❑S DU N. A. NOT A COMPLETE TEST If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: N. A. Floodplain, indicate Floodplain elevation: N. A. 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- / 6.4 N. A. NONE 2. 3' all / (/.0)On ri/ (1.39 On r/ w1cmd RM0t (/.59 Bn s (2.6'1 B_ 2 6.8 t ° n X 6.8 Bel (0.9') Bnoil(0.99On s/ and sr 35%(1.49an r13.69 B_ 3 5.8' I 7 5.8' Ba 111.4') On s i I (I. 8'1 8n r/ (3.0') 1 Bn/ (1.5 9 On ril 10.6'1 an sI (0.5') Bn rI and r/ 351% (1.29 B- 4 6.7 6.7 Bn r/ / /.e') an r/ cnd it JS % (0.7'1 On r(0.4 B- 5 6.3' I' ~I 6.3 8n I B') Bn x/(3.5'1 an r (1.0'1 rB- TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIODI PERIOD2 PERIOD PER INCH P_No : This is not a com lete so test. No perco tion tests were 'conducted. ese were on y P-pre im nar borings. comp e e o es s were con uc e y Tom ang a tirled P_ es er. 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. SYSTEM ELEVATION N.A. I ~R _,V JF-,-P, sc L~I 001i A _ b L i f BACKHOf PIT t 1 tt v ! i I ? g?k~ ! ! ! I ~ E 9 ( i ~ } f ' B4 ~ I ~ ~ i ~ ~ I s I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and o s 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: LAURENC£ W. MURP'MY 5- 17- 87 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): R/ BOX36A R/VERFALL S, W/ 54022 55- 2445 423 - 9032 CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) - OVER - it Cn , Ate, 76r. 73 AK_S01'34'12"E 001.00, MAY ` cif tl)! Q ` A J • , I of i \ \ " o 3c), •w 1 \iM I o ~ I ~~1' ~ i \ ` M h I e1 ~ ~X Q I. h! \ \ u ti t T \ bik v U t i tj 91 b N ` It N o; ♦ x i 1 Tltirn O ao i e N " I irioodbtiry► 1> 55123 2 tOi ~ Va. r vm Dated t Nay 2, 2997 O r p, ~ \ ^ N 3 \ a a yzs st O'nonts• 1" x 84" trot pipe W010king 1.1~ lb*.;' o O~ \Z N Zo' 4y4. r .11n. ft. aft. ly N N O A 1 4 W I N % 1 1 2 11 ^ I e y _ 4= N ~ ♦ ' 1 ' r h h ~3 Q h 1 ,t " a I V z 1 vv ti m o f I' ^ N I • w y 1~ Q 1' 1 ~ N h 1 Q t i I g !v J WI j'II o W l 1_ • a ~a Q 0 1 1 „ t ~i _ $ t 0 ^ O N 1 ' N ~ Q h b ~ b• w ~ V ti. I w mW Q ` e l O®Z ILc'~ . % V v r ♦ Ot N. 0 O RO Q. C, ` tM r ~I p Z' o ~ a `O` ~A~ h ~Ir - x 1 1 W I I II N I ~ 1 I I ~ ti % ,,,11/1111111IhOf II ti Go N Om I o LAUREN( ST W MURC►Sr' ER FALL:,.:. S ~.IAK~ b h I• J h ~ v ~ ~ aJ Laurence W. Murphy stored Land Surveyor I M t o Vol. Page 41, % %0 1/1 Certified Survey Maps '•r,, I < 4,_ PJ 1, cl St. Croix County, Wisconsin. SK' CoR. SEC. 3o, T2®N,R/B W, M , t rouN TY SURvr roR'S MON.) h SHEET / OF 2