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Parcel #: 034-1066-10-100 02/22/2007 09:51 AM
PAGE 1 OF 1
Alt. Parcel#: 30.29.15.450B 034-TOWN OF SPRINGFIELD
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- RICKARD, PAUL H &JEAN M
PAUL H &JEAN M RICKARD
2779 80TH AVE
WOODVILLE WI 54028
Districts: SC=School SP=Special Property Address(es): '=Primary
Type Dist# Description *2779 80TH AVE
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 10.150 Plat: N/A-NOT AVAILABLE
SEC 30 T29N R15W NE NE THE W 335'OF NE Block/Condo Bldg:
NE
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
30-29N-15W
Notes: Parcel History:
Date Doc# Vol/Page Type
10/20/2004 777518 2679/236 WD
12/01/2003 747890 2465/178 AMLC
06/06/1995 529808 1125/064 LC
779/382
2007 SUMMARY Bill#: Fair Market Value: Assessed with:
Use Value Assessment
Valuations: Last Changed: 04/14/2006
Description Class Acres Land Improve Total State Reason
AGRICULTURAL G4 8.150 1,100 0 1,100 NO
OTHER G7 2.000 9,550 121,900 131,450 NO
Totals for 2007:
General Property 10.150 10,650 121,900 132,550
Woodland 0.000 0 0
Totals for 2006:
General Property 10.150 10,650 121,900 132,550
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch#: 215
Specials:
User Special Code Category Amount
I
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Si on Manufacturer: Pump Size
Elevation of inlet: Bottom/of tank levation:
Pump off switch elevation: Gallons per cycle:
i
Alarm Manufacturer: Alarm itch Type:
i
Number of feet from neare t property line: Front, Side, O Rear,0 Ft.
Number%of feet fr7/ well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed:
If-,, Trench:
Width: `2- Lenth: Number of Lines: Area Built:
Fill depth to top of pipe:
i
Number of feet from nearest property line: Front, O Side, O Rear,O Ft .
Number of feet from well: X o �
Number of feet from building: X90
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of i s: ��ameter:
Liquid depth: t om of seepage 4t elevation:
i
Area Built:
Has either a drop box O or stributi n box been �sed on any of the above soil
absorbtion sytems? (Check on ) .
HOLDING TANK
Manufacturer: , Capacity:
I
Number of rings used: E evation of bo't of tank:
Elevation of inlet:
Number of feet from nearest pr e ty line. rout, O Side, O Rear, 0Ft.
Number of et from
-`/well:
Number of fe from buU ding:
Number of feet from nearest// road:
Alarm Manufacturer:
Inspector: /
Dated: Plumber on job:
License Number:
3/84:mj
1
Form - S T C - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER .. �-� - TOWNSHIP r,/�. T/ L°� SEC. -�� T �7 N-R ��CW
ADDRESS ST. CROIX COUNTY, WISCONSIN
`f
SUBDIVISION �(� LOT / LOT SIZE /►✓
PLAN VIEW
Distances and dimensions to meet requirements of I1HR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
' el
�5
/ODU p
o
eq
C
— — — — ina -- --
�,M d Gprpgei
SDI
INDICATE NORTH ARROW
"Ole--
r
BENCHMARK: Describe the vertical reference point used
be cc��c'/1
Elevation of vertical reference point: Proposed
/slope at site:
SEPTIC TANK: Manufacturer: /C Liquid Capacity: /n it q-/
Number of rings used: Ova Tank manhole cover elevation: 102- -412
Tank Inlet Elevation: 100,0-41 Tank Outlet Elevation:
v
I
Number of feet from nearest Road: Front,O Side A6,1 Rear, O iX-O feet
i
From nearest property line : Front,(D Side 10 Rear,O 123 feet
Number of feet from: well 75 , building:
,include this information of the above plot plan.) ( 2 reference dimensions to septic tank)
SEE REVERS IDE
-DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS
LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
P.O.BOX 7969 BUREAU OF PLUMBING
{ MADISON-Vyl 53707
E291 NEk, S30,T29N—R15W CONVENTIONAL ❑ALTERNATIVE State Plan I.D.Number:
(If assigned)
} Town of Springfield El Holding Tank 1:1 In-Ground Pressure 1:1 Mound
NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER INSPECTION DATE:
E. A. Rickard Route 1, Box 26, Woodville, WI 54028 ' v U (�- F/'7
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:
Dale E. Hudson 6629 St. Croix 95975
t
SEPTIC TANK/HOLDING TANK:
F MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER
P OVID D: PROVIDED:
ES
El No ❑YESO
c BEDDING: I VENT DIA.: VENT HIGH WATER � �^ ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH
ALARM: � , LINE: AIR INLET:
DYES NO ❑YES NO
rE�!' ",
DOSING CHAMBER:
MANUFACTURER: BEDDING: LIQUID CAPACITY. JPUMP MODEL. JPUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER
PROVIDED: PROVIDED:
DYES ❑NO ❑YES ❑NO DYES ONO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMWR OF"= 'PROPERTY WELL: BUILDING. VENTTOFRESH
(DIFFERENCE BETWEEN LINE AIR INLET:
PUMP ON AND OFF) ❑YES ❑NO MAW
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
the soil is dry enough to continue.)
NIL1l1N`
CONVENTIONAL SYSTEM:
e; WIDT ILENfiH NR ENS. DISTR.PI PACING: MATERIAL: ]INSIDE DIA.. #PITS: DEPTH:L QUID
GRAVEL DEPTH a FILL EPTH/U DISTR((. IPF DISTR.PIPE DISTR.PIPE MATERIAL: NO.DISTR ' PROPERTY WELL: BUILDING: VENT TO FRESH
BELOW PIPES r( ABOVE COVER. ELEV.INLET.ELEV.END PIPES LINE, AIR INLET
°ILSS 91, 32 %o
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.
OYES NO
SOIL COVER ITEXTURE PERMANENT MARKERS: OBSERVATION WELLS.
DYES ❑NO DYES El NO
DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL: SODDED SEEDED MULCHED:
CENTER. EDGES:
❑YES ❑NO YES ❑NO ❑YES 0 N
PRESSURIZED DISTRIBUTION SYSTEM:
°WIDTH: LENGTH: NO OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER.
TRENCHES: -
�&; Ilri�eMp� �-
�1?'i �� MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL: NO-DISTR_ DISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING:
ELEV.: ELEV.: DIA. ELEV.: PIPES: DIA.:
I -9
i '°' K HOLE SIZE HOLE SPACING. DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
❑YES ONO ❑YES El NO
COMMENTS: PERMANENT MARKERS: li OBSERVATION WELLS: ..PROPERTY WELL: BUILDING:
LINE:
❑YES ❑NO EYES ❑NO
1
Sketch System on Retain in county file for audit.
Reverse Side.
SIGN TITLE:
DILHR SBD 6710(R.01/62) Zoning Administrator
INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT
APPLICATION
C.
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 owners 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;
Ill. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or
repai r;
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 8Y2 x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement
system areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a 115 form.
GROUNDWATER SURCHARGE
On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more
commonly known as the groundwater protection law. This change in statutes was the
result of over 2 years of steady negotiation and public debate. The groundwater bill Ground Ater
included the creation of surcharges fees for a number of regulated practices which •'
9 ) 9 P ,
Wisco in's
can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried rer'1su
is used in your building is returned tc the groundwater through your soil absorption o
system or the disposal site used by your holding tank pumper.
0
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.
S9D-6338(8.03/86)
SANITARY PERMIT APPLICATION COUNTY
TDILHFi
In accord with ILHR 83.05,Wis.Adm.Code s ` 6 i/X
STATE SANITARY PERMIT##
-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 Sd NO
PROPERTY OWNER PROPERTY LOCATION
Z_, (9. /'C -,— Z-yZt W_ %, S 56 T 2Q, N, R /S V(or)r
PROPERTY OWNER'S MAILING ADDRESS LOT NUM�R BLOCK NUMBER SUBDIVISION NAME
OP'
/
CITY,STATE ZIP CODE PHONE NUMBER CITY f7 ��V f�7'�l°/� NEAREST ROAD,LAKE OR LANDMARK
GC/OOG7!/j �il -'OZ? /.5 11,692?- C-1 L0 TOWN OR
VILLAGE : ✓�I
11. TYPE OF BUILDING OR USE SERVED:
Number of Bedrooms if 1 or 2 Family OR ❑ Public(Specify): //X
III. PURPOSE OF APPLICATION: (Check only one in##1. Check##2,3 or 4,if applicable)
1. a. ❑ New b.X 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.,X Conventional b. ❑Alternative c. ❑ Experimental
2. a. ❑System- b. ❑ Holding c.❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP
In-Fill Tank
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. Seepage Bed b. ❑Seepage Trench c. ❑Seepage Pit
2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY:
(Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): /�
?/44 5 ❑ r�Q A 70'73 Feet Private ❑Joint ❑ Public
VI. TANK CAPACITY Site
in allons Total ##of Prefab. Fiber- Exper.
INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks �" 1 structed -0
Septic Tank or Holding Tank Tanks an 0OC3 [.CAP—�.
Lift Pum Tank/Si hon Chamber ❑ ❑
VII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans.
Plumber's Name(Print): Plumber's Signature:(No Stamps) MP/MPRSW No.: Business Phone Number:
Da/e /6�uO&Ij n e'. 6��Z 1 (71-,5' y-337
Plumber's Address(Street,City,State,Zip Code): Name of Designer:
IV �IZD 11V011n
VIII. SOIL TEST INFORMATION
Certified Soil Tester tCST)Name / CST##
��/e Z-,
CST's ADDRESS(Street,City,State,Zip Code) Phone Number:
Q Z-1,/)/,) ��z�/z,- 71 -3�4�
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature(No Stamps)
Approved ❑ Owner Given Initial S rc�]ha�rge�F+r L
Adverse Determination
X. COMUFNTS/REAS04S 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
S T C - 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 �-'(li r ��✓ OI
Location of Property . ,�✓� 14, Section 30 , T N - R 457' W
Township r�/)CIi'�
Mailing Address V 30.0
Subdivision Name
Lot Number &
Previous Owner of Property vin �CIYSD�
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 7 7q and Page Number as recorded with the Register of Deeds
INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING:
1. Warranty Deed
2_ i.anA rnntrart
i
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 5—1982 THIS SPACE RESERVED FOR RECORDING DATA
PERSONAL REPRESENTATIVE'S DEED
REGISTERS OFHCE
Harvey Larson and _Eugene Larson
ST. CROIX CO., WISj
-----------------------------------------
RoC'd. for R(icord this 26th
-___ __ -------------------------- as Personal Representative of the estate of ( &e/ Qf May A ; 1$87
_A1vin..E..__Laro - , I
!
-------- -------- -------
-----•---------------------------------------------------------------•----------------- ("Decendent") #
1
a aluab a cons'de ation cone s witllou warranty, to __.E.. Arthur_ ___ avb1W of pwde . ,l
f ic'kar� an uElla Rictard,
3 •----------------------------------------•--------------•---•------------•------
-_______________________________________________________________________________________________________________ ..... ...... ...." .
------------------------------------------------------I- -------- -- --------------------------, Grantee, RETURN To REMINGTON LAW
-- . T O 1 X
the following described real estate in __.t _______________-----_---------------------Count Yr OFFICES
State of Wisconsin (hereinafter called the"Property")
The West 335 feet of the East Half of the Northeast
Quarter , Section 30 , Township 29 North, Tax Parcel No_ ______________________________
Range 15 West.
I
'160
FETT
�y
Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which
the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the
Personal Representative has since acquired.
Dated this 12 I
------------------------------------------------ day of --Mai'--�-----------------------------------....----------.....---r 19._$7._.
E
(SEAL) --- -- ---•----- --- --------- ------------------(SEAL)
------------------- -------------------------------------
1
Harvey Larson Eugene Larson
------------------------------------------------------------------ ----------•---------..._....---------.._.__...------......--•-•---
j Personal Representative Personal Representative {{
4:
17
i'
AUTHENTICATION ACKNOWLEDGMENT
Harvey Larson and STATE OF WISCONSIN
Signature(s) . . .. •-•-•- --•- ---- - - - ss.
Eugene Larson
j -- -------------------•-----------------._...--------------......---...--------
' ----------•...........................County.
jj au Personally came before me this ________________day of
------------------------------------------- 19..------ the above named
E ----------------------------------•---------------------------------------------
Thomas R. Schumacher
-----------------------------------------------------------------------------
TITLE: MEMBER STATE BAR OF WISCONSIN
I'
(If not- ----------------------------------------------------------- ------------------------•-------------------•-----•-------- E
authorized by § 706.06, Wis. Stats.) to me known to be the person ............ who executed the
foregoing instrument and acknowledge the same. j
!1 THIS INSTRUMENT WAS DRAFTED BY I
BAKKE, NORMAN & SCHUMACHER, S . C .
1 New Richmond, WI 54017
Notary Public ----------------------- County,, Wis. ;
(Signatures may be authenticated or acknowledged. Both My Commission is permanent.(If not, state expiration j
are not necessary.)
date: ---•-•---••----------------------•----------------------r 19--------•) I
*Names of persons signing in any capacity should be typed or printed below their signatures.
ii
....._... _ _.._.._ ._ _._ .__ _.- __._ __ .. _._. _. _ __ ._. .._.__..._.._.
H-GMillarComparry� STATFO M No. WISCONSIN SIN Stock NO. 13005
, H
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H
a
STC 105 r
a
H
SEPTIC TANK MAINTENANCE AGREEMENT � +
• o
St . Croix County z
a
/ a
OWNER/BUYER
ROUTE/BOX NUMBER Fire Number
CITY/STATE C�oOlJi�i'//� (.C�iSGOl�S�� ZIP
PROPERTY LOCATION : Z $, N� 14, Section SO , T 29 N , R W,
I
Town of $p,- /
io, �i/� , St . Croix County ,
Subdivision /�i� Lot number vi9
I
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- i
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
I/WE, the undersigned , have read the above requirements and agree Ln
to maintain the private sewage disposal system in accordance with x
the standards set forth , herein , as set by the Wisconsin Depart-
ment of Natural Resources . Certification form must be completed
and returned to the St . Croix County Zoning Office within 30 days
of the three year expiration date .
SIGNED
i
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 .
°,`VENT OF REPORT ON SOIL BORINGS AND SAFETY&
INDUSTRY, DIVISION
LABOR AND P.O. BOX 7969
HUMAN RELATIONS PERCOLATION TESTS (115) MADISON,WI 53707
(H63.09(1)& Chapter 145.045)
LOCAT TI TOWNSHIP/MU IC��ALITY: LOT NO.:BLK.NO.: SUBDIVISION N ME:
E"ZWe% 30 /T 9N/R/5B(or S .�,'ra tl�/c� i(/�9
COUNTY: OWNER'S/BUYER'S NAM MAILING ADDRESS:
01 C'ro ' ,�`. '� rG�' 7`� �o Z� 4<�eoalvi' : SAO Z�
USE DATES OBSERVATIONS MADE
IND.BEDRMS :1COMMERCIAL DESCRIPTION: PR FI NS: A TESTS:
®Residence ❑New XRepiace 13_ 5 ��•// —4/
s RATING:S-Site suitable for system U-Site unsuitable for system J �0 0
CONVENTI NAL: MOUND: IN-GROUND-PRESSUR. :S STEM-IN-FILLHOLDINGfil RECOMMENDEDSYSTEM:(optional)
OS O U ®S ❑U ®S ❑U 111S"�U ❑S
If Percolation Testsare NOT required DESIGN RATE: If any portion of the tested area is in the
under s.H63.09(5)(b),indicate: �� I Floodplain,indicate Floodplainelevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.)
CJ
B- lvp/ /o/, arm IV
B-
B- e s s owe o-1c 160ale` a l .
' PERCOLATION TESTS
TEST DEPTH•, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN.
PERIOD 1 PERIOD 2 PER INCH
'j P- / 3 0 /O / /
P. Z
P- r! %' /
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 90-73�
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