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HomeMy WebLinkAbout040-1031-50-000 \ ¥ � 2 § � \ ~ 0 f \ 0 , \ � � R § G x ) / � � \ � r k ) z J - 0 / ? � $ � � z E § � ® k / § . a m \ z k 2 ) % $ J ® \ m _ § f § e c N A -� \ } / \ § � } ) k )CD W z z c \ � k ) 2 � ƒ o � § f ƒ � f \ 2 a a { £ { Z n \ \ m m } _ k 2 k } -� _t § a 2 2 EL j \ § \ § § a ) CL Cl)a\ cl� @@ » © § � � � � � � � � OD 2 ] % » = u � ■ - ; � � k § c } e ( § § 0 \ \ b ) k \ a R ) z a ] 5 - 6 \ / � { E ) ° E i = § o ) / & ■ / % k � 2 ) m k — , : ; ; a E 2' @ a § / J a 2 0 0 v - l Parcel #: 040-1031-50-000 04/12/2005 07:30 AM PAGE 1 OF 1 Alt. Parcel#: 7.28.19.104D 040-TOWN OF TROY Current 'X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): *=Current Owner * PAUL G,&KATHERINE REED GERTENBACH GERTENBACH, PAUL G,&KATHERINE REED 438 STAG'S LEAP LA HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *438 STAG'S LEAP LN SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 1.920 Plat: N/A-NOT AVAILABLE SEC 7 T28N R19W 1.92 AC NW SW LOT 3 OF Block/Condo Bldg: CERT SURVEY MAP IN VOL I PAGE 147 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-28N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 799/448 07/23/1997 764/91 2004 SUMMARY Bill M Fair Market Value: Assessed with: 26335 785,800 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.920 193,600 593,800 787,400 NO Totals for 2004: General Property 1.920 193,600 593,800 787,400 Woodland 0.000 0 0 Totals for 2003: General Property 1.920 176,000 547,300 723,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 132 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 PUMP CHAMBER "� t Manufacturer: Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size , Elevation of inlet: Bottom of tank elevation: Pump off switch elevation: Gallons per cycle: Alarm Manufacturer: Alarm Switch Type: Number of feet from nearest property line: Front, O Side, O Rear,0 Ft. Number of feet from well: Number of feet from building: (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: 9s,/O Trench Width: /oZ Length: �3 �. Number of Lines: Area Built: / .34P a Fill depth to top of pipe: 35 Number of feet from nearest property line: Front,' O Side, (?rg—ear,0 it V Number of feet from well: '�a?3 Number of feet from building: 36-10 (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one) . HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: Dated: Plumber on job: License Number: 1/7/300IL,r- ,��d� 3/84:mj Form - STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP 7, p SEC. T N- ADDRESS ST. CROIX COUNTY, WISCONSIN o �0- (0 31 �SZ� � SUBDIVISION VI ` � LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of I•IHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM tj zLL r: /loo S-All INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used /~ royl . + QC"-0 4ji—Mi aMe Elevation of vertical reference point: /DO Proposed slope at site: SEPTIC TANK: Manufacturer: Liquid Capacity: /000 te7a /. Number of rings used: f Tank manhole cover elevation: Tank Inlet Elevation: 9. 3 ' Tank Outlet Elevation: 014/1. 9� Number of feet from nearest Road: Front,O Sideo Rear,/2j/� feet From nearest property line Front 10Side, ear,0 s� feet Number of feet from: well //a , building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) SEE REVERSE SIDE DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.BOX 7969 BUREAU OF PLUMBING P41S_OPJ�WI 53707 SW�yS7,T28N-R19W [CONVENTIONAL ❑ALTERNATIVE StassigneLD.Numbec a Town of Troy ❑Holding Tank ❑ In-Ground Pressure ❑Mound (If assigned) Lot 3 NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE Paul Gertenbach & Katherine teed 504 Hunter Hill Road Apt. 2, Hudson, WI 54016 9-1 y"Y 7 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN. REF.PT.ELEV.: CST REF.PT.ELEV.: } 3 Name of Plumber: MP/MPRSW No County: Sanitary Permit Number: Gary Zappa 3300 St. Croix 95994 SEPTIC TANK/HOLDING TANK: MANUFACTURER d LIQUID CAPACITY: TANK INLET ELEV.. TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER r / P OV DED: PROVIDED: U 0 0 9 � 7I S YES ONO DYES �AO BEDDING: VENT DIA.. VENT MATL. HIGH WATER NUMBER( ROAD: PROPERTY WELL BUILDING: VENT TO FRESH 4 C I ALARM -7y LINES ' I f 2 I AIR INLET. FEET FROM / C/_r ❑YES NO ❑YES NO NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY. PUMP MODEL. JIUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO OYES ONO DYES ONO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL. BUILDING:I (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET PUMP ON AND OFF) ❑YES ONO NEAREST SOIL ABSORPTION SYSTEM.Check the soil moisture at the depth of plowing FORCE LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,construction shall cease until MAIN' the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH LENGTH NO.OF DISTR.PIPE SPACING. COVER WSIUE DIA.-. #PITS. LIQUID TRENCII-ES. I MA RIALt PIT DEPTH - t31ANI1wfi1SIONS L GRAVEL DEPTH FILL DEPTH DISTR.PI E DISTR.PIPE DISTR.PIPE MATERIAL. NO.DIST NUMBER OF PROPERTY WELL: BUILDING. V NT TO FRESH RE LOW PrrIPES. ABOVE COVER. E�LyE V.INLET.ELEV.END. PIPES. LINE I 1 A►(2 IET; G S �ICO,(� 95.01'6 Z�.� FEET FROM 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. OYES 1:1 NO SOIL COVER TEXTURE PERMANENT MARKERS OBSERVATION WELLS. ❑YES ❑NO DYES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL. SODDED. SEEDED. MULCHED. CENTER. EDGES. El YES ONO DYES ONO I DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: qsz.� WIDTH: LENGTH. NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER: � It[C,r^h TRENCHES: N MANIFOLD PUMP MANIFOLD DISTR.PIPE MANIFOLD MATERIAL. NO.DISTR. ID ISTR.PIPE DISTRIBUTION PIPE MATERIAL&MARKING. ELEV.: ELEV.: DIA.. ELEV.: PIPES: DIA.: XLEVATOW'AND TIyN 'ri�E� HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO APPROVED 1 '" PLANS: E YES ❑NO ❑YES El NO COMMENTS PERMANENT MARKERS: OBSERVATION WELLS: NUMBED OF" PROPERTY WELL: BUILDING: LINE: ❑YES 1:1 NO DYES 1:1 NO NEAREST fi 0- 9- 33 Sketch System on ounty file for audit. Reverse Side. SIGNATU TITLE: Zoning Administrator DILHR SBD6710 (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, 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: I. 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 42 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% 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 then -� 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 Wisco irt's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried reasllre 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. V The Fnonies 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 "ate;, groundwater contamination investigations and establishment of standards. Groundwaier, _._._ 5 worth protect ng. c DD-6398(9.03186) SANITARY PERMIT APPLICATION COU3' r,— � DILHFi In accord with ILHR 83.05,Wis.Adm.Code ' ��RMI 'Y STATE SANITARY PERMIT# 9 =Attach Complete plans(to the county copy only)for the system,on paper not less than STATE PLAN I.D.NUMBER 8%x 11 inches in size. —See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION—PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑YES NO PROPERTY OWNER PROPERTY LOCATION Aj d '/4 '/4, S T , N, R E (or)W PROPERTY OWNER'S MAILING ADDRESS JE&EaUMBER LOT NUMBER SUBDIVISION NAME n CITY,STATFf ZIP CODE PH AE NUMBER CI_TYS? NEAREST ROAD,LAKE OR LANDMARK C-1 VILLAGE: d 11. TYPE OF BUILDING OR USE SERVED: /w Q 1fa— /mod 1— —aw 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. 9 New b.❑ Replacement c. ❑ Replacement of d.❑ Reconnection of e.❑ Repair of an System System Septic Tank Only an Existing System Existing System 2. ❑ A Sanitary Permit was previously issued. Permit## Date Issued 3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements. 4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy. IV. TYPE OF SYSTEM: (Check only one in#1 and only one in#2) 1. a. ts 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. X Seepage Bed b. ❑seepage Trench c. ❑ See a e Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5.SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED(Square Feet): PROPOSED(Square Feet): 4�3 b � O 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 , O J Lift Pump Tank/Siphon Chamber ❑ ❑ VII. RESPONSIBILITY STATEMENT I,the undersigned,assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name(Print): Plumber's ignature:(No Stamps) 4AWMPRSW No.: Business Phone Number: r-7At-1V 2_41'40A umber' Address( r et,City,State,Zip Code): 401#IV Name of Designer: X( r t 4 O,^✓ VIII. SOIL TEST INFORMATION Certified Soil Tester(CST)Name CST# v pr ev CST's ADDRE (Stre t,City,State,Zip Code) Phone Number: IX. COUNTY/DEPARTMENT 10SE ONLY ❑ Disapproved Sa nary Permit Fee ix�_,Oo ndwater ate Issuing Agent Signature(No Stamps) h rge Fee Approved ❑ Owner Given Initial � /�+�`„�,q �Adverse Determination W (Q ( Jam+ X. COMMENTS/REASONS FOR DISAPPROVAL Ian ()j 4? ed mc�.s C' . /.,j 4e kS v/.,j 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 SW 4, Section , T N-R_1 W Township —i-(ou Mailing Address )41 (2-OZ 2 k4�kS y' , W T_ 1�5 4O l lQ Address of Site S.�I� L I Subdivision Name Lot Number Previous Owner of Property J 1��p �1 �}�-�d�11�- 1 y rn Total Size of Parcel 1 . 9Z 0A Date Parcel was Created � ?(s9z at I SLAt� Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes . No Volume _1` 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPFRTy OWNER CERTIFICATION I (We) cvLaby that att statements on thi,6 jonm ane true to the but o6 my (oun) knowledge; that 1 (we) am (are) the oWneV.6b o6 the pnopenty des embed in thin inbarmation bonm, by viAtue ab a neeonded in the 066ice ob the County Regi--ten ob Deeds as Document No. 2p 32 ; and that I (We) pnesentty own the pnopos ed s.c to bon the sewage diz pas s ys• em (on I (we) have obtained an easement, to nun with the above ducA bed pnopenty, bon the eon,dtnucti.on ob sold system, and the same has been duty recorded in the Obbbce ob the County Regi.6ten ob Deeds, as Document No. ) . SIGNATURE OV OWNER SIGATURE OF CO-OWNER (IF APPLICABLE) Z211 T 2 D SIGNED DATE SIGNED 71',rte 11 4 327701 NORTH LINE OF OIL cN�N �N�aa4� S 89°25' 58"E 000 Ld S' X `X O S,�'f,�: :WEST 1/4 CORNER 42 8. 10 N ,tea O X�p� SECTION 71 T 28N,R 19 W ANN 7 LN �0 I oo Q,a&Id (r SCALE rn-d Z 100 0 50 100 M �Q' 61, ='83°27'3d' 33. J ' N 19°07 35�E R = 130.79 i 33 .\ L =190.51 p 235°30 O2' % POINT OF BEGINNING �gEgR /CENTERLINWE 0 N 60°51'2C;'EE 2 ING �2 SOUTHEASTERLY 66°2?-' RIGHT-OF-WAY LINE OF PRIVATE PARK ACCESS ROAD 3 NW 1/4 — W 1/4 1.92 ACRES 83DIS4T' LEGEND ,y ® SECTION CORNER MONUMENT 9 2°sr�• NORTHWESTERLY 43: B9 40t• RIGHT-OF-WAY ,` p 0 1" X 24" IRON PIPE 4 ip LINE 0 WEIGHING 1. 68#/LINEAL FOOT. =� M 0/ Co O. SURVEYED FOR: Dr. John Alden and Dr. Robert Flom �',� R. R. #1, Hudson, Wisconsin 54016 DESCRIPTION A parcel of land located in the NW1/4 of the SW1/4 of 33;� Section 7 , T28N , R19W, Town of Troy, St. Croix County , Wisconsin, described as follows : Commencing at . the N1/4 corner of said Section 7 ; thence S89° 25 ' 58"E (true bearing) 428 . 10 ' along the North line of said SIV1/4 ; thence SO°34102"W 253 . 60 ' to the point of beginning ; thence S63 038138"E 410..461 ; thence S33°07135"W 238 . 20 ' along the Northwesterly right- of-way line of proposed town road "B" ; thence N52 041 ' 40"W 489 . 91 ' ; thence Northeasterly 190 . 51 ' along the Southeasterly right-of-way line of a private park access road on a 130. 79 ' radius curve concave Northwesterly whose chord bears N60 051120"E 174 . 10 ' to the point of beginning . I certify that the above description and map are correct and that I have fully complied with the provisions of sec . 236 . 34 of the � Wisconsin ssin Statutes . "4Z v Date : March 31 , 197 S 9 �FAN E 8 Map No. 75452 0 A FILED rf JUN 231975 Z Co LAMES O'CONNELL 40bl. of D"d, ti C' 64 Croix C°"nty' volume 1 Page 147 Wbco.n H z N H a r STC - 105 a H SEPTIC TANK MAINTENANCE AGREEMENT c St . Croix County z d a OWNER/BUYER PAtALC--�' ROUTE/BOX NUMBER �� ►Ct�\ �t\ Fire Number .CITY/STATE 4, ASQn ' ZIP PROPERTY LOCATION:_j6LI�_3t, c�7KJ 36, Section, T N, R_I_W, Town of ��(a�� , St . Croix County, Subdivision , Lot number 3 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 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. Ho • E I/WE, the undersigned, have read the above requirements and agree N to maintain the private sewage disposal system in accordance with x rr the standards set forth, herein, as set by the Wisconsin Depart- 'd ment of Natural Resources . Certification form must be completed and returned to the St . Croix County Zoning ff rpe i in 0 ay 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. cy t0 n h p u � Qw J Mr 1 `sd 3 s Z �_ ra r o r► 3 o Itf e� = o 30- a I.- z w .•�. '" A ti •A � 4b 4 • 1N, Z~ dMrT � ` p at M M 44 J R i �� a 'Fig « ,�w T ON SOIL BORINGS AND SAFETY& BUILDINGS DEPARTMENT OF REPORT DIVISION JNDUSTRY, P.O.BOX 7969 LABOR AND PERCOLATION TESTS (115) MADISON,WI 53707 HWMAN KELATIONS (1-163.090)& Chapter 145.045) _ UNICIPALITY: �-O N O.: LK.NO.: SUBDIVISION N�- t_OCATII -5 S CTION: T r'�E-te 5,4 Nw 1/'4w'/4 :7 /TzeN NO tor i+eoy COUNTY: WNER' BU AME: MA 1 DD SS: Sr64>6 `r, PAUL 6LR-TtN&AC - N DATES OBSERVATIONS MADE USE - --—---- N : — -`- - - NO.BE[7Ft(v5.c COMMA L U SCRIPTION� ,�. L�Re lace I �g z/9 Residence —. ) Ml1New P MAY Sc7 �r'1y 7 /9� / -------1---N --� Sots $obK C 73 SarLS - Ptn - PiLLnT" RATING:S=Site suitable for system U=Site unsuitable for system - ENTI NAL: MOrrU,,ND:091 IN-GROUND-PR oU E: SYSTEM-IN-FILL ��G � R�QNV N_ID�N/4C (oP �1�TkN EIS J S -_`�S IlO1/JIU -- — - S El ._ 1 [If'Percolation Tests are NOT required DESIGN RATE: If any port,nn of the tested area is in the -f� der s.H63.09(5)(bl,indicate CLASS. I Floodpl;nn indicate FloodPlain elevation— -sV- �Ec�r PROFILE DESCRIPTIONS BORING TOTAL P H T R UND ATER INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER EP'TH3 ELEVATION ____OBSERVED H S TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- 7,6� 99. 14 ortr, "$RN B Z 7.5O ,/FS NoNf- `l 7.56 12"19L LTS 4 Q S r S L 74"ig 4 MS M � B- 3 -7 1JomL > 7.S0 21 $LLTs 7'Seas►SL tS! B S 'r B-4 B.r1-7 9�.�� ` > H.1-7 /� B«-rs 'so M B4N AS B- S� q.00 y4 6-7 1v >9.06 �''fIJ�CTS io"�QN 5,5� $7..�eN M5 - - —^ '- PERCOLATION TESTS c DEPTH WATER IN HOLE "TEST TIME DROP IN WATER LEV_L-IN HES RATE MINU•EES • — __ _ P_ER INCH NUMBER IkIES /AFT ER SWELLING INTERVAL-MIN. P _____PERInn .__...._. .._.._._.P._R P. ��--- —. .---------- --�� - — P_ 3 4 ,3u -ONC C19AO 3 Cam`.' - -:--- } — P-_ t!1S1Q. .�T ��_... ---- ------- 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 horings and the direction and percent of land slope. CdWTE�Lt N�' SYSTEM ELEVATION of A F-L_ I \ , .w.>ti ALTC ATr \ X V iex is a iu,ss t P-1 1MA�. ---- --�_3- 1 1 tN \ ♦ ♦ ! P e r innv s SeALC ♦ S y.rscA ..r . IZ4 °�"3 t •. Ao'_* u' for $M_ 1/'1 'V Apt -.CT •e/s>�n t AT QF 'S 100,00 LOT LttJv t 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedunrs and ItN!th(r(fS spaCllie(I ilt tlu!Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. 1NEHE COM1I kTEll ON: -- NAME(print): ' 9'w7 NAIRNCI G , Jo NSoti -_.-_-�Pu r S e� ,rrrvv_. `NC _ May_- 19 i. -- ------------ - "-' L;FEiIIFICAIIONNUMIS[:It 1'HONENL1MRfl;(optirnrd): ADD�ESS 3%G- 4o�O d I `J FvtON tom-_ L.Y v ( ------ -- - -- -- DISTRIBUTION: Otitpnat,Ind onecupy ur Local Artlh-11Y,t4npr•iry "wn•i anf Soil le,lcr. OVER jilt HR-SRD 6195 (Et fV/82) � 1 .q� r ty C$�9 e qd' "mot; s �9i .Y~ a.... REPORT ON 541E BORINGS AND SAFETY & BUILDINGS DEPARTMENT OF DIVISION INDUSTRY, P.O.BOX 7969 LABOR AND PERCOLATION TESTS �115) MADISON,WI 53707 HOMAN FtF LATIONS M63.090)& Chapter 145.045) _ TO UNICIPALITY: _OT NO.:BL K.NO.: SUBDIVISION NAME LOCATI; .e ' SECTION: — — Jl'rETeS,4 S row /4w/ `1 /Tze 11119 t(or oY COUNTY: WNEH' HIJ AME: MAI 1 AOD SS: S-r PAUf: �, -+eTttAACN DATES 08SE-RVATIONS MADE USE __— ------_..._ NQ HEDRMS.: COMM RZ`1 L DESCRIPTION: L]Replaie /hNy 19 /9�7 ,�{ _ 1 New d 4q Rl ,- dencI UNK.---� --�—•� ---- - c E ,A _ P►L�o1- Sn t Ls t�K �/'A ti 7 3 Sa 1�s - RATING:S=Site suitable for system U-Site unsuitable for system ENTI NAL: MOUND: 1N-G PRESSURE: SYSTEM-IN-FILL 01 S T K.Rr�dNVEN JD SYS7EM:(opt' nal) U S ❑U D S PlU D S IU�_ V _oN ALA saulos � I. Z_ If Percolation Tests are NOT required DESSIIGN RATE: If any portion of Ihe.tested area is in the �A under s.H63.09(5)(b),indicate: CLdSS I �Lj Floodplain, indicate Floodplain elevation: bccC-t PROFILE DESCRIPTIONS BORING TOTAL H R UN ATER INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH 8 Ep11i ELEVATION pgSERV D I H TO BEDROCK IF OBSERVED(SEE ABBRV.ON BACK.) B- I -7,6-7 99- /4 at�IL 7 7,67 io� ELL-TS /Z'' �eK SIS� .76"btisi Ms B- z 7,SO IFS iyoNL y 7 so J Z.'9L STS 4"' J9eNS I S L 74" i9 Q MS B- 3 7 Sd 9� 77 1 , r 7 7.50 2ZM&L 1 s T"$e.�5t5C �/ S 4 1x3.1-7 9`x.63 > S.►7 /��' BC.L75 ,. PQN B- 5 q.W -99.67 No >9.06 "QcC 7'S�oA�QN 515 g�.,�e.v MS PERCOLATION TESTS c T DEPTFI WATER IN HOLE 'TEST TIME _DRO_P IN W/�1'f.H l f VEI IN .FIES HATE MINUTES NUER td�1ES AFTERSWELLING INTERVAL-MIN_ ` loci)- PLRI<1� _ PEH INCH MB P_ Z 3 C Z MoF„L _ 98 .-7z 33.------- --- _— --- _->z----- c P- 3 4 '3° �_ g9AO 3 f- — — ------- - PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all horings and the direction and percent of land slope. �}5,�0 CENTE�LINZ' SYSTEM ELEVATION _ or fnAAN f-L I i ..,t. AcT�>,NATC x x Mm 1 V I P I I Pl n12.y -- --P-3 1 1'N l 1 P rICA `1$igRft SC►4LG Flo'! 12l Jo, $M_ 1/�l �rPc sET q •E/. AT LASE of 'S " LATHE tBBpN l00,00 LOT LInit: t I, the undersigned, hereby certify that the soil tests reported on this Form were made bV Ine in acl:(ud with the procedurm and 111et11-Is sfulciliell 111 thl!Wlsc:clnsin Administrative Code,and that the data recorded and the location of the tests are correct u)the best of my knowledge and 1whef. WFHF COMPt FTED ON: AM/E Spri I0 9 9 14A VCI V�–����5�.!s ___�U`�J�_.. " J�C (:t H1IFICAIIOdNN0MIlIAi NION//E.NUMHUHf(plicmal): A DRESS - t..>r I Nn TURF DISTRIBUTION: (911purd arn!unu cnlly m Local Aulhm lly,I'Inllrl ly"wool '11111 Still l e,l" y OVTR /IL1-IR SFID-F?'195 1W 01$?) J P 1Zvl06ZTy Lr nl / l��oT ��o Cn.oSS //0"70 I b,v4 J�G7�on/ ✓'��ON,C /'i optnTv La• I PaorcSEO WELL l nosEGT ss---T�— —A— — ----` -P p Au L GE12TE1v oAc N )04 so bAolops' o 61-VEP.AY /�A7, nx,)E /ZFED 7o-vvti of TAc r Pno no S�o I ST• C/LaSX LDU,OOT Y nEMFNGE ALT. S=E , Qy To EAST L63 /°RoAFRTY L1NE 0 V E"rr STACK s- f�`_ , 0L 6' /fi Jo7o GAL S67= 'D � Akio o✓E2 2001 � 23 NO SCALE To I-EST 102o PE&TY L2nrE .fLoPt yl i<--&� 7s /2(Zon/ Ip ZPE SFT AT OASE of S IJE tl )-) LATHE t ;a-;,D Iv EL EV._/w.00 sown• PiloPE2TY ZZ'E &c--40y,0Xv4oPE4 Lo I- —� FRESH AIR INLET AND OBSERVATION PIPE ? A P PROVED VENT CAP M-kXlk&IM 12" ABOVE FINAL GRADE 4"CAST IRON VENT PIPE MAXIM1M OF 42"ABOVE PIPE TO FINAL GRADE c SIGNED: _ MARSH HAY OR SYNTHETIC COVERING LICENSE: MINiMIJM 2" AGGREGATE DATE: &&OP.Z OVER PIPE � �T DISTRIBUTION PIPE TEE SOIL TESTING BY: ELEVATION BED 6" AGGREGATE • BOTTOM PER SOIL,~ BENEATH PIPE PERFORATED PIPE BELOW TEST IS �, COUPLING TERMINATING ��./0 FT. AT BOTTOM OF SYSTEM