HomeMy WebLinkAbout006-1012-90-000
St. Croix County Planning and Zoning F►iday,February 02, 200 7 at 8.50.53 AM
Detafl Sanitary Information Page 1 of l
Computer 006-1012-90-000 Sub/Plat: 40 acres Section: 6
Parcel 06.31.16.95 Lot: TNIRNG: T31N R16W
Municipality: Cylon, Twin of CSM: 114114: SW 1/4 SE 114
Owner: Hemauer, James 2068 Cty Rd. H Deer Park, WI 54007
State Permit: 79145 Issued: 0511611986 POWTS Dispersal: Non-Pressurized In ground Permit: Replacement
County Permit: 0 Installed: 0512111986 POWTS Detall: Bed- Seepage Bedrooms: 3 WI Fund:
POWTS Pretreatment: NA
Notes
issuedInspector Built Plumber Other Reauirements Additional Notes Money
Harold Barber Yes Bird, Byron Jr. notecard only $0.00
Tom Nelson Signed Off: No
Maintenance
Scheduled Pump Date Pumped 1 st Notification 2nd Notification 3rd Notification
5/2112006
- t'o _yo -d06
HEMAUER, JAMES Wil SK, Section 6
xt T31N-R16W. j,
Deer Park, WI 54007 Town of Cylon
San.Permit#79145 5-16-86 B. Bird, Jr.
Conventional, Replacement
f
INSTALLED 5-21-86
,YV 1
Form- S T C - 104
t. AS BUILT SANITARY SYSTEM REPORT
OWNER in P5 27a li e TOWNSHIP Cale h SEC. _ TN-R~f _W
ADDRESS ST. CROIX COUNTY, WISCONSIN
/lei C
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of I•IHR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
i
a -
je;'/
f9~ ~
mss= ~ ~
j
I -
INDICATE NORTH ARROW
C~o a
Z• Co nc~j,.
BENCHMARK: Describe the vertical reference point used O~4sy
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer: Wee Liquid Capacity: /C-Z~-v
Number of rings used: f Tank manhole cover elevation: 3 J y
Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road:
Front,a.Side,Q Rear, O ~2r30a feet
From nearest property line Front 10 Side 10 Rear, O 7 ,500 / feet
Number of feet from: well building: /
.aclude this information of the above plot plan)( 2 reference dimensions to septic tank)
SRR RRURRSR STAR
PUMP CHAMBER
Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft.
Number of feet from well:
` Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: ~f , ~4' Trench
Width: ~
Length: Number of Lines:, Area Built:
~l
Fill depth to top of pipe:
Number of feet from nearest property line: Front, O Side , Rear,O It.&ID #4
Number of feet from well :
Number of feet from building: ,2,S_
/ (Include distances on plot plan).
1
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: lz~
Jt-
Dated: Plumber on job:
License Number : ~l•=-_ t~3l~
3/84:mj
DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR
LABOR & HUMAN RELATIONS SAFETY & BUILDINGS
P.O. BOX 7969 PRIVATE SEWAGE SYSTEMS DIVISION
MADISON, WI 53707 BUREAU OF PLUMBING
5aCONVENTIONAL ❑ALTERNATIVE State Plan l.D.Number:
❑ Holding Tank ❑ In-Ground Pressure ❑ Mound (if assigned)
NAME OF. ERMIT HOLDER: DRESS OF PERMIT HOLDER:
INSPEC ION A E:
James Hemauer Rt. 1, Deer Park, WI 54007 ~ ~ ~ 40j
BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FADROM PLAN:
REF. PT. ELEV.: CST REF. PT. ELEV.
Wig of the SEk of Section 6, T31N-R16W, Town of Cylon
Name of Plumber
MP/MPRSW No. County Sanitary Permit Number:
Byron Bird, Jr. 3318 St. Croix 79145
SEPTIC TANK/HOLDING TANK:
MANUFACTURER:
LIQUID CAPACITY. TANK INLET ELEV.. TAN, OUTLET ELEV.. WARNING LABEL
--tQ P OV DED: LOCKING COVER
0 11 . ? iJ n PROVIDED: t&4 A BEDDING: VENT DIA.: VENTMATI HIGH WATER J Gam' 7 YES ❑NO ❑YES NO
1 ALARM NUMBER OF ROAD: P, OPERTY WELL. , BUILDING: VENT OFRESH
❑YES Q C FEET FROM LINE AIR INLET
❑YES NO NEAREST &00 f
DOSING CH MBER:
MANUFACTURER. BEDDING. LIQUID CAPACITY PUMP MODEL PUMP; SIPHON MANUF AC EH
WARNING LABEL LOCKING COVER
❑YES ❑NO PROVIDED PROVIDED:
GALLONS PER CYCLE: PUMPANDCONTROLSOPERATIONAL ❑YES ❑NO ❑YES ❑NO
(DIFFERENCE BETWEEN BE OF PROPERTY WELL BUILDINf, VENT TO FRESH
PUMP ON AND OFF) YES EET F OM LINE AIR INLET:
F-1
SOIL ABSORPTION SYSTEM. Check the soi ❑ NO EARE
l
or moisture at the depth of, plowing 111'-Tfi uInM
excavation. (If soil can be rolled into a wire, construction shall case until FO CE E TEfT MATERIAL AND MARKING
the soil is dry enough to continue.) MAIN
CONVENTIONAL SYSTEM:
BED/TRENCH WIDTH LENGTH NO OF UISTR PIPE SPACING COVER
DIMENSIONS t ( \ TRENCHES M HIAL INSIDE CIA -PITS LIQUID
-l PIT DEPTH:
-L_ I l I•' FILL DEPTH DST If PIPE DISTH PIPE DISTR. PIPE MATERIA
BELOW PIP S sl ggOyE (nVER jE1!1 . 1N1{ F ELE V. EN NO DIS I 'NUMBER OF PROPERTY WELL BUILDING: V NT TO FRESH
//arrII1117/✓(' S3 pIPE ~ FEET FROM LINE'f
r NEAREST--~. ~/O S ~)SL Apyqt Ej.
MOUND SYSTEM: oC / a(J
Mound site plowed perpendicular to slope
and furrows thrown
uPslope: rpendi Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM
mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA-
❑YES ❑NO meets the criteria for medium sand. TIONS MEASURED.
SOIL COVER TEXTURE
PER I Nf NT MAHKFHS OBSERVATION WELLS
DEPTH OVER TRENCH BED DEPTH OVER TRENCH H EU ❑YES ❑NO ❑YES ❑NO
CENTER EDGES DEPTH OF TOPSOIL SODUFO SEEDED
MULCHED
❑ ❑
PRESSURIZED DISTRIBUTION SYSTEM: :]YES. ❑NO YES N0 ❑ YES ONO
BED/TRENCH WIDTH LENGTH NO. OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE
DIMENSIONS TRENCHES: FILL DEPTH ABOVE COVER
MANIFOLD PUMP
ELEV. ELEV. DMIAA NIFOLD DISTR. PIPE MANIFOLD MATERIAL
ELEVATION AND EL NO DISTH DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING
' . EV. PIPES DIA
DISTRIBUTION
INFORMATION HOLE SIZE HOLE SPACING OH ILLED CORRECT LY
COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED
PLANS
COMMENTS: ❑YES ❑ ❑YES ❑NO
PERMANENT MARKERS: OBSERVATION WELLS:
NUMBER QF PROPERTY WELL: BUILDING:
❑YES ❑NO FEET FROM LINE:
I I d ❑YES ❑NO NEAREST
ld G
Q
10.
Sketch System on
Reverse Side. etain in•county file for audit.
SIG R
(,,._..a TITLE:
DILHR SBD 6710 (R. 01/82)
s~ wisconsin APPLICATION FOR SANITARY PERMIT
DILHR ~ <y' COUNTY
OEPggTmEnT OF (P L B 67 )
-,InOUSTR Ill Og6NUmgnqELWTIOns UNIFORM SANITARY PERMIT #
-Attach'complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 81/2x 11 inches in size.
-See reverse side for instructions for completing this application. PLEASE PRINT
PROPERTY OWNER MAILING ADDRESS
PROPERTY LOCATION 6p
--CITY:
VILLA-
v E:
Wy E1/4, S , T✓-3/, N, R lol~ E (or)~ rn
LOT NU BER BLOCK NUMBER SUBDIVISION NAME NEAREST RO D, LAKE OR LANDMARK
STATE PLAN I.D. NUMBER
6
TYPE OF BUILDING OR USE SERVED /w. two ^/O~a_ ~0
_411 1 or 2 Family Number of Bedrooms:
Public (Specify):
THIS PERMIT IS FOR A:
EJ New System ❑ Tank Replacement ❑ Repair
Replacement Soil Absorption System ❑ Revision ❑ Privy
Alternate System ❑ Reconnection ❑ Petition for Modification
IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK.
Seepage Bed ❑ Seepage Trench C7 Seepage Pit ❑ Holding Tank
❑ System-In-Fill ❑ In-Ground Pressure ❑ Vault Privy ❑ Pit Privy
❑ Existing, For Which A Previous Permit Is On File, Permit #
issued
❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions.
Total #of Prefab. Site
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
Septic Tank Capacity
Lift Pump Tank/Siphon Chamber
Holding Tank capacity
Manufacturer:
IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In-Ground Pressure
Total *of Prefab. Site
Gallons Tanks Concrete Constructed Steel Fiberglass Plastic
Septic Tank Capacity
Lift Pump/Siphon Chamber
Manufacturer:
PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): WATER SUPPLY:
d a
Private ❑ Joint ❑ Public
I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans.
Name of Plumber (Print): Signatur r MP/MPRSW No.: Phone Number:
Plum is Address:
i Name o esigner. r
op
lid
COUNTY/DEPARTMENT USE ONL
Signature of Issuing Agent: Fee: Date:
S ❑ Disapproved
x.Z /s~0 p ❑ Owner Given Initial
Reason for
0$ I pil ~ sa rov Approved Adverse Determination
Alternate coursels► of Action Available:
DILHR-SBD-6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber
INSTRUCTIONS FOR COMPLETING THIS PERMIT APPLICATION, PLB 67 - SBD 6398
To be complete and accurate the permit application must include:
1. Property owner's name and complete legal description, please circle the appropriate municipal government unit, (whether this is in
a city, village or town);
2. Indicate specifically what type of use is served, if public is checked indicate type of use (i.e. 10 unit apartment, 30 seat restaurant,
etc.) ;
3. Complete the block for conventional or alternate system depending on system type, check all appropriate boxes or blanks.
4. Indicate the design percolation rate listed on the 115 soil test report, the number of square feet required by code and the number of
square feet to be installed;
5. Complete the section on water supply;
6. PRINT the name of the master plumber or master plumber restricted who will install the system, circle the appropriate license classi-
fication, place your license number in the space provided and sign the permit in the signature block;
7. Please place the plumbers business phone number in the blank provided, if there is a problem or question this will speed review of the
permit;
8. Change of ownership or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to installation.
Failure to comply will void the sanitary permit.
9. This permit maybe renewed, and at the time of renewal any new criteria in the Wis. Adm. Code will be applicable.
10. A new permit will be needed if there is a change in, estimated wastewater flow, (number of bedrooms, etc.), location of the system,
depth of the system, type of system.
11. All revisions to this permit must be approved by the permit issuing authority.
12. A complete plan including a plot plan, drawn to scale or with complete dimensions.
13. Horizontal and vertical elevation reference points that are permanent and clearly shown.
14. Piping detail including pipe size, separating distances, distances between beds if appropriate, tank locations, effluent line from tank(s)
to system, building sewer and vent observation pipe(s).
15. The permit issuing agent may require a cross section drawing of the effluent disposal system.
TO THE OWNER: This is valid for two years. Changes in your building plans or locations may require you to obtain a new permit. Private sewage systems
must be properly maintained. Have a licensed pumper clean your septic tank whenever necessary usually every 2 to 3 years. If you have questions concerning
your system, contact your local code administrator or the Bureau of Plumbing, DILHR, State of Wisconsin.
APPLICATION FOR SANITARY PERMIT
• ST 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 `1 ~I~'l e $ lTe k-A Q L-t _2,
Location of Property it, Section T Z/ _N-R~ W
,
Township (,o h
Mailing Address 14~ 1 Pe e~ r w SG Od 7
Address of Site 67 ( P,~,< IJ t sC 9'V00 7
Subdivision Name
Lot Number
Previous Owner of Property OIJ
Total Size of Parcel ~D
Date Parcel was Created C7~ 1 72-
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale .(spec house) ? Yes t/ No
Volume ' and Page Number a
as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A Warranty Deed which includes a Document number, volume and page number, and the
Seal of the Register of Deeds. In addition, a certified survey, if available, would be
helpful so as to avoid delays of the reviewing process. If the deed description refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
1 (We) ceAti6y that att atatementa on this 6onm are tAue to the beat o6 my (ouA)
knowledge; that I (we) am (are) the owneA(a) o6 the pnopeAty ducAi,bed in th.ia
in6oAmati.on 6o4m, by vc itue o6 a wanhanty deed n corded in the 066ice o6 the
County Reg-i4teA o6 Duda as Document No. ; and that I (We) pneaentty
own the pnopoaed 6 to 6oA the sewage diApoz d ya em (on I (we) have obtained an
eaaement, to nun with the above deAchibed pnopehty, bon the conatAucti,on o6 said
ayatem, and the .name has been duty tecokded in the 04jice og the County Regi6teA o6
Deeds, a4 Document No. 9 i .
Aol
SI TURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE)
s/1~/ _
DATE SIGNED DATE SIGNED
• H
z
En
H
ST C- 105 r
• r
'a Y
SEPTIC TANK MAINTENANCE AGREEMENT ry,
St. Croix County o
z
d
a
OWNER/ BUYER_ tJA-1~,~°S CV ftAjCtLt e- A!~.
ROUTE/BOX NUMBER is
- Fire Number
CITY/STATE flL~~iZ PA'JzK; {i(~1' ZIP LQ0
PROPERTY LOCATION: ~Z 5' Section 4::, T 3I N, R W,
Lb f-i
Town of C St. Croix County,
Subdivision AA' Lot number /V1
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
r 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. y
0
I/WE, the undersigned, have read the above requirements and agree Cn
z
to maintain the private sewage disposal system in accordance with
the standards set forth, herein, as set by the Wisconsin Depart- b
went 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 Q.
DATE/3 J,
St. Croix County Zoning Office
P.0. Box 98
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
uwsconsin
ILHR SANITARY PERMIT
GROUNDWATER SURCHARGE Cow
Sanitary Permit No.
On May 4, 1984, 1983, Wisconsin Act ! 9~4~5
monly known as the groundwater Prote
com-
410 was signed into law. ction law. This change in hstat statutes wason the more result t of of over
2 years of steady negotiation and public debate. The groundwatereffectbill incl
surcharges (fees) for a number of regulated practices which can groundwater
surcharge took effect on July 1, 1984, All of the water that is used in uded the creation of
the groundwater through your soil absorption system or the disposal
site The
tank pumper. Your building is returned to
used by your holding
The monies collected through these surcharges are credited to the round
tered
tered by the Department of Natural Resources. These funds are used for monitoring -
water,
water, groundwater contamination investigations and establishment of water fund adminis-
it's ground-
worth protecting,
standards. Groundwater,
Sig lure of Issuing age t: Ground
Ground S Fee: Ali
Date: WISCO ` ('s
DILHR SBD- 9 .0 ) -
buried.
-I?6 trrg~g
<e
t
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 P.O. BOX 76
HUMAN RELATIONS
(ILHR 83.09(1) & Chapter 145)
LOCATI N: SECTION: OWNSHI MUNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME:
_'4 /T H1 R~6 E for c -
CO NTY: O NER'S BUYER'S NAME: MAILING ADDRESS:
f,Grn
e,rJ- ke Qr ) . 5'V op
USE DATES OBSERVATIONS MADE
NO. BEDRMS : COMMERCIAL DESCRIPTION: 'PROFILE DESCRIPTIONS-: A ION TESTS:
Residence ❑ New PX( R
eplace
X7
RATING: S= Site suitable for system U= Site unsuitable for system
CONVENTIONAL: MOUND: IN-GROUND III I URE: SYSTEM-I N- ILL HOLDING TANK]
: RECOMMENDED SYSTEM: (optional)
S DU DU $ ❑U U
If Percolation Tests are NOT required DESIGN RATE: [Floodplain, an
under s. ILHR 83.09(5)(b), indicate: .30^ / Y portion of the tested area is in the
` indicate Floodplain elevation: j1
PROFILE DESCRIPTIONS 6
BORING TOTAL -DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN. ELEVATION OBSERVED EST. GHEST TO BEDROCK 1 IF OBSERVED (SEE ABBRV. ON BACK,)
To 7l-
fp ~ S c~i^
_70 !n:2
!a- 03rD -slio -oZo
B-
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER AFTERSWELLING INTERVAL-MIN. PERIOD I- PERIOD 2 P R PER INCH
P- l
P-
P - '
P-
P-
P-
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent
of land slope.
SYSTEM ELEVATION
A .
TT
X55/~ ~co
f_J
~I._.: A _
i
r
tN
:9 f&
i
E 4 t
t €
f i 1
I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME (print
TESTS WERE COMPLETED ON:
o j
AD S•
CERTIFICATION NUMBER: PHONE NUMBER optional):
fir' 8b ~6 ~3 7oz
CST SIGNATURE:
100111
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R• 10/83) - OVER -
)LETINi 1 ;
To be a "')n.
1, Camplet€, description;
itrclicata vvhettrc:r his is a resin r project;
2. The u, : to t. c` y"
3_ MAX9(VE~_ number _ms or (,ontmercial use piZ~Wrted;
4, is this a ne-4 or repi~rc;r)erlt system;
5, Compiete the suitability rating boxes, A SITE IS SUITABLE FOR A HOLD!NG TANK ONLY IF ALL
OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS;
6. PLEASE use the abb eviations shown here for vvriting profile descriptions end completing the plot elan,
7. MAKE A LEGIBLE diagrarn accurately locating your test locations. Drawing to scale, is preferred. A
separate sheet inay o„ rased it deed:
B. faker sere your benchmark <rl elevation reference point ai e clear- , is ,rr€( are permanent;
9. Complete a )proptiat.e b€ xx t= dates, narnes,-addresses, flood plain 6 p olat:.€.rn vest exernp-
ticsn if s;;ap 10, If the info , 7n (such as Trod ,slain?, elevation) (loin not: apply, place I' A. in th ;ariate box;
11; Sign the for ind place your current address aril your certification r, °n _
12. Make legible copies and dktribut>a as required. ALL SOIL T ST;o' (v„ >i BE I `LED WITH THE
LOCAL AUTHORITY WITHIN 30 CLAYS OF COMPLETION,
ABBREVIATIONS OR CERTIFIED OIL TESTERS
Soil Separates and Textures Other Symbols
st Stone tov£er 10") BR - Bedrock
cob Cobble, {3 - 10") SS Sandstone
gr Gravel (under 3") LS Limestone
Sand HGW - High Groundwater
cs coarse,: Sand pi l.c. Percolation Rate
uteri s - Medium Sand W - welt
fs Fine Sand Bldg Building
Is Lo wny Sand > C,,;icat„r Than
~sl >ar;dy Loam < L ` I-yarn
L im inn I +r
I L( am
;y t
~cl C ay !-oam } 0AN,
-
sc - "R }
,
{ Ciiity ~ ~-.C? rTi
sic, Loar-
sic: _ ~ iIt yvz ; ne, feaint
c C "'y cc common, coarse,
art Feat n1m - Many, mediurn
r-n kluck d distinct
o prominent
I-IWL. - High vvatrt!evel,
surface vvater
fie: I , al BCC Bench Mark
`ARP - Vertical Reference poHat
TO THE OWNER:
This soil test report is the first step in securing a sanitary permit. The county or the Department may request
verification of this soil test in the field prior to permit issuance. A complete set of plans for the private
sevvage system and a permit application must be submitted to the appropriate local authority in order to
obtain a pert-nit. The sanitary permit must be obtained and posted prior to the start of any construction.
PROJECT -Tctrh~s ~ma4re,- ADDRESS
of 1 4St- 114/S4 /T.3/ NW,6 W TOWN COUNTYj"o~ X
N • BJEDRO0M,,2_ CLASS PERC
CONVENTIONAL CONVENTIONAL LIFT_ MOUND- HOLDING TANK-
IN-GROUND PRESSURE- - -
SEPTIC TANK SIZE - LIFT TANK SIZE
DOSE TANK SIZE HOLDING TANK SIZE
ABSORPTION AREA 6 PERC RATE 4 3zo BED SIZE
PLUMBER
LISCENSE NO. _DATE Assume elevation 100'
Location of Benchmark w d - ~oo s r ff a 5-
s,ie
Borehole -
_
• G) Perc Hole well
System Elevation
TYPAR COVERING
2" 2.. 2..
2"
12 C ~4) 3/ ~4)
6" Sewer Rock
i
12 ft. 18 ft. 2 4 ft.
`7 /
CiBas ~
®-es ~~~ye4 r
J7 ow
3 6
~ Y
yod - J
Parcel 006-1012-90-000
0210212007 08:47 AM
Alt. Parcel 6.31.16.95 PAGE 1 OF 1
Current X 006 -TOWN OF CYLON
Creation Date Historical Date Map # Sales Area Application # Permit #
ST. C Permit OTypeY, WISCONSIN
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
JAMES A & DARLENE HEMAUER O - HEMAUER, JAMES A & DARLENE
2068 CTY RD H
DEER PARK WI 54007
Districts: SC = School SP = Special Property Address(es): • = Primary
Type Dist # Description * 2068 CTY RD H N
SC 0119 AMERY
SP 8020 UPPER WILLOW REHAB DIST
SP 1700 WITC
Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE
SEC 6 T31 N RI 6W 40A SW SE Block/Condo Bldg:
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
06-31N-16W
Notes: Parcel History:
Date Doc # Vol/Page Type
2006 SUMMARY Bill M Fair Market Value: Assessed with:
144234 Use Value Assessment
Valuations: Last Changed: 09/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 15,000 123,200 138,200 NO
AGRICULTURAL G4 33.000 4,800 0 4,800 NO
UNDEVELOPED G5 5.000 5,000 0 5,000 NO
Totals for 2006:
General Property 40.000 24,800 123,200 148,000
Woodland 0.000 0 0
Totals for 2005:
General Property 40.000 24,800 123,200 148,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch 512
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 UU Q.00