Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
020-1120-60-000
f 0 0) 0 1 3 - c d ti CO) o 0 CD a m c • • • U co 3 °if C F, U— U oVII S - CD N .O�r a CD n 2. � W S cD ° O ^ a N N v : p0 N CP m .,:z-4 n W O at I 3 O 7 N CO O C U N C70 C CD [m) Cfl N R. 7'O W CD C O-.a .-. m w o V N a �r�' O C\1 0 nruo I co 3 a ' I o N -p * * * '', N -i CM) v 3 alaicCii ° `• v cr TJ v v � ;1 p rp y o f W C D Gt O 1 y a . s, O) !� 1 3 0 N o N • F, y • CD o 0 • O -ADO ' t�l I1 � `� N tv A CC:Ni.I fD N `�y C CD cn W a a 3 7 z CD Ca o N c xi 1 v a. A 0 3 0 I a z 3 a o - � 1 0 n. 0 8 I If!3 z co 1 :ill • GO ; — CO ED CDo a Oo a co • �m 7 -Ti • =ao w c o - - m v y 3 D', oz a m • I o� N a, v w sa ca.-r, cCD A yy N 1 o m o� ti m o• o a: N co 0 0 . a Ei. I O o• • • CD DQ A O p b o as Parcel #: 020-1120-60-000 03/24/2006 09:17 AM PAGE 1 OF 1 Alt. Parcel#: 17.29.19.523 020-TOWN OF HUDSON Current !X ST. CROIX COUNTY,WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type 00 0 Tax Address: Owner(s): 0=Current Owner, C=Current Co-Owner O-GILBERT, JEROME L&SUSAN K TRST JEROME L&SUSAN K TRST GILBERT 398 BROOKWOOD DR HUDSON WI 54016 Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *398 BROOKWOOD DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.100 Plat: 2553-TROUT BROOK WOODS ADDITION SEC 17& 18 T29N R19W TROUT BROOK WOODS Block/Condo Bldg: LOT 20 ADDITION LOT 20 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 17-29N-19W Notes: Parcel History: Date Doc# Vol/Page Type 07/25/2000 626937 1529/39 WD 06/04/1998 580380 1329/177 WD 07/23/1997 660/605 2005 SUMMARY Bill#: Fair Market Value: Assessed with: 92393 278,400 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.100 77,400 206,500 283,900 NO 05 Totals for 2005: General Property 2.100 77,400 206,500 283,900 Woodland 0.000 0 0 Totals for 2004: General Property 2.100 40,600 198,300 238,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 118 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 r AS BUILT SANITARY SYSTEM REPORT w OWNER 0//u c E TOWNSHIP /14 LA/ SEC ..),TQN-R19W ADDRESS 12712/� /'{j� / izr J ST . CROIX COUNTY , WISCONSIN . Mu�,re,N ii/If. -Yeit SUBDIVISION Z o.j7 61voi Wads LOT oC 0 LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM —ill IIII ;1111:11 FIW _ 0' 1A VIII ■I� 1111M111.111 ' ilffl 1101111111� 1C,`E IWI ..�� wrjoir. o • 111131$11111•11111111111111111111 — .� Ninon + __. _ p.o,M dic at w IIIIIIIIIIMMERININIEMITEMEIUMEMININIIII BENCHMARK: (Permanent reference Point) Describe : Elevation of vertical reference point : jO O, oQ Slope at site : , 2 SEPTIC TANK: Manufacturer : Liquid Capacity : .40(7 Number of rings on cover : / Tank manhole cover elevation : Tank Inlet Elevation : Tank Outlet Elevation : PUMP CHAMBER Manufacturer : Number of gallons Number of gal . pump set for a cycle gallons ; Total capacity of distribution lines gallon : size of pump head ; gallon per minute ; horsepower ;brand name of pump and model number ; Type of warning device HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover ; Type of warning device / SEEPAGE PIT SIZE ; ,,/uhO 9,42_ Number of pits y feet diameter ,;? feet liquid depth (/s-'ed, seepage pt inlet pipe-elevation 92. 5' bottom of seepage pit elevation f.23 feet . SEEPAGE BED SIZE : number of lines width length tile depth SEEPAGE TRENCH : width_ length . PERCOLATION RATE y.3 AREA REQUIRED d 4.' , ' • B 4. ?(7:' / / INS ' OR DATED C� ✓� LICENSE NUMBER 4„, ' " DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY&BUILDINGS LABOR&HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O.VOX 7164 BUREAU OF PLUMBING MADISON,WI 53707 - 121 CONVENTIONAL 0 ALTERNATIVE State Plan I.D.Number: Of assigned) ❑Holding Tank ❑In-Ground Pressure ❑Mound NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Chuck & Mona Fehr RR#3, River Ridge , Hudson,WI (6- - 3 31,-; 0 BENCH MARK(Permanent reference point)DESCRIBE IF DIFFERENT FROM PLAN: REF.PT.ELEV.: CST REF.PT.ELEV.. SE4 SE4 Section 18 , T29N-R19W Hudson Township Name of Plumber: PRSW No.: County: • Sanitary Permit Number: �Q% Anthony Zappa 1614 St . Croix 34790 SEPTIC TANK/HOLDING TANK: MANUFACTURER: i LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOC /G C' E' ��ej 76,3° P •V •ED: PRO ED:' �- 1 5 (OZ t. l 7,05 RI YES O N O '� • ■NO „JO BEDDING: VENT DIA.: VENT MAIL.: HIGH WATEA NUMBER OF ROAD: / PROPERTY WELL: BUIL•ING: VE■ TO FRESH ALARM: FEET FROM /j-e( LINE . s o f AIR INLET: OYES ONO 4 -( ❑YES ONO NEAREST )► w t �-t, • DOSING CHAMBER: -- MANUFACTURER: BEDDING: LIQUID CAPACITY: -U P •DEL: •N MANUFACTURER: WARNING LABEL LOCKING COVER ' PROVIDED: PROVIDED: OYES ONO OYES ONO OYES ONO. GALLONS PER CYCLE: PUMP 41.CON •OLS••E- TIONAL: NUMBER OF PROPERTY WELL BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM (LINE. AIR INLET: PUMP ON AND OFF) ■Y S ON A NEAREST-------��� SOIL ABSORPTION SYSTEM.Check the soil moisture: he de, of plowing FORCE LENGTH: DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire,constr.ction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH: TH: • 0 DISTR.PIPE SPACING: COVER INSIDE DIA SPITS LIQUID BED/TRENCH RE HES MA RW.�„IAL PIT S4" .J De H5 A DIMENSIONS e GRAVEL DEPTH FILL DEPTH ' PIPF • M VI NT PI E 'DISTR.PIPE MATERIAL: NO.DISTR. NUMBER OF PROPERTY WELL: BUILDING: V NT TO FRESH BELOW PIPES: ABOVE COVE. INLET. V.E •: PIPES: FEET FROM LINE' f r AW INLET _ NEAREST_ x/00, o�OO( <OOr MOUND SYSTEM: Mound site plowed perpendicular to slop• Check the texture of a ill material for PROVIDE A DIAGRAM OF SYSTEM and furrows thrown upslope: mound systems to ak cert."- th t it ON REVERSE SIDE.SHOW ELEVA- meets the criteria'f me iu and. TIONS MEASURED. OYES ONO SOIL COVER ITEXTURE N TMARKERS: OBSERVATION WELLS /YES ONO ❑YES ONO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL, SODDED. SEEDED: MULCHED: CENTER: EDGES: / OYES ONO ED YES ONO OYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH- LENGTH. TRENCHES: LATERAL SPACING GRAVEL: •TH B'LOW P. . FILL DEPTH ABOVE COVER: DIMENSIONS A MANIFOLD PUM• MANIFOLD DISTR.PIPE MANI r LD • I DISTR.'I DISTRIBUTION PIPE MATERIAL&MARKING ELEV. ELEV.: DIA. ELEV. ' ; � •�.••. ELEVATION AND • DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING DRILLED CORRECT LV COVERT E AL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS ❑YES ❑Ncf � OYES ONO COMMENTS: TERMANENT MA 9KERS: LI OBS TI• Y S: NUMBER OF ,PROE PERTY WELL: BUILDING: Al.7 1 '' 1IILIN ,!'k ❑YES NO ES FEET FROM NO NEAREST icb 0'314 %,„ cc'. ,151(cia-i) A - CO' 1 I . 414) It \-•• 0,, 0. ,, .0 i 531 Sketch System on r �� Retain I county file for audit. Reverse Side. \ 51/Fi/_ DILHR SBD 6710(R.01/82) % �.�- I F � a I i APPLICATION DEPARTMENT OF , �, SAFETY■ / �; , FOR SANITARY t , 1 l INDUSTRY, Vs y;; 1 fl. 11 r LABOR AND at: . PERMIT HUMAN RELATIONS ? (PLB 67) r_ MADISO\, Attach plans for the system on paper not less than 8'/2 x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale.Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed,sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. A legible reproduction of the soil test report or the owner's copy must be included. Property Owner: Mailing Address: e//ixe nadir P 6' R7: 3 o va Aofre_ ill-upsOA) lvis. 53'ô, Property Location: City,Village or Township: County: • 50- 14 56 /aS IP /1" 2 /q NCR W I f. E (ori / PASO/ 571161-60/ Lot Number: Blk No.: Subdivision Name: Nearest Road,Lake or Landmark: State Plan I.D.Number: . 2-0 1ir/�OVT/leoo E' w OOP C 7../e0 or ook 4)o D5 Arie (If assigned) A.)7/..._ TYPE OF BUILDING Number of ❑ Public* ❑ Variance* ❑ Other (specify)* Bedrooms: 1 or 2 Family *State Approval Required. 3 TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY /Q'ZYO / X X HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER /r* MANUFACTURER: 1'/e E GA)61,02_, A.-ose447 - 7NA/DEsJ Roc& zo/S EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED(Square feet): New ❑ Replacement ❑ Experimental e ❑ Seepage Bed .� Seepage Pit L y995" y �ywE�ls rretiae (specify) '9%4• X 5$ �'l3eety J1U ❑ Seepage Trench 3 7 £Aan- Water Supply: • Owner's Name as Listed on Soil Test Report(If other than present owner): Private ❑ Joint •❑ Public I,the undersigned,hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Sign e: MP/MMPRSW No • Phone_Number: 14. ;4-P/9/1-- o'l (7i5 ).3X1225-0 Plumber's Address: 317-1-41-----Name of Designer: 722 AO A A06 5-r- NowfA, //OP,SOA) eas 3 YO1(e COUNTY/DEPARTMENT USE ONLY •Signature of Issuing Agent: Fee: Dater DISAPPROVED Sanitary Permit Number:APPROVED C Qit.v.ed, Cc 4AigA) l 0 � 02 13 CI 9 / q(J Reason for Disapproval: Alternate course(s)of Action Available: ' Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION:White-County,Canary-Bureau of Plumbing, Pink-Owner,Goldenrod-Plumber DILHR-SBD-6398(R.07/81) • .48••■•• • • • • • • • • • • • • • • • • • • • • • • • • • • • r lvbNTEt TEST e9 ;TioN5 : So iwY, s? °F, '' f POST PA6-c/ of a, 12.46-k-5 IM.ND RTRMENT OF REPORT ON SOIL BORINGS AND SAFETY& BU DIVISION I LiABpR`AN@ PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS C (H63.09(1)&Chapter 145.045) LOCATION:J TIO SE N: TOWNSHIP/MUNICIPALITY: LOT NO.:BLK.NO.: SUBDIVISION NAME: sr 1/ 1/ /0 /T29H/R19E (or 11 VP5OAJ 20 rifloor efloo& w000s COUNTY: • OWNER'S/BUYER'§NAME: MAI LING ADDRESS: S/-641x Cyvc e .j fo v4- re 41/e RT 3 Aver iPiv,i,e/ yW7$OA) w/s . Syoil9 USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: %Residence 3 Nn- XNew ❑Replace 71 q,Pat 3 -f3 *.eti c/ .7-f3 7 SO J`7 Bo/el-1=4,474- wiet,. 54-4 seumecr RATING:S=Site suitable for system U=Site unsuitable for system -S¢TU,QitrEQ S4-T-C44f 57Z41,ff CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) © S DU ®S ❑U BS ❑U OS ®U ❑S ©U PlywEIL-5 NOT P/t'A/A)FiELPS /14 - of 5Z ?w4tt y ThM'4TED cTtAT4 66€1,41 3g " -to 5-5-" 5e6-r3E'/o! 1 If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL EVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE, AND DEPTH ` NUMBER DEPTH IN. EL OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B.f /Q✓ /f.✓y Fr > /f $110-40.SL, 17"OA St. /33 ' PD-111-,BA) , CS B. Z I fO nog. Pr : /a'0 PiP� ,�N.�s, i�'�4,'• $L, /0" O4 $L , /y( „ B- 3 k ? 772-& Fr i SE4040.14, 0E T 161'P4-4AI. 5L, 27"/3A/ se., /0"4/•06ioE-yed-E,,, c ,, y ys 1/41-0411 */ Ff• Oe-6 Hors, /33 „ P i -R ) . e5 f�„ B- y l6 I jam,D,'T � 56 -T N /91'9,4A).5'4,/6"/3.i, 54, /V" Lk•QVu-54-1 /0"`�0.-- 1 o,,, 32-i,ey urn) cmyGo,in w/ ir.o,P•..M ors, //7 "'pate-13 A) C$ B$ 170 gel Tr > /70 6�o' ,o.CL, iy--i3A,,s4, /� " t1'r3,4. SL, /zz" Nb B CO 7� q o .5/ FT. /O"D,�BN. s L, /a-/34v,5L, /a, 041, 54 3!'' New-,1A) 9 S"-r w/ pRoMlt,.,T• Oe-6f. "-fors pax_ Poet, I/I f- f PERCOLATION TESTS TEST DEPTH WATER I HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER ELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- / 90 7P 2 P- �) 11/4TE/2 /A/ 41-L 3 Tt3r 440zes P &.v ai c 7--- P- 9(0 A 10 �r 2- a ,...t c.MbtVet, O/Q .et,,.L. • /3 P- P-3 y/ Q.3 2ifc Z 7457-5 4 e E' Co volic E1) AT 11/121o/AjT P ----- , of- 19IO/7oSEp 1l4 &EU-5, AT F/E T.oN D /-OAT. 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 pl t plan. Show the surface elevation at all borings and�tthe d'rection annd�percent of land slope. I /'&ELL5. ZISEI ,/ e /3o 0.(grip/4. X 5 G " f ' /,V _. . % &-e SYSTEM ELEVATION TAP of /WETS 9.3.5-Fr. f.�o rTem 0 TA.ok = � _ Re c v/,et� . 1, 6hi ( I I { 1 r 3 T i/ , I r f Lo o / b ) _ I j i , pit j j pp �_ r / la= a , i , ir , ' 4 � I o . f lid /S1-� t__ P _ . _ /a = \,; *1 v � I` sT 1 Aati(kti = J3 ! I r 1 e jr-144 1#"' m r 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): Q06 j' �/�46 ,,c A7— TESTS WERE COMPLETED ON: NOME_S`ITE TESTING CO. 3 i y�3 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): RT.3, O'NEIL ROAD 33 -02-g P2-- 316-(1)/S93 HUDSON, WIS. 54016 CST SIGNATU E:IC t C-44-- DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. DI LHR-SBD-6395 (R.02/82) —OVER — r 7 INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include, • • 1. Complete legal description; 2, The use section must clearly indicate whether this is a residence or commercial project; 3, MAXIMUM number of bedrooms or commercial use planned; 4, Is this a new or replacement system; 5. Complete the suitability rating boxes, A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6, PLEASE use the abbreviations shown here for writing profile descriptions and completing•the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations, Drawing to scale is preferred. A separate sheet may be used if desired; d. Make sure your benchmark and vertical elevation reference wallet are clearly shown,and are permanent; 9, Complete all appropriate boxes as to dates, names, addresses. Hood 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 appropriate box; 1 1. 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 WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st -- Stony, (over 10"l BR --- Br'froack cola -- Cobble (3- 10") SS - Sardstorte yr Gravel (under 3°') LS -- Limestone s --- Sand HGhV — High Groundwater cs — Coarse Sand Pere — Percolation Rate rued s --- Medium Sand • 13' Well fs Fine Sand Bldg — Building Loamy Sand > — Greater Than sf _. Sandy Loam --- Less Than Loam En -- Brown Set Loam} h1 — Blank. si — Silt Cy Grey �cl -- Clay Loam Y Yc liow se,. ---- Sandy Clay Loam P — Red ,id Silty CIW Loam mot — Mettles • sec _ Sandy Clay sic Silty Clay tit tety, tine, faint c Clue cc -• <zr>mr+nor= coarse p.l. - Pent tam Ml rr y, medium is — Muck d — distinct p — prominent HWL -- High water level; Six general Soil textures surface water for liquid srwiiste disposal • BM — Bench Mark 'a NP --- Vertical Refer nce Point 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 sail test kit the field prior to perrnit issuance, A cumpiete set of plans for the private sei„Yege system and a permit application must be submitted to the apicop late local authority In order to obtain a u peri-11 It. The sanitary permit must be .' Dined and pasted prior to the start of any construction, • r . j 65 - -1/, /416-k— . - o p .NDL"''rRYENTOF REPORT ON SOIL BORINGS AND SAFETY& BUILDINGS DIVISION LABOR AND PERCOLATION TESTS (115) MADISON,WI 57969 HUMAN RELATIONS (H63.09(1)&Chapter 145.045) LOCATION:(b SECTION: 2 " ( ' TOWNSHIP/MUNICIPALITY: 'LOT NO.:BLK.NO. SUBDIVISION NAME: 5c 1/4 %/ 1 g /T N/R E (o C' NOPSOAJ 20 T,VoOT/, ' O4 ' o gopf COUNTY: OWNER'S/ UYER'S NAME: MAILING ADDRESS: 5 -40ix _C//uck , liov4- Ft-i' 1T, ,9itt,' c,e A'� o Noo,SoA) Wic syoi�, USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESCRIPTION: XNew ❑Replace ,3iA� S3 6e3 P -/ 3 TESTS:) Residence 3 ""W( �'l Q RATING:S=Site suitable for system U=Site unsuitable for system CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(optional) 1 iS DU GaS ❑U © S ❑U ❑S EU ❑S ©U See- ® / _1 If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b),indicate: Floodplain,indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR,TEXTURE,AND DEPTH NUMBER DE(P�TH IN, q V OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B.7._ lig pat'QA! .3'c L tvie t..- .-4-aup,+. r, PIS 77M c T — o,P- 6-y. A40 7--; B- B- B- B- B- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD 3 PER INCH P- P_ IP- , S./e'll' 7-65,e_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 Set 146c/e- 7 s ( �z 1 1-------1-- --- - - i 1 I , 4-- 4 44 ..,Ii ,,_,1_ _IL___L±4.4.44. ____14, .._ti_ 441_4_„___..t4: .44.4tL44,4..14,4_4_,.44 i 1 , 1 x I t z � € l € I � I i I 1 � -4- 4 i : ( i L i i 1 i f 3 F 9 I - t d E t I I : r 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. bar U(M e` c hi- NAME(print): HOMESITE TESTING CO. TESTS WERE COMPLETED ON: ' _"R{, O'NEIL ROAD 2 -x.. 3 /9f3 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER(optional): ge61 1, WIS. 54016 3-3-- D . IAN— 3a7-2//j- CST SIGNATURE: DISTRIBUTION:Original and one copy to Local Authority,Property Owner and Soil Tester. L DILHR-SBD-6395 (R.02/82) —OVER-- J INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test,your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5, Complete the suitability rating boxes, A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7, MAKE A LEGIBLE diagram accurately locating your test locations. Drawing to scale is preferred. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown,and are permanent; 9, Complete 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 appropriate box; 1 1. 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 WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st --- Stone toyer 10") BR -- Bedrock eels - Cobble {3- 10") SS - Sandstone gr - Gravel (under 3") LS --- Limestone s ----- Sand HOW -- High Groundwater cis - Coarse Sand Fare, - Perrseriation Rate med s -- Medium Sand W - its - Fine Sand Bldg - Building s - Loamy Sand ) -.- Greater 1-han *al Sandy Loam -- Less Tha( "l -- Loam Srt - Brown oil -- Silt Learn B -- Black - Sint Gy - Gray cl _- Clay Loam 1 _ Yellow scl --- Sandy Clay Lrnarr B -- Red sW _, Silty Clay Loam mot - Mottles c _ Sandy Clay w/ --` with €C --, Silty Clay fff __ feat, tint "taint Clay rc --- common commont coarae pt - Peat mm -- Many, medium rl. — Muck d - distinct p - prunguent HWL - High veabidi tevr;, Six general soul tsorlures surface metre- for liquid waste disposal BM __ Bench Mark V RP --- ical Reference Point 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 te. set cf plans for the private sewage system and a permit application must be submitted to the eppIopoate local authority in order to obtain a permit. The earnCary permit must be obtained and posted prior to the start of any construction. coUE oorR s , 4'( 1N,� MAu i 0IL Covet . f LC3 Co�' PLOT 0. o °� i� / � P C ROSS SECTIONS P IAus q�P• o� S°t t J�PI QED W �a0 °V h C• ��1��0 PRoPoSi P -ll /�usr �i� " �hS• Imo' �V 1 w`�' well �, @ �"'c Fr• (laM o st rc Ta.. „,. � MdM PkapofrP- -- - - - - - - - - RADA 174714C OW uc,Q{e N kiir 405 i.-- , kf _i 'c j , N1a' t e SO a .� o 0 e o o 0 PPR I'r ' 0 0 0 • NiUiN N `") ly S 0 0 ° o a or ,4007-/0,) • o 0 0 D foil' 13""- A tioi. • 0 0 0 ° lo`ET• �ERttCRL REF. T. ►s BASE of 1.°T e� ° o d o E !Rot.),AT GRADE FT </,QM ?,Pou4/p to 6 IE VRTI 04 = X00. 0 ,'AN p. .�./,m PQ, Soil TEST. VI EIEVAr�oN 'b4o;1 16' H" P�'` ( 1 fOM FA/ FT• t° yg0(V'mor' ((•Rv► T e4 r 5 b�' �,�Q1�4 "',�' jOO • y I 4% �� Eli s/GAPS . -, ' 4Gr Z ,,7-E- 4-tfk `_� ,; y 1 o K \ ` �'yo X o f \ `F v y �oridEds • /° • _ ��-- > W x 25' /J�D,�t y S7-47E A �Plaue -Chf T 3 y' 2 1141 , Des rftii orwU f3 • ci , 7/Pou T /3/Po ok" C000pS iC2J2 Y Jo; ft 20 rktur / eook WooD5 cow 7�S �'�v /*'OTtC/ 80 ytR: c. M. FEHR �EN O c + HOMESITE TESTING CO. fG04//3t-,f h. Z9P 'A--- /301 RT.3, O'NEIL ROAD Digit— 3 " 2 — /?13 ql q3 HUDSON, WOS. 5.4016 - — 51.5/70/P /d rr,c 'j .c...