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HomeMy WebLinkAbout020-1177-80-000 n N O -0 n d c ~ c a+ o m (D m 3 ~ 3 rt ~ ~ w 0 M O w vOi O O CO w c ONO N ? 3 c W 7 a N O ~.y CY CD CD l a z C_ N CD CD O Co CD O CD CD 7 tD V III CD W N CS 7 O ?C to W O O 0 0 7 7 CD - O COIL C O N C) V 7 OD 3 y c D d a l~ CL o a CD D C CD CU' N 0 G C7 (D a 3 W C7 _ m O N G m O0 N° M ~J :j N O l77 co OOD 7 n 0 N G b p cn rn rn' 3 rT c tv rt (D V FJ r• r~i~V z OOOo N rt N o 0 rr3- Oo 00 cn (A CD coo FH w p 3 (D D n~ ED 57 rt ON CD !1 F- N < 3 N Q (D CD a z zz W z 0 F- a ONO ° CD m N1 • 00 V .Zl -q to lr c CD N. rn O N W a a 3 W G N CZrJ Z Co -4 C A z m F- fa~ %o O 23 H ca t4 z r_ ED 01mr 0 a A`z F- 0 w o V W T m N) ON G rt rr y rt o z W H of o' 3 z A oo p G 0 m m n O ONO Cj CD A r w M I a I a ~ o - v_ z o a CD I I I ~ I y A I O N I oc a 0 :3 b v CD OHO fug C, O C) d y Parcel 020-1177-80-000 06/01/2006 07:55 AM PAGE 1 OF 1 Alt. Parcel 28.29.19.1118 020 - TOWN OF HUDSON Current X1 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 - STARK, SANDI L SANDI L STARK 782 ALDRO CIR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 782 ALDRO CIR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 2.030 Plat: 0151-CEDAR HILLS ESTATES SEC 28 T29N R1 9W 2.030AC LOT 18 CEDAR Block/Condo Bldg: LOT 18 HILLS ESTATES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 28-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 08/15/2001 653891 1700/169 QC 07/23/1997 1060/566 WD 07/23/1997 893/203 07/23/1997 777/161 2006 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/25/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.030 69,100 184,600 253,700 NO Totals for 2006: General Property 2.030 69,100 184,600 253,700 Woodland 0.000 0 0 Totals for 2005: General Property 2.030 69,100 184,600 253,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 311 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Form-STC- 10~ e t AS BUILT SANITARY SYSTEM REPORT OWNER 4„/, ,/4'a-vi ruJ Q TOWNSHIP SEC. 02 f T 2ffl N-R W ADDRESS R7'( l~ct~l~,t✓ ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT ZF LOT SIZE °57 PLAN VIEW Distances and dimensions to meet requirements of i•ZHR, 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM lO' S~ G INDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: /da' Proposed slope at site: 3f 0 SEPTIC TANK: Manufacturer: /A/,4~ Liquid Capacity: 60 C, o r Number of rings used: I Tank manhole cover elevation: Tank Inlet Elevation: Tank Outlet Elevation: Number of feet from nearest Road: Front Side,Q Rear, O feet # From nearest property line Front O Side,O Rear, O feet Number of feet from: well building: (Include this information of the above plot plan)( 2 reference dimensions to septic tank) C SEE REVERSE SIDE 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: K Trench: Width: 1A Length: Ste. Number of Lines:_ 2 Area Built: / Fill depth to top of pipe: fo 'r Number of feet from nearest property line: Front, O Side, ® Rear,O Ft.~~ Number of feet from well: ~j3 r Number of feet from building: (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, OFt. Number of feet from well: Number of feet from building: Number of feet from nearest road: Alarm Manufacturer: Inspector: /f Dated: _ Plumber on job: License Number: 4 ~ 7 ~a 3/84:mj DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS P.O. BOX 769 . PRIVATE SEWAGE SYSTEMS DIVISION MADIS'O'N, WI 537Q7 BUREAU OF PLUMBING UCONVENTIONAL ❑ALTERNATIVE state Plan I. D. Number: ❑ Holding Tank D In-Ground Pressure ❑ Mound (If assigned) NAME OF PERMIT HOLDER: JADDRESS OF PERMIT HOLDER: INSPECTION DATE: William Harwell Rt. 5 Hudson WI 54016 BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: NE NE Section 28, T29N-R19W Twn, of Hudson Lot 18, Cedar Hills Es t. Name of Plumber: MP/MPRSW No.: : Sanitary Permit Number: William Schumaker 6382 TC1"1ySt. Croix 88399 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARN NG LABEL PR ED LOCKIING COVER (s~ / V : PROVDED: BEDDING: VENT DIA.: VENTMATL.: HIGH WATER YES NO DYES ❑NO ALARM: NUMBER OF ROAD: PROPERT WELL: BUILDING: VENT TO FRESH FEET FROM LINE: k Jl/ AIR INLFSr DYES NO DYES ❑NO NEAREST DOSING HAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY. PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER DYES ❑NO PROVIDED: PROVIDED GALLONS PER CYCLE: PUMP ANOCONTROLS OPERATIONAL: DYES ONO DYES ❑NO (DIFFERENCE BETWEEN NUMBER OF PRI"E OPERTY IWELL aulLOwc vENNLET SH FEET FROM L AIR ILE PUMP ON AND OFF) DYES ❑NO NEAREST 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 FORCE the soil is dry enough to continue.) MAIN ICONVENTIONALSYSTEM: BED/TRENCH WIDTH: LENGTH: NO.OF DISTR. PIP SPAT ING: COVER INSIDE DIA *PITS 2 TRENCHES M RIAL LJQUID DIMENSIONS J PIT DEPTH GRAVEL DEPTH FILL DEPTH DISTR. PI F DISTR. PIPE DISTR. PIPE MATERIAL: NO. R. BELOW P_, CC ABOpE/COyE R/ EV. INLET. ELEV. END A`SJII'~ e_ L 1 NUMBER OF LRO ERTV WELL: BUILDING: V NT TO FRESH q PIPES. FEET FROM ~ ? ~ glr~►NLp.T 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- D YES ❑ NO meets the criteria for medium sand. TIONS MEASURED. OIL COVER TEXTURE: =RS OBSE RVATION WELLS DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL ❑ NO CENTER : SODDED ONO : EDGES. SEEDED. MULCHED ❑NO D YES DYES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: DYES ❑NO DYES BED/TRENCH WIDTH: LENGTH NO.OF LATERAL SPACING GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER rRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MA ERIAL. NO. DISTH DISTR. PIPE DISTHIBU 7 10N PIPE MATERIAL & MARKING ELEVATION AND ELEV.: ELEV.: DIA. ELEV PIPES : DIA DISTRIBUTION INFORMATION HOLE SIZE HOLE SPACING: DRILLED CORRECTLY COVER MATERIAL VERTICAL LIFT CORRESPONDS TO APPROVED PLANS DYES ❑NO DYES ❑NO COMMENTS: PERMANENT MARKERS: JOBSERVATION WELLS: NUMBER OF PROPERTY WELL BUILDING. FEET FROM LINE: DYES ❑NO DYES ❑NO NEAREST 1 Sketch System on Reverse Side. ain in county file for audit. IGNAT - TITLE. DILHR SBD 6710 (R. 01/82) SANITARY PERMIT APPLICATION COU Y E:7::QILHR In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT -Attach complefe plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8Y2 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 1.~/Ai m a Y4 ,y , S T N, R E (or) PROPERTY OWNER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME CITY, STATE ZIP CODE PHONE NUMBER CITY VILLAGE: NEAREST ROAD, LAKE OR LANDMARK r TOWN OR k s O II. TYPE OF BUILDING OR USE SERVED: 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. (1 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. Conventional b. E] 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 See a e Bed b. ❑ Seepage Trench c. ❑ Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (M' iinnutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet): ? Feet Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holding Tank ❑ ❑ ❑ Lift Pump Tank/Si hon Chamber ❑ ❑ ❑ ❑ VII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the private sewage system sho on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) P/ PRSW No.: Business Phone Number: 4Z, A ' 'a S muter .ci G 1.21 Plumber's Address (Street, City, State, Zip Code): Name of Design r: VIII. SOIL TEST INFORMATION kc ertified Soil Tester (CST ame CST T's ADDR (St t, City, State, Zip Code) Phone Number: r IX. C LINTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate Issuing Agent Signature (No Stamp Approved ❑ Owner Given Initial S lWharge Fee Adverse Determination 0 > ~o~ l -Ob X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber 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: 1. Property owner's name and mailing address. Provide the legal description where the system is to be installed; II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling; 111. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or repair; IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in ##1-6; 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; Vlll. 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'/z 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 Groundwater included the creation of surcharges (tees) for a number of regulated practices which Wisconsin's can effect groundwater. The surcharge took effect on July 1, 1984. All of the water that buried treasure is used in your building is returned to the groundwater through your soil absorption o system or the disposal site used by your holding tank pumper. The monies collected through these surcharges z eol~ed to tha groundwater fn d ,dw; yd,~> x tered by the Department of Natural Resource=. These funds are used for monitoring g ou ?,J water, groundwater contamination investigations and establishment of standards i's worth protecting. 3D 6338 (8.03!86) 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 issuauce. 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - T - - - - - - - - - - - - - (Owner of Property Wi 11 i,am 11arwg11 Location of Property Section ~28 T _29 N - R 19 W Township Hudson Malling Address R t. 5 Hudson, Wisconsin 54016 Subdivision Name Cedar Hi l 1 s Estates Lot Number 18 Previous Owner of Property Wi 1 l i am Har3Ne11 Total. Size of Parcel 2 1/2 Acre Date Parcel was Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? X Yes No Volume 43 and Page Number 186 as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) eeAti6y that aU ,atatements on th z 6o4m ahe tn.ue to the beat o6 my (ouA) knowl'edge; .that 1 (we) am (aae) the owneh(b) o6 the pnopehty de6cA bed in thin .616olimia.tion 6onm, by vi tue o6 a woAAanty deed neconded in the 066ice o6 .the County Register 06 Deedd ab Document No. 41.39 ; and that I (we) pi►.ese.iitty own the phopobed .6 to 6o& the aewage pobatby.6tem (Oh I (we) have obtained an e"ement, to nu.n with the above duc4ibed pnopenty, bon the coroVtuct,ion o6 aaid .ay,6tem, and the .bame ha4 been duty neeonded in the 066.~ce o6 the County Reg.usteA o6 Deede, ass Document No. 41j1z9 j . d& SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) 41 t& DATE SIGNED DATE SIGNED L y ST C- 105 r r H SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County z 0 9 OWNER/BUYER William Harwell ROUTE/BOX NUMBER Rt. 5 Fire Number • CITY/STATE Hudson, Wisconsin ZIP 54016 PROPERTY LOCATION: NE It, NE 14, Section 28 T 29 N, R19 W, Town of'Hudson St. Croix County, Subdivision Cedar Hills Lot number A 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 um er. What you put into the system can affect the function o''f- 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 prioi -~u guy--;--r97$r- 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 bya master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-pite wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H 0 • E I/WE, the undersigned, have read the above requirements and agree vi to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart- b 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 DATE September 6,1986 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 sddress. SAFETY & BUILDINGS )EPARTMENT OF REPORT ON SOIL BORINGS AND DIVISION NDUSTRY, P.O. BOX 7989 AqND- -ABOR IEL PERCOLATION TESTS (115) MADISON, WI 53707 IUMAN riELA710RIS (H03.09(l) & Chapter 145.0466) t~C~fti: OWN MUNICIPALITY: T NO.: BLK NO.: SUBDIVI ON NA E: NE ~ T25 N/R/s la _ trCtiSrJ N - T /g AP J41LLs EST4 c- COUNTY: M : MAILIMG 'r-r Ut IA fI-Lf,A Rcac)Tt /~uas~N t S' O/6 !SE DATES OBSERVATIONS MADE MM AMXLDE9C§I ION: TESTS: PROFILE DISMPTIONS: FERCOLAI ION KResidence ZNew ❑Replaca IS&T 'Q P y- I s..---- 5br~s K ';t 66 Salts Qa Kc-rA SATING: S- Site sultW34oo for system U~ Sits rutattitabN for systte`m~ ~ P., r~ t4A P, dY MOUND: .ONV e7 IONAL: DS ~ iN ou To s YovT " STEM-IR-FIL OL sG TANK: RF~~NM CNT/0SYSTEM: tgA L (o ion N t -GROUND-PRESSURE U t l -77 1 If Percolation Tests are NOT required IDESIGN RATE: If any portion of the tested area is in the under s,Ii63.0915)(b), indicate: L L r4sS Floodplain, indicate FloodPlain elevation: N V PROFILE DESCRIPTIONS BORING TOTAL AT R•IN HE A A ER SOIL WITH HI KN SS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH•13i ELEVATION B V TO BEDROCK IF BSERVED (SEE ABBRV. ON BACK.) R,~~„efts 16"ALIT"- 9" tti SL Z/'L-r$PN M'S /6" &K B- iZ.1? 9786 Nont~ biz. i7 -1~ < /"&,A Sr8AC.r° 32'1$eHC-M -S44k '*Zr8Ry C-M s C"&- CTS / 7 AP,, -0 L Za" ARN M •S 6 Q &N l~ P- 13- Z 0. 97.4'7 `.x/6,33 -~tzad~- ebApw t• ,$nLis. S/"@i; C-M S VCdb . i0"Bu7-s 7"&rASL.7W e►.i MS Ss i-jSitst / eN P~ ! r 1> • L 5 4aES w,~ To 54"©N ExTRf mk CAST B- 3 •00 96 79 0/1,00 BeNCS4CaR34 SeaMS' yp _ _q L B- 4 It 3.3 97,19 04: 9 f 3 'ALL- s A4' ~Q~u~e 8eN 5C. 344 8erv C-m'S c e 6"kLLrS :0.1ktN SL /9"Qftrt 62 7t„ RNS16R B- S $ g3 94.76 p `I 8 .c33 so" aftN M S B- , r PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVIL-INCHES RAT MINUTES NUMBER !L*FffLW AFTERS WELLING INTERVAL-MIN. PER INCH P: '6, s6. N c,&w ar 97.-bc. 3 > 6 < Py3 5,49 N-ONC %.79 .3 ?6 <3 P. 4 "S,lb9 Nortrr 11 3- f ? C3 P- Al- c-kV. P- P- `LOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori• ontal 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 )f land slope. '5t_'"r4 hAAY SV >i Er`1 SYSTEM ELEVATION RimAtey sysnm /N CE N i E k ©rr .Cicx.- ~ -S►1C f E i i i + i 4 ( 4 { j R 4ttlC.; I S A ~r`. NU M gE~ is Q , • ' ~ ~ ~ ~ i ~ ~'Nt~ S~rnr: ~ r15 Q~~a~>UY +Bt~/NIaS h , 11 P I 3 ~ TN . 4o' i , 1 I 4` + , \ i a p_ Z 4 r ; SiJpWJv dN ; Igo' K bC 06 C, Ii I 1, the undersigned, hereby certify that the soil teats reported on this form were made by mein 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: NAkV&Y . 04N<zaKl dsa RS I ~cP'rrrn %c-. a') !9B 6 ADDRESS: t CERTIFICATION NUMBER: PHONE NUMBER (optional): 40~ SELoN e, '5~r+r rgUA`roru W I S4©/ ~ 34x34 ?86- ~0 315 - CSTS ATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. OIl HR SRII-8345 (R. n?/S?) - OVER _ 'Q910N Sga'lNC1 ~la0r~ ~'~v~d - --8g' L~ ~Z r ~ roi1u~t7? ggl ~ a-~ ~SnoN VZ' , ~i w <0 adi~ tvpyi ~ I i p~ 0O~ . r31 7~5_aQ_~~J ~Q ~N~vd s~~vv~ la ~a ~d Noy ~ ~ st w~ - Ala N uw.rD,M u..q~j (4y-gp lyre ~ rr s ?G// ov,~yy /bib yx> .fly Al Or ts' ~mi.i~iq P "1Dd /(1 ) e OW/ / ritasc oyy • r ~,5p~ wsvpy pipaiJ~/ • .tom uen SS / nn lay 7wwn~ ~4 obi C`tC7 ~Yi"y4-] ]1+S ,?eZr 74 ell 0 n x fa ` % 10 ~o v .c o `s f