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HomeMy WebLinkAbout020-1099-20-000 0 CA 0 O 3 d c m °c 3 A d m F a W N • h O t'n O ° w C W° CD OD Q O FBI 00 O. 3 CD (=D n N OD O p M to :3 to CO C r , co C O co i CD C,) O S 7 W O O :3 i 3 2, C A O 7 N F W I, O CO O W G I~ m (o ti N d fl m -I (D I'd 0 O D co CD rt Ili 1;:; CD Fl 0 O O N • O H. 10. w rt H C..i G (O (O a n r fn W 24;:~ O CD OD OD = N o c I-' 00 x rn a> c 3 ' a "A q W In Z C -p 00 w Z o v I 00 F- 0 0000 (a Co Cl) > ~ v v o 0 Q H W 0 0) 3 p _~1 V tp CD N,, 3 m (D ~Z~3pp . D z 00 c -iz ON m o n o N i m O o 0 CD I - ~i U]C! 7 N CD CD U) i O .d v (D m N 00 Fry O 0) N (D CD OL a (D (o -1 N H In v N o N cfDi Fl- O ^ O Zl) v CL L Lo Z W o ` I ao T (co (D Z 4-- 00 3 aD 3 m .P N Q O Q N 0 T o w c Z C. C p (D (D N a ~ a ~ a. m e a N A CT S X p N S O w ti b CD DC A Efl 0 b °O L Parcel 020-1099-20-000 01/19/2005 10:29 AM PAGE 1OF1 Alt. Parcel 33.29.19.399B4 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): Current Owner GERBOZY, JOHN K & NANCY D JOHN K & NANCY D GERBOZY 639 PINE TREE RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description " 639 PINE TREE RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 7.870 Plat: N/A-NOT AVAILABLE SEC 33 T29N R1 9W NW SE LOT 4 OF CERT Block/Condo Bldg: SURVEY MAP VOL III PAGE 749 ORD Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 752/124 07/23/1997 714/134 2004 SUMMARY Bill Fair Market Value: Assessed with: 48397 298,000 Valuations: Last Changed: 10/29/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 7.870 59,400 171,100 230,500 NO Totals for 2004: General Property 7.870 59,400 171,100 230,500 Woodland 0.000 0 0 Totals for 2003: General Property 7.870 59,400 171,100 230,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 119 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 , Form - S T C - 104 i F AS BUILT SANITARY SYSTEM REPORT OWNER J6jtq _ TOWNSHIP "d is SEC. T i-R W ADDRESS((' ( ST. CROIX COUNTY, WISCONSIN SUBDIVISION (!f r"_ {~ylcc LOT / LOT SIZE /J' PLAN VIEW Distances and dimensions to meet requirements of ILHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM 13 Ve4\ y ti 1 r~ i vof }sh it i~ ~ t AINDICATE NORTH ARROW BENCHMARK: Describe the vertical reference point used Elevation of vertical reference point: Aw Proposed slope at site: SEPTIC TANK: Manufacturer: OV C ks Liquid Capacity: / Ztw Number of rings used: I Tank manhole cover elevation: Tank Inlet Elevation: J _ Tank Outlet Elevation: Number of feet from nearest Road: Front,O Side Rear, O feet I -From nearest-property line Front 10Side ,ORear, 0 feet Number of feet from: well CZCD building: ~/'z- (Include this information of the above plot plan)( 2 reference dimensions to septic tank) cctv~v~nc~ errs 1 PUMP CHAMBER Manufacturer: ~j Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size i 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: Trench: X Width: Lenth: ~o Number of Lines: Z. Area Built Fill depth to top of pipe: j . Number of feet from nearest property line: Front, O Side, O Rear , Ft. Number of feet from well: 6;' 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 or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer:I V 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: '."aa License Number: 3/84:mj EPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS ABOR & HUMAN RALATIONS PRIVATE SEWAGE SYSTEMS DIVISION .O. BOX,7969 BUREAU OF PLUMBING ADISON, WI 53707 l.o.Numlter CONVENTIONAL ❑ALTERNATIVE S 11ImafefPIrpnanM) 1 D Holding Tank ❑ In-Ground Pressure D Mound NAME OF PERMIT HOLDER. ADDRESS OF PERMIT HOLDER. INSPECTIO UAiE John Gtrbozy Rt. 1, Hudson, WI 54016 3,110% j0tN1;"MARK (Permanent relerence point) DESCRIBE IF DIFFERENT FROM PLAN- REF. PT. ELEV.: CST REF PT ELI V NW SW, Section 33, T29N-R19W, Town of Hudson, Lot 4 F Plumlw._ IMP, MPRSW No.. Coumv Saint arv Perms N.,M- Ro er Timm 3224 St. Croix 83848 F EPTIC TANK/HOLDING TANK: -71 [MANUFACTURER LIQUID CAPACITY F ANK INLET ELEV. TANK OUTLET ELEV WARNING LA L LOCKING COVEN G~ PROVIDED PROVIDED i,o / 7 /O t7 [YES ❑NO DYES PFNO BEDDING VENT DIA. VENT MAIL. I/IGII WATER NUMBER OF ROAD: PROPERTY WELL HUI )tN(~ VENi TO f RES" JALARM FEET FROM LINE 1 ~j l~ AIR INLET DYES NO - 1. DYES NO NEAREST OSING CHAMBER: MANUFACTURER BEDDING ILIQUIOCAPACI1Y VUAIP MUUEL PUMP. SIPHON MANUF ACTOHEH WARNING LABEL LOCK I NGCOVER PROVIDED PROVIDED DYES ❑NO L 114 ONO DYES EINO GALLONS PER CYCLE: PUMP A ND CONTROLS OPERATIONAL NUMBER OF VF11 )I'F HTV [Vt LI [1111 DING VENT iOfHl;Sn (DIFFERENCE BETWEEN L/XFEET FROM LINE AIR INtI I PUMP ON AND OFF) DYES ONO NEAREST-> OIL ABSORPTION SYSTEM. Check the soil moisture at the depth of Plowing FORCE LI NI.I It 11) 1 A ki I I I I1 1 A I I HIAI AND NIA I I K IN1. Or excavation. (If soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH LENGTH NO OF DISTH PIPE SPAI:IN( COVER NIII PIA -VIIS T UIITHE CHFS MpYEHIAL' DIMENSIONS rlll f,HAVFL OFP H FILL UEPTII UIS 111 1'll'I UISTH PIPE DISTR. PIP. MATERIAL NI DISTH NUMBER OF VHOVEHIY WELL. HUILDIN(i VFNT I()I III!,,, HE LOW PIPES ABOVE COVER f 6v INI I t EL U PIPES 2 FEET FROM LIN-17 A AIH INIf T .J I Z~ 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- DYES ONO meets the criteria for medium sand. TIONS MEASURED. IL COVER TFXTIIHF VFHMANINIMAHKIH$ FNI4VAIION.111S _ -L YES ONO _ DYES LINO UEPTHOVEH TRENCII HFU UE VI HOVFHTHENCHBEII I)EPTROFTOVSoIL 7 CENTER EDGES MUII: HI U DYES ❑NO DYES DNO DYES LINO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDiH LF N6 711 NO.OF LA]EHAL SPA' IN(i IiHAVEL UI PTH HI LOW VIP( I II L OF PI11 AHUVI CUVf It TRENCHES DIMENSIONS MAN/F UIU Pl1M MANY OI U UI S IR PIPE MANIFOLD MA I.R.A N!) DISIH I:IS 111 PIP( IilS tiliHllfH)N VII'1 A1!\If HIAI KAtAHKINr, ELEVATION AND ELEV ELEV DIA ELEV_ Arts DIA DISTRIBUTION INFORMATION HOLESIIF IIOLESPA(:ING UHILIEDCllltllf Ctl Y COVEN MAT(HIAI Vf I+IICAI t l! I COHHFSVI)NUS I1) APPH(IVI 1) PL ANS YES ❑NO DYES ❑NO COMMENTS: PERMANENT MARKER : OBSERVATION WELLS: NUMBER OF PROPERTY WELL BUILDING FEET FROM LINE DYES uN0 ]--0YES D NEAREST- Fl,. Sketch System one Retain in county file for audit. Reverse Side. SIGNATURE TITLE DILHR SBD 6710 (R. 01/82) SANITARY PERMIT APPLICATION COUNTY ILHF~ In accord with ILHR 83.05, Wis. Adm. Code SATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than STATE PLAN I.D. NUMBER 8% x 11 inches in size. -See reverse side for instructions for completing this application. PETITION 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. FOR VARIANCE ❑ YES ❑ NO PROPER OWNER PROPERTY LOCATION le~sy =A, it)~'tj 1/4, S _3 T Z N, R 1 (or PROP RTY OWNE 'S MAILINGADDRESS / LOT NUM ER BLOCK N R SUB/D~IVISI N NAME y CITY, STATE i, ZIP CODE PHONE NUMBER CITY NEAREST ROAD, LAKE OR LAND ARK O / - T x-j{~ O VILLAGE : 11. TYPE OF BUILDING OR USE SERVED: .J~ 'Oebl' &Z Public . Number of Bedrooms if 1 or 2 Family OR (Specify): 3q9 13 III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) 1. a. 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. E1 Alternative C. ❑ Experimental 2. a. ❑ System- b. ❑ Holding c. E1 Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP In-Fill Tank V. ABSORPTION SYSTEM INFORMATION: (Check one) 1. a. ❑ See a e Bed b. Seepage Trench c. E1 Seepage Pit 2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED Square Feet): PROPOSED (Square Feet): '5pFeet Private ❑ Joint ❑ Public VI. TANK CAPACITY Site in al Ions Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed 1:1 El 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 shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No tamps) /MPR~ SW No.: Business Phone Number: -5 7- 7- 77,Z 3ZIX Plu b is Addre (Street, City, State, Zip Code): Name of Designer: VIII. SOIL TEST INFORMATION _ Certif' d Soil Tester (CSC Name CST # es 2 , 15o,6 CST's ADDRESS (Street, City, State, ip Code) 4(.// /T- 1/ Phone Number: IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee Groundwater ate issuing Agent Signature (No Stamps) Surcharge Fee I y 4/ XApproved ❑ Owner Given Initial ,p , b Adverse Determination V'im' n" 'a"h=:j 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 p~rmit 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 oenever 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; III. 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; 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 the result of over 2 years of steady negotiation and public debate. The groundwater bill Groundwater - _ included the creation of surcharges (fees) for a number of regulated practices which 1/1,%iscortsin's can effect groundwater. The surcharge took effect on July 1, 1984..411 of the water tha` buriedreas;ire is used in your building is returned to the groundwater through your soil absorption system or the disposal site used by your holding tank pumper. The monies collected through these surcharges are credited to the groundwater tend adminis- tered by the Department of Natural Resources. These funds are used for rnonitoring 2 ound- water, groundwater contamination investigations and establishment of standards rt} indwat- , it's worth protecting. SBD-6398 (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 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 Tohv~_ 1~ , IV0.~Lcy D, ~erboZ~ Tl Location of Property N 5tE 14, Section )3 , T a9 N-R c? W Township ISO Mailing Address 5 10 Nu~er 1'~~ lIoQ (,(n;l~ RUASOn, Q1 Sg01(o Address of Site R) • 3 Box ?~yA Subdivision Name Ord, i el ~t u~ - F-i ~ed is !4 ~ ~ U y) . 3 -h2 {up~~ Lot Number Previous Owner of Property LOroxi ac en 610C1,0- T KcUlfr Total Size of Parcel . T19 CtC T- C.5 Date Parcel was Created De-c- . 14 , 1 q79 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes X No Volume and Page Number 139 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 I (We) eeAti.sy that aU .6tatement6 on xh.6 6okm cAe tAue to the best o6 my (outs) knowledge, tAat I (we) am (aAe) they wnett ( ) o4 the pnopeh ty de s cAibed in this .in6ormati.on 6otrm, by viAtue oS a ee.d A.eeonded in the 044ice o6 the Counts Regls.# Dl,ed ozs Documem-t. No. ~fUZ~S q ; are' thQ ; (rlto) ,.hoAe-..jtr J _ own the pupo.sed site 6ot the sewage dapozat System (o%i I (we) have obtained an easement, to nun w.cth the above desci i.bed ptcopehty, 6otc the constAuet%on o6 said ayztem, and the .same hay, been du.-y ,Lecmded in the O~~iee o6 the County Register ob Deeds, as Document No. ) iMl~ SIG AT OF OWNER SIGNAT OF CO-OWNER (I APPLICABLE $I~Ig~ DATE SIGNED DATE SIGNED r ul I N U M P r R 18,047 ABSTRACT oF -TITLE '?5o the following describcd `Deal tmm, situated in ST. CROIX COUNTY, WI`-C.ONSIN Part of NW'/4 of SE'h of Sect i on 43-29-19 described as follows: Lot 4 of Cert i I j,j Survey Map filed December 14, 1978 in Vol. ":I". sage 749 (No. 61). TOGETHER WITH road easement shown on said Certified survey Map. uI F: ~I f I I I ~I r 35393 0 61 • ' CERTIFIED SURVEY MAP FILED NORTH DEC 14 1975 A \NNIt.~ r JAJgES O' CONnEU Croix Coun~ d t SCALE CNS:'!~ Utter CIJI!`pRE ipN1NG GOM~ r po whccnalm 200 100 0 200 _ v S~vp~viS~G'~ . t, Fo?. ~~;,5 A'111•~??;.GV~'~' 0= I11X 2411 IRON PIPE WEIGHING `Or1 1.13 LBS. / LINEAL FOOT...?e?OV • IRON PIPE FOUND_ ~1~,tiC' 0 ` OZ SAY = OpV~E~$ Sb2•l~' ?~F~R to S 89050.001E 1230.16' 00.1 717.G0• I 512.5 G1 00 Cb• I 500°. 661 1 I RESERVED FOR I 13 FUTURE STREET w_ I lb ur- I 14N C) l \ ' H z H STC - 105 r r SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County 0 z d 9 OWNER/BUYER o In K, nJan , D• Gc7C6 b7c)VtF ROUTE/BOX NUMBER R-L 3 Rn,( 4( ~ A- re N umber a3Q CITY/STATE L~ r~!cAsoY, ZIP SYy t4=1 PROPERTY LOCATION: IUD k, SE 14, Section 13 T 0_9 N, R W, Town of _so yt St. Croix County, Ctr~-'~ r- SU-Y,) Subdivision 7 Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. 0 I/WE, the undersigned, have read the above requirements and agree z to maintain the private sewage disposal system in accordance with x 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. S I G N E Dwt.r~ 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. DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY BUiLD(N INDUSTRY N , 0(VISiON LABOR PERCOLATION TESTS (115 P.O. BOX 7707 HU(V6AP~ RELATIONS 1 ) MADISON, WI 53707 (1-163.09(11 & Chapter 145.045) LOCATION: NSHI UNICIPALITY: T NO. LK NO,: SUBDIVISION NAME: N 'l~s T2 . U DS o rj r 4 S Lj Rv, K4A- p COUNTY A : SE DATES !OBSERVATIONS MADE O Residence A t xNew ❑Replace ( 8Z Q e5 b Qy 6 ':,O i L- a ~ P. & 4 V F t -B= `L- S E 1°r►~" s' ~ M M E Par' ~7 C7 RATING: Ss Site suit*W for system U- She unsuft" for system O S S o~ S 011 ❑ `7Q TAI ~ • R. NG LADED SYSTEM: foptji'onal O ou Ns IM il • ION If Percolation Tests are NOT required DESIGN RATE: If any portion of the tasted area is in the under s.1-163.09(5)(b), indicate: (V,~ G L Q~ I [Floodplain, indicate Floodplain elevation: ~IMJ4t_ PROFILE DESCRIPTIONS Fr- E ET BORINRG, ELEVATION -i H L T H K ESS, COLOR, TEXTURE, AND DEPTH T £ K IF OBSERVE SE ABBRV. ON BACK.) B' 1.00• 3(- S;4.. rs; 0.83'S"SL 7.ocn tJ tc B- /o,o~' Bto,4-4 ~1orJlr 7, io.vo. Z.ao' g 5; L rs- 1.0075 05 S 1- Z-F 6'e'i uo' $~a Msn -S 11 g.3 ;0.10, bz,G,j /v/dtJ6' >/O,/©' Z.vo 8c S-L 7"5~ i ~o'6~vL wr6 ~ 7,ud~B- 7, 73 36-3(1 Nor:jE ? 7.73' 0.90' 8L T5 Q. 3' T!JQ I e B-!~; 4. 84,12.. tlg > 8,8+ 1,11' 15L S,L T 1 g a 5t- w A-j 0,2-S•, 13~ LS , ~,ov +g /t~~ S 8- _ D 6L1 M/F4 PERCOLATION TESTS R tT TEST DEPTH WATER IN HOLE TEST TIME S RAT MINUTES NUMBER 4NO44" AFTER SWELLIN INTERVAL-MIN. PER INCH P.i .17 Nor-J- / ?'(0 3 P. Z 'fr- , 31 8& -Al P- T 0 P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe at are the hori• zontet and vertical elevation reference points and slow their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. 6z "o C) U P Pop . -1-2-a r4 C. 14 SYSTEM ELEVATION A o. 6 0 i-ovu a rz -r-I a lac H M 67 a rJ ( arc s~r 1 P ! , ? i o'f33b~ µor..~ r~sr t c w ii"E ~Eo vc.= t~ er. s , ~e v, I i ob, l o.J TM-0 1 P, 1-4 i 9^ Z P s 3 *60 *m f~7 i 5►i1 r 'f~Q~... ' i iS. , J i ~ ~ ~ t" pii~'tb~'i~- ;'1"11~1VCsN A•It.~ t'E, I alt iQ. ; 5 oil K.~ Coorr.-, W>. &I) , P4 0:!l - 7 do ; i . i _ - _ iii . . _...1. { ~ I ~ ~ , j r 1 i i i I Ael _ l ~tcaie•1. _ , 1, the undersigned, hereby certify that the mil tents 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 prin4 : _ T ST WERE COMPLETED ON: ens ' v, A8 11A /a 6 DDRESS: CERTIFICATION UMBER: PHONE NUMBER (optional): ' b '5 -40 0 CS NATURE: 3 r DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Teter. 011-t-IR-SOD-6395 (R. 02/82) - OVER - roe _ wTa-1~ ~ ~ ROHL & TIMM EXCAVATING 310 Arch Street SHEET NO. ~ OF Z HUDSON, WIS. 54016 CALCULATED BY DATE 7 (715) 386.8664 J 3 CHECKED BY DATE_ SCALE Gs reg~ T✓~ne~l ~f7„ no _ ~ _tc~2c:~ ;S won c ~e.1c ~d ~5. . b-1 Cl y M r 8 r~ PRODUCT 204-1 ses Inc., Groton, Mass. 01471. l 10B " 1(~~ {2 V ROHL & TIMM EXCAVATING R 310 Arch Street SHEET NO. cY- OF Z HUDSON, WIS. 54016 CALCULATED BY DATE Z'7- (715) 386-8664 CHECKED BY DATE_ SCALE ~ l!LL Flan, l y~ V I r t PRODJCT 204-1 Ees Inc., Groton, Mass 01471.